Pharm 1 USMLE Flashcards
28 y/o chemist presents w/ MPTP exposuree. what NT is depleted
dopamine
woman taking tetracycline exhibits photosensitivity. What are the clinical manifestations?
rash on sun exposed retions of body
African American man who goes to Africa develops a hemolytic anemia after taking malarial prophylaxis. what is the enzyme deficiency
glucose 6 phosphate dehydrogenase
farmer presents w/ dyspnea, salivation, miosis, diarrhea, cramping, and blurry vision. What caused this, and what is the MOA
insecticide poisoning; inhibition of acetylcholinesterase
27 y/o female w/ hx of psych illness now has urinary retention due to a neuroleptic. What do you tx it with?
bethancechol
pt w/ recent kidney transplant is on cyclosporine for immunosuppression. Requires antifungal agent for candidiasis. What antifungal drug would result in cyclosporine toxicity
ketoconazole
pt is on carbamazepine. What routine workup should always be done?
LFTs
23 y/o female who is on rifampin for TB prophylaxis and on birth control (estrogen) gets pregnant. why
rifampin augments estrogen metabolism in the liver, rendering it less effective
what is the volume of distribution
relates the amount of drug in the body to the plasma concentration
=amount of drug in body/plasma drug concentration
Vd of plasma protein bound drugs can be altered by dzs in these 2 organ systems
liver and kidney
what is clearance (CL)
relates the rate of elimination to the plasma concentration
Cl=rate of elimination of drug/plasma drug concentration
what is the half life (t1/2)
the time required to change the amount of drug in the body by 1/2 during elimination (or constant infusion). A drug infused at a constant rate reaches about 94% of steady state after 4 t(1/2_
t(1/2)=0.7xVd/Cl
what is concentration of drug in the body after 1 half life
50%
what is concentration of drug in the body after 2 half lives
75%
what is concentration of drug in the body after 3 half lives
87.5%
what is concentration of drug in the body after 4 half lives
~94%
Cp =
target plasma concentration
F=
bioavalability
Loading dose=
Cp x Vd/F
maintenance dose=
CpxCL/F
what happens to the loading dose and maitenance dose in pts will impared renal or hepatic fxn
loading dose remains the same
maitenence dose is decreased
this order elimination describes a constant rate of elimination regardless of C (i.e. constant AMOUNT of drug eliminated per unit time). Cp decreases linearly with time. E.g., etoh, phenytoin, and asprin (at high or toxic concentrations)
zero order elimination
image. p. 195
this order elimination describes a rate of elimination proportional to the drug concentration (i.e., constant FRACTION of drug eliminated per unit time). Cp decreases exponentially with time.
first order elimination
image. p. 195
In drugs with 1st order kinetics rate of elimination is ________ plasma concentration (Cp).
image. p. 195
proportional to