Cardiovascular Pharmacology/TBQs

Question 1

Name the four drug catergories employed that treat hypertension.

Answer 1

1. Diuretics
2. Calcium Channel Blockers; Alpha-1 Blockers
3. ACE Inhibitors; Angiotensin II Blockers
4. Beta-1 Blockers; clonidine

Question 2

Name four examples of diuretics.

Answer 2

1. HCTZ
2. furosemide (Lasix)
3. triamterene (Dyrenium)
4. triamterene/ HCTZ (Dyazide)

Question 3

What action do the four examples of diuretics induce?

1. HCTZ
2. furosemide (Lasix)
3. triamterene (Dyrenium)
4. triamterene/ HCTZ (Dyazide)

Answer 3

Action: Reduces plasma volume and with it systemic blood pressure

Question 4

Diuretics are used to treat which two diseases?

Answer 4

1. Hypertension
2. Congestive Heart Failure

Question 5

Name the three adverse effects of diuretics.

Answer 5

1. Xerostomia (increased risk of fungal infection)
2. Orthostatic hypotension
3. Hypokalemia

Question 6

NSAIA’s decrease the effectiveness of ______.

Answer 6

Diuretics

Question 7

Calcium channel blockers are one of the four drugs employed to treat ____. Name three examples of calcium channel blockers.

Answer 7

Hypertension

1. amiodipine (Norvasc)

**2. diltiazem (Cardizem)**

3. nifedipine (Procardia)

Question 8

What are the actions produced by calcium channel blockers.

Answer 8

1. vasodilation
2. heart rate reduction
3. cardiac activity

Question 9

Name four diseases treated by Calcium channel blockers?

Answer 9

1. Hypertension
2. Angine
3. Mild to moderate CHF only
4. Cardiac arythmia

Question 10

Name two adverse effects of calcium channel blockers.

Answer 10

1. Orthostatic hypotension
2. Constipation

Question 11

Name two adverse reactions by calcium channel blockers.

Answer 11

1. Possible gingival enlargement
2. Dysgeusia
3. No interaction with NSAIA’s

Question 12

Alpha-1 Blockers always end in ______.

Answer 12

“-zosin”

Question 13

Name two alpha-1 blockers.

Answer 13

1. doxazosin (Cardura)
2. terazosin (Hytrin)

Question 14

What action is produced by alpha-1 blockers?

Answer 14

peripheral vasodilation

Question 15

Name two diseases that are treated using alpha-1 blockers.

Answer 15

1. Hypertension
2. Mostly used for Benign Prostatic Hypertrophy

Question 16

Name two adverse effects of alpha-1 blockers.

Answer 16

1. Orthostatic hypotension (may be severe with epinephrine)
2. Xerostomia

Question 17

Taking _____ may interfere with the action of epinephrine.

Answer 17

alpha-1 blockers

(also can decrease effectiveness of NSAIA’s)

Question 18

_______ and _____ are used to treat both hypertension and cognitive heart failure.

Answer 18

Diuretics; RAAS antihypertensive agents

Question 19

Give two examples of ACE inhibitors.

Answer 19

1. Lisinopril
2. Ramopril
   * (-pril)*

Question 20

Give two examples of angiotensin II receptor blockers.

Answer 20

1. irbesartan (Avapro)
2. valsartan (Diovan)

Question 21

Both ACE inhibitors and angiotensin II Receptor Blockers are ________ which cause _________.

Answer 21

RAAS Antihypertensive Agents; vasodilation

Question 22

RAAS abtihypertensive agents are used to treat _____ and _____.

Answer 22

1. Hypertension
2. Congestive Heart Failure

Question 23

Adverse effects of ACE inhibitors are orthostatic hypotension and ______.

Answer 23

Dry cough

(cough is worsened when patient is put in supine position)

Question 24

Adverse effects of Angiotensin II Receptor Blockers are orthostatic hypotension and ______.

Answer 24

headache

Question 25

NSAIA’s ______ the effects of Angiotensin II receptor blockers and are not to be used in cases of _____.

Answer 25

decrease; pregnancy

Question 26

An example of an alpha-2 agonists is ______.

Answer 26

Clonidine (Catapres)

Question 27

What four treatments is Clonidine (Catapres) is used for?

Answer 27

1. hypertension

2. withdrawal symptoms

3. Migraine prophylaxis

4. ADHD

Question 28

_____ is a very special drug because it is an Alpha/Beta blocker.

Answer 28

carvedilol (Coreg)

Question 29

carvedilol (Coreg) is used to treat hypertension without reflex ______.

Answer 29

bradycardia.

Question 30

Knowledge of pharmacology aids the dental professional in

A) obtaining a patient’s health history.

B) administering drugs in the office.

C) handling emergency situations.

D) selection of a nonprescription medication.

E) All of the above

Answer 30

E) All of the above
All of the choices are true. Because many of our patients are being treated with drugs, knowledge of pharmacology helps in understanding and interpreting patients’ responses to health history questions. Knowledge of the therapeutic and adverse effects of medications obviously helps in their proper administration in the office. Emergency situations may be caused by drugs or treated by drugs; thus, knowledge of pharmacology is of great help, especially because a rapid response is sometimes required. A clear understanding of the concepts of drug action, drug handling by the body, and drug interactions will allow the dental practitioner to make proper judgments and grasp the concepts relevant to new drug therapies on the market.

Question 31

Which of the following statements is true regarding planning appointments?

A) Whether or not patients are taking medication for systemic diseases is of little consequence in the dental office.

B) Asthmatic patients should have dental appointments in the morning.

C) Diabetic patients usually have fewer problems with a morning appointment compared with afternoon appointments.

D) Both B and C are true.

Answer 31

D) Both B and C are true.
Asthmatic patients who experience dental anxiety should schedule their appointments when they are not rushed or under pressure early in the morning. Diabetic patients usually have relatively fewer problems with a morning appointment. Patients taking medication for systemic diseases may require special handling in the dental office.

Question 32

Nutritional or herbal supplements

A) carry the U.S. Food and Drug Administration (FDA) approval for disease states.

B) are not drugs.

C) can cause adverse effects.

D) will not interact with other drugs the patient may be taking.

Answer 32

C) can cause adverse effects.
Nutritional or herbal supplements are quite capable of causing adverse effects. The majority of nutritional or herbal supplements do not carry FDA approval for treating disease states. These supplements are drugs and can cause adverse effects and interact with different drugs.

Question 33

Which type of drug name usually begins with a lowercase letter?

A) Brand name

B) Code name

C) Generic name

D) Trade name

Answer 33

C) Generic name
Before any drug is marketed, it is given a generic name that becomes the “official” name of the drug. Each drug is assigned only one generic name selected by the U.S. Adopted Name Council, and the name is not capitalized. The brand name is equivalent to the trade name and is capitalized. Although the brand name is technically the name of the company marketing the product, this term is often used interchangeably with the trade name. The code name is the initial term used within a pharmaceutical company to refer to a drug while it is undergoing investigation and is often a combination of capital letters and numbers, the letters representing an abbreviation of the company name.

Question 34

A drug’s generic name is selected by the

A) pharmaceutical company manufacturing it.

B) Food and Drug Administration (FDA).

C) U.S. Adopted Name Council.

D) Federal Patent Office.

Answer 34

C) U.S. Adopted Name Council.
Each drug is assigned only one generic name (e.g., ibuprofen). It is selected by the U.S. Adopted Name Council. The generic name is not selected by the FDA or the Federal Patent Office. The pharmaceutical company manufacturing the drug clearly has an influence on the generic name given its drug, but the final decision is not the company’s.

Question 35

Which of the following is true concerning generic and trade names of drugs?

A) A drug may only have one generic name and one trade name.

B) A drug may only have one generic name, but it may have several trade names.

C) A drug may have several generic names, but it may only have one trade name.

D) A drug may have several generic names and several trade names.

Answer 35

B) A drug may only have one generic name, but it may have several trade names.

Question 36

Two drugs that are found to be chemically equivalent, but not biologically equivalent or therapeutically equivalent are said to differ in

A) potency.

B) efficacy.

C) bioavailability.

D) therapeutic index.

Answer 36

C) bioavailability.

A preparation can be chemically equivalent yet not biologically or therapeutically equivalent. These products are said to differ in their bioavailability. The potency of a drug is a function of the amount of drug required to produce an effect. The efficacy is the maximum intensity of effect or response that can be produced by a drug. The therapeutic index is the ratio of the lethal dose for 50% of the experimental animals divided by the effective dose for 50% of the experimental animals. If the value of the therapeutic index is small, toxicity is more likely.

Question 37

Two drug formulations that produce similar concentrations in the blood and tissues after drug administration are termed _____ equivalent.

A) chemically

B) biologically

C) therapeutically

Answer 37

B) biologically

Biologic equivalence refers to identical pharmacokinetic parameters of two drug formulations (bioequivalence, for short). Chemical equivalence indicates that two formulations of a drug meet the chemical and physical standards established by the regulatory agencies. Therapeutic equivalence means that two formulations produce the same therapeutic effects over the same duration.

Question 38

The federal body that determines whether a drug is considered a controlled substance and to which schedule it belongs is the

A) Food and Drug Administration (FDA).

B) Federal Trade Commission (FTC).

C) Drug Enforcement Administration (DEA).

D) U.S. Pharmacopeia (USP).

Answer 38

C) Drug Enforcement Administration (DEA).
The DEA regulates the manufacture and distribution of substances with abuse potential. Hence prescriber DEA numbers must appear on prescriptions for controlled substances. The FDA does not have any special powers in regard to drugs of abuse. The FTC regulates commerce and advertising claims of foods, over-the-counter (OTC) products, and cosmetics. The USP regulates the uniformity and purity of drugs.

Question 39

Which federal regulatory agency decides which drugs require a prescription and which drugs may be sold over-the-counter (OTC)?

A) FDA

B) OSHA

C) FTC

D) DEA

Answer 39

A) FDA
The Food and Drug Administration (FDA) is part of Department of Human and Health Services (DHHS), and determines what drugs may be sold by prescription and OTC and regulates the labeling and advertising of prescription drugs. The Occupational Safety and Health Administration (OSHA) ensures the safety and health of workers in the United States by setting and enforcing standards. The Federal Trade Commission (FTC) regulates the trade practices of drug companies and prohibits the false advertising of foods, nonprescription (OTC) drugs, and cosmetics. The Drug Enforcement Administration (DEA) is a part of the Department of Justice and regulates the manufacture and distribution of substances that have a potential for abuse, including opioids, stimulants, and sedatives.

Question 40

Which of the following is a schedule II controlled substance?

A) Heroin

B) Propranolol

C) Amphetamine

D) Dextropropoxyphene (Darvon)

Answer 40

ANS: C

Amphetamine, oxycodone, morphine, and secobarbital are all schedule II controlled

substances. Heroin is a schedule I substance. Propranolol is a nonscheduled prescription drug.

NURSINGTB.COM

Dextropropoxyphene is a schedule IV substance.

Question 41

The word stat on a prescription means

A) before meals.

B) at bedtime.

C) immediately.

D) every.

Answer 41

C) immediately.
The word stat on a prescription means immediately (now). The abbreviation ac means before meals, hs means at bedtime, and q means every.

Question 42

The abbreviation used on prescriptions for four times a day is

A) bid.

B) qid.

C) qd.

D) ud.

Answer 42

B) qid.
qid is the abbreviation for quarter in die, or _four times a da_y. bid stands for twice a day, qd stands for every day, and ud stands for as directed.

Question 43

On a prescription, the directions to the patient are preceded by

A) Rx.

B) Sig.

C) #.

D) Disp.

Answer 43

B) Sig.
Sig. is the abbreviation for the Latin word signa, or write. This word precedes the instructions to the patient. Rx means take thou and precedes the prescription instructions, # denotes the number of tablets, capsules, and so forth to be dispensed. Disp. is short for dispense and precedes the amount to be dispensed, analogous to #.

Question 44

Which of the following are true of an off-label use of a drug? (Select all that apply.)

A) Prescribers are allowed to use drugs for off-label use under certain circumstances.

B) The FDA approves the use of drugs for specific indications, which are listed or labeled on the package insert of the drug.

C) Drug manufacturers have much useful information regarding off-label uses of their drugs on their websites.

D) Off-label use of drugs is not permitted in the United States.

E) Off-label drugs are repackaged for sale by clandestine organizations outside the United States and are illegal to transport or distribute.

Answer 44

A) Prescribers are allowed to use drugs for off-label use under certain circumstances.

B) The FDA approves the use of drugs for specific indications, which are listed or labeled on the package insert of the drug.

Practitioners are allowed to use off-label drugs if good medical practice justifies their use, the use is well documented in the medical literature, and the drug meets the current standard of medical care. The FDA approves the use of drugs for specific indications, and they are listed or labeled on the package insert of the drug. Drug manufacturers are not allowed to bring up off-label uses when speaking with the prescribing practitioner, nor can they distribute written material regarding off-label uses. The off-label use of drugs is permitted in the United States provided that several rules are followed.

Question 45

Which of the following are associated with increased patient nonadherence to medication therapy? (Select all that apply.)

A) Some patients may fear of the side effects of the medication.

B) A longer duration of drug therapy is associated with the risk for nonadherence with medication therapy.

C) Increased dosing frequency is associated with nonadherence with medication therapy.

D) The issue of nonadherence to medication therapy is not important, as patients reliably take their medication as prescribed.

Answer 45

A) Some patients may fear of the side effects of the medication.

B) A longer duration of drug therapy is associated with the risk for nonadherence with medication therapy.

C) Increased dosing frequency is associated with nonadherence with medication therapy.

Many factors are associated with nonadherence to medication therapy. These include poor understanding of the disease and a need for medication to treat it, fear of side effects of the medication, distrust of health care professionals, economic factors, or forgetfulness. Longer duration of drug therapy and the number of times a day the patient must take a prescription increase the chances that a patient will not adhere to the regimen. For example, patients are more compliant with twice-a-day dosing than they are with four-times-a-day dosing. Statistics reveal that only a minority of patients will take their medication as prescribed.

Question 46

A drug is defined as a biologically active substance that can modify

A) the environment.

B) the pH of tissue.

C) cellular function.

D) immune response.

Answer 46

C) cellular function.
A drug can modify cellular function. A general understanding of drug action allows the dental hygienist to make informed decisions regarding possible drug interactions or adverse reactions for the patient. It is a concern that discarded drugs may be affecting the environment, but this is not the definition of a drug. Some drugs may have the capacity to modify body compartment pH; however, this is not the definition for a drug. Some drugs may have the capacity to modify the immune response, but this is not the definition of a drug.

Question 47

In comparing two drugs, the dose-response curve for the drug that is more efficacious would

A) be closer to the y-axis.

B) be farther from the y-axis.

C) have a greater curve height.

D) have a higher median effective dose (ETD50).

Answer 47

C) have a greater curve height.
Efficacy is an expression of maximum intensity of effect or response that can be produced by a drug. The other choices refer to indicators of drug potency, not efficacy. The potency of a drug is a function of the amount of drug required to produce an effect. The potency of drug is shown by the location of that drug’s curve along the log-dose axis (x-axis).

Question 48

Administering a drug of greater potency is better because drugs of greater potency do not require as high a dose.

A) Both parts of the statement are true.

B) Both parts of the statement are false.

C) The first part of the statement is true; the second part is false.

D) The first part of the statement is false; the second part is true.

Answer 48

D) The first part of the statement is false; the second part is true.

The first part of the statement is false, the second part is true. The absolute potency of a drug is immaterial as long as the appropriate dose is administered. If equally efficacious, both drugs will produce the same effect. Both meperidine and morphine, for example, have the ability to treat severe pain, but approximately 100 mg of meperidine would be required to produce the same action as 10 mg of morphine. The dose of meperidine needed to produce pain relief is larger than that for morphine. Less potent drugs require higher doses to produce therapeutic effects whereas more potent drugs can reach toxic levels at lower doses.

Question 49

Which of the following statements is true regarding the therapeutic index (TI) of a drug?

A) A drug with a large TI is more dangerous than a drug with a small TI.

B) The formula for TI is ED50/LD50.

C) ED50 is 50% of the effective clinical dose.

D) TI is the ratio of the median lethal dose to the median effective dose.

Answer 49

D) TI is the ratio of the median lethal dose to the median effective dose.
LD50 is the dose causing death in 50% of test animals and ED50 is the dose required to produce the desired clinical effect in 50% of test animals. The greater the TI, the safer the drug. The formula is TI = LD50/ED50. The ED50 is the dose required to produce the desired clinical effect in 50% of test animals, not 50% of the effective clinical dose.

Question 50

Which of the following statements is true concerning the mechanism of action of drugs?

A) Drugs are capable of imparting a new function to the organism.

B) Drugs either produce the same action as an exogenous agent or block the action of an exogenous agent.

C) Drugs either produce the same action as an exogenous agent or block the action of an endogenous agent.

D) Drugs either produce the same action as an endogenous agent or block the action of an endogenous agent.

Answer 50

D) Drugs either produce the same action as an endogenous agent or block the action of an endogenous agent.
Drugs either produce the same action as an endogenous agent or block the action of an endogenous agent. Drugs do not impart a new function to the organism; they merely either produce the same action as an endogenous agent or block the action of an endogenous agent.

Question 51

When different drugs compete for the same receptor sites, the drug with the stronger affinity for the receptor will bind to

A) more receptors than the drug with the weaker affinity.

B) fewer receptors than the drug with the weaker affinity.

C) all of the available receptors.

D) none of the available receptors.

Answer 51

A) more receptors than the drug with the weaker affinity.

When different drugs compete for the same receptor sites, the drug with the stronger affinity for the receptor will bind to more receptors than the drug with the weaker affinity. More of the drug with weaker affinity will be required to produce a pharmacologic response. Drugs with a stronger affinity for receptor sites are more potent than drugs with weaker affinities for the same site.

Question 52

When a drug has affinity for a receptor and produces no effect, it is called a(n)

A) agonist.

B) competitive antagonist.

C) competitive agonist.

D) physiologic agonist.

Answer 52

B) competitive antagonist.
A competitive antagonist has affinity for a receptor, combines with the receptor, competes with the agonist for the receptor, and produces no effect. An agonist has affinity for a receptor, combines with the receptor, and produces an effect. Competitive agonist is nonsensical terminology. A physiologic antagonist has affinity for a site different from that of the agonist in question.

Question 53

A noncompetitive antagonist
A) binds to the same receptor site as the binding site for the agonist.

B) causes a shift to the right in the dose-response curve.

C) enhances the maximal response of the agonist.

D) reduces the maximal response of the agonist.

Answer 53

D) reduces the maximal response of the agonist.
A noncompetitive antagonist reduces the maximal response of the agonist. Noncompetitive antagonists bind to a receptor site that is different from the binding site for the agonist. A competitive antagonist will cause a shift to the right in the dose-response curve.

Question 54

Which of the following is not a subject of pharmacokinetics?

A) Physiologic action of drugs

B) Metabolism of drugs

C) Elimination of drugs

D) Absorption of drugs

Answer 54

A) Physiologic action of drugs
The physiologic action of drugs is a subject of pharmacology, not pharmacokinetics. Pharmacokinetics does have to do with the subjects of absorption, distribution, metabolism, and excretion of drugs.

Question 55

Which of the following statements is (are) true concerning passage across body membranes?

A) The membrane lipids make the membrane relatively permeable to ions and polar molecules.

B) The lipid molecules orient themselves so that they form a fluid bimolecular leaflet structure with the hydrophobic ends of the molecules shielded from the surrounding aqueous environment.

C) Membrane carbohydrates make up the structural components of the membrane and help move the molecules across the membrane during the transport process.

D) Both A and B are true.

E) Both B and C are true.

Answer 55

B) The lipid molecules orient themselves so that they form a fluid bimolecular leaflet structure with the hydrophobic ends of the molecules shielded from the surrounding aqueous environment.
The lipid molecules orient themselves so that they form a fluid bimolecular leaflet structure with the hydrophobic ends of the molecules shielded from the surrounding aqueous environment. The hydrophilic ends are in contact with water. The membrane lipids make the membrane relatively impermeable to ions and polar molecules. Membrane proteins make up the structural components of the membrane and help move the molecules across the membrane during the transport process.

Question 56

11. Which of the following choices is the process by which a substance is transported against a concentration gradient?

A) Passive transfer

B) Active transport

C) Facilitated diffusion

D) Filtration

Answer 56

B) Active transport
Active transport is a mechanism for movement of substances, often against a concentration gradient, that uses the energy of the cell to actively pump the substance from one side of a membrane to the other. Passive transfer and filtration entail the passage of substances in a manner proportional to their concentration on each side of the membrane. The substances move without any assistance. Facilitated transport uses a carrier protein but cannot transport substances against a gradient.

Question 57

Drugs that are weak electrolytes will cross body membranes best when they are (1) nonionized, (2) ionized, (3) polar, (4) nonpolar, (5) lipid soluble, (6) water soluble.

A) 1, 3, 5

B) 1, 3, 6

C) 1, 4, 5

D) 1, 4, 6

E) 2, 4, 5

Answer 57

C) 1, 4, 5
Drugs that are weak electrolytes will cross body membranes best when they are nonionized, nonpolar, and lipid soluble. These drugs dissociate in solution and equilibrate into a nonionized form and an ionized form. The nonionized, or uncharged, portion acts as a nonpolar, lipid-soluble compound that readily crosses body membranes. The ionized portion of drugs that are weak electrolytes will traverse membranes with greater difficulty because they are less lipid soluble.

Question 58

Increasing the pH of a solution will cause

A) a greater percentage of a weak base in the solution to be in the ionized form.

B) a greater percentage of a weak acid in the solution to be in the un-ionized form.

C) the hydrogen ion concentration to increase.

D) a greater percentage of a weak base in the solution to be in the un-ionized form.

E) no change in the relative ionization of weak acids or weak bases.

Answer 58

D) a greater percentage of a weak base in the solution to be in the un-ionized form.
Weak bases become ionized at low pH and un-ionized at higher pH. If the pH of the site rises, the hydrogen ion concentration will fall. For weak bases, this results in the un-ionized form (B), which can more easily penetrate tissues. Conversely, if the pH of the site falls, the hydrogen ion concentration will rise. This results in an increase in the ionized form (BH+), which cannot easily penetrate tissues.

Question 59

When the acidity of the tissue increases, as in instances of infection, the effect of a local anesthetic decreases; therefore, the local anesthetic is a weak acid.

A) Both parts of the statement are true.

B) Both parts of the statement are false.

C) The first part of the statement is true; the second part is false.

D) The first part of the statement is false; the second part is true.

Answer 59

C) The first part of the statement is true; the second part is false.
The first part of the statement is true, the second part is false. Infections lead to an accumulation of acidic waste products, which lowers the pH of the local area. Local anesthetics must penetrate the nerve cell membrane to cause their action. They become more ionized as the pH drops. This property is a characteristic of weak bases, not weak acids. Local anesthetics are weak bases. Weak bases are better absorbed when the pH is greater than the pKa. A weak base is associated and ionized when the pH is less than the pKa.

Question 60

Which of the following is true regarding basic principles of drug distribution in the bloodstream?

A) All drugs in the blood are either bound to plasma proteins or free.

B) Only the drug that is bound to plasma proteins can exert the pharmacologic effect.

C) Only the drug that is bound to plasma proteins can pass across cell membranes.

D) The free drug is a reservoir for the drug.

Answer 60

A) All drugs in the blood are either bound to plasma proteins or free.
All drugs in the blood are either bound to plasma proteins or free. Only the drug that is free can exert the pharmacologic effect. Only the free drug can pass across cell membranes. The bound drug is a reservoir for the drug.

Question 61

The movement of a drug from one site in the body to other sites is called

A) distribution.

B) disruption.

C) dispersion.

D) active transport.

Answer 61

A) distribution.

Distribution is the movement of a drug from the site of absorption or injection to other sites. Disruption is the initial destruction of a tablet coating or capsule during oral absorption. Dispersion is the spread of concentrated drug particles throughout the stomach or intestines. Active transport is a process involved in the passage of certain agents, including some drugs, across membrane barriers and may be involved in not only drug redistribution but also drug absorption, distribution, or excretion.

Question 62

The distribution of a drug is determined by

A) blood flow to the organ.

B) presence of certain barriers.

C) plasma protein–binding capacity.

D) solubility of the drug.

E) All of the above

Answer 62

E) All of the above
All of the above choices are correct. If the blood circulation to an organ is low, it will receive less drug. The more membranes and barriers a drug needs to cross, the slower the rate at which it will reach the organ in question. The binding of drugs to plasma proteins reduces the concentration of drug that can leave the circulation and be taken up by an organ. The relative level of fat or water solubility of a drug will influence where and how rapidly a drug will distribute. The distribution of a drug is determined by several factors, such as the size of the organ, the blood flow to the organ, the solubility of the drug, the plasma protein–binding capacity, and the presence of certain barriers (e.g., blood-brain barrier, placenta).

Question 63

If one dose of a drug is administered and the drug’s half-life in the body is 3 hours, what percentage of the drug would be left after four half-lives?

A) 50%

B) 6.25%

C) 2%

D) Insufficient information to determine

Answer 63

B) 6.25%
The half-life is the time required for a drug level to fall to one half of its concentration. The drug concentration would go to 50% → 25% → 12.5% → 6.25% in four half-lives. The information given is more than sufficient to answer the question. One needs merely to count the number of half-lives and divide the percentage drug in half for every half-life passed since the drug was administered.

Question 64

One dose of a drug is administered that has a half-life of 8 hours. Assuming first-order kinetics, how much time is needed for this drug to be over 96% eliminated from the body?

A) 8 hours

B) 40 hours

C) 60 hours

D) 120 hours

Answer 64

B) 40 hours
Assuming first-order kineticsN, 40 hours would be required for this drug to be over 96% eliminated from the body. Five half-lives are needed to reduce the levels of a drug to 3.125% of the original levels, or eliminate over 96%. For a drug with an 8-hour half-life, this amounts to five half-lives x 8 hours per half-life, or 40 hours.

Question 65

The half-life of a drug is most related to its

A) onset.

B) duration.

C) safety.

D) time to peak concentration.

Answer 65

B) duration.
Half-life is the amount of time required for a drug to fall to one half of its blood level. It is an expression of how long the drug lasts in the body. Onset is the time at which a drug starts to take effect. The half-life does not predict the relative safety of a drug; safe drugs can have long or short half-lives. Time to peak concentration refers to how much time is required for a drug to reach effective levels in the body, not how long a drug lasts in the body.

Question 66

The _____ is the most common site for biotransformation.

A) kidney

B) blood plasma

C) liver

D) small intestine

Answer 66

C) liver
The liver is the most common site for biotransformation. Biotransformation is the body’s way of changing a drug so that the kidneys can more easily excrete it. The liver rather than kidney, blood plasma, or small intestine is the most common site for biotransformation.

Question 67

The metabolite formed during metabolism (biotransformation) is usually _____ polar and _____ lipid soluble than its parent compound.

A) more; more

B) more; less

C) less; more

D) less; less

Answer 67

B) more; less
The metabolite is usually more polar and less lipid soluble than its parent compound, meaning that renal tubular reabsorption of the metabolite will be reduced because reabsorption favors lipid-soluble compounds. Metabolites are also less likely to bind to plasma or tissue proteins and less likely to be stored in fat tissue. Drugs must pass through various membranes such as cellular membranes, blood capillary membranes, and intracellular membranes. The lipid in the membranes makes them relatively impermeable to ions and polar molecules. Decreased renal tubular absorption, decreased binding to the plasma or tissue proteins, and decreased fat storage cause the metabolite to be excreted more easily.

Question 68

If a drug displays zero-order elimination kinetics

A) elimination increases as the dose of the drug is increased.

B) a constant amount is eliminated per unit time.

C) the drug is not eliminated and is retained in the body.

D) the elimination of the drug cannot be predicted mathematically.

Answer 68

B) a constant amount is eliminated per unit time.
With zero-order kinetics, the metabolism or excretion mechanisms for a drug in the body are saturated, meaning that they are at their maximal level. If more drug is given, then the body cannot keep up, and the drug levels will increase. The body cannot adjust to more drug, and elimination of a drug will remain the same as the dose of the drug is increased. If the drug is eliminated but a longer time is required, then it would for a first-order elimination. The elimination of the drug can be mathematically predicted.

Question 69

Which term refers to the time required for a drug to begin to have its effect?

A) First pass

B) Duration

C) Onset

D) Efficacy

Answer 69

C) Onset
Onset is the time at which a drug starts to take effect. First pass refers to the metabolism of drugs by the liver during their movement from the gastrointestinal tract to the systemic circulation via the portal circulation. Duration is the amount of time the drug is active in the body. Efficacy is an assessment of the effectiveness of a drug and does not refer to how quickly or how long a drug acts in the body.

Question 70

An enteral route of administration would be

A) intravenous.

B) oral.

C) sublingual.

D) transdermal.

Answer 70

B) oral.

Enteral means situated or occurring inside of the gastrointestinal tract (intestines). Intravenous, sublingual, and transdermal routes of administration bypass the gastrointestinal tract.

Question 71

What of the following choices is considered the safest, least expensive, and most convenient route for administering drugs?

A) Inhalation

B) Rectal

C) Oral

D) Subcutaneous

Answer 71

C) Oral
Oral administration requires no sophisticated devices, is slow enough in onset to gauge reactions and stop the next dose, and is easy for a patient to administer without assistance. Inhalation and subcutaneous administration require devices, such as inhalers and needles, and the drug is irretrievable once administered. Rectal dosing has lower patient acceptance, and absorption can be variable.

Question 72

Advantages of oral administration of a drug include all the following except

A) large surface area for drug absorption.

B) many different dose forms that may be administered orally.

C) more predictable response than intravenous administration.

D) the simplest way to introduce a drug into the body.

Answer 72

C) more predictable response than intravenous administration.

Intravenous administration offers a more predictable response than the oral route because the drug is injected directly into the bloodstream, bypassing many physiologic barriers, the hostile environment of the gastrointestinal tract, and drug-metabolizing enzymes that are encountered during oral absorption of a drug. Others are all characteristics of oral administration.

Question 73

Which organ is involved in the first-pass effect after oral administration of a drug?

A) Kidney

B)Lungs

C) Liver

D) Spleen

Answer 73

C) Liver
On oral administration, drugs are absorbed and are carried via the portal circulation to the liver, where a percentage of the drug may be metabolized before entering the systemic circulation. After oral dosing, drugs reach the kidney, lungs, and spleen after passing through the liver.

Question 74

Which of the following routes of drug administration produces the most rapid drug response?

A) Intravenous

B) Intramuscular

C) Subcutaneous

D) Intradermal

Answer 74

A) Intravenous
Intravenous administration produces the most rapid drug response, with an almost immediate onset of action. Because the injection is made directly into the blood, the absorption phase is bypassed. The intramuscular route, subcutaneous route, and intradermal route all have slower drug response rates than intravenous drug administration.

Question 75

What route is used to administer the tuberculosis skin test?

A) Intramuscular

B) Intradermal

C) Intravenous

D) Subcutaneous

Answer 75

B) Intradermal
Intradermal administration is used to provide local, rather than systemic, action. Local anesthetics are also given this way. The other routes are all chosen when systemic action is desired. Intramuscular, intradermal, and subcutaneous routes of administration are not used to administer the tuberculosis skin test.

Question 76

What type of administration involves the injection of solutions into the spinal subarachnoid space?

A) Intrathecal route

B) Intraperitoneal route

C) Intravenous route

D) Intradermal route

Answer 76

A) Intrathecal route
The intrathecal route is used for injection of solutions into the spinal subarachnoid space. Intraperitoneal route refers to placing fluids into the peritoneal cavity. Intravenous route refers to administering drugs directly into the blood circulation. Intradermal route refers to injecting a drug just under the skin.

Question 77

Drug preparations may be administered for local or systemic effects. Which is an example of a dose form used for a local effect?

A) Sublingual tablet

B) Transdermal patch

C) Ophthalmic ointment

D) Subcutaneous injection

Answer 77

C) Ophthalmic ointment
Ophthalmic ointments and drops are used specifically for treating the eye, not for treating a systemic disorder. Administration of a sublingual tablet leads to rapid entry of the drug into the systemic circulation. A transdermal patch is a specialized dose form for the controlled delivery of a drug into the systemic circulation. A subcutaneous injection is applied into the subcutaneous areolar tissue to gain access to the systemic circulation.

Question 78

Application of a transdermal patch is an example of parenteral administration because the drug is delivered in a manner that bypasses the gastrointestinal tract.

A) Both parts of the statements are true.

B) Both parts of the statements are false.

C) The first part of the statement is true; the second part is false.

D) The first part of the statement is false; the second part is true.

Answer 78

A) Both parts of the statements are true.
Both parts of the statement are true. A transdermal patch is designed to provide continuous controlled release of medication through a semipermeable membrane over a given period after application to the intact skin. Drugs given by the enteral route are placed directly into the gastrointestinal tract by oral or rectal administration. Parenteral means situated or occurring outside of the gastrointestinal tract (intestines). Examples of routes that bypass the gastrointestinal tract include various injection routes, inhalation, and topical administration. In practice, the term parenteral usually refers to an injection.

Question 79

A prodrug is an example of which type mechanism of metabolism?

A) Active to active

B) Active to inactive

C) Inactive to active

D) Inactive to inactive

Answer 79

C) Inactive to active
An inactive parent drug (prodrug) may be transformed into an active compound. Active to active occurs when an active parent drug is converted to a second active compound, which is then converted to an inactive product. When an active metabolite is formed, the action of the drug is prolonged. Active to inactive is the most common type of reaction in drug biotransformation. Inactive to inactive is not one of the mechanisms of metabolism. A placebo may be an example.

Question 80

Which is true of a drug with a stronger affinity for a receptor site versus a drug with a weaker affinity for the same site?

A) A drug with stronger affinity is more potent than a drug with weaker affinity.

B) A drug with stronger affinity will function as a competitive antagonist rather than as an agonist.

C) A drug with stronger affinity will function as a competitive antagonist rather than as an agonist.

D) A drug with stronger affinity will function as an agonist.

Answer 80

ANS: A

Drugs with stronger affinity for receptor sites are more potent than drugs with weaker

affinities for the same sites. An antagonist counteracts the action of the agonist. There are

three types of antagonists: competitive antagonist, noncompetitive antagonist, and physiologic

antagonist. An agonist is a drNug tRhatIhasGaffiBni.tyCforMa receptor, combines with the receptor,

and produces an effect.

Question 81

The route of administration of a drug affects

A) both the onset and duration of response.

B) the onset, but not the duration of response.

C) the duration, but not the onset of response.

D) neither the onset nor the duration of response.

Answer 81

A) both the onset and duration of response.
Onset refers to the time required for the drug to begin to have its effect. Duration is the length of a drug’s effect. Both onset and response are affected by the route of administration. The routes of administration may be categorized as enteral when placed in the gastrointestinal tract, or parenteral, which usually means an injection.

Question 82

Which drug is eliminated with zero-order kinetics?

A) Probenecid

B) Aspirin

C) Allopurinol

D) Penicillin

E) Naproxyn sodium

Answer 82

B) Aspirin
A few drugs, such as aspirin and alcohol, exhibit zero-order kinetics. The enzymes that metabolize these drugs can become saturated at usual therapeutic doses. Small changes in the dosage of these drugs may produce a large change in concentration in blood serum. There are few drugs that are eliminated with zero-order kinetics, namely aspirin and alcohol.

Question 83

With zero-order kinetics, the

A) same amount of drug is metabolized and eliminated from the body per unit of time regardless of dose.

B) same percentage of drug is metabolized and eliminated from the body per unit of time.

C) drug is irreversibly bound to receptor sites.

D)d. drug is not bound to receptor sites.

Answer 83

ANS: A
With high doses, the metabolism of the drug cannot increase and the duration of action of the drug can be greatly prolonged. Zero-order kinetics occurs because the enzymes that metabolize these drugs can become saturated at usual therapeutic doses. If the dose of the drug is increased, the metabolism cannot increase above its maximum rate.

Question 84

Which of the following statements are true regarding drug-receptor interactions? (Select all that apply.)

A) Drug receptors appear to consist of many large molecules that exist either on the cell membrane or within the cell itself.

B) A specific drug will usually bind with a specific receptor in a lock-and-key fashion.

C) Only a single receptor type is found at the site of action.

D) The energy formed by a drug-receptor interaction is very strong and the bond is difficult to break.

Answer 84

A) Drug receptors appear to consist of many large molecules that exist either on the cell membrane or within the cell itself.

B) A specific drug will usually bind with a specific receptor in a lock-and-key fashion.

Drug receptors may exist either on the cell membrane or within the cell. Usually, a specific drug will bind with a specific receptor. More than one receptor type or identical receptors can be found at the site of action. Many drug-receptor interactions consist of weak chemical bonds, and the energy formed during the interaction is very low. As a result, the bonds can be formed and broken easily. Once a bond is broken, another drug molecule immediately binds to the receptor.

Question 85

A prodrug is an inactive drug compound that becomes transformed into an active drug compound.

True

False

Answer 85

True
This statement represents an example of drug metabolism (converting a drug from inactive to active).

Question 86

If a drug is a weak base that is excreted via the kidneys, then acidifying the urine will enhance its excretion.

True

False

Answer 86

True
Weak bases will become ionized in an acid environment and will not be able to passively diffuse out of the kidney tubule.

Question 87

The route of administration of a drug affects both the onset and duration of response.

True

False

Answer 87

True
Onset refers to the time required the drug to begin to have its effect. Duration is the length of a drug’s effect.

Question 88

A dose-related reaction that produces undesirable effects caused by the action on nontarget organs is called a

A) therapeutic effect.

B) toxic reaction.

C) side effect.

D) drug allergy.

Answer 88

C) side effect.
A side effect is a predictable, dose-related drug effect that acts on nontarget organs. Therapeutic effect is the desired effect of the drug. Toxic reaction is a predictable, dose-related drug effect that acts on nontarget organs and produces an adverse reaction. In a drug allergy, the immune system of an individual responds to a drug, resulting in an allergic reaction. Drug reactions are not dose related or predictable.

Question 89

An acute, life-threatening allergic reaction characterized by hypotension, bronchospasm, laryngeal edema, and cardiac arrhythmias is what type of hypersensitivity?

A) Type I

B) Type II

C) Type III

D) Type IV

Answer 89

A) Type I
Type I hypersensitivity, or immediate-type hypersensitivity, is a rapidly produced response targeting the bronchioles, the respiratory system, and the skin. Type II, III, and IV reactions are all slower than type I reactions. Type II hypersensitivity causes cytolytic reactions, such as hemolytic anemia. Type III hypersensitivity is a reaction in which soluble antibody-antigen complexes are formed, causing arthralgia, urticarial skin eruptions, and so forth, with little or no lung involvement. Type IV hypersensitivity, or delayed-type hypersensitivity, is generally manifested as skin eruptions.

Question 90

Type _____ hypersensitivity is mediated by IgE antibodies.

A) I

B) II

C) III

D) IV

Answer 90

ANS: A

Type I hypersensitivity, or immediate-type hypersensitivity, involves drug antigen or allergen binding to IgE antibodies on inflammatory cells. Type II hypersensitivity causes cytolytic reactions, such as hemolytic anemia. Type III hypersensitivity is a reaction in which soluble antibody-antigen complexes are formed and deposited, causing arthralgia, urticarial skin eruptions, and so forth. Type IV hypersensitivity, or delayed-type hypersensitivity, generally manifests as skin eruptions, such as in poison ivy

Question 91

A dose of a drug that kills 50% of experimental animals is termed

A) ED50.

B) minimally effective dose.

C) LD50.

D) therapeutic index.

Answer 91

C) LD50.
By definition, the LD50 is the median lethal dose, that is, a dose level that leads to death in 50% of the animals tested. ED50 is the median effective dose, a dose that produces a therapeutic effect in 50% of the subjects tested. A minimally effective dose should not cause death unless death is the desired endpoint. In this case, the incidence of death should be lower to be designated minimal. The therapeutic index is the ratio of LD50 to ED50.

Question 92

n an assessment of drug action for a certain therapeutic agent, results indicate that the ED50 is 3 mg/kg, and the LD50 is 300 mg/kg. What is the therapeutic index for this agent?
A) 3
B) 300

C) 0.01

D) 100

Answer 92

D) 100

If the value of the TI is small, then toxicity is more likely. If the TI is large, then the drug will be safer. A drug with a wide TI will have a large LD50 and a small ED50 (the distance between these curves is large). A TI of greater than 10 is usually needed to produce a therapeutically useful drug. One must divide the LD50 value by the ED50 value. The LD50 value (300) divided by the ED50 value (3) equals 100.

Question 93

Although drug A and drug B have the same ED50, drug B has a wider therapeutic index (TI); therefore, drug A has a greater LD50 than drug B.

A) Both statements are true.

B) Both statements are false.

C) The first statement is true, the second is false.

D) The first statement is false, the second is true.

Answer 93

C) The first statement is true, the second is false.
Drug B has a wider therapeutic index. This means that drug B must be safer than drug A and that the amount of drug needed to be lethal to 50% of test animals must be greater for drug B than for drug A. Therefore, drug B has a greater LD50 than drug A. The therapeutic index is the ratio of the LD50 to ED50. A wide therapeutic index means a greater difference between the LD50 and the ED50 and therefore a greater ratio. If drug B has a wider therapeutic index than drug A and the two drugs have an equivalent ED50, then the LD50 of drug B must be greater.

Question 94

Which of the following is the recommended solution for the adverse effect of nausea following administration of a drug?

A) Cease taking the drug.

B) Go outside and get some fresh air.

C) Take the drug with food or milk.

D) Take the drug at bedtime.

E) Seek medical attention.

Answer 94

C) Take the drug with food or milk.
Nausea can usually be alleviated by taking the drug with food or milk. It is important to continue taking drugs as prescribed unless the patient has consulted with the prescriber. Some adverse effects, such as headache or upset stomach, normally do not require medical attention. Sedation can be minimized by taking the drug at bedtime. Other adverse effects require medical attention.

Question 95

What should the dental hygienist do first if a patient reports a suspected adverse drug effect?

A) Administer epinephrine.

B) Determine what drugs the patient is taking.

C) Have that patient drink a sugary liquid such as apple juice.

D) Call 9-1-1.

E) Drive the patient to the nearest hospital emergency room.

Answer 95

B) Determine what drugs the patient is taking.

Question 96

Which will block the action of histamine during an allergic reaction?

a. Macrolide
b. Epinephrine
c. Anticonvulsants
d. Benzodiazepines

Answer 96

b. Epinephrine

Epinephrine blocks the action of histamine during an allergic reaction. Macrolides will not block the action of histamine; however, they will raise the plasma levels of many drugs. Anticonvulsants do not block the action of histamine, although they can increase or decrease the metabolism of many drugs and each other, leading to either increased or decreased plasma levels of these drugs. Benzodiazepines and first-generation antihistamines will increase the level of sedation, but will not block the action of histamine.

Question 97

Which is safe to administer to a pregnant patient?

a. Tetracycline
b. NSAIDs
c. Penicillin
d. Benzodiazepines

Answer 97

c. Penicillin
* Penicillin and erythromycin, acetaminophen, and lidocaine are considered to be among the safest; however, even these drugs should be administered only if there is clear need. Tetracycline, NSAIDs, and the benzodiazepines are examples of drugs used in dentistry that are contraindicated during pregnancy.*

Question 98

Which is least likely to be a true allergic reaction?

a. Urticaria
b. Rash
c. Anaphylaxis
d. Dyspepsia

Answer 98

d. Dyspepsia

Drugs taken orally can produce gastrointestinal symptoms, such as nausea or dyspepsia, because of their local actions on the gastrointestinal tract. A drug allergy is an immunologic response to a drug resulting in a reaction such as rash or anaphylaxis. The targets of this reaction are the bronchioles, resulting in anaphylactic shock; the respiratory system, resulting in rhinitis and asthma; and the skin, resulting in urticaria and dermatitis.

Question 99

etracycline, nonsteroidal antiinflammatory drugs (NSAIDs), and the benzodiazepines are safe to administer to a pregnant patient.

True

False

Answer 99

False
Tetracycline, NSAIDs, and the benzodiazepines are examples of drugs used in dentistry that are contraindicated during pregnancy.

Question 100

The greater the therapeutic index is, the greater the toxicity will be.

True

False

Answer 100

False

The therapeutic index is the ratio of the LD50 to ED50. The smaller the ratio is, the closer the LD50 is to the ED50 and therefore the closer a deadly dose is to the therapeutic dose. Consequently, the lesser the therapeutic index is, the greater the toxicity will be.

Question 101

Which of the following is the primary type of drug recommended for patients who have edema or fluid retention with heart failure (HF)?

A) Angiotensin-converting enzyme inhibitor

B) Angiotensin receptor antagonist

C) Beta-blocker

D) Aldosterone antagonist

E) Diuretic

Answer 101

E) Diuretic

Most patients with HF have edema or fluid retention. Diuretics are used in these patients to relieve the symptoms of HF. The American College of Cardiology and the American Heart Association recommend that all patients who have evidence of fluid retention and for most patients with a history of fluid retention be prescribed a diuretic. Diuretics should be combined with angiotensin-converting enzyme inhibitors, beta-blockers, angiotensin receptor antagonists, or aldosterone antagonists.

Question 102

Which of the following choices are effects of digoxin on the heart?

A) Digoxin accelerates atrioventricular (AV) conduction.

B) Digoxin prolongs the refractory period of the atrioventricular (AV) node.

C) Digoxin increases the rate of the sinoatrial (SA) node.

D) Both A and B are effects.

E) Both B and C are effects.

Answer 102

B) Digoxin prolongs the refractory period of the atrioventricular (AV) node.

Digoxin prolongs the refractory period of the AV node. By prolonging the refractory period of the AV node, fewer impulses will be transmitted to the ventricle, and the heart rate will fall. These effects are useful in the treatment of certain arrhythmias. Digoxin slows AV conduction and decreases the rate of the SA node. This effect is desired; however, an overdose may cause excessive slowing of the heart. The pulse must always be taken prior to administering a dose. The medication should not be given if the dose is below 60 beats per minute.

Question 103

Hypersalivation is a sign of toxicity for which of the following agents?

a. Clonidine
b. Digoxin
c. Enalapril
d. Hydrochlorothiazide
e. Nifedipine

Answer 103

b. Digoxin
* Early signs of digoxin toxicity include anorexia, nausea and vomiting, and copious salivation. A reduction in the dose level of digoxin usually alleviates these adverse reactions. None of the other choices cause hypersalivation as a sign of toxicity. Clonidine is most likely to cause xerostomia and enalapril the least likely (oral manifestations include dry cough and dysgeusia). Nifedipine and hydrochlorothiazide can produce mild to moderate xerostomia.*

Question 104

Which of the following categories of drug is the best choice to relieve the acute symptoms of angina?

A) Nitroglycerin (NTG, Nitrostat, Nitrolingual)

B) Nitroglycerin (Nitro-Bid)

C) Propranolol

D) Verapamil (Calan, Isoptin)

E) Nifedipine (Procardia)

Answer 104

A) Nitroglycerin (NTG, Nitrostat, Nitrolingual)

Question 105

Which of the following statement is true concerning the use of B-adrenergic blocking agents for the treatment of angina pectoris? These drugs block the 𝑦 response to catecholamine stimulation, thereby reducing

A) both the chronotropic and inotropic effects.

B) 𝘉-adrenergic blockers are effective in reducing exercise but not stress-induced anginal episodes.

C) Adverse effects of 𝘉-adrenergic blocking agents include tachycardia, headache, The net result of the use of 𝘉-adrenergic blocking agents for the treatment of

D) and excessive salivation.

E) angina pectoris is a reduced myocardial oxygen demand.

Answer 105

D) and excessive salivation.

Question 106

Before administering nitroglycerine (NTG), the dental team should make sure that the patient has not used a _____ within the past 24 hours.

A) phenothiazine

B) PDE5 inhibitor

C) ranolazine

D) guanethidin

Answer 106

B) PDE5 inhibitor

Question 107

Which of the following is the most common cardiovascular disease?

A) Heart failure

B) Cardiac arrhythmia

C) Angina

D) Hypertension

Answer 107

D) Hypertension

Question 108

Approximately _____% of people with hypertension are properly treated.

a. 20
b. 40
c. 50
d. 60

Answer 108

c. 50

Question 109

Common adverse reactions associated with thiazides include

A) hypokalemia and hypouricemia.

B) hyperkalemia and hypouricemia.

C) hypokalemia and hyperuricemia.

D) hyperkalemia and hyperuricemia.

Answer 109

C) hypokalemia and hyperuricemia.

Question 110

Which of the following is the most important dental drug interaction with the thiazide diuretics?

A) Aspirin

B) Nonsteroidal antiinflammatory drugs (NSAIDs)

C) Penicillin

D) Chlorhexidine

Answer 110

B) Nonsteroidal antiinflammatory drugs (NSAIDs)

Question 111

B1-Receptor stimulation is associated with

A) vasodilation in skeletal muscles.

B) bronchodilation in pulmonary tissues.

C) a decrease in heart rate.

D) an increase in cardiac contractility.

Answer 111

D) an increase in cardiac contractility.

Question 112

Which of the following categories of antihypertensive agents end in the suffix -dipine? a. Diuretics

A) Diuretics

B) B-Adrenergic blockers

C) Calcium channel blockers

D) Angiotensin receptor blockers (ARBs)

Answer 112

C) Calcium channel blockers

Question 113

Many _____ end in the suffix -pril.

A) B-adrenergic blockers

B) angiotensin-converting enzyme inhibitors (ACEIs)

C) calcium channel blockers

D) angiotensin receptor blockers (ARBs)

Answer 113

B) angiotensin-converting enzyme inhibitors (ACEIs)

Question 114

Angiotensin receptor blockers (ARBs) end with the suffix

a. -olol.
b. -dipine.
c. -pril.
d. -artan.

Answer 114

c. -pril.

Question 115

NSAIDs can antagonize the effects of which of the following antihypertensive medications?

A) Angiotensin-converting enzyme inhibitors (ACEIs)

B) B-Adrenergic antagonists d. Loop diuretics

C) Calcium channel blockers

E) Centrally acting hypertensive agents

Answer 115

A) Angiotensin-converting enzyme inhibitors (ACEIs)

Question 116

Which agent is most likely to cause xerostomia?

a. Losartan
b. Clonidine
c. Enalapril
d. Atenolol

Answer 116

b. Clonidine

Question 117

Severe hypotension and reflex tachycardia are caused by combination of sympathomimetics, such as epinephrine, with which antihypertensive agent class?

a. Calcium channel blockers
b. B1-Adrenergic blocking agents
c. Angiotensin receptor blockers (ARBs)
d. Potassium-sparing diuretics

Answer 117

d. Potassium-sparing diuretics

Question 118

Each of the following agents is associated with development of gingival hypertrophy except one. Which is the exception?

a. Verapamil
b. Phenytoin
c. Clonidine
d. Felodipine

Answer 118

c. Clonidine

Question 119

Which of the following statements is true concerning hyperlipidemia and cholesterol?

A) Hyperlipidemia includes elevations in cholesterol or triglycerides and is associated with the development of arteriosclerosis.

B) High-density lipoprotein (HDL) is good cholesterol.

C) Foam cells become filled with lipid.

D) Both A and B are correct.

E) Both B and C are correct.

Answer 119

D) Both A and B are correct.

Question 120

When a physician finds out that his female patient wishes to start a family, he decides to change her cholesterol-lowering medication. He changes her medication from

A) niacin to simvastatin.

B) simvastatin to atorvastatin.

C) simvastatin to niacin.

D) gemfibrozil to losartan.

Answer 120

C) simvastatin to niacin.

Question 121

A patient taking warfarin (Coumadin) may experience interactions with which of the following?

A) Phenobarbital

B) Erythromycin

C) Aspirin

D) All of the above

Answer 121

D) All of the above

Question 122

Which of the following agents has the most serious drug interaction with warfarin?

a. Omeprazole
b. Aspirin
c. Digitalis
d. Lomotil

Answer 122

b. Aspirin

Question 124

All of the following drugs are ACE inhibitors except:

A) Accupril (quinapril)

B) Calan (verapamil)

C) Capoten (captopril)

D) Altace (ramipril)

E) Vasotec (enalapril)

Answer 124

B) Calan (verapamil)

Question 125

Beta bloackers may mask the signs and symptoms of hypoglycemia

True

False

Answer 125

True