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Pharm Final Gold > Test 1 > Flashcards

Test 1 Flashcards

0
Q

Pharmacodynamics

A

What a drug does to the critter

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1
Q

Pharmacokinetics

A

What the critter does to the drug

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2
Q

Pharmacokinetics: LADME

A 
Liberation
Absorption
Distribution
Metabolism
Elimination
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3
Q

Two categories of drug administration

A

Enteral

Parenteral

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4
Q

Additive interaction

A

1+1=2

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5
Q

Synergistic reaction

A

1+1=3

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6
Q

Potentiation reaction

A

1+0=3

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7
Q

4 types of receptors

A

Regulatory proteins
Enzymes
Transport proteins
Structural proteins

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8
Q

3 aspects of drug receptor function

A
  1. Receptors determine the nature and characteristics of the drug concentration response curve
  2. Receptors function as regulatory proteins and part of chemical signaling mechanisms that provide targets for drugs
  3. Receptors determine the therapeutic and toxic effects of drugs on a critter
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9
Q

4 transmembrane signaling mechanisms

A

Ligand gated ion channels
G protein coupled receptors
Enzyme linked receptors
Intracellular receptors

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10
Q

How can differences in potency be overcome?

A

Giving more drug

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11
Q

Which is more important, potency or efficacy?

A

Efficacy

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12
Q

Therapeutic index

A

TD50/ED50

Toxic effect in 50% of population vs. therapeutic effect in 50%

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13
Q

Dangerous therapeutic index

A

<2

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14
Q

Definition of bioavailability

A

Fraction of administered drug that reaches systemic circulation

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15
Q

First pass metabolism

A

Via portal circulation
Liver metabolizes drugs limiting their bioavailability
Drugs with high first pass metabolism must be given in high doses orally or parenteral lay

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16
Q

Solubility characteristics of drugs

A

Too lipopholic: poorly absorbed
Too hydrophilic: difficulty passing through cell membranes
MOST COMMONLY ADMINISTERED DRUGS ARE WEAKLY ALKALINIC OR ACIDIC

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17
Q

Factors affecting bioavailability

A

Chemical stability in the GI tract

Drug formulation

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18
Q

3 factors affecting volume of distribution

A

Blood flow
Water/fat solubility
Protein binding

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19
Q

Major factor affecting sieving coefficient

A

Degree of protein binding

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20
Q

Volume of distribution calculation

A

Vd=D/Co

Dose/concentration

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21
Q

5 main ways to eliminate drugs

A 
Urine
Bile
Hepatic metabolism
Lung/oxygenator expiration
Artificial filtration (hemoconcentrator)
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22
Q

Half life: 3.3, 4.3, and 4.3 years

A
  1. 3: 90%
  2. 3: 95%
  3. 3: 97.5%
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23
Q

Clearance rate equation

A

Cl= (0.693*Vd)/half life

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24
Q

Loading dose equation

A

LD= (Vd*target plasma concentration)/bioavailability

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25
Q

Maintenance dose equation

A

MD= (Clearance rate *target plasma concentration)/bioavailability

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26
Q

Two phases of biotransformation

A

Phase 1: metabolizes drug into more polar form

Phase2: conjugates drug with a chemical (acetylation)

27
Q

Complex Liver biotransformation drugs through

A

Cytochrome P450 complex

28
Q

Somatic nervous system transmission

A

One junction system travels via single nerve axon

Neurotranmitter: ACh

29
Q

Autonomic nervous system

A

Extensive use of feedback arcs

Uses electrical impulses and neurotransmitters

30
Q

Definition of ganglion

A

Nerve cell that lies outside the CNS

31
Q

Preganglionic neurotransmitter

A

Acetylcholine for both PNS and SNS

32
Q

3 divisions of the ANS

A

Parasympathetic
Sympathetic
Enteric

33
Q

2 semiautonomous parts of the enteric division

A 
Myenteric plexus (plexus of Auerbach)
Submucous plexus (plexus of Meissner)
34
Q

3 organs only recieving specifically sympathetic stimulation

A

Pilorector muscles, sweat glands, adrenal medulla

35
Q

Types of receptors for cholinergic neurons

A

Nicotinic or muscarinic

36
Q

Receptors for adrenergic neurons

A

Alpha
Beta
Dopaminergic

37
Q

1 cardiovascular variable your body seeks to auto regulate

38
Q

Net effect of Levophed

A

Increase SVR
Decrease HR
(Even though positive chronotrope)

39
Q

Only location for muscarinic receptors

A

Effector postsynaptic cells of the PNS

40
Q

Nicotinic receptor location

A

Neuromuscular junctions and ganglia of ANS

41
Q

Rate limiting step for synthesis of ACh

A

Uptake of choline

42
Q

Anesthetic adjuncts

A

Neuromuscular blockers

43
Q

Antimuscarinic uses

A

Symptomatic bradycardia, pulseless electrical activity, AV block
Other Clinical use: adjunct Parkinson’s disease, motion sickness, eye exams, GI hyper motility, urinary incontinence

44
Q

Side effects of antimuscarinics

A

Hot, dry, red, crazy

Tachycardia

45
Q

Effects of Ganglionic blockers

A

Profound hypotension

Profound constipation

46
Q

Major drug interactions for nondepolarizing neuromuscular blockers

A

Antagonized by acetylcholinesterase inhibitors
Synergistic with Ca channel blockers
Synergistic with halogenated hydrocarbon gas anesthetics

47
Q

SUX side effect with psuedocholinesterase deficiency

A

Prolonged apnea

Most common in Persian Jews and Indian Hindu

48
Q

Major SUX side effect

A

Hyperkalemia

49
Q

Main SNS neurotransmitter

A

Norepinephrine

50
Q

Rate limiting step of adrenergic neurotransmission

A

Tyrosine transported intracellularly and hydroxylated into DOPA

51
Q

Most common method to get rid of norepinephrine

A

Reabsorption by presynaptic membrane

52
Q

Alpha1 receptors have a high affinity for

A

Norepinephrine

53
Q

Alpha2 receptors have a high affinity for

A

Clonidine (Catapres)

54
Q

Alpha1 works on…

A

Smooth muscle of noncardiac organs

Eyes, bladder, and prostate

55
Q

Apha2 use in cardiac surgery

A

Sedative as part of multimodal anesthesia

56
Q

Epinephrine effect on SBP and DBP

A

Increase SBP

decrease DBP

57
Q

Norepinephrine effect on SBP and DBP

A

Increased SBP

Increase DBP

58
Q

DOC for cardiogenic or septic shock

59
Q

DOC for struggling to come off bypass

A

Dobutamine

60
Q

Isoproteronol effect on SBP and DBP

A

Same SBP

Greatly decreased DBP

61
Q

Phenylephrine effect on SBP and DBP

A

Increases SBP

Increases DBP

62
Q

Drug very commonly used in adult perfusion to increase SVR / arterial pressure

A

Phenylephrine (Neo)

63
Q

4 privileged sites

A

Brain
Eye
Testicle
Fetus

64
Q

Drug causing epinephrine reversal

A

Phentolamine

65
Q

5 perfusion relevances for beta blockers

A
  1. MI
  2. Long term management of stable angina
  3. Hypertension
  4. Migraine headaches
  5. Hyperthyroidism and thyroid storm
66
Q

5 Beta blocker side effects

A
  1. Bronchoconstriction
  2. Arrhythmias
  3. Hypoglycemia
  4. Drowsiness
  5. Sexual dysfunction

Pharm Final Gold (12 decks)

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