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SBA Dentistry > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Which of the following drugs is likely to cause gingival enlargement?
a. Amlodipine
b. Bisoprolol
c. Candesartan
d. Nicorandil
e. Propanolol

A

A. Amlodipine
Common side effects of amlodipine include: ankle swelling, dizziness, flushing, headaches, oedema, stomach pain, nausea, and tiredness.

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2
Q

Bisphosphonates affect which cell most commonly?
a. Cementoblast
b. Chondroblast
c. Fibroblast
d. Osteoblast
e. Osteoclast

A

E. Osteoclast
Bone undergoes constant turnover and is kept in balance (homeostasis) by osteoblasts creating bone and osteoclast destroying bone. Bisphosphonates inhibit the digestion of bone by encouraging osteoclasts to undergo apoptosis, or cell death, thereby, slowing bone loss.

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3
Q

Which of the following drugs is associated with altered taste as a side effect?
a. Amoxicillin
b. Co-amoxiclav
c. Chloramphenicol
d. Flucloxacillin
e. Metronidazole

A

E. Metronidazole
Oral side effects for metronidazole include; candidiasis, altered taste and stomatitis.

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4
Q

The upper limit of the safe dosage of lidocaine in a 50kg woman is:
a. 100mg
b. 150mg
c. 200mg
d. 250mg
e. 300mg

A

B. 150mg
The safe dosage of lidocaine without adrenaline is 3mg/kg. Whereas, with adrenaline it is 7mg/kg.

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5
Q

The speed of onset of a local anaesthetic is most closely associated with which of the following?
a. Lipid binding
b. pKa
c. Protein binding
d. Volume
e. Weight of patient

A

B. The pKa
The pKa is most closely related to the speed of onset. Tissue pH is 7.4 and if the LA pH is close to this, it will work faster. The potency of the LA is associated with increased lipid solubility and duration is associated with protein binding.

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6
Q

A patient with candidiasis returns to your surgery extremely upset. His INR has altered greatly since you prescribed him a medication. Which of the following medications is likely to cause this issue?
a. Clotrimazole
b. Erythromycin
c. Ketoconazole
d. Miconazole
e. Nystatin

A

D. Miconazole.
Miconazole, similar to warfarin, is hepatically metabolised by cytochrome P450. Miconazole has a high probability of potentiating the hypoprothrombinaemic effects of warfarin by decreasing warfarin’s intrinsic clearance and increasing its plasma-free fraction.

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7
Q

Which one of the following statements regarding paracetamol is true?
a. It is excreted unchanged by the kidney
b. The maximum recommended daily dose in an adult is 4g
c. It is not antipyretic
d. It inhibits coughing
e. It should not be given in patients allergic to aspirin

A

B. The maximum recommended daily dose is 4g
Paracetamol is metabolised in the liver, is antipyretic, and does not inhibit coughing.

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8
Q

Which one of the following drugs cannot be used in pregnancy?
a. Tetracycline
b. Paracetamol
c. Nystatin
d. Lidocaine
e. Penicillin

A

A. Tetracycline
Tetracycline affects tooth and bone formation. This is particularly relevant in dentistry with the brown lines which appear on teeth that were developing during the period of administration of tetracycline.

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9
Q

Which one of the following is not a recognised effect of orally administered steroids?
a. Weight loss
b. Osteoporosis
c. Hyperglycaemia
d. Mental disturbances
e. Immunosuppression

A

A. Weight loss
Steroids cause Cushingoid effects leading to weight gain, osteoporosis, diabetes and immunosuppression.

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10
Q

Which one of the following statements is not true?
a. Carbamazepine leads to abnormal liver function tests
b. Flumazenil is a benzodiazepine antagonist
c. Benzodiazepines are commonly used anxiolytics
d. Benzodiazepines are used in the treatment of epilepsy
e. Carbamazepine is a benzodiazepine

A

E.
Carbamazepine is a drug used for trigeminal neuralgia and epilepsy, however, it is not a benzodiazepine

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11
Q

Which one of the following statements is correct about local anaesthetics?
a. The most commonly used LA in dental surgeries is 0.2% lidocaine 1:80k adrenaline
b. Lidocaine must be stored under 5 degrees celcius
c. Lidocaine has a longer lasting effect than bupivacaine
d. Lidocaine without adrenaline has a longer lasting effect than lidocaine with adrenaline
e. 3% prilocaine with 0.03 IU/ml felypressin is a commonly used dental LA

A

E. Prilocaine is more commonly known as Citanest. Lidocaine is normally used as a 2% solution and adrenaline causes vasoconstriction, leading to increased anaesthesia.

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12
Q

Which one of the following statements is correct about lidocaine?
a. A 2.2ml cartridge of 2% lidocaine contains 4.4mg of lidocaine
b. Lidocaine and prilocaine are esters
c. Esters are more likely to cause an allergic reaction than amides
d. Amide LA are metabolised in the liver
e. Prilocaine is more toxic than lidocaine

A

C. Esters are more likely to cause an allergic reaction than amides.
The 2.2ml cartridge of 2% lidocaine contains 44mg lidocaine. Both lidocaine and prilocaine are amides and therefore less likely to cause an allergic reaction. Lidocaine is a much more toxic drug than prilocaine.

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13
Q

Which one of the following is not an anti-fungal drug?
a. Miconazole
b. Fluconazole
c. Aciclovir
d. Nystatin
e. Itraconazole

A

C. Aciclovir
Aciclovir is an anti-viral drug, commonly used topically for herpes simplex. It can also be used more effectively systemically.

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14
Q

Regarding penicillin, which one of the following statements is incorrect?
a. Penicillin is the antibiotic of choice for anaerobic infections
b. Penicillin works by interfering with bacterial cell wall synthesis
c. It is bactericidal
d. It is antagonistic to tetracycline
e. It frequently causes allergic reactions

A

A.
Penicillin’s are a bactericidal group of antibiotics. Their mode of action is to inhibit the cross linking of mucopeptides in cell walls and therefore prevent cell wall synthesis. The drug of choice for anaerobic infections is metronidazole.

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15
Q

Which one of the following drugs can be prescribed safely in pregnancy?
a. Metronidazole
b. Paracetamol
c. Prilocaine
d. Miconazole
e. Methotrexate

A

B. Paracetamol
Methotrexate can be used to produce an abortion in the early stages of pregnancy. Prilocaine can induce labour, especially when combined with felypressin.

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16
Q

Which one of the following drugs does not induce gingival hyperplasia?
a. Nifedipine
b. Carbamazepine
c. Phenytoin
d. Diltiazem
e. Ciclosporin

A

B. Carbamazepine
Nifedipine and diltiazem are calcium channel blockers, phenytoin is an anti-epileptic drug and ciclosporin is an immuno-suppressant. these all induce gingival hyperplasia.

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17
Q

Patients who take warfarin should always:
a. Carry a purple warning card
b. Have a therapeutic range of INR between 2-3
c. Stop all anticoagulants 3 days prior to tooth extractions
d. Have their blood regularly monitored to measure their INR
e. Wear a medicAlert bracelet

A

D. Have their blood regularly monitored to measure their INR.
The warning card is yellow, they do not need to wear a medic alert bracelet. Their doctor decides the appropriate level of INR (can be as much as 4.5 in some patients who have had a valve replacement). They may not need to stop anti-coagulants for simple XLA if their INR is below 3.5.

18
Q

Which of the following statements regarding tetracyclines is true?
a. They are narrow spectrum antibiotics
b. They are absorbed better when taken with milk
c. They may be used as a mouthwash in a dose of 45mg dissolved in a little water and held in the mouth
d. They cause intrinsic staining of the teeth
e. They cause extrinsic staining of the teeth

A

D. They cause intrinsic staining of the teeth.
Tetracyclines should not be given in pregnancy or patients who are under 12 years old. A 250mg tetracycline capsule can be used as a mouthwash to prevent or treat oral ulceration.

19
Q

Which one of the following is a sign or symptom of lidocaine overdose?
a. Light headedness
b. Tachycardia
c. Rash
d. Hypertension
e. Hyperventilation

A

A. Light headedness
Signs and symptoms of lidocaine overdoses are: respiratory depression, hypotension, bradycardia, confusion, convulsions and light headedness.

20
Q

Which one of the following does not always need to be included on a prescription?
a. The prescriber’s signature
b. The date of the prescription
c. The dose of the drug in words
d. The name and address of the prescriber
e. The address of the patient

A

C. The dose of the drug in words.
Only if the drug being prescribed is a controlled drug does the dose of the drug have to be written in words.

21
Q

Lidocaine works by blocking which one of the following channels?
a. Calcium channels
b. Sodium channels
c. Potassium channels
d. Hydrogen channels
e. Chloride channels

A

B. Sodium channels
Lidocaine works by blocking sodium channels, and prevents depolarisation of the nerve membranes as it stabilises the membranes.

22
Q

Which one of the following statements regarding aspirin is false?
a. It is a non-steroidal anti-inflammatory drug (NSAID)
b. It prevents the synthesis of prostaglandin E2
c. It has anti-pyretic properties
d. It is a commonly used analgesic for children
e. It may cause gastric mucosal irritation and bleeding

A

D.
Aspirin is an NSAID which prevents the synthesis of prostaglandin E2. It has anti-pyretic properties because of its action on the hypothalamus and should be avoided in children due to the possibility of Reye’s syndrome.

23
Q

Which one of the following interacts with warfarin to lower the patient’s INR?
a. Fluconazole
b. Vitamin K
c. Metronidazole
d. Erythromycin
e. Aspirin

A

B. Vitamin K
Fluconazole, metronidazole and erythromycin potentiate warfarin’s action. Vitamin K interacts with warfarin but causes a lowering of the INR. Aspirin does not effect the INR as it does not interfere with the clotting cascade, only the function of platelets.

24
Q

Which one of the following is not an NSAID?
a. Aspirin
b. Ibuprofen
c. Indometacin
d. Naproxen
e. Paracetamol

A

E. Paracetamol
All the above are NSAIDs except paracetamol. Indometacin and Naproxen are used especially in rheumatoid arthritis.

25
Q

Which one of the following is the mechanism by which erythromycin works?
a. It blocks protein synthesis at 30S ribosomal sub-unit
b. It blocks protein synthesis at the 50S ribosomal sub-unit
c. It blocks mRNA synthesis
d. It blocks peptidoglycan synthesis
e. It blocks cell wall synthesis

A

B. It blocks protein synthesis at the 50S ribosomal sub-unit.
Gentamicin works at the 30S sub-unit; rifampicin blocks mRNA synthesis; vancomycin classically blocks peptidoglycan synthesis and penicillin blocks cell wall synthesis.

26
Q

Which one of the following antibiotics can cause pseudomembranous colitis?
a. Amoxicillin
b. Erythromycin
c. Clindamycin
d. Metronidazole
e. Chloramphenicol

A

C. Clindamycin
Clindamycin causes the death of many commensal organisms in the colon and leads to overgrowth of less favourable organisms, causing pseudomembranous colitis, which has a high mortality.

27
Q

Which one of the following clotting factors is not affected by warfarin?
a. II
b. VII
c. VIII
d. IX
e. X

A

C. VIII
Warfarin affects the extrinsic clotting pathway and prolongs prothrombin time. It increases bleeding and is teratogenic.

28
Q

Which one of the following commonly prescribed antibiotics produces a disulfiram-like reaction on ingestion of alcohol?
a. Amoxicillin
b. Erythromycin
c. Clindamycin
d. Metronidazole
e. Chloramphenicol

A

D. Metronidazole
Metronidazole has the classic disulfiram-like reaction with alcohol. Patients should be always advised to avoid alcohol when taking this medication.

29
Q

Which is the most important drug to be administered in an addisonian crisis?
a. Adrenaline
b. Hydrocortisone sodium succinate
c. Prednisolone
d. Chlorphenamine
e. Flumazenil

A

B. Hydrocortisone sodium succinate
A patient having an Addisonian crisis has a lack or corticosteroids in their circulation, which leads to collapse. Intravenous hydrocortisone sodium succinate is the drug of choice and will help rectify the situation. Prednisolone is a steroid also, however, it is given orally and takes longer to act. Therefore it is ineffectual in an emergency situation.

30
Q

Which one of the following is not a side effect of an excess of opioid treatment?
a. Respiratory depression
b. Constipation
c. Addiction
d. Hallucination
e. Dilated pupils

A

E. Dilated pupils
Miosis or pinpoint pupils is one of the signs of opiate misuse or overdose. All other options are correct.

31
Q

Which one of the following drugs should not be given to asthmatic people?
a. Metronidazole
b. Amoxicillin
c. Ibuprofen
d. Captopril
e. Paracetamol

A

C. Ibuprofen
Ibuprofen is contraindicated in asthma as it can cause bronchoconstriction and can precipitate an asthma attack.

32
Q

Which one of the following statements regarding paracetamol is incorrect?
a. It is an anti-pyretic
b. An overdose is treated by N-acetylcysteine
c. It is locally acting
d. It is hepatotoxic in overdose
e. It is prescribed in doses of between 500mg and 1g four times daily

A

C.
Paracetamol has a systemic action, acts centrally and has an anti-pyretic action. An overdose is hepatoxic and is treated by N-acetylcysteine.

33
Q

Which of the following doses of adrenaline in the treatment of anaphylaxis is correct?
a. Adrenaline 0.5ml of 1:100 intramuscular
b. Adrenaline 5ml of 1:100 intramuscular
c. Adrenaline 0.5ml of 1:1k intramuscular
d. Adrenaline 5ml of 1:1k intramuscular
e. Adrenaline 0.5ml of 1:10k intramuscular

A

C. Adrenaline 0.5ml of 1:1k intramuscularly
The correct dose is 0.5-1ml of 1:1k intramuscularly, with hydrocortisone sodium succinate 200mg, chlorphenamine 10-30mg intramuscularly, oxygen and 1-2 litres of colloid.

34
Q

Which one of the following causes dry mouth?
a. Adrenaline
b. Atropine
c. Amoxicillin
d. Anti-malarials
e. Angiotensin-converting enzyme (ACE) inhibitors

A

B. Atropine
Atropine is an antimuscarinic drug which leads to the decreased salivary outflow and dry mouth.

35
Q

The most effective drug in the treatment of Parkinson’s disease is:
a. Levodopa
b. Sulfasalazine
c. Metoclopramide
d. Bactroban
e. Clopidogrel

A

A. Levodopa
Parkinson’s disease belongs to a group of conditions called movement disorders. It is characterised by muscle rigidity, tremor, a slowing of physical movement (bradykinesia) and (in extreme cases) a loss of physical movement (akinesia).

36
Q

Penicillin is an effective agent against rapidly growing cells because it:
a. Interferes with folinic acid production
b. Inhibits RNA synthesis
c. Inhibits DNA synthesis
d. Inhibits cell wall synthesis
e. Interferes with folate synthesis

A

D. It inhibits cell wall synthesis
Penicillin causes cytolysis or death due to osmotic pressure. Gram-positive bacteria are called protoplasts when they lose their cell wall. Gram-negative bacteria do not lose their cell wall completely and are called spheroplasts after treatment with penicillin.

37
Q

Sulphonamides are synergistic bacteriostatic agents because in bacteria they:
a. Interfere with folinic acid production
b. Inhibits RNA synthesis
c. Inhibits DNA synthesis
d. Inhibits cell wall synthesis
e. Interferes with folate synthesis

A

A. Interfere with folinic acid production
In bacteria, antibacterial sulphonamides act as competitive inhibitors of the enzyme dihydropteroate synthetase (DHPS).

38
Q

Procaine is an:
a. Amide
b. Ester
c. Benzoate
d. Hypnotic anxiolytic
e. Alkylating agent

A

B. Ester
Procaine is a local anaesthetic drug of the amino-ester group. Procaine is used less frequently today as more effective and more hypoallergenic alternatives (such as lidocaine) are available. Prior to the discovery of procaine, cocaine was the most commonly used LA. Procaine (and cocaine) have the advantages of constricting the blood vessels which reduces bleeding, unlike other LAs like lidocaine.

39
Q

Metronidazole:
a. Interferes with folinic acid production
b. Inhibits RNA synthesis
c. Inhibits nucleic acid synthesis
d. Inhibits cell wall synthesis
e. Interferes with folate synthesis

A

C. Metronidazole inhibits nucleic acid synthesis
The nitro group of metronidazole is chemically reduced by ferredoxin and the products are responsible for disrupting the DNA helical structure, thus inhibiting nucleic acid synthesis.

40
Q

Which topically applied antibiotic can be applied to facial wounds to prevent infection and reduce scarring?
a. Penicillin
b. Erythromycin
c. Chloramphenicol
d. Metronidazole
e. Fluconazole

A

C. Chloramphenicol
Chloramphenicol is frequently applied to facial wounds to reduce infection and prevent scarring.

41
Q
A

SBA Dentistry (10 decks)

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