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236 Cards in this Set
- Front
- Back
What is Km?
|
Km = (K-1 + K2)/K1
Reflects affinity of enzyme for its substrate Lower Km --> higher affinity |
|
What is Vmax proportional to
|
Vmax is directly proportional to enzyme concentration
|
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Linewoever-Burke Plot
eq? x.-int? y-int? slope? |
(1/Vo) = (Km/Vmax)(1/S) + (1/Vmax)
x-int = 1/-Km y-int = 1/Vmax Slope = Km/Vmax |
|
What happens on a Linewoever Burke plot when you add
a. competitive inhibitor b. non-competitive inhibitor |
a. x-int moves right (Km increases), y-int stays same
b. Y-int shifts up (Vmax decreases), x-int stays "competitive inhibitors cross, noncompetitives do not" |
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at 1/2 Vmax, Km = ?
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Km = [S]
|
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Competitive inhibitor vs. non-competitive
a. does it resemble substrate b. overcome by increasing [S] c. Bind active site |
a. C = yes
U = No b. C = yes U = No c. C = yes U = No |
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Competitive inhibitor vs. non-competitive
d. effect on Vmax e. effect on Km f. pharmacodynamics (potency/efficacy) |
d. C = none
U = decreases e. C = decreases U = none f. C = decreased potency U =decrease efficacy |
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What is Volume of distribution
equation? |
Volume in which the total drug would need to be uniformly distributed to produce desired blood concentration
Vd = amount in body/plasma drug concentration |
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If drugs are bound by plasma proteins, how is their volume of distribution affected by liver or kidney disease?
|
Liver disease --> altered protein and body fluid --> higher Vd
Kidney disease --> fluid retention --> higher Vd |
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where do the drugs distribute
a. Vd = 4-8 L (low) b. Vd = medium c. Vd > body wt. |
a. distribute in blood
b. distribute in extracellular space or body water c. distribute in all tissues, sequester in fat |
|
What is clearance?
How is it calculated |
Relates rate of elimination to plasma concentration
CL = (rate of elimination of drug) / (plasma drug conc) = Vd * Ke (elimination constant) = Vd * 0.7/t^1/2 |
|
What is half life
What type of kinetics does t1/2 apply to? |
t = (0.7)(Vd) / CL
Time required to change the amount of drug in the body by 1/2 during elimination or constant infusion applies to first order elimination |
|
Infusing a drug at a constant rate, what is the concentration at
a. 1 half life b. 2 c. 3 d. 4 |
a. 50%
b. 75% c. 87.5% d. 93.75% |
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How do you calculate loading dose
|
Loading dose = Cp * (Vd/F)
Cp = target plasma conc Vd = vol of dist F = bioavailability |
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How do you calculate maintenance dose
|
Maintenance dose = Cp * (CL/F)
Cp = target plasma conc CL = clearance F = bioavail |
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In liver or renal disease, how do the maintenance and loading dose change
|
loading = unchanged
maintenance = decrease |
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What is bioavailability?
|
F = fraction of dose of unchanged drug that reaches systemic circulation
F=1 if IV infusion |
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What are the characteristics of zero order elimination
3 drugs that have this |
Rate of elimination is constant regardless of Cp (constant amount of drug lost per time, linear)
PEA = Phenytoin, Ethanol, Aspirin (at high/toxic conc) |
|
What is first order elimination
|
Rate of elimination proportional to drug conc (constant fraction of drug elimnated per time)
plasma conc decreases exponentially |
|
What happens to ionized species in urine?
Neutral foms? |
Ionized - trapped and cleared quickly
neutral - reabsorbed |
|
Phenobarbitol, methotrexate, aspirin
pH? how do you trap these? Treat overdose? |
weak acids
trap in basic environment Treat with bicarbonate |
|
Amphetimines
pH? how do you trap these? how do you treat overdsoe? |
pH = weak bases
trap in acidic treat overdose with ammonium chloride |
|
Phase I metabolism
a. where b. what happens |
a. cyt P45-
b. reduction, oxidation, hydrolysis to yeield a slightly polar, water-soluble molecule |
|
Phase II metabolism
a. where b. what happens |
a. conjugation
b. acetylate, glucuronidate, sulfation to yield polar, inactive metabolites that are renally excreted |
|
Phase I or Phase II metab
which one do geriatric patients lose first |
Phase I
|
|
Efficacy = ?
Potency? |
Efficacy = max effect of a drug
Potency = amount of drug needed for a given effect |
|
Effect on efficacy and potency of
a.partial agonist |
efficacy = goes down (less max effect)
potency = goes up or down |
|
Effect on efficacy and potency of
a. competitive antagonist |
potency goes down, efficacy no change
|
|
Effect on efficacy and potency of
a. noncompetitive antagonist |
Potency no change, efficacy down
|
|
What type of interaction do these drugs have
diazepam and flumazenil |
competitive antag
|
|
What type of interaction do these drugs have
NE and phenoxybenzamine on a-receptor |
noncompetitive inhibitor
|
|
What type of interaction do these drugs have
morphine + burenorphine at opioid mu-receptor |
partial agonist
|
|
What is physiologic antagonism
an example that counters muscarinic overactivity in asthma |
substance that produces opposite effects of an agonist but works at a different receptor
epinepherine stimulates B2 receptor --> bronchodilator |
|
What is therapeutic index
what is a "safer drug" |
Measures drug safety
(TILE) TI = LD50/ED50 = median lethal dose/effective dose Safer drugs have higher TI |
|
Where would you find nicotinic ACh receptors?
What kind of receptors are these? |
Autonomic ganglia (symp and parasymp, adrenal medulla)
NMJ |
|
receptors on sweat glands?
|
ACh muscarinic
|
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Receptors on cardiac and smooth muscle, gland cells, and nerve terminals
|
NE (alpha, beta)
|
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Receptors on renal vascular smooth muscle
|
D1
|
|
Receptors on adrenal medulla?
|
ACh nicotinic
|
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2 organs that are part of the sympathetic nervous system that are innervated by cholinergic fibers
what type of receptor does each have? |
sweat glands (Ach muscarinic)
adrenal medulla (Ach Nicotinic) |
|
how does signal transduction take place form a muscarinic receptor
|
Gprotein --> 2nd messenger
|
|
Receptor: a1
a. G-protein? b. Major functions |
a. Gq
b. Vascular smooth muscle contract, mydriasis (pupillary dilator), increases intestinal and bladder sphincter contraction |
|
Receptor: a2
a. G-protein? b. Major functions |
a. Gi
b. Decreases sympathetic outflow, dec. insulin release |
|
Receptor: b1
a. G-protein? b. Major functions |
a. Gs
b. increase heart rate, contractility, renin release, lipolysis |
|
Receptor: b2
a. G-protein? b. Major functions |
a. Gs
b. vasodilation, bronchodilation, increase heart rate, contractility, renin release, lipolysis, insulin release, decreases uterine tone |
|
Receptor: M1
a. G-protein? b. Major functions |
a. Gq
b. CNS, enteric NS |
|
Receptor: M2
a. G-protein? b. Major functions |
a. Gi
b, decrease ht rate and contractility of aorta |
|
Receptor: M3
a. G-protein? b. Major functions |
a. Gq
b. increase sweat and gastric acid (exocrine gland), gut peristalsis, bladder contraction, bronchoconstriction, miosis (pupillary sphincter contraction), accomodation (ciliary muscle contract) |
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Receptor: D1
a. G-protein? b. Major functions |
a. Gs
b. relaxes renal vascular smooth muscle |
|
Receptor: D2
a. G-protein? b. Major functions |
a. Gi
b. Modulates transmitter release, especially in brain |
|
Receptor: H1
a. G-protein? b. Major functions |
a. Gq
b. increases nasal and bronchial mucus production, contraction of bronchioles, pruritis, pain |
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Receptor: H2
a. G-protein? b. Major functions |
a. Gs
b. increases gastric acid secretion |
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Receptor: V1
a. G-protein? b. Major functions |
a. Gq
b. increases vascular smooth muscle contraction |
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Receptor: V2
a. G-protein? b. Major functions |
a. Gs
b. increases H20 permeability and reabsorption in the collecting tubules of the kidney (V2 in the 2 kidneys) |
|
5 receptors that use Gq
|
H1, a1, V1, M1, M3
HAVe 1 M&M |
|
5 receptors that use Gs
|
b1, b2, D1, H2, V2
|
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3 receptors that use Gi
|
M2, a2, D2
MAD 2's |
|
function of hemicholinium
function of vesamicol |
inhibits transporter that brings choline into presynaptic terminal
inhibits Ach transport into vesicle in presynaptic terminal |
|
Function of
a. metyrosine b. reserpine c. guanethidine |
a. Inhibits Tyrosine --> Dopa in presynaptic terminal (NE pathway)
b. Inhibits dopamine transport into presynaptic vesicle (where it will made to NE) c. inhibits release of NE-containing vesicle |
|
effect on NE
a. amphetimine |
a. increases NE release into synapse
|
|
3 agents that inhibit NE reuptake to presynaptic terminal
|
Cocaine
TCAs Amphetamine |
|
Role of Choline acetyltransferase
|
converts choline + acetyl CoA --> acetylcholine
|
|
2 receptors on the presynaptic terminal that inhibit NE release
1 receptor that increases release |
M2 (Ach). a2 (NE)
Angiotensin II receptor |
|
Cholinomimetics
Drug used in postop and neurogenic ileus, urinary retention |
Bethanechol
Beth Anne, Call me if you want to activate your Bowel and Bladder |
|
Cholinomimetics
Drug used in glaucoma, pupillary contraction, and in relief of intraocular pressure |
Carbachol
CARBon copy of Ach |
|
Cholinomimetics
Drug used as a challenge test for asthma |
Methacholine
Stimulates muscarinic receptors --> bronchoconstriction |
|
Indirect agonist of Ach (anticholinesterases)
Drug used in postoperative and neurogenic ileus, urinary retention, myasthenia gravis, reversal of NMJ blockade (postop) does it go into CNS |
Neostigmine
NEO CNS = NO CNS |
|
Indirect agonist of Ach (anticholinesterases)
Drug used in myasthenia gravis (long acting) that does not penerate CNS |
Pyridostigmine --> increases strength in myasthenia patients
quarternary, no CNS |
|
Indirect agonist of Ach (anticholinesterases)
Extremely short acting drug that is used to diagnose myasthenia gravis |
Edrophonium
Tensilon test - if endrophonium can reduce weakness, you know the problem is lack of Ach --> indicates myasthenia gravis |
|
Indirect agonist of Ach (anticholinesterases)
Drug used for glaucoma (crosses bbb) and atropine overdose |
Physostigmine
"Phys for eyes" |
|
Indirect agonist of Ach (anticholinesterases)
drug used only in glaucoma |
echotiophate
|
|
Cholinemimetic agents can exacerbate which 3 underlying conditions
|
COPD
Asthma Peptic ulcers |
|
Farmer working with insecticides now has
-Diarrhea -Urination -Miosis -Bronchoconstriction -Bradycardida -Excitaiton of skeletal muscle and CNS -Lacrimation -Sweating -Salivation What happened? What is the agent? How do you treat? |
DUMBBELSS = symptoms of cholinesterase inhibitor poisoning, often due to organophosphates (parathion) found in insecticides
Antidote = atropine + pralidoxime (regenerates active AchE) |
|
Muscarinic anatgonists
3 used to produce mydriasis and cycloplegia |
Atropine
homatropine tropicamide apply to eyes |
|
Muscarinic anatgonists
Treatment for Parkinsons |
Benztropine
PARKinson's my BENZ |
|
Muscarinic anatgonists
used for motion sickness |
scopalamine
|
|
Muscarinic anatgonists
drug used for asthma, COPD |
ipratropium
(I PRAY I can breathe soon) |
|
Muscarinic anatgonists
2 Drugs used to reduce urgency in mild cystitis and reduce bladder spasms |
oxybutinin
glycopyrrolate |
|
Muscarinic anatgonists
3 drugs used to treat peptic ulcer |
methscopalamine
pirenzepine propantheline |
|
Effect of Atropine (muscarinic antagonist)
a. eyes b. airway c. stomach d. gut e. bladder |
a. cycloplegia, mydriasis
b. decreased secretions c. decrease acid secretion d. decrease motility e. decrease urgency in crisis |
|
Patient has
-high body temp (no sweating) -Rapid pulse -dry mouth -dry, flushed skin -cycloplegia -constipation -disorientation what has happened? |
Atropine toxicity
Hot as a Hare Dry as a Bone Red as a Beet Blind as a Bat Mad as a Hatter |
|
Special effect of atropine toxicity in
a. elderly b. men with BPH c. infants |
a. acute angle closure glaucoma
b. urinary retention c. hyperthermia |
|
Drug used to prevent vagal reflex responses to changes in blood pressure (prevents reflex bradycardia caused by NE)
4 symptoms of toxicity |
hexamethonium - nicotinic antagonist --> blocks ganglion
"Put a HEX on smokers (NICOTINE))" -severe orthostatic hypotension -blurred vision -constipation -sexual dysfunction |
|
Sympathomimetics
Drug you use for: -anaphylaxis -open angle glaucoma -asthma -hypotension Receptors? low doses are selective for which receptor? |
epinepherine
a1. a2, b1, b2 (low doses selective for b1) |
|
Sympathomimetics
Drug you use for: -hypotension, but causes decreased renal perfusion Receptors? |
NE
a1, a2>b1 |
|
Sympathomimetics
Drug you use for: -AV block Receptors? |
Isoproterenol
B1 = B2 "ISO to b" |
|
Sympathomimetics
Drug you use for: -Shock (increases renal perfusion) -heart failure Receptors? effect on heart? |
Dopamine
D1 = D2 > b > a inotropic and chronotropic |
|
Sympathomimetics
Drug you use for: -pupillary dilation -vasoconstriction -nasal decongestion Receptors? |
phenylepherine
a1 > a2 |
|
Sympathomimetics
Drug you use for: -acute asthma Receptors? |
Metaproterenol and albuterol
b2 |
|
Sympathomimetics
Drug you use for: -Long-term asthma Receptors? |
salmeterol
B2>B1 agonists |
|
Sympathomimetics
Drug you use for: -reduce premature uterine contractions Receptors? |
Terbutaline
B2 agonist |
|
Sympathomimetics
Drug you use for: -Heart failure, cardiac stress testing Receptors? |
dobutamine
b1 > b2, inotropic but not chronotropic |
|
4 b2 agonists
|
MAST
metaproterenol albuterol salmeterol terbutaline |
|
Sympathomimetics
Drug you use for: Reduce premature uterine contractions Receptors? |
Ritodrine
B2 |
|
Indirect sympathomimetics
drug used for -Narcolepsy -Obesity -ADD how does it work? |
Amphetamine
Indirect agonist, releases stored catecholamine |
|
Indirect sympathomimetics
drug used for -Nasal decongestion -Urinary incontinence -Hypotension how does it work? |
Ephedrine
Indirect general agonist, releases stored catecholamines |
|
Indirect sympathomimetics
drug used for -Vasoconstriction -Local anesthesia how does it work? |
Cocaine
Indirect general agonist, uptake inhibitor |
|
2 sympathoplegics that are used in hypertension with renal disease
how do they work? |
Clonidine, a-methyldopa (no decrease in blood flow to kidney)
a2 agonists --> decreases central adrenergic outflow |
|
a-blockers
2 drugs used to treat -Pheochromocytoma What does the toxicity cause? |
Phenoxybenzamine (irreversible, use before removing tumor), phentolamine (reversible)
- nonselective orthostatic hypotension, reflex tachycardia |
|
a-blockers
drug used to treat -HTN -Urinary retention in BPH What does the toxicity cause |
Prazosin, terazosin, doxazosin
(a1 selectives) -First dose orthostatic hypotension -dizziness -headache |
|
a-blockers
drug used to treat -depression What does the toxicity cause |
mirtazapine (a2 selective)
-sedation -increased serum cholesterol -increased appetite |
|
Im the presence of an a-blocker, what is the effect of
a. epinepherine b. phenylephrine |
a. decreased bp due to b2 activity
b. suppression, but not reversal of bp because phenyepherine is a pure alpha agonist |
|
Type of drugs
Acebutolol, betaxolol, esmolol, atenolol, metoprolol, propanolol. timolol pindolol, labetalol |
b-blockers
|
|
Effect of b-blockers on HTN? (renal means)
|
Lowers CO, lowers renin secretion (blocks b1-receptor on JGA cells)
|
|
Effect of b-blockers on angina pectoris
|
decrease HR and contractility --> decreased O2 consumption
|
|
Effect of b-blockers on MI
|
decrease mortality
|
|
2 b-blockers used to treat supraventricular tachycardia
effect? |
propanolol, esmolol
decreases AV conduction velocity (class I antiarrhythmic) |
|
Effect of b-blockers on CHF
|
Slows progression of chronic failure
|
|
1 b-blocker used to treat glaucoma
effect |
timolol
decreases secretion of aqueous humor |
|
If you have b-blocker toxicity, what are some symptoms
should be used with caution in which patients? |
-impotence
-asthma exacerbation -CV = bradycardia, AV block, CHF -CNS = sedation, sleep alterations -use w/caution in diabetics |
|
propanolol, timolol, nadolol, pindolol
type of drugs |
non-selective b-blockers (b1 = b2)
|
|
Acebutolol (partial agonist)
Betaxolol Esmolol (short acting) Atenolol Metoprolol when are these better to use |
A BEAM of b1 blockers
5 b1-selective antagonists use in patients with comorbid pulmonary disease |
|
Carvedilol, labetalol
type of drug |
non-selective a- and b-antagonist
|
|
pindolol, acebutolol
type of drug |
partial b-agonist
|
|
Toxin: acetaminophen
Antidote? |
N-acetylcysteine
|
|
Toxin: salicylates
Antidote? |
NaHCO3 (alkanize urine), dialysis
|
|
Toxin: Amphetamines (basic)
Antidote? |
NH4Cl (acidify urine)
|
|
Toxin: AchE inhibotrs, anticholinergic agents
Antidote? |
Atropine, pralidoxime
|
|
Toxin: antimuscarinic, anticholinergics
Antidote? |
physostigmine salicylate
|
|
Toxin: b-blockers
Antidote? |
glucagon
- ^ cAMP (bypass beta adrenergic second messenger system) |
|
Toxin: digitalis
Antidote? |
Stop digitalis, normalize K, lidocaine, anti-dig Fab fragments, Mg
|
|
Toxin: Iron
Antidote? |
Deferoxamine
|
|
Toxin: Lead
Antidote? |
CaEDTA, dimercaprol, succimer, penicillamine
|
|
Toxin: Mercury, aresenic, gold
Antidote? |
Dimercaprol (BAL), succimer
|
|
Toxin: Lead
Antidote? |
CaEDTA, dimercaprol, succimer, penicillamine
|
|
Toxin: Copper, arsenic, gold
Antidote? |
Penicillamine
|
|
Toxin: Mercury, aresenic, gold
Antidote? |
Dimercaprol (BAL), succimer
|
|
Toxin: Cyaide
Antidote? |
Nitrite, hydroxocobalamin, thiosulfate
|
|
Toxin: Copper, arsenic, gold
Antidote? |
Penicillamine
|
|
Toxin: Methemoglobin
Antidote? |
Methylene blue, vitamin C
METHemoglobin --> METHylene blue |
|
Toxin: Cyanide
Antidote? |
Nitrite, hydroxocobalamin, thiosulfate
|
|
Toxin: CO
Antidote? |
100% O2, hyperbaric O2
|
|
Toxin: Methemoglobin
Antidote? |
Methylene blue, vitamin C
METHemoglobin --> METHylene blue |
|
Toxin: Methanol, ethylene glycol (antifreeze)
Antidote? |
Ethanol, dialysis, fomepizole
|
|
Toxin: CO
Antidote? |
100% O2, hyperbaric O2
|
|
Toxin: opiods
Antidote? |
naloxone/naltrexone
|
|
Toxin: Methanol, ethylene glycol (antifreeze)
Antidote? |
Ethanol, dialysis, fomepizole
|
|
Toxin: benzodiazepines
Antidote? |
flumenazil
|
|
Toxin: opiods
Antidote? |
naloxone/naltrexone
|
|
Toxin: TCAs
Antidote? |
NaHCO3 (plasma alkalinzation)
|
|
Toxin: benzodiazepines
Antidote? |
flumenazil
|
|
Toxin: TCAs
Antidote? |
NaHCO3 (plasma alkalinzation)
|
|
Toxin: Heparin
Antidote? |
Protamine
|
|
Toxin: Warfarin
Antidote? |
Vit. K, fresh frozen plasma
|
|
Toxin: tPA, streptokinase
Antidote? |
aminocaproic acid
|
|
Toxin: theophylline
Antidote? |
b-blocker
|
|
Drug reactions - what reaction in the CV system do these cause?
TCA |
atropine-like side effects
|
|
Drug reactions - what reaction in the CV system do these cause
Cocaine, sumatriptan |
Coronary vasospasm
|
|
Drug reactions - what reaction in the CV system do these cause
VANC Vancomycin Adenosine Niacin Ca-channel blockers |
Cutaneous flushing
|
|
Drug reactions - what reaction in the CV system do these cause
Doxorubicin, daunorubicin |
dilated cardiomyopathy
|
|
Drug reactions - what reaction in the CV system do these cause
class III (sotalol), class IA (quinidine) antiarrhythmics |
torsades de pointes
|
|
Drug reactions - what reaction in the hematologic system do these cause
Clozapine, carbamazepine, colchicine, propylthiouracil, methimazole, dapsone |
agranulocytosis
|
|
Drug reactions - what reaction in the hematologic system do these cause
Chloramphenicol, benzene, NSAIDS, propylthiouraci, methimazole |
aplastic anemia
|
|
Drug reactions - what reaction in the hematologic system do these cause
Methyldopa |
Direct coombs-positive hemolytic anemia
|
|
Drug reactions - what reaction in the hematologic system do these cause
Chloramphenicol |
Gray baby syndrome
|
|
Drug reactions - what reaction in the hematologic system do these cause
Isoniazid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin |
Hemolysis in G6PD-deficient patients
hemolysis IS PAIN |
|
Drug reactions - what reaction in the hematologic system do these cause
Phenytoin, Methotrexate, Sulfa |
MegaloBLASTic anemia
have a BLAST with PMS |
|
Drug reactions - what reaction in the hematologic system do these cause
OCPs (estrogen and progestins) |
Thrombotic complications
|
|
Drug reactions - what reaction in the respiratory system do these cause
ACE inhibitors |
Cough
|
|
Drug reactions - what reaction in the respiratory system do these cause
BLeomycin Amiodarone Busulfan |
Pulmonary fibrosis
hard to BLAB when you have pulmonary fibrosis |
|
Drug reactions - what reaction in the GI system do these cause
macrolides |
Acute cholestatic hepatitis
|
|
Drug reactions - what reaction in the GI system do these cause
Halothane Valproic acid Acetaminophen Amanita phalloides |
Focal to massive hepatic necrosis
|
|
Drug reactions - what reaction in the GI system do these cause
INH |
hepatitis
|
|
Drug reactions - what reaction in the GI system do these cause
Clindamycin, ampicillin |
Pseudomembranous colitis
|
|
Drug reactions - what reaction in the reproductive/endocrine system do these cause
glucocorticoid withdrawal (HPA suppression) |
Adrenocortical insufficiency
|
|
Drug reactions - what reaction in the reproductive/endocrine system do these cause
Spironolactone Digitalis Cimetidine chronic Alcohol use Estrogens Ketoconazole |
Gynecomastia
Some Drugs Create AwesomE Knockers |
|
Drug reactions - what reaction in the reproductive/endocrine system do these cause
Tamoxifen Climphene |
Hot flashes
|
|
Drug reactions - what reaction in the reproductive/endocrine system do these cause
Lithium Amiordarone |
hypothyroidism
|
|
Drug reactions - what reaction in the musculoskeletal/CT system do these cause
phenytoin |
gingival hyperplasia
|
|
Drug reactions - what reaction in the musculoskeletal/CT system do these cause
furosemide, thiazides |
Gout
|
|
Drug reactions - what reaction in the musculoskeletal/CT system do these cause
Corticosteroids, heparin |
Osteoperosis
|
|
Drug reactions - what reaction in the musculoskeletal/CT system do these cause
Sulfonamides, Amiodarone, Tetracycline |
Photosensitivity (SAT for a PHOTO)
|
|
Drug reactions - what reaction in the musculoskeletal/CT system do these cause
Ethosuximide Lamotrigine Carbamazepine Phenobarbital Phenytoin Sulfa drugs Penicillin Allopurinol |
Rash (stevens-johnson syndrome)
|
|
Drug reactions - what reaction in the musculoskeletal/CT system do these cause
Hydralazine INH Procainamide Phenytoin |
SLE-like syndrome
"it's not HIPP to have lupus" |
|
Drug reactions - what reaction in the musculoskeletal/CT system do these cause
fluoroquinolones |
tendonitis, tendon rupture, cartilage damage (kids)
|
|
Drug reactions - what reaction in the renal/GU system do these cause
Expired tetracycline |
Fanconi's syndrome
|
|
Drug reactions - what reaction in the renal/GU system do these cause
Methicillin, NSAIDS, furosemide |
Interstitial nephritis
|
|
Drug reactions - what reaction in the renal/GU system do these cause
Cyclophosphamide, ifosfamide (prevent by coadministering with mesna) - cancer drugs: nitrogen mustard alkylating agent |
Hemorrhagic cystitis
|
|
Drug reactions - what reaction in the neuro system do these cause
quinidine, quinine |
cinchonism
|
|
Drug reactions - what reaction in the neuro system do these cause
Lithium, demeclocycline |
Diabetes insibidus
|
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Drug reactions - what reaction in the neuro system do these cause
halperidol chlorpromazine reserpine metoclopramide |
Parkinson-like syndrome
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Drug reactions - what reaction in the neuro system do these cause
bupropion, imipenem/cilastatin, isoniazid |
seizures
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Drug reactions - what reaction in the neuro system do these cause
antipsychotics |
tardive dyskinesia
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Drug reactions - what reaction in the multiorgan system do these cause
metronidazole, certain cephalosporins, procarbazine, first gen sulfaonylureas |
disulfiram-like rxn
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Drug reactions - what reaction in the multiorgan system do these cause
polymyxins |
nephrotoxicity, neurotoxicity
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Drug reactions - what reaction in the multiorgan system do these cause
aminoglycosides vancomycin loop diuretics cisplatin |
nephrotoxicity, ototoxicity
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Inducers of cyt P450
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Quinidine
Barbituates St. john's wart Phenytoin Rifampin Griseofulvin Carbamazepine CHRONIC alcohol use Queen Barb Steals Phen-phen and Refuses Greasy Carbs CHRONICally |
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Inhibitors of P-450
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HIV protease inhibitors
Ketoconazole Erythromycin Grapefruit juice ACUTE alcohol use Sulfonamides Isoniazid Cimetidine INHIBIT ourself from drinking beer from a KEG because it makes you ACUTEly SICk. |
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3 competitive substrates for alcohol dehydrogenase
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ethylene glycol
methanol ethanol |
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metabolism of ethylene glycol
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ethylene glycol --> oxalic acid (ADH) --> acidosis, nephrotixicity
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Metabolism of methanol
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Methanol --> formaldehyde and formic acid (ADH) --> severe acidosis, retinal damage
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Metabolism of ethanol
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Ethanol --> Acetaldehyde (ADH) can cause nausea, vomiting, headache hypotension
--> acetaldehyde dehydrogenase --> acetic acid |
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Alcohol metabolism depletes NAD. what is the effect?
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cannot do fatty oxidation in liver or convert lactate to pyruvate --> fatty liver, lactic acidosis
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Why do some people get a 'glow' after drinking
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polymorphism in a gene encoding for acetaldehyde dehydrogenase --> buildup of acetaldehyde --> facial flushing
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Celecoxib
furosemide probenecid thiazides TMP-SMX sulfasalazine sulofonylureas acetazolamide sulfonamide type of drugs |
sulfa drugs
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Patient took furosemide, now has
-fever -pruritic rash -stevens-johnson syndrome -hemolytic anemia -thrombocytopenia -agranulocytosis -urticaria (hives) what happened? |
sulfa drug allergy
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Category of drug that ends with:
-afil |
erectile dysfunction
sildenafil |
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Category of drug that ends with: -ane
|
Inhalation general anesthetic
halothane |
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Category of drug that ends with: -azepam
|
benzodiazepine
diazepam |
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Category of drug that ends with: -azine
|
phenothiazine (neuroleptic, antiemetic)
chlorpromazine |
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Category of drug that ends with: -azole
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antifungal
ketoconazole |
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Category of drug that ends with:
-barbital |
barbituate
phenobarbital |
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Category of drug that ends with:
-caine |
local anethetic
lidocaine |
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Category of drug that ends with:
-cillin |
penicilin
methicillin |
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Category of drug that ends with:
-cycline |
antibiotic, protein synthesis inhibitor
tetracycline |
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Category of drug that ends with:
-etine |
SSRI
fluoxetine |
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Category of drug that ends with:
-ipramine |
TCA
imipramine |
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Category of drug that ends with:
-navir |
protease inhibitor
saquinavir |
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Category of drug that ends with:
-olol |
b-antagonist
propanolol |
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Category of drug that ends with:
-operidol |
butyrophenone (neuroleptic)
haloperidol |
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Category of drug that ends with:
-oxin |
cardiac glycoside (inotropic agent)
digoxin |
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Category of drug that ends with:
-phylline |
methylxanthine
theophylline |
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Category of drug that ends with:
-pril |
ACE inhibitor
captopril |
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Category of drug that ends with:
-terol |
B2 agonist
albuterol |
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Category of drug that ends with:
-tidine |
H2 antagonist
cimetidine |
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Category of drug that ends with:
-triptan |
5-HT1B/1D agonist (migraine)
Sumatriptan |
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Category of drug that ends with:
-triptyline |
TCA
Amitryptiline |
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Category of drug that ends with:
-tropin |
pituitary hormone
somatotropin |
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Category of drug that ends with:
-zolam |
benzodiazepine
alprazolam |
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Category of drug that ends with:
-zosin |
a1 antagonist
prazosin |
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4 drugs with a narrow TI
|
Phenobarbitol
Lithium Digoxin Coumadin Please Detach Lid Carefully |
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7 drugs that inhibit Cyt P450
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PICK EGS
Protease inhibitors Isoniazid Cimetidine Ketoconazole Erythrmycin Grapefruit juice Sulfonamides |
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3 drugs used for Alzheimer's that affect ACh
What is their affect |
Alzheimers --> low ACh, so these drugs work as anticholinesterases
Donepazil Galantamine Rivastigmine |
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4 anticholinergics used to treat urge incontinence
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darifenacin/solifenacin
oxybutinin tolterodine trospium - muscarinic antagonists dott (constantly pee out little DOTT's) |
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Pharm endings
-dronate use? mechanism? |
bisphosphonate
prevent bone breakdown - inhibit osteoclasts - benefit osteoblasts (inhibit apoptosis) |
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Pharm endings
-sartan |
AII receptor antag
|
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Pharm endings
-chol |
Cholinergic agonist
|
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Pharm endings
-stigmine |
Anticholinesterase
|
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Pharm endings
-Mustine |
Nitrosureas (brain tumor meds)
|
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Pharm endings
Curium, curonium |
non-depolarizing neurmuscular antagonists
|
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Pharm endings
-statin |
HMG CoA reductase inhibitor
|
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Pharm endings
-glitazone |
increases target cell response to insulin
|
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Pharm endings
bendazole |
antihelminth
|
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Pharm endings
-dipine |
dihydropyridine Ca channel blockers
|
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Pharm endings
-prost |
Prostaglandin analog
|
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Pharm endings
-mab |
monoclonal Ab
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