question

what does an anticonvulsant drug do?

answer

quickly stops the seizure a they time they are happening

question

What does an antiepileptic drug do?

answer

it is a prophilactic that prvents future seizures from occurring

question

Cardopa enhances Levadopa by inhibiting...

answer

it inhibits the conversion of Levodopa to dopamine in the periphery

question

The mechanism of action in an anti-epileptic drug.

answer

they decrease the excitability of the brain cells consequently reducing the severity of the seizure

question

Certain bacteria have been building to produce enzymes that inactivate PCN to ... in the body

answer

Betalactimaces

question

What class of antibiotics is the primary therapy for topical placement and pt reported compromised skin integrety resulting in a high protential for infection

answer

Sulfamerazine

question

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

answer

. Cerebral cortex

question

A loud noise would stimulate _____ fibers in the _____.

answer

Excitatory, reticular formation

question

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

answer

Thalamus

question

The cerebrum contains _____ that consists of _____.

answer

White matter, myelinated axons

question

All of the following are examples of information carried by afferent neurons except

answer

Voluntary movement

question

Two types of medications that can be used to control people primarily having emotional or certain behavioral problems

answer

Antianxiety and antidepressants

question

A person who has developed a speech problem as a result of head trauma probably has damaged what area of the brain?

answer

Frontal lobe

question

Explain the relationship between GABA and the sedative-hypnotic drug agents.

answer

. Sedative-hypnotic agents increase the GABA receptor-mediated chloride influx into nerves, inhibiting neuronal activity

question

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

answer

REM

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

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

. 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

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

answer

Pregnancy Category D

question

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

answer

Neuroleptic malignant syndrome

question

An important inhibitory neurotransmitter that keeps emotion and behavior under control is

answer

GABA

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

Long term use of the typical antipsychotics, especially the phenothiazines, can result in this serious condition.

answer

Tardive dyskinesia

question

Excessive blockade of dopamine D2 receptors will eventually result in

answer

Extrapyramidal syndrome

question

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

answer

Anemia

question

One main characteristic of the typical antipsychotics is their ability to

answer

Block dopamine D2 receptors to a greater degree than serotonin 5HT2A receptors

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

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

. 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

Lithium acts directly to stimulate norepinephrine and dopamine receptors, which stimulate the release of norepinephrine and dopamine from the nerve endings, and it inhibits the reuptake of these neurotransmitters back into the nerve endings, alleviating the symptoms

answer

Dry mouth, tachycardia, hypertension, and insomnia

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

The tricyclic antidepressants interact with many other types of drugs. Using the Physicians' Desk Reference, you determine that the tricyclics will interfere with the antihistamine and anticholinergic drug agents, resulting in:

answer

Dry mouth, constipation, urinary retention, and blurred vision

question

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

answer

Pregnancy Category D

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

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

answer

Red eyes and increased heart rate

question

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

answer

Inhalation, smoked as in a pipe

question

A patient presents to the emergency room with a temperature of 106 degrees Fahrenheit, confused and severely dehydrated. Upon placing a foley catheter in his bladder, 750 ml of urine drains out immediately. The most likely cause of the patients' symptoms would be

answer

Anticholinergic toxicity

question

Which of the following psychomotor stimulants is controlled by the drug enforcement agency and labeled as a schedule 1 drug

answer

. LSD

question

One of the effects that occur with aging is a reduction in the amount of time spent in this stage of sleep:

answer

. Stages 3 and 4 NREM

question

This drug class is often used for procedures requiring the patient to be able to maintain their vital signs within normal limits in addition to responding to the staff when used at therapeutic doses because it increases the NREM stage 2:

answer

benzodiazepines

question

Which stage of sleep is important for physical restoration

answer

. Stage 3 and 4 NREM

question

The main site of action of antipsychotic drugs is on neural pathways involving which portions of the brain:

answer

cerebral cortex and limbic system

question

Which condition may develop after long-term antipsychotic therapy recognized as involuntary movements of the lips, jaw, tongue, and extremities

answer

Tardive dyskinesia

question

Flumazenil (Romazicon) is used to reverse the depressant effects of

answer

alprazolam (Xanax)

question

Extrapyramidal symptoms (EPS) are caused mainly by

answer

blockage of dopamine receptors

question

The main pharmacologic effect of the SSRI's is

answer

increase levels of serotonin

question

Amphetamine and cocaine are potent CNS stimulants. Both increase the amount of _______ and ________ in the brain.

answer

Norepinephrine and dopamine

question

Individuals who abuse alcohol frequently have nutritional deficiencies due to the intake of alcohol instead of food. These individuals can develop neurologic deficits due to the lack of:

answer

. B vitamins

question

. The main pharmacologic effects of TCAs on neurotransmitter activity is:

answer

only A and C

question

Which medication can be given as a depot treatment if the patient is non-compliant with their antipsychotics:

answer

atypical antipsychotics

question

___________ is a skeletal muscle relaxant given during neuroleptic malignant syndrome to avoid skeletal muscle breakdown and subsequent renal failure:

answer

Dantrolene

question

. Cholinergic nerve endings release which neurotransmitter

answer

Acetylcholine

question

Benzodiazepines are a class of drugs widely used in the treatment of anxiety and when taken in excess can cause sedation and respiratory depression. If severe respiratory depression has occurred, giving this medication can reverse the effects of the benzodiazepine decreasing the severity of CNS depression.

answer

flumazenil (Romazicon)

question

. A common side effect of antidepressants which can cause the patient to stop taking their medications is:

answer

sexual dysfunction

question

. Which of the following is not a function of the spinal cord:

answer

regulation of breathing

question

The "vital centers" are regulated by the:

answer

medulla oblangata

question

Explain what is meant by: Barbiturates produce a dose dependent depression of the CNS.

answer

. the higher the dose of barbiturates the greater the CNS depression

question

Treatment of comatose patients from barbiturate overdose includes:

answer

supportive therapy

question

Which of the following organs does not see pharmacologic effects with the ingestion of alcohol:

answer

lungs

question

Zolpidem (Ambien) is one of the most widely prescribed hypnotic drugs on the market. These drugs:

answer

bind to the benzodiazepine receptor

question

For individuals whose main problem is falling asleep, which of the following may be the most helpful:

answer

the shorter acting drug zaleplon (Sonata

question

The symptoms of alcohol intoxication often resemble all the following EXCEPT:

answer

. stroke

question

Which of the following is unique to alcohol metabolism compared to other drugs:

answer

. alcohol is metabolized at a constant rate

question

Which of the following drug classes, when stopped, will not have any physical symptoms of withdrawal:

answer

anticholinergics

question

The alpha blocking actions of the tricyclic antidepressants may cause:

answer

postural hypotension

question

One of the dangers of antidepressant drug treatment is the risk of:

answer

patients attempting suicide by overdosing on their medications

question

Psychomotor stimulants are prescribed for all the following disorders EXCEPT:

answer

Treatment of depression

question

Unoxygenated blood enters from the Inferior and Superior Vena Cava to the _______________ through the ____________________ to the _________________through the ___________________ to the ________________ ______ then in to the ______________. Oxygenated blood is then returned through the _________________ to the__________________ through the ______________ to the ______________ through the ____________________ to the ____________ where it is then distributed to the periphery

answer

Right Atria, Tricuspid, Right Ventrical, Pulmonic Valve, Pulmonary artery, Lung. Pulmonary vein, Left Atria, Mitral Valve, Left Ventricle, Aortic valve, Aorta

question

What regulates the rate and force of contraction of the heart?

answer

Autonomic nervous system

question

. Which term denotes the amount of blood that is ejected by the ventricles per minute:

answer

cardiac output

question

A characteristic sign of left-sided heart failure is:

answer

Pulmonary edema

question

Insufficient blood flow in coronary arteries to the heart is common in all of these conditions except:

answer

Arrhythmias

question

. Identify the main therapeutic effect of the diuretic agents.

answer

The main therapeutic effect produced by diuretics is the elimination of excess sodium and water by the kidneys

question

Explain the physiological changes that occur in the heart when there is a diagnosis of chronic heart failure.

answer

Chronic heart failure leads to cardiac muscle undergoing hypertrophy, where the walls of the heart chambers increase in size and undergo structural remodeling in an attempt to generate more forceful contractions.

question

Describe the physiological effect of restricting sodium intake along with diuretic therapy for a patient with mild CHF.

answer

Restriction of sodium intake along with diuretic therapy may decrease the edema, congestion, and reduced cardiac output that occurs with CHF.

question

Select the correct statement related to the renin-angiotensin-aldosterone (RAA) mechanism.

answer

A drop in systemic blood pressure or a decrease in renal blood flow stimulates the release of renin from the kidneys. Renin initiates reactions that lead to the formation of angiotensin II. Angiotensin II causes vasoconstriction and the release of aldosterone (sodium retention) and ADH (water retention). These actions normally function to maintain normal blood pressure and blood volume.

question

Select the preferred beta-blockers used for the treatment of CHF.

answer

. Metoprolol (Lopressor) and carvedilol (Coreg)

question

. Differentiate between preload and afterload, and select the correct statement.

answer

Preload is the amount of blood returning to the heart (venous return). Afterload is the force (force of ventricular contraction) that the heart must generate in order to overcome vascular resistance (open the aortic valve) and eject blood out of the left ventricle.

question

The type of angina that is characterized by vasospasm is classified as:

answer

Prinzmetal angina

question

Compare the routes of administration of the nitrates and determine the most common route of administration during attacks of angina.

answer

. Sublingual

question

Use critical thinking to determine the correct nitrate drug that is used prophylactically to prevent the occurrence of anginal attacks.

answer

. Nitroglycerin extended-release capsules

question

Use the adverse-effect profile of the nitrates to determine which of the following is not an adverse effect of this drug class.

answer

Bradycardia

question

Alice is experiencing periods of angina, and she places a sublingual nitroglycerin tablet under her tongue as directed by her physician. After 5 minutes have passed, she is not feeling any relief. What step should be implemented next?

answer

. Place another sublingual nitroglycerin tablet under her tongue.

question

Using the available treatment options for Prinzmetal angina, determine the preferred drug class for the treatment of variant or Prinzmetal angina.

answer

Calcium channel blockers

question

The process of filtration in a nephron occurs in the:

answer

Glomerulus

question

Diuretics can be used to manage all of these conditions except

answer

Hypotension

question

Due to the potency of sodium and water removal by thiazide and thiazide-like diuretics, patients taking these diuretics may experience

answer

Orthostatic hypotension

question

The buffering capacity of blood utilizes which ion to neutralize cellular waste products?

answer

Bicarbonate

question

. _____ is a diuretic that also has a beneficial effect for people with open-angle glaucoma, since _____ is associated with ocular fluid formation.

answer

Acetazolamide, carbonic anhydrase

question

Spironolactone produces its potassium-sparing diuretic effect by being an aldosterone receptor:

answer

. Antagonist that inhibits sodium and potassium exchange

question

. Explain the role of the kidneys in the development of hypertension.

answer

Activation of the RAA mechanism causes vasoconstriction, and sodium and water retention, which leads to an increase in blood pressure.

question

Using the adverse-effects profile of the diuretic drug agents, select the true statement related to the thiazide and loop diuretics.

answer

The thiazide and loop diuretics interfere with the renal excretion of uric acid.

question

Select the statement that is not consistent with the pharmacologic effect or adverse-effects profile of the vasodilator hydralazine (Apresoline).

answer

. The main adverse effects are nausea, headache, hypertension, and reflex bradycardia.

question

. Select the primary indication for the use of minoxidil (Loniten).

answer

Minoxidil is indicated for patients who do not respond to triple therapy with other drug combinations

question

Select the correct statement related to the mechanism of action of aliskiren (Tekturna).

answer

Aliskiren inhibits the enzymatic activity of renin and decreases the conversion of angiotensinogen to angiotensin I, thereby reducing the formation of angiotensin II.

question

Which medication given during a hypertensive crisis/emergency metabolizes to thiocyanate resulting in toxicity if the patient's renal function is inadequate for excretion:

answer

Nitroprusside

question

The presence of _____ can occur from overactive clotting activity in the body that is not properly regulated.

answer

Thromboembolisms

question

. What are the two groups in which heparin can be classified?

answer

Standard heparin and low-molecular-weight heparin

question

The preferred anticoagulant during pregnancy is:

answer

. Heparin

question

A patient experiencing hemorrhaging after receiving heparin should be given:

answer

Protamine sulfate

question

. Why would a patient currently experiencing thromboembolisms be given warfarin?

answer

To prevent secondary thromboembolic complications

question

Patients on the oral anticoagulant therapy, Warfarin, should be monitored by which tests?

answer

Protime (PT) or INR

question

. Why is an unstable plaque more dangerous?

answer

Thrombus formation that can block blood flow

question

. Endogenous cholesterol synthesis takes place in the _____ and _____.

answer

. Liver and small intestines

question

Which of the following is not a useful purpose for cholesterol in the body?

answer

Building blocks for amino acids

question

What is the first line of defense when treating hyperlipidemia?

answer

Diet control

question

Which of the following activities would not result in an elevation of HDL levels?

answer

Cholesterol is endogenously produced at night

question

Rhabdomyolysis is a serious side effect that may be experienced by patients on statin medications because

answer

Myoglobin molecules can disrupt blood flow to kidneys and cause renal failure

question

The irreversible process by which aspirin inactivates cyclooxygenase production is:

answer

Platelets lack a nucleus and can't produce more cyclooxygenase.

question

The formation of _____ practically guarantees the clotting cascade to proceed.

answer

Thromboplastin

question

The primary reason heparin cannot be administered orally is that:

answer

The mucopolysaccharide is destroyed by gastric acid in the stomach

question

Which medications mechanism of action works by converting plasminogen to plasmin?

answer

Alteplase

question

Which lipoprotein is produced in the intestines for the transport of exogenous cholesterol and triglycerides?

answer

Chylomicrons

question

What region of the heart is responsible for cardiac muscle contraction?

answer

Myocardium

question

A disease in which the aging process leads to fibrosis and narrowing of the arteries is:

answer

Arteriosclerosis

question

What condition occurs when there is insufficient blood in the coronary arteries which can be reversed if therapy is initiated immediately?

answer

Angina pectoris

question

. A decrease in blood flow to the myocardium will immediately result in:

answer

Ischemia

question

The parasympathetic nervous system has _____ effect on myocardial contraction

answer

. Very little

question

. Differentiate between the classes of drugs available to treat angina, and select the drug that can be used in combination with the nitrates for patients who require more than one drug to control angina.

answer

. Beta-adrenergic blockers

question

Distinguish between the adverse effects of the beta-adrenergic blockers and those of the calcium channel blockers, and select the statement that does not correspond with an adverse effect that would result from an overdosage of the calcium channel blocker verapamil.

answer

Increased myocardial contraction

question

Use mechanism of antihypertensive action to determine the treatment options when the desired effect is blocking of the beta-1 receptors in the heart to decrease cardiac output and blood pressure;

answer

Atenolol (Tenormin), metoprolol (Lopressor), and nadolol (Corgard)

question

Select the preferred treatment for hypertension for patients with cardiac arrhythmias or ischemic heart disease.

answer

Calcium channel blockers or beta-blockers

question

Which of the following would be the first line treatment for someone who has been admitted with an active GI bleed with an INR of 6?

answer

Vitamin K

question

Patients receiving the anticoagulant therapy, Heparin, should be monitored by which test?

answer

. Heparin Xa level

question

All of the following electrolytes play an important role in cardiac function EXCEPT:

answer

. glucose

question

Lasix would be the drug of choice to treat an acute CHF exacerbation. Lasix will increase urine output in the patient and decrease the workload of which chamber of the heart:

answer

left ventricle

question

The drug that is classified as an arterial vasodilator and that also has a direct effect to decrease heart rate and cardiac contractility is:

answer

Diltiazem

question

. ____________ dilatation decreases _____________ which decreases the workload of the heart, thereby decreasing oxygen consumption:

answer

venous; preload

question

All of the following are true EXCEPT:

answer

tubular reabsorption of water is diuresis

question

The drug of choice for causing a decrease in preload is:

answer

nitrates

question

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

answer

Loperamide

question

One advantage of administering an opioid analgesic over an NSAID drug for post-operative pain would

answer

Reduce risk of bleeding

question

. Opioid overdose results in respiratory depression because

answer

The suppressed medulla cannot respond to CO2 stimulation

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

The specific class of opioid receptor in the CNS responsible for respiratory depression is:

answer

Mu2

question

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

answer

Alprazolam

question

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

answer

Aspirin

question

Using the preferred drug therapy for the treatment of acute gout attacks, select the true statement

answer

For the treatment of acute gout attacks, relief of pain, and interruption of the inflammatory process, colchicine and specific NSAIDs (indomethacin, naproxen) and sodium thiosalicylate are indicated.

question

. Use the side-effects profile of the salicylates to select the false statement related to their use.

answer

Salicylates stimulate prostaglandin synthesis

question

Use the administration guidelines for the nonsteroidal antiinflammatory drugs to select the NSAID that is commercially available for parenteral administration to induce closure of the atrial opening in premature infants with patent ductus arteriosis.

answer

Ibuprofen and indomethacin

question

Select the statement that best explains why some patients develop nausea and vomiting after taking aspirin.

answer

Salicylates stimulate the medullary center known as the chemoreceptor trigger zone. This zone directly excites the vomiting center so that emesis may occur.

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

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

Select the correct statement about the enzymes referred to as cyclooxygenase (COX).

answer

Cyclooxygenase makes various prostaglandins needed from arachidonic acid.

question

Select the correct statement related to the uricosuric drug agent probenecid

answer

Probenecid causes GI disturbances, so it is recommended that it be taken with milk, meals, or antacids.

question

Select the statement that best describes the mechanism of action of colchicine.

answer

Colchicine specifically alters the ability of the phagocytes to attack uric acid crystals. As a result, the pH of the joint fluid does not fall.

question

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

answer

Heart rate will increase

question

Match the drug preparation verenicline with the correct trade name:

answer

Chantix

question

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

answer

Have little clinical use

question

Differentiating between the adverse effects of Nicorette and Nicoderm, you determine that use of Nicorette can result in all of the following adverse effects except:

answer

Drowsiness

question

When integrating a smoking cessation treatment with the Nicotrol inhaler, it should be used with caution because:

answer

Use of the inhaler may cause minor breathing difficulties

question

The major toxicity associated with neuromuscular blocker overdose is:

answer

Respiratory muscle paralysis

question

What is the drug of choice for treating malignant hyperthermia?

answer

Dantrolene

question

. Which type of skeletal muscle relaxant can be considered a cholinergic receptor antagonist?

answer

Nondepolarizing

question

Some patients may have a genetic predisposition to developing malignant hyperthermia when taking an inhalation anesthetic with which type of skeletal muscle relaxant?

answer

Succinylcholine

question

Prolonged use of which centrally acting skeletal muscle relaxant can lead to dependency? A. Baclofen

answer

Diazepam

question

Dantrolene relaxes muscle by inhibiting the release of which ion from the sarcoplasmic reticulum?

answer

Calcium

question

Discontinuation of intrathecal baclofen therapy should be gradual in order to prevent:

answer

Rebound spasticity

question

A patient with breathing problems has been given a muscle relaxant and begins to experience bronchospasms, which may lead to an asthmatic attack. This can be attributed to the release of:

answer

Histamine

question

One way to overcome the effects of a rapidly metabolized skeletal muscle relaxant and maintain paralysis is to administer the medication by:

answer

Baclofen

question

Which medication can potentiate the effects of succinylcholine due to shifting the levels of potassium in the body?

answer

Diuretics

question

Identify the most commonly used local anesthetic technique

answer

Infiltration anesthesia

question

Match lidocaine, a local anesthetic, to a condition it is used to treat

answer

Cardiac arrhythmias

question

Explain why local anesthetics are valuable as a treatment for pain management.

answer

Local anesthetics block sensory nerves at low doses that do not inhibit motor nerve function

question

. Explain the reason why local anesthetics that are given by injection occasionally contain epinephrine

answer

Epinephrine counteracts the vasodilation that occurs with local anesthetic use

question

Why are local anesthetic agents that contain epinephrine contraindicated for use in the areas of the fingers, toes, ears, nose, or penis?

answer

Epinephrine in these areas may lead to ischemia and gangrene

question

Using the Physicians' Desk Reference available in the office, you determine that the amide local anesthetics have a moderate to long duration of action and that the drug group that falls into this category includes:

answer

Lidocaine, bupivacaine, and mepivacaine

question

Injection of local anesthetics is used for surgical, suturing, and obstetrical procedures. Using your knowledge of this drug class, what product should be used to relieve the pain of postherpetic neuralgia?

answer

Lidoderm 5% transdermal patch

question

Injections of anesthetic agents must be administered slowly, and the patient must be monitored for vital signs. Select the signs to look for that could indicate central nervous system toxicity.

answer

Dizziness, blurred vision, and slurred speech

question

Select the statement that best explains potency of a local anesthetic

answer

. Potency is the ability to produce a nerve block at a relatively low dose.

question

When differentiating between local and general anesthetics, general anesthetics:

answer

Cause total loss of consciousness

question

Identify the neurotransmitter found at the autonomic ganglia that stimulates the nicotinic-neural

answer

Acetylcholine

question

Nicorette gum has been classified as Pregnancy Category:

answer

D

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

Nicotrol Inhaler

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 (Inversine

question

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

answer

Severe hypertension

question

. Implementing a treatment plan that includes ganglionic blocking drugs and vasodilators could lead to a drug interaction that could result in:

answer

Additive vasodilating effects

question

Select the main effect of the ganglionic blockers on the gastrointestinal system.

answer

Decrease intestinal secretions

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

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

answer

Impotence

question

The antidote given for depolarizing muscle blocker toxicity is:

answer

None available

question

Two types of receptors that can be manipulated to reduce spasticity are:

answer

Alpha-2 adrenergic and GABA

question

Which of the following would be observed from a low dose of a nondepolarizing muscle relaxant used to promote a neuromuscular blockade?

answer

Relaxation of facial muscles

question

A medication that results in spinal hyperpolarization would belong to which class of skeletal muscle relaxants?

answer

. Centrally acting

question

Cocaine was the first local anesthetic to be discovered. Explain the reason why cocaine can't be used by injection

answer

Injected cocaine produces vasoconstriction

question

Explain how local anesthetics affect cardiac function.

answer

Local anesthetics depress the function of the cardiac conduction system.

question

Implementing the use of potent local anesthetics can lead to adverse effects on the central nervous system. These effects can lead to nervousness, excitation, tremors, and convulsions. The probable cause of these effects is:

answer

. Stimulation of the cerebral cortex

question

Overdose of local anesthetics can lead to CNS excitation. What treatment would you use to reverse the effects of the local anesthetics?

answer

Barbiturates and diazepam (Valium)

question

When differentiating between injectable bupivacaine, which is available as a 0.25% to 0.75% solution with a duration of action of 2 to 4 hours, and injectable procaine, which is available as a 1% to 2% solution with a duration of action of 15 minutes to 1 hour, the choice of agent used for injection around the spinal cord is primarily determined by the:

answer

Duration of action required

question

Because of the contraindications of use of the amide local anesthetics, patients who have any form of liver disease should be monitored for

answer

. Accumulation of the amide metabolites

question

Two naturally occurring opiates derived from the poppy plant are:

answer

Morphine and codeine

question

Mu receptors have _____ ion channels which will be _____, thereby decreasing the release of neurotransmitters associated with pain.

answer

Ca, blocked

question

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

answer

Chewed, an enhanced effect leading to side effects

question

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

answer

Bradykinin

question

What type of antibody is produced the first time a person is sensitized by tree pollen?

answer

IgE

question

Why shouldn't oral cromolyn dosage forms be taken with fruit juice or milk?

answer

Absorption of drug will be compromised

question

The effects of histamine on the vasculature are that it:

answer

Promotes vasodilation of the blood vessels and capillaries

question

A person allergic to chocolate may develop a migraine headache because:

answer

Histamine dilates cerebral blood vessels that will stimulate nearby pain receptors.

question

What occurs in an allergic reaction when histamine binds to receptors on sensory nerve endings?

answer

Itch-specific fibers are stimulated, causing itching and pain

question

Nonselective interactions of first-generation antihistamines include:

answer

. Relief of allergy symptoms and sedation

question

Antihistaminics can be used in cold remedies because of the anticholinergic properties responsible for:

answer

. Drying nasal secretions

question

What role do H1-receptors play in the bronchioles for patients with asthma?

answer

Contraction of bronchiolar smooth muscle and making breathing difficult

question

) Why would Dr. Smith not prescribe an antihistamine for his patient with asthma?

answer

Antihistamines are not therapeutically useful in the treatment of asthma

question

Advantages of newer-generation antihistaminics over first-generation antihistaminics are

answer

Increased selectivity for peripheral H1-receptors and less sedation

question

Explain the mechanism of action of the anticholinergic drug agents used to treat asthma

answer

By blocking the actions of acetylcholine, anticholinergic drugs produce

question

Explain the reason why theophylline may be contraindicated in patients with existing cardiovascular disease.

answer

Theophylline may cause excessive cardiac stimulation

question

Summarize the preferred therapy for the relief of moderate or persistent asthma.

answer

Daily treatment with low-to-moderate-dose inhaled antiinflammatory corticosteroids and inhaled selective beta-2 adrenergic bronchodilators.

question

Summarize the role that the autonomic nervous system plays in the development of asthma.

answer

Parasympathetic activation through the release of acetylcholine produces bronchoconstriction and increased secretion of mucus.

question

) Compare the expectorant and the mucolytic agent, and select the product that is available over the counter without a prescription for the relief of an unproductive cough.

answer

Mucinex

question

A patient complains of hoarseness and changes in his voice. Using your knowledge of steroids and leukotriene inhibitors, you advise the patient that the best way to avoid these adverse effects is to:

answer

Rinse his mouth with water after inhaling the medication to reduce the amount of steroid that remains in his mouth and throat.

question

Use the mechanism of action of the corticosteroids to determine the physiologic action that results from their administration

answer

Corticosteroids inhibit the release of inflammatory mediators from the mast cells.

question

Compare the mucolytic and expectorant drug agents, and determine the primary mechanism of action of the mucolytic agents

answer

Increase in liquification of the bronchial mucus

question

Use the adverse-effect profile of the systemic steroids to determine the statement that is true regarding the use of these steroids in the treatment of asthma.

answer

Systemic steroid use leads to increased susceptibility to infection

question

Using the onset of action as the primary factor, determine the preferred therapy for the treatment of the sudden onset of asthma symptoms.

answer

. Albuterol

question

Differentiate between the chemical mediators that are formed and released from injured tissue, mast cells, and leukocytes in the respiratory tract, and select the function of histamine as it relates to asthma.

answer

Histamine causes bronchoconstriction, increased vascular permeability that contributes to mucosal edema, and infiltration of leukocytes.

question

Select the primary reason why the preferred route of administration for the corticosteroids in the treatment of chronic asthma and COPD is oral inhalation with metered-dose inhalers.

answer

. The advantage of inhalation is that lower dosages of steroid are delivered directly into the respiratory tract, therefore limiting systemic absorption and the adverse effects associated with steroid use

question

Receptors found on parietal cells that increase secretion of HCl when activated

answer

Histamine

question

Gastric juices are released during the gastric phase from

answer

. Distention of the stomach when food enters

question

Which of the following is not a common cause of peptic ulcers?

answer

Overproduction of inhibitory enzyme to stop acid secretion

question

Which medications can actually promote the formation of ulcers by interfering with mucus production or secretion?

answer

. NSAIDs and steroids

question

To completely stop acid secretion between meals would put a person at increased risk of

answer

GI infections

question

Symptoms of chronic erosion of mucosal lining and perforation would include

answer

Presence of blood in stool or vomit

question

In treating an H. pylori peptic ulcer, triple therapy refers to using

answer

Two antibiotics and a proton pump inhibitor

question

One way to directly block the secretion of acid and pepsin in the stomach would be to

answer

Administer an H2 blocker

question

Omeprazole (Prilosec) works by

answer

. Inhibiting a hydrogen-potassium pump in parietal cells

question

Select the statement that best explains why increased dietary fiber is a major component in the management of constipation.

answer

Fiber increases stool bulk and fluid content and decreases transit time, resulting in an increase in the frequency of defecation

question

The production of the hormone erythropoietin in the formation of red blood cells is regulated by the

answer

. Kidney cells

question

An example of a therapeutic use for a hormone for a condition other than hormone insufficiency would be

answer

Administering cortisol to a patient after an organ transplant

question

Compare the mineralocorticoids and glucocorticoids, and select the true statement about these hormones.

answer

The main effect of the mineralocorticoid hormones is to regulate the fluid balance of the body.

question

Which clinical condition has shown an improvement with HRT?

answer

Osteoporosis

question

Select the true statement related to the body's response to calcium levels of more than 10.5 mg/dL.

answer

When the plasma calcium level reaches 10.5 mg/dL, calcitonin is secreted. It lowers the circulating calcium level by antagonizing the effect of PTH on bone.

question

When teaching a patient who is taking biphosphonates, you would tell them all the following EXCEPT

answer

lie down for 30 minutes after taking

question

Teaching an individual who is going to be on long-term steroids would include all the following EXCEPT:

answer

steroids increase the ability of the immune system to fight off infection

question

This hormone is released in response to pregnancy. Performing a blood test would show high levels

answer

HCG

question

Naturally occurring female hormones are contained in soy, spearmint, and tofu. These hormones are called:

answer

Naturally occurring female hormones are contained in soy, spearmint, and tofu. These hormones are called:

question

You would teach a woman who uses any type of birth control all of the following EXCEPT

answer

a discharge with intrauterine devices is not uncommon

question

Why would Dr. Smith not prescribe an antihistamine for his patient with asthma?

answer

Antihistamines are not therapeutically useful in the treatment of asthma

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