Pharm Flashcards

1
Q

NMS vs serotonin syndrome
- Timeline

A

NMS - 1-3 days
Serotonin syndrome <12 hours

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2
Q

NMS vs serotonin syndrome
- Neuro

A

NMS - hyporeflexia, but diffuse lead pipe rigidity

Serotonin syndrome - hyperreflexia, clonus, ocular signs and pupil dilation

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3
Q

NMS vs serotonin syndrome
- Bowels

A

NMS - hypoactive

Serotonin - hyperactive

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4
Q

NMS vs serotonin syndrome
- Pathophys and Rx

A

NMS - Da antagonists. Rx with bromocriptine (Da agonist)

Serotonin syndrome. Serotenergic agents. Managed with cyproheptadine

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5
Q

Medication CI with tamoxifen due to CYP2D6 inhibition (reduced conversion)

A

Paroxetine/fluoxetine`

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6
Q

CYP2C19 - pro-drugs that are converted to active form by this cyp enzyme

A

Clopidogrel (clopidogrel resistance)

PPI’s

Use pantoprazole as competes least with clopidogrel when concurrently used

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7
Q

Which rate control is substrate of CYP2D6

A

Metoprolol

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8
Q

Can decrease excretion of Lithium

A

Thiazide
ACEi

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9
Q

P gylcoprotein inhibitiors

A

Ketoconazole
Verapamil

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10
Q

Hypertension
Tachycardia
Fever
Pupil dilation

A

Sympathomimetic toxidrome

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11
Q

Differentiate between MDA and cocaine OD

A

Cocaine more likely to have conduction abnormalities (due to Na channel blockade)

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12
Q

Biosimilar

A

When biologic becomes off patent, near identical cheaper version

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13
Q

Phase 1 reaction
- End product
- Processes
- Enzyme

A

Reactive metabolites

Via oxidation, reduction, hydrolysis

CYP class enzymes

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14
Q

Phase 2 reactions
- End product
- Processes

A

REactive metabolite –> conjugated drug

Multiple processes - glurodination, sulfation, acetylation etc

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15
Q

Phase 3 reaction

A

Conjugate drug transport intol bile - P GP

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16
Q

Drug that skip phase I and direct phase II

A

Isoniazid - acetylation

17
Q

Medication causing most severe serotonin syndrome

A

MAO - CNS specific

18
Q

Long halflife SSRI’s

A

Fluoextine

Norfluoextine - 2.5 wees (metabolite)

19
Q

Smoking cessation and concomittant psychiatric disorder

A

Varenicline (nicotinic receptor agonist)

20
Q

Smoking cessation, history of seizure disorder - do not use?

A

Bupropion

21
Q

Clearance formula with AUC?

A

Clearance = dose/AUC

22
Q

ANtipsychotic most associated with photosensitivity

A

Clozapine

23
Q

Gentamicin ineffective in which body location?

A

Lung

24
Q

Bilateral schqannomas

A

NF2

25
Q

2 formulas for renal clearance

A

1) - fraction unbound x GFR

2) Urine conc/Plasma conc. (proportion) x Urine output (L/hr)

26
Q

Clearance formula with AUC

A

Cl =

AUC

27
Q

Clearance formula with elimination

A

El = Cl x Css / F

28
Q

CYP inducers

A

CRP GPSS
CBZ
Rifampacin
Phenytoin
Griseofulvin
Phenobarbitol
Smoking/SUlfonylureas
St Johns Wort