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Clinical Pharmacology > Final review > Flashcards

Final review Flashcards

1
Q

What the drug does to the body

A

pharmacodynamics

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2
Q

What the body does to the drug

A

pharmacokinetics “ADME”

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3
Q

compound that binds to the receptor and stimulates biological response

A

agonist

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4
Q

block or reverse effect of agonists

A

antagonist

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5
Q

opposite effect of agonist

A

inverse agonist

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6
Q

maximal response a drug can produce

A

efficacy

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7
Q

measure of dose required to produce a response

A

potency

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8
Q

theraputic dose

A

lethal dose/effective dose
LD = kills 50%
ED = 50% respond

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9
Q

Is a higher index or lower index a safer drug?

A

larger

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10
Q

most common form of drug deactivation

A

active drug to inactive metabolite

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11
Q

inactive drug to active metabolite

A

prodrug

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12
Q

acetaminophen drug metabolism

A

active drug to toxic metabolite

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13
Q

What’s St. John’s wort effect on reuptake?

A

inhibits 5-HT, NE, DA

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14
Q

What are ADRs of St. John’s Wort?

A

photosensitization and mild GI effects, induces formation of CYP450 isoforms (3A4, 2C9, 1A2) and p-glycoprotein drug transporter
lowers effectiveness of birth control pills, cyclosporine, digoxin, HIV PIs, warfarin

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15
Q

What can coenzyme q be used for?

A

cardiovascular CHF, HTN, statin induced myopathy, Parkinson’s

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16
Q

What’s the chemistry behind coenzyme q?

A

antioxidant

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17
Q

What are the ADRs of coenzyme q?

A

GI disturbances (MC), rash, thrombocytopenia, dizziness, irritability, headache
similar to vitamin K and can decrease effects of warfarin

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18
Q

What’s the evidence of coq?

A

significantly lower SBP by 11 and DBP by 7, improve ejection fraction by 3.7%, supplementation ameliorated statin associated muscle symptoms

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19
Q

What are first gen oral antihistmaines?

A

chlorpheniramine
diphenhydramine
doxylamine
hydroxyzine
meclizine
promethazine

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20
Q

What are second gen oral antihistamines?

A

cetirizine
desloratadine
fexofenadine
loratadine
levocetirizine

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21
Q

What’s the MOA of oral antihistamines?

A

block H1 receptor-mediated response to histamine, competitive binding

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22
Q

What’s the difference between 1st and 2nd gen oral antihistamines?

A

1st = penetrate CNS, cause sedation, interact w/ other receptors
2nd = specific for H1

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23
Q

When to consider abx for bacterial sinusitis?

A

> 10 days, facial/dental pain, fever, maxillary edema

24
Q

What to treat bacterial sinusitis with if PCN allergy?

A

clindamycin, cefdinir, doxy

25
Q

Can you put eye drops in teh ear?

A

yes

26
Q

can you put ear drops in the eye?

A

no

27
Q

pharmacodynamic DI: drug alters pharmacologic action of another drug – can it be remediated by dosing?

A

no

28
Q

pharmacokinetic DI: drug alters concentration, ex: P-glycoprotein, anion transporting polypeptides, cytochrome P450 – can it be remediated by dosing?

A

yes

29
Q

What are medications that cause hyperkalemia?

A

angiotensin converting enzyme inhibs (ACE)
angiotensin receptor blockers (ARB)
potassium-sparing diuretics (amiloride, triamterene)
trimethoprim
aldosterone antagonists (spironolactone, eplereonone)
NSAIDS
Digoxin
Cyclosporine or tacrolimus

30
Q

What are signs of a sedative-hypnotic overdose?

A

slurring, drunken behavior, dilated pupils, weak/rapid pulse, clammy skin, shallow respiration, coma, death

31
Q

What are signs of a sedative-hypnotic withdrawal?

A

weight loss, paresthesias, headache

32
Q

What indicates opioid overdose?

A

euphoria -> sedation -> resp depression -> coma -> death
pinpoint pupils! (exp meperidine), drowsiness/sedation, bradycardia

33
Q

What indicates opioid withdrawal?

A

lacrimation, rhinorrhea, yawning, sweating, tremor, muscle jerks

34
Q

What indicates stimulant (amphetamine) overdose?

A

agitation, restlessness, tachy, hyperthermia, hyperreflexia, seizures

35
Q

What indicates stimulant withdrawal?

A

increased appetite, sleepiness, exhaustion, mental depression

36
Q

What indicates cocaine overdose?

A

euphoria, self confidence, mental alertness

37
Q

What’s the DOC for cyanide?

A

cyanokit - hydroxycobalamin (v B12) so nontoxic cyanocobalamin is formed

38
Q

What is the antidote for warfarin?

A

phytonadione (vitamin K) 5-10mg

39
Q

What are G+ pathogens?

A

staph, strep, enterococci, listeria

40
Q

What do tetracyclines have DI with?

A

polyvalent cations decreasing absorption, take 2 hrs before or after

41
Q

When are macrolides reliable?

A

H. flu (not ery) H. pylori, MAC
mod=s. pneumoniae, s. pyogenes

42
Q

When are macrolides clinically utilized?

A

community acquired respiratory infections, atypical mycobacterial infections, traveler’s diarrhea

43
Q

When are macrolides your DOC?

A

chlamydia, H. pylori

44
Q

What are ADRs of fluoroquinolones?

A

prolongation of QT interval, Achilles tendon rupture

NO in pregnant women and children
inhibits warfarin metabolism too

45
Q

What are ADRs of metronidazole?

A

metallic taste, dark urine, disulfuram-like reaction with ETOH

46
Q

How do you treat paronychia for MSSA versus MRSA?

A

cephalexin vs doxycycline

47
Q

Dental infection?

A

clindamycin

48
Q

dog bites?

A

augmentin

49
Q

UTIS?

A

cipro, macrobid, bactrim

50
Q

C diff?

A

metronidazole, vanc

51
Q

CAP outpatient?

A

doxycycline or doxy + beta-lactam or lavaquin alone

52
Q

What are the 3 opioid receptors?

A

mu delta kappa

53
Q

What opioids are metabolized to active metabolites by CYP2D6?

A

codeine, oxycodone, hydrocodone

fentanyl and methadone have no active metabolites!

54
Q

How to treat pain with hepatic impairment?

A

hydrocodone, morphine, oxycodone

55
Q

How to treat pain with renal impairment?

A

fetanyl

56
Q

How to treat acute pain?

A

mild - tramadol, codeine, hydrocodone
moderate - oxycodone
severe - hydromorphone, meperidine, morphine, fetanyl

57
Q

How to treat chronic pain?

A

mild - tramadol
norco, percocet, morphine, fetanyl

Clinical Pharmacology (14 decks)

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