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Pharmacology > Pharm (Q/A) > Flashcards

Pharm (Q/A) Flashcards

1
Q

Km

A

Measures the affinity of an enzyme for its substrate ( dec Km = inc affinity)

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2
Q

Vmax

A

Maximal velocity of an enzymatic reaction (proportional to enzyme concentration)

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3
Q

Competitive inhibition

A

Does not change Vmax (Lineweaver-Burke lines cross each other “competitively”)

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4
Q

Noncompetitive inhibition

A

Decreases Vmax (Lineweaver-Burke lines do not cross each other)

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5
Q

Volume of Distribution (Vd)

A

Drug in body / plasma drug concentration (low Vd (4-8L: in blood), medium Vd (in extracellular space), High Vd (> body weight: in tissues))

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6
Q

Clearance (CL)

A

Rate of elimination of drug / plasma drug concentration (OR Vd x Kc, where Kc is the elimination constant)

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7
Q

Half life (t1/2)

A

T1/2 = (0.7 x Vd) / CL

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8
Q

Concentration of a substance after X half lives (1,2,3,4)

A

1:50%, 2:75%, 3:87.5%, 4:93.75%

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9
Q

Loading dose

A

= Cp x (Vd / F); (Cp: target plasma conc., F: bioavailability, 1 if by IV)

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10
Q

Maintenance dose

A

= Cp x (CL / F); (Cp: target plasma conc., F: bioavailability, 1 if by IV; a renal patient would have decreased clearance, so they would need a decreased maintenance dose)

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11
Q

Common drugs that follow zero-order elimination

A

PEA (phenytoin, ethanol, aspirin)

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12
Q

Treating a weak acid overdose

A

Will get trapped in a basic environment, treat with bicarbonate

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13
Q

Treating a weak base overdose

A

Will get trapped in an acidic environment, treat with ammonium chloride

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14
Q

Reactions involved in phase I drug metabolism

A

(Cytochrome P450) 1. reduction, 2. oxidation, 3. hydrolysis (drugs became slightly polarized, may still be active)

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15
Q

Reactions involved in phase II drug metabolism

A

(Conjugation) 1. acetylation, 2. glucuronidation, 3. sulfonation (drugs become very polarized, are inactivated)

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16
Q

Effect of competitive antagonists on efficacy curves versus noncompetitive antagonists

A

Competitive antagonist shifts curve right, requires bigger dose of drug for effect (inc EC50); noncompetitive antagonist shortens curve, cannot reach same level of effect (dec efficacy)

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17
Q

Effect of partial agonists versus full agnoists on efficacy curves

A

Partial agonists will have a lower maximal efficacy than full agonists (however potency is independent, they may still be more potent or less potent than a full agonist)

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18
Q

Therapeutic index (TI)

A

TILE: TI = LD50 / ED50 (median toxic dose / median effective dose; Safer drugs have HIGHER TI values)

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19
Q

Nm receptors

A

Receptor location: NMJ; Function: skeletal muscle contraction; Mechanism: ion channel (Na influx)

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20
Q

Nn receptors

A

Receptor location: Ganglia; Function: stimulates sympathetics and parasympathetics; Mechanism: ion channel (Na influx);

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21
Q

M1 receptors

A

Receptor location: Nerve endings; Function: Gastric acid secretion; Mechanism: Gq protein;

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22
Q

M2 receptors

A

Receptor location: Heart; Function: Inhibitory, reduces heart rate; Mechanism: Gi protein;

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23
Q

M3 receptors

A

Receptor location: Smooth muscle, endothelium, glands; Function: bronchoconstriction, pupil constriction, accommodation, increases secretions; Mechanism: Gq proteins;

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24
Q

alpha1

A

Receptor location: Arterioles, glands; Function: vasoconstriction (smooth muscle), pupillary dilation, /\ intestine and bladder sphincter contraction; Mechanism: Gq protein;

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25
Q

alpha2

A

Receptor location: presynaptic nerve endings; Function: inhibitory, feedback inhibition of NT release, \/ insulin; Mechanism: Gi protein;

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26
Q

Beta1

A

Receptor location: heart, kidney; Function: heart stimulation, renin release; Mechanism: Gs protein;

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27
Q

Beta2

A

Receptor location: lungs, skeletal muscle; Function: Vasodilation, bronchiole dilation, ciliary process (makes aqueous humour), \/ uterine tone, /\ insulin, /\ lipolysis; Mechanism: Gs protein;

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28
Q

D1

A

Function: renal vasodilation; Mechanism: Gs protein;

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28
Q

D2

A

Function: Causes NT release in brain; Mechanism: Gi protein;

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29
Q

H1

A

Function: /\ mucus production, bronchiole constriction, pain, itching; Mechanism: Gq protein;

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30
Q

H2

A

Function: gastric acid secretion; Mechanism: Gs protein;

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31
Q

V1

A

Function: vasoconstriction (smooth muscle); Mechanism: Gq protein;

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32
Q

V2

A

Function: /\ H20 permeability, reabsorption in collecting tubules in kidney; Mechanism: Gs protein;

$V2 is found in the 2 kidneys$

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33
Q

Mnemonic for gprotein receptors used for D, H, and V receptors

A

Sick of sex (SIQ, SQS) D1,D2, H1, H2, V1, V2

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34
Q

Function of Gq protein receptors

A

Gq protein activates PLC, IP3 + DAG, inc Ca++ (IP3) and activate PKC (DAG)

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35
Q

Function of Gi protein receptors

A

Gi protein activates K+ channels, inhibition of adenylate cyclase, reduction of cAMP

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36
Q

Function of Gs protein receptors

A

Gs protein activates adenylate cyclase, increases cAMP

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37
Q

Symptoms of cholinesterase inhibitor poisoning (I.e. organophosphates like PARATHION) + Tx

A

DUMBBELSS (Diarrhea, urination, miosis, bronchospasm, bradycardia, excitation (of skeletal muscle), lacrimation, sweating, salivation); treatment: atropine (reverses symptoms) + pralidoxime (regenerates cholinesterase)

$Ooze from every oriface$

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38
Q

Symptoms of muscarinic antagonist overdose

A

Hot as a hare (inc temp), Dry as a bone (dec secretions), Red as a beet (flushed skin), Blind as a bat (cycloplegia), Mad as a hatter

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39
Q

Direct cholinergic agonist drugs

A

Bethanechol, carbachol, pilocarpine, methacholine

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40
Q

Direct cholinergic agonist; activates bowel and bladder post operation

A

Bethanechol

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41
Q

Direct cholinergic agonist; used in glaucoma (causes pupillary contraction and reduces ICP)

A

Carbachol

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42
Q

Direct cholinergic agonist; potent stimulator of sweat and tears

A

Pilocarpine (PILE on the sweat and tears)

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43
Q

Direct cholinergic agonist; challenge test for asthma diagnosis

A

Methacholine

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44
Q

Indirect cholinergic agonist drugs (anticholinesterases)

A

(-stigmine, Ed PHYSted the MAiLman and it ECHOed) Neostigmine, pyridostigmine, physostigmine, edrophonium, echothiophate, malathion

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45
Q

Indirect cholinergic agonist; used in post operative reversal of NMJ block; does NOT penetrate the CNS

A

Neostigmine (NEO CNS)

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46
Q

Indirect cholinergic agonist; used for myasthenia gravis (due to it’s long action); does NOT penetrate the CNS

A

Pyridostigmine

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47
Q

Indirect cholinergic agonist; Used for glaucoma and atropine overdose (does cross CNS)

A

Physostigmine (PHYS is for EYES)

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48
Q

Indirect cholinergic agonist; Used to diagnose myasthenia gravis (extremely short action)

A

Edrophonium

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49
Q

Indirect cholinergic agonist; used for glaucoma

A

Echothiophate

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50
Q

Muscarinic antagonist drugs

A

Atropine, homatropine, tropicamide, benztropine, scopolamine, ipratropium, methscopolamine, oxybutynin, glycopyrrolate, pirenzepine, propantheline

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51
Q

Muscarinic antagonist drug(s); produces mydriasis and cycloplegia (eye)

A

Atropine (or homatropine, tropicamide)

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52
Q

Muscarinic antagonist drug; treatment for parkinson’s (CNS)

A

Benztropine (PARK my BENZ)

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53
Q

Muscarinic antagonist drug; treatment of motion sickness (CNS)

A

Scopolamine

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54
Q

Muscarinic antagonist drug; treats asthma and COPD (respiratory)

A

Ipratropium

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55
Q

Muscarinic antagonist drug(s); Reduces bladder urgency in cystitis and bladder spasms (GI)

A

Methscopolamine (or oxybutynin, glycopyrrolate)

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56
Q

Muscarinic antagonist drug(s); treatment of peptic ulcers (GI)

A

Pirenzepine (or propantheline)

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57
Q

Muscarinic antagonist drug; Used to block DUMBBELSS; Toxicity: hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter

A

Atropine

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58
Q

Nicotinic antagonist; ganglion blocker, used in experimental models to prevent vaga reflex responses to BP changes

A

Hexamethonium

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59
Q

Low doses of epinephrine are selective for what receptor?

A

B1

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60
Q

Drug used for anaphylaxis, open angle glaucoma, asthma and hypotension. Binds a1, a2, B1 and B2 receptors.

A

Epinephrine

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61
Q

Drug used for hypotension. Binds a1, a2 > B1

A

Norepinephrine

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62
Q

Drug that binds B1 = B2. Used rarely for AV block

A

Isoproterenol

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63
Q

Drug used for shock (by increased renal perfusion), and heart failure. Binds D1 = D2 > B > a.

A

Dopamine

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64
Q

Drug used for shock, heart failure, and cardiac stress test. Bind B1 > B2.

A

Dobutamine

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65
Q

What is the difference in inotropy and chronotropy between dopamine and dobutamine.

A

Dopamine is inotropic and chronotropic, Dobutamine is inotropic but not chronotropic.

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66
Q

Drug used for pupillary dilation, vasoconstriction, and nasal decongestion. Binds a1 > a2.

A

Phenylephrine.

67
Q

Drugs used for acute asthma. Binds B2>B1/

A

Albuterol

68
Q

Drug used to reduce premature uterine contractions. Binds B2 > B1.

A

Terbutaline

69
Q

Drug used to reduce premature uterine contractions. Binds B2 only.

A

Ritodrine

70
Q

Drug used to treat narcolepsy, obesity, ADD. Releases stored catecholamines.

A

Amphetamine

71
Q

Drug used for nasal decongestion, urinary incontinence, and hypotension. Releases stored catecholamines.

A

Ephedrine

72
Q

Drug that causes vasoconstriction and local anesthesia. Inhibits reuptake of NE.

A

Cocaine

73
Q

Drug used to treat hypertension (esp in renal disease because it prevents decrease in blood flow to kidney. Centrally acting a2 agonist.

A

Clonidine, a-methyldopa

74
Q

Effect of NE on systolic and diastolic BP, and heart rate.

A

Increased systolic and diastolic pressure, reflex bradycardia (all because a>B)

75
Q

Effect of epinephrineon systolic, diastolic BP and heart rate

A

Increased systolic (B1), decreased diastolic (B2) (wide PP, no change in mean BP), increased heart rate (B1)

76
Q

Effect of isoproterenol on BP and heart rate

A

Decrease BP (sys and diastolic, B2), BIG increase in HR (B1) (isoproterenol = B > a)

77
Q

Mnemonic for selective B2 agonists

A

MAST (metaproterenol, albuterol, salmeterol, terbutaline)

78
Q

Drugs (2) used in pheochromocytoma before tumor is removed. SE: orthostatic hypotension, reflex tachycardia

A

Phenoxybenzamine (irreversible), Phentolamine (reversible, both nonselective alpha blockers)

79
Q

Alpha antagonist used for hypertension and urinary retention in BPH. SE: first dose orthostatic hypotension

A

(a1 antagonists) Prazosin, Terazosin, doxazosin

80
Q

Alpha antagonist used for depression. SE: sedation, inc serum cholesterol, inc appetite.

A

(a2 selective) Mirtazapine

81
Q

How do beta blockers effect hypertension

A

Dec CO, dec renin secretion (B1)

82
Q

How are B blockers used in MI

A

Dec mortality after MI

83
Q

What B blockers are used in supraventricular tachycardia

A

Propanolol, esmolol

84
Q

What type of arrhythmia are B blockers used for

A

Dec. AV conduction velocity (SVT)

85
Q

How are B blockers used in glaucoma.

A

Dec secretion of aqueous humor (timolol)

86
Q

What are the sideeffects of B blockers

A

Impotence, exacerbates asthma, don’t use with diabetics

87
Q

What are the nonselective B blockers

A

Propanolol, timolol, nadolol, pindolol, labetalol

88
Q

What are the selective B1 blockers (mnemonic)

A

A BEAM of B1 blockers (acebutolol, betaxolol, esmolol, atenolol, metoprolol)

89
Q

Nonselective alpha and beta antagonists

A

Carvedilol, labetalol

90
Q

Treatment for overdose of acetominophen

A

N-acetylcysteine

91
Q

Treatment for overdose of Salicylates

A

NaHCO3 (alkalinize urine), dialysis

92
Q

Treatment for overdose of amphetamines

A

NH4Cl (acidify urine)

93
Q

Treatment for overdose of anticholinesterases, organophosphates

A

Atropine, pralidoxime

94
Q

Treatment for overdose of antimuscainic and anticholinergic agents

A

Physostigmine saligylate

95
Q

Treatment for overdose of B blockers

A

Glucagon

96
Q

Treatment for overdose of digitalis

A

K+, lidocaine, digibind, Mg2+

97
Q

Treatment for overdose of iron

A

Deferoxamine

98
Q

Treatment for overdose of lead

A

CaEDTA, dimercaprol, succimer (kids), penicilamine

99
Q

Treatment for overdose of arsenic, mercury, gold

A

Dimercapol, succimer

100
Q

Treatment for overdose of copper, arsenic, gold

A

Penicillamine

101
Q

Treatment for overdose of cyanide

A

Nitrite, hydroxycobalamin, thiosulfate

102
Q

Treatment for overdose of methemoglobin

A

Methylene blue

103
Q

Treatment for overdose of CO

A

100% O2, hyperbaric O2

104
Q

Treatment for overdose of methanol or ethylene glycol (antifreeze)

A

Ehtanol, dialysis, fomezipol

105
Q

Treatment for overdose of opiods

A

Naloxone, naltrexone

106
Q

Treatment for overdose of benzodiazapines

A

Flumazenil

107
Q

Treatment for overdose of TCAs

A

NaHCO3 (serum alkanization)

108
Q

Treatment for overdose of heparin

A

Protamine

109
Q

Treatment for overdose of warfarin

A

Vitamin K, fresh frozen plasma

110
Q

Treatment for overdose of tPA, streptokinase

A

Aminocaproic acid

111
Q

Sx: lines on gingivae and long bone epiphyses, encephalopathy and erythrocyte basophilic stippling, abdominal colic, sideroblastic anemia, wrist and foot drop

A

Lead poisining

112
Q

Acute poisining = gastric bleeding, chronic poisining = metaboic acidosis, GI obstruction (scarring). MOA = peroxidation of lipids

A

Iron poisining

113
Q

What drugs give an atropine like side effect to the cardiovascular system?

A

Tricyclics

114
Q

What drugs (2) cause coronary vasospasm as a side effect?

A

Cocaine, sumatripan

115
Q

What drugs (4) cause cutaneous flushing as a side effect

A

Niacin, Ca channel blockers, adenosine, vancomycin

116
Q

What drugs (2) cause dilated cardiomyopathy as a side effect

A

Doxorubicin, daunorubicin

117
Q

What drugs (3) cause torsades de pointes as a side effect

A

Class III antiarrythmics (sotalol), Class IA (quinidine) antiarrhythmics, cisapride

118
Q

What drugs (5) can cause agranulocytosis as a side effect

A

Clozapine, carbamazapine, colchicine, propylthiouracil, methimazole

119
Q

What drugs (5) can cause Aplastic anemia as a side effect

A

Chloramphenicol, benzene, NSAIDs, propylthiouracil, methimazole

120
Q

What drug can give a direct positive coomb’s hemolytic anemia?

A

Methyldopa

121
Q

What drug can cause grey baby syndrome as a side effect

A

Chloramphenicol

122
Q

What drugs (6 - mnemonic) can cause hemolysis in G6PD patients.

A

INH, sulfonamides, primaquin, aspirin, ibuprofen, nitrofurantoin (hemolysis IS PAIN)

123
Q

What drug class can cause thrombotic compications as a side effect?

A

OCPs (estrogen and progestins)

124
Q

What drug causes a dry cough as a side effect?

A

ACE inhibitors (NOT ARBs)

125
Q

What drugs (3) can cause pulmonary fibrosis as a side effect?

A

Bleomycin, busulfan, amiodarone

126
Q

What drug can cause acute cholestatic hepatitis as a side effect?

A

Macrolides

127
Q

What drus (4) can cause focal to massive hepatic necrosis as a side effect?

A

Halothane, valproic acid, acetominophen, Amanita phalloides

128
Q

What drug can cause hepatitis as a side effect?

A

INH

129
Q

What drugs (2) can cause psuedomembranous colitis as a side effect?

A

Clindamycin, ampicillin

130
Q

What drug can cause adrenocortical insufficiency as a side effect

A

Glucocorticoid withdrawal

131
Q

What drugs (6) can cause gynecomastia as a side effect? (mnemonic)

A

Spironolactone, digitalis, cimetidine, chronic alcohol use, estrogens, ketoconazole (Some Drugs Create Awesome Knockers)

132
Q

What drugs (2) can cause hot flashes as a side effect?

A

Tamoxifen, clomiphene

133
Q

What drug causes gingival hyperplasia as a side effect?

A

Phenytoin

134
Q

What drugs (2) can cause gout as a side effect

A

Furosemide, thiazides

135
Q

What drugs (2) can cause osteoporosis as a side effect?

A

Corticosteroids, heparin

136
Q

What drugs (3) can cause photosensitivity as a side effect (mnemonic)?

A

Sulfonamides, Amiodarone, Tetracycline (SAT for a PHOTO)

137
Q

What drugs (4) can cause an SLE-like syndrome as a side effect?

A

Hydralazine, INH, procainamide, phenytoin (it’s not HIPP to have lupus)

138
Q

What drug causes tendonitis, tendon rupture and cartilage damage as a side effect in kids?

A

Fluoroquinalones

139
Q

What drug causes Fanconi’s syndrome as a side effect

A

Expired tetracycline

140
Q

What drugs (2) cause interstitial nephritis as a side effect?

A

Methicillin, NSAIDs

141
Q

What drugs (2) cause hemorrhagic cystitis as a side effect?

A

Cyclophosphamide, ifosfamide

142
Q

What drugs (2) cause cinchonism as a side effect?

A

Quinidine, quinine

143
Q

What drugs (2) cause diabetes insipidus as a side effect

A

Lithium, demeclocycline

144
Q

What drugs (2) cause seizures as a side effect?

A

Bupropion, imipenem/cilastin

145
Q

What drugs cause tardive dyskinesia?

A

Antipsychotics (typical)

146
Q

What drugs (4) cause a disulfiram-like reaction as a side effect

A

Metronidazole, cephalosporins (some), procarbazine, 1st generation sulfonylureas

147
Q

What drug causes nephrotoxicity and neurotoxicity as side effects?

A

Polymixins

148
Q

What drugs (3) cause nephrotoxicity and ototoxicity as a side effect?

A

Aminoglycosides, loop diuretics, cisplatin

149
Q

Mnemonic for p450 inducers

A

Queen barb takes Phen-phen and Refuses Greasy Card Shakes (quinidine, barbiturates, phenytoin, rifampin, griseofulvin, carbamazapine, st. john’s wart)

150
Q

Mnemonic for p450 inhibitors

A

Inhibitors Stop Cyber-Kids from Eating Grapefruit (INH, sulfonamides, cimetidine, ketoconazole, erythromycin, grapefruit juice)

151
Q

Method to prevent hymorrhagic cystitis caused by cyclophosphamide or ifosfamide

A

Coadminister with mesna

152
Q

What is ethylene glycol converted to in the body

A

Oxalic acid

153
Q

What does oxalic acid (metabolic product of ethylene glycol) cause?

A

Acidosis, nephrotoxicity

154
Q

What metabolic products (2) is methanol converted to in the body

A

Formaldehyde and formic acid

155
Q

What are the effects of formaldehyde and formic acid (metabolic products of methanol) in the body?

A

Severe acidosis, and retinal damage

156
Q

What is ethanol broken down by in the body?

A

Acetaldehyde

157
Q

What enzyme breaks down ethylene glycol, methanol, and ethanol?

A

Alcohol dehydrogenase

158
Q

Inhibitor of alcohol DH

A

Fomepizole

159
Q

What drugs do you not give people with sulfa allergies

A

Sulfa drugs (celcoxib, furosemide, thiazides, TMP-SMX, sulfonyureas, sulfasalazine

160
Q

Herbal agent that can cause arrythmias, stroke, and seizures at high doses

A

Ephedra

161
Q

Herbal agents that have antiplatelet actions

A

Feverfew (migraines) and ginko (claudication)

162
Q

Herbal agent that can cause phototoxicity and dermatotoxicity

A

Kava (chronic anxiety)

163
Q

Herbal agent that can cause hypertension

A

Saw palmetto (benign prostatic hyperplasia)

164
Q

Herbal agent that can cause serotonin syndrome w/ ssris, and induces p-450

A

St. John’s wort (depression)

165
Q

Herbal agent that causes androgenization in premenopausal women, and estrogen effects in postmenopausal women and feminization in young men

A

Dehydroepiandosterone (SLE or AIDs)

Pharmacology (6 decks)

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