Pharm Test 4 Flashcards
Explanation of insulin secretion
When BG is high, we will get a large influx of glucose through Glut 2 transporters into the beta cell.
That glucose is metabolized via glycolysis to produce ATP
High levels of ATP bind to the potassium channels on the cell surface (inward rectifying K+ channel that maintains the normal membrane polarization).
ATP closes the potassium channels, depolarizing the membrane making us more positive.
This causes VG- CA++ channels to open
Ca++ rushes into cell and increased Ca++ levels bind to the vesicle complex that contains the stored insulin
The vesicle then fuses with the cell membrane and releases insulin into the blood
how do we protect clots from lysis?
aminocaproic acid
which coagulation blood test measures the activity of the intrinsic pathway?
aPTT
which coagulation blood test measures the activity of the extrinsic pathway?
PT
Normal INR for warfarin?
2-3
what does HMW primarily work on?
antithrombin
what does LMW primarily work on?
Factor Xa
what does Fondaparinux primarily work on?
antithrombin (much less than HMW heparin)
How does warfarin work?
Reversals?
through oxidation/reduction reactions on the various factors that are in the blood coagulation cascade like thrombin.
Reversal: Vit. K and FFP
which drug will mostly likely be given after a stent placement?
plavix
what foods have vitamin K?
green leafy veggies
what does Vit. K work on?
prothrombin
factor VII, IX, X
which drug is given for hemorrhages
Transischemic acid
what are the incretin based therapies and MOA
GLP-1 agonist
DPP-4 antagonists
-GI like hormones
DPP-4 enzyme inactivates GLP-1 (DPP-4 inhibitors inhibit this)
GLP-1 stimulates insulin release and inhibits glucagon release
lowers BG
What are the 4 different types of lipoproteins? Where are they produced?
What is their basic role?
- Chylomicrons: formed in intestine (dietary)
Carry triglycerides and cholesterol - VLDL: secreted from liver
Converts to LDL - LDL: made from LDL
Transports cholesterol and binds to LDL-r - HDL: not sure where made.. Liver?
scavenger of cholesterol from cells
calculate the LDL to HDL cholesterol risk ratio:
LDL=120
HDL=40
LDL=60
HDL=60
LDL=200
HDL=40
LDL=120
HDL=30
120/4=3 average risk
60/60=1 half average
200/40=5 twice average
200/30=6.66 about 3 times average
(I know this math ain’t mathin I was going off his slides & recording)
This is the risk of the pt. getting coronary artery disease
what are the 2 most important numbers to look at when determining if the pt should be put on a statin?
LDL/HDL ratio (should be <3)
Total cholesterol (should be <200)
Chronic inflammation results in what being released?
additional mediators
what causes an inflammatory response?
release of COX from the cell membrane
acute effects of glucocorticoids?
suppresses inflammation!
what is the thought process behind anti-inflammatory drugs like daily low dose asa helping in the prevention of cancer?
reduce NFKB and STAT 3 which drive cell cycle progression
in pharm which fiber transmits pain?
C fibers
in pharm, which fibers can help in lateral inhibition when you have pain?
a fibers
which pain pathway is more psychological?
spinoreticular
which pain pathway is more physical?
spinothalamic
which pathway do we use to shut down pain via endogenous endorphins being released into the periaqueductal grey area where there the area is rich in _____ receptors?
spinomesolimbic
Mu
what are the 2 symptoms from opioids that you canNOT develop a tolerance to?
miosis
constipation
Tolerance vs dependence
tolerance: need more and more for the same effect
dependence: continuation despite negative effects
withdrawal symptoms usually happen if try to stop
difference in gram + and gram - bacteria
gram + have a big fat wall so stains purple. Release exotoxins.
gram - have a skinny wall so stains pink.
Have 2 outer cell membrane with little hairs called lipopolysaccharide. When those are released into the body they’re called endotoxins which can be very dangerous.
what is a capsid?
an outer shell around a nucleic acid. ALL viruses have these 2 things at minimum
what is an envelope? (Virus)
an outer cell membrane that was made by the cell that the virus has infected.
what is a retrovirus?
start as RNA and converted into DNA. The virus’s DNA gets put into the human DNA and is there forever now.
i.e. HIV
does this via reverse transcriptase. Drug target.
what is a virus spike?
the “honing beacon” that targets a specific cell protein
What is a naked virus?
a virus without an envelope
draw a beta lactam ring
The red part
what are the 3 populations of different types of organisms that we have in the body when you have bacterial infection:
highly sensitive organisms
intermediate organisms
highly resistant organisms
what are the effects or premature termination of antibiotic treatment?
day 0:
a lot of all 3-
highly sensitive organisms
intermediate organisms
highly resistant organisms
day 3:
small amount left of highly sensitive organisms
a little intermediate organisms
a lot of highly resistant organisms
Day 6:
barely any highly sensitive organisms
a couple intermediate organisms
still quite a few highly resistant organisms
-people stop abx here but the highly resistant bacteria are still in too high of a number for the body to be able to kill it so we get abx resistance
define athetosis
slow and writhing
define dystonia
abnormal posture
define tics
single repetitive movements especially of the face
define chorea
muscle jerks in various areas
define ballismus
subcategory of chorea: violent abnormal movements
what drug can help with the on-off phenomenon in Parkinson’s?
apomorphine
what is the on off phenomenon in Parkinson’s?
periods of increased mobility followed by marked akinesia. Some people take a drug holiday to help but not recommended
What is benign hereditary chorea?
autosomal dominant disorder occurs in childhood-no progression. Treat with tetrabenazine
what is Gowers sign ?
Go from downwards facing dog to standing- toddler should stand right up .
If Dowers sign is positive the toddler will place hands on knees to push themselves up because they don’t have enough strength in their back to stand straight up.
Positive is a sign of Duchenne’s disease.
what are the 2 main s/s of alzheimer’s disease?
neurofibrillary tangles
senile plaques
