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My Notes > Straight Pharm > Flashcards

Straight Pharm Flashcards

1
Q

Describe the treatment for cyanide poisoning

A
  1. amyl nitrite (NOT nitrate) → oxidize Hb to methemoglobin → binds CN-
  2. give thiosulfate to bind CN- → forms thiosulfate → renally excreted
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2
Q

What is pKA?

A

pH at which 50% of drug is ionized and 50% unionized

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3
Q

What form of weak acids crosses membranes?

A

non-ionized form

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4
Q

What are 5 important drugs to remember as weak acids?

A
  1. aspirn (acetylsalicylic acid)
  2. penicillins
  3. cephalosporins
  4. loop diuretics
  5. thiazide diuretics
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5
Q

What are 4 important drugs/groups to remember as weak bases?

A
  1. morphine
  2. local anaesthetics
  3. amphetamines
  4. PCP
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6
Q

If you have a weak acid drug with a pKA of 5, would it be more effectively absorbed in the stomach or small intestine?

A

the stomach, because it would have to be in an acid environment to be in its unionized form - for a drug with a pKA of 5, an acidic environment for it would be a pH < 5; stomach pH = 1-2; sm. intestine pH = 6

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7
Q

What is the pH in the following locations?

  • Stomach
  • Sm. intestine
  • Blood
  • Urine
A
  • Stomach: 1-2
  • Sm. intestine: 6
  • Blood: 7.4
  • Urine: 5-8
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8
Q

When would you want to acidify urine?

A

To eliminate a weak base drug (e.g. amphetamines, morphine, PCP, local anaesthetics) → ionizes the drug so becomes trapped in kidney tubule

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9
Q

What three things can you give patients to acidify urine (thus help to eliminate weak bases)?

A
  1. NH4Cl (ammonium chloride)
  2. vitamin C
  3. cranberry juice
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10
Q

What can you give to help eliminate weak acid drugs (eg. asprin)?

A
  1. NaHCO3 (sodium bicarb) - base → ionized form

2. Acetazolamide (CA inhibitor → lots of bicarb in urine→ ↑ pH → ionize WA)

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11
Q

What can you give to help prevent ammonia (NH3) toxicity in hepatic encephalopathy?

A

Lactulose → lactic acid by gut bacteria → donates a proton to NH3 → NH4+ → NH4+ can’t leave gut

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12
Q

Most drugs are transported via passive diffusion. What are two examples of drugs that are actively transported? What does this imply?

A
  1. penicillins
  2. diuretics
    Since carriers are required for facilitated and active transport, the systems are saturable
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13
Q

Give two examples of competition between a drug and another substrate in the body for protein binding sites

A
  1. Sulfonamides displace bilirubin from albumin → kernicterus in newborns
  2. Sulfonamides displace warfarin (which is 98% protein bound) → ↑ plasma concentrations → bleeding/bruising
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14
Q

What are the 2 characteristics which allow a drug to penetrate the placenta or BBB?

A
  1. small size - e.g. Li+ (charged), EtOH (polar)
  2. Lipid soluble
    Note: if a drug can cross the BBB, it will easily cross the placenta
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15
Q

What are the 3 drug characteristics that increase the likelihood it is safe in pregnancy?

A
  1. large
  2. charged
  3. highly protein bound (e.g. phenobarbital)
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16
Q

If a drug is highly bound to plasma proteins, will the Vd be low or high?

A

low

17
Q

Thiopental has a long half life (9 hours), but only works for < 1 min in the brain. What pharmacological concept explains this?

A

redistribution - a property of lipid soluble drugs: there is a fall in plasma concentration soon after delivery because of redistribution to fat tissue; consequently, multiple doses will have increasing effectiveness as fat becomes saturated
Side note: remember that THIO indicates there is a sulfur group → lipid soluble

18
Q

What 3 drugs have zero order elimination?

A
  1. phenytoin
  2. ethanol
  3. salicylates (asprin)
19
Q

What does a zero order elimination drug look like on a linear vs. a log scale? 1st order?

A

Zero order:
1. linear scale - linear decrease
2. log scale - curved (convex) decreased line
1st order:
1. linear scale - curved (concave) decrease
2. log scale - linear decrease

20
Q

If a drug is 80% protein bound and GFR = 120 ml/min, what is the clearance rate?

A

Cl = free fraction x GFR = .20 x 120 ml/min = 24 ml/min

21
Q

How can you determine F experimentally for a drug?

A

give equivalent doses orally and by IV, then take area under curve for oral dose / AOC for IV administration; if different doses you can multiply the oral dose by the IV dose and the IV dose by the oral dose in the above equation

22
Q

How do you calculate the T1/2 if given the Vd and CL?

A

T1/2 = (Vd x ln2) / CL; ln2 is about .7 so (Vd x .7)/CL

23
Q

What does it mean to induce p450? Would the Vmax or Km be affected?

A

↑ gene expression → ↑ Vmax

24
Q

What drug has the side effect of livedo reticularis?

A

amantadine

My Notes (23 decks)

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