Pharmacology Flashcards
1
Q
Km
A
proportional to 1/affininty of enzyme of substrate
2
Q
Vmax
A
proportional to enzyme conc
3
Q
Vd=
A
amount of drug in body/plasma conc
4
Q
Clearance
A
rate of elimination of drug/plamsa drug conc: Vd*Ke (elimination constant)
5
Q
Half life
A
t1/2=0.7*Vd/Clearance
6
Q
Loading dose/maintenance dose
A
Loading dose=CpVd/F, Maintenance dose=CpCL*dosage interval/F
7
Q
Amount of half lives to reach steady state
A
4-5 half lives
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
9
Q
3 drugs that have zero order elimination
A
Phenytoin, Ethanol, Aspirin
10
Q
Treat weak acid overdose with?
A
Bicarbonate
11
Q
Treat weak base overdose with?
A
Ammonium chloride
12
Q
Phase geriatric patients lose first?
A
Phase I
13
Q
Therapeutic index equation
A
TD50/TE50=median toxic tose/median effective dose
14
Q
Drugs with lower therapeutic index
A
Digoxin, warfarin, lithium, theophylline “THEO, DIEGO went to WAR over LITHIUM”
15
Q
Competitive antagonist example
A
Diazepam (agonist + flumazenil (competitive antagonist) on GABA receptor
16
Q
Noncompetitive antagonist example
A
Norepinephrine (agonist) + phenoxybenzamine (noncompetitive antagonist on alpha receptor)
17
Q
Example of partial agonist
A
Morphine (full agonist) vs. buprenorphine (partial agonist) at opioid mu receptors
18
Q
Prevents ACh packaging in vesicles
A
Vesamicol
19
Q
Prevents NE release for noradrenergic axon
A
a2 negative feedack, bretylium, guanethidine
20
Q
Prevents tyrosine to DOPA conversion
A
metyrosine
21
Q
Postoperative ileus, neurogenic ileus, urinary retention
A
Bethanechol
22
Q
Constricts pupil and relieves intraocular pressure in glaucoma
A
Carbachol
23
Q
Challenge test for diagnosis of asthma
A
Methacholine
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
25
Alzheimer disease help increasing ACh
Donepezil, galantamine, rivastigmine
26
Diagnosis of myasthenia gravis
Edrophonium (extremely short acting
27
Postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade (post operative)
Neostigmine
28
AChe that penetrates CNS
Physostigmine
29
AChe that does not penetrate CNS
Neostigmine
30
When giving cholinomimetic agents, what 3 things do you have to watch out for exacerbation of
COPD, asthma, peptic ulcers
31
Organophosphate poisoning symptoms and what does it inhibit
Irreversible inhibits AChe
| Diarrhea, Urination, Miosis, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, Salivation
32
Atropine vs Pralidoxime
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
33
Produces mydriasis and cycloplegia
Atropine, homatropine, tropicamide
34
Treats acute dystonia in parkinson
Benztropine
35
Use parenterally: preoperative use to reduce airway secretions. Orally: drooling, peptic ulcer
Glycopyrrolate
36
Antispasmodic for irritable bowel syndrome
Hyoscyamine, dicyclomine
37
Used for COPD, asthma to help decrease bronchoconstriction
Ipratropium, tiotropium
38
Reduces bladder spasms and urge urinary incontinence (overactive bladder)
Oxybutynin, solifenacin, tolterodine
39
Used for motion sickness
Scopolamine
40
Atropine poisoning treatment
Physostigmine
41
Used to treat bradycardia and for ophthalmic applications
Atropine
42
Atropine effects on
| Eye, airway, stomach, gut, bladder
Mydriasis+cycloplegia, decrease secretions, decrease acid production, decrease motility, decrease urgency in cystitis
43
Atropine toxicity
increase temp, dry, flushing, cycloplegia, disorientation
44
Consequence of mydriasis in atropine toxicity
angle-closure glaucoma
45
Hot feels cold and cold feels hot diagnosis
temperature related dysesthesia specific finding for ciguatoxin from ciguatera fish poisoning
46
Toxin that binds fast voltage-gated Na+ channels in cardiac and nerve tissue, preventing depolarization
Tetrodotoxin
47
MOA of patient with anaphylaxis like presentation who consumed dark meet fish and reasoning
Histidine in enteric system converted via bacterial histidine decarboxylase to histamine and histamine is not degraded by fish.
48
Used for acute asthma
Albuterol
49
Used for long term asthma and COPD control
Salmeterol
50
Albuterol, salmeterol receptor effect
B2>B1
51
Dobutamine
B1>B2, alpha
52
Dopamine
D1=D2>B>alpha
53
Epinephrine
B>alpha
54
Isoproterenol
B1=B2
55
Norepinephrine
alpha1>alpha2>beta1
56
Phenylephrine
alpha1>alpha2
57
Hypertensive urgency, ADHDm tourette syndrome
Clonidine
58
Hypertenision in pregnancy
alpha methyl dopa
59
Used to treat pheochromocytoma (preoperatively) to prevent catecholamine (hypertensive) crisis and MOA
Phenoxybenzamine via alpha blockade
60
Used to treat patients who eat tyramine-containing foods who are on MAO inhibitors
Phentolamine
61
Used for depression and is a alpha 2 selective antagonist
| Side effects?
Mirtazapine
| Sedation, increase serum cholesterol, increase appetite
62
Urinary symptoms of BPH
| Side effects?
Terazosin, tamsulosin
| 1st dose orthostatic hypotension, dizziness, headache
63
Toxin:Acetaminophen
| Antidote/treatment:
N-acetylcystenine (replenishes glutathione)
64
Toxin: AChE inhibitor/organophosphate
| Antidote/treatment:
Atropine>pralidoxime
65
Toxin: Amphetamines
| Antidote/ treatment:
NH4Cl
66
Toxin: Antimuscarinic, anticholinergic agents
| Antidote/treatment:
Physostigmine
67
Toxin: Benzodiazepines
| Antidote/treatment:
Flumazenil
68
Toxin: Beta blockers
| Antidote/treatment:
Glucagon
69
Toxin Carbon monoxide
| Antidote/treatment:
Hyperbaric oxygen
70
Toxin: Copper, arsenic, gold
| Antidote/treatment:
Penicillamine
71
Toxin: Cyanine
| Antidote/treatment:
Nitrite+thiosulfate, hydroxocobalamin
72
Digitalis (digoxin)
| Antidote/treatmetn
Anti-dig Fab fragments
73
Heparin
| Antidote/treatment
Protamine sulfate
74
Iron
| Antidote/treatment
Deferoxamine, deferasirox
75
Lead
| Antidote/treatment
EDTA, dimercaprol, succimer.
76
Toxin: Mercury, arsenic gold
| Antidote/treatment
Dimercaprol
77
Methanol, ethylne glycol
| Antidote/treatment
Fomepizol>ethanol
78
Methemoglobin
| Antidote/treatment
Methylene blue, vitamin C
79
Opioids
| Antidote/treatment
Naloxone, naltrexone
80
Salicylates, TCA
| Antidote/treatment
NaHCO3
81
tPA, streptokinase urokinase
| Antidote/treatment
Aminocaproic acid
82
Warfarin
| Antidote/treatment
```
Vitamin K (delayed)
fresh frozen plasma (immediate)
```
83
Category: azole
Ergosterol synthesis inhibitor
84
Category: bendazole
Antiparasitic/antihelmintic
85
Category: cillin
Peptidoglycan synthesis inhibitor
86
Category: cycline
Protein synthesis inhibitor
87
Category ivir
Neuraminidase inhibitor
88
Category: navir
Protease inhibitor
89
Category: ovir
DNA polymerase inhibitor
90
Category: thromycin
Macrolide antibiotic
91
Category: ane
Inhalaed anesthetic
92
Category: azine
Typical antipsychotic
93
Category: barbital
Barbiturate
94
Category: caine
Local anesthetic
95
Category: etine
SSRI
96
Category: ipramine, triptyline
TCA
97
Category: triptan
5HT 1B/1D agonists
98
Category: zepam, zolam
Benzodiazepine
99
Category: chol
Cholinergic agonist
100
Category: curium, curonium
Nondepolarizing paralytic
101
Category: olol
Beta blocker
102
Category: stigmine
AChe inhibitor
103
Category: terol
B2 agonist
104
Category: zosin
alpha1 antagonist
105
Category: afil
PDE5 inhibitor
106
Category: dipine
Dihydropyridine calcium channel blocker
107
Category: pril
ACE inhibitor
108
Category: sartan
Angiotensin-II receptor blocker
109
Category: statin
HMG-CoA reductase inhibitor
110
Category: dronate
Bisphosphonate
111
Category: glitazone
PPAR-gamma activator
112
Category: prazole
proton pump inhibitor
113
Category: prost
Prostaglanding analog
114
Category: tidine
H2 antagonist
115
Category: tropin
Pituitary hormone
116
Category: ximab
Chimeric monoclonal Ab
117
Category: zumab
Humanized monoclonal Ab
118
CP450 Inducers
Griseofulvin, Carbamazepine, Phenytoin, Barbiturates, Rifampin, St. Johns wort, Chronic alcoholism "Guinness, Corona, and PBRS induce chronic alcoholism"
119
CP450 inhibitors
Cimetidine, Ritonavir, AMiodarone, Ciprofloxacin, Ketoconazole, Acute alcohol use, Macrolides, Isoniazid, Grapefruit juice, Omeprazole, Sulfonamides "CRACK AMIGOS"
120
Substrates for CYP450
Anti-epileptics, Theophylline, Warfarin, OCPs (Always Think When Outdoors)
121
Sulfa drugs
Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamide antibiotitics, Sulfasalazine, Sulfonyurease (Popular FACTSSS)
122
Release of ACh at NMJ depends on what ion to allow for release?
Ca2+ influx into presynaptic terminal secondary to VG calcium channels opening when action potential depolarizes causing influx of extracellular calcium
123
How can there be peripheral blood vessel vasodilation even though blood vessels do not have cholinergic innervation?
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
What channel does cocaine block preventing its reuptake?
Na+/K+ ATPase
125
Why do non-selctive blockers exacerbate hypoglycemia?
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
B-blocker used for CHF
Nonselective (carvedilol, labetolol)
