Pharm Final

B

What does ADME stand for:

A. Administration, Distribution, Metabolism, Excretion

B. Absorption, Distribution, Metabolism, Excretion

C. Anaphylaxis, Diarrhea, Metabolism, Excretion

D. Absorption, Dysfunction, Metabolism, Excretion

E

The distribution of a drug is determined by:

A. Blood flow to the organ

B. Presence of certain barriers

C. Plasma protein-binding capacity

D. Solubility of the drug

E. All of the above

D

Phase 1 clinical trials involve all of the following except which one?

A. Safe dose range in humans

B. Toxic effects of the drug

C. Metabolism

D. Effectiveness

B

If a drug displays zero-order elimination kinetics:

A. Elimination increases as the dose of the drug is increased

B. A constant amount is eliminated per unit time

C. The drug is not eliminated and is retained in the body

D. The elimination of the drug cannot be predicted mathematically

C

What of the following choices is considered the safest, least expensive, and most convenient route for administering drugs?

A. Inhalation

B. Rectal

C. Oral

D. Subcutaneous

C

Which organ is involved in the first-pass effect after oral administration of a drug?

A. Kidney

B. Lungs

C. Liver

D. Spleen

A

Which of the following routes of drug administration produces the most rapid drug response?

A. Intravenous

B. Intramuscular

C. Subcutaneous

D. Intradermal

B

What route is used to administer the tuberculosis skin test?

A. Intramuscular

B. Intradermal

C. Intravenous

D. Subcutaneous

A

Application of a transdermal patch is an example of parenteral administration because the drug is delivered in a manner that bypasses the gastrointestinal tract.

A. Both parts of the statements are true.

B. Both parts of the statements are false.

C. The first part of the statement is true; the second part is false

D. The first part of the statement is false; the second part is true.

E

A patient's perception that a pill without active ingredients is having a pharmacologic effect is termed:

A. Tachyphylaxis

B. Hypersensitivity

C. Neurosis

D. Compliance

E. Placebo Effect

D

A drug effect that is neither predictable nor dose related is called a:

A. Therapeutic effect

B. Toxic reaction

C. Side effect

D. Drug allergy

E. Both b and d

C

A dose-related reaction that produces undesirable effects caused by the action on nontarget organs is called:

A. Therapeutic effect

B. Toxic reaction

C. Side effect

D. Drug allergy

D

Controlled substances in schedule ______ require a written prescription with the provider's signature and do not permit refills?

A. II, III, and IV

B. II and III

C. III and IV

D. II only

E. III only

B

An "orphan drug" is:

A. Not related to any other medication currently available.

B. Developed specifically to treat a rare medical condition.

C. A drug that has been on the market for longer than 20 years and generic substitution is permitted.

D. No longer available for use as newer, more effective medications are available.

A

An acute, life-threatening allergic reaction characterized by hypotension, bronchospasm, laryngeal edema, and cardiac arrhythmias is what type of hypersensitivity?

A. Type I

B. Type II

C. Type III

D. Type IV

C

A dose of a drug that kills 50% of experimental animals is termed:

A. ED50

B. Minimally effective dose

C. LD50

D. Therapeutic index

D

What is the purpose of a "black box warning" on a package insert?

A. It is used to reconstruct the events leading to a fatality resulting from a medication error.

B. It is issued by the Drug Enforcement Administration (DEA) to indicate medications that may be used to manufacture illicit drugs such as methamphetamine.

C. It means the effects of the drug have not yet been determined.

D. It is used to draw attention to potentially fatal, life threatening, or disabling adverse effects for different medications.

C

The FDA approves the use of drugs for specific indications, which are listed or labeled on the package insert of the drug. Prescribers are not allowed to use drugs for off-label use under any circumstance.

A. Both parts of the statements are true.

B. Both parts of the statements are false.

C. The first part of the statement is true; the second part is false.

D. The first part of the statement is false; the second part is true.

C

The federal body that determines whether a drug is considered a controlled substance and to which schedule it belongs is the:

A. Food and Drug Administration (FDA)

B. Federal Trade Commission (FTC)

C. Drug Enforcement Administration (DEA)

D. Department of Health and Human Services (DHHS)

A

The anatomy of what system contains long preganglionic nerves and short postganglionic nerves?

A. Parasympathetic autonomic

B. Sympathetic autonomic

C. Somatic

D. Sensory afferent

D

The neurotransmitter released from a preganglionic neuron in the sympathetic division of the ANS is:

A. Epinephrine

B. Norepinephrine

C. Dopamine

D. Acetylcholine

C

Which of the following choices is true concerning the pharmacologic effects associated with cholinergic agents?

A. Tachycardia and an increase in blood pressure and cardiac output

B. Decrease in intestinal motility

C. Miosis

D. An increase in intraocular pressure

C

Which drug would be best to treat xerostomia?

A. Atropine

B. Propranolol

C. Pilocarpine

D. Pseudoephedrine

A

b1-receptors control:

A. Heart

B. Lungs

C. Heart and Lungs

D. Gastrointestinal (GI) tract

C

Stimulation of b2-receptors results in:

A. Vasoconstriction of skin and skeletal muscle

B. Increase in heart rate and force of contraction

C. Smooth-muscle relaxation

D. Bronchoconstriction

B

Sympathomimetic agents should be used with caution in patients with (1) angina, (2) hypertension, (3) hypothyroidism.

A. 1, 2, 3

B. 1, 2

C. 1, 3

D. 2, 3

D

Nonopioid analgesics reduce pain by inhibiting the production of:

A. Acetylcholine

B. Acetylcholinesterase

C. Norepinephrine

D. Prostaglandin

E. None of the above

C

Which of the following choices has antiinflammatory, antipyretic, analgesic, and antiplatelet action?

A. Acetaminophen

B. Codeine

C. Aspirin

D. Hydrocodone

D

Which of the following statements is true concerning the pharmacokinetics of aspirin?

A. Plain, unbuffered aspirin produces its peak effect on an empty stomach in 15 minutes.

B. Buffered aspirin has a slower peak of action than plain aspirin.

C. The half-life of unhydrolyzed aspirin is approximately 90 minutes.

D. Aspirin exhibits zero-order kinetics.

B

Which of the following choices is the best to use in pediatric patients for both its analgesic and antipyretic action?

A. Aspirin

B. Acetaminophen

C. NSAIDs

D. Codeine

B

A drug interaction between aspirin and ____________ can result in significant bleeding

A. Probenecid

B. Warfarin

C. Methotrexate

D. Sulfonylureas

C

What is the usual adult dosage of aspirin for the treatment of pain or fever?

A. 250 mg every 4 hours

B. 3 to 6 g per day

C. 650 mg every 4 hours

D. 800 mg every 4 hours

E. 160 mg per day

C

Which of the following NSAIDs is considered the drug of choice for management of dental pain when an NSAID is indicated?

A. Naproxen

B. Naproxen sodium

C. Ibuprofen

D. Diflunisal

D

Nonopioid analgesics act primarily within the central nervous system (CNS), while opioids act primarily at the peripheral nerve endings.

A. Both statements are TRUE

B. The first statement is TRUE; the second statement is FALSE

C. The first statement is FALSE; the second statement is TRUE

D. Both statements are FALSE

E

Acetaminophen does not possess any of these clinically significant __________ effects: (1) antipyretic, (2) antiinflammatory, (3) analgesic

A. 1, 2, 3

B. 1 and 2

C. 1 and 3

D. 1

E. 2

B

An acute overdose with acetaminophen may damage the:

A. Eyes

B. Liver

C. Spleen

D. Kidneys

C

A patient with a true allergy to codeine should be given:

A. Meperidine

B. Fentanyl

C. A and B

D. None of the above

B

Which is the major life-threatening symptom of opioid overdose?

A. Miosis

B. Respiratory depression

C. Urticaria

D. Mydriasis

C

Which of the following products is the most commonly used opioid in dentistry?

A. Hydrocodone

B. Morphine

C. Codeine

D. Propoxyphene

D

Which of the following opioids is used primarily in the treatment of opioid addicts?

A. Propoxyphene

B. Meperidine

C. Hydromorphone

D. Methadone

B

Which of the following choices is the drug of choice to treat a patient who has taken an overdose of an opioid?

A. 2-Pralidoxime

B. Naloxone

C. N-acetylcysteine

D. Activated charcoal

E. Methadone

A

Which is an advantage of the nonsteroidal antiinflammatory drugs (NSAIDs) over the opioids?

A. They are not addictive.

B. They are antitussive

C. They are all useful if the patient is pregnant.

D. They cause less fluid retention (edema).

A

The route of administration of a drug affects both the onset and duration of response.

A. True

B. False

B

Tetracycline, nonsteroidal antiinflammatory drugs (NSAIDs), and the benzodiazepines are safe to administer to a pregnant patient

A. True

B. False

B

The greater the therapeutic index is, the greater the toxicity will bE

A. True

B. False

B

Salivation, lacrimation, urination, and defecation refer to toxic effects seen with adrenergic agents.

A. True

B. False

A

Aspirin should not be given to children until they are18 years of age

A. True

B. False

A

Combining an opioid with a nonopioid analgesic produces an additive analgesic effect with fewer adverse reactions

A. True

B. False

B

A patient who feels nauseated after taking codeine is allergic to it

A. True

B. False

B

Scopolamine is an anticholinergic agent used to reduce tremors and rigidity associated with Parkinson's disease.

A. True

B. False

C

Reducing the rate of systemic absorption of a local anesthetic is important when it is used in dentistry because:

A. Otherwise, too large an area would be anesthetized.

B. If not, the anesthesia would not last long enough to complete a dental procedure

C. The chance of systemic toxicity is reduced

D. Local anesthesia is associated with respiratory depression.

A

Addition of vasoconstrictor to local anesthetic (1) reduces blood supply to the area, (2) increases blood supply to the area, (3) limits systemic absorption, (4) increases systemic absorption, (5) reduces systemic toxicity, (6) increases systemic toxicity. Which of the three pairs of choices is correct

A. 1, 3, 5

B. 1, 4, 5

C. 2, 3, 5

D. 2, 3, 6

B

Amide local anesthetics are metabolized:

A. By being hydrolyzed by plasma pseudocholinesterase

B. Primarily by the liver

C. In the spleen

D. Minimally and are excreted virtually unchanged

D

Which of the following local anesthetic agents have the potential to cause methemoglobinemia as an adverse effect?

A. Prilocaine and lidocaine

B. Lidocaine and mepivacaine

C. Prilocaine and mepivacaine

D. Prilocaine and articaine

E. Mepivacaine and articaine

B

Which of the following local anesthetics is safest to use for dental treatment for a pregnant woman?

A. Mepivacaine

B. Lidocaine

C. Articaine

D. Bupivacaine

D

Which of the following local anesthetics has the longest duration of action?

A. Lidocaine

B. Mepivacaine

C. Prilocaine

D. Bupivacaine

B

The maximal safe dose of epinephrine for the cardiac patient is __________ mg.

A. 0.02

B. 0.04

C. 0.2

D. 0.4

B

Which of the following agents is the most common topical local anesthetic?

A. Lidocaine

B. Benzocaine

C. Tetracaine

D. Dyclonine

B

At the termination of an N2O/O2 sedation procedure, the patient should be placed on 100% oxygen for at least __________ minutes.

A. 2

B. 5

C. 8

D. 11

C

The best indicator of the degree of sedation under nitrous oxide is:

A. Response to a painful stimulus

B. Percentage of nitrous oxide being delivered

C. Response to questions

D. Muscle tone

E. Eye movements

B

Nitrous oxide cylinders are __________ and oxygen cylinders are __________. (1) red, (2) green, (3) blue, (4) orange, (5) tan

A. 1, 2

B. 3, 2

C. 2, 4

D. 3, 4

E. 3, 5

B

Nitrous oxide is contraindicated for use in a patient with which of the following conditions?

A. Diabetes

B. Emphysema

C. Hypertension

D. Glaucoma

E. None of the above

C

Benzodiazepines enhance or facilitate the action of the neurotransmitter:

A. Acetylcholine

B. Epinephrine

C. -Aminobutyric acid (GABA)

D. Serotonin

A

The most common side effects attributed to benzodiaezepines include all of the following except:

A. diarrhea

B. Fatigue

C. Drowsiness

D. muscle weakness

B

The rapid onset of action of the benzodiazepines is related to their water solubility.

A. True

B. False

C

Which of the following benzodiazapines used in dentistry can be only be used intravenously?

A. Lorazepam

B. Clorazepate

C. Midazolam

D. Triazolam

B

Bezodiazapines have been know for their high rate of abuse and complete cardiovascular and respiratory depression with overdose, where as Barbiturates have replaced benzodiazapines in the treatment of anxiety and insomnia.

A. True

B. False

C

The onset of this anesthesia stage is characterized with the return of respiratory movements, muscle relaxation and normal heart and pulse rates.

A. Stage 1

B. Stage 2

C. Stage 3

D. Stage 4

B

According to Flagg's approach to levels of anesthesia which of the following is not one of the categories?

A. Maintenance

B. Initiaion

C. Induction

D. Recovery

D

The first signs that the patient is responding to nitrous oxide and oxygen sedation is___________.

A. numbness of the tongue

B. Nausea due the the smell

C. Laughing

D. Tingling of hands and feet

B

Which of the following combinations of three drugs is administered concurrently in all active cases of tuberculosis (TB)?

a. Pyrazinamide (PZA), rifapentine, and Rifater

b. Isoniazid (INH), rifampin, and pyrazinamide

c. Ethambutol, isoniazid (INH), and Rifater

d. Rifampin, PZA, and streptomycin

C

Nystatin is used for both the treatment and the prevention of __________ in susceptible cases.

a. Blastomycosis

b. Histoplasmosis

c. Oral candidiasis

d. Tinea

B

The most serious adverse reaction associated with ketoconazole is:

a. Tachycardia

b. Hepatotoxicity

c. Hypotension

d. Achlorhydria

A

Viruses are difficult to treat because they cooperate with the host's cells.

a. Both parts of the statement are true.

b. Both parts of the statement are false.

c. The first part of the statement is true; the second part is false.

d. The first part of the statement is false; the second part is true.

A

Which of the following conditions is an absolute contraindication to dental treatment until a consultation with the patient's provider has determined any special treatment alterations that might be warranted?

A. Recent myocardial infarct within the preceding 3 months

B. Diabetes

C. Hyperlipidemia

D. Gout

A

MI refers to:

A. injury or necrosis of the heart muscle.

B. transient lack of oxygen to the heart.

C. congestive heart failure (CHF).

D. abnormal sinus rhythm of the heart

C

Dental patients with left heart failure may need to be positioned in the dental chair:

A. with their left hip elevated.

B. with their right hip elevated.

C. in a semireclined position.

D. with their feet at a higher elevation than their head.

E. lying flat

E

Which of the following is the primary type of drug recommended for patients who have edema or fluid retention with heart failure (HF)?

A. Angiotensin converting enzyme inhibitor

B. Angiotensin receptor antagonist

C. Beta-blocker

D. Aldosterone antagonist

E. Diuretic

B

The cells of cardiac muscles have an intrinsic rhythm called:

A.Spontaneity

B.automaticity

C. anarchy

D. hierachy

D

Nitroglycerine (NTG) is used for what cardiovascular disease?

A. atherosclerosis

B. Coronary Artery disease

C. Arrythmias

D. Angina Pectoris

B

Nitroglycerine (NTG) is a(n) _____ that produces relaxation of vascular smooth muscle throughout the body.

A. vasoconstrictor

B. vasodilator

C. beta-blocker

D. angiotensin-converting enzyme inhibitor

E. angiotensin receptor blocker

C

If the _____ tablet of sublingual nitroglycerin (NTG) does not stop the anginal attack, the patient should be taken to the emergency room.

A. first

B.second

C. third

D. fourth

E. fifth

D

Which of the following statements is true regarding hypertension?

A.High blood pressure occurs without regard to stress or tension.

B.Complications of hypertension are greatly increased with concomitant smoking.

C. In most cases of hypertension, the cause can be identified and associated with a specific disease process.

D. Both a and b are true.

E. Both b and c are true.

C

Approximately _____% of people with hypertension are properly treated.

A. 20

B. 40

C. 50

D. 60

D

b1-Receptor stimulation is associated with:

A.vasodilation in skeletal muscles.

B.bronchodilation in pulmonary tissues.

C. a decrease in heart rate.

D. an increase in cardiac contractility.

B

Which b-adrenergic blocking agent has partial agonist activity and causes some b-stimulation while blocking catecholamine action?

A.Atenolol

B.Acebutolol

C. Metoprolol

D. Carvedilol

B

Which of the following is a b-adrenergic blocking drug that also has a-receptor blocking activity?

A.Atenolol

B.Labetalol

C. Doxazosin

D. Minoxidil

C

Many _____ end in the suffix -pril.

A.b-adrenergic blockers

B.calcium channel blockers

C. angiotensin-converting enzyme inhibitors (ACEIs)

D. angiotensin receptor blockers (ARBs)

C

Which of the following categories of agents may be used to treat both hypertension and benign prostatic hypertrophy?

A.Diuretic agents

B. b-Adrenergic blocking agents

C. a1-Adrenergic blocking agents

D. Calcium channel blocking agents

E

Which of the following is the first choice of therapy for most patients with atherosclerotic heart disease and elevated cholesterol levels?

A. Fenofibrate

B. Niacin

C. Cholestipol (Colesevelam)

D. Omega-3 fish oil

E. 3-Hydroxy-3- methylglutaryl coenzyme A reductase inhibitor

C

When a physician finds out that his female patient wishes to start a family, he decides to change her cholesterol-lowering medication. He changes her medication from:

A.niacin to simvastatin.

B.simvastatin to atorvastatin.

C. simvastatin to niacin.

D. gemfibrozil to candesartan.

D

Which of the following antihyperlipidemic agents can promote gallstone formation?

A.HGM CoA reductase inhibitors

B. Niacin

C. Cholestyamine

D. Gemfibrozil

D

A patient taking warfarin (Coumadin) may experience interactions with which of the following?

A. Phenobarbital

B. Erythromycin

C. Aspirin

D. All of the above

B

The presence of _____ in the oral cavity can be a sign of an adverse effect associated with the oral anticoagulants.

A. lichen planus

B.petechial hemorrhages

C. linear gingival erythema

D. hairy tongue

C

Which of the following is the main problem causing gastroesophageal reflux disease (GERD)?

A. Excess stomach acid

B. A diet that is too high in saturated fat

C. Lack of adequate function of the cardiac sphincter

D. Being overweight

B

Which of the following agents is the drug of choice for NSAID-induced ulcers?

A.Ranitidine

B.Misoprostol

C. Omeprazole

D. Metoclopramide

A

Which of the following adverse reactions is common to all of the currently marketed H2-blocking agents?Correct!

A. Abnormal liver function tests

B. Thrombocytopenia

C. Slurred speech

D. Gynecomastia

A

Magnesium sulfate should be used with caution in patients with renal impairment because hypermagnesemia has been reported in patients with renal disease.

A. Both the statement and the reason are correct and related.

B. Both the statement and the reason are correct, but not related.

C. The statement is correct, but the reason is not.

D. The statement is not correct, but the reason is correct.

E. Neither the statement nor the reason is correct.

B

Many drugs have a potential to be abused. Certain gastrointestinal drugs such as emetics _____ and have been abused by patients with _____.

A. antiemetics; low blood sugar

B. laxatives; bulimia

C. nitroglycerin; familial hypercholesterolemia

D. antispasmodics; diabetes

C

Which type of drugs work by blocking 5-HT3 receptors in the central nervous system and the chemoreceptor trigger zone

A. Laxatives

B. Antidiarrheals

C. Antiemetics

D. Antacids

E. Proton pump inhibitors