PRTTEST 6 Flashcards
- A patient presents to your office with the following current medication list:
warfarin, aspirin, and clotrimazole. Before beginning the procedure you had
planned, you decide it is worthwhile to look up further information on these
drugs. Warfarin is metabolized in the liver and has a volume of distribution of
approximately 0.14 L/kg. You are slightly concerned that this patient may
experience increased bleeding because of these properties along with the
concomitant medications he is taking. Which of the following properties of a
drug is the least likely to contribute to a significant adverse interaction with
another drug?
a. The drug has a low therapeutic index
b. The drug has minimal protein binding
c. The drug undergoes extensive cytochrome P450 metabolism
d. The drug is an enzyme inducer
e. The drug has a low volume of distribution
b. The drug has minimal protein binding
with the alpha receptors in the eye, which response listed below
would you, except?
a. Miosis (contraction of the pupil) –(parasympa)
b. Mydriasis (dilation of the pupil) –(sympa)
c. Neither of the above; norepinephrine and epinephrine do
not stimulate or combine with alpha receptors in the eye
b. Mydriasis (dilation of the pupil)
- Methicillin-resistant Staphylococci are most likely to be
inhibited by which drug?
a. Amoxicillin
b. Clarithromycin
c. Clindamycin
d. Vancomycin
e. Penicillin V
d. Vancomycin –red man syndrome
- Which of the following is not an action of diazepam?
a. Antianxiety
b. Anti-inflammatory
c. Sedative
d. Antispasticity
b. Anti-inflammatory
- The ratio of LD50 and ED50 is:
a. Potency
b. Toxicity Index
c. Efficacy
d. Therapeutic index
d. Therapeutic index
- What is the mechanism of the analgesic action of aspirin?
a. Stimulates μ opioid receptors
b. Blocks histamine H2 receptors
c. Inhibits cyclooxygenase
d. Inhibits lipoxygenase
e. Blocks sodium channels in nerves
c. Inhibits cyclooxygenase
- Which of the following compounds after being metabolized to
form ACETAMINOPHEN is an active analgesic and antipyretic
agent?
a. Propoxyphene
b. Aminopyrine
c. ASA
d. Phenacitin
e. Phenylbutazone
d. Phenacitin
- You received a call from the emergency department at your local hospital concerning a pediatric patient that you recently treated. The patient is a 6-year-old boy who was brought to the emergency department in a comatose state. His parents state that he recently visited your office for extraction of a grossly decayed primary tooth. The parents state that they had given him a few pain pills to help with the discomfort following the extraction. Physical examination of the boy revealed “comatose, hepatomegaly, and yellow sclera.” A computerized tomography (CT) scan revealed cerebral edema. Laboratory results showed elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and prothrombin time (PT). The emergency department physician believes that treatment with the antidote N-acetylcysteine is necessary but has called you to confirm whether you prescribed any medications. What agent is most likely involved in the symptoms of this patient?
a. Aspirin
b. Acetaminophen
c. Codeine
d. Celecoxib
e. Ibuprofen
b. Acetaminophen
**
a. Aspirin— administration of platelet concentrate
c. Codeine –naloxone
d. Celecoxib –NSAIDS
e. Ibuprofen – NSAIDS
- Penicillin V is ideally given
a. Orally
b. Subcutaneously
c. Intravenously
d. None of the above
a. Orally
- Which of the following refers to potency of drug?
a. The strength of a drug in relation to its usage
b. The ability of the drug to produce an effect
c. The amount of drug needed to produce an action
d. The amount of drug required to produce a given maximal effect
–
c. The amount of drug needed to produce an action
- Streptomycin and other aminoglycosides inhibit bacterial
protein synthesis by binding to:
a. DNA
b. Messenger RNA
c. 30s ribosomal particle
d. 50s subunit
c. 30s ribosomal particle
- Nitrous oxide is used during conscious sedation. The maximum NO2-O2 mixture should be:
a. 95% NO2, 5% O2
b. 70% NO2, 30% O2
c. 70% O2, 30% NO2
d. 50% NO2, 50% O2
b. 70% NO2, 30% O2
- What is the antibiotic classification of Tetracycline?
a. Bacteriostatic
b. Bactericidal
c. All of the above
d. None of the above
a. Bacteriostatic
- Which drug is often combined with sulfamethoxazole for the
treatment of respiratory tract and urinary tract infections?
a. Amoxicillin
b. Ciprofloxacin
c. Clindamycin
d. Metronidazole
e. Trimethoprim
e. Trimethoprim
- Identify the enzyme whose inhibition is most responsible for
the cell wall synthesis inhibitory effect of penicillin G.
a. β-lactamase
b. DNA gyrase
c. Nitro reductase
d. Transglycosylase
e. Transpeptidase
e. Transpeptidase
- Clavulanic acid offers an advantage therapeutically because
it has what action?
a. It inhibits Streptococci at a low minimum inhibitory
concentration (MIC).
b. It inhibits transpeptidase.
c. It inhibits penicillinase.
d. It inhibits anaerobes at a low MIC.
e. It inhibits DNA gyrase.
c. It inhibits penicillinase.
- Areas anesthetized by Nasopalatine nerve block
a. Bilateral posterior molars
b. Unilateral canine
c. Bilateral canine
d. Unilateral posterior molars
c. Bilateral canine
- Nitrates and nitrites have what effect on blood vessel smooth
muscle?
a. Increase in the level of intracellular calcium
b. Increase in the level of cyclic guanosine monophosphate
(cGMP)
c. Antagonism at α1-adrenergic receptors
d. Antagonism at β-adrenergic receptors
e. Inhibition of L-type calcium channels
b. Increase in the level of cyclic guanosine monophosphate
(cGMP)
- Which of the following is a method of true mandibular nerve
block?
a. Lingual Nerve Block
b. Akinosi Technique
c. Classical IAN Block
d. Gow-Gates Technique
d. Gow-Gates Technique
- All of the following statement is true regarding NSAIDs,
except:
a. Aspirin irreversibly inhibits cox-1 and cox-2
cyclooxygenases
b. All NSAIDs, except aspirin, are reversible inhibitors of cox-1
and cox-2 cyclooxygenases
c. Prostaglandin synthesis is rarely affected
d. They are used for inflammation, analgesia, and antipyrexia
c. Prostaglandin synthesis is rarely affected
- The following are the nerves to be anesthetized when
extracting tooth #26, except
a. Greater Palatine Nerve
b. Lesser Palatine Nerve
c. Middle Superior Alveolar Nerve
d. Posterior Superior Alveolar Nerve
b. Lesser Palatine Nerve
- Which class of antihypertensive drug most effectively reduces
the release of renin from the kidney?
a. β-adrenergic receptor blockers
b. ACE inhibitors
c. α-adrenergic receptor blockers
d. Calcium channel blockers
e. Angiotensin II receptor blockers
a. β-adrenergic receptor blockers
- The use of H2 histamine receptor blockers is most clinically
useful at what cell type?
a. Beta cells of the pancreas
b. Basophils
c. Mast cells
d. Juxtaglomerular cells
e. Parietal cells
e. Parietal cells
- What is the clinical setting for the use of ketorolac by the oral
route?
a. For severe pain
b. For initial treatment of pain
c. To continue therapy after an IV or IM dose of ketorolac
d. Only in combination with an opioid
e. Only in combination with an NSAID
c. To continue therapy after an IV or IM dose of ketorolac
- The following effects result from what type of pharmacological
agent?
* Tachycardia
* Lower blood pressure
* Vasodilation
* Orthostatic hypotension
a. Alpha adrenergic receptor blocker (alpha blocker)
b. Beta adrenergic receptor blocker (beta blocker)
c. Muscarinic cholinergic blocker (muscarinic blocker)
d. Nicotinic cholinergic blocker (nicotinic blocker
a. Alpha adrenergic receptor blocker (alpha blocker)
- A patient presents to your office for a surgical extraction. Following the procedure, you prescribe the patient tylenol #3 (acetaminophen + codeine). The patient is taking several other drugs concurrently. Which of the following drugs is most likely to inhibit the effectiveness of
codeine?
a. Terazosin
b. Glipizide
c. Lisinopril
d. Fluoxetine
e. Lithium
d. Fluoxetine
- Duration of action of bupivacaine
a. 4 hours
b. 2 hours
c. 10 hours
d. 8 hours
c. 10 hours
- Brand name of mepivacaine
a. Carbocaine
b. Marcaine
c. Cocaine
d. Metacaine
a. Carbocaine
- Of the following, which is clinically significant adverse
reaction due to metoprolol?
a. Drowsiness
b. Hallucinations
c. Arthralgia
d. Dry mouth
a. Drowsiness
- All of the following are centrally acting antihypertensives,
except:
a. Methyldopa (Aldomet)
b. Clonidine (Catapres)
c. Tolazoline (Priscoline)
d. Guanabenz (Wytension)
e. Guanfacine (Tenex)
c. Tolazoline (Priscoline)
–Moderate alpha 2 selective antagomit
- After taking Drug X for 5 days, steady free blood levels average
about 20 ug/mL. Drug Z is then introduced while the patient continues to take Drug X, and the free blood levels of Drug X increase to 100
ug/mL. What could have accounted for this?
a. Drug Z is a liver microsomal enzyme inducer
b. Drugs X and Z formed a chelation product in the intestine
c. Drug Z increased the glomerular filtration rate
d. Drug Z has a positive inotropic and chronotropic effect
e. Drugs X and Z are highly bound to plasma proteins
e. Drugs X and Z are highly bound to plasma proteins
- What substance produces all of the following physiologic actions?
* Constrict arteriolar blood vessels (vasoconstriction)
* Relaxes bronchial smooth muscle (bronchodilation)
* Decrease blood volume in nasal tissues
* Causes a hypertensive response
* Produces physiological actions opposite to that of histamine
a. Epinephrine
b. Bradykinin
c. Acetylcholine
d. Serotonin
a. Epinephrine
***
b. Bradykinin — promotes inflammation -> Vasodilation
- Which of the following patterns on the use of drugs refers to a
decrease response to a drug?
a. Dependence
b. Cross dependence
c. Tolerance
d. Withdrawal
c. Tolerance
- Which of the most preferable antibiotic form the treatment of
non-penicillinase producing gram positive staphylococcal
infections?
a. Clindamycin
b. Penicillin VK
c. Ampicillin
d. Cefaclor
b. Penicillin VK
- Which of the following has the broadest spectrum of action, activity against gram positive and gram-negative bacteria?
a. Tetracycline
b. Clindamycin
c. Erythromycin
d. Ampicillin
d. Ampicillin
***
b and c both gram +
- The heart is generally considered to have predominantly
which type of adrenergic receptors?
a. Alpha 1 receptors
b. Beta 1 receptors
c. Alpha 2 receptors
d. Beta 2 receptors
b. Beta 1 receptors —heart
***
a. Alpha 1 receptors –blood vessels (skin)
c. Alpha 2 receptors –blood vessels
d. Beta 2 receptors
-lungs
- Many people use herbal supplements as alternate therapy for a variety
of conditions. It is important for physicians and dentists to know what
medications their patients are taking, including herbal supplements. St.
John’s Wort is an example of a supplement commonly used to relieve
depression. The simultaneous ingestion of the herbal St. John’s Wort has been shown to decrease the half-life of oral contraceptives because St. John’s Wort:
a. Blocks the active secretion of oral contraceptive
b. Induces CYP-3A4 in the gut and liver
c. Increases stomach acidity
d. Blocks both estrogen and progesterone receptors
e. Decreases serotonin levels in the brain
b. Induces CYP-3A4 in the gut and liver
- A 55-year-old female patient was referred to your office by her physician
because she is preparing to receive an infusion of zoledronic acid. Her physician
told her to see a dentist to determine if she has any teeth that may need to be
extracted in the near future. If so, these should be extracted prior to the infusion
because of the risk of poor bone healing (osteonecrosis) that sometimes occurs in
patients receiving infusions of zoledronic acid. Prior to the infusion, the patient was
taking an oral form of this type of drug. What is another major side effect of the oral
form that her physician may have warned her about?
a. Anemia
b. Xerostomia
c. Edema
d. Esophageal perforation
e. Orthostatic hypotension
d. Esophageal perforation
–=invitation of the esophagus -> perforation
**
a. Anemia
-cephalosporins and penicillins, levodopa, methyldopa, quinidine
b. Xerostomia
–antihistamines, anticholinergic, antidepressants, anti-HAN, anti-psychotic
c. Edema
–chemotherapy agents,corticosteroids
e. Orthostatic hypotension
–alpha 1 receptor blocker
- Which of the following organisms is usually sensitive to
clindamycin?
a. Candida albicans
b. Klebsiella pneumoniae
c. Methicillin-resistant Staphylococcus aureus
d. Streptococcus viridans
e. Pseudomonas aeruginosa
d. Streptococcus viridans
- Pharmaceutical agents that bring about tissue responses
resembling those produced by stimulation of the sympathetic
nervous system are called?
a. Cholinomimetic
b. Antiadrenergic
c. Anticholinergic
d. Sympathomimetic
d. Sympathomimetic