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Pharmacology
Week 1 - 6
Question | Answer |
---|---|
What is pharmacology? | The study of drugs. |
What are side effects? | The minor unintended negative effects. More annoying than anything. |
What are adverse effects? | The serious unintended negative effects. Severity requires changes in drug or dosage. |
What are toxic effects? | Very serious/harmful/deadly effects. Implies drug poisoning. Treatment has to be stopped and intervention may be required. |
What are drugs? | Any substance that, when administered to living tissues, produces a change in function. |
What are the majors subdivisions of pharmacology? | 1. Pharmacodynamic 2. Pharmacokinetic 3. Pharmacotherapeutic 4. Pharmacy 5. Posology 6. Toxicology |
What is pharmacokinetic? | The study of the process of drug absorption, distribution, metabolism and excretion. ADME |
What is pharmacodynamic? | The study of the action of drugs on living organisms. |
What is pharmacotherapeutic? | The study of the use of drugs to treat diseases. |
What is pharmacy? | The science of dispensing and preparing medecines. |
Whats is posology? | The study of the amount of drugs that is required to produce therapeutic effects. |
What is toxicology? | The study of the harmful effects of drugs on living organisms. |
What are drug sources? | When they started, drugs were obtained from plants and animal sources. Now, they are derived from those sources, chemically manufactured or products of genetic modifications. |
What is an indication? | The therapeutic use of a drug. |
What is a contraindication? | A situation when a drug should NOT be used. |
What is a therapeutic effect? | The intended beneficial effect |
What is a site of action? | The location in the body where the drugs acts.Known for most but still unknown for a few. |
What is a mechanism of action? | How a drug produces its effect at a molecular level. |
What is a receptor site? | A specific chemical structure on a cell where the drug interacts with the cell. |
What are agonists? | Drugs that induce an action when bound to the receptor site. |
What are antigonists? | Drugs that inhibit agonist drugs or cellular function when bound to the receptor site. |
What is competitive antagonism? | 2 drugs administered together target the same receptor site. They compete for the receptors, the one that gets the most wins! |
What is uncompetitive antagonism? | Drugs interfere with each other without targeting the same receptor site. |
LD 50 VS ED 50 | Dosage where 50% people got the lethal dose (died) VS where 50% people got effective dose (responded). |
What is the therapeutic index (window)? | Dosage where a drug has max therapeutic effects and min negative effect ratio. |
What are the 3 major naming systems? | 1. Chemical name 2. Nonproprietary name : generic 3. Proprietary name: brand |
Prescription VS nonprescription drugs | Prescription drugs have to be prescribed by a doctor. Nonprescription drug are available over the counter. |
What are the 4 types of drug preparation? | 1. Acqueous 2. Solid 3. Semi solid 4. Alcoholic |
What are the 4 routes of drug administration? | 1. Oral 2. Parenteral 3. Skin 4. Lungs |
What are the 4 oral routes of drug administration? | 1. Sublingual 2. Buccal 3. Rectal 4. Digestive tract |
What are 3 parenteral routes of drug administration? | 1. Intravenous 2. Intramuscular 3. Subcutaneous |
What are the 4 drug processes involved in pharmacokinetics? | A-D-M-E |
What is the most common source of drugs? | Plants |
List effects in increasing order of concern. | side-adverse-toxic |
What kind of drugs are classified Schedule I? | Drugs w/ high abuse potential and no accepted medical use. |
What kind of drugs are classified Schedule II? | Drugs w/ high abuse potential and accepted medical use. |
What kind of drugs are classified Schedule III? | Drugs w/ moderate abuse potential and accepted medical use. |
What kind of drugs are classified Schedule IV? | Drugs w/ low abuse potential and accepted medical use. |
What kind of drugs are classified Schedule V? | Drugs w/ limited abuse potential and accepted medical use. |
What chemical property do most drugs have? | Water solubility |
An ionized drug means that the drug is... | charged |
What type of compound crosses membranes easiest? | Lipids |
What is the first-pass effect? | The blood flowing from the GI tract through the liver before going to any other organs. |
What protein carriers are found in the blood? | Albumin and Globulins |
Where do biotransformation primarily occur? | In the liver |
Where do acidic drugs get absorbed? | In acidic conditions. e.g. stomach |
Where do basic drugs get absorbed? | In basic conditions. e.g. GI tract |
What is the primary excretory organ for drugs? | The kidney |
Do liquid or solid drugs get absorbed the fastest? | Liquids |
Where do drugs go after they are absorbed? | In the bloodstream |
Name a high blood flow organ | The liver |
Name a low blood flow organ | Adipose tissue |
What stops most of the drug from getting to the brain? | Additional lipid membrane between blood and brain cells. |
What does the blood brain barrier blocks? | Electrolytes and water soluble compounds. |
What does the blood brain barrier allow through? | Lipid-soluble compounds. e.g. Morphine and Heroine. |
What are hepatocytes? | Liver cells |
What is he major cause in the reduction of drug bioavailability? | First-pass metabolism. |
What are 2 phenomenon that can change biotransformation? | 1. Enzyme induction (CYP) 2. Enzyme inhibition (CYP) |
What are the 4 routes of drug excretion? | 1. Renal 2. GI tract 3. Respiratory 4. Misc. (minor) [sweat, saliva, milk] |
What is the most important route of drug excretion? | Renal |
How does GI tract excretion work? | Oral drugs are never entirely excreted. They travel in a loop in the enterohepatic pathway. (liver-bile-intestine-liver) |
What is a half-life? | The time required for the plasma concentration of a drug to decrease to 50% of its original level. |
What does the half-life depend on? | A-D-M-E |
What is bioavailability? | The percentage of drug administered that makes it into the blood stream. |
What can affect bioavailability? (5) | 1. Coating 2. Particle size 3. Carrier molecules 4. Fillers 5. Individual variation |
What are factors of individual variation? | 1. Age 2. Weight 3. Sex/Percent body fat 4. Genetic variation 5. Emotional state 6. Placebo effect 7. Disease 8. Patient compliance |
What is drug tolerance? | Decreased drug effect that occur after repeated administration. |
What is drug dependence? | Reliance on the administration of a particular drug becomes extremely important to the well-being of an individual. |
What is drug addiction? | When drug dependence is severe and compulsive drug behavior dominates all other activities. |
What is drug incompatibility? | Physical alterations of drugs before administration when drugs are mixed in the same syringe or container. |
What are additive effects? | When combined effect of 2 drugs producing the same biological response by the same mechanism of action is equal to the sum of their individual effects. |
What is drug summation? | When combined effect of 2 drugs producing the same biological response by a different mechanism of action is equal to the sum of their individual effects. |
What is drug synergism? | When the combined effect of 2 drugs is greater than the sum of their individual effects. |
What is drug antagonism? | When the combined effect of 2 drugs is less than the sum of their individual effects. |
What are 2 types of dependence? | 1. Psychological (unpleasant) 2. Physical (withdrawal symptoms) |
What are 2 types of tolerance? | 1. Metabolic tolerance : Enzyme induction 2. Parmacodynamic tolerance : Reduction in drug receptor expression |
What are the 2 divisions of the Nervous system? | 1. Peripheral NS 2. Central NS |
What is included in the central NS? | The brain and the spine. |
What are the 2 divisions of the peripheral NS? | 1. Somatic NS 2. Autonomic NS |
What are the 2 divisions of the autonomic NS? | 1. Sympathetic NS 2. Parasympathetic NS |
What reaction is associated with the Sympathetic NS? | Fight-Or-Flight |
What reaction is associated with the Parasympathetic NS? | Rest and Recovery |
What does the parasympathetic NS rely on? | Acetylcholine and muscarinic receptor |
An increase in sympathetic tone would cause? (6) | 1. ˅ digestion 2. ˄ pupil diameter 3. ˄ breathing 4. ˄ heart rate 5. ˄ blood pressure 6. ˅ blood flow |
What does the sympathetic NS rely on? | Nor-epinephrine and adrenergic receptor |
An increase in parasympathetic tone would cause? (6) | 1. ˄ digestion 2. ˅ pupil diameter 3. ˅ breathing 4. ˅ heart rate 5. ˅ blood pressure 6. ˄ blood flow |
What is a bundle of nerve connection? | Ganglion |
Alpha-adrenergic drug use would increase GI motility. (T or F) | False |
A selective beta-1 adrenergic receptor blocker should increase bronchodilation. (T or F) | False |
Anticholonergics have similar effects as reversible ACE inhibitors. (T or F) | False |
Direct acting cholinergics activate nicotinic muscarinic receptors. (T or F) | True |
What are 2 cholinergic receptors? | Nicotinic and muscarinic |
What are the 2 types of nicotinic receptors? | Muscle and nerve. |
What are the 2 types of adrenergic receptors? | Alpha and beta |
What is the difference between sedative and hypnotic effects of a sedative-hypnotic drug? | The dosage |
What is the order of sleep aides in order of increasing effects? | Misc. - BDZ - Barbiturate |
REM sleep is entered from which stage? | Stage 1 |
Which stage is usually lengthened by sleep aides? | Stage 2 |
Which drugs interact with Chlorine channels? (3) | 1. BDZ 2. Alcohol 3. Barbiturates |
Is anxiety always unhealthy? | NO |
What drug should you use if you have trouble sleeping? | Sonata |
What is reduced with antipsychotics? | Serotonin and dopamine |
What is the role of the limbic region of the brain? | Regulates emotions |
What are the four areas of the CNS that Benzodiazepine affect? | 1. Limbic system 2. Reticular formation 3. Cerebral cortex 4. Spinal cord |
What do adrenergic alpha-1 regulate? | Contraction of smooth muscle |
What do adrenergic alpha-2 regulate? | -ve feedback |
What do adrenergic beta-1 regulate? | Increase force of heart concentration and heart rate. |
What do adrenergic beta-2 regulate? | Relaxation of smooth muscle |
What is drug idiosyncrasy? | Individual unusual response to a drug |
What are drug allergy? | Individual genetic response to a drug. |
What is the difference between afferent and efferent nerves? | Afferent nerves receive and transfer the signal while efferent acts upon the signal. |
Differentiate cholinergic and adrenergic receptors. | Colinergic receptor are for the parasympathetic NS while adrenergic is for the sympathetic NS. Cholinergic binds to ACH and adrenergic binds to NE or E. |
From what area of the CNS does the parasympathetic NS originate? | The brain and spinal cord. |
From what area of the CNs does the sympathetic NS originate? | Thoracic and lumbar spinal nerves. |
Explain "dual autonomic innervation". | Each organ is connect to nerves from the parasympathetic NS and the sympathetic NS. |
What property of smooth muscle allows them to contract on their own? | Autorhythmicity. |
What condition activates a fight-or-flight reaction? | A frighteneing or emergency situation. |
Where do autonomic nerve conduct their nerve impulse? | To visceral organs. |
Where do somatic nerves send their nerve impulse? | To skeletal muscles. |
What nerves are part of the parasympathetic division? | Cranial and Sacral |
What nerves are part of the sympathetic division? | Thoracic and lumbar |
What drugs block or decrease sympathetic NS activity? | Sympatholitic |
What drug acts at the neural endings to reduce the formation or release of NE? | Adrenergic neural blockers |
What receptor mediates smooth muscle contraction? | Alpha-1 receptors. |
What adrenergic receptorsare located on either the heart or smooth muscle? | Beta receptors. |
What drug blocks both beta-1 and beta-2 effects of EPI? | Non selective beta blockers. |
What drug blocks the alpha effects of NE and EPI? | Alpha blockers |
What is the chemical classification of NE and EPI? | Catecholamine. |
What is an adrenergic drug or effect that increase the sympathetic NS activity? | Sympathomimetic |
What hormone is released from the adrenal medulla that stimulates the sympathetic NS? | EPI |
Describe the difference between the effect of NE and EPI. | NE contracts smooth muscles and EPI relaxes smooth muscles. |
What receptors does EPI stimulate? | Alpha and beta |
What is the drug of choice to treat acute allergic reactions? | EPI |
What receptors does NE stimulate? | Alpha-1 |
What is the function oc acetylcholinesterase? | It breaks down ACH. |
Where is acetulcholinesterase found? | In the area of cholinergic receptors. |
Where are the 3 cholinergic receptors located and what drug blocks them? | 1. Muscarinic : postganglionic nerve endings - anticholinergic 2. Nicotinic-muscle : NMJ of skeletal muscle - NM-blockers or muscle relaxants 3. Nicotinic-nerve : Ganglionic sites (PSNS-SNS) - Ganglionic blockers |
Explain direct-acting cholinergic drugs. | Binds to muscarinic receptors and acts like ACH but for a longer period than ACH. |
Explain indirect-acting cholinergic drugs. | Inhibits acetylcholinestearse and allows accumulation of ACH. |
What are 2 types of indirect-acting cholinergic drugs? | Reversible and irreversible inhibitors. |
What is a potential adverse effect of cholinergic drugs? | Excessive stimulation. |
What is a potential adverse effect of anticholinergic drugs? | Excessive blockage. |
What parasympathetic receptors are located on the membranes of internal organs? | Muscarinic receptors. |
What are depolarizing blockers? | They inhibit muscle contraction by binding to Nm receptor and depolarizing so ACH can't stimulate it. |
What are nondepolarizing blockers? | They bind to Nm receptors but don't stimulate it. act as antagonist to ACH. |
What are peripheral skeletal muscle relaxants? | Inhibits muscle contraction at NMJ by blocking Nm receptors. |
What are centrally acting skeletal muscle relaxants? | Block conduction in the spinal cord and brain. |
What is Nervemuscular junction? | Where nerve connects to muscle. |
What are 2 types of peripheral skeletal muscle relaxants? | Depolarizing and nondepolarizing. |
what is fasiculation? | Twitching of muscle fiber group. |
What is hyperthermia? | Drastic increase in temperature. |
What is vagolytic action? | Inhibition of vagus nerve to the heart, causes increase in heart rate. |
What is a vasodilator? | relaxes sphincters linding to increase in blood flow. |
What is the major toxicity associated w/ NM-blockers and what is the antidote? | Paralysis of respiratory muscle. Neostigmine or edrophonium. |
Explain how Dantrolene works. | Dantrolene inhibits muscle contraction by blocking calcium release in the muscle cells |
When are centrally acting skeletal muscle relaxant used? | situations where spinal cord has been damaged or for surgical procedures. |
what are spasmotytics? | Drugs that can inhibit or interrupt painful intermittent muscle contractions. |
What is a thin membrane enclosing a striated, skeletal muscle fiber? | sarcolemma |
What is the space around the brain and spinal cord that contains the cerebrospinal fluid called? | Intrathecal |
What is myelin? | The fatty sub. that covers and protects nerves and allows efficient conduction of action potential down the axon. |
Synonym to potentiates? | Synergy |
What is the difference between local and general anesthetics? | A general anesthetic depresses response to the CNS while local affects nerve conduction which can be specific to limited area of the body. |
What is an exagerated response to a local anesthetic? | hypersensitivity. |
What is placing a drug on the surface of the skin or a mucous membrane? | Topical application |
What is an injection of a local anaesthetic into the subarachnoid space? | spinal anesthesia |
What is an injection of a local anaesthetic into the extradural space? | Epidural anesthesia |
What is an injection of a local anaesthetic into the caudal or subcaudal cnal? | Caudal anesthesia |
What is an injection of a local anaesthetic directly into the tissue? | Infiltration anesthesia |
What is an injection of a local anaesthetic under the skin? | intradermal anesthesia |
How do local anesthetics block the response to pain. | Blocks nerve fiber conduction by inhibiting sodium ions from crossing the membrane. This inhibits sensory nerves that carry pain. |
Why are local anesthetics valuable? | Because they block sensory nerves without inhibiting motor nerve functions. |
Which nerves are first affected by local anesthetics? | Sensory and autonomic nerves. |
Which nerves are last affected by local anesthetics? | Motor nerves. |
What are 2 classes of local anesthetics? | Ester and amide. |
What is the difference between ester and amide local anesthetics? | Esters have a short or moderate duration of action because they are metabolized by enzymes in the blood or skin. Amides have longer duration of action because they are metabolized in the liver. |
What body system is mostly affected by systemic absorbtion of a local anesthetic? | Blood vessel, heart and brain. |
Name an ester local anesthetic. | Procaine |
Name an amide local anesthetic. | Lidocaine |
Name a combination of ester and amide local anesthetic. | TAC |
What is special about cocaine? | It induces vasoconstriction. |
What are signs of CNS toxicity from local anesthetic injection? (4) | Restlessness, blurred vision, slurred speech and dizziness. |
What are 2 centrally acting skeletal muscle relaxants? | valium and robaxin |
Name an alpha-blocker. | Flomax |
Name a nonselective beta-blocker. | Propanolol |
Name a selective beta-1 blocker. | Bisoprolol |
Name an alpha-agonists. | NE |
Name a beta-agonists. | Isoproterenol |
Name a beta-1 agonist. | Dobutamine |
Name a beta-2 agonist. | Ventolin |
What are the effects of adrenergic neural blockers? (3) | 1. Fake NE transmitter 2. Decrease NE storage 3. Decrease NE release. |
Name a adrenergic neural blocker | Reserpine, methyldopa |
What is automatism? | Drug induced confusion that can cause increased drug consumption. |
What are hyptnotics? | drugs used to induce and maintain sleep. |
What are sedative? | Drugs used to produce mental relaxation and to reduce the desire for physical activity. |
What are the 2 types of sleep? | REM and NREM |
Describe the NREM stages. | 1. Alpha waves, still aware, few min. 2. Theta waves, unaware, easily roused, 50% 3/4. Deep sleep, delta waves, physical rest, 25 % |
What is REM sleep? | Rapid Eye Mouvement sleep, dreaming, 25%, very hard to rouse, beta waves, mental restauration. |
What does GABA stands for? | Gamma-aminobutyric acid |
WHy do you take sedative-hypnotics? | To induce or maintain sleep. |
Explain BDZ. | they increase inhitory activity of GABA. |
Where do sonata and ambien bind? | BDZ subunit receptor. |
What is special about ethanol? | It has no half-life. It is not concentration dependent. |
What is akathisia? | Continuous body mouvement in which an individual is restless. |
What is dystonic reaction? | Reaction characterized by muscle spasms, twutching, facial grimacing or toticollis. |
What is EPS? | Mouvement disorder. |
What is tardive dyskinesia? | Drug-induced involuntary mouvements of the lips, jaw, tongue and extremities. |
What are the 2 receptors antagonists of antipsychotics? | Dopamine and serotonin. |
wHat are the 3 types of depressions? | 1. Reactive depression 2. MDD - Major depressive disorder 3. Bipolar mood disorder. |
What is the monoamine theory of mental depression? | Depression is caused by low levels of serotonin and Ne. |
What is a seizure? | abnormal electrical discharge of neuron resultin in unvoluntary mouvement. |
What is epilepsy? | Comdition involving recurrent seizures caused by an underlying neuron activity issue. |
What are the types of seizure? | Tonic (cont. all), Clonic (cont.-rel), tonic-clonic, myoclonic (clonic 1 area), atonic (loss tone), absence (unconscience) |