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BDS2 diseases of human systems > Clinical pharmacology > Flashcards

Clinical pharmacology Flashcards

1
Q

what is a drug?

A

external substance that acts on living tissue to produce a measurable change in the function of that tissue

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2
Q

give 3 types of drugs used in dentistry

A

analgesics - reduce post op pain
local anaesthetics - prevent pain
antimicrobials - prevent infection
anxiolytics - reduce anxiety

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3
Q

which messages communicate to ALL tissues?

A

hormonal

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4
Q

which messages give targeted information for specific tissues?

A

neural

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5
Q

what drug can replace missing T3 and T4?

A

thyroxine

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6
Q

how does the sympathetic nervous system affect heart rate?

A

increases HR via beta receptors

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7
Q

how does the parasympathetic nervous system affect heart rate?

A

decreases heart rate via cholinergic receptors

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8
Q

what nervous system causes release of adrenaline?

A

autonomic sympathetic

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9
Q

what nervous system causes release of acetylcholine?

A

autonomic parasympathetic

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10
Q

give an example of a beta agonist drug

A

adrenaline

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11
Q

give an example of a beta blocker drug

A

atenolol

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12
Q

give an example of a cholinergic agonist drug

A

pilocarpine

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13
Q

give an example of a cholinergic blocker drug

A

atropine

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14
Q

give 3 possible drug hazards

A
  • drug interactions
  • acute toxic reaction
  • anaphylaxis/allergy to drug
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15
Q

what drugs should be avoided if on warfarin and/or aspirin?

A

NSAIDs

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16
Q

how long is a prescription valid for?

A

6 months

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17
Q

give examples of some prescribing errors

A
  • the decision to prescribe
  • wrong drug
  • incorrectly completing prescription
  • dose
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18
Q

what are the 4 main modes of drug action?

A
  • activation or blocking of receptors
  • activating or blocking enzyme function
  • facilitating or blocking transport systems
  • opening or blocking transport systems
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19
Q

what determines the response to drug-receptor interaction?

A
  • the affinity of the drug binding to the receptor

- the occupancy of the drug

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20
Q

describe how an agonist works

A

binds to receptor and activates it to produce natural response

21
Q

describe how a partial agonist works

A

the drug/receptor effect is more difficult to produce than with an agonist

22
Q

describe how an antagonist works

A

they bind to the receptor and do not activate them

  • competitive or non-competitive
  • reversible antagonists effect can be reduced by increasing agonist concentration
  • irreversible antagonist binds and reduces available receptors for agonist
23
Q

how can drugs change enzyme action?

A
  • competitive substrate antagonism

- non-competitive substrate inhibition

24
Q

give a drug that affects ion channels

A

local anaesthetic

25
Q

what are pharmacokinetics?

A

what the drug does to the body

26
Q

what are pharmacodynamics?

A

what the body does to the drug

27
Q

what are disadvantages of oral administration?

A
  • first pass metabolism
  • GI disease can reduce surface area for absorption
  • gastric acid can destroy drug
  • food can interact
28
Q

where does first pass metabolism take place?

A

liver

29
Q

where does GI tract blood drain to?

A

hepatic portal vein which drains to the liver

30
Q

what is first pass metabolism?

A
  • liver metabolises drug and the drug only reaches systemic circulation after passing through the liver
  • FPM can activate or inactivate the drug
31
Q

where can the drug directly enter the systemic circulation?

A

rectal and sublingual veins

32
Q

why is glyceryl tri-nitrate administered sublingually?

A

FPM inactivates the GTN and very little enters systemic circulation. giving sublingually bypasses hepatic portal system

33
Q

what is the effect of liver disease on drug metabolism?

A

reduced metabolism will lead to drug accumulation and toxicity

34
Q

give an example of a drug activated by FPM

A

valaciclovir produces aciclover in liver so less doses are needed than aciclover

35
Q

advantages of intravenous and intramuscular

A

no drug lost as no FPM

rapid onset

36
Q

disadvantages of intravenous and intramuscular

A

severe allergic reactions
high cost
short duration of action

37
Q

transdermal and subcutaneous advantages

A

no FPM

prolonged action

38
Q

transdermal and subcutaneous disadvantages

A

slow onset due to low blood flow

39
Q

what is bioavailability?

A

the proportion of an injected drug available for clinical effect

40
Q

what may affect bioavailability?

A 
route of administration
dosage
food in gut
poor absorption
FPM
41
Q

how does blood flow affect drug distribution?

A

drug is distributed pending on blood flow, tissues with the highest blood flow receive highest level of drug

42
Q

how are drugs distributed?

A

drug dissolves in blood and is transported bound to plasma protein carriers such as albumin

43
Q

what is the most common drug metabolism pathway?

A

p450 mono-oxygenate system

44
Q

describe the 2 main reactions of drug metabolism

A

phase 1 changes the drug - oxidation, hydrolysis, reduction

phase 2 - conjugation e.g. sulphation, methylation

45
Q

what can cause issues with excretion of drugs?

A
  • renal disease will affect renal blood flow and therefore renal ability to excrete drugs - reduce dose
  • liver disease can lead to liver failure, reduce doses
46
Q

what is the plasma half life of a drug?

A

the time taken to eliminate half the drug

47
Q

what does it mean if a drug follows first order kinetics?

A

drug metabolism increases as drug concentration increases

excretion by passive diffusion only

48
Q

what does it mean if a drug follows zero order kinetics?

A

drug metabolism is at a fixed rate, not affected by drug concentration
can lead to accumulation if saturation exceeded

BDS2 diseases of human systems (19 decks)

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