Pharmacology Flashcards
(132 cards)
1
Q
Highest abuse potential, no accepted medical use. Heroin and LSD.
A
Schedule I
2
Q
High abuse potential, written RX w/signature only, no refills. Morphine, codeine alone, amphetamines and oxycodone.
A
Schedule II
3
Q
Moderate abuse potential, may phone in, 5 RX in 6 months. Tylenol 3
A
Schedule III
4
Q
Lower abuse potential, may phone in, 5 RX in 6 months. Valium (Diazepam) And Darvon.
A
Schedule IV
5
Q
Lowest abuse potential, some available OTC. Codeine-containing cough meds (not OTC).
A
Schedule V
6
Q
Graph of the relationship between dose of a drug and the response
A
Log Dose-effect curve
7
Q
Where the dose is increasing sharply
A
Therapeutic range
8
Q
Where the curve plateaus (flattens out)
A
Maximum response
9
Q
Amount of drug necessary to produce an effect, it is greater when dose is smaller.
A
Potency
10
Q
Maximum response of a drug, regardless of the dose
A
Efficacy
11
Q
Time it takes for the drug to have an effect
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Onset
12
Q
Length of time that a drug has an effect
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Duration
13
Q
One measure of duration, amount of time necessary for a drug to fall to 1/2 of its original blood level.
A
Half life
14
Q
Placed directly in GI tract, oral route and rectal route.
A
Enteral
15
Q
Bypasses the GI tract, IV, IM, SQ, Intradermal, inhalation, topical and sublingual.
A
Parenteral
16
Q
Safest, least expensive and most convenient, less predictable blood levels, large area for absorption (small intestine).
A
Oral route of administration
17
Q
Occurs when orally-administered drugs initially pass through the hepatic portal circulation (liver), which reduces the amount of effective drug.
A
First-pass effect
18
Q
Suppositories, creams, enema. Patient is vomiting, unconscious, poor and irregular absorption rectally.
A
Rectal route of administration
19
Q
Most rapid drug response, best for emergency situations, absorption phased bypassed, disadvantages include phlebitis, irretrievability and allergy.
A
IV (intravascular)
20
Q
Provides sustained effect, massaging muscle will increase the drugs absorption, Deltoid or gluteal muscles common injection sites.
A
IM (intramuscular)
21
Q
Used to administer protein products, insulin is administered subcutaneously-it is activated by GI acid/enzymes, local anesthesia in dentistry is delivered this way, side effects include sterile abscess or hematoma
A
Subcutaneous
22
Q
Injection into epidermis, example is tuberculin skin test
A
Intradermal
23
Q
Rapid delivery across large surface area of respiratory mucosa. Includes inhalers and nitrous oxide/oxygen.
A
Inhalation
24
Q
Applied to body surface (skin, mucosa), most effective in non-keratinized areas, require an increased concentration of the drug, contraindicated in ulcerated burned or abraded surfaces.
A
Topical
25
Study how a drug enters the body, circulates in the body, and leaves the body.
Pharmacokinetics
26
Transfer of a drug from the site of administration to the blood stream.
Absorption
27
What is most important for absorption of oral drugs?
Small intestine
28
Process by which a drug leaves the blood stream and enters the body systems.
Distribution
29
What step does IV administered drugs bypass?
Absorption
30
Where are drugs distributed?
To organs with highest blood flow
31
Breaking down of a drug for its removal from the body, also known as biotransformation.
Metabolism
32
What is the most important site for metabolism of drugs?
Liver
33
Removal of the drug from the body, terminates drug affects.
Elimination
34
What is the most important organ for elimination?
Kidneys
35
Dose-related reaction
Side effects
36
Occurs when the desired effect is excessive, dose-related
Toxic effects
37
Hypersensitivity response to a drug, NOT dose related
Allergy
38
Causal relationship between the drug use of a mother and congenital abnormalities.
Teratogenic effect
39
Functions without conscious effort.
Autonomic nervous system
40
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“Fight or flight”
Increase BP thru vasoconstriction
Increase HR
Dilates bronchioles and pupils
Reduce saliva flow
Adrenergic drugs (sympathomimetics)
Preganglionic: acetylcholine
Postganglionic: norepinephrine
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Sympathetic (SANS)
41
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“Rest and digest”
Increased blood flow to digestive organs
Accelerated peristalsis
Constricts bronchioles and pupils
Increase saliva
Pre and postganglionic: acetylcholine
Cholinergic drugs (parasympathomimetics)
```
Parasympathetic (PANS)
42
Effects mimic the sympathetic nervous system. Should be avoided with angina, uncontrolled HTN and hyperthyroidism.
Adrenergic Drugs
43
What are the adverse effects of adrenergic drugs?
CNS(anxiety, fear, tremor, headache)
Cardiac arrhythmia
Hypertension
Xerostomia
44
Examples of Adrenergic Drugs.
Epinephrine (treats anaphylactic reaction, in local anesthetic as vasoconstrictor, to stimulate heart muscle)
Dopamine (treats shock, low BP and Parkinson’s)
45
Examples of Adrenergic-blocking Drugs?
Inderal (propranolol): non-selective bets blocker to treat HTN
Tenormin (atenolol): selective beta-blocker to treat HTN
Lopressor (metoprolol): selective beta-blocker to treat HTN
Timoptic (timolol): treat glaucoma
46
Effects mimic parasympathetic nervous system, contraindicated with asthma, ulcers and cardiac disease.
Cholinergic Drugs
47
Examples of Cholinergic Drugs?
Pilocarpine used to increase saliva flow in patient’s with Sjogren’s syndrome and can treat glaucoma.
48
These block the parasympathetic nervous system. Adverse reactions include blurred vision, bladder retention, constipation and dry mouth.
Anticholinergic Drugs
49
Examples of anticholinergic Drugs.
Atropine: decreases saliva for dental procedures
Imodium: treat diarrhea
Scopolamine: treat motion sickness
Dramamine: treat motion sickness
50
Nonopioid, mechanism of action is inhibition of prostaglandin synthesis. It is an analgesic, antipyretic, anti-inflammatory, and anti-platelet.
Aspirin
51
What are the adverse effects of aspirin?
Interferes with clotting, contraindicated with Coumadin (warfarin), GI irritation, hypersensitivity, association with Reye’s syndrome, and tinnitus
52
Nonopioid, NSAID, Motrin, Advil, mechanism of action is inhibition of prostaglandin synthesis. It is an analgesic, antipyretic and anti-inflammatory. Contraindicated with gastric ulcers, decrease effect of many drugs, and interferes with clotting.
Ibuprofen
53
Nonopioid, Tylenol, Analgesic, antipyretic NOT anti-inflammatory, drug of choice for children, patients on anticoagulants, ulcers, post-op pain after periodontal treatment and may cause hepatotoxicity and liver necrosis at high doses/overdose.
Acetaminophen
54
Blocks pain receptors in the brain. Analgesic, antitussive, sedation, and euphoria. May cause respiratory depression, nausea/vomiting, constipation and addiction. Codeine is most commonly used in dentistry in combo with acetaminophen
Narcotics/Opioid Drugs
55
Opioid antagonist that reverses the effects of opioid Drugs.
Narcan (Naloxone)
56
Used in the treatment of narcotic dependence and withdrawal.
Methadone
57
Kills bacteria
Bactericidal
58
Inhibits the growth or multiplication of bacteria
Bacteriostatic
59
Ability of an organism to be unaffected by an antimicrobial drug
Resistance
60
Range of activity of a drug (marrow or broad)
Spectrum
61
When a combo of 2 antibiotics produces greater effect than would be expected if their individual actions were added
Synergism
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When a combination of 2 antibiotics produce less effect than either agent alone
Antagonism
63
Most commonly prescribed antibiotic in dentistry, bactericidal, produce an anaphylactic reaction, most common side effect/allergy sign is a rash, safe for pregnant patients
Penicillin
64
Which penicillin is preferred due to more consistent absorption?
Penicillin VK
65
Bacteriostatic Drugs, pre Mrs for dentistry, examples include erythromycin, aziythromycin (Zithromax), and clarithromycin (Biaxin)
Macrolide Antibiotics
66
Broad spectrum, bacteriostatic antibiotics, used to TX acne and penicillin resistant periodontal infections such as NUG, don’t take. During pregnancy/early childhood due to tooth discoloration, don’t take with dairy products, antacids or iron which bing with this and it concentrates in crevicular fluid.
Tetracycline
67
10% of patient’s allergic to penicillin are also allergic to Keflex (cross-allergenicity), action similar to penicillin, examples include Cephalexin (Keflex), Cefaclor (Ceclor), Cefuroxime (Ceftin)
Cephalosporins
68
Antiobiotics used to treat tuberculosis?
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
69
What TB drugs are used as prevention ONLY.
Rifampin or isoniazid
70
First alternative if patient is allergic to amoxicillin
Clindamycin
71
Used to treat anaerobic infections, also treatment of periodontal infections and ANUG.
Metronidazole (Flagyl)
72
Conditions requiring premedication
Artificial heart valves, h/o infective endocarditis, heart defect repaired with prosthetic patch or device, cardiac transplant w/valve problems, renal dialysis shunt, ventriculoatrial hydrocephalic shunt
73
Conditions that MAY require premedication
Joint replacements less than 2 years ago, previous prosthetic joint infection, multiple joint replacements, and immunocompromised patients.
74
Recommended drug regimens
Amoxicillin 2000mg (2g) one hour prior to procedure.
If pen/amox allergy:
Cephalexin (Keflex) 2000 mg (2g) one hour prior to procedure.
Clindamycin 600 mg prior to procedure
Azithromycin or clarithromycin 500 mg one hour prior to procedure
75
Inhibit viral DNA synthesis, examples: Acyclovir (Zovirax), Penciclovir (Denavir), and Valacyclovir (Valtrex), used to treat oral herpes
Antiviral medications
76
How do antiviral medications use to treat HIV/AIDS effect the oral cavity?
By causing gingival bleeding and oral ulcers
77
TX oral candidiasis, oral dose is 5 ml QID for 2 weeks.
Nystatin (mycostatin)
78
Inhibit the influx of sodium ions by blocking sodium channels in the neuron membrane. Hey are weak bases, work poorly in inflamed tissues.
Local Anesthetics
79
What’s the best way to reduce the risk of systemic toxicity?
Aspiration
80
Metabolized in the liver, “i-Caines”, lidocaine most common. Mepivacaine, prilocaine, bupivicaine, And articaine.
Amides
81
Metabolized in blood plasma, not used as injection, benzocaine 20% topical, novocaine.
Esters
82
Most commonly used anesthetic in dentistry, safe in pregnancy, also available in topical anesthetic, and medium duration.
Lidocaine (Xylocaine)
83
Short duration, comes with vasoconstrictor or as plain solution.
Mepivacaine (Carbocaine)
84
Avoid this in patients with anemia and taking acetaminophen, medium duration.
Prilocaine (Citanest)
85
Has the longest duration.
Bupivicaine ( marcaine)
86
4% solution and increased risk of paresthesia especially with mandibular block, medium duration
Articaine (Septocaine)
87
Why are vasoconstrictors in local anesthetic solutions?
Prolong and increase the depth of anesthesia, delay absorption and decreases toxicity and hemorrhage. Examples include epinephrine and levonordefrin
88
MRD of vasoconstrictors.
.2mg in a healthy patient and .04mg in a medically compromised patient (about 2 cartridges)
89
What is NOT contraindicated in a patient with controlled HTN?
Epinephrine
90
Short-term treatment of anxiety and insomnia, anxiety reduction and sedation, used in dentistry to reduce pt. Anxiety and TMJ disorders. Examples include diazepam (Valium), lorazepam (Ativan), and alprazolam (Xanax).
Anti anxiety drugs-Benzodiazepines
91
CNS is the major system affected, raises the pain threshold, excreted through exhalation.
Anti anxiety drugs-nitrous oxide/oxygen sedation.
92
What color is the nitrous tank and the oxygen tank?
Nitrous-Blue
| Oxygen-Green
93
What are the contraindications of Nitrous Oxide?
COPD, upper respiratory tract infection or stuffy nose, pregnancy, emotional or behavioral instability, communication barriers and abuse potential.
94
Prolonged exposure of nitrous oxide may lead to?
Tremors and other neurological symptoms, spontaneous abortion/miscarriage, numbness and tingling in the extremities.
95
Cause CNS stimulation and xerostomia, examples include Prozac (fluoxetine) and Zoloft (setraline).
Serotonin Reuptake Inhibitors (SRIs)
96
Used to treat bipolar disorder and Motrin is contraindicated when patient is taking this.
Lithium
97
Cause sedation and xerostomia, Elavil (amitriptyline), DO NOT use epinephrine with patients taking this.
Tricyclic antidepressants
98
Depresses CNS, used for epilepsy, causes gingival hyperplasia in 50% of patient’s.
Anticonvulsants-Dilantin (phenytoin)
99
Barbiturate used in management of epilepsy and causes sedation.
Phenobarbital
100
Treats partial seizures and used in dentistry to treat trigeminal neuralgia.
Carbamazepine (Tegretol)
101
Most common to treat mild allergic reactions, side effects are xerostomia and sedation, works by blocking histamine receptors in the body.
Antihistamines- Diphenhydramine (Benadryl)
102
what does H1 receptors cause?
Vasodilation, bronchoconstriction, pain and itching when stimulated.
103
What does H2 receptors cause?
Gastric acid secretion when stimulated.
104
Treats type 1 DM, subcutaneous injection, and hypoglycemia is the most common side effect.
Insulin
105
Oral hypoglycemic drugs that increased the body’s sensitivity to insulin
Metflrmin (Glucophage)
106
Oral hypoglycemic drug that stimulates the release of insulin from the b-cells of the pancreas.
Glyburide (Micronase, Diabeta)
107
What meds should be avoided in asthma patients?
Aspirin
108
Adrenergic drug, bronchodilator (opens air passages), inhaler form for immediate relief, and may cause insomnia.
Ventolin (albuterol)
109
Ends in sone or lone, used long term to prevent asthma attacks and not used for immediate relief.
Corticosteroids.
110
Combines a corticosteroid and a bronchodilator
Advair Diskus
111
Oral Med to treat asthma, emphysema and chronic bronchitis, combined with erythromycin can cause toxicity.
Theophylline
112
Systemic antacid, contraindicated in cardiovascular patients due to sodium content.
Sodium bicarbonate
113
Treats GERD and gastric ulcers, has prazole ending.
Proton-pump inhibitors
114
Block H2 histamine receptors which reduces acid secretion, has dine ending.
Histamine blocking agents
115
Used to treat cancer, often IV administered, also treats osteoporosis, associated with osteonecrosis of jaw
Biphosphonate drugs
116
Used for contraception, menopause therapy and menstrual disturbances. Steroid hormone. May cause gingival inflammation, nausea and vomiting, and may promote endometrial and breast cancer
Estrogen
117
Intermediate-acting steroid, used to TX autoimmune and inflammatory disorders: addisons and allergy. Reduces body’s inflammatory response, suppressed immunity, increased risk of infection and delays healing.
Prednisone
118
Drugs that cause gingival hyperplasia/overgrowth.
Dilantin (phenytoin), Procardia (nifedipine) and other CCBs, cyclosporine.
119
Drugs that cause gingival bleeding.
Coumadin (warfarin), Plavix (clopidogrel), Aspirin-contraindicated in patient’s taking Coumadin.
120
Drugs that cause Xerostomia.
Diuretics, CCBs, antihistamines and many others.
121
Drug used to treat Angina Pectoris/chest pain.
Nitroglycerin, works as vasodilator, administered sublingual.
122
Drugs used to treat CHF.
Cardiac glycosides, examples are digitalis and Lanoxin (digoxin).
123
Drugs used for anticoagulant therapy.
Used to prevent stroke and heart attack, patients are at increased risk of gingival hemorrhage, examples are Coumadin (warfarin), Plavix (clopidogrel), Aspirin, And heparin.
124
Drugs used for high cholesterol.
Known as antihyperlipidemics, -statin Drugs, examples are Lipitor (atorvastatin), Mevacor (lovastatin), Zocor (simvastatin), and Crestor (rosuvastatin)
125
Drugs used to treat HTN
Diuretics, beta adrenergic blocking agents, CCBs, ACE inhibitors.
126
Promote excretion of sodium and water from the body, side effects include xerostomia and orthostatic hypotension.
Diuretics
127
-olol meds, avoid epinephrine with these, Inderal (propranolol) non-selective beta blocker.
Beta-adrenergic blockers
128
Causes systemic vasodilation, side effects include gingival enlargement and xerostomia.
CCB
129
-pril meds, adverse reactions include altered taste (dysgeusia), orthostatic hypotension and dry cough.
ACE inhibitors
130
CNS stimulant, causes vasoconstriction and dilation of pupils, present with active dental decay
Cocaine
131
CNS and respiratory depression, causes sedation and “pinpoint” pupils.
Heroin
132
CNS stimulant, brain damage and severe oral effects, males aged 19-40 most common affected, rampant caries, xerostomia, And soda consumption.
Methamphetamine
