Principles of Pharmacology Flashcards
Products/drugs commonly used in the dental office
- Fluorides
- Analgesics (pain reliever)
- Chemotherapeutics (arrestin rinsing)
- Local Anesthesia
- Nitrous Oxide
Biomedical study of how drugs effect the body
Pharmacology
What do drugs do to the body?
An interaction of chemicals with living tissue.
Medication or drugs don’t create new physiological responses, rather they alter normal processes by increasing or decreasing the function of the cell/ depressing or exciting
What are the 3 Regulatory Agencies
- Food and Drug Administration
- Federal Trade Commission
- Drug Enforcement Agency
- Determine safety and efficacy
- Physical and chemical standards
- Quality control in manufacturing
- Rx or OTC
- Regulates labeling and advertising
Food and Drug Administration
- Protects consumers by stopping unfair practices
in the marketplace. - Benefits consumers by keeping prices low and
quality high - Protects against False advertising of food, OTC,
and cosmetics
Federal Trade Commission
FTC
- Manufacturers and distribution of controlled substances, including narcotics, stimulants, and sedatives
- The mission of the DEA is to enforce the
controlled substance laws and regulations in the United States.
Drug Enforcement Agency DEA
What are the 3 names of Drug Names and Properties
Chemical Name
Brand Name (Trade Name)
Generic Name
Chemical make up of drug (unique molecular structure)
Chemical Name
A drug that is trademarked and belongs to a specific manufacturer. For 17 years, only the brand name has rights to drug. Generics are available after the patent expires
Brand Name (Trade Name)
Official preferred name
Contains same therapeutically active chemical
ingredients as brand name. (same dosage and
form) Indented to reduce cost of drug
Generic Name
- Intended Use
- Effect Produced in body
- AKA pharmacologic category, therapeutic effect
Drug Classification
Involves drug being absorbed from the GI track
- Oral (PO)
- Sublingual
- Buccal:
- Rectal (PR)
Enteral Administration
- Taken by mouth
- Under tongue
- Between cheek and tongue
- When drug is too irritating to the stomach, patient is vomitting or nauseated or cannot swallow
common for children and infants
Drug delivered via a needle
into skin layers. The needle is angled at different
degrees depending on type of injection
- Intravenous (IV):
- Intramuscular (IM)
- Subcutaneous (SC, SQ)
- Intradermal
- Intrathecal
Parenteral Administration
- Directly into circulation via a vein
- Muscle
- Connective tissue under skin
- Dermis layer of skin directly under epidermis
- Into cerebral spinal fluid used for spinal anesthesia
Give an example of the type of drug delivered via the following routes
- Intravenous IV: Morphine/Antibiotic
- Intramuscular (IM): Vaccines/Hormones
- Subcutaneous: Insulin local anesthetic
- Intrathecal epidural pain pump
Administration of drugs directly to the surface of body where action is desired
- Inhalation
- Opthalmic
- Otic
- Transdermal
Topical Administration
- Inhaled through mouth or nose
- Eye drops, irrigations, ointments or disks
- Otic: Ear drops or irrigations
- Transdermal: Adhesive patch on the skin delievers a time relased dose through the skin into the blood stream ex nicotin patch and contracepticves
**The way the body
affects the drug (absorption, distribution,
metabolism, excretion)
Pharmacokinetics
The way drugs work in living organisms
- Includes drug mechanism of action, receptor interactions, dose response relationship, and therapetuic and toxic reactions
Pharmacodynamics
Deals with genetic factors
that influence an organisms response to a
drug
Pharmacogenetics
Part of science that
studies the use of drugs in the prevention,
diagnosis, and treatment of diseases
Pharmacotherapeutics
The study of poisons, chemical
pollutants, and undesirable effects of drugs
on living cells, tissues and organisms
Toxicology
Molecules are transferred from site of administration in body to circulating fluids - How drugs penetrate cell/tissue membranes
Absorption
__ Solubility is one of the most important factors in the pharmacokinetic characteristics of a drug
Lipid solubility
Passive membrane
Moves down concentration gradient
Facilitated
Helps molecule/pathway attach to protein uses NGY
Most drugs are weak __ or weak __
acids or bases
Drugs are present in solution in ionized and non-ionized forms
what do those mean
Ionized form: Low lipid solubility (does not easily cross border)
Non-Ionized Form: Lipid soluble (easily crosses cell membrane )
pH is the
concentration of H+ ions
pH of weak acids
3-5
pH of weak basis
8-10
Drugs are absorbed with they are mostly in their __-___ form
non-ionized
Weak acids:
absorbed in stomach (pH:2) nonionized
Weak bases
absorbed in small intestine (pH 8) ionized
- Drugs are absorbed into the __ in the non-ionized, lipid soluble form
- Highly ionized drugs ___ pass lipid membranes
- Non-ionized drugs _ cross lipid membranes freely
blood
cannot
can
Most drugs are either weak __ or weak __
acids
basis
Distribution
Passage of drugs through blood plasma to site of action
Drug is carried through blood stream in 2 forms
-Free drug-produces effect - Bound to a plasma protein (usually albumin)-inactive
If a drug is highly protein bound, will it require a higher or lower dose of the drug to have an effect.
What else can effect protein bound drugs?
Higher
They will be removed from the body quicker
Metabolism (Biotransformation) of drugs
- Body changes drug from lipid- soluble form to more water soluble form to be excreted
- Most drugs are metabolized into inactive metabolites
Metabolism (Biotransformation) of drugs
- Body changes drug from lipid- soluble form to more water soluble form to be excreted
- Most drugs are metabolized into inactive metabolites
- Metabolites convert the drug to the water soluble form = less likely to be reabsorbed
- Takes place in liver most commonly
- Also in plasma, kidneys and intestines
Excretion of drugs
- Most drugs leave by way of the kidneys through the urine
- Other ways: lungs, exocrine glands, skin, and intestinal tract
Biologic Half-Life (t1/2)
- Time required for concentration of drug to be halved after absorption is completed
- Example
Actions of drugs on the body and involves
drug-receptor interactions, mechanism of
action, and dose-response relationship.
Pharmakodynamiks
Drug Action: Receptor:
The site where such drug attachment takes place
- Receptors will bind either a drug or an endogenous substance
Drug Action
Agonist
Antagonist
Partial Agonist
Agonist- Drugs that bind with a receptor to produce an effect
Antagonist- Drugs that bind with a receptor to block results of an agonist to produce an effect
Partial Agonist- Drugs that partially bind w/ a receptor to produce a milder theraputic effect
Desirable actions
Therapeutic Effect
- Undesirable actions or effect of the drug
- Unfavorable and unintended response to the drug
- MORE SEVERE
Adverse Drug Event
-Undesirable side effect of a drug
- occurs with normal doses and normal use of a
medication
Adverse Drug Reaction
Desirable actions
-headache goes away
Therapeutic Effect
-Undesirable side effect of a drug
- occurs with normal doses and normal use of a
medication
-stomach ache mouth feels dry are examples
Adverse Drug Reaction
Drug Events- ADE’s /Adverse Drug Events
- Type A
- Type B
Type A
- Predictable, Preventable and may lead to death
(Overdosing, drug-drug interactions, Drug-food interactions)
Type B
- Unpredictable, unpreventable, rare
- Individuals response to genetic differences
- Slow metabolizers of drugs- thus risk for toxicity
Drug Reactions- Adverse Drug Reaction
- Adverse Effects
- Toxic Reactions
- Allergic Reactions
- Idiosyncratic Reactions
- Teratogenic Effects
Adverse Effects:
- Undesirable side effects
- Drugs are not totally selective in their actions
- Higher dose =greater adverse effects (If you take more hydrocodon you will have more and more nausea
Toxic Reactions:
- Permanent damage to cell or tissue - abuse aspirin long term damage
Allergic Reactions:
- Antibodies get sensitized to antigens that enter the body
- Rash or anaphylaxis shock
Idiosyncratic Reactions
- Unexplained, uncharacteristic response to a drug
- Often caused by hereditary factors or genetic differences
Teratogenic Effects
- Effects fetus not mother
Drug Use During Pregnancy
FDA Pregnancy Categories
Category A-B
Category A — Studies have not demonstrated
risk to the fetus
Category B — Studies have not been done on
humans but in animal studies there was no risk
to the fetus
Category C — Studies have not been done on
humans or animals or studies done on animals
have shown teratogenic effects
Category D — Studies have revealed adverse
risk to the fetus so benefit-to-risk ratio must
be established before use in pregnancy
Category X — Studies have revealed
teratogenic effects in women and/or animals;
fetal risk clearly outweighs benefit and drug is
contraindicated in pregnancy
Drug Interactions: Adverse/toxic side effects when certain drugs are given concurrently with another \_\_, herbal supplement, or food.
Give example
drug
Tetracycline taken with milk forms a complex that prevents absorption making it ineffective
if fluoride overdose pt can take milk
Are drug interactions an example of ADE’s or ADR’s
depends on the interaction they can overlap
Pharmacotheraputics
Drug Dose:
Loading Dose:
Maintenance Dose:
Drug Dose: Quantity of drug administered
Loading Dose: A high dose of a drug is given intiitally to rapidly establish a therapetic plasma drug concentration
Maintenance Dose: Lower doses used to maintain a desired drug level
Therapeutics vs. Toxicity
Minimum Effective Concentration: Amount of drug required to produce a therapetuic effect
Toxic Concentration: Level of drug which will produce serious adverse effects
Therapeutic Range: Somewhere between minimum effective concentration and toxic concentration
Dose-Response Relationship
- Potency
- Efficacy
Potency- Dose or amount of drug required to produce a particular or specific biologic effect
Efficacy- Ability to produce a therapeutic effect regardless of the dose
- Potency and efficacy often describe the success of drug therapy
