Review Questions for Unit 1 Key

Unit 1 review sheet 5/30/2018 10:40:44 AM 1

Review Questions for Unit 1 Key RSPT 1213 Pharmacology for Respiratory Care

1. A therapeutic drug is one that: a. Treats a disorder b. Treats the symptoms of a disorder c. Diagnosis a disorder d. None of these

2. A palliative drug is one that: a. Treats a disorder b. Treats the symptoms of a disorder c. Diagnosis a disorder d. None of these

3. Define a pharmacist: A trained & licensed health professional that prepares & dispenses drugs

4. Other than a pharmacist, who can distribute drugs? Other health care workers such as nurses and RCP can act as ‘agents of the hospital’ who are following orders from the physician.

5. List some sources of pharmacological substances. Plants, minerals, animals, human tissue, recently genetic research & synthetic drugs created in the lab

6. List & discuss the social limitations to drug research 1. Social contracts such as the 10 Commandments and the Hippocratic Oath 2. Limitation of education only to the upper class 3. Limitation of education by church or government 4. Secrets kept by pharmacologists for proprietary reasons 5. Simple supply and demand

7. List & discuss the technical limitations to drug research. a) Unquestioning dependence on classical texts that may or may not be right b) Inability to isolate single active agents; using entire leaf c) Inability to contain drugs until porcelain was invented

8. List the Arabic advances in pharmacology in the 12th century. a) Separation of pharmacology as a separate profession b) Invention of porcelain as safe, stable containers c) Drug distillation & fermentation to create more isolated agents 9. Define these terms: 1. Pharmacopeia: a recipe book containing the formulae for various drugs. For centuries these recipe books were written in code and hidden from the rivals, but by the 1880s medical schools started collecting and publishing the best ones.

2. Formulary : see pharmacopeia

3. FDA: Food and Drug Agency 4. PDR: physicians’ desk reference is a collection of all the drug inserts as over seen by the FDA. These are available as hardcopies or over the internet

10. Discuss the need for the creation of the Pure Food and Drug Act of 1906. After a series of articles exposed the industries shortcomings, Congress passed a law that forced companies to warn their patients of the presence of opium and alcohol in their products. People could now choose not to take addictive drugs Unit 1 review sheet 5/30/2018 10:40:44 AM 2

11. Discuss the need for the creation of the 1912 the Shirley Amendment Drug companies were forced to stop making fraudulent claims about their drugs’ actions and results 12. Discuss the need for the creation of the FDA in 1938. The FDA was created in 1938 to regulate the safety of drugs and to regulate the labeling of drugs. It accepted the US pharmacopeia & the US Formulary as the official recipe books for drugs 13. List and discuss the three powers of the FDA. a) Approve all drugs for safety b) Control labeling of drugs c) Control the naming of ingredients based on the USP & the US Formulary

14. Discuss the need for the creation of the Harris-Kefauver Amendment of 1962 a) The FDA is now given the power to approve a drug not only for safety but for efficacy b) Every 5 years, new research is reviewed so drug companies must remove or re-label their products 15. How often does the FDA revise information found in drug inserts? About every 5 years

16. Discuss the effect of new research of a new and better drug on the FDA’s action on the older drug; The FDA will not remove a older drug because another one is ‘better’--only if the older drug doesn’t meet the criteria for safety and effectiveness

17. Discuss the effect on the FDA’s action of new research on an older drug’s side effects or effectiveness. Older drugs labels will have to include the new information 18. Discuss the role played by RCP in the regulation of medical devices when used as directed by the manufacturer. a) Medical devices are regulated, but less rigorously. b) Health care workers must send written notification to the companies of any injuries or death c) The companies must keep all complaints associated with injuries when equipment is used as advised.

19. A code name is a. the name for a drug while it is still in the pre-clinical stage b. the name for a drug while it is still in the clinical research stage c. based on the chemical composition of the drug d. is the name used by the company to sell the drug

20. A generic name is the a. the name for a drug while it is still in the pre-clinical stage b. the name for a drug while it is still in the clinical research stage c. based on the chemical composition of the drug d. is the name used by the company to sell the drug e. b and d

21. the chemical name is a. the name for a drug while it is still in the pre-clinical stag b. the name for a drug while it is still in the clinical research stage c. based on the chemical composition of the drug d. the name used by the company to sell the drug

22. The trade name is a. the name for a drug while it is still in the pre-clinical stag Unit 1 review sheet 5/30/2018 10:40:44 AM 3

b. the name for a drug while it is still in the clinical research stage c. based on the chemical composition of the drug d. the name used by the company to sell the drug

23. Define pharmacokinetic: the ability of a drug to be useful in the body is based on several factors

24. List and discuss the 4 factors that determine pharmacokinetic a) Ability to be absorbed b) Ability to be distributed c) Ability to metabolized d) Ability to be excreted

25. List and discuss twelve items found in the packet insert for a prescription drug. a) trade and generic names as well as the chemical name. b) primary and side effects are discussed c) indications, hazards and contraindications are listed. These hazards should be listed in order of frequency from the most common to the rarest. d) strength of the drug and dosage ranges. e) Onset of action and duration of action are discussed. f) pharmacokinetic action is discussed g) pharmacodynamic action is discussed h) tetragenic effects of the drug on the fetus are discussed. i) carcinogenic effects of the drug- j) While any large molecule [especially proteins] can cause allergic reactions, some drugs are more likely to cause them than others; this is discussed k) its drug interactions are discussed

26. The Therapeutic level is a measurable amount of: a) active ingredient found in the tissue which is enough to cause the desire effect. b) active ingredient found in the tissue which exceeds the therapeutic level to the point that adverse hazards become more likely to occur c) at the time interval in which it should be at its highest level. d) of the drug at a time interval just prior to the next scheduled dose. It should be the lowest level.

27. The Toxic level is a measurable amount of: a) active ingredient found in the tissue which is enough to cause the desire effect. b) active ingredient found in the tissue which exceeds the therapeutic level to the point that adverse hazards become more likely to occur c) at the time interval in which it should be at its highest level. d) of the drug at a time interval just prior to the next scheduled dose. It should be the lowest level.

28. The Peak level is a measurable amount of: a. active ingredient found in the tissue which is enough to cause the desire effect. b. active ingredient found in the tissue which exceeds the therapeutic level to the point that adverse hazards become more likely to occur c. at the time interval in which it should be at its highest level. d. of the drug at a time interval just prior to the next scheduled dose. It should be the lowest level.

29. The Trough level is a measurable amount of: Unit 1 review sheet 5/30/2018 10:40:44 AM 4

a. active ingredient found in the tissue which is enough to cause the desire effect. b.active ingredient found in the tissue which exceeds the therapeutic level to the point that adverse hazards become more likely to occur c. at the time interval in which it should be at its highest level. d.of the drug at a time interval just prior to the next scheduled dose. It should be the lowest level.

30. Define pharmacodynamics. The study of how the drug works on the cells

31. List and discuss the three ways that drug enter the cell. a. Channels and pores: usually only small ions such as calcium can cross these tiny pores b. Transport systems [active or passive]: based on a drug’s structure it might be carried into the cell by a transport system c. Direct Penetration: a drug that is lipo-soluble or has electrical polarity can enter a cell by direct penetration.

32. Discuss the receptor theory of pharmacodynamics: The surface of cells contains 1000s of receptors that can be stimulated by different substances. This is how hormones and other chemical messages get to the cell to start, speed up or stop an action. These receptors are very specific and are seen as locks that can be opened, closed or blocked. The chemical that fits the receptor acts as the key. Some chemicals are master keys that open [trigger] several different receptors, while others are specific to only one lock.

33. The drug interaction of an additive drug is one that: a. An active drug which affects other drugs by an effect equal to the sum of double one or the other. b. Two active drugs which, when given together, have an effect greater than the sum of these two c. An active drug is given more effectiveness by the addition of an inactive drug which creates an effect greater than doubling the active drug. d. have opposite effects. So that they cancel out the other's effects.

34. In potentiation, we have an interaction in which: a. An active drug, which affects other drugs by an effect equal to the sum of double one or the other. b.Two active drugs which, when given together, have an effect greater than the sum of these two c. An active drug is given more effectiveness by the addition of an inactive drug which creates an effect greater than doubling the active drug. d.have opposite effects, so that they cancel out the other's effects.

35. The drug interaction of synergistic drugs is: a. An active drug, which affects other drugs by an effect equal to the sum of double one or the other. b. Two active drugs which, when given together, have an effect greater than the sum of these two c. An active drug is given more effectiveness by the addition of an inactive drug which creates an effect greater than doubling the active drug. d. have opposite effects, so that they cancel out the other's effects.

36. In antagonistic drug reaction, we have one in which : a. An active drug, which affects other drugs by an effect equal to the sum of double one or the other. b.Two active drugs which, when given together, have an effect greater than the sum of these two Unit 1 review sheet 5/30/2018 10:40:44 AM 5

c. An active drug is given more effectiveness by the addition of an inactive drug which creates an effect greater than doubling the active drug. d.have opposite effects, so that they cancel out the other's effects.

37. Differentiate between drug tolerance and tachyphylaxis. The longer a person takes some drugs, the more drug is required for the same effect. This is called tolerance, but if tolerance is reached in only a few doses, we say that this drug is subject to tachyphylaxix.

38. Compare the autonomic system to the voluntary CNS. The autonomic system controls the parts of the body that do not require conscious active decisions to perform the action. An example is digestion. You can use your voluntary muscles to pick up food and eat consciously, but the actual act of digestion is performed by the autonomic system. 39. Compare the function of the sympathetic system to that of the parasympathetic system. The sympathetic system controls the fight or flight reactions, while the parasympathetic controls the slow regulatory actions of the body. Because these two systems are in conflict, they tend to trigger opposite reaction in the same target organ. If the sympathetic causes the heart rate to increase, the parasympathetic stimulation of the myocardial cells will cause the heart rate to decrease.

40. Identify the neurotransmitter for the sympathetic system. Epinephrine, nor-epinephrine

41. Identify the neurotransmitter for the parasympathetic system acetylcholine

42. List the things that happen to the body during the fight or flight response. Increased HR Increase stroke volume—increases Cardiac output Vasoconstriction of dermal capillaries & of blood vessels going to the gut Increased blood pressure Vasodilation of skeletal muscles, myocardial muscles Relaxation of bronchial smooth muscles Relaxation of digestive tract smooth muscles Relaxation of uterine wall muscles

43. Explain how the adrenal gland gets involved with the fight or flight response. When nor-epinephrine is released at the junction between the synapsis, some will get into the blood stream. Once nor-epinephrine reaches the receptors on the adrenal gland, this gland will dump huge amount of epinephrine into the blood stream so that the response is body wide.

44. Complete this table

Autonomic system increases the increases the bronchospasm bronchodilation capillary blood capillary blood flow to the flow in the skeletal muscles mucosal sympathetic yes no no yes

parasympathetic no yes yes no

45. Identify the reaction of the mucus glands to parasympathic stimulation of cholinergic receptors. a. Increase secretions b. Decrease secretions c. Nothing Unit 1 review sheet 5/30/2018 10:40:44 AM 6

46. Identify the reaction of the mucus glands to parasympathic stimulation of adrenergic receptors. Increase secretions Decrease secretions Nothing

47. Identify the reaction of the myocardium to parasympathic stimulation of its adrenergic receptors. a. Increase heart rate b. Decrease heart rate c. Nothing

48. Identify the reaction of the myocardium to parasympathic stimulation of its cholinergic receptors. a. Increase heart rate b. Decrease heart rate c. nothing

49. Identify the substances that limit the duration of action of the endogenous catecholamines during the fight or flight response. Endogenous catecholamines are quickly broken down by two enzymes called MAO (monoamine oxidase) and COMT (catechol-o-methyl transferase).

50. Identify the substance that renders exogenous catecholamines such poor oral drugs. MAO is found in great numbers in the digestive tract, so that these drugs just don’t work orally because the enzyme breaks them down

51. Identify the substance that limits the duration of action of cholinergic stimuli. the acetylcholine is stopped by the presence of the enzyme, CHOLINESTERASE. This enzyme is secreted by the target organ after the cholinergic receptor has been stimulated to halt the transmission of the parasympathetic nerve impulse.