Pharmacology

Question 1

What are the four pharmacokinetic phases?

Answer 1

• Administration or Absorption (into circulation)
• Distribution (circulation to target tissues),
• Metabolism (inactivation, usually in the liver),
• Excretion (elimination through biliary secretion, breast milk, saliva, tears and sweat).

Question 2

What is the difference between pharmacokinetics and pharmacodynamics?

Answer 2

Pharmacokinetics describes what the body does to medications.

Pharmacodynamics describes what the medication does to the body.

Question 3

What is a narrow therapeutic window (therapeutic index)?

Answer 3

A drug with a narrow therapeutic window means that the concentration of drug required to exert the preferred response is very close to the concentration at which toxic events are likely.

Question 4

What is drug tolerance?

Answer 4

Drug tolerance occurs when the body makes adaptations due to the constant presence of the drug, and thus the effectiveness of the drug diminishes over time with chronic use.

An athlete who has built up tolerance to a drug should be tapered off of it under MD supervision.

Question 5

In general, NSAIDs all work by blocking a key mediator of inflammation:

Answer 5

prostaglandins.

Question 6

Categories of NSAIDs include:

Answer 6

• Aspirin,
• Non-acetylated salicylates (salsalate),
• First-generation NSAIDs (ibuprofen),
• COX-2 inhibitor (celecoxib/Celebrex).

Question 7

NSAIDs reduce inflammation by inhibiting the enzyme, __________, and thus inhibiting the production of __________.

Answer 7

cyclooxygenase type-2 (COX-2)

prostaglandins

Question 8

Aspirin, NSAIDs, and salicylates inhibit both COX-2 and COX-1. Inhibition of COX-1 leads to

Answer 8

gastrointestinal adverse effects include dyspepsia, heartburn, nausea, abdominal pain, peptic ulcer and gastrointestinal bleeding.

Question 9

Yearly in the US, (number) hospitalizations and (number) deaths are due to first-generation NSAIDs.

Answer 9

100,000

16,500

Question 10

What is considered “chronic NSAID use”?

Answer 10

> 10days

Question 11

Non-acetylated salicylates and the COX-2 inhibitors have a (lower or higher) risk of gastrointestinal complications?

Answer 11

lower

Question 12

What are some advantages of topical NSAIDs, such as diclofenac (Flector Patch®, Voltaren Gel®, Pennsaid®), which don’t produce COX-1 inhibition?

Answer 12

Good levels of pain relief in acute sprains, strains, and overuse injuries similar to that of oral NSAIDs, without the common gastrointestinal problems.

Question 13

Which NSAIDs act as anti-coagulants (have antiplatelet effects)?
Which NSAIDs don’t?

Answer 13

First-generation NSAIDs

Non-acetylated salicylates and the COX-2 inhibitors

Question 14

Which drugs target pain without effects on inflammation?

Answer 14

Acetaminophen

Opioid Analgesics

Question 15

What puts the liver at additional risk for an athlete that is using acetaminophen?

Answer 15

older,
have hepatitis,
consume alcohol daily, or
exceed four grams per day

Question 16

What is the primary accidental overdosed drug in the US?

What is the maximum gram dosage per 24-hour period?

Answer 16

Acetaminophen

4 grams

Question 17

Opioid medications include:

How do opioids work?

Answer 17

morphine,
codeine,
hydrocodone,
oxycodone and others

They mimic endogenous endorphins, which are neurotransmitters that modulate pain transmission to the brain and spinal cord and induce euphoria. They alter the perception of pain, but do not block inflammation (prostaglandins) or mediate the cause of pain.

Question 18

What are side effects of opioid use?

Answer 18

Sedation, fatigue, lethargy, drowsiness, dizziness, impaired judgment and/or inability to concentrate.

Constipation, allergic reaction, respiratory distress, hives, anaphylaxis.

Question 19

What is the general time frame for opioid withdrawal symptoms?

Answer 19

Symptoms usually occur within 6-10 hours after the last dose, and peak on day 2 or 3. Symptoms of withdrawal may last for up to 5 days following the last dose.

Question 20

What are localized side effects of inhaled corticosteroids?

Answer 20

oropharyngeal candidiasis (thrush) 
dysphonia (difficulty speaking)

Question 21

How do rescue inhalers, such as abuterol or levalbuterol, operate?

Answer 21

They stimulate beta-2 receptors on the smooth muscle surrounding bronchioles, causing immediate bronchodilation and quick reversal of acute shortness of air.

Question 22

Adverse effects of inhaled bronchodilators include:

Answer 22

tremor, 
nervousness, 
dizziness, 
headache, 
nausea, and tachycardia

Question 23

How long do short-acting bronchodilators last, as compared to long-acting bronchodilators?

Answer 23

2-3 hours

12 hours

Question 24

Exercise-induced bronchospasm is due to:

Answer 24

Not warming up

Breathing in cold air

Question 25

Transmission of fungal and bacterial infections occur with

Answer 25

direct skin to skin contact, or contact with infected clothing, towels, combs, pool or whirlpool surfaces, shower floors, and equipment.

Question 26

When treating fungal and bacterial skin infections, improvement is generally seen within a week. How long should treatment continue?

Answer 26

6 weeks