PHARM 126 FINALS.pdf

EXAM 1 - Anti Cancer Agents, Pain Medicines, and Autacoids 1. Agents for breast cancer treatment, EXCEPT for: Flutamide 2. Inhibits estrogen synthesis by inhibiting aromatase enzyme Anastrozole 3. Binds to DNA in the presence of magnesium or other divalent cat...

EXAM 1 - Anti Cancer Agents, Pain Medicines, and Autacoids 1. Agents for breast cancer treatment, EXCEPT for: Flutamide 2. Inhibits estrogen synthesis by inhibiting aromatase enzyme Anastrozole 3. Binds to DNA in the presence of magnesium or other divalent cations Plicamycin 4. A drug that enhances tubulin polymerization, thus clogging microtubules and inhibiting cell division in malignant cells Paclitaxel 5. It cause DNA strand break due to iron oxidation producing free radicals Bleomycin 6. Indicated for hairy cell leukemia; undergoes phosphorylation and incorporated into DNA causing strand breaks Cladribine 7. Vincristine CCS agent 8. It has been proven to be beneficial in preventing breast cancer in high-risk women. Tamoxifen Raloxifene 9. Alkylating agents that are highly lipophilic and can cross BBB so they are useful for the treatment of brain tumors. Nitrosoureas 10. It is not administered by the oral route because its bioavailability is erratic due to the high levels of the breakdown enzyme dihydropyrimidine dehydrogenase present in the gut mucosa. 5-FU EXAM 2 - Respiratory, Blood, and Dyslipidemia Drugs CORRECT ANSWERS TRUE 1. Anticholinergics are especially useful in the management of COPD than asthma. 2. Bronchodilator group is the foundation of symptomatic treatment for both asthma and COPD. FALSE 1. In COPD, it is necessary for all patients to be provided with a short acting beta agonist even when using a long acting bronchodilator. 2. Rosuvastatin is contraindicated in all pregnant patients. 3. Lowering LDL far beyond lower limits of normal values with Evolocumab for several years would lead to harmful neurological effects. OBJECTIVE 1. What drug therapy should be available to all asthma patients regardless of severity classification? short acting beta agonists 2. Which of the following medications for asthma exert its activity by inhibiting 5-lipoxygenase? Zileuton 3. True about theophylline, EXCEPT: It is a rescue medicine for patients who cannot receive beta agonists 4. AJ presents to his family physician with worsening shortness of breath due to asthma. He is started on Zileuton and asked to return to the clinic in 3 months to check liver enzymes. What is the mechanism of action for this new medication? Inhibits leukotriene synthesis 5. RG was admitted for a gall bladder surgery and started on subcutaneous heparin treatment to prevent formation of deep vein thrombosis, a major risk factor for pulmonary embolism. How does heparin prevent these potential complications? It increases the activity of antithrombin III 6. It inhibits platelet aggregation by inhibiting phosphodiesterase enzyme. Dipyridamole 7. FJ is currently on theophylline for the management of chronic asthma. Which of the following statements correctly describes the action for this medication? Adenosine-receptor antagonist 8. Causes hemorrhagic disorder and other serious birth defects when used as anticoagulant during pregnancy: Warfarin 9. Fibrinogen receptor antagonist: Abciximab 10. ______has a brief pro-coagulant effect during the first week of therapy due to inhibition of ______. Warfarin, Protein C 11. Antiplatelet drug which is adenosine diphosphate receptor antagonist: Ticlopidine 12. Plasmin activator that causes consequent therapeutic resistance due to the formed antibodies after the first administration. Streptokinase 13. Activates plasminogen to plasmin only in the presence of fibrin: Alteplase 14. A must to monitor neutrophil and platelet counts during therapy of which drug: Ticlopidine 15. Alcoholism causes folic acid deficiency by: Preventing storage of folic acid in the liver 16. A patient is experiencing an acute asthma attack. What is the first-line therapy for relief of an acute asthma attack? Beta2 adrenergic agonist 17. Inhaled corticosteroids are recommended as monotherapy for _____? Asthma 18. WR presents to her doctor with complaints of urinary retention and dry mouth for the past 2 weeks. Recently, she was started on a new medication for the management of COPD. Which of the following medications most likely caused these symptoms? Tiotropium 19. Oral iron salt with highest elemental iron content requiring lesser frequency of administration: ferrous fumarate 20. GM presents to the Cancer Institute for her next cycle of chemotherapy for his advanced lung cancer. After his previous treatment, he was hospitalized due to febrile neutropenia. To prevent similar complications with chemotherapy cycle, which medication should be given? Filgrastim 21. A 24-year-old woman has been coughing and wheezing about four times weekly, and she wakes up at night about thrice per month. She has never been given a diagnosis of asthma, and she has not been to a doctor “in years.” She uses her boyfriend’s albuterol inhaler, but he recently ran out of refills, so she is seeking care. Her activities are not limited by her symptoms. Spirometry is done today, and her FEV1 is 82% of predicted. What is the asthma severity level of the patient? Mild Persistent 22. Which treatment step will you recommend to the patient? Step 2 23. At first, her symptoms were well controlled on your recommended therapy. However, when winter arrived, she started having symptoms about 4 days per week and using her albuterol about 3 days per week. Not well controlled 24. Is treatment change necessary for the patient? Yes, step up 1 step 25. JZ was diagnosed of moderate myocardial infarction due to occlusion of the left descending coronary artery. Which of the following is the best treatment for this patient? Alteplase 26. A young pregnant lady was prescribed with folic acid supplementation during her first prenatal appointment. If she disregards the recommendation for folic acid supplementation, what is the risk to the fetus? Neural tube defects 27. Best antidote for acute iron toxicity which is potentially fatal in children: Deferoxamine 28. CDG, a 34 years old company supervisor, was diagnosed with asthma 5 years ago and is currently prescribed with a medium dose ICS. She has come to see you today as her asthma cannot be controlled and symptoms seemed worsened, even when using salmeterol at the same time. She regretfully confessed that she stopped taking her medicines when she found out that she’s pregnant. What is the severity level of her asthma? Severe persistent 29. Given this set of medications, what is her treatment step? Step 4 30. Would you recommend stepping up her current treatment step? No. She should be in the same treatment step. 31. Would you recommend stepping up her current treatment step? No. Treating asthma with medications is safer for the mother ad fetus than having asthma attacks. 32. HP is a 56 year old man who was recently diagnosed with Deep Vein Thrombosis. The patient was admitted and started on warfarin therapy. The doctor also started heparin to achieve immediate anticoagulation. Initial decreases in which of the following levels make heparin administration necessary? Protein C 33. Which of the following drugs accelerates the conversion of plasminogen to plasmin? Reteplase 34. It is approved agent for prophylaxis or treatment of thrombosis due to heparin-induced thrombocytopenia. Argatroban 35. FD is a 65 year old grandmother who was diagnosed with moderate myocardial infarction due to occlusion of the left descending coronary artery. Which of the following would be the best course of treatment for this patient? Alteplase 36. You are designing a new drug for elevated cholesterol and recent phase II clinical trials showed a significantly greater lowering of LDL cholesterol compared to placebo. Is this sufficient to conclude that your new drug is effective for hypercholesterolemia? No. 37. Which would lower LDL to a greater extent, Rosuvastatin 20 mg or Atorvastatin 20 mg? They would lower LDL to about the same degree 38. Gemfibrozil + Simvastatin would cause what effect on myopathies? increased risk 39. It is released intact from the complex for rebinding to more antithrombin: Heparin 40. The immediate hemostatic physiological response to a damaged vessel: Vasospasm 41. A kidney enzyme that directly converts plasminogen to active plasmin. Urokinase 42. Warfarin competitively inhibits which enzyme: Vitamin K reductase 43. Fibrinolytic agent associated with formation of antibodies that can cause development of severe allergic reaction. Streptokinase CORRECTIONS 1. Action/s of anticholinergics: reverses bronchoconstriction decreases vagal tone decreases mucus production 2. Phosphodiesterase inhibitor: Aminophylline 3. Which anti-asthma drug acts by activating pulmonary beta receptors thus increasing cAMP? Terbutaline 4. A patient is experiencing an acute asthma attack. Which of the following medications is of no use in managing acute asthma? Cromolyn sodium 5. In the management of bronchial asthma, which of the following medications is/are considered as controller medications? Formoterol Salmeterol Bambuterol 6. Stimulation of beta-2 receptors can alleviate bronchoconstriction. Drugs that stimulate these receptors can be called using these terms, EXCEPT: Catecholamines 7. Tolerance to therapeutic effectiveness has been demonstrated by which specific group of anti-asthma drugs? Beta-agonists 8. Adverse effect/s of inhaled corticosteroids: Adrenal suppression Skin changes Oral candidiasis Decreased bone density 9. Which of the following statements is CORRECT: COPD, unlike asthma, is characterized by destruction of airways 10. JZ was prescribed with new anticoagulant to reduce his risk of stroke. He was counseled to avoid drinking alcohol and intake of green leafy vegetables. He was asked to return to the clinic in one week to monitor his international normalized ratio (INR). What is the mechanism of action/s for the anticoagulant that the patient was prescribed? Prevents the reductive metabolism of Vitamin K 11. An agent approved for patients with anemia due to chronic kidney disease: Epoetin alfa 12. LC is a young mother who was admitted to the hospital with complaints of fatigue and dark tarry stools. One hour after admission, she begins vomiting what looks like coffee grounds. She has a history of Deep Vein Thrombosis for which she is taking warfarin. Which of the following would be the most appropriate treatment for LC? Phytonadione 13. Use of anticholinergic in asthma is mediated through which receptor? M2 **(B1 una kong sagot pero mali ata) 14. TRUE statement/s about Parenteral Iron: indicated for conditions with chronic heavy bleeding with similar efficacy with oral iron products for non-compliant patients 15. Acute toxicity of which leads to gastrointestinal hemorrhage: Iron 16. JJ undergoes regular dialysis for his end-stage renal disease. His nephrologist also prescribed him with epoetin alfa. What is the mechanism for which this agent will help the patient? Increase proliferation of erythroid precursor cells in the body 17. vWF receptor: GP Ib 18. Anticoagulant drug which binds to calcium ions causing osteoporosis: Heparin 19. TRUE about Cromolyn Sodium: Must be administered 2-4 weeks prior to allergen exposure Has bronchodilatory effect beneficial for asthma DOC in pregnancy for rhinorrhea 20. TRUE about Inhaled Corticosteroids: potentially beneficial in severe asthma inhibit release of leukotrienes which are bronchoconstrictors frequent side effects such as thrush, growth retardation and adrenal suppression limit its use as prophylaxis of severe asthma 21. LU has pernicious anemia and was prescribed with a medication to prevent development of neurologic disorders. Which of the following medication was prescribed? Cyanocobalamin 22. A Non-selective beta agonist: Isoproterenol 23. A child is prescribed an inhaled corticosteroid agent to decrease airway inflammation. The child’s parent administers high doses for the assumption of faster recovery. What is the patient at risk for? Adrenal insufficiency  24. Which of the following statement describe/s the use of anticholinergic agents in COPD and asthma? Available as tertiary ammonium compounds They are safely given by inhalation. They are bronchodilators and reduce bronchial secretions Can be used in combination with beta-agonists 25. A woman was hospitalized due to severe stomach pain and, severe headache and dark tarry stools. One hour after admission, she starts to vomit blood. She has a history of Deep Vein Thrombosis for which she is taking warfarin. Which of the following is the most appropriate treatment? Phytonadione 26. Which of the following drug/s may impair iron absorption when taken together with ferric gluconate for iron deficiency anemia? Tetracycline 27. TRUE about oral iron supplementation: GI distress such as nausea, constipation and diarrhea are common adverse effects. Inorganic iron in the ferrous state is much more readily absorbed than that in the ferric state. Oral iron treatment may require 3-6 months to replenish iron body stores. 28. TRUE about deoxyadenosylcobalamin as Vitamin B12 cofactor: deficiency may lead to production of abnormal fatty acids 29. A selective inhibitor of factor Xa: Fondaparinux 30. Which of the following anticoagulants is a direct inhibitor of thrombin? Dabigatran 31. Which is TRUE about Enoxaparin? It can be used without monitoring the patient's aPTT. 32. An NSAID with established anti-thrombotic activity and approved as first line agent as prophylaxis for MI. Aspirin 33. Conversion of this antiplatelet drug to its active metabolite is inhibited by PPIs like pantoprazole. Clopidogrel 34. How does Atorvastatin affect the number of LDL receptors in the liver: increase, decrease, or no change? Increase  35. Which of these statins will disappear from the body long before the patient wakes up if they take it several hours before their bedtime, Atorvastatin or Simvastatin? Simvastatin 36. During a counselling session on Atorvastatin, you open up MIMS and encounter the following side effects in the choices. Which of them is most important to counsel to the patient? Muscle pain and myalgia 37. Carbamazepine is a CYP3A4 inducer. What effect will it have on blood levels of Atorvastatin? Decrease 38. Between Evolocumab and Ezetimibe, which is more financially toxic? Evolocumab 39. Patient N.C. got her lipid profile back with the following results: Total Cholesterol: 189 mg/dL (normal: 125-200mg/dL) LDL: 95 mg/dL (normal: /=40mg/dL) TG: 537 mg/dL (normal: