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205 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Which of the following insulins is given by IV and for DKA in 50yr old with a long Hx of DMII?
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a)glargine insulin
b) long-acting insulin c) short-acting insulin d) regular insulin e) ultra-lente insulin |
c) short-acting insulin
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pt with CHF complainsof SOB, imparied hearing, ankle edema and resp difficulty, even at rest.
what is the most appropriate immediatel Tx? |
a) ethacrynic acid
b) furosemide c) clonidine d) acetazolamide e)verapamil |
b) furosemide
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56 yo male treated for depression with an SSRI has too much sexual SE. you switch him to a drug which inhibits the reuptake of DA. other meds that lower seizure threshold should be avoided. what is this drug?
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a) citalopram
b)buproprion c)Amytriptyline d) buspirone e) duloxetine |
b) buproprion
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Orthostatic hypoTN is predictable adverse SE in clinical use of which of the following?
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a) metoprolol
b)phentolamine c) atropine d)atenolol e)methyldopa |
e) methyldopa
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Tamoxifen:
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a)used to Tx infertility
b) may cause osteoporosis if taken longer than 6mos c) is an antagonist at the estrogen rec in the breast d)promotes the shedding of endometrium in HRT e) is used for the Tx of hot flashes |
c) is an antagonist at estrogen rec in the breast
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69yo male complains of urinary difficulty. he has enlarged prostate and normal BP. which treatment will help BPH and not effect BP?
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a) methytestosterone
b) prasozin c) propranolol d) tamsulosin e) tolterodine |
e) tolterodine- used for overactive bladder esp good in elderly
d) tamsulosin- is good for BPH and doesn't cause increase in BP;alpha1a selective |
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effects of parasympathetic stim include all except?
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a) slowing of the heart
b) bronchospasm c) dilation of pupils d) contraction of the bladder detrusor e) salivation |
c) dilation of pupils
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28 yo female with recurrent UTI is prescribed an drug that when given orally should only reach therapeutic levels in the urine. which is the most likely?
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a) TMP/SMX
b) cefoperozone c) chloramphenicol d) metronidazole e) nitrofurantoin |
e) nitrofurantoin
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5 yo boy with localized staph infection; which of the following would be best treatment based on oral admin, acid stability and resist to beta lactamases?
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a) amoxicillin
b) oxacillin c) nafcillin d) penicillin e) ticaracillin |
b) oxacillin
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atovaquone+proguanil is indicated for which of the following?
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a)uncomplicated infection with chloroquine resistant malaria
b)toxplasmosis c) small cell carcinoma of the lung d) chronic myelogenous luekemia e) prophylaxis against organ transplant rejection |
a) uncomplicated malaria
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which of the following pairs of drugs and indications is correct?
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a) amphetamine;Alzheimer's
b) fluoxetine; insomnia c) bupropion; acute anxiety d) selegiline; Parkinson's e) Chlorpromazine; ADHD |
d) selegiline; Parkinson's
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a 66 yo female with SLE is treated with predinose for the lupus, levothyroxine for hypothyroid and propranolol for HTN. she develops osteopporosis and you Rx alendronate. after 3 mos she develops GERD. which is the best choice of treatment that will have the lowest liklihood of drug interactions?
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a) cimetidine
b) Magnesium/aluminum hydroxide c)calcium carbonate d) esomeprazole e) sulcrafate |
d) esomeprazole
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one of the benefits of long-term use of oral contraceptives is that they significantly reduce the risk of:
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a) DVT
b) ovarian cancer c) formation of gallstones d) Migraine headaches e) breast cancer |
b) ovarian cancer
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which of the following is least likely to produce reflex tachycardia?
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a) prazosin
b) labetalol c) phentolamine d)doxozosin e) nifedipine |
b) labetalol- blocks B1,B2 an a1
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correct statement regarding zidovudine:
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a) inhibits the reverse transcriptase in the HIV virus
b) it must not be used in pregnancy c)it is a potent inhibitor of CYP3A4 d) it inhibits the HIV protease e) it must be activated by viral thymidine kinase |
a) inhibits reverse transciptase in the HIV virus
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which is most appropriate for a 69yo pt recently Dx with DMII?
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a) metformin
b) miglitol c) glyburide d) glimepiride e) insulin glargine |
a) metformin
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33 yo woman gets a kidney transplant from her sister who is HLA-identical and matched blood type. to prevent rejection, she is treated with purine synthesis inhibitors:
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a) prednisone
b) cylcosporine c) thalidomide d) mycophenolate mofetil e) azthioprine |
d) mycophenolate mofetil
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a pt is treated for a chronic viral illness, develops truncal obesity, inc cholesterol and a gaunt, thin face. what drug is most likely to produce these SE?
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a) ribavirin
b) interferon alfa 2b c)zidovudine d)saquanivir e)acyclovir |
d) saquanivir- protease inhibitor; similar to cushing's but without the moon face
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for which situation is it most appropriate to use an emetic?
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a) 20 yo who attempted suicide who is in a deep coma
b) 30 yo who mistakenly drank a cup of chlorine bleach c) child who drank gasoline d) child who swallowed liquid plumber e) child who has taken a large aspirin overdose ten minutes prior to coming to ER |
e) large aspirin OD kid
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which of the following would be used in SJogrens/ pilocarpine or cevimeline?
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cevimiline
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causes inc salivation with less sweating than the other muscarinc agonist. Is M3 selective
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am immunecompromised pt with HIV/AIDS presents with low CD4+ count. Which of the following is the best choice for prophylaxis against P jirovecii in this pt?
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a) praziquantel
b) piperacillin c) doxycylcine d) TMP-SMX e) pyrazinamide |
d) TMP-SMX
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pt treated for depression with fluoxetine strains his lower back and comes to your office complaining of pain. which of the following will have less analgesic efficacy in a pt taking fluoxetine?
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a) acetaminophen
b) tizanidine c) acetylsalicylic d) hydrocodone e) ibuprofen |
d) hydrocodone
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which of the following is used as a treatment to bridge a pt with glaucoma to surgery?
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a) physostigmine
b) neostigmine c) echothoiophate d) pralidoxine |
c) echothiophate- cholinesterase inhibitor; long acting
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which of the following is used to prevent bladder spasms after prostate surgery?
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a) benztropine
b) solefenicin c) oxybutynin d) tolteridine |
oxybutynin- muscarinic anatgonist
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which of the vasodilator causes drug-induced SLE?
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a) Na+ nitroprusside
b) isosorbide dinitrate c) hydralizine |
c) hydralizine
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a 53 yo man has a stroke and is left with spasticity in his right leg, after use is worst. which of the following is least likely to be used for treatment in this man's spasticity ?
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a) diazepam
b) baclofen c)dantrolene d) tizanidine |
c) dantrolene- used to reverse neuromuscular blockade in malignant hyperthermia
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which of the following blocks the ion channels in the thalamus responsible for generating an absence seizure?
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a) phenytoin
b) carbamezapine c) phenobarbital d) diazepam e) valproic acid |
e) valproic acid
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a 64 yo woman with a total cholesterol of 280 with LDL of 180 began treatment with a antihyperlipid agent. she experiences severe flushing of the skin. which of the following agents would alleviate this side effect?
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a) acetaminophen
b) edrophonium c) acetesalicylic acid d) lovastatin e) ceterizine |
c) acetesalicylic acid
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a 24 yo male with kyphosis, limited neck motion, chest expansion and sclerosis of the SI joint is diagnosed with ankylosing spondylytis. He had peptic ulcer disease 2 years ago, but has no evidence of it now. which of the following NSAIDs would be most effective in treating this pt?
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a) acetaminophen
b) aspirin c) celecoxib d) ibuprofen e) indomethacin |
d) ibuprofen is the NSAID with the fewest adverse effects
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which of the following would lower the BP without dilating the blood vessels in the brain of a 78 yo male patient with cerebral hemorrhage.
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a)nifedipine
b) diltiazem c) labetalol d) sodium nitroprusside e) hydralazine |
b) diltiazem- potent peripheral CA+ channel blocker; vasodilator
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a woman is about to undergo same day surgery for a bunion. IV anesthesia will be used. a short acting drug that acts on the GABA receptors is chosen that can also be used for maintenance of anesthesia. it has a low incidence of post-op nausea and few residual side effects in the CNS, what drug is this most likely to be?
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a) fentanyl
b) Ketamine c) thiopental d) Propofol e) isoflurane |
d) propofol- rapid onset and emrgence. DOC for most surgeries
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43yo woman with several atacks of PSVT during the past few years. they are now more frequent. which of the following is most appropriate for prophylaxis in this pt?
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a) procainamide
b) esmolol c) nifedipine d) verapamil e) lidocaine |
a) procainamide
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which of the following drugs may produce hyperpyrexia if combined with opioids?
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a) benzodiazepines
b) NSAIDs c) MAOinhbitors d) acetaminophen e) dantrolene |
c) MAOinhibitors
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after admin to the hospital, a 46 yo woman with DVT is immediately started on IV heparin therapy. the next day she is placed on oral manitenance dose of warfarin. the t1/2 of warfarin in this patient is 2 days. about how long will it take to reach a steady state concentration of warfarin in this pt?
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a) 2 days
b) 4.5 days c) 9.0 days d) 18 days e) depends on the dose of warfarin given |
c) 9.0 days
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typical response to beta-receptor stimulation include:
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a) hypoglycemia
b) lipolysis c) decreased HR d) decreased renin secretion e) uterine stimulation |
b) lipolysis
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37 yo male pt is treated in ER for phenobarb o/d. which of the following drugs would substantially increase the renal excretion of phenobarbital?
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a) furosemide
b) linozolid c) acetazolamide d) probenecid e) dobutamine |
c) acetazolamide- a carbonic anhydrase inhibitor; alkalinize the urine and pull acidic phenobarbs out
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correct statement regarding zolpidem:
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a) used to prevent symptoms of withdrawal from alcohol
b) slow onset and long duration of action c) chronic use induces heaptic cytochrome P-450 d) fast acting sedative hypnotic acts on benzo receptor subtype e) anxiolytic effect takes 2-3 weeks to develop |
d) fast acting sedative hypnotic..
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34 yo female pt with long history of generalized seizures needs a very effective analgesic drug for a painful procedure. which of the following should be avoided in this pt?
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a) fentanly
b) merperidine c) oxycodone d) morphine e) methadone |
b) merperidine- antimuscarinic and also blocks reuptake of 5HT and SE of seizures.
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a pt is treated for asthma develops painful oral candidiasis. which of the following is most likely responsible for this SE?
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a) theophylline
b) beclomethasone c) albuterol d) salmeterol e) montelukast |
b) beclomethasone- steroid
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which of the following statements regarding general anesthesia is most accurate?
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a) drug with high MAC is more potent than with low MAC
b) majority of inhaled gen anesthetics cause increase in BP c) an anesthetic agent that is very soluble in the blood will have a very fast onset of action d) inhalation agents must be used for long procedures because the IV agents are too toxic for prolonged use e) addition of a second gas with low solubility in the blood can increase the rate of induction of anesthesia |
e) addition of a second gas with low solubility in the blood will inc rate of induction; ie. nitrous oxide
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which is/are contraindications for the "triptans" e.g. sumatriptan?
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a) coronary artery disease
b) hypertension c) peripheral vascular disease d) seizures e) all of the above |
e) all of the above
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which of the following would lower BP with nor reflex tachycardia when treating a 60yo hypertensive woman with coronary artery disease and mild CHF?
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a) nifedipine
b) phenotloamine c) minoxidil d) carvedilol e) diazoxide |
d) carvedilol- non-selective Beta blocker and a1 blocker
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a 19 yo woman is being treated chronically with phenobarbital to control seizures. hepatic induction by phenobarb can dramatically alter the optimal dose of which of the following medications?
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a) NPH insulin
b) lithium c) penicillin d) warfarin e) gentamicin |
d) warfarin
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which of the following adverse effects would most liekly be observed with excessive insulin therapy in the treatment of 85yo woman with type II diabetes?
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a) insomnia,polyuria and tremors
b) convulsions, mental confusion and sweating c) hypertension, insomnia and anorexia d) polyphagia, hypotension adn coughing e) bradycardia, coughing and dyspnea |
b) convulsions, mental confusion and sweating
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a pt complains of progressive muscle weakness, esp as he becomes tired. you suspect myasthenia gravis. which of the following drugs would you use for diagnosis of MG?
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a) succinylcholine
b) edrophonium c) tizanidine d) pilocarpine e) echothiophate |
b) edrophonium
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pt on a psychiatric med complains about weight gain, postural hypotension, impotence and blurred vision. which of the following is MOST likely to cause this effect?
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a) Chlorpromazine
b) diazepam c) fluoxetine d) buspirone e) aripiprazole |
a) chlorpromazine
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which of the following drugs used to treat Hodgkin's lymphoma can cause lung fibrosis
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a) doxorubicin HCl
b) bleomycin sulfate c) vinblastine sulfate d) vincristine sulfate e) dacarbazine |
b) bloemycin sulfate
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which of the following is the drug of choice for treating schistosomiasis?
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a) praziquantel
b) metronidazole c) paromomycin d) mebendazole e) pyrantel pamoate |
a) praziquantel
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treatment of a fungal infection in a 65yo immunosupressed male requires long-term therapy. which of the following may be useful in treatment of this pt but has to be given orally becuase it is eneffective when used topically?
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a) flucytosine
b) griseofulvin c) ketoconazole d) miconazole e) nystatin |
b) griseofulvin
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51 yo male on furosemide and enalapril for CHF has had digoxin added to his regimen due to condition worsening. what is the molecular target for the beneficial actions of digoxin in this pt?
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a) angiotensin-converting enzyme
b) alpha-adrenergic receptors c) Na+/K+- ATPase d) Na+/K+/2Cl- cotransport system e) phosphodiesterase |
c) Na+/K+-ATPase
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which of the following drugs is primarily a bacterial agent?
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a) clarithromycin
b) sulfamethoxazole c) penicillin G d) chloramphenicol e) linezolid |
c) penicillin G
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which neurotransmitter blocking agent would cause severe toxicity in someone with a genetic defect that decreased cholinesterase activity?
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a) d-Tubocurarine
b) atropine c) succinylcholine d) pancuronium e) neostigmine |
c) succinylcholine
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in a 65yo woman with CHF and pulmonary edema, the rank order in diuretic effectiveness for relieving edema is:
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a) spironolactone>furosemide>metolazone
b) metoazone>spinoloactone>furosemide c) metolazone> furosemide> spironolactone d) furosemide> spironolactone> metolazone e) furosemide> meotlazone> spironolactone |
e) furosemide>metolazone> spironolactone
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experimental drugs being evaluated for their pharmokinetic properties. which is most likely to contribute to a short half-life of a drug in experimental subjects?
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a) increased tubular resorption in the kidney
b) high water solubility c) high tissue binding d) high lipid solubility e) enterohepatic recirculation |
b) high water solubility
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a pt taking a medication that causes GI distress self medicates with cimetidine. after several day he begins suffering from sedation , ataxia and diplopia. which of the following mediation was this pt likely being treated with?
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a) warfarin
b) tetracycline c) hydrochlorothiazide d) carbamazepine e) lithium |
d) carbamazepine- blocks Na+ channels to prevent seizures. induces p450
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65yo man suffers form an acute MI. he is started on an oral anticoagulant before leaving the hospital. which of the following would be injected sub cut to provide anticoagulant until the oral medication becomes effective?
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a) abciximab
b) warfarin c) enoxaprin d) anistreplase e) clopidogrel |
c) enoxaprin- low molecular weight heparin
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quantal-dose-response curves are often used for drug evaluations in laboratory and clinical subjects. which of the following in an experimental subject requires the used of a quantal-dose-response curve?
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a) desensitization
b) receptor affinity c) maximal efficacy d) therapeutic index e) signaling process |
d) therapeutic index
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36 yo man is treated with cyclosporine and prednisolone immediately following a liver transplant. levels were carefully titrated to avoid nephrotoxicity. 3 weeks later he develops a resp infection and is treated with erythromycin. shortly after he develops kidney damage. which statement best describes the reason for the kidney damage?
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a) accumulation of dead bacteria in kidney after erythromycin
b) additive nephrotoxcicity of cyclosporine and erythromycin c) decreased first-pass elimination from plasma proteins by erythromycin d) displacement of cyclosporinefrom plasma proteins by erythromycin e) inhibition of cyclosporine metabolism by erythromycin |
b) additive nephrotoxicity of cyclosporine and erythromycin
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33 yo asthmatic women becomes pregnant and develops insomnia, tachycardia and heat intolerance. she is diagnosed with hyperthyroidism. which drug should NOT be used for treatment of this woman?
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a) albuterol
b) propylthiouracil c) propranolol d) verapamil e) montelukast |
a) albuterol
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frantic mother brings her 3 yo into the ER stating the child had ingested a drug from a bottle with the label ripped off. the child is hallucinating, has a rapid HR, elevated temp, flushed appearance and dry mucous membranes. the most likely drug ingested is:
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a) atropine
b) cocaine c) pilocarpine d) diazepam e) fluoxetine |
a) atropine- hot as a hare, dry as a bone, red as a beet and mad as a hatter
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a 58 yo man experiences chest pin with strenuous exercise. he uses nitroglycerine for these acute attacks. what is the most common side effects of sublingual nitro for acute angina?
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a) bradycardia
b) diruesis c) headache d) vomiting e) marked sedation |
c) headache
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which is the best way of preventing superinfection in a 45 yo woman being treated with an antibiotic for a lower respiratory tract infection?
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a) use low dosage levels of the agent
b) use high dosage levels of teh agent c) use an agent with a broad chemotherapeutic spectrum d) give the agent orally rather than parenterally e) use an agent with a narrow chemotherapeutic spectrum |
e) use narrow spectrum chemotherapeutic aagent
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pt with tophaceous gout is prescribed allopurinol. within a few days they complain of severe pain in the joints.how would you treat this pt?
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a) continue the allopurinol and begin therapy with colchicine
b) continue the allopurinol and begin therapy with probenicid or sulfinpyrazone c) continue the allopurinol and begin aspirin d) discontinue the allopurinol and begin probenicid or sulfinpyrazone e) discontinue the allopurinol and begin therapy with indomethacin |
e) discontinue allopurinol and begin indomethacin
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77yo man with allergic rhinitis has a Hx of UTIs. he is currently being evaluated for recent onset urinary hesitancy,nocturia and dribbling. which of the following meds may contribute to his urinary retention?
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a) diphenhydramine
b) edrophonium c) propranolol d) tamsulosin e) loratadine |
a) diphenhydramine- anticholinergic antihistamine
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30 yo male with HIV is treated with zidovudine, lamivudine, ritonavir and saquanavir. he develops a cytomegalovirus infection. which of the following orally administered drugs would you use to initiate treatment of CMV?
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a) acyclovir
b) valgancyclovir c) ribavirin d) TMP-SMX e) Foscarnet |
b) valgancyclovir
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47 yo woman with known SLE requires therapy for a cardiovascular disorder. which one of these drugs should be used with caution in this pt?
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a) hydrochlorothiazide
b) procainamide c) quinidine d) lisinopril e) verapamil |
b) procainamide- is a Class 1a anti-arrhythmic with a SE of SLE
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which of the following should be avoided in a 23yo woman with long QT syndrome to avoid Torsades?
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a) metoprolol
b) varapamil c) sotalol d) nifedipine e) lidocaine |
c) sotalol
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a pt taking a drug for a psych problem for 6 mos has gained a considerable amount of weight and fasting blood sugar are elevated to point you are concerned about DMII. which of the drugs is likely to have caused the elevation in blood sugar?
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a) fluoxetine
b) bupropion c) halperidol d) buspirone e) Olanzapine |
e) olanzapine-"fat like O"
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which of the following drugs is LEAST likely to produce sedation?
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a) diazepam
b) buspirone c) zolpidem d) tizanidine e) isoproterenol |
e) isopreterenol
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a pt is diagnosed with open-angle glaucoma. which of the following is LEAST likely to be useful in this condition?
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a) timolol
b) pilocarpine c) acetazolamide d) epinephrine e) isoproterenol |
e) isoproterenol
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46 yo woman with an active peptic ulcer is being treated with OTC omeprazole. she develops a high fever, thought to be due to a viral infection. which of the following is most appropriate med for relief of fever in this patient?
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a) acetaminophen
b) ibuprofen c) indomethacin d) aspirin e) ketorolac |
a) acetaminophen
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78 yo man is treated with an antihypertensive drug for years has recently gained ~ 20 lbs. he admitted to the hospital with SOB, cyanosis, tachycardia and pulse of 99 and bp of 159/99 with pitting edema. digoxin is given and treatment with an antiHTN agent is continued . which of the following CV drugs causes hypokalemia and could potentiate the toxicity of digoxin in this pt?
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a) enalapril
b) metoprolol c) hydrochlorothiazide d) quinidine e) verapamil |
c) HCT
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which of the following antiarrhythmics acts by binding to an open or inactivated sodium channels?
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a) adenosine
b) diltiazem c) esmolol d) lidocaine e) verapamil |
d) lidocaine
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a 45yo man is tentatively diagnosed with mycoplasma pneumo infection. therapy is initiated using a broad spectrum antibiotic which is unlikely to alter the other drugs the pt is taking. but which can cause some GI disturbances and at high doses can be hepatotoxic. which of the following is most likely prescribed for this pt?
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a) linezolid
b) erythromycin c) doxycycline d) cefepime e) ampicillin |
b) erythromycin
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which of the following drugs is most likely to cause Stevens-Johnson syndrome in a 13yo girl?
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a) sulfisoxazole
b) gentamicin c) clindamycin d) penicillin e) cefazolin |
a) sulfisoxazole
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a 43 yo male who is a heavy smoker is scheduled to undergo a bronchoscopy. He is given an IV injection of midazolam because of its anxiolytic and amnestic actions. which of the following is the molecular site of action for the anxiolytic and amnestic actions of this drug?
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a) calcium channel
b) cAMP pathway c) GABA receptor -chloride channel d) NMDA receptor e) sodium channel |
c) GABA receptor-chloride channel
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a drug causes vasoconstriction, inc BP and a slightly reduced HR. pretreatment with atropine or propranolol did not produce any change on the effect of this drug. the drug is probably a (an):
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a) ganglion blocker
b) beta antagonist c) muscarinic agonist d) alpha 1 antagonist e) alpha agoinst |
e) alpha agonist
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physician is treating an injury that has become infected and inflamed, lowering the pH of the extracellular fluid in the tissue. how would the potency of lidocaine be affected in this region?
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a) increased
b) decreased c) unchanged d) not predictable |
b) decreased
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which of the following is used to treat small-cell lung carcinoma but can cause renal dysfunction, acoustic nerve damage and nausea?
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a) mechlorethamine
b) carmustine c) dactinomycin d) paclitaxel e) cisplatin |
e) cisplatin
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69yo man suffers an MI and is treated prophylactically with warfarin. later his Dr. decides to add an antilipidemic agent. which of the following agents is most likely to potentiate the anticoagulant effect of warfarin upon addition to this pt's drug therapy?
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a) ezetimibe
b) gemfibrozil c) daptomycin d) stavudine e) lovastatin |
e) lovastatin
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which of the following should be avoided in a 35yo female SLE pt with serious renal involvement?
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a) amphotericin B
b) cyclosporine c) vancomycin d) cisplatin e) all of the above |
e) all of the above
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produces pupil dilation with cycloplegia?
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a) timolol
b) phenylephrine c) physostigmine d) atropine e) pilocarpine |
d) atropine
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a pt who has been a very heavy EtOH drinker wishes to stop. which drug could be used to prevent withdrawal symptoms such as seizures and hallucinations?
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a) disulfiram
b) naltrexone c) diazepam d) cimetidine e) risperidone |
c) diazepam
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a 54 yo man receives a liver transplant from a donor who is positive for CMV. which of the following statements regarding drug therapy in this man is correct?
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a) tacrolimus can produce hypertension and hyperglycemia
b) acyclovir is the treatmen t of choice for prophylaxis of CMV c) myophenolate mofetil is very likely to produce nephrotoxicity d) cyclosporine is cytotoxic and can inhibit an established immune response e) ribavirin is combined with prednisone to inhibit rejection and prevent develpoment of CMV infection |
d) cyclosporine is cytotoxic and can inhibit an established immune response
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which of the following is most likely to increase the risk of Reye's syndrome in 4yo girl with a viral infection?
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a)acetaminophen
b) aspirin c) ibuprofen d) leflunomide e) ribavirin |
b) aspirin
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pt with a history of anaphylactic Rx to shellfish is treated with epinephrine. he recently began treatment for HTN. when he developed another anaphylactic rxn he was given epi and this time his BP was greatly increased compared to previously. the drug he was taking for HTN was MOST likely:
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a) metoprolol
b) propranolol c) prazosin d) Nifedipine e) enalapril |
b) propranolol has reflex renin inc and is Beta nonspecific
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55yo man comes to your office having recently been treated with interferon alfa2b. he states that he feels depressed and is having trouble sleeping. you prescribe fluoxetine to treat his depression. a common side effect of this drug is?
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a) priapism and increased libido
b) sexual dysfunction c) tardive dyskinesia d) gingival hyperplasia e) torsades de pointes |
b) sexual dysfunction
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a pt treated for methicillin resistant staph aureus with linezolid SHOULD AVOID the following drug:
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a) diazepam
b) propranolol c) fluoxetine d) zolpidem e) lithium |
c) fluoxetine
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a new virus emerges that causes and outbreak of skin lesions and nausea that favors pregnant women. the virus is found to be sensitive to drugs that are activated by thymidine kinase and is safe for use in pregnancy. the drug is most likely to be?
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a) ribavirin
b) efavirenz c) thlidamide d) acyclovir e) saquanavir |
d) acyclovir
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63 yo man receives a rapid IV infusion of an anti-bacterial drug for Gram+ infection and quickly develops pronounced flushing. the adverse effect responds to anti-histamines. which of the following is most likely to cause this adverse effect?
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a) gentamicin
b) vancomycin c) erythromycin d) chloramphenicol e) aztreonam |
b) vancomycin
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naloxone:
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a) binds to the mu receptor and has an agonist action
b) binds to the mu receptor and has an antagonist action c) produces analgesia by binding to delta receptors d) develops tolerance to its own action e) can be administered orally |
b) binds to the mu receptor and has an antagonist action. IV only
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a woman with MRSA is treated with a 2 drug combo that has a synergistic bacctericidal effect, a concern is the combo has marked inhibition of drug metabolizing enzymes. which of the following combos is being used?
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a) amoxicillin and clavulanic acid
b) cefepime and probenicid c) imipenem + cilastatin d) quinupristin + dalfopristin e) sulfamethoxazole+ trimethoprim |
d) quinupristin + dalfopristin
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an abdominal hernia surgery pt is given a drug to increase GI motility. the drug is most likely to be?
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a) propranolol
b) tolterodine c) bethanecol d) oxycodone e) prazosin |
c) bethanecol
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which of the following is used to lyse blood clots and limit the damage caused by MI if administered within 6h?
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a) tissue plasminogen activator
b) propranolol c) aminocaprioc acid d) erythropoietin e) cilostazol |
a) t-PA
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ergonovine maleate is used primarily to:
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a) induce abortion
b) prevent involution of the uterus c) relieve tension headache d) prevent or control post partum hemorrhage e) promote relaxation of the uterus |
d) prevent or control post partum hemorrhage
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72yo woman with a gram- infection is treated with a drug with known nephrotoxicity. you ensure she has good renal function and is not on any other meds that are renal toxic. you decide to give one large dose rather than several smaller doses. which of the following are you using?
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a) clarithromycin
b) chloremphenicol c) oxacilin d) ofloxacin e) gentamicin |
e) gentamicin
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44 yo woman enters a treatment center for alcoholism. in addition to attending AA and psychological counseling, she is given a drug which will decrease her alcohol cravings. however if she does consume EtOH this drug does not produce any adverse of aditive effects. the drug is most likely to be?
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a) sertraline
b) disulfiram c) diazepam d) buspirone e) naltrexone |
e) naltrexone
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23 yo man is taking a substance that is eliminated by zero order kinetics. this is most likely which of the following?
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a) penicillin
b) isoniazid c) ethanol d) erythromycin e) cocaine |
c) ethanol
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pt on a psychiatric med develops polyuria and polydipsia as well as weight gain and edema. which of the following is most likely the cause of this effect?
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a) chlorpromazine
b) diazepam c) lithium d) fluoxetine e) buspirone |
c) lithium- diabetes insipitus
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the cause of death from barbituate o/d is usually:
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a) respiratory failure
b) cerebral hemorrhage c) convulsions d) kidney damage e) jaundice |
a) respiratory failure
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hypoglycemia may occur in diabetic pts as a result of:
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a) administration of hydrochlorothiazide
b) injection of glucagon c) ingestion of high-fat/hig-carb meal d) ingestion of ethyl alcohol e) administration of albuterol |
d) ingestion of ethyl alcohol
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which of the following routes of admin may result in an extensive first-pass metabolism when a new drug is given to an experimental subject?
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a) intramuscular
b) subcutaneous c) oral d) intravenous e) sublingual |
c) oral
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which of the following is NOT a side effect of typical antipsychotics?
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a) weight gain
b) dry mouth c) sedation d) hypertension e)extrapyramidal symptoms |
d) hypertension- they can actually cause orthostatic hypotension
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true or false. atypical antipsychotics are better for treating the negative psychotic symptoms with fewer side effects
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true- they act on the D4 and D5( some still act on D2 as well) and 5HT2a which are responsible for the negative symptoms
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match the atypical antipsychotic with its most notable side effect:
1) Clozapine 2) Olanzapine 3) risperidone 4) aripiprazole a) dec espophageal motility b) agranulocytosis c) type II diabetes and hyperglycemia d) long QT |
clozapine-->agranulocytosis
olanzapine--> type II DM adn hypperglycemia risperidone--> long QT apripiprazole--> dec esophageal motility |
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which is not a phenothiazine( most used as antipsychotics- typical)?
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a) chlorpromazine
b) thioridazine c) prochlorperazine d) quetiapine e) haloperidol |
d) quetiapine- is an atypical antipsychotic
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DOC for bipolar is lithium. which of the following is NOT true about this drug?
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a) it competes with Na+ for reabsorbption.
b) it can dec thyroid function and cause weight gain c) it is excreted by the kidneys d) it is a relatively safe natural element. pts can inc/dec dose prn. e) it can cause diabetes insipidus |
d) this is not a benign element. it has a very narrow therapeutic range and blood levels need to be closely monitored.
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you have a 71 yo male pt whom you have a diagnosis of parkinson's. you decide to start him on two medications, one being L-dopa and the other is an MAO-B inhbitior that has potential to slow the progression of his diease. what is this second drug?
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a) benztropine
b) pramipexole c) bromocriptine d) amantadine e) selegiline |
e) selegiline
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of the following agents used to treat Alzheimer's, which may slow the disease progression, but can cause agitation , incontinence and insomnia?
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a) rivastigmine
b) donepezil c) memantine d) tacrine e) galantamine |
c) memantine- it is a NMDA antagonist that prevents glutamate neurotox. the others are all cholinesterase inhbitors.
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ampetamine.methylphenidat and atomoxetine are all used to treat ADHD. which one effects the reuptake of NE?
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atomoxetine- is an SNRI.
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match the disorders with the targeted NT(s):
1) depression 2) anxiety 3) seizures 4) memory/learning 5) pain 6) schizophrenia a) 5HT, NE, DA b)DA c) NE d) NMDA, GABA e) ACh, NMDA f) GABA, 5HT |
1) depression-->a)5HT,NE, DA
2) anxiety-->f)GABA,5HT 3) seizures-->d) NMDA, GABA 4) memory/learning-->e) ACh, NMDA 5) Pain--> NE 6) schizo-->b)DA |
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of the inhaled anesthetics whichis safest in CV surgery, which is useful for neurosurgery due to low cerebral O2 consumption and which has the highest risk of malignant hyperthermia?
a) halothane b) sevoflurane c) isoflurane |
a) halothane= risk of malig hypertherm
b) sevoflurane= safest for CV; least inc in BP c) isoflurane= neurosurgery; less cerebral O2 consumption |
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which of the following is not a property of propofol?
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a) rapid onset and emergence
b) dec cerebral blood flow c) dec intracranial pressure d) dec in BP without reflex tachycardia e) compensatory inc respiratory rate |
e) compensatory inc resp rate- this drug has SE of resp depression
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your drug of choice for analgesia in a pediatric surgery pt is which of the following?
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a) thiopental
b) fentanyl c) ketamine d) propofol e) etomidate |
b) fentanyl- comes in lollipops and is fast acting opioid
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true or false: local anesthetic work better in acidic tissue because they are more ionized.
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false- they are more ionized which dec their effect. a solution is to employ carbonation with the administration of the local to inc the local pH.
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in a pt with know sulfa allergies the safest local anesthetic would be which of the following for an in office removals of a cyst?
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a) procaine
b) tetracaine c) lidocaine d) benzocaine |
c) lidocaine- is an amide, the rest are esters that are assoc with PABA allergic Rxn.
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19 yo man takes an overdose of phenobarbital(weak organic acid) which of the following will enhance its renal elimination?
a) acetazolamide b) N-acetylcysteine c) ammonium chloride d) cholestyramine e) fomepizole |
a) acetazolamide- Carbonic anhydrase inhibitor that alkalinizes the urine= excretion of acid
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76 yo man with renal function reduced by 40%, for which of the following drugs is it most important to reduce the dose?
a) acetaminophen b) azithromycin c) doxycycline d) gentamicin e) warfarin |
d) gentamicin- SE= nephrotoxic and ototoxic
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29 yo woman is infected simultaneously with Treponema pallidum, Neisseria gonorrhoeae, Chlamydia trachmatis. which of the following would be most effective to treat all 3 os these?
a) amoxicillin b) cefaclor c) doxycycline d) fluconazole e) gentamicin |
c) doxycycline- broad spectrum; works on spirochetes.
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36 yo woman with cellulitis experienced anaphylaxis after receiving amoxicillin 2 yrs ago, which of the following antibiotics should be avoided for the treatment of cellulitis in this pt?
a) aztreonam b) cefuroxime c) gentamicin d) ciprofloxacin e) vancomycin |
b) cefuroxime- anaphylaxis is a possible side effect with cephalosporins and caution needs to be used in pts with know penicillin allergies.
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which is an appropriate therapy in a 59 you man with a 6 yr Hx of frequent, recurrent and painful kidney stones?
a) eplerenone b) furosemide c) hydrochlorothiazide d) meperidine e) probenecid |
c) HCT is calcium sparing and will decrease the stones
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a 55 yo man with Mycoplasma pneumoniae is treated with azithromycin. azithromycin has: urinary excretion =10%
bioavailability=35% clearance=35L/h volume of distribution=2500L calculate the half life of azithromycin: a) 10h b) 25h c) 50h d)75h e) 100h |
c) 50h t1/2= (Vdx0.693)/Cl
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32 yo heroin addict present to ER with a broken leg and requires a morphine dose 5xs that of typical. which of the following best explains this?
a) cpmpetitive antagonism b) pharmacodynamic tolerance c) pharmcokinetic tolerance d) physiological antagonism e) supersensitivity |
b) pharmacodynamic tolerance- tolerance at the cellular level; down regulation of receptors
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a 3yo girl in a comatose state after drinking a substance found in the garage. she was found to have Ca++ oxalate crystals in her urine. which of the following is an appropriate antidote?
a) N-acetylcysteine b) deferoxamine c) fomepizole d) methylene blue e) succimer |
c) fomepizole- she likely ingested antifreeze; fomepizole is a alcohol dehydrogenase inhibitor
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which of the following poisons is improperly matched with its indicated treatment or antidote
a) organophosphate--> atropine b) cabon monoxide-->oxygen c) cyanide-->amyl nitrite d) lead-->methylene blue e) acetaminophen-->N-acetylcysteine |
d) lead-->methylene blue is incorrect. use dimercaprol, EDTACaNa2,succimer, or penicillimine to chelate the lead
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man was brought to ER who attempted suicide. he has dry skin and mucous membranes, dilated pupils, sinus tach with prolonged QT and symptoms of coma. 3 hrs later, recurrent seizures are treated with diazepam and pancuronium. in addition he is given soadium bicarbonate. he most likely took an overdose of:
a) acetaminophen b) amitriptyline c) lithium d) nifedipine e)propranolol |
b) amitripyline- inh reuptake of 5HT&NE, blocks M, alpha and H rec; SE=sedation, dry mouth, mydriasis, reflex tachycardia
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65 you man with diabetes and CHF is being managed with several drugs. which of his meds is most likely responsible for causing hypokalemia?
a) digoxin b) enalapril c) furosemide d) metformin e) spironolactone |
c) furosemide- causes hypoK+, flushes out K,Cl,Na,Ca and H+.
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untoward side effect of quinidine would include which of the following:
a) dec plasma digoxin levels causing reduced toxicity of digoxin b) SLE-like syndrome in susceptible individuals c) paradoxical ventricular bradycardia d) syncope due to Torsades de pointes e) constipation |
d) syncope due to Torsades
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which of the following is most appropriate treatment in a 59 yo man with a life threatening ventricular arrhythmia who has severe COPD?
a)adenosine b) amiodarone c) esmolol d) lidocaine e) verapamil |
d) lidocaine- treats ventricular arrhythmias; type 1a
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which is DOC for treatment of a 64 yo man with paroxysmal supraventricular tachycardia?
a) adenosine b) lidocaine c) sotalol d) procainamide e) propranolol |
a) adenosine- DOC for acute PSVT, WPW and reentry's
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which of the following antihypertensive drugs may increase hair growth and induce anginal attacks?
a) verapamil b) doxazosin c) minoxidil d) enalapril e) lasartan |
c) minoxidil- aka rogaine, vasodialtor opens K+ channels
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which of the following is a logical drug combination for chronic treatment of hypertension in a 65 yo woman?
a) HCT and sodium nitroprusside b) HCT and monoxidil c) HCT and spironolactone d) indapamide and furosemide e) verapamil and diltiazem |
c) HCT and spironolactone- HCT is DOC for HTN and spironolactone is K+ sparing and inc estrogen (gynecomastia)
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pt being treated for HTN complains of dry cough and alb results show hyperkalemia. which of the following classes of anti-hypertensive drugs is most likely to produce these effects?
a) alpha adrenergic antagonists b) angiotensin converting enzyme inhibitors c) sodium channel blockers d) beta adrenergic antagonist e) calcium channel blockers |
b) ACE inhibitors; SE= dry cough ( bradykinin ) and hyperK+(K+ sparing).
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antiHTN drug that lowers BP by blocking angiotensin receptors (ATII) competitively:
a) propranolol b) nifedipine c) enalapril d) losartan e) amiodarone |
d) losartan- ARB
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47yo female with BP of 148/99 was treated with monotherapy. which of the following drugs lowers BP by blocking Ca channels?
a) propranolol b) losartan c) hydrochlorothiazide d) enalapril e) verapamil |
e) verapamil
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propranolol=beta blocker
losartan=ARB HCT= thiazide enalapril= ACEi |
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this drug has the greatest potential to increase gallstones:
a) cholestyramine b) probucol c) gemfibrozil d) niacin e) lovastatin |
c) gemfibrozil- inc LPL activity w/SE=liver and cholethiasis
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chelstyramine=binds bile acids and prevents absorb,SE=constipation and bloating
probucol- inh chol transport from intestines, SE= dec HDL niacin- inh VLDL synth, SE=flushing and hyperuricemia lovastatin-HMGCoA reductase inh, SE=liver and rhabdomyolysis |
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DOC for acute anginal attacks is:
a) nitroglycerin b) verapamil c) doxazosin d) propranolol e) enalapril |
a) nitro- sublingual=fast and dialtes coronary veins
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which if the following can prevent angina pectoris by decreasing myocardial work but may rpecipitate congestive heart failure?
a) methyldopa b) metoprolol c) metolazone d) inamrinone |
b) metoprolol- beta1 blocker= decreases the contractility/rate )(work load) of the heart.
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methyldopa is an a2 agoinst and dec renin and SNS tone, SE= hemolytic anemia
metolazone- a thiazide-like diuretic with + inotropic effects inamrinone- PDE3 inh= inc cAMP=inccontractility, vasodialtion and is for short term use only. |
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most suitable drug for treatment of pain in terminal cancer?
a) loperamide b) merperidine c) morphine d)codeine e) amitriptylilne |
c) morphine- strong u,k,s agoinst
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loperamide- opiod that treats diarrhea
merperidine-too many side effects codeine- only treats mild-mod pain amitriptyline-TCA, better for CNS origin pain |
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which of the following are classified as a pure opioid antagoinist?
a) disulfiram b) naloxone c) fomepizole d) pentazocine e) flumazenil |
b) naloxone- fast acting IV opiod receptor antagonist
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disulfiram=blocks aldehyde dehydrogenase
fomepizole=alcohol dehydrogenase inhibitor pentazocine= agoinsts on u and k receptors flumazenil=benzo competitive antagonist |
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primary cause of death in opiod overdose?
a) stroke b) cardiac failure c) hepatotoxicity d) renal failure e) respiratory depression |
e) resp depress
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which of the following INCORRECTLY matches the drug with its principal target site?
a) aspirin-->cyclooxygenase b) allopurinol-->xanthine oxidase c) colchicine-->tubulin d) indomethacin--> cyclooxygenase e) probenecid-->dihydrofolate reductase |
e) probenecid--> uric acid resorb at proximal tubules not DHF reductase
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which of the following statements about acetaminophen is FALSE?
a) activated by cyp450 to an hepatotoxic metabolite b) as effective as aspirin for analgesia and antipyretic c) it is as effective as aspirin as an anti-inflammatory d) its toxicity may be potentiated by prior alcohol comsumption e) an overdose is treated with N-acetylcysteine |
c) acetaminophen has no anti-inflammatory properties
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which of the following drugs binds primarily to COX-2?
a) celecoxib b) allopurinol c) piroxicam d) diclofenac e) ibuprofen |
a) celecoxib
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allopurinol inh xanthine oxidase and the rest are non-selective COX inhibitors
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which of the following drugs is expected to have the LEAST effect on renal excretion of uric acid?
a) furosemide b) probenecid c) sumatriptan d) ethacrynic acid e)aspirin |
c) sumatriptan- no effect. it is a 5HT1d/1b agonist used to vasoconstrict intracranial vessels
this was a BS answer! |
furosemide- is CI in gout as well as aspirin and ethacrynic acid(loop diurtetic). probenecid blocks the reabsorb of uric acid at the prox tubules in kidney
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this drug binds to and inactivates TNF-alpha:
a) sulfasalazine b) mycophenolate mofetil c) infliximab d) lefllunomide e) penicillamine |
c) infliximab- chimeric IgG against TNF-a
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sulfasalazine=in COX and LO
mycophenolate=inh lymph purine synth leflunomide=cytotoxic agent penicillamine=oral chelator and dec T-cell activity and IgM RA factor |
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insulin induced hypoglycemia produces:
a) sweating b) cardiac palpitation c) confusion and disorientation d) hunger and nausea e) all of the above |
e) all of the above
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hypoglycemic efficacy of the sulfonylureas in treatment of DMII depends on:
a) liver b) anterior pituitary gland c) alpha cells of the pancreas islets d) beta cells of the pancreas islets e) hypothalamus |
d) beta cells of pancreas islets
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indicated for parenteral use in severe DKA?
a) ultralente insulin b) regular insulin c) insulin glargine d) NPH insulin e) mixed NPH and regular insulin |
b) regular insulin
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select the correct drug--adverse side effect pair:
a) metformin--hypoglycemia b) pioglitazone--bone marrow damage c) tolbutamide--hypoglycemia d) insulin--weight loss e) glyburide--gastric ulceration |
c) tolbutamide--hypoglycemia
metformin--lactic acidosis and diarrhea; CI in CHF pioglitazone--weight gain , edema and hepatic dz. insulin--hypoglycemia and lipodystrophy glyburide--hypoglycemia, hyperinsulinemia and weight gain |
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both ergonovine and oxytocin:
a) are used to induce abortion b) are used only by nasal instillation c) effectively control postpartum hemorrhage d) stimulate milk "let down" e) causes systemic vasodilation |
c) effectively control postpartum hemorrhage
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macrolide antibiotics should not be combined with penicillin in the treatment of a bacterial infection because the antagonize the therapeutic effect of penicillins by:
a) dec GI absorb of penicillin b) inc the renal excreation of penicillin c) inc the glomerular filtration of penicillin d) inh the growth of bacteria e) altering the tissue penetration of penicllins |
d) inhibit the growth of bacteria- penicillin need bacteria in the active growth phase in order to inhibit cell wall synthesis. macrolides reversibly bind 50s ribosome and are an alternative to penicillins with a similar spectrum
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the use of extended spectrum and broad spectrum antibiotics may result in:
a) intestinal candidiasis b) pseudomembranous colitis c) superinfections d) development of resistance e) all of the above |
e) all of the above
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most important and most frequently seen side effect of the aminoglycosides:
a) allergy b) nephrotoxicity c) hepatotoxicity d) GI disturbances e) cardiomyopathy |
b) nephrotoxicity
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tetracycline therapy is effective against a broad spectrum of organisms; howver, it shoulf be used with caution, if at all, in:
a) geriatric pts b) pts awaiting surgery c) pts taking MAO inhibitors d) pregnant women e) young adults |
d) pregnant women- deposits in bone and teeth; CI in pregnant and kids under 6
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28 yo female treated with tetracycline for 2 wks for Mycoplasma pneumoniae. at the end of the treatment period she developed oral candidasis. which of the following drugs would be suitable for the treatment of this infection?
a) paromomycin b) nystatin c) ivermectin d) niclosamide e) metronidazole |
b) nystatin
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ethambutol, rifampin adn pyrazinamide are administered concurrently with isoniazid in the treatment of tuberculosis in order to:
a) reduce the pain of injection b) facilitate penetration of the blood brain barrier c) minimize the development of organisms resistant to isoniazid d) delay excretion of isoniazid by the kidney e) retard absorption after intramuscular injection |
c) minimize the development of organisms resistant to isoniazid
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which of the following drugs binds reversibly to 50s ribosomes?
a) cycloserine b) ceftriaxone c) chloramphenicol d) gentamicin e) sulfamethoxazole |
c) chloramphenicol binds 50s ribosomes reversibly
ceftriaxone-cell wall synth inhibitor getamicin-irreversibly binds 30s sulfas- PABA antagonist |
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the most important adverse side effect of vancomycin is:
a) nephrotoxicity b) hepatotoxicity c) seizures d) hypersensitivity e) pseudomembranous colitis |
a) nephrotoxicity
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the most important adverse effect of penicillin G is:
a) nephrotoxicity b) hepatotoxicity c) seizures d) hypersensitivity e) pseudomembranous colitis |
d) hypersensitivity
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as you are watching the news you hear of a new drug that the side effects of the drug include dry mouth, blurred vision and constipation. men with BPH and people with glaucoma should not take this drug. based on this info you conclude that the drug is probably:
a) blocks dopamine D2 receptors b) blocks alpha1 receptors c) blocks muscarinic receptors d) inh reuptake of DA and NE e) blocks beta2 receptors |
c) blocks muscarinic receptors
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a new drug tested in anesthetized animals,decreases the HR. if the animals were pretreated with neostigmine the drug caused a larger dec in HR. if the animals were pretreated with atropine, the drug had no effect. the new drug is most likely similar to which of the following?
a) epinephrine b) acetylcholine c) tolerodine d) nicotine e) propranolol |
b) acetylcholine- cholinergic agonist, acts on muscarinic receptors and dec HR and BP
epi is alpha and beta agonist tolterodine is selective for M3 rec nicotine nicotinic receptor agonist; (treat poisoning with atropine) propranolol is a beta blocker |
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which combination of receptor--effect is correct?
a) alpha1--vasocontriction b) alpha2 --inc HR and BP c) beta1--dec HR d) beta2-- bronchoconstriction e) muscarinic--mydriasis |
a) alpha1--vasoconstriction
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a worker is exposed to an unknown powder in an agricultural setting. he comes to the ER with difficulty breathing, bradycardia, excessive salivation, diarrhea, cramping and blurred vision. which statement about this situation is correct?
a) he should be treated with prazosin to inc HR and CO b) treat with epinephrine adn diphenhydramine to block histamine c) treat with propranolol to reduce bronchoconstriction d) treat with atropine and pralidoxime(PAM) to block muscarinic receptors and prevent enzyme aging e) treat with pilocarpine to decrease salivation and diarrhea |
d) treat with atropine and 2-PAM
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69yo man complains of difficulty urinating, physical exam reveals and enlarged prostate and BP of 160/100. he is given a drug that is effective for both BPH and BP. however he experiences dizziness the first time he takes it, the drug is most likely?
a) finasteride b) atropine c) prazosin d) propranolol e) nifedipine |
c) prazosin- alpha 1 blocker Tx both BP and BPH
finasteride- 5,a reductase inh atropine-muscarinic antagonist propranolol-B-blocker Nifedipine-Ca channel blocker |
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one of your patients is a 68yo man with type1 diabetes. he has several episodes of hypoglycemia, for which he carries glucose tabs. he now needs to be treated for HTN. which of the following is the LEAST appropriate treatment for this pt?
a) prazosin b) metoprolol c) propranolol d) losartan e) nifedipine |
c) propranolol- CI in diabetic because is non-specific beta blocker and can cause hypoglycemia by reducing lipolysis and glycogenolysis.
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a 55 you man with astham needs to be treated for glaucoma. which of the following would be LEAST suitable for this pt?
a) pilocarpine b) timolol c) betaxolol d) brimonidine e)acetazolamide |
b) timolol- B-blocker that has potential to be absorbed systemically- bad for asthmatics
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short acting drug commonly used for diagnosis of myasthenia gravis:
a) edrophonium b) vecuronium c) esmolol d) isoproterenol e) succinylcholine |
a) edrophonium-short acting, reversibly binding cholinesterase inhibitor
vecuronium-nondepolarizing NM blocker esmolol-short acting B1 blocker isoproterenol-catecholamine succinylcholine-depolarizing NM blocker |
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causes non-depolarizing blockade of neuromuscular junction that is reversed with neostigmine:
a) edrophonium b) vecuronium c) esmolol d) isoproterenol e) succinylcholine |
b) vecuronium
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effects of epinephrine include all except:
a) positive inotropic and chronotropic effect in the heart b) vasoconstriction c) strong reflex slowing of the heart rate d) bronchodilation e) tremor |
c) strong reflex slowing of the heart rate
epi has a strong inotropic/chronotropic effect in the heart. |
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clonidine:
a) inhibits reuptake of NE into nerve terminals in the brain b) is an alpha2 agonist used in treatment of hypertension c) blocks both alpha and beta receptors d) may cause agranulocytosis e) is an alpha1 agonist used primarily as a decongestant |
b) is an alpha2 agonist used in treatment of HTN
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rapid withdrawal after chronic high-level alcohol abuse is often associated with hyperactivity of the brain and seizures. what is the likely mechanism?
a) down-regulation of GABAa receptors b) induction of aldehyde dehydrogenase c) inh of microsomal ethanol oxidizing system d) decreased sensitivity of NMDA recepotors e) inc release of serotonin |
a) down-regulation of GABAa receptors
* treat with long acting benzos to taper withdrawal |
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which of the following drugs is LEAST likely to increase the incidence of seizures?
a) Chlopromazine b) amitriptyline c) Buspirone d) buproprion d) meperidine |
c) Buspirone- 5HT1a partial agonist ; TX anxiety without sedation
all the others either decrease the seizure threshold or are c/i in pts with seizures |
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pt taking a medication complains of lightheadedness when he stands up too quickly. which of the following is LEAST likely to produce postural hypotesion?
a)fluoxetine b) chlorpromazine c) amitriptylline d) prazosin e) risperidone |
a) fluoxetine
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which of the following is a common side effect of fluoxetine?
a) dry mouth and urinary retention b) sexual dysfunction c) tardive dyskinesia d) gingival hyperplasia e) torsades de pointes |
b) sexual dysfunction, also insomnia, anxiety and CNS stimulation
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dantrolene is given to a pt in the ER. which of the following is LEAST likely to cause the symtpoms treated by dantrolene?
a) haloperidol b) succinylcholine c) halothane d) chlorpromazine e) diazepam |
e) diazepam
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blocks D2 and 5HT2a receptors; considered DOC for treatment of schizophrenia:
a) fluoxetine b) risperidone c) lithium d) aripiprazole e) chlorpromazine |
b) risperidone- SE postural hypotension, long QT and inc prolactin
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inhibits the reuptake of dopamine, useful in depression which hasn't responded to other drugs:
a) aripiprazole b) fluoxetine c) bupropion d) escitalopram e) buspirone |
c) burpoprion- inh reuptake of DA
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used for the treatment of anxiety, partial agonist at 5HT1a receptors and will NOT prevent alcohol withdrawal symptoms?
a) aripiprazole b) fluoxetine c) buproprion d) diazepam e) buspirone |
e) buspirone- good to treat anxiety in recovering addicts
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a 22yo man is increasingly anxious and irritable. he is brought to the ER by his friends after he started screaming that people were attacking him with giant birds. his BP is 195/110,pupils dilated and HR 135. he has round cuts on his arms and legs which he tells you were from cutting out bugs. you suspect drug abuse. the drug most likely is:
a) alcohol b) carisprodol c) heroin d) cocaine e) MDMA |
d) cocaine- cause tachycardia, dilated pupils, cocaine bugs and risk of MI or stroke in young pts.
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which of the following regarding l-dopa.carbidopa combo is correct?
a) addition of carbidopa will decrease the CNS effect of l-dopa b) it is effective in treatment of malignant melanoma c) its effectiveness will improve with time d) admin in divided doses may decrease nausea e) a common SE is red,swollen painful feet |
d) admin in divided doses may dec nausea
it can cause malig melanoma, its effectiveness dec over time and carbidopa inc the amount of levidopa that gets into the brain. bromocriptine (also treats parkinson's; a direct DA agonist)causes red,swollen painful feet |
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respiratory depression following the use of this drug in general anesthesia regimen may be reversed by flumazenil:
a) propofol b) isoflurane c) fentanyl d) midazolam e) nitrous oxide |
d) midazolam - a benzo and fomazenil is a direct benzo antagonist
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pt has an allergic reaction during surgery. which of the following anesthetic agents is MOST likely to have caused this problem?
a) propofol b) isoflurane c) halothane d) midazolam e) nitrous oxide |
a) propofol- has a risk of anaphylactic reaction (eggs,albumin)
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useful for the treatment of diarrhea?
a) magnesium hydroxide b) tegaserod c) metoclopramide d) esomeprazole e) loperamide |
e) loperamide- opioid that dec peristalsis without CNS effects
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46 yo man develops DVT after surgery and is treated for 6mos with warfarin. during this period he develops heartburn and self treats with an over the counter med. 2 weeks later he came to your office with bruises and his INR inc from 2.5 to 4. which of the following medications is MOST likely ot have caused this effect?
a) ranitidine b) cimetidine c) aluminum/magnesium hydroxide d) patoprazole e) misprostol |
b) cimetidine- H2 blocker that inh CYP3A4 = dec metabolism of warfarin, digoxin and phenytoin
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useful in the treatment of asthma because it blocks leukotriene receptors:
a) albuterol b) salmeterol c) montelukast d) theophylline e) ipratropium |
c) montelukast- leukotriene inhibitior
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albuterol and salmeterol are both beta 2 agoinist
thoephylline is a adenosine blocker and inh PDE ipratropium is a muscarinic antagonist(DOC for COPD) |
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29 yo woman with chronic asthma develops graves disease. she is 2 mos pregnant.f the following drugs, which would you use to treat her Grave's?
a) propranolol b) propythiouracil c) methythiouracil d) radioactive iodine e) levothyroxine |
b) propylthiouracil- DOC for hyperthyroidism in pregnant women- inh synth of thyroid homone
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blocks H1 receptors but causes little sedation because it doesn't cross the BBB:
a) diphenhydramine b) cimetidine c) amitriptyline d) loratidine e) albuterol |
d) loratidine- newer generation antihistamine that aren't sedating
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treatment of choice for cytomegalovirus, but may cause neutropenia:
a) acyclovir b) zidovudine c) ribavirin d) gancyclovir e) saquanavir |
d) gancyclovir
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drugs that induce CYP3A may cause this drug to be ineffective:
a) acyclovir b) zidovudine c) ribavirin d) gancyclovir e) saquinavir |
e) saquinavir
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may be used to prevent transmission of HIV from mother to fetus:
a) acyclovir b) zidovudine c) ribavirin d) gancyclovir e) saquinavir |
b) zidovudine- inh viral reverse transcriptase and dec transmit from mom to baby , safe in pregnancy
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mechanism of action of cyclosporine:
a) inh reverse transcriptase b) binds CD3 receptor on activated T cells c) dec production of TNFa d) inh calcinuerin, preventing activation of T cells e) inc activity of macrophages and B cells |
d) inhibits calcinuerin, preventing activation of T cells
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inhibits inosine monophosphate dehydrogenase, needed for de novo synth of purines in T and B cells and has a mild side effect profile:
a) interferon alfa 2B b) azthioprine c) cyclosporine d) muromonab-CD3 e) mycophenolate mofetil |
e) mycophenolate mofetil
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25yo female with clotting factor V Leiden mutation is being treated with oral anticoagulants but wishes to become pregnant. which would be the best choice for mgnt of her thrombophilia during her pregnancy?
a) warfarin b) abciximab c) enoxaparin d) ticlopidine e) reteplase |
c) enoxaparin- low molecular weight heparin
warfarin is category X in preg abiciximab is monoclonal antibody against GPiib/IIIa ($$$) |
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10yo boy suffers from frequent episodes of absence seizures . despite several attempts to treat with ethosuximide(DOC for absence) severe gastric pain prevents it. which of the following would be the best alternative treatment for this patient?
a) carbamazepine b) clonazepam c) gabapentin d) phenytoin e) valproic acid |
e) valproic acid- dec repetitive firing. DOC for tonic clonic seizures but can also treat absence. it is hepatotoxic and many drug interactions
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which of the following is sthe best choice for treating toxplamosis?
a) pyrimethamine,sulfadiazine and folinic acid b) tetracycline c) azithromycin d) paromomycin e) metronidazole |
a) pyrimithamine,sulfadiazine & folinic acid
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which of the following is the best choice for treating an infection with nematode Trichris trichuria, but is considered teratogenic and is not suitable for use during pregnancy?
a) paromomycin b) mebendazole c) trimethoprim plus sulfamethoxazole d) ivermectin e) praziquantel |
b) mebendazole
paromomycin-DOC histolytica and T vaginalis TMP-SMX-preg cat C ivermectin- DOC filaria infestation praziquantel-DOC all shistosomes and neurocysticercosis |
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30 yo man returns from traveling in Borneo and arrives unconscious int he ER after collapsing upon returning home. he has a high fever and lab results indicate a severe infection with P falciparum. which of the following is the best choice for immediate treatment in this pt?
a) chloroquine b) mefloquine c) atovaquone+proguanil d) quinidine gluconate e) primaquine |
d) quinidine is the DOC for malaria infection in an unconscious pt.
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28 yo man is diagnosed with testicular cancer. which of the following drugs is used to treat this type of cancer and is LEAST likely to cause myelosupression?
a) vinblastine b) etoposide c) cisplatin d) methotrexate e) cyclophosphamide |
c) cisplatin- treats advance testicular cancer and solid tumors and has little myelosupression
vinblastine- testicle CA, but huge myelosupress etoposide- souble strand breaks in DNA; SE myelosupress methotrexate- inh DHF reductase; SE myelosupress cyclophosphamide- treat hodkins and burkitts;SE= myelosupress |
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which of the following drugs is used to treat lung carcinoma and works by inhibiting diassembly of microtubules?
a) paclitaxel b) methotrexate c) cisplatin d) doxorubicin e) 5-fluorouracil |
a) paclitaxel- bnds microtubles and arrest mitosis
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30 yo woman asks her doctor about oral contraceptives. she smokes and has poorly controlled HTN. which of the following would be the most serious side effect of using estrogens in this pt?
a) stroke b) breast cancer c) uterine hyperplasia d) hepatotoxicity e) osteoporosis |
a) stroke- inc risk of blood clots woth smoking and HTN
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30 yo woman with 5 yr history of endometriosis presents complaining of sever pelvic pain. laparoscopy confirms progression of her disease. which of the following woulld ve the best choice to treat her endometriosis?
a) flutamide b) finasteride c) danazol d) methyltestosterone e) tamoxifen |
c) danazol- antiprogestin supresses ovarian function. Treatment of endometriosis
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an asthma pt with poorly controlled disease has been forced to rely on oral corticosteroids for the last 15 yrs. which of the following is the most serious side effect of long term glucocorticoid therapy?
a) tolerance b) hyperglycemia c) sodium and water retention d) osteoporosis e) congestive heart failure |
d) osteoporosis
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a peptic ulcer is diagnosed in a 55yo man and is successfully treated with esomeprazole. which of the following might have precipitated the formation of the ulcer in this pt?
a) simvastatin b) penicillin G c) warfarin d) bleomycin e) methylprenisolone |
e) methylprenisolone- corticosteroids supress prostaglandins= ulcer
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12 yo boy is brought ot ER for stitches. which would be the best choice to provide local anesthesia while suturing his wounds?
a) lidocaine b)bupivicaine c) ropivicaine d) cocaine e) benzocaine |
a) lidocaine- is an amide with rapid onset and intermediate length of action
bupivicaine-amide, long act and cardiotoxic ropivicaine- amide long duration cocaine- NOT benxocaine- ester and only topical |
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