Pharmacy

Front 1

What is the definition of : relationship b/w amount of drug in the body w/ serum concentration

Back 1

Volume of distribution

Front 2

How many half lives of a drug does it take to reach 97% of its final steady state plasma concentration?

Back 2

5 half lives **

Front 3

How many half lives does it take for a drug to reach 90% of steady state concentration?

Back 3

3 half lives

Front 4

When do u use epi during resuscitiation?

Back 4

Bradycardia, pulseless arrest

Front 5

What are alternate routes of epi?

Back 5

IV, IO, IM, ETT

Front 6

Whats mechanism of action of alpha agonist?

Back 6

Sympathomomimetic agents; acitivating alpha 1, 2 inihibits adenylate cyclase which then activates cAMP and induces smooth muscle and blood vessel constriction

Front 7

Whats mechanism of action of beta agonist?

Back 7

Beta 2 receptor stimulation; leads to bronchodilation

Front 8

How does albuterol exert its primar side effect of tachycardia?

Back 8

Stimulation f cardiovascular beta receptors

Front 9

What does epi do to smooth m.?

Back 9

Relaxation of bronchial smooth muscle , cardiac stimulation; vasodilation at low doses; vasoconstriction at high doses

Front 10

What are side effects of beta agonists?

Back 10

Tacky, hyperglycemia, hypokalemia, agitation, anxiety, cardiac arrhythmias

Front 11

How long do mixed adrenergic agents lasts?

Back 11

Inhaled: 3-4 hours; IV/IO/ET: < 20 min

Front 12

What are side effects of mixed adrenergic (epi)?

Back 12

Arrhythmias, tacky, htn, anxiety, tremor, vasoconstriction, vasodilation

Front 13

What med indicated for nocturnal asthma and is an alternative but not preffered long term prevenative asthma tx?

Back 13

Theophylline

Front 14

Whats mechanism of action of theophylline?

Back 14

Inhibits 2 isoenzymes of enzyme: phosphodiesterase (PDE) resulting in increased cAMP

Front 15

What are side effects of theophylline?

Back 15

Tacky, H/A, insomnia, GER, nausea, vomiting, tremor, mental status change, sz

Front 16

What kind of lung effects does theophylline have?

Back 16

Bronchodilating; smooth ms. Relaxer; dilates pulm arteries, diuresis;

Front 17

What are signs of acute theophylline overdose?

Back 17

Over 20 mcg/mL : get nausea, vomiting, tremor, agitation; then tacky; later sz, coma, mental status changes, sz

Front 18

When do u use anticholinergic w/ lung diz

Back 18

Adjunctive for acute asthma and COPD tx

Front 19

Whats mechanism of ipratropium and tiotropium? And what’s their class?

Back 19

Anticholinergic; blocks action of Ach at parasympathetic sites in bronchial smooth m.

Front 20

Whats clinical effects of ipratropium and tiotropium ?

Back 20

Bronchodilation and drying effects of airway secretions

Front 21

What are side effects of ipratropium and tiotroprium ?

Back 21

Tacky, mydirasis, urinary retention; hyperthermia, constipation, dry mucous membranes; disorientation

Front 22

Why does ipratropium have less side effects than atropine?

Back 22

atropine are directly related to its antimuscarinic action. Dryness of the mouth, blurred vision, photophobia and tachycardia commonly; iptratropium has anticholinergic effects: relax muscles and dilate airways and very little is absorbed, travels directly to airway!!

Front 23

What kind of inflammatory effects do steroids have/ mechanism of action6?

Back 23

Suppression of cytokine generation, airway eosinophil, recruitment, inflammatory mediator release

Front 24

What are the clinical effects of steroids? +

Back 24

Resotre beta adrengergic responsiveness, block lae reaction to allergens, reduce airway hyper-responsiveness

Front 25

What are major side effects of systemic steroids?

Back 25

HPA suppression; immunospression; growth suppression; osteoporosis; cataract

Front 26

What are side effects of inhaled steroids?

Back 26

HPA suppression; immunospression; growth suppression; cataract; cushings, steroid withdrawal

Front 27

How does montelukast work? And last

Back 27

Selective LTRA (Cys T1); 24 hrs

Front 28

How does zafirulukast work? And last

Back 28

Selective LTRA of cys LT C4,D4, E4); 12 hrs

Front 29

How does zilueton work? And last

Back 29

5 lipoxygenase inhibirotr- inhibits leukotriene formation; 6-12 hrs

Front 30

Which leukotriene modifier affects liver? /hepatotoxicity?

Back 30

Zileuton and zafirlukast (z~ liver changes)

Front 31

When is appropriate therapeutic drug monitoring of theophylline when a pt is receiving a SR prep? Steady-state peak; steady state trough; steady state random; any consistent time w/in dosing interval

Back 31

any consistent time w/in dosing interval

Front 32

What are effects of loop diuretics/furosemide?

Back 32

Increases excretion of water, na, K, cl, mg, ca

Front 33

MOA of loop?

Back 33

Inhibits reabosroption of na, cl in ascending loop of henle and distal renal tubule

Front 34

Which drugs cause ototoxicity, lyte imbalance, nephrocalcinosis, renal insufficiency?

Back 34

Furosemide; ototox also due to combo w/ aminoglycoside

Front 35

Which drug inhibitis na reabsorption in distal tubules?

Back 35

Thiazide

Front 36

Which drug does everything that loop does, but also increases excretion f bicarb ?

Back 36

Thiazide

Front 37

Which drug competes w/ aldo for receptor at distal renal tubule?

Back 37

K sparing: spironolactone; increases excretion of water, na, cl

Front 38

Which drug inhibits carbonic anhydrase?

Back 38

Acetazolamide

Front 39

Which drug causes tinnitus, nephrolithiasis, renal insuff?

Back 39

Carbonic anhydrase inhib (acetazolimade)

Front 40

What do loop and thiazide diuretics do to acid base balance? And how?

Back 40

Metabolic alkalosis; depletion of k, cl, na

Front 41

Whats MOA of xolair/omalizumab?

Back 41

IgG monoclonal Ab which binds to free IgE , prevents binding to surface of mast cells, basophils, limting release of allergic mediators;

Front 42

What’s effect of omalizumab? Duration of action?

Back 42

Decreased asthma exacerbation, steroid use; duration: 2-4 wks