M4 DRILLS Flashcards by Sam Agao

Which of the following is TRUE regarding acidic drugs?

I. They exist mainly in the ionized form at the stomach.

II. They exist in a non-ionized form at an acidic environment.

III. They exist mainly in the polar form in an acidic urine.

A.
I

B.
III

C.
II

D.
I, II and III

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When a weak acid drug is in an acidic medium, what usually happens?

A.
The drug becomes unionized and has a higher chance of being absorbed

B.
The drug becomes ionized and has a higher chance of being absorbed

C.
The drug becomes unionized and has a lesser chance of being absorbed

D.
The drug becomes ionized and has a lesser chance of being absorbed

E.
Nothing happens

A The drug becomes unionized and has a higher chance of being absorbed

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Which of the following is an INCORRECT pairing?

A.
Hepatitis: Pyrazinamide

B.
Optic neuritis: Ethambutol

C.
Ototoxicity: Rifampicin

D.
Peripheral neuropathy: Isoniazid

C. Ototoxicity: Rifampicin

BEQ21 – AE of streptomycin is ototoxicity

These are pairings of adverse effects and anti-TB drugs. Ototoxicity (irreversible cochlear and vestibular dysfunction) is associated with Streptomycin. Rifampicin can cause red-orange discoloration of secretions.

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Which of the following is/are characteristic/s of Type B ADR?

I. unpredictable

II. unrelated to the mechanism of action of drug

III. dose-dependent

IV. common

A.
I and II

B.
III and IV

C.
II

D.
I, II, III and IV

BEQ21

Type B ADR is a rare, unpredictable, unrelated to the pharmacological action of the drug and not dose dependent. It also depends on patient’s susceptibility to the adverse reaction. While dose-dependent and common refer to Type A ADR.

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Poisons may enter the human body through which the following routes of exposure.

I. Orally by ingestion

II. By inhalation

III. From mother to infant via transplacental route

A.
I and II

B.
I and III

C.
II and III

D.
I, II and III

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Which of the following are water-soluble vitamins?

I. Vitamin A

II. Vitamin B

III. Vitamin C

IV. Vitamin D

A.
I and II

B.
III and IV

C.
II and III

D.
II, III and IV

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Which of the following acts by inhibiting the action of 5-alpha-reductase?

A.
Flutamide

B.
Finasteride

C.
Nandrolone

D.
Danazol

Flutamide – androgen receptor blocker (also Bicalutamide)

Nandrolone and Danazol – testosterone analogs

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Pharmacokinetic variations in Drug Metabolizing Enzymes (DME) are considered significant if _____.

Active metabolites are formed
The drug has a very wide margin of safety
The parent drug is prodrug that requires activation by DME

A.
I and III

B.
I, II and III

C.
III

D.
II

A I and III

DME is highly considered for drugs with narrow TI or margin of safety

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The enzyme capacity in newborns and infants is reduced. What possible effects would this have on clearance and elimination half-life of drugs?

A.
Increase in clearance and decrease in elimination half life

B.
Increase in clearance and increase in elimination half life

C.
Decrease in clearance and decrease in elimination half-life

D.
Decrease in clearance and increase in elimination half-ife

Decrease in clearance and increase in elimination half-ife

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Abrupt discontinuation of beta blockers can lead to rebound hypertension or tachycardia.

This is due to:

A.
Receptor upregulation

B.
An increase in excretion of active drug

C.
Receptor dowregulation

D.
Inactivation of counterregulatory physiologic response

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Which would be the pair that best gives an example for physiologic antagonism?

A.
Acetylcholine and Atropine

B.
Heparin and Protamine sulfate

C.
Ferrous sulfate and Deferoxamine

D.
Histamine and Epinephrine

Ans: D

Histamine (acts on H receptors) and Epinephrine (acts on α1 and β2 receptors to manage the anaphylactic shock and bronchoconstriction caused by histamine) (aka Functional Antagonism)

Acetylcholine and Atropine – Pharmacologic Antagonism (both attach to the same receptor, with atropine blocking ACh)

Heparin and Protamine sulfate – Chemical Antagonism (protamine ionizes heparin, making it more water-soluble and thus, more excretable)

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Describes the concept of dissolution in the absorption of orally administered medications

A.
Fick’s Law of Diffusion

B.
Noyes-Whitney Equation for Dissolution

C.
Fick’s Law of Dissolution

D.
Noyes-Whitney Equation for Diffusion

Ans: B

Noyes-Whitney Equation for Dissolution

Fick’s Law of Diffusion – describes the concept of diffusion in passive transport

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Which of the following would be best regarded as a factor that affects the distribution of a drug?

A.
Cardiac Output

B.
Gastric Emptying Time

C.
Dose of the Drug

D.
Degree of Perfusion of the Intestines

Ans: A. Cardiac Output

The rest of the choices are factors that affect the ABSORPTION of a drug.

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Which of the following statements regarding protein binding is true?

A.
Protein bound drugs are distributed throughout the body and used

B.
Protein binding helps the body eliminate drugs

C.
Protein bound drugs are metabolized in the liver

D.
Both A and C

E.
None

Ans: E. None

All of the statements refer to a free drug or an unbound drug

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Drug metabolism usually results in a product that is

A.
More lipid soluble

B.
More water soluble

C.
More likely to be reabsorbed by the kidneys

D.
More likely to distribute intracellularly

Ans: B. more water soluble

BEQ21

Biotransformation
● less lipid soluble
● more water soluble

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Always true for carrier-mediated transport

A.
Requires ATP

B.
Solvent-driven through opposite-charged pore lining

C.
Works against concentration gradient

D.
Follows Michaelis-Menten kinetics when saturated

E.
A and C

Ans: D

Follows Michaelis-Menten kinetics when saturated

A & C: Carrier-mediated, but only if active transport

B: Convective transport

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Digoxin inhibits Na+/K+ ATPase pump. What kind of transport protein is Na+/K+ ATPase pump?

A.
Ion pair

B.
Active, Primary

C.
Active, Secondary

D.
Active, Antiport

E.
Convective through opposite-charged pore lining

Ans: B

ATPase: Active transport

Active transport: Uses energy source to move molecules across membrane against their gradient

Primary active transport: Directly uses ATP as energy source; May generate an electrochemical gradient

Secondary / Cotransport: Uses electrochemical gradient (by 1o active transport); I.e. Symport / Antiport

Ion pair: Same direction vs Opposite direction PiSo; Non-energy requiring (+/- = netural)

Convective: Ionized sulfonamide

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The displacement of drug from protein binding site causes

A.
Decrease intensity of pharmacological response

B.
Decrease side effects

C.
toxicity

D.
all of the above

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A drug was withdrawn from the market due to reports of cardiac arrythmia caused by unusually high level of the said drug. Which of the following BEST explains this effect?

A.
Intake of drugs that enhances its excretion

B.
Intake of drugs that are used to treat cardiac arrythmia

C.
Intake of drugs that enhances its metabolism

D.
Intake of drugs that inhibits its metabolism

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Which of the following statements are true?

A.
Excretion through kidneys requires the drug to be nonpolar

B.
A drug undergoes biliary excretion when its molecular weight is less than 400

C.
Renal excretion is more dominant

D.
Both A and C

E.
All of the choices

Ans: C

Excretion through kidneys require polar or water-soluble drugs

Biliary Excretion requires drug with a mw of more than 400

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Adrenergic peripheral responses are mediated by what type of receptors?

Alpha receptor
Beta-receptor
Muscarinic receptors

A.
I and II

B.
I, II and III

C.
II and III

D.
I and III

Note:

Muscarinic Receptors

Recall that eccrine sweat glands contain “sympathetic-cholinergic” receptors, stimulated by ACh but produces vasodilation and sweat release. This is a M receptor despite the term “sympathetic”
because “adrenergic” and “sympathetic” are NOT synonymous.

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Which of the following is TRUE regarding the effect of adrenergic agonist on peristalsis?

A.
No effect

B.
Decrease in peristalsis

C.
Effect is either an increase or decrease in peristalsis

D.
Increase in peristalsis

Recall fight or flight versus rest and digest

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Which receptor is responsible for tocolysis?

A.
Alpha-1

B.
Beta-1

C.
Beta-2

D.
Beta-3

E.
Nm

Ans: C. (Beta-2) Piloerection = goosebumps

Beta-1: (+) inotropism, chronotropism, dromotropism

Beta-2: bronchodilation, relaxation of uterus

Beta-3: lipolysis, relaxation of detrussor muscle of bladder

Nm: skeletal muscle contractions

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Phenylephrine is a/an .

A.
Adrenergic antagonist

B.
Cholinergic agonist

C.
Adrenergic agonist

D.
Cholinergic antagonist

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Tamsulosin acts selectively on what type of receptor? A. Beta-2 B. Alpha-1 C. Beta-1 D. Alpha-2

Which of the following neurotransmitter will be increased by Rivastigmine in the Central Nervous System synapses? A. Dopamine B. Acetylcholine C. Epinephrine D. Serotonin

Telenzepine is used for the treatment of peptic ulcers. What receptor does it target? A. M1 B. M2 C. M3 D. Nm E. Nn

Which of the following drugs induces α1 receptor selectively? I. Naphazoline II. Clonidine III. Methoxamine IV. Isoproterenol A. I only B. II, III C. II only D. I, III E. I, II, III, IV

Ans: D. I, III Clonidine is a selective α2 agonist drug Isoproterenol is a nonselective β agonist drug

All of the drugs listed are SABA drugs, but which one is for inhalation only? A. Salbutamol B. Metaproterenol C. Pirbuterol D. Terbutaline

Ans: C. Pirbuterol Salbutamol – Inhalational, PO Metaproterenol – Inhalational, PO Terbutaline – Inhalational, PO, SQ

What is the action of ephedrine on the sympathetic nervous system? A. Direct action at alpha-1, beta-1, and beta-2 adrenergic receptors B. Indirect action by increasing the exocytosis of norepinephrine C. Mixed direct action at alpha-1, beta-1, and beta-2 adrenergic receptors and indirect action by increasing the exocytosis of norepinephrine D. Indirect action by inhibition of norepinephrine reuptake

Ans: C. Mixed action (Direct: α1, β1, β2 activation; Indirect: increased NE exocytosis)

Which parasympathomimetic drug is likely to cause oropharyngeal cancer? A. Neostigmine B. Edrophonium C. Pilocarpine D. Arecoline

Ans: D. Arecoline Arecoline is parasympathomimetic drug found on areca nut. Research shows that this is either due to arecoline or due to nitrosamine constituents

Which of the following is most likely to be used in the management of Alzheimer’s disease? A. Physostigmine B. Neostigmine C. Rivastigmine D. Pyridostigmine

Ans: C Rivastigmine (CNS-acting anticholinesterase; other e.g.: Tacrine, Donepezil, Galantamine)

Which of the following is a depolarizing neuromuscular blocker? A. Tubocurarine B. Pancuronium C. Succinylcholine D. Hexamethonium

Ans: C. Succinylcholine Tubocurarine – non-depolarizing isoquinoline neuromuscular blocker (also -curiums) Pancuronium – non-depolarizing steroidal neuromuscular blocker (also other -curoniums) Hexamethonium – ganglionic blocker (also Trimethaphan and Mecamylamine)

Which of the following is an effect not produced by Atropine? A. Bronchodilation B. Miosis C. Flushing D. Decreased sweating

Ans: B. Miosis Atropine causes mydriasis instead of miosis

Nondepolarizing, neuromuscular blockers are competitive drugs used for skeletal muscle relaxation during surgeries or for patients with spastic disorders. Which of the following are nondepolarizing, steroidal, neuromuscular blockers? Atracurium Mivacurium Rocuronium Vecuronium A. I, II B. II, III C. III, IV D. I, II, III, IV

Ans: C. III, IV Nondepolarizing, steroidal, neuromuscular blockers end with “curonium” Nondepolarizing, isoquinoline, neuromuscular blockers end with “curium”

Correct use of pralidoxime A. Attempt to regenerate inhibited acetylcholinesterase. B. Dispense as the only antidote to poisoned farmer who was not properly guided by haciendero-management about proper dithane and malathion use. C. Carefully administer after the aging process. D. AOTA E. NOTA

Ans: A. AChase regenerator Pralidoxime: Chemical antagonist with an oxime group which combines with phosphorus of AChase inhibitors Atropine: Physiologic antagonist that treats organophosphate poisoning by blocking acetylcholine action at the receptors; May be used even after aging process

Which is/are incorrectly paired? A. Metyrosine at rate-limiting step: Hemicholinium at rate-limiting step B. Reserpine : Vesamicol C. Guanethidine : Botulinum toxin D. AOTA E. NOTA

Ans: E. NOTA A: Metyrosine inhibits RLS tyrosine hydroxylation in catecholamine synthesis: Hemicholinium blocks RLS choline re/uptake in acetylcholine synthesis B: Storage vesicle C: Release

Which of the following NSAIDs is correctly paired? A. Indomethacin – Pyrrole alkanoic acid B. Tolmetin – Pyrrole alkanoic acid C. Ibuprofen – Fenamate D. Diclofenac – Fenamate E. NOTA

Ans: B. Tolmetin – Pyrrole alkanoic acid Indomethacin: Indole Ibuprofen: Propionate Diclofenac: Phenyl acetic acid / acetate Mefenamic acid: Fenamate -ac / -pro- >> -fen-

A selective COX-2 inhibitor A. Celecoxib B. Indomethacin C. Meloxicam D. Phenylbutazon

Ans: C. Meloxicam Celecoxib and other -coxibs – SPECIFIC COX-2 inhibitors

This is a naturally occurring prostaglandin used to induce labor and cervical ripening. A. Dinoprostone B. Latanoprost C. Misoprostol D. Alprostadil E. All of the choices

Ans: A. Dinoprostone Latanoprost – for the mgt of glaucoma Misoprostol – a synthetic prostaglandin medication used as cytoprotectant Alprostadil – used for erectile dysfunction

Celecoxib is a specific COX2 inhibitor, what does this imply? A. Celecoxib inhibits both COX1 and COX2 B. Celecoxib inhibits COX2 only, thus increasing the risk of gastritis C. Celecoxib inhibits COX2 only, but it does not create a significant difference from nonselective COX inhibitors. D. Celecoxib inhibits COX2 only, thus preventing risk of gastritis. E. None

Ans: D. Celecoxib inhibits COX2 only, thus preventing risk of gastritis. A COX2 inhibitor selectively inhibits COX2 only, thus reducing the risk for gastritis but increases the risk for thrombotic events

The only NSAID that is not a weak acid. A. Ketorolac B. Ibuprofen C. Sulindac D. Nabumetone E. None

Ans: D. Nabumetone Nabumetone is a nonacidic NSAID prodrug that is rapidly metabolized in the liver to the active metabolite, 6-methoxy-2-naphthyl acetic acid.

Which of the following is useful in treating ascites and pulmonary edema? The principal site of action of this drug is on the thick ascending limb of Henle’sloop. A. Hydrochlorothiazide B. Acetazolamide C. Spironolactone D. Furosemide

Ans: D. (Furosemide) BEQ Thick ascending limb of Henle’s loop - This is a buzz phrase for diuretics.

Adenosine is classified as a/an, A. diuretic B. tocolytic C. antidiabetic medicine D. antiarrhythmic agent

Which of the following is an antihypertensive medication most likely to be used by pregnant women? A. Candesartan B. Lisinopril C. Labetalol D. Clonidine

Ans: C. Labetalol Antihypertensive drugs for pregnant women: ⮚ Methyldopa ⮚ Hydralazine ⮚ Labetalol ⮚ Nifedipine “Mother Hates Labor and Nifedipine”

Which of the following conditions would increase the risk of digoxin toxicity? A. Increased levels of potassium ions in the blood B. Increased levels of magnesium ions in the blood C. Increased levels of calcium ions in the blood D. Hyperbaric oxygen therapy

Ans: C. Increased levels of calcium ions in the blood (Hypercalcemia) Conditions that would increase risk of digoxin toxicity: ⮚ Hypo – K, Mg, O (hypokalemia, hypomagnesemia, hypoxia) Hyper – Ca (hypercalcemia)

Which drug/s increase/s body lithium levels? A. Acetazolamide B. Xanthines C. Mannitol D. Hydrochlorothiazide E. AOTA

Ans: D. Hydrochlorothiazide ↑[Li]: Na+ loss / Natriuretic: Thiazides, ACEis, NSAIDs ↓ [Li]: Na+ supplement / Aquaretic: Acetazolamide (Carbonic anhydrase diuretics), Xanthines, Osmotic diuretics

Which of the following would most likely be used for a patient with a non-productive cough? A. Acetylcysteine B. Bromhexine C. Guaifenesin D. Dextromethorphan

Ans: D. Dextromethorphan (other examples of cough suppressants/antitussives: Levodropropizine, Butamirate citrate, Codeine, Noscapine) Other choices are used for productive cough.

Which of the following is most likely to be administered as an MDI? A. Ipratropium B. Theophylline C. Montelukast

Ans: A. Ipratropium – is available as a metered dose inhaler (MDI) (e.g., Atrovent®) Theophylline – oral Montelukast – oral Aminophylline – parenteral (IV)

Which of the following is most likely to be inhaled to control a bronchial asthma attack? A. Prednisone B. Hydrocortisone C. Fluticasone D. Methylprednisolone

Ans: C. Fluticasone Prednisone – oral Hydrocortisone – parenteral (IV) Methylprednisolone – oral or parenteral (IV)

LTD4 receptor antagonist A. Zafirlukast B. Montelukast C. Zilueton D. A and B

D (lukasts)

This drug is used as an alternative to Warfarin for stroke prophylaxis except for patients with prosthetic heart valves. A. Lepirudin B. Bivalirudin C. Argatroban D. Dabigatran E. None

Ans: D. Dabigatran Lepirudin and Argatroban – for Heparin Induced thrombocytopenia Bivalirudin – prevent thrombosis post angioplasty

Which factor/s can cause an increased risk of thrombosis? Phenobarbital Cephalosporins Chronic liver diseases Hyperthyroidism Hypothyroidism A. I, V B. II, V C. I, III, IV D. II, III, IV E. III, IV, V

Ans: A. I, V Decreased PT-INR (risk: thrombosis): ● Enzyme inducers like Phenobarbital ● Cholestyramine ● Green leafy vegetables ● Diuretics ● Hypothyroidism Increased PT-INR (risk: bleeding) ● Enzyme inhibitors ● Cephalosporins ● Other antithrombotics ● Hyperthyroidism ● Chronic liver diseases

Which of the following is the antidote for opioid poisoning? A. Antropine B. Flumazenil C. Deferoxamine D. Naloxone

Nizatidine acts on which receptor? A. H1 receptor B. H2 receptor C. H3 receptor D. H4 receptor

Ans: B. H2 receptor (antagonizes H2) Other examples of H2 antagonists: Cimetidine, Famotidine, Ranitidine

Among the drugs listed below, which of the following is used for cold medications? A. Cyproheptadine B. Meclizine C. Diphenhydramine D. Brompheniramine E. None

Ans: D. Brompheniramine Cyproheptadine is an antihistamine with an additional anticholinergic and antiserotonergic effect. Meclizine is used for motion sickness Diphenhydramine is used for the management of dystonic crisis

The following statements regarding H2 antihistamines are not true, except: A. Cimetidine is an antihistamine with significant enzyme inhibition and can help people with low libido. B. Famotidine is an H2 antagonist drug more potent than Cimetidine C. Nizatidine has a variety of dosage forms including IV infusions D. All of the statements are false

Ans: B. Famotidine is an H2 antagonist drug more potent than Cimetidine Cimetidine may contribute to the loss of libido in rare cases. Nizatidine has only oral dosage forms

Alosetron is a 5-HT3 antagonist drug, what is its clinical significance? A. It is used to manage nausea and vomiting induced by chemotherapy B. It is used to manage irritable bowel syndrome with predominant diarrhea C. It is used to manage irritable bowel syndrome with predominant constipation D. It is used to manage migraine E. Both b and c

Ans: B. It is used to manage irritable bowel syndrome with predominant diarrhea A. This is the indication of other 5-HT3 antagonist drugs like Ondansetron C. This is the indication of Tegaserod, a 5-HT4 partial agonist D. This is the indication of 5-HT1b/1d drugs like Sumatriptan, and also to Ergotamine

Four milligrams of Methimazole would approximately be equivalent to A. 0.4 mg of propylthiouracil B. 4 mg of propylthiouracil C. 20 mg of propylthiouracil D. 40 mg propylthiouracil

Ans: D. 40 mg of PTU (Methimazole is more potent than PTU by approximately 10x) PTU dose = Methimazole dose x 10 PTU dose = 4 mg x 10 PTU dose = 40 mg

Which of the following is the main adverse effect of Insulin? A. Hypoglycemia B. Hyperglycemia C. Bone marrow depression D. Hepatotoxicity

Ans: A. (Hypoglycemia) BEQ Recall MOA, desired effect, main ADR which all converge to hypoglycemia. Be careful however for choices that are outside of the polar opposites.

The following statements are true about thioamides, EXCEPT: A. Methimazole is teratogenic and causes aplasia cutis, while PTU is safe for use in pregnancy. B. Thioamides are inhibitors of thyroid peroxidase C. 5 mg is the equivalent methimazole dose of 50 mg PTU D. PTU has an additional mechanism which is inhibition of proteolysis.

Ans: D. PTU has an additional mechanism which is inhibition of proteolysis. This inhibits peripheral deiodination

Repaglinide is believed to work by A. Decreasing hepatic gluconeogenesis B. Stimulating the release of insulin from the pancreas C. Increasing hepatic gluconeogenesis D. Reducing glucagon secretion from the pancreas

Ans: B. Stimulating the release of insulin from the pancreas Repaglinide is an insulin secretagogue.

This antidiabetic drug may cause an adverse effect of lactic acidosis A. Rosiglitazone B. Metformin C. Miglitol D. Sitagliptin E. Chlorpropramide

Ans: B. Metformin Rosiglitazone – may cause cardiovascular events Miglitol – may cause flatulence Sitagliptin – may cause an increase in pancreatic size Chlorpropramide – may cause hypoglycemia, weight gain and cholestatic jaundice

Peak-less insulin A. Insulin Lispro B. NPH C. Insulin Aspart D. Insulin Glargine

Which of the following statements regarding thioamides (methimazole and propylthiouracil) are true? I. Both agents inhibit iodoperoxidase II. Aside from inhibition of iodide oxidation, propylthiouracil also inhibits peripheral deiodination of T4 to T3 III. Propylthiouracil is generally preferred because of its longer duration of action, more rapid efficacy, and lower incidence of side effects IV. Methimazole is the treatment of choice when therapy is indicated during the first trimester of pregnancy A. I, III, IV B. I, II C. II, IV D. II, III, IV

Ans: B. I, II III - Propylthiouracil is generally preferred because of its longer duration of action, more rapid efficacy, and lower incidence of side effects Methimazole is generally preferred because of its longer duration of action, more rapid efficacy, and lower incidence of side effects IV - Methimazole is the treatment of choice when therapy is indicated during the first trimester of pregnancy Propylthiouracil is the treatment of choice when therapy is indicated during the first trimester of pregnancy

Gabapentin is used for what indication? A. Antidote for lead poisoning B. Antiarrythmia C. Anticonvulsant D. Anticancer

Nefazodone, a second generation antidepressant, has been withdrawn due to what adverse effect? A. Hepatotoxicity B. Nephrotoxicity C. Cardiotoxicity D. Aplastic anemia

Phenytoin is effective for the treatment of all of the following types of seizures except A. Generalized tonic-clonic B. Simple partial C. Complex partial D. Absence E. Grand mal

Ans: D. Phenytoin is not effective for absence (petit mal) seizures DOC for absence seizures: Ethosuximide

Considered to be the drug of choice for patients having recurrent seizure attacks without regaining consciousness. A. Carbamazepine B. Phenytoin C. Lorazepam D. Diazepam

Ans: C. Lorazepam Lorazepam is the DOC for Status epilepticus.

Metronidazole is effective against these type of organism except A. Aerobic B. Anaerobic C. Protozoan D. None of the above- Metronidazole is effective against all of the organism stated above

Ans: A. Aerobic MOA of Metronidzaole: generates nitroso free radical to damage and degrade DNA

Prussian blue is used to chelate A. Thallium B. Cesium C. Cyanide D. A and B E. B and C

Type B adverse drug reactions are I. Dose-dependent Serious and life-threatening II. Responsible for majority of ADRs III. A function of patient susceptibility A. I, III B. I, II C. II, III D. II, IV

Increased digoxin toxicity is seen in which of the following conditions? A. Hypokalemia B. Hypocalcemia C. Hyperkalemia D. Hypermagnesemia E. B, C, & D

Ans: A. HypOkalemia Digoxin toxicity: HypoKMgO2, Hypercalcemia ● Hypokalemia ● Hypomagnesemia ● Hypoxia

If the patient was inadvertently given penicillin in spite of the documented allergy, which of the following will BEST describe the incident? A. Medication Error – Omission Error B. Adverse Drug Reaction – Type A C. Medication Error – Commission Error D. Adverse Drug Reaction – Type B

Ans: C. (Medication Error – Commission Error) BEQ Recall Types A-F of ADRs. This question is looking for medication errors, NOT mechanisms of ADRs.

Which of the following is the adverse effect associated with Streptomycin? A. Peripheral B. Ototoxicity C. Optic neuritis D. Hepatitis

Benzodiazepine overdose is managed by the use of __________. A. Atropine B. Naloxone C. Flumazenil D. Deferoxamine

Ans: C. Flumazenil BEQ21 Rationale: Atropine – cholinesterase inhibitors poisoning; naloxone – opioid poisoning; deferoxamine – iron poisoning.

Ethanol may be used for ________ poisoning. A. opioids B. methanol C. benzodiazepines D. carbon monoxide

Salicylate poisoning is best managed by _______. A. Emetic agents B. Gastric lavage C. Urinary alkalinization D. Urinary acidification

Drug X is reported to reverse the action of another drug by interacting directly with the drug and not with its receptors. Which of the following mechanism of antagonism best describes Drug A? A. Chemical antagonism B. Mechanical antagonism C. Pharmacologic antagonism D. Physiologic antagonism

Which of the following is an adverse effect associated with the use of chloramphenicol? A. Phototoxicity B. Aplastic anemia C. Alopecia D. Staining of teeth

Which of the following drugs are associated with pulmonary toxicity? A. Bleomycin B. Methotrexate C. Doxorubicin D. Cisplatin

Which of the following adverse effects is associated with Ethambutol? A. Optic neuritis B. Peripheral neuropathy C. Hepatitis D. Ototoxicity

Which of the following refers to the process that distinguishes the elimination of ethanol from the elimination of the most other drugs? A. First-order elimination B. Biliary excretion C. First-pass effect D. Zero-order elimination

Pharmaceutical equivalent drugs products must have the same ____. Therapeutically active drug ingredient/s Salt or ester Dosage form and strength A. I, II and III B. I C. II D. III

According to pH partition hypothesis, a weak acidic drug will not be absorbed from the intestines because: A. The drug will exist primarily in the unionized, more lipid soluble form B. The drug will exist primarily in the ionized, more water-soluble form C. Weak acids are more soluble in acid medium D. The ionic form of the drug facilitates absorption

Which of the following is TRUE if there is a significant difference between the oral and parenteral doses of the same drug; for example oral dose (tablet) is 40 mg vs. IV dose of 4 mg? A. Drug preparation has fast rate of dissolution B. Drug has very good absorption at the GI tract C. Drug undergoes significant first pass effect D. Drug preparation has fast disintegration rate.

Which of the following is not an example of cholinergic agent? A. Ipratropium B. Neostigmine C. Dicyclomine D. Betanechol

Which of the following is the mechanism of action of anticholinergics? I. Enhances the sympathetic nervous system II. Enhances parasympathetic nervous system III. Enhances the action of acetylcholine at the neuromuscular junction

Which of the following is an anticholinergic drug? A. Pilocarpine B. Homatropine C. Neostigmine D. Rivastigmine

Physostigmine can managed poisoning with which of the following drugs? A. Muscarinic agonists B. Muscarinic antagonists C. Beta-blockers D. Organophosphates

Royal jelly, a popular nutritional supplement form honeybee has been reported to cause which of the following adverse effects? A. Hepatotoxicity B. CNS depression C. CNS stimulation D. Anaphylaxis

Which of the following can be used for methanol poisoning? A. Succimer B. Atropine C. Fomepizole D. Flumazenil

Which of the following toxidromes are consistent with organophosphate insecticides? I. Bronchodilation II. Profuse sweating III. Drooling

Which should be administered to the patient who presents symptoms of organophosphate poisoning? A. Neostigmine B. Atropine C. Glucagon D. Flumazenil

Ans: B. Atropine BEQ21 Pralidoxime can also be given within 72 hours of poisoning to regenerate acetylcholinesterase enzymes.

Which of the following is NOT true about the effect of significant organ dysfunction on pharmacokinetic variables? A. renal insufficiency increases clearance of renally-excreted drugs B. cardiac impairment decreases cardiac output resulting to reduction of volume of distribution C. Liver dysfunction may result to inability of transforming the drug to its active metabolite D. hepatic impairment prolongs half-life of drugs that are highly dependent on the liver for elimination

Ans: A. renal insufficiency increases clearance of renally-excreted drugs BEQ21 Renal impairment decreases clearance of drugs primarily dependent on the kidney for elimination

Which of the following factors can prolong duration of a drug? I. Decreased protein binding II. Greater tubular reabsorption III. Reduced polarity A. I and II B. II and III C. I and III D. I, II and III

Dobutamine acts selectively on what type of receptor? A. Alpha-1 B. Alpha-2 C. Beta-1 D. Beta-2

Ans: C. Beta-1 Selective a1 agonists: Phenylephrine, oxymetazoline Selective a2 agonists: clonidine, guanfacine, guanabenz, methyldopa Selective b1 agonists: Dobutamine, Dopamine Selective b2 agonists: SABA and LABA

Pharmacokinetic curve

Pkin curve: conc vs time Pdy curve: Response or #Responder vs log dose

True about graph B, EXCEPT: It shows a quantal dose response curve It shows a graded dose response curve It shows all-or-none response It shows response on a continuous scale Efficacy and potency can be determined from this graph A. i, iii B. i, iii, v C. ii, iv D. ii, iv, v

True about the graph above showing the curves for Drugs X, Y, Z: Drug X is the most efficacious and the most potent Drug X is the most efficacious but the least potent Drug Z is the most efficacious and the most potent Drug Z is the most efficacious but the least potent Drug Z has a higher ceiling dose than Drug Y A. i only B. iv only C. i, v D. ii, v E. iii, v

C Efficacy – ceiling effect, max achieved response (Emax) Potency – dose producing 50% of ceiling effect (EC50) Ceiling Dose – smallest dose producing ceiling effect

M4 DRILLS Flashcards

(100 cards)