Exam 1

Question 0

Antifreeze tx

Answer 0

Alcohol IV

Question 1

not after 4 hrs or if
after 30 min since ingestion of a corrosive metal
Hydrocarbon solvents ingested
Coma, stupor, delirium or convultions are present

Answer 1

Lavage

Question 2

Double vision, paralysis

Answer 2

Botox

Question 3

wrist drop

Answer 3

lead

Question 4

RBC stippling

Answer 4

lead

Question 5

anemia and irritable

Answer 5

lead

Question 6

Keizer… ring around cornea

Answer 6

copper

Question 7

jaundice

Answer 7

copper

Question 8

lung cancer

Answer 8

Asbestos

Question 9

cherry red blood

Answer 9

CO

Question 10

almond smell

Answer 10

cyanide

SOB

Question 11

O2 is tx for

Answer 11

cyanide

Question 12

Do not use lavage

Answer 12

Bleaches

Strong acids

Question 13

metabolized by CYP450 to free radicals

Answer 13

CCl4 chloroform Carbon tetrachloride

carcinogenic

Question 14

cirrhosis of liver

Answer 14

Arsenic

Question 15

CO mechanism

Answer 15

greater affinity for Hb than O2
impares ability of Hb to transport O2
Carboxyhemoglobin is CHERRY RED

Question 16

isoniazid is example of

Answer 16

PhII before Ph1

Question 17

Phase 1

Answer 17

Modification of mol thru OXIDATION Rxns
hydroxylation or demethylation (+OH, -CH3)
enzymes attack fx’l groups
can be excreted or to PhII

Question 18

Phase II

Answer 18

Conjugation: adds Ionized, charged group to PhI to make it more water soluble

Question 19

Drugs with toxic metabolites

Answer 19

diazepam - nordiazepam - oxazepam
acetaminophen - N -acetyl-benzo - quinone imine

codein – morphine

Question 20

Cyt P450s

Answer 20

Ph1
microsomal and inducable
oxidation fx (form OH)
acts as HANDLE (OH) for Ph2

Question 21

inducer is ethanol,

substrate tylenol, ethanol

Answer 21

2E1

Question 22

Inducer is smoking and charcoal foods

substrate: tylenol, warfarin

Answer 22

1A2 cyp450

Question 23

inducer” barbituates, St. John’s wort

substrate: tylenol, advil diazepam, lidocaine

Answer 23

All 2… enzymes + 3A4

Question 24

which impairs codeine metabolism

condeine to morphine

Answer 24

2D6

Question 25

which metabolizes and induces by alcohol

Answer 25

2E1

Question 26

which metabolizes > 50% drugs and has high drug interactions?

Answer 26

3A4

Question 27

Glucoronyl transferase is

Answer 27

only Ph2 inducible and microsomal

Question 28

inhibitor: grapefruit juice
sub: tylenol, diazepam, lidocaine

Answer 28

3A4

Question 29

Inhibitor: quinidine
sub: codeine, (oxycodone)

Answer 29

2D6

Question 30

Phase 2 rxns:

Answer 30

conjugate (bind) a protein to a Ph1 drug with handle (OH, SH, NH2)
Most by glucoronidation and UGTs
End result:
lower lipid solubility, make polar and inactive, increase MW
fast elimination

Question 31

conjugation of drug with handle with glucorinic acid

Answer 31

UGT (transferase) catalyzes the tranferring of glucoronic acid to substrate drug
Bilirubin and adrenal conticosteroids are conjugated like this

Question 32

Rule of thumb: the smaller the Vd

Answer 32

The more effective the dialysis bc high plasma [ ], high binding to plasma proteins

Question 33

Higher dose, bioavail, and half life predict

Answer 33

higher Css

Question 34

Higher CL or higher Vd

Answer 34

Lower Css

Question 35

High Vd

Answer 35

High [ ] in body and bound to peripheral tissues

Question 36

Low Vd

Answer 36

High plasma [ ] and binding to plasma proteins

Question 37

Warfarin

Answer 37

92% bound to plasma proteins, 8% free

add drug that displaces warfarin from proteint, increase free warfarine and increase effect

Question 38

example of low Vd and high t1/2

Answer 38

warfarin

Question 39

if increase binding to albumine

Answer 39

accumulates in plasma

Question 40

Vd is

Answer 40

drug in body/drug in plasma

can make assumption ab drug in body by measuring plasma [ ]

Question 41

decreased liver fx

Answer 41

increased bioavail of drug

Question 42

2D6 enz metabolizes what?

Answer 42

condeine to morphine

Question 43

tylenol and warfarin are metabolized by

Answer 43

1A2

Question 44

tylenol and alcohol are metabolized by

Answer 44

2E1

Question 45

Tylenol, DIAZEPAM, advil, lidocaine are met d by

Answer 45

all 2 and 3A4

Question 46

tylenol DIAZEPAM and lidocain met d by

Answer 46

3A4

grapefruit juice

Question 47

codeine is met d into morphine by

Answer 47

2D6