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88 Cards in this Set
- Front
- Back
Broadly defined as chemical substances used for the diagnosis, prevention, or treatment of disease or for the prevention of pregnancy
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Drugs
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The dose of a drug plotted against the intensity of the effect on a graph is called a _________
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Dose-response curve
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This term describes the amount of drug required to produce an effect
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Potency
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The maximum intensity of effect or response that can be produced by a drug is called the _________
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Efficacy
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The space between the axon of one nerve and the dendrite of another is called the ____
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Synapse
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These are chemicals reponsible for transporting a variety of messages across a synapse
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Neurotransmitters
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Two chemicals that work locally to increase inflammation are_____ & ____
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Histamine & Prostaglandin
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These chemicals are released from glands in the body, travel through the blood to act on receptors on cells or inside the cells
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Hormones
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The impulse that travels down a neuron is called a _____ _____ _______
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Nerve action potential
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Proteins located on or in cells that react to other proteins in the blood or at the synapse are called ____________
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Receptors
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For a drug to exert an effect it must bind to a _____site on the cell membrane
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Receptor
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A protein binds to a receptor in a ____-___-_____ fashion
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lock-and-key
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A drug that has an affinity for a receptor, combines with the receptor and produces an effect is called a/an _________
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Agonist
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A drug that counteracts the action of an agonist is called a/an ___________
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Antagonist
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A drug that has an affinity for a receptor, combines with that receptor and produces no effect is a ____________ antagonist
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Competitive
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A drug that binds to a receptor site different than the receptor for the agonists but decreases the agonist response is called a ___________antagonist
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Noncompetitive
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A drug that has an affinity for a different receptor than the agonist and acts oppositely of the agonist to reduce its response is called a/an ________antagonist
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Physiologic
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What are the proteins called that terminate the neurotransmitters response at the synapse?
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Enzymes
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The enzyme that terminates the action of acetylcholine is __________
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Acetylcholinesterase
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The cell membrane is composed primarily of a _________ bilayer
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Phospholipid
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Also present in cell membranes are ______ which can act as receptors, make up the structure of the membrane, act as pores, or help move molecules into the cell
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Proteins
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These four physicochemical properties of drugs influence their passage across biologic membranes
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Lipid solubility( more soluble passes easier), degree of ionization (nonionized passes easier), molecular size, molecular shape
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Lipid soluble substances cross the cell membrane based on the concentration differences from high to low. This is called _____________
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Simple diffusion
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Water-soluble drugs cross the cell membrane by passing through _________
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Pores
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Very small water-soluble molecules (drugs) may pass through the membrane by ___________
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Filtration
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Insulin passively carries glucose across the cell membrane. This is an example of ________ _______
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Facilitated diffusion
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Active transport of a substance from low to high concentration requires energy in the form of ______
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ATP
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These factors influence the rate of absorption of a drug.
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Lipid solubility, Ionization, Size, Shape, site of absorption, and solubility of the drug in solution
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Weak acids are more nonionized and therefore more easily absorbed in a solution with a pH that is more __________ than the acid.
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Acidic
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Weak bases are best absorbed when dissolved in a _______ solution
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Basic
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Local anesthetics (weak bases) don't work in areas where infection is present due to the ________pH of the site
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Acidic
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Release of a drug from its tablet or capsule requires these four steps
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Disruption, disintegration, dispersion, and dissolution
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Which has the quickest onset of action given orally: a tablet, capsule, or solution?
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Solution
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Absorption of the site of injection depends on these attributes.
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Solubility of the drug and blood flow at the site and whether a solution or suspension
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In the blood, drugs are found in one of these two forms.
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Bound to proteins (albumin or globulin) or Free in the plasma
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Bound drug can act as a _______ of the drug to increase it's duration of action
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Reservoir
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_________ is the mechanism by which a drug is made available at its site of action
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Distribution
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Distribution of a drug can be affected by _____.
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Size of the organ, blood flow to organ, solubility of the drug (lipid solubility, ionization, size, and shape), % plasma protein binding, and barriers (blood-brain or placenta).
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If a drug is bound to plasma proteins and another more highly bound drug is given what happens to the first drug.
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It is pushed off plasma proteins increasing free drug available and may increase it to toxic levels
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T1/2 stands for _______
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The half-life of a drug (time for 1/2 of drug to be removed from the body)
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A drug is mostly gone from the body (only 3-6% left) after ______ half-lives
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5
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To attain a steady blood concentration of a drug one must take it for _____ half-lives
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5
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What kinds of drugs are most likely to cross the blood-brain barrier?
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Nonionized, lipid-solluble drugs
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Sometimes drugs given orally are processed by the liver and sent back to the intestines via the bile to be reabsorbed. This is called ____________ circulation
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Enterohepatic
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arduous
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hard; strenuous; difficult
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Does enterohepatic circulation of a drug prolong or shorten the effect of the drug?
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Prolongs it
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The movement of a drug from the site of action to nonspecific sites of action is known as ___________
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Redistribution
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Thiopental produces rapid loss of consciousness but then the patient awakens within 3-5 minutes yet its t1/2 is 12-24 hours. Why is this?
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Thiopental produces high blood levels in the brain within 30-60seconds after injection but is rapidly redistributed to lipid containing tissues therefore decreasing blood levels rapidly to allow return of consciousness
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When the body changes a drug so it can be more easily excreted from the body this is called ______________
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Biotransformation or metabolism
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When drugs are metabolized the metabolite is generally more ____ and _____ than the parent compound
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ionized, less lipid soluble
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Name three ways drugs may be metabolized (active, inactive)?
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Active to inactive: Inactive to active: Active to active
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Phase I metabolism of drugs can occur by these three processes.
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Oxidation, reduction and hydrolysis
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Oxidation of drugs takes plase in the liver by these enzymes
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Cytochrome P-450 enzymes
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Someone who takes a drug for a long time may find it takes increasing doses or may find that other drugs also require higher than usual doses to achieve the desired effect. This is an example of _______ of the cytochrome P-450 enzyme system
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Induction
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Induction of cytochrome P-450 enzymes in patients can lead to patients requiring ever increasing dosages of a drug. This is called _____________
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Tolerance
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Phase II reactions involve conjugation with glucuronic acid, sulfuric acid, acetic acid, or an amino acid. Conjugation with glucuronic acid is called __________
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Glucuronidation
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This route of elimination of drugs from the body is the most important
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Renal excretion
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When a drug is removed from the body at a constant rate over time no matter what dose is given this is call _____-_____ kinetics
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Zero-order
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When the amount of drug removed over time is related to the concentration of the drug in the body this is called ____-____ kinetics
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First-order
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Renal elimination of drugs can occur by these three routes.
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Glomerular filtration, active tubular secretion, and passive tubular diffusion (passive reabsorption)
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Glomerular filtration of a drug depends on _____, ______, _______
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Blood pressure, size of the drug molecule, and plasma protein biniding of the drug
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What types of drugs are most likely to be reabsorbed by the kidney tubules? (ionized vs unionize, lipid solubility)
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nonionized and lipid soluble will be reabsorbed
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Weak acids are excreted more rapidly with _______ urine due to the acid in the tubules being more ionized/less lipid soluble
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Alkaline
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Gases used in anesthesia are primarily eliminated by this route.
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The lungs
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Drugs that go from the liver and end up in the duodenum of the small intestine are said to undergo ________ excretion
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Biliary
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Name two minor routes of drug elimination of which one may concern nursing mothers
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Sweat and breast milk
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Drug elimination via saliva relies on the _______ of the drug
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Lipid solubility, ionization
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Tetracycline is used in periodontal disease because it tends to be concentrated in this area
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The gingival crevicular fluid
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The time it takes for a drug to begin to have its effect is the _______
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Onset
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The length of a drugs effect
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Duration
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Drugs can be administered by these two routes
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Enteral or parenteral
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Parenteral administration includes these routes
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IM, IV, SQ, ID, inhalation, intrathecal, intra-articular, and topical
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Safest, least expensive, and most convenient route of drug administration
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Oral
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Disadvantages of oral administration of drugs
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Slower onset, less predictable blood levels
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A drug given orally may be largely metabolized on its way through the liver via the portal venous system. This is called the _____-_______ effect
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First-pass
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A drug that has a high first-pass effect would require what kind of dose compared to giving that drug parenterally
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A higher dose would be required due to the removal of a large portion of the dose by the liver
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What kinds of conditions may alter blood levels of drugs administered orally?
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Food in stomach, GI diseases, gastric acidity, and enterohepatic circulation
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Suppositories, creams or enemas can be administered by this route
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Rectal
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The most rapid drug response with almost immediate onset of action is obtained with ______ administration of a drug
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Intravenous (IV)
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IM injections are generally given in the ______ region or the ______ region
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Deltoid, gluteal
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TB skin test is administered by this route
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Intradermal (ID)
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Peritoneal dialysis administers dialysate via this route
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Intraperitoneal
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What types of drug forms may be given by the inhalation route
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Microcrystalline, liquid, or powdered
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Examples of the topical route of administration include _____, _____, and ______
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Skin, oral mucosa, sublingually
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An example of a subgingival gel is __________
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Doxycycline gel (Atridox)
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This dosage form of drugs is most often given orally to children
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Liquid form (solution or suspension)
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Factors that alter drug effects are:
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Patient compliance, physiologic factors, tolerance, pathologic state, time of administration, route of administration, sex, genetic variation, drug interactions, age/weight, environment, and patient provider interactions
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A pill given to a patient that looks like an active agent but contains nothing but sugar is called a _________
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Placebo
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