Pharm

Question 1

Michaelis menten constant (Km) =

Answer 1

[S] at 1/2 Vmax

Question 2

Km relationship to affinity of enzyme for substrate

Answer 2

inverse - high affinity is low Km

Question 3

Lineweaver-Burk plot - what does it show

Answer 3

reciprocal plot of Michaelis Menten curve (1/V vs 1/[S])

Question 4

(non)competitive inhibitors - effects on efficacy vs potency

Answer 4

competitive dec potency

noncompetitive dec efficacy

Question 5

volume of distribution eqn

Answer 5

= amt of drug in body / plasma drug conc

it is the amt of volume needed to contain the drug at the observed conc

Question 6

how many half lives to reach steady state drug conc

Answer 6

4-5 half lives

Question 7

eqn to calc half life

Answer 7

= 0.7 * Vd / Cl

Cl = clearance

Question 8

eqns for loading and maintenance doses

Answer 8

loading = Cp x Vd/F
maintenance = Cp x CL/F

F is bioavailability

Question 9

3 drugs eliminated by zero order kinetics

Answer 9

phenytoin, ETOH, aspirin

PEA

Question 10

phase 1 vs 2 of drug metabolism

Answer 10

1 - reduction, oxidation, hydrolysis by CYP450. Product still usually active. Geriatic pts lose this first

2 - conjugation (glucuronidation, acetylation, sulfation). product not usually active and ready to be excreted

Question 11

G protein classes of SYNS, PSNS, DA, histamine, and vasopressin receptors

Answer 11

QISS and QIQ till you're SIQ of SQS
alpha 1 - Q
alpha 2 - I
beta 1 - S
beta 2 - S
M1 - Q
M2 - I
M3 - Q
D1 - S
D2 - I
H1 - Q
H2 - S
V1 - Q
V2 - S

Question 12

alpha 2 action

Answer 12

dec symp outflow
dec insulin release, lipolysis
inc platelet aggregation

Question 13

M1 and M2 actions

Answer 13

M1 - CNS, enteric NS

M2 - dec HR and contractility

Question 14

D1 vs D2 action

Answer 14

D1 - relax renal vascular smooth muscle

D2 - NT release, esp in brain

Question 15

V1 vs V2 action

Answer 15

V1 - inc vascular smooth muscle contraction

V2 - ADH action in kidneys

Question 16

bethanecol - mech use

Answer 16

direct cholinomimetic

used for ileus and urinary retention - bowel and bladder

Question 17

carbachol - mech use

Answer 17

direct cholinomimetic

glaucoma, pupillary contraction, relief of IOP

Question 18

pilocarpine - mech use

Answer 18

direct cholinomimetic

stimulates secrections, glaucoma

Question 19

methacholine - mech use

Answer 19

direct cholinomimetic

challenge test for asthma dx

Question 20

neostigmine - mech use

Answer 20

indirect cholinergic agonist

ileus, urinary retention, myasthenia gravis, reversal of NMJ blockades

Question 21

pyridostigmine - mech use

Answer 21

indirect cholinergic agonist
myasthenia gravis (long acting) - non CNS penetrating

Question 22

edrophonium - mech use

Answer 22

indirect cholinergic agonist

dx of myasthenia gravis (very short acting)

Question 23

physostigmine - mech use

Answer 23

indirect cholinergic agonist

anticholinergic toxicity - crosses BBB

Question 24

donepezil - mech use

Answer 24

indirect cholinergic agonist

Alzheimer’s dz

Question 25

cholinesterase inhibitor poisoning - sx and tx

Answer 25

DUMBBELSS diarrhea, urination, miosis, bronchospasm, bradycardia, excitation of skeletal muscle & CNS, lacrimation, sweating, salivation atropine + pralidoxime

Question 26

atropine, homatropine, and tropicamide - mech, use

Answer 26

muscarinic antagonists | eye - mydriasis, cyclopegia

Question 27

benztropine - mech use

Answer 27

muscarinic antagonist | Parkinson's dz

Question 28

ipratropium, tiotropium - mech use

Answer 28

muscarinic antagonist | COPD, asthma

Question 29

oxybutynin - mech use

Answer 29

muscarinic antagonist | reduce urinary urgency and bladder spasms

Question 30

glycopyrrolate - mech use

Answer 30

muscarinic antagonist | reduce airway secretions preop

Question 31

receptors affected by epi, NE, and isoproterenol

Answer 31

epi - alpha 1, 2, beta 1, 2 (all strongly) NE - alphas strongly, beta 1 weaker isoproterenol - only betas

Question 32

order that DA affects receptors based on inc dose

Answer 32

low dose - D1 med dose - add betas high dose - add alphas

Question 33

phenylephrine affects what receptors?

Answer 33

alphas

Question 34

ritodrine - mech, use

Answer 34

beta 2 agonist | reduces premature uterine contractions

Question 35

how do amphetamines and cocaine work?

Answer 35

both indirect sympathomimetics amphetamines - releases stored catecholamines cocaine - reuptake inhibitor

Question 36

NE vs isoproterenol effects of BP / HR

Answer 36

NE - more alpha effect > vasoconstriction > inc MAP > reflex brady isoproterenol - only beta effect > vasodilation > dec MAP > inc HR through reflex and beta 1

Question 37

clonidine mech

Answer 37

alpha 2 agonist

Question 38

phenoxybenzamine and phentolamine - mechs, uses

Answer 38

both alpha blockers, phenoxy is irreversible and phento is reversible phenoxy - pheo phento - MAO inhib pts who eat tyramine containing foods

Question 39

-osin drugs - mech, use

Answer 39

alpha 1 blockers | HTN, BPH

Question 40

tox of beta blockers

Answer 40

impotence, exacerbation of asthma, CV adverse effects - brady, AV block, CHF; CNS - seizures, sedation; use w/ caution in diabetics b/c dec insulin release

Question 41

beta 1 selective beta blockers

Answer 41

A BEAM - acebutolol, betaxolol, esmolol, atenolol, metoprolol

Question 42

partial beta agonist drugs

Answer 42

pindolol and acebutolol

Question 43

drug causing gray baby syndrome

Answer 43

chloramphenicol

Question 44

drugs causing hemolysis in G6PD def (6)

Answer 44

INH, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin

Question 45

causes of drug induced lupus (4)

Answer 45

hydralazine, INH, procainamide, phenytoin

Question 46

cinchonism caused by

Answer 46

quinidine, quinine

Question 47

6 drugs causing seizures

Answer 47

INH, bupropion, imipenem, tramadol, enflurane, metoclopramide

Question 48

-triptan class

Answer 48

5HT agonists for migraines

Question 49

-zolam class

Answer 49

benzos (also -azepam)