Intro to Pharmacology

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Intro to Pharmacology
2010-09-16 22:52:34

Intro to Pharmacology
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  1. What is pharmacokinetics?
    How a drug gets into the body and how it is distributed throughout.
  2. What is pharmacodynamics?
    How a drug effects the body processes. Important in pharmacodynamics is the difference between therapeutic effects and side effects.
  3. What is the chemical name of a drug?
    Name that describes the chemical make-up of a drug. No one uses this name.
  4. What is a generic name of a drug?
    Generic name is the name that is assigned to a drug when it is first given to humans.
  5. What is the trade name of a drug?
    The name given to a drug by a company who manufactures it for market.
  6. What are the five rights of drug administration?
    What part of the nursing process do they occur? Right patient, right dose, right drug, right route, right time.
  7. What are the three ways drugs can be classified?
    By chemical structure, by mechanism of action and according to use.
  8. What is the best way to classify a drug and why?
    Mechanism of action, because you can tell a lot of things about a drug by its mechanism of action. Use is okay, but one drug can be used for many things, like diphenhydramine. Sleep aid and antihistamine. Chemical structure doesn’t tell what a drug does and therefore is not very useful.
  9. What is efficacy?
    Able to produced the desired result.
  10. What is indication?
    A symptom that suggests medical treatment is necessary.
  11. What does a drug company have to prove before it can market a drug to the public?
    It has to prove that the drug is efficacious for the indication for which it is marketed. It has to proved that the drug is safe.
  12. What is off-label use?
    Using a drug for something other than the approved indication.
  13. What are three factors that determine how safe a drug has to be?
    Long-term vs. short-term use, over the counter use and prescribed use.
  14. What is the name of the FDA process used to test a drug on humans?
    Clinical trials.
  15. What must a drug company do to be approved for clinical trials and what is the name of the application?
    The company must test the drug on animals to determine if there are any side effects. Long-term medications are tested for cancer over long periods of time. IND, Investigation New Drug application.
  16. What does the IND include?
    Data from animal testing and a plan for how the drug will be tested on humans.
  17. How many phases are there in clinical trials?
    3, Phase I, Phase II and Phase III
  18. What is the purpose of Phase I and who/how many is/are involved?
    Phase I determines the maximum tolerated dose to be used in future phases. The dose is increased step-wise with healthy people until the adverse effects are not tolerable. This phase includes very few people, less than 50 and sometimes only 10.
  19. What is the purpose of Phase II and who is involved/how many?
    The purpose of Phase II is to determine the dosing range for people who have the indication the drug is supposed to help. Blood and urine samples determine distribution and elimination of the drug. People should get better with use. Fewer than 50 people with the indication participate in Phase II.
  20. What is the purpose of Phase III and who is involved/how many?
    Phase III is supposed to demonstrate safety and efficacy of the drug in question. Several hundred people with the indication are tested using a double-blinded study. Some receive a placebo (unless it is not ethical and standard treatment is used) and some received the drug being tested. Pregnant women and people with serious comorbidities are excluded. May last months or years. Must do separate Phase III studies for separate indications. Patients are closely monitored and FDA can request a repeat of Phase III or halt process altogether. FDA and company negotiate prescribing dose and information about adverse effects.
  21. What are controlled substances and who regulates them?
    Controlled substances are substances that have the potential to be abused and the Drug Enforcement Agency (DEA) regulates them.
  22. What are examples of a Schedule I drugs and what is their abuse potential?
    Heroine, LSD, high abuse potential
  23. What is an example of a Schedule II drug?
    Amphetamines and some opoiods, high abuse potential
  24. What are examples of Schedule III drugs?
    Many opioids, some stimulants and anabolic steroids. Moderate
  25. What are examples of Schedule IV drugs?
    Tranquilizers (like Valium) and weak opioids, low abuse potential
  26. What are examples of Schedule V drugs?
    Antidiarrheals and drugs that contain small amounts of opioids in mixtures. Limited abuse potential.
  27. What is Pharmocology?
    Study of drugs and their interaction with living systems.
  28. What is a drug?
    Any chemical that can affect a living process.
  29. What types of macromolecules can serve as receptors for drugs?
    Almost any molecule in the body: neurotransmitters, enzymes, transport proteins, channels, etc…
  30. What are the four classes of macromolecules defined as receptors?
    • G protein receptor
    • Membrane bound receptor
    • Ligand gated ion channels
    • Transcription factors with activating ligands
  31. What determines drug specificity?
    The number of receptors it can bind. Fewer receptors increases specificity.
  32. What is a better consideration when choosing a drug, potency or efficacy?
    Efficacy. Because if the drug doesn’t work to relieve the symptom then potency doesn’t matter. If a drug is more potent, but has the same efficacy then potency still doesn’t matter.
  33. What is simple occupancy theory?
    Receptors for a drug are occupied a higher rates as dose levels increase until all receptors are bound and a plateau is reached.
  34. What is modified occupancy theory?
    Takes into account that a drug binding to a receptor may mimic the effect of an endogenous ligans, produce a lesser effect than the endogenous ligand, produce no effect.
  35. What happens when a drug binds to a receptor and produces no effect?
    It prevents the endogenous ligand from binding to the receptor
  36. What is intrinsic activity?
    The ability of a drug to activate a particular receptor when bound to it.
  37. What substances have full (100%) intrinsic activity?
    Endogenous ligands and full agonists.
  38. What is an agonist?
  39. What is an antagonist?
  40. What is the difference between a competitive antagonist and a non-competitive antagonist?
    A competitive antagonist binds reversibly with a receptor in equilibrium with the endogenous ligands. Can be overcome with higher concentration of agonists or endogenous ligands. Non-competitive ligands bind irreversibly with receptors and cannot be overcome by agonists, competitive antagonists or endogenous ligsnds.
  41. What kind of bonds to competitive antagonists form with receptors? And non-competitive?
    Competitive antagonists bind electrostatically and non-competitive antagonists bind covalently.
  42. What happens when receptors are continually exposed to agonists?
    They downregulate their response. This can be rapid (desensitization) or slow and permanent (tolerance). This lessens the effect of the drug.
  43. What else can lessen the effect of a drug?
    Anything that speeds up the drug’s elimination from the body.
  44. What happens when receptors are continually exposed to antagonists?
    Upregulation of receptors and can lead to supersensitivity.
  45. What happens when an antagonist drug is suddenly discontinued?
    The increased numbers of receptors bind more endogenous ligands causing exaggerated effects.
  46. What is ED50%
    The dose at which 50% of the people taking the drug are getting a desired effect.
  47. What is LD50%
    The dose at which the drug is lethal for 50% of the population.
  48. What is the formula for therapeutic index?
    • LD50% / ED50%
    • Is a drug with a large therapeutic effect more or less safe?
    • Large therapeutic effect is a safer drug. If a drug has a narrow therapeutic effect then lethal dose is more likely.
  49. What is toxicity?
    Undesireable or dangerous effect of a drug brought on by high levels of the drug.
  50. What is side effect?
    Undesireable effects of the drug a therapeutic levels as a result of the drug’s interaction with the receptor.
  51. What is an allergic reaction?
    A reaction to the drug brought about by the immune system.
  52. What happens when a person has a drug allergy?
    They are given another class of drug that produces the same therapeutic effect
  53. What is the exception?
    NSAIDs, because the reaction is not mediated by antibodies. Someone allergic to NSAIDs can never take NSAIDs again.