ToxExam1Breakdown Flashcards
(127 cards)
1
Q
Any substance that, when administered to living organisms, produces a change in function.
A
Drug
2
Q
Study of the adverse effects of chemical, physical or bio agents on living organisms and the ecosystem.
A
Toxicology
3
Q
Study of the science of drugs including their uses, effects, and modes of action.
A
Pharmacology
4
Q
What is the intended physiological effect of a drug.
A
Therapeutic effect
5
Q
Medical conditions or diseases for which the drug is meant to be used?
A
Indication
6
Q
Conditions/circumstances for which the drug should NOT be used?
A
Contraindications
7
Q
Conditions or types of patients that warrant closer observation for specific side effects.
A
Caution
8
Q
Unintended effects other than therapeutic effect, may or may not be negative.
A
Side effect
9
Q
A side effect that is negative, undesirable, unpleasant, or even dangerous.
A
Adverse effect
10
Q
Adverse effect of a drug resulting in drug poisoning, can be life-threatening.
A
Toxic effect/Toxicity
11
Q
Drugs, supplements, or foods that may alter the effect of the drug, and usually should not be given during the same course of therapy.
A
Interaction
12
Q
Location w/in the body where the drug exerts its therapeutic effect.
A
Site of action
13
Q
How a drug produces its effects.
A
Mechanism of action
14
Q
Action usually begins after drug attaches itself to some chemical structure, usually specific location.
A
Receptor site
15
Q
Drugs that bind to a specific receptor and produce an action.
A
Agonist
16
Q
Drugs that bind to specific receptors, prohibiting an effect.
A
Antagonists
17
Q
When both agonist and antagonist drugs bind to the same receptor and are administered together.
A
Competitive antagonism
18
Q
Which drug action is beneficial for overdoses: agonists, antagonists, or competitive antagonists?
A
Competitive antagonists
19
Q
Amount of drug given to produce an effect.
A
Dose (dose-response relationship)
20
Q
How often the drug is given.
A
Frequency (time-response relationship)
21
Q
Smallest amount of a drug that will produce a therapeutic effect.
A
Minimum dose
22
Q
Initial high dose used to quickly elevate blood levels of the drug.
A
Loading dose
23
Q
Dose that is customarily given to produce a desired effect.
A
Therapeutic dose
24
Q
Largest amount of a drug that will produce a desired effect w/out producing symptoms of toxicity.
A
Maximum dose
25
Dose required to keep the drug blood levels steady in order to maintain the desired effect.
Maintenance dose
26
Amount of a drug that will produce harmful side effects or symptoms of poisoning.
Toxic dose
27
Dose necessary to produce half of the maximum response, used to compare potency of drugs.
Effective Dose 50 (ED50)
28
First attempt to protect consumers in manufacture of drugs and foods.
1906 Pure Food and Drug Act
29
What 2 things did the 1906 Pure Food and Drug Act require drug makers to do?
1. Label dangerous ingredients
| 2. All drugs to meet minimal standards of strength, purity, and quality
30
Drug Law passed after a drug company distributed a sulfa drug to pediatric patients.
1938 Federal Food, Drug, and Cosmetic Act (FD and C)
31
The 1938 FD and C authorized the FDA to demand what 3 things of drug makers?
1. ) Evidence of safety for new drugs
2. ) Issue standards for Foods
3. ) Conduct factory inspections
32
Drug Law defining drugs that could only be purchased if the patient had a prescription form a licensed practitioner.
1951 FDandC Durham-Humphrey Amendment
33
Drug Law requiring approval of all new food additives.
1958 FDandC Food Additives Amendment
34
What are the Food Additives Amendment Exemptions?
1. ) "Generally recognized as safe (GRAS)"
| 2. ) substances approved prior to amendment
35
Drug Law requiring all colors (natural or synthetic) must be approved.
1960 FDandC Color Additives Amendment
36
Drug Law requiring drug manufacturers to use standard labeling, listing adverse reactions and contraindications.
1962 FDandC Kefauver-Harris Amendment
37
Drug Law designed to regulate the dispensing of drugs that have the potential for abuse.
1970 Comprehensive Drug Abuse Prevent and Control Act
38
What Schedule is described as:
| --High abuse potential, no accepted medical use.
Schedule 1
39
What are examples of Schedule 1 substances?
Heroin
LSD
Marijuana
Methaquilone (qualudes)
40
What schedule is defined as:
| --High abuse potential, accepted medical use.
Schedule 2
41
What are examples of schedule 2 substances?
Vicodin
Cochin
Demerol
Adderall
42
What schedule is defined as:
| --Moderate abuse potential and accepted medical use.
Schedule 3
43
What are examples of schedule 3 substances?
Tylenol w/ codeine
Ketamine
Anabolic steroids
44
What schedule is defined as:
| --Low abuse potential and accepted medical use.
Schedule 4
45
What are examples of Schedule 4 substances?
Xanax
Valium
Ativan
Ambien
46
What schedule is defined as:
| --Limited abuse potential and accepted medical use.
Robitussin AC (codeine)
Lomotil
Lyrics
Motown
47
Drug Law allowing FDA to take action against any unsafe dietary supplement.
1994 Dietary Supplements Health and Education Act
48
What Drug Law reinvestigated pesticide tolerance levels?
1996 Food Quality Protection Act
49
Prior to FDA approval for use in humans, every drug must fulfill what 2 requirements?
1. ) Efficacy
| 2. ) Safety
50
Dose that will kill 50% of animals tested?
Lethal Dose (LD50)
51
What is used to establish dosage levels in animal trials?
Therapeutic Index (TI)
52
Highest dose w/out any adverse effects?
No Observed Adverse Effect Level (NOAEL)
53
Lowest dose found by experiment or observation at which there was a statistically significant observed adverse effect
Lowest Observed Adverse Effect Level (LOAEL)
54
Drug acts as an antigen and body produces antibodies against the drug.
Drug Allergy
55
A drug allergy causes release of what 2 compounds from mast cells?
Histamine and inflammatory compounds
56
What are the 2 categories of drug allergy?
Hypersensitivity and anaphylaxis
57
Milder response, usually rash, hives, itching, runny nose.
Hypersensitivity
58
Severe, possibly fatal reaction - urticaria, vascular collapse, low BP, shock, cyanosis, laryngeal edema, bronchoconstriction, dyspnea.
Anaphylaxis
59
Genetic variations in enzymes, alters drug metabolism resulting in an unexpected response.
Idiosyncrasy
60
What drug effect creates an opposite effect from what is expected?
Paradoxical
61
Decreased response that develops after repeated doses are given?
Tolerance
62
Acquired need for a drug, may produce psychological or physical symptoms of w/draw all when discontinued.
Dependence
63
What drug response is described as:
| --Patient give sedative to sleep, but continues to sleep all night and well into the day.
Idiosyncrasy
64
What FDA Prgenancy category is described as:
| --Drug studies in pregnant women have not yet demonstrated risk to the fetus.
Pregnancy category A
65
What FDA Pregnancy Category is described as:
| --Drug studies have not been performed in pregnant women; animal studies have not demonstrated fetal risk.
Pregnancy category B
66
What FDA Pregnancy Category is described as:
--Drug studies have not been performed in pregnant women or in animals, or animal studies revealed some teratogenic potential but the risk to the fetus is unknown.
Pregnancy Category C
67
What FDA Pregnancy Category is described as:
--Drug studies have revealed adverse risk to the fetus. The benefit-to-risk ratio of the drug must be established before use during pregnancy.
Pregnancy Category D
68
What FDA Pregnancy Category is described as:
--Drug studies have revealed teratogenic effects in women and/or animals. Fetal risk clearly outweighs benefit. Drug is contraindicated in pregnancy.
Pregnancy category X
69
What FDA Pregnancy Category is described as:
| --Drug has not yet been rated by FDA
Pregnancy category NR
70
What are the Teratogenic effects of Carbazepine (Tegretol)?
craniofacial and fingernail deformities
71
What are the Teratogenic effects of Diethylstilbestrol (Synthetic estrogen)?
Vaginal tumors and genital malformations in offspring
72
What are the Teratogenic effects of Phenytoin (Dilantin)?
craniofacial and limb deformities, growth retardation
73
What are the Teratogenic effects of Thalidomide?
Phocomelia (limb deformities)
74
What are the Teratogenic effects of Warfarin (Coumadin)?
Facial, cartilage, and CNS defects
75
What are the Teratogenic effects of Depakote?
heart problems, spina bifida, facial & limb deformities, cleft plate/lip
76
What organs are most susceptible to damage for direct toxicity?
liver, kidneys, lungs
77
Why is the liver a specific organ targeted for damage from direct toxicity?
b/c its metabolically active
- -exposed to many toxic substances via GI tract
- -recieves ~25% of C.O.
78
If you detect liver damage, what biomarkers in the blood will be high and what will be low?
High: AST, ALT, Bilirubin
Low: Albumin
79
Why is the liver a specific organ targeted for damage from direct toxicity?
role in filtering waste
80
If you detect Kidney damage, what biomarkers in the blood will be high?
Blood Urea Nitrogen (BUN) and Creatinine
81
If you detect Kidney damage, what biomarkers will be present during a Urinalysis?
Y-Glutamyltransferase
N-acetylglucosaminidase
82
Why is the lung a specific organ targeted for damage from direct toxicity?
position and function
83
If you detect Lung damage, what biochemical tests can be used to determine?
none
84
What tests can you do to determine if lung damage is present?
spirometry (Forced Expiratory Volume)
| tissue biopsy
85
What are the effects of Pharmacokinetic-based drugs?
increased concentration of the compound or active metabolite
86
What are the effects of Pharmacodynamic-based drugs?
altered responsiveness of the target site
87
What are the pharmocological effects of insecticides and nerve gasses?
respiratory failure
88
What are the pharmocological effects of organophosphate insecticides?
CNS disturbances
89
What are the pharmocological effects of RX meds?
altered BP or blood sugar
90
What are the pharmocological effects of industrial solvents (hydrazine)?
altered blood sugar
91
What are the pharmocological effects of toxic solvents (carbon tetrachloride, vinyl chloride)?
anesthesia/unconsciousness
92
What are the pharmocological effects of furosemide, caffeine, ehtanol, mercury?
electrolyte imbalances
93
When are Teratogens most susceptible/damaging?
during organogensis (~18-55 days)
94
What are the 2 possible reactions for immunotoxicity?
immunosuppression or allergic reax (immediate/delayed or localized/widespread)
95
W/ Mutagenesis, drugs interact directly w/ DNA. What is the result?
base substitutions, additions or deletions
96
What are the results of clastogenesis?
chromosomal damage
97
What are the results of aneugenesis?
acquistition or loss of complete chromosomes
98
What are the 3 possible outcomes of carcinogens?
unusual tumors
increased incidence of typical tumors
appearance of tumors earlier
99
What are the 3 phases of drug activity?
pharmaceutic
pharmocokinetic
pharmacodynamic
100
What phase of drug forms occurs after the drug is given and involves disintegration and dissolution of the dosage form
pharmaceutic phase
101
What phase of drug happens as the drug moves through the body?
pharmacokinetic phase
102
What phase of drug has an action on living tissue?
pharmacodynamic phase
103
What is the most common way drugs are absorbed?
passive diffusion
104
What factors impact drug absorption?
```
drug ionization
lipid solubility
presence or absence of food in the stomach
drug formulation
circulation/rout of administration
```
105
In order for Ionized molecules to be absorbed, what needs to happen?
need to be un-ionized
106
Acid drugs mostly unionized when in what type of fluids?
acidic fluids
107
Basic drugs mostly unionized when in what type of fluids?
alkaline fluid
108
To increase excretion of basic drugs, what changes to urine pH are required?
acidic urine
109
High doses of what 2 substances acidifies urine?
Vit C or ammonium chloride
110
To increase the excretion of acid drugs, what changes to urine pH are required?
alkaline urine
111
High doses of what substance alkalinizes urine?
sodium bicarbonate
112
What are benefits of lipid soluble drugs and what is an example of what?
easier to pass through cell membranes
| --anesthesia
113
What affect does food have on drug absorption?
slows it down
114
The % of a dose that reaches the bloodstream is referred to as the...
bioavailability of a drug
115
What is the bioavailability of oral medications to reach the blood?
20-40%
116
What enzyme is needed for the metabolism of drugs?
Cytochrome P450
117
What are the 2 outcomes of drug metabolism?
excretion or return to circulation
118
What is the difference between enzyme induction and enzyme inhibition?
induction speeds up drug metabolism of all drugs
inhibition slows the drug metabolism of all drugs
119
After oral administration, some drugs are metabolized significantly as they pass through the liver the first time.
first pass metabolism
120
What are the 5 major routes of excretion?
urine, bile, lungs, GI tract, breast milk
121
What are the 4 types of drug interactions?
drug-drug
drug-dietary supps
drug-food
nutrient depletions
122
How does St. John's Wort affect drug interactions?
can reduce the concentration of meds in the blood, b/c it's an inducer of CYP450 enzyme
123
What are some examples of Grapefruit-Drug interactions?
- -Ca+ channel blockers (hypotension)
- -Statins (myopathy)
- -Antihistamines (cardiac effects)
- -Cyclosporine (transplant rejection)
124
What veggies should be avoided if taking warfarin?
green leafy veggies and avocados
125
Patients on MAOI's need to avoid what types of foods to prevent spikes in BP?
Tyramine "Wisconsin" foods
| --(aged cheesses, alcohol, sauerkraut, sausage/pepperoni/salami)
126
What types of food/supplements induce CYP450?
alcohol, caffeine, St John's Wort
127
What types of food/supplements inhibit CYP450?
echinacea, grapefruit, peppermint
