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Pharm: Mental Dental Flashcards

1
Q

What is the ideal drug to use for Ab prophy if. pt is allergic to Pen?

A

Azithromycin

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2
Q

Can Clinda be the correct answer if seen on the INBDE for ABx prophy if pt is allergic to pen or amox?

A

yes if azithro isn’t an answer choice

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3
Q

Mechanism of Action:

Damages microbial DNA and inhibits nucleic acid synthesis via reactive oxygen species
Indications:

is commonly prescribed in dentistry as a second line treatment that complements another antibiotic such as amoxicillin.

A

Metronidazole

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4
Q

Penicillin is cross-allergenic with ________, which is another β-lactam antibiotic, due to their similar chemical structure

A

cephalosporins

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5
Q

Mechanism of Action:

Inhibits protein synthesis (30s ribosomal subunit)
Indications:

Used as an adjunct in periodontal therapy
Concentrates well in the gingival crevicular fluid
Inhibits matrix metalloproteinases (MMPs) and helps prevents breakdown of collagen in gingival tissues

A

Tetracyclines (30s)

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6
Q

Mechanism of Action:

Protein synthesis inhibitor (50s ribosomal subunit)
Indications:

Commonly used in dentistry as an alternative to penicillin

A

Macrolides (50s)

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7
Q

___ LAs are metabolized in the liver

A

Amides
-Ones we use

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8
Q

_____ LAs are metabolized by pseudocholinesterase in plasma

A

Esters

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9
Q

What amide is the safest in children?

A

2% Lido

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10
Q

What amide is no safe in children?
-Longest duration

A

0.5 % Bupivicaine

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11
Q

What amide causes the least vasodilation?

A

2 or 3 %Mepivicaine

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12
Q

Which amide has one ester chain?
-Shortest duration

A

4% Articaine

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13
Q

What amide is linked to methemoglobinemia?

A

Prilocaine

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14
Q

Which ester is a vasoconstrictor?

A

Cocaine

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15
Q

What form of the drug can penetrate neuron membrane?

A

Non-ionized

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16
Q

How does increased blood flow affect duration of action?

A

Shorter duration of action

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17
Q

How does increased lipid solubility/ hydrophobicity affect duration of action and potency?

A

MOre potent, longer duration of action

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18
Q

How does increased protein binding affect duration of action?

A

Longer duration of action

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19
Q

How does decreased pKa affect onset of action?

A

Faster onset

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20
Q

How many mg of liquid is in a carp?

A

1.8 g 1800 mg

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21
Q

What is max dose of lido without epi in mg/kg?

A

4.4 mg/kg

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22
Q

What is max dose of lido with epi in mg/kg?

A

7 mg/kg

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23
Q

How deep in. mm should you go for a PSA block?

A

16 mm

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24
Q

What max nerve block has a high hematoma risk?

A

PSA

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25
Q

Which nerve block hits the ASA and MSA?

A

Infraorbital block

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26
Q

Bacteriostatic
Folate synthesis inhibitor (competes with PABA)
-Causes folic acid deficiency

A

Sulfonamides
Sulfadiazine, Sulfamethoxazole

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27
Q

Bactericidal
DNA synthesis inhibitor

A

Fluoroquinolones
-Floxacins

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28
Q

Bactericidal
Cell wall synthesis inhibitor, B lactam
Cross allergenic with cephalosporins
K: oral
G: IV

A

Penicillins

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29
Q

Is Pen V or Pen G oral?

A

Pen V

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30
Q

What penicillin has the broadest gram negative spectrum?

A

Ampicillin

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31
Q

What penicillin is used specficially against pseudomonas?

A

Carbenicillin

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32
Q

Bacteriostatic
Protein synthesis inhibiotr (30 S)
Broadest antimicrobial spetrum

A

Tetracyclines
Doxycycline

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33
Q

Bacteriostatic
Protein synthesis inhibiotr (50 S)

A

Macrolides
Erythromycin

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34
Q

What Abx has the broadest antimicrobial spectrum?

A

Tetracyclines

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35
Q

What drug is the drug of choice for prosthetic joint abx prophy?

A

Keflex 2 g

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36
Q

What ABX causes GI upset and pseduomonas colitis?

A

Clinda

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37
Q

What ABX is assc with aplatic anemia

A

Cholramphenicol

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38
Q

What ABX is assc with liver damage?

A

Tetracyclines

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39
Q

What ABX is assc with allergic cholestatic hepatitis?

A

Erythromycin estolate

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40
Q

Which antifungal is in troche form?

A

Clotrimazole

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41
Q

What NSAID is assc with GI issues more than others?

A

Aspirin

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42
Q

What NSAID is assc with kidney issues?

A

Ibuprofen

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43
Q

What 2 NSAIDs are selective Cox 2 blockers?

A

Meloxicam and Celecoxib

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44
Q

What NSAID is assc with blood dyscrasias?

A

Indomethacin

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45
Q

Which analgesic is assc with liver issues?

A

Acetaminophen

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46
Q

How does aspiriin cause analgesic and anti inflammatory response?

A

Inhibit PG2 synthesis via Cox 1 and 2

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47
Q

How does the antipyretic action of aspirin work?

A

Inhibits PG synthesis in temp regulation center of hypothalamus

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48
Q

HOw do corticosteroids exhibit analgesic and anti-inflammatory effects?

A

Inhibit phospholipase A2 blocking Arachadonic acid synthesis

49
Q

WHat analgesic can cause Reye’s syndrome?

50
Q

ADME and abosorption deals with what part of pharmacology?

A

Pharmacokinetics

51
Q

Is the pH or pKa higher for weak acids?

A

PkA is higher

52
Q

Is the pH or pKa higher for weak bases?

A

pH is higher

53
Q

Where is the majority of metabolism of drugs done in the body?

54
Q

Do drug to drug interaction deal more with pharmacokinetics or pharmacodynamics?

55
Q

Which elimination kinetics has a higher risk of drug accumulation?

A

Zero order kinetics

56
Q

Which elimination kinetics is a constant fraction of drug that is eliminated per unit time?

A

First order kinetics

57
Q

What part of pharmacology deals with rc binding/ agonist:antagonist?

A

Pharmacodynamics

58
Q

What shape is a type 1 dose curve?

59
Q

What is the maximal effect of a drug on the type 1 dose response curve?

60
Q

If Kd (dissociating constant) is higher, how does the affinity respond?

A

Lower affinity

61
Q

How is potency measured?

A

EC50 value

62
Q

If the EC50 value is higher, is drug more or less potent?

A

Less potent

63
Q

How does type 1 dose response curve shift in a competitive antagonist?

64
Q

How does type 1 dose response curve shift in a noncompetitive antagonist?

65
Q

Which dose response curve shows differences in number of subjects responding to curve?

A

Type 2 dose response curve (therapeutic, toxic, lethal)

66
Q

How do you measure Therapeutic index in human studies?

A

TD50/ ED50
Toxic effect/Therapeutic effect

67
Q

If the therapeutic index is higher, is the drug safer or more toxic?

A

Drug is safer

68
Q

What portion of the nervous system does PSNS come from?

A

Cranial nerves and sacral nerves

69
Q

What portion of the nervous system does SSNS come from?

A

Thoracolumbar region of spinal cord

70
Q

How are PSNS preganglionic and postganglionic nerves in length?

A

Long pre, short post

71
Q

What NT is released in pregang and post gang nerves in the PSNS?

72
Q

How are SSNS preganglionic and postganglionic nerves in length?

A

Short pre, long post

73
Q

All ganglionic rcs are what type of rc?

A

Nicotinic (nAChR: ionotropic)

74
Q

The rc in target organs for PSNS are what type of rc?

A

Muscarinic (mAChR: metabotropic)

75
Q

The rc in target organs for SSNS are what type of rc?

A

Adrenergic (metabotropic)

76
Q

What NT do cholinergic rc bind?

77
Q

What NT do adrenergic rcs bind?

A

NE and Epi

78
Q

_____ rc: Bradycardia
decreases HR and electrical conduction

79
Q

_____ rc: SLUDS and BAM
-Salivation, lacrimation, urination, defeation, sweating
-Bronchoconstriction, ab cramps, miosis

80
Q

What 3 conditions should Muscarinic agonist be avoided?

A

CHF, COPD/Emphysema, Peptic ulcers
PSNS stimulation

81
Q

The following drugs are what category?
Pilocarpine, methacholine, Neostigmine, Organophosphates

A

M agonists

82
Q

What is the reversal agent for organophosphates?

A

Pralidoxime

83
Q

The following drugs are in what category?
Atropine, scopolamine, propantheline?

A

M antagonists

84
Q

The following drugs are what category?
Tubocuraine, Succinylcholine, Mecamylamine, Hexamethonium, Nicotine

A

N antagonists

85
Q

What are the 3 catecholamines?

A

Dopamine, NE, and epi

86
Q

What 2 NTs stimulate adrenrgic rcs?

A

NE and Epi

87
Q

Alpha adrenergic rcs act on _____

A

Smooth muscle vasculature

88
Q

B1 adrenergic rcs act on ____

89
Q

B2 adrenergic rcs act on _____

A

Smooth muscle of lungs

90
Q

____ rcs cause vasoconstriction, urinary retention, and pupil dilation (mydriasis)

A

Alpha 1 adrenergic

91
Q

____ rcs: Tachycardia
INcrease HR, electrical conduction, and strength of contraction
Renin release from kidneys

92
Q

____ Rcs:
Bronchodilation, vasodilation, stop peristalsis

93
Q

What muscarinic rc has the opposite effect of the B1 adrenergic rc?

94
Q

The following drugs are what category?
Isoproterenol, NE, Epi, Phenylphrine, Oxymetazoline, Dobutamide, albuterol

A

Adrenergic agonist

95
Q

The following drugs are what category?
Prazosin, chlorpromazine, Metoprolol, Atenolol, Propranolol, Carvedilol, Phentolamine, Phenoxybenzamine

A

Adrenergic antagonists

96
Q

The following drugs are what category?
Amphetamine, Tyramine, Ephedrine, Cocaine, Methylphenidate, TCAs, MAOIs

A

Sympathommimetics

97
Q

The following drugs are what category?
Guanethidine, Resperine, Clonidine, methyldopa

A

Smpatholytics

98
Q

What 2 drugs agonize alpha 2 rcs but block SNS signal?

A

Clonidine and methyldopa

99
Q

____ is a phenomena when NE can activate baroreceptors which stimulate reflex to reduce HR leading to an opposite response to what NE usually does

A

Vasovagal reflex

100
Q

____ is a phenomena when epi’s effect is turned into a vasodilatory effect when an alpha blocker (prazosin) is used causing a B2 dilatory effect

A

Epinephrine reversal

101
Q

What 2 things are multipled to get BP?

A

BP: CO x PR

102
Q

Pressure in ventricles before heart contracts

103
Q

Pressure in arteries against which the ventricles must pump

104
Q

The following drugs are what category?
Furosemide, hydrochlorothiazide, and spironolactone

A

Diuretics (Antihypertensives)

105
Q

Which diuretic is can induce hyperkalemia?

A

Spironolactone

106
Q

Which diuretic can induce hypokalemia?

A

Hydrochlorothiazide

107
Q

The following drugs are what category?
Verapamil, Diltiazem, Amlodipine, Nifedipine

108
Q

The following drugs are what category?
-Prils: Lisinopril

A

ACE inhibitors

109
Q

The following drugs are what category?
-Sartans: Losartan

110
Q

The following drugs are what category?
-Digoxin and Digitalis

A

Cardiac glycosides

111
Q

Type ___ antiarrhythmics are sodium channel blockers

112
Q

Type ___ antiarrhythmics are Beta adrenergic blockers

113
Q

Type ___ antiarrhythmics are potassium channel blockers

114
Q

Type ___ antiarrhythmics are calcium channel blockers

115
Q

_____ is used to treat manic depression

116
Q

Stage ____ general anesthesia:
-Analgesia/feeling better

117
Q

Stage ____ general anesthesia:
Delirium

118
Q

Stage ____ general anesthesia:
Surgical anesthesia

119
Q

Stage ____ general anesthesia:
Medullary paralysis
-overdose

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