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BOARD REVIEW > PHARMACOLOGY > Flashcards

PHARMACOLOGY Flashcards

1
Q

A centrally-acting antihypertensive that is associated with lupus like syndrome

A

Methyldopa

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2
Q

Adrenoreceptors that causes mydriasis, ejaculation and vasoconstriction of peripheral circulation

A

Alpha 1

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3
Q

Selective beta blocker that has a very short half-life and is used to treat intraoperative hypertension.

A

Esmolol

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4
Q

Calcium channel blocker utilized to treat vasospasm in Subarachnoid hemorrhage due to a ruptured cerebral aneurysm

A

Nimodipine

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5
Q

A non-dihydropyridine calcium channel blocker that causes constipation and is contraindicated in heart failure

A

Verapamil

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6
Q

autonomic or somatic system? Associated with skeletal system

A

somatic

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7
Q

autonomic or somatic system? regulation of very important organs such as lungs and heart

A

Autonomic

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8
Q

Sympathetic

A

Thoracolumbar division

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9
Q

Parasympathetic

A

Craniosacral division

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10
Q

Predominant neurotransmitter in sympathetic preganlionic

A

ACH

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11
Q

Predominant neurotransmitter Sympathetic preganglionic

A

ACH

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12
Q

Predominant neurotransmitter Parasympathetic postganlionic

A

ACH

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13
Q

Predominant neurotransmitter Sympathetic postganglionic

A

NE

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14
Q

cholinergic receptor that supplies the sweat glands and some specialized blood vessels

A

Muscarinic

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15
Q

Cholinergic receptor indirectly stimulated by malathion or organophosphate

A

Muscarinic

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16
Q

Adrenergic receptor involved in peripheral vasoconstriction

A

Alpha 1

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17
Q

Adrenergic receptor abundant in heart

A

Beta 1

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18
Q

Adrenergic receptor abundant in lungs

A

Beta 2

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19
Q

Alpha 1 receptor agonist for treatment of septic shock

A

Norepinephrine (Levophed)

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20
Q

Alpha 1 blocker which is used to treat BPH

A

Prazosin
Terazosin
Tamsulosin

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21
Q

Side effect of alpha 1 blockers for treatment of hypertension

A

Orthostatic hypotension/ 1st dose hypotension

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22
Q

Side effect of beta blockers (beta 2)

A

Bronchoconstriction
Bradycardia

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23
Q

Beta 2 agonist tocolytic

A

Terbutaline - used for asthma
Ritodrine
Isoxuprine (duvadilan)

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24
Q

Alpha 1 selective agent used for nasal decongestion

A

Phenylephrine
Oxymethazoline

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25
Q

Side effect of phenylephrine

A

Hypertension

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26
Q

Rebound hyperemic or nasal congestion. Occurs in 3 days of use of nasal sprays

A

Rhinitis medicamentosa

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27
Q

Alpha 2 selective agonists useful for management of hypertension which causes lupus like syndrome and can be used in pregnancy

A

Methyldopa

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28
Q

DOC of Pre eclampsia

A

Methyldopa

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29
Q

Beta 1 selective agonist used for management of cardiogenic shock (hypotension) on acute heart failure

A

Dobutamine

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30
Q

Beta 2 selective agonist used for asthma as relievers

A

Terbutaline
Salbutamol
Fenoterol

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31
Q

Cholinergic antagonist given to COPD patients in combination to beta 2 agonist (like salbutamol or fenoterol)

A

Ipratropium

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32
Q

Side effect of Beta 2 agonist

A

Hypokalemia
Muscle tremors (Terbutaline)
Tolerance
Tachycardia

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33
Q

causes depression or suicide tendencies

A

Reserpine

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34
Q

DOC for treatment of pheochromocytoma

A

Phenoxybenzamine

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35
Q

Adrenal medulla tumor

A

Pheochromocytoma

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36
Q

Parasympathetic agents - Cholinergic agonist

A

DDUMBELS
Diarrhea
Decrease BP
Urination
Miosis
Bronchoconstriction
Excitation of skeletal muscle
Lacrimation
Salivation and sweating

= Organophosphate poisoning

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37
Q

Direct acting cholinomimetic DOC for Post op urinary retention

A

Bethanichol

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38
Q

Direct acting cholinergic agonist used as eyedrops

A

Pilocarpine

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39
Q

DOC for Myasthenia Gravis

A

Pyridostigmine
Physostigmine
Neostigmine

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40
Q

DOC for glaucoma

A

Carbachol
Pilocarpine

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41
Q

Cholinergic antagonist associated with malignant hyperthermia

A

Succinylcholine
or halothane

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42
Q

DOC for malignant hyperthermia

A

Dantrolene

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43
Q

Antimuscarinic acts as anti-motion sickness

Anterograde amnesia

A

Scopolamine

Morphine + scopolamine “twilight sleep”’

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44
Q

Famous anticonvulsant that binds to synaptic vesicle protein (SV2)

Metabolized int he kidney

A

Leviteracetam

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45
Q

Actions of the body on the drug

A

PharmacoKinetics
Katawan

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46
Q

Major organ where the drug metabolized

A

Liver and kidney

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47
Q

Actions of the Drug on the bidy

A

PharmacoDynamics

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48
Q

Drug has affinity for receptros but no ability to activate them

A

Antagonist

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49
Q

Dose required to cause one half of individuals

A

ED50 / Median dose

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50
Q

LD 50 divided by ED50

A

Therapeutic index

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51
Q

RATE and EXTENT of drug absorption from a dosage form

A

Bioavailability

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52
Q

Transfer of drug from of administration to bloodstream/systemic circulation

SITE of admin TO BLOOD

A

Drug absorption

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53
Q

Absorbable or Excretable drug?

NON-POLAR
LIPID soluble
NON IONIZED

A

Absorbable

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54
Q

Study of RATE PROCESSES involved in absorption, distribution, metab and excretion of drug

What the BODY DOES TO DRUG

A

PharmacoKinetics

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55
Q

Basic pharmacokinetic processes (ADME)

A

Absorption
Distribution
Metabolism
Excretion

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56
Q

Drug DISPOSITION (DME)

A

Distribution
Metabolism
Excretion

57
Q

Drug ELIMINATION (ME)

A

Metabolism
Excretion

58
Q

Relationship between drug concentration at the site of action and pharmacologic response

Drug DOES TO THE BODY
“Mechanism of action of drug”

A

PharmacoDynamics

59
Q

A drug with both affinity and intrinsic activity

A

Agonist

60
Q

A drug with affinity but NO intrinsic activity

A

Antagonist

61
Q

Drug disposition commences with which of the pharmacokinetic processes

A

Distribution

62
Q

Drug elimination commences with which of the followinh pharmacokinetic processes

A

Metabolism

63
Q

Refers to the amount of drug in the blood stream

Greatly affected by drug absorption

A

Bioavailability

64
Q

Route of administration with NO absorption, 100% bioavailability and no loss of drug

A

IV (intravenous)

65
Q

“Depot effect” (storage effect) can be achieved

A

IntraMuscular (IM)

66
Q

Basis why acidic drug is best absorbed in the stomach

A

Henderson-hasselbach equation

67
Q

Most important site of drug absorption

A

Small intestine (DUODENUM - BEST!!)

*except for acidic drugs!!

68
Q

Site of absorption for SLOWLY absorbed drugs

A

Large intestine

69
Q

Rate at which the drug solution leaves the stomach and enters the duodenum

A

Gastric emptying rate

70
Q

The ony drug that has higher bioavailability when ingested with fatty meal!

A

Griseofulvin

Normally, fatty meal (as well as high carb meal) DECREASES drug bioavailability.
HOT foods Increases GER

71
Q

INCREASE o DECREASE?

Lying on the LEFT side?

A

DECREASE GER

72
Q

INCREASE o DECREASE?

Lying down vs Standing?

A

DECREASE GER when LYING DOWN

73
Q

Antiemetics like metoclopramide will __(increase or decrease)__ GER?

A

Increase

74
Q

Is there First pass effect in Middle rectal vein and Inferior rectal vein?

A

NO. It will no go to the hepatic portal system (Superior Rectal Vein only)

75
Q

Reversible transfer of drug from one compartment to another

A

Distribution

76
Q

Most important contributory factor that affects drug distribution

A

Perfusion (q)

77
Q

Basis of computation of the loading dose

A

Volume of distribution of a drug

78
Q

Conversion of a drug to an excretable form

A

Metabolism

79
Q

Phase 1 reactions (RedOx reaction) :
HORD

A

Hydrolysis
Oxidation
Reduction
Deamination

80
Q

Most important site of drug metabolism

A

Liver!

Kidneys, intestines, skin, heart

81
Q

Danger of enzyme inducers

A

Low therapeutic effect

82
Q

Danger of enzyme inhibition

A

Toxicity

83
Q

Enzyme inducers:

A

Phenobarbital
Phenytoin
Rifampicin
Carbamazepine —AUTOINDUCTION
Barbequed/ charboiled/ cigarette smoking
Chronic alcoholism
St johns wort

84
Q

Enzyme inhibitors (ME-DICK-VAG)

A

Metronidazole
Erythromycin
Disulfiram
INH
Cimetidine
Ketoconazole
Valproic acid
Acute alcoholism
Grapefruit juice

85
Q

Phenobarbital (enzyme inducer) when given to a patient on chronic warfarin is classified as

A

Pharmacokinetic antagonist

86
Q

Constant AMOUNT per unit of time is metabolized

Elimination rate - Rate does NOT increase as drug concentration increases- concentration independent

Halflife = conc Dependent

A

Zero- order kinetics

87
Q

Constant FRACTION per unit time is metabolized

Elimination rate- Rate increases as drug concentration increases - concentration dependent

Halflife = conc Independent

A

First order kinetics

88
Q

Drugs with Zero order kinetics: (WHAT-PET)

A

Warfarin
Heparin
Aspirin
Theophylline
Phenytoin
Ethanol (alcohol)
Tolbutamide

89
Q

Time it takes for drug concentrations to decrease by one half

A

Half life (t1/2)

90
Q

Non- linear on semilog paper
Aka: saturable kinetics, michaelis menten kinetics, capacity limited kinetics

A

Zero order kinetics

91
Q

Linear on semilog paper

A

First order kinetics

92
Q

Removal of drug from the system

A

Excretion

93
Q

Volume of blood cleared of drug in unit time

A

Renal clearance

94
Q

Competes with active tubular secretion of penicillin, thus, decreases the excretion of penicillin

A

Probenecid

95
Q

Doxycycline excreted thru?

A

Intestinal excretion

96
Q

Anticancer drugs and teratogenic drugs excreted thru?

A

Mammary excretion

97
Q

Mediates inflammation

A

Prostaglandin

98
Q

Parent compound of prostaglandin

A

Cholesterol
———> arachidonic acid
—–> COX (PGG > PGH) / LOX / EPOX

99
Q

Vasodilator prostaglandins

A

PGE and PGI

100
Q

COX 3 inhibitor

A

Paracetamol

101
Q

Only IRREVERSIBLE inhibitor of COX

A

Aspirin

102
Q

Mostly used as anti platelet

A

Aspirin 80mg OD

103
Q

Propionic acid derivatives

A

-profen

Ibuprofen
Ketoprofeb
Flurbiprofen

104
Q

Ibuprofen + aspirin = ?

A

Therapeutic duplication so avoid that!

105
Q

Flurbiprofen is a long duration profen with adverse reactions such as?

A

Severe gastric irritation
Myocardial infarction!

106
Q

Only non acid derived nsaids?

A

Nabumetone — ketone

107
Q

Used in post op therapy as substitute for Morphine

A

Etodolac
Ketorolac

108
Q

Sulfa drug adverse effect?

A

SJS!

109
Q

Inhibits phospholipase A2
Used for closure of PDA

A

Indomethacin

110
Q

COX 2 selective drugs that were phased out? Why?

A

Lumiracoxib
Valdecoxib
Rofecoxib

Because it causes MI and HTN — thrombus formation

111
Q

Arthritis — due to wear and tear of joints and obesity

A

Osteoarthritis

112
Q

Arthritis — due to autoimmunity (WBCs, TNF-a destroy joints and joint destruction due to chemotaxis

A

Rheumatoid arthritis

113
Q

Arthritis— hyperuricemia (uric acid rich in bagoong, patis, alcohol, animal liver

A

Gouty arthritis

114
Q

Osteoarthritis hallmark in radiograph?
Synovial fluid?

A

Osteophyte formation

Transparent
Yellowish
Viscus
200 - 1000 WBC — non inflam

115
Q

Morning stiffness
Improves with movement

A

Inflammatory arthritis — rheumatoid arthritis , psoriatic or crystal induced arthritis

116
Q

Pannus formation
Pathogenesis driven by T lymphocytes

A

Rheumatoid arthritis

117
Q

Tophi mc involved joint?
Uric acid formation

A

Gouty arthritis
1st metacarpophalyngeal joint - lowest temperature —– podagra

118
Q

Main treatment in rheumatoid arthritis

A

DMARDs – againts chemotaxis

Supplement with NSAID for pain
Glucocorticoids for severe pain

119
Q

MOA of DMARDs

ADR?

A

Immunosuppression

ADR - immunocompromised

120
Q

Example of DMARDs

A

Methotrexate
TNF alpha blockers - inflixiMAB, adalizuMAB, etanercept (receptor blocker)

121
Q

Abatacept MOA and ADR?

A

MOA: target CD80 and CD86
ADR: URTI

A BATA — 80 AND 86

122
Q

Azathioprine MOA?

A

Inhibits DNA synthesis by affecting INOSINOC ACID (essential in DNA synthesis)

123
Q

***Cyclophosphamide

A

Alkylating agent
ADR: leukopenia, NDV, hemorrhagic cystitis

Rescue drug - MESNA

124
Q

CyclospoRINe

A

Targets calcineuRIN
ADR: Hirsutism and gingival hyperplasia

125
Q

Chloroquine/ hydrochloroquine

A

Antimalarial drug
MOA: unknown
ADR: ocular toxicity and prolongation of QT interval

126
Q

*** Leflunomide

A

Inhibits DIHYDROOROTATE DEHYDROGENASE therefore DNA synthesis is inhibited

ADR: GI toxicicty, hepatotoxicity

127
Q

***Methotrexate

A

Current DMARD of Choice!!!

Inhibit FOLATE Synthesis by inhibiting AICAR Ttransformylase, **Thymidilate synthetase and **dihydrofolate reductase

ADR: mucositis/mucosal ulcer

Rescue drug: FOLINIC ACID/LEUCOVERIN

128
Q

Mycophenolate mofetil

A

not an antifungal!!!

Inhibits CMP
ADR: aplastic anemia

129
Q

Sulfasalazine

A

Metabolite: SULFAPYRIDINE

ADR: Allergy – SJS

130
Q

TNF alpha blockers

A

MOA: inhibits TNF alpha

ADR: reactivation of Tuberculosis

131
Q

DOC for acute attack of gout?

A

COLCHICINE
MOA: inhibit TUBULIN (for WBC migration)

Short duration of action
ADR: diarrhea, GI disturbance, hepatotoxic, nephrotoxic

132
Q

Drugs that decrease uric acid

A

Allopurinol
Febuxostat
Probenecid
Sulfapyrazone

133
Q

Allopurinol

A

Xanthine oxidase inhibitor
Metabolite : allocanthine

Purine –XO—-> uric acid

134
Q

Febuxostat

A

First NON PURINE XANTHINE OXIDASE inhibitor

135
Q

Probenecid and sulfapyrazolne

A

Inhibit reabsorptiin of uric acid in *PCT — *URICOSURIC AGENT

Note— ***** PROBENECID and PENICILLIN — Prolongs the action of penicillin
* probenecid prevents tubular active reabsorption of penicillin

136
Q

Standard prophylactic antibiotic class for colon sx

A

2nd gen Cephalosporin (Cefotetan & Cefoxitan)
- combines Gram neg and anaerombe coverage

137
Q

Standard prophylactic antibiotic for gastric surgery

A

1st Gen cephalosporin (Cephazolin)

138
Q

Antibiotic of choice for Gram positive becteremia in inpatient setting

A

Vancomycin bec MRSA for inpatients until sensitivities are available

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