Pharmacology

Question 1

Which medications are contraindicated in a patient with gout?

Answer 1

Thiazide diuretics

Question 2

When prescribing an ACE or and ARB what baseline labs should be checked?

Answer 2

serum potassium and serum creatinine should be monitored at baseline, within the first month, and periodically, especially in the elderly, diabetics, and those with chronic kidney disease

Question 3

The herb feverfew is used for what conditions?

Answer 3

migraine, irregular menstrual periods, tinnitus

Question 4

Pharmacology

Answer 4

The study of the interaction between the body and drugs.

Question 5

Pharmacokinetics

Answer 5

The movement of drugs through the body (absorption, bioavailability, distribution, metabolism, and excretion

Question 6

Pharmacodynamics

Answer 6

The study of the physiologic and biochemical effects of drugs (what a drug does to the body).

Question 7

Pharmacogenomics

Answer 7

The study of how a person’s genes affect response to medications

Question 8

Area under the curve

Answer 8

a measure of the bioavailability of a drug after it is administered.

Question 9

Inducers

Answer 9

Speed up drug metabolism

Question 10

Inhibitors

Answer 10

Slow down drug metabolism

Question 11

Age related body changes that affect medication

Answer 11

• Increase in fat-to-water ratio
• Decrease in albumin and plasma proteins
• Decrease in liver blood flow and size
• Decrease in some CYP450 enzyme pathways (decreased drug clearance)
• Decrease in glomerular filtration rate (GFR)

Question 12

Potent inhibitors

Answer 12

• Macrolides (erythromycin, clarithromycin, telithromycin)
• Antifungals (ketoconazole, fluconazole, itraconazole)
• Cimetidine (Tagamet)
• Citalopram (Celexa)
• Protease inhibitors (saquinavir, indinavir, nelfinavir)
• Antipsychotics (clozapine, olanzapine, quetiapine)
• grapefruit juice affects the CYP450 system.

Question 13

Monitoring for lithium

Answer 13

blood levels and TSH (risk of hypothyroidism).

Question 14

Monitoring for digoxin

Answer 14

Monitor digoxin level
EKG
electrolytes (potassium, magnesium, calcium

Question 15

Drugs affected by kidney disease

Answer 15

NSAIDS
ACEi
Warfarin
Lithium
Contrast dye
Potassium-sparing diuretic

Question 16

Fluoroquinolones black box warning

Answer 16

increased risk of tendinitis and acute tendon rupture, especially in patients older than 60 years and in those who are on steroid treatment or who have received an organ transplant

Question 17

Which antibiotic should never be prescribed with wafarin?

Answer 17

Trimethoprim-sulfamethoxazole –> if needed closely monitor the patient’s INR

Question 18

Topical steroid potentcy levels

Answer 18

Clobetasol (Temovate) is classified as a superpotent (group 1)

Halcinonide is classified as high potency (group 2)

Mometasone furoate is high/medium potency (group 3),

Desonide gel is considered medium/low potency (group 5).

Question 19

Adverse effects of calcium channel blockers

Answer 19

Constipation

Question 20

First line treatment for gonorrhea

Answer 20

ceftriaxone

Question 21

First line treatment for MRSA

Answer 21

Bactrim

Question 22

First line treatment for MRSA with a sulfa allergy

Answer 22

Clarithromycin

Question 23

What medication is first line for Atrial flutter?

Answer 23

Non-dihydropyridine CCBs
Diltiazem

Question 24

What medication is used to treat a genital herpes simplex virus (HSV) infection?

Answer 24

Valcyclovir

Question 25

What medication can be used for erectile dysfunction but has also been approved for the treatment of lower urinary tract symptoms secondary to BPH?

Answer 25

Tadalafil

Question 26

Treatment for bacterial meningitis

Answer 26

Vancomycin (Vancocin), ceftriaxone (Rocephin), ampicillin (Omnipen)

Question 27

Which antibiotics are associated with tendon rupture?

Answer 27

Fluoroquinolones
- oxofloxacin
- ciprofloxacin

Question 28

Tetracyclines can produce what in babies?

Answer 28

Neural tube defects. Yellowing of teeth.

Question 29

Schedule I Drugs

Answer 29

Schedule I drugs (e.g., heroin, ecstasy/MDMA, phencyclidine [PCP]) are illegal to prescribe; no currently accepted medical use; high abuse potential

Question 30

Schedule II Drugs

Answer 30

e.g., Demerol, Dilaudid, OxyContin, cocaine, amphetamines, fentanyl)

Only the original prescription with the prescriber’s signature (not stamped) is acceptable.

The total number of pills must be indicated. Write the date clearly (important); it will expire in 6 months automatically.

If the medication is to be taken regularly, then a new prescription is written every month because Schedule II medications cannot be refilled on the same script. For example, a patient with attention deficit hyperactivity disorder (ADHD) who is on methylphenidate (Ritalin) daily needs a new paper prescription every month. Some states now accept electronic prescribing for Schedule II drugs. Make sure the date is written clearly.

Question 31

Schedule III drugs

Answer 31

(e.g., Tylenol with codeine, Vicodin, anabolic steroids, testosterone)

Question 32

Schedule IV drugs

Answer 32

(e.g., benzodiazepines, Ambien, Lunesta, Soma)

Question 33

Schedule V drugs

Answer 33

(cough medicines with <200 mg of codeine, Lomotil, Lyrica)

Question 34

CAP - first and second line treatment

Answer 34

1. amoxiciliin
2. doxycycline or macrolide