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18 Cards in this Set

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what does the plasma drug concentration _generally_ correlate well with?
the effect of the drug
define: volume of distribution
the volume that would be required to contain the total amount of absorbed drug in the body at a uniform concentration equivalent to that in the plasma at steady state
equation for volume of distribution
Vd = Dose/[Drug]_plasma
how are alcohol and anesthetit gases elimiated?
lungs
give an example of an osmotic diuretic
mannitol
How are H ions targeted by drugs
administratino of ammunium chloride can acidify urine. The ammonium is metabolized to urea and the Cl goes into the urine. Loss of Cl obligates loss of H in urine --> lowered pH
How do drugs target metal ions?
chelating EDTA can bind Pb++. Metal ions are frequntly drug targets in poison cases
How does digitalis glycosides work?
inhibits membrane enzye Na/K/ATPase --> increases myocardial contractility
explain the mechanism of CHF
LV has systplic dysfunction --> not enough CO. To improve this, the heart increase the end diastolic volume, and stroke volume increases. At a certain point, the increase in end diastolic volume cause an increase in LV diastolic pressures. Increased pressures cause increased LA and pulmonary capillary pressures --> interstitial and alveolar edema --> elevated RH pressures --> systemic venous hypertension and peripheral edema
what are cardiac glycosides?
positive inotropes --> increased contractile force of myocytes
define: Starling relationship
increased streatch of the muscle exposes additioanl sites for calcium binding and for actin-,myosin interaction.

an increase in the end diastolic volume of the LV leads to an increase in stroke volume
what are the three key proteins involved in Ca regulation in the sarcolemma?
1. Na/K/ATPase (sodium pump)
2. Na Ca exchanger
3. Ca pump
what belongs in the cardiac glycoside family?
digitalis derivatives: digoxin and digitoxin
non digitalis agents: ouabain
what is the most commonly used cardiac glycoside?
digoxin
how does digoxin work?
inhibits the Na/K/ATPase pump. Intracellular Na levels rise, and the Na Ca exchanger doesn't work as well. You get more Ca intracellularly
During an action potential, there is more Ca available to bind troponin C and tension development during contraction is facilitated
Note also: the SR of digoxin-treated cells sequesters more Ca for use in subsequent contraction cycles
Define ED_50
the median effective dose: the dose at which 50% of the patients will have a response to the drug
Define efficacy
the maximum effective of which the drug is capable
how is affinity quantified?
by k_D