Advanced Pharmacology Final Exam Review

ADVANCED PHARMACOLOGY FINAL EXAM REVIEW Why are nitrate-free periods every 24 hours necessary for the patient on nitroglycerin therapy? - ANS-To inhibit the development of tolerance What does a low level of thyroid-stimulating hormone indicate? - ANS-Hyperthroidism What would be the best option to treat a newly diagnosed patient with a low TSH level with? - ANS-Propanolol (Inderal) Spironoaldactone (Aldactone) has what mechanism of action (MOA)? - ANSAldosterone antagonist Heparin exerts its therapeutic action by what? - ANS-Upregulating the activity of one of the body's natural anticoagulant molecules, antithrombin III What physiologic action happens when the offending drug is administered during an anaphylactic reaction. - ANS-Mast cells liberate large doses of histamine. What are two systemic psoriasis medications? - ANS-Photo-therapy and topical corticosteroids What is the first choice of drug therapy for the majority of patients with uncomplicated stage I hypertension? - ANS-Thiazide diuretics What is the effect of cardiac glycosides? - ANS-Digitalis glycosides have a negative chronotropic effect on the cardiac muscle cells. Amenorrhea is the most common side effect of which birth control medication? - ANSMedroxyprogesterone (Depo-Provera) What is an anti-hypertensive agent which competes with epinephrine for available betareceptor sites? - ANS-Atenolol (Tenormin) What type of action does nitrates have on the body? - ANS-Reduction in systemic venous tone. What is the recommended level of low-density lipoprotein cholesterol (LDL) for patients with known coronary artery disease? - ANS-100mg/dl or less. What is the MOA of group IV anti-dysrhythmia drugs? - ANS-Depressing phase 4 depolarization and lengthening phases 1 and 2 repolarization. Which drug therapy should be used to lower the serum concentration of thyroid hormones and re-establish eumetabolic state in a patient with Graves' disease? - ANSAnti-thyroid drugs. Which type of diuretic would be used for a stage I hypertension in a patient with renal insufficiency? - ANS-Loop diuretic. What drug should be considered as first-line therapy for a client with hypertension and heart failure? - ANS-Enalapril (Vasotec) Which drug is considered safe for hypertension treatment during pregnancy? - ANSMethyldopa (Aldomet) What drug will reduce afterload because it is an alpha-adrenergic blocker? - ANSPrazosin (Minipress) What is an expected effect of the use of a beta-adrenergic blocker to control angina? - ANS-Reduced force of cardiac contraction. What side effect should be monitored closely in the elderly when taking Metformin (Glucophage) for type 2 diabetes? - ANS-Lactic acidosis. What is the primary role of cytochrome p-450 in the liver? - ANS-Deactivate and detoxify medications and other substances. What is a component of Vitamin K-dependent clotting factors? - ANS-Prothrombin How are IV morphine and nitroglycerin beneficial in acute heart failure? - ANS-Decrease preload. What is the purpose of administering a vasodilating drug to a patient in heart failure? - ANS-Decrease afterload. What are some contrindications for HMG-co A reductase inhibitors (statins)? - ANSThey cause myopathies, especially at higher doses or in combination with certain drugs. They should never be used in patients taking Warfarin (Coumadin). Which drug can reduce serum LDL the most in patients with hyperlipidemia? - ANSLovastatin (Mevacor) Which drug is contrindicated in a patient with Myasthena Gravis? - ANS-Procainamide (Pronestyl). What action is most effective in decreasing the risk of hyperkalemia associated with the start of angiotensin-converting enzyme inhibitor (ACEI) therapy? - ANS-Making sure that the patient is well hydrated. What factor influences plasma protein drug binding and distribution of that drug? - ANSThe amount of albumin available in the blood stream. What does the half-life of a medication determine? - ANS-How often the drug is to be administered. What important information should be given to a patient who is taking Metoprolol (Lopressor) for angina and hypertension? - ANS-The drug should not be taken with milk or dairy products. Which medications should be avoided for patients with a sulfa allergy? - ANSSulfamethoxazole/Trimethoprim (Bactrim) and Celecoxib (Celebrex). What should be taken into consideration when prescribing fat-soluable drugs in the elderly? - ANS-They are associated with increased duration of drug action. Which hypolipidemic class of drugs does not have to have liver function studies? - ANSHydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) FYI: I actually just looked this up because it didn't seem right...From the FDA: "The good news—no more periodic blood tests for liver function. The warnings—taking a statin may increase the odds of developing type 2 diabetes or suffering reversible memory loss or problems thinking. The FDA warned that one statin, lovastatin, shouldn't be taken with some antibiotics, anti-fungal agents, or medications used to treat AIDS." What is the MOA of cardiac glycosides? - ANS-Increase the force of cardiac contraction. What age-related changes place the elderly at risk for an exaggerated response to Warfarin (Coumadin) and Heparin? - ANS-Protein binding changes and decrease in clotting factors. Along with diet, what drug is used to treat hypertriglyceridemia? - ANS-Gemfibrozil (Lopid). What drug is the best choice of treatment for a newly diagnosed patient with type 2 diabetes only having postprandial glucose elevation? - ANS-Meglitinide (Prandin). Which medication is considered the safest for a diabetic patient if hypoglycemia is a major concern? - ANS-Metformin (Glucophage). What drug is an absolute contraindication if the patient is a smoker and taking medications for type 2 diabetes? - ANS-Birth control. How should an oral glucocorticoid be taken? - ANS-With food.