test 1 Flashcards
ACE inhibitor Suffix and Primary Indication/ Desired Effect
-pril (ex. catopril, enalapril)
antihypertensive, congestive heart failure
Angiotenisin- 11 receptor blockers Suffix and Primary Indication
-sartan (ex. candesartan, losartan)
Antihypertensive, congestive heart failure
Beta Blockers Suffix and Primary Indication/Desired Effect
-olol (ex. Metoprolol, propranolol)
Antihypertensive, antianginal, antiarrhythmic, congestive heart failure
Calcium channel blocker Suffix and Primary Indication/Desired Effect
-ipine (ex. nifedipine, nicardipine)
antihypertensive, antianginal
HMG-CoA reductase inhibitors
-statin (ex. pravastatin, simvastatin)
Hyperlipidemia
What is defined as the development of unhealthy conditions or disease?
Pathogenesis
The WHO describes health as…
state of mental, physical and social well being and not merely the absence of disease
Describe illness vs disease
Disease- supported by objective data such as elevated temperature or presence of infection
Illness- sickness or deviation from a healthy state
If an individual has experienced brain damage that leads to decreased executive function, which area of the brain is most likely injured?
Right hemisphere
Who created the germ theory?
Louis Pasteur
Who made a ground breaking study of mitochondrial DNA in the beginning of the 21st century?
Douglas Wallace
Describe the difference between Primary, Secondary and Tertiary Care
Primary- removing risk of disease risk factors (seatbelts)
Secondary- to promote early detection of disease and to employ preventative measures to avoid further complications (Immunizations)
Tertiary- limit the impact of already established disease (Antibiotics)
When was the Human Genome Project started?
1990
Heart disease has been reduced by how much due to changed in diet and lifestyle?
52%
Endocrine disrupting compounds may exert what kind of effect?
Multigenerational effect
Who are examples of successful aging?
Those in their 100s
Healthcare improvements have created an additional how many years of that 35?
7 yrs
Which group has seen the most rapid population increase in the past decade?
Over age 85
Supercenturians live to be past how many years over 100?
10 years
What is the set time frame to define a subacute condition?
There is no set time frame
What is the process of growing old that may be the result of cellular metabolism, cellular damage, and inefficient repair systems through the entire lifespan?
Senescence
Which of the following age groups is most likely to assume a passive role in their own healthcare?
Age 80 and older
Recent epigenetics studies have shown benefits to people with increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels with what interventions?
Therapeutic activities and exercise
What has been shown to have the ability to control DNA accessibility and gene activation or inactivation?
DNA methylation and histone acetylation
Which if the following is the product of gene expression?
Protein
Preclinical Testing Purpose, Subjects, and Time Period
Initial Lab tests to determine drug effects and safety
Lab animals
1-2 years
Phase 1 Purpose, Subjects, and Time Period
Determine effects, safe dosage, pharmokinetics
Small number (10-100) of healthy volunteers
Less than 1 Year
Phase 2 Purpose, Subjects, and Time Period
Assess drug’s effectiveness in treating a specific disease
Limited number of patients (50-500) with targe disorder
2 years
Phase 3 Purpose, Subjects, and Time Period
Assess safety and effectiveness in a larger patient population
Large number of patients (1000-3000) targeted
3 years
Phase 4 Purpose, Subjects, and Time Period
Monitor any problems that occur after NDA approval
General patient population
Indefinite
The use of specific drugs to prevent, treat, or diagnose disease is…
Pharmacotherapeutics
What is toxicology?
the study of harmful effects of chemicals
What is an orphan drug?
given special funding for development because it is used in a small patient population
Off label prescribing is…
legal and quite common in the US
When two drugs are compared, the drug that requires a lower dosage to produce the same effect as a higher dose is said to be…
More potent
What is the first-pass effect?
when drugs are transported initially to the liver where a significant amount of the drug may be metabolized and destroyed before the drug reaches its primary site of action
What is bioavailability?
the extent to which a drug reaches the systemic circulation
A drug that has a volume of distribution of approximately 42 L in a healthy 70 kg man will typically be
distributed uniformly throughout all of the body fluids
What is biotransformation?
Drug metabolism that occurs when a drug is changed chemically following transformation
Most drugs are metabolized by ____ to the molecule and the enzymes that catalyze these reactions are typically located at the _____ of specific cells
adding an oxygen or removing a hydrogen; smooth ER
What is enzyme induction?
Prolonged administration of therapeutic drugs and other substances that may enhance the liver’s ability to metabolize certain drugs
Where are drugs and metabolites excreted in the body?
Kidneys
The AcH pore functions as a
ion channel or pore
What is a partial agonist?
A drug that fails to evoke a maximal response even though it occupies all available receptors
What is pharmacokinetics?
The study of how the body deals with a drug absorption, distribution, and elimination
Enteral vs Parenteral Routes for Drugs?
Enteral Routes- Oral, Buccal, and Rectal
Parenteral Routes- Inhalation, Injection (IV, intramuscular, intra arterial, subcutaneous)Topical (applied to skin), Transdermal
The first pass effect is of particular concern when drugs are administered…
Orally, Enterally
When crossing cell membranes, drugs will diffuse more readily through the lipid layer if they are
In a neutral, non ionized form
Simple Diffusion, Active Transport and Facilitated Diffusion
Simple Diffusion- No energy required down concentration gradient
Active Transport- energy required against concentration gradient
Facilitated Diffusion- form of passivee transport that uses a carrier protein
If there is no existing patent for a drug, or if the patent has expired, the same drug may be marketed by separate drug companies under different
Trade Names
The primary location for receptors that recognize drugs and endogenous compounds is…
On the surface on the cell
Glucocorticoids
-olone, -sone
Anti inflammatory
Immunosuppressants
Cyclooxygenase type 2
(COX-2) inhibitors
-coxib
Pain, inflammation
What are the phases of healing?
- Homeostasis and degeneration- stop the bleeding and begin breaking down damaged cells
- Inflammation- the body’s defense mechanism kicks into protect and repair
- Proliferation and migration- new cells start growing and moving into the damaged area
- Remodeling and maturation- the new tissue strengthens and matures
What is ischemia?
Less oxygen to the cell because of reduced blood flow (blood clot)
What condition is generally not thought to be caused by free radicals?
Rheumatoid arthritis
During acute reversible cell injury, the concentrations of which two elements are increased?
Sodium and calcium
Necrosis Plasma membrane, adjacent inflammation, cell contents, and cell size
Disrupted, Frequent, may leak out of the cell, enlarged
What chemical mediator is responsible for increasing vascular permeability and causing vasodilation during an acute inflammatory response?
Histamine, stored in granule cells
Inflammatory exudate Sanguineous appearance
bright red or bloody and signals the presence of red blood cells
Inflammatory exudate serosanguineous appearance
blood tinged yellow or pink, presence of RBC
Inflammatory exudate serous appearance
thin, clear yellow or straw colored contains albumin and immunoglobins
Inflammatory exudate purulent appearance
viscous cloudy, pus, cellular debris from necrotic cells
Inflammatory exudate catarrhal appearance
thin, clear mucus
What is the approximate life cycle of a neutrophil after extrusion from the circulation?
24 hours
What is the first step in the migration of leukocytes from the vasculature to the interstitial tissues?
Binding of leukocytes to receptors on endothelial cells of venules
What is the sequence for leukocyte accumulation during an inflammatory response?
Margination- adhesion- diapedesis- chemotaxis
What is the role of diapedesis in the inflammatory response?
Diapedesis is the active migration of leukocytes out of the blood vessels and into the interstitial tissues, enabling them to reach the site of injury
What releases histamine?
mast cells, basophils, and platelets
What is phagocytosis and its purpose?
The process of ingestion of microorganisms, other foreign substances by specialized cells
Purpose: to inactivate and remove the inflammatory stimulus and to begin the process of healing
What is fibronectin?
Acts like a scaffold that holds cells together, making the tissue strong
What is secreted by fibroblasts early during the tissue repair reaction?
Proteoglycans
Which collagen type is first deposited during wound healing, contributes to the elasticity of skin and blood, and is eventually replaced by type 1 collagen?
Type 3 collagen
What type of collagen is the predominant component of growth plates in bones?
Type 2 collagen
What tissues have delayed healing because of low blood supply?
tendons, ligaments, cartilage, disc
What role do myofibroblasts play during the remodeling and maturation phase of tissue healing?
Contribute to tissue contraction by containing contractile proteins that help shrink the healing tissue
What is a labile cell and examples?
Cell that divides continuously, epithelial cells of the skin
What is a permanent cell and examples?
Regeneration does not occur and tissues cannot divide, cardiac myocytes
What is a stable cell and examples?
does not divide but can be induced to undergo mitosis by an appropriate stimulus, kidney cells and skeletal muscle fibers
Lung tissue repair after injury
Regeneration can only occur only when the basement membrane is intact
Healing is also achieved by fibrosis and scar formation
Peripheral nerve repair after injury
Rapidly undergoes myelin degeneration, within 24 hours new axonal sprouts from the central stump are observed, nerve gap less than 3 mm, and the most important factor for repair is the maintenance of the neurotubules
How much of skeletal tissue is cortical bone and cancellous bone?
80% cortical- compact bone, hard
20% cancellous- spongy bone, surrounded by cortical
What is the reparative phase of a bone fracture?
When the soft callus seen on x rays around 2 weeks is eventually replaced by the hard callus
Tendinitis vs Tendinosis?
Tendinitis- inflammatory response
Tendinosis- a degenerative process with no inflammation but changed to collagen matrix
Where is it vascular and not vascular in meniscus and significance?
Outer 1/3 of meniscus is vascular meaning more effective healing
Inner 2/3 of meniscus not vascular meaning not effective healing
What are some issues with disc degenration?
dehydration and loss of shock absorption capability due to aging
