2011 Exam Flashcards
Which of the following physiological reflexes is LEAST likely to occur in a hypertensive pt. taking a short acting dihydropyridine calcium channel blocker (e.g. Nifedipine) for the first time?
A. increased cardiac output
B. reduced sympathetic nervous system activity
C. Increased sodium and water retention
D. increased heart rate
B
Which of the following statements best explains what determines arterial blood pressure?
A. mean arterial blood pressure is the product of cardiac output and total peripheal resistance; in other terms, M.A.P. = CO x TPR
B. MAP = SV x HR x TPR
C. arterial pressure is equivalent to central venous pressure
D. Both A and B are correct answers
D
The main objective of the drug therapy in pts diagnosed with primary (aka essential) hypertension is to ___
bring their blood pressure back down within the normal range.
Which of the following statements best describe the mechanisms of antihypertensive action of drugs that act through adrenergic receptors?
A. beta adrenergic receptor antagonists reduce BP primarily by reducing CO through blockade fo beta-1 adrenergic receptors in the heart.
B. alpha-1 adrenergic receptor antagonists cause vasodilation by blocking the constrictive effects of sympathetic nervous system tone on resistance arterioles.
C. Agonists of alpha-2 agrenergic receptors act in the CNS to reduce sympathetic outflow from the brain
D. All of the above are correct
D. All of the above
In the Vaughan-Williams classification of anti-arrhythmic drugs, Na and K channel blockers are categorized into which classes?
class I and III
Which of the following is/are used to classify anti-arrhythmic drugs according to the Vaughan-Williams method?
A. low therapeutic index
B. extra-cardiac toxicity
C. pro-arrhythmic potential
D. none of the above
D. none of the above
According to Vaughan-Williams classification fo anti-arrhythmic drugs, Lidocaine is a ______
class I drug that is most effective on depolarized cardica tissue.
Amiodarone (Cordarone) does what?
prolongs the cardiac action potential and increases the QT interval
An AT1 receptor antagonist that blocks angiotensin II’s effects in resistance arterioles and in the adrenal gland
A. Hydrochlorothiazine (Hydrodiuril)
B. Losartan (Cozarr)
C. Propranolol (Inderal)
D. Lisinopril (Prinivil)
B. Losartan (Cozarr)
A non-selective antagonist of beta-adrenergic receptors
A. Hydrochlorothiazine (Hydrodiuril)
B. Losartan (Cozarr)
C. Propranolol (Inderal)
D. Lisinopril (Prinivil)
c. Propranolol (Inderal)
Inhibits angiotensin converting enzyme (ACE), blocking the formation of angiotensin II from angiotensin I
A. Hydrochlorothiazine (Hydrodiuril)
B. Losartan (Cozarr)
C. Propranolol (Inderal)
D. Lisinopril (Prinivil)
D. Lisinopril (Prinivil)
Causes a transient reduction in total body fluid volume, but when tht diuretic effect diminishes, the drug has a sustained antihypertensive effect.
A. Hydrochlorothiazine (Hydrodiuril)
B. Losartan (Cozarr)
C. Propranolol (Inderal)
D. Lisinopril (Prinivil)
A. Hydrochlorothiazine
A weak diuretic that inhibits carbonic anhydrase in the proximal tubule to inhibit bicarbonate reabsorption.
A. Spironolactone (Aldactone)
B. Hydrochlorothiazine (Hydrodiuril)
C. Furosemide (Lasix)
D. Acetazolamide (Diamox)
D. Acetazolamide
A strong, or high ceiling, diuretic used to treat chronic and/or severe volume-expanded conditions; for example, edema associated with heart failure.
A. Spironolactone (Aldactone)
B. Hydrochlorothiazine (Hydrodiuril)
C. Furosemide (Lasix)
D. Acetazolamide (Diamox)
C. Furosemide (Lasix)
A low ceiling diuretic that inhibits the Na-Cl cotransporter in the distal tubule.
A. Spironolactone (Aldactone)
B. Hydrochlorothiazine (Hydrodiuril)
C. Furosemide (Lasix)
D. Acetazolamide (Diamox)
B. Hydrochlorothiazide
A potassium sparing diuretic that is an antagonist of collecting duct aldosterone receptors
A. Spironolactone (Aldactone)
B. Hydrochlorothiazine (Hydrodiuril)
C. Furosemide (Lasix)
D. Acetazolamide (Diamox)
A. Spironolactone
Prevents parietal cell acid secretion by antagonism of the H2-histamine receptor subtype.
A. Colloidal bismuth compounds (Pepto-Bismol)
B. Omeprazole (Prilosec)
C. Cimetidine (Tagamet)
D. Ursodiol (Actigal)
C. Cimetidine (Tagamet)
Protects the gastrointestinal mucosa from attack by pepsin and acid
A. Colloidal bismuth compounds (Pepto-Bismol)
B. Omeprazole (Prilosec)
C. Cimetidine (Tagamet)
D. Ursodiol (Actigal)
A colloidal bismuth compounds (Pepto-Bismol)
Prevents parietal cell acid secretion by direct inhibition of a proton-potassium ATPase
A. Colloidal bismuth compounds (Pepto-Bismol)
B. Omeprazole (Prilosec)
C. Cimetidine (Tagamet)
D. Ursodiol (Actigal)
B. omeprazole (prilosec)
A gallstone dissolution agent whose use was first described in compendiums of 7th century Chinese folk medicine, and is presumably the active ingredient of dried gallbladders taken from the Himalayan bear
A. Colloidal bismuth compounds (Pepto-Bismol)
B. Omeprazole (Prilosec)
C. Cimetidine (Tagamet)
D. Ursodiol (Actigal)
D. Ursodiol (Actigal)
Decreases fat soluble vitamin absorption as a side effect
A. Bile acid sequestrant
B. Ezetimibe (Zetia)
C. Fenofibrate (Fenoglide)
D. Niacin
E. HMG CoA reductase inhibitor
A. bile acid sequestrant
The most effective pharmacologic inducer of HDL levels
A. Bile acid sequestrant
B. Ezetimibe (Zetia)
C. Fenofibrate (Fenoglide)
D. Niacin
E. HMG CoA reductase inhibitor
D. Niacin
Inhibits the rate-limiting enzyme of cholesterol biosynthesis in the hepatocyte
A. Bile acid sequestrant
B. Ezetimibe (Zetia)
C. Fenofibrate (Fenoglide)
D. Niacin
E. HMG CoA reductase inhibitor
E. HMG CoA reductase inhibitor
Selectively inhibits cholesterol absorption by enterocytes
A. Bile acid sequestrant
B. Ezetimibe (Zetia)
C. Fenofibrate (Fenoglide)
D. Niacin
E. HMG CoA reductase inhibitor
B. ezetimibe (Zetia)
Beta-adrenergic receptor antagonists are useful antianginal drugs because they___
A. attenuate exercise-induces tachycardia
B. reduce preload
C. Both
D. Neither
A. attenuate exercise-induced tachycardia
Dihydropyridine-type calcium channel blocking drugs, e.g. nifedipine (procardia), are useful anti-anginal agents b/c they
A. lower peripheal resistance
B. inhibit coronary artery spasm
C. Both
D. Niether
C. Both
When used for the treatment of angina, which of the following statements about nitroglycerin (Nitrostat) is FALSE?
A. it reduces myocardial work by decreasing preload
B. It has a high bioavailability when dissolved in the mouth
C. It directly reduces cardiac rate contractility
D. It prolongs the diastolic interval
C. It directly reduces cardiac rate contractility
Which of the following mechanisms do NOT contribute to reduced mortality in the pharmacologic treatment of heart failure?
A. interference with the actions of angiotensin II
B. partial blockade of cardiac beta-1 adrenergic receptors
C. blockade of cardiac slow calcium channels
D. blockade of aldosterone receptors
C. blockade of cardiac slow Ca channels
When used for the treatment of heart failure, which of the following statements about ACE inhibitors is FALSE?
A. they reduce peripheal resistance
B. They promote sodium excretion
C. They decrease venous capacitance
D. They reduce aldosterone secretion
C. The decrease venouse capacitance
Digitalis glycosides
A. have a wide margin of safety, similar to that of aspirin
B. increase the intracellular free Ca concentration in cardiac myocytes
C. Both
D. Neither
B.
Warfarin (Coumadin)
A. Inhibits Vitamin K-dependent synthesis fo clotting factors
B. is an oral anticoagulant
C. Both
D. neither
C. Both
Alteplase (Activase)
A. selectively prevents platelet aggregation
B. is a plasminogen activator
C. Both
D. Neither
B
Aspirin
A. prevents binding of fibrinogen to glycoprotein IIb/IIIa receptors on platelets.
B. activates the ADP receptor on platelets
C. irreversibly inhibits cyclo-oxygenase (COX)
D. All of the above
C. irreversibly inhibits COX
A new drug is being tested against the standard chemotherpeutic regimen used to treat metastatic breast cancer. Initial results of the clinical trial show reduced metastases, indicating potential clinical benefit of the new drug. Investigators are considering filling a New Drug Application (NDA). In which phase of clinical trials is this new drug?
A. Phase I
B. Phase II
C. Phase III
D. Phase IV
C. Phase III
A drug that has a high potential for abuse, and no federally recognized medical use, is placed in which class of controlled substances?
A. Schedule I
B. Schedule II
C. Schedule III
D. Schedule V
A. Schedule I
You have been working for 10 yrs developing a new drug for potential clinical use. You have collected preclinical data, which yhou now intend to submit to the FDA to receive Investigational New Drug (IND) status. Which of the following must be submitted to receive IND status?
A. chemical synthesis protocols for making the drug
B. informed consent form for studies perfomed in humans
C. toxicology studies performed in animals
D. All of the above
D. All of the above
Phase I cliinical trials serve to
A. determine the efficacy of the experimental drug
B. establish the max. tolerated dose
C. increase the market of an already approved drug
D. priority rank multiple promising compounds
B. establish the maximum tolerated dose
The mechanisms of aciton of drugs used for the treatment of angina pectoris that is precipitated by exercise or emotional stress is dilation stress is dilation of coronary arteries and restoration of blood flow to the ischemic myocardium.
T or F
F
Low molecular weight heparin selectivity inhibits factor Xa.
T or F
T
Current drugs of choice for the treatment of heart failure act primarily to increase the force of cardiac contraction.
T or F
F
the mechanism of action for short-acting beta 2 adrenergic receptor agonists for the treatment of asthma include…
A. bronchodilation
B. immunosuppression
C. anti-inflammatory effects
D. all
E. none
A
of the following treatments, which of the following is MOST LIKELY to cause oral candidiasis in a patient with asthma?
A. a tablet formulation of corticosteroid, such as prednisone taper
B. inhaled corticosteroid, such as fluticasone via MDI
C. long-acting beta 2 agonist (salmetrol)
D. short-acting beta 2 agonist (albuterol)
B
which one of the following drugs is effective ONLY on targets within the CNS?
A. ibuprofen (motrin)
B. acetaminophen (tylenol)
C. celecoxib (celebrex)
D. acetylsalicylic acid (aspirin)
B
which one of the following drugs irreversibly inactivates COX?
A. Naproxen (aleve)
B. misopristol (cytotec)
C. celecoxib (celebrex)
D. acetylsalicylic acid (aspirin)
D
which of the following is TRUE regarding prednisone?
A. prednisone binds to a cell surface receptor to exert its therapeutic effects
B. is only know antagonist of H3 receptors
C. long term use can lead to suppression of the hypothalamic-pituitary axis
D. 1st generation H1 antagonist
C
2nd generation H1 receptor antagonists used in the treatment of seasonal allergies
A. bind to muscarinic receptors
B. bind to dopamine receptors
C. commonly result in dry mouth
D. do not cross the blood-brain barrier in appreciable amounts
D
Which of the following is NOT responsible for the therapeutic effect of glucocorticoids?
A. stimulating expression of IKB
B. Blocking H2 receptors
C. Inhibiting T cell proliferation
D. Decreasing lymphocyte trafficking
B
which of the following types of drugs is most commonly used in the treatment of rheumatoid arthritis?
A. 1st generation H1 antagonist
B. mast cell stabilizer
C. antibody against Tumor Necrosis Factor (TNF)
D. antibody against histamine
C
____ is a tumor necrosis factor (TNF) alpha antagonist used in the treatment of rheumatoid arthritis
A. indomethacin (indocin)
B. methotrexate (MTX)
C. probenecid (benemid)
D. etanercept (Enbrel)
E. Allopurinol (Zyloprim)
D
____ is a small molecule immunosuppressant for the treatment of most RA
A. indomethacin (indocin)
B. methotrexate (MTX)
C. probenecid (benemid)
D. etanercept (Enbrel)
E. Allopurinol (Zyloprim)
B
____ inhibits uric acid biosynthesis for the treatment of chronic gout
A. indomethacin (indocin)
B. methotrexate (MTX)
C. probenecid (benemid)
D. etanercept (Enbrel)
E. Allopurinol (Zyloprim)
E
_____ is used in patients with acute gout attack
A. indomethacin (indocin)
B. methotrexate (MTX)
C. probenecid (benemid)
D. etanercept (Enbrel)
E. Allopurinol (Zyloprim)
A
T or F: the growth rate and size of some cancerous tumors can be effectively reducaed by treatment with NSAIDs
True
All drugs administered by aerosol route only reach the airway surface, can never be absorbed by the body, and therefore have no systemic side effects
False
T or F: a short-acting beta-2 adrenergic receptor agonist should be prescribed for a patient with occasional asthma symptoms, such as an individual subject only to episodes of exercise induced asthma
True
