Term VI Pharm Ch 1-2
Terms in this set (129)
what is pharmacology
the study of drugs
who were the first pharmacologists
human ancestors who observed and remembered which plants products produced predictable results
Knowledge of pharmacology is required to perform what types of functions in the dental office?
- obtaining a health hx
- administering drugs in the office
- handling emergency situations
- planning appts
- nonprescription meds
- nutritional/ herbal supplements
- discussing drugs
- life-long learning
what is the most common Drug Information Reference
Physicians' Desk Reference (PDR)
Which drug reference book contains Drug information for the health care provider as well as advice for the patient
US Pharmacopeia Drug Information (USP DI)
Which drug reference book provides info directly from the manufacturer's package insert and lists the drugs alphabetically
PDR- Physician's Desk Reference
which drug reference book lists drugs alphabetically by generic name
Mosby's Dental Drug Reference
which drug reference book contains concise lists of drug attributes and sections relevant to dentistry for each drug?
Lexi- Comp's Drug Information Handbook for Dentistry
how many names do drugs have
at least two names, and many have more
what is a drugs chemical name
the drugs chemical structure
What is a trade name? When would a drug be given a trade name?
- Trade name is a brand name.
- trade name given if a compound is found to be Useful and if it will be marketed.
How can you distinguish a generic name from a Trade name?
Trade names are CAPITALIZED, generic names are NOT capitalized
The trademark is protected by Federal Patent Law for how many yearsW
when is a drug given a generic name? how many generic names are drugs given?
generic name is given before the drug is marketed.
Each drug has only ONE generic name
In 1984, Congress passed the Drug Price Competition and Patent Term Restoration Act, which allowed generic drugs to receive expedited approval. What is the FDA's requirement regarding the generic and the trade name product?
FDA requires the active ingredient of the generic product to enter the bloodstream at the same rate as the trade name product.
When two formulations of a drug meet the chemical and physical standards established by the regulatory agencies
when the two formulations produce similar concentrations of the drug in blood and tissues
when the two formulations prove to have an equal therapeutic effect in a clinical trial
which federal agency regulates production, distribution, and import use of opiates, opium, and cocaine
Harrison Narcotic Act
What agency determines which drugs can be sold by prescription and OTC and regulates the labeling and advertising of prescription drugs
US Food and Drug Administration (FDA)
the FDA is part of...
US Department of Health and Human Services (USHHS)
What agency regulates the trade practices of drug companies and prohibits the false advertising of foods, OTC drugs, and cosmetics
Federal Trade Commission (FTC)
what agency regulates the manufacture and distribution of substances that have a potential for abuse, including opinoids (narcotics), stimulants, and sedatives
Drug Enforcement Admistration (DEA)
Part of the Department of Justice
What Act mandates that pharmacists must provide patient counseling and a prospective drug utilization review (DUR) for Medicaid patients
Obnibus Budget Reconciliation Act (OBRA)
a discovered or synthesized compound must pass through many steps before it is approved to become a marketed drug. What are these steps called?
Clinical Evaluation of a New Drug
what must be done before any clinical trials can be performed?
an Investigational New Drug application (INDA) must be filled out
During a clinical evaluation, which phase deals with administering small then increasing doses to a limited number of healthy human volunteers. It is primarily for safety determination
what is the main purpose of Phase 2 of a clinical evaluation
main purpose is to TEST EFFECTIVENESS. Large groups of humans given the drug and any adverse reactions are reported to the FDA
what phase of a clinical evaluation involves large # of patients who have the condition; both SAFETY and EFFICACY must be demonstrated; dosage is determined
what phase of a clinical evaluation involves the general population; toxicity that occurs in patients taking the drug after it is released, is recorded
Have several drugs in recent years been removed from the market only after phase 4 has shown serious toxicity?
What ACT provided federal control over narcotic drugs and required registration of all practitioners prescribing narcotics?
The Harrison Narcotic Act of 1914
What replaced The Harrison Narcotic Act
The Controlled Substance Act of 1970
what are the current requirements for prescribing controlled drugs
- DEA number required
- all Schedule II through IV drugs require a prescription
Which schedule of controlled substance has the highest potential for abuse
Which schedule of controlled substance can be bought OTC in some states
Which schedule of controlled substance can prescriptions be phoned in; no more than five prescriptions in 6 months
Schedule III and IV
Which schedule of controlled substance require written prescriptions with provider's signature only; no refills
Which part of the prescription contains:
- name, address,and number of prescriber
- name, address, age, and number of patient
- date of the prescription
prescription not valid unless the DATE is filled out
what is the inscription part of the prescription
- RX symbol
- name and dose size/ concentration of the drug
what is the subscription part of the prescription
Amt of drug to be dispensed
what part of the prescription are the "directions to the patient"
what info is found at the closing of a prescription
- prescriber's signature
- DEA number, if needed (controlled substance)
- Refill instructions
what two criteria must be met before a dentist can legally write a prescription for a patient
- must be patient of record
- condition for which the prescription is being prescribed is a dental- related condition
twice per day
three times per day
four times per day
the amt of drug required to produce an effect
the maximum intensity of effect or response that can be produced by a drug
is potency and efficacy related
what does chemical signaling involve
release of neurotransmitters, local substances, and hormone secretion
messengers that move the electrical impulses from a nerve across the synapse
what are examples of neurotransmitters
- norepinephrine/ epinephrine
some organs secrete chemicals that work near them; they are not released into systemic circulations. examples: prostaglandins and histamine
chemicals that are secreted to produce effects throughout the body. these reactions are slower than the ones associated with the neurotransmitters
what must a drug do to exert its effects?
it must bind with the receptor site on the cell membrane
True or False:
Drugs with a stronger affinity for a receptor site are more potent than drugs with a weaker affinity for the same site.
Drugs that combine with the receptor may be classified as...
Agonist or Antagonist
Has affinity for the receptor, combines with the receptor, produces an effect; mimics same response as the body
what counteracts the action of the agonist
what are the three different types of antagonist
- competitive antagonist
- noncompetitive antagonist
- physiologic antagonist
has affinity for a receptor, combines with the receptor, produces NO effect
has affinity for a diff receptor site than the agonist; decreases the maximal effect of the agonist by producing an OPPOSITE effect via different receptors
binds to a different receptor site than the agonist, REDUCES the MAX response of the agonist
what is pharmacokinetics
the study of how a drug enters the body, circulates within the body, is changed by the body, and leaves the body.
what are the four major steps that influence the movement of a drug in the body
Lipid- soluble substances move across the lipoprotein membrane by a passive transfer called..
process by which a substance is transported AGAINST a concentration or electrochemical gradient
True or False:
Facilitated diffusion moves against a concentration gradient
False; it DOES NOT move against a concentration gradient
process by which drug molecules are transferred from the site of administration to the circulating blood
what factors must a drug have in order to penetrate through the cell membrane
- non-ionized (not charged)
what happens to a drug if it is water- soluble, ionized/ polar (charged)
drug will be blocked and will go through the liver and get metabolized
for weak acids, what must the pH and hydrogen ion concentration be in order to easily penetrate through the tissues?
pH down, hydrogen ion up
for weak bases, what must the pH and hydrogen ion concentration be in order to easily penetrate through the tissues?
pH up, hydrogen ion down.
True or False:
Weak acids are better absorbed when the pH is less than the pKa, whereas weak bases are better absorbed when the pH is greater than the pKa.
passage of drugs into various body fluid compartments such as plasma, interstitial fluids, and intracellular fluids.
All drugs occur in what two forms?
- bound to plasma proteins
- the free drug
Which of the two forms of drugs can pass across the cell membrane
the free drug
which is a reservoir for the drug and does not get absorbed
the bound drug
what form of drug exerts the pharmacologic effect; absorbs well
the free drug
Distribution of a drug is determined by what factors?
- size of the organ
- blood flow to the organ
- solubility of the drug
- plasma protein- binding capacity
- presence of barriers (blood- brain, placenta)
what results in enterohepatic circulation
it prolongs the effect of a drug.
how does enterohepatic circulation work
- After the drug is metabolized, it becomes "metabolite" and is secreted through bile into the intestine.
- The metabolite is broken down by enzymes and releases the drug
- The drug is absorbed AGAIN and the process continues
After being taken up by the liver a second time, the drugs are again secreted into the bile. Each time it goes through the pattern, a little of the drug escapes with each passing. This is why it prolongs the effect of the drug
the movement of a drug from the site of action to nonspecific sites of action.
what happens if redistribution occurs between specific sites and nonspecific sites?
the drug's action will be terminated.
what is the body's way of changing a drug so that it can be more easily excreted by the kidneys?
metabolism aka biotransformation
True or False:
The metabolite formed is usually more polar and less lipid soluble than the parent compound.
what are the 3 ways a drug can be metabolized. Which is the most common?
- Active -------> inactive **
- Inactive ------> active
- Active ---------> active
During metabolism in Phase I reaction, lipid molecules are metabolized by what three processes
what enzymes are responsible for inactivating the drug during Phase I reaction
- microsomal enzyme
- cytochrome P-450
- mixed function oxidases
If smoking/ alcohol tolerance induces microsomal enzymes, what happens to the drug?
if microsomal enzymes are induced, the amt of enzymes increase so the drug will get metabolized faster
If microsomal enzymes are decreased (inhibit), what happens to the drug?
The drug will not metabolize as fast, so the drug stays in the body longer
What happens in Phase II reaction during metabolism of a drug
involves conjugation (attach) with glucuronic acid( most common), acetic acid, and amino acid
these acids will bind to the drug then get excreted
the enzymes that mediate the conjugation are termed...
Between Phase I and Phase II reactions in metabolism, which is easier?
what is the most important route a drug is excreted
renal (kidney) excretion
a mathematical representation of the way in which drugs are removed from the body
what are the three routes substances can be eliminated in the kidneys
- Glomerular filtration
- Active tubular secretion
- Passive tubular diffusion
What other route, other than kidneys, can certain drugs be eliminated
by the lungs
Gases used in general anesthesia are excreted where? what else is partially excreted by the lungs?
across lung tissue by simple diffusion; Alcohol
the major route by which systemically absorbed drugs enter the gastrointestinal tract and are eliminated in the feces
To increase the drug's usefulness in the treatment of periodontal disease, where should the drug be excreted?
in the GCF ( gingival crevicular fluid)
time it takes for the drug to begin to have its effect
the length of a drug's effect
Drugs given by the _____ route are placed directly into the gastrointestinal tract by oral or rectal administration.
_______ administration bypasses the gastrointestinal tract and includes various injection routes, inhalation, and topical administration.
what is parenteral usually referred to as?
what is the most common and most popular route of administration
Does oral administration produce a slower onset or a faster onset of action than parenterally administered agents?
What route of administration is useful for emergency situations?
what route of administration produces the most rapid drug response and is more predictable than oral administration
what route of administration absorbs drugs injected into the muscle
what is the common route of administration for insulin and can cause a sterile abscess?
route of administration under the skin
route of administration into the spinal subarachnoid space
route of administration where fluid is placed into the peritoneal cavity, where exchange of substances can occur
route of administration of gaseous, microcrystalline, liquid, or powdered form of drugs. may be used for either local or systemic effect
route of administration where application is to body surfaces, generally used on skin for local effect
what is the most common problems with the transdermal patches?
local irritation, erythema, and edema
what is the most commonly used dose forms in dentistry?
table and capsule given orally
what are the two ways drugs can be applied topically?
- sublingual route
- buccal route