Pharm

Question 1

Dexamethasone and methylprednisolone are what type of drugs? What is their theraputic use and MOA?

Answer 1

Corticosteroids

MOA bind glucocorticoid receptors

Enhance the efficacy of serotonin 5-HT receptor antagonists

Question 2

Name a serotonin 5-HT receptor antagonist?

Answer 2

ondansetron

Question 3

Aprepitant is what type of drug? MOA and theraputic use?

Answer 3

Neurokinin receptor antagonist which is also its MOA.

Used prophylacticly in combo with 5-HT antagonists and corticosteroids. Acute and delayed nausea

Question 4

Aprepitant has what metabolic effects?

Answer 4

CYP inducer which will decrease the activity of certain drugs specifically warfarin; decrease INR.

Question 5

Phenothiazines end in what prefix? What types of drugs are these? MOA

Answer 5

-azine

Antipsychotics and antiemetics

MOA dopamine antagonists-antiemetic inhibition of dopamine and muscarinic receptors

Question 6

Metoclopramide is an antiemetic that acts on what receptor in the brain? What type of drug is it?

Answer 6

dopamine antagonist

substituted banzamides

Question 7

Which antimuscarinic agent is used to treat motion sickness and can be used via a transdermal patch?

Answer 7

scopolamine

Question 8

Prochlorperazine and promethazine are what type of drugs?

Answer 8

phenothiazines

Question 9

You have a patient suffering from C. diff infection. The metronidazole you prescribed isn’t working. what should you use next?

A IV vancomycin
B IV vancomycin and fidaxomicin
C oral vancomycin and fidaxomicin
D oral vancomycin

Answer 9

C) oral or rectal administration of vancomycin is important b/c IV is NOT effective at achieving adequate intra-colonic levels. Both drugs can be used for more severe disease.

Fidaxomicin is for oral use and is expensive

Question 10

You just found out your patients antibiotic regimen lead to them acquiring C. diff, what do you do next?

Answer 10

Discontinue antibiotic
hydrate
enteric isolationm
NO anti peristaltic medicine
anticipate relapse 10-20%
treat metronidazole mild
vancomicin and fidaxomicin for more severe cases

Question 11

Which anti-diarrheal, anti-cholinergic drugs are used primarily for their antispasmodic effects?

Answer 11

dicyclomine and hyoscyamine

Question 12

When is the use of opioids for diarrhea indicated? Which are used primarily; why?

Answer 12

refractory cases

Loperamide, diphenoxylate/atropine

little to no CNS effects

Question 13

Bismuth subsalicylate can cause which of the following?

A light colored stools
B metabolic acidosis
C metabolic alkalosis
D increased secretions

Answer 13

B metabolic acidosis (anion gap)

Question 14

How does bismuth subsalicylate work? Side effects

Answer 14

It reacts with HCL forming bismuth oxychloride and salicylic acid: anti secretory, anti-inflammatory, and antimicrobial.

Cause dark stools and black tounge

Question 15

What are the side effects of anticholinergic drugs?

Answer 15

mad as a hatter, red as a beet, hot as a hare, blind as a bat, and dry as a bone.

Question 16

Muscarinic receptor antagonist are also called what?

Answer 16

anticholinergics b/c blocking muscarinic receptors blocked ACh which activates them.

Question 17

What’s the prefix for the mesalamine pro drugs? When is their use indicated?

Answer 17

-salazine -salazide

Oral drug is used for treatment of crohns disease; must be delayed release to achieve theraputic intraluminal levels.

Topical treatment for Ulcerative collitis : rectal suppository or enema.

Question 18

What is 5-ASA?

Answer 18

5-Aminosalicylic acid =mesalamine

Question 19

How do bulk forming laxatives work? Name one

Answer 19

Psyllium. Works like fiber; hydrophillic colloids absorb water increasing stool bulk and peristalsis.

Question 20

How do stool surfactant agents work?

Answer 20

Surfactants decrease surface tension and act as detergents or emulsifyers. These act to absorb lipids and water into stool

Docusate Na+/Ca2+

Question 21

Magnesium hydroxide and lactulose are used for what?

Answer 21

osmotic laxatives used to increase liquid in stool; treat constipation and peptic disorders.

precaution in patients with renal insufficiency

Question 22

You decide your patient needs a colonoscopy what drug do you prescribe them? What if they’re elderly and frail? Adverse effects?

Answer 22

purgatives: Mg citrate, or Na/Phosphate (used to cleanse bowels and for constipation.
Adverse effects- increase phosphate and sodium, decrease potassium

PEG-polyethylene glycol- safe for all.

Question 23

you’re doing an endoscopy on a patient with chronic constipation and notice their colon is pigmented brown. what type of medication could be the cause of this? What is their MOA?

Answer 23

stimulant laxative such as senna, or bisacodyl

MOA stimulate ENS fluid secretion; use for acute and chronic constipation

Question 24

Name a Chloride channel activator used to treat constipation and IBS?

Answer 24

lubiprostone -lube that prostate stone

Increase motility by lubing the gut with CL-

Question 25

What are the uses of Mg hydroxide and AL hydroxide; what happens if you use them simultaneously?

Answer 25

Antacids Mg hydroxide is a laxative Al hydroxide causes constipation together they lower stomach acid without either undesirable effect

Question 26

Simethicone is used for what?

Answer 26

anti-gas MOA defoaming action breaks up gas in intestine Used for belching bloating or discomfort of the gut

Question 27

Your daughter was playing at the park and digging in the sand when she pulls out a cat turd. You notice this is the same sand your some just ate. If he gets an infection from this what's the drug of choice for treatment? Name the offending parasite.

Answer 27

Albendazole Toxocara canis-toxocariasis infection

Question 28

You notice your daughter picking her bum again right before she hands your infant son a toy. Assuming she has infected him with pinworms what's the alternative drug therapy he should receive if he's allergic to the drug of choice for this parasite? What does the sanford guide recommend now that two of your family members are infected?

Answer 28

pyrantel pamoate everyone gets treatment In this cause the rest of the family members will get albendazole and then repeat treatment in 2 weeks for both drugs.

Question 29

Taenia solium requires what drug therapy? What complications are you most concerned about with this infection? What type of helmith is it?

Answer 29

Praziquantel Concerned about larval cysts infecting the brain and causing adult onset seizures. (only with pork tapeworm solium) Neurocistercercosis treat with: Albendazole + praziquantel + dexamethasone (swelling) cestode

Question 30

Toxocara is what type of worm?

Answer 30

round worm/nematode

Question 31

Which drug is the drug of choice in the treatment of pinworm, toxocara, and neurocystercercosis?

Answer 31

Albendazole