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inbde > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Hydralazine (Apresoline®)

A

is a vasodilator used to treat hypertension.

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2
Q

The treatment of angular cheilitis involves the use of a combination of

A

antifungal and anti-inflammatory agents.
(nystatin and triamcinolone cream)

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3
Q

Internal bleaching for non-vital teeth options:

A
  1. carbamide peroxide
  2. sodium perborate
  3. hydrogen peroxide (not ideal, if hydrogen peroxide with heat is contraindicated can cause external root resorption)
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4
Q

what is methadone

A

it is synthetic opioid agonist can prevent withdrawal symtoms and relieveopioid cravings in those with substance use disorders.

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5
Q

bacteriocidal

A

cephalosporin, fluoroquinolones, metronidazole, penicillin, vancomycin

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6
Q

Tramadol (Ultram®)

A

is an opioid that functions as a serotonin and norepinephrine reuptake inhibitor

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7
Q

Potassium-sparing diuretics, such as spironolactone, are associated with

A

hyperkalemia.

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8
Q

symptoms of hypoglycemia

A

sweating,
pallor
dizzy
shakiness
agitation
hunger
lack of coordination
sleepiness

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9
Q

methemoglobinemia

A

It increases the rate of oxidation of hemoglobin to methemoglobin. Methemoglobin strongly binds to oxygen, impairing the ability to release oxygen to tissues. This can result in tissue hypoxia and end-organ damage.
All LA can cause in young patients bc enzyme that converts is found less in children

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10
Q

Antimalarials, such as hydroxychloroquine, can also be taken by patients to

A

treat muscle and joint pain, skin rashes, pericarditis, pleuritis, and other symptoms such as fatigue and fever

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11
Q

Grave’s disease

A

the body makes antibodies which mimic the function of TSH

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12
Q

Nifedipine MOA

A

block L-type calcium channel blocker, it belongs to the dihydropyridine class so does not affect cardiac contractility.

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13
Q

Percocet

A

Oxycodone +APAP

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14
Q

Risperidone (Risperdal®)

A

second-generation antipsychotic agent, for the treatment of bipolar disorder, is a risk factor for developing tardive dyskinesia (TD). TD is a medication-induced movement disorder associated with dopamine receptor-blocking agents such as first and second-generation antipsychotics, antiemetic drugs, and rarely lithium.

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15
Q

what is associated with liver damage

A

tetracycline

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16
Q

Both clopidogrel and aspirin affect platelet quantity (T/F)

A

False
Platelet function

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17
Q

the first drug of choice for Prosthetic joint prophylaxis

A

Keflex 2 g

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18
Q

fomatidine (pepcid) is for what

A

for managing GERD
MOA : H2 receptor antagonist

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19
Q

MOA of antiviral like Acyclovir used to treat Herpes simplex virus

A

inhibit the viral DNA polymerase.

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20
Q

What antibiotics are contraindicated for patients w liver disease/cirrhosis

A

erythromycin (bc excreted and detoxy by liver)
Vancomycin

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21
Q

synthetic

A

fentanyl and methadone

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22
Q

Steroid

A

Dexamethasone

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23
Q

Name esters and amides in local anesthetics

A

esters: Procaine, Chloroprocaine, Tetracaine, Benzocaine
Amides: Lidocaine Mepivacaine Prilocaine Bupivacaine Articaine ** (has ester group as well)
Esters do not have “i” before the “caine”

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24
Q

natural opioids

A

morphine and codeine

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25
Q

type 1and type 2 dose response curve

A
  • Type I: dose vs. efficacy of the drug
  • Type II: dose vs. response of patient
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26
Q

HbA1c measures glycated hemoglobin in what cells

A

red blood cells.

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27
Q

where does alpha-1 and 2, beta 1 and 2

A

alpha 1 and 2 = smooth muscles
beta 1 = heart
beta 2 = smooth muscles and skeletal muscles

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28
Q

beta-lactamase resistant

A

augmentin, methicillin, dicloxacillin

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29
Q

what is associated with allergic cholestatic hepatitis

A

erythromycin estolate

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30
Q

Two types of COPD

A

Chronic bronchitis and emphysema

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31
Q

contraindication of Bupropion

A

epilepsy

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32
Q

_______should be avoided in patients with asthma as they are known to cause bronchospasms and trigger asthma exacerbations.

A

Non-steroidal anti-inflammatory drugs (NSAIDs)

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33
Q

antiphychotic drug associated with tardive dyskinesia (TD).

A

Risperidone (Risperdal®)

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34
Q

anti-seizure medication with mood-stabilizing properties used to treat seizures, neuropathic pain (such as trigeminal neuralgia), and bipolar disorder

A

Carbamazepine (Tegretol®)

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35
Q

What to give patient with angina/chest pain

A

nitroglycerin
Initial: Nitroglycerin, oxygen and aspirin

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36
Q

moa of Denosumab

A

is a monoclonal antibody that binds to RANKL and prevents this interaction, which thereby blocks osteoclast maturation and reduces bone resorption. It is typically used to treat osteoporosis.

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37
Q

Cells that are predominant in acute and chronic infection

A

Acute: Neutrophils
Chronic: Lymphocytes (e.g. T cell and B cells), monocytes

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38
Q

INR for hemophilia patients?

A

Normal INR

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39
Q

High cholestrol can lead to ?

A

weight gain, muscel weakness, fatigue and hyperglycemia. it if often referred as cushing’s syndrome

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40
Q

Zero-order kinetics of elimination of drug

A

A constant amount of drug is eliminated per unit
time (mg/hour)
– Less common
– Higher risk of drug accumulation

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41
Q

Protein binding is associated with the duration of action? How does pKa affect diffusion?

A

the lower the protein binding, the shorter the duration of action
Lower pKa increase diffusion means more rapid onset of action

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42
Q

Which LA is not safe to use in children

A

Bupivacaine

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43
Q

what is vasovagal reflex and what blocks it?

A

NE can activate baroreceptors
which stimulate vagal reflex to
reduce heart rate, leading to an
opposite response to what NE
usually does
* Atropine blocks this reflex

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44
Q

Nitrogen-containing bisphosphonates primarily work by

A

inhibiting abnormal osteoclast activity.
One effect is triggering apoptosis of osteoclasts and another is inhibition of osteoclast metabolism, which interferes with its ability to bind to bone

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45
Q

MOA of heparin

A

acts on activation of antithrombin; this binds to thrombin (that converts fibrinogen to fibrin) and inactivates it and inhibit the ability to clot.

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46
Q

pKa

A

lower pKa = stronger acid
faster onset of action
pka for mepivicaine 7.6
lidocaine, prilocaine, Articaine = 7.8
bupivacaine = 8.1

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47
Q

beta blockers to treat what?

A
  • to treat hypertension.
    -olol
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48
Q

Maximum dose of acetaminophen and ibuprofen

A

APAP: 4 g/day
ibuprofen 3.2 g/day

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49
Q

Selegiline?

A

Selegiline is a monoamine oxidase inhibitor, an enzyme that metabolizes dopamine. This medication increases the half-life of levodopa

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50
Q

Cyclosporine MOA

A

calcineurin inhibitor prescribed to prevent organ rejection in transplant patients. It is an immunosuppressant drug. By inhibiting calcineurin activity, the synthesis of various cytokines is prevented, leading to decreased T-cell activation and decreased immune response.

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51
Q

what is MOA for denosumab

A

RNAKL inhibitor - reduction in the number and activity of osteoclasts , thereby decreasing bone resorption and increasing bone density

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52
Q

When to do rescue breaths

A

when pulse present and breathing abnormal/impaired
1 breath every 3 sec = KID
1 breath every 5 sec = adult

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53
Q

what to prescribe for parkinson?

A

NOT DOPAMINE: it is unstable to cross the blood-brain barrier to target sites in CNS.
GIVE: levodopa, selegiline, benztropine

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54
Q

Which LA causes methemoglobinemia?

A

prilocaine

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55
Q

Long term exposure of nitrous

A

peripheral neuropathy

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56
Q

Why not prescribe Fluconazole in patients with congenital long QT

A

reported to cause QT interval prolongation which can lead to torsades de pointes in extreme situations

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57
Q

What’s parkinson disease?

A

deficiency of dopamine

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58
Q

interaction btw diazepam and clarithromycin

A

Increased sedation because of reduced metabolism of benzodiazepine

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59
Q

which are more potent bisphosphonates. In addition, they are administered intravenously, which is associated with higher rates of MRONJ than oral bisphosphonates.

A

Zoledronate (Zometa®) and pamidronate (Aredia®)

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60
Q

MOA of benzodiazepam

A

acts by binding to GAPA receptors that increase the FREQUENCY of chloride ion channel opening in CNS.
- sedating and anxiolytic effects

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61
Q

antifungal medication used for localized, superficial Candida infections of the oral cavity, skin, vagina, and esophagus. I

A

Nystatin

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62
Q

what is epinephrine reversal?

A

The vasoconstrictor effect of epinephrine is converted into a vasodilator effect in the presence of an α-blocker whereby the β2 vasodilator effect becomes the major vascular response
* Basically α-blocker cancels out epinephrine’s α activation effects and it only activates β receptors

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63
Q

serotonin syndrome caused by

A

combination of St. John’s Wort and tramadol (Ultram®)

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64
Q

medication for smoking cessation (given to pt w nicotine stomatitis)

A

varenicline (chantix)

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65
Q

what is drug-induced immune hemolytic anemia

A

is a rare presentation of anemia and has been found to be associated with penicillins like amoxicillin and cephalosporins.
- appear as cyanosis

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66
Q

First lne of tx of antibiotics for patients with liver disease/cirrhosis

A

Penicillin and its derivatives, cephalosporins, and fluoroquinolones

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67
Q

what can cause adrenal suppression?

A

Steroids taking: 20 mg for 2 weeks in the time frame of 2 years

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68
Q

Side effect of nitrous

A

nausea

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69
Q

Bacteriostatic antibiotics

A

clindamycin, tetracycline ,erythromycin, chloramphenicol, sulfamethoxazole.

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70
Q

Explain what happens when hemoglobin dissociation curve shift right and left

A

Mnemonic: “CADET, face Right”.

Causes of right shift:

Increased CO2

Increased Acid (decreased pH)

Increased 2,3-DPG (DPG is an allosteric effector found in red blood cells. Its function is to stabilize hemoglobin when it is in its low oxygen state. This causes oxygen to dissociate from hemoglobin and be released into target tissues.)

Increased Exercise

Increased Temperature
decrease hemoglobin saturation

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71
Q

Prilocaine, above the recommended maximum of 600 mg, puts the patient at risk of developing methemoglobinemia. what’s the treatment

A

Administer Oxygen, vitamin C and methylene blue

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72
Q

Safest in children

A

Lidocaine (xylocaine)

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73
Q

Example of anti coagulants

A
  1. warfarin
  2. dabigatran
    Apixaban (eliquid) = Novel oral anticoagulant
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74
Q

How does aspirin effect as analgesic, anti-inflammatory and ant-pyretuic
Where in the brain is the temperature regulation center is for antipyretic MOA of aspirin?

A

Analgesic = inhibit COX 1 and 2 (PG synthesis)
* Anti-inflammatory = same
* Antipyretic = inhibit PG synthesis in temperature regulation center of hypothalamus
* Bleeding time = inhibit TXA2 synthesis thereby inhibiting platelet aggregation

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75
Q

MOA of carbamazepine

A

anticonvulsant, as well as an analgesic. It is a sodium channel blocker that binds to voltage-gated sodium channels in nerves and prevents the repetitive and sustained firing of an actional potential.

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76
Q

following a myocardial infarcation, after how many months emergency dental treatment can be provided under appropriate care.

A

6 months

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77
Q

HPV vaccines :
Under age 9
Under age 15

A

under age 9: 2 doses
Under age 15: 3 doses

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78
Q

What to prescribe to patients with severe fungal infection like mucormycosis

A

Iv Amphotericin B (Fungizone®)

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79
Q

MOA of fluconazole

A

inhibits fungal cytochrome P450, decreasing ergosterol synthesis, which results in decreased cell membrane formation

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80
Q

How is heparin overdose administered

A

Protamine sulfate

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81
Q

most common medical emergency in the dental chair and often occurs before, during, or after administration of local anesthetic.

A

Syncope

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82
Q

Which amide group has the longest duration for LA and which is the shortes?

A

Bupivacaine (Longest), Articaine (shortest)

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83
Q

Which LA is a vasoconstrictor?

A

Cocaine

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84
Q

Obesity can lead to cancer in what organs?

A

kidney and colon

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85
Q

which is associated with aplastic anemia.

A

chloramphenicol

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86
Q

symptoms of hypothyroidism

A

cold intolerance, alopecia, ad hair loss, a decreased sympathetic nervous system response.

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87
Q

which antibiotic category has the broadest antimicrobial spectrum

A

tetracyclines

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88
Q

cushing syndrome

A

too much cortisol
weight gain, fatty tissue deposits, red striae of abdomen, muscle weakness

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89
Q

explain metabolize of drug

A

lipi-soluble drug converts to water-solube drug by increasing drug polarity and increasing ts hydrosolubility: allowing decrease reabsorption of drug in kidney and thus promoting its excretion

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90
Q

addison’s disease

A

adrenal insufficiency
A loss of appetite

Fatigue

Low blood pressure

High heart rate

Sweating

Bronzing of the skin

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91
Q

what causes pseudomembranous colitis

A

Clindamycin

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92
Q

MOA of Hydrochlorothiazide (Microzide®)

A

is a diuretic that acts by blocking the Na+/Cl- transporter at the distal convoluted tubule.

93
Q

antiretroviral medications are commonly used to prevent and treat HIV/AIDS.

A

NRTIs(nucleoside/nucleotide reverse transcriptase inhibitors)tx for ; zidovudine or stavudine and lamivudine

94
Q

Receptors in ANS:
1. Cholinergic
2. Adrenergic
Where does it bind and how

A

Cholinergic= binds acetylcholine
– Nicotinic (nAChR)= also binds nicotine; ionotropic
– Muscarinic (mAChR)= also binds muscarine; metabotropic
Adrenergic= binds Epi/NE; metabotropic

95
Q

what’s the effects of beta -2

A

vasodilation , bronchodilation

96
Q

serotonin is ____ in anxiety and ____ in depression

A

increase in anxiety and decrease in depression

97
Q

how is the dissociation constant related to affinity

A

The lower the dissociation constant (Kd) the higher
the affinity

98
Q

interaction btw tetracyclines and oral antacids

A

reduced absorption of tetracyclines

99
Q

Moderate pain:

A

Ibuprofen 400 mg q4h
Contraindication to NSAID, use Tylenol 2 or 3

100
Q

what/s the purpose of epi in LA

A

vasoconstrictor:
1. prolong numbness
2. reduce toxicity
3. promote hemostasis

101
Q

therapeutic and side effects of morphine

A
  • Miosis
  • Out of it
  • Respiratory depression
  • Pneumonia
  • Hypotension
  • Infrequency
  • Nausea and vomiting
  • Euphoria and dysphoria
102
Q

semi-synthetic opioids

A

oxycodone and hydrocodone

103
Q

gamma cells in pancreatic islet products q

A

pancreatic polypeptides

104
Q

first line of analgesic for patient with liver failure

A

tylenol if its without alchohol consumption

105
Q

Median rhomboid glossitis can be suspected when an erythematous zone is in the mid-dorsal tongue. tx?

A

No tx for asymptomatic
if symptomatic: antifungal to alleviate pain

106
Q

Emphysema manifestations

A

PINK PUFFERs
- permanent enlargement and destruction of airspaces distal to terminal bronchiole
severe dyspnea, older and thin, quiet chest

107
Q

which LA are more allergic (esters or amides)?

A

esthers

108
Q

First line of tx for smoking cessation

A

bupropion

109
Q

denosumab (prolia ) is for what

A

osteopororsis

110
Q

Tylenol 1,2,3,4

A

300 mg APAP+ 8 mg codeine
tylenol 2; 300 mg APAP+ 15 mg codeine
tylenol 3; 300 mg APAP+ 30 mg codeine
tylenol 4; 300 mg APAP+ 60 mg codeine

111
Q

Which LA is metabolized in both liver and blood plasma?

A

Articaine (septcaine)

112
Q

selective serotonin reuptake inhibitor (SSRI)

A
  • tine
    Fluoxetine (Prozac®) : depression
    Sertraline (Zoloft®) : depression
113
Q

what stimulatory neurotransmitter associated with learning and memory.

A

glutamate

114
Q

______ have been shown to significantly increase pulp chamber calcification when compared with patients who had not taken statins.

A

Statin drugs

115
Q

describe interaction between nsaids in hemophilia pts

A

nsaids block Cox so can increase risk of bleeding, leading to inhibition of platelet aggregation and prolong bleeding time

116
Q

Refractory asthma

A

is a condition where asthma symptoms or attacks persist even though the condition is being managed with medication

117
Q

what other factor is affected by facot V leiden

A

factor X

118
Q

Nucleoside reverse transcriptase inhibitor is used for

A

HIV infection

119
Q

what test to assess intrinsic pathway

A

intrinsic pathway: factors 8,9, and 11 : PTT

120
Q

half life of denosumab is

A

28 days so don’t need premeds if patient stopped taking a month ago

121
Q

Drug Induced Lupus symptoms

A

phenytoin, hydralazine, isoniazid, and procainamide and can occur within several months to a year of drug use. Many of the symptoms of this reaction are similar to those of systemic lupus erythematosus and can also include a malar rash, purpura, and serositis.

122
Q

Ideal time to receive HPV vaccine

A

11-12 years old

123
Q

why not take fluconazole and warfarin together

A

This medication is a strong inhibitor of cytochrome P450, an enzyme that metabolizes warfarin (Coumadin®).

124
Q

The mechanism of action of amlodipine (Norvasc®)

A

is to block L-type calcium channels.

125
Q

Clotrimazole (Mycelex) is antifungal found in what form
MOA???

A

troche form and is prescribed when patient suffers from oral thrush
Like all Azoles: it inhibits the synthesis of sterols, such as ergosterol, which are necessary components of the fungal cell membrane.

126
Q

How does competitive or noncompetitive antagonist shift the curve

A

Competitive antagonist shifts agonist curve RIGHT
* Noncompetitive antagonist shifts agonist curve DOWN

127
Q

non-productive cough in ace inhibitors is because of

A

increase in bradykinin levels results in bronchoconstriction, airway inflammation, and a dry, non-productive cough.

128
Q

which one is only cox 2 blocker

A

Celecoxib and meloxicam

129
Q

cells that function mainly in allergic reactions and parasitic infections

A

eosinophilis

130
Q

Calculate max dose LA formula

A

max dose mg/kg X weight (kg)/10 X 1/Concentration(%) = max mL

131
Q

Carisoprodol (Soma®) is a

A

muscle relaxant, also called an antispasmodic, used to treat muscle spasms.

132
Q

interaction btw aspirin with anticoagulants, probenecid, and methotrexate

A

aspirin and anticoagulants: Increased bleeding tendency
Aspirin and Probenecid Decreased effect of probenecid
Aspirin and Methotrexate Increased methotrexate toxicity

133
Q

MOA of furosemide

A

diuretic that acts by blocking the Na+/K+/2Cl- transporter at the thick ascending loop of Henle.

134
Q

Vicodin

A

Hydrocodone +APAP

135
Q

Factor V Leiden

A
136
Q

Side effects of SSRIs like citalopram

A

sexual dysfunction, prolonged QT, diarrhea, and xerostomia.

137
Q

patients with Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, and amyotrophic lateral sclerosis (ALS) may have higher levels of

A

glutamate

138
Q

Benzodiazepam
Short-acting
Intermediate
long-acting

A

Short: Midazolam, triazolam
Intermediate: Lorazepam
Long: diazepam

139
Q

delta cells in pancreatic islet products q

A

somatostatin

140
Q

Nitroglycerin for what?

A

Antihypertensive medication acts by nitric oxide release
- cause vasodilation and reduce blood pressure

141
Q

Fluconazole for what

A

antifungal to treat candidiasis,

142
Q

are side effect of corticosteroid therapy, such as prednisone (Deltasone®) is

A

Psychiatric disturbances like stress, mood chnage, sleep issues, mania.

143
Q

which penicillin drug has best/broad gram-negative spectrum

A

ampicillin

144
Q

Mild Pain

A

Acetaminophen 500 – 1,000 mg q4h

145
Q

St. John’s Wort

A

St. John’s Wort is a yellow flowering plant prescribed for depression. Similar to other antidepressants, St. John’s Wort increases the availability of serotonin by decreasing serotonin reuptake into nerve terminals

146
Q

what test to assess warfarin

A

extrinsic pathway: INR

147
Q

which penicillin ab used against pseudomonas

A

carbenicillin

148
Q

which NSAIDs is irreversible

A

Aspirin COX 1and 2

149
Q

side effects of antidiabetic medication like metformin

A

vitamin B12 deficiency, gastrointestinal upset, and a metallic taste in the patient’s mouth.
Not to prescribe pt with kidney /renal failure as it causes lactic acidosis

150
Q

Flumazenil

A

effective in reversing drug activity
will act as a competitive antagonist that displaces benzodiazepine

151
Q

why not stop antibiotic course

A

Stopping treatment early may also allow some more resistant bacteria to survive, providing them the opportunity to increase in the future

152
Q

Gabapentin

A

Anticonulsant for treating serizures and nerve pain
treat post-herpetic neuralgia
inhibits alpha 2 delta subunit f voltage-gated calcium chennels

153
Q

Hyperthyroidism have increase levels of what hormones

A

increase of T3 and T4
but low levels of TSH

154
Q

Name all med cause gingival hyperplasia

A

Ca2+ channel blockers: verapamil, nifedipine

anti-convulsant: phenytoin, lamotrigine

Cyclosporin

155
Q

MOA of warfarin

A

inhibition of epoxide reductase that reduces vitamin K to its active form

156
Q

alpha cells in pancreatic islet produces

A

glucagon

157
Q

drug holiday for bisphosphonates is for how long

A

bone remodeling period - 3-6 months
help prevent osteonecrosis following extractions.

158
Q

Oral triazolam used for wht pre-medication

A

short-acting benzodiazepine with a rapid onset of action with effects taking place within 20-40 minutes after administration. Due to its short half-life of 2-5 hours, oral triazolam is quickly absorbed and eliminated, making it safe and effective as premedication for an anxious adult for a 1 hour appointmen

159
Q

sexual dysfunction is side effect of

A

SSRIs

160
Q

trigeminal neuralgia pain:

A

sudden and severe facial pain, often characterized as a sharp, shooting pain or similar to an electric shock. short, unpredictable attacks that can last from a few seconds to about 2 minutes. The condition is treated with carbamazepine,

161
Q

side effects of ACE inhibitors

A

cough, angioedema, selling.
orthostatic hypotension, hyperkalemia,

162
Q

MOA of bisphosphonates

A

alendronate (Fosamax®), act by inducing apoptosis of osteoclasts. Without functioning osteoclasts, there is a disruption of bone resorption and an increase in bone density.

163
Q

how is acetaminophen overdose corrected?

A

n-acetylcysteine and activated charcoal

164
Q

what is alternative to ace inhibitor if patient experiencing cough

A

prescribe ARBs : angiotensin receptor blocker - like losartan

165
Q

antifungal medication used to treat nail and skin infections.

A

Terbinafine

166
Q

MOA of sulfonamides?

A

Folate synthesis inhibito (competes with PABA), bacteriostatic.
sulfadiazine, sulfamethoxazole

167
Q

common side effects of 0.12% chlorhexidine gluconate (Peridex®)

A

extrinsic staining, altered taste, and calculus buildup.

168
Q

Side effects of hydrochlorothiazide may include

A

dizziness, headaches, xerostomia, arrhythmias, and hypokalemia, increase urination, hypercalcemia, loss of appetite

169
Q

Naloxone (narcan)

A

Mu-opioid receptor antagonist
- used to reverse effects of opioid overdose mainly that of respiratory depression

170
Q

Gout

A

is a common inflammatory disorder characterized by sudden attacks of severe pain, swelling, redness, and tenderness in one or more joints. Gout most often affects the joints in the toes. It is caused by a build-up of uric acid crystals

171
Q

MOA of NOACs

A

inhibit factor Xa

172
Q

factor 8 deficiency what disease?

A

hemophilia

173
Q

Barbiturates MOA

A

gamma-aminobutyric acid (GABA) receptors which increase the DURATION of chloride ion channel opening in the cns.

174
Q

Lisinopril is an ACE inhibitor cause what

A

ACE inhibitor elevates substance P and bradykinin causing dry cough

175
Q

MOA of 5-fluorocytosine

A

antifungal agent that competes with uracil and inhibits fungal RNA synthesis
-primarily used as a combination treatment with amphotericin B to treat meningitis caused by Cryptococcus neoformans

176
Q

How is bupropion different from other antidepressants

A

not same side effects; it can cause increase risk of seizures

177
Q

what is contraindicated in patients with bleeding problems or stomach ulcers, and what to give instead

A

non-selective NSAIDs

178
Q

Clopidogrel is antiplatelet or anticoagulant

A

antiplatelet

179
Q

what is a drug of choice in children with fever? and why?

A

APAP as aspirin can cause Reye’s syndrome

180
Q

taking oral bisphosphonates for an extended period of time______ puts the patient at an increased risk of MRONJ.

A

> 3 years

181
Q

Harmful to what organs:
Aspirin
Ibuprofen
APAP

A

Aspirin: GI
Ibuprofen: Kidney
APAP: Liver

182
Q

which is most likely to cause superinfection

A

broad spectrum antibiotics

183
Q

MOA of narcotics/ opioids

A

mu-opioid receptor agonists

184
Q

moa of Allopurinol

A

used to treat gout and acts by inhibiting xanthine oxidase, an important enzyme in the production of uric acid.

185
Q

MOA of sulfonylureas

A

acting on pancreatic beta cells

186
Q

what’s contraindicated in patients with AIP because they enhance porphyrin synthesis.

A

Barbiturates

187
Q

Kids who can’t take oral antibiotic

A
  1. ampicillin
    if penicillin allergy: cefazolin or ceftriaxone
188
Q

Chronic bronchitis patient’s manifestation

A

overweight and cyanotic and will have peripheral edema
BLUE BLOATERS

189
Q

Amphotericin B (Fungizone®), MOA

A

action of binding to ergosterol and forming pores in the fungal cell membrane.

190
Q

First-order kinetics of elimination of drug

A

Constant fraction of drug is eliminated per unit
time (%/hour)
– More common

191
Q

What to use for IV sedation

A

Midazolam

192
Q

Nitrous:
Sensation before onset

A

tingling

193
Q

Omeprazol

A

Protein pump inhibitor taken for GERD
MOA: irreversible inactivating the H+/K+ ATPase of gastric parietal cells to prevent the transport of acid into the stomach lumen.

Omeprazole is formulated as a pro-drug and is only converted to its active form in the presence of an acid, which is conveniently located at the site of action (the parietal cell).

194
Q

what position to avoid for patients with COPD

A

supine position: can experience orthopnea, shortness of breath when lying

195
Q

Organophosphate poisoning

A

irreversibly inhibits cholinesterase, poisoning can be treated
with Pralidoxime

196
Q

Drug induced hepatitis

A

inflammatio nin liver caused by advere medications like analgesics, anabolic steroids, oral contraceptives, antibiotics, statins,

197
Q

what;s acute intermittent porphyria (AIP).

A

rare metabolic condition involving a deficiency in the hydroxymethylbilane synthase enzyme. This enzyme plays a role in the pathway converting toxic porphyrin precursors into the iron-containing porphyrin known as heme, which is the red pigment of human blood.

198
Q

which bisphosphonate will have higher risk for MRONJ

A

IV bisphosphonates like zoledronate (Reclast®)

199
Q

What analgesic to prescribe in patients with kidney failure/ renal disease.

A

Acetaminophen

200
Q

potencies of all
bisphosphonates

A

(Least to most potent)
Etidronate<Pamidronate<
Alendronate<Risedronate
<Zoledronate

201
Q

how does lipid solubility effect the pharmacokinetics of the drug

A

more lipid solubility, more potent and longer duration of action

202
Q

Which medication is safe to prescribe with digoxin ,or patient with heart failure medication

A

doxycycline

203
Q

moa of adalimumab

A

Adalimumab is a monoclonal antibody that binds to TNF-alpha, which is an inflammatory cytokine that contributes to joint inflammation and pain. Therefore, by targeting TNF-alpha, the medication inhibits the cytokine and reduces inflammation, pain, and damage to the joints.

204
Q

convulsion

A

seizures: supine position
if repeated then given midazolan (versed)

205
Q

MOA of opioids

A

mu, delta and kappa
primarily Mu

206
Q

Isoniazid (Tubizid®) rifampin (RIF), ethambutol (EMB), and pyrazinamide (PZA

A

Tuberculosis

207
Q

People taking warfarin what is acceptable INR value

A

2-3
if more then 3 reschedue

208
Q

MOA of albuterol

A

beta 2 agonist : causes smooth muscle relaxation , bronchodilation

209
Q

moa of benzodiazepines and barbiturate

A

Increasing GABA binding to its receptors

210
Q

Methotrexate for what?

A

Chemotherapy and immunosuppressive drug. Used for cancer but also for RA ad psoriasis

211
Q

MOA of fluoroquinolones

A

Bactericidal, DNA synthesis inhibitor
Ciprofloxacin, levofloxacin

212
Q

Severe pain

A

Bupivacaine for long duration of LA
Ibuprofen 600 mg q4h
1000 mg acetaminophen + 400 mg ibuprofen q4h
Tylenol 3, 1 - 2 pills q4h

213
Q

why is Dexamethasone used in IV sedation

A

it is corticosteroid used to prevent post-op nausea and vomiting.

214
Q

beta cells makes up about 75% of the cells of the pancreatic islet and produces

A

insulin

215
Q

MOA of digoxin

A

inhibits Na+/K+ ATPase : increase calcium ion influx in cardiac muscles and promotes positive inotropy
Antiarrhythmic and blood pressure support

216
Q

Cocaine affects what transporter in CNS

A

dopamine transporter. It binds and blocks reuptake of monoamines: dopamne, norepinephrne, epi and serotonin. However, cocaine has a very direct effect on dopamine signaling and binds specifically to dopamine transporters in the central nervous system (CNS).

217
Q

Is antibiotic considered for patients undergoing chemotherapy?
If not what is important

A

Patients undergoing chemotherapy are not considered for antibiotic prophylaxis unless they are receiving surgical dental treatment and their neutrophil count is less than 1000/mm3.

Give Nystatin to prevent from opportunistic infections

218
Q

what category of patients can’t take azithryomycin

A

Azithromycin is associated with a risk for QT prolongation in patients, which can cause arrhythmias, especially in those on vasoconstrictors.

219
Q

At what diastolic BP consult is required

A

> 109 mmHg

220
Q

Benztropine

A

anticholinergic: for reducing tremor symptoms

221
Q

moa of Anti-angiogenic tyrosine kinase inhibitors (e.g. sunitinib)

A

prevent signaling processes necessary for angiogenesis and are used in certain types of cancer therapies.

222
Q

MOA of onabotulinumtoxinA (Botox®)

A

blocks the release of Ach.
when Ach binds to receptors on the cell membrane it causes deporlarization and leds to muscle contraction so botox inhibits and cause muscle paralysis

223
Q

factor V leiden

A

causes patients to be in a hypercoagulable state.

224
Q

What causes GI upset and pseudomonas colitis

A

clindamycin

225
Q

which is the least potent of all bisphosphonates and is the least likely to interfere with bone remodeling and cause MRONJ.

A

etidronate

226
Q

what can happen if NSAIDs taken with ace inhibitors

A

kidney damage, nsaids reduce the effectivness of ace inhibitors

227
Q

all side effects associated with methylphenidate (Ritalin®) use (For ADHD)

A

Nervousness, weight loss, and sweating

228
Q

Bupropion

A

inhibits norepinephrine and dopamine reuptake, which increases the concentration of both neurotransmitters. It can be used to treat various conditions such as major depressive disorder and to aid in smoking cessation.

inbde (10 decks)

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