Pharmacology Cameron McCloskey Flashcards

Question

How can half life be shortened?

Answer 1

If C_l is **increase** Opposite relationship

Answer 2

This describes drugs that are eliminated at a constant rate, regardless of their concentration An increase in drug concentration will have no effect on the rate of elimination (at very low concentrations some drugs may initially function at first order kinetics because concentration is the limiting factor)

Answer 3

The enzyme that breaks them down has a Km that is lower than the concentration of the drug in the body

Answer 4

A group of cells at which a synpase is present

Answer 5

It is innervated by a preganglionic neurone Acetylcholine is released The adrenal gland acts as the postganglionic neurone, by releasing adrenaline

Answer 6

The sympathetic chain (thoracolumbar outflow) Between the levels of T1 and L2

Answer 7

* Cranial nerves III, VII, IX and X * Cranio-sacral outflow * Thoraco-lumbar outflow * Sacral spinal nerves

Answer 8

It is reabsorbed

Answer 9

Broken down and re-synthesised

Answer 10

* The action potential causes volatge gated calcium ion channels to open allowing for calcium influx into the preganglionic neurone * Acetylcholine is released into the synaptic cleft * Acetylcholine bins to receptors (nicotinic) on the postsynaptic neurone and ligand gated ions channels open * The postsynaptic neurone becomes depolarised and calcium ions enter via voltage gated ion channels * Noradrenaline is released at the effector site * Noradrenaline activates G-protein coupled adrenoceptors

Answer 11

* Acetylcholine is released at effector sites * Acetylcholine activates muscarinic acetylcholine receptors on the target cell instead of nicotinic receptors - this is a slower process

Answer 12

Ligand gated channels

Answer 13

Guanine nucleotide binding protein It is a **peripheral membrane protein** with 3 subunits, alpha, beta and gamma It contains a binding site for GTP/GDP * Heterotrimeric G proteins (peripheral proteins) conduct signals from membrane receptors (integral proteins) to regulatory proteins localized to various cellular compartments

Answer 14

* When the receptor is bound, the G-proteins couples with the receptor * GDP dissociates from the G-protein (bound in inactive state) and will bind to the alpha subunit * The alpha subunit then combines with the effector altering its activity * The receptor and effector are not linked so the signal can still be exerted even after the agonist dissociates * The signal stops when the alpha subunit hydrolyses GTP releasing energy to rembine to subunits and cause dissociation from the effector

Answer 15

Up to 5 different glycoprotein subunits They form a transmembrane channel that allows conduction of cations

Answer 16

* Skeletal ((α1)₂βγε) * Ganglionic (α3β4)

Answer 17

* α4β2 * α7

Answer 18

1. Uptake of choline *via* transporter 2. ACh synthesised*via* choline acetyltransferase (CAT) – choline combines with acetyl CoA provided by mitochondria 3. ACh packaged into vesicles 4. Depolarization by action potential – must be present for exocytosis 5. Ca²⁺ influx through voltage-activated Ca²⁺ channels – must occur for exocytosis 6. Ca²⁺- induced release of ACh (exocytosis) 7. Activation of ACh receptors (nicotinic or muscarinic) causing cellular response 8. Degradation of ACh to choline and acetate by acetylcholinesterase (AChE) – terminates transmission 9. Reuptake and reuse of choline

Answer 19

* Nicotinic (ligand gated receptors) * Muscarinic (G-protein coupled receptors)

Answer 20

* M1 – signals to specific G-protein (Gq) which stimulates phospholipase C which causes increased acid secretion in the stomach. * M2 – signal to specific G-protein (Gi) which stimulates inhibition of adenylyl cyclase which opens K+ channel causing decreased heart rate. * M3 – signals to specific G-protein (Gq) which stimulates phospholipase C production which causes increased secretion of saliva or contraction of visceral smooth muscle.

Answer 21

1. Synthesis of NA (multiple steps) – L-Tyrosine is converted through a variety of steps to noradrenaline 2. Storage of NA by transporter (concentrates) – into vesicles 3. Depolarization by action potential 4. Ca²⁺ influx through voltage-activated Ca²⁺ channels 5. Ca²⁺-induced release of NA - exocytosis 6. Activation of adrenoceptor (receptors for noradrenaline) subtypes causing cellular response (tissue dependent) 7. Reuptake of NA by transporters uptake 1 (U1) or uptake 2 (U2) 8. Metabolism of NA by monoamine oxidase (MAO) and catechol-*O*-methyltransferase (COMT)

Answer 22

* B1 – stimulates through Gs stimulating adenylyl cyclase increasing heart rate and force * B2 – stimulates through Gs stimulating adenylyl cyclase causing relaxation bronchial and vascular * a1 – stimulates through Gq stimulating phospholipase C causing contraction of vascular smooth muscle * a2 – stimulates through Gi stimulating inhibition of adenylyl cyclase causing inhibition of NA

Answer 23

* Pre-synaptic auto-receptors are either muscarinic or G-protein coupled (based on type of synapse) * Instead of being present exclusively on the post synaptic neurone, they also occur on the pre-synaptic neurone * This leads to the control of further neurotransmitter release by means of a negative feedback loop. * When stimulated, the pre-synaptic muscarinic receptor for acetylcholine, causes the reduction of calcium influx into the pre-synaptic terminal through calcium channels.

Answer 24

An inactive precursor of a drug

Answer 25

To increase polarity and add functional groups increasing chance of excretion

Answer 26

* Bile * Sweat * Breast milk * Urine

Answer 27

Cytochrome P450 monooxygenases

Answer 28

1. Metabolism 2. Excretion

Answer 29

The pH at which 50% of the drug is ionised and 50% is not

Answer 30

The theoretical volume necessary to contain the total amount of drug at the same concentration that it is observed in the blood plasma

Answer 31

opposite relationship

Answer 32

signmoidal curve

Answer 33

ligand concertation and proportion of receptors occupied

Answer 34

Affinity افانادي and efficacy افاكسي

Answer 35

its the expression of the activity of a drug, in terms of the concentration or amount needed to produce an effect such as EC50 **Note** : _it does not require 100% of the receptors in the tissue to be occupied_

Answer 36

its an agonist which bind to **nicotinic acetylcholine receptor** ion channel, imitate a confirmational change in receptor causing the ion channels to open allowing Na+ to rapidly flow into the cell and begin biological response, to stimulate sympathetic reaction

Answer 37

**The lower the EC₅₀, the less the concentration of a drug is required to produce 50% of maximum effect and the higher the potency**.

Answer 38

The ‘antagonist’ reduces the concentration of the active drug at its site of action (e.g., phenobarbitone increases hepatic metabolism of the anticoagulant drug warfarin)

Answer 39

the antagonist combines in solution directly with the chemical being antagonised (e.g., chelating agents, used to treat lead poisoning, bind to heavy metals and form a less toxic chelate).

Answer 40

Two agonists that produce opposing physiological actions and cancel each other out. Each drug acts through its own receptors (e.g., adrenaline relaxes bronchial smooth muscle reducing the bronchoconstriction of histamine)

Answer 41

Separate glycoprotein subunits forming a central, ion conducting channel

Answer 42

Rapid change in the permeability of membrane to certain ions They can rapidly alter membrane potential

Answer 43

1. ⍺ subunit acts as an enzyme - hydrolyses GTP to GDP and Pi (signal is now off) 2. ⍺ subunit recombines with β𝛾 subunit

Answer 44

* Can affect synaptic transmission - speed up, slow down or block transmission * **Affect the receptors’ affinity**

Answer 45

After attachment to a receptor site the drug will either initiate act as agonist or prevent a response by acting as antagonist

Answer 46

* involved in growth and metabolism. * Hydrophilic protein mediators * Hour timescale * Example - insulin

Answer 47

* They are bound by steroid hormones or chemically similar analogues. That is because the steroids can cross the plasma membrane (because they are lipophilic) * activate these receptors leading to changes in gene transcription. * The time course for these actions are hours (or longer) compared to ligand-gated ion channels or G-protein coupled receptors.

Answer 48

The enteric nervous system (ENS) is a web of sensory neurons, motor neurons, and interneurons **embedded in the wall of the gastrointesinal system, stretching from the lower third of the esophagus right through to the rectum**.

Answer 49

False ## Footnote **⍺ subunit and β𝛾 dimer are both signaling units**

Answer 50

Absorption Process by which a drug enters the body from its site of administration Distribution Process by which drug leaves circulation and enters tissues perfused by blood Metabolism Process by which tissue enzymes catalyse chemical conversion of a drug to a more polar form that is more readily excreted from the body Excretion Process that removes the drug from the body Absorption Distribution Metabolism Excretion

Answer 51

pKa of the drug and the local pH

Answer 52

pH-pKa= log (A-/AH) = acid Strong acid

Answer 53

Determine how active a drug may be in the body

Answer 54

Vd= dose/plasma concentration Volume of distribution : **is the theoretical volume necessary to contain the total amount of an administered drug at the same concentration that is observed in the blood plasma**

Answer 55

Minimum effective concentration

Answer 56

Maximum tolerated concentration

Answer 57

The higher the TA the safer the drug

Answer 58

Approx 5 half lives

Answer 59

Employed to decrease time to steady state for drugs with a long half-life

Answer 60

Convert drugs to more polar metabolites not readily absorbed in renal tubules, facilitating excretion

Answer 61

Phase 1 - Oxidation, reduction and hydrolysis - Makes a drug more polar, adds a chemically reactive group permitting conjugation * phase1- occur in the RHS of liver * Phase 2 Occur in the LHS * During Phase 2 * Conjugation (Glucuronidation, is a conjugation reaction) Glucuronidation, **a conjugation reaction** -Adds an endogenous compound increasing polarity

Answer 62

1. Glomerular filtration 2. Active tubular secretion 3. Passive reabsorption

Answer 63

The membrane potential becomes less negative (or even positive) The membrane potential becomes more negative

Answer 64

**A** Voltage activated Na channels = depolarizing Voltage activated K channels = Hyperpolarizing

Answer 65

Inwardly the driving force is Vm-Ena

Answer 66

Outwardly (when positive) The driving force is Vm-Ek

Answer 67

No stimulus, however strong, can elicit a second AP

Answer 68

Produce myelinated cells in CNS (Shwann cells do it in PNS)

Answer 69

False Decreased and sphincters are constricted

Answer 70

Noradrenaline

Answer 71

Separate glycoprotein subunits forming a central, ion conducting channel

Answer 72

M1-Gq= stimulates phospholipase C= increased stomach acid secretion M2-Gi = Inhibition of adenylyl cyclase, opening of K+ channels- decreased HR M3- Gq = stimulates phospholipase C= Increased saliva secretion and bronchoconstriction

Answer 73

B1- Gs = Stimulation of adenylyl cyclase = increased HR and force B2- Gs = Stimulation of adenylyl cyclase- relaxation of bronchial and vascular smooth muscle A1- Gq = Stimulation of phospholipase C = Contraction of vascular smooth muscle A2-Gi = Inhibition of adenylyl cyclase = Inhibition of NA release

Answer 74

Competitive antagonist of muscarinic ACh receptors , does not block nicotinic ACh recpetors THUS blockade of parasympathetic division * Used to reverse bradycardia post MI and in AChE poisoning

Answer 75

Intravenous -fluid-directly-into-a-vein-

Answer 76

vincristine Side effects of vincristine to warn patients about include peripheral neuropathy, constipation and hair loss. One of the initial symptoms of peripheral neuropathy includes a foot drop, tingling numbness, pain and hypersensitivity to cold, which begins distally and progresses proximally. Vincristine is **never given intrathecally** (into the spinal canal) for this reason

Answer 77

The relative risk ratio

Answer 78

Second order kinetics is where doubling the concentration of the reagents quadruples the reaction rate

Answer 79

they are molecules with positive or negative (GAIN ELECTRON)charge. THUS ONLY unionised molecules can pass through the membrane

Answer 80

The Beta-1 adrenoceptor is a G-protein coupled receptor, and does indeed activate adenylyl cyclase via the Gs G protein

Answer 81

Relative risk is calculated by (Experimental event rate/Control event rate). 0.133 is the control event rate. ans : 0.75

Answer 82

* The leptin receptor is a kinase-linked receptor. * All histamine and adrenergic receptors are GPCRs, as well as the GABA-B receptor * It is important to note that GABA-A receptor is a ligand-gated ion channel.

Answer 83

Through dimerization and tyrosine autophosphorylation

Answer 84

produce an effect opposite to that of an agonist. They bind to the same receptors at the same site as an agonist

Answer 85

1. **Activation of EP1** receptors causes contraction of smooth muscle in bronchi and the gut. 2. **Activation of EP2** receptors causes relaxation of smooth muscle in bronchi, the gut and blood vessels as well as stimulation of intestinal fluid secretion. **3. Activation of EP3** receptors causes inhibition of gastric acid secretion, increased gastric mucus secretion, contraction of intestinal and uterine smooth muscle, inhibition of lipolysis and inhibition of autonomic neurotransmitter release. **4. Activation of EP4** receptors causes contraction of bronchial smooth muscle and vasodilatation.

Answer 86

its also called Ibuprofen this is a non-selective COX inhibitor so inhibits the activity of COX-1 and COX-2. Inhibition of COX-2 decreases prostaglandin synthesis (via the arachidonic acid pathway) which in turn will decrease inflammation, pain, fever, and swelling

Answer 87

Arachidonic acid

Answer 88

paracrine signalling

Answer 89

the ones which are **Cytochrome P450 enzyme inducer** * One of the known side effects of Carbamazepine is P450 enzyme induction. This case it has led to increased metabolism of the oral contraceptive leading to subcontraceptive levels

Answer 90

Ligand-gated ion channel

Answer 91

G-protein coupled receptors

Answer 92

G-protein coupled receptors

Answer 93

intracellular nuclear receptor

Answer 94

Ligand-gated ion channel

Answer 95

G-protein coupled receptors

Answer 96

They are G protein coupled receptors which activate phospholipase C enzymes via Gq proteins

Answer 97

Irreversible inhibition of COX with platelets unable to synthesise new proteins

Answer 98

Prostaglandin E2 receptor 1

Answer 99

It is a potent vasodilator, bronchoconstrictor and chemotaxin and also increases vascular permeability.

Answer 100

G-protein-coupled receptor

Answer 101

Conversion of arachidonic acid into endoperoxidase

Answer 102

They inhibit prostaglandins, leading to increased gastric acid secretion (increasing risk of stomach ulcers)

Answer 103

Omeprazole

Answer 104

Active bleeding Gastro-intestinal ulceration History of gastro-intestinal bleeding/perforation Severe heart failure

Answer 105

Decreases salicylate reabsorption in the renal tubular cells

Answer 106

GABA is ligate gate ion channel it work by allowing Cl- to go into the cell decreeing the chance of generating action potential

Answer 107

Drug B has lower potency than drug A since E50 is higher than drug A * the curve is shift to the right in B case

Answer 108

Epinephrine is an agonist propranolol is competitive antagonist

Answer 109

D you don’t want all receptors to be saturated.

Answer 110

* What the drug is doing to the body * what the body is doing to the drug (drug distribution)

Answer 111

It consist of receptor domain ( intracellular domain) connect to G protein e.g Gq Gi

Answer 112

ligand bid to receptor domain casing GDP to pop out of G protein and GTP to bind in * Gq move along cell memebrane bound to phospholipase C which break down PIP2 into diacyloglycerol and inositol trisphosphate. * these components will activate protein kinase C that increase Ca2+ intracellular * this could eventually stimulate the cell generate action potential

Answer 113

similarly Gs+GTP will move along cell membrane to activate adenylate cyclase * ATP is convert to cyclic AMP by adenylate cyclase * CAMP ACTIVATE protein kinase A

Answer 114

Gi+ GTP adenylate cyclase thus decrease phosphorylation of particular proteins

Answer 115

When ligand bind two monomers combine tyrosines cross phosphorylate each other each trigger separate cellular responses

Answer 116

* Ligand gate ion channels , GPCR and tyrosine receptors are for Hydrophilic , large , polar and charged drugs. * intracellular are for hydrophobic, small and uncharged drugs **they take time e.g nucleus receptors**

Answer 117

* **Is rapid response to large initial does of drug** * **is chronic responses to repeated exposure of drug**

Answer 118

The strong the bond the more affinity the more potent the drug is the Low EC50 high EC50 mean the curve is shift to the right thus low the affinity

Answer 119

High drug receptor interaction ( how many receptors are bound) and high intrinsic activity efficiency = Vmax not potent

Answer 120

TD50 / ED50 is the concentration of drug to produce toxic effect divide by the desire effect the larger the therapeutic index the safer the drug

Answer 121

Both cause cellular response but partial produce lower Vmax

Answer 122

Affinity/ potent decrease as curve is shift tie the right but Vmax stay the same this increase EC50

Answer 123

It decrease VMAX BUT affinity and potent stays the same

Answer 124

Is the concentration at which the dosing rate is equivalent to the elimination rate dosage rate is the rate at which we delivering drug

Answer 125

Is heavily depend upon the T½ which is about 4 to 5 half life’s therefore its where dosing rate is equal to elimination rate * **it’s not only half life it’s also depend on infusion rate as it increase SS will increase**

Answer 126

is the does that we give to the patient to maintain steady state concentration

Answer 127

Is dose to reach steady state quickly amd from there we can give maintain doses

Answer 128

Volume of distribution * high it mean its require high loading does because of decrease in plasma contraction of the drug * Low it mean it require low loading does because increase plasma concentration of the drug

Answer 129

Lower the maintenance does this can be done by * reduce dose * change the dosing interval to be less frequent c

Answer 130

Both will increase

Answer 131

* The rate of elimination of particular drug over the plasma concentration of the drug. * define as the volume of plasma clearance of drug per unit of time

Answer 132

Cl will decrease and drug will accumulate

Answer 133

* happen to most drugs which is the drug concentration ( amount of drug given to patient ) is directly proportional to the rate of elimination and form exponentail curve. Half life is constant * only to number of drugs aspirin , ethanol and phenytoin T½ is variable but rate of elimination so constant and is independent of concentration of drug given. * See the summery table in the notes

Answer 134

Zero order kinetic

Answer 135

1. zero 2. first

Answer 136

Through urine other excretion bath ways are * gall bladder (Bile ) * lungs * Git * Breast milk * other hair / skin

Answer 137

1. Filtration 2. secretion 3. reabsorption

Answer 138

1. GFR if it decreases blood plasma concentration increases thus less filtration 2. protein binding e.g albumin heavy protein bind lead to less filtration , low protein binding most of drug will be excreted thus less will be used by cells e.g cirrhosis of liver .

Answer 139

* Drug pass into Arterioles around glomerulus then to peri tubular capillary then to tubular cells then into the lumen of the tubular to be excreted. * solubility of the drug polar vs non polar

Answer 140

This happen in the DCT 1. drugs moves along the concentration gradient 2. drug require to have non polar character 3. drugs will become more Polaris and llipophobic by the liver

Answer 141

Decrease reabsorption increase increase urinary secretion.

Answer 142

Using sodium bicarbonate (HCO3-) this will decrease the concentration protons alkalinize urine thus shift the reaction to right

Answer 143

Using ammonium chloride (CL- ) to acidify urine thus increase proton concentration this will shift reaction to left

Answer 144

Probenecid prevent penicillin secretion this increase its concentration in drug

Answer 145

false other 3 ways

Answer 146

1. Oxidation adding O- 2. Reduction adding H 1. Hydrolytic reaction adding OH

Answer 147

conjugation reactions 1. methyl 2. acetyl 3. sulfa 4. glutathione 5. glucuronate

Answer 148

1. Azoles 2. erythromycin 3. ritonavir 4. omeprazole

Answer 149

1. Rifampin 2. Phenytoin 3. PHB 4. carbamazepine

Answer 150

1. Toxic substance convert to non toxic 2. prodrug is converted into active drug 3. most commonly active drug is converted into an inactive metabolite that easily excreted

Answer 151

Inside hepatocytes there are smooth endoplasmic reticulum and mitochondria they contain heme containing enzymes called. CYP450 system in this system there are two type of families which catalase most of the drugs CYP3A4 CYP2D6

Answer 152

CYP2D6 in most cases convert active drug into inactive drug this can happen 1. rapid metabolism this decrease amount of active drug present in the serum thus decreasing the therapeutic effect 2. slow metabolism increase concentration of active drug in serum lead to increase toxicity

Answer 153

Hydrophobic other require transporters

Answer 154

Vd = F x dose / C

Answer 155

1. Organs with an increase blood flow brain , kidney and liver 2. organs with decrease blood flow skin , adipose tissue 3. clinical correlation e.g shock which decrease blood flow thus lower distribution of drug

Answer 156

1. blood flow 2. capillaries permeability 3. albumin binding 4. solubility 5. volume of distribution

Answer 157

Drug whcih strongly bound will have low free drugs low distribution and more concentrated in the plasma low protein bound will have free drug increase distribution and concentrated in ICF and interstitial fluid

Answer 158

The ability of drug to cross into interstitial fluid and tissue this effect by a. Small nonpolar ( uncharged) hydrophobic drugs will have high distribution and high solubility b. Large polar hydrophilic drug still have high distribution **but** poor solubility c. Drugs bound to albumin strongly will have poor solubility due to charge and large size and very little distribution

Answer 159

* Low volume distribution this will be due to either plasma protein binding drug , large polar hydrophilic drugs , low blood flow and poor capillary permeability warfarin * medium volume distribution * High volume of distribution due to either free drug , small non polar hydrophobic head large amount of drug flow and increase capillary permeability e.g cholroquine

Answer 160

False Signalling only terminated by the hydrolysis NOT the agonist discussion (the action may persist WITHOUT the presence of an agonist)

Answer 161

1. Everything pre-ganglionic in the ANS uses acetylcholine 2. Acetylcholine is used in the post-ganglionic parasympathetic division 3. acetylcholine 4. noradrnaline

Answer 162

As a partial agonist, varenicline has a lower intrinsic activity than the full agonist nicotine, meaning that it produces a weaker activation of the receptor than nicotine does. When varenicline binds to the α4β2 nAChR, it can cause a partial activation of the receptor, which leads to a release of dopamine in the reward pathway of the brain. This can help reduce the craving and withdrawal symptoms associated with smoking cessation.

Answer 163

Isoprenaline and salbutamol

Answer 164

It decreases the volume of distribution." Tissue protein binding can reduce the amount of free drug available to distribute to other tissues

Answer 165

True becasue less of it will be remain for the site of action because most of it went into the tissues.

Answer 166

The amount of drug that is absorbed into the body after administration

Answer 167

a) The route of administration b) The dosage form **c) The presence of food in the stomach**

Answer 168

Hepatic drug-metabolising enzymes (microsomal enzymes) are embedded in the smooth endoplasmic reticulum of the liver hepatocytes.

Answer 169

if the rate of absorption is slower than the rate of elimination, the drug may not reach therapeutic concentrations in the bloodstream, and the efficacy of the drug may be reduced.

Answer 170

If both absorption and elimination are occurring simultaneously

Answer 171

if the rate of absorption is faster than the rate of elimination, the drug may accumulate in the body and lead to toxicity.

Answer 172

Clearance (CL) and volume of distribution (Vd) are independent of each other, but both determine the elimination half-life (t1/2) of a drug.

Answer 173

Dosage Rate = [Drug]PlasmaSS x CL / F (IV=1) 60 mg/hour would need to administered (20mg/L X 3L/hour)

Answer 174

adenosine triphosphate (ATP) and neuropeptide Y (NPY) from sympathetic fibres nitric oxide (NO) and vasoactive intestinal peptide (VIP) from parasympathetic fibres

Answer 175

1. Uptake of precursor 2. Synthesis of transmitter (T), or intermediate 3. Storage of transmitter (T), or intermediate # 4. Depolarization by action potential # 5. Ca2+ entry via voltage-activated Ca2+ channels# 6. Ca2+- induced release of transmitter (exocytosis) # 7. Receptor activation # 8. Enzyme-mediated inactivation of transmitter (cholinergic), # or 8. Reuptake of transmitter (adrenergic) # | Every step is a drug target, often of clinical significance (#)

Answer 176

1. it increase noradernaline in synaptic cleft lead to increase adrenorepcetor stimulation. 2. this causes vasoconstraction aplpha 1 receptors and arrthymia by stimulating beata 1 reeptors

Answer 177

1. Also cause increase adrenorepceptor stimulation lead to aplpha 1 and Beta 1 stimulation.

Answer 178

its slective apha 1 antagoinst vasodialtor and anti-hyeprtensive

Answer 179

selecctive beta 1 anatagoisnt anti anginal and anti-hypertenisve

Answer 180

selecctive beta 1 anatagoisnt anti anginal and anti-hypertenisve

Answer 181

selcctive B2broncodilator antagoisnt broncodilator

Answer 182

competotve muscarinic antagoisnt ACh block all muscarinic receptors with equall affinity Used to reverse bradycardia following MI and in anticholinesterase poisoning

Answer 183

Astrocytes

Pharmacology Cameron McCloskey Flashcards

(216 cards)