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USMLE Step 1-2015 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Km

A

proportional to 1/affininty of enzyme of substrate

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2
Q

Vmax

A

proportional to enzyme conc

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3
Q

Vd=

A

amount of drug in body/plasma conc

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4
Q

Clearance

A

rate of elimination of drug/plamsa drug conc: Vd*Ke (elimination constant)

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5
Q

Half life

A

t1/2=0.7*Vd/Clearance

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6
Q

Loading dose/maintenance dose

A

Loading dose=CpVd/F, Maintenance dose=CpCL*dosage interval/F

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7
Q

Amount of half lives to reach steady state

A

4-5 half lives

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8
Q

What is dosage interval constant and Cp constant

A 
Dosage interval (time between doses), if not administered continuously
Cp-target plasma concentration in steady state
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9
Q

3 drugs that have zero order elimination

A

Phenytoin, Ethanol, Aspirin

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10
Q

Treat weak acid overdose with?

A

Bicarbonate

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11
Q

Treat weak base overdose with?

A

Ammonium chloride

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12
Q

Phase geriatric patients lose first?

A

Phase I

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13
Q

Therapeutic index equation

A

TD50/TE50=median toxic tose/median effective dose

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14
Q

Drugs with lower therapeutic index

A

Digoxin, warfarin, lithium, theophylline “THEO, DIEGO went to WAR over LITHIUM”

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15
Q

Competitive antagonist example

A

Diazepam (agonist + flumazenil (competitive antagonist) on GABA receptor

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16
Q

Noncompetitive antagonist example

A

Norepinephrine (agonist) + phenoxybenzamine (noncompetitive antagonist on alpha receptor)

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17
Q

Example of partial agonist

A

Morphine (full agonist) vs. buprenorphine (partial agonist) at opioid mu receptors

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18
Q

Prevents ACh packaging in vesicles

A

Vesamicol

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19
Q

Prevents NE release for noradrenergic axon

A

a2 negative feedack, bretylium, guanethidine

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20
Q

Prevents tyrosine to DOPA conversion

A

metyrosine

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21
Q

Postoperative ileus, neurogenic ileus, urinary retention

A

Bethanechol

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22
Q

Constricts pupil and relieves intraocular pressure in glaucoma

A

Carbachol

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23
Q

Challenge test for diagnosis of asthma

A

Methacholine

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24
Q

Potent stimulator of sweat, tears, and saliva. Open- and closed angle glaucoma. Open angle constricts what and close angle constricts what?

A

Pilocarbine

Open-ciliary muscle contraction
Closed-pupillary sphincter muscle contraction

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25
Q

Alzheimer disease help increasing ACh

A

Donepezil, galantamine, rivastigmine

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26
Q

Diagnosis of myasthenia gravis

A

Edrophonium (extremely short acting

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27
Q

Postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade (post operative)

A

Neostigmine

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28
Q

AChe that penetrates CNS

A

Physostigmine

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29
Q

AChe that does not penetrate CNS

A

Neostigmine

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30
Q

When giving cholinomimetic agents, what 3 things do you have to watch out for exacerbation of

A

COPD, asthma, peptic ulcers

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31
Q

Organophosphate poisoning symptoms and what does it inhibit

A

Irreversible inhibits AChe

Diarrhea, Urination, Miosis, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, Salivation

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32
Q

Atropine vs Pralidoxime

A

Atroprine reverses muscaraninc effects but does not prevent development of nicotinic effects such as muscle paralysis
Pralidoxime is only medication that reverses both muscarininc and nicotinic effects of organophosphates

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33
Q

Produces mydriasis and cycloplegia

A

Atropine, homatropine, tropicamide

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34
Q

Treats acute dystonia in parkinson

A

Benztropine

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35
Q

Use parenterally: preoperative use to reduce airway secretions. Orally: drooling, peptic ulcer

A

Glycopyrrolate

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36
Q

Antispasmodic for irritable bowel syndrome

A

Hyoscyamine, dicyclomine

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37
Q

Used for COPD, asthma to help decrease bronchoconstriction

A

Ipratropium, tiotropium

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38
Q

Reduces bladder spasms and urge urinary incontinence (overactive bladder)

A

Oxybutynin, solifenacin, tolterodine

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39
Q

Used for motion sickness

A

Scopolamine

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40
Q

Atropine poisoning treatment

A

Physostigmine

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41
Q

Used to treat bradycardia and for ophthalmic applications

A

Atropine

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42
Q

Atropine effects on

Eye, airway, stomach, gut, bladder

A

Mydriasis+cycloplegia, decrease secretions, decrease acid production, decrease motility, decrease urgency in cystitis

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43
Q

Atropine toxicity

A

increase temp, dry, flushing, cycloplegia, disorientation

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44
Q

Consequence of mydriasis in atropine toxicity

A

angle-closure glaucoma

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45
Q

Hot feels cold and cold feels hot diagnosis

A

temperature related dysesthesia specific finding for ciguatoxin from ciguatera fish poisoning

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46
Q

Toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue, preventing depolarization

A

Tetrodotoxin

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47
Q

MOA of patient with anaphylaxis like presentation who consumed dark meet fish and reasoning

A

Histidine in enteric system converted via bacterial histidine decarboxylase to histamine and histamine is not degraded by fish.

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48
Q

Used for acute asthma

A

Albuterol

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49
Q

Used for long term asthma and COPD control

A

Salmeterol

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50
Q

Albuterol, salmeterol receptor effect

A

B2>B1

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51
Q

Dobutamine

A

B1>B2, alpha

52
Q

Dopamine

A

D1=D2>B>alpha

53
Q

Epinephrine

54
Q

Isoproterenol

55
Q

Norepinephrine

A

alpha1>alpha2>beta1

56
Q

Phenylephrine

A

alpha1>alpha2

57
Q

Hypertensive urgency, ADHDm tourette syndrome

58
Q

Hypertenision in pregnancy

A

alpha methyl dopa

59
Q

Used to treat pheochromocytoma (preoperatively) to prevent catecholamine (hypertensive) crisis and MOA

A

Phenoxybenzamine via alpha blockade

60
Q

Used to treat patients who eat tyramine-containing foods who are on MAO inhibitors

A

Phentolamine

61
Q

Used for depression and is a alpha 2 selective antagonist

Side effects?

A

Mirtazapine

Sedation, increase serum cholesterol, increase appetite

62
Q

Urinary symptoms of BPH

Side effects?

A

Terazosin, tamsulosin

1st dose orthostatic hypotension, dizziness, headache

63
Q

Toxin:Acetaminophen

Antidote/treatment:

A

N-acetylcystenine (replenishes glutathione)

64
Q

Toxin: AChE inhibitor/organophosphate

Antidote/treatment:

A

Atropine>pralidoxime

65
Q

Toxin: Amphetamines

Antidote/ treatment:

66
Q

Toxin: Antimuscarinic, anticholinergic agents

Antidote/treatment:

A

Physostigmine

67
Q

Toxin: Benzodiazepines

Antidote/treatment:

A

Flumazenil

68
Q

Toxin: Beta blockers

Antidote/treatment:

69
Q

Toxin Carbon monoxide

Antidote/treatment:

A

Hyperbaric oxygen

70
Q

Toxin: Copper, arsenic, gold

Antidote/treatment:

A

Penicillamine

71
Q

Toxin: Cyanine

Antidote/treatment:

A

Nitrite+thiosulfate, hydroxocobalamin

72
Q

Digitalis (digoxin)

Antidote/treatmetn

A

Anti-dig Fab fragments

73
Q

Heparin

Antidote/treatment

A

Protamine sulfate

74
Q

Iron

Antidote/treatment

A

Deferoxamine, deferasirox

75
Q

Lead

Antidote/treatment

A

EDTA, dimercaprol, succimer.

76
Q

Toxin: Mercury, arsenic gold

Antidote/treatment

A

Dimercaprol

77
Q

Methanol, ethylne glycol

Antidote/treatment

A

Fomepizol>ethanol

78
Q

Methemoglobin

Antidote/treatment

A

Methylene blue, vitamin C

79
Q

Opioids

Antidote/treatment

A

Naloxone, naltrexone

80
Q

Salicylates, TCA

Antidote/treatment

81
Q

tPA, streptokinase urokinase

Antidote/treatment

A

Aminocaproic acid

82
Q

Warfarin

Antidote/treatment

A 
Vitamin K (delayed)
fresh frozen plasma (immediate)
83
Q

Category: azole

A

Ergosterol synthesis inhibitor

84
Q

Category: bendazole

A

Antiparasitic/antihelmintic

85
Q

Category: cillin

A

Peptidoglycan synthesis inhibitor

86
Q

Category: cycline

A

Protein synthesis inhibitor

87
Q

Category ivir

A

Neuraminidase inhibitor

88
Q

Category: navir

A

Protease inhibitor

89
Q

Category: ovir

A

DNA polymerase inhibitor

90
Q

Category: thromycin

A

Macrolide antibiotic

91
Q

Category: ane

A

Inhalaed anesthetic

92
Q

Category: azine

A

Typical antipsychotic

93
Q

Category: barbital

A

Barbiturate

94
Q

Category: caine

A

Local anesthetic

95
Q

Category: etine

96
Q

Category: ipramine, triptyline

97
Q

Category: triptan

A

5HT 1B/1D agonists

98
Q

Category: zepam, zolam

A

Benzodiazepine

99
Q

Category: chol

A

Cholinergic agonist

100
Q

Category: curium, curonium

A

Nondepolarizing paralytic

101
Q

Category: olol

A

Beta blocker

102
Q

Category: stigmine

A

AChe inhibitor

103
Q

Category: terol

A

B2 agonist

104
Q

Category: zosin

A

alpha1 antagonist

105
Q

Category: afil

A

PDE5 inhibitor

106
Q

Category: dipine

A

Dihydropyridine calcium channel blocker

107
Q

Category: pril

A

ACE inhibitor

108
Q

Category: sartan

A

Angiotensin-II receptor blocker

109
Q

Category: statin

A

HMG-CoA reductase inhibitor

110
Q

Category: dronate

A

Bisphosphonate

111
Q

Category: glitazone

A

PPAR-gamma activator

112
Q

Category: prazole

A

proton pump inhibitor

113
Q

Category: prost

A

Prostaglanding analog

114
Q

Category: tidine

A

H2 antagonist

115
Q

Category: tropin

A

Pituitary hormone

116
Q

Category: ximab

A

Chimeric monoclonal Ab

117
Q

Category: zumab

A

Humanized monoclonal Ab

118
Q

CP450 Inducers

A

Griseofulvin, Carbamazepine, Phenytoin, Barbiturates, Rifampin, St. Johns wort, Chronic alcoholism “Guinness, Corona, and PBRS induce chronic alcoholism”

119
Q

CP450 inhibitors

A

Cimetidine, Ritonavir, AMiodarone, Ciprofloxacin, Ketoconazole, Acute alcohol use, Macrolides, Isoniazid, Grapefruit juice, Omeprazole, Sulfonamides “CRACK AMIGOS”

120
Q

Substrates for CYP450

A

Anti-epileptics, Theophylline, Warfarin, OCPs (Always Think When Outdoors)

121
Q

Sulfa drugs

A

Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotitics, Sulfasalazine, Sulfonyurease (Popular FACTSSS)

122
Q

Release of ACh at NMJ depends on what ion to allow for release?

A

Ca2+ influx into presynaptic terminal secondary to VG calcium channels opening when action potential depolarizes causing influx of extracellular calcium

123
Q

How can there be peripheral blood vessel vasodilation even though blood vessels do not have cholinergic innervation?

A

Muscarinic agonists are present on endothelial surface binding cholinomimetic agents to these receptors that promotes release of NO (EDRF). NO activates guanylate cyclase–>increase intracellular cGMP. cGMP acticates Ca pump and causes Ca efflux from cell and with decrease calcium concentration–>vascular smooth muscle relaxation

124
Q

What channel does cocaine block preventing its reuptake?

A

Na+/K+ ATPase

125
Q

Why do non-selctive blockers exacerbate hypoglycemia?

A

They mask its adrenergic symptoms and for this reason should not be used in diabetes mellitus. Adrenergic symptoms include sweating tremor palpitations hunger nervounsess due to NE/ Epi release. Non-selective B-blockers inhibit compensatory reactions to hypoglycemia by blocking NE/Epi. Instead, selective B1 antagonists should be used because they dont block metabolic sympathetic effects

126
Q

B-blocker used for CHF

A

Nonselective (carvedilol, labetolol)

USMLE Step 1-2015 (18 decks)

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