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FRACP > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What are the four stages of pharmacokinetics

A

Absorption
Distribution
Metabolism
Excretion

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2
Q

How does albumin binding affect distribution

How does blood flow affect distribution

A

More albumin bound- harder to distribute

More blood flow= better distribution

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3
Q

What is the definition of volume of distribution
How does molecular weight affect this
What does volume of distribution help calculate

A

The theoretical volume the drug would have to occupy to equate to plasma concentration

Higher molecular weight- more likely to be protein bound therefore less volume of distribution

Dosing (larger vD needs bigger dose to get concentration)

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4
Q

What is bioavailability
What is it normally in IV drugs
How do you calculate bioavailability

A

The amount of unchanged drug reaching the circulation
100%
AUC (oral)/ AUC (IV) x100

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5
Q

Elimination

What is the difference between first and zero order kinetics

A

First- a constant proportion of the drug is excreted in time. Depends on the concentration in the body.

Zero order- a constant amount is excreted over time. Not dependant on concentration

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6
Q

How do you calculate half life

A

Volume of distribution/clearance

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7
Q

How many half lives does it take to get to steady state
To prevent toxicity what do you want the steady state to do?
How can you achieve steady state more rapidly?
Which pharmacology principle contributes most to steady state

A

4-5
Be within therapeutic range
Loading doses
Clearance

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8
Q

What type of drugs need to be metabolised by the liver before they can be Renally excreted?

What are the three processes in phase 1. What enzymes do they need

A

Lipophillic

Oxidation, reduction and hydrolysis
Cytochrome p450

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9
Q

What are the two most common cytochrome p450s

Which is needed in codeine. What does a low analgesic response mean

A

CYP1A2
CYP34A4
CYP206- poor metabolism

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10
Q

What are examples of p450 inducers. Give 5 p450 inhibitors

A

Phenobarbitone/ phenytoin, carbamazepine, alcohol, ridampicin, St. John’s wort

Grapefruit, erythromycin, cipro, cotrimox, amiodarone

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11
Q

What are examples of processes seen in phase 2 liver metabolism

A

Acetylation, sulphination, glutathione production and glucuronidation

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12
Q

What defines antibiotic tolerance

A

MBC>4x MIC

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13
Q

What is the most important mechanism of the following antibiotics
Beta lactams
Aminoglycosides
Vancomycin

Give an example of a bacteriostatic antibiotic

A

MIC
Concentration dependant killing
Time dependent killing

Trimethoprim

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14
Q 
Which chemo acts on the following cell cycles 
G1 
S 
G2
m
A

G1 asparginase and prednisone
S methotrexate and 6MCP
g2 etoposide and bleomycin
M vincristine and vinblastane

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15
Q

Which chemo causes radiation recall

Which causes extravasation injuries

A

Daunorubicin

Vincristine and doxyrubicin

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16
Q

Which 2 chemo cause vomiting ++

A

Cisplatin

Cytarabine

17
Q

Which chemo causes fever

A

Cytarabine (araC)

18
Q

Which chemo causes anaphylaxis

A

Asparginase

19
Q

Which chemo causes pancreatitis

A

Asparginase

20
Q

Which antibiotic acts on the cell wall directly

A

Vancomycin

21
Q

Which antibiotics act on protein synthesis and how

A

Gent and tetracyclines- 30s

Macrolides and clinda- 50s

22
Q

Which antibiotics act on DNA synthesis and how

A

DNA gyrase- cipro
Folate- trimethoprim
RNA- rifampicin

23
Q

1mg pred= how much hydrocortisone

1mg dex=‘

A

4mg

25mg

24
Q

What are the main side effects of
Cyclosporine
Tacrolimus

A

Hirsuitism and gum hypertrophy

Alopecia, diabetes and low mg

25
Q

What does a clockwise hysteresis loop show? Anti-clockwise?

A

Tachyphylaxis

Delayed distribution

26
Q

How do the following diabetes meds work
Metformin
Glicazide
Thiazolinedinedones

A

Increased sensitivity
Increased production
Increased sensitivity

27
Q 
What MABs work on the following 
Terminal complement pathway
Cd20
Interferon alpha 
Il 1
Il6 
IgE
A 
Ecilizumab 
Rituximab 
Infliximab/adalimumab
Anakinara
Tocilizumab 
Omalizumab
28
Q

What is the main mechanism of omeprazole

A

Serotonin antagonist

29
Q 
What are the main side effects of
Rifampicin
Isoniazid
Ethambutol 
Pyrazinamide
A

Orange secretions and liver toxicity
Peripheral neuropathy and liver toxic
Hepatitis esp with isoniazid
Reduced colour vision

30
Q

What are the main side effects of the following AEDS
Vigabatrin
Topirimate
Ethosuximide

A

Behaviours and ocular toxicity
Renal stones and weight loss
GI

31
Q 
AED side effects
Keppra
Sodium valproate 
Lamotrigine
Carbamazepine
A

Behavioural change and weight gain
Pancreatitis low plt weight gain
GI, liver and pancytopenia
Liver and SJS

32
Q

Which chemo causes bad constipation

A

Vincristine

33
Q

Which two chemos cause secondary malignancies

A

Cyclophosphamide

Etoposide

34
Q

What are the three main steps in treatment of hyperkalaemia and what does each step do

A

1) give gluconate- stabilises the myocardium
2) give insulin/dextrose- moves it all intracellular
3) give resonium- reduces total body potassium

35
Q

How does MMF work

What are the three main side effects

A

Blocks purine synthesis
Stops proliferation of b and T cells
Diarrhoea vomiting and renal

36
Q

How does methotrexate work
What are the main side effect
What is a serious but rare side effect

A

Anti folate- reduces TNF alpha
Ulcers mood changes
Hepatitis

37
Q

What is the main cause of liver toxicity in paracetamol overdose

A

Conversion by CYP450 to NAPQI

FRACP (23 decks)

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