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NU 600
Exam 2 - Cultural Environmental and Genetic Influences on Drug Therapy
| Question | Answer |
|---|---|
| What are some undesirable side effects that accompany the use of anesthetics? | Apnea, bradycardia, hypotension, increased ICP |
| Propofol induces what two undesirable side effects? | Apnea, hypotension |
| What two IV induction agents increase ICP? | Succinylcholine, ketamine |
| What is ethnopharmacology (aka ethnic pharmacology)? | The study of ethnic groups and their use of drugs |
| What types of diseases has skunk cabbage been used to treat? | Asthma, respiratory and nervous disorders, rheumatism, dropsy |
| Skunk cabbage has been used to stimulate the removal of ____________ in asthma. | Phlegm |
| Skunk cabbage was successfully used by what native American tribe(s)? | Winnebago, Dakota |
| The ______________ has a tea made from its leaves that alleviates bronchial and other respiratory problems. | Creosote bush |
| What type of root can be boiled in order to remedy pneumonia? | Pleurisy root |
| Besides being used as a remedy for bronchitis, what other ailments has it been used for in ethnic pharmacology? | Pneumonia, expulsion of phlegm |
| What function does the wormwood leaf have when its leaves are boiled? | Curative for bronchitis |
| What group of native Americans used the wormwood leaf for bronchitis? | Yokia Indians |
| Bronchitis has been treated with what 4 plants? | Creosote bush, pleurisy root, wormwood, skunk cabbage |
| What are two ethnic pharmaceuticals used to speed childbirth? | Partridgeberry (leaves) and blue cohosh (root) |
| The role of genetics and pharmacology is recorded as far back as the _____________. | Early 1800s |
| What type of enzyme is plasma cholinesterase and how is its activity in the body determined? | Non-CYP450, genetically |
| What does pharmacogenomics study? | How a person's genome or genetic code affects their response to pharmacologic agents |
| What is a xenobiotic? | A chemical substance that creates an effect on the body |
| What are the two body responses to xenobiotics? | Elimination or accomodation |
| What system mediates the majority of drug metabolism in the body? | CYP450 |
| How many CYP450 enzymes are responsible for the majority of drug breakdown? | 50 |
| What is responsible for giving each enzyme a certain construction? | genetic code |
| In what two ways can CYP enzyme activity be altered? | Via stimulation or inhibition |
| What vitamin alters the metabolism of warfarin in the body? | Vitamin K |
| What are 4 herbal plants that prolong bleeding time? | Garlic, ginger, ginseng, gingko |
| What are phytochemicals? | Naturally occurring plant compounds that provide a variety of organoleptic (experienced by the senses) properties |
| What are two beneficial effects of phytochemicals? | Anti-oxidant, anti-inflammatory |
| What types of vegetables are known to have phytochemicals? | Cruciferous, pumpkins, carrots, and tomatoes |
| Give 3 examples of cruciferous vegetables. | Broccoli, brussel sprouts, cauliflower |
| How do cruciferous vegetables affect enzymatic activity? | Induces CYP1A2, increasing the rate of Phase I metabolism |
| How do grapefruits interfere with drug metabolism? | Inhibits intestinal P450 activity |
| What are three medications that are affected by the consumption of grapefruit? | Felodipine, midazolam, erythryomycin |
| How do solanaceous glycoalkaloids alter drug metabolism? | Inhibits acetylcholinesterase and plasma cholinesterase |
| What are three food sources that contain solanaceous glycoalkaloids? | Potatoes, tomatoes, eggplants |
| What are types of medications affected by the presence of solanaceous glycoalkaloids in the body? | Esmolol, ester local anesthetics, succinylcholine |
| What demographic has the highest rate of alcohol consumption? | White males 18-44 |
| Acute alcohol consumption can result in changes in _______________. | Sensorium |
| What are effects to the sensorium that are caused by acute alcohol consumption? | Psychomotor impairments, vomiting, delayed gastric emptying, inability to make rational decisions |
| How does alcohol affect the metabolism of other drugs and why? | Increases sensitivity to other drugs due to the additive depressant effects |
| What two physiological processes lead to altered drug distribution and metabolism from ETOH use? | Hypoalbuminemia and impaired blood flow |
| The effects of NMBDs is [shortened/prolonged] due to the influence of alcohol. | Prolonged |
| How does alcohol influence the dosing of induction agents? (i.e. propofol, phenobarbital, opioids, inhaled anesthetics) | Alcohol causes CYP induction and therefore increased amounts of induction agents to achieve a therapeutic effect |
| Besides altering enzyme function how else do CYP enzymes affect the body? | Plays a role in some diseases, producing toxic metabolites in some instances |
| A hepatotoxic effect can occur as a result of toxic metabolites from the degradation of what two medications? | Acetaminophen and halothane |
| What types of particulate components and gaseous compounds do cigarettes contain? | Benzene, polyphenols, arsenic, carbon monoxide, polycyclic aromatic hydrocarbons |
| Besides toxic effects in the lungs, tobacco also influences what other metabolic system? | Enzymes of the CYP450 system |
| What element in cigarettes causes enzyme induction and is thought to contributing to the potential development of certain cancers? | Aromatic hydrocarbons |
| What post-op effect occurs more often in smokers? | PONV |
| The enzyme induction effect of smoking affects that two types of medications in anesthesia? | NMBDs and opioids |
| What is the name of the chemical compounds in plants that influence CYP450 enzymes? | phytochemicals |
| Approximately how many genes does a human contain? | 30,000 |
| What is the name for a complete instructional gene map? | Genome |
| What are genes composed of? | Molecules of DNA arranged in a double helix |
| What type of bond is responsible for providing the double helix structure of DNA? | Hydrogen |
| What are the four nitrogenous bases that pair together to form DNA helices? | Adenine, thymine, cytosine, guanine |
| Name each nitrogenous base and what it pairs with. | Adenine pairs with thymine, cytosine pairs with guanine |
| How many DNA base pairs does the human genome have? | Over 3 billion |
| The DNA sequence is comprised of the combination of __________________. | Base pairs |
| How is DNA stored? | In package units called chromosomes |
| How many sets of chromosomes do humans contain? | 23 sets (total of 46 chromosomes) |
| How are chromosomes subdivided? | 44 autosomes and 2 sex chromosomes |
| Any chromosome that is not a sex chromosome is called a/an ____________________. | autosome |
| What is the representation of the male and female chromosomal pairs? | XX=F, XY=M |
| DNA mutations are a result of _____________. | Genotypic variation |
| What role do mutations have in biology? | Serve as a form of adaptation |
| What is a single nucleotide polymorphism and what does it lead to? | It is a substitution or replacement of a nucleotide for another and results in individual differences in drug responses |
| Single nucleotide polymorphism results in changes in _____________ and _____________. | Pharmacokinetics and pharmacodynamics |
| True/False: Some ethnic groups have higher polymorphisms than others. | True |
| How can polymorphism affect enzyme activity? | May result in greater, reduced, or no enzyme activity |
| How does the presence of red hair affect MAC concentration? | People with red hair have been shown to require higher concentrations of MAC for anesthesia |
| What affects drug distribution and metabolism in chronic alcoholism? | Hypoalbuminemia and impaired blood flow through the liver (ex. duration of NMB may be prolonged) |
| How do CYP enzymes contribute to some disease processes? | Can lead to toxic metabolites (seen with metabolites of APAP and halothane) |
| 1a2 | metabolizes caffeine, zofran, theophylline, affected by cruciferous vegetables |
| Which CYP enzyme metabolizes caffeine, zofran, and theophylline? | P1A2 |
| What genetic mutation in red-haired individuals increase MAC concentration? | Mutation in the melanocortin-1 receptor gene |
| blue for boys, berries for girls | |
| How does elevated levels of K affect clotting time? | Prolongs clotting time |
| What 3 drugs does CYP3A4 breakdown? | Decadron, fentanyl, oxycodone |
| What was the first plant used in the U.S. pharmacopeia? | Skunk cabbage |
| What two drugs can increase ICP? | Ketamine and succinylcholine |
| Which CYP enzyme metabolizes alcohol? | 2E1 |
| What products does CYP1A2 metabolize? | Caffeine, Zofran, theophylline |
| Which CYP enzyme breaks down caffeine, Zofran, and theophylline? | P1A2 |
| What does CYP1A2 metabolize? | caffeine, zofran, and theophylline |
| Which CYP enzyme breaks down decadron, fentanyl, and oxycodone? | P3A4 |
| What does CYP3A4 break down? | decadron, fentanyl, and oxycodone |
| What vegetable affects CYP1A2 activity and how does it affect it? | Cruciferous vegetables. Causes enzyme induction of CYP1A2 |
| Which CYP enzyme breaks down alcohol? | P2E1 |
| What does CYP2E1 break down? | alcohol |
| Which Native American plant has been used to treat pneumonia and phlegm expulsion? | Pleurisy root |
| The boiled leaves of which plant aids in childbirth? | Partridgeberry |
| What plant is prepared in warm water in order to promote rapid delivery in pregnancy? | Blue cohosh |
| What was the first Native American plant to be featured in the U.S. Pharmacopoeia and when was it included? | Skunk cabbage, featured in the U.S. Pharmacopoeia from 1880-1882 |
| What diseases are effectively treated with skunk cabbage? | Respiratory and nervous disorders, rheumatism, dropsy |
| What two native American plants are used to treat bronchitis? | creosote bush, wormwood |
| What native American plant was used for pneumonia and found to promote phlegm expulsion? | Pleurisy root |
| What two plants were used in the weeks preceding childbirth to facilitate a rapid delivery? Which was prepared boiled and which was prepared in warm water? | Partridgeberry and blue cohosh. Partridgeberry=boiled, blue cohosh=warm water |
| What are two medications that can increase ICP? | Ketamine, succinylcholine |
| What determines the amount of plasma cholinesterase in an individual? | Genetics |
Created by:
philip.truong
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