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BioMed S2 R > 19. Pharmacology - Intro > Flashcards

19. Pharmacology - Intro Flashcards

1
Q

Characteristics of allopathic therapies

A 
Treats symptoms
Symptom care
Suppresses symptoms
Toxic
Invasive
Adverse effects/aggravations can be severe and permanent
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2
Q

Examples of allopathic therapies

A 
Drugs
Surgery
X-rays
Radiation
Chemicals
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3
Q

Characteristics of natural therapies

A 
Treats whole person
Patient care
Corrects vital force of body
Non-toxic
Non-invasive
Aggravations/healing crisis (not life threatening)
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4
Q

Examples of natural therapies

A 
Nutrition
Herbs
Essences
Oils
Physical therapies
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5
Q

What is suppression?

A

Disappearance of an illness without having healed it

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6
Q

What can suppression cause?

A

The disease to go deeper into the body
It can reappear in another form
Adverse effects
Reoccurrence

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7
Q

Examples of suppressive treatments

A 
NSAIDs
Steroids
Analgesics
Anti-hypertensive medication
Chemo
Radiation
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8
Q

Classifications of drugs

A 
Anti-microbial
Anti-inflammatory
Analgesic
Anti-convulsant
Anti-cancer
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9
Q

Naming conventions for drugs

A

Proprietary/Brand/Trade name e.g. Anadin, Nurofen
Generic name e.g. paracetamol
Chemical name e.g. N-acetyl-para-aminophenol

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10
Q

What is indication?

A

Approved uses of disease for which the drug has been proved effective

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11
Q

What is contraindication?

A

Circumstances under which the drug shouldn’t be taken

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12
Q

Should aspirin be taken by asthmatics?

A

No

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13
Q

What is ‘adverse effects’?

A

Additional effect on the body even at the recommended dose e.g. drowsiness

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14
Q

If a patient is experiencing adverse effects from a drug, what should you do?

A

Refer back to GP

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15
Q

Classifications of adverse effects

A

Predictable

Unpredictable

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16
Q

What are predictable adverse effects?

A

Exaggerated physiological effect

Toxicity

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17
Q

What are unpredictable adverse effects?

A

Allergy

Idiosyncratic reaction

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18
Q

Adverse effects of statins

A 
Reduced CoQ10 levels leading to:
Muscle pain
Liver dysfunction
Renal failure
Cataracts
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19
Q

What is CoQ10?

A

Powerful antioxidant found in mitochondria

More concentrated in cells that are more active

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20
Q

Examples of hypersensitivity adverse effects

A

Penicillin - nausea, vomiting, pruritus, hives

Local anaesthetics

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21
Q

What is an idiosyncratic reaction?

A

Reaction to a substance specific to the sufferer

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22
Q

What can cause an idiosyncratic reaction?

A

Enzymopathy

Disturbance in enzyme function

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23
Q

Example of idiosyncratic reaction

A

Excessive excitement in children after taking a sedative drug

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24
Q

Categories of drug interactions

A

Synergism

Antagonism

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25
Q

What is synergism?

A

Effect of drug increased

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26
Q

Examples of drug synergism

A

Painkiller combination

Some supplements e.g. fish oils and anti-coagulation medication

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27
Q

What is antagonism?

A

Effect of drug decreased

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28
Q

Examples of drug antagonism

A

Vitamin K counteracts anti-coagulants

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29
Q

What is an iatrogenic effect?

A

Induced by physician/practitioner

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30
Q

Why can some interactions between orthodox medications be fatal?

A

Some medications block liver/intestine enzyme pathways
Some affect liver detoxification
Facilitates an iatrogenic overdose

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31
Q

Why can grapefruit juice significantly alter drug levels in the body?

A

Inhibits enzyme CYP 3A4 in intestinal wall

Leads to excessive quantity of the drug

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32
Q

What does enzyme CYP 3A4 do?

A

Breaks down/metabolises hundreds of medications

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33
Q

Which drugs can be affected by grapefruit juice?

A

Statins
HRT/OCP
Anti-retrovirals
Calcium channel blockers

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34
Q

How long can the inhibition of CYP3A4 last?

A

Up to 24 hours

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35
Q

What impact does the lasting effects of grapefruit juice on CYP3A4 have?

A

Can’t separate grapefruit and drugs

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36
Q

Why can the consumption of alcohol significantly interact with drugs?

A

Alcohol can inhibit a drug’s metabolism by competing with the drug for the same set of metabolising enzymes

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37
Q

What can long-term alcohol ingestion have on drug interaction?

A

May activate drug metabolising enzymes, therefore decreasing the drug’s availability
Diminishes the drug’s effects

Can also transform some drugs into toxic chemicals that can damage the liver/other organs

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38
Q

What effects can alcohol have on sedative/narcotic drugs?

A

Magnify the inhibitory effects of the drugs in the brain

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39
Q

What effects can alcohol have on slow-releasing drugs?

A

Can force them to release faster - resulting in overdose

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40
Q

Can some herbs interact with drugs?

A

Yes

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41
Q

Example of St John’s Wort interacting with drugs

A

St John’s Wort reduces the effectiveness of anti-retroviral drugs for HIV

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42
Q

Examples of liquorice interacting with drugs

A

Digoxin - can increase adverse effects by lowering potassium levels

Interferes with ACE inhibitors and diuretics

Contraceptives - can elevate blood pressure and lower potassium

May effect breakdown of drugs in the liver

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43
Q

Examples of senna interacting with drugs

A

Can increase adverse effects of digoxin

Can cause diarrhoea if taken in high doses

Can increase the effect of warfarin

May cause dependence if taken long-term

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44
Q

What is pharmacokinetics?

A

How drugs are absorbed and moved around the body

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45
Q

What does pharmacokinetics comprise of?

A

Absorption
Distribution
Metabolism
Excretion

46
Q

What is pharmacodynamics?

A

How drugs exert their effects e.g. block receptors

47
Q

What factors should be considered when administering a drug?

A 
Cost
Patient compliance
Bioavailability
Speed of effects
Safety
Food interactions
Ability to absorb
Whether it bypasses the liver
48
Q

In what ways can drugs be administered?

A 
Orally
Sublingually
Injection
Inhalation
Topically
49
Q

Types of oral drugs

A

Tablets
Capsules
Liquids

50
Q

Where are oral drugs absorbed?

A

Stomach

Intestines

51
Q

What does the bioavailability of oral drugs depend on?

A

Release of the active form
Destruction in the gut
Absorption
Loss of active form via the first pass

52
Q

Types of sublingual drugs

A

Nitro-glycerine (GTN)
B12
Homeopathy

53
Q

What is the benefit of sublingual drugs?

A

Avoids first pass effect in the liver, so avoids becoming deactivated

54
Q

Categories of drug injections

A

Intradermal
Subcutaneous
Intramuscular
Intravenous

55
Q

Examples of drug injections

A

Insulin into adipose tissue

B12

56
Q

Examples of inhalation drugs

A

Bronchodilators
Anaesthetics
Essential oils

57
Q

What do topical drugs need to be to able to penetrate the skin?

A

Lipid soluble

58
Q

Examples of topical drugs

A

Nicotine patch
Oestradiol HRT patch
Steroid creams for psoriasis/eczema

59
Q

Where do suppositories/pessaries go?

A

Rectum

Vagina

60
Q

What can suppositories/pessaries be used for?

A

Haemorrhoids

61
Q

What is an enema?

A

Procedure using gas or water to extract/clean

62
Q

Which circulatory systems do drugs enter?

A

Blood

Lymphatic

63
Q

Why do lipid-soluble substances cross cell membranes easily?

A

Due to the phospholipid bilayer

64
Q

What barriers are in the body to inhibit the movement of drugs?

A

Placenta

BBB

65
Q

Why can the BBB make treating pathologies of the nervous system difficult?

A

Drug can work in the general circulation but can’t cross into the brain

66
Q

Which substances can cross the BBB?

A

Very lipophilic substances

Substances actively transported

67
Q

Why should care with medications be taken during pregnancy?

A

The placenta is much less effective than the BBB at keeping medications out

68
Q

What is dosage?

A

The amount of drug required to produce the desired effect

69
Q

How is dosage calculated?

A

To ensure a therapeutic concentration is maintained for the time period required

70
Q

How is dosage usually expressed?

A

By a weight/measure and by time e.g. 2x BD, 3x TDS

71
Q

What are dosage parameters?

A

Weight
Age
Sex
How eliminated and rate

72
Q

What is dosage frequency based on?

A

Absorption
Transport
Half-life

73
Q

What factors can influence patient compliance?

A

Feels better
Forgetting
Inconvenience

74
Q

What can taking a drug too frequently or at a higher dose lead to?

A

Toxicity

75
Q

What is the compliance rate for a once a day dosage regime?

A

95%

76
Q

What is the compliance rate for a twice a day dosage regime?

A

76%

77
Q

What is the compliance rate for a three times a day dosage regime?

A

75%

78
Q

What is the compliance rate for a four times a day dosage regime?

A

58%

79
Q

What is ‘half-life’?

A

Time it takes for a drug’s concentration in the body to fall by half

80
Q

What does half-life reflect?

A

The rate of elimination

81
Q

How does a long half-life affect dosage?

A

Take less often

82
Q

Types of dosing regimes

A

Toxic dosing
Sub-optimal dosing
Therapeutic dosing

83
Q

What is toxic dosing?

A

Drug given too frequently or at too high a dose

84
Q

What is sub-optimal dosing?

A

Drug given too infrequently or at too low a dose

85
Q

What is therapeutic dosing?

A

A dosing regime that maintains drug concentration within the therapeutic range

86
Q

What is a loading dose?

A

A larger dose given initially, followed by smaller maintenance doses

87
Q

What is the benefit of a loading dose?

A

Allows the drug to rapidly reach therapeutic levels

88
Q

When can a loading dose be done?

A

When there are no adverse effects from taking a larger dose

89
Q

What can affect drug absorption?

A 
Large or small molecules
Lipid soluble vs water soluble
Acid vs alkaline
Chemically reactive vs chemically inert/stable
Gut health
Digestive function
Foods ingested
90
Q

Characteristics of lipid soluble drugs

A

Get quicker into the cell

91
Q

Characteristics of water soluble drugs

A

Repelled so slower getting into the cell

92
Q

Characteristics of acid and alkaline drugs

A

Best absorbed in an environment that matches the drug type

e.g. aspirin is acidic and is absorbed in the stomach (which is also acidic)

93
Q

What happens to the metabolism of synthetic drugs?

A

Body won’t have a natural mechanism to remove it

It may be metabolised to render it inactive

94
Q

Which enzyme system becomes active with exposure to certain drugs?

A

CYP450

95
Q

Where do CYP450 enzymes exist?

A

Intestines

Liver

96
Q

Why are some drug metabolites toxic?

A

Products formed during metabolism can be hepatotoxic and deplete the liver of its natural antioxidant (glutathione)

97
Q

Why can’t some drugs be taken orally?

A

They are metabolised so quickly by the liver

98
Q

Where does most drug excretion take place?

A

Kidneys

Intestines

99
Q

How do the kidneys excrete drugs?

A

Glomerular filtration

Tubular secretion

100
Q

How do the intestines excrete drugs?

A

Bile

101
Q

What can also assist in drug excretion?

A

Lungs

Skin

102
Q

What are the main modes of action for drugs?

A

Specific
General
Placebo

103
Q

What is a specific mode of action?

A

Chemical structure is paramount

104
Q

What is a general mode of action?

A

Physical and chemical properties are important

105
Q

Examples of general modes of action?

A

General anaesthetics blocking impulses in neurons

Antacids neutralising stomach acid

106
Q

What does the effectiveness of a placebo depend on?

A

Patient having belief in the remedy/practitioner, confidence from their consultation and the form of remedy

107
Q

What are agonist drugs?

A

Bind to receptors and stimulate increased activity

108
Q

Example of an agonist drug

A

Blue inhaler

109
Q

What are antagonist drugs?

A

Drugs that bind to receptors and block the natural chemical from attaching and sending its message

110
Q

Example of an antagonist drug

A

Betablockers

BioMed S2 R (34 decks)

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