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160 terms

Intro to pharm, part 1

pharm
STUDY
PLAY
pharmacology
what is the understanding of chemicals interaction w bio systems for the purpose of treating diseases
pharmacotherapeutics
what is the use of drugs in the tx of disease
drug
what is a natural product, chemical subst, or pharmaceutical prep to be given to humans or animals to treat a disease
safety and pharmacokinetics, healthy (is it safe)
what happens in phase I of drug development
efficacy, safety, dosing, small groups (you think it is safe)
what happens in phase II of drug development
verify efficacy and safety (detect adverse effects), (be presented to ppl and approved by FDA) large groups
what happens in phase III of drug development
post-marketing surveillance; obtain additional data following approval
what happens in phase IV of drug development
DEA
who regulate that diff prescriptions have diff regulations
schedule 1
what type of drugs are not legally prescribed other than in a lab setting (ex-LSD or marijunana) bc no medical use
schedule 2
what type of drugs are powerful and high abuse potential but w medical use (ex-oxycodone)
schedule 3
what type of drugs have a lower abuse potential (ex-codine or anabolic steroids)
schedule 4
what type of drugs have a low abuse potential (ex-anxiety or sedatives)
schedule 5
what type of drugs have no prescription needed federally, but may have some regulations state to state
united states
who has the strictest rules about prescriptions
bioavailability
what is it called when a generic must prove that they are almost the same with time and concentration for IV and for oral as the brand name
II-V
what schedule prescriptions can PA's write prescriptions for in NJ
pt name, date written, name of drug, strength of drug, directions, quantity of drug, prescriber name, signature,
what must be included when writing a prescription
prescriber's address, patient's address, DEA number
what must be included when writing a scheduled prescription
the stricter one
when determining the legal aspects of drug prescribing should the federal law or state law take precedent
FDA
who determines whether something is a prescription, OTC, or a food additive
DEA #
what do you need to prescribe on a federal level
CDS #
what do you need to prescribe controlled substances on a state level
safe place
where should prescription pads be stored
no
should you sign blank prescriptions in advance
legal requirements
written prescriptions need specific info to meed what
paper
oral rx should be transcribed to what immediately
1 yr
expiration of rx is usually how long after it is written
physician name
what should be written on all PA rx in addition to other stuff mentioned already
ink or indelible pencil
what should rx be written with
1000
1 kg = how many g
1000
1 g = how many mg
1000
1 mg = how many mcg
1000
1 mcg = how many ng
64.8
1 grain = how many mg
1000
1 L = how many ml
100
1 dL = how many ml
30
1 fluid ounce = how many ml
5
1 teaspoon = how many ml
15
1 tbsp = how many ml
240
1 glassful or 8 fluid ounces = how many ml
caps
what is the abbreviation for capsule
sol
what is the abbreviation for solution
supp
what is the abbreviation for suppositiory
susp
what is the abbreviation for suspension
syr
what is the abbreviation for syrup
tab
what is the abbreviation for tablet
p.o.
what is the abbreviation for by mouth
I.V.
what is the abbreviation for by intravenous
no abbreviation write out (I.M.)
what is the abbreviation for intramuscular
I.D.
what is the abbreviation for intradermal injection
pr
what is the abbreviation for per rectum
write out
what is the abbreviation for both eyes, right eye, left eye
write out
what is the abbreviation for both ears, right ear, left ear
d.
what is the abbreviation for day
h.
what is the abbreviation for hour
q.
what is the abbreviation for every
q4h.
what is the abbreviation for every 4 hours
daily
what is the abbreviation for every day
every other day
what is the abbreviation for every other day
b.i.d
what is the abbreviation for twice a day
t.i.d
what is the abbreviation for three times a day
q.i.d
what is the abbreviation for four times a day
bedtime
what is the abbreviation for bedtime
stat
what is the abbreviation for immediately
c.
what is the abbreviation for food, meal
a.c.
what is the abbreviation for before meals
p.c.
what is the abbreviation for after meals
with (-c)
what is the abbreviation for with
without (-s)
what is the abbreviation for without
rep.
what is the abbreviation for repeat
e.m.p.
what is the abbreviation for in the manner prescribed
ut dict.
what is the abbreviation for as directed
p.r.n.
what is the abbreviation for as needed
disp
what is the abbreviation for dispense
re
review percent strength in packet
receptor theory
a drug works by combining w a receptor which is then modified to produce the effect desired
equilibrium
a drug interaction occurs in what kind of environment where binding and unbinding is influenced by multiple things
covalent bonds
what bonds are very strong, irreversible at body temp, and uncommon in pharm
non-covalent
what bonds are weakers, work together or against each other, reversibly bind, often in pharm
ex: ionic, hydrogen, van der waals, hydrophobic
receptors
what are molecular subst or macromolecules in tissues that combine chemically w drug
yes
is each receptor different
no
do receptors interact w many things
fit
compounds have a maximum response at receptor sites that is related to their what
asymmetrical carbon atom
most compounds contain what that means that a molecule can be built either left or right handed
mirror images
left and right stereoisomers are not superimposable but are what
one (or one more strongly called stereospecificity)
biological receptors may only except how many isomers
racemic mixture
most drugs have equal proportions of dextro and levo isomers called WHAT even though there may be diff receptor specificities
dose-response relationship
what describes the relationship btwn conc of drug at receptor site and magnitude of response
maximum response capacity
drug response increases until it reaches what as the administered dose is increased
all functional receptors are occupied
the maximum response of a drug is when
number of receptors
the response of a drug is directly related to what which the drug interacts with
the law of mass action
what is when the fraction of all receptors are combined with the drug and this is a part of the conc of drug that is near the receptor and also of the dissociation constant of the drug-receptor complex
affinity
what is the tendency of a drug to combine w receptor
intrinsic activity
what is the ability of a drug to start a cellular effect
potency
what is the measure of drug activity on a milligram of drug per kilogram of body weight (depends on activity, affinity, kinetics)
efficacy
what is the measure of a drug's ability to produce a desired effect
agonist
what has affinity and intrinsic activity
antagonist
what has affinity and no intrinsic activity
effective dose
what is the dose where 50% of subjects have the same effect that you want
lethal dose
what is the dose where 50% of the subjects die
therapeutic index
what is the LD 50% / ED 50%
additive effects
what is when two drugs given at the same time produce the exact effect predicted from the sum of their effects alone
potentiation/synergism
what is when the effects of two drugs are greater than would have been predicted from their effects alone
antagonism
what is when two drugs used together produce less than the predicted effect alone
chemical antagonism
what is when drugs don't have an effect bc what you used to treat one thing blocks the other
functional antagonism
what is when you use two drugs that have opposing effects on the body
population heterogenecity
what is when there is not as many enzymes in the liver to digest
100
what percentage of an intravenous drug is in the blood at 0 time
pharmacokinetics
what is the dose, frequency, route of administration to drug level in time relationship of the body
pharmacodynamics
what is the conc of drug at the site of action to the magnitude of the effects produced
administration
the route of absorption depends on the route of what
physiochemical factors (quality of drug) and patient factors (alteration of GI tract and other systems)
what two factors effect drug absorption
first pass effect
what refers to hepatic elimination or deactivation of orally administered drugs before systemic absorption
first pass hepatic elimination
the following are drugs w low oral availability due to what:
-aspirin, desipramine, hydralazine, isoproterenol, lidocain, methylphenidate, morphine, nitroglycerin, pentazocine, propoxyphene, propanolol
distribution
what is the amt of drug in the body relative to its conc in blood
apparent volume of distribution (Vd)
what is a volume into which the drug would distribute if it existed in the same conc throughout the body as it does in the serum or plasma where it is being measured
apparent volume of distribution (Vd)
what do the following factors affect:
-size of person, plasma protein binding, tissue dist (intra and extra vascular compartments, fat solubility)
unbound
what type of drug is capable of leaving and entering the tissues
liver
most drugs are altered where before being eliminated and the goal of this is to increase water solubility
non-synthetic
the liver does WHAT reactions like oxidation, reduction, hydrolysis to make drugs more soluble
synthetic
the liver does WHAT reactions like conjugation via glucuronidation, sulfation, acetylation, methylation to make drugs more soluble
p450
what enzyme of the liver may be induced to dec the conc of drug in the blood or decreased to inc the conc of drug in the blood
clearance
what is a proportionality constant that relates the conc to the rate of drug elimination
volume per unit time
the units of kidney clearance are what
clearance x concentration
clearance (of kidney is what formula)
glomerular filtration rate
how is renal excretion measured
urine pH
active secretion and reabsorption often occur in the kidney and is influenced by what
plasma drug conc and plasma protein binding
what can effect renal excretion
half-life
what is the time to eliminate half of the drug in the body or reduce Cp by one half
first order kinetics
what means that you have a fixed % of drug over time
monitor drug levels, suspected toxicity, suspected undertreatment, cost factors
what are the four reasons why you should use pharmacokinetics
yes
should the following types of drugs be used for pharmacokinetics:
-good correlation btwn plasma conc and pharmacological response
-narrow therapeutic range
-widely variable plasma levels btwn subjects from a given dose
-drug assay is readily available
neuromuscular junction
the somatic nervous system originates in the CNS and has a nerve cell body found there and then has its synapse where
Ach
what is the neurotransmitter for the somatic nervous system
two
how many synapses are needed to affect an organ when using the autonomic nervous system
Ach (1) and NE (2)
what are the two sympathetic neurotransmitters that effect smooth muscle, cardiac muscle, and gland cells
Ach (1) and Ach (2)
what are the two sympathetic neurotransmitters that effect sweat glands
E and NE
what are the two sympathetic neurotransmitters that effect the adrenal medulla
Ach (1) and Ach (2)
what are the two parasympathetic neurotransmitters that effect smooth muscle, cardiac muscle, and gland cells
adrenal medulla
what is the exception to the rule that the sympathetic nervous system has short preganglionic fibers and long postganglionic fibers
pre-synaptic
what part of the nerve ending is a neurotransmitter factory (uptake of precursors, synthesis, and packaging) for Ach and NE
nerve action potential
what causes the release of neurotransmitters at synapses
at a receptor
the conc of drug or neurotransmitter where will quantitatively grade the response
Ach and NE
what neurotransmitters can diffuse out of the cleft to terminate the action
Ach
what neurotransmitter can be enzymatically converted to terminate the action
NE
what neurotransmitter can be uptaken to terminate the action
modification of chemical transmission by drugs
what is the foundation of modern pharmacology
drugs
what can do the following:
-block pre-synaptic release
-cause inc pre-synaptic release
-mimic the endogenous transmitter (agonist)
-block the endogenous transmitter (antagonist)
-interfere with the termination step
-modulate related systems (second messenger)
cholinergic
acetylcholine receptors are also called what
adrenergic
norepinephrine receptors are also called what
neurotransmitter receptor specificity
what is the key to controlling drug effects
biologic drugs
what are drugs work by understanding the macromolecular receptors on cells, their role in cell activity and how they signal, and understanding how to inc/dec those activities
45-50
biologics in the future are expected to be what % of the total drug market
large molecule drugs
biologics are clasically known as what bc their structures are large and biologically drive to carry out their function
small molecule drugs
most drugs in market today are what that are created in industry and act in a diff manner
biosimilars
what are like generic biologic drugs, but bc of big size and complex molecule, method of production, they are not exactly matched when switching from brand to generic
small molecules (generic)
what are:
-simple structures and relatively pure components that make generic easier than biologic
-batch to batch variation small
-produced in daily batches
-well understood MOA
large molecules (biosimilars)
what are:
-require growing and harvesting product from living cells
-biologics are often dozens to thousands x bigger than chemical drugs
-can take months to make
-complex MOA
clinical trial
for biosimilars what is required for each to demonstrate safety and efficacy
providers
when switching from brand to biosimilar a medical benfit or pharmacy must notify whom