pharmodynamics

Question 1

what type of reaction is within an above therapeutic range and give an example of the reaction

Answer 1

toxic reaction

example: bleeding following too high dose of anticoagulant

Question 2

what type of reaction is within a therapeutic range and give an example of the reaction

Answer 2

collateral

example: drowsiness with antidepressant

Question 3

what type of reaction is within a below therapeutic range and give an example of the reaction

Answer 3

hyper susceptibility reaction

example: penicillin reaction

Question 4

What are first dose reactions and give an example

Answer 4

Occur straight away. hypotension after first dose of ACE inhibitor

Question 5

give an example of the reaction of early reactions

Answer 5

nitrate-induced headache

Question 6

What are intermediate reactions and give an example

Answer 6

Happen within days to weeks of taking the drug. thromboembolism due to antipsychotic drugs

Question 7

What are late reactions give an example

Answer 7

bruising due to corticocosteroids

Question 8

When do withdrawal reactions occur.

give an example of the reaction of withdrawal reactions

Answer 8

After the medication is stopped

SSRI antidepressant discontinuation

Question 9

What are delayed reactions

give an example of the reaction of delayed reactions

Answer 9

Side effects that appear long after stopped. severe white blood cell loss after certain chemotherapy drugs

Question 10

what are the four types of pharmocological actions of drugs

Answer 10

1. via direct effects on cellular receptor function
   2 via action on ion Channels
2. Via action on membrane transport processes
3. via enzyme inhibition

Question 11

what is an agonist

Answer 11

molecule that binds to a receptor and activates it

Question 12

what is a partial agonist

Answer 12

an agonist that cannot illicit the same change as a full agnostic

Question 13

what are antagonists

Answer 13

diminish or abolish the effect of an agonist via interaction with the receptor

Question 14

what are the two types of antagonists

Answer 14

competitive and non-competitive

Question 15

what are competitive antagonists

Answer 15

compete for the same binding site as the agonist

Question 16

what are non-competitive antagonists

Answer 16

alter the binding ‘site’ for the agonist, which decreases agonist activity

Question 17

drugs that act on ion channels commonly affect…

what is an example of a drug

Answer 17

neural transmission and muscle contractibility and vaerapamil

Question 18

what is the function of transporters, what is a drug that affects the function

Answer 18

mediate the movement of specific endogenous molecules and nutrients in and out of the cell

Sertraline

Question 19

what are phrarmodynamic interactions

Answer 19

interactions between drugs which have similar or antagonistic pharmacological or side effects

Question 20

what are pharmokinetic interactions

Answer 20

part of a key point in the metabolism PK phase where drugs can directly alter the activity of the liver

Question 21

which type of interaction are predictable

Answer 21

phrarmodynamic

Question 22

what are pharmacogenetics

Answer 22

variations can occur in individual response to a drug, if you don’t have the enzyme you can’t metabolise the drug

Question 23

pharmcogenetics is important for

Answer 23

personalised medicine

Question 24

what is polypharmacy

Answer 24

where people take > 4 medicines simultaneously

Question 25

what is an adverse drug reaction

Answer 25

effect of a drug beyond its anticipated therapeutic effects occurring during clinical use

Question 26

what are adverse drug reactions ADRs classified by

Answer 26

DoTS classification

Question 27

what does DoTS classification stand for

Answer 27

Dose time-course susceptibility

Question 28

below dose ADRs result in

Answer 28

permanent avoidance of the drug

Question 29

within therapeutic range ADRs result in

Answer 29

may not be unavoidable, may not reduce by reducing dose

Question 30

above therapeutic range ADRs result in

Answer 30

treat by reducing dose

Question 31

what do ACE inhibitors effect

Answer 31

enzymes

Question 32

example Cytochrome PY50 what happens when CYP50 is induced what happens during initiation of CYP50 what happens during withdrawal of CYP50

Answer 32

1. rate of metabolism of other drug increases, decreasing plasma concentration = decreased effect 2. rate of metabolism of other drug deceased, plasma concentration increases = toxicity 3. plasma concentration of other drug increases = decreased rate of metabolism of other drug = increased plasma concentration and increased toxicity

Question 33

what are examples of drugs affected by PY50 induction/inhibition (remember the acronym COWPAT)

Answer 33

C ciclosporin O oral contraceptive pill W warparin P phenytoin A Ace inhibitors T theophylline S statins