Chapter 8 - Individual Variation in Drug Responses Flashcards Preview

Nu 578: Ch 4-19 Exam 1 > Chapter 8 - Individual Variation in Drug Responses > Flashcards

Flashcards in Chapter 8 - Individual Variation in Drug Responses Deck (30):
1

In the very young patient, heightened drug sensitivity is the result of

organ immaturity

2

in older adults, heightened sensitivity results largely from

decline in organ function

3

Recall that, because of pH partitioning, if there is a difference in pH on two sides of a membrane, a drug will accumulate on the side where

the pH most favors its ionization

4

if liver function declines, the rate of metabolism will

decline, causing drug levels to climb

5

Tachyphylaxis?

a reduction in drug responsiveness brought on by repeated dosing over a short time

6

The most serious toxicity of digoxin is production of

potentially fatal dysrhythmias

7

The tendency of digoxin to disturb cardiac rhythm is related to levels of

potassium

8

When potassium levels are low, the ability of digoxin to induce dysrhythmias

greatly increased

9

Pharmacodynamic tolerance is the result of

adaptive processes that occur in response to chronic receptor occupation.

10

How is metabolic tolerance brought about?

by the ability of certain drugs (eg, barbiturates) to induce synthesis of hepatic drug-metabolizing enzymes, thereby causing rates of drug metabolism to increase

11

Diarrhea can _____ absorption by accelerating transport of drugs through the intestine.

reduce

12

Pharmacogenomics

the study of how genetic variations can affect individual responses to drugs

13

What two drugs require genetic testing before use?

maraviroc [Selzentry] and trastuzumab [Herceptin

14

Variants in the gene that codes for cytochrome _____ can greatly reduce the benefits of tamoxifen [Soltamox, Nolvadex-Dimage], a drug used to prevent breast cancer recurrence

CYP2D6

15

Variants of the gene that codes for ______ can greatly reduce the benefits of clopidogrel [Plavix], a drug that prevents platelet aggregation

CYP2C19

16

About 1 in 14 people of European heritage have a form of ______ that is unable to convert codeine into morphine, the active form of codeine.

CYP2D6 --- As a result, codeine cannot relieve pain in these people.

17

Variants in the gene that codes for _______ can increase the risk of toxicity (bleeding) from warfarin [Coumadin], an anticoagulant with a narrow TI.

CYP2C9

18

Variants in the genes that code for the beta1-adrenergic receptor (ADRB1) produce receptors that are

hyperresponsive to activation

19

The most common mechanism by which genetic variants modify drug responses is by

altering drug metabolism

20

The most serious adverse effect of MAO inhibitors is ______ , which can be triggered by foods that contain

malignant hypertension ; tyramine, a breakdown product of the amino acid tyrosine. Accordingly, patients taking MAO inhibitors must rigidly avoid all tyramine-rich foods (eg, beef liver, ripe cheeses, yeast products, Chianti wine).

21

The most serious adverse effect of MAO inhibitors is ______ , which can be triggered by foods that contain_____

malignant hypertension ; tyramine, a breakdown product of the amino acid tyrosine. Accordingly, patients taking MAO inhibitors must rigidly avoid all tyramine-rich foods (eg, beef liver, ripe cheeses, yeast products, Chianti wine).

22

Kidney disease can _________ drug excretion

Reduce

23

If liver function declines, the rate o metabolism will _______

Decline, causing drug levels to climb

24

Recall that because of PH partitioning, if there is a difference in pH on two sides of a membrane, a drug will accumulate in the side where_____

The pH most favors ionization

25

The most serious toxicity of digoxin is production of______

Potentially fatal dysthymias

26

The tendency of digoxin to disturb cardiac rhythm is related to levels of

Potassium.

27

When potassium levels are low, the ability of digoxin to induce dysthymias ______

Greatly increases

28

Pharmacodynamic tolerance is the result of ________

Adaptive process that occur in response to chronic receptor occupation

29

Metabolic tolerance?

Tolerance resulting from accelerated drug metabolism.

30

The most common mechanism by which genetic variants modify drug response is by _____

Altering drug metabolism