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AUDE 6120 > quiz 2 > Flashcards

quiz 2 Flashcards

1
Q

controlled substance

A

medications that can produce a toxic and potentially fatal adverse effects
-officials must ensure that patients with medical needs have access while keeping the drugs away from the people who would abuse them

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2
Q

united states code- controlled substance act of 1970

A

congress gave the united states drug enforcement administration (DEA) authority to
-set the schedule of controlled substances
-control and enforce laws related to these substances

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3
Q

controlled substances are divided into categories/schedules, what are these based on

A

drugs acceptable medical use, drugs potential for abuse and drugs safety or dependence liability

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4
Q

schedule 1 substance

A

the most addictive and most potential for abuse
-no currently acceptable medical use with a high potential for abuse
-severe psychological and or physical dependence
-examples include heroin, LSD and extasy

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5
Q

schedule 2 substance

A

can potentially lead to severe psychological or physical dependence and are also considered dangerous
-examples include morphine, fentanyl and adderall

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6
Q

schedule 3 substance

A

moderate to low potential for physical and psychological dependence
-examples include ketamine, anabolic steroids and cannabis

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7
Q

schedule 4 substance

A

defined as drugs with a low potential for abuse and low risk of dependence
-examples include xanax, valium and tramadol

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8
Q

schedule 5 substance

A

lowest potential for abuse
-preparations containing limited quantities of certain narcotics
-generally used for antidiarrheal, antitussive and analgesic purposes
-examples include lomotil, lyrica and cough presentations

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9
Q

adverse drug reactions (ADRs)

A

any undesirable action (side effect) and can also include toxicity reactions

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10
Q

undesirable actions can include ….

A

undesired effects, generally reversible upon drug discontinuation and they are dose related

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11
Q

toxicity reactions can include …

A

cell and tissue damage or permanent/generally intolerable reaction

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12
Q

what are some factors that can increase the risk of ADRs

A

increasing age of child, increasing number of drugs and oncological treatment

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13
Q

GA agents and opiate analgesics were found to be a ____________

A

significant cause of ADRs

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14
Q

reporting of ADRs

A

requires all to be included within the monograph (inserts that accompany prescription drugs in the pharmacy inventory)
-reported by systems/organs affected and the percentage of population affected

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15
Q

how are ADRs categorized

A

by the body/organ system affects and by the general side effects that affect the whole body

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16
Q

how can the skin be impacted with ADRs

A

drug induced itching and redness, acne, alopecia, herpes simplex, sweating, hives (ultricaria), skin ulcers and steven johnson syndrome

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17
Q

how can the nervous system be impacted with ADRs

A

dizziness, drowsiness, confusion, depression, delusions, hallucinations, decreased mental acuity, delayed reaction time and headaches

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18
Q

how can the eyes be impacted with ADRs

A

blurred/double vision, increased ocular pressure, damage to retina and optic nerve and erythema multiforme

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19
Q

what is erythema multiforme

A

allergic reactions to some antibiotics, NSAIDs and infections
-involves mucous membranes, skin and eyelids
-produces variety of skin lesions from bumps, plaques to blisters
-the most severe for is stevens johnson syndrome

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20
Q

how can the auditory vestibular system be impacted with ADRs

A

dizziness, vertigo, balance disorders, HL and tinnitus
-tinnitus and dizziness are the most common side effects

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21
Q

common side effects that impact the whole body

A

malaise, fatigue, body pain and lower extremity pain such as back pain

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22
Q

explain the various components of the immune system

A

parts are antigen-specific, parts are systemic and parts have memory

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23
Q

how is self/non-self recognition accomplished

A

based on having the major histocompatibility complex (MHC)

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24
Q

major histocompatibility complex (MHC)

A

every cell of the body will have this
-these are a group of genes that code for cell surface proteins essential for the immune system

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25
Q

what occurs when the immune system attacks the body’s own cells

A

can cause autoimmune diseases
-such as multiple sclerosis or sudden sensorineural hearing loss

26
Q

what can happen when there is an overwhelming immune response

A

allergies
-a substance elicits this response

27
Q

main fluid systems of the immune system

A

hematopoietic (blood system) and the lymphatic system

28
Q

hematopoietic (blood system)

A

this contains erythrocytes or red blood cells, leukocytes or white blood cells and thrombocytes or platelets
-RBCs carry oxygen
-WBCs fight infections
-platelets help control bleeding

29
Q

what are WBCs further divided into

A

granulocytes and agranulocytes
-most plentiful are granulocytes
-agranulocytes consist of B cells, T cells and monocytes

30
Q

where do the cells of the blood system develop

A

within the bone marrow, from the pluripotent hematopoietic stem cell
-through hematopoietic growth factors in how they become individualized

31
Q

lymphatic system

A

lymph flows alongside the blood vessels, tissues and organs in order to act as a fighting mechanism
-lymph nodes act as filters

32
Q

what are the main cells of the lymphatic system

A

T cells : involved with cell mediated immunity, mature within the thymus gland but produced in bone marrow
B cells : involved in humoral immunity, antibodies are produced here, produced in bone marrow

33
Q

antibodies or immunoglobulins (Igs)

A

used by the immune system to identify and neutralize foreign objects such as bacteria and viruses
-recognizes unique molecule of the pathogen called an antigen
-secreted by plasma and are offsprings of primed B cells

34
Q

development of antibodies or Igs

A

B lymphocyte is stimulated to maturity and when an antigen binds to the surface receptor the B cell becomes sensitized or primed and undergoes clonal selection reproducing by mitosis. most of these clones will become plasma cells.
-after a initial timeframe of up to 14 days, highly specific antibodies will be produced (primary immune response)
-other B cells become long lived memory cells (secondary immune response

35
Q

secondary immune response is ……

A

quicker and more effective

36
Q

B cells that become long lived memory cells and the interaction of the same antigen will do ….

A

they have been identified and they know to then go against that antigen

37
Q

what are the various types of gamma globulin’s

A

IgG, IgA, IgM, IgD, and IgE

38
Q

which globulin is the most dominant in the body

A

IgG

39
Q

which globulin dominates the secondary immune response

A

IgG

40
Q

which globulin crosses the placental barrier to the fetus

A

IgG
-responsible for the immune protection to newborns

41
Q

which globulin dominates in primary immune responses

A

IgM

42
Q

how do vaccines work

A

-activates T cells that detect the presence of a virus (peak of 10-18 days after the shot)
-instructs B cells to create antibodies that block the virus from being able to replicate and the T killer cells will destroy the infected cells

43
Q

when ________ is released at a too high quantity, this causes hypersensitivity and allergies

A

histamine

44
Q

what are the target cells of immediate type reactions

A

mast cells and basophils (WBCs)
-both containing histamine (important for fighting infections)

45
Q

what causes hypersensitivity or allergies

A

antigens combine with molecules of IgE antibodies that have become attached to the mast or basophil cells surface which causes the release of histamine resulting in an allergic reactions

46
Q

types of allergic reactions and the type of globulin associated with it

A

-type 1 (mediated by IgE)
-type 2 (mediated by IgG and IgM)
-type 3 (mediated by IgG)

47
Q

what type of allergic reaction is the most severe and can lead to anaphylaxis

A

type 1
-can also show asthma syndrome and dermatitis

48
Q

what do type 2 reactions lead to

A

hemolysis of RBCs (breaking down)

49
Q

what do type 3 reactions lead to

A

arthralgia (muscle or joint pain) or fever, lymphadenopathy (swollen lymph glands)

50
Q

anaphylaxis

A

severe, progressive, whole body allergic reaction to a chemical that has become an allergen
-typically within the second reaction and can be life threatening

51
Q

risks of anaphylaxis

A

history of any type of allergic reaction but can occur with no known cause during a first exposure

52
Q

symptoms of anaphylaxis

A

abdominal pain, anxiety, chest discomfort, dizziness, cough and difficulty breathing, nausea/vomiting

53
Q

treatment of anaphylaxis

A

epinephrine to reduce the body’s allergic response, oxygen to help breathing, IV antihistamines and cortisone to reduce inflammation and swelling

54
Q

common teratogens and fetal development

A

drugs (isotretinoin and thalidomide) infections (rubella) and environmental factors (radiation)

55
Q

drugs may still be approved by the FDA if there are any teratogens if ….

A

therapeutic benefits outweigh the risk, physician labeling clearly contraindicated use during pregnancy and the FDA requires testing of all new drugs for teratogens during toxicity trials with animal studies

56
Q

pharmacogenomics

A

study of the role of the genome in drug response, a combination of pharmacology and genetics
-interindividual differences can exist

57
Q

single nucleotide polymorphism (SNP)

A

when one nucleotide in a specific position is exchanged with another nucleotide
-variations can affect protein amount or function by altering coding sequence of transcription or mRNA translation

58
Q

examples of polymorphisms

A

the inherited variation of enzymatic hydrolysis of short acting muscle relaxant by the enzyme serum cholinesterase and cytochrome P450 (CYP) liver enzyme

59
Q

explain the cholinesterase enzyme

A

one of these enzymes function is to metabolize the muscle relaxant succinylcholine however, the altered enzyme has a decreased affinity for this causing decreased metabolism, slow elimination and prolonged circulation

60
Q

explain the CYP enzyme

A

genetic variations can cause less active/inactive forms of CYP that can then alter drug metabolism for drugs leading to overdose
-both in phase 1 and 2 liver enzymes
-results in significant drug efficacy and toxicity for individuals with these compared to those without

61
Q

potential benefits of pharmacogenomics

A

development of drugs to target specific disease based on genetic information, establishing gene phenotype prior to the use of certain medications, matching the right drug/dose to patients genotype, removing the need to experiment with medication, advanced screening for disease susceptibility to monitor conditions and maximize therapy, developing better vaccines and decreasing overall health care costs

62
Q

barriers present with pharmacogenomics

A

very complex/time consuming, knowing a genetic make up will not be helpful if the two drugs are contraindicated, little incentive for drug manufacturers to spend high amounts of money and development of the start of the art technologies to detect and analyze DNA sequencing data and translate that knowledge to the clinic

AUDE 6120 (4 decks)

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