Step 1 Buzzwords Pharmacology Flashcards
USMLE Step 1 Recall: Buzzwords for the Boards Second Edition (351 cards)
0
Q
Which antispasmodic blocks the release of Ca2+ from the SR and is used in the treatment of malignant hyperthermia?
A
Dantrolene
1
Q
True or false?
Hyperkalemia increases the effect of digoxin.
A
False. Hyperkalemia decreases digoxin’s activity, while hypokalemia, hypomagnesemia, and hypercalcemia all increase digoxin toxicity.
2
Q
Which overdose carries a higher mortality rate, that of benzodiazepines or barbiturates?
A
Barbiturate overdose and benzodiazepine withdrawal carry the highest mortality rates.
3
Q
What antiviral agent is used in the treatment of drug-induced Parkinson’s disease?
A
Amantadine
4
Q
Are the following responses associated with histamines H1 or H2 receptor activation?
Edema
A
H1
5
Q
Gastric acid secretion
A
H2
6
Q
SA nodal activity
A
H2
7
Q
Pain and pruritus
A
H1
8
Q
Bronchial smooth muscle activity
A
H1
9
Q
Inotropic action and automaticity
A
H2
10
Q
True or false? The lack of dopamine production in the substantia nigra leads to the extrapyramidal dysfunction, characteristically seen in patients with Parkinson’s disease.
A
True. The lack of dopamine leads to an excess of ACh, hence extrapyramidal dysfunction.
11
Q
Which PG maintains patency of the ductus arteriosus and is used in the treatment of primary pulmonary HTN?
A
PGI2
12
Q
Which CNS ACh receptor or receptors are excitatory? Inhibitory?
A
M1 and nicotinic receptors are excitatory in the CNS and M2 receptor is inhibitory.
13
Q
True or false? β2-Adrenergic agents are used in the management of an acute asthmatic attack.
A
True. They are useful in the early-phase response to an asthmatic attack.
14
Q
Do local anesthetics bind to the activated or inactivated sodium channels?
A
Inactivated
15
Q
What is the DOC for treating Tourette syndrome?
A
Pimozide
16
Q
What mosquito is responsible for the transmission of malaria?
A
Anopheles mosquito
17
Q
What enzyme is inhibited by disulfiram?
A
Acetaldehyde dehydrogenase
18
Q
Which diuretic is used as an adrenal steroid antagonist?
A
Spironolactone
19
Q
What drug is given transdermally for chronic pain but can cause chest wall rigidity if given IV?
A
Fentanyl
20
Q
What is the drug of choice for penicillin-resistant gonococcal infections?
A
Spectinomycin
21
Q
What is the DOC for treating torsade de pointes?
A
Magnesium
22
Q
Is heparin contraindicated in pregnancy?
A
No. Heparin is safe in pregnancy, but warfarin is contraindicated in pregnancy because of its ability to cross the placenta.
23
Q
What oral antifungal agent is used to treat dermatophyte infections by disrupting microtubule structure and depositing keratin?
A
Griseofulvin
24
Which anticonvulsant can cause teratogenic craniofacial abnormalities and spina bifida?
Carbamazepine
25
What are the three β-lactamase inhibitors?
1. Clavulanic acid
2. Sulbactam
3. Tazobactam
26
Which anticonvulsant used in the treatment of bipolar disorder is refractory to lithium?
Carbamazepine
27
Are antineoplastic agents that work on actively proliferating cells schedule or dose dependent?
Schedule dependent; antineoplastic agents that work on nonproliferating cells are dose dependent.
28
Which class of diuretic is used to treat metabolic acidosis, acute mountain sicknesses, and glaucoma and to aid in the elimination of acidic drug overdoses?
Carbonic anhydrase inhibitors (acetazolamide and dorzolamide)
29
What estrogen receptor agonist in bone is used in the treatment and prevention of osteoporosis?
Raloxifene
30
Which tetracycline is used in the treatment of SIADH?
Demeclocycline
31
How is the eye affected by use of opioids?
With opioid use the pupils become pinpoint (miosis) because of increased cholinergic activity.
32
Name the antimicrobial agent whose major side effect is listed.
Grey baby syndrome
Chloramphenicol
33
CN VIII damage (vestibulotoxic)
Aminoglycosides
34
Teratogenicity
Metronidazole
35
Cholestatic hepatitis
Erythromycin
36
Hemolytic anemia
Nitrofurantoin
37
Dental staining in children
Tetracycline
38
Altered folate metabolism
Trimethoprim
39
Auditory toxicity
Vancomycin
40
Cartilage abnormalities
Quinolones
41
What are the two side effects of opioids to which the user will not develop tolerance?
Constipation and miosis
42
Which anticonvulsant is also used in the treatment of bipolar disorder and for migraine headaches?
Valproic acid
43
What antitubercular agent causes loss of red-green visual discrimination?
Ethambutol
44
Name the insulin preparation based on the peak effect and duration of action.
Peak, 8 to 16 hours; duration, 24 to 36 hours
Ultralente
45
Peak, 0.5 to 3 hours; duration, 5 to 7 hours
Regular insulin
46
Peak, 8 to 12 hours; duration, 18 to 24 hours
Lente or NPH insulin (neutral protamine Hagedorn insulin)
47
Peak, 0.3 to 2 hours; duration, 3 to 4 hours
Lispro insulin
48
Is digoxin or digitoxin renally eliminated?
Digoxin is renally eliminated; digitoxin is hepatically eliminated.
49
What is the DOC for steroid-induced osteoporosis?
Alendronate
50
What are the first signs of overdose from phenobarbitals?
Nystagmus and ataxia
51
How are lipid solubility and potency related for inhaled anesthetics? How do they affect onset and recovery?
Inhaled anesthetics with low lipid solubility have low potency (directly related), so they have rapid induction and rapid recovery; vice versa for drugs with high lipid solubility.
52
What α1-agonist, not inactivated by COMT, is used as a decongestant and for treatment of paroxysmal atrial tachycardia?
Phenylephrine
53
Which laxative is used in the treatment of hepatic encephalopathy?
Lactulose
54
Are hydrolysis, oxidation, and reduction phase I or II biotransformations?
Phase I
55
What β-blocker is also an α-blocker?
Labetalol
56
What agent is used IM to treat acute dystonias?
Diphenhydromine
57
True or false? Anaerobes are resistant to the effects of aminoglycosides.
True. Aminoglycosides use O2-dependent uptake and therefore are ineffective for treatment of anaerobic infections.
58
What two β-blockers decreased serum lipids?
Pindolol and acebutolol
59
If a drug is ionized, is it water or lipid soluble? Can it cross a biomemebrane?
Ionized drugs are water soluble, and since only lipid-soluble drugs can cross biomembranes, an ionized drug cannot cross them without the help of a carrier.
60
What are the longest-acting and shortest-acting benzodiazepines?
Diazepam is the longest acting and midazolam is shortest acting.
61
What is the DOC for severe infections with Sporothrix, Mucor, Histoplasma, Cryptococcus, Candida, and Aspergillus?
Amphotericin B
62
What neurotrasmitter is presynaptically inhibited by reserpine and guanethidine?
NE
63
Which two cephalosporins cross the blood-brain barrier?
Cefuroxime and cefaclor
64
What agent, in combination with a MAOI inhibitor, can cause hypertensive crisis?
Tyramine
65
True or false? Cocaine-induced coronary ischemia should not be treated with β-blockers.
True. β-Blockade would result in unopposed α-adrenergic stimulation and worsen the patient's symptoms. Calcium channel blockers are the way to go.
66
What antimuscarinic is used as an inhalant for asthma?
Ipratropium
67
What two forms of insulin, if mixed together, precipitate zinc?
Lente insulin and either NPH or protamine zinc insulin (PZI)
68
What androgen receptor blocker is used in the treatment of prostatic cancer?
Flutamide
69
What are the first signs of phenobarbital overdose?
Nystagmus and ataxia
70
Which virus is treated with the monoclonal antibody palivizumab?
RSV
71
Which medication used in the treatment of bipolar disorder decreases the release of T4 from the thyroid gland?
Lithium
72
Which class of antiarrhythmics are potassium channel blockers?
Class III
73
Which muscarinic receptor uses a decrease in adenyl cyclase as its second messenger?
M2
74
What antiepileptic agent has SIADH as a side effect?
Carbamazepine
75
What is the only anesthetic that causes cardiovascular stimulation?
Ketamine
76
Which bacteriostatic drug whose major side effect is the lepra reaction inhibits folic acid synthesis?
Dapsone
77
What form of antimicrobial therapy is best for an immunocompromised patient?
Bactericidal
78
Which direct-acting vasodilator is associated with SLE-like syndrome in slow acetylators?
Hydralazine
79
What class of heparin is active against factor Xa and has no effect on PT or PTT?
Low molecular weight heparin (LMWH)
80
What is the DOC for coccidioidomycosis?
Fluconazole
81
What three cephalosporins have good penetration against Bacterioides fragilis?
1. Cefotetan
2. Cefoxitin
3. Ceftizoxime
82
Which form of alcohol toxicity results in ocular damage?
Methanol
83
What immunosuppressive agent is converted to 6-mercaptopurine?
Azathioprine
84
Which size nerve fibers (small or large diameter) are more sensitive to local anesthetic blockade?
Nerve fibers with small diameter and high firing rates are most sensitive to local blockade.
85
What enzyme is inhibited by trimethorprim?
Dihydrofolate reductase
86
What are the two absolute requirements for the cytochrome P450 enzyme system?
NADPH and molecular O2
87
What three PGs are potent platelet aggregators?
PGE1, PGI2 (most potent), and TXA2
88
A depressive patient who is taking paroxetine goes to the ER with pain and is given meperidine. Shortly afterward she develops diaphoresis, myoclonus, muscle rigidity, hyperthermia, and seizures. What is your diagnosis?
Serotonergic crisis may be precipitated when an SSRI is mixed with MAOIs, TCADs, dextromethorphan, and meperidine. Treat it with cyproheptadine.
89
What class of drugs is used in the treatment of demineralization of the bone?
Bisphosphonates
90
What is the only class of diuretics to retain Cl- used in the short-term treatment of glaucoma and of acute mountain sickness?
Acetazolamide
91
True or false? All aluminum-containing antacids can cause hypophosphatemia.
True. Aluminum reacts with PO4-, resulting in AlPO4, an insoluble compound that cannot be absorbed.
92
What TCAD causes sudden cardiac death in children?
Desipramine
93
What two β2-agonists are used to produce bronchodilation?
Metaproterenol and albuterol
94
What IV-only agent inhibits water reabsorption in the PCTs and is used to treat increased intracranial pressure, increased intraocular pressure, and acute renal failure?
Mannitol
95
What cell type do cromolyn and nedocromil affect for prophylactic management of asthma via blockade?
They prevent mast cell degranulation.
96
What two β2-agonists cause myometrial relaxation?
Ritodrine and terbutaline
97
Where is the spinal cord are the presynaptic opioid receptors?
In the dorsal horn of the spinal cord on the primary afferent neurons
98
What thrombolytic agent is derived from β-hemolytic streptococci, is antigenic, and produces depletion of circulating fibrinogen, plasminogen, and factors V and VII?
Streptokinase
99
What antifungal agent is used to treat dermatophyte infections by inhibiting squalene epoxidase?
Terbinafine
100
Which class of antihypertensives produces angioedema, hyperkalemia, and a dry cough?
ACE inhibitors (the -pril agents)
101
Which medication requires an acidic gastric pH for activation to form a protective gel-like coating over ulcers and GI epithelium?
Sucralfate
102
Of what serotonin receptor is sumatriptan an agonist?
5HT1D
103
A patient with a history of epilepsy goes to the ER with sedation, gait ataxia, diplopia, and vertical nystagmus. Which anticonvulsant overdose resulted in the patient's symptoms?
Phenytoin
104
What are the five penicillinase-resistant penicillins?
1. Cloxacillin
2. Oxacillin
3. Nafcillin
4. Dicloxacillin
5. Methicillin
(CONDM)
105
Which aminoglycoside is the DOC for tularemia and the bubonic plague?
Streptomycin
106
Is the following description characteristic of competitive or noncompetitive antagonists: parallel shift to the right on a dose-response curve, complete reversibility with increase of the dose of the agonist drug, and capacity to decrease the potency of the agonist drug?
Competitive antagonist
107
True or false? Progestins are used in combination with estrogens to decrease the risk of endometrial cancer.
True
108
What nueroleptic agent causes agranulocytosis but does not induce tardive dyskinesia?
Clozapine
109
What two factors influence low oral bioavaiability?
First-pass metabolism and acid lability
110
What is the only site in the body that uses M1 receptors?
The stomach
111
What vitamin is a cofactor of aromatic AACD and decreases the efficacy of L-dopa if used concomitantly?
Vitamin B6 (pyridoxine)
112
True or false? Acetaminophen has analgesic and antipyretic activities but lacks anti-inflammatory effects.
True
113
What happens to plasma concentration of a drug is there is a large volume of distribution?
The larger the volume of distribution, the lower the plasma concentration of a drug.
114
Why should opioid analgesics be avoided for patients with head trauma?
Opioids cause cerebral vasodilation and can result in increased intracerebral pressure.
115
What is the drug of choice in the treatment of the lepra reaction?
Clofazimine
116
What two drugs, when mixed, can lead to malignant hyperthermia?
Succinylcholine and halothane (Treatment is with dantrolene.)
117
What three β-blockers are used in the treatment of glaucoma?
1. Propranolol
2. Timolol
3. Carteolol
118
What is the neurotransmitter at the k-receptor?
Dynorphin
119
True or false? Succinylcholine is a nicotinic receptor agonist.
True
120
What is the drug of choice for hypertensive patients with a decreased renal function?
α-Methyldopa (Guanabenz or clonidine is also used.)
121
What is the volume of distribution (increased or decreased) of a drug when a large percentage is protein bound?
Volume of distribution is decreased when a large percentage of drug is protein bound.
122
What antihistamine is used in the treatment of serotonergic crisis?
Cyproheptadine
123
What is the drug of choice for early Parkinson's disease?
Selegiline
124
What is the site of action of the following?
| Osmotic diuretics
The entire tubule barring the thick ascending limb
125
Loop diuretics
Ascending limb
126
Thiazide diurectics
Early distal tubule
127
K+ -sparing diuretics
Early collecting duct
128
Aldosterone antagonists
Distal convoluted tubules
129
What hematologic malignancy is treated with the monoclonal antibody rituximab?
Non-Hodgkin lymphoma
130
Which sodium channel blocker is used to treat lithium-induced diabetes inspidus?
Amiloride
131
Which two antipsychotic drugs create a high risk for developing EPS side effects?
Haloperidol and fluphenazine (but use of any high-potency phenothiazine runs the risk of EPS)
132
Could an overdose with either zolpidem or zaleplon be reversed with flumazenil?
Yes, because they both activate the BZ1-receptors, which can be reversed by flumazenil.
133
What drug blocks intragranular uptake of NE?
Reserpine
134
True or false? Antimicrobial agents that slow bacterial growht are bactericidal.
False. Bacteriocidals kill; bacteriostatics slow growth.
135
Which antihyperlipidemic agent would you not prescribe for a patient with a history of gout or PUD?
Nicotinic acid, because its side effects include hyperuricemia and exacerbation of ulcers.
136
What inhibitors of microtubule synthesis is the drug of choice for whipworm and pinworm?
Mebendazole
137
What antiviral agents inhibit neuraminidases of influenza A and B?
Zanamivir and oseltamivir
138
What three cephalosporins inhibit vitamin K-dependent factors?
Cefamandole, cefoperazone, and moxalactam
139
Which direct-acting vasodilator is used clinically to treat hypertensive emergencies, insulinomas, and as a uterine smooth muscle relaxant?
Diazoxide
140
Which leukotriene - LTA4, LTB4, LTC4, or LTD4 - is not associated with anaphylaxis and bronchoconstriction?
LTB4
141
What neuroleptic agent causes retinal deposits, hypotension, and torsades de pointes?
Thioridazine
142
What oral hypoglycemic agent inbhits α-glucosidase in the brush border of the small intestine?
Acarbose
143
What enzyme is inhibited by sulfonamides?
Dihydropteroate synthetase
144
What is the most important determinant of drug potency?
The affinity of the drug for its receptor
145
True or false? Estrogen use increases the risk of developing ovarian cancer.
False. Risk of breast and endometrial cancer but not ovarian cancer increases with the use of estrogen.
146
Which sedative-hypnotic is contraindicated for patients taking warfarin?
Chloral hydrate
147
What mixed α-antagonists are used for patients with pheochromocytoma?
Phentolamine and phenoxybenzamine
148
What are the four types of signaling mechanisms?
1. Intracellular receptors
2. Membrane receptors
3. Enzymes
4. Intracellular effectors
149
The dose of which second-generation sulfonylurea agent must be decreased for patients with hepatic dysfunction?
The dose of glipizide must be decreased in hepatic dysfunction. Glyburide's dose must be decreased in renal dysfunction.
150
Which nicotinic receptor antagonist causes hypotension and is associated with malignant hyperthermia?
d-Tubocurarine
151
What transient deficiency may result in a hypercoagulable state is warfarin is given alone?
Transient protein C deficiency, because of its relatively short half-life, may result if warfarin is instituted alone.
152
What component of the vascular system is most sensitive to the effects of calcium channel blockers?
Arterioles
153
What drug blocks glucose uptake, leading to decreased formation of ATP and resulting in immobilization of the parasite?
Albendazole
154
What is the site of action for carbonic anhydrase inhibitors?
Proximal tubule
155
What phase of the cell cycle are the following antineoplastic agents specific for?
Bleomycin
G2 phase
156
Cytarabine
S phase
157
Vinblastine
Mitosis
158
Alkylating agents
G0 phase
159
Paclitaxel
Mitosis
160
Vincristine
Mitosis
161
6-Thioguanine
S phase
162
6-Mercaptopurine
S phase
163
Dacarbazine
G0 phase
164
Hydroxyurea
S phase
165
Cisplatin
G0 phase
166
Nitrosoureas
G0 phase
167
Inhibition of peripheral COMT, allowing increased CNS availability of L-dopa, is accomplished by what two agents?
Tolcapone and entacapone
168
What medication is a PGE1 analog that results in increased secretions of mucus and HCO3- in the GI tract?
Misoprostol
169
Is there a difference between mathematical and clinical steady states? If so, what are their values (half-lives)?
There is a difference; it takes about 7 to 8 half-lives to reach mathematical steady state and 4 to 5 half-lives to reach clinical steady state.
170
True or false? At high doses aspirin has uricosuric properties.
True. At high doses ASA decreases uric acid reabsorption in the renal tubules, resulting in uricosuric actions. At low doses ASA decreases tubular secretion of uric acid, leading to hyperuricemia.
171
What antiviral agent is used to treat RSV, influenza A and B, Lassa fever, and hantavirus and as an adjunct to IFN-α in hepatitis C?
Ribavirin
172
Which aminoglycoside is used only topically because it is too toxic for systemic use?
Neomycin
173
Which class of antiarrhythmics blocks sodium channels?
Class 1 (1A, 1B, and 1C)
174
What form of penicillin is used in the treatment of life-threatening illnesses?
Penicillin G (benzylpenicillin)
175
What is the DOC for esophageal candidiasis?
Fluconazole
176
True or false? Flumazenil is used in the treatement of barbiturate overdose.
False. Flumazenil is unable to block the effects of barbiturates.
177
Which three aminoglycosides have vestibular toxicity?
1. Streptomycin
2. Gentamicin
3. Tobramycin
178
What is the term for the amount of a drug that is needed to produce the desired effect?
Potency
179
What agent used in the treatment of BPH and baldness is a 5-α-reductase inhibitor?
Finasteride
180
What β-blocker is also a membrane stabilizer?
Propranolol
181
Name one of the ADP receptor antagonists used in patients who are post-MI, have had TIAs, have unstable angina, and are allergic to ASA?
Ticlopidine or clopidogrel
182
What is the treatment for nephrogenic diabetes insipidus induced by lithium?
Amiloride
183
Which calcium channel blocker is used to treat subarachnoid hemorrhages by preventing posthemorrhagic vasospasms?
Nimodipine
184
What two drugs inhibit the release of neurotransmitters from storage granules?
Guanethidine and bretylium
185
What is the DOC for hyperprolactinemia?
Pergolide
186
True or false? The faster the rate of absorption, the smaller the time of maximum concentration (Tmax) and the maximum concentration (Cmax).
False. The faster the rate of absorption, the smaller the Tmax and larger the Cmax(bioinequivalence). The slower the rate of absorption, the larger the Tmax and smaller the Cmax.
187
What tetracycline is associated with hepatotoxicity?
Chlortetracycline
188
What is the term for how well a drug produces its desired response?
Efficacy
189
What drug, if given during pregnancy, would cause the uterus to exhibit signs of progesterone withdrawal and induce an abortion?
RU 486
190
Is allopurinol used in the acute treatement of gout?
No, it is used in chronic treatment of gout to decrease the uric acid pools in the body.
191
What three cephalosporins can produce disulfiram-like reactions?
1. Cefamandole
2. Cefoperazone
3. Moxalactam
192
What is the physiologic basis for the actions of birth control pills?
They block the midcycle surge of LH.
193
When a drug is administered orally and enters into portal circulation, it undergoes hepatic metabolism. What is the name of this effect?
First-pass effect
194
Which thrombolytic agent, activated in the presence of fibrin, is manufactured by recombinant DNA process?
Alteplase
195
Which benzodiazepine is most commonly used IV in conscious sedation protocols?
Midazolam
196
What is the drug of choice for threadworm, trichinosis, and larva migrans?
Thiabendazole
197
Can you tell which drug is more toxic based on therapeutic indices alone?
No, therapeutic indices can tell which drug is safer, not more toxic.
198
What blood disorder is a side effect of metformin?
Megaloblastic anemia (decreased absorption of vitamin B12 and folic acid)
199
A schizophrenic patient who is taking haloperidol is brought to your ER with muscle rigidity, a temperature of 104°F, altered mental status, and hypotension. What is your diagnosis and what is the treatment?
Neuroleptic malignant syndrome is a potentially life-threatening condition which is treated with symptomatic support, bromocriptine, and dantrolene.
200
Which α-blocking agent is used to treat refractory hypertension and baldness?
Minoxidil (orally and topically, respectively!)
201
What components of the coagulation cascade are affected by estrogen?
Estrogen can result in a hypercoagulable state because of the decrease in AT III and increase in factors II, VII, IX, and X.
202
What class of antimicrobial agents should be avoided in patients with a history of GPDH deficiency?
Sulfonamides
203
What enzyme of cholesterol synthesis is inhibited by the statins?
HMG-CoA reductase
204
What bacterial agents are resistant to β-lactamases and are used to treat in-hospital life-threatening infections?
Imipenem and meropenem
205
What adrenergic receptors use inositol triphosphate (IP3) and diacyglycerol (DAG) for their second messenger system?
α1-Receptors
206
True or false? Dopamine antagonists at the D2A receptor have the capacity to induce pseudoparkinsonism.
True
207
What two PGs are used to induce labor?
PGE2 and PGF2α
208
How are drugs that are excreted via the biliary system resorbed by the GI tract?
Enterohepatic cycling
209
Which drugs bind to the 30S ribosomal subunit and interfere with the initiation complex, causing a misreading of mRNA?
Aminoglycosides
210
What antiviral agent blocks the attachment and penetration of influenza A virus?
Amantadine
211
What is the antidote for organophosphate ingestion?
Atropine and 2-PAM (pralidoxime)
212
Which antihypertensive class is used to help stop the progression of microalbuminuria?
ACE inhibitors (-pril)
213
What class of drugs are the DOCs for peptic ulcer disease, Zollinger-Ellison syndrome, and gastroesophageal reflux disease?
Proton pump inhibitors
214
What bacteriostatic agent's side effect profile includes grey baby syndrome and aplastic anemia?
Chloramphenicol
215
Inhibition of peripheral aromatic AADC and increased CNS availability of L-dopa are results of what drug used in the treatment of Parkinson's disease?
Carbidopa and benserazide
216
What type of drug elimination is characterized by the following?
Elimination independent of plasma concentration; constant amount eliminated per unit time; no fixed half-life
Zero-order elimination
217
Elimination directly proportional to plasma level; constant fraction eliminated per unit time; fixed half-life
First-order elimination
218
True or false? NSAIDs have analgesic, antipyretic, anti-inflammatory, and antiplatelet activities.
True
219
True or false? Tetracyclines are bactericidal.
False. They are bacteriostatic.
220
What class 1A antiarrhythmic agent has SLE-like syndrome side effect in slow acetylators?
Procainamide
221
What is the major pulmonary side effect of μ-activators?
Respiratory depression
222
What neuroleptic agent is also considered to be an antihistamine?
Risperidone
223
What form of penicillin is stable in acid environments?
Penicillin V
224
What is the term for the proportion of a drug that reaches systemic circulation?
Bioavailability
225
What two drugs block dopa-decarboxylase in the periphery to decrease the conversion of L-dopa to dopamine?
Carbidopa and benserazide
226
What is the DOC for bipolar disorder?
Lithium
227
True or false? If a mother delivers a Rho-positive baby, she should receive Rho-immunoglobulin.
True if she is Rho-negative; false if she is Rho-positive.
228
True or false? Both GABA and glutamic acid are excitatory neurotransmitters in the CNS.
False. Glutamic acid is excitatory, but GABA is inhibitory.
229
What is the drug of choice for asymptomatic meningitis carriers?
Rifampin
230
What drug is used to differentiate a cholinergic crisis from myasthenia gravis?
Edrophonium
231
What class of antianginal activates the NO pathway to produce endothelial vasodilation?
Nitrates
232
What selective Cox-a inhibitor should be avoided in patients with a history of sulfonamide allergy?
Celecoxib
233
What is the DOC for blastomycoses and sporotrichoses?
Itraconazole
234
What are the two most important features in the diagnosis of malaria?
Splenomegaly and anemia (with a high index of suspicion)
235
Name the three benzodiazepines that are not metabolized by the cytochrome P450 enzyme system.
Oxazepam, temazepam, and lorazepam (OTL, Outside The Liver)
236
What drug is an M1-specific antispasmodic?
Pirenzepine
237
Which centrally acting α2-adrenergic agonist is safe for use in renal dysfunction and in HTN during pregnancy?
Methyldopa
238
What is the monoamine oxidase B (MAOB) inhibitor?
Selegiline
239
What antitubercular agent causes a red-orange tinge to tears and urine?
Rifampin
240
What two classes of drugs can cause schizoid behavior?
Glucocorticoids and amphetamines
241
What tetracycline is associated with vestibular toxicity?
Minocycline
242
What is the most potent NMJ blocker and also has no cardiovascular side effects?
Doxacurium
243
What two receptors in the chemoreceptor trigger zone lead to vomiting when stimulated?
D2 and 5HT3 receptors
244
Which group of antihypertensive agents best decrease left ventricular hypertrophy?
Thiazide diuretics
245
What area of the brain is linked to emotion and movement?
Mesolimbic system
246
Why are clozapine and olanzapine unlikely to result in EPS effects?
Because they do not block D2A receptors, they are antagonists of 5HT2 receptors.
247
What class of pharmaceuticals are inactive until they are metabolized to their active products?
Prodrugs
248
True or false? You would not prescribe probenecid for a patient with gout who is an overexcretor of uric acid.
True. Probenecid can precipitate uric acid crystals in the kidney if the patient is an overexcretor of urate.
249
True or false? Dopamine antagonists are antiemetic.
True. They block the dopamine receptors in the chemoreceptor trigger zone.
250
What bactericidal agent is the DOC for MRSA, enterococci, and Clostridium difficile?
Vancomycin
251
True or false? β-Blockers are contraindicated in patients who present to the hospital with CHF.
True. β-Blockers are a component of CHF regimen for stable patients, not those who are decompensated. (This means you discharge a patient from the hospital with a prescription for a β-blocker; you don't start β-blockers when the patient is admitted.)
252
True or false? Fluoroquinolones are bactericidal.
True. They inhibit DNA gyrase (topo II).
253
What antiviral agent for ganciclovir-resistant infections has limited utility because of its nephrotoxic side effect?
Foscarnet
254
What oral hypoglycemic agent stimulates pancreatic β-cell release of insulin and is given just prior to meals because of its short half-life?
Repaglinide
255
True or false? There is no absorption of an IV-administered drug.
True. No loss of drug and no absorption if a drug is given IV.
256
What hypothesis states that an antineoplastic agent kills a fixed percentage of tumor cells, not a fixed number?
Log-kill hypothesis (follows first order kinetics)
257
What is the only local anesthetic to produce vasoconstriction?
Cocaine
258
Which agent used in the treatment of asthma is a selective inhibitor of the lipoxygenase pathway?
Zileuton
259
What is the only diuretic that works on the blood side of the nephron?
Spironolactone (binds to aldosterone receptors)
260
Do you monitor heparin's therapeutic levels by PT or PTT?
Heparin, intrinsic pathway, PTT; warfarin, extrinsic pathway, PT (mnemonic: hPiTT, wPeT)
261
What is the only neuroleptic that does not cause an increase in weight or appetite?
Molindone
262
What α1-agonist is used to treat paroxysmal atrial tachycardia with hypotension?
Metaraminol (α1, β1)
263
What antiarrhythmic agent is the DOC for treating and diagnosing PSVT and AV nodal arrhythmias?
Adenosine (it is an excellent agent to use in emergencies because its half-life is 30 seconds)
264
What phosphodiesterase inhibitor is used IV in the management of status asthmaticus?
Aminophylline
265
Which nicotinic receptor antagonist is inactivated to laudanosine?
Atracurium
266
What α2-antagonist is used to treat impotence and postural hypotension?
Yohimbine
267
What drug of choice for ascaris causes neuromuscular blockade of the worm?
Pyrantel pamoate
268
Testing of a drug in a small group of volunteers without the disease is a component of which phase of clinical drug testing?
Phase 1
269
Which antimicrobial class may cause tooth enamel dysplasia and decreased bone growth in children?
Tetracycline
270
What antifungal agent is used in the treatment of androgen receptor-positive cancers?
Ketoconazole
271
What MAOI does not cause a hypertensive crisis?
Selegiline
272
Which penicillin can cause interstitial nephritis?
Methicillin
273
Is hirsutism a side effect of estrogen or progestin therapy?
Progestin
274
Which potassium-sparing drug is an aldosterone receptor antagonist?
Spironolactone
275
What are the three signs of morphine overdose?
1. Pinpoint pupils
2. Decreased respiratory rate
3. Coma
276
Which anticonvulsant is used in the treatment of bipolar disorder and neuropathic pain?
Gabapentin
277
True or false? Metformin is contraindicated in obese patients because of weight gain as its side effect.
False. Metformin does not have weight gain as a potential side effect (unlike sulfonylureas).
278
What is the DOC for the treatment of the late phase response in an asthmatic attack?
Corticosteroid
279
If you double the infusion rate of a drug, how long will it take to reach steady state?
Regardless of the rate of infusion, it takes 4 to 5 half-lives to reach steady state.
280
What is the neurotransmitter at the μ-receptor?
β-Endorphin
281
What is the DOC for the following protozoal infections?
| Amebiasis
Metronidazole
282
Leishmaniasis
Stibogluconate
283
Pneumocystis carinii pneumonia
Trimethoprim/sulfamethoxazole (TMP-SMX)
284
Giardiasis
Metronidazole
285
Trichomoniasis
Metronidazole
286
What hematologic agent is used in the treatment of intermittent claudication because it decreases blood viscosity and increases RBC membrane flexibility and stability?
Pentoxifylline
287
What enzyme system is the most commom form of phase II biotransformation?
Glucuronidation
288
In what three areas of the body are sympathetics the predominant tone?
1. Sweat glands
2. Arterioles
3. Veins
289
What is the only antifungal agent to penetrate CSF?
Fluconazole
290
Which class of antiarrhythmics are β-blockers?
Class II
291
What three cephalosporins are eliminated via biliary mechanisms?
1. Cefamandole
2. Cefoperazone
3. Ceftriaxone
292
Which centrally acting α2-adrenergic agonist is used in the treatment protocol of opioid withdrawal?
Clonidine
293
What is the name of the monoclonal antibody used in the treatment of Crohn disease and rheumatoid arthritis?
Infliximab
294
Which macrolide is used in the treatment of gastroparesis?
Erythromycin
295
What syndrome is characterized by the triad of renal tubular acidosis, nephrosis, and amino aciduria?
Fanconi-like syndrome
296
In what area of the brain can an excess of dopamine lead to psychotic symptoms?
Mesocortical area
297
Name five causes for zero-order metabolism.
1. Sustained release
2. IV drip
3. Phenytoin
4. Alcohol
5. Aspirin toxicity
298
What antitubercular agent requires vitamin B6 supplementation?
Isoniazid
299
Which antihistamine is one of the DOCs for treatment of vertigo?
Meclizine
300
What is the DOC for treating Entamoeba histolytica, Giardia, Trichomonas, Bacillus fragilis, and Clostridium difficile infections?
Metronidazole
301
Which class of antihypertensives is used in the treatment of BPH?
α-Blockers (-zosins)
302
Which macrolide is given as 1200 mg/week for the prophylaxis of Mycobacterium avium-intracellulare complex?
Azithromycin
303
What is the drug of choice, which inhibits oxidative phosphorylation in cestodes, for taeniasis?
Niclosamide
304
Which class of antihyperlipidemics would you avoid for a patient with elevated triglyceride levels?
Bile acid sequestrants (cholestyramine and colestipol) increase VLDL and triglyceride levels; therefore, they are not used is a patient has hypertriglyceridemia.
305
True or false? Ergotamines, because of their vasodilation action, are used in the treatment of migraines.
False. Ergotamines are used in the treatment of migraines for their vasoconstrictive action in the cerebral circulation.
306
Is DM a contraindication to use of a β-blocker in a patient who is having an MI?
Absolutely not. Diabetics who are given a β-blocker for an acute chest syndrome have significantly better outcomes than those who do not.
307
What β2-agonist is used as a prophylactic agent in the treatment of asthma?
Salmeterol
308
What hormone can be affected by dopamine release in the tuberoinfundibular pathway?
In the tuberoinfundibular pathway, dopamine release will decrease prolactin release, which is why dopamine agonists are used in the treatment of hyperprolactinemic states.
309
What determines the plasma level as steady state?
The rate of infusion
310
What enzyme is inhibited by propylthiouracil (PTU)?
5' deiodinase
311
What is the DOC for CMV retinitis?
Ganciclovir
312
What agent antagonized the effects of heparin?
Protamine sulfate
313
What antihypertensive agent produces cyanide and thiocyanate as byproducts?
Nitroprusside
314
What is the DOC for β-blocker-induced bronchospasms?
Ipratropium
315
What is the only neuroleptic agent that does not cause hyperprolactinemia?
Clozapine
316
True or false? Gynecomastia is a side effect of cimetidine.
True. Cimetidine can decrease androgen production and lead to gynecomastia.
317
What three drugs are associated with SLE-like syndrome in slow acetylators?
Hydralazine, isoniazid, and procainamide (HIP)
318
What is the drug of choice for filariasis and onchocerciasis?
Diethylcarbamazine
319
What aminoglycoside causes disruption of CN I?
Streptomycin
320
Which anticonvulsant causes gingival hyperplasia?
Phenytoin (cyclosporine and nifedipine also result in gingival hyperplasia)
321
What is the only NSAID that causes irreversible inhibition of the cyclooxygenase pathway?
ASA
322
What antifungal agent is activated by fungal cytosine deaminase to form 5-FU?
Flucytosine
323
Irreversible ototoxicity is associated with which loop diuretic?
Ethacrynic acid
324
What competitive estrogen receptor antagonist is used in the treatment of breast cancer?
Tamoxifen
325
Which tetracycline is used to treat prostatitis because it concentrates strongly in prostatic fluid?
Doxycycline
326
True or false? Dopamine is an excitatory neurotransmitter in the CNS.
False. Dopamine is an inhibitory neurotransmitter in the CNS.
327
What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?
Metformin
328
Which phase of clinical drug testing includes postmarket reporting of adverse reactions?
Phase 4
329
Which prophylactic asthmatic agent is an antagonist of LTD4?
Zafirlukast
330
What are the three C's of a TCAD overdose?
Coma, convulsions, and cardiotoxicity
331
What is the neurotransmitter at the δ-receptor?
Enkephalin
332
What body fluid preferentially breaks down esters?
Blood
333
What are the two broad-spectrum penicillins?
Ampicillin and amoxicillin
334
What are the three components to the asthma triad?
Nasal polyps, rhinitis, and ASA hypersensitivity
335
Which class of antiarrhythmics are calcium channel blockers?
Class IV
336
What are the glycoprotein receptors that platelets and fibrinogen cross-link to when forming a thrombus?
GP IIb and IIIa receptors
337
Which IV agent has the lowest incidence of postoperative emesis and has the fastest rate of recovery?
Propofol
338
Are two different receptors with two different agonists characteristic of pharmacologic or physiologic antagonism?
Physiologic antagonism
339
What GnRH analog is used as a repository form of treatment in prostatic cancer?
Leuprolide
340
Which antimicrobial agent is used with pyrimethamine to treat toxoplasmosis?
Clindamycin
341
What is the DOC for trigeminal neuralgia?
Carbamazepine
342
What drug that penetrates the blood-brain barrier is found in asthma preparations and used as a nasal decongestant?
Ephedrine
343
What is the term for drug removal per unit of time in a given volume of blood?
Clearance
344
Which two tetracyclines have the highest plasma binding?
Doxycycline and minocycline
345
What do the following values indicate?
| ED50
Effective dose for 50% of drug takers (median effective dose)
346
TD50
Toxic dose for 50% of drug takers (median toxic dose)
347
LD50
Lethal dose for 50% of drug takers (median lethal dose)
348
Do agents used in the treatment of Parkinson's disease that decrease ACh function have little effect on reducing tremors and rigidity?
Agents that decrease ACh function reduce tremors and rigitidy, not bradykinesias.
349
A patient goes to the ER with signs and symptoms of biliary colic. Which opioid analgesic do you choose?
Spams of the uterus, bladder, and the biliary tree occur with all of the opioids except meperidine.
350
What form of oxidation takes place with the addition of a water molecule and breakage of bonds?
Hydrolysis
