pharmacology Flashcards
Which of the following statements regarding paracetamol is true?
a. excreted unchanged by the kidney
b. maximum recommended dose in an adult is 4g
c. not antipyretic
d. inhibits coughing
e. should not be given in pts allergic to aspirin
B - max dose is 4g per day
- paracetamol is metabolised in the liver
- is an antipyretic
- does not inhibit coughing
Which of the following drugs cannot be used in pregnancy?
a. tetracycline
b. paracetamol
c. nystatin
d. lidocaine
e. penicillin
A - tetracycline
Tetracycline can affect tooth and bone formation - forms brown lines on teeth.
Which 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 - weight loss
Steroids cause Cushingoid effects leading to weight gain, osteoporosis, diabetes and immunosuppression.
Which of the following 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
E - carbamazepine is a benzodiazepine
- Carbamazepine is used to trigeminal neuralgia and epilepsy.
- It DOES have side effects including abnormal liver function tests and bone marrow suppression.
Which of the following statements is correct about local anaesthetics?
a. most commonly used anaesthetic is 0.2% lidocaine with 1:80000 epinephrine
b. lidocaine must be stored below 5º
c. lidocaine has a longer lasting effect than bupivicaine
d. lidocaine without adrenaline has a longer lasting effect than lidocaine with adrenaline
e. 3% prilocaine with 0.03 IU/ml felypressin is commonly used dental anaesthetic
E - 3% prilocaine is commonly used in practice
- lidocaine is used as a 2% solution
- adrenaline causes vasoconstriction leading to increased anaesthesia
Which of the following is correct about lidocaine?
a. 2.2ml cartridge of 2% lidocaine contains 4.4mg of lidocaine
b. lidocaine and prilocaine are esther’s
c. esters are more likely to cause an allergic reaction than amides
d. amide LA are metabolised by the liver
e. prilocaine is more toxic than lidocaine
D - amides are metabolised by the liver
- cartridges contain 44mg of lidocaine
- both lidocaine and prilocaine are amides so less likely to cause an allergic reaction
- lidocaine is a more toxic drug than prilocaine
Which of the following is not an anti-fungal drug?
a. miconazole
b. fluconazole
c. aciclovir
d. nystatin
e. itraconazole
C - aciclovir
Which of the following statements is INCORRECT regarding penicillin?
a. antibiotic of choice for anaerobic infections
b. works by interfering with bacterial cell wall synthesis
c. is bactericidal
d. is antagonistic to tetracycline
e. frequently causes allergic reactions
A - antibiotic of choice for anaerobic infections
The drug of choice for this situation would be metronidazole.
Which of the following can be prescribed safely in pregnancy?
a. metronidazole
b. paracetamol
c. prilocaine
d. miconazole
e. methotrexate
B - paracetamol
- methotrexate can cause an abortion in the early stages of pregnancy
- prilocaine can induce labour, especially when combined with felypressin
Which of the following drugs does NOT induce gingival hyperplasia?
a. nifedipine (ca channel blocker)
b. carbamazepine
c. phenytoin
d. diltiazem (ca channel blocker)
e. ciclosporin
B - carbamazepine
Pts who take warfarin should always:
a. carry a purple warning card
b. have a INR of between 2-3
c. stop all anticoagulants 3 days prior to XLA
d. have their blood regularly monitored to measure INR
e. wear a MedicAlert bracelet
D - pts taking warfarin should have their INR regularly checked
- warning card is yellow
- INR can be up to 4.5 but ideally under 4 for dental procedures
- anticoagulants shouldn’t be stopped prior to XLA
Which of the following statements regarding tetracyclines is true?
a. narrow spectrum antibiotics
b. absorbed better when taken with milk
c. may be used as a mouthwash in a dose of 45mg dissolved in a little water and held in the mouth
d. cause intrinsic staining of teeth
e. cause extrinsic staining of teeth
D - tetracyclines cause intrinsic staining
- should not be given in pregnancy or for pts under 12.
- 250mg capsule can be used as mouthwash to prevent or treat infected oral ulceration.
Which of the following is a symptom of lidocaine overdose?
a. light headedness
b. tachycardia
c. rash
d. hypertension
e. hyperventilation
A - light headedness
Signs of lidocaine overdose include:
- respiratory depression
- hypotension
- bradycardia
- confusion
- convulsions
- light headedness
Lidocaine works by blocking which of the following channels?
a. calcium
b. sodium
c. potassium
d. hydrogen
e. chloride
B - sodium channels
Which of the following regarding aspirin is FALSE?
a. it is a non-steroidal anti-inflammatory drug (NSAID)
b. prevents the synthesis of prostaglandin E2
c. has antipyretic properties
d. commonly used analgesic for children
e. may cause gastric mucosal irritation and bleeding
D - common analgesic for children
Aspirin should be avoided in children due to the possibility of Reye’s syndrome.
Which one of the following interacts with warfarin to alter the pts INR?
a. fluconazole
b. vitamin K
c. metronidazole
d. erythromycin
e. aspirin
B - vitamin K
Interacts with warfarin to lower the INR.
Which of the following is the mechanism by which erythromycin works?
a. blocks protein synthesis at the 30S ribosomal subunit
b. blocks protein synthesis at the 50S ribosomal subunit
c. blocks mRNA synthesis
d. blocks peptidoglycan synthesis
e. blocks cell wall synthesis
B - blocks protein synthesis at the 50S ribosomal subunit.
Which of the following is not an NSAID?
a. aspirin
b. ibuprofen
c. indometacin
d. naproxen
e. paracetamol
E - paracetamol
(indometacin and naproxen mainly used in rheumatoid arthritis)
Which of the following can cause psudomembranous colitis?
a. amoxicillin
b. erythromycin
c. clindamycin
d. metronidazole
e. chloramphenicol
C - clindamycin
Can cause death of many commensal organisms in the colon and leads to overgrowth of less favourable organisms. This causes psudomembranous colitis which has a high mortality.
Which of the following clotting factors is NOT affected by warfarin?
a. II
b. VII
c. VIII
d. IX
e. X
C - factor VIII
Warfarin affects the extrinsic clotting pathway and prolongs the prothrombin time.
(factor 8 is in the intrinsic pathway)
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
B - hydrocortisone sodium succinate
A pt having an addisonian crisis has a lack of corticosteroids in their circulation, leading to collapse.
IV hydrocortisone sodium succinate will rectify this.
Which of the following is NOT a side effect of opioid treatment excess?
a. respiratory depression
b. constipation
c. addiction
d. hallucination
e. dilated pupils
E - dilated pupils
Which of the following should NOT be given to an asthmatic?
a. metronidazole
b. amoxicillin
c. ibuprofen
d. captopril
e. paracetamol
C - ibuprofen
This is because it can cause bronchoconstriction and therefore an asthma attack.
Which of the following regarding paracetamol is incorrect?
a. is an antipyretic
b. overdose is treated by N-acetylcysteine
c. locally acting
d. hepatoxic in overdose
e. prescribed in doses between 500mg and 1g 4x daily
C - locally acting
Paracetamol has a systemic action, acting centrally with antipyretic properties.
Which of the following doses of adrenaline in the treatment of anaphylaxis is correct?
a. 0.5ml of 1:100 IM
b. 5ml of 1:100 IM
c. 0.5ml of 1:1000 IM
d. 5ml of 1:1000 IM
e. 0.5ml of 1:10000 IM
C - 0.5ml of 1:1000 IM
Which of the following can cause a dry mouth?
a. adrenaline
b. atropine
c. amoxicillin
d. anti-malarial
e. ACE inhibitors
B - atropine
Atropine is an antimuscarinic drug leading to decreased salivary outflow and dry mouth.
Which is the most appropriate term to describe the following:
Re-analysis of a trial to determine if treatment affects males more than females.
a. absolute risk reduction
b. bias
c. double blind
d. real end point
e. subgroup analysis
f. surrogate end point
E - subgroup analysis
Which is the most appropriate term to describe the following:
A clinical trial in which neither investigator nor patient is aware of the treatment allocation.
a. absolute risk reduction
b. bias
c. double blind
d. real end point
e. subgroup analysis
f. surrogate end point
C - double blind
Which is the most appropriate term to describe the following:
Stroke - in a trial investigating the effect of an antihypertensive drug on the cerebrovascular system.
a. absolute risk reduction
b. bias
c. double blind
d. real end point
e. subgroup analysis
f. surrogate end point
D - real end point
Which is the most appropriate term to describe the following:
Suppression of ventricular ectopic beats - in a trial to evaluate the function of anti-arrhythmic drugs after myocardial infarction.
a. absolute risk reduction
b. bias
c. double blind
d. real end point
e. subgroup analysis
f. surrogate end point
A - absolute risk reduction
Which is the most appropriate term to describe the following:
In a clinical trial investigating a treatment for myocardial infarction, the percentage of patients with infarcts in the placebo group minus the percentage of patients with infarcts in the treatment group.
a. absolute risk reduction
b. bias
c. double blind
d. real end point
e. subgroup analysis
f. surrogate end point
F - surrogate end point
Explain how codeine works.
Binds to receptors for endorphins which are neurotransmitter used in sensory nerve pathways (pain pathways)
Explain how botulinum toxin works.
Inhibits the release of acetylcholine
Which of the following drugs causes a lichenoid reaction?
a. beta blockers
b. nifedipine
c. allopurinol
d. phenytoin
e. anti-malarial
A, C and E
- beta blockers
- allopurinol
- anti-malarials
(phenytoin and nifedipine cause gingival hyperplasia)
Aspirin:
a. is an NSAID
b. prevents the synthesis of prostaglandin E3
c. is anti-pyretic
d. may cause gastric mucosal irritation and bleeding
e. is commonly used as an analgesic for children
A, C and D - aspirin is an NSAID, has anti-pyretic properties and may cause gastric mucosal irritation/bleeding.
Erythromycin:
a. is a macrolide
b. is active against some penicillinas resistant staphylococci
c. is active against chlamydia and mycoplasmas
d. should not be used during pregnancy
e. is given to an adult (250-500mg 3x a day for 5 days)
A, B and C - erythromycin is a macrolide, is active against some penicillin resistant staphylococci, chlamydia and mycoplasmas.
Tetracyclines:
a. are broad spectrum antibiotics
b. are absorbed better when taken with milk
c. may be used as a mouthwash in a dose of 25mg dissolved in a little water and held in the mouth
d. cause intrinsic staining of teeth
e. cause extrinsic staining of teeth
A and D - tetracyclines are broad spectrum antibiotics and cause INTRINSIC staining.
What is the treatment for primary herpetic gingivostomatitis?
Analgesics / Pain Management up until 2 weeks.
(only aciclovir if longer than 2 weeks)
Which types of medications can cause oral lichen planus?
- beta blockers (-olol)
- ACE inhibitors (-pril)
- carbamazepine
- NSAIDs
(A, B, C and N)
Which 2 antibiotics are best for aggressive periodontal disease?
amoxicillin and doxycycline
Which parasympathetic medication used for the tx of Sjogren’s can cause visual disturbance?
prilocarpine
