Usmle 1 Pharm Basics

Front 1

amount of drug in body/_______ = Vd

Back 1

plasma drug concentration


(Vd is Volume of Distribution)

Front 2

rate of elimination of drug/[plasma drug] = ?

Back 2

CL (Clearance)

Front 3

(.7)(Vd)/CL = ?

Back 3

T 1/2

Front 4

A drug infused at a constant rate reaches about 94% of steady state after _______ t 1/2s.

Back 4

4

Front 5

A loading dose is calculated using this formula.

Back 5

Loading Dose = (Cp)(Vd)/F

(Cp = target plasma conc; F = bioavailability)

Front 6

A maintenance dose is calculated using this formula.

Back 6

(Cp)(CL)/F

(CL = Clearance)

Front 7

Rate of elimination is proportional to _______ ______ in 1st order elimination.

Back 7

drug concentration

Front 8

In the case of EtOH, which is elimated by _____ order elimination, a constant amount of drug is eliminated per unit time.

Back 8

zero

Front 9

Phase ____ (I or II) reactions yield slightly polar metabolites that are often _____ (active or inactive)

Back 9

I, active

Front 10

Phase ____ (I or II) reactions yield very polar metabolites that are often _____ (active or inactive) and are excreted by the _______.

Back 10

II, inactive, kidney

Front 11

Phase II reactions are often of this type.

Back 11

conjugation

Front 12

Cytochrome P-450 is involved in _____ phase (I or II) reactions.

Back 12

I

Front 13

A drug patent lasts for _____ years after filing for application.

Back 13

20

Front 14

How many phases are there in drug development?

Back 14

4

Front 15

Drugs are first tested in patients in phase _____ of clinical testing, pharmacokinetic safety is determined in phase ______ of clinical testing, double blind tests are done in phase ____ and post-market surveillance is done in phase _____.

Back 15

2,1,3,4

Front 16

In a dose response curve, a competitive antagonist shifts the curve _____

a non-competitive antagonist shifts the curve ______.

Back 16

right

down

Front 17

What pharmacologic relationship would determine the existence of spare receptors?

Back 17

EC50 is lower then Kd (EC50 is more to the left)

Front 18

What does it mean if EC50 and Kd are equal?

Back 18

The system does not have spare receptors

Front 19

A partial agonist acts on the same receptor system as a full agonist? T/F

Back 19

TRUE

Front 20

What's the main difference between a partial agonist and a full agonist?

Back 20

A partial agonist has a lower maximal efficacy.

Front 21

Is a partial agonist less potent than a full agonist?

Back 21

Not necessarily. It can be less, more or equally potent as a full agonist.

Front 22

Equation for Half Life

Back 22

T 1/2 = (0.7 x Vd)/CL

Front 23

Percent of concentration in the following number of half lives:
1
2
3
3.3

Back 23

1 = 50%

2 = 75%

3 = 87.5%

3.3 = 90%

Front 24

How do the Loading and Maintenance doses change in a patient w/ Renal or Hepatic dysfunction?

Back 24

Loading - unchanged


Maintenance - Decreased

Front 25

Equation for Theraputic Index

Back 25

TI = Toxic dose/Effective dose

Front 26

Phase in clinical drug testing:

safety, pharmacokinetics

Back 26

1

Front 27

Phase in clinical drug testing:

Protocol, dose level, work on patients

Back 27

2

Front 28

Phase in clinical drug testing:

double blind study, efficacy, adverse effects

Back 28

3

Front 29

(3) drugs that use Zero-order elimination

Back 29

Alcohol,

Aspirin,

Phenytoin

Front 30

What phase of a reaction uses cytP-450?

What is the purpose of this phase?

Back 30

Phase I

converts lipophilic to polar

Front 31

What is the main focus of Phase II reactions?

Back 31

Conjugation

Front 32

When pH < pKa, what is more common?
(2)

which can pass through the membrane?

Back 32

HA and BH+


HA passes thru the membrane (uncharged)

Front 33

Definition:

Amount of the drug required for a given response

Back 33

Potency

Front 34

what is the first NT to everything?

the first receptor?

Back 34

NT: ACh

Receptor: Nicotinic

Front 35

what system does not have a synapse from the spinal cord to the tissue?

Back 35

Somatic NS

(skeletal muscle)

ACh to Nicotinic receptor

Front 36

what is the only sympathetic ACh?

what is the receptor?

Back 36

Sweat gland


receptor: Muscarinic

Front 37

what is the receptor for the Parasympathetic system at the tissue?

Back 37

Muscarinic

Front 38

what are the Adverse Effects of Acetylcholine?

which is the only Nicotinic receptor response?

Back 38

DUMBBELSS:
Diarrhea, Urination,
Miosis,
Bradycardia, Bronchoconstriction,
Excite skeletal muscle (N),
Lacrimation,
Sweat, Salivation

Front 39

what receptors use Gq as their second messenger?
(5)

Back 39

HAVe 1 M&M:
H1
Alpha1
V1
M1
M3

Front 40

what G-protein uses Phospholipase C?

Back 40

Gq

Front 41

what receptors use Gi as their second messenger?

action?

Back 41

MAD 2s:
M2
Alpha2
D2

inhibits Adenylyl Cyclase

Front 42

what receptor increases gastric acid secretion?

Back 42

H2

Front 43

Inhibits choline re-entering the presynaptic terminal

Back 43

Hemicholinium

Front 44

Inhibits ACh into vesicles

Back 44

Vesamicol

Front 45

Inhibits NE into vesicles

Back 45

Reserpine

Front 46

Inhibits release of ACh into synaptic membrane

Back 46

Botulinum

Front 47

Inhibits release of NE into synaptic membrane

Back 47

Guanethidine

Front 48

Promotes release of NE into synaptic membrane

Back 48

Amphetamines

Front 49

Inhibits reuptake of NE into presynaptic nerve
(2)

Back 49

Cocaine

TCA

Front 50

what receptor does NE act on in the presynaptic neuron as neg feedback to inhibit its release?

Back 50

alpha-2

Front 51

(3) Cholinomimetrics and use of each

Back 51

Bethanechol - post-OP activates GI/GU

Carbachol - Glaucoma

Pilocarpine - Glaucoma

Front 52

Anticholinesterase used for post-OP activation of GI/GU, myasthinia gravis

what is it an antidote for?

Back 52

Neostigmine


antidote: Curarae (NMJ block)

Front 53

Anticholinesterase used for glaucoma and crosses BBB

what is it an Antidote for?

Back 53

Physostigmine


antidote: Atropine overdose

Front 54

(3) ACh receptor blockers

Back 54

Atropine,

Scopalamine,

Ipratropium

Front 55

ACh receptor blocker used for Motion Sickness

Back 55

Scopolamine

(DOC)

Front 56

ACh receptor blocker used for Asthma/COPD

Back 56

Ipratropium

Front 57

what drug slows the HR at 0.5mg and increases it at >1.0mg?

Back 57

Atropine

(muscarinic antagonist)

Front 58

what are the AE of Atropine?

Back 58

Opposite of DUMBBELSS:

Hot as hare,
Dry as bone,
Red as beet,
Blind as Bat,
Mad as hatter

Front 59

Insecticide antidote

Back 59

Atropine

Front 60

Nicotinic ACh receptor antagonist

use?

Back 60

Hexamethonium

use:
prevents reflex bradycardia caused by NE

Front 61

drug used for intubation for its rapid onset and quick duration in causing flaccid paralysis

Back 61

Succinylcholide

Front 62

which NMJ (nicotinic) blocker also releases histamine?

Back 62

Tubocurarine

Front 63

Epinepherine effects on:

1. BP

2. HR

3. TPR

Back 63

Epinepherine

BP: Inc Systolic, Dec Diastolic

HR: Inc (tachycardia)

TPR: Dec

Front 64

NE effects on:

1. BP

2. HR

3. TPR

Back 64

NE

BP: BIG INC in systolic and diastolic

HR: DECREASES

TPR: BIG INCREASE

Front 65

Isoproterenol effects on:

1. BP

2. HR

3. TPR

Back 65

Isproterenol

BP: Decrease in systolic and diastolic

HR: BIG INCREASE

TPR: BIG DECREASE

Front 66

DOC for Shock to increase renal perfusion and for CHF to increase CO

Back 66

Dopamine

Front 67

DOC for CHF to increase CO w/o increasing oxygen demand

Back 67

Dobutamine

Front 68

Alpha agonist that is used for HTN w/ renal Dz

Back 68

Clonidine

Front 69

what occurs if atropine is given before NE?

Back 69

Heart rate increases instead of decreases

Front 70

a1-blocker for urinary retention in BPH and HTN

Back 70

Prazosin

Front 71

a2-blocker for depression

Back 71

Mirtazapine

Front 72

what occurs w/ BP if a-blocker is given before Isoproterenol?

Back 72

No change!

Front 73

what occurs w/ BP if a-blocker is given before Epinepherine?

Back 73

Reverses the vasoconstriction effect of Epi and Decreases BP

Front 74

which beta-blockers are beta1 selective?

Back 74

if they start w/ A-M in alphabet

(except Labetalol - partial agonist)

Front 75

what glaucoma drug should not be used in closed-angle glaucoma?

Back 75

Epinepherine

Front 76

Antidote/Tx for:

Salicylates

Back 76

Alkalinize urine

Front 77

Antidote/Tx for:

Anticholinesterases;
Organophosphates
(2)

Back 77

Atropine,

Pralidoxime

Front 78

Antidote/Tx for:

Antimuscarinic;
Anticholinergic agents

Back 78

Physostigmine

Front 79

Antidote/Tx for:

beta-blockers

Back 79

Glucagon

Front 80

Antidote/Tx for:

Digitalis
(4)

Back 80

Stop Dig,

normalize K,

Lidocaine,

Magnesium

Front 81

Antidote/Tx for:

Iron

Back 81

Deferoxamine

Front 82

Antidote/Tx for:

Lead
(3)

Back 82

CaEDTA,

Dimercaprol,

Succimer (kids)

Front 83

Antidote/Tx for:

Arsenic, gold, mercury
(2)

Back 83

Dimercaprol,

Succimer (kids)

Front 84

Antidote/Tx for:

Copper

Back 84

Penicillamine

Front 85

Antidote/Tx for:

Cyanide
(3)

Back 85

Nitrite,

Hydrocobalamin,

Thiosulfate

Front 86

Antidote/Tx for:

Methemoglobin

Back 86

Methylene Blue

Front 87

Antidote/Tx for:

Carbon Monoxide

Back 87

100% O2

(or hyperbaric O2)

Front 88

Antidote/Tx for:

Methanol,
Ethylene glycol (antifreeze)
(2)

Back 88

Ethanol,

Fomepizole

Front 89

Antidote/Tx for:

Opioids
(2)

Back 89

Naloxone,

Naltrexone

Front 90

Antidote/Tx for:

Benzodiazepines

Back 90

Flumazenil

Front 91

Antidote/Tx for:

TCAs

Back 91

NaHCO3

Front 92

Antidote/Tx for:

Heparin

Back 92

Protamine

Front 93

Antidote/Tx for:

Warfarin
(2)

Back 93

Vitamin K,

FFP

Front 94

Antidote/Tx for:

tPA, Streptokinase

Back 94

Aminocaproic acid

Front 95

Urine pH and drug elimination for:

Weak acids

Back 95

alkalinize urine w/ Bicarb

Front 96

Urine pH and drug elimination for:

Weak bases

Back 96

Acidify urine w/ NH4Cl

Front 97

What is the reversible cholinesterase inhibitor indicated for the Tx of Alzheimer's Dz?

Back 97

Tacrine

Front 98

what is the skeletal muscle relaxant that acts directly on the contractile mechanism of the muscle fiber?

Back 98

Dantrolene

Front 99

which Glaucoma agent acts by decreaseing production of aqueous humor?

Back 99

Timolol

Front 100

why is Epi mixed w/ anesthetics?

Back 100

to retard the systemic absorption

Front 101

which muscles are most affected by tubocurarine?

Back 101

fine movement muscles (head, neck, face)

Front 102

what is the alpha receptor-assoc eye muscle?

Back 102

Radial muscle

Front 103

what agent for bronchial asthma causes tremor?

Back 103

Salmeterol

(b-agonist)

Front 104

what ANS drug class masks hypoglycemia in treated diabetics?

how?

Back 104

b-blockers


blocks catecholamines, which stimulate Glyconeogenesis

Front 105

(2) MAO inhibitors that are used for depression

Back 105

Tranylclpromine,

Phenelzine sulfate

Front 106

DOC for thyroid storm

Back 106

Propranolol

Front 107

Definition:

two drugs act on the same tissue via independent receptors resulting in effects in the opposite direction

Back 107

Physiologic antagonist

Front 108

Definition:

when two drugs combine and the activity of one or both drugs is blocked

Back 108

Chemical antagonist

Front 109

equation for the Elimination constant
(2)

Back 109

Ke = 0.7/half-life = CL/Vd

Front 110

when calculating an IV dosage, what needs to be remembered?

Back 110

multiply drug (mg/kg) by weight (kg)

Front 111

(2) equations for Extraction ratio

Back 111

ER = (Ci-Co)/Ci = CL/Q

Front 112

Which is not absorbed well in the stomach:
Aspirin (pKa = 3) or Propranolol (pka = 9.4)?

Back 112

Propranolol

Front 113

the AE of convulsions are MC w/ what drug?

Back 113

Strychnine

Front 114

what drug can cause Hypocalemic Tetany?

Back 114

Edetate Disodium (Na-EDTA)

Front 115

what mineral toxicity can decrease Amylase secretion?

Back 115

Zinc

Front 116

AE of drug is Congenital goiter, Hypothyroidism

Back 116

Methimazole

Front 117

AE of drug is Agenesis of fetal kidneys

Back 117

Chlorambucil