COMLEX LEVEL 1 PHARMACOLOGY EXAM
2025-2026 QUESTIONS AND ANSWERS GRADED
A+
What is the definition of a hypertensive emergency?
HTN >180/120
End organ damage
i.e. elevated BUN and Cr, altered mental status
Drugs used for hypertensive emergency
Nitroprusside
Fenoldopam
labetalol
clevidipine
nicardipine
MOA of nitroprusside
short acting vasodilator that increases cGMP by directly releasing NO from the endothelium
,AE of nitroprusside
cyanide toxicity
What's the foal of treatment of hypertensive emergencies?
Lower BP by 25% and maintain diastolic BP at no less than 100-110 mmHg
Names of bisphosphonate drugs
"-onates"
Alendronate
ibandronate
ridedronate
zoledronate
MOA of bisphosphonates
Bind calcium (hydroxyapetite) in bone AND inhibit osteoclast activity
Clinical use of bisphosphonates
Osteoporosis, hypercalcemia, Paget disease of bone, metastatic bone disease, osteogenesis imperfecta
,AEs of bisphosphonates
Esophagitis
**if take orally, stay upright for 30 min and take fasted in the AM with water only
Indication for typical antipsychotics
Schizophrenia
Bipolar
Tourrettes
OCd
Huntington's
Names of typical antipsychotics
Haloperidol
Chlorpromazine ("-azines")
MOA of typical antipsychotic medications
Potent D2 (dopamine) receptor blockers
Increase cAMP
, Main AEs of typical antipsychotics
Hyperprolactinemia --> galactorhhea, oligomenorrhea, gynecomastia
QT prolongation
ADAPT:
Acute dystonia (muscle spasms or stiffness)
Akasthisia (restless, uncontrollable need to move)
Parkinsonism (bradykinesia, mask-like facies, drooling, tremor)
Tardive Dyskinesia (involuntary twisting, worm like movements, disabling, irreversible -- late effect)
Neuroleptic Malignant Syndrome
What is Neuroleptic Malignant Syndrome
fever, muscles rigid, confusion, dysrhythmias, BP fluctuation
stop drug ASAP
happens bc of typical antipsychotic haloperidol --> blocking D2 receptor induces massive glutamate
release @ synapse --> catatonia, neurotoxicity, myotoxicity
Atypical antipsychotics & their MOA
-apines
-idones
2025-2026 QUESTIONS AND ANSWERS GRADED
A+
What is the definition of a hypertensive emergency?
HTN >180/120
End organ damage
i.e. elevated BUN and Cr, altered mental status
Drugs used for hypertensive emergency
Nitroprusside
Fenoldopam
labetalol
clevidipine
nicardipine
MOA of nitroprusside
short acting vasodilator that increases cGMP by directly releasing NO from the endothelium
,AE of nitroprusside
cyanide toxicity
What's the foal of treatment of hypertensive emergencies?
Lower BP by 25% and maintain diastolic BP at no less than 100-110 mmHg
Names of bisphosphonate drugs
"-onates"
Alendronate
ibandronate
ridedronate
zoledronate
MOA of bisphosphonates
Bind calcium (hydroxyapetite) in bone AND inhibit osteoclast activity
Clinical use of bisphosphonates
Osteoporosis, hypercalcemia, Paget disease of bone, metastatic bone disease, osteogenesis imperfecta
,AEs of bisphosphonates
Esophagitis
**if take orally, stay upright for 30 min and take fasted in the AM with water only
Indication for typical antipsychotics
Schizophrenia
Bipolar
Tourrettes
OCd
Huntington's
Names of typical antipsychotics
Haloperidol
Chlorpromazine ("-azines")
MOA of typical antipsychotic medications
Potent D2 (dopamine) receptor blockers
Increase cAMP
, Main AEs of typical antipsychotics
Hyperprolactinemia --> galactorhhea, oligomenorrhea, gynecomastia
QT prolongation
ADAPT:
Acute dystonia (muscle spasms or stiffness)
Akasthisia (restless, uncontrollable need to move)
Parkinsonism (bradykinesia, mask-like facies, drooling, tremor)
Tardive Dyskinesia (involuntary twisting, worm like movements, disabling, irreversible -- late effect)
Neuroleptic Malignant Syndrome
What is Neuroleptic Malignant Syndrome
fever, muscles rigid, confusion, dysrhythmias, BP fluctuation
stop drug ASAP
happens bc of typical antipsychotic haloperidol --> blocking D2 receptor induces massive glutamate
release @ synapse --> catatonia, neurotoxicity, myotoxicity
Atypical antipsychotics & their MOA
-apines
-idones
