Pharmacology Flashcards

Question

What is the mechanism of action of Lithium?

Answer 1

Inhibits inositol monophosphatase, reducing inositol triphosphate, and decreasing IP3/DAG signaling, ultimately **stabilizing mood** | Lithium stabilizes mood by affecting intracellular signaling pathways.

Answer 2

* Gastrointestinal irritation * Fine hand tremor and muscular weakness * Polyuria, thirst * Sleepiness | It has a very **narrow therapeutic window**

Answer 3

* Nausea * Diarrhea * Hyperreflexia * Heart Arrhythmias * Hypotension * Seizure * Coma | It has a very **narrow therapeutic window** ## Footnote Acute toxicity requires immediate medical attention.

Answer 4

* Tetracyclines * Metronidazole * Macrolides * Aspirin and some NSAIDs * Diuretics * Trimethoprim + Sulfamethoxazole ## Footnote These interactions can lead to increased side effects or toxicity.

Answer 5

Increased nephrotoxicity

Answer 6

Natural Opioids

Answer 7

Chest pain unresponsive to Nitroglycerin | IV Dose: 2mg IM Dose: 5mg

Answer 8

Fluorquinolones | Fluorquinolones are a class of antibiotics.

Answer 9

Ciprofloxacin

Answer 10

Ciprofloxacin ## Footnote This makes Ciprofloxacin a unique option in pediatric cases among Fluorquinolones.

Answer 11

Fluorquinolones

Answer 12

Fluorquinolones

Answer 13

Fluorquinolones

Answer 14

[Natural Opioids](http://https://www.brainscape.com/l/dashboard/afk-memorization-22693044/decks/18159804/cards/572480113/edit)

Answer 15

Natural Opioids

Answer 16

Corticosteroids

Answer 17

Natural Opioids

Answer 18

Corticosteroids

Answer 19

β-adrenergic Blockers

Answer 20

Fast Sodium Channel Blockers

Answer 21

Potassium Channel Blockers

Answer 22

Type 3 Anti-arrythmics (Potassium Channel Blockers)

Answer 23

Blockage of sodium channels in the heart ## Footnote This additional mechanism enhances its anti-arrhythmic properties, making it the most potent and with the broadest spectrum

Answer 24

Amiodarone ## Footnote Due to blocking both potassium and sodium channels in the heart

Answer 25

Type 3 Anti-arrythmics (Potassium Channel Blockers) ## Footnote Sotalol is frequently used for treating ventricular arrhythmias.

Answer 26

Type 3 Anti-arrythmics (Potassium Channel Blockers) ## Footnote Dofetilide is effective in maintaining sinus rhythm in patients with atrial fibrillation.

Answer 27

Type 3 Anti-arrythmics (Potassium Channel Blockers) ## Footnote Ibutilide is used primarily for the rapid conversion of atrial flutter or atrial fibrillation.

Answer 28

Natural Opioids

Answer 29

300mg Acetaminophen + 8mg Codeine

Answer 30

300mg Acetaminophen + 15mg Codeine

Answer 31

300mg Acetaminophen + 30mg Codeine

Answer 32

300mg Acetaminophen + 60mg Codeine

Answer 33

Morphine | It is a pro-drug

Answer 34

Worse | It must be combined with an NSAID or acetaminophen for better analgesia

Answer 35

Tylenol No. 3 or 4 | Codeine 30-60mg + Acetaminophen 300mg

Answer 36

Under 12 years of age ## Footnote Due to increased risk of ultra-rapid metabolism genetic variation of CYP-2D6 that may lead to Morphine overdose

Answer 37

Limit to 3-4 days

Answer 38

Natural Opioids

Answer 39

Oxycodone (5mg) + Acetaminophen (325mg) ## Footnote Percocet is a combination medication used for severe dental pain relief in patients unresponsive to milder compositions (ex: Tylenol No.3-4)

Answer 40

Corticosteroids

Answer 41

Corticosteroids

Answer 42

Corticosteroids

Answer 43

Corticosteroids

Answer 44

Corticosteroids

Answer 45

Antifungals

Answer 46

Binds to ergosterol in fungal cell membranes, forming pores that allow leaking and cell death

Answer 47

Intravenous

Answer 48

* Nausea * Vomiting * Headache * Fever * Chills * Nephrotoxicity * Electrolyte imbalances * Hypotension * Heart Arrhythmias

Answer 49

Aminoglycosides ## Footnote Gentamicin is used primarily as an antibiotic.

Answer 50

Angiotensin-Converting Enzyme Inhibitor (ACEi) ## Footnote Captopril is commonly used to treat hypertension.

Answer 51

Macrolides ## Footnote Macrolides are a class of antimicrobials

Answer 52

250-500mg 2x per day for 7 days ## Footnote This dosage is tailored for adult patients.

Answer 53

15mg/kg 2x per day for 7 days ## Footnote This dosage is tailored for pediatric patients.

Answer 54

Benzodiazepines ## Footnote Triazolam is often used for sedation in dental procedures.

Answer 55

0.125-0.250mg ## Footnote This dosage is recommended for short procedures.

Answer 56

0.250mg ## Footnote This dosage is for longer sedation requirements.

Answer 57

Triazolam ## Footnote Triazolam is preferred due to its **rapid onset and short duration**.

Answer 58

Benzodiazepines ## Footnote Midazolam is used for sedation and seizure management.

Answer 59

* Pediatric minimal to moderate sedation * Seizures >3min (IM 5mg). ## Footnote Midazolam has a rapid onset and a short duration of action.

Answer 60

0.5mg/Kg, up to 15mg

Answer 61

Synthetic Opioids ## Footnote Meperidine is used for pain management.

Answer 62

Angiotensin-Converting Enzyme Inhibitor (ACEi) ## Footnote Enalapril is another medication used for hypertension.

Answer 63

Benzodiazepines ## Footnote Clonazepam is used for anxiety and seizure disorders.

Answer 64

Synthetic Opioids ## Footnote Pentazocine has mixed agonist-antagonist properties.

Answer 65

Benzodiazepines ## Footnote Flurazepam is a medication used primarily for its sedative properties.

Answer 66

Angiotensin-Converting Enzyme Inhibitor (ACEi) ## Footnote Quinapril is an angiotensin-converting enzyme inhibitor used for hypertension.

Answer 67

Benzodiazepines ## Footnote Lorazepam is commonly used for anxiety and sedation.

Answer 68

* Anxiety Control (1-10mg) * >3h Minimal-moderate Sedation (0.250mg) * Seizures >3min. (IM 4mg)

Answer 69

Synthetic Opioids

Answer 70

Synthetic Opioids

Answer 71

Synthetic Opioids

Answer 72

* Anxiety Control (1-4mg) * >3h Minimal-moderate Sedation (0.250mg)

Answer 73

Benzodiazepines ## Footnote Alprazolam is commonly prescribed for anxiety and panic disorders.

Answer 74

Benzodiazepines ## Footnote Temazepam is primarily used for the treatment of insomnia.

Answer 75

Benzodiazepines ## Footnote Oxazepam is used for anxiety and alcohol withdrawal.

Answer 76

Synthetic Opioids ## Footnote It is a **partial agonist** of Opioid Receptors, which also inhibitis serotonin and norepinephrine reuptake

Answer 77

If a MAOi drug has been used in the previous 14 days | MAOi: Monoamine-oxidase Inhibitor ## Footnote Combining Tramadol with MAOIs can lead to serious side effects, including serotonin syndrome.

Answer 78

Benzodiazepines

Answer 79

Long, due to active metabolite ## Footnote Diazepam's active metabolites contribute to its prolonged effect, making it useful in dental procedures requiring sedation.

Answer 80

Thrombophlebitis | Due to addition of propylene glycol ## Footnote Thrombophlebitis is the inflammation of a vein.

Answer 81

0.5mg/Kg, up to 15mg per appointment.

Answer 82

* Adult and pediatric mild-moderate sedation >2h * Status Epilepticus * Anxiety Control (4-40mg) ## Footnote Status epilepticus is a medical emergency characterized by prolonged seizures

Answer 83

Synthetic Opioids ## Footnote Methadone is a synthetic opioid used primarily for pain management and in the treatment of opioid addiction.

Answer 84

Antagonist of NMDA glutamate receptors ## Footnote This mechanism contributes to its efficacy in pain management and in reducing opioid cravings.

Answer 85

* Torsade de Pointes * Vasodepressor Syncope * Severe hypotension ## Footnote These side effects highlight the importance of monitoring patients on Methadone for cardiovascular stability.

Answer 86

Type IB Fast Sodium Channel Blocker ## Footnote Primarily used to treat ventricular arrhythmias.

Answer 87

Competitive antagonist of the GABA receptor site of Benzodiazepines ## Footnote Flumazenil reverses the effects of benzodiazepines in cases of overdose or sedation.

Answer 88

* Apnea following Benzodiazepines use * Oversedation (unresponsive to painful stimuli)

Answer 89

Angiotensin-Converting Enzyme Inhibitor (ACEi)

Answer 90

GABA Analogs Anticonvulsants

Answer 91

Blockage of sodium channels and calcium channels in the CNS

Answer 92

Macrolides ## Footnote Macrolides are a class of antimicrobials

Answer 93

1st Generation Cephalosporins

Answer 94

α1 antagonist

Answer 95

Reverse soft tissue anesthesia

Answer 96

Same number of local anesthetic cartridges administered ## Footnote Up to 2 cartridges

Answer 97

2 cartridges

Answer 98

* Children <6 years * Children <15kg (33lbs)

Answer 99

Aminoglycosides

Answer 100

Monobactams (β-Lactams)

Answer 101

Aerobic Gram-negatives

Answer 102

H2 Receptor Blockers

Answer 103

Antiandrogen effect

Answer 104

Reversible Anticholinesterasics ## Footnote Edrophonium is used in the diagnosis of myasthenia gravis.

Answer 105

Reversible Anticholinesterasics ## Footnote Neostigmine is utilized for the treatment of myasthenia gravis.

Answer 106

Reversible Anticholinesterasics ## Footnote Physostigmine is often used to treat anticholinergic toxicity.

Answer 107

Reversible Anticholinesterasics ## Footnote Pyridostigmine is frequently prescribed for myasthenia gravis.

Answer 108

Reversible Anticholinesterasics ## Footnote Tacrine was one of the first medications used for Alzheimer's disease.

Answer 109

Reversible Anticholinesterasics ## Footnote Donepezil is commonly used for treating Alzheimer's disease.

Answer 110

Calcium Channel Blockers (CCBs) ## Footnote Verapamil is used to treat hypertension and certain types of angina.

Answer 111

Hydantoins Anticonvulsants ## Footnote Phenytoin is primarily used to control seizures.

Answer 112

1st Generation H1 Receptor Blockers ## Footnote Diphenhydramine is used to treat allergies, insomnia, and motion sickness.

Answer 113

* Local anesthesia for allergic patients * Hypersensitivity Reactions

Answer 114

* Oral 50mg 3-4x per day for 2-3 days * IV 50mg * IM 50mg

Answer 115

Direct Vasodilators ## Footnote Hydralazine is used to treat hypertension.

Answer 116

Aldosterone Antagonists **Potassium Sparing Diuretics** ## Footnote Spironolactone is used for conditions like heart failure and hypertension.

Answer 117

Antiemetics ## Footnote Metoclopramide is used to treat nausea and gastroparesis.

Answer 118

Blocks Dopamine-2 and serotonin 5-HT3 receptors in the chemoreceptor trigger zone ## Footnote This action helps reduce nausea and vomiting.

Answer 119

Inhibits vesicular uptake of Norepinephrine, Serotonin, and Dopamine

Answer 120

β2-adrenergic Agonists

Answer 121

Albuterol (Salbutamol)

Answer 122

Factor Xa Inhibitors

Answer 123

Loop Diuretics

Answer 124

Sodium Channel Blockers** Potassium Sparing Diuretics**

Answer 125

1st Generation Cephalosporins

Answer 126

Aminoglycosides

Answer 127

1st Generation Cephalosporins

Answer 128

1st Generation H1 Receptor Blockers

Answer 129

50-100mg 1h before procedure

Answer 130

0.5-1mg/Kg 1h, up to 30mg/appointment

Answer 131

25mg 3-4x per day

Answer 132

1st Generation Cephalosporins

Answer 133

Macrolides ## Footnote Macrolides are a class of antimicrobials

Answer 134

500mg 1h before procedure

Answer 135

15mg/kg 1h before procedure ## Footnote This dose is different from the typical antimicrobial dose for children

Answer 136

500mg on day 1, then 250mg 1x per day for 4 days

Answer 137

Up to 12mg/kg on day 1, then up to 6mg/kg per day for 4 days ## Footnote This is different from the recommende dose for infective endocarditis

Answer 138

500mg 1x per day for 4-7 days

Answer 139

β2-adrenergic Agonists

Answer 140

Calcium Channel Blockers (CCBs)

Answer 141

Direct Vasodilators

Answer 142

Aldosterone Antagonists **Potassium Sparing Diuretics**

Answer 143

H2 Receptor Blockers

Answer 144

GABA Analogs Anticonvulsants

Answer 145

Sodium Channel Blockers **Potassium Sparing Diuretics**

Answer 146

Factor Xa Inhibitors

Answer 147

1st Generation H1 Receptor Blockers

Answer 148

Loop Diuretics

Answer 149

2nd Generation Cephalosporins

Answer 150

Calcium Channel Blockers (CCBs)

Answer 151

2nd Generation Cephalosporins

Answer 152

Loop Diuretics

Answer 153

H2 Receptor Blockers

Answer 154

Factor Xa Inhibitors

Answer 155

H2 Receptor Blockers

Answer 156

1st Generation H1 Receptor Blockers ## Footnote Used for conditions such as allergies and motion sickness

Answer 157

25mg ## Footnote This dosage is used in dental settings

Answer 158

Loop Diuretics ## Footnote Used for conditions like edema and hypertension

Answer 159

Factor Xa Inhibitors ## Footnote Used for anticoagulation

Answer 160

Calcium Channel Blockers (CCBs) ## Footnote CCBs are used to treat hypertension and angina

Answer 161

Angiotensin-Converting Enzyme Inhibitors (ACEi) ## Footnote ACE inhibitors are commonly used for hypertension and heart failure

Answer 162

2nd Generation H1 Receptor Blockers ## Footnote Used for allergy relief

Answer 163

2nd Generation Cephalosporins ## Footnote Used to treat bacterial infections

Answer 164

2nd Generation H1 Receptor Blockers ## Footnote Another option for allergy treatment

Answer 165

Calcium Channel Blockers (CCBs) ## Footnote Often used for hypertension and angina

Answer 166

Factor Xa Inhibitors

Answer 167

3rd Generation Cephalosporins ## Footnote Effective against a broader range of bacteria

Answer 168

2nd Generation H1 Receptor Blockers

Answer 169

3rd Generation Cephalosporins ## Footnote Known for its broad-spectrum activity

Answer 170

4th Generation Cephalosporins ## Footnote Used for more resistant bacterial infections, specially Pseudomonas aeruginosa

Answer 171

4th Generation Cephalosporins ## Footnote Used for more resistant bacterial infections, specially Pseudomonas aeruginosa

Answer 172

* Paget's Disease of Bone * Osteoporosis ## Footnote Oral bisphosphonates include Alendronate, Etidronate, Risedronate, Tiludronate, and Ibandronate.

Answer 173

Intravenous | Compared to Oral

Answer 174

* Malignancies * Paget's Disease of Bone

Answer 175

Pamidronate, Zoledronic Acid and Clodronate ## Footnote 🧠**PAM**'s **ZO**o **CL**ouds

Answer 176

Anti-Parkinson's Drugs ## Footnote Levodopa is converted into dopamine in the brain.

Answer 177

Carbidopa ## Footnote It inhibits the peripheral decarboxylation and inactivation of Levodopa

Answer 178

Inhibition the peripheral decarboxylation and inactivation of Levodopa ## Footnote It is always administered with Levodopa to prevent its inactivation

Answer 179

Dopamine cannot cross the blood-brain barrier.

Answer 180

Non-selective β-Blockers

Answer 181

Cardioselective β1-Blockers

Answer 182

Non-selective β agonists

Answer 183

Combined α and β blockers

Answer 184

Ganglionic Blockers

Answer 185

α1 Blockers

Answer 186

Corticosteroids

Answer 187

α1 Agonists

Answer 188

β1 Agonists

Answer 189

α2 Agonists

Answer 190

Antisialogogues (Inhibition of Salivation)

Answer 191

Type IA Fast Sodium Channel Blocker **Antiarrhythmic**

Answer 192

β2 Agonists

Answer 193

Synthetic Opioids ## Footnote It is used as an **anti-diarrheal** that **does not cross the blood-brain** barrier

Answer 194

GABA Analogs Anticonvulsants

Answer 195

Thioxanthines **1st Generation Antipsychotics**

Answer 196

Sulfonamides

Answer 197

Thiazide Diuretics

Answer 198

Direct Agonist of Muscarinic Receptors

Answer 199

Treatment of Xerostomia in Sjögren's Syndrome and during radiotherapy

Answer 200

Butyrophenones 1st Generation Antipsychotics ## Footnote Haloperidol is primarily used to treat schizophrenia and acute psychosis.

Answer 201

Type IC Fast Sodium Channel Blocker **Antiarrhythmic**

Answer 202

Tricyclic antidepressants ## Footnote Amitriptyline is commonly prescribed for depression and certain types of pain.

Answer 203

Amitriptyline ## Footnote Anticholinergic effects can lead to dry mouth and other side effects.

Answer 204

2nd Generation Antipsychotics ## Footnote Risperidone is often used to treat schizophrenia, bipolar disorder, and irritability associated with autism.

Answer 205

Proton Pump Inhibitors ## Footnote Omeprazole is used to treat gastroesophageal reflux disease (GERD) and other conditions involving excess stomach acid.

Answer 206

Antimuscarinics ## Footnote Atropine is used in various medical settings, including as an antidote for certain types of poisoning.

Answer 207

Bradycardia in Medical Emergency setting (IM or IV 0.6mg)

Answer 208

Inhibits Release of norepinephrine from sympathetic neurons ## Footnote This action helps reduce blood pressure and is used in hypertension treatment.

Answer 209

Angiotensin Receptor Blockers ## Footnote Used to treat high blood pressure.

Answer 210

Monoamine Oxidase Inhibitors (MAOi) ## Footnote Used for treating depression.

Answer 211

* Intravenous * Inhalation

Answer 212

Pharmacokinetic process where the rate of elimination is directly proportional to the concentration of the drug in the body ## Footnote This means that as the concentration of the drug decreases, the rate of elimination also decreases.

Answer 213

Time required for the concentration of a drug in the body to decrease by half ## Footnote It serves the purpose of estimating how long a drug stays active in the body.

Answer 214

~4 half-lives

Answer 215

Inhalation Anesthetics

Answer 216

Anti-Herpes Antivirals

Answer 217

Inhibits herpesvirus DNA polymerase and viral replication

Answer 218

* Intravenous * Subcutaneous ## Footnote It **is not** administered orally

Answer 219

* Inhibits thrombin (factor IIa) * Inhibits factor Xa (Stuart-Power Factor) * Stimulates antithrombin III

Answer 220

Protamine Sulfate

Answer 221

Schedule surgery at least** 6 hours** after administration

Answer 222

Schedule surgery at least **24 hours **after administration

Answer 223

* Increased aPTT * Increased Thrombin Time * Decreased Anti-factor Xa\

Answer 224

2nd Generation Antipsychotics

Answer 225

Monoamine Oxidase Inhibitors (MAOIs)

Answer 226

Combined α and β blockers

Answer 227

Leukotriene Synthesis Inhibitors

Answer 228

Inhibit factor Xa

Answer 229

Subcutaneous

Answer 230

* Increased Thrombin Time * Decreased Anti-factor Xa

Answer 231

1-2 days before

Answer 232

Low Molecular Weight Heparins

Answer 233

α1 Blockers

Answer 234

HMG-CoA Reductase Inhibitors (Statins)

Answer 235

Opioid receptors antagonist ## Footnote Mostly to μ receptors.

Answer 236

To reverse overdose by Opioids

Answer 237

* Nasal * Subcutaneous * Intravenous * Intramuscular

Answer 238

Intramuscular

Answer 239

Sulfonamides

Answer 240

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Answer 241

Corticosteroids

Answer 242

COMT Inhibitors ## Footnote Used as Anti-Parkinson's Drugs

Answer 243

Phenothiazines **1st Generation Antipsychotics**

Answer 244

Pharmacokinetic process where a constant amount of a drug is eliminated per unit of time regardless of its concentration in the body.

Answer 245

Greater risk of drug accumulation

Answer 246

* Warfarin * Alcohol * Aspirin * Theophylline * Tolbutamide * Phenytoin ## Footnote 🧠Zero **WAATT** **P**ower

Answer 247

Type IC Fast Sodium Channel Blockers (FSCB)

Answer 248

Blocks viral DNA polymerase, inhibiting DNA synthesis ## Footnote This action is crucial for preventing the replication of herpes viruses.

Answer 249

Anti-Herpes Antivirals

Answer 250

400mg 2x per day ## Footnote This dosing helps prevent outbreaks in susceptible individuals and is to be used before the exposure to known triggers

Answer 251

400mg every 5 hours for 5 days ## Footnote Timely administration is key to effectively aborting the outbreak.

Answer 252

15mg/kg 5x per day ## Footnote This high frequency of dosing is necessary to combat the viral infection effectively.

Answer 253

800mg 5x per day ## Footnote Shingles treatment requires aggressive dosing to reduce symptoms and speed healing.

Answer 254

Antifungals

Answer 255

Binds to ergosterol in fungal cell membranes, forming pores that allow leaking and cell death

Answer 256

Topical ## Footnote Nystatin is commonly administered **topically only** for localized fungal infections. It has **no systemic absorption**

Answer 257

* Swish and swallow method * Soak denture overnight ## Footnote Oral administration does not result in drug absorption or systemic effects

Answer 258

* Nausea * Vomiting * Diarrhea * Stomach pain * Rash * Local irritation * Allergic reactions ## Footnote These are due to the local effects of the drug

Answer 259

Patients with Hyposalivation ## Footnote The high sucrose content in the suspension is a risk factor for dental caries

Answer 260

Swish-and-swallow: 1 **tea**spoon (5mL) of 100,000 U.I./mL suspension for 2 minutes 4x/day for 7-14 days

Answer 261

GABA Analogs, Anticonvulsants ## Footnote Lamotrigine is primarily used to treat epilepsy and bipolar disorder.

Answer 262

Inhibit Factor Xa (Stuart-Power Factor) ## Footnote This inhibition is crucial in the coagulation cascade.

Answer 263

* Increased PT/INR * Increased aPTT * Decreased Anti-factor Xa

Answer 264

Selective Serotonin Reuptake Inhibitors (SSRIs) ## Footnote Fluoxetine is commonly prescribed for depression and anxiety disorders.

Answer 265

Leukotriene Receptor Antagonists ## Footnote Montelukast is used to manage asthma and allergic rhinitis.

Answer 266

Angiotensin Receptor Blockers (ARBs) ## Footnote Eprosartan is used primarily to treat high blood pressure.

Answer 267

Tricyclic antidepressants ## Footnote Nortriptyline is used to treat depression and can also help with chronic pain.

Answer 268

Non-selective β-Blockers ## Footnote Timolol is often used in the treatment of glaucoma and hypertension.

Answer 269

Osmotic Diuretics ## Footnote Mannitol is used to reduce intracranial pressure and treat oliguric renal failure.

Answer 270

Type IA Fast Sodium Channel Blockers (FSCB) ## Footnote Quinidine is used primarily for the treatment of arrhythmias.

Answer 271

Alpha-Glucosidase Inhibitors ## Footnote Acarbose is used to manage postprandial blood glucose levels in diabetes.

Answer 272

Synthetic Opioids (used as anti-diarrheal) ## Footnote Contrasting with Loperamide, another opioid used for diarrhea, it **crosses the blood-brain barrier**.

Answer 273

Sulfonylureas ## Footnote Act by stimulating insulin release and reducing tissue insulin resistance

Answer 274

Carbonic Anhydrase Inhibitors ## Footnote Acetazolamide is often used to treat glaucoma and altitude sickness.

Answer 275

Non-depolarizing Neuromuscular Blockers ## Footnote Curare is historically used for muscle relaxation during surgery.

Answer 276

Antimuscarinics ## Footnote Scopolamine is commonly used to prevent motion sickness.

Answer 277

Thiazide Diuretics ## Footnote Hydrochlorothiazide is frequently prescribed for hypertension.

Answer 278

Glitazones ## Footnote Rosiglitazone is used in the management of type 2 diabetes by activating PPAR-γ receptors and **increasing tissue insulin sensitivity**

Answer 279

Proton Pump Inhibitors ## Footnote Esomeprazole is used to treat gastroesophageal reflux disease (GERD).

Answer 280

Ganglionic Blockers ## Footnote Mecamylamine can be used to control blood pressure.

Answer 281

Inhibitors of Mast Cell Degranulation ## Footnote Cromolyn is used primarily in the treatment of asthma.

Answer 282

Depolarizing Neuromuscular Blockers ## Footnote Succinylcholine is the **main agent used to facilitate endotracheal intubation for surgical anesthesia**.

Answer 283

Succinylcholine ## Footnote It's **main side effect is respiratory paralysis**

Answer 284

Ultra-Short acting **Barbiturates** ## Footnote Thiopental is often used for** induction of anesthesia.**

Answer 285

Non-selective α blockers ## Footnote Phenoxybenzamine is used primarily in the treatment of pheochromocytoma.

Answer 286

Direct Thrombin Inhibitors ## Footnote Dabigatran is **administered orally** and is used for anticoagulation.

Answer 287

Xanthines ## Footnote Aminophylline is used as a **bronchodilator in asthma treatment**.

Answer 288

α1 Agonists ## Footnote Tetrahydrozoline is commonly found in over-the-counter eye drops.

Answer 289

Amphetamines ## Footnote Dextroamphetamine is used to treat attention deficit hyperactivity disorder (ADHD).

Answer 290

β2 Agonists ## Footnote Salmeterol is used for the long-term control of asthma and chronic obstructive pulmonary disease (COPD).

Answer 291

Carbapenems (β-Lactams) ## Footnote Imipenem has the broadest spectrum among the β-Lactams.

Answer 292

Anti-tuberculosis Drugs

Answer 293

Inhibition of the synthesis of mycolic acids ## Footnote It is effective against Mycobacterium tuberculosis and Mycobacterium kansasii

Answer 294

* Xerostomia * Peripheral neuritis * Hepatotoxicity * Allergy * Epigastric distress * Hematologic reactions * Convulsion in susceptible patient

Answer 295

Azole Antifungals ## Footnote Fluconazole is used for treating systemic fungal infections.

Answer 296

100mg 1x per day for 7-14 days ## Footnote This dosage is specifically for **immunocompromised** patients.

Answer 297

Cardioselective β1-Blockers ## Footnote Acebutolol is primarily used for cardiovascular conditions.

Answer 298

α2 Agonists ## Footnote Methyldopa is often used in the treatment of hypertension.

Answer 299

Direct Agonist of Muscarinic Receptors ## Footnote Cevimeline is used in the treatment of xerostomia in Sjögren's syndrome.

Answer 300

Treatment of **xerostomia** in Sjögren's syndrome

Answer 301

Biguanides ## Footnote Metformin is primarily used for managing type 2 diabetes and act by **decreasing hepatic gluconeogenesis**

Answer 302

Inhibits tyrosine hydroxylase, reducing catecholamine synthesis ## Footnote This action decreases the production of catecholamines, which can be useful in certain conditions.

Answer 303

Neuronal Depleting Sympatholytics | Inhibits tyrosine hydroxylase, **reducing catecholamine synthesis** ## Footnote Metyrosine is used in the management of pheochromocytoma.

Answer 304

Inhalation Anesthetics ## Footnote Sevoflurane is commonly used for induction and maintenance of general anesthesia.

Answer 305

Direct Agonist of Muscarinic Receptors ## Footnote Carbachol is used in ophthalmology to induce miosis.

Answer 306

Low Molecular Weight Heparins ## Footnote Dalteparin is used for the prevention and treatment of thromboembolic disorders.

Answer 307

Type IA Fast Sodium Channel Blockers (FSCB) ## Footnote Disopyramide is primarily used for the treatment of ventricular arrhythmias.

Answer 308

GABA Analogs Anticonvulsants ## Footnote Topiramate is used in the management of epilepsy and migraine prophylaxis.

Answer 309

HMG-CoA Reductase Inhibitors (Statins) ## Footnote Pravastatin is used to lower cholesterol levels in the blood.

Answer 310

Antimuscarinics ## Footnote Glycopyrrolate is used in dentistry for **ptyalism (hypersalivation)** at doses of **1-2mg**.

Answer 311

Thrombin antagonists

Answer 312

* NSAIDs * Aspirin * High doses of Acetaminophen* * Warfarin * Heparin ## Footnote *High-dose of Acetaminophen: ≥1.3g for over 10 days

Answer 313

* Increased INR/PT * Increased aPTT * Increased Thrombin Time

Answer 314

**No adaptation **is needed other than additional hemostasis procedures.

Answer 315

Ultra-Short acting **Barbiturates**

Answer 316

Inhibition on COX-2 in the CNS and peripherally

Answer 317

* Analgesia * Antipyresis

Answer 318

* Nausea * Vomiting * Headaches * Insomnia * Dose-dependent hepatotoxicity * Hypersensitivity reactions

Answer 319

* Severe or active liver disease * History of hypersensitivity reaction

Answer 320

* Alcohol * β Blockers * Barbiturates * Isoniazid * Phenytoin

Answer 321

Acetaminophen

Answer 322

Acetaminophen

Answer 323

10-15mg/kg up to 4x/day to a maximum of 75mg/kg or 2.6g

Answer 324

* β-Lactams * Aminoglycosides * Metronidazole * Fluorquinolones * Vancomycin * Bacitracin * Polymyxin * Rifampin ## Footnote 🧠 It is better to memorize the bactericidal antibiotics. **Bacteriostatic Antibiotics:** * Clindamycin* * Macrolides* * Tetracyclines * Chloramphenicol * Trimethoprim & Sulfamethoxazole * Others: Streptogramins, Spectinomycin *Clindamycin and Macrolides can be bactericidal depending on dose and specific microbe species

Answer 325

Proton Pump Inhibitors

Answer 326

Leukotriene Receptor Antagonists

Answer 327

Combined α and β blockers

Answer 328

Non-selective β-Blockers

Answer 329

Cardioselective β1-Blockers

Answer 330

Anti-tuberculosis Drugs

Answer 331

Inhibition of DNA-dependent RNA polymerase of bacteria

Answer 332

* Red-orange color of fluids * Mouth and tongue soreness * Hemolysis and thrombocytopenia * Flu-like symptoms * Hepatotoxicity * Nephrotoxicity * Gastrointestinal disturbances * Suppression of T-lymphocytes * Neurologic disorders * Allergic reactions

Answer 333

α1 Agonists

Answer 334

COMT Inhibitors ## Footnote Typically used as Anti-Parkinson's Drugs

Answer 335

Sulfonylureas ## Footnote Act by stimulating insulin release and reducing tissue insulin resistance

Answer 336

Carbonic Anhydrase Inhibitors

Answer 337

Angiotensin Receptor Blockers (ARBs)

Answer 338

Osmotic Diuretics

Answer 339

Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer 340

300-600mg 4x per day

Answer 341

up to 12mg/kg 4x per day

Answer 342

Monoamine Oxidase Inhibitors (MAOIs)

Answer 343

Azole Antifungals

Answer 344

Irreversible liver damage and jaundice

Answer 345

≥3 weeks

Answer 346

Alpha-Glucosidase Inhibitors ## Footnote Reducing starch breakdown in the gastrointestinal tract, thus reducing the absorption of carbohydrates

Answer 347

Direct Thrombin Inhibitors

Answer 348

Corticosteroids

Answer 349

Phenothiazines** 1st Generation Antipsychotics**

Answer 350

Non-depolarizing Neuromuscular Blockers

Answer 351

2nd Generation Antipsychotics

Answer 352

Sulfonamides

Answer 353

Anti-Herpes Antivirals

Answer 354

2g 2x per day for 1 day ## Footnote Must be initiated at the first prodrome sign

Answer 355

Inhibits hepatic synthesis of vitamin K-dependent clotting factors: * II * VII * IX * X * Protein C * Protein S * Prothrombin

Answer 356

* II * VII * IX * X * Protein C * Protein S * Prothrombin

Answer 357

* Other anticoagulant drugs * **Metronidazole**, **Macrolides**, Penicillins * **Azole Antifungals** * Aspirin, NSAIDs, Corticosteroids, High dose of Acetaminophen * **SSRIs** * **Cimetidine** * **Barbiturates** * Garlic, Ginkgo Biloba, Dong Quai * Statins * Sitagliptin * Chloral Hydrate * Valproic Acid

Answer 358

* Barbiturates * Carbamazepine * Phenytoin * St. John's Wort * Rifampicin * Griseofulvin

Answer 359

* Increased INR /PT * Increased aPTT * Reduced anti-factor Xa

Answer 360

**Hospital** administration of coagulation factors in blood or plasma

Answer 361

Vitamin K ## Footnote It takes **48-72h** for the antagonistic effects to take place, thus **Vitamin K is not used for emergency reversal of Warfarin**

Answer 362

Acetaminophen

Answer 363

Glitazones ## Footnote **Increase tissue sensitivity to Insuline** by activating PPAR-γ receptors

Answer 364

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Answer 365

Inhibitors of Mast Cell Degranulation

Answer 366

Inhalation Anesthetics

Answer 367

Tricyclic antidepressants

Answer 368

α1 Blockers

Answer 369

Thiazide Diuretics

Answer 370

Inhalation Anesthetics

Answer 371

Anti-staphylococcal **Penicillins** | It is **penicillinase resistant** ## Footnote It its acid-stable, thus **can be administed orally**

Answer 372

Sulfonylureas ## Footnote Act by stimulating insulin release and reducing tissue insulin resistance

Answer 373

Anti-tuberculosis Drugs

Answer 374

Medication that acts as a mucolytic agent and antioxidant, **commonly used to treat Acetaminophen overdose** and to improve lung function in certain respiratory conditions ## Footnote N-Acetylcisteine is often used in emergency medicine for its **protective effects on the liver**.

Answer 375

2nd Generation Antipsychotics ## Footnote Aripiprazole is used to treat schizophrenia and bipolar disorder.

Answer 376

Cardioselective β1-Blockers ## Footnote Labetalol is often used to treat high blood pressure.

Answer 377

Non-depolarizing Neuromuscular Blockers ## Footnote Atracurium is used during surgical procedures for muscle relaxation.

Answer 378

Non-selective β-Blockers ## Footnote Pindolol is used in the treatment of hypertension and angina.

Answer 379

* Garlic * Ginger * Ginkgo Biloba * Ginseng * Willow * Dong Quai ## Footnote These supplements may interact with blood-thinning medications.

Answer 380

Monoamine Oxidase-B Inhibitor (MAO-B inhibitor) ## Footnote Selegiline is used to manage symptoms of Parkinson's disease.

Answer 381

Corticosteroids ## Footnote Fluticasone is used to treat allergic rhinitis and asthma.

Answer 382

Low Molecular Weight Heparins ## Footnote Certoparin is used for the prevention and treatment of thromboembolic disorders.

Answer 383

Tetracyclines

Answer 384

Inhibition of the production of MMP-1 and MMP-8 ## Footnote This action is significant in managing conditions involving bone remodeling, such as periodontitis

Answer 385

100mg 1-2x/day for 21 days

Answer 386

* Treatment of Orofacial infections * Host modulation in chronic periodontitis patient (sub-antimicrobial dose) * Locally-acting antimicrobial in chronic periodontitis

Answer 387

20mg 2x/day for **9 months**

Answer 388

**Host modulation** in chronic periodontitis patient | Dose of 20mg 2x/day for **9 months**

Answer 389

Tricyclic antidepressants ## Footnote Imipramine is used to treat depression and certain anxiety disorders.

Answer 390

Amphetamines ## Footnote Methylphenidate is commonly prescribed for Attention Deficit Hyperactivity Disorder (ADHD).

Answer 391

Selective Serotonin Reuptake Inhibitors (SSRIs) ## Footnote Sertraline is used to treat depression, anxiety, and obsessive-compulsive disorder.

Answer 392

HMG-CoA Reductase Inhibitors (Statins) ## Footnote Sinvastatin is used to lower cholesterol levels.

Answer 393

Angiotensin Receptor Blockers (ARBs) ## Footnote Valsartan is used to treat high blood pressure and heart failure.

Answer 394

Antimuscarinics ## Footnote Propantheline is used to **reduce salivation** and treat gastrointestinal disorders.

Answer 395

Ptyalism (Hypersalivation) - 7.5-15mg

Answer 396

Ultra-Short acting **Barbiturates**

Answer 397

Sulfonamides

Answer 398

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Answer 399

Phenothiazines **1st Generation Antipsychotics**

Answer 400

Anti-Herpes Antivirals

Answer 401

250mg 2x per day ## Footnote To be used when exposure to known trigger factors is expected

Answer 402

Single 1500mg dose | To be employed at first prodrome sign

Answer 403

Direct Thrombin Inhibitors

Answer 404

α1 Blockers

Answer 405

Antimuscarinics

Answer 406

Ptyalism (10-20mg)

Answer 407

* Penicillin G * Metronidazole * Clindamycin * Vancomycin * Macrolides * Monobactams ## Footnote 🧠

Answer 408

Antimuscarinics

Answer 409

Antimuscarinics

Answer 410

Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Answer 411

Sulfonamides

Answer 412

Sulfonylureas ## Footnote Act by stimulating insulin release and reducing tissue insulin resistance

Answer 413

Anti-staphylococcal **Penicillins** ## Footnote It is **penicillinase resistant** It its acid-stable can be **administed orally**

Answer 414

Tricyclic antidepressants

Answer 415

Desipramine

Answer 416

Superinfection | May impair coagulation due to poor vitamin K metabolism by gut microbes ## Footnote Superinfection occurs when antibiotic therapy disrupts normal flora, allowing opportunistic infections to occur.

Answer 417

HMG-CoA Reductase Inhibitors (Statins)

Answer 418

Antimuscarinics ## Footnote Typically used as Anti-Parkinson's Drugs

Answer 419

Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer 420

Direct Thrombin Inhibitors

Answer 421

Amphetamines

Answer 422

Hypotension in Medical Emergencies | * IV 5mg * IM 10-25mg

Answer 423

Non-depolarizing Neuromuscular Blockers

Answer 424

Cardioselective β1-Blockers

Answer 425

Tetracyclines

Answer 426

Short acting **Barbiturates**

Answer 427

Anti-tuberculosis Drugs

Answer 428

Impairs bacterial metabolism and ceases multiplication

Answer 429

Azole Antifungals

Answer 430

200mg 1x per day for 7-14 days

Answer 431

Glycopeptides

Answer 432

Inhibits bacterial Cell Wall phospholipid synthesis of Gram-positive bacteria

Answer 433

* Oral * Intravenous

Answer 434

* Nausea, vomiting * Bitter taste, mouth irritation * Ototoxicity, vertigo, tinnitus * Nephrotoxicity * Red Neck Syndrome

Answer 435

* Ototoxicity and nephrotoxicity increased by Aminoglycosides and Aspirin * Enhances neuromuscular blockade by Non-depolarizing Neuromuscular Blockers

Answer 436

* Pseudomembranous Colitis caused by Clostridium difficile * MRSA infection

Answer 437

Angiotensin Receptor Blockers (ARBs)

Answer 438

Inhalation Anesthetics

Answer 439

Phenothiazines **1st Generation Antipsychotics**

Answer 440

Dipeptidyl peptidase-4 (DPP-4) inhibitor

Answer 441

* Increase of incretin levels * Increase of insulin secretion * Reduction of glucagon secretion

Answer 442

* Hypoglycemia * Pancreatitis * Upper respiratory infection, Nasopharyngitis * Headache * Nausea, abdominal pain, diarrhea

Answer 443

* Effects increased by Corticosteroids * Increased risk for nephrotoxicity with NSAIDs * Altered glucose metabolism by Vasoconstrictors in Local Anesthetics

Answer 444

Phenothiazines **1st Generation Antipsychotics**

Answer 445

GLP-1 receptor agonist

Answer 446

* Enhances glucose-dependent Insulin secretion * Suppresses Glucagon Release * Slows gastric emptying * Promotes satiety

Answer 447

* Personal or family history of medullary thyroid carcinoma * MEN-2A or MEN-2B * History of pancreatitis * Severe gastrointestinal disease

Answer 448

Antimuscarinics ## Footnote Typically used as Anti-Parkinson's Drugs

Answer 449

Short acting **Barbiturates**

Answer 450

Azole Antifungals

Answer 451

Cardioselective β1-Blockers

Answer 452

Amphetamines

Answer 453

Anti-staphylococcal **Penicillins** ## Footnote It is **penicillinase resistant** It its acid-stable can be **administed orally**

Answer 454

Non-depolarizing Neuromuscular Blockers

Answer 455

Non-steroidal anti-inflammatory drugs (NSAIDs) | Salicylic Acid Derivative, similar to Aspirin

Answer 456

Analgesia: 1st dose of 1000mg, then 500mg 2x/day

Answer 457

Direct Thrombin Inhibitors

Answer 458

* Glycopyrrolate (1-2mg) * Propantheline (7.5-15mg) * Dicyclomine (10-20mg) * Atropine * Clonidine

Answer 459

Azole Antifungals

Answer 460

Anti-staphylococcal **Penicillins** ## Footnote It is **penicillinase resistant** It its acid-stable can be **administed orally**

Answer 461

Direct Thrombin Inhibitors ## Footnote Desirudin is used in the prevention of thromboembolic events.

Answer 462

Amphetamines ## Footnote Phentermine is often prescribed for weight loss.

Answer 463

Intermediate acting **Barbiturates** ## Footnote Amobarbital is utilized for sedation and anxiety relief.

Answer 464

Non-depolarizing Neuromuscular Blockers ## Footnote Doxacurium is used in anesthesia to induce muscle relaxation.

Answer 465

Non-steroidal anti-inflammatory drugs (NSAIDs) | Propionic Acid Derivative ## Footnote Ibuprofen is commonly used for its analgesic and anti-inflammatory properties.

Answer 466

200-600mg 4-6x/day up to a daily maximum of 2400mg | As per **Canadian Guidelines**

Answer 467

5-10mg/kg 4-6x/day | As per **Canadian Guidelines**

Answer 468

Selective Serotonin Reuptake Inhibitors (SSRIs) ## Footnote Escitalopram is commonly prescribed for depression and anxiety disorders.

Answer 469

Proportion of a drug that reaches the general circulation in comparison to the total amount administered ## Footnote The only route of administration that has 100% Bioavailability is Intravenous.

Answer 470

Intravenous

Answer 471

Amphetamines

Answer 472

Agonist of α1, α2, β1 and β2 receptors

Answer 473

* Positive chronotropic and inotropic effects on heart * Increased blood pressure * Skin, mucosa and gut vasoconstriction * Increase in blood glucose through glycogenolysis and gluconeogenesis * Lipolysis * Bronchodilation

Answer 474

* Headaches * Agitation, anxiety * Tachycardia

Answer 475

* Increased blood pressure * Secondary bradycardia

Answer 476

Intravenous, Intramuscular

Answer 477

0.3-0.5mg, 1:1.000 dilution

Answer 478

0.3-0.5mg, 1:1.000 dilution

Answer 479

0.01-0.1mg, 1:10.000 dilution

Answer 480

0.01mg/Kg, 1:10.000 dilution

Answer 481

1mg, 1:10.000

Answer 482

0.01-0.1mg, 1:10.000 dilution

Answer 483

0.01mg/Kg (up to 0.3mg per dose), 1:1000 dilution

Answer 484

0.01mg/Kg (up to 0.3mg per dose), 1:1000 dilution

Answer 485

0.3mg | 1:1000 dilution

Answer 486

0.15mg | 1:2000 dilution

Answer 487

Phenomenon where Epinephrine acts as a vasodilator in the presence of α1 Blockers due to activation of β2 receptors

Answer 488

Intermediate acting **Barbiturates**

Answer 489

Anti-staphylococcal **Penicillins** ## Footnote It is **penicillinase resistant** It its acid-stable can be **administed orally**

Answer 490

Vancomycin

Answer 491

Direct Thrombin Inhibitors

Answer 492

Non-steroidal Anti-inflammatory Drugs (NSAIDs) | Propionic Acid Derivative

Answer 493

1st dose of 500mg, then 250mg 3-4x per day to a daily maximum of 1250mg

Answer 494

Long acting **Barbiturates**

Answer 495

Extended-spectrum Amino**penicillins**

Answer 496

* Amoxicillin * Penicillin VK

Answer 497

Oral 2g, 60min. before the procedure

Answer 498

Non-steroidal Anti-inflammatory Drug (NSAIDs) | Acetic Acid Derivative

Answer 499

Theoretical volume that would be necessary to contain the total amount of an administered drug at the same concentration observed in the blood plasma ## Footnote A high volume of distribution indicates that a drug is highly tissue-bound, whereas a low volume of distribution indicates that a drug mostly remains in the circulation

Answer 500

Drug is highly tissue-bound

Answer 501

Drug remains mostly in the circulation

Answer 502

Long acting **Barbiturates**

Answer 503

Extended-spectrum Amino**penicillins**

Answer 504

Ampicillin

Answer 505

Lincosamide antimicrobials

Answer 506

Reversibly binds to **50S** subunit of bacterial ribosomes, **inhibiting protein synthesis**

Answer 507

* Abdominal pain * Diarrhea * Nausea and vomiting * Metallic taste * Pseudomembranous Colitis * Myelosuppression and blood dyscrasias * Nephrotoxicity * Neuromuscular blockade

Answer 508

* Less than 2 months since Pseudomembranous Colitis or Clostridium difficile-associated diarrhea * Patients receiving Non-depolarizing Neuromuscular Blockers

Answer 509

Non-depolarizing Neuromuscular Blockers

Answer 510

150-300mg 4x per day

Answer 511

Long acting **Barbiturates**

Answer 512

Non-steroidal Anti-inflammatory Drugs (NSAIDs) | Acetic Acid Derivative

Answer 513

40mg for up to 5 days

Answer 514

Extended-spectrum **Penicillins**

Answer 515

Reversible bind to bacterial **50S** ribosomal subunit, inhibiting protein synthesis

Answer 516

* Nausea * Vomiting * Diarrhea * Glossitis * **Stomatitis** * **Aplastic Anemia** * **Leukopenia** * **Thrombocytopenia** * **Gray Baby Syndrome**

Answer 517

* Pregnancy and Breastfeeding * Bone marrow suppression * History of aplastic anemia * Newborns due to risk of Gray Baby Syndrome

Answer 518

NSAIDs : Acetic Acid Derivative

Answer 519

Extended-spectrum **Penicillins**

Answer 520

The effects of the bactericidal antibiotics are inhibited by the bacteriostatic antibiotics

Answer 521

Induction of metabolites in the bacterial cell that interfere with DNA synthesis

Answer 522

* 1st trimester of Pregnancy (Teratogeny) * Patient taking Warfarin (Increased INR) * Patient taking Lithium * Alcohol consumption (Dissulfiram effect) * Seizure disorders (Increased risk) * Liver impairment

Answer 523

Increases INR ## Footnote This can increase the risk of bleeding.

Answer 524

Decreased effects of Oral contraceptives ## Footnote Patients must be advised to employ alternative contraceptive methods during treatment with Metronidazole

Answer 525

* Lithium * Phenytoin * Carbamazepine

Answer 526

* Abdominal cramps * Diarrhea * Nausea * Vomiting * Metallic taste * Hyposalivation and Xerostomia * Furry tongue * Glossitis * Dark urine * Leukopenia * Pancreatitis * Peripheral neuropathy * Alteration of the T wave in the electrocardiogram * Seizure

Answer 527

* Alternative to patient allergic to Penicillins for Odontogenic Infections * Molar-Incisor Pattern Periodontitis * Necrotizing Periodontal Diseases

Answer 528

250-500mg 3x per day

Answer 529

500mg 3x per day for 8 days ## Footnote 250mg 3x per day for 8 days is the dose if associated with Amoxicillin, which is used 500mg 3x/day for 8 days

Answer 530

Systemic disease Pseudomembranous Colitis ## Footnote This highlights its importance in treating specific systemic conditions.

Answer 531

250mg 3x per day for 8 days | Associated Amoxicillin dose is 500mg 3x/day for 8 days ## Footnote It may be used as an isolated agent in the dose of 500mg 3x per day for 8 days

Answer 532

500mg 3x per day for 8 days | Same as for Molar-Incisor Pattern Periodontitis as isolated agent

Answer 533

Non-steroidal Anti-inflammatory Drugs (NSAIDs) | Acetic Acid Derivative

Answer 534

Extended-spectrum **Penicillins**

Answer 535

A drug that competes with the agonist for the **same binding site**, binding without activating the receptor ## Footnote It causes a **shift of the dose-response curve to the right**, but the **maximum response may be reached by increasing the concentration of the agonist**

Answer 536

Shift to the right ## Footnote This indicates that a higher concentration of agonist is required to achieve the same effect.

Answer 537

* At risk for Infective Endocarditis * Blood glucose level of 200-300mg/dL * HIV-positive patient with CD4+ count <200μL * End-Stage Kidney Disease * Advanced Leukemia or Lymphoma * Organ Transplantation undergoing immunosuppressive therapy * Moderate Neutropenia to Severe Neutropenia

Answer 538

* Any procedure involving manipulation of gingival or periapical tissues * Perforation of oral mucosa * Scaling and Root Planning * Dental Prophylaxis with expected intense bleeding * Orthodontic band placement * Intraligamentary or intraosseous local anesthesia ## Footnote **Local anesthesia through non-infected tissue does not require prophylaxis.**

Answer 539

Amoxicillin 2g Orally ## Footnote **Alternatives:** * IM/IV : Ampicillin 2g * Patient allergic to penicillins: Cephalexin 2g, Azithromycin/Clarithromycin 500mg, Doxycycline 100mg * IM/IV for Patient allergic to penicillins: Cefazolin 1g, Ceftriaxone 2g

Answer 540

Ampicillin 2g IM or IV ## Footnote **Alternatives** * IM/IV for Patient allergic to penicillins: Cefazolin 1g, Ceftriaxone 2g

Answer 541

* Oral Cephalexin 2g * Oral Azithromycin 500mg * Oral Clarithromycin 500mg * Oral Doxycycline 100mg ## Footnote **Alternatives:** * IM/IV for Patient allergic to penicillins: Cefazolin 1g, Ceftriaxone 2g

Answer 542

* Cefazolin 1g IV or IM * Ceftriaxone 2g IV or IM

Answer 543

Oral Amoxicillin 50mg/Kg ## Footnote **Alternatives:** * IM/IV : Ampicillin 50mg/Kg * Patient allergic to penicillins: Cephalexin 50mg/Kg, Azithromycin/Clarithromycin 15mg/Kg, Doxycycline 4.4mg/Kg or 100mg * IM/IV for Patient allergic to penicillins: Cefazolin 50mg/Kg, Ceftriaxone 50mg/Kg

Answer 544

* Oral Cephalexin 50mg/Kg * Oral Azithromycin 15mg/Kg * Oral Clarithromycin 15mg/Kg * Oral Doxycycline (2.2mg/Kg if ≤45kg; 100mg if ≥45kg) ## Footnote **Alternatives:** * IM/IV for Patient allergic to penicillins: Cefazolin 50mg/Kg, Ceftriaxone 50mg/Kg

Answer 545

* Cefazolin 50mg/Kg * Ceftriaxone 50mg/Kg

Answer 546

Administer the dose up to 2 hours after the procedure

Answer 547

Choose a different class for the antibiotic prophylaxis ## Footnote This prevents resistance and ensures effectiveness.

Answer 548

Administer a second dose of the same drug, if possible

Answer 549

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Answer 550

Competes with the agonist for a different binding site, affecting the overall efficacy of the agonist. ## Footnote **Shifts the dose-response curve down**, which means the **maxmimum effect cannot be achieved** despite increases of agonist concentration

Answer 551

Shifts it down ## Footnote This means the **maxmimum effect cannot be achieved** despite increases of agonist concentration

Answer 552

**NSAIDs** with analgesic and anesthetic effects used **topically** in mouthwashes to **relieve pain** associated with **Shifts the dose-response curve down**, which means the **maxmimum effect cannot be achieved** despite increases of agonist concentration

Answer 553

A drug's effectiveness based on the amount required to produce a desired effect | The desired effect is standardized as 50% of the maximal effect (EC50) ## Footnote Potency is primarily **influenced by a drug's affinity** for its target.

Answer 554

Ratio that compares the lethal dose (LD50) of a drug to its effective dose (ED50), indicating the safety margin of the drug | Therapeutic Index = LD50/ED50 ## Footnote Safer drugs have a greater Therapeutic Indices

Answer 555

It is a safer drug ## Footnote A higher therapeutic index suggests a larger margin between effective and lethal doses.

Answer 556

Ratio that indicates how much of a gas will dissolve in blood compared to how much will remain in the gas phase at a given temperature and pressure | Indicates how fast an inhaled drug reaches the bloodstream ## Footnote A** lower blood:gas solubility coefficient means faster distribution to the brain.**

Answer 557

The agent will reach the brain faster and the onset of action will be quicker | **Nitrous Oxide has a low blood:gas solubility coefficient**

Answer 558

Concentration of an inhaled anesthetic in the alveoli that results in 50% of patients being unresponsive to surgical stimuli ## Footnote MAC is a standard measure of **anesthetic potency**.

Answer 559

Lower potency of the inhaled anesthetic ## Footnote **Nitrous oxide has a high MAC**, meaning a higher concentration is needed for effective anesthesia.

Answer 560

Inhibition of COX-1 and COX-2 | COX stands for Cyclo-oxygenase, enzyme that produces prostaglandins

Answer 561

* Anti-inflammatory * Analgesic * Antipyretic

Answer 562

* Nausea, vomiting * Gastric irritation, gastric ulcer, dyspepsia * Bleeding, prolonged Bleeding Time * Renal, liver or cardiovascular impairment

Answer 563

**Increased risk of:** * Risk of premature closure of the ductus arteriosus in the fetus * Prolonged gestation time * Prolonged labor * Oligohydramnios

Answer 564

* Pregnant in the 3rd trimester * Active gastric bleeding or ulcer * Inflammatory bowel disease (ex: Crohn's Disease) * History or current bleeding disorder or use of anticoagulants * Antineoplastic dose of methotrexate * Use of Lithium * Older or kidney patient using Digitalis * Severe renal or hepatic disease * History of hypersensitivity to any other and Aspirin * History of NSAIDs or Aspirin -induced Asthma or Nasal Polyps

Answer 565

* History of Myocardial Infarction * History of Stroke * Heart Failure using Angiotensin-Converting Enzyme Inhibitors (ACEi), Diuretics or β-Blockers

Answer 566

* Adding Misoprostol * Using Celecoxibe instead ## Footnote **This is due to Pharmacokinetic Alterations in the Elderly:** * High lipid solubility causes widespread distribution and slow elimination * High unbound drug and impaired renal function may lead to excessive seric levels and toxicity * Increased risk of gastric erosion due to higher gastric pH

Answer 567

* Diuretics * Angiotensin-Converting Enzyme Inhibitors (ACEi) * β blockers ## Footnote **This is due to:** * Inhibition of prostaglandins-induced vasodilation * Reduction of kidney blood flow * Prevention of production of prostaglandins responsible for salt and water excretion

Answer 568

Act as competitive antagonists for COX-1 in platelets, preventing Aspirin binding

Answer 569

Renal impairment

Answer 570

* Other NSAIDs * Alcohol * Selective Serotonin Reuptake Inhibitors (SSRIs)

Answer 571

* Oral anticoagulants (ex: Factor Xa inhibitors, PY12-inhibitors) * Heparin * Calcium Channel Blockers (CCBs)

Answer 572

Increased risk of overdose due to reduced renal excretion.

Answer 573

Agonists of the μ, δ and κ opioid receptors in the CNS

Answer 574

Attenuation of physical and emotional components of pain Inhibition of cough reflex Decreased peristalsis Miosis* Sedation ## Footnote ***Meperidine is an opioid that causes mydriasis instead of miosis**

Answer 575

Meperidine

Answer 576

* Nausea, vomiting * Constipation * Drowsiness, dizziness, sedation * Euphoria, dysphoria * Miosis * Orthostatic Hypotension * Xerostomia * Respiratory depression * Pruritus (non-immunologic release of histamine from mastocytes)

Answer 577

* Pregnancy (except Oxycodone) * Elderly * Severe chronic respiratory disease (ex: Asthma) * Severe inflammatory bowel disease (ex: Crohn's Disease, Ulcerative Colitis) * Paralytic Ileus * Associated use with other depressants (ex: Alcohol, Cannabis, Benzodiazepines) * History of substance abuse

Answer 578

* Other depressants: Alcohol, Benzodiazepines, other Opioids, 1st-generation * Local Anesthetic * Centrally Acting Sympatholytics * Verapamil, Diltiazem

Answer 579

* Antihistamine * Tricyclic antidepressants * Chlorpromazine

Answer 580

* Selective Serotonine Reuptake Inhibitors (SSRIs) * Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

Answer 581

* Fetal dependence * Neonatal respiratory depression * Premature delivery * Growth retardation

Answer 582

Reduction in half. ## Footnote Medication should be used with caution in the elderly due to increased depth and duration of effects.

Answer 583

* Morphine * Codeine * Oxycodone * Hydrocodone * Oxymorphone * Hydromorphone ## Footnote 🧠Codeine, Codone, Morphine, Morphone 🎵 **Synthetic Opioids**: * Methadone * Meperidine * Pentazocine * Tramadol * Fentanyl * Tapentadol * Propoxyphene

Answer 584

* **Respiratory depression, cyanosis** * **Severe Miosis causing pinpoint pupils** * Clammy skin * Bradycardia, hypotension * Unconsciousness and coma

Answer 585

Inhibition of microbial Cell Wall producing enzymes, causing osmotic lysis | They are β-lactams antimicrobials

Answer 586

* Diarrhea * Nausea * Vomiting * Secondary Oral Candidiasis * Acute interstitial nephritis * Hypersensitivity and Anaphylaxis * Non-allergic pruritic rash * Convulsion * Serum-sickness-like reaction * Antibiotic-related colitis * Increase in Bleeding Time

Answer 587

Skin reactions

Answer 588

* Ampicillin * Cytomegalovirus or Infectious Mononucleosis * Acute Lymphoblastic Leukemia * Allopurinol

Answer 589

* Overdosing * Kidney disease

Answer 590

* Infectious Mononucleosis * Type 1 Hypersensitivity to Cephalosporins or other penicillins

Answer 591

Increase bacterial uptake of Metronidazole

Answer 592

Clindamycin

Answer 593

* Changing to Clindamycin * Adding another antimicrobial (e.g., Metronidazole) * Adding Clavulanic Acid | **Clavulanic Acid is an inhibitor of bacterial penicillinases**

Answer 594

It inhibits the renal tubular secretion of certain drugs, such as Penicillins, **increasing their plasma concentration and duration of action**

Answer 595

Inhibition of bacterial cell wall synthesis | They are β-lactams, just like Penicillins

Answer 596

Mostly active against Gram-positive bacteria ## Footnote The **spectrum is widened for Gram-negative bacteria from the 1st to the 3rd generation**. **3rd Generation Cephalosporins have the broadest antimicrobial spectrum.** 4th-generation is mainly dedicated to treat infections by Pseudomonas aeruginosa.

Answer 597

Mostly effective against Pseudomonas aeruginosa ## Footnote This generation is particularly important for treating severe infections caused by this pathogen.

Answer 598

* Dissulfiram-like reaction * Hepatotoxicity * Nephrotoxicity * Reversible neutropenia, eosinophilia and thrombocytopenia * Aseptic meningitis

Answer 599

Patients with Type 1 Hypersensitivity to Penicillins ## Footnote Due to the risk of cross-reactivity.

Answer 600

* Aminoglycosides * Aspirin * Amphotericin B * Cisplatin

Answer 601

Inhibition of bacterial cell wall synthesis | They are β-lactams, just like Penicillins

Answer 602

* Anti-staphylococcal Penicillins * Carbapenems

Answer 603

Aminoglycosides

Answer 604

Inhibition of bacterial cell wall synthesis | They are β-lactams, just like Penicillins

Answer 605

Non-steroidal Anti-inflammatory Drugs (NSAIDs) | Salicylic Acid Derivative

Answer 606

**Irreversible** inhibition of COX-1 and COX-2

Answer 607

* Inhibition of platelet aggregation * Antipyretic * Anti-inflammatory * Analgesic

Answer 608

* Gastrointestinal discomfort * Nausea * Vomiting * Dyspepsia * Heartburn * Gastrointestinal bleeding * Peptic Ulcer * Prolonged Bleeding Time * Bronchospasm * Hemolytic Anemia * Renal, liver or cardiovascular impairment

Answer 609

* Respiratory alkalosis * Hypokalemia * Nausea * Vomiting * Tinnitus * Dizziness * Confusion * Headaches * Dehydration * Hyperthermia * Hematologic abnormalities * Coma * Respiratory collapse

Answer 610

* Salicylism * Bleeding * Gastrointestinal disturbances

Answer 611

* Pregnancy in the 1st (teratogeny) and 3rd (delivery complications, premature closure of ductus arteriosus) trimester * Active pathologic bleeding or ulcer * Hemorrhagic disorder or anticoagulant use * Children under 12 with viral infections * History of Aspirin-induced Asthma or Nasal Polyps (Risk of acute bronchospasm) * Inflammatory bowel disease * End-Stage Kidney Disease (Risk of acute kidney damage) * Hepatic disease (Increased risk of bleeding) * Patients with Gout (Increased uric acid production) * Type II Diabetic taking Sulfonylureas (increased risk of hypoglycemia) * Antineoplastic dose of methotrexate * Use of Lithium (Increased toxicity) * Older or kidney patient using Digitalis * History of hypersensitivity to Aspirin

Answer 612

Increased risk of Reye Syndrome.

Answer 613

* P2Y¹² Receptor Blockers * Heparin * Oral Anticoagulants * Non-Steroidal Anti-inflammatory Drugs (NSAIDs) * Extended-spectrum Penicillins * Macrolides * Selective Serotonin Reuptake Inhibitors (SSRIs) * Diltiazem * Valproic Acid ## Footnote NSAIDs may impair the anti-platelet effect of Aspirin due to competition for the binding site in COX-1 in platelets

Answer 614

* Corticosteroids * Non-steroidal Anti-inflammatory Drugs (NSAIDs) * Alcohol

Answer 615

* Continuation of antiplatelet therapy * Use of additional hemostasis practices ## Footnote **Pause for 5 days in high-risk for bleeding procedures**

Answer 616

Pause for 5 days in high-risk for bleeding procedures ## Footnote **For routine procedures, no dose modification** is necessary, and local hemostatic measures may be employed

Answer 617

325-650mg 4-6x/day to a daily maximum of 4,000mg ## Footnote Aspirin may also be used chronically for the prevention of thrombotic events in doses of 160-325mg

Answer 618

Increased Bleeding Time ## Footnote Platelet count may be sightly reduced

Answer 619

- Aminoglycosides - Vancomycin - Cephalosporins - Furosemide - Cyclosporine

Answer 620

Antacids ## Footnote Because Aspirin is an acidic compound, it tends to be better absorbed in more acidic environments

Answer 621

Reversible bind to bacterial **50S** ribosomal subunit, **inhibiting protein synthesis** ## Footnote The main mechanism for bacterial resistance is reduced macrolide binding (ribosomal protection).

Answer 622

Antimicrobial effect that persists after the antibiotic concentration has fallen below the minimum inhibitory concentration. | Typical of Macrolide Antibiotics, specially Azithromycin

Answer 623

* Gastrointestinal symptoms: abdominal cramping, diarrhea, nausea, vomiting, epigastric pain * Cholestatic hepatitis * Torsade de Pointes (QT interval prolongation) * Ototoxicity (deafness) * Acute pancreatitis * Mania ## Footnote Most common with Erythromycin estolate

Answer 624

Tongue discoloration

Answer 625

Altered taste

Answer 626

* History of cholestatic jaundice * History of Hepatitis C * Patient with Torsade de Pointes or taking drugs that may induce Torsade de Pointes ## Footnote **Drugs that may induce Torsade de Pointes:** - Macrolides - Fluorquinolones - Fluconazole - Type IA FSCB - Amiodarone - Chloroquine - Citalopram, Escitalopram - Fluoxetine - Others

Answer 627

* Digitalis¹ * Oral Anticoagulants * P2Y¹² Receptor Blockers * Benzodiazepines * Cyclosporine and Tacrolimus * Selective Serotonin Reuptake Inhibitors (SSRIs) * Xanthines * Warfarin * HMG-CoA Reductase Inhibitors (Statins) ## Footnote ¹Due to elimination of Eubacterium lentum and reduction of digoxin metabolization in the gut

Answer 628

HMG-CoA Reductase Inhibitors (Statins)

Answer 629

Reversible bind to bacterial **30S** ribosomal subunit, **inhibiting protein synthesis** ## Footnote The main mechanism for resistance is drug efflux from bacteria.

Answer 630

* Diarrhea * Nausea * Vomiting * Abdominal cramps * Liver toxicity * Photosensitivity * Pigmentation of skin or mucous membranes ## Footnote Mostly caused by Minocycline.

Answer 631

Doxycycline ## Footnote Intrinsic staining of teeth occurs if consumed during the Maturation and Calcification stage of tooth development.

Answer 632

* Children under 8 years of age¹ * Pregnancy * Lactation ## Footnote ¹ In children, Tetracyclines can cause **irreversible discoloration of teeth and enamel hypoplasia.**

Answer 633

* Antacids * Ca++, Mg++, Iron or Zinc salts * Dairy products * Antihistamines

Answer 634

* Highly concentrated in the Gingival Crevicular Fluid * Promote connective tissue attachment and fibroblastic activity * Inhibit osteoclasts * Inhibit MMP-8 (anti-collagenase activity)

Answer 635

Tetracyclines

Answer 636

Irreversible bind to bacterial **30S** ribosomal subunit, **inhibiting protein synthesis** ## Footnote **They are inefective against anaerobe microrganisms**

Answer 637

* Ototoxicity and hearing loss * Non-depolarizing neuromuscular blockade * Peripheral neuropathy * Nephrotoxicity * Neurotoxicity * Blood dyscrasias

Answer 638

* Pregnancy and lactation * Myasthenia Gravis * Botulism * Parkinson's Disease * History of ototoxicity * Pre-existing renal impairment * Concurrent use of nephrotoxic drug¹ ## Footnote ¹Such as Aspirin, Vancomycin, and others

Answer 639

* β-Lactams

Answer 640

* Aztreonam * Cephalosporins * Aspirin * Vancomycin * Loop Diuretics

Answer 641

Compete with PABA and interfere with the bacterial synthesis of folic acid, nucleotides, and DNA

Answer 642

* Nausea * Vomiting * Diarrhea * Renal toxicity * Crystalluria * Blood dyscrasias

Answer 643

* Pregnancy and breastfeeding * Severe renal impairment * Porphyria

Answer 644

Increased effect

Answer 645

Increased effect

Answer 646

Reduced effects

Answer 647

Inhibit gastric acid secretion by blocking H+/K+-ATPase enzyme in parietal cells ## Footnote Proton Pump Inhibitors are commonly used to treat conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers.

Answer 648

Inhibits phosphodiesterase, antagonizing adenosine receptors ## Footnote They are typically used as bronchodilators

Answer 649

* Bronchodilation * CNS stimulation * Increased heart rate * Diuresis * Gastric acid secretion increase * Relaxation of smooth muscles | 🧠Same effects as coffee (which is a xanthine) ## Footnote These effects contribute to their therapeutic use in respiratory conditions.

Answer 650

* Macrolides * Ciprofloxacin

Answer 651

* Barbiturates

Answer 652

* Stimulate release of Insulin from β-cells in pancreas¹ * Increase Insulin sensitivity of peripheral cells * Decrease seric glucagon levels ## Footnote ¹Via closing ATP-dependent potassium channels

Answer 653

* Aspirin * Azole Antifungals * Macrolides ## Footnote Increasing the risk of hypoglycemia

Answer 654

Reduction of blood glucose by **decreasing hepatic gluconeogenesis**

Answer 655

**Increase of Insulin sensitivity** in tissues by activating PPAR-gamma receptors

Answer 656

Inhibit intestinal alpha-glucosidases that break down starches and disaccharides, **reducing glucose absorption** ## Footnote This leads to a slower rise in blood glucose levels after meals.

Answer 657

Inhibit conversion of HMG-CoA to mevalonate, **reducing cholesterol synthesis in liver** | These drugs are used to control blood cholesterol levels

Answer 658

* Myopathy * Rhabdomyolysis * Liver enzyme elevation * Gastrointestinal disturbances * Increased blood sugar levels * Kidney failure

Answer 659

* Azole Antifungals * Macrolides¹ ## Footnote ¹There is an increased risk of rhabdomyolosis when both drugs are used concomitantly

Answer 660

* Increased uptake of glucose * Decreased gluconeogenesis * Increased glycogen and protein synthesis * Increased K+ uptake * Increased triglyceride storage

Answer 661

- Sweating - Nausea - Confusion - Tachycardia - Hypoglycemia

Answer 662

Subcutaneous

Answer 663

Inhibit osteoclast activity by binding to hydroxyapatite in bone ## Footnote * Low concentration leads to inhibition of osteoclasts * High concentration results in osteoclast apoptosis

Answer 664

* Gastrointestinal issues * Esophageal erosions * Musculoskeletal pain * Hypocalcemia * Renal impairment * MRONJ¹ * Impediment of orthodontic tractioning of teeth ## Footnote ¹Medication-Related Osteonecrosis of the Jaw.

Answer 665

* Perform surgical procedures as atraumatically as possible * Ensure primary closure * Avoid Apicoectomy | This is to prevent Medication-related Osteonecrosis of the Jaws (MRONJ)

Answer 666

At least 4-6 weeks before Bisphosphonates therapy initiation

Answer 667

* Elective surgical procedures * Apicoectomy * Implant placement | Procedures involving bone manipulation in general ## Footnote Non-invasive procedures, such as root canal treatment (RCT), are preferred.

Answer 668

* Wait 2 months after medication administration * Perform atraumatically * Ensure primary closure * Start antibiotic coverage 1 day before and continue for 3 days after * Employ Hyperbaric Oxygen therapy (20-30 dives before, 10 dives after) ## Footnote This approach minimizes the risk of Medication-related Osteonecrosis of the Jaws (MRONJ)

Answer 669

* Inhibition of phospholipase A2, reducing prostaglandin and leukotriene production * Suppression multiple genes

Answer 670

* Inhibition of inflammation * Immunosuppression * Prevention of histamine release and hypersensitivity reactions * Increased blood glucose and lipid levels * Increased protein breakdown and blood amino acids * Muscle weakness * Reduced capillary permeability * Impaired fibroblast growth * Increased production of gastric acids * Increased intraocular pressure and cataracts * Psychosis and altered mood * Hypokalemia

Answer 671

* Cushing Syndrome * Edema * Hypertension * Hypokalemia * Osteoporosis * Myopathy * Growth inhibition * Opportunistic infections * Hyperglycemia * Altered fat distribution (Buffalo Hump) * Peptic Ulcer * Hirsutism * Bruising * Impaired healing * Cataracts * Glaucoma

Answer 672

* Systemic fungal infections * Latent infections * Live vaccines * Uncontrolled Diabetes Mellitus type II * Heart Failure * Severe Hypertension * Osteoporosis * Peptic Ulcer

Answer 673

They are converted into Nitric oxide, which induce vasodilation by enhancing reuptake of calcium in the sarcoplasmic reticulum

Answer 674

* Reduction of heart preload¹ - Decreased myocardial oxygen demand - Increased coronary blood flow - Vasodilation and decrease in Total Peripheral Resistance | **Preload** is the pressure in the ventricules before the heart contract ## Footnote ¹Due to dilating more veins than arteries

Answer 675

* Headache * Dizziness * Flushing * Tachycardia * Orthostatic Hypotension

Answer 676

* Blood pressure <90/60mmHg * Having taken phosphodiesterase-5 inhibitors¹ in the previous 24h ## Footnote ¹ These are drugs used for erectile dysfunction, such as sildenafil, tadalafil, vardenafil, and others

Answer 677

Block the P2Y¹² components of ADP receptors on platelets, preventing activation of the GPIIb/IIIa receptor complex and **inhibiting platelet agregation**

Answer 678

* Other anticoagulants * NSAIDs * Aspirin * High dose of Acetaminophen¹ | ¹ Doses >1.3g for at leasdt 10 days

Answer 679

**No adaptation** other than using additional hemostatic measures as necessary

Answer 680

Antagonists of fast sodium channels in the heart ## Footnote They are used as anti-arrhythmic drugs

Answer 681

* Dizziness * Nausea * Paresthesia * Tingling * Seizure * Worsening of Heart Arrhythmias * Hypotension and cardiovascular collapse

Answer 682

* Prolongation of action potential duration * Prolongation of heart contraction * Increased refractory period

Answer 683

* Shortening of action potential * Decrease in refractory period * Decrease in excitability and conduction velocity ## Footnote Type IB FSCB are often effective in treating ventricular arrhythmias.

Answer 684

* Prolonged depolarization * Increased refractory period * Decreased conduction velocity * Minimal to no effect on action potential duration ## Footnote Type IC FSCB are used in the management of atrial fibrillation and flutter.

Answer 685

Inhibit potassium efflux from cardiac cells, affecting cardiac repolarization

Answer 686

* Prolongation of action potential * Increase in refractory period * Decreased myocardial excitability ## Footnote These effects help in managing various arrhythmias by stabilizing cardiac electrical activity.

Answer 687

Inhibit sodium reabsorption in the distal convoluted tubes of the kidneys ## Footnote Used as diuretics for the treatment of hypertension

Answer 688

* Increased excretion of sodium and water * Increased urine output * Decreased blood volume * Decrease in blood pressure * Reduced calcium excretion

Answer 689

* Hyposalivation * Xerostomia * Oral Lichenoid Drug Eruptions * Hypokalemia * Hyponatremia * Hyperuricemia * Orthostatic Hypotension

Answer 690

* Aspirin * Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Answer 691

Inhibit the reabsorption of sodium, potassium, and chloride in the thick ascending limb of Henle of the kidneys

Answer 692

* Hyponatremia * Hyperuricemia * Hypovolemia * Ototoxicity (Tinnitus, hearing loss) * Xerostomia

Answer 693

* Aminoglycosides

Answer 694

Increase osmolarity of renal tubule fluid, preventing water reabsorption by the proximal tubule and thin descending limb of Henle of the kidneys

Answer 695

Inhibit carbonic anhydrase enzyme in the proximal tubules, decreasing bicarbonate reabsorption, increase sodium and water excretion

Answer 696

Inhibit sodium reabsorption, potassium and hydrogen resorption in the cortical collecting duct of the kidneys | They are part of the **Potassium Sparing Diuretics**

Answer 697

Hyperkalemia

Answer 698

Blocks Aldosterone receptors in the cortical collecting duct of the kidneys | They are part of the **Potassium Sparing Diuretics**

Answer 699

* Increase sodium and water excretion * Reduce blood volume and pressure * Potassium retention

Answer 700

Hyperkalemia

Answer 701

Potassium Sparing Diuretics | Includes Aldosterone Antagonists and Sodium Channel Blocker Diuretics

Answer 702

Inhibit influx of calcium ions into cardiac and smooth muscle cells

Answer 703

* Increase in refractory period * Vasodilation * Reduced cardiac output * Reduced venous pressure (reduced Preload) * Reduced arteriolar pressure (reduced Afterload) * Reduced myocardial O² consumption * Negative inotropic effect

Answer 704

* Gingival Enlargement (>20%) * Xerostomia * Edema * Hypotension

Answer 705

* Macrolides * Rifampicin * Azole Antifungals * Aspirin

Answer 706

Open potassium channels in blood vessels, causing vasodilation and reducing blood pressure ## Footnote Used in the treatment of Hypertension and Heart Failure

Answer 707

* Lymphadenopathy * Lupus Erythematosus-like oral and skin lesions * Orthostatic Hypotension

Answer 708

* Aspirin * NSAIDs

Answer 709

Block of Na/K ATPase and increase influx of calcium into cardiac muscle cells ## Footnote This mechanism enhances cardiac contractility.

Answer 710

* Positive inotropic effect * Negative chronotropic effect * Decreased Preload * Decreased Afterload ## Footnote These effects contribute to improved cardiac function.

Answer 711

* Sialorrhea * Nausea * Diarrhea * Malaise * Ventricular Heart Arrhythmias * Heart block * Visual and mental disturbances | They have **narrow therapeutic indices**

Answer 712

* Macrolides * Tetracyclines * Azole Antifungals * NSAIDs * Amiodarone * Quinidine * Propafenone * CCBs * Benzodiazepines * Protease Inhibitors * Thiazide Diuretics * Loop Diuretics

Answer 713

* Local anesthetics * β-Blockers

Answer 714

* Thyroid hormone replacement therapy (ex: Levothyroxine) * Barbiturates * Antacids * St. John's Wort

Answer 715

Inhibition of Angiotensin-converting Enzyme, preventing conversion of Angiotensin I to Angiotensin II ## Footnote This action leads to hypotensive effects

Answer 716

* Vasodilation * Reduction in Aldosterone production * Less water and sodium retention * **Reduction of blood pressure**

Answer 717

* Taste alterations * Stomatopyrosis * Cough¹ * Hyperkalemia * Orthostatic Hypotension * Neutropenia * Anorexia * Polyuria ## Footnote ¹ Due to bradykinin accumulation, which is usually cleaved by angiotensin-converting enzyme

Answer 718

* Aspirin * NSAIDs

Answer 719

* Vasodilation * Reduction in Aldosterone production * Reduction in blood pressure

Answer 720

* Fetal toxicity * Dizziness * Diarrhea * Myalgia * Orthostatic Hypotension

Answer 721

* Increased glandular secretions * Bronchoconstriction * Negative chronotropic effect * Increased gastrointestinal motility and urinary tract activity * Miosis * Decrease in ocular pressure * Vasodilation * Hypotension * Skin flushing ## Footnote None

Answer 722

* Peptic Ulcer * Asthma * COPD * Heart Failure ## Footnote None

Answer 723

Non-competitive antagonists of acetylcholinesterase¹ at both Muscarinic Receptors and Nicotinic Receptors ## Footnote ¹ Enzyme is located at the sinapses and responsible for breaking down acetylcholine

Answer 724

Indirect Agonists of Muscarinic Receptors (Anticholinesterasics) ## Footnote None

Answer 725

Pralidoxime

Answer 726

* Glaucoma * GI tract obstruction * Prostate hyperplasia * Tachycardia and cardiovascular disease ## Footnote None

Answer 727

Competitive antagonist of acetylcholine to Nicotinic Receptors at the neuromuscular junction ## Footnote None

Answer 728

Through the use of Reversible Anticholinesterasics ## Footnote Such as Neostigmine, Pyridostigmine

Answer 729

Bind to ACh receptors, causing persistent depolarization of the motor end plate, leading to muscle paralysis due to neuromediator depletion ## Footnote None

Answer 730

Inhibits the reuptake of serotonin and norepinephrine in the brain ## Footnote TCAs are used to treat various mood disorders.

Answer 731

- Drowsiness - Mild analgesia - Constipation - Anticholinergic effects and Xerostomia - Orthostatic Hypotension - Sexual dysfunction - Heart Arrhythmias and Torsade de Pointes

Answer 732

* Recent myocardial infarction * Concurrent use of Monoamine Oxidase Inhibitors (MAOIs) * Using other drugs that may cause QT interval prolongation

Answer 733

* Vasoconstrictors in local anesthetics * Monoamine Oxidase Inhibitors (MAOis)

Answer 734

Macrolides

Answer 735

Tricyclic Antidepressants (TCAs)

Answer 736

Tricyclic Antidepressants (TCAs)

Answer 737

Tricyclic Antidepressants (TCAs)

Answer 738

Inhibit the recapture of serotonin in the brain ## Footnote SSRIs are commonly prescribed for depression and anxiety disorders.

Answer 739

- Nausea - Headaches - Anxiety, agitation, insomnia - Sexual dysfunction - Drug-induced Bruxism - Increased risk of bleeding¹ ## Footnote ¹ Due to inhibition of serotonin reuptake by platelets

Answer 740

* Selective Serotonin Reuptake Inhibitors (SSRIs) * Monoamine Oxidase Inhibitors (MAOIs)

Answer 741

Inhibit Monoamine Oxidase, an enzyme responsible for the breakdown of catecholamines in the brain

Answer 742

- Nausea, drowsiness, insomnia, tremors - Hypertensive crisis and Serotonin Syndrome - Orthostatic Hypotension - Weight gain - Sexual dysfunction

Answer 743

- Meperidine - Vasoconstrictors in Local anesthetics - Tricyclic Antidepressants (TCAs)

Answer 744

Monoamine Oxidase Inhibitors (MAOIs)

Answer 745

Inhibit voltage-gated Na+ channels, reducing neuronal excitability ## Footnote Hydantoins are primarily used as anticonvulsants.

Answer 746

- Gingival Enlargement¹ - Drowsiness, dizziness, sedation, Ataxia - Diplopia - Nystagmus, vertigo - Rash - Hirsutism - Osteomalacia² - Blood dyscrasias, folate deficiency, megaloblastic anemia - Hyperglycemia - Teratogeny³ ## Footnote ¹ In over >50% of patients ² Due to Vitamin D metabolism interference ³ Must not be used during pregnancy

Answer 747

* Decrease heart rate * Lower blood pressure * Increase refractory period * Decrease conduction velocity ## Footnote β Blockers are often used for managing hypertension and heart conditions.

Answer 748

- Decrease heart rate and myocardial contractility - Increase refractory period - Decrease conduction velocity - Lower blood pressure

Answer 749

Increases the release of norepinephrine and dopamine while inhibiting their reuptake ## Footnote Amphetamines are often prescribed for ADHD and certain sleep disorders.

Answer 750

* Aspirin * Non-steroidal Anti-inflammatory Drugs

Answer 751

Vasoconstrictors in local anesthetics

Answer 752

- Hypotension - Bradycardia - Drowsiness

Answer 753

Bradycardia with increased blood pressure

Answer 754

- Headaches - Increased heart rate and blood pressure - Insomnia, anxiety - Loss of appetite - Xerostomia - Potential for addiction

Answer 755

- Patients taking Monoamine Oxidase Inhibitors (MAOIs) - Hypertension and Heart Arrhythmias - Hyperthyroidism

Answer 756

Antagonists of D2 dopamine receptors in the mesolimbic and mesocortical pathways ## Footnote This mechanism helps in managing symptoms of psychosis.

Answer 757

Antagonists of D1, D2, D4, D5 and 5-HT2 receptors in the mesolimbic and mesocortical pathways ## Footnote This broader receptor activity contributes to their efficacy and side effect profile.

Answer 758

Fewer side effects

Answer 759

* Extrapyramidal symptoms * Tardive Dyskinesia * Anticholinergic effects * Antiadrenergic effects * Antiemetic effects * Orthostatic Hypotension * Torsade de Pointes * Photosensitivity * Dystonia and Akathisia * Phenothiazines-induced Pigmentation * Neuroleptic Malignant Syndrome * Seizure

Answer 760

* Opioids¹ * Benzodiazepines ## Footnote **¹ The dose of opioids must be reduced by half in patients taking antipsychotics**

Answer 761

Enhance GABA's ¹ inhibitory effects by increasing duration of Cl- channel opening ## Footnote ¹ GABA is a neurotransmitter that plays a key role in inhibiting brain activity.

Answer 762

* Sedation and hypnosis * Potent anesthesia * Amnesia

Answer 763

* Emphysema * Liver dysfunction * Porphyria

Answer 764

- Digitalis - Xanthines - Corticosteroids - Warfarin

Answer 765

* Other sedatives ## Footnote Such as Benzodiazepines, Antihistamines, Alcohol, and others

Answer 766

General Anesthesia induction | Ex: Thiopental, Methohexital, Thiamylal

Answer 767

* Treatment of insomnia * Anxiety control | Ex: Secobarbital, Pentobarbital

Answer 768

* Treatment of insomnia * Anxiety control * Sedation | Ex: Amobarbital, Butabarbital

Answer 769

Seizure control | Ex: Phenobarbital, Mephobarbital, Primidone

Answer 770

Enhance the effect of GABA by binding to GABA-A chloride receptors in the CNS ## Footnote GABA is an inhibitory neurotransmitter in the CNS

Answer 771

* Anxiolysis * Sedation and Hypnosis * Amnesia * Muscle relaxation * Anticonvulsion

Answer 772

* Drowsiness * Dizziness * Fatigue * Confusion * Ataxia * Xerostomia * Amnesia * Respiratory depression * Hypotension * Paradoxical excitatory effects * Dependence and withdrawal

Answer 773

* Pregnancy and lactation * Severe hepatic impairment * Severe respiratory insufficiency * Narrow-angle glaucoma

Answer 774

Scopolamine

Answer 775

* Diazepam * Midazolam * Clonazepam

Answer 776

Inhibit lanosterol 14-alpha-demethylase, blocking ergosterol synthesis in fungal cell membranes

Answer 777

* Gastrointestinal disturbances * Rash * Headache * Hepatotoxicity * Induction of Cytochrome P-450 System * Torsade de Pointes * Endocrine effects (ex: gynecomastia, impotency, decreased libido)

Answer 778

* Barbiturates * Rifampin

Answer 779

Inhibit DNA gyrase and topoisomerase IV, preventing DNA replication and repair in bacteria ## Footnote None

Answer 780

- Nausea, vomiting, abdominal pain, Pseudomembranous Colitis - Dyspepsia, heartburn - Headache, dizziness, restlessness, nightmares ¹ - Rash, pruritus - Phototoxicity - Stevens-Johnson Syndrome - Torsade de Pointes - Tendon rupture, arthralgia, joint swelling, tendinitis ## Footnote ¹ Specially if associated with Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Answer 781

* Pregnancy and lactation * Children under 18¹ ² * History of tendon disorders * Myasthenia Gravis * Severe renal impairment ## Footnote ¹ Due to the risk of arthropathy ² Ciprofloxacin is the only Fluorquinolone that can be used in patients under 18.

Answer 782

* Antacids * Calcium * Iron * Zinc * Sucralfate

Answer 783

* Oxidation reactions * Reduction reactions * Hydrolysis reactions ## Footnote These are **functionalization reactions** to modify the chemical structure of substances to facilitate their excretion through urination

Answer 784

Cytochrome P-450 enzymes

Answer 785

- Rifampicin - Phenobarbital - Phenytoin - St. John's Wort - Benzodiazepines - Carbamazepine - Chronic Alcohol use ## Footnote They therefore reduce the effects of drugs metabolized by the Cytochrome P-450 system

Answer 786

- Cimetidine - Acute Alcohol consumption - Itraconazole - Ketoconazole - Grapefruit juice - Macrolides ## Footnote They therefore enhance the effects of drugs metabolized by the Cytochrome P-450 system

Answer 787

* Glucuronidation reactions * Acetylation reactions * Sulfation reactions ## Footnote These are **conjugation reactions** to further modify drugs to enhance elimination through defecation

Answer 788

Coxibes | They are a subclass of non-steroidal anti-inflammatory drugs (NSAIDs)

Answer 789

Selective COX-2 inhibition

Answer 790

* Anti-inflammation * Analgesia * Antipyresis

Answer 791

* Analgesia in patients with gastrointestinal ulcers * Treatment of Rheumatoid Arthritis * Treatment of Osteoarthritis

Answer 792

* Gastrointestinal discomfort * Diarrhea * Dyspepsia * Flatulence * Peripheral edema * Dizziness * Headache * Upper respiratory tract infections * Gastrointestinal bleeding and ulceration * Cardiovascular events (e.g., Myocardial Infarction, Stroke) * Renal and hepatotoxicity * Hypersensitivity reactions * Skin reactions (e.g., Stevens-Johnson Syndrome)

Answer 793

* History of hypersensitivity to NSAIDs or Sulfonamides * History of asthma or nasal polyps ¹ * Pregnant in the 3rd trimester ² * History of Myocardial Infarction, Stroke, or Heart Failure ³ ## Footnote ¹ Due to risk of brochospasms and asthma exacerbation ² Due to Risk of premature closure of the ductus arteriosus, prolonged gestation time, prolonged labor and oligohydramnios ³ Due to pro-thrombotic effects leading to increased cardiovascular risk

Answer 794

* Oral Anticoagulants * Heparin

Answer 795

Non-steroidal Anti-inflammatory Drugs (NSAIDs)

Answer 796

200mg 1-2 times a day

Answer 797

- Gastric mucosa protection - Platelet aggregation - Regulates renal blood flow - Vasoconstriction

Answer 798

Increases ## Footnote The drug shifts towards non-ionized form, which is capable of crossing physiologic membranes

Answer 799

Increases ## Footnote The drug shifts towards non-ionized form, which is capable of crossing physiologic membranes

Answer 800

Decreases ## Footnote The drug shifts towards ionized form, which is incapable of crossing physiologic membranes

Answer 801

Decreases ## Footnote The drug shifts towards ionized form, which is incapable of crossing physiologic membranes

Answer 802

If the pKa is higher than the environment pH, the absorption enhanced

Answer 803

If the pKa is lower than the environment pH, the absorption enhanced

Answer 804

It is unable to diffuse to extravascular tissues

Answer 805

- Increased concentration - Lipophilic - Non-ionized (neutrally charged) state - Increased blood flow - Smaller molecular size

Pharmacology Flashcards

(861 cards)