Important Info 2.1 ex 2 Flashcards
Beta adrenoreceptor blocks (beta blockers) are in which Vaugh williams classification for antiarrhythmic medications?
a. Class I
b. Class II
c. Class III
d. Class IV
b. Class II
Which of the following substances is released by the adrenal medulla and is considered to be a neurohormone?
a. Epinephrine
b. Norepinephrine
c. Dopamine
d. Acetylcholine
a. Epinephrine
In older pt or those over the age of 65 years, it is not uncommon to see a decrease in hepatic activity, especially ______ metabolism which can lead to drug accumulation
a. Phase I
b. Phase 2
c. Phase 3
d. Phase 4
a. Phase I
Which antianginal medication has a risk of QT prolongation and may cause an arrhythmia called torsade de points (TdP)?
a. Atenolol
b. Isosorbide mononitrate
c. Ranolazine
d. Verapamil
c. Ranolazine
Beta 1 receptor agonism leads to all of the following except
a. increased HR
b. Bronchodilation
c. Positive inotropy
d. Increased conduction
b. Bronchodilation
Gingival hyperplasia is a side effect that has been associated MOST COMMONLY with which one of the following antiseizure medications?
a. Iamotrtigine
b. Topiramate
c. Phenytoin
d. Levetiracetam
c. Phenytoin
Cardiac output is a function of HR and other factor ?
a. Afterload
b. End diastolic volume
c. End systolic volume
d. Stroke volume
d. Stroke volume
Which of the following agents has the greatest risk causing orthostatic hypotension when your pt goes from sitting to standing
a. Tamsulosin
b. Clonidine
c. Dexmedetomidine
d. Terazosin
d. Terazosin
Which of the following agents is considered first line treatment to increase HR and to dry secretion in patients exposed to nerve agents, e.g. VX nerve gas?
a. Glycopyrrolate
b. Atropine
c. Edrophonium
d. Pralidoxime
b. Atropine
Which medication increased cardiac contractility by stimulating myocardial beta 1 receptors?
a. Digitoxin
b. DOBUTamin (Dobutrex)
c. Levosimendan
d. Milirinone
b. DOBUTamin (Dobutrex)
Which of the following is a good surrogate marker of myocardial oxygen demand (MVO2)?
a. Afterload
b. Double product (heart x systolic BP)
c. Preload
d. Troponin
b. Double product (heart x systolic BP)
A patient is utilizing the beta agonist albuterol (ventolin) on an as needed basis for asthma. Which on the following meds is most likely to result in a pharmacodynamic interaction and negate the beneficial effect of albuterol?
a. Propanolol
b. Ibuprofen, NSAID
c. Cetirizine
d. Furosemide
Propranolol
Individual drug variation can result from pharmacokinetic and pharmacodynamic differences and may also be categorized as idiosyncratic. Which of the following statements provides an example of a pharmacodynamic effect?
a. Metabolism by liver enzyme CYP3A4
b. Protein binding to albumin
c. Sedation from blocking histamine 1 receptor
d. Increased distribution
c. Sedation from blocking histamine 1 receptor
Which one of the following med is more likely to be association w the development of anaphylactic shock?
a. Clozapine
b. Valproic acid
c. Sulfamethoxazole trimethoprim (bactrim)
d. Penicillin (pen VK)
d. Penicillin (pen VK)
During dental procedure which drugs should you avoid in pt w history of asthma?
a. Aspirin
b. Opiates
c. Antihistamines
d. All of the above
d. All of the above
Which of the following neuromuscular blockers is classified as depolarizing paralytic?
a. Pancuronium
b. Rocuronium
c. Succinylcholine
d. Vecuronium
c. Succinylcholine
Grapefruit juice inhibitor of which liver enzyme
a. Cyp2d6
b. cyp3A4
c. Cyp2c9
d. Cyp2b19
b. cyp3A4
Ventricular repolarization represented on the ECG by the
a. P wave
b. PR interval
c. QRS complex
d. T wave
d. T wave
Which of the following agent is a phosphodiesterase 3 inhibitor
a. Dobutamine
b. Dopamine
c. Milirinone
d. Phenylephrine
c. Milirinone
Which of the following is an example of an irreversible indirect acting cholinergic agent?
a. Sarin
b. Donepezil
c. Galantamine
d. Rivastigmine
a. Sarin
Toxin induced cell damage from drug metabolites can occur through a series of noncovalent and covalent interactions. Which one of the following is considered a noncovalent type of interaction
a. Exposed hepatocytes resulting in hepatoxicity
b. Increase protein resulting in nephrotoxicity
c. Increased build up of glutathione
d. Formation of hydrogen peroxide
d. Formation of hydrogen peroxide
A patient present to the dental clinic for routine cleaning. The pt complains of extreme dry mouth and feeling sleepy. You review the medication profile, which one of the following medications is most likely to result in dry mouth and sedation due to pharmacodynamic based receptor effects at the histamine receptor?
a. Diphenhydramine, benadryl
b. Sertraline (zoloft), depression
c. Propranolol, blood pressure medication
d. Valproic acid, anti seizure medication
a. Diphenhydramine, benadryl - allergy med this is what I found too
What are the 3 endogenous catecholamines?
a. Norepinephrine, dopamine, epinephrine
b. Dopamine, vasopressin, phenylephrine
c. Norepinephrine, dobutamine, epinephrine
d. Dobutamine, vasopressin, norepinephrine
a. Norepinephrine, dopamine, epinephrine
Which of the following results from covalent modification and alteration of DNA?
a. Teratogenicity
b. Mutagenesis
c. Carcinogenicity
d. Cardiotoxicity
b. Mutagenesis
Which of the following beta blockers would be considered be safest to use in a pt with severe asthma?
a. Timolol
b. Metoprolol
c. Carvedilol
d. Propranolol
b. Metoprolol
Sympathetic post ganglionic neuron released which of the following
a. Norepinephrine
b. Acetylcholine
c. Dopamine
d. Tyrosine
a. Norepinephrine
A new drug is in developement that is designed to treat chronic dry mouth. In order to minimize the potential for adverse effects and unwanted clinical effects while maximizing the ability to stimulate saliva secretion, which of the following receptors should this new drug be a selective agonist of?
a. M1
b. M2
c. M3
d. Post ganglionic nicotinic receptor
c. M3
Physical state of pregnancy can contribute to the drug variation. Which of the following
statement is a correct observation of a physiologic change that commonly occurs during
pregnancy?
a. Increased renal blood flow and decreased GFR
b. Increased renal blood flow and GFR
c. Increased maternal plasma protein
d. Decreased cardiac output
b. Increased renal blood flow and GFR
Calcium channel blockers are in which vaughan-williams classification for antiarrhythmic
medications?
a. Class I
b. Class II
c. Class III
d. Class IV
d. Class IV
Which of the following anticholinergic drugs is considered a quaternary amine, meaning
it has greater peripheral effects and few CNS effects?
a. Atropine
b. Benztropine
c. Dicyclomine
d. Glycopyrrolate
d. Glycopyrrolate
Which of the following is a characteristic of alpha 1 adrenergic receptor activation?
a. Inhibitory peripheral response
b. Increases sympathetic tone
c. Decreases blood pressure
d. Causes bronchodilation
b. Increases sympathetic tone
In a patient who presents w severe cholinergic toxicity, which of the following symptoms
would atropine not be effective in treatment
a. Bradycardia
b. Hypersalivation
c. Paralysis
d. Urination
c. Paralysis
Which potent alpha agonist can be used both as a nasal decongestant and for short
term management for hypotension
a. Epinephrine
b. Phenylephrine
c. Dobutamine
d. Dopamine
b. Phenylephrine
An example of adverse effect that is independent of the drug’s main pharmacological
mechanism of action is which of the following
a. Aspirin and tinnitus
b. Sertraline and stomach upset
c. Clozapine and sedation
d. Hydroxyzine and dry eyes
a. Aspirin and tinnitus
Which type of arrhythmia with a HR greater than 100 beats pr minute?
a. Asystole
b. bradycardia
c. Heart block
d. Tachycardia
d. Tachycardia
Which of the following drugs is used to regenerated acetylcholinesterase following
exposure to nerve agents
a. Atropine
b. Pyridostigmine
c. Pralidoxime
d. Succinylcholine
c. Pralidoxime
Which of the following medication improves angina by inhibiting calcium ions influx
through L type of slow calcium channels?
a. Amlodipine (norvasc)
b. Metoprolol (lopressor/tropol XL)
c. Nitroglycerine (nitrostat)
d. Ranolazine (ranexa)
a. Amlodipine (norvasc)
Which of the following is the preferred dose and route of epinephrine for management of
anaphylaxis?
a. 0.3 mg IV
b. 0.3 mg subcutaneously
c. 0.3 mg IM
d. 1 mg IV
c. 0.3 mg IM
Fluoxetine is a SSRI antidepressant and inhibitor of cytochrome p450 2d6. Risperidone
is antipsychotic and is a substance for cytochrome p450 2d6. What effect would you
expect fluoxetine to have on risperidone in terms of concentration?
a. Risperidone levels increase
b. Risperidone leaves decrease
c. Risperidone levels not impacted
a. Risperidone levels increase
Which medication is an example of selective beta 2 agonist that provides short term
control in patients w asthma?
a. Albuterol
b. Formoterol
c. Salmeterol
d. Budesonide
a. Albuterol
Which of the following is TRUE regarding beta 2 adrenergic receptor
a. Enhanced myocardial contractility
b. Excitatory responses
c. Triggers bronchodilation
d. Increase in chronotropy and inotropy
c. Triggers bronchodilation
Which of the following medication has a risk of gingival hyperplasia ?
a. Acebutolol
b. Dilitazem
c. Ivabradine
d. Ranolazine
b. Dilitazem
A drug that has an effect of increasing gastric emptying will have an effect on
gastrointestinal absorption of drug?
a. Increased absorption
b. Decreased absorption
c. Initial decrease and then an increase in absorption
d. No effect on absorption
a. Increased absorption
Ethnic variation is a possible contributor to the quantitative and qualitative responses
that individuals experience to medication and other drugs. An example of this is that
some individuals of chinese descent do not metabolize alcohol as well and may
experience flushing and palpitations. This is because of a buildup of plasma
concentrations of _________
a. Nitric oxide
b. Acetaldehyde
c. Renin
d. Acetic acid
b. Acetaldehyde
Which of the following neurotransmitters is released by postganglionic fibers of the
parasympathetic system?
a. Norepinephrine
b. Epinephrine
c. Atropine
d. Acetylcholine
d. Acetylcholine
Which of the following medication has a possible adverse drug reaction (ADR) of
photosensitivity which may make it painful for pt to have a dental light in their eyes?
a. Amiodarone (Cordarone)
b. Disopyramide
c. Metoprolol
d. Propafenone
a. Amiodarone (Cordarone)
Which ion is required to bind to actin and myosin to produce cardiac contractility?
a. Calcium
b. Chloride
c. Potassium
d. Magnesium
a. Calcium
Which of the following symptoms would you NOT expect to see in patient presenting
with acute cholinergic toxicity?
a. Diarrhea
b. Dry mouth
c. Emesis
d. Miosis
b. Dry mouth
Movement of this ion is responsible for the rapid repolarization phase (phase 3) of the
cardiac action potential?
a. Calcium
b. Magnesium
c. Potassium
d. Sodium
c. Potassium
What is a common pharmacologic effect of alpha adrenergic antagonist that can occur if
a dental patients gets up from their chair too quickly?
a. Alpha 2 blockade - orthostatic hypertension
b. Alpha 2 blockade - orthostatic hypotension
c. Alpha 1 blockade - orthostatic hypotension
d. Alpha 1 blockade - orthostatic hypertension
c. Alpha 1 blockade - orthostatic hypotension
Which of the following enzymes is responsible for breaking down free acetylcholine in
the serum?
a. Monoamine oxidase
b. catechol O methyl transferase
c. Acetylcholinesterase
d. Dopamine
c. Acetylcholinesterase
What substance is released by PREGANGLIONIC fibers in the autonomic nervous
system?
a. Acetylcholine
b. COMT
c. Epinephrine
a. Acetylcholine
