INBDE Pharmacology Exam Questions
and Revised Answers 100% Correct
What is the only Local Anesthesia that causes vasoconstriction? - Answer- Cocaine
What Local Anesthesia can produce powerful stimulation of cerebral cortex? - Answer-
Cocaine because it BLOCKS reuptake of NE, which potentiates nerve endings
Which antibiotics are not cross-allergenic with Penicillin? - Answer- Macrolides like
Erythromycin
What is the Medication of choice for Chronic Asthma? - Answer- Corticosteroids
HIV Medication - Answer- 1. Anti-Retroviral Medications such as Zidovudine
Bisphosphonates - Answer- 1. PREVENT Bone Resorption by causing Osteoclasts ->
Apoptosis
-INCREASES Bone Density
-SLOW Tooth Movement
-IMPAIRS Bone Healing
-Can lead to OSTEONECROSIS
Bisphosphonates are used against - Answer- 1. Osteoporosis
2. Paget's Dx
3. Multiple Myeloma
4. Metastatic Bone Lesions of Various Cancers
Bisphosphonate List and Relative Potency - Answer- -End in "-Nate"
1. Etidronate (1)
2. Tiludronate and Clodronate (10)
3. Pamidronate (100) (IV)
4. Alendronate (1000) (Oral)
5. Risedronate and Ibandronate (5000) (Oral)
6. Zolendronate (10000) (IV)
Bisphosphonate Pharmacokinetics - Answer- 1. Oral has LOWER Bioavailability then IV
2. HIGH Binding Affinity to Calcium, Iron and Magnesium in Intestinal Tract
3. HIGHER Concentrations in TRABECULAR Bone versus Cortical Bone
Bisphosphonate Pharmacodynamics - Answer- 1. REDUCES Osteoclast FUNCTION +
NUMBER
2. NITROGEN Side Groups INCREASE Potency
,Ester Local Anesthetics - Answer- Procaine, Tetracaine and Cocaine
Amide Local Anesthetics - Answer- Anything that is NOT Procaine, Tetracaine or
Cocaine and ends in "-caine"
Lidocaine - Answer- 1. SAFEST to use in children
2. 2%
3. pKa = 7.8
Bupivacaine - Answer- 1. LEAST SAFE to use in children
2. 0.5%
3. pKa = 8.1
Mepivicaine - Answer- 1. Causes LEAST amount of Vasodilation, thus can be packaged
WITHOUT Epinephrine
2. 2% or 3%
3. pKa = 7.6
Articaine - Answer- 1. Has an Ester Chain and Amide Chain, thus can be metabolized in
BOTH Liver and Plasma
2. 4%
3. pKa = 7.8
Where are Amides metabolized? - Answer- Liver
Where are Esters metabolized? - Answer- Plasma via Esterases
What toxic effect can Prilocaine cause? - Answer- Methemoglobinemia
How do Local Anesthetics work? - Answer- Block Na+ Channels
What form of Local Anesthetics can cross membrane? - Answer- Free Base or NON-
Ionized
Short Acting Local Anesthetics - Answer- Procaine
Moderate Acting Local Anesthetics - Answer- Prilocaine, Mepivacaine and Lidocaine
Long Acting Local Anesthetics - Answer- Bupivacaine, Tetracaine and Etidocaine
What does increased blood flow do to drug duration? - Answer- SHORTENS
What does increased lipid solubility/hydrophobicity do to drug potency and duration? -
Answer- INCREASES
, What does lower pKa do to drug activation time? - Answer- Makes it FASTER
What does increased protein binding do to drug duration? - Answer- INCREASES
MAX Epi for ASA I Patient - Answer- 0.2mg
MAX Epi for Cardiac Patient - Answer- 0.04mg (1x 1:50,000 or 2x 1:100,000 or 4x
1:200,000)
MAX Lido with Epi - Answer- 4.4mg/kg
MAX Lido without Epi - Answer- 7.0mg/kg
What is the injection technique that has highest risk of hematoma? - Answer- PSA
How much of needle is required to enter for PSA? - Answer- 16mm
Lidocaine and Propranolol - Answer- 1. Propranolol DECREASES Lidocaine Breakdown
2. Compete for SAME Enzyme
Initially, Local Anesthetics inhibit... - Answer- Central Inhibitory Neurons
At greater doses, Local Anesthetics inhibit... - Answer- BOTH Central Inhibitory and
Excitatory Neurons
Local Anesthesia and Graves Disease (Hyperthyroidism) - Answer- Graves Disease =
Hyperthyroidism, which makes patient MORE SENSITIVE to LA
Cardiovascular collapse due to high dose of LA may be caused by - Answer- Myocardial
Depression
Penicillin prescription - Answer- 250-500mg, dispense 30 (loading dose) or 28 and take
1 every 6 hrs until gone
Clindamycin prescription - Answer- 150-300mg, dispense 21 and take 1 every 8 hrs
until gone
Amoxicillin prescription - Answer- 500mg, dispense 21 and take 1 every 8 hrs until gone
How do bactericidal antibiotics such as penicillin work? - Answer- INHIBIT Cell Wall
Synthesis
How do bacteriostatic antibiotics such as tetracycline work? - Answer- INHIBIT Protein
Synthesis via BINDING to Ribosomes
Sulfonamides - Answer- 1. Start with "Sulfa-" and Bactrim
and Revised Answers 100% Correct
What is the only Local Anesthesia that causes vasoconstriction? - Answer- Cocaine
What Local Anesthesia can produce powerful stimulation of cerebral cortex? - Answer-
Cocaine because it BLOCKS reuptake of NE, which potentiates nerve endings
Which antibiotics are not cross-allergenic with Penicillin? - Answer- Macrolides like
Erythromycin
What is the Medication of choice for Chronic Asthma? - Answer- Corticosteroids
HIV Medication - Answer- 1. Anti-Retroviral Medications such as Zidovudine
Bisphosphonates - Answer- 1. PREVENT Bone Resorption by causing Osteoclasts ->
Apoptosis
-INCREASES Bone Density
-SLOW Tooth Movement
-IMPAIRS Bone Healing
-Can lead to OSTEONECROSIS
Bisphosphonates are used against - Answer- 1. Osteoporosis
2. Paget's Dx
3. Multiple Myeloma
4. Metastatic Bone Lesions of Various Cancers
Bisphosphonate List and Relative Potency - Answer- -End in "-Nate"
1. Etidronate (1)
2. Tiludronate and Clodronate (10)
3. Pamidronate (100) (IV)
4. Alendronate (1000) (Oral)
5. Risedronate and Ibandronate (5000) (Oral)
6. Zolendronate (10000) (IV)
Bisphosphonate Pharmacokinetics - Answer- 1. Oral has LOWER Bioavailability then IV
2. HIGH Binding Affinity to Calcium, Iron and Magnesium in Intestinal Tract
3. HIGHER Concentrations in TRABECULAR Bone versus Cortical Bone
Bisphosphonate Pharmacodynamics - Answer- 1. REDUCES Osteoclast FUNCTION +
NUMBER
2. NITROGEN Side Groups INCREASE Potency
,Ester Local Anesthetics - Answer- Procaine, Tetracaine and Cocaine
Amide Local Anesthetics - Answer- Anything that is NOT Procaine, Tetracaine or
Cocaine and ends in "-caine"
Lidocaine - Answer- 1. SAFEST to use in children
2. 2%
3. pKa = 7.8
Bupivacaine - Answer- 1. LEAST SAFE to use in children
2. 0.5%
3. pKa = 8.1
Mepivicaine - Answer- 1. Causes LEAST amount of Vasodilation, thus can be packaged
WITHOUT Epinephrine
2. 2% or 3%
3. pKa = 7.6
Articaine - Answer- 1. Has an Ester Chain and Amide Chain, thus can be metabolized in
BOTH Liver and Plasma
2. 4%
3. pKa = 7.8
Where are Amides metabolized? - Answer- Liver
Where are Esters metabolized? - Answer- Plasma via Esterases
What toxic effect can Prilocaine cause? - Answer- Methemoglobinemia
How do Local Anesthetics work? - Answer- Block Na+ Channels
What form of Local Anesthetics can cross membrane? - Answer- Free Base or NON-
Ionized
Short Acting Local Anesthetics - Answer- Procaine
Moderate Acting Local Anesthetics - Answer- Prilocaine, Mepivacaine and Lidocaine
Long Acting Local Anesthetics - Answer- Bupivacaine, Tetracaine and Etidocaine
What does increased blood flow do to drug duration? - Answer- SHORTENS
What does increased lipid solubility/hydrophobicity do to drug potency and duration? -
Answer- INCREASES
, What does lower pKa do to drug activation time? - Answer- Makes it FASTER
What does increased protein binding do to drug duration? - Answer- INCREASES
MAX Epi for ASA I Patient - Answer- 0.2mg
MAX Epi for Cardiac Patient - Answer- 0.04mg (1x 1:50,000 or 2x 1:100,000 or 4x
1:200,000)
MAX Lido with Epi - Answer- 4.4mg/kg
MAX Lido without Epi - Answer- 7.0mg/kg
What is the injection technique that has highest risk of hematoma? - Answer- PSA
How much of needle is required to enter for PSA? - Answer- 16mm
Lidocaine and Propranolol - Answer- 1. Propranolol DECREASES Lidocaine Breakdown
2. Compete for SAME Enzyme
Initially, Local Anesthetics inhibit... - Answer- Central Inhibitory Neurons
At greater doses, Local Anesthetics inhibit... - Answer- BOTH Central Inhibitory and
Excitatory Neurons
Local Anesthesia and Graves Disease (Hyperthyroidism) - Answer- Graves Disease =
Hyperthyroidism, which makes patient MORE SENSITIVE to LA
Cardiovascular collapse due to high dose of LA may be caused by - Answer- Myocardial
Depression
Penicillin prescription - Answer- 250-500mg, dispense 30 (loading dose) or 28 and take
1 every 6 hrs until gone
Clindamycin prescription - Answer- 150-300mg, dispense 21 and take 1 every 8 hrs
until gone
Amoxicillin prescription - Answer- 500mg, dispense 21 and take 1 every 8 hrs until gone
How do bactericidal antibiotics such as penicillin work? - Answer- INHIBIT Cell Wall
Synthesis
How do bacteriostatic antibiotics such as tetracycline work? - Answer- INHIBIT Protein
Synthesis via BINDING to Ribosomes
Sulfonamides - Answer- 1. Start with "Sulfa-" and Bactrim
