Exam 1 Flashcards

0
Q

Antifreeze tx

A

Alcohol IV

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1
Q

not after 4 hrs or if
after 30 min since ingestion of a corrosive metal
Hydrocarbon solvents ingested
Coma, stupor, delirium or convultions are present

A

Lavage

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2
Q

Double vision, paralysis

A

Botox

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3
Q

wrist drop

A

lead

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4
Q

RBC stippling

A

lead

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5
Q

anemia and irritable

A

lead

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6
Q

Keizer… ring around cornea

A

copper

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7
Q

jaundice

A

copper

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8
Q

lung cancer

A

Asbestos

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9
Q

cherry red blood

A

CO

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10
Q

almond smell

A

cyanide

SOB

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11
Q

O2 is tx for

A

cyanide

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12
Q

Do not use lavage

A

Bleaches

Strong acids

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13
Q

metabolized by CYP450 to free radicals

A

CCl4 chloroform Carbon tetrachloride

carcinogenic

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14
Q

cirrhosis of liver

A

Arsenic

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15
Q

CO mechanism

A

greater affinity for Hb than O2
impares ability of Hb to transport O2
Carboxyhemoglobin is CHERRY RED

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16
Q

isoniazid is example of

A

PhII before Ph1

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17
Q

Phase 1

A

Modification of mol thru OXIDATION Rxns
hydroxylation or demethylation (+OH, -CH3)
enzymes attack fx’l groups
can be excreted or to PhII

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18
Q

Phase II

A

Conjugation: adds Ionized, charged group to PhI to make it more water soluble

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19
Q

Drugs with toxic metabolites

A

diazepam - nordiazepam - oxazepam
acetaminophen - N -acetyl-benzo - quinone imine

codein – morphine

20
Q

Cyt P450s

A

Ph1
microsomal and inducable
oxidation fx (form OH)
acts as HANDLE (OH) for Ph2

21
Q

inducer is ethanol,

substrate tylenol, ethanol

22
Q

Inducer is smoking and charcoal foods

substrate: tylenol, warfarin

A

1A2 cyp450

23
Q

inducer” barbituates, St. John’s wort

substrate: tylenol, advil diazepam, lidocaine

A

All 2… enzymes + 3A4

24
which impairs codeine metabolism | condeine to morphine
2D6
25
which metabolizes and induces by alcohol
2E1
26
which metabolizes > 50% drugs and has high drug interactions?
3A4
27
Glucoronyl transferase is
only Ph2 inducible and microsomal
28
inhibitor: grapefruit juice sub: tylenol, diazepam, lidocaine
3A4
29
Inhibitor: quinidine sub: codeine, (oxycodone)
2D6
30
Phase 2 rxns:
conjugate (bind) a protein to a Ph1 drug with handle (OH, SH, NH2) Most by glucoronidation and UGTs End result: lower lipid solubility, make polar and inactive, increase MW fast elimination
31
conjugation of drug with handle with glucorinic acid
UGT (transferase) catalyzes the tranferring of glucoronic acid to substrate drug Bilirubin and adrenal conticosteroids are conjugated like this
32
Rule of thumb: the smaller the Vd
The more effective the dialysis bc high plasma [ ], high binding to plasma proteins
33
Higher dose, bioavail, and half life predict
higher Css
34
Higher CL or higher Vd
Lower Css
35
High Vd
High [ ] in body and bound to peripheral tissues
36
Low Vd
High plasma [ ] and binding to plasma proteins
37
Warfarin
92% bound to plasma proteins, 8% free | add drug that displaces warfarin from proteint, increase free warfarine and increase effect
38
example of low Vd and high t1/2
warfarin
39
if increase binding to albumine
accumulates in plasma
40
Vd is
drug in body/drug in plasma | can make assumption ab drug in body by measuring plasma [ ]
41
decreased liver fx
increased bioavail of drug
42
2D6 enz metabolizes what?
condeine to morphine
43
tylenol and warfarin are metabolized by
1A2
44
tylenol and alcohol are metabolized by
2E1
45
Tylenol, DIAZEPAM, advil, lidocaine are met d by
all 2 and 3A4
46
tylenol DIAZEPAM and lidocain met d by
3A4 | grapefruit juice
47
codeine is met d into morphine by
2D6