1
Q
What is pharmacokinetics?
A
Study of how drugs move through the body; includes absorption, distribution, metabolism, and elimination.
2
Q
What is pharmacodynamics?
A
Study of what a drug does to the body; generally determined by the drug’s affinity and activity at its site of action, often a receptor.
3
Q
Define:
Bioavailability
A
Ability of a drug to be absorbed and used by the body.
4
Q
What is the half-life of a drug?
A
The time it takes for the amount of a drug’s active substance in the body to reduce by half.
5
Q
What is the first pass effect?
A
Pharmacological phenomenon where a drug undergoes metabolism at a specific location in the body, reducing the availability of the drug to travel to distant sites.
6
Q
What is the cytochrome P450 system?
A
Group of enzymes that metabolizes drugs; largely concentrated in the liver.
7
Q
List strong inhibitors of the cytochrome P450 system.
A
- Clarithromycin
- Darunavir
- Ketoconazole
- Lopinavir
- Nirmatrelvir/ritonavir
- Saquinavir
- Voriconazole
- Grapefruit juice
8
Q
List moderate inhibitors of the cytochrome P450 system.
A
- Amiodarone
- Cimetidine
- Cyclosporine
- Diltiazem
- Erythromycin
- Fluconazole
- Letermovir
- Verapamil
9
Q
List strong inducers of the cytochrome P450 system.
A
- Apalutamide
- Carbamazepine
- Encorafenib
- Fosphenytoin
- Lumacaftor/ivacaftor
- Mitapivat
- Mitotane
- Phenobarbital
- Rifampin
- St. John’s Wort
10
Q
List moderate inducers of the cytochrome P450 system.
A
- Bexarotene
- Cenobomate
- Dexamethasone
- Eslicarbazepine
- Modafinil
- Pexidartinib
- Primidone
- Rifabutin
11
Q
What is the function of glomerular filtration?
A
Filters waste and excess fluid from the blood into the urine.
12
Q
What does the glomerular barrier restrict?
A
Restricts passage of plasma proteins, such as albumin, red blood cells, and other large blood constituents.
13
Q
Which drugs bind to albumin?
A
- Barbiturates
- Benzodiazepines
- Penicillin
- Valproate
- Phenytoin
- Warfarin
- NSAIDs
14
Q
What happens to glomerular filtration rate with aging?
A
Decreases by approximately 1% per year.
15
Q
What is the primary effect of NSAIDs?
A
Inhibit cyclooxygenase
(an enzyme that produces prostaglandins)
16
Q
What are prostaglandins?
A
Hormone-like substances that affect several bodily functions.
e.g., inflammation, pain
17
Q
What are the two variants of cyclooxygenase?
A
- COX-1: helps to regulate normal cellular functions (vascular homeostasis, platelet aggregation, kidney function).
- COX-2: expressed in the brain, kidney, bone, and likely the female reproductive system; expression is increased during states of inflammation and is inhibited by glucocorticoids.
18
Q
Which medications should be avoided with NSAIDs?
A
- Phenytoin
- Warfarin
- Methotrexate
- ACE inhibitors
- Glucocorticoids
19
Q
Which populations should avoid NSAIDs?
A
- Peptic ulcer disease
- Gastrointestinal disease (current or at risk)
- Cardiovascular disease (current or at risk)
- Kidney disease (current or at risk)
20
Q
What does a Gram stain categorize?
A
Categorizes bacteria into either gram-negative or gram-positive bacteria.
21
Q
What color do gram-positive bacteria appear after Gram staining?
A
Purple
22
Q
What color do gram-negative bacteria appear after Gram staining?
A
Pink
23
Q
Which bacteria cannot be visualized with a Gram stain?
A
- Mycoplasma species
- Chlamydia
- Mycobacterium
24
Q
List examples of gram-positive bacteria.
A
- Streptococcus
- Staphylococcus
- Enterococcus
- Clostridium difficile
- Listeriosis
- Diphtheria
- Botulism
- Tetanus
- Anthrax
25
List **examples** of **gram-negative** bacteria.
* Neisseria meningitidis or Neisseria gonorrhoeae
* Moraxella catarrhalis
* Escherichia
* Klebsiella
* Enterobacter
* Pseudomonas
* Haemophilus
* Acinetobacter
* Moraxella
* Prevotella
* Porphyromonas
26
What are **beta lactam antibiotics**?
Includes penicillins and cephalosporins; both contain a beta lactam ring in their chemical makeup.
27
What **protects** against beta lactamase?
Clavulanic acid
28
What is **Penicillin G** active against?
* Gram positive cocci
* Gram positive rods (listeria)
* Gram negative cocci (neisseria)
* Most anaerobes
* Spirochetes
29
What are **anti-staphylococcal penicillins** active against?
* Penicillinase-producing staphylococci
* Staphylococcus aureus
30
List **second generation** broad spectrum penicillins.
* Ampicillin
* Amoxicillin
31
What is **ampicillin** a preferred treatment for?
Treatment of shigella
32
What are **third and fourth generation** broad spectrum penicillins?
* Third generation: ticarcillin
* Fourth generation: piperacillin
33
What is **cephalexin** active against?
* Most gram-positive cocci
* Most strains of Escherichia coli
* Proteus mirabilis
* Klebsiella pneumoniae
34
What are **second generation cephalosporins** active against?
* Haemophilus influenzae
* Moraxella catarrhalis
35
What are **third generation cephalosporins** active against?
* Enterobacterales
* Neisseria
* H. Influenzae
36
What is **cefepime** active against?
* Enterobacterales
* Neisseria
* H. Influenzae
* P. aeruginosa
37
What is **ceftaroline** active against?
* Methicillin-resistant staphylococci
* Penicillin-resistant pneumococci
* Enteric gram-negative rods
38
What are **tetracyclines** active against?
Many aerobic gram-positive and gram-negative bacteria and atypical pathogens, such as mycoplasma and chlamydia.
39
What is a **side effect** of tetracyclines in children?
Permanent tooth discoloration in children <8 years of age.
40
What are **sulfonamides** active against?
* Variety of aerobic gram-positive bacteria
* Variety of aerobic gram-negative bacteria
* Methicillin-resistant Staphylococcus aureus
41
What are **fluoroquinolones** active against?
* Aerobic, enteric gram-negative bacilli
* Many common respiratory pathogens
* Pseudomonas
* Selected gram-positive organisms
* Anaerobes
* Mycobacteria
* Tuberculosis anthrax
42
What is **ciprofloxacin** particularly effective against?
* Aerobic, enteric gram-negative bacilli (e.g., Escherichia coli)
* Pseudomonas aeruginosa
43
What are **potential adverse effects** of fluoroquinolones?
* Clostridium difficile infection
* Tendinopathy
* Tendon rupture
* Neuropathy
* QT interval prolongation
* Small alleged risk of aortic dissection and rupture
44
What do **beta blockers** block?
Beta adrenergic receptors
45
Where are **beta-1 receptors** mainly found?
Heart and kidneys
46
Where are **beta-2 receptors** mainly found?
Smooth muscle tissue within the respiratory system, blood vessels, and nervous system
47
Where are **beta-3 receptors** mainly found?
Fat cells and within the bladder
48
List **cardioselective** beta blockers.
* Acebutolol
* Atenolol
* Betaxolol
* Bisoprolol
* Esmolol
* Metoprolol
* Nebivolol
49
List **non-selective** beta blockers.
* Carvedilol
* Labetalol
* Nadolol
* Penbutolol
* Propranolol
* Sotalol
* Timolol
50
What do angiotensin converting enzyme inhibitors **prevent**?
Prevents the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.
51
What are **ACE inhibitors** first line treatment for?
Hypertension
52
List **examples** of ACE inhibitors.
* Lisinopril
* Benazepril
* Captopril
* Enalapril
53
What are side effects of **decreased angiotensin II** from ACE inhibitors?
* Hypotension
* Acute kidney injury
* Hyperkalemia
* Pregnancy complications
54
What are side effects of **increased kinins** from ACE inhibitors?
* Dry hacking cough
* Angioedema (rare, but life threatening)
55
Are ACE inhibitors **contraindicated** in pregnancy?
Yes
56
What are **calcium channel blockers** first line treatment for?
Hypertension
57
What are **non-dihydropyridine calcium channel blockers** used for?
Hypertension (less frequently), chronic stable angina, cardiac arrhythmias
58
List **examples** of non-dihydropyridine calcium channel blockers.
* Verapamil
* Diltiazem
59
What are **side effects** of non-dihydropyridine calcium channel blockers?
* Constipation
* Bradycardia
* Decreased cardiac output
* Gingival hyperplasia
60
What are **dihydropyridine calcium channel blockers** used for?
Hypertension, or chronic stable angina
61
List **examples** of dihydropyridine calcium channel blockers.
* Amlodipine
* Nifedipine
* Nicardipine
62
What are **side effects** of dihydropyridine calcium channel blockers?
* Headache
* Lightheadedness
* Flushing
* Dependent peripheral edema
* Gingival hyperplasia
63
What is the first line treatment for **dyslipidemia**?
Statin therapy
64
List **examples** of low intensity statins.
* Lovastatin (20 mg)
* Pravastatin (10 to 20 mg)
* Simvastatin (10 mg)
* Fluvastatin (20 to 40 mg)
65
List **examples** of moderate intensity statins.
* Lovastatin (40 to 80 mg)
* Pravastatin (40 to 80 mg)
* Simvastatin (20 to 40 mg)
* Atorvastatin (10 to 20 mg)
* Rosuvastatin (5 to 10 mg)
66
List **examples** of high intensity statins.
* Atorvastatin (40 to 80 mg)
* Rosuvastatin (20 to 40 mg)
67
What labs should be **checked** before initiating statins?
Baseline aminotransferase levels and thyroid function (TSH)
68
What is **digoxin** used for?
Heart failure and supraventricular arrhythmias
69
What does digoxin **inhibit**?
Inhibits the sodium potassium pump
70
What are **symptoms** of digoxin toxicity?
* Arrhythmias
* Gastrointestinal symptoms
* Confusion
* Vision changes, such as halos or xanthopsia
71
What is **levothyroxine**?
Synthetic T4
72
What is the first line treatment for **hypothyroidism**?
Levothyroxine
73
What is the **onset of action** for levothyroxine when taken orally?
3 to 5 days
74
What is **metformin** first line treatment for?
Diabetes Type 2
75
What are **benefits** of metformin?
* Decreases A1C by 1% to 2%
* Not known to cause hypoglycemia
* Decreases food intake and body weight
* May help reduce likelihood of cardiac events
76
What is the **most reported side effect** of metformin?
Diarrhea
77
What are **contraindications** for metformin?
* Hypersensitivity to metformin or any component of the formulation
* Severe renal dysfunction (eGFR <30 mL/minute)
* Acute or chronic metabolic acidosis with or without coma
78
What is the first line treatment for **unipolar depression**?
Selective serotonin reuptake inhibitors (SSRIs)
79
What do **SSRIs** block?
SSRIs block the reabsorption of serotonin, allowing for more serotonin to be available.
80
List **examples** of SSRIs.
* Fluoxetine (Prozac)
* Paroxetine (Paxil)
* Sertraline (Zoloft)
* Citalopram (Celexa)
* Escitalopram (Lexapro)
81
What are **side effects** of SSRIs?
* GI discomfort (diarrhea)
* Sexual dysfunction
* Weight gain
Family Nurse Practitioner (FNP)
flashcards
Decks in class (19)
# Cards
-
Musculoskeletal87
-
Endocrine29
-
Hematology53
-
Genitourinary43
-
Gastrointestinal101
-
Respiratory79
-
Cardiovascular114
-
Dermatological85
-
EENT45
-
STIs34
-
Men’s Health42
-
Women’s Health48
-
Neurological101
-
Mental Health36
-
Adult Screenings14
-
Pediatrics90
-
Diagnostic Imaging17
-
Pharmacology81
-
Non-Clinical36
