HCA 212 Connect Quizzes – Flashcards

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Toxic effects that are most often fatal occur from:
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High doses
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Three medications have the following therapeutic index values : 2, 4, 0.5. Which is the safest?
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4
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When epinephrine is administered to stimulate heart rate, the, the medication is acting as an:
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agonist (mimic)
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The therapeutic index of a drug is determined by comparing the _____ to the _____ in order to predict drug safety.
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LD50; ED50
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When differentiating between free drug molecules and drug molecules that have bound to plasma proteins, the main focus is:
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Only unbound or free drug molecules can exert a pharmacological effect
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Differentiate between the routes of drug administration in order to select the route that is restricted to use in the hospital setting due to immediate onset of action and high percentage of drug bioavailability.
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IV injection
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Match the dosage form commonly known as a "troche" to the medical condition it is used to treat.
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Sore throat (Troches are flattened tablets that are allowed to dissolve in the mouth.)
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Use a half-life of 8 hours to determine how much drug is left in the body at 4 p.m. after a 500-mg dose was taken at 8 am.
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250mg
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Half Life
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the time required for the blood or plasma concentration of the drug to fall to half of its original level.
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In summarizing the factors that affect IV solutions, you conclude that:
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-IV drug solutions must be compatible with all of the ingredients, free of organisms. and be adjusted to a targeted pH range.
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incidence
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number of new cases of disease or disorder
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prevalence
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percentage of people with the disease/ disorder currently in population
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Mrs. Breaux almost became comatose after receiving an overdose of morphine while in the hospital. In order to reverse this effect, the doctor ordered naloxone, which served as a(n):
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Antagonist (prevent the effects of morphine)
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What type of curve should be used for representing data when a proper dosing frequency is being determined?
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Time-response curve
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Which of the following would not be considered an adverse effect from taking an oral antibiotic?
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Extravasion (Oral drugs often cause nausea, vomiting, and diarrhea because of GI irritation.)
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Drug potencies are compared using what value on a dose-response curve?
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ED50
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Compare the processes of drug absorption, drug distribution, drug metabolism, and drug excretion. These are all components of the study known as:
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Pharmacokinetics
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Identify the term used for the process by which a drug enters the bloodstream from its site of administration.
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Drug absorption
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The fact that adipose tissue receives a relatively poor blood supply can be interpreted as indicating that adipose tissue:
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Does not accumulate large amounts of drug (due to poor blood supply)
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A patient with tachycardia is experiencing:
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Sympathetic activation
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What is the main chemical released by the medulla in sympathetic stimulation?
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Epinephrine
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The ultimate purpose of the autonomic nervous system is to:
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Maintain homeostasis in the body
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The neurotransmitter common to both preganglionic fibers in the sympathetic and parasympathetic nervous system is:
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Acetylcholine
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Neurons innervating increased heart rate and breathing originate from the:
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Thoracic and lumbar regions
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Identify the physical effects of anaphylaxis caused by insect stings, drugs, or other allergens.
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Difficulty breathing, decreased blood pressure, and symptoms of shock
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Identify the symptom(s) associated with benign prostatic hyperplasia in males.
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Enlargement of the prostate gland Decreased urine flow increased constriction of the smooth muscle of the ureter
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Explain the use of an EpiPen Auto-Injector.
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The EpiPen must be carried at all times and should be administered immediately following the onset of an anaphylactic allergic reaction.
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Analyze the major adrenergic effects of the alpha drug class, and select the main drug effect that the alpha drugs have on the alpha-2 receptor site.
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Negative feedback effect to decrease the release of norepinephrine [The alpha-1 effect results in contraction of alpha-1 mediated smooth muscle (vasoconstriction). The alpha-2 effect is a negative feedback effect that decreases the release of norepinephrine.]
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What are the symptoms with the sympathetic signs of overdose of the adrenergic drugs.
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Sweating and trembling, increase in blood pressure, chest pain and difficulty breathing
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A parasympathetic stimulating medication would be good for which condition?
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constipation [The parasympathetic nerves increase body functions such as digestion and elimination of waste products (urination, defecation).]
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Neurons innervating increased digestion and urinary output originate from the:
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Cranial and sacral regions
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A patient with asthma can benefit from taking a medication that stimulates which receptor?
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Beta-2 [Beta-2 receptors are located on smooth muscle and produce relaxation of smooth muscle; for example, relaxation of respiratory smooth muscle (bronchodilation).]
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Patients undergoing a chemical stress test at a doctor's office could expect to receive an injection of which neurotransmitter?
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Epinephrine [However, the daily stresses, anxieties, and illnesses we do experience are sufficient enough to activate the sympathetic system to produce changes that are similar to the fight or flight reaction.]
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Esmolol is a short-acting, intravenously administered drug that is used for emergencies and has a half-life of 10 minutes. Use the definition of half-life to select the correct statement about esmolol.
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In 10 minutes the dose of esmolol will be reduced to 50 percent of the initial dose
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Use your critical-thinking skills to determine the effects of the beta-adrenergic blocking drugs on the heart.
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Decrease in heart rate, decrease in the force of contractions, and decrease in impulse conduction through the heart
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Identify the neurotransmitter found at the autonomic ganglia that stimulates the nicotinic-neural (Nn) receptors.
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Acetylcholine
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Indirect-acting anticholinesterase drugs are effective at treating glaucoma because they produce:
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Miosis
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A patient who recently started on a smoking cessation treatment plan is complaining of throat irritation. Using what you have learned about the smoking cessation products, you determine that this adverse effect is due to his use of:
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Nicorette inhaler [Common adverse effects of oral inhalers and nasal sprays may cause local mouth and throat irritation, minor breathing difficulties, and GI disturbances.]
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Ganglionic blockers are contraindicated in patients with glaucoma. You interpret this to be due to the fact that:
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The ganglionic blockers have a mydriatic effect that increases intraocular pressure.
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Neostigmine is an indirect-acting anticholinesterase drug used to treat urinary retention by:
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Stimulating bladder contractions
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Selection of the ganglionic blockers for the treatment of severe hypertension in males can lead to:
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Impotence
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Implementing a treatment plan that includes mecamylamine is indicative of a diagnosis of:
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Severe hypertension
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Implementing a treatment plan that includes mecamylamine requires monitoring the patient for:
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Depression of the cardiovascular system
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What class of drugs is preferred for increasing urinary flow in patients with benign prostatic hyperplasia?
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Alpha-blockers
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Integrating a cholinergic drug into the existing treatment plan of a patient already taking a ganglionic blocking drug could result in a drug interaction characterized by:
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Antagonism of anticholinergic effects, especially on the GI and urinary tracts
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Match the drug preparation verenicline with the correct trade name:
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Chantix
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A patient complains of weakness, dizziness, and feelings of faintness when standing up. Using your knowledge of ganglionic stimulants and blockers, you determine from the patient's medication profile that the drug that is probably causing these adverse effects is:
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mecamylamine
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Which medication is preferred for treating all stages of Alzheimer's disease?
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Donepezil
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Pyridostigmine is useful in treating patients with myasthenia gravis because:
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Reversible inhibition of acetylcholinesterase increases levels of acetylcholine
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Which type of cholinergic receptor would need to be stimulated for activation of the gastrointestinal system after surgery?term-87
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Muscarinic
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Cholinergic drugs that exert their effect at the receptor belong to which class of medications?
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Direct-acting cholinergic drugs
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Use of nicotine products leads to sympathetic stimulation. As a result, one can conclude that:
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Heart rate will increase
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Botulinin toxin can be used to reduce wrinkles and lines on the face by inducing what type of paralysis?
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Flaccid [Some of these toxins can inhibit the release of acetylcholine from the cholinergic nerve ending to produce a flaccid type of skeletal muscle paralysis.]
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A patient's wife is concerned that her husband is overusing the Nicorette 4-mg gum product. She would like to confirm how many pieces he can use in a day. Using what you know about Nicorette gum, you determine that the dosage is limited to:
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20 pieces per day [Table 8;1,"Drugs Used in the Treatment of Smoking Cessation," includes this listing: Drug preparation: Nicotine gum; Trade Name: Nicorette; Dosage: 2 mg (limit 30 pieces/day) and 4 mg (limit 20 pieces/day).]
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What was the name used for the receptors at the autonomic ganglia prior to the discovery of the neurotransmitter acetylcholine?
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Nicotinic receptors
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Nicorette gum has been classified as Pregnancy Category:
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C
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When differentiating between ganglionic stimulants and ganglionic blockers, you determine that ganglionic stimulants:
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Have little clinical use
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Differentiate between the FDA pregnancy categories, and determine the proper category for the barbiturates.
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Pregnancy category D
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The pituitary gland is closely associated with which midbrain structure?
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Hypothalamus
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A person choking on a piece of steak is displaying activation of which brain structure?
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Medulla Oblongata
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Degeneration of neurons in the basal ganglia will lead to
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Parkinson's disease
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A gambling addict may need a medication affecting which part of the brain?
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Limbic system
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All of the following are major anatomical parts of the brain except
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Basal ganglia
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Identify the clinical indication for the use of benzodiazepines.
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Mental relaxtion and sleep disorders
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All of the following are vital centers located in the medulla oblongata except
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Thermoregulatory
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Flurazepam (Dalmane) is classified as a long-acting benzodiazepine. The antianxiety effects of flurazepam are usually evident the day after taking the flurazepam dose. Select the precaution that you will emphasize to the patient when you give him the prescription the doctor has written.
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Avoid hazardous activities. Do not take other antianxiety agents at the same time. Do not drink alcohol while taking flurazepam
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Body movement, posture, and equilibrium are maintained by the
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Cerebellum
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Eszopiclone (Lunesta) is a hypnotic agent with a rapid onset of action, intermediate duration of action, and a half-life of 6 hours. Using half-life, at approximately what time would a dose administered to a patient at 8 a.m. be reduced to 50 percent?
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2 p.m.
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Use critical thinking to determine the major difference between flurazepam and temazepam.
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Flurazepam is a long-acting hypnotic that forms several active metabolites, and temazepam is an intermediate-acting hypnotic that does not form active metabolites.
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Identify the main characteristic of the REM stage of the sleep cycle.
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Periods of rapid eye movement. Dreaming Increased autonomic system activity
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Using the Physicians' Desk Reference, you determine that a common adverse effect that an elderly patient may experience while taking zolpidem (Ambien) is:
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Confusion and memory disturbances
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Use critical thinking to determine the cause of the nausea, vomiting, and headache that an alcoholic patient is experiencing while taking disulfiram.
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Acetaldehyde is accumulating in the blood, causing this reaction to occur. The patient may be drinking alcoholic beverages again while taking disulfiram. The patient may be using OTC products that contain alcohol while taking disulfiram.
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Select the contributing factor that leads to physical dependency while taking barbiturates.
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Greater therapeutic dosages taken on a regular basis for more than 1 to 2 months
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Differentiate between secobarbital, amobarbital, pentobarbital, and phenobarbital, and select the product indicated for patients who have difficulty falling asleep but not staying asleep.
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Secobarbital
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Many college students will drink a lot of coffee the night before a major exam. The effects of caffeine are being used to
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Stimulate activity of the reticular formation
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Select the adverse effects associated with the use of the barbiturate class of drugs.
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Drowsiness and dry mouth Lethargy Lack of coordination
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Using the Drug Facts and Comparisons manual, you determine that ramelteon (Rozerem) is classified as a:
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Melatonin agonist
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Select the primary mechanism of action of disulfiram (Antabuse).
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Disulfiram slows the conversion of acetaldehyde to acetyl coenzyme A.
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Use the stages of the sleep cycle to select the stage that corresponds with the ability to dream.
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REM
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Select the correct indication of use for zaleplon (Sonata).
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Zaleplon is used in individuals who have difficulty falling asleep, but it does not increase total sleep time.
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Identify the clinical indication for the use of a sedative.
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Mental relaxation and sleep disorders
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Inhibitory fibers of the _____ become more active during periods of _____.
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Reticular formation, sleep
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The statement that best explains automatism is:
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Drug-induced confusion that can lead to barbiturate drug overdose
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Someone who is unable to sense pain or temperature stimulation may have a problem in this region of the brain
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Thalamus
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Which of the following is the only brain structure that is under conscious control?
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Cerebral cortex
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All of the following are examples of information carried out by efferent neurons except
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Pain
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A patient informs you that she has been taking more phenobarbital than the doctor prescribed because she cannot sleep with the amount he prescribed. She also states that now if she doesn't take the drug, she becomes very anxious, starts to have tremors, and begins to have unusual thoughts that she is being watched. Using your knowledge of the sedative-hypnotic drugs, how would you explain to this patient that she has developed a physical dependency on phenobarbital?
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The anxiety, tremors, and paranoid behavior are signs of withdrawal, which occurs when the patient has taken larger than therapeutic dosages for more than 1 to 2 months.
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A loud noise would stimulate _____ fibers in the _____.
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Excitatory, reticular formation
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Explain the reason why aspirin-sensitive patients may substitute acetaminophen for headache pain.
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All of these are correct [Acetaminophen does not produce GI irritation or ulceration in therapeutic doses. Acetaminophen does not affect platelet aggregation or prothrombin response.]
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What can a patient do to prevent recurring pain and psychological factors associated with discomfort?
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Adhere to a prescribed schedule
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Which of these groups of medications can play an adjunct role in pain management?
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Antiepileptic drugs and tricyclic antidepressants
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Select the statement that best explains why acetaminophen is effective in the treatment of headache pains but not effective in the treatment of muscle aches and inflammation.
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Acetaminophen is effective against the pain of headache because it inhibits prostaglandin synthesis within the CNS but does not significantly inhibit the synthesis of prostaglandins in peripheral systems, which accounts for the lack of antiinflammatory activity.
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The opioids used to suppress coughing include all of the following except:
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Loperamide
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Identify the chemicals that stimulate peripheral nerve endings and carry pain impulses to the CNS.
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Bradykinin
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Oral formulations of opioid drugs should never be _____ in order to avoid _____.
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Chewed, an enhanced effect leading to side effects
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Use the clinical indications for the use of nonsteroidal antiinflammatory drugs to select the true statement about their use.
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All of these are true. [Nonsteroidal antiinflammatory drugs are approved for the relief of mild to moderate pain where opioids are not indicated or warranted. This includes pain arising from local inflammatory responses including headache, dental extraction, soft tissue injury, sunburn, musculoskeletal, and joint overexertion and strain. Because of the direct action on regional prostaglandin production, NSAIDs also are indicated for the chronic treatment of dysmenorrhea and for controlling the signs and symptoms of]
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In _____, more drug is needed to produce _____ therapeutic effect.
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Tolerance, the same
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Nonopioid analgesics consist of all of the following except:
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Meperidine
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A common sign of opioid toxicity would be:
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Pinpoint pupils
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Describe the physical ramifications of excess use of acetaminophen.
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The excessive use of acetaminophen causes metabolites of the drug to bind to tissue groups in the kidney and liver, causing hepatotoxicity.
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Identify the physiological signs that indicate the presence of inflammation.
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All of these are correct.
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Differentiate between acetaminophen and the NSAIDs, and select the true statement related to their use.
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Acetaminophen is recommended for use in patients who experience GI upset from aspirin or nonsteroidal antiinflammatory drugs (NSAIDs); however, it is not interchangeable with these products for chronic therapy of inflammatory conditions such as osteoarthritis.
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Pain resulting from abnormal signals or nerves damaged by entrapment, amputation, or diabetes is called:
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Neuropathic pain
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Which one of these drugs would produce a synergistic depression with an opioid drug?
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Alprazolam
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Two naturally occurring opiates derived from the poppy plant are:
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Morphine and codeine
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Use the guidelines of the American Geriatric Society issued in 2009 to select the true statement related to the use of pain medications in elderly patients.
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Because patients over 75 years of age often have multiple chronic conditions associated with pain and are usually more susceptible to the adverse effects of NSAIDs, especially the cardiovascular and gastrointestinal effects, the newest guidelines specifically recommend that patients with moderate-to-severe pain or diminished quality of life due to pain should be considered for opioid treatment rather than NSAIDs.
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Identify the drug agent that irreversibly inhibits the aggregation of platelets necessary for blood clot formation.
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Aspirin
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Using the Physicians' Desk Reference, you determine that the common adverse effects of use of the psychomotor stimulant drugs are:
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Dry mouth, tachycardia, hypertension, and insomnia
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Excessive blockade of dopamine D2 receptors will eventually result in:
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Extrapyramidal syndrome
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Identify the type of depression that originates from within the individual and may not be able to be linked to specific causes.
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Major depressive disorder
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Differentiate between mania and depression, and select the correct statement.
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All of these are correct.
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Differentiate between the FDA pregnancy categories and determine the proper category for lithium.
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Pregnancy Category D
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Identify the type of depression in which there is a period of shock followed by a period of readjustment and resolve that life must go on.
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Exogenous
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When comparing the SSRI and the atypical SSRI antidepressants, you determine that:
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The SSRIs increase the concentration of serotonin in the synaptic cleft, resulting in increased stimulation of serotonin receptors. The increase in serotonin activity in the brain is believed to contribute to the antidepressant effect.
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You have been asked to explain to a patient the common side effects that he should report while taking the SSRIs. You explain to the patient that the reportable side effects include:
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All of these are correct.
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Explain how lithium works to decrease nerve conduction.
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The body uses lithium as if it were sodium. Na+ is normally required for conduction of nerve impulses; Li+ interferes with the nerve conduction, resulting in a decrease in the excitability of nerve tissue.
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When summarizing the adverse effects of the atypical SSRIs, you identify the key adverse effects to be:
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Sedation, orthostatic hypotension, and liver toxicity
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A person taking an atypical antipsychotic medication could be expected to develop all of the following metabolic disorders except:
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Anemia
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Select the statement that is not consistent with the mechanism of action or adverse effect profile of the SSRI mirtazapine (Remeron).
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Mirtazapine decreases the release of norepinephrine and serotonin.
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A patient on which type of atypical antipsychotic would be more likely to develop an infection?
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Clozapine
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Use the pharmacological action of the psychomotor stimulant drugs in the treatment of narcolepsy and hyperactivity disorders to select the correct statement.
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Amphetamines have the disadvantage of producing drug tolerance and dependence.
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Select the pair that is approved for the treatment of premenstrual dysphoric disorder, where the mood disturbances occur in relation to the menstrual cycle.
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Fluoxetine and sertraline
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Atypical antipsychotics differ from the other classes of antipsychotics because they:
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Have a greater impact on reducing serotonin activity over dopamine activity
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The statement that best explains bipolar mood disorder is:
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Disorder consisting of alternating periods of depression and hyperexcitability and elation
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A patient calls the office and states that she has been taking amitriptyline for 2 to 3 days and she is still experiencing the feelings of depression she had before she began the treatment. She wants the doctor to change her medication because the amitriptyline is not working. After doing research on amitriptyline, you call the patient and explain to her that:
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The amitriptyline is working, but the full antidepressant effect can take as long as 2 to 4 weeks to develop.
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A potentially fatal condition associated with antipsychotic use characterized by hyperthermia, muscular rigidity, and catatonia:
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Neuroleptic malignant syndrome
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Adverse effects of phenothiazine antipsychotics are due to:
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Blocking of cholinergic and histamine receptors
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Explain the pharmacologic actions of bupropion (Wellbutrin).
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All of these are correct.
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You have been asked to explain to a patient that while on MAOI therapy she must avoid foods that contain tyramine. The patient does not know what foods to avoid. You summarize the list of foods to avoid as:
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Beer, wine, herring, and certain cheeses
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A beneficial side effect of phenothiazine antipsychotics would be for the treatment of what condition?
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Nausea and vomiting
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Using the Physicians' Desk Reference, you determine that due to their alpha-blocking, anticholinergic and antihistaminic effects, the TCAs are contraindicated in patients suffering from:
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Glaucoma and epilepsy
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Use critical thinking to determine the recommended effective treatment for a patient with absence seizures.
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Clonazepam (Klonopin)
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Select the correct FDA pregnancy category for carbamazepine (Tegretol) based on the association of carbamazepine use with fetal development of spina bifida, craniofacial defects, and developmental delay.
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Pregnancy Category D
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What physical characteristics would you expect to see from someone who habitually smokes marijuana?
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Red eyes and increased heart rate
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Using adverse effects, determine the information you will need to educate a patient who takes carbamazepine (Tegretol).
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All of these are correct.
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Increased amphetamine usage results in behavior very similar to:
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Paranoid schizophrenia
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Identify the type of seizure that does not involve any type of motor convulsion.
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Absence seizure
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Drug dependency is more likely to develop in an addict taking _____, because it has a very _____.
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Cocaine, short duration of action
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Select the drug used to treat partial seizures for patients who do not respond to other drugs and whose epilepsy is so severe that the benefits of therapy outweigh the risks of developing serious adverse effects.
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Felbamate (Felbatol)
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The consumption of larger doses of a drug to prevent onset of psychological and physical withdrawal symptoms.
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Drug dependency
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A drug abuser experiences a psychotomimetic flashback experience after using marijuana. What other drug was probably abused in the past?
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LSD
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Tonic-clonic (grand mal) seizures are the most dramatic seizures in appearance. Describe the signs to look for in order to determine that a person has experienced a grand mal seizure.
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All of these are correct.
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Tricyclic antidepressant drugs have been used in treating cocaine dependency because they:
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Lessen euphoric effect and reduce cravings
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What type of behavior would be expected from an amphetamine addict after discontinuing use of the drug?
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Profound sleep followed by drug seeking behavior upon awakening
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As cocaine dosages are increased, _____ may cause _____ to occur.
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Excessive CNS stimulation, clonic-tonic convulsions
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Explain why diazepam (Valium), although effective in the treatment of status epilepticus, may require additional administration of the drug to control the seizures.
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Diazepam has a short duration of action.
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Which route of administration is not an effective way for a cocaine addict to take cocaine hydrochloride?
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Inhalation, smoked as a cigarette
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Describe the difference between anticonvulsant drug agents and antiepileptic drug agents.
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An anticonvulsant is a drug, usually administered IM or IV, that terminates convulsive seizures. An antiepileptic is a drug, usually administered orally, that can be used prophylactically to reduce or prevent epileptic seizures.
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Hallucinogenic effects of LSD are thought to result from:
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Activation of serotonin receptors in the brain
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Which hallucinogen is one of the least potent?
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Mescaline
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Treatment for hallucinogenic drug intoxication may include the administration of which medications?
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Benzodiazepines or barbituates
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Heavy marijuana use can cause _____ which could be an indication of _____.
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Psychosis, a latent psychiatric disorder
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Cross-tolerance has been found to exist within which group of commonly abused drugs?
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LSD
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Describe the most common type of adverse effect that a patient who takes phenytoin (Dilantin) should be made aware of.
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All of these are correct.
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