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Medicine 2 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is the calculation for loading dose?

A

Target concentration x Volume of Distribution

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2
Q

What is the maintenance dose calculation for oral medication?

A

Target concentration x Clearance rate x Dosing interval amount (hours)
/
Bio-availability

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3
Q

what is the half life calculation?

A

0.693 x Volume of Distribution

/

Clearance rate

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4
Q

What does a PPI work on in the parietal cell?

A

H+/ K ATPase

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5
Q

What is the CrCl equation?

A

1.2 x (140 - age) x weight

/

Plasma creatinine

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6
Q

How does Gentamicin effect the body in renal impairment?

A

Reduced filtration - hangs around in body longer

High levels toxic to PCT - necrosis

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7
Q

What is the risk in using Biguanides in renal impairment?

A

Risk of Lactic acid is higher when eGFR falls below <30

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8
Q

What is the risk in using Sulphonylureas in renal impairment?

A

Hypoglyceamia - insulin is metabolised in PCT - so if renal impairment more insulin is already hanging about

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9
Q

What is the maintenance dose calculation for oral intake?

A

Target concentration x Clearance Rate x Dose amount/ interval

/

bio-availability

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10
Q

What is the measurement for the previous days deficit (PDD) of fluid?

A

Measured losses + Insensible losses (800ml) - oral intake

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11
Q

How do you calculate the fluid required for the next 24 hours? and what is an important factor to keep in mind?

A

Measured losses + Insensible losses + Previous days Deficit.

that this doesn’t strictly have to be given over 24 hours in the presence of heart disease etc.

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12
Q

When would you give dextrose?

A

When there has been no electrolyte loss

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13
Q

When would you give 0.9% saline?

A

When there is Na2+ and water depletion

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14
Q

What percentage of parietal cells are deactivated with the use of PPIs?

A

90%

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15
Q

Whats the greatest risk of PPI?

A

Enteric Infection

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16
Q

What is the definition of steady state?

A

When the amount of drug administered is equal to the amount excreted

17
Q

In comparison to enteric route, how much morphine should be given?

A

1/3rd of the enteric

18
Q

What type of dynamics does Phenytoin have?

A

Non-linear pharmokinetics

19
Q

Name two peripheral dopa decarboxylase inhibitors

A

Carbidopa

Benserazide

20
Q

How does methlypheniate work?

A

Dopamine re-uptake inhibitor - increasing dopamine across the striatum and prefrontal cortex

21
Q

What is Atomoextine’s mechanism of action?

A

Noradrenaline re-uptake inhibitor

22
Q

Name two Alpha 2 agonists used in ADHD treatment and outline their mechanisms of action

A

Clonidine

Gaunfaucine

Mimic noradrenaline in the prefrontal cortex by preventing hyper-polarisation allowing more neural firing

23
Q

How does amphetamine work?

A

Increases dopamine release from vesicles and also prevents re-uptake.

24
Q

What is the drug that blocks Raf kinase and is used in melonoma treatment?

A

Vemurafenib

25
Q

How much reabsorption does thiazides prevent? and where is this achieved?

A

5% in the early DCT

26
Q

What are the various receptors a drug can work on? and name some properties of them.

A

Enzyme linked - multiple actions

Ion Channel Linked - speedy action

G-protein linked - amplifier

Nuclear/ Gene linked - long lasting

27
Q

What is the affinity of a drug?

A

The propensity to bind to the receptor

28
Q

Which direction will a more potent drug move on the graph?

A

To the left

29
Q

Which is more potent Morphine or hydromorphine?

A

Hydromorphine

30
Q

What antobiotic is statins most contraindicated with?

A

erythromycin

31
Q

In renal disease, what is the main effect on the pharmocokinetics of a drug? and how can this be managed?

A

Prolonged elimination time - increased half life.

increase dosing interval

32
Q

In liver disease, what is the main effect on the pharmocokinetics of the drug? and how can this be managed?

A

Slower rate of metabolism

  • increased half life
  • increased bio- availability

increase dosing interval

reduce dosage

33
Q

In cystic fibrosis, what is the main effect on the pharmocokinetics of the drug? and how can this be managed?

A

Decreased elimination and metabolism time.
increased volume of distribution

increase dosage

decrease dosing interval

34
Q

Name some effects renal disease has on drug effects to the body and why:

A

Pharmokinetics:
Decreased elimination

Decreased protein binding

decreased hepatic metabolism

Pharmodynamics:
increased sensitivity

Adverse effects

35
Q

What two classes of drugs should be avoided in renal impairment?

A

Metaformin

NSAIDs

extreme caution with ACE inhibitors

36
Q

In hepatic disease what consideration need to be considered with drug use?

A

Increased bio-availability

reduced albumin binding

Increased half life

reduced elimination

**also important to remember pro-drugs won’t work as well.

Medicine 2 (28 decks)

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