Intro to Pharm

Question 1

A dose-response curve is an example of?

Answer 1

Pharmacodynamics

“drugs on body”

Question 2

What is the most dangerous schedule of drugs w/ no recognized medicinal use?

exs: heroin, marijuana

Answer 2

Schedule I

Question 3

Drugs in this schedule have high abuse potential but accepted medicinal use

exs: oxycodone, adderall

Answer 3

Schedule II

Question 4

Drugs in this schedule have high (but less than II) abuse potential, but accepted medicial use

exs: vicodin, ketamine, testosterone

Answer 4

Schedule III

Question 5

Drugs in this schedule have lower abuse potential + accepted medicinal use

exs: xanax, soma, valium, ambien, Robitussin AC, lyrica

Answer 5

Schedule IV + V

Question 6

In this phase of clinical testing researchers test an experimental drug/treatment in a small group of people (20-80) for 1st time to evaluate safety

“clinical pharmacology”

Answer 6

Phase I

Question 7

In this phase of clinical testing, experimental tx given to a larger group (100-300) to see if its effective and to further evaluate its safety

“clinical investigations”

Answer 7

Phase II

Question 8

In this phase of clinical testing, tx given to larger groups (1,000-3,000) to confirm its effectiveness, monitor SEs, compare it to commonly used tx and collect info for it to be used safely

“clinical trials”

Answer 8

Phase III

Question 9

In this phase of clinical testing, postmarketing studies delineate add. info (risks/benefits/optimal use); phase never stops

“post marketing studies”

Answer 9

Phase IV

Question 10

Which is safer: a drug w/ a low or high TI?

Answer 10

High TI (TD1/ED1 = minimum toxic dose is large, minimum effective dose is small)

Question 11

What is a drug’s site of action?

Answer 11

Receptor

Question 12

Estrogen replacement is what type of drug action?

Answer 12

Replacement

Question 13

What type of drug action happens when anti-hypertensives interfere w/ vasoconstriction?

Answer 13

Interruption

Question 14

What type of drug action is a diuretic?

Answer 14

Potentiation

Question 15

What are drugs that combine w/ a receptor, activate it and produce the same response as an endogenous chemical or stimulate release of endogenous chemical?

Answer 15

Agonist

Question 16

The capacity of a single drug-receptor complex to evoke a response is known as?

Answer 16

Intrinsic activity

• Agonists have intrinic activity (affinity for a receptor + efficacy)

Question 17

What are drugs that combine w/ a receptor used by an endogenous chemical and block/diminish response of the endogenous agent?

Answer 17

Antagonists

Question 18

What are drugs the have affinity but low efficacy?

Answer 18

Partial agonists

Question 19

What is it called when agonists and antagonists compete for the same receptor site?

Answer 19

Competitive antagonism

Question 20

What is it called when agonist and antagonist bind at different sites on the same receptor?

Answer 20

Non-competitive antagonism

Question 21

If the dose of drug A is less than drug B to achieve the same response, what is drug A?

Answer 21

More potent

Question 22

What is the magnitude of the maximum effect called?

Answer 22

Efficacy

Question 23

What is rapid drug tolerance called?

Answer 23

Tachyphylaxis

Question 24

This type of hypersensitivity is an anaphylactic rxn mediated by IgE. Involves release of histamine, prostaglandins, and leukotrienes. Sx: urticaria, rash, vasodilation, hypotension, edema, inflamm, rhinitis, asthma, tachycardia. Ex: Penicillin

Answer 24

Type I

Question 25

This type of hypersensitivity rxn is a cytolytic rxn mediated by IgG and IgM. Affects cells of circulatory sx. Sx: hemolytic anemia, thrombocytopenia, granulocytopenia. These autoimmune rxns subside several months after drug discontinuation. Exs: quinidine, methyldopa

Answer 25

Type II

Question 26

This type of hypersensitivity rxn is an arthus rxn mediated by IgG. Immune complexes are deposited in vascular endothelium -\> serum sickness. Sx: erythema multiforme, arthritis, nephritis, CNS abnormalities, myocarditis, SLE, Steven-Johnson syndrome. Exs: sulfonamide abx

Answer 26

Type III

Question 27

This is a delayed hypersensitivity rxn mediated by T-lymphs and macrophages. When sensitized cells come in contact w/ antigen, lymphokines cause an inflamm rxn. Exs: poison ivy, abx, benzocaine

Answer 27

Type IV

Question 28

What is an unusual response to a drug called?

Answer 28

Idiosyncratic rxn

Question 29

What's important to do (especially with low TI meds) if TE is not observable?

Answer 29

Check blood/plasma levels (hyporeactive)

Question 30

Which drugs cross membranes more readily?

Answer 30

Lipophilic * Drugs are usually weakly acid or weakly basic -\> in some pH ranges charged, in others uncharged -\> uncharged form = lipid soluble

Question 31

Most drugs pass through membranes by this mechanism; diffuse down the concentration gradient.

Answer 31

Passive diffusion

Question 32

In this mechanism drugs pass w/ concentration gradient, but requires a carrier protein.

Answer 32

Facilitated diffusion

Question 33

In this mechanism drugs go against concentration gradient and requires ATP.

Answer 33

Active transport

Question 34

In this mechanism drugs move by formation and movement of vesicles (packages) across membranes and requires energy.

Answer 34

Pinocytosis

Question 35

Drugs that are well absorbed from the GI tract and are metabolized in liver, have decreased bioavailability as a result of this.

Answer 35

First-pass effect

Question 36

List these in order of solubility: tablets, capsules, suspensions, solutions

Answer 36

Solutions \> suspensions \> capsules \> tablets

Question 37

This type of administration is safest, easiest, cheapest; Absorption occurs in the 1st 3rd of SI, but some drugs can't be absorbed

Answer 37

PO

Question 38

This type of administration is used for very highly lipid soluble or potent drugs; bypasses harsh GI and avoids first-pass effect

Answer 38

SL

Question 39

This type of administration is only useful when oral is not possible; most drugs irritate this area's mucosa and their absorption is unpredictable/variable

Answer 39

Rectal (PR)

Question 40

This type of administration has no absorption phase, accurate, immediate, irreversible, must be aqueous.

Answer 40

IV

Question 41

This type of administration has a slower onset and longer duration than IV, absorption is delayed and is related to vascularity.

Answer 41

IM

Question 42

This type of administration has a slower onset and longer duration than IM b/c fat is less vascular than muscle.

Answer 42

SQ, SC

Question 43

This type of admin. has a local drug effect; Creams, lotions, etc.

Answer 43

Topical

Question 44

This type of admin. crosses skin and enters circulation for systemic effect.

Answer 44

Transdermal

Question 45

This type of amin. has very rapid onset, extremely large SA for absorption and good blood supply; Used mostly for a local effect.

Answer 45

Aerosols

Question 46

What is the partition between the 2 compartments dependent upon?

Answer 46

1. Lipid/protein content 2. pH 3. Osmotic pressure 4. Blood supply

Question 47

Drugs that are bound to anything (other than a receptor) are \_\_\_\_\_.

Answer 47

Inactive

Question 48

What is one of the most restrictive membranes and is highly lipophilic?

Answer 48

BBB

Question 49

What is a less restrictive membrane?

Answer 49

Placental barrier ASSUME ALL DRUGS WILL CROSS

Question 50

Where does metabolism of drugs primarily occur?

Answer 50

In liver (also in GI tract, lung, skin/kidneys)

Question 51

The goal of this phase of metabolism is to make a more polar/hydrophilic metabolite that can be excreted. It involves non-synthetic oxidation (CP450) reduction, hydrolysis.

Answer 51

Phase I

Question 52

If the metabolite created in phase I of metabolism is not sufficiently polar, what happens?

Answer 52

Phase 2: synthetic - conjugation (glucoronidation, sulfonation)

Question 53

This isoform of C450 is the most common in CYP-mediated metabolism (50%); its substrates are benzos, HIV drugs, Ca2+ channel blockers.

Answer 53

CYP3A4

Question 54

This isoform of C450 is the 2nd most common in CYP-mediated metabolism (30%); its substrates are psychotropics, codeine, beta-blockers, anti-arrhythmics. Also most studied polymorphism.

Answer 54

CYP2D6

Question 55

This isoform of C450 is the least common in CYP-mediated metabolism (10%); its substrates are phenytoin, warfarin, NSAIDs.

Answer 55

CYP2C9

Question 56

What effect do enzyme inhibitors have on bioavailability?

Answer 56

Increase

Question 57

What effect do enzyme inducers have on bioavailability?

Answer 57

Decrease

Question 58

A response to a drug is often linked to these DNA variations; variations in the human genome.

Answer 58

SNPs

Question 59

What does decreased alcohol/aldehyde dehydrogenase in Asians lead to?

Answer 59

Increase in cancer in URT

Question 60

What is associated with G6PD deficiency in 14% African Americans?

Answer 60

RBC hemolysis w/ sulfa drugs

Question 61

What do "slow acetylators" (common in middle east pop) have an increased risk for?

Answer 61

Higher INH levels, higher risk for ADRs (hepatitis, peripheral neuropathy) * "Fast acetylators" -\> lower INH levels -\> lower therapeutic efficacy (common in Japanese)

Question 62

Drugs are eliminated uncharged or as metabolites via what 3 routes?

Answer 62

1. Kidney 2. Feces 3. Breast milk

Question 63

More alkaline urine will increase excretion of \_\_\_\_\_\_; more acidic urine will increase excretion of \_\_\_\_\_\_\_.

Answer 63

Weak acid; weak base

Question 64

When rate of administration = clearance

Answer 64

Steady state

Question 65

How do you find the elimination half-life (time it takes for drug to be completely eliminated from sx)?

Answer 65

T1/2 x 5

Question 66

What is the drug interaction when combined effect \> sum?

Answer 66

Synergism

Question 67

What is the drug interaction when inactive drug increases effect of another?

Answer 67

Potentiation

Question 68

What is the drug interaction when one drug increases drug-metabolizing enzyme activity of another (decreasing bioavailability)?

Answer 68

Induction

Question 69

What is the drug interaction when one drug blocks another drug's metabolism/excretion?

Answer 69

Inhibition

Question 70

What is the drug interaction when one drug displaces another from protein binding site (increasing bioavailability)?

Answer 70

Unbinding

Question 71

Which categories of drugs are safe in pregnant women?

Answer 71

A - only one w/ human studies showing no risk B + C - animal studies show no risk, no human studies done

Question 72

Which categories of drugs aren't safe in pregnant females?

Answer 72

D - human studies show a risk X - absolutely don't use