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Basics Flashcards

1
Q

Monitor PTT

Activates anti-thrombin III

A

Heparin

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2
Q

Warfarin antidote

A

Vit K

FFP

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3
Q

Heparin antidote

A

Protamine sulfate

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4
Q

Antidote for Organophosphate poisoning

A

Pralidoxime

First line is Atropine

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5
Q

Most important limiting factor for permeation

A

Lipid diffusion

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6
Q

Predicts rate of movement of molecules across a barrier

A

Fick’s law of diffusion

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7
Q

What molecules are more water soluble, leading to increased clearnace?

A

Ionized (charged) and polar

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8
Q

What molecules are more lipid soluble, leading to increased capacity to cross biological membranes?

A

Non-ionized (uncharged) and non polar

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9
Q

PH= pKa + log of A?/B?

A

A: Unprotonated
B: Protonated

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10
Q

Weak acid can be excreted faster by __________ the urine with __________.

A

Alkalinizing
Bicarbonate HCO3

To make ACIDIC BASIC, give BICARB

ABB

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11
Q

Weak base can be excreted faster by __________ the urine with __________.

A 
Acidifying 
Ammonium chloride (NH4Cl) or KCl

To make BASIC ACIDIC, give AMMONIUM CHLORIDE

BAA

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12
Q

Identify: Site of drug metabolism is in the gut wall, portal circulation and liver, usually noted in oral drugs

A

First Pass Effect

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13
Q

Bypasses first pass effect

A

IV
IM
Sublingual
Transdermal

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14
Q

Anticoagulants cannot be given via _____ route

A

IM

Can cause hematomas

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15
Q

Order based on superiority

Oral, IV, IM, SubCu, Buccal/Sublingual, Rectal

A 
IV
IM
SubCu
Buccal/Sublingual
Rectal
Oral
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16
Q

Partial avoidance of first pass effect in ________ route

A

Rectal

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17
Q

Which of the 3 veins of the rectum exhibits first pass effect?

A

Superior Rectal Vein

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18
Q

Order based on decreasing evaporation:

Ointment
Gel
Lotion
Cream

A

Lotion
Gel
Cream
Ointment

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19
Q

Acute inflammation of the skin:

Use drugs with Increased or decreased evaporation?

A

Increased

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20
Q

Chronic inflammation of the skin:

Use drugs with Increased or decreased evaporation?

A

Decreased

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21
Q

Can bound drugs cross membranes?

A

No
Only unbound drugs can cross
Acidic and basic drugs are BOUND

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22
Q

Drugs that are not modified by the body and continue to act until excreted

Drugs?

A

Mannitol

Lithium

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23
Q

Concentration decreases 50% for every half life
Concentration decreases exponentially
Most common

Type of elimination

A

First Order

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24
Q

Rate of elimination is constant for every half life

Concentration decreases linearly

A

Zero order

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25
Q

Drugs that display Zero Order Kinetics

WHAT PET

A 
Warfarin
Heparin
Aspirin
Tolbutamide
Phenytoin
Ethanol
Theophylline
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26
Q

In the presence of a full agonist, a ___________ agonist can act as an inhibitor

A

Partial

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27
Q

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

A

Antagonist

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28
Q

Irreversible antagonist

Not overcome by adding more agonist

A

Non-competitive

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29
Q

Reversible antagonist

Overcome by adding more agonist

A

Competitive

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30
Q

Shifts dose response curve to the right

A

Competitive antagonist

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31
Q

Shifts dose response curve to the left

A

Non-competitive antagonist

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32
Q

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

A

Physiologic antagonists

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33
Q

Reduces constituitive activity
Opposite effects are produced by the agonist

I.e. Propranolol, thyroid hormone

A

Inverse agonist

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34
Q

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

A

Chemical antagonists

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35
Q

Drugs that exhibit Tachyphylaxis

DELaMar watches CNN in HD

A 
Dobutamine
Ephedrine
LSD
Metoclopramide
Calcitonin
Nitroglycerin
Nicotine
Hydralazine
Desmopressin
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36
Q

Define: Drug input equals rate of elimination

A

Steady state

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37
Q

Number of half lives to reach steady state

38
Q

Plasma drug concentration is inversely proportional to_______

A

Vd and Clearance

39
Q

Vd is __________ proportional to half life

40
Q

Clearance is ___________ proportional to half life

41
Q

Area under the curve (AUC ) is a measure of_________

A

Bioavailability

42
Q

Clearance is __________ proportional to Maintenance dose

43
Q

Desired plasma concentration is _______ proportional to maintenance dose

44
Q

Bioavailability is ___________ proportional to maintenance dose

45
Q

Monitor PT/INR

Inhibits Vit K dependen5 factors

46
Q

Trough determinines the minimum ___________ concentration

47
Q

Peak determines the minimum ___________ concentration

48
Q

Effect of renal disease and reduced CO on drug clearance

49
Q

Phase I reactions that convert a parent drug to a more polar or water soluble product
Not highly selective of substrates

HORD

A

Hydroxylation
Oxidation
Reduction
Deamination

50
Q

75% of drugs are metabolized by Cytochrome______

A

CYP 3A4

CYP 2D6

51
Q

Phase II reactions that makes original drug more polar (water soluble) less lipid soluble
Not very selective

GAG GSM

A 
Glucuronidation
Acetylation
Glutathione conjugation
Glycine conjugation
Sulfation
Methylation
52
Q

Asians are ______ acetylators

A

Fast

Must increase drug

53
Q

Caucasians are ________ acetylators

54
Q

Cytochrome P450 inducers

A 
Ethanol
Barbiturates
Phenytoin
Rifampicin
Griseofulvin
Carbamazepine
St. John's Wort/Smoking

Ethel Booba takes PHEN-phen and Refuses Greasy Carb Shakes

55
Q

Cytochrome P450 Inhibitors

A 
Isoniazid
Sulfonamides
Cimetidine
Ketoconazole
Erythromycin
Grapefruit Juice
Quinidine
Valproic Acid
Ritonavir
Amiodarone

ISO Santa Claus Kissing Every Girl, Quickly Vanishing Right After

56
Q

Class of Drugs:
Safe in pregnant human
Safe in pregnant animal

Folic acid, thyroid hormone

57
Q

Class of Drugs:
No studies in pregnant human, Safe in pregnant animal
OR
Safe in pregnant human, unsafe in pregnant animal

Zidovudine

58
Q

Class of Drugs:
No studies in pregnant human, Unsafe in pregnant animal
OR No studies in both human and pregnant animals

Aspirin

59
Q

Class of Drugs:
Unsafe in pregnant human
Unsafe in pregnant animal

ACE inhibitors, Anticonvulsants

60
Q

Class of Drugs:
Unsafe in pregnant human
Unsafe in pregnant animal

Statins, OCPs, Chlomiphene, Misoprostol, High Dose Vit A
Teratogenic

61
Q

Fetal-renal damage

A

ACE inhibitors

62
Q

Neural Tube Defects

ADR of which drug?

A

Anti-epileptic drugs

63
Q

Fetal Hydantoin Syndrome

ADR of which drug?

64
Q

Neonatal hypoglycemia

ADR of which drug?

A

Oral hypoglycemic agents

65
Q

Neonatal dependence

ADR of which drug?

A

Barbiturates

66
Q

Vaginal Clear Cell AdenoCA

ADR of which drug?

A

Diethylstilbestrol (DES)

67
Q

Fetal Alcohol syndrome

ADR of which drug?

68
Q

Ebstein’s anomaly

ADR of which drug?

69
Q

Craniofacial malformations

ADR of which drug?

A

Isotretinoin

70
Q

Congenital hypothyroidism

ADR of which drug?

71
Q

Mobius sequence

ADR of which drug?

A

Misoprostol

72
Q

Cutis laxa

ADR of which drug?

A

Penicillamine

73
Q

Phocomelia

ADR of which drug?

A

Thalidomide

74
Q

IUGR

ADR of which drug?

75
Q

Tooth discoloration

ADR of which drug?

A

Tetracycline

76
Q

Ototoxicity

ADR of which drug?

A

Streptomycin

77
Q

Aplasia Cutis Congenita

ADR of which drug?

A

Methimazole

78
Q

Kernicterus

ADR of which drug?

A

Sulfonamides

79
Q

Cartilage damage

ADR of which drug?

A

Fluoroquinolones

80
Q

Chondrodysplasia

ADR of which drug?

A

Warfarin 1st trimester

81
Q

CNS malformations

ADR of which drug?

A

Warfarin 2nd trimester

82
Q

Bleeding diatheses

ADR of which drug?

A

Warfarin 3rd trimester

83
Q

In vitro test for mutagenicity

84
Q

In vivo mutagenicity test in mice

A

Dominant lethal test

85
Q

Preclinical data up to proposal for clinical trials

A

Investigational New Drug

86
Q

Includes preclinical and clinical testing

Request for approval of general marketing of drug for prescription use

A

New Drug Application

87
Q

Phases of Drug Trial:
Among normal human volunteers (25-50)
Is it safe?

A

Phase I Trial

88
Q

Phases of Drug Trial:
Among volunteers with target disease (100-300)
Is it effective?

A

Phase II Trial

89
Q

Phases of Drug Trial:
Among many patients and clinicians (1000-5000)
Compare with older therapies and discover toxicities

A

Phase III Trial

90
Q

Detects infrequent toxicities

Post-marketing surveillance

A

Phase IV Trial

91
Q

Drug for a rare disease, affecting fewer than 1 every 200,000 people

A

Orphan drug

110
Q

Safe range between the minimum therapeutic concentration and minimum toxic concentration of a drug

A

Therapeutic window

Pharmacology by THer (31 decks)

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