Pharmacology Unit 1-3

Front 1

Pharmacotherapeutics

Back 1

clinical Pharmacology

Front 2

Pharmacodynamics

Back 2

action and observable effects, biochemical and physiological

Front 3

Pharmacokinetics

Back 3

absorption, distribution, metabolism, excretion

Front 4

Toxicology

Back 4

study of harmful effects

Front 5

Therapeutic effect

Back 5

effect for which drug is administered

Front 6

side effect

Back 6

any effect other than the therapeutic effect

Front 7

untoward effect

Back 7

harmfull/ unpleasent side effet

Front 8

3 cardinal rules of drug action

Back 8

1. all drugs are potential poison
2. all drugs have more than one effect
3.drugs do not cure disease, they relieve symptoms

Front 9

1906 Pure Food and drug act

Back 9

drugs to be labeled and manufactured according to USP and NF
drugs did not have to be safe or effective

Front 10

1938 Federal Food Drug and Cosmetic Act

Back 10

saftey ensured
quality/ purity of origin assured
improved labeling

Front 11

1952 Durham-Humphrey Amendment

Back 11

distinguishes rx drugs (legend drugs) vs over the counter (no rx needed)

Front 12

1962 Kefauver-Harris Drug Amendements

Back 12

drug must be effective as well as safe
Thalidomide incident (1958)

Front 13

1970 Drug Abuse Prevention and Control Act

Back 13

Controlled Substances Act
reserach into and prevention of drug abuse
treatment/ rehab of abuseres
strengthen law inforcement authority
improve regulation of manufacture and distribution

Front 14

Schedule of controlled drugs I-V

Back 14

I - moste stringent regulations V- least strict

Front 15

Schedule I

Back 15

forbidden except for research
highest abuse potential
researchers must apply to FDA for clearance - IND9investigational new drug exemption)

Front 16

Schedule II

Back 16

high potential for abuse (psychological and physiological dependence)
30 day supply, no refill, must renew rx
90 day supply in some cases

Front 17

Schedule III

Back 17

moderate to low physical dependence
maybe high psychological dependence
5 refills then new rx, may renew by phone/ fax

Front 18

Schedule IV

Back 18

lower potential for abuse
rx like Schedule III

Front 19

Schedule V

Back 19

DEA monitors distribution
Pharmacy keeps records
RX needed in Ca

Front 20

FDA

Back 20

must approve studies
quality control

Front 21

Public Health Service
under HHS (health and human services)

Back 21

helps with biologics, if company makes serum, antitoxin etc. - Department of Public Health
-inspects and licenses establishment
-examines and licenses products

Front 22

D.E.A. under Department of Justice

Back 22

Drug Enforcemnet Administration, established in 1973
controles distribution and sale of all drugs
seperation of drug enforcement and approval for new drugs

Front 23

Department of Commerce,
Federal Trade Commission

Back 23

controles misleading advertisment for over the counter drugs

Front 24

efficacy

Back 24

largest effect that a drug can produce

Front 25

potency

Back 25

amount of drug needed to get an effect

Front 26

Therapeutic index

Back 26

lethal dose/ effective dose
high number desired
indicate relative margin of safety

Front 27

additive

Back 27

when the combined effect of two or more drugs administered at the same time is equal to the sum of their individual effects (2+2=4)

Front 28

antagonistic

Back 28

two or more drugs are given together and combined effects are less then the algebraic sum of the individual effects (2+2=1)

Front 29

synergistic

Back 29

when the combined effect of two or more drugs administered at the same time is greater than anticipated from the sum of their individual effects (2+2=6)

Front 30

potentiation

Back 30

the increase in effectiveness seen when a drug that has no effect by itself increases the effect of a different drug (0+2=3)

Front 31

official name

Back 31

name used in the official drug reference, the U.S.P
between 1906 and 1976 N.F. was also official, now combined with U.S.P.

Front 32

chemical name

Back 32

name describing the exact chemical composition of a drug

Front 33

generic name

Back 33

code name given during testing
will become official name when included in U.S.P.

Front 34

Trade name

Back 34

copyrighted name, copyright might be renewed so name stays with company
in contrast to patent on the drug itself (17 years)
after that other companies can produce under generic name

Front 35

U.S.P.

Back 35

Pharmacopeia of the United States of America
first in 1820, every 5 years
single drugs
older drugs deleted in favor of newer, more effective agents

Front 36

N.F.

Back 36

National Formulary 1888-1975, now with U.S.P.
single drugs and formulas for drug mixtures
often includes drugs deleted from U.S.P.

Front 37

AMA Drug Evaluations

Back 37

prepared by appointed experts
drugs grouped according to use
general discussion provided for each group

Front 38

P.D.R.

Back 38

Physician's desk reference
manufactures buy space
cross references
information like drug inserts

Front 39

Drug Facts and Comparisons

Back 39

grouped according to use
includes over the counter medications

Front 40

A.H.F.S.

Back 40

American Hospital Formulary Service

Front 41

local drug activity

Back 41

drug action occurring only at site of application (usually skin or mucous membranes)

Front 42

Systemic drug activity

Back 42

action of drug that is absorbed then distributed through the body
1. whole body or target organ
2. toxic effects may occur when drug applied for local effects - becomes systemically absorbed

Front 43

parenteral

Back 43

everywhere but GI tract

Front 44

Skin

Back 44

local action intended
caution broken skin
uses: antiseptic, cleaning, emollient

Front 45

Nasal mucosa

Back 45

local - too much may become systemically absorbed

Front 46

Inhalation

Back 46

local - antibiotics, detergents and enzymes for breaking up secretions
systemic- anesthetics

Front 47

Genitourinary

Back 47

usually local action intended
caution: if traumatized tissue can get dangerous systemic effect

Front 48

Gastrointestinal Tract (Enternal Routes)

Back 48

oral
sublingual or buccla
rectal

Front 49

Oral - usually systemic effect

Back 49

timing around meals:
before - quicker absorbtion
with - drug irritations
after - slower absorbtion

contraindications
patient vomitting or unconscious
drug too irritating
drug doesn't reach blood in high enough concentration (not absorbed through GI tract, destroyed by digestive enzymes, destroyed by liver) bypass using sublingual, buccal or rectal route

Front 50

Sublingual and buccal

Back 50

systemic (for drugs destroyed by liver)
local anesthetic or entiseptic

Front 51

Rectal

Back 51

local - stimulate defecation refelx
systemic - retention enemas or suppositories
1. bypass liver and digestive enzymes
2. irritating to stomach
3. uncooperative/ unconcious patient
4. antiemetic

Front 52

Parenteral routes

Back 52

referes to injetions

Front 53

Parental routes
more hazardous

Back 53

rapidly absorbed
local tissue damage
entrance of microorganisms

Front 54

Types of injection

Back 54

intradermal
subcutaneous
intramuscular
intravenous
antraarterial
intraspinal
intraarticular

Front 55

subcutaneous

Back 55

must be highly soluble and potent in small volume

Front 56

intramuscular

Back 56

spreads over larger area
suspensions absorb slowly
fewer sensory nerve endings
irritation less likely
caution - blood vessels and nerves in area

Front 57

intravenous

Back 57

most rapid, most dangerous
injection - irritating subsatnce or emergency
infusion - often just fluids and electrolytes

Front 58

agonist

Back 58

increases/ intensifies activity of receptor

Front 59

partial agonist

Back 59

compound which increases the activity of a receptor but is less effective than other agonist and can decrease their effectiveness when in competition with the for the same receptor

Front 60

antagonist

Back 60

decreases activity of receptor or prevents agonist from acting on receptor

Front 61

competitive antagonist

Back 61

binds to same receptor site as agonist
effects are reversible
competition with agonist

can control exact degree of response

Front 62

noncompetitive antagonist

Back 62

binds to different part of receptor than agonist but still prevents normal agonist action
cannot be displaced by competition

can block effect no matter what concentration of agonist

Front 63

structurally specific drug

Back 63

drug that requires a specific receptor

Front 64

structurally nonspecific drug

Back 64

simple chemical/ physical reaction

Front 65

Factors that influence the rate of passage through a membrane

Back 65

lipid solubility
non ionized move more readily
ionized particles are trapped

Front 66

passage through pores

Back 66

influenced by size and shape of molecule
degree of ionization
acidic drugs - less ionized at low pH
alkaline drugs - less ionized at high pH

Front 67

absorption

Back 67

transfer of drug molecules from place deposited to circulating fluids

Front 68

factors that affect drug absorption

Back 68

route of administration
local conditions at site of administration
chemical properties of drug
form of medication given

Front 69

factors that affect drug absorption
"chemical properties of drug"

Back 69

lipid solubility vs water solubility
lipid soluble will pass through membrane passively, water soluble will be repelled (charged)

size and shape of molecule, the smaller the easier

degree of ionization (ionization produces charged molecules that will not pass through the cell membrane, therefor degree of ionization influences absorption)

Front 70

distribution

Back 70

blood brain barrier
placental barrier

Front 71

blood brain barrier

Back 71

very tight junctions
capillaries are less permeable, glial cells are tightly packed together, small pores

lipid soluble drugs will be able to dissolve in blood brain barrier and gain access to the CNS

Front 72

placental barrier

Back 72

very large intracellular spaces
low perfusion area

Front 73

effect of plasma protein binding on drug distribution

Back 73

slow release of drug
cn affect onset, intensity ad duration
sometimes use prime dose, than smaller maintenance dose

Front 74

drug metabolism

Back 74

usually liver
usually changed to less active chemical, if more active often metabolized again
more ionized, so more readily eliminated

cytochrome P450

Front 75

cytochrome P450

Back 75

enzymes induced by drug, than that drug will be metabolized more readily

enzymes inhibited by drug than drug will be metabolized more slowly

smoking/ drinking induce P450

Front 76

individual patient differences

Back 76

age
a. infant - immature systems, incomplete blood brain barrier
b. aged - deterioration of systems, cardiovascular disease

weight

sex

environment (physical/ psychosocial issues)

Physiological, pharmacological or pathological state

genetic

predrug status

Front 77

drug idiosyncracy

Back 77

any abnormal or peculiar response to a drug generally thought to be a result of genetic deficiencies that lead to abnormal metabolism of drug

can not be predicted!!!!

Front 78

drug allergy

Back 78

reaction to drug resulting from previous exposure
local or systemic

can not be predicted without prior "allergic" experience