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First Aid & Firecracker > First Aid: Pharmacology > Flashcards

First Aid: Pharmacology Flashcards

1
Q

Formula for loading dose

A

Cp x Vd / F

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2
Q

Formula for maintenance dose

A

Cp x CL x T / F

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3
Q

Which drugs have zero order elimination?

A

PEA = Phenytoin, Ethanol and Aspirin(at high dosages)

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4
Q

What is the acid base equation?

A 
KA  = [H][A-]/[HA]
pKa = pH + log([HA]/[A-])
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5
Q

What type of reactions constitute Phase I metabolism? Who looses it?

A

Reduction, Oxidation, Hydrolysis with Cyt P450. Old people loose it.

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6
Q

What type of reactions constitute Phase II metabolism?

A

Conjugation: Glucoronidation, Acetylation, Sulfation. Old people have GAS. Slow acetylators have more side effects from drugs.

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7
Q

Efficacy versus Potency

A 
Efficacy = Maximal Effect
Potency = Less concentration needed to achieve the same effect.
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8
Q

What is the mechanism of action of ketamine?

A

Non-competitive NMDA antagonist

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9
Q

What is the therapeutic index?

A

TD50/ED50 Where TD50 equals the median dose at which people had toxic effects and ED 50 equals the median dose at which people had therapeutic effects.

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10
Q

The entire sympathetic nervous system is innervated by adrenergic neurons except…

A

the adrenal medulla and sweat glands which are innervated by cholinergic neurons and have M receptors.

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11
Q

What are the two nicotinic receptor subtypes and where are they found?

A

N_N found in autonomic ganglia and N_M found in NMJs. Both are Na channels.

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12
Q

What G protein subclass are alpha1 receptors and what is their function?

A

Gq

Vasoconstriction, Mydriasis, Sphincter contraction (GI & GU)

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13
Q

What G protein subclass are alpha2 receptors and what is their function?

A

Gi

Presynaptic receptor that decreases sympathetic tone. Decrease insulin and lipolysis. Increase platelet aggregation.

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14
Q

What G protein subclass are beta1 receptors and what is their function?

A

Gs

Increase HR, heart contraction, renin release, and lipolysis

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15
Q

What G protein subclass are beta2 receptors and what is their function?

A

Gs
Bronchodilation, vasodilation, increase HR, contractility, lipolysis, insulin release, and decrease uterine tone, promote ciliary muscle relaxation and increase humor production.

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16
Q

What G protein subclass are M1 receptors and what is their function?

A

Gq

CNS and Enteric nervous system

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17
Q

What G protein subclass are M2 receptors and what is their function?

A

Gi

Decrease HR and contractility of atria

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18
Q

What G protein subclass are M3 receptors and what is their function?

A

Gq

Increase exocrine gland secretion, gut peristalsis, bladder contraction, bronchoconstriction, and miosis

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19
Q

What G protein subclass are D1 receptors and what is their function?

A

Gs

Relaxes renal vascular smooth muscle

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20
Q

What G protein subclass are D2 receptors and what is their function?

A

Gi

Modulates transmitter release in the CNS

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21
Q

What G protein subclass are H1 receptors and what is their function?

A

Gq

Increase mucus production and vascular permeability. Bronchocontraction, pruritus and pain.

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22
Q

What G protein subclass are H2 receptors and what is their function?

A

Gs

Gastric acid secretion

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23
Q

What G protein subclass are V1 receptors and what is their function?

A

Gq

Increase vascular tone

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24
Q

What G protein subclass are V2 receptors and what is their function?

A

Gs

Increase H2O permeability for reabsorption in collection ducts

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25
Q

Which receptors belong in the Gq class and what is their downstream signal?

A

HAV 1 M & M (H1, alpha1, V1, M1 & M3)

Gq -> Phospholipase C -> DAG and IP3

DAG-> PKC

IP3 -> Ca -> Smooth muscle contraction

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26
Q

Which receptors belong in the Gs class and what is their downstream signal?

A

beta1, beta2, D1, H2 & V2
Gs -> Adenyl Cyclase -> cAMP -> PKA

PKA -> Ca in the heart
PKA -l Myosin Kinase

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27
Q

Which receptors belong in the Gi class and what is their downstream signal?

A

MAD 2s (M2, alpha2, & D2)
G1 -| Adenyl Cyclase -> cAMP -> PKA
Essentially opposes Gs

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28
Q

What is the mechanism of action of vesamicol?

A

Inhibits the uptake of cytosolic ACh into vesicles.

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29
Q

What is the mechanism of action of hemicholinium?

A

Inhibits ACh reuptake from synapse.

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30
Q

What is the mechanism of action of metyrosine?

A

Inhibits conversion of tyrosine to DOPA

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31
Q

What is the mechanism of action of amphetamines?

A

They get into the presynaptic Dopamine vesicles and inhibit the VMAT transporter. They also increase the pH and shut down the H+ transporter allowing Dopamine to diffuse out. In the cytosol they inhibit MOA and they reverse the action of the re-uptake DAT. This ultimately causes dopamine to be released.

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32
Q

Which four drugs inhibit re-uptake in the noradrenergic synapse?

A

SNRI, Amphetamines, TCAs, and Cocaine

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33
Q

What are the four direct cholinomimetics?

A

Bethanechol, Carbachol, Pilocarpine & Methacholine

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34
Q

What is bethanechol used for?

A

Ileus (neuro or post-op) and Urinary retention. Bethany call me maybe if you want to activate your bowel and your bladder.

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35
Q

What is carbachol used for?

A

Glaucoma & Pupillary Constriction

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36
Q

What is pilocarpine used for?

A

Increases sweat, tears and saliva (make your PILO wet). Used for glaucoma.

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37
Q

What is methacholine used for?

A

Diagnosis of asthma. (If it gets worst.)

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38
Q

What are the acetylcholine esterase inhibitors?

A

All the drugs that end in -stigmine plus edrophonium, donepezil & galantine.

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39
Q

What is neostigmine used for?

A

Ileus, post-op reversal of NMJ block, myasthenia gravis and urinary retention.

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40
Q

What is pyridostigmine used for?

A

Myasthenia gravis. (Get RID of MG)

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41
Q

What is physostigmine used for?

A

Atropine poisoning. BBB crossing.

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42
Q

What is donepezil used for?

A

Alzheimer’s Disease

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43
Q

What is edrophonium used for?

A

Myasthenia gravis diagnosis.

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44
Q

What are the symptoms of AChE inhibitor poisoning?

A 
DUMBBELLS (Treat with atropine)
D = Diarrhea
U = Urination
M = Miosis
B = Bronchospasm
B = Bradycardia
E = Excitacion of muscle
L = Lacrimation
S = Sweating
S = Salivation
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45
Q

Which muscarinic antagonist is used to treat Parkinson?

A

Benztropine “I Park my Benz”

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46
Q

Which muscarinic antagonist is used to treat motion sickness?

A

Scopolamine, which has CNS activity

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47
Q

Which muscarinic antagonist is used to treat COPD or Asthma?

A

Ipratropium (I pray I can breath) & Tiotropium

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48
Q 
What are the effects of atropine on the following organs?
Eye
Airway
Stomach
Gut
Bladder
A 
Eye = Mydriasis & Cycloplagia
Airway = Bronchodilation
Stomach = Decrease acid production
Gut = Decrease motility
Bladder = Decrease urgency
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49
Q

Which muscarinic antagonist is used to treat urinary frequency?

A

Oxybutynin, Darrifenacin or Solifenacin

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50
Q

What is the selection profile of epinephrine and what is it used for?

A

beta > alpha

Anaphylaxis, Open angle glaucoma, asthma and hypotension.

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51
Q

What is the selection profile of Norepinephrine and what is it used for?

A

alpha1 > alpha2 > beta1

Hypotension (beware is decreases renal perfusion)

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52
Q

What is the selection profile of isoproterenol and what is it used for?

A

beta1 = beta2

ECG evaluation or tachyarrythmia

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53
Q

What is the selection profile of dopamine and what is it used for?

A

D1 = D2 > beta > alpha
Low dose to increase renal flow.
High dose dopamine for shock because it faso constricts, it is inotropic and chronotropic. (First line)

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54
Q

What is the selection profile of Fenoldopam and what is it used for?

A

D1 partial agonist only.

So it is used to treat HTN slowly by increasing GFR and decreasing resistance.

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55
Q

What is the selection profile of dobutamine and what is it used for?

A

beta1 > beta2 = alpha

Used in heart failure and has mostly inotropic effects.

56
Q

What is the selection profile of phenylephrine and what is it used for?

A

alpha1 > alpha2

Hypotension, rhinitis and optho procedures (mydriasis)

57
Q

What is the selection profile of albuterol and what is it used for?

A

beta2 > beta1

Acute asthma attacks

58
Q

What is the selection profile of metaproterenol and what is it used for?

A

beta2 > beta1

Acute asthma attacks

59
Q

What is the selection profile of salmeterol and what is it used for?

A

beta2 > beta1

Long term asthma or COPD management

60
Q

What is the selection profile of terbutaline and what is it used for?

A

beta2 > beta1

It decreases uterine contractions in premature labor

61
Q

What is the selection profile of ephedrine and what is it used for?

A

alpha = beta (it causes vesicle release)

Nasal decongestion, incontinence and hypotension

62
Q

What is the mechanism of action of cocaine?

A

NE re-uptake inhibitor.

63
Q

Compare the effects on mean arterial pressure and heart rate between NE and Isoproterenol.

A

With NE there is an alpha1 mediated increase in MAP with a reflex bradycardia. With Isoproterenol there is a beta2 vasodilatory effect and a beta1 and beta2 tachycardia.

64
Q

What is the mechanism of action of clonidine and what is used for?

A

alpha2 agonist used for hypertensive urgency, ADHD, Severe pain, EtOH withdrawal, opioid withdrawal.

65
Q

What is the mechanism of action of alpha-methyldoma and what is used for?

A

alpha2 agonist used for gestational hypertension.

66
Q

What is the selection profile of phenoxybenzamine and what is it used for?

A

Non selective alpha blocker used for pheo. Can cause hypotension and reflex tachycardia.

67
Q

What is the selection profile of phentolamine and what is it used for?

A

Non selective alpha blocker used for patients in a hypertensive emergency caused by tyramine ingestion while on MAO inhibitors. Also used for NE extraversion on IV sites.

68
Q

What is the selection profile of prazosin, terazosin, and doxazosin and what is it used for?

A

alpha1 blockers used to relieve BPH symptoms. Prazosin is also used for PTSD. Can treat hypertension. Can cause orthostatic hypotension.

69
Q

What is the selection profile of tamsulosin and what is it used for?

A

alpha1 blocker used to relieve BPH symptoms. Can cause orthostatic hypotension.

70
Q

What is the selection profile of mirtazapine and what is it used for?

A

alpha2 blocker used for depression. Can cause sedation, increase in cholesterol and increased appetite.

71
Q

What type of arrhythmia are beta blockers useful for and how do they work?

A

They decrease AV conduction velocity and can be used for SVTs.

72
Q

What is the effect of beta blockers in the eye and what are they used for?

A

They decrease humor production. Timolol is used for glaucoma.

73
Q

What are the toxicities of beta blockers?

A 
Impotence
Bradycardia
AV block
Seizures
Sedation
Dislipidemia (metoprolol)
Worst asthma or COPD
Unopposed alpha effect on cocaine users.
74
Q

Which beta blockers are beta 1 selective?

A

Acetabutolol (partial agonist), Atenolol, Betaxolol, Esmolol, Metoprolol (all the ones from A to M)

75
Q

Which beta blockers are non-selective?

A

Nadolol, Pindolol (partial agonist), Propanolol, Timolol (all the ones from N to Z on the alphabet)

76
Q

Which drugs are alpha AND beta blockers?

A

Carvedilol and Labetalol (do not ened in “-olol”)

77
Q

Antidote for acetaminophen…

A

N-acetylcysteine (replenishes glutathione)

78
Q

Antidote for AChE inhibitors…

A

Atropine (agonist) followed by pralidoxine (removes AChE blockade)

79
Q

Antidote for Amphetamines…

A

NH4Cl to acidify urine

80
Q

Antidote for anticholinergics…

A

Physostigmine and control of hyperthermia

81
Q

Antidote for benzodiazepines…

A

Flumazenil (GABA_A antagonist)

82
Q

Antidote for beta-blockers…

83
Q

Antidote for carbon monoxide…

A

Hyperbaric O2

84
Q

Antidote for copper, arsenic or gold…

A

Penicillamine (chelator)

85
Q

Antidote for cyanide…

A

Nitrite (oxidizes hemoglobin and prevents binding by cyanide) and thiosulfate

86
Q

Antidote for methemoglobin or nitrite…

A

Methylene blue (turns methemoglobin back to hemoglobin)

87
Q

Antidote for digitalis…

A

Anti-dig Fab fragments

88
Q

Antidote for heparine…

A

Protamine sulfate

89
Q

Antidote for Iron…

A

Deferoxamine or Deferasirox

90
Q

Antidote for lead…

A

EDTA, dimercaprol, succiner, penicillamine

91
Q

Antidote for mercury, arsenic or gold…

A

diMERcaprol, succiner

92
Q

Antidote for methanol or ethylene glycol…

A

Fomepizole

93
Q

Antidote for opioids…

A

Naloxone (mu receptor inhibitor)

94
Q

Antidote for salicylates…

A

NaHCO3 to alk the urine

95
Q

Antidote for TCAs…

A

NaHCO3 to alk the plasma

96
Q

Antidote for tPA, streptokinase or urokinase…

A

Aminocaproic acid

97
Q

Antidote for Warfarin…

98
Q

Antibiotics ending in -azole

A

Ergosterol synthesis inhibitors

99
Q

Antibiotics ending in -bendazole

A

Anti helmintic or anti parasitic

100
Q

Antibiotics ending in -cilin

A

Peptidoglycan synthesis inhibitor

101
Q

Antibiotics ending in -cycline

A

Aminoacyl-tRNA binding to 30S inhibition

102
Q

Antibiotics ending in -ivir

A

Neuroaminase inhibitors

103
Q

Antibiotics ending in -navir

A

Protease inhibitors

104
Q

Antibiotics ending in -ovir

A

DNA polymerase inhibitor

105
Q

Antibiotics ending in -thromycin

A

Macrolides that block translocation on 50S

106
Q

CNS drugs that end in -ane

A

Inhaled general anesthetic (ie. halothane)

107
Q

CNS drugs that end in -azine

A

Typical anti-psychotics

108
Q

CNS drugs that end in -barbital

A

Barbiturates

109
Q

CNS drugs that end in -caine

A

Local anesthetic

110
Q

CNS drugs that end in -etine

111
Q

CNS drugs that end in -ipramine

112
Q

CNS drugs that end in -triptan

A

5-HT_{1B/1D} agonist (ie. sumatriptan)

113
Q

CNS drugs that end in -triptyline

114
Q

CNS drugs that end in -zepam

A

Benzodiazepine

115
Q

CNS drugs that end in -zolam

A

Benzodiazepine

116
Q

Autonomic drugs that end in -chol

A

Cholinergic agonist

117
Q

Autonomic drugs that end in -curium or -curonium

A

Non-depolarizing muscular blocker derived from curare

118
Q

Autonomic drugs that end in -olol

A

Beta blcoker

119
Q

Autonomic drugs that end in -stigmine

A

AChE inhibitor

120
Q

Autonomic drugs that end in -terol

A

Beta2 agonist

121
Q

Autonomic drugs that end in -zosin

A

Alpha1 antagonist

122
Q

Cardiovascular drugs that end in -afil

A

PDE-5 inhibitors

123
Q

Cardiovascular drugs that end in -dipine

A

Dihydropyridine CCB (Ca+ channel blocker of vasculature)

124
Q

Cardiovascular drugs that end in -pril

A

ACE inhibitor

125
Q

Cardiovascular drugs that end in -sartan

A

Angiotensin II receptor blcoker

126
Q

Cardiovascular drugs that end in -statin

A

HMG-CoA reductase inhibitor

127
Q

Drugs ending in -dronate

A

Biphosphonate

128
Q

Drugs ending in -glitazone

A

PPAR-gamma activator (insulin sensitizer)

129
Q

Drugs ending in -prazole

A

Proton Pump Inhibitor

130
Q

Drugs ending in -prost

A

Prostaglandin analog

131
Q

Drugs ending in -tidine

A

H2 antagonist (Cimitedine)

132
Q

Drugs ending in -tropin

A

Pituitary hormone

133
Q

Drugs ending in -ximab

A

These are chimeric monoclonal antibodies

134
Q

Drugs ending in -zumab

A

These are humanized monoclonal antibodies

135
Q

Which drugs can cause gynecomastia?

A 
Spironalactone
Marijuana (dope)
Digitalis
Estrogen
Cimetadine
Alcohol
Heroin
Dopamine
D2 antagonist
Ketoconazole
[Some dope drugs easily cause awkward hairy DD knocker.]

First Aid & Firecracker (7 decks)

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