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CLIN MED EXAM 2 > Pharmacology Lecture > Flashcards

Pharmacology Lecture Flashcards

1
Q

What are PT responsibilities related to Medication Management?

A

Monitor and report
- desired effects
- Adverse effects
- toxic effects
- Vital signs during treatment

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2
Q

What should we coordinate Pt treatment with in terms of medications?

A

optimal drug effects

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3
Q

What do we need to schedule PT around to maximize the drug’s effects?

A

The drug schedule

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4
Q

What do PTs need to be able to recognize in terms of medications?

A

Drug-related side effects and adverse reactions

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5
Q

What should PT’s be knowledgeable on in terms of drugs the patient is taking?

A

Potential drug interactions

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6
Q

What do PTs have to monitor while doing activity and exercise in terms of drugs?

A

Responses to medications

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7
Q

What does patient and family education and compliance result in?

A

safe administration of drugs
adherence to a medication schedule
appropriate doses and frequence

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8
Q

What do we encourage the patient and the family to do in terms of pharmacies?

A

Encourage centralization of medication through use of one pharmacy

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9
Q

What is the chemical in terms of drug nomenclature?

A

specific structure of the compound

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10
Q

What does generic mean in terms of drug nomenclature?

A

non-proprietary name, used in US pharmacopeia

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11
Q

What is a trade name in terms of drug nomenclature?

A

Assigned by pharmaceutical companies, copyright name

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12
Q

How long does it take to get proprietary rights through a patent?

A

20 years

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13
Q

How long does drug discovery take?

A

2-5 years

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14
Q

How long does pre-clinical development last?

A

1.5 years

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15
Q

How long does Clinical development last?

A

5-7 years

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16
Q

How long does it take to get regulatory approval?

A

1-2 years

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17
Q

What is phase IV?

A

Postmarketing surveillance

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18
Q

When does drug exclusivity mean?

A

a period of time when a brand-name drug is protected from generic drug competition.

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19
Q

What does drug exclusivity promote?

A

A balance between drug innovation and generic drug competition

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20
Q

When does drug exclusivity begin?

A

Upon drug approval

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21
Q

Some drugs have both ________ & __________ protection

A

Patent
Exclusivity

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22
Q

How long do new brand-name drugs have exclusivity?

A

5 years

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23
Q

How long is orphan drug exclusivity?

A

7 years

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24
Q

What is an orphan drug?

A

a brand name drug for a disease or condition that effects fewer than 200,000 people in the US

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25
Q

What is new clinical investigation exclusivity?

A

A brand name drug with an active ingredient that has been approved before, but being administered in a new way

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26
Q

How long does clinical investigation exclusivity last?

A

3 years

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27
Q

What organization controls drug regulation?

A

FDA
Food and Drug Administration

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28
Q

What are the purposes of drug regulation?

A

-balance needs of the drug companies and the patient
- ensure safety and efficacy of drugs
- regulate manufacturing process
- control public access to drugs with the potential for abuse

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29
Q

What does the drug enforcement administration do?

A

Classifies drugs into 5 categories(schedules) based on their acceptable medical use and potential for abuse or dependency

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30
Q

What do schedule 1 of drugs contain?

A

High dependance, high abuse potential

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31
Q

What are examples of schedule 1 drugs?

A

heroin, LSD, Cannabis

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32
Q

What do schedule II drugs contain?

A

medical use, high potential of dependance, high abuse potential

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33
Q

What are examples of schedule II drugs?

A

Vicodin, cocaine, Dalaudid, Demerol, OxyContin

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34
Q

What do schedule III drugs contain?

A

Medical use, mod to low potential for dependance, mod to low abuse potential

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35
Q

What are examples of schedule III drugs?

A

Tylenol w/ codine, testosterone, anabolic steroids

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36
Q

What are some characteristics of schedule IV drugs?

A

Medical use, low potential for dependance, low abuse potential

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37
Q

What are some examples of schedule IV drugies?

A

Xanax, Soma, Ambien, Darvon

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38
Q

What are some characteristics of schedule V drugs?

A

medical use, low potential for dependance, low abuse potential

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39
Q

What are some examples of schedule V drugs?

A

Cough, antidiarrheal drugs

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40
Q

What are characteristics of an ideal drug?

A

Effectiveness, safety, selectivity, reversible action, predictability, freedom from drug interactions, low cost, chemically stable, simple generic name

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41
Q

What is a pharmakon?

A

Drug, medicine, or poison

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42
Q

What is logia?

A

Study

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43
Q

What is the definition of pharmacology?

A

The unified study of the properties of chemicals and living organisms and all aspects of their interaction

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44
Q

Pharmacology can be split into what two fields?

A

Pharmacotherpeutics and toxicology

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45
Q

What can pharmacotherapeutics be split into?

A

Pharmacokinetics and pharmacodynamics

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46
Q

What are pharmacokinetics?

A

Drug absorption, distribution, metabolism, excretion

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47
Q

What are pharmacodynamics?

A

Cellular and systemic effects

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48
Q

What is a desired dose?

A

large enough dose to reach the target site and produce a beneficial response but small enough to prevent / minimize unwanted side effects

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49
Q

What are dose response curves used for?

A

Provide info about the dosage range over which the drug is effective

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50
Q

What does the quantal dose response curve show?

A

Shows the percentage of people who show the desired response

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51
Q

What does a ED 50 dose response curve show?

A

The percentage of people who show the desired response at 50% of the dose

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52
Q

What can we have as a part of the quantal dose response curve?

A

Analgesia
Nausea
Respiratory depression

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53
Q

What is the therapeutic index?

A

TD 50 over ED 50

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54
Q

What is the margin of safety?

A

TD 0.1 / ED 99.9

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55
Q

What does the graded dose response curve graph do instead of the others?

A

Instead of graphing % of people responding, graphs % of maximum response

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56
Q

What does the graded dose response curve allow us to compare?

A

Efficacy and potency of different drugs

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57
Q

What is efficacy?

A

degree to which a drug is able to induce maximal effects

58
Q

What is potency?

A

The amount of drug necessary for obtaining the desired effect

59
Q

What is a drug mechanism of action?

A

The means by which the presence of a drug produces and alteration in function

60
Q

Drugs usually must combine with a ___________ ________________ to produce an effect

A

Cellular receptor

61
Q

What happens following a receptor binding during the drug’s mechanism of action?

A

An ion channel is opened/ closed

2nd messengers are activated

normal cell function is inhibited

normal cell function is activated

62
Q

Why are selective drugs better than nonselective drugs?

A

they are more beneficial and have less side effects than non selective drugs

63
Q

What is an agonist in terms of a drug?

A

encourage cell function

64
Q

What does an antagonist do in terms of drugs?

A

Blocks cell function

65
Q

What is an antaonism?

A

Drug inhibits the effect of another drug

66
Q

What is an altered absoption?

A

Drugs may inhibit absorption of other drugs across biologic membranes

67
Q

What is an altered metabolism?

A

Induction or competition for metabolizing enzymes

68
Q

What is plasma protein competition?

A

Drugs that bind to plasma proteins may compete with other drugs for protein binding sites.

69
Q

What is addition in terms of drug interactions?

A

The response elicited by combined drugs is EQUAL to the combined responses of the individual drugs

70
Q

What is synergism in terms of drug interactions?

A

The response elicited by combined drugs is GREATER THAN the combined responses of the individual drugs

71
Q

What is potentiation in terms of drug interactions?

A

A drug which has no effect enhances the effect of a second drug

72
Q

What is antagonism in terms of drug interactions?

A

A drug which inhibits the effect of another drug

73
Q

What are ways that a patient can vary?

A

Body weight and size
age
genetic factors
pregnancy status
smoking and drinking habits
liver or kidney disease
drug tolerance

74
Q

What does the body do with the drug?

A

Administration
absorption
distribution
elimination

75
Q

What is an enteral route of drug administration?

A

Through the alimentary canal

76
Q

What is a parenteral route of drug administration?

A

Around the GI tract

77
Q

How do we take enteral drugs?

A

oral
sublingual
rectal

78
Q

How do we take parenteral drugs?

A

Intramuscular
subcutaneous
Intravenous
Intradermal
Local
(INJECTIONS)

79
Q

How do we take topical drugs?

A

Epidermic
instillation
irrigation

80
Q

How do we take drugs that are inhaled?

A

Vapotization
Gas inhalation
Nebulization

81
Q

What does first pass effect dimish?

A

Bioavailability of a drug administered orally

82
Q

How do drugs travel through the GI system?

A

Swallowed drugs -> digestive system -> hepatic portal system -> liver -> rest of body

83
Q

What is an advantage of oral drugs?

A

Indep administered
convenient
economical

84
Q

What is a disadvantage of oral drugs?

A

Must be conscious and aware, first pass effects

85
Q

What is an advantage of sublingual drugs?

A

Indep administered
convenient
Avoids first-pass effects

86
Q

What is a disadvantage of sublingual drugs?

A

More expensive
May be inconvenient

87
Q

What is an advantage of rectal drugs?

A

By-passes liver
Good for older and younger
Unconscious patients
slow, steady effect

88
Q

What is a disadvantage of rectal drugs?

A

Unpredictable absorption
uncomfortable

89
Q

What are examples of parenteral routes of administration?

A

Intravenous
Intramuscular
Subcutaneous
Inhalation
Topical
Transdermal

90
Q

What is absorption of drugs do?

A

Transfers the drug to the blood stream

91
Q

What can affect absorption of the drug?

A

Molecular size and shape
solubility at the site
degree of ionization
lipid solubility

92
Q

What are patient associated factors affecting absorption?

A

Route of administration
blood flow
tissue permeability
binding to plasma proteins
disease process
storage

93
Q

What is distribution of a drug?

A

Transfer of drug from the blood stream to specific organs/ compartments

94
Q

What are the distribution concepts?

A

Transport mechanisms
Volume of Distribution
Bioavailability

95
Q

What are transport mechanisms?

A
  1. passive diffusion
  2. active transport
  3. facilitated diffusion
  4. endocytosis
96
Q

Which transport mechanism is most important for drug transport?

A

Passive diffusions

97
Q

What does passive diffusion depend on?

A

Concentration gradient
lipid solubility
channels/pores

98
Q

Passive diffusion moves from _____ concentration to _____ concentration?

A

High to low

99
Q

Is there energy expenditure with passive diffusion?

A

NO

100
Q

What is active transport?

A

Carrier specificity

101
Q

Does active transport require expenditure of energy?

A

YES

102
Q

Where does active transport move substances?

A

Against a concentration gradient

Low to high

103
Q

What is facilitated diffusion?

A

Uses a carrier protein to assist transport

104
Q

Does facilitated diffusion use energy?

A

No energy expenditure

105
Q

Where does facilitated diffusion move contents?

A

With the concentration gradient

high concentration to low concentration

106
Q

What is endocytosis?

A

A drug is engulfed via invagination of cell membrane

107
Q

Does endocytosis require energy expediture?

A

NO

108
Q

Where does endocytosis move contents?

A

With a concentration gradient

High concentration to low concentration

109
Q

What is volume of distribution?

A

the amount of the drug that actually reaches the target site

110
Q

What is the volume of distribution?

A

The ration of the amount of drug administered to the concentration of drug in the plasma

111
Q

How many liters is the total body fluid?

A

42 L

112
Q

What is the plasma volume of distribution?

A

3L

113
Q

Extracellular volume of distribution?

A

16L

114
Q

Volume of distribution involves the volume of the drug in …

A

Plasma
Intracellular water
adipose tissue
interstitial water
organs

115
Q

If there is more of the drug in the plasma, there is a _____ volume of distribution

A

low

116
Q

If there is less of the drug in the plasma, there is a ______ volume of ditribution

A

high

117
Q

What does bioavailability depend on?

A

Route of administration
first-pass effects
drug’s ability to cross membrane barriers

118
Q

What kind of drugs are usually incompletely absorbed?

A

Orally administered

119
Q

What is bioavailability?

A

The % of a drug that enters the systemic circulation in an unchanged form after drug administration

120
Q

How does the body get rid of the drug?

A

Biotransformation

121
Q

What are the types of biotransformation?

A
  • drug undergoes enzyme catalyzed transformation
  • drug undergoes no transformation & is excreted unchanged
  • Drug changes spontaneously into other substances without help of enzymes
122
Q

Where are metabolic sites?

A

Liver, intestines, lungs, kidney, adrenals, skins, placenta

123
Q

What are implications of metabolic sites?

A

Increased / decreased metabolism
decreased therapeutic effects
toxic amount of drug

124
Q

What are methods of excretion?

A

Liver via bile
Kidney via urine

125
Q

What are implications of excretion?

A
126
Q

What is first order kinetics?

A

Drugs eliminated from the body at a rate dependent on the amount of drug present in the body

127
Q

What is zero order kinetics?

A

Drugs eliminated from the body at a constant rate regardless of the concentration of drug in the body

128
Q

What is a half-life?

A

Time required for the plasma concentration to decline by one-half after a single dose administration

129
Q

Is half-life changed by the dose of the drug given?

A

Half life is unchanged regardless of the dose of drug given

130
Q

How much of a drug concentration is gone after 2 half lives?

A

75%

131
Q

How much of a drug concentration is gone after 3 half lives?

A

87.5%

132
Q

How much of a drug concentration is gone after 4 half-lives?

A

93.8%

133
Q

What is the significance of 4 half lives?

A

it takes 4T1/2 to reach steady state (with multiple doses) or to be eliminated (after only one dose)

134
Q

What is a dose regimen?

A

Appropriate dosage regimen based on half life and therapeutic index

135
Q

What does the loading dose produce?

A

a rapid therapeutic concentration in blood or tissue

(Vd x c)

136
Q

What is a maintenance dose?

A

A dose given at appropriate intervals to maintain therapeutic concentration and effect

(Css x CI)

137
Q

When a supplemental dose is given and the dose is eliminated what is the result?

A

Steady State (ss)

138
Q

What are examples of a dose regimen?

A

Single dose
Continuous infusion
Intermittent dose

139
Q

What is the definition of pharmacogenomics?

A

Study of how a person’s genes affect their response to medication

140
Q

What does pharmacogenomics encompass?

A

The development of drug therapies to compensate for genetic differences in patients which cause varied responses to a single therapeutic regimen

CLIN MED EXAM 2 (4 decks)

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