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70 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Vd equation
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Vd = (amount of drug in body)/(plasma drug concentration)
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Low Vd
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distributes to blood
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Medium Vd (8-60L)
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distributes to extracellular space
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High Vd (60+L)
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distributes to tissues
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Loading dose equation
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Cp x (Vd/F)
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Maintenance dose equation
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Cp x (CL/F)
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Change in loading dose and maintenance dose w/ impaired renal or hepatic function
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loading dose remains the same, but maintenance dose decreases
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Drugs w/ zero-order elimination
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Phenytoin, Ethanol, Aspirin
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Weak acid drugs
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phenobarbitol, MTX, TCAs, aspirin
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Treat overdose w/ bicarbonate in order to deprotonate them so that they can't escape the environment
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Weak base drugs
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amphetamines
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Treat overdose w/ ammonium chloride to protonate them so they can't leave the environment
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Phase I metabolism
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reduction, oxidation, hydrolysis by P450 enymes
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Phase II metabolism
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acetylation, glucuronidation, sulfation to yield poloar, inactive metabolites that can be renally excreted
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Therapeutic index
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LD50/ED50
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High therapeutic index is a good thing because it means that effective dose is low and lethal dose is relatively higher than the effective dose
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Sweat gland innervation
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Sympathetic
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Muscarinic ACh postsynaptic fibers
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Cardiac, smooth muscle, gland, and nerve cell sympathetic innervation
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NE (alpha or beta adrenergic)
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Renal vascular smooth muscle innervation
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sympathetic
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D1 agonist
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Skeletal muscle innervation
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somatic
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Nicotininc ACh postsynaptic fibers
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Cardiac, smooth muscle, gland, and nerve cell parasympathetic innervation
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muscarinic ACh postsynaptic fibers
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All preganglionic fibers are...
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Nicotinic ACh
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a1 adrenergic
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increases vascular smooth muscle contraction, mydriasis, increases intestinal and bladder sphincter muscle contraction
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a2 adrenergic
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decreases sympathetic outflow, decreases insulin release
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B1 adrenergic
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increases heart rate, contractility, renin release, lipolysis
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B2 adrenergic
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B1 + vasodilation, bronchodilation, insulin release, decrease in uterine tone
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M1 cholinergic
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CNS, enteric nervous system
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M2 cholinergic
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decrease heart rate and contractility of atria
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M3 cholinergic
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increase exocrine gland secretion, gut peristalsis, bladder contraction, bronchoconstriction, miosis, accomodation
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D1 dopaminergic
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relaxes renal vascular smooth muscle
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D2 dopaminergic
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modulates transmitter release in brain
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H1 histaminergic
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increases mucus production in nasal and bronchial, bronchoconstriction, pruritis, pain, vasodilation, vasopermeability
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H2 histaminergic
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increases gastric acid secretion
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V1 vasopressinergic
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vasoconstriction
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V2 vasopressinergic
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reabsorption of kidney H20
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Q g-protein mechanism
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activates phospholipase C, which cleaves lipids into PIP2. PIP2 then is cleaved into IP3 and DAG. IP3 directly increases calcium, while DAG activates protein kinase C
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Hemicholinium
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prevents reuptake of choline into the presynaptic nerve terminal
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Vesamicol
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prevents packaging of ACh into presynaptic vesicles
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Metyrosine
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inhibits conversion of tyrosine into DOPA
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Reserpine
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VMAT inhibitor
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Guanethidine
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prevents NE vesicles from fusing w/ the presynaptic nerve terminal
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Amphetamine
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increases release of NE from the presynaptic nerve terminal
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pilocarpine
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used in glaucoma and dry mouth
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resistant to AChE
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Neostigmine uses
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ileus and urinary retention, myasthenia gravis, reversal of NMJ blockade
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Cholinesterase poisoning
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Parathion and organophosphates
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Oxybutynin analog
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glycopyrrolate: used to reduce urinary urgency and mild cystitis and reduce bladder spasms
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Methscopolamine analogs
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Pirenzepine, propantheline: used to PUD treatment
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Atropine S/E in ederly, BPH, infants
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elderly: acute angle-closure glaucoma. BPH: urinary retention. Infant: hyperthermia
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Hexamethonium
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nicotinic antagonist that acts as a ganglionic blocker. leads to severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction
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Low dose of epinephrine
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selective for B1, similar to dobutamine
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Indirect general sympathomimetic agonists
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amphetamine, ephedrine, cocaine
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Tx of HTN w/ renal disease
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clonidine, methldopa
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Mirtazapine
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presynaptic a2 blocker used in treating depression
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S/E: sedation, increased serum cholesterol, increases appetite
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Side effects of beta blockers
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impotence, exacerbation of asthma, AV block, sedation, hyperlipidemia (metoprolol) and masking of hypoglycemic episodes
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Partial B-agonists
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pindolol, acebutolol
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contraindicated in angina because they have sympathomimetic properties
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B1-selective antagonists
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Acebutolol, betaxolol, esmolol, atenolol, metoprolol (A BEAM)
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Treatment of digoxin overdose
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Anti-Dig Fab, normalize K+, Mg2+, lidocaine
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Iron overdose tx
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deferoxamine
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Lead overdose tx
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EDTA, dimercaprol, succimer, penicillamine
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Mercury, arsenic, gold overdose tx
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dimercaprol
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Copper, arsenic, gold overdose tx
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penicillamine
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Methanol, ethylene glycol tx
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Ethanol, fomepizole
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Drugs that cause cutaneous flushing
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vancomycin, adenosine, niacin, Ca2+ blockers
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Drugs that cause agranulocytosis
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clozapine, carbamazepine, colchicine, propylthiouracil, methimazole, dapsone
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Drug that causes acute cholestatic hepatitis
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Macrolides
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Drugs that cause hot flashes
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clomiphene, tamoxifen
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Drugs that cause hypothyroidism
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lithium, amiodarone
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Drugs that cause gout
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furosemide, thiazides, niacin
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Drugs that cause photosensitivity
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sulfonamides, amiodarone, tetracycline, 5-FU
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Drug induced lupus
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"Q CHIMPP": quinidine, chlorpromazine, hydralazine, isoniazid, methyldopa, penicillamine, procainamide
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anti-histone antibodies
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Cinchonism
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caused by quinidine, quinine
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tinnitus, dizziness, occasional fainting
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Nephrotoxicity/Ototoxicity
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aminoglycosides, vancomycin, loop diuretics, cisplatin
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Overdose of methanol tx
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folate (induces formic acid conversion to CO2), fomepizole, ethanol
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