Chapter 13 Flashcards
1
Q
- Which of the following statements regarding pharmacology is correct?
A) The selection and administration of most medications are based largely on anecdotal research.
B) The action of the human body in response to a particular medication is called pharmacology.
C) Evidence-based guidelines, while helpful, are not the primary factor that drives medication administration.
D) Despite the advanced science of pharmacology, adverse reactions are commonplace.
A
D) Despite the advanced science of pharmacology, adverse reactions are commonplace.
2
Q
2. Which of the following medications is derived from a plant source? A) Lithium B) Insulin C) Heparin D) Digoxin
A
D) Digoxin
3
Q
- A medication is used “off-label.” This means that it:
A) is used for a purpose not approved by the FDA, at doses different from the recommended doses, or by a route of administration not approved by the FDA.
B) has been determined to be safe by a physician, and is used to treat a patient’s illness before the medication has been approved by the FDA for any purpose.
C) is administered in clinical trials while the manufacturer conducts further research and before the FDA has approved the medication for use.
D) is administered in an extreme emergency situation, but only if initial clinical trials have determined that the medication will not cause harm to the patient.
A
A) is used for a purpose not approved by the FDA, at doses different from the recommended doses, or by a route of administration not approved by the FDA.
4
Q
4. A(n) \_\_\_\_\_\_\_\_\_ medication typically includes a “stem” that links it to other medications in the same class. A) trade B) official C) brand D) generic
A
D) generic
5
Q
5. All of the following medications fall in the same classification, EXCEPT: A) captopril B) enalapril C) diazepam D) lisinopril
A
C) diazepam
6
Q
6. Metoprolol has the brand name \_\_\_\_\_\_\_\_\_\_\_\_\_, which may be a subtle reference to lowering the blood pressure. A) Cordarone B) Lopressor C) Vasotec D) Norpramin
A
B) Lopressor
7
Q
7. Common components of a medication profile include all of the following, EXCEPT: A) pregnancy risk factors. B) the weight of the drug. C) potential incompatibility. D) mechanism of action.
A
B) the weight of the drug.
8
Q
- Medications that are manufactured synthetically:
A) do not use animal, mineral, or vegetable sources.
B) include insulin, digitalis, and thyroid medications.
C) are derived from certain plants and animal organs.
D) include calcium, iron, magnesium, and other minerals.
A
A) do not use animal, mineral, or vegetable sources.
9
Q
- The Comprehensive Drug Abuse Prevention and Control Act of 1970:
A) regulated the import, manufacture, prescription, and sale of several nonnarcotic medications and cocaine, opium, and their derivatives.
B) was aimed at protecting the public from mislabeled, poisonous, or otherwise harmful food, medications, and alcoholic beverages.
C) increased the penalties for violation of the Harrison Narcotic Act, made the possession of heroin illegal, and outlawed the acquisition and transportation of marijuana.
D) was a legislative act dealing with narcotic and nonnarcotic medications that have a potential for abuse, and developed a drug classification system according to the abuse potential of the medications.
A
D) was a legislative act dealing with narcotic and nonnarcotic medications that have a potential for abuse, and developed a drug classification system according to the abuse potential of the medications.
10
Q
10. Unlike Schedule I drugs, Schedule II drugs have: A) accepted medical uses. B) a higher abuse potential. C) limited dependence potential. D) no accepted medical application.
A
A) accepted medical uses.
11
Q
- Compared to Schedule III drugs, Schedule IV drugs:
A) include medications such as Vicodin and have a high potential for psychological dependence.
B) have a moderate potential for physical dependence and include cough syrups that contain codeine.
C) may lead to severe addiction and include short-acting barbiturates, amphetamines, and opiates.
D) have a lower abuse potential and include medications such as diazepam (Valium) and lorazepam (Ativan).
A
D) have a lower abuse potential and include medications such as diazepam (Valium) and lorazepam (Ativan).
12
Q
12. All of the following are Schedule II substances, EXCEPT: A) Ritalin. B) fentanyl. C) cocaine. D) heroin.
A
D) heroin.
13
Q
- The generic name of a medication:
A) does not require FDA approval.
B) is proposed by the manufacturer.
C) is proprietary and cannot be reproduced.
D) contains a string of letters and numbers
A
B) is proposed by the manufacturer.
14
Q
- The paramedic must use caution when referencing a medication in an American Medical Association (AMA) publication because:
A) the AMA publication only lists medications that are in human clinical trials.
B) not every medication listed in the compendium has received FDA approval.
C) medications listed in an AMA publication are typically not for prehospital use.
D) all medications in an AMA publication are listed by their chemical name only.
A
B) not every medication listed in the compendium has received FDA approval.
15
Q
15. The United States Pharmacopeia (USP) recommended temperature range for MOST medications in the prehospital setting is: A) 40°F to 76°F. B) 45°F to 80°F. C) 55°F to 86°F. D) 60°F to 90°F.
A
C) 55°F to 86°F.
16
Q
- The paramedic should be MOST suspicious that a controlled substance has been tampered with if:
A) repeated doses of the same drug are administered and the patient experiences an adverse reaction.
B) an appropriate dose of the drug seems ineffective, especially when patient tolerance is unlikely.
C) the box that the drug is stored in is torn, even if the drug cartridge itself is structurally intact.
D) there are any stray markings on the drug cartridge or vial, even if the contents are not discolored.
A
B) an appropriate dose of the drug seems ineffective, especially when patient tolerance is unlikely.
17
Q
17. The action of the body in response to a medication is called: A) pharmacology. B) biotransformation. C) pharmacokinetics. D) pharmacodynamics.
A
C) pharmacokinetics.
18
Q
18. Newer medications are designed to target only specific receptor sites on certain cells in an attempt to: A) treat more than one condition. B) minimize the adverse effects. C) reduce their therapeutic effect. D) eliminate all side effects.
A
B) minimize the adverse effects.
19
Q
19. A medication that initiates or alters a cellular activity by attaching to receptor sites and prompting a cell response is said to be: A) synergistic. B) an agonist. C) an antagonist. D) a competitive binder.
A
B) an agonist.
20
Q
- The term affinity, as it applies to pharmacology, is MOST accurately defined as the:
A) ability of a medication to bind to a receptor.
B) process of a medication binding to a receptor.
C) blocking of a receptor site by a particular medication.
D) strength of the bond between a medication and its receptor.
A
A) ability of a medication to bind to a receptor.
21
Q
- A medication is called an antagonist if:
A) it has a higher affinity for the receptor site than the chemical mediator.
B) it stimulates a receptor site to cause the response that that receptor normally causes.
C) it attaches to a receptor site and produces an effect or series of effects.
D) the chemical mediator of a receptor has a higher affinity than the medication.
A
A) it has a higher affinity for the receptor site than the chemical mediator.
22
Q
22. The ability of a medication to initiate or alter cell activity in a therapeutic or desired manner is referred to as: A) potency. B) efficacy. C) affinity. D) the threshold level.
A
B) efficacy.
23
Q
23. Stimulation of alpha-1 receptors results in: A) insulin secretion. B) vasoconstriction. C) arterial dilation. D) glucagon secretion.
A
B) vasoconstriction.
24
Q
- Stimulation of beta-1 adrenergic receptors would produce all of the following effects, EXCEPT:
A) an increase in heart rate.
B) increased renin secretion.
C) increased cardiac electrical conduction.
D) decreased myocardial contractility.
A
D) decreased myocardial contractility.
25
Q
25. In order to cause a negative inotropic effect on the heart, you would have to administer a(n): A) beta-1 adrenergic antagonist. B) alpha-2 adrenergic agonist. C) beta-2 adrenergic agonist. D) alpha-1 adrenergic antagonist.
A
A) beta-1 adrenergic antagonist.
26
Q
- Stimulation of beta-2 receptors will cause:
A) bronchoconstriction.
B) the airway diameter to dilate.
C) vasoconstriction and hypertension.
D) a decreased release of norepinephrine.
A
B) the airway diameter to dilate.
27
Q
- A medication that possesses a negative chronotropic effect will:
A) cause a decrease in the heart rate.
B) cause an increase in blood pressure.
C) decrease myocardial contractile force.
D) increase cardiac electrical conduction velocity.
A
A) cause a decrease in the heart rate.
28
Q
28. When a medication alters the velocity of the conduction of electricity through the heart, it is said to have a(n) \_\_\_\_\_\_\_\_\_\_\_\_\_ effect. A) inotropic B) dromotropic C) chronotropic D) alpha agonistic
A
B) dromotropic
29
Q
29. Which adrenergic receptor, when stimulated, inhibits norepinephrine release? A) Beta-1 B) Alpha-1 C) Alpha-2 D) Beta-2
A
C) Alpha-2
30
Q
30. In order to relieve the bronchospasm associated with an acute asthma attack, the paramedic would give a(n): A) alpha-1 agonist. B) beta-2 agonist. C) beta-1 agonist. D) alpha-2 agonist.
A
B) beta-2 agonist.
31
Q
- Lipid-soluble medications require higher weight-based doses in elderly patients because:
A) there are fewer barriers to absorption in elderly patients.
B) elderly patients have a much faster basil metabolic rate.
C) elderly patients have a higher body fat percentage and fat distribution.
D) elderly patients have a higher overall percentage of body water.
A
C) elderly patients have a higher body fat percentage and fat distribution.
32
Q
32. What term is used to describe a situation in which a patient experiences clinical effects from a medication that are opposite from the intended effects? A) Side effect B) Subtherapeutic effect C) Idiosyncrasy D) Paradoxical reaction
A
D) Paradoxical reaction
33
Q
33. The ideal body weight for a woman who is 5 ft 5 in tall is: A) 52 kg. B) 57 kg. C) 62 kg. D) 66 kg.
A
B) 57 kg.
34
Q
34. Patients with primary pulmonary hypertension may experience acute decompensation if they are given a: A) salicylate. B) vasopressor. C) diuretic. D) bronchodilator.
A
B) vasopressor.
35
Q
35. Which of the following factors would be the LEAST likely to affect a patient's response to a medication? A) Body temperature B) Pregnancy C) Past medical history D) Age and weight
A
C) Past medical history
36
Q
36. During a study, a patient experiences measurable clinical improvement or unexplained adverse effects after receiving a medication with no pharmacologic properties. This is referred to as: A) an idiosyncrasy. B) the placebo effect. C) an untoward effect. D) the therapeutic ratio.
A
B) the placebo effect.
37
Q
- A drug is assigned a pregnancy category “A” if:
A) there is evidence of fetal risk based on human experience, and the risk of using the drug in pregnant women clearly outweighs any possible benefit.
B) there is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the documented risk.
C) studies in animals have revealed adverse effects on the fetus and there are no controlled studies in women, or studies in women and animals are not available.
D) controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, there is no evidence of risk in later trimesters, and the possibility of fetal harm appears remote.
A
D) controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, there is no evidence of risk in later trimesters, and the possibility of fetal harm appears remote.
38
Q
38. If studies in animals or human beings have demonstrated fetal abnormalities, or if there is evidence of fetal risk based on human experience, a pregnancy category \_\_\_ is assigned to a medication. A) B B) C C) D D) X
A
D) X
39
Q
- A paramedic gives a woman with chronic pain an injection of sterile saline and tells her that it is a narcotic analgesic. The paramedic’s action:
A) could result in criminal prosecution.
B) will likely be of therapeutic benefit.
C) is acceptable under the circumstances.
D) demonstrates compassion and empathy.
A
A) could result in criminal prosecution.
40
Q
40. A drug that possesses the same desired clinical effect in several smaller doses as it does in a larger single dose has demonstrated: A) an idiosyncratic reaction. B) the placebo effect. C) a cumulative action. D) cross-tolerance.
A
C) a cumulative action.
41
Q
41. An undesirable clinical change caused by a medication that causes some degree of harm or discomfort to the patient is called a(n): A) side effect. B) idiosyncrasy. C) placebo effect. D) adverse effect.
A
D) adverse effect.
42
Q
42. Which of the following conditions would make a patient the MOST susceptible to an adverse effect from a medication? A) Hypertension B) Renal failure C) Minor trauma D) Chronic pain
A
B) Renal failure
43
Q
- Certain antibiotics and antiseizure medications are known to cause Stevens-Johnson syndrome, which is a:
A) severe, possibly fatal reaction that mimics a burn.
B) rare condition characterized by painful neck spasms.
C) condition in which the renal system acutely fails.
D) nonfatal reaction characterized by a diffuse rash.
A
A) severe, possibly fatal reaction that mimics a burn.
44
Q
44. An abnormal susceptibility to a medication that is peculiar to an individual patient is called an: A) untoward effect. B) adverse reaction. C) idiosyncratic reaction. D) exaggerated therapeutic effect.
A
C) idiosyncratic reaction.
45
Q
- The therapeutic index of a medication is defined as the:
A) plasma level at which the medication begins to exert its effect.
B) period of time in which the medication is excreted from the body.
C) duration of therapeutic action for a given medication on the body.
D) difference between the median effective dose and the median toxic dose.
A
D) difference between the median effective dose and the median toxic dose.
46
Q
- A medication that has a narrow therapeutic index:
A) can be given, but not without close patient monitoring.
B) should not be given to patients over 50 years of age.
C) is safe to give because the chance of toxicity is remote.
D) should not be given because its effects are too harmful.
A
A) can be given, but not without close patient monitoring.
47
Q
- Patients who are genetically predisposed to an immune-mediated medication response:
A) typically have a history of more than one autoimmune disorder.
B) had an initial exposure and sensitization to a particular antigen.
C) should be given an antihistamine before receiving the medication.
D) will experience a minor reaction that is generally limited to hives.
A
B) had an initial exposure and sensitization to a particular antigen.
48
Q
48. Which of the following medications MOST often causes an immune-mediated medication response? A) Ibuprofen B) Penicillin C) Fentanyl D) Atropine
A
B) Penicillin
49
Q
49. Decreased efficacy or potency of a medication when taken repeatedly by a patient is called: A) addiction. B) immunity. C) tolerance. D) habituation.
A
C) tolerance.
50
Q
- Cross-tolerance to a medication occurs when:
A) the body’s metabolism increases, resulting in a decreased concentration of the medication present near receptor sites.
B) repeated doses of a medication within a short time rapidly cause tolerance, which renders the medication ineffective.
C) repeated exposure to a medication causes an abnormal tolerance to the adverse or therapeutic effects of the medication.
D) repeated exposure to a medication within a particular class causes tolerance to other medications in the same class.
A
D) repeated exposure to a medication within a particular class causes tolerance to other medications in the same class.
51
Q
51. A patient receives several doses of the same drug within a short period of time, after which point the medication does not relieve his symptoms. Which of the following has MOST likely occurred? A) Tachyphylaxis B) Cross-tolerance C) Down-regulation D) Dependence
A
A) Tachyphylaxis
52
Q
52. The physical, emotional, or behavioral need for a medication in order to maintain a certain level of “normal” function is called: A) withdrawal. B) synergism. C) dependence. D) habituation.
A
C) dependence.
53
Q
53. Which of the following factors would have the LEAST influence on the duration and effectiveness of a medication? A) Dose administered B) Patient's dietary habits C) Route of administration D) Patient's clinical status
A
B) Patient’s dietary habits
54
Q
54. The peak of a medication's effect depends on \_\_\_\_\_\_\_\_\_\_\_\_\_, whereas the duration of effect depends on \_\_\_\_\_\_\_\_\_\_\_\_\_\_. A) distribution, absorption B) absorption, metabolism C) elimination, absorption D) metabolism, distribution
A
B) absorption, metabolism
55
Q
55. The percentage of an unchanged medication that reaches the systemic circulation is referred to as: A) bioavailability. B) drug interference. C) peak plasma level. D) pharmacodynamics.
A
A) bioavailability.
56
Q
56. Medications administered by the \_\_\_\_\_\_\_\_\_\_\_ route, by definition, have 100% bioavailability. A) sublingual B) intramuscular C) endotracheal D) intravenous
A
D) intravenous
57
Q
57. Medication X is given to increase the effects of medication Y, which provides more relief than if medication Y were given alone. This is an example of: A) synergism. B) summation. C) potentiation. D) antagonism.
A
C) potentiation
58
Q
58. A patient experiences profound sedation when an opioid, such as fentanyl, is given together with a benzodiazepine, such as midazolam. This is an example of: A) synergism. B) summation. C) potentiation. D) antagonism.
A
A) synergism.
59
Q
- Physiologic drug antagonism occurs when:
A) the action of one medication increases or decreases the ability of another medication to be absorbed by the body.
B) two medications, each producing opposite effects, are present simultaneously, resulting in minimal or no clinical changes.
C) the effect of one medication is enhanced by the presence of another medication, which does not have the ability to produce the same effect.
D) two medications, each producing identical effects, are present simultaneously, resulting in an enhanced physiologic response.
A
B) two medications, each producing opposite effects, are present simultaneously, resulting in minimal or no clinical changes.
60
Q
60. A medication undergoes first-pass metabolism in the: A) liver. B) spleen. C) stomach. D) bone marrow.
A
A) liver.
61
Q
- First-pass metabolism of a medication occurs when:
A) a medication’s effects are greatly enhanced by digestive enzymes in the stomach.
B) a medication’s bioavailability is immediately reduced when it enters the bloodstream.
C) the bioavailability of a medication is reduced before it reaches the systemic circulation.
D) the liver increases a medication’s effects before it reaches the systemic circulation.
A
C) the bioavailability of a medication is reduced before it reaches the systemic circulation.
62
Q
- Which of the following statements regarding the endotracheal route of medication administration is correct?
A) If a medication must be given via the endotracheal route, five times the standard IV dose should be given.
B) Evidence has shown that medications given via the endotracheal route quickly achieve a peak plasma level.
C) Medications given via the endotracheal route should be flushed with 20 to 30 mL of sterile water.
D) The endotracheal route is no longer considered a reliable method of medication administration.
A
D) The endotracheal route is no longer considered a reliable method of medication administration.
