Which Schedule am I?

1) Morphine
Oxycodone (Oxycontin®) or Oxycodone/APAP (Percocet®)
Cocaine (used topically…)
Amphetamines (Ritalin®, Focalin®, Adderall®)
Meperidine (Demerol®)
Hydromorphone (Dilaudid®)
 2)  Herion
LSD
PCP

1)  Schedule 2...prescriptions must be written everytime and must include a DEA number.

2)   Schedule 1...no known medical benefit and cannot be prescribed.

Which Schedule?

1) Codeine with acetaminophen (Tylenol #3®)
Hydrocodone with acetaminophen (Lortab®, Norco®)
Testosterone and anabolic steroids

1. Address and phone number of where the prescription originates
2.  Patient’s name and address
3.  Date the prescription is written
4.  The drug
5.  The dosage form and strength

6.  Directions for use or “sig”
7.  Quantity or number of units to dispense
“Disp” or “#”
8.  Refill information
9.  Signature and DEA # when applicable
 

FDA 2 Types of review:
1)  for drugs that appear to have therapeutic qualities similar to those of one or more already marketed drugs in the treatment, diagnosis or prevention of a disease
2)  given to a drug that appears to have significant improvement compared to marketed products

3)  T or F Unlike DEHA drugs, FDA approved drugs do not require animal, lab, or human testing?

1) Standard

2) Priority

3) False...DEHA drugs do not...FDA drugs do.  

1)  Telling people what CAN go wrong and then patients experience what you told them

2)  Using an approved drug in an unapproved manner
 3) Name this Program:The FDA Safety Information and Adverse Event Reporting Program
Serves both healthcare professionals and medical product-using public to report serious problems that they suspect are associated with the drugs and medical devices they prescribe, dispense, or use

1)  Nocebo Affect

2)   Off-label use (40% of cancer drugs prescribed this way)

3)  Medwatch

Pharmacology

 Pharmacokinetics

Pharmacodynamics

1)  If an adverse effect is of enough clinical significance and occurs with enough frequency, the FDA may require this be added to a package insert

2)    has potential use in only a small number of people but is significant enough for FDA to provide incentives to company to research, develop and market the drug

3)  LD50/ED50 or TD50/ED50 – a measure of the margin of safety
 

1)  Black Box Warning

2)  Orphan drug

3) Therapeutic Index

1) Intracellular receptors

2)  Ligand regulated transmembrane enzymes

3) Cytokine receptors and tyrosine kinase activity

4)  Ligand-gated channels

__ = association constant

K2 =_____ _____

K2/ K1 = __ = dissociation constant of drug

High KD = indicates low affinity for receptor = drug dissociates rapidly from receptor and the response is short acting

___ KD = high binding affinity and long lasting drug effect

K1

Dissociation Constant

KD

Low KD

1)  Is equal to the concentration neccesary for the drug to reach 50% of it's maximum Effectiveness.

2)  Dose required to kill 50% of population

3)  LD50/ED50=?

1)  EC 50 (very similiar to ED...ED 50 or Effective dose 50)

2) LD 50

3) Therapeautic Index...if it is low the drug must be prescribed with great caution since the effective dosage is so similiar to the lethal dosage.  

1) Efficacy (The most efficacious drug may be least potent or most potent
Amount of drug required is NOT important in evaluation of efficacy)

2) Potency (Depends on KD and efficiency of receptor mediated response
The drug that produces Emax at the lowest concentration is the more potent drug)

1)  Bioavailability (F) (F = 1 (drugs given IV): no barriers to overcome for absorption to occur)

2)  False... Drugs with high lipid solubility and low protein binding cross BBB easily

1) Drugs that are activated by metabolism

2)  Drug activation: Phase __ reactions: oxidation, reduction, hydrolysis, CYP450
Phase __ reactions: glucuronic acid conjugation, sulfate conjugation, acetylation, glutathione conjugation

3)  Enzyme system most commonly found in liver (intestines, lungs, other organs)
Understanding the unique functions/characteristics of this system leads to managing drug interactions
Enzyme Inhibitors: inhibit enzyme responsible for metabolizing drug…causes  blood level of drug
 

1)  Prodrugs

2) Phase 1

3)  Phase 2

4)  Cytochrome p450 System

Kinetics which order is this?

Rate of elimination is proportional to drug concentration

During each half-life, 50% of drug is eliminated

Each half-life is the same amount of time...

Which order of elimination kinetics is this?

Half-life decreases with decreasing concentration. Resulting in a linear, downward sloping conc/elimination time curve.

T or F? 

1)  Drug metabolism in Geriatrics and Pediatrics by the Liver are decreased?

2) Rate of drug absorbtion is rapid in the pediatric population?

3)  The major intervention for medical personnel is to add medications to the Geriatric population?

1)  True

2) False...it is slower than other populations

3) False.... Prescriber’s major intervention is usually withdrawing a medication rather than prescribing a new medication
 

1) Phase II:

2)  Phase I:

3) Phase IV: