High Yield - Pharm Flashcards
1
Q
Where are alpha-1 receptors found and what is their function?
A
Vascular smooth muscle. Vasoconstriction.
2
Q
If alpha-1 receptors are blocked, what would be the result?
A
Vasodilation. Decrease in blood pressure.
3
Q
Where are beta-1 receptors found and what is their function?
A
Heart. Increase heart rate and contractility.
4
Q
If beta-1 receptors are blocked what would be the result?
A
Decreased heart rate. Decreased blood pressure.
5
Q
Where are beta-2 receptors found, what is their function?
A
Skeletal muscle and bronchial smooth muscle. Vasodilation and bronchodilation.
6
Q
What is the result of epinephrine on the various receptors?
A
a1 - vasoconstriction
a2 - complicated
b1 - increased heart rate/CO
b2 - bronchodilation
7
Q
What is the target receptor of hemostatic agents in retraction cord?
A
A1 - vasoconstriction
8
Q
Amphetamines lead to release of what chemicals in brain?
A
norepinephrine
9
Q
What are the active agents in Ritalin and Adderral?
A
Ritalin = methylphenidate Adderral = Amphetamine
10
Q
________ exerts its effects through dopamine uptake blockade of central adrenergic neurons (norepinephrine-dopamine reuptake inhibitor).
A
Ritalin (methylphenidate)
11
Q
_______ exerts its effects by increasing catecholamine NE, serotonin, dopamine release as its primary action.
A
Adderral (amphetamine)
12
Q
T/F: Nervous patients should continue taking amphetamines.
A
False
13
Q
ADHD is most common in what gender?
A
Boys
14
Q
Vascular smooth muscle relaxation is caused by what types of drugs?
A
Alpha 1 blockers.
- zosin.
ex. prazosin
15
Q
Corticosteroids?
A
Variety of anti-inflammatory affects. -isone Pred- -olone -onide
ex. Fluticasone, Prednisone
16
Q
Barbituates?
A
Sedatives, CNS depressants.
- bital
ex. butalbital
17
Q
What types of drugs end in -dazole?
A
Antibiotics
18
Q
Calcium channel blockers?
A
Reduce CO and cause vasodilation.
- dipine
- Verapamil, Diltiazem
19
Q
What are the two main classes of Calcium channel blockers?
A
Dihydropyridines: end in -dipine
Non-dihydropyridines: Verapamil, Diltiazem
20
Q
Bisphosphonates?
A
Prevent loss of bone density, treat osteoporosis. Reduce osteoclast activity.
- dronate
ex. Alendronate
21
Q
Which types of bisphosphonates put patients at risk for osteonecrosis of the jaw?
A
IV bisphosphonates often used in cancer treatment.
ex. Denosumab, teriparatide, abaloparatide
22
Q
Proton pump inhibitor (PPI)?
A
Treat GERD.
- eprazole
ex. Omeprazole
23
Q
Antihistamines?
A
Block histamine receptors, treat allergies and nasal congestion.
- iramine
- tadine
ex. pheniramine, loratadine
24
Q
Which histamine receptor is found in the nose and often the target of OTC antihistamines?
A
H1
25
Beta blockers?
Block Beta1 receptor, decrease CO, lower BP.
- olol
ex. atenolol, propanolol
26
ACE inhibitors?
Block conversion of angiotensin 1 -> angiotensin 2, lower CO, lower BP.
- pril
ex. lisinopril
27
What are the effects of ACE inhibitors?
Vasodilation, reduced CO, increase in Bradykinin
28
Angiotensin II receptor blockers?
Do not allow Angiotensin II to bind to receptors, lower CO, lower BP.
- sartan.
ex. losartan
29
T/F: ACE inhibitors and Angiotensin II receptor blockers are among the first line of defense for hypertensive patients.
True
ARBs may have less adverse side effects
30
Loop diuretics?
Treat hypertension in pts with reduced kidney function.
- semide
ex. furosemide, bumetanide
31
Which part of the kidney do loop diuretics act on?
ascending limb of the loop of Henle
32
Beta agonists?
Cause bronchodilation.
- terol
ex. albuterol
33
T/F: Most beta agonists that end in -terol are selective for the beta2 receptor.
True
Except prenalterol and xamoterol
34
Thiazide diuretics?
Treat hypertension.
- thiazide
ex. chlorothiazide
35
Benzodiazepines?
Enhance effect of GABA, treat seizures, anxiety, good for sedation.
- zepam
- zolam
ex. diazepam, midazolam
36
Alpha blockers?
Block A1 receptor leading to vasodilation.
- zosin
ex. prazosin
37
_______ is a negative side effect of amphetamines.
Insomnia
38
T/F: Terazosin would lead to vasoconstriction in the gingiva.
False
-zosin = A1 blocker. Would vasodilate.
39
What would be the ultimate result of taking epinephrine and propanolol?
Propanolol = beta blocker. Epinephrine would only act on A1 -> increased BP. Feedback loop would lower heart rate as a result.
Increase BP, lower HR
40
T/F: Nitroglyceride, Ca channel blockers, and propranolol are all used to treat angina.
True
41
T/F: Sympathomimetic drugs should be avoided in patients taking propanolol.
True
Epinephrine in combo with beta-blockers can have adverse effects
42
What types of drugs will reverse effects of epinephrine?
Alpha blockers
| ex. phenoxybenzamine
43
T/F: Cholinergic drugs mimic the parasympathetic system.
True
Cholinergic = parasympathetic (salivation, urination, vasodilation, bradycardia, miosis, bronchoconstriction)
Adrenergic = sympathetic
44
Salivary secretion _______ with cholinergic drugs such as Pilocarpine and Neostigmine.
increases
45
T/F: Scopolamine and atropine are anticholinergic drugs.
True
Can be used for motion sickness
46
T/F: Antihistamines are used for motion sickness.
True
47
Neostigmine, physostigmine, and pilocarpine are all _______.
cholinergic drugs
48
Atropine, scopolamine, Belladonna alkaloids and glycopyrrolate are ________.
anticholinergic drugs
49
T/F: Anticholinergics are contraindicated in patients with glaucoma.
True
50
______ is a term for the constriction of pupils. Which types of drugs cause this?
Miosis; opioids, cholinergics
51
_______ is a term for dilation of pupils. Which types of drugs cause this?
Mydriasis; amphetamines, anticholinergics, serotonergics
52
How is an adrenergic signal terminated?
MAO degrades NE
53
What is the mechanism of levodopa to treat Parkinson's?
Replenishes deficiency of dopamine
54
Why must you take carbidopa with levodopa?
Prevents breakdown of levodopa befor crossing blood brain barrier
55
What causes Parkinson's disease?
Dopamine deficiency
56
What is a therapeutic index?
Lethal dose/effective dose.
| High = safe
57
What is the bioavailability of a drug?
Amount available in blood
58
What is the most important factor in drug dosing?
Potency
59
Two drugs are similar in everything except they have different affinities for the receptor. How are they the same?
Same efficacy, different potency
60
Three carpules of local anesthetic X are required to obtain adequate local anesthesia. Five carpules of local anesthetic Y are required to achieve the same level of anesthesia. Drug X is more _____ than drug Y.
potent
61
Which benzodiazepine is often used for anxiety disorders?
Xanax = alprazolam
62
How do benzodiazepines effect GABA receptors?
Increase frequency of chloride channel opening
63
T/F: Long acting benzos (diazepam) are contraindicated in elderly patients.
True
64
Which is the best benzo for IV sedation?
Midazolam
Has amnesia effect
65
Which benzos are not metabolized in the liver?
Lorazepam
Oxazepam
Temazepam
66
Which drug reverses benzo action?
Flumazenil
67
T/F: Benzos are indicated in pregnant women.
False
68
How does the body metabolize most short acting barbiturates?
Oxidation in liver
69
Why do ultrashort acting barbiturates work so fast?
Redistribution
70
What is the #1 problem for patients during IV sedation?
Hypoxia
71
What drug class is used for seizures?
Benzodiazepines
72
Which sedative is indicated for pregnant women?
Promethazine
73
Which hormone does prozac act on?
Serotonin; SSRI
74
T/F: Many geriatric patients suffer from depression.
True
75
What is the 1st sign of dementia?
Short term memory loss
76
How do TCAs work?
Decrease re-uptake of NE and serotonin
77
What is a side effect of taking TCA and epinephrine?
hypertension
78
What type of antidepressant is Zoloft (Sertraline)
SSRI; inhibits re-uptake of serotonin
79
St. John's Wort helps with what disorder?
Depression
80
What drug is used for bipolar disorders?
Lithium
81
What is a strong, long-acting corticosteroid?
Dexamethasone
82
What is the main long-term side effect of corticosteroid use?
Osteoporosis, hyperglycimia, immunosuppression
83
What is the most effective medication for reducing airway inflammation and mucus production?
Inhaled corticosteroid.
| ex. fluticasone
84
What is Addison's disease?
Adrenal glands do not produce enough steroids. Will cause mucosal pigmentation. Treated with long-term corticosteroid therapy.
85
T/F: Someone with Addison's disease should be advised to increase their corticosteroid dose during dental treatment.
True
86
T/F: Nitrous oxide has the fastest onset among inhalation agents.
True
87
T/F: Nitrous oxide has a very low solubility in the blood.
True
| Allows it to be removed rapidly via exhalation
88
T/F: Nitrous oxide has a very high MAC.
True
| Not very potent
89
T/F: Nitrous oxide should be avoided in pregnant patients.
True (esp in 1st trimester)
Also contraindicated in COPD
90
What is the max amount of nitrous to safely give a child?
50%
Most machines have cut off at 70%
91
What is the most common side effect with nitrous?
Nausea
92
What is the effect of using hydroxizyne with chloral hydrate?
Reduce nausea
93
Which two anesthetics might have a cross-allergy?
Looking for an answer with either two amides (two I's) or two esters (one I)
94
Amides are metabolized where?
Liver via P450
95
How are esters metabolized?
Pseudocholinerstserase in plasma
96
How does LA work?
Blocks intracellular sodium channels. Decrease sodium uptake
97
What is the primary reason for adding epinephrine to LA?
Prolong action by decreasing rate of absorption
98
What is biotransformation?
How anesthetics are broken down. Makes them more polar (ionic) and water soluble for excretion
99
Which drug will increase excretion of an acidic drug?
Sodium bicarbonate
100
What is the first pass effect?
Drugs passed through liver prior to reaching site of action. Happens with oral meds.
101
T/F: Drugs that are more liposoluble are excreted more easily.
False
Liposoluble = better action
Water soluble = excreted
102
Why does a local infection make LA not work as well?
Lower pH in the area reduces free base amount of anesthetic (more ionized form due to low pH)
103
What is the most difficult pulpal condition to anesthetize?
Irreversible pulpitis on mandibular teeth
104
T/F: pKa affects onset.
True
105
T/F: Kids have higher pulse but lower BP.
True
106
How do you treat a lidocaine overdose?
Diazepam
107
How much epinephrine is safe for a cardio patient?
0. 04mg
| 0. 2mg for healthy patient
108
What is the max amount of carps for healthy patient? Cardio patient? (1:100,000)
```
Healthy = 8 carps
Cardio = 2 carps
```
109
T/F: Pts with muscular dystrophy are at a greater risk for LA toxicity.
True
110
What will a patient with muscular dystrophy look like?
Lower face with open bite
111
Cocaine use will cause pupils to ______.
dilate (mydriasis)
112
Opioid use will cause pupils to ______.
constrict (miosis)
113
Which LA causes vasoconstriction?
Cocaine
114
Overdose of which LA will cause methemoglobinemia?
Prilocaine
115
Which LA has no epinephrine?
Mepivocaine
116
What is unique about Articaine?
Amide but metabolized in blood
117
T/F: Anesthesia of facial nerve will cause excessive salivation.
False
118
What is contraindicated in patients taking MAO inhibitors?
Epinephrine
119
What is best indicator of intrapulpal anesthesia?
Back pressure
120
Which muscles elevate the jaw?
Masseter, temporalis, medial pterigoid
121
What are the indicatiions for premed?
1. Artificial heart valve
2. History of infective endocarditis
3. Congenital heart conditions unrepaired, or repaired with prosthetics
4. Cardiac transplant w/ valve problem
122
What is the proper dose of Amoxicillin for a kid premed?
50mg/kg
| 20mg/kg Clindamycin
123
How do most bacteriostatic abx work?
Affect protein synthesis
124
T/F: Tetracyclines are broad spectrum antibiotics
True
125
Chronic use of ______ will affect antibiotic metabolism.
benzos
126
Which antibiotic is antimicrobial and anitcollagenylitic?
Doxycycline
127
What dose of Clarithromycin can you give for a premed?
500mg
128
Which drug does not mix well with amoxicillin?
Methotrexate
129
How does tetracycline work?
black activity of collegenase; bind to 30s
130
T/F: Tetracycline is bacteriocidal.
False
bacteriostatic
131
Which type of antibiotic can cause intrinsic staining?
Tetracycline taken before birth
132
T/F: Tetracyclines have the highest concentration in GCF.
True
133
_______ have a cross allergy with penecillin.
Cephalosporin
134
T/F: Penecillin is inactivated with tetracycline.
True
135
What antibiotic is often used in perio?
Metronidazole
136
What antibiotic is often used for endo?
Pen VK
137
What drug treats overdose in methotrexate?
Leucovorin
138
_______ is an anticancer drug that inhibits folate reductase.
Methotrexate
139
Which race has lowest survival rate for OSCC?
Black
140
T/F: Amantadine is an antiviral.
True
141
Which are the systemic antifungals?
Flucanazole, Amphotericin-B, Ketocanazole
142
What are topical antifungals?
Nystatin, clotrimazole
143
How many human testing phases before a drug is taken to market?
Three
144
Very few postganglionic nerves in the sympathetic nervous system are cholinergic in nature. In which situation is this the case?
Most nerves to sweat glands are cholinergic even though they are part of the sympathetic nervous system
145
The nigrostriatal pathway contains dopaminergic neurons, which are important in muscle control. Many _______ drugs block these, leading to motor side effects.
antipsychotic
146
Haloperidol is an ________ drug. It is often taken in conjunction with _______, an anti-muscarinic to help control the motor side effects of haloperidol.
antipsychotic; benztropine
147
Benzodiazepine receptors are located on _______ channels.
chloride (ion channel)
148
Which inhalation sedative sensitizes the heart to epinephrine?
Halothane
149
Which two COX inhibitors are most similar in their action? Ibuprofen, naproxen or aspirin, ibuprofen?
Ibuprofen, naproxen. Both are reversible inhibitors and propionic acid derivatives. Aspirin is a salicylate and an irreversible inhibitor.
150
T/F: Albuterol and Famotidine are H1 histamine receptor blockers.
False
```
Albuterol = B2 blocker
Famotidine = H2 histamine blocker
```
151
Diphenhydramine, hydroxyzine, and fexofenadine are all _________. Which one is least involved in the CNS?
H1 histamine blockers; Fexofenadine
152
What adverse effects have been seen with selective COX2 inhibitors?
Cardiovascular
153
Most loop diuretics end in -semide. What is the exception?
Bumetanide
154
What type of channel does epinephrine act on?
G-protein linked receptor
155
What type of channel does insulin act on?
Tyrosine kinase-linked receptor
156
_______ act on nuclear receptors.
Thyroid hormone and steroid hormones
157
Which two diabetes drugs inhibit alpha-glucosidase, delaying carbohydrate digestion?
Acarbose and Miglitol
158
________ is a diabetes drug that activates PPARgamma.
Rosiglitzone
159
_______ is a diabetes drug that inhibits dipeptidyl peptidase-4, increasing glucagonlike peptide.
Sitagliptin
160
______ is a diabetes drug that increases the release of insulin.
Glibenclamide
161
How does Metformin act?
Activates adenosine monophosphate (AMP) kinase. This reduces liver glucose production, gluconeogenesis, and lipogenesis
162
Which types of diuretics act on the late distal tubule and collecting duct. Many of them block the aldosterone receptor.
Potassium sparing diuretics.
| ex. Spironolactone
163
Aldosterone and fludrocortisone are selective ________.
mineralcorticosteroids
164
Dexamethasone has mostly ________ activity.
glucocorticosteroid
165
Glucocorticoids such as _________, stimulate gluconeogenesis and lypolysis.
cortisol and glucagon
166
________ results in kidney problems from outdated tetracyclines.
Fanconi's syndrome
167
T/F: Clindamycin is effective against MRSA.
False
Vancomycin
168
Why are mycoplasma not effected by Penecillins?
They have no cell wall
169
What antibiotics are effective against mycoplasma?
Macrolides (ex. Clarithromycin) act as ribosomal protein synthesis inhibitors
170
What is the approximate elimination half-time for Penicillin V?
30mins
Rapid excretion through urine and very little metabolism
171
Which two benzodiazepines have the shortest half-lives?
Midazolam (2-5hrs)
| Triazolam (1-2hrs)
172
T/F: Diazepam has a relatively short half-life.
False
| 30-60hrs
