ADVANCED PHARM: FINAL EXAM
QUESTIONS AND ANSWERS
Charliesissas65-year-
oldsmaleswhoshassbeensdiagnosedswithshypertensionsandsbenignsprostaticshyperplasia.sDo
xazosinshassbeenschosenstostreatshisshypertensionsbecausesit:
1.sIncreasessperipheralsvasoconstriction
2.sDecreasessdetrusorsmusclescontractility
3.sLowersssupinesbloodspressuresmoresthansstandingspressure
4.sRelaxesssmoothsmusclesinsthesbladdersnecks-
sans✔✔4.sRelaxesssmoothsmusclesinsthesbladdersneck
Tosreducespotentialsadverseseffects,spatientsstakingsasperipherallysactingsalpha1santagonis
tsshouldsdosallsofsthesfollowingsEXCEPT:s
1.sTakesthesdosesatsbedtime
2.sSitsupsslowlysandsdanglestheirsfeetsbeforesstanding
3.sMonitorstheirsbloodspressuresandsskipsasdosesifsthespressuresisslesssthans120/80
4.sWeighsdailysandsreportsweightsgainsofsgreatersthans2spoundssinsonesdays-
sans✔✔3.sMonitorstheirsbloodspressuresandsskipsasdosesifsthespressuresissless sthans120/80
Johnshassclonidine,sascentrallysactingsadrenergicsblocker,sprescribedsforshisshypertension.s
Hesshould:
1.sNotsmisssasdosesorsstopstakingsthesdrugsbecausesofspotentialsreboundshypertension
2.sIncreasesfibersinsthesdietstostreatsanysdiarrheasthatsmaysoccur
3.sReducesfluidsintakestoslesssthans2slitersspersdaystospreventsfluidsretention
4.sAvoidssittingsforslongsperiods,sassthisscansleadstosdeepsveinsthrombosiss-
sans✔✔1.sNotsmisssa sdosesorsstopstakingsthesdrugsbecausesofspotentialsreboundshypertens
ion
Clonidineshassseveralsoff-labelsuses,sincluding:
1.sAlcoholsandsnicotineswithdrawal
2.sPost-herpeticsneuralgia
3.sBoths1sands2
4.sNeithers1snors2s-sans✔✔3.sBoths1sands2
Jimsissbeingstreatedsforshypertension.sBecausesheshassashistorysofsheartsattack,sthesdrugsch
osensissatenolol.sBetasblockersstreatshypertensionsby:
1.sIncreasingsheartsratestosimprovescardiacsoutput
2.sReducingsvascularssmoothsmusclestone
3.sIncreasingsaldosterone-mediatedsvolumesactivity
,4.sReducingsaqueousshumorsproductions-
sans✔✔2.sReducingsvascularssmoothsmusclestone
Whichsofsthesfollowingsadverseseffectssareslessslikelysinsasbetas1-selectivesblocker?
1.sDysrhythmias
2.sImpairedsinsulinsrelease
3.sReflexsorthostaticschanges
4.sDecreasedstriglyceridessandscholesterols-sans✔✔2.sImpairedsinsulinsrelease
Richardsiss70syearssoldsandshassashistorysofscardiacsdysrhythmias.sHeshassbeensprescribed
snadolol.sYousdoshissannualslaboratorysworksandsfindsasCrClsofs25sml/min.sWhatsactionsshou
ldsyoustakesrelatedstoshissnadolol?
1.sExtendsthesdosagesinterval.
2.sDecreasesthesdosesbys75%.
3.sTakesnosactionsbecausesthissvaluesissexpectedsinsthesoldersadult.
4.sSchedulesasserumscreatinineslevelstosvalidatesthesCrClsvalue.s-
sans✔✔1.sExtendsthesdosagesinterval.
Betasblockerssaresthesdrugssofschoicesforsexertionalsanginasbecausesthey:
1.sImprovesmyocardialsoxygenssupplysbysvasodilatingsthescoronarysarteries
2.sDecreasesmyocardialsoxygensdemandsbysdecreasingsheartsratesandsvascularsresistance
3.sBoths1sands2
4.sNeithers1snors2s-
sans✔✔2.sDecreasesmyocardialsoxygensdemandsbysdecreasingsheartsratesandsvascularsre
sistance
Adherencestosbetasblockerstherapysmaysbesaffectedsbystheir:
1.sShortshalf-livessrequiringstwicesdailysdosing
2.sTendencystoselevateslipidslevels
3.sEffectssonsthesmalesgenitalia,swhichsmaysproducesimpotence
4.sNonesofsthesaboves-
sans✔✔3.sEffectssonsthesmalesgenitalia,swhich smaysproducesimpotence
Betasblockersshavesfavorableseffectssonssurvivalsandsdiseasesprogressionsinsheartsfailure.s
Treatmentsshouldsbesinitiatedswhensthe:
1.sSymptomssaressevere
2.sPatientshassnotsrespondedstosotherstherapies
3.sPatientshassconcurrentshypertension
4.sLeftsventricularsdysfunctionsissdiagnoseds-
sans✔✔4.sLeftsventricularsdysfunctionsissdiagnosed
Abruptswithdrawalsofsbetasblockersscansbeslifesthreatening.sPatientssatshighestsrisksforsserio
ussconsequencessofsrapidswithdrawalsaresthoseswith:
1.sAngina
2.sCoronarysarterysdisease
3.sBoths1sands2
,4.sNeithers1snors2s-sans✔✔3.sBoths1sands2
Tospreventslife-threateningseventssfromsrapidswithdrawalsofsasbetasblocker:
1.sThesdosagesintervalsshouldsbesincreasedsbys1shourseachsday.
2.sAnsalphasblockersshouldsbesaddedstosthestreatmentsregimensbeforeswithdrawal.
3.sThesdosagesshouldsbestaperedsoversasperiodsofsweeks.
4.sThesdosagesshouldsbesdecreasedsbysone-halfseverys4sdays.s-
sans✔✔4.sThesdosagesshouldsbesdecreasedsbysone-half severys4 sdays.
Betasblockerssaresprescribedsforsdiabeticsswithscautionsbecausesofstheirsabilitystosproduces
hypoglycemiasandsblocksthescommonssymptomssofsit.sWhichsofsthesfollowingssymptomssofs
hypoglycemiasissnotsblockedsbysthesesdrugssandssoscansbesusedstoswarnsdiabeticssofspossi
blesdecreasedsbloodsglucose?
1.sDizziness
2.sIncreasedsheartsrate
3.sNervousnesssandsshakiness
4.sDiaphoresiss-sans✔✔4.sDiaphoresis
Combinedsalpha-
betasantagonistssaresusedstosreducesthesprogressionsofsheartsfailuresbecausesthey:
1.sVasodilatesthesperipheralsvasculature
2.sDecreasescardiacsoutput
3.sIncreasesrenalsvascularsresistance
4.sReducesatherosclerosisssecondarystoselevatedsserumslipoproteinss-
sans✔✔1.sVasodilatesthesperipheralsvasculature
CarvedilolsissheavilysmetabolizedsbysCYP2D6sands2C9,sresultingsinsdrugsinteractionsswiths
whichsofsthesfollowingsdrugsclasses?
1.sHistamines2sblockers
2.sQuinolones
3.sSerotoninsre-uptakesinhibitors
4.sAllsofsthesaboves-sans✔✔4.sAllsofsthesabove
Alpha-betasblockerssaresespeciallyseffectivestostreatshypertensionsforswhichsethnicsgroup?
1.sWhite
2.sAsian
3.sAfricansAmerican
4.sNativesAmericans-sans✔✔3.sAfricansAmerican
Bethanechol:
1.sIncreasessdetrusorsmusclestonestosemptysthesbladder
2.sDecreasessgastricsacidssecretionstostreatspepticsulcersdisease
3.sStimulatessvoluntarysmusclestonestosimprovesstrength
4.sReducessbronchialsairwaysconstrictionstostreatsasthmas-
sans✔✔1.sIncreasessdetrusorsmusclestonestosemptysthesbladder
, ClinicalsdosingsofsBethanechol:
1.sBeginssatstheshighestseffectivesdosestosobtainsasrapidsresponse
2.sStartssats5smgstos10smgsPOsandsissrepeatedseveryshoursuntilsassatisfactorysclinicalsrespo
nsesissachieved
3.sRequiressdosingsonlysoncesdaily
4.sIssthessamesforsbothsthesoralsandsparenteralsroutes-
sans✔✔2.sStartssats5smgsto s10smgsPOsandsissrepeatedseveryshoursuntilsassatisfactorysclinica
lsresponsesissachieved
Patientsswhosneedstosremainsalertsarestaughtstosavoidswhichsdrugsduestositssantimuscarinics
effects?
1.sLevothyroxine
2.sPrilosec
3.sDulcolax
4.sDiphenhydramines-sans✔✔4.sDiphenhydramine
Anticholinesterasesinhibitorssaresusedstostreat:
1.sPepticsulcersdisease
2.sMyastheniasgravis
3.sBoths1sands2
4.sNeithers1snors2s-sans✔✔2.sMyastheniasgravis
WhichsofsthesfollowingsdrugssusedstostreatsAlzheimer'ssdiseasesissnotsansanticholinergic?
1.sDonepezil
2.sMemantine
3.sRivastigmine
4.sGalantamines-sans✔✔2.sMemantine
Takingswhichsdrugswithsfoodsmaximizessitssbioavailability?
1.sDonepezil
2.sGalantamine
3.sRivastigmine
4.sMemantines-sans✔✔3.sRivastigmine
Whichsofsthesfollowingsdrugssshouldsbesusedsonlyswhensclearlysneededsinspregnantsandsbr
eastfeedingswomen?
1.sMemantine
2.sPyridostigmine
3.sGalantamine
4.sRivastigmines-sans✔✔2.sPyridostigmine
TheresissasnarrowsmarginsbetweensfirstsappearancesofsadversesreactionstosAChEsinhibitorss
andsseriousstoxicseffects.sAdversesreactionssthatsrequiresimmediatesactionsinclude:
1.sDizzinesssandsheadache
2.sNausea
QUESTIONS AND ANSWERS
Charliesissas65-year-
oldsmaleswhoshassbeensdiagnosedswithshypertensionsandsbenignsprostaticshyperplasia.sDo
xazosinshassbeenschosenstostreatshisshypertensionsbecausesit:
1.sIncreasessperipheralsvasoconstriction
2.sDecreasessdetrusorsmusclescontractility
3.sLowersssupinesbloodspressuresmoresthansstandingspressure
4.sRelaxesssmoothsmusclesinsthesbladdersnecks-
sans✔✔4.sRelaxesssmoothsmusclesinsthesbladdersneck
Tosreducespotentialsadverseseffects,spatientsstakingsasperipherallysactingsalpha1santagonis
tsshouldsdosallsofsthesfollowingsEXCEPT:s
1.sTakesthesdosesatsbedtime
2.sSitsupsslowlysandsdanglestheirsfeetsbeforesstanding
3.sMonitorstheirsbloodspressuresandsskipsasdosesifsthespressuresisslesssthans120/80
4.sWeighsdailysandsreportsweightsgainsofsgreatersthans2spoundssinsonesdays-
sans✔✔3.sMonitorstheirsbloodspressuresandsskipsasdosesifsthespressuresissless sthans120/80
Johnshassclonidine,sascentrallysactingsadrenergicsblocker,sprescribedsforshisshypertension.s
Hesshould:
1.sNotsmisssasdosesorsstopstakingsthesdrugsbecausesofspotentialsreboundshypertension
2.sIncreasesfibersinsthesdietstostreatsanysdiarrheasthatsmaysoccur
3.sReducesfluidsintakestoslesssthans2slitersspersdaystospreventsfluidsretention
4.sAvoidssittingsforslongsperiods,sassthisscansleadstosdeepsveinsthrombosiss-
sans✔✔1.sNotsmisssa sdosesorsstopstakingsthesdrugsbecausesofspotentialsreboundshypertens
ion
Clonidineshassseveralsoff-labelsuses,sincluding:
1.sAlcoholsandsnicotineswithdrawal
2.sPost-herpeticsneuralgia
3.sBoths1sands2
4.sNeithers1snors2s-sans✔✔3.sBoths1sands2
Jimsissbeingstreatedsforshypertension.sBecausesheshassashistorysofsheartsattack,sthesdrugsch
osensissatenolol.sBetasblockersstreatshypertensionsby:
1.sIncreasingsheartsratestosimprovescardiacsoutput
2.sReducingsvascularssmoothsmusclestone
3.sIncreasingsaldosterone-mediatedsvolumesactivity
,4.sReducingsaqueousshumorsproductions-
sans✔✔2.sReducingsvascularssmoothsmusclestone
Whichsofsthesfollowingsadverseseffectssareslessslikelysinsasbetas1-selectivesblocker?
1.sDysrhythmias
2.sImpairedsinsulinsrelease
3.sReflexsorthostaticschanges
4.sDecreasedstriglyceridessandscholesterols-sans✔✔2.sImpairedsinsulinsrelease
Richardsiss70syearssoldsandshassashistorysofscardiacsdysrhythmias.sHeshassbeensprescribed
snadolol.sYousdoshissannualslaboratorysworksandsfindsasCrClsofs25sml/min.sWhatsactionsshou
ldsyoustakesrelatedstoshissnadolol?
1.sExtendsthesdosagesinterval.
2.sDecreasesthesdosesbys75%.
3.sTakesnosactionsbecausesthissvaluesissexpectedsinsthesoldersadult.
4.sSchedulesasserumscreatinineslevelstosvalidatesthesCrClsvalue.s-
sans✔✔1.sExtendsthesdosagesinterval.
Betasblockerssaresthesdrugssofschoicesforsexertionalsanginasbecausesthey:
1.sImprovesmyocardialsoxygenssupplysbysvasodilatingsthescoronarysarteries
2.sDecreasesmyocardialsoxygensdemandsbysdecreasingsheartsratesandsvascularsresistance
3.sBoths1sands2
4.sNeithers1snors2s-
sans✔✔2.sDecreasesmyocardialsoxygensdemandsbysdecreasingsheartsratesandsvascularsre
sistance
Adherencestosbetasblockerstherapysmaysbesaffectedsbystheir:
1.sShortshalf-livessrequiringstwicesdailysdosing
2.sTendencystoselevateslipidslevels
3.sEffectssonsthesmalesgenitalia,swhichsmaysproducesimpotence
4.sNonesofsthesaboves-
sans✔✔3.sEffectssonsthesmalesgenitalia,swhich smaysproducesimpotence
Betasblockersshavesfavorableseffectssonssurvivalsandsdiseasesprogressionsinsheartsfailure.s
Treatmentsshouldsbesinitiatedswhensthe:
1.sSymptomssaressevere
2.sPatientshassnotsrespondedstosotherstherapies
3.sPatientshassconcurrentshypertension
4.sLeftsventricularsdysfunctionsissdiagnoseds-
sans✔✔4.sLeftsventricularsdysfunctionsissdiagnosed
Abruptswithdrawalsofsbetasblockersscansbeslifesthreatening.sPatientssatshighestsrisksforsserio
ussconsequencessofsrapidswithdrawalsaresthoseswith:
1.sAngina
2.sCoronarysarterysdisease
3.sBoths1sands2
,4.sNeithers1snors2s-sans✔✔3.sBoths1sands2
Tospreventslife-threateningseventssfromsrapidswithdrawalsofsasbetasblocker:
1.sThesdosagesintervalsshouldsbesincreasedsbys1shourseachsday.
2.sAnsalphasblockersshouldsbesaddedstosthestreatmentsregimensbeforeswithdrawal.
3.sThesdosagesshouldsbestaperedsoversasperiodsofsweeks.
4.sThesdosagesshouldsbesdecreasedsbysone-halfseverys4sdays.s-
sans✔✔4.sThesdosagesshouldsbesdecreasedsbysone-half severys4 sdays.
Betasblockerssaresprescribedsforsdiabeticsswithscautionsbecausesofstheirsabilitystosproduces
hypoglycemiasandsblocksthescommonssymptomssofsit.sWhichsofsthesfollowingssymptomssofs
hypoglycemiasissnotsblockedsbysthesesdrugssandssoscansbesusedstoswarnsdiabeticssofspossi
blesdecreasedsbloodsglucose?
1.sDizziness
2.sIncreasedsheartsrate
3.sNervousnesssandsshakiness
4.sDiaphoresiss-sans✔✔4.sDiaphoresis
Combinedsalpha-
betasantagonistssaresusedstosreducesthesprogressionsofsheartsfailuresbecausesthey:
1.sVasodilatesthesperipheralsvasculature
2.sDecreasescardiacsoutput
3.sIncreasesrenalsvascularsresistance
4.sReducesatherosclerosisssecondarystoselevatedsserumslipoproteinss-
sans✔✔1.sVasodilatesthesperipheralsvasculature
CarvedilolsissheavilysmetabolizedsbysCYP2D6sands2C9,sresultingsinsdrugsinteractionsswiths
whichsofsthesfollowingsdrugsclasses?
1.sHistamines2sblockers
2.sQuinolones
3.sSerotoninsre-uptakesinhibitors
4.sAllsofsthesaboves-sans✔✔4.sAllsofsthesabove
Alpha-betasblockerssaresespeciallyseffectivestostreatshypertensionsforswhichsethnicsgroup?
1.sWhite
2.sAsian
3.sAfricansAmerican
4.sNativesAmericans-sans✔✔3.sAfricansAmerican
Bethanechol:
1.sIncreasessdetrusorsmusclestonestosemptysthesbladder
2.sDecreasessgastricsacidssecretionstostreatspepticsulcersdisease
3.sStimulatessvoluntarysmusclestonestosimprovesstrength
4.sReducessbronchialsairwaysconstrictionstostreatsasthmas-
sans✔✔1.sIncreasessdetrusorsmusclestonestosemptysthesbladder
, ClinicalsdosingsofsBethanechol:
1.sBeginssatstheshighestseffectivesdosestosobtainsasrapidsresponse
2.sStartssats5smgstos10smgsPOsandsissrepeatedseveryshoursuntilsassatisfactorysclinicalsrespo
nsesissachieved
3.sRequiressdosingsonlysoncesdaily
4.sIssthessamesforsbothsthesoralsandsparenteralsroutes-
sans✔✔2.sStartssats5smgsto s10smgsPOsandsissrepeatedseveryshoursuntilsassatisfactorysclinica
lsresponsesissachieved
Patientsswhosneedstosremainsalertsarestaughtstosavoidswhichsdrugsduestositssantimuscarinics
effects?
1.sLevothyroxine
2.sPrilosec
3.sDulcolax
4.sDiphenhydramines-sans✔✔4.sDiphenhydramine
Anticholinesterasesinhibitorssaresusedstostreat:
1.sPepticsulcersdisease
2.sMyastheniasgravis
3.sBoths1sands2
4.sNeithers1snors2s-sans✔✔2.sMyastheniasgravis
WhichsofsthesfollowingsdrugssusedstostreatsAlzheimer'ssdiseasesissnotsansanticholinergic?
1.sDonepezil
2.sMemantine
3.sRivastigmine
4.sGalantamines-sans✔✔2.sMemantine
Takingswhichsdrugswithsfoodsmaximizessitssbioavailability?
1.sDonepezil
2.sGalantamine
3.sRivastigmine
4.sMemantines-sans✔✔3.sRivastigmine
Whichsofsthesfollowingsdrugssshouldsbesusedsonlyswhensclearlysneededsinspregnantsandsbr
eastfeedingswomen?
1.sMemantine
2.sPyridostigmine
3.sGalantamine
4.sRivastigmines-sans✔✔2.sPyridostigmine
TheresissasnarrowsmarginsbetweensfirstsappearancesofsadversesreactionstosAChEsinhibitorss
andsseriousstoxicseffects.sAdversesreactionssthatsrequiresimmediatesactionsinclude:
1.sDizzinesssandsheadache
2.sNausea
