| Term 
 | Definition 
 
        | Higher risk of Neurotoxicity with ISONIAZID |  | 
        |  | 
        
        | Term 
 
        | Thiopurine-S-methyltransfrase |  | Definition 
 
        | Higher hematopoietic toxicity AZATHIOPRINE and 6-MERCAPTOPURINE |  | 
        |  | 
        
        | Term 
 
        | TA(TATA Box) Repeats in Promoter Region |  | Definition 
 
        | Higher risk of toxicity for IRINOTECAN 
 UDP-glucuronosyl-transferase(UGT1A1) has lower expression
 |  | 
        |  | 
        
        | Term 
 
        | Glutathione-S-transferase |  | Definition 
 
        | Higher toxicity with anti-cancer drugs |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Impaired function causes facial flushing with alcohol |  | 
        |  | 
        
        | Term 
 
        | Butyrylcholinesterase (pseudocholinesterae) |  | Definition 
 
        | Prolonged muscle relaxant response to Succinylcholine |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Member of ATP-binding cassette family (ABCB1) Toxicity for anti-cancer drugs and digoxin
 |  | 
        |  | 
        
        | Term 
 
        | Variation in a anion transporter |  | Definition 
 
        | Statins and methorexate adverse effects increased |  | 
        |  | 
        
        | Term 
 
        | Variations in cation transporter |  | Definition 
 
        | Influence effect of Metformin |  | 
        |  | 
        
        | Term 
 
        | Receptors that signal through Gq |  | Definition 
 
        | M1   M3   M5  Alpha1 (Increases intraceullular Ca2+) |  | 
        |  | 
        
        | Term 
 
        | Receptors that signal through Gi |  | Definition 
 
        | M2   M4 Alpha 2 (Opens K+ and REDUCES cAMP) |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Smooth Muscle,  Vascular Endothelium, Excorine Glands |  | 
        |  | 
        
        | Term 
 
        | Receptors that Signal through Gs |  | Definition 
 
        | All Beta receptors (B1, B2, B3) ad D1 (Elevates cAMP) |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Lung and Various Smooth muscle |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | INCREASED Heart rate and Force of Contraction INCREASED blood flow to skeletal muscle
 INCREASED Renin release from Kidney
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Relaxation of Bronchilar Smooth Muscle 
 INCREASED Gluconeogenesis and GLycogenolysis in Liver
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | INCREASED lipolysis in fat cells |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | DECREASED Blood flow to skin and viscera Vasoconstriction on vascular smooth muscle (skin and splanchnic)
 
 INCREASED Gluconeogenesis and Glycogenolysis in liver
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Parasympathetic reduces heart rate |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | INCREASED Blood flow to skeletal muscle 
 Contraction of bronchiolar smooth muscle
 
 Constriction of pupils in eyes due to contraction of ciliary Muscles
 |  | 
        |  | 
        
        | Term 
 
        | Renin Production Regulated by which system and receptor? |  | Definition 
 
        | Sympathetic Nervous System , B1 receptor |  | 
        |  | 
        
        | Term 
 
        | Location of Sensory Input for Afferent Fibers |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Location of Baroreceptors typically found |  | Definition 
 
        | Carotid Sinus and Aortic Arch |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Alpha1-adrenoceptor Agonists 
 INCREASE in Systolic and Diastolic
 
 Nasal Decongestion (Dose too high you lose this selectivity)
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Alpha1-adrenoceptor Agonists 
 INCREASE in Systolic and Diastolic
 
 Orthostatic HYPOtension
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Alpha2-Adrenoceptor AGONIST 
 Treats Hypertension
 
 Suppresses sympathetic tone through negative feedback of Alpha2 pre-ganglionic
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Beta1-Adrenoceptor AGONIST 
 Treats Acute Heart Failure
 
 Positive Inotrophic and Chronotropic (HR).  Chronotropic less prominent
 
 Increase in Cardiac Output
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Beta2-Adrenoceptor Agonist 
 Treats Asthma and COPD
 
 Relaxes bronchial Smooth Muscle
 
 MILD INCREASE in HR and Force of Contraction
 
 Vasodilation in some vascular Beds of Skeletal Muscle
 
 Inhalation dose minimizes effects on Heart and Vascular Beds
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Similar Potency for B1 and B2 receptors, NO EFFECT on Alpha 
 Vasodilator EXCEPT on Blood vessel in skin
 
 Positive Chronotropic and Inotropic
 
 REDUCTION in Diastolic, little effect on Systolic
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Alpha1, Alpha2, B1 (less for B2) 
 Vasoctriction, Increase in BP
 
 Reduction in HR due to Baroceptor reflex
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Alpha1,  Alpha2, B1 and B2 recpeotrs 
 Inotropic effect but is equaled out due to baroceptor reflex
 
 Increase in cardiac OUTPUT
 
 Increase in Systolic, little effect on Diastolic
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | (Minipress) 
 Alpha 1-Adrenoceptor Antagonist
 
 Treats Hypertension & Hyperplasia of prostate
 
 Vaasodilation on Vascular Smooth muscle
 
 DECREASE in peripheral arterial resistance
 
 DECREASE in venous tone
 
 Decrease in mean Arterial Pressure primarily due to Diastolic
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | (Inderal) 
 Beta1 Antagonist
 
 Similar potency for B1 and B2 receptor.  B2 less selection
 
 Negative Inotropic and Chronotropic Effects
 ACUTE EFFECT:  INCREASE in peripheral resistance
 
 CHRONIC EFFECT:  DECREASE in peripheral resistance to decrease BP
 
 Suppression of Renin
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Beta1-Antagonist 
 Negative Inotropic and Chronotropic Effects
 
 Treats Hypertension
 
 Suppresses Renin release
 |  | 
        |  | 
        
        | Term 
 
        | Other Effects of B1 antagonist besides anti-hypertension? |  | Definition 
 
        | Contraction of Bronchial Smooth Muscle (Mainly propanolol) |  | 
        |  | 
        
        | Term 
 
        | B1 can what effect on asthma patients? |  | Definition 
 
        | Problematic effects since it causes bronchial smooth muscle contraction |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | (Miochol-E) 
 Direct-Acting Cholinergic Agonist
 
 
 Naturla transmitter, short acting and non-selective,  interacts with muscarinic AND nicotinic
 
 M3 Receptor
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Direct-Acting Cholinergic Agonist 
 Interactis with Muscarinic Receptors due to Methyl group
 
 M3 Receptor
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | (Carboptic) 
 Direct-Acting Cholinergic
 
 Resistant to Cholinesterase and is NON-selective
 
 Treats Glaucoma
 
 M3 Receptor
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | (Urecholine) 
 Resistant to Cholinesterase and SELECTIVE for muscarinic receptors
 
 Treats Urinary Retention
 
 M3 Receptor
 |  | 
        |  | 
        
        | Term 
 
        | How do Cholinergic drugs work? |  | Definition 
 
        | Cause vasodilation through M3 reeptor.  Vascular Endothelium releases NO and DECREASES BP.  Baroreceptors stimulate sympathetic and INCREASE heart rate |  | 
        |  | 
        
        | Term 
 
        | Organ Effects of Direct Acting Cholinergic Agonists 
 Cardiovascular System
 |  | Definition 
 
        | Vasodilation through M3 receptors in Vascular endothelium that release NO 
 Decrease in BP
 
 Reflex INCREASE in Heart rate with Low doses
 |  | 
        |  | 
        
        | Term 
 
        | Organ Effects of Direct Acting Cholinergic Agonists 
 Eye
 |  | Definition 
 
        | Contraction of Iris Circular Muscle (constriction of pupil) 
 Contraction of Ciliary Muscle (Accommodation)
 |  | 
        |  | 
        
        | Term 
 
        | Organ Effects of Direct Acting Cholinergic Agonists 
 Respiratory System
 |  | Definition 
 
        | Contraction of Bronchial Smooth Muscle 
 Stimulation of Glandular Secretion (mucus in lung)
 |  | 
        |  | 
        
        | Term 
 
        | Organ Effects of Direct Acting Cholinergic Agonists 
 GI Tract
 |  | Definition 
 
        | INCREASED motility and relaxation of sphincters (Increase movement of food through GI tract) 
 Stimulation of secretion from salivary and gastric glands
 |  | 
        |  | 
        
        | Term 
 
        | Organ Effects of Direct Acting Cholinergic Agonists 
 Urinary Bladder
 |  | Definition 
 
        | Contraction of Bladder and Relaxation of Sphincter (Voiding of Bladder) |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | (Tensilon)   Indirect-Cholinergic Agonist   Short Acting Drug   Treats Myasthenia Gravis Inhibits   cholinesterase which will increase ACh |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | (Prostigmin) 
 Treats Myasthenia Gravis
 
 Inhibits cholinesterase which will increase ACh
 |  | 
        |  | 
        
        | Term 
 
        | Indirect Acting Cholinergic Agonist have what side effects? |  | Definition 
 
        | DIRECTLY cause bradycardia 
 Reduces Cardiac Output
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Cholinergic Antagonist 
 Used in Ophthalmology
 
 Selective for all muscarinic ACh receptors
 
 Tertiary Amine
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | (Atrovent) 
 Selective for ALL muscarinic ACh
 
 Treats Asthma and COPD
 
 Quaternary Amine
 |  | 
        |  | 
        
        | Term 
 
        | Why does it matter that Ipratropium is a tertiary amine? |  | Definition 
 
        | Makes it much more limited and more lipohilic, which allows it to be used for COPD and asthma |  | 
        |  | 
        
        | Term 
 
        | Cholinergic Antagonist given at too high doses can have an effect on? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Cholinergic Antagonist Organ System Effects 
 Cardiovascular Effects
 |  | Definition 
 
        | Minimal effect on BP or heart rate at NORMAL dosage 
 Slight Tachycardia may occur
 |  | 
        |  | 
        
        | Term 
 
        | Cholinergic Antagonist Organ System Effects 
 Eye
 |  | Definition 
 
        | Relaxation of Iris circular Muscle (dilation of pupil) 
 Relaxation of Ciliary Muscle (loos of accommodation)
 |  | 
        |  | 
        
        | Term 
 
        | Cholinergic Antagonist Organ System Effects 
 Respiratory System
 |  | Definition 
 
        | Relaxation of bronchial smooth muscle 
 Inhibition of Glandular secretion (decrease secretion of mucous)
 |  | 
        |  | 
        
        | Term 
 
        | Cholinergic Antagonist Organ System Effects 
 GI Tract
 |  | Definition 
 
        | Reduced Motility 
 Inhibition of secretion from salivary gland
 |  | 
        |  | 
        
        | Term 
 
        | Cholinergic Antagonist Organ System Effects 
 Urinary Bladder
 |  | Definition 
 
        | Relaxation of Bladder muscles |  | 
        |  | 
        
        | Term 
 
        | Cholinergic Antagonist Organ System Effects 
 Secretory Glands
 |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Study of Genetic basis for Variation in drug response |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Assess the contribution from multiple genes on drug reponse |  | 
        |  | 
        
        | Term 
 
        | Phenotype-Gentoype approach |  | Definition 
 
        | Find the phenotype first, then use a pedigree to tract back |  | 
        |  | 
        
        | Term 
 
        | Genotype-Phenotype approach |  | Definition 
 
        | Find the Genotype first,then see what phenotype it expresses |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Location on chromosome where gene resides |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Specific DNA sequence at a particular Locus |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Particular combination of alleles at nearby loci on a chromosome that tend to be inherited together |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Tendency for alleles at nearby loci to be inherited together |  | 
        |  | 
        
        | Term 
 
        | SNP occurring in promoter region? |  | Definition 
 
        | INCREASE or DECREASE mRNA expression |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 
        | Alters mRNA stability and Protein expression |  | 
        |  | 
        
        | Term 
 
        | SNP at exon-intron splicing site? |  | Definition 
 
        | Causes alternative splicing |  | 
        |  | 
        
        | Term 
 
        | VNTR stands for what and is normally found where? |  | Definition 
 
        | Variable Number of Tandem Repeats,  Normally found in non-coding regions |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Insertion or deletion of one or more nucleotide in DNA sequences |  | 
        |  | 
        
        | Term 
 
        | Genetic Variation is greatest in what group? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Hardy-Weinberg Equilibrium |  | Definition 
 
        | Evaluates effect of polymorphic variants in a specific gene. |  | 
        |  | 
        
        | Term 
 
        | Genome Wide Associated Study |  | Definition 
 
        | Used to discover unanticipated gene effects. Powerful approach to identify novel pharmacogenetic contribution |  | 
        |  | 
        
        | Term 
 
        | Limitations of Genome Wide Associated Study |  | Definition 
 
        | Has a high rate of False positive findings |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Validates significance of potentials causative genetic variants. 
 Used for Drug transporters and metabolizing Enzymes
 |  | 
        |  | 
        
        | Term 
 
        | Functional Studies are particularly useful when? |  | Definition 
 
        | Doing non-synonymous coding SNP and indel it can identify loss of function and gain of function variants |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | CYP450 Predominant Enzymes |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Prominent effects on Pharmacokinetics due to poor metabolizer polymorphism |  | Definition 
 
        | INCREASED risk of toxicity of antidepressant and anti-psychotic drugs 
 Reduced analgesic effect of Codeine (pro-drug for morphine)
 
 Reduced anti-neoplastic action of Tamoxifen (pro-drug for endoxifen)
 
 Metabolism of Other drugs also affected
 |  | 
        |  | 
        
        | Term 
 
        | Enzymes with prominent role in Wafarin Metabolism |  | Definition 
 
        | CYP2C9 and Vitamin K Epoxidase |  | 
        |  | 
        
        | Term 
 
        | This enzyme causes 10-fold reduction in Wafarin clearance |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | CYP2C9*3 affects what drugs? |  | Definition 
 
        | NSAIDs, Warfarin, Phenytoin, Tolbutamide |  | 
        |  | 
        
        | Term 
 
        | 2 Poor metabolizer variants of CYP2C19 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Ultra-rapid metabolizer of CYP2C19 |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Phase I Biotransformation |  | Definition 
 
        | Increases Hydrophilicity 
 Inactivate Drug
 
 Provides a Handle for Phase II
 |  | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | Phase II Biotransformation |  | Definition 
 
        | Increases Hydrophilicity 
 Inactivates Drug
 
 ADDS a recognition element for Active excretion
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Oxidation Hydroxylation
 Reduction
 Hydrolysis
 |  | 
        |  | 
        
        | Term 
 
        | Oxidation on Carbon Susceptibility |  | Definition 
 
        | Methyl Substituents on Skeleton easily accessible for oxidation to form alcohol --> carboxylic Acids 
 Longer-chain substituents the terminal carbon and penultimate carbon are most exposed which make them susceptible to oxidation
 
 Aliphatic rings, most exposed region is likely to be oxidized
 
 Activated carbon atoms next to sp2 or sp carbon MORE likely to be oxidized
 
 Methyl--> Primary Alcohol --> aldehyde --> COOH
 
 Oxidation of carbon Next to N,O,S
 |  | 
        |  | 
        
        | Term 
 
        | Aromatic Hydroxylation Predominate form |  | Definition 
 
        | Predominate form is PARA position, with some ortho formed |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Aromatic amines --> aromatic Nitro groups N(OH)HCHRR--> O2N-CHRR
 
 Aromatic Primary Amines --> aromatic Nitro groups
 AR-NH-OH-->AR-NO2
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Oxidation of Nitrogen, Sulfur, Phosphorus (NPS) |  | 
        |  | 
        
        | Term 
 
        | Oxiation pathway of Aldehyde, Carboxylic and Alcohol |  | Definition 
 
        | Alcohol --> Aldehyde --> Carboxylic Acid |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Ketones, Aldehyde, Azo and Nitro |  | 
        |  | 
        
        | Term 
 
        | Reduction of Disulfide bridge forms? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Phase I Ester/Amide hydrolysis, which is hydrolyzed faster? |  | Definition 
 
        | Esters are faster hydrolyzed than amides, Esters readily react with water |  | 
        |  | 
        
        | Term 
 
        | Phase II Conjugation Metabolisms |  | Definition 
 
        | Glucuronic Acid Conjugation Sulfate Conjugation
 Amino Acid Conjugation
 Acetylation
 Methylation
 Glutathione Conjugation
 |  | 
        |  | 
        
        | Term 
 
        | Phase II Most important conjugation? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Glucuronidation Most susceptible functional groups |  | Definition 
 
        | Amines, PHenols, Alcohols, Hydroxylamines, Carboxylic Acid, Sulfonadmides, Amides and Thiols |  | 
        |  | 
        
        | Term 
 
        | Which one is the metabolite after conjugation with glucuronic acid? |  | Definition 
 
        | C1,  (Carbon next to oxygen) |  | 
        |  | 
        
        | Term 
 
        | Sulfate Conjugation, Most susceptible functional groups |  | Definition 
 
        | Phenols, Alcohols, Aryl Amines and N-hydroxy compounds |  | 
        |  | 
        
        | Term 
 
        | Sulfate conjugation competes with which Phase II? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Sulfate Conjugation is catalyzed by what enzyme? |  | Definition 
 
        | Sulfotransferase with co-factor PAPS which donates the Sulfur |  | 
        |  | 
        
        | Term 
 
        | Where does the sulfate for PAPS come from? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | How does Amino acid Conjugation work? |  | Definition 
 
        | Drug with a Carboxylic acid is activated by CoA-thioester and links it to a amino acid |  | 
        |  | 
        
        | Term 
 
        | Acetylation occurs in what functional groups? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Methylation occurs in what functional groups? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Methylation receives it's methyl from where? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Glutathione/Mercapturic Acid Conjugates interact with? |  | Definition 
 
        | Electrophilic Functional Groups :Epoxides, Alkyl Halides, Sulfonates, Disulfides, Radical species |  | 
        |  | 
        
        | Term 
 
        | Which group on Glutathione interacts? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Glutathione takes place Especially where in the body? |  | Definition 
 | 
        |  | 
        
        | Term 
 
        | Glutathione reactions are catalyzed by what enzyme? |  | Definition 
 | 
        |  | 
        
        | Term 
 | Definition 
 | 
        |  | 
        
        | Term 
 
        | Why is acetylcysteine a antidote for APAP? |  | Definition 
 
        | Its the precursor for glutathione |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Wafarin Phenytoid
 NSAIDS
 Tolbutamide
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | Mephenytoin          INCREASED toxicity Omeprazole           INCREASED efficacy
 Clopidrogel          DECREASED efficacy
 |  | 
        |  | 
        
        | Term 
 | Definition 
 
        | INCREASED risk of Toxicity of Anti-depressant and Anti-psychotic 
 Reduced analgesic effect of Codeine
 
 Reduced antineoplastic action of Tamoxifen
 |  | 
        |  |