Pharm Fa Mnemonics & Drugs

Front 1

Bioavailability

Half-life

Back 1

IV ~ 100%
F = (AUCpo*Div)/(Dpo*AUCiv)

t1/2 = .7*Vd/CL

Front 2

Dosage Calculations--
Loading dose
Maintenance dose

Back 2

LD: = Cp*Vd/F

MD: = Cp*CL*dose interval

Cp-plasma concentration at steady state
Steady state typically reached in 4-5 half-lives

Front 3

Elimination of drugs--
Zero-order
First-order

Back 3

Z: constant amount eliminated per unit time; PEA--**Phenytoin, Ethanol, Aspirin**

F: constant percentage per unit time

Front 4

Urine pH and drug elimination--
Weak acids
Weak bases

Back 4

Ionized species are trapped in urine and cleared quickly

WA: phenobarbital, MTX, ASA; trapped in basic environment; Tx is NaBicarb

WB: amphetamines; trapped in acidic environment; Tx is ammonium chloride

Front 5

Drug metabolism--
Phase I
Phase II

Back 5

I: reduction, oxidation, hydrolysis w/P450; geriatrics lose this first

II: conjugation (glucuronidation, acetylation, sulfation); geriatrics typically have this ability

Front 6

Therapeutic index--
Calculation
Examples of drugs w/low TI

Back 6

'TITE'
TI = TD50/ED50

Examples: digoxin, lithium, theophylline, warfarin

Front 7

ACh receptors--
Nicotinic
Muscarinic

Back 7

N: ligand-gated Na/K channels; Nn found in autonomic ganglia and Nm are found in NMJ

M: G-protein coupled receptors; M1-5 subtypes
**Muscarinic agonists will always increase secretions (sweat included)

Front 8

Innervation of eye & affect--
Sphincter muscle
Radial muscle
Ciliary muscle

Back 8

S: muscarinic receptors; miosis

R: a1 receptors; mydriasis

C: muscarinic receptors; accomodation

Front 9

G-protein linked 2nd messengers

Back 9

"QISS and QIQ till you're SIQ of SQS (super qinky sex)"

a1, a2, b1, b2--QISS
a1--pupillary dilator m.; GI sphincter contraction
b1--heart, renin release
b2--insulin release; relaxes uterus; aqueous humor production
M1-3--QIQ
M2--heart rate
M3--secretions, bladder contraction, bronchoconstriction, miosis, accomodation
D1, D2--SI
D1--relaxes renal vascular tone
H1, H2--QS
V1, V2--QS

Front 10

Random drugs--
Hemicholinium
Metyrosine
Reserpine
Botulinum
Amphetamine
Cocaine, TCAs, amphetamine

Back 10

H: blocks choline uptake into cholinergic nerve
M: blocks tyrosine hydroxylase-->can't convert tyrosine to DOPA
R: inhibit storage of DA in vesicles; *risk of suicide*
B: prevents release of ACh vesicles at nerve terminal
A: stimulates vesicle release of NE
C, T, A: blocks reuptake of NE into nerve terminal

Front 11

Cholinomimetic direct agonists--
Bethanechol
Carbachol
Pilocarpine
Methacholine

Back 11

All cause bradycardia, inc secretions, diarrhea, miosis
B: postop ileus; urinary retention; resistant to AChE
C: glaucoma
P: "you cry, drool and sweat on your PILOw"--CF sweat test, both types of glaucoma
M: challenge test for asthma (bronchial hypersensitivity)

*may exacerbate COPD, asthma, peptic ulcers*

Front 12

Cholinomimetic indirect agonists--AChE inhibitors
Neostigmine
Pyridostigmine
Physostigmine
Donepezil
Edrophonium

Back 12

Activates both N and M muscarinic receptors
N: "NeO CNS"; also for MG, postop ileus
Py: gets RID of myasthenia gravis
Ph: "phyxes" atropine overdose; uncharged and cross BBB
D: Alzheimer disease
E: dx of MG

*may exacerbate COPD, asthma, peptic ulcers*

Front 13

Cholinesterase inhibitor poisoning
Symptoms
Tx

Back 13

Due to organophosphates such as parathion or malathion; irreversibly inhibit AChE & affects both muscarinic and nicotinic receptors; antidote only fixes muscarinic blockade, may see NMJ issues

Sx's: diarrhea, miosis, sweating, lacrimation, salivation, bradycardia, bronchospasm, urination

Tx: atropine + pralidoxime (2-PAM)

2-PAM--regenerates AChE

Front 14

Atropine toxicity

Back 14

"Hot as a hare, Dry as a bone, Red as a beet, Blind as a bat, Mad as a hatter"
--increased body temp (dec sweating), tachycardia; dry/flushed skin; dry mouth; cycloplegia; disorientation (confusion)

**Jimson weed can cause similar effects
**Tx is physostigmine

Front 15

Sympathomimetics--direct
Epi
NE
Isoproterenol
Dopamine
Dobutamine
Phenylephrine
Albuterol, salmeterol, terbutaline

Back 15

E: b>a; low dose--b; high dose--a; anaphylaxis, htn,
NE: a1>a2>b1; htn (reflex bradycardia)
Iso: b1=b2
DA: D1=D2>b>a; only symp drug to increase renal blood flow while also correcting htn
Do: b1>b2; heart failure
P: a1>a2; htn, rhinitis
A/S/T: b2

Front 16

Sympatholytics--
Clonidine
a-methyldopa
Phenoxybenzamine
Phentolamine
Prazosin
Mirtazapine

Back 16

C: a2 agonist; used in hypertensive urgency; may cause CNS depression
a-m: a2 agonist; used for HTN in pregnancy
Px: irreversible, nonselective a-blocker; pheochromocytoma (preop)
Pa: reversible nonselective a-blocker; pts on MAO inhibitors who eat tyramine-containing foods (cheese, wine)
Pr: a1 selective blocker; BPH, PTSD; HTN
M: a2 selective blocker; depression

Front 17

b-blockers
Special notes
Selectivity
Toxicity

Back 17

Sn: dec mortality in MI; dec renin secretion (b1); dec secretion of aqueous humor

S: A-M b1 selective; N-Z nonselective; carvedilol/labetalol are nonselective a & b antagonists

T: **impotence, AV block, CNS adverse effects; may exacerbate COPD or asthma

Front 18

Drug rxns--cutaneous flushing

Back 18

"VANC"
Vancomycin
Adenosine
Niacin
Ca channel blockers

Front 19

Drug rxns--aplastic anemia

Back 19

"Can't Make New Blood Cells Properly"

Carbamazepine, Methimazole, NSAIDs, Benzene, Chloramphenicol, Propylthiouracil

Front 20

Drug rxns--fat redistribution

Back 20

"Fat PiG"
Protease inhibitors
Glucocorticoids

Front 21

Drug rxns--SLE-like syndrome

Back 21

"SHIPPE"
Sulfa drugs, Hydralazine, INH, Procainamide, Phenytoin, Etanercept

All metabolized by N-acetylation--slow acetylators have increased risk for developing drug-induced lupus

Front 22

Drug rxns--seizures

Back 22

"With seizures, I BITE My tongue"
INH (B6 deficiency)
Bupropion
Imipenem/cilastatin
Tramadol
Enflurane
Metoclopramide

Front 23

Drug rxns--antimuscarinics

Back 23

Atropine, TCAs, H1-blockers, antipsychotics

Front 24

Drug rxns--disulfiram-like rxn

Back 24

Metronidazole, griseofulvin, procarbazine, 1-gen sulfonylureas

Front 25

Drug rxns--nephrotoxicity

Back 25

Aminoglycosides, vancomycin, loop diuretics, cisplatin

Front 26

Drug rxns--pulmonary fibrosis

Back 26

Bleomycin, amiodarone, busulfan, methotrexate