Pharmaco 💊

Question 1

P450 INDUCERS

Answer 1

CRAPGPS

Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseoflavin
Sulfonylurea

Question 2

MOA of P450 inducer

Answer 2

Speed up drug metabolism
i.e, Increase clearance

Question 3

P450 subtypes
CYP 1A2/2E1/2C9/2D6/3A4

Answer 3

Acetaminophen
Ethanol
Warfarin (K dependent - 2/7/9/10)
CVS drugs ( ECHO-2D)
Most common most drugs /toxin

Question 4

Pharmacodynamic means

Answer 4

Conc of drug and it effect
How the drug interact with the body
Eg: Receptor+Ligands complex

Question 5

Pharmakinetics stages

Answer 5

Absorption
Distribution
Metabolism
Excretion

Question 6

Bioavailability

Answer 6

Amount of drug available in the systemic circulation ( blood)
IV- 100% available
PO- < 100% due to barriers( BBB/ Placenta/ GI tract /Testicular)

Question 7

Potency of drugs

Answer 7

Strength of drug depending on dosage

Question 8

Efficacy

Answer 8

Maximum effect independent of the dose ( max response drug can give)

Question 9

Affinity of drugs

Answer 9

Ability of drug ligand to bind to receptors
Affinity & Potency(I.e: the more affinity the more molecule of drug bind to receptor and not leaving out unbound wasted drug molecules)

Question 10

Antibiotic classes

Answer 10

1. Cell wall inhibitor/B-lactamase - penicillin / Amoxicillin
2. Protein synthesis inhibitor
   -50s Ribosomal - tetracycline /aminoglycoside
   -30s ribosomal - macrolide /clindamycin/linezolid/chlorenphenicol
   3.NA inhibitor
   - DNA gyrase ( Quinolones)
   -RNA Pol(Rifampin)
   4.Folate synthesis inhibitor (SMP-TMX)

Question 11

Most common Empirical Antibiotics

Answer 11

1.Piperacillin + Clavulanate (or) tazobactem
-covers all except MRSA and Atypical

2. 5th Gen cephalosporin (cover all except Pseudomonas and Atypical )

Question 12

Antibiotics against Pseudomonas

Answer 12

3rd and 4th gen cephalosporin
Piperacillin+ clavulanic acid (or) Tazobectam
Quinolones
Aminoglycosides
Fosfomycin
Colistin

Question 13

Antibiotics against MRSA

Answer 13

5th gen Cephalosporin
Folate antagonist (SMX-TMP)
macrolides/Clindamycin/Vancomycin/Linezolid (NA-I)
Tetracycline (30s)

Question 14

MOA of Acyclovir
Treat what viral illness ?

Answer 14

Inhibit DNA polymerase by mutating viral thymidine kinase
Adding 3 phosphate chain to acyclovir which interfere with DNA replication
HSV/VZV

Question 15

MOA of Oseltamivir
Used to treat which viral illness?
What other drugs can be used and MOA?

Answer 15

Influenza
1.Oseltamivir- Prevent release of copied virus into plasma via blocking viral attachment to cell membrane

2.endonuclease Inhibitor ( mRNA for viral translation and replication)

3.M2 Ion channel inhibitor ( block Viral genome released to host nucleus)

Question 16

HRT of HIV MOA

Answer 16

1. Entry inhibitor ( CD4 Receptor -I / C5R/CXCR -4-I)
2. Reverse Transcriptase Inhibitor ( NRTIS/NNRTIS)
3. Integrate Inhibitor
   4.Protease inhibitor (prevent viral protein cleavage&raquo_space; viral protein loss virulence)

Question 17

ART regime in HIV

Answer 17

Most preferred / 1st line
1. 2NRTIS + NNRTIS
AZT + 3TC+EFV (zedovudine+Lemivudine + Efavirenz)

2. 2 NRTIS + PI

Question 18

Volume Distribution equation

Answer 18

Vd = Amount of Drug / Conc of plasma

Question 19

Therapeutic Index (TI)
Is high TI good?

Answer 19

TI - minimum amount of drug to be effective
High TI is bad bc it means drugs needed a lot to be effective which can leads to toxicity and ADR

Question 20

Half life equation

Answer 20

HL(t1/2)= 0.7 x Vd/CL(clearance )

Question 21

How many half life needed for the drug to be eliminated or metabolized completely ?

Answer 21

Between 4 and 5 half life
Half life happen via 1st order elimination -happen to most drugs

Question 22

Drugs with 0 order elimination

Answer 22

Ethanol
Aspirin
Phenytoin

Question 23

Types of G Protein Receptor

Answer 23

1. Gs- increase cAMP ( all b, H2 D2 receptors)
   2.Gi - decrease cAMP (MAD2)
   3.Gq - PIP /IP3 (M1 /M3)

Question 24

Adrenergic receptors ( Sympathetic)

Answer 24

Alpha 1 (NE>E)-vasoconstriction /bronchoconstriction
Alpha 2 (E>NE)- inhibit Glu,cAMP,Insulin,NE
Beta1 (E=NE)- Increase HR/Lipolysis / heart contraction , Renin
Beta 2 (E>NE)- vasodilation /Bronchodilation/glycogenolysis

Question 25

Cholinergic receptors

Answer 25

Muscurinic -M1 to M5 - Act on NMJ

Nicotinic - Nm/Nn (ligand gated R)- act on CNS/adrenal glands )

Question 26

Nitric Oxide and cGMP signaling

Answer 26

Vasodilation
Muscle Relaxation

NO acts on cGMP and cause dephosphorylation of myosin light chain along with endogenous compound (Bradykinin / His)