EXAM FOUR Flashcards
The majority of drugs are absorbed from the GI tract by the process of
passive lipid diffusion
Dexamethasone (Decadron)
is used for the diagnosis of Cushing’s syndrome
Which of the following is the drug of choice for the treatment of acute adrenocorticol insufficiency?
fludrocortisone (Florinef)
Which of the following drugs is used for the long-term mgmt of hypothyroidism?
levothyroxine (Synthroid, L-T4)
Which of the following is the drug of choice for the treatment of thyroid storm?
propranolol (inderal)
Tamoxifen (Nolvadex)
is a selective estrogen receptor modulator (SERM)
Which of the following contraceptives increases the risk of thrombus formation?
the transdermal patch containing ethinyl estradiol and norelgestromin (Ortho evra)
Clomiphene citrate
induces ovulation
Which of the following drugs prevents osteoporosis in postmenopausal women?
raloxifene (Evista)
Dexamethasone (Decadron)
ALL (is used for the diagnosis of Cushing’s, does not bind to corticosteroid-binding-globulin, has maximal anti-inflammatory activity and minimal salt-retaining activity)
? prevents parietal cell acid secretion by antagonism of the H2-histamine receptor subtype
Cimetidine (Tagament)
? Protects the GI mucosa from attack by pepsin and acid
Colloidal bismuth compound (Pepto-Bismol)
? Prevents parietal cell acid secretion by direct inhibition of a proton-potassium ATPase
Omeprazole (Prilosec)
? Is a gallstone dissolution agent who’s use was first described in compendiums of 7th century Chinese folk medicine, and is presumably the active ingredient of dried gallbladders taken from the Himalayan bear
ursodiol (Tagamet) (one test had amoxicillin as the answer)
? Convulsant effects are due to GABA receptor antagonism
picrotoxin
? May induce long-term depletion of brain serotonin
MDMA
? Induces a high incidence of emergence delirium
Phencyclidine
Drug X is being tested against the standard chemotherapeutic regimen currently used to treat pancreatic cancer. Initial results of the clinical trial show reduced metastases, indicating potential clinical benefit of drug X. Investigators are considering filing a new drug application (NDA) as their next step. Drug X is currently in what phase of clinical trials?
Phase III
A drug that has a high potential for abuse, an approved medical use in the US, and for which no automatic refills can be prescribed is placed in which class of controlled substances?
Schedule II
Which of the following must be submitted to the FDA to receive investigational new drug (IND) status?
All (a. chemical synthesis protocols for making the drug,b. informed consent for studies performed in humans, c. toxicology studies performed in animals)
Phase I clinical trials serve to
establish the maximum tolerated dose and safety
A drug that has a high potential for abuse, and no federally recognized medical use, is placed in which class of controlled substance?
Schedule I
Which of the following drugs is not appropriate for tx of GERD?
Ioperamide (Imodium) / (other choices were Tagamet, Mylanta, antimicrobials to eliminate helicobacter pylori)
The federal agency that regulates the advertising of prescription drugs is the
Food and Drug Administration
The Food and Drug administration regulates all of the following EXCEPT the
Importation of Schedule II drugs (it regulates development of new prescription drugs, approval of new prescription drugs, marketing of prescription drugs, advertising of prescription drugs
? A competitive antagonist at histamine H2 receptors
Cimetidine (Tagament)
? A noncompetitive inhibitor of the “proton pump”, a prodrug which requires an acidic environment for conversion to its active form
Omeprazole (Prilosec)
? Physically protects the stomach mucosal lining by selectively binding to damaged surfaces
Sucralfate (Carafate)
T/F According to federal law, Schedule 1 drugs can only be prescribed for life threatening diseases
FALSE
T/F Phase I clinical trials involve laboratory animal testing to assess the safety and biological activity of new drugs
FALSE
T/F The Food and Drug Administration requires data demonstrating the bioavailability, safety, and efficacy of a new prescription drug
TRUE
Raloxifene (Evista)
has the properties of B and C (B. reduced the risk of breast and uterine cancers C. prevents postmenopausal osteoporosis)
Which of the following contraceptives in contraindicated in women older than 35 who smoke?
the transdermal patch containing ethinyl estradiol and norelgestromin (Ortho evra)
Clomiphene citrate
induces ovulation AND is an estrogen receptor antagonist
? Has the highest anti-inflammatory activity of the drugs listed above
Dexamethasone (Decadron)
? Is an antagonist for the aldosterone receptor
Spironolactone (Aldactone)
? Is the drug of choice for the tx of acute adrenocorticol insufficiency
hydrocortisone (cortef)
? Inhibits the production of all adrenal steroids
Aminoglutethimide (Cytadren)
T/F Contraceptives combining estrogen and progestin may increase the risk of blood clots in older women who smoke
FALSE
T/F Clomiphene citrate (Clomid) is a progesterone receptor antagonist used for medical abortion
FALSE
Medroxyprogesterone acetate (Depo-Provera)
has an extended half-life compared to progesterone
? Is an agonist for the mineralocorticoid receptor
fludrocortisone (Florinef)
Molecular targets for antibiotic agents include
all of the above (a. bacterial call wall synthesis, b. bacterial ribosomes, c. bacterial DNA gyrases)
Common mechanisms by which bacteria develop resistance to beta-lactam antibiotic drugs include
both A and B (a. spontaneous mutations in the transpeptidases resulting in loss of drug binding b. beta-lactamases that inactivate the drug)
A beta-lactam antibiotic that is effective only against Gram(-) bacteria is
aztreonam (Azactam)
This antibiotic agent is used most commonly as a surgical prophylaxis to prevent post-op infections
ceftriaxone (Rocephin)
This bacterial agent was developed recently (2005) to treat bacterial strains that are resistant to most established antibiotics including MRSA and VR strains
tigecycline (Tygacil)
This bacterial agent has been used for decades as the tx of choice for MRSA
vancomycin (Vancocin)
This bacteriocidal agent acts of lipids of Gram(-) bacteria to lyse their outer lipid bilayer membrane
polymyxin B (Aerosporin)
Which one of the following cell cycle phases is inhibited by cancer chemotherapy drugs?
S
The term “targeted cancer therapy” refers to which of the following?
Drugs that selectively target cancer-associated molecules
Which of the following describes a mechanism by which a non-specific chemotherapy agent blocks DNA replication?
A drug is a structural analog of a nucleotide required for DNA synthesis
Which of the following is an example of an endocrine therapy for cancer treatment?
Drugs that block the activity of aromatase
Which of the following factors affects the amount of drug that crosses the placenta?
All (A. levels and activates of placental enzymes that metabolize the drug B. lipid solubility of the drug c. the molecular weight of the drug)
Based on the FDA’s drug-in-pregnancy rating scale, a category X drug
is contraindicated during pregnancy
A pregnant woman consumes a teratogenic agent during weeks 30 to 35 of fetal development. Which of the following fetal defects is most likely to occur?
growth retardation
Cocaine and tobacco-associated intrauterine growth retardation occur due to which of the following mechanisms?
restriction of uterine blood vessels
? Inhibits bacterial DNA gyrase
Ciprofloxacin (Cipro)
? Is a sulfonamide rapidly absorbed by the body and used for the tx of systemic bacterial infections
Sulfsoxaxole (Gantrisin)
? Is a combination of trimethoprim (Primsol) with sulfamethoxazole
Co-trimoxazole (Bactrim)
? Is a aminoglycoside for the tx of patients with TB
Streptomycin
? Inhibits mycobacterial cell wall biosynthesis
Isoniazid (INH)
? Is the first choice of aminoglycosides due to its low cost and reliable activity
Gentamicin (Garamycin)
? Requires herpes viral kinase for activation of its antiviral activity
Acyclovir (Zovirax)
? Inhibits influenza A infection by binding to the viral M2 protein
Amantadine (Symmetrel)
? Is a triazole used in the tx of fungal meningitis
Fluconazole (Diflucan)
? Blocks the biosynthesis of the fungal cell wall
Caspofungin (Cancidas)
T/F A future stategy to circumvent bacterial resistance to antibiotic drugs might involve inhibiting bacterial signalling by quorum-sensing
TRUE
T/F Sulfonamides are bacterial folate synthesis inhibitors
TRUE
T/F For treating multidrug resistant TB patients, “compound drug therapy”/combination therapy is optional
FALSE
The antibacterial action of vancomycin (Vancocin) is due to its inhibition of bacterial
cell wall synthesis
The antibacterial action of azithromycin (Zithromax) is due to its inhibition of bacterial
protein synthesis
Which of of the following drugs is useful for the tx of bacterial infections due to either MRSA or VRE?
daptomycin (Cydectin)
Which of the following stategies is being used to develop future drugs that will combat bacterial strains resistant to current drugs?
All (A, develop new synthetic drugs based on old drugs B. search for new natural antibiotics, C. identify new target proteins from the sequenced genomes of resistant bacteria D. Target quorum sensing signaling bt bacteria)
An antibiotic that kills only Gram(-) bacteria is classified as
bacteriocidal, narrow-spectrum
Cancer chemotherapy targets which of the following cell cycle phases?
Both A and B (A. DNA synthesis (S phase) B. Mitosis (M phase))
Which one of the following statements regarding the anti-cancer activity of tamoxifen (Novaldex) is true?
Tamoxifen is a selective estrogen receptor modulator that binds to the estrogen receptor)
Which one of the following drugs is a monoclonal antibody against human epidermal growth factor receptor 2?
Trastuzamab (Herceptin)
Which of the following statement(s) is true for cancer chemotherapeutic drugs that block DNA syntheses (S phase)
All. A, They may be structural analogs of nucleotides B They may be structural analogs of molecules needed for the synthesis of nucleotides C. They may physically bind DNA and deform its structure)
Which of the following statements is true regarding drugs and teratogenesis?
The greater the drug exposure, the more sever the detrimental effects are on the developing fetus.
? Is a fluoroquinolone that is used to treat inhalational anthrax
Ciprofloxacin (Cipro)
? Is a highly soluble sulfonamide used for the treatment of urinary tract infections
Sulfsoxaxole (Gantrisin)
? Is a poorly absorbed sulfonamide used for the tx of inflammatory bowel disorders
Sulfasalazine (Azulfidine)
? Is a semisynthetic product of kanamycin with decreased tendency for developing drug resistance
Ethambutol (Myambutol)
? Inhibits the synthesis of mycolic acid, an essential component in mycobacterial cell wall
Isoniazid (INH)
? Is a first-line antiTB agent that inhibits DNA-dependent RNA polymerase in prokaryotic cells
Rifampin (Rifadin)
? Is the most commonly used aminoglycoside due to its low cost and reliable antibacterial activity
Gentamicin (Garamycin)
T/F Bacterial resistance to antibiotics emerged only recently due entirely to the indiscriminant overuse of antibiotics by humans
FALSE
T/F Nearly 15% of americans experience some form of allergic rxn to the Batalactam antibiotics
TRUE
T/F Due to its exceptionally broad-spectrum of activity, imipenem/cilastatin (Primaxin) is recommended for use as a first line drug of choice for most bacterial infections
FALSE
T/F Amantadine (Symmtrel) targets the M2 protein of the influenza A virus
TRUE
T/F For the tx of herpes simplex virus infections, acyclovis (Zovirax) requires viral thymidine kinase for activation
TRUE
T/F Fluconazole (Diflucan) is used in the tx of fungal meningitis
TRUE
T/F Amphotericin B (Amphocin) inhibits the biosynthesis of ergosterol in the fungal cell membrane
FALSE
Which of the following factors significantly contributes to the development of antibiotic drug resistance?
Agricultural feedlots
Which of the following mechanisms contributes to the anti-cancer activity of aromatase inhibitors?
inhibition of estrogen production
Which of the following drugs is a monoclonal antibody against vascular endothelial growth factor?
bevacizumab (Avastin)
Based on the FDA’s drug-in-pregnancy rating scale, which of the following drugs is an example of a category X drug?
Thalidomide (Thalomid)
? Used historically as an important alternative tx for MRSA
vancomycin (Vancocin)
? A semi-synthetic, extended spectrum Beta-lactam antibiotic of the penicillin family
Amoxacillin/clavulante (Augmentin)
? Used most commonly as a prophylactic against opportunistic bacterial infections following surgery
Cephtriaxone (Rhocephine)
? A safe, broad spectrum antibiotic that binds to the 50S robisomal subunit to inhibit protein synthesis
Azithromycin (Zithromax)
? A new generation antibiotic that is effective for the treatment of Gram postive skin infections due to MRSA and VRE
daptomycin (Cydectin)
? A drug-of-choice for infections due to intracellular bacteria such as chlamydia
Minocycline (Minocin)
? A fluoroquinolone that blocks bacterial DNA gyrase
Ciprofloxacin (Cipro)
? A sulfonamide rapidly absorbed by the body and used for tx of systemic bacterial infections
Sulfisoxazole (Gantrisin)
? Is an aminoglycoside for tx of TB
Streptomycin
? Is a broad spectrum antibacterial agent with activity against mycobacterium tb
Rifampin (Rifadin)
? Binds to the viral M2 protein and inhibits the uncoating step during viral infection
Amantadine (Symmetrel)
T/F a drug induced fever can be a common late allergic rxn to long-course tx with beta-lactam antibiotics
TRUE
An example of a phase-non-specific drugs is
cisplatin (Platinol)
Which of the following mechanisms contributes to the anti-cancer activity of anthracyclines?
Anthracycline inhibition of topoisomerase II
Bleomycin-associated pulmonary fibrosis is likely to occur due to which of the following mechanisms?
Bleomycin hydrolase is not expressed in lung tissue
Tobacco-associated intrauterine growth retardation occurs due to which of the following mechanisms?
restriction of uterine blood vessels
Hydrocortisone (Cortef)
can activate both the glucocorticoid receptor and the mineralocorticoid receptor
Which of the following is an antagonist of the aldosterone receptor?
Spironolactone (Aldactone)
The antibacterial action of minocycline (Minocin) is due to its inhibition of bacterial
protein synthesis
The antibacterial action of amoxicillin/clavulanate (Augmentin) is due to its inhibition of bacterial
cell-wall synthesis
The antibacterial action of Cefepime (Maxiprime) is due to its inhibition of bacterial
cell wall synthesis
The antibacterial action of bacitracin (Baciguent) is due to its inhibition of
cell wall synthesis
Which of the following drugs is useful for the treatment of Gram-positive bacterial infections of MRSA?
vancomycin (Vancocin)
? Inhibits two steps in the bacterial folate biosynthesis pathway
Co-trimoxazole (Bactrim)
? Inhibits bacterial dihydrofolate reductase
Trimethoprim (Primsol)
? Blocks fungal cell wall biosynthesis through inhibiting glucan synthase
Caspofungin (Cancidas)
T/F Drug induced fever is a common allergic reaction to a long-term treatment with Beta-lactam antibiotics
TRUE
T/F The addition of antibiotics to livestock food in large-scale agricultural feedlots is a major contributor to community-acquired resistant strains of bacteria
TRUE
T/F Future strategies to circumvent antibiotic resistance include the development of new drugs that challenge bug survival (ei that are bactericidal)
FALSE
A semi-synthetic, broad spectrum beta-lactam antibiotic is
Amoxacillin/clavulante (Augmentin)
This bacterial agent was developed recently to treat bacterial strains that are resistant to most establised antibiotics
daptomycin (Cydectin)
The “fractional cell kill” or “log kill” hypothesis of cancer chemotherapy refers to the concept that
Both A and B are correct (A. a set drug concentration given for a defined period of time will kill a constant percentage of cells, independent of the absolute number of cells B. chemotherapy theoretically never reduces the tumor cell population to zero)
Antimicrotubule drugs are effective chemotherapy agents bc they
interfere with tubulin polymerization or mircrotubule depolymerization
? Is a DNA gyrase inhibitor used in the tx of inhalational anthrax infection
Ciprofloxacin (Cipro)
? Is derived from kanamycin with decreased tendency for drug resistance
Amikacin (Amikin)
? Is used for the tx of infections by influenza A virus
Amantadine (Symmetrel)
? Is a glucan synthase inhibitor that blocks fungal cell wall biosynthesis
Caspofungin (Cancidas)
? Targets ergosterol in the fungal cell membrane, leading to channel formation and the loss of intracellular constituents
Amphotericin B (Amphocin)
? Is only activated in cells that are infected with herpes simplex virus
Acyclovir (Zovirax)
? Is able to cross the blood-brain barrier for the tx of primary brain tumors
Carmustine (BCNU)
? Is used for the treatment of breast cancer patients only when their tumor epidermal growth factor receptor 2 (HER2) is overexpressed
Doxorubicin (Adriamycin)
? Stabilizes polymerized microtubles, leading to mitotic arrest
Paclitaxel (Taxol)
? Inhibits thymidylate synthase in tumor cells
Fluorouracil (5-FU)
? Blocks peptidoglycan cross-linking during bacterial cell wall synthesis
Amoxacillin/clavulante (Augmentin)
? Is primarily responsible for bacterial resistance to both penicillins and cephalosporins
beta-lactamase
? Was developed recently for use in specific cases to treat Gram-positive bacterial infections that are resistant to vancomycin
daptomycin (Cydectin)
? Binds the 30S ribosome to inhibit protein synthesis in many Gram-positive and Gram-negative bacterial strains
Minocycline (Minocin)
T/F Fludrocortisone (Florinef) is used for the tx of acute adrenocortical insufficiency
TRUE
T/F Spironolactone (Aldactone) is an antagonist for the aldosterone receptor
TRUE
T/F Gram-negative bacteria contain a thick outer cell wall and a single lipid bilayer
FALSE
T/F Sirolimus blocks the response of T cells to cytokines
TRUE
T/F Weeks 2-8 of human embryonic development are the least sensitive to teratogenic agents
FALSE
T/F Most drugs can be teratogenic if given at the right time and dose to a susceptible host
TRUE
T/F Thalidomide is an example of a delayed teratogen
FALSE
? A strong, or high ceiling, diuretic used to treat chronic and/or severe volume exapanded conditions; for example, edema associated with organ failure
Furosemide (Lasix)
? A low ceiling diuretic that inhibits Na-Cl cotransporter in the distal tubule
Hydrochlorothiazide (Hydrodiuil)
? A weak diuretic that inhibits carbonic anhydrase in the proximal tubule to inhibit bicarbonate reabsorption
Acetazolamide (Diamox)
? An osmotic diuretic that works in the proximal tuble and descending loop of Henle, has a fase onset of action and is used in acute situation such as cerebral edema
Mannitol
? A potassium sparing adjuvant diuretic that is an antagonist of collecting duct aldosterone receptors
Spironolactone (Aldactone)