Pharmacotoxicology(Online-4th)

Question 1

Toxic Side effect classification

Answer 1

Class A

ClassB

Question 2

Class A Side Effects

Answer 2

80% of SE;

Predictable and dose-dependent.

Question 3

Class B Side Effects

Answer 3

20% of SE;

not dose dependent and often called idiosyncratic

Question 4

Mechanisms of drug toxicity

Answer 4

1. exaggerated therapeutic effects eg. warfarin causing uncontrolled bleeding.
2. rebound responses are induced by abrupt drug withdrawal. eg. Propranolol can cause rebound HTN

Question 5

Why is tapering drugs important?

Answer 5

When taking Propranolol, the body upregulates receptors in response to a lack of stimulation.With abrupt withdrawal, all of the receptors are able to be filled by a drug like epi, and can cause rebound HTN or worse. By tapering the drug, you give the body time to downregulate the receptors back to normal.

Question 6

When is fetus most susceptible to teratogens?

Answer 6

Embryogenesis (week 3-8)

Question 7

Pregnancy Categories

Answer 7

Category A, B, C, D, X

Question 8

Category A

Answer 8

Drug appears to be safe during pregnancy (Vit B6)

Question 9

Category B

Answer 9

Drug appears to be safe in animals. (Cimetidine)

Question 10

Category C

Answer 10

Drug produces malformations in animals (Codeine)

Question 11

Category D

Answer 11

Drug causes malformations in humans, but sometimes worth the risk. (tetracycline)

Question 12

Category X

Answer 12

Drug causes malformations in humans and never worth the risk (methotrexate, sex steroids)

Question 13

What is the Reward Circuit?

Answer 13

Dopamine is used as a “reward” for biologically critical behaviors. Many drugs trigger Dopamine release.

Question 14

Dopaminergic Pathway

Answer 14

This pathway projects into limbic system and regulates emotion and addictive behaviors.
CNS depressants inhibit, inhbitory GABA. CNS stimulants activate this pathway.
The result from both is an increase in Dopamine.

Question 15

Addiction

Answer 15

Having >3 of the drug dependent behaviors:

1. Unsuccessful attempts to stop.
2. Tolerance
3. abandonment of social and professional activities
4. frequent withdrawal or intoxication symptoms
5. Increasing dosage or frequency
6. Continued use with adverse effects

Question 16

Schedule of Drugs

Answer 16

Schedules 1-4

Question 17

Schedule I

Answer 17

highly addictive and no useful therapeutic effects.

Crack

Question 18

Schedule II

Answer 18

Highly addictive but have therapeutic value

Morphine

Question 19

Schedule III

Answer 19

Moderately Addictive with therapeutic value

Barbiturates

Question 20

Schedule IV

Answer 20

Mildly addictive with therapeutic value.

Benzos

Question 21

Down regularion

Answer 21

Albuterol can cause down regulation r/t hyperstimulation of receptors.

Question 22

Resistance via induction

Answer 22

Barbiturates can induce CYP production that break down drug.

Neoplastic cells can do the same thing to inactivate drugs used to target cancer cell production.

Question 23

Resistance via upregulation

Answer 23

Some drugs will produce ABC (ATP-binding cassette), transporters that export drugs from the cell.
Like P-glycoproteins and MDR-1 transporters

Question 24

SNIPS

Answer 24

Single nucleotide polymorphsim.

A major source of genetic variation.