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351 Cards in this Set

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  • Back
True or false? Hyperkalemia increases the effect of digoxin.
False. hyperkalemia decreases digoxin's activity, while hypokalemia, hypomagnesemia, and hypercalcemia all increase digoxin toxicity.
Which antispasmodic blocks the release of Ca 2+from the SR and is used in the treatment of malignant hyperthermia?
Dantrolene
Which overdose carries a higher mortality rate, that of benzodiazepines or barbiturates?
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
What antiviral agent is used in the treatment of drug-induced Parkinson's disease?
Amantadine
Are the following responses associated with histamines H1 or H2 receptor activation?
• Edema
H 1
Are the following responses associated with histamines H1 or H2 receptor activation?
• Gastric acid secretion
H 2
Are the following responses associated with histamines H1 or H2 receptor activation?
• SA nodal activity
H 2
Are the following responses associated with histamines H1 or H2 receptor activation?
• Pain and pruritus
H 1
Are the following responses associated with histamines H1 or H2 receptor activation?
• Bronchial smooth muscle activity
H 1
Are the following responses associated with histamines H1 or H2 receptor activation?
• Inotropic action and automaticity
H 2
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.
True. The lack of dopamine leads to an excess of ACh, hence extrapyramidal dysfunction.
Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
PGI 2
Which CNS ACh receptor or receptors are excitatory? Inhibitory?
M 1 and nicotinic receptors are excitatory in the CNS and M 2 receptor is inhibitory.
True or false? Beta2-Adrenergic agents are used in the management of an acute asthmatic attack.
True. They are useful in the early-phase response to an asthmatic attack.
Do local anesthetics bind to the activated or inactivated sodium channels?
Inactivated
What is the drug of choice for treating Tourette syndrome?
Pimozide
What mosquito is responsible for the transmission of malaria?
Anopheles mosquito
What enzyme is inhibited by disulfiram?
Acetaldehyde dehydrogenase
Which diuretic is used as an adrenal steroid antagonist?
Spironolactone
What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
Fentanyl
What is the drug of choice for penicillin-resistant gonococcal infections?
Spectinomycin
What is the DOC for treating torsade de pointes?
Magnesium
Is heparin contraindicated in pregnancy?
No. Heparin is safe in pregnancy, but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
Griseofulvin
Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
Carbamazepine
What are the three Beta-lactamase inhibitors?
1. Clavulanic acid
2. Sulbactam
3. Tazobactam
Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
Carbamazepine
Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent
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?
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Raloxifene
Which tetracycline is used in the treatment of SIADH?
Demeclocycline
How is the eye affected by use of opioids?
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
Name the antimicrobial agent whose major side effect is listed.
• Grey baby syndrome
Chloramphenicol
Name the antimicrobial agent whose major side effect is listed.
• CN VIII damage (vestibulotoxic)
Aminoglycosides
Name the antimicrobial agent whose major side effect is listed.
• Teratogenicity
Metronidazole
Name the antimicrobial agent whose major side effect is listed.
• Cholestatic hepatitis
Erythromycin
Name the antimicrobial agent whose major side effect is listed.
• Hemolytic anemia
Nitrofurantoin
Name the antimicrobial agent whose major side effect is listed.
• Dental staining in children
Tetracycline
Name the antimicrobial agent whose major side effect is listed.
• Altered folate metabolism
Trimethoprim
Name the antimicrobial agent whose major side effect is listed.
• Auditory toxicity
Vancomycin
Name the antimicrobial agent whose major side effect is listed.
• Cartilage abnormalities
Quinolones
What are the two side effects of opioids to which the user will not develop tolerance?
Constipation and miosis
Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
Valproic acid
What antitubercular agent causes loss of red-green visual discrimination?
Ethambutol
Name the insulin preparation based on the peak effect and duration of action.
• Peak, 8 to 16 hours; duration, 24 to 36 hours
Ultralente
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
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)
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
Is digoxin or digitoxin renally eliminated?
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
What is the drug of choice for steroid-induced osteoporosis?
Alendronate
What are the first signs of overdose from phenobarbitals?
Nystagmus and ataxia
How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
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.
What α1-agonist, not inactivated by catechol-O-methyl transferase (COMT), is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
Phenylephrine
Which laxative is used in the treatment of hepatic encephalopathy ?
Lactulose
Are hydrolysis, oxidation, and reduction phase I or II biotransformations?
Phase I
What β-blocker is also an α-blocker?
Labetalol
What agent is used IM to treat acute dystonias?
Diphenhydramine
True or false? Anaerobes are resistant to the effects of aminoglycosides.
True. Aminoglycosides use O 2-dependent uptake and therefore are ineffective for treatment of anaerobic infections.
What two β-blockers decrease serum lipids?
Acebutolol and Pindolol
If a drug is ionized, is it water or lipid soluble? Can it cross a biomembrane?
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.
What are the longest-acting and shortest-acting benzodiazepines?
Diazepam is longest acting and midazolam is shortest acting.
What is the DOC for severe infections with Sporothrix, Mucor, Histoplasma, Cryptococcus, Candida, and Aspergillus?
Amphotericin B
What neurotransmitter is presynaptically inhibited by reserpine and guanethidine?
NE
Which two cephalosporins cross the blood-brain barrier?
Cefuroxime and cefaclor
What agent, in combination with a MAOI inhibitor, can cause hypertensive crisis?
Tyramine
True or false? Cocaine-induced coronary ischemia should not be treated with β-blockers.
True. β-Blockade would result in unopposed-adrenergic stimulation and worsen the patient's symptoms. Calcium channel blockers are the way to go.
What antimuscarinic is used as an inhalant for asthma?
Ipratropium
What two forms of insulin, if mixed together, precipitate zinc?
Lente insulin and either NPH or protamine zinc insulin (PZI)
What androgen receptor blocker is used in the treatment of prostatic cancer?
Flutamide
What are the first signs of phenobarbital overdose?
Nystagmus and ataxia
Which virus is treated with the monoclonal antibody palivizumab?
RSV
Which medication used in the treatment of bipolar disorder decreases the release of T 4 from the thyroid gland?
Lithium
Which class of antiarrhythmics are potassium channel blockers?
Class III
Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
M 2
What antiepileptic agent has SIADH as a side effect?
Carbamazepine
What is the only IV anesthetic that causes cardiovascular stimulation?
Ketamine
Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
Dapsone
What form of antimicrobial therapy is best for an immunocompromised patient?
Bactericidal
Which direct-acting vasodilator is associated with SLE-like syndrome in slow acetylators?
Hydralazine
What class of heparin is active against factor Xa and has no effect on PT or PTT?
Low molecular weight heparin (LMWH)
What is the DOC for coccidioidomycosis?
Fluconazole
What three cephalosporins have good penetration against Bacteroides fragilis?
1. Cefotetan
2. Cefoxitin
3. Ceftizoxime
Which form of alcohol toxicity results in ocular damage?
Methanol
What immunosuppressive agent is converted to 6-mercaptopurine?
Azathioprine
Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade
What enzyme is inhibited by trimethoprim?
Dihydrofolate reductase
What are the two absolute requirements for the cytochrome P450 enzyme system?
NADPH and molecular O 2
What PG is a potent platelet aggregator?
TXA2
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?
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs, TCADs, dextromethorphan, and meperidine. Treat it with cyproheptadine.
What class of drugs is used in the treatment of demineralization of the bone?
Bisphosphonates
What is the only class of diuretics to retain Cl- used in the short-term treatment of glaucoma and of acute mountain sickness?
Acetazolamide
True or false? All aluminum-containing antacids can cause hypophosphatemia.
True. Aluminum reacts with PO4, resulting in AlPO4, an insoluble compound that cannot be absorbed.
What TCAD causes sudden cardiac death in children?
Desipramine
What two β2-agonists are used to produce bronchodilation?
Metaproterenol and albuterol
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?
Mannitol
What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
They prevent mast cell degranulation.
What two β2-agonists cause myometrial relaxation?
Ritodrine and terbutaline
Where in the spinal cord are the presynaptic opioid receptors?
In the dorsal horn of the spinal cord on the primary afferent neurons
What thrombolytic agent is derived from β-hemolytic streptococci, is antigenic, and produces depletion of circulating fibrinogen, plasminogen, and factors V and VII?
Streptokinase
What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Terbinafine
Which class of antihypertensives produces angioedema, hyperkalemia, and a dry cough?
ACE inhibitors (the-pril agents)
Which medication requires an acidic gastric pH for activation to form a protective gel-like coating over ulcers and GI epithelium?
Sucralfate
Of what serotonin receptor is sumatriptan an agonist?
5HT1D
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?
Phenytoin
What are the five penicillinase-resistant penicillins?
1. Cloxacillin
2. Oxacillin
3. Nafcillin
4. Dicloxacillin
5. Methicillin


(CONDM)
Which aminoglycoside is the DOC for tularemia and the bubonic plague?
Streptomycin
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?
Competitive antagonist
True or false? Progestins are used in combination with estrogens to decrease the risk of endometrial cancer.
True
What neuroleptic agent causes agranulocytosis but does not induce tardive dyskinesia?
Clozapine
What two factors influence low oral bioavailability?
First-pass metabolism and acid lability
What is the only site in the body that uses M1 receptors?
The stomach
What vitamin is a cofactor of aromatic amino acid decarboxylase and decreases the efficacy of L-dopa if used concomitantly?
Vitamin B 6 (pyridoxine)
True or false? Acetaminophen has analgesic and antipyretic activities but lacks anti-inflammatory effects.
True
What happens to plasma concentration of a drug if there is a large volume of distribution?
The larger the volume of distribution, the lower the plasma concentration of a drug.
Why should opioid analgesics be avoided for patients with head trauma?
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
What is the drug of choice in the treatment of the lepra reaction?
Clofazimine
What two drugs, when mixed, can lead to malignant hyperthermia?
Succinylcholine and halothane (Treatment is with dantrolene.)
What three β-blockers are used in the treatment of glaucoma?
1. Betaxolol
2. Timolol
3. Carteolol
BTC
Decrease aqueous humor secretion
What is the neurotransmitter at the Kappa-receptor?
Dynorphin
True or false? Succinylcholine is a nicotinic receptor agonist.
True
What is the drug of choice for hypertensive patients with a decreased renal function?
α-Methyldopa (Guanabenz or clonidine is also used.)
What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?
Volume of distribution is decreased when a large percentage of drug is protein bound.
What antihistamine is used in the treatment of serotonergic crisis?
Cyproheptadine
What is the drug of choice for early Parkinson's disease?
Selegiline
What is the site of action of the following?
• Osmotic diuretics
The entire tubule barring the thick ascending limb
What is the site of action of the following?
• Loop diuretics
Ascending limb
What is the site of action of the following?
• Thiazide diuretics
Early distal tubule
What is the site of action of the following?
• K+-sparing diuretics
Early collecting duct
What is the site of action of the following?
• Aldosterone antagonists
Distal convoluted tubules
What hematologic malignancy is treated with the monoclonal antibody rituximab?
Non-Hodgkin lymphoma
Which sodium channel blocker is used to treat lithium-induced diabetes insipidus?
Amiloride
Which two antipsychotic drugs create a high risk for developing extrapyramidal syndrome (EPS) side effects?
Haloperidol and fluphenazine (but use of any high-potency phenothiazine runs the risk of EPS)
Could an overdose with either zolpidem or zaleplon be reversed with flumazenil?
Yes, because they both activate the BZ1-receptors, which can be reversed by flumazenil.
What drug blocks intragranular uptake of NE?
Reserpine
True or false? Antimicrobial agents that slow bacterial growth are bactericidal.
False. Bacteriocidals kill; bacteriostatics slow growth.
Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
Nicotinic acid, because its side effects include hyperuricemia and exacerbation of ulcers.
What inhibitor of microtubule synthesis is the drug of choice for whipworm and pinworm?
Mebendazole
What antiviral agents inhibit neuraminidases of influenza A and B?
Zanamivir and oseltamivir
What three cephalosporins inhibit vitamin K–dependent factors?
Cefamandole, cefoperazone, and moxalactam
Which direct-acting vasodilator is used clinically to treat hypertensive emergencies, insulinomas, and as a uterine smooth muscle relaxant?
Diazoxide
Which leukotriene—LTA4, LTB4, LTC4, or LTD4—is not associated with anaphylaxis and bronchoconstriction?
LTB4, a neutrophil chemotactic agent
What neuroleptic agent causes retinal deposits, hypotension, and torsades de pointes?
Thioridazine
What oral hypoglycemic agent inhibits α-glucosidase in the brush border of the small intestine?
Acarbose
What enzyme is inhibited by sulfonamides?
Dihydropteroate synthetase
What is the most important determinant of drug potency?
The affinity of the drug for its receptor
True or false? Estrogen use increases the risk of developing ovarian cancer.
False. Risk of breast and endometrial cancer but not ovarian cancer increases with the use of estrogen.
Which sedative–hypnotic is contraindicated for patients taking warfarin?
Chloral hydrate
What mixed α-antagonists are used for patients with pheochromocytoma?
Phentolamine and phenoxybenzamine
What are the four types of signaling mechanisms?
1. Intracellular receptors
2. Membrane receptors
3. Enzymes
4. Intracellular effectors
The dose of which second-generation sulfonylurea agent must be decreased for patients with hepatic dysfunction?
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
d-Tubocurarine
What transient deficiency may result in a hypercoagulable state if warfarin is given alone?
Transient protein C deficiency, because of its relatively short half-life, may result if warfarin is instituted alone.
What component of the vascular system is most sensitive to the effects of calcium channel blockers?
Arterioles
What drug blocks glucose uptake, leading to decreased formation of ATP and resulting in immobilization of the parasite?
Albendazole
What is the site of action for carbonic anhydrase inhibitors?
Proximal tubule
What phase of the cell cycle are the following antineoplastic agents specific for?
• Bleomycin
G2 phase
What phase of the cell cycle are the following antineoplastic agents specific for?
• Cytarabine
S phase
What phase of the cell cycle are the following antineoplastic agents specific for?
• Vinblastine
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for?
• Alkylating agents
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for?
• Paclitaxel
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for?
• Vincristine
Mitosis
What phase of the cell cycle are the following antineoplastic agents specific for?
• 6-Thioguanine
S phase
What phase of the cell cycle are the following antineoplastic agents specific for?
• 6-Mercaptopurine
S phase
What phase of the cell cycle are the following antineoplastic agents specific for?
• Dacarbazine
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for?
• Hydroxyurea
S phase
What phase of the cell cycle are the following antineoplastic agents specific for?
• Cisplatin
G0 phase
What phase of the cell cycle are the following antineoplastic agents specific for?
• Nitrosoureas
G0 phase
Inhibition of peripheral COMT, allowing increased CNS availability of L-dopa, is accomplished by what two agents?
Tolcapone and entacapone
What medication is a PGE1 analog that results in increased secretions of mucus and HCO3-in the GI tract?
Misoprostol
Is there a difference between mathematical and clinical steady states? If so, what are their values (half-lives)?
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.
True or false? At high doses aspirin has uricosuric properties.
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.
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?
Ribavirin
Which aminoglycoside is used only topically because it is too toxic for systemic use?
Neomycin
Which class of antiarrhythmics blocks sodium channels?
Class 1 (1A, 1B, and 1C)
What form of penicillin is used in the treatment of life-threatening illnesses?
Penicillin G (benzylpenicillin)
What is the DOC for esophageal candidiasis?
Fluconazole
True or false? Flumazenil is used in the treatment of barbiturate overdose.
False. Flumazenil is unable to block the effects of barbiturates.
Which three aminoglycosides have vestibular toxicity?
1. Streptomycin
2. Gentamicin
3. Tobramycin
What is the term for the amount of a drug that is needed to produce the desired effect?
Potency
What agent used in the treatment of BPH and baldness is a 5-α-reductase inhibitor?
Finasteride
What β-blocker is also a membrane stabilizer?
Propranolol
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?
Ticlopidine or clopidogrel
What is the treatment for nephrogenic diabetes insipidus induced by lithium?
Amiloride
Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
Nimodipine
What two drugs inhibit the release of neurotransmitters from storage granules?
Guanethidine and bretylium
What is the DOC for hyperprolactinemia?
Pergolide
True or false? The faster the rate of absorption, the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
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.
What tetracycline is associated with hepatotoxicity?
Chlortetracycline
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