Pharmacology

Card Set Information

Author:
sthomp88
ID:
65771
Filename:
Pharmacology
Updated:
2011-02-12 09:16:28
Tags:
Chapter five interactions
Folders:

Description:
week five
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user sthomp88 on FreezingBlue Flashcards. What would you like to do?


  1. desireable drug effects
    therapeutic effects
  2. true or false. There are absolutely no safe biologically active agents
    true
  3. What are 4 factors that that prescribers must take into consideration when selecting drugs?
    • diagnosis of the problem - what will the drug be used for?
    • Individual variations in physiologic status
    • Variations in desease states (i.e. pregnancy)
    • drug related pharmacodynamic and pharmacokinetic variables - exaggerated response, expected but undesired response etc.
  4. Who approves drugs for specific indications or uses?
    FDA
  5. When a drug is prescribed for other conditions than what the FDA approved it for; e.g. antihistamine used to treat insomnia
    "off-label" use
  6. What drug is contraindicated in individuals with peptic ulcer disease?
    aspirin
  7. occur when other biologically active chemicals compete with a drug at the receptor site or during the pharmacokinetic phases of medication action
    drug-related pharmacodynamic and pharmacokinetic variables
  8. __________ during the reveiw of drugs listed on the health history should include monitoring for potential side effects
    follow-up questioning
  9. What are 6 factors that can influence the effect of a drug?
    • pt noncompliance
    • psychologic factors (placebo effect)
    • tolerance to medecation (tachyphylaxis)
    • time of administration
    • sex of client
    • age and weight
  10. The placebo effect results from what 3 things?
    • doctor-patient relationship
    • significance of the therapeutic effect to the pt
    • mental setting imparted by the clinician
  11. true or false. all drugs can produce a placebo effect. The placebo effect can significantly contribute to the success of therapy
    both are true
  12. What can develop when a drug is taken for a long period of time?
    tolerance to the medication
  13. What can solve the problem when tolerance to a drug arises?
    changing to another drug with the same effect
  14. Is it more likely for women or men to be sensitive to certain drugs requiring lower doses?
    women
  15. Which of the following would require a higher dose of a drug?
    a lean but muscular 200 lb man
    a lean 150 lb man with a smaller muslce mass
    200 lb man who is more muscly
  16. What percent of office visits to medical practitioners are associated with the initiation or continuation of pharmacotherapy?
    75%
  17. What percent of hospital admissions could be attributed to ADE's?
    3-11%
  18. The incidence of ADE's during hospitilization ranges from what percentages depending on the type of hospital, definition of an ADE, and study methology?
    .3%-44%
  19. What are the two classifications of ADEs?
    Type A or Type B
  20. associated with administration of therapeutic dosages of a drug (rather than high doses) usually are predicatable and avoidable, and are responsible for most ADE's
    Type A ADE's
  21. The following reactions usually occur in what type of ADE?
    cytotoxic reactions
    drug-drug interactions
    drug-food interactions
    drug-disease interactions
    Type A
  22. ADE's that are generally independant of the dose and are rarely predictable or avoidable
    Type B
  23. The following reactions occur in what type of ADE?
    Idiosyncratic reactions
    immunologic/allergic reactions
    pseudoallergic reactions
    teratogenic effects
    oncogenic effects
    Type B
  24. Which type of ADE is uncommon, but are among the most serious and potentially life threatening of all
    Type B
  25. Type B ADEs usually affect which certain organ systems?
    • liver
    • hematopoietic system (spleen and bone marrow)
    • skin and mucosa
  26. How long does it usually take for Type B ADEs to show clinical effects?
    often up to 12 weeks, with the exception of immediate hypersensitivity reactions
  27. What is an important example of a type B ADE with relevance to dentistry?
    Osteonecrosis of the jaw (ONJ) following bisphosphonate administration
  28. What is bisphosphonate used to treat? And what is an ADE that may result from taking it?
    • prevention of bone density changes during chemotherapy
    • to treat osteoperosis
    • may cause ONJ
  29. Which mechanisms are associated with type A ADE reactions?
    cell damage and vary from minor side effects to severe organ damage
  30. What are the most adverse effects of overdose?
    extensions of the drug's therapeutic effect
  31. reactions that are most commonly caused by the formation of unstable or reactive metabolites following biotransformation and are related to some abnormality that interferes with the normal metabolism and/or excretion of therapeutic dosages of a drug; events which lead to the saturation of hepatic enzyme systems
    cytotoxic reactions
  32. What are the 2 main mechanisms that lead to the formation of intermediate compounds during biotransformation, or cytotoxic reactions?
    • oxidative pathway
    • reductive pathway
  33. can produce compounds capable of binding covalently with cellular macromolecules
    oxidative pathway
  34. gives rise to the formation of such substances as free radicals
    reductive pathway
  35. substances that react with oxygen and produce reaction metabolites do what?
    overwhelm normal antioxidant defense systems
  36. covalent binding to proteins and the oxidation of biologic macromolecules lead to what?
    direct cytotoxic effects
  37. two or more drugs administered in therapeutic dosages at the same time or in close sequence may have what three interactions?
    • act independantly
    • interact to increase or diminish the magnitude or duration of action of one or more drugs
    • interact to cause an unintended reaction
  38. all drug-drug interactions all seem to have a _____________ or a ____________ basis; the same pharmacologic mechanisms that account for a drugs efficacy also can account for many if its adverse effects
    • pharmacodynamic
    • pharmacokinetic
  39. in pharamcodynamic interactions, of drug-drug interactions, the intended effect produced by a given plasma level is altered in the presence of a second drug; what are 4 different characterizations of these type of ineractinos?
    • pharmacologic interactions
    • physiologic interactions
    • chemical interactions
    • drug-related recepter alterations
  40. What type of pharmacodynamic drug-drug interaction mechanism is described:
    drug A and drug B compete for the same receptor site and, as a function of their repective concentrations, either produce (an agonist) or prevent (an antagonist) an effect
    pharmacologic
  41. What type of pharmacodynamic drug-drug interaction mechanism is described:
    drug A and drug B interact with different receptor sites and either enhance each other's action or produce an opposing effect via different cellular mechanisms
    physiologic
  42. What type of pharmacodynamic drug-drug interaction mechanism is described:
    drug A competes with drug B and prevents drug B from interacting with its intended receptor
    chemical
  43. What type of pharmacodynamic drug-drug interaction mechanism is described:
    drug A, when administered long term, may either increase, or decrease the number of its own receptors or alter the adaptability of receptors to physiologic events
    receptor alterations
  44. What are 3 examples of drugs that will result in a pharmacologic drug-drug interacion mechanism?
    • opiods vs. naloxone
    • acetylcholine vs. atropine
    • epinephrine vs. adrenergic receptor blocking agents
  45. What are 3 examples of drugs that will result in a physiologic drug-drug interaction mechanism?
    • cholinergic agents enhance the action of diazepam
    • epinephrine opposes the action of histamine
    • epinephrine opposes the action of lidocaine
  46. What is one example of drugs that will result in a chemical drug-drug interaction mechanism?
    protamine sulfate inhibits heparin
  47. What are 2 examples of drugs that will result in a receptor alteration drug-drug interaction mechanism?
    • alpha 1-adrenergic receptor agonists down-regulate their own receptors
    • beta 1-adrenergic receptor antagonists up-regulate their own receptors
  48. The duration and intensity of a drug's action is based on what? Which is also called what?
    • the amount of drug in the circulation
    • plasma level of drug
  49. The plasma level of the drug is directly related to what 4 things?
    • rate of absorption
    • distribution
    • metabolism
    • excretion
    • (describing pharmacokinetic drug-drug interactions)
  50. The concept of affinity illustrates what type of drug-drug interaction when 2 drugs are together and the drug with the greater overall affinity for the plasma protein will in crease in the free unbound molecules of the second drug
    pharmacokinetic drug-drug interaction
  51. When a drug with greater affinity for the plasma protein causes an increased in the free, unbound molecules of the second drug, what results?
    • toxic effects (overdose) of the second drug
    • (a pharmacokinetic drug-drug interaction)
  52. The following mechanism describes what type of pharmacokinetic drug-drug interaction?
    When Drug A interferes with the absorption of Drug B
    interactions that affect absorption
  53. The following mechanism describes what type of pharmacokinetic drug-drug interaction?
    When Drug A competes for plasma protein binding with Drug B
    interactions that affect distribution
  54. The following mechanism describes what type of pharmacokinetic drug-drug interaction?
    When Drug A interferes somehow with enzyme activity responsible for Drug B
    interactions that affect metabolism
  55. The following mechanism describes what type of pharmadokinetic drug-drug interaction?
    Drug A increases or decreases the plasma level of drug B by somehow reacting with urine or transport mechanisms
    interactions that affect renal excretion
  56. The following mechanism describes what type of pharmacokinetic drug-drug interaction?
    Drug A decreases the plasma level of drug B by affecting bioflow or enterohepatic circulation
    interactions that affect biliary excretion
  57. The following mechanism is describing a pharmacokinetic drug-drug interaction that affects absorption; what are the drugs that use this mechanism?
    Drug A, by causing vasoconstriction, interferes with the systemic absorption of drug B
    epinephrine vs. lidocaine (or other LA agents)
  58. The following mechanism is describing a pharmacokinetic drug-drug interaction that affects absorption; what are the drugs that use this mechanism?
    drug A, by forming a complex with Drug B, interferes with the systemic absorption of drug B
    calcium vs. tetracycline
  59. The following mechanism is describing a pharmacokinetic drug-drug interaction that affects absorption; what are the drugs that use this mechanism?
    Drug A, by delaying gastric empying, delays the systemic absorption of Drug B, which is absorbed primarily in the intestine
    opioids vs. acetominophen
  60. The following mechanism is describing a pharmacokinteic drug-drug interaction that affects absorption; what are the drugs that use this mechanism?
    Drug A, by elevating gastric pH, prevents the absorption of drug B (a weak acid)
    antacids vs. acetylsalicylic acid
  61. the following mechanism is describing a pharmacokinetic drug-drug interaction that affects distribution; what are the drugs that use this mechanism?
    Drug A (a weak acid), by compensating for plasma protein binding with Drug B, increases the plasma level of Drug B.
    acetylsalicylic acid vs. sulfonylureas and many other drugs
  62. The following mechanism is describing a pharmacokinetic drug-drug interaction that affects metabolism; what are the drugs that use this mechanism?
    Drug A, by increasing or decreasing hepatic microsomal enzyme activity responsible for the metabolism of Drug B, increases or decreases the plasma level of Drug B, respectively
    • macrolides, azole antifungals, and ethanol (chronic use) increase the plasma level of many drugs
    • H2-receptor antagonists decrease the plasma level of many drugs
  63. the following mechanism is describing a pharmacokinetic drug-drug interaction that affects metabolism; what drugs use this mechanism?
    Drug A, by decreaseing hepatic nonmicrosomal enzyme activity responsible for the metabolism of drug B, increases the plasma level of Drug B
    MAO-inhibitors increase the plasma level of benzodiazepines
  64. The following mechanism is describing a pharmacokinetic drug-drug interaction that affects metabolism; what drugs use this mechanism?
    drug A, by inhibiting the enzyme acetaldehyde dehydrogenase, interferes with the further metabolism of intermediate metabolites (oxidation product) of Drug B
    disulfiram and metronidazole inhibit the metabolism of intermediate metabolites of ethanol
  65. The following mechanism is describing a pharmacokinetic drug-drug interaction that affects renal excretion; what drugs use this mechanism?
    Drug A, which competes with Drug B for the same excretory transport mechanisms in the proximal tubules, increases the plasma level of drug B
    acetylsalicylic acid and probenecid increase the plasma level of penicillin and other weak acids
  66. The following mechanism is describing a pharmacokinteic drug-drug interaction that affects renal excretioin; what drugs use this mechanism?
    Drug A, by alkalizing the urine, decreases the plasma level of drug B
    sodium bicarbonate decreases the plasma level of weak acids
  67. The following mechanism is describing a pharmacokinetic interaction that affects renal secretion; what drugs use this mechanism?
    Drug A, by acidifying the urine, decreases the plasma level of Drug B
    ammonium chloride decreases the plasma level of weak bases
  68. The following mechanism is describing a pharmacokinetic interaction that affect biliary excretion; what drugs use this mechanism?
    drug A, by increasing bile flow and the synthesis of proteins, which function in biliary conjugation mechanisms, decreases the plasma level of drug B
    phenobarbital decreases the plasma level of many drugs
  69. the followin mechanism is describing a pharmacokinetic interaction that affect biliary excretion; what drugs use this mechanism?Drug A binds to Drug B, which would undergo extensive enterohepatic recirculation, and decrease the plasma level of drug B
    activated charcoal and cholestyramine decreases the plasma level of many drugs
  70. What are the 5 different types of pharmacokinetic drug-drug interactions?
    • interactions that affect absorption
    • interactions that affect distribution
    • interactions that affect metabolism
    • ineractions that affect renal excretion
    • interactions that affect biliary excretion
  71. True or false. nutrients may may reduce the efficacy of or increase the duration of certain medications (a drug-food interaction)
    true
  72. Why would it benefit us to be aware of certain drug-food interactions?
    to educate patients on foods to avoid while taking a drug, and optomized the pharmacotherapy
  73. What food product should be avoided while taking tetracycline?
    milk products
  74. drug-food interactions can affect what 3 things?
    • absorption
    • metabolism
    • excretion
  75. a meal with high fatty acid content will __________ the absorption of lipid soluble drugs
    increase
  76. The interaction of tetracycline with calcium in milk and other dairy products is an example of a __________ reaction
    chelating (chemical interaction affecting absorption)
  77. a reaction that can produce inactive complexes that cannot cross the intestinal mucosa during the absorption phase
    chelating reaction
  78. ferrous or ferric salts in liver or organ meats can bind with tetracycline and fluoroquinolonge antibiotics, preventing what?
    their absorption
  79. Components in grapefruit juice inhibit what? Causing what?
    • the CYP450 3A4 isoenzyme in the liver
    • plasma levels of drugs metabolized by this isoenzyme to greatly increase and relust in overdose or toxicity
  80. What are 3 examples of drugs used in dentistry that are affected by the affects of grapefruit juice?
    • calcium channel blockers
    • benzodiapines
    • warfarin
  81. What drug class is clarithromycin? And what is it's affect if taken with grapefruit?
    • antibiotic
    • arrhythmia
  82. What drug class is diazepam, midazolam, and triazolam? And what are their affects when taken with grapefruit?
    • benzodiazepines
    • decreased psychomotor function and increased sedation
  83. What drug class is amlodipine, felodipine, and nifedipine? And what are their effects when taken with grapefruit?
    • clacium channel blocking agents
    • tachycardia and hypotension
  84. What drug class is warfarin? And what is its effect when taken with grapefruit?
    • oral anticoagulants
    • increased bleeding
  85. Can changes in the pH of kidney fluids inhibit excretion of some drugs? What is an example of this?
    • yes
    • large dose of Vitamin C (ascorbic acid) can lower pH in glomerulus and cause acidic drugs to be reabsorbed in the kidney, delaying excreation and placing vitamin back in circulation
  86. drug-disease interactions can involve mechanisms related to both ___________ and ____________ principles
    • pharmacodynamic
    • pharmacokinetic
  87. this drug-disease interaction; nonselective beta-adrenergic receptor antagonists such as propranolol, can induce an asthma attack in susceptible individuals by blocking beta 2-adrenerbic receptors that aid in bronchodilation; is what type of interaction?
    pharmacodynamic
  88. this drug-disease interaction; beta 1-adrenergic receptor antagonists can adversely effect glycogen metabolism and inhibit an endogenous epinephrine-mediated hyperglycemic response to excessive insulin levels, thus placing the diabetic pt at risk; is what type of interaction?
    pharmacodynamic

What would you like to do?

Home > Flashcards > Print Preview