1. Chylomicrons 2. VLDL 3. LDL 4. HDL

Final Drugs and Diseases Flashcards by Astan Kamissoko

Pellagra is the deficiency of …

niacin (vitamin B3)

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Niacin is an important precursor for ___

NAD+ and NADP+

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Niacin is vitamin __

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Which disease state causes pts to have rough skin and the 3D’s ( dermatitis, dementia and diarrhea)?

Pellagra

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If a person has a deficiency in transferring hydride ions (H-) they will get what disease?

Pellagra

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NAD+ plus H+ plus 2e-&raquo_space; NADH
NADP+ plus H+ plus 2e-&raquo_space; NADPH
These equation shows the transfer of _____

hydride ions

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FAD plus 2H+ plus 2 electrons&raquo_space;> FADH2
This equation shows the transfer of ___

hydrogen atoms

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Ariboflavinosis is the deficiency in ____

Riboflavin (vitamin B2)

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Riboflavin is vitamin __

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If a person has a deficiency in transferring hydrogen atoms, they will get what disease?

Ariboflavinosis

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Which disease state causes pts to have angular cheilitis, itchy eyes, light sensitivity, dermatitis around mouth and anemia?

Ariboflavinosis

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What mitochondrial mutation result in a rare form of diabetes?

defect in oxidative phosphorylation

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Defect in oxidative phosphorylation result in what in the rare form of diabetes?

Low ATP in the cell therefore causing insulin NOT to be released

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T/F High ω-6 to ω-3 fatty acids lead to cardiovascular disease.

True

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Essential fatty acids include

omega 6 and omega 3

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Omega __ : Linoleate 18:2 →Arachidonate 20:4 (AA)

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Omega __ : Linoleate 18:2 → a- Linoleate 18:3 (fish oils) →Eicosapentaenoic acid (EPA) 20:5 → Docosahexaenoic acid (DHA)
22:6

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What insulin sensitizers decrease insulin resistance, a phenomenon that occurs with high blood levels of free fatty acids which causes obesity in type 2 diabetes?

Thiazolidinediones such as Rosiglitazone (Avandia) and Pioglitazone (Actos)

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MOA of Thiazolidinediones

They stimulate PPARy which regulates gene expression such as PEPCK
and other systems like GLUT-4, a glucose transporter in fat cells.

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What type of drugs lower cholesterol?

Statins

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MOA of statins

inhibits HMG-CoA
reductase that forms mevalonate

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Examples of statins

lovastatin (mevacor) and rosuvastatin (crestor)

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4 major lipoproteins

Chylomicrons
VLDL
LDL
HDL

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function of lipoproteins

transport TG (triglycerides) and cholesterol from one tissue to another

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where are chylomicrons synthesized?

intestines

where is VLDL synthesized?

liver

where is LDL synthesized?

liver and blood (highest amount of cholesterol)

where is HDL synthesized?

liver

Atherosclerosis and Coronary heart disease: are correlated with what 4 things?

1. serum cholesterol 2. deposition of cholesterol 3. cholesterol ester 4. lipoproteins containing apo-B

So when someone has elevated ___ and normal ___ or vice versa or both are elevated there will be elevated cholesterol levels which is unhealthy

VLDL, LDL

Low HDL or high LDL (VLDL) is very bad because ...

there will be a high amount of cholesterol injected into the body and very little harvested back.

what serum cholesterol causes Atherosclerosis and Coronary heart disease.

low HDL and high LDL (VLDL)

what are the 3 polyunsaturated fatty acids (PUFAs) that lower blood cholesterol?

1. eicosapentaenoic (EPA) 2. docosahexaenoic (DHA) 3. Omacor

Jaundice is caused by:

1. The accumulation of bilirubin due to liver disease ( liver cancer, hepatitis) 2. blocked bile secretion (due to pancreatic cancer, gallstones) 3. the lack of UDPGT (Crigler-Najjar)

infant jaundice is centered on ___ which is toxic.

4Z, 15E ( bilirubin)

treatment of infant jaundice

phototherapy

what are the 2 steps of heme being degraded to bilirubin?

1. Heme oxygenase linerarizes heme to create biliverdin (green compound, seen in a bruise) 2. Biliverdin reductase converts biliverdin to bilirubin (yellow compound that travel bound to serum albumin in the bloodstream)

Major pigment of urine come from bilirubin being degraded to ___

urobilin

urobilin is further degraded by intestinal microbiota to _____

stercobilin ( major pigment of feces)

HMG-CoA reductase inhibitors

Statins (e.g. Lovastatin (Mevacor) and Rosuvastatin (Crestor))

Drugs that decrease VLDL synthesis

Fenofibrate (Tricor) and Niacin (Nicotinic Acid)

What drug is a resin that absorb bile acids and in pts with high cholesterol/LDL, converts more cholesterol to bile acid?

cholestyramine (questran)

Pyridoxal phosphate (PLP) is an active form of vitamin __ involved in transaminations

Porphyrias are a result of enzyme deficiency along the porphyrin (heme) biosynthesis pathway that starts with ____ and ___resulting in a heme.

succinyl-CoA, glycine

T/F Porphyrias causes a buildup of precursors in RBC, body fluids, and the liver.

true

Accumulation of precursor uroporphyrinogen leads to .... A. urine being pink to dark purple B. Urine being red C. teeth being red under UV D. skin is sensitive to UV light E. craving for heme (vampire myth)

A. urine being pink to dark purple C. teeth being red under UV D. skin is sensitive to UV light E. craving for heme (vampire myth)

most common type of porphyria

acute intermittent

rate-limiting step of purine synthesis

Glutamine-PRPP amindotransferance

Glutamine-PRPP amindotransferance may be inhibited by what anticancer drugs?

6-mercaptopurine and 6-thioguanine

what two things provide the atoms to create a ring for pyrimidine synthesis to then attach to a ribose 5-phosphate.

Aspartate and carbamoyl phosphate

UMP is phosphorylated to __ then it is converted to ___

UTP, CTP

______is the target for anti cancer drugs such as 5-fluorouracil (5FU), floxuridine and capecitabine

Thymidylate synthase

5-fluorouracil (5FU), floxuridine and capecitabine are ___ inhibitors of thymidylate synthase

irreversible

what anti cancer drugs irreversible inhibit thymidylate synthase?

5-fluorouracil (5FU) , floxuridine and capecitabine

_______ is blocked by anticancer drugs such as methotrexate which is very toxic

Dihydrofolate reductase (DHFR)

Dihydrofolate reductase (DHFR) is blocked by anticancer drugs such as ____ which is very toxic

methotrexate

Dihydrofolate reductase (DHFR) reduces __ to ___ which is required in both purine and pyrimidine synthesis

DHF (dihydrofolate) , THF (tetrahydrofolate)

Lesch-Nyhan disease: total lack of ____ , that is used in the salvage pathway to convert purines and their nucleosides to mononucleotides.

HGPRT

symptoms of Lesch-Nyhan disease

1. severe mental disabilities 2. deposits of orange sand-like crystals in the diapers of infants with this condition

Gout is caused by an excess of ___

uric acid

symptoms of gout

1. painful joints (toes) due to deposits of sodium urate crystals

gout primarily affects males or females

males

Gout may involve A. overproduction or genetic under-excretion of uric acid B. overconsumption of fructose C. HGPRT deficiency from the salvage pathway D. overconsumption of lactose

A. overproduction or genetic under-excretion of uric acid B. overconsumption of fructose C. HGPRT deficiency from the salvage pathway

How can gout be treated (diet related) ?

1. avoidance of purine rich foods (seafood,liver) 2. avoidance of fructose

How can gout be treated (drug related) ?

1. xanthine oxidase inhibitors e.g. allopurinol (Zyloprim) and febuxostat (Uloric) 2. administration of porcine uric acid oxidase (uricase, Krystexxa)

examples of endocrine hormones that are released to blood and carried to their target cells

insulin and glucagon

examples of paracrine hormones that are released into extracellular space, diffuses to a nearby target (act locally)

Eicosanoids: prostaglandins, thromboxanes, and leukotrienes

paracrine hormones are produced from ______ via _________

arachidonic acid, phospholipase A2

____: affects the cell where they are produced, but can bind to surface receptors. Very lipophilic

Autocrine

______: bind to receptors that span the membrane and induce conformational change that produces a secondary messenger. Causes signal amplification and affects many targets.

Extracellular hormones

peptide and amine

Peptide hormones

insulin, glucagon, somatostatin

Insulin is synthesized ....

on the ribosome of Beta cells of the pancreas as preproinsulin

which is the correct order? A. preproinsulin→proinsulin→matured insulin B. proinsulin →matured → preproinsulin C. matured → preproinsulin → proinsulin D. proinsulin → preproinsulin→ →matured insulin

A. preproinsulin→proinsulin→matured insulin (5.8 kDa)

Insulin has __ AA

the B chain is the same in pigs and cows but we do not use the cows due to “____”.

mad cow disease

Amine hormone

epinephrine (adrenaline)

epinephrine (adrenaline) and norepinephrine are ___ hormones

catecholamine b