Advanced Pharmacology

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mom4connor
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208174
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Advanced Pharmacology
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2013-03-19 15:55:47
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Final exam questions
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  1. 1.       Antihistamines work primarily through:
    a.      Action on H1 receptor sites
  2. 1.       A patient receiving nedocromil (Tilade) asks how this drug will help control a respiratory condition.  Which of the following responses would be most appropriate for the health care provider to give the patient?
    It stabilizes mast cells to block reaction to allergens
  3. 1.      A patient is experiencing rhinitis medicamentosa, which of the following drugs would you suspect is at fault?
    Sympathomimetic nasal spray
  4. Whichof the following medications would cause a health care provider to question theorder if the patient was also receiving nadolol (Corgard)?
    Albuterol (Ventolin)
  5. The patient is scheduled to begin treatment with omeprazole.  Before treatment is begun, he should be cautioned not to
  6. The patient will be requiring an antidiarrheal medication for a type of diarrhea that has been found to produce WBC's in the stool.  Review the following classifications and select the one that accurately describes this type of diarrhea
    inflammatory diarrhea
  7. Which of the following conditions could be best treated by the Leukotriene Receptor Antagonist (LTRA) drug montelukast (Singulair)
    Mild persistent asthma
  8. Of the following classifications of asthma that form a basis for step therapy, which describes a patient who experiences more than two daytime symptoms per week, but not daily symptoms
    Mild persistent
  9. Which of the following procedure may lead to a false-negative result if conducted concurrently with use of a histamine 1 (H1) antagonist
    Allergy skin test
  10. A patient with chronic respiratory disease has an order for salmeterol (Serevent), two puffs every 12 hours.  Review the following possible adverse effects, and select the one that could occur following a dose of this drug
    Heart rate changes
  11. Which of the following anticholinergic effects may a patient experience when receiving brompheniramine (Dimetapp)
    Dry mouth
  12. A patient has been instructed to take benzonatate (Tessalon Perls) for nonproductive cough due to bronchial irritation.  Which patient instruction should the health care provider give to this patient
    Swallow the capsule whole
  13. A patient is beginning to take the antiallergy mast cell stabilizer drug cromolyn.  Which of the following instructions is important to give patient when starting the medication?
    Maximum effects are not seen for 2-4 weeks
  14. Which of the following treatment options should only be done in life-threatening cases, and then only if less than 60 minutes has elapsed since ingestion of the poison
    Gastric lavage
  15. A patient is being rehabilitated after addiction to heroin.  Which one of the following drugs would be prescribed by the health care provider to alleviate the opioid craving for heroin in this patient
    Methadone
  16. A pt complains of decreased vision at night and is noted to have unusual dryness of the cornea and conjunctiva.  the pt is likely to be deficient in
    Vitamin A
  17. Treatment protocols for ADHD includes drugs that have which type of autonomic nervous system activity
    sympathetic
  18. The health care provider is preparing to administer a drug that affects the sympathetic (adrenergic) nervous system.  Which one of the following reactions would occur after administration
    Increase rate and force of myocardial contraction
  19. A pt with chronic alcoholism who wishes to avoid "binge drinking" has obtained a prescription for disulfiram (Antabuse).  Review the following reactions, and choose the one that will occur if alcohol is ingested while taking this drug
    facial flushing, headache, and nausea and vomiting
  20. An adrenergic agent is ordered for the pt in shock.  Consider the following effects, and select the one that will be noted if the drug produces the intended response.
    increased blood pressure
  21. A pt is being treated for obstructive uropathy due to BPH.  Which of the following drugs should appear on the patient's medical record
    Terazosin (Hytrin)
  22. The use of garlic is contraindicated in patients taking which drug
    Warfarin (Coumadin)
  23. Which one of the following laxatives could be suggested for a woman who is 33 weeks pregnant and has begun to experience constipation
    Psyllium hydrophilic mucilloid (Metamucil)
  24. Which one of the following effects is likely to accompany presystemic biotransformation of a drug
    First pass effect in the liver
  25. Which one of the following weeks of gestation would most interest a health care provider who is concerned about heightened drug transfer via the placenta
    8 weeks
  26. Which of the following is an implication of physiologic changes such as decreased lean body mass and increased body fat in the older adult that the health care provider who is assessing drug response in this patient must take into consideration
    Drug half-life is lengthened
  27. Which of the following principles are applicable when prescribing drugs for the older adult?
    start low and go slow with prescribing drugs and use drug interactions database to id possible problems
  28. Which one of the following statements is an accurate description of a drug with a designation of "FDA Pregnancy Category A"
    The drug is not likely to cause fetal harm
  29. A drug is an inducer of the cytochrome (CYP) P450 enzyme system.  What will be the result of this interaction on drugs that are substrates for the CYP P450 enzyme system
    the substrate drug will have a lower plasma concentration than expected
  30. Which substance produces a response equal to or greater than the effects of an endogenous chemical in the body
    Agonist
  31. The patient is a 12-year old female who has been diagnosed with an ulcer.  The medication for reduction of acidity that should be avoided with this patient is
    Cimetidine
  32. Which drug is considered to be a loop diuretic
    Bumetanide
  33. Prevention options for GERD include all of the following primary and secondary measures EXCEPT which of the following
    • smoking cessation
    • SURGICAL INTERVENTION
    • NSAID Avoidance
    • avoidance of foods which irritate esophageal mucosa
  34. Ondasetron (Zofran) mechanism of action is
    antagonizing the 5HT3 receptors located centrally in the chemoreceptor trigger zone
  35. the patient is scheduled to begin treatment with an antacid.  His treatment regimen contains several other medications as well.  In relation to his other medications, the antacids should be administered
    1-2 hours before or 2 hours after other medications are taken
  36. A patient who is due to begin treatment with a chemotherapeutic agent has questions regarding the drug's action.  The health care provider explains to the patient that the majority of drugs are thought to act through which of the following mechanisms
    Attaching to receptors on cell surfaces
  37. What parameters would be most useful in calculating drug dosages for a child
    Weight
  38. Your patient who takes HCTZ, lisinopril, and metoprolol is complaining of being unable to achieve an erection.  Which of the medications mentioned is most likely responsible
    Metoprolol
  39. An Alpha Blocker drug, Doxazosin (Cardura) has been ordered for a hypertensive patient.  What adverse effect may result from this drug
    Hypotension
  40. The following factors can reduce total and low-density lipoprotein (LDL) cholesterol levels while raising high-density (HDL) levels EXCEPT FOR:
    • Diet
    • Exercise
    • Smoking cessation
    • POSITIVE MENTAL OUTLOOK
  41. What is not a goal for antihypertensive theray
    Reduce number of medications
  42. Which of the following statements is most accurate regarding the action of heparin
    Heparin inactivates clotting factors that are currently circulating in the bloodstream
  43. The patient has undergone implantation of a mechanical heart valve.  The INR goal should be
    2.5-3.5
  44. The patient has been placed on niacin in addition to a statin drug.  What lab values should be monitored
    LFT's and CPK's
  45. The blood pressure goal of antihypertensive therapy for general CAD prevention is
    less than 140/90
  46. Consider the following supplements, and select the one that a health care provider should advise patients receiving an ACEI to avoid
    Potassium
  47. When a patient cannot tolerate a drug from the ACEI class, a reasonable alternative is
    Angiotensin II Receptor Blockers
  48. An older adult is receiving an antihypertensive drug and a potassium wasting diuretic on a daily basis.  What adverse effect can be compounded by age related physical changes in the patient
    orthostatic hypotension
  49. What statement describes the problem with polypharmacy in the older adult that is least likely to occur
    There are a limited number of health care providers
  50. Which reaction is part of phase II of drug biotransformation
    Conjugation
  51. Which of the four phases of pharmacokinetics is concerned with passive diffusion
    Absorption
  52. Which body system is primarily responsible for drug elimination
    Renal
  53. Which type of antibodies (IG's) protect most full term newborns against infectious agents
    IgG
  54. A drug that causes an enzyme in the CYP450 system to metabolize more slowly is called
    Inhibitor
  55. Which term describes the phenomenon that occurs when the results of two drugs used together have a greater combined effect than when either drug is used alone
    Synergism
  56. Which of the four phases of pharmacokinetics is concerned with volume of distribution
    Distribution
  57. What effects on pharmacokinetics results from the reduced gastric motility that occurs during pregnancy
    delayed drug absorption
  58. At which age does renal tubular secretion reach adult levels
    5 months of age
  59. The patient is instructed on steps to keep his chronic stable angina under control.  Why should beta blocker therapy should be considered for this patient
    It is the only antianginal agent shown to prevent death in patients with angina
  60. Which symptom should the health care provider instruct the patient about before beginning drug therapy with lovastatin (Mevacor)
    Headache
  61. Twelve weeks after a patient starts a statin drug which lab tests should be completed
    LFT's
  62. Which adverse effects are most frequently associated with the use of beta blockers
    bronchoconstriction, hypoglycemia, and depression
  63. ACEI produce down regulation of the sympathetic nervous system by suppressing the vasodilation effects of Angiotensin II
    False
  64. The therapeutic INR value for prophaylaxis and treatment of DVT is
    2.0-3.0
  65. A nonprescription supplement that is known to reduce the level of VLDL cholesterol is
    Fish oil containing EPA and DHA omega 3 fatty acids
  66. Which arrhythmia is not amenable to treatment with digoxin
    PVC's
  67. The pt has been placed on lisinopril.  What time should it take for the patient to see the full effects
    4 weeks
  68. What is the main limitation with niacin therapy
    flushing
  69. Explain how Coumadin works
    Warfarin interferes with production of Vitamin K-dependent clotting factors in the liver
  70. Which parameter needs to be followed closely to assess accurately the effects of NTG
    blood pressure
  71. what is the most common side effect of ACEI drugs like Lisinopril
    Cough
  72. What is the purpose of Alteplase (Activase)
    It actively dissolves the thrombus that has formed
  73. What is the most common side effect that occurs with many of the therapeutic drugs used to treat hyperlipidemia
    GI disturbances
  74. Which condition would contraindicate the use of Warfarin therapy in a patient
    Pregnancy
  75. Treatment with a calcium channel blocker is begun in an older adult patient.  Which dosage is most appropriate for an older adult
    Lower than usual
  76. When should a patient be told to take Zocor
    in the evening
  77. Hypertension in pregnancy is often treated with which of the following drugs
    Aldomet (Methyldopa)
  78. The patient has received an excessive amount of warfarin.  The primary health care provider should expect to treat him with high-dose Vitamin K if the patient's INR is
    >5
  79. The PCP has just started the patient on Digoxin.  How long will the provider need to wait before he is assured that the level of digoxin in the patient's body has reached a steady state
    5 to 8 days
  80. A patient has a drug order for Gemifibrozil (Lopid).  Which of the lipoproteins must be elevated in this patient
    triglycerides
  81. Patients on HMG-CoA reductase inhibitors should be screened for what in about 6 to 12 weeks
    LFT's and myalgias
  82. A pt is experiencing heart failure that is characterized by symptoms experienced with less than ordinary physical activity.  Which class of heart failure is this pt experiencing
    Class III
  83. What age related change would be considered by the health care provider making decisions about pharmacotherapy for an older adult
    Decreased total body mass
  84. The health care provider is prescribing drug therapy for a patient who is 10 weeks pregnant.  In prescribing the drug, the PCP must take into consideration that an expected outcome for this patient at this stage of her pregnancy is
    Increased cardiac output
  85. The cytochrome P450 enzyme that metabolizes over one half of all drugs is
    CYP3A4
  86. Which age group encompasses the most common victims of accidental prescription drug poisoning
    2-3 years
  87. Which condition can be effectively treated using black cohosh
    menopausal symptoms
  88. Which is an adverse effect of an alpha adrenergic agonist
    tachycardia, hypertension and necrosis
  89. Atropine is prescribed for a patient with GI hypermotility.  Which condition could warrant withholding the drug
    Narrow angle glaucoma
  90. What symptom is anticipated with an overdose of barbiturates
    Respiratory depression
  91. Which condition would the health care provider expect a patient on Tacrine (Cognex) has
    Dementia of the Alzheimer's type
  92. Which vitamin is required for the regulation of neurotransmitters and can produce neuropathies if a deficiency develops
    Pyridoxine (B6)
  93. clonidine,  an alpha 2 agonist drug, is likely to be used to treat which condition
    hypertension
  94. Which vitamin will most likely be deficient in a patient with alcoholism
    Thiamine (B1)
  95. A health care provider is working with a patient who has a deficiency in Vitamin D.  Which mineral may also be deficient in this patient?
    Calcium
  96. Bethanechol (Urecholine), a drug used for urinary retention, exerts through which mechanism of action
    cholinergic effects
  97. Which body system may be stimulated by use of echinacea
    immune system
  98. A patient is experiencing an age-related decline in mental functioning.  which herbal supplement may be helpful
    Ginkgo
  99. Which condition may result from the use of garlic
    Reduced total serum cholesterol and triglycerides
  100. Which vitamin may be deficient in a patient with petechiae in a few areas of the body and ecchymoses from even minor trauma to the skin
    Vitamin K
  101. Which condition can be treated with muscarinic anticholinergic drugs
    IBS
  102. Which substances is the favored method for poison removal from the GI tract
    Activated charcoal
  103. What is the definition of asthma
    Chronic airway inflammation hyperresponsiveness, and airway obstruction
  104. What is the action of codeine when added to an antitussive medication
    Codeine suppresses cough because it has a depressant effect on the cough center in the medulla
  105. A patient reports feeling drowsy after taking a first-generation antihistamine.  Which statement is the most appropriate response for the health care provider to give the patient
    This effect is to be expected; a second generation antihistamine can be substituted
  106. Which adverse effect is most commonly associated with the use of intranasal Cromolyn
    nasal burning and congestion
  107. Which is a condition would cause a pt to avoid use of antihistamines
    constipation
  108. A patient taking an antihistamine.  He should be cautioned that driving under the influence of which medication that would be considered illegal in many states
    Clemastine (Tavist)
  109. Which medication is most likely to provide relief of nasal symptoms from allergic rhinitis
    Corticosteroid nasal spray
  110. Beta agonists are commonly used for acute asthma attacks.  Which beta agonist should NOT be used for acute exacerbations of asthmas
    Salmeterol
  111. A patient not on any medication is complaining of cough and difficulty in expiration during breathing but the symptoms are intermittent, occurring less than 2 times/week.  Which drug is appropriate
    Albuterol
  112. A patient has been instructed to take an antitussive medication to control cough.  Which adverse effect is most frequently associated with this group of drugs?
    Drowsiness
  113. A patient has excellent control of wheezing using Albuterol 2 puffs 3-4 times/day.  Which additional drug should be considered?
    A long-acting beta agonist
  114. Which of the following conditions would an expectorant drug such as guaifenesin treat effectively
    Acute bronchitis
  115. Which class of diuretics is contraindicated in a patient who has been given the diagnosis of SLE
    Thiazides
  116. Which class of diuretics is least expensive and used to treat hypertension
    Thiazides
  117. A patient has been diagnosed with GERD and has been instructed to avoid medications that may lower esophageal sphincter pressure.  The provider specifically instructs the patient to avoid taking
    Calcium channel blockers
  118. The patient has cardiovascular disease and should be prevented from straining at stool.  Which class of laxatives would be most effective
    Stool softeners
  119. Which health problem should a health care provider avoid bisacodyl (Dulcolax) for a constipated patient
    Abdominal pain of unknown origin
  120. The non-specific alpha 1 adrenergic receptor blocker doxazosin (Cardura) is best used to treat what condition
    BPH and hypertension
  121. What is the therapeutic effect of Omeprazole (Prilosec)
    It affects the proton pump system to block hydrogen secretion from parietal cells
  122. An integral part of treatment for peptic ulcers is
    lifestyle modification
  123. Ranitidine (Zantac) binds to a receptor that is responsible for decreasing acid production.  That receptor is
    H2 Receptor
  124. The most serious side affect of Desmopressin (DDAVP) is
    hyponatremia and fluid overload
  125. A patient is starting Metoclopramide (Reglan) for gastroparesis.  Side effects of this drug include
    sedation, diarrhea, and extrapyramidal symptoms
  126. Which symptom would be indicative of overdosage of loperamide hydrochloride
    Respiratory depression

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