Questions and Answers
What is the main purpose of respiratory drugs?
Decongestant nasal sprays should be used for more than 3 days.
False
What do mucolytics do?
They attempt to reduce the viscosity of respiratory secretions.
The primary method of administering beta-adrenergic agonists is through _____ .
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Which of the following medications is not typically used for treating respiratory issues?
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What is the role of leukotriene inhibitors?
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Antihistamines can cause sedation in all patients.
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The drugs used to treat bronchial asthma often include _____ and beta-2 agonists.
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Which of the following is a side effect of glucocorticoids?
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What condition results in thick, viscous secretions that block the pulmonary tree?
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Match the following terms with their definitions:
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What are common symptoms of hyperthyroidism? (Select all that apply)
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Which medication is the drug of choice for hypothyroidism?
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Proton Pump Inhibitors (PPIs) are generally less effective than H2 blockers.
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What does the acronym GERD stand for?
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Name one side effect of long-term PPI use.
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The main goal of chemotherapy is to limit cell proliferation by killing or attenuating the growth of __________ cells.
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Which type of medication is commonly used to prevent vomiting?
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What is the pharmacological function of aminoglycosides?
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Levothyroxine can cause symptoms of hyperthyroidism if overdosed.
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Match the drug class with its primary action:
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What is the branch of pharmacology that refers to the use of drugs to prevent, treat, or diagnose disease?
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What process describes how the body absorbs, distributes, and eliminates drugs?
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What is the study of harmful effects of chemicals called?
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What is one of the main differences between brand and generic drugs?
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What is the total time from conception to market for new drugs?
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The 'On-Off Phenomenon' refers to the gradual improvement of symptoms in patients taking Levodopa.
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Which of the following symptoms is part of the TRAP acronym associated with Parkinson's disease?
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What is the primary purpose of Carbidopa when given with Levodopa?
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General anesthetics may bind to receptors such as GABA, Potassium, and ______ depending on the medication.
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Which of the following is NOT a property of nonsteroidal anti-inflammatory drugs (NSAIDs)?
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What is a common side effect of general anesthesia?
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Which medication is known to have irreversible retinal damage as a major side effect?
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What is the mechanism of action for glucocorticoids?
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What is spasticity caused by?
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Spasticity occurs due to decreased stretch reflex.
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Patient-controlled analgesia (PCA) typically allows patients to ______ as needed for pain relief.
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What is the primary use of Viscosupplementation?
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What is a potential side effect of using Diazepam?
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What is the role of adrenocorticotropic hormone (ACTH)?
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Which of the following is a symptom of Serotonin Syndrome?
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In Cushing Syndrome, excessive levels of __________ are secreted.
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What condition is treated with hormone replacement therapy (HRT)?
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What type of hormones are androgens?
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Which drug can lead to generalized sedation as a side effect?
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Botulinum toxin (Botox) is used to enhance muscle contraction.
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What is the function of glucocorticoids?
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Study Notes
Pharmacology Overview
- Pharmacotherapeutics involves drug use to prevent, treat, or diagnose diseases.
- Pharmacokinetics: Study of drug absorption, distribution, metabolism, and elimination by the body.
- Pharmacodynamics: Examination of drug effects on the body and how they produce their effects.
- Toxicology: Focuses on the harmful effects of chemicals.
Drug Nomenclature
- Chemical Name: Describes the chemical structure.
- Trade/Brand Name: Commercial name given to a drug.
- Generic Name (Nonproprietary): Shorter name derived from the chemical name.
Brand vs. Generic Drugs
- Brand-name drugs are protected by patents.
- Generic drugs are typically cheaper and must demonstrate bioequivalence:
- Same active ingredients and dosage.
- Identical route of administration and pharmacokinetic profile.
- Comparable therapeutic effects.
Drug Approval Process
- Preclinical Trials: Animal testing lasts 1-2 years.
- Clinical Trials: Human testing across three phases over 5-6 years.
- Postmarketing Surveillance (Phase IV): Ongoing monitoring after market introduction.
- Average total time from conception to market is 7-9 years.
Parkinson's Disease (PD)
- Characterized by degeneration of dopamine-producing neurons in the basal ganglia.
- Symptoms include TRAP: Resting Tremor, Bradykinesia, Rigidity, and Postural Instability.
- Imbalance of dopamine and acetylcholine contributes to bradykinesia.
Causes of Parkinson's Disease
- No single cause; likely due to genetic predisposition and environmental factors.
- Environmental triggers include herbicides, insecticides, and industrial waste exposure.
Drug Treatment Overview for PD
- Levodopa (Sinemet): Converts to dopamine and is most effective for symptom relief. Long-term use may result in reduced efficacy.
- Carbidopa: Prevents Levodopa conversion in the periphery, allowing more to reach the brain.
- Dopamine Agonists: Directly stimulate dopamine receptors, possibly causing fewer side effects.
- Anticholinergics: Reduce acetylcholine effects but have limited use due to side effects.
- Amantadine: Modulates excitatory amino acid activity; suitable for early stages or as an adjunct.
- MAO-B Inhibitors: Extend dopamine activity and may have neuroprotective effects.
- COMT Inhibitors: Help maintain dopamine levels by hindering its breakdown.
Levodopa-Carbidopa (Sinemet)
- Background: Levodopa is converted to dopamine by Dopa Decarboxylase. Only 1% gets through the blood-brain barrier (BBB) without assistance.
- Dosage: Initial dosing is typically 25mg Carbidopa/100mg Levodopa, with an average maintenance dose of 600-700mg/day.
- Side Effects: Include end-of-dose akinesia, on-off phenomenon, freezing episodes, and gastrointestinal problems.
New Parkinson's Disease Research
- Focus on the balance of neurotransmitters. Dopamine depletion complicates acetylcholine levels and may contribute to cognitive issues in PD.
- New treatments aim to address the hormonal balance between acetylcholine and dopamine.
Neurosurgical Interventions for PD
- Deep Brain Stimulation: Inserting electrodes to normalize circuitry in the basal ganglia.
- Pallidotomy/Thalamotomy: Surgical lesions in specific pathways used in advanced PD cases.
Anesthesia Overview
- General Anesthetics: Induce unconsciousness for procedures; may be gaseous or IV forms.
- Balanced anesthesia requires a combination of drugs to achieve effects such as immobility, unconsciousness, and analgesia.
General Anesthetics MOA
- Medications bind to receptors, affecting neurotransmitter activity which impacts consciousness. Neuromuscular blockers may enhance mechanical ventilation.
General Anesthesia Side Effects
- Risks include confusion, fatigue, nausea, and potentially malignant hyperthermia, characterized by rapid increases in body temperature and muscle rigidity.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
- NSAIDs reduce inflammation, alleviate pain, and have antipyretic properties.
- Primary distinctions between Aspirin (anti-inflammatory) and Acetaminophen (analgesic/antipyretic) highlight different mechanisms and uses.
Pathophysiology of Rheumatoid Arthritis (RA)
- Systemic autoimmune disease characterized by synovitis, leading to destructive joint inflammation. Higher incidence in women.
- Antibodies form against antigens, causing immune responses that damage cartilage and bone.
RA Drug Treatment
- Involves NSAIDs, glucocorticoids, and disease-modifying antirheumatic drugs (DMARDs).
- Glucocorticoids are potent anti-inflammatories but have catabolic side effects.
DMARDs
- Non-biologic DMARDs, including antimalarials and gold therapy, can suppress immune function but have a range of side effects.
- Biologic DMARDs specifically inhibit tumor necrosis factor (TNF) to moderate the inflammatory response with a lower side effect profile.
Viscosupplementation
- Involves injecting hyaluronic acid into joints, improving synovial fluid viscosity, beneficial for knee osteoarthritis, and delaying joint replacement.
Patient Controlled Analgesia (PCA)
- Allows patients to self-administer analgesics for pain management, commonly through IV routes but also via epidural or transdermal methods.
Local Anesthetics
- Enable pain relief without residual effects, commonly using agents like lidocaine. They work primarily by inhibiting sodium channel activity on nerve membranes.### Anesthesia
- Block, epidural, or spinal nerve block administers medication in the subarachnoid space.
- Global effects occur below the administration site, typically around L3-L4.
- Delivery method significantly influences the overall effects experienced.
Respiratory System
- Mediates gas exchange between the external environment and bloodstream.
- The upper respiratory system warms and moistens the air, protecting lungs from irritants.
- Gas exchange primarily occurs in the alveoli with pulmonary circulation.
- Many patients experience both acute and chronic pulmonary conditions; understanding medication effects is essential.
Respiratory Drugs
- Maintain proper airflow and gas exchange in respiratory passages; two main categories:
- Minor (e.g., nasal congestion, cough, seasonal allergies).
- Chronic/Serious (e.g., asthma, bronchitis, emphysema, COPD).
Cough/Cold/Allergies Treatments
- Antitussives: Suppress coughing; not recommended for productive cough. Generally not for children under six.
- Decongestants: Mainly Alpha-1-Adrenergic Agonists creating vasoconstriction in nasal mucosa. Usage is limited to short terms to avoid rebound congestion.
- Antihistamines: Block H1 receptors to alleviate allergic symptoms. Newer versions do not cause sedation.
Mucolytics and Expectorants
- Mucolytics (e.g., acetylcysteine) reduce secretion viscosity; expectorants help clear mucus. Efficacy is often debated, with Mucinex being FDA-approved.
Asthma & COPD Treatments
- Characterized by bronchospasms and inflammation. Strategies focus on preventing or reversing bronchoconstriction.
- Bronchodilators: Stimulate B2 receptors for bronchodilation via various administration methods (oral, inhalation).
- Anti-inflammatories: Corticosteroids control inflammation; adverse effects reduced when inhaled.
Leukotriene Inhibitors
- Medications that inhibit leukotriene production, aiding in inflammation control; commonly used alongside corticosteroids and beta agonists.
Bronchial Asthma Management
- Treatment involves corticosteroids plus long-acting beta-2 agonists. Asthma patients should have a rescue inhaler available during physical therapy.
COPD Management
- Focus on managing bronchitis and emphysema symptoms with anticholinergics, long-acting B2 agonists, and steroids tailored to patient needs.
Cystic Fibrosis Challenges
- Characterized by thick secretions causing blockages in pulmonary and related organs, leading to serious complications. Treatment includes various drugs for mucus management and respiratory hygiene practices.
Muscle Relaxants / Spasticity Treatment
- Address hyperexcitable muscle tissue, aiding with spasticity and spasms.
- Spasms: Continuous muscle contraction often caused by injury or inflammation.
- Spasticity: Exaggerated stretch reflex associated with CNS damage, graded by the Modified Ashworth Scale.
Anti-Spasm Drugs
- Diazepam (Valium): Increases GABA inhibition for muscle relaxation. Risks include tolerance and withdrawal symptoms.
- Centrally Acting Anti-spasm Drugs: Inhibit AMN excitability, often used short-term, with side effects including drowsiness and dizziness.
Neuroleptic and Anticholinergic Syndromes
- Serotonin Syndrome: Can occur from serotonin agonists; symptoms include altered mental status and muscle rigidity.
- Neuroleptic Malignant Syndrome: Typically follows exposure to dopamine antagonists; symptoms develop over days and include rigidity.
- Malignant Hyperthermia: Triggered by specific anesthetics; symptoms include rising end-tidal CO2 and skin mottling.
Antispasticity Medications
- Diazepam, Baclofen (oral/intrathecal), Dantrolene Sodium, Gabapentin, Tizanidine, Botulinum Toxin: Each have distinct mechanisms, indications, and side effect profiles.
Endocrine Pharmacology
- Focuses on maintaining homeostasis via hormone secretion across various glands (hypothalamus, pituitary, thyroid, etc.).
- Hormone supplementation is commonly a foundation for many medications.### Endocrine Control
- Adrenocorticotropic hormone (ACTH) is produced in the anterior pituitary gland and regulates cortisol levels from the adrenal gland.
Adrenocorticosteroids
- Adrenal cortex produces two types of steroids:
- Glucocorticoids (e.g., cortisol) regulate metabolism and response to stress.
- Mineralocorticoids (e.g., aldosterone) maintain fluid and electrolyte balance.
- Administered in two ways:
- Physiologic dose: Equivalent to normal production (hormone replacement).
- Pharmacologic dose: Higher dosages for specific effects, such as anti-inflammation.
Glucocorticoids
- Glucocorticoids, primarily cortisol, peak in release at 8 am, preparing the body for activity.
- They increase blood glucose and facilitate muscle breakdown for glycogen storage in the liver, inhibiting glucose uptake in muscles and fat.
Glucocorticoids & Endocrine Disorders
- Cushing Syndrome: Excess cortisol causing a “moon face,” hypertension, and glucose intolerance. Treatment involves adrenalectomy and hormone replacement therapy.
- Addison Disease: Insufficient aldosterone and cortisol lead to fatigue, low blood pressure, and potential adrenal failure requiring hormone replacement.
Male and Female Hormones
- Androgens (e.g., testosterone) produced in male gonads control reproduction and secondary sexual characteristics.
- Estrogens and progestins produced in female ovaries regulate menstruation and have medical uses in contraception and treatment.
Androgens
- Clinical uses include replacement therapy for aging, catabolic states, delayed puberty, breast cancer, and anemia.
- Abuse potential through anabolic steroids can lead to liver damage, cardiovascular issues, and mood swings.
Estrogen and Progesterone
- Key for female sexual maturation and regulation of menstrual cycles, with cyclic production and variations.
- Medical uses include treatment for osteoporosis, hypogonadism, and menopausal symptoms, with risks of cardiovascular issues.
Thyroid Hormones
- Control metabolism through increased BMR, body temperature, and respiratory functions.
- Secretes thyroxine (T4) and triiodothyronine (T3); discrepancies in hormone levels linked to autoimmune conditions like Graves and Hashimoto's diseases.
Hyperthyroidism
- Symptoms include nervousness, weight loss, rapid heart rate, heat intolerance, and muscle wasting.
- Treatments involve antithyroid medications, radioactive iodine therapy, and surgery.
Hypothyroidism
- Symptoms include fatigue, weight gain, slow heart rate, and cold intolerance.
- Treated with hormone replacement therapy, particularly levothyroxine, with careful monitoring of TSH levels.
Gastrointestinal Pharmacology
- GERD arises from mechanisms like transient esophageal relaxation and anatomic disruptions, treatable by lifestyle changes and medications.
Antacids and Anti-Acid Medications
- Antacids neutralize stomach acid; H2 blockers inhibit acid production; proton pump inhibitors (PPIs) are more effective in reducing acid secretion.
Antiemetics
- Used for symptom relief in various conditions; types include antihistamines and serotonergic blockers.
Anti-Diarrheals
- Should be avoided with abdominal pain or fever; options include loperamide for motility and bismuth subsalicylate for antimicrobial effects.
Constipation Management
- Non-pharmacological methods include fiber intake and fluid consumption, while pharmacological options range from bulk-forming agents to stimulants.
Antibacterial Drugs
- Classified as bactericidal or bacteriostatic, inhibiting bacterial wall synthesis or protein production via various drug classes, including penicillins and cephalosporins.
Drug Resistance
- Overuse of antibiotics has contributed to the emergence of resistant strains like MRSA and VRE.
Antiviral Drugs
- Target viral function with common side effects affecting multiple organ systems, emphasizing the need for careful management.
Interferons
- Proteins that enhance immune resistance to viral infections, grouped into three classes, with potential adverse effects like flu-like symptoms.
HIV
- Retrovirus impairing T-cell function can lead to severe immunocompromised states; no cure exists, but treatments aim to slow replication and manage infections.
Antifungal and Antiparasitic Drugs
- Mycosis-treated primarily topically; considerations for skin inspections and hygiene in high-risk environments.
Chemotherapy
- Aims to limit cancer cell proliferation by targeting rapidly dividing cells; cell kill hypothesizes a proportional reduction in cancer cells per treatment cycle.
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Description
Explore the foundational concepts of pharmacology, including pharmacotherapeutics, pharmacokinetics, and pharmacodynamics. This quiz also covers toxicology and drug nomenclature, providing a thorough overview of drug interactions and effects on the body. Test your knowledge in the important principles guiding pharmaceutical science.
