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National Board > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Function of the AMOUNT of a drug to produce an effect. Greater when dose is Smaller.

A

Potency

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2
Q

Maximum intensity that can be produced by drug Regardless of Dose. Only can increase side effects

A

Efficacy

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3
Q

Placed directly into GI tract by oral or rectal.

A

Enteral

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4
Q

Bypasses GI tract including injection, inhalation, and topical

A

Parenteral

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5
Q

Orally delivered drugs must FIRST pass through HEPATIC PORTAL CIRCULATION possibly inactivating some drugs

A

First-Pass Effect

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6
Q

Phase 1 reactions carried out by ___ (aka mixed functions oxidases) in the LIVER.
(Oral Route)

A

Cytochrome P-450 enzymes

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7
Q

Route: Safest, least expensive, convenient. Mostly absorbed in small intestine. Drug blood levels less predictable.

A

Oral

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8
Q

Route: Used if patient is vomiting or unconscious. Poorly absorbed.

A

Rectal

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9
Q

Route: Produces MOST RAPID drug response. Absorption phase bypassed. EMERGENCY situations

A

Intravascular

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10
Q

Route: Sustained effect. Massage increases absorption.

A

Intramuscular

deltoid or gluteal most common site

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11
Q

Route: Administering protein products. Insulin and LAs. Sterile abscess.

A

Subcutaneous

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12
Q

Route: Injected into epidermis. TB

A

Intradermal

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13
Q

Route: Rapid delivery across large surface area.

A

Inhalation

inhalers & nitrous

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14
Q

Route: Increased concentration of active ingredient. Local effect. May have systemic uptake.

A

Topical

contraindicated if surface is ulcerated, burned, or abraded

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15
Q

ADME

A

Absorption, Distribution, Metabolism, Excretion

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16
Q

Study of how a drug is absorbed, distributed, metabolized, and excreted by the body

A

Pharmacokinetics

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17
Q

Transfer of drug from site to blood. Active or Passive. Occurs at MANY sites. Dependent on several factors.

A

Absorption of drugs

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18
Q

Readily move across MOST biological membranes by diffusion. ONLY drugs to pass BBB

A

Lipid Soluble Drugs

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19
Q

Factors dependent on drug absorption (6)

A

1) Drug solubility 2) Circulation at site 3) Surface area 4) Drug pH 5) Temperature at site 6) Mechanical factors

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20
Q

Transfer of drug from blood to system with Highest Blood Flow. (oral-liver, sublingual-heart) Dependent on few factors.

A

Distribution of drugs

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21
Q

Factors dependent on drug distribution (3)

A

1) Blood flow 2) Capillary permeability (BBB) 3) Binding of drug to proteins (plasma albumin)

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22
Q

Major site of drug metabolism. (disease may impair metabolism)

A

Liver

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23
Q

Termination of drug effects

A

Elimination

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24
Q

Elimination is by ___ and/or ___ into urine or bile

A

Biotransformation ; Excretion

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25
Q

Routes of elimination (10)

A

1)RENAL (kidney) 2)Gingival Crevicular Fluid 3)Saliva 4)Liver 5)Bile 6)Lungs 7)Exhalation 8)GI 9)Sweat 10)Milk

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26
Q

Fluoride eliminated by ___

A

Excretion in the Urine

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27
Q

Drug altering effects (12)

A

1)Pt compliance 2)Psychologic factors 3)Tolerance 4)Pathologic state 5)Time 6)Route 7)Gender 8)Genes 9)Drug interactions 10)Age 11)WEIGHT 12)Environment

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28
Q

Child dosing determined by ___

Cowling and Young Rules

A

Age

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29
Q

Surface Area Rule determined by ___

A

Weight in kg

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30
Q

Reaction - Abnormal drug response that is usually genetically related

A

Idiosyncratic

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31
Q

Adverse Drug Reactions (7)

A

1) Toxic 2) Side effects 3) Idiosyncratic 4) Teratogenic 5) Local 6) Drug interactions 7) Allergic Reactions

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32
Q

Reaction - amount of desired effect is excessive; dose related

A

Toxic

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33
Q

Reaction - dose-related, not part of the therapeutic outcome; e.g. drowsiness with benadryl

A

Side effect

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34
Q

Reaction - hypersensitivity response to a drug that pt has been previously exposed; NOT dose related; mild to life-threatening

A

Allergic

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35
Q

Reaction - maternal drug use causing congenital abnormalities

A

Teratogenic

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36
Q

Reaction - local tissue irritation

A

Local

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37
Q

Reaction - one drug altered by another; can result in toxicity or lack of efficacy

A

Drug interaction

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38
Q

Treatment of allergic reactions: mild , anaphylactic

A

mild - antihistamine with or without steroids

anaphylactic - epinephrine subcutaneously with or without steroids

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39
Q

What can generate gingival overgrowth (5)

A

1) mouth breathing 2) Phenytoin 3) Genes 4) Cyclosporin 5) Calcium Channel Blockers

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40
Q

Med - an organ rejection preventative medication

A

Cyclosporine

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41
Q

Med - calcium channel blockers (2)

A

nifedipine (procardia)

dilatiazem (cardizem)

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42
Q

Med - drugs that do NOT cause gingival overgrowth (2)

A

Digoxin, Beta blockers

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43
Q

ANS regulates (5)

A

1) BP 2) Heart rate 3) GI motility 4) Salivation 5) Bronchial/smooth muscle tone

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44
Q

Rest and Digest

A

Parasympathetic

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45
Q

Drugs that mimic PANS (3)

A

Parasympathomimetics, cholinergic agents, muscarinic drugs

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46
Q

Drugs that mimic PANS are used for (3)

A

xerostomia, urinary retention, glaucoma

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47
Q

Cholinergic agents from plant alkaloids (2)

A

Pilocarpine (stimulates saliva)

Nicotine (tobacco cessation)

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48
Q

Contraindications to drugs that mimic PANS (4)

A

Asthma(bronchoconstriction) Peptic ulcer(increases GI secretions) Cardiac disease(heart rate decrease) GI/Urinary obstruction(GI motility increase)

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49
Q

Agent - blocks ach receptors by inhibiting ach effects

A

Anticholinergic

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50
Q

Effects of Anticholinergic agents (4)

A

ABCD - Anticholinergic agents, Blurred vision & Bladder retention, Constipation, Dry mouth

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51
Q

Examples of Anticholinergic agents (3)

A

Immodium(diarrhea)
Atropine(decrease salivary flow)
Scopolamine(motion sickness)

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52
Q

PANS neurotransmitter

A

Acetylcholine

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53
Q

SANS neurotransmitter

A

Norepinephrine

ach in PRE-ganglionic synapse

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54
Q

Fight or Flight

A

Sympathetic

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55
Q

Examples of drugs that mimic SANS (5)

A 
Epinephrine
Pseudoephedrine
Albuterol
Ritalin
Adderall
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56
Q

Drugs that mimic SANS (2)

A

Sympathomimetics, adrenergic agents

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57
Q

Drugs that mimic SANS are used for (8)

A

Colds(decongestants), asthma(bronchodialators), anaphylactic shock, glaucoma, vasoconstrictors, cardiac arrest, CNS stimulation, ADD

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58
Q

Functions of SANS (4)

A

Vasoconstricts, dilates bronchioles, increases heart rate, dilates pupils

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59
Q

Functions of PANS (4)

A

Stimulates salivary gland secretion, dilates blood vessels, accelerates peristalsis, absorption of nutrients

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60
Q

Contraindications to drugs that mimic SANS (4)

A

Angina
Uncontrolled hypertension
Uncontrolled hyperthyroidism
Cocaine & Amphetamine Abuse

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61
Q

___ is contraindicated for Cocaine & Amphetamine abuser if used within ___

A

Epinephrine & 24 hours

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62
Q

Adverse reactions of adrenergic agents (4)

A

CNS disturbances (anxiety, fear, tension, headache, tremor)
Cardiac arrythmias
Cerebral hemorrhage
Pulmonary edema

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63
Q

Oral signs - rampant caries & burned mucosal surfaces

A

Meth abuse

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64
Q

How to treat meth abusers

A

no medications available, cognitive behavioral interventions

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65
Q

Adrenergic drugs to know (3)

A

Albuterol
Dopamine
Clonidine

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66
Q

Med - minimizes symptoms that accompany withdrawal from opiates and benzodiazepines

A

Clonidine

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67
Q

Med - drug of choice for shock; continuous infusion

A

Dopamine

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68
Q

Med - bronchodilator, acute asthma, few cv effects

A

Albuterol

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69
Q

Beta blockers (type/location)

A

Beta 1 : heart

Beta 2: lungs, muscles, arterioles

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70
Q

increases heart rate, BP, and oxygen needed for blood

A

Beta 1 receptor

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71
Q

Beta 1 blocker drug action

A

decreases heart rate, BP, and useful when heart is deprived of oxygen

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72
Q

Often Rx after heart attack

A

Beta 1 blocker

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73
Q

Hormone produced in kidney that constricts blood vessels; beta blockers prevent release of

A

Renin

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74
Q

Relaxing effect, Rx for anxiety, migraine, and alcohol withdrawal

A

Beta 2 blocker

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75
Q

Should not be used in pt with asthma or any reactive airway disease

A

Non-selective beta blockers

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76
Q

Beta blockers are used for (6)

A

Cardiac arrhythmias, angina pectoris, hyperthyroidism, M.I., glaucoma, migraine prevention

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77
Q

Beta adrenergic drugs to know (4)

A

Propranolol
Timolol
Atenolol
Metoprolol

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78
Q

Med - lowers BP by lowering cardiac output; adverse reaction bronchoconstriction & arrhythmias

A

Propranolol

Inderol

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79
Q

Med - reduces aqueous humor in the eye, tx of glaucoma

A

Timolol

Timoptol, Timoptic

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80
Q

Med - eliminates bronchoconstrictor effect, tx of hypersensitive asthmatic pts; cardioselective

A

Atenolol

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81
Q

Med - tx of hypertension, prevention of M.I. and angina

A

Metoprolol

Lopressor

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82
Q

Nonopioid Analgesics (3)

A

Aspirin, NSAIDs, Acetaminophen

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83
Q

Med - used for Analgesia, Antipyretic, Anti-inflammatory; inhibition of prostaglandin synthesis

A

Aspirin & NSAIDs

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84
Q

Med - used for Analgesia & Antipyretic

A

Acetaminophen

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85
Q

Med - fever reduced through hypothalamus

A

Aspirin

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86
Q

Contraindications for Aspirin & NSAIDs (2)

A

Coumadin (warfarin) - blood clotting effect

Peptic ulcer

87
Q

Med - children with hx of chicken pox or influenza should NOT use ___ due to what metabolic disorder

A

Aspirin; Reye’s Syndrome

88
Q

Term - overdose of Aspirin

A

salicylism

89
Q

Define - ringing of the ears

A

Tinnitus

90
Q

Ibuprofen can decrease effects of drugs including (7)

A

ACE inhibitors, Aspirin, Beta blockers, Corticosteroids, Cyclosporine, Lithium, Loop diuretics

91
Q

Acetaminophen overdose (3)

A

Hepatotoxicity
Liver necrosis
Death

92
Q

Med - for post-operative pain, drug of choice after root planning

A

Acetaminophen

93
Q

Narcotic / Opioid Analgesics (4)

A

Morphine, Codeine, Demerol, Dilaudid

94
Q

MOA of narcotics and opioids

A

Blocks pain receptors in brain w/o loss of consciousness

95
Q

Most commonly used opioid in Dentistry

A

Codeine in conjunction with Acetaminophen (schedule 3 narcotic)

96
Q

Sign of OD or addiction to ANY opioid

A

Pinpoint pupils (<2.9mm)

97
Q

Med - antitussive; may cause constipation, emesis (vomiting); OD leads to respiratory depression & death

A

Codeine

98
Q

Med - opioid antagonist, used for tx of opioid OD; should be in Dental Emergency Kit

A

Narcan

99
Q

Med - tx of narcotic withdrawal/dependence; 1x day, works for 24-36 hrs, only effective for opioid addictions

A

Methadone

100
Q

Pain meds for heroine addicts

A

NSAIDs

101
Q

Type of drug abuser needs pre-med with antibiotics

A

IV

102
Q

Define - substance acts against/destroys infections

A

Anti-infective/antibiotic

103
Q

Define - substance that destroys/suppresses growth of bacteria

A

Antibacterial

104
Q

Define - Kills bacteria; irreversible

A

Bactericidal

105
Q

Define - Inhibits bacterial growth

A

Bacteriostatic

106
Q

Lowest concentration needed to inhibit visible growth of an organism

A

MIC - minimum inhibitory concentration

107
Q

Range of activity to drug

A

Spectrum

108
Q

drug combo for better effect

A

Synergism

109
Q

drug combo lessens effect

A

Antagonism

110
Q

Antibiotic types (3)

A

Penicillins, Tetracyclines, Nitromidazoles

111
Q

Penicillin derivatives (3)

A

Amoxicillin, Augmentin, Ampicillin

112
Q

Most common Rx in dentistry; effective in 90% of bacteria in dental infections

A

Pen VK

113
Q

MOA of penicillin

A

destroys bacterial cell wall integrity; lysis

114
Q

Med - Not effective against penicillinase (beta lactamase)

A

Amoxicillin

115
Q

Med - Clavulanic acid combined with Amoxicillin; prevents penicillinase from breaking down Amox.

A

Augmentin

116
Q

Med - avoid use in early pregnancy and childhood; tooth discoloration

A

Tetracycline

117
Q

Do Not take tetracycline with ___ (3)

A

dairy, antacids, iron tablets

118
Q

Med - topically used for aggressive perio; systemically for NUG/NUP

A

Tetracycline

119
Q

Med - NO Alcohol Mouth Rinse! Effective against obligate anaerobes only; alcohol should be avoided.

A

Nitromidazoles

Metronidazole

120
Q

Antibacterial side effects (3)

A

GI upset, secondary fungal infections(candidiasis/yeast infection), Allergies

121
Q

Antituberculosis Agents (4); must be on all if active

A

RIPE - Rifampin, Isoniazid, Pyrazinamide, Ethambutol

122
Q

Med - red urine, tears, and saliva

A

Rifampin (TB)

123
Q

Med - affects vision; decreases acuity and red/green differentiation

A

Ethambutol (TB)

Myambutol

124
Q

Med - preventative against developing TB

A

Isoniazid

125
Q

TB - no longer contagious if…

A

3 consecutive negative sputum smears

126
Q

Antigen used to diagnose TB, known as Mantoux skin test

A

PPD - purified protein derivative

127
Q

Fungal infections common… (3)

A

after antibiotics, steroids, or immunocompromised

128
Q

Most common Antifungals (4)

A

Nystatin, Fluconazole, Mycelex(clotrimazole), Nizoral(ketoconazole)

129
Q

Med - most common antifungal used in dentistry, tx of candidiasis, topical

A

Nystatin

130
Q

Med - systemic tx of candidiasis

A

Fluconazole

Diflucan

131
Q

Abbreviation - ac

A

before meals (ahead of consumption)

132
Q

Abbreviation - bid

A

twice a day (bi daily)

133
Q

Abbreviation - gt

A

drop

134
Q

Abbreviation - hs

A

before bedtime (heavy sleeping)

135
Q

Abbreviation - po

A

by mouth (per oral)

136
Q

Abbreviation - pc

A

after meals (post consumption)

137
Q

Abbreviation - prn

A

as needed (per Rx need)

138
Q

Abbreviation - q3h

A

every 3 hours

139
Q

Abbreviation - qd

A

per day

140
Q

Abbreviation - qid

A

4x a day (quad daily)

141
Q

Abbreviation - tid

A

3x a day (tri daily)

142
Q

Abbreviation - sig

A

label; instructions (see instruction guide)

143
Q

Abbreviation - stat

A

immediately

144
Q

Abbreviation - tab

A

tablet

145
Q

Abbreviation - ud

A

use as directed

146
Q

Schedule 1 (abuse potential/handling)

A

highest - no accepted medical use (cocaine)

147
Q

Schedule 2 (abuse potential/handling)

A

high - Rx only, NO REFILLS, most abused (codeine)

148
Q

Schedule 3 (abuse potential/handling)

A

moderate - Rx, phone in, no more than 5 refills within 6 months (tylenol with codeine)

149
Q

Schedule 4 (abuse potential/handling)

A

less - Rx, phone in, no more than 5 refills within 6 months (alprazolam/Xanex)

150
Q

Schedule 5 (abuse potential/handling)

A

least - OTC (ibuprofen)

151
Q

Requirement for any Rx controlled substance

A

DEA number

152
Q

Requirement for Schedule 2 drugs

A

written in pen or typed; some states require triplicate pads

153
Q

Antianxiety agents (2)

A

Barbiturates & Benzodiazepines

154
Q

Med - no analgesic effect, CNS depression

A

Barbiturates

155
Q

Med - long acting; used in tx of epilepsy

A

Phenobarbital

156
Q

Med - short acting, tx of anxiety, insomnia, and alcohol withdrawal, does not affect ANS, can be given prior to sedation

A

Benzodiazepines

157
Q

Benzodiazepines (4)

A

Diazepam(Valium), Lorazepam(Ativan), Xanax(Alprazolam), Tranxene

158
Q

Anesthesia Stage 1

A

Analgesia - remains conscious, breathes regularly, Nitrous maintains

159
Q

Anesthesia Stage 2

A

Delirium or excitement - unconscious, involuntary movement

160
Q

Anesthesia Stage 3

A

Surgical anesthesia - major surgery

161
Q

Anesthesia Stage 4

A

Respiratory or medullary paralysis - stops breathing, if not reversed death will occur

162
Q

Med - most common used for CHF (increases contractile strength); also increases gag reflex and salivation

A

Digitalis Glycosides

Digoxin (Lanoxin)

163
Q

Med - increases Digoxin levels in ~10% of pts (2)

A

Tetracycline & erythromycin

164
Q

Med - tx of angina, vasodilator, smooth muscle relaxant, sublingual, emergency kit!

A

Nitroglycerine

165
Q

Hypertension symptoms (3)

A

Usually asymptomatic; occ. headache, vision changes, and dizziness

166
Q

First line therapy for hypertension - why

A

Diuretics - excretes sodium & water/decreases blood volume & pressure

167
Q

Med - Diuretics (2)

A

Thiazide - xerostomia, orthostatic hypotension

Loop - CHF

168
Q

ACE Inhibitor drugs (3)

A

Lisinopril (prinivil, zestril)
Captopril (capoten)
Enalapril (vasotec)

169
Q

Most common ACE inhibitor used with CHF

A

Enalapril

170
Q

ACE inhibitors adverse reactions (3)

A

avoid postural hypotension, allergic reactions, dry cough; also associated with dysgeusia(taste)

171
Q

Second line therapy for hypertension - why

A

Beta blockers - decreases cardiac output

172
Q

Anticoagulants (2)

A

Coumarins & Heparin

173
Q

Coumarin prevents inactive to active conversion of ___

A

Vitamin K

174
Q

Med - anticoagulant for hospitalized pts, by injection only

A

Heparin

175
Q

Consideration of Warfarin pts

A

Dose reduction under advising physician several days before tx

176
Q

Anticonvulsants (3)

A

Phenytoin (dilantin)
Phenobarbital
Carbamazepine (tegretol)

177
Q

Antihistamines block __ receptors

A

H1 (bronchospasm and vasodilation)

178
Q

Most common side effect with insulin is __ ;

shortness of breath is not a sign of this

A

hypoglycemia

179
Q

Insulin dependent

A

Type 1 - juvenile-onset

180
Q

Non insulin dependent

A

Type 2 - adult-onset

181
Q

Diabetes Mellitus Drugs (2)

A

Metformin (glucophage), Glyburide (diabeta, micronase)

182
Q

Med - bronchodilator tx of asthma; reverses bronchospasm

A

Metaproterenol

183
Q

Types of Asthma inhalers (4)

A

short acting, corticosteroids, corticosteroid plus long acting, long acting

184
Q

inhaler type - immediate relief; albuterol and pirbuterol

A

short acting

185
Q

inhaler type - long term to prevent asthma attack; QVAR, Flovent

A

corticosteroid

186
Q

inhaler type - for asthma, combo; Advair

A

corticosteroid plus long acting

187
Q

inhaler type - relieves asthma for longer time; Salmeterol (serevent)

A

long acting

188
Q

Med - treats chronic asthma; erythromycin can cause toxicity

A

Theophylline

189
Q

Med - can cause insomnia

A

Albuterol

190
Q

Med - should be avoided in asthmatics (4-19% have hypersensitivity)

A

Aspirin

191
Q

Med - tx of COPD

A

Atrovent (Ipratropium); anticholinergics

192
Q

Med - rebound swelling can occur, do not use for more than few days

A

nasal decongestants

193
Q

Med - removes exudate and mucus

A

expectorant

194
Q

Med - for non productive dry cough

A

antitussive

195
Q

Med - a systemic antacid contraindicated in cv pts due to high sodium load

A

Sodium bicarbonate

196
Q

Antacids can inhibit absorption of (3)

A

Tetracyclines, Digitalis, Iron

197
Q

Most prevalant GI disease in US

A

GERD - gastroesophageal reflux disease

198
Q

GERD is treated by 1 of 2 meds

A

Histamine 2 blocking agent, PPI - protein pump inhibitor

199
Q

Med - should not be used with antacids (disrupts absorption); ex. TagametHB (cimetidine), Pepcid AC (famotidine)

A

Histamine 2 blocking agents

200
Q

Med - potent inhibitor of gastric acid secretion; ex. Prilosec (omeprazole)

A

PPI - protein pump inhibitors

201
Q

Med - used for tx of gastric ulcers

*gastric ulcers do not cause gingival bleeding

A

TagametHB (cimetidine)

202
Q

Med - commonly used for HIV protease inhibitor

A

AZT (zidovudine)

203
Q

Med - alcohol in combo with ___ will result in dangerously low BP

A

nitroglycerin

204
Q

Med - acceptable drugs to use during pregnancy (7)

A

LAs, acetaminophen, PenV, Amoxicillin, Cephalosporins, Clindamycin, Nystatin

205
Q

Med - decreases effectiveness of muscle relaxants

A

NSAIDs

206
Q

Med - SSRIs (selective serotonin reuptake inhibitors) FDA approved (2)

A

Prozac (fluoxetine)
Zoloft (sertraline)
Paxil (paroxetine)

207
Q

Med - can promote endometrial carcinoma and breast cancer in post menopausal women, can cause gingival enlargement

A

estrogen steroid hormone

208
Q

Med - can increase anticoagulant effect of Warfarin; HMG Co-A inhibitor

A

Lipitor (Atorvastatin)

209
Q

Med - glucocorticoid; risk of infection & delays healing; increase hypertension; adrenal crisis possible; osteoporosis

A

Prednisone

210
Q

Prednisone side effects (8)

A

edema, buffalo hump, moon face, peptic ulcer, mental disturbances, increase body hair growth, acne, insomnia

211
Q

Prednisone used for (4)

A

autoimmune disorders, Addisons disease, inflammatory symptoms, allergies

212
Q

Med - hypothyroidism; long half-life

A

Synthroid (levothyroxine)

213
Q

Synthroid (levothyroxine) side effects (3)

A

nervousness, tachycardia, intolerance to heat

National Board (7 decks)

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