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NBDE Pt 2 Flash Cards > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

The end plate potential of neuromuscular junctions is estabished through the ___

A

Reduction of the resting potential at the post synaptic area by acetylcholine

End plate potentials are depolarizations of skeletal muscle fibers caused by neurotransmitters binding to the post synaptic membrane in the neuromuscular junction

When an action potential reaches the axon terminal of a motor neuron, vesicles carrying NT (mostly Ach) are exocytosed, and the contents are released into the neuromuscular junction

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2
Q

What organ is affected by taking expired tetracyclines, an effect known as the Fanconi Syndrome? How is it damaged?

A

Kidney

Results in damage to the proximal tubule, resulting in renal tubular acidosis and loss of glucose, amino acids, and excessive phosphate and bicarbonate via the urine.

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3
Q

How does erythromycin interact with other drugs?

A

It decreases metabolism of drugs that interact with cytochrome P450. (Inhibits metabolism of drugs within the liver, leading to possible increased toxicity of other drugs.)

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4
Q

____ is a side effect of inflammatory bowel diseases like Crohn disease and ulcerative colitis, which prevents pharmaceutical absorption

A

Toxic megacolon

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5
Q

___ and ___ in the __ are affected when ethanol is found in the blood stream.

A

GABA (gamma-aminobutyric acid)

Dopamine

Frontal cortex

Ethanol alters the response of both GABA and the dopamine receptors. It binds to the GABA, increasing the GABA receptor response, leading to a reduction in the inhibition of socially unacceptable behaviors

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6
Q

The most medically accepted definition of alcohol abuse is when someone…

A

Consumes alcohol enough that it puts their relationships, jobs, or health in jeopardy

Alcohol abuse manifests differently for both acute and chronic effects on the CNS, including poor judgement, tipsiness, irritability, and sleeping difficulties

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7
Q

True or false… biotransformation usually converts a drug into its lipid-soluble, non-ionized form

A

False.

Biotransformation typically involves the conversion of a lipid-soluble, non-ionized form into its more water-soluble metabolites. It increases the absorption of a drug into the bloodstream, enhancing the bioavailability of the drug. Water-soluble drugs are also easily excreted in urine.

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8
Q

Tetracycline antibiotics are considered [bacteriocidal/bacteriostatic].

A

Bacteriostatic

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9
Q

What is the mnemonic for bacteriostatic antibiotics?

A

ECSTATiC

E - Erythromycin 
C - Clindamycin 
S - Sulfonamides
T - Tetracycline 
A - Azithromycin 
Ti- Trimethoprim 
C - Chloramphenicol
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10
Q

What is the mnemonic for bacteriocidal antibiotics?

A

Very Finely Proficient At Cell Murder

Vancomycin 
Fluoroquinolones
Penicillins
Aminoglycosides
Cephalosporins
Metronidazole
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11
Q

What type of drug administration method has the slowest absorption?

A

Oral

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12
Q

How many milliliters are in one tablespoon? How many teaspoons in a tablespoon?

A

15ml

3 teaspoons in a tablespoon (1 teaspoon = 5ml)

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13
Q

Penicillin’s and cephalosporing’s inhibition of the enzyme ___ is responsible for inhibiting cell wall synthesis. How does this enzyme normally work?

A

Transpeptidase

Transpeptidase is responsible for catalyze game the peptide cross-linking of the peptidoglycan in bacterial cell walls

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14
Q

____ is a bacterial enzyme that cleaves penicillins, making them ineffective against bacteria

A

B-lactamase

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15
Q

How is penicillin VK eliminated from the body?

A

Metabolized by the liver and excreted in urine.

Penicillin VK is an augmented form of penicillin that combines acid stability with an immediate solubility and faster rate of absorption.

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16
Q

Penicillin VK is highly effective against ___ and ___ except for strains producing penicillinase and streptococci groups A, C, G, H, L, and M. Its half-life is approximately ___ and it takes about __ hours to clear the body entirely.

A

Pneumococci

Staphylococci

30-60 minutes

5 hours

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17
Q

Condylar hyperplasia is an idiopathic, slowly progressive unilateral enlargement of the head and neck of the condyle. It typically results in __ malocclusion, facial ___, and shifting of the ___ of the chin to the ___ side.

A

Crossbite

Asymmetry

Midline

Unaffected

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18
Q

What is the treatment of choice if condylar hyperplasia it occurs during the active growth period? What is the treatment of choice following growth cessation?

A

Condylectomy

Orthodontics or surgical mandibular repositioning

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19
Q

Describe the characteristics of trigeminal neuralgia.

A

(Tic douloureux, prosopalgia, fothergill disease)

Having brief periods of sharp/excruciating pain

Experiencing paroxysmal attacks of pain lasting from a fraction of a second or two minutes

Affecting one or more divisions of the trigeminal nerve

Pain may or may not be persistent between paroxysms

Pain is usually a sudden and sharp or stabbing feeling after stimulating a trigger zone. Trigger zones are affected within branches of the trigeminal nerve.

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20
Q

Why do highly polar pharmaceutical work more rapidly?

A

They are hydrophilic so they less permeable to cell membranes and increase their absorption into the blood stream

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21
Q

What is another term for maximal effect of a drug?

A

Efficacy - the maximal or ceiling effect of a drug. It is the capacity of a drug to produce its pharmacological effect in the body.

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22
Q

What does the inscription contain?

A

The name of the drug

Quantity

Dosage form

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23
Q

What does the subscription include?

A

Guidelines to be followed by the pharmacist regarding the preparation and distribution of the medication

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24
Q

What is the transcription of a prescription?

A

The information regarding the intake of the medication (how much, when, how often, how)

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25
Q

When ethanol is consumed while a patient is taking barbiturates, the resulting reaction is called ___. Describe this.

A

Potentiation - occurs when one drug administered simultaneously with another drug interacts to produce a synergistic effect.

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26
Q

Barbiturates are drugs known to cause ___ of the ___. Due to their ability to make people ___, they are also called __.

A

Depression of the CNS

Relax and sleepy

Sedative-hypnotics

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27
Q

True or false… alcohol taken with barbiturates can result in unconsciousness or death

A

True

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28
Q

What are some biological changes that occur with advancing age that affects the pharmacokinetics and pharmacodynamics of pharmaceuticals?

A

Altered volume of distribution and sequestration of a drug in body fat

Decreased rate of biotransformation

Decreased renal excretion

Increased half-lives of some drugs

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29
Q

Define median lethal dose.

A

Dose of a substance that would kill half of the experimental population

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30
Q

What is the medial lethal dose of alcohol/

A

0.4-0.5%

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31
Q

True or false… ethanol is partially absorbed in the stomach and partly in the intestine

A

True - roughly 20% of absorption occurs in the stomach, and 80% takes places in the small intestine

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32
Q

What is the elimination half-life for penicillin NK? What is the range of activity of this drug?

A

30 minutes

Penicillin VK has a range of antimicrobial activity against gram-positive bacteria. Penicillin VK demonstrates a short, half life because it is rapidly excreted in the urine.

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33
Q

Name 4 antibiotics that attack the 50S ribosomal subunit

A

Azithromycin

Clarithromycin

Erythromycin

Lincomycin

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34
Q

Minocycline prevents the function of the ___ ribosomal subunit

A

30s

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35
Q

What is the leading cause of medical problems in children?

A

Inaccurate pediatric dosage

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36
Q

What is the Clark rule and the young rule?

A

Methods used to calculate pediatric dosage

Clark rule = adult dose x (lbs/50)

Young rule = adult dose (age / (age +12)

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37
Q

What is the most common drug reaction seen in a cross-reactivity of penicillin with cephalosporin?

A

Immediate-type hypersensitivity reaction

(Patients experience a penicillin allergy also have a tendency to elicit cross-allergic reactions with cephalosporin drugs

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38
Q

What is a type 1 (immediate) hypersensitivity reaction?

A

Type of rapidly acting allergic response over a certain kind of allergen. An immediate hypersensitivity reaction may result in severe systemic reactions like anaphylaxis, which can cause difficulty in breathing and death. Administration of epinephrine and antihistamines may help slow down and prevent this allergic reaction

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39
Q

True or false.. patients demonstrating a rash or hives following penicillin administration is a contraindication for use of cephalosporin antibiotics but is not a severe contraindication, and they may still use it in certain situation.

A

True

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40
Q

What are the four types of hypersensitivity reactions?

A

ABCD

Anaphylaxis

AntiBody mediated

Immune Complex mediated

Delayed hypersensitivity

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41
Q

Isopropyl alcohol is oxidized in the liver by alcohol dehydrogenase to form ___ and ___, __, then finally ___

A

Acetone

Acetate

Formate

CO2

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42
Q

Prostaglandins are lipid molecules that are enzymatically derived from ___ in the __

A

Arachadonic acid. Cell membrane

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43
Q

___ cells secrete serotonin

A

Enterochromaffin

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44
Q

___ is a protein peptide that belongs with the kinin group

A

Bradykinin

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45
Q

True or false… a person under the influence of ethanol experiences pupil dilation

A

False.. they experience pupil constriction

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46
Q

___ drugs are the most common hypnotic drugs today. What are hypnotic drugs?

A

Benzodiazepines and non-benzodiazepine

Psychoactive medications that are mainly used to induce sleep and are often used to treat sleep disorders like insomnia as well as surgical anesthesia.

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47
Q

What is the therapeutic index?

A

A ratio of the dose of a drug that causes lethal effect to the minimal dose of the drug that can elicit a therapeutic effect. The therapeutic index measures safety and is important to check the margin of safety for a certain drug.

A high therapeutic index value states that the drug is effective at a minimum dose a lot lower than the lethal dose. A low therapeutic index suggests that the drug has a narrow margin of safety

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48
Q

The muscle relaxation experienced by patients under diazepam has a similar mechanism of action to ___. Describe it.

A

Meprobamate

They are both anxiolytic and hypnotic agents. Meprobamate is a barbiturate subgroup and a non-selective CNS depressant that can induce surgical anesthesia. Diazepam is a benzodiazepine and is a selective neuronal depressant.

Benzodiazepines have replaced barbiturates due to their non-selective effect on the CNS and high potential for addiction. Both drugs potentiation GABA, the neurotransmitter responsible for inhibition.

Both barbiturates and benzos potentiation GABA by increasing chloride conductance and the synaptic inhibition efficacy of GABA

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49
Q

What drug class is known to produce a neurological side effect known as tardive dyskinesia?

A

Phenothiazine antipsychotics

Tardive dyskinesia is a condition in which the patient exhibits slow, involuntary, and repetitive muscle movements. It is thought that this occurs due to the neuroleptic-induced dopamine supersensitivity in the nigrostriatal pathway.

Neuroleptic act primarily on this dopamine system.

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50
Q

What is the central mechanism of action in a patient being treated for Parkinson’s disease by L-DOPA (levodopa)?

A

It replenishes insufficient dopamine levels.

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51
Q

Levodopa is an agent administered to patients to be converted by the body into ___. It has no ability to cure Parkinson’s disease but functions to ___

A

Dopamine

Delay its effects and enable the patient to live and function normally for a period of time.

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52
Q

Phenothiazine is a(n) ____ that has demonstrated antiemetic and sedation properties. They are also used for treating headaches and migraines in the emergency rooms.

A

Antipsychotic

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53
Q

___ is a barbiturate that has the highest lipid solubility, allowing for easy crossing of the blood-brain barrier. It is short acting, yet has a rapid onset

A

Thiopental

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54
Q

___ was previously used for the general anesthesia induction phase, but now ___ is used int its place.

A

Thiopental

Propofol

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55
Q

What could be administered to a patient after accidental intramuscular administration to counteract the effects?

A

Propranolol (beta blocker) and prazosin (alpha blocker). When administered together, they create vasodilation and block cardiovascular actions of the sympathomimetic drug

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56
Q

____ is classified as an irreversible cholinesterase inhibitor?

A

Diisoproyl fluorophosphate (DFP)- its an organophosphate insecticide that can act as an irreversible cholinesterase inhibitor. The substance can elicit a parasympathetic action and act as an irreversible anticholinesterase.

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57
Q

What is the mechanism by which succinylcholine inhibits neuromuscular transmission?

A

Depolarizing the motor endplates of skeletal muscle. It acts like acetylcholine because it binds to the acetylcholine receptor and causes muscular twitches or contractions during phase 1.

The phase 2, due to the repetitive excitation and depolarization, the motor endplates become resistant to acetylcholine activation. The resistance of motor endplates from acetylcholine activation prevents neuromuscular transmission, preventing muscular contraction

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58
Q

What is the mechanism of action of nystatin?

A

Bonds to cell membrane of fungi to form porosities which result in leakage of K+. Leads to cell death

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59
Q

How does neostigmine differ from physostigmine?

A

Neostigmine has an additional direct effect at the neuromuscular junction

Neostigmine is a synthetic drug that is poorly absorbed when taken orally and is useful for managing myasthenia gravis

Physostigmine, however, is a naturally occurring lipid-soluble drug that is absorbed very well when taken orally

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60
Q

What drug category is contraindicated in glaucoma patients? Why?

A

Anticholinergics

Anticholinergic agents like atropine are contraindicated in patients predisposed to narrow-angled glaucoma, because they prevent the evacuation of aqueous humor through the canal of schlemm and elevate intraocular pressure by increasing pupillary diameter

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61
Q

Atropine causes pupil dilation by paralysis of the ___, preventing lens accommodation and prevents action of __ on ____ receptors (___), causing an increase in ___.

A

Ciliary muscle

Acetylcholine on muscarinic receptors (M1-M5)

SA node output and increase in heart rate

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62
Q

What is glaucoma?

A

Pathology in which an increased fluid pressure in the aqueous humor of the eye causes pain and can result in blindness if not treated.

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63
Q

What is myasthenia gravis?

A

An autoimmune neuromuscular disease that leads to fluctuating muscle weakness and fatigability. The symptoms are caused by circulating antibodies that block acetylcholine receptors at the postsynaptic neuromuscular junction which inhibits the excitatory effects of the neurotransmitter acetylcholine on nicotinic receptors throughout neuromuscular junction

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64
Q

Stimulation of nicotinic or muscarinic receptors can [increase/decrease] saliva secretion.

A

Increase

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65
Q

Cholinomimetic drugs are designed to directly or indirectly inhibit ____.

A

Acetylcholinesterase

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66
Q

What is the most dangerous effect of a digoxin overdose?

A

Ventricular fibrillation

Other dangerous effects include: bradycardia, prolonged PR interval, accelerated rhythm, and possible bidirectional ventricular tachycardia

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67
Q

True or false.. digitalis is a drug indicated for use in patients suffering from congestive heart failure and cardiac dysrhythmias

A

True

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68
Q

How does digitalis work?

A

It makes cardiac muscles contract more strongly and pump more efficiently, improving blood circulation and reducing edema

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69
Q

What are four symptoms of digitalis intoxication?

A

Nausea

Emesis

Diarrhea

Cardiac arrhythmia

Headache

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70
Q

Which strain of bacteria is most commonly associated with dental-related subacute bacterial endocarditis?

A

Alpha-hemolytic streptococci

Species include: S. Mitis, S. Mutans, S. Salivarius, S. Sanguinus.

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71
Q

___ time is the time required by the blood to form a clot and is measured in seconds

A

Prothrombin

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72
Q

If a patient on warfarin wants a tooth extracted and has an INR over ___, the patient’s physician should be consulted about how to proceed. A common practice is for the physician to prescribe…

A

3.5

The patient to stop taking warfarin two days prior to the day of extraction

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73
Q

____ is a broad-spectrum bacteriostatic antibiotic associated with a risk of aplastic anemia, pancytopenia (bone marrow inhibition), and gray baby syndrome (liver failure in fetuses). This drug is used most commonly to treat ___

A

Eye infections

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74
Q

____ is the first-line drug to be used to treat bradycardia. It is an anti muscarinic agent. It increases the heart rate by blocking the action of the __ nerve and increasing the firing of the ___ node.

A

Atropine

Vagus

SA

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75
Q

The heart has both __ and ___ adrenergic receptors, but __ are the most prevalent receptor present, they can cause an increase in heart rate and contractile force. ___ receptors are predominately present in vascular smooth muscle.

A

B1 and B2

B1

B2

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76
Q

Hydrochlorothiazide, a thiazide diuretic, may necessitate a supplementation with ___ in order to reduce the patient’s blood pressure and prevent occurrence of ___ (hydrochlorothiazide causes teh body to lose ___).

A

Potassium

Hypokalemia

Potassium

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77
Q

Cardiac glycosides are known to decrease the concentration of ___ ions in cardiac myocytes. ___ is a cardiac glycoside known to be a potent inhibitor of Na+K+ATPase in the cell. When cardiac glycosides inhibit Na+K+ATPase, the transition state stabilizes and the sodium ions are not extruded, increasing intracellular sodium concentration.

A

Potassium

Digitalis

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78
Q

Which class of antihypertensive drugs inhibits the release of renin from the kidney?

A

B-adrenergic receptor blockers

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79
Q

Describe the mechanims of action of hydralazine.

A

Acts to directly relax the vascular smooth muscle in the arteries and arterioles causing vasodilation, which decreases blood pressure.

It is not a primary drug in the management of hypertension, because it also stimulates the baroreceptor reflex, increasing the patient’s heart rate and cardiac output.

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80
Q

Hydralazine is contraindicated in patients with ___ because…

A

Coronary artery disease

It could trigger angina pectoris or possibly a myocardial infarction

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81
Q

Describe the mechanism of action of propranolol to relieve angina.

A

Blocks the B-adrenergic receptors of cardiac muscle.

Propranolol is the first nonselective beta blocker developed and is used to treat hypertension, anxiety, and panic attacks

Propranolol blocks the action of epinephrine and norepinephrine on both B1 and B2 adrenergic receptors and exhibits little intrinsic sympathomimetic activity.

Due to its high penetration across the blood brain barrier, lipophilic beta blockers such as propranolol and metoprolol are more likely to cause sleep disturbances such as insomnia, vivid dreams, and nightmares.

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82
Q

What test is the most valuable for evaluating the surgical risk of a patient on warfarin who needs a tooth extracted? Describe this test. What is the normal range?

A

Prothrombin time - measures the clotting tendency of blood. Normal range is 12-13 seconds.

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83
Q

The __ is used in conjunction with prothrombin time. It should come within range of __-__.

A

0.8 - 1.2

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84
Q

Heparin function by preventing the conversion of ___ to ___.

A

Prothrombin to thrombin

Heparin activates and potentiates the activity of antithrombin, which inactivated thrombin and other pro teases involved in blood clotting (most notably factor Xa)

Heparin plays an important role in hemostasis, preventing coagulation by directly preventing soluble fibrinogen conversion into insoluble fibrin.

Heparin is secreted by basophils and mast cells.

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85
Q

___ is a short-acting vasodilator administers through inhalation to treat angina pectoris or cyanide poisoning. It takes effect within 30 seconds of inhalation and lasts about 5 minutes. Physiologic effects include dizziness, headache, decrease in BP, increased heart rate, and relaxation of involuntary muscles. It causes coronary artery dilation, decrease in arterial blood pressure, peripheral arterial dilation, tachycardia.

A

Amyl nitrite

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86
Q

What is the correct dosage necessary for subacute bacterial endocarditis prophylaxis using clindamycin? (Pt is allergic to penicillin)

A

600mg one hour prior to the procedure

Or 500mg azithromycin, or 500mg clarithromycin

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87
Q

What is the correct dosage necessary for subacute bacterial endocarditis prophylaxis using amoxicillin?

A

2g one hour prior to appointment

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88
Q

If the patient is unable to take oral medication, what should be administered to the patient one hour prior to appointment to prevent subacute bacterial endocarditis?

A

Ampicillin 2g intramuscularly or intravenously

Or

Cefazolin/ceftriaxone 1g IM or IV

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89
Q

What class of drug is atenolol? What is it used to treat?

A

B-adrenergic receptor blocking drug

Used to treat low-grade essential hypertension. Atenolol is currently recommended only in special circumstances as complementary medication in HTN.

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90
Q

Verapamil is a ___ blocker

A

Calcium channel

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91
Q

What are the 8 beta blockers? What is the mnemonic?

A

The NEPAL Prime Minister

Timolol
Nadolol
Esmolol
Pindolol
Atenolol
Labetalol
Propranolol
Metoprolol
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92
Q

What are some common side effects of Hydrochlorothiazide?

A 
Hypokalemia (low potassium)
Hypomagnesemia (low magnesium)
Hyponatremia (low sodium)
Hypercalcemia (high calcium)
Hyperuricemia leading to gout
Hyperglycemia 
Hyperlipidemia
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93
Q

What is the pediatric dose of amoxicillin?

A

50mg/kg of body weight up to a max of 2000mg

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94
Q

What is the mechanism of action through which propranolol functions as an antianginal?

A

Blocking the B-adrenergic receptors of cardiac muscle

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95
Q

Thromboemboli formation is prevented by inhibiting ___

A

Synthesis of thromboxane by COX

Thromboxane is a vasoconstrictor responsible for platelet aggregation and for thromboemboli

Aspirin causes the irreversible inactivation of the enzyme cyclooxygenase (COX), which is responsible for the production of prostaglandin and thromboxane. Thromboxane synthetase is the enzyme that mediates the reaction of thromboxane formation

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96
Q

Sine individuals may exhibit hypersensitivity to a local anesthetic agent or the preservative added to it. Allergic reactions have been seen mainly during the administration of ___-type local anesthetic and are due to the release of ____, which is a strong antigens and may sensitize the lymphocytes and induce the production of antibodies.

A

Ester

PABA (para-amino benzoic acid)

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97
Q

The therapeutic function of nalidixic acid is best characterized as an ____. It is a ___ antibiotic effective against gram-____ and is most considered bacteriostatic in low concentrations and bacteriocidal in higher concentrations.

A

Antiseptic for the urinary tract

Quinolone

Negative and gram positive

98
Q

Neuromuscular blockade of the phrenic nerve can be caused by extremely high doses of ___. This pharmaceutical is a bacteriocidal ___ IV/IM antibiotic.

A

Streptomycin

Aminoglycoside

99
Q

_____ has been reported to possess neuromuscular-blocking properties. Extremely high doses have allegedly resulted in lethal neuromuscular blockades of the ___ nerve.

A

Streptomycin

Phrenic

100
Q

What is streptomycin typically prescribed for?

A

Tuberculosis

Infective endocarditis

Plague

101
Q

Uncomplicated respiratory tuberculosis is best treated with a combination of ___ and ___, because they function by different mechanisms. ___ functions by inhibiting the synthesis of mycolic acid, a component of the mycobacterium cell wall. ___ functions by inhibitin bacterial DNA-dependent RNA polymerase, stopping bacterial RNA production.

A

Rifampin and isoniazid

Isoniazid

Rifampin (rifampicin)

102
Q

Tuberculosis and inactive meningitis are treated with a cocktail of ___, ___, ___, __, and ___. What is the mnemonic?

A

RIPES

Rifampin 
Isoniazid
Pyrazinamide
Ethambutol
Streptomycin
103
Q

Why is isoniazid one of the most potent and most common antibiotics used to treat Mycobacterium Tuberculosis?

A

It is very effective against actively multiplying bacteria

It can be prescribed alone or co-administered with other antibiotics

Isoniazid treatment takes 6-12 months to completely eradicate tuberculosis

Isoniazid is usually administered orally or intramuscularly

104
Q

Isoniazid treatment takes __ - ___ [months/weeks] to completely eradicate tuberculosis

A

6-12 months

105
Q

Which tetracycline group has the longest half-life?

A

Doxycycline

106
Q

What is doxycycline used to treat?

A

Malaria

Lyme disease

Rocky Mountain spotted fever

Acne

107
Q

Taking doxycycline with __, __, __, or __ may decrease the effectiveness of the drug

A

Dairy

Antacids

Calcium supplements

Iron products

Laxatives containing magnesium

108
Q

Describe the mechanism of action for the tetracycline family of drugs.

A

Inhibits protein synthesis

It binds to the 30S subunit of bacterial ribosomes, preventing the aminoacyl-tRNA from binding to th acceptor site

109
Q

Prolonged use (more than ___ days) of clindamycin is discouraged because…

A

14 days

There is a high incidence of pseudomembranous colitis.

110
Q

Clindamycin is a ___ antibiotic used to treat ___ bacterial infections and some ___ diseases such as ___, and its use is associated with ____. Clindamycin may prolong the effects of ___ drugs such as ___.

A

Lincosamide

Anaerobic

Protozoal

Malaria

Pseudomembranous colitis

Neuromuscular-blocking drugs

Succinylcholine

111
Q

Crystalluria is less likely to occur with sulfonamide treatment if accompanied by ___. Describe this technique.

A

Sulfanamide cocktail method.

Adequate fluid intake may lessen the chances of urolithiasis when taking sulfonamides.

The sulfanilamide cocktail method is the use of sulfanamide antibiotics in conjunction with other agents to decrease sulfanamide needed and thereby prevent crystallurea and stone formation

112
Q

What is the mnemonic for the characteristics os sulfonamides?

A

SULFA

Steven-Johnson Syndrome (skin rash, solubility low)
Urine precipitation (useful for UTI)
Large spectrum (G+ and -)
Folic acids synthesis blocker (and synthesis of nucleic acids)
Analog of PABA

113
Q

Tetracycline is a [broad/narrow] spectrum [bacteriostatic/bacteriorcidal] antibiotic that functions by inhibiting ___. IT has higher levels of concentration in ___ than in the ___. It is used to treat ___ diseases caused by pathogens like ___ and ___.

A

Broad

Bacteriostatic

Protein synthesis

Crevicular than in serum

Aggregatibacter actinomycetemcomitans

Porphyromonas gingivalis

114
Q

What is benzylpenicillin? It exits the body primarily through ___.

A

Penicillin G

Tubular secretion in kidney

115
Q

Long-term tetracycline use is associated with __, __, and ___. As well as causing discoloration of teeth during the mineralization stage of development.

A

Diarrhea

Photosensitivity

Superinfection

116
Q

What is amantadine?

A

An anti-Parkinson’s drug.

It is a weak antagonist of the NMDA type glutamate receptor, which increases dopamine release and blocks dopamine reuptake

117
Q

What erythromycin compound is enterically coated and has prolonged action?

A

Eryc

118
Q

What is zidovudine and what is it used to treat?

A

A nucleoside analog reverse-transcriptase (NRTI) inhibitor antiretroviral drug

Used to treat HIV

119
Q

True or false… the american heart associations recommendations suggest antibiotic prophylaxis for patients with high-moderate risk heart conditions prior to having dental treatments with significant bleeding in the mouth.

A

True

Restorative procedures are usually ok without prophylaxis

Subgingival placement of antibiotic fibers/strips are indicated to use prophylactic systemic antibiotics because this could induce significant bleeding

120
Q

Carbonicillin is a ___ antibiotic belonging to the ___ subgroup of the penicillins. It has gram ___ coverage, which includes ___, but has limited gram ___ coverage. It is susceptible to degradation by ___ enzymes

A

Bacteriolytic

Carboxypenicillin

Negative

Pseudomonas aeruginosa

Positive

Beta-lactamase

121
Q

____ is a macrolide antibiotic that binds to the 50S subunit of the bacterial ribosome, inhibiting peptide synthesis. It can indirectly inhibit digoxin metabolism and can thus contribute to serious complications. 75% of patients taking this drug experience nausea and vomiting and has numerous other important drug interactions. This drug is not recommended.

A

Erythromycin

122
Q

___ are similar in effect and chemical structure to penicillin, so this drug is not prescribed to patients with a penicillin allergy

A

Cephalosporins

123
Q

____ is a lyncomycin antibiotic that can be used if the patient is allergic to penicillin and is very effective in fighting gram positive bacteria, including ___, which is responsible for pus and abscess formation.

A

Clindamycin

Staphylococcus aureus

124
Q

The relative insolubility in water of ____ may lead to An increased incidence of renal lithiasis (kidney stones). Because of the risk of kidney stones it is usually prescribed with ___, creating a synergistic combination that allows less ___ to be given, decreasing kidney stone risk.

A

Sulfamethoxazole

Trimethoprim

Sulfamethoxazole

125
Q

Sulfamethoxazole is most commonly prescribed for __, ___, and __ infections.

A

Streptococcus

Staphylococcus

E. Coil

126
Q

Describe the mechanism of action of sulfa drugs.

A

Sulfa drugs are structural analogs and competitive antagonists of para-aminobenzoic acid (PABA) , which is used in the synthesis of folic acid. Interfering with folic acid synthesis prevents bacterial DNA replication

127
Q

The fluoroquinolone antibiotic ciprofloxacin (___ generation) is effective against ___. it has [poor/excellent] tissue penetration

A

Second

Pseudomonas aeruginosa (because of its effectiveness against gram-negative organisms.

Excellent

128
Q

Describe the mechanism of action of ciprofloxacin

A

It is bacteriocidal because it interferes with the rewinding of bacterial DNA after its copied, stoping DNA synthesis

129
Q

Ciprofloxacin is also known for its tendency to cause spontaneous ___ and may worsen the symptoms of ___

A

Tendon ruptures

Myasthenia gravis

130
Q

Name 5 third-generation cephalosporins

A 
Cefcapene
Cefuroxime
Cefdinir
Cefixime
Moxalactam
131
Q

Pseudomonas infections indicate prescription of what kind of penicillin?

A

Ticarcillin and carbenicillin

Pseudomonas are bacteria that most commonly cause nosocomial infections. Carbenicillin and ticarcillin are two penicillin-derived antibiotic drugs that are effective against pseudomonas and enterobacter infections.

132
Q

True or false, all members of the tetracycline class may induce photosensitivty, interfere with bone development, and discolor teeth

A

True

133
Q

____ is the only tetracycline known to cause ___. It acts by binding to the ___, impairing protein synthesis of bacteira.

A

Demeclocycline

Nephrogenic diabetes insipidus

30S and 50S

134
Q

Women taking oral contraceptives are more susceptible to what potentially fatal condition? This is due to the increase in activity of ___ and ___ due to the increase in the blood levels of estrogen and progesterone

A

Thromboembolism

Fibrinogen

Coagulation factors VII, VIII, and X

135
Q

What is the only anesthetic drug that can both induce vasoconstriction of blood vessels and increase systemic blood pressure?

A

Cocaine

136
Q

True or false.. acetaminophen has no anti-inflammatory property f

A

False. It an analgesic that has antipyretic (anti-fever) property and some anti-inflammatory response (although much weaker than NSAIDs)

137
Q

What is acetylsalicyclic acid?

A

Aspirin

138
Q

Describe the mechanism of action of Aspirin.

A

Inhibits COX 1 and COX 2

139
Q

COX is an enzyme involved in the synthesis of prostaglandins including ___ and ___, which function to…

A

PGE2

PGF2-alpha

Mediate pain within the body

140
Q

Why are opioids absolutely contraindicated in patients with severe cranial trauma?

A

Because of the possible increase in intracranial pressure

Opioid have the ability to significantly elevate the intracranial pressure which may cause each of the following in cranial trauma patients:

Intracranial bleeding
Blood clot
Brain damage
Shifting of brain structures
Herniation of the brain
Impeded supply of blood to the brain
141
Q

During the administration of opioid analgesics, stimulation of ___ is responsible for the feeling of nausea and vomiting.

A

Chemoreceptor trigger zone

The CTZ of the medulla oblongata functions by receiving input signals from hormones or certain blood borne medications, then relays it toward the vomiting center of the brain to induce vomiting.

The neurotransmitters involved in the control of vomiting and nasuea may include dopamine, histamine, serotonin, substance p, and acetylcholine

The presence and activation of opioid receptors may be responsible for the reason why administration of opioid analgesics may cause nausea and vomiting.

142
Q

In comparison to codeine, morphine is [more/less] potent. Morphine is used in managing pains caused by myocardial infarction and labor.

A

More

It is used to alleviate moderate-to-severe pain

143
Q

Blood dyscrasias, like leukopenia, aplastic anemia, and neutropenia, are most commonly caused by which NSAID?

A

Indomethacin (although blood dyscrasia caused by NSAIDs are rare)

144
Q

____ is a drug that provides anti-inflammatory, antipyretic, and analgesic effects. It is proven to be useful in managing conditions like chronic arthritis. The use of this drug is limited due to its ability to inhibit ____

A

Indomethacin

The aggregation of platelets

145
Q

The supraspinal analgesic action of morphine is achieved by binding to ___ receptors. Activation of these receptors creates…

A

Mu

Sedation, itching, analgesia, euphoria

Decreased respiration, constricted pupils or miosis, and reduces blood pressure

Decreased bowel movement that eventually leads to constipation

146
Q

___ opioid receptors are responsible for spinal anesthesia

A

Delta

147
Q

___ ions regulate the binding affinity of opioid agonists and antagonists to opioid receptors. Binding affinity depends on what 3 things?

A

Sodium

Receptor type

Affinity of sodium with the receptor

Whether the substance is an opioid agonist or antagonist

148
Q

What kind of anesthetic can penetrate mucosal tissues up to 3mm, allowing it to function as a topical anesthetic?

A

Lidocaine

149
Q

__, taken in childhood, is associated with Reye’s syndrome. What are the symptoms of Reye’s syndrome?

A

Aspirin

Rashes
Vomiting
Brain damage
Liver damage

The exact cause is unknown and while it ha Ben associated with aspirin consumption with children with viral illness, is has also occurred in the absence of aspirin use

150
Q

Tylenol 1, 2, 3, and 4 contains __mg of codeine?

A

1 - 8mg
2 - 15mg
3 - 30mg
4 - 60mg

151
Q

___ is an opiate drug that is typically indicated for patients suffering from ___, __, and __ pain because it stays in the blood longer and provides relief over a longer period of time. This drug has a high drug dependency/addiction rate.

A

Oxycodone.

Moderate, severe, spontaneous

152
Q

When nitrous oxide reacts with oxygen and converted into ___, it causes ___

A

Nitric oxide

Vasodilation

153
Q

What anesthetic is prone to induce allergic reactions due to PABA metabolite that is formed during its metabolism? It is an ester-type anesthetic with a short duration of action.

A

Procaine

154
Q

Name 5 symptoms of an opiate overdose.

A

Pin-point pupils (pulpillary miosis)

Seizures

Muscle spasms

Decreased heart rate

Decreased respiratory rate

155
Q

____ can reverse the effects caused by opioid overdose.

A

Naloxone

156
Q

What constituent of IV digoxin, IV diazepam, IV phenytoin is considered the putative agent responsible for inducing thrombophlebitis? What is its purpose?

A

Propylene glycol

Purpose is to make the drugs more soluble and stable

Propylene glycol is regarded safe although it may become toxic in high levels with pediatric patients

157
Q

What is ketorolac?

A

An anti-inflammatory that can be administered through IV, IM and oral routes.

It is primarily used to relive moderate levels of pain. It is usually prescribed as a post-operative pain reliever or after any other painful procedures

The administration of a ketorolac injection together with ketorolac tablets should not exceed or go beyond 5 days to avoid the increased risk of experiencing severe adverse effects

158
Q

The preservative methylparaben most likely demonstrates cross-sensitivity to ___ because the ___ of paraben is located on the para position which can eventually react with para-amino structure of PABA ester. The para position of amino group in PABA ester is a free amino group on the benzene ring that can react with the hydroxyl group of the paraben and cause the cross-sensitivity reaction.

A

Esters of para-amino benzoic acid (PABA ester)

Hydroxyl

159
Q

___ is indicated for mild-moderate pain in pregnant women. ___ is contraindicated in early pregnancy because it may increase the risk of ___. It is contraindicated in the 3rd trimester because it may increase the child’s risk of ___. Aspirin is contraindicated for pregnant women because it may induce premature closure of ___.

A

Acetaminophen

Ibuprofen

Miscarriage

Heart problems

Fetal ductus arteriousus

160
Q

What is the mechanism of action by which epinephrine blocks the effects of histamine?

A

Induction of physiologic effects opposite to histamine.

161
Q

Histamine release causes ___, ___, ___, ___, and ___

A

Contraction of smooth muscles of lungs

Bronchoconstriction

Swelling

Difficulty breathing

Anaphylaxis

Also causes… hypotension due to relaxation of vascular smooth muscle and increased capillary permeability. Stimulation of H1 receptors to cause bronchoconstriction. Stimulation of H2 receptors that stimulate gastric acid secretion. Histamine-selective C-fiber stimulation that is responsible for creating an “itching” sensation

162
Q

NE release or epinephrine administration produces ___, ___, and ___

A

Bronchodilation

Blood vessel constriction

Increased cardiac output

Epinephrine is the best drug for managing anaphylaxis due to its ability to counteract the effects that causes anaphylaxis

163
Q

What is an antihistamine that can be injected as a local anesthetic if the patient reports that they are allergic to ester and amide anesthetics?

A

Diphenhydramine

164
Q

What is the intended target of H2 histamine receptor blockers?

A

Parietal cells of the stomach - induces proton release to decrease pH

165
Q

What is the purpose of H2 receptor blockers?

A

Reduce the amount of acid in the stomach

166
Q

What is the formula for the therapeutic index of pharmaceutical agents?

A

LD50/ED50

This is a comparison of a drug’s therapeutic effect over its toxic or lethal side effect. The index is measured by dividing the lethal dose over its median effective dose

Drugs having a low therapeutic index provide a narrow margin of safety, which means the drug may pose a great risk compared to its medical value

167
Q

True or false… calcium channel blockers are vasoconstrictors

A

False. They are vasodilators

168
Q

What medication inhibit a-glucosidase and reduce glucose absorption in the GI tract?

A

Acarbose

Acarbose inhibits a-glucosidase, an intestinal enzyme found in the small intestine that breaks down starch into glucose. This reduces the glucose absorbed by the GI tract

If a patient is taking acarbose and becomes hypoglycemic, the patient must eat something with monosaccharides, such as glucose tablets or gel. Fruit juice or starchy foods do not effectively reverse the hypoglycemic state

Hepatitis may develop from acarbose use; liver enzymes should be checked before and during use.

169
Q

True or false… hepatitis may develop from acarbose use

A

True

170
Q

Which opioid analgesic can create a serious, life-threatening adverse drug reaction when given to a patient on monoamine oxidase inhibitors?

A

Meperidine

Meperidine when combined with an MAOI can cause life-threatening effects. Including fever, excessive sweating, nervous system excitability, and respiratory depression which can lead to unconsciousness

Meperidine is a drug that helps to control the amount of serotonin and dopamine in the blood. Excessive amounts of these substances can cause a hypertensive crisis.

171
Q

Vaginal candidiasis can be treated by which oral antifungal drug? How does it work?

A

Fluconazole - which is an oral triazole antifungal agent prescribed to treat and prevent superficial and systemic fungal infections by inhibiting the fungal cytochrome P450 enzyme. Inhibition of this enzyme prevents the conversion of lanosterol to ergosterol, an essential component of the fungal cytoplasmic membrane.

172
Q

What is the recommended pharmacological treatment for xerostomia?

A

5mg pilocarpine

Pilocarpine is a parasympathomimetic alkaloid considered a nonselective muscarinic receptor agonist. It stimulates the secretion of large amounts of saliva and sweat through muscarinic receptor stimulation

Pilocarpine has been used in the treatment of chronic open-angle glaucoma

173
Q

What is the mnemonic for the muscarinic effects?

A

SLUG BAM

Salivation, secretions, sweating

Lacrimation

Urination

Gastrointestinal upset

Bradycardia, bronchoconstriction, bowel movement

Abdominal cramps, Anorexia

Miosis

174
Q

Hydroxyine can cause ____ due to its antimuscarinic effects.

A

Xerostomia

175
Q

Clotrimazole is a/an ____ that inhibits ____ synthesis to prevent fungal cell wall production. It is a topical antifungal delivered as a troche that is dissolved in the mouth

A

Imidazole

Ergosterol

176
Q

Ketoconazole and flucanozale are [systemic/topical] antifungal s.

A

Systemic

177
Q

isoproterenol is a ____ that is similar to ___ in its cardiac excitatory action but different from epinephrine in its vasodilation properly. It is a potent ___ when used in __ and ___ forms.

A

Sympathomimetic

Epinephrine

Bronchodilator

Sulfate and hydrochloride forms

178
Q

_____ is a sedative hypnotic drug used to alleviate anxiety that does not cause depression of the CNS. It does not impair cognitive and motor coordination, as observed with other anxiolytic drugs. It also does not cause physical dependence or any form of withdrawal syndrome. It is typically used for generalized anxiety disorder, but it is not known to be effective in controlling panic disorder.

A

Buspirone

179
Q

Belladonna alkaloids are contraindicated to patients predisposed to _____ because…

A

narrow-angle glaucoma

because they prevent evacuation of aqueous humor through the canal of Schlemm and elevate intraocular pressure by increasing pupillary diameter.

180
Q

_____ like atropine are derived from the Atropa belladonna, or deadly nightshade, plant and function as anticholinergic drugs. ____ causes pupil dilation by paralysis of the ciliary muscle, preventing lens accommodation. It prevents action of acetylcholine on muscarinic receptors M1–M5, causing an increase in sinoatrial (SA) node output.

A

Belladonna alkaloids

Atropine

181
Q

Local anesthetic agents can be classified into ___ and ___. Articaine, bupivacaine, lidocaine and prilocaine are examples of ____

A

amides and esters.

amides.

182
Q

Benzylpenicillin (penicillin G) is administered parenterally because it is unstable to hydrochloric acid of the stomach and can achieve high tissue concentration within tissues.

______ can be taken orally because it is more stable in the acidic environment of the stomach and is absorbed better than penicillin G.

A

Phenoxymethylpenicillin (penicillin V)

183
Q

Antihypertensive drugs often cause postural hypotension because they interfere with ____

A

Sympathetic control of vascular reflexes

Baroreflex and autonomic pathways normally ensure that blood pressure is maintained despite various stimuli, including postural change.

α-adrenergic (sympathetic) activity is the predominant pathophysiologic mechanism of orthostatic hypotension in hypertensive patients, especially with patients taking receptor-blocking medications.

184
Q

Which pharmaceutical is the etiologic agent in the remission of acute leukemia in children?

It is a 4-amino analog of folic acid that acts as an antineoplastic agent with immunosuppressive properties. It was replaced by methotrexate due to its more favorable therapeutic index.

It competes for the folate-binding site of the enzyme dihydrofolate reductase, blocking tetrahydrofolate (THF) and resulting in the depletion of nucleotide precursors and inhibition of DNA, RNA, and protein synthesis.

A

Aminopterin

185
Q

Name 4 medication classes that reduce cardiac contractility and exacerbate congestive heart failure:

A

Antiarrhythmics

Beta blockers

Calcium channel blockers

NSAIDs

186
Q

______ —specifically carvedilol, metoprolol, and bisoprolol—are part of the foundation of care for chronic heart failure.

A

Beta blockers

187
Q

____ is a powerful antibiotic but has to be administered with extreme caution due to its adverse effects on the auditory nerve. It is an aminoglycoside used in treatment of severe infections. It may cause ototoxicity and renal dysfunction.

A

Gentamycin

188
Q

_____ regulates the heartbeat of patients with atrial fibrillation by slowing down the ventricular contraction rate._____ is often prescribed for patients suffering from congestive heart failure.

A

Digitalis

189
Q

Why is phenytoin indicated over phenobarbital for grand meal seizures?

A

Phenytoin has less of a sedative effect

190
Q

What is the first line treatment indicated to reverse tricyclic antidepressant overdose?

A

Activated charcoal

Initial treatment of an acute overdose includes gastric decontamination of the patient by administering activated charcoal lavage, which absorbs the drug in the gastrointestinal tract.
Physostigmine is a reversible cholinesterase inhibitor that can reverse the effect of tricyclic antidepressant overdose in five to twenty minutes. However, it increases the risk of cardiac toxicity and may induce seizures.

191
Q

Tricyclic antidepressant drugs enhance the ___ activity of the body

A

Anticholinergic

192
Q

____ is a bacteriostatic antimycobacterial drug prescribed to treat tuberculosis and is usually co-administered with isoniazid, rifampicin, or pyrazinamide. It is bacteriostatic against actively growing tuberculosis (TB) bacilli and functions by obstructing the formation of the cell wall.

A

Ethambutol

193
Q

The pediatric dose of clindamycin is ___ up to ___mg (which is the adult dosage)

A

20mg/kg

600mg

194
Q

_____ is used to treat seizures, and abruptly stopping its use increases the risk of bleeding, complicating hemostasis. Thrombocytopenia may develop in patients taking this drug, because it inhibits the secondary phase of platelet aggregation and causes abnormal coagulation. Platelet count should be monitored in patients taking valproic acid.

A

Valproic acid

195
Q

True or false… if a pt who is physically dependent on pentobarbital discontinues the medication it can induce convulsions

A

True

196
Q

____ is a short-acting barbiturate or CNS depressant. Withdraw symptoms may be treated by administering another type of drug with similar effects as this drug.

A

Pentobarbital

197
Q

Eccrine glands are innervated by the [parasympathetic/sympathetic] nervous system, primarily by [cholinergic/adrenergic] fibers.

A

Sympathetic

Cholinergic

198
Q

Apocrine glands secrete sweat and oily compounds that act as pheromones when they are stimulated by ____

A

Adrenaline

199
Q

One of the main side effects of antipsychotics is involuntary muscle movement, like ____ syndrome, due to their effect on the ___. This syndrome is suggested by the occurrence of involuntary muscle movement that usually occurs when there is incorrect regulation of ___ release and reuptake in the brain.

A

Extrapyramidal

Basal ganglia

Dopamine

200
Q

True or false… corticosteroid can cause peptic ulcers

A

True

Corticosteroids have shown a marked increase in gastric acid secretion and a reduction in gastric mucus, as well as gastrin and parietal cell hyperplasia in animal studies. Studies have also shown that corticosteroids delay healing of previous ulcers.

201
Q

The quaternary ammonium group in the structure of a cholinergic agent allows for it to act as a ___

A

Direct nicotinic antagonist

Nicotinic antagonists are a type of anticholinergic agent that inhibit the action of ACh at nicotinic ACh receptors and are used for peripheral muscle paralysis during surgery

202
Q

What is the mnemonic for nicotinic effects?

A

M-T-W-Th-F

Mydriasis, muscle cramps

Tachycardia

Weakness

Twitching

Hypertension, hyperglycemia

Fasiculation

203
Q

Tramadol binds to ___ receptors and inhibits the reuptake of ___ and ___. It must be metabolized In the hepatic pathway into a more active form. It is a ____-acting synthetic analgesic.

A

Mu-opioid

Norepinephrine and serotonin

Centrally

204
Q

Erythromycin is a ___ antibiotic able to inhibit the metabolism of other drugs.

A

Macrolide

205
Q

____ is a realtively safe antihistamine that may cause cardiac arrhythmias with overdoes. It is a popular drug because it is less sedating than other ____. If taken with _____ it may cause death.

A

Terfenadine

Anti-histamines

Erythromycin

206
Q

Cross-allergy is most likely to happen with what two local anesthetic agents?

A

Lidocaine and mepivicaine

207
Q

What types of diabetes drugs stimulate insulin release from B-cells in the pancreas?

A

Sulfonylureas

Meglitinides

208
Q

What types of diabetes drugs block glucagon release from the pancreas?

A

Exenatide

Liraglutide

Pramlintide

209
Q

What is the mechanism of action of metformin?

A

Acts to increase tissue glucose uptake

210
Q

What drug class is the first-line treatment for depression?

A

Selective serotonin reuptake inhibitors

211
Q

How does succinylcholine inhibit neuromuscular transmission?

A

Depolarization of the motor endplates of skeletal muscle

212
Q

Administration of amyl nitrate for a prolonged period of time may result in___, which is….

A

Methemoglobinemia - a blood disorder characterized by levels of methemoglobin exceeding 1%

Hemoglobin with the presence of ferric heme group is called methemoglobin, which cannot carry oxygen

213
Q

Name 3 causes of methemoglobinemia

A

Environmental factors

Benzocaine

Benzene

Nitrites

214
Q

Trigeminal neuralgia is most commonly treated through the prescription of ___ drugs such as ___.

A

Anti-convulsants

Carbamazepine

215
Q

Phenytoin is commonly prescribed as an anticonvulsant and has an ___ effect. It decreases activity of the ___, thereby controlling seizures. It can treat ___ secondary to ___ intoxication but cannot treat ___ due to cardiac diseases.

A

Antiarrhythmia

Arrhythmias

Digitalis

Arrhythmias

216
Q

Homatropine bromide is a short-acting chemical drug utilized to cause ____ and ___. It is very useful as a ____ during ___ and as a treatment for ___. It is also used to temporarily paralyze ___ of the eyes

A

Mydriasis

Cyclopegia

Pupil dilator

Retinoscopy

Uveitis

Accommodation

217
Q

What drug class is dextroamphetamine? What does this class of drugs do?

A

Indirect sympathomimetics

Work by blocking the norepinephrine transporter, inhibiting the reuptake of norepinephrine

These drugs have been used to treat low blood pressure, cardiac arrest, and delaying premature labor

218
Q

Which class of antihypertensive drugs inhibits the release of renin from the kidneys?

A

B-adrenergic receptor blockers

Renin release from the kidney is stimulated by the B1-adrenergic receptors in the juxtoglomerular cells of the kidneys. B-adrenergic blockers (beta blockers) block the release of renin

219
Q

____-based local anesthetics like ___ are metabolized by plasma cholinesterase

A

Ester

Procaine, chloroprocraine, tetracaine.

220
Q

Amide-based local anesthetics are metabolized by the ___

A

Liver

221
Q

Unlike other sedative hypnotic drugs, ___ is used to alleviate anxiety and does not cause depression of the CNS. It does not impair cognitive and motor coordination, as observed with other anxiolytic drugs. It also does not cause physical dependence or any form of withdrawal syndrome. It is effective in treating generalized anxiety but is not effective in controlling panic disorders. It is a serotonin 5-HT receptor agonist that does NOTcause CNS depression.

A

Buspirone

222
Q

____ is a short-acting benzodiazepine that is used to treat acute seizures and moderate to severe insomnia, and to induce sedation and amnesia before medical procedures. It is more commonly associated with respiratory depression than diazepam. It professes potent anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxant, and sedative properties. It has a fast recovery time. It is the most commonly used benzodiazepine for sedation and is used less commonly for induction and maintenance of anesthesia.

A

Midazolam

223
Q

____, a benzodiazepine antagonist, can be used to treat an overdose of midazolam as well as to reverse sedation.

A

Flumazenil

224
Q

As local anesthetics become more hydrophobic, their ___, ___, and ___ increases

A

Half life

Neurotoxicity

Potentcy

225
Q

Diisopropyl fluorophsophate (DFP), and organophosphate pesticides function by…

A

Noncompetively inhibiting cholinesterases

226
Q

Type ___ hypersensitivity reactions to local anesthetics have been well documented, predominately to __-type anesthetics.

A

4

Ester (benzocaine, chloroprocaine, cocaine, piperocaine, procaine, tetracaine)

227
Q

lidocaine, mepivicaine, bupivicaine, prilocaine, articaine, and ropivicaine are all ___-type anesthetics

A

Amide

228
Q

____ is an alkaloid nicotinic acetylcholine receptor antagonist used as an adjunctive drug in anesthesia. It works by relaxing skeletal muscles during surgery or intubation. It is also used as an agent in diagnosing myasthenia gravis. It has a slow onset of action and an unnecessary prolonged duration of about one to two hours.

A

D-tubocurarine

229
Q

Methacholine is related to acetylcholine as a ___. Which is…

A

Congener

A congener is a substance that is closely related in composition, function, or origin

Methacholine is a synthetically made choline ester that is more predisposed to function as a muscarinic receptor agonist within the parasympathetic nervous system

Methacholine and acetylcholine are both cholinergic agonists, but methacholine’s duration of action is longer than that of acetylcholine

230
Q

A physician may enhance renal excretion of an acidic drug by administering ___

A

Sodium bicarbonate

Alkalinization of urine through the use of sodium bicarbonate decreases acidic drug reabsorption and increases renal excretion of the drug

Acidic urine allows weak acid drugs to be easily reabsorbed

If the drug is a weak base, making the urine more alkaline helps the drug be reabsorbed

Excretion of drugs can be greatly affected by urinary pH

231
Q

Pts with a history of cardiovascular problems should not exceed ___mg of epinephrine in a single visit.

A

0.04

232
Q

When chlorpromazine is administered to a patient who then stands up, the patient may experience dizziness due to ___

A

Alpha-adrenergic inhibition

233
Q

Chlorpromazine inhibits the __ and ___ ___ receptors, which results in symptoms including reflex tachycardia, sedation, vertigo, hypersalivation, and a possibility of sexual dysfunction

A

Alpha 1 and alpha 2 adrenergic

234
Q

Name 5 penicillinase-resistant antibiotics

A 
Cloxaclillin 
Dicloxacillin
Methicillin
Oxacillin
Nafcillin
235
Q

What oral antibiotic is most likely to cause the failure of contraceptives? How?

A

Rifampin

Rifampin is an antibiotic that affects the metabolism of oral contraceptive drugs within the body. Rifampin induces cytochrome P450 enzyme, so drugs that use this metabolic pathway undergo accelerated elimination

236
Q

Flumazenil is a benzodiazepine receptor antagonist available for injection exclusively that reverses the effects of benzodiazepines by…

A

Competitive inhibition of benzodiazepine binding site on the GABA receptor

237
Q

What is the likely mechanism of death for an irreversible anticholinesterase inhibitor? What are some other effects of the overdose?

A

Resipiratory failure due to diaphragmatic and intercostal muscle paralysis

Bradycardia
Bronchoconstriction
GI motility and secretion problems
Miosis

238
Q

What is the mnemonic for effects of aorganophosphate overdose?

A

MUDGELS

Miosis
Urination
Defication 
Gastrointestinal motility 
Emesis
Lacrimation
Salivation
239
Q

The duration of action of diazepam is due to the long half-life of its main active metabolite, known as ____, what may last from __-___days

A

Desmethyldiazepam

Three - seven

240
Q

Diazepam is a [slow/fast] acting agent with a [long/short] duration of action. It is [water/lipid] soluble, binds to protein, and is widely distributed throughout the body after administration

A

Fast

Long

Lipid

NBDE Pt 2 Flash Cards (23 decks)

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