Psychopharm Exam 1 (Set 1-Intro)

Front 1

multiple

Back 1

every drug has _____ effects

Front 2

amount taken (dose-response effect)

Back 2

the effects of a drug depend on_____

Front 3

individuals history and expectation

Back 3

the effects of a drug depends on an individual's _______ and _______ of the drug taking experience

Front 4

site of action

Back 4

the place in the body where the drug acts to produce its effect

Front 5

1. route of admin

2. amount admin

3. extent and rate of absorbtion

4. distribution in the body

5. binding or deposition in tissues

6. biotransformation rate

7. excretion rate

Back 5

relevant factors for achieving an adequate conc in the SOA

Front 6

1. molecular size and shape

2. solubility at site of absorbtion

3. degree of ionization

4. relative lipid solub of ionized and non-ionized forms

Back 6

drug characteristics that influence absorption at the site of admin

Front 7

enteral

Back 7

route of drug admin that includes oral, rectal, sublingual

Front 8

liver

Back 8

drugs administered by the enteral route reach the ______ before going into general circulation

Front 9

rectal route

Back 9

route is useful when oral ingestion is precluded by vomiting or when patient is unconscious

-absorption is irregular and incomplete however

Front 10

microbes

Back 10

affects how your brain will get drugs to the SOA,

contribute more genes to human survival than human genes

Front 11

gut microbiota

Back 11

bidirectional communication between ______ and components of the gut brain axis influence normal homeostasis and contribute to the risk of disease

-depressed people more at risk for health issues

Front 12

siblingual

Back 12

this route does not go through the liver first

-drain out of mucus and go right intoc the vena cava into the heart and then to the brain quickly

Front 13

acidic, basic

Back 13

in the stomach ____ drugs are absorbed and _____ drugs accumulate

Front 14

basic, acidic

Back 14

in the intestine which is only slightly acidic, ____ drugs are better absorbed than acidic drugs

Front 15

nonioniozed

Back 15

______ drug are better at getting through the membranes

Front 16

fats

Back 16

dietary _____ can increase the absorption of fat soluble vitamins and drugs

Front 17

empty

Back 17

drugs are absorbed fastest and most completely when the stomach is ______

Front 18

small intestine

Back 18

orally administered drugs are primarily absorbed through the _______

-anything that slows emptying of the stomach thus slows absorption of the drug

Front 19

temp, size of food particle and pH in stomach

Back 19

passage of drugs from the stomach is influenced by ______, ______and ________

Front 20

parenteral

Back 20

route that are given other than via intestines

-injection, inhalation (intravenous, subcutaneous, and intramuscular routes)

Front 21

safe, self-admin, economical, no needle related complications

Back 21

oral (PO) advantages

Front 22

slow, and highly variable absorption, subject to first-pass metabolism, less predictable blood levels

Back 22

oral (PO) disadvantages

Front 23

most rapid, most accurate blood conc

Back 23

intravenous (IV) pros

Front 24

overdose danger, cannot readily be reversed, requires sterile needles and medical technique

Back 24

intravenous (IV) cons

Front 25

slow and even absorption

Back 25

intramuscular (IM) pros

Front 26

localized at site of injection, needs sterile equip

Back 26

intramuscular (IM) cons

Front 27

slow and prolonged absorption

Back 27

subcutaneous injection (SC) pros

Front 28

variable absorption depending on blood flow

Back 28

subcutaneous injection (SC) cons

Front 29

large absorption surface, very rapid onset, no injection equipment needed

Back 29

inhalation pros

Front 30

irritation of nasal passages, small particles inhaled may damage lungs

Back 30

inhalation cons

Front 31

localized action and effects, easy to self-administer

Back 31

topical pros

Front 32

may be absorbed into general circulation

Back 32

topical cons

Front 33

controlled and prolonged absorption

Back 33

transdermal pros

Front 34

local irritation, useful only for lipid soluble drugs

Back 34

transdermal cons

Front 35

bypasses blood-brain barrier, very rapid effect on CNS

Back 35

epidural pros

Front 36

not reversible, needs trained anesthesiologist, possible nerve damage

Back 36

epidural cons

Front 37

increases blood flow

Back 37

if a drug _______into its own region, it enhances its own rate of absorption

-vasodilation of blood vessels and enhanced absorption

Front 38

cocaine

Back 38

example of a drug that contricts blood vessels and reduces its own absorption into the body

-blocks Na+ channels -> causes less blood flow to the nose and he cartilage becomes necropsic and breaks down

Front 39

mucous and skin surfaces, inunction

Back 39

two types of topical applications and name given for application

Front 40

mucous membranes

Back 40

type of topical application with fast absorption

Front 41

skin

Back 41

few drugs can readily penetrate intact ______

-absorption usually proportional to the surface area over which they are applied and to their lipid solubility

Front 42

dermis

Back 42

skin layer that is freely permeable to many drugs

Front 43

abraded, burned, denuded

Back 43

systemic absorption occurs more readily through __________ skin

Front 44

inflammation

Back 44

also causes enhanced absorption

Front 45

hydrated

Back 45

______ skin is more permeable than dry skin

Front 46

oily vehicle

Back 46

suspending the drug in _______ and rubbing into skin can help (in inner forearm and thigh)

Front 47

lymph nodes

Back 47

these on inner surfaces can develop large lumps sometimes when suntan lotion is rubbed in

Front 48

brain, bone, fat

Back 48

anything that collects in _________ has to go through the blood and metabolizes most of the time and doesn't go to the site of action

Front 49

highest

Back 49

well vascularized areas will have the ________ concentration of the drug

(brain receives 20% of blood flow to the heart)

Front 50

partition coefficient

Back 50

the relative affinity of a drug for either lipid or water environments

-determines how fast a drug with pass out of the barriers to get to the site of action

-statement of how soluble a drug is in oil v water

Front 51

euphoric effect

Back 51

speed of entry into the brain is the basis of its __________

Front 52

size and degree of ionization

Back 52

______ and _________ of a molecule effects its entry rate into the brain

Front 53

ionization factor

Back 53

how easily ionized a drug is by the solution it is in (depends on the pH of the solution)

Front 54

pKa

Back 54

the extent of ionization of a drug is expressed as the ____ of a drug

Front 55

pH

Back 55

pKa is equal to the _____ of the aqueous solution in which the drug is 50% ionized

Front 56

acids, bases

Back 56

weak ______ ionize more readily in alkaline solutions, and weak _____ ionize more readily in acidic solutions

Front 57

ionized drugs

Back 57

ionized/nonionized drugs do not move around easily and cannot get to their SOA

Front 58

ion trapping

Back 58

when drugs and metabolites can become trapped inside or outside of membranes and cannot move across

Front 59

excreted with the urine

Back 59

once a drug is 'caught' outside of the blood, inside of the kidneys, it is NOT reabsorbed and will be___________

Front 60

urine

Back 60

ionized drugs carry a charge and attracts water molecules which makes it bigger and prevents it from getting out of the _________

Front 61

kidney compartment

Back 61

ionized drugs are transported out of the blood into the ______ where the pH can vary due to what you've eaten recently (eg orange juice)

Front 62

plasma membrane and blood-brain barrier

Back 62

before getting to the brain a drug must pass these two barriers

-they prevent drugs from diffusing out of the bloodstream

Front 63

subarachnoid space

Back 63

the BBB is in this part of the brain

Front 64

blood brain barrier

Back 64

made up of many parts, most important may be the peculiar type of capillaries that are in the brain

Front 65

tight junctions, no fenestra, no pinocytosis, presence of a thick basement membrane

Back 65

characteristics of capillaries in the brain

Front 66

astrocytes

Back 66

these buffer pH changes in the brain, electrolyte changes etc

-conduct nutrients and drugs from the blood to the neurons and transport waste away from the blood and CSF

-take nutrients out of vascular system and take nutrient/drug into the neuron and is much closer to SOA

Front 67

astrocytic process

Back 67

this covers the basement membrane in brain capillaries

Front 68

carrier

Back 68

transport is ________ mediated

Front 69

lipophylic elements

Back 69

the BBB is composed of ________ elements

Front 70

lipids

Back 70

drugs solubles in ____ will enter the brain easier

Front 71

BBB

Back 71

selectively permeable to what it thinks you need, reduces flow of water soluble or ionized molecules

-does not impede on lipid soluble or un-ionized molecules

Front 72

area potreme

Back 72

-place in the brain where the BBB is not intact

-vomiting center/projectile vomiting

-samples the presence of molecules that are toxic, metabolites of a drug that you take and to induce vomiting

-small network of neurons that initiate small motor program that makes you vomit

Front 73

feeding centers

Back 73

no BBB on feeding centers

Front 74

neurotransmitters

Back 74

the BBB is not permeable to _______

-this conserves them within the nervous systems so they don't leak out

-isolates brain from exogenously produces ______ systems

Front 75

plasma proteins

Back 75

drugs bind to __________ to help them circulate in the blood

-prevents the drug from diffusing out of the blood stream

-produced in healthy livers

Front 76

distribution

Back 76

the ______ of many drugs is slowed because they combine readily with proteins within the blood plasma

Front 77

synapse

Back 77

the site of action in the brain for a drug

Front 78

law of mass action

Back 78

the cells response to a drub is proportional to the total number of receptors occupied

-more receptors stimulate/bind=more effect

Front 79

receptor protein

Back 79

within the synpase, the SOA is often a _______

Front 80

receptors

Back 80

these live on the surface of the neuron

Front 81

neurotransmitters

Back 81

old_____ are discarded very quickly and only the newest and freshest _____ released first

-make a lot of _____ but do not release it, it will just become desensitized

Front 82

agonist

Back 82

binds to receptors and produces a pharmacological action

Front 83

antagonist

Back 83

binds to receptors but produces no pharmacological action

Front 84

intracellular action

Back 84

-after drug binds to a receptor

promotes synthesis or release of an intracellular regulatory molecule (second messenger)

Front 85

desensitization

Back 85

following continued stimulation of receptors

aka down regulation

Front 86

agonist

Back 86

-this causes desensitization

-to much stimulation so # receptors go down

Front 87

super sensitivity

Back 87

following continued blockade of receptors

-upregulation

Front 88

antagonist

Back 88

this causes increased # receptors

-not enough stim, so increase # receptors to increase stimulation

Front 89

maximum response

Back 89

achieved when all receptors are fully occupied

Front 90

dose

Back 90

amount of pharmocological effects for a given concentration

Front 91

potency

Back 91

determined by the affinity of drug for the receptor, as well as accessibility of drug to receptor site

-only determines drug dose, does not alter maximum effectiveness

Front 92

maximal efficacy

Back 92

the maximal effects produced by a drug, determined by drugs inherent properties, reflected as a plateau in doe response curve

Front 93

undesired side effects

Back 93

efficacy can be limited by ________ that limit the amount or use of the drug, regardless of its efficacy

Front 94

TD(LD)50/ED50

Back 94

therapeutic index

Front 95

redistribution away from the SOA

Back 95

a mechanism by which drug action is terminated

Front 96

metabolized in the liver and excreted by the kidneys

Back 96

most drugs are metabolized in ________

as a way to terminate drug action

Front 97

metabolism

Back 97

______ may take place in the plasma, kidneys, and other tissues, but most occur within the liver

Front 98

convert fat soluble substances into water soluble substances

Back 98

primary effect of metabolic process is to convert ____________ substances which are more easily excreted by the kidneys

Front 99

oxidation

Back 99

most common type of transformation in metabolism of drugs

Front 100

conjugation

Back 100

when drugs are are converted into a larger molecule which is water soluble

Front 101

cytochrome p450

Back 101

-concentrated in the liver

-oxidizes drugs

-levels depend on the need for this enzyme which can be up or down regulated

Front 102

active

Back 102

some drugs are metabolized into more ______ substances (must be taken into account)

Front 103

chemical transformations

Back 103

only a few types of _________ are actually involved in spite of the enormous diversity of drug types that exist

Front 104

stimulating or inhibiting the oxidation system

Back 104

some drugs influence the metabolism of other drugs by _______

Front 105

rapidly

Back 105

in general the more _______ a drug is metabolized, the lower the blood levels, the smaller the drug effect

Front 106

carcinogenic compound

Back 106

occasionally, a non-toxic drug may be metabolized by the liver into a ______

(eg hot dogs with sodium nitrite)

Front 107

urine, feces, expired air, sweat, and breastmilk

kidney

Back 107

drugs can be excreted in ______

primary excretory pathway is the _____

Front 108

rate

Back 108

the _____ at which a substances is excreted is pH dependent

Front 109

basic, acidic

Back 109

drugs that are _____ are excreted more rapidly when urine is acidic, where ____ drugs are excreted faster when urine is alkaline

Front 110

alkaline

Back 110

nicotine is excreted more slowly when the urine is _____ (bc nicotine is basic)

they wil smoke less

Front 111

eating

Back 111

______affects urine pH ( the urine becomes more acidic 30 minutes after _____

Front 112

increases

Back 112

-heavy breathing also blows of CO2 and _______ blood pH

-accelerates the removal of nicotine from the brain

Front 113

plasma proteins, hemoglobin, and carbonic acid

Back 113

three blood pH buffers

Front 114

excretion rate

Back 114

given as the half life of the drug in the body

the time to reduce plasma concentration by half

-because if its in the blood then it can do something

Front 115

rebound effects

Back 115

the withdrawal of drugs that modify physiological or behavioral systems is often accompanied by changes in the opposite direction of the original compound

(eg alcohol and barbiturates suppress dreaming and REM sleep and also reduce the vividness of dreams, during withdrawal, dream time and vividness of the dreams are increased

Front 116

age, weight, biological rhythms and personality

Back 116

4 important factors that influence responsiveness to drugs

Front 117

children

Back 117

often are hyperactive to drugs because of incomplete development of metabolic enzyme systems

Front 118

older people

Back 118

may be hyperactive to drugs because of impaired metabolic excretory mechanisms

Front 119

BBB

Back 119

in some young species drug responsiveness changes due to an underdeveloped __________

Front 120

drugs

Back 120

at least 200,000 elderly are hospitalized every year because of _______ accidents

Front 121

dose

Back 121

______ must b adjusted to the weight of the drug recipient

Front 122

9:30 and 11:30pm

Back 122

people are more responsive to drugs during the hours of ___________

due to rhythmic variations and activity of physiological systems

Front 123

law of initial value

Back 123

describes the personality variables that effect responsiveness to drugs

-says degree of response depends on the beginning level of excitation

Front 124

law of initial action

Back 124

describes why a dose of morphine given to a patient in pain causes euphoria, but similar dose in a happy pain-free pt causes mild anxiety and fear

Front 125

physiological state

Back 125

this alters a drugs actions in an individual

-ex, aspirin lowers temp in patients with fever but not in patients with normal temp

-ex caffeine more toxic in dehydrated mice

Front 126

examples of genetic causes to different responsiveness to drugs

Back 126

-different strains of mice metabolize drugs at different rates

-ibuprofen more effective in men than women

-women metabolize morphine and anti-rejection drugs faster

Front 127

tolerance

Back 127

progressive requirement with chronic use for higher drug doses to produce a given effect

Front 128

cross tolerance

Back 128

develops among related drugs

-become tolerant of a drug we didn't take bc similar in structure to a drug we did take

Front 129

characteristics of tolerance

Back 129

-reversible when drug use stops

-dependent on dose and frequency of drug use and drug-taking environment

-may occur rapidly or never (after long use)

-not all effects of a drug show the same amount of tolerance

-several different mechanisms explain multiple forms of tolerance

Front 130

sensitization

Back 130

when responsiveness to a drug increases with repeated administrations

eg marijuana, amphetamine, cocaine, barbiturates, and morphine

Front 131

withdrawal

Back 131

-the abstinence syndrome

-set of behaviors and physiologic symptoms that occur when drug treatment is withdrawn from a person who has developed a tolerance to the drug

Front 132

physical dependence

Back 132

an adaptive state that manifests itself by intense physical disturbances when the administration of the drug is suspendeD

Front 133

pharmacodynamic tolerance

Back 133

cause for the craving of certain substances

(neurochemical adjustment of brain to presence of the drug)

Front 134

psychological dependence

Back 134

condition in which a drug produces a feeling of satisfaction and a psychic drive that requires periodic or continuous administration of the drug to reduce pleasure or to avoid discomfort

Front 135

bioavailability

Back 135

refers to the efectiveness with which a drug is absorbed

-all preparations that contain identical amounts of active ingredients are not equally utlized

Front 136

dosage regimen

Back 136

the uniform administration of drugs to maintain a steady state level of a drug that should be given at uniform intervals equal to the drug's half life

Front 137

placebo effect

Back 137

may have greater implications for psychotherapy than any other form of treatment because psychotherapy and _________ function primarily through psychological mechanisms

-influence both SELECTIVE and OBJECTIVE measures

Front 138

diabetes, blood sugar levels

Back 138

what does the placebo effect NOT influence

Front 139

virgin mary

Back 139

devout catholics reported feeling peaceful and secure when viewing the ________ and felt less pain