Pharm100 Practice Questions

Front 1

Mechanismof action of nitroglycerin:

Back 1

GTNis converted to nitric oxide.

NO isgenerated endogenously and acts as a vasodilator. It binds to guanylylcyclase and triggers a series of events that relaxes the vascular smoothmuscle.

Dilateslargecoronary arteries increasing oxygen supply to the heart muscle

Dilateslarge veins, reduces venous return to the heart , less blood to pump and lesswork load, less oxygen demand. –

Front 2

Whydo we still use GTN?

Back 2

Itisthe most effective agent acting acutely

Front 3

Why treat hypertension?

Back 3

•Untreatedleads to stroke, myocardial infarcts, vascular and kidney disease.

Front 4

Antihypertensives

Back 4

Any threeclasses of agents,but needto describe the consequencesofthe mechanisms.

Eg.Propranolol blocksbeta receptors in the heart. What doesthis do?

Front 5

Why have antibiotic resistant organismemerged?

Back 5

Reasons:

1) Overprescribing

2) Patientsdemand an antibiotic

3) SoldOTC in some countries

4) Nottaken properly by patient

5) Useof combinations

6) Inappropriateuse – not using sensitivity tests. 7) Prophylacticuse

Front 6

Thegeneral population has a concept that herbals are non-toxic compared toprescription drugs. Why is this notcorrect?

Back 6

Allsubstances can be toxic and toxicity should be determined on the basis of thesubstance and not on the source of the substance. A natural substance is the most toxicsubstance known to science.

Front 7

•Designof a trial (Phase III)

Back 7

–Whoand why?

–Randomassignment

–Doubleblind

–Objectivemeasures

–Stats

Front 8

Factors affecting the concentration of the drug at the site of action

Back 8

•Absorption

•Distribution

•Metabolism

•Excretion

•Knowdrug-interaction mechanisms

Front 9

Themost common method by which drugs cross membranes is?

Back 9

Simplediffusion through lipid

Front 10

Theappearanceof a drug withdrawal syndrome signifies that the drug can produce:

Back 10

Dependence

Front 11

How does drug tolerance manifest?

Back 11

It manifestsas a decrease in drug potency.

Front 12

Thepropertythat makes benzodiazepines attractive as therapeutic agents is:

Back 12

The widesafety margin (high therapeutic index).

Front 13

On which receptor doesCannabis act?

Back 13

CB1

Front 14

What does Nitroglycerindo?

Back 14

Nitroglycerindilates veins and reduces the return of blood to the heart.

Front 15

VitaminC is required for?

Back 15

VitaminC is required for the synthesis of collagen

Front 16

The major mechanism of action of theestrogen/progestin oral contraceptive is?

Back 16

Inhibition of ovulation.

Front 17

The most effective contraceptive is?

Back 17

Estrogen/progestinOC

Front 18

Describe the mechanism of action for the following antibiotic/antifungal drugs:

1) Penicillin

2) Tetracycline

3) Sulfonamides

4) Itraconazole

5)Trimethoprim

Back 18

1) Penicillin: inhibits cell wall synthesis

2) Tetracycline:Inhibits protein synthesis

3) Sulfonamides:Inhibits folate metabolism

4) Itraconazole:Inhibits cell membrane formation

5) Trimethoprim: Inhibits folate metabolism

Front 19

Which mechanism lead to the therapeutic action of chlorpromazine (a phenothiazine) in schizophrenia?

Back 19

Blockade of dopamine receptors

Front 20

Tolerance occurs to which effects of the benzodiazepines?

Back 20

Tolerance occurs to the SEDATIVE & HYPNOTIC effects of the benzodiazepines

Front 21

The CNS depressant effects of ethanol are additive with ________?

Back 21

Benzodiazepine

Front 22

In the lungs, morphine causes?

Back 22

Morphine – respiratory depression

Front 23

Marijuana is classified by law as a ________?

And pharmacologically as a ___________?

Back 23

as a narcotic

as a CNS depressant, euphoriant, hallucinogen

Front 24

Pentazocine

Back 24

= an opioid with mixed agonist/antagonist action

Front 25

Zolpidem

Back 25

= a new GABA receptor agonist which has minimal effects on sleep patterns

Front 26

Flumazenil

Back 26

= a GABA receptor antagonist

can be used as antidote for Benzodiazepine poisoning (Michael Jackson) (= a benzodiazepine receptor antagonist)

Front 27

Phenobarbital

Back 27

a narcotic and sedative barbiturate drug used chiefly to treat epilepsy.

Front 28

Chronic ethanol abuse can result in ?

Back 28

cirrhosis of the liver, an irreversible condition

Front 29

Which mechanism leads to the therapeutic action of nifedipine in angina?

Back 29

Blockade of calcium channels

Front 30

Heparin mechanism of action

Back 30

Heparin binds to antithrombin III, and enhances the action of antithrombin III

Front 31

Low molecular weight heparins are _______ purified than heparin

Back 31

Low molecular weight heparins are MORE purified than heparin

Front 32

Mechanism of action of aspirin

Back 32

?

Front 33

For a young adult, normal blood pressure is?

The higher figure is?

The lower figure is?

Back 33

For a young adult, normal blood pressure is about 120/80;

the higher figure is the systolic and the lower figure the diastolic blood pressure

Front 34

define systolic & diastolic

Back 34

systolic = when heart is contracting

diastolic = when heart is in between contractions

Front 35

The definition of normal blood pressure depends on ?

Back 35

The definition of normal blood pressure depends on the age of the individual, with the normal value in creasing with age

Front 36

Hydrochlorothiazide mechanism of action

Back 36

Hydrochlorothiazide decreases the volume of fluid in blood vessels by enhancing sodium and water excretion

Front 37

Clonidine mechanism of action

Back 37

?

Front 38

Mechanism of action of lovastatin (a statin)

Back 38

Inhibition of the rate-controlling enzyme in cholesterol (!) synthesis

Front 39

Which mechanism leads to the therapeutic action of propranolol in angina?

Back 39

Blockade of beta receptors

Front 40

The lipoprotein referred to as the “bad” lipoprotein is:

Back 40

LDL

Front 41

Warfarin mechanism of action

Back 41

Warfarin acts as a vitamin K antagonist

---> inhibits the synthesis of clotting cofactors

Front 42

Tissue plasminogen mechanism of action

Back 42

?

Front 43

Which of the penicillins is resistant to the action of penicillinase?

Back 43

Methicillin

Front 44

Which of the following is the target for the bactericidal action of penicillin G?

Back 44

Cell walls

penicillin G = natural penicillin

Front 45

Antivirals for Influenza:

Back 45

Amantidine and Oseltamivir (Tamiflu)

Oseltamivir inhibits the enzyme that allows for the spread of the virus

Front 46

In 1961 in England an epidemic resulted in the death of young turkeys, ducks and chickens.

---> attributable to the peanut meal used as poultry feed. The peanuts were contaminated with the fungus "Aspergillus flavus" which produced the carcinogen, ___________(1).

Which kind of cancer was induced this carcinogen (2)?

Back 46

1) aflatoxin

2) liver cancer

Front 47

Which of the modifiable, environmental factors cause the most cancer deaths?

Back 47

Tobacco and nutrition

Front 48

An anticancer drug that blocks estrogen from binding to its receptor is best-described as:

Back 48

Hormone antagonist

Front 49

The cancer anticipated to lead to the largest number of deaths in Canada is:

Back 49

lung cancer

Front 50

Co-trimoxazole is a combination of trimethoprim and:

Back 50

Sulfamethoxazole

Front 51

Augmentin is a combination of amoxacillin and:

Back 51

Clavulinic acid

Front 52

Toxicity associated with sodium benzoate?

Back 52

There is no real known toxicity associated with sodium benzoate as it is rapidly metabolized and excreted in humans.

Front 53

Smoke is both a food preservative and ?

Back 53

and flavouring agent

Front 54

Sodium chloride

Back 54

one of the first compounds used as a preservative

Front 55

Toxicity associated with Texture Agents?

Back 55

Texture agents possess little or no toxicity.

Front 56

Gossypol:

Back 56

Potential Male Contraceptives

obtained from cottonseed

destroys elements of the seminiferous tubules, decreasing sperm production

recovery of sperm count after discontinuing use of gossypol is not always guaranteed

led to a reduction in sperm count in 99% of the subjects.

Front 57

simulated flavours

Back 57

simulated flavours are mixtures of artificial flavours.

Front 58

monosodium glutamate (MSG)

Back 58

MSG causes a tightening of muscles in the face and neck, accompanied by headache.

= a flavour enhancer

Front 59

Drug use by athletes to

1) Increase endurance and speed

2) Increase strength.

3) Reduce body weight.

Back 59

1) amphetamines (often results in less than 5% increase in athletic performance)

2) Anabolic steroids & growth hormone

3) Diuretics to reduce body water, and thus weight

Front 60

Mifepristone (RU-486)

Back 60

Mifepristone (RU-486) is an anti-progestin and is taken after a “missed period”

Front 61

Food additives

Back 61

substances added to food to improve appearance, texture, storage, and nutritional value of food

Front 62

effective cough suppressants (antitussives)

Back 62

Codeine and dextromethorphan HBr

Front 63

Which vitamin requires successive biotransformation (chemical change) in the liver AND kidney to become a biologically active substance?

Back 63

Vitamin D

Front 64

Arguments (circumstantial evidence) for the dopamine hypothesis of schizophrenia

Back 64

1) binding affinity of drug to the receptor is highly correlated with their antipsychotic potency

2) drugs that increase dopamine aggravate/induce schizophrenia

3) dopamine receptor density is increased in (untreated) schizophrenics (compared to non-schizophrenics)

Front 65

3 features of 2nd generation antipsychotics

Back 65

1) treat positive AND negative symptoms

2) less extrapyramidal side effects

3) block both dopamine AND serotonin receptors

Front 66

Drugs for bipolar disorder

Back 66

lithium carbonate (mood stabilizer, many adverse effects)

anticonvulsants

(plus antidepressants and antipsychotics for depressive and manic phase)

Front 67

phenobarbital was the first _____________ while chlordiazepoxide was the first _____________

Back 67

phenobarbital was the first barbiturate while chlordiazepoxide was the first benzodiazepine

Front 68

mechanism of action of barbiturates & benzodiazepines

Back 68

reduce glutamate-induced excitation (anxiety) by enhancing GABA inhibition

Front 69

Barbiturates _________ REM sleep, while benzodiazepines ___________, and the drug Zolpidem __________

Back 69

Barbiturates suppress REM sleep, while benzodiazepines do so less, and the drug Zolpidem even less

Front 70

what benzodiazepine is drug of choice for panic disorder?

Back 70

Alprazolam

Front 71

Buspirone

Back 71

anti anxiety drug (acts on serotonin receptor)

advantage: no additive effects with other sedative-hypnotic drugs

Front 72

Gamma-hydroxybutyric acid (GHB)

Back 72

= date rape drug

GABA agonist

Front 73

diazepam

Back 73

anticonvulsant (against seizures)

can treat alcohol withdrawal (cross-dependance principle)

Front 74

major site of absorption of alcohol

Back 74

upper small intestine

Front 75

alcohol distributes via the ____________?

Back 75

total body water

Front 76

how much pure alcohol is metabolized in 1 hour?

Back 76

13 ml

Front 77

drugs to treat alcohol abuse act by _______?

Back 77

they inhibit ADH, which leads to the accumulation of acetaldehyde --> making person feel ill

(i.e. disulfiram)

Front 78

a person twice as likely to have an accident, has a blood alcohol level of ______?

Back 78

0.05%

50mg/100ml

(with 0.08% the chance are 8 (!) times higher)

Front 79

effects of chronic high use of alcohol

Back 79

1) CNS: damages axons --> alcoholic dementia

2) Cardiovascular: alcoholic cardiomyopathy (destruction of heart muscle), hypertension, stroke

3) Liver: alcoholic liver disease

4) Vitamin B1: thiamine deficiency (results ion Wernicke & Korsakoff syndromes)

5) Peripheral NS: damages axons (loss of feeling in feet, pain, difficulty walking)

Front 80

3 stages of alcoholic liver disease

Back 80

fatty liver (reversible) ---> alcohol hepatitis (usually reversible) ---> cirrhosis (not reversible)

alcohol hepatitis = inflamed liver

cirrhosis = scar tissue on liver, impairing blood flow

Front 81

Alcohol withdrawal produces _______________ of the CNS

Back 81

excitability

(restlessness, anxiety, sweating)

Front 82

delirium tremens

Back 82

= a severe alcohol withdrawal symtom

1) tremolousness

2) hallucinations

3) confusion

4) psychomotor agitation

5) sleep disorders

starts later (3rd day of disuse) and lasts longer than other symptoms

Front 83

drugs used in treatment of alcoholism

Back 83

1) disulfiram (--> person feels ill)

2) naltrexone (diminishes craving)

3) acomprosate (ethanol subsitute) (evidence is not overwhelming)

Front 84

What is the endogenous ligand for cannabis receptors?

Back 84

Anandamide, a retrograde transmitter (post to presynaptic neuron)

when receptor gets activated: inhibits release of excitatory neurotransmitters

Front 85

treat alcohol dependance with ___________ and opioid dependance with ____________

Back 85

alcohol: naltrexone

opioids: naloxone

Front 86

heroin is more ________ then morphine, but not more __________

Back 86

heroin is more potent then morphine, but not more efficacious

Front 87

rickets

Back 87

vitamin D

Front 88

scurvy

Back 88

vitamin C

Front 89

beriberi

Back 89

vitamin B1 (thiamin)

Front 90

pellagra

Back 90

vitamin B3 (niacin)

Front 91

pernicious anemia

Back 91

vitamin B12

Front 92

1) Alzheimers: loss of _______ neurons from ________

2) Parkinson's: loss of _______ neurons from ________

3) Huntington's: loss of neurons from the ________

Back 92

1) cholinergic, cortex

2) dopaminergic, substantia nigra

3) striatum

Front 93

1) which class of drugs produces no dependence?

2) and which produces no tolerance?

Back 93

1) hallucinogens

2) nicotine

Front 94

sympathetic

Back 94

fight and flight

Front 95

parasympathetic

Back 95

rest and relax

Front 96

peripheral NS

Back 96

somatic - voluntary

autonomic - involuntary:

-sympathetic & parasympathetic

Front 97

Lou Gehrig's disease (ALS): loss of neurons in __________

Back 97

spinal cord & brain

Front 98

cocaine inhibits reuptake of

Back 98

dopamine & norepinephrine

Front 99

cocaine abuse liability & inherent harmfulness =

Back 99

highest among all abused drugs

Front 100

caffeine mechanism of action

Back 100

block ADENOSINE receptors, which ?????

Front 101

when body contains alcohol it ______ biotransformation, when body contains no alcohol it ______ biotransformation

Back 101

1) decreases

2) increases

Front 102

which 2 vitamins are antioxidants?

Back 102

vitamin C and E

Front 103

which vitamin is involved in homocysteine levels?

Back 103

vitamin B6

Front 104

which vitamin is involved in night vision?

Back 104

vitamin A

Front 105

which vitamin causes rickets & osteoporosis ?

Back 105

vitamin D