Pharmacology Flashcards
Which medication is a GP IIb/IIIa antagonist and therefore inhibits the final common pathway of platelet aggregation?
A) Abcixamab
B) Aspirin
C) Clopidogrel
D) Enoxaparin (low molecular weight heparin)
E) Ticagrelor
A) Abcixamab
Which antidepressant is also used in the management of smoking cessation?
A) Amitryptiline
B) Bupropion
C) Citalopram
D) Sertraline
E) St John’s wort
F) Venlafaxine
= B) Bupropion
Explanation: Buproprion is a weak norepinephrine-dopamine-reuptake-inhibitor (NDRI) that is also thought to block the stimulatory effects of nicotine.
Which of the following antihypertensives is contraindicated during pregnancy?
A) Hydralazine
B) Labetalol
C) Methyldopa
D) Nifedipine
E) Ramipril
= E) Ramipril
Explanation: Methyldopa and labetalol are currently first line agents in the treatment of hypertension during pregnancy, while nifedipine, hydralazine and prazosin are used second line. ACE-inhibitors have an association with fetal death and neonatal renal failure in third-trimester use.
Which antibiotic is potentially both ototoxic and nephrotoxic?
A) Azithromycin
B) Cefazolin
C) Doxycycline
D) Gentamicin
E) Trimethoprim
= D) Gentamicin
Explanation: Aminoglycosides have bactericidal activity in which they bind to the bacteria ribosomal 30S subunit. The main noted adverse effects of aminoglycosides are ototoxicity, nephrotoxicity, and neuromuscular blockade.
Patients taking which antipsychotic require regular white blood cell count monitoring?
A) Clozapine
B) Fluphenazine
C) Haloperidol
D) Olanzapine
E) Risperidone
= A) Clozapine
Explanation: Agranulocytosis is a rare side-effect of clozapine. Other side-effects include a lower seizure threshold, myocarditis, metabolic syndrome, and QT prolongation.
What is the mechanism of thiazide diuretics such as chlorothiazide?
A ) Block the actions of the aldosterone receptor at the distal segment of the distal tubule
B ) Inhibit sodium-chloride transporter in the distal tubule
C ) Inhibit the sodium-potassium-chloride co-transporter in the thick ascending limb of the Loop of Henle
D ) Inhibit the transport of bicarbonate out of the proximal convoluted tubule into the interstitium
E ) Oppose the action of ADH on the collecting tubule
= B) Inhibit sodium-chloride transporter in the distal tubule
What is the mechanism of action of tiotropium?
A ) Combined long-acting beta agonist and corticosteroid
B ) Long-acting beta-agonist
C ) Long-acting muscarinic antagonist
D ) Short-acting beta agonist
E ) Short-acting muscarinic antagonist
= C) Long-acting muscarinic antagonist
Explanation: Tiotropium is a second-generation is a long-acting muscarinic receptor antagonist that exerts its primary therapeutic effect on the M1, M2, and M3 muscarinic acetylcholine receptors in the lungs preventing acetylcholine binding.
Which antibiotic is a DNA gyrase inhibitor and has the potential side-effect of causing tendonitis and tendon rupture?
A ) Amoxicillin
B ) Ciprofloxacin
C ) Gentamicin
D ) Trimethoprim
E ) Vancomycin
= B) Ciprofloxacin
Explanation: Ciprofloxacin is a fluroquinolone that is most often used in the coverage of gram negative rods of the urinary and GI tract. Side effects include headache and dizziness, prolonged QT interval, GI upset, skin rash, tendonitis, and tendon rupture.
Which medication is used to treat both urinary retention and hypertension?
A ) Clonidine
B ) Metoprolol
C ) Nitroglycerin
D ) Prazosin
E ) Propranolol
= D) Prazosin
Explanation: Prazosin is an alpha-1 antagonist that causes vasodilation by blocking the action of norepinephrine on vascular smooth muscle. It is used for the management of urinary retention, hypertension, phaeochromocytoma, and of nightmares associated with PTSD. As with other antihypertensives, it has the potential side-effects of orthostatic hypotension, headaches, and dizziness.
Which of the following medications is used in the management of both focal and generalised seizures?
A ) Donepazil
B ) Levetiracetam
C ) Levodopa
D ) Metoclopramide
E ) Prochlorperazine
Which of the following medications is used in the management of both focal and generalised seizures?
A ) Donepazil
B ) Levetiracetam
C ) Levodopa
D ) Metoclopramide
E ) Prochlorperazine
= B) Levetiracetam
Explanation: Levetiracetam (brand names: Keppra, Elepsia) is used to treat epilepsy. It is also used second-line in the management of status epilepticus.
Which of the following is an example of an SGLT2-inhibitor used in the management of type II diabetes mellitus?
A ) Acarbose
B ) Dapagliflozin
C ) Insulin glargine
D ) Metformin
E ) Repaglinide
= B) Dapagliflozin
Explanation: SGLT-2 inhibitors, such dapagliflozin and canagliflozin, block reabsorption of glucose in the proximal convoluted tubule.
Which diabetic drug has the rare but potential side-effect of lactic acidosis?
A ) GLP-1 agonists
B ) Meglitinides
C ) Metformin
D ) Sulfonylureas
E ) Thiazolidinediones
= C) Metformin
Explanation: Side effects of metformin include anorexia, epigastric discomfort, and diarrhoea. Lactic acidosis can potentially occur in patients with severe renal or hepatic disease.
A 28-year-old woman presented to the emergency department with breathing difficulty and increasing swelling of her face, eyes, lips, and tongue. An hour earlier she had received an intramuscular injection of ampicillin to treat acute pharyngitis. A diagnosis of anaphylactic reaction was made, and an intramuscular injection of epinephrine was given. Which of the following expected effects of the drug was most likely mediated by the activation of peripheral postsynaptic α2 receptors?
A ) Constriction of skin vessels
B ) Decreased secretion of insulin
C ) Dilation of skeletal muscle vessels
D ) Increased heart rate
E ) Increased secretion of renin
F ) Mydriasis
= B) Decreased secretion of insulin
= A) Adenosine
= Diltiazem
Amiodarone
- Amiodarone is one of the most commonly used anti-arrhythmic drugs. It is a primarily a class III antiarrhythmic. Like other antiarrhythmic drugs of this class, amiodarone works by blocking potassium rectifier currents that are responsible for the repolarization of the heart during phase 3 of the cardiac action potential. This potassium channel-blocking effect results in increased action potential duration and a prolonged effective refractory period in cardiac myocytes.
= Nitroglycerin
Similar to other nitrates used to treat anginal chest pain, nitroglycerin converts to nitric oxide (NO) in the body. This activity causes the relaxation of smooth muscle within blood vessels, resulting in the desired vasodilatory effect.
**= Ramipril **
Ramipril inhibits Angiotensin-Converting Enzyme and decreases Angiotensin II formation. As a result, sympathetic activity goes down, sodium and water reabsorption from the kidneys reduces, smooth muscles in the arterioles also relax.
Irbesartan