Basic pharm Flashcards

(55 cards)

1
Q

Michaelis Menten graph and key variables

A

Velocity vs. substrate, MM = hyperbolic curve

Km = inversely related to enzyme’s affinity for substrate, is equal to [substrate] at 50% Vmax) ie as affinity increases, [substrate] needed to reach 50% decreases!

Vmax = directly proportional to enzyme concentration

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2
Q

Lineweaver-Burk plot and intercept meanings

A

1/V vs. 1/S
used to show relationships of inhibitors

y-intercept = 1/Vmax (therefore, incr. y-intercept = decr. Vmax)
x-intercept = 1/Km (therefore, closer to 0 = incr. Km = decr. affinity)
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3
Q

Inhibitors and their effects on Vmax and Km

A

Competitive, reversible: no change on Vmax, incr. Km
leads to decr. potency of a drug

Comp., irreversible: decr. Vmax, no change on Km
leads to decr. efficacy of a drug

Noncompetitive: decr. Vmax, no change on Km
leads to decr. efficacy

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4
Q

Volume of distribution

give formula for Vd

A
  • for protein-bound drugs, this volume can be affected by liver or renal disease (decr. protein binding = incr. volume)
  • Vd = amount of drug in body / plasma drug concentration
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5
Q

Clearance of a drug

give formula

A

volume of plasma cleared of drug per unit time. IT’S A VOLUME!

CL = rate of elimination / plasma drug concentration = Vd x Ke (elim constant)

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6
Q

Half-life

A

4-5 half-lives to reach steady state

3.3 half-lives to reach 90% steady state

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7
Q

Dosage calculations

Loading dose, maintenance dose

A

Loading dose = Cp x Vd / F
Maintenance = Cp x CL x r / F

F = bioavailability (100 for IV dose)
Cp = target plasma concentration
r = dosage interval (time)
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8
Q

Zero-order elimination

A

constant rate of elimination (no effect of target plasma conc.), therefore linear decrease in conc. with time

aka. capacity dependent

Ex: phenytoin, ethanol, aspirin

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9
Q

First-order elimination

A

rate of elimination is proportional to drug concentration, therefore exponential decrease in conc. with time

aka. flow dependent

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10
Q

Weak acid overdose

A

ex. phenobarbital, methotrexate, ASPIRIN

Get trapped in basic environment (when they are ionized), therefore treat with bicarbonate

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11
Q

Weak base overdose

A

ex. amphetamines

Trapped in acidic environment, therefore treat with ammonium chloride

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12
Q

Drug metabolism Phase 1 (modification)

A

Reduction, oxidation, hydrolysis with cytochrome p450

Yields slightly polar, still-active metabolites

Lost first in old people

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13
Q

Drug metabolism Phase 2 (conjugation)

A

Glucoronidation, Acetylation, Sulfation

Yields very polar, inactive metabolites (renally excreted)

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14
Q

Definition of efficacy

A

maximal effect a drug can produce

represented by Vmax

partial agonists < full agonists

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15
Q

Definition of potency

A

amount of drug needed for a given effect

represented by EC50 (effective concentration)

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16
Q

Competitive antagonist effects

A

Decreased potency

Overcome by increasing concentration of agonist substrate

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17
Q

Noncompetitive antagonist

A

Decreased efficacy

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18
Q

Partial agonist

A

Lowers the maximal effect of the full agonist

Note: potency is an independent variable, though generally, a partial agonist is designed to have a higher potency

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19
Q

Therapeutic index

A

TD50/ED50 = median toxic dose/median effective dose

Safe drugs have higher TI values (means there is more wiggle room between the efficacious dose and possibly going up to the toxic dose)

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20
Q

Nicotinic Ach receptors

A

Ligand-gated Na/K channels

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21
Q

Muscarinic Ach receptors

A

G-protein coupled receptors that act through 2nd messengers

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22
Q

What is special about the sweat glands and adrenal medulla vs. all other autonomic nervous systems organs?

A

They are innervated by the SYMPATHETIC nervous system, but are innervated by CHOLINERGIC (sweat glands have muscarinic receptors, but adrenal medulla has nicotinic)

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23
Q

Give the G-protein class for the appropriate sympathetic receptor

Alpha1
Alpha2
Beta1
Beta2

A

Alpha1: Gq (IP3)
Alpha2: Gi (decr. cAMP)
Beta1: Gs (incr. cAMP)
Beta2: Gs (incr. cAMP)

24
Q

Describe the major functions of the sympathetic receptors

Alpha1
Alpha2
Beta1
Beta2

A

Alpha1: vascular smooth muscle contraction, sphincter contraction, pupillary dilator
Alpha2: decr. symp. outflow
Beta1: incr. heart rate, contractility, incr. renin release
Beta2: vasodilation, bronchodilation, tocolysis

25
Give the G protein class for the parasympathetic receptors
M1: Gq M2: Gi M3: Gq Gq = h1, a1, V1, M1, M3
26
Describe the major functions of the parasympathetic receptors
M1: CNS, enteric nervous system M2: decr. heart rate and contractility of atria M3: incr. exocrine secretions, incr. peristalsis, bladder contraction, close pupil
27
Describe the general roles of dopamine in the body
D1: relaxes renal vascular smooth muscle D2: modulates transmitter release
28
Describe the general roles of histamine in the body
H1: mucus production, allergic response H2: gastric acid production
29
Gq pathway
Receptor --> phospholipase C 1. ) ---> DAG ---> protein kinase C 2. ) ---> IP3 ---> incr. in [Ca] (smooth muscle contraction)
30
Gs pathway Gi opposes this from happening
adenylyl cyclase --> (ATP to cAMP) --> protein kinase A - -> heart [Ca] incr. - -> smooth muscle relaxation
31
Notable cholinergic drugs and specific mechanisms
``` Botulinum: block Ach-granule release AChE inhibitor (-stigmines, donepezil): block breakdown of choline in the synaptic cleft ```
32
Notable noradrenergic drugs and specific mechanisms
Reserpine: block transport of dopamine into granule (for converstion to NE) Amphetamine/ephedrine: promote NE release into cleft Cocaine/TCAs/amphetamine: inhibition of NE re-uptake
33
Direct cholinergic memetics
bethanecol: activates bowel/bladder smooth muscle pilocarpine: stimulate sweat/tears/saliva, glaucoma
34
Indirect Ach agonists, anticholinesterase inhibitors
All increase Ach! donepezil: Alzheimer edrophonium: test for MG neostigmine: urinary retention, MG "phys"ostigmine: "phyxes" atropine overdose (note: crosses CNS barrier) py"rid"ostigmine: gets "rid" of MG
35
Indirect Ach agonist (AChEi) poisoning | Aka Organophosphates
tx: atropine! (ACh antag) DUMBBELSS: diarrhea, urination, miosis, brochospasm, bradycardia, excitation of muscle, lacrimation, sweating, salivation
36
Muscarinic antagonists (block Ach) aka anticholinergics
atropine: mydriasis (dilation) benztropine: parkinson dz (park my benz), dystonia glycopyrrolate: reduce airway secretions ipratropium: COPD, asthma oxybutynin: reduce bladder spasms, overactive bladder scopolamine: motion sickness
37
Atropine toxicity
Hot, Dry, Red, Blind, Mad can cause... - acute angle glaucoma due to mydriasis - urinary retention w/ prostatic hyperplasia - hyperthermia in infants
38
Fish toxins
Pufferfish: tetrodotoxin (binds fast voltage-gated Na, prevent depol) Reef fish: ciguatoxin (opens Na channels, causing depol) Dark-meat fish: histamine build-up (aka scombroid)
39
Lipid-lowering therapies
``` HMG-CoA reductase inhibitors Bile acid resins (cholestyramine) Ezetimibe Fibrates Niacin ```
40
Gastric acid suppresion therapy
histamine inhibitors (octreotide, ECL cell) H2 receptor blockers (ranitidine, parietal cell) PPIs mucus layer enhancers (misoprostol, bismuth) antacids
41
Heparin vs. warfarin
heparin = large, acts in blood, acute onset, PTT, no placenta crossing warfarin = small, acts in liver, long onset, PT/INR, can be teratogenic
42
Cancer chemotherapeutics and the cell cycle
Mitosis: microtubule inhibitors (taxols, vinca alkaloids) G1/G0 inhibs: carmustine, cisplatin S phase: antimetabolites (azathioprine/6-MP, 5-FU, hydroxyurea, MTX) G2 inhib: bleomycin
43
Inflammatory mediators
LTB4 - neutrophil chemotaxis PGI2 - inhibits plt. aggregation (Plt Gathering Inhibitor) Steroids basically block synthesis of arachidonic acid
44
Glaucoma treatment
goal: decr. intraocular pressure (decr. aqueous humor) decr. aq humor synthesis: alpha agonists (via vasoconstriction) epinephrine, b-blockers timolol, acetazolomide incr. aq humor outflow (opening of meshwork): direct/indirect cholinergic agonist (use pilocarpine in emergencies), prostaglandin
45
Opioid analgesics mechanism
open K channels, close Ca channels --> decr. synaptic transmission ``` mu = morphine delta = enkephalin kappa = dynorphin ```
46
Anesthetics
decr. blood solubility = rapid induction and recovery incr. lipid solubility = incr. potency 1/MAC eg. NO. incr. blood/lipid solubility = slow induction, high potency halothane: high lipid/blood solubility = high potency, slow induction
47
Malignant hyperthermia
Caused by inhaled anesthetics and succinylcholine often defect in the sarcoplasmic reticulum ryanodine receptor tx: dantrolene (inhibits Ca flux through ryanodine receptor)
48
Local anesthetics Esters vs. amides variables for rate of analgesia
block activated Na channels by binding to receptors on inner portion of channel (most effective in rapidly firing neurons) ``` Esters = procaine, cocaine Amides = 2 I's in the name (eg. lidocaine, bupivicaine) ``` infected tissue requires more anesthetic small diameter/myelinated fibers affected before large diameter/unmyelinated fibers (size matters more than myelination) lose pain, then temp, then touch
49
Parkinson's drugs
BALSA: increase dopamine and decrease cholinergics ``` Bromocriptine Amantadine Levodopa Selegiline Antimuscarinics ```
50
Diuretics: order of location of action
``` PCT: acetazolomide Thin descending limb: mannitol Thick ascending limb: loop diuretics DCT: thiazides Collecting tubule: K sparing diuretics Medullary CT: ADH antagnonists ```
51
Electrolyte changes with diuretics
acidemia: CA inhibs, K sparing alkalemia: loops, thiazides (volume contraction alkalosis, K loss) urine Ca incr. w/ loop (decr. paracellular reabsorption!) urine Ca decr. w/ thiazides (enhanced Ca reabsorption in DCT)
52
Centrally acting reproductive drugs
Clomiphene - activates GnRH GnRH antagonists GnRH agonists
53
Location of female reproductive drugs
OCPs - ovary Danazol - cytochrome p450c17 (synthesis of androstenedione/testosterone) Anastrozole - block aromatase SERMs - block estrogen reception in sensitive cells
54
Location of male reproductive drugs
Spironolactone - block synthesis of testosterone Finasteride - 5a-reductase Flutamide - blocks androgen-receptor complex
55
Asthma treatment basics
Exposure --> antigen and IgE complex on mast cells --> mediators (leukotrienes, histamine) --> 1.) bronchoconstriction 2.) inflammation Steroids block release of mediators Early response tx: B-agonists, theophylline, muscarinic antagonists Late response tx: steroids, anti-leukotrienes