Pharm Comprehensive Study Guide Review Updates, Study Guides, Projects, Research of Pharmacology

Pharm Comprehensive Study Guide Review Updates

Typology: Study Guides, Projects, Research

2025/2026

Available from 02/02/2026

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Pharm Comprehensive Study Guide Review Updates
1.
volume
of
distribution:
amount of drug in body/plasma drug
concentration
2.
Lipid
solubility
+
partition
coefficient:
higher
lipid
solubility
=
higher
partition
coefficient
3.Alkalkine Drugs : examples and pH + pKa:
LA, opioids
-
pH > pkA = unionized
-
pH = pKa = unionized and ionized are equal
-
pH
<
pKa
=
ionized
4.Acidic Drugs: examples and pH + pKa:
barbituates
-
pH > pkA = ionized
-
pH = pKa = unionized and ionized are equal
-
pH
<
pKa
=
unionized
5.Normal creatine clearance males and females: males 97-137 mL/min
females 88-
128mL/min
6.
creatinine
clearance
formula:
((140-age)
x
weight
(kg))
/
(72
x
SCr)
multiply
by
.85
if
female
7.Therapeutic Index:
LD50/ED50
LD50-
dose
required
to
produce
death
in
50%
of
patient
ED50-
dose
required
to
produce
specific
response
in
50%
of
patient
want
this
to
be
large
as
possible
8.
TC:
1 TC - 63%
2
TC
-
86%
3
TC
-
95%
4
TC
-
98%
pf3
pf4
pf5
pf8
pf9
pfa
pfd
pfe
pff
pf12
pf13
pf14
pf15
pf16
pf17
pf18
pf19
pf1a
pf1b
pf1c
pf1d
pf1e
pf1f
pf20
pf21
pf22
pf23

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Pharm Comprehensive Study Guide Review Updates

1.volume of distribution: amount of drug in body/plasma drug concentration 2.Lipid solubility + partition coefficient: higher lipid solubility = higher partition coefficient 3.Alkalkine Drugs : examples and pH + pKa: LA, opioids

  • pH > pkA = unionized
  • pH = pKa = unionized and ionized are equal
  • pH < pKa = ionized 4.Acidic Drugs: examples and pH + pKa: barbituates
  • pH > pkA = ionized
  • pH = pKa = unionized and ionized are equal
  • pH < pKa = unionized 5.Normal creatine clearance males and females: males 97-137 mL/min females 88- 128mL/min 6.creatinine clearance formula: ((140-age) x weight (kg)) / (72 x SCr) multiply by .85 if female 7.Therapeutic Index: LD50/ED LD50- dose required to produce death in 50% of patient ED50- dose required to produce specific response in 50% of patient want this to be large as possible 8.TC: 1 TC - 63% 2 TC - 86% 3 TC - 95% 4 TC - 98%

2 / 35 9.TC formula: TC = Volume/FGF

  1. Anesthetic uptake formula: Solubility x CO x (PA- Pv)
  2. Nitrous partition coefficient: 0.
  3. Halothane partition coefficient: 2.
  4. Iso partition coefficient: 1.
  5. Des Partition Coefficient:.
  6. Sevo Partition Coefficient:.
  7. Nitrous MAC value: 104%
  8. Sevo Mac Value: 2%
  9. Des Mac value: 6.6%
  10. Isoflurane Mac value: 1.17%
  11. MAC BAR: concentration that blocks autonomic reflexes 1.7-2.0MAC
  12. MAC awake: .3-.5 MAC concentration that prevents consciousness in 50% of people
  13. MAC memory: less than MAC bar concentration that associated with amnesia in 50% of people
  14. Increase in MAC value: hypernatremia hyperthermia red head drug induced increase in CNS catecholamines
  15. decrease in MAC value: acute alcohol intoxication hypothermia hyponatremia old age pregnancy
  16. No impact on mac: potassium levels, chronic alcoholic, thyroid gland dysfunction
  17. treatment of MH: dantrolene 2.5mg/kg
  18. spinothalamic tract: pain, temp, itching
  19. spinobulbar tract: homeostasis and behavior
  20. spinohypothalamic: emotional aspects of pain, autonomic, neuroendocrine

4 / 35 duration potency of opiods are dependent on: onset- pKa duration- protein binding potency - lipid solubility

  1. spasms of sphincter of oddi treatment: 2mg glucagon narcan also works
  2. samters triad: aspirin exacerbated respiratory disease

1. Nasal polyps

2. Asthma

3. Aspirin sensitivity

  1. drugs that can close PDA (2): endomethacin NSAIDS
  2. toradol dosing: 15-30mg q 6 hr
  3. baby aspirin dosing: 81mg
  4. aspirin should be stopped: 7-10 days before
  5. decadron analgesia dose: .15mg/kg
  6. decadron antimetic dose: 4-8 mg/kg k
  7. ketamine dose anaglesia preop and intraop: preop .1mg-.5mg/kg intraop .1mg -.3mg/kg
  8. alpha 2 agonist MOA and site of action: MOA- inhibits presynaptic release of norepi pain - works @ spinal cord hyponsis - works @ locus coerelus in brain
  9. precedex drip vs infusion CV effects: drip - brady and hotn bolus - htn

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  1. precedex bolus dose: 1mcg/kg over 10 minutes
  2. precedex infusion dose: .2-.7mcg/kg/hr
  3. Pregabalin trade name + dose: lyrica 75-100mg
  4. gabapentin trade name + dose: neurontin 300-900mg
  5. lidocaine dosing bolus for pain: 1.5mg/kg
  6. lidocaine infusion dosing for pain `: 2mg/kg/hr
  7. tramadol dose PO: 50-100mg
  8. magnesium sulfate dose bolus and infusion: 3-4gm bolus 1-2g/hr infusion
  9. treatment for carcinoid crisis: octerotride
  10. differential conduction blockade order: sympathetic > pain/temp > motor fibers
  11. Which LA do not cause VD?: cocaine mepivicaine ropivicaine
  12. BICEPS mnemonic: B- blood I- intercostal C- caudal E
  • epidural P- plexus/PNB S- subarchnoid/subcu blood highest
  1. lidocaine max dose
  • w/o epi
  • w/ epi: - w/ epi: 4.5mg/kg , 300mg max
  • w/o: 7mg/kg, 500mg max
  1. bupivicaine max dose
  • w/o epi
  • w/ epi: 2.5mg/kg w/o epi 3.0mg/kg w/ epi
  1. LAST treatment - first step: Intralipid 20%- initial dose of 1.5ml/kg bolus

7 / 35 distal cutt down LA injected IV removed

  1. TQ pain + bier block: distal cut up proximal down
  2. what subunits of nictonic choinergic receptor can bind ACH?: 5 total, 2 alpha ones can
  3. acetylcholinesterase vs butrylcholinesterase: acetylcholinesterase hydrolyzes aCh at synaptic cleft butryl aka plasma cholinesterase aka psuedocholinesterase hydrolyzes sux in the plasma
  4. dibucaine number: normal: 70- 80 heterozygous atypical; 50- 60 homozygous atypical: 20- 30
  5. sux + brady more common in (2): peds after second dose
  6. Sux potassium increase: .5meQ/dL increase in K+ with SUX
  7. Sux + Burn patient: okay w/in 24 hrs not okay after and up to 1-2 years
  8. Sux + stroke: avoid for 6 months
  9. Sux + upper motor injury (spinal cord denervating injury): okay w/in 72 hours not okay after and up to 9 months post injury
  10. Ryanodex amount in 1 vial + dilution: 250mg per 1 vial dilute it in 5 cc -> 250mg/5ml or 50 mg/ml
  11. Dantrium amount in 1 vial + dilution: 20mg per 1 vial dilute it in 60 cc -> 20mg/60 mL -> .33 mg/mL

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  1. which NMB has vagolytic effect ?: panc -> increase HR, MAP, CO
  2. NDMR prolonged duration: ABX (3): aminoglycosides (gent) tetracycylines bacitracin
  3. NDMR prolonged duration: CV drugs (3): quinidine and verapamil
  4. NDMR prolonged duration: disease state: MG
  5. NDMR prolonged duration: electrolyte (4): increased mag and sodium decreased calcium and potassium
  6. NDMR prolonged duration: physiologic (3): hepatic dysfunction hypothermia acidosis
  7. NDMR prolonged duration: seizure meds: phenytoin (short acting) chronic anticonvulsant need higher doses
  8. NDMR and increases resistance (4): burns chronic anticonvulsant therapy cerebral palsy central nerve injury
  9. phase 1 block: typical of Depolarizing MR
  • no fade with TOF or ST
  • decreasing amplitude over time
  1. phase 2 block: typical of nondepolarizing MR fade with TOF or ST sux can resemble this if you give too much of it
  2. suggamadex reversal dosages: •2 mg/kg for shallow blockade (2/4 TOF) •4 mg/kg for deep blockade (0/4 TOF)

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  1. suggamadex contraindications: birth control allergy severe renal impairment < 2 years old concern for increased PTT/PT/INR if using anyting other than ROC/VEC
  2. suggamadex incompatible with: zofran
  3. If neuromuscular blockade is required before the recommended waiting time has elapsed after reversal with suggamadex , what should you do?: Use a nonsteroidal neuromuscular blocking agent.
  4. What percentage of the body is water in males? females? infants?: •Body = 60% water male, 50% female, 75%. infants
  5. Total body water can be split up into these two subcategories + their per- centages: intracellular - 66% extracellular- 33%
  6. extracellular fluid is found in these three locations: interstitial, intravascular, transcellular
  7. extracellular fluid percentages: 25% is interstitial 8% is plasma
  8. Which electrolytes are higher outside of cells?: Outside of the cell Na and Cl Inside of the cell
  • Potassium (K+)
  • Phosphate (PO42-)
  • Magnesium (Mg2+)
  • Calcium (Ca2+)
  1. max infusion rate of peripherial v central potassium: peripherial: 10 meQ/hr central: 20 meQ/hr

11 / 35

  1. calcium chloride precautions: Do not push calcium chloride through the IV, if last resort use largest gauge possible
  2. maintenance fluid shortcut: if atleast 20kg add 40 to their weight to obtain maintenance require- ments

13 / 35 hyperglycemia

14 / 35

  1. When do you not give a stress dose of steroids?: < 3 weeks or < 5mg of daily prednisone
  2. minor surgical stress -> steroid stress dose: 25mg hydrocortisone 5mg methylprednisone
  3. moderate surgical stress -> steroid stress dose: 50-75mg hydrocortisone for 1-2 days
  4. major surgical stress -> steroid stress dose: 100-150mg hydrocortisone
  5. CaCl2 _ gm = calcium gluconate _ gm: 1 gm = 3 gm
  6. Neuroleptic Malignant Syndrome what is it + symptoms + tx: adevrse reaction to antipsychotic neuroleptic medications dopamine overload F: fever E: encephalopathy( altered mental status) V: vital signs (tachycardia, labile BP), also autonomic instability(sweating, incontinence) E:enzymes (increase creatinine kinase) R: Rigidity tx is dopamine antagonist
  7. alpha 1 receptor
  • major effector tissues
  • major function: - smooth muscles/sphincters
  • increased constriction
  1. alpha 2 receptor: decrease release of neurotransmitter (think precedex )
  2. Beta 1 receptor
  • major effector tissues
  • major function: - cardiac muscle and kidney
  • increase HR and contractility in the heart
  • increase renin secretion

16 / 35

  1. digoxin main effects: increased CO and decreased AV node conduction
  2. digoxin EKG changes: prolonged PR shortened QT ST depression (scooped out appearance) diminished or inverted T waves
  3. contraindications to digoxin: WPW and HOCM
  4. ortho vs antidromic WPW: av node to apex of heart -> narrow QRS antidromic goes in the opposte direction -> wide QRS
  5. PDE inhbitors MOA and impacts on VSM and myocardium: increases cAMP vasodilation increased contractility
  6. why do you alpha block before beta block in pheo?: beta blockade before alpha blockade will lead to unopposed alpha activity if sympathetic activity occurs, leading to HTN crisis
  7. nonselectie alpha blockers: phentolamine and phenoxybenzamines
  8. alpha 1 selective blockers: - end in zosin
  9. TRUE alpha 1 selective blocker + use case: prazosin HTN, CHF, Raynauds
  10. alpha 1 a blocker medication + what it treats: tamsulosin targets receptors in bladder -> faciliates urination better than others will less hoTN
  11. non-selective beta blockers: propranolol, timolol, nadolol
  12. cardiselective beta blockers: metoprolol, esmolol, atenolol
  13. nonselective beta plus alpha 1 blockers: labetaolol
  14. partial beta antagonist + examples: level of blockade depends on intrinsic sympathetic tone when it is low, will act more like a beta agonist labetalol

17 / 35

  1. nonselective beta blocker precaustions: will increase risk of bronchospasm may worsen PVD hypoglycemia
  2. hypoglycemia + nonselective beta blockade considerations: hypoglycemia will lead to tachycardia typically but with beta blockade, this will be masked
  3. side effects of propanolol: if given with heparin, free drug will increase -> brady decreases clearance of amide LA -> toxicity esp with bupivicaine decrease first pass uptake of fent -> much more enters blood
  4. systemic absorption of timolol will lead to: bradycardia
  5. how to decrease BP of patient on cocaine?: do not beta block -> Removes the ability of heart to increase HR and myocardial contractility to compensate for catecholamine -induced increases in left ventricular afterload (SVR) instead use NTG
  6. labetalol MOA: non-selective beta blocker & alpha-1 blocker decreased BP due to alpha 1 activity no reflex tachy due to beta blockade
  7. treatment for beta blocker overdose: glucagon
  8. contraindications for beta blockade:
  9. arbitrary limit for BP in cancelling surgery `: SBP > 180 DBP > 110
  10. DOS
  • Beta blockers
  • Ace

19 / 35

  1. carbonic anhydrase inhibitors: - work at PCT
  • example: acetazolamide
  • decrease reabsorption of Na, Water, and Bicarb
  • can lead to metabolic acidosis
  • some cross reactivity with sulfa drugs
  1. osmotic dieuretics: - work at PCT and loop of henle
  • example: mannitol
  • not reabsorbed
  1. Loop diuertics are first in line treatment for: CHF
  2. loop diuertics MOA + example: prevent reabsorption of na/cl/k furosemide/bumetadine
  3. loop diuretic cons: hypokalemia bad in renal (nephrotoxic) cross reactivity with sulfa
  4. thiazide diuertics: block na reabsorption in DCT hydrochlorothiazide typically used for long term tx of HTN
  5. thiazide dieuretic side effects: •Hypokalemia, hypochloremia, metabolic alkalosis
  6. K+ sparing diuretics: work at CD
  • triametrene. (Pteridine analog)
  • spirinolactone (aldoseterone receptor antagonist)
  1. K+ sparing dieuretic consideration: poor antiHTN, typically used with other diuertics
  2. Natriuretic Peptides: anp and bnp work in CD by blocking the basal Na/K ATPase channel
  3. main cells involved in asthma vs COPD: asthma - eosinophils COPD- nuetrophils
  4. SABA examples: MAL

20 / 35 metaproterenol albuterol levalbuterol

  1. when should someone go from SABA to something stronger?: if using > 2x week
  2. examples of LABA: SAF salmeterol arformetrol formoterol
  3. examples of SAMA + use: ipatroprium (atrovent) Short-acting Maintenance for COPD; Rescue for Asthma and COPD
  4. examples of LAMA + use: tiotropium (spiriva) Long-acting maintenance for COPD
  5. Side effects of muscarinic antagonists (anticholinergics): cant see cant pee cant spit cant shit
  6. cholinergic effects: BLUDS
  • bradycardia
  • lacrimation
  • urination
  • defecation
  • salivation
  1. ICS monotherapy examples: Beclomethasone Budesonide Flunisolide