1
Q
What are the 4 phases of the drug investigative process?
A
- Preclincal investigation- involves extensive lab research
- Clinical Investigation- tests are preformed on volunteers to determine proper dosage and adverse effects
- NDA Review- the drugs brand name is finalized
- Postmarketing studies- survey for harmful effects in a larger population
2
Q
What are examples of attenuated vaccines? “ROME is my best place to yell”
A
-Measles, mumps, rubella Rubella Oral polio vaccine Measles Epidemic typhus Influenza Mumps BCG Plague Typhoid oral vaccine Yellow Fever
3
Q
What are examples of inactivated vaccines?
A
Hepatitis A
4
Q
What are examples of toxoid vaccines?
A
Tetanus and diphtheria
5
Q
Interferons (explain)
- mechanism of action
- use
- adverse effects
A
-help to boost patients immune system
-MoA: slows activity of viral infection; enhance activity of leukocytes
-Use: primarily used with cancer treatments, viral infections, herpes simplex
Adverse effects: flu-like symptoms and bone marrow suppression
increase in liver enzymes
6
Q
What diseases are interferon alpha used with?
A
Leukemia, AIDS, and hepatits.
7
Q
Clyclosporine (Sandimmune, Neoral, Gengraf)
- classification
- use
- mechanism of action
A
*Black box warning because of risk for infection
Class: Immunosuppresor; calineurin inhibitor
Use: Primarily used for transplant rejection
MoA: Inhibits helper T cells
8
Q
Where are H1 and H2 receptors located?
A
H1-smooth muscles (lungs, sensory nerves, heart)
H2-stomach
9
Q
NSAID’s
- max dose
- adverse effects
- mechanism of action
- prototype drug
A
- Max dose: 3200 mg/day
- have anti-pyretic components (fever)
- Adverse effects: GI issues, long term use effects the kidneys (renal function)
- MoA: inhibit prostaglandin synthesis (prostaglandins are lipids found in tissue; cause inflammation)
- Prototype: Ibuprofen (Advil, Motrin, others)
10
Q
Aspirin
- mechanism of action
- normal dose (adult and baby)
- adverse effects
- patient teaching
A
- used mostly for heart problems; blood thinner
- MoA: inhibits both COX-1 & COX-2
- Dose: Adults->325 mg & Baby 81mg
- Adverse Effects: GI (ulcers)
- Patient teaching: take with food or milk (coating of the stomach); tinnitus (ringing of the ears) caused by high doses
11
Q
Tylenol (acetaminophen)
- mechanism of action
- major issue
- max dose
- how supplied
- adverse effects
- things to monitor
A
- *NO ANTI-INFLAMMATORY; reduces fever**
- MoA: reduce fever by direction action@ hypothalamus & dilation of peripheral blood vessels
- Major issue: liver failure (excreted through the liver)
- Max dose: 4,000mg/day
- Supplied: 325mg and maximum strength is 500mg
- Adverse Effects: enables sweating and dissipation of heat
- Things to monitor: bilirubin levels & hepatic enzymes
12
Q
Prednisone
- class
- mechanism of action
- use
- adverse effects
A
- Class: corticosteroid
- MoA: being metabolized to an active form of glucocorticoid
- Use: primarily used to treat inflammation
- Adverse Effects: suppresses adrenal gland function, hyperglycemia (pt on sliding scale insulin because of this)
13
Q
Corticosteroid
- use
- mechanism of action
- adverse effects
- effect of long term therapy
A
- Use: short term treatment of acute inflammation
- MoA: suppresses histamine and prostaglandins
- Adverse Effects: moon face, mood changes, suppress adrenal gland function, hyperglycemia, big appetite, electrolyte imbalance (mainly sodium)
- Effects of long-term effect: Cushing’s syndrome (too much steroid)
- *Can mask infection-> creates potential for existing infection to grow rapidly and undetected
14
Q
Antibiotics
-mechanism of action
A
-MoA: disrupt bacterial cell wall
15
Q
Penicillin
- mechanism of action
- use
- adverse effect
- contraindications
A
- MoA: disrupts the bacterial cell wall (most effective on Gram+ bacteria)
- Use: Pneumonia, meningitis, tetanus
- Adverse effects: rash, lowered red/white blood cell and platelets levels
- Contra: any kind of issues with the kidneys (secreted by the kidneys)
16
Q
Cephlosporins (2nd generation to Penicillin)
- mechanism of action
- use
- adverse effects
- contraindications
A
- MoA: disrupts the bacterial cell wall
- Use: sinus infection, bladder infection
- Adverse Effects: diarrhea
- Contra: any kind of issues with the kidneys (secreted by the kidneys)
17
Q
Tetracycline
- use
- adverse effects
- contraindications
- avoid
A
- Use: Rocky Mount spotted fever, lyme disease (tick-borne diseases), h. plyoric (ulcers)
- Adverse Effects: GI upset, sunlight sensitivity, teeth discoloration
- Contraindications: children under 8 years old
- Avoid: do not take with milk or any iron supplements
18
Q
Genatmycin
- use
- route given
- adverse effects
A
- Use: serious infections
- Route: only given IV (not absorbed through the GI tract); given over time (usually and hour)
- Adverse Effects: respiratory issues, nephrotoxic (kidney), ototoxic (ear)
19
Q
Flagyl (Metronidaole)
- class
- mechanism of action
- use
- adverse effects
A
- Class: antiprotozoal drug
- MoA: antiprotozoal drug that ask has antibiotic activity against anaerobic bacteria
- Use: treats most forms of amebiasis
- Adverse Effects:excessive candidiasis (yeast infection)
20
Q
Fosamax (Alendronate)
- class
- use
- mechanism of action
- adverse effects
- implications
A
- Class: bisphosphonate; bone resorption inhibitor
- Use: Prevent and treat osteoporosis; Piaget’s disease
- MoA: lowers serum alkaline phosphate, and enzyme important to bone turnover (inhibits bone respiration)
- Adverse Effects: erosive esophagitis
- Implications: take 1-2 hours before eating or on an empty stomach, take with full glass of water, sit w/no activity for a min. of 30 minutes
21
Q
Plaquenil (hydroxychloroquine sulfate
- class)
- use
- adverse effects:
A
- Class: modifying anti-rheumatic drug
- Use: rheumatoid arthritis and lupus
- Adverse Effects: anorexia, GI disturbances, loss of hair, possible ocular effects, headache, mood and mental changes
22
Q
Calcium supplements
- recommended daily allowance
- use
- adverse effects
A
- Daily allowance: 800-1200 mg/day
- Use: prevent and treat mild hypocalcemia, osteoporosis, Piaget’s disease, chronic hypoparathyroidism
- Adverse Effects: hypercalcemia, hypotension (from IV administration), bradycardia, dysrthmias, cardiac arrest
23
Q
Definition of gout.
A
Form of acute arthritis characterized by a buildup or uric acid in blood or joint cavities.
24
Q
Symptoms of gout
A
- muscle spasms
- localized pain and stiffness
- joint and bone enlargement
- red swollen tissue (often in big toes, ankles, fingers, wrists, knees, and elbows)
25
Medications for gout.
- classification
- 2 types used and why
- mechanism of action
- use
- adverse effects
- prototype
- Classification: uric acid inhibitor
- 2 types: NSAID's for pain and inflammation & corticosteroids for severe pain and inflammation
- MoA:inhibits synthesis of microtubules; subcellular structures responsible for helping white blood cells infiltrate area
- Use: to reduce inflammation associated with cute goutry arthritis
- Adverse Effects: rash, hypersensitivity. headache, vertigo, nausea, vomiting, abdominal discomfort
- Prototype:Allopurinol (Lopurin, Zyloprim)
26
Medications for psoriasis
- 3 topical therapies
- what is prescribed when topical form fails
- prescribed for sever conditions
- biological therapies
- 3 Topical: corticosteroids, immunomodulators (TIMS- suppress the immune system), and Retinoid-like compounds
- When topical fails: Methotrexate (and Trexall)
- Sever conditions: Cyclosporine (Sandimmune, Neoral)
- Biological therapies: alefacept (Amevive), adalimumab (Humira)
27
Sunburn Treatment
| -topical anesthetics
- Topical anesthetics: benzocaine (Solarcaine), dibucaine (Nupercainal), lidocaine (Xylocaine, and tetracaine HCl (Pontocaine)
* Aloe vera is also popular
28
Treatment for lice
- type classifications
- mechanism of action
- use
- adverse effects
- contraindication
- prototype
- Classification: scabicides, Pediculicides
- MoA: kills head and crab lice and mites and eradicate their ova
- Use: marketed as lotion; 1% is approved for lice and 5% for mites
- Adverse Effects: cause few systemic side effect; location reactions include pruritus, rash, transient tingling, burning, stinging, and edema
- Contra: pt's with history of seizures when using Lindane (Kwell)
- Prototype: Permethrin (Acitin, Elimite, Nix), Lindane (Kwell), Crotamiton (Eurax) and Ivermectin (Sklice)
29
Drugs for Glaucoma
| -2 classifications
-2 Class': Prostaglandins and Beta-adrenergic Blocker
30
Xalatan (Iatanoprost)
- classification
- mechanism of action
- use
- adverse effecrs
- Class:Prostaglandin
- MoA: reduce IOP by increasing outflow of aqueous humor
- Use: treat open-angle glaucoma
- Adverse effects: patients complain of "burning-like" sensation
31
Timolol
- classification
- mechanism of action
- use
- adverse effect
- contraindications
- Class: Beta-adrenergic Blocker
- MoA: reduces formation of aqueous humor
- Use: reduce elevated intraocular pressure in chronic open-angle glaucoma
- Adverse Effects: local burning and stinging upon instillation
- Contra: asthma, COPD (any breathing issues)
32
Side effects of Corticosteroids
| "Cushingoid"
```
Cataracts
Ulcers
Skin thinning, bruising and stiae
Hyperglycemia/hypertension/hirsutism
Infections
Necrosis
Glycouria
Osteoporosis, Obesity
Immunosuppression
Diabetes
```
Pharmacology
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