Pharmacology Phinal Portage

Portage Pharmacology Final

Match the route of oral administration to its indication:
oral =
transdermal =
intravenous =
vaginal =

with

provides continuous absorption

given as creams and suppositories

safest and most convenient

used in emergency situations

oral = safest and most convenient
transdermal = provides continuous absorption
intravenous = used in emergency situations
vaginal = given as creams and suppositories

The drug buprenorphine is given to decrease withdrawal symptoms in opioid users. It binds to opioid receptors in the brain but without the strength of other drugs.

Buprenorphine is an…

Partial Agonist

Aging can lead to decreased intestinal blood flow, surface area, and motility, which can slow the onset of action of an oral drug. Which pharmacokinetic process is affected in this scenario?

Absorption

When the combined effect of 2 drugs is greater than the sum of their individual effects its referred to as…

Synergism

T/F: Schedule IV drugs have high abuse potential and no accepted medical use

FALSE — Low abuse potential and an accepted medical use

Michael is a 2 year old male with a history of liver cirrhosis problem caused by biliary atresia. While on a family vacation, Michael developed a fever, and his parents found children's Motrin as the only antipyretic option at the hotel convenience shop. Is this appropriate for Michael? Explain why.

No, the doctor should be consulted first due to the liver cirrhosis

Match the drug or pharmacologic class found in OTC cold medication to its MOA or indication:

NSAID =
dextromethorphan =
decongestant =
chlorpheniramine =

with

sneezing/runny nose

nasal congestion

pain/fever

dry cough

NSAID = pain/fever
dextromethorphan = dry cough
decongestant = nasal congestion
chlorpheniramine = sneezing/runny nose

T/F: The term H2 blockers is referencing antihistamines

False, it’s H1 blockers

Match OTC treatment for heartburn to its MOA. some choices may be used more than once:

antacid =
cimetidine =
tums =
omeprazole (Prilosec) =

to:

proton pump inhibitor

block h2 receptors

neutralize gastric acidity

antacid = neutralize gastric acidity
cimetidine = block h2 receptors
tums = neutralize gastric acidity
omeprazole (Prilosec) = proton pump inhibitor

Carl, a 57 year old male, has come to the clinic for a standard wellness visit. The PA asks carl what, if any, medications he's taking. He lists medications associated with high blood pressure and heart disease. The PA has had patients with carl's similar medical history also take supplements of vitamin E, garlic and omega 3 but fail to report taking them since they do not associate them with being medications. What should the PA discuss with carl pertaining to supplementation and reporting whether he takes them?

There is less regulation for dietary and herbal supplements through the FDA.

They can also have drug interactions with prescribed medications, and/or cause adverse effects.

Which treatment for chronic heart failure works by decreasing blood volume, preload and workload required of the heart?

ACE

ARBs

T/F: Nitrates work to treat angina by decreasing heart rate, workload and oxygen need

False, nitrates treat angina by increasing the amount of nitric oxide in smooth muscle cells leading to vasodilation

match antihypertensive drug class to MOA

alpha agonist =
calcium channel blocker =
ACE inhibitor =
diuretic =
alpha blocker =
vasodilator =
direct renin inhibitor =
angiotensin II receptor blocker =

To:

prevents formation of angiotensin I to II

prevents smooth muscle contraction

works at kidney to decrease water absorption

directly causes peripheral vasodilation

decreases norepinephrine and epinephrine

blocks binding of AngII

reduces stroke volume

inhibits renin

alpha agonist = decreases norepinephrine and epinephrine
calcium channel blocker = prevents smooth muscle contraction
ACE inhibitor = prevents formation of angiotensin I to II
diuretic = works at kidney to decrease water absorption
alpha blocker = reduces stroke volume
vasodilator = directly causes peripheral vasodilation
direct renin inhibitor = inhibits renin
angiotensin II receptor blocker = blocks binding of AngII

At connie's yearly physical, her physician discovered she had stage 1 hypertension and her cardiovascular risk assessment was greater than 10%. what would be the recommended treatment?

Lifestyle changes and ACE inhibitor

Match following treatment to its indication:

somatropin =
mineralocorticoid =
methimazole =
estrogen/progesterone combination =

To:

oral contraceptive

promotes linear growth in children

hyperthyroidism

addison's disease

somatropin = promotes linear growth in children
mineralocorticoid = addison's disease
methimazole = hyperthyroidism
estrogen/progesterone combination = oral contraceptive

Thomas was diagnosed with type 2 diabetes at his yearly physical. Along with lifestyle modifications, whats the first line pharmaceutical intervention that would be prescribed?

Metformin

A 52 year old female was brought to her family physician because she had diffuse myalgia (muscle weakness) in her arms and legs. she reported feeling extremely weak and fatigued with dull muscle aches. her urine sample showed visible myoglobinuria (dark urine). blood tests showed elevated creatine kinase, indicating skeletal muscle injury. the patient's medical history included the following pathologies and treatments.

Renal insufficiency, treatment: thiazide (diuretic)
hypertension, treatment: lisinopril, verapamil (ACE, ARB)
hyperlipidemia, treatment: simvastatin (statin)
hypothyroidism, treatment: levothyroxine (hormone)

a. whats the potentially life threatening adverse effect experienced?
b. what medication is mostly the cause of the adverse effect?

a. rhabdomyolysis

b. statin/simvastatin

Rob is 12 year old boy who was just diagnosed with type 1 diabetes. You are explaining his treatment regimen to him and his parents. His father is overwhelmed by the number of insulin injections and needle pricks needed. The father asks you why rob can't just take oral pills like other diabetics he knows.
a. Explain why oral anti diabetic drugs do not treat type 1 diabetes
b. Explain why rob will benefit from the treatment plan he's being placed on

a. oral anti diabetic drugs depend on body having its own source of insulin. as a type 1 diabetic, rob's body has an insulin deficiency that must be replaced for proper functioning.

b. Rob will benefit from his regimen because its the most physiologic, and monitoring will ensure hyper/hypoglycemia

A diabetic patient who injects insulin once daily is taking which class of insulin?

Long-acting

Narrowing of bronchioles cause by unknown factors or precipitated by factors like respiratory infections, stress or cold weather is referred to as…

Intrinsic Asthma

match drug to common administration route

albuterol =
ipratropium =
theophylline =
fluticasone =
montelukast =

albuterol = inhalation
ipratropium = inhalation
theophylline = tablet
fluticasone = inhalation
montelukast = tablet

Armaan is treated for asthma. His medication activates adenylate cyclase to produce cAMP leading to relaxation of bronchial smooth muscles. Name the drug class Armaan has been prescribed

Beta 2 adrenergic Agonist

T/F: A metered dose inhaler contains a pressurized canister that delivers a consistent amount of medication via an aerosolized mist

True

Rico is being treated for COPD. his chart says his treatment plan includes short acting beta agonists.

Do you agree with his treatment plain? Explain

No, SABA is not recommended for regular use to treat COPD.

Treatment of COPD centers on use of LABA and Long Acting Anticholinergics

Gram (-) Bacteria example

E Coli

Jose arrives at the doctor's office complaining of continued ear pain after treating his second ear infection this year with amoxicillin. he took the same medication and the same dose that worked that last time. this time the doctor prescribes a different medication called augmentin. what term best describes why the doctor prescribed a different antibiotic this time?

antibiotic resistance

Select the drug class that's bactericidial and works by binding to bacterial ribosome causing the inhibition of protein synthesis

aminoglycosides

Based on your knowledge of antibiotic spectrums and keeping in mind antibiotic stewardship, which drug would be most appropriate for a simple gram positive infection if the patient has a penicillin allergy

azithromycin

match specific antibiotic to correct drug class

levofloxacin =
tobramycin =
augmentin =
minocycline =

levofloxacin = fluoroquinolone
tobramycin = aminoglycoside
augmentin = pencillin
minocycline = tetracycline

T/F: Due to its basic nature, HCl aids in breakdown of food entering the stomach

FALSE - ACIDIC nature

Denise comes to see her physician with complaints of daily burning sensation in her chest, especially prevalent after big meals. it is worse if she eats something like pasta sauce or a fatty meal and bothers her most at night when she lies down to go to bed. the doctor tells her she is suffering from severe GERD and thinks she would benefit from a daily PPI. select the best medication for Denise

Omeprazole

Unfortunately, the PPI prescribed to treat Denise's GERD didn't resolve her symptoms. after further testing, its discovered she has a peptic ulcer caused by H. pylori. her doctor decided to start her on quadruple therapy. which medication is NOT part of quadruple therapy?

doxycycline

match the drug class for treatment of constipation to the corresponding MOA

bulk forming =
hyper osmotic =
stimulant =

saline =
emollient =

TO

lowers surface tension

acts on the nerve

absorbs water into intestines

works by increasing osmotic pressure

increases fecal water content

bulk forming = absorbs water into intestines
hyper osmotic = increases fecal water content
stimulant = acts on the nerve
saline = works by increasing osmotic pressure
emollient = lowers surface tension

which anti nausea medication would you NOT want to recommend for patient also taking risperidone for their bipolar disorder?

prochlorperazine

Michael is in need of medication to treat knee pain post surgery. doctor thinks that he needs to be on opioid. however, he has history of abuse. what medication could be given in case of an overdose? explain with MOA

naloxone and naltrexone are 2 opioid antagonists that can actually reverse adverse effects such as respiratory depression caused by opioid overdose

Joanna suffers from fibromyalgia pain. which medication would NOT be appropriate treatment option?

hydromorphone

which anxiety medication would NOT be appropriate to recommend for patient with history of abuse?

alprazolam

match psychiatric medication to correct MOA

amitriptyline =
fluoxetine =
quetiapine =
venlafaxine =

TO:

blocks reuptake of serotonin

blocks reuptake of serotonin and norepinephrine

corrects imbalance of serotonin

blocks dopamine receptors

amitriptyline = corrects imbalance of serotonin
fluoxetine = blocks reuptake of serotonin
quetiapine = blocks dopamine receptors
venlafaxine = blocks reuptake of serotonin and norepinephrine

Joelle is treated with chlorpromazine for her schizophrenia. she recently developed involuntary movement of her lips, jaw and tongue. what is the medical term for this adverse event?

tardive dyskinesia

t/f payers can define what they consider to be specialty medication for reimbursement and contracting purposes.

TRUE

match disease description to corresponding disease

cancer =
rheumatoid arthritis =
HIV =
Crohn's disease =

TO:

disease process that involves abnormal cells

typically presents with an acute phase then a latency phase

causes inflammation in the digestive tract

a chronic autoimmune disorder

cancer = disease process that involves abnormal cells
rheumatoid arthritis = a chronic autoimmune disorder
HIV = typically presents with an acute phase then a latency phase
Crohn's disease = causes inflammation in the digestive tract

jamie has been diagnosed with multiple sclerosis. she would prefer a medication that she can give to herself instead of having to go to an infusion center on a monthly basis. which medication below would be the most appropriate option?

interferon beta 1a (rebif)

what serious adverse event of HIV medications must be monitored for frequent blood counts?

neutropenia

Lucille was previously treated with interferon and ribavirin for her chronic hepatitis c virus. she did not tolerate the regimen well and it did not cure her hepatitis c. explain why she could or could not try a medication regimen like ombitasvir/paritaprevir/ritonavir with dasaburvir.

ribavirin does not target the virus itself but rather helps enhance the immune system with the hope that the body could fight off the virus. the new treatments available are considered direct acting antiviral medications. in simple terms, they interfere with the proteins that help the virus grow and spread. they have a much higher chance of cure, as high as 96% in only 12 weeks of treatment.

interpret the following sig code: take 1 tab po q6h prn

take 1 tablet by mouth every 6 hours as needed

you need to determine the dose for a 96kg patient. the medication is dosed 10mg/kg. what would be the dose in mg?

960 mg

the recommended dosing range for amoxicillin is 25-45 mg/kg per day divided into 2 doses given every 12 hours. select the appropriate dose based on the stock bottle and the 5ml measuring device shown below for a 35 pound child

250mg/3ml

5ml every 12 hours

a patient is in need of IV fluids. the total volume being infused is 2000ml over 60 min. calculate the infusion rate in liters per hour.

2000ml/60 min x 1L/1000ml x 60min/1hr = 2L/hr

vancomycin is dosed 10mg/kg IV every 6 hours. calculate the appropriate total daily dose for a 125 pound patient. it is available in 1.5g/300ml IV bags

125 lbs x 1kg/2.2 lbs x 10mg/1kg x 1g/1000mg x 300ml/1.5g = 113.625 ml

113.625ml x 4 doses = 454.5 ml total daily dose