7 -Meds and Pharm

Question 1

Do not pass through liver (no 1st pass metabolism)

Answer 1

Sublingual and rectal drugs

Question 2

Absorption based on lipid solubility through epidermis

Answer 2

Skin absorption

Question 3

Absorption restricted to non-ionized lipid-soluble drugs

Answer 3

CSF absorption

Question 4

Largely responsible for binding drugs

Answer 4

Albumin

Question 5

Drugs that will displace unconjugated bili from albumin in newborns

Answer 5

Sulfonamides (Bactrim, Sulfasalazine)

Question 6

Causes kernicterus (brain damage) in newborns

Answer 6

Sulfonamides (Bactrim, Sulfasalazine)

Question 7

Drug types (2) stored in bone

Answer 7

Tetracycline and Heavy metals

Question 8

Constant amount of drug eliminated regardless of dose

Answer 8

0 (zero) order kinetics

Question 9

Drug amount eliminated proportional to dose

Answer 9

1st order kinetics

Question 10

Time for a drug to reach steady state

Answer 10

5 half lives

Question 11

Amount of drug in body divided by amount in plasma/blood

Answer 11

Volume of Distribution

Question 12

Drugs with high volume of distribution have higher concentrations in extravascular or intravascular compartment?

Answer 12

Extravascular (eg fat tissue)

Question 13

Fraction of unchanged drug reaching systemic circulation known as

Answer 13

Bioavailabilityq

Question 14

Drug level at which desired effect occurs in 50% of pts

Answer 14

ED50

Question 15

Drug level at which death occurs in 50% of pts

Answer 15

LD50

Question 16

Decline in potency with continued use

Answer 16

Tolerance

Question 17

Effect at an unusually low dose

Answer 17

Hyperactive

Question 18

Tolerance after only a few doses

Answer 18

Tachyphylaxis

Question 19

Dose required for effect

Answer 19

Potency

Question 20

Ability to achieve results without untoward effect

Answer 20

Efficacy

Question 21

Responsible for drug metabolism

Answer 21

Smooth ER (Liver), P450 system

Question 22

Demethylation, oxidation, reduction, hydrolysis metabolism phase

Answer 22

Phase 1

Question 23

Metabolism Phase for glucuronic acid and sulfate attached to for water-soluble metabolite

Answer 23

Phase 2

Question 24

Product of phase 2 metabolism that’s usually inactive and ready for excretion

Answer 24

water-soluble metabolite

Question 25

INHIBITORS of P450

Answer 25

``` MAMA bit (inhibit) VICK'S FACE MAOIs Amiodarone Metronidazole Alcohol (acute/binge-drinking) ``` ``` Verapamil Isonaizid Cimetidine Ketonzaole 'Sulfonamides ``` Flagyl Allopurinol Ciprofloxacin Erythromycin

Question 26

INDUCERS of P450

Answer 26

``` CRAP GPS induces WAR Carbamazepines Rifampin Alcohol (Chronic) Phenytoin ``` Green and leafy veggies Phenobarb Smoking WARfarin

Question 27

Most important organ for eliminating most drugs

Answer 27

Kidneys

Question 28

How do the kidneys eliminate most drugs (2 ways)

Answer 28

Glomerular filtration | Tubular secretion

Question 29

Water soluble drugs, more likely to be eliminated unaltered

Answer 29

Polar/Ionized Drugs

Question 30

Fat soluble drugs, more likely to be metabolized before excretion

Answer 30

Nonpolar/Non-ionized Drugs

Question 31

Negatively birefringent crystals that cause gout; End production of PURINE metabolism

Answer 31

Uric Acid

Question 32

Gout affecting big toe joint

Answer 32

Podagra

Question 33

Anti-inflammatory gout drug; binds TUBULIN and inhibit chemotaxis of WBCs

Answer 33

Colchicine

Question 34

NSAID gout drug; inhibits prostaglandin synthesis (reversible COX)

Answer 34

Indomethacin

Question 35

Xanthine oxidase inhibitor gout drug; blocks xanthine from forming uric acid

Answer 35

Allopurinol

Question 36

Gout drug increasing renal secretion of uric acid

Answer 36

Probenecid

Question 37

Gout drugs (4) and which for acute, which for chronic

Answer 37

``` I CAP the AC Indomethacin Colchicine Allopurinol Probenecid ``` Acute - Colchicine Chronic - Allopurinol

Question 38

Binds bile acids in gut forcing body to resynthesize bile acids from cholesterol; can bind vitamin K, causing bleeding tendency

Answer 38

Cholestyramine

Question 39

Lipid lowering drug that can cause liver dysfunction and rhabdo

Answer 39

HMG-CoA reductase inhibitors (Statins)

Question 40

Lipid lowering drug that can cause flushing (Tx with ASA); inhibits cholesterol synthesis

Answer 40

Niacin

Question 41

Prokinetic GI drug that inhibits dopamine receptors; increase gastric and gut motility

Answer 41

Metoclopramide (Reglan)

Question 42

Prokinetic GI drug that binds and activates motolin receptor

Answer 42

Erythromycin

Question 43

Prokinetic GI drug that acts as ANTAgonist to mu-opioid receptor

Answer 43

Alvimopan

Question 44

GI drug that slows gut motility; AGONIST to mu-opioid receptor

Answer 44

Loperamide

Question 45

GI drug that slows gut motility; AGONIST to opioid receptor and inhibits muscarinic receptors

Answer 45

Lomotil (Atropine/Diphenoxylate)

Question 46

Antiemetic GI drug that inhibits dopamine receptors

Answer 46

Promethazine (phenergan)

Question 47

Antiemetic GI drug that acts centrally to inhibit serotonin receptors

Answer 47

Ondansetron (zofran)

Question 48

GI drug that is proton pump inhibitor; blocks H/K ATPase in stomach PARIETAL CELLS

Answer 48

Omeprazole

Question 49

GI drug that blocks H2 receptors; decrease stomach acid

Answer 49

Cimetidine/Ranitidine

Question 50

GI drug that acts as somatostatin analogue; decrease gut secretions

Answer 50

Octreotide

Question 51

Cardiac drug that inhibits Na/K ATPase; increase myocardial Ca

Answer 51

Digoxin

Question 52

Cardiac drug that is inotrope, slows AV conduction and NOT cleared with dialysis

Answer 52

Digoxin

Question 53

Side effects of amiodarone (3)

Answer 53

Pulmonary fibrosis Hypothyroidism Hyperthyroidism

Question 54

Used to treat torsades

Answer 54

Magnesium

Question 55

Cardiac drug that causes transient interruption of AV node

Answer 55

Adenosine

Question 56

Cardiac drug shown to be best single agent to improve survival in pts with CHF and prevent CHF after MI

Answer 56

ACE inhibitor

Question 57

Cardiac drug that can prevent progression of renal dysfunction in pts with DM and HTN

Answer 57

ACE inhibitor

Question 58

Cardiac drug shown to be best single agent to improve survival after MI

Answer 58

Beta-Blockers

Question 59

Cardiac drug that is an acetylcholine antagonist, INCREASES heart rate

Answer 59

Atropine

Question 60

Analogue of GnRH and LHRH

Answer 60

Leuprolide

Question 61

Alpha-adrenergic receptor antagonist; BPH

Answer 61

Tamsulosin

Question 62

PGE1 derivative; protective prostaglandin used to prevent peptic ulcer disease

Answer 62

misoprostol

Question 63

Antipsychotic, inhibits dopamine receptors

Answer 63

Haldol

Question 64

Most common side effect of iodine contrast

Answer 64

Nausea

Question 65

ASA poisoning causes what metabolic conditions (2, it switches)

Answer 65

1st - respiratory alkalosis | 2nd - metabolic acidosis