Pharmacology - Pharmacotherapeutics: Clinical Use of Drugs (Exam 1) Flashcards
When is a higher dose needed?
hypo-reactivity
tolerance
tachyphylaxis
When is a lower dose needed?
hyper-reactivity
supersensitivity
hypersensitivity
What are the 4 pharmaco- types of drug-drug interactions?
- pharmaceutical
- pharmacokinetic
- pharmacodynamic
- pharmacotherapeutic
How do you get pharmaceutical drug-drug interactions?
physical or chemical incompatibilities
administration
How do you get pharmacokinetic drug-drug interactions?
absorption
distribution
transport
biotransformation
excretion
How do you get pharmacodynamic drug-drug interactions?
CNS depressants
How do you get pharmacotherapeutic drug-drug interactions?
fixed dose combinations
What are the other 4 types of drug-drug interactions?
- antagonism
- potentiation
- summation
- synergism
During antagonism, there is _________ competition
receptor
During antagonism, the combined use of antibiotics inhibit _______ _______ synthesis and _________ synthesis
cell wall; protein
During antagonism, there is increased _________ _______ or excretion
metabolic inactivation
During antagonism, there can be physiological antagonism such as CNS _________ and ________
stimulants; depressants
(T/F) During potentiation, two drugs do NOT share similar effects, but one drug increases the effect of another drug
true
Potentiation often occurs by increasing the active ________ of a drug
concentration
During potentiation, local anesthetic action is enhanced and prolonged when administered with a ___________
vasoconstrictor
The combined activities of 2 or more drugs that elicit identical or related effects
summation
Summation can be….
additive
infra-additive (less)
supra-additive (more, but not greater than max. effect of either drug)
The combination of 2 or more drugs produces effects greater than the summation of drug effects
synergism
What does synergism minimize the development of?
drug resistance
(T/F) Children should be thought of as mini adults
FALSE
What are some environmental factors that affect drugs?
diet
temperature
indigenous microflora
How many drug allergy types are there?
4
-Disturbances appear in minutes or hours of taking drug
-IgE antibodies attach to mast cells and basophils
-Release of HA, LTE, cytokines, etc.
-GI cramps, erythema, urticaria, edema, bronchoconstriction, vasodilation, increase in blood vessel permeability
-Epinephrine reverses severe responses
type 1 - anaphylactic response
-Delayed and manifest from hours to days after drug exposure
-Causes by circulating IgG and IgM antibodies
-Plasma membrane constituent can be hapten carrier (ex: platelets) or complete antigen absorbed on membrane, Ig binding followed by complement fixation and cell lysis cocurs
-Drug induced hemolytic anemia, leukopenia, and thrombocytopenia
type 2 - cytotoxic reaction
-Soluble antigen-antibody complexes form in intravascular or interstitial spaces
-Deposition of complexes on small blood vessel walls
-Complement activation and neutrophils migrate to area
-Degranulation of immune cells trying to remove complexes causing lysosomal enzymes
-Local tissue damage
-Looks like disease states (neuropathy, glomerulonephritis, etc.)
-Can also be cytotoxic like (type 2)
type 3 - immune complex reaction
-Sensitized T lymphocytes exposed to drug hapten or conjugate; release lymphokines to attract more cells (lymphocytes, macrophages, cytotoxic T cells)
-Lysosomes and toxic lymphokines produce tissue damage
-Dentists experience this type of delayed rxn via contact dermatitis due to exposure to local anesthetics like procaine
-Now that amides are available, not as much
type 4 - cell mediated immunity
Anaphylaxis, allergic rhinitis, asthma
type 1 - anaphylactic response
Hemolytic anemia, thrombocytopenia
type 2 - cytotoxic reaction
Serum sickness, arthus reaction
type 3 - immune complex reaction
Contact dermatitis, delayed hypersensitivity
type 4 - cell mediated immunity
Indirect and often unpredictable consequences of a drug’s primary action
secondary reaction
Any agent capable of altering DNA
potential carcinogen
