Pharmacology Exam 2

The flashcards below were created by user Rx2013 on FreezingBlue Flashcards.

Types of DI/ADR
- augmented pharmacologic effect
- Bizarre effects
- chronic effects
- delayed effects
- end of treatment effects
- failure of therapy
Chronic effect example
- reversible
- hairloss due to drug
Delayed effect example
- damage to DNA caused by chemo which later causes cancer
- birth defects
levels of severity of ADR
- Death
- Life-threatening
- disability
- congenital anomaly
Prevalence of ADR
- 2 million ADR/year
- 100,000 deaths / year
- 6th leading cause of death
- 350,000 per year in nursing homes
Costs associated with ADR
- 136 billion /year
- cost of bringing drugs to market and then having them removed due to ADR
- increasing hospital stay, cost and mortality for ADR pts.
Common Drug classes of ADR
- Cardiac
- Liver
Drugs eliminated from development due to ADR

38%
Stages at which drug interactions occur
- pharmacodynamics
- pharmaceuticals
- pharmacokinetics
Pharmacodynamic
- Antagonists/agonist competition
- Additive/synergistic effects
- Fluid/e- imbalance
- Indirect interactions
Pharmaceutical
- incompatibility between two drugs
- precipitation (physical)
- change in the nature of the drug (chemical)
Pharmacokinetic
- Altered absorption
- Altered distribution
- Altered metabolism
- Altered elimination
Altered absorption (non transporter based)
- changes in GI pH
- chelation
- changes in GI flora
- change in GI motility
- malabsorption caused by other drug
Altered absorption (transporter based)
- modulation of transporter activity (inh. or ind. by other drug)
- polymorphisms of transporters (genetic)
- nonlinear kinetics result
P-glycoprotein inhibition

increased plasma levels of digoxin
p-glycoprotein induction

decreases plasma digoxin
Altered metabolism
- toxic drug metabolites
- inhibition or induction of CYP 450
- CYP polymorphism
Reason for toxic metabolite formations with drugs metabolized by CYP

80% of drugs are metabolized by CYP
induction of CYP
- increased metabolism
- changes efficacy
- increases toxicity
inhibition of cyp
- decreases metabolism
- changes efficacy
- increases toxicity
CYP304

50%of drugs metabolized
Inducers of CYP
- ethanol
- st. john's wart
Polymorphism with no CYP2D6
- slow metabolism
- high drug levels
- high risk for ADR
- no response from some prodrugs
Polymorphism with increased CYP2D6
- too rapid metabolism
- no drug response at normal dose
Altered Excretion
- 1-2% of DI
- change in active excretion
- change in biliary excretion
- change in renal blood flow
- change in urine pH
Which of the following are examples of DI/ADR due to non-transport mediated altered absorption?
A. Physical interaction
B. change in GI pH, Chelation and GI Flora
C. change in GI pH
D. GI Flora
E. Chelation

B. change in GI pH, Chelation and GI Flora
(this multiple choice question has been scrambled)
What is the most prevalent stage of DI?
A.Pharmacokinetics
B. Pharmaceutical
C. Pharmacodynamics

A.Pharmacokinetics (metabolism)
(this multiple choice question has been scrambled)

Author

Rx2013

39012

Card Set

Pharmacology Exam 2

Description

Drug Interactions, Adverse Drug Reactions

Updated

2010-10-02T02:23:46Z

Show Answers