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Finak Year 3 > Pharma > Flashcards

Pharma Flashcards

1
Q

\Which of the following” body of the prescription” is the most clear?
A. Ibuprofen, 400 mg, tid, prn
B. Ibuprofen tb, q8h, prn temp. over 38,5° C
C. Ibuprofen, 400 mg, q8h, PO, prn temp. over 38,5° C
D. Ibuprofen, 400 mg tb, swallow one tablet with water if axillary temperature is over
38,5°C, minimum 8 hours between doses
E. Ibuprofen tb, PO, take as directed

A

D. Ibuprofen, 400 mg tb, swallow one tablet with water if axillary temperature is over
38,5°C, minimum 8 hours between doses

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2
Q

? Which of the following poor prescription writing example and leading situation is not
suitable?
A. Misplaced and ambigous decimal point (e.g. ,1 or 1,0) - Misread, tenfold overdose
B. Using the abbreviation “U” for units- “U” - Misread as “O” (e.g. 10 U= 100)
C. Using the abbreviated form of microgram (“ug”) - Misread as “mg,” a 1000-fold overdose
D. Unclear handwriting- lethal when drugs with similar names but very different effects
E. Ordering “one ampule of furosemide” - Acceptable, ampules contain 20, 40, or 100 mg of the drug

A

E. Ordering “one ampule of furosemide” - Acceptable, ampules contain 20, 40, or 100 mg of the drug

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3
Q

What is “brown bag” analysis or review of medicines?
A. It is a procedure that doctor give a bag of prescribed medications to associated elderly.
B. It is a process that doctor look for elderly patients’ medical documents
C. It is a procedure that examination of patients’ bag to ensure that he or she took all the necessary prescribed medication.
D. It is is a common practice that involves encouraging patients to bring all of their medicines and supplements to their visit to doctor and reviewing them
E. There is no analysis or review mentioned

A

D. It is is a common practice that involves encouraging patients to bring all of their medicines and supplements to their visit to doctor and reviewing them

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4
Q

Extrapyramidal symptoms associated drugs? T/F
• Metoclopramide
• Sucralfate
• Aprepitant
• Bisacodyl
• Magnesium hydroxide (Milk og Magnesia)
• Haloperidol

A

Metoclopramide

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5
Q

What are extrapyramidal symptoms?

A

dwug-indluced movement disorders

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6
Q

elderly patient with a history of heart disease has difficulty breathing and is diagnosed with acute pulmonary edema. Treat the patient.

A

furosemide

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7
Q

Which of the following drugs is routinely added to calcium supplements and milk for the purpose of preventing rickets in children and osteomalacia in adults?
A. Cholecalciferol
B. Calcitriol
C. Gallium nitrate
D. Sevelamer
E. Plicamycin

A

A. Cholecalciferol

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8
Q

To supplement other oral type 2 diabetes medication, a patient is prescribed a drug to inhibit the intestinal absorption of carbohydrates. What would be an appropriate drug?
A. Metformin
B. .Acarbose
C. Repaglinide
D. Insulin lispro
E. Pioglitazone

A

B. .Acarbose

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9
Q

An 18-month-old boy dies from an accidental overdose of acetaminophen. Which of the following is the most likely cause of this patient’s death?
A. Arrhythmia
B. Hemorrhagic stroke
C. Liver failure
D. Noncardiogenic pulmonary edema
E. Ventilatory failure

A

C. Liver failure

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10
Q

Which teratogenic effect is the result of thalidomide (a drug formerly used for nausea-vomiting of pregnant women and resulted in Thalidomide Disaster)?

A

Phocomelia

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11
Q

16 A 45-year-old man with a duodenal ulcer was treated with a combination of drugs intended to heal the mucosal damage and to eradicate Helicobacter pylori. Which of the following antibacterial drugs is used commonly to eradicate intestinal H pylori?

A.. Clarithromycin
B. Ciprofloxacin
C. Cefazolin
D. Clindamycin
E. Vancomycin

A

A.. Clarithromycin

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12
Q

Which drug has been known to cause discoloration (darkening) of the tongue?
A. Amoxicillin
B. Omeprazole
C. Mineral oil
D.. Bismuth subsalicylate
E. Lubiprostone

A

D.. Bismuth subsalicylate

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13
Q

Which agent for gastrointestinal problems is contraindicated in pregnancy?
A. Misoprostol
B. Famotidine
C. Lansoprazole
D. Calcium carbonate
E. Sucralfate

A

A. Misoprostol

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14
Q

Men who use large doses of anabolic steroids are at increased risk of which of the following?
A Anemia
B Testicular enlargement
CHirsutism - In women!
D Hyperprolactinemia
E Cholestatic jaundice and elevation of aspartate transaminase levels in the blood

A

E Cholestatic jaundice and elevation of aspartate transaminase levels in the blood

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15
Q

A 75-year-old woman with hypertension and glaucoma is being treated with chlorthalidone, amlodipine, lisinopril, and acetazolamide. In clinic today, she complains of acute joint pain and redness in her great toe, which is diagnosed as gout. Which medication is most likely to have caused the gout attack?
A. Amlodipine
B. Chlorthalidone
C. Acetazolamide
D. Lisinopril
E. None of her drugs

A

B. Chlorthalidone

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16
Q

36-year-old woman requests birth control. She has no medical conditions, and she smokes one pack of cigarettes per day. Which would be the most appropriate to recommend?
A. Vaginal contraceptive ring
B. Progestin-only “mini-pill’
C. Transdermal contraceptive patch
D. Combination oral contraceptive pill
E. Eustrogen containing oral contraceptive pill

A

B. Progestin-only “mini-pill’

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17
Q

pulse of testosterone is most appropriate in which patient?
A. A 30-year-old man with hypogonadism due to testicular injury
B. A 25-year-old competitive athlete
C. A 50-year-old man with low testosterone related to aging
D. A 65-year-old man with low testosterone and a history of myocardial infarction
E. A teenager for muscle strength

A

A. A 30-year-old man with hypogonadism due to testicular injury

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18
Q

Which is contraindicated in a patient with hyperkalemia?
A. Acetazolamide
B. Chlorothiazide
C. Eplerenone
D. Ethacrynic acid
E. Chlorthalidone

A

C. Eplerenone

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19
Q

A 13-year-old boy with type 1 diabetes is brought to the hospital complaining of dizziness.
Laboratory findings include severe hyperglycemia, ketoacidosis, and a blood pH of 7.15. 1.
(Following 2 questions)
Which of the following agents should be administered to achieve rapid control of the severe ketoacidosis in this diabetic boy?
A. Regular insulin
B. Glyburide
C. Insulin glargine
D. NPH insulin suspension
E. Tolbutamide

A

A. Regular insulin

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20
Q

Which of the following is the most likely complication of insulin therapy in this patient?
A. Dilutional hyponatremia
B. Hypoglycemia
C. Increased bleeding tendency
D. Pancreatitis
E. Severe hypertension

A

B. Hypoglycemia

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21
Q

26 A 24-year-old woman was found to have mild hyperthyroidism due to Graves’ disease. She appears to be in good health otherwise. (Following two questions)
In Graves’ disease, the cause of the hyperthyroidism is the production of an antibody that does which of the following?
A. Activates the pituitary thyrotropin-releasing hormone (TRH) receptor and stimulates TSH release
B. .Activates the thyroid gland TSH receptor and stimulates thyroid hormone synthesis and release
C. Activates thyroid hormone receptors in peripheral tissues
D. Binds to thyroid gland thyroglobulin and accelerates its proteolysis and the release of its supply of T4 and T3
E. Binds to thyroid-binding globulin (TBG) and displaces bound T4 and T3

A

A. Activates the pituitary thyrotropin-releasing hormone (TRH) receptor and stimulates TSH release

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22
Q

The decision is made to begin treatment with methimazole. Methimazole reduces serum concentration of T3 primarily by which of the following mechanisms?
A. Accelerating the peripheral metabolism of T3
B. Inhibiting the proteolysis of thyroid-binding globulin
C. Preventing the addition of iodine to tyrosine residues on thyroglobulin
D. Inhibiting the secretion of TSH
E. Inhibiting the uptake of iodide by cells in the thyroid

A

C. Preventing the addition of iodine to tyrosine residues on thyroglobulin

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23
Q

25-year-old woman presents with insomnia and fears she may have “something wrong with her heart.” She describes “her heart jumping out of her chest.” She feels healthy otherwise and reports she has lots of energy. Lab tests confirm hyperthyroidism. Which of the following is a drug that produces a permanent reduction in thyroid activity?
A. Thiocyanate (SCN- )
B. Methimazole
C. Propylthiouracil
D. 131 (Radioactive iodine).
E. Thyroglobulin

A

131 (Radioactive iodine)

24
Q

62-year-old woman presents with complaints of fatigue, sluggishness, and weight gain. She needs to nap several times a day, which is unusual for her. She has been taking T4 for the past 15 years without significant problems regarding her energy level. Her recent history is significant for diagnosis of arrhythmia, and she is currently taking an antiarrhythmic drug.
What is the most likely cause of her current condition?
A. Amiodarone.
B. Lidocaine
C. Procainamide
D. Sotalol
E. Verapamil

A

Amiodarone

25
Q

Glucocorticoids have proved useful in the treatment of which of the following medical conditions?
A. Essential hypertension
B. Hyperprolactinemia
C. Parkinson’s disease
D. Chemotherapy-induced vomiting.
E. Type Il diabetes

A

D Chemotherapy-induced vomiting.

26
Q

patient presents with pain and stiffness in his wrists and knees. The stiffness is worse first thing in the morning. A blood test confirms rheumatoid arthritis. You advise a short course of steroids. Which one of the following is the most potent anti-inflammatory steroid?
A. Cortisol
B. Triamcinolone
C. Fludrocortisone
D. Prednisone
E. Dexamethasone.

A

D. Prednisone

27
Q

56-year-old woman with systemic lupus erythematosus had been maintained on a moderate daily dose of prednisone for 9 months. Her disease has finally gone into remission and she now wishes to gradually taper and then discontinue the prednisone. Gradual tapering of a glucocorticoid is required for recovery of which of the following?
A. Depressed release of insulin from pancreatic B cells
B. The hypothalamic-pituitary-adrenal system.
C. Normal osteoblast function
D. The control by vasopressin of water excretion
E. Hematopoiesis in the bone marrow

A

B. The hypothalamic-pituitary-adrenal system.

28
Q

A 3-year-old girl was referred to the genetic counselor by her pediatrician. She presents with short stature (height is 85 cm, -3 standard deviations) and appears to have loose skin on her neck. Cytogenetic testing reveals an XO karyotype. Which of the following drugs will allow her to achieve a higher adult height?
A. Somatropin.
B. Adrenocorticotropin (ACTH)
C. Corticotropin-releasing hormone (CH)
D. Growth hormone-releasing hormone (GHRH)
E. Gonadotropin-releasing hormone (GnRH)

A

A. Somatropin.

29
Q

Which one of the following drugs promotes the release of endogenous insulin?
A. Acarbose
B. Canagliflozin
C. Glipizide.
D. Metformin
E. Miglitol

A

C. Glipizide

30
Q

Which of the following is an important effect of insulin?
A. Increased glucose transport into cells.
B. Increased conversion of amino acids into glucose
C. Increased gluconeogenesis
D. Inhibition of lipoprotein lipase
E. Stimulation of glycogenolysis

A

A. Increased glucose transport into cells.

31
Q

The PPAR-y receptor that is activated by thiazolidinediones increases tissue sensitivity to
insulin by which of the following mechanisms?
A. Activating adenyly| cyclase and increasing the intracellular concentration of cAMP
B. Inactivating a cellular inhibitor of the GLUT2 glucose transporter
C. Inhibiting acid glucosidase, a key enzyme in glycogen breakdown pathways
D. Regulating transcription of genes involved in glucose utilization.
E. Stimulating the activity of a tyrosine kinase that phosphorylates the insulin receptor

A

D. Regulating transcription of genes involved in glucose utilization.

32
Q

34-year-old woman with ulcerative colitis has required long-term treatment with pharmacologic doses of a glucocorticoid agonist. Which of the following is a toxic effect associated with long-term glucocorticoid treatment?
A. Osteoporosis.
B. A lupus-like syndrome
C. Adrenal gland neoplasm
D. Hepatotoxicity
E. Precocious puberty in children

A

Osteoporosis

33
Q

7-year-old boy underwent successful chemotherapy and cranial radiation for treatment of acute lymphocytic leukemia. One month after the completion of therapy, the patient presented with excessive thirst and urination plus hypernatremia. Laboratory testing revealed pituitary diabetes insipidus. To correct these problems, this patient is likely to be treated with which of the following?
A. Corticotropin
B. Thyrotropin
C. hCG
D. Menotropins
E. Desmopressin.

A

Desmopressin.

34
Q

Which of the following statement is wrong?
A. Lipophilic drug’s passage across placenta is higher
B. Most of the drugs are designated in Category C of the formerly used FDA’s teratogenic risk categories FDA: Food and Drug Administration)
C. ACE inhibitors are contraindicated in 2nd & 3rd trimesters of pregnancy due to significant and irreversible renal damage in fetus
D. Neonatal exposure to Lithium through breastmilk would be clinically meaningful
E. If the mother has to use radioactive substances breast-feeding is not contraindicated.

A

E. If the mother has to use radioactive substances breast-feeding is not contraindicated.

35
Q

Which of the following principles for drug therapy in the geriatric patient is not suitable?
A. Taking a careful drug history
B. Prescribing only for a specific and rational indication
C. Maintaining high index of suspicion regarding drug reactions and interactions including the the other drugs and herbals patient is taking
D. Starting with usual doses, titration of dose to the desired response is not needed
E. Defining the goal of a drug therapy

A

D. Starting with usual doses, titration of dose to the desired response is not needed

36
Q

Which of the following changes associated with aging is the most important for the changes in
pharmacokinetics of drugs?
A. Concurrent disease
B. Decline in cardiac index
C. Decline in renal functions
D. Decline in maximal breathing capacity
E. Changes in gastric emptying

A

Decline in renal functions

37
Q

Which of the following is wrong for pediatric drug dosage?
A. Pediatric doses are generally stated as milligrams per kilogram
B. It is appropriate to use a calculated pediatric drug dose that exceeds the adult dose
C. If explicit pediatric dose recommendations are absent an approximation can be made by methods based on age, weight, or surface area.
D. If the manufacturer provides a pediatric dose, that pediatric dose should be used
E. Pediatric dose information is not available for the majority of products provided by the manufacturer

A

B. It is appropriate to use a calculated pediatric drug dose that exceeds the adult dose

38
Q

Which of the following statement is wrong for pediatric drug prescribing?
A. Prescriber should make every attempt to check dosages and medical content for accuracy when prescribing for pediatric age group
B. Prescriber should check product information and published literature for changes in dosing, especially for newer medicines.
C. Because of the complete data on pediatric dosing, many drug dosages are accurate and can not be modified
D. Calculations of dosage based on age or weight are tend to underestimate the required dose.
E. Doses based on surface area are more likely to be adequate.

A

C. Because of the complete data on pediatric dosing, many drug dosages are accurate and can not be modified

39
Q

Which of the following is not included in the criteria for serious ADRs?
A. Life threatening
B. Results in long-term disability
C. Manageable with dose adjustment
D. All congenital anomalies
E. Causes or prolongs hospitalisation

A

C. Manageable with dose adjustment

40
Q

intramuscular drug use? T/F Expert and a trained person is required

A

F

41
Q

intramuscular drug use? T/F The onset and duration of the action of the drug is not adjustable

A

F

42
Q

intramuscular drug use? T/F Intramuscular injection at the appropriate landmarks may be difficult in a child as well as in patients requiring physical restrain

A

T

43
Q

intramuscular drug use? T/F Highly efficacious in emergency scenarios such as acute psychosis and status epilepticus

A

T

44
Q

intramuscular drug use? T/F In case of inadvertent scenarios such as anaphylaxis or neurovascular injuries, additional intravenous routes for emergency drug administration need to be secured

A

F

45
Q

predisposing factors for Adverse Drug Reactions (ADRs)?T, F Any previous history of an ADR

A

T

46
Q

predisposing factors for Adverse Drug Reactions (ADRs)?T, F Normal hepatic and/ or renal function

A

F

47
Q

predisposing factors for Adverse Drug Reactions (ADRs)?T, F Elderly patient

A

T

48
Q

predisposing factors for Adverse Drug Reactions (ADRs)?T, F

Neonatal patient

A

T

49
Q

predisposing factors for Adverse Drug Reactions (ADRs)?T, F Using multiple drugs simulatenously (Polypharmacy)

A

T

50
Q

Prescribing cascades, T/F?

Prescribing cascades occur when an adverse drug effect is misdiagnosed as a new medical condition, and treated with a potentially unnecessary drug.

The patient is then at risk for developing additional ADEs related to the new and potentially unnecessary treatment.

Older adults with chronic disease and multiple drug therapies are at particular risk for
prescribing cascades.

Drug-induced symptoms in an older person can be easily misinterpreted as indicating a new disease or attributed to the aging process itself rather than the drug therapy.

Misinterpretation is particularly likely when the drug-induced symptoms are indistinguishable from illnesses that are common in older persons.

A

T

51
Q

Prescribing cascade examples,

antiparkinson therapy for symptoms arising from use of drugs such as antipsychotics or metoclopramide (dopamine inhibitor)

antiparkinson drugs can then lead to new symptoms, including orthostatic hypotension and delirium. (“Drug-induced parkinsonism”.)

A prescribing cascade occurs when the prescription of a cholinesterase inhibitor is followed by a prescription for an anticholinergic therapy (eg, oxybutynin) to treat incontinence.

Patients treated with calcium channel blockers can develop peripheral edema due to fluid redistribution, which may be interpreted as a new condition and treated with a
diuretic.

A

T

52
Q

Contraindicated in a patient with hyperkalemia? T/F
• Acetazolamide
• Hydrochlorothiazide
• Spironolactone
• Ethacrynic acid
• Chlorthalidone
• Isolyte-S
• Ringer Lactate

A

Spironolactone

Isolyte-S

53
Q

gastrointestinal irritation and bleeding

A

Aspirin

54
Q

renal toxicity

A

1Aminoglycosides-

55
Q

-hepatotoxicity

A

Paracetamol

56
Q

teratogenity

A

Thalidomide-

57
Q

-hypoglicemia

A

1Insulin

Finak Year 3 (11 decks)

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