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Advanced Pharmacology > Final Review > Flashcards

Final Review Flashcards

Final Study Guide Questions

1
Q

Drug categories utilized in treating hyperlipidemia and what lipid levels are affected by them

A

HMG CoA Reductase Inhibitors (Statins)- decrease LDL
Niacin/Nicotinic acid/ Vitamin B3- reduce LDL’s slightly, mostly increase HDL
Fibric Acid Derivatives- Significant decrease in Triglycerides, moderate effect in raising HDL’s, minimal effect in lowering LDL & VLDL,& lowers total cholesterol
BASR- Questran- decreases cholesterol
Omega-3 Fatty Acids- inhibits VLDL and TG synthesis in the liver
Cholesterol Absorption inhibitors: lowers TG, lowers cholesterol, increases HDL

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2
Q

Statins

A

Simvastatin ( Zocor)
Atorvastatin ( Lipitor)
Lovastatin ( Mevacor)
Rosuvastatin ( Crestor)

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3
Q

Fibric Acid Derivatives

A

Gemfibrozil – Lopid

Fenofibrate –Tricor

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4
Q

Cholesterol Absorption Inhibitors

A

Ezetimibe ( Zetia)

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5
Q

The HMG-CoA Reductase Inhibitors, as a class, generally have their most beneficial effect on which serum lipid level ?

A

Decrease Low Density Lipoproteins ( LDL )

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6
Q

A cholesterol drug that is; a) associated with a cutaneous flush, and b) is considered most effective for increasing HDL levels

A

Niacin

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7
Q

The 2 hyperlipidemia drug classes most associated with lowering serum Triglyceride levels are

A

Fibric Acid Derivative Gemfibrozil- (Lopid) & Omega-3 Fatty Acids ( Fish Oil, Lovaza, Vacepa)

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8
Q

The cholesterol drug Ezetimibe ( Zetia)…. is what class of cholesterol drug?

A

Cholesterol Absorption Inhibitor

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9
Q

Vasopressin- what is it and where does it originate?

A

Posterior pituitary; Stimulates reabsorption of water in collecting duct of kidney
aka ADH

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10
Q

ADH analogs

A

oxytocin, vasopressin, desmopressin

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11
Q

A Posterior Pituitary Drug that is an analog of Antidiuretic Hormone ( ADH) and is utilized to treat noctural enuresis is

A

Desmopressin

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12
Q

A Posterior Pituitary Drug that is used in obstetrics, where it is employed to stimulate uterine contractions to induce or reinforce labor.

A

oxytocin (pitocin)

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13
Q

Use of vasopressin (pitressin)

A

Vasopressin ( antidiuretic hormone ) ( ADH ) ( Pitressin)
two primary functions are:
to retain water in the body , and
to constrict blood vessels.
Vasopressin regulates the body’s retention of water by acting to increase water absorption in the collecting ducts of the kidney nephron.
Major use is to treat Diabetes Insipidus

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14
Q

Growth hormone and growth hormone inhibiting hormone. Where do they originate?

A

GHIH from hypothalmus; inhibits the release of GH from AP

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15
Q

A drug that mimics Growth Hormone ( GH) and is used to treat growth failure in children and adults who lack natural growth hormone is?

A

Somatropin ( Humatrope)

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16
Q

A drug that is an analog of Growth Hormone Inhibiting Hormone (GHIH) and is used to treat excessive growth

A

Octreotide ( Sandostatin )

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17
Q

Gonadotropin-Releasing Hormone Drug- where does it originate and what does it do?

A

secreted from hypothalmus. Normal Pulsatile secretion of GnRH from the hypothalamus and interaction on GnRH receptors on the Anterior Pituitary is essential for the proper release of FSH & LH from the Anterior Pituitary in a normal fashion.
Continuous GnRH receptor activity inhibits release of FSH & LH from the Anterior Pituitary.

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18
Q

LH

A

Principal actions in female-stimulates secretion of estrogens and progesterone, ovulation, and formation of corpus luteum. Principal actions in males-stimulates interstitial cells in testes to secrete testosterone.

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19
Q

FSH

A

Females - interacts with LH (leutenizing hormone) to control uterine and ovarian follicle development induces secretion of estrogen.
Males - acts on Sertoli Cells ( nurse cells) in the Seminiferous Tubules to increase sperm production.

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20
Q

Drugs associated with GnRH/ LH/ FSH pathway

A

Menopur, Gonal- F, Pregnyl

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21
Q

An infertility drug that is a mixture of NATURALLY occurring LH and FSH obtained from the urine of post menopausal women is called?

A

Menopur

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22
Q

A drug that Suppresses the production & release of gonadal hormones ( FSH & LH ) by acting as a continuous agonist at pituitary GnRH receptors at the Anterior Pituitary is?

A

Leuprolide ( Lupron)

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23
Q

Gonal- F

A

Is an FSH only preparation manufactured using recombinat DNA technology
Injected IM or SQ over a period of 5 to 12 days causes follicular stimulation, growth and maturation.

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24
Q

Pregnyl

A

A highly purified preparation of Human Chorionic Gonadotropin ( HCG ) obtained from the urine of pregnant females that has an action virtually identical to that of LH and stimulates the corpus luteum to produce progesterone in women and the testes to produce testosterone in men.

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25
Q

TRH

A

Thyrotrophic Releasing Hormone – influences Thyroid Stimulating Hormone ( TSH) from the Anterior Pituitary Thyroid gland

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26
Q

TSH

A

Targets the Thyroid Gland leading to Triiodothyronine (T3), and Thyroxine ( T4) release which maintain a level of metabolism in the tissues that is optimal for their normal function.

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27
Q

Synthroid/ Levothyroxine

A

is a synthetic form of the thyroid hormone thyroxine used to treat hypothyroidism

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28
Q

Propylthiouracil (PTU)

A

Used to treat hyperthyroidism by inhibiting the iodination and condensation steps in the process of Thyroid Hormone synthesis

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29
Q

PIH

A

Prolactin Inhibiting Hormone ( Dopamine ) (dual role as a neurotransmitter and a hormone) – negatively influences Prolactin from Anterior Pituitary

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30
Q

Prolactin

A

from Anterior Pituitary
A hormone similar in structure to GH
Primary function to stimulate and maintain mammary glands/ lactation. ( decreases sexual drive and reproductive function )
primary function is to enhance breast development during pregnancy and to induce lactation.
Secretion of Prolactin from the AP is pulsatile and is under the control of HYPOTHALMIC ; Prolactin Inhibitory Hormone (PIH) ( Dopamine) and Prolactin Releasing Hormone (PRH).
Excess Prolactin or Hyperprolactinemia may cause galactorrhea (the spontaneous flow of milk from the breast, unassociated with childbirth or nursing.) and disruptions in the normal menstrual period in women and hypogonadism, infertility and erectile dysfunction in men.
So, a drug that acts as a dopamine agonist would be beneficial in treating Hyperprolactemia.
There is no preparation available for hypo-prolactinemic conditions

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31
Q

Bromocriptine ( Parlodel)

A

Mimics Dopamine ( Prolactin Inhibitory Hormone) ( PIH) and is used in treating the HYPERPROLACTEMIA, that is associated with galactorrhea (the spontaneous flow of milk from the breast, unassociated with childbirth or nursing.)

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32
Q

Primary Adrenal insufficiency

A

Addisons disease; adrenal disorder with decreased cortisol release

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33
Q

Corticotropin (HP Acthar Gel) and Cosyntropin (Cortrosyn) are used in diagnostic testing of Adrenal / Anterior Pituitary function & insufficiency.

A

If these drugs are given and cortisol release is insufficient and abnormal = this means the adrenal gland is not responding to the ACTH and that the Adrenal Gland is insufficient; giving a diagnosis of Primary Adrenal insufficiency ( Addisons Disease)
If these drugs are given and cortisol release is stimulated and normal= this means the Adrenal gland ( cortex ) is responding to the ACTH…….and that the Anterior Pituitary is what is insufficient; giving a diagnosis of Secondary Adrenal insufficiency

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34
Q

Sulfonylurea Insulin Secretegogues

A

Glyburide ( Diabeta), Glipizide ( Glucotrol), Glimepiride ( Amaryl)

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35
Q

Glyburide ( Diabeta), Glipizide ( Glucotrol), Glimepiride ( Amaryl)

A

Sulfonylurea Insulin Secretegogues that 1.Stimulate insulin release from beta cells of pancreas ( by blocking K+ channels and maintaining depolarization of cell), 2.Reduce hepatic glucose production, and 3.Increase peripheral insulin sensitivity

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36
Q

Metformin ( Glucophage)

A

Biquanide Insulin Sensitizer that lowers blood glucose levels by increasing peripheral insulin sensitivity which increases peripheral glucose uptake and use by target tissues. ( no increase in insulin secretion) q

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37
Q

Oral Secretegogues that have a similar mechanism of action as the Sulfonylurea drugs, but have a more rapid onset of action and a shorter duration of action

A

Repaglinide ( Prandin), Nateglinide ( Starlix)

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38
Q

Pramlintide ( Symlin)

A

A drug administered SQ immediately prior to meals that mimics or simulates the peptide hormone AMYLIN and inhibits the appearance of glucose in the blood plasma by; a) slowing down gastric emptying, b) inhibiting digestive gastric acid, pancreatic enzymes and bile ejection, and c) inhibiting the secretion of the hormone glucagon from the pancreas that converts stored glycogen to glucose.

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39
Q

Humalog ( Lispro), Novog ( Aspart)

A

Rapid acting insulins

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40
Q

Regular Insulin ( Novolin-R and Humulin-R)

A

short acting insulins

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41
Q

NPH Insulin ( Humulin-N, Novolin-N) & Lente Insulin ( Humulin-L, Novolin-L)

A

intermediate acting insulins

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42
Q

Ultralente Insulin , Lantus ( glargine) Insulin

A

long acting insulins

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43
Q

Exenatide ( Byetta), Liraglutide ( Victoza) , Dulaglutide ( Trulicity) , Exenatide ( Bydureon )

A

INCRETIN MIMETICS ( GLP-1 Incretin Receptor Agonists) that lower blood glucose by; a) causing an increase in the amount of insulin released by the pancreas, b) inhibiting glucagon release by the pancreas, and c) reducing gastric emptying.

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44
Q

All of the following are ADVERSE EFFECTS associated with ESTROGEN THERAPY……….EXCEPT:

A

all are

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45
Q

T/F: Estrogen Repacement Therapy ( ERT) has been, and continues to be very widely used for the prevention of post menopausal osteoporosis.

A

False

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46
Q

Therapeutic uses of androgens

A

Primary Hypogonadism – inadequate androgen secretion directly from the testes
Secondary Hypogonadism – due to failure of Hypothalamus ( GnRH) or Anterior Pituitary ( LH/FSH)
Treat the symptoms of sexual dysfunction in men/Hot flashes in women
Potential benefits include improved libido, increased bone mass, and increased sense of well-being.
In individuals with human immunodeficiency virus infection or other chronic diseases, testosterone can be used to treat chronic wasting.
Unapproved Use: increase lean body mass, muscle strength, and endurance in athletes and body builders.

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47
Q

Which drug that affects estrogen receptors has all of the following characteristics?

a. has anti-estrogenic effects on hormone depedent cancer cells ( positive effect)
b. has pro-estrogenic effects on bone cells( positive effect )
c. has LITTLE to NO pro-estrogenic effects on the uterine endometrium ( positive effect)
d. indicated for the treatment and prevention of osteoporosis in postmenopausal women
e. Indicated for the reduction in the risk of invasive breast cancer in postmenopausal women with osteoporosis
f. Indicated for the reduction in the risk of invasive breast cancer in postmenopausal women at high risk of invasive breast cancer.

A

Raloxifene ( Evista )

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48
Q

Which drug that affects estrogen receptors has all of the following characteristics?

a. has anti-estrogenic effects on hormone dependent cancer cells ( positive effect )
b. has pro-estrogenic effects on bone cells in postmenopausal women……..preventing bone density loss. ( positive effect)
c. has anti-estrogenic effects on bone cells in premenopausal women………causing bone density loss. ( negative effect)
c. has pro-estrogenic effects on the uterine endometrium. predisposing the patient to uterine hyperplasia and uterine cancer. ( negative effect)
d. Used n the treatment of metastatic breast cancer.
e. Used for the treatment of node-positive breast cancer in post menopausal women following total mastectomy or segmental mastectomy, axillary dissection, and breast radiation.
f. Although it has a pro-estrogenic effect on bone in post menopausal women, it is NOT officially indicated in the treatment of osteoporosis in postmenopausal women….!!!!

A

Tamoxifen ( Nolvadex )

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49
Q

Which drug that affects estrogen receptors has all of the following characteristics?

a. It is a pure anti-estrogen drug throughout the body.
b. it has no estrogen agonist effects AT ALL.
c. It is not a straight “SERM” drug as it does not modulate receptors and just antagonizes estrogen receptors throughout the body
d. indicated for the treatment of advanced metastatic breast cancers that have stopped responding to SERM & Aromatase Inhibitor treatment options.
e. is a reversible inhibitor of the growth of tamoxifen- resistant , as well as estrogen sensitive breast cancers
f. It binds competetively to estrogen receptors with an affinity approximately 100 times greater than that of tamoxifen.
g. After initial loading dose injections, the eventual dose is 500mg injected IM once monthly.

A

Fulvestrant Injection ( Faslodex)

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50
Q

Which drug that affects estrogen receptors has all of the following characteristics?

a. has anti-estrogenic effects on breast tissue ( positive effect ) ( not indicated for this use)
b. has pro-estrogenic effects on bone cells..preventing bone density loss. ( positive effect) ( not indicated for this use)
c. has pro-estrogenic effects on the uterine endometrium ( used as a positive effect and indicated for this use)
d. FDA approved and Indicated in the treatment of Dyspareunia ( pain during intercourse)

A

Ospemifene ( Osphena )

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51
Q

Progestogens in birth control pills

A

Synthetic Progestogens ( progestins), used in contraception are more stable to first-pass metabolism, allowing lower doses when administered orally. Inhibit the production of gonadotropins ( LH specifically ) and prevent ovulation

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52
Q

Risks associated with the estrogen component of estrogen/progesterone BC pills

A

Nausea and breast tenderness are among the most common adverse effects of estrogen therapy
Postmenopausal uterine bleeding can occur
Risk of thromboembolic events, myocardial infarction ( from the increased clotting factors 2, 7, 9 & 10, increased platelet adhesiveness, decreased AT III)
Increased risk of breast cancer ( for hormone dependent cancers)
Increased risk of endometrial cancer ( due to the endometrial hyperplasia endometrial cancer )

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53
Q

All of the following are therapeutic uses of PROGESTERONE/PROGESTINS……EXCEPT
contraception

treatment of dysmenorrhea

management and treatment of endometriosis and infertility

control of dysfunctional uterine bleeding

:

A

all

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54
Q

2. High dose progestogen-only contraception completely inhibits follicular development and ovulation.

T/F: #1.Progesterone only birth control contraception is not associated with the increased risks of DVT or heart disease that combination birth control pills containing both progesterone and estrogen are associated with.

A

both are true

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55
Q

Corticosteroid Adverse Effects

A

Osteoporosis is a common adverse effect due to suppression of intestinal Ca++ absorption and inhibition of bone formation. ( calcium D supplementation advised )
Cushing-like Syndrome ( puffy face, increased body hair growth, acne, insomnia, increased appetite)
-Cushing’s syndrome describes the signs and symptoms associated with prolonged exposure to inappropriately high levels of the hormone cortisol. This can be caused by taking glucocorticoid drugs, or diseases that result in excess cortisol, adrenocorticotropic hormone (ACTH), or CRH levels
Hyperglycemia may develop ( diabetic patients should monitor blood glucose and adjust medications accordingly)
Hypokalemia( countered with K+ supplements)
Increased risk of infection ( decreased WBC’s as mentioned)

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56
Q

All of the following are clinical uses of Glucocorticoids EXCEPT:
Replacement therapy for Primary Adrenal Cortex Insufficiency ( Addison’s Disease)

Diagnosis of Cushing’s Syndrome ( A hypersecretion of glucocorticoids)

Relief of Inflammmatory Symptoms ( redness, swelling, heeat, tenderness)

Treatment of Allergies - Bronchial Asthma - allergic rhinitis, drug/serum allergic reactions.

A

all

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57
Q

Glucocorticoids

A 
Hydrocortisone,Cortisone
Prednisone
Prednisolone
Methylprednisolone ( medrol dosepak ) Triamcinolone ( Kenalog, Nasacort)
Betamethasone ( Diprolene)
Dexamethasone ( Decadron)
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58
Q

Mineralcorticoid

A

Florinef

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59
Q

Phentermine ( Adipex-P)

A

CNS Stimulant ( Anorexiant)

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60
Q

Diethylproprion ( Tenuate)

A

CNS Stimulant ( Anorexiant)

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61
Q

Orlistat ( Xenical )

A

Inhibits gastric & pancreatic lipase, decreasing the breakdown of dietary fat molecules for absorption, decreasing caloric intake.

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62
Q

Lorcaserin (Belviq)

A

A scheduled drug approved in 2012 that is a Selective 5-HT2C Serotonin Receptor agonist in the CNS that promotes satiety and a decrease in appetite.

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63
Q

Qsymia

A

A combination obesity drug combining an anticonvulsant drug (Topiramate) that suppresses the appetite with a CNS stimulant ( Phentermine) that combats the sedation associated with the anticonvulsant drug component.

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64
Q

Liraglutide ( Saxenda )

A

A drug approved in December 2014 that is a GLP-1 Receptor Agonist that regulates appetite and calorie intake.

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65
Q

Respiratory Bronchodilation in treating Asthma and is achieved via_______________________ receptor stimulation.

A

Beta-2 receptor

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66
Q

All of the following are SHORT-ACTING Beta-2 Specific Adrenergic Agonists….EXCEPT?
Albuterol ( Proventil HFA ) ( Ventolin HFA )

Metaproterenol ( Alupent)
Salmeterol ( Serevent)
Levalbuterol ( Xopenex)
Albuterol (Proventil HFA)

A

Short-Acting:

  1. Albuterol (Proventil HFA) ( ProAir HFA)
  2. Metaproterenol ( Alupent)
  3. Levalbuterol ( Xopenex)

Long-Acting:
1. Salmeterol –(Serevent)

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67
Q

Inhaled Corticosteroid Drugs ( ICS’s)

A
  1. Fluticasone ( Flovent)
  2. Triamcinolone ( Azmacort)
  3. Budesonide ( Pulmicort)
  4. Mometasone Furoate( Asmanex )
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68
Q

Inhaled Corticosteroid ( ICS ) + Long Acting Beta-2 Agonsist (LABA) combination products

A
  1. Fluticasone ( ICS ) + Salmeterol ( LABA )- Advair
  2. Budesonide ( ICS ) + Formoterol ( LABA )- Symbicort
  3. Mometasone Furoate ( ICS in Asmanex) + Formoterol ( LABA ) - Dulera
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69
Q

Ipratropium ( Atrovent)

A

A Cholinergic Antagonist that blocks the Parasympathetic mediated Bronchoconstriction.

70
Q

Advair

A

A combination Inhaled Corticosteroid and Beta-2 specific adrenergic agonsist. ( LABA)

71
Q

Fluticasone ( Flovent)

A

An Inhaled Corticosteroid Asthmatic Drug

72
Q

Albuterol ( Proventil )

A

A short acting beta-2 specific inhaled adrenergic agonist

73
Q

ANNORO /ELLIPTA

A

A combination inhaled Anticholinergic and Long Acting Beta-2 specific adrenergic agonist indicated for COPD, BUT NOT Asthma

74
Q

Dulera

A

A combination Inhaled Corticosteroid and Beta-2 specific adrenergic agonsist. ( LABA)

75
Q

Sildenafil ( Revatio )

A

A Phosphodiesterase-5 ( PDE-5) Inhibitor utilized in the treatment of Pulmonary Aterial Hypertension ( PAH )

76
Q

Omalizumab ( Xolair )

A

A monoclonal Antibody drug used in the treatment of moderate to persistent asthma

77
Q

First Generation H1-Blockers

A

effective, cheap, and still widely used, BUT, most of these drugs penetrate the CNS blood brain barrier as well and cause sedation by blocking the wakefullness associated with central Histamine.
Also interact with other receptors ( cholinergic, adrenergic, serotonin…etc) producing a variety of unwanted adverse effects.

78
Q

Second Generation H1-Blockers:

A

are more specific for H1 Receptors, ( less effect on cholinergic, adrenergic and serotonin) ( less unwanted adverse effects)
because they also carry a polar group ( making them more water soluble) , they do not penetrate the CNS blood brain barrier and therefore cause less sedation than first generation H1 blockers.

79
Q

Diphenhydramine ( Benadryl)

A

First Generation ( sedating)

80
Q

Chlorpheniramine ( Chlor-Trimeton)

A

First Generation ( sedating)

81
Q

Hydroxyzine ( Atarax) ( Vistaril)

A

First Generation ( sedating)

82
Q

Meclizine ( Antivert)

A

First Generation ( sedating)

83
Q

Loratidine ( Claritin)

A

Second Generation ( non-sedating)

84
Q

Fexofenadine ( Allegra)

A

Second Generation ( non-sedating)

85
Q

Cetrizine ( Zyrtec)

A

Second Generation ( non-sedating)

86
Q 
All of the following are H2 Receptor Antagonists utilized in the treatment of Peptic Ulcers, EXCEPT.
OMEPRAZOLE ( PRILOSEC) 
NIZANTIDINE ( AXID) 
FAMOTIDIINE ( PEPCID)
RANITIDINE ( ZANTAC) 
CIMETIDINE ( TAGAMET )
A

omeprazole

87
Q 
All of the following are Proton Pump Inhibitirs utilized in treating Peptic Ulcers.....EXCEPT.
Omeprazole ( Prilosec) 
Rapiprazole ( Aciphex )
Esomeprazole ( Nexium ) 
Misoprostol ( Cytotec) 
Lansoprazole ( Prevacid)
A

misoprostol (cytotec)

88
Q

indications are for both the H2 Receptor Antagonists and Proton Pump Inhibitors:

A

Short-Term Treatment Of Active Duodenal Ulcer.

  1. Maintenance Of Healed Duodenal Ulcers.
  2. Short-Term Treatment Of Active Benign Gastric Ulcer.
  3. Short-term treatment of gastroesophageal reflux disease (GERD).
  4. Treatment of pathological hypersecretory conditions. e.g., Zollinger-Ellison Syndrome
89
Q

An Antiemetic Drug that selectively blocks Serotonin Receptors at the Chemoreceptor Trigger Zone ( CTZ) is….

A

Ondansetron ( Zofran )

90
Q

Antiemetic Drug(s) that block Dopamine Receptors at the Chemoreceptor Trigger Zone ( CTZ).

A

Prochlorperazine ( Compazine ) and Metoclopramide ( Reglan )

91
Q

All the following are true with respect to Lubiprostone ( Amitiza) , EXCEPT:
The recommended dose is a convenient once daily dosage of a 24mcg soft capsule with food and water.
FDA approved for Chronic Idiopathic Constipation ( CIC )
FDA approved for Opiod-Induced Constipation ( OIC)
FDA approved for Irritable Bowel Syndrome with Constipation ( IBS-C)

Usage in children has not been established

Is classified as a Chloride Channel Activator

A

The recommended dose is a convenient once daily dosage of a 24mcg soft capsule with food and water.

92
Q

All of the following are true with respect to Naloxegol ( Movantik) , EXCEPT:
Naloxegol ( movantik) is a laxative indicated for Opioid Induced Constipation ( OIC)
Naloxegol ( movantik) is an antagonist of peripheral Delta opiod receptors
Naloxegol ( movantik) is derived from from naloxone ( an opioid antagonist)
The recommended dose of Naloxegol ( movantik) is 25mg once daily in the morning
All of the above are true

A

Naloxegol ( movantik) is an antagonist of peripheral Delta opioid receptors

93
Q

Bisacodyl ( Dulcolax)

A

stimulant laxative

94
Q

Lactulose ( Enulose )

A

Osmotic laxative that is degraded by colonic bacteria to form salts that increase osmotic pressure, cause fluid accumulation, colon distention, soft stools, and defecation

95
Q

Senna ( sennosoids) ( Ex-LAx)

A

stimulant laxative

96
Q

Docusate Sodium ( Colace )

A

Emulsifies stool producing softer feces and ease of passage. ( often used for prophylaxis)

97
Q

Polyethylene Glycol ( PEG ) ( Miralax) ( GOLYTELY)

A

a bowel cleansing osmotic agent which causes water to be retained with the stool

98
Q

Lubiprostone ( Amitiza)

A

Chloride Channel Activator

99
Q

Naloxegol ( Movantik)

A

an antagonist of peripheral acting mu opiod receptors

100
Q

Inhibition of Phosphodiesterase-5 ( PDE5) in the vascular smooth muscle of the corpus cavernosum leads to a __________________________ in Guanasine Monophosphate ( cGMP ) . which produces the needed vascular smooth muscle _______________________ needed for an erection

A

increase

vasodilation

101
Q

Phosphodiesterase-5 ( PDE5) Inhibitors ___________________ the hypotensive activity of Nitric Oxide (NO),and administration of PDE5 Inhibitors inpatients taking any form of organic nitrates is contraindicated.

A

potentiate

102
Q 
All of the following are PHOSPHODIESTERASE-5 ( PDE-5) INHIBITORS......EXCEPT:Sildenafil ( Viagra) 
Dutasteride ( Avodart) 
Tadalafil ( Cialis) 
Vardenafil ( Levitra) 
Avanafil ( Stendra)
A

Dutasteride ( Avodart)

103
Q

Doxazocin ( Cardura)

A

ndicated for both HTN & BPH ( blocks both Alpha-1A & Alpha-1B receptors)

104
Q

Terazocin ( Hytrin)

A

Indicated for both HTN & BPH ( blocks both Alpha-1A & Alpha-1B receptors)

105
Q

Prazocin ( Minpress)

A

Indicated more for HTN ( blocks Alpha-1B receptors more selectively)

106
Q

Tamsulosin ( Flomax)

A

Indicated more for BPH ( blocks Alpha-1A receptors more selectively)

107
Q

The 5-Alpha Reductase Inhibitors ….Finasteride ( Proscar) & Dutasteride ( Avodart )…..treat BPH by inhibiting the conversion of _________________________________ to __________________________, which causes the prostate to shrink and allow for an increased urine flow.

A

Testosterone, Dihydrotestosterone ( DHT)

108
Q

2. Granulocyte Colony Stimulating Factor Drugs are used prophylactically to stimulate granuloctyes production in the bone marrow and reduce the risk of neutropenia.

1 Neutropenia is associated with chemotherapy and bone marrow transplantation.

A

both are true

109
Q

Ferrous Sulfate

A

Iron Deficient Anemia

110
Q

Folic Acid

A

Megaloblastic Anemia

111
Q

Vitamin B12 ( Cyanocobalamin )

A

Pernicious Anemia

112
Q

Filgrastim ( Neupogen) & Pegfilgrastim ( Neulasta)

A

Neutropenia

113
Q

Hydroxyurea ( Hydrea)

A

Sickle Cell Disease ( Increases fetal hemoglobin production )

114
Q

All of the following are contributions of the Retinoids in treating Acne…..EXCEPT?

Decrease cohesiveness of follicular units, which decreases comedo formation

controls the proliferation of Proprionibacterium Acnes

Influences sebum production

normalizes abnormal growth and differentiation of keratinocytes.

A

Correct

controls the proliferation of Proprionibacterium Acnes

115
Q

Tretinoin ( Retin-A)

A

Normalizes abnormal growth and differentiation in keratinocytes.

116
Q

Benzoyl Peroxide

A

Characterized as a ‘peeling agent’ that increases skin turnover, leading to a clearing of pores and a reduced bacterial count.

117
Q

Salicylic Acid

A

characterized as an ‘exfoliant’ that is mostly used to treat mild to moderate acne

118
Q

Azelaic Acid

A

3-fold mechanism of action; a) antibacterial activity, b) antinflammatory activity and c) inhibits keratinization of skin layers
used for the treatment of mild to moderate inflammatory acne.

119
Q

All of the following Drugs or Drug Classes Contribute to Bone Loss….EXCEPT:

Glucocorticoids

Proton Pump Inhibitors

Selctive Serotonin Ruptake Inhibitors ( SSRI’s)

Anticonvulsants ( Phenytoin)

Furosemide ( Lasix)

Alcohol

All of the above increase Bone Loss and contribute to Osteoporosis.

A

All of the above increase Bone Loss and contribute to Osteoporosis.

120
Q

The Mechanism of Action for the BiPhosphonate Drugs is________________________.

A

inhibition of Osteoclasts

121
Q

The Mechanism of Action for the Selective Estrogen Receptor Modulator ( SERM) drug Raloxifene ( Evista) , in treating osteoporosis, is related to _____________________________.

A

its Pro-Estrogenic effects on bone and decreasing osteoclast function

122
Q

All the following are TRUE with respect to the drug Denosumab ( Prolia ) , EXCEPT:

It is a Monoclonal Antibody Drug.
It is parenteral drug given ( SQ ) subcutaneously.
It is indicated in the treatment of:
Osteoporosis in Postemenopausal women at high risk of bone fracture
To increase bone mass in men with osteoporosis
And in the treatment of bone loss in men receiving androgen deprivation therapy for prostate cancer.
The dosage is 60mg every 6 months.
Prolia targets and inhibits specific transmembrane proteins that are vital in the formation, function and survival of osteoblasts.
All of the above are TRUE

A

Prolia targets and inhibits specific transmembrane proteins that are vital in the formation, function and survival of osteoblasts.

123
Q

Arachidonic acid is converted to good “housekeeping’ prostaglandins” that promote normal cellular responses by ___________________________, while the the prostaglandins that are responsible for an inflammatory response are converted from arachidonic acid by _____________________________________.

A

Cyclooxygenase-1 ( COX1), Cyclooxygenase-2 ( COX2)

124
Q

All of the following are Clinical Uses of Prostaglandins……..EXCEPT: Used to treat Pulmonary Hypertension via their ability to cause bronchodilation ( PGI2)

Used to induce childbirth/uterine contraction ( PGE2)

Used to maintain patency and prevent closure of the Ductus Arteriosus ( PDA ) ( the blood vessel connecting the pulmonary artery to the proximal descending aorta. It allows most of the blood from the right ventricle to bypass the fetus’s fluid-filled non-functioning lungs. Upon closure at birth, it becomes the ligamentum arteriosum.) ( PGI2 & PGE2)

Used to prevent Peptic Ulcers ( PGE2 )

Used to treat Glaucoma / Ocular Hypertension

All of the above are clinical uses of Prostaglandins

A

All

125
Q

Misoprostol ( Cytotec )

A

Used as a PGE ANALOG to treat/prevent peptic ulcer by increasing mucus production and decreasing gastric acid secretion.

(*** also utilized to induce uterine contractions and labor)

126
Q

Iloprost ( Ventavis)

A

A PGI ANALOG that , when inhaled, is a potent pulmonary vasodilator used to treat PULMONARY ARTERIAL HYPERTENSION

127
Q

Alprostadil

A

A PGE ANALOG that is used to elicit local vasodilation in maintaining the patency of the ductus arteriosus in newborns with congenital heart conditions.

( ** Also used in the treatment of erectile dysfunction via urethral suppository)

128
Q

Latanoprost ( Xalatan ) & Bimatoprost ( Lumigan )

A

Used to reduce elevated intraocular pressure in patients with open-angle glaucoma or ocular hypertension.

129
Q

All of the following are Non-Selective ( COX1 & COX2 ) Cyclooxygenase Inhibitors…..EXCEPT:
Aspirin ( ASA)

Ibuprofen ( Motrin)

Naproxen ( Naprosyn )

Diclofenac ( Voltaren)

Celecoxib ( Celebrex)

Ketorolac ( Toradol )

A

Celebrex

130
Q

Methotrexate (MTX)

A

A ‘antimetabolite’ anticancer drug used also to treat Rheumatoid Athritis ( but given just once weekly and at much lower doses to minimize adverse effects) . Mechanism of action involves inhibition of enzymes needed for T-Cell expression.

131
Q

Etanercept ( Enbrel)

A

A Tumor Necrosis Factor ( TNF ) Inhibitor, given SQ twice a week, that reduces the ability of TNF to regulate Immune Cells theri role in inflammation. ( warning = increased risk fro developing serious infections )

132
Q

Adalimumab ( Humira )

A

A Monoclonal Antibody, given SQ weekly or every other week, that binds to TNF thereby interfering with its ability to regulate the immune response and inflammatory response ( warning = increased risk fro developing serious infections )

133
Q

Tofacitnib ( Xeljanx)

A

A Janus-Associated Kinase ( JAK) Inhibitor that disrupts the signaling of cytokines associated with the inflammation of Rheumatoid Arhtritis ( RA) . ( given orally twice daily ) ( warning = increased risk fro developing serious infections )

134
Q

Abatacept ( Orencia )

A

Inhibitor of T-Cell ( T-Lymphocyte ) activation by binding to; a) proteins found on Antigen Presenting Cells, b) proteins found on Activated B-Cells, and c) proteins expressed on T-Cells.

135
Q

All of the following are TRUE with respect to Ustekinumab ( Stelara) , EXCEPT:

Ustekinumab ( Stelara) is a monoclonal Antibody Drug that targets Iinterleukin IL-12 and IL-23 Cytokines for its anti-inflammatory mechanism of action.

Ustekinumab ( Stelara) has an initial dosage of 45mg, then 45mg 4 weeks later, then 45 mg every 12 weeks.

Ustekinumab ( Stelara) is indicated for Plaque Psoriasis (Ps)

Ustekinumab ( Stelara) is indicated Rheumatoid Arthritis ( RA)

Ustekinumab ( Stelara) is indicated for Psoriatic Arthritis

A

Ustekinumab ( Stelara) is indicated Rheumatoid Arthritis ( RA)

136
Q

Allopurinol ( Zyloprim )

A

Xanthine Oxidase inhibitor ( used more to prevent gouty attacks)

137
Q

Febouxostat ( Uloric)

A

Xanthine Oxidase inhibitor ( used more to prevent gouty attacks)

138
Q

Probenecid

A

Increase uric Acid excretion in the kidney ( uricosuric) ( used more to prevent gouty attacks)

139
Q

Colchicine

A

Reduces inflammatory response associated with gout, and is used more for treatment and relief of pain in acute gouty attacks

140
Q

The mechanism of action for the “Triptan” drug class {Sumatriptin ( Imitrex), Rizatriptan ( Maxalt), Zolmitriptan ( Zomig)

A

Their agonistic effects on central serotonin receptors in cranial blood vessels which causes their constriction. AND Their influence on Trigeminal Nerve Endings…causing subsequent inhibition of Pro-Inflammatory and Pain transmitter release. ( Substance-P)

141
Q

The Pregnancy Category where there is positive evidence of human fetal risk, but potential benefits may warrant use of the drug in pregnant women despite potential risks is_______________________.

A

Category D

142
Q

The penicillin and cephalosporin antibiotics are listed under what pregnancy category?

A

Category B
Category B, the most common category, includes antibiotics that are not known to cause birth defects or any pregnancy complications. Examples of antibiotics listed as Category B include all penicillins, all cephalosporins, and erythromycin.

143
Q

Antibiotics that are effective against gram positive organisms and also against a specific number of
gram negative organisms are _______________________ antibiotics.

A

Extended Spectrum – antibiotics that are effective against gram positive organisms and also against a specific number of gram negative organisms

–Example: ampicillin is considered to have an extended spectrum because it acts against gram positive and some gram negative bacilli

144
Q

Narrow Spectrum antibiotics

A

– antibiotics acting only on a single or limited group of microorganisms.
Example: Isoniazid is active only against mycobacteria
Example: only gram +

145
Q

Broad spectrum antibiotics

A

antibiotic drugs that affect a wide variety of microbial species.
Example: Tetracyline effective against gram positive, gram negative, Chlamydia, Rickettsia….etc

146
Q

In general, Gram negative cell walls are less difficult for antibiotics to cross than are Gram Positive cell walls

A

False. They have an outer envelope unlike gram positive cells.

147
Q

Gram-Negative Bacteria are particularly susceptible to Penicillins.

A

False. Gram positive bacteria.

148
Q

t/f: The Cephalosporins are related both structurally and functionally to the penicillins, have the same mode of action, and tend to be more resistant than the penicillins to certain beta-lactamases.

A

true

149
Q

t/f: First Generation Cephalosporins have greater activity against Gram Negative Bacteria than do the Third Generation Cephalosporins.

A

false

150
Q

All of the following statements about the carbapenems are TRUE…..EXCEPT:

Are one of the ‘Antibiotics of last resort’ for many bacterial infections.

they have a structure that renders them highly resistant to MOST beta-lactamases

they have a narrow spectrum of activity, being effective against only gram negative bacteria

They are synthetic INJECTABLE beta-lactam antibiotics

A

they have a narrow spectrum of activity, being effective against only gram negative bacteria

151
Q

Cephalosporin Generations

A 
First Generation:
Cephalexin ( Keflex)
Second Generation:
Cefaclor ( Ceclor)
Third Generation:
Ceftriaxone ( Rocephen)
Fourth Generation:
Cefepime ( Maxipime)
152
Q

Parenteral Carbapenem Drugs

A

Doripenem ( Doribax)
Ertapenem ( Invanz)
Meropenem ( Merrum IV)

153
Q

Aminoglycosides:

A 
.Gentamycin ( Garamycin)
Streptomycin
Tobramycin ( Tobrex)
Amikacin
Neomycin
154
Q

All of the following are Macrolide Antiobiotics…..EXCEPT.

Tobramycin ( Tobrex)

Erythromycin ( Erythrocin )

Azithromycin ( Zithromax)

Clarithromycin ( Biaxin )

A

Tobramycin ( Tobrex)

155
Q

The mechanism of action for the Floroquinolone Antibiotics is:

A

Inhibit the bacterial enzyme, DNA Gyrase, which is needed for DNA replication

156
Q

The Flouroquinolones Antibiotics are generally effective against ____________________ organisms, with newer generations showing improved coverage against _____________________ organisms and atypical organisms ( Mycoplasma, Chlamydia..etc)

A

Gram Negative, Gram Positive

157
Q

The flouroquinolone antibiotic drugs are generally safe to take, however, they are also associated with rare but serious tendonopathy and neuropathy adverse effects.

A

true

158
Q

Active Mycobacterium Tuberculosis Therapy is best treated with:

A

A combination of antibiotics for 6 to 12 months to decrease risk of developing resistant strains

159
Q

Ciprofloxacin ( Cipro)

A

Flouroquinolone Antibiotic

160
Q

Levofloxacin ( Levaquin)

A

Flouroquinolone Antibiotic

161
Q

Sulfamethoxazole

A

Folic Acid Antagonist

162
Q

Trimethoprim

A

Folic Acid Antagonist

163
Q

Bactrim DS

A

A combination Folic Acid Antagonist Drug

164
Q

Rifampin

A

Anti-Mycobacterial Drug ( TB )

165
Q

Isoniazid

A

Anti-Mycobacterial Drug ( TB )

166
Q

Pyrazinamide

A

Anti-Mycobacterial Drug ( TB )

167
Q

Clotrimazole ( Lotrimin)

A

Anti-Fungal - topical

168
Q

Amphotericin

A

Anti-Fungal - IV

169
Q

Chloroquine

A

Anti-Malarial

170
Q

Mefloquine ( Liriam )

A

Anti-Malarial

171
Q

Ivermectin ( Stromectol )

A

Anti-Helmintic Drug

172
Q

Albendazole ( Albenza)

A

Anti-Helmintic Drug

Advanced Pharmacology (1 decks)

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