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Locomotion, Past Q > Pharma quiz > Flashcards

Pharma quiz Flashcards

1
Q

Fill in the blanks:

Calcitriol —- gastrointestinal absorption of calcium and —- gastrointestinal absorption of phosphate, —- renal excretion of calcium and —- renal excretion of phosphate.

A
  • increases
  • increases
  • reduces
  • reduces
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2
Q

Select true statements on strontium ranelate:

select one or more:

a. it increases the risk of myocardial infarction
b. it increases the risk of venous thromboembolism
c. it promotes bone formation
d. it has been used only for the treatment of severe osteoporosis and only if risk of fracture is high and other treatments are contraindicated or not tolerated
e. it blocks differentiation of osteoclasts and promotes their apoptosis

A

c. it promotes bone formation

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3
Q

Why oral bisphosphonates are administered with plain water at least 30 minutes before breakfast?

a. to reduce the risk of esophagitis and esophageal ulcers
b. because food interferes with their gastrointestinal absorption
c. to reduce the risk of diarrhoea
d. to reduce the risk of abdominal pain
e. to reduce the risk of atypical fractures of femur
f. to reduce the risk of osteonecrosis of the jaw
g. to reduce the risk of musculoskeletal pain

A

b. because food interferes with their gastrointestinal absorption

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4
Q

Why should patients remain upright at least 30 minutes after their oral intake bisphosphonates (reduce bone loss)?

  • to reduce the risk of abdominal pain
  • because food interferes with their gastrointestinal absorption
  • to reduce the risk of musculoskeletal pain
  • to reduce the risk of esophagitis and esopahgeaal ulcers
  • to reduce the risk of diarrhoea
  • to reduce the risk of osteonecrosis of the jaw and atypical fractures of femur
A
  • to reduce the risk of esophagitis and esopahgeaal ulcers
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5
Q

Which drug(s) is/are fragment of PTH?

a. bisphonates
b. calcitriol
c. estrogens
d. teriparatide
e. selective modulators of esterogen receptor
f. denusumab
g. strontium ranelate

A

d. teriparatide

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6
Q

Which one is the most potent female (natural) oestrogen?

a. esterone
b. gestodene
c. ethinylestradiol
d. levonorgestrel
e. conjugated oestrogen’s
f. estradiol
g. estriol
h. desogestrel

A

f. estradiol

-estradiol:
is the main oestrogen in premenopausal woman and the most potent female oestrogen

-estrone:
is the main oestrogen n postmenopausal woman

-estriol:
main oestrogen produced by the placenta

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7
Q

Which drug or drug class is the first monoclonal antibody used for treatment of osteoporosis*?

a. denosumab
b. estrogens
c. calcitonin
d. teriparatide
e. strontium renelate
f. selective modulators of oestrogen receptors
g. parathromone
h. bisphosphonates

*Osteoporosis causes bones to become weak and brittle — so brittle that a fall or even mild stresses such as bending over or coughing can

A

a. denosumab, in postmenopausal women and in men

Even romosozumab Is used in cases of severe osteoporosis!!!

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8
Q

Which one is the most potent stimulator of intestinal absorption of calcium?

a. 1-hydroxyvitanin D3 (alphacalcidol)
b. 1,25-dihydroxyvitamin D3 (calcitriol)
c. Vitamin D2 (ergocalciferol)
d. 25-hydroxyvitamin D3 (calcifediol)
e. vitamin D3 (cholecalciferol)

A

b. 1,25-dihydroxyvitamin D3 (calcitriol)

Also it is the most potent stimulator of bone resorption & used in treatment of secondary hyperparathyroidism in patients with renal failure!

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9
Q

Which drug is used for first choice treatment of postmenopausal osteoporosis?

A

bisphosphonates

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10
Q

Which drugs increase bone formation?

select one or more:

  • selective modulators of oestrogen receptors
  • stronitium ranelate
  • calcitriol
  • bisphosphonates
  • teriparatide
  • estrogens
  • parathromone
  • denosumab
A
  • parathromone
  • calcitriol
  • teriparatide
  • stronitium ranelate
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11
Q

Which one is the most potent stimulator of bone resorption?

A

1.25-dihydroxyvitamin D3 (calcitriol)

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12
Q

Which metabolites/analogues of vitamin D are used for the treatment of secondary hyperparathydroidsm in patients with renal failure?

A
  • 1,25 dihydroxyvitamin D3 (calcitriol)

- 1-hydroxyvitamin D3 (alphacalcidol)

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13
Q

Which 2 are most important risks associated with the use of strontium ranelate?

A
  • venous thromoboembolism

- myocardial infarction

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14
Q

Which drug cause osteoporosis most commonly?

A

GLUCOCORTICOIDS!!!

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15
Q

Choose correct statements on estrogens:

select one or more:

  • estrogens are hydrophilic and therefore circulate in plasma unbound
  • estrogens act on G protein coupled receptors to cause rapid effects
  • estrogens bind to specific nuclear receptors proteins
  • estrogen reduce synthesis of clotting factors in the liver
  • estrogens act on intracellular receptors
  • estrogens act on enzyme linked receptors to cause rapid effects
  • duration of response following binding of oestrogen to intracellular receptor is minutes to hours
  • estrogens act on ligand gated ion channels
A
  • estrogen are hydrophilic but circulate in plasma bound!
  • estrogen INCREASE synthesis of clotting factors in the liver!

Correct answers:

  • estrogens act on G protein coupled receptors to cause rapid effects
  • estrogens bind to specific nuclear receptors proteins
  • estrogens act on intracellular receptors
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16
Q

Which drugs reduce bone loss without important effect on bone formation?

4 drugs*

A

*

  • Bisphosphonates
  • Estrogens
  • Selective modulators of oestrogen receptors
  • Denosumab
17
Q

Which one is the principle oestrogen in postmenopausal women?

A

estrone

18
Q

Select true statements on bisphosphonates:

select one or more:

  • they have low oral bioavailability and therefore should not administered orally
  • they may cause venous thromboembolism and therefore have been used only in patients who do not tolerate oestrogens or stroncium ranelate
  • they should be administered intramuscular
  • some of them may be administered once monthly and even once yearly intravenously
  • they have been rapidly cleared from the plasma due to binding to hydroxyapatite in the bone
A
  • some of them may be administered once monthly and even once yearly intravenously
  • they have been rapidly cleared from the plasma due to binding to hydroxyapatite in the bone
19
Q

Which drug is rapidly cleared from the plasma due to binding to hydroxyapatite in the bone (once bound they are cleared over hours to years)?

A

Bisphosphonates

20
Q

Elect true statements on denusumab:

select one or more:

  • it targets RANKL
  • it target the osteoclastic proton pump necessary for dissolution of hydroxyapatite
  • it acts on intracellular receptors
  • it acts on G protein coupled receptors
  • it acts on enzyme linked receptors
  • it has been obtained from salmon
  • it has similar action to the natural substance osteoprotegerin
  • it reduces osteoclasts formation, function and survival
A
  • it targets RANKL
  • it has similar action to the natural substance osteoprotegerin
  • it reduces osteoclasts formation, function and survival
21
Q

Which drug stimulate bone formation but not recommended for the use longer than 24 months?

A

teriparatide

22
Q

Select true statements on bisphosphonates:

  • they act on G protein coupled receptors
  • they decrease formation/activation of osteoclasts
  • they act on ligand gated ion channels
  • they increase apoptosis of osteoclasts
  • they inhibit biosynthesis of cholesterol important for the function of osteoclasts
  • they act on intracellular receptors
  • they inhibit the osteoclastic proton pump necessary for dissolution of hydroxyapatite
  • they act on enzyme linked receptors
A
  • they decrease formation/activation of osteoclasts
  • they increase apoptosis of osteoclasts
  • they inhibit biosynthesis of cholesterol important for the function of osteoclasts
  • they inhibit the osteoclastic proton pump necessary for dissolution of hydroxyapatite

Locomotion, Past Q (10 decks)

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