Ch 9 Therapeutic Drugs and Drugs of Abuse

Question 1

oral contraceptives

Answer 1

do not increase the risk of BC
protective effect against endometrial cancer and ovarian cancers
increased risk of venous thrombosis and pulmonary thromboembolism

Question 2

acetaminophen

Answer 2

major pathway of destruction - 95% by phase II enzymes

minor pathway - 21% CYP2E1 to NAPQ

Question 3

when acetaminophen is taken in large doses what causes the liver damage

Answer 3

unconjugated NAPQI accumulates and causes hepatocellular injury, leading to centrilobular necrosis that may progress to liver failure. The injury produced by NAPQI involves two mechanisms: (1) covalent binding to hepatic proteins, which causes damage to cellular membranes and mitochondrial dysfunction, and (2) depletion of GSH, making hepatocytes more susceptible to reactive oxygen species-induced injury.

Question 4

aspirin acute overdose

Answer 4

alkalosis due to stimulation of respiratory center followed by metabolic acidosis and accumulation of pyruvate and lactate due to uncoupling of oxidative phosphorylation and inhibition of krebs cycle

Question 5

aspirin chronic toxicity

Answer 5

headaches, dizziness, ringing in the ears, hearing impairment, mental confusion, drowsiness, nausea, vomiting, diarrhea

Question 6

cocaine

Answer 6

produces intense euphoria and stimulation
cardiovascular - tachycardia, hypertension, peripheral vasoconstriction, myocardial ischemia, arrhythmias
CNS - hyperpyrexia and seizures
Effects on pregnancy - fetal hypoxia, spontaneous abortion

Question 7

opiates (heroin)

Answer 7

CNS - euphoria, hallucinations, somnolence, sedation

most important adverse effect of heroin - sudden death, pulmonary injury, infections, skin, kidney