Basic Science Concepts

Question 1

The NS is divided to:

Answer 1

Central and Peripheral Nervous System

Question 2

What is the CNS responsible for:

Answer 2

Consists of the Brain and Spinal Cord; which then sends signals to the PNS

Question 3

The PNS (peripheral nervous system) is divided into:

Answer 3

Somatic (Voluntary) and Autonomic (involuntary) NS

Question 4

Somatic (voluntary)

Answer 4

Controls the Skeletal muscle (Ach the primary NT plays a major role here)

Question 5

Autonomic (involuntary)
**automatic

Answer 5

Controls the GI tract and the heart (cardio) NE and Epi play a major role here

Question 6

Autonomic NS is divided into:

Answer 6

Sympathetic (SNS): “fight or flight”

Parasympathetic (PSNS): “rest and digest”

Question 7

SNS works by;

Answer 7

releasing Epi and NE that act on adrenergic receptors (alpha-1, beta-1, beta-2)

Question 8

PSNS works by

Answer 8

releasing Ach which binds to muscarinic receptors

Question 9

Activation of the SNS leads to;

Answer 9

incr’ HR, BP and bronchodilation

Question 10

Activation of PSNS leads to:

Answer 10

incr; SLUDD
Salivation
Lacrimation
Urination
Diarrhea/defecation
Digestion

Question 11

Adrenergic receptors

Answer 11

Alpha -1: smooth muscles; blood vessels

Beta-1: 1 heart

Beta-2: 2 lungs

Question 12

Endogenous substrate (NE or Epi)
Exogenous substrate (drug)

Answer 12

binds to the receptor, enzyme, or transporter to create a signal cascade that produces a biological effect

Question 13

Substrates can be either;
Agonist or antagonist

Answer 13

Agonist will bind to activate while anatgonist will bind to block or inhibit

Question 14

Competitive inhibition

Answer 14

This occurs when an antagonist binds to the same active site as the endogenous substrate, preventing it from binding.

Question 15

Non-competitive inhibition

Answer 15

This occurs when the anatagonist binds to a site other than the active site called an allosteric site, there by changing the shape of the active site and preventing the endo-substrate from binding

Question 16

Identifying structures:
There are 4 iodines in the structure.

Answer 16

The drug is levothyroxine, also known as T4. Levothyroxine is used for hypothyroidism.

Question 17

The somatic nervous system controls voluntary muscle movement by releasing which neurotransmitter?

Answer 17

Ach
It is released in response to neuron signals and binds to nicotinic receptors in the skeletal muscles to affect muscle movement.

Question 18

Identify essential drug structure:
Structure shows amoxicillin, which drug can cause a cross reaction

Answer 18

Ceftriaxone or ertapenem

Question 19

Stimulation of the alpha-2 adrenergic receptors will cause:

Answer 19

Decrease sympathetic output.Centrally acting alpha-2 adrenergic agonists (e.g., clonidine) lower blood pressure and heart rate by decreasing sympathetic outflow (epinephrine, norepinephrine).

Question 20

Which statement describes the effect of a drug that is a selective beta2- agonist?

Answer 20

Relaxation of bronchial smooth muscle.

A selective beta-2 agonist (e.g., albuterol) is expected to stimulate beta-2 receptors (lung, bronchial smooth muscle), leading to bronchodilation. It mimics the effects of natural catecholamines predominantly in the lungs and bronchial smooth muscle. Another selective beta-2 agonist is terbutaline; it can be used as a bronchodilator, and to reduce uterine contractions in preterm labor (relax uterine smooth muscle).

Question 21

What must the pharmacist do?

TZ has a RX of selegiline. dgx: Depression and PD and is currently taking tranylcypromine (Parnate)

Answer 21

Call the prescriber to discuss the major DDI

Selegiline and Parnate are MAO Inhibitors: A 14 day washout period is recommended as this can prevent the risk of hypertensive crisis and serotonin syndrome

Question 22

Which factor could be contributing to the patient’s current condition: Agitation, tremors, tachycardia, elevated temp

Hypertensive crisis and SS

Answer 22

~6 Beers/night - increase in consumption of tyramine-containing foods/beverages

• Phenelzine (Nardil) MAO
• Sertraline (Zoloft) SSRI

Question 23

Phenylephrine is an alpha-1 AGONIST. How does it interact with alpha-1 receptors

Answer 23

It behaves similarly to an endogenous substrate at alpha-1 receptors.

Similar to some endogenous substrates, phenylephrine will bind to and activate the alpha-1 receptors leading to vasoconstriction.

Question 24

Identify essential drug structure: 2 iodines in the structure

Answer 24

Amiodarone

Since there are two iodine molecules in the structure, amiodarone places the patient at risk for developing hyperthyroidism, hypothyroidism and a reaction in a patient with an iodine allergy.

Question 25

Identify essential drug structure: multiple NH2 (ammonia) amino-

Answer 25

Gentamicin - aminoglycoside antibiotic

Question 26

The most common type/s of chemical reactions that cause most drugs to lose stability. (SATA)

Answer 26

Oxidation-Reduction Hydrolysis Photolysis The USP identifies oxidation-reduction, hydrolysis and photolysis as the three most common causes of drug degradation. Epimerization, isomerization and decarboxylation are additional chemical reactions that cause drugs to become unstable and degrade but occur less frequently.

Question 27

Which drug-receptor interaction would most likely result in smooth muscle vasodilation?

Answer 27

Alpha-1 receptor antagonist Alpha-1 receptors are primarily found in peripheral smooth muscle. Antagonism of alpha-1 receptors causes smooth muscle vasodilation and a decrease in blood pressure.

Question 28

A pharmacist has prepared tetracycline hydrochloride 2.2 mg/mL topical solution. Tetracycline is susceptible to photolysis. Which auxiliary label should be placed on the container?

Answer 28

Protect from light Many drugs are sensitive to UV light exposure, which causes photolysis (breakage) of covalent bonds, which will degrade the drug. Prevent light exposure by using light protective sleeves and tightly-closed, light-protective containers.

Question 29

Reasonable methods to limit oxidative damage?

Answer 29

Temperature control with refrigeration Maintain pH with a buffer Use chelators to bind metal ions Oxidation is catalyzed by heat, light and metal ions. To control oxidation, it is important that changes in temperature and pH be carefully controlled.

Question 30

Side effects of IV epinephrine

Answer 30

Increased HR Increased BP Bronchodilation Epinephrine stimulates alpha-1, beta-1 and beta-2 receptors. This creates a sympathetic nervous system (SNS) or "fight or flight" response.

Question 31

Side effect of a non-selective muscarinic antagonist

Answer 31

anti-SLUDD Dry mouth Urinary retention Constipation Dry eyes ...

Question 32

Excess norepinephrine?

Answer 32

Hypertensive crisis An excess of norepinephrine can lead to a hypertensive crisis. This can occur when an MAO inhibitor is used with a drug that increases norepinephrine (e.g., bupropion).

Question 33

Identify essential drug structure: Three interconnected rings with a tail -N-

Answer 33

Amitriptyline, is a tricyclic antidepressant (TCA). TCAs have three rings in their structure.

Question 34

Role of catechol-O-methyltransferase

Answer 34

Breaks down levodopa Catechol-O-methyltransferase (COMT) breaks down levodopa in the body. COMT inhibitors (e.g., entacapone) are used to prevent the peripheral breakdown of levodopa.

Question 35

Which enzyme does Allopurinol work on?

Answer 35

Xanthine oxidase Allopurinol is a medication used for gout. It inhibits the xanthine oxidase enzyme to decrease the production of uric acid.

Question 36

Irinotecan is a chemotherapy drug known to cause many side effects through an increase in acetylcholine. Which of the following are expected side effects of increased acetylcholine? (Select ALL that apply.)

Answer 36

Urination Increased peristalsis Increased secretion of tears Salivation Increased acetylcholine produces side effects similar to the activation of the parasympathetic nervous system (PSNS). The PSNS is known as the "rest and digest" system, and the mnemonic to remember the side effects is SLUDD (salivation, lacrimation, urination, diarrhea/defecation, digestion).

Question 37

Identify essential drug structure: contains a carboxyl group

Answer 37

NSAID: Ibuprofen

Question 38

Which drug contains an acidic, carboxyl functional group

Answer 38

Aspirin Aspirin is also known as acetylsalicylic acid. Aspirin has an acidic, carboxyl functional group.

Question 39

A pharmacist prepares caramelized onions to use in omelets. She slices some yellow onions and places them into a wide pan to permit water to easily evaporate while the onions slowly cook. After ~20 minutes of cooking, the sliced onions have shrunk down to a smaller amount of brown, caramelized onions because much of the water in the onions has been lost. What is the chemical process that is central to this desirable effect?

Answer 39

Oxidation The sugar is caramelized in a series of reactions, which begins when the alcohol functional group in the sugar is oxidized. An alcohol is a hydroxyl functional group (-OH) bound to a carbon. The water is removed when the steam evaporates. The sugar is broken down by a series of other reactions.

Question 40

A pharmacy technician has checked the drugs in stock and noticed that the contents of the epinephrine vials for injection appear darker than normal. She holds the vials against the white wall and can see a clear amber (i.e., yellowish-orange) tint. Which statement is most appropriate to explain the color change?

Answer 40

The epinephrine has been subject to oxidation The process of oxidation damages drugs. For some drugs this damage leads to a color change that is noticeable. For other drugs a color change may not be apparent.

Question 41

Which drug contains a ketone functional group?

Answer 41

Fenofibrate Has 2 ketone functional group

Question 42

A patient reports a serious allergy to the drug pictured below. Which of the following drugs should this patient avoid due to a potential cross-reactivity?

Answer 42

The drug is sulfamethoxazole Celecoxib can cause cross-reactivity The patient reports an allergy to sulfamethoxazole (the chemical structure shown). Celecoxib has a sulfonamide functional group and carries a risk for cross-reactivity with other sulfonamides.