NGR6172 exam 1 study: knowledge checks/ neuropharmacology with 100% correct answers already graded A+

Since 2015 the FDA replaced the pregnancy risk letter categories with new information that attempts to make the information more meaningful to patients and providers. Categorize the following drugs that are contraindicated or safe during pregnancy

losartan; albuterol/ folic acid/ lisinopril; levothyroxine; insulin; atorvastatin; isotretinoin; labetalol; heparin; warfarin; methotrexate;

Contraindicated in pregnancy:

Losartan; isotretinoin; warfarin; atorvastatin; lisinopril; methotrexate

Safe in pregnancy:

heparin; levothyroxine; insulin; labetalol; albuterol; folic acid

Which of the following antibiotics are safe to give during pregnancy?

-amoxicillin

-doxycycline

-ciprofloxacin

-levofloxacin

amoxicillin

Drug suspensions in children are calculated using mg/kg/day, however, as children reach near adult weight, using mg/kg/day would calculate to a dosage higher than that of an adult dose. Once a child reaches ___ lbs, a dosage no greater than an adult dose should be given

-40-50lbs

50-60 lbs

-60-80 lbs

-80-110 lbs

80-110 lbs

Which of the following drugs are not recommended in children? (SATA)

-doxycycline (age <8)

-fluroquinolone antibiotics

-amoxicillin

-codeine

-aspirin

-doxycycline (age <8)

-fluroquinolone antibiotics

-codeine

-aspirin

Dr. Beers developed a list of medications that are inappropriate in older adults. Drugs should be aboided that have a narrow therapeutic range, a long half-life, and are renally excreted. Which of the following drugs are on the Beers list? (SATA)

-amiodarone

-sedating antihistamines

-sulfonylureas

-NSAIDs

-SSRIs with short half life

amiodarone

sedating antihistamines

sulfonylureas

NSAIDs

Which of the following are true about placental drug transfer? (SATA)

-lipid soluble drugs cross the placenta easily

-the placenta and mammary tissues serve as a protective shield

-drugs with large molecular weights such as heparin and insulin do not pass into the fetal circulation

-factors that determine drug passages across membranes of the placenta are the same factors that determine drug passages across other membranes

-lipid soluble drugs cross the placenta easily

-drugs with large molecular weights such as heparin and insulin do not pass into the fetal circulation

-factors that determine drug passages across membranes of the placenta are the same factors that determine drug passages across other membranes

An expectant mother exposes her fetus to an illicit drug during the fetal period (2nd or 3rd trimester). the exposure is most likely to produce:

-truncated limbs

-cardiac defects

-neural tube defects

-learning deficits and behavioral abnormalities

learning deficits and behavioral abnormalities

Which of the following has a remote risk of harming the fetus if given to a pregnant woman (Formally FDA category-A)

vitamin A 8000 units

isotretinoin

warfarin

levothyroxine

levothyroxine

a woman of childbearing age is found to have hypertension. which of the following treatments would be problematic?

low sodium diet

ACE inhibitor

weight lsos

exercise

ACE inhibitor

select the appropriate advise for medication administration to a nursing mother: (SATA)

-the drug will be the highest for the baby when the drug peaks for the mother

-drugs don't cross into breast milk

-dosing immediately after breast-feeding is best

-avoid drugs with a long half-life

-the drug will be the highest for the baby when the drug peaks for the mother

-dosing immediately after breast-feeding is best

-avoid drugs with a long half-life

Pharmacokinetics in neonates and infants vary because:

gastric emptying time is more rapid

albumin levels are higher than adults

albumin levels are lower in infants

the skin is thick

albumin levels are lower in infants

a patient has an eGFR of 20. What stage of chronic renal failure does this represent?

CKD Stage 4

A patient presents with proteinuria. The eGFR is >90. This represents CKD stage __?

CKD Stage 1

Which of the following statements are true regarding kidney function in the older adult? (SATA)

-serum creatinine is the best measure of renal function

-women have reduced creatinine levels

-older adults have less creatinine because they have less muscle

-African Americans have lower creatinine levels

=women have reduced creatinine levels

-older adults have less creatinine because they have less muscle

Many children approach adult weight at a younger age. Prescribers know that when a child reached ____ in weight, an adult dose is given because if mg/kg/day is calculated, it will be higher than an adult dose: (SATA)

40-50 lbs

40-50kg

88-110 lbs

120 lbs

40-50 kgs

80-110 lbs

Which of the following drugs are considered inappropriate for older adults (SATA)

hydroxazine; quetiapine; alprazolam; tolterodine; clonidine; lisinopril

hydroxazine; quetiapine; alprazolam; tolterodine; clonidine

Match the drug class to the drug prototype

Classes: Alpha 2 agonist; beta 2 agonist; anticholinergic; beta adrenergic antagonist; alpha 1 antagonist

medications: metoprolol; albuterol; clonidine; prazosin; ipratropium (atrovent)

Alpha 2 agonist - clonidine

Beta 2 agonist - albuterol

anticholinergic - ipratropium (atrovent)

beta adrenergic antagonist - metoprolol

alpha 1 antagonist - prazosin

Which of the following are anticholinergic drugs?

Metoprolol

Atropine

Tolterodine (Detrol LA)

Clonidine

Ipratropium (Atrovent)

Atropine

Ipratropium (atrovent)

tolterodine (detrol LA)

Which of the following are anticholinergic side effects?

bronchoconstriction

tachycardia

sweating

constipation

dry mouth

blurry vision

anhidrosis

sedation

urinary retention

bradycardia

sedation; anhidrosis; blurry vision; tachycardia; dry mouth; constipation; urinary retention

BUDCATS

Which of the following are drug classes with anticholinergic properties?

Alpha 2 agonists

Antipsychotics

Alpha 1 agonists

First generation antihistamine

SSRI- paroxetine (paxil)

beta adrenergic antagonists

tricyclic antidepressants

antipsychotics, first generation antihistamine, SSRI- paroxetine (Paxil), tricyclic antidepressants

Which of the following responses are parasympathetic/sympathetic?

pin point pupils (miosis); increased glucose; bronchodilation; bradycardia; bronchoconstriction; dilated pupils (mydriasis); voiding and defecation; uterine relaxation; tachycardia

Parasympathetic response (vagal response)

voiding and defecation; pin point pupils (miosis); bradycardia; bronchoconstriction

Sympathetic response

tachycardia; uterine relaxation; increased glucose; bronchodilation; dilated pupils (mydriasis)

Another name for muscarinic agonist is:

sympathetic agents

parasympathomimetic agents

parasympatholytic agents

anticholinergic agents

parasympathomimetic agents

Which of the following is a common effect of muscarinic stimulant drugs?

Decreased peristalsis

Decreased secretion by salivary glands

Miosis

Tachycardia

Miosis

The main therapeutic effect from a muscarinic agonist such as bethanechol is:

constriction of the bronchioles

urinary retention

promotion of urination

increased heart rate

promotion of urination

Select the therapeutic indications for the use of antimuscarinic drugs (SATA)

hypertension

motion sickness

chronic obstructive pulmonary disease

overactive bladder

motion sickness

chronic obstructive pulmonary disease

overactive bladder

Anticholinergic side effects include all of the following: (SATA)

bradycardia

blurry vision

urinary retention

dry mouth

blurry vision

urinary retention

dry mouth

Select the drugs that are classified as anticholinergics: (SATA)

Ipatropium bromide (atrovent)

tolterodine (detrol)

albuterol

drugs used to treat overactive bladder

ipatropium bromide (atrovent)

tolterodine (detrol)

drugs used to treat overactive bladder

Atropine overdose may cause which of the following?

gastrointestinal cramping

increased heart rate

increased gastric secretions

urinary frequency

increased heart rate

a 70 year old male with benign prostatic hypertrophy (BPH) has a worsening of symptoms of urinary retention after taking an OTC remedy for an upper respiratory system. The medication was most likely:

antiinflammatory

antihistamine

antitussive

mucolytic

antihistamine

Which of the following drug classes have anticholinergic properties? (SATA)

tricyclic antidepressants

antihistamines

antipsychotics

beta blockers

tricyclic antidepressants

antihistamines

antipsychotics

Cholinesterase inhibitors decrease the levels of acetylcholine and are used to treat Parkinsons disease. T/F

False

Which patient should not receive any atropine like drugs?

a 50-year old with parkinsonism

a 35-year old with peptic ulcer

a 60-year old with glaucoma

a 55-year old with cirrhosis

a 60-year old with glaucoma

Which drug treats myasthenia gravis by increasing muscle strength?

Bethanechol (urecholine)

atropine

neostigmine (prostigmin)

donepezil (aricept)

neostigmine (prostigmin)

Match the terms:

acetylcholine

neurotransmitter

Match the terms:

muscarinic agonist

stimulates muscarinic receptors

Match the terms:

anticholinergic

blocks the actions of acetylcholine

Match the terms:

Cholinesterase

an enzyme that causes the breakdown of acetylcholine

Match the terms:

Atropine

example of an anticholinergic drug

Match the terms:

Nicotinic receptor

Activation impacts skeletal muscle

Match the terms:

Cholinesterase inhibitors

drugs used to treat myasthenia gravis and Alzheimer's disease

A patient with myasthenia has severe muscle weakness and trouble breathing. She is given edrophonium and her symptoms approve. The patient has:

myasthenic crisis

cholinergic crisis

adrenergic crisis

muscarinic poisoning

myasthenic crisis