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Pharmacology – First

Pharm 1

QuestionAnswer
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