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Board Review > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Highest abuse potential, no accepted medical use. Heroin and LSD.

A

Schedule I

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2
Q

High abuse potential, written RX w/signature only, no refills. Morphine, codeine alone, amphetamines and oxycodone.

A

Schedule II

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3
Q

Moderate abuse potential, may phone in, 5 RX in 6 months. Tylenol 3

A

Schedule III

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4
Q

Lower abuse potential, may phone in, 5 RX in 6 months. Valium (Diazepam) And Darvon.

A

Schedule IV

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5
Q

Lowest abuse potential, some available OTC. Codeine-containing cough meds (not OTC).

A

Schedule V

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6
Q

Graph of the relationship between dose of a drug and the response

A

Log Dose-effect curve

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7
Q

Where the dose is increasing sharply

A

Therapeutic range

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8
Q

Where the curve plateaus (flattens out)

A

Maximum response

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9
Q

Amount of drug necessary to produce an effect, it is greater when dose is smaller.

A

Potency

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10
Q

Maximum response of a drug, regardless of the dose

A

Efficacy

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11
Q

Time it takes for the drug to have an effect

A

Onset

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12
Q

Length of time that a drug has an effect

A

Duration

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13
Q

One measure of duration, amount of time necessary for a drug to fall to 1/2 of its original blood level.

A

Half life

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14
Q

Placed directly in GI tract, oral route and rectal route.

A

Enteral

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15
Q

Bypasses the GI tract, IV, IM, SQ, Intradermal, inhalation, topical and sublingual.

A

Parenteral

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16
Q

Safest, least expensive and most convenient, less predictable blood levels, large area for absorption (small intestine).

A

Oral route of administration

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17
Q

Occurs when orally-administered drugs initially pass through the hepatic portal circulation (liver), which reduces the amount of effective drug.

A

First-pass effect

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18
Q

Suppositories, creams, enema. Patient is vomiting, unconscious, poor and irregular absorption rectally.

A

Rectal route of administration

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19
Q

Most rapid drug response, best for emergency situations, absorption phased bypassed, disadvantages include phlebitis, irretrievability and allergy.

A

IV (intravascular)

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20
Q

Provides sustained effect, massaging muscle will increase the drugs absorption, Deltoid or gluteal muscles common injection sites.

A

IM (intramuscular)

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21
Q

Used to administer protein products, insulin is administered subcutaneously-it is activated by GI acid/enzymes, local anesthesia in dentistry is delivered this way, side effects include sterile abscess or hematoma

A

Subcutaneous

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22
Q

Injection into epidermis, example is tuberculin skin test

A

Intradermal

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23
Q

Rapid delivery across large surface area of respiratory mucosa. Includes inhalers and nitrous oxide/oxygen.

A

Inhalation

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24
Q

Applied to body surface (skin, mucosa), most effective in non-keratinized areas, require an increased concentration of the drug, contraindicated in ulcerated burned or abraded surfaces.

A

Topical

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25
Q

Study how a drug enters the body, circulates in the body, and leaves the body.

A

Pharmacokinetics

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26
Q

Transfer of a drug from the site of administration to the blood stream.

A

Absorption

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27
Q

What is most important for absorption of oral drugs?

A

Small intestine

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28
Q

Process by which a drug leaves the blood stream and enters the body systems.

A

Distribution

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29
Q

What step does IV administered drugs bypass?

A

Absorption

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30
Q

Where are drugs distributed?

A

To organs with highest blood flow

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31
Q

Breaking down of a drug for its removal from the body, also known as biotransformation.

A

Metabolism

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32
Q

What is the most important site for metabolism of drugs?

A

Liver

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33
Q

Removal of the drug from the body, terminates drug affects.

A

Elimination

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34
Q

What is the most important organ for elimination?

A

Kidneys

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35
Q

Dose-related reaction

A

Side effects

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36
Q

Occurs when the desired effect is excessive, dose-related

A

Toxic effects

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37
Q

Hypersensitivity response to a drug, NOT dose related

A

Allergy

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38
Q

Causal relationship between the drug use of a mother and congenital abnormalities.

A

Teratogenic effect

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39
Q

Functions without conscious effort.

A

Autonomic nervous system

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40
Q 
“Fight or flight”
Increase BP thru vasoconstriction
Increase HR
Dilates bronchioles and pupils
Reduce saliva flow
Adrenergic drugs (sympathomimetics)
Preganglionic: acetylcholine
Postganglionic: norepinephrine
A

Sympathetic (SANS)

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41
Q 
“Rest and digest”
Increased blood flow to digestive organs
Accelerated peristalsis
Constricts bronchioles and pupils 
Increase saliva 
Pre and postganglionic: acetylcholine
Cholinergic drugs (parasympathomimetics)
A

Parasympathetic (PANS)

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42
Q

Effects mimic the sympathetic nervous system. Should be avoided with angina, uncontrolled HTN and hyperthyroidism.

A

Adrenergic Drugs

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43
Q

What are the adverse effects of adrenergic drugs?

A

CNS(anxiety, fear, tremor, headache)
Cardiac arrhythmia
Hypertension
Xerostomia

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44
Q

Examples of Adrenergic Drugs.

A

Epinephrine (treats anaphylactic reaction, in local anesthetic as vasoconstrictor, to stimulate heart muscle)
Dopamine (treats shock, low BP and Parkinson’s)

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45
Q

Examples of Adrenergic-blocking Drugs?

A

Inderal (propranolol): non-selective bets blocker to treat HTN
Tenormin (atenolol): selective beta-blocker to treat HTN
Lopressor (metoprolol): selective beta-blocker to treat HTN
Timoptic (timolol): treat glaucoma

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46
Q

Effects mimic parasympathetic nervous system, contraindicated with asthma, ulcers and cardiac disease.

A

Cholinergic Drugs

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47
Q

Examples of Cholinergic Drugs?

A

Pilocarpine used to increase saliva flow in patient’s with Sjogren’s syndrome and can treat glaucoma.

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48
Q

These block the parasympathetic nervous system. Adverse reactions include blurred vision, bladder retention, constipation and dry mouth.

A

Anticholinergic Drugs

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49
Q

Examples of anticholinergic Drugs.

A

Atropine: decreases saliva for dental procedures
Imodium: treat diarrhea
Scopolamine: treat motion sickness
Dramamine: treat motion sickness

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50
Q

Nonopioid, mechanism of action is inhibition of prostaglandin synthesis. It is an analgesic, antipyretic, anti-inflammatory, and anti-platelet.

A

Aspirin

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51
Q

What are the adverse effects of aspirin?

A

Interferes with clotting, contraindicated with Coumadin (warfarin), GI irritation, hypersensitivity, association with Reye’s syndrome, and tinnitus

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52
Q

Nonopioid, NSAID, Motrin, Advil, mechanism of action is inhibition of prostaglandin synthesis. It is an analgesic, antipyretic and anti-inflammatory. Contraindicated with gastric ulcers, decrease effect of many drugs, and interferes with clotting.

A

Ibuprofen

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53
Q

Nonopioid, Tylenol, Analgesic, antipyretic NOT anti-inflammatory, drug of choice for children, patients on anticoagulants, ulcers, post-op pain after periodontal treatment and may cause hepatotoxicity and liver necrosis at high doses/overdose.

A

Acetaminophen

54
Q

Blocks pain receptors in the brain. Analgesic, antitussive, sedation, and euphoria. May cause respiratory depression, nausea/vomiting, constipation and addiction. Codeine is most commonly used in dentistry in combo with acetaminophen

A

Narcotics/Opioid Drugs

55
Q

Opioid antagonist that reverses the effects of opioid Drugs.

A

Narcan (Naloxone)

56
Q

Used in the treatment of narcotic dependence and withdrawal.

A

Methadone

57
Q

Kills bacteria

A

Bactericidal

58
Q

Inhibits the growth or multiplication of bacteria

A

Bacteriostatic

59
Q

Ability of an organism to be unaffected by an antimicrobial drug

A

Resistance

60
Q

Range of activity of a drug (marrow or broad)

A

Spectrum

61
Q

When a combo of 2 antibiotics produces greater effect than would be expected if their individual actions were added

A

Synergism

62
Q

When a combination of 2 antibiotics produce less effect than either agent alone

A

Antagonism

63
Q

Most commonly prescribed antibiotic in dentistry, bactericidal, produce an anaphylactic reaction, most common side effect/allergy sign is a rash, safe for pregnant patients

A

Penicillin

64
Q

Which penicillin is preferred due to more consistent absorption?

A

Penicillin VK

65
Q

Bacteriostatic Drugs, pre Mrs for dentistry, examples include erythromycin, aziythromycin (Zithromax), and clarithromycin (Biaxin)

A

Macrolide Antibiotics

66
Q

Broad spectrum, bacteriostatic antibiotics, used to TX acne and penicillin resistant periodontal infections such as NUG, don’t take. During pregnancy/early childhood due to tooth discoloration, don’t take with dairy products, antacids or iron which bing with this and it concentrates in crevicular fluid.

A

Tetracycline

67
Q

10% of patient’s allergic to penicillin are also allergic to Keflex (cross-allergenicity), action similar to penicillin, examples include Cephalexin (Keflex), Cefaclor (Ceclor), Cefuroxime (Ceftin)

A

Cephalosporins

68
Q

Antiobiotics used to treat tuberculosis?

A

Rifampin
Isoniazid
Pyrazinamide
Ethambutol

69
Q

What TB drugs are used as prevention ONLY.

A

Rifampin or isoniazid

70
Q

First alternative if patient is allergic to amoxicillin

A

Clindamycin

71
Q

Used to treat anaerobic infections, also treatment of periodontal infections and ANUG.

A

Metronidazole (Flagyl)

72
Q

Conditions requiring premedication

A

Artificial heart valves, h/o infective endocarditis, heart defect repaired with prosthetic patch or device, cardiac transplant w/valve problems, renal dialysis shunt, ventriculoatrial hydrocephalic shunt

73
Q

Conditions that MAY require premedication

A

Joint replacements less than 2 years ago, previous prosthetic joint infection, multiple joint replacements, and immunocompromised patients.

74
Q

Recommended drug regimens

A

Amoxicillin 2000mg (2g) one hour prior to procedure.
If pen/amox allergy:
Cephalexin (Keflex) 2000 mg (2g) one hour prior to procedure.
Clindamycin 600 mg prior to procedure
Azithromycin or clarithromycin 500 mg one hour prior to procedure

75
Q

Inhibit viral DNA synthesis, examples: Acyclovir (Zovirax), Penciclovir (Denavir), and Valacyclovir (Valtrex), used to treat oral herpes

A

Antiviral medications

76
Q

How do antiviral medications use to treat HIV/AIDS effect the oral cavity?

A

By causing gingival bleeding and oral ulcers

77
Q

TX oral candidiasis, oral dose is 5 ml QID for 2 weeks.

A

Nystatin (mycostatin)

78
Q

Inhibit the influx of sodium ions by blocking sodium channels in the neuron membrane. Hey are weak bases, work poorly in inflamed tissues.

A

Local Anesthetics

79
Q

What’s the best way to reduce the risk of systemic toxicity?

A

Aspiration

80
Q

Metabolized in the liver, “i-Caines”, lidocaine most common. Mepivacaine, prilocaine, bupivicaine, And articaine.

A

Amides

81
Q

Metabolized in blood plasma, not used as injection, benzocaine 20% topical, novocaine.

A

Esters

82
Q

Most commonly used anesthetic in dentistry, safe in pregnancy, also available in topical anesthetic, and medium duration.

A

Lidocaine (Xylocaine)

83
Q

Short duration, comes with vasoconstrictor or as plain solution.

A

Mepivacaine (Carbocaine)

84
Q

Avoid this in patients with anemia and taking acetaminophen, medium duration.

A

Prilocaine (Citanest)

85
Q

Has the longest duration.

A

Bupivicaine ( marcaine)

86
Q

4% solution and increased risk of paresthesia especially with mandibular block, medium duration

A

Articaine (Septocaine)

87
Q

Why are vasoconstrictors in local anesthetic solutions?

A

Prolong and increase the depth of anesthesia, delay absorption and decreases toxicity and hemorrhage. Examples include epinephrine and levonordefrin

88
Q

MRD of vasoconstrictors.

A

.2mg in a healthy patient and .04mg in a medically compromised patient (about 2 cartridges)

89
Q

What is NOT contraindicated in a patient with controlled HTN?

A

Epinephrine

90
Q

Short-term treatment of anxiety and insomnia, anxiety reduction and sedation, used in dentistry to reduce pt. Anxiety and TMJ disorders. Examples include diazepam (Valium), lorazepam (Ativan), and alprazolam (Xanax).

A

Anti anxiety drugs-Benzodiazepines

91
Q

CNS is the major system affected, raises the pain threshold, excreted through exhalation.

A

Anti anxiety drugs-nitrous oxide/oxygen sedation.

92
Q

What color is the nitrous tank and the oxygen tank?

A

Nitrous-Blue

Oxygen-Green

93
Q

What are the contraindications of Nitrous Oxide?

A

COPD, upper respiratory tract infection or stuffy nose, pregnancy, emotional or behavioral instability, communication barriers and abuse potential.

94
Q

Prolonged exposure of nitrous oxide may lead to?

A

Tremors and other neurological symptoms, spontaneous abortion/miscarriage, numbness and tingling in the extremities.

95
Q

Cause CNS stimulation and xerostomia, examples include Prozac (fluoxetine) and Zoloft (setraline).

A

Serotonin Reuptake Inhibitors (SRIs)

96
Q

Used to treat bipolar disorder and Motrin is contraindicated when patient is taking this.

A

Lithium

97
Q

Cause sedation and xerostomia, Elavil (amitriptyline), DO NOT use epinephrine with patients taking this.

A

Tricyclic antidepressants

98
Q

Depresses CNS, used for epilepsy, causes gingival hyperplasia in 50% of patient’s.

A

Anticonvulsants-Dilantin (phenytoin)

99
Q

Barbiturate used in management of epilepsy and causes sedation.

A

Phenobarbital

100
Q

Treats partial seizures and used in dentistry to treat trigeminal neuralgia.

A

Carbamazepine (Tegretol)

101
Q

Most common to treat mild allergic reactions, side effects are xerostomia and sedation, works by blocking histamine receptors in the body.

A

Antihistamines- Diphenhydramine (Benadryl)

102
Q

what does H1 receptors cause?

A

Vasodilation, bronchoconstriction, pain and itching when stimulated.

103
Q

What does H2 receptors cause?

A

Gastric acid secretion when stimulated.

104
Q

Treats type 1 DM, subcutaneous injection, and hypoglycemia is the most common side effect.

A

Insulin

105
Q

Oral hypoglycemic drugs that increased the body’s sensitivity to insulin

A

Metflrmin (Glucophage)

106
Q

Oral hypoglycemic drug that stimulates the release of insulin from the b-cells of the pancreas.

A

Glyburide (Micronase, Diabeta)

107
Q

What meds should be avoided in asthma patients?

A

Aspirin

108
Q

Adrenergic drug, bronchodilator (opens air passages), inhaler form for immediate relief, and may cause insomnia.

A

Ventolin (albuterol)

109
Q

Ends in sone or lone, used long term to prevent asthma attacks and not used for immediate relief.

A

Corticosteroids.

110
Q

Combines a corticosteroid and a bronchodilator

A

Advair Diskus

111
Q

Oral Med to treat asthma, emphysema and chronic bronchitis, combined with erythromycin can cause toxicity.

A

Theophylline

112
Q

Systemic antacid, contraindicated in cardiovascular patients due to sodium content.

A

Sodium bicarbonate

113
Q

Treats GERD and gastric ulcers, has prazole ending.

A

Proton-pump inhibitors

114
Q

Block H2 histamine receptors which reduces acid secretion, has dine ending.

A

Histamine blocking agents

115
Q

Used to treat cancer, often IV administered, also treats osteoporosis, associated with osteonecrosis of jaw

A

Biphosphonate drugs

116
Q

Used for contraception, menopause therapy and menstrual disturbances. Steroid hormone. May cause gingival inflammation, nausea and vomiting, and may promote endometrial and breast cancer

A

Estrogen

117
Q

Intermediate-acting steroid, used to TX autoimmune and inflammatory disorders: addisons and allergy. Reduces body’s inflammatory response, suppressed immunity, increased risk of infection and delays healing.

A

Prednisone

118
Q

Drugs that cause gingival hyperplasia/overgrowth.

A

Dilantin (phenytoin), Procardia (nifedipine) and other CCBs, cyclosporine.

119
Q

Drugs that cause gingival bleeding.

A

Coumadin (warfarin), Plavix (clopidogrel), Aspirin-contraindicated in patient’s taking Coumadin.

120
Q

Drugs that cause Xerostomia.

A

Diuretics, CCBs, antihistamines and many others.

121
Q

Drug used to treat Angina Pectoris/chest pain.

A

Nitroglycerin, works as vasodilator, administered sublingual.

122
Q

Drugs used to treat CHF.

A

Cardiac glycosides, examples are digitalis and Lanoxin (digoxin).

123
Q

Drugs used for anticoagulant therapy.

A

Used to prevent stroke and heart attack, patients are at increased risk of gingival hemorrhage, examples are Coumadin (warfarin), Plavix (clopidogrel), Aspirin, And heparin.

124
Q

Drugs used for high cholesterol.

A

Known as antihyperlipidemics, -statin Drugs, examples are Lipitor (atorvastatin), Mevacor (lovastatin), Zocor (simvastatin), and Crestor (rosuvastatin)

125
Q

Drugs used to treat HTN

A

Diuretics, beta adrenergic blocking agents, CCBs, ACE inhibitors.

126
Q

Promote excretion of sodium and water from the body, side effects include xerostomia and orthostatic hypotension.

A

Diuretics

127
Q

-olol meds, avoid epinephrine with these, Inderal (propranolol) non-selective beta blocker.

A

Beta-adrenergic blockers

128
Q

Causes systemic vasodilation, side effects include gingival enlargement and xerostomia.

A

CCB

129
Q

-pril meds, adverse reactions include altered taste (dysgeusia), orthostatic hypotension and dry cough.

A

ACE inhibitors

130
Q

CNS stimulant, causes vasoconstriction and dilation of pupils, present with active dental decay

A

Cocaine

131
Q

CNS and respiratory depression, causes sedation and “pinpoint” pupils.

A

Heroin

132
Q

CNS stimulant, brain damage and severe oral effects, males aged 19-40 most common affected, rampant caries, xerostomia, And soda consumption.

A

Methamphetamine

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