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week 2 tutorial on quiz prep PART 2 | PharmacoPhoto | YouTubeToText
YouTube Transcript: week 2 tutorial on quiz prep PART 2
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Core Theme
This content focuses on key concepts in pharmacology, specifically drug nomenclature through suffixes, the function and regulation of cellular receptors, pharmacokinetic principles like Cmax, and drug absorption influenced by factors such as administration route and gastrointestinal motility.
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okay for the next question you're going
to need to know just five suffixes which
are the ones that I've talked about most
in module one so the question will be
worded the following are fictitious
drugs using your knowledge of drug
suffixes choose the one that for
instance would be a benzo dipene or I
may say choose the one that is a beta
blocker or the one that is a
corticosteroid or the one that is an
alpha blocker or the one that is a
proton pump inhibitor I don't want to
give you the exact question because
you'll just learn one suffix and this
way you're going to learn five suffixes
so there are five fictitious drugs
obviously if you look up a fictitious
drug you're not going to find anything
about that drug it doesn't exist so uh
remember what the generic name is it's a
shortened version of the chemical name
so for meta prolol that is an
abbreviated version of this full
chemical name and you see exactly how we
actually derive that meta prolol from
that chemical name
name
other drugs are not as straightforward
as this it they you won't find exactly
the uh the word exactly in the chemical
name but you get the point from this
example we're never going to need to to
know the chemical name but it is best to
know the generic name and normally we
learn at least one of the popular brand
names as well but it's the key portion
of the drug name that we look for to
identify drugs that we've never heard
before for instance beta
blockers uh have the suffix o lol
l and for
corticosteroids they're a bit more
difficult because corticosteroids have
different affixes and some of them come
in the middle portion of the word some
of them come as prefixes and some of
them come at the end portion known as a
suffix most of them actually come at the
end portion but like I said it's
variable and uh suffixes are actually
coming at the end portion of the
word this is an example of different
cortico steroids uh look for the pr the
aone and the court in the in a portion
of the generic name and that's going to
be a corticosteroid corticosteroids are
so diverse though that they have many
different affixes those are the most
common the pr asone and Court in the
somewhere in the
name going back to this list the zosin
is z o s i n is an alpha blocker
remember we learned that in module 2 uh
praos Saosin those are used for benign
prostatic hyperplasia they're used for
hypertension but they actually
selectively block the alpha
receptor the alpha adrenergic receptor
and what is the oprol o p r a z o l e
suffix it's a proton pump inhibitor
remember that was in module one when we
talked about them being in irreversible
inhibitor the aapam or AOL Lam is a
benzo dipine remember benzodiazapines
are like xanx and Valium they're a
medication that's used for
anxiety so there's just five different
suffixes that you need to learn and I
guarantee that one of those is going to
be in the quiz and hopefully that's
enough information for you to get in
that habit of looking for that little
snippet of the word of the drug uh name
of the generic drug name to identify
which drug class it is actually
in okay so hopefully you do uh develop
that habit uh with those five uh
examples and we'll go on to the next
question the next multiple choice
question has is this one right here it's
which of the following is incorrect
About Cellular
receptors so the first choice is when
the cellular receptor is B by the
natural liand or a drug that mimics the
natural liand that is the signal for the
cell to do
something and if you take a look at this
right here this diagram right here it's
depicted in this diagram where the liand
binds to the receptor and indeed that is
the signal for the cell to do something
when our cells start to communicate with
each other that's the very process that
we use we send out a messenger molecule
and then it's going to land on the
proper receptor on certain cells and
that's the cell that's that signal for
the cell to do something so it's our
communication Network the second choice
is cellular receptors can be increased
or decreased by the cell thereby
increasing or decreasing the number of
messages to that cell and this is
depicted in this diagram here with the insulin
insulin
receptors one of the notable examples
with respect to this has to do with the
number of opioid receptors on the cell
surfaces when we start taking opioids on
a regular basis it's part of the reason
that when somebody takes opioids for a
few weeks they become tolerant of the
opioids and they need more and because
of the fact that um we are decreasing
the number of opioid receptors on the
surface of the cell of the surface of the
the
neuron so indeed cellular receptors can
be increased or decreased by the cell
thereby increasing or decreasing the
number of messages to that
cell so that statement it was correct
and the next one the cellular receptors
that most of our drugs buy to in order
to perform their therapeutic actions are
involved in communication between other
cells or other parts of the body and
pretty much uh that's something that
we've kind of taken already that is a
correct statement there are a very few
exceptions to that rule but generally
the drug is basically acting to
communicate with the cell as it binds to the
the
receptor and statement D is most
commonly when the cellular receptor is
bound by the natural liand that results
in a confirmational change in the shape
of the receptor uh thus signaling other
actions in the cell and that one is
correct as well for instance when two
insulin molecules bind to their insulin
receptor as depicted in this picture the
protein changes shape and that change of
the shape actually is the start of a
Cascade that happens inside the
cell uh the one statement that is
missing from the PowerPoint is choose
this one if you believe that each of the
comments about cellular receptors is
correct just just remember with this one
you can get really pedantic about it and
you can get really pedantic about just
about anything in Pharmacology but
please don't think that I'm trying to
trick you in any of these questions it's
just testing your general
knowledge not your ability to pick up
pedantic little points so there's always
exceptions to the rule in medicine
nothing happens 100% of the time but
this is an introductory pharmacology unit
unit
and all of the statements in the uh
question here is uh generally correct so
if you would like to contest that answer
or any of the answers that we go through
or the uh questions within the modules
as well so there's activities in the
modules and some of the questions on the
quiz are going to be in the from the
activities if you're going to question
any of the answers to those I want you
to do it before the
quiz it is too late to contest it after
youve taken the quiz and you're
desperately trying to find some source
that actually makes it look like your
answer was correct so yeah just make
sure that you can test it before that
and we can talk about it and I'll tell
you which answer to actually put down if
it's in the
quiz now the next question is this one
here it has to to do with cmax or
concentration Max now what is cmax cmax
is the maximum or Peak serum
concentration of that a drug achieves
okay and it's kind of a standard
measurement in pharmacokinetics and it's
important to understand it because of
the fact that with the understanding of
that you're going to understand why one
type of administration is chosen over
another uh important safety issues about
for instance um U drug that are going to
be administered via the lungs or drugs
that are administered by IV and so forth
so it is an important concept the
question is going to go which of the
following is
incorrect and the first statement is
cmax or concentration Max is the maximum
or Peak serum concentration that a drug
achieves and of course that's is correct
that is the definition of cmax or
concentration Max it's the maximum serum
concentration that a drug achieves after
the Drug's been
administered the next statement is a
mode of administration that achieves a
very high concentration Max is going to
result in that drug being metabolized
faster in the initial stages of
metabolism so if you take a look at
these graphs here these two graphs first
of all time is on the x axis and plasma
concentration is on the Y AIS can you
tell me me which of these two would be
depicting IV or Administration by the
lungs versus which one is depicting
orally administered
drug yeah okay so the one that is on the
right the one that has a high cmax is
indeed the one that's inhaled or it
could depict the type of cax that's
evident in a
intravenously administered drug as well
uh and the one to the left actually
depicts the oral
Administration and just by looking at
the graph though look at these and say
which of those is metabolized faster in
the initial
stages you you see how quickly the one
with the higher cmax is metabolized in
comparison to the other in that first
portion and you may be thinking you know
why is the one on the left the oral
Administration such a low cmax
well when you take a medication orally
what happens is that it starts to get
absorbed and there's a whole process of
getting absorbed some of it may actually
go through the stomach some of it may go
through the intestines and um it's a
it's a longer process a much longer
process to even get absorbed and then it
goes into the liver first and that's uh
going to take some time to get
metabolized and so forth and that's the
reason you have this low cmax for an
orally administered medication and
conversely when you administer
anesthesia by
inhalation or or you inject the drug
that goes straight into the blood and it
doesn't go through the liver at all it's
goes straight into the blood and you get
that response almost immediately so the
statement a motive Administration that
achieves a very high concentration Max
is going to result in the drug being
metabolized in the fast in the initial
stages of metabolism is
correct and the next statement is there
is a greater potential for overdose side
effects and complications with the mode
of administration that gets the medicine
into the system the fastest and looking
at this graph again which of these is
most likely to have side effects and
from the graph obviously it's very
obvious the one that has the highest
concentration Max or cmax is actually
going to wind up with the greatest and
there's a number of Reason greatest side
effects there's a number of reasons for
that which we've uh taken in module
one okay and one of the other options is
intravenus Administration has a greater
cmax than oral Administration and that
one is of course correct um that that
one's obvious um and and final the final
statement is when a drug is in High
concentration it is less likely to bind
to enzymes or receptors that it's not
supposed to bind to and that one is
categorically incorrect In fact it is
the opposite a correct statement would
be when a drug is in low concentration
it is less likely to bind to receptors
or enzymes that it's not supposed to
bind to in the modules we
explained that with this example in a low
low
concentration a selective beta 2
antagonist for instance would bind only
to the beta 2 receptor but when the drug
is administered in a bit higher
concentration it starts binding to for
instance the alpha adrenergic receptors
so there's a bit of a crossover effect
um at the higher
concentrations and that additional
binding is one of the reasons that a
drug has greater side effects with
higher doses so does everybody
understand cax and the important issues
around that
concept I've got a follow-up question
about cmax but I'm going to hold off on
taking that right now I think it'll be
probably a little bit better for the two
cmax questions to be
divided uh just remember uh that brings
up a point well as I'm presenting these
to you obviously what's going to happen
is as as these are going to be in the uh
quiz is they won't be in any particular
order so you may get the 10th one that I
Pro provide to you today as being number
one in your quiz also the different
choices will be mixed up as well so
they're randomized in two separate ways
do just be prepared for that
one let's go to this next question here
and uh this one has to do with
pharmacokinetics the movement of drugs
around the body
and let's take a look at which of the
following is incorrect the very first
choice has to do with suppositories
should be placed in the lower portion of
the rectum if they're to avoid the
hepatic first
pass remember what the first pass is it
has to do with the fact that the blood
supply that goes to every cell in the
git from the middle portion of the
esophagus all the way down to the middle
portion of the rectum is going to go
through the liver first before it gets
into systemic circulation so if there's
any blood containing any nutrient or
poison from that area it's going to go
into the liver to detoxify it and that's
one of our protective
mechanisms but suppose you had a drug
that will get metabolized to an inactive
form once it goes through the liver well
that kind of drug needs to be delivered
by something other than a pill for
instance it needs to find a different
pathway and some of our drugs are made
as suppositories to do just that to
avoid the first pass the hepatic first
pass and the point of this topic is that
if you place the suppository too high
into the rectum so let's say that you're
you're placing it right here where is it
going to go first it's going to go
straight into the liver which is exactly
what we're trying to avoid doing and
therefore uh yes suppositories the the
statement suppositories should be placed
in the lower portion of the rectum if
they're to to avoid the hepatic first
pass is a correct
statement the next statement has to do
with lipophilic drugs and lipophilic
drugs often access a protein carrier
molecule so that they can be carried
through the water soluble
plasma uh lipophilic of course means fat
loving so a fat loving drugs a a fatty
drug is going to access a protein
carrier and absolutely that statement is
correct if you put a greasy pan into the
dishwater before the detergent is in all
of the oil goes to the top of the water
and it just kind of sits there doesn't
it uh and in the body we can't use a
detergent so we get those fat soluble
substances the fat soluble drugs the fat
soluble messenger molecules in the in
the body and so forth all of those fat
soluble substances are going to access a
carrier and protein carrier
molecule the the next statement is each
drug is different as to the percent of
the drug that is bound to plasma
proteins sometimes it is a high protein
binding and other times it's a low
protein binding and I'm going to take
this along with another one of the
statements uh which is not actually in
your study notes uh so you have to take
this one down only the Unbound portion
of the drug is active and it's only the
Unbound portion of the drug that can be
metabolized so both of those statements
are actually true and let's take a
example used in module one the example
that we use in module one has to do with
this drug which is 80% bound to protein
so that means 20% of it is free and that
is the 20% that can get into the cells
and be metabolized or it it I can act on
receptors or it's free to do just about
anything right but you know this other
80% is bound to proteins so this is
where some of the students actually get
unstuck because they think well if it's
bound to if 80% is bound to proteins
that 80% is never really going to get
metabolized is it but that's totally
untrue because as soon as you know this
portion a portion of this 20% over here
this free drug is as soon as this free
drug is bound to a receptor or something
it it leaves a little bit of room for
something to dissociate from the protein
so another one of the particles of drugs
is going to dissociate from the proteins
and then it's free to do its job so only
the Unbound portion of the drug is going
to be metabolized and that means that a
drug which is highly bound to proteins
may take a bit longer to get out of this
system it's kind of waiting around to be
released from the protein carrier
molecules until you know the free drug
is actually bound to
something and finally The Last Choice is
obviously going to be false since every
other statement that we've taken already
is true so far there if there is a high
motility in the git drugs are going to
be absorbed faster because everything is
sped up and that one is incorrect
um a high motility actually decreases
absorption because there's an inadequate
amount of time to absorb the drug okay
is everyone happy with that and feels
like they can answer that question correctly
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