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My step 1 mnemonics > Basic Pharmacology and Public Health > Flashcards

Basic Pharmacology and Public Health Flashcards

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1
Q

Low Volume of distribution

COMPARTMENT & DRUG TYPES

A

Intravascular

Large/charged molecules; plasma protein-bound

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2
Q

Medium Volume of distribution

COMPARTMENT & DRUG TYPES

A

ECF

Small hydrophilic molecules

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3
Q

High Volume of distribution

COMPARTMENT & DRUG TYPES

A

All tissues including fat

Small lipophilic molecules, especially if bound to tissue protein

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4
Q

Types of drug interactions

Additive - EXAMPLE

A

Aspirin and acetaminophen

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5
Q

Types of drug interactions

Permissive - EXAMPLE

A

Cortisol on catecholamine responsiveness

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6
Q

Types of drug interactions

Synergistic - EXAMPLE

A

Clopidogrel with aspirin

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7
Q

Types of drug interactions

Tachyphylactic - EXAMPLE

A

An acute decrease in response to a drug after initial/repeated administration

P - phenylephrine
L - LSD
a
N - Nitrates
N - niacin
e
M' - MDMA
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8
Q

Drug metabolism - Phase I

A

Reduction, Oxidation, Hydrolysis with
cytochrome P-450

Geriatric patients lose phase I first.

R-OH

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9
Q

Drug metabolism - Phase II

A

Conjugation (Methylation, Glucuronidation, Acetylation, Sulfation) usually yields very polar, inactive metabolites (renally excreted).

conjugating MAGS

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10
Q

Therapeutic index

A

TITE: Therapeutic Index = TD50/ED50·

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11
Q

Drugs with lower TI values frequently require monitoring, for example…

A

Warfarin, Theophylline, Digoxin, Antiepileptic drugs, Lithium;

Warning! These Drugs Are Lethal!

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12
Q

Anticholinesterase poisoning - Muscarinic effects:

A

Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Emesis, Lacrimation, Sweating, Salivation.

DUMBBELSS.
Reversed by atropine, a competitive inhibitor. Atropine can cross BBB to relieve CNS symptoms.

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13
Q

Anticholinesterase poisoning - Nicotinic effects

A

Neuromuscular blockade (a mechanism similar to succinylcholine). Reversed by pralidoxime, regenerates AChE if given early.

Pralidoxime (quaternary amine) does not readily cross BBB.

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14
Q

Anticholinesterase poisoning - CNS effects

A

Respiratory depression, lethargy, seizures, coma.

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15
Q

Atropine - ADVERSE EFFECTS

A 
Side effects:
Hot as a hare
Dry as a bone
Red as a beet
Blind as a bat
Mad as a hatter
Full as a flask
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16
Q

Albuterol, salmeterol,terbutaline - ACTION

A

beta2 >beta1

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17
Q

Dobutamine- ACTION

A

beta1 > beta2, alfa

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18
Q

Dopamine- ACTION

A

D1 = D2 >beta > alfa

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19
Q

Epinephrine- ACTION

A

beta > a

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20
Q

Fenoldopam- ACTION

A

D1

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21
Q

lsoproterenol- ACTION

A

betaI = beta2

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22
Q

Midodrine- ACTION

A

a1

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23
Q

Mirabegron- ACTION

A

beta 3

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24
Q

Norepinephrine- ACTION

Study These Flashcards
A

alfa1 > alfa2 >beta1

25
Phenylephrine- ACTION
a1 > a2
26
Nebivolol ACTIONS
combines cardiac-selective beta 1-adrenergic blockade with stimulation of beta 3 receptors (activate nitric oxide synthase in the vasculature and dec. SVR) NebivOlol increases NO
27
Beers criteria Examples include:
* a -blockers (risk of hypotension) * Anticholinergics, antidepressants, antihistamines, opioids (risk of delirium, sedation, falls, constipation, urinary retention) * Benzodiazepines (risk of delirium, sedation, falls) * NSAIDs (risk of GI bleeding, especially with concomitant anticoagulation) * PPIs (risk of C difficile infection) A-alfa blockers B - BNZ C - antiCholinergics D - antiDepressants. ``` P - PPI H - antiHistamins O - Opioids N - NSAIDs e ```
28
Specific toxicity treatments - Acetaminophen
N-acetylcysteine (replenishes glutathione)
29
Specific toxicity treatments - AChE inhibitors, organophosphates
Atropine> pralidoxime
30
Specific toxicity treatments - Antimuscarinic, anticholinergic agents
Physostigmine, control hyperthermia
31
Specific toxicity treatments - Benzodiazepines
Flumazenil
32
Specific toxicity treatments - beta-blockers
Atropine, glucagon, saline | GAS
33
Specific toxicity treatments - Carbon monoxide
100% O2, hyperbaric O2
34
Specific toxicity treatments - Copper
penicillamine, trientine
35
Specific toxicity treatments - Cyanide
Nitrite + thiosulfate, hydroxocobalamin | THiN
36
Specific toxicity treatments - Digitalis (digoxin)
Digoxin-specific antibody fragments
37
Specific toxicity treatments - Heparin
Protamine sulfate
38
Specific toxicity treatments - Iron
Deferoxamine, deferasirox, deferiprone
39
Specific toxicity treatments - Methanol, ethylene glycol (antifreeze)
Fomepizole > ethanol, dialysis
40
Specific toxicity treatments - Methemoglobin
Methylene blue, vitamin C (reducing agent)
41
Specific toxicity treatments - OpiOids
NalOxOne
42
Specific toxicity treatments - Salicylates
NaHCO3 (alkalinize urine), dialysis
43
Specific toxicity treatments - TCAs
NaHCO3 (stabilizes cardiac cell membrane)
44
Specific toxicity treatments - Warfarin
``` Vitamin K (delayed effect), PCC/FFP (immediate effect) ```
45
Specific toxicity treatments - Dimercaprol, succimer TREAT
Lead Arsenic Mercury LAMe
46
Specific toxicity treatments - Lead
Calcium disodium EDTA, Dimercaprol, succimer, penicillamine
47
Cytochrome P-450 interactions - Substrates
Warfarin Anti-epileptics Theophylline OCPs War Against The OCPs
48
Cytochrome P-450 interactions - Inducers
``` Modafinil Chronic alcohol use St. John's wort Phenytoin Phenobarbital Nevi rapine Rifampin Griseofulvin Carbamazepine ``` Most chronic alcoholics Steal Phen-Phen and Never Refuse Creasy Carbs
49
Cytochrome P-450 interactions - Inhibitors
``` Sodium valproate lsoniazid Cimetidine Ketoconazole Fluconazole Acute alcohol abuse Chloramphenicol Erythromycin/clarithromycin Sulfonamides Ciprofloxacin Omeprazole Metronidazole Amiodarone Grapefruit juice ``` SICKFACES.COM (when I Am drinking Grapefruit juice)
50
-umab ending means
hUman monoclonal Ab
51
-zumab ending means
hUmaniZed mouse monoclonal Ab
52
-ximab ending means
CHImeric human-mouse monoclonal Ab
53
Informed consent
``` A process (not just a document/signature) that requires: • Disclosure • Understanding • Capacity • Voluntariness ``` DUC-V
54
Exceptions to informed consent
* Waiver * Incompetent (Legally) * Privilege (Therapeutic) * Emergency situation WIPE
55
Decision-making capacity Components:
* Goals - Decision is consistent with the patient's Values and Goals * Informed - Patient is Informed (knows and understands) * Expression - Patient Expresses a choice * Mental status/Mood - The decision is not a result of altered Mental status (eg, delirium, psychosis, intoxication), Mood disorder * Stable- Decision remains Stable over time * Age - Patient is 18 years of age (or older) or otherwise legally emancipated GIEMSA
56
Advance directives
Written advance directive Oral advance directive Do not resuscitate order Medical power of attorney WOD-power
57
Changes in the elderly
R- recomposition (inc. fat, dec. muscle) E - ejaculation/erection (slower, longer RP) V - vaginal shortening, thinning, drying. I - immune response dec. S - suicide rate inc. I - intelligence does not change. O - organ function dec. (GI, renal, pulmonary) n -nothing S - Sleep patterns: dec. REM and slow-wave sleep; inc. sleep onset latency; inc. early awakenings. S - sensory (vision and hearing dec.)
58
Confidentiality - General principles for exceptions to confidentiality:
* Potential physical harm to others is serious and imminent * Alternative means to warn or protect those at risk is not possible * Self-harm is likely * Steps can be taken to prevent harm
59
Confidentiality - Examples of exceptions
* Suicidal/homicidal patients * Abuse (children, elderly, and/or prisoners) * Victim - Duty to protect: State-specific laws that sometimes allow the physician to inform or somehow protect potential Victim from harm. * Epileptic patients and other impaired automobile drivers. * Diseases (Reportable) The physician's good judgment SAVED the day

My step 1 mnemonics (19 decks)

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