Pharmaco1 Flashcards
All of the following sites are generally accepted for IM injections EXCEPT one. Which one is the EXCEPTION?
- the buttocks
- the biceps muscle
- the deltoid muscle
- the anterior thigh
the biceps muscle (For young children, the anterior thigh is usually the place to give IM injections), Never go beyond two-thirds of the needle length
Which term refers to a drug that binds to physiological receptors to result in specific cellular effects producing a predictable pharmacologic response?
- pharmacologic agonist
- pharmacologic antagonist
pharmacologic agonist (An antagonist is a drug which binds to the physiologic receptor but does not trigger an effect. When antagonist is present, the agonist drug cannot reach the receptor site to produce an effect)
Which of the following routes of drug administration is generally used for local drug effects? • topical administration • oral ingestion • subcutaneous injection • intravenous injection
topical administration
The most important enzyme systems for the biotransformation of drug molecules are found in: • lungs • liver • brain • kidneys • gastrointestinal tract
liver
implicit in the interaction of a drug with its physiological receptor is that the drug ? create effects, but rather, modulates ? physiological cell functions. • does; extrinsic • does not; extrinsic • does; intrinsic • does not; intrinsic
does not; intrinsic
The safest and easiest route for drug administration is: • oral • IV • rectal • inhalation
oral (abbreviated P.O., but the most unpredictable and least effective)
A major advantage of IV administration of a drug is it allows for ? of the drug. Other advantages of IV administration include ?
- titration
* rapid onset
The majority of drugs penetrate biomembranes by ? through membrane phospholipids. • active transport • facilitated diffusion • filtration • simple diffusion
simple diffusion
A teaspoon can hold what volume of liquid? • 5 milliliters • 10 milliliters • 15 milliliters • 20 milliliters
5 milliliters
Which of the following drugs are known to produce orthostatic hypotension as an adverse reaction. Select all that apply. • levodopa (Larodopa, Dopar) • prazosin (Minipress) • indomethacin (Indocin) • morphine
• levodopa (Larodopa, Dopar) = Antiparkinson drugs
• prazosin (Minipress) = Antihypertensives
• morphine
Indomethacin (Indocin) is an NSAID which may cause GI bleeding, ulcers and possible stomach perforation
Pain that has no organic basis and is fixed upon some portion of the anatomy is referred to as: • intractable pain • referred pain • psychogenic pain • phantom pain
phantom pain (the sensation of pain felt in a limb, although that limb has been amputated. Intractable pain: is pain that is resistant or refractory to ordinary analgesic agents)
Which schedule of drugs would include a drug that is considered to have a strong potential for abuse or addiction, but which has legitimate (قانوني) medical use? • schedule I • schedule II • schedule III • schedule IV • schedule V
schedule II Schedule I (not considered legitimate for medicinal use such as heroin, and marijuana) Schedule III (considered to have less potential for abuse or addiction such as acetaminophen codeine) Schedule IV (have less potential for abuse or addiction such as diazepam or lorazepam) schedule V (a small potential for abuse or addiction such as medications that contain a small amount of Codeine)
A drug with a high LD50 and a low ED50 has a:
• high therapeutic index and is, therefore, very dangerous
• high therapeutic index and is, therefore, relatively safe
• low therapeutic index and is, therefore, very dangerous
• low therapeutic index and is, therefore, relatively safe
high therapeutic index and is, therefore, relatively safe (LD=lethal dose, ED=Effective dose)
The term bioavailability of a drug refers to:
• the movement of a drug into the body tissues over time
• the dissolution of a drug in the GI tract
• the measurement of the rate and amount of therapeutically active drug that reaches the systemic circulation
• the relationship between the physical and chemical properties of a drug and the systemic absorption of the drug
• the amount of drug destroyed by the liver prior to systemic absorption from the GI tract
the measurement of the rate and amount of therapeutically active drug that reaches the systemic circulation (The bioavailability of a drug is affected by:
• The dissolution of a drug in the GI tract
• The destruction of a drug by the liver)
Factors influencing hepatic drug metabolism include which of the following? • microsomal enzyme inhibition • microsomal enzyme induction • plasma protein binding • genetic factors • liver disease • all of the above
all of the above (Most drugs are given at lower doses in hepatically impaired individuals)
The urinary elimination of drugs is controlled by which of the following? Select all that apply.
• glomerular filtration
• microsomal enzyme induction
• renal tubular reabsorption
• active transport through renal tubular cells
- glomerular filtration
- renal tubular reabsorption
- active transport through renal tubular cells
The average time for the onset of drug effect after subcutaneous administration is: • immediate • 5 minutes • 15 minutes • 30 minutes
15 minutes
Oral route 30 minutes, Intramuscular injection 5 minutes
Which term is a compulsive, uncontrollable dependence on a substance, habit or practice to such a degree that cessation causes severe emotional, mental or physiological/ reactions? • habituation • tolerance • addiction • none of the above
addiction
Which of the following refers to the efficacy of a drug?
• the relative concentrations of two or more drugs that produce the same drug effect
• the ability of a drug to produce a desired therapeutic effect regardless of dosage
• the dose of a drug that will kill a patient
the ability of a drug to produce a desired therapeutic effect regardless of dosage (A drug with high efficacy needs to stimulate only a small percentage of receptors)
- ? is a measure of the tightness that a drug binds to the receptor.
- ? is a measure of the ability of a drug once bound to the receptor to generate an effect activating stimulus and producing a change in cellular activity
- Affinity
* Intrinsic activity
? is the relative concentrations of two or more drugs that produce the same drug effect. Drug #1 in a dose of 10 mg produces the same magnitude of response as Drug #2 in a dose of 50 mg. The following is true: Drug #1 is five times as potent as Drug #2.
Potency
When a drug is administered repeatedly, a higher concentration of the drug than is desired may be achieved. The effect of this excessive accumulation is known as: • additive effect • synergistic response • cumulative action • diosyncrasy
cumulative action
When two drugs having similar effects are administered in combination, and the resulting response is the sum of the individual actions of each drug when given alone, then this result is referred to as: • an additive effect • a synergistic response • an antagonistic effect • cumulative action
an additive effect (A synergistic response occurs when the combined action of two drugs having similar pharmacological effects is greater than the sum of the individual actions. Alcohol is synergistic with the Valium family of drugs)
Amphetamines are sympathomimetic amines that cause rapid release of? Select all that apply. • dopamine in the brain • serotonin in the brain • norepinephrine in the brain • acetylcholine in the brain
• dopamine in the brain
• serotonin in the brain
• norepinephrine in the brain
(used in ADHD) The physical effects of amphetamines (e.g., increased blood pressure, bronchodilation) are largely due to the adrenergic effects of norepinepherine.
The psychological effects of amphetamines (e.g., dependence, addiction, euphoria) are largely due to increases in dopamine and serotonin
The following effects result from what type of pharmacological agent:
lower blood pressure
vasodilation
orthostatic hypotension
• an alpha-adrenergic receptor blocker (alpha-blocker)
• a beta-adrenergic receptor blocker (beta-blocker)
an alpha-adrenergic receptor blocker (alpha-blocker)
Alpha1-blockers cause orthostatic hypotension, also known as postural hypotension, adverse effects include tachycardia and dry mouth.
A drug that reduces the actors of the sympathetic nervous system is called a: • sympathomimetic • sympatholytic • sympathetic amine • adrenergic agent
sympatholytic - Also called adrenergic blocking agent or adrenergic receptor blockers, all used to treat hypertension
The following drugs belong to which pharmacologic category? epinephrine (Adrenalin) phenylephrine (Neo-Synephrine) albuterol (Proventil; Ventolin) isoproterenol • adrenergic agonists • adrenergic antagonists
adrenergic agonists The adrenergic receptors are divided into the subtypes of:
• α1 and α2
• β1 and β2
α1 and β2 are most common
Adrenaline (epinephrine) stimulates?
both α1,2 and β1,2 receptors
Ali of the following drugs are indirect-acting adrenergic agonists, EXCEPT one. Which one is the EXCEPTION? • tyramine • amphetamine • epinephrine • methamphetamine • hydroxyamphetamine
epinephrine (direct and indirect-acting adrenergic agonists means direct and indirect-acting sympathomimetic agents)
All of the following drugs are alpha-adrenergic receptor blockers EXCEPT one. Which one is the EXCEPTION?
• doxazosin (Cardura)
• phenoxybenzamine hydrochloride (Dibenzyline)
• phentolamine hydrochloride (Regitine)
• prazosin (Minipress)
• propranolol (Inderal)
• terazosin (Hytrin)
propranolol (Inderal) - it is a beta-blocker
Alpha-blockers are medications that act by ?
inhibiting the action of catecholamines at the alpha receptor site. They act on blood vessels, causing them to relax. Alpha-blockers are commonly used to reduce high blood pressure and to treat an enlarged prostate
The heart is generally considered to have predominantly which type of adrenergic receptors?
β1 receptors
Alpha adrenergic receptors are located on: • vascular smooth muscle • presynaptic nerve terminals • blood platelets • fat cells • neurons in the CNS • all of the above
all of the above
There are two main types of adrenergic receptors:
• Alpha (a) receptors responsible for ?
• Beta (B) receptors — responsible for ?
- most of the excitatory effects such as vaso-constriction and contraction of the uterus and spleen.
- most of the inhibitory effects such as vasodilation and relaxation of respiratory smooth muscle (exception: some beta receptors mediate increases in the force and rate of contractions of the heart)
All of the following neurons are cholinergic EXCEPT one. Which one is the EXCEPTION? • preganglionic sympathetic neurons • preganglionic parasympathetic neurons • postganglionic sympathetic neurons • postganglionic parasympathetic neurons
postganglionic sympathetic neurons (others are cholinergic that secret acetylcholine)
What substance produces all of the following physiologic actions?
constricts arteriolar blood vessels (vasoconstriction)
relaxes bronchial smooth muscle (bronchodikition)
decrease blood volume in nasal tissues
causes a hypertensive response
produces physiological actions opposite to that of histamine
• serotonin
• epinephrine
• dopamine
• acetylcholine
epinephrine
Therapeutic indications for epinephrine:
Epinephrine should be used with caution in patients with high blood pressure and hyperthyroidism
- To alleviate symptoms of an acute asthma attack
- To treat bronchospasm associated with hypotension, as in anaphylaxis
- To treat hypersensitivity reactions
- Agent of choice for anaphylactic reactions (given sublingually or subcutaneously)
- It is added to local anesthetics as a vasoconstrictor to prolong the activity of the local anesthetic solutions, by decreasing the rate of diffusion and absorption from the injection site
- To restore cardiac activity in cardiac arrest
- To relieve congestion of the nose, sinuses, and throat
Epinephrine is the agent of shoke for treating an anaphylactic reaction because of its stimulatory effects on both alpha and beta adrenergic receptors.
All of the following are desirable effects of epinephrine that make it the agent of choice for treating an anaphylactic reaction.
it has vasopressor activity
it has bronchodilator properties
it causes increased cardiac output
it has a rapid onset of action
• both statements are true
• both statements are false
• the first statement is true, the second is false
• the first statement is false, the second is true
both statements are true
"Epinephrine reversal" is a predictable result of the use of epinephrine in a patient who has received a/an: • beta-blocker • alpha-blocker • adrenergic agonist • all of the above
alpha-blocker (In the absence of blocking agents, epinephrine and norepinephrine both cause the blood pressure to rise. After the alpha-receptors have been blocked by an alpha-blocker, the pressor effect of norepinephrine is reduced or abolished while epinephrine brings about a fall in blood pressure.
This is because epinephrine stimulates both alpha and beta-receptors in the cardiovascular system but norepinephrine only stimulates alpha-receptors (norepinephrine lacks beta2 effects). After blockage of the alpha-receptors, only the beta-receptors can be stimulated)
Of the following, which is a clinically significant adverse reaction due to Metoprolol? • drowsiness • hallucinations • arthralgia • dry mouth
drowsiness - the most common side effects of beta1-blockers (cardioselective) are weakness and drowsiness such as Metoprolol, Atenolol and Propranolol. Atenolol is the least.
If norepinephrine or epinephrine were to stimulate or combine with the alpha receptors in the eye, which response would you expect?
• miosis (contraction of the pupil)
• mydriasis (dilation of the pupil)
• neither of the above; norepinephrine and epinephrine do not stimulate or combine with alpha receptors in the eye
mydriasis (dilation of the pupil)
