Highlighted content wk 1 Flashcards
highlights on ppts + stuff i think is important
1) What is the primary site of metabolism?
2) Via what?
3) What phase of metabolism is this?
1) Liver
2) CYP P450 isoenzymes
3) Phase I
1) What is the mnemonic to remember the strongest inducers?
2) What is the mnemonic to remember the strongest inhibitors?
3) Is this an element of pharmacokinetics or dynamics?
*(this is on EVERY EXAM)
1) PS PORCS
2) G PACMAN
3) Pharmacokinetics
What are the strongest inducers?
*(this is on EVERY EXAM)
Phenytoin
Smoking
Phenobarbital
Oxcarbazepine
Rifampin (and rifabutin / rifapentine)
Carbamazepine
St. John’s Wort
PS PORCS
What are the strongest inhibitors?
*(this is on EVERY EXAM)
Grapefruit
PIs (protease inhibitors)
Azoles
C–cyclosporin & cimetidine
Macrolides –not azithromycin
Amiodarone (and dronedarone)
Non-DHP CCBs (diltiazem and verapamil)
G PACMAN
List the 4 drugs that increase AQ humor outflow
1) Prostaglandin analogs
2) Pilocarpine (Isopto Carpine)
3) Brimonidine (Alphagan P)
4) Netarsudil (Rhopressa)
1) What is the max adult dose of APAP per day?
2) What abt ibuprofen per day?
1) 4000mg
2) 200-400mg every 4-6 hours as needed (1200mg)
Why do children start taking adult doses at age 12?
Your liver fully matures
FDA requires manufacturers to include a boxed warning on acetaminophen products that addresses its potential to cause ___________________
hepatotoxicity
1) Acetaminophen is metabolized by the cytochrome P450 enzyme system to a hepatotoxic intermediate metabolite that is detoxified by ____________________
2) May be treated with activated charcoal or __________________ to supplement it.
1) glutathione (Phase II conjugation)
2) acetylcysteine
Core body temperature is controlled by the _________________ and regulated by a feedback system involving information transmitted between the thermoregulatory center in the anterior hypothalamus and the thermosensitive neurons in the skin and central nervous system (CNS)
hypothalamus
______________ , either exogenous or endogenous, are fever-producing substances that activate the body’s host defenses, resulting in an increase in the set point
Pyrogens
Fever is treated w what?
APAP or ibuprofen (or alternate both)
Adverse effects associated with cholinergic blockage include what 5 things?
1) Dryness of the eyes and mucous membranes (mouth, nose, vagina)
2) Blurred vision
3) Urinary hesitancy and retention
4) Constipation
5) Reflex tachycardia
1) What medications inhibit cytochrome P450 (CYP) enzymes in the cell membrane of the infecting pathogen?
2) What does this do to the cell?
1) Azoles
2) Decreases synthesis of the fungal sterol ergosterol
1) What do “cold” viruses bind to?
2) Their inflammatory mediators and parasympathetic nervous system reflex mechanisms cause what?
1) Intercellular adhesion molecule-1 receptors
2) Hypersecretion of watery nasal fluid
IgE production is associated with what phase of allergic rhinitis?
Sensitization phase
Mast cell mediators are released in what stage of allergic rhinitis?
Early phase
When are eosinophils recruited with allergic rhinitis?
Cellular recruitment (3rd phase)
Mucus hypersecretion occurs in what phase of allergic rhinitis?
Late phase (last phase)
List the 4 stages of allergic rhinitis in order and what’s characteristic of each
1) Sensitization phase: IgE
2) Early phase: Mast cell mediators
3) Cellular recruitment: eosinophils
4) Late phase: Mucus hypersecretion
List some drugs that can cause non-allergic rhinitis
Cocaine, beta blockers, ACEIs, chlorpromazine, hydralazine, oral contraceptives, aspirin or other NSAIDs, overuse of topical decongestants
What are the 3 classifications of cough duration?
Acute, subacute, chronic
Oxymetazoline is also called what?
Afrin
Productive coughs:
1) What usually causes a clear productive cough?
2) What usually causes a purulent productive cough?
3) What usually causes a productive cough with a putrid malodor?
4) How would you describe a smoker’s cough? What usually causes it?
1) Acute bronchitis
2) Bacteria
3) Anerobic bacteria
4) Purulent; chronic bronchitis (from smoking)
Dryness of the eyes and mucous membranes (mouth, nose, vagina), blurred vision, urinary hesitancy and retention, constipation, and reflex tachycardia are all side effects of what?
Cholinergic blocking (by 1st gen antihistamines)
1st gen antihistamines:
1) Sedating antihistamines are contraindicated in what groups?
2) What drug do they interact with to increase risk of ulcers?
1) Newborns or premature infants, lactating women, and patients with narrow-angle glaucoma
2) Potassium chloride
Give some examples of second generation histamines (inhibit mast cells). Specify which is most sedating.
1) Loratadine (Claritin)
2) Cetirizine (Zyrtec) – most sedating second generation antihistamine
3) Levocetirizine (Xyzal)
4) Fexofenadine (Allegra)
Is antihistamine nasal spray new? What is it called?
New to OTC market (2022); azelastine 0.15 % (Astepro)
Anticholinergic is a term interchangeable with what?
Antimuscarinic
What medication should be taken 1-2 weeks before exposure to allergens?
Cromolyn sodium
Name 2 things that interact with CYP2D6 inhibitors bupropion, fluoxetine & paroxetine
The antitussives:
1) Dextromethorphan (Robitussin or Delsym)
2) Codeine (Cheratussin AC [codeine 10mg / guaifenesin 100 mg / 5 mL])
True or false: Codeine is a prodrug, Dextromethorphan (Robitussin or Delsym) is not
True
1) What is the first line of defense when treating colds, allergic rhinitis and cough during pregnancy?
2) What is the preferred first line nasal decongestant if there is severe congestion in pregnancy?
1) Intranasal cromolyn
2) Oxymetazoline
Differentiate between heartburn and dyspepsia
1) Hearburn: Acidic stomach contents regurgitate through lower esophageal sphincter and stimulates mucosal chemoreceptors
2) Dyspepsia: orginiating from stomach / duodenal area
Increasing the pH of the stomach (eating) will cause lots of drug interactions between heartburn/ dyspepsia meds and what?
Azoles, protease inhibitors, fluoroquinolones, thyroxine, digoxin and others
0.5 – 2% salicylic acid can be used to treat what?
Acne
Silicon sheets or gels are the preferred Tx method for what?
Minimizing scarring
What two dermatologic conditions likely need an Rx?
Tinea unguium & Tinea capitis
Which drug formulation would you recommend for tinea pedis? Cream or spray?
Spray
Permethrin 1% (Nix) and Ivermectin 0.5% (Sklice) both kill lice, but which acts on sodium channels? Which acts on chloride channels?
1) Sodium: Permethrin 1% (Nix)
2) Chloride: Ivermectin 0.5% (Sklice)
Can cranberry juice treat or prevent a urinary tract infection?
Possibly, has antibiotic properties
