General Pharm

Question 1

Common CYP 450 inducers (increase metabolism of other drugs)

Answer 1

"Most Chronic alcoholics Steal Phen-Phen and Never Refuse Greasy Carbs"
Modafinil
Chronic alcohol use
St. John's wort
Phenytoin
Phenobarbital
Nevirapine
Rifampin
Griseofulvin
Carbamazepine

Question 2

Common CYP 450 inhibitors (decrease metabolism/increase serum concentration and toxicity of other drugs)

Answer 2

"SICKFACES.COM when i Am drinking Grapefruit juice"
Sodium valproate
INH
Cimetidine
Ketoconazole
Fluconazole
Acute alcohol abuse
Chloramphenicol
Erythro/clarithromycin
Sulfonamides
Ciprofloxacin
Omeprazole
Metronidazole
Amiodarone
Grapefruit juice

Question 3

Equation for maintenance dose

Answer 3

maintenance dose = (dose required for steady state) * CL/[bioavailability fraction]

(bioavailability fraction = 1 if given IV)

Question 4

Half life equation

Answer 4

t1/2 = Vd*0.7 / CL

Question 5

Equation for loading dose

Answer 5

Vd * (dose required for steady state) / [bioavailability fraction]

(bioavailability fraction = 1 if given IV)

Question 6

Phase I metabolism

Answer 6

Reduction, Oxidation, Hydrolysis (“R-OH”). Geriatric pts lose phase I first. CYP450 responsible for most Phase I rxns; also converts pro-carcinogens into carcinogens that can cause mutations in human DNA

slightly polar, water soluble, often active metabolites

Question 7

Phase II metabolism

Answer 7

“Geriatric pts have More GAS”
Methylation, Glucuronidation, Acetylation, Sulfation

very polar, inactive metabolites (renally excreted)

Question 8

GPCR pathways for various receptor types

Answer 8

• HAVe 1 M&M: H1, alpha1, V1, M1 & M3 receptors follow Gq pathway (PLC –> IP3/DAG –> increased Ca2+ –> SM contrxn)
• MAD 2’s: M2, alpha2, D2 receptors follow Gi pathway (reduce cAMP –> increased MLCK activation –> SM relax
• all else (beta1/2/3, D1, H2, V2): Gs pathways (increased cAMP, increased PKA, Ca2+ in heart –> contraction

Question 9

Drugs that increase risk of osteoporosis

Answer 9

Corticosteroids (decrease bone formation)
Depot medoxyprogesterone acetate, Aromatase inhibitors (decreased E)
GnRH agonists (reduced T & E)
Anticonvulsants that induce CYP450 - phenobarb, phenytoin, carbamazepine (increased vit D breakdown)
Heparin (stimulates clasts/suppresses blasts)
PPI’s (decrease Ca2+ reabsorption)

Question 10

Equilibrium potential of Na+, K+, Cl-, Ca2+ and resting membrane potential

Answer 10

Na+ = +60 mV (into cell)
K+ = -90 mV (out of cell)
Cl- = -75 mV (into cell)
Ca2+ = +125 mV (into cell)
(resting potential = -70 mV)

Question 11

Equation for bioavailability (F) of a drug administred non-IV route

Answer 11

F = (AUC oral)(dose IV) / (AUC IV)(dose oral)

Question 12

Qualities of drugs that are preferentially processed by the liver vs. the kidney

Answer 12

High lipophilicity and high Vd. These drugs have good CNS penetration and are preferentially by the liver into more polar compounds for easier elimination in bile and urine. These drugs are poorly eliminated by kidney as they will rapidly cross tubular membranes after filtration to reenter tissues