BIOM1061: QUM Exam 2023 Questions and Answers
Complete
Clinical pharmacology is...
the science of drugs and their clinical use (mechanisms).
Clinical epidemiology is...
The science of making predictions about individual patients based on clinical events in
groups of similar patients (outcomes).
Therapeutics is...
the branch of medicine concerned with treatment of diseases and action of remedial
agents
Quality use of medicines is...
selecting management options wisely, choosing suitable medicines, and using
medicines safely and effectively
What is a drugs indication?
The specific disease or symptoms that the drug treats
What is the treatment goal?
The outcome we are hoping to achieve by treating the disease or symptoms
Common goals of drug therapy include...
Alleviating symptoms e.g. paracetamol for headache.
Cure disease e.g. antibiotics.
Reduce risk of event e.g. antihypertensives.
Restore physiological function e.g. thyroxine in hypothyroidism.
Reduce progression of disease e.g. Ach inhibitors in AD.
Why is it important to understand goals of drug therapy?
Drugs may have more than one indication. There may be good or bad evidence for
drug. Drugs may be licensed for a particular indication.
Knowing the indication and goal of therapy provides guidance on...
what to monitor to assess effectiveness, when the patient can stop treatment, and the
impact of missing a dose
Plasma concentration over time for IV...
no absorption, so mostly seeing elimination
Plasma concentration over time for IM...
got to go through muscle
Plasma concentration over time for PO...
has to disintegrate → dissolve in gastric juices → absorbed through GIT → travel to
liver → into systemic circulation
What is the most common route of administration?
PO: drug needs to dissolve in gastric juices → absorbed through GIT → travel to liver →
into systemic circulation
Factors that can influence absorption PO...
Fe or Ca binds with thyroxine → thyroxine is not absorbed and is passed out through
stool.
Some drugs absorbed better in acidic environments → itraconazole with cola increases
absorption
, What factors determine the extent and rate of distribution?
Physiciochemistry of the drug and the perfusion of body tissue
What is first pass metabolism?
Metabolism of an orally administered drug before it reaches systemic circulation;
avoided by IV, inhalation, rectal, subling
What is a pro-drug?
A drug that needs to be metabolised before it is active e.g. codeine into morphine
What are cytochrome P450 enzymes?
Liver enzymes that are responsible for metabolising drugs and are a common site of
drug interactions
What is a substrate?
A drug that gets metabolised by an enzyme
How does the drug leave the body?
Via the kidneys (urine), GIT (faeces), or lung (exhalation)
What is the half life?
The amount of time it takes for the plasma concentrations of a drug to decline in half its
value.
The shorter the half life, the often you need to give the drug.
How long does it take for a drug to reach steady state?
4-5 half lives.
What happens to the half life in renal impairment?
The clearance of the drug is reduced, therefore increasing half life.
Who does the renal function change in pregnancy?
Renal function increases, changing the clearance of renally cleared drugs.
Dose will have to increase, because the kidneys are excreting the drugs faster.
What is drug tolerance?
A reduced repsonse from the drug following repeated exposure.
What is drug dependence?
When stopping or reducing drug exposure leads to withdrawal symptoms.
Population therapeutic decision.
Do the benefits of the interventions outweigh the harms in a defined population?
Individual therapeutic decision.
Do the benefits of the interventions outweigh the harms in an individual?
Efficacy.
Does the intervention possess the proposed benefits in a define population?
Effectiveness.
Does the intervention possess the proposed benefits in patients under routine care?
What are adverse drug reactions?
A harmful or unpleasant reaction related to the use of a medicinal product.
What is a confounder?
A factor that is associated with both exposure to the drug and the outcomes of interest
(and is not an intermediate step in the casual path between the two).
What are randomized trials?
The method used to evaluate the efficacy of the drug.
What are cohort studies and case-controlled studies?
Complete
Clinical pharmacology is...
the science of drugs and their clinical use (mechanisms).
Clinical epidemiology is...
The science of making predictions about individual patients based on clinical events in
groups of similar patients (outcomes).
Therapeutics is...
the branch of medicine concerned with treatment of diseases and action of remedial
agents
Quality use of medicines is...
selecting management options wisely, choosing suitable medicines, and using
medicines safely and effectively
What is a drugs indication?
The specific disease or symptoms that the drug treats
What is the treatment goal?
The outcome we are hoping to achieve by treating the disease or symptoms
Common goals of drug therapy include...
Alleviating symptoms e.g. paracetamol for headache.
Cure disease e.g. antibiotics.
Reduce risk of event e.g. antihypertensives.
Restore physiological function e.g. thyroxine in hypothyroidism.
Reduce progression of disease e.g. Ach inhibitors in AD.
Why is it important to understand goals of drug therapy?
Drugs may have more than one indication. There may be good or bad evidence for
drug. Drugs may be licensed for a particular indication.
Knowing the indication and goal of therapy provides guidance on...
what to monitor to assess effectiveness, when the patient can stop treatment, and the
impact of missing a dose
Plasma concentration over time for IV...
no absorption, so mostly seeing elimination
Plasma concentration over time for IM...
got to go through muscle
Plasma concentration over time for PO...
has to disintegrate → dissolve in gastric juices → absorbed through GIT → travel to
liver → into systemic circulation
What is the most common route of administration?
PO: drug needs to dissolve in gastric juices → absorbed through GIT → travel to liver →
into systemic circulation
Factors that can influence absorption PO...
Fe or Ca binds with thyroxine → thyroxine is not absorbed and is passed out through
stool.
Some drugs absorbed better in acidic environments → itraconazole with cola increases
absorption
, What factors determine the extent and rate of distribution?
Physiciochemistry of the drug and the perfusion of body tissue
What is first pass metabolism?
Metabolism of an orally administered drug before it reaches systemic circulation;
avoided by IV, inhalation, rectal, subling
What is a pro-drug?
A drug that needs to be metabolised before it is active e.g. codeine into morphine
What are cytochrome P450 enzymes?
Liver enzymes that are responsible for metabolising drugs and are a common site of
drug interactions
What is a substrate?
A drug that gets metabolised by an enzyme
How does the drug leave the body?
Via the kidneys (urine), GIT (faeces), or lung (exhalation)
What is the half life?
The amount of time it takes for the plasma concentrations of a drug to decline in half its
value.
The shorter the half life, the often you need to give the drug.
How long does it take for a drug to reach steady state?
4-5 half lives.
What happens to the half life in renal impairment?
The clearance of the drug is reduced, therefore increasing half life.
Who does the renal function change in pregnancy?
Renal function increases, changing the clearance of renally cleared drugs.
Dose will have to increase, because the kidneys are excreting the drugs faster.
What is drug tolerance?
A reduced repsonse from the drug following repeated exposure.
What is drug dependence?
When stopping or reducing drug exposure leads to withdrawal symptoms.
Population therapeutic decision.
Do the benefits of the interventions outweigh the harms in a defined population?
Individual therapeutic decision.
Do the benefits of the interventions outweigh the harms in an individual?
Efficacy.
Does the intervention possess the proposed benefits in a define population?
Effectiveness.
Does the intervention possess the proposed benefits in patients under routine care?
What are adverse drug reactions?
A harmful or unpleasant reaction related to the use of a medicinal product.
What is a confounder?
A factor that is associated with both exposure to the drug and the outcomes of interest
(and is not an intermediate step in the casual path between the two).
What are randomized trials?
The method used to evaluate the efficacy of the drug.
What are cohort studies and case-controlled studies?
