Pharmacology

Question 1

What is pharmacokinetics?

Answer 1

Effects of body on drug (absorption, distribution, metabolism, excretion)

Question 2

What is dosing rate equation?

Answer 2

Dosing rate = Css x CL

Question 3

What is loading dose?

Answer 3

Loading dose = (Css)(Vd)/F

Question 4

What is maintenance dose?

Answer 4

Maintenance dose = (Css)(CL)(dosing interval)/F

Question 5

Which drugs have zero order elimination?

Answer 5

Phenytoin, Ethanol, Aspirin

Question 6

How do you eliminate salicylates?

Answer 6

Make urine basic (remember salicylate is salicylic acid)

Question 7

How do you eliminate amphetamines?

Answer 7

Acidify urine

Question 8

What does alpha1 do?

Answer 8

Increases vasoconstriction, mydriasis (pupillary dilator contraction), sphincter contraction

Question 9

What does alpha2 do?

Answer 9

Decreases sympathetic output, renin, lipolysis. Increases platelet aggregation

Question 10

What does beta1 do?

Answer 10

Increases HR, contractility, renin, lipolysis

Question 11

What does beta2 do?

Answer 11

Decreases uterine contraction

Increases vasodilation, bronchodilation, HR, contractility, lipolysis, insulin, aqueous humor, ciliary muscle relaxation

Question 12

Which parasympathetic receptor does ENS?

Answer 12

M1

Question 13

Which parasympathetic receptor increases gut peristalsis?

Answer 13

M3

Question 14

What do you use to treat postoperative or neurogenic ileus?

Answer 14

Bethanechol or neostigmine

Question 15

What are the antimuscarinics used for parkinsons?

Answer 15

Triphenhexidyl and Benztropine

Question 16

What is scopolamine?

Answer 16

Antimuscarinic for motion sickness

Question 17

What is an antimuscarinic used for COPD, asthma?

Answer 17

Ipratropium, Tiotropium

Question 18

What is glycopyrrolate?

Answer 18

Antimuscarinic used parenterally to reduce airway secretions preop and orally for drooling and peptic ulcer

Question 19

What do you use for evaluation of tachyarrhythmias?

Answer 19

Isoproterenol

Question 20

What is terbutaline used for?

Answer 20

Premature uterine contractions

Question 21

What do you never give to cocaine users?

Answer 21

Beta blockers due to unopposed alpha1 activation

Question 22

What do you give to pregnant women for HTN?

Answer 22

Methyldopa, Hydralazine

Question 23

Which adrenergic agonist would you use for opiod withdrawal?

Answer 23

Clonidine (alpha-2 agonist)

Question 24

What do you give to people who use MAOI but eat tyramine containing foods?

Answer 24

Phentolamine because it causes a hypertensive crisis

Question 25

Which beta blocker do you use for glaucoma?

Answer 25

Timolol because it blocks beta2 effect of increased aqueous humor production

Question 26

What is nebivolol?

Answer 26

Beta1 antagonist and beta3 agonist (activates NO synthase)

Question 27

What do you give for tPA, streptokinase, urokinase toxicity?

Answer 27

Aminocaproic acid

Question 28

What do you give for copper poisoning?

Answer 28

Pencillamine

Question 29

What is DRESS syndrome?

Answer 29

Fever, lymphadenopathy, skin rash, eosinophilia, internal organ dysfunction after exposure to carbamazepine, phenotyoin, sulfonamides, allopurinol, antibiotics

Question 30

What drugs cause osteoporosis due to toxicity?

Answer 30

Heparin

Question 31

What is demeclocycline?

Answer 31

ADH antagonist used for SIADH

Question 32

What is etanercept?

Answer 32

Decoy receptor (soluble TNF linked to Fc portion of IgG)

Question 33

What should you consider when thinking of Vd?

Answer 33

Think of normal distributions of fluid in the body (ie total is 41, how much is extracellular vs intra) and whether the drug can cross is lipophilic or small etc.

Question 34

How to antiseptic alcohols work?

Answer 34

Disorganize the lipids in membrane and denature proteins

Question 35

How does salicylate poisoning change acid base?

Answer 35

Mixed respiratory alkalosis and high anion gap metabolic acidosis; normal pH

Question 36

What are the side effects of MTX?

Answer 36

Aphthous ulcers, hepatotoxicity pancytopenia, pulmonary fibrosis, megalobastic anemia

Question 37

How does Maraviroc work?

Answer 37

CCR5 receptor antagonist so prevents gp120 from attaching

Question 38

What are the side effects of fluoroquinolones?

Answer 38

Tendon rupture, arthropathy, photoxicity in younger children

Question 39

How do salicylates cause respiratory alkalosis?

Answer 39

Centrally mediating hyperventilation and hyperpnea

Question 40

What are the side effects of Sirolimus?

Answer 40

Hyperlipidemia, atrial fibrillation, HF, interstitial pneumonitis, hypovolemia, palpitations, no neurotoxicity or nephrotoxicity

Question 41

What are the side effects of chloramphenicol?

Answer 41

Grey baby and aplastic anemia

Question 42

How does TMP-SMX affect warfarin?

Answer 42

Inhibits its metabolism

Question 43

What is B. fragilis treated with?

Answer 43

Piperacilin- Tazobactam

Question 44

What drugs have ototoxicity/nephrotoxicity?

Answer 44

Salicylates, aminoglycosides, cisplatin, furosemide

Question 45

What antimicrobial causes hypokalemia and hypomagnesia?

Answer 45

Amphotericin B

Question 46

What is isoniazid simialr to?

Answer 46

PLP (Vit B6) - decreases it

Question 47

What is the mechanism of resistance against aminoglycosides?

Answer 47

Acetylation, phosphorylation, adenylaton of the drug

Question 48

What do you use for arsenic and lead poisoning?

Answer 48

Dimercaprol

Question 49

What can you use for lead poisoning?

Answer 49

EDTA, Dimercaprol

Question 50

Which drug has really fat redistribution to skeletal muscle?

Answer 50

Thiopental (short acting barbiturate anesthetic)

Question 51

Does Tamoxifen or Raloxifene have increased risk for endometrial cancer?

Answer 51

Tamoxifen

Question 52

How do you treat cisplatin toxicity?

Answer 52

Amifostine or chloride diuresis

Question 53

What does it mean when anesthetics have large arteriovenous gradient?

Answer 53

High tissue solubility and slower onset of action

Question 54

Which of the adrenergic receptors does pupillary dilation?

Answer 54

Alpha1

Question 55

Which of the adrenergic receptors does increased humor production and ciliary muscle relaxation?

Answer 55

Beta2

Question 56

Which of the adrenergic receptors does decreased uterine tone?

Answer 56

Beta2

Question 57

What does caspofungin do?

Answer 57

Inhibit cell wall synthesis

Question 58

What do the conazoles do?

Answer 58

Inhibit CYP450 enzyme makes ergosterol

Question 59

What is the side effect of cylophosphamide and what is its antidote?

Answer 59

Hemorrhagic cystitis, Mesna

Question 60

What is a major side effect of protease inhibitors?

Answer 60

Redistribution of fat that resembles Cushing's; lipodystrophy

Question 61

What is a side effect of Linezolid?

Answer 61

Sertonin syndrome

Question 62

What is a major side effect of acyclovir?

Answer 62

Nephrotoxicity (crystalline nephropathy) --> must rehydrate

Question 63

What must you do before you start isoretinoin?

Answer 63

Pregnancy test

Question 64

Which drug causes hypocalcemia and hypomagnesia?

Answer 64

Foscarnet

Question 65

Is phenoxybenzamine reversible?

Answer 65

No phentolamine is

Question 66

What properties do you need for pure hepatic clearance?

Answer 66

High lipophilicity so it can cross hepatocyte membrane and high Vd

Question 67

What do you use to treat essential tremor?

Answer 67

Primidone (also an anticonvulsant)

Question 68

How does ribavirin work?

Answer 68

Inhibits viral genome duplication

Question 69

How do NRTI work?

Answer 69

Inhibit reverse transcriptase and incorporate into viral DNA as thymidine analog that prevents phosphodiesterase bond and chain elongation

Question 70

What is naficillin used for?

Answer 70

Soft tissue infections by S. aureus

Question 71

How do you calculate first order half life?

Answer 71

Half of the REMAINING drug is eliminated

Question 72

How do muscarinic agonists cause vasodilation?

Answer 72

Bind to endothelial cells and cause release of NO

Question 73

How does dobutamine affect the heart?

Answer 73

Increases contractility and weakly increases HR --> increase myocardial oxyen demand

Question 74

What is zero order kinetics?

Answer 74

Constant amount metabolized

Question 75

What is first order kinetics?

Answer 75

Constant proportion metabolized

Question 76

When do you use fidaxomicin?

Answer 76

For recurrent C. diff; It is bactericidal (metronidazole not good for recurrent)

Question 77

Which one crosses BBB, neo or physostigmine?

Answer 77

Physostigmine

Question 78

What is Dantrolene?

Answer 78

It inhibits ryanodine receptor from releasing Ca into cytoplasm

Question 79

What is the major determinant of bioavailability of oral drugs that accounts for differences in plasma drug concentrations via other routes?

Answer 79

Liver blood flow: oral drugs undergo first pass metabolism by the liver while other routes don't.

Question 80

What drug inhibits penicillin secretion?

Answer 80

Probenecid

Question 81

If warfarin and TMP-SMX given together, what should the dosage of warfarin be?

Answer 81

Lower than normal because sulfonamides are CYP inhibitors

Question 82

What are the inhibitors of CYP?

Answer 82

Alochol abuse, gemfibrozil, ciprofloxacin, isoniazid, quinidine, amiodarone, ketoconazole, macrolides, sulfondamides, cimetidine, ritonavir

Question 83

Which drug used for CMV retinitis treatment causes granulocytopenia?

Answer 83

Ganciclovir Remember Foscarnet causes nephrotoxicity (hypocalcemia, hypomagnesia)

Question 84

What drug can you not take with antacids?

Answer 84

Fluoroquinolones, tetracyclines Can't take tetracyclines with milk or iron containing preps either

Question 85

What do you give with Cidofovir to decrease its nephrotoxicity?

Answer 85

Probenecid and IV saline

Question 86

What can you give with penicillin to inhibit its secretion in the kidney?

Answer 86

Probenecid

Question 87

What is fenoldopam?

Answer 87

D1 agonist used in hypertensive emergencies (decreases BP and increases natriuresis

Question 88

What is the toxicity of pyrazinamide?

Answer 88

Hepatotoxicity, hyperuricemia

Question 89

What is the toxicity of ribavirin?

Answer 89

Hemolytic anemia, severe teratogen