Pharmacy Foundations Flashcards
What are the two subtypes of the peripheral nervous system?
Somatic (Voluntary) and Autonomic (Involuntary)
What type of neurotransmitter does the somatic nervous system send? What receptor does it act on?
Acetylcholine, Nicotinic receptors
What are the two divisions of the autonomic nervous system?
Parasympathetic and sympathetic
What physiological responses occur when the parasympathetic system is activated?
Rest and Digest (SLUDD):
Salivation, Lacrimation, Urination, Diarrhea/Defecation, Digestion
What physiological response occurs when the sympathetic system is activated
Fight of Flight:
Increased HR, BP, pupil dilation, glucose dilation, bronchodilation.
What neurotransmitters are used and what receptors are acted on in the parasympathetic system?
Acetylcholine acts on the nicotinic receptor to release more acetylcholine to activate the muscarinic receptor.
What neurotransmitters are used and what receptors are acted on in the sympathetic system?
Acetylcholine act on the nicotinic receptor to release norepinephrine and epinephrine on to the adrenergic receptors (Alpha-1, Beta-1, and Beta-2 receptors)
Activation of the Alpha-1 Receptors result in what physiologic response?
Smooth muscle (including blood vessel) constriction/ Vasoconstriction
Beta-1 activation results in what physiological response?
Increased heart rate, contraction and cardiac output
Beta-2 activation results in what physiologic response?
Bronchodilation
What neurotransmitters do monoamine oxidase inhibitors break down?
Dopamine, norepinephrine, serotonin, tyramine
About how long should the wash out period be between use of an MAO inhibitor and a drug that increases neurotransmitters (i.e. SSRI)?
~14 days
What is pharmacodynamics?
The effect or change that a drug has on some type of organism (i.e. bacteria, human). “What the drug does to the body”
What is pharmacokinetics?
The effect the body has on the drug: ADME; “What the body does to the drug”
What is ADME?
Absorption
Distribution
Metabolism
Excretion
How can we increase the serum concentration of penicillin to allow it to cross the BBB?
Providing Probenecid will block the renal excretion of penicillin.
How do you treat salicylate (Aspirin) overdoses?
Give IV Sodium Bicarbonate to alkalinize the urine. This causes salicylate to become ionized.
What is phase I metabolism?
Chemical reactions that change the parent molecule into a metabolite. Mostly oxidation reactions but can be hydrolysis or reduction reactions. This step primarily inactivates the compound.
What is phase II metabolism?
Phase II metabolism are conjugation reactions that may increase water solubility to help facilitate excretion. (i.e. glucuronidation)
What are the 6 main CYP 450 enzymes that metabolize most drugs?
CYP 2C8/9, 3A4, 2E1, 2D6, 1A2
What drugs are strong (big) inducers?
PS CORPS: Phenytoin Smoking Carbamazepine (also an autoinducer) Oxcarbazepine (and eslicarbazepine) Rifampin (and rifabutin, rifapentine) Phenobarbital St. John's Wort
What drugs are known to be big (strong) inhibitors?
G <3 Pacman Grapefruit Protease Inhibitors Azole Antifungals Cyclosporine/Cimetidine/Cobicistat Macrolides Amiodarone (and dronedarone) Non-DHP CCB (Diltiazem and verapamil)
How long does it take for the full effect of induction to be seen? How long could it take for the effects of induction to disappear?
Up to 4 weeks as additional enzyme production must be built up; it may take 2-4 weeks for the induction effects to disappear completely based on the enzyme’s half life (degradation)
What is the purpose of the P-glycoprotein pump?
They act as efflux pumps to pump out foreign substances out of the body and into the gut for excretion.
What is enterohepatic recycling?
Already metabolized drugs that is reabsorbed from the gut, enter the portal vein and travel back to liver. Results in increased duration of action of many drugs.
