Comlex Pharmacology

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  1. The disease modifying anti-rheumatoid drug that causes retinal deposits is?
  2. What is an anti-psychotic drug that causes retinal deposits?
  3. binds tumor necrosis factor, an important mediator for joint destruction. Its adverse effects include hypersensitivity reactions and infections
  4. is an anti-tuberculosis drug that can cause optic neuritis
  5. is a muscarinic antagonist used for Parkinson disease. It may cause blurred vision from cycloplegia which is a common side-effect of any anti-cholinergic drug
  6. inhibits dihydrofolate reductase which interferes with the synthesis of thymine and purine nucleotides. It doesn't interfere with iron metabolism
  7. is a folinic acid analog commonly used to reverse the bone marrow suppression caused by methotrexate.
  8. is a vitamin B12 analog
  9. is a vitamin B6 analog commonly used in patients taking isoniazid for tuberculosis
  10. is vitamin B1 given to alcoholics to prevent Wernicke-Korsakoff encephalopathy
  11. What Drugs cause pancreatitis?
    • FaST Z
    • furosemide , Sulfonamides, Tetracycline, and zathioprine
  12. What causes increased incidence for cholangiocarcinoma?
    Primary sclerosing cholangitis, infection with Clonorchis sinensis, and Ulcerative colitis.
  13. What causes Increased incidence of hepatocellular carcinoma ?
    cirrhosis, chemicals (vinyl chloride, aflatoxin, thorotrast), Hemochromatosis, Wilson’s disease, AAT disease, Schistosomiasis, Hepatic adenoma, cigarette smoking and glycogen storage disease type 1.
  14. What are the major side effects of oral retinoids?
    include suicidal ideations, teratogenicity, hypertriglyceridemia, hypercholesterolemia and elevated liver enzymes.
  15. An increase in Km is consistent with What type of inhibition explain...
    competitive inhibition in which higher concentrations of the substrate are needed to overcome inhibitor bind
  16. What causes a lower total enzyme conc?
    Once a drug binds to an enzyme irreversibly that enzyme molecule is no longer available to bind substrate thus it is equivalent to having a lower total enzyme concentration
  17. What is V max?
    The result is a lower Vmax (the maximum reaction rate when the enzyme is saturated
  18. what is consistent with high substrate affinitiy?
    A decrease in Km (B) and a shift the left
  19. What is the difference btwn irreversible inhibition and competitive inhibition in terms of VMax and Km
    Irreversible inhibition decreases Vmax, while competitive inhibition increases Km
  20. What drug is both an antiemetic and prokinetic drug for the GI tract. It stimulates peristalsis which is impaired in gastroparesis. It works by blocking dopamine receptors.
  21. What are the side effects of Metoclopramide?
    Side-effects consist of extrapyramidal symptoms including parkinsonism and dystonia.
  22. What drug is a serotonin antagonist used primarily for chemotherapy induced vomiting?
  23. How does Lactulose work? is a osmotic laxative
    osmotic laxative
  24. What is an antihistamine used for nausea and motion sickness
  25. What is a serotonin agonist used for irritable bowel syndrome associated with constipation?
  26. Describes MOA of nitroglycerine.
    What drug works by increasing nitric oxide (NO) which triggers an increase in intracellular cGMP. This causes smooth muscle relaxation.
  27. Besides nitroglycerine what causes an increase in NO?
    The binding of acetylcholine to muscarinic receptors on blood vessels also increases NO.
  28. How does bethanochol work?
    The binding of acetylcholine to muscarinic receptors on blood vessels also increases NO. Bethanechol is a direct muscarinic agonist.
  29. What is the mechanism of Physostigmine and can it stimulate nerves?
    Physostigmine inhibits acetylcholinesterase at nerve synapses. The muscarinic receptors on blood vessels are not associated with nerves thus physostigmine cannot stimulate them
  30. Give an example of a beta agonist causing smooth m. relaxation not involving NO
    Isoproterenol is a beta agonist. Beta-2 receptors on blood vessels also cause smooth muscle relaxation but the mechanism doesn’t involve NO
  31. What is Methyldopas MOA and where does it work?
    Methyldopa is an alpha2 agonist in the CNS
  32. How does Nifedipine relax smooth m?
    Nifedipine is a calcium channel blocker that relaxes smooth muscle by decreasing intracellular calcium which does not involve NO
  33. How do Musc receptors relax smooth m. are acetylcholinesterase inhibitors similar?
    Muscarinic receptors on blood vessels relax smooth muscle by stimulating NO. There is no nerve synapse for these receptors thus acetylcholinesterase inhibitors cannot produce the same effect.
  34. How does trimethoprim sulfamethoxazole treat a UTI (pos LE, nitrites, and WBCs) with inc frequency and dysuria?
    Trimethoprim/sulfamethoxazole is a sulfonamide derivative. These antibiotics prevent the synthesis of dihydrofolic acid, which is a substrate for tetrahydrofolic acid. The latter compound is essential for the production of bacterial nucleic acids.
  35. What drug Prevents mycolic acid synthesis in treating tuberculosis?
  36. What drugs bind to bacterial 30S ribosomal subunits and what does this do?
    Tetracyclines and aminoglycosides bind to the bacterial 30S ribosomal subunit it prevents protein translation
  37. What drugs bind to the 50 S ribosomal subunit?
    macrolides, like erythromycin, which bind irreversibly to the bacterial 50S ribosomal subunit
  38. What prevent the cross-linking of peptidoglycan in bacterial cell walls?
  39. What is an anti-neoplastic agent that has been indicated for reducing the rate of painful occlusive attacks in patient’s with sickle cell disease. and causes an increase in the production of fetal hemoglobin (HbF).
  40. What two therapies are indicated when there are coagulation dysfunctions that result in excess bleeding. These therapies replenish necessary clotting factors.
    FFP and Vit K
  41. what does EPO do?
    stimulates the production of RBC's
  42. What medication inhibits platelet aggregation by irreversibly blocking ADP receptors.
  43. What drug given after MIs can cause lupus like symptoms of joint pain fever fatigue and elevated anti histone antibodies? What other drug that is non antiarrythmic also causes lupus symptoms?
    Procainamide;Hydralazine can also cause a lupus-like syndrome but it is not an anti-arrhythmia drug
  44. What is Procainamide's MOA?
    Procainamide is an anti-arrhythmia drug that blocks sodium channels and prolongs the action potential duration.
  45. What are side effects of procainamide?
    Side-effects include dizziness, vertigo, visual disturbances and tinnitus.
  46. Side effects such as dizziness, vertigo, visual disturbances and tinnitus are part of a syndrome known as what?
  47. Name a vasodialator used for HTN
  48. Lidocaine causes what type of cytotoxicity?
  49. Amiodarone causes toxic effects on what organs?
    lungs thyroid liver
  50. What drug clears cholesterol from the blood by inhibits HMG-Coa reductase, the rate-limiting step in intra-hepatic cholesterol synthesis. This lowers intracellular cholesterol thus stimulating LDL receptor expression to pick up more cholesterol from the periphery.
  51. What drug interferes with the absorption of dietary cholesterol?
  52. What is the product of HMG-Coa reductase thus lovastatin inhibits the enzyme that produces it.
  53. Lipoprotein lipase hydrolyzes lipids from chylomicrons and VLDLs. Inhibiting lipoprotein lipase would do what?
    increase plasma triglycerides.
  54. 25-year-old woman presents with mild fever, malaise and joint pains. She admits to having mouth ulcers last week that self-resolved. Serology is positive for anti-nuclear antibodies. what does this patient have and what should you tx it with?
    SLE and corticosteroids
  55. What drug can diffuse through the plasma membrane and bind to intracellar receptors. The receptor-hormone complex then moves into the nucleus to bind DNA and control gene expression.
    corticosteroids like other steroid hormones
  56. What is a complication of corticosteroids?
    Corticosteroids can lead to insulin resistance and increase the risk for diabetes
  57. How can Corticosteroids decrease arachidonic acid release from the membrane ?
    by interfering with phospholipase A2
  58. How do corticosteroids suppress the immune system?
    decrease macrophage function
  59. Describe the mechanism of action of an NSAID ie Ibuprfen.
    These drugs inhibit cyclooxygenase (COX) thus preventing the synthesis of prostaglandins and thromboxanes which mediate inflammation.
  60. What drug works by Inhibition of lipoxygenase and would prevent the formation of leukotrienes?
  61. What drug inhibits mast cell degranulation and is used to treat asthma and allergic rhinitis
  62. What drugs produce their analgesic effects by binding to μ-receptors?
  63. What are histamine (H1) receptor antagonists used for allergies?
    antihistamines, like diphenhydramine
  64. What pregnancy category is Studies in animals or humans show fetal abnormalities or adverse reaction. Risk of use outweighs possible benefit.
    Category X
  65. What pregnancy category is this? Adequate studies in pregnant women do not show risk to a first trimester fetus. There is no evidence of risk for later trimester fetuses.
    Category A
  66. What pregnancy category is this? Animal studies have shown adverse effects on fetuses, but no adequate tests have been performed on humans.
    Category C
  67. What pregnancy category is this? Animal studies do not show risk to fetus and there are no adequate studies in pregnant woman.
    Category B
  68. What pregnancy category is this?There is evidence of fetal risk, but potential benefits from use of drug in pregnancy may be acceptable despite its potential risks.
    Category D
  69. What is the MOA of Slidenafil and what is it used for?
    This patient has erectile dysfunction. Decreased morning erections indicate that his erectile dysfunction is medical, not psychological. Sildenafil is the drug of choice. It inhibits cGMP phosphodiesterase, an enzyme that breaks down cGMP, thus increasing the levels of cGMP. cGMP relaxes the smooth muscle of the corpus cavernosum allowing increased blood flow to maintain an erection.
  70. What is the MOA in finesteride and what is it used to treat?
    5-alpha-reductase inhibition is the mechanism of action for finasteride used for treating benign prostatic hyperplasia (BPH). It inhibits the conversion of testosterone to DHT.
  71. What drug is an anti-thyroid drug that prevents the synthesis of T3 and T4 in the thyroid gland. It inhibits the addition of iodine to the tyrosine residues of thyroglobulin and the coupling reactions between tyrosines to form T3 and T4.
  72. What is used preoperatively to reduce gland size and vascularity of the thyroid in Graves dx?
  73. The enzyme 5’deiodinase converts T4 to T3 in the periphery. This enzyme is inhibited by what three drugs?
    ipodate, propranolol and propylthiouracil
  74. T3 and T4 are made from the tyrosine residues of thyroglobulin located in the ________? In the periphery T3 and T4 bind to ________?
    • thyroid gland follicles
    • thyroid binding globulin (TBG)
  75. What is safer in pregnancy Propylthiouracil or methimazole and why?
    Propylthiouracil is safer in pregnancy than methimazole because it is more extensively protein bound thus less of it is free to cross the placenta (E).
  76. What is first choice management of stable angina?
    Nitrates and beta blockers
  77. If beta blockers can not be used in addition to nitrates for stable angina what can be used secondarily?
    Calcium Channel Blockers
  78. When are only nitrates acceptable for the tx of stable angina?
    If the episodes of exertional angina are occuring one or less times per week.
  79. A boy with seasonal allergies needs to be treated with something nondrowsy what do you prescribe? What may cause him to be drowsy?
    This boy has seasonal allergies which should be treated with an H1 antihistamine. Loratadine is a second generation antihistamine which doesn’t enter the CNS thus doesn’t cause as much sedation as the first generation drugs. Diphenhydramine is a first generation antihistamine and thus causes drowsiness
  80. What drug is a muscarinic antagonist used to treat motion sickness?
  81. What drug is a serotonin antagonist used for carcinoid?
  82. What drug is a leukotriene antagonist used for asthma?
  83. Phenelzine is in the What class of antidepressants?
    monoamine oxidase inhibitors (MAOIs). Monoamine oxidase is an enzyme in the presynaptic cleft that degrades unused monamines, like serotonin and norepinephrine.
  84. What drug class works on serotonin reuptake at the synapse? give an example
    selective serotonin reuptake inhibitors, of which the prototype is fluoxetine.
  85. Inhibition of the neuronal uptake of norepinephrine and dopamine describes the mechanism of what drug?
    bupropion, a medication used in the treatment of depression and smoking addiction
  86. The combined inhibition of norepinephrine, serotonin, and dopamine reuptake describes the mechanism of what drug?
    venlafaxine, another medication used in the treatment of depression.
  87. inhibition of norepinephrine and serotonin reuptake describes the mechanism of action of the what drug class? and give an example..
    .tricyclic antidepressants, of which the prototype is amitryptyline.
  88. What drug lowers LDL, raises HDL, and also lowers triglyceride levels. It functions by inhibiting lipolysis in adipose tissue and by reducing VLDL that is released into the circulation by the liver.
  89. What are the side effects of niacin?
    Side effects of niacin include flushed skin, hyperglycemia, and hyperuricemia.
  90. What is a statin that lowers the cholesterol precursor, mevalonate?
  91. What is a fibrate that increase triglyceride clearance by upregulating lipoprotein lipase activity?
  92. What blocks cholesterol absorption at the small intestine?
  93. What forces the liver to make more bile acids by preventing the reabsorption of bile acids by the intestine?
    the bile acid resin known as cholestyramine
  94. What condition is most likely to affect children 5 to 15 years of age. This child presents with class symptoms including temperature, sore throat, strawberry tongue, exudates, and tender lymph nodes.
    Streptococcal infections from group A strep
  95. What further complications do you want to prevent strep A leading to? What do you treat with to prevent these?
    In order to prevent further complications like rheumatic fever and glomerulonephritis in this patient, it is necessary to treat with penicillin.
  96. Whatt is a bacterial infection; viral upper respiratory infections are treated with supportive care with the use of lozenges and warm salt water
    strep throat
  97. What drug can be toxic to the liver thus liver function should be tested regularly and is contraindicated in pregnancy thus she should continue her contraceptive pills
  98. What drug that prevents the breakdown of purines to uric acid, is sometimes used to control uric acid levels in chemotherapy patients?
  99. Allopurinol inhibits the enzyme _______which is involved in the metabolism mercaptopurines thus greatly increases their toxicity. Additionally what other drug may allopurinol interfere with?
    • xanthine oxidase
    • The dosage may need to be lowered by as much as 75%! Allopurinol doesn’t interact with methotrexate (A), cisplatin (C) or fluorouracil (D). Allopurinol may interfere with the metabolism of cyclophosphamide but not nearly as much as mercaptopurines (E).
  100. What is a calcium channel blocker that causes muscle relaxation of the heart and blood vessels.?
  101. By relaxing cardiac muscle verampimil decreases contractility thus decreasing cardiac output. This could exacerbate what condition?
    Congestive heart failure
  102. What drug used in angina, can promote methemoglobin formation
  103. What drug is more cardio-selective than vascular-selective thus it is useful for patients with a history of angina and myocardial infarction (coronary artery disease)
  104. Verapamil is only useful for supra-ventricular tachycardia (like atrial fibrillation). Due to its slowing effects on AV conduction velocity verapamil may cause what?
    heart block The heart block is usually first degree and of no clinical significance.
  105. 24-year-old boy presents with a painless lesion on his penis. What is the most appropriate treatment? and what does this boy have?
    Primary syphillis tx with penicillin G
  106. What drug is more commonly used for a staph or strep infection.
  107. what is best used for Neisseria gonorrhea infections or Neisseria meningitis?
  108. What is best used to treat Chlamydia?
  109. What is used for many different infections, such as Gardnerella vaginalis?
  110. What drug is a carbonic anhydrase inhibitor that is useful as a diuretic and for glaucoma. It prevents the reabsorption of bicarbonate from the proximal tubules thus causing hyperchloric acidosis.
  111. elevated calcium is associated with what type of diuretics?
  112. Vertigo and ototoxicity is associated with what type of diuretics and what drug?
    loop; aminoglycosides
  113. By inhibiting the reabsorption of bicarbonate, What drug increases the pH of urine thus allowing more ammonia (NH3) to escape into the plasma. Acidic urine normally traps ammonia as the ammonium (NH4+) cation and is an issue For patients with impaired liver function, this can worsen or precipitate hepatic encephalopathy.
  114. A 16-year-old boy presents to the Emergency room with slurred speech, ataxia and impaired consciousness. He complains of abdominal pain and nausea. His friends state that he consumed a lot of alcohol at a party. He has never tasted alcohol before this event. What is most likely associated with his current condition?

    This boy has acute alcohol intoxication. The metabolism of alcohol involves its oxidation to acetaldehyde and then acetic acid. This generates excess NADH which reduces the metabolites needed for gluconeogenesis and thus increases the risk for hypoglycemia.
  115. What are signs of alcohol withdrawl?
    tremor and seizures
  116. How does myasthania gravis work and what drug do you use to test for it?
    Myasthenia gravis (MG) is caused by antibodies that block the acetylcholine receptor at the neuromuscular junction. Edrophonium is a short-acting acetylcholinesterase inhibitor that prevents acetylcholine breakdown thus increasing its concentration in the junction. The diagnosis is confirmed if the symptoms improve when edrophonium is given.
  117. How do you treat myasthania gravis long term?
    Pyridostigmine is a longer acting acetylcholinesterase inhibitor used to treat MG
  118. What disease does pilocarpine tx?
    Pilocarpine is a muscarinic agonist used in glaucoma
  119. Glycopyrrolate is what type of blocker?
    Glycopyrrolate is a muscarinic blocker .
  120. What drug is a beta-1 agonist that increases heart rate and contractility in cardiogenic shock?
  121. What condition is associated with thymomas or hyperplasia of the thymus?
    Myasthenia gravis
  122. Lung cancer is associated with this syndrome, which presents similarly to Myasthenia gravis but repeated stimulation improves weakness additionally there are ab's against Ca channels
  123. Pyridostigmine used in myasthania gravis MOA is what?
    gets rid of acetylcholinesterase; this prevents the breakdown of acetylcholine at the neuromuscular junction thus increasing its concentration which helps overcome the antibodies that block its receptor. Receptor agonists are not used to treat myasthenia gravis.
  124. Name two conditions carbonic anhydrase inhibitors are used for.
    glaucoma and mountain sickness
  125. What drug is used to increase catecholamines at adrenergic synapses and are used as antidepressants
    Monoamine oxidase inhibitors
  126. The onset of HA, nausea and dizziness after consuming alcohol is known as what type of reaction and what is inhibited by this reaction
    disulfuram-like reaction. Disulfiram is a medication given to alcoholics to deter alcohol consumption. It inhibits acetaldehyde dehydrogenase, which is responsible for the breakdown of acetaldehyde (a breakdown product of ethanol) to acetic acid. This causes accumulation of acetaldehyde accompanied by nausea, vomiting, headache, and hypotension.
  127. What medications may cause a disulfiram type reaction when alcohol is consumed
    metronidazole, procarbazine, sulfonylureas, and some cephalosporins.
  128. What drug is an anti-viral medication for the herpes virus?
  129. What is the drug of choice to treat MRSA infections? What is the MOA?
    Vancomyocin; The antibiotic functions by binding to the terminal end of a growing peptidoglycan chain, preventing cell wall synthesis.
  130. What is a medication used to treat mycobacterial infections including tuberculosis.
  131. What anti TB drug can cause optic neuritis (blurred vision with mild pain around eyes cannot discriminate btwn red and green)?
  132. What drug can cause hepatitis, orange-colored body fluids and induction of P450s
  133. Give an example of an aminoglycoside that can cause ototoxicity and nephrotoxicity
  134. What drug can cause hepatitis, neuropathy and lupus?
  135. What drug can cause hepatitis, arthralgia and elevated uric acid?
  136. In Testing for organophosphate poisoning you would used a test dose of what drug?
    Atropine;The anticholinergic effects will confirm the diagnosis of compromised acetylcholine uptake.
  137. What is a chelator used for heavy metal poisoning?
  138. What is an antidote for benzodiazepine overdose?
  139. What is an antidote for acetaminophen overdose?
  140. What is the difference btwn zero order and first order elimination kinetics?
    In zero-order kinetics the rate of elimination is constant regardless of the plasma concentration. In first-order kinetics the half-life is constant and the rate of elimination increases with plasma concentration.
  141. At toxic levels what order elimination does aspirin follow?
    At toxic levels aspirin follows zero-order elimination kinetics. By definition, this means that the elimination rate is constant and independent of the plasma concentration. This occurs because the drug metabolizing enzymes are saturated (have reached Vmax) thus additional drug cannot influence the elimination rate.
  142. How is Ph seen in accordance to Pka when acids are neutral ex for aspirin?
    At pH below their pKa acids are neutral
  143. In the case of an Acetaminophen ( a reversible COX inhibitor used to relieve fever and pain) overdose N-acetylcysteine is used how does this work?
    It replenishes the glutathione stores that were depleted from the toxic levels of acetaminophen. This can help prevent permanent liver damage.
  144. What is the antidote to an opioid overdose?
  145. What is the antidote for iron overload?
  146. What is a chelating agent that directly binds to metals in the blood? It is used for lead, arsenic, gold, and mercury poisoning.
  147. Acetaminophen overdose can cause what type of organ damage. by what mechanism?
    It is metabolized in the liver where toxic levels can deplete glutathione stores allowing damage by free radicals. Liver failure is the most common cause of death due to an acetaminophen overdose.
  148. Medications such as, aminoglycosides, cisplatin and loop diuretics have the potential to cause what type of damage (2)?
    Nephrotoxicity and ototoxicity
  149. Hemorrhagic cystitis (D) is inflammation and bleeding of the bladder which may be caused by what drug?
  150. Pulmonary fibrosis (E) involves destruction of normal lung tissue and subsequent replacement with fibrous scar tissue. Drugs associated with this are (3)?
    amiodarone (anti-arrhythmic), bleomycin and busulfan (chemotherapeutics).
  151. This drug is a pain reliever and fever reducer. Fever reduction is achieved by reducing the production of prostaglandins which mediate the fever response.
  152. What cytokine activates the arachidonic acid pathway, which increases production of prostaglandins, thus stimulating a fever? (note Its release is not inhibited by acetaminophen)
  153. What are major differences btwn aspirin and acetaminophen?
    While aspirin (an NSAID) inhibits thromboxane production (thromboxane promotes platelet aggregation) which helpful for preventing clot formation, acetaminophen does not (C). Unike NSAIDs, acetaminophen doesn't inhibit inflammation (E).
  154. Arachidonic acid is released from the membrane by what?
  155. What diuretic may cause this situation? A 50-year-old man develops hyperkalemia and gynecomastia
    Spironolactone blocks aldosterone receptors at the collecting ducts. This leads to decreased plasma Na+ and increased plasma K+. It also blocks androgen receptors which could cause gynecomastia in men and improve hirsutism in women.
  156. What type of diuretic may cause this situation?
    A 60-year-old male, taking a diuretic for 20-years admits to decreased frequency of kidney stones. Labs show hypercalcemia.
    Thiazides decrease Na+ reabsorption from the distal convoluted tubule. This change in ion balance drives Ca2+ out of the tubules and into the blood. The hypercalcemia caused is usually mild and asymptomatic. Patients who are prone to renal stones can benefit from this transfer of Ca2+ from the urine to the blood.
  157. What type of diuretic may cause this situation? A 60-year-old male develops vertigo, nausea and hypocalcemia
    Furosemide is a loop diuretic that blocks Na+ reabsorption at the thick ascending loop. Side-effects include otoxicity (vertigo, nausea and hearing loss). Unlike thiazides that increase plasma Ca2+, loop diuretics decrease plasma Ca2+.
  158. What type of diuretic fits this situation? A 25-year-old man takes it when he goes mountain climbing.
    Acetazolamide is a carbonic anhydrase inhibitor that decreases Na+ reabsorption in the proximal tubule. It causes metabolic acidosis which helps counteract the effects of respiratory alkalosis experienced at high altitudes.
  159. A 45-year-old man has trouble falling asleep. He states that he worries about money. He is an accountant and fears that he will be laid off. He is prescribed triazolam. What is its MOA?
    Triazolam is a benzodiazepine used to treat insomnia. These drugs bind to the GABA receptor, which is also a chloride channel, and increases its frequency of opening.
  160. What drug enhances GABA effects?
  161. A 35-year-old woman presents with a headache, tachycardia and diaphoresis. Her blood pressure is 165/95. Urinalysis is positive for vanillylmandelic acid (VMA). What is the best initial drug treatment?

    The diagnosis is pheochromocytoma, a tumor usually found in the adrenal medulla that secretes norepinephrine causing excess sympathetic stimulation. Phentolamine blocks both alpha1 and alpha2 receptors and is the drug of choice to control the symptoms of this disease. Propranolol is a non-selective beta-blocker. It is dangerous to give a beta-blocker before an alpha-blocker because it can worsen the hypertension due to loss of the beta-2 vasodilation effect
  162. What is an example of an alpha-1 blocker used specifically for benign prostatic hyperplasia?
  163. What is an example of a serotonin blocker used for nausea associated with cancer chemotherapy
  164. What are two times to remember not to give a beta-blocker before an alpha-blocker?
    cocaine toxicity and pheochromocytoma. The beta-blocker will prevent the beta-2 mediated vasodilation thus worsening hypertension
  165. This patient has peptic ulcer disease caused by H. pylori due to the positive urease test. What can you use to treat this that may be worisome for phototoxicity? what can also tx without photosensivity?
    Tetracyclines (such as doxycycline) can be used to eradicate these bacteria and they are known to cause skin photosensitivity.

    proton-pump inhibitors (A) and H2-blockers (B) are also used but do not cause photosensitivity.
  166. A patient has had to change their insurance carrier. Their hypertension medication is no longer covered. You see the patient in the ER three weeks after their Primary Care Physician quickly switched them to a new angiotenson receptor blocker. The patient now has hypercalcemia. You suspect that the ARB might be packaged with a diuretic. Which of the following is the medicinal culprit for the elevated calcium?
    Hydrochlorothiazide and Losartan
  167. Metclizine is what type of drug?
    the anti-histamine used for anti-emesis.
  168. Give an example of a diuretic used to treat congestive heart failure and edema.
  169. What is the MOA of Amlodipine?
    is a long-acting calcium channel blocker.
  170. What does Doxylamine and pheniramine have in common?
    Doxylamine is used as an over the counter sedative Pheniramine, or Avil, is another first-generation antihistamine. It is generally used in combination with other medicines due its highly sedating effects
  171. What is the benefit of 2nd generation antihistamines?
    second-generation antihistamines such as loratadine (Claritin) have less sedating effects than first-generation antihistamines such as diphenhydramine (Benadryl).
  172. How does acetaminophen overdose increases the risk of liver failure?
    Inducing P450 enzymes (phase I reactions)
  173. What is the difference between carbamazepine and cimetidine?
    Carbamazepine, an anti-seizure drug, induces P450’s. Cimetidine, an H2-blocker used for gastric reflux disease, inhibits P450’s
  174. High levels of what reduces this acetaminophen toxicity protecting the liver?
    High levels of glutathione reduce this toxin protecting the liver. When the overdose is high enough to deplete glutathione, liver failure occurs. Most of the ingested acetaminophen is metabolized by phase II reactions and these products are not harmful to the liver (D). When these reactions are saturated, the phase I pathway takes over.
  175. A 50-year-old woman has not had a bowel movement for 3-days since her gallbladder was surgically removed. She is given subcutaneous bethanechol. By accident the nurse doubled her dose and she develops diarrhea.Which of the following additional effects is most likely?
    • Urinary incontinence;
    • Bethanechol is a muscarinic agonist commonly used for post-operative ileus as seen in the above case. Muscarinic stimulation increases parasympathetic activity and peristalsis in the GI tract. Muscarinic stimulation in the bladder causes smooth muscle contraction leading to urination. In fact bethanechol can be used to treat urinary retention. Muscarininc stimulation causes sweating (A) and miosis (B). Bethanechol binds muscarinic receptors with much higher affinity than nicotinic.
  176. Nicotinic stimulation causes _____ _______ excitation and stimulates the ______ _______
    skeletal muscle;adrenal medulla
  177. Prazosin is used as a blood pressure lowering agent due to the fact that it inhibits____ __ _____ on blood vessels. What are major and minor side effects of Prazosin?
    alpha 1 receptors ; prozosin is first started heart rate and contractility rise to maintain homeostasis because the drug lowers blood pressure. After an extended time period on the drug, blood pressure is lowered while heart rate and contractility return to normal. Syncopoe and nasal congestion are minor side effects while the major side effect that must be monitored for is first-dose hypotension
  178. What caused gingival hyperplasia?
  179. What type of side effects are seen commonly with the use of drugs that are dopamine antagonists including haloperidol and chlorpromazine?
    Parkinson-like side effects
  180. What type of reactions can be seen with the use of metronidazole and cephalosporins?
  181. The most common side effects of ACE inhibitors is?
  182. The major side effect of alpha 1inhibitos including prazosin is What?
    first dose hypotension
  183. A 14-year-old boy injured his medial meniscus while playing soccer. The orthopedic surgeon decides to do arthroscopy as an outpatient surgical procedure. He uses ketamine as an anesthetic. What is the MOA and concerning effects of this drug?
    Ketamine is an intravenous anesthetic that has a rapid onset and short duration. An emergence reaction in which vivid dreams and hallucinations can occur during recovery. Ketamine blocks glutamate receptors, which is the major excitatory neurotransmitter of the CNS Ketamine causes dissociative anesthesia which consists of amnesia, analgesia and catatonia without loss of consciousness Cardiovascular excitation is a side-effect of ketamine
  184. Anti-emetic effects are associated with which intravenous anesthetic?
  185. What drug is used primarily for the prophylaxis of asthma by stabilizing mast cells preventing the release of inflammatory mediators?
  186. Diphenhydramine, Dimenhydrinate, Clorpheniramine, hydroxyzineare all what type of drug and what common side effect do they produce?
    first generation antihistamine causing sedative effects
  187. oratadine, fexofenadine, desloratadine, cetirizine are all what type of drug class?
    second generation antihistamines
  188. A 3-year-old male presents to the pediatrician with his mother. The child was born deaf. Physical exam reveals centrally-notched incisors, a flattened nose, a sharp anterior bowing of the tibia, and corneal erythema.
    This child has congenital syphilis characterized by deafness, Hutchinson's teeth (centrally notched, widely-spaced peg-shaped upper central incisors), saddle nose, saber shins, and interstitial keratitis of the cornea. The treatment for syphilis is Penicillin G Treatment is for both the pregnant mother and the neonate.
  189. What is given for herpes? Can you give it during pregnancy?
    Acyclovir (B) is given for herpesvirus infections. Animal studies have shown it to be safe during pregnancy.
  190. What can be used to treat and prevent congenital syphilis, only used in patients with a penicillin allergy instead of penicillin G.
  191. What drug is a nucleoside reverse transcriptase inhibitor (NRTI) used to prevent vertical transmission of HIV?
  192. Is Gentamicin safe in pregnancy?
    Gentamicin is an aminoglycoside antibiotic that is not recommended during pregnancy and not effective in preventing syphilis.
Card Set
Comlex Pharmacology
Pharmacology Combank
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