Otopharmacology Test 1

What does the FDA require on all medication labels?

• Name of the product

• Table of drug facts

• Active ingredients

• Proper use and purpose

• Warnings

• Directions

• Allergic reactions/harmful side effects

• Inactive ingredients

What are the drug levels/schedules?

C-I, C-II, C-III, C-IV, C-V

What determines a C-I categorization?

High potential for abuse, with no currently accepted medical use in the US. Considered dangerous when used without medical supervision

What are some examples of C-I drugs?

MDMA, ecstasy, LSD, GHB, heroin

What determines a C-II categorization?

High potential for abuse, but with some accepted medical uses in the US. Abuse leads to physical and/or psychological dependence and is considered dangerous

What are some examples of C-II drugs?

Morphine, cocaine, PCP, opium

What determines a C-III categorization?

Potential for abuse, but lower than previous categories. There are accepted medical uses, and abuse can lead to mild physical dependence or great psychological dependence

What are some examples of C-III drugs?

Ketamine, codeine, lysergic acid, anabolic steroids

What determines a C-IV categorization?

Relatively low potential for abuse. Have accepted medical uses in the US. Abuse leads to limited dependence

What are some examples of C-IV drugs?

benzodiazepines, phenobarbital

What determines a C-V categorization?

Low potential for abuse. Have accepted medical uses in the Us. Abuse may lead to limited dependence.

What are some examples for C-V drugs?

pyrovalerone, retigabine

What are the health professional guidelines for drug management?

• Access a CURRENT drug reference

• Controlled substances have to be locked securely

• Conceal and secure prescription pads at office

• Keep accurate records of controlled substances

• Keep up to date with FDA/DEA

• Establish working rapport with pharmacist

• Maintain ethical relationship with pharmaceutical reps as part of Affordable Care Act, and Sunshine act, requires reporting compensation/gifts

What are the top 10 drug classifications?

• Lipid-lowering agents

• Antidepressants

• Narcotic analgesics

• Beta-blockers

• Antihypertensives

• Diuretics

• Antidiabetics

• Antibiotics

• Proton pump inhibitors

• Anticoagulants

What do lipid lowering agents do?

Lowers low density lipoprotein (LDL) cholesterol

What do antidepressants do?

Improves symptoms of depression. Also used for anxiety and other neurological disorders

What do narcotic analgesics do?

Relieve severe pain

What do Beta blockers do?

Lowers heart rate and blood pressure

What do antihypertensives do?

Lowers blood pressure

What do diuretics do?

Increases urinary output

What do antibiotics do?

Eliminates infection

What do proton pump inhibitors do?

Decreases acidity of stomach

What do anticoagulants do?

Decreases clotting in blood

What 4 names do a drug have?

Generic, trade, chemical, and official

What is a generic drug name?

Common or general name assigned to drug by the US Adopted Name Council

Do generic names have an upper or lower case initial letter?

Lower

What is a trade drug name?

Proprietary or brand name owned by pharmaceutical company

Do trade names have an upper or lower case initial letter?

Upper

What is a chemical drug name?

The exact molecular formula of the drug

What is a official drug name?

Name of the drug as it appears in the official reference, the United States Pharmacopeia/National Formulary (USP/NF). Generally, the same as the generic name

What is tall man lettering?

Upper case lettering often used to highlight difference between confused drugs. Ex: CeleXA vs CeleBREX

Indications

List of medical conditions of diseases for which the drug is meant to be used

Actions

description of cellular changes that occur as a result of the drug (technical)

Contraindications

a list of conditions for which the drug should NOT be given

Cautions

a list of conditions or types of patients that warrant closer observations for specific side effects

Side effects/adverse reactions

a list of possible unpleasant or dangerous secondary effects, other than the desired effects

Interactions

a list of drugs or foods that may alter the effect of the drug and usually should not be given during the course of therapy

What are the routes of drug administration?

• Oral

• Digestive Tract (enteral)

• Buccal / Sublabial / Sublingual

• Respiratory Tract / Endotracheal

• Injection / Infusion (tissue or blood)

• Ophthalmologic

• Urogenital

• Rectal (enteral)

• Nasal

• Topical / Transdermal

• Otologic

What is First Pass Metabolism?

A phenomenon of drug metabolism where the concentration of a drug is greatly reduced before it reaches the systemic circulation during the process of absorption in the liver and gut wall

What are the challenges to get drugs to the inner ear?

Anatomical

• Difficult area to access

• Blood-inner ear barrier

• Limited labyrinthine artery supply

Mechanistic

• Variations in RWM permeability

• Biotherapeutic instability

• Uncontrolled drug elimination

• ·Nonspecific drug delivery

What are inner ear drug delivery approaches?

• Intratympanic injection

• Hydrogel

• CI

• Round window micro catheter

• Silverstein microwick

• Cochleostomy

• Nanoparticle

Why is active transport different than passive transport?

Active transport requires energy (ATP), whereas passive doesn’t (facilitated diffusion)

What is signal transduction?

When a receptor binds to its substrate and causes a conformational change in the receptor, this change in shape will cause it to either release something inside the cell or bind to something else inside the cell

What are the functional roles of proteins?

• Stabilization of the membrane

• Selective transport of both ions and large molecules

• Anchor the membrane to adjacent cells or substrates

• Communication

What is the cochlear protein that is a likely player when sound is converted into electrical signals?

Protocadherin-15

What’s the difference between apoptosis and necrosis?

Apoptosis is described as an active, programmed process of autonomous cellular dismantling that avoids eliciting inflammation. Necrosis has been characterized as passive, accidental cell death resulting from environmental perturbations with uncontrolled release of inflammatory cellular contents.

What do cellular adhesion molecules (CAMs) do?

Help guide white blood cells to the injured areas

What are the DNA pairs?

• A-T

• T-A

• C-G

• G-C

What protein are cilia?

Microtubules

What microfilament works with mechanical strength, phagocytosis, and motility?

Actin

Free Radical

An atom, molecule, or ion that has at least one unpaired valence electron

Pharmacokinetics describes how the body affects a specific chemical after administration through the mechanisms of absorption and distribution, metabolism, and the effects and routes of excretion. (what the body does to the drug)

Pharmacokinetics

Biochemical and physiologic effects of drugs on the human body (what a drug does to the body)

Pharmacodynamics

The range of doses at which a medication is effective without unacceptable adverse events. Drugs with a narrow TI have a narrow window between their effective doses and those at which they produce adverse toxic effects.

Therapeutic Index

The time required for a quantity (of substance) to reduce to half of its initial value

Half Life

What did the US Food, Drug, and Cosmetic Act do?

Gave authority to the FDA to oversee the safety of food, drugs, medical devices, and cosmetics

What did the Pure Food and Drug Act do?

Ban mislabeled food products, required that active ingredients be placed on the label of a drug's packaging, and that drugs could not fall below purity levels established by the United States Pharmacopeia or the National Formulary.

What did the Pediatric Rule do?

Ensure that drugs commonly used for the treatment of children are actually tested for pediatric use

What did the Controlled Substances Act do?

Established Drug Enforcement Administration (DEA), created tighter controls on some substances, and categorized drugs into 5 Levels