Primer 21 - Drug Metabolism

Question 1

Which metabolites does yield from phase I?

Answer 1

1) Sightly polar. 2) Water-soluble. 3) Active.

Question 2

Which are the reaction and metabolites yield from phase II?

Answer 2

Reactions (conjugation): Glucuronidation, Acetylation and Sulfation “GAS”.
Metabolites: Very polar and inactive.

Question 3

Which is the phase that geriatric patients lose?

Answer 3

Phase I, Geriatric patients have GAS (phase II).

Question 4

Which cytochrome performance phase I reactions?

Answer 4

Cytochrome P-450 in liver.

Question 5

What kind of patients are more susceptibles for high side effects?

Answer 5

Patients who are slow acetylators have increase side effects from certain drugs because of decrease rate of metabolism.

Question 6

What is happened when two drugs have the same metabolism by Cytochrome P-450?

Answer 6

Drug-drug interaction, one of them drugs going to increase in serum plasma levels or prolong the action.

Question 7

What is the subfamily type of CYP3A4?

Answer 7

CYP (Cytochrome) 3 (Family) A (Subfamily) 4(Form).

Question 8

Which are the substances than inhibit Cyp 450?

Answer 8

[CRACK AMIGOS] Cimetidine, Ritonavir(protease inhibitor),Amiodarone, Ciprofloxacin, Ketoconazol, Acute alcohol abuse, Macrolides (except azithromycin), Isoniazid, Grapefruit juice, Omeprazole, Sulfonamides.

Question 9

Which are the inducers from CYP-450?

Answer 9

[Kenyon Rides Shotgun in Barbie’s Girl Car]Phenytoin, Rifampin, St. John’s wort, Barbiturates, Griseofulvin and carbamazepine.

Question 10

Which drugs inhibit the alcohol metabolism, and which is the enzyme inhibited?

Answer 10

Fomepizole: inhibits alcohol dehydrogenase.
Disulfiram: inhibits acetaldehyde dehydrogenase.

Question 11

Which is the drug that you have to use when you want to know that your patient drank alcohol?

Answer 11

Disulfiram because made the acetaldehyde up and that induce Nausea, Vomiting, Headache and Hypotension.

Question 12

Which are another drugs with Disulfiram-like reaction?

Answer 12

1)Metronidazole. 2)Certain cephalosporins. 3)Procarbazine. 4) 1st generation sulfonylureas.

Question 13

Causes of acidosis?

Answer 13

[MUD PILES ]Methanol, Uremia, Diabetic ketoacidosis, Paraldehyde or phenformin, Iron tablets or INH, Lactic acidosis (and shock), Ethylene glycol and Salicylates.

Question 14

What is the antidote for methanol intoxication?

Answer 14

Ethanol and Fomepizol.

Question 15

What is Zero-order elimination?

Answer 15

Plasma concentration decrease linearly with time.

Question 16

Which drugs are Zero-order elimination?

Answer 16

Phenytoin, Ethanol and Aspirin ( at high or toxic concentration).

Question 17

What is First-order elimination?

Answer 17

Rate of elimination is directly proportional to the drug concentration. Constant fraction of drug eliminated per unit time.

Question 18

Plasma concentration drug is 10 at the 0 hrs, 7.5 at the 1 hrs and 5 at the 2 hrs, at what hour it will be 0 plasma concentration, if is it Zero-order elimination?

Answer 18

4 hour, it decrease 2.5 plasma concentration per hour.

Question 19

Plasma concentration drug is 10 at the 0 hrs, 5 at the 1hrs, 2.5 at the 2 hrs, if it is First-order elimination, what plasma concentration it will be at the 4 hour?

Answer 19

0.625 at the 4 hrs, because it eliminated 50% of the plasma concentration per hour.

Question 20

What is PKA?

Answer 20

Acid Dissociation constant.

Question 21

In which environments are trapped phenobarbital, methotrexate, TCAs and aspirin?

Answer 21

Those trapped in basic environments.

Question 22

Which is the treat for aspirin overdose?

Answer 22

Bicarbonate, also for all weak acids substance.

Question 23

In which environment amphetamines are trapped, and what is the treat for overdose?

Answer 23

Trapped in acidic environments and it is treat with Ammonium chloride.

Question 24

What do you have to give to eliminate acids?

Answer 24

You have to give bases, and give acids to help eliminate bases.

Question 25

Drug ends with -azole. What does it do and give an example.

Answer 25

Ergosterol synthesis inhibitor, Ketoconazole.

Question 26

Drug ends with -bendazole. What does it do and give an example.

Answer 26

Antiparasitic/antihelmintic. Mebendazole.

Question 27

Drug ends with -cillin. What does it do and give an example.

Answer 27

Peptidpglycan synthesis inhibitor. Ampicillin. Antimicrobial

Question 28

Drug ends with -cycline. What does it do and give an example.

Answer 28

Protein synthesis inhibitor. Tetracycline. Antimicrobial.

Question 29

Drug ends with -ivir. What does it do and give an example.

Answer 29

Neuraminidase inhibitor. Oseltamivir. Antimicrobial

Question 30

Drug ends with -navir. What does it do and give an example.

Answer 30

Protease inhibitor. Ritonavir. Antimicrobial.

Question 31

Drug ends with -ovir. What does it do and give an example.

Answer 31

DNA polymerase inhibitor. Acyclovir. Antimicrobial.

Question 32

Drug ends with -thromycin. What does it do and give an example.

Answer 32

Macrolide antibiotic. Azithromycin. Antimicrobial.

Question 33

Drug ends with -ane. What does it do and give an example.

Answer 33

Inhalation general anesthetic. Halothane. CNS.

Question 34

Drug ends with -azine. What does it do and give an example.

Answer 34

Typical antipsychotic. Thioridazine. CNS

Question 35

Drug ends with -barbital. What does it do and give an example.

Answer 35

Barbiturate. Phenobarbital. CNS

Question 36

Drug ends with -caine. What does it do and give an example.

Answer 36

Local anesthetic. Lidocaine. CNS

Question 37

Drug ends with -etine. What does it do and give an example

Answer 37

SSRI. Fluoxetine. CNS

Question 38

Drug ends with -ipramine. What does it do and give an example.

Answer 38

TCA. Imipramine. CNS

Question 39

Drug ends with -triptyline. What does it do and give an example.

Answer 39

TCA. Amitriptyline. CNS

Question 40

Drug ends with -triptan. What does it do and give an example.

Answer 40

5-HT (1B/1D) agonist. Sumatriptan. CNS

Question 41

Drug ends with -zepam. What does it do and give an example.

Answer 41

Benzodiazepine. Diazepam. CNS

Question 42

Drug ends with -zolam. What does it do and give an example.

Answer 42

Benzodiazepine. Alprazolam. CNS

Question 43

Drug ends with -chol. What does it do and give an example.

Answer 43

Cholinergic agonist. Bethanechol/carbachol. Autonomic

Question 44

Drug ends with -curium. What does it do and give an example.

Answer 44

Nondepolarizing paralytic. Atracurium. autonomic.

Question 45

Drug ends with -curonium. What does it do and give an example.

Answer 45

Nondepolarizing paralytic. Vecuronium. Autonomic

Question 46

Drug ends with -olol. What does it do and give an example.

Answer 46

Beta blocker. Propranolol. Autonomic.

Question 47

Drug ends with -stigmine. What does it do and give an example.

Answer 47

AChE inhibitor. Neostigmine. Autonomic

Question 48

Drug ends with -terol. What does it do and give an example.

Answer 48

Beta 2 agonist. Albuterol. Autonomic

Question 49

Drug ends with -zosin. What does it do and give an example.

Answer 49

Alpha 1 antagonist. Prazosin. Autonomic

Question 50

Drug ends with -afil. What does it do and give an example.

Answer 50

PDE-5 inhibitor. Sidenafil. Cardiovascular

Question 51

Drug ends with -dipine. What does it do and give an example.

Answer 51

Dihydropyridine Calcium channel blockers (CCB). Amlodipine. Cardiovascular.

Question 52

Drug ends with -pril. What does it do and give an example.

Answer 52

ACE inhibitor. Captopril. Cardiovascular

Question 53

Drug ends with -sartan. What does it do and give an example.

Answer 53

Angiotensin II receptor blocker. Losartan. Cardiovascular

Question 54

Drug ends with -statin. What does it do and give an example.

Answer 54

MHG-CoA reductase inhibitor. Atorvastatin. Cardiovascular.

Question 55

Drug ends with -dronate. What does it do and give an example.

Answer 55

Biphosphonate. Alendronate.

Question 56

Drug ends with -glitazone. What does it do and give an example.

Answer 56

PPAR-gamma activator(peroxisome proliferator activated Receptor- Gamma). Rosiglitazone.

Question 57

Drug ends with -Prazole. What does it do and give an example.

Answer 57

Proton pump inhibitor (ppi). Omeprazole.

Question 58

Drug ends with -prost. What does it do and give an example.

Answer 58

Prostaglandin analog. Latanprost.

Question 59

Drug ends with -tidine. What does it do and give an example.

Answer 59

H2 antagonist. Cimetidine

Question 60

Drug ends with -tropin. What does it do and give an example.

Answer 60

Pituitary hormone. Somatotropin.

Question 61

Drug ends with -ximab. What does it do and give an example.

Answer 61

Chimeric monoclonal Ab. Basiliximab

Question 62

Drug ends with -zumab. What does it do and give an example.

Answer 62

Humanized monoclonal Ab. Daclizumab.

Question 63

Which are the beta and alpha blockers?

Answer 63

Carvedilol and Labetalol.

Question 64

Which hepatic phase of metabolism is lost by geriatric patients? Which phase is mediated by cytochrome p450?

Answer 64

Phase I for both answers

Question 65

Which medication overdose can be treated with bicarbonate ?

Answer 65

Weak acids (ex. Aspirin)

Question 66

Which medication can be treated with ammonium chloride?

Answer 66

Weak bases (ex. Amphetamines)

Question 67

What medication inhibits alcohol dehydrogenase ?

Answer 67

Fomepizole.

Question 68

Which medication inhibit acetaldehyde dehydrogenase ?

Answer 68

Disulfiram.

Question 69

Which phase include reduction, oxidation and hydrolysis as a reactions?

Answer 69

Phase I.