Created by Jennifer Huber
over 6 years ago
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Question | Answer |
What type of drugs can have CSF absorption? | restricted to nonionized, lipid soluble drugs |
Albumin effects on medication | binds drugs PCN and Warfarin 90% bound |
Sulfonamides effect on bilirubin | will displace unconjugated bilirubin from albumin in newborns (therefore avoid in newborns or they can develop kernicterus) |
Where are tetracycline and heavy metals stored? | stored in bone |
0 order kinetics | constant amount of drug is eliminated regardless of dose |
1st order kinetics | drug eliminated proportional to dose |
# of half-lives for drug to reach steady state | 5 |
What is Volume of Distribution? | amount of drug in body divided by amount of drug in plasma or blood the higher the number, higher conc in extravascular compartment |
What is bioavailability? | fraction of unchanged drug reaching the systemic circulation assumed to be 100% in IV drugs |
ED50 | Drug level at which desired effect occurs in 50% of patients |
LD50 | drug level at which death occurs in 50% of patients |
What is Tolerance? | decline in potency with continued use |
What is Tachyphylaxis? | Tolerance of a drug only after a few doses |
What is Potency? | dose required for effect |
What is efficacy? | ability to achieve result without untoward effect |
Phase I Drug metabolism | demethylation, oxidation, reduction, hydrolysis reactions mixed function oxidases, requires NADPH/oxygen |
Phase II Drug Metabolism | Glucuronic acid and sulfates attached (forms water-soluble metabolite) usually inactive and ready for excretion, deconjugation in intestines |
Inhibitors of P450 | cimetidine, isoniazid, ketoconazole, erythromycin, Cipro, Flagyl, allopurinol, verapamil, amiodarone, MAO-I, disulfiram |
Inducers of P450 | cruciform vegetables, ETOH, cigarette smoke, phenobarbital, barbituates, Dilantin, Theophylline, Warfarin |
What are Polar Drugs? | Ionized water soluble more likely to eliminated unaltered |
What are nonpolar drugs? | non-ionized, fat soluble more likely to be metabolized before excretion |
Causes of Gout | caused by uric acid build-up negatively birefringent crystals end product of purine metabolism |
Podagra | gout that affects the big toe 1st MTP joint space 50% of gout cases |
Colchicine | anti-inflammatory binds tubulin and inhibits migration (chemotaxis) of WBCs for gout |
Indomethacin | NSAID; inhibits prostaglandin synthesis reversible cyclooxygenase inhibitor for Gout |
Allopurinol | xanthine oxidase inhibitor blocks uric acid formation from xanthine for Gout |
Probenecid | Increases Renal Secretion of Uric Acid Treats gout |
Cholestyramine | binds bile acids in gut forces body to resynthesize bile acids from cholesterol. thereby lowering body cholesterol; can bind vitamin K |
HMG-CoA Reductase Inhibitors side effects | Statins can cause liver dysfunction and rhabdomyolysis |
MoA of Niacin side effect and its treatment | inhibits cholesterol synthesis can cause flushing Tx with ASA |
Metoclopramide | Reglan, prokinetic inhibits dopamine receptors can increase gastric acid and gut motility |
Alvimopan | prokinetic antagonist to mu-opioid receptor for post-op ileus |
Loperamide | slows gut motility agonist to mu-receptors |
Lomotil | Diphenoxylate/Atropine slows gut; agonist to opioid receptors |
Promethazine & s/e | Phenergan, antiemetic inhibits dopamine receptors s/e: tardive dyskinesia (tx w/ benadryl) |
Ondansetron | Zofran, antiemetic central acting serotonin receptor inhibitor |
Omeprazole | PPI Blocks H/K ATPase in stomach parietal cells |
Cimetidine/Ranitidine | Histamine H2 receptor blockers decrease acid in stomach |
MoA Octreotide | long-acting somatostatin analogue, decreased gut secretions |
Digoxin MoA and effect on heart | Inhibits Na/K ATPase and increases myocardial calcium Slows AV conduction, Inotrope decreased blood flow to intestines |
Side effects of Digoxin | may cause mesenteric ischemia vision changes (yellow hue) arrhythmias, fatigue worse if HypoK |
Amiodarone use and side effects | good for acute atrial and ventricular arrhythmias s/e: pulmonary fibrosis, hypo- hyperthyroidism, Blue Man, peripheral neuropathy, hepatic dysfxn |
Used to treat Torsades de pointes | Magnesium |
Adenosine Use | treatment of stable narrow-complex SVT (Supraventricular Tachycardia) |
Best single agent shown to improve survival in patients with CHF | ACE inhibitors |
Medication that may reduce risk of MI and atrial fibrillation postoperatively | beta-blockers |
Best single agent to improve survival after MI | Beta-blockers |
Atropine MoA and effect | Acetylcholine Antagonist increases HR |
Metyrapone & Aminoglutethimide MoA and when to use it | inhibit adrenal steroid synthesis in patients with adrenocortical CA |
Leuprolide MoA and use | Analogue of GnRH and LHRH inhibits release of LH and FSH from pituitary when given continuously (paradoxic effect) for metastatic prostate cancer |
Tamsulosin (Flomax) | alpha-adrenergic receptor antagonist used for BPH |
Nonselective COX inhibitors What are they? What do they do? | indomethacin, ibuprofen inhibits prostaglandin synthesis and decreases mucus and HCO3 secretion, increases acid production constricts renal afferent arterioles |
Selective COX2 Inhibitors what is it? MoA | Celecoxib only binds inducible cyclooxygenase 2 fewer GI side effects increased risk for cardiovascular events |
What is Misoprostol? who to use it in? | PGE1 derivative protective prostaglandin used to prevent peptic ulcer disease consider use in patients on chronic NSAIDs |
Haldol MoA and s/e | antipsychotic inhibits dopamine receptors can cause extrapyramidal effects (tx with benadryl) |
Side effects of Furosemide | metabolic alkalosis, hypokalemia, ototoxicity |
MoA and side effects of spironolactone | inhibits aldosterone s/e: overdiuresis, hyperK, metabolic acidosis, gynecomastia |
Infliximad (Remicade) MoA, Use, Side effects | antibody to TNF-alpha For IBD Risk of TB activation can develop CHF |
ASA poisoning | tinnitus, HAs, nausea and vomiting 1st: respiratory alkalosis 2nd: metabolic acidosis |
Side effects of Gadolinium | Nausea can cause acute renal failure and nephrogenic systemic fibrosis |
MC side effect of Iodine contrast | Nausea |
MC side effect requiring medical treatment that occurs with iodine contrast | dyspnea |
Treatment for Tylenol Overdose | N-acetylcysteine |
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