Test Taking Tip
The most commonly tested mechanism of action of drugs are succinylcholine (vs. other paralytics), imatinib, fluoroquinolones, warfarin, and corticosteroids. Don’t overmemorize intricate details of exotic drug classes.
What are some basic drug properties?
What is first-order kinetics?
What is zero-order kinetics?
What is the primary role of the P-450 system?
What are some of the inducers of the P-450 system?
Cigarette smoke, phenobarbital, rifampin, ethanol, INH, phenytoin, etc.
What are some of the inhibitors of the P-450 system?
Grapefruit, erythromycin, nelfinavir, itraconazole, etc.
Drug administration by continuous intravenous infusion (upper panel) or intermittent intravenous bolus (lower panel). Attainment of steady-state plasma concentration (Cpss) occurs after 3 to 5 half-lives, regardless of the dosing regimen. Peak and trough fluctuations around Cpss are aimed to each be within the therapeutic range (therapeutic but subtoxic plasma levels). (Reproduced with permission from Hall JB, Schmidt GA, Wood LDH. Principles of Critical Care, 3rd ed. New York, NY: McGraw Hill; 2005.)
What is the half-life of a drug?
What is a phase I reaction?
Also known as modification. Nonsynthetic reaction, for example, oxidation/reduction/hydrolysis, NOT conjugation. Catalyzed mainly by cytochrome P-450.
What is a phase II reaction?
Synthetic reaction, for example, conjugation, methylation, sulfation, etc.
What are some treatments for achalasia?
What is the management for esophageal varices bleeding?
Vasoactive medications: vasopressin (splanchnic vasoconstrictor at V1 receptors, increases factor VIII and VWF via extrarenal V2 receptors), somatostatin/octreotide (inhibits release of vasodilator hormones—indirect cause of splanchnic vasoconstriction and decreased portal flow)
Prophylaxis: nonselective β blockade: Propranolol/nadolol (preventative role; inhibits B2 adrenergic splanchnic vasodilation). Carvedilol (β blocker with mild anti α-1 activity) and alternative to nonselective blockade. Must watch for significant MAP drops, which won’t be tolerated in cirrhotic patients. Nitrates (not recommended as primary prophylaxis).
What are some treatment options for reflux disease?