Gvsu Pharmacology Exam 3

Front 1

An older patient has a normal lipid profile, is not obese, and blood sugar level is under 180 mg/dL when fasting. This type of candidate was discussed in class (good luck finding this patient!) & would be considered ideal for:

Back 1

Glipizide (Glucotrol)

Front 2

With careful control of dosage, one class of drugs for heart failure can improve patient status. This is thought to occur through blockade of excessive sympathetic stimulation. Adverse effects include fluid retention, fatigue, hypotension, & bradycardia. Which of the following classes is it?

Back 2

Beta Blockers

Front 3

A patient is being treated for supraventricular dysrhythmia with a drug that affects repolarization by blocking sodium channels. Adverse effects of this drug include: diarrhea, cinchonism, cardiotoxicity, hypotension, and rarely hypersensitivity reactions. Which is it?

Back 3

Quinidine

Front 4

An article was posted on BlackBoard discussing the recent decision by Pfizer to stop development of a new drug, Torcetrapib. Clinical trials were halted due to "an imbalance of mortality and cardiovascular events." What was this drug being developed to do?

Back 4

Raise Levels of HDL cholesterol

Front 5

A patient is re-evaluated for his elevated cholesterol. In addition to diet & exercise, it is decided to start this patient on a drug to lower LDL levels. Since the patient responded adversely to statins, he will be prescribed a bile-acid sequestrant. This drug is the ‘newer’ drug that 1) is better tolerated, 2) does not reduce the absorption of fat-soluble vitamins, & 3) does not significantly reduce the absorption of most other drugs studied. Which is it?

Back 5

Colesevelam (Welchol)

Front 6

A patient is diagnosed with hypothyroidism. The patient requests that she receive the drug that has the mixture of T4:T3 found in the plasma. The patient already knows that this medication is relatively expensive compared to drug of choice for this condition. However, she also knows that some patients appear to have better ‘mental-functioning’ when on this medication. Which one is it?

Back 6

Liotrix (Thyrolar)

Front 7

Data indicate that this drug can delay development of type 2 diabetes in high-risk individuals (except older & less obese patients). However, a rare liver disease with a 50% mortality rate has been reported with this drug. Which of the following is it?

Back 7

Metformin (Glucophage, others)

Front 8

When discussing the use of nitroglycerin for angina pectoris, which of the following is FALSE?

Back 8

No significant drug interactions

Front 9

Which of the following is a thrombolytic drug, which is used for myocardial infarction, deep vein thrombosis & massive pulmonary emboli? Adverse effects of this drug include bleeding, hypotension, fever, and antibody production (against a foreign protein).

Back 9

Streptokinase (Streptase)

Front 10

One of the goals of cardiovascular pharmacology is the modulation of cardiac output. What is the cardiac output of an average adult?

Back 10

5 L/min

Front 11

Which of the following is FALSE regarding Heparin?

Back 11

Rapidly acting thrombolytic

Front 12

Which of the following would be considered adjunctive (supportive) therapy for hyperthyroidism until a 'permanent' therapy can be applied?

Back 12

D&E

(Zolpidem (Ambien) & Proranolol (Inderal) )

Front 13

A female patient is presenting for a follow-up visit after starting on an anti-hypertensive medication. She complains of gynecomastia, menstrual irregularities, hirsutism, and deepening of her voice. Blood tests reveal elevated potassium levels. Her medication blocks aldosterone receptors, but also binds with receptors for other steroid hormones. Which drug is it?

Back 13

Spironolactone (Aldactone)

Front 14

Which of the following medication is used for diabetes mellitus, but peak effects can take up to 3 months? The adverse effects of this medication are generally mild, but can include weight gain, mild anemia, peripheral edema & increased LDL cholesterol.

Back 14

Rosiglitazone (Avandia)

Front 15

Acarbose (Precose) and Miglitol (Glyset) slow the breakdown and absorption of carbohydrates in the small intestine, thereby reducing postprandial glucose blood sugar levels. GI side effects are very common with these drugs but no significant interactions have been reported. What class of diabetes drugs do these belong to?

Back 15

α-Glucosidase inhibitors

Front 16

An adult patient has been diagnosed with a severe deficiency of circulating thyroid hormone. Which of the following would NOT be considered a typical clinical presentation of this disorder?

Back 16

Heart rate and body temperature increased

Front 17

In regards to specific acquired immunity, which cells have the following 3 functions? First, they are required for the activation of T cells (as ‘antigen-presenting cells’). Second, they are the final mediators of DTH. Third, they phagocytize cells that have been tagged with antibodies.

Back 17

Macrophages

Front 18

A patient presents at the ER with a hypertensive crisis. An IV vasodilator is administered that is a potent venous and arterial vasodilator & considered the fastest acting anti-hypertensive agent. Adverse effects of this medication include thiocyanate toxicity, cyanide poisoning, & excessive hypotension. Which of the following is it?

Back 18

Sodium Nitroprusside (Nipride)

Front 19

Recently, adverse effects including deaths have been linked to "a blood-thinning drug that contained active pharmaceutical ingredient (API) from China". An article was posted on Black Board describing the announcements from the FDA concerning this drug. Which one?

Back 19

Heparin

Front 20

Recently, there has been much legal activity regarding the link between childhood immunizations, a specific preservative, and the development of autism. The most recent of these (posted on Black Board), reports a special court's ruling against families claiming a link between autism and which of the following?

Back 20

Measles, mumps, & rubella virus vaccine (MMR)

Front 21

There are many factors that determine the magnitude of arterial pressure, cardiac output & peripheral resistance. As discussed in class & highlighted in Figure 46.1, the main determinant of peripheral resistance is:

Back 21

Arteriolar constriction

Front 22

In the ‘Renin-Angiotensin-Aldosterone System’ (RAAS), from which structure is renin released?

Back 22

kidneys

Front 23

A link to the official Januvia (Sitagliptin) web-site is posted on Black Board. This oral therapy for diabetics is the first in a new class of drugs. What class?

Back 23

Dipeptidyl peptidase-4 (DPP-4) inhibitors

Front 24

When used for cardiovascular pharmacology, calcium channel blockers work ‘downstream’. In other words, they block channels that are regulated by activation of which of the following?

Back 24

Adrenergic Beta-1 receptors

Front 25

Metformin (Glucophage, others) belongs to which class of medications for diabetes?

Back 25

biguanides

Front 26

A female patient is diagnosed with acute heart failure. It is decided to start this patient on an inotropic agent other than a cardiac glycoside. The drug to be used is a synthetic catecholamine that causes selective activation of beta-1 adrenergic receptors. Which is it?

Back 26

Dobutamine (Dobutrex)

Front 27

You are on a mission trip with limited resources. In your pharmacy, you only have access to Class II drugs and Class IV drugs. You could use these drugs to treat dysrhythmias originating in which cardiac tissue? In other words, what are the targets of these ‘classes’ of drugs (illustrated in Figure 48-2)?

Back 27

All of the Above
(SA node, AV node, His-Purkinje system, myocardium)

Front 28

A patient is diagnosed with high triglyceride levels & low HDL levels. It is decided to start this patient on a fibric acid derivative since they are the most effective drugs for lowering triglyceride levels & can raise HDL levels. Which of the following is the fibric acid derivative?

Back 28

Gemfibrozil (Lopid)

Front 29

Despite the availability of newer drugs, this drug remains the drug of choice for relieving acute anginal attacks. This drug is effective, fast acting, and inexpensive. This drug acts directly on the vascular smooth muscle to promote vasodilation through the formation of nitric oxide and cGMP. Which drug is it?

Back 29

Nitroglycerin

Front 30

When discussing features of the immune response, which could be characterized as: ‘exposure to an antigen affects the immune system such that re-exposure produces a faster, larger, and more prolonged response’?

Back 30

Memory

Front 31

A patient is diagnosed with elevated LDL cholesterol levels. It is decided to start this patient on a HMG-CoA reductase inhibitor. These drugs are the most effective drugs for lowering LDL cholesterol levels and have other beneficial actions. Adverse effects include hepatotoxicity and muscle injury (which can range from weakness to a rare but fatal condition). Which is a HMG-CoA reductase inhibitor?

Back 31

Atorvastatin (Lipitor)

Front 32

Which of the following is FALSE regarding Warfarin (Coumadin)?

Back 32

ALL of the above are TRUE
(adverse effects include hemorrhage, oral delivery, vitamin K for overdose, isolated from spoiled clover, used for long- term prophylaxis of thrombosis, and contraindicated in pregnancy and lactation)

Front 33

You are on a mission trip (different from #27) with limited resources. In your pharmacy, you only have access to Class I drugs and Class III drugs. You could use these drugs to treat dysrhythmias originating in which cardiac tissue? In other words, what are the targets of these ‘classes’ of drugs (illustrated in Figure 48-2)?

Back 33

C & D

(His-Purkinje System & myocardium)

Front 34

A patient is diagnosed with hypothyroidism. He mentions that his grandfather had the same disorder and he wants to use the same medication his grandfather used. You explain that even though this medication is very inexpensive, it is rarely prescribed for new patients. This is due to inconsistent drug levels in this preparation & because of its source. Which of the following does this patient want?

Back 34

Armour Thyroid

Front 35

A link was posted on Black Board to the official Exenatide (Byetta) web-site. This drug is the first in a new class of drugs for diabetics. What class?

Back 35

Incretin mimetic

Front 36

When concern over an approved drug arises, it is usually due to reports of adverse effects. Which of the following cholesterol-lowering medications has recently come under attack (article posted on Black Board)? However, the main concern over this drug is the lack of any clear benefit.

Back 36

Ezetimibe (Zetia)

Front 37

A link was posted on Black Board to the official Clopidogrel (Plavix) web-site. The site describes this drug as ‘a prescription anti-platelet medication that is proven to help keep platelets in the blood from sticking together and forming clots. This helps your blood to flow more easily, reducing the risk of a future heart attack or stroke.’ What is the mechanism of action of this drug; how does it work?

Back 37

ADP receptor antagonist

Front 38

Which of the following is a Class IV drug in the Vaughn-Williams Classification Scheme? This drug reduces SA nodal automaticity & myocardial contractility, and delays AV nodal conduction. Adverse effects include: bradycardia, hypotension, AV block, heart failure, peripheral edema, and constipation.

Back 38

Verapamil (Calan)

Front 39

When discussing the distribution of blood in the circulatory system, which of the following contains the greatest percentage of blood?

Back 39

Veins, venules, and venous sinuses

Front 40

Which of the following immune cells can: directly promote antibody production by B cells, promote delayed-type hypersensitivity (DTH), & activate cytolytic T cells?

Back 40

Helper T lymphocytes

Front 41

An elderly female patient is presenting for a follow-up visit for her pulmonary edema and peripheral edema (mainly swollen ankles and wrists). You suspect that this patient is actually being treated for heart failure as her medication is a widely used drug that reduces blood volume by producing moderate diuresis. Which of the following is most likely her drug?

Back 41

Hydrochlorothiazide (HydroDIURIL, others)

Front 42

‘Angiotensin-Converting Enzyme Inhibitors’ can cause vasodilation, decrease blood volume, & decrease cardiac and vascular remodeling. However, they can also cause cough and angioedema because of which of the following mechanisms of action? In other words, what is the cause of the cough and angioedema?

Back 42

increase in bradykinin

Front 43

Which of the following is a ‘modified’ human insulin with a prolonged duration of action (at least 24 hours). The drug is indicated for once-daily subQ administration to treat adults and children with type 1 diabetes and adults with type 2 diabetes.

Back 43

Insulin glargine (Lantus)

Front 44

Of the following, which is a calcium channel blocker used for primary hypertension, cardiac dysrhythmias, & migraine? This drug acts on vascular smooth muscle and the heart to produce vasodilation, reduced arterial pressure, and increased coronary perfusion.

Back 44

Verapamil (Calan)

Front 45

Vasodilators are drugs that cause dilation of blood vessels either directly or indirectly. Table 45-1 lists different categories of vasodilators. Which of the following would NOT be considered a category?

Back 45

Diuretics

Front 46

Figure 46-2 of the text shows the myriad of sites that can be targeted to lower blood pressure. Which of the following is NOT a site of action of antihypertensive drugs?

Back 46

Beta-2 receptors

Front 47

An article was posted on Black Board describing an article in the New England Journal of Medicine about the diabetes medication Rosiglitazone (Avandia). That article stated that patients taking Rosiglitazone (Avandia) were at a greater risk for what?

Back 47

Heart attacks (myocardial infarction)

Front 48

A patient is diagnosed with hypothyroidism. It is decided that a medication that can provide “speedy” results is needed. A lower dose of this medication is needed (vs. the usual medication), but the duration of action is short due to its half-life. The patient is informed that is medication is not used for long-term therapy due to its duration & it is relatively expensive (even though it is one compound). Which one is it?

Back 48

Liothyronine (Cytomel)

Front 49

A patient is prescribed a positive inotropic drug for heart failure. The patient is informed that potassium levels must be kept within the normal physiologic range while on this drug. And, plasma levels will need to be monitored to maintain the narrow therapeutic range for this drug. Which is it?

Back 49

Digoxin (Lanoxin)

Front 50

The Varicella Virus Vaccine (Varivax) has been available in Japan since 1973, but not until 1995 in the USA. Despite being a very safe vaccine, not all eligible children in the USA have received the vaccine. Also, the vaccine appears to have the added advantage of preventing shingles later in life. What is the original target or purpose of this vaccine? What was it intended to prevent?

Back 50

Chicken pox