Pharmacology

Front 1

Low Vd (4-8)

Back 1

Distributes in blood - large, charged molecules

Front 2

Medium Vd

Back 2

Distributes into extracellular space or body water - small hydrophilic molecules that do NOT bind plasma proteins

Front 3

High Vd (>body weight)

Back 3

Distributes into all tissues - small, lipophilic molecules that bind strongly to extravascular proteins

Front 4

What determines oral bioavailability?

Back 4

Absorptive properties - 1st pass metabolism at liver

Front 5

Zero-order drugs

Back 5

Phenytoin, Ethanol, Aspirin

Front 6

Therapeutic Index

Back 6

LD50 (med lethal dose)/ED50 (med effective dose)

Front 7

What is unique about sweat glands and adrenal medulla

Back 7

They are part of the sympathetic NS, but are innervated by cholinergic fibers

Front 8

M1, M2, M3

Back 8

M1 - CNS
M2 - heart
M3 - glands, SM

Front 9

V1 vs. V2

Back 9

V1 - vascular smooth muscle contractions
V2 - increased h20 permeability and reabsorption

Front 10

Reserpine

Back 10

Inhibits VMAT (transport) -> prevents pre-syn packaging of NE, DA, 5-HT into vesicles; can also be used for HTN

Front 11

Cocaine, TCAs, Amphetamine

Back 11

prevents reuptake of NE

Front 12

Amphetamines, tyramines, ephedrine

Back 12

Increases release of NE vesicles from pre-syn

Front 13

Guanethidine

Back 13

inhibits the release of NE vesicles from presyn

Front 14

How is NE release from sympathetic nerve ending regulated?

Back 14

Negative - NE itself on a2-rec, M2
Positive - Ach, ATII

Front 15

MAO vs. COMT

Back 15

MAO - oxidizes
COMT - methylates

Front 16

Which cholinomimetic is resistant to AChE?

Back 16

Pilocarpine

Front 17

Echothiophate

Back 17

Indirect Ach agonist - glaucoma

Front 18

Oxybutynin, Glycopyrrolate

Back 18

Anti-muscarinic; reduce urgency in mild cystitis and reduce bladder spasms

Front 19

Pirenzipine, Methscopolamine

Back 19

Anti-muscarinic; peptic ulcer rx

Front 20

What ophthalmic complication is seen with atropine?

Back 20

Closed-angled glaucoma in elderly

Front 21

Dobutamine effects (4)

Back 21

Increases HR, contractility, conduction velocity, and myocardial O2 consumption

Front 22

Drugs with anticholinergic side effects

Back 22

1st gen H1 blockers
Traditional neuroleptics
TCAs
Amantidine

Front 23

Ritodrine, Terbutaline

Back 23

B2 agonist; reduces premature uterine contractions

Front 24

alpha-methyldopa

Back 24

(and clonidine) central-acting a2 agonists

Front 25

Rx for pts on MAO inhibitors that eat tyramine-containing foods

Back 25

Phentolamine (reversible a-blocker)

Front 26

Mirtazapine

Back 26

a2-antagonist; used for depression

Front 27

Can block catecholamine-induced renin secretion

Back 27

B-blockers (via B-receptors at JG cells)

Front 28

Partial B-agonists

Back 28

Pindolol, Acebutolol

Front 29

B-blocker usage in Thyroid storm, CHF, Post MI, and Liver Failure

Back 29

Thyroid Storm - Propanolol
CHF - Esmolol (short acting)
Post MI - Carvedilol, metoprolol
Liver failure - Nadolol (decreased bleeding)

Front 30

Why do you use glucagon to treat a B-blocker toxicity

Back 30

Activate GPCR -> inc cAMP in cardiac myocytes and inc SA node firing

Front 31

Complications of Anti-phospholipid (VDRL) antibody syndrome associated with SLE

Back 31

Venous TE
Arterial TE
Increased fetal loss (miscarriages 2/3 trim)

Front 32

Rx for acute asthma exacerbations

Back 32

B2-agonists -> increase cAMP accumulation in smooth muscle cells (Gs)

Front 33

Inhaled Anesthetics - CV effect

Back 33

myocardial depression; decreased CO; increase in A and V pressures

Front 34

Inhaled Anesthetics - Respiratory

Back 34

All are respiratory depressants (except NO)

Front 35

Inhaled Anesthetics - Brian

Back 35

Fluorinated anesthetics -> decrease vascular resistance -> increased cerebral blood flow -> increase cerebral pressures

Front 36

Inhaled anesthetics - kidney

Back 36

decrease GFR and renal plasma flow, increase renal vascular resistance

Front 37

Inhaled anesthetics - liver

Back 37

Fluorinated anesthetics -> decrease hepatic blood flow

Front 38

What happens if PID is not properly rx for BOTH N.gon and Chlamydia?

Back 38

If only one is treated, scarring of fallopian tubes, infertility, or ectopic pregnancy

Front 39

Ondansetron MOA

Back 39

5-HT3-antagonist; effective in preventing chemo-induced vomiting

Front 40

V/Q and the lung

Back 40

Apex: Very low Q, low V, high V/Q
Base: Very high Q, high V, low V/Q
So higher ventilation and perfusion at the base of hte lung, but a higher V/Q at the apex

Front 41

How is Crohn's related to NF-kB?

Back 41

NF-kB is responsible for cytokine production

Front 42

What is caudal regression syndrome and why does it appear in newborns?

Back 42

Sacral agenesis -> LE paralysis and urinary incontinence; related to poorly controlled maternal diabetes

Front 43

Where does isotype switching occur?

Back 43

Germinal center of LN

Front 44

What causes LV outflow obstruction in HCM?

Back 44

abnormal systolic motion of the anterior leaflet of the mitral valve and toward the hypertrophied interventricular septum

Front 45

What happens to arteriolar walls in diabetes as a result of non-enzymatic glycosylation?

Back 45

increased thickness, hyalinization, narrow of the walls

Front 46

These drugs cause hypothyroidism

Back 46

Lithium, amiodarone, sulfonamides

Front 47

These drugs cause hyperglycemia

Back 47

Niacin, tacrolimus, protease inh

Front 48

These drugs can cause gout

Back 48

HCTZ, furosemide, niacin, cyclosporine, pyrazinamide

Front 49

These drugs cause SIADH

Back 49

Cyclophosphamide, Carbamazepine

Front 50

These drugs cause Parkinson-like symptoms

Back 50

Antipsychotics, reserpine, metoclopramide

Front 51

Sulfa Drugs

Back 51

Probenecid, Furosemide, Acetazolamide, Celecoxib, Thiazides, Sulfonamides, Sulfsalazine, Sulfonylureas