Equations/Pharm/Biostat

Question 1

Filtration Fraction?

Answer 1

GFR/RPF = Cr Clear/PAH Clear

Question 2

Drugs with zero order kinetics?

Answer 2

“PEAs shaped like zero” Phenytoin, Ethanol, Aspirin

Question 3

Vd?

Answer 3

Vd= Amount of Drug Given/Concentration of Drug in Serum Nb: most of the time Vd will be given in L/Kg therefore you need to multiply by the mass of person

Question 4

Clearance?

Answer 4

Cl=0.7*Vd/half life

Question 5

Loading dose?

Answer 5

Loading Dose=Vd * Conc at steady state

Question 6

Maintenance dose

Answer 6

Maintenance dose=Clearance * conc at steady state

Question 7

Hardy Weinberg: NB: Frequencies in an x-linked rec trait?

Answer 7

p+q=1 p^2 + 2pq + q^2 = 1 Males=q; females q^2

Question 8

Cyp P450 Inhibitors and inducers?

Answer 8

PICCKEGS (cimetidine and cipro)

Protease Inhibitors, INH, Cimetindine AND CIPRO, Ketoconazole, Erythromycin, Grapefruit Juice, Sulfonamides

BCG PQRS (phenytoin/phenobartibtol is inducer)

-Barbiutes, Carbemezepine, Griseofulvin, Phenytoin, Quinidine, Rifampin, St John’s Wart, Crhonic ETOH

Question 9

Confidence interval formula?

Answer 9

CI=Mean+- Z*SEM (Z usually ~2 for 95%) SEM: STDEV/sqrt(sample size)

Question 10

Case Control vs Cohort?

Answer 10

Case control: Group based on disease and look at risk factors: ODDS RATIO

Cohort: Group based on risk factors and look at disease outcome: RELATIVE RISK

Question 11

Cross sectional Study?

Answer 11

Snap shot of population at a particular time. Tells you prevelance, cannot tell you incidence or causality (but can infer some risk factor association with it)

Question 12

Clincal Trial phases?

Answer 12

1) Is it safe?
2) Does it work?
3) Is it better?
4) Survalience for unknown SEs.

Question 13

Bias of a Meta-analysis?

Answer 13

Selection bias based on what studies the examiners decide to inclue/throw out

Question 14

Screen test is good to have a high?

Answer 14

Sensitivity

Question 15

As frequency of disease change what variables change?

Answer 15

PPV and NPV.

Sens and spec do not as these characteristics are inherent to the test

Question 16

Sens

Spec

PPV

NPV

Answer 16

Sens: TP/(TP+FN)

Spec: TN/(TN+FP)

PPV: TP/(TP+FP)

NPV: TN/(TN+FN)

Question 17

Calculating Incidence?

Answer 17

New cases/Population at risk during time period

NB: need to subtract out people with disease from denominator…its people without the disease but at risk to get disease NOT total population

Question 18

Odds ratio used in

Answer 18

Case-control studies

Question 19

Relative risk used in

Answer 19

Cohort studies

Question 20

What is used Case-control studies? What’s the formula?

Answer 20

Odds ratio (“start with disease”):

(a/c)/(b/d)

this also equals: ad/bc

Odds ratio approximates relative risk if the disease prevelance is not very high

Question 21

What is used in Cohort studies? Formula?

Answer 21

Relative risk (“start with risk factor”):

a/(a+b)

c/(c+d)

Question 22

Attributable risk?

Absolute risk reduction?

Answer 22

AR:

a/(a+b) - c/(c+d)

this is Relative risk but differnce btwn the two rather than ratio

ARR:

c/(c+d) - a/(a+b)

Question 23

NNT?

NNH?

Answer 23

1/ARR

1/AR

Question 24

1) Berkson Bias
2) Confounding Bias
3) Pygmalion Effect
4) Hawthorn Effect

Answer 24

1) Looking only at inpatients of hospitals
2) Third variable affecting disease/risk interaction: asbestos miners more likley to smoke (increases lung cancer rates)
3) Self fulfilling prophecy: Dr believes so much in therapy they unconciously bias outcome
4) Measurement bias where people who know they are being watched act differently: washing you hands more cuz you know your in a trial

Question 25

Positive Distribution vs Negative distribution in mean median and mode?

Answer 25

+: Peak is to the left: "ameoba creeping towards the positive end" Mean \> Median \> Mode -: Peak is to the left Mode \> Median \> Mean

Question 26

Single most preventable cause of death in the US?

Answer 26

Smoking.

Question 27

Pathways that use cAMP?

Answer 27

FLAT ChAMP FSH, LH, ACH, TSH, CRH, hCG, ADH (V2), MSH, PTH and calcitonin, GHRH, glucagon

Question 28

Endocrine pathways that use IP3

Answer 28

GOAT HAG GnRH, Oxytocin, ADH (V1), TRH, Histaimine, Angiotensin II, Gastrin

Question 29

Steroid Receptors?

Answer 29

VETTT CAP Vitamin D, Estrogen, Testo, T3, T4 Cotrisol Aldo, P4

Question 30

Drugs with anticholinergic effects that aren't anticholinergics per se?

Answer 30

H1 blockers, TCAs, Typical Neuroleptics. Amantidine

Question 31

Gq GCPR subunit mechanism and ANS receptors using it?

Answer 31

"cue-tsie" Q--\>Ca--\>PLC--\>PKC HAVe 1 M&M H1, A1, V1 (vasopressin), M1, and M3\*\*\* just gotta remember M3 (bladder, eyes, exocrine secretion)

Question 32

Gi subunit mechanism? Receptors?

Answer 32

Gi inhibits AC which decreases cAMP "MAD 2's" M2, alpha2, D2 (dopamine)

Question 33

1) Tyrosine Kinase Receptor? What binds it? 2) JAK STAT pathway?

Answer 33

1) "Growth Factors" Insulin, IGF, FGF, PDGF, EGF Think about tyrosine kinase receptor inhibitors used to stop cancer cuz you want to stop the growth factor signal 2) Prolactin, Immunomodulators (Interleukins), Growth Hormone (NOT PDGF\*\*\*), EPO

Question 34

1. Epi? 2. NE? 3. Isoproterenol? 4. DA? 5. Dutamine? 6. Phenyleprine? 7. Alubterol?

Answer 34

1. B\>A (alpha wins at high doses, **_thus use for septic shock_**) **_EBA_** 2. a1\>a2\>b1 Increases BP but decreases Renal Perfusion **_NAAB (dont use in septic shock cuz A1 agonism causes too much vasoconstriction which decreases CO)_** 3. ONLY BETA **_IBB_** 4. D1=D2\>B\>A **_DADBA_** 1. Low doses: increased GFR and renal excretion (D1/D2) (good for renal's!) 2. High doses increase inotropy (B1) and vasoconstriction (A1) 5. B1\>B2, alpha thus Ionotrophic \> Chronotropic **_DBBA (give in acute Heart failure)_** 1. Stronger inotrope than chronotrope 6. a1\>a2 Vasconstriction **_PAA_** 7. B2\>B1

Question 35

Drugs used for: Anphalyctic shock Cardiogenic shock Septic Shock

Answer 35

Epi Dubatamine NE

Question 36

Drug induced lupus: Antibody? Metabolism type? Why?

Answer 36

Anti-Histone Antibody Acetylation---studies show slow acetylators are more likely to develop drug induced SLE, suggesting the parent drug is more likely to cause the reaction

Question 37

Receptor for: Pupillary Dilation? Uterine Relaxation? Bladder Internal Urethral Contraction?

Answer 37

Alpha 1 Beta 2 Alpha 1

Question 38

ADPKD chromos? ADPKD systemic issues and other manifestations?

Answer 38

1) PKD1 is 16 PKD2 is 4 (4^2=16) 2) Renal failure=uremia, HTN, anemia (no EPO) etc **_"Cysts in Kidneys, Brain (berries), liver, and heart (papillary muscles=mitral valve prolaspe)"_**

Question 39

ARPKD

Answer 39

Infatile presentation. If severe Potter's Sequence. Associated with congenital hepatic fibrosis. Kids that survive have HTN, portal HTN and progressive renal insuf

Question 40

2 Common Lithium SEs?

Answer 40

1) Diabetes Insipidus 2) Hypothyroidism

Question 41

Which AChEI pass thru BBB which does not?

Answer 41

P-hysostigmine P-asses N-eostigmine does N-ot (nor does edrophonium)