Exam 1 Flashcards
1
Q
Definition of Pharmacology
A
Study of introducing chemical agent into a living system (Origin, Chemistry & Effects of a drug)
2
Q
Definition of Pharmacodynamics
A
Effects of drug on living system
3
Q
Definition ofPharmacokinetics
A
How the body response to a drug (4 aspects)
1) Absorption
2) Distribution
3) metabolism
4) Elimination
4
Q
Definition of Prodrug
A
Drug that’s INACTIVE when you take it
5
Q
B1 is in the…
A
Heart
6
Q
B2 is in the…
A
Non vascular smooth muscle (causes it to relax)
7
Q
Definition of Pharmacotherapeutics
A
Use of drugs to Dx, Tx or prevent disease
8
Q
Definition of Toxicology
A
Study of Poisons
9
Q
Definition of Pharmacognosy
A
Study of drugs in crude form (original source/plant-based)
10
Q
Definition of Drug vs. Medication
A
Drug: ONE chemical agent
Med: ONE OR MORE chemical agents
11
Q
Definition of Synergism
A
1+1=21 (sum of 2 or more agents is greater than sum of individual effects) “enhancing”
12
Q
Definition of Antagonism
A
Blocks effect of agonist
13
Q
Example of Antagonism
A
Naloxone Tx for Heroin overdose
14
Q
Definition of Hypperactivity
A
Response greater than anticipated to a given dose
15
Q
Definition of Tolerance
A
Prolapsed exposure to liver causes enzyme induction (liver increases enzyme to inactivate the drug)
16
Q
Definition of Tachyphylaxis
A
Form of tolerance that only occurs after 2-3 doses
17
Q
Definition of Adverse reaction
A
Reaction that warrants DC of the drug
18
Q
Definition of Habituation
A
Psychological Dependance
19
Q
Definition of Addiction
A
Physical Dependance
20
Q
Definition of Bioavailability
A
What % of dose really makes it to the target tissue
21
Q
Definition of First-Pass Effect
A
Effect the liver, stomach, intestines has on drug
Liver is MC to break down
22
Q
What is the most effective way to deliver a drug?
A
IV so it bypasses the Liver
23
Q
Definition of Proprietary
A
Owns the Name of the Drug (BRAND NAME)
(ADVIL)
24
Q
Definition of Non-Proprietary
A
Same drug but under a different name (WALGREEN”S BRAND)
25
Patient-Related Factors that influence Drug Safety & Effectiveness (10)
1) Weight (mg/kg)
2) Age (young & old)
3) Sex
4) Physiological
5) Pathological
6) Nutrition
7) Allergy-Hypersensitivity Reaction
8) Enzyme Induction
9) Hormonal Factors
10) Pt. Compliance
26
Definition of Dyscrasias
Abnormal Blood Work
27
Do side effects affect Compliance?
YES
28
What are Concomitant drugs?
Taking 2 or more drugs at the same time
29
Most Thearapeutic bonds are…
IONIC
30
What are ionic therapeutic bonds?
Weak, easily digested, used and excreted
31
What is a covalent therapeutic bond?
IRREVERSIBLE/not wanted
Indy’s to heavy metals and pulls it out of the tissue
32
What type of curve is the Dose-Response Curve?
Logarithmic Curve
33
Definition of Potency
How much your taking (DOSE)
34
Definition of Slope
Steeper the slope, less of the drug you have to take to get the same effect
35
Definition of Maximal efficacy
Effect (variability)
36
Definition of Median Effective Dose (ED50)
Dose at which 50% of population will get the maximum effect
37
Definition of Median Lethal dose (LD50)
Dose at which 50% of population will die if they take that dose
38
Definition of Theurpeutic Index
[LD50 / ED50]
Higher TI -> less likely to kill you
39
Example of Competitive drug
Atropine for nerve gas
40
MC route for absorption
Simple Passive diffusion
41
MC route for absorption in GI tract
ORAL (1st order kinetics)
42
Inhalation is the…
2nd Most Effective way to absorb (B2 receptors)
43
Parenteral Administration most effective route
IV
44
Definition of Zero-Order Kinetics
Drug absorbption that proceeds at a constant rate
(Can give all @ once or push w/ an IV)
45
Definition of First-Order Kinetics
Absorption that proceeds @ a changing rate but is always proportional to the amount absorbed (take 500mg and after 1 hour have 250mg left)
46
Definition of Drug Metabolism
Converting pharmacologically inactive drug into metabolites
47
Example of a Prodrug
Theophylline for Asthma
48
Definition of Phase I of Biotransformation
Inactivation of a drug to diminish its overall effect
49
Example of Phase I Biotransformation
1) Hydrolysis
2) Oxidation
3) Reduction
50
Definition of Phase II Biotransformation
To convert lipid sable into water soluble
51
Examples of Phase II Biotransformation
1) Glucuronide Formation
2) Acetylation
3) Sulfate Conjugation
4) Methylation
52
Example of Glucunoride Formation
Unconjugated Bilirubin -> Glucunoride Formation -> H20 soluble (Conjugated)
53
Major pathway of drug excretion:
Renal Excretion
54
2nd MC pathway of Excretion:
Biliary Excretion
55
Oral Meds are what order kinetics?
1st
56
IV Meds are what order kinetics?
Zero
57
What does Elixir mean?
Med has a % of alcohol in it
58
1 teaspoon =
5mL or 5 cc’s
59
1 Tablespoon =
3 teaspoons, 15mL or 15 cc’s
60
1 ounce =
2 Tablespoons, 6 teaspoons or 30 cc’s
61
3 major functions of the Autonomic NS
1) heart
2) Secratory function
3) contraction/Relaxation of Smooth muscle
62
3 Major elements of the Autonomic NS
1) Afferent Limb
2) Central Intergrated Elements
3) Efferent Limb
63
What does the Afferent limb of the Autonomic NS do?
Carries sensory from peripheral to spinal cord (GVA)
64
What does the Central Integrated Element of the Autonomic NS do?
Info is processed to Hypothalamus/Lower brain
65
What does the Efferent limb of the Autonomic NS do?
Carrie motor to neuroeffector tissues (GVE)
66
What receptors are located in the Parasympathetic NS?
ALL Cholinergic (ACh)
67
What receptors are located in the Sympathetic NS?
Mostly Noradrenergic (norepinephrine)
68
Parasympathetic vs. Sympathetic Effects on the Heart:
P: Slow down
S: Speed up
69
Parasympathetic vs. Sympathetic Effects on the Sexual Organs:
P: Arousal
S: Orgasm
70
Primary neurotransmitter of the Cholinergic System is _________ and it is released from the ____________.
ACh; PREsynaptic & POSTsynaptic Axon terminal
71
Cholinoceptors (2)
1) Muscarinic (autonomic NS)
2) Nicotinic
72
Edinburg Westphal Nucleus: CN & Function
3; smooth eye muscle
73
Superior Salivatory Nucleus: CN & Function
7; Lacrimal glands & Salivary Glands (except parotid)
74
Inferior Salivatory Nucleus: CN & Function
9; Parotid Gland
75
Dorsal Motor Nucleus of the Vagus Nerve: CN & Function
10; Thoracic & Abdominal Viscera
76
Basic functions of the Parasympathetic NS
1) dec. Heart rate
2) inc. GI secretions
3) miosis
4) Near vision accommodation
5) defecation
6) Emptying Bladder
7) Bronchial smooth Muscle contraction
77
Enzyme for ACh:
Acetylcholinesterase
78
Type 2 Nicotinic receptors are located
In all autonomic NS ganglia & the Adrenal Medulla
79
Stimulation of Type 2 Nicotinic receptors results in the release of…
1) ACh (parasympathetic)
2) norepinephrine (sympathetic)
3) epinephrine (adrenal medulla)
80
Type 1 Nicotinic receptors are located
At NMJ of somatic muscles
81
Function of Type 1 Nicotinic receptors
Skeletal Muscle Contraction
82
Muscarinic Receptors are located in
All parasympathetic target organs
83
Function of Muscarinic Receptors
1) Near vision (ciliary muscles)
2) Miosis (iris sphincter
3) Dec. heart rate
4) contract Bronchi
5) GI secretion
6) Sweating
7) Penile erection
8) Vasodilation
84
2 sites where drugs can act in the autonomic NS
1) Synapse between Pre & Post ganglionic neurons
2) Junctions between post ganglionic & effector organ
85
Definition of Direct Stimulation Neurotransmitter
Drugs mimic same effect as ACh or Norepinephrine
86
Definition of Indirect Neurotransmitter Stimulation
Drugs given that inactivate an enzyme (ACh-nerve gas)
87
Definition of Block Receptor Neurotransmitter
Drugs that compete for same receptor site
88
Lytic means:
Blocking the effect
89
Origin & where they exit (Preganglionic neurons in the Sympathetic NS)
Lateral horn of Thoracolumbar spinal cord (T1-L2)
GVE fibers exit through ventral Root via white rami
90
White Rami ______ and Gray Rami ________
Exit SC; Enter SC
91
Basic function of sympathetic NS
1) inc. heart rate & force
2) BronchoDilation
3) Mydriasis
4) Sweating
5) Smooth muscle of blood vessels
6) Dec. GI motility
92
Adrenergic neurotransmitters that affect the Somatic NS
[Synthesized from Tyrosine]
- Norepinephrine
- epinephrine
- amino acids
93
Receptors of the Sympathetic NS:
Cholinergic
94
Norepinephrine is released from
POSTganglionic axons of Adrenal Medulla
95
Epinephrine is released from:
Adrenal Medulla
96
Norepinephrine and Epinephrine are broken down by:
80% is re-uptake into PREsynaptic neuron terminus
97
Norepinephrine and Epinephrine are inactivated by __________ in the Neuron Terminus.
MAO (MonoAmine Oxidase)
98
Norepinephrine and Epinephrine that are left in the Synaptic Cleft are inactivated by
COMT (Catechol-O-Methyl Transferase)
99
Alpha-1 Sympathetic are what type of Receptorr?
Adrenergic
100
Alpha-1 Receptor Bodily Reactions
Eye: contract radial muscles or iris
Arterioles: Constrict
Veins: Constrict
Sex Organs: Ejaculation
Bladder, Neck & Prostate: Constrict
101
Alpha 2 Receptor Site
PREsynaptic nerve terminal
102
Alpha 2 Function
Inhibit Neurotransmitter release
103
Beta 1 Bodily Reactions
Heart: inc. rate, force & AV conduction velocity
Kidney: Release Renin
104
Beta 2 Bodily Reactions
Arterioles: Dilation, heart, lungs, skeletal muscle
Bronchi: Dilation
Uterus: Relaxation
Liver: Glycogenolysis
105
Dopamine Effect on Kidney:
Dilation of Renal Vasculature
106
5 Neurotransmitters that bind to Autonomic Receptors:
1) Nitric Oxide
2) GABA
3) ATP
4) Neuropeptide Y
5) Vasoactive Intestinal peptide (VIP)
107
Main pharmacological Target organs in Clinical Medicine are…
- Gut
- Heart
- Lungs
- Blood Vessels
108
Sympathetic Muscarinic Receptors are located on:
- Eccrine Sweat Glands
- Blood vessels in Skeletal Muscle
109
Sympathetic Nicotinic Receptors are located on:
- Cells of Adrenal Medulla
- POSTganglionic neuron cell bodies & Dendrites
110
3 ways to Manipulate the Adrenergic System using Sympathomimetic-Adrenomimetic processes:
1) Sympathomimetic drugs as agonists (direct)
2) Inhibit uptake (Indirect)
3) Inhibit MAO (Indirect)
111
3 ways to Manipulate the Adrenergic System using Sympatholytic processes:
1) Dec. Norepinephrine Release
2) Block Adrenergic Recpetors (Alpha/Beta Blockers)
3) Stimulating Alpha 2 Receptors
112
Definition of Cholinomimetic:
Mimic the effect of ACh
113
Cholinomimetic Muscarinic Agonists (3) Examples
Bethenechol
Pilocarpine
Muscarine
114
Bethanechol is used for
- Relieving Constipation
- Paralytic Ileus
- Urinary Retention
115
Pilocarpine is used for:
- Treating Glaucoma
- Increase Aqueous Outflow
116
Muscarine is gathered from
Certain toxic Mushrooms
117
Adverse effects of Direct Acting Cholinomimetic’s
- Diaphoresis
- hypotension/bradycardia
- inc. salivation & gastric acid
- abdominal cramps & diarrhea
- exacerbation of asthma
118
Reversible Cholinesterase Inhibitors (Indirect Acting Cholinomimetic’s)
- Neostigmine
- Physostigmine
- Edrophonium
119
Neostigmine is used for
Treating Myasthenia Gravis
120
Physostigmine is used as a
Cholinergic agent
121
Edrophonium is used for
Diagnosing Myasthenia Gravis
122
Adverse Effects of Indirect Acting Cholinomimetic’s
- Miosis/blurred vision
- inc. salvation, lacrimation, GI & respiratory secretions
- abdominal cramps & diarrhea
- diaphoresis
- bradycardia
- neuromuscular blockade & paralysis
123
Muscarinic Antagonists are found in
Smooth Muscle & Cardiac Muscle
124
Function of Atropine
Blocks Muscarinic Receptors (ANTAGONIST)
125
Where is Atropine located?
POSTganglionic & POSTsynaptic site
126
Bodily Reactions from Atropine:
- inc. heart rate
- mydriasis
- Dec. secretions
- Dec. tone of urinary and respiratory tracts
127
Higher doses of Atropine can cause
Hallucinations & Delirium
128
Parasympatholytic Muscarinic Antagonist: (e.g.)
Atropine
129
Adverse Effects of Muscarinic Antagonists:
- Xerostomia
- Blurred Vision/Photophobia
- inc. Intraocular pressure
- urinary retention
- constipation
- anhydrosis
- tachycardia
- exacerbates asthma
130
Definition of Adrenomimetic Drugs
Mimic effects of norepinephrine or epinephrine
131
Amphetamines inhibit the re-uptake of
norepinephrine (cocaine, adderall)
132
Tricyclic Antidepressants inhibit
MAO
133
Indirect Acting Adrenomimetic Drugs promote the release of
Norepinephrine; Ephedrine
134
What is the MC cause of drug induced psychosis
Methamphetamine
135
What does methamphetamine do to the body?
1) promotes adrenergic release
2) creates hyper adrenergic state
136
Direct Acting Adrenomimetic Alpha 1 Agonists
Phenylephrine & Epinephrine
137
Direct Acting Adrenomimetic Alpha 1 Agonists Functions
Vasoconstrict & Dilate pupil
138
Direct Acting Adrenomimetic Alpha 1 Agonists Therapeutic Uses:
- Homeostasis
- Nasal Decongestion
- local anesthetic
- elevate BP
- Dilate Pupil (Mydriatics)
139
Direct Acting Adrenomimetic Alpha 1 Agonists Adverse Effects:
- Hypertention
- Localized necrosis
- Reflex Braycardia
- urinary retention in BPH patients
140
Direct Acting Adrenomimetic Beta 1 Agonists
Isoproterenol & Epinephrine
141
Direct Acting Adrenomimetic Beta 1 Agonists Therapeutic Uses:
Cardiac Arrest (initiate contraction)
Shock (positive ianotropic and chronotropic effects)
142
Direct Acting Adrenomimetic Beta 1 Agonists Adverse effects
Angina pectoris & Tachycardia
143
Direct Acting Adrenomimetic Beta 2 Agonists
Isoproterenol, Epinephrine & Terbutaline
144
Direct Acting Adrenomimetic Beta 2 Agonists Therapeutic uses
Asthma: Bronchodilator
Delay Preterm labor (Relaxes Uterus)
145
Direct Acting Adrenomimetic Beta 2 Agonists Adverse effects
Hyperglycemia
146
Direct Acting Adrenomimetic Multiple Receptor Activation is Used for
Tx of Anaphalactic Shock
147
Problems with Direct Acting Adrenomimetic Multiple Receptor Activation
- Hypotension
- Glottis Edema
- Bronchoconstriction
148
Indirect Acting Adrenomimetic Drugs
Tricyclic Antidepressants, MAO inhibitors & Ephedrine
149
What is special about Ephedrine?
It’s a mixed-acting agent causing Norepinephrine release and activation of alpha and beta receptors directly
150
Indirect Acting Adrenomimetic Drugs Therapeutic Uses
- Nasal Congestion
- Asthma
- Narcolepsy
151
Indirect Acting Adrenomimetic Drugs Adverse Effects
Hypertension & Angina
152
Alpha 1 Adrenergic Antagonists:
Prazosin
Phentolamine
Phenoxybenzamine
153
Alpha 1 Adrenergic Antagonists Function
Vasodilation
154
Alpha 1 Adrenergic Antagonists Therapeutic uses:
- Essential Hypertension
- Benign Prostatic Hyperplasia (Dec. Smooth muscle tone)
- Pheochromocytoma
155
Alpha 1 Adrenergic Antagonists Adverse effects
- Orthostatic hypertension
- Reflex tachycardia
- Nasal congestion
- Inhibition of ejaculation
156
Beta 1 Adrenergic Antagonists:
Propranolol (Inderal)
Metoprolol (Lopressor)
Tim o lol
157
Beta 1 Adrenergic Antagonists Bodily Reactions
- Dec. heart rate & force
- dec. conduction velocity
158
Beta 1 Adrenergic Antagonists Therapeutic uses
- hypertention
- angina pectoris
- hyperthyroidism
- stage fright
- glaucoma
- migraine’s
159
Beta Adrenergic Receptor Antagonists Adverse Reactions
- bradycardia
- Dec. cardiac output
- bronchoconstriction
- insomnia
- depression
- Dec. libido
160
Botulism Toxin prevents release of
ACh
161
Nicotine promote release of
Neurotransmitters from POSTganglionic neurons
162
Ephedrine, Amphetamines and Tyramine promote release of
Norepinephrine
163
AChase is inhibited by
Physostigmine
Organophosphate
Carbamates
164
Clonidine is a __________ antagonist used to treat ______________.
Alpha 2; Hypertension
165
MC Neurotransmitter in the CNS & PNS
Norepinephrine
166
Excitatory vs. Inhibitory: Norepinephrine
Excitatory
167
Excitatory vs. Inhibitory: Serotonin
Excitatory
168
Excitatory vs. Inhibitory: Dopamine
Inhibitory
169
Excitatory vs. Inhibitory: GABA
Inhibitory to the CNS
170
What processes are Affected by: Norepinephrine
- Sleep/Wake
- Learning & Memory
- Mood
171
What processes are Affected by: Serotonin
- Sleep/Wake
- Pain perception
- depression
- Sexual Activity
- Aggressive Behavior
172
Dopamine Is found in:
Substantial Nigra
Caudate Nucleus
173
Serotonin Is found in:
Hypothalamus
Limbic System
Brain Stem
174
Norepinephrine Is found in:
Pons
Neurons of Reticular Formation
175
What neurotransmitters are derived from Tyrosine?
Norepinephrine
Dopamine
176
What neurotransmitter is derived from Tryptophan?
Serotonin
177
What does GABA do to the nerve?
Enhances Cl- ions; decreasing Firing
178
Excitatory vs. Inhibitory: Glycine
Inhibitory
179
Excitatory vs. inhibitory: Glutamine Acid
Excitatory (classified as a stimulant))
180
3 things that exaggerate neurotransmitter effect by increasing the neurotransmitter at the synapse
1) Inc. rate of synthesis & release (amphetamines)
2) Dec. enzyme breakdown (cocaine)
3) Prolong the time in the synapse (atropine)
181
4 things that decrease the overall effect of a neurotransmitter
1) Dec. synthesis or release
2) inc. rate of enzyme breakdown
3) inc. pre-synaptic uptake
4) block post-synaptic receptor sites
182
Analeptic Stimulants: MOA
Inhibits GABA
183
Analeptic Stimulants: Example
Doxapram
184
Analeptic Stimulants: Clinical Use
- Doxopram stimulates respiration in pt’s w/ barbiturate overdose
- Post-anesthetic pt’s
- Neonatal RDS
185
Psychomotor Stimulants: MOA
Inc. norepinephrine release from pre-synaptic neurons
186
Psychomotor Stimulants: Examples
Methylphenidate (Ritalin)
Adderall
187
Psychomotor Stimulants: Clinical Use
Hyperkinesis (ADD)
Obesity
Narcolepsy
188
Psychomotor Stimulants: Acute Effects
Euphoria
Dizziness
Tremor
Irritability
Insomnia
Tachycardia
Arrhythmias
189
Methylxanthines: MOA
Dec. chloride conductance
Dec. adenosine activity at post-synaptic sites
190
Methylxanthines: Examples
Caffeine
191
Methylxanthines: Clinical use
BronchoDilation
Tx of CNS depressant overdose
Fatigue
Headaches
192
Endogenous Definition
Struggle to get out of bed in the morning even though things in your life are perfect
193
Exogenous definition
You had a bad weekend and are depressed
194
Example’s of SSRI’s
Fluoxetine (Prozac) 1/2 life = 24 hours
195
SSRI’s: MOA
Block re-uptake of serotonin
196
SSRI’s Clinical Indications/Usage
Treats OCD & Clinical Depression
197
SSRI’s: Side Effects
- Nausea
- Weight loss/Decreased Appetite
- Serotonin Syndrome: Jitters, Elevated core temp
198
Tricyclics: Examples
Amitriptyline (Elavil) - Prototype
**Prodrug (inactive when taken)
199
1st drug to be approved for children
Imipramine
200
Tricyclics: MOA
Block re-uptake of Norepinephrine, increasing levels of norepinephrine
201
Tricyclics: Clinical Use
Clinical Depression
202
Tricyclics: Adverse Reactions
Sedation, Dry-Mouth
Weight gain
Suicidal ideation
203
MonoAmine Oxidase Inhibitors: Examples
[Dangerous-use as last resort]
Phenelzine (Nardil)
204
MonoAmine Oxidase Inhibitors: MOA
Blocks enzymatic breakdown of norepinephrine in the BRAIN (90%) & Gut (10%)
W/O MAO -> Hypertensive crisis
205
MonoAmine Oxidase Inhibitors: Clinical Use
Clinical Depression
206
MonoAmine Oxidase Inhibitors: Side Effects
Have to be on Tyramine diet or else Hypertensive Crisis
207
Bupropion effect on the body
Suppresses Nicotine fits
Can lower seizure threshold
208
Anti manic Agents function
minimize the highs of a manic phase
209
Antimanic: examples
Lithium Salts
210
Antimanic Agents: MOA
Only treats manic phase; need another drug for depressive low
211
Anxiolytic Agents: MC Classification
Minor tranquilizers (treat psychosis)
212
Anxiolytic Agents: Example
Benzodiazepines (Diazepam) (Valium)
213
Anxiolytic Agents: MOA
Stimulates GABA (more negatively charged00
214
Anxiolytic Agents: Clinical Use
Anxiety
Panic Attacks
215
Anxiolytic Agents: Side Effects
Stronger Potency
216
Sedative-Hypnotic Agents: MC Classification
Insomnia
217
Drug therapy for Imsomnia
Benzodiazepines (taking sleeping pills ruins REM sleep causing rebound insomnia)
218
Sedative-Hypnotic Agents: MOA
Enhance GABA activity in the brain
