Pharmacology Midterm

What are two plant and animal sources used to derive therapeutic drugs?

Heparin (derived from animal tissues) and cardiac glycosides (derived from the foxglove plant).

What is the chemical name?

Precise molecular structure

What is the generic name?

Generic Name

What is the trade name?

Brand name registered by a manufacturer (e.g., Advil, Motrin)

What is generic equivalence, and why are look-alike drug names dangerous?

the active generic ingredient enters blood at the exact same rate as the brand name. Similar drug names (e.g., Celebrex vs. Celexa) can cause fatal medication errors.

What are the main duties of the FDA?

Approves drug marketing, sets manufacturing standards, and regulates prescription labeling/ads.

What are the main duties of the DEA?

Regulates manufacturing and distribution of controlled substances substances with the possibility of abuse

What are the key rules for Controlled Substance Schedules I to V?

Schedule I: Highest abuse potential; no medical use (e.g., heroin, LSD).

Schedule II: High abuse; requires written/typed prescription in ink, no refills, cannot be phoned in.

Schedule III & IV: Moderate/low abuse; max 5 refills in 6 months.

Schedule V: Lowest abuse potential (e.g., cough syrups with codeine).

What is a Black Box Warning, and what was the 2011 acetaminophen regulation?

FDA warning drawing explicit attention to severe drug safety hazards. In 2011, prescription combination tablets were capped at a maximum of 325 mg of acetaminophen per tablet.

What is the difference between labeled and off-label drug use?

Labeled use is FDA-approved for a specific condition. Off-label use is prescribing a drug for an unapproved indication

What are the 3 main sections of a prescription?

Heading: Prescriber/patient information and date.

Body: Rx symbol, drug name, dosage, quantity (Disp), and directions (Sig).

Closing: Prescriber signature, DEA number, refill count, and substitution directions.

What do the prescription abbreviations ac mean?

before meals

What do the prescription abbreviations pc mean?

after meals

What do the prescription abbreviations bid mean?

2 times a day

What do the prescription abbreviations tid mean?

3 times a day

Qid

4 times a day

Po

by mouth

prn

as needed

sig

write on label / instructions

stat

immediately

How do drug potency and efficacy differ?

Potency is related to dose (smaller dose needed = higher potency). Efficacy is the maximum overall effect regardless of dose. They are completely unrelated.

What is the difference between an agonist and an antagonist?

An agonist binds receptors to produce a therapeutic response. An antagonist binds receptors to block or counteract an agonist.

Define Pharmacokinetics, Pharmacodynamics, Pharmacogenetics, and Toxicology

Pharmacokinetics: Study of drug movement through the body.

Pharmacodynamics: Action of a drug on a target organ/cell.

Pharmacogenetics: How genetics affect individual drug response.

Toxicology: Study of poisons and adverse drug effects.

What steps form the LADME acronym?

Liberation, Absorption, Distribution, Metabolism, Excretion

How do tissue pH and pKa affect local anesthetic onset?

Higher pH increases the nonionized form, causing faster onset.

What is the first-pass effect?

Breakdown of an oral drug in the liver before it reaches circulation

What is the difference between enteral and parenteral administration?

Enteral uses the GI tract; parenteral bypasses the GI tract

What are the main organs for drug metabolism and excretion?

Liver for metabolism; kidneys for excretion

What is bioavailability, and how does IV compare to oral?

Percentage of unchanged drug reaching circulation; IV is 100%

What is the difference between a loading dose and maintenance dose?

Loading dose is a large initial dose; maintenance dose maintains drug levels

What distinguishes a therapeutic effect from an adverse reaction?

Therapeutic effects are intended; adverse reactions are unwanted and harmful

What are LD50 and ED50?

LD50 kills 50%; ED50 produces the desired effect in 50%

What interaction occurs with these drug combinations?

Alprazolam + diphenhydramine = additive; penicillin + azithromycin = antagonistic

What steps help prevent prescription errors?

Write exact instructions, spell out quantities, include patient age, and state refills/NR

The term for the ability of a drug to produce a therapeutic effect regardless of the dose is the

efficency

A drug administered sublingually goes directly to the

Heart

What components make up the Central Nervous System (CNS)?

Brain and spinal cord

The Autonomic Nervous System (ANS) controls which of the following involuntary functions?

Blood pressure, pulse, respiration, and salivary gland excretion

What is the term for the junction between two communicating neurons?

Synapse

If a cluster of neuronal connections between two nerve cells lies outside the Central Nervous System, it is called a

Ganglion

A neuron that conducts impulses before the synaptic cleft is referred to as the

Preganglionic neuron

Which primary neurotransmitter is released from all preganglionic neurons in both the Sympathetic (SANS) and Parasympathetic (PANS) divisions?

Acetylcholine

Which neurotransmitter is released by most postganglionic neurons in the Sympathetic Autonomic Nervous System (SANS)?

Norepinephrine

Which sympathetic organ or gland is innervated directly by preganglionic neurons that release acetylcholine, without any postganglionic fibers?

Adrenal medulla

Cell bodies of preganglionic neurons in the Parasympathetic Autonomic Nervous System originate from which cranial nerves?

CN III, VII, IX, and X

What is the primary physiological state associated with activation of the Parasympathetic Autonomic Nervous System?

Resting and digesting response

Parasympathetic receptors on target tissues are categorized into which two types?

Muscarinic and Nicotinic

The mnemonic "SLUD" represents parasympathetic stimulation. What does the letter "U" stand for?

Urination

Adrenergic receptors that predominantly stimulate heart muscle rate and contraction strength are classified as:

Beta-1 receptors

Activation of Beta-2 adrenergic receptors produces which primary physiological response?

Bronchodilation in the lungs

What is the medical term for pupil dilation caused by sympathetic activation or adrenergic drugs?

Mydriasis

Which adrenergic drug is a selective Beta-2 agonist used as a quick-relief bronchodilator for acute asthma attacks?

Albuterol (Ventolin)

Which medication is a non-selective beta-blocker that blocks both Beta-1 and Beta-2 receptors?

Propranolol (Inderal)

What is the maximum recommended "cardiac dose" of epinephrine (1:100,000) for a patient taking a non-selective beta-blocker?

B) 0.04 mg (approx. 2 cartridges)

Which direct-acting cholinergic agent is used in dentistry to treat xerostomia associated with Sjogren's syndrome?

Pilocarpine (Salagen)

Indirect-acting cholinergic drugs like Donepezil (Aricept) increase acetylcholine concentration by inhibiting which enzyme?

Acetylcholinesterase

In the "ABCD" mnemonic for anticholinergic drug adverse effects, what does the letter "C" stand for?

Constipation

Which anticholinergic drug is administered to reduce salivary flow before specific dental procedures?

Atropine

Which dietary or hygiene advice is recommended for a dental patient suffering from drug-induced xerostomia?

Chew sugarless gum or candy

Why should patients who use an albuterol inhaler be instructed to rinse their mouth with water after each dose?

To reduce the risk of oral candidiasis and dry mouth

Using a drug in the wrong dose or for a longer duration than prescribed is defined as

misuse

What term describes the state in which emotional abnormalities and drug-seeking behavior occur when a drug is withdrawn?

Psychological dependence

The requirement to continually increase the drug dosage to achieve the same therapeutic or euphoric effect is termed

Tolerance

Delirium tremens (DTs) refers to a severe, shaky withdrawal state associated with chronic abuse of

Ethyl alcohol

Which agent used to treat alcoholism makes a person physically ill if alcohol is consumed by inhibiting aldehyde dehydrogenase?

Disulfiram (Antabuse)

Chronic abuse of nitrous oxide by dental health professionals can cause myeloneuropathy, which manifests as:

Loss of finger dexterity, numbness, and paresthesia of extremities

Which classical triad of clinical signs is characteristic of acute opioid overdose?

Pinpoint pupils miosis, respiratory depression, and unconsciousness/sedation

What drug is administered to reverse acute opioid overdose and respiratory depression?

Naloxone (Narcan)

Which long-acting opioid agonist is used in medical detoxification and maintenance programs for opioid dependence?

Methadone

Dental local anesthetics containing vasoconstrictors (epinephrine) must be avoided for at least 24 hours after recent use of

Cocaine or methamphetamine

"Meth mouth" is typically characterized by rampant decay located primarily on which area of the teeth?

Cervical third of the teeth

Chronic methamphetamine users often experience formication, which is

The sensation of insects crawling under the skin

Which oral medication prescribed for smoking cessation acts as an antidepressant?

Bupropion (Zyban / Wellbutrin)

if an emergency dental extraction is required on a patient actively under the influence of opioids, which local anesthetic is preferred to avoid potentiating cardiac effects?

3% Mepivacaine plain (without vasoconstrictor)

Which autonomic nervous system response occurs during sympathetic activation?

Relaxation of the urinary bladder and bronchodilation

How do anticholinergic drugs affect eye function?

Cause blurred vision and pupil dilation

Which spinal cord region gives rise to the preganglionic neurons of the Sympathetic Autonomic Nervous System (SANS)?

Thoracolumbar portion

Where do preganglionic neurons of the Parasympathetic Autonomic Nervous System (PANS) originate?

Brain stem cranial nerves (CN III, VII, IX, X) and sacral spinal cord (S2-S5)

Which neurotransmitter is released by postganglionic neurons in the Parasympathetic division?

Acetylcholine

In the Sympathetic division, most postganglionic neurons release which neurotransmitter onto target organs?

Norepinephrine

What exception exists for neurotransmitter release in sympathetic postganglionic innervation?

Sweat glands are innervated by SANS but release acetylcholine

Which statement correctly compares ocular responses under SANS versus PANS activation?

SANS causes pupil dilation (mydriasis); PANS causes pupil constriction (miosis)

How do SANS and PANS differ in their effect on salivary gland secretions?

SANS stimulates mucus-secreting cells producing thick saliva and xerostomia; PANS stimulates salivary flow

What effect does the Parasympathetic division have on the respiratory system?

Constricts breathing and bronchioles

Receptors in the sympathetic nervous system are categorized as

Alpha and beta receptors

Parasympathetic receptors located on target tissues are categorized as

Muscarinic and nicotinic

The term used for drugs that block sympathetic receptors (alpha or beta) is

Sympatholytics

the term used for drugs that block muscarinic or nicotinic receptors is

Parasympatholytics or anticholinergics

Which statement best describes gastrointestinal tract responses to SANS and PANS activation?

SANS inhibits digestion; PANS stimulates digestion and GI activity

What is the primary function and memory key for Beta receptor distribution?

Beta-1 affects heart; Beta-2 affects lungs ("ONE heart, TWO lungs")

What is the effect of SANS vs PANS on the urinary bladder?

SANS relaxes the bladder; PANS contracts the bladder

Sympathomimetic (Adrenergic)

Drugs or agents that mimic the flight-or-fight response of the sympathetic nervous system.

Sympatholytic

Drugs that block alpha or beta sympathetic receptors.

Parasympathomimetic (Cholinergic):

Drugs or agents that mimic the rest-and-digest response of the parasympathetic nervous system.

Parasympatholytic (Anticholinergic)

Drugs that block muscarinic or nicotinic parasympathetic receptors.

What is the primary purpose of a local anesthetic?

To prevent pain by inhibiting the conduction of nerve impulses

Local anesthetics work primarily by blocking which channels in the nerve membrane?

Sodium channels

Blocking sodium channels prevents the generation of:

Action potentials

Which method involves injecting the anesthetic close to a major nerve bundle?

Nerve block

Which statement about local anesthetics is correct?

They decrease the rate of depolarization