Chapter 7 - Medicines and Pharmacology

Question 2

Requirement for skin absorption?

Answer 2

Lipid solubility through the epidermis

Question 3

Requirement for CSF absorption?

Answer 3

Nonionized, lipid-soluble drugs

Question 4

Sulfonamides will do what in newborns?

Answer 4

Displace unconjugated bilirubin

Question 5

What is 0 order kinetics?

Answer 5

Constant amount of drug is eliminated regardless of dose

Question 6

What is 1st order kinetics?

Answer 6

Drug eliminated proportional to dose

Question 7

How many half-lives for a drug to reach steady state?

Answer 7

5

Question 8

Where are tetracycline and heavy metals stored?

Answer 8

In bone

Question 9

Volume of distribution is equal to what?

Answer 9

Amnt of drug in the body divided by amnt of drug in plasma or blood

Question 10

High volume of distribution means what?

Answer 10

Higher concentrations in the extravascular compartment compared with intravascular concentrations

Question 11

What is bioavailability?

Answer 11

Fraction of unchanged drug reaching the systemic circulation; 100% for IV drugs

Question 12

What is ED50?

Answer 12

Drug level at which desired effect occurs in 50% of patients

Question 13

What is LD50?

Answer 13

Drug level at which death occurs in 50% of patients

Question 14

What is tachyphylaxis?

Answer 14

Tolerance after only a few doses

Question 15

What is potency?

Answer 15

Dose required for effect

Question 16

What is efficacy?

Answer 16

Ability to achieve result without untoward effect

Question 17

What is Phase I of microsomal drug metabolism?

Answer 17

Demethylation, oxidation, reduction, hydrolysis reaction (requries NADPH/O2)

Question 18

What is Phase II of microsomal drug metabolism?

Answer 18

Glucuronic acid (#1) and sulfates attached (forms water-soluble metabolite)

Question 19

Inhibitors of P-450?

Answer 19

Cimetidine, isoniazid, ketoconazole, erythromycin, Cipro, Flagyl, allopurinol, verapamil, amiodarone, MAOIs, disulfiram

Question 20

Inducers of P-450?

Answer 20

Cruciform vegetables, ETOH, insecticides, cigarette smoke, phenobarbital, dilantin, theophylline, warfarin

Question 21

Most important organ for eliminating most drugs?

Answer 21

Kidney

Question 22

How are polar (ionized) drugs eliminated?

Answer 22

More water soluble, more likely to be eliminated in unaltered form

Question 23

How are nonpolar (nonionized) drugs eliminated?

Answer 23

More fat soluble, more likely to be metabolized before excretion

Question 24

What causes gout?

Answer 24

Uric acid buildup; end product of purine metabolism

Question 25

Colchicine MOA?

Answer 25

Anti-inflammatory; binds tubulin, inhibits migration

Question 26

Allopurinol MOA?

Answer 26

Xanthine oxidase inhibitor, blocks uric acid formation from xanthine

Question 27

Probenecid MOA?

Answer 27

Increases renal secretion of uric acid

Question 28

Side effect of cholestyramine?

Answer 28

Can bind Vit K and cause bleeding tendency

Question 29

Side effect of HMG-CoA reductase inhibitors?

Answer 29

Liver dysfunction, rhabdo

Question 30

Side effect of niacin?

Answer 30

Flushing (Tx: ASA)

Question 31

Side effect of promethazine?

Answer 31

Tardive dyskinesia (inhibits dopamine receptors); Tx: Benadryl

Question 32

Metoclopramide MOA?

Answer 32

Dopamine receptor blocker, used to increase gastric/gut motility

Question 33

Ondansetron MOA?

Answer 33

Serotonin receptor inhibitor

Question 34

Digoxin MOA?

Answer 34

Inhibits Na/K ATPase and increases myocardial calcium; increases atrial contraction rate but slows AV conduction

Question 35

Side effects of digoxin?

Answer 35

Decreased blood flow to intestines, has been implicated in causing mesenteric ischemia; hypokalemia, increases sensitivity of heart to digitalis causing arrhythmias/AV block; visual changes (yellow hue), fatigue

Question 36

Adenosine MOA?

Answer 36

Transient interruption of the AV node

Question 37

Side effects of procainamide?

Answer 37

Lupus-like syndrome, pulmonary fibrosis, torsades (follow drug levels and QT intervals, torsades treated w/ Mg2+)

Question 38

What is the best single agent shown to reduce mortality in pts with CHF?

Answer 38

ACE-I

Question 39

When can ACE-I precipitate renal failure?

Answer 39

In pts with renal artery stenosis

Question 40

What medication can reduce the risk of MI and a-fib post-op?

Answer 40

Beta-blockers

Question 41

Atropine MOA?

Answer 41

ACh antagonist; increases heart rate

Question 42

Leuprolide MOA?

Answer 42

Analogue of GnRH and LHRH; inhibits release of LH and FSH from pituitary when given continuously (paradoxic effect)

Question 43

Vasopressin MOA?

Answer 43

Acts on V-1 receptors found on vascular smooth muscle causing constriction

Question 44

Indomethacin MOA and uses?

Answer 44

Inhibits prostaglandin production; used to close PDA in children and used in pts with gout

Question 45

Misoprostol MOA and uses?

Answer 45

PGE1 derivative; protective prostaglandin used to prevent PUD

Question 46

Mechanism of ulcer formation in patients on NSAIDs?

Answer 46

Inhibits prostaglandin synthesis and leads to decreased mucus and HCO3- secretion and increases acid production

Question 47

Haldol side effect?

Answer 47

Extrapyramidal manifestations

Question 48

Symptoms of ASA poisoning?

Answer 48

Tinnitus, headaches, nausea, vomiting; 1st respiratory alkalosis, 2nd metabolic acidosis

Question 49

Side effect of gadolinium?

Answer 49

Nausea