Exam 1 Review Questions

Question 1

-ol

Answer 1

Beta 2 agonist

Question 2

-zoline

Answer 2

Alpha 1 selective agonists

Question 3

-zosin

Answer 3

Alpha 1 selective antagonists

-high incidence of orthostatic hypotension (limited effect on reflex tachycardia)

doxa-pra-tera

Question 4

Non-selective alpha blockers

Answer 4

phentolamine (OraVerse) - LA reversal/vasodilation

phenoxybenzamine (Dibenzyline) - Raynaud’s/vasodil.

Question 5

-lol

Answer 5

beta 2 antagonists

Question 6

Mixed Alpha/Beta Antagonists

Answer 6

labetolol

carvedilol: hypertensive emergency/cocaine OD

Question 7

Non-selective beta antagonist

Answer 7

propranolol (high lipid solubility - BBB)

-Migraines, essential tremor, thyrotoxicosis, etc.

Question 8

sotalol (Betaspace)

Answer 8

Non-selective beta blocker

class 3 K⁺ channel blocker

Anti-arrythmic

Question 9

metoprolol

Answer 9

Beta 1 specific antagonist

-Most common prescription for A-Fib

Question 10

timolol (Timoptic) vs. betaxolol (Kerlone)

Answer 10

timolol is non-selective beta antagonist

betaxolol is beta 1 selective antagonist

Both used for glaucoma patient (ciliary body)

Question 11

-mab

Answer 11

Monoclonal antibody (seratonin

Question 12

Fremanezumab

Galcanezumab

Answer 12

Attach to CGRP; migraine treatment

Question 13

Erenumab

Answer 13

Blocks CGRP receptor; migraine treatment

Question 14

ergonovine (Ergotrate)

Answer 14

post-partum hemhorrage control

alpha and seratonin stimulation

Question 15

bromocriptine

Answer 15

Parkinson’s

Dopamime stimulation

Question 16

ergotamine

Answer 16

migraine treatment

alpha vasoconstriction and seratonin stimulation

Question 17

sumatriptan (Imititrex)

Answer 17

5-HT_1B/D Seratonin agonists

• prevent vasodilation (migraine treatment)
• Seratonin Syndrome (life threatening) is treated with esmolol (a Beta 1 antagonist)

Question 18

Sympathomimetic Antagonists

Answer 18

acebutolol

penbutalol

pindolol

Question 19

For epinephrine, which receptors dominate at low doses?

Answer 19

Beta receptors

Question 20

phenylephrine (Neo-Synephrine)

Answer 20

Alpha 1 agonist

Main drug used for common cold (vasoconstriction to stop runny nose, etc)

Question 21

albuterol & terbutaline

Answer 21

Both Beta 2 selective agonists

Terbutaline is the exception to the -ol rule

Question 22

nebivolol

Answer 22

beta 1 specific antagonist

also nitric oxide - induced vasodilation

Question 23

Mixed Alpha and Beta Agonists

Answer 23

NE (Beta 1)

Epi

ephedrine

pseudoephedrine (Beta 2)

*Others have b1=b2 and all have a1=a2

Question 24

Beta 1 selective agonist

Answer 24

Dobutamine

Question 25

Alpha 2 selective agonists

Answer 25

clonidine guanfacine methyldopa Precedex (sedation/intubation) \*All antihypertensives

Question 26

Opthalmic Agonists

Answer 26

Epi **hydroxy**amphetamine (**can't cross BBB)** phenylephrine

Question 27

Thiazide diuretics

Answer 27

chlorthoalidone hydrochlorothiazide metolazone (Chronic Kidney Disease) \*_Decrease_ everything **except Ca⁺⁺** (K, Na, Mg, Cl)

Question 28

Loop Diuretics

Answer 28

furosem**ide** torsem**ide** Decreased K, Na, Mg, and Cl

Question 29

Potassium Sparing Diuretics

Answer 29

Amiloride Triamterene Avert urinary loss of Mg to help correct hypokalemia

Question 30

Aldoster**one** Antagonists

Answer 30

Epleren**one** Spirolact**one** Block aldosterone receptors in distal renal tubules; conserve K⁺ and H⁺ ions

Question 31

ACE Inhibitors

Answer 31

capto**pril** enala**pril** fosino**pril** lisino**pril** - **Angioedema can be life threatening** - Diminished bradykinin degr. = cough side effect - Increase vasodilation, decrease aldosterone, and decrease sodium retention - Increased K and Serum creatinine - Avoid in pregnancy (Fetal death)

Question 32

-pril

Answer 32

ACE inhibitors

Question 33

Angiotensin Receptor Blockers

Answer 33

Los**artan** Vals**artan** -Increased K and Serum creatinine Avoid in pregnancy (Fetal death)

Question 34

-artan

Answer 34

ARBs (Angiotensin Receptor Blocker)

Question 35

Calcium Channel Blockers (non-dihydropryridine)

Answer 35

**Verapamil** **Diltazem**

Question 36

Calcium Channel Blockers (Dihydropyridine)

Answer 36

amlodi**pine** nicarda**pine** nifeda**pine** **\*Gingival hyperplasia**

Question 37

-pine

Answer 37

Ca⁺⁺ channel blocker

Question 38

Which types of drugs have the potential side effect of postural/orthostatic hypertension?

Answer 38

**Alpha 1 antagonists** (doxa-pra-terazosin) **Alpha 2 agonists** (clonidine/methyldopa/guanfacine) **Reserpine** (Adrenergic Neuronal Blocking agent) **Hydralazine** (direct vasodilator)

Question 39

Which of the following would put the person at highest risk for hypokalemia? What is the classification of each? hydrochlorothiazide furosemide triamterene bumetanide

Answer 39

**Answer- hydrochlorothiazide: Thiazide diuretic** furosemide: Loop diuretic triamterene: Potassium sparing diuretic bumetanide: Loop diuretic

Question 40

Which medication is most likely to cause angioedema? What are their classifications? Atenolol Amlodapine Lisinopril Eplerenone

Answer 40

Atenolol: Beta 1 selective antagonist Amlodapine: Ca⁺⁺ channel blocker **Lisinopril**: ACE Inhibitor Eplerenone: Aldosterone Antagonist

Question 41

Which of the following drug(s) has the potential to cause an increase in heart rate? What are the classifications of each? amlodopine verapamil hydralazine terazosin

Answer 41

**amlodopine**: Ca⁺⁺ channel blocker verapamil: Non-dihydropyridine Ca channel blocker; ONLY ONE THAT DOESNT **hydralazine**: direct vasodilator **terazosin**: alpha 1 antagonist

Question 42

Which of the following has the side effect of gingival hyperplasia? ACE Inhibitors Ca⁺⁺ channel blockers Beta blockers ARBs

Answer 42

**Ca⁺⁺ channel blockers**

Question 43

JS is a 68 year old male with hypertension, CAD, COPD, hypothyroidism, and anxiety and comes in for a routine dental cleaning. He mentions that his COPD has worsened and he experienced shortness of breath throughout the day. Medications include: propranolol, aspirin, alorvastatin, tiotropium (Spiriva), albuterol, levothyroxine, and alprazolam (Xanax). Is he on a medication that could be causing his shortness of breath?

Answer 43

**Yes**. The **propranol** is a beta 2 antagonist, which is directly antagonizing the beta 2 agonist (albuterol)

Question 44

JS is a 72 year old male with BPH and CAD. His current medications include: aspirin, rosuvastatin, doxazosin, nebivolol, and nitroglycerin. He visits your clinic today because he fell when getting out of bed this morning and broke one of his teeth. Which medication may have contributed to his fall?

Answer 44

**Doxazosin**, an alpha 1 selective antagonist nebivolol is a beta 2 selective antagonist

Question 45

The ROCK ON 53 trial was a double-blinded, placebo controlled study in 2600 patients with resistant hypertension assessing the efficacy of Dilatex daily or placebo. The primary endpoint was reduction in mean SBP after 24 months of treatment. What phase trial is this? What does double-blinded mean? What does placebo-controlled mean?

Answer 45

Phase 3 trial Double-blinded: neither the physician nor the patient knows which treatment they will be prescribing/receiving Placebo controlled: There is a non-therapeutic option available to control the experiment and measure the effectiveness of the dependent treatment.

Question 46

What does this prescription mean? Ibuprofen 800 mg **po TID PRN** dental pain

Answer 46

Ibuprofen 800 mg; **taken orally**; **three times per da**y; take **as needed for** dental pain

Question 47

A 55-year old female underwent a surgical procedure in your dental clinic and experienced a reaction to anesthesia. She has persistent nausea and vomiting. The dentist would like to prescribe prometazine (Phenergen), a histamine 1 recepotr antagonist. What would be the best rout of administration? PO, PR, IM

Answer 47

Not IV because it causes severe tissue damage if administered too quickly PO

Question 48

Warfarin is metabolized in the liver by CYP₄₅₀ 2C9 and 3A4. JS recently tested positive for a UTI. She was prescribed an antibiotic, BactrimDS. This drug is a potent enzyme inhibitor of CYP4502C9. She calls your office again because her gums are bleeding again. How should this be addressed?

Answer 48

Prescribe an alternative antibiotic that doesn't affect the metabolism of warfarin (amoxicillin)