USMLE Step 1 Lecture Notes (Kaplan) 2018: Pharmacology

Cover......Page 0
Title Page......Page 2
Table of Contents......Page 3
Copyright......Page 9
Editors......Page 11
Feedback Page......Page 13
Part I: General Principles......Page 14
Pharmacokinetics......Page 15
Figure I-1-1. Drug Biodisposition......Page 16
IONIZATION......Page 17
NOTE......Page 18
Figure I-1-2. Degree of Ionization and Clearance Versus pH Deviationfrom pKa......Page 19
CLINICAL CORRELATE......Page 20
MODES OF DRUG TRANSPORT ACROSS A MEMBRANE......Page 21
BRIDGE TO PHYSIOLOGY......Page 22
PLASMA LEVEL CURVES......Page 23
BIOAVAILABILITY (F)......Page 24
Figure I-1-5. Area Under the Curve for an IV Bolus and Extravascular......Page 25
Figure I-1-6. Bioavailability and First-Pass Metabolism......Page 26
Distribution......Page 27
Biotransformation......Page 32
Elimination......Page 39
Steady State......Page 46
Pharmacokinetics Calculations......Page 53
Definitions......Page 55
Graded (Quantitative) Dose-Response (D-R) Curves......Page 58
Quantal (Cumulative) D-R Curves......Page 64
Signaling Mechanisms: Types of Drug-Responsive Signaling Mechanisms......Page 67
Practice Questions......Page 76
ANSWER KEY......Page 85
ANSWERS AND EXPLANATIONS......Page 86
Part II: Autonomic Pharmacology......Page 93
Anatomy of the ANS......Page 94
Blood Pressure Control Mechanisms......Page 98
Pupillary Size and Accommodation Mechanisms......Page 104
Cholinergic Neuroeffector Junctions......Page 107
Muscarinic Receptor Activators......Page 113
Muscarinic Receptor Antagonists......Page 118
Nicotinic Receptor Antagonists......Page 121
Adrenergic Neuroeffector Junctions......Page 124
Direct-Acting Adrenoceptor Agonists......Page 131
Indirect-Acting Adrenergic Receptor Agonists......Page 137
Adrenergic Antagonists......Page 139
Glaucoma Treatment......Page 144
ANS Practice Problems......Page 148
ANS Practice Problems: Answers and Explanations......Page 158
Chapter 5: Autonomic Drug List and Practice Questions......Page 162
Practice Questions......Page 165
Practice Questions: Answers and Explanations......Page 178
Part III: Cardiac and Renal Pharmacology......Page 188
Chapter 1: Diuretics......Page 189
Types of Diuretics......Page 191
Drug Strategy......Page 204
Thiazide Diuretics......Page 206
Drugs Altering Sympathetic Activity......Page 211
Direct-Acting Vasodilators......Page 214
Indications for Use of Antihypertensive Drugs in Comorbid Conditions......Page 217
Treatment of Pulmonary Hypertension......Page 220
Chapter 3: Drugs for Heart Failure......Page 222
Primary Treatments for CHF......Page 224
Inotropes......Page 226
Cardiac Action Potential......Page 230
Na+ Channels......Page 238
ANS Regulation of Heart Rate......Page 240
Class I: Na+ Channel Blockers......Page 241
Class II: Beta Blockers......Page 245
Class III: K+ Channel Blockers......Page 246
Class IV: Ca2⁺ Channel Blockers......Page 248
Unclassified......Page 250
Rationale for Use......Page 252
Key  Antianginal Drugs......Page 254
Cardiovascular Risks of Hyperlipidemia......Page 261
Lipid-Lowering Drugs......Page 263
Chapter 7: Cardiac and Renal Drug List and Practice Questions......Page 267
Practice Questions......Page 269
Practice Questions: Answers and Explanations......Page 279
Part IV: CNS Pharmacology......Page 288
Drugs Used for Sedation, Sleep, Anxiety......Page 289
Chapter 2: Alcohols......Page 296
Chapter 3: Drugs Used for Depression, Bipolar Disorders, and Attention Deficit Hyperactivity Disorder (ADHD)......Page 299
Drugs Used in Depression......Page 300
Drugs Used in Bipolar Disorders......Page 304
Drugs Used in ADHD......Page 306
Dopaminergic Neural Pathways......Page 308
Dopamine Receptors......Page 311
Drugs Used in Parkinson Disease......Page 312
Antipsychotic Drugs......Page 317
Drugs Used in Seizures......Page 322
General Anesthetics......Page 328
Local Anesthetics......Page 332
Skeletal Muscle Relaxants......Page 336
Properties of Opioids......Page 339
Chapter 8: Drugs of Abuse......Page 345
Chapter 9: CNS Drug List and Practice Questions......Page 349
Practice Questions......Page 352
Practice Questions: Answers and Explanations......Page 365
Part V: Antimicrobial Agents......Page 375
Principles of Antimicrobial Chemotherapy......Page 376
Inhibitors of Cell-Wall Synthesis......Page 379
Inhibitors of Bacterial Protein Synthesis......Page 390
Inhibitors of Nucleic Acid Synthesis......Page 401
Unclassified Antibiotic......Page 407
Antitubercular Drugs......Page 408
Polyenes (Amphotericin B [Amp B], Nystatin)......Page 411
Antiviral Drug Properties......Page 417
Treatment of HIV......Page 423
Other Antivirals......Page 428
Overview......Page 431
Chapter 5: Antimicrobial Drug List and Practice Questions......Page 434
Practice Questions......Page 436
Practice Questions: Answers and Explanations......Page 448
Part VI: Drugs for Inflammatory and Related Disorders......Page 457
Histamine......Page 458
Drugs Used in Peptic Ulcer Disease (PUD)......Page 461
Antiemetics......Page 466
Drug Actions on 5HT Receptors......Page 468
Drugs Used in Migraine Headaches......Page 471
Eicosanoids......Page 473
Nonsteroidal Antiinflammatory Drug (NSAIDs)......Page 480
Other Drugs......Page 486
Rheumatoid Arthritis......Page 488
Gout......Page 491
Glucocorticoid Properties......Page 495
Asthma Treatments......Page 498
Chapter 9: Inflammatory Disorder Drug List and Practice Questions......Page 505
Practice Questions......Page 509
Practice Questions: Answers and Explanations......Page 521
Part VII: Drugs Used in Blood Disorders......Page 531
Anticoagulant Overview......Page 532
Thrombolytic Overview......Page 539
Antiplatelet Overview......Page 542
Chapter 4: Blood Disorder Drug List and Practice Questions......Page 545
Practice Questions......Page 547
Practice Questions: Answers and Explanations......Page 551
Part VIII: Endocrine Pharmacology......Page 554
Diabetes Mellitus......Page 555
Insulins Forms......Page 558
Drugs for Type II Diabetes......Page 559
Adrenal Steroids......Page 567
Estrogens......Page 569
Progestins......Page 573
Oral Contraceptives......Page 575
Androgens......Page 576
Thyroid Hormones......Page 579
Chapter 4: Drugs Related to Hypothalamic and Pituitary Hormones......Page 582
Osteoporosis Treatment......Page 584
Chapter 6: Endocrine Drug List and Practice Questions......Page 586
Practice Questions......Page 588
Practice Questions: Answers and Explanations......Page 593
Part IX: Anticancer Drugs......Page 597
Principles......Page 598
Drugs and Drug Properties......Page 600
Anticancer Drug Practice Questions......Page 607
Anticancer Drug Practice Questions: Answers and Explanations......Page 611
Part X: Immunopharmacology......Page 613
Immunosuppressants......Page 614
Immunopharmacology Practice Questions......Page 618
Immunopharmacology Practice Questions: Answers and Explanations......Page 620
Part XI: Toxicology......Page 621
Toxicology......Page 622
Toxicology Practice Questions......Page 631
Toxicology Practice Questions: Answers and Explanations......Page 633