Pk Final Cont.

Front 1

CYP 450 is involve w/ _____ rxns

Back 1

phase 1 (oxidation, reduction, and hydrolysis)

Front 2

Nomenclature CYP3A4
3=?
A=?
4=?

Back 2

3=gene family
A=gene-sub-family
4=ind. gene

Front 3

Competitive interactions=?

Back 3

drugs compete with binding sites of the same metabolizing enzymes

Front 4

Onset of compeptitive interactions depend on??

Back 4

half life of the inhibitor

Front 5

rifampin induction (dec. conc.) can be apparent when? bc?

Back 5

w/i 24 hours because of short 1/2L

Front 6

Phenobarbital induction is?? bc?

Back 6

gradual, can take abt. 1 week bc of longer 1/2 l

Front 7

induction of drugs decreases with?

Back 7

age, and hepatic disease

Front 8

substates for CYP-1A2

Back 8

theophylline, caffeine, clozapine, fluvoxamine, amitriptylline, propranolol

Front 9

inh. of CYP-1A2

Back 9

Fluvoxamine (use escitalopram), ciprofloxacin (use another quinolone), clarithromycin, e-mycin, cimetidine

Front 10

inducers of CYP1A2

Back 10

rifampin, st. John's wort

carmabazepine, phenytoin, primidone, phenobarbital

cigarette smoke (nicotine patch won't affect substrates, charcoal-broiled foods

Front 11

CYP2C9 substrates

Back 11

phenytoin, warfarin, fluoxetine, voriconazole, fluvastatin

Front 12

CYP-2C9 inhibitors

Back 12

Omeprazole, cimetidine (use lansopazole or famotidine)

amiodarone (use sotalol)

fluconazole (use voriconazole)

ibuprofen

metronidazole

Front 13

CYP-2C9 inducers

Back 13

rifampin, st. johns wort

carbamezepine, phenytoin, primidone, phenobarbital

Front 14

CYP2D6 substrates

Back 14

codeine-morphine
hydrocodone-methadone
oxycodone
dextromethorphan
tramadol
haloperidol, thioridazine
risperdone
propranolol, metroprolol
tricyclic antidepressants,
SSRI antidepressants

Front 15

CYP2D6 inh.

Back 15

quinidine, amiodarone

fluoxetine, paroxetine (use escitalopram)

sertraline

ritonavir

cimetidine

Front 16

CYP2D6 inducers

Back 16

rifampin, st. johns wort

carbamezepine, phenytoin, phenobarb.

Front 17

quinidine + metoprolol

Back 17

85% inc. in metoprolol serum conc.

Front 18

PIs

Back 18

CYP3A4 substate

Front 19

Oral contraceptives

Back 19

CYP3A4 substate

Front 20

alprazolam, triazolam, diazepam, and midazolam

Back 20

CYP3A4 substate

Use lorazepam or oxazepam

Front 21

ergot alkaloids

Back 21

CYP3A4 substate

Front 22

atorvastatin, lovastatin, simvastatin

Back 22

use pravastatin, or rosuvastatin

Front 23

warfarin, cilostazol

Back 23

CYP3A4 substate

Front 24

sildenafil, verdenafil, tadalafil

Back 24

CYP3A4 substate

Front 25

carbamezepine

Back 25

CYP3A4 substate

Front 26

cyclosporine, tacrolimus

Back 26

CYP3A4 substate

Front 27

Cimetidine

Back 27

inh. of CYP3A4

Front 28

Ritonavir

Back 28

inh. of CYP3A4

Front 29

e-mycin, clarithromycin

Back 29

inh. of CYP3A4
for e-mcyin, use azithromycin

Front 30

itraconazole, ketoconazole, fluconazole, voriconazole

Back 30

inh. of CYP3A4

Front 31

metronidazole

Back 31

inh. of CYP3A4

Front 32

grapefruit juice

Back 32

inh. of CYP3A4

Front 33

rifampin

Back 33

inducer of CYP3A4

Front 34

antiepileptic drugs

Back 34

inducer of CYP3A4

Front 35

st. john's wort

Back 35

inducer of CYP3A4

Front 36

ritonavir

Back 36

mixed inducer and inh.

Front 37

indinavir, saquinavir, amprenavir, atazanavir

Back 37

inh. 3YP3A4

Front 38

Delavirdine

Back 38

inh. 3YP3A4

Front 39

Nevirapine

Back 39

inh. 3YP3A4

Front 40

efavirenz

Back 40

inh. and inducer of 3YP3A4

Front 41

5-10% of caucasians
1-3% of a.a and asians

Back 41

poor met. (may completely lack the enzyme, or may have enzymes with low activitiy) of CYP2D6

Front 42

90% of caucasians
>98% of asians and native americans

Back 42

extensive met. of CYP2D6

Front 43

20% of a.a. and asians
3-5% of caucasians

Back 43

pm of CYP 2C19

Front 44

CYP3A4 and CYP1A2

Back 44

no data available

Front 45

probenecid dec. clearance of pencillin, methotrexate and zidovudine bc.

Back 45

elimination rxns:
inh. of renal tubular secretion

Front 46

quinidine , amiodarone, and bactrim dec. clearnace of _______ bc?

Back 46

dig.; elimination rxns:
inh. of renal tubular secretion (may need to dec. dose of digoxin by half)

Front 47

cimetidine and ranatidine dec. clearance of ________ bc.

Back 47

procainamide; elimination rxns:
inh. of renal tubular secretion

Front 48

ampicillin, penacillin, nitrofurantoin, sulfonamides, and tetracyclines are?

Back 48

inh. of enterohepatic recirculation.

Front 49

ampicillin, penacillin, nitrofurantoin, sulfonamides, and tetracyclines inc. CL of ?

Back 49

oral contraceptives bc of dec. absorption due to dec. enterohepatic circulation.

Front 50

quinidine , amiodarone, and bactrim dec. clearnace of _______ bc?

Back 50

digoxin; elimination rxns:
inh. of renal tubular secretion (may need to dec. dose of digoxin by half)

Front 51

cimetidine and ranatidine dec. clearance of ________ bc.

Back 51

procainamide; elimination rxns:
inh. of renal tubular secretion

Front 52

ampicillin, penacillin, nitrofurantoin, sulfonamides, and tetracyclines are?

Back 52

inh. of enterohepatic recirculation.

Front 53

ampicillin, penacillin, nitrofurantoin, sulfonamides, and tetracyclines dec. CL of ?

Back 53

oral contraceptives bc of dec. absorption due to dec. enterohepatic circulation.

Front 54

quinidine , amiodarone, and bactrim dec. clearnace of _______ bc?

Back 54

dig.; elimination rxns:
inh. of renal tubular secretion (may need to dec. dose of digoxin by half)

Front 55

cimetidine and ranatidine dec. clearance of ________ bc.

Back 55

procainamide; elimination rxns:
inh. of renal tubular secretion

Front 56

ampicillin, penacillin, nitrofurantoin, sulfonamides, and tetracyclines are?

Back 56

inh. of enterohepatic recirculation.

Front 57

ampicillin, penacillin, nitrofurantoin, sulfonamides, and tetracyclines dec. CL of ?

Back 57

oral contraceptives bc of dec. absorption due to dec. enterohepatic circulation.