13 Principles of Pharmacology and Emergency Medications Flashcards
1
Q
Which drugs were developed to treat rare chronic diseases, such as leprosy and hemophilia, that will not be profitable for the drug manufacturing company? A. Next-generation C. Second-class B. Nonmarketable D. Orphan
A
D
2
Q
Drugs are derived from five major sources. Among them are: A. Water, air, and minerals B. Minerals, chemicals, and water C. Plants, animals, and microorganisms D. Food products, ambient air, and synthetics
A
C
3
Q
What is the study of how a drug acts on a living organism? A. Pharmaceutics C. Pharmacodynamics B. Pharmacokinetics D. Pharmacodistribution
A
C
4
Q
Which is this drug’s generic name, as approved by the Food and Drug Administration? A. Demerol B. Meperidine hydrochloride C. Meperidine hydrochloride, USP D. Ethyl 1-methyl-4-phenylisoni-pecotate hydrochloride
A
B
5
Q
Which is the drug’s chemical name? A. Demerol B. Meperidine hydrochloride C. Meperidine hydrochloride, USP D. Ethyl 1-methyl-4-phenylisoni-pecotate hydrochloride
A
D
6
Q
Which is the drug’s trade name, as designated by the company that sells the medication? A. Demerol B. Meperidine hydrochloride C. Meperidine hydrochloride, USP D. Ethyl 1-methyl-4-phenylisoni-pecotate hydrochloride
A
A
7
Q
Which is the drug’s official name? A. Demerol B. Meperidine hydrochloride C. Meperidine hydrochloride, USP D. Ethyl 1-methyl-4-phenylisoni-pecotate hydrochloride
A
C
8
Q
Which is true in regards to generic drugs?
A.
Have 75% to 90% of the strength of the trade-name drugs
B.
Have the same therapeutic efficacy as the trade-name version
C.
Are produced by the government; trade-name drugs are produced by private industry
D.
Are typically the repackaged versions of trade-name drugs that have exceeded their shelf life
A
B
9
Q
Following a drug name are the letters USP—what do these letters represent? A. Name of the manufacturer B. Route of administration of the drug C. Official publication in which the drug is listed D. City in which the drug was manufactured
A
C
10
Q
Which would provide the most up-to-date information on a drug? A. The Physicians’ Desk Reference B. American Medical Association Drug Evaluation C. The American Hospital Formulary Service D. Internet Web sites such as MedLine Plus
A
D
11
Q
Which 1906 act by the United States Congress was enacted to protect the public from mislabeled or adulterated drugs? A. The National Formulary Act C. The Controlled Substance Act B. The Pure Food and Drug Act D. The United States Pharmacopeia Act
A
B
12
Q
Which agency is responsible for the regulation of biological products such as viruses and therapeutic serums? A. The Public Health Service C. The Federal Trade Commission B. The Drug Enforcement Agency D. The Food and Drug Administration
A
A
13
Q
Which agency is responsible for the regulation of biological products such as viruses and therapeutic serums? A. The Public Health Service C. The Federal Trade Commission B. The Drug Enforcement Agency D. The Food and Drug Administration
A
C
14
Q
Which is an enteral route of administration? A. Rectal C. Sublingual B. Intramuscular D. Intravenous
A
A
15
Q
Which is an advantage of the enteral route? A. Fast absorption of drugs C. Safety B. Reliable onset of action D. Immediate distribution
A
C
16
Q
Which location does most absorption of drugs administered by the enteral route occur? A. Mucosal lining of the mouth C. Small intestine B. Stomach D. Large intestine
A
C
17
Q
Which describes sublingual drug administration?
A.
Injected into the tongue
B.
Placed under the tongue
C.
Rubbed on the skin inferior to the mandible
D.
Placed between the tongue and the roof of the mouth
A
B
18
Q
Drugs administered rectally: A. Have dependable absorption rates B. Can be affected by rectal contents C. Completely bypass first-pass metabolism D. Have absorption rates identical to those of oral medications
A
B
19
Q
Parenteral drugs are administered through which route? A. GI tract C. Injection B. Mouth D. Skin
A
C
20
Q
What is the maximum volume of injected medication for subcutaneous administration?
A.
5.0 mL
B.
0.5 mL
C.
The same as that for intramuscular administration
D.
Twice the amount as that for intramuscular administration
A
B
21
Q
Which area is subcutaneous injection introduced? A. Epidermis C. Fat and connective tissue B. Dermis D. Muscle
A
C
22
Q
An intramuscular injection:
A.
Is absorbed more slowly than an orally administered medication
B.
Is absorbed more quickly than a subcutaneous injection
C.
Has the same rate of absorption as an intravenous injection
D.
Has the same rate of absorption as a subcutaneous injection
A
B
23
Q
Which route has the most rapid onset of action? A. Subcutaneous C. Intravenous B. Intramuscular D. Intradermal
A
D
24
Q
Intradermal routes of administration are intended primarily for which purpose? A. Allergy testing C. Systemic distribution B. Rapid onset of action D. Vaccinations
A
A
25
```
Intraosseous medications are delivered into which location?
A.
Bone marrow cavity
C.
Periosteum of the bone
B.
Cortex of the bone
D.
Blood vessels surrounding bones
```
A
26
```
The onset of action of medications administered by the intraosseous route is equivalent to _____ administration.
A.
Intradermal
C.
Intramuscular
B.
Subcutaneous
D.
Intravenous
```
D
27
Which drugs may be administered via an endotracheal tube?
A.
Normal saline, lactated Ringer’s, and D5W
B.
Sodium bicarbonate, calcium, and dextrose
C.
Epinephrine, lidocaine, atropine, naloxone, and vasopressin
D.
Dopamine, epinephrine, lidocaine, and atropine
C
28
```
If the normal intravenous dose of a medication is 5 mg, how much would you administer if you chose to give the medication via the endotracheal tube (assuming the medicine is compatible with this route)?
A.
1 mg
C.
10 mg
B.
5 mg
D.
25 mg
```
C
29
```
Endotracheal medications should be diluted in which solution?
A.
50 mL of D5W
C.
100 mL of normal saline
B.
10 mL of normal saline
D.
20 mL of Bronkaid Mist
```
B
30
Endotracheal administration of drugs is recommended at which point?
A.
Any time a patient is intubated
B.
Whenever a patient requires a medication compatible with this route
C.
When an IV or IO line is not available
D.
When the medications are intended to act on lung tissue
C
31
```
What are the most commonly inhaled medications?
A.
Bronchodilators
C.
Antihypertensives
B.
Vasoconstrictors
D.
Narcotic antagonists
```
A
32
Lipid-soluble compounds for topical application:
A.
Cannot be absorbed through the skin
B.
Should not be applied unless no other routes are available
C.
Are rapidly absorbed through the skin
D.
Will cause burns to the skin if applied for too long
C
33
What effect will diarrhea have on a medication absorbed primarily in the small intestine?
A.
None of the medication will be absorbed.
B.
The medication will be absorbed much more quickly in this liquid environment.
C.
There will be no change in absorption because diarrhea affects the large intestine only.
D.
The medication will have decreased exposure and therefore decreased absorption.
D
34
The pH of the small intestine is greater than the pH of the stomach. Based on this fact, which choice can be assumed?
A.
Acidic drugs will not be absorbed in the stomach.
B.
Alkaloid drugs will be absorbed quickly in the stomach.
C.
Alkaloid drugs will be absorbed more quickly in the small intestine than in the stomach.
D.
Alkaloid drugs will be absorbed more quickly in the stomach than in the small intestine.
C
35
```
What study refers to how a body handles a drug over time?
A.
Pharmaceutics
C.
Pharmacodynamics
B.
Pharmacokinetics
D.
Pharmacodistribution
```
B
36
```
Which is the science of dispensing drugs?
A.
Pharmaceutics
C.
Pharmacodynamics
B.
Pharmacokinetics
D.
Pharmacodistribution
```
A
37
The rate and extent of drug absorption depends on six factors. Among these are:
A.
The classification of the drug, the pH of the drug, and the drug concentration
B.
The classification of the drug, the temperature of the drug, and the solubility of the drug
C.
The blood flow to the site of administration, the drug concentration, and the pH of the drug environment
D.
The blood flow to the site of administration, the temperature of the drug, and the solubility of the drug
C
38
Drug absorption refers to the movement of the drug from the:
A.
Entry site to the general circulation
B.
Entry site to the target organ or tissue
C.
Entry site to the organ of drug metabolism
D.
Target organ or tissue to the organ of drug metabolism
A
39
Which is true of drugs absorbed in the upper GI tract versus drugs absorbed in the lower GI tract?
A.
Drug absorption is slower in the upper GI tract.
B.
Larger doses are required for the desired effect if the drug is absorbed in the upper GI tract.
C.
Drugs absorbed in the upper GI tract are routed through the liver before entering the general circulation.
D.
Drugs absorbed in the upper GI tract are not subject to first-pass metabolism.
D
40
Most intravenous injections should be administered:
A.
As a maintenance infusion
B.
Slowly to help prevent an adverse reaction
C.
As a bolus to prevent medication stagnation
D.
Quickly to help prevent the formation of an embolism
B
41
Which is correct regarding drug distribution and absorption?
A.
Water-soluble and lipid-soluble drugs readily cross the cell membrane.
B.
Lipid-insoluble drugs readily cross the cell membrane.
C.
Lipid-soluble drugs readily cross the cell membrane.
D.
Water-soluble drugs readily cross the cell membrane.
C
42
```
Where is a drug generally distributed first?
A.
Target organ
C.
Muscle
B.
Heart
D.
Fat
```
B
43
```
What are the single layers of capillary endothelial cells that line the blood vessels entering the central nervous system?
A.
Blockade
C.
Barrier to distribution
B.
Protective lining
D.
Blood-brain barrier
```
D
44
```
What is a drug conversion to a metabolite called?
A.
Excretion
C.
Sublimation
B.
Elimination
D.
Biotransformation
```
D
45
```
What is/are the primary site(s) of drug metabolism?
A.
Liver
C.
Spleen
B.
Lungs
D.
Kidneys
```
A
46
First-pass metabolism:
A.
Reduces the amount of drug available for distribution
B.
Commonly occurs in parenterally administered drugs
C.
Increases the ability of drugs to affect target organs
D.
Is desirable for drugs that are highly concentrated
A
47
```
Which is/are the primary organ(s) of drug excretion?
A.
Liver
C.
Spleen
B.
Lungs
D.
Kidneys
```
D
48
```
The term clearance refers to the complete:
A.
Binding of a drug to a protein
B.
Removal of a drug by the kidneys
C.
Metabolism of a drug by the liver
D.
Absorption of a drug by the target tissues
```
B
49
```
A drug is considered to be eliminated from the body after what occurs?
A.
20 minutes
B.
Less than 5% of the drug remains in the body
C.
The patient is no longer showing effects
D.
The drug has reached its half-life
```
B
50
```
Which is a product of the endocrine portion of the pancreas?
A.
Iodine
C.
Synovial fluid
B.
Glucagon
D.
Digestive enzymes
```
B
51
```
Which drug stimulates the liver to break down glycogen?
A.
Insulin
C.
Glucagon
B.
Bilirubin
D.
Levothyroxine
```
C
52
```
Which is the primary hormone that regulates glucose metabolism?
A.
Insulin
C.
Thyroxine
B.
Glycogen
D.
Levothyroxine
```
A
53
```
A drug that interacts with a receptor to stimulate a response is known as a(n) _____.
A.
Actor
C.
Promoter
B.
Agonist
D.
Proactive
```
B
54
```
You would expect a drug with a fast rate of dissolution to:
A.
Be absorbed quickly into the body
B.
Expire soon after it is manufactured
C.
Lose its effectiveness quickly once it enters the body
D.
Have a very short half-life
```
A
55
What occurs as the levels of an unbound drug decrease?
A.
More drug is released from plasma protein binding.
B.
More drug is bound to tissues to preserve the circulating level.
C.
Less drug is released into the bloodstream to allow for elimination.
D.
Less drug is released from plasma protein binding.
A
56
```
Reactive sites within cells or on cellular surfaces where a drug may bind are called:
A.
Locks
C.
Keys
B.
Binders
D.
Receptors
```
D
57
```
In parasympathetic nervous action, the binding of acetylcholine at nicotinic receptors produces which result of the effector organ?
A.
Blocking
C.
Inhibition
B.
Relaxation
D.
Excitatory response
```
D
58
The binding of acetylcholine at muscarinic receptors produces which effect?
A.
An excitatory response in the effector organ
B.
An inhibition of the effector organ
C.
Either an excitatory response or an inhibition, depending on the tissues involved
D.
A massive release of muscarine into the target organ
C
59
Which response appropriately describes the effects atropine has on the parasympathetic nervous system?
A.
Blocking muscarinic receptor sites in the heart, thus slowing the heart rate
B.
Stimulating both muscarinic and nicotinic receptor sites in the heart, thus slowing the heart rate
C.
Stimulating muscarinic receptor sites while blocking the nicotinic receptor sites, thus slowing the heart rate
D.
Blocking both muscarinic and nicotinic receptor sites for the heart, causing paralysis
A
60
Curare is a drug that blocks parasympathetic tone. The drug acts on which receptor sites?
A.
Nicotinic, causing paralysis
B.
Adrenergic, causing paralysis
C.
Nicotinic, causing a rapid heart rate and subsequent myocardial infarction
D.
Muscarinic, causing a rapid heart rate and subsequent myocardial infarction
A
61
```
Although norepinephrine will bind to both postganglionic adrenergic receptor sites, it has an affinity for which receptors?
A.
Beta
C.
Nicotinic
B.
Alpha
D.
Muscarinic
```
B
62
```
Epinephrine is an adrenergic substance that is a(n):
A.
Enzyme produced by the kidneys
B.
Enzyme produced in the cerebral cortex
C.
Hormone produced by the adrenal medulla
D.
Hormone produced by the medulla oblongata
```
C
63
```
What is Alpha-1 stimulation associated?
A.
Dilation of smooth muscle
C.
Inhibition of sympathetic action
B.
Contraction of smooth muscle
D.
Dilation of bronchial smooth muscle
```
B
64
```
Which is an alpha activity?
A.
Cardiac acceleration
B.
Bronchial relaxation
C.
Vasodilation of arterioles supplying skeletal muscles
D.
Pupil dilation
```
D
65
Diuretics are commonly used with other antihypertensive medications to control blood pressure effectively, resulting in which response?
B
66
```
Which electrolyte deficiency is commonly associated with Lasix administration?
A.
Zinc
C.
Potassium
B.
Calcium
D.
Magnesium
```
C
67
Loop diuretics are powerful, short-acting agents that:
A.
Inhibit sugar and water reabsorption in the loop of Henle
B.
Facilitate sugar and water reabsorption in the loop of Henle
C.
Inhibit sodium and chloride reabsorption in the loop of Henle
D.
Facilitate sodium and chloride reabsorption in the loop of Henle
C
68
```
Besides its use for treating angina pectoris, nitroglycerin is effective as an antihypertensive agent by causing which response?
A.
Venous constriction
B.
Adrenergic blocking
C.
Arterial and venous dilation
D.
Increased renal and mesenteric perfusion
```
C
69
```
Zantac, Tagamet, and Pepcid all work because of their antagonistic action at which receptor site?
A.
G-1
C.
Alpha-2
B.
H-2
D.
Gastro-2
```
B
70
```
Abuse of laxatives may result in which condition?
A.
Hemorrhoids
C.
Diabetes (type 2, adult onset)
B.
Eating disorders
D.
Electrolyte imbalance
```
D
71
```
Where are alpha-1 receptors located?
A.
In the brain only
B.
At the presynaptic nerve endings
C.
In the brain and heart only
D.
In a postsynaptic position, on the effector organ
```
D
72
```
Where are alpha-2 receptors located?
A.
In the heart only
B.
At the presynaptic nerve endings
C.
In a postsynaptic position, on the effector organ
D.
At the presynaptic and postsynaptic nerve endings
```
D
73
The biological half-life of a drug is the amount of time required:
A.
To administer half the drug dose
B.
To metabolize and eliminate half the drug dose
C.
For half the drug to reach its target tissue or organ
D.
For the patient to show the desired effects of the drug
B
74
```
By which means do most drugs cross the cell membranes?
A.
Cell-mediated transport
C.
Diffusion
B.
Carrier-mediated mechanism
D.
Osmosis
```
C
75
After the administration of a drug, a percentage of the drug circulates throughout the body unbound while the remainder of the drug is bound at a drug reservoir. What are the two general types of drug reservoirs?
A.
Fat binding and muscle binding
B.
Plasma protein binding and tissue binding
C.
Erythrocyte binding and leukocyte binding
D.
Preganglionic binding and postganglionic binding
B
76
```
Which location do lipid-soluble drugs tend to be stored?
A.
Muscle
C.
Bones
B.
Tendons
D.
Fat
```
D
77
```
What does an increase in urinary pH cause?
A.
Increased clearance of a weak acid
C.
Increased clearance of a base
B.
Delayed clearance of a weak acid
D.
Delayed clearance of a base
```
A
78
```
Drugs may affect men and women differently because of an average difference in which aspect?
A.
Hormone levels
C.
Size
B.
Activity levels
D.
Health
```
C
79
The therapeutic index of a drug represents the ratio between
A.
Mortality and morbidity
B.
The lethal dose and the effective dose
C.
The rate of delivery and the rate of elimination
D.
The biological half-life and the metabolism rate
B
80
```
Which drug is classified as an anticoagulant?
A.
Digoxin (Lanoxin)
C.
Dobutamine (Dobutrex)
B.
Lorazepam (Ativan)
D.
Heparin (Liquaemin)
```
D
81
```
Your crew is dispatched to a motor vehicle crash where a 68-year-old male is complaining of abdominal pain after a T-bone collision. While questioning this patient about his past medical history, you gather information about medications he is currently taking. Which medication would directly affect this patient’s response to trauma by preventing coagulation?
A.
Dilantin
C.
Furosemide
B.
Warfarin
D.
Sodium nitroprusside
```
B
82
```
Which medication is commonly used during hemodialysis to prevent the formation of blood clots?
A.
Paxil
C.
Mevacor
B.
Heparin
D.
Diabinese
```
B
83
```
Which classification of medication is designed to dissolve clots after their formation?
A.
Antiplatelets
C.
Plasma blockers
B.
Fibrinolytics
D.
Plasma enhancers
```
B
84
You are treating an asthmatic patient complaining of difficulty breathing. According to local protocol, you administer 2.5 mg of albuterol, which stimulates beta receptors. Which response would you anticipate in reaction to this drug’s beta effects?
A.
Stimulation of the heart (increased heart rate) and bronchial dilation
B.
Suppression of heart activity (decreased heart rate) and bronchial dilation
C.
Stimulation of the heart (increased heart rate) and bronchial constriction
D.
Suppression of heart activity (decreased heart rate) and bronchial constriction
A
85
```
Neuromuscular blocking agents:
A.
Cause complete paralysis
C.
Inhibit pain transmitters
B.
Inhibit pain receptors
D.
Suppress seizure activity
```
A
86
Drugs such as Pavulon and Norcuron may produce transient but total paralysis by binding to which receptors?
A.
Alpha-1 receptor site in the peripheral smooth musculature
B.
Alpha-2 receptor site in the peripheral skeletal musculature
C.
Nicotinic receptor for acetylcholine at the neuromuscular junction
D.
Muscarinic receptor for cholinesterase at the neuromuscular junction
C
87
```
Which ovarian hormone is used pharmacologically to treat breast cancer and osteoporosis?
A.
Estrogen
C.
Luteinizing hormone (LH)
B.
Progesterone
D.
Follicle stimulating hormone (FSH)
```
A
88
Your crew is called to the home of a 56-year-old male who is found unconscious. In an attempt to gain some insight into the patient’s past medical history, you review the bottles of prescribed medications found in the bathroom. One medication you find is labeled, “Retrovir.” What assumption might you make, based on the presence of this medication?
A.
HIV
B.
Tuberculosis
C.
Recent history of coronary bypass surgery
D.
Electrolyte imbalance secondary to hemodialysis
A
89
You are called to the home of a 76-year-old female who is complaining of dizziness. She is currently taking digoxin for a heart condition unidentified to the paramedic. Which correctly identifies the actions of digoxin?
A.
Positive chronotrope (increased heart rate) and negative dromotrope (decreased conduction velocity)
B.
Positive dromotrope (increased conduction velocity) and negative chronotrope (decreased heart rate)
C.
Negative inotrope (decreased strength of contraction) and positive dromotrope (increased conduction velocity)
D.
Positive inotrope (increased strength of contraction) and negative dromotrope (decreased conduction velocity)
D
90
```
Digoxin is a common cardiac glycoside used to treat heart failure and certain tachycardias. What is one characteristic of this drug?
A.
Limited side effects
B.
Lack of effects on organs outside of the cardiovascular system
C.
Small therapeutic index
D.
Limited drug interactions
```
C
91
What does the placebo effect mean?
A.
A drug may work because the patient believes it will.
B.
Some drugs work better in men than in women.
C.
Drugs are more effective in smaller patients when given at a standard dose.
D.
Some drugs may have an enhanced effect in children or the elderly.
A
92
Which is true regarding the therapeutic index of drugs?
A.
A therapeutic index close to 1 indicates a dangerous drug.
B.
A therapeutic index of 1 indicates that the effective dose and the lethal dose vary widely.
C.
A therapeutic index that is very low indicates a dangerous drug.
D.
A therapeutic index close to 1 indicates a benign drug.
A
93
```
What drug is an example of a synthetic catecholamine?
A.
Epinephrine
C.
Levophed
B.
Norepinephrine
D.
Dopamine
```
C
94
```
What is the process of analyzing a drug’s strength, purity, or effectiveness?
A.
Regulating
C.
Chem analysis
B.
Assay
D.
Derivation
```
B
95
```
The reticular activating system is involved in the:
A.
Perception of pain
B.
Regulation of the sleep-and-wake cycle
C.
Release of chemicals
D.
Distribution of hormones
```
B
96
Actions of benzodiazepines include which effects?
A.
Euphoria, anesthesia, relaxation, and anxiety reduction
B.
Anxiety reduction, mild hallucinogen, and mild hypnotic
C.
Hypnosis, euphoria, anxiety reduction, and mild hallucinogen
D.
Muscle relaxation, anxiety reduction, sedative, and anticonvulsant
D
97
```
Barbiturates, once commonly prescribed for sedation, are divided into four categories, based on which feature?
A.
Addictiveness
C.
Duration of action
B.
Therapeutic index
D.
Route of administration
```
C
98
```
The popular antidepressant Elavil is which type of drug?
A.
MAO inhibitor
C.
Tricyclic antidepressant
B.
Sympathetic blocker
D.
Parasympathetic blocker
```
C
99
```
Which the following drugs are classified as MAO inhibitors?
A.
Lithium, Desyrel, and Zoloft
C.
Prozac, Wellbutrin, and Zoloft
B.
Marplan, Nardil, and Parnate
D.
Bupropion, Fluoxetine, and Trazodone
```
B
100
```
Lithium is used to treat which condition?
A.
Manic disorders
C.
Schizophrenia
B.
Depression
D.
Multiple personality disorder
```
A
101
Antihypertensive drugs used to reduce blood pressure are classified into four major categories. What are these categories?
A.
Diuretics, MAO inhibitors, vasodilators, and cardiac glycosides
B.
Diuretics, sympathetic blocking agents, vasodilators, and ACE inhibitors
C.
Diuretics, sympathetic blocking agents, vasoconstrictors, and MAO inhibitors
D.
Diuretics, cardiac glycosides, sympathetic adrenergic agents, and vasoconstrictors
B
102
```
Class I antidysrhythmics are:
A.
Beta-blocking agents
C.
Monoamine oxidase inhibitors
B.
Sodium-channel blockers
D.
Calcium-channel blockers
```
B
103
```
Class III antidysrhythmics (e.g., amiodarone) do not suppress automaticity and do not affect conduction velocity. These drugs produce which response?
A.
Increased contractility
C.
Increased automaticity
B.
Decreased contractility
D.
Decreased automaticity
```
A
104
```
Which drug is an example of a Class IV antidysrhythmic?
A.
Inderal
C.
Amiodarone
B.
Metoprolol
D.
Verapamil
```
D
105
```
Immunosuppressant drugs work by:
A.
Suppressing the activity of lymphocytes
B.
Activating the immune defenses
C.
Vaccinating against disease
D.
Causing the body to form antibodies
```
A
106
```
A drug that has a high potential for abuse and no accepted medical uses is a schedule _____ drug.
A.
I
C.
III
B.
II
D.
IV
```
A
107
```
Which pregnancy category means the drug has remote possibilities of harming the fetus?
A.
A
C.
C
B.
B
D.
D
```
A
108
Which of the following is true of the placental barrier?
A.
No drug can pass through the placental barrier.
B.
Many lipid-insoluble drugs cannot pass through the placental barrier.
C.
Almost every drug can pass through the placental barrier.
D.
Drugs harmful to the fetus cannot pass through the placental barrier
B
109
When administering drugs to patients in extreme age categories, it is important to remember which aspect?
A.
Because of immature hepatic and renal systems, children may not respond to drugs at all.
B.
Greater amounts of a medication are required to maintain a therapeutic level in elderly patients.
C.
Maintenance infusions for elderly patients should be doubled because of kidney and liver impairment.
D.
Older patients may have unexpected variations in response to drug therapy.
D
110
Which is true regarding the excretion of drugs via the mammary glands?
A.
In a lactating female, the mammary glands become the primary site of drug excretion.
B.
Many drugs and their metabolites are excreted in breast milk.
C.
Drugs do not pass the blood-mammary barrier because of the presence of a single layer of capillary endothelial cells that lines the blood vessels.
D.
The mammary glands receive nutrients via the GI tract and therefore are not subjected to drugs by cardiovascular circulation.
B
111
The average adult drug dose is based on the amount of drug that will produce the desired effect in which age population?
A.
75% of the adult population with an average weight of 50 pounds
B.
90% of the adult population with an average weight of 100 pounds
C.
50% of the adult population with an average weight of 150 pounds
D.
25% of the adult population with an average weight of 100 pounds
C
112
```
Drug dosages for children who weigh less than 150 pounds and are younger than 18 years of age are based on:
A.
Age
C.
Body mass
B.
Activity level
D.
BMI
```
C
113
When administering a water-soluble drug to a newborn, you can anticipate which effect?
A.
Lesser amounts of the drug may be necessary because of the hypovolemic state common among newborns.
B.
The majority of the drug will be excreted via the kidneys before it can have a therapeutic effect.
C.
Congestive heart failure will result if the total volume of infusion is greater than 10 mL/kg.
D.
Greater amounts of the drug may be necessary because of the proportionally higher volume of total body water in newborns.
D
114
Which consideration is true for infants related to drug administration?
A.
Infants have proportionally less water content in their bodies than do adults.
B.
Protein binding of drugs is reduced in infants.
C.
The blood-brain barrier is hypersensitive and highly effective in infants.
D.
The concentration of free drug in plasma is generally decreased.
B
115
```
Which age-related change has the greatest impact on medication administration and drug clearance in older patients?
A.
Decreased renal function
C.
Breakdown of the blood-brain barrier
B.
Hyperactive liver function
D.
Decreased cardiac output
```
A
116
A gradual decrease in the production of serum albumin with age causes what to occur?
A.
An increase in the TI of the drug
B.
A shortening of the drug’s half-life
C.
A much faster rate of metabolism of the drug
D.
Less binding of the drug in the bloodstream and more free drug in circulation
D
117
What two anatomical structures are the nervous system divided?
A.
The brain and the spinal cord
B.
Cranial nerves and peripheral nerves
C.
The central and peripheral nervous systems
D.
The sympathetic and parasympathetic nervous systems
C
118
```
What does the somatic nervous system control?
A.
Actions under conscious voluntary control
B.
Automatic functions such as respiration
C.
Smooth-muscle dilation and constriction
D.
The tone of sphincters in the GI tract
```
A
119
```
What is another name for cholinergic nerve fibers?
A.
Voluntary nerve fibers
C.
Sympathetic nerve fibers
B.
Adrenergic nerve fibers
D.
Parasympathetic nerve fibers
```
D
120
Which is true of the sympathetic and the parasympathetic nervous systems?
A.
Only one system is operating at any given time.
B.
Both systems are always operating, but one exerts dominant effects at any given time.
C.
The sympathetic and the parasympathetic systems innervate different organs.
D.
Most organs respond only to signals from either the sympathetic or the parasympathetic system.
B
121
```
What is the area that serves as a functional junction between two neurons?
A.
Cleft
C.
Synapse
B.
Crevice
D.
Break
```
C
122
```
What is the preganglionic neurotransmitter for sympathetic and parasympathetic nerve fibers?
A.
Adrenalin
C.
Acetylcholine
B.
Muscarine
D.
Norepinephrine
```
C
123
```
The neurotransmitter at the junction of the parasympathetic postganglionic fiber and the effector cell is:
A.
Adrenalin
C.
Acetylcholine
B.
Muscarine
D.
Norepinephrine
```
C
124
```
The neurotransmitter at the junction of the sympathetic postganglionic fiber and the effector cell is:
A.
Adrenalin
C.
Acetylcholine
B.
Muscarine
D.
Norepinephrine
```
D
125
```
Fibers that release acetylcholine are known as which receptors?
A.
Adrenergic
C.
Cholinergic
B.
Muscarinic
D.
Anticholinergic
```
C
126
```
What are the two divisions of the nervous system that function continuously, stimulate many of the same organs, and oppose each other in the attempt to maintain balance?
A.
Effector and reactor nervous systems
B.
Central and peripheral nervous systems
C.
Somatic and autonomic nervous systems
D.
Parasympathetic and sympathetic nervous systems
```
D
127
```
Nicotinic receptors are found at the neuromuscular junction of which muscles?
A.
Skeletal
C.
Smooth
B.
Cardiac
D.
GI tract
```
A
128
```
What occurs when ACh binds to muscarinic receptors in cardiac muscles?
A.
Heart rate slows.
C.
Strength of contractions increases.
B.
Heart rate increases.
D.
Strength of contractions decreases.
```
A
129
```
What does the effect of the parasympathetic stimulation have on the heart?
A.
Slowed rate
C.
Increased force of contraction
B.
Increased rate
D.
Constriction of coronary arteries
```
A
130
Which is true of the endocrine system?
A.
The mode of transmission of messages is chiefly chemical.
B.
The information is generally transmitted along nerves.
C.
Hormones secreted are targeted for specific action by specific organs.
D.
Generally, only a few cells are affected by endocrine transmission of chemicals.
A
131
```
What are drugs that mimic the actions of the parasympathetic nervous system?
A.
Parasympatholytic
C.
Sympatholytic
B.
Parasympathomimetic
D.
Sympathomimetic
```
B
132
What are common patient responses to atropine?
A.
Increased heart rate and dilated pupils
B.
Decreased heart rate and unequal pupils
C.
Increased heart rate and constricted pupils
D.
Decreased heart rate and constricted pupils
A
133
```
Three naturally occurring catecholamines present in the body are epinephrine, norepinephrine, and what other pharmaceutical?
A.
Dobutamine
C.
Muscarine
B.
Acetylcholine
D.
Dopamine
```
D
134
```
When stimulated, presynaptic alpha-2 receptors are responsible for which reaction?
A.
Vasodilation
C.
Norepinephrine release inhibition
B.
Vasoconstriction
D.
Dilation of bronchial smooth muscle
```
C
135
```
Beta-1 receptors are located primarily in which location?
A.
Heart
C.
Lungs
B.
Brain
D.
Peripheral vascular system
```
A
136
```
Beta-2 receptors are located predominantly in which location?
A.
Heart
C.
Peripheral vascular system
B.
Lungs
D.
Renal and mesenteric vascular systems
```
B
137
```
Norepinephrine acts primarily on which receptors?
A.
Alpha
C.
Beta-2
B.
Beta-1
D.
Alpha and beta-1
```
A
138
```
Epinephrine acts on which receptors?
A.
Alpha only
C.
Beta-2 only
B.
Beta-1 only
D.
Alpha and beta
```
D
139
```
Metoprolol and atenolol are:
A.
Beta agonists
C.
Selective beta-1 blockers
B.
General beta blockers
D.
Selective beta-2 blockers
```
C
140
```
You are dispatched to the home of a terminally ill cancer patient who is on a morphine pump. His respirations are 6 per minute and shallow. His family thinks he may have overdosed on the morphine. Which opioid antagonist medication might you administer to this patient?
A.
Heparin
C.
Naloxone
B.
Dextrose
D.
Thiamine
```
C
141
```
Which drug classification should ketorolac (Toradol) be placed?
A.
Opioid
C.
Nonsteroidal antiinflammatory drug
B.
Opiate
D.
Narcotic analgesic
```
C
142
```
You are dispatched to a local mental health facility for a 42-year-old female who is acting inappropriately. Upon arrival, you find the patient sitting in a chair in no apparent physical distress. She continually blinks her eyes (excessively) and is smacking her lips. She informs you that she has schizophrenia and has been taking Thorazine for many years. Her presentation may be attributed to which condition?
A.
Ocular toxemia
C.
Bipolar disorder
B.
Senile dementia
D.
Tardive dyskinesia
```
D
143
Patients who have more circulating digitalis than necessary may develop digitalis toxicity. Treatment for digitalis toxicity is aimed primarily at which aspect?
A.
Rapid hemodialysis
B.
Rapid fluid replacement and correction of a blood-sugar imbalance with insulin
C.
Correction of electrolyte imbalances, neutralization of the drug, and use of antidysrhythmics
D.
Rapid administration of calcium chloride, neutralization of the drug, and correction of a blood-sugar imbalance with intravenous dextrose
C
144
Class IV antidysrhythmic drugs depress myocardial and smooth muscle contractions, decrease automaticity, and sometimes decrease conduction velocity. This mechanism of action is thought to be attributable to which response?
A.
Increasing adrenergic stimulation of the heart
B.
Reducing adrenergic stimulation of the heart (beta blocking)
C.
Blocking the inflow of calcium though the cell membrane (calcium-channel blocking)
D.
Indirectly increasing the calcium concentration to the contractile proteins of the heart muscle and selected smooth muscles
C
145
```
Primatene Mist is one example of a nonselective adrenergic respiratory medication. Which is an undesirable effect of nonselective adrenergic drug?
A.
Bronchodilation
B.
Muscle tremors
C.
Increased risk of hemorrhage
D.
Increased risk of cerebrovascular accident
```
B
146
```
You have been dispatched to a local high school for a 15-year-old male complaining of shortness of breath. He informs you that he has taken “six hits” off of his Ventolin inhaler. Which side effects would be common to this scenario?
A.
Laryngospasm
C.
Transient deafness
B.
Muscle tremors
D.
Swelling in the feet
```
B
147
```
Theophylline is one example of the group of respiratory medications known as xanthines. Unlike other respiratory medications, this group of medications produces which response?
A.
Promotes diuresis
C.
Stimulates bronchial smooth muscle
B.
Relaxes the cardiac muscle
D.
Decreases diaphragmatic contractility
```
A
148
```
A patient taking Mucomyst is likely to have which condition?
A.
Asthma
C.
Allergic reactions
B.
Chronic obstructive pulmonary disease
D.
Congestive heart failure
```
B
149
Histamine is a chemical that plays an important role in the body’s response to an antigen. Which of the following is true of histamine?
A.
It helps prevent dangerous bronchoconstriction.
B.
It increases cardiac output to counteract peripheral blood pooling.
C.
It is concentrated highest in the skin, lungs, and gastrointestinal tract.
D.
It counteracts antihistamine chemicals by decreasing the swelling of tissues and decreasing capillary permeability.
C
150
Benadryl has some anticholinergic properties that may produce which effects?
A.
Shortness of breath, tachycardia, and nausea
B.
Bradycardia, diarrhea, nausea, and drowsiness
C.
Salivation, lacrimation, defecation, and urination
D.
Tachycardia, constipation, inhibition of secretions, and sedation
D
151
```
Claritin and Allegra are two examples of newer antihistamine medications that target receptors that act primarily on the blood vessels and the bronchioles to minimize the allergic reaction. Which receptor site is targeted by these medications?
A.
H-1 receptor
C.
Alpha-1 receptor
B.
Beta-2 receptor
D.
Alpha-2 receptor
```
A
152
```
Which hormone, released from the adrenal medulla, stimulates beta-2 receptors in the lungs to promote bronchodilation?
A.
Albuterol
C.
Acetylcholine
B.
Epinephrine
D.
Methylprednisolone
```
B
153
What is the mechanism of action of emetics?
A.
Induces vomiting to rid the body of a drug
B.
Binds to the ingested drug or poison to prevent absorption
C.
Binds to red blood cells to prevent transport of a drug throughout the body
D.
Promotes rapid and forceful diarrhea to speed the elimination of the ingested drug or poison
A
154
```
Because of their potential for abuse, benzodiazepines are listed as which controlled substance?
A.
Schedule I
C.
Schedule III
B.
Schedule II
D.
Schedule IV
```
D
155
What are the three major risk factors for various thromboses formation?
A.
Aspirin use, localized trauma, and smoking
B.
Localized trauma, atrial fibrillation, and smoking
C.
Stasis, localized trauma, and hypercoagulable states
D.
Recent surgery, smoking, and the use of oral contraceptives
C
