Pharmacology General Flashcards

1
Q

Drugs with zero order elimination?

A

PEA– Phenytoin; Ethanol; Aspirin

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2
Q

Treat base overdoses with?

A

Amonium chloride

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3
Q

Phase 1 drug metabolism?

A

Reduction, oxidation, hydrolysis with cyp P450– usually yields slightly polar water soluble metabolites

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4
Q

Phase 2 metabolism?

A

Conjugation– glucuronidation; acetylation; sulfation

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5
Q

Efficacy vs potency?

A

Efficacy– maximal effect a drug can produce

Potency– amount of drug needed to produce an effect

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6
Q

Competitive antagonists shift curve?

A

To the right– decrease the potency (Diazepam+flumazenil on GABA)

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7
Q

Noncompetitive antagonist shifts curve?

A

Down– decreases efficacy

NE+phenoxybenzamine on alpha receptors

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8
Q

Partial agonist?

A

Reduce efficacy– potency can go up or down

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9
Q

therapeutic index?

A

Median lethal dose over median effective dose

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10
Q

Lineweaver burk plot– what happens if my point moves more to the right? i.e. greater x intercept?

A

The greater the Km and the lower the affinity

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11
Q

What happens if my x intercept gets smaller in the lineweaver burk plot?

A

Lower Km and higher affinity

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12
Q

Volume of distribution

A

Amount of drug in body/plasma drug concentration

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13
Q

Half life?

A

(.7*Vd)/Clearance

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14
Q

Adrenal medulla and sweat glands are innervated by?

A

Cholinergic fibers even though they are SYMPATHETIC

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15
Q

Muscarinic receptors are of what type?

A

GPCR (M1-M5)

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16
Q

Parasympathetics act on?

A

Cardiac and smooth muscle, glands, and nerve terminals

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17
Q

Mechanism of Gq?

A

Phospholipase c converts lipids into PIP2 which can go to

1) IP3–>inc Ca–>smooth muscle contraction
2) DAG–>protein kinase C

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18
Q

Mechanism of Gs/Gi?

A

Adenylyl cyclase converts ATP to cAMP–>protein kinase A which 1) blocks myosin light chain kinase and 2) increases Ca in heart

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19
Q

Qiss Qiq (till you’re) siq (of) Sqs?

A

alpha 1,2 beta1,2 M1,2,3 D1,D2 H1, H2 V1, v2

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20
Q

Increases vascular smooth muscle contraction?

A

alpha 1

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21
Q

increases pupillary dilator muscle?

A

alpha 1

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22
Q

Increases gastic acid secretion?

A

H2

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23
Q

Relaxes renal vascular smooth muscle?

A

D1

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24
Q

Dec insulin release? and dec lipolysis

A

alpha2

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25
Q

Increase insulin release? and inc lipolysis

A

beta2

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26
Q

Bronchodilation and tocolytic?

A

Beta 2

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27
Q

Ciliary muscle relaxation?

A

Beta 2

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28
Q

Increase platelet aggregation?

A

alpha 2

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29
Q

dec hr and contractility of atria?

A

M2

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30
Q

Increases lacrimal productoin (exocrine gland)?

A

M3

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31
Q

Increase bladder contraction?

A

M3

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32
Q

Bronchoconstriction?

A

M3

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33
Q

miosis and ciliary muscle contraction (i.e. accommodation)

A

M3

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34
Q

Pruritus?

A

H1

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35
Q

Intestinal and bladder sphincter muscle contraction?

A

alpha1

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36
Q

Epi effects blank more than blank?

A

Beta more than alpha

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37
Q

Norepi effects blank more than blank?

A

alpha more than beta

38
Q

Increase aqueous humor production?

A

beta2

39
Q

M3 rhyme?

A

M3 makes you pee (parasymp)

40
Q

Blocks tyrosine to dopa?

A

Metyrosine

41
Q

Blocks packaging of dopamine?

A

reserpine

42
Q

Blocks reuptake of NE?

A

Cocaine, TCA, and amphetamine

43
Q

Guanethidine and bretylium?

A

block NE release from presynaptic

44
Q

NE acts on blank to autoregulate itself?

A

Alpha 2

45
Q

Blocks choline uptake?

A

Hemicholinium

46
Q

Blocks ACh from moving into vesicles?

A

Vesamicol

47
Q

Urinary retention and postoperative ileus?

A

Bethanechol– Beth, call me if you want to pee or crap

48
Q

Carbachol?

A

Glaucoma, pupillary contraction; CARBon copy of AcetylCHOLINE

49
Q

Stimulator of sweat, tears, and saliva, and open and closed glaucoma?

A

PILOcarpine– RESISTANT TO AChE

you cry, drool, and sweat on your PILlow

50
Q

Long acting drug for myasthenia gravis?

A

Pyridostigmine– pyRIDostiGM– gets rid of MG

51
Q

Indirect anticholinesterase that crosses blood brain barrier?

A

Physostigmine– PHYSO PHYXES atropine overdose

52
Q

AChEI for Alzheimers?

A

Donepezil

53
Q

What should you be careful about exacerbating with cholinomimetic agents?

A

COPD, Asthma, and Peptic ulcers

54
Q

Side effects of cholinesterase inhibitor drugs?

A

Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating and Salivation

55
Q

Antidote to cholinesterase inhibitor toxicity?

A

Atropine+ pralidoxime

56
Q

Benztropine

A

Muscarinic antagonist for parkinsons

57
Q

Scopolamine?

A

Motion sickness– need SCOPolamine if we’re going to drive around SCOPing out the scene in New brunswick

58
Q

Ipratropium, tiotropium?

A

I PRAy I can breath soon– asthma and copd

59
Q

Oxybutynin?

A

Reduces bladder spasms– oxybladdertynin

60
Q

Glycopyrrolate?

A

Preoperative use to reduce airway secretions or drooling, peptic ulcer— glycoPYRROLate for Peptic ulcer

61
Q

Deleterious effect of atropine in elderly?

A

Can cause acute angle closure glaucoma

62
Q

Epinephrine?

A

Alpha, and beta– NO D1– used for anaphylaxis, glaucoma, asthma, and hypotension

increases HR and BP

63
Q

Norepi?

A

Alpha>beta (no beta 2 or D1)– used for hypotension (decreases renal perfusion)— causes increase in diastolic and systolic pressures

64
Q

Isoproterenol?

A

All Beta– Torsades, bradyarrhythmias (but can worse ischemia)— IsoPROterenol is PRO BRO i.e. pro Beta

Decreases BP via B2 and Inc HR via B1 and reflex activity

65
Q

Dopamine uses?

A

Shock, heart failure, inotropic and chronotropic

66
Q

Cardiac stress testing?

A

Dobutamine (mostly b1)– doBETAmONE– also used for heart failure

67
Q

Mydriatic effect, only act on alpha 1 and 2?

A

Phenylephrine– used as decongestant as well

68
Q

Albuterol/Terbutaline

A

Beta agonists (Terbetaline)

69
Q

Acts on B2 only and reduces premature uterine contractions?

A

Ritodrine prevents UteRINE (ritodrine rhymes with uterine)

70
Q

Used to treat narcolepsy?

A

Amphetamines

71
Q

Sympathoplegic used in hypertension in a person with renal disease?

A

Clonidine– centrally acting alpha 2 agonists

clonidine decreases central sympathetic outflow

72
Q

Phenoxybenzamine?

A

Phenoxy for Pheo– alpha blocker– may cause orthostatic hypotension or reflex tachycardia

73
Q

Phentolamine?

A

alpha blocker– give to patients on MAO inhibitor

Too much PHEN (fun) at the wine and cheese party, will take it’s TOL and you’ll need PHENTOLAMINE

74
Q

Patient comes to you with insomnia. You give her an alpha 2 selective blocker– what is the drug? what are the side effects?

A

Drug is Mirtazapine and side effects are inc serum cholesterol and inc appetite

75
Q

Difference between Epinephrine and Phenylephrine?

A

Epi has alpha AND beta response

Phenylephrine only has Alpha

76
Q

These beta blockers should be used in those with pulmonary disease?

A

A BEAM

Acebutolol, btaxolol, esmolol, atenolol, metoprolol

77
Q

Carvedilol?

A

nonselective alpha and beta antagonist

78
Q

Clearance?

A

Rate of elimination/plasma drug concentration

79
Q

Loading dose?

A

Vd*CSS

80
Q

Maintenance Dose?

A

css*cl

81
Q

amphetamine overdose

A

NH4Cl

82
Q

Beta blocker overdose

A

glucagon

83
Q

Digitalis overdose

A

Lidocaine, mg2+, normalize K+

84
Q

Arsenic and gold overdose

A

Dimercaprol; succimer and penicillamine

85
Q

copper

A

penicillamine

86
Q

theophylline overdose

A

Beta blockers

87
Q

drug that can cause acute cholestatic hepatitis

A

erythromycin (maCro)

88
Q

gingival hyperplasia

A

phenytoin and verapamil and cyclosporin

89
Q

photosensitivity

A

sulfonamides amiodoroaone tetracycline

90
Q

drug that can cause fanconi syndrome

A

tetracycline

91
Q

Can cause torsades

A

Some risky meds can prolong qT

Sotalol; Risperidone; Mcrolides; chloroquine; protease inhibitors; quinidine thiazides