PHAR 100 Final Exam: Drug History & Development Review, Exams of Advanced Education

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Drugsi-iCorrectiAnswer- Anyisubstanceireceivedibyia.biologicalisystemithatiisinotireceivediforinu tritiveipurposesiandiwhichiinfluencesitheibiologicalifunctioniofitheiorga nism.iMeansithatichemicals,ibiologicaliagentsiandiherbaliproductsiareial lidrugs. Wheniwereitheimajorityioficlinicallyiusefulidrugsideveloped?i- iCorrectiAnswer-Overitheipasti 250 iyears. Pharmaologyi-iCorrectiAnswer- Theiscienceiofidrugs,iincludingitheiriuses,ieffectsiandimechanismsiofiacti on. Keyihistoricaliinfluencesithatihaveishapedimodernipharmacologyi- iCorrectiAnswer-Theimanyidiscoveriesimadeibyiancienticivilizations Theiroleiofipoisonsiinihistory. Theiinfluenceiofireligion.

AncientiCivilizationsi-iCorrectiAnswer- HealersiexistediiniainumberiofiancienticulturesiincludingiAncientiGreece ,iAncientiEgyptiandiAncientiChina. AncientiGreece:iThreophastusi-iCorrectiAnswer- Threophrastus,iaipupiliofiAristotleiwroteiaitextbookionitherapeuticsitha tiincludediopium. Opiumiisiobtainedifromitheiopiumipoppy. AncientiGreece:iSerturneri-iCorrectiAnswer- AipharmacistiworkingiiniGermanyiini1803.iIsolatedicrystalsiofimorphinei iniopiumianditesteditheipureisubstance.iDiscoverediiticouldirelieveipain. Whatidoesiopiumicontaini-iCorrectiAnswer-Morphine,icodeine Morphinei-iCorrectiAnswer- Opiumicontainsiapproximatelyi10%imorphine.iCoinedifromiMorpheus. Codeinei-iCorrectiAnswer-Containsi0.5%icodeine. AncientiEgypti-iCorrectiAnswer-recordedionidocumentsicalledipapyri. q

Ebersipapyrusi-iCorrectiAnswer- 1550 iBCE:iIntendeditoibeiaitextbookiofidrugiuseiforimedicalistudents. Theipapyrusicontainedimainyitrueiobservationsionitheiuseiofidrugs,iesp eciallyipurgatives. Senna-istilliuseditoday AncientiChinai-iCorrectiAnswer- EarliestirecordedidrugiexperimentsicomeifromiChinaiinitheiyeari 2700 iBC E.iSheniNungiuseditoiclassifyidrugsiaccordingitoitaste. MaiHuangiwasiclassifiediasiaimediumidrug.iWidelyiusediforicoughs,iinflu enzaiandifevers. EphedrineihasibeeniisolatedifromiMaiHuang.iUseditoitreatiasthma.iCani beiusediasiaidecongestant. Poisons:iCurarei-iCorrectiAnswer-Plant- derivedidrug.iHistoricallyiusedibyiindigenousipeopleiiniregionsiofitheiAm azon.

Curare:iUseiofiaipoisoni-iCorrectiAnswer- IndigenousipeoplesiofitheiAmazonidippeditheiriarrowsiinicurareiforihunt ing.iActediuponivoluntaryimusclesicausingiparalysis. Curare:iUseiasiaidrugi-iCorrectiAnswer- UsedibyiIndigenousiPeopleiinspirediallopathicimedicine.iEventuallyiuse dibyianestheticsiduringisurgery.iSmallidosesicouldirelieveimuscles.iTheis tructureihasisinceibeenimodifieditoimakeiitisafer. Ergoti-iCorrectiAnswer- Aipoisonousifungusithatigrowsionitheiheadsiofirye. Grounditogetheriwithiryeiinitheimiddleiages,ifindingiitsiwayiintoibread.iC ausediterribleiepidemics,ikillingiasimanyiasi 20 i 000 ipeopleiiniRussia. Ergot:iEffectsiofiPoisoning;iNervousiSystemi-iCorrectiAnswer- Onceiitientersitheibody,iergotitargetsitheinervousisystem.iResultsiinisym ptomsisuchiasimentalifrenzy,ihallucinationsiandiconvulsions. Ergot:iEffectsiofiPoisoning;iCariovasculariSystemi-iCorrectiAnswer- Ergotipoisoningicanicauseiconstrictionsiofibloodivesselsileadingitoifinger s,itoesiandilimbsibecomingistarvediofitheiribloodisupply. Ergot:iEffectsiofiPoisoning;iReproductiveiSystemi-iCorrectiAnswer- Canicauseiviolenticontractionsiofitheiuterus.

Someimidwivesirecognizedithatismalliamountsiofiergoticouldibeiusefulii nihasteningilabour.iUsediasiearlyiasithei16thicentury. Physiciansiinithei1800siusediergotitoiexpediteilingeringilabour.iCouldires ultiinideath. Ergot:iUseiasiaidrugi-iCorrectiAnswer- Ergotamineiandiergonovineiareitheitwoicompoundsiderivedifromiergoti withipharmocologicaliuses. Ergotaminei-iCorrectiAnswer-Isiusefuliinitheitreatmentiofimigraines.i Ergotamineiconstrictsitheibloodivesselsipreventingitheipulsationiofiarte rialibloodivesselsithaticarryiblooditoitheihead. Ergonovinei-iCorrectiAnswer- Onceiuseditoihastenibirth.iForceiofiuterineicontractionsimayibeitooistro ngiandiparentimayibeiinjuredibyitooirapidideliveryiofitheichild. Canibeiuseditoiarrestiuterineibleeding. TheiInfluenceiofiReligioni-iCorrectiAnswer- Traditionalihealersiactediasibothiphysiciansiandipriests.iThisiresultsiinith erapyibeingiheavilyiinfluencedionibothireligioniandimagic.

Plantsicontainingiintoxicatingisubstancesiwereiusedibyitraditionaliheale rsitoialteritheiristateioficonsciousnessiandifacilitateicommunicationiwith itheirigods. Peyotei-iCorrectiAnswer- AicactusiusediiniMexicoitoiachieveiaimysticalistate,ilinkeditoispiritualian diritualisticiuse. Containsiaipotentisubstanceimescaline,iwhichicausesihallucinations,iaife elingiofiwell-beingiandidistortioniofiperception,isimilaritoiLSD. ZinciOxidei-iCorrectiAnswer- Usediiniancientitimes,iconsiderediofigreatiimportanceitoitherapies.i Foundiiniainumberiofitopicalicreamsisuchiasirashicreamsiandicalamineilo tion. RomaniShippingiVesseli-iCorrectiAnswer- SunkioffitheicoastiofiTuscanyiaroundi 120 iBCE.iExcavatediinithei1980sian di90s,iuncoveringiancientiromanimedicalitabletsisealediinitinicontainers. Analysisiofitheimedicalitabletsirevealediainumberiofizincicompounds,iiro nioxide,ibesswax,ipineiresiniandiotheriplantiderivedimaterial.

Abouti 25 i%iofitheidrugsiuseditodayiare...i-iCorrectiAnswer- derivedifromiplantisources,iwithitheiactiveisubstancesibeingipurifiedian dithenimodifieditoibeieitherimoreieffectiveiorilessitoxic. Drugsiactingionitheibrain:idiscoveryi-iCorrectiAnswer- AlbertiHofmanniworkediforiaiSwissipharmaceuticalifirmiwasiinvolvediini tryingitoisynthesizeiimprovedipharmaceuticaliproductsiusingiergot.i SynthesizediLSD,isimilariinistructureitoiergotamineiandiergonovine. DrugsiActingionitheiBraini-iCorrectiAnswer- Alteritheinormalichemicalisignallingiinitheibrain. LSDi-iCorrectiAnswer-LysergiciAcidiDiethylamide. Classifiediasiaicontrolledisubstanceiinithei1970s. DrugsiActingiOnitheiBrain:iContributionitoiPharmacologyi- iCorrectiAnswer- DiscoveryiofiLSDipsychedelicieffectsisupporteditheiideaithaticertainimen taliillnessesimayibeidueitoitheiproductioniofipotentisubstancesiofitheibr ainithatiproducedidistrubance. DrugsiActingiAgainstiInfectiousiDiseasei-iCorrectiAnswer- Aniinfectiousidiseaseiisianyidiseaseicausedibyianiorganism.

1900siOrganoarsenicalsi-iCorrectiAnswer- PauliEhrlich:iDesignedicomplexesiofiarseniciandiorganicimoleculesicalle diorsanoarsenicalsiwhichiselectivelyibounditoiparasites.i Applieditoiotheriinfectiousidiseasesiandileditoicureiforisyphilis. Syphilisi-iCorrectiAnswer- Aibacterialiinfectionitransmittedisexuallyithroughidirecticontactiwithiais yphilisisore.iEasyitoicureiwhenidiagnosedianditreatediearly. 1930s:iSulfaiDrugsi-iCorrectiAnswer- GerhardiDomagkiintroducedisulfaidrugsiini1930siGermany. Firstisyntheticidrugiusediforitreatmentiofibacterialidisease. Nowitermediantibacterialicompounds. 1940s:iPenicillini-iCorrectiAnswer- AlexanderiFlemingidiscoveredipenicilin,itheifirstiantibiotic. IntroductionitoimodernimedicineioccurrediduringiWWII Majorlyiusediinigram-positiveibacterialidisease.

Gram-positivei-iCorrectiAnswer- Bacteriaiwithithickicelliwallsiandinoiouterimembrane. 1950s:iStreptomycini-iCorrectiAnswer- SelmaniWaksmanidiscoveredistreptomycin.iHelpeditoitreatiGram- negativeibacterialidiseasesiandituberculosis. Gram-negativei-iCorrectiAnswer- Bacteriaiwithithinicelliwallsiandianiouterimembrane. Drugidevelopmentiprocessistepsi-iCorrectiAnswer- Basiciresearchiandidrugidiscovery,ipreclinicalitrials,iclinicalitrials,iHealthi Canadaireviewiandimanufacturing,ipost- marketisurveillanceiandiphaseiIViclinicalitrials 3 - 6 iyearsi-iCorrectiAnswer- Basiciresearchiandidrugidiscoveryiandipreclinicalitrials 6 - 7 iyearsi-iCorrectiAnswer-Clinicalitrialsi

• Phasei1:i10siofipatientsienrollediinistudy.
• Phasei2:i100siofipatients
• Phasei3:i1000siofipatients

0.5- 2 iyearsi-iCorrectiAnswer-HealthiCanadaiReviewiandiManufacturing Continuousi-iCorrectiAnswer-Post- marketisurveillanceiandiphaseiIViclinicalidrugitrials. DrugiDiscovery:iBasiciResearchiandiDiscoveryiofiTarget Stepi1:iIdentificationiofitheiTargeti-iCorrectiAnswer- Aitargetiforiainewipotentialidrugicouldibeiaireceptorithaticausesipainireli efiwheniactivated.i Wheniaicompoundithatibindsiwellitoitheitargetiisifound,iitianithenibeistu dieditoidetermineiitsipharmacologicalieffects. DrugiDiscovery:iBasiciResearchiandiDiscoveryiofiTarget Stepi2:iStudyingitheiTargeti-iCorrectiAnswer- Leadicompoundsiareicompoundsithatishowipromiseiinitheiinitialistudies . Enterimoreidetailedistudiesiforisafetyiandiefficacy.

Effficacyi-iCorrectiAnswer- Theimaximumipharmacologicaliresponseithaticanibeiproducedibyiaispec ificidrugiinithatibiologicalisystem. PreclinicaliStudiesi-iCorrectiAnswer- Conductediprioritoitestingitheidrugiinihumans.iCanimeasureimolecules/ cells,itissuesioriwholeianimalsistudies. Twoitypesioficlinicalistudiesi-iCorrectiAnswer- Pharmacologyistudies,itoxicologyistudies Pharmacologyistudiesi-iCorrectiAnswer- Determineitheidetailedimechanismiofiactioniofitheidrug. ToxicologyiStudiesi-iCorrectiAnswer- Determineitheipotentialirisksioriharmfulieffectsiofitheidrug.i Canilookiatiacuteitoxicity,ichronicitoxicity,iandieffectsionireproductive,ic arcinogenic,iandimutagenicipotential. Canitakeiupitoi 6 iyearsitoicomplete. ClinicaliTrials:iInitialiStepsi-iCorrectiAnswer-Threeisteps:i

• proofiofisafety

• methodology
• investigation Proofiofisafetyi-iCorrectiAnswer- Theipharmaceuticalimanufacturerimustiadmitiproofiofitheisafetyiandieff icacyiofitheidrugiiniseveralianimalispecies. FDAiisiAmerican. Methodologyi-iCorrectiAnswer- Theimethodologyiofitheiproposeditrialiisirequired. Investigationi-iCorrectiAnswer- Submissioniisievaluatedibyiqualifiediscientistsiinitheiregulatoryiagency.i Permissionigiveniforiclinicalipharmacologistsitoibeginitheistudyiinihuma nsiifisatisfied. ClinicaliTrialsiPhasei1,i 2 iandi 3 i-iCorrectiAnswer- Occuriafteripermissioniisigranted.iStudiesiperformedionihumans. Anywhereifromi 5 - 30 icompoundsimayimakeiitithroughipreclinicalitestingihoweverionlyione ioritwoiwillimakeiititoiphaseiIIIitrials,

Phasei 1 i-iCorrectiAnswer- Evaluateiabsorption,idistribution,ieliminationiandiadverseieffectsiofithei newidrug. Testioneioritwoidosesiofitheinewidrugitoidetermineitolerability. Efficacyinotiassessed. Conductediinilimitedinumberiofihealthyivolunteers. Phasei 2 i-iCorrectiAnswer- Determineiwhetheritheidrugiisieffectiveiatitreatingitheicondition.iLimite dinumberiofipeople,i 100 - 500. Conductediinipatientsiwithitheidiseaseiforiwhichitheidrugiisidesigneditoit reat. Phasei 3 i-iCorrectiAnswer-Alsoicalledirandomizedicontrolitrials Numberiofiparticipants:ilargeinumber,i1000s Goal:iDetermineitheisafetyiandiefficacyiofitheidrugicompareditoitheiplac ebo/goldistandardidrug.

Duration:iLongerithaniphasei 2 istudies Location:iStudiesiareiconductediaticentresiinimanyicities.iOneicentreioft enidoesinotihaveienoughidiversity. Cost:iMayicostioneimillionitoiupwardsiofi 50 imillionidollars. DesigniofiPhaseithreeiclinicalitrialsi-iCorrectiAnswer-Threeilargeristages: Determiningienrolmentiprioritoitheistudy Allocatingiparticipantsitoitreatmentigroupsiandiconductingitheitrial. Monitoringiandianalyzingitheiresults. Hypertensioni-iCorrectiAnswer-Highibloodipressure Enrolmenti-iCorrectiAnswer- Theitargetipopulationiisitheigroupiofipatientsiforiwhichitheidrugiisiinten ded.iAisubsetiofitheitargetipopulationithatimeetsiallirequiredicriteriaiisit heistudyipopulation.

Inclusioniinitheistudyipopulationiisideterminedibyibothiinclusion/exclus ionicriteriaiandiconsentiinfluence. InclusioniExclusionicriteriai-iCorrectiAnswer- Characteristicsiofitheipatientsitoibeiincludediinitheistudy,ideterminingiw hoiisiandiwhoiisinotieligibleitoibeipartiofitheitrials. Commonicomorbiditiesiareiofteniincluded. Comorbiditiesi-iCorrectiAnswer- Oneiorimoreiconditionsipresentiiniadditionitoitheiprimaryicondition, TreatmentiAllocationi-iCorrectiAnswer- Doubleiblindidesign,irandomization,icontrol Doubleiblindidesigni-iCorrectiAnswer- Neitheritheiinvestigatorinoritheistudyisubjectiisiawareiofitheitreatmentit heistudyisubjectiisiassignedito.iBiasicanioccuriifiaistudyisubjectibelievesit heidrugiwilliworkiorianiinvestigatorimayiexpectipositiveiresults. Randomizationi-iCorrectiAnswer- Patientsiassigneditoieitheriaitreatmentigroupioriaicontroligroup.iAssigne diusingiaiprocessiknowniasirandomization.iHelpsitoiensureitheiconfound ingivariablesi(knowniandiunknown)iareidistributediequallyibetweenibot higroupsiandiremovesibiasifromiassigningipatients.

Controli-iCorrectiAnswer- Eitheriaiplaceboioriaigoldistandardidrug.iUseditoicompareitheiactualieffic acyiofitheiexperimentalidrug. Placeboi-iCorrectiAnswer- Doesinoticontainianiactiveidrugibutiisiadministereditheisameiasitheiexpe rimentalidrug.iTheiplaceboiresponseicanibeiasihighiasi40%isinceipeopleie xpectithemselvesitoifeelibetter. Goldistandardi-iCorrectiAnswer- Theidrugiacceptedibyitheimedicalicommunityiasitheibestiavailableitreat mentiforitheispecificidiseaseiatithatitime.iTheicontroligroupiwillireceiveit hisiifiavailableiasiitiisiunethicalitoiwithholditreatment. HealthiCanadaiReviewi-iCorrectiAnswer- Theimanufactureriwillisubmitiainewidrugiapplicationicontainingitheidet ailediresultsiofitheiclinicalitrials.iTheidrugiisireviewsibyiregulatoryiscienti stsiandicanithenibeigrantediapproval. Manufacturing:iGenericiandiBrandinamei-iCorrectiAnswer- Aidrug'siformalichemicalinameiisitooicomplexiforicommoniuse.iAigeneric inameiforitheidrugiisiselectediwhileiatitheisameitime,itheimanufactureri williapplyiforiaipatentiwithiaibrandinameiforitheidrug,iwhichiwilligiveithei companyirightsitoimarketitheidrug.

Whatimustianyigenericiversionsiofitheioriginalidrugicontain?i- iCorrectiAnswer- Identicaliactiveiingredientsiinitheisameiamountiandiform Bioequivalenti-iCorrectiAnswer- Theisameiactiveiingredientsiareicontainediinitwoidrugiproductsiwhichigi veisimilaribloodilevels. Post-MarketiSurveillancei-iCorrectiAnswer- Risksithatiareidelayediorilessifrequentithani1/1000iadministrationsimayi beimissediiniphaseithreeiclinicalitrials.iSurveillanceiofitheieffectsiofitheid rugsiisirequirediafteritheidrugiisireleasediforigeneraliuse.i(Figuresioutiho withey'reireactingioriaffectingicertainigroups) Whatifactorsimustioneilookiatitoiseeitheieffectsiofidrugsionitheibody?i- iCorrectiAnswer-Drugitargets Drugiresponse Efficacyiandipotency Therapeuticirange. Receptorsi-iCorrectiAnswer- Aimoleculeioricomplexiofimoleculesionitheioutside/insideiofiaicellithatih asiairegulatoryiorifunctionaliroleiinitheiorganism.

Manyiofitheisameireceptorsimayiexistioniaisingleicelliandimanyiofitheisa meicellitypesiexistiinianiorganism. Opioidireceptorsicauseipainireliefiwheniactivated.iIfiactivatediinitheigast rointestinalitractitheniconstipationioccurs. Howielseimayidrugsiinteractiotherithanireceptors?i-iCorrectiAnswer- Drugsimayinotiinteractiviaireceptors,ibutithroughiaichemicalireactioni(a ntacidsineutralizeistomachiacid)ioriphysicalichemicaliforces Cholestyraminei-iCorrectiAnswer- Cholestyramineiisiaidrugiuseditoilowericholesterol.iItiworksibyichemicall yibindingitoibileiacidsiinitheigastrointestinalitract,ipreventingitheirireabs orptioniandiincreasingitheieliminationiofibileisaltsiuseditoimakeicholest erol. Ligandi-iCorrectiAnswer-Aimoleculeithatibindsitoiaireceptor. Howidoesiaidrugicauseiairesponsei-iCorrectiAnswer- Drugsimimicitheiactioniofitheiendogenousiligandiatitheireceptor. Agonistsi-iCorrectiAnswer-Drugsithatibinditoiandistimulateiaireceptor. Antagonistsi-iCorrectiAnswer- Drugsithatibinditoibutiblockitheiresponseiatiaireceptor.

Dose-responseirelationshipi-iCorrectiAnswer- Intensityiofitheipharmacologicalieffectsiproducedibyitheidrugiincreasesii niproportionitoitheidose. Marijuanai-iCorrectiAnswer- Refersispecificallyitoicannabisiproductiobtainedifromidriediplants. Subjectsiexperiencingiai"socialimarijuanaihigh"...i-iCorrectiAnswer- Subjectsiexperiencingiai"socialimarijuanaihigh"iaccumulatedisignificantl yimoreispeedometerierrorsithaniundericontroliconditions.iNoidifference siiniaccelerator,ibrake,isignal,isteeringianditotalierrors. Subjectsiintoxicatedifromialcoholiaccumulatedisignificantlyimore...i- iCorrectiAnswer- accelerator,ibrake,isignal,ispeedometer,ianditotalierrorsithaniunderinor maliconditions,ibutinoisignificantidifferenceiinisteeringierrors. Whatiwasitheifindingsiofidrivingihighioridrunk?i-iCorrectiAnswer- Impairmentiinisimulatedidrivingidoesinotiseemitoibeiaifunctioniofiincrea sedimarijuanaidosageioriinexperienceiwithitheidrug. Problemsiwithitheicannabisiv.ialcoholistudyi-iCorrectiAnswer- Theiintensityiofitheieffectsioficannabisiincreaseiiniproportionitoitheidose .iLargeidosesioficannabisidoiimpairimotoriperformance.

DoseiResponseiRelationships:iLowiDosesi-iCorrectiAnswer- Veryilittleiresponseiisiobserved,inotimanyireceptorsibeingiactivated. DoseiResponseiRelationships:iThresholdi-iCorrectiAnswer- Asitheidoseiincreases,imoreireceptorsiareiactivatediuntilitheidesiredires ponseiisiseen.iAicertaininumberiofireceptorsiareineedediforianieffect. DoseiResponseiRelationships:iTherapeuticidosesi-iCorrectiAnswer- Afteritheithreshold,iaismalliincreaseiinidoseiresultsiiniailargeiincreaseiinir esponse. DoseiResponseiRelationships:iMaximaliEffecti-iCorrectiAnswer- Onceitheimaximalieffectiisireached,icontinuingitoiincreaseitheiamountio fidrugiwillihaveinoifurtheriincreaseiinitherapeuticiresponse. ED50i-iCorrectiAnswer- Effectiveidoseififty.iTheidoseiatiwhichi%iresponseiisi50%. Efficacyi-iCorrectiAnswer- Theimaximumipharmacologicaliresponseithaticanibeiproducedibyiaispec ificidrugiinithatibiologicalisystem. Potencyi-iCorrectiAnswer- Theidoseiofiaidrugithatiisirequireditoiproduceiairesponseiofiaicertainimag nitude,iusuallyi50%iofitheimaximaliresponseiforithatidrug.

TherapeuticiRangei-iCorrectiAnswer- Drugsiareiadministereditoiachieveiaitherapeuticieffect. Theiaimiofitherapyiisitoigiveiaidoseithatikeepsitheibloodiconcentrationia boveitheiminimumiconcentrationitoiproduceiaidesirableiresponseiwhilei keepingiitibelowitheiconcentrationithatiproducesiaitoxiciresponse. Pharmacokineticsi-iCorrectiAnswer- Refersitoitheimovementiofiaidrugiinto,ithroughiandioutitheibody. ProcessesiInvolvediiniPharmacokineticsi-iCorrectiAnswer- Administrationiofiaidrugicanihappenithroughithreeiroutes:itopical,ienter aliandiparenteral. Fourikeyiprocessesioccuriafteriadministration:iabsorption,idistribution,i metabolismiandiexcretioni(ADME). RoutesiofiAdministrationi-iCorrectiAnswer- Topical:iDrugsithatiareiappliedidirectlyitoiaiparticulariplaceionioriinitheib ody.iThisicanibeionitheikin,ithroughitheiskin,iorithroughiinhalation. Enteral:iRefersitoiadministrationiviaitheiGIitract.iCanibeidirectlyiviaithei mouthiorianiartificialiopening.iRoutesiofiadministrationiincludeimouth,ir ectum,isublingualiandibuccal.

• Sublingualiisiunderitheitongue.
• Buccaliisiinitheicheek. Parenteral:iRefersitoiadministrationibypassingitheiGIitract.iRoutesiofiad ministrationiincludeiintravenous,iintramusculariandisubcutaneous. TopicaliAdministrationionitheiSkini-iCorrectiAnswer- Drugsiapplieditoitheiskiniareiuseditoitreatimilditoimoderateiskiniconditio nsiincludingieczema,iacneiandiinfections.iDrugsiapplieditoitheiskiniforilo calieffecticanibeiabsorbediandiproduceiaisystemicieffect. SystemiciEffecti-iCorrectiAnswer- Aidescriptoriuseditoiindicateisomethingithatiaffectsitheiwholeibodyiorim ultipleiorganisystems. ThroughitheiSkin:iTransdermali-iCorrectiAnswer- Allowsiforiabsorptioniintoitheigeneralicirculationiforisystemicieffect.iAlt houghiiticanibeiexpensiveioricauseilocaliirritation,iitiisialsoiconvenient,id eliversiaisteadyidrugisupplyiforiseveralidaysi(eliminatesifrequentioralido sing),iandibypassesitheienzymesiofitheistomach,iintestine,iandiliver.z Inhalationi-iCorrectiAnswer- Inhaledidrugsicanibeirapidlyiabsorbediintoitheilungs.iUsediforibothilocali andisystemicieffects.

Ex.iGaseousianestheticsi(systemic),isteroidiandiotheridrugsi(localieffects iinilungs) Quantitiesiofidrugsiforilocalieffectiareismalliandioftenilessithanirequiredi forisystemicieffect. Disadvantage:irequiresiproperiuseibyitheipatient. EnteraliAdministrationi-iCorrectiAnswer- Enteritheibloodithroughitheigastrointestinalitract. Firstidelivereditoitheiliveriwhichicontainsienzymesithaticanidecreaseithei amountiofiactiveidrugileftitoienteritheigeneralicirculation.iCalleditheifirs tipassieffect. MouthiAdministrationiAdvantagesi-iCorrectiAnswer- Theimouthiisicommonlyiuseditoiadministeridrugs.i>90%iofiallidrugsiareit akenibyithisiroute. Mosticonvenientiandileastiexpensiveimeansiofitakingiaidrug Non-invasiveiandicanibeiself-administered

MouthiAdministrationiDisadvantagesi-iCorrectiAnswer- Variableiabsorptionibetweenipatientsidueitoidifferencesiiniintestinalim otilityiandidisease. Rectumiadministrationiadvantagesi-iCorrectiAnswer- Canibeiforisystemiciorilocalieffect Canibeiusediinipatientsiwhoiareinauseatediorivomiting,ioriasiailessiinvasi veirouteiforithoseiwhoiareicomatose. Digestiveienzymesiofitheistomachiandiintestinesiareibypassed RectumiAdministrationiDisadvantagesi-iCorrectiAnswer- Onlyiailimitedinumberiofimedicationsiareiavailableiorisuitableiforirectali administration. Absorptionifromitheirectalimucosaiisislow,iincompleteiandivariable,idep endingionitheitimeitheimedicationiisiretained. SublingualiandiBuccaliAdministrationiAdvantagesi-iCorrectiAnswer- Enzymesiofitheistomach,iintestinesiandiliveriareibypassed SublingualiandiBuccaliAdministrationiDisadvantagesi-iCorrectiAnswer- Notiallidrugsiareiadequatelyiabsorbedithroughithisiroute

Drugimayibeiswallowed,iandithenitheidrugibehavesiasiifiitiwereitakenior ally. ParenteraliAdministrationi-iCorrectiAnswer- Injectediintoitheibodyiandithenienteritheibloodstreamidirectly ParenteraliAdministrations:iIntravenousi-iCorrectiAnswer- Theidrugiisiplacedidirectlyiintoitheibloodiand,itherefore,ihasiimmediatei effects.iRouteiofiadministrationicanibeiusediforidrugsithatiareipoorlyiabs orbed,iprovidingithatitheyicanibeimadeiintoiaisolutioniinipurifiediwaterif oriinjection. Responseiisiirreversible,ihighiriskiforidrugireactions. Administrationirequiresisignificantihumaniresources Preparationimustibeisterileiandifreeiofifeveriproducingisubstances. ParenteraliAdminstrations:iIntramusculari-iCorrectiAnswer- Theidrugiisiinjectedideepiintoiaimuscle.iTheivolumeiofidrugiisilimiteditoi 2

• 3 imLiinianiadult. Subcutaneousi-iCorrectiAnswer- Drugiinjectediintoitheideepestilayeriofitheiskin.