CSW Pharmacology - Pharm Chapter, Step 1

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1.

2 drugs that cause dilated cardiomyopathy (both start with D) 4 drugs that cause cutaneous flushing A drug infused at a constant rate reaches about 94% of steady state after A lower Km means A partial agonist has a lower Acute alcohol use, P450 interaction Acute cholestatic hepatitis Acute systems of iron poisoning Adrenocortical insufficiency Alpha 1 receptor uses which G protein signal system? Alpha 2 receptor uses which G protein signal system? Anticholinergic used to treat asthma, COPD Anticholinergic used to treat peptic ulcer disease (3) antidepressant that causes atropine like sideeffects Antidote for acetaminophen Antidote for amphetamines Antidote for anticholinesterases Antidote for Antimuscarinic agents; anticholinergics Antidote for arsenic, gold, mercury

doxorubicin (chemotherapy agent that intercalates into DNA) , daunorubicin (intercalating agent) VANC: vancomycin, adenosine, niacin, Ca2+ channel blockers 4t(1/2) -- four half lives

20.

Antidote for benzodiazepines Antidote for Betablocker Antidote for CO Antidote for copper, arsenic, gold Antidote for cyanide Antidote for Digitalis Antidote for Heparin Antidote for iron Antidote for lead Antidote for Methanol, ethylene glycol (antifreeze) Antidote for methemoglobin Antidote for opioids Antidote for organophosphates Antidote for salicylates Antidote for TCA Antidote for theophylline Antidote for tPA, streptokinase Antidote for warfarn Atropine action at Eye, airway, stomach, gut, bladder Barbiturates, P450 interaction Beta 1 receptor uses which G protein signal system?

flumazenil glucagon 100% O2, hyperbaric O2 penicillamine

21.

2.

22. 23.

3.

24.

nitrites, hydroxocobalamin, thiosulfate stop dig, normalize K, lidocaine, antidig Fab fragments, Mg2+ Protamine deferozamine CaEDTA, dimercaprol, succimer, penicillamine ethanolo, dialysis, fomepizole

4. 5.

Increased affinity maximal efficacy (result produced); may be more potent, less potent or equally potent inhibitor
27. 25.

26.

6.

7.

macrolides gastric bleeding glucocorticoid withdrawal

28.

8.

29.

9.

30.

methylene blue, vitamin C nalozone/naltrexone atropine, pralidoxime (regenerates Ach Esterase NaHCO3 or dialysis NaHCO3 B-blocker aminocaproic acid vit. K, fresh frozen plas Anticholinergic: pupil dilation, cycloplegia; decreased secretion, decreased acid secretion, decrease motility, decreased urgency inducer S --> adenylyl cyclase --> ATP -> cAMP --> increased protein kinase A

10.

q --> Phospholipase C --> increased Ca I --> adenylyl cyclase --> decreased cAMP --> less protein A ipratropium; M3 antagonist

31.

11.

32.

33.

12.

34.

13.

methscopolamine, pirenzepine, propantheline (decrease exocrine secretions by binding to M3) TCAs

35.

36.

14.

37.

15.

n-acetylcystein NH4Cl (acidify the urine) atropine, pralidoxime (regenerates Ach Esterase physostigmine salicylate

38.

16.

39.

17.

40.

18.

19.

dimercaprol (BAL), succimer

41.

Beta 2 receptor uses which G protein signal system?

S --> adenylyl cyclase --> ATP -> cAMP --> increased protein kinase A M2

60. 61.

DI Diarrhea, Urination, Miosis, Bronchospasm, Bradycardia (M2), Excitation of skeletal muscle, Lacrimation, Sweating and Salivation - think overdose of what? Direct cooms-positive hemolytic anemia Disulfiram-like reaction

lithium, demeclocycline Cholinergic agents like organophosphates

42.

binding at this receptor decreases the heart rate and contracility of the atria Binding here increase gastric acid secretion Binding here increases nasal and bronchial mucus production, contraction of bronchioles, pruritis, and pain Binding relaxes renal vascular smooth muscle Can cause acute angle-closer glaucoma in elderly (relaxes ciliary muscle and pupillary sphincter); can cause urinary retention in men with BPH (relaxes the bladder muscles), and hyperthermia in infants Carbamazepine, P450 interaction celecoxib, furosemide, probenecid, thiazide, bactrim, sulfasalazine, sulfonylureas, sumatriptan Challenge test for diagnosis of asthma

43.

H2 H1

62.

methyldopa metonidazole, some cephalosporins, procarbazine, 1st generation sulfonyluras S --> adenylyl cyclase --> ATP -> cAMP --> increased protein kinase A I --> adenylyl cyclase --> decreased cAMP --> less protein kinase A inhibitor alcohol dehydrogenase -> acetaldehyde (causes nausea, vomiting, headache, hypotension) -> acetadehyde dehydrogenase --> acetic acid Rash

44.

63.

45.

D1 atropine

64.

46.

Dopamine 1 receptor uses which G protein signal system? Dopamine 2 receptor uses which G protein signal system? Erythromycin, P450 interaction Ethanol metabolism

65.

66.

47. 48.

inducer ...

67.

49.

methacholine -triggers M3 mediated bronchoconstriction aplastic anemia

68.

50.

Chloramphenicol, benzene, NSAIDs, PTU, methimazole can cause Chronic alcohol use, P450 interaction Chronic symptoms of iron poisoning Cimetidine, P450 interaction Cinchonism Clearance equation

51.

inducer
69.

ethosuximide, lamotrigine, carbamazepine, phenobarbital, phenytoin, sulfa-drugs, penicillin, allopurinol Fanconi's syndrome focal to massive hepatic necrosis (4) Formula for Half-life Formula for the loading dose

Expired tetracycline halothane, valproic acid, acetaminophen, amanita phalloides .7 x Vd / (Clearance) Cp (target plasma concentration) x Vd/bioavailability Cp x CL/F Phase I phenytoin furosemide, thiazides inhibitor

52.

metabolic acidosis, scarring --> GI obstruction inhibitor quinidine, quinine Vd x Ke (elimination constant) agranulocytosis

70.

53. 54. 55.

71. 72.

73.

56.

Clozapine, carbamazepine, colchicine, PTU, methimazole, dapsone Major side effect: Competitive inhibitors lower Cough decreased sympathetic outflow, insulin release

Formula for the maintenance dose Geriatric patients lose which phase of metabolism first? Gingival hyperplasia gout (2) Grapefruit juice, P450 interaction

74.

57. 58. 59.

Potency ACE inhibitors alpha 2

75. 76. 77.

78. 79.

Gray baby syndrome Griseofulvin, P450 interaction Gynecomastia

Chloramphenicol inducer spironolactone, digitalis, cimetidine, alcohol, estrogens, ketoconazole (some drugs create awesome knockers) Gq (have 1 M&M in the GQ lounge) hemolytic anemia, thrombocytopenia, agranulocytosis cyclophosphamide, ifofamide INH distribute in tissues q --> Phospholipase C --> increased Ca S --> adenylyl cyclase --> ATP -> cAMP --> increased protein kinase A muscarinic antagonist like atropine

98.

Increase H2O permeability and reabsoprtion in the collecting tubules of the kidney increased heart rate, increased contractility, increased renin rlease increased lipolysis increases exocrine gland secretions (sweat, gastric acid), increase gut peristalsis, increase bladder contractions, bronchoconstriction, increase pupillary sphincter muscle contraction (miosis), ciliary muscle contraction (accommodation) increases vascular smooth muscle contraction Increases vascular smooth muscle contraction, pupillary dilator muscle, intestinal and bladder sphicter muscle contraction Inhibit yourself from drinking beer from a keg because it makes you acutely sick

V2 (ADH)

99.

80.

B1

100.

M3

81.

H1, alpha1, V1, M1, M3 all use which second messanger system? Hemapoetic effects of sulfa reaction hemorrhagic cystitis Hepatitis High Vd (> body weight) Histamine 1 receptor uses which G protein signal system? Histamine 2 receptor uses which G protein signal system? hot as a hare, dry as a bone, red as a beet, blind as a bat, mad as a hatter -- overdose of what? hot flashes How is the signal transduced at muscarinic Ach receptors How is the signal transduced at Nicotinic Ach receptors How is the therapeutic index calculated Hypothydoidism If a patient has renal or hepatic dysfunction, the maintenance dose should be if patient has renal or hepatic dysfunction, the loading dose should be... In first order kinetics, the plasma concentration of a drug concentration decreases In zero-order, the drug concentration decreases

82.

101.

V1 alpha 1

83. 84. 85. 86.

102.

103.

87.

88.

Inhibitors: Ketoconazole, Erythromycin, Grapefruit juice, Sulfonamide, isoniazid, cimetidine Methicillin, NSAIDs, furosemide inhibitor all cause hemolysis in patients with G6PD deficiency inhibitor volume of distribution for plasma protein-bound drugs pyridostigmine; does not penetrate the CNS, stronger than neostigmine Blood CNS and enteric nervous system

104.

Interstitial nephritis

89. 90.

tamoxifen, clomphene G-protein coupled with second messenger systems ligand gated N+/K+ channel
105. 106.

Isoniazid, P450 interaction Isoniazid, sulfonamides, primaquine, aspirin, ibuprofen, nitrofurantoin

91.

92.

LD50/ED50 (median toxic dose / median effective dose) lithium, amiodarone Decreased

107. 108.

Ketoconazole, P450 interaction Liver and Kidney disease lower what in pharmacokinetics

93. 94.

109. 95.

unchanged

Long acting treatment for MG

96.

exponentially, the fraction of the drug excreted is the same

110. 111.

Low Vd drugs are distributed where? M1 is found where?

97.

linearly

112.

M2, Alpha 2, and Dopamine 2 all use which second messanger system? Mechanism of iron poisoning Mechanism of lead poisoning

Gi (I'm MAD at 2s)

128.

Parkinson-like syndrome Phase I metabolism usually involves ... and the chemical reactions are Phase II metabolism chemical reactions usually are Phenytoin, P450 interaction Photosensitivity (3) Potent stimulator of sweat, tears and saliva Pseudomembraneous colitis pulmonary fibrosis Queen Barb Steals Phen-phen and Refuses Greasy Carbs Chronically Quinidine, P450 interaction Rifampin, P450 interaction Safer drugs have a ____ TI Seizures side effects of hexamethonium SLE-like syndrome St. John's wart, P450 interaction Sulfonamide, P450 interaction Tardive dyskinesia Tendointis, tendon rupture in kids The ___ receptor modulates dopamine release in the brain

haloperidol, chlorpromazine, reserpine, metoclopramide cytochrome P450 system, reduction, oxidation, hydrolysis --> metabolites are water-soluble and slightly polar, usually still active acetylation, glucuronidation, sulfation --> yields very polar, inactive metabolites inducer sulfonamides, amiodarone, tetracyclines (SAT for a photo) Pilocarpine (directly increases exocrine gland secretions, resistance to AChE) clindamycin, ampicillin bleomycine, amiodarone, busulfan (hard to BLAB) induces of P450: quinidine, Barbiturates, st. johns wart, phenytoin, rifampin, griseofulvin, carbamazepine, chronic alcohol inducer inducer higher Bupropion, impenem/cilastatin, isoniazid severe orthostatic hypotension, blurred vision, constipation, sexual dysfunction hydralazine, INH, procainamide, phenytoin inducer inhibitor antipychotics fluoroquinolones D2

129.

113.

causes cell dreath due to peroxidation of membrane lipids Prevents iron from being incorporating into the heme molecule; actions of delta-aminolevulinic acid dehydratase and ferrochetase are decreased extracellular space or body water Phenytoin, methotrexate, sulfa drugs (have a blast with PMS) alcohol dehydrogenase --> oxalic acid --> acidosis, nephrotoxicity alcohol dehydrogenase --> formaldehyde and formic acid --> severe acidosis and retinal damage q --> Phospholipase C --> increased Ca I --> adenylyl cyclase --> decreased cAMP --> less protein kinase A q --> Phospholipase C --> increased Ca polymyxins aminoglycosides, vancomycin, loop diuretics, cisplatin hexamethonium
130.

114.

131.

115.

Medium Vd durgs are distributed where? Megaloblastic anemia

132.

133.

116.

117.

Metabolism of ethylene glycol: Metabolism of methanol:

134.

135.

118.

136.

119.

Muscarinic 1 receptor receptor uses which G protein signal system? Muscarinic 2 receptor uses which G protein signal system? Muscarinic 3 receptor uses which G protein signal system? Nephrotoxicity and neurotoxicity nephrotoxicity/ototoxicity

137.

120.

138.

139.

121.

140.

122.

141.

123.

142.

124.

Nicotonic antagonist used in experimental models to prevent vagal reflex responses to change in blood pressure (preventing reflex bradycardia) Noncompetitive inhibitors lower osteoporosis (2) Overdose should be treated with ammonium chloride since this drug is trapped in an acidic environment

143.

144.

145.

125.

efficacy corticosteroids, heparin amphetamine

146.

126. 127.

147.

148.

These four drugs are trapped in a basic environement and so overdose should be treated with bicarb three examples of zero-order drugs thrombosis Torsades de pointes Treatment for organosphosphate or cholinergic overdose Treatment for postoperative and neurogenic ileus and urinary retention Treatment of glaucoma, to induce pupillary contraction, and used to decrease intraocular pressure two CNS drugs that cause coronary vasospasm Use to treat glaucoma Used for the treatment of motion sickness Used for the treatment of parkinsons Used to diagnose MG (very short acting) Used to produce mydriasis and cycloplegia (3) Used to reduce urgency in mild cystitis and reduce bladder spasms Used to treat atropine overdose

phenobarb, methotrexate, TCA, aspirin (T MAP)

163.

Used to treat mysthenia gravis, reverse NM junction blockade postoperatively vasodilation, bronchodilation, increased heart rate, increased contractility, increase lipolysis, increased insulin release, decrease uterine tone Vasopressin 1 receptor uses which G protein signal system? Vasopressin 2 receptor uses which G protein signal system?

neostigmine (inhibits AChE) B2

164.

149.

phenytoin, ethanol and aspirin

165.

150. 151.

OCPs Class III agents (sotalol), class IA antiarrhythmics (quinidine), cisprida Atropine (muscarinic antangonist) and pralidoxime (used to regenerate active cholinesterase) Bethanechol (directly activates M3 Ach receptor, increases bladder contraction and peristalsis); neostigmine (increase endogenous Ach by inhibiting anticholinesterase; does not penetrate the CNS) Carbachol (directly actives M3 Ach receptor)
167.

q --> Phospholipase C -> increased Ca S --> adenylyl cyclase --> ATP -> cAMP --> increased protein kinase A Volume of distribution = (amount of drug in the body)/(plasma drug concentration) on acetaldehyde dehydrogenase On alcohol dehydrogenase

166.

152.

153.

Vd = (equations)

168.

154.

Where does disulfiram work? Where does fomepizole work

169.

155.

cocaine, sumatriptan

156.

Physostigmine (PHYS for EYES); crosses the blood brain barrier scopolamine (Muscarinic antagonist)

157.

158.

Benzotropine (antagonist to M1 receptor in the brain) edrophonium

159.

160.

atropine, homatropine, tropicamide

161.

oxybutynin and glycopyrrolate (M3 antagonist)

162.

physostigmine