Basics Flashcards
Monitor PTT
Activates anti-thrombin III
Heparin
Monitor PT/INR
Inhibits Vit K dependen5 factors
Warfarin
Warfarin antidote
Vit K
FFP
Heparin antidote
Protamine sulfate
Antidote for Organophosphate poisoning
Pralidoxime
First line is Atropine
Most important limiting factor for permeation
Lipid diffusion
Predicts rate of movement of molecules across a barrier
Fick’s law of diffusion
What molecules are more water soluble, leading to increased clearnace?
Ionized (charged) and polar
What molecules are more lipid soluble, leading to increased capacity to cross biological membranes?
Non-ionized (uncharged) and non polar
PH= pKa + log of A?/B?
A: Unprotonated
B: Protonated
Weak acid can be excreted faster by __________ the urine with __________.
Alkalinizing
Bicarbonate HCO3
To make ACIDIC BASIC, give BICARB
ABB
Weak base can be excreted faster by __________ the urine with __________.
Acidifying Ammonium chloride (NH4Cl) or KCl
To make BASIC ACIDIC, give AMMONIUM CHLORIDE
BAA
Identify: Site of drug metabolism is in the gut wall, portal circulation and liver, usually noted in oral drugs
First Pass Effect
Bypasses first pass effect
IV
IM
Sublingual
Transdermal
Anticoagulants cannot be given via _____ route
IM
Can cause hematomas
Order based on superiority
Oral, IV, IM, SubCu, Buccal/Sublingual, Rectal
IV IM SubCu Buccal/Sublingual Rectal Oral
Partial avoidance of first pass effect in ________ route
Rectal
Which of the 3 veins of the rectum exhibits first pass effect?
Superior Rectal Vein
Order based on decreasing evaporation:
Ointment
Gel
Lotion
Cream
Lotion
Gel
Cream
Ointment
Acute inflammation of the skin:
Use drugs with Increased or decreased evaporation?
Increased
Chronic inflammation of the skin:
Use drugs with Increased or decreased evaporation?
Decreased
Can bound drugs cross membranes?
No
Only unbound drugs can cross
Acidic and basic drugs are BOUND
Drugs that are not modified by the body and continue to act until excreted
Drugs?
Mannitol
Lithium
Concentration decreases 50% for every half life
Concentration decreases exponentially
Most common
Type of elimination
First Order
Rate of elimination is constant for every half life
Concentration decreases linearly
Zero order
Drugs that display Zero Order Kinetics
WHAT PET
Warfarin Heparin Aspirin Tolbutamide Phenytoin Ethanol Theophylline
In the presence of a full agonist, a ___________ agonist can act as an inhibitor
Partial
These do not provoke a biological response by themselves upon binding to a receptor
Blocks or dampens drug response in the presence of an agonist
Antagonist
Irreversible antagonist
Not overcome by adding more agonist
Non-competitive
Reversible antagonist
Overcome by adding more agonist
Competitive
Shifts dose response curve to the right
Competitive antagonist
Shifts dose response curve to the left
Non-competitive antagonist
Binds to a different receptor producing an effect that is opposite to the effect of the drug it is antagonizing
I.e. Histamine and epinephrine
Physiologic antagonists
Reduces constituitive activity
Opposite effects are produced by the agonist
I.e. Propranolol, thyroid hormone
Inverse agonist
Antagonist that interacts directly with the drug to remove it or prevent it from reaching its target
Doesn’t depend on interaction with agonist receptors
I.e. Dimercaprol for lead poisoning
Pralidoxime for organophosphate poisoning
Chemical antagonists
Drugs that exhibit Tachyphylaxis
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Dobutamine Ephedrine LSD Metoclopramide Calcitonin Nitroglycerin Nicotine Hydralazine Desmopressin