Pharm 1
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| 28 year old chemist presents with MPTP exposure. What NT is depleted? | Dopamine
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| Woman taking tetracycline exhibits photosensitivity. What are the clinical manifestations? | Rash on sun-exposed regions of body
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| Nondiabetic patient presents with hypoglycemia but low levels of C peptide. What is the diagnosis | Surreptitious insulin injection
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| African American male who goes to Africa develops hemolytic anemia after taking malaria prophylaxis. What is the enzyme defficiency | Glucose 6 phosphate dehydrogenase
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| 27 year old female with history of psychiatric illness now has urinary retention due to neuroleptic. What do you treat it with? | Bethanechol
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| Farmer presents with dyspnea, salivation, miosis, diarrhea, cramping and blurry vision. What caused this and what is the mechanism | Insecticide poisoning, inhibition of acetylcholinesterase
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| 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
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| Man on several medications including antidepressants and antihypertensives, has mydriasis and becomes constipated. What is the cause of symptoms? | TCA
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| 55 year old postmenopausal woman on tamoxifen therapy. What is she at increased risk of acquiring? | Endometrial carcinoma
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| Woman on MAO inhibitor has hypertensive crisis after meal. What did she ingest? | Tyramine (wine or cheese)
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| After taking clindamycin, patient develops toxic megacolon and diarrhea. What is the mechanism of diarrhea? | Clostridium difficile overgrowth
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| Man starts a medication for hyperlipidemia. He then develops rash, pruritus and GI upset. What drug was it? | Niacin
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| Patient is on carbamazepine. What routine workup should be done? | LFT's
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| 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
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| 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
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| Relates the amount of drug in the body to plasma concentration | Vd - volume of distribution
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| Formule for volume of distribution | Vd = amount of drug in the body/plasma drug concentration
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| Vd of plasma protein-bound drugs can be altered by what disease? | Liver and kidney
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| Relates the rate of elimination to plasma concentration | CLEARANCE
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| Formula for clearance | Cl = rate of elimination of drug/plasma drug concentration
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| 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
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| After 1 half life concentration of drug equals _ % | 50%
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| After 2 half lifes concentration of drug equals_ | 75%
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| A drug infused at constant rate reaches about _ % of steady state after 4 T1/2 | 94
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| Formula for T1/2 | T1/2 = 0.7 * Vd/CL
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| Loading dose formula | Loading dose = Cp * Vd/F, Cp= target plasma concentration, F = bioavailibility
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| Formula for maintenance dose | Cp * CL / F, Cp = target plasma concentration, F = bioavailibility
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| In patients with impaired renal or hepatic function, the loading dose decreases, increases or remains unchanged? Maintenance dose? | Loading dose remains unchanged, Maintenance dose decreases
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| Rate of elimination is constant (constant amount of drug is eliminated per unit time) - what order elimination? What happens to target plasma concentration? | Zero order elimination, Target plasma concentration decreases linearly with time
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| Rate of elimination is proportional to drug concentration (constant fraction of drug eliminated per unit time) - what order elimination? What happens to target plasma concentration? | First order elimination, Cp decreases exponentially with time
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| Give examples of drugs with zero order elimination | Ethanol, Phenytoin, Aspirin (at high or toxic concentration)
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| Phase I metabolism (reduction, oxidation, hydrolysis) yields _ metabolites (often still active) | Slightly polar, water soluble
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| What phase of metabolism associated with cytochrome P450 | Phase I
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| What phase of metabolism associated with conjugation | Phase I
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| Phase II metabolism (acetylation, glucoronidation, sulfation) yields _ metanolites (renally excreted) | Very polar, inactive
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| Geriatric patients lose which phase of metabolism first? | Phase I
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| Is it safe? Pharmacokinetics? - which phase of clinical testing of the drug | Phase I
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| Does it work in patients?- which phase of clinical testing of the drug | Phase II
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| Does it work? Double blind - which phase of clinical testing of the drug | Phase III
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| What happens in phase IV of clinical testing of the drug | Postmarketing surveillance
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| A competitive antagonist shifts agonist curve where? | To the right
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| A noncompetitive antagonist (irreversible) shifts agonist curve where? | Downward
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| Name antibiotics that block cell wall synthesis by inhibition of peptidoglycan cross linking | Penicillin, Ampicillin, Ticarcillin, Pipercarcillin, Imipenem, Aztreonam, Cephalosporins
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| Name antibiotics that block peptidoglycan synthesis | Bacitracin, Vancomycin, Cycloserine
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