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USMLE Step 1 > Pharmacology > Flashcards

Pharmacology Flashcards

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USMLE® Step 1 flashcards
1
Q

How does one calculate: 1. Volume of distribution 2. Clearance 3. Loading dose 4. Maintenance dose >> MUST KNOW EQUATIONS

A

Vd = D/C

  • Vd = Volume of distribution
  • D = Amount of drug in IV form (100% bioavailability)
  • C: Concentration of drug in plasma

CL = 0.7/0.5t x Vd = rate of elimination of drug/plasma concentration of the drug

  • CL = Clearance
  • 0.5t = 1/2t = half-life of the drug

LD = Css x Vd

  • LD = Loading Dose
  • Css = Concentration at steady state = Desired/Target concentration of the drug

MD = Css x CL
- MD = Maintenance Dose

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2
Q

What is efficacy (of a drug)?

A

The maximal effect a drug can produce

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3
Q

What is potency (of a drug)?

A

The amount of drug needed for a given effect

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4
Q

What drug inhibits the transport of choline into the presynaptic cell?

A

Hemicholinium

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5
Q

What drug inhibits the packaging of acetylcholine into vesicles in the presynaptic cell?

A

Vesamicole

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6
Q

What enzyme catalyzes the production of acetylcholine from choline and acetyl-CoA?

A

Choline acetyltransferase

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7
Q

What toxin further stimulates acetylcholine presynpatic release, and what kind of paralysis does it cause?

A

Black widow spider toxin
- Spastic paralysis

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8
Q

What toxin inhibits acetycholine presynpatic release, and what kind of paralysis does it cause?

A

Botulinum toxin
- Flaccid paralysis

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9
Q

Describe the catecholamine synthesis pathway.

A

Phenylalanine —–> Tyrosine (phenylalanine hydroxylase)

Tyrosine ——> DOPA (tyrosine hydroxylase)

DOPA ——> Dopamine (DOPA carboxylase + B6)

Dopamine ——> Norepinephrine (requires vit. C)

Norepinephrine ——-> Epinephrine

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10
Q

What drug inhibits tyrosine hydroxylase?

A

Metyrosine

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11
Q

What drug inhibits the packaging of norepinephrine vesicles?

A

Reserpine

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12
Q

What drugs further stimulate the release of norepinephrine from the presynaptic cell?

A
  • Calcium
  • Amphetamines
  • Ephedrine
  • Tyramine
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13
Q

What drugs inhibit the release of norepinephrine from the presynaptic cell?

A
  • Guanethidine
  • Bretylium
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14
Q

What drugs inhibit the reuptake of norepinephrine into the presynaptic cell?

A
  • Cocaine
  • Tricyclic antidepressants
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15
Q

What are the enzymes responsible for metabolism of catecholamines?

A
  • COMT (methylation of NE)
  • MAO (oxidation of NE)
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16
Q

Which receptors are Gq-protein-linked receptors?

A

Cutsies HAVe 1 M&M.

  • Histamine 1 receptor
  • Alpha-1 adrenergic receptor
  • Vasopressin V1 receptor
  • Muscarinic 1 M1 receptor
  • Muscarinic 3 M3 receptor
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17
Q

Which receptors are Gi-protein-linked receptors?

A

MAD2

  • Muscarinic M2 receptor
  • Alpha-2 adrenergic receptor
  • Dopamine D2 receptor
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18
Q

Which receptors are Gs-protein-linked receptors?

A
  • Beta-1 adrenergic receptor
  • Beta-2 adrenergic receptor
  • Dopamine D1 receptor
  • Histamine H2 receptor
  • Vasopressin V2 receptor
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19
Q

Put the following in their respective categories of:

(A) Direct cholinergic agonists
(B) Indirect cholinergic agonists
(C) Anti-muscarinic/anti-cholinergic drugs
(D) Direct sympathomimetics
(E) Indirect sympathomimetics
(F) Alpha blockers: selective VS. nonselective
(G) Beta blockers

Phentolamine, prazosin, terazosin, homatropine, acebutolol, rivastigmine, bethanechol, propranolol, timolol, physostigmine, nadolol, norepinephrine, albuterol, clonidine, ephedrine, carvedilol, darifenacin, atenolol, echothiophate, atropine, tropicamide, benztropine, tamsulosin, dobutamine, pilocarpine, epinephrine, esmolol, methacholine, neostigmine, a-methyldopa, mirtazapine, tolterodine, ipratropium, glycopyrrolate, carbachol, donepezil, galantamine, salmeterol, pyridostigmine, labetalol, solifenacin, cocaine, pindolol, trospium, dopamine, isoproterenol, oxybutynin, edrophonium, terbutaline, amphetamine, phenoxybenzamine, phenylephrine, doxazosin, metoprolol, scopolamine, tiotropium

A

Direct cholinergic agonists

  • Bethanechol
  • Pilocarpine
  • Methacholine
  • Carbachol

Indirect cholinergic agonists

  • Neostigmine
  • Pyridostigmine
  • Edrophonium
  • Physostigmine
  • Echothiophate
  • Donezepil
  • Galantamine
  • Rivastigmine

Anti-muscarinics

  • Atropine
  • Homatropine
  • Tropicamide
  • Benztropine
  • Scopolamine
  • Ipratropium
  • Tiotropium
  • Glycopyrrolate
  • Oxybutynin
  • Tolterodine
  • Darifenacin
  • Solifenacin
  • Trospium

Direct sympathomimetics

  • Epinephrine (a1, a2, b1, b2)
  • Norepinephrine (a1, a2, b1)
  • Dopamine (D1, D2 >> b1, b2 >> a1, a2)
  • Dobutamine (b1)
  • Isoproterenol (b1, b2)
  • Phenylephrine (a1)
  • Albuterol (b2)
  • Salmeterol (b2)
  • Terbutaline (b2)
  • Clonidine (a2)
  • a-methyldopa (a2)

Indirect sympathomimetics

  • Ephedrine
  • Cocaine
  • Amphetamine

Alpha blockers

  • Nonselective: phentolamine, phenoxybenzamine
  • Selective: prazosin, terazosin, doxazosin, tamsulosin
  • a2-selective: mirtazapine

Beta-blockers

  • Non-selective: propranolol, timolol, nadolol
  • Beta-1 selective: atenolol, esmolol, metoprolol
  • Beta-1 and alpha-1 selective: carvedilol, labetalol
  • Weak beta-1 and beta-2 agonists: acebutolol, pindolol
20
Q

Antidote and treatment: acetaminophen

A

N-acetylcysteine

21
Q

Antidote and treatment: AChE inhibitors overdose/organophosphate poisoning

A
  • Atropine
  • Pralidoxime
22
Q

Antidote and treatment: amphetamine

A
  • NH4CL
  • Benzodiazepines
  • Antipsychotics
  • Antihypertensives
23
Q

Antidote and treatment: antimuscarinics

A

Physostigmine salicylate

24
Q

Antidote and treatment: benzodiazepines

A
  • Flumazenil
25
Q

Antidote and treatment: B-blockers

A
  • Glucagon
  • Atropine
  • Calcium
26
Q

Antidote and treatment: carbon monoxide

A
  • 100% oxygen
  • Hyperbaric oxygen
27
Q

Antidote and treatment: copper, arsenic and gold

A
  • Penicillamine
28
Q

Antidote and treatment: cyanide

A
  • Thiosulfate + nitrite
  • Hydroxocobalamin
29
Q

Antidote and treatment: digitalis/digoxin

A
  • Potassium and magnesium balance
  • Anti-dig Fab fragments
30
Q

Antidote and treatment: heparin

A
  • Protamine sulfate
31
Q

Antidote and treatment: iron

A
  • Deferoxamine
  • Deferasirox
32
Q

Antidote and treatment: lead

A
  • EDTA
  • Dimercaprol
  • Succimer
  • Penicillamine
33
Q

Antidote and treatment: mercury, arsenic, gold

A
  • Dimercaprol
  • Succimer
34
Q

Antidote and treatment: methanol, ethylene glycol

A
  • Fomepizole
  • Ethanol
  • Dialysis
35
Q

Antidote and treatment: methemoglobin

A
  • Methylene blue
  • Vitamin C
36
Q

Antidote and treatment: Opioids

A
  • Naloxone
  • Naltrexone
37
Q

Antidote and treatment: salicylates

A
  • NaHCO3
38
Q

Antidote and treatment: TCAs

A
  • NaHCO3
39
Q

Antidote and treatment: tPA, streptokinase, urokinase

A
  • Aminocaproic acid
40
Q

Antidote and treatment: warfarin

A
  • Vitamin K
  • Fresh frozen plasma
41
Q

Antidote and treatment: theophylline

A
  • B-blockers
42
Q

What drugs (other than muscarinic antagonists themselves) have anticholinergic effects?

A
  • First generation H1R antagonist
    >> Diphenhydramine
    >> Chlorpheniramine
  • Neuroleptics
    >> Thioridazine
    >> Chlorpromazine
    >> Olanzapine
    >> Clozapine
  • Tricyclic antidepressants
  • Amantadine
43
Q

What drugs can cause agranulocytosis?

A

4Cs and 1D

  • Clozapine
  • Carbamazepine
  • Colchicine
  • Carbimazole/methimazole and PTU
  • Dapsone
44
Q

What drugs can cause aplastic anemia?

A

Can’t Make New Blood Cells Properly

  • Carbamazepine
  • Methimazole
  • NSAIDs
  • Benzene
  • Chloramphenicol
  • Propiothiouracil (PTU)
45
Q

What drugs can cause megaloblastic anemia?

A

Have a blast with PMS.

  • Phenytoin
  • Methotrexate
  • Sulfa drugs
46
Q
A

USMLE Step 1 (14 decks)

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