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DECKS Flashcards

1
Q

Amphetamines are sympathomimetic amines that cause rapid release of all of the following EXCEPT one. Which one is the EXCEPTION?

a. Dopamine in the brain
b. Serotonin in the brain
c. Norepinephrine in the brain
d. Acetylcholine in the brain

A

d. Acetylcholine in the brain❌

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2
Q

The following effects result from what type of pharmacological agent:
Lower blood pressure
Vasodilation
Orthostatic hypotension

a. An alpha-adrenergic receptor blocker (alpha-blocker)
b. A beta-adrenergic receptor blocker (beta-blocker)

A

a. An alpha-adrenergic receptor blocker (alpha-blocker)

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3
Q

A drug that reduces the actions of the sympathetic nervous system is called a:

a. Sympathomimetic
b. Sympatholytic
c. Sympathetic amine
d. Adrenergic agent

A

b. Sympatholytic (Also called adrenergic blocking agent or adrenergic receptor blockers)

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4
Q

The following drugs belong to which pharmacologic category?
Epinephrine (Adrenalin)
Phenylephrine (Neo-Synephrine)
Albuterol (Proventil; Ventolin)
Isoproterenol

a. Adrenergic agonists
b. Adrenergic antagonists

A

a. Adrenergic agonists

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5
Q

A patient experiencing dental fear will release adrenaline having all of the following effects EXCEPT one. Which one is the EXCEPTION?

a. Gluconeogenesis in the liver
b. Bronchial vasodilation
c. Increased cardiac rate and force of contraction
d. Increased parasympathetic tone in digestive tract

A

d. Increased parasympathetic tone in digestive tract❌

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6
Q

All of the following drugs are indirect-acting adrenergic agonists, EXCEPT one. Which one is the EXCEPTION?

a. Tyramine
b. Amphetamine
c. Epinephrine
d. Methamphetamine
e. Hydroxyamphetamine

A

c. Epinephrine❌ (direct-acting)

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7
Q

All of the following drugs are alpha-adrenergic receptor blockers EXCEPT one. Which one is the EXCEPTION?

a. Doxazosin (Cardura)
b. Phenoxybenzamine hydrochloride (Dibenzyline)
c. Phentolamine hydrochloride (Regitine)
d. Prazosin (Minipress)
e. Propranolol (Inderal)
f. Terazosin (Hytrin)

A

e. Propranolol (Inderal)❌ —beta-blocker (specifically a non-selective beta-blocker)

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8
Q

The heart is generally considered to have predominantly which type of adrenergic receptors?

a. Alpha 1 (a1) receptors
b. Beta 1 (B1) receptors
c. Alpha 2 (a2) receptors
d. Beta 2 (B2) receptors

A

b. Beta 1 (B1) receptors

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9
Q

Alpha adrenergic receptors are located on:

a. Vascular smooth muscle
b. Presynaptic nerve terminals
c. Blood platelets
d. Fat cells
e. Neurons in the CNS
f. All of the above

A

f. All of the above

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10
Q

All of the following neurons are cholinergic EXCEPT one. Which one is the EXCEPTION?

a. Preganglionic sympathetic neurons
b. Preganglionic parasympathetic neurons
c. Postganglionic sympathetic neurons
d. Postganglionic parasympathetic neurons

A

c. Postganglionic sympathetic neurons❌

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11
Q

What substance produces all of the following physiologic actions?
Constricts arteriolar blood vessels (vasoconstriction)
Relaxes bronchial smooth muscle (bronchodilation)
Decrease blood volume in nasal tissues
Causes a hypertensive response
Produces physiological actions opposite to that of histamine

a. Serotonin
b. Epinephrine
c. Dopamine
d. Acetylcholine

A

b. Epinephrine

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12
Q

Epinephrine is the agent of choice for treating an anaphylactic reaction because of its stimulatory effects on both alpha and beta adrenergic receptors.

All of the following are desirable effects of epinephrine that make it the agent of choice for treating an anaphylactic reaction.
It has vasopressor activity
It has bronchodilator properties
It causes increased cardiac output
It has a rapid onset of action

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

A

a. Both statements are true

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13
Q

“Epinephrine reversal” is a predictable result of the use of epinephrine in a patient who has received a/an:

a. Beta-blocker
b. Alpha-blocker
c. Adrenergic agonist
d. All of the above

A

b. Alpha-blocker

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14
Q

All of the following are selective beta blockers EXCEPT one. Which one is the EXCEPTION?

a. Metoprolol
b. Atenolol
c. Propranolol
d. Acebutolol

A

c. Propranolol❌—nonselective beta blockers

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15
Q

If norepinephrine or epinephrine were to stimulate or combine with the alpha receptors in the eye, which response would you expect?

a. Miosis (contraction of the pupil)
b. Mydriasis (dilation of the pupil)
c. Neither of the above; norepinephrine and epinephrine do not stimulate or combine with alpha receptors in the eye

A

b. Mydriasis (dilation of the pupil)

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16
Q

All of the following drugs are bronchodilators EXCEPT one. Which one is the EXCEPTION?

a. Epinephrine
b. Levalbuterol (Xopenex)
c. Albuterol (Proventil)
d. Salmeterol (Serevent)
e. Metaproterenol (Alupent)
f. Histamine
g. Aminophylline

A

f. Histamine❌

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17
Q

Pharmaceutical agents that bring about tissue responses resembling those produced by stimulation of the sympathetic nervous system are called?

a. Cholinomimetic
b. Antiadrenergic
c. Parasympathomimetic
d. Sympathomimetic

A

d. Sympathomimetic

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18
Q

The medical uses of a drug having adrenergic agonist actions would include which of the following?

a. Reverse an anaphylactic reaction
b. Treat hypertension
c. Prevent angina pectoris
d. Reduce anxiety
e. All of the above

A

a. Reverse an anaphylactic reaction

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19
Q

A fear reaction activates the sympathetic division of the autonomic nervous system to result in:

a. Miosis
b. Bradycardia
c. Hypertension
d. Increased salivation

A

c. Hypertension

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20
Q

AIl of the following amide local anesthetics are metabolized exclusively in the liver EXCEPT one. Which one is the EXCEPTION?

a. Lidocaine
b. Marcaine
c. Mepivacaine
d. Articaine

A

d. Articaine❌ can be metabolized in the blood

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21
Q

Allergic reactions are more prevalent in which type of local anesthetics?

a. Amide anesthetics
b. Ester anesthetics

A

b. Ester anesthetics

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22
Q

Which statement best describes the mechanism of action of local anesthetics on the nerve axon?

a. Decreases sodium uptake through sodium channels of the axon
b. Increases potassium outflow from inside to outside the nerve
c. Increases the membrane’s permeability to sodium
d. Increases the excitability of the nerve axon

A

a. Decreases sodium uptake through sodium channels of the axon

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23
Q

A patient presents to your office with an acute apical abscess on #27 requiring immediate extraction. However, the pH of the tissue has decreased to 5.9 due to the bacterial infection. You realize that achieving local anesthesia will be difficult because:

a. The pKa of lidocaine is lower than the pH of the tissue
b. Most of the lidocaine will be in a free-base form
c. Most of the lidocaine will penetrate the nerve sheath
d. The majority of the lidocaine will have a positive charge

A

d. The majority of the lidocaine will have a positive charge

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24
Q

The following are sedatives often used in the management of anxious pediatric dental patients EXCEPT 2. These are:

a. Midazolam
b. Diazepam
c. Hydroxyzine
d. Pentobarbital
e. Secobarbital
f. Chloral hydrate
g. Meperidine

A

d. Pentobarbital❌
e. Secobarbital❌

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25
Q

Ester-type local anesthetics are metabolized where?

a. Liver
b. Lungs
c. Plasma
d. Kidneys

A

c. Plasma

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26
Q

Which of the following is a contraindication or precaution to the use of Prilocaine?

a. Biliary tract disease
b. Type II diabetes
c. Rheumatoid arthritis
d. Hepatic disease

A

d. Hepatic disease

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27
Q

Which local anesthetic has no place in the routine practice of dentistry?

a. Articaine
b. Cocaine
c. Lidocaine
d. Bupivacaine
e. Prilocaine

A

b. Cocaine

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28
Q

Local anesthetics theoretically should be less effective in acutely inflamed tissue than in normal tissue because in inflamed tissue what happens?

a. The pH rises, thus inactivating the anesthetic
b. The pH rises, thus decreasing available free base
c. The pH decreases, thus decreasing available free base
d. The pH remains the same, the extracellular fluid dilutes the anesthetic

A

c. The pH decreases, thus decreasing available free base

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29
Q

A dental anesthetic carpule contains 1.8 ml of a 2% solution of lidocaine with 1:100,000 epinephrine. How much lidocaine and epinephrine does the carpule contain?

a. 3.6 mg lidocaine and 0.18 mg epinephrine
b. 3.6 mg lidocaine and 0.018 mg epinephrine
c. 36 mg lidocaine and 0.18 mg epinephrine
d. 36 mg lidocaine and 0.018 mg epinephrine

A

d. 36 mg lidocaine and 0.018 mg epinephrine

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30
Q

The maximal recommended adult dose of Lidocaine is 300 mg. How many milliliters of 2% Lidocaine need to be given to reach this level?

a. 7.5 milliliters
b. 10 milliliters
c. 15 milliliters
d. 20 milliliters

A

c. 15 milliliters

NOTES:
Lidocaine= 15ml
Mepivacaine= 10 ml
Prilocaine= 10ml
Bupivacaine= 18ml

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31
Q

The maximum recommended dose of a local anesthetic that can be administered to a child < 10 years of age is determined by:

a. Age
b. Weight
c. Height
d. Gender

A

b. Weight - (mg/kg)

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32
Q

Local anesthetics depress which of the following nerve fibers first?

a. Large myelinated fibers
b. Small unmyelinated fibers
c. Small myelinated fibers
d. Large unmyelinated fibers

A

b. Small unmyelinated fibers—These conduct pain and temperature.

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33
Q

The maximum dose of articaine (Septocaine) that is recommended in one appointment is expressed as mg per kilogram body weight rather than total milligrams. Which dose is the maximum recommended dose for articaine in children and adults?

a. 7 mg/kg
b. 100 mg/kg
c. 1 mg/kg
d. 300 mg/kg

A

a. 7 mg/kg

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34
Q

Which of the following is the most frequently utilized route of administration for sedation in pediatric patients?

a. Oral
b. Inhalation
c. IV
d. IM

A

b. Inhalation—The agent used most frequently is nitrous oxide.

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35
Q

All of the following are true regarding the use of nitrous oxide analgesia EXCEPT one. Which one is the EXCEPTION?

a. Rapid onset of action
b. Produces euphoria
c. Respiratory irritant
d. Titratable
e. Fast recovery time
f. Virtually no adverse effects in absence of hypoxia
g. Therapeutic sedative for many medically compromised patients
h. Generally suitable for all ages

A

c. Respiratory irritant❌

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36
Q

All of the following are reasons why epinephrine is included in dental local anesthetics EXCEPT one. Which one is the EXCEPTION?

a. It prolongs the duration of local anesthesia
b. To increase the local pH and therefore increase the available free base form of the local anesthetic
c. To provide local hemostasis
d. To delay the absorption of anesthetic into the systemic circulation thus reducing the chance of systemic toxicities

A

b. To increase the local pH and therefore increase the available free base form of the local anesthetic❌

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37
Q

Which stage of general anesthesia begins with unconsciousness?

a. Stage I
b. Stage II
c. Stage III
d. Stage IV

A

b. Stage II

NOTES:
Stage I (amnesia and analgesia): administration of anesthesia
Stage II (delirium and excitement): beggining of loss of consciousness
Stage III (surgical anesthesia): total loss of consciousness
Stage IV (premortem): Signals danger. Cardiac arrest is imminent.

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38
Q

Nitrous oxide is used as a single agent to produce general anesthesia.

Nitrous oxide is used to produce sedation and mild analgesia.

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

A

d. The first statement is false, the second is true
Nitrous oxide is used as a single agent to produce general anesthesia.❌
Nitrous oxide is UNABLE to produce general anesthesia except if it is given at concentrations greater than 80%

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39
Q

Which component of a lidocaine local anesthetic solution causes an allergy?

a. Water
b. Bisulfites
c. Lidocaine
d. Epinephrine (vasoconstrictor)

A

b. Bisulfites

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40
Q

Of the amide-type local anesthetics listed below, which is metabolized in the bloodstream rather than the liver?

a. Articaine (Septocaine, Zorcaine)
b. Mepivacaine (Carbocaine)
c. Lidocaine (Xylocaine)
d. Prilocaine (Citanest)
e. Bupivacaine (Marcaine)

A

a. Articaine (Septocaine, Zorcaine)

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41
Q

When phentolamine mesylate (OraVerse) is given after a dental procedure to reverse the local anesthetics effects, approximately how fast is the return to normal nerve sensation compared to the normal time for the anesthetic to wear off?

a. 10% decrease in the time for normal sensation to return
b. 25% decrease in the time for normal sensation to return
c. 50% decrease in the time for normal sensation to return
d. 80% decrease in the time for normal sensation to return

A

c. 50% decrease in the time for normal sensation to return

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42
Q

Phentolamine mesylate (OraVerse) is a drug used to reverse soft tissue anesthesia and the associated functional deficits resulting from a local dental anesthetic containing a vasoconstrictor. Which statement best describes its mechanism of action?

a. Prevents the influx of sodium into the neuron by blocking neuronal channels
b. Causes vasodilation and increased blood flow in injection area
c. Prevents the efflux of sodium out of the neuron
d. Causes vasoconstriction and decreased blood flow in injection area

A

b. Causes vasodilation and increased blood flow in injection area

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43
Q

Please rank the following benzodiazepines according to their duration of action starting with the shortest to longest:

a. Diazepam (Valium)
b. Midazolam (Versed)
c. Alprazolam (Xanax)

A

(b) Midazolam
(c) Alprazolam
(a) Diazepam

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44
Q

The most common adverse effects associated with the benzodiazepines include all of the following EXCEPT one. Which one is the EXCEPTION?

a. CNS depression (drowsiness and sedation)
b. GI disturbances (nausea, vomiting and diarrhea)
c. Confusion
d. Respiratory depression
e. Disorientation
f. Ataxia

A

d. Respiratory depression❌

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45
Q

Buspirone (BuSpar) is a partial agonist at a specific:

a. GABA (gamma-aminobutyric acid) receptor
b. Norepinephrine receptor
c. Dopamine receptor
d. Serotonin receptor

A

d. Serotonin receptor

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46
Q

An adult patient with a history of epilepsy enters into a state of status epilepticus during a dental procedure. As part of your emergency management protocol, you decide to administer an IV benzodiazepine. Which benzodiazepine would you administer in this situation?

a. Diazepam (Valium)
b. Midazolam (Versed)
c. Alprazolam (Xanax)
d. Triazolam (Halcion)

A

a. Diazepam (Valium) - enters the brain rapidly due to its high lipid solubility

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47
Q

The barbiturates Phenobarbital (Luminal), Mephobarbital (Mebaral), and Primidone (Mysoline) are classified as what type of barbiturate?

a. Ultrashort-acting
b. Short-acting
c. Intermediate-acting
d. Long-acting

A

d. Long-acting

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48
Q

The brief duration of general anesthetic action of an ultra-short-acting barbiturate is due to what factor?

a. Rapid rate of metabolism in the liver
b. Low lipid solubility, resulting in a minimal concentration in the brain
c. High degree of binding to plasma proteins
d. Rapid rate of redistribution from the brain to peripheral tissues
e. Slow rate of excretion by the kidneys

A

d. Rapid rate of redistribution from the brain to peripheral tissues

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49
Q

All of the following statements concerning barbiturates are true EXCEPT one. Which one is the EXCEPTION?

a. Barbiturates depress neuronal activity by increasing membrane ion conductance (primarily chloride), reducing glutamate-induced depolarizations and potentiating the inhibitory effects of GABA
b. Compared with benzodiazepines, the barbiturates exhibit a steeper dose-response relationship
c. Barbiturates may increase the half-lives of drugs metabolized by the liver
d. Barbiturates may precipitate acute porphyria in susceptible patients

A

c. Barbiturates may increase the half-lives of drugs metabolized by the liver❌
Barbiturates may DECREASE the half-lives of drugs metabolized by the liver.

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50
Q

Which of the following antiepileptic drugs has been known to cause gingival hyperplasia?

a. Carbamazepine (Tegretol)
b. Valproic acid (Depakene)
c. Phenytoin (Dilantin)
d. Gabapentin (Neurontin)

A

c. Phenytoin (Dilantin)

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51
Q

The most widely used tricyclic antidepressant (TCA) drug is:

a. Imipramine (Tofranil)
b. Amitriptyline (Elavil)
c. Desipramine (Norpramin)
d. Nortriptyline (Pamelor)
e. Doxepin (Sinequan)

A

b. Amitriptyline (Elavil)

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52
Q

Which drug is the current drug of choice for the treatment of the manic phase of bipolar disorder (or manic-depressive syndrome)?

a. Phenobarbital
b. Imipramine
c. Lithium
d. Haloperidol

A

c. Lithium

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53
Q

Which of the following is a major limitation for the widespread use of MAO inhibitors as a first-line agent in cases of refractory and atypical depression?

a. Dry mouth
b. Hypertensive crisis
c. GI disturbances
d. Grand-Mal seizure

A

b. Hypertensive crisis

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54
Q

The vasoconstrictor epinephrine in local anesthetic injections must be used cautiously in patients taking all of the following antidepressant drugs EXCEPT one in order to avoid transient and significant increases in blood pressure. Which one is the EXCEPTION?

a. Tricyclic antidepressants (i.e., Elavil)
b. Selective serotonin reuptake inhibitors (i.e., Prozac and Paxil)
c. Serotonin and norepinephrine reuptake inhibitors (i.e., Effexor and Cymbalta)

A

b. Selective serotonin reuptake inhibitors (i.e., Prozac and Paxil)❌

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55
Q

Which TWO groups of antidepressant drugs has the highest incidence of dry mouth (xerostomia)?

a. Tricyclic antidepressants (i.e., Elavil)
b. Selective serotonin reuptake inhibitors (i.e., Prozac and Paxil)
c. Serotonin and norepinephrine reuptake inhibitors (i.e., Effexor and Cymbalta)
d. Monoamine oxidase inhibitors (i.e., Nardil)

A

a. Tricyclic antidepressants (i.e., Elavil)
c. Serotonin and norepinephrine reuptake inhibitors (i.e., Effexor and Cymbalta)

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56
Q

All of the following anti-depressant drugs are serotonin and norepinephrine reuptake inhibitors EXCEPT one. Which one is the EXCEPTION?

a. Venlafaxine (Effexor)
b. Nortriptyline (Pamelor)
c. Desipramine (Norpramin)
d. Desvenlafaxine (Pristiq)
e. Sertraline (Zoloft)
f. Duloxetine (Cymbalta)

A

e. Sertraline (Zoloft)❌—Selective serotonin reuptake inhibitor

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57
Q

All of the following are H1-receptor blockers EXCEPT one. Which one is the EXCEPTION?

a. Diphenhydramine HCL (Benadryl)
b. Chlorpheniramine maleate (Chlor-Trimeton)
c. Cimetidine (Tagamet)
d. Loratadine (Claritin)
e. Desloratadine (Clarinex)

A

c. Cimetidine (Tagamet)❌— is an antihistamine H2-receptor blocker.

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58
Q

For which of the following conditions can Ranitidine be used?

a. Prostatitis
b. GERD (heartburn)
c. Toxic-shock syndrome
d. Renal failure

A

b. GERD (heartburn)

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59
Q

Diphenhydramine HCL (Benadryl), chlorpheniramine maleate (Chlor-Trime-ton), loratadine (Claritin), and desloratadine (Clarinex) are antihistamines at which histamine receptor site listed below?

a. H1-receptor site
b. H2-receptor site

A

a. H1-receptor site

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60
Q

Antibiotic regimens for patients with prosthetic implants include all of the following drugs as standard therapy of first choice in patients not allergic to penicillin EXCEPT one. Which one is the EXCEPTION?

a. Cephalexin
b. Cephradine
c. Amoxicillin
d. Tetracycline

A

d. Tetracycline❌

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61
Q

All of the following antibiotics exerts its mode of action by interfering with protein synthesis EXCEPT one. Which one is the EXCEPTION?

a. Aminoglycosides
b. Clarithromycin
c. Clindamycin
d. Tetracycline
e. Erythromycin
f. Cephalosporins

A

f. Cephalosporins❌—Agent affecting cell wall.

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62
Q

Mefloquine (Lariam) belongs to a class of drugs which is useful in treating which of the following conditions?

a. Malaria
b. AIDS
c. Hepatitis
d. Cancer
e. Chlamydia

A

a. Malaria

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63
Q

What percentage of patients expressing an allergy to penicillin will have cross allergenicity to a cephalosporin?

a. 40%
b. 60%
c. 10%
d. 90%

A

c. 10%

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64
Q

Tetracyclines are the drugs of first choice in the treatment of all of the following EXCEPT one. Which one is the EXCEPTION?

a. Mycoplasma pneumonia
b. Chlamydia infections
c. Rickettsial infections
d. Staphylococcal infections

A

d. Staphylococcal infections

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65
Q

Macrolide antibiotics such as Azithromycin and Erythromycin differ in their mechanism of action from Tetracyclines and Aminoglycosides. How are Tetracyclines and aminoglycosides different?

a. They belong to the Beta Lactam class
b. They target DNA Gyrase
c. They inhibit cell wall synthesis
d. They act on the 30s subunit of the ribosome

A

d. They act on the 30s subunit of the ribosome —Macrolides act on the 50s subunit

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66
Q

Erythromycin is well known to cause adverse:

a. CNS effects
b. GI effects
c. Hematologic effects
d. Renal effects

A

b. GI effects

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67
Q

The most commonly used aminoglycoside is:

a. Neomycin
b. Streptomycin
c. Tobramycin
d. Gentamicin

A

d. Gentamicin

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68
Q

Sulfonamides (also known as sulfa drugs) are structurally similar to:

a. Penicillins
b. Erythromycins
c. Acetylsalicyclic acid (Aspirin)
d. Para-aminobenzoic acid (PABA)

A

d. Para-aminobenzoic acid (PABA)

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69
Q

Which antibiotic is not only effective against most staphylococci, aerobic and anaerobic streptococci, but is most effective in treating infections due to bacteroides species?

a. Penicillin VK
b. Erythromycin
c. Tetracycline
d. Cephalexin (Keflex)
e. Clindamycin (Cleocin)
f. Vancomycin

A

e. Clindamycin (Cleocin)

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70
Q

The most important adverse effect of chloramphenicol is on the:

a. GI tract
b. Kidneys
c. Bone marrow
d. Liver

A

c. Bone marrow

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71
Q

Nitazoxanide (Alinia) is an oral antiprotozoal agent used to treat which of the following conditions?

a. Leprosy
b. Malaria
c. AIDS
d. Diarrhea caused by Clostridium difficile
e. Diarrhea caused by Giardia lamblia

A

e. Diarrhea caused by Giardia lamblia

NOTES:
This type of diarrhea is an intestinal infection also known as Giardiasis, and is the most common protozoan infection in the United States.

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72
Q

All of the following drugs are useful for treating which disease?
Isoniazid
Streptomycin
Rifampin
Ethambutol
Pyrazinamide

a. Malaria
b. AIDS
c. Rheumatoid arthritis
d. Tuberculosis

A

d. Tuberculosis

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73
Q

The antiviral agent penciclovir (Denavir) is active against which virus?

a. Herpes zoster
b. Genital herpes
c. Herpes simplex type 1 (HSV-1)
d. Papilloma virus

A

c. Herpes simplex type 1 (HSV-1)

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74
Q

The following drugs are used to treat which viral disease?
Didanosine
Zidovudine
Ritonavir
Indinavir
Delavirdine

a. Herpes
b. Mumps
c. AIDS
d. Chicken pox

A

c. AIDS

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75
Q

Which of the following is classified as an antifungal agent?

a. Bacitracin
b. Ketoconazole
c. Polymyxin-B
d. Neomycin

A

b. Ketoconazole

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76
Q

The drug of choice for treating Candidiasis is:

a. Penicillin
b. Erythromycin
c. Nystatin
d. Chloramphenicol

A

c. Nystatin

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77
Q

Which of the following is known as the original penicillin?

a. Penicillin V
b. Penicillin G
c. Ampicillin
d. Amoxicillin

A

b. Penicillin G

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78
Q

Which penicillin is degraded in stomach acid and is usually given parenterally (by injection)?

a. Penicillin VK
b. Amoxicillin
c. Penicillin G
d. Ampicillin

A

c. Penicillin G

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79
Q

The antibiotic of choice for standard prophylactic regimen of antibiotic coverage for the prevention of bacterial endocarditis is:

a. Penicillin VK
b. Tetracycline
c. Erythromycin
d. Amoxicillin

A

d. Amoxicillin

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80
Q

Of the drugs listed which is the most preferable antibiotic for the treatment of non-penicillinase-producing gram-positive staphylococcal infections?

a. Tetracycline
b. Clindamycin
c. Ampicillin
d. Cefaclor (Celcor)
e. Penicillin VK

A

e. Penicillin VK

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81
Q

Which of the following penicillin antibiotics have the widest spectrum of antibacterial activity?
Select 2.

a. Penicillin VK
b. Dicloxacillin
c. Ticarcillin
d. Amoxicillin
e. Piperacillin
f. Nafcillin

A

c. Ticarcillin
e. Piperacillin

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82
Q

Which of the following has a clinically significant drug interaction with Amoxicillin?

a. Triazolam (Halcion)
b. Methotrexate
c. Calcitrol
d. Candesartan

A

b. Methotrexate

NOTES:
Amoxicillin in large doses inhibits the renal tubular secretion of methotrexate, thereby causing higher, prolonged serum levels of methotrexate.

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83
Q

What do all of the following penicillin antibiotics have in common?
Amoxicillin and clavulanate potassium (Augmentin)
Ampicillin and sulbactam (Unasyn)
Cloxacillin
Dicloxacillin

a. Broad spectrum
b. Penicillinase resistant
c. Active against viruses
d. They are all aminopenicillins

A

b. Penicillinase resistant

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84
Q

Beta-lactamases (enzymes) include which of the following? Select 2.

a. Penicillinase
b. ATPase
c. Protein kinase
d. Cephalosporinase

A

a. Penicillinase
d. Cephalosporinase

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85
Q

Which of the following is often co-administered with antibiotics to delay the renal clearance of the antibiotic?

a. Imipenem
b. Probenecid
c. Hydrochlorothiazide
d. Aztreonam

A

b. Probenecid—This elevates and prolongs the serum concentrations of the antibiotic when high tissue concentrations are necessary.

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86
Q

Which antibiotic is bacteriostatic?

a. Clarithromycin (Biaxin)
b. Streptomycin
c. Penicillin VK
d. Cephalexin (Keflex)

A

a. Clarithromycin (Biaxin)

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87
Q

Which antibiotic/antimicrobial is associated with the highest incidence of drug allergy?

a. Ciprofloxacin (Cipro)
b. Penicillin VK
c. Clindamycin
d. Metronidazole (Flagyl)

A

b. Penicillin VK

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88
Q

Stavudine (also known as d4T , or Zerit) is an antiretroviral drug used in the treatment of adults with HIV infection in combination with other antiretroviral agents. Which of the following categories does this agent belong to?

a. Nucleoside reverse transcriptase inhibitor
b. Protease inhibitor
c. Non-nucleoside reverse transcriptase inhibitor

A

a. Nucleoside reverse transcriptase inhibitor

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89
Q

All of the following are common adverse effects caused by the use of tetracyclines EXCEPT one. Which one is the EXCEPTION?

a. Photosensitivity
b. Nausea
c. Bone marrow disturbances
d. Diarrhea
e. Discoloration of teeth and enamel hypoplasia in young children

A

c. Bone marrow disturbances❌

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90
Q

Which of the following are referred to as aminopenicillins? Select 2.

a. Penicillin VK
b. Ampicillin (Polycillin)
c. Cloxacillin (Cloxapen)
d. Dicloxacillin
e. Nafcillin
f. Amoxicillin (Amoxil)
g. Oxacillin

A

b. Ampicillin (Polycillin)
f. Amoxicillin (Amoxil)

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91
Q

Which antibiotic family listed below interferes with bacterial protein synthesis?

a. Penicillins
b. Fluoroquinolones
c. Sulfonamides
d. Erythromycins

A

d. Erythromycins

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92
Q

Which of the following is the mode of action of the Tetracyclines?

a. Bacterial cell wall destruction
b. Prevent protein synthesis in the bacterial cell
c. Interfere with nucleic acid synthesis
d. Cause mutations within bacterial DNA

A

b. Prevent protein synthesis in the bacterial cell

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93
Q

Which antibiotics exert their antibacterial activity through inhibition of protein synthesis in the bacterial cell? Select 3.

a. Cephalosporins
b. Tetracycline
c. Penicillin VK
d. Macrolides
e. Clindamycin
f. Sulfonamides

A

b. Tetracycline
d. Macrolides
e. Clindamycin

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94
Q

Erythromycin is a _____ antibiotic which binds to the ____ ribosomal subunit of susceptible bacteria. The result is the inhibition of protein synthesis.

a. bactericidal; 30s
b. bactericidal; 50s
c. bacteriostatic; 30s
d. bacteriostatic; 50s

A

d. bacteriostatic; 50s

95
Q

Which antimicrobial below is associated with pseudomembranous colitis?

a. Tetracycline
b. Penicillin VK
c. Metronidazole (Flagyl)
d. Clindamycin

A

d. Clindamycin—Adverse effects of clindamycin include diarrhea and abdominal pain. It is known to cause pseudomembranous colitis.

96
Q

Which of the following antivirals are classified as neuraminidase inhibitors? Select 2.

a. Acyclovir (Zovirax)
b. Oseltamivir (Tamiflu)
c. Amantadine (Symmetrel)
d. Rimantadine (Flumadine)
e. Zanamivir (Relenza)

A

b. Oseltamivir (Tamiflu)
e. Zanamivir (Relenza)

97
Q

Which drug can be used in the pregnant patient?

a. Tetracycline
b. Doxycycline (Vibramycin)
c. Minocycline (Minocin)
d. Penicillin VK

A

d. Penicillin VK

98
Q

A patient was given penicillin 15 minutes ago and develops the following signs and symptoms.
Laryngeal edema, Urticaria (welts that itch), Severe hypotension, GI disturbances, Bronchoconstriction (airway constriction) and Shock. What kind of reaction is this patient having?

A

Anaphylactic reaction (anaphylactic shock)—This reaction most commonly occurs with parenteral administration of penicillin.

99
Q

Antipsychotic drugs include all of the following EXCEPT one. Which one is the EXCEPTION?

a. The phenothiazines
b. The thioxanthenes
c. The butyrophenones
d. The benzodiazepines

A

d. The benzodiazepines❌

100
Q

All of the following are phenothiazines EXCEPT one. Which one is the EXCEPTION?

a. Chlorpromazine (Thorazine)
b. Haloperidol (Haldol)
c. Prochlorperazine (Compazine)
d. Thioridazine
e. Perphenazine
f. Trifluoperazine (Stelazine)

A

b. Haloperidol (Haldol)❌

101
Q

Typical antipsychotic drugs are ___ of ___ receptors. Newer or second generation drugs have greater selectivity for receptors in the limbic system.

a. antagonists, dopamine
b. agonists, serotonin
c. antagonists, GABA
d. agonists, chloride

A

a. antagonists, dopamine

102
Q

Which statement describes the extrapyramidal syndrome (EPS) caused by the phenothiazine-type antipsychotics?

a. Orthostatic hypotension
b. Sedation
c. Headache
d. Dry mouth
e. Muscle spasms of the oral-facial region

A

e. Muscle spasms of the oral-facial region

103
Q

All of the following are characteristics of a salicylate (aspirin) EXCEPT one. Which one is the EXCEPTION?

a. Selective COX-2 inhibitor
b. Irreversible platelet inhibitor
c. Excretion takes place in the kidney
d. Associated with Reye syndrome

A

a. Selective COX-2 inhibitor❌

104
Q

The main ingredient in Advil is also the main ingredient in which of the following prescription products?

a. Percodan
b. Vicodin ES
c. Motrin
d. Naprosyn

105
Q

Which non-narcotic analgesics would you most likely use in a patient taking anti-coagulant medication?

a. Ibuprofen (Motrin, Advil)
b. Acetaminophen (Tylenol)
c. Aspirin
d. Naproxen sodium (Aleve)

A

b. Acetaminophen (Tylenol)

106
Q

Which agent has anti-inflammatory properties?

a. Codeine
b. Acetaminophen
c. Hydrocodone
d. Ibuprofen

A

d. Ibuprofen

107
Q

Your patient has a history of drug abuse. Which agent could be given (if needed in the treatment plan) with no liability to cause an addiction?

a. Phenobarbital
b. Ibuprofen
c. Hydrocodone
d. Meperidine
e. Codeine

A

b. Ibuprofen

108
Q

NSAIDs reduce the production of ____ associated with pain and inflammation.

a. Leukotrienes
b. Cytokines
c. Prostaglandins
d. Interferons

A

c. Prostaglandins

109
Q

Which of the following agents has little value in treating acute inflammation?

a. Ibuprofen
b. Acetaminophen
c. Aspirin
d. Naproxen
e. Nabumetone

A

b. Acetaminophen — (Tylenol)

110
Q

Your patient is taking the following medications. Which are used to reduce the signs and symptoms of rheumatoid arthritis? Select 2.

a. Amlodipine (Norvasc)
b. Enalapril (Vasotec)
c. Piroxicam (Feldene)
d. Prednisone
e. Fosamax (Alendronate sodium)

A

c. Piroxicam (Feldene)
d. Prednisone

111
Q

Celecoxib (Celebrex) is a member of which category of drugs?

a. Salicyclates
b. Opiates
c. COX-2 selective inhibitors
d. Non-selective COX inhibitors
e. Steroidal anti-inflammatories

A

c. COX-2 selective inhibitors

112
Q

All preganglionic neurons of the sympathetic and parasympathetic system are ___ and most postganglionic sympathetic neurons are ___

a. cholinergic, adrenergic
b. cholinergic, muscarinic
c. adrenergic, cholinergic
d. adrenergic, muscarinic

A

a. cholinergic, adrenergic

113
Q

All of the following are cholinergic actions EXCEPT one. Which one is the EXCEPTION?

a. Slowing of the heart
b. Dilation of the pupils
c. The stimulation of the smooth muscles of the bronchi, GI tract, gallbladder, bile duct, bladder and ureters
d. The stimulation of sweat, salivary, tear and bronchial glands

A

b. Dilation of the pupils❌
Constriction of pupils (Miosis)

114
Q

All of the following are antimuscarinic agents EXCEPT one. Which one is the EXCEPTION?

a. Atropine
b. Scopolamine
c. Glycopyrrolate (Robinul)
d. Mecamylamine (Inversine)
e. Propantheline (Pro-Banthine)

A

d. Mecamylamine (Inversine)❌— is a nicotinic ganglion-blocking drug.

115
Q

The currently available ganglionic blocker for clinical use is:

a. Mecamylamine
b. Hexamethonium
c. Tetraethylammonium
d. Trimethaphan

A

a. Mecamylamine

NOTES:
Hexamethonium, trimethaphan, and tetraethylammonium are no longer available in the U.S. for clinical use

116
Q

Curare is a prototype _____ neuromuscular blocker which acts through _____, whereas Succinylcholine is a _____ blocker which acts through _____.

a. Nondepolarizing, non-competitive inhibition, depolarizing, competitive inhibition
b. Nondepolarizing, competitive inhibition, depolarizing, non-competitive inhibition
c. Depolarizing, competitive inhibition, Non-depolarizing, non-competitive inhibition
d. Depolarizing, non-competitive inhibition, Non-depolarizing, competitive inhibition

A

b. Nondepolarizing, competitive inhibition, depolarizing, non-competitive inhibition

117
Q

All of the following are cholinesterase inhibitors EXCEPT one. Which one is the EXCEPTION?

a. Physostigmine
b. Edrophonium
c. Pyridostigmine
d. Phentolamine
e. Neostigmine

A

d. Phentolamine❌— (and phenoxybenzamine) are prototypes of non-selective alpha-adrenergic receptor blockers.

118
Q

All of the following are cholinergic drugs EXCEPT one. Which one is the EXCEPTION?

a. Acetylcholine
b. Methacholine
c. Bethanechol (Urecholine)
d. Dobutamine
e. Carbachol (Isopto-Carbachol)
f. Pilocarpine hydrochloride

A

d. Dobutamine❌— is an adrenergic agonist.

119
Q

In dentistry, drugs such as Pilocarpine are used to treat xerostomia in head and neck cancer patients. This class of drugs are known as:

a. Cholinergic antagonists
b. Cholinergic agonists
c. Cholinergic inhibitors
d. Cholinergic accelerators

A

b. Cholinergic agonists

120
Q

All of the following statements concerning edrophonium are true EXCEPT one. Which one is the EXCEPTION?

a. It is a direct-acting cholinergic agonist (cholinomimetic)
b. It is a rapid-acting, short-duration, injectable cholinesterase inhibitor
c. It is the drug of choice for diagnosing myasthenia gravis because of its rapid onset of action and reversibility
d. It is also useful in differentiating a myasthenic crisis from a cholinergic crisis

A

a. It is a direct-acting cholinergic agonist (cholinomimetic)❌
It is an INDIRECT-acting cholinergic agonist (cholinomimetic)

121
Q

Poisoning with an organophosphate cholinesterase inhibitor can be treated with:

a. Edrophonium
b. Carbachol
c. Pralidoxime
d. Nicotine

A

c. Pralidoxime

122
Q

The muscarinic effects of cholinergic agonists include all of the following EXCEPT one. Which one is the EXCEPTION?

a. Miosis
b. Flushing
c. Bronchoconstriction
d. Increased GI motility
e. Increased urination
f. Tachycardia
g. Salivation
h. Sweating

A

f. Tachycardia❌
Bradycardia

123
Q

All of the following drugs may be useful in controlling salivary secretions to help in obtaining a dry field EXCEPT one. Which one is the EXCEPTION?

a. Atropine sulfate
b. Carbachol
c. Glycopyrrolate (Robinul)
d. Belladonna derivatives
e. Propantheline bromide (Pro-banthine)

A

b. Carbachol❌— is a direct-acting cholinergic drug.

124
Q

The major natural glucocorticoid is:

a. Triamcinolone
b. Cortisol
c. Dexamethasone
d. Prednisone
e. Prednisolone

A

b. Cortisol

125
Q

All of the following are pharmacologic effects of glucocorticoids EXCEPT one. Which one is the EXCEPTION?

a. Stimulate protein breakdown, which results in increased plasma amino acid levels
b. Stimulate gluconeogenesis in the liver and inhibit peripheral glucose use
c. Impaired wound healing
d. Reduce the immune response
e. Decreased lipolysis
f. Inhibit local edema, capillary dilation, migration and activation of white blood cells, and phagocytosis by macrophages
g. Increase hemoglobin concentration and increase the numbers of circulating red blood cells and platelets

A

e. Decreased lipolysis❌
INCREASED lipolysis—Glucocorticoids affect the mobilization of fats from areas of deposition.

126
Q

The primary mechanism behind antihypertensive drugs such as Prinivil (lisinopril) is to block the conversion of to prevent release of aldosterone from the adrenal cortex.

a. angiotensinogen to angiotensin I
b. angiotensin I to angiotensin II
c. angiotensin II to aldosterone
d. renin to angiotensinogen

A

b. angiotensin I to angiotensin II—Conversion takes place on angiotensin conversion enzymes (ACE) in the lungs.

127
Q

Which corticosteroid is administered by inhalation to treat asthma?

a. Hydrocortisone
b. Prednisone
c. Cortisone
d. Fluticasone (Flonase)
e. Methylprednisolone (Medrol)

A

d. Fluticasone (Flonase)

128
Q

The following drugs are classified as corticosteroids (steroids) EXCEPT 2

a. Hydrocortisone
b. Methylprednisolone
c. Prednisone
d. Compazine
e. Fluoxetine
f. Triamcinolone
g. Dexamethasone

A

d. Compazine❌ anti-psychotic
e. Fluoxetine❌ anti-depression

129
Q

All of the following drugs are direct vasodilators EXCEPT one. Which one is the EXCEPTION?

a. Hydralazine (Apresoline)
b. Diazoxide (Proglycem)
c. Captopril (Capoten)
d. Sodium nitroprusside (Nipride)
e. Nitroglycerin (Nitrostat)

A

c. Captopril (Capoten)— is an angiotensin-converting enzyme inhibitor.

130
Q

All of the following drugs are used to prevent or to provide relief of angina pectoris EXCEPT one. Which one is the EXCEPTION?

a. Nitroglycerin (Nitrostat)
b. Isoflurophate
c. Nifedipine (Procardia)
d. Diltiazem (Cardizem)
e. Propranolol (Inderal)
f. Isosorbide (Isordil)

A

b. Isoflurophate❌— is an organophosphate cholinesterase inhibitor used in the treatment of glaucoma

131
Q

Amyl nitrite is used in the emergency treatment of cyanide poisoning because it:

a. Oxidizes hemoglobin
b. Irreversibly binds cyanide
c. Competes with cyanide for binding of cytochromes
d. Inhibits tubular reabsorption of cyanide

A

a. Oxidizes hemoglobin

132
Q

All of the following correctly describe properties of digoxin EXCEPT one. Which one is the EXCEPTION?

a. Inhibits Na+-K+-ATPase membrane pump
b. Causes increased calcium ion influx with augments a positive ionotropic effect
c. Promotes tachycardia
d. Often used to treat supraventricular arrhythmias
e. Increases the refractory period of the cardiac muscle

A

c. Promotes tachycardia❌
Promotes BRADYCARDIA—This positive inotropic effect is independent of a normal sinus rhythm and adrenergic stimulation.

133
Q

All of the following are angiotensin-converting enzyme (ACE) inhibitors EXCEPT one. Which one is the EXCEPTION?

a. Captopril (Capoten)
b. Hydralazine (Apresoline)
c. Enalapril (Vasotec)
d. Lisinopril (Zestril)
e. Fosinopril (Monopril)

A

b. Hydralazine (Apresoline)❌— is a direct peripheral vasodilator.

134
Q

All of the following drugs are Class II antiarrhythmic agents EXCEPT one. Which one is the EXCEPTION?

a. Propranolol (Inderal)
b. Acetbutolol (Sectral)
c. Metoprolol (Lopressor)
d. Verapamil (Calan)

A

d. Verapamil (Calan)❌

135
Q

Amiodarone (Cordarone) is the most potent and “broad-spectrum” anti- arrhythmic compound currently available.

Procainamide is an antihypertensive drug used to treat high blood pressure.

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

A

c. The first statement is true, the second is false
Procainamide is an antihypertensive drug used to treat high blood pressure.❌
Procainamide is a Class IA antiarrhythmic agent that is used in the treatment of several cardiac arrhythmias including atrial fibrillation, atrial flutter, paroxysmal atrial tachycardia, and ventricular tachycardia.

136
Q

Verapamil is useful for the treatment of:

a. Angina
b. Hypertension
c. Supraventricular tachyarrhythmias
d. All of the above

A

d. All of the above

137
Q

All of the following drugs are classified as low molecular weight heparin type anticoagulants EXCEPT one. Which one is the EXCEPTION?

a. Enoxaparin (Lovenox)
b. Dalteparin (Fragmin)
c. Tinzaparin (Innohep)
d. Clopidogrel (Plavix)

A

d. Clopidogrel (Plavix)❌—inhibits blood clotting by inhibiting platelet aggregation in an irreversible manner.

138
Q

All of the following drugs are classified as glycoprotein IIb/Illa inhibitor type of anti-platelet agents EXCEPT one. Which one is the EXCEPTION?

a. Abciximab (Reopro)
b. Anagrelide (Agrylin)
c. Eptifibatide (Integrilin)
d. Tirofiban (Aggrastat)

A

b. Anagrelide (Agrylin)❌

139
Q

All of the following drugs are classified as what type?
Lepirudin (Reflidan)
Argatroban
Danaparoid (Orgaran)
Bivalirudin (Angiomax)

a. Adrenergic antagonists
b. Thrombin-inhibitor type anticoagulants
c. Thioxanthenes
d. ACE inhibitors

A

b. Thrombin-inhibitor type anticoagulants

140
Q

For a patient who is taking anticoagulants, what is the most valuable test used in evaluating the patient as a surgical risk?

a. PTT (Partial Thromboplastin Time)
b. PT (Prothrombin Time)
c. Platelet count

A

b. PT (Prothrombin Time)

141
Q

AIl of the following conditions are managed by using anticoagulants and anti-platelet agents EXCEPT one. Which one is the EXCEPTION?

a. Coronary artery disease (CAD)
b. Angina pectoris (Unstable Angina)
c. Myocardial infarction (Heart Attack)
d. Stroke
e. Hypertension

A

e. Hypertension❌

142
Q

Which of the following class of drugs lower blood cholesterol levels by inhibiting a key enzyme in the cholesterol synthesis pathway in the liver?

a. HPG-CoB Reductase Inhibitors
b. HCG-CoG Reductase Inhibitors
c. HMG-CoA Reductase Inhibitors
d. HCG-CoB Reductase Inhibitors

A

c. HMG-CoA Reductase Inhibitors

143
Q

Antihypertensive agents lower blood pressure by reducing total peripheral resistance and by reducing cardiac output through a variety of mechanisms.

ACE inhibitors inhibit the conversion of inactive angiotensin I to the angiotensin II, a vasoconstrictor.

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

A

a. Both statements are true

144
Q

Which of the drugs below can prolong the QT interval of cardiac electrical conduction and thus can increase the risk of cardiac arrhythmias?

a. Erythromycin
b. Ibuprofen
c. Hydrocodone
d. Penicillin VK
e. Azithromycin (Z-Pak)

A

a. Erythromycin

145
Q

Exemestane (Aromasin) and letrozole (Femara) are anticancer drugs classified under what category listed below?

a. Antibiotics
b. Aromatase inhibitors
c. Antimetabolites
d. Alkylating agents
e. Antimicrotubular

A

b. Aromatase inhibitors

146
Q

Alkylating agents are most effective in treating all of the following EXCEPT one. Which one is the EXCEPTION?

a. Chronic leukemias
b. Lymphomas
c. AIDS
d. Myelomas
e. Carcinomas of the breast and ovary

A

c. AIDS❌

147
Q

The following drugs belong to what pharmaceutical class of agents:
Darbepoetin alpha
Pegfilgrastim
Sargramostin

a. Immune modulators
b. Monoclonal antibodies
c. Colony stimulating factors
d. Interferons
e. Immunosuppressants

A

c. Colony stimulating factors

148
Q

Match the following popular chemotherapy agents on the left with their appropriate mechanism of action on the right:

  1. Cisplatin
  2. 5-Fluorouracil
  3. Paclitaxel (taxol)
  4. Tamoxifen

a. Antiestrogen
b. Antimetabolite
c. Alkylating agent
d. Antimicrotubular

A
  1. Cisplatin - Alkylating Agent
  2. 5-Fluorouracil - Antimetabolite
  3. Paclitaxel (taxol) - Antimicrotubular
  4. Tamoxifen - Antiestrogen
149
Q

Your patient with a history of breast cancer is undergoing chemotherapy with a drug called cisplatin (Platinol). All of the following are expected adverse effects of cisplatin EXCEPT one. Which one is the EXCEPTION?

a. Nausea and vomiting
b. Hair loss (alopecia)
c. Blood test abnormalities (low magnesium, low calcium, low potassium)
d. Peptic ulcers
e. Changes within the tissues of the oral cavity such as mucositis
f. Low white blood cells
g. Low red blood cells (anemia)
h. Xerostomia

A

d. Peptic ulcers❌
Cisplatin is an anti-cancer (“antineoplastic”) chemotherapy drug. It is classified as an “alkylating agent.”

150
Q

Antimetabolites are cell cycle-specific drugs acting primarily in the:

a. Go phase or resting phase of the cell cycle
b. S phase of the cell cycle
c. Gi phase of the cell cycle
d. G2 phase of the cell cycle

A

b. S phase of the cell cycle = DNA synthesis

152
Q

The prototype loop diuretic is:
• Hydrochlorothiazide (HCTZ)
• Furosemide (Lasix)
• Spironolactone (Aldactone)
• Triamterene (Dyrenium)

A

• Furosemide (Lasix)

153
Q

Which of the following is a pharmacologic antagonist of aldosterone in the
collecting tubule?
• Mannitol (Osmitrol)
• Glycerin (Glyrol)
• Spironolactone (Aldactone)
• Urea (Ureaphil)

A

• Spironolactone (Aldactone)

154
Q

Which of the following is true regarding Metformin as an Antidiabetic agent?
• It is a second generation sulfonylurea
• It enhances insulin secretion
• It has major effects on insulin sensitivity of peripheral tissues
• It decreases hepatic glucose production

A

• It decreases hepatic glucose production
*** Metformin is classified as a biguanide

155
Q

Insulin regular, also known as Humulin R, is considered a/an:
• Short-acting insulin with a duration of 6-8 hours
• Long-acting insulin with a duration of 20-24 hours
• Intermediate-acting insulin with a duration of 10-16 hours
• Rapid-acting insulin with a duration of 3-4 hour

A

• Short-acting insulin with a duration of 6-8 hours

156
Q

Al of the following are effects of insulin EXCEPT one. Which one is the
EXCEPTION?
• Decreased gluconeogenesis
• Increased triglyceride storage
• Decreased protein synthesis
• Increased glycogen synthesis

A

• Decreased protein synthesis
*** This is false; insulin increases protein synthesis.

157
Q

Humulin 70/30 is the brand name for a mixture of insulins containing: 70%
insulin NPH and 30% regular insulin injection. The advantage of this insulin
mixture is which of the following?
• Fast onset, short duration
• Slow onset, short duration
• Fast onset, long duration
• Slow onset, long duration

A

• Fast onset, long duration

158
Q

Which of the following is a high molecular weight heteropolysaccharide that
inactivates thrombin and other coagulation factors and thus prevents blood
clotting?
• Prothrombin
• Fibrin
• Heparin
• Plasmin

A

• Heparin

159
Q

The following drugs are classified as what type of drugs?
Etanercept (Enbrel)
Infliximab (Remicade)
Adalimumab (Humira)
• Anti-anxiety agents
• Anti-malarial agents
• Immunosuppressants
• Anti-rheumatic agents

A

• Anti-rheumatic agents

160
Q

Triazolam (Halcion), a pre-operative sedative in dentistry, is metabolized in the
liver by the P-450 isoform CYP 3A4 enzyme. Drugs which inhibit the actions of
CYP 3A4 would affect triazolam in which way?
• Cause an increase in serum levels of triazolam
• Cause a decrease in serum levels of triazolam
• Cause no change in serum levels of triazolam

A

• C a u s e a n i n c r e a s e i n s e r u m levels o f t r i a z o l a m

161
Q

When writing a prescription, t.i.d. is the abbreviation for:
• Twice a day
• Every 4 hours
• Three times a day
• Four times a day

A

• Three times a day

NOTES:
• b.i.d. = twice a day
• t.i.d. = three times a day
• q.12.h. = every 12 hours
• q.4.h. = every 4 hours
• stat. = immediately
• h.s. = at bedtime
• p.r.n. = as needed
• a.c. = before meals
• p.c. = after meals
• p.o. = by mouth
• Sig. = Label

162
Q

Al of the following drugs are useful in treating what medical condition?
Pilocarpine (Isopto-Carpine)
Latanoprost (Xalatan)
Betaxolol (Betoptic)
Bimatoprost (Lumigan)
• Pink eye
• Blepharitis
• Glaucoma
• Uveitis

A

• G l a u c o m a

163
Q

A patient presents to your office with a history of Sjögren syndrome and a chief
complaint of dry mouth. In order to help this patient, you would recommend all
of the following EXCEPT one. Which one is the EXCEPTION?
• Cevimeline 30mg
• Oral Balance
• Sugarless gum w/xylitol
• Atropine Sulphate 600 ug

A

• Atropine Sulphate 600 ug

164
Q

Levodopa is used in the treatment of Parkinson’s disease to replenish the brain’s supply of serotonin, the neurotransmitter that is deficient in this disorder.

Aministering carbidopa in combination with levodopa reduces the required dose of levodopa by about 75%.
• Both statements are true
• Both statements are false
• The first statement is true, the second is false
• The first statement is false, the second is true

A

• The first statement is false, the second is true
Levodopa is used in the treatment of Parkinson’s disease to replenish the brain’s supply of serotonin, the neurotransmitter that is deficient in this disorder.❌
Levodopa is used in the treatment of Parkinson’s disease to replenish the brain’s supply of DOPAMINE, the neurotransmitter that is deficient in this disorder

165
Q

Vhich antiarrhythmic agent is effective only on the ventricle and is often
administered IV to treat life-threatening ventricular arrhythmias?
• Quinidine (Quinidex)
• Lidocaine (Xylocaine)
• Flecainide (Tambocor)
• Propafenone (Rythmol)
• N o n e o f the a b o v e

A

• Lidocaine

166
Q

All of the following drugs are useful for treating which common medical
condition?
P r e d n i s o n e
Gold injections
M e t h o t r e x a t e
Nabumetone (Relafen)
Piroxicam (Feldene)
• Osteoarthritis
• Systemic lupus erythematosus
• Lyme disease
• Rheumatoid arthritis

A

• R h e u m a t o i d a r t h r i t i s

167
Q

Which of the following gastrointestinal drugs reduce the formation of stomach
acid by inhibiting the proton pump of the stomach parietal cells?
Select all that apply.
• Ranitidine (Zantac)
• Omeprazole (Prilosec)
• Cimetidine (Tagamet)
• Famotidine (Pepcid)
• Lansoprazole (Prevacid)

A

• Lansoprazole (Prevacid)
• Omeprazole (Prilosec)

168
Q

Which of the following drugs inhibit blood clotting by affecting the coagulation
pathway to prevent fibrin formation?
Select all that apply.
• Heparin
• Vitamin K
• Aspirin
• Clopidogrel (Plavix)
• Warfarin (Coumadin)

A

Heparin
• Warfarin (Coumadin)

169
Q

What serious dental effect is associated with the following drugs:
Zolendronic acid (Zometa)
Pamidronate (Aredia)
Risedronate (Actonel)
Ibandronate (Boniva)
Alendronate (Fosamax)
• Mucositis
• Osteonecrosis o f the jaw bone
• Angular cheilitis
• Oral yeast infection
• Xerostomia

A

Osteonecrosis of the jaw bone

170
Q

Which substance is an enzyme formed in the kidney and released into the
bloodstream where it has an important role in the formation of angiotensin?
• Plasmin
• Lysozyme
• Renin
• Heparin

171
Q

Disulfiram (Antabuse) is used in the management of:
• Nicotine abuse
• Ethanol abuse
• Opioid abuse
• NSAID abuse

A

• E t h a n o l abuse

172
Q

Antacids do not prevent the overproduction of acid.
Antacids do neutralize the acid once it is in the stomach.
• Both statements are true
• Both statements are false
• The first statement is true, the second is false
• The first statement is false, the second is true

A

• Both statements are true

173
Q

Before starting a root canal procedure on a nervous patient, he admits feeling
dizzy and having cold, clammy hands. As you reach for the anesthetic syringe,
the patient gasps and has an episode of vasovagal syncope. In managing this
patient, you will do all of the following EXCEPT one. Which one is the
EXCEPTION?
• Administration of 100% oxygen
• Use Inhaled ammonia to help patient regain consciousness
• Place the patient in a supine position
• Elevate the patients feet 30 degrees higher than his head to restore blood flow to the
brain

A

• Elevate the patients feet 30 degrees higher than his head to
restore blood flow to the b r a i n

174
Q

Ethyl alcohol (ethanol) causes a well-marked diuresis by inhibiting the
production of which hormone?
• Growth hormone
• Insulin
• Antidiuretic hormone (ADH)
• Epinephrine

A

• Antidiuretic hormone (ADH)

175
Q

Growth hormone is also called:
• Dopamine
• Aldosterone
• Vasopressin
• Somatotropin

A

• Somatotropin

176
Q

All of the following drugs are useful in the treatment of which medical
condition?
Colchicine
Indomethacin
Sulfinpyrazone
Probenecid
Allopurinol
• Colitis
• G o u t
• Jaundice
• Rheumatoid arthritis

A

• G o u t

177
Q

All of the following are catecholamines EXCEPT one. Which one is the
EXCEPTION?
• Epinephrine
• Norepinephrine
• Chlorpromazine
• Isoproterenol
• Dopamine
• Dobutamine

A

Chlorpromazine
*** Chlorpromazine is a dopamine antagonist and antipsychotic agent.

178
Q

Of the following drugs, which ones are skeletal muscle relaxants?
Select all that apply.
• Methocarbamol (Robaxin)
• Cyclobenzaprine (Flexeril)
• Baclofen (Lioresal)
• Succinylcholine (Anectine)
• Carisoprodol (Soma)
• Omeprazole (Prilosec)

A

• Methocarbamol (Robaxin)
• Cyclobenzaprine (Flexeril)
• Baclofen (Lioresal)
• Carisoprodol (Soma)
*** Succinylcholine is the prototype depolarizing neuromuscular blocking drug. Omeprazole is a
proton pump inhibitor.

179
Q

Which of the following is not a dental implication of Anti-Parkinson’s agents:
• Orthostatic hypotension with levodopa
• Xerostomia with MAO-B inhibitors
• Dyskinesia with levodopa
• Breathing difficulties with levodopa

A

• Breathing difficulties with levodopa

180
Q

Al of the following are CNS stimulants EXCEPT one. Which one is the
EXCEPTION?
• Caffeine
• Doxapram (Dopram)
• Phenobarbital
• Methylphenidate
• P h e n d i m e t r a z i n e
• Strychnine

A

• P h e n o b a r b i t a l
*** Phenobarbital is a barbiturate (sedative-hypnotic).

181
Q

The symptoms of chronic caffeine consumption can include all of the following
EXCEPT one. Which one is the EXCEPTION?
• Feelings of anxiety and nervousness
• Sleep disruption
• Coughing
• Irritability
• Diuresis
• Stomach complaints
• Palpitations and arrhythmias

A

• Coughing

182
Q

All of the following drugs are used to treat what condition?
Dexmethylphenidate (Focalin)
Extended-release methylphenidate (Concerta)
Mixed amphetamine salts (Adderal)
Atemoxetine (Strattera)
Controlled-delivery methylphenidate (Metadate CR)
Lisdexamfetamine (Vyvanse)
• I n s o m n i a in adults
• Tourette’s syndrome in children
• Attention deficit hyperactivity disorder (ADHD)
• Insomnia in children

A

• Attention deficit hyperactivity disorder (ADHD)

183
Q

Which drug belongs to the opioid family and reduces GI motility ?
• Loperamide (Imodium)
• Lorazepam (Ativan)
• Prochlorperazine (Compazine)
• Propranolol (Inderal)

A

• Loperamide (Imodium)

184
Q

All of the following are prominent toxic effects of mercury EXCEPT one. Which
one is the EXCEPTION?
• Irritability
• Xerostomia
• L o o s e n e d teeth
• G u m disorders
• Slurred speech
• Tr e m o r s

A

• X e r o s t o m i a
*** Excessive saliva is a prominent toxic effect of mercury not xerostomia

185
Q

Which one of the following is an excitatory neurotransmitter?
• Glycine
• Glutamate
• GABA (g -aminobutyric acid)
• None o f the above

A

• G l u t a m a t e

186
Q

Oral contraceptives block ovulation by inhibiting which anterior pituitary
hormones below?
Select all that apply.
• Follicle stimulating hormone (FSH)
• Growth hormone (GH)
• Thyroid stimulating hormone (TSH)
• Luteinizing hormone (LH)
• Adrenocorticotrophic hormone (ACTH)

A

• Follicle stimulating hormone (FSH)
• Luteinizing hormone (LH)

187
Q

Drugs travel through the blood stream by binding to albumin plasma protein.

However, only a small number of drugs travel through the blood stream by this mechanism.

• Both statements are true
• Both statements are false
• The first statement is true, the second is false
• The first statement is false, the second is true

A

• The first statement is true, the second is false
However, only a small number of drugs travel through the blood stream by this mechanism.❌

MOST drugs travel through the blood stream by this mechanism

188
Q

What are four criteria to consider when selecting an analgesic agent for a patient?
• Type of pain
• Location of pain
• Age of patient
• Sex of patient
• Patient’s weight
• Concurrent medication
• Pregnancy

A

• Type of pain
• Age of patient
• Concurrent medications
• Pregnancy

189
Q

Which of the following competitively blocks vitamin K-binding sites and inhibits
the synthesis of vitamin K-dependent coagulation factors VII, IX, X, and II
(prothrombin) and anticoagulant proteins C and S?
• Heparin
• Warfarin (Coumadin)
• Aspirin
• Anagrelide

A

• Warfarin (Coumadin)

190
Q

Which drugs below act to induce gene transcription, inhibit cellular growth and
alter the state of cell differentiation.
• Immune globulins
• Immunosuppressants
• Keratinocyte growth factor
• Interferons

A

• Interferons

191
Q

Granisetron (Kytril) and ondansetron (Zofran) are selective 5-HT, receptor
antagonists used to treat what condition?
• B r e a s t c a n c e r
• Osteoporosis
• Emesis caused by cancer chemotherapy
• Mucositis caused by radiation therapy

A

• Emesis caused by cancer chemotherapy

192
Q

The following drugs belong to what pharmaceutical class of agents:
Pimecrolimus
Sirolimus
Tacrolimus
• Immune modulators
• M o n o c l o n a l antibodies
• Immunosuppressants
• Interferons
• Colony stimulating factors

A

• Immunosuppressants

193
Q

Which of the following monoclonal antibodies would be useful to treat patients
with metastatic breast cancer whose tumors overexpress the HER-2 protein?
• Adalimumab
• Alefacept
• Infliximab
• Tr a s t u z u m a b

A

• Trastuzumab

194
Q

Your patient’s medication history includes modafinil (Provigil). Your patient is
probably using this drug in order to:
• Improve wakefulness during daytime sleepiness
• Improve salivary flow in dry mouth disorders
• Manage psychotic disorder
• Treat mental depression

A

• Improve wakefulness during daytime sleepiness

195
Q

Which herbal supplement below is known to be somewhat effective in treating
mild forms of mental depression?
• Ginkgo biloba
• St. Johns Wort
• Garlic
• Echinacea
• Ginseng

A

• St. Johns Wort

196
Q

St. Johns Wort is a herbal supplement which can interact with some
conventional medications to:
• Increase the effectiveness of medications
• Decrease the effectiveness of medications
• Increase the toxicity of medications

A

• Decrease the effectiveness of medications

197
Q

All of the following drugs are serotonin 5-HTip receptor agonists used to treat
nigraines EXCEPT one. Which one is the EXCEPTION?
• Sumatriptan (Imitrex)
• Frovatriptan (Frova)
• Naratriptan (Amerge)
• Donepezil (Aricept)
• Rizatriptan (Maxalt)
• Almotriptan (Axert)
• Zolmitriptan (Zomig)

A

• Donepezil (Aricept)
*** Donepezil (Aricept) is a cholinesterase inhibitor used in the treatment of Alzheimer’s
disease.

198
Q

All of the following are drugs used to treat hypothyroidism EXCEPT one. Which
one is the EXCEPTION?
• Levothyroxine sodium (Synthroid)
• Liothyronine (Cytomel)
• Liotrix (Thyrolar)
• Methimazole (Tapazole)

A

• Methimazole (Tapazole)

199
Q

Nicotine is rapidly absorbed across the pulmonary capillary membrane and is
delivered to the brain in high concentration within seconds of inhalation.
The nasal spray has the fastest delivery of the NRTs and more closely resembles
the onset of the nicotine effects of smoking.
• Both statements are true
• Both statements are false
• The first statement is true, the second is false
• The first statement is false, the second is true

A

• Both statements are true

200
Q

Opioid drugs are very effective analgesics and anti-inflammatories for oral
surgery procedures.

Additionally, they are effective antidiarrheal and antitussive agents.
• Both statements are true
• Both statements are false
• The first statement is true, the second statement is false
• The first statement is false, the second statement is true

A

• The first statement is false, the second statement is true
Opioid drugs are very effective analgesics and anti-inflammatories for oral
surgery procedures❌
Opioid drugs are very effective analgesics but DO NOT have anti-inflammatory properties.

201
Q

Which drug is the standard to which all opiates (narcotics) are compared?
• Codeine
• Oxycodone
• Hydrocodone
• Meperidine
• Morphine
• Fentanyl

A

• Morphine

202
Q

Which adverse effect is associated with opioid analgesics and not non-narcotic
pain relievers?
• Allergic response
• Nausea
• Vomiting
• Respiratory depression

A

• Respiratory depression

203
Q

Which of the following is commonly used as an analgesic in a patient exhibiting
an opioid dependence?
• Morphine
• Meperidine
• Methadone
• Codeine

A

• M e t h a d o n e

204
Q

Which drug is the prototype opioid antagonist?
• Morphine
• Naloxone
• Propranolol
• Ibuprofen

A

• N a l o x o n e

205
Q

The central nervous system contains three types of endogenous opioids.
Which one of the following is NOT one of them?
• Beta-endorphins
• Morphine
• Enkephalins
• Dynorphins

A

• Morphine

206
Q

Please match the following narcotic analgesies with their commonly prescribed brand name.

  1. Hydrocodone and acetaminiphen
  2. Codeine and acetaminophen
  3. Oxycodone with acetaminophen
  4. IV Fentanyl

A. Vicodin
B. Percocet
C. Tylenol #3
D. Sublimaze

A
  1. Hydrocodone and acetaminiphen—Vicodin
  2. Codeine and acetaminophen—Tylenol #3
  3. Oxycodone with acetaminophen—Percocet
  4. IV Fentanyl—Sublimaze
207
Q

Which of the following analgesics may interact with warfarin (Coumadin) to
cause increased bleeding?
Select all that apply.
• Acetaminophen
• Ibuprofen
• Hydrocodone with acetaminophen
• Aspirin
• Oxycodone with acetaminophen

A

• Ibuprofen
• Aspirin

208
Q

Your patient has a history of neuropathic pain. They are currently taking
oxycodone (OxyContin), which is an opiate analgesic. Which of the following are
adverse effects of oxycodone?
Select all that apply.
• Nausea
• Peptic ulcers
• Insomnia
• Constipation
• Xerostomia
• Excessive perspiration

A

• N a u s e a
• Constipation

209
Q

Which drug is a synthetic opioid analgesic used as an intravenous sedative and
is more potent than morphine?
• Meperidine (Demerol)
• Pentazocine (Talwin)
• Propoxyphene (Darvon)
• Fentanyl

A

• Fentanyl

210
Q

Al of the following analgesics can produce drug dependence and addiction
EXCEPT one. Which one is the EXCEPTION?
• Codeine
• Morphine
• Hydrocodone
• Meperidine (Demerol)
• Oxycodone
• Voltaren

A

• Vo l t a r e n
*** Voltaren is an NSAID, which as a class of drugs, do not produce drug dependence
and addiction.

211
Q

All of the following sites are generally accepted for IM injections EXCEPT one.
Which one is the EXCEPTION?
• The buttocks
• The biceps muscle
• The deltoid muscle
• The anterior thigh

A

• The biceps muscle
*** For young children, the anterior thigh is usually the place to give IM injections.

212
Q

Naloxone is a drug given in the case of an opioid overdose. The mechanism of
action of this particular drug is to displace an opioid drug from its U-opioid
receptor, thereby decreasing its effect on the CNS. This drug is an example of
a / a n :
• Partial agonist
• Non-competitive antagonist
• Competitive antagonist
• Agonist

A

• Competitive antagonist

213
Q

Which of the following routes of drug administration is generally used for local
drug effects?
• Topical administration
• Oral ingestion
• Subcutaneous injection
• Intravenous injection

A

• Topical administration

214
Q

The process which involves the coupling of drugs to molecules like glucuronic
acid to make them more easily excreted from the body is called:
• Conjugation
• Oxidation
• Addition
• Sublimination

A

• Conjugation

215
Q

Implicit in the interaction of a drug with its physiological receptor is that the
drug _create effects, but rather, modulates physiolog-
ical cell functions.
• does; extrinsic
• does not; extrinsic
• does; intrinsic
• does not; intrinsic

A

• does not; intrinsic

216
Q

The safest and easiest route for drug administration is:
• Oral
• IV
• Rectal
• Inhalation

A

• Oral — *** abbreviated P.O.

217
Q

The majority of drugs penetrate biomembranes by
membrane phospholipids.
terms/definitions
through
• active transport
• facilitated diffusion
• filtration
• simple diffusion

A

• simple diffusion

218
Q

A tablespoon can hold what volume of liquid?
• 5 milliliters
• 10 milliliters
• 15 milliliters
• 20 milliliters

A

• 15 milliliters

219
Q

Which of the following drugs are known to produce orthostatic hypotension as
an adverse reaction.
Select all that apply.
• Levodopa (Larodopa, Dopar)
• Prazosin (Minipress)
• Indomethacin (Indocin)
• Morphine

A

• Levodopa (Larodopa, Dopar)
• Prazosin (Minipress)
• Morphine

220
Q

Pain that has no organic basis and is fixed upon some portion of the anatomy is
referred to as:
• Intractable pain
• Referred pain
• Psychogenic pain
• Phantom pain

A

• Phantom pain
*** For example, the sensation of pain felt in a limb, although that limb has been
amputated.

221
Q

Which of the following drugs would require a written prescription signed by a
health professional in order to be filled at the pharmacy?
• Lorazepam (Ativan)
• Chloral hydrate
• Hydrocodone
• Acetaminiphen

A

• Hydrocodone

222
Q

A drug with a low LDs0 and a high EDso has a:
• High therapeutic index and is, therefore, very dangerous
• High therapeutic index and is, therefore, relatively safe
• Low therapeutic index and is, therefore, very dangerous
• Low therapeutic index and is, therefore, relatively safe

A

• Low therapeutic index and is, therefore, very dangerous

223
Q

Which route of administration of a drug listed below is most known for its
significant hepatic “first pass” metabolism?
• Intramuscular
• Inhalation
• Sublingual
• Oral

A

• O r a l

224
Q

The term bioavailability of a drug refers to:
• The movement of a drug into the body tissues over time
• The dissolution of a drug in the GI tract
• The measurement of the rate and amount of therapeutically active drug that reaches
t h e s y s t e m i c c i r c u l a t i o n
• The relationship between the physical and chemical properties of a drug and the
systemic absorption of the drug
• The amount of drug destroyed by the liver prior to systemic absorption from the GI
tract

A

• The measurement of the rate and amount of therapeutically
active drug that reaches the systemic circulation

225
Q

Factors influencing hepatic drug metabolism include which of the following?
• Microsomal enzyme inhibition
• Microsomal enzyme induction
• Plasma protein binding
• Genetic factors
• Liver disease
• A l l o f the a b o v e

A

• All of the above

226
Q

Drugs can be actively eliminated from the body through one of several renal
mechanisms. Which of the following is not a method of elimination?
• Glomerular filtration
• Microsomal enzyme induction
• Renal tubular reabsorption
• Active transport through renal tubular cells

A

Microsomal enzyme induction

227
Q

The average time for the onset of drug effect after intramuscular administration
is approximately:
• Immediate
• 5 minutes
• 15 m i n u t e s
• 3 0 m i n u t e s

A

• 5 minutes

228
Q

Which term is a compulsive, uncontrollable dependence on a substance, habit or
practice to such a degree that cessation causes severe emotional, mental or
physiological reactions?
• Habituation
• Tolerance
• Addiction
• N o n e o f the a b o v e

A

• Addiction

229
Q

Which route of drug administration will there be the greatest bioavailability and
most rapid onset of pharmacological effect?
• Oral administration
• Subcutaneous injection
• Intravenous injection
• Intramuscular injection

A

• Intravenous injection

230
Q

When a drug is administered repeatedly, a higher concentration of the drug than
is desired may be achieved. The effect of this excessive accumulation is known as:
• Additive effect
• Synergistic response
• Cumulative action
• Idiosyncrasy

A

• C u m u l a t i v e action

231
Q

The Controlled Substance Act of 1970 uses which criteria for inclusion of a drug
into one of the five schedules?
• Potential for abuse
• Medical usefulness
• Degree to which it produces physiological dependence
• Degree to which it produces physical dependence
• All of the above

A

• All of the above

232
Q

A drug that binds to its target receptor tightly but produces a small biological
effect on the cell is said to have:
• Low affinity, high intrinsic activity
• High affinity, high intrinsic activity
• Low affinity, low intrinsic activity
• High affinity, low intrinsic activity

A

• High affinity, low intrinsic activity

233
Q

When two drugs having similar effects are administered in combination, and the
resulting response is the sum of the individual actions of each drug when given
lone, then this result is referred to as:
• An additive effect
• A synergistic response
• An antagonistic effect
• C u m u l a t i v e action

A

A n a d d i t i v e e ff e c t

H. Pharmacology (3 decks)

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