Final Exam Flashcards
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
Ectascy (MDMA/Molly)
Sitagliptin works by what mechanism?
Dipeptidyl Peptidase-4 INHIBITOR
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
Glucose tablet
Liraglutide. The generic suffix for a GLP1 inhibitor is “Gluitide.” What is the MOA?
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.
Brand new diabetic patient – what’s the first thing we are going to put him on?
a. Metformin (Glucophage)
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
Inhibits 5-alpha-reductase which shrinks the prostate
Zovorax/Acyclovir – what do you think?
Herpes (HVS1-cold sores) (HVS2-genetal)
What is the main HIV drug?
a. Norvile
b. Cobicistat aka Stribild
c. Evlostaz -
d. Steva
e. Cemetro
Cobicistat aka Stribild, which is a four combo drug that has elvitegavir/cobicistat/emtricitabine/tenofovir
Got someone with parkinsons disease and on Carbadopa/levodopa?
a. Dental pain
b. Allergy
c. Severe shaking
d. Osteonecrosis
e. Limit epinephrine
Limit epinephrine – because it increases dopamine and dopamine is a precursor for norepi
Flomax/Hytrin(terazosin) are used for benign prostate hypertrophy and their main side effect is what?
Orthostatic hypotension
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
Increase xerostomia gingivitis tardive dyskinesia
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?
Metabisulfites as an antioxidant – so if allergic, avoid epinephrine
– GIVE Mepivacaine without epinephrine
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
tamiflu
Treating with antihypertensives – which one would most likely cause gingivla hyperplasia
a. Calcium channel blockers
b. ACE inhibitors
c. Alpha blockers
d. ARBs
Calcium channel blockers
Zyrtec is a second generation – Benadryl is first generation – what’s the advantage of Zyrtec over first generation?
Non-drowsy
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
Aberva
Someone is using a corticode steroid inhaler – after they take a dose, what should they do?
Rinse mouth to prevent candida or any sort of fungal infection
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
aspartate (Novolog) is short acting
AVOID insulin glargine – this is the only one you want to avoid because that’s long term
Nonselective beta blocker – where could that be a problem
a. Hypertension
b. Depression
c. Headache
d. Bronchial asthma
e. Panic disorder
Bronchial asthma
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
dilantin
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. Dry mouth – Anti-histamine H1 inhibitors are notorious for their anticholinergic effects
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
Increase the drug effect
Which one causes bruxism?
a. Antihistamines
b. Antidepressents
c. Antipsychotics
d. Antihypertensives
e. Anti-axnity
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
Xanax is what class of drugs
a. Benzos
b. Antihistamine
c. Loop direutic
d. Beta blocker
Benzos
Viagra is what for
a. post-menopause
b. endometrious
c. hypothyroidism
d. erectile dysfunction
erectile dysfunction
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
Hypoglycemia
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
Corticosteroids
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
Harvoni
Somebody comes in, increased heart rate, peforated nasal septum
cocaine
Methotrexate
a. Inhibit angiogenesis
b. Stimulate macrophage
c. Inhibit myospindle fiber formation
d. Inihibit dihydrofolate reductase (DHF)
Inihibit dihydrofolate reductase (DHF) –We need folate for DNA synthesis
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
Decrease coordinating and motor imparement
Used for breast cancer – which of the following?
a. Cylcophosphomade
b. Vinblastine
c. Pacletaxol
d. Trestuzumab
Trestuzumab (HERCEPTIN) – MAB means monoclonal antibody
This drug is classified antitumor antibiotic and has an FDA black box warning of potentially causing severe myelosurpression and myocardiotoxicity
Answer: Doxorubicin
Methotrexate is NOT the answer
Describe MOA cyclophosphamide
a. Inhibits estrogen
b. Inhibits mitotoic spindle
c. Angiogenesis
d. Alkalytes DNA and leads to DNA strand breaks
Alkalytes DNA and leads to DNA strand breaks
What condition accounts for sudden sniffing death syndrome
a. Hyperthermia
b. Hyperventilation
c. Dehydration
d. Hypertension
e. Cardiac arrythmia
Cardiac arrythmia (bc of sudden sniffing death syndrome)
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
Inhibit the rewarding and craving effects of alcohol
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
AVASTIN is vascular that’s the one you want to go with – not
i. Novadex
ii. F5u
iii. Taxol
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
Amantadine - Cemetrel
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
Can be used neuropathic pain and analgesia – LSD is NOT used for analgesia
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
Cause weight gain – metformin causes weight loss
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
Cause hypoglycemia
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
inhibits PTH secretion
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
Over the counter – this is a controlled 4!! This is false fam. Not OTC
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
Weight loss- you have weight gain
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
Bisphosphates have angiogenic properties – bisphosphonates are ANTI-angiogenic
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
Hypothyroidism leads to weight loss – cause weight lgain – this is false
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
Sulfonorueas increase hepatic gluconeogenesis – Sulfonoureas decrease inuslin release by
Clovir – like acyclovir – valacyclovir. Gonna be least likey to work on
a. HSV1
b. HSV2
c. Shingles
d. EBV
e. Influenza A
Influenza A – neuraminidase inhibits are the main ones for this
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
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
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
Ability to control drug use
– You cannot control drug you if you have a drug addiction
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
Inhibit appetite
– Cause some hypoglycemia and lead to increased appetite
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
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
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
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
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
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
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
Blocks mitotic spingle fiber/microtubule dynamic so to speak – locks them as soon as they form
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
Use can lead to hypercalcemia - Inhibit calcium absorption in the gut and exacerbate the excretion of calcium in kidney
Which statement below explains the analgestic codeine Toxicology – the analgesic activity of codeine and codeine metabolites is best described by
morphine 6 glucoranide has more activity than codeine and codeine 6 glucoranide is the same
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
2E1
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
Recognize and binds to estrogen receptors and can lead to dysregulation of cellular growth
** THIS IS THE TRUTH
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
Morphine and morphine 6
- When codeine works, it gets converted to morphine
Mentioned in class that the old time guy – all substances are poisons with the right dose – extremely demonstrated when participant ingested the following
water
Phase 1 metaboilsm vs phase 2 metabolism. phase 1 best described as?
primarily coagulates, makes drug hydrophilic for MORE soluble
(phase 2 is conjugation)
Dental amalgam uses elemental mercury – what is the most toxic?
a. Elemental
b. Mercuric chloride
c. Methyl mercury
Methyl mercury - most lipid soluable and gets into the brain
— Looks lke CH3-mercury – comes down to soluability
Patient taking digoxin, why?
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)
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
**PCXK9 inhibitors – these are the newest and latest – mainly used for genetic (Alicroumab)
-Statins are main
