Basic & Clinical Pharmacology, Katzung;
Chapter 1-4
Pharmacology - ANS study of f the history, source, physical and chemical properties,
compounding, biochemical and physiological effect, mechanisms of action, absorption,
distribution, biotransformation and excretion, and therapeutic and other uses of drugs
Drug - ANS any chemical agent that when taken into a living organism may modify one or
more of its functions
Toxicology - ANS study of poisonous substances and their effects upon body parts
Pharmacokinetics - ANS where drugs go, how long they stay, what chemical changes occur,
how they are removed; effect of body on a drug
Absorption - ANS the movement of a drug from the site of administration to bloodstream;
intake of a drug into the system
Distribution - ANS the transfer of a drug from one location to another within the body; where
the drug goes following absorption
Elimination - ANS the removal of materials from the body; removal of a drug
Pharmacodynamics - ANS what the drug does to the body; mechanism of action
systemic effects - ANS generalized distribution of the chemical throughout the body by the
bloodstream to internal organs
Effect - ANS the change in the organism caused by the chemical
Law of Mass Action - ANS the rate of a chemical reaction is proportional to the product of the
activities or concentrations of the reactants
Response - ANS is a function of the drug-receptor complex
ED50 - ANS median effective dose; therapeutic effect; the dose required to achieve 50% of
desired response in 50% of the population
TD50 - ANS median toxic dose; toxic effect; the dose required to get 50% of population
reporting this specific toxic effect
,LD50 - ANS median lethal dose; lethal effect; dose required to achieve 50% mortality from
toxicity
EC50 - ANS half maximum effective concentration; concentration of a drug at which 50% of its
maximum response is observed
LC50 - ANS half lethal concentration; concentration of a drug at which 50% mortality
Quantal dose response curve - ANS A graph of the fraction of a population that shows a
specified response at progressively increasing doses
Continuous dose response curve - ANS A graph of increasing response to increasing drug
concentration or dose
Potency - ANS amount of drug needed to produce a certain response
Therapeutic window - ANS dosage range between the minimum effective therapeutic
concentration and the minimum toxic concentration
Efficacy - ANS the maximum response of a drug
Therapeutic index - ANS the ratio between the toxic and therapeutic concentrations of a drug;
TD50/ED50
Administration - ANS ways of drug delivery
Metabolism - ANS enzymatic breakdown of the drug
Routes of administration - ANS oral, sublingual, transdermal, intravenous, subcutaneous,
rectal, intramuscular, epidural, pulmonary absorption, topical, mucousal/nasal
Bioavailability - ANS the portion of the drug that reaches the bloodstream
Lipid diffusion - ANS non-charged molecules can pass through lipid membranes
Passive aqueous diffusion - ANS moves from high concentration towards low; can be via
spaces between cells or in large liquid volumes (blood stream)
Active transport - ANS carriers grab the drug and use energy to move it across the membrane
Antacids - ANS affects pH (gastric)
Laxatives - ANS gastric emptying
,Factors influencing distribution - ANS tissue permeability, blood flow, binding to proteins
Biotransformation - ANS the chemical changes that occur to a drug following administration
Liver - ANS the primary organ for biotransformation
Kidney - ANS the primary organ for elimination
Half-life - ANS the time is takes to reduce the concentration of a drug by half
Dosing frequency - ANS the time interval between doses when a drug is given intermittently
Frequent dosing - ANS allows less concentration difference between the maximum and
minimum concentration
Continuous infusion - ANS Introduction of a substance such as IV fluids or interstitial fluids
over a period of time without interruption
Minimal toxic concentration - ANS lowest concentration producing toxic effects
Minimal effective concentration - ANS lowest concentration producing desired effect
Factors influencing drug response and kinetics - ANS Genetics, disease, age, gender, other
drugs, diet
Lack of compliance - ANS drug therapy may fail if patient chooses formulations that are easier
to administer, cannot open container, cannot see label, etc.
Drug regimen simplification - ANS using same dosing schedule; pill organizers; blister packs
Receptors - ANS specific target proteins to which endogenous compounds as well as drugs
binds
Drug-receptor interaction - ANS leads to either increase or decrease in a biochemical process
in the cell
Agonist - ANS drug binds to a receptor and activates the receptor
Antagonist - ANS drug binds to receptor and does not activate
4 types of agonist receptors - ANS Ion channels, G-protein coupled, enzyme coupled,
intracellular
, Partial agonist - ANS drug binds to receptor but does not elicit a maximal response
Competitive - ANS the drug comes onto and off of the receptor, so if another agent that can
bind to the receptor is present, they will compete
Non-competitive - ANS once the drug binds, that receptor is no longer available
Question 43:
A 55-year-old executive has cardiomyopathy and congestive heart failure. He is being treated
with diuretics. The mechanism of action of furosemide is best described as - ANS •
furosemide
The correct answer is B.
Explanation:
Furosemide acts on the ascending limb of the loop of Henle and inhibits the major transporter in
this segment, a Na+/K+/2Cl- transporter.
Question 39:
A 52-year-old plumber comes to the office with a complaint of periodic onset of chest pain,
described as a sensation of heavy pressure over the sternum that comes on when he exercises
and disappears within 15 min when he stops. After a full physical examination and further
evaluation, you make the diagnosis of angina of effort. In considering medical therapy for this
patient, which of the following best describes the beneficial action of nitroglycerin in this
condition? - ANS • nitroglycerin
The correct answer is C.
Dilation of systemic veins results in decreased diastolic cardiac size
Explanation:
Although nitrates may dilate large and medium coronary vessels, they have little effect on the
arterioles in ischemic tissue, which are already dilated maximally by local ischemia. A major
beneficial effect is venodilation, leading to reduction in cardiac size, which decreases diastolic
fiber tension and reduces myocardial oxygen demand.
Question 1:
A 52-year-old woman is admitted to the emergency department with a history of drug treatment
for several conditions. Her serum electrolytes are found to be as follows (normal values in
parentheses):
|
Na+ 140 mEq/L (135-145) K+ 6.5 mEq/L (3.5-5.0)
Cl− 100 mEq/L (98-107) pH 7.3 (7.31-7.41)
This patient has probably been taking - ANS • spironolactone
The correct answer is E.
Explanation:
This patient is hyperkalemic and slightly acidotic. These changes are typical of a K+-sparing
diuretic such as spironolactone.
Chapter 1-4
Pharmacology - ANS study of f the history, source, physical and chemical properties,
compounding, biochemical and physiological effect, mechanisms of action, absorption,
distribution, biotransformation and excretion, and therapeutic and other uses of drugs
Drug - ANS any chemical agent that when taken into a living organism may modify one or
more of its functions
Toxicology - ANS study of poisonous substances and their effects upon body parts
Pharmacokinetics - ANS where drugs go, how long they stay, what chemical changes occur,
how they are removed; effect of body on a drug
Absorption - ANS the movement of a drug from the site of administration to bloodstream;
intake of a drug into the system
Distribution - ANS the transfer of a drug from one location to another within the body; where
the drug goes following absorption
Elimination - ANS the removal of materials from the body; removal of a drug
Pharmacodynamics - ANS what the drug does to the body; mechanism of action
systemic effects - ANS generalized distribution of the chemical throughout the body by the
bloodstream to internal organs
Effect - ANS the change in the organism caused by the chemical
Law of Mass Action - ANS the rate of a chemical reaction is proportional to the product of the
activities or concentrations of the reactants
Response - ANS is a function of the drug-receptor complex
ED50 - ANS median effective dose; therapeutic effect; the dose required to achieve 50% of
desired response in 50% of the population
TD50 - ANS median toxic dose; toxic effect; the dose required to get 50% of population
reporting this specific toxic effect
,LD50 - ANS median lethal dose; lethal effect; dose required to achieve 50% mortality from
toxicity
EC50 - ANS half maximum effective concentration; concentration of a drug at which 50% of its
maximum response is observed
LC50 - ANS half lethal concentration; concentration of a drug at which 50% mortality
Quantal dose response curve - ANS A graph of the fraction of a population that shows a
specified response at progressively increasing doses
Continuous dose response curve - ANS A graph of increasing response to increasing drug
concentration or dose
Potency - ANS amount of drug needed to produce a certain response
Therapeutic window - ANS dosage range between the minimum effective therapeutic
concentration and the minimum toxic concentration
Efficacy - ANS the maximum response of a drug
Therapeutic index - ANS the ratio between the toxic and therapeutic concentrations of a drug;
TD50/ED50
Administration - ANS ways of drug delivery
Metabolism - ANS enzymatic breakdown of the drug
Routes of administration - ANS oral, sublingual, transdermal, intravenous, subcutaneous,
rectal, intramuscular, epidural, pulmonary absorption, topical, mucousal/nasal
Bioavailability - ANS the portion of the drug that reaches the bloodstream
Lipid diffusion - ANS non-charged molecules can pass through lipid membranes
Passive aqueous diffusion - ANS moves from high concentration towards low; can be via
spaces between cells or in large liquid volumes (blood stream)
Active transport - ANS carriers grab the drug and use energy to move it across the membrane
Antacids - ANS affects pH (gastric)
Laxatives - ANS gastric emptying
,Factors influencing distribution - ANS tissue permeability, blood flow, binding to proteins
Biotransformation - ANS the chemical changes that occur to a drug following administration
Liver - ANS the primary organ for biotransformation
Kidney - ANS the primary organ for elimination
Half-life - ANS the time is takes to reduce the concentration of a drug by half
Dosing frequency - ANS the time interval between doses when a drug is given intermittently
Frequent dosing - ANS allows less concentration difference between the maximum and
minimum concentration
Continuous infusion - ANS Introduction of a substance such as IV fluids or interstitial fluids
over a period of time without interruption
Minimal toxic concentration - ANS lowest concentration producing toxic effects
Minimal effective concentration - ANS lowest concentration producing desired effect
Factors influencing drug response and kinetics - ANS Genetics, disease, age, gender, other
drugs, diet
Lack of compliance - ANS drug therapy may fail if patient chooses formulations that are easier
to administer, cannot open container, cannot see label, etc.
Drug regimen simplification - ANS using same dosing schedule; pill organizers; blister packs
Receptors - ANS specific target proteins to which endogenous compounds as well as drugs
binds
Drug-receptor interaction - ANS leads to either increase or decrease in a biochemical process
in the cell
Agonist - ANS drug binds to a receptor and activates the receptor
Antagonist - ANS drug binds to receptor and does not activate
4 types of agonist receptors - ANS Ion channels, G-protein coupled, enzyme coupled,
intracellular
, Partial agonist - ANS drug binds to receptor but does not elicit a maximal response
Competitive - ANS the drug comes onto and off of the receptor, so if another agent that can
bind to the receptor is present, they will compete
Non-competitive - ANS once the drug binds, that receptor is no longer available
Question 43:
A 55-year-old executive has cardiomyopathy and congestive heart failure. He is being treated
with diuretics. The mechanism of action of furosemide is best described as - ANS •
furosemide
The correct answer is B.
Explanation:
Furosemide acts on the ascending limb of the loop of Henle and inhibits the major transporter in
this segment, a Na+/K+/2Cl- transporter.
Question 39:
A 52-year-old plumber comes to the office with a complaint of periodic onset of chest pain,
described as a sensation of heavy pressure over the sternum that comes on when he exercises
and disappears within 15 min when he stops. After a full physical examination and further
evaluation, you make the diagnosis of angina of effort. In considering medical therapy for this
patient, which of the following best describes the beneficial action of nitroglycerin in this
condition? - ANS • nitroglycerin
The correct answer is C.
Dilation of systemic veins results in decreased diastolic cardiac size
Explanation:
Although nitrates may dilate large and medium coronary vessels, they have little effect on the
arterioles in ischemic tissue, which are already dilated maximally by local ischemia. A major
beneficial effect is venodilation, leading to reduction in cardiac size, which decreases diastolic
fiber tension and reduces myocardial oxygen demand.
Question 1:
A 52-year-old woman is admitted to the emergency department with a history of drug treatment
for several conditions. Her serum electrolytes are found to be as follows (normal values in
parentheses):
|
Na+ 140 mEq/L (135-145) K+ 6.5 mEq/L (3.5-5.0)
Cl− 100 mEq/L (98-107) pH 7.3 (7.31-7.41)
This patient has probably been taking - ANS • spironolactone
The correct answer is E.
Explanation:
This patient is hyperkalemic and slightly acidotic. These changes are typical of a K+-sparing
diuretic such as spironolactone.
