Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/34

Click to flip

34 Cards in this Set

  • Front
  • Back
Drugs to Avoid in Pregnancy

SAFE Moms Take Really Good Care
Sulfonamides (kernicterus), Aminoglycosides (ototoxic), Fluoroquinilones (cartilage damage), Erythromycin (acute cholestatic hepatitis), Metronidazole (mutagenic), Tetracycline (discolored teeth), Ribavarin, Griseofulvin, Chloramphenicol (gray baby)
Volume of Distribution
Vd= amount of drug in body / plasma drug concentration

If bound to plasma proteins, this is altered in liver disease
Clearance
CL= rate of elimination / plasma concentration
Half Life
t1/2= [0.7 * Vd] / CL

If infused at a constant rate, it reached 94% of steady state in 4 t1/2
Dosage Calculation
Loading Dose = Desired Conc * [Vd/bioavailability]

Maintainance Dose= Desired Conc * [Clearance/Bioavailability]

In pts with Renal/Liver disease, the loading dose is constant, it's the maintainance dose that decreases
Zero Order Elimination
Cp (plasma conc) falls at a steady rate no matter what the starting point (linear decrease)

Ex- EtOH, Phenytoin, Aspirin
First Order Elimination
Rate of elimination is proportional to concentration (faster at high concentration, slower at low) -- exponential curve
Excretion occurs in 2 phases

Phase 1 occurs in ____ and yields _____. An example is the ______ system

Phase 2 uses ______ and yields _______
Liver
Oxidized and Reduced compounds that are slightly polar and still active
Cyt p450 System

Acetylation, Glucuronidation
Very polar substances that are inactive
Competitive Antagonist

Will shift the curve to the _____
To achieve the same % maximum effect req's a higher dose --> curve shifts to the right

Still able to achieve 100% max effect
Irreversible Antagonist

Will shift the curve ______
Decreases the % maximum effect --> shifts the curve downward.

Even at high concentrations of the drug, it cannot overcome the antagonist and it's effect is decreased
EC(50) vs Kd
Kd= dose req'd to occupy 50% of all receptors

EC(50)= dose req'd to get 50% of maximum effect --> this is most imp't clinically

EC(50) < Kd means that there are "spare receptors" or less than 50% receptors need to be occupied for activity
Potency
Dose req'd to get an effect...it is independent of full or partial agonist
Full agonist v Partial Agonist
Partial Agonist is never able to reach the same maximum effect as a Full Agonist (it has lower efficacy). However, the partial agonist can be more potent.
Therapeutic Index
TD50/ED50

Dose to get 50% people sick/ Dose to get 50% people better

Narrow Index= lower dose causes more toxic effects compared to therapeutic

Large Index(desirable)= need a higher dose to cause toxicity compared to effective dose
Guanylate Cyclase q receptor
HAV 1 M&M
H1, alpha 1, V1, M1, and M3
Guanylate Cyclase i receptor
MAD 2's
M2, alpha 2, D2
Guanylate Cyclase s receptor
B1, B2, D1, H2, V2
Cholinomimetics (Direct Agonists)
1)Bethanechol
2)Pilocarpine
1) Used for post-op ileus and bladder retention (Bowel and Bladder)

2)Used for Glaucoma by opening the angle via cilary muscle contraction and by dilating the pupilary sphincter. Works on narrow angle and open angle
Cholinomimetics (Indirect via AChE inhibition)
1)Neostigmine
2)Pyridostigmine
3)Edrophonium
4)Physostigmine
5)Echothiophate
1) Myasthenia gravis, post-op reversal of neuromuscular blockade

2)Myasthenia gravis

3)Short acting, used to diagnose Myasthenia gravis

4) Glaucoma -->able to cross BBB and Atropine overdose

5)Glaucoma
Signs of Cholinesterase Poisoning

DUMBBELSS

Caused by Parathion and Organophosphates
Diarhhea, Urination ,Miosis, Bronchospasm, Bradycardia, Excitation of muscles, Lacrimation, Sweat, Salivate

Trt- Atropine (blocks muscarinic receptors) and pralidoxime (regenerates AChE)
Cholinoreceptor Blockers

1)Atropine,Homatropine
2)Benztropine
3)Ipatropium
1) Used in eye to cause Mydriasis (dilation) and cycloplegia(can't focus)

2)Used in CNS for Parkinson's (blocks indirect pathway)
3) Used in Lungs for Asthma/COPD
Atropine
MOA= muscarinic anatogonist

Blocks Salivation, Lacrimation, Urination, and Defecation

Toxic= Hot, Dry, Red Flushed Skin, Vision problems, Disorientation
Hexamethonium
MOA= Blocks nicotinic receptors

Use= used to block vasovagal response to prevent reflex bradycardia with NE increase BP
Epinephrine
1)receptor specificity
2)Low Dose
3)High Dose
4)Uses
1) Beta>Alpha but more Alpha receptors in body
2) Binds only Beta receptors causing inc HR,Contractility via B1, but also Vasodilation via B2 --> no change in Blood Pressure
3) Mostly alpha receptor effects--> vasoconstriction causing increased BP....prevented by giving Alpha Blocker previously leading to decreased BP (Epi reversal)

4) Anaphylaxis, open angle glaucoma, asthma (B2 stim), hypotension
NorEpi
1)receptors
2)Effects
3)Pretreat with Alpha blocker
4)Uses
1) Alpha1 > Beta 1
2) causes increased vasoconstriction along with increased contractility leading to massive increase in BP --> reflex bradycardia
3)Will prevent pressor effect but no reversal to depressor like Epi
4) Hypotension
Isoproterenol
1)receptors
2)effects
1) only B1 and B2
2) decreases BP via B2 leading to reflex Tachy
Dopamine
1)Receptors
2)Effects
3)Use
1) D1=D2>Beta>Alpha
2)Low Dose= Renal vasodilation to help in cardiac shock
Med Dose= increase HR
High Dose= Increase Vasoconstriction to Inc BP
3) Cardiac Shock, Heart Failure
Ephedrine
1)MOA
2)Use
1)increase release of stored catecholamines
2)nasal decongestion, urinary incontinence, hypotension
Phenylephrine
1)MOA
2)Uses
1)Acts on Alpha receptors
2)Dilates pupil, vasoconstrictor, nasal decongestion
Albuterol
B2 agonist used in Asthma
Clonidine and Methyldopa
1)MOA
2)Use
1)Binds alpha 2 receptors in CNS to prevent catecholamine outflow
2) Hypertension in pts with renal disease because it won't decrease renal blood flow
Nonselective Alpha Blockers

1) Irreversible is ____
2) Reversible is ______
3) Used to trt
4) Toxicity
1)Phenoxybenzamine
2)Phentolamine
3)Pheochromocytoma
4)Hypotension with reflex tachy
Alpha 1 blockers
Prazosin, Terazosin
1) used in hypertension, urinary retention from BPH

2)can cause 1st dose hypotension and dizziness
Beta Blockers
All that start with A-->M are selective for B1 receptor (safe in asthmatics)

Used to lower BP, lower HR, slow CHF progression, lower Aqueous humor production (Glaucoma)

Toxicity- Impotence, Bradycardia, sedation, can cause hyperglycemia in Diabetics