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NBDE Pt 2 > High Yield - Pharm > Flashcards

High Yield - Pharm Flashcards

1
Q

Where are alpha-1 receptors found and what is their function?

A

Vascular smooth muscle. Vasoconstriction.

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2
Q

If alpha-1 receptors are blocked, what would be the result?

A

Vasodilation. Decrease in blood pressure.

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3
Q

Where are beta-1 receptors found and what is their function?

A

Heart. Increase heart rate and contractility.

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4
Q

If beta-1 receptors are blocked what would be the result?

A

Decreased heart rate. Decreased blood pressure.

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5
Q

Where are beta-2 receptors found, what is their function?

A

Skeletal muscle and bronchial smooth muscle. Vasodilation and bronchodilation.

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6
Q

What is the result of epinephrine on the various receptors?

A

a1 - vasoconstriction
a2 - complicated
b1 - increased heart rate/CO
b2 - bronchodilation

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7
Q

What is the target receptor of hemostatic agents in retraction cord?

A

A1 - vasoconstriction

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8
Q

Amphetamines lead to release of what chemicals in brain?

A

norepinephrine

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9
Q

What are the active agents in Ritalin and Adderral?

A 
Ritalin = methylphenidate
Adderral = Amphetamine
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10
Q

________ exerts its effects through dopamine uptake blockade of central adrenergic neurons (norepinephrine-dopamine reuptake inhibitor).

A

Ritalin (methylphenidate)

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11
Q

_______ exerts its effects by increasing catecholamine NE, serotonin, dopamine release as its primary action.

A

Adderral (amphetamine)

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12
Q

T/F: Nervous patients should continue taking amphetamines.

A

False

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13
Q

ADHD is most common in what gender?

A

Boys

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14
Q

Vascular smooth muscle relaxation is caused by what types of drugs?

A

Alpha 1 blockers.

  • zosin.
    ex. prazosin
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15
Q

Corticosteroids?

A 
Variety of anti-inflammatory affects.
-isone
Pred-
-olone
-onide

ex. Fluticasone, Prednisone

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16
Q

Barbituates?

A

Sedatives, CNS depressants.

  • bital
    ex. butalbital
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17
Q

What types of drugs end in -dazole?

A

Antibiotics

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18
Q

Calcium channel blockers?

A

Reduce CO and cause vasodilation.

  • dipine
  • Verapamil, Diltiazem
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19
Q

What are the two main classes of Calcium channel blockers?

A

Dihydropyridines: end in -dipine

Non-dihydropyridines: Verapamil, Diltiazem

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20
Q

Bisphosphonates?

A

Prevent loss of bone density, treat osteoporosis. Reduce osteoclast activity.

  • dronate
    ex. Alendronate
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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

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22
Q

Proton pump inhibitor (PPI)?

A

Treat GERD.

  • eprazole
    ex. Omeprazole
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23
Q

Antihistamines?

A

Block histamine receptors, treat allergies and nasal congestion.

  • iramine
  • tadine
    ex. pheniramine, loratadine
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24
Q

Which histamine receptor is found in the nose and often the target of OTC antihistamines?

A

H1

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25
Q

Beta blockers?

A

Block Beta1 receptor, decrease CO, lower BP.

  • olol
    ex. atenolol, propanolol
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26
Q

ACE inhibitors?

A

Block conversion of angiotensin 1 -> angiotensin 2, lower CO, lower BP.

  • pril
    ex. lisinopril
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27
Q

What are the effects of ACE inhibitors?

A

Vasodilation, reduced CO, increase in Bradykinin

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28
Q

Angiotensin II receptor blockers?

A

Do not allow Angiotensin II to bind to receptors, lower CO, lower BP.

  • sartan.
    ex. losartan
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29
Q

T/F: ACE inhibitors and Angiotensin II receptor blockers are among the first line of defense for hypertensive patients.

A

True

ARBs may have less adverse side effects

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30
Q

Loop diuretics?

A

Treat hypertension in pts with reduced kidney function.

  • semide
    ex. furosemide, bumetanide
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31
Q

Which part of the kidney do loop diuretics act on?

A

ascending limb of the loop of Henle

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32
Q

Beta agonists?

A

Cause bronchodilation.

  • terol
    ex. albuterol
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33
Q

T/F: Most beta agonists that end in -terol are selective for the beta2 receptor.

A

True

Except prenalterol and xamoterol

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34
Q

Thiazide diuretics?

A

Treat hypertension.

  • thiazide
    ex. chlorothiazide
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35
Q

Benzodiazepines?

A

Enhance effect of GABA, treat seizures, anxiety, good for sedation.

  • zepam
  • zolam
    ex. diazepam, midazolam
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36
Q

Alpha blockers?

A

Block A1 receptor leading to vasodilation.

  • zosin
    ex. prazosin
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37
Q

_______ is a negative side effect of amphetamines.

A

Insomnia

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38
Q

T/F: Terazosin would lead to vasoconstriction in the gingiva.

A

False

-zosin = A1 blocker. Would vasodilate.

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39
Q

What would be the ultimate result of taking epinephrine and propanolol?

A

Propanolol = beta blocker. Epinephrine would only act on A1 -> increased BP. Feedback loop would lower heart rate as a result.
Increase BP, lower HR

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40
Q

T/F: Nitroglyceride, Ca channel blockers, and propranolol are all used to treat angina.

A

True

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41
Q

T/F: Sympathomimetic drugs should be avoided in patients taking propanolol.

A

True

Epinephrine in combo with beta-blockers can have adverse effects

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42
Q

What types of drugs will reverse effects of epinephrine?

A

Alpha blockers

ex. phenoxybenzamine

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43
Q

T/F: Cholinergic drugs mimic the parasympathetic system.

A

True

Cholinergic = parasympathetic (salivation, urination, vasodilation, bradycardia, miosis, bronchoconstriction)

Adrenergic = sympathetic

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44
Q

Salivary secretion _______ with cholinergic drugs such as Pilocarpine and Neostigmine.

A

increases

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45
Q

T/F: Scopolamine and atropine are anticholinergic drugs.

A

True

Can be used for motion sickness

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46
Q

T/F: Antihistamines are used for motion sickness.

A

True

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47
Q

Neostigmine, physostigmine, and pilocarpine are all _______.

A

cholinergic drugs

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48
Q

Atropine, scopolamine, Belladonna alkaloids and glycopyrrolate are ________.

A

anticholinergic drugs

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49
Q

T/F: Anticholinergics are contraindicated in patients with glaucoma.

A

True

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50
Q

______ is a term for the constriction of pupils. Which types of drugs cause this?

A

Miosis; opioids, cholinergics

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51
Q

_______ is a term for dilation of pupils. Which types of drugs cause this?

A

Mydriasis; amphetamines, anticholinergics, serotonergics

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52
Q

How is an adrenergic signal terminated?

A

MAO degrades NE

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53
Q

What is the mechanism of levodopa to treat Parkinson’s?

A

Replenishes deficiency of dopamine

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54
Q

Why must you take carbidopa with levodopa?

A

Prevents breakdown of levodopa befor crossing blood brain barrier

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55
Q

What causes Parkinson’s disease?

A

Dopamine deficiency

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56
Q

What is a therapeutic index?

A

Lethal dose/effective dose.

High = safe

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57
Q

What is the bioavailability of a drug?

A

Amount available in blood

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58
Q

What is the most important factor in drug dosing?

A

Potency

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59
Q

Two drugs are similar in everything except they have different affinities for the receptor. How are they the same?

A

Same efficacy, different potency

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60
Q

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.

A

potent

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61
Q

Which benzodiazepine is often used for anxiety disorders?

A

Xanax = alprazolam

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62
Q

How do benzodiazepines effect GABA receptors?

A

Increase frequency of chloride channel opening

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63
Q

T/F: Long acting benzos (diazepam) are contraindicated in elderly patients.

A

True

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64
Q

Which is the best benzo for IV sedation?

A

Midazolam

Has amnesia effect

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65
Q

Which benzos are not metabolized in the liver?

A

Lorazepam
Oxazepam
Temazepam

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66
Q

Which drug reverses benzo action?

A

Flumazenil

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67
Q

T/F: Benzos are indicated in pregnant women.

A

False

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68
Q

How does the body metabolize most short acting barbiturates?

A

Oxidation in liver

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69
Q

Why do ultrashort acting barbiturates work so fast?

A

Redistribution

70
Q

What is the #1 problem for patients during IV sedation?

A

Hypoxia

71
Q

What drug class is used for seizures?

A

Benzodiazepines

72
Q

Which sedative is indicated for pregnant women?

A

Promethazine

73
Q

Which hormone does prozac act on?

A

Serotonin; SSRI

74
Q

T/F: Many geriatric patients suffer from depression.

A

True

75
Q

What is the 1st sign of dementia?

A

Short term memory loss

76
Q

How do TCAs work?

A

Decrease re-uptake of NE and serotonin

77
Q

What is a side effect of taking TCA and epinephrine?

A

hypertension

78
Q

What type of antidepressant is Zoloft (Sertraline)

A

SSRI; inhibits re-uptake of serotonin

79
Q

St. John’s Wort helps with what disorder?

A

Depression

80
Q

What drug is used for bipolar disorders?

A

Lithium

81
Q

What is a strong, long-acting corticosteroid?

A

Dexamethasone

82
Q

What is the main long-term side effect of corticosteroid use?

A

Osteoporosis, hyperglycimia, immunosuppression

83
Q

What is the most effective medication for reducing airway inflammation and mucus production?

A

Inhaled corticosteroid.

ex. fluticasone

84
Q

What is Addison’s disease?

A

Adrenal glands do not produce enough steroids. Will cause mucosal pigmentation. Treated with long-term corticosteroid therapy.

85
Q

T/F: Someone with Addison’s disease should be advised to increase their corticosteroid dose during dental treatment.

A

True

86
Q

T/F: Nitrous oxide has the fastest onset among inhalation agents.

A

True

87
Q

T/F: Nitrous oxide has a very low solubility in the blood.

A

True

Allows it to be removed rapidly via exhalation

88
Q

T/F: Nitrous oxide has a very high MAC.

A

True

Not very potent

89
Q

T/F: Nitrous oxide should be avoided in pregnant patients.

A

True (esp in 1st trimester)

Also contraindicated in COPD

90
Q

What is the max amount of nitrous to safely give a child?

A

50%

Most machines have cut off at 70%

91
Q

What is the most common side effect with nitrous?

A

Nausea

92
Q

What is the effect of using hydroxizyne with chloral hydrate?

A

Reduce nausea

93
Q

Which two anesthetics might have a cross-allergy?

A

Looking for an answer with either two amides (two I’s) or two esters (one I)

94
Q

Amides are metabolized where?

A

Liver via P450

95
Q

How are esters metabolized?

A

Pseudocholinerstserase in plasma

96
Q

How does LA work?

A

Blocks intracellular sodium channels. Decrease sodium uptake

97
Q

What is the primary reason for adding epinephrine to LA?

A

Prolong action by decreasing rate of absorption

98
Q

What is biotransformation?

A

How anesthetics are broken down. Makes them more polar (ionic) and water soluble for excretion

99
Q

Which drug will increase excretion of an acidic drug?

A

Sodium bicarbonate

100
Q

What is the first pass effect?

A

Drugs passed through liver prior to reaching site of action. Happens with oral meds.

101
Q

T/F: Drugs that are more liposoluble are excreted more easily.

A

False
Liposoluble = better action
Water soluble = excreted

102
Q

Why does a local infection make LA not work as well?

A

Lower pH in the area reduces free base amount of anesthetic (more ionized form due to low pH)

103
Q

What is the most difficult pulpal condition to anesthetize?

A

Irreversible pulpitis on mandibular teeth

104
Q

T/F: pKa affects onset.

A

True

105
Q

T/F: Kids have higher pulse but lower BP.

A

True

106
Q

How do you treat a lidocaine overdose?

A

Diazepam

107
Q

How much epinephrine is safe for a cardio patient?

A
  1. 04mg

0. 2mg for healthy patient

108
Q

What is the max amount of carps for healthy patient? Cardio patient? (1:100,000)

A 
Healthy = 8 carps
Cardio = 2 carps
109
Q

T/F: Pts with muscular dystrophy are at a greater risk for LA toxicity.

A

True

110
Q

What will a patient with muscular dystrophy look like?

A

Lower face with open bite

111
Q

Cocaine use will cause pupils to ______.

A

dilate (mydriasis)

112
Q

Opioid use will cause pupils to ______.

A

constrict (miosis)

113
Q

Which LA causes vasoconstriction?

A

Cocaine

114
Q

Overdose of which LA will cause methemoglobinemia?

A

Prilocaine

115
Q

Which LA has no epinephrine?

A

Mepivocaine

116
Q

What is unique about Articaine?

A

Amide but metabolized in blood

117
Q

T/F: Anesthesia of facial nerve will cause excessive salivation.

A

False

118
Q

What is contraindicated in patients taking MAO inhibitors?

A

Epinephrine

119
Q

What is best indicator of intrapulpal anesthesia?

A

Back pressure

120
Q

Which muscles elevate the jaw?

A

Masseter, temporalis, medial pterigoid

121
Q

What are the indicatiions for premed?

A
  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
Q

What is the proper dose of Amoxicillin for a kid premed?

A

50mg/kg

20mg/kg Clindamycin

123
Q

How do most bacteriostatic abx work?

A

Affect protein synthesis

124
Q

T/F: Tetracyclines are broad spectrum antibiotics

A

True

125
Q

Chronic use of ______ will affect antibiotic metabolism.

A

benzos

126
Q

Which antibiotic is antimicrobial and anitcollagenylitic?

A

Doxycycline

127
Q

What dose of Clarithromycin can you give for a premed?

A

500mg

128
Q

Which drug does not mix well with amoxicillin?

A

Methotrexate

129
Q

How does tetracycline work?

A

black activity of collegenase; bind to 30s

130
Q

T/F: Tetracycline is bacteriocidal.

A

False

bacteriostatic

131
Q

Which type of antibiotic can cause intrinsic staining?

A

Tetracycline taken before birth

132
Q

T/F: Tetracyclines have the highest concentration in GCF.

A

True

133
Q

_______ have a cross allergy with penecillin.

A

Cephalosporin

134
Q

T/F: Penecillin is inactivated with tetracycline.

A

True

135
Q

What antibiotic is often used in perio?

A

Metronidazole

136
Q

What antibiotic is often used for endo?

A

Pen VK

137
Q

What drug treats overdose in methotrexate?

A

Leucovorin

138
Q

_______ is an anticancer drug that inhibits folate reductase.

A

Methotrexate

139
Q

Which race has lowest survival rate for OSCC?

A

Black

140
Q

T/F: Amantadine is an antiviral.

A

True

141
Q

Which are the systemic antifungals?

A

Flucanazole, Amphotericin-B, Ketocanazole

142
Q

What are topical antifungals?

A

Nystatin, clotrimazole

143
Q

How many human testing phases before a drug is taken to market?

A

Three

144
Q

Very few postganglionic nerves in the sympathetic nervous system are cholinergic in nature. In which situation is this the case?

A

Most nerves to sweat glands are cholinergic even though they are part of the sympathetic nervous system

145
Q

The nigrostriatal pathway contains dopaminergic neurons, which are important in muscle control. Many _______ drugs block these, leading to motor side effects.

A

antipsychotic

146
Q

Haloperidol is an ________ drug. It is often taken in conjunction with _______, an anti-muscarinic to help control the motor side effects of haloperidol.

A

antipsychotic; benztropine

147
Q

Benzodiazepine receptors are located on _______ channels.

A

chloride (ion channel)

148
Q

Which inhalation sedative sensitizes the heart to epinephrine?

A

Halothane

149
Q

Which two COX inhibitors are most similar in their action? Ibuprofen, naproxen or aspirin, ibuprofen?

A

Ibuprofen, naproxen. Both are reversible inhibitors and propionic acid derivatives. Aspirin is a salicylate and an irreversible inhibitor.

150
Q

T/F: Albuterol and Famotidine are H1 histamine receptor blockers.

A

False

Albuterol = B2 blocker
Famotidine = H2 histamine blocker
151
Q

Diphenhydramine, hydroxyzine, and fexofenadine are all _________. Which one is least involved in the CNS?

A

H1 histamine blockers; Fexofenadine

152
Q

What adverse effects have been seen with selective COX2 inhibitors?

A

Cardiovascular

153
Q

Most loop diuretics end in -semide. What is the exception?

A

Bumetanide

154
Q

What type of channel does epinephrine act on?

A

G-protein linked receptor

155
Q

What type of channel does insulin act on?

A

Tyrosine kinase-linked receptor

156
Q

_______ act on nuclear receptors.

A

Thyroid hormone and steroid hormones

157
Q

Which two diabetes drugs inhibit alpha-glucosidase, delaying carbohydrate digestion?

A

Acarbose and Miglitol

158
Q

________ is a diabetes drug that activates PPARgamma.

A

Rosiglitzone

159
Q

_______ is a diabetes drug that inhibits dipeptidyl peptidase-4, increasing glucagonlike peptide.

A

Sitagliptin

160
Q

______ is a diabetes drug that increases the release of insulin.

A

Glibenclamide

161
Q

How does Metformin act?

A

Activates adenosine monophosphate (AMP) kinase. This reduces liver glucose production, gluconeogenesis, and lipogenesis

162
Q

Which types of diuretics act on the late distal tubule and collecting duct. Many of them block the aldosterone receptor.

A

Potassium sparing diuretics.

ex. Spironolactone

163
Q

Aldosterone and fludrocortisone are selective ________.

A

mineralcorticosteroids

164
Q

Dexamethasone has mostly ________ activity.

A

glucocorticosteroid

165
Q

Glucocorticoids such as _________, stimulate gluconeogenesis and lypolysis.

A

cortisol and glucagon

166
Q

________ results in kidney problems from outdated tetracyclines.

A

Fanconi’s syndrome

167
Q

T/F: Clindamycin is effective against MRSA.

A

False

Vancomycin

168
Q

Why are mycoplasma not effected by Penecillins?

A

They have no cell wall

169
Q

What antibiotics are effective against mycoplasma?

A

Macrolides (ex. Clarithromycin) act as ribosomal protein synthesis inhibitors

170
Q

What is the approximate elimination half-time for Penicillin V?

A

30mins

Rapid excretion through urine and very little metabolism

171
Q

Which two benzodiazepines have the shortest half-lives?

A

Midazolam (2-5hrs)

Triazolam (1-2hrs)

172
Q

T/F: Diazepam has a relatively short half-life.

A

False

30-60hrs

NBDE Pt 2 (12 decks)

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