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Pharmacology
Introduction to Pharm
47
Medical
Graduate
11/17/2010

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Term
pharmacogenomics
Definition
genome-wide comparisions of individuals to determine how one affects pharmacological function and therapeutic response
Term
pharmacogenetics
Definition
variation in DNA sequence and the effect on pharmacokinetics or pharmacodynamics - for specific determination of individual drug effects
Term
pharmacotherapeutics
Definition
use of drugs in the treatment of disease
Term
molecular therapies
Definition
novel use of antibodies, target delivery, gene therapy
Term
pharmacovigilance
Definition
study of drug safety - adverse drug reactions and other effects of drugs on people (ADRs are the 5th leading cause of death of people in the states
Term
toxicology
Definition
study of adverse effects of drugs and toxins
Term
nutraceutical
Definition
any substance that is a food or part of alleging to provide health benefits
Term
phytochemical
Definition
non-nutrient chemical that has function in the body
Term
enteral
Definition
through a membrane of the body (buccal, sublingual, rectal, oral)
Term
parenteral
Definition
intravascular, intramuscular, subcutaneous
Term
4 steps of pharmacokinetics
Definition
ADME
absorption
distribution
metabolism
excretion
Term
drug transport
Definition
most passive diffusion
some facilitated diffusion
active transport
endocytosis - large proteins
Term
oil/water partition coefficient
Definition
amount of drug in the oil versus water. the higher the number the greater membrane permeability and the higher intake through the stomach
Term
pH effect on acid
Definition
high pH protonates the acid and de-ionizes it
Term
pH effect on Base
Definition
higher the pH the base is protonated and the base is ionized
Term
effect of pH (H-H formula)
Definition
log ([HA]/[A-]) = pKa - pH
Term
small intestines
Definition
major location of absorption due to surface area and pH (bases)
Term
first-pass effect
Definition
amount of absorbed drug that is metabolized in the liver - most for oral due to gut wall and liver
Term
oral bioavailability
Definition
fraction of administered drug that meets the systemic circulation as a percent of what was injected
Term
distribution
Definition
leaving of the blood to the tissues; flow, protein binding, permeability and size are factors
Term
protein binding in blood
Definition
albumin, determines freedom of drugs in serum, the most tightly bound drug will out compete and will drive the free concentration of the drug higher in the blood
Term
distribution volume
Definition
plasma only (4 L)
extracellular fluid (14 L)
intracellular fluid (42 L)
VERY Hydrophobic (volume depends on how much effective volume there is compared to amount left in blood)
Term
distribution determination
Definition
is it eliminated? or metabolized?
if neither then there is an equilibration period (distribution phase)
Term
distribution w/ elimination
Definition
log scale the concentration axis and take x intercept to determine the hypothetical distribution concentration (with elimination there is a constant logarithmic excretion to account for) - allows determination of the distribution volume
Term
biotransformation kinetics
Definition
v=vmax*[C]/Km when there is low concentration

v= vmax when there is a high concentration

major purpose is to allow for excretion
Term
endobiotic
Definition
substance occuring naturally in the body
Term
biotransformation phases
Definition
phase 1 - small functional group changes (still active)
phase 2 - large conjucation products (inactive)
Term
biotransformation phase 1 reactions
Definition
oxidative, hydrolytic, reductive
Term
biotransformation phase II reactions
Definition
glucuronidation; sulfation; acetylation; methylation; conjugation with GSH and AAs
Term
give one example of a phase II biotransformation enzyme and cofactor
Definition
UDP-glucuronosyltransferase (UDP-GT); UDP-glucoronic acid
Term
individual genetic variations
Definition
inherited variation and polymorphisms
Term
name two drugs that have genetically affect actions
Definition
succinylcholine, NAT2 effect on isoniazid metabolism
Term
race changes in metabolism/action
Definition
BiDil is more active in heart failure for African Americans than other races
Term
environmental
Definition
smoking induces P450, grapefruit juice inhibits P450
Term
renal excretion
Definition
glumerular filtration + active tubular secretion - pass-reabsorption = excretion; pH can determine this process both in the lumen and the blood
Term
biliary excretion
Definition
can be enterohepatically recycled; not as common as renal
Term
p-glycoprotein pump
Definition
pumps foreign substances out of cells in the GI epithelium using 2 ATPs, an inherent protective mechanism
Term
drug effects on p-glycoprotein pump
Definition
induction - heightens activity of pump (St. John's Wart)
inhibition (quinidine)
Term
albumin
Definition
when displaced with a competitor (sulfonamides)bilirubin is removed and can promote toxicity
Term
what is the proper nomenclature for cytochromes?
Definition
CYP + Arabic Number + Letter + Arabic Number
Term
P450 Family
Definition
xenobiotic transformation, synthesis of sterols and vitamins
Term
CYP2D6 characteristics
Definition
UM - ultra-fast metabolizer
EM - extensive
IM - intermediate
PM - poor

when inhibited type is changed to a lower level
Term
CYP3A
Definition
largest subfamily, expressed in Liver and intestine
Term
age and gender in P450
Definition
women not tested well
after two weeks the enzymes are active and progress into adolescence - decline into old age
Term
statins and P450
Definition
zoles, grapefruite juice and other inhibitors prevent metabolism of this drug; causes myolysis - requires choice of best type of this class

lower amount of treatment till the drug that interacts with it is not used anymore
Term
non-depolarizing agents - neuromuscular
Definition
competitive antagonist: -curium, -curonium, Tubocurarine
Term
depolarizing agents
Definition
agonist: succinylcholine
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