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Drugs > General > Flashcards

General Flashcards

1
Q

Permissive drug

A

1) Allows other drugs to reach their full capacity

2) Cortisol for norepinephrine (cortisol increases alpha 1 receptors)

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2
Q

Decreased drug responsiveness with repeated administration

A

Tachyphylaxis

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3
Q

Combination of two drugs that creates an effect that is equal to the sum of the effects from the individual drugs

A

Additive

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4
Q

Combination of two drugs that creates an effect greater than the sum of the individual drugs effects

A

Synergistic

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5
Q

Drug used for cyanide poisoning?

A

1) Amyl nitrite

2) Thiosulfate

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6
Q

Drug used for iron poisoning?

A

1) Deferoxamine (chelating agent)

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7
Q

Drug used for arsenic poisoning? What does arsenic inhibit?

A

1) Dimercaprol

2) Lipoic acid (results in Pyruvate dehydrogenase and alpha ketoglutarate impairment)

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8
Q

How many drug half lives does it take for it to be completely removed from the system?

A

1) 4-5 half lives

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9
Q

How do you calculate a half life?

A

t1/2 = (V x .7)/Clearance

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10
Q

Study of drug effects and their mechanism of action; “What drugs do to you”

A

Pharmacodynamics

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11
Q

Quantitative descriptions of the time course of drug and drug metabolite; “What the body does to the drug”

A

Pharmacokinetics

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12
Q

What is inversely related to the affinity of an enzyme to its substrate?

A

Km

- Low Km = High affinity (seen in hexokinase)

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13
Q

What does a high Km mean?

A

Low affinity for substrate

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14
Q

Proportional to enzyme concentration

A

Vmax

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15
Q

What are the x and y axis on a lineweaver burk plot

A

1) X axis = 1/S(concentration substrate)

2) y axis = 1/V

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16
Q

As the y intercept increases on the lieweaver burk plot what happens to Vmax

A

1) Vmax decreases

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17
Q

Inhibitor that resembles the substrate, binds to the active site, increases Km (decreases affinity)

A

Competitive inhibitor

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18
Q

How can a competitive inhibitor be overcome?

A

Increase the substrate

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19
Q

Inhibitor that does not resemble the substrate, does not bind to the active site, decreases the Vmax

A

Non-competitive inhibitor

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20
Q

Fraction of administered drug that reaches the systemic circulation unchanged

A

Bioavailability (F)

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21
Q

What is the bioavailablility of an IV drug

A

100% (all of it reaches the systemic circulation unchanged)

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22
Q

How do you calculate volume of distribution

A

V = amount of drug in body divided by plasma drug concentration

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23
Q

What order of elimination are half lives only applicable to?

A

1) First order elimination

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24
Q

How do you calculate Clearance of a drug?

A

Cl = rate of elimination divided plasma concentration

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25
Q

How do you calculate a loading dose?

A

Loading dose = Cp x (Vd/F)

  • Cp = target plasma concentration
  • F = bioavailability
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26
Q

How do you calculate maintenance dose?

A

Maintenance dose = Cp x CL/F

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27
Q

Elimination rate that is constant regardless of target plasma concentration; Decreases linear with time

A

Zero order elimination

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28
Q

What drugs have zero order elimination?

A

Think: PEA (pea is round, shaped like the 0 in zero order)

1) Phenytoin
2) Ethanol
3) Aspirin (at high or toxic concentration)

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29
Q

Elimination rate that is directly proportional to concentration of drug

A

First order elimination

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30
Q

What determines whether a drug is reabsorbed or excreted in the urine?

A

1) If the drug is in its neutral form

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31
Q

How do you ensure a weak acid is excreted in the urine? weak base?

A

1) Make the urine basic (give bicarb) so that it remains in its ionized form
2) Make the urine acidic (give ammonium chloride) so that it becomes ionized

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32
Q

What phase of drug metabolism includes reduction, oxidation, and hydrolysis with P-450

A

Phase I

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33
Q

what is the result of phase I drug metabolism?

A

Production of water-soluble metabolites

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34
Q

What phase of drug metabolism is lost as we grow older

A

Phase I

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35
Q

What phase of drug metabolism includes conjugation yielding very polar, inactive metabolites

A

Phase II

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36
Q

Maximal effect a drug can produce

A

Efficacy

37
Q

Amount of drug needed for a given effect

A

Potency

38
Q

What changes potency

A

Competitive inhibitor

39
Q

What changes efficacy

A

Noncomeptive inhibitor

40
Q

What inhibitor cannot be overcome by the addition of more substrate?

A

Noncompetitive inhibitor

41
Q

What is the effect of a partial agonist?

A

1) Decreases efficacy and changes potency

42
Q

Median lethal dose/ median effective dose

A

Therapeutic index
Think: TILED
Therapeutic index = Lethal dose/Effective dose

43
Q

Treatment for acetaminophen overdose

A

N-acetylcysteine (replenishes glutathione)

44
Q

Treatment for salicylate overdose

A

NaHCO3 (alkalinize urine), dialysis

45
Q

Treatment for amphetamines overdose

A

NH4Cl (acidify urine)

46
Q

Treatment for Acetylcholine esterase inhibitors overdose/poisoning

A

1) Atropine

2) Pralidoxime (regenerates acetylcholine esterase)

47
Q

Treatment for Antimuscarinic agents overdose

A

1) Physostigimine

48
Q

Treatment for beta blocker overdose

A

1) Glucagon

49
Q

Treatment for digitalis overdose

A

Think: KLAM

1) normalize K
2) Lidocaine
3) Anti-dig Fab fragments
4) Mg

50
Q

Treatment for Lead intoxication

A

1) CaEDTA
2) Dimercaprol
3) Penicillamine

51
Q

Treatment for Mercury/Arsenic/Gold intoxication

A

1) Dimercaprol

2) Succimer

52
Q

Treatment for Copper/Arsenic/Gold intoxication

A

1) Penicillamine

53
Q

Treatment for Methemoglobin intoxication

A

1) METHylene blue

54
Q

Treatment for carbon monoxide poisoning

A

1) 100% O2

2) Hyperbaric chamber

55
Q

Treatment for methanol/ethylene glycol intoxication

A

1) Fomepizol

2) Ethanol

56
Q

Treatment for Opioid overdose

A

1) Naloxone (IV)

2) Naltrexone (oral)

57
Q

Treatment for BZD overdose

A

1) Flumazenil (BZD antagonist)

58
Q

Treatment for TCA overdose

A

1) NaHCO3 (plasma alkalinization)

2) Pt. will present with QRS and QT prolongation

59
Q

Treatment for Heparin overdose

A

Protamine

60
Q

Treatment for Warfarin overdose

A

1) Vitamin K

2) Fresh frozen plasma

61
Q

Treatment for tPA overdose

A

Aminocaproic acid

62
Q

Treatment for Theophylline overdose

A

Beta blocker

63
Q

Drugs that cause cutaneous flushing

A

Think: VANC

1) Vancomycin (Red man syndrome)
2) Adenosine
3) Niacin
4) Ca Channel blockers

64
Q

Drugs that cause agranulocytosis

A

Think: Agranulocytosis Could Certainly Cause Pretty Major Damage

1) Clozapine (atypical antipsychotic)
2) Carbamezpine
3) Colchicine
4) Propylthiouracil
5) Methimazole
6) Dapsone

65
Q

Drugs that could cause grey baby syndrome

A

Chloramphenicol

66
Q

Drugs that can cause hemolysis in G6PD deficienct pt (x-linked)

A

Think: hemolysis IS PAIN

1) INH
2) Sulfonamides
3) Primaquine
4) Aspirin
5) Ibuprofen
6) Nitrofurantoin

67
Q

Drugs that cause megaloblastic anemia

A

Think: having a blast with PMS

1) Phenytoin
2) Methotrexate
3) Sulfa drugs

68
Q

What drugs can cause pulmonary fibrosis?

A

think: BLAB
1) BLeomycin
2) Amiodarone
3) Busulfan

69
Q

What drug can cause hepatitis?

A

INH

70
Q

Drugs that cause Pseudomembranous colits to occur?

A

1) Clindamycin

2) Ampicillin

71
Q

Drugs that cause Gynecomastia?

A

Think: Some Drugs Create Awkward Knockers

1) Spironolactone
2) Digitalis
3) Cimetidine (H2 receptor)
4) Alcohol
5) Ketoconazole (anti-fungal)

72
Q

Drugs that cause myopathies?

A

Think: Fish N CHIPS Give you myopathies

1) Fibrates
2) Niacin (also causes cutaneous flushing)
3) Colchicine (also causes agranulocytosis)
4) Hydroxychloroquine
5) INF-alpha
6) Penicillamine (Used for gold, arsenic, copper, and lead poisoning)
7) Statins
8) Glucocorticoids

73
Q

What drugs cause gingival hyperplasia

A

1) Phenytoin

2) Verapamil

74
Q

What drugs cause Steven Johnson syndrome

A

Think: Bad rash after PEC SLAPP

1) Penicillin
2) Ethosuximide
3) Cababazepine
4) Sulfa drugs
5) Lamotrigine
6) Allopurinol
7) Phenytoin
8) Phenobarbital

75
Q

Drug that causes teeth problems as well as bone problemsproblems

A

Tetracylcine

76
Q

Drug that causes tendonitis/ rupture of tendon and cartilage damage

A

Fluoroquinolones

77
Q

Drugs that cause nephrotoxicity/ototoxicity

A

1) Aminoglycans
2) Vancomycin
3) Loop diuretics
4) Cisplatin (cross link dna)

78
Q

Drugs that induce the P-450

A

Think: BCG PQRS

1) Barbiturates
2) Carbamazepine
3) Griseofulvin
4) Phenytoin
5) Quinidine
6) Rifampin

79
Q

Drugs that inhibit P-450

A

Think: PICK EGS

1) protease inhibitors (Ritanavir)
2) INH
3) Cimetidine/Ciprofloxacin
4) Ketoconazole
5) Erythromycin
6) Grapefruit juice
7) Sulfonamides

80
Q

What are the sulfa drugs?

A

Think: Popular FACTSS

1) Probenecid
2) Furosemide
3) Acetazolamide
4) Celecoxib
5) Thiazides
6) Sulfonamide antibiotics
7) Sulfonylureas (Hypoglycemic drug)

81
Q

Drugs that cause Seizures

A

think: I BITE My tongue
1) INH
2) Bupropion
3) Imipenem
4) Tramadol
5) Enflurane (local anesthetic)
6) Metclopramide (D2 antagonist)

82
Q

How is INH metabolized?

A

Acetylation

83
Q

What type of drug would have a volume distribution of 3-5L? 14-16L? 41L?

A

1) Charged or large drug
2) Small molecular weight but is hydrophilic
3) Small molecular weight and is lipophilic

84
Q

What results with carbon tetrachloride exposure?

A

Free radical injury that results in hepatic necrosis

85
Q

Microsomal monoxygenase

A

cytochrome P450

86
Q

What is the general affect of general anesthesia?

A

1) Decreases cardiact output
2) Increases atrial and ventricular pressures
3) Respiratory depressant
3) Fluorinated anesthetics decrease vascular resistance
4) Increase renal vascular resitance
5) Decrease hepatic blood flow

87
Q

What does an increased arterio-venous gradient for an anesthetic mean?

A

1) It means the anesthetic has a increased peripheral tissue solubility (aka it is taken up by the tissue fast)
2) This means that less of the anesthetic gets to the brain resulting in a slow onset of action

88
Q

A 48-year-old male presents to the office with the complaints of diarrhea and an inability to extend his right wrist. History reveals this began a few weeks ago. He states he has worked in an ammunition factory since age 18. Physical examination reveals 2/5 motor strength with right wrist extension. A urinalysis is obtained and is positive for bicarbonate, protein, phosphate, and glucose.

A

Lead poisoning

Drugs (13 decks)

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