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Step 1 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Vmax is proportional to

A

the enzyme concentration

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2
Q

Km is inversley proportional to

A

the affinity of the enzyme to its substate

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3
Q

Enzyme reaction showing a sigmoid curve

A

cooperative kinetics

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4
Q

Km =

A

saturation at 1/2 Vmax

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5
Q

Michaelis-Mentin kinetics

A

hyperbolic curve shape

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6
Q

Lineweaver-Burk plot gradient

A

Km/Vmax

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7
Q

How do reversible competitive inhibitors change Vmax and Km?

A

No change

Increase Km

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8
Q

How to irreversible competitive inhibitors change Vmax?

A

Decrease Vmax

No change

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9
Q

How do noncompetitive inhibitors change Vmx?

A

Decrease Vmax

No change

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10
Q

What do reversible compeititve inhibitors do?

A

decrese the potency

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11
Q

What do irreversible competitive inhibitors do?

A

decrease efficacy

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12
Q

What do noncompetitive inhibitors do?

A

decrease efficacy

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13
Q

Volume of distribution

A

volume occupied by drug in body relative to plasma concentration

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14
Q

Vd =

A

amount of drug in body/ plasma drug concentration

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15
Q

Clearance =

A

rate of elimination/ plasma drug concentration

= Vd x elimination constant

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16
Q

Half life =

A

0.693 x Vd / Clearance

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17
Q

when is steady state reached?

A

after 4-5 half lives

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18
Q

Loading dose =

A

(Cp x Vd) / F
Cp = target plasma concentration
F = bioavailability
Vd = volume of distribution

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19
Q

Maintenance dose =

A

(Cp x CL x dosage interval) / F

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20
Q

how should loading and maintenance doses change in renal and liver disease?

A

same loading dose, decrease maintenance dose

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21
Q

permissive interaction

A

A is required for the full effect of B

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22
Q

synergistic interaction

A

the effect of A+B is greater than the sum of the individual effects

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23
Q

tachyphylactic interactions

A

acute decrease in drug response after initial/ repeated administration

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24
Q

zero order kinetics

A

rate of elimination is always constant

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25
Q

first order kinetics

A

rate of elimination is proportional to drug concentration

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26
Q

drugs using zero order kinetics

A

PEA
Phenytoin
Ethanol
Aspirin

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27
Q

Rx for aspirin, methotrexate, phenobarbital OD and why

A

Bicarbonate

They are weak acids

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28
Q

Rx for amphetamine, TCA OD and why

A

ammonium chloride

they are weak bases

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29
Q

phase I drug metabolism

A

reduction, oxidation, hydrolysis

P-450

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30
Q

what phase of drug metabolism is lost first?

A

phase I

elderly

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31
Q

phase II drug metabolism

A

conjugation

–> polar and inactive

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32
Q

what will increase the side effects of a drug?

A

being a slow acetylator

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33
Q

what happens in conjucation phase II?

A

methylation, glucuronidation, acetylation, sulfation

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34
Q

efficacy

A

maximal effect a drug can produce

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35
Q

potency

A

amount of drug needed for a given effect

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36
Q

EC50 is

A

the dose of drug needed to give 50% of the maximum effect

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37
Q

theraputic index =

A

median toxic dose / median effective dose

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38
Q

very safe drug theraputic index will be

A

high

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39
Q

sympathetic NS

A

short pre-synaptic

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40
Q

P-ANS

A

long pre-synaptic

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41
Q

P-ANS receptors

A

Nicotinic ACh

Muscarinic ACh

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42
Q

S-ANS receptors

A

Nicotinic ACh

Muscarinic ACh, NE, D, Epinephrine

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43
Q

somatic receptors

A

voluntary motor nerve

ACh at NMJ

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44
Q

how muscarinic ACh receptors work

A

GPCR

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45
Q

sympathetic receptors and g protein classes

A

a1 - Q
a2 - I
B1, 2, 3 - S

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46
Q

action of a1

A

smooth muscle contraction, mydriasis, intestine and bladder contraction

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47
Q

action of a2

A

decrease sympathetic flow, decrese insulin, decrease lypolysis, increase plt aggregation, decrease aq humour production

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48
Q

action of B1

A

increase HR and contractility, lipilysis, renin release

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49
Q

action of B2

A

vasodilation, bronchodilation, lipolysis, insulin, decrease uterine tone, ciliary muscle relaxation, increase aq humour production

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50
Q

B3 action

A

lipolysis, thermogenesis in skeletal muscle

be free to take off your clothes and shiver!

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51
Q

M1 action

A

CNS, enteric nervous system

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52
Q

M2 action

A

decrease Hr and contractility of aorta

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53
Q

M3 action

A

exocrine secretion, gut peristalsis, bladder contraction, btonchoconstriction, miosis, accomodation

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54
Q

D1 action

A

relax renal vascular smooth muscle

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55
Q

D2 action

A

modulates transmitter release (brain)

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56
Q

H1 action

A

mucus production, vascular permeability, contraction of bronchioles, pruitus, pain

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57
Q

H2 action

A

gastric acid secretion

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58
Q

V1 action

A

vascular smooth muscle contraction

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59
Q

V2 action

A

H2O reabsorbtion in collecting duct

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60
Q

mneumonic for Q g protein class

A

A Very Quick MuMMy Must Hop

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61
Q

mneumonic for I g protein class

A

2 MAD I’s

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62
Q

mneumonic for S g protein class

A

you See, 3 Bees, 2 Honeypots and a Very Victorious Dog

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63
Q

action of Gq

A

phospholipase C –> PIP2 –> DAG –> PKC

–> IP3 –> Ca2+ rise

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64
Q

action of Gs

A

Adenylyl cyclase –> cAMP –> PKA –> Ca2+ rise, inhibits myosin light chain kinase

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65
Q

action of Gi

A

Inhibits Gs (Adenylyl cyclase –> cAMP –> PKA –> Ca2+ rise, inhibits myosin light chain kinase)

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66
Q

hemicholinium

A

stops formation of ACh

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67
Q

vesamicol

A

stops ACh entering vesicles

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68
Q

Botulinum

A

stops vesicle release

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69
Q

stops NA reuptake

A

cocaine, TCA, amphetamine

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70
Q

Increases NA release

A

amphetamine, ephedrine

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71
Q

Stops NA release

A

Bretylium, guanethidine

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72
Q

Reserpine

A

stops DA moving into vesicles

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73
Q

Metryrosine

A

analog of tyrosine, stops NA being synthesised

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74
Q

tyramine excess results in

why

A

htn crisis

excess tyramine displaces NA in vesicles, more NA diffuses into the cleft increasing sympathetic activation

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75
Q

cholinomimetics

A

bethanechol, carbachol, methacholine, pilocarpine

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76
Q

methacholine

A

stimualtes muscarinic receptors in airway

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77
Q

carbachol use

A

miosis for open angle glaucoma

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78
Q

bethanechol use

A

post op ileus, neurogenic ileus, urinary retention

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79
Q

anticholinesterases

A

neostigmine, edrophonium, donepezil, galantamine

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80
Q

edrophonium use

A

dgx myasthenia gravis

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81
Q

donepezil, galantamine, rivastigmine use

A

alzheimer disease

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82
Q

neostigmine use

A

ileus, urinary retention, myasthenia gravis, reverses NMJ block

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83
Q

physostigmine use

A

crosses BBB, anticholinergic toxicity

84
Q

pyridostigmine use

A

myasthenia gravis

85
Q

what must you be careful with when using cholemimetics?

A

COPD, asthma, peptic ulcers

86
Q

diarrhoea, urination, miosis, bronchospasm, bradycardia, lacrimation, sweating, salivation

A 
anticholinesterase poisoning (neostigmine, edrophonium, donepezil, galantamine)
organophosphates
87
Q

Rx anticholinesterase poisoning

A

atropine + pralidoxime

88
Q

Atropine

A

muscarinic antagoinst

89
Q

benztropine is, does

A

muscarinic antagoinst

parkinson’s

90
Q

glycopyrrolate is, does

A

muscarinic antagoinst

drooling, peptic ulcer

91
Q

hyoscyamine is, does

A

muscarinic antagoinst

antispasm for IBS

92
Q

ipratropium is, does

A

muscarinic antagoinst

COPD, asthma

93
Q

oxybutynin, sloifenacin, tolterodine are, do

A

muscarinic antagoinsts

reduce urge urinary incontinance

94
Q

scopolamine is, does

A

muscarinic antagoinst

motion sickness

95
Q

dry flushed skin, cycloplegia, disorientation

memory aide

A

atropine poisoning

hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter

96
Q

dobutamine is, use

A

sympathomimetic (B1)

HF

97
Q

dopamine is, does

A

sympathomimetic

bradycardia, HF, shock

98
Q

epinephrine is, effects, for

A

sympathomimetic

B > a

99
Q

fenoldopam, is, acts, does

A

sympathomimetic
D1
post op htn, vasodilator

100
Q

isoproterenol is, does

A

sympathomimetic

evaluation of tachyarrhythmias

101
Q

midodrine is, acts on, does

A

sympathomimetic
a1
postural hOtn

102
Q

NE is, acts on, for

A

sympathomimetic
a1 > a2 > B1
hOtn, septic shock

103
Q

phenylephrine is, acts on, for

A

sympathomimetic
a1 > a2
hOtn, decongestant

104
Q

clonidine, guanfacine, is, for

A

a2 agonist

htn urgency, ADHD, tourette’s

105
Q

a-methyldopa is, for

A

a2 agonist

htn in pregnancy

106
Q

prazosin, tamsulosin is, for

A

a1 blocker

BPH urinary symptoms, praxosin for htn

107
Q

mirtazapine is, use

A

a2 blocker

depression

108
Q

phenoxynenzamine is, for

A

a blocker

pheochromocytoma to prevent catecholamine crisis

109
Q

phentolamine is, for

A

a blocker

MAO inhibitor patients who eat tyramine rich foods

110
Q

a blockers cause

A

orthostatic hOtn, reflex tachycardia

111
Q

how are B blockers useful in variceal bleeding?

A

decrease hepatic venous pressure and portal htn

112
Q

B1 antagonists

A

acebutol, atenolol, betaxolil, esmolol, metoprolol (1st half of alphabet)

113
Q

non selective B antagonists

A

nadolol, pindolol, propranolol, timolol (2nd half of alphabet from N)

114
Q

carvedilol, labetalol

A

a and b antagonists

115
Q

nebivolol

A

B1 and B3

116
Q

tetrodotoxin

effect

A

pufferfish

binds fast voltage gated Na channels in heart/NS preventing depolarisation

117
Q

ciguatoxin

effect

A

reef fish - barracuda, snapper, eel

opens Na channels, causing depolarisation

118
Q

histamine (scombroid poisoning)

A

spoiled dark-meat fish

119
Q

action histamine toxin

A

mimics anaphylaxis

120
Q

amphetamine overdose

A

NH4Cl

121
Q

antimuscarinic overdose

A

physostigmine

122
Q

aresenic OD

A

dimercaprol, succimer

123
Q

benzodiazapine OD

A

flumazenil

124
Q

B blocker OD

A

saline, atropine, glucagon

125
Q

Cu OD

A

penicillamine, trientine

126
Q

Cyanide OD

A

nitrite + thiosulfate, hydroxocobalamin

127
Q

Digoxin OD

A

anti-dig Fab fragments

128
Q

Gold OD

A

Penicillamine, dimercaprol (BAL), succimer

129
Q

Iron OD

A

deferoxamine, deferasiroz, deferiprone

130
Q

Lead OD

A

EDTA, dimercaprol, succimer, penicillamine

131
Q

Mercury OD

A

Dimercaprol, succimer

132
Q

Methanol OD

A

fomepizol > ethanol, dialysis

133
Q

Methemoglobin OD

A

methylene blue, vitamin C

134
Q

salicylate OD

A

NaHCO3, dialysis

135
Q

TCA OD

A

NaHCO3

136
Q

dilated cardiomyopathy from

A

doxorubicin, daunorubicin

137
Q

cutaneous flushing caused by

A

vancomycin, adenosine, niacin, Ca blockers, echinocanidins (VANCE)

138
Q

what can cause hot flashes?

A

tamoxifen, clomiphene

139
Q

what can cause hyperglycaemia?

A

tacrolimas, protease inhibitors, niacin, HCTZ, corticosteroids
Note: Taking Pills Causes Hyperglycemia

140
Q

what can cause hypothyroidism?

A

lithium, amiodarone, sulfonamides

141
Q

what drug can cause acute cholestatic hepatitis?

A

erythromycin

142
Q

what drug can cause hepatic necrosis?

A

halothane, amanita phalloides, valproic acid, acetaminophen

143
Q

What drugs can cause hepatitis?

A

rifampin, isoniazid, pyrazinamide, statins, fibrates

144
Q

what drugs can cause pancreatitis?

A

didanosine, valproic acid, azathioprine, diuretics - furosemide, HCTZ
Don’t HAV Fun

145
Q

What drugs can cause pill-enduced eosophagitis?

A

tetracyclines, bisphosphonates, potassium chloride

146
Q

what drugs can cause pseudomembranous colitis?

A

clindamicin, ampicillin, cephalosporins

147
Q

what drugs cause agranulocytosis?

A

clozapine, carbamexapine, propylthiouracil, methimazole, colchicine, ganciclovir
Can Cause Pretty Major Collapse of Granulocytes

148
Q

what drugs can cause aplastic anaemia?

A

Carbamazepine, methimazole, NSAIDs, benzene, chloramphenicol, propylthiouracil
Can’t Make New Blood Cells Properly

149
Q

What drugs cause hemolytic anaemia, and what type?

A

direct coombs positive

methyldopa, penicillin

150
Q

what causes grey baby syndrome?

A

chloramphenicol

151
Q

what causes hemolysis in G6PDH?

A

isoniazid, sulfonamides, dapsone, primaquine, aspirin, ibuprofen, nitrofurantoin
Hemolysis IS D PAIN

152
Q

drugs causing megaloblastic anaemia

A

phenytoin, methotrexate, sulfa drugs

Having a BLAST with PMS

153
Q

drug causing thrombocytopenia

A

heparin

154
Q

drugs causing fat redistribution

A

protease inhibitors, glucocortocoids

Fat PiG

155
Q

drugs causing gingival hyperplasia

A

phenytoin, Ca channel blockers, cyclosporine

156
Q

drugs causing gout

A

pyrazinamide, thiazides, furosemide, niacin, cyclosporine

Painful Feet Tophi Need Care

157
Q

drugs causing myopathy

A

fibrates, niacin, colchicine, hydroxychloroquine, interferon-a, penicillamine, statins, glucocorticoids

158
Q

osteoporosis

A

corticosteroids, heparin

159
Q

photosensitivity

A

sulfonamindes, amiodarone, tetracyclines, 5-FU

SAT For photo

160
Q

Steven’s Johnson syndrome

A

anti-epileptics, allopurinol, sulfa dugs, penicillin

161
Q

SLE-like syndrome

A

sulfa-drugs, hydralazine, isoniazid, procainamide, phenytoin, etanercept
SHIPP-E

162
Q

tendonitis

A

fluroquinolones

163
Q

ondansetron

A

5-HT3

164
Q

mechanism acyclovir

A

incorporates into new DNA

165
Q

side effect of muscarinic antagonism

A

urinary retention

166
Q

protection against haemorrhagic cystitis

A

mesna

167
Q

cinchonism

A

overdose of quinine

168
Q

drugs causing parkinson like symptoms

A

antipsychotics, reserpine, metoclopramide

ARM

169
Q

drugs causing seizures

A

BITE your tongue

Isoniazid, Bupropion, Imipenem/cilastatin, Tramadol, Enflurane

170
Q

When can isoniazid cause seizures?

A

with vitamin B6 deficiency

171
Q

What can cause Tardive dyskinesia?

A

antipsychotics, metoclopramide

172
Q

what drugs can cause diabetes insipidus

A

lithium, demeclocycline

173
Q

what drugs can cause fanconi syndrome?

A

tenofovir, ifosfamide

174
Q

what drugs can cause hemorrhagic cystitis?

A

cyclophosphamide, ifosfamide

175
Q

what drugs can cause interstitial nephritis?

A

methicillin, NSAIDs, furosemide

176
Q

what drugs can cause SIADH?

A

carbamazepine, cyclophosphamide, SSRIs

Can’t Concentrate Serum Sodium

177
Q

Which drugs can cause pulmonary fibrosis?

A

Methotrexate, Nitrofurantoin, Carmustine, Bleomycin, Busulfan, Amiodarone
My Breathing Becomes A Nasty Crackle

178
Q

What drugs have antimuscarinic action?

A

Atropine, TCA, H1 blockers, antipsychotics

179
Q

What drugs cause a disulfarim like reaction?

A

metronidazole, certain cephalosporins, griseofulvin, procarbazine, 1st generation sulfonylureas

180
Q

What drugs can cause nephro/oto toxicity?

A

Aminoglycosides, vancoycin, loop diuretics, cisplatin

be Very Careful of Little Arteries

181
Q

What may cisplatin toxicity respond to?

A

amifostine

182
Q

Induce cytochrome P-450

A

Chronic alcohol, St John’s wart, Phenytoin, Phenobarbitol, Nevirapine, Rifampin, Griseofulvin, Carbamazepine
Cytochrome P-450 Needs Regular Stimulation Greeting Circulating Pills

183
Q

P-450 breaks down

A

Anti-epileptics, Theophylline, Warfarin, OCPs

metabolised Each One With T

184
Q

P-450 inhibitors

A

Acute alcohol, ritonavir, Amiodarone, Cimetidine/ciprofloxacin, Ketoconazole, Sulfonamides, Isoniazid, Grapefruit juice, Quinidine, Macrolides
AAA RACKS IN GQ Magazine

185
Q

Macrolide not inhibiting O-450

A

azithromycin

186
Q

What are sulfa drugs?

A

sulfonamide antibiotics, sulfasalazine, probenecid, furosemide, acetazolamide, celecoxib, thiazides, sulfonylureas
Scary Sulfa Pharm FACTS

187
Q

fever, urinary infection, rash, hemolytic anaemia, thrombocytopenia, agranulocytosis, urticaria, recent new medication

A

Sulfa drug

188
Q

-ivir

A

neuraminidase inhibitor

189
Q

-navir

A

protease inhibitor

190
Q

-ovir

A

DNA polymerase inhibitor

191
Q

-bendazole

A

antiparasitic/antihelminithic

192
Q

-azole

A

ergosterol synthesis inhibitor

193
Q

-etine

A

SSRI

194
Q

-triptan

A

%-HT agonist

195
Q

-chol

A

cholinergic

196
Q

-curium

A

nondepolarising paralytic

197
Q

-stigmine

A

ACHE inhibitor

198
Q

-terol

A

B2 agonist

199
Q

-zosin

A

a1 antagonist

200
Q

-afil

A

PDE-5 inhibitor

201
Q

-sartan

A

AT II R blocker

202
Q

-glitazone

A

PPAR-gamma activator

203
Q

-tidine

A

H2 antagonist

204
Q

-ximab

A

chimeric mab

205
Q

-zumab

A

humanized mab

206
Q

cilostazol

A

decreases platelet activation and vasodilates

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