1What features of drugs allow them to easily pass the phospholipid bilayer?
Small, Lipid Soluble, Non-Ionized
2Drugs are present in the blood in what two forms?
Bound and Free
3Where are bound drugs located in the blood?
Bound to plasma proteins (albumin, globulin)
4Where are free drugs located in the blood?
Free in the Plasma
5What does a bound drug do?
Acts as a storage site
6What does the free drug do?
Produces the pharmacologic effect
7Which portion of the drug is metabolized more quickly and clears the circulation faster?
Unbound
8Which drugs have longer half-lives?
High Protein Bound Drugs
9What happens when 2 drugs that are protein-bound are taken?
One drug displaces the other, increasing the concentration of one of the drugs
10What is first pass metabolism?
The fraction of drug lost during absorption
11What forms of drugs are most susceptible to first pass?
Oral Forms
12What happens to P-450 enzymes in the liver after the use of some drugs such as tobacco and alcohol?
They Increase
13What happens when there is an increase in the P-450 enzyme level?
Drug is metabolized more quickly and tolerance increases
14What happens when there is a decrease in the P-450 enzymes?
The drug is metabolized more slowly and tolerance decreases
15How does liver disease impact metabolism?
Decreases the 1st pass effect, increases the concentration in blood, and increases toxicity
16What is the primary organ involved in excretion?
Kidneys
17What is the drug half-life?
The amount of time it takes for the concentration of a drug to fall to one-half of its blood level at any time
18How do you calculate half-life?
Divide the drug in half for each half-life
19What is first order kinetics?
A constant percentage/fraction of a drug is eliminated from the body per each unit of time
20What is zero order kinetics?
A constant amount (not a fraction) of the drug is elimited per unit of time
21Which order kinetics do most drugs follow?
First Order Kinetics
22What happens during zero order kinetics when the dose is increased?
Drug effects are prolonged, metabolism is not increased
23Are Zero or First order drugs more likely to go toxic?
Zero Order Drugs
24What route of administration is placed directly into the gastrointestinal tract?
Enteral
25What is the most common, convenient, and least predictable route of administration?
Oral
26What are the types of enteral administration routes?
Oral and Rectal
27Which type of admission route has irregularnpredictable absorption?
Rectal
28What route of administration bypasses the gastrointestinal tract?
Parenteral
29What are the types of parenteral administration?
Intravenous, Intramuscular, Subcutaneous, and Intradermal
30What route of administration has the most rapid drug response?
Intravenous
31What route of administration is the drug irretrievable once administered?
Intravenous
32What makes intravenous administration the fastest?
Skips absorption phase
33Which route of administration uses a gaseous, liquid or powdered form of drugs?
Inhalation
34Which route of administration is administered to the skin, oral mucosa, or sublingually?
Topical
35Which route of administration sensitizes patients to allergy more than systemic routes?
Topical
36What route of administration rarely produces systemic adverse effects?
Topical
37What is the dose needed to produce the desired therapeutic effect called?
Potency
38What is the magnitute of response obtained from optimal receptor site occupancy by a drug called?
Efficacy
39What is potency related to?
Affinity of the drug to its receptor
40Why is toxicity related to potency?
More potent drugs reach toxic levels at lower doses
41What is efficacy related to?
Intrinsic activity of the drug once a receptor complex is formed
42How does efficacy relate to therapeutic effect?
The drug with higher efficacy will have a better therapeutic effect
43Which name of a drug is determined by the chemical structure of the drug?
Chemical Name
44Which name of a drug is the official name that appears on all prescription labels?
Generic Name
45How many generic names does each drug have?
1
46Is the generic name capitalized?
No
47Which name of a drug is registered property of the manufacturing company and is protected for 20 years under the federal patent law?
Trade (Brand) Name
48Is a trade name capitalized?
Yes
49How many trade names can a drug have?
Several
50What are the requirements for writing prescriptions called?
Drug Scheduling
51Which schedule drugs have the highest abuse potential?
Schedule I
52Which schedule drugs have the lowest abuse potential?
Schedule V
53Which schedule drugs are not accepted for medical use?
Schedule I
54Which schedule drugs require a written prescription with a provider's signature and do not allow for refills?
II
55Which schedule drugs may be prescribed by telephone, but no more than 5 prescriptions in 6 months are allowed?
Schedule III & IV
56Which schedule drugs can be bought over the counter?
Schedule V
57How many milligrams are in a gram?
1000 mg
60What is po?
By Mouth (per oral)
63What are the classifications of adverse reactions?
Side Effect, Toxic Reaction, Allergic Reaction
64Which classification of adverse reactions is predictable, dose-related, and acts on nontarget organs?
Side Effects
65What classification of adverse reactions are predictable, dose-related, and acts on target organs?
Toxic Reaction
66Which classification of adverse affects are not predictable or dose related?
Allergic reaction
67What is a genetically related abnormal drug response called?
Idiosyncratic
68What is the reduced ability to fight infections as a result of a drug called?
Interference with Natural Defense Mechanisms
69What is ED?
Median Effective Dose: produces a specific effect in 50% of test subjects
70What is LD?
Median Lethal Dose: results in death of 50% of test subjects
71What is TD?
Toxic Dose: Results in Toxicity for 50% of test subjects
72What is TI?
Therapeutic Index: ratio of the median lethal dose to the median effective dose
73How do you calculate TI?
LD/ED
74What is the principle neurotransmitter of the SANS?
Norepinephrine
75What is the principle neurotransmitter of the PANS?
Acetylcholine
76Which nervous system is the rest and digest system?
Parasympathetic
77Which nervous system is the fight or flight system?
Sympathetic
78What is the effect of the PNS on the pupils?
Constrict Pupils
79What is the effect of the PNS on saliva production?
Stimulates Salivia Production
80What is the effect of the PNS on the heart?
Slows HR
81What is the effect of the PNS on the airways?
Constricts Airways
82What is the effect of the PNS system on the stomach?
Stimulates Activity of the Stomach
83What is the effect of the PNS on the pancreas and gallbladder?
Inhibits release of glucose and stimulates the gallbladder
84What is the effect of the PNS on the intestines?
Stimulates Intestinal Activity
85What is the effect of the SNS on the pupils?
Dilates Pupils
86What is the effect of the SNS on salivia production?
Inhibits Salivia Production
87What is the effect of the SNS on the heart?
Increases HR
88What is the effect of the SNS on the airways?
Relaxes Airways
89What is the effect of the SNS on the stomach?
Inhibits activity of the Stomach
90What is the effect of the SNS on the pancreas and gallbladder?
Stimulates the release of glucose and inhibits the gallbladder
91What is the effect of the SNS on the intestines?
Inhibit Intestinal Activity
92Which nervous system releases epinephrine and norepinephrine?
SNS
93What are the effects of the SNS on the bladder?
Relaxes the Bladder
94Which nervous system promotes ejaculation and vaginal contraction?
SNS
95What is the effect of the PNS on the bladder?
Contracts Bladder
96Which nervous system promotes erection of genitals?
PNS
97What does P+ stand for?
Stimulation of PANS
98What does P- stand for?
Inhibition of PANS
99What does S+ stand for?
Stimulation of SANS
100What does S- stand for?
Inhibition of SANS
101What type of drugs stimulate the PANS?
Cholinergic and Parasympathomimetics
102What type of drugs inhibit the PANS?
Anticholinergics, Parasympatholytics, and Cholinergic Blockers
103What type of drugs stimulate the SANS?
Sympathomimetics and Adrenergics
104What type of drugs inhibit the SANS?
Adrenergic Blockers, Sympathetic Blockers, and Sympatholytics
105What does an agonist do?
Increases Function
106What does an antagonist do?
Decreasees Function
107What are drugs that act on the location where acytylcholine is the neurotransmitter released?
Cholinergic
108What are the drugs that act on the location where norepinephrine is the neurotransmitter released?
Adrenergic
109What prefix is attached to drugs that act on locations where PANS acts?
Parasympatho-
110What prefix is attached to drugs that act on locations where SANS acts?
Sympatho-
111What suffix is attached to drugs that act on the location where a division of the ANS acts and produces the same effect as the neurotransmitter?
-mimetic
112What suffix is attached to drugs that act on the location where a division of the ANS acts and blocks the action of the neurotransmitter?
-lytic or -blocker
113What type of drug is a sympathomimetic drug?
Adrenergic Agonist
114What effects does a sympathomimetic drug have?
Increases Sypathetic Effects
115What type of drug is a Sympatholytic drug?
Adrenergic Antagonist
116What effects do sympatholytic drugs have?
Decrease sympathatic effects
117What does SLUD stand for?
Salivation Lacrimation Urination Defecation
118What type of drug has the SLUD effect?
Cholinergics
119What effects are produced by cholinergic drugs?
Salivaiton, Lacrimation, Urination, Defecation
120What happens in case of an overdose on cholinergic drugs?
Neuromuscular Paralysis and Confusion
121How are overdoses on cholinergic drugs treated?
Pralidoxime: Regenerates irreversibly bound ACh receptor sites that are bound by the inhibitors
Atropine: Competitively Blocks muscarinic effects of excess ACh
122What are the cardiovascular effects of cholinergic agents?
Lowers HR, Lessens Contractions, Lowers Output
123What does chronotropic mean?
Lowers Heartrate
124What does inotropic mean?
Decreases Strength of Heart Contractions
125What are the effects of cholinergic agents on the GI?
Increases Activity, Increases Secretion, Increases Motility
126What are the effects of cholinergic agents on salivation?
Increases Saliviation
127What are the effects of cholinergic agents on the eyes?
Pupil Constriction
128What is the word that means pupil constriciton?
Miosis
129What do direct-acting parasympathomimetic drugs do?
Act directly on the receptor
130What do indirect-acting parasympathomimetic drugs do?
Inhibit Cholinesterase
131What does cholinesterase do?
Breaks doesn Ach
132What type of drug is a cholinesterase inhibitor?
Parasympathomimetic
133What is pilocarpine used for?
Oral Administration treats xerostomia, Topical Application Constricts Pupils, Also used to reduce side effects of morphine (dry mouth, constipation, urinary retention)
134What are the effects of sypathetic drugs?
Vasoconstriction, Cardiac Effects, Produces Bronchodilation
135What are the uses of vasoconstriction effects of sympathetic drugs?
Local Anesthetic, Hemostasis, and Nasal Decongestion
136What are the uses of cardiac effecs of sympathetic drugs?
Tx of Shock, Cardiac Arrest, and Anaphylaxis
137What are the uses of the bronchodilation effects of sympathetic drugs?
Treats Emphysema or Asthma
138What is the agonist response from Alpha-1 SANS Receptors?
Vasoconstriction, Inhibition of the GI tract, and Mydriasis (pupil dilation)
139What organ(s) do Beta-1 SANS receptor affect?
Heart
140What is the agonist response from Beta-1 SANS receptors?
Increased Force of Contraction and Increased HR
141What organ(s) is affected by Beta-2 SANS receptors?
Lungs and Coronary Blood Vessels
142What is the agonist response of Beta-2 SANS receptors?
Bronchodilation and Vasodilation
143What are the effects of stimulating the alpha-1 receptor?
Vasoconstriction of Vessels in the periphery and kidnes, Mydriasis, Uterine Contraction, and Inhibition of GI Tract
144What are the effects of blocking the alpha-1 receptor?
Vasoconstriction of vessels in the periphery and kidneys is prevented and pupil dilation is prevented
145What happens when alpha-2 receptors are stimulated?
Acetylcholine and Norephinephrine is inhibited
146What happens when alpha-2 receptors are blocked?
Suppresses the modulatory effects on the SANS, prolonging sympathetic activity
147What happens when Beta-1 receptors are stimulated?
HR, Force of Contraction, and Conduction Velocity Increase
148What happens when beta-1 receptors are blcoked?
HR, Contractile Force, and Conduction Velocity Decrease
149When happens when beta-2 receptors are stimulated?
Bronchodilation
150What happens when beta-2 receptors are blocked?
Decreased bronchodilation
151What are the cardiovasucal effects of adrenergic drugs?
Force and Strength of Contraction, Blood Pressure, and HR Increase
152What are the effects of adrenergic drugs on the lungs?
Bronchodilation
153What type of drug is an adrenergic or sympathomimetic drug?
Albuterol