Comlex/usmle Step 1 Review: General Pharmacology

Front 1

volume of distribution = ?

Back 1

Vd = amount of drug in the body / plasma drug concentration

Front 2

clearance = ?

Back 2

Cl= rate elimination of a drug / plasma drug concentration

Front 3

half-life = ?

Back 3

half-life = (0.7 x Vd) / clearance

Front 4

loading dose = ?

Back 4

loading dose = (plasma drug concentration x volume of distribution) / bioavailability

Front 5

maintenance dose = ?

Back 5

maintenance dose = (plasma drug concentration x clearance) / bioavailability

Front 6

3 main drugs that undergo zero-order elimination

Back 6

phenytoin, ethanol, and aspirin

Front 7

rate of elimination is proportional to drug concentration

Back 7

first-order mechanics

Front 8

rate of elimination is constant regardless of drug concentration

Back 8

zero-order mechanics

Front 9

reactions in phase 1 mechanics

Back 9

reduction, oxidation, and hydrolysis

Front 10

reactions in phase 2 mechanics

Back 10

acetylation, glucuronidation, and sulfation

Front 11

neurotransmitter that provides sympathetic innervation to the adrenals and sweat glands

Back 11

ACh

Front 12

location of D1 versus D2 receptors

Back 12

D1- renal vascular smooth tissue
D2- brain

Front 13

location of H1 versus H2 receptors

Back 13

H1- nose, respiratory tree
H2- stomach

Front 14

location on B1 versus B2 receptors

Back 14

B1- heart
B2- lung

Front 15

DOC for postoperative and neurogenic ileus and urinary retention

Back 15

bethanechol

Front 16

DOC to help diagnose asthma

Back 16

methacholine

Front 17

DOC for myasthenia gravis

Back 17

pyridostigmine

Front 18

anti-muscarinic used for Parkinsons

Back 18

benzotropine

Front 19

anti-muscarinic used for motion sickness

Back 19

scopolamine

Front 20

anti-muscarinic used for asthma

Back 20

ipratropium

Front 21

effect of atropine on the eye

Back 21

mydriasis and cycloplegia

Front 22

contraindications of atropine

Back 22

can not give atropine to infants (hyperthermia risk) or the elderly (may cause closed-angle glaucoma and increase risk for BPH)

Front 23

DOC to diagnose myasthenia gravis

Back 23

edrophonium

Front 24

antidote for acetaminophen toxicity

Back 24

N-acetylcysteine

Front 25

antidote for salicylate toxicity (i.e. aspirin)

Back 25

sodium bicarbonate, alkalinize the urine, dialysis

Front 26

antidote for amphetamine toxicity

Back 26

ammonium chloride, acidify the urine

Front 27

antidote for AChE inhibitors (i.e. physostigmine) or organophosphates (i.e. parathion)

Back 27

atropine or pralidoxime

Front 28

antidote for anticholinergic/antimuscarinic toxicity (i.e. atropine)

Back 28

physostigmine

Front 29

antidote for beta-blocker toxicity

Back 29

glucagon

Front 30

antidote for digitalis toxicity

Back 30

normalize K+, lidocaine, anti-digitalis antibodies, and magnesium

Front 31

antidote for iron toxicity

Back 31

deferoxamine

Front 32

antidote for lead toxicity

Back 32

EDTA, dimercaprol, or succimer

Front 33

antidote for mercury, arsenic, or gold

Back 33

dimercaprol or succimer

Front 34

antidote for copper toxicity

Back 34

penicillamine

Front 35

antidote for cyanide toxicity

Back 35

thiosulfate, nitrite

Front 36

antidote for methemoglobin toxicity

Back 36

methylene blue and vitamin C

Front 37

antidote for carbon monoxide toxicity

Back 37

100% oxygen and hyperbaric oxygen

Front 38

antidote for methanol or ethylene glycol (antifreeze) toxicity

Back 38

ethanol or fomepizole

Front 39

antidote for opioid toxicity

Back 39

naloxone or naltrexone

Front 40

antidote for benzodiazepine toxicity

Back 40

flumazenil

Front 41

antidote for TCA toxicity

Back 41

sodium bicarbonate

Front 42

antidote for heparin toxicity

Back 42

protamine

Front 43

antidote for warfarin toxicity

Back 43

vitamin K and fresh frozen plasma

Front 44

antidote for tPA or streptokinase toxicity

Back 44

aminocaproic acid

Front 45

antidote for theophylline toxicity

Back 45

B-blocker

Front 46

breakdown product of ethylene glycol

Back 46

oxalic acid

Front 47

breakdown product of methanol

Back 47

formaldehyde

Front 48

metabolic pathway of alcohol breakdown

Back 48

ethanol -> alcohol dehydrogenase -> acetaldehyde -> acetaldehyde dehydrogenase -> acetic acid

Front 49

which enzyme in the metabolic pathway of alcohol inhibits alcohol dehydrogenase

Back 49

fomepizole

Front 50

which enzyme in the metabolic pathway of alcohol inhibits acetaldehyde dehydrogenase

Back 50

disulfiram

Front 51

what is the metabolite in the metabolic pathway of alcohol that causes the nausea, vomiting, headache, ataxia, hypotension etc...

Back 51

acetaldehyde

Front 52

why do chronic alcohol ingestion cause lactic acidosis

Back 52

the metabolism of alcohol depletes NAD (therefore the NADH/NAD ratio increase) which is normally needed for the conversion of pyruvate into lactate

Front 53

CYP450 enzyme in alcohol metabolism

Back 53

CYP2E1

Front 54

why does alcohol precipitate acetaminophen toxicity

Back 54

normally, 95% of acetaminophen is metabolized by phase II enzymes and 5% is metabolized by CYP2E1
Normally, when that 5% gets metabolized by CYP2E1, it gets converted into NAPQI which is toxic and causes liver failure
Overdosing on acetaminophen requires a much larger precentage to be metabolized by CYP2E1 thus creating more NAPQI and increasing the risk for liver failure and death
Since alcohol is metabolized by CYP2E1, people taking even normal doses of acetaminophen but who are also chronic alcoholics will upregulate CYP2E1 and thus produce large amounts of NAPQI, thus increasing the risk for death

Front 55

does salicylate toxicity cause alkalosis or acidosis

Back 55

intially, it causes a respiratory alkalosis (due to hyperventilation); shortly after, it causes a metabolic acidosis due to the accumulation of pyruvate and lactate (Krebs cycle)