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Pharmacology – First
Pharm 1
| Question | Answer |
|---|---|
| 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 higherthe affinity. |
| The ???? the Km, the higherthe affinity. | lower |
| Competitive inhibitors vsNoncompetitive inhibitors WRT Resemble substrate | Competitive-- YesNoncompetitive-- NO |
| Competitive inhibitors vsNoncompetitive inhibitors WRT Overcome by ↑ [S] | Competitive-- YesNoncompetitive-- NO |
| Competitive inhibitors vsNoncompetitive inhibitors WRT Bind active site | Competitive-- YesNoncompetitive-- NO |
| Competitive inhibitors vsNoncompetitive inhibitors WRT Effect on Vmax | Competitive-- no changeNoncompetitive-- decrease |
| Competitive inhibitors vsNoncompetitive inhibitors WRT Effect on Km | Competitive-- increaseNoncompetitive-- 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 plasmamedium Vd distribute in extracellular spacehigh Vd distribute in tissues |
| t1/2 = | 0.7 × Vd/CL |
| 0.7 × Vd/CL = | half life |
| concentration after | of half-lives |
| 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 |
| Formula 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 |
Created by:
christinapham
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