Final Flashcards
(139 cards)
1
Q
A zero order kinetics pattern of biotransformation is more common than first order kinetics.
True or False
A
False
2
Q
What is an antagonist?
A
A drug or molecule with an affinity for a receptor, but after binding blocks its response
3
Q
Which of the following pediatric dosing calculation types is the most accurate?
A
Body Surface Area (BSA)
4
Q
What must be included on a prescription when written for any controlled substance?
A
DEA Number
5
Q
Besides the quicker onset of action, what is the most common reason for drugs to be administered sublingually
rather orally?
A
To avoid the first pass effect
6
Q
What is a drug’s “half life”?
A
The time it takes for a drug’s concentration in the blood to fall by half of the original level
7
Q
A toxic reaction is an adverse effect that usually occurs from taking too much of a drug (similar to an overdose). T/F
A
True
8
Q
A toxic reaction is an adverse effect that usually occurs from taking too much of a drug (similar to an overdose).
A
4-5
9
Q
Which body of government controls the Drug Enforcement Agency?
A
Department of Justice
10
Q
What is a drug’s therapeutic index (TI)?
A
A ranking of a drug’s safety—drug’s with a low TI become toxic more easily
11
Q
Translate the following instructions: Take 1-2 tablets [qid, pc]
A
Four times a day after meals
12
Q
Affinity for a receptor is related to _______. The response produced once bound to the receptor is related to _________
A
Potency, efficacy
13
Q
Which type of absorption method allows most lipid soluble drugs to pass through cell membranes with their concentration
gradient?
A
Simple diffusion
14
Q
What is the first pass effect?
A
When a drug goes directly to the liver after being absorbed and becomes metabolized before it can reach the site of action
15
Q
Which type of absorption method for drugs is most common?
A
Simple diffusion
16
Q
Phase III clinical trials is primarily focused on:
A
Testing the drug on a large sample of people to confirm safety and effectiveness of drug
17
Q
Which of the following is TRUE regarding routes of drug administration?
A
Parenteral routes avoid the GI tract
18
Q
What did the United States Federal Food, Drug, and Cosmetic Act of 1938 do?
A
It gave rise to the FDA and gave it the control to regulate drugs
19
Q
Which type of adverse drug reaction is predictable and happens on the target organ as an extension of the drugs
pharmacological effect?
A
A toxic effect
20
Q
Drug A comes in 10 or 20 mg tablets and drug B comes in 500 or 750 mg tablets. Both reduce pain by binding to receptors in
the CNS, but drug A reduces moderate to severe pain whereas drug B only acts on mild to moderate pain. Given this
information, which of the following statements is true?
A
Drug A is more potent and has more efficacy than drug B
21
Q
Metabolites are secreted from the liver into the bile where they are redeposited into the gut, broken down by intestinal enzymes
and reabsorbed for use on the target organ again. This describes:
A
Enterohepatic recirculation
22
Q
What is an agonist?
A
A drug or molecule with an affinity for a receptor that binds to produce an effect
23
Q
Which best describes phase 1 biotransformation?
A
The cytochrome P450 enzymes perform oxidation and reduction reactions to a drug so it can be excreted
24
Q
What is the biggest disadvantage of the enteral route of administration?
A
The first pass effect
25
Which types of drugs can get past the blood brain barrier (BBB)?
Those administered by the intrathecal method
AND
Very small, lipid soluble drugs that are non- ionized
26
What is the ultimate goal of phase 1 and phase II reactions in the liver?
To make a drug more water soluble
27
The pH and pKa of a drug in relation to the pH of the surrounding tissue will affect its degree of ________________:
Ionization
28
Which of the following best describes “efficacy”?
How much of a response (effect) that a drug is capable of producing
29
Drug A is an inhibitor of a metabolic enzyme. Drug B is metabolized by that same CYP enzyme. What could happen if those two
drugs are taken together?
Blood levels of drug B could become too high
30
Which type of drug absorption method requires energy (ATP)?
Active transport
31
Drugs prescribed by a doctor with a high level of abuse potential with the strictest prescription laws would be placed into what
schedule?
II
32
What does first order kinetics mean?
As blood levels of a drug fall, so does the rate of metabolism
33
What is the effect of glucagon on the body?
Raises blood sugar
AND
Causes release of glycogen
34
What is the correct dosing for diphenhydramine (Benadryl)?
25-50mg
35
Which of the following is a major concern related to corticosteroid drug use?
Immune suppression and poor healing
36
Which of the following is the anticholinergic drug commonly used for COPD and sometimes used for asthma?
Ipratropium
37
Which antibiotic is given by IV only and used to treat antibiotic resistant strains of staphylococci and streptococci, often in
hospitals?
Vancomycin
38
Your patient reports heart problems on his medical history. During his cleaning appointment you notice heavy salivation, and he
has a bad headache. You take his pulse and notice it is irregular and he says it looks fuzzy around the lights. What is most
likely occurring?
Toxicity from digoxin
39
Nitrous oxide is usually contraindicated for patients with which disorder?
COPD
40
Which of the following products is used in low doses to inhibit collagenase activity (slowing periodontal tissue destruction by the
host)?
Doxycycline
41
Yogurt, cheese or other dairy products should NOT be given concomitantly (at the same time) with:
Tetracycline
42
Which drug works by targeting the bronchoconstriction associated with asthma, rather than inflammation?
Methylxanthines (Xanthines) such as Theophylline or Aminophylline
43
What does the term insulin resistance mean?
Insulin's action on cells are reduced, and it is more difficult to get glucose into the cell
44
A patient reports taking Simvastatin. What is he being treated for?
High cholesterol
45
What is Addison's disease?
Adrenal insufficiency
46
Your new patient reports taking Isoniazid (INH), rifampin, and streptomycin. What condition is he most likely being treated for?
Tuberculosis
47
Candidiasis, diabetes, hypertension, mental aggravation, poor healing and unusual hair growth are all potential side effects of
what class of medication?
Corticosteroids
48
Which antibiotic is most often prescribed for dental infections?
Penicillin or amoxicillin
49
What is a potential side effect with daily use of a corticosteroid inhaler?
Superinfection of candidiasis
AND
Cough
50
What adverse effect can occur when more than the cardiac dose of epinephrine is given to a patient who takes a non-selective
beta blocker?
Initial hypertension and potential tachycardia followed by a reflex bradycardia
51
Why must yogurt, cheese and dairy be avoided with certain antibiotics?
They block absorption
52
Which class of cardiac drug lowers blood pressure by blocking catecholamine receptors on the heart?
Beta Blockers
53
Which of the following drugs is used DAILY for long-term control of mild persistent asthma?
Inhaled corticosteroids
54
Which drug is considered the first line treatment (mainstay of initial therapy) for stage 1 hypertension?
Hydrochlorothiazide (HCTZ)
55
What is the most common problem with the use of erythromycin?
GI problems and nausea
56
What class of drugs do Metformin and Glucophage from and what are they used for?
Biguanides for type II diabetes
57
Which beta blocker is safe for a person with asthma and does NOT necessarily warrant use of the cardiac dose of epinephrine?
Atenolol (Tenormin)
58
Which of the following antibiotics has the highest risk of causing pseudomembranous colitis?
Clindamycin
59
Your patient reports taking digoxin. What does this most typically indicate?
That the patient has a more severe stage/progression of heart failure
60
Which antibiotic is known for having a particularly high number of drug/drug interactions because it inhibits certain CYP P450
enzymes?
Erythromycin
61
Which drug below has a significant risk for causing birth defects (pregnancy category X), will increase the risk of liver damage
and has lots of drug/drug interactions?
Lovastatin
62
What is the most important thing to warn patients about who are given metronidazole?
Using alcoholic beverage
63
What is most commonly used as the first line treatment for heart failure?
Furosemide and Lisinopril
64
Which BEST represents how nitroglycerin works?
Causes vascular dilation
65
Which is the most potent diuretic?
Furosemide (Lasix)
66
A patient’s INR number must be ________ or below to be treated without a medical consult:
3.5
67
Which of the following is TRUE regarding bronchitis due to COPD?
Skin tone tends to be more blue than with emphysema because they can't breathe air into clogged,
fibrotic bronchioles
68
The dental hygienist should instruct the patient to rinse the mouth after inhaling which drug?
Beclomethasone
69
Which disease has the classic symptoms of fluid retention in the legs, feet and ankles, coughing when lying down and becoming
winded with normal physical activity like walking up the stairs?
Heart failure
70
A diabetic emergency is most likely to occur in the dental office with which situation below?
A type 1 diabetic took insulin and forgot to eat or didn't eat enough
71
What is typically used to control moderate to severe persistent asthma?
Inhaled corticosteroids plus a long acting B2 agonist
72
Which two antibiotics are often given together to treat aggressive or refractory periodontitis?
Amoxicillin and Metronidazole
73
What is Dextromethorphan?
A cough medicine
74
Which BP medication works by altering the RAAS system to keep angiotensin 1 from being converted to angiotensin II in the
lungs?
ACE inhibitors
75
Penicillins and cephalosporins are bacteriocidal antibiotics, whereas tetracyclines are bacteriostatic.
T/F
TRUE
76
A patient who has been taking 5 mg's oral prednisone for the last 2 years is about to have an invasive, potentially traumatic
dental procedure. How might this affect her medication?
She may need the dose increased before the procedure
77
Which two meds below are most often used for Angina besides nitro and aspirin?
Calcium channel blockers and beta blockers
78
What is the typical, recommended adult dose of diphenhydramine when used orally for seasonal allergies?
25-50 mg's
79
Which class of drugs is known for being particularly hard on the liver and is pregnancy category X?
Statin Drugs
80
Dextromethorphan
OTC Antitussive for cough
81
Guaifenesin
OTC Expectorant used to loosen chest
congestion
82
Montelukast
Anti-inflammatory used to control asthma
83
Ipratropium bromide
(Atrovent)
Anticholinergic used for COPD and as a quick-relief med for asthma
84
What are anticholinergic drugs use to treat?
Bradycardia, overactive bladder, motion sickness
85
Where are Beta 2 receptors located?
Lungs
86
Where are nicotinic receptors located?
On postsynaptic neurons in the PANS
On postsynaptic neurons in the SANS
87
A drug has the following side effects: increased urination, increased tear production, diarrhea, and pupil constriction. Of the
following, which class of drugs does it most likely belong?
Cholinergic
88
Which type of receptor is found on organs and tissues in the PANS?
Muscarinic
89
What do sympathomimetic drugs affect (act upon)?
Alpha1, beta 1 and beta 2 receptors
90
What is considered the primary neurotransmitter in the PANS?
Acetylcholine
91
Beta 1 receptors are found in highest concentration on which of the following organs or tissues?
Heart
92
Where are adrenergic receptors found?
Organs and tissues in the SANS
93
Which of the following best describes the action of cholinergic drugs?
Intensifies the PANS
94
How do NSAIDS and ASA most directly work within the prostaglandin synthesis pathway?
They inhibit the cyclooxygenase (COX) enzymes
95
Which of the following statements is TRUE regarding pain perception?
It is the physiological process by which pain is transmitted in the body
96
Which OTC pain reliever would you NOT recommend to a heavy drinker after SRP?
Acetaminophen
97
Why do aspirin and NSAIDS tend to cause GI and stomach problems with long term use?
They inhibit key prostaglandins that play a protective role there
98
Aspirin
325 or 600 mg tabs. Take 1 to 2 every 4 hour
99
Naproxen
220 mg or 250 mg tabs. Take 2 pills to start followed by
1 pill every 8-12 hours for a max of 500 mg per day
100
Acetaminaphen
325 or 500 mg tabs. Take 650 to 1000 mg's every 4-6
hours.
101
Ibuprofen
200 mg OTC tabs. Take 2 pills q 4 hours, 3 pills q 3
hours, and 4 pills q 8 hours
102
Which is the biggest benefit of prescribing a selective COX2 Inhibitor?
Less GI problems
103
Aspirin and NSAIDS work on pain perception at the site of injury. Acetaminophen works in the CNS and affects pain reaction.
The first statement is TRUE, the second is FALSE
104
Which regimen is recommended for general dentists to suggest for patients with chronic, long term neuropathic orofacial
pain?
Anti-seizure meds such as pregabalin (Lyrica), tricyclic antidepressants, NSAIDS, and lidocaine patches
105
Which of the following is contraindicated for children under 18?
Aspirin
106
The recommended, normal blood sugar after fasting (before eating in the morning) for a healthy non-diabetic person
should be _____________or below:
100 mg/dL
107
Which A1C number is considered ideal (as opposed to adequate)?
6
108
Diabetes is particularly hard on this organ, in fact, over 30% of cases that result in total failure are due to diabetes:
Kidney
109
How long does a patient have to be on oral steroids before a med consult might be needed?
After 2 weeks of taking oral steroids
110
Besides age, what is the most common risk factor for type II diabetes?
Obesity
111
How do corticosteroids work on a sports injury or autoimmune disease?
By suppressing the immune system
112
Finish the following sentence with the correct statement below: Rifampin and isoniazid are___________________________.
Antibiotics used to treat Tuberculosis.
113
Which drug works by acting on the RAAS system and is best for diabetics?
ACE inhibitors
114
Sudafed is a/an
Alpha 1 agonist acting on the SANS
115
What class of drugs is used to treat Alzheimers disease?
Cholinergics
116
Receptors found on organs/tissues in the parasympathetic nervous system PANS are called
Muncarinic
117
Receptors found on organs/tissues within the sympathetic nervous system (SANS)
Adrenergic
118
SANS neurotransmitter
PANS neurotransmitter
SANS-norepinephrine
PANS- acetylcholine
119
Know the Alzheimer’s meds and what class they are
o 1. Aricept
o 2. Exelon
o 3. Razadyne
o 4. Memantine
120
Functions of COX 1 vs. COX 2
-COX 1 enzyme: "house keeper" and protects stomach lining from acid
-COX 2 enzyme: Wakes up only during injury/ inflammation and turns AA into prostaglandins responsible for pain
121
Relate the non-narcotic pain meds to asthma; what is the concern? Which two should you be cautious with recommending? Which is safe?
o Asthma+nasal polyps= aspirin intolerance
o Cautious- ASA and NSAIDS
o Safe- Acetaminophen
122
- Nonnarcotic analgesics: which work on fever, pain, inflammation
o Aspirin: Pain, Fever and Inflammation
o Acetaminophen: Pain and Fever
o NSAIDS: Pain, Fever and Inflammation
123
- Which one hardest on liver?
o Acetaminophen
124
- What is Suboxone?
o Suboxone is buprenorphine with naloxone is used to treat opiate withdrawals and dependence. Buprenorphine is the active ingredient. Naloxone is added to produce withdrawal symptoms if the drug is injected or smoked.
125
o Buprenorphine
Buprenorphine is a mixed agonist used to treat opiate withdrawal and dependence. It is often mixed with a secondary drug to prevent abuse and brings on withdrawal in people who abuse buprenorphine by injecting it.
126
o Bactericidal
Pencillin
Cephalosporins
Nitroimidazole
Quinolones
Aminoglycosides
Vancomycin
127
o Bacteriostatic
o Macrolides (Erythromycin and Azithromycin)
o Lincomycin (Clindamycin)
o Tetracycline (Minocycline and Doxycycline)
128
- Which type has a cross allergen city with penicillin
o Cephalosporin has a cross-sensitivity with penicillin allergies.
129
- What antifungal is given orally for more severe infections?
o Amphotericin B- administered parenterally
130
GERD drugs
Antacids, H2 receptors, and Proton pump inhibitors
131
H2 Blocking Agents
=dine
132
What are the dental considerations for GERD?
Asthma
Hoarseness
Benign esophageal strictures
Dental erosions
Pre-cancerous transformation of the esophageal epithelium
133
PUD :Causes and Etiology
-Infection with H. pylori
-Chronic ingestion of NSAID drugs
134
Treatment of PUD
1. Antibiotics
2. Proton Pump Inhibitors (Omeprazole) or H2 receptor blocking agents (Cimetidine)
3. Antacids
4. Coating agents
135
- Know the cardiac dose of epinephrine for epi 1;100,000 and epi 1:200,000 (such as with Lidocaine and Prilocaine)
( 4 carts if 1:100,000, or 2 carts if 1:200,00)
136
o Type I Diabetes:
Sudden onset, usually early in life.
Requires daily insulin injections for life.
137
o Type II Diabetes:
Slow onset, usually in older individuals.
138
- A1C ranges-which are acceptable, which are ideal
o Acceptable: Less than 7%
o Ideal: 4-6%
139
- Know the two first-line classes for type II and the drug names under those classes.
o Biguanides:
Drug: Metformin (Glucophage)
o Sulfonylureas:
Drugs:Glyburide
Glimepiride (Amaryl)
Glipizide (Glucotrol)
