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| 28-year-old chemist presents ;with MPTP exposure. What neurotransmitter is depleted? |
Dopamine. |
| Woman taking tetracycline ;exhibits photosensitivity. |
Rash on sun-exposed regions of ;the body. |
| African-American man who ;goes to Africa develops a ;hemolytic anemia after taking ;malarial prophylaxis. |
Glucose-6-phosphate ;dehydrogenase deficiency |
| Farmer presents with dyspnea, ;salivation, miosis, diarrhea, ;cramping, and blurry vision. |
Insecticide poisoning; inhibition of acetylcholinesterase. |
| 27-year-old female with a history of psychiatric illness now has urinary retention due to a neuroleptic. What do you treat it with? |
Bethanechol. |
| Patient with recent kidney ;transplant is on cyclosporine for ;immunosuppression. Requires ;antifungal agent for candidiasis. What antifungal drug would result in cyclosporine toxicity? |
Ketoconazole. |
| Patient is on carbamazepine. What routine workup should always be done? |
LFTs. |
| 23-year-old female who is on ;rifampin for TB prophylaxis and ;on birth control (estrogen) gets ;pregnant. Why? |
Rifampin augments estrogen ;metabolism in the liver, rendering it less effective. |
| Km reflects |
the affinity of the ;enzyme for its substrate. |
| Vmax is directly proportional |
to ;the enzyme concentration. |
| The lower the Km, the |
The lower the Km, the higher;the affinity. |
| The ???? the Km, the higher;the affinity. |
lower |
| Competitive inhibitors ;vs;Noncompetitive inhibitors ;;WRT Resemble substrate |
Competitive-- Yes;;Noncompetitive-- NO |
| Competitive inhibitors ;vs;Noncompetitive inhibitors ;;WRT Overcome by ↑ [S] |
Competitive-- Yes;;Noncompetitive-- NO |
| Competitive inhibitors ;vs;Noncompetitive inhibitors ;;WRT Bind active site |
Competitive-- Yes;;Noncompetitive-- NO |
| Competitive inhibitors ;vs;Noncompetitive inhibitors ;;WRT Effect on Vmax |
Competitive-- no change;;Noncompetitive-- decrease |
| Competitive inhibitors ;vs;Noncompetitive inhibitors ;;WRT Effect on Km |
Competitive-- increase;;Noncompetitive-- no change |
| Volume of ;distribution (Vd) ;;describe and altered by |
Relates the amount of drug in the body to the plasma concentration. ;;Vd of plasma ;protein–bound drugs can be altered by liver and kidney disease. |
| Vd equation |
amount of drug in the body /;plasma drug concentration |
| Vd ranges and what the mean for where the drug is |
low Vd distribute in plasma;;medium Vd distribute in extracellular space;;high Vd distribute in tissues |
| t1/2 = |
0.7 × Vd/CL |
| 0.7 × Vd/CL = |
half life |
| concentration after no. of half-lives |
1 - 50% ;2 - 75% ;3 - 87.5;3.3 - 90%;4 - 94% |
| Loading dose = |
Cp × Vd/F. |
| 28 year old chemist presents with MPTP exposure What NT is depleted? |
Dopamine |
| Woman taking tetracycline exhibits photosensitivity What are the clinical manifestations? |
Rash on sun-exposed regions of body |
| Nondiabetic patient presents with hypoglycemia but low levels of C peptide What is the diagnosis |
Surreptitious insulin injection |
| African American male who goes to Africa develops hemolytic anemia after taking malaria prophylaxis What is the enzyme defficiency |
Glucose 6 phosphate dehydrogenase |
| 27 year old female with history of psychiatric illness now has urinary retention due to neuroleptic What do you treat it with? |
Bethanechol |
| Farmer presents with dyspnea, salivation, miosis, diarrhea, cramping and blurry vision What caused this and what is the mechanism |
Insecticide poisoning, inhibition of acetylcholinesterase |
| Patient with recent kidney transplant is on cyclosporine for immunosuppresion, he requires antifungal agent for candidiasis What antifungal drug would result in cyclosporine toxicity? |
Ketoconazole |
| Man on several medications including antidepressants and antihypertensives, has mydriasis and becomes constipated What is the cause of symptoms? |
TCA |
| 55 year old postmenopausal woman on tamoxifen therapy What is she at increased risk of acquiring? |
Endometrial carcinoma |
| Woman on MAO inhibitor has hypertensive crisis after meal What did she ingest? |
Tyramine (wine or cheese) |
| After taking clindamycin, patient develops toxic megacolon and diarrhea What is the mechanism of diarrhea? |
Clostridium difficile overgrowth |
| Man starts a medication for hyperlipidemia. He then develops rash, pruritus and GI upset What drug was it? |
Niacin |
| Patient is on carbamazepine What routine workup should be done? |
LFT's |
| 23 year old female who is on rifampin for TB prophylaxis and on birth control (estrogen) gets pregnant Why? |
Rifampin augments estrogen metabolism in liver rendering it less effective |
| Patient develops cough and must discontinue captopril WHat is a good replacement drug and why doesnt it have the same side effects? |
Losartan - an angiotensin II receptor antagonist, does not increase bradykinin as captopril does |
| Relates the amount of drug in the body to plasma concentration |
Vd - volume of distribution |
| Formule for volume of distribution |
Vd = amount of drug in the body/plasma drug concentration |
| Vd of plasma protein-bound drugs can be altered by what disease? |
Liver and kidney |
| Relates the rate of elimination to plasma concentration |
CLEARANCE |
| Formula for clearance |
Cl = rate of elimination of drug/plasma drug concentration |
| The time required to change the amount of drug in the body by 1/2 during elimination (or during constant infusion) is called _ |
Half life T1/2 |
| After 1 half life concentration of drug equals _ % |
0.5 |
| After 2 half lifes concentration of drug equals_ |
0.75 |
| A drug infused at constant rate reaches about _ % of steady state after 4 T1/2 |
94 |
| Formula for T1/2 |
T1/2 = 0.7 * Vd/CL |
| Loading dose formula |
Loading dose = Cp * Vd/F ;;Cp= target plasma concentration F = bioavailibility |
