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Comprehensive Prep > Chapter 7: Medicines and Pharmacology > Flashcards

Chapter 7: Medicines and Pharmacology Flashcards

(56 cards)

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1
Q

Drug admin: do not pass through liver first (no first-pass metabolism)

A

Sublingual and rectal drugs

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2
Q

Drug admin: Skin absorption is based on…

A

lipid solubility through the epidermis

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3
Q

Drug admin: properties for CSF absorption

A

nonionized, lipid-soluble drugs

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4
Q

Largely responsible for binding drugs (PCNs and warfarin 90% bound)

A

Albumin

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5
Q

Why are sulfonamides not used in newborns?

A

Sulfonamides displace unconjugated bilirubin from albumin in newborns

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6
Q

Where are tetracycline and heavy metals stored?

A

bone

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7
Q

Constant amount of drug is eliminated regardless of dose

A

Zero order kinetics

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8
Q

Drug eliminated proportional to dose

A

First order kinetics

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9
Q

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

A

5

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10
Q

Volume of distribution

A

Amount of drug in the body divided by the amount of drug in plasma or blood.

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11
Q

Drugs with a high volume of distribution: extravascular vs intravascular concentrations

A

High volume of distribution: higher concentrations in extravascular compartment (e.g., fat) compared with intravascular concentrations

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12
Q

Fraction of unchanged drug reaching the systemic circulation

A

Bioavailability

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13
Q

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

A

ED-50

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14
Q

Drug level at which death occurs in 50% of patients

A

LD-50

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15
Q

Dose required for effect

A

Potency

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16
Q

Ability to achieve result without untoward effect

A

Efficacy

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17
Q

Drug metabolism: components of Phase 1

A

Demethylation, oxidation, reduction, hydrolysis reactions (mixed function oxidases, requires NADPH/oxygen)

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18
Q

Drug metabolism: components of Phase 2

A

Glucuronic acid (#1) and sulfates attached (forms water-soluble metabolite); usually inactive and ready for excretion.

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19
Q

Entero-hepatic recirculation (eg, cyclosporine)

A

biliary excreted drugs may become deconjugated in intestines with reabsorption, some in active form

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20
Q

Inhibitors of p-450

A

Cimetidine. Isoniazid. Ketoconazole. Erythromycin. Cipro. Flagyl. Allopurinol. Verapamil. Amiodarone. MAOIs. Disfulfiram.

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21
Q

Inducers of p-450

A

Cruciform vegetables. ETOH. Insecticides. Cigarette smoke. Phenobarbital (barbiturates). Dilantin. Theophylline. Warfarin.

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22
Q

Polar drugs

A
  • Ionized
  • Water soluble
  • More likely to be eliminated in unaltered form
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23
Q

Nonpolar drugs

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A
  • Non-ionized
  • Fat soluble
  • More likely metabolized before excretion
24
Q

Colchicine

Study These Flashcards
A

Anti-inflammatory

- Binds tubulin and inhibits migration of WBCs

25
Indomethacin
- NSAID | - Inhibits prostaglandin synthesis (reversible cyclooxygenase inhibitor)
26
Allopurinol
- Xanthine oxidase inhibitor | - Blocks uric acid formation from xanthine
27
Probenecid
Increases renal secretion of uric acid
28
Cholecystramine (lipid-lowering agents)
Binds bile acids in gut, forcing body to resynthesize bile acids from cholesterol, thereby lowering body cholesterol; can bind vitamin K and cause bleeding tendency
29
statins
HMG-CoA Reductase Inhibitors | - side effects: liver dysfunction, rhabdomyolysis
30
Niacin
- Inhibits cholesterol synthesis - Can cause flushing - Tx: ASA
31
Promethazine (Phenergan, antiemetic)
- Inhibits dopamine receptors - SE: tardive dyskinesia - Tx: diphenhydramine (Benadryl)
32
Metoclopramide (Reglan, prokinetic)
- Inhibits dopamine receptors | - Can be used to increase gastric and gut motility
33
Ondansetron (Zofran, antiemetic)
Central-acting serotonin receptor inhibitor
34
Omeprazole
- Proton pump inhibitor | - Blocks H/K ATPase in stomach parietal cells
35
Cimetidine / ranitidine
Histamine H2 receptor blockers | - Decrease acid in stomach
36
Octreotide
Long-acting somatostatin analogue | - Decreases gut secretions
37
Digoxin
- Inhibits Na/K ATPase and increases myocardial calcium - Slows atrial-ventricular conduction - Inotrope - Not cleared with dialysis - SE: Visual changes (yellow hue), fatigue, arrhythmias
38
Why has digoxin been implicated in causing mesenteric ischemia?
Decreases blood flow to intestines
39
Amiodarone
- Good for acute atrial and ventricular arrhythmias | - SE: pulmonary fibrosis w/ prolonged use; can also cause hypo- and hyperthyroidism
40
Used to treat tornadoes de pointes (ventricular tachycardia)
Magnesium
41
Causes transient interruption of the AV node
Adenosine
42
ACE inhibitors | angiotensin-converting enzyme inhibitors
- Best single agent shown to improve survival in patients with CHF - Can prevent CHF after MI - Can prevent progression of renal dysfxn in pts with HTN and DM. - Can precipitate renal failure in patients with renal artery stenosis
43
What increases the sensitivity of the heart to digitalis?
Hypokalemia | - Can precipitate arrhythmias or AV block
44
- May prolong life in patients with severe LV failure | - Reduce risk of MI and atrial fibrillation post
Beta blockers
45
Best single agent shown to improve survival after myocardial infarction
Beta-blockers
46
Atropine
- Acetylcholine antagonist | - Increases heart rate
47
Metyrapone and aminoglutethimide
- Inhibit adrenal steroid synthesis | - Used in patients with adrenocortical CA
48
Leuprolide
- analogue of GnRH and LHRH - Inhibitors release of LH and FSH form pituitary when given continuously (paradoxic effect) - Used in patients with metastatic prostate CA
49
NSAIDs
Inhibits prostaglandin synthesis and leads to decreased mucus and HCO3- secretion and increased acid production (mechanism of ulcer formation)
50
Misoprostol
PGE1 derivative; a protective prostaglandin used to prevent peptic ulcer disease; consider use in patients on chronic NSAIDs
51
Haldol
l- Antipsychotic - Inhibits dopamine receptors - Can cause extrapyramidal manifestations (Tx: benadryl)
52
ASA poisoning
Tinnitus, headaches, nausea, and vomiting.
53
Two manifestations of aspirin poisoning
1st: respiratory alkalosis 2nd: metabolic acidosis
54
MC side effect of gadolinium
Nausea
55
Iodine: - MC side effect? - MC side effect requiring medical treatment?
Iodine: - MC side effect: nausea - MC side effect requiring medical treatment: dyspnea
56
Tx: tylenol overdose
N-acetylcysteine

Comprehensive Prep (45 decks)

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