Pharmacology Flashcards
(240 cards)
1
Q
The end plate potential of neuromuscular junctions is estabished through the ___
A
Reduction of the resting potential at the post synaptic area by acetylcholine
End plate potentials are depolarizations of skeletal muscle fibers caused by neurotransmitters binding to the post synaptic membrane in the neuromuscular junction
When an action potential reaches the axon terminal of a motor neuron, vesicles carrying NT (mostly Ach) are exocytosed, and the contents are released into the neuromuscular junction
2
Q
What organ is affected by taking expired tetracyclines, an effect known as the Fanconi Syndrome? How is it damaged?
A
Kidney
Results in damage to the proximal tubule, resulting in renal tubular acidosis and loss of glucose, amino acids, and excessive phosphate and bicarbonate via the urine.
3
Q
How does erythromycin interact with other drugs?
A
It decreases metabolism of drugs that interact with cytochrome P450. (Inhibits metabolism of drugs within the liver, leading to possible increased toxicity of other drugs.)
4
Q
____ is a side effect of inflammatory bowel diseases like Crohn disease and ulcerative colitis, which prevents pharmaceutical absorption
A
Toxic megacolon
5
Q
___ and ___ in the __ are affected when ethanol is found in the blood stream.
A
GABA (gamma-aminobutyric acid)
Dopamine
Frontal cortex
Ethanol alters the response of both GABA and the dopamine receptors. It binds to the GABA, increasing the GABA receptor response, leading to a reduction in the inhibition of socially unacceptable behaviors
6
Q
The most medically accepted definition of alcohol abuse is when someone…
A
Consumes alcohol enough that it puts their relationships, jobs, or health in jeopardy
Alcohol abuse manifests differently for both acute and chronic effects on the CNS, including poor judgement, tipsiness, irritability, and sleeping difficulties
7
Q
True or false… biotransformation usually converts a drug into its lipid-soluble, non-ionized form
A
False.
Biotransformation typically involves the conversion of a lipid-soluble, non-ionized form into its more water-soluble metabolites. It increases the absorption of a drug into the bloodstream, enhancing the bioavailability of the drug. Water-soluble drugs are also easily excreted in urine.
8
Q
Tetracycline antibiotics are considered [bacteriocidal/bacteriostatic].
A
Bacteriostatic
9
Q
What is the mnemonic for bacteriostatic antibiotics?
A
ECSTATiC
E - Erythromycin C - Clindamycin S - Sulfonamides T - Tetracycline A - Azithromycin Ti- Trimethoprim C - Chloramphenicol
10
Q
What is the mnemonic for bacteriocidal antibiotics?
A
Very Finely Proficient At Cell Murder
Vancomycin Fluoroquinolones Penicillins Aminoglycosides Cephalosporins Metronidazole
11
Q
What type of drug administration method has the slowest absorption?
A
Oral
12
Q
How many milliliters are in one tablespoon? How many teaspoons in a tablespoon?
A
15ml
3 teaspoons in a tablespoon (1 teaspoon = 5ml)
13
Q
Penicillin’s and cephalosporing’s inhibition of the enzyme ___ is responsible for inhibiting cell wall synthesis. How does this enzyme normally work?
A
Transpeptidase
Transpeptidase is responsible for catalyze game the peptide cross-linking of the peptidoglycan in bacterial cell walls
14
Q
____ is a bacterial enzyme that cleaves penicillins, making them ineffective against bacteria
A
B-lactamase
15
Q
How is penicillin VK eliminated from the body?
A
Metabolized by the liver and excreted in urine.
Penicillin VK is an augmented form of penicillin that combines acid stability with an immediate solubility and faster rate of absorption.
16
Q
Penicillin VK is highly effective against ___ and ___ except for strains producing penicillinase and streptococci groups A, C, G, H, L, and M. Its half-life is approximately ___ and it takes about __ hours to clear the body entirely.
A
Pneumococci
Staphylococci
30-60 minutes
5 hours
17
Q
Condylar hyperplasia is an idiopathic, slowly progressive unilateral enlargement of the head and neck of the condyle. It typically results in __ malocclusion, facial ___, and shifting of the ___ of the chin to the ___ side.
A
Crossbite
Asymmetry
Midline
Unaffected
18
Q
What is the treatment of choice if condylar hyperplasia it occurs during the active growth period? What is the treatment of choice following growth cessation?
A
Condylectomy
Orthodontics or surgical mandibular repositioning
19
Q
Describe the characteristics of trigeminal neuralgia.
A
(Tic douloureux, prosopalgia, fothergill disease)
Having brief periods of sharp/excruciating pain
Experiencing paroxysmal attacks of pain lasting from a fraction of a second or two minutes
Affecting one or more divisions of the trigeminal nerve
Pain may or may not be persistent between paroxysms
Pain is usually a sudden and sharp or stabbing feeling after stimulating a trigger zone. Trigger zones are affected within branches of the trigeminal nerve.
20
Q
Why do highly polar pharmaceutical work more rapidly?
A
They are hydrophilic so they less permeable to cell membranes and increase their absorption into the blood stream
21
Q
What is another term for maximal effect of a drug?
A
Efficacy - the maximal or ceiling effect of a drug. It is the capacity of a drug to produce its pharmacological effect in the body.
22
Q
What does the inscription contain?
A
The name of the drug
Quantity
Dosage form
23
Q
What does the subscription include?
A
Guidelines to be followed by the pharmacist regarding the preparation and distribution of the medication
24
Q
What is the transcription of a prescription?
A
The information regarding the intake of the medication (how much, when, how often, how)
25
When ethanol is consumed while a patient is taking barbiturates, the resulting reaction is called ___. Describe this.
Potentiation - occurs when one drug administered simultaneously with another drug interacts to produce a synergistic effect.
26
Barbiturates are drugs known to cause ___ of the ___. Due to their ability to make people ___, they are also called __.
Depression of the CNS
Relax and sleepy
Sedative-hypnotics
27
True or false... alcohol taken with barbiturates can result in unconsciousness or death
True
28
What are some biological changes that occur with advancing age that affects the pharmacokinetics and pharmacodynamics of pharmaceuticals?
Altered volume of distribution and sequestration of a drug in body fat
Decreased rate of biotransformation
Decreased renal excretion
Increased half-lives of some drugs
29
Define median lethal dose.
Dose of a substance that would kill half of the experimental population
30
What is the medial lethal dose of alcohol/
0.4-0.5%
31
True or false... ethanol is partially absorbed in the stomach and partly in the intestine
True - roughly 20% of absorption occurs in the stomach, and 80% takes places in the small intestine
32
What is the elimination half-life for penicillin NK? What is the range of activity of this drug?
30 minutes
Penicillin VK has a range of antimicrobial activity against gram-positive bacteria. Penicillin VK demonstrates a short, half life because it is rapidly excreted in the urine.
33
Name 4 antibiotics that attack the 50S ribosomal subunit
Azithromycin
Clarithromycin
Erythromycin
Lincomycin
34
Minocycline prevents the function of the ___ ribosomal subunit
30s
35
What is the leading cause of medical problems in children?
Inaccurate pediatric dosage
36
What is the Clark rule and the young rule?
Methods used to calculate pediatric dosage
Clark rule = adult dose x (lbs/50)
Young rule = adult dose (age / (age +12)
37
What is the most common drug reaction seen in a cross-reactivity of penicillin with cephalosporin?
Immediate-type hypersensitivity reaction
(Patients experience a penicillin allergy also have a tendency to elicit cross-allergic reactions with cephalosporin drugs
38
What is a type 1 (immediate) hypersensitivity reaction?
Type of rapidly acting allergic response over a certain kind of allergen. An immediate hypersensitivity reaction may result in severe systemic reactions like anaphylaxis, which can cause difficulty in breathing and death. Administration of epinephrine and antihistamines may help slow down and prevent this allergic reaction
39
True or false.. patients demonstrating a rash or hives following penicillin administration is a contraindication for use of cephalosporin antibiotics but is not a severe contraindication, and they may still use it in certain situation.
True
40
What are the four types of hypersensitivity reactions?
ABCD
Anaphylaxis
AntiBody mediated
Immune Complex mediated
Delayed hypersensitivity
41
Isopropyl alcohol is oxidized in the liver by alcohol dehydrogenase to form ___ and ___, __, then finally ___
Acetone
Acetate
Formate
CO2
42
Prostaglandins are lipid molecules that are enzymatically derived from ___ in the __
Arachadonic acid. Cell membrane
43
___ cells secrete serotonin
Enterochromaffin
44
___ is a protein peptide that belongs with the kinin group
Bradykinin
45
True or false... a person under the influence of ethanol experiences pupil dilation
False.. they experience pupil constriction
46
___ drugs are the most common hypnotic drugs today. What are hypnotic drugs?
Benzodiazepines and non-benzodiazepine
Psychoactive medications that are mainly used to induce sleep and are often used to treat sleep disorders like insomnia as well as surgical anesthesia.
47
What is the therapeutic index?
A ratio of the dose of a drug that causes lethal effect to the minimal dose of the drug that can elicit a therapeutic effect. The therapeutic index measures safety and is important to check the margin of safety for a certain drug.
A high therapeutic index value states that the drug is effective at a minimum dose a lot lower than the lethal dose. A low therapeutic index suggests that the drug has a narrow margin of safety
48
The muscle relaxation experienced by patients under diazepam has a similar mechanism of action to ___. Describe it.
Meprobamate
They are both anxiolytic and hypnotic agents. Meprobamate is a barbiturate subgroup and a non-selective CNS depressant that can induce surgical anesthesia. Diazepam is a benzodiazepine and is a selective neuronal depressant.
Benzodiazepines have replaced barbiturates due to their non-selective effect on the CNS and high potential for addiction. Both drugs potentiation GABA, the neurotransmitter responsible for inhibition.
Both barbiturates and benzos potentiation GABA by increasing chloride conductance and the synaptic inhibition efficacy of GABA
49
What drug class is known to produce a neurological side effect known as tardive dyskinesia?
Phenothiazine antipsychotics
Tardive dyskinesia is a condition in which the patient exhibits slow, involuntary, and repetitive muscle movements. It is thought that this occurs due to the neuroleptic-induced dopamine supersensitivity in the nigrostriatal pathway.
Neuroleptic act primarily on this dopamine system.
50
What is the central mechanism of action in a patient being treated for Parkinson’s disease by L-DOPA (levodopa)?
It replenishes insufficient dopamine levels.
51
Levodopa is an agent administered to patients to be converted by the body into ___. It has no ability to cure Parkinson’s disease but functions to ___
Dopamine
Delay its effects and enable the patient to live and function normally for a period of time.
52
Phenothiazine is a(n) ____ that has demonstrated antiemetic and sedation properties. They are also used for treating headaches and migraines in the emergency rooms.
Antipsychotic
53
___ is a barbiturate that has the highest lipid solubility, allowing for easy crossing of the blood-brain barrier. It is short acting, yet has a rapid onset
Thiopental
54
___ was previously used for the general anesthesia induction phase, but now ___ is used int its place.
Thiopental
Propofol
55
What could be administered to a patient after accidental intramuscular administration to counteract the effects?
Propranolol (beta blocker) and prazosin (alpha blocker). When administered together, they create vasodilation and block cardiovascular actions of the sympathomimetic drug
56
____ is classified as an irreversible cholinesterase inhibitor?
Diisoproyl fluorophosphate (DFP)- its an organophosphate insecticide that can act as an irreversible cholinesterase inhibitor. The substance can elicit a parasympathetic action and act as an irreversible anticholinesterase.
57
What is the mechanism by which succinylcholine inhibits neuromuscular transmission?
Depolarizing the motor endplates of skeletal muscle. It acts like acetylcholine because it binds to the acetylcholine receptor and causes muscular twitches or contractions during phase 1.
The phase 2, due to the repetitive excitation and depolarization, the motor endplates become resistant to acetylcholine activation. The resistance of motor endplates from acetylcholine activation prevents neuromuscular transmission, preventing muscular contraction
58
What is the mechanism of action of nystatin?
Bonds to cell membrane of fungi to form porosities which result in leakage of K+. Leads to cell death
59
How does neostigmine differ from physostigmine?
Neostigmine has an additional direct effect at the neuromuscular junction
Neostigmine is a synthetic drug that is poorly absorbed when taken orally and is useful for managing myasthenia gravis
Physostigmine, however, is a naturally occurring lipid-soluble drug that is absorbed very well when taken orally
60
What drug category is contraindicated in glaucoma patients? Why?
Anticholinergics
Anticholinergic agents like atropine are contraindicated in patients predisposed to narrow-angled glaucoma, because they prevent the evacuation of aqueous humor through the canal of schlemm and elevate intraocular pressure by increasing pupillary diameter
61
Atropine causes pupil dilation by paralysis of the ___, preventing lens accommodation and prevents action of __ on ____ receptors (___), causing an increase in ___.
Ciliary muscle
Acetylcholine on muscarinic receptors (M1-M5)
SA node output and increase in heart rate
62
What is glaucoma?
Pathology in which an increased fluid pressure in the aqueous humor of the eye causes pain and can result in blindness if not treated.
63
What is myasthenia gravis?
An autoimmune neuromuscular disease that leads to fluctuating muscle weakness and fatigability. The symptoms are caused by circulating antibodies that block acetylcholine receptors at the postsynaptic neuromuscular junction which inhibits the excitatory effects of the neurotransmitter acetylcholine on nicotinic receptors throughout neuromuscular junction
64
Stimulation of nicotinic or muscarinic receptors can [increase/decrease] saliva secretion.
Increase
65
Cholinomimetic drugs are designed to directly or indirectly inhibit ____.
Acetylcholinesterase
66
What is the most dangerous effect of a digoxin overdose?
Ventricular fibrillation
Other dangerous effects include: bradycardia, prolonged PR interval, accelerated rhythm, and possible bidirectional ventricular tachycardia
67
True or false.. digitalis is a drug indicated for use in patients suffering from congestive heart failure and cardiac dysrhythmias
True
68
How does digitalis work?
It makes cardiac muscles contract more strongly and pump more efficiently, improving blood circulation and reducing edema
69
What are four symptoms of digitalis intoxication?
Nausea
Emesis
Diarrhea
Cardiac arrhythmia
Headache
70
Which strain of bacteria is most commonly associated with dental-related subacute bacterial endocarditis?
Alpha-hemolytic streptococci
Species include: S. Mitis, S. Mutans, S. Salivarius, S. Sanguinus.
71
___ time is the time required by the blood to form a clot and is measured in seconds
Prothrombin
72
If a patient on warfarin wants a tooth extracted and has an INR over ___, the patient’s physician should be consulted about how to proceed. A common practice is for the physician to prescribe...
3.5
The patient to stop taking warfarin two days prior to the day of extraction
73
____ is a broad-spectrum bacteriostatic antibiotic associated with a risk of aplastic anemia, pancytopenia (bone marrow inhibition), and gray baby syndrome (liver failure in fetuses). This drug is used most commonly to treat ___
Eye infections
74
____ is the first-line drug to be used to treat bradycardia. It is an anti muscarinic agent. It increases the heart rate by blocking the action of the __ nerve and increasing the firing of the ___ node.
Atropine
Vagus
SA
75
The heart has both __ and ___ adrenergic receptors, but __ are the most prevalent receptor present, they can cause an increase in heart rate and contractile force. ___ receptors are predominately present in vascular smooth muscle.
B1 and B2
B1
B2
76
Hydrochlorothiazide, a thiazide diuretic, may necessitate a supplementation with ___ in order to reduce the patient’s blood pressure and prevent occurrence of ___ (hydrochlorothiazide causes teh body to lose ___).
Potassium
Hypokalemia
Potassium
77
Cardiac glycosides are known to decrease the concentration of ___ ions in cardiac myocytes. ___ is a cardiac glycoside known to be a potent inhibitor of Na+K+ATPase in the cell. When cardiac glycosides inhibit Na+K+ATPase, the transition state stabilizes and the sodium ions are not extruded, increasing intracellular sodium concentration.
Potassium
Digitalis
78
Which class of antihypertensive drugs inhibits the release of renin from the kidney?
B-adrenergic receptor blockers
79
Describe the mechanims of action of hydralazine.
Acts to directly relax the vascular smooth muscle in the arteries and arterioles causing vasodilation, which decreases blood pressure.
It is not a primary drug in the management of hypertension, because it also stimulates the baroreceptor reflex, increasing the patient’s heart rate and cardiac output.
80
Hydralazine is contraindicated in patients with ___ because...
Coronary artery disease
It could trigger angina pectoris or possibly a myocardial infarction
81
Describe the mechanism of action of propranolol to relieve angina.
Blocks the B-adrenergic receptors of cardiac muscle.
Propranolol is the first nonselective beta blocker developed and is used to treat hypertension, anxiety, and panic attacks
Propranolol blocks the action of epinephrine and norepinephrine on both B1 and B2 adrenergic receptors and exhibits little intrinsic sympathomimetic activity.
Due to its high penetration across the blood brain barrier, lipophilic beta blockers such as propranolol and metoprolol are more likely to cause sleep disturbances such as insomnia, vivid dreams, and nightmares.
82
What test is the most valuable for evaluating the surgical risk of a patient on warfarin who needs a tooth extracted? Describe this test. What is the normal range?
Prothrombin time - measures the clotting tendency of blood. Normal range is 12-13 seconds.
83
The __ is used in conjunction with prothrombin time. It should come within range of __-__.
0.8 - 1.2
84
Heparin function by preventing the conversion of ___ to ___.
Prothrombin to thrombin
Heparin activates and potentiates the activity of antithrombin, which inactivated thrombin and other pro teases involved in blood clotting (most notably factor Xa)
Heparin plays an important role in hemostasis, preventing coagulation by directly preventing soluble fibrinogen conversion into insoluble fibrin.
Heparin is secreted by basophils and mast cells.
85
___ is a short-acting vasodilator administers through inhalation to treat angina pectoris or cyanide poisoning. It takes effect within 30 seconds of inhalation and lasts about 5 minutes. Physiologic effects include dizziness, headache, decrease in BP, increased heart rate, and relaxation of involuntary muscles. It causes coronary artery dilation, decrease in arterial blood pressure, peripheral arterial dilation, tachycardia.
Amyl nitrite
86
What is the correct dosage necessary for subacute bacterial endocarditis prophylaxis using clindamycin? (Pt is allergic to penicillin)
600mg one hour prior to the procedure
Or 500mg azithromycin, or 500mg clarithromycin
87
What is the correct dosage necessary for subacute bacterial endocarditis prophylaxis using amoxicillin?
2g one hour prior to appointment
88
If the patient is unable to take oral medication, what should be administered to the patient one hour prior to appointment to prevent subacute bacterial endocarditis?
Ampicillin 2g intramuscularly or intravenously
Or
Cefazolin/ceftriaxone 1g IM or IV
89
What class of drug is atenolol? What is it used to treat?
B-adrenergic receptor blocking drug
Used to treat low-grade essential hypertension. Atenolol is currently recommended only in special circumstances as complementary medication in HTN.
90
Verapamil is a ___ blocker
Calcium channel
91
What are the 8 beta blockers? What is the mnemonic?
The NEPAL Prime Minister
```
Timolol
Nadolol
Esmolol
Pindolol
Atenolol
Labetalol
Propranolol
Metoprolol
```
92
What are some common side effects of Hydrochlorothiazide?
```
Hypokalemia (low potassium)
Hypomagnesemia (low magnesium)
Hyponatremia (low sodium)
Hypercalcemia (high calcium)
Hyperuricemia leading to gout
Hyperglycemia
Hyperlipidemia
```
93
What is the pediatric dose of amoxicillin?
50mg/kg of body weight up to a max of 2000mg
94
What is the mechanism of action through which propranolol functions as an antianginal?
Blocking the B-adrenergic receptors of cardiac muscle
95
Thromboemboli formation is prevented by inhibiting ___
Synthesis of thromboxane by COX
Thromboxane is a vasoconstrictor responsible for platelet aggregation and for thromboemboli
Aspirin causes the irreversible inactivation of the enzyme cyclooxygenase (COX), which is responsible for the production of prostaglandin and thromboxane. Thromboxane synthetase is the enzyme that mediates the reaction of thromboxane formation
96
Sine individuals may exhibit hypersensitivity to a local anesthetic agent or the preservative added to it. Allergic reactions have been seen mainly during the administration of ___-type local anesthetic and are due to the release of ____, which is a strong antigens and may sensitize the lymphocytes and induce the production of antibodies.
Ester
PABA (para-amino benzoic acid)
97
The therapeutic function of nalidixic acid is best characterized as an ____. It is a ___ antibiotic effective against gram-____ and is most considered bacteriostatic in low concentrations and bacteriocidal in higher concentrations.
Antiseptic for the urinary tract
Quinolone
Negative and gram positive
98
Neuromuscular blockade of the phrenic nerve can be caused by extremely high doses of ___. This pharmaceutical is a bacteriocidal ___ IV/IM antibiotic.
Streptomycin
Aminoglycoside
99
_____ has been reported to possess neuromuscular-blocking properties. Extremely high doses have allegedly resulted in lethal neuromuscular blockades of the ___ nerve.
Streptomycin
Phrenic
100
What is streptomycin typically prescribed for?
Tuberculosis
Infective endocarditis
Plague
101
Uncomplicated respiratory tuberculosis is best treated with a combination of ___ and ___, because they function by different mechanisms. ___ functions by inhibiting the synthesis of mycolic acid, a component of the mycobacterium cell wall. ___ functions by inhibitin bacterial DNA-dependent RNA polymerase, stopping bacterial RNA production.
Rifampin and isoniazid
Isoniazid
Rifampin (rifampicin)
102
Tuberculosis and inactive meningitis are treated with a cocktail of ___, ___, ___, __, and ___. What is the mnemonic?
RIPES
```
Rifampin
Isoniazid
Pyrazinamide
Ethambutol
Streptomycin
```
103
Why is isoniazid one of the most potent and most common antibiotics used to treat Mycobacterium Tuberculosis?
It is very effective against actively multiplying bacteria
It can be prescribed alone or co-administered with other antibiotics
Isoniazid treatment takes 6-12 months to completely eradicate tuberculosis
Isoniazid is usually administered orally or intramuscularly
104
Isoniazid treatment takes __ - ___ [months/weeks] to completely eradicate tuberculosis
6-12 months
105
Which tetracycline group has the longest half-life?
Doxycycline
106
What is doxycycline used to treat?
Malaria
Lyme disease
Rocky Mountain spotted fever
Acne
107
Taking doxycycline with __, __, __, or __ may decrease the effectiveness of the drug
Dairy
Antacids
Calcium supplements
Iron products
Laxatives containing magnesium
108
Describe the mechanism of action for the tetracycline family of drugs.
Inhibits protein synthesis
It binds to the 30S subunit of bacterial ribosomes, preventing the aminoacyl-tRNA from binding to th acceptor site
109
Prolonged use (more than ___ days) of clindamycin is discouraged because...
14 days
There is a high incidence of pseudomembranous colitis.
110
Clindamycin is a ___ antibiotic used to treat ___ bacterial infections and some ___ diseases such as ___, and its use is associated with ____. Clindamycin may prolong the effects of ___ drugs such as ___.
Lincosamide
Anaerobic
Protozoal
Malaria
Pseudomembranous colitis
Neuromuscular-blocking drugs
Succinylcholine
111
Crystalluria is less likely to occur with sulfonamide treatment if accompanied by ___. Describe this technique.
Sulfanamide cocktail method.
Adequate fluid intake may lessen the chances of urolithiasis when taking sulfonamides.
The sulfanilamide cocktail method is the use of sulfanamide antibiotics in conjunction with other agents to decrease sulfanamide needed and thereby prevent crystallurea and stone formation
112
What is the mnemonic for the characteristics os sulfonamides?
SULFA
Steven-Johnson Syndrome (skin rash, solubility low)
Urine precipitation (useful for UTI)
Large spectrum (G+ and -)
Folic acids synthesis blocker (and synthesis of nucleic acids)
Analog of PABA
113
Tetracycline is a [broad/narrow] spectrum [bacteriostatic/bacteriorcidal] antibiotic that functions by inhibiting ___. IT has higher levels of concentration in ___ than in the ___. It is used to treat ___ diseases caused by pathogens like ___ and ___.
Broad
Bacteriostatic
Protein synthesis
Crevicular than in serum
Aggregatibacter actinomycetemcomitans
Porphyromonas gingivalis
114
What is benzylpenicillin? It exits the body primarily through ___.
Penicillin G
Tubular secretion in kidney
115
Long-term tetracycline use is associated with __, __, and ___. As well as causing discoloration of teeth during the mineralization stage of development.
Diarrhea
Photosensitivity
Superinfection
116
What is amantadine?
An anti-Parkinson’s drug.
It is a weak antagonist of the NMDA type glutamate receptor, which increases dopamine release and blocks dopamine reuptake
117
What erythromycin compound is enterically coated and has prolonged action?
Eryc
118
What is zidovudine and what is it used to treat?
A nucleoside analog reverse-transcriptase (NRTI) inhibitor antiretroviral drug
Used to treat HIV
119
True or false... the american heart associations recommendations suggest antibiotic prophylaxis for patients with high-moderate risk heart conditions prior to having dental treatments with significant bleeding in the mouth.
True
Restorative procedures are usually ok without prophylaxis
Subgingival placement of antibiotic fibers/strips are indicated to use prophylactic systemic antibiotics because this could induce significant bleeding
120
Carbonicillin is a ___ antibiotic belonging to the ___ subgroup of the penicillins. It has gram ___ coverage, which includes ___, but has limited gram ___ coverage. It is susceptible to degradation by ___ enzymes
Bacteriolytic
Carboxypenicillin
Negative
Pseudomonas aeruginosa
Positive
Beta-lactamase
121
____ is a macrolide antibiotic that binds to the 50S subunit of the bacterial ribosome, inhibiting peptide synthesis. It can indirectly inhibit digoxin metabolism and can thus contribute to serious complications. 75% of patients taking this drug experience nausea and vomiting and has numerous other important drug interactions. This drug is not recommended.
Erythromycin
122
___ are similar in effect and chemical structure to penicillin, so this drug is not prescribed to patients with a penicillin allergy
Cephalosporins
123
____ is a lyncomycin antibiotic that can be used if the patient is allergic to penicillin and is very effective in fighting gram positive bacteria, including ___, which is responsible for pus and abscess formation.
Clindamycin
Staphylococcus aureus
124
The relative insolubility in water of ____ may lead to An increased incidence of renal lithiasis (kidney stones). Because of the risk of kidney stones it is usually prescribed with ___, creating a synergistic combination that allows less ___ to be given, decreasing kidney stone risk.
Sulfamethoxazole
Trimethoprim
Sulfamethoxazole
125
Sulfamethoxazole is most commonly prescribed for __, ___, and __ infections.
Streptococcus
Staphylococcus
E. Coil
126
Describe the mechanism of action of sulfa drugs.
Sulfa drugs are structural analogs and competitive antagonists of para-aminobenzoic acid (PABA) , which is used in the synthesis of folic acid. Interfering with folic acid synthesis prevents bacterial DNA replication
127
The fluoroquinolone antibiotic ciprofloxacin (___ generation) is effective against ___. it has [poor/excellent] tissue penetration
Second
Pseudomonas aeruginosa (because of its effectiveness against gram-negative organisms.
Excellent
128
Describe the mechanism of action of ciprofloxacin
It is bacteriocidal because it interferes with the rewinding of bacterial DNA after its copied, stoping DNA synthesis
129
Ciprofloxacin is also known for its tendency to cause spontaneous ___ and may worsen the symptoms of ___
Tendon ruptures
Myasthenia gravis
130
Name 5 third-generation cephalosporins
```
Cefcapene
Cefuroxime
Cefdinir
Cefixime
Moxalactam
```
131
Pseudomonas infections indicate prescription of what kind of penicillin?
Ticarcillin and carbenicillin
Pseudomonas are bacteria that most commonly cause nosocomial infections. Carbenicillin and ticarcillin are two penicillin-derived antibiotic drugs that are effective against pseudomonas and enterobacter infections.
132
True or false, all members of the tetracycline class may induce photosensitivty, interfere with bone development, and discolor teeth
True
133
____ is the only tetracycline known to cause ___. It acts by binding to the ___, impairing protein synthesis of bacteira.
Demeclocycline
Nephrogenic diabetes insipidus
30S and 50S
134
Women taking oral contraceptives are more susceptible to what potentially fatal condition? This is due to the increase in activity of ___ and ___ due to the increase in the blood levels of estrogen and progesterone
Thromboembolism
Fibrinogen
Coagulation factors VII, VIII, and X
135
What is the only anesthetic drug that can both induce vasoconstriction of blood vessels and increase systemic blood pressure?
Cocaine
136
True or false.. acetaminophen has no anti-inflammatory property f
False. It an analgesic that has antipyretic (anti-fever) property and some anti-inflammatory response (although much weaker than NSAIDs)
137
What is acetylsalicyclic acid?
Aspirin
138
Describe the mechanism of action of Aspirin.
Inhibits COX 1 and COX 2
139
COX is an enzyme involved in the synthesis of prostaglandins including ___ and ___, which function to...
PGE2
PGF2-alpha
Mediate pain within the body
140
Why are opioids absolutely contraindicated in patients with severe cranial trauma?
Because of the possible increase in intracranial pressure
Opioid have the ability to significantly elevate the intracranial pressure which may cause each of the following in cranial trauma patients:
```
Intracranial bleeding
Blood clot
Brain damage
Shifting of brain structures
Herniation of the brain
Impeded supply of blood to the brain
```
141
During the administration of opioid analgesics, stimulation of ___ is responsible for the feeling of nausea and vomiting.
Chemoreceptor trigger zone
The CTZ of the medulla oblongata functions by receiving input signals from hormones or certain blood borne medications, then relays it toward the vomiting center of the brain to induce vomiting.
The neurotransmitters involved in the control of vomiting and nasuea may include dopamine, histamine, serotonin, substance p, and acetylcholine
The presence and activation of opioid receptors may be responsible for the reason why administration of opioid analgesics may cause nausea and vomiting.
142
In comparison to codeine, morphine is [more/less] potent. Morphine is used in managing pains caused by myocardial infarction and labor.
More
It is used to alleviate moderate-to-severe pain
143
Blood dyscrasias, like leukopenia, aplastic anemia, and neutropenia, are most commonly caused by which NSAID?
Indomethacin (although blood dyscrasia caused by NSAIDs are rare)
144
____ is a drug that provides anti-inflammatory, antipyretic, and analgesic effects. It is proven to be useful in managing conditions like chronic arthritis. The use of this drug is limited due to its ability to inhibit ____
Indomethacin
The aggregation of platelets
145
The supraspinal analgesic action of morphine is achieved by binding to ___ receptors. Activation of these receptors creates...
Mu
Sedation, itching, analgesia, euphoria
Decreased respiration, constricted pupils or miosis, and reduces blood pressure
Decreased bowel movement that eventually leads to constipation
146
___ opioid receptors are responsible for spinal anesthesia
Delta
147
___ ions regulate the binding affinity of opioid agonists and antagonists to opioid receptors. Binding affinity depends on what 3 things?
Sodium
Receptor type
Affinity of sodium with the receptor
Whether the substance is an opioid agonist or antagonist
148
What kind of anesthetic can penetrate mucosal tissues up to 3mm, allowing it to function as a topical anesthetic?
Lidocaine
149
__, taken in childhood, is associated with Reye’s syndrome. What are the symptoms of Reye’s syndrome?
Aspirin
Rashes
Vomiting
Brain damage
Liver damage
The exact cause is unknown and while it ha Ben associated with aspirin consumption with children with viral illness, is has also occurred in the absence of aspirin use
150
Tylenol 1, 2, 3, and 4 contains __mg of codeine?
1 - 8mg
2 - 15mg
3 - 30mg
4 - 60mg
151
___ is an opiate drug that is typically indicated for patients suffering from ___, __, and __ pain because it stays in the blood longer and provides relief over a longer period of time. This drug has a high drug dependency/addiction rate.
Oxycodone.
Moderate, severe, spontaneous
152
When nitrous oxide reacts with oxygen and converted into ___, it causes ___
Nitric oxide
Vasodilation
153
What anesthetic is prone to induce allergic reactions due to PABA metabolite that is formed during its metabolism? It is an ester-type anesthetic with a short duration of action.
Procaine
154
Name 5 symptoms of an opiate overdose.
Pin-point pupils (pulpillary miosis)
Seizures
Muscle spasms
Decreased heart rate
Decreased respiratory rate
155
____ can reverse the effects caused by opioid overdose.
Naloxone
156
What constituent of IV digoxin, IV diazepam, IV phenytoin is considered the putative agent responsible for inducing thrombophlebitis? What is its purpose?
Propylene glycol
Purpose is to make the drugs more soluble and stable
Propylene glycol is regarded safe although it may become toxic in high levels with pediatric patients
157
What is ketorolac?
An anti-inflammatory that can be administered through IV, IM and oral routes.
It is primarily used to relive moderate levels of pain. It is usually prescribed as a post-operative pain reliever or after any other painful procedures
The administration of a ketorolac injection together with ketorolac tablets should not exceed or go beyond 5 days to avoid the increased risk of experiencing severe adverse effects
158
The preservative methylparaben most likely demonstrates cross-sensitivity to ___ because the ___ of paraben is located on the para position which can eventually react with para-amino structure of PABA ester. The para position of amino group in PABA ester is a free amino group on the benzene ring that can react with the hydroxyl group of the paraben and cause the cross-sensitivity reaction.
Esters of para-amino benzoic acid (PABA ester)
Hydroxyl
159
___ is indicated for mild-moderate pain in pregnant women. ___ is contraindicated in early pregnancy because it may increase the risk of ___. It is contraindicated in the 3rd trimester because it may increase the child’s risk of ___. Aspirin is contraindicated for pregnant women because it may induce premature closure of ___.
Acetaminophen
Ibuprofen
Miscarriage
Heart problems
Fetal ductus arteriousus
160
What is the mechanism of action by which epinephrine blocks the effects of histamine?
Induction of physiologic effects opposite to histamine.
161
Histamine release causes ___, ___, ___, ___, and ___
Contraction of smooth muscles of lungs
Bronchoconstriction
Swelling
Difficulty breathing
Anaphylaxis
Also causes... hypotension due to relaxation of vascular smooth muscle and increased capillary permeability. Stimulation of H1 receptors to cause bronchoconstriction. Stimulation of H2 receptors that stimulate gastric acid secretion. Histamine-selective C-fiber stimulation that is responsible for creating an “itching” sensation
162
NE release or epinephrine administration produces ___, ___, and ___
Bronchodilation
Blood vessel constriction
Increased cardiac output
Epinephrine is the best drug for managing anaphylaxis due to its ability to counteract the effects that causes anaphylaxis
163
What is an antihistamine that can be injected as a local anesthetic if the patient reports that they are allergic to ester and amide anesthetics?
Diphenhydramine
164
What is the intended target of H2 histamine receptor blockers?
Parietal cells of the stomach - induces proton release to decrease pH
165
What is the purpose of H2 receptor blockers?
Reduce the amount of acid in the stomach
166
What is the formula for the therapeutic index of pharmaceutical agents?
LD50/ED50
This is a comparison of a drug’s therapeutic effect over its toxic or lethal side effect. The index is measured by dividing the lethal dose over its median effective dose
Drugs having a low therapeutic index provide a narrow margin of safety, which means the drug may pose a great risk compared to its medical value
167
True or false... calcium channel blockers are vasoconstrictors
False. They are vasodilators
168
What medication inhibit a-glucosidase and reduce glucose absorption in the GI tract?
Acarbose
Acarbose inhibits a-glucosidase, an intestinal enzyme found in the small intestine that breaks down starch into glucose. This reduces the glucose absorbed by the GI tract
If a patient is taking acarbose and becomes hypoglycemic, the patient must eat something with monosaccharides, such as glucose tablets or gel. Fruit juice or starchy foods do not effectively reverse the hypoglycemic state
Hepatitis may develop from acarbose use; liver enzymes should be checked before and during use.
169
True or false... hepatitis may develop from acarbose use
True
170
Which opioid analgesic can create a serious, life-threatening adverse drug reaction when given to a patient on monoamine oxidase inhibitors?
Meperidine
Meperidine when combined with an MAOI can cause life-threatening effects. Including fever, excessive sweating, nervous system excitability, and respiratory depression which can lead to unconsciousness
Meperidine is a drug that helps to control the amount of serotonin and dopamine in the blood. Excessive amounts of these substances can cause a hypertensive crisis.
171
Vaginal candidiasis can be treated by which oral antifungal drug? How does it work?
Fluconazole - which is an oral triazole antifungal agent prescribed to treat and prevent superficial and systemic fungal infections by inhibiting the fungal cytochrome P450 enzyme. Inhibition of this enzyme prevents the conversion of lanosterol to ergosterol, an essential component of the fungal cytoplasmic membrane.
172
What is the recommended pharmacological treatment for xerostomia?
5mg pilocarpine
Pilocarpine is a parasympathomimetic alkaloid considered a nonselective muscarinic receptor agonist. It stimulates the secretion of large amounts of saliva and sweat through muscarinic receptor stimulation
Pilocarpine has been used in the treatment of chronic open-angle glaucoma
173
What is the mnemonic for the muscarinic effects?
SLUG BAM
Salivation, secretions, sweating
Lacrimation
Urination
Gastrointestinal upset
Bradycardia, bronchoconstriction, bowel movement
Abdominal cramps, Anorexia
Miosis
174
Hydroxyine can cause ____ due to its antimuscarinic effects.
Xerostomia
175
Clotrimazole is a/an ____ that inhibits ____ synthesis to prevent fungal cell wall production. It is a topical antifungal delivered as a troche that is dissolved in the mouth
Imidazole
Ergosterol
176
Ketoconazole and flucanozale are [systemic/topical] antifungal s.
Systemic
177
isoproterenol is a ____ that is similar to ___ in its cardiac excitatory action but different from epinephrine in its vasodilation properly. It is a potent ___ when used in __ and ___ forms.
Sympathomimetic
Epinephrine
Bronchodilator
Sulfate and hydrochloride forms
178
_____ is a sedative hypnotic drug used to alleviate anxiety that does not cause depression of the CNS. It does not impair cognitive and motor coordination, as observed with other anxiolytic drugs. It also does not cause physical dependence or any form of withdrawal syndrome. It is typically used for generalized anxiety disorder, but it is not known to be effective in controlling panic disorder.
Buspirone
179
Belladonna alkaloids are contraindicated to patients predisposed to _____ because...
narrow-angle glaucoma
because they prevent evacuation of aqueous humor through the canal of Schlemm and elevate intraocular pressure by increasing pupillary diameter.
180
_____ like atropine are derived from the Atropa belladonna, or deadly nightshade, plant and function as anticholinergic drugs. ____ causes pupil dilation by paralysis of the ciliary muscle, preventing lens accommodation. It prevents action of acetylcholine on muscarinic receptors M1–M5, causing an increase in sinoatrial (SA) node output.
Belladonna alkaloids
Atropine
181
Local anesthetic agents can be classified into ___ and ___. Articaine, bupivacaine, lidocaine and prilocaine are examples of ____
amides and esters.
amides.
182
Benzylpenicillin (penicillin G) is administered parenterally because it is unstable to hydrochloric acid of the stomach and can achieve high tissue concentration within tissues.
______ can be taken orally because it is more stable in the acidic environment of the stomach and is absorbed better than penicillin G.
Phenoxymethylpenicillin (penicillin V)
183
Antihypertensive drugs often cause postural hypotension because they interfere with ____
Sympathetic control of vascular reflexes
Baroreflex and autonomic pathways normally ensure that blood pressure is maintained despite various stimuli, including postural change.
α-adrenergic (sympathetic) activity is the predominant pathophysiologic mechanism of orthostatic hypotension in hypertensive patients, especially with patients taking receptor-blocking medications.
184
Which pharmaceutical is the etiologic agent in the remission of acute leukemia in children?
It is a 4-amino analog of folic acid that acts as an antineoplastic agent with immunosuppressive properties. It was replaced by methotrexate due to its more favorable therapeutic index.
It competes for the folate-binding site of the enzyme dihydrofolate reductase, blocking tetrahydrofolate (THF) and resulting in the depletion of nucleotide precursors and inhibition of DNA, RNA, and protein synthesis.
Aminopterin
185
Name 4 medication classes that reduce cardiac contractility and exacerbate congestive heart failure:
Antiarrhythmics
Beta blockers
Calcium channel blockers
NSAIDs
186
______ —specifically carvedilol, metoprolol, and bisoprolol—are part of the foundation of care for chronic heart failure.
Beta blockers
187
____ is a powerful antibiotic but has to be administered with extreme caution due to its adverse effects on the auditory nerve. It is an aminoglycoside used in treatment of severe infections. It may cause ototoxicity and renal dysfunction.
Gentamycin
188
_____ regulates the heartbeat of patients with atrial fibrillation by slowing down the ventricular contraction rate._____ is often prescribed for patients suffering from congestive heart failure.
Digitalis
189
Why is phenytoin indicated over phenobarbital for grand meal seizures?
Phenytoin has less of a sedative effect
190
What is the first line treatment indicated to reverse tricyclic antidepressant overdose?
Activated charcoal
Initial treatment of an acute overdose includes gastric decontamination of the patient by administering activated charcoal lavage, which absorbs the drug in the gastrointestinal tract.
Physostigmine is a reversible cholinesterase inhibitor that can reverse the effect of tricyclic antidepressant overdose in five to twenty minutes. However, it increases the risk of cardiac toxicity and may induce seizures.
191
Tricyclic antidepressant drugs enhance the ___ activity of the body
Anticholinergic
192
____ is a bacteriostatic antimycobacterial drug prescribed to treat tuberculosis and is usually co-administered with isoniazid, rifampicin, or pyrazinamide. It is bacteriostatic against actively growing tuberculosis (TB) bacilli and functions by obstructing the formation of the cell wall.
Ethambutol
193
The pediatric dose of clindamycin is ___ up to ___mg (which is the adult dosage)
20mg/kg
600mg
194
_____ is used to treat seizures, and abruptly stopping its use increases the risk of bleeding, complicating hemostasis. Thrombocytopenia may develop in patients taking this drug, because it inhibits the secondary phase of platelet aggregation and causes abnormal coagulation. Platelet count should be monitored in patients taking valproic acid.
Valproic acid
195
True or false... if a pt who is physically dependent on pentobarbital discontinues the medication it can induce convulsions
True
196
____ is a short-acting barbiturate or CNS depressant. Withdraw symptoms may be treated by administering another type of drug with similar effects as this drug.
Pentobarbital
197
Eccrine glands are innervated by the [parasympathetic/sympathetic] nervous system, primarily by [cholinergic/adrenergic] fibers.
Sympathetic
Cholinergic
198
Apocrine glands secrete sweat and oily compounds that act as pheromones when they are stimulated by ____
Adrenaline
199
One of the main side effects of antipsychotics is involuntary muscle movement, like ____ syndrome, due to their effect on the ___. This syndrome is suggested by the occurrence of involuntary muscle movement that usually occurs when there is incorrect regulation of ___ release and reuptake in the brain.
Extrapyramidal
Basal ganglia
Dopamine
200
True or false... corticosteroid can cause peptic ulcers
True
Corticosteroids have shown a marked increase in gastric acid secretion and a reduction in gastric mucus, as well as gastrin and parietal cell hyperplasia in animal studies. Studies have also shown that corticosteroids delay healing of previous ulcers.
201
The quaternary ammonium group in the structure of a cholinergic agent allows for it to act as a ___
Direct nicotinic antagonist
Nicotinic antagonists are a type of anticholinergic agent that inhibit the action of ACh at nicotinic ACh receptors and are used for peripheral muscle paralysis during surgery
202
What is the mnemonic for nicotinic effects?
M-T-W-Th-F
Mydriasis, muscle cramps
Tachycardia
Weakness
Twitching
Hypertension, hyperglycemia
Fasiculation
203
Tramadol binds to ___ receptors and inhibits the reuptake of ___ and ___. It must be metabolized In the hepatic pathway into a more active form. It is a ____-acting synthetic analgesic.
Mu-opioid
Norepinephrine and serotonin
Centrally
204
Erythromycin is a ___ antibiotic able to inhibit the metabolism of other drugs.
Macrolide
205
____ is a realtively safe antihistamine that may cause cardiac arrhythmias with overdoes. It is a popular drug because it is less sedating than other ____. If taken with _____ it may cause death.
Terfenadine
Anti-histamines
Erythromycin
206
Cross-allergy is most likely to happen with what two local anesthetic agents?
Lidocaine and mepivicaine
207
What types of diabetes drugs stimulate insulin release from B-cells in the pancreas?
Sulfonylureas
Meglitinides
208
What types of diabetes drugs block glucagon release from the pancreas?
Exenatide
Liraglutide
Pramlintide
209
What is the mechanism of action of metformin?
Acts to increase tissue glucose uptake
210
What drug class is the first-line treatment for depression?
Selective serotonin reuptake inhibitors
211
How does succinylcholine inhibit neuromuscular transmission?
Depolarization of the motor endplates of skeletal muscle
212
Administration of amyl nitrate for a prolonged period of time may result in___, which is....
Methemoglobinemia - a blood disorder characterized by levels of methemoglobin exceeding 1%
Hemoglobin with the presence of ferric heme group is called methemoglobin, which cannot carry oxygen
213
Name 3 causes of methemoglobinemia
Environmental factors
Benzocaine
Benzene
Nitrites
214
Trigeminal neuralgia is most commonly treated through the prescription of ___ drugs such as ___.
Anti-convulsants
Carbamazepine
215
Phenytoin is commonly prescribed as an anticonvulsant and has an ___ effect. It decreases activity of the ___, thereby controlling seizures. It can treat ___ secondary to ___ intoxication but cannot treat ___ due to cardiac diseases.
Antiarrhythmia
Arrhythmias
Digitalis
Arrhythmias
216
Homatropine bromide is a short-acting chemical drug utilized to cause ____ and ___. It is very useful as a ____ during ___ and as a treatment for ___. It is also used to temporarily paralyze ___ of the eyes
Mydriasis
Cyclopegia
Pupil dilator
Retinoscopy
Uveitis
Accommodation
217
What drug class is dextroamphetamine? What does this class of drugs do?
Indirect sympathomimetics
Work by blocking the norepinephrine transporter, inhibiting the reuptake of norepinephrine
These drugs have been used to treat low blood pressure, cardiac arrest, and delaying premature labor
218
Which class of antihypertensive drugs inhibits the release of renin from the kidneys?
B-adrenergic receptor blockers
Renin release from the kidney is stimulated by the B1-adrenergic receptors in the juxtoglomerular cells of the kidneys. B-adrenergic blockers (beta blockers) block the release of renin
219
____-based local anesthetics like ___ are metabolized by plasma cholinesterase
Ester
Procaine, chloroprocraine, tetracaine.
220
Amide-based local anesthetics are metabolized by the ___
Liver
221
Unlike other sedative hypnotic drugs, ___ is used to alleviate anxiety and does not cause depression of the CNS. It does not impair cognitive and motor coordination, as observed with other anxiolytic drugs. It also does not cause physical dependence or any form of withdrawal syndrome. It is effective in treating generalized anxiety but is not effective in controlling panic disorders. It is a serotonin 5-HT receptor agonist that does NOTcause CNS depression.
Buspirone
222
____ is a short-acting benzodiazepine that is used to treat acute seizures and moderate to severe insomnia, and to induce sedation and amnesia before medical procedures. It is more commonly associated with respiratory depression than diazepam. It professes potent anxiolytic, amnestic, hypnotic, anticonvulsant, skeletal muscle relaxant, and sedative properties. It has a fast recovery time. It is the most commonly used benzodiazepine for sedation and is used less commonly for induction and maintenance of anesthesia.
Midazolam
223
____, a benzodiazepine antagonist, can be used to treat an overdose of midazolam as well as to reverse sedation.
Flumazenil
224
As local anesthetics become more hydrophobic, their ___, ___, and ___ increases
Half life
Neurotoxicity
Potentcy
225
Diisopropyl fluorophsophate (DFP), and organophosphate pesticides function by...
Noncompetively inhibiting cholinesterases
226
Type ___ hypersensitivity reactions to local anesthetics have been well documented, predominately to __-type anesthetics.
4
Ester (benzocaine, chloroprocaine, cocaine, piperocaine, procaine, tetracaine)
227
lidocaine, mepivicaine, bupivicaine, prilocaine, articaine, and ropivicaine are all ___-type anesthetics
Amide
228
____ is an alkaloid nicotinic acetylcholine receptor antagonist used as an adjunctive drug in anesthesia. It works by relaxing skeletal muscles during surgery or intubation. It is also used as an agent in diagnosing myasthenia gravis. It has a slow onset of action and an unnecessary prolonged duration of about one to two hours.
D-tubocurarine
229
Methacholine is related to acetylcholine as a ___. Which is...
Congener
A congener is a substance that is closely related in composition, function, or origin
Methacholine is a synthetically made choline ester that is more predisposed to function as a muscarinic receptor agonist within the parasympathetic nervous system
Methacholine and acetylcholine are both cholinergic agonists, but methacholine’s duration of action is longer than that of acetylcholine
230
A physician may enhance renal excretion of an acidic drug by administering ___
Sodium bicarbonate
Alkalinization of urine through the use of sodium bicarbonate decreases acidic drug reabsorption and increases renal excretion of the drug
Acidic urine allows weak acid drugs to be easily reabsorbed
If the drug is a weak base, making the urine more alkaline helps the drug be reabsorbed
Excretion of drugs can be greatly affected by urinary pH
231
Pts with a history of cardiovascular problems should not exceed ___mg of epinephrine in a single visit.
0.04
232
When chlorpromazine is administered to a patient who then stands up, the patient may experience dizziness due to ___
Alpha-adrenergic inhibition
233
Chlorpromazine inhibits the __ and ___ ___ receptors, which results in symptoms including reflex tachycardia, sedation, vertigo, hypersalivation, and a possibility of sexual dysfunction
Alpha 1 and alpha 2 adrenergic
234
Name 5 penicillinase-resistant antibiotics
```
Cloxaclillin
Dicloxacillin
Methicillin
Oxacillin
Nafcillin
```
235
What oral antibiotic is most likely to cause the failure of contraceptives? How?
Rifampin
Rifampin is an antibiotic that affects the metabolism of oral contraceptive drugs within the body. Rifampin induces cytochrome P450 enzyme, so drugs that use this metabolic pathway undergo accelerated elimination
236
Flumazenil is a benzodiazepine receptor antagonist available for injection exclusively that reverses the effects of benzodiazepines by...
Competitive inhibition of benzodiazepine binding site on the GABA receptor
237
What is the likely mechanism of death for an irreversible anticholinesterase inhibitor? What are some other effects of the overdose?
Resipiratory failure due to diaphragmatic and intercostal muscle paralysis
Bradycardia
Bronchoconstriction
GI motility and secretion problems
Miosis
238
What is the mnemonic for effects of aorganophosphate overdose?
MUDGELS
```
Miosis
Urination
Defication
Gastrointestinal motility
Emesis
Lacrimation
Salivation
```
239
The duration of action of diazepam is due to the long half-life of its main active metabolite, known as ____, what may last from __-___days
Desmethyldiazepam
Three - seven
240
Diazepam is a [slow/fast] acting agent with a [long/short] duration of action. It is [water/lipid] soluble, binds to protein, and is widely distributed throughout the body after administration
Fast
Long
Lipid
