PHARMACOLOGY part 1 Flashcards
the following suffix is indicative of what corresponding drug class?
“caine”
local anesthetic
the following suffix is indicative of what corresponding drug class?
“coxib”
cyclooxygenase (COX)-2 inhibitors
the following suffix is indicative of what corresponding drug class?
“dipine”
dihydropyridine calcium channel blockers
the following suffix is indicative of what corresponding drug class?
“dronate”
bisphosphonates
the following suffix is indicative of what corresponding drug class?
“fungin”
glucan synthesis inhibitor, antifungal
the following suffix is indicative of what corresponding drug class?
“gliptin”
dipeptidyl peptidase-4 inhibitor drug for type 2 diabetes
the following suffix is indicative of what corresponding drug class?
“glitazone”
peroxisome proliferator activated receptor gamma activator for type 2 diabetes
the following suffix is indicative of what corresponding drug class?
“grel”
P2Y12 adenosine diphosphate receptor inhibitor in platelets
the following suffix is indicative of what corresponding drug class?
“olol”
beta adrenergic receptor blockers
the following suffix is indicative of what corresponding drug class?
“ilol” or “alol”
beta adrenergic receptor blocker that also blocks alpha1 adrenergic receptors
the following suffix is indicative of what corresponding drug class?
“mab”
monoclonal antibodies
the following suffix is indicative of what corresponding drug class?
“onium” or “urium”
quaternary ammonium compounds, usually competitive, peripherally acting skeletal muscle relaxers
the following suffix is indicative of what corresponding drug class?
“osin”
alpha1 adrenergic receptor blockers
the following suffix is indicative of what corresponding drug class?
“oxacin”
fluoroquinolone antibacterial
the following suffix is indicative of what corresponding drug class?
“parin”
heparin or low-molecular-weight heparin
the following suffix is indicative of what corresponding drug class?
“prazole”
proton pump inhibitor
the following suffix is indicative of what corresponding drug class?
“penem”
carbapenem beta lactam antibacterial
the following suffix is indicative of what corresponding drug class?
“pril” or “prilat”
angiotensin-converting enzyme (ACE) inhibitors
the following suffix is indicative of what corresponding drug class?
“sartan”
angiotensin II receptor blockers
the following suffix is indicative of what corresponding drug class?
“statin”
3-hydroxy-3-methylglutaryl coenzyme A (HMG-COA) reductase inhibitor antilipid drugs
the following suffix is indicative of what corresponding drug class?
“teplase”
tissue plasminogen activator drug
the following suffix is indicative of what corresponding drug class?
“ triptan”
serotonin 5-HT agonist antimigraine drugs
___ is the maximal effect of a drug
intrinsic acvitity
___ is the effect of a drug as a function of level of binding to its receptor
efficacy
___ is a term that refers to the attractiveness of a drug to its receptor
- affinity
- measured by the dissociation constant (Kd)
- lower Kd corresponds to higher affinity
___ is the response to a drug over a given range of concentrations
potency
___ is the study of what the body does to the drug
pharmacokinetics
if a drug is made active by metabolism, it is called a ___
prodrug
what are examples of phase I reactions?
oxidation, reduction, and hydrolysis
what are examples of phase II reactions?
conjugation, in which a chemical substituent is added to the drug
most metabolism of drugs occurs in which organ?
liver
excretion of drugs usually occurs in what organ?
the kidney, especially for more soluble drugs
___ refers to the elimination of a constant amount of drug eliminated regardless of dose
zero-order elimination kinetics
___ is the most common type of elimination kinetics, in which a constant percentage of remaining drug is eliminated
first-order elimination kinetics
between zero-order and first-order kinetics, the risk of accumulation is usually greater for which one?
zero-order kinetics
the most common form of drug-drug interaction is one drug affecting the ___ of another drug
metabolism
describe the drug-drug interaction between the following drugs commonly used in dentistry:
- aspirin
- anticoagulants
increased bleeding tendency
___ describes an adverse drug reaction that is due to a genetic change usually involving a change in enzyme activity
idiosyncratic reaction
what is the idiosyncratic response to the following genetic abnormality and involved drug:
- altered muscle calcium homeostasis
- volatile inhalation anesthetics, succinylcholine
malignant hyperthermia
what is the idiosyncratic response to the following genetic abnormality and involved drug:
- prolonged Q-T interval
- some antipsychotics and antiarrhythmics
torsades de pointes
all nerve pathways originate from the CNS; the sympathetics from ___ outflow, and the parasympathetics from ___ outflow
- thoracolumbar
- cranial-sacral
the adrenal medulla secretes which two hormones?
- epinephrine and norepinephrine
- there is no ganglion here, but the ACh receptors are ganglionic nicotinic in type
what is the sympathetic response of salivary glands? what about the parasympathetic response?
- sympathetic response is a viscous secretion, amylase secretion
- parasympathetic response is a more profuse, watery secretion
what is the main use for the following adrenergic agonists?
- epinephrine
- norepinephrine
- epinephrine: reverse anaphylaxis, vasoconstriction, bronchodilation
- norepinephrine: vasoconstriction
what are alpha-1 blockers used to for?
to treat hypertension, heart failure, and benign prostate hypertrophy
what are the adverse effects of alpha-1 blockers?
hypotension (especially first-dose effect), fluid retention, dry mouth, and nasal stuffiness
which adrenergic neuron blockers indirectly reduce granule content of NE but increase it in the cytoplasmic pool of adrenergic neurons?
MAO inhibitors, such as pargyline and tranylcypromine
which medication is used in dentistry to reverse soft tissue anesthesia more quickly after procedures involving a local anesthetic with a vasoconstrictor?
- phentolamine (oraverse)
- nonselective alpha-adrenergic receptor blocker (alpha 1 and 2)
beta blockers increase the ___ response to epinephrine, but reduce the ___ resulting from epinephrine
- vasoconstrictor response
- tachycardia
what is the use for the following cholinergic receptor agonists:
- pilocarpine
- cevimeline
- pilocarpine: treat glaucoma and stimulate salivary flow
- cevimeline: stimulate salivary flow
what is the use for the following cholinesterase inhibitors:
- physostigmine
- pyridostigmine
- physostigmine: glaucoma, antidote for atripine
- pyridostigmine: treat myasthenia gravis
what is the use for the following cholinesterase inhibitors:
- tacrine
- donepezil
both: treat alzheimer’s disease
what is the use for the following cholinesterase inhibitors:
- galantamine
- rivastigmine
both: treat alzheimer’s disease
what is the use for the following cholinesterase inhibitors:
- sarin
- soman
both: nerve gas
___ is used to reactivate acetylcholinesterase after irreversible inhibition by an organophosphate (echothiophate, isoflurophate, sarin, soman)
pralidoxime
what are the uses for the following antimuscarinic drugs?
- atropine
- scopolamine
- atropine: prototype, to reduce salivary flow, for antivagal effect during surgery, antidote for physostigmine
- scopolamine: prototype, for motion sickness
what is the dose of atropine for reducing salivary flow?
oral administration is 0.5mg (adult dose)
what are the contraindications for antimuscarinic drugs?
- narrow-angle glaucoma
- prostate hypertrophy
- paralytic ileus
- tachycardia
what are skeletal neuromuscular blockers used for?
during surgery for relaxing skeletal muscle, for endotracheal intubation, and for treatment of tetanus
what are examples of curare-type neuromuscular junction blockers?
d-tubocurarine, pancuronium, atracurium, vecuronium, pipecuronium, rocuronium, doxacurium, mivacurium
which skeletal neuromuscular junction blocker relaxes skeletal muscle without blocking nicotinic receptors?
dantrolene
botulinum toxin A (botox) is a skeletal neuromuscular junction blocker that prevents the release of ___ from neurons
ACh
what are the uses of botulinum toxin A?
- ophthalmology to relax extraocular muscles
- muscle dystonias
- remove wrinkles
which local anesthetics are esters?
procaine, tetracaine, and cocaine
which local anesthetics are amides?
lidocaine, mepivacaine, bupivacaine, prilocaine, and dibucaine
where are ester local anesthetics metabolized?
plasma, by esterases
where are amide local anesthetics metabolized?
liber
which class of drugs has the most consistency in structure?
- local anesthetics
- they are either esters or amides, and differ only in their structure in the intermediate chain (either ester or amide) that connects the aromatic group to the secondary or tertiary amino terminus
what are the toxic reactions to local anesthetics due to?
either high systemic levels of LA in general (cardiovascular collapse due to myocardial depression, hypotensive shock), or to a specific agent (such as prilocaine, which causes methemoglobinemia)
what is the mechanism of action of local anesthetics?
they prevent the generation of nerve impulses by interfering with sodium transport into the neuron
in terms of absorption of local anesthetics, which form penetrates tissue membranes?
- the non-ionized (free base) form
- once inside the neuron, only the ionized form is effective
describe the pH of inflamed tissue and how that affects absorption of local anesthetics
inflamed tissue has a lower than normal pH, which decreases the amount of non-ionized form available to penetrate
which local anesthetics have a short duration of action?
procaine
which local anesthetics have a moderate duration of action?
prilocaine, mepivacaine, and lidocaine
which local anesthetics have a long duration of action?
bupivacaine, tetracaine, and etidocaine
initially, local anesthetics inhibit ___ neurons, which results in CNS ___, which can proceed to ___. at higher doses, they inhibit both ___ and ___ neurons, leading to a generalized state of CNS ___, which can result in ___ and ___
- central inhibitory
- stimulation
- convulsions
- inhibitory and excitatory
- depression
- respiratory depression and death
in toxic doses, local anesthetics depress ___ and ___
membrane excitability and conduction velocity
which is the only local anesthetic that predictably produces vasoconstriction?
cocaine