Placebo is
allergic drug reaction
drug form, without active substance
method for treatment of acute pain
drug tolerance
Tobacco smoking
increases drugs metabolism
decreases drug metabolism
decreases plasma concentrations of methylxanthines
doesn’ t change drugs metabolism
Nocebo effect is
Allergic drug reaction
Analgesic method
Adverse drug reaction, caused by placebo
CNS depression
When patient and doctor are aware of the contents of the formulation, the trial is defined as
open trial
blind trial
placebo trial
double-blind trial
Surrogates in rational pharmacotherapy are
clinical- laboratory indexes
instrumental investigations - ECG; EMG; MRT etc
disease improvement
decreased mortality rate
Pharmacodynamic changes in elderly are
increased sensitivity to drugs suppressing central nervous system
decreased sensitivity to drugs suppressing central nervous system
paradoxal reactions are observed
adverse drug reactions are more frequent
Steady-state plasma concentration is
blood concentration of the drug 2 hours after administration
blood concentration of the drug after repeated administration when there is a balance between absorption and excretion
blood concentration of the drug after it has been ceased
blood concentration of the drug during its absorption
Drugs half-life is an index for
the route of administration of the drug
the duration of the drug effect when there is a relationship between it and plasma concentrations
time to reach steady-state plasma concentration after repeated administration
determination of dose interval
Drugs contraindicated in the first half of pregnancy are
Erythromycin
Sex steroids
Penicillins
Oral anticoagulants
For pharmacokinetics in elderly is true
decreased excretion
decreased metabolism
decreased volume of distribution
increased volume of distribution
Reasons for inadequate pharmaceutical availability are
chronic renal failure
improper use of the drug formulation
bad quality of the drug substance
participating in treatment
Categories of ADRs are
certain
probable
possible
unlikely
Therapeutic drug monitoring is
method for neuroleptanalgesy
used when there is relationship between plasma concentrations and drug effect
used for drugs with narrow therapeutic window
used for drugs with long half- live
Irrational ready-made drug formulations contain
drugs with different half-life
drugs for ethiotropic and symptomatic treatment
drugs with narrow therapeutic window
drugs affecting different pathogenic mechanisms
First phase of clinical trial can be determinated as
first application of a new substance to healthy volunteers
first application of a new substance to patients
efficacy and safety in a large number of patients
post-marketing surveillance in thousands of patients
Binding of drugs with plasma proteins is important for
half- life
drugs interactions
bioavailabillity
the value of the pharmacological effect
Adverse drug reactions lead to
increased pharmacological effect
decreased risk of toxicity
decreased efficacy of the treatment
developement of unpredictable drug effects
Bad compliance of the patient may be due to
dose regimen with many drugs with frequent administration
a large number of drugs
lack of information for the treatment
the drug must be taken once daily
Fourth phase of clinical trial can be determinated as
Drugs clearance is
Amount of drug, that reaches systemic circulation
Blood plasma volume from which the drug is eliminated for defined period of time
Steady- state plasma concentration
Withdrawal syndrome
Monitoring of therapeutic plasma concentrations is necessary for
theophyllin
phenobarbital
carbamazepin
amoxicillin
Third phase of clinical trial can be determinated as
Clearance is an index for
drugs excretion
determination of mantaining dose of the drugs
drugs absorbtion
effects of the drugs on the heart
Pharmacogenetic differences lead to
decreased effect
increased effect
development of adverse drug reactions
avitaminosis
Drug surveillance is done by
spontaneous reporting
observation studies
family doctors
population statistics
Adverse drug reactions are the following types
augmented
bizarre
chronic
delayed
Mechanisms of drug interactions are
unpredictable
pharmacokinetic
pharmacodynamic
pharmaceutical
The quality of therapeutic decision (outcomes) can be measured by
clinical outcomes
costs — direct and indirect
functional status pf patient
overall patient satisfaction
Method of evaluation of cost/benefits ration are
cost minimization analysis
cost effectiveness analysis
cost utility analysis
cost consequence analysis
Drug metabolism involving some enzyme defects includes the following reactions
acetylation
oxidation
hydrolysis
red cells enzyme defects
The reasons for drug abuse are
relief of anxiety, tension and depression
entertainment, fun
improvement of performance in competitive sports
conformity with own social subgroup
How many types of dependence do you know?
psychological
physical (physiological)
acute
Which pharmacological drug groups cause drug dependence and tolerance?
Opioid analgesics
Antidepressants
CNS stimulants
Benzodiazepines
The neuropharmacological mechanisms of drug addiction are
activation of endogenous opiate encephalin receptors
activation of μ-opioid receptors in the brain
activation of cannabinoid receptors (CB1) in the hypothalamus
increase of glutamate release in the brain cortex
Benzodiazepine withdrawal syndrome is characterized by
it develops after 6-weeks of treatment
it develops after 2 weeks of treatment
psychological symptoms — anxiety, agitation, insomnia, seizures
physical symptoms — nausea, vomiting, muscle pain, ataxia
Opioid (heroin, morphine) withdrawal syndrome is characterized by
begins 8 hours after last dose
the peak is between 36-72 h
first physical symptoms are lacrimation, rhinorrhea and sweating
abdominal cramps, diarrhoea, bone and muscle pain, weakness and chills
Why is methadone used for treatment of opioid-dependence?
it is taken orally
it is applied intravenously
has prolonged action
has short-action
