Pharmacology Flashcards
(213 cards)
1
Q
Function of the AMOUNT of a drug to produce an effect. Greater when dose is Smaller.
A
Potency
2
Q
Maximum intensity that can be produced by drug Regardless of Dose. Only can increase side effects
A
Efficacy
3
Q
Placed directly into GI tract by oral or rectal.
A
Enteral
4
Q
Bypasses GI tract including injection, inhalation, and topical
A
Parenteral
5
Q
Orally delivered drugs must FIRST pass through HEPATIC PORTAL CIRCULATION possibly inactivating some drugs
A
First-Pass Effect
6
Q
Phase 1 reactions carried out by ___ (aka mixed functions oxidases) in the LIVER.
(Oral Route)
A
Cytochrome P-450 enzymes
7
Q
Route: Safest, least expensive, convenient. Mostly absorbed in small intestine. Drug blood levels less predictable.
A
Oral
8
Q
Route: Used if patient is vomiting or unconscious. Poorly absorbed.
A
Rectal
9
Q
Route: Produces MOST RAPID drug response. Absorption phase bypassed. EMERGENCY situations
A
Intravascular
10
Q
Route: Sustained effect. Massage increases absorption.
A
Intramuscular
deltoid or gluteal most common site
11
Q
Route: Administering protein products. Insulin and LAs. Sterile abscess.
A
Subcutaneous
12
Q
Route: Injected into epidermis. TB
A
Intradermal
13
Q
Route: Rapid delivery across large surface area.
A
Inhalation
inhalers & nitrous
14
Q
Route: Increased concentration of active ingredient. Local effect. May have systemic uptake.
A
Topical
contraindicated if surface is ulcerated, burned, or abraded
15
Q
ADME
A
Absorption, Distribution, Metabolism, Excretion
16
Q
Study of how a drug is absorbed, distributed, metabolized, and excreted by the body
A
Pharmacokinetics
17
Q
Transfer of drug from site to blood. Active or Passive. Occurs at MANY sites. Dependent on several factors.
A
Absorption of drugs
18
Q
Readily move across MOST biological membranes by diffusion. ONLY drugs to pass BBB
A
Lipid Soluble Drugs
19
Q
Factors dependent on drug absorption (6)
A
1) Drug solubility 2) Circulation at site 3) Surface area 4) Drug pH 5) Temperature at site 6) Mechanical factors
20
Q
Transfer of drug from blood to system with Highest Blood Flow. (oral-liver, sublingual-heart) Dependent on few factors.
A
Distribution of drugs
21
Q
Factors dependent on drug distribution (3)
A
1) Blood flow 2) Capillary permeability (BBB) 3) Binding of drug to proteins (plasma albumin)
22
Q
Major site of drug metabolism. (disease may impair metabolism)
A
Liver
23
Q
Termination of drug effects
A
Elimination
24
Q
Elimination is by ___ and/or ___ into urine or bile
A
Biotransformation ; Excretion
25
Routes of elimination (10)
1)RENAL (kidney) 2)Gingival Crevicular Fluid 3)Saliva 4)Liver 5)Bile 6)Lungs 7)Exhalation 8)GI 9)Sweat 10)Milk
26
Fluoride eliminated by ___
Excretion in the Urine
27
Drug altering effects (12)
1)Pt compliance 2)Psychologic factors 3)Tolerance 4)Pathologic state 5)Time 6)Route 7)Gender 8)Genes 9)Drug interactions 10)Age 11)WEIGHT 12)Environment
28
Child dosing determined by ___
| Cowling and Young Rules
Age
29
Surface Area Rule determined by ___
Weight in kg
30
Reaction - Abnormal drug response that is usually genetically related
Idiosyncratic
31
Adverse Drug Reactions (7)
1) Toxic 2) Side effects 3) Idiosyncratic 4) Teratogenic 5) Local 6) Drug interactions 7) Allergic Reactions
32
Reaction - amount of desired effect is excessive; dose related
Toxic
33
Reaction - dose-related, not part of the therapeutic outcome; e.g. drowsiness with benadryl
Side effect
34
Reaction - hypersensitivity response to a drug that pt has been previously exposed; NOT dose related; mild to life-threatening
Allergic
35
Reaction - maternal drug use causing congenital abnormalities
Teratogenic
36
Reaction - local tissue irritation
Local
37
Reaction - one drug altered by another; can result in toxicity or lack of efficacy
Drug interaction
38
Treatment of allergic reactions: mild , anaphylactic
mild - antihistamine with or without steroids
| anaphylactic - epinephrine subcutaneously with or without steroids
39
What can generate gingival overgrowth (5)
1) mouth breathing 2) Phenytoin 3) Genes 4) Cyclosporin 5) Calcium Channel Blockers
40
Med - an organ rejection preventative medication
Cyclosporine
41
Med - calcium channel blockers (2)
nifedipine (procardia)
| dilatiazem (cardizem)
42
Med - drugs that do NOT cause gingival overgrowth (2)
Digoxin, Beta blockers
43
ANS regulates (5)
1) BP 2) Heart rate 3) GI motility 4) Salivation 5) Bronchial/smooth muscle tone
44
Rest and Digest
Parasympathetic
45
Drugs that mimic PANS (3)
Parasympathomimetics, cholinergic agents, muscarinic drugs
46
Drugs that mimic PANS are used for (3)
xerostomia, urinary retention, glaucoma
47
Cholinergic agents from plant alkaloids (2)
Pilocarpine (stimulates saliva)
| Nicotine (tobacco cessation)
48
Contraindications to drugs that mimic PANS (4)
Asthma(bronchoconstriction) Peptic ulcer(increases GI secretions) Cardiac disease(heart rate decrease) GI/Urinary obstruction(GI motility increase)
49
Agent - blocks ach receptors by inhibiting ach effects
Anticholinergic
50
Effects of Anticholinergic agents (4)
ABCD - Anticholinergic agents, Blurred vision & Bladder retention, Constipation, Dry mouth
51
Examples of Anticholinergic agents (3)
Immodium(diarrhea)
Atropine(decrease salivary flow)
Scopolamine(motion sickness)
52
PANS neurotransmitter
Acetylcholine
53
SANS neurotransmitter
Norepinephrine
| ach in PRE-ganglionic synapse
54
Fight or Flight
Sympathetic
55
Examples of drugs that mimic SANS (5)
```
Epinephrine
Pseudoephedrine
Albuterol
Ritalin
Adderall
```
56
Drugs that mimic SANS (2)
Sympathomimetics, adrenergic agents
57
Drugs that mimic SANS are used for (8)
Colds(decongestants), asthma(bronchodialators), anaphylactic shock, glaucoma, vasoconstrictors, cardiac arrest, CNS stimulation, ADD
58
Functions of SANS (4)
Vasoconstricts, dilates bronchioles, increases heart rate, dilates pupils
59
Functions of PANS (4)
Stimulates salivary gland secretion, dilates blood vessels, accelerates peristalsis, absorption of nutrients
60
Contraindications to drugs that mimic SANS (4)
Angina
Uncontrolled hypertension
Uncontrolled hyperthyroidism
Cocaine & Amphetamine Abuse
61
___ is contraindicated for Cocaine & Amphetamine abuser if used within ___
Epinephrine & 24 hours
62
Adverse reactions of adrenergic agents (4)
CNS disturbances (anxiety, fear, tension, headache, tremor)
Cardiac arrythmias
Cerebral hemorrhage
Pulmonary edema
63
Oral signs - rampant caries & burned mucosal surfaces
Meth abuse
64
How to treat meth abusers
no medications available, cognitive behavioral interventions
65
Adrenergic drugs to know (3)
Albuterol
Dopamine
Clonidine
66
Med - minimizes symptoms that accompany withdrawal from opiates and benzodiazepines
Clonidine
67
Med - drug of choice for shock; continuous infusion
Dopamine
68
Med - bronchodilator, acute asthma, few cv effects
Albuterol
69
Beta blockers (type/location)
Beta 1 : heart
| Beta 2: lungs, muscles, arterioles
70
increases heart rate, BP, and oxygen needed for blood
Beta 1 receptor
71
Beta 1 blocker drug action
decreases heart rate, BP, and useful when heart is deprived of oxygen
72
Often Rx after heart attack
Beta 1 blocker
73
Hormone produced in kidney that constricts blood vessels; beta blockers prevent release of
Renin
74
Relaxing effect, Rx for anxiety, migraine, and alcohol withdrawal
Beta 2 blocker
75
Should not be used in pt with asthma or any reactive airway disease
Non-selective beta blockers
76
Beta blockers are used for (6)
Cardiac arrhythmias, angina pectoris, hyperthyroidism, M.I., glaucoma, migraine prevention
77
Beta adrenergic drugs to know (4)
Propranolol
Timolol
Atenolol
Metoprolol
78
Med - lowers BP by lowering cardiac output; adverse reaction bronchoconstriction & arrhythmias
Propranolol
| Inderol
79
Med - reduces aqueous humor in the eye, tx of glaucoma
Timolol
| Timoptol, Timoptic
80
Med - eliminates bronchoconstrictor effect, tx of hypersensitive asthmatic pts; cardioselective
Atenolol
81
Med - tx of hypertension, prevention of M.I. and angina
Metoprolol
| Lopressor
82
Nonopioid Analgesics (3)
Aspirin, NSAIDs, Acetaminophen
83
Med - used for Analgesia, Antipyretic, Anti-inflammatory; inhibition of prostaglandin synthesis
Aspirin & NSAIDs
84
Med - used for Analgesia & Antipyretic
Acetaminophen
85
Med - fever reduced through hypothalamus
Aspirin
86
Contraindications for Aspirin & NSAIDs (2)
Coumadin (warfarin) - blood clotting effect
| Peptic ulcer
87
Med - children with hx of chicken pox or influenza should NOT use ___ due to what metabolic disorder
Aspirin; Reye's Syndrome
88
Term - overdose of Aspirin
salicylism
89
Define - ringing of the ears
Tinnitus
90
Ibuprofen can decrease effects of drugs including (7)
ACE inhibitors, Aspirin, Beta blockers, Corticosteroids, Cyclosporine, Lithium, Loop diuretics
91
Acetaminophen overdose (3)
Hepatotoxicity
Liver necrosis
Death
92
Med - for post-operative pain, drug of choice after root planning
Acetaminophen
93
Narcotic / Opioid Analgesics (4)
Morphine, Codeine, Demerol, Dilaudid
94
MOA of narcotics and opioids
Blocks pain receptors in brain w/o loss of consciousness
95
Most commonly used opioid in Dentistry
Codeine in conjunction with Acetaminophen (schedule 3 narcotic)
96
Sign of OD or addiction to ANY opioid
Pinpoint pupils (<2.9mm)
97
Med - antitussive; may cause constipation, emesis (vomiting); OD leads to respiratory depression & death
Codeine
98
Med - opioid antagonist, used for tx of opioid OD; should be in Dental Emergency Kit
Narcan
99
Med - tx of narcotic withdrawal/dependence; 1x day, works for 24-36 hrs, only effective for opioid addictions
Methadone
100
Pain meds for heroine addicts
NSAIDs
101
Type of drug abuser needs pre-med with antibiotics
IV
102
Define - substance acts against/destroys infections
Anti-infective/antibiotic
103
Define - substance that destroys/suppresses growth of bacteria
Antibacterial
104
Define - Kills bacteria; irreversible
Bactericidal
105
Define - Inhibits bacterial growth
Bacteriostatic
106
Lowest concentration needed to inhibit visible growth of an organism
MIC - minimum inhibitory concentration
107
Range of activity to drug
Spectrum
108
drug combo for better effect
Synergism
109
drug combo lessens effect
Antagonism
110
Antibiotic types (3)
Penicillins, Tetracyclines, Nitromidazoles
111
Penicillin derivatives (3)
Amoxicillin, Augmentin, Ampicillin
112
Most common Rx in dentistry; effective in 90% of bacteria in dental infections
Pen VK
113
MOA of penicillin
destroys bacterial cell wall integrity; lysis
114
Med - Not effective against penicillinase (beta lactamase)
Amoxicillin
115
Med - Clavulanic acid combined with Amoxicillin; prevents penicillinase from breaking down Amox.
Augmentin
116
Med - avoid use in early pregnancy and childhood; tooth discoloration
Tetracycline
117
Do Not take tetracycline with ___ (3)
dairy, antacids, iron tablets
118
Med - topically used for aggressive perio; systemically for NUG/NUP
Tetracycline
119
Med - NO Alcohol Mouth Rinse! Effective against obligate anaerobes only; alcohol should be avoided.
Nitromidazoles
| Metronidazole
120
Antibacterial side effects (3)
GI upset, secondary fungal infections(candidiasis/yeast infection), Allergies
121
Antituberculosis Agents (4); must be on all if active
RIPE - Rifampin, Isoniazid, Pyrazinamide, Ethambutol
122
Med - red urine, tears, and saliva
Rifampin (TB)
123
Med - affects vision; decreases acuity and red/green differentiation
Ethambutol (TB)
| Myambutol
124
Med - preventative against developing TB
Isoniazid
125
TB - no longer contagious if...
3 consecutive negative sputum smears
126
Antigen used to diagnose TB, known as Mantoux skin test
PPD - purified protein derivative
127
Fungal infections common... (3)
after antibiotics, steroids, or immunocompromised
128
Most common Antifungals (4)
Nystatin, Fluconazole, Mycelex(clotrimazole), Nizoral(ketoconazole)
129
Med - most common antifungal used in dentistry, tx of candidiasis, topical
Nystatin
130
Med - systemic tx of candidiasis
Fluconazole
| Diflucan
131
Abbreviation - ac
before meals (ahead of consumption)
132
Abbreviation - bid
twice a day (bi daily)
133
Abbreviation - gt
drop
134
Abbreviation - hs
before bedtime (heavy sleeping)
135
Abbreviation - po
by mouth (per oral)
136
Abbreviation - pc
after meals (post consumption)
137
Abbreviation - prn
as needed (per Rx need)
138
Abbreviation - q3h
every 3 hours
139
Abbreviation - qd
per day
140
Abbreviation - qid
4x a day (quad daily)
141
Abbreviation - tid
3x a day (tri daily)
142
Abbreviation - sig
label; instructions (see instruction guide)
143
Abbreviation - stat
immediately
144
Abbreviation - tab
tablet
145
Abbreviation - ud
use as directed
146
Schedule 1 (abuse potential/handling)
highest - no accepted medical use (cocaine)
147
Schedule 2 (abuse potential/handling)
high - Rx only, NO REFILLS, most abused (codeine)
148
Schedule 3 (abuse potential/handling)
moderate - Rx, phone in, no more than 5 refills within 6 months (tylenol with codeine)
149
Schedule 4 (abuse potential/handling)
less - Rx, phone in, no more than 5 refills within 6 months (alprazolam/Xanex)
150
Schedule 5 (abuse potential/handling)
least - OTC (ibuprofen)
151
Requirement for any Rx controlled substance
DEA number
152
Requirement for Schedule 2 drugs
written in pen or typed; some states require triplicate pads
153
Antianxiety agents (2)
Barbiturates & Benzodiazepines
154
Med - no analgesic effect, CNS depression
Barbiturates
155
Med - long acting; used in tx of epilepsy
Phenobarbital
156
Med - short acting, tx of anxiety, insomnia, and alcohol withdrawal, does not affect ANS, can be given prior to sedation
Benzodiazepines
157
Benzodiazepines (4)
Diazepam(Valium), Lorazepam(Ativan), Xanax(Alprazolam), Tranxene
158
Anesthesia Stage 1
Analgesia - remains conscious, breathes regularly, Nitrous maintains
159
Anesthesia Stage 2
Delirium or excitement - unconscious, involuntary movement
160
Anesthesia Stage 3
Surgical anesthesia - major surgery
161
Anesthesia Stage 4
Respiratory or medullary paralysis - stops breathing, if not reversed death will occur
162
Med - most common used for CHF (increases contractile strength); also increases gag reflex and salivation
Digitalis Glycosides
| Digoxin (Lanoxin)
163
Med - increases Digoxin levels in ~10% of pts (2)
Tetracycline & erythromycin
164
Med - tx of angina, vasodilator, smooth muscle relaxant, sublingual, emergency kit!
Nitroglycerine
165
Hypertension symptoms (3)
Usually asymptomatic; occ. headache, vision changes, and dizziness
166
First line therapy for hypertension - why
Diuretics - excretes sodium & water/decreases blood volume & pressure
167
Med - Diuretics (2)
Thiazide - xerostomia, orthostatic hypotension
| Loop - CHF
168
ACE Inhibitor drugs (3)
Lisinopril (prinivil, zestril)
Captopril (capoten)
Enalapril (vasotec)
169
Most common ACE inhibitor used with CHF
Enalapril
170
ACE inhibitors adverse reactions (3)
avoid postural hypotension, allergic reactions, dry cough; also associated with dysgeusia(taste)
171
Second line therapy for hypertension - why
Beta blockers - decreases cardiac output
172
Anticoagulants (2)
Coumarins & Heparin
173
Coumarin prevents inactive to active conversion of ___
Vitamin K
174
Med - anticoagulant for hospitalized pts, by injection only
Heparin
175
Consideration of Warfarin pts
Dose reduction under advising physician several days before tx
176
Anticonvulsants (3)
Phenytoin (dilantin)
Phenobarbital
Carbamazepine (tegretol)
177
Antihistamines block __ receptors
H1 (bronchospasm and vasodilation)
178
Most common side effect with insulin is __ ;
| shortness of breath is not a sign of this
hypoglycemia
179
Insulin dependent
Type 1 - juvenile-onset
180
Non insulin dependent
Type 2 - adult-onset
181
Diabetes Mellitus Drugs (2)
Metformin (glucophage), Glyburide (diabeta, micronase)
182
Med - bronchodilator tx of asthma; reverses bronchospasm
Metaproterenol
183
Types of Asthma inhalers (4)
short acting, corticosteroids, corticosteroid plus long acting, long acting
184
inhaler type - immediate relief; albuterol and pirbuterol
short acting
185
inhaler type - long term to prevent asthma attack; QVAR, Flovent
corticosteroid
186
inhaler type - for asthma, combo; Advair
corticosteroid plus long acting
187
inhaler type - relieves asthma for longer time; Salmeterol (serevent)
long acting
188
Med - treats chronic asthma; erythromycin can cause toxicity
Theophylline
189
Med - can cause insomnia
Albuterol
190
Med - should be avoided in asthmatics (4-19% have hypersensitivity)
Aspirin
191
Med - tx of COPD
Atrovent (Ipratropium); anticholinergics
192
Med - rebound swelling can occur, do not use for more than few days
nasal decongestants
193
Med - removes exudate and mucus
expectorant
194
Med - for non productive dry cough
antitussive
195
Med - a systemic antacid contraindicated in cv pts due to high sodium load
Sodium bicarbonate
196
Antacids can inhibit absorption of (3)
Tetracyclines, Digitalis, Iron
197
Most prevalant GI disease in US
GERD - gastroesophageal reflux disease
198
GERD is treated by 1 of 2 meds
Histamine 2 blocking agent, PPI - protein pump inhibitor
199
Med - should not be used with antacids (disrupts absorption); ex. TagametHB (cimetidine), Pepcid AC (famotidine)
Histamine 2 blocking agents
200
Med - potent inhibitor of gastric acid secretion; ex. Prilosec (omeprazole)
PPI - protein pump inhibitors
201
Med - used for tx of gastric ulcers
| *gastric ulcers do not cause gingival bleeding
TagametHB (cimetidine)
202
Med - commonly used for HIV protease inhibitor
AZT (zidovudine)
203
Med - alcohol in combo with ___ will result in dangerously low BP
nitroglycerin
204
Med - acceptable drugs to use during pregnancy (7)
LAs, acetaminophen, PenV, Amoxicillin, Cephalosporins, Clindamycin, Nystatin
205
Med - decreases effectiveness of muscle relaxants
NSAIDs
206
Med - SSRIs (selective serotonin reuptake inhibitors) FDA approved (2)
Prozac (fluoxetine)
Zoloft (sertraline)
Paxil (paroxetine)
207
Med - can promote endometrial carcinoma and breast cancer in post menopausal women, can cause gingival enlargement
estrogen steroid hormone
208
Med - can increase anticoagulant effect of Warfarin; HMG Co-A inhibitor
Lipitor (Atorvastatin)
209
Med - glucocorticoid; risk of infection & delays healing; increase hypertension; adrenal crisis possible; osteoporosis
Prednisone
210
Prednisone side effects (8)
edema, buffalo hump, moon face, peptic ulcer, mental disturbances, increase body hair growth, acne, insomnia
211
Prednisone used for (4)
autoimmune disorders, Addisons disease, inflammatory symptoms, allergies
212
Med - hypothyroidism; long half-life
Synthroid (levothyroxine)
213
Synthroid (levothyroxine) side effects (3)
nervousness, tachycardia, intolerance to heat
