45 NOTES TO PG

Dr. Ankit Yadavendra, M.B.B.S., Dr.V.M.G.M.C., Solapur

14-PHARMACOLOGY
receptor
ligand gated/ch link/ionotropic(fastest)
GABAAR(open Cl ch), nAChR, 5HT3R, GlyR
Gprot coupled/metabotropic
shape-serpentine(7memb)
Gprot-GDP couple with Alp(Active),, subunit
adenyl cyclase pathw(cAMP)
Gs(adr)
Gi(M2,M4,2adr,adr antag)
cAMP-TSHR, FSHR, LHR, ACTHR, PTHR, glucagonR, calcitoninR, adrenalineR,
vasopressinR(V2)
cAMP-DR
phospholiase C pathw(IP3,DAG)
Gq(M1,M3,M5,1adr)
Gt(transducin)-generate signal in rod
small Gprot(monomer)-Ras prot
enzyme linked
insulinR(tyrosine kinase), GHR(janase kinase), prolactin(janase kinase), cytokineR,
ANFR(cGMP), NO(cGMP)
intracellular(slowest)
Cytoplasmic-Corticosteroid, mineraloCorticoid
nucleus-testosterone, E, vitA&D, thy h
grp I-nuclear recept
grp II-surf recept
2nd messenger
hydrophobic-DAG,IP3
hydrophilic-cAMP,cGMP
gas-NO,CO,H2S
clinical trial(HECP)
0-microdosing
I-Human pharmacology
Healthy Human volunteer
safety&tolerance
ADR
pharmacodynamic

pharmacokinetic
II-therapeutic Exploration
Efcacy
III-therapeutic Conrmation
Comparision with established drug
IV-Postmarketting suveillance
ADR/toxicity
pharmacogenetic-genetic basis for variable response
pharmacogenomics-genetic information to guide DOC
pharmacognosy-drug fr plant
pharmacovigilance-detection, assessm, understand, prevent ADR
pharmacodynamic&pharmacokinetic
0 order kinetic indep of-pl conc
ED50-potency
area under time&pl conc-pl clearance
loading dose-vol distribution
maintenance dose-clearance
chloroquine, digoxin, doxycycline, long acting sulfonamide, phenylbutazone,
lignocaine(short t)
Li excreted by kidn, not metab
oscillatory response-+ve feedback
entrOPy not change-OPen system
biotransformat rxn
phase I(non synth) rxn
oxidation(MI-cytP450), reduction, hydrolysis, cyclization, decyclization
phase II(synth) rxn
acetylation, glucuronide conjugation, Gly conjugation, SO4 conjugation, methylation,
nucleotide synth
less polar more polar
bioavailability
extensive 1st pass metab-oral route
drug-bioavailability(%)
bisphosphonate,remelteon=2
furosemide=60
sotalol,pindolol,penbutolol=100
Acidic drug-Albumin
basic drug-1glycoprot

preparation-drug
capsule
hard-tetracycline
soft-vitE
sustain release-theophylline
time release-indomethacin
depot preparation-flupentixol, fluphenazine, haloperidol, imipramine, risperidone
ETT-adrenaline, atropine, diazepam, naloxone, lignocaine
ID-BCG vacc
inhaler
aerosol-salbutamol, beclomethasone
dry powder-salbutamol
gas-GA
spinhaler-diNa chromoglycate
desmopressin, liposome, butorphanol, zanamivir, calcitonin
intravitreal-bevacizumab, foscarnet, ganciclovir, ranibizumab, pegaptanib
nasal spray-sumatriptan
SC-sumatriptan, morphine, vitB3, exenatide
SL-isosorbide diNO3, buprenorphine, ergot amine tartrate, isoprenaline,
nitroglycerine, desaminooxytocin, clonidine, nifedipine
suppository-diclofenac, indomethacin, aminophyllin, diazepam, metronidazole,
chlorpromazine, bisacodyl, glycerine, morphine, ergotamine, paracetamol
tablet
chewable-ergotamine tartrate, acarbose, Al(OH)3, Mg trisilicate
double strength-cotrimoxazole
enteric coated-bisacodyl
mouth dissolving-ondansetron
sugar coated-metronidazole
sustain release-pyridostigmine, morphine, diclofenac, theophylline, pinacidil,
prazosin, pentoxyphylline
uncoated-amlodipine
transdermal-fentanyl, nicotine, nitroglycerine, estradiol, hyoscine, rotigotine
ability of vehicle to retard evaporation fr skin
ointment> foam> cream> paste> powder> aerosol> gel> lotion> wet dress> tincture
liposome
anticancer drug-daunorubicin, vincristin, camptothecin, mtx, cisplatin, mitoxantron
antifungal-amphotericinB, nystatin
antibiotic-amikacin, ampicillin, ciproflox, ribavirin, ganciclovir, chloroquine
other-IL2, cyclosporine
food

-CBZ, chloroquine, griseofulvin(fatty), halofantrine, LiCO3, nitrofurantoin, vitB2,

spironolactone
-ampicillin, aspirin, captopril, digoxin, furosemide, hydrochlothiazide, INH, Ldopa,
penicillinG, phenytoin, rifampicin, tetracycline
drug with extensive 1st pass metab
V-Verapamil
P-Propranolol
Singh-Salbutamol
Not-Nitroglycerine
A-Amitryptyline
Popular-Propoxyphene
P-Pethidine
M-Methyltestosterone
drug with low 1st pass metab
Phenobarbitone
Phenylephrine
Pindolol
Theophylline
Tolbutamide
ts-drug conc
adipose ts-thiopentone, ether, minocycline, phenoxybenzamine, DDT
bone,teeth-tetracycline, heavy metal, bisphosphonat
brain-chlorpromazine, acetazolamide, INH
iris-ephedrine, atropine
kidn-digoxin, chloroquine, emetine
liver-chloroquine, tetracycline, emetine, digoxin
retina-chloroquine
sk m,heart-digoxin, emetine
thy gld-I2
drug-source
cephalosporin-fungus
colistin-bact
griseofulvin-fungus
penicillin(fung)
discover fr-Penicillium notatum
now develop fr-P chrysogenum
KG+acetylcoA homocitrate aminoadipic acid Lys+penicillin
Rifamycin-Streptomyces mediteRRanei
streptomycin-Streptomyces griseus

tobramycin-Streptomyces tenebrarius
drug causing hemolysis in G6PD def
A-Aspirin
D-Dapsone
Na-Nalidixic acid
N-Nitrofurantoin
Sami-Sulfonamide
Pe-Primaquine,Phenacetin
M-Menadione(vitK3)
C-Chloroquine
Q-Quinine
drug causing hyperpigmentation(CCAM)
Chlorpromazine
Clofazimine
Amiodarone
Minocycline
drug causing disulram like rxn
C-Chlorpropamide, Cefoperazone, Cefamandole, Citrate Ca carbamide, Cyanamide,
animal Charcoal
M-Metronidazole
Praised-Procarbazine
G-Griseofulvon
T-Tinidazole
Naidu-Nitrofurantoin
drug causing deafness(BEDEAFM2C2Q)
Bleomycin
Ethacrynic acid
Desferoxamine
Erythromycin
Aminoglycoside
Furosemide
Minocycline
Mustine
Chloroquine
Cisplatin
Quinine
enzyme inducer
G-Griseofulvin

P-Phenytoin
R-Rifampicin
S-Smoking
Cell-CBZ
Phone-Pnenobarbitone
enzyme inhibitor
Vitamin-Valproate
K-Ketoconazole
Cannot-Cimetidine
Cause-Ciprofloxacin
Enzyme-Erythromycin
Inhibition-INH
grape fruit juice
drug metab by acetylation(SHIPCD)
Sulfonamide
Hydralazine
INH
Procainamide,PAS
Clonazepam
Dapsone
fAsT acet-hepATiTis
sLOw acet-peripheraL neurOpathy
drug with low therapeutic index
V-Vancomycin
C-Clonidine
D-Digoxin
P-Phenytoin
Layer-Lithium
G-Glipizide
I-Imipramine
F-Flucytosine
T-Theophylline
drug with 0 order kinetic
Zero-Zidovudine
W-Warfarin
A-Aspirin
T-Theophylline
T-Tolbutamide
Power-Phenytoin

drug causing pulm brosis

amiodarone, bleomycin, busulfan, Au, mtx, cyclophosphamide, methysergide,
nitrofurantoin, phenytoin
drug causing cataract
Au(gold),Amiodarone
Busulfan
Chlorpromazine
Dexamethasone(oral)
Echothiophate,pilocarpine
drug ppt a/c interm porphyria
barbiturate, OCP, griseofulvin, estrogen, chlorpropamide, phenytoin, rifampicin,
sulfonamide
drug inh nephrogenesis
ACEI, ARB, dexamethasone, gentamicin, NSAID
drug cause peptic ulcer
bisphosphonate, CT, clopidogrel, cocaine, steroid, mycophenolate mofetil, KCl
prophylaxis TB child-INH(5mg/kg)6mth
posttrauma myelopathy-methylprednisolone(30mg/kg<3h)
75mg/d-aspirin, clopidogrel, oseltamivir, amiodarone
75mg/w-mtx
chemical
Adrenalectomy-Aminoglutethimide
pancreatectomy-streptozocin
debrillator-bretylium
antibiotic SMR(MAQ)
Macrolide
Aminoglycoside(neomycin)
Quinolone
orphan drug
Na nitrite, fomepizole, liposomal amphotericinB, miltefosine, rifabutin, succimer,
somatropine, digoxin immune Fab, liothrionine
GnRH agonist(A-F&HIP)
A-Adenomyosis

B-irritable Bowel synd

C-Ca Breast(tamoxifen+GnRH agonist)
D-DUB
E-Endometriosis
F-Fibromyoma uterus
H-Hirsutism
I-Infertility
P-Precocious puberty
topical steroid potency
betamethasone diproprionate> betamethasone valerate> clobetasol propionate>
hydrocortisone butyrate
antiHTN drug
lipid hostilE-blockEr, thiazidE
lipid neutral-ACEI, ARB, CCB, indapamide
lipid friendly-doxazosin, prazosin
erectile dysfn
highest risk-diuretic
high risk-atenolol, carvedilol,metoprolol
risk-ACEI
antibiotic acting on cell wall
lactam antibiotic
vancomycin
teicoplanin
bacitracin
cycloserine
fosfomycin
antibiotic acting on cell memb
polypeptide-polymyxinB, polymyxinE(colistin)
polyene antifungal-amphotericinB
azole antifungal-ketoconazole
allylamine-terbinane
antimicrobial sensitivity
method
disc diffusion
broth culture with break pt
potency
Min Inh Conc(MIC)-lowest conc which prevent visible growth of bact
Min Bact Conc(MBC)-kill 99.9% bact
MBCMIC-bacteriostatic

MBCMIC-bactericidal
warfarin
INR=ptPT/contrPT=2-3, prosthetic valve=2.5-3.5, long term=1.5-1.9
paracetamol does not
stimulate respiration
affect acid base balance
cause gastric irritation
have CVS affect
affect PLT fn
cause uricosuria
pethidine(meperidine)
hydrolysis meperidinic acid(maj), inh by MAOI producing more demethylation
demethylat norpethidine(min) sz
opioid recept
endorphin(),enkephaLin(DeLta)
P-Physical dependence,Prolactin
M-Miosis
C-Constipation,Convusion(M3G)
A-Analgesic(spinal,supraspinal)
R-Resp depression
E-Euphoria
S-Sedation
Dynorphin()
D-Dysphoria
M-Miosis
A-Analgesic
R-Resp depression
D-Diuresis
S-Sedation
Muscle rigidity-Mu
digitalis
toxicity-hypokalemia, hypercalcemia, hypermagnesemia, ren failure
CFTR
corrector-lumacaftor-correct trafcking defect
potentIator-Ivacaftor-open Cl ch
drug act on

cortical part nephron-+ve H2O clearance

medullary part-ve H2O clearance
adr antag
loNgest-Nadolol
Shortest-eSmolol
c/i ren fail(PANS)-Pindolol, Atenolol, Nadolol, Sotalol
H2O soluble-ANS
lipid soluble(MP3)-Metoprolol, Pindolol, Propranolol(max), Penbutolol
hep elimina(LMP)-Labetalol, Metoprolol, Propranolol
memb stabilising(LMPTAPCB)-Labetalol, Metoprolol, Propranolol(max), Timolol,
Acebutolol, Pindolol, Carvedilol(max), Betaxolol
no memb stabilising-bevantolol
acebutolol-cardioselective, partial agonist, memb stabilising, lipid insoluble
CHF-Carvedilol(1+1+2)
100% bioavail(PPS)-Pindolol, Penbutol, Sotalol
mAx prot bind-cArvedilol
mIn prot bind-celIprolol
l isomer-propranolol, atenolol, esmolol, metoprolol, timolol
d isomer-nebivolol
iron dextran-IM, IV, high molec wt, 10-30% get locally bound, no excret, absorb
through lymphat, not bound to transferrin
iron sorbitoL citric acid-IM, Low molec wt, not locally bound, 30%excret in urine,
absorb directly in circulat, bound to transferrin
parenteral Fe req=4.3body wt(kg)Hb decit(g/dl)
gramicidin
A:B:C=80:6:14=D(linear pentadecapeptide 15AA chain)
S-cyclic peptide chain
G+ve bact(except G+ve bacilli), N gonorrhoea
BDZ
midbrain ascending reticular formation, limbic
Medulla-M relaxation
cerebellum-ataxia
sleep-stage2,REM,stage3,4
nitRazEpaM-REM
SMR-clonazepam, diazepam
anticonv-clonazepam, diazepam, nitrazepam, flurazepam
coronary dilatat-IV diazepam
analgesic, nocturn gastric secretion, stress ulcer-diazepam

tamoxifen
E antag-Breast,Bld vess
E agonist-uterus,bone,lipid
dopamine
dose(g/kg/min)-action
low(1-2)-renal&mesenteric vasodilat
moder high(2-10)-1adr agonist, +ve ionotropic
high(>10)-1adr agonist, vasoconstrict
steroid
0mineralocort-triamcinolone, paramethasone, dexamethasone, betamethasone
0glucocort-DOCA(DeOxyCorticosterone Acetate)
most potent glucocort-betamethasone
least potent glucocort-cortisone
max mineralocort-aldosterone> fludrocortisone> DOCA
max glucocort-dexa&betamethasone
hydrocortisone:prednisolone:dexamethasone= 1:4:40
advantage 2nd gen antihistam
less-sedation, interaction with alcohol, psychomotor disturb
FDC malaria-artemether+lumefantrine
Abbreviations
a-artery, AA-amino acid, abtc-antibiotic, AI-autoimmune
bef-before, bel-below, b/l-bilateral, bld-blood, b/n-between, bn-benign, br-branch,
Bx-biopsy
ca-carcinoma, carb-carbohydrate, c/i-contraindication, c/l-contralateral,
conc-concentration, cong-congenital, Cx-cervix
d-day, def-deficient, ds-disease, d/t-due to, Dx-diagnosis
E-estrogen
fem-female, fr-from
gld-gland, glu-glucose
h-hormone
idiop-idiopathic, i/l-ipsilateral, inf-infection, inj-injury
lig-ligament, LL-lower limb, l/t-leading to
m-muscle, maj-major, mal-male, MC-most common, met-metastasis, min-minor,
mtx-methotrexate, Mx-management
n-nerve, norm-normal
P-progesterone, pl-plasma, prot-protein, pt-patient
Rx-treatment
SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure
tm-tumour, ts-tissue
UL-upper limb, u/l-unilateral
vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume
w-week, wt-weight

Xr-X ray
y-year
#-fracture
-degree
-(N.B.-THESE NOTES ARE ONLY FOR THE PURPOSE OF GUIDANCE AND HELP
TO PG ASPIRANTS, NOT FOR COMMERCIAL OR OTHER PURPOSE. REFERENCE
HAS BEEN TAKEN FROM VARIOUS STANDARD TEXTBOOKS. FOR ANY
FEEDBACK/QUERY PLEASE CONTACT- ankit.yadavendra@facebook.com or
dr.ankityadavendra@gmail.com )