NR 565 Midterm Exam
Study Guide Advanced
Pharmacology
Fundamentals
1. Pharmacokinetics & Pharmacodynamics (PK/PD)
Pharmacokinetics (what the body does to the drug):
Absorption: Bioavailability, first-pass effect, routes of administration.
Distribution: Protein binding, volume of distribution (Vd).
Metabolism: Phase I (CYP450 oxidation/reduction/hydrolysis), Phase II (conjugation).
Excretion: Renal (glomerular filtration, tubular secretion/reabsorption), hepatic.
Pharmacodynamics (what the drug does to the body):
Receptor binding: agonist, partial agonist, antagonist, inverse agonist.
Dose–response curves: potency vs. efficacy.
Therapeutic index: narrow vs. wide TI drugs (e.g., lithium, digoxin, warfarin =
narrow).
,2. Autonomic Nervous System (ANS) Pharmacology
Sympathetic (adrenergic):
α1 = vasoconstriction, ↑ BP.
α2 = ↓ NE release (negative feedback).
β1 = ↑ HR, contractility.
β2 = bronchodilation, vasodilation, uterine relaxation.
Parasympathetic (cholinergic):
Muscarinic receptors: salivation, lacrimation, urination, diarrhea,
bronchoconstriction, bradycardia.
Major drug classes:
Adrenergic agonists: Epinephrine, norepinephrine, albuterol.
Adrenergic antagonists (β-blockers): Metoprolol, propranolol, carvedilol.
Anticholinergics: Atropine, ipratropium.
Cholinergic agonists: Bethanechol, pilocarpine.
3. Cardiovascular Pharmacology
Antihypertensives:
,ACE inhibitors (lisinopril): block conversion of angiotensin I → II; adverse = cough,
angioedema, hyperkalemia.
ARBs (losartan): similar to ACEI but no cough.
Beta blockers: decrease HR/contractility, reduce renin release.
Calcium channel blockers:
DHP (amlodipine) = vasodilation.
Non-DHP (verapamil, diltiazem) = decrease HR/contractility.
Diuretics:
Thiazides (HCTZ) = Na/Cl reabsorption blocker in distal tubule.
Loops (furosemide) = Na/K/Cl blocker in loop of Henle.
K-sparing (spironolactone) = aldosterone antagonist.
Antiarrhythmics (Vaughan-Williams classification):
Class I (Na+ blockers), II (β-blockers), III (K+ blockers), IV (Ca++ blockers).
Antiplatelets/Anticoagulants:
Aspirin (COX inhibitor), clopidogrel (P2Y12 inhibitor).
Warfarin (Vit K antagonist, monitor INR).
DOACs (apixaban, rivaroxaban).
, 4. Respiratory Pharmacology
Asthma/COPD management:
Short-acting β2 agonists (SABA): albuterol.
Long-acting β2 agonists (LABA): salmeterol (must combine with ICS in asthma).
Inhaled corticosteroids (ICS): fluticasone, budesonide.
Anticholinergics: ipratropium, tiotropium.
Leukotriene receptor antagonists: montelukast.
5. Endocrine Pharmacology
Diabetes:
Type 1: insulin therapy only.
Type 2:
Biguanides: metformin (↓ hepatic gluconeogenesis, caution in renal impairment).
Sulfonylureas: glipizide, glyburide (stimulate insulin release).
GLP-1 agonists: semaglutide (weight loss, GI side effects).
SGLT2 inhibitors: empagliflozin (risk UTI, DKA).
DPP-4 inhibitors: sitagliptin (well tolerated).
Study Guide Advanced
Pharmacology
Fundamentals
1. Pharmacokinetics & Pharmacodynamics (PK/PD)
Pharmacokinetics (what the body does to the drug):
Absorption: Bioavailability, first-pass effect, routes of administration.
Distribution: Protein binding, volume of distribution (Vd).
Metabolism: Phase I (CYP450 oxidation/reduction/hydrolysis), Phase II (conjugation).
Excretion: Renal (glomerular filtration, tubular secretion/reabsorption), hepatic.
Pharmacodynamics (what the drug does to the body):
Receptor binding: agonist, partial agonist, antagonist, inverse agonist.
Dose–response curves: potency vs. efficacy.
Therapeutic index: narrow vs. wide TI drugs (e.g., lithium, digoxin, warfarin =
narrow).
,2. Autonomic Nervous System (ANS) Pharmacology
Sympathetic (adrenergic):
α1 = vasoconstriction, ↑ BP.
α2 = ↓ NE release (negative feedback).
β1 = ↑ HR, contractility.
β2 = bronchodilation, vasodilation, uterine relaxation.
Parasympathetic (cholinergic):
Muscarinic receptors: salivation, lacrimation, urination, diarrhea,
bronchoconstriction, bradycardia.
Major drug classes:
Adrenergic agonists: Epinephrine, norepinephrine, albuterol.
Adrenergic antagonists (β-blockers): Metoprolol, propranolol, carvedilol.
Anticholinergics: Atropine, ipratropium.
Cholinergic agonists: Bethanechol, pilocarpine.
3. Cardiovascular Pharmacology
Antihypertensives:
,ACE inhibitors (lisinopril): block conversion of angiotensin I → II; adverse = cough,
angioedema, hyperkalemia.
ARBs (losartan): similar to ACEI but no cough.
Beta blockers: decrease HR/contractility, reduce renin release.
Calcium channel blockers:
DHP (amlodipine) = vasodilation.
Non-DHP (verapamil, diltiazem) = decrease HR/contractility.
Diuretics:
Thiazides (HCTZ) = Na/Cl reabsorption blocker in distal tubule.
Loops (furosemide) = Na/K/Cl blocker in loop of Henle.
K-sparing (spironolactone) = aldosterone antagonist.
Antiarrhythmics (Vaughan-Williams classification):
Class I (Na+ blockers), II (β-blockers), III (K+ blockers), IV (Ca++ blockers).
Antiplatelets/Anticoagulants:
Aspirin (COX inhibitor), clopidogrel (P2Y12 inhibitor).
Warfarin (Vit K antagonist, monitor INR).
DOACs (apixaban, rivaroxaban).
, 4. Respiratory Pharmacology
Asthma/COPD management:
Short-acting β2 agonists (SABA): albuterol.
Long-acting β2 agonists (LABA): salmeterol (must combine with ICS in asthma).
Inhaled corticosteroids (ICS): fluticasone, budesonide.
Anticholinergics: ipratropium, tiotropium.
Leukotriene receptor antagonists: montelukast.
5. Endocrine Pharmacology
Diabetes:
Type 1: insulin therapy only.
Type 2:
Biguanides: metformin (↓ hepatic gluconeogenesis, caution in renal impairment).
Sulfonylureas: glipizide, glyburide (stimulate insulin release).
GLP-1 agonists: semaglutide (weight loss, GI side effects).
SGLT2 inhibitors: empagliflozin (risk UTI, DKA).
DPP-4 inhibitors: sitagliptin (well tolerated).
