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Step 1 > Pharmacolgy > Flashcards

Pharmacolgy Flashcards

1
Q

Briefly describe additive, synergistic and permissive effects

A

Additive - A w/ B = A + B. Synergistic - A w/ B > A + B. Permissive - B = 0 but A w/ B > A

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2
Q

Formula for volume of distribution

A

[Amount of drug in body] / [plasma dug concentration]

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3
Q

Formula for half life

A

(0.7 x Vd) / CL

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4
Q

Formula for loading dose

A

Cp x Vd/F. Cp is desired peak concentration, Vd is volume of distribution. F is bioavailability

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5
Q

Drugs that undergo zero order elimination

A

Phenytoin, Ethanol, Aspirin (very high dosese)

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6
Q

What type of compounds preferentially get metabolized by the liver?

A

Lipophilic compounds

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7
Q

On a dose response curve, which axis is potency and which is efficacy?

A

Potency is x axis, efficacy is y axis

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8
Q

What relationship do norepinephrine and phenoxybenzamine have at alpha receptors?

A

Noncompetitive antagonist

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9
Q

What type of receptors are nicotinic receptors?

A

Ligand-gated Na/K channels

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10
Q

G protein class for the sympathetic receptors

A

A1 - q, A2 - i, B1 - s, B2 - s

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11
Q

G protein class for the parasympathetic receptors

A

M1 - q, M2 - i, M3 - q

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12
Q

G protein class for dopamine, histamine, and vasopressin receptors

A

D1 - s, D2 - i. H1 - q, H2 - s. V1 - q, V2 - s

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13
Q

Gq receptors

A

Use phospholipase C to create PIP2 which creates DAG (PKC) and IP3 (Ca influx)

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14
Q

Gs receptors

A

Stimulate adenylyl cyclase to increase cAMP levels, which increases PKA levels, which increases Ca influx (heart) and inhibits MLCK (SM)

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15
Q

Gi receptors

A

Inhibit adenylyl cyclase levels, decreasing cAMP

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16
Q

Which sympathetic receptor does NE not act much on?

A

B2

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17
Q

How can you tell the difference between an alpha agonist and a muscarinic antagonist?

A

Alpha agonism causes mydriasis, muscarinic antagonism causes mydriasis AND FLUSHING

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18
Q

Direct cholinomimetic agents

A

Bethanechol, carbachol, pilocarpine, methacholine

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19
Q

Indirect cholinomimetics (AChE-Is)

A

Neostigmine, pyridostigmine, edrophonium, physostigmine, echothiophate, donepezil

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20
Q

What do organophosphates do biochemically?

A

Shut down AChE

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21
Q

Treatment for organophosphate poisoning and rationale

A

Atropine to help muscarinic receptors, pralidoxime to help nicotinic receptors (muscle paralysis)

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22
Q

Pralidoxime

A

Regenerates active AChE. Give with atropine in cholinesterase poisoning

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23
Q

Muscarinic antagonists

A

Eye - atropine, homatropine, tropicamide. CNS - benztropine, scopolamine. Respiratory - ipratropium. GU - oxybutynin, glycopyrrolate. GI - methscopolamine, pirenzepine, propantheline

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24
Q

Tiotropium

A

Trade name spiriva. Muscarinic antagonist used in asthma and COPD

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25
Q

Which sympathetic receptors does epi act at?

A

A1, A2, B1, B2 (all of them except D1)

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26
Q

Isoproterenol

A

B1 and B2 agonist. Used in AV block

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27
Q

Which sympathetic receptors does dopamine act at?

A

High dose - A1 and A2. Medium dose - B1 and B2. Low dose - D1. Use in shock to increase renal perfusion

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28
Q

Dobutamine

A

B1 agonist with some activity at A1, A2, and B2. Inotropic but not chronotropic

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29
Q

Phenylephrine

A

A1 and A2 agonist (more activity at A1 than A2)

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30
Q

Ritodrine

A

Selective B2 agonist. Reduces premature uterine contractions

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31
Q

Action of amphetamine and ephedrine

A

Indirect sympathetic agonists. Release stored catecholamines

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32
Q

Action of cocaine

A

Indirect general sympathetic agonist. Uptake inhibitor

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33
Q

Clonidine, alpha-methyldopa

A

Centrally acting alpha 2 agonists. Decrease adrenergic outflow. Use in HTN with renal disease

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34
Q

Phenoxybenzamine

A

Nonselective irreversible alpha blocker. Use in pheochromocytoma

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35
Q

Phentolamine

A

Reversible nonselective alpha blocker. Give to patients on MAOIs who eat tyramine-containing foods

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36
Q

Prazosin, terazosin, doxasin

A

Alpha-1 blockers. Use in HTN, BPH

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37
Q

Mirtazapine

A

Alpha-2 blocker. Use in depression

38
Q

What neurologic disorder is propanolol used in and in what concurrent conditions might it be contraindicated?

A

Migraine prophylaxis. Do not use if pt has COPD or asthma

39
Q

B1-selective antagonist with partial agonist activity

A

Acebutolol

40
Q

B1-selective antagonists

A

Acebutolol (partial agonist), Betaxolol, Esmolol, Atenolol, Metoprolol

41
Q

Carvedilol and Labetalol

A

Nonselective (vasodilatory) alpha and beta antagonists

42
Q

Partial Beta Agonists

A

Pindolol, Acebutolol

43
Q

Salicylate antidote

A

NaHCO3, dialysis

44
Q

Amphetamine antidote

A

NH4Cl (to acidify urine)

45
Q

Beta-blocker antidote

A

Glucagon

46
Q

Lead, Mercury, Arsenic, Gold, Copper, and Cyanide antidotes

A

LEad - CaEDTA, dimercaprol, succimer and penicillamine. Mercury, Arsenic and Gold - Dimercaprol, succimer. Copper, arsenic and gold - Penicillamine. Cyanide - Nitrite, hydroxycobalamin, thiosulfate

47
Q

TCA antidote

A

NaHCO3 (plasma alkalinization)

48
Q

tPA, streptokinase, and urokinase antidote

A

Aminocaproic acid

49
Q

Theophylline antidote

A

Beta-blocker

50
Q

Hexamethonium

A

Essentially blocks the entire ANS (sympathetic and parasympathetic)

51
Q

Drugs that cause cutaneous flushing

A

Vancomycin, Adenosine, Niacin, Ca channel blockers

52
Q

Drugs that cause dilated cardiomyopathy

A

Doxorubicin, daunorubicin

53
Q

Anti-arrhythmic drugs that cause torsades de pointes

A

Class 3 (sotalol), class 1A (quinidine) antiarrhythmics

54
Q

Drugs that cause agranulocytosis

A

Clozapine, Carbamazepine, Colchicine, PTU, Methimazole, Dapsone

55
Q

Drugs that cause aplastic anemia

A

Chloramphenicol, benzene, NSAIDs, PTU, methimazole

56
Q

Drugs that cause direct coombs positive hemolytic anemia

A

Methyldopa

57
Q

Drugs that cause hemolysis in G6PD patients

A

INH, Sulfonamides, Primaquine, Aspirin, Ibuprofen, Nitrofurantoin

58
Q

Drugs that cause megaloblastic anemia

A

Phenytoin, Methotrexate, Sulfa drugs

59
Q

Drugs that cause pulmonary fibrosis

A

Bleomycin, Amiodarone, Busulfan

60
Q

Drugs that cause acute cholestatic hepatitis

A

Macrolides

61
Q

Drugs that cause focal to massive hepatic necrosis

A

Halothane, acetaminophen, valproic acid, amanita phalloides (mushroom)

62
Q

Drugs that cause hepatitis

A

INH

63
Q

Drugs that cause pseudomembranous colitis

A

Clindamycin, ampicillin

64
Q

Drugs that cause gynecomastia

A

Spironolactone, Digitalis, Cimetidine, chronic alcohol use, Estrogens, Ketoconazole

65
Q

Drugs that cause hypothyroidism

A

Lithium, amiodarone, sulfonamides

66
Q

Drugs that cause hyperglycemia

A

Niacin, tacrolimus, protease inhibitors

67
Q

Drugs that cause fat redistribution

A

Glucocorticoids and protease inhibitors

68
Q

Drugs that cause gingival hyperplasia

A

Phenytoin, verapamil

69
Q

Drugs that cause gout

A

Furosemide, thiazides, niacin, cyclosporine, pyrazinamide

70
Q

Drugs that cause myopathy

A

Fibrates, Niacin, Colchicine, Hydroxychloroquine, Interferon-a, Penicillamine, Statins, Glucocorticoids

71
Q

Drugs that cause osteoporosis

A

Corticosteroids, heparin

72
Q

Drugs that cause photosensitivity

A

Sulfonamides, Amiodarone, Tetracycline

73
Q

Drugs that cause stevens-johnson

A

Penicillin, Ethosuximide, Carbamazepine, Sulfa drugs, Lamotrigine, Allopurinol, Phenytoin, Phenobarbital

74
Q

Drugs that cause SLE-like syndrome

A

Hydralazine, INH, Procainamide, Phenytoin

75
Q

Who tends to get drug induced lupus?

A

Slow acetylators. The drugs that cause this all required n-acetylation in the liver

76
Q

Drugs that cause tendonitis, tendon rupture, and cartilage damage in kids

A

Fluoroquinolones

77
Q

Drugs that cause DI

A

Lithium, demeclocycline

78
Q

Drugs that cause fanconis syndrome

A

Expired tetracycline

79
Q

Drugs that cause interstitial nephritis

A

Methicillin, NSAIDs, furosemide

80
Q

Drugs that cause hemorrhagic cystitis

A

Cyclophosphamide, ifosfamide (give with mesna)

81
Q

Drugs that cause SIADH

A

Carbamazepine, cyclophosphamide

82
Q

Drugs that cause cinchonism (flushed and sweaty skin, tinnitus, blurred vision, confusion, headache, abdominal pain, rashes, photosensitivity, vertigo, dysphoria, nausea, vomiting and diarrhea)

A

Quinidine, quinine

83
Q

Drugs that cause Parkinsonism

A

Antipsychotics, reserpine, metoclopramide

84
Q

Drugs that cause seizures

A

Bupropion, imipenem/cilastatin, INH

85
Q

Drugs that cause disulfiram-like reaction

A

Metronidazole, cephalosporins, procarbazine, sulfonylureas

86
Q

Drugs that cause nephrotoxicity/ototoxicity

A

Aminoglycosides, vancomycin, loop diuretics, cisplatin

87
Q

List the P-450 inducers (7)

A

Barbiturates, St. Johns wort, Phenytoin, Rifampin, Griseofulvin, Carbamazepine, Alcohol (chronic)

88
Q

List the P-450 inhibitors (11)

A

Quinidine, Macrolides, Amiodarone, Grapefruit juice, INH, Cimetidine, Ritonavir, Alcohol (acute), Ciprofloxacin, Ketoconazole, Sulfonamides

89
Q

Sulfa drugs (8)

A

Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotics, Sulfasalazine, Sulfonylureas

90
Q

POMC derivatives

A

ACTH, MSH, B-endorphins

91
Q

High CYP activity is associated with increased susceptibility to what?

A

Cancer. Most carcinogens come in as pro-carcinogens and are metabolized by the CYP-450 system (monooxygenases)

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