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NBDE Part II > Pharmacology - General Principles > Flashcards

Pharmacology - General Principles Flashcards

1
Q

What kinds of things do drugs target?

A
  1. Proteins on/in cells (g-proteins, ion channels, transmembrane receptors, intracellular receptors, or adhesion proteins)
  2. enzymes
  3. or can be free-floating chemical messengers
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2
Q

What is a type 1 dose-response relationship?

A

The graph represents the relationship between a dose and the number of receptors it binds to

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3
Q

With a type 1 dose-response curve, what does an antagonist chemical do to a curve/dose for an agonist drug?

A

It causes the curve to shift right, meaning the drug must be at a higher concentration to get the desired effect

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4
Q

With a type 1 dose-response curve, what happens to the agonist’s curve if there’s a noncompeting antagonist thrown into the mix?

A

The curve shortens, meaning the drug simply cannot bind to as many receptors

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5
Q

What is a type 2 dose-response relationship?

A

The graph represents the relationship between dose and the desired efficacy

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6
Q

How do you calculate therapeutic index (TI)?

A

Lethal dose 50/Effective dose 50

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7
Q

What is Emax on the dose-response curve?

A

It is the maximum number of receptors/efficacy that the drug can handle, regardless if the dose is raised

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8
Q

What does ADME stand for?

A

absorption, distribution, metabolism, excretion

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9
Q

How are drugs absorbed if taken orally?

A

Through the intestines and then the hepatic portal venous system

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10
Q

How are acids/bases distributed in the body?

A

weak bases tend to stay in the very acidic tissues, and weak acids tend to stay in the very basic tissues

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11
Q

What is an example of a distribution barrier in the body?

A

blood-brain barrier

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12
Q

Where are most drugs metabolized?

A

The liver, by cytochrome P-450 enzyme

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13
Q

Where are most drugs excreted?

A

The kidneys, by glomerular filtration, active tubular secretion, or passive tubular transfer

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14
Q

What are phase 1 metabolism techniques that the body uses?

A

oxidation, reduction, or hydrolysis

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15
Q

What are phase 2 metabolism techniques?

A

conjugation, meaning a chemical constituent is attached to the drug molecule

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16
Q

How do you calculate doseage?

A

Cp0 x Vd = initial plasma concentration, multiplied by volume of distribution

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17
Q

What does the curve look like for zero-order kinetics? First order?

A 
Zero-order = linear line w/ negative slope
First-order = concave line that slowly approaches x-axis
18
Q

Do zero-order kinetic drugs or first-order have a greater risk for drug accumulation?

A

Zero-order

19
Q

How can drug-drug interactions occur?

A

A drug could compete for receptors, or they can alter the metabolism of another drug

20
Q

What is induction of drug metabolism?

A

It means a drug increases enzyme metabolism (usually P-450 in the liver) which speeds up the metabolism of another drug. Causes efficacy to drop.

21
Q

What is inhibition of drug metabolism?

A

Means a drug competes for the enzyme or totally inhibits the enzyme’s action - this causes a drug to remain in the body longer and can be bad

22
Q

How do genetic effect drugs?

A

A person’s enzyme profile determines the rate of metabolism/clearance of a drug

23
Q

What is an idiosyncratic reaction?

A

an adverse reaction due to genetic changes usually involving a change in enzyme activity

24
Q

What happens if you give diazepam/triazolam to a pt taking clarithromycin or itraconazole?

A

Increases sedation because the clarithromycin and itraconazole are metabolism inhibitors of CYP-450

25
Q

What happens if you give tetracyclines to someone taking oral antacids?

A

reduced absorption/efficacy of tetracyclines

26
Q

What happens if you give aspirin to someone taking probenecid?

A

decreased efficacy of probenecid

27
Q

What happens if you give aspirin to someone already taking methotrexate?

A

increases methotrexate toxicity

28
Q

What happens if you give local anesthetic to someone taking cholinesterase inhibitors?

A

antagonism of cholinesterase inhibitors, and reduced efficacy with myasthenia gravis patients

29
Q

Why should you not give benzocaine or procaine to someone with an NADH-methemoglobin reductase deficiency?

A

Chance for methemoglobinemia

30
Q

Aspirin, Primaquin, or sulfonamides should NOT be given to someone with what genetic condition? Why?

A

Glucose-6-phosphate dehydrogenase deficiency, because it can cause hemolytic anemia

31
Q

Barbiturates and sulfonamides should NOT be given to pt with this condition?

A

abnormal heme synthesis, because it can cause porphyria

32
Q

Procaine and other ester anesthetics should not be given to people with what condition?

A

low plasma cholinesterase activity, because it can can local anesthetic toxicity

33
Q

A pt with abnormal muscle calcium homeostasis should not be given what?

A

Nitrous oxide or succinylcholine, because it can cause malignant hyperthermia

34
Q

A pt with prolonged Q-T interval should not be given what?

A

some antipsychotics and antiarrhythmias, because it can cause torsades de pointes

35
Q

At what step of the drug testing phase does a drug hit market?

A

After step 3. Step 4 is post-marketing surveillance

36
Q

What are drug pregnancy risk categories?

A

They are categorized as A, B, C, D, and X. A being no effects to baby during pregnancy, and X being that there were abnormalities or death with baby.

37
Q

What did the Pure Food and Drug Act do in 1906?

A

forbade the adulteration and mislabeling of drugs

38
Q

What did the Harrision Narcotic Act do in 1914?

A

regulated opiates and cocaine

39
Q

What did the Food, Drug, and Cosmetic Act do in 1938?

A

Mandated safety of drugs, and established FDA as the enforcer

40
Q

What was the Durham-Humphrey act of 1952?

A

Made certaind drugs prescription-only

41
Q

What was the Orphan Drug Amendment of 1983?

A

Provided incentive for drugs developd for rare diseases

42
Q

What did the FDA Modernization Act do in 1997?

A

New regulations for ephedrine, pseudoephedrine, and phenylpropanolamine

NBDE Part II (13 decks)

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