Pharmacology Exam I Overview

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Questions and Answers

Which of the following statements accurately describes the role of clavulanic acid?

It is used to treat anaerobic infections.

It enhances the effectiveness of non-beta-lactam antibiotics.

It protects the beta-lactam ring. (correct)

It is a bacteriostatic agent.

What is a potential side effect of using fluoroquinolones?

Nephrotoxicity.

Nausea and vomiting.

Prolonged QT interval. (correct)

Hypersensitivity rash.

In the context of antimicrobial therapy, what does 'bactericidal' mean?

It destroys bacteria. (correct)

It prevents bacteria from forming spores.

It reduces the virulence of bacteria.

It inhibits the growth of bacteria.

What is the primary concern when administering first doses of beta-lactam antibiotics?

Hypersensitivity reactions. Signup and view all the answers

Which route of potassium chloride administration requires dilution and a controlled rate?

Intravenous. Signup and view all the answers

Before a surgical procedure, how long should cefazolin be administered to meet QSEN guidelines?

60 minutes. Signup and view all the answers

What adverse effect should be monitored when administering macrolides?

Prolonged QT interval. Signup and view all the answers

Which medication would be contraindicated in patients with severe renal impairment or untreated Addisons?

Potassium-sparing diuretics. Signup and view all the answers

What is a primary mechanism of action for Ozempic in treating diabetes?

Slows gastrointestinal emptying Signup and view all the answers

Which of the following is a contraindication for lipase inhibitors?

Malabsorption Signup and view all the answers

What is a common adverse effect of prostaglandins in gastric treatment?

Diarrhea Signup and view all the answers

What is a critical consideration when administering H2 receptor antagonists like Cimetidine?

They are enzyme inhibitors that may increase drug serum levels. Signup and view all the answers

Which class of laxatives is considered the strongest and most abused?

Stimulant cathartics Signup and view all the answers

What precaution should be taken when using Ondansetron, a 5-HT3 serotonin receptor antagonist?

Exceeding 16mg may increase the risk of QT prolongation. Signup and view all the answers

What effect does a hypertonic solution have on cells?

Cells shrink due to fluid being drawn out. Signup and view all the answers

When should antacids be administered in relation to meals?

1 hour before or after meals Signup and view all the answers

What is the primary action of calcium channel blockers in the context of cardiovascular health?

Promote vasodilation of arteries. Signup and view all the answers

What adverse effect is specifically associated with dipine calcium channel blockers?

Peripheral edema. Signup and view all the answers

What is a common side effect of vincristine that is indicated by the phrase 'gets on nerves'?

Peripheral neuropathy Signup and view all the answers

Which medication is associated with the management of anemia as indicated by the use of erythropoietin?

Procrit Signup and view all the answers

Which class of medications is used to lower preload and afterload in heart failure?

ACE inhibitors and ARBs. Signup and view all the answers

What is the antidote for heparin, an anticoagulant?

Protamine sulfate. Signup and view all the answers

What type of vaccine is indicated as being more stable due to its components being weakened?

Attenuated vaccine Signup and view all the answers

Which medication is contraindicated for children due to the risk of Reye's syndrome?

Aspirin Signup and view all the answers

Which treatment is recommended for hand-foot syndrome associated with chemotherapy?

Tylenol Signup and view all the answers

Which condition is a contraindication for anticoagulant administration?

Recent surgery. Signup and view all the answers

What is the primary treatment for acute gout pain?

NSAIDs Signup and view all the answers

What is the main purpose of cytokine inhibitors in therapy?

To promote tissue repair Signup and view all the answers

What is a notable side effect of phenytoin?

Gingival hyperplasia Signup and view all the answers

What is the mechanism of action for aspirin as an antiplatelet medication?

Irreversibly binds to thromboxane A2 and inhibits its production. Signup and view all the answers

Which medication is specifically contraindicated for organ transplant recipients or those with serious cardiopulmonary diseases?

Neumega Signup and view all the answers

Which of the following statements is true regarding warfarin?

It requires monitoring of PT/INR levels. Signup and view all the answers

Which of the following medications is specifically used for migraine relief by constricting blood vessels?

Triptans Signup and view all the answers

Which medication should not be combined with triptans due to the risk of vasoconstriction?

Ergot preparations Signup and view all the answers

What is a common adverse effect of potassium-sparing diuretics?

Hyperkalemia. Signup and view all the answers

What is the precaution regarding Levothyroxine in the management of hypothyroidism?

It should be taken alone 30-60 minutes before breakfast Signup and view all the answers

What is the primary goal of using Aricept in Alzheimer's treatment?

Slow disease progression Signup and view all the answers

Which statement accurately describes monoclonal and polyclonal antibodies?

Monoclonal antibodies are derived from a single cell line Signup and view all the answers

What is a possible consequence of acetaminophen overdose in individuals with liver impairment?

Liver necrosis Signup and view all the answers

What is the preferred initial treatment for permanent relief of Parkinson's Disease symptoms?

Levodopa Signup and view all the answers

What is a key characteristic of Terbutaline in its use during pregnancy?

Category C medication for pre-term labor Signup and view all the answers

Which adverse effect is associated with anticholinergics when used for bronchoconstriction?

Anticholinergic effects Signup and view all the answers

What is the primary use of corticosteroids in the management of asthma?

For chronic management on a daily basis Signup and view all the answers

Which statement is true regarding leukotriene modifiers?

Prevent leukotrienes from binding and can be combined with other drugs Signup and view all the answers

Which drug is associated with the risk of pulmonary toxicity?

Bleomycin Signup and view all the answers

What is crucial to remember when using immunosuppressant monoclonal antibodies?

Have a significant risk for anaphylaxis and malignancies Signup and view all the answers

What type of medication is characterized by a narrow therapeutic range of 5-15 mcg/mL?

Xanthines Signup and view all the answers

Which side effect is specifically associated with Adriamycin?

Cardiac toxicity and red discoloration of secretions Signup and view all the answers

Study Notes

EXAM-I Overview

Local effects at site; Systemic through blood to target tissue
Pure Food and Drug Act: No adulterants. Food, Drug, and Cosmetic Act: Testing required to prove safety. Durham-Humphrey Amendment: OTC vs. prescription drugs (refills need prescriptions). Kefauver-Harris Amendment: Prove drugs' effectiveness (testing older drugs necessary). Comprehensive Drug Abuse Prevention and Control Act: DEA/locked-up, inventory, & disposal; nurses involved.
SCH-I: Non-medical use; SCH-II: High abuse; no refills; SCH-III: Abuse; SCH-IV: Some abuse; SCH-V: Controlled substances; record keeping needed. NIH Revitalization Act: Inclusion of women/minorities required in drug trials. FDA Modernization Act: Experimental drug access.
Drug Development Phases:
- Phase I: Healthy volunteers; toxicity testing.
- Phase II: Disease subjects; comparison.
- Phase III: Double blind studies.
- Phase IV: Marketed drugs.
Beers Criteria: Outcomes in older adults.
Absorption: Administering drugs to enter the bloodstream; Enteral (GI tract); Parenteral (other routes). Bioavailability: Portion reaching circulation (PO < 100%).
Distribution: Systemic distribution to target cells; BBB (blood-brain barrier); Protein Binding (Bound drugs, inactive).
Metabolism: Liver (CYP-P450 enzymes); Enzyme Induction & Inhibition. Excretion: Elimination (kidney).
Toxicity: Therapeutic range; Minimum Effective Concentration (MEC); Steady state (4-5 half-lives). Pharmacodynamics: Drug effects on body systems; Agonist/Antagonist; Up/Down regulation; Additive/Synergistic actions. Pharmacogenomic Variations: Age, sex, ethnicity, genetics affect drug response & metabolism.
Pregnancy Categories: A (no risk), B (no risk in animals), C (risk in animals), D (risk in babies), X (unacceptable risk),
Drug Orders: Date, time, drug, dose, route, frequency, and signature needed.

Anti-Microbial Drugs

Colonization: Doesn't cause injury; Superinfection: Depletion of normal flora. Community-Acquired (<48 hours post-admission); Hospital-acquired (>46 hours).
Bacteriostatic: Inhibits growth; C&S (culture & sensitivity): Before first dose. Beta-Lactam: Cell wall inhibitor; need "ring." Clavulanate protects.
"Cillin": Bactericidal (ruptures cell wall); Hypersensitivity; BBW: Don't administer IV PCN G; monitor for 30 minutes after first dose; QSEN: Don't double dose.
"Cef"/"ceph": Bactericidal (broad spectrum); QSEN: 60 minutes before surgery; superinfection risk.
"Micin"/"mycin": Bactericidal (ribosomal); serious systemic infections; prolonged QT interval; hypersensitivity; oto/nephrotoxicity; 2-3 liters of water/day; peak/trough monitoring.
"Floxacin": Bactericidal (DNA); 1st line anthrax; adverse effects: photosensitivity, tendinitis/tendon rupture, peripheral neuropathy, CNS/CV effects, prolonged QT interval; BBW: Myasthenia gravis exacerbation.
"Cycline": Bacteriostatic (protein synthesis); Lyme disease/animal bites/STIs; H. Pilori; Photosensitivity; take with water; no hypersensitivity/renal failure/pregnancy/<8-year-old use.
"Sulfa": Bacteriostatic (folic acid); UTI, burns, bronchitis; Late pregnancy use caution; Photosensitivity, kernicterus babies, blood dyscrasias, Stevens-Johnson Syndrome.
"Thromycin": Cidal/static (protein synthesis); strep/URI/STIs; put on babies' eyes; caution in liver disease; Adverse: Temporary hearing loss.
Vancomycin: Cida (cell wall gram-positive); serious infections (MRSA); Red man syndrome; Slow IV administration (1-2 hours).

Tuberculosis Treatment (TB)

Latent TB: 3 options for 3-9 months; Active TB: 10 options for 6-9 months.
Isoniazid (INH): Cell wall inhibition; common; used in combination for active TB; Adverse: Peripheral neuropathy, hepatotoxicity. Avoid alcohol (ETOH); many drug interactions.
Rifamycins (RNA): Enzyme inducer; used in combination for active TB; Adverse: Orange/red urine, hepatotoxicity.

Other Anti-infective Drugs

Antivirals: Harm host cells; DNA replication issues. HIV/AIDS: Combination therapy is essential; "Zidovudine (AZT)" for childbirth; Review PEP & PrEP. Antifungals: IV with a pump and in-line filter; use with antipyretics/antiemetics/antihistamines; BBW: Fatal infection.
Antiparasitics: less info provided.

GI Drugs

A, D, E, K vitamins are fat-soluble; Folic Acid/Vit B12 crucial during pregnancy; Vitamin K prevents bleeding; all toxic at high levels.
Iron supplements: 10-20% absorbed; excreted in stool; black, tarry stool; use in anemia/motherhood; may stain teeth; take on empty stomach, 2-4 hours before/after meals; BBW: Anaphylaxis (iron dextran); Z-track method for IM injection.
Hyperkalemia: "CRIK"; Calcium gluconate protects heart; Remove K; Insulin+glucose; Restrict K; Monitor acidosis, peaked T-waves.
Hypokalemia: KCL; Contraindications: Severe renal impairment, hyperkalemia, untreated Addison's, potassium-sparing diuretics. Check K levels; Administer IV diluted & slowly (10 mEq/hr).
Magnesium: MG = BM; antidote is calcium gluconate.

Other Drugs and Treatments

Nutritional products: Enteral preferred; complications include aspiration. CVC/PICC lines.
Anorexiants: Phentermine; increases SNS activity; contraindicated if SNS is already elevated; habit/tolerance forming.
Lipase inhibitors: Block 30% of fat; contraindicated in malabsorption; vitamin supplementation needed.
Ozempic: Slows GI emptying & increases satiety; BBW: Thyroid cancer/pancreatitis.
PUD: My Belly's Basic Protection (mucus, Bicarbonate, Blood flow, Prostaglandins).
Antacids: Localized action; neutralize HCL; shake before use; Aluminum (constipation); Magnesium (diarrhea); 1 hour before/after meals.
H2RA: Cimetidine; blocks H2 receptors; decreased acid; QSEN: enzyme inhibitor>increased drug serum levels.
PPIs: "Prazole"; 1st-line; bind to acid enzyme (prevents pumping); may affect B12 absorption; QSEN: pharmacogenomic effects.
Prostaglandin: Inhibits gastric acid secretion; Adverse: Diarrhea in 10-40% of patients; BBW: Birth defects.
Bismuth Subsalicylate (Pepto-Bismol): Avoid in aspirin allergy.
Antiemetics: Phenothiazine ("azine"): Blocks CTZ; Adverse: EPS (Extrapyramidal symptoms, anticholinergic effects, sedation, orthostatic hypotension); BBW: Increased death risk in dementia.
Antihistamines: DO NOT give hydroxyzine IV; administer deep IM.

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This quiz covers essential topics from Pharmacology Exam I, including local and systemic drug effects, key legislative acts related to drug safety and control, and phases of drug development. Additionally, it addresses the criteria for older adults' medication outcomes and controlled substance classifications. Test your understanding of these crucial concepts in pharmacology.