Professional Documents
Culture Documents
Spring 2011
By Rho Chi Pharmaceutical Honor Society
In order to facilitate preparation for your upcoming Milestone Exam, the Rho Chi
Pharmaceutical Honor Society has attempted to compile fundamental information and
topics that are likelyto appear ontheexam. However,the followingreview should be
usedasstudyaidratherthanaonestopreferenceforallmaterialcoveredduringyour
P1year.ToensuresuccessontheMilestoneExam,usethefollowinglearningobjectives
as a guide to your studies but always consult your notes or textbooks for indepth
explanationsandclarifications.
GOODLUCK!
Study Strategies
1.
2.
Focus on one subject at a time. Rather than studying Anatomys first test material one
day, Medicinal Chemistrys first test material the second, Biochemistrys first test
material the third (and so on), finish one courses workload before moving on to the next.
Many of the concepts presented early in the class notes can be clarified by specific
examples later on the semesters notes.
3.
Pace yourself. Devote one week to each course. That way, you can spread the review
material for the corresponding course over several days rather than losing an entire day of
summer vacation by cramming. Remember: cramming does not ensure long-term recall
of the information!
4.
Refer to your class notes. Use the following compilation of objectives as a study guide
instead of a tutor. If further information or explanation is needed concerning a topic, the
best place to look is your class notes. After all, Milestone Exam questions are submitted
by professors; their respective lecture slides and/or handouts are fundamental to gaining
insight to their idea of key concepts for the course.
5.
Collaborate with friends. If the learning objectives, your own notes, and pharmacy
references are not helpful, ask a classmate. Everybody learns in different ways so perhaps
learning the concept from a new perspective will help resolve any confusion.
6.
Dont stress. The Milestone Exam was created to ensure that pharmacy students acquire
essential knowledge during each year of pharmacy school. You passed your first year
(hopefully with flying colors), so you must have put in the effort to learn the material for
each course the first time around. This summer will just serve as a refresher of the
knowledge you already have!
Table of Contents
5-6
7-10
11-15
16-19
20-24
25-28
29-38
39-40
41
42-46
47
48
49-56
57-58
59-61
62-66
67
68-71
72-76
Describe and define in detail the anatomy and physiology of the cardiovascular system
with a focus upon cardiac electrophysiology and hemodynamics (at both the organ and
systems levels).
Establish a theoretical knowledge base for a better understanding of human anatomy
and physiology in preparation for the Doctor of Pharmacy career in the context of lifelong learning.
Detailed and specific learning objectives for each topic are found in the textbook and
study guides provided by the instructor.
8. Arrhythmias can be broadly differentiated on the basis of the cell type involved those
involving FAST versus SLOW tissue. Please choose the following pairs which correctly
describe conditions which are most likely to cause an arrhythmia in FAST and SLOW
tissue, respectively.
A. reduced inactivation of Na+ channels in ventricular muscle, reduced activation of
delayed-rectifier K+ channels in AV node.
B. enhanced inactivation of Na+ channels in SA node, enhanced activation of delayedrectifier K+ channels in AV node.
C. reduced inactivation of Na+ channels in ventricular muscle, enhanced activation of
delayed-rectifier K+ channels in HIS/Purkinjie fibers.
D. enhanced inactivation of Na+ channels in ventricular muscle, reduced activation of
delayed-rectifier K+ channels in atrial muscle.
E. reduced inactivation of Na+ channels in ventricular muscle, reduced activation of
delayed-rectifier K+ channels in ventricular muscle.
9. Which of the following lists the answers in the correct order?
The heart rate is calculated from the _____; the time required to complete ventricular
activation is derived from the _______ whereas the _____ indicates the entire time of
hemodynamic systole; and the time required for a normal SA heart beat to reach the
ventricles from its point of initiation is due mainly to the time indicated by the ______.
A. PP interval, QRS interval, QT interval, PR interval
B. PR interval, PP interval, QRS interval, QT interval
C. PR interval, QRS interval, QT interval, PP interval
D. PP interval, QT interval, QRS interval, PR interval
E. PP interval, PR interval, QRS interval, QT interval
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11
Lectures #6-7
The structure and properties of myoglobin and hemoglobin, heme chemistry, behavior of
iron with oxygen, oxygen binding to myoglobin and hemoglobin, interpretation of
oxygen binding curves, implications of curves and properties of myoglobin and
hemoglobin for oxygen transport, cooperativity, and structural basis for cooperativity (T
and R states). Definition, role, and effects of allosteric regulators, (e.g., 2,3-bisphosphoD-glycerate, protons, carbon dioxide), on adult and fetal hemoglobin and structural basis
for the effects. Understand the Bohr effect, the molecular basis for it, and the
implications. Understand what Sickle Cell Anemia is, the molecular basis, and the
implications.
Lecture #8
Know what an enzyme is and the importance of enzymes to Pharmacy and drugs. Know
the basics of enzymatic catalysis, general concepts, terminology, and properties of
enzymes, specificity, and how enzymes work (in general).
Lecture #9-10
Know/understand the basics of enzyme kinetics, the Michaelis-Menten equation, terms,
implications, general observations (on the plot), and the importance, relevance, and
interpretation of the equation and terminology, the definition of the kinetic parameters
(Km, kcat, kcat/Km) and their importance.
Definition of an enzyme inhibitor, its role and importance, definition and difference between
reversible and irreversible inhibitors, competitive and non-competitive inhibition, the
meaning and relevance of Ki, Lineweaver-Burke plots and interpretations, and examples
of the different types of inhibitors. Know the mechanism of penicillin.
Lectures #10-12
Know the definition of a protease and the importance of proteases to pharmacy, the
characteristics/properties and mechanisms (arrow pushing) of serine proteases and
hydrolases (acetylcholinesterase and b-lactamases), cysteine proteases, metalloproteases
(angiotensin converting enzyme), and aspartic proteases (HIV protease). Know the
structural basis of specificity for proteases and the mechanism of inhibition of DIPF,
nerve gases, augmentin, captopril/ACE inhibitors, and HIV protease inhibitors. For all,
know the relevance and importance to pharmacy.
Lecture #13
Know the importance/significance of regulatory strategies and key strategies
(phosphorylation, zymogen activation) and examples (digestive enzymes and blood
clotting). Know the role of protease inhibitors (also a regulatory strategy) and examples
(a-antitrypsin and emphysema).
Lectures #13-14
Know the distinction between the two classes of vitamins (water-soluble vs lipid soluble)
and the distinguishing properties.
12
For the water-soluble vitamins know the vitamin, coenzyme (if relevant), potential
disease (if deficient and relevant), biochemical role and mechanism of action for this role
(if relevant). At a minimum, thiamine, riboflavin, niacin, pantothenic acid, and
pyridoxine will be covered. The other water-soluble vitamins may not be covered.
Know the important structural features, as indicated in class.
For the lipid-soluble vitamins know the vitamin, coenzyme (if relevant), potential disease
(if deficient and relevant), biochemical role and mechanism of action for this role (if
relevant). The lipid-soluble vitamins may not be covered. Know the important structural
features, as indicated in class.
Lecture #14-15
The classification, nomenclature, and chemistry of mono-, di-, and polysaccharides
including reducing sugars and the reaction of glucose with proteins (Amadori
rearrangement and advanced glycation products). Know the distinction between reducing
and non-reducing end of a sugar. Know the glycosidic bond and the basis for lactose
intolerance, and structure of sucralose (Splenda). For all, know the important structural
features, as indicated in class.
Lectures #16-17
Know the structures of ATP and other phosphorylated compounds (if covered) and the
electron carriers, NAD+ and FAD, as indicated in class. Understand the structural basis
for the hydrolysis of ATP and importance of ATP and phosphorylated compounds.
Know the 10 reactions of glycolysis (and location), the key features of each reaction and of
each of the three stages, and understand the overall logic and relevance to various
conditions/diseases. Know the mechanism of aldolase and the mechanism and
importance of the glyceraldehyde 3-phosphate dehydrogenase reaction, fates of pyruvate,
and the energy yield (aerobic vs anaerobic) and the implications of the yield for various
diseases/conditions and drug design. Know the important structural features of the
glycolytic intermediates, as indicated in class.
Know/understand how glycolysis is regulated at the enzyme and hormone levels, the roles of
Insulin vs Glucagon, and the effects of low carbohydrate diets and diabetes on regulation.
Lecture #18-19
Know the location and significance of the Pyruvate Dehydrogenase reaction and the eight
reactions of the Citric Acid (Krebs) Cycle, the mechanism and importance of citrate
synthase, aconitase, and isocitrate dehydrogenase, and the regulation of the cycle. Know
the importance of the cycle in terms of energy production and the production of
biosynthetic precursors. Know how the cycle fits into the overall scheme of metabolism
(including oxidative phosphorylation).
13
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15
B.
C.
In the histidine buffer solution at pH 6.5, the side chain is mostly charged.
D.
The percentage of conjugate base for histidine (ignoring functional groups other
than the side chain) at pH 5 is about 90.9%.
2. Absorption of food in the stomach and intestine depends on the ability of molecules to
penetrate the cell membranes and pass into the bloodstream. Because hydrophobic
molecules are more likely to be absorbed than hydrophilic or charged molecules, the
absorption of orally administered drugs may depend on their pKa values and the pH in
the digestive organs. Using a pKa of 3.5 for the ionizable carboxyl group of aspirin
which of the following statements is/are TRUE?
A.
B.
C.
D.
16
A.
B.
C.
D.
glucose is converted to lactate in the muscles and this lactate returns to the liver
where it is converted to glucose.
B.
C.
glucose is converted to pyruvate in the muscles and this pyruvate returns to the
liver where it is converted to glucose.
D.
5. Pyruvate
A.
B.
can be converted to lactate under anaerobic conditions. At the same time, NAD is
converted to NADH (+ H+), which is a critical requirement for the glyceraldehyde3-phosphate dehydrogenase reaction
C.
D.
6. A patient has a Vitamin B12 deficiency. Assuming the patient is taking adequate amounts of
all other vitamins, the Vitamin B12 deficiency is likely to lead to
A.
B.
C.
D.
17
CHOH
CH2
CHOH
O
O
P
O
CH2
A.
B.
C.
D.
B.
C.
D.
9. Plasmodium falciparum, the parasite that causes malaria, slightly decreases the pH of the
blood cells it infects. Why does this decrease in pH cause these blood cells to sickle in
patients with the sickle cell mutation of hemoglobin (HbS)?
CO2
A.
B.
The lower pH favors the deoxy form, which causes HbS polymerization and
subsequent sickling.
C.
The lower pH facilitates the release of oxygen from HbS. The increased oxygen
pressure causes HbS polymerization and subsequent sickling.
D.
The lower pH increases the CO2 levels in the blood, which causes HbS
polymerization and subsequent sickling.
18
10. As blood glucose rises after a meal, the rate of glucose uptake by liver cells increases
proportionately, whereas the rate of uptake by muscle cells levels off. Why?
A.
B.
C.
D. The chemical properties of glucose make it more difficult to get into muscle cells.
11. Inhibitors of acetylcholinesterase, such as edrophonium (below), can be used to treat
Alzheimers disease. The substrate for acetylcholinesterase, acetylcholine, is also shown
below. Which of the following statement(s) is/are true about these compounds?
A.
B.
C.
D.
12. An enzyme recognizes only the a-anomer of glucose as a substrate and converts it to
product. If the enzyme is added to a mixture of the a- and b-anomers, why are all the
sugar molecules eventually converted to product?
A. The a- and b-anomers are in equilibrium. Depletion of the a-anomer will cause
more of the b-anomer to convert to the a-anomer.
B.
The enzyme changes the equilibrium constant for the a- and b-anomers. Depletion
of the a-anomer will cause more of the b-anomer to convert to the a-anomer.
C.
The enzyme increases the energy of activation for the b-anomer so that the
enzyme can now recognize the b-anomer.
D.
The enzyme decreases the energy of activation for the b-anomer so that the
enzyme can now recognize the b-anomer.
19
20
21
o Genetics
o Environmental
o Drug-Drug Interaction
6. Transport of Drugs Across Biological Membranes
Membrane Structure and Composition
o Davson-Danieli Model
o Singer-Nicolson Model
o Intrinsic, Extrinsic Proteins, Cholesterol, Glycolipids, and oigosacharides
o Fusogenic Peptides
Transport Mechanisms
o Ficks Law and Passive Diffusion
o Facilitated Diffusion
o Active Transport
o Vesicular Transport
Pinocytosis
Phagocytosis
Exocytosis
o Solvent Drag
o Pore Filtration
o Ion-Pair Formation
Role of Intestinal Transporters in Drug Absorption
o Absorption and Exsorption
Apical Transporters Organic Anions and Cations
The ABC (ATP- binding cassette proteins), Pgp (for lipophilic
compounds), MRP2 (for drug Conjugates), BCRP
7. Physiological Variables In The GI Tract Relevant to Drug Absorption
pH
Complexation
Transit time
Bile Components
Luminal and Brush Border Enzymes
Absorbing Capacity of the Epithelia
8. Hormonal and Anatomical Variables in The GI Tract Relevant To Drug Absorption
Basal Secretion
Prandial Secretion
Cephalic Phase
Gastric Phase
Chemical Agents
Stomach Emptying
Functional Types Of Movements In the GI Tract
o Mixing Movements
o Propulsive Movements
22
23
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Describe the basic reasons why the study of metabolism is important from the
pharmaceutical perspective.
Describe the major possible consequences of metabolism related to therapeutic activity
(bioinactivation, bioactivation, detoxification, and toxification) and give an example of
each.
Describe the role of metabolism in prodrug design.
Describe the metabolic basis of potential drug-drug interactions and give two specific
examples.
Describe the importance of sterochemistry in metabolism (both in terms of substrate and
product stereoselectivity).
Describe (in general terms) how medicinal chemists systematically modify drug structure
to control metabolism.
Differentiate phase-1 and phase-2 metabolism from the standpoint of functional group
involvement and the polarity consequences.
Describe the location and involvement of the major organs involved in drug metabolism.
Differentiate the importance of the liver relative to the other organs (quantitatively and
qualitatively).
3. Phase 1 Reactions
4. Phase 2 Reactions
25
Describe the mechanism of arly sulfate formation, and the functional groups potentially
involved.
Describe the mechanism by which glutathione inactivates biologically-derived
electrophiles. Describe this role in terms of detoxification, and the implications of
glutathione depletion.
Describe the major factors that affect drug metabolism positively or negatively.
Using model therapeutic agents, be able to describe whether each of these factors would
be expected to increase or decrease drug metabolism, and what the therapeutic &
toxicological consequences would be in each case.
Based on your understanding of P-450 isoforms, clearly distinguish between an isoform
and an isozyme.
Based on your understanding of P-450 isoform biology, predict instances in which one
drug (or nutrient) would impact (positively or negatively) the metabolism of another
drug.
Define pharmacogenomics. Explain why genetic differences in drug metabolism (in
particular), drug transport, and drug receptor formation influence drug action.
Based on the chemical structure of a drug molecule (i.e., the functional groups
present), predict logical pathways for metabolism of that drug?
Explain how changes in metabolic pathways (e.g., induction, inhibition) can impact
the therapeutic activity, toxicity, and/or drug interactions.
Explain how genetic differences in drug metabolism result in predictable differences
in drug response.
26
27
o
o
o
o
o
o
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29
A.
D.
B.
E.
C.
Learning Objective:
Be able to identify and employ a Craig plot to dissect electronic and
lipophillic/hydrophilic contributions of substituents to biological activity.
Question: The following series of compounds were tested for their ability inhibit thrombin,
and the results, reported as the concentration required for one-half maximal inhibition
(IC50) appear in the table below. Based upon this data, what can you conclude about the
role of the R substituent on thrombin inhibition. You may want to refer to the Craig Plot
shown at the end of this question to answer this question.
R=
Cl
IC50
1 M
30
H
Me
tBu
OMe
A.
B.
C.
D.
E.
10 M
1 M
0.05 M
10 M
The role of the R substituent is primarily electronic the more electron withdrawing the
R substituent, the tighter the receptor binding.
The role of the R substituent is primarily electronic the more electron donating the R
substitutent, the tighter the receptor binding.
The role of the R substituent is primarily lipophilic the more lipophilic the R
substituent, the tighter the receptor binding.
The role of the R substituent is primarily hydrophilic the more hydrophilic the R
substituent, the tighter the receptor binding.
The role of the R substituent is neither electronic nor lipophilic/hydrophilic.
31
The use of St. Johns Wort in this patient without adjusting any doses may result in much
more profound immunosuppression (with resultant bone marrow destruction).
Enhanced metabolism of hyperforin (in St. Johns Wort) may result in inadequate
treatment of his depression.
The use of St. Johns Wort in this patient without adjusting any doses may result in liver
rejection.
Decreased metabolism of hyperforin (in St. Johns Wort) may result in hyperforin
toxicity.
There really isnt a problem here since other P450 isoforms will probably metabolize
cyclosporin.
Learning Objective:
Based on the chemical structure of a drug molecule (i.e., the functional groups
present), predict logical pathways for metabolism of that drug.
Question: For the pathways shown below, all of the following are acceptable (possible)
except:
32
A.
B.
C.
D.
E.
Pathway I
Pathway II.
Pathway VII.
Pathway VIII.
All four pathways listed above (I, II, VII, VIII) are possible.
Learning Objective:
Explain how genetic differences in drug metabolism result in predictable differences
in drug response.
Question: S-Mephenytoin (shown below) is an anticonvulsant that shows sedation as a
potential side effect. This drug is metabolized primarily by CYP2C19 to inactive
products.
There are significant polymorphisms associated with CYP2C19. For example, ~20% of
subjects of Southeast Asian descent are poor metabolizers based on their inability to
produce active enzyme in sufficient quantities.
Mrs. Nguyen (an immigrant from Viet Nam) is your patient; she is currently stabilized on a
standard dosing regimen (standard dose and time) with mephenytoin in the treatment of
her epilepsy. She is now going to start taking the fluoxetine to treat her depression.
Fluoxetine is a potent inhibitor of CYP2C19. What are your concerns?
A.
B.
C.
D.
E.
33
Learning Objective:
Be able to show the flow of electrons (push arrows) for common chemical reactions
in medicinal chemistry, including: ester/amide hydrolysis, the NIH-shift,
aldol/retro-aldol reactions, biotin-dependent enzymes, and PLP-dependent enzymes.
Question: Which of the following best represents the flow of electrons (arrow pushing) for the
N-formylation reaction shown?
A.
B.
34
C.
D.
Learning Objective:
Be able to apply the CIP nomenclature system to describe the stereochemistry of
drug molecules.
Question: Describe the correct stereochemical descriptors to the hydrogens labeled A and
B in the structure of valacycloriv below?
A.
B.
A.
B.
C.
D.
E.
Trichlrorethanol has the higher LogPo based on Hansch p values, and therefore the faster
onset of action.
Ethchlorvynol has the higher LogPo based on Hansch p values, and therefore the faster
onset of action.
Both trichloroethanol and ethchlorvynol have similar LogPo based on Hansch p values
(within 0.5 units), and therefore similar onset of action.
Both trichloroethanol and ethchlorvynol have similar LogPo based on Hansch p values
(within 0.5 units), but ethchlorvynol, being branched, is predicted to be less lipophillic
and have slower onset of action.
Both trichloroethanol and ethchlorvynol have similar LogPo based on Hansch p values
(within 0.5 units), but ethchlorvynol, being branched, is predicted be more lipophillic and
have a faster onset of action.
Learning Objective
Be able to explain the utility of produgs employing ester groups in modifying the
physiochemical properties of drugs.
Question: Valacyclovir is the L-valine ester of acyclovir (see structures below), an antiviral
agent effective against herpes viruses. Both oral acyclovir (200 mg, 5 times a day for 710 days) and oral valacyclovir (1 g, twice a day for 7-10 days) are recommended for the
treatment of initial episodes of genital herpes simplex virus (HSV-2) infection in
immunocompetent adults and adolescents. Which of the following statements best
36
describe the factors that you would consider in making a choice of oral acyclovir versus
oral valacyclovir in treating a patient suffering from genital HSV-2 infection?
A.
B.
C.
D.
E.
The different sensitivity of this particular strain of HSV-2 to these two drugs.
The different potential for the emergence of resistance to these two drugs.
The difference in the potential for patient compliance with the dosing schedule between
these two drugs
Both A and C
All of the above (A, B, and C)
Learning Objective:
Know the definitions of LogPo and LogPapp. Be able to estimate LogPo for drugs
containing the functional groups reviewed in class. Be able to explain the
significance of LogPapp in ADME.
Question: The induction period for sodium salts of barbiturates is attributed to the rapid
partitioning of the predominant solution form of these drugs in the blood, across the
blood/brain barrier and into the sites of action in the brain. This rapid partitioning is a
function of the LogPapp of these drugs: the higher the LogPapp, the more rapid the
partitioning into the brain. By predicting the LogPapp for the two barbiturates below,
predict which one will have the more rapid onset of action.
HINT1: The pKas for these two drugs are identical
HINT 2: Assume the Hansch p value for sp carbons is the same as that for sp2 carbons.
A. Methohexital has a higher LogPo than butabarbital, but a lower LogPapp, which indicates
that butabarbital has a more rapid partitioning to the brain and a shorter induction period
than methohexital.
B. Methohexital has a higher LogPo than butabarbital, and a higher LogPapp, which indicates
that methohexital has a more rapid partitioning to the brain and a shorter induction period
than butabarbital.
C. Butabarbital has the higher LogPo, but a lower LogPapp, which indicates that methohexital
has a more rapid partitioning to the brain and a shorter induction period than butabarbital.
37
D. Butabarbital has the higher LogPo, and a higher LogPapp, which indicates that butabarbital
has a more rapid partitioning to the brain and a shorter induction period than
methohexital.
E. Methohexital and butabarbital have approximately the same LogPo (within 0.5 units), and
approximately the same LogPapp, which indicates they have similar partitioning to the
brain and similar induction periods.
38
39
o electrolytes
o nonelectrolytes
PartitioningofNonElectrolytes
5.Acid/BaseEquilibria
Basicdefinitions
SolvingpHandbufferproblems
o pHandbufferproblemsinphysiology
EffectofpHonsolubilityofdrugs
EffectofpHondrugpartitioningandabsorption
6.ChemicalKinetics
Basicconcepts
Zeroorderprocesses
Firstorderprocesses
Pseudoorderprocesses
Effectoftemperatureonrateofaprocess
EffectofpHonrateofaprocess
40
41
42
Describe how a manager's assumptions about the nature of people will change their
management style.
How does Theory X and Y differ.
Apply McGregor's Theory X and Y to a management problem in a pharmacy setting.
Discuss Theory Z, Six Sigma and Balanced Scorecards and how they are applied in
pharmacy.
Motivation Theories: Maslow & Herzberg
Describe Maslow's hierarchy theory.
Given a description of an employee explain where that person would fit into Maslow's
hierarchy.
Apply Maslow's theory to a pharmacy setting.
Explain the Hawthorne studies.
Describe Herzberg's hygiene theory and apply it to a pharmacy setting.
Compare and contrast Maslow's and Herzberg's theories.
Leadership Differences Based Upon Sex-Role Orientation
Define leadership.
Define and compare the five theories of leadership.
Describe the elements of the leadership style characterized as "Androgynous Leadership."
Discuss the advantages for men and women to become androgynous leaders.
Customer Service
Explain the purpose, importance and basic facts relating to quality customer service.
Discuss the importance of quality customer service to the success of any organization.
Define quality customer service and discuss the four basic guidelines for providing it to
customers.
Explain and distinguish between external and internal customers.
Employee Performance and Evaluation
Discuss the importance to the individual employee of objective performance appraisals.
Discuss the importance and value of an objective performance appraisal system to
organizational success.
Describe the basic components, procedures and techniques utilized in conducting
performance appraisals.
Explain the three basic functions of performance appraisals.
43
Describe and explain the three "secrets" of the "One Minute Manager."
Time Management
List and explain the "Top Ten Time Eaters."
Compare and explain efficiency and effectiveness.
Explain and demonstrate the theory and application of Pareto's Principle (80/20 rule).
Identify and explain the three essential steps to planning your day.
Briefly discuss task management, a planning tool for project management.
Managing Generations
(new unit underdevelopment)
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Course Outline
INTRODUCTION Chapters 1-5
multidisciplinary development of a drug candidate
routes of drug administration
the variety of dosage forms
therapeutic considerations in dosage form design
biopharmaceutic considerations
o bioavailability and bioequivalence
current cGMP and cGCP
patents
POWDERS AND GRANULES Chapter 6
advantages - disadvantages
particle size reduction
comminution, mixing of powders
packaging
o bulk, divided powders
official powders and granules
effervescent products
CAPSULES Chapter 7
advantages disadvantages
materials
o gelatin, plasticizers, colorants, preservatives
hard gelatin capsules
o sizes and shapes
o sealing and self-locking closures
soft gelatin capsules
preparation of capsules
formulation
filling operation
o solid, semisolid, and liquid formulations
special capsules
packaging and storage
TABLETS Chapter 8 Dr. McGinity
types and classes of tablets
advantages - disadvantages
drug release from tablets in gastrointestinal tract
properties of good tablets
tablet excipients
o fillers, binders, disintegrants, glidants, lubricants, etc.
manufacturing
o single-rotary punch tablet press
o wet granulation -direct compression
50
o recompression
evaluation of tablets
o dissolution and disintegration testing
o hardness, friability
o weight and drug content uniformity
special tablets
o layered tablets
o buccal and sublingual tablets
o lozenges
o chewable tablets
o effervescent tablets
SOLUTION THEORY Chapters 5, 13
definition of a solution, solvent, solute, mole fraction, solubility and dissolution rate
dissolution - energetics
hydrogen bonding and solvation
dielectric constant
cosolvents
Factors Influencing Solubility
o salt forms of drugs and pH
o intermolecular hydrogen binding
o crystal lattice energy
o ionic strength
o polymorphism
PHARMACEUTICAL LIQUIDS Chapter 13 Dr. Williams
alcohols in water
volatile oils in water
water USP - definition of 5 grades
aromatic water
syrups, their preparation and use
miscellaneous liquid preparations
isotonic solutions
nonaqueous solutions
alcohols and ethers
spirits and elixirs
tinctures and fluid extracts
the extraction process
examples of the above
DISPERSE OF POLYPHASIC SYSTEMS Chapter 14 Dr. Williams
definitions
types of polyphasic systems: colloids, suspensions, emulsions and creams
Colloids
o distinction between a colloid and a true solution
51
52
definition of terms
internal and external emulsions
preparation of emulsions
emulsifying agents
HLB and emulsification
preservation of emulsions
examples
53
54
o
o
o
o
o
o
liposomes
nanoparticles
prodrugs
cellular drug carriers
storage and sterility
toxicity
55
RADIOPHARMACEUTICALS Chapter 18
definitions
physical half-life
radioisotopes
application
diagnostic and therapeutic
production using cyclotron and a nuclear reactor
corporation, vehicle and biodistribution moiety
56
57
58
59
RESPONSE (% of maximal)
100
60
Figure 6
40
20
0
-16 -14 -12 -10 -8 -6 -4 -2 0
LOG DRUG CONCENTRATION (M)
1.
a.
Repeat the dose-response curve with the same agonist and a lower concentration of
antagonist.
Repeat the agonist dose-response curve with the same agonist and a single concentration
of a known orthosteric antagonist.
Do the experiment over with a known high efficacy full agonist.
Determine the dose response curve with a known partial agonist in the presence and
absence of the same concentration of the antagonist.
There is no need to do any more experiments because it can be concluded that the
antagonist is orthosteric because it shifted the agonist dose response curve to the right in
a parallel manner.
b.
c.
d.
e.
80
60
2. The following two curves represent equilibrium binding data for two drugs obtained using
the same preparation of receptors. If the two drugs bind to the same receptor, which of
the following is true?
a.
b.
c.
d.
e.
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Know and understand these immune processes: Antigen Presentation to activate Tcells; Immune tolerance and autoimmune disease; Immune surveillance and immune
disease; External defenses
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A lower pO2 gradient between the alveoli and capillary blood resulting in lower
Hgb affinity for O2 in the lungs.
Respiratory acidosis
A lower pO2 gradient between the alveoli and capillary blood resulting in
lower Hgb saturation and O2 delivery to the tissues.
Metabolic alkalosis
Objective: Integrate your understanding of the immune system components into how
tolerance prevents autoimmunity.
A patient is visiting with you about an allergy attack they are having against oak pollen. They
are curious as to why they are experiencing allergies to oak pollen when they have never
had them before. What do you tell them?
(a) They are experiencing a delayed hypersensitivity response that is mediated by B cells
secreting antibodies against a harmless antigen.
(b) They are experiencing a delayed hypersensitivity response that is a T cell-mediated
immunity against a harmless antigen.
(c) They are experiencing an immediate hypersensitivity response that is a T cellmediated immunity against a harmless antigen.
(d) They are experiencing an immediate hypersensitivity response that is mediated
by B cells secreting antibodies against a harmless antigen.
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Cardiovascular I & II
Pulmonary Pathology
Renal Pathology
Metabolic Diseases
Diseases of Aging
Geriatric Clinical Pharmacology
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less, non-overlapping?
Where in the cell does protein synthesis occur?
How are amino acids activated for incorporation into proteins?
What are the structural features of tRNA and amino-acylated tRNA?
How is the fidelity of the genetic code maintained during amino-acyl tRNA synthesis?
What portion of ribosome is involved peptide bond formation catalysis.
How does protein synthesis initiate?
What features of the mRNA are recognized inbprokaryotes? In eukaryotes?
What is required for protein synthesis elongation? What is required for translation
termination?
How does puromycin work, and how can it be used to make RNA-protein chimeras?
How do antibiotic aminoglycosides and macrocyclic lactones work?
How does ricin work?
How does diptheria toxin work?
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