Pharm Q7

Front 1

meperidine (Demerol) is good for what?

What does long term use do?

Back 1

-good for post-surgical pain control.

-builds up toxic liver metabolite

Front 2

meperidine (Demerol) causes less _______________ than morphine

Back 2

constipation

Front 3

________ is available in transdermal 3 day patches

Back 3

fentanyl (Duragesic)

Front 4

what is the preferred analgesic to control serious pain during childbirth

Back 4

fentanyl

Front 5

drug that was popular for dental pain but isn't on the market anymore

Back 5

propoxyphene (Darvon)

Front 6

Darvon + ASA or APAP = ???

Back 6

Darvocet

Front 7

moderate cough suppressant without analgesic

Back 7

Robitussin

Front 8

robitussin in large doses causes...

Back 8

hallucinations

Front 9

what is used to suppress withdrawal symptoms in opioid dependent individuals

Back 9

methadone

Front 10

what happens when repeated doses of methadone are taken?

Back 10

severe respiratory depression and death

Front 11

what's a drug used to treat opioid overdose?

Back 11

naloxone (Narcan)

Front 12

drug that police carry that is a pure antagonist

Back 12

naloxone (Narcan)

Front 13

opioid used to treat diarrhea

Back 13

imodium

Front 14

what does imodium do?

Back 14

relaxes GI tract, but doesn't give a high

Front 15

what do local anesthetics do?

Back 15

act as Na ion channel blockers and block all nerve conduction in nerves into which they dissolve

Front 16

two classes of local anesthetics?

Back 16

Esters and Amides

Front 17

three types of esters used?

Back 17

benzocaine, cocaine, procaine (Novocaine)

Front 18

strictly topical anesthetic?

Back 18

benzocaine

Front 19

what is also sold OTC for pain associated with sun burn (solarcaine) and vaginal itching (vagisil)

Back 19

benzocaine

Front 20

local anesthetic that is schedule 2 drug but is rarely prescribed

Back 20

cocaine

Front 21

local anesthetic that is useful in nasal and oral surgery that causes vasoconstriction that can result in insufficient blood supply to the tissues

Back 21

cocaine

Front 22

local anesthetic that isn't used anymore

Back 22

procaine (Novocaine)

Front 23

local anesthetic that is an amide?

Back 23

lidocaine (Xylocaine)

Front 24

what has been the local anesthetic of choice in dental offices but getting competition from articaine

Back 24

lidocaine

Front 25

commonly combined with epinephrine to reduce absorption of it into the blood stream

Back 25

lidocaine

Front 26

what drug is a combo of ester and amide?

Back 26

articaine (Septocaine)

Front 27

what is becoming an increasingly important dental local anesthetic?

Back 27

articaine

Front 28

who used to chew coca leaves

Back 28

Andean Indians

Front 29

how is cocaine formed?

Back 29

HCl converted to free base form by adding a base and evaporating off the water

Front 30

what causes ulcers

Back 30

due to gap in the protective mucosal layer of stomach or duodenum

Front 31

what are the vast majority of ulcers due to?

Back 31

Helicobacter pylori or use of NSAIDs

Front 32

other factors that increase the use of ulcers

Back 32

smoking, alcohol and stress

Front 33

what 3 things are used to treat ulcers?

Back 33

H2 antagonists, PPIs, antacids

Front 34

what does the stimulation of H2 receptors in the stomach result in?

Back 34

secretion of HCl into the stomach

Front 35

what do H2 antagonists inhibit?

Back 35

secretion of HCl

Front 36

types of H2 antagonists

Back 36

cimetidine (Tagamet)

ranitidine (Zantac)

famotidine (Pepcid)

nizatidine (Axid)

Front 37

what was the first H2 antagonist?

Back 37

cimetidine (Tagamet)

-short half life

Front 38

adverse effects of cimetidine (Tagamet)?

Back 38

1. inhibits CYP-450 drug metabolizing enzymes-> increasing effects of any other drug being taken

2. antagonist of androgenic receptors -> gynecomastia, reducing libido and erectile dysfunction

Front 39

other newer H2 antagonists?

Back 39

ranitidine, famotidine, nizatidine

longer half life

Front 40

what is different about newer H2 antagonists than cimetidine?

Back 40

-have a longer half life

-don't have the adverse effects

Front 41

what is the suffix of H2 antagonists?

Back 41

-tidine

Front 42

what are somewhat more effective in inhibiting HCl secretion than H2 antagonists?

Back 42

proton pump inhibitors - PPIs

Front 43

statistical correlations of PPIs

Back 43

anemia

osteoporosis

pneumonia

vitamin B12 deficiency

infection

Front 44

3 kinds of PPIs

Back 44

Omeprazole (Prilosec)

esomeprazole (Nexium)

pantoprazole (Protonix)

Front 45

direct inhibitor of the proton pump in stomach parietal cells

Back 45

omeprazole (Prilosec)

Front 46

PPI commonly used when H2 antagonists do not provide sufficient relief

Back 46

omeprazole

Front 47

what is the S mirror image version of omeprazole?

Back 47

esomeprazole

Front 48

esomeprazole claims to have fewer what than omeprazole?

Back 48

adverse effects

Front 49

third kind of PPI

Back 49

pantoprazole

Front 50

all generic PPIs end in what?

Back 50

-prazole

Front 51

4 kinds of antacids that neutralize HCl

Back 51

sodium bicarbonate

calcium carbonate

magnesium hydroxide

aluminum hydroxide

Front 52

the bacteria that causes ulcers:

Back 52

Helicobacter pylori

Front 53

how do you get Helicobacter pylori?

Back 53

oral fecal contamination

Front 54

recommended treatments for H. pylori and ulcers

Back 54

metronidazole

amoxicillin

PPIs

Front 55

what causes GERD

Back 55

gastric HCl passes into esophagus due to lower esophageal sphincter relaxation

Front 56

who mostly gets GERD

Back 56

older patients, especially bed ridden

Front 57

what are commonly prescribed for GERD

Back 57

H2 antagonists and PPIs

Front 58

diabetes mellitus is characterized by _______ which can occur after a meal, during fasting, or both

Back 58

hyperglycermia

Front 59

type 1 diabetes is due to a complete:

Back 59

lack of insulin produced by beta cells of pancreas

Front 60

type 2 diabetes is due to:

Back 60

insulin resistance

Front 61

in type ___, beta cells are being overworked and are eventually worn out

Back 61

2

Front 62

how do you treat type 1 diabetes?

Back 62

SC injection of insulin

Front 63

why can't insulin be taken orally?

Back 63

b/c insulin is a small protein and the digestive enzymes of the stomach and small intestine denature and hydrolyze it into amino acids

Front 64

injection of insulin stimulates:

Back 64

conversion of glucose into fat as well as storage as glycogen

Front 65

what can regular injections to the same site lead to?

Back 65

lipohypertrophy

Front 66

trade names of short acting regular (soluble) insulin

Back 66

Humulin R

Novolin R

Front 67

what short acting regular insulin has faster onset and faster degredation

Back 67

Lispro (Humalog)

Front 68

how does intermediate acting insulin exist?

Back 68

as cloudy suspension of tiny insulin crystals that must dissolve in tissue before being active

Front 69

which form is taken before a meal?

Back 69

short acting

Front 70

which form is taken between meals:

Back 70

intermediate acting insulin

Front 71

reaches peak in 2-5 hours

Back 71

short acting

Front 72

reaches peak in 6-12 hours

Back 72

intermediate acting

Front 73

the intermediate form of insulin exists as an insoluble suspension of insulin crystals which have been made by precipitating insulin with the protein protamine...

Back 73

NPH- neutral protamine hagedorn (Humulin N, Novolin N)

Front 74

combo product of intermediate acting insulin and regular insulin in a stable ___/___ mix

Back 74

Humulin 70/30

Novolin 70/30

Front 75

long acting (24 hours) insulin

Back 75

glargine (Lantus)

Front 76

hyperglycemia

Back 76

insufficient insulin

Front 77

hypoglycemia

Back 77

blood insulin levels are too high

Front 78

mild hypoglycemia may produce

Back 78

headache, drowsiness, and fatigue

Front 79

severe cases of hypoglycemia may produce

Back 79

tachycardia, sweating, nervousness

Front 80

long-term blood sugar control is monitored by measuring the amount of.....

Back 80

glycated hemoglobin

Front 81

how is glycated hemoglobin abreviated

Back 81

HbA1c

Front 82

a diabetic with a HbA1c value of 6.3% would have....

Back 82

excellent blood glucose control

Front 83

a diabetic with a HbA1c value of 8.5% would have....

Back 83

poor blood glucose control

Front 84

a diabetic's HbA1c levels should try to stay below....

Back 84

7%

Front 85

inhalation form of insulin

Back 85

Exubera

Front 86

3 ways to treat type 2 diabetes

Back 86

-diet/exercise

-sulfonylurea family drugs

-glitazone family drugs

Front 87

what do sulfonylureas stimulate..... thus promoting....

Back 87

-release of insulin from the beta cells of the pancreas

-promoting uptake of blood sugar and storage of glycogen

Front 88

most commonly used sulfonylurea drugs

Back 88

-glipizide

-glyburide

-glimepiride

Front 89

adverse effects of sulfonylureas

Back 89

increased appetite and weight gain

Front 90

most commonly prescribed oral diabetic drug for type 2 diabetics

Back 90

metformin

Front 91

adverse effects of metformin

Back 91

nausea

Front 92

unlike sulfonylurea drugs, metformin doesn't cause...

Back 92

hypoglycemia

Front 93

glitazone family drugs that increase sensitivity of insulin receptors primarily in the muscle and adipocytes

Back 93

rosiglitazone and pioglitazone

Front 94

glitazone drugs have recently gotten black box warnings because of...

Back 94

increased risk of CHF and mortality

Front 95

original glitazone drug that had to be taken off market for fatal liver failure

Back 95

troglitazone

Front 96

glitazones are examples of ________ because lower blood sugar but increase mortality

Back 96

surrogate outcome

Front 97

what are naturally occurring peptide hormones that stimulate the release of insulin from beta cells

Back 97

incretins

Front 98

an opiate available as a 3 day patch

Back 98

fentanyl

Front 99

one can get hallucinations by taking large doses of the OTC opiate....

Back 99

Robitussin

Front 100

what is an opiate used to control pain during childbirth

Back 100

fentanyl

Front 101

the antidote for an opiate OD

Back 101

naloxone

Front 102

_________ is an opiate initially introduced to suppress withdrawal symptoms of heroin addiction but has become a commonly prescribed pain med in its own right

Back 102

methadone

Front 103

-an OTC opiate used for treating diarrhea:

-doesn't have addictive potential because:

Back 103

-imodium

-not absorbed

Front 104

a topical local anesthetic used in solarcaine, vagisil, and for topical numbing of gums

Back 104

benzocaine

Front 105

commone dental local anesthetic

Back 105

lidocaine

Front 106

form of cocaine that crosses the BBB quickly

Back 106

free base

Front 107

snorting cocaine on a long term basis can cause __________ in the nose due to the _____________ properties of the drug

Back 107

tissue necrosis, vasoconstrictive

Front 108

H2 antagonists are commonly used to treat

Back 108

GERD, ulcers

Front 109

the H stands for

Back 109

histamine

Front 110

all of the H2 antagonists have generic names that end in

Back 110

-tidine

Front 111

a newer family of drugs that compete with the H2 antagonists:

Back 111

PPIs

Front 112

original drug in this family. when its patent ran out, the maker came out with the pure right hand glove form of the drug: ___________

Back 112

-omeprazole

-esomeprazole

Front 113

many ulcers that appear are due to infection with the bacterium

Back 113

Helicobacter pylori

Front 114

immediate acting genetically engineered human insulin is called

Back 114

Humulin R or Novolin R

Front 115

a form of insulin that works even more rapidly than regular insulin

Back 115

Humalog or Lispro

Front 116

intermediate acting form of insulin that is in crystalline form

Back 116

Humulin N (NPH)

Front 117

a long acting (24 hr) form of insulin

Back 117

glargine

Front 118

at a molecular level, early stage type 2 diabetes is due to dysfunction

Back 118

insulin receptors

Front 119

the family name for the oral diabetes drugs that stimulate insulin release from the beta cells of the pancreas

Back 119

sulfonylurea

Front 120

one specific member of this family:

Back 120

glipizide, glyburide, glimepiride

Front 121

a common adverse effect of this family:

Back 121

weight gain

Front 122

a first-line oral diabetic drug which improves insulin receptor sensitivity

Back 122

metformin

Front 123

a second oral diabetic drug which improves insulin receptor sensitivity but has been associated with increased risk of heart attacks and strokes

Back 123

rosiglitazone, pioglitazone

Front 124

naturally occurring peptide that stimulates insulin secretion, ___________, was first isolated from the

Back 124

incretins, gila monster's saliva

Front 125

the drug that increases the lifetime of this peptide in the blood

Back 125

Januvia

Front 126

long-term blood glucose control is measured with a quantity called _________ or __________

Back 126

HbA1c or glycated hemoglobin

Front 127

non diabetics typically have a value of about.......

Back 127

5-5.5

Front 128

specific member(s) of H2 antagonist family

Back 128

ranitidine, cimetidine

Front 129

full medical name for heartburn

Back 129

gastroesophageal reflux disease

Front 130

a drug family that is even more effective than the previous family

Back 130

ppi

Front 131

the generic names of all the members of this family end in

Back 131

-prazole

Front 132

the bacteria implicated in causing many ulcers is

Back 132

Helicobacter pylori