Nbme Pharmacology

Front 1

slow acetylator phenotype

*page 62 in B&W:
Ester anesthetics are rapidly hydrolyzed by plasma cholinesterases (presumably also procainamide is broken down by plasma choinesterases too). Some people are "slow acetylators," meaning they have unusually slow cholinesterases and the effects of these drugs last an unusually long time."

Back 1

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Front 2

Isoflurophate (DFP)

Back 2

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Hint 2

This appears to be chilinesterase inhibitor poisoning (*page 201 from FA):

Symptoms include Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating, and Salivation (also abdominal cramping).

Mnemonic: D.U.M.B.B.E.L.S.S.

Caused by: Parathion and other organophosphates. Therefore, Isoflurophate (DFP) must be a cholinesterase inhibitor. Antidote: atropine (muscarinic antagonist) plus pralidoxime (chemical antagonist used to regenerate active cholinesterase by breaking the bond).

Front 3

Chlorpromazine
*see hint for explanation*

Back 3

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Hint 3

pg 35 in Pharm B&W:
Antipsychotic agents --> TYPICAL antipsychotics:

chlorpormazine: low potency, the original phenothiazine, highly sedating

Adverse effects of typical antipsychotics:

1. movement disorders caused by D2 blockade
2. anticholinergic effects = blurry vission, dry mouth, urinary retention, confusion, loss of memory
3. adrenergic effect = orthostatic hypotension
4. Endocrine effects = gynecomastia, galactorrhea, amenorrhea (increase prolactin release induced by dopamine blockade)
5. lowers seizure threshold

*LOW potency agents have less D2 blockade, and thus have less Parkinsonism and more anticholinergic effects.*

Front 4

Dopaminergic
*page 199 in FA: D1 receptor = Gs --> relaxes renal vascular smooth muscle*

Back 4

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Front 5

Dihydrofolate reductase

Back 5

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Front 6

Acetaminophen

Back 6

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