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102 Cards in this Set
- Front
- Back
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What neurotransmitter is depleted in a 28 y/o chemist with MPTP exposure?
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Dopamine
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What are the clinical manifestations of someone taking tetracycline with photosensitivity?
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Rash on sun-exposed regions
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What is the enzyme deficiency in someone who develops hemolytic anemia while on chloroquine?
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G6PD defeciency
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What causes a farmer to develop dyspnea, salivation, miosis, diarrhea, cramping and blurry vision?
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pesticides, inhibit AChE
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How do you treat a female with a Hx of psychiatric illness who has urinary retention from a neuroleptic?
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Bethanechol
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A patient with a kidney transplant is on cyclosporine for immunosuppresion. and needs an antifungal, what would cause cyclosporine toxicity?
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Ketoconazole
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What routine workup should be done on a patient with carbamazepine?
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LFTs
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Why would a girl on rifampin get pregnant despite her birth control?
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Rifampin augments egen metabolism in the liver. OCs are less effective.
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How do you calculate volume of distribution?
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Vd=amount of drug in the body/plasma drug concentration
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How do you calculate clearance?
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CL=rate of elimination/plasma drug concentration
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How do you calculate t1/2?
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t/2=.7xVd/CL
3.3 1/2 lives-> 90% concentration |
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How do you calculate loading dose?
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CpxVd/F
Cp is the target plasma concentration F is the bioavailability Renal failure does not change the loading dose |
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How do you calculate Maintenance dose?
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CpxCL/F
Cp is the target plasma concentration F is the bioavailability Renal Failure decreases the maintenance dose |
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What is the difference between zero-order elimination and first-order elimination?
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zero-order- constant rate of elim regardless of C. Ethanol, phenytoin and aspirin
First-order- Rate is dependant on concentration. |
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What are three drugs that are eliminated with zero-order kinetics?
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EtOH
Phenytoin Aspirin |
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breakdown phase I vs. phase II metabolism
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Phase I- reduction, oxidation, hydrolysis-> polar, water-soluble metabolites- can be active
C-p450. Geris lose phase I first Phase 2= acetylation, glucuronidation, sulfation- polar, inactive metabolites- renally excreted conjugation. |
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How do thses affect the curve of drug action?
competative antagonist non-competative antagonist |
competative- kicks the curve to the right. decreases potency
non-competative- kicks the curve downward. decreases efficacy |
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Breakdown drug development.
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In Vitro Studies- 2 years
Animal testing- 2 years Clinical testing- 4 yrs Marketing and surveillance- 10 yrs Generics |
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What are the differences between Phase 1, 2, 3, 4 trials?
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1- is it safe?
2- does it work in patients? 3- does it work , double blind? 4- postmarketing surveillance |
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What type of G-protein is alpha1?
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q- increased vascular smooth muscle contraction
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What is the type of G-protein is alpha2?
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i- decreased outflow, decreased insulin
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What is the type of G-protein is B1?
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s- increase heart rate, contractility, renein release, lipolysis, aqueous humor formation
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What is the type of G-protein is B2?
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s- Vasodilation, bronchodilation, Increase glucagon release
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What is the type of G-protein is M1?
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q- CNS
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What is the type of G-protein is M2?
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i- Decreased heart rate
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What is the type of G-protein is M3?
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q- Increased exocrine gland secretions
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What is the type of G-protein is D1?
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s- relaxes renal vascular smooth muscle
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What is the type of G-protein is D2?
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i- modulates transmitter release in the brain
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What is the type of G-protein is H1?
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q- Increase nasal and bronchial mucus production, contraction of bronchiles, pruritus, and pain
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What is the type of G-protein is H2?
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s- increase gastric acid secretion
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What is the type of G-protein is V1?
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q- increase vascular smooth muscle contraction
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What is the type of G-protein is V2?
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s- increase of H2O permeability and reabsorption in the collecting tubules of the kidney
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What is the mechanism of action of Gq?
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Phospho C-> PIP-> IP3->increased Ca
or DAG->protein kinase C |
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What is the mechanism of action of Gs?
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Adenylcyclase-> increase cAMP -> Protein kinase A
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What is the mechanism of action of Gi?
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inhib of Adenylcyclase-> decrease in cAMP-> decreased Protein kinase A
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Which receptors are Gq?
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every1 but DB
a1, M1, H1, V1 M3 |
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Which receptors are Gs?
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B1, B2, D1
H2, V2 |
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Which receptors are Gi?
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A2, M2, D2
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What drugs end in afil?
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erectile dysfunction drugs
sildenafil |
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What drugs end in ane?
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inhalation general anesthetics
halothane |
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What drugs end in azepam?
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Bezodiazepines
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What drugs end in Azole?
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antifungals
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what drugs end in barbital?
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Barbituates
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what drugs end in cycline?
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AAbtics, protein synthesis inhibitors
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What drugs end in ipramine
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TCA
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What drugs end in navir?
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protease inhibitors
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What drugs end in olol?
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B-antags
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What drugs end in operidol?
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Butyrophenone (neuroleptic)
Haloperidol |
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What drugs end in oxin?
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cardiac glycoside
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What drugs end in phylline?
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methylxanthine
Theophylline |
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what drugs end in pril?
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ace inhibitors
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what drugs end in terol
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B2 agonists
albuterol |
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what drugs end in tidine?
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H2 antagonists
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what drugs end in triptyline?
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TCA
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what drugs end in tropin?
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pituitary hormone
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what drugs end in zosin
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alpha1 antagonists
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What is Echinacea used for?
What toxicities does it have? |
Common cold
GI distress, dizziness, headache |
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What is Ephedra used for?
What toxicities does it have? |
ephedrine
CNS adn CV stimulation, arrythmias, stroke, seizures |
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What is Feverfew used for?
What toxicities does it have? |
Migraines
GI distress, mouth ulcers, antiplatelets |
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What is Ginkgo used for?
What toxicities does it have? |
Intermittent claudication
GI distress, anxiety, insomnia, headache, antiplatelet actions |
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What is Kava used for?
What toxicities does it have? |
Chronic Anxiety
GI distress, sedation, ataxia, hepatotoxicity, phototoxicity, dermatotoxicity |
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What is Milk Thistle used for?
What toxicities does it have? |
Viral hepatitis
loose stools |
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What is Saw palmetto used for?
What toxicities does it have? |
Benign prostatic hyperplasia
GI distress, decreased libido, hypertension |
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What is St. John's wort used for?
What toxicities does it have? |
depression
GI distress, phototoxicity, serotonin syndrome, inhibits p450 |
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What is Dehydroepiandrosterone used for?
What toxicities does it have? |
Sx of SLE and AIDs for females
Androgenization (premenopausal) estrogenic (post menopausal) feminization (young men) |
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What is melatonin used for?
What toxicities does it have? |
Jet lag, insomnia
Sedation, suppresses midcycle LH, HypoPRL |
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What drugs induce cP450?
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Queen Barb takes Phen-phen and Refuses Greasy Carbs
Quinidine Barbiturates Phenytoin Rifampin Griseofulvin Carbamazepine |
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What drugs inhibit cP450?
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Ihibitors Stop Cyber-Kids from Eating GrapefruitS
Isoniazid Sulfonamides Cimetidine Ketoconazole Erythromycin Grapefruit juice St. Johns wort |
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What is the antidote for Acetaminophen OD?
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N-acetylcysteine
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What is the antidote for Salicylates OD?
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Alkalinize urine, dialysis
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What is the antidote for Anticholinesterases, organophosphates OD?
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Atropine, pralidoxime
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What is the antidote for Antimuscarinic, anticholinergic OD?
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Physostigmine salicylate
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What is the antidote for B-blockers OD?
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Glucagon
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What is the antidote for Digitalis OD?
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Stop dig, normalize K, lidocaine, anti dig Fab fragments, Mg2+
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What is the antidote for Iron OD?
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Deferoxamine
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What is the antidote for Lead OD?
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CaEDTA, dimercaprol, succimer, penicillamine
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What is the antidote for Arsenic, mercury, gold OD?
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Dimercaprol, succimer
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What is the antidote for Copper, arsenic, gold?
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Penicillamine
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What is the antidote for Cyanide?
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Nitrite, hydroxocobalamin thiosulfate
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What is the antidote for Methemoglobin?
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Methylene blue
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What is the antidote for CO?
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100% O2, hyperbaric O2
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What is the antidote for Methanol, ethylene glycol
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Ethanol, dialysis, fomepizole
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What is the antidote for Opioids?
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Naloxone/naltrexone
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What is the antidote for benzodiazepines
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Flumazenil
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What is the antidote for TCAs?
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NAHCO3
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What is the antidote for Heparin?
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Protamine
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What is the antidote for Warfarin?
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Vit K, plasma
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What is the antidote for tPA, streptokinase?
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Aminocaproic acid
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What are signs of lead poisoning?
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LEAD
Lead Lines on gingivae and epiphyses of long bones on x-ray Encephalopathy and Erythrocyte basophilic stippling Abdominal colic and sideroblastic Anemia Drops- wrist and foot drop. Dimercaprol and EDTA 1st line of treatment. Sucks to be a kid Succimer for kids |
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What are the effects of urine pH on drug elimination?
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Weak acids- phenobarbital, methotrexate, aspirin
clearance can be increased if urine is alkalinized with bicarbinate to increase clearance. Weak bases (amphetamines) acidify urine to increase clearance (give NH4Cl) |
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What is the role of alcohol dehydrogenase?
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converts ethylene glycol to Oxalic acid-> Acidosis, nephrotoxicity
converts methanol to formaldehyde and formic acid-> Severe acidosis, retinal damage converts ethanol to Acetaldehyde-> nausea, vomiting, headache, hypotension These all compete for ADH, Ethanol has the highest affinity. |
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What happens to Acetaldehyde in alcohol breakdown?
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Acetaldehyde dehydrogenase breaks it down into acetic acid
This is inhibited by disulfiram |
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What are the Sx of salicylate toxicity?
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dizziness, hearing impairment, tinnitus
leads to vomiting, hyperventilation, flushing, sweating, tachycardia, etc Acidic urine decreases the elimination of salicylate. NH3Cl is one that acidifies urine |
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what changes would CaCO3 do to urine?
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alkanize
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What would bicarb do to urine?
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alkanize
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what would sodium lactate do to urine?
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alkanize
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What is the mechanism of action of erythromycin?
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translocation of a growing peptide chain along the mRNA
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What is the mechanism of action of chloramphenicol?
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inhibs ribosomal peptidyl transferase
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what is the mechanism of action of cyclohexamide?
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inhibs ribosomal peptidyl transferase
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What is the mechanism of action of puromycin?
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ihibits elongation by binding to the A site
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What is the mechanism of action of streptomycin?
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causes misreading of the code in prokaryotes
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what is the mechanism of action of tetracyclines?
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acts on prokaryotes to prevent binding of the t-RNA to the ribosome
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