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Pharm > Final Exam > Flashcards

Final Exam Flashcards

1
Q

Police officers respond to a young man running through a backyard and he’s climbing over fences – toxicology shows which of the following substances

a. Anabuse
b. Lorazepam
c. Ectascy

A

Ectascy (MDMA/Molly)

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2
Q

Sitagliptin works by what mechanism?

A

Dipeptidyl Peptidase-4 INHIBITOR

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3
Q

Patient is taking both Glipizide, a Sulfonylurea, and Acarbose, a alpha gluocosidase inhibitor and he’s got super hypoglycemic reaction – what do we want to help that

a. Juice
b. Chocoloate cereal bar
c. Litre of pop
d. Glucose tablet

A

Glucose tablet

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4
Q

Liraglutide. The generic suffix for a GLP1 inhibitor is “Gluitide.” What is the MOA?

A

Glucagon Like Peptide – aka a GLP1 agonists – act like incretins which increase the production of insulin in response to high blood glucose. Above we said that DPP4 inhibitors block DPP4, which degrade incretin.

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5
Q

Brand new diabetic patient – what’s the first thing we are going to put him on?

A

a. Metformin (Glucophage)

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6
Q

Finasteride – endocrine lecture – works by what?

a. Potent inhibitor of osteoclasts
b. Monoclonal antibody
c. Inhibits PTH
d. Blocks ovulation
e. Inhibits 5-alpha-reductase which shrinks the prostate

A

Inhibits 5-alpha-reductase which shrinks the prostate

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7
Q

Zovorax/Acyclovir – what do you think?

A

Herpes (HVS1-cold sores) (HVS2-genetal)

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8
Q

What is the main HIV drug?

a. Norvile
b. Cobicistat aka Stribild
c. Evlostaz -
d. Steva
e. Cemetro

A

Cobicistat aka Stribild, which is a four combo drug that has elvitegavir/cobicistat/emtricitabine/tenofovir

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9
Q

Got someone with parkinsons disease and on Carbadopa/levodopa?

a. Dental pain
b. Allergy
c. Severe shaking
d. Osteonecrosis
e. Limit epinephrine

A

Limit epinephrine – because it increases dopamine and dopamine is a precursor for norepi

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10
Q

Flomax/Hytrin(terazosin) are used for benign prostate hypertrophy and their main side effect is what?

A

Orthostatic hypotension

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11
Q

Olanzapine or Zyprexa is a second generational antipsychotic – what concerns with dental care should we be worried about?

a. Increase xerostomia gingivitis tardive dyskinesia
b. Qt prolongation
c. Weight loss
d. Liver toxicity
e. Patient undergoes some sort of electroconvulsive therapy

A

Increase xerostomia gingivitis tardive dyskinesia

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12
Q

Brand new patient – allergy to sulfur – if we want to do local anesthetic – when we put epinephrine in an ampule, what else do we put in there? so what would we give?

A

Metabisulfites as an antioxidant – so if allergic, avoid epinephrine
– GIVE Mepivacaine without epinephrine

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13
Q

Neuramidase enzyme that helps clip the virus from the cell as it’s leaving the cell and causes it to go out and infect other cells. We have inhibitors of that to treat Influenza A or B infections. Best neuroamididase inhibitor?

a. Tamiflu
b. Adenovir
c. Cyclophosphomaide
d. Atenovir

A

tamiflu

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14
Q

Treating with antihypertensives – which one would most likely cause gingivla hyperplasia

a. Calcium channel blockers
b. ACE inhibitors
c. Alpha blockers
d. ARBs

A

Calcium channel blockers

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15
Q

Zyrtec is a second generation – Benadryl is first generation – what’s the advantage of Zyrtec over first generation?

A

Non-drowsy

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16
Q

We’ve got a drug effective for cold sores – herpes simplex 1 – would that be

a. Betamethazones
b. Benzocaine
c. Estrogen
d. Hydrocortisone
e. Docusonla
f. Aberva

A

Aberva

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17
Q

Someone is using a corticode steroid inhaler – after they take a dose, what should they do?

A

Rinse mouth to prevent candida or any sort of fungal infection

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18
Q

Rapid acting insulin that has a quick onset – 15 minutes peak, 2-5 hours duration –

a. Humilin regular
b. Insulin glargine
c. NPH
d. aspartate

A

aspartate (Novolog) is short acting

AVOID insulin glargine – this is the only one you want to avoid because that’s long term

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19
Q

Nonselective beta blocker – where could that be a problem

a. Hypertension
b. Depression
c. Headache
d. Bronchial asthma
e. Panic disorder

A

Bronchial asthma

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20
Q

A young man has epilepsy and overgrowth of gingival tissues – lots of gum growth – which of the following drugs could cause a problem?

a. Furosamide
b. Risoloft – Zoloft
c. dilantin

A

dilantin

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21
Q

Main problem or complaint that a patient would have after taking an anti-histamine for a long time. They have sleeping disorder and medicate themselves to help them go to sleep – first generation – so they’re taking it for a long

a. Diarrhea
b. Hypertension
c. Jaw pain
d. Oral ulcers
e. Dry mouth

A

a. Dry mouth – Anti-histamine H1 inhibitors are notorious for their anticholinergic effects

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22
Q

So if you have a drug that is highly bound to an albumin – take another drug that displacing that – what is that going to do to the drug – drug displacement, what is that called? When it becomes unbound to albumin

a. Decrease the drug effect
b. Increase the drug effect

A

Increase the drug effect

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23
Q

Which one causes bruxism?

a. Antihistamines
b. Antidepressents
c. Antipsychotics
d. Antihypertensives
e. Anti-axnity

A

Antidepressents* – these increase serotonin but they also increase nor-epi and that’ll be the main cause
— Antipsychotics – close, it increases dopamine and that could lead to bruxism too but

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24
Q

Xanax is what class of drugs

a. Benzos
b. Antihistamine
c. Loop direutic
d. Beta blocker

A

Benzos

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25
Q

Viagra is what for

a. post-menopause
b. endometrious
c. hypothyroidism
d. erectile dysfunction

A

erectile dysfunction

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26
Q

Diabetic patient that is treated with insulin and that’s on medical record. What is the main concern with insulin treatment?

a. Anorexia
b. Hypertension
c. Hypoglycemia
d. Increased bleeding
e. Salivation

A

Hypoglycemia

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27
Q

Got someone that is a diabetic, and have to take another drug and if they take this certain drug, we are worried about their glucose control?

a. Benzos
b. Bisphosphonates
c. Protease inhibitrs
d. Antihistamines
e. Corticosteroids

A

Corticosteroids

28
Q

What’s the best treatment for HepC to bring it down to a viral load of nondectable, which is essentially a cure

a. Truvada
b. INdurin
c. Denovir
d. Variadic
e. Harvoni

A

Harvoni

29
Q

Somebody comes in, increased heart rate, peforated nasal septum

A

cocaine

30
Q

Methotrexate

a. Inhibit angiogenesis
b. Stimulate macrophage
c. Inhibit myospindle fiber formation
d. Inihibit dihydrofolate reductase (DHF)

A

Inihibit dihydrofolate reductase (DHF) –We need folate for DNA synthesis

31
Q

What may occur is someone just happens to take a few marijuana/cannibus?

a. Decrease appetite
b. Induce nausea and vomiting
c. Increase cognitive
d. Cause miosis
e. Decrease coordinating and motor imparement

A

Decrease coordinating and motor imparement

32
Q

Used for breast cancer – which of the following?

a. Cylcophosphomade
b. Vinblastine
c. Pacletaxol
d. Trestuzumab

A

Trestuzumab (HERCEPTIN) – MAB means monoclonal antibody

33
Q

This drug is classified antitumor antibiotic and has an FDA black box warning of potentially causing severe myelosurpression and myocardiotoxicity

A

Answer: Doxorubicin

Methotrexate is NOT the answer

34
Q

Describe MOA cyclophosphamide

a. Inhibits estrogen
b. Inhibits mitotoic spindle
c. Angiogenesis
d. Alkalytes DNA and leads to DNA strand breaks

A

Alkalytes DNA and leads to DNA strand breaks

35
Q

What condition accounts for sudden sniffing death syndrome

a. Hyperthermia
b. Hyperventilation
c. Dehydration
d. Hypertension
e. Cardiac arrythmia

A

Cardiac arrythmia (bc of sudden sniffing death syndrome)

36
Q

Naltrexone works in alcohol dependence by what – what does it inhibit

a. Mu receptors in opioid binding
b. Inhibits alcohol absorption
c. Inhibits metabolism alcohol
d. Increase endorphin release
e. Inhibit the rewarding and craving effects of alcohol

A

Inhibit the rewarding and craving effects of alcohol

37
Q

Which if the following anticancer rugs by inhibit angiogenesis – this is the new production of capillaries and other type of blood access to the for the cell aaaand just to increase the vascular synthesis around the cancer drug right so you wanna inhibit that

A

AVASTIN is vascular that’s the one you want to go with – not

i. Novadex
ii. F5u
iii. Taxol

38
Q

Anti-viral drug that inhibits viral penetration is is used more for parkinsons disease

a. Valacyclovir – very similar to acyclovir
b. Amantadine - Cemetrel
c. AZT – discontinued next year – first HIV drug
d. Cyclophosphamide – this is a cancer drug – antialkylating agent
e. Zanimirvir – reverse transcriptase inhibitor

A

Amantadine - Cemetrel

39
Q

Drop acid – all of the following are true except EXCEPT

a. LSD – serotonin 2A receptor as a partial agonist
b. LSD leads to enhanced perceptions and hallucinations
c. LSD can lead to miscarriages due to uterine contractions
d. Cause an increase in body temp or heart
e. Can be used neuropathic pain and analgesia

A

Can be used neuropathic pain and analgesia – LSD is NOT used for analgesia

40
Q

Number one drug for diabetes- metaformin – all the following are true except

a. Decreases hepatic glucose out
b. Cause metallic cost
c. Cause weight gain
d. Cause diarrhea

A

Cause weight gain – metformin causes weight loss

41
Q

Prednisone has all the following effects except

a. Decrease lymphocytes and WBCs – eosphoils, monocytes
b. Decreased prostoglandins
c. Decrease bradykinin
d. Cause osteoporosis
e. Sodium and fluid retention
f. Cause hypoglycemia

A

Cause hypoglycemia

42
Q

Boniva – all these statements are true except

a. Potent inhibitor osteoclasts
b. Used to treats pagets
c. Cause osteonecoriss of jaw in cancer patients
d. Inhibits PTH secretion

A

inhibits PTH secretion

43
Q

We’ve got an older patient started on tonazopam that helped him sleep – what can they do

a. Could experience withdrawl
b. Develop physical dependence
c. Could impaire driving performance
d. Decreases time to fall asleep
e. Over the counter

A

Over the counter – this is a controlled 4!! This is false fam. Not OTC

44
Q

All of the following are potential side effects of ortho novum 777 except

a. Venous thrombosis
b. Acne hypertension
c. Increased risk of breast cancer
d. Weight loss

A

Weight loss- you have weight gain

45
Q

All of the following about bisphosonates are correct except

a. Post-menopausal osteo
b. Often administered with hypercalcemia
c. Ossicated with cancer
d. Bisphosphates have angiogenic properties
e. Very long half lives
f. Act by inhibiting activity of osteoclasts

A

Bisphosphates have angiogenic properties – bisphosphonates are ANTI-angiogenic

46
Q

All of these are true except

a. Brand vs generic of levothyroxine can vary by 20%
b. T3 is more potent than T4
c. Levothyroxine narrow
d. Radiation iodone is used to treat hyperthyroidism
e. Hypothyroidism leads to weight loss

A

Hypothyroidism leads to weight loss – cause weight lgain – this is false

47
Q

Sullfonoureas which are what - Diabetic drugs – got first generation and second generation. Sulfonoureas do all the following except

a. Type 2 diabetes – because you gotta have insulin production so type 1 diabetic pancreaes is not doing anything
b. Sulfonureas stimulate the release of insulin from pancreatic beta cells
c. Sulfonorueas increase hepatic gluconeogenesis
d. Cause weight gain
e. People with sulfur allergy can’t take this

A

Sulfonorueas increase hepatic gluconeogenesis – Sulfonoureas decrease inuslin release by

48
Q

Clovir – like acyclovir – valacyclovir. Gonna be least likey to work on

a. HSV1
b. HSV2
c. Shingles
d. EBV
e. Influenza A

A

Influenza A – neuraminidase inhibits are the main ones for this

49
Q

Dopamine is a neurotransmitter implicated in most drugs of use

a. Cocaine acts by inhibit nor epi and dopamine
b. Topical application causes vaso
c. Activation of cannaboid receptors produces analgesic
d. Chronic cocaine increases brains ability to use glucose

A

Chronic cocaine increases brains ability to use glucose – this is false mother fucker
— Makes sense since vasoconstrictor since it reduces blood intake of brain – get less glucose and decrease the ability of the brain to metabolize and work normally

50
Q

DSM-V – which of the following is not listed as a characteristic of drug tolerance

a. Drug tolerance
b. Ability to control drug use
c. Continue drug use despite knowing

A

Ability to control drug use

– You cannot control drug you if you have a drug addiction

51
Q

If we all light up a joint because we had these ailments, it would work for all the following except

a. Neuropathic pain
b. Seizures
c. Analgescis
d. Cancer patients
e. Tourette’s syndrome
f. Inhibit appetite

A

Inhibit appetite

– Cause some hypoglycemia and lead to increased appetite

52
Q

All these are true except

a. Alcohol preferred for dental professionals
b. In selecting drug – efficacy more important than potency
c. Alcohol considered CNS depressant
d. Respiratory depression is often cause of death with
e. Alkaline nature of meth contributes to meth mouth

A

Alkaline nature of meth contributes to meth mouth
i. It’s acidic actually, not alkaline. Most people that snort meth have it drain into mouth and could cause meth mouth with a lack of oral hygiene

53
Q

All of the following statements are correct except

a. Meth increases brain levels of dopamine
b. Chemical dependency affects 9%
c. Methamphetamine produces euphoria which lasts for 3-4 hours
d. Methamphetamine produces hyperthermia
e. Methamphetamine contributes to poor oral hygiene

A

Methamphetamine produces euphoria which lasts for 3-4 hours is WRONG – really 8-12 hours
i. The problem with santa is diminishing returns. When he snorts second, not as high. Then he snorts another one and all he’s getting is side effects

54
Q

What are true except for Pioglitazone (thiazolidinedione – glitazones). Mechanism involves (all true except what) ?

a. Decreaseing production of glucose in LIVER – TRUE – A PPAR GAMMA AGONIST THAT INHIBITS GLUCOSE IN LIVER
b. Increasing sensitivity of insulin in tissues – DECREASES INSULI NRESISTANCE
c. Decreasesing insulin resistance
d. Causes fluid retention so not ued in patients in heart failure
e. Causes increased incidence of UTI infecitons and genital fungal infections

A

Causes increased incidence of UTI infecitons and genital fungal infections
i. THESE ARE THE FLOZEN – THESE ARE THE SGLPT2 INHIBITORS THAT CAUSE THIS due to increased of sugar into the exception and into the kidneys

55
Q

Paclotaxol works by

a. Alkaltying DNA – bunch of them – cyclophosphamide
b. Inhibits angiogenesis – VASTIN
c. Blocks mitotic spingle fiber/microtubule dynamic so to speak
d. Inhibits aromatase – inhibitors are used for breast cancer
e. Inhibits DHF – methotrexate

A

Blocks mitotic spingle fiber/microtubule dynamic so to speak – locks them as soon as they form

56
Q

Corticosteroids – all true except for fluticasone

a. Patients should rinse mouth with water
b. Drug can be used in combination with other drugs such as beta 2 agonist
c. Used for asthma and COPD
d. Use can lead to oral fungal infection
e. Use can lead to hypercalcemia

A

Use can lead to hypercalcemia - Inhibit calcium absorption in the gut and exacerbate the excretion of calcium in kidney

57
Q

Which statement below explains the analgestic codeine Toxicology – the analgesic activity of codeine and codeine metabolites is best described by

A

morphine 6 glucoranide has more activity than codeine and codeine 6 glucoranide is the same

58
Q

BIG ASS DIABETIC – type 2 – smells of alcohol and tobacco – has an increased risk of acetaminophen metabolite due to the induced expression of P450

a. 1A2
b. 2E1
c. 2C8
d. 219

A

2E1

59
Q

What is the primary concern bisphenol A

a. Metabolized as O-NO
b. Binds to angiotensin 2 receptors
c. Activates p450219 which can increase bleeding
d. Recognize and binds to estrogen receptors and can lead to dysregulation of cellular growth
e. Binds to melecorte 1 receptor
f. Lowers threshold of pain

A

Recognize and binds to estrogen receptors and can lead to dysregulation of cellular growth
** THIS IS THE TRUTH

60
Q

2D6 polymorphism normally decreases analgesic activity – so that means he’s a poor metabolizer – but some people are ultra-metabolizers and combine that with a UDP -glucoysarly transfreases – so when they take codeine, they can get an increase for what?

a. Hydro and its metab
b. Oxy and its metabo
c. Morphine and morphine 6
d. Codeine and its codeine 6
e. Hydromorphie and metabo

A

Morphine and morphine 6

- When codeine works, it gets converted to morphine

61
Q

Mentioned in class that the old time guy – all substances are poisons with the right dose – extremely demonstrated when participant ingested the following

A

water

62
Q

Phase 1 metaboilsm vs phase 2 metabolism. phase 1 best described as?

A

primarily coagulates, makes drug hydrophilic for MORE soluble

(phase 2 is conjugation)

63
Q

Dental amalgam uses elemental mercury – what is the most toxic?

a. Elemental
b. Mercuric chloride
c. Methyl mercury

A

Methyl mercury - most lipid soluable and gets into the brain
— Looks lke CH3-mercury – comes down to soluability

64
Q

Patient taking digoxin, why?

A

congestive heart failure
-most likely to have various stages of heart block – ectopic systoles of ventricular origin – atriobradycardia – hypertension or CHF (THIS IS WHY YOU WOULD GIVE DIGIOXON)

65
Q

Which drug represents a major advance in cholesterol lowering therapy!

i. Lipoprotein lipase inhibitors
ii. HMGCoareducatase inhibitors
iii. Statins
iv. Bioacid sequestrants
v. Cholestroal absorptants
vi. PCXK9 inhibitors

A

**PCXK9 inhibitors – these are the newest and latest – mainly used for genetic (Alicroumab)

-Statins are main

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