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Pharm Exam 2 Verified and Updated
Questions and Answers (100% Correct
Answers)
A decrease in ______ drives renin release
Answer: A decrease in blood pressure drives renin release
Acetaminophen: Pharmacodynamic effects
Answer: Analgesic, antipyretic
Acetaminophen: Adverse Effects
Answer: - Usually very well tolerated
- Hepatotoxic
- Interaction with warfarin?
Acetaminophen: MOA
Answer: - "very much unclear"
- we do know it doesn't inhibit PGs (this is probably why it doesn't reduce
inflammation)
- Does reduce pain in brain
- Works in hypothalamus as an antipyretic the way NSAIDs do
#1 drug to cause drug-related liver deaths
Answer: Acetaminophen is the #1 drug to cause drug-related liver deaths
• The big risk factor for liver damage here is the frequency and amount (dose)
Acetaminophen has a relativity ______ half life
Answer: short
Acetaminophen is "very well tolerated" with little known side effects which is great
BUT
Answer: this is also an issue because this means you can take too much and still feel
fine
,Inquire through: | Professional | Confidential Support
If this drug were to go through the FDA now it would be Rx only
Answer: Acetaminophen
Analgesic that is good to use when there is excess bleeding in the pt
Answer: Acetaminophen because it won't increase likelihood of bleeding like
warfarin or NSAIDs will
A 54 yo man is diagnosed with hepatic failure secondary to acetaminophen use.
Which of the following most likely contributed?
a) poor underlying kidney function
b) inadequate nutrition
c) combination use with ibuprofen
Answer: B: Glutathione comes from good nutrition, this is what helps convert the
intermediate to the inactive/safe metabolite
Acetaminophen detoxified to
Answer: glucuronide
Acetaminophen converted to ______ by the enzymes ______
Answer: NAPQI (toxic intermediate), CYP1A2, CYP2E1, CYP23A4
Acetaminophen bioactivated to ______ by ______
Answer: glutathione conjugate by N-acetlycysteine
NAPQI is toxic and can lead to
Answer: cell toxicity, cell death
Almost all acetaminophen goes
Answer: to the right and is detoxified into sulfate or glucuronide
"a little bit" of acetaminophen goes
Answer: down to become toxic NAPQI (quinonimine)
· if you flood the body with acetaminophen it can't all go to the right -->
(proportionally) more will go down and produce more toxic NAPQI quinonimine
if you combine acetaminophen and alcohol you get an increase in
Answer: toxicity
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alcoholics are at an increased risk for _______ because
Answer: Liver toxicity from acetaminophen use because their livers are already
more efficient at metabolizing CYP2E1 --> this efficiency means that because the liver
is already good at metabolizing it with CYP2E1 it will go down this path rather than
being detoxified --> very efficient at converting intermediate to toxic end product
N-acetylcysteine MOA
Answer: Neutralizes NAPQI toxic metabolite
Give within _____ hours of acetaminophen ingestion
Answer: 16-24 hours
N-acetylcysteine adverse effects
Answer: -smells like eggs, this smell fills a room
-nausea, vomiting
-allergic rxn
______ is the IV version of N-acetylcysteine and has the benefit of
Answer: Acetadote, you don't smell it because it's given IV (it smells the same but
you aren't able to smell it)
N-acetylcysteine needs to be given
Answer: very soon and in large doses to have desired effect
Don't check N-acetylcysteine levels before
Answer: 4 hours because you aren't at the peak absorbed yet so it's too early to tell
Corticosteroid name to know
Answer: prednisone
Corticosteroids come from the
Answer: cortex (outer part) of adrenal glands
Androgens and other transmitters come from the
Answer: medulla (middle part)
Mineralocorticoids have _____-like activity
Answer: aldosterone-like activity (promote Na+ and H2O reabsorption)
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Glucocorticoids have _______-like activity
Answer: cortisol-like activity
More cortisol-like effect is the better the medication is at
Answer: suppressing inflammation
If you take steroids incorrectly
Answer: your adrenal glands can atrophy because your body thinks you have
enough so it doesn't make any (suppresses hypothalamic-pituitary action), can help
to build muscle mass
Don't want kids exposed to steroids because
Answer: they can stunt their growth
Steroid use can lead to
Answer: o manic/depressive episodes (CNS changes), "roid rage"
o increased weight and BP d/t Na+ and H2O retention
o chronic use can lead to osteoporosis, can lead to weakened immune system
(prednisone taken is such high amounts that it can do this)
Appearance of Cushing's Disease
Answer: o "Moon face"
o Skin pigmentation
o Skin becomes thinner (can impair wound healing d/t a decrease in the integrity of
this part of the immune system)
Prednisone MOA
Answer: Knock out phospholipase --> no arachidonic acid --> suppression of COX-1
and COX-2
What makes steroids so good at treating inflammation in the lungs?
Answer: They inhibit inflammation mediators in the lungs (in addition to elsewhere)
"very few drugs can ________ as well as corticosteroids. Very effective, very potent"
Answer: "very few drugs can suppress inflammation as well as corticosteroids. Very
effective, very potent"
Pharm Exam 2 Verified and Updated
Questions and Answers (100% Correct
Answers)
A decrease in ______ drives renin release
Answer: A decrease in blood pressure drives renin release
Acetaminophen: Pharmacodynamic effects
Answer: Analgesic, antipyretic
Acetaminophen: Adverse Effects
Answer: - Usually very well tolerated
- Hepatotoxic
- Interaction with warfarin?
Acetaminophen: MOA
Answer: - "very much unclear"
- we do know it doesn't inhibit PGs (this is probably why it doesn't reduce
inflammation)
- Does reduce pain in brain
- Works in hypothalamus as an antipyretic the way NSAIDs do
#1 drug to cause drug-related liver deaths
Answer: Acetaminophen is the #1 drug to cause drug-related liver deaths
• The big risk factor for liver damage here is the frequency and amount (dose)
Acetaminophen has a relativity ______ half life
Answer: short
Acetaminophen is "very well tolerated" with little known side effects which is great
BUT
Answer: this is also an issue because this means you can take too much and still feel
fine
,Inquire through: | Professional | Confidential Support
If this drug were to go through the FDA now it would be Rx only
Answer: Acetaminophen
Analgesic that is good to use when there is excess bleeding in the pt
Answer: Acetaminophen because it won't increase likelihood of bleeding like
warfarin or NSAIDs will
A 54 yo man is diagnosed with hepatic failure secondary to acetaminophen use.
Which of the following most likely contributed?
a) poor underlying kidney function
b) inadequate nutrition
c) combination use with ibuprofen
Answer: B: Glutathione comes from good nutrition, this is what helps convert the
intermediate to the inactive/safe metabolite
Acetaminophen detoxified to
Answer: glucuronide
Acetaminophen converted to ______ by the enzymes ______
Answer: NAPQI (toxic intermediate), CYP1A2, CYP2E1, CYP23A4
Acetaminophen bioactivated to ______ by ______
Answer: glutathione conjugate by N-acetlycysteine
NAPQI is toxic and can lead to
Answer: cell toxicity, cell death
Almost all acetaminophen goes
Answer: to the right and is detoxified into sulfate or glucuronide
"a little bit" of acetaminophen goes
Answer: down to become toxic NAPQI (quinonimine)
· if you flood the body with acetaminophen it can't all go to the right -->
(proportionally) more will go down and produce more toxic NAPQI quinonimine
if you combine acetaminophen and alcohol you get an increase in
Answer: toxicity
,Inquire through: | Professional | Confidential Support
alcoholics are at an increased risk for _______ because
Answer: Liver toxicity from acetaminophen use because their livers are already
more efficient at metabolizing CYP2E1 --> this efficiency means that because the liver
is already good at metabolizing it with CYP2E1 it will go down this path rather than
being detoxified --> very efficient at converting intermediate to toxic end product
N-acetylcysteine MOA
Answer: Neutralizes NAPQI toxic metabolite
Give within _____ hours of acetaminophen ingestion
Answer: 16-24 hours
N-acetylcysteine adverse effects
Answer: -smells like eggs, this smell fills a room
-nausea, vomiting
-allergic rxn
______ is the IV version of N-acetylcysteine and has the benefit of
Answer: Acetadote, you don't smell it because it's given IV (it smells the same but
you aren't able to smell it)
N-acetylcysteine needs to be given
Answer: very soon and in large doses to have desired effect
Don't check N-acetylcysteine levels before
Answer: 4 hours because you aren't at the peak absorbed yet so it's too early to tell
Corticosteroid name to know
Answer: prednisone
Corticosteroids come from the
Answer: cortex (outer part) of adrenal glands
Androgens and other transmitters come from the
Answer: medulla (middle part)
Mineralocorticoids have _____-like activity
Answer: aldosterone-like activity (promote Na+ and H2O reabsorption)
, Inquire through: | Professional | Confidential Support
Glucocorticoids have _______-like activity
Answer: cortisol-like activity
More cortisol-like effect is the better the medication is at
Answer: suppressing inflammation
If you take steroids incorrectly
Answer: your adrenal glands can atrophy because your body thinks you have
enough so it doesn't make any (suppresses hypothalamic-pituitary action), can help
to build muscle mass
Don't want kids exposed to steroids because
Answer: they can stunt their growth
Steroid use can lead to
Answer: o manic/depressive episodes (CNS changes), "roid rage"
o increased weight and BP d/t Na+ and H2O retention
o chronic use can lead to osteoporosis, can lead to weakened immune system
(prednisone taken is such high amounts that it can do this)
Appearance of Cushing's Disease
Answer: o "Moon face"
o Skin pigmentation
o Skin becomes thinner (can impair wound healing d/t a decrease in the integrity of
this part of the immune system)
Prednisone MOA
Answer: Knock out phospholipase --> no arachidonic acid --> suppression of COX-1
and COX-2
What makes steroids so good at treating inflammation in the lungs?
Answer: They inhibit inflammation mediators in the lungs (in addition to elsewhere)
"very few drugs can ________ as well as corticosteroids. Very effective, very potent"
Answer: "very few drugs can suppress inflammation as well as corticosteroids. Very
effective, very potent"
