question

Toxic effects that are most often fatal occur from:

answer

High doses

question

Three medications have the following therapeutic index values : 2, 4, 0.5. Which is the safest?

answer

4

question

When epinephrine is administered to stimulate heart rate, the, the medication is acting as an:

answer

agonist (mimic)

question

The therapeutic index of a drug is determined by comparing the _____ to the _____ in order to predict drug safety.

answer

LD50; ED50

question

When differentiating between free drug molecules and drug molecules that have bound to plasma proteins, the main focus is:

answer

Only unbound or free drug molecules can exert a pharmacological effect

question

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.

answer

IV injection

question

Match the dosage form commonly known as a "troche" to the medical condition it is used to treat.

answer

Sore throat (Troches are flattened tablets that are allowed to dissolve in the mouth.)

question

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.

answer

250mg

question

Half Life

answer

the time required for the blood or plasma concentration of the drug to fall to half of its original level.

question

In summarizing the factors that affect IV solutions, you conclude that:

answer

-IV drug solutions must be compatible with all of the ingredients, free of organisms. and be adjusted to a targeted pH range.

question

incidence

answer

number of new cases of disease or disorder

question

prevalence

answer

percentage of people with the disease/ disorder currently in population

question

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):

answer

Antagonist (prevent the effects of morphine)

question

What type of curve should be used for representing data when a proper dosing frequency is being determined?

answer

Time-response curve

question

Which of the following would not be considered an adverse effect from taking an oral antibiotic?

answer

Extravasion (Oral drugs often cause nausea, vomiting, and diarrhea because of GI irritation.)

question

Drug potencies are compared using what value on a dose-response curve?

answer

ED50

question

Compare the processes of drug absorption, drug distribution, drug metabolism, and drug excretion. These are all components of the study known as:

answer

Pharmacokinetics

question

Identify the term used for the process by which a drug enters the bloodstream from its site of administration.

answer

Drug absorption

question

The fact that adipose tissue receives a relatively poor blood supply can be interpreted as indicating that adipose tissue:

answer

Does not accumulate large amounts of drug (due to poor blood supply)

question

A patient with tachycardia is experiencing:

answer

Sympathetic activation

question

What is the main chemical released by the medulla in sympathetic stimulation?

answer

Epinephrine

question

The ultimate purpose of the autonomic nervous system is to:

answer

Maintain homeostasis in the body

question

The neurotransmitter common to both preganglionic fibers in the sympathetic and parasympathetic nervous system is:

answer

Acetylcholine

question

Neurons innervating increased heart rate and breathing originate from the:

answer

Thoracic and lumbar regions

question

Identify the physical effects of anaphylaxis caused by insect stings, drugs, or other allergens.

answer

Difficulty breathing, decreased blood pressure, and symptoms of shock

question

Identify the symptom(s) associated with benign prostatic hyperplasia in males.

answer

Enlargement of the prostate gland Decreased urine flow increased constriction of the smooth muscle of the ureter

question

Explain the use of an EpiPen Auto-Injector.

answer

The EpiPen must be carried at all times and should be administered immediately following the onset of an anaphylactic allergic reaction.

question

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.

answer

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.]

question

What are the symptoms with the sympathetic signs of overdose of the adrenergic drugs.

answer

Sweating and trembling, increase in blood pressure, chest pain and difficulty breathing

question

A parasympathetic stimulating medication would be good for which condition?

answer

constipation [The parasympathetic nerves increase body functions such as digestion and elimination of waste products (urination, defecation).]

question

Neurons innervating increased digestion and urinary output originate from the:

answer

Cranial and sacral regions

question

A patient with asthma can benefit from taking a medication that stimulates which receptor?

answer

Beta-2 [Beta-2 receptors are located on smooth muscle and produce relaxation of smooth muscle; for example, relaxation of respiratory smooth muscle (bronchodilation).]

question

Patients undergoing a chemical stress test at a doctor's office could expect to receive an injection of which neurotransmitter?

answer

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.]

question

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.

answer

In 10 minutes the dose of esmolol will be reduced to 50 percent of the initial dose

question

Use your critical-thinking skills to determine the effects of the beta-adrenergic blocking drugs on the heart.

answer

Decrease in heart rate, decrease in the force of contractions, and decrease in impulse conduction through the heart

question

Identify the neurotransmitter found at the autonomic ganglia that stimulates the nicotinic-neural (Nn) receptors.

answer

Acetylcholine

question

Indirect-acting anticholinesterase drugs are effective at treating glaucoma because they produce:

answer

Miosis

question

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:

answer

Nicorette inhaler [Common adverse effects of oral inhalers and nasal sprays may cause local mouth and throat irritation, minor breathing difficulties, and GI disturbances.]

question

Ganglionic blockers are contraindicated in patients with glaucoma. You interpret this to be due to the fact that:

answer

The ganglionic blockers have a mydriatic effect that increases intraocular pressure.

question

Neostigmine is an indirect-acting anticholinesterase drug used to treat urinary retention by:

answer

Stimulating bladder contractions

question

Selection of the ganglionic blockers for the treatment of severe hypertension in males can lead to:

answer

Impotence

question

Implementing a treatment plan that includes mecamylamine is indicative of a diagnosis of:

answer

Severe hypertension

question

Implementing a treatment plan that includes mecamylamine requires monitoring the patient for:

answer

Depression of the cardiovascular system

question

What class of drugs is preferred for increasing urinary flow in patients with benign prostatic hyperplasia?

answer

Alpha-blockers

question

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:

answer

Antagonism of anticholinergic effects, especially on the GI and urinary tracts

question

Match the drug preparation verenicline with the correct trade name:

answer

Chantix

question

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:

answer

mecamylamine

question

Which medication is preferred for treating all stages of Alzheimer's disease?

answer

Donepezil

question

Pyridostigmine is useful in treating patients with myasthenia gravis because:

answer

Reversible inhibition of acetylcholinesterase increases levels of acetylcholine

question

Which type of cholinergic receptor would need to be stimulated for activation of the gastrointestinal system after surgery?term-87

answer

Muscarinic

question

Cholinergic drugs that exert their effect at the receptor belong to which class of medications?

answer

Direct-acting cholinergic drugs

question

Use of nicotine products leads to sympathetic stimulation. As a result, one can conclude that:

answer

Heart rate will increase

question

Botulinin toxin can be used to reduce wrinkles and lines on the face by inducing what type of paralysis?

answer

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.]

question

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:

answer

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).]

question

What was the name used for the receptors at the autonomic ganglia prior to the discovery of the neurotransmitter acetylcholine?

answer

Nicotinic receptors

question

Nicorette gum has been classified as Pregnancy Category:

answer

C

question

When differentiating between ganglionic stimulants and ganglionic blockers, you determine that ganglionic stimulants:

answer

Have little clinical use

question

Differentiate between the FDA pregnancy categories, and determine the proper category for the barbiturates.

answer

Pregnancy category D

question

The pituitary gland is closely associated with which midbrain structure?

answer

Hypothalamus

question

A person choking on a piece of steak is displaying activation of which brain structure?

answer

Medulla Oblongata

question

Degeneration of neurons in the basal ganglia will lead to

answer

Parkinson's disease

question

A gambling addict may need a medication affecting which part of the brain?

answer

Limbic system

question

All of the following are major anatomical parts of the brain except

answer

Basal ganglia

question

Identify the clinical indication for the use of benzodiazepines.

answer

Mental relaxtion and sleep disorders

question

All of the following are vital centers located in the medulla oblongata except

answer

Thermoregulatory

question

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.

answer

Avoid hazardous activities. Do not take other antianxiety agents at the same time. Do not drink alcohol while taking flurazepam

question

Body movement, posture, and equilibrium are maintained by the

answer

Cerebellum

question

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?

answer

2 p.m.

question

Use critical thinking to determine the major difference between flurazepam and temazepam.

answer

Flurazepam is a long-acting hypnotic that forms several active metabolites, and temazepam is an intermediate-acting hypnotic that does not form active metabolites.

question

Identify the main characteristic of the REM stage of the sleep cycle.

answer

Periods of rapid eye movement. Dreaming Increased autonomic system activity

question

Using the Physicians' Desk Reference, you determine that a common adverse effect that an elderly patient may experience while taking zolpidem (Ambien) is:

answer

Confusion and memory disturbances

question

Use critical thinking to determine the cause of the nausea, vomiting, and headache that an alcoholic patient is experiencing while taking disulfiram.

answer

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.

question

Select the contributing factor that leads to physical dependency while taking barbiturates.

answer

Greater therapeutic dosages taken on a regular basis for more than 1 to 2 months

question

Differentiate between secobarbital, amobarbital, pentobarbital, and phenobarbital, and select the product indicated for patients who have difficulty falling asleep but not staying asleep.

answer

Secobarbital

question

Many college students will drink a lot of coffee the night before a major exam. The effects of caffeine are being used to

answer

Stimulate activity of the reticular formation

question

Select the adverse effects associated with the use of the barbiturate class of drugs.

answer

Drowsiness and dry mouth Lethargy Lack of coordination

question

Using the Drug Facts and Comparisons manual, you determine that ramelteon (Rozerem) is classified as a:

answer

Melatonin agonist

question

Select the primary mechanism of action of disulfiram (Antabuse).

answer

Disulfiram slows the conversion of acetaldehyde to acetyl coenzyme A.

question

Use the stages of the sleep cycle to select the stage that corresponds with the ability to dream.

answer

REM

question

Select the correct indication of use for zaleplon (Sonata).

answer

Zaleplon is used in individuals who have difficulty falling asleep, but it does not increase total sleep time.

question

Identify the clinical indication for the use of a sedative.

answer

Mental relaxation and sleep disorders

question

Inhibitory fibers of the _____ become more active during periods of _____.

answer

Reticular formation, sleep

question

The statement that best explains automatism is:

answer

Drug-induced confusion that can lead to barbiturate drug overdose

question

Someone who is unable to sense pain or temperature stimulation may have a problem in this region of the brain

answer

Thalamus

question

Which of the following is the only brain structure that is under conscious control?

answer

Cerebral cortex

question

All of the following are examples of information carried out by efferent neurons except

answer

Pain

question

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?

answer

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.

question

A loud noise would stimulate _____ fibers in the _____.

answer

Excitatory, reticular formation

question

Explain the reason why aspirin-sensitive patients may substitute acetaminophen for headache pain.

answer

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.]

question

What can a patient do to prevent recurring pain and psychological factors associated with discomfort?

answer

Adhere to a prescribed schedule

question

Which of these groups of medications can play an adjunct role in pain management?

answer

Antiepileptic drugs and tricyclic antidepressants

question

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.

answer

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.

question

The opioids used to suppress coughing include all of the following except:

answer

Loperamide

question

Identify the chemicals that stimulate peripheral nerve endings and carry pain impulses to the CNS.

answer

Bradykinin

question

Oral formulations of opioid drugs should never be _____ in order to avoid _____.

answer

Chewed, an enhanced effect leading to side effects

question

Use the clinical indications for the use of nonsteroidal antiinflammatory drugs to select the true statement about their use.

answer

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]

question

In _____, more drug is needed to produce _____ therapeutic effect.

answer

Tolerance, the same

question

Nonopioid analgesics consist of all of the following except:

answer

Meperidine

question

A common sign of opioid toxicity would be:

answer

Pinpoint pupils

question

Describe the physical ramifications of excess use of acetaminophen.

answer

The excessive use of acetaminophen causes metabolites of the drug to bind to tissue groups in the kidney and liver, causing hepatotoxicity.

question

Identify the physiological signs that indicate the presence of inflammation.

answer

All of these are correct.

question

Differentiate between acetaminophen and the NSAIDs, and select the true statement related to their use.

answer

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.

question

Pain resulting from abnormal signals or nerves damaged by entrapment, amputation, or diabetes is called:

answer

Neuropathic pain

question

Which one of these drugs would produce a synergistic depression with an opioid drug?

answer

Alprazolam

question

Two naturally occurring opiates derived from the poppy plant are:

answer

Morphine and codeine

question

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.

answer

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.

question

Identify the drug agent that irreversibly inhibits the aggregation of platelets necessary for blood clot formation.

answer

Aspirin

question

Using the Physicians' Desk Reference, you determine that the common adverse effects of use of the psychomotor stimulant drugs are:

answer

Dry mouth, tachycardia, hypertension, and insomnia

question

Excessive blockade of dopamine D2 receptors will eventually result in:

answer

Extrapyramidal syndrome

question

Identify the type of depression that originates from within the individual and may not be able to be linked to specific causes.

answer

Major depressive disorder

question

Differentiate between mania and depression, and select the correct statement.

answer

All of these are correct.

question

Differentiate between the FDA pregnancy categories and determine the proper category for lithium.

answer

Pregnancy Category D

question

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.

answer

Exogenous

question

When comparing the SSRI and the atypical SSRI antidepressants, you determine that:

answer

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.

question

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:

answer

All of these are correct.

question

Explain how lithium works to decrease nerve conduction.

answer

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.

question

When summarizing the adverse effects of the atypical SSRIs, you identify the key adverse effects to be:

answer

Sedation, orthostatic hypotension, and liver toxicity

question

A person taking an atypical antipsychotic medication could be expected to develop all of the following metabolic disorders except:

answer

Anemia

question

Select the statement that is not consistent with the mechanism of action or adverse effect profile of the SSRI mirtazapine (Remeron).

answer

Mirtazapine decreases the release of norepinephrine and serotonin.

question

A patient on which type of atypical antipsychotic would be more likely to develop an infection?

answer

Clozapine

question

Use the pharmacological action of the psychomotor stimulant drugs in the treatment of narcolepsy and hyperactivity disorders to select the correct statement.

answer

Amphetamines have the disadvantage of producing drug tolerance and dependence.

question

Select the pair that is approved for the treatment of premenstrual dysphoric disorder, where the mood disturbances occur in relation to the menstrual cycle.

answer

Fluoxetine and sertraline

question

Atypical antipsychotics differ from the other classes of antipsychotics because they:

answer

Have a greater impact on reducing serotonin activity over dopamine activity

question

The statement that best explains bipolar mood disorder is:

answer

Disorder consisting of alternating periods of depression and hyperexcitability and elation

question

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:

answer

The amitriptyline is working, but the full antidepressant effect can take as long as 2 to 4 weeks to develop.

question

A potentially fatal condition associated with antipsychotic use characterized by hyperthermia, muscular rigidity, and catatonia:

answer

Neuroleptic malignant syndrome

question

Adverse effects of phenothiazine antipsychotics are due to:

answer

Blocking of cholinergic and histamine receptors

question

Explain the pharmacologic actions of bupropion (Wellbutrin).

answer

All of these are correct.

question

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:

answer

Beer, wine, herring, and certain cheeses

question

A beneficial side effect of phenothiazine antipsychotics would be for the treatment of what condition?

answer

Nausea and vomiting

question

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:

answer

Glaucoma and epilepsy

question

Use critical thinking to determine the recommended effective treatment for a patient with absence seizures.

answer

Clonazepam (Klonopin)

question

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.

answer

Pregnancy Category D

question

What physical characteristics would you expect to see from someone who habitually smokes marijuana?

answer

Red eyes and increased heart rate

question

Using adverse effects, determine the information you will need to educate a patient who takes carbamazepine (Tegretol).

answer

All of these are correct.

question

Increased amphetamine usage results in behavior very similar to:

answer

Paranoid schizophrenia

question

Identify the type of seizure that does not involve any type of motor convulsion.

answer

Absence seizure

question

Drug dependency is more likely to develop in an addict taking _____, because it has a very _____.

answer

Cocaine, short duration of action

question

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.

answer

Felbamate (Felbatol)

question

The consumption of larger doses of a drug to prevent onset of psychological and physical withdrawal symptoms.

answer

Drug dependency

question

A drug abuser experiences a psychotomimetic flashback experience after using marijuana. What other drug was probably abused in the past?

answer

LSD

question

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.

answer

All of these are correct.

question

Tricyclic antidepressant drugs have been used in treating cocaine dependency because they:

answer

Lessen euphoric effect and reduce cravings

question

What type of behavior would be expected from an amphetamine addict after discontinuing use of the drug?

answer

Profound sleep followed by drug seeking behavior upon awakening

question

As cocaine dosages are increased, _____ may cause _____ to occur.

answer

Excessive CNS stimulation, clonic-tonic convulsions

question

Explain why diazepam (Valium), although effective in the treatment of status epilepticus, may require additional administration of the drug to control the seizures.

answer

Diazepam has a short duration of action.

question

Which route of administration is not an effective way for a cocaine addict to take cocaine hydrochloride?

answer

Inhalation, smoked as a cigarette

question

Describe the difference between anticonvulsant drug agents and antiepileptic drug agents.

answer

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.

question

Hallucinogenic effects of LSD are thought to result from:

answer

Activation of serotonin receptors in the brain

question

Which hallucinogen is one of the least potent?

answer

Mescaline

question

Treatment for hallucinogenic drug intoxication may include the administration of which medications?

answer

Benzodiazepines or barbituates

question

Heavy marijuana use can cause _____ which could be an indication of _____.

answer

Psychosis, a latent psychiatric disorder

question

Cross-tolerance has been found to exist within which group of commonly abused drugs?

answer

LSD

question

Describe the most common type of adverse effect that a patient who takes phenytoin (Dilantin) should be made aware of.

answer

All of these are correct.

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