MOSBY Flashcards
Which drugs tend to concentrate in body compartments of high pH?
A. Permanently charged drugs
B. Drugs that are not charged
C. Weak organic acids
D. Weak organic bases
E. Inorganic ions
C. Weak organic acids
Drug agonists having the same intrinsic activity also have the same _____.
A. Maximal effect
B. Potency
C. Receptor affinity
D. Therapeutic index
E. Aqueous solubility
A. Maximal effect
What receptor or signaling pathway is linked most directly to a2-adrenoceptor stimulation?
A. Gi and a reduction in cAMP
B. Gs and an increase in cAMP
C. Gq and calcium
D. Sodium ion channel
E. Membrane receptor containing tyrosine kinase
A. Gi and a reduction in cAMP
What tissue or organ has many muscarinic receptors but lacks innervation to those receptors?
A. Heart
B. Parotid gland
C. Blood vessels
D. Sweat glands
E. Urinary bladder
C. Blood vessels
Which drug used in the therapy for Parkinsonism does not cross the blood–brain barrier?
A. Amantadine
B. Carbidopa
C. L-dopa
D. Selegiline
E. Tolcapone
B. Carbidopa
After an injection, which drug would be expected to have the longest duration of action? (Assume no vasoconstrictor was injected with the local anesthetic.)
A. Bupivacaine
B. Lidocaine
C. Mepivacaine
D. Prilocaine
E. Procaine
A. Bupivacaine
A very low blood:gas solubility coefficient (partition coefficient = 0.47), analgesic effect, and a drug that inhibits methionine synthase best describes which drug?
A. Ketamine
B. Nitrous oxide
C. Halothane
D. Isoflurane
E. Propofol
B. Nitrous oxide
Levonordefrin is added to certain cartridges containing mepivacaine. The desired effect of levonordefrin is due to what pharmacological effect?
A. Inhibition of nicotinic cholinergic receptors
B. Inhibition of muscarinic cholinergic receptors
C. Stimulation of α-adrenergic receptors
D. Stimulation of β-adrenergic receptors
E. Stimulation of dopamine receptors
C. Stimulation of α-adrenergic receptors
The analgesic effects of dextromethorphan are due to what receptor effect?
A. Gamma aminobutyric acid (GABA) receptor antagonism.
B. Dopamine receptor antagonism.
C. Nicotinic cholinergic receptor antagonism.
D. Mu (μ) opioid receptor antagonism.
E. N-methyl-D-aspartate (NMDA) receptor antagonism.
E. N-methyl-D-aspartate (NMDA) receptor antagonism.
Naloxone antagonizes the therapeutic and toxic effects of which drug?
A. Acetaminophen
B. Aspirin
C. Carbamazepine
D. Fentanyl
E. Ibuprofen
D. Fentanyl
What is the mechanism of the analgesic action of aspirin?
A. Stimulates μ opioid receptors
B. Blocks histamine H2 receptors
C. Inhibits cyclooxygenase
D. Inhibits lipoxygenase
E. Blocks sodium channels in nerves
C. Inhibits cyclooxygenase
What is the clinical setting for the use of ketorolac by the oral route?
A. For severe pain
B. For initial treatment of pain
C. To continue therapy after an IV or IM dose of ketorolac
D. Only in combination with an opioid
E. Only in combination with an NSAID
C. To continue therapy after an IV or IM dose of ketorolac
The use of H2 histamine receptor blockers is most clinically useful at what cell type?
A. Beta cells of the pancreas
B. Basophils
C. Mast cells
D. Juxtaglomerular cells
E. Parietal cells
E. Parietal cells
Which class of antihypertensive drug most effectively reduces the release of renin from the kidney?
A. β-adrenergic receptor blockers
B. ACE inhibitors
C. α-adrenergic receptor blockers
D. Calcium channel blockers
E. Angiotensin II receptor blockers
A. β-adrenergic receptor blockers
The administration of which compound will give “epinephrine reversal” (drop in blood pressure from epinephrine) if given prior to administration of epinephrine?
A. Guanethidine
B. Propranolol
C. Phenoxybenzamine
D. Tyramine
C. Phenoxybenzamine
What is the mechanism of action of enoxaparin?
A. Inhibition of synthesis of clotting factors II, VII, IX, and X
B. Activation of antithrombin III with resulting inhibition of clotting factor Xa
C. Indirect activation of tissue plasminogen activator
D. Direct inhibition of plasminogen with resulting degradation of fibrin
E. Dilation of coronary blood vessels
B. Activation of antithrombin III with resulting inhibition of clotting factor Xa
Oropharyngeal candidiasis is an adverse effect most likely with which drug?
A. Inhaled salmeterol
B. Inhaled ipratropium
C. Inhaled nedocromil
D. Inhaled beclomethasone
E. Inhaled methacholine
D. Inhaled beclomethasone
Oral antacids are most likely to reduce the absorption of which drug when it is given orally?
A. Clarithromycin
B. Clindamycin
C. Metronidazole
D. Penicillin V
E. Tetracycline
E. Tetracycline
A decrease in glycogenolysis in the liver would be expected from which drug?
A. Albuterol
B. Epinephrine
C. Glucagon
D. Insulin
E. Parathyroid hormone
D. Insulin
Nitrates and nitrites have what effect on blood vessel smooth muscle?
A. Increase in the level of intracellular calcium
B. Increase in the level of cyclic guanosine monophosphate (cGMP)
C. Antagonism at α1-adrenergic receptors
D. Antagonism at β-adrenergic receptors
E. Inhibition of L-type calcium channels
B. Increase in the level of cyclic guanosine monophosphate (cGMP)
Clavulanic acid offers an advantage therapeutically because it has what action?
A. It inhibits Streptococci at a low minimum inhibitory concentration (MIC).
B. It inhibits transpeptidase.
C. It inhibits penicillinase.
D. It inhibits anaerobes at a low MIC.
E. It inhibits DNA gyrase.
C. It inhibits penicillinase.
Identify the enzyme whose inhibition is most responsible for the cell wall synthesis inhibitory effect of penicillin G.
A. β-lactamase
B. DNA gyrase
C. Nitro reductase
D. Transglycosylase
E. Transpeptidase
E. Transpeptidase
Which drug is often combined with sulfamethoxazole for the treatment of respiratory tract and urinary tract infections?
A. Amoxicillin
B. Ciprofloxacin
C. Clindamycin
D. Metronidazole
E. Trimethoprim
E. Trimethoprim
Which of the following organisms is usually sensitive to clindamycin?
A. Candida albicans
B. Klebsiella pneumoniae
C. Methicillin-resistant Staphylococcus aureus
D. Streptococcus viridans
E. Pseudomonas aeruginosa
D. Streptococcus viridans
Dihydrofolate reductase is an enzyme inhibited by which anticancer drug?
A. Bleomycin
B. Cisplatin
C. Doxorubicin
D. 5-fluorouracil
E. Methotrexate
E. Methotrexate
Tight capillary cell junctions resulting in an added barrier to the entry of drugs is most characteristic of which organ or tissue?
A. Adrenal gland
B. Brain
C. Heart
D. Liver
E. Lung
B. Brain
A prescription for which of the following drugs requires a valid DEA number on the prescription?
A. Amoxicillin
B. Carbamazepine
C. Dexamethasone
D. Diphenhydramine
E. Oxycodone
E. Oxycodone
What would be the effect of prior administration of a competitive drug antagonist on the concentration–response profile of a drug agonist on a graded concentration–response curve? (Assume that both drugs act at the same receptor.)
A. The agonist curve would shift to the left.
B. The agonist curve would shift to the right.
C. The agonist curve would not change.
D. The agonist curve would not shift but would reach a lower maximal effect than the curve with agonist alone.
E. The agonist curve would both shift to the left and have a lower maximal effect.
A. The agonist curve would shift to the left.
How many human drug testing phases are carried out before a drug is marketed?
A. One
B. Two
C. Three
D. Four
C. Three
In what situation is the postganglionic nerve of the sympathetic system a cholinergic nerve?
A. The nerves to the eye
B. The nerves to the heart
C. Most nerves to blood vessels
D. Most nerves to sweat glands
E. Most nerves to salivary glands
D. Most nerves to sweat glands
Which is a nicotinic receptor?
A. Receptor for the neurotransmitter at the skeletal–neuromuscular junction
B. Receptor for the neurotransmitter at the junction between the postganglionic sympathetic nerve and sweat glands
C. Receptor for the neurotransmitter at the junction between the postganglionic parasympathetic nerve and the parotid gland
D. Receptor for the neurotransmitter at the junction between the postganglionic sympathetic nerve and blood vessels
E. Receptor for the neurotransmitter at the junction between the postganglionic parasympathetic nerve and the heart
A. Receptor for the neurotransmitter at the skeletal–neuromuscular junction
Which of the following effects is a typical effect of an antimuscarinic drug?
A. Bronchoconstriction
B. Lacrimation
C. Miosis
D. Sweating
E. Urinary retention
E. Urinary retention
The administration of which compound will give “epinephrine reversal” (drop in blood pressure from epinephrine) if given prior to administration of epinephrine?
A. Atropine
B. Guanethidine
C. Propranolol
D. Phenoxybenzamine
E. Tyramine
D. Phenoxybenzamine
Motor adverse effects from phenothiazine antipsychotic drugs are due to drug effects in what region of the brain?
A. Chemoreceptor trigger zone
B. Cerebrum
C. Cerebellum
D. Nigro-striatal pathway
E. Mesolimbic pathway
D. Nigro-striatal pathway
A patient is administered haloperidol. Along with the haloperidol, the patient also receives benztropine. What is the most likely reason for administering the benztropine?
A. To reduce the effects of histamine release
B. To aid in the therapeutic response to haloperidol
C. To reduce the motor adverse effects of haloperidol
D. To overcome a decrease in salivary flow resulting from haloperidol
E. To reduce the rate of kidney excretion of haloperidol
C. To reduce the motor adverse effects of haloperidol
The benzodiazepine receptors BZ 1 and BZ 2 are located on which ion channel?
A. Calcium
B. Chloride
C. Magnesium
D. Potassium
E. Sodium
B. Chloride
Methemoglobinemia is an adverse effect associated with which local anesthetic due to its metabolism to o-toluidine?
A. Lidocaine
B. Mepivacaine
C. Prilocaine
D. Bupivacaine
E. Benzocaine
C. Prilocaine
Which drug poses the greatest risk of a cardiac arrhythmia when administered at the same time as epinephrine?
A. Desflurane
B. Halothane
C. Isoflurane
D. Propofol
E. Sevoflurane
B. Halothane
Local anesthetics act on what type of receptor?
A. An ion channel receptor
B. A nuclear receptor
C. A 7-membrane domain receptor linked to Gs
D. A 7-membrane domain receptor linked to Gq
E. A membrane receptor with tyrosine kinase activity
A. An ion channel receptor
Which drug lacks the amine group that other anesthetics have and is used only topically?
A. Procaine
B. Mepivacaine
C. Lidocaine
D. Benzocaine
E. Prilocaine
D. Benzocaine
Injecting a local anesthetic into an area of inflammation would have which effect?
A. Increase the rate of onset of anesthesia.
B. Decrease the rate of metabolism of the anesthetic.
C. Reduce the net anesthetic effect of the drug.
D. Reduce the vasodilator effect of the localanesthetic.
E. Reduce the need for a vasoconstrictor with the local anesthetic.
C. Reduce the net anesthetic effect of the drug.
Which two drugs have mechanisms of analgesic action that are most similar?
A. Fentanyl, ibuprofen
B. Aspirin, codeine
C. Oxycodone, acetaminophen
D. Ibuprofen, naproxen
E. Aspirin, ibuprofen
D. Ibuprofen, naproxen
Your patient is continually taking a small daily dose of aspirin (82 mg) prescribed by the patient’s physician. The object of this therapy is most likely what mechanism?
A. To mimic the effect of endogenous endorphins
B. To inhibit the production of prostaglandin E1
C. To inhibit the production of thromboxane A2
D. To inhibit the production of arachidonic acid
E. To inhibit the production of leukotrienes
C. To inhibit the production of thromboxane A2
Your patient indicates that he is taking medication for atrial fibrillation. He reports that a blood test has indicated that he has an INR number of 4.0. An emergency dental extraction is now required. Which postoperative medication would pose the greatest risk for an adverse effect in this patient?
A. Acetaminophen
B. Amoxicillin
C. Aspirin
D. Codeine
E. Ibuprofen
C. Aspirin
Which drug blocks H1 histamine receptors but is least likely to cause sedation?
A. Diphenhydramine
B. Hydroxyzine
C. Fexofenadine
D. Albuterol
E. Famotidine
C. Fexofenadine
The use of selective COX-2 inhibitors has recently been restricted or discontinued because of what type of adverse effects?
A. Carcinogenesis
B. Cardiovascular disorders
C. Convulsive disorders
D. Striated muscle disorders
E. Skeletal disorders
B. Cardiovascular disorders
Sodium reabsorption in the thick ascending limb of the loop of Henle is inhibited by which drug?
A. Bumetanide
B. Chlorthalidone
C. Hydrochlorothiazide
D. Spironolactone
E. Triamterene
A. Bumetanide
Torsades de pointes, or polymorphic ventricular tachycardia, is linked most closely to what characteristic of the electrocardiogram?
A. Inverted T wave
B. Shorter P-R interval
C. Shorter P-P interval
D. Longer Q-T interval
E. Normal electrocardiogram
D. Longer Q-T interval
Which antihypertensive drug also increases bradykinin levels?
A. Candesartan
B. Furosemide
C. Lisinopril
D. Metoprolol
E. Nifedipine
C. Lisinopril
Which one of the following drugs enters the target cell and acts on a nuclear receptor?
A. Diazepam
B. Epinephrine
C. Insulin
D. Prednisone
E. Heparin
D. Prednisone
Inhibiting a-glucosidase and reducing glucose absorption from the gastrointestinal tract is the mechanism of action of which drug?
A. Acarbose
B. Acetoheximide
C. Glyburide
D. Metformin
E. Pioglitazone
A. Acarbose
Which of the following drugs blocks the aldosterone receptor?
A. Amiloride
B. Triamterene
C. Losartan
D. Spironolactone
E. Furosemide
D. Spironolactone
Which drug is most selective as a glucocorticosteroid?
A. Aldosterone
B. Dexamethasone
C. Fludrocortisone
D. Hydrocortisone
B. Dexamethasone
Stimulation of gluconeogenesis and lipolysis are most characteristic of which hormone?
A. Calcitonin
B. Cortisol
C. Insulin
D. Parathyroid hormone
E. Progesterone
B. Cortisol
Fanconi syndrome from outdated tetracyclines affects predominantly which organ?
A. Brain
B. Heart
C. Kidney
D. Pancreas
E. Stomach
C. Kidney
Methicillin-resistant Staphylococci are most likely to be inhibited by which drug?
A. Amoxicillin
B. Clarithromycin
C. Clindamycin
D. Vancomycin
E. Penicillin V
D. Vancomycin
Pick the organism that is usually clinically sensitive to clarithromycin but not to penicillin V.
A. Streptococcus viridans
B. Leptotrichia buccalis
C. Mycoplasma pneumoniae
D. Streptococcus pneumoniae
E. Streptococcus pyogenes
C. Mycoplasma pneumoniae
What is the approximate elimination half-time for penicillin V?
A. 0.5 hour
B. 2 hours
C. 4 hours
D. 8 hours
E. 12 hours
A. 0.5 hour
Which drug has an antibacterial spectrum that is limited to anaerobes?
A. Amoxicillin
B. Clarithromycin
C. Clindamycin
D. Gentamicin
E. Metronidazole
E. Metronidazole
