Applied Pharmacology For The Dental Hygienist Ch. 2

Front 1

Broadly defined as chemical substances used for the diagnosis, prevention, or treatment of disease or for the prevention of pregnancy

Back 1

Drugs

Front 2

The dose of a drug plotted against the intensity of the effect on a graph is called a _________

Back 2

Dose-response curve

Front 3

This term describes the amount of drug required to produce an effect

Back 3

Potency

Front 4

The maximum intensity of effect or response that can be produced by a drug is called the _________

Back 4

Efficacy

Front 5

The space between the axon of one nerve and the dendrite of another is called the ____

Back 5

Synapse

Front 6

These are chemicals reponsible for transporting a variety of messages across a synapse

Back 6

Neurotransmitters

Front 7

Two chemicals that work locally to increase inflammation are_____ & ____

Back 7

Histamine & Prostaglandin

Front 8

These chemicals are released from glands in the body, travel through the blood to act on receptors on cells or inside the cells

Back 8

Hormones

Front 9

The impulse that travels down a neuron is called a _____ _____ _______

Back 9

Nerve action potential

Front 10

Proteins located on or in cells that react to other proteins in the blood or at the synapse are called ____________

Back 10

Receptors

Front 11

For a drug to exert an effect it must bind to a _____site on the cell membrane

Back 11

Receptor

Front 12

A protein binds to a receptor in a ____-___-_____ fashion

Back 12

lock-and-key

Front 13

A drug that has an affinity for a receptor, combines with the receptor and produces an effect is called a/an _________

Back 13

Agonist

Front 14

A drug that counteracts the action of an agonist is called a/an ___________

Back 14

Antagonist

Front 15

A drug that has an affinity for a receptor, combines with that receptor and produces no effect is a ____________ antagonist

Back 15

Competitive

Front 16

A drug that binds to a receptor site different than the receptor for the agonists but decreases the agonist response is called a ___________antagonist

Back 16

Noncompetitive

Front 17

A drug that has an affinity for a different receptor than the agonist and acts oppositely of the agonist to reduce its response is called a/an ________antagonist

Back 17

Physiologic

Front 18

What are the proteins called that terminate the neurotransmitters response at the synapse?

Back 18

Enzymes

Front 19

The enzyme that terminates the action of acetylcholine is __________

Back 19

Acetylcholinesterase

Front 20

The cell membrane is composed primarily of a _________ bilayer

Back 20

Phospholipid

Front 21

Also present in cell membranes are ______ which can act as receptors, make up the structure of the membrane, act as pores, or help move molecules into the cell

Back 21

Proteins

Front 22

These four physicochemical properties of drugs influence their passage across biologic membranes

Back 22

Lipid solubility( more soluble passes easier), degree of ionization (nonionized passes easier), molecular size, molecular shape

Front 23

Lipid soluble substances cross the cell membrane based on the concentration differences from high to low. This is called _____________

Back 23

Simple diffusion

Front 24

Water-soluble drugs cross the cell membrane by passing through _________

Back 24

Pores

Front 25

Very small water-soluble molecules (drugs) may pass through the membrane by ___________

Back 25

Filtration

Front 26

Insulin passively carries glucose across the cell membrane. This is an example of ________ _______

Back 26

Facilitated diffusion

Front 27

Active transport of a substance from low to high concentration requires energy in the form of ______

Back 27

ATP

Front 28

These factors influence the rate of absorption of a drug.

Back 28

Lipid solubility, Ionization, Size, Shape, site of absorption, and solubility of the drug in solution

Front 29

Weak acids are more nonionized and therefore more easily absorbed in a solution with a pH that is more __________ than the acid.

Back 29

Acidic

Front 30

Weak bases are best absorbed when dissolved in a _______ solution

Back 30

Basic

Front 31

Local anesthetics (weak bases) don't work in areas where infection is present due to the ________pH of the site

Back 31

Acidic

Front 32

Release of a drug from its tablet or capsule requires these four steps

Back 32

Disruption, disintegration, dispersion, and dissolution

Front 33

Which has the quickest onset of action given orally: a tablet, capsule, or solution?

Back 33

Solution

Front 34

Absorption of the site of injection depends on these attributes.

Back 34

Solubility of the drug and blood flow at the site and whether a solution or suspension

Front 35

In the blood, drugs are found in one of these two forms.

Back 35

Bound to proteins (albumin or globulin) or Free in the plasma

Front 36

Bound drug can act as a _______ of the drug to increase it's duration of action

Back 36

Reservoir

Front 37

_________ is the mechanism by which a drug is made available at its site of action

Back 37

Distribution

Front 38

Distribution of a drug can be affected by _____.

Back 38

Size of the organ, blood flow to organ, solubility of the drug (lipid solubility, ionization, size, and shape), % plasma protein binding, and barriers (blood-brain or placenta).

Front 39

If a drug is bound to plasma proteins and another more highly bound drug is given what happens to the first drug.

Back 39

It is pushed off plasma proteins increasing free drug available and may increase it to toxic levels

Front 40

T1/2 stands for _______

Back 40

The half-life of a drug (time for 1/2 of drug to be removed from the body)

Front 41

A drug is mostly gone from the body (only 3-6% left) after ______ half-lives

Back 41

5

Front 42

To attain a steady blood concentration of a drug one must take it for _____ half-lives

Back 42

5

Front 43

What kinds of drugs are most likely to cross the blood-brain barrier?

Back 43

Nonionized, lipid-solluble drugs

Front 44

Sometimes drugs given orally are processed by the liver and sent back to the intestines via the bile to be reabsorbed. This is called ____________ circulation

Back 44

Enterohepatic

Front 45

arduous

Back 45

hard; strenuous; difficult

Front 46

Does enterohepatic circulation of a drug prolong or shorten the effect of the drug?

Back 46

Prolongs it

Front 47

The movement of a drug from the site of action to nonspecific sites of action is known as ___________

Back 47

Redistribution

Front 48

Thiopental produces rapid loss of consciousness but then the patient awakens within 3-5 minutes yet its t1/2 is 12-24 hours. Why is this?

Back 48

Thiopental produces high blood levels in the brain within 30-60seconds after injection but is rapidly redistributed to lipid containing tissues therefore decreasing blood levels rapidly to allow return of consciousness

Front 49

When the body changes a drug so it can be more easily excreted from the body this is called ______________

Back 49

Biotransformation or metabolism

Front 50

When drugs are metabolized the metabolite is generally more ____ and _____ than the parent compound

Back 50

ionized, less lipid soluble

Front 51

Name three ways drugs may be metabolized (active, inactive)?

Back 51

Active to inactive: Inactive to active: Active to active

Front 52

Phase I metabolism of drugs can occur by these three processes.

Back 52

Oxidation, reduction and hydrolysis

Front 53

Oxidation of drugs takes plase in the liver by these enzymes

Back 53

Cytochrome P-450 enzymes

Front 54

Someone who takes a drug for a long time may find it takes increasing doses or may find that other drugs also require higher than usual doses to achieve the desired effect. This is an example of _______ of the cytochrome P-450 enzyme system

Back 54

Induction

Front 55

Induction of cytochrome P-450 enzymes in patients can lead to patients requiring ever increasing dosages of a drug. This is called _____________

Back 55

Tolerance

Front 56

Phase II reactions involve conjugation with glucuronic acid, sulfuric acid, acetic acid, or an amino acid. Conjugation with glucuronic acid is called __________

Back 56

Glucuronidation

Front 57

This route of elimination of drugs from the body is the most important

Back 57

Renal excretion

Front 58

When a drug is removed from the body at a constant rate over time no matter what dose is given this is call _____-_____ kinetics

Back 58

Zero-order

Front 59

When the amount of drug removed over time is related to the concentration of the drug in the body this is called ____-____ kinetics

Back 59

First-order

Front 60

Renal elimination of drugs can occur by these three routes.

Back 60

Glomerular filtration, active tubular secretion, and passive tubular diffusion (passive reabsorption)

Front 61

Glomerular filtration of a drug depends on _____, ______, _______

Back 61

Blood pressure, size of the drug molecule, and plasma protein biniding of the drug

Front 62

What types of drugs are most likely to be reabsorbed by the kidney tubules? (ionized vs unionize, lipid solubility)

Back 62

nonionized and lipid soluble will be reabsorbed

Front 63

Weak acids are excreted more rapidly with _______ urine due to the acid in the tubules being more ionized/less lipid soluble

Back 63

Alkaline

Front 64

Gases used in anesthesia are primarily eliminated by this route.

Back 64

The lungs

Front 65

Drugs that go from the liver and end up in the duodenum of the small intestine are said to undergo ________ excretion

Back 65

Biliary

Front 66

Name two minor routes of drug elimination of which one may concern nursing mothers

Back 66

Sweat and breast milk

Front 67

Drug elimination via saliva relies on the _______ of the drug

Back 67

Lipid solubility, ionization

Front 68

Tetracycline is used in periodontal disease because it tends to be concentrated in this area

Back 68

The gingival crevicular fluid

Front 69

The time it takes for a drug to begin to have its effect is the _______

Back 69

Onset

Front 70

The length of a drugs effect

Back 70

Duration

Front 71

Drugs can be administered by these two routes

Back 71

Enteral or parenteral

Front 72

Parenteral administration includes these routes

Back 72

IM, IV, SQ, ID, inhalation, intrathecal, intra-articular, and topical

Front 73

Safest, least expensive, and most convenient route of drug administration

Back 73

Oral

Front 74

Disadvantages of oral administration of drugs

Back 74

Slower onset, less predictable blood levels

Front 75

A drug given orally may be largely metabolized on its way through the liver via the portal venous system. This is called the _____-_______ effect

Back 75

First-pass

Front 76

A drug that has a high first-pass effect would require what kind of dose compared to giving that drug parenterally

Back 76

A higher dose would be required due to the removal of a large portion of the dose by the liver

Front 77

What kinds of conditions may alter blood levels of drugs administered orally?

Back 77

Food in stomach, GI diseases, gastric acidity, and enterohepatic circulation

Front 78

Suppositories, creams or enemas can be administered by this route

Back 78

Rectal

Front 79

The most rapid drug response with almost immediate onset of action is obtained with ______ administration of a drug

Back 79

Intravenous (IV)

Front 80

IM injections are generally given in the ______ region or the ______ region

Back 80

Deltoid, gluteal

Front 81

TB skin test is administered by this route

Back 81

Intradermal (ID)

Front 82

Peritoneal dialysis administers dialysate via this route

Back 82

Intraperitoneal

Front 83

What types of drug forms may be given by the inhalation route

Back 83

Microcrystalline, liquid, or powdered

Front 84

Examples of the topical route of administration include _____, _____, and ______

Back 84

Skin, oral mucosa, sublingually

Front 85

An example of a subgingival gel is __________

Back 85

Doxycycline gel (Atridox)

Front 86

This dosage form of drugs is most often given orally to children

Back 86

Liquid form (solution or suspension)

Front 87

Factors that alter drug effects are:

Back 87

Patient compliance, physiologic factors, tolerance, pathologic state, time of administration, route of administration, sex, genetic variation, drug interactions, age/weight, environment, and patient provider interactions

Front 88

A pill given to a patient that looks like an active agent but contains nothing but sugar is called a _________

Back 88

Placebo