Pharm Test 4 Flashcards by Rae Perry

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

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how do we protect clots from lysis?

aminocaproic acid

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which coagulation blood test measures the activity of the intrinsic pathway?

aPTT

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which coagulation blood test measures the activity of the extrinsic pathway?

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Normal INR for warfarin?

2-3

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what does HMW primarily work on?

antithrombin

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what does LMW primarily work on?

Factor Xa

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what does Fondaparinux primarily work on?

antithrombin (much less than HMW heparin)

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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

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which drug will mostly likely be given after a stent placement?

plavix

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what foods have vitamin K?

green leafy veggies

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what does Vit. K work on?

prothrombin
factor VII, IX, X

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which drug is given for hemorrhages

Transischemic acid

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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

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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

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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

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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)

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Chronic inflammation results in what being released?

additional mediators

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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