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Pharmacology > PLE: PHARMA PEARLS > Flashcards

PLE: PHARMA PEARLS Flashcards

Master Pharma with the help of Topnotch Medical Board Prep PEARLS

1
Q

CYTOCHROME P450 INDUCERS MNEMONIC

A

Ethel Booba takes Phen-Phen and Refuses Greasy Carb Shakes

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2
Q

Cytochrome P450 Inducers

A 
Ethanol (chronic ingestion)
Barbiturates exceot SECOBARBITAL
Phenytoin
Rifampicin
Griseofulvin
Carbamazepine
St. John's Wort/Smoking
*Glutethimide, Phenylbutazone, chronic/repeated use of Ritonavir
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3
Q

CYTOCHROME P450 INHIBITORS MNEMONICS

A

Inhibitors Stop Cyberkids From Eating Grapefruit QV

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4
Q

CYTOCHROME P450 INHIBITORS

A 
Isoniazid
Sulfonamides
Cimetidine
Ketoconazole
Erythromycin
Grapefruit Juice
Ritonavir (acute ingestion)
Amiodarone
Quinidine
Valproic Acid
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5
Q

OTHER CYP450 INHIBITORS (12)

A

Allopurinol, Chloramphenicol, Chlorpromazine, Dicumarol, Disulfiram, Ethanol (acute toxicty), Itraconazole, Nortriptyline, OCP, Phenylbutazone, Saquinavir, Secobarbital, Spironolactone, Troleandromycin

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6
Q

Drugs with NARROW THERAPEUTIC INDEX mnemonics

A

WALA na Cyang Papa! VasTeD na!

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7
Q

Drugs with NARROW THERAPEUTIC INDEX (10)

A 
Warfarin
Aminoglycosides
Lithium
Amphotericin B
Carbamzepine
Phenobarbital
Phenytoin
Vancomycin
Theophylline
Digoxin
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8
Q

Drugs that display ZERO ORDER KINETICS mnemonics

A

WHAT PET

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9
Q

Drugs that display ZERO ORDER KINETICS (7)

A 
Warfarin
Heparin
Aspirin
Tolbutamide
Phenytoin
Ethanol
Theophylline
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10
Q

Drugs that display TACHYPHYLAXIS mnemonics

A

MEDical students Love to watch CNN in HD!

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11
Q

Drugs that display TACHYPHYLAXIS (9)

A 
Metoclopramide
Ephedrine
Dobutamin
LSD
Calcitonin
Nitroglycerin
Nicotine
Hydralazine
Desmopressin
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12
Q

PHASE 1 of drug study

A

Is the drug safe?

Dose-response relationship, normal human volunteers, acute effects

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13
Q

PHASE 2 of drug study

A

Is the drug effective for the sick patient?

Placebo, usually in the hospital, sick patients

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14
Q

PHASE 3 of drug study

A

Randomized, double-blind, controlled trials

Special population, very expensive

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15
Q

PHASE 4 of drug study

A

Post-marketing surveillance

Infrequent toxicities

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16
Q

Pregnancy Category A

A

Safe in controlled studies of women

Fetal harm is remote

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17
Q

Pregnancy Category B

A

No controlled studies in women
No risk in animal reproduction studies

OR

Not confirmed in controlled studies in women
No AE in animal reproduction studies

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18
Q

Pregnancy Category C

A

No controlled studies in women
With AE in both animal studies

OR

Give only if benefit > risk

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19
Q

Pregnancy Category D

A

(+) AE but Benefits > Risk

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20
Q

Pregnancy Category X

A

(+) AE, Contraindicated

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21
Q

Alpha 1 location and action

A

Alpha 1 in smooth muscles for vasconstriction

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22
Q

Alpha 2 location and action

A

Alpha 2 in nerve terminals for inhibition of NT release

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23
Q

Alpha 1 preferred substrate

A

Epinephrine

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24
Q

Alpha 2 preferred substrate

A

Epinephrine

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25
Q

Beta 1 location and action

A

Beta 1 in heart to increase rate and contractility

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26
Q

Beta 1 preferred substrate

A

Isoproterenol > Epinephrine > Norepinephrine

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27
Q

Beta 2 location and action

A

Beta 2 in respiratory smooth muscles and uterus for bronchodilation and uterine relaxation

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28
Q

Dopamine 1 location and action

A

Dopamine 2 in splanchnic and renal vessels for vasodilation of renal blood vessels

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29
Q

Dopamine 2 location and action

A

Dopamine 2 in nerve terminals of CNS for regulation of NT

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30
Q

Muscarinic 1 location and action

A

Muscarinic 1 in CNS for stimulation

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31
Q

Muscarinic 1 preferred substrate

A

Acetylcholine

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32
Q

Muscarinic 2 location and action

A

Muscarinic 2 in heart for decreasing heart rate

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33
Q

Muscarinic 2 preferred substrate

A

Acetylcholine

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34
Q

Muscarinic 3 location and action

A

Muscarinic 3 in smooth muscle, GIT, GUT, pulmonary, and eyes for peristalsis, bladder contraction, bronchoconstriction, and pupil constriction

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35
Q

Muscarinic 3 preferred substrate

A

Isoproterenol > Epinephrine > Norepinephrine

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36
Q

Ach cholinergic inhibitor of its SYNTHESIS

A

Hemicholinium

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37
Q

Ach adrenergic inhibitor of its SYNTHESIS

A

Metyrosine

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38
Q

Ach cholinergic inhibitor of its STORAGE

A

Vesamicol

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39
Q

Ach adrenergic inhibitor of its STORAGE

A

Reserpine

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40
Q

Cholinergic inhibitor of Ach RELEASE

A

Botulinum

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41
Q

Adrenergic inhibitor of Ach RELEASE

A

Guanethidine

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42
Q

Cholinergic inhibitor of ACh metabolism

A

Neostigmine

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43
Q

Adrenergic inhibitor of Ach metabolism

A

MAOIs, COMTs

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44
Q

Cholinergic inhibitor of Ach REUPTAKE

A

NONE

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45
Q

Adrenergic inhibitor of Ach REUPTAKE

A

Cocaine, TCAs

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46
Q

How does EDROPHONIUM differentiate MYASTHENIC crisis from CHOLINERGIC crisis?

A

Edrophonium IMPROVES muscle strength in MYASTHENIC crisis and WEAKENS muscle strength in CHOLINERGIC crisis.

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47
Q

Spinal roots of origin of SNS

A

T1-T12 and L1-L5

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48
Q

Location of ganglia of SNS

A

Paravertebral chains that lie along the spinal columnm some along the anterior aspect of the abdominal aorta

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49
Q

Distance of preganglionic fibers of SNS

A

Short

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50
Q

Distance of postganglionic fibers of PNS

A

Long

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51
Q

Spinal roots of origin of PNS

A

CN III, VII, IX, X

Sacral segments of spinal cord

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52
Q

Location of ganglia of PNS

A

Most are in organs innervated more distant from the spinal cord

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53
Q

Distance of preganglionic fibers of PNS

A

Long

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54
Q

Distance of postganglionic fibers of PNS

A

Short

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55
Q

Direct acting muscarinic 3 receptor for bladder and bowel atony

A

Betanechol

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56
Q

M3 cholinomimetic for glaucoma and Sjogren and Sicca syndrome

A

Pilocarpine

Selective M3: Cevimeline

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57
Q

Indirect acting cholinomimetic for diagnosis of Myasthenia Gravis

A

Edrophonium (Tensilon Test)

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58
Q

ACE inhibitors teratogenic effect

A

fetal renal damage

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59
Q

Antiepileptic drugs teratogenic effect

A

neural tube defect

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60
Q

Phenytoin teratogenic effect

A

fetal hydantoin syndrome

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61
Q

Barbiturates teratogenic effect

A

neonatal dependence

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62
Q

Diethylstilbestrol (DES) teratogenic effect

A

Vaginal clear cell adenoCA

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63
Q

Ethanol teratogenic effect

A

fetal alcohol syndrome

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64
Q

LIthium teratogenic effect

A

Ebstein’s anomaly

(septal and posterior leaflets of the tricuspid valve are displaced towards the apex of the right ventricle of the heart)

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65
Q

Isoretinoin teratogenic effect

A

craniofacial malformations

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66
Q

Iodide teratogenic effect

A

congenital hypothyroidism

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67
Q

Misoprostol teratogenic effect

A

Mobius sequence

Palsy of CNs, usually VI and VII

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68
Q

Penicillamine teratogenic effect

A

cutis laxa

(chalazoderma, dermatochalasia, dermatolysis, dermatomegaly, generalized elastolysis, generalized elastorrhexis, or pachydermatocele)

the skin becomes inelastic and hangs loosely in folds

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69
Q

Thalidomide teratogenic effect

A

phocomelia

70
Q

Smoking teratogenic effect

A

IUGR

71
Q

Tetracycline teratogenic effect

A

tooth discoloration

72
Q

Streptomycin teratogenic effect

A

ototoxicity

73
Q

Methimazole teratogenic effect

A

aplasia cutis congenita

74
Q

Sulfonamide teratogenic effect

A

kernicterus

75
Q

Fluoroquinolone teratogenic effect

A

cartilage damage

76
Q

Warfarin teratogenic effect 1st trimester

A

chondrodysplasia

77
Q

Warfarin teratogenic effect 2nd trimester

A

CNS malformation

78
Q

Warfarin teratogenic effect 3rd trimester

A

bleeding diatheses

79
Q

SNS effect on pupils (general)

A

mydriasis (alpha 1)

miosis (M3)

80
Q

SNS on iris

A

Contraction of dilator pupillae muscles (radial muscles)

mydriasis(α­1)

81
Q

PNS on iris

A

Contraction of sphincter pupillae muscles (circular muscles)

miosis (M3)

82
Q

SNS on ciliary muscle

A

Relaxation for distant vision (β2)

83
Q

PNS on ciliary muscle

A

Contraction (M) for accommodation of lens (near vision) and increase aqueous humor outflow into canal of Schlemm

84
Q

SNS on ciliary body epithelium

A

Increased aqueous humor production (β1)

85
Q

PNS on ciliary body epithelium

A

None

86
Q

SNS on heart contractility

A

Increased via B1

87
Q

PNS on heart contractility

A

Decreased via M2

88
Q

SNS on skin and splanchnic blood vessels

A

Constriction via A1

89
Q

PNS on skin and splanchnic blood vessels

A

NO EFFECT

90
Q

SNS on skeletal blood vessels

A

Dilation via B2 and M3

91
Q

PNS on skeletal blood vessels

A

NO EFFECT

92
Q

SNS on bronchi

A

Dilation via B2

93
Q

PNS on bronchi

A

Constriction via M3

94
Q

SNS on GIT walls

A

Relaxation via A2 and B2

95
Q

PNS on GIT walls

A

Contraction via M3

96
Q

SNS on GIT secretion

A

NO EFFECT

97
Q

PNS on GIT secretion

A

Increased via M1 and M3

98
Q

SNS on bladder wall

A

Relaxation via B2

99
Q

PNS on bladder wall

A

Contraction via M3

100
Q

SNS on uterus

A

Contraction via A1

Relaxation via B2

101
Q

PNS on uterus

A

Contraction via M3

102
Q

SNS on penis

A

Ejaculation via alpha

103
Q

PNS on penis

A

Erection via muscarinic

104
Q

SNS on sweat glands

A

Increased sweating via alpha

105
Q

PNS on sweat glands

A

NO EFFECT

106
Q

SNS on liver

A

Gluconeogenesis, glycogenolysis (Alpha, B2)

107
Q

PNS on liver

A

NO EFFECT

108
Q

SNS on fat cells

A

Lipolysis (B3)

109
Q

PNS on fat cells

A

NO EFFECT

110
Q

SNS on kidney

A

Increased renin secretion via B1

111
Q

PNS on kidney

A

NO EFFECT

112
Q

Effect of Gq protein stimulation on M1, M3, and M5 receptors

A

↑ IP 3 , DAG cascade

113
Q

Effect of Gi protein stimulation on M2 and M4receptors

A

↓ cAMP synthesis

114
Q

Effect of stimulation of Nn/Ng (ganglion) and Nm (neuromuscular) receptors

A

Na + /K + depolarizing current

115
Q

ORGANOPHOSPHATE POISONING

A

DUMBBELSS

116
Q

DUMBBELSS

A

ORGANOPHOSPHATE poisoning
Diarrhea, urination, miosis, bronchoconstriction, bradycardia, excitation of SkM & CNS, lacrimation, salivation, sweating

117
Q

ATROPINE TOXICITY

A 
Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter
118
Q

Inhibits synthesis of catecholamines via inhibiting hydroxylation of tyrosine to dopamine

A

Metyrosine

119
Q

Inhibits synthesis of acetylcholine by blocking choline transport

A

Hemicholinium

120
Q

Inhibits storage of Ach into vesicles via VAT

A

Vesamicol

121
Q

Alters synaptobrevin to prevent release of Ach

A

Botulinum toxin

122
Q

Inhibits acetylcholinesterase

A

Carbamates and organophosphates (indirect acting cholinomimetics)

123
Q

Increase stores of NE and dopamine by blocking its metabolism

A

MAOIs

124
Q

Inhibits release of catecholamines via VAMPs and SNAPs

A

Guanethidine

125
Q

Promotes increased release of catecholamines

A

Ampheramines and tyramines

126
Q

Inhibits diffusion and reuptake of catecholamines via NET and DAT

A

cocaine, tricyclic antidepressants

127
Q

Inhibits reuptake of acetylcholine

A

NONE

128
Q

Low dose dopamine (1-5 mcg/kg/min) acts on

A

D1 receptors (to increase RBF and UO)

129
Q

Medium dose dopamine (5-15 mcg/kg/min) acts on

A

B1 receptors

130
Q

High dose dopamine (>15 mcg/kg/min) acts on

A

alpha receptors (increase CO and BP)

131
Q

Non-selective beta agonist that can be used for asthma or AV block

A

isoprotenerol

132
Q

Antidote for alpha 1 agonist overdose

A

phentolamine

133
Q

Phenylephrine, pseudoepehdrine, oxymetazoline all act on what receptor to produce nasal decongestion

A

Alpha 1

134
Q

Side effectof phenylephrine, pseudopehedrine, oxymetazoline

A

Rebound nasal congestion (rhinitis medicamentosa)

135
Q

MOA of clonidine

A

When given orally, they accumulate in the CNS to decrease central sympathetic outflow

136
Q

Pregnancy category of methyldopa

A

B

137
Q

Alpha 2 agonist that decreases CNS sympathetic outflow for pre-eclampsia and gestational HPN

A

methyldopa

138
Q

Alpha 2 agonist used for reducing conscious sedation

A

dexmedetomidine

139
Q

Alpha 2 agonist used as muscle relaxant

A

tinazinidine

140
Q

Side effect of methyldopa

A

(+) Coomb’s test - hemolytic anemia

141
Q

Alpha 2 agonist used in glaucoma to decrease secretion of aqueous humor

A

apraclonidine, brimonidine

142
Q

Side effect of dobutamine

A

tachyphylaxis

143
Q

General clinical use of alpha 1 agonist

A

Hemostasis (epinephrine locally)
Decongestion
Spinal shock

144
Q

General clinical use of alpha 2 agonist

A

Hypertension

Glaucoma

145
Q

General clinical use of beta 1 and dopa 1 agonsit

A

Acute heart failure

Septic shock

146
Q

General clincal use of beta 2 agonist

A

Bronchospasm

Premarture labor

147
Q

Has a direct adrenergic receptor agonist aside from causing release of NE;
Nasal vasoconstrictor and appetite stimulant

A

phenylpropanolamine

148
Q

Adverse effect of phenylpropanolamine

A

hemorrhagic stroke

149
Q

Longest acting Beta blocker

A

Nadolol

150
Q

non-selective beta blocker that can cause reduction in size of infantile hemangioma

A

propanolol

151
Q

beta blockers for heart failure

A

labetolol, carvedilol, metoprolol

152
Q

Irreversible non-selective alpha blocker used for pre-op of pheochromocytoma

A

phenoxybenzamine

153
Q

Reversible non-selective short acting alpha antagonist for rebound hypertension

A

phentolamine (tolazoline)

154
Q

Disadvantage of using betablockers in the eye

A

Local anesthetic activity (membrane stabilizing activity)

Decreased protective reflexes

155
Q

Beta blockers with partial agonist activity
(with intrinsic sympathomimetic activity)
beneficial for asthma bec less bronchospasm

A 
Acebutolol
Pindolol
Carteolol, Celiprolol
Bopindolol
Penbutolol
156
Q

Beta 1 blocker used parenterally for SVT

A

esmolol

157
Q

Teratogenic effect of atenolol

A

Low BW and impaired fetal growth

158
Q

Beta blocker for decreasing secretion of aqueous humor

A

timolol

159
Q

Osmotic agent for decreasing aqueous humor

A

mannitol

160
Q

Alpha 2 agonist for decreasing aqueous humor

A

apraclonidine

161
Q

Carbonic anhydrase inhibitor for decreasing aqueous humor

A

acetazolamide

dorzolamide

162
Q

Cholinomimetics for ciliary muscle contraction causing opening of trabecular meshwork, and increased aqueous humor outflow

A

pilocarpine

physostigmine

163
Q

Prostaglandin that increases outflow through canal of Schlemm

A

latanoprost

164
Q

Non-selective alpha agonist that increases outflow via uveoscleral veins

A

epinephrine

165
Q

Beta blockers with combined alpha and beta blocking actions

Do not cause epinephrine reversal

A

Labetalol

Carvedilol

166
Q

Chronic use of beta blockers contributes which mechanism for anti hypertension?

A

Chronic use of beta blockers can cause decreasenin vascular resistance from reduced renin release from kidney

167
Q

A newer beta blocker that has some direct vasodilator action caused by NO release

A

Nebivolol

168
Q

Anti hypertensive (sympathoplegic directly acting on CNS) that is associated with positive Coombs test

A

Methyldopa

169
Q

Calcium channel blocker associated with lupus like syndrome

A

Hydralazine

170
Q

Common electrolyte imbalance caused by aliskiren and other RAAS blockers

A

Hyperkalemia

Pharmacology (8 decks)

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