Phar 100: Final Exam Questions with 100% Correct Answers | Verified | Latest Update, Exams of Advanced Education

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Phar 100: Final Exam Questions with 100% Correct Answers | Verified | Latest Update Drugsi-iCorrectiAnswer- anyisubstanceireceivedibyiaibiologicalisystemithatiisinotireceivediforinut ritiveipurposesiandiwhichiinfluencesitheibiologicalifunctioniofitheiorgani sm Pharmacologyi-iCorrectiAnswer- theiscienceiofidrugs,iincludingitheiriuses,ieffects,iandimechanismsiofiacti on keyihistoricaliinfluencesishapedimodernipharmacologyi- iCorrectiAnswer-1.idiscoveriesimadeibyiancienticivilizationsi 2.itheiroleiofipoisonsiinihistoryi 3.itheiinfluenceiofireligion ancientigreecei-iCorrectiAnswer- opium:iobtainedifromitheiopiumipoppy.i - Serturneri(Germanipharmacist)iisolatedicrystalsiofimorphineifromiopiu mianditesteditheipureisubstanceionihimselfi morphine:irelieveipainiofigreatiintensityi codeine:iwidelyiusediforipainirelief AncientiEgypti-iCorrectiAnswer- papyri:iintendediasitextbookiofidrugiuseiforimedicalistudents,icontainsi manyitrueiobservationsionitheiuseiofidrugs,ispecificallyionipurgativesi(la xatives) senna:iindicatediinitextbookiasiaipurgativei(stilliuseditoday) ancientichinai-iCorrectiAnswer-earliestirecordiofidrugiexperiments.i SheniNungiclassifiediallidrugsiaccordingitoitaste - mediumidrug:iwidelyiusediinichineseimedicineiforicoughs,iinfluenza,ian difeversi ephedrine:iisolatedifromichinai(useditoitreatiasthmai&iasiaidecongestan t) curarei-iCorrectiAnswer-plant- derivedidrug,iindigenousipeoplesiofitheiamazonidippediarrowsiiniandius ediasipoisoniforihunting -lowidose:imuscleirelaxation -highidose:iparalysisileadingitoirespiratoryiparalysisiandideath - theistructureioficurareihasibeenimodifieditoimakeitheidrugisafer,iandith eseineweriderivativesioficurareiareiuseditoday 5.ipost-marketisurveillancei&iphasei5iclinicalitrials basiciresearchiandidiscoveryi-iCorrectiAnswer-3-6iYears: 1.iTargetiIdentification:iIdentifyiaireceptoriorimechanismiforipotentialid rugiaction,isuchiasipainirelief.iStudyicompoundibindingiandiitsieffectsioni molecular,icellular,iorgan,iandiwhole-animalilevels. 2.iTargetiStudy:iDetailediinvestigationioficompoundieffectsionitheitarge t,ievaluatingisafetyiandiefficacy.iForiinstance,istudyingitheidrug'siimpact ionipainirelief. preclinicalitrialsi-iCorrectiAnswer-3-6iyearsi - conductediprioritoitestingitheinewidrugiinihumansiandirangeifromimole culariandicellularistudies,itoitissueiandiwholeianimalistudiesi -twoimainicategories:i pharmacologyistudiesianditoxicologyistudies Phasei1iclinicalitrialsi-iCorrectiAnswer--6-7iyears - icarefullyievaluateitheiabsorption,idistribution,ieliminationiandiadversei effectsiofitheinewidrug - testioneioritwoidosesiofitheinewidrugitoidetermineitheitolerabilityiofithe idrug -conductediwithilimitedinumberiofivolunteersi(20- 80)i(usuallyiyoungihealthyipeople) Phasei2iclinicalitrialsi-iCorrectiAnswer--6-7iyears i - determinesiwhetheritheidrugiisieffectiveiinitreatingitheiconditioniforiwh ichiitiisirecommended -limitedinumberiofipeoplei(100-500)i(peopleiaffectedibyitheidisease) -alsoipaysiattentionitoisafetyiofitheidrug Phasei3iclinicalitrialsi-iCorrectiAnswer--i6-7iyearsi - oftenirandomizedicontrolleditrialsi(RCT)iusediforilicensingiandimarketin giofitheidrugi - largei#iofiparticipantsi(1000+)itoiobtainiinformationiaboutitheidrugiiniai moreidiverseipopulationi - goal=idetermineihowisafeiandieffectiveicompareditoinoitreatmentioricu rrentirecommendeditreatmenti -longerithaniphasei2i(monthsitoiyears)i -conductediaticentresiinimanyicitiesi(multi-centered)i - mostiexpensiveipartiofidrugidevelopment,icouldicosti1miliupwardsiofi50 imil phasei3iclinicalitrialsi-ienrolmenti-iCorrectiAnswer-- iTargetipopulation:igroupiforidrugiusei(e.g.,iadultsiwithihypertension) -iStudyipopulation:isubsetimeetingicriteria -iInclusion/exclusionicriteriaidefineieligibility -iInformediconsentidetailsirisks,iprocedures -iEthicsiboardireviewsitrialimethodology -iParticipantsicaniwithdrawiconsentianytime -buccal:iinitheicheek systemici-iCorrectiAnswer- descriptoriuseditoiindicateisomethingithatiaffectsitheiwholeibodyiorimul tipleiorganisystems doseiresponseicurvei-iCorrectiAnswer-- iGraphicalirepresentationiofihowimuchidrugiyouineediinitheibodyitoiseei aispecificieffecti - theirelationshipibetweenichangesiinitheisizeiofiaidoseioriexposureiandic hangesiiniresponse. i-generallyihasiani"S"ishape. 1.iy- axis:ieffectiofidrugiandiplottedioniailineariscale,imaximaliresponseitheib odyicaniproduceiisisetiati100% 2.ix-axis:doseiofidrugiplottedionilogarithmiciscalei 3.ilowidoses 4.ireceptorithresholdi 5.ED50 6.iMaximaliresponse efficacyi-iCorrectiAnswer- maximumipharmacologicaliresponseithaticaniproducedibyiaispecificidru giinithatibiologicalisystem potencyi-iCorrectiAnswer-- doseithatiisirequireditoiproduceiairesponseiofiaicertainimagnitude,iusual lyi50%iofitheimaximaliresponseiforithatidrugi - onlyirefersitoitheiamountiofidrugithatimustibeigivenitoiobtainiaiparticula riresponsei - sayingidrugiAiisimoreipotentithanidrugiBisimplyimeansithationeineedsitoi takeilessiofidrugiAitoiachieveitheisameieffectiobtainedifromidrugiB therapeuticirangei-iCorrectiAnswer-- drugsiareiadministereditoiachieveiaitherapeuticieffecti - aimiofitherapyiisitoigiveidoseithatikeepsitheibloodiconcentrationiofiaidru giaboveitheiminimumiconcentrationithatiproducesitheidesirableirespon seibutibelowitheiconcentrationithatiproducesiaitoxiciresponse Pharmacokineticsi-iCorrectiAnswer-- foriaidrugitoiproduceiitsidesiredieffect,iitimustireachitheicellularisiteiofiac tioniatitheirighticoncentration,iexertiitsieffect,iandithenibeiremovedifro mitheibodyi -movementiofiaidrugiinto,ithrough,iandioutiofitheibody ADMEi-iCorrectiAnswer-- absorption,idistribution,imetabolism,iexcretion - actingitogetheritheseifourifactorsidetermineitheiconcentrationiofitheidr ugiinitheiblood,iwhichiiniturnideterminesitheiconcentrationiofitheidrugia titheisiteiofiaction administrationiroutesi-iCorrectiAnswer--topical,ienteral,iandiparenteral -beforeiaidrugicanibeiabsorbed,iitimustibeiadministered thiopentali-iCorrectiAnswer--iUltra- shortiactingisedativeiinducesirapidianesthesia -iHighibloodiconcentrationipost-injection -iInitiallyielevatedibrainiconcentrationiinducesisleep -iConcentrationiinimuscle/fatiincreases,ibloodidecreases -iDrugiredistributesifromibrainitoimuscle/fat -iPatientiawakensiini15-30imins -iDrugiremainsiinibody,iactioniterminated metabolismi-iCorrectiAnswer-- iDrugiconverteditoidifferenticompoundiforielimination -iMetabolitesilackipharmacologicaliaction -iConversionimakesidrugiwaterisolubleiforikidneyiexcretion -iLiveriisiprimaryisite,iotheriorgansialsoimetabolize biotransformationireactionsi-iCorrectiAnswer-- dividediintoiphasei1iandi2ireactionsi 1.iaddioriunmaskifunctionaligroupionitheidrugitoiprepareiitiforitheiadditi oniofiailargeisolubleimoleculeiiniphasei2ireaction 2.iaddilargeisolubleimoiety,iusuallyiglucuroniciacidiorisulfate,itoitheiprod uctifromiphasei1,imakingitheimetaboliteiwater- isolubleiforikidneyiexcretion excretioni-iCorrectiAnswer-- iEliminationiroutesiforidrugsiandimetabolites -iKidneys:imajorieliminationisite,iexcreteiwater- solubleidrugs,ireabsorbilipid-solubleiones -iGIitract:isomeidrugsiexcretediviaifecesiafteriliveribiotransformation -iLungs:ivolatileiorigaseousidrugsiexcretedi(e.g.,ianesthetics,ialcohol) -iBreastimilk:iminorirouteiforiparent,iexposureiforinursingiinfant - iSaliva/sweat:idetectableidrugipresence,iespeciallyiinimisuseicasesi(tellsi youiwho'sitakenidrugs) geneticifactorsicontributingitoidrugiresponsei-iCorrectiAnswer-- iGeneticivariabilityiaffectsidrugireceptorsiandimetabolism -iEnzymeiactivityicanivaryidueitoigeneticidifferences -iIndividualsicategorizediasislowiorifastimetabolizers -iExample:ialcoholimetabolismivariesidueitoigenetics adverseieffectsiofidrugsi-iCorrectiAnswer-- iAdverseieffects:iunintendedidrugieffects -iExtensioniofitherapeuticieffect:ioverdoseileadsitoiexcess -iUnrelatedieffects:inauseaioriotheriunexpectedireactions -iAllergicireactions:iimmuneisystemiresponse - iWithdrawaliandiaddiction:iunwantediphysiological/psychologicalieffec ts -iTeratogenesis:ifetalidefects - iAdverseibiotransformationireactions:imetaboliteicausesitissueidamage predictingiadverseidrugireactionsi-iCorrectiAnswer- 1.iOccurrenceirarity:iAdverseireactionsimayibeirare,iharditoipredicti(e.g., ichloramphenicol'siboneimarrowidamage) 2.iUsageilength:iToxicieffectsimayiemergeiafteriprolongediusei(e.g.,istre ptomycin'sideafnessirisk) 3.iAnimalidetectability:iSomeireactionsinotievidentiinianimalitestingi(e.g .,iheadaches,inausea) 4.iTimeispecificity:iEffectsimayibeispecificitoiaiperiodi(e.g.,ithalidomide's ifetalilimbideformities) ORiYouiLoveiAndiDespiseiThisiShit TherapeuticiIndexi(TI)i-iCorrectiAnswer--TD50/ED50 - tellsiyouihowisafeiaidrugiis.iItirelatesitheidoseiofitheidrugirequireditoipro duceiaibeneficialieffectitoitheidoseirequireditoiproduceianiundesirableio riadverseieffect Neuroplasticityi-iCorrectiAnswer- theiconnectionibetweenineuronsiconstantlyibeingireshaped dentritesi-iCorrectiAnswer-- shortiandicanihaveihighlyicomplexibranchingipatternsi - functioniasitheireceivingiantennaeiforiincomingiinfoiandiacceptiinfoithro ughireceptorsilocatedionitheidentriticimembranesi - uponireceivingithisiinfoifromianothericell,ianielectricicurrentiisigenerate diandidirectedidownitheineuron cellibodyi-iCorrectiAnswer--orisomai - largestipartiofitheineuroniandicontainsiainucleusiandisurroundingicytopl asmi -cytoplasmicontainsiabundantipre- packagedineurotransmittersiwhichicanibeisecreted axoni-iCorrectiAnswer-- singleifibreithatiextendsifromitheicellibodyiandiendsiatiaisynapsei - axonicontinuesitoicarryitheiincomingiinformationiawayifromitheidendrit esiandicellibodyibyiwayiofielectricalipulses -thisiinfoiisithenipassedionitoisubsequentineurons Synapsei-iCorrectiAnswer-- anielectricaliimpulseihasitoibeisomehowicommunicatediacrossitheijunct ioniofioneineuronitoianotherineuroniifiitiisitoiproduceifurtherieffect - theijunctionibetweenitheitwoineuronsiisitheisynapse,iandiisitheiareaiwh ereioneineuron'siaxoniendsianditheidendriteioricellibodyiofitheireceivingi neuronibegins synapticitransmissioni-iCorrectiAnswer-- theipassageiofiaisignalifromioneineuronitoianotheri -alsoicalledineurotransmissioni - veryirapidiandiusuallyichemicaliininature,imeaningiaisubstanceiisiquickly ireleasedithatiactivatesitheinextineuroni - usually,ioneisynapseiconnectsitwoineurons,ihoweveriaisingleineuronica nimakeisynapticiconnectionsiwithimanyineurons Neurotransmittersi-iCorrectiAnswer- endogenousichemicalsithatitransmitiaisignalibetweenitwoineurons Glutamatei-iCorrectiAnswer-- AimajoriexcitatoryineurotransmitteriinitheiCNSiandiisifoundiinialmostialli neuronsi -actsioniaifamilyiofireceptorsicalleditheiglutamatergicireceptors - neuronsithatireleaseiglutamate,itermediglutamatergicineurons,iareiimp ortant Serotonini-iCorrectiAnswer-- theitheiCNS,ihyperactivityiofitheiserotonergicisystemiisiinvolvediinianxie ty,iandihypo-activityihasibeeniimplicatediinidepressioni - someiclassesiofiCNSistimulantsiactibyiincreasingiserotoniniatitheisynaps e preoccupationiwithitheidrugsieffectsiandibyiaipersistenticravingiforitheid rug,iregardlessiofitheiconsequences - aistateiiniwhichistoppingioriabruptlyireducingitheidoseiofiaigivenidrugipr oducesinon-physicalisymptoms theidopamineihypothesisi-iCorrectiAnswer-- predominantihypothesisitoiexplainiaddictioni - commonlyimisusedidrugsiincreaseidopamineiinitheirewardisystemsiofith eibraini(limbicisystem),iincreasediinidopamineiappearsitoibeiaikeyicomp onentiofitheibrain'sirewardisystemi - dopaminergicisystemsiareialsoiresponsibleiforinaturalirewardsisuchiasif oodiandisex,iasiwelliasistimulus-relatedirewardsi(videoigames)i - drugsiassociatediwithiaddictionicauseianiexaggeratediincreaseiinidopam ine,ialteringicommunicationiinitheibrain characteristicsiofiaddictiveidrugsi-iCorrectiAnswer--increaseidopaminei i -produceinovelty i -reduceianxiety drugiwithdrawali-iCorrectiAnswer-- iDrugidependence:iPhysiologicalistateifromirepeatediuse,ileadsitoiwithd rawalisyndromeiuponidiscontinuationioridoseidecrease. - iWithdrawaliseverityiincreasesiwithispeediofiwithdrawalidueitoiincompl eteireversaliofibiologicaliprocesses. -iFeariofiwithdrawalicontributesitoicontinuationiofidrug- takingibehavior. stimulantsi-iCorrectiAnswer-- mosticommoni=icocaineiandiamphetamines,i - withdrawalisymptoms:isleepiness,imuscleipain,ianxiety,itremors,ilowim ood,isuicidaliideations,icardiovasculariproblems opioidsi-iCorrectiAnswer-- iCommoniopioids:iheroin,imorphine,ioxycodone - iWithdrawalisymptoms:isweating,imuscleiaches,iagitation,idiarrhea,iab dominalicramping,ivomiting -iFoundiiniopiumipoppyiplanti(Papaverisomniferum) -iPurifiediintoidrugsilikeimorphineiandicodeine -iSubstanceibindingitoiopioidireceptors,inaturaliorisynthetic drugitolerancei-iCorrectiAnswer-- iTolerance:iReducedidrugieffectioveritime -iIncreasedidoseineedediforisameieffect -iShortenediduration,idecreasedieffectimagnitude -iToleranceimayidevelopiselectivelyi(e.g.,ieuphoriaiwithimorphine) crossitolerancei-iCorrectiAnswer--iCross- tolerance:iResistanceitoioneidrugidueitoiresistanceitoiaisimilaridrug - iExample:iToleranceitoialcoholileadsitoitoleranceitoibenzodiazepines,ide spiteinotitakingithemibefore factorsiinfluencingiSUDi-iCorrectiAnswer-- iGeneticifactors:iMutationsiinidopaminergicipathwaysiincreaseiSUDirisk. -iPre- existingidisorders:iMajoriaffective,ianxiety,iorischizophreniaidisordersie levateiSUDirisk. -iEnvironmentalifactors:iExposureitoidrug- promotingienvironments,ifamilyidynamics,itrauma,iandisocial/workigro upsiincreaseiSUDirisk;ihigheririskiforispousesiandisiblingsiofithoseiwithiS UD. - drugiclassiincludesiamphetamine,idextroamphetamine,iandimethamph etamine Methylphenidatei(Ritalin)i-iCorrectiAnswer--iAmphetamine- relatedicompound -iTreatsiADHD -iStructurallyisimilaritoinorepinephrineiandidopamine -iIllicitlyisynthesized,iespeciallyimethamphetamine - iVariableipurity,imayicontainiharmfuliadditivesilikeistarchioribakingisoda AmphetaminesiMOAi-iCorrectiAnswer- increaseidopamineiandinorepiireleaseiinipresynapticineurons amphetaminesiCNSieffectsi-iCorrectiAnswer- 1.idecreasedithresholdiforitransmittingisensoryiinputitoitheicerebralicor tex,ileadingitoiCNSiexcitationi 2.iaifeelingiofieuphoriaiandirewardi 3.itemperature- regulationiandifeedingicentreimodificationsileadingitoiappetiteisuppres sioni 4.ianiincreaseiiniaggressiveibehaviouriandimoodiswings CNSiexcitationi-iCorrectiAnswer- canicause:ioverstimulation,irestlessness,idizziness,imildiconfusion,itrem or,iandiinirareiinstances,ipaniciandipsychosis,iespeciallyiwithihighidoses MDMA(Ectasy)i-iCorrectiAnswer--amphetamine-relatedicompound -aiderivativeiofimethamphetamineithatiisioftenimisusedi - fosteritheifeelingiofiintimacyiandiempathy,iwhileiimprovingiintellectuali capacities - neurotoxic,icausingineuronalidamageiandideath,ieffectiisilongilasting,iifi notipermanent short-termieffectsiininon-CNSiissuesiofiamphetaminesi-iCorrectiAnswer- -chestipaini(angina)ioriheartiattack - cardiovascularicollapse:iseverelyilowibloodipressureiresultingifromiaifail ureiofitheiheartitoipumpibloodiarounditheibodyi -increasedirespiratoryiratei -overdoseimayiresultiiniseizure,ihighifever,ioristroke long-termieffectsiininon-CNSiissuesiofiamphetaminesi-iCorrectiAnswer-- chronicisleepingiproblems -pooriappetite -anxietyi -repetitiveibehaviour,ipsychosis,iaggressiveibehaviour -elevatedibloodipressureiandiabnormalicardiacirhythm concurrentidrugiuseiofiamphetaminesi-iCorrectiAnswer-- otheridrugsimayibeisoughticoncurrentlyiwithiamphetaminesiinianiattem ptitoiantagonizeivariousitoxicieffectsi - ex:iindividualiwhoiisiexperiencingisleepingiproblemsidueitoichroniciamp hetamineiuseimayiseekiaiCNSidepressanti(ex:ibenzodiazepines)it0itryian disleepi therapeuticiuseioficocainei-iCorrectiAnswer-- onlyilegitimateiuseiisiasiailocalianestheticiforitheimouthiandithroati - rarelyiuseditherapeuticallyiasibetterilocalianestheticsihaveibeenidevelo pedithatihaveichemicalistructuresisimilaritoicokeibutidoinotihaveitheiass ociatedipotentialiforimisuseiandiSUD effectsiofilongitermiuseioficocainei-iCorrectiAnswer-- iToxicipsychosis:iParanoia,ihallucinations -iSensationsiofiinsectsiunderiskin -iImpairedisexualifunction -iBrainidamageiandineuronaliimpairment -iHighibloodipressure,iirregulariheartirhythm -iNasalimucosaichangesifromisniffing - iAlcoholiandicocaineicomboidangerous;iformsicocaethylene,iincreasingi bloodipressure,iaggression,ipoorijudgment misuseiandiSUDiandicocainei-iCorrectiAnswer-- iWidelyimisused,iofteniwithiotheripsychoactiveidrugs - iHighimisuseiriskidueitoipowerfulieuphoria,iespeciallyithroughiinjectioni orismoking - iInherentiharmfulness:iCausesiphysicaliandipsychologicalideficits,ibutido esn'tideterimisuse -iTolerance:iDevelopsitoimood- elevatingieffectibutinotipsychoticieffect;ilessitoihallucinatory/behaviora lieffects -iWithdrawal:iSimilaritoiamphetamines - iAddiction:iOccurs;ibehaviorieffectsiperceivediasipleasurableiandireinfor cing,ileadingitoirepeatediuse freebasei-iCorrectiAnswer- aipurifiediformioficocaineithatihasiailowimeltingipointimakingiitieasieritoi smoke mechanismiofiactioniofiamphetaminesi-iCorrectiAnswer- blocksivesicularimonamineitransportersi(VMAT),iincreasesidopamine/n orepinephrineiatisynapse ADMEiofinicotinei-iCorrectiAnswer-1.iAbsorption - inicotineiisiiniveryismalliparticlesiinicigaretteismokeithatigetirapidlyiabso rbediwheniinhaled,ialsoiabsorbedifromiGIitract,ioralimucosa,iandiacrossi theiskin,idoseiisicontrolledibyitheidepthiofiinhalationiandifrequencyi 2.iDistribution - inicotineiisidistributedithroughoutitheibodyiandigainsiaccessitoitheibraini quickly i 3.iMetabolism -inicotineiIsiquicklyimetabolizedibyitheiliveri 4.iExcretion -metabolitesiareiexcretediinipee,ihalf-lifeiisiabouti2ihours MechanismiofiActioniofinicotinei-iCorrectiAnswer-- stimulatesinicotinicireceptorsiatitheisynapses,isimilaritoiacetylcholinei( ACh)i - activationiofireceptorsiincreasesipsychomotoriactivity,icognitiveifunctio n,iattention,iandimemoryi -inilargeidosesicanicauseiagitation,itremors,iandiseizuresi -effectsiiniCNSiareimediatedibyinicotinicireceptor- mediatedireleaseiofiCNSineurotransmittersidopamineiandiserotonin therapeuticiusesiofinicotinei-iCorrectiAnswer- Theionlyitherapeuticiuseiofinicotineiisiinismokingicessationiprograms,iw potentialiforimisuseiandiSUDiofinicotinei-iCorrectiAnswer-- powerfulireinforceriandihasihighidegreeiofimisuseipotential,imeetiallith eirequirementsiofiaddictiveisubstancesi -attemptsiaticessationioftenifailiasicravingiisisoigreati -tolerance:idoesinotiappearitoioccuriatigreatiextent - withdrawal:iirritability,irestlessness,ianxiety,iinsomnia,ifatigue,iandiina bilityitoiconcentratei -addiction:ioccursiandimanifestsiasianiextremeiurgeitoismoke diureticsi-iCorrectiAnswer- substancesithatiincreaseiurineiproductionianditheiexcretioniofiwaterifro mitheibodyithroughitheikidneys caffeinei-iCorrectiAnswer-- foundiinisignificanticoncentrationsiinitea,icoffee,ichocolate,iandicolaidri nks,iasiwelliasiOTCistimulants,ianalgesics,iandidiureticsi -lethalidoseioficaffeineiisi10g ADMEioficaffeinei-iCorrectiAnswer- 1.iabsorption:itakeniorally,irapidlyiandicompletelyiabsorbed,ibloodileve lsiareisignificantiati30iminsiandipeaki2ihoursiafteriingestioni 2.idistribution:iallipartsiofitheibodyiandifreelyicrossesiintoitheibrainiandi placentai 3.imetabolism:ideterminedibyigenetics,irapidimetabolizersiandislowime tabolizersi 4.ielimination:ihalf-lifeivariesitoi2-10ihrs mechanismiofiactionioficaffeinei-iCorrectiAnswer--abouti1- 2icupsipficoffeeiincreasesimentaliperformanceiandimotoriactivityiwhilei decreasingidrowsinessiandifatigue - exertedibyicompetitivelyiblockingiadenosineireceptorsicausingitheineur onsitoireleaseifromitheiadenosineiinhibitionicausingianiincreaseiinidopa mineirelease,istimulatingitheiCNS short-termieffectsioficaffeinei-iCorrectiAnswer-CNS: -imildimoodielevationiandireducedifatigue -icleareriflowiofithought - highidosesiwillicauseiirritability,inervousness,iandiramblingiflowiofithou ght/speechi Cardiovascular:i - producediconstrictionioficerebralibloodivesselsi(usefuliduringiaiheadach e)i -heartirateiincreasei Respiration: -imildistimulationiofirespiratoryiratei -canistimulateibreathingiinipreterminewborns lethalidose:i10gioficaffeine long-termieffectsioficaffeinei-iCorrectiAnswer--restlessness -nervousness -insomnia -increasediurinaryioutput -gastriciupset -ramblingispeechiandithought performanceienhancingidrugs-i2012i-iCorrectiAnswer- LanceiArmstrongi(TourideiFranceiwinner)istrippediofi7ititlesiforidopingis cheme performanceienhancingidrugs-i2016i-iCorrectiAnswer- numerousiRussianiathletesisetitoicompeteiiniRioiOlympicsibannedidueit oistate-runidopingiscandal performanceienhancingidrugs-i2019i-iCorrectiAnswer- WADAibannediRussiaifromiallimajorisportingieventsi(includingitheiolym pics)ifori4iyears,iati2020iolympicsirussianiathletesiwereialloweditoicomp eteiatineutraliifitheyicouldiproveitheyihadinoilink amphetamineiuseiinisportsi-iCorrectiAnswer-- iEffects:iEuphoria,iincreasedirespiration,iinsomnia,ipsychoses - iPowerfulipsychomotoristimulants:iAlertness,ipower,ireducedifatigue,ia ggression,iresponsiveness,iincreasediheartirateiandibloodipressureienh ancingienduranceiandispeed -iAppetiteisuppressioniaidsiweightilossiinisports - iEndurance:iPerformanceidurationiextendedibyi40%iwithi10mgimetham phetamine -iSpeed:iMostiswimmersifaster,i73%irunnersiimproveditimes -iToxicity:iFatalibloodipressureiincrease,icrashes,iwithdrawal,itolerance anabolicisteroidsi-iCorrectiAnswer-- iSyntheticianabolicisteroids:iMosticommonlyibannedidrugsiinisports -iIncreaseimuscleimass,istrength,iandisecondaryimaleisexicharacteristics -iAnabolicieffects:iBuildimuscleimass,ianti- catabolicieffectireducesiproteinibreakdown - iMotivation:iMayicauseiaggressiveibehaviori("roidirage"),ibeneficialiinis ports -iGreaterieffectsiinithoseiwithiloweritestosteroneilevels -iLargeidosesi+ihigh- proteinidietiincreaseileanibodyimass,iweight,istrength - iToxicities:iMoodiswings,isevereiacne,icardiovascularidisease,iliveridam age,ireduceditestosteroneilevels,iinfertility,ialteredifemaleicharacteristi cs benzodiazepinesiinisportsi-iCorrectiAnswer- reduceistressiandianxietyiduringicompetition - impairipsychomotoricoordinationiandifocusiatihigheridoses,isoibenefitsi areicloselyiweighediwithipotentialiimpairmentsiiniperformance Bloodidoping/erythropoietini-iCorrectiAnswer-- bloodidoping:ireinfusioniofiathlete'siowniredibloodicellsiintoitheiricircul ationibeforeiperformance,icanibeidetectedibyimeasuringitheiageiofiredib loodicellsi - erythropoietin:ihormoneithatiincreaseditheiamountiofiredibloodicellsipr oducediinitheibody,idetectediiniurineitestingi - bothiresultiinianiincreaseiinitheioxygenicarryingicapacityiofitheibloodiwh ichiincreasesienduranceiandispeedi -caniresultiinithromboticievents diureticsiinisportsi-iCorrectiAnswer- Drugsithatienhanceitheirateiofiexcretioniofisaltiandiwaterithroughitheiki dneysi -useditoireduceibodyiwateridecreasingiweight i -alsoitakenitoihastenitheiexcretioniofibannedidrugs - toxicities:iexcessielectrolyteiandiwateridepletioni(ex:ibloodipressureidr opiandikidneyifailure) - haveiaihighitherapeuticiindex,iandiaiwideimarginiofisafetyimeaningideat hifromioverdoseiisirarei - deathioccursifollowingiingestioniofienormousidoses,irapidiintravenousii njectioniofiailargeidose,ioriwhenicombinediwithiotherisedatingidrugsi(al cohol) Flumazenili-iCorrectiAnswer--antidoteiforibenzodiazepines -aibenzodiazepineireceptoriantagonistithatiblocksitheieffects Benzodiazepinesishortitermieffectsi-iCorrectiAnswer-- CNS:idrowsiness,ilethargy,ifatigue,iandiimpairmentiofithinkingiandimem ory,iCNSidepressioni - breathing:irespiratoryidepressionifollowingirapidiintravenousiadministr ationi - motoricoordination:iimpairimotoricoordinationiandidriving,ishouldirefr ainifromidrivingiwheniusing Benzodiazepinesilongitermieffectsi-iCorrectiAnswer-- vary,isomeimayiexperienceinoieffectsi -symptomsiofichronicisedative- hypnoticiintoxicationisuchiasiimpairedithinking,ipoorimemoryiandijudg ment,idisorientation,iincoordination,iandislurredispeech benzodiazepineiuseiinispecialipopulationsi-iCorrectiAnswer-- iPregnant/breastfeeding:iCrossiplacenta,idistributeitoifetus;i1stitrimest eriposesifetaliabnormalityirisk.iSecretediintoimilk,iexposingiinfantsitoidr ugidoses,isedation,iorideath. - iOlderiadults:iMayicauseicognitiveidysfunction;icautionineedediwithiuse .iMetabolizedislower,ileadingitoisedation,ifalls,iandiinjury. BenzodiazepinesiSUDi-iCorrectiAnswer-- iWeakerireinforcingiproperties,ilowiinherentiharmfulness. - iToleranceicanidevelopitoisedativeieffects,icoordinationiimpairment,ian xiolytic,iandieuphoricieffects;ihighicross-toleranceiwithibenzos. - iWithdrawal:iMildibutidistinct,iincludesianxiety,iheadache,iinsomnia;ich roniciuseidiscontinuationicanileaditoiagitation,iparanoia,iseizures,ideliri um. -iAddiction:iMayidevelopidependingionivariousifactors. barbituratesi-iCorrectiAnswer--iClassifiedibyiduration:iLong-actingi(1- 2idays),ishort-actingi(3-8ihours),iandiultra-shortiactingi(20imins). -iOldericlassiofidrugs,ireplacedibyisafer,imoreieffectiveisedative- hypnotics. -iAdministerediorallyiforiepilepsy,iintravenouslyiforianesthesia. - iActivationiofibarbiturateireceptorsiincreasesichlorideichanneliopening,i leadingitoiCNSidepressionispectrumi(anti-anxietyitoideath). -iTherapeuticiuses:iTranquility,irelaxation,isleepiinduction,itonic- cloniciseizures. -iLimitediclinicaliuse;iultra-shortiandishort-actingiforianesthesia,ilong- actingiasiantiepileptics. - iLowitherapeuticiindex,ipotentialilethalityidueitoirespiratoryidepressioni (especiallyiwithialcohol);inoiantidoteiexists.iDeathicanioccuriduringiwith drawal. Barbituratesiadverseieffectsi-iCorrectiAnswer--iSuppressiREMisleep. -iShort- termieffects:iMildieuphoria,idisinterestiinisurroundings,idizziness,imildi motoricoordinationiimpairment.iHighidosesidepressicardiovascularisyst em,islowingiheartirateiandiloweringibloodipressure. -iLong- termieffects:iChroniciinebriation,iimpairedimemory,ijudgment,iandithin king;ihostility,imoodiswings,iincludingidepression. alcoholi-iCorrectiAnswer-- CNSidepressantithatiworksibyislowingidownibrainifunctioniandineuraliac tivity -ethanoliisitheionlyitypeiofialcoholithaticanibeisafetyiconsumed ADMEiofialcoholi-iCorrectiAnswer-- iAbsorption:iRapidithroughistomachi(20%)iandiupperismalliintestinei(80 %),iaffectedibyistomach- emptyingitime,iethanoliconcentrationiiniGIitract,iandipresenceiofifood. - iDistribution:iThroughoutitotalibodyiwater,iincludingitheibrain;icrossesi placentaitoifetus. - iMetabolism:iEthanoliconverteditoiacetaldehydeibyiADHienzyme,ithenif urtherimetabolizedibyiMEOSiandialdehydeidehydrogenasei(ALDH)itoiac etate,ifinallyitoiCO2iandiwater. - iExcretion:iOveri95%ieliminatedibyibiotransformationiiniliver,iremaining i5%iinibreath,iurine,iandisweat. geneticivariabilityiiniethanolimetabolismi-iCorrectiAnswer-- geneticivariantsiinitheigeneithaticodesiforialcoholidehydrogenasei(ADH)i existi - someicanirapidlyiconcertialcoholitoiacetaldehydeicausingianiaccumulati oniofiacetaldehydeiinitheibodyi(aiprotectiveiagainstialcoholismisinceithe iaccumulationiproducesiunpleasantisideieffectsisuchiasiaiflushediface)i - aldehydeidehydrogenasei(ALDH)ialsoiexhibitsigeneticivariabilityiiniaipo pulation rateiofiethanolimetabolismi-iCorrectiAnswer-- metabolismiofialcoholiisiunusual,iitioccursiatiaiconstantirate,iirrespectiv eiofitheibloodialcoholiconcentrationi(BAC)i -alcoholidehydrogenasei(ADH)ibecomesirate- limitingiorisaturatediati20imgiofialcoholiperi100imliofiblood - theibodyirateiofiethanolimetabolismiisiabouti120imgiethanol/kgibodyiw eight/hour Medicaliusesiofialcoholi-iCorrectiAnswer--Alcoholispongesiforifever -Skinidisinfectants -Handisanitizer -Antidoteiforimethanoli(woodialcohol)ipoisoning CNSieffectsiofiethanoli-iCorrectiAnswer-- classifiediasiaigeneraliCNSidepressanti -effectsiareiproportionalitoitheibloodialcoholiconcentrationi(BAC) BACiandidrivingi-iCorrectiAnswer-- riskiforiaidriverigettingiintoianiaccidentiincreasesiexponentiallyiinirelatio nitoiBACi(approx.i29%iofiallifatalicariaccidentsiiniCanadaiwereiassociated iwithialcoholiorialcoholiandidrugsicombined)i - inicanada,inewidriversiandidriversiunderitheiageiofi22ihavei0itoleranceiB AC,ialliotheridriversihavei0.05%iBACiisiaiprovincialioffenceiandiBACiofi0.0 8%iisiaicriminalioffence MOAiofialcoholi-iCorrectiAnswer-- effectsiailargeinumberiofimembraneiproteinsithatiparticipateiinisignallin gipathways - ioneimainimechanism:iitibindsitoitheichlorideiionichanneliandiaugmentsi GABA-mediatedineuronaliinhibition alcoholimisuseiandiSUDi-iCorrectiAnswer-- iSignificantireinforcingipropertiesileaditoimoderateimisuseipotential,iai dedibyiavailabilityiandisocial/legaliacceptance. - iToleranceidevelopsiwithichroniciconsumption;iindividualsitolerateitask siperformediunderiinfluenceimoreirapidlyiwithirepetition. -iCross-toleranceioccursiwithisedative- hypnoticsiandigeneralianesthetics,irequiringihigheridoses. - iWithdrawalifromiethanolicausesiCNSiexcitation,ipotentiallyisevereiwith ideliriumitremensi(DTs),iinvolvingiconvulsions,icoma,iandideath. -iAddictioniisipresent. treatmentiofialcoholiwithdrawali-iCorrectiAnswer- Initialitherapyiofialcoholiwithdrawalisyndromeiisitoimaintainifluidiandiel ectrolyteibalanceianditoipreventiseizures.i - Moreisevereialcoholiwithdrawalicanibeitreatedieffectivelyibyioraliadmin istrationiofidiazepam,iaibenzodiazepine. Naltexonei-iCorrectiAnswer-- opioidiantagonistieffectiveiinitheitreatmentiofialcoholiaddictioni - diminishesitheicravingiforiethanol,iandiassistsiinitheimaintenanceiofiabs tinencei -blocksitheiactivationiofidopaminergicirewardipathwaysiinitheibrain cannabisi-iCorrectiAnswer-- iMarijuanaiderivedifromianiherbaceousiannualiplant. - iContainsioveri60ichemicalicompoundsiknowniasicannabinoidsi(CB),iwit hiI-trans-delta- 9tetrahydrocannabinoli(THC)iasitheimostipotentipsychoactiveiagent. - iClassifiediasiaiCNSidepressant,ieuphoriant,iandihallucinogen,ithoughiha llucinogenicipropertiesioccurimainlyiatihighidoses. - iTypicallyismokedioriinhalediinidriedifloweringiplantiform;iconcentratedi cannabinoidiextractsi(oil)icanibeivapedioriorallyiconsumed. narcotici-iCorrectiAnswer- drugithatiaffectsibehaviouriorimood,iconsumeriforinon-medicalireasons mechanismiofiactionioficannabisi-iCorrectiAnswer--notifullyiunderstood -THCibindsitoireceptorsilocatediinibrainiandispinalicordi(CB1)i - anadamidei(endogenousiligandiforiCBireceptors)iisiinvolvediinilearningi andimemoryi - wheniCB1iisiactivatedibyianadamideioriTHC,iit.iinhibitsitheireleaseiofiexc itatoryineurotransmittersiexplainingitheireductioniinicognitiveifunctioni andiCNSidepressantieffects typei1icannabinoidi(CB1)ireceptorsi-iCorrectiAnswer-- locatediinibrainiandispinalicordi - initheicerebralicorteximediateitheidistortionsiofitime,icolour,isound,iand itasteiasiwelliasimediateitheidecreaseiinicognitiveifunctioniandiconcentr ation -initheihippocampusimayiaccountiforichangesiinimemoryiandilearning -nonifoundiinibrainistemiandithereforeidoinotidepressirespiration CB2ireceptorsi-iCorrectiAnswer--onlyifoundioutsideitheiCNSi analgesiai-iCorrectiAnswer- lossiofisensationiofipainidueitoianiinterruptioniofinervousisystemipathw aysibetweenisenseiorgansianditheibrain medicaliusesioficannabisi-iCorrectiAnswer-- notiaihealthicanadaiapproveditherapeuticiproducti - healthcareipractitionersimayiauthorizeitheiuseioficannabisiforitheireliefi ofiainumberiofisymptomsiwhichidoinotihaveiconventionalimedicalitreat mentsi - ex:iusediforipreventioniofinauseaiandivomitingiassociatediwithianticanc eridrugs - syntheticiTHCiderivativesiareigenerallyimoreiselectiveithanicannabisiinit reatinginausea SUDiofimarijuanai-iCorrectiAnswer-- iMisuse:iLowitoimoderateidueitoimildieuphoria.iLowiinherentiharmiwithi infrequentiuse. -iTolerance:iDevelopsitoipsychoactiveieffectsiandicardiovasculariimpact. - iWithdrawal:iMayiincludeisleepidisturbances,iirritability,iandilossiofiapp etiteiwithilong-term,ihigh-doseiuse. - iAddiction:iPossible,iespeciallyiwheniusediasiaicopingimechanismiforistr ess. endogenousiopioidsi-iCorrectiAnswer-- notiadministeredidrugsibutimadeiinitheibodyithatibinditoiopioidirecepto rsiandiexertianalgesicieffects -3ifamilies:ienkephalins,idynorphines,iandibeta- endorphinsi(AKAiendorphins)i - effectitheiperceptioniofipainiandiemotionaliresponseitoipain,ialsoiinflue nceimoodiandiassociatediwithirewardipathwaysiinitheibraini -ex:iwheniyouiexerciseiendorphinsiareireleased naturaliopioidsi-iCorrectiAnswer-- notimadeibyihumanibody,ibutiareiderivedifromiopiumipoppyiplanti -morphineiandicodeine morphinei-iCorrectiAnswer- bindsidirectlyitoiopioidireceptors,iuseditoitreatisevereiacuteiandichronici painiandicanicauseieuphoria codeinei-iCorrectiAnswer- converteditoimorphineiinitheibodyibyiliverienzymes -lessipotentithanimorphinei - commonlyiprescribedidrugiyouicontainingicoedeineiisiTylenoli3,iaicombi nationioficodeine,iacetaminopheniandicaffeine semi-syntheticiopioidsi-iCorrectiAnswer-- slightlyialterediversionsiofimorphineithatiareichemicallyichangeditoiobt ainidifferentipharmacologicalipropertiesi(ex:ipotency,idurationiofiactio n,idistribution)ibutimaintainiaiveryisimilarieffectiprofilei -hydromorhphoneiandidiacetylmorphine Hydromorphonei-iCorrectiAnswer--semi-syntheticiopioid -clinicallyiusediforianalegisa -difficultitoiobtainidrugsiwithiaiseparationibetweenitwoiresponsesi -involvediinitheicompulsiveimisuseiofiopioids Kappaireceptorsi-iCorrectiAnswer--opioidireceptori - iinvolvediinianalgesia,idysphoriai(stateiofidissatisfactorioriunease)iandi miosisi(pinpointipupils) Deltaireceptorsi-iCorrectiAnswer--opioidireceptor -involvediinianalgesiaiatitheileveliofitheispinalicordiandibraini i -modulateitheiemotionaliresponseitoiopioid mechanismiofiactioniofiopioidsi-iCorrectiAnswer-- blockipainipathwaysiinitheispinalicordiandibrain,iprimarilyiexertedithrou ghiactivationiofimuiopioidireceptorsi - precentipainisignalsifromitravellingibyireducingineurotransmitterireleas eifromipresynapticineuronsiandireducingitheieffectionipostsynapticineur onsi - reduceiemotionalireactionitoipainithroughimodulationiofitheilimbicisyst em shortitermieffectsiofiopioidsi-iCorrectiAnswer-- iAnalgesia:ireducingipainiintensityiandiperception. -iSedationiandihypnosis:iinducingiaidrowsy,idreamyistate. -iSuppressionioficough:ipreventingiorirelievingicough. - iRespiratoryidepression:ibluntingitheiresponseitoicarbonidioxide,ileadin gitoidecreasedibreathing. - iEndocrineieffects:ireducingihormoneireleaseiresponsibleiforisexihormo neiregulation. -iMiosis:iconstrictioniofipupils. - iHeartirateiandithermoregulation:iirregulariheartirateiandiloweredibodyi temperature. -iDecreasediintestinalimotility:ileadingitoiconstipation. therapeuticiuseiofiopioidsi-iCorrectiAnswer-- Reliefiofimoderateitoisevereipaini(mayibeiuseditoimitigateipost- surgicalipainiandipainiexperiencedibyiterminallyiillipatients)i -treatmentiofidiarrheai(loperamideiisianiOTC)i - coughisuppressioni(betterialternativesiwithilowerimisuseipotentialiareia vailable) opioidsipotentialiforimisusei-iCorrectiAnswer-- iPowerfulieuphoricieffects:ileadingitoiaihighiriskiofimisuse. -iInherentiharmfulness:iinihighidoses,ipotentiallyilife-threatening. - iRiskiofiinjections:iassociatediwithiabscesses,iinfections,ianditheispreadi ofidiseasesilikeihepatitisiandiAIDS. - iOverdose:icausingiprofoundirespiratoryidepressioniandipotentialideath ,irequiringiopioidiantagonistsiandisupportiveicare. riskiofiOUDi-iCorrectiAnswer-- iTolerance:idevelopsitoimostieffectsiexceptimiosisiandiconstipation,iwit hisloweridevelopmentitoirespiratoryidepression.iReversesishortlyiafteri discontinuation.iCross-toleranceibetweeniopioidsioccurs. structureiofibacteriai-iCorrectiAnswer-- iCelliwall:iSurroundsicytoplasmicimembrane -iPeptidoglycanilayer:iComplex,icross-linkedipolymer -iMaintainsicellishape:iPreventsicellilysisifromiosmoticipressure gramipositiveibacteriai-iCorrectiAnswer- Bacteriaithatiaithickipeptidoglycanilayeriandinoiouterimembrane Gram-negativeibacteriai-iCorrectiAnswer- Bacteriaithatihaveithinipeptidoglycanilayeriandianiouterimembrane Narrowispectrumiantibioticsi-iCorrectiAnswer- onlyiEffectiveiagainstispecificibacteria ex:ipenicilliniGiisiprimarilyieffectiveiagainstigram-positiveibacteria broadispectrumiantibioticsi-iCorrectiAnswer- affectiaibroadirangeiofigram-positiveiorigram-negativeibacteria Ex:itetracyclines classificationiofiantibioticsibyibiochemicalipathwayi-iCorrectiAnswer-- classify'siantibioticsibasedionitheibiochemicalipathwayitargetediinitheib acteriaicell - utilizeitheiconceptiofiselectiveitoxicityibyitargetingiandiinterferingiwithi essentialicomponentsiofibiochemicalireactionsiinibacteria,ikillingitheiba cteriai -classifiedibyimechanismsiofiaction celliwallisythesisiinhibitorsi-iCorrectiAnswer- functionitoistopitheiproperiformationiofitheibacterialicelliwalliand/orim embrane,iinfluencingitheistructuraliintegrityiofitheicell - 2iclassesiofiantibioticsithatitargetibacterialicelliwallisynthesis:ipenicillinsi andicephalosporins Proteinisynthesisiinhibitorsi-iCorrectiAnswer- inhibitiproteinitranslationiwithinibacteriaianditherebyiproteinisynthesis -2iclasses:itetracylinesiandimacrolides DNAisynthesisiinhibitorsi-iCorrectiAnswer- inhibitiDNAireplicationiinibacteria,ipreventingigrowth -fluroquinolones metaboliciinhibitorsi-iCorrectiAnswer- blockitheiformationiofikeyibacterialimetabolicisubstratesineedediforibac teriaitoisurviveiandireproduce -antifolateidrugs celliwallisynthesis:ipenicillinsi-iCorrectiAnswer- penicilliumimouldiwasifirstidiscoveredibyiAlexanderiFlemingiini1929,ibu tiwasn'tisuccessfullyiisolatediuntiliWW2ibyiFloreyiandiChain -2itypes:inaturaliandisemisynthetic penicilliniGi-iCorrectiAnswer- extractediandipurifiedifromipenicilliumimould,iitsiainarrowispectrumian tibioticithatidestroysimainlyigram- positiveibacteria,iitsiaiusefulitreatmentiofipneumonia,imiddleieariinfecti ons,iskiniinfectionsiandimeningitisiandisyphilis methicillini-iCorrectiAnswer- organismsicaniproduceipenicillinasei(anienzymeithatibreaksidownipenic illin)iandibecomeiresistantitoipenicilliniGithereforeiitiisianiantibioticiresis tantitoiattackibyipenillinase Ampicilliniandiamoxicillini-iCorrectiAnswer- antibioticsithatihaveiaibroaderispectrumiofiantibacterialiactivityithanipe tetracyclinesi-iCorrectiAnswer--iEarlyibroadispectrumiantibiotic -iInhibitsiproteinisynthesis -iWidespreadiresistanceidueitoioveruse -iBindsitoi30Siribosomalisubunit -iAdverseieffects:iGIiissues,itoothidiscoloration,iboneigrowthiinhibition -iAvoidiinipregnancyiandichildreni<12 -iDegradesiintoitoxiciproductsiifistoredilong macrolidesi-iCorrectiAnswer-- activeiagentiagainstiseveralibacterialiinfectionsicausedibyigram- positiveimicroorganisms -proteinisynthesisiinhibitorsi -alternativeiforithoseiallergicitoipenicillin -erythomycini(iaitypeiofimicrolide)iisieffectiveiinitreatingigram- negativeibacteriai - binditoi50SiribosomalisubunitionitRNAiandiblockipeptideibondiformatio n -adverseieffectsiincludeinausea,ivomitingiandidiarrhea MetaboliciInhibitorsi-iCorrectiAnswer-- antifolatesiareiinhibitorsiofifolateimetabolismiinibacteriai - tetrahydrofoliciacidi(aifolate))iisiessentialiforibacteriaitoisynthesizeiDNAi andiprotein,iifiitiisinotiformedibacterialigrowthiwillislowi -sulfonamidesianditrimethhoprimiareibothiclassifiediantifolateidrugs TetrahydofoliciAcidi-iCorrectiAnswer--metaboliciinhibitor - inhibitsitheienzymeidihydrofoliciacidireductase,ithusiinhibitingitetrahyd rofoliciacidiformationi - humansipossessithisienzyme,ibutitrimethoprimiisiselectivelyitoxicitoibac teriaibecauseiitihasigreateriinhibitoryiactionsionitheibacterialienzymeith anionitheihumanione trimethoprimi-iCorrectiAnswer-- iInhibitsibacterialidihydrofolateireductase -iBacteriostatic -iUsediwithisulfonamidesiforisequentialiblockiofifolateisynthesis -iTreatsiUTIs,iShigella,iSalmonella,iPneumocystisijiroveciiipneumonia -iToxicity:imegaloblasticianemia,ileukopenia,igranulocytopenia -iMayialleviateitoxicityiwithisupplementalifoliniciacid Sulfonamidesi-iCorrectiAnswer--iCompetitiveiinhibitoriofipara- aminobenzoiciacidi(PABA) -iInhibitsisynthesisiofiTetrahydrofoliciAcid -iBacteriostatic - iSelectivelyitoxicitoibacteriaiasitheyimustisynthesizeitetrahydrofoliciacidi fromiPABA - iMammalianicellsiuseipreformeditetrahydrofoliciacidifromisurroundings combinationiantifolatesi-iCorrectiAnswer-- byiinhibitingisequentialistepsiinitheimetabolicipathway,iaisynergisticiant ibacterialieffectiisiproducedi - aicombinationiproducticontainingisulfamethoxazoleianditrimethoprimi wasidevelopedi howiorganismsibecomeiresistanti-iCorrectiAnswer-- iUptake:iMicroorganismsiresistiantibioticsibyimutatingiorilackingiporesii nimembranes,ipreventingidrugientry. - iTarget:iMutationsiiniantibioticitargetsireduceidrugibindingieffectivenes s. - iInactivation:iMicroorganismsiproduceienzymesithatideactivateiantibiot ics. - iEffluxipumps:iSomeimicroorganismsioverexpressitransportersithatirem oveidrugsibeforeitheyicanicauseiharm. antifungalidrugsi-iCorrectiAnswer-- theiincidenceiofiseriousifungaliinfectionsicontinuesitoiincrease,iparticul arlyiinipatientsiwhoiareirequireditoitakeiimmunosuppressiveidrugsi -onlyifewihighlyieffectiveiantifungalidrugsiavaliable Echinocandinsi-iCorrectiAnswer-- newericlassiofiantifungalsithatiareicommonlyiused - theyiactibyiinhibitingitheisynthesisiofiaicomponentiofitheicelliwalliresulti ngiinidisruptioniofitheicelliwalliandifungalideath -ex:imicafunginiandicaspofungin - wellitoleratediinipatientsiandionlyiavailableiintravenousiadministration Imidazolesi(Azoles)i-iCorrectiAnswer-- iEffectiveiorallyioriintravenouslyiagainstisystemicifungaliinfections. - iInhibitifungalicytochromeiP450,ihinderingiergosterolisynthesisicrucialif orifungalicelliwallifunction. - iSelectiveitoxicityidueitoihigheriaffinityiforifungaliP450ioverihumaniP450 siinvolvediinidrugimetabolism. -iExamplesiincludeiketoconazoleiandifluconazole. -iSomeiavailableiover-the- counteri(OTC)iforiyeastiinfectionitreatment,ilikeimiconazole. virusi-iCorrectiAnswer- small,iinfectiousiagentithatiisionlyiableitoimultiplyiwithinilivingicellsiofia notheriorganismi(animals,iplants,iandibacteria) viralicyclei-iCorrectiAnswer- Virusientersicell,ihostienzymesireplicateiviralimrna,iviraligenomesiandica psisiproteinsiself-assembleiintoinewiviruses Oseltamiviri(Tamiflu)i-iCorrectiAnswer--Antiviral -neurominidaseiinhibitoriuseditoitreatiinfluenza - neurominidaseiisianienzymeithatiallowsitheispreadiofitheivirusifromicelli toicell,idrugsiofithisiclassipreventineighbouringicellsifromibeingiinfectedi withitheivirus acycloviri-iCorrectiAnswer--iAntiviralidrug. -iActivatedibyiinfectedicells;iinhibitsiDNAireplication. - iPreferrediforiseriousiHSViinfections;ireducesigenitaliherpesirecurrence. -iEffectiveiagainstiVZViinfectionsi(chickenpox,ishingles). antiviralsivs.ivaccinesi-iCorrectiAnswer-- iVaccines:iIntroduceivirusifragmentsipre- infectioniforiimmuneirecognition. -iAntivirals:iTreatiexistingiinfectionsiinitheibody. -iVaccinesiprevent;iantiviralsitreat. monthlyiovarianicyclei-iCorrectiAnswer-- Involvesitheiintricateiandicoordinatediinteractioniofiainumberiofihormo nesiandifactors.i adverseieffectsiofioralicontraceptivesi-iCorrectiAnswer-- iMild:inausea,iedema,iheadache. - iModerate:ibreakthroughibleeding,iweightigain,iincreasediskinipigment ation,iacne,ihirsutismi(abnormalihairigrowth),iincreasedivaginaliandiute rineiinfections,ipost-drugiamenorrheai(absenceiofimenstruation). -iSerious:ibloodiclots,iheartiattack,istroke,ihypertension,icancer. non-contraceptiveibenefitsiofiOCPsi-iCorrectiAnswer--iReducediriskiof:i --->iovarianicysts. --->ireducediriskiofiovarianiandiendometrialicancer. --->iectopicipregnancyi(fertilizedieggiplantsiitselfioutsideiofitheiuterus). i-iLess:i --->iironideficiencyianemia,iasimenstrualiflowiisireduced.i --->iacneiandihirsutism. DepoiProveraiShoti-iCorrectiAnswer-- iHormonalicontraceptiveiinjection.i -iCanilastiupitoi3itoi4imonths.i - iProgestinidoseiisiinjectediintramuscularlyieveryi3imonthsiandiprovidesi contraceptioniforiroughlyiarounditheisameitime. adverseieffectsiofiDepoiProveraishoti-iCorrectiAnswer-- iBreakthroughibleeding: --->iAltersiplasmailipidiprofile. --->iLowersihigh-densityilipoproteinsi(HDL),iraisesilow- densityilipoproteinsi(LDL). --->iIncreasesiriskioficoronaryivascularidisease. intrauterineidevicei(IUD)i-iCorrectiAnswer--iSmall,iT- shapedideviceiinsertedibyiaiphysicianiinsideitheiuterusitoipreventipregn ancy -iReleasesilevonorgestreli(aiprogestin). -iEffectiveifori5iyears. adverseieffectsiofiintrauterineidevicei(IUD)i-iCorrectiAnswer-- iHeavyimenstrualiflow,ipelvicidiscomfortiandiincreasediuterineiinfection s. transdermalicontraceptiveipatchi-iCorrectiAnswer-- iContainsiestrogeniandiprogestin. --- >iDeliverediaticontinuousilevelsithroughitheiskiniintoisubcutaneousitiss ue.i --->iInhibitsiovulationibyithickeningicervicalimucus.iD --->iDeliverediatiaiconstantirateifori2idaysirequiringi3ipatchesipericycle. enterali(oralicontraceptives)iprosiandiconsi-iCorrectiAnswer--pros:i --->imosticonvient --->ileastiexpensiveimeansiofitakingiaidrug --->inon-invasive --->iself-administeredi -cons: --- >ivariableiamountiofiabsorptionibetweenipatientsidueitoidifferencesiinii ntestinalimotility --->isubjectitoitheifirst-passieffect parenterali(intramusculari-itheishot)iprosiandiconsi-iCorrectiAnswer-- pros:i --->ipatientsidoinoticontrolidosing --->ideliversiaisteadyisupplyiofidrugiforiaisetiperiod, --->iavoidsitheifirst-passieffecti nesisianditestosteroneiproduction,ireducingimaleisecondaryisexicharact eristics. - iAndrogeniaddeditoireplaceilostitestosteroneiandimaintainisexicharacte ristics. - iMethodishowsipromise,ibutifindingiappropriateiexogenousiandrogenid oseiisichallenging. Gossypoli(MaleiContraceptive)i-iCorrectiAnswer-- iCompoundifromicottonseedidestroysiseminiferousitubuleielements,ire ducingispermiproductioniwithoutiaffectingisexidriveioritestosteroneifun ctions. - iExtensiveiclinicalitrialsiiniChina:iAppropriateiuseileditoiinfertileispermic ountsiini99%iofisubjects;ispermicountirecoveryipost- discontinuationinotiguaranteed. -iHypokalemiaireported,ileadingitoitransientiparalysis. injectableimaleicontraceptivei-iCorrectiAnswer--iNon- hormonalimaleicontraceptiveiavoidsihormone- relatedisideieffectsilikeiincreasediaggression,idecreasedilibido,iorifemini neicharacteristics. - iAllowsiusersitoiensureicontraceptiveiprotectionibeforeiengagingiinisexu aliactivity. Non-prescriptionidrugsi-iCorrectiAnswer-- drugsithaticanibeisolditoitheigeneralipubliciwithoutiaiprescriptioni -includesiover-the-counteridrugsi(OTC) over-the-counteri(OTC)idrugsi-iCorrectiAnswer-- drugsiareisoldiwithoutiaiprescriptionibasedionitheipremiseithatitheigene ralipubliciisiableitoidiagnoseimildisymptomsiandiselectiappropriateiagen tsitoitreatitheseisymptoms guildlinesiforiusingianiOTCidrugi-iCorrectiAnswer-- iFamiliarizeiwithisymptoms;imildiillness/symptomsimanageableiwithou tiphysician. -iIfisymptomsiworsen,iconsultiaiphysicianipromptly. -iCeaseiOTCimedicationiimmediatelyiifiadverseieventsioccur. - iOTCsimayicauseitoxicitiesioridrugiinteractions;iconsultipharmacistiifiuns ure. -iSelf- medicationiwithiOTCsishouldinotiexceedi2iweeksiwithouticonsultation. SafetyiandiEfficacyiofiOTCiDrugsi-iCorrectiAnswer-- iSomeiOTCiproducts,ilikeiacetaminophen,iareiavailableidueitoilongimark etipresencei(grandparenting),inoticontrolleditrials. - iEffectivenessiofisuchiproductsimayibeilimited;iseriousitoxicitiesipossibl e. -iNewiOTCiproductsiundergoirigorousipreclinicalisafetyitesting;ipost- marketisurveillanceiconductediforialliOTCiproducts. selectioniofiappropriateiOTCidrugsi-iCorrectiAnswer-- proveniefficacyiandiknownitoxicityi -simpleiformulationsiandiingredientsi(bestiOTCihasisingleiingredient)i - brandivs.iGenerici(genericsiareiusuallyicheaperithaninameibrandiandiare ijustiasieffective)i - appropriateiandieffectiveidosei(bestiOTCiwillicomeiinitheiappropriateido sageiform) internalianalgesicsi-iCorrectiAnswer-provideireliefifromipain AcetylsalicyliciAcidi(Aspirin)i-iCorrectiAnswer--iInternalianalgesic: i-iRelievesipain,ifever,iinflammationieffectively. i-iLowidosesimayipreventistrokeiandiheartiattack. i-iInhibitsiprostaglandinisynthesis,ireducingipain,ifever,iinflammation. i-iPreventsistrokeiandiheartiattackibyiinhibitingiplateletiaggregation.