Chapter 7 - Medicines and Pharmacology Flashcards

2
Q

Requirement for skin absorption?

A

Lipid solubility through the epidermis

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3
Q

Requirement for CSF absorption?

A

Nonionized, lipid-soluble drugs

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4
Q

Sulfonamides will do what in newborns?

A

Displace unconjugated bilirubin

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5
Q

What is 0 order kinetics?

A

Constant amount of drug is eliminated regardless of dose

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6
Q

What is 1st order kinetics?

A

Drug eliminated proportional to dose

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7
Q

How many half-lives for a drug to reach steady state?

A

5

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8
Q

Where are tetracycline and heavy metals stored?

A

In bone

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9
Q

Volume of distribution is equal to what?

A

Amnt of drug in the body divided by amnt of drug in plasma or blood

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10
Q

High volume of distribution means what?

A

Higher concentrations in the extravascular compartment compared with intravascular concentrations

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11
Q

What is bioavailability?

A

Fraction of unchanged drug reaching the systemic circulation; 100% for IV drugs

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12
Q

What is ED50?

A

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

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13
Q

What is LD50?

A

Drug level at which death occurs in 50% of patients

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14
Q

What is tachyphylaxis?

A

Tolerance after only a few doses

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15
Q

What is potency?

A

Dose required for effect

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16
Q

What is efficacy?

A

Ability to achieve result without untoward effect

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17
Q

What is Phase I of microsomal drug metabolism?

A

Demethylation, oxidation, reduction, hydrolysis reaction (requries NADPH/O2)

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18
Q

What is Phase II of microsomal drug metabolism?

A

Glucuronic acid (#1) and sulfates attached (forms water-soluble metabolite)

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19
Q

Inhibitors of P-450?

A

Cimetidine, isoniazid, ketoconazole, erythromycin, Cipro, Flagyl, allopurinol, verapamil, amiodarone, MAOIs, disulfiram

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20
Q

Inducers of P-450?

A

Cruciform vegetables, ETOH, insecticides, cigarette smoke, phenobarbital, dilantin, theophylline, warfarin

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21
Q

Most important organ for eliminating most drugs?

A

Kidney

22
Q

How are polar (ionized) drugs eliminated?

A

More water soluble, more likely to be eliminated in unaltered form

23
Q

How are nonpolar (nonionized) drugs eliminated?

A

More fat soluble, more likely to be metabolized before excretion

24
Q

What causes gout?

A

Uric acid buildup; end product of purine metabolism

25
Q

Colchicine MOA?

A

Anti-inflammatory; binds tubulin, inhibits migration

26
Q

Allopurinol MOA?

A

Xanthine oxidase inhibitor, blocks uric acid formation from xanthine

27
Q

Probenecid MOA?

A

Increases renal secretion of uric acid

28
Q

Side effect of cholestyramine?

A

Can bind Vit K and cause bleeding tendency

29
Q

Side effect of HMG-CoA reductase inhibitors?

A

Liver dysfunction, rhabdo

30
Q

Side effect of niacin?

A

Flushing (Tx: ASA)

31
Q

Side effect of promethazine?

A

Tardive dyskinesia (inhibits dopamine receptors); Tx: Benadryl

32
Q

Metoclopramide MOA?

A

Dopamine receptor blocker, used to increase gastric/gut motility

33
Q

Ondansetron MOA?

A

Serotonin receptor inhibitor

34
Q

Digoxin MOA?

A

Inhibits Na/K ATPase and increases myocardial calcium; increases atrial contraction rate but slows AV conduction

35
Q

Side effects of digoxin?

A

Decreased blood flow to intestines, has been implicated in causing mesenteric ischemia; hypokalemia, increases sensitivity of heart to digitalis causing arrhythmias/AV block; visual changes (yellow hue), fatigue

36
Q

Adenosine MOA?

A

Transient interruption of the AV node

37
Q

Side effects of procainamide?

A

Lupus-like syndrome, pulmonary fibrosis, torsades (follow drug levels and QT intervals, torsades treated w/ Mg2+)

38
Q

What is the best single agent shown to reduce mortality in pts with CHF?

A

ACE-I

39
Q

When can ACE-I precipitate renal failure?

A

In pts with renal artery stenosis

40
Q

What medication can reduce the risk of MI and a-fib post-op?

A

Beta-blockers

41
Q

Atropine MOA?

A

ACh antagonist; increases heart rate

42
Q

Leuprolide MOA?

A

Analogue of GnRH and LHRH; inhibits release of LH and FSH from pituitary when given continuously (paradoxic effect)

43
Q

Vasopressin MOA?

A

Acts on V-1 receptors found on vascular smooth muscle causing constriction

44
Q

Indomethacin MOA and uses?

A

Inhibits prostaglandin production; used to close PDA in children and used in pts with gout

45
Q

Misoprostol MOA and uses?

A

PGE1 derivative; protective prostaglandin used to prevent PUD

46
Q

Mechanism of ulcer formation in patients on NSAIDs?

A

Inhibits prostaglandin synthesis and leads to decreased mucus and HCO3- secretion and increases acid production

47
Q

Haldol side effect?

A

Extrapyramidal manifestations

48
Q

Symptoms of ASA poisoning?

A

Tinnitus, headaches, nausea, vomiting; 1st respiratory alkalosis, 2nd metabolic acidosis

49
Q

Side effect of gadolinium?

A

Nausea