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Pharmacology Flashcards

1
Q

What is the equation for volume of distribution?

A

V(d) = amount of drug in the body/ plasma drug concentration

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2
Q

What is the formula for clearance?

A

CL= rate of elimination of drug/ plasma drug concentration = Vd X K(e)

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3
Q

What is the formula for half life?

A

half life= (0.7 X Vd) / Clearance

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4
Q

What is the formula for loading dose?

A

loading dose = (target plasma concetration X Volume of distribution) / bioavailability

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5
Q

What is the formula for maintenance dose?

A

maintenance dose = (target plasma concentration X clearance) / bioavailability

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6
Q

What is the formula for therapeutic index?

A

TI= median lethal dose/ median effective dose

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7
Q

What are the effects of the alpha 1 receptor?

A

increase vascular smooth muscle contraction, increase pupillary dilator muscle contraction (mydriasis), increase intestinal and bladder sphincter muscle contraction

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8
Q

What are the effects of the alpha 2 receptor?

A

decrease sympathetic outflow, decrease insulin release

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9
Q

What are the effects of the beta 1 receptor?

A

increase heart rate, increase contractility, increase renin release, increase lipolysis

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10
Q

What are the effects of the beta 2 receptor?

A

vasodilation, bronchodilation, increase heart rate, increase contractility, increase lipolysis, increase insulin release, decrease uterine tone

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11
Q

What are the effects of the M1 receptor?

A

CNS, enteric nervous system

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12
Q

What are the effects of the M2 receptor?

A

decrease heart rate and contractility of the atria

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13
Q

What are the effects of the M3 receptor?

A

increase exocrine gland secretions, increase gut peristalsis, increase bladder contraction, bronchoconstriction, increase pupillary sphincter muscle contraction (miosis), ciliary muscle contraction (accommodation)

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14
Q

What are the effects of the D1 receptor?

A

relaxes renal vascular smooth muscle

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15
Q

What are the effects of the D2 receptor?

A

modulatees transmitter release, esp in the brain

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16
Q

What are the effects of the H1 receptor?

A

increases nasal and bronchial mucus production, contraction of the bronchioles, pruritus, and pain

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17
Q

What are the effects of the H2 receptor?

A

increase gastric acid secretion

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18
Q

What are the effects of the V1 receptor?

A

increase vascular smooth muscle contraction

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19
Q

What are the effects of the V2 receptor?

A

increase H20 permeability and reabsorption in the collecting tubules of the kidney

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20
Q

bethanoechol

A 
cholinomimetic agent (direct agonist)
use: postoperative and neurogenic ileus and urinary retention --> activates bowel and bladder smooth muscle
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21
Q

carbachol

A 
cholinomimetic agent (direct agonist)
use: glaucoma, pupillary contraction, and relief of IOP
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22
Q

pilocarpine

A 
cholinomimetic agent (direct agonist)
use: potent stimulator of sweat, tears, saliva
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23
Q

methacholine

A 
cholinomimetic agent (direct agonist)
use: challenge test for dx of asthma (stimulates muscarinic receptors in airway causing bronchoconstriction)
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24
Q

neostigmine

A

anticholinesterase
use: postoperative and neurogenic ileus and urinary retention, myasthenia gravis, reversal of neuromuscular junction blockade (postoperative)

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25
Q

pyridostigmine

A

anticholinesterase

use: myasthenia gravis (long acting), does not penetrate CNS

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26
Q

edrophonium

A

anticholinesterase

use: dx of myasthenia gravis ( extremely short acting)

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27
Q

physostigmine

A

anticholinesterase

use: glaucoma (crosses bbb –> cns) and atropine overdose

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28
Q

echothiophate

A

anticholinesterase

use: glaucoma

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29
Q

What are the symptoms of cholinesterase inhibitor poisoning?

A

often due to organophosphates, such as parathion, that irreversibly inhibit AchE

causes diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle and CNS, lacrimation, sweating, and salivation

antidote- atropine + pralidoxime (regenerates active AchE)

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30
Q

atropine

A

muscarinic antagonist

affects the eye- produces mydraisis and cycloplegia

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31
Q

homatropine

A

muscarinic antagonist

affects the eye- produces mydriasis and cycloplegia

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32
Q

tropicamide

A

muscarinic antagonist

affects the eye- produce mydriasis and cycloplegia

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33
Q

benzotropine

A

muscarinic antagonist
affects CNS
use: parkinson’s disease to reduce adverse effects of antipsychotics (ie tremor)

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34
Q

scopolamine

A

muscarinic antagonist
affects CNS
use: motion sickness

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35
Q

ipratropium

A

muscarinic antagonist
affects respiratory
use: asthma, COPD

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36
Q

oxybutynin

A

muscarinic antagonist

affects genitourinary, reduce urgency in mild cystitis and reduce bladder spasms

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37
Q

glycopyrrolate

A

muscarinic antagonist

affects genitourinary, reduce urgency in mild cystitis and reduce bladder spasms

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38
Q

methscopolamine

A

muscarinic antagonist

affects GI system, used for peptic ucler tx

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39
Q

pirenzepine

A

muscarinic antagonist

affects GI system, used for peptic ucler tx

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40
Q

propantheline

A

muscarinic antagonist

affects GI system, used for peptic ucler tx

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41
Q

What are the effects of atropine?

A

increase pupil dilation, cycloplegia

decrease secretion, acid secretion, gut motility, urgency in cystitis

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42
Q

hexamethonium

A

nicotinic antagonist
use: ganglionic blocker, used to prevent vagal reflex responses to changes in BP, ie prevents reflex bradycardia caused by NE

toxicity: severe orthostatic hypotension, blurred visions, constipation, sexual dysfunction

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43
Q

epinephrine

A

alpha 1, alpha 2, beta 1, beta 2

app: anaphylaxis, glaucoma, asthma, hypotension

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44
Q

NE

A

alpha 1, alpha 2 > beta 1

use: hypotension (but decreased renal perfusion)

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45
Q

isoproterenol

A

B1= B2

use: AV block (rare)

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46
Q

dopamine

A

D1 = D2 > beta > alpha, inotropic and chronotropic

use: shock (increase renal perfusion), heart failure

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47
Q

dobutamine

A

beta 1 > beta 2, inotropic but not chronotropic

use: heart failure, cardiac stress testing

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48
Q

phenylephrine

A

alpha 1 > alpha 2

use: pupillary dilation, vasoconstriction, nasal decongestion

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49
Q

metaproterenol, albuterol, salmeterol, terbutaline

A

selective beta 2- agonists
use: MAST
Metaproterenol and Albuterol for acute asthma
Salmeterol for long-term treatment
Terbutaline to reduce premature uterine contractions

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50
Q

ritodrine

A

beta 2

use: reduces premature uterine contractions

51
Q

ephedrine

A

indirect general agonist, releases stored catecholamines

use: nasal decongestion, urinary incontinence, hypotension

52
Q

clonidine, alpha- methyldopa

A

centrally acting alpha2-agonists, decreased central adrenergic outflow
used for hypertension, especially with renal disease (no decrease in blood flow to kidney)

53
Q

phenoxybenzamine

A

irreversible alpha blocker

used: pheochromocytoma (use it before removing tumor, since high levels of released catecholamines will not be able to overcome blockage)
toxicity: orthostatic hypotension, reflex tachycardia

54
Q

phentalamine

A

reversible alpha-blocker

used: pheochromocytoma (use it before removing tumor, since high levels of released catecholamines will not be able to overcome blockage)
toxicity: orthostatic hypotension, reflex tachycardia

55
Q

prazosin, terazosin, doxazosin

A

alpha 1 selective

use: hypertension, urinary retension in BPH
use: 1st dose orthostatic hypotension, dizziness, headache

56
Q

mirtazapine

A

alpha 2 selective

use: depression
toxicity: sedation, increase serum cholesterol, increase appetite

57
Q

nonselective beta antagonists

A

propranolol, timolol, nadolol, pindolol

58
Q

beta-1 selective antagonist

A

acebutolol (partial), betaxolol, esmolol (short acting), atenolol, metoprolol

59
Q

nonselective alpha and beta antagonist

A

carvedilol, labetalol

60
Q

partial beta agonist

A

pindolol, acebutolol

61
Q

antidote for acetaminophen

A

N-acetylcysteine

62
Q

antidote for salicylates

A

NaHCO3 (alkalinize urine), dialysis

63
Q

antidote for amphetamines (basic)

A

NH4Cl (acidify urine)

64
Q

antidote for acetylcholinesterase inhibitors, organophosphates

A

atropine, pralidoxime

65
Q

antidote for antimuscarinic, anticholinergic agents

A

physostigmine salicylate

66
Q

antidote for beta blockers

A

glucagon

67
Q

antidote for digitalis

A

stop dig, normalize K+, lidocaine, anti-dig Fab fragments, Mg2+

68
Q

antidote for iron

A

deferoxamine

69
Q

antidote for lead

A

CaEDTA, dimercaprol, succimer, pinacillamine

70
Q

antidote for mercury, arsenic, gold

A

dimercaprol (BAL), succimer

71
Q

antidote for copper, arsenic, gold

A

penicillamine

72
Q

antidote for cyanide

A

nitrite, hydrocobalamin, thiosulfate

73
Q

antidote for methemoglobin

A

methylene blue, vitamin C

74
Q

antidote for carbon monoxide

A

100 O2%, hyperbaric O2

75
Q

antidote for methanol, ethylene glycol (antifreeze)

A

ethanol, dialysis, fomepizole

76
Q

antidote for opioids

A

naloxone, naltrexone

77
Q

antidote for benzodiazepines

A

flumazenil

78
Q

antidote for TCAs

A

NaHCO3 (plasma alkalinization)

79
Q

antidote for heparin

A

protamine (antagonist)

80
Q

antidote for warfarin

A

vitamin K, fresh frozen plasma

81
Q

antidote for tPA, streptokinase

A

aminocaproic acid (analogue of lysine, so inhibitor of enzymes that bind lysine)

82
Q

antidote for theophylline

A

beta blocker

83
Q

Which drug causes atropine-like side effects?

A

TCAs

84
Q

Which drug causes coronary vasospasm?

A

cocaine, sumatriptan

85
Q

Which drug causes cutaneous flushing?

A

VANC: vancomycin, adenosine, niacin, Ca2+ channel blokers

86
Q

Which drug causes dilated cardiomyopathy?

A

doxorubicin, daunorubicin

87
Q

Which drug causes torsades de pointes?

A

class III (sotalol), class IA (quinidine) antirrhythmics

88
Q

Which drug causes agranulocytosis?

A

clozapine, carbamazepine, clchicine, propylthiouracil, methimazole, dapsone

89
Q

Which drug causes aplastic anemia?

A

chloramphenicol, benzene, NSAIDS, propylthiouracil, methimazole

90
Q

Which drug causes a direct Cooms-positive hemolytic anemia?

A

methyldopa

91
Q

Which drug causes gray baby syndrome?

A

chloramphenicol

92
Q

Which drug causes hemolysis in G6PD- deficient patients?

A

Isoniazid (INH), sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin (hemolysis IS PAIN)

93
Q

Which drug causes megaloblastic anemia?

A

phenytoin, methotrexate, sulfa drugs

94
Q

Which drug causes thrombotic complications?

A

OCPs

95
Q

Which drug causes cough?

A

ACE inhibitors

96
Q

Which drug causes pulmonary fibrosis

A

bleomycin, amiodarone, busulfan (its ahrd to BLAB when you have fibrosis)

97
Q

Which drug causes acute cholestatic hepatitis?

A

macrolides

98
Q

Which drug causes focal to massive hepatic necrosis?

A

halothane, valproic acid, acetaminophen, Aminita phalloides

99
Q

Which drug causes hepatitis?

A

INH

100
Q

Which drug causes pseduomembranous colitis?

A

clindamycin, ampicillin

101
Q

Which drug causes adrenocortical insufficiency?

A

glucocorticoid withdrawal (HPA suppression)

102
Q

Which drug causes gynecomastia?

A

spironolactone, digitalis, cimetidine, chronic alcohol use, estrogens ketoconazole

103
Q

Which drug causes hot flashes?

A

tamoxifen, clomiphene

104
Q

Which drug causes hypothyroidism?

A

lithium, amiodarone

105
Q

Which drug causes gingival hyperplasia?

A

phenytoin

106
Q

Which drug causes gout?

A

furosemide, thiazides

107
Q

Which drug causes osteoporosis?

A

corticosteroids, heparin

108
Q

Which drug causes photosensitivity?

A

sulfonamides, amiodarone, tetracycline (SAT for a photo)

109
Q

Which drug causes rash (stevens-johnson syndrome)

A

ethosuximide, lamotrigine, carbamazepine, phenobarbital, phenytoin, sulfa drugs, penicillin, allopurinol

110
Q

Which drug causes SLE-like syndrome?

A

hydralazine, INH, procainamide, phenytoin

111
Q

Which drug causes tendonitis, tendon rupture and cartilage damage?

A

fluoroquinolones

112
Q

Which drug causes Fanconi’s syndrome?

A

expired tetracycline

113
Q

Which drug causes interstitial nephritis?

A

methicillin, NSAIDs, furosemide

114
Q

Which drug causes hemorrhagic cystitis?

A

cyclophosphamide, ifosmide

115
Q

Which drug causes cinchonism?

A

quinidine, quinine

116
Q

Which drug causes diabetes insipidus?

A

lithium, democlocyline

117
Q

Which drug causes Parkinson-like syndrome?

A

haloperiodl, chlorpromazine, reserpine, metocloprine

118
Q

Which drug causes seizures?

A

bupropion, imipenem/cilastatin, isoniazid

119
Q

Which drug causes tardive dyskinesia?

A

antipsychotics

120
Q

Which drug causes disulfiram-like reaction?

A

metronidazole, certain cephalosporins, procarbazine, 1-st generation sulfonyureas

121
Q

Which drug causes nephrotoxicity/neurotoxicity?

A

polymyxins

122
Q

Which drug causes nephrotoxicity/ototoxicity?

A

aminoglycosides, vancomycin, loop diuretics, cisplatin

123
Q

What drugs are p-450 inducers?

A

Queen Barb Steals Phen-phen and Refuses Greasy Carbs Chronically

quinidine, barbiturates, St. John’s wort, phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol use

124
Q

What drugs are p-450 inhibitors?

A

INHIBIT yourself from drinking beer from a KEG because it makes you Acutely SICk.

HIV protease inhibitors
ketoconazole
erythromycin
grapefruit juice
acute alcohol juice
acute alcohol use
sulfonamides
isoniazid
cimetidine

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