pharmaceutics - biotech, NDDs II, research Flashcards

Question

DNA probe technology what is it used for what is a small piece of DNA used for what can we now locate and monitor and what can it lead to what can be easily performed what has it been used to identify what is the level of accuracy are the results easy to read

Answer 1

This technology is used to diagnose disease. Small piece of DNA is used to search a cell for viral infection or genetic defect, Cancer, infectious disease, genetic defects, gene susceptibility We can now locate and monitor disease causing-genes that can lead to development of gene replacement therapies Easy-to-perform moderately-complex DNA probe technology that takes about 45 minutes. Conclusive identification of Candida species, Gardnerella vaginalis and Trichomonas vaginalis from a single vaginal sample. Accuracy up to 30% higher than slide microscopy. Results are easy-to-read too. so DNA probe technology: use a small piece of DNA to search a cell for infection and can be used to locate and monitor a gene causing a disease!

Answer 2

A dose of erythropoietin lasts about a day, - but its effect is seen approximately 5 days later (when the red cell proliferation it has induced is mature enough for release into the circulation). Epoetin Alpha: - IV or subcutaneous administration - 50-100 IU/kg body weight 3 times per week - If >8 weeks of therapy the hematocrit has not increased to at least 5 to 6 points (below 30-33%) the dose is increased. - In April 1993, epoetin alfa (EPO) first entered the U.S. market as the only biopharmaceutical product approved by the FDA for the treatment of *CIA. - EPO is biologically indistinguishable from endogenous erythropoietin *CIA = Chemotherapy-Induced Anemia anemia because this a recombinanat DNA technology product that is used to stumultae the production of RBCs

Answer 3

“Monoclonal antibodies are purified antibodies produced by a single source of clone of cells. They are engineered to recognize and bind to a single specific antigen.” Examples: - Rituximab (Rituxan)- The first monoclonal antibody approved for the treatment of cancer in 1997. - Trastuzumab (Herceptin)-The second monoclonal antibody approved for the treatment of cancer in 1998. *what are they used for, what cancers* know for the exam *on final exam*

Answer 4

area 1 - right abdomen - leave about 2" on the right side of naval area 2 - right thigh - low area 3- left abdomen (leave about 2" on left side of navel) area 4- left thigh area 5- left arm (upper back portion) area 6- left buttock area 7- right arm (upper back portion) area 8- right buttock start and end with right side!

Answer 5

The office was established in 1989. Was created to serve as a central coordinating, problem-solving, and advisory role within the Office of the Commissioner. Effective point of contact with the FDA for those outside of the agency on issues related to new biotechnology The office is no longer in existence: - Replaced by six divisions relating to biotechnological products - Division of Monoclonal Antibodies created under the Centers for Biologics Evaluation and Research of the FDA, Office of Therapeutics Research and Review.

Answer 6

Pharmacist should instruct patients on parenteral administration Pharmacists should reinforce the printed information sheet *The first injection should be performed by a health care professional to assure patient comprehension and understanding of techniques* Some products (e.g., Betaseron) come with training videos demonstrating reconstitution and self-administration techniques Patients should be educated on how to prepare, give injections, and how to rotate injection sites Patients should be shown how to dispose of needles and syringes. The patient must understand that the product should not be agitated or shaken. Pharmacists must emphasize the need for compliance with dosage regimens. - For example, Betaseron is administered every other day. A calendar reminder system might be helpful for patients using medication.

Answer 7

biotech. product has live/living organisms - the organisms are still alive while more conventional pharmaceutics products have killed or attenuated organisms (such as biologics) or no organisms at all also Biotech companies research, develop, and market products derived from living organisms. The products of pharma companies tend to be derived from chemicals and artificial sources.

Answer 8

1 - cells are removed from the patient 2- the virus is altered so that it will not replicate/reproduce 3- A gene is inserted into the virus that codes for a protein that will help cure the genetic defect 4- the virus is mixed with the patient's cells 5- patient cells become genetically altered due to their exposure to the viral cells 6- cells are reinjected into the patient 7- the genetically altered cells produce the desired protein or hormone

Answer 9

make sure I use the right broth when growing and keeping the viral or human cells alive making sure that I am not intorudcing anything like phenol or heat that could kill the cells

Answer 10

Increased levels *Oncogenes *Growth factors/receptors *Nutrient importers *ABC transporters *Aerobic glycolysis *Interstitial fluid pressure *DNA repair *Detoxification enzymes - altar the structure of the drug to get eliminated faster Decreased levels *Tumor suppressors *Oxidative phosphorylation *pH - specifically the center; so very acidic! *Cell cycle regulation *Increased apoptosis looking for ways to overcome tumors being resistant to drugs

Answer 11

Drug efflux pumps altered apoptotic pathway, if Bcl-2 is altered then cells do not die and live on decrease drug uptake as a result of the drug efflux pumps altered drug targets altered DNA repair delivered to a specific tumor not only to get to the tumor but also to get absorbed etc Bcl-2

Answer 12

In this approach, a nano drug delivery system is loaded with a ferrofluid (attracted to an externally applied magnet) or drug and ferrofluid alone. The parameters to consider are as follows: - Concentration of ferrofluid must be sufficient to get attracted to a magnetic field. (If too low, nanoparticles are not as responsive, and will not be able to retain much because it is as if the ferrofluid is not even there. sufficient amount) - The magnetic strength of the external magnet should be sufficient to attract the magnetic particle. You can use permanent magnets. - The duration of magnetic field application should be the Optimum amount of time for ferrofluid to get attracted to the magnet. length of time you are going to apply the magnet to the tumor surface so basically - concentration of ferrofluid in the drug - magnetic strength of external magnet - duration of time for the external magnet to be applied the purpose of NDDs II 1 - add ferrofluid (has magnetic properties) to liposome with the drug (usually in the aqueous layer especially for Doxorubicin) 2 - give drug to patient 3 - apply external magnet to tumor site for the ferrofluid within the drug to be attracted to it. This allowed better drug accumulation of 15% as compared to 5% without any magnet applied goal: improve the accumulation of drug to the tumor site hmm okay :)

Answer 13

1) Increase drug-to-lipid ratio (1% vs 10%), want to be potent so you will not need as much. The drug should be compatible with ferrofluid 2) change the lipid composition, bilayer now ferrofluid is already there and will take up some space, so need to make space for drugs as well use appropriate lipids drug and Ferro (if water-soluble) can be in the bilayer or the aqueous layer before, want to increase the drug in the bilayer: DMPC vs DSPC, DSPC is larger and incorporates more drugs -- this works out if the bilayer is where you want to put the drug

Answer 14

Core has magnetite (Fe3O4) Matrix has Citric Acid Zeta Potential: -35 mv, negatively charged, (anionic liposome). If +35 mv it will be positively charged (cationic liposome) ferro has - magnetite in the core - citric acid matrix on the outside citric acid matrix on the outside - needed otherwise magnetite will aggregate. With it, magnetite will not aggregate Zeta potential - is the charge - the electric potential along the double membrane surface - For example: if we introduce phosphatidylglycerol which is negatively charged, we will have negatively charged liposomes. We can take a vesicle and measure the surface charge

Answer 15

MAG-C = Ferrofluid MAGnetite & Citric acid phase transition temp. - when it is reached: 50% gel, 50% lipo crystalline phase particle size and zeta potential characteristics shown in two graphs - both are important for targeting efficiency - both are determinants of targeting MAG-C = ferrofluid graph for particle size and [MAG-C] - particle size as a function of concentration MAG-C - we see a signification increase in particle size as we increase [MAG-C] graph for zeta potential (or surface charge) - zeta potential as a function of concentration MAG-C - zeta potential at 0 [MAG-C]: almost +60 mv - as we increase the concentration of MAG-C, the zeta potential decreases - the Zeta potential decreases, which tells us at 2.5 it is saturated. Levels off, MAG-C goes inside and not on the surface anymore, saturates on the surface as much as possible and the rest goes inside graph for phase transition temp. and [MAG-C] - phase transition temp as a function of concentration MAG-C - melting temp. is 55 degrees Celsius - stays relatively the same from 0 to 0.5 then the temp. drops when it reaches 2.5, (from 0 to 2.5 it increases just a little bit) because MAG-C does not alter the properties deeper in the bilayer. If you want to change the melting temp then you need to change some of the properties deeper inside the bilayer. If it stays on the surface then there is not much change (to do that, you need higher amounts of MAG-C). - at 2.5, it starts to go deeper inside the bilayer because 2.5 is a high concentration of MAG-C so: based on size, zeta potential, and melting temp., 2.5mg was probably used 2.5mg had the biggest particle size, lowest zeta potential and lowest phase transition temp.

Answer 16

take any of the drug delivery systems: liposomes, micelles administer through iV want to accumulate the drug to one site for example to a tumor and reduce reuptake by healthy tissue we can accumulate a lot more to the target site as compared to the free drug magnetic: the drug is attracted to an externally applied magnetic field, because delivery systems have something attracted to other magnet the drug goes to the tumor and is attracted to the tumor rather than the healthy tissue

Answer 17

- can see ferrofluid inside - these are melanoma cells - can see plasma membrane and nucleus - get a perinucleus accumulation formation - the drug is probably around the nucleus, will target the nucleus, and kill cells

Answer 18

- a tumor with blood vessels on the top left - take the mouse anesthetized and can see blood vessels - inject magnetic cation liposomes with ferrofluids - apply magnetic to the window of the tumor for one hour - then we looked at the extent to which the nanoparticles will accumulate in the tumor with and without the magnet - no magnetic, also wait just as long no magnet: NDD part 1 magnet: NDD part 2- can see the advantage: can accumulate more drug to the tumor site these are vascular targeting tumorous blood vessels have an overexpression of negatively charged functional groups, these accumulate in the tumor and accumulate in the blood vessels forcing tumors to be retained magnetic cationic liposome - + charge - liposome vesicle - ferrofluid - chemotherapy agents the negative charge of the tumor is attracted to the + charge of the cationic liposome endothelial cells... - can accumulate more drugs!!!! wow exam: regarding physiochemical changes

Answer 19

primary tumor is not the issue but the issue is when the tumor starts metastasizing - when it goes to lymph nodes to move onto secondary site and cannot control that happens through blood vessels, must go through blood vessels

Answer 20

- removed organs primary tumor metastasizing to liver, lung, spleen

Answer 21

- remove mice organs - euthanized - all black: melanoma - apply magnetic: no evidence at all of the metastasizing tumor! - following IV administration - inject a million cells subq - inject IV magentic liposomes that have chemotherapy agent - wait 2 weeks and wait for the tumor to respond - apply magnet for 1 hour then remove for an hour - so we were able to retain enough of the liposome in the tumor to cause destruction to the blood vessels that it did not allow for disseminating of the cancer cell to a secondary site like the lungs. we damaged the blood vessels so much that we were not able to get transport to distant sites. that is why the mice with the magnet are clear. there were more uptake of the nanoparticle by using the magnet - we were able to retain enough chemotherapy drug liposomes in the tumor and cause dissemination to the blood vessels which was so severe that did not allow dissemination to a secondary site - take a mouse, inject a million cells, and wait for the tumor to grow, you will see it. It naturally metastasizes to an area outside the lungs. - this is the control group - then for a free drug: chemotherapy agent without magnetic liposome. We see there is less perinuclear. - with magetic with liposome (+ charge), ferrofluid. We had 3 out of 6 mice had melanoma but when we applied the magnet to the tumor, all of the mice did not have any more cells

Answer 22

- did surgery for the mouse and implanted a small tumor piece into the center of the window so it would grow - once it grows, place the mouse anesthetized look for blood vessels, and inject the magnetic cationic liposomes. Applied the magnet to the window of the tumor for 1 hour - now we look for the extent to which the nanopartciles (has the drug) will accumatte within the blood vessels in tumro with or without the magnet - with magnet: 15% was targeted, but 5% was targetted without the magnet - this is all following the IV administration of the magnetic cationic liposomes chart: - natural accumulation: 5% - this would be NDD part 1 - accumulation with magnet: 15% - this would be NDD part 2 - the magnetic component, we can see the advantage. Accumulate more nanoparticles are the blood vessels why is this important: - these are magnetic cationic liposomes - tumorous blood vessels have an overexpression of negatively charged functional groups, these accumulate in the tumor and accumulate in the blood vessels. the charge is more than what you would find in healthy tissue - if + charge liposomes with ferrofluid, it will accumulate the tumor along the blood vessel wall - if you have a magnet, in addition to the natural accumulation, you are also forcing the magnetic cationic liposomes to be retained (and be attracted to the - charged tumor and blood vessels) clinical implication - magnetic liposomes have a chemotherapy agent - chemotherapy agent in the vesicle accumulates along the wall of the vessel: will exert its action against endothelial cells and kill them :( - the vessel has endothelial cells - if you kill the blood vessel of the tumor

Answer 23

tumor - control: metastasize to the liver - free drug: metastasize to the liver - no magnet - magnet liver - control: metastasize to spleen - free drug: metastasize to spleen - no magnet: less metastasize - magnet spleen - control: metastasize to the lung - free drug: metastasize to the lung - no magnet: less metastasize - magnet lung - control: metastasize - free drug: nothing here - no magnet: less metastasize - magnet drug: vinblastine sulfate IV to mice free drug: FDA approved very qualitative study will the free drug, drug with no magnet or drug with magnet prevent the metastasis of the tumor to the liver, lung and spleen result: no magnet: had better results than the free drug and caused less metastasis

Answer 24

To determine where doxorubicin-loaded liposomes accumulate in liver tumors following injections by 3 different routes of administration

Answer 25

Drugs, contrast agents, genes, and peptides can be trapped within the aqueous or lipid phases of liposomes for delivery to various biological targets – Doxorubicin can be encapsulated in liposomes and this formulation has been used to target tumors in various experimental animal models. Doxorubicin???

Answer 26

Formulations incorporating doxorubicin have been developed to decrease the incidence of severe toxicity seen with the conventional formulation of doxorubicin while taking advantage of the unique delivery properties of liposomes and the cytotoxic effects of doxorubicin. Approved for treatment of Aids-related Kaposi Sarcoma, Ovarian cancer and many other Solid tumor varieties Commercial product using stealth (limits uptake by liver, lung, and spleen so should be available long enough to circulate in the blood so the tumor can take up more of it) liposomes - in the vesicle and is surrounded by PEG Doxil itself is not more effective (reducing tumors) than the free drug (active drug). So then why use it, if you load Doxil into the liposome because it is not taken up long enough then it turns out that it reduces cardiotoxicity

Answer 27

Activity against: Lymphomas Leukemias Sarcomas Carcinomas *read the article to distinguish one from the other* Mechanism(s) of action: - Directly cytotoxic to cells without entry by cancer cells - Intercalate with DNA in cancer cells & inhibit DNA synthesis - Can inhibit topoisomerase I and II activity and interfere with DNA strand separation - interfere with DNA replication Side effects: - Severe cardiotoxicity (which is why stealth is used because it reduces this) is associated with treatment but liposomes have been shown to reduce the toxicity of the drug. so this drug prevents DNA replication of the cancer cells and if it is put into a liposome then it will reduce the cardiotoxic effects

Answer 28

Bolus injection- drug undergoes biotransformation in the liver to active and inactive metabolites Drug binds extensively to plasma proteins and tissues (about 70%) Drug is excreted primarily in the bile (40 to 50%) Drug clears slowly from blood (half-life- 18 to 32 hrs). Drug does not cross blood brain barrier in clinically relevant concentrations Limited data suggest that doxorubicin can cross the placenta into fetal tissue, but fetal damage is rare

Answer 29

establish if the drug is effective, carry them out in vivo 4 groups have 6-8 mice with tumor (inject a million cells sub Q and the tumor will grow on the surface so we can monitor and measure the size, we cannot do this if we did this parenterally A- is a placebo. We inject a million cells and the tumor has to grow. Not all tumor cells will grow in mouse models but this tumor will. Graph: tumor volume as a function of days. Inject cells and wait and see how long it will take the tumor to grow D- takes 30 days to grow another took 20 days take a human cell line and mice, tumors are heterogeneous, because of genetic, cellular, and molecular reasons. If injected, half may move to one area of the mouse and some may split into other areas. So the amount of cells that will participate in a tumor varies because they go in different directions B vs A- B is delayed in growth and takes a longer time to grow. To achieve 30 days - the tumor growth rate was suppressed C - drug into liposome now, D- the tumor is not able to grow, it never gets to the full amount. It looks like the tumor is responding to the therapy. They applied to the tumors probably. Applied heat, the tumor is not affected by heat. It does not kill the tumor but it makes it more susceptible to the celsion's doxo.

Answer 30

liver matters routes of admin: hepatic artery, hepatic portal vein

Answer 31

To determine where doxorubicin-loaded liposomes accumulate in liver tumors following injections by 3 different routes of administration (3 routes are important) Liver Metastases from Colorectal Cancer: Drug delivery with liposome-encapsulated doxorubicin( Osman Cay, MD, Jonathan B. Druskal, MD, PhD, Imad Nasser, MD, Peter Thomas, PhD, Melvin E. Clouse, MD., Radiology 1997; 205:95-101) volume and then page numbers ***********

Answer 32

To compare Intra-venous, Intra-portal, and Intra-arterial administration of liposomal doxorubicin, by using an established mouse model of hepatic colorectal cancer metastasis Why is this important? - Improve drug access to target sites, and - It’s a way to circumvent drug barriers

Answer 33

Intravenous: mouse tail vein Intra-portal: carries all blood from the abdominal GI tract, spleen, pancreas, and gall bladder to the heart through the liver Intra-arterial: Carrier of oxygen-rich blood to the liver from the heart the liver is the eventual organ site, we want to target tumors in the liver

Answer 34

Studies were performed with adult nude mice (Mean weight 20 grams) - immunocompromised Animals were housed under controlled temperature and humidity and were allowed access to water and laboratory chow

Answer 35

Cells maintained in RPMI 1640 medium (like a broth) with 10% FBS (fetal bovine serum) Anesthesia: 30 mg of sodium pentobarbital per/ kilogram of body weight (mg/kg) was injected intra-peritoneally 5,000,000 human CX-1 (colorectal cancer, metastases to the liver) cells in a solution of 0.5 ml of phosphate-buffered saline (pH 7.4) (will not kill cells, isotonic) were injected into the spleen. want to inject 5 million cells. they could have injected the tumor cells into the liver itself but they took colorectal cancer cells into the spleen because the liver tumors will develop more naturally as opposed to forcing them to grow in the liver

Answer 36

In vivo Video Microscopy In vivo Biologic Distribution of Doxorubicin In vitro uptake studies Electron Microscopy Statistical Analyses _______________________________________ In vitro: studies conducted in culture In vivo: studies conducted in small animal models, usually rats or mice *pay attention to this question, will be on an exam lol*

Answer 37

Intrasplenic injection of CX-1 human colorectal cancer cells into mice resulted in spontaneous growth of multiple (avascular) metastatic tumors in all livers within 7 days of injection. In each mouse, an average of 5 tumors (range 3-6) were observed in the liver - good to know because when you inject the 5 million cells and they develop in the liver, we will not open the mouse to look at the tumor. Now we have a clinically relevant tumor model that can be used to carry out overall research

Answer 38

Five minutes after injection of the hepatic, portal vein, or tail vein no visible fluorescent activity was observed in the: - Hepatic intravascular compartment - Parenchymal (normal tissue areas in the liver) - Tumors - Hepatocytes or - Sinusoidal endothelial cells why expect to see fluorescent activity, doxorubicin hydrochloride is red and is naturally fluorescent detect presence in the liver: video microscopy

Answer 39

30 minutes after intrarterial or intraportal injection, what about tail vein injection (ut has been dropped off for some reason) Focal spots of fluorescence activity (evidence of liposomal doxorubicin) were observed in areas corresponding to the tumor nodule and to the peritumoral (outside of the tumor mass) (regions immediately surrounding the tumor). Able to see some of the red dots

Answer 40

60 minutes after intra-arterial or intra-portal injection, fluorescent spots were observed in all microscopy fields and these spots correspond to the metastatic tumors. No differences between intra-arterial and intra-portal injections No differences between tumors of different sizes and in different zones of the liver lobules No differences were noted between the accumulation of liposomes by arterial and intra-portal injections 3 routes: IV, IA, IP

Answer 41

fluorescein (the fluorescence channel that is used to detect the presence of doxorubicin) intensity after intraarterial or intraportal injection of doxorubicin in Mice: tumorous at 30 minutes, they see 81 at 60 minutes, they see 119 nontumorous at 30 minutes, they see 62 at 60 minutes, they see 82 the higher the fluoresce intensity the more drug is there

Answer 42

Minimal accumulation was noted in normal liver and in liver with tumors No significant differences were observed between tumor and background liver fluorescent activity. Uptake for the tumor and normal area were all similar which is what we do not want - This offers evidence to support insufficient concentration levels of doxorubicin in tumors relative to controls.

Answer 43

Doxorubicin can be selectively targeted to hepatic metastases from colorectal cancer via the hepatic artery or the portal vein by using a novel delivery vehicle (i.e., Liposomes) - so through the hepatic artery and the portal, colorectal tumor cells that metastatsize in the liver (so liver tumor can be targetted) can be targeted by doxorubicin through 3 routes of admin - really just 2 routes of admin that had very similar results of accumulation overall An evaluation of the efficacy of this agent in the treatment of hepatic metastases related to colorectal cancer (and hepatic metastases) in humans is needed oooh so we injected the CX-1 (colorectal cells) into the spleen (intrasplenic injection) and it metatsized to the liver naturally. then we injected teh drug throguh 3 different routes: IV, IP, IA to find out which route would give the more accumulation of the drug to the tumor site!

Answer 44

want to know liposome cell interaction, the extent to which the cells interact with the liposome the formulation accumulates in the tumor, well are they taken up by the cells well plates, cell growth ( brain cancer, breast) put the cell in a well expose cells in various concentrations to different liposomal amounts do not load in the first column so we can compare 3000 cells per well, exposed to fluorescently labeled. liposomal vehicle (no doxorubicin yet)

Answer 45

the graph shows: - the % of uptake of liposome-encapsulated doxorubicin (drug) in CX-1 cells under normoxic and hypoxic conditions in Kupffer cells - so how much of the drug was taken up by the Kupffer cells in different conditions - there was a gradual uptake of liposomes in tumor cells and in Kupffer cells (macrophages in the liver so they will take up anything that is introduced to it), regardless of the availability of oxygen in the environment - maximum uptake was achieved in tumor cells at 60 minutes of incubation - the rate of uptake in Kupffer cells was less than that in the tumor cells taken up by the tumor in the liver cells taken up liposomes as a function of the duration of incubation good news because the CX-1 cells in the tumor hypoxic: do not worry about

Answer 46

antisense tries to target sense strand but you end up targeting a different sequence than the sense sequence. So you knock down the expression of a sequence that you did not mean to target

Answer 47

antisense drug, FDA approved for treatment of CMV in patients with AIDS. This is a drug that treats that virus. Also used for CMV retinitis (a type of CMV)

Answer 48

enhances erythropoiesis (production of red blood cells). It does this by stimulating proerythroblasts which produce red blood cells. This is not antisense drug but an rDNA technology drug! :)

Answer 49

the brand name of erythropoietin, can be IV or subQ. Dose increased if treatment has occured >8 weeks of therapy the Hct has not increased. Used to stimulate the erythropoiesis for anemic patients (got anemia from chemotherapy)

Answer 50

Off-target effects. It recognizes and bind a specific sense sequence of an mRNA molecule. And this prevents the synthesis of proteins that sense sequence will code for.

Answer 51

a different class of biotech drugs, purified antibodies produced by a single source of clonal cells. Examples of Rituximab, and Trastuzumab. T he trick to remembering the examples is they all end in “mab” = monoclonal antibodies. Rituximab is used for non-Hodgkin lymphoma & lymphocytic leukemia Trastuzumab is used for early-stage breast cancer.

Answer 52

Patient has a virus (antigen), they’re bodies produce antibodies for that antigen. Those antibiotics are extracted and cloned and so 100s of 1000s are cloned and are now fused and cloned into the patient. And now a patient has the antigen and their body is not producing antibodies then the patient will be given monoclonal antibodies to recover.

Answer 53

patients have colon cancer but now the cancer spreads to the liver. Drug delivery of Doxorubicin in liposomes. Long travel of the tumor

Answer 54

intra-portal and intra-arterial are more effective than intravenous because at least they prodcued different results compared to the control but the portal and arterial injections had similar results and accumulated at the liver tumor site and so these were the best roue of admins while the IV route had the same result as the control

Answer 55

portal and arterial are most effective

Answer 56

In vivo: studies conducted in small animal models, usually rats or mice In vitro: studies conducted in culture

Answer 57

small [ ] in normal liver and liver with tumor - there was no difference between the 2. So the control and the experiment looked the same - no big differences so that route of admin was dropped

Answer 58

actually they all (except intravenous through the tail vein) had very similar results

pharmaceutics - biotech, NDDs II, research Flashcards

(85 cards)