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Pharmacology Exam 1
Exam 1 Dr. Taylor
99
Medical
Graduate
10/21/2012

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Term
The area of pharmocology that refers to the use of specific drugs to prevent, treat, or diagnose a disease.
Definition
Pharmacotherapeutics
Term
The study of how the body deals with the drug in terms of the way it is absorbed, distributed, and eliminated.
Definition
Pharmacokinetics
Term
The study of harmful effects of chemicals.
Definition
Toxicology
Term
The official or nonproprietary name. Tends to be somewhat shorter and is often derived from the chemical name.
Definition
Generic Name
Term
The brand name that is assigned to the compound by the pharmaceutical company and may or may not bear any reference at all to the chemical and generic terminology.
Definition
Trade Name
Term
If there is no existing patent for that compound or if the patent has expired, can the same drug be marketed by separate drug companies?
Definition
Yes
Term
1. Should undergo testing to establish that it has the same type and amount of active ingredients
2. The same administration route
3. Same pharmacokinetic profile
4. Same therapeutic effects as brand name.
Definition
Generic Form
Term
Which phase of clinical studies is this? The drug is usually tested with a small number of healthy volunteers.
Definition
Phase 1
Term
Which phase of clinical studies is this? The drug is tested in a relatively small sample (200-300) with a specific disease or pathological condition.
Definition
Phase 2
Term
Which phase of clinical studies is this? Clinical evaluation is expanded to include more patients (several hundred to several thousand) as well as more evaluators.
Definition
Phase 3
Term
Meds used to treat relatively minor problems and make the consumer more comfortable until the condition is resolved. Non-prescription drugs that can be purchased directly by the consumer.
Definition
Over-the-counter (OTC)
Term
The point at which there is no further increase in the response of the drug
Definition
Ceiling Effect
Maximal Efficacy
Term
Related to the dose that produces a given response in a specific amplitude.
Definition
Potency
Term
When two drugs ae compared, the __ potent drug requires a lower dose to produce the same effect as the higher dose of the second drug.
Definition
More
Lower
Term
The dose at which 50% of the population respond to the drug in a specified manner
Definition
Median effective dose
Term
The dose at which 50% of the group exhibits the adverse effect
Definition
Median Toxic Dose
Term
T1 = TD/ED. Uses the median effective and toxic doses. The greater the value of T1, the safer the drug is considered to be.
Definition
Therapeutic Index
Term
Drugs that are given orally are subject to a phenomenon known as what? This means that the drug is metabolized in the liver prior to reaching its target tissue.
Definition
First-Pass Effect
Term
Name two common routes of drug administration.
Definition
Enteral
Parenteral
Term
What does enteral mean?
Definition
Use the GI tract
Term
What does parenteral mean?
Definition
Does not use the GI tract
Term
Name the Enteral routes of drug administration.
Definition
Oral
Sublingual
Rectal
Term
Name 4 parenteral routes of drug administration
Definition
Inhalation
Injection
Topical
Transdermal
Term
Iontophoresis and phonophoresis are administered via which route?
Definition
Transdermal
Term
The extent to which the drug reaches the systemic circulation is referred to as ___, which is a parameter expressed as the percentage of the drug administered that reaches the bloodstream.
Definition
Bioavailability
Term
Drugs will diffuse more rapidly if they are in their __, __ form
Definition
Neutral, nonionized
Term
The special case of the diffusion where the diffusion substance is water.
Definition
Osmosis
Term
Name 3 characteristics of active transport.
Definition
-Carrier specificity
-Expenditure of energy
-Ability to transport substances against a concentration gradient
Term
The primary site for drug storage in the body is __ tissue.
Definition
Adipose
Term
The amount of drug administered divided by the concentration of drug in plasma
Definition
Vd
Term
A normal 70kg man has a total body fluid content of ~42L (5.5L blood). If the calculated Vd of a drug is approx equal to the total amount of body water, then the drug is distributed uniformly througout where?
Definition
All of the body's fluids
Term
Refers to chemical changes that take place in the drug following administration.
Definition
Biotransformation/Drug Metabolism
Term
Biotransformation usually results in an altered version of the original compound known as __, which is usually inactive or has a greatly reduced level of pharmacologic activity.
Definition
Metabolite
Term
Occurs when either oxygen is added or hydrogen is removed from the original compound.
Definition
Oxidation
Term
The original compound is broken into separate parts.
Definition
Hydrolysis
Term
Where is the primary location for drug metabolism?
Definition
Liver
Term
Prolonged use of certain drugs "induces" the body to be able to enzymatically destroy the drug more rapidly, usually because either more metabolizing enzymes are being manufactured or less are being degraded. May cause drugs to be metabolized more rapidly than expected, thus decreasing their therapeutic effect.
Definition
Enzyme Induction
Term
One reason why tolerance to some drugs occurs when it is used for extended periods (tolerance is the need for increased drug dosages to produce the same effect).
Definition
Enzyme induction
Term
One reason why tolerance to some drugs occurs when it is used for extended periods (tolerance is the need for increased drug dosages to produce the same effect).
Definition
Enzyme induction
Term
The primary site for drug excretion
Definition
Kidneys
Term
Can be described either in terms of all organ's and tissue's ability to eliminate the drug (systemic) or in terms of a single organ or tissue's ability to eliminate the drug.
Definition
Drug Clearance
Term
The amount of time required for 50% of the drug remaining in the body to be eliminated.
Definition
Half-Life
Term
Name 7 variations in drug response and metabolism
Definition
1. Genetic Factors
2. Disease
3. Drug Interactions
4. Age
5. Diet
6. Gender
7. Other Factors
Term
The principle site for receptors that recognize endogenous and exogenous compounds is the what?
Definition
Outer surface of the cell membrane
Term
When bound by ACh molecules, the receptor activates and opens a pore through the cell membrane, thereby increasing the permeability of the muscle cell to Na+
Definition
Ion Channels
Term
Activated by binding guanine nucleotides. When a substance binds to the surface receptor, the receptor moves laterally in the cell membrane and attaches to a G protein - cyclic AMP acts as the second messenger in this sytem by activating other enzymes.
Definition
G (regulatory) proteins
Term
An enzyme that is located on the inner surface of the cell membrane, is responsible for hydrolyzing adenosine triphosphate (ATP) into cAMP.
Definition
Adenylate Cyclase
Term
The amount of attraction between a drug and a receptor. A drug with high __ binds readily to open receptors, even if the concentration of the drug is relatively low.
Definition
Affinity
Term
A drug that can bind to the receptor and initiate a change in cell function. Has affinity and efficacy.
Definition
Agonist
Term
Often calle "blockers" because they block the effect of another chemical, preventing change in cell function. Only has affinity.
Definition
Antagonist
Term
Both the agonist and antagonist have an equal opportunity to occupy the ___.
Definition
Receptor
Term
Form strong, essentially permanent bond to the receptor. Have either extremely high affinity for the receptor or actually form irreversible covalent bonds to the receptor.
Definition
Noncompetitive Antagonists
Term
The noncompetitive antagonist cannot be displaced by the agonist, regardless of how much the agonist is present. Thus the term ___ refers to the inability of the agonist to compete with the antagonist for the recptor site. The obvious disadvantage to this type of receptor blocker is that the inhibition cannot be overcome in cases of an overdose of the antagonist.
Definition
Noncompetitive
Term
Drugs are classified as this when they do not evoke a maximal response compared to a strong agonists. Still occupies all available receptors.
Definition
Partial Agonists
Term
A fairly brief and transient decrease in responsiveness. Decrease in appropriate receptor population through prolonged stimulation.
Definition
Desensitization
Term
A slower, more prolonged process in which the actual number of available receptors is diminished.
Definition
Down-Regulation
Term
Drugs that are classified as __ are used both to relax the patient and to promote sleep.
Definition
Sedative - Hypnotics
Term
Exert their effects by increasing the inhibitory effects of GABA in CNS. GABA typically exerts its inhibitory effects by binding to its receptor site and initiating an increase in Cl- conductance.
Definition
Benzodiazepines
Term
When used in sedative-hypnotic doses, __ may function in a similar fasion to the bensodiazepines in that they also potentiate the inhibitory effects of GABA.
Definition
Barbiturates
Term
Residual (hangover) effects can be resolved somewhat by: (3)
Definition
1. Taking a smaller dose
2. Using a drug with a shorter half-life
3. Newer drugs appear to have milder effects, due to short half-life and limited action duration
Term
Withdrawal after short-term benzodiazepine use may be associated with problems such as sleep disturbances or so-called __ __
Definition
Rebound Insomnia
Term
Buspirone does not act on the __ receptor, but exerts its antianxiety effects by increasing the effects of serotonin in certain areas of the brain.
Definition
GABA
Term
Valium increases its inhibitory effects of ___.
Definition
GABA
Term
Certain antidepressants such as Paxil and Effexor can help reduce anxiety independent of their effects on __. The antidepressants ahve therefore been advocated as an alternative treatment for anxiety, especially for people who cannot tolerate the side effects of traditional antiolytics, or who might be especially susceptible to the addictive properties of drugs like the ___
Definition
Depression
Bensodiazepines
Term
Transmitter for depression
Definition
Epinephrine and Norepinephrine
Term
These drugs work by blocking the reuptake of amine neurotransmitters into the presynaptic terminal
Definition
Tricyclics
Term
An enzyme that is located at amine synapses and helps removed released transmitters through enzymatic destruction. Drugs that inhibit this enzyme allow more of the transmitter to remain in the synaptic cleft and continue to exert an effect.
Definition
MAOI
Term
Second-generation drugs that selectively block the reuptake of serotonin.
Definition
SSRI's (Selective Serotonin Reuptake Inhibitors)
Term
Serotonin syndrome is characterized by what 5 things?
Definition
Sweating
Shivering
Movement Disorders
Muscle Fasciculations
Other neuromuscular Stuff
Term
Traditional __ medications such as amitriptyline and nortriptyline are often considered the drugs of choice for chronic pain
Definition
Tricyclics
Term
The primary form of drug treatment for bipolar disorder consists of what?
Definition
Lithium Salts
Term
This is not metabolized, and drug elimination takes place almost exclusively through excretion in the urine.
Definition
Lithium
Term
Improvement in mood may occur within __ weeks after beginning antidepressant drug treatment, but these agents must often be administered for 1 __ or more before an appreciable improvement in symptoms occur.
Definition
2 weeks
1 month
Term
** we had some question where this was the answer **
Definition
Imipramine (Tofranil)
Term
Appears to be caused by an overactivity of dopamine pathways in certain parts of hte brain such as the limbic system.
Definition
Schizophrenia
Term
These are used to successfully treat schizophrenia block central dopamine receptors to some extent. It is a dopamine receptor antagonist.
Definition
Antipsychotic Drugs
Term
Newer __ agents do not block the D2 receptors in the basal ganglia as strongly as conventional antipsychotics, hence their reduced risk of motor side effects.
Definition
Atypical a
Term
__ are often used in Alzheimer disease and other cases of dementia to help control aggression and agitation.
Definition
Antipsychotics
Term
One of the more seriuos problems occurring from the use of antipsychotics is the production of abnormal movement patterns
Definition
Extrapyramidal Symptoms
Term
Characterized by the number of involuntary and fragmented movements. It is the most feared side effect of antipsychotic drugs. Drug-induced __ __ appears irreversible.
Definition
Tardive Dyskinesia
Term
Name 5 Extrapyramidal Symptoms
Definition
Tardive Dyskinesia
Pseudoparkinsonism
Akathisia
Dyskinesia and Dystonias
Meuroleptic Malignant Syndrome
Term
Patients taking relatively high doses of the more potent antipsychotics
Definition
Neuroleptic Malignant Syndrome
Term
Name 3 types of Partial Seizures
Definition
1. Simple Partial
2. Complex Partial
3. Partial becoming Generalized
Term
Name 6 types of Generalized Seizures
Definition
1. Absence (petit mal)
2. Myoclonic
3. Clonic
4. Tonic
5. Tonic-Clonic
6. Atonic
Term
Limited (focal) motor or sensory signs (convulsions confined to one limb, specific sensory hallucinations); consciousness remains intact
Definition
Simple Partial Seizures
Term
Consciousness impaired; bizarre behavior; wide variety of other manifestations; specific electroenchephalography abnormality
Definition
Complex Partial Seizures
Term
Symptoms progressively increase until seizure resembles a generalized (tonic-clonic) seizure
Definition
Partial becoming generalized
Term
Sudden, brief loss of consciousness; motor signs may be absent or may range from rapid eye-blinking to symmetrical jerking movements of entire body
Definition
Absence (petit mal) seizures
Term
Sudden, brief, "shock-like" contractions of muscles in the face and trunk, or in one or more extremeties; contractions may be single or multiple; consciousness may be impaired
Definition
Myoclonic seizures
Term
Rhythmic, synchronized contractions throughout hte body; loss of consciousness
Definition
Clonic Seizures
Term
Generalized sustained muscle contractions throughout body; loss of consciousness
Definition
Tonic Seizures
Term
Major convulsions of entire body; sustained contraction of all muscles followed by powerful rhythmic contractions; loss of consciousness
Definition
Tonic-Clonic (grand mal) seizures
Term
Sudden loss of muscle tone in the head and neck, one limb, or throughout the entire body; consciousness may be maintained or lost briefly.
Definition
Atonic Seizures
Term
Epileptic drugs try to inhibit firing of certain neurons by: (3)
Definition
1. Increasing the inhibitory effects of GABA
2. Decreasing the effects of excitatory amino acids
3. Altering the movement of ions across the neuronal membrane
Term
What is the primary problem with antiepileptic drugs?
Definition
Sedation
Term
Antiepileptics mainly work by inhibiting what?
Definition
GABA
Term
Name 2 bensodiazepines that work as an antiepileptic
Definition
Klonopin (Clonazepam)
Tranxene (Clorazepate)
Term
___ __ agents have favorable pharmacokinetic characteristics, and have relatively mild side effects that allow their use along with the more traditional anti-seizure meds
Definition
Second generation
Term
Name the 3 factors associated with successful medication withdrawal
Definition
-Being free of seizures for at least 2 years while on meds
-Having a normal neurologic examination prior to withdrawal
-Being young when the seizures started
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