Pharmacology Grand Finals

Pharmacology  Vd is directly proportional to ECV and tissue binding but inversely proportional to plasma protein       

binding (PPB). Therefore, the higher the Vd, the lower the PPB. Drugs with zero order kinetics: phenytoin, ethanol, aspirin Bioavailability AUC – degree of drug absorption Cholinergic receptors Nicotinic receptors Noradrenergic receptors Skeletal muscle tremor due to beta 2 effect. Therefore, b2 antagonist would help remove the tremor.

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i.e. Propanolol For acute angle closure glaucoma: Pilocarpine Contraindicated in acute angle closure glaucoma: Atropine GI and bladder atony: Betanechol "Sufficient quantity": qs Rx - superscript Direction to the pharmacist - subscript Direction to the patient – transcription Basis, adjuvant, corrective, vehicle – self explanatory Anticholinergic of choice for asthma: Ipratropium bromide Ipratropium bromide is usually given with: Salbutamol Needs drug monitoring due to its narrow margin of safety: Theophylline Long half-life of salmeterol is due to its: High lipophilicity Patients are instructed to gargle after taking this drug (budesonide) to prevent: Oral candidiasis Can be used with other drugs for helicobacter pylori infection: Bismuth sulcralfate Anti-emetic for chemotherapy induced nausea and vomiting: Ondansentron Ulcer/ Zollinger-ellison/Gastroesophageal disease: Omeprazole Acetazolamide – side effect: hyperchloremic metabolic acidosis; Indicated for glaucoma and acute

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mountain sickness Which diuretic is the best for calcium stones: Thiazides Which diuretic is best for HPN: Thiazides Which diuretic is best for heart failure: Loop diuretics Most common indication for your carbonic anhydrase inhibitor: Glaucoma What diuretic will cause stone formation: Loop diuretics Aldosterone antagonist: Spironolactone Most common site of digitalis toxicity: GIT Inc Ca, dec K, dec Mg – risk factors for digitalis toxicity: Furosemide/ Amiodarone MOA as a PDE inhibitor – Bipyridines (Milrinone/inamrinone) Beta drugs with ISA - Labetalol Highest probability of torsade de pointes: Class III Not a prodrug for ACE inhibitors: Captopril Block GPIIb/IIIa (i.e. Tirofiban, eptifibatide): Abciximab Antihyperlipidemic that is a ligand of PPAR: Fibrates Fibrates + statins are not recommended due to w/c side effect: Rhabdomyolysis Which drug will inhibit the HMG-Coa reductase inhibitors: Statins Anti-epileptic agent that produces paradoxical hyperactivity in children: Phenobarbital Anti-epileptic used for SIADH: Carbamazepine

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SSRI's, have delayed effect due to: Post receptor down regulation Action is affected by kinetics at low and high dose: Phenytoin Most potent psychopharmacologic, for schizophrenia: Haloperidol Indicated for all types of seizures (grand mal, absence, myoclonic seizures): Valproic acid Side effect of psychopharmacologic drugs: Motor dysfunction Displaces phenytoin from CHON binding: Aspirin Gabapentin Anticonvulsant with bad effect to heart: Phenytoin? Anticonvulsant best for acute epileptic attacks: Diazepam? Antibiotic with the same spectrum of activity as aminoglycosides: Aztreonam Antibiotic which has a decreased absorption in presence of food: Phenoxymethylpenicillin or penV Antifungal that can safely cross BBB: Fluconazole Antiviral drug that prevents uncoating of virus: Amantadine Antiviral drug that prevents the release of virus: Oseltamivir Antiviral drug that prevents penetration: Enfurvitide Antiparasitic drug for amebic cyst passers but do not kill tissue trophozoites: Diloxanide furoate Antiparasitic drug for tissue trophozoites but not amebic cysts: Metronidazole Antimalaria drug for radical cure: Primaquine Anti-TB drug that is used to reduce emergence of resistance: Ethambutol Anti-TB drug for latent infection (boy, exposed to TB): Isoniazid 9mos. Anti-TB drug that has a biphasic kinetics: Isoniazid Anti-TB drug for slowly growing tubercle bacilli: Pyrazinamide Anti-TB drug that can also be used in leprosy: Rifampicin Drug for multibacillary leprosy: Clofazimine Non-depolarizing neuromuscular blocker whose metabolite laudanosine can induce seizures when it

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gets accumulated and requires greater anesthetic concentration: Atracurium Accumulation of O-toluidine metabolite: Prilocaine Anesthetic drug that can cause cardiac toxicity: Halothane Condition that is resistant to non-depolarizing neuromuscular blockers: Severe burns Steroid for salt-losing addison’s disease: Fludrocortisone Least sedating 1st gen. H1 blocker: Chlorphenamine Antithyroid drug for rapid improvement of symptoms in goiter: Iodide Anti-thyroid for pregnant women: PTU Anti-thyroid for compliance: Methimazole SERM beneficial effect to bone but not to breast: Raloxifene Anti-diabetic drug for obese patients with good renal function: Metformin Anti-diabetic sulfonylurea drug good for elderly patients: Tolbutamide Drug for prostate cancer: Flutamide Vincristine (adverse effect): Neurotoxicity Cyclophosphamide (adverse effect): Hemorrhagic cystitis Cisplatin (adverse effect): Nephrotoxicity Doxorubicin (adverse effect): First sign of salicylate toxicity: Hyperventilation & respiratory alkalosis Lead accumulates where in children: Bone marrow Heparin (antidote): Protamine Warfarin should not be used for pregnant women: Heparin more advisable Breastfeeding women are more prone to pass on to their babies their drug intake when drug is taken: before breastfeeding

Magnesium – Ma = madaming poopoo – se: diarrhea Aluminum – Al = ala – wAlang poopoo – se: constipation -tidine = h2 antagonist Cimetidine – enzyme inhibitor; hormonal adverse effects Famotidine – most potent -azole = proton pump inhibitor Dopamine – alpha 1, beta 1, dopamine receptors At low doses – causes vasodilation Disopyramide and flecainide, verapamil – negative inotropic effect Beta-blockers Calcium Channel Blockers Cephalosporins