Pharmacology Chapter 5

Front 1

factors that influence the effects of a drug

Back 1

1. patient compliance
2. pychologic factors--ex. placebo
3. tolerance to medication
4.Time of administration
5. gender of patient
6. age & weight

Front 2

uncommon condition where tolerance develops rapidly

Back 2

Tachphylaxis

Front 3

At what age are patients more likely to experience ADEs than young adults?

Back 3

65

Front 4

what % of office visits is associated with initiation or continuation of pharmcotherapy

Back 4

75%

Front 5

what two age groups are more likely to experience ADEs

Back 5

the very old and the very young

Front 6

associated with the administration of therapeutic dosages of a drug ( rather than high doses)

Back 6

Type A ADEs

**this type result interaction with other drugs, interaction with food or interaction of change is disease change(disease-drug interaction)

Front 7

What type of ADE type is predictable and avoidable

Back 7

Type A


**associated with cytotoxic and toxic rxn

Front 8

What type of ADE type is unpredictable and and maybe unavoidable and not dose related

Back 8

Type B

Front 9

This type of ADE type has idosyncratic response
Immunologic/Allergic reaction
Pseudoallergic reactions
Teratogenic effects
Oncogenic effects

Back 9

Type B


**ex. ONJ

Front 10

most commonly caused by formation of unstable or reactive metabolites following biotransformation and are related to some abnormality that interferes with the normal metabolism and/or excretion

Back 10

Cytotoxic Reactions

Front 11

a mechanism that leads to the formation of intermediate compound capable of binding covalently

Back 11

Oxidative Pathway

Front 12

a mechanism that leads to the formation of free radicals

Back 12

Reductive Pathway

Front 13

What are the pharmacodynamic Drug-Drug interaction Types

Back 13

1. Pharmacologic- two drugs competes with the same receptor site
2.Physiologic- two drugs interact w/ different receptor site to either enhance each other's rxn or diminish
3. Chemical- one drug competes with another drug and prevents that drug from interacting with its intended receptor
4. Receptor alteration- Drug A increase or decrease the # of its own receptors to alter adaptibility

Front 14

duration and intensity of a drug's actions is based on the amt. of drug in the circulation called

Back 14

plasma level

Front 15

this type of agent produces inactive complexes that cannot cross the intestinal mucosa

Back 15

chelating

** ex. interaction with tetracycline with calcium in milk

Front 16

Interactions that Affect Metabolism:
some ex. are:

Back 16

Grapefruit interaction with:
Abx
CCB
Benzos
Warfarin

**grapefruit inhibits CYP450 enzyme in liver of breaking down drugs mentioned above

Front 17

Interactions that affect excretions, ex. are:

Back 17

1. change in pH in kidney--inhibit excretion of some drugs

**Probenecid inhibits renal tubular excretion of penicillin thereby increasing duration of action

Front 18

interactions that affect distribution,
ex.are:

Back 18

Drug A ( weak Acid) competes for plasma protein binding with Drug B, increase the plasma level of Drug B

Front 19

Interactions that affect absorptions

Back 19

- Drug A forms complex with Drug B interferes with absorption
-delaying gastric emptying
-elevating gastric pH
-causing vasoconstrition interfering with absorption

Front 20

Which ADEs are related to genetic determination?

Back 20

Type B

**remember Idiosyncratic response are genetic variation or age-related variables

Front 21

Which type of ADE manifests after long time periods following drug ingestion

Back 21

Type B

**remember ONJ (osteonecrosis of Jaw) due to taking bisphosphonate to tx osteoporosis

Front 22

what patient instructions should be given if prescribed Tetracycline

Back 22

not to take with milk or calcium containing products

Front 23

Why are some drugs to be taken on an empty stomach?

Back 23

Nutrients may act as a mechanical barrier that prevents drug access to mucosal surface affecting absorption of drug

Front 24

An example of chelating drug-food interation is?

Back 24

tetracycline and milk

Front 25

Which liver enzymes are responsible for drug-grapefruit interactions

Back 25

CYP450 3A4 isoenzymes

Front 26

How would an acid agent affect excretion of other acid drugs used simultaneously?

Back 26

acidic agents can lower the pH in the glomerulus and cause acidic drugs to be reabsorbed in the kidney, thereby delaying excretion and placing the acidic agent back into circulation

Front 27

An unusual reaction of any intensity observed in a small percentage of individuals

Back 27

Idiosyncrasy


**are most often related to genetic variation affecting the biotransformation activities amoung CYP450 enzymes in the liver

Front 28

a drug that produces its usual effects at an unexpectedly high dose

Back 28

Hyporeactive

Front 29

a drug that produces its effect at an unexpectedly low dosage

Back 29

hyperreactive

Front 30

Patients who LACK this enzyme activity will exhibit poor metabolism of certain drugs

Back 30

CYP2D6

Front 31

patients who have REDUCED activity of CY2D6

Back 31

intermediate metabolism

Front 32

is a substance recognized as "foreign" to host antibodies

Back 32

antigen

Front 33

is a substance of lower molecular weight than an antigen and can react with and antibody

Back 33

Hapten

*remember is is unable to induce antibody production unless it is attached to another molecule, usually a protein

Front 34

Example of a Hapten

Back 34

Penicillin

** Penicillin must attach to albumin before it can induce antibody synthesis

Front 35

the first time a individual exposed to an allergic chemical, plasma cell form antibodies to destroy the antigen

Back 35

sensitization

Front 36

drug allergies are observed TWICE as frequent in who? women or men

Back 36

Women

Front 37

What are the 4 main types of antigen/antibody hypersensitivity rxns?

Back 37

- Immediate (Type I)
-cytotoxic (Type II)
-immune-complex (Type III)
-Delayed (Type IV)

Front 38

In what type of Hypersensitivity Rxn does IgE get produced?

Back 38

Type I