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351 Cards in this Set
- Front
- Back
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True or false? Hyperkalemia increases the effect of digoxin.
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False. hyperkalemia decreases digoxin's activity, while hypokalemia, hypomagnesemia, and hypercalcemia all increase digoxin toxicity.
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Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
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Dantrolene
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Which overdose carries a higher mortality rate, that of benzodiazepines or barbiturates?
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Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
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What antiviral agent is used in the treatment of drug-induced Parkinson's disease?
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Amantadine
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Are the following responses associated with histamines H1 or H2 receptor activation?
• Edema |
H 1
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Are the following responses associated with histamines H1 or H2 receptor activation?
• Gastric acid secretion |
H 2
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Are the following responses associated with histamines H1 or H2 receptor activation?
• SA nodal activity |
H 2
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Are the following responses associated with histamines H1 or H2 receptor activation?
• Pain and pruritus |
H 1
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Are the following responses associated with histamines H1 or H2 receptor activation?
• Bronchial smooth muscle activity |
H 1
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Are the following responses associated with histamines H1 or H2 receptor activation?
• Inotropic action and automaticity |
H 2
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True or false? The lack of dopamine production in the substantia nigra leads to the extrapyramidal dysfunction, characteristically seen in patients with Parkinson's disease.
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True. The lack of dopamine leads to an excess of ACh, hence extrapyramidal dysfunction.
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Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
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PGI 2
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Which CNS ACh receptor or receptors are excitatory? Inhibitory?
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M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
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True or false? Beta2-Adrenergic agents are used in the management of an acute asthmatic attack.
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True. They are useful in the early-phase response to an asthmatic attack.
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Do local anesthetics bind to the activated or inactivated sodium channels?
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Inactivated
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What is the drug of choice for treating Tourette syndrome?
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Pimozide
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What mosquito is responsible for the transmission of malaria?
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Anopheles mosquito
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What enzyme is inhibited by disulfiram?
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Acetaldehyde dehydrogenase
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Which diuretic is used as an adrenal steroid antagonist?
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Spironolactone
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What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
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Fentanyl
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What is the drug of choice for penicillin-resistant gonococcal infections?
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Spectinomycin
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What is the DOC for treating torsade de pointes?
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Magnesium
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Is heparin contraindicated in pregnancy?
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No. Heparin is safe in pregnancy, but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
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What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
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Griseofulvin
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Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
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Carbamazepine
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What are the three Beta-lactamase inhibitors?
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1. Clavulanic acid
2. Sulbactam 3. Tazobactam |
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Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
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Carbamazepine
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Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
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Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
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Which class of diuretics is used to treat metabolic alkalosis, acute mountain sicknesses, and glaucoma and to aid in the elimination of acidic drug overdoses?
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Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
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What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
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Raloxifene
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Which tetracycline is used in the treatment of SIADH?
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Demeclocycline
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How is the eye affected by use of opioids?
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With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
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Name the antimicrobial agent whose major side effect is listed.
• Grey baby syndrome |
Chloramphenicol
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Name the antimicrobial agent whose major side effect is listed.
• CN VIII damage (vestibulotoxic) |
Aminoglycosides
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Name the antimicrobial agent whose major side effect is listed.
• Teratogenicity |
Metronidazole
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Name the antimicrobial agent whose major side effect is listed.
• Cholestatic hepatitis |
Erythromycin
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Name the antimicrobial agent whose major side effect is listed.
• Hemolytic anemia |
Nitrofurantoin
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Name the antimicrobial agent whose major side effect is listed.
• Dental staining in children |
Tetracycline
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Name the antimicrobial agent whose major side effect is listed.
• Altered folate metabolism |
Trimethoprim
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Name the antimicrobial agent whose major side effect is listed.
• Auditory toxicity |
Vancomycin
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Name the antimicrobial agent whose major side effect is listed.
• Cartilage abnormalities |
Quinolones
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What are the two side effects of opioids to which the user will not develop tolerance?
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Constipation and miosis
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Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
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Valproic acid
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What antitubercular agent causes loss of red-green visual discrimination?
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Ethambutol
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Name the insulin preparation based on the peak effect and duration of action.
• Peak, 8 to 16 hours; duration, 24 to 36 hours |
Ultralente
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Name the insulin preparation based on the peak effect and duration of action.
• Peak, 0.5 to 3 hours; duration, 5 to 7 hours |
Regular insulin
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Name the insulin preparation based on the peak effect and duration of action.
• Peak, 8 to 12 hours; duration, 18 to 24 hours |
Lente or NPH insulin (neutral protamine Hagedorn insulin)
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Name the insulin preparation based on the peak effect and duration of action.
• Peak, 0.3 to 2 hours; duration, 3 to 4 hours |
Lispro insulin
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Is digoxin or digitoxin renally eliminated?
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Digoxin is renally eliminated; digitoxin is hepatically eliminated.
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What is the drug of choice for steroid-induced osteoporosis?
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Alendronate
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What are the first signs of overdose from phenobarbitals?
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Nystagmus and ataxia
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How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
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Inhaled anesthetics with low lipid solubility have low potency (directly related), so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
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What α1-agonist, not inactivated by catechol-O-methyl transferase (COMT), is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
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Phenylephrine
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Which laxative is used in the treatment of hepatic encephalopathy ?
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Lactulose
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Are hydrolysis, oxidation, and reduction phase I or II biotransformations?
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Phase I
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What β-blocker is also an α-blocker?
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Labetalol
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What agent is used IM to treat acute dystonias?
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Diphenhydramine
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True or false? Anaerobes are resistant to the effects of aminoglycosides.
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True. Aminoglycosides use O 2-dependent uptake and therefore are ineffective for treatment of anaerobic infections.
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What two β-blockers decrease serum lipids?
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Acebutolol and Pindolol
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If a drug is ionized, is it water or lipid soluble? Can it cross a biomembrane?
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Ionized drugs are water soluble, and since only lipid-soluble drugs can cross biomembranes, an ionized drug cannot cross them without the help of a carrier.
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What are the longest-acting and shortest-acting benzodiazepines?
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Diazepam is longest acting and midazolam is shortest acting.
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What is the DOC for severe infections with Sporothrix, Mucor, Histoplasma, Cryptococcus, Candida, and Aspergillus?
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Amphotericin B
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What neurotransmitter is presynaptically inhibited by reserpine and guanethidine?
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NE
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Which two cephalosporins cross the blood-brain barrier?
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Cefuroxime and cefaclor
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What agent, in combination with a MAOI inhibitor, can cause hypertensive crisis?
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Tyramine
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True or false? Cocaine-induced coronary ischemia should not be treated with β-blockers.
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True. β-Blockade would result in unopposed-adrenergic stimulation and worsen the patient's symptoms. Calcium channel blockers are the way to go.
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What antimuscarinic is used as an inhalant for asthma?
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Ipratropium
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What two forms of insulin, if mixed together, precipitate zinc?
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Lente insulin and either NPH or protamine zinc insulin (PZI)
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What androgen receptor blocker is used in the treatment of prostatic cancer?
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Flutamide
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What are the first signs of phenobarbital overdose?
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Nystagmus and ataxia
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Which virus is treated with the monoclonal antibody palivizumab?
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RSV
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Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?
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Lithium
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Which class of antiarrhythmics are potassium channel blockers?
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Class III
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Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
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M 2
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What antiepileptic agent has SIADH as a side effect?
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Carbamazepine
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What is the only IV anesthetic that causes cardiovascular stimulation?
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Ketamine
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Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
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Dapsone
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What form of antimicrobial therapy is best for an immunocompromised patient?
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Bactericidal
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Which direct-acting vasodilator is associated with SLE-like syndrome in slow acetylators?
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Hydralazine
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What class of heparin is active against factor Xa and has no effect on PT or PTT?
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Low molecular weight heparin (LMWH)
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What is the DOC for coccidioidomycosis?
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Fluconazole
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What three cephalosporins have good penetration against Bacteroides fragilis?
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1. Cefotetan
2. Cefoxitin 3. Ceftizoxime |
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Which form of alcohol toxicity results in ocular damage?
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Methanol
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What immunosuppressive agent is converted to 6-mercaptopurine?
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Azathioprine
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Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
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Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
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What enzyme is inhibited by trimethoprim?
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Dihydrofolate reductase
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What are the two absolute requirements for the cytochrome P450 enzyme system?
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NADPH and molecular O 2
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What PG is a potent platelet aggregator?
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TXA2
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A depressive patient who is taking paroxetine goes to the ER with pain and is given meperidine. Shortly afterward she develops diaphoresis, myoclonus, muscle rigidity, hyperthermia, and seizures. What is your diagnosis, what can cause it (4), and what is the treatment?
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Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs, TCADs, dextromethorphan, and meperidine. Treat it with cyproheptadine.
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What class of drugs is used in the treatment of demineralization of the bone?
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Bisphosphonates
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What is the only class of diuretics to retain Cl- used in the short-term treatment of glaucoma and of acute mountain sickness?
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Acetazolamide
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True or false? All aluminum-containing antacids can cause hypophosphatemia.
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True. Aluminum reacts with PO4, resulting in AlPO4, an insoluble compound that cannot be absorbed.
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What TCAD causes sudden cardiac death in children?
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Desipramine
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What two β2-agonists are used to produce bronchodilation?
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Metaproterenol and albuterol
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What IV-only agent inhibits water reabsorption in the PCTs and is used to treat increased intracranial pressure, increased intraocular pressure, and acute renal failure?
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Mannitol
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What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
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They prevent mast cell degranulation.
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What two β2-agonists cause myometrial relaxation?
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Ritodrine and terbutaline
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Where in the spinal cord are the presynaptic opioid receptors?
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In the dorsal horn of the spinal cord on the primary afferent neurons
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What thrombolytic agent is derived from β-hemolytic streptococci, is antigenic, and produces depletion of circulating fibrinogen, plasminogen, and factors V and VII?
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Streptokinase
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What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
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Terbinafine
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Which class of antihypertensives produces angioedema, hyperkalemia, and a dry cough?
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ACE inhibitors (the-pril agents)
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Which medication requires an acidic gastric pH for activation to form a protective gel-like coating over ulcers and GI epithelium?
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Sucralfate
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Of what serotonin receptor is sumatriptan an agonist?
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5HT1D
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A patient with a history of epilepsy goes to the ER with sedation, gait ataxia, diplopia, and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
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Phenytoin
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What are the five penicillinase-resistant penicillins?
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1. Cloxacillin
2. Oxacillin 3. Nafcillin 4. Dicloxacillin 5. Methicillin (CONDM) |
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Which aminoglycoside is the DOC for tularemia and the bubonic plague?
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Streptomycin
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Is the following description characteristic of competitive or noncompetitive antagonists: parallel shift to the right on a dose-response curve, complete reversibility with increase of the dose of the agonist drug, and capacity to decrease the potency of the agonist drug?
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Competitive antagonist
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True or false? Progestins are used in combination with estrogens to decrease the risk of endometrial cancer.
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True
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What neuroleptic agent causes agranulocytosis but does not induce tardive dyskinesia?
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Clozapine
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What two factors influence low oral bioavailability?
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First-pass metabolism and acid lability
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What is the only site in the body that uses M1 receptors?
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The stomach
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What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L-dopa if used concomitantly?
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Vitamin B 6 (pyridoxine)
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True or false? Acetaminophen has analgesic and antipyretic activities but lacks anti-inflammatory effects.
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True
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What happens to plasma concentration of a drug if there is a large volume of distribution?
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The larger the volume of distribution, the lower the plasma concentration of a drug.
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Why should opioid analgesics be avoided for patients with head trauma?
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Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
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What is the drug of choice in the treatment of the lepra reaction?
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Clofazimine
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What two drugs, when mixed, can lead to malignant hyperthermia?
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Succinylcholine and halothane (Treatment is with dantrolene.)
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What three β-blockers are used in the treatment of glaucoma?
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1. Betaxolol
2. Timolol 3. Carteolol BTC Decrease aqueous humor secretion |
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What is the neurotransmitter at the Kappa-receptor?
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Dynorphin
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True or false? Succinylcholine is a nicotinic receptor agonist.
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True
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What is the drug of choice for hypertensive patients with a decreased renal function?
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α-Methyldopa (Guanabenz or clonidine is also used.)
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What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?
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Volume of distribution is decreased when a large percentage of drug is protein bound.
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What antihistamine is used in the treatment of serotonergic crisis?
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Cyproheptadine
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What is the drug of choice for early Parkinson's disease?
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Selegiline
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What is the site of action of the following?
• Osmotic diuretics |
The entire tubule barring the thick ascending limb
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What is the site of action of the following?
• Loop diuretics |
Ascending limb
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What is the site of action of the following?
• Thiazide diuretics |
Early distal tubule
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What is the site of action of the following?
• K+-sparing diuretics |
Early collecting duct
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What is the site of action of the following?
• Aldosterone antagonists |
Distal convoluted tubules
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What hematologic malignancy is treated with the monoclonal antibody rituximab?
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Non-Hodgkin lymphoma
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Which sodium channel blocker is used to treat lithium-induced diabetes insipidus?
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Amiloride
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Which two antipsychotic drugs create a high risk for developing extrapyramidal syndrome (EPS) side effects?
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Haloperidol and fluphenazine (but use of any high-potency phenothiazine runs the risk of EPS)
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Could an overdose with either zolpidem or zaleplon be reversed with flumazenil?
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Yes, because they both activate the BZ1-receptors, which can be reversed by flumazenil.
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What drug blocks intragranular uptake of NE?
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Reserpine
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True or false? Antimicrobial agents that slow bacterial growth are bactericidal.
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False. Bacteriocidals kill; bacteriostatics slow growth.
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Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
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Nicotinic acid, because its side effects include hyperuricemia and exacerbation of ulcers.
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What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
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Mebendazole
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What antiviral agents inhibit neuraminidases of influenza A and B?
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Zanamivir and oseltamivir
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What three cephalosporins inhibit vitamin K–dependent factors?
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Cefamandole, cefoperazone, and moxalactam
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Which direct-acting vasodilator is used clinically to treat hypertensive emergencies, insulinomas, and as a uterine smooth muscle relaxant?
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Diazoxide
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Which leukotriene—LTA4, LTB4, LTC4, or LTD4—is not associated with anaphylaxis and bronchoconstriction?
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LTB4, a neutrophil chemotactic agent
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What neuroleptic agent causes retinal deposits, hypotension, and torsades de pointes?
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Thioridazine
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What oral hypoglycemic agent inhibits α-glucosidase in the brush border of the small intestine?
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Acarbose
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What enzyme is inhibited by sulfonamides?
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Dihydropteroate synthetase
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What is the most important determinant of drug potency?
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The affinity of the drug for its receptor
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True or false? Estrogen use increases the risk of developing ovarian cancer.
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False. Risk of breast and endometrial cancer but not ovarian cancer increases with the use of estrogen.
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Which sedative–hypnotic is contraindicated for patients taking warfarin?
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Chloral hydrate
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What mixed α-antagonists are used for patients with pheochromocytoma?
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Phentolamine and phenoxybenzamine
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What are the four types of signaling mechanisms?
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1. Intracellular receptors
2. Membrane receptors 3. Enzymes 4. Intracellular effectors |
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The dose of which second-generation sulfonylurea agent must be decreased for patients with hepatic dysfunction?
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The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
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Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
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d-Tubocurarine
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What transient deficiency may result in a hypercoagulable state if warfarin is given alone?
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Transient protein C deficiency, because of its relatively short half-life, may result if warfarin is instituted alone.
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What component of the vascular system is most sensitive to the effects of calcium channel blockers?
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Arterioles
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What drug blocks glucose uptake, leading to decreased formation of ATP and resulting in immobilization of the parasite?
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Albendazole
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What is the site of action for carbonic anhydrase inhibitors?
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Proximal tubule
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Bleomycin |
G2 phase
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Cytarabine |
S phase
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Vinblastine |
Mitosis
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Alkylating agents |
G0 phase
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Paclitaxel |
Mitosis
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Vincristine |
Mitosis
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What phase of the cell cycle are the following antineoplastic agents specific for?
• 6-Thioguanine |
S phase
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What phase of the cell cycle are the following antineoplastic agents specific for?
• 6-Mercaptopurine |
S phase
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Dacarbazine |
G0 phase
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Hydroxyurea |
S phase
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Cisplatin |
G0 phase
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What phase of the cell cycle are the following antineoplastic agents specific for?
• Nitrosoureas |
G0 phase
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Inhibition of peripheral COMT, allowing increased CNS availability of L-dopa, is accomplished by what two agents?
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Tolcapone and entacapone
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What medication is a PGE1 analog that results in increased secretions of mucus and HCO3-in the GI tract?
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Misoprostol
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Is there a difference between mathematical and clinical steady states? If so, what are their values (half-lives)?
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There is a difference; it takes about 7 to 8 half-lives to reach mathematical steady state and 4 to 5 half-lives to reach clinical steady state.
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True or false? At high doses aspirin has uricosuric properties.
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True. At high doses ASA decreases uric acid reabsorption in the renal tubules, resulting in uricosuric actions. At low doses ASA decreases tubular secretion of uric acid, leading to hyperuricemia.
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What antiviral agent is used to treat RSV, influenza A and B, Lassa fever, and hantavirus and as an adjunct to IFN-alpha hepatitis C?
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Ribavirin
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Which aminoglycoside is used only topically because it is too toxic for systemic use?
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Neomycin
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Which class of antiarrhythmics blocks sodium channels?
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Class 1 (1A, 1B, and 1C)
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What form of penicillin is used in the treatment of life-threatening illnesses?
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Penicillin G (benzylpenicillin)
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What is the DOC for esophageal candidiasis?
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Fluconazole
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True or false? Flumazenil is used in the treatment of barbiturate overdose.
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False. Flumazenil is unable to block the effects of barbiturates.
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Which three aminoglycosides have vestibular toxicity?
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1. Streptomycin
2. Gentamicin 3. Tobramycin |
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What is the term for the amount of a drug that is needed to produce the desired effect?
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Potency
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What agent used in the treatment of BPH and baldness is a 5-α-reductase inhibitor?
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Finasteride
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What β-blocker is also a membrane stabilizer?
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Propranolol
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Name one of the ADP receptor antagonists used in patients who are post-MI, have had TIAs, have unstable angina, and are allergic to ASA?
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Ticlopidine or clopidogrel
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What is the treatment for nephrogenic diabetes insipidus induced by lithium?
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Amiloride
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Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
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Nimodipine
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What two drugs inhibit the release of neurotransmitters from storage granules?
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Guanethidine and bretylium
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What is the DOC for hyperprolactinemia?
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Pergolide
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True or false? The faster the rate of absorption, the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
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False. The faster the rate of absorption, the smaller the Tmax and larger the Cmax (bioinequivalence). The slower the rate of absorption, the larger the Tmax and smaller the Cmax.
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What tetracycline is associated with hepatotoxicity?
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Chlortetracycline
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|
|
What is the term for how well a drug produces its desired response?
|
Efficacy
|
|
|
What drug, if given during pregnancy, would cause the uterus to exhibit signs of progesterone withdrawal and induce an abortion?
|
RU 486 (Mifepristone)
|
|
|
Is allopurinol used in the acute treatment of gout?
|
No, it is used in chronic treatment of gout to decrease the uric acid pools in the body.
|
|
|
What three cephalosporins can produce disulfiram-like reactions?
|
1. Cefamandole (no longer available in the US)
2. Cefoperazone 3. Moxalactam |
|
|
What is the physiologic basis for the actions of birth control pills?
|
They block the midcycle surge of LH.
|
|
|
When a drug is administered orally and enters into portal circulation, it undergoes hepatic metabolism. What is the name of this effect?
|
First-pass effect
|
|
|
Which thrombolytic agent, activated in the presence of fibrin, is manufactured by recombinant DNA process?
|
Alteplase
|
|
|
Which benzodiazepine is most commonly used IV in conscious sedation protocols?
|
Midazolam
|
|
|
What is the drug of choice for threadworm, trichinosis, and larva migrans?
|
Thiabendazole
|
|
|
Can you tell which drug is more toxic based on therapeutic indices alone?
|
No, therapeutic indices can tell which drug is safer, not more toxic.
|
|
|
What blood disorder is a side effect of metformin?
|
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
|
|
|
A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity, a temperature of 104° F, altered mental status, and hypotension. What is your diagnosis and what is the treatment?
|
Neuroleptic malignant syndrome is a potentially life-threatening condition which is treated with symptomatic support, bromocriptine, and dantrolene.
|
|
|
Which α-blocking agent is used to treat refractory hypertension and baldness?
|
Minoxidil (orally and topically, respectively!)
|
|
|
What components of the coagulation cascade are affected by estrogen?
|
Estrogen can result in a hypercoagulable state because of the decrease in AntiThrombin III and increase in factors II, VII, IX, and X.
|
|
|
What class of antimicrobial agents should be avoided in patients with a history of G6PDH deficiency?
|
Sulfonamides
|
|
|
What enzyme of cholesterol synthesis is inhibited by the statins?
|
HMG-CoA reductase
|
|
|
What bactericidal agents are resistant to β-lactamases and are used to treat in-hospital life-threatening infections?
|
Imipenem and meropenem
|
|
|
What adrenergic receptors use inositol triphosphate (IP3) and diacylglycerol (DAG) for their second messenger system?
|
α1-Receptors
|
|
|
True or false? Dopamine antagonists at the D2A receptor have the capacity to induce pseudoparkinsonism.
|
True
|
|
|
What two PGs are used to induce labor?
|
PGE2 and PGF2α
|
|
|
How are drugs that are excreted via the biliary system resorbed by the GI tract?
|
Enterohepatic cycling
|
|
|
Which drugs bind to the 30S ribosomal subunit and interfere with the initiation complex, causing a misreading of mRNA?
|
Aminoglycosides
|
|
|
What antiviral agent blocks the attachment and penetration of influenza A virus?
|
Amantadine
|
|
|
What is the antidote for organophosphate ingestion?
|
Atropine and 2-PAM (pralidoxime)
|
|
|
Which antihypertensive class is used to help stop the progression of microalbuminuria?
|
ACE inhibitors (-pril)
|
|
|
What class of drugs are the DOCs for peptic ulcer disease, Zollinger-Ellison syndrome, and gastroesophageal reflux disease?
|
Proton pump inhibitors
|
|
|
What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
|
Chloramphenicol
|
|
|
Inhibition of peripheral aromatic amino acid decarboxylase and increased CNS availability of L-dopa are results of what drug used in the treatment of Parkinson's disease?
|
Carbidopa and benserazide
|
|
|
What type of drug elimination is characterized by the following?
• Elimination independent of plasma concentration; constant amount eliminated per unit time; no fixed half-life |
Zero-order elimination
|
|
|
What type of drug elimination is characterized by the following?
• Elimination directly proportional to plasma level; constant fraction eliminated per unit time; fixed half-life |
First-order elimination
|
|
|
True or false? NSAIDs have analgesic, antipyretic, anti-inflammatory, and antiplatelet activities.
|
True
|
|
|
True or false? Tetracyclines are bactericidal.
|
False. They are bacteriostatic.
|
|
|
What class 1A antiarrhythmic agent has SLE-like syndrome side effect in slow acetylators?
|
Procainamide
|
|
|
What is the major pulmonary side effect of µ-activators?
|
Respiratory depression
|
|
|
What neuroleptic agent is also considered to be an antihistamine?
|
Risperidone
|
|
|
What form of penicillin is stable in acid environments?
|
Penicillin V
|
|
|
What is the term for the proportion of a drug that reaches systemic circulation?
|
Bioavailability
|
|
|
What two drugs block dopa-decarboxylase in the periphery to decrease the conversion of L-dopa to dopamine?
|
Carbidopa and benserazide
|
|
|
What is the DOC for bipolar disorder?
|
Lithium
|
|
|
True or false? If a mother delivers a Rho-positive baby, she should receive Rho-immunoglobulin.
|
True if she is Rho-negative; false if she is Rho-positive
|
|
|
True or false? Both GABA and glutamic acid are excitatory neurotransmitters in the CNS.
|
False. Glutamic acid is excitatory, but GABA is inhibitory.
|
|
|
What is the drug of choice for prophylactic treatment of asymptomatic meningitis carriers?
|
Rifampin, used as prophylaxis for Haemophilus influenzae type B meningitis in children
|
|
|
What drug is used to differentiate a cholinergic crisis from myasthenia gravis?
|
Edrophonium
|
|
|
What class of antianginal activates the NO pathway to produce endothelial vasodilation?
|
Nitrates
|
|
|
What selective Cox-2 inhibitor should be avoided in patients with a history of sulfonamide allergy?
|
Celecoxib
|
|
|
What is the DOC for blastomycoses and sporotrichoses?
|
Itraconazole
|
|
|
What are the two most important features in the diagnosis of malaria?
|
Splenomegaly and anemia (with a high index of suspicion)
|
|
|
Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system.
|
Oxazepam, temazepam, and lorazepam ( OTL, Outside The Liver)
|
|
|
What drug is an M1-specific antispasmodic?
|
Pirenzepine
|
|
|
Which centrally acting α2-adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy?
|
Methyldopa
|
|
|
What is the monoamine oxidase B (MAOB) inhibitor?
|
Selegiline
|
|
|
What antitubercular agent causes a red-orange tinge to tears and urine?
|
Rifampin
|
|
|
What two classes of drugs can cause schizoid behavior?
|
Glucocorticoids and amphetamines
|
|
|
What tetracycline is associated with vestibular toxicity?
|
Minocycline
|
|
|
What is the most potent NMJ blocker and also has no cardiovascular side effects?
|
Doxacurium
|
|
|
What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
|
D2 and 5HT3 receptors
|
|
|
Which group of antihypertensive agents best decreases left ventricular hypertrophy?
|
Thiazide diuretics
|
|
|
What area of the brain is linked to emotion and movement?
|
Mesolimbic system
|
|
|
Why are clozapine and olanzapine unlikely to result in EPS effects?
|
Because they do not block D2A receptors, they are antagonists of 5HT2 receptors.
|
|
|
What class of pharmaceuticals are inactive until they are metabolized to their active products?
|
Prodrugs
|
|
|
True or false? You would not prescribe probenecid for a patient with gout who is an overexcretor of uric acid.
|
True. Probenecid can precipitate uric acid crystals in the kidney if the patient is an overexcretor of urate.
|
|
|
True or false? Dopamine antagonists are antiemetic.
|
True. They block the dopamine receptors in the chemoreceptor trigger zone.
|
|
|
What bactericidal agent is the DOC for MRSA, enterococci, and Clostridium difficile?
|
Vancomycin
|
|
|
True or false? β-Blockers are contraindicated in patients who present to the hospital with CHF.
|
True. β-Blockers are a component of CHF regimen for stable patients, not those who are decompensated. (This means you discharge a patient from the hospital with a prescription for a Beta-blocker; you don't start Beta-blockers when the patient is admitted.)
|
|
|
True or false? Fluoroquinolones are bactericidal.
|
True. They inhibit DNA gyrase (topo II).
|
|
|
What antiviral agent for ganciclovir-resistant infections has limited utility because of its nephrotoxic side effect?
|
Foscarnet
|
|
|
What oral hypoglycemic agent stimulates pancreatic β-cell release of insulin and is given just prior to meals because of its short half-life?
|
Repaglinide
|
|
|
True or false? There is no absorption of an IV-administered drug.
|
True. No loss of drug and no absorption if a drug is given IV.
|
|
|
What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells, not a fixed number?
|
Log-kill hypothesis (follows first order kinetics)
|
|
|
What is the only local anesthetic to produce vasoconstriction?
|
Cocaine
|
|
|
Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway?
|
Zileuton
|
|
|
What is the only diuretic that works on the blood side of the nephron?
|
Spironolactone (binds to aldosterone receptors)
|
|
|
Do you monitor heparin's therapeutic levels by PT or PTT?
|
Heparin, intrinsic pathway, PTT; warfarin, extrinsic pathway, PT (mnemonic: hPiTT, wPeT)
|
|
|
What is the only neuroleptic that does not cause an increase in weight or appetite?
|
Molindone
|
|
|
What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension?
|
Metaraminol (α1, β1 )
|
|
|
What antiarrhythmic agent is the DOC for treating and diagnosing paroxysmal supraventricular tachycardia (PSVT) and AV nodal arrhythmias?
|
Adenosine (it is an excellent agent to use in emergencies because its half-life is 30 seconds)
|
|
|
What phosphodiesterase inhibitor is used IV in the management of status asthmaticus ?
|
Aminophylline
|
|
|
Which nicotinic receptor antagonist is inactivated to laudanosine?
|
Atracurium
|
|
|
What α2-antagonist is used to treat impotence and postural hypotension?
|
Yohimbine
|
|
|
What drug of choice for ascaris causes neuromuscular blockade of the worm?
|
Pyrantel pamoate
|
|
|
Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing?
|
Phase 1
|
|
|
Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?
|
Tetracycline
|
|
|
What antifungal agent is used in the treatment of androgen receptor–positive cancers?
|
Ketoconazole
|
|
|
What MAOI does not cause a hypertensive crisis?
|
Selegiline (type B MAOI)
|
|
|
Which penicillin can cause interstitial nephritis?
|
Methicillin
|
|
|
Is hirsutism a side effect of estrogen or progestin therapy?
|
Progestin
|
|
|
Which potassium-sparing drug is an aldosterone receptor antagonist ?
|
Spironolactone
|
|
|
What are the three signs of morphine overdose?
|
1. Pinpoint pupils
2. Decreased respiratory rate 3. Coma |
|
|
Which anticonvulsant is used in the treatment of bipolar disorder and neuropathic pain?
|
Gabapentin
|
|
|
True or false? Metformin is contraindicated in obese patients because of weight gain as its side effect.
|
False. Metformin does not have weight gain as a potential side effect (unlike sulfonylureas).
|
|
|
What is the DOC for the treatment of the late phase response in an asthmatic attack?
|
Corticosteroid
|
|
|
If you double the infusion rate of a drug, how long will it take to reach steady state?
|
Regardless of the rate of infusion, it takes 4 to 5 half-lives to reach steady state.
|
|
|
What is the neurotransmitter at the µ-receptor?
|
β-Endorphin
|
|
|
What is the DOC for the following protozoal infections?
• Amebiasis |
Metronidazole
|
|
|
What is the DOC for the following protozoal infections?
• Leishmaniasis |
Stibogluconate
|
|
|
What is the DOC for the following protozoal infections?
• Pneumocystis carinii pneumonia |
Trimethoprim/sulfamethoxazole (TMP-SMX)
|
|
|
What is the DOC for the following protozoal infections?
• Giardiasis |
Metronidazole
|
|
|
What is the DOC for the following protozoal infections?
• Trichomoniasis |
Metronidazole
|
|
|
What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability?
|
Pentoxifylline
|
|
|
What enzyme system is the most common form of phase II biotransformation?
|
Glucuronidation
|
|
|
In what three areas of the body are sympathetics the predominant tone?
|
1. Sweat glands
2. Arterioles 3. Veins |
|
|
What is the only antifungal agent to penetrate CSF?
|
Fluconazole
|
|
|
Which class of antiarrhythmics are β-blockers?
|
Class II
|
|
|
What three cephalosporins are eliminated via biliary mechanisms?
|
1. Cefamandole
2. Cefoperazone 3. Ceftriaxone |
|
|
Which centrally acting α2-adrenergic agonist is used in the treatment protocol of opioid withdrawal?
|
Clonidine
|
|
|
What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?
|
Infliximab
|
|
|
Which macrolide is used in the treatment of gastroparesis?
|
Erythromycin
|
|
|
What syndrome is characterized by the triad of renal tubular acidosis, nephrosis, and amino aciduria?
|
Fanconi-like syndrome
|
|
|
In what area of the brain can an excess of dopamine lead to psychotic symptoms?
|
Mesocortical area
|
|
|
Name five causes for zero-order metabolism.
|
1. Sustained release
2. IV drip 3. Phenytoin 4. Alcohol 5. Aspirin toxicity |
|
|
What antitubercular agent requires vitamin B6 supplementation?
|
Isoniazid
|
|
|
Which antihistamine is one of the DOCs for treatment of vertigo?
|
Meclizine
|
|
|
What is the DOC for treating Entamoeba histolytica, Giardia, Trichomonas, Bacillus fragilis, and Clostridium difficile infections?
|
Metronidazole
|
|
|
Which class of antihypertensives is used in the treatment of BPH?
|
α-Blockers (-zosins)
|
|
|
Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium intracellulare complex?
|
Azithromycin
|
|
|
What is the drug of choice, which inhibits oxidative phosphorylation in cestodes, for taeniasis?
|
Niclosamide
|
|
|
Which class of antihyperlipidemics would you avoid for a patient with elevated triglyceride levels?
|
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore, they are not used if a patient has hypertriglyceridemia.
|
|
|
True or false? Ergotamines, because of their vasodilation action, cause migraines.
|
False. Ergotamines are used in the treatment of migraines for their vasoconstrictive action in the cerebral circulation.
|
|
|
Is DM a contraindication to use of a β-blocker in a patient who is having an MI?
|
Absolutely not. Diabetics who are given a β-blocker for an acute chest syndrome have significantly better outcomes than those who do not.
|
|
|
What β2-agonist is used as a prophylactic agent in the treatment of asthma?
|
Salmeterol
|
|
|
What hormone can be affected by dopamine release in the tuberoinfundibular pathway?
|
In the tuberoinfundibular pathway, dopamine release will decrease prolactin release, which is why dopamine agonists are used in the treatment of hyperprolactinemic states.
|
|
|
What determines the plasma level at steady state?
|
The rate of infusion
|
|
|
What enzyme is inhibited by propylthiouracil (PTU)?
|
5' deiodinase
|
|
|
What is the DOC for CMV retinitis?
|
Ganciclovir
|
|
|
What agent antagonizes the effects of heparin?
|
Protamine sulfate
|
|
|
What antihypertensive agent produces cyanide and thiocyanate as byproducts?
|
Nitroprusside
|
|
|
What is the DOC for β-blocker-induced bronchospasms?
|
Ipratropium
|
|
|
What is the only neuroleptic agent that does not cause hyperprolactinemia?
|
Clozapine
|
|
|
True or false? Gynecomastia is a side effect of cimetidine.
|
True. Cimetidine can decrease androgen production and lead to gynecomastia.
|
|
|
What three drugs are associated with SLE-like syndrome in slow acetylators?
|
Hydralazine, isoniazid, and procainamide (HIP)
|
|
|
What is the drug of choice for filariasis and onchocerciasis?
|
Diethylcarbamazine
|
|
|
What aminoglycoside causes disruption of CN I?
|
Streptomycin
|
|
|
What three drugs are known to cause gingival hyperplasia?
|
Phenytoin, cyclosporine and nifedipine
|
|
|
What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
|
ASA
|
|
|
What antifungal agent is activated by fungal cytosine deaminase to form 5-FU?
|
Flucytosine
|
|
|
Irreversible ototoxicity is associated with which loop diuretic?
|
Ethacrynic acid
|
|
|
What competitive estrogen receptor antagonist is used in the treatment of breast cancer?
|
Tamoxifen
|
|
|
Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
|
Doxycycline
|
|
|
True or false? Dopamine is an excitatory neurotransmitter in the CNS.
|
False. Dopamine is an inhibitory neurotransmitter in the CNS.
|
|
|
What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?
|
Metformin
|
|
|
Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
|
Phase 4
|
|
|
What prophylactic asthmatic agents are antagonists of LTD4?
|
Zafirlukast and Montelukast
|
|
|
What are the three C's of a TCAD overdose?
|
Coma, convulsions, and cardiotoxicity
|
|
|
What is the neurotransmitter at the δ-receptor?
|
Enkephalin
|
|
|
What body fluid preferentially breaks down esters?
|
Blood
|
|
|
What are the two broad-spectrum penicillins?
|
Ampicillin and amoxicillin
|
|
|
What are the three components to the asthma triad?
|
Nasal polyps, rhinitis, and aspirin hypersensitivity
|
|
|
Which class of antiarrhythmics are calcium channel blockers?
|
Class IV
|
|
|
What are the glycoprotein receptors that platelets and fibrinogen cross-link to when forming a thrombus?
|
GP IIb and IIIa receptors
|
|
|
Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
|
Propofol
|
|
|
Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
|
Physiologic antagonism
|
|
|
What GnRH analog is used as a repository form of treatment in prostatic cancer?
|
Leuprolide
|
|
|
Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis?
|
Clindamycin
|
|
|
What is the DOC for trigeminal neuralgia?
|
Carbamazepine
|
|
|
What drug that penetrates the blood-brain barrier is found in asthma preparations and used as a nasal decongestant?
|
Ephedrine
|
|
|
What is the term for drug removal per unit of time in a given volume of blood?
|
Clearance
|
|
|
Which two tetracyclines have the highest plasma binding?
|
Doxycycline and minocycline
|
|
|
What do the following values indicate?
• ED50 |
Effective dose for 50% of drug takers (median effective dose)
|
|
|
What do the following values indicate?
• TD50 |
Toxic dose for 50% of drug takers (median toxic dose)
|
|
|
What do the following values indicate?
• LD50 |
Lethal dose for 50% of drug takers (median lethal dose)
|
|
|
Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity?
|
Agents that decrease ACh function reduce tremors and rigidity, not bradykinesias.
|
|
|
A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
|
Spasms of the uterus, bladder, and the biliary tree occur with all of the opioids except meperidine.
Loperamide is a meperidine analog |
|
|
What form of oxidation takes place with the addition of a water molecule and breakage of bonds?
|
Hydrolysis
|
