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USMLE Step 1 Quick Notes > Pharmacology > Flashcards

Pharmacology Flashcards

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USMLE® Step 1 flashcards
1
Q

What is pharmacokinetics?

A

Effects of body on drug (absorption, distribution, metabolism, excretion)

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2
Q

What is dosing rate equation?

A

Dosing rate = Css x CL

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3
Q

What is loading dose?

A

Loading dose = (Css)(Vd)/F

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4
Q

What is maintenance dose?

A

Maintenance dose = (Css)(CL)(dosing interval)/F

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5
Q

Which drugs have zero order elimination?

A

Phenytoin, Ethanol, Aspirin

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6
Q

How do you eliminate salicylates?

A

Make urine basic (remember salicylate is salicylic acid)

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7
Q

How do you eliminate amphetamines?

A

Acidify urine

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8
Q

What does alpha1 do?

A

Increases vasoconstriction, mydriasis (pupillary dilator contraction), sphincter contraction

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9
Q

What does alpha2 do?

A

Decreases sympathetic output, renin, lipolysis. Increases platelet aggregation

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10
Q

What does beta1 do?

A

Increases HR, contractility, renin, lipolysis

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11
Q

What does beta2 do?

A

Decreases uterine contraction

Increases vasodilation, bronchodilation, HR, contractility, lipolysis, insulin, aqueous humor, ciliary muscle relaxation

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12
Q

Which parasympathetic receptor does ENS?

A

M1

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13
Q

Which parasympathetic receptor increases gut peristalsis?

A

M3

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14
Q

What do you use to treat postoperative or neurogenic ileus?

A

Bethanechol or neostigmine

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15
Q

What are the antimuscarinics used for parkinsons?

A

Triphenhexidyl and Benztropine

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16
Q

What is scopolamine?

A

Antimuscarinic for motion sickness

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17
Q

What is an antimuscarinic used for COPD, asthma?

A

Ipratropium, Tiotropium

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18
Q

What is glycopyrrolate?

A

Antimuscarinic used parenterally to reduce airway secretions preop and orally for drooling and peptic ulcer

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19
Q

What do you use for evaluation of tachyarrhythmias?

A

Isoproterenol

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20
Q

What is terbutaline used for?

A

Premature uterine contractions

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21
Q

What do you never give to cocaine users?

A

Beta blockers due to unopposed alpha1 activation

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22
Q

What do you give to pregnant women for HTN?

A

Methyldopa, Hydralazine

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23
Q

Which adrenergic agonist would you use for opiod withdrawal?

A

Clonidine (alpha-2 agonist)

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24
Q

What do you give to people who use MAOI but eat tyramine containing foods?

A

Phentolamine because it causes a hypertensive crisis

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25
Q

Which beta blocker do you use for glaucoma?

A

Timolol because it blocks beta2 effect of increased aqueous humor production

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26
Q

What is nebivolol?

A

Beta1 antagonist and beta3 agonist (activates NO synthase)

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27
Q

What do you give for tPA, streptokinase, urokinase toxicity?

A

Aminocaproic acid

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28
Q

What do you give for copper poisoning?

A

Pencillamine

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29
Q

What is DRESS syndrome?

A

Fever, lymphadenopathy, skin rash, eosinophilia, internal organ dysfunction after exposure to carbamazepine, phenotyoin, sulfonamides, allopurinol, antibiotics

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30
Q

What drugs cause osteoporosis due to toxicity?

A

Heparin

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31
Q

What is demeclocycline?

A

ADH antagonist used for SIADH

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32
Q

What is etanercept?

A

Decoy receptor (soluble TNF linked to Fc portion of IgG)

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33
Q

What should you consider when thinking of Vd?

A

Think of normal distributions of fluid in the body (ie total is 41, how much is extracellular vs intra) and whether the drug can cross is lipophilic or small etc.

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34
Q

How to antiseptic alcohols work?

A

Disorganize the lipids in membrane and denature proteins

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35
Q

How does salicylate poisoning change acid base?

A

Mixed respiratory alkalosis and high anion gap metabolic acidosis; normal pH

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36
Q

What are the side effects of MTX?

A

Aphthous ulcers, hepatotoxicity pancytopenia, pulmonary fibrosis, megalobastic anemia

37
Q

How does Maraviroc work?

A

CCR5 receptor antagonist so prevents gp120 from attaching

38
Q

What are the side effects of fluoroquinolones?

A

Tendon rupture, arthropathy, photoxicity in younger children

39
Q

How do salicylates cause respiratory alkalosis?

A

Centrally mediating hyperventilation and hyperpnea

40
Q

What are the side effects of Sirolimus?

A

Hyperlipidemia, atrial fibrillation, HF, interstitial pneumonitis, hypovolemia, palpitations, no neurotoxicity or nephrotoxicity

41
Q

What are the side effects of chloramphenicol?

A

Grey baby and aplastic anemia

42
Q

How does TMP-SMX affect warfarin?

A

Inhibits its metabolism

43
Q

What is B. fragilis treated with?

A

Piperacilin- Tazobactam

44
Q

What drugs have ototoxicity/nephrotoxicity?

A

Salicylates, aminoglycosides, cisplatin, furosemide

45
Q

What antimicrobial causes hypokalemia and hypomagnesia?

A

Amphotericin B

46
Q

What is isoniazid simialr to?

A

PLP (Vit B6) - decreases it

47
Q

What is the mechanism of resistance against aminoglycosides?

A

Acetylation, phosphorylation, adenylaton of the drug

48
Q

What do you use for arsenic and lead poisoning?

A

Dimercaprol

49
Q

What can you use for lead poisoning?

A

EDTA, Dimercaprol

50
Q

Which drug has really fat redistribution to skeletal muscle?

A

Thiopental (short acting barbiturate anesthetic)

51
Q

Does Tamoxifen or Raloxifene have increased risk for endometrial cancer?

A

Tamoxifen

52
Q

How do you treat cisplatin toxicity?

A

Amifostine or chloride diuresis

53
Q

What does it mean when anesthetics have large arteriovenous gradient?

A

High tissue solubility and slower onset of action

54
Q

Which of the adrenergic receptors does pupillary dilation?

A

Alpha1

55
Q

Which of the adrenergic receptors does increased humor production and ciliary muscle relaxation?

A

Beta2

56
Q

Which of the adrenergic receptors does decreased uterine tone?

A

Beta2

57
Q

What does caspofungin do?

A

Inhibit cell wall synthesis

58
Q

What do the conazoles do?

A

Inhibit CYP450 enzyme makes ergosterol

59
Q

What is the side effect of cylophosphamide and what is its antidote?

A

Hemorrhagic cystitis, Mesna

60
Q

What is a major side effect of protease inhibitors?

A

Redistribution of fat that resembles Cushing’s; lipodystrophy

61
Q

What is a side effect of Linezolid?

A

Sertonin syndrome

62
Q

What is a major side effect of acyclovir?

A

Nephrotoxicity (crystalline nephropathy) –> must rehydrate

63
Q

What must you do before you start isoretinoin?

A

Pregnancy test

64
Q

Which drug causes hypocalcemia and hypomagnesia?

A

Foscarnet

65
Q

Is phenoxybenzamine reversible?

A

No phentolamine is

66
Q

What properties do you need for pure hepatic clearance?

A

High lipophilicity so it can cross hepatocyte membrane and high Vd

67
Q

What do you use to treat essential tremor?

A

Primidone (also an anticonvulsant)

68
Q

How does ribavirin work?

A

Inhibits viral genome duplication

69
Q

How do NRTI work?

A

Inhibit reverse transcriptase and incorporate into viral DNA as thymidine analog that prevents phosphodiesterase bond and chain elongation

70
Q

What is naficillin used for?

A

Soft tissue infections by S. aureus

71
Q

How do you calculate first order half life?

A

Half of the REMAINING drug is eliminated

72
Q

How do muscarinic agonists cause vasodilation?

A

Bind to endothelial cells and cause release of NO

73
Q

How does dobutamine affect the heart?

A

Increases contractility and weakly increases HR –> increase myocardial oxyen demand

74
Q

What is zero order kinetics?

A

Constant amount metabolized

75
Q

What is first order kinetics?

A

Constant proportion metabolized

76
Q

When do you use fidaxomicin?

A

For recurrent C. diff; It is bactericidal (metronidazole not good for recurrent)

77
Q

Which one crosses BBB, neo or physostigmine?

A

Physostigmine

78
Q

What is Dantrolene?

A

It inhibits ryanodine receptor from releasing Ca into cytoplasm

79
Q

What is the major determinant of bioavailability of oral drugs that accounts for differences in plasma drug concentrations via other routes?

A

Liver blood flow: oral drugs undergo first pass metabolism by the liver while other routes don’t.

80
Q

What drug inhibits penicillin secretion?

A

Probenecid

81
Q

If warfarin and TMP-SMX given together, what should the dosage of warfarin be?

A

Lower than normal because sulfonamides are CYP inhibitors

82
Q

What are the inhibitors of CYP?

A

Alochol abuse, gemfibrozil, ciprofloxacin, isoniazid, quinidine, amiodarone, ketoconazole, macrolides, sulfondamides, cimetidine, ritonavir

83
Q

Which drug used for CMV retinitis treatment causes granulocytopenia?

A

Ganciclovir

Remember Foscarnet causes nephrotoxicity (hypocalcemia, hypomagnesia)

84
Q

What drug can you not take with antacids?

A

Fluoroquinolones, tetracyclines

Can’t take tetracyclines with milk or iron containing preps either

85
Q

What do you give with Cidofovir to decrease its nephrotoxicity?

A

Probenecid and IV saline

86
Q

What can you give with penicillin to inhibit its secretion in the kidney?

A

Probenecid

87
Q

What is fenoldopam?

A

D1 agonist used in hypertensive emergencies (decreases BP and increases natriuresis

88
Q

What is the toxicity of pyrazinamide?

A

Hepatotoxicity, hyperuricemia

89
Q

What is the toxicity of ribavirin?

A

Hemolytic anemia, severe teratogen

USMLE Step 1 Quick Notes (17 decks)

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