Pharmacology General

Question 1

Drugs with zero order elimination?

Answer 1

PEA– Phenytoin; Ethanol; Aspirin

Question 2

Treat base overdoses with?

Answer 2

Amonium chloride

Question 3

Phase 1 drug metabolism?

Answer 3

Reduction, oxidation, hydrolysis with cyp P450– usually yields slightly polar water soluble metabolites

Question 4

Phase 2 metabolism?

Answer 4

Conjugation– glucuronidation; acetylation; sulfation

Question 5

Efficacy vs potency?

Answer 5

Efficacy– maximal effect a drug can produce

Potency– amount of drug needed to produce an effect

Question 6

Competitive antagonists shift curve?

Answer 6

To the right– decrease the potency (Diazepam+flumazenil on GABA)

Question 7

Noncompetitive antagonist shifts curve?

Answer 7

Down– decreases efficacy

NE+phenoxybenzamine on alpha receptors

Question 8

Partial agonist?

Answer 8

Reduce efficacy– potency can go up or down

Question 9

therapeutic index?

Answer 9

Median lethal dose over median effective dose

Question 10

Lineweaver burk plot– what happens if my point moves more to the right? i.e. greater x intercept?

Answer 10

The greater the Km and the lower the affinity

Question 11

What happens if my x intercept gets smaller in the lineweaver burk plot?

Answer 11

Lower Km and higher affinity

Question 12

Volume of distribution

Answer 12

Amount of drug in body/plasma drug concentration

Question 13

Half life?

Answer 13

(.7*Vd)/Clearance

Question 14

Adrenal medulla and sweat glands are innervated by?

Answer 14

Cholinergic fibers even though they are SYMPATHETIC

Question 15

Muscarinic receptors are of what type?

Answer 15

GPCR (M1-M5)

Question 16

Parasympathetics act on?

Answer 16

Cardiac and smooth muscle, glands, and nerve terminals

Question 17

Mechanism of Gq?

Answer 17

Phospholipase c converts lipids into PIP2 which can go to

1) IP3–>inc Ca–>smooth muscle contraction
2) DAG–>protein kinase C

Question 18

Mechanism of Gs/Gi?

Answer 18

Adenylyl cyclase converts ATP to cAMP–>protein kinase A which 1) blocks myosin light chain kinase and 2) increases Ca in heart

Question 19

Qiss Qiq (till you’re) siq (of) Sqs?

Answer 19

alpha 1,2 beta1,2 M1,2,3 D1,D2 H1, H2 V1, v2

Question 20

Increases vascular smooth muscle contraction?

Answer 20

alpha 1

Question 21

increases pupillary dilator muscle?

Answer 21

alpha 1

Question 22

Increases gastic acid secretion?

Answer 22

H2

Question 23

Relaxes renal vascular smooth muscle?

Answer 23

D1

Question 24

Dec insulin release? and dec lipolysis

Answer 24

alpha2

Question 25

Increase insulin release? and inc lipolysis

Answer 25

beta2

Question 26

Bronchodilation and tocolytic?

Answer 26

Beta 2

Question 27

Ciliary muscle relaxation?

Answer 27

Beta 2

Question 28

Increase platelet aggregation?

Answer 28

alpha 2

Question 29

dec hr and contractility of atria?

Answer 29

M2

Question 30

Increases lacrimal productoin (exocrine gland)?

Answer 30

M3

Question 31

Increase bladder contraction?

Answer 31

M3

Question 32

Bronchoconstriction?

Answer 32

M3

Question 33

miosis and ciliary muscle contraction (i.e. accommodation)

Answer 33

M3

Question 34

Pruritus?

Answer 34

H1

Question 35

Intestinal and bladder sphincter muscle contraction?

Answer 35

alpha1

Question 36

Epi effects blank more than blank?

Answer 36

Beta more than alpha

Question 37

Norepi effects blank more than blank?

Answer 37

alpha more than beta

Question 38

Increase aqueous humor production?

Answer 38

beta2

Question 39

M3 rhyme?

Answer 39

M3 makes you pee (parasymp)

Question 40

Blocks tyrosine to dopa?

Answer 40

Metyrosine

Question 41

Blocks packaging of dopamine?

Answer 41

reserpine

Question 42

Blocks reuptake of NE?

Answer 42

Cocaine, TCA, and amphetamine

Question 43

Guanethidine and bretylium?

Answer 43

block NE release from presynaptic

Question 44

NE acts on blank to autoregulate itself?

Answer 44

Alpha 2

Question 45

Blocks choline uptake?

Answer 45

Hemicholinium

Question 46

Blocks ACh from moving into vesicles?

Answer 46

Vesamicol

Question 47

Urinary retention and postoperative ileus?

Answer 47

Bethanechol-- Beth, call me if you want to pee or crap

Question 48

Carbachol?

Answer 48

Glaucoma, pupillary contraction; CARBon copy of AcetylCHOLINE

Question 49

Stimulator of sweat, tears, and saliva, and open and closed glaucoma?

Answer 49

PILOcarpine-- RESISTANT TO AChE you cry, drool, and sweat on your PILlow

Question 50

Long acting drug for myasthenia gravis?

Answer 50

Pyridostigmine-- pyRIDostiGM-- gets rid of MG

Question 51

Indirect anticholinesterase that crosses blood brain barrier?

Answer 51

Physostigmine-- PHYSO PHYXES atropine overdose

Question 52

AChEI for Alzheimers?

Answer 52

Donepezil

Question 53

What should you be careful about exacerbating with cholinomimetic agents?

Answer 53

COPD, Asthma, and Peptic ulcers

Question 54

Side effects of cholinesterase inhibitor drugs?

Answer 54

Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia, Excitation of skeletal muscle and CNS, Lacrimation, Sweating and Salivation

Question 55

Antidote to cholinesterase inhibitor toxicity?

Answer 55

Atropine+ pralidoxime

Question 56

Benztropine

Answer 56

Muscarinic antagonist for parkinsons

Question 57

Scopolamine?

Answer 57

Motion sickness-- need SCOPolamine if we're going to drive around SCOPing out the scene in New brunswick

Question 58

Ipratropium, tiotropium?

Answer 58

I PRAy I can breath soon-- asthma and copd

Question 59

Oxybutynin?

Answer 59

Reduces bladder spasms-- oxybladdertynin

Question 60

Glycopyrrolate?

Answer 60

Preoperative use to reduce airway secretions or drooling, peptic ulcer--- glycoPYRROLate for Peptic ulcer

Question 61

Deleterious effect of atropine in elderly?

Answer 61

Can cause acute angle closure glaucoma

Question 62

Epinephrine?

Answer 62

Alpha, and beta-- NO D1-- used for anaphylaxis, glaucoma, asthma, and hypotension increases HR and BP

Question 63

Norepi?

Answer 63

Alpha>beta (no beta 2 or D1)-- used for hypotension (decreases renal perfusion)--- causes increase in diastolic and systolic pressures

Question 64

Isoproterenol?

Answer 64

All Beta-- Torsades, bradyarrhythmias (but can worse ischemia)--- IsoPROterenol is PRO BRO i.e. pro Beta Decreases BP via B2 and Inc HR via B1 and reflex activity

Question 65

Dopamine uses?

Answer 65

Shock, heart failure, inotropic and chronotropic

Question 66

Cardiac stress testing?

Answer 66

Dobutamine (mostly b1)-- doBETAmONE-- also used for heart failure

Question 67

Mydriatic effect, only act on alpha 1 and 2?

Answer 67

Phenylephrine-- used as decongestant as well

Question 68

Albuterol/Terbutaline

Answer 68

Beta agonists (Terbetaline)

Question 69

Acts on B2 only and reduces premature uterine contractions?

Answer 69

Ritodrine prevents UteRINE (ritodrine rhymes with uterine)

Question 70

Used to treat narcolepsy?

Answer 70

Amphetamines

Question 71

Sympathoplegic used in hypertension in a person with renal disease?

Answer 71

Clonidine-- centrally acting alpha 2 agonists clonidine decreases central sympathetic outflow

Question 72

Phenoxybenzamine?

Answer 72

Phenoxy for Pheo-- alpha blocker-- may cause orthostatic hypotension or reflex tachycardia

Question 73

Phentolamine?

Answer 73

alpha blocker-- give to patients on MAO inhibitor Too much PHEN (fun) at the wine and cheese party, will take it's TOL and you'll need PHENTOLAMINE

Question 74

Patient comes to you with insomnia. You give her an alpha 2 selective blocker-- what is the drug? what are the side effects?

Answer 74

Drug is Mirtazapine and side effects are inc serum cholesterol and inc appetite

Question 75

Difference between Epinephrine and Phenylephrine?

Answer 75

Epi has alpha AND beta response | Phenylephrine only has Alpha

Question 76

These beta blockers should be used in those with pulmonary disease?

Answer 76

A BEAM | Acebutolol, btaxolol, esmolol, atenolol, metoprolol

Question 77

Carvedilol?

Answer 77

nonselective alpha and beta antagonist

Question 78

Clearance?

Answer 78

Rate of elimination/plasma drug concentration

Question 79

Loading dose?

Answer 79

Vd*CSS

Question 80

Maintenance Dose?

Answer 80

css*cl

Question 81

amphetamine overdose

Answer 81

NH4Cl

Question 82

Beta blocker overdose

Answer 82

glucagon

Question 83

Digitalis overdose

Answer 83

Lidocaine, mg2+, normalize K+

Question 84

Arsenic and gold overdose

Answer 84

Dimercaprol; succimer and penicillamine

Question 85

copper

Answer 85

penicillamine

Question 86

theophylline overdose

Answer 86

Beta blockers

Question 87

drug that can cause acute cholestatic hepatitis

Answer 87

erythromycin (maCro)

Question 88

gingival hyperplasia

Answer 88

phenytoin and verapamil and cyclosporin

Question 89

photosensitivity

Answer 89

sulfonamides amiodoroaone tetracycline

Question 90

drug that can cause fanconi syndrome

Answer 90

tetracycline

Question 91

Can cause torsades

Answer 91

Some risky meds can prolong qT | Sotalol; Risperidone; Mcrolides; chloroquine; protease inhibitors; quinidine thiazides