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Flashcards by ACAPUN INSTITUTE, updated more than 1 year ago
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Created by ACAPUN INSTITUTE
almost 3 years ago
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| Question | Answer |
| Which act in 1906 forbade the adulteration and mislabeling of drugs? | Pure Food and Drug Act |
| Which act regulated opiates and cocaine in 1914? | Harrison Narcotic Act |
| Which act mandated the safety of drugs and the role of FDA in enforcing safety in 1938? | Food, Drug, and Cosmetic Act |
| Which act used restrictions for certain drugs by prescription only in 1952? | Durham-Humphrey Act |
| Which act provided incentives for developing drugs for rare diseases in 1983? | Orphan Drug Amendment |
| Which act in 1997 replaced "legend" with label "Rx only", -allowed manufacturer to discuss off-label uses of drugs with practitioners -revised accelerated track approval for drugs that treat life-threatening disorders -made provisions for pediatric drug research -revised interaction of agency with individuals doing clinical trials? | FDA Modernization Act |
| Which 2005 act established new regulations for sale of ephedrine, pseudoephedrine, and phenylpropanolamine ? | Combat Methamphetamine Epidemic Act |
| In the somatic nervous system, the nerve goes from the CNS to striated muscle. Which neurotransmitter acts on striated muscle? | ACh |
| In the sympathetic division of the autonomic nervous system, the path is: CNS ------------> ACh-nicotinic (ganglion) ------------> What is final neurotransmitter for *heart, smooth muscle, glands* | NE |
| Epinephrine is a physiological antagonist of what two drugs? | histamine & nitroglycerin |
| CNS --------->ACh-nicotinic (adrenal medulla) ----------->what is made at the adrenal medulla? | epinephrine, norepinephrine |
| In the parasympathetic division: CNS ---------> ACh-nicotinic (ganglion) --------------> ACh (is this a nicotinic or muscarinic site?) | Muscarinic (heart, smooth muscle, glands) |
| Epinephrine is a physiological antagonist of what two drugs? | histamine & nitroglycerin |
| What best describes biotransformation? | Increase in polarity, more ionized and more water soluble |
| In relation to their parent drug, conjugated metabolites are what? | more ionized in plasma (more water soluble) |
| First pass of oral drugs is referred to as? | enterohepatic circulation |
| What is used to determine whether a drug will cross glomerulus? | attached to a protein or not |
| In order for a drug to do its effect in what state should it be? Weak acid, Weak base Liposoluble Hydrophobic Hydrophilic | liposoluble |
| When a drug does not exert its maximum effect is because it's bound to? Albumin gamma betasomething alpha | Albumin drugs highly bound to plasma proteins will not enter liver to be metabolized, resulting in longer half-life. |
| What protein is used to attach to medication? | Albumin |
| Which of the following best explains why drugs that are highly ionized tend to be more rapidly excreted than those that are less ionized? The highly ionized are A. less lipid soluble. B. less water soluble. C. more rapidly metabolized. D. more extensively bound to tissue | A |
| Therapeutic Index LD/ED is a measure of? | safety of drug |
| What pharmacokinetic factor influences the need for multiple doses in a day (dose rate)? half-life; other option is bioavailability, or clearance | half-life |
| Drug A has greater efficacy than Drug B and therefore has higher? | Potency; Drug A will produce higher effect at lower dose. Drug A has a higher potency |
| Fixed dose drug A w/ low dose of Drug B increase drug B effect when same dose of drug A is give w/ increased does of drug B. competitive antagonist, synergism, partial agonist | partial agonist |
| Slow infusion of epinephrine will cause which of the following and know which receptor is responsible? | Alpha 1 (Vasoconstriction during anaphylaxis), Beta 1 (Increases cardiac output), Beta 2 (bronchodilation) |
| Patients BP spike after EPI, what receptor? | B1 |
| Condition that DOES NOT require antibiotic prophylaxis o Prosthetic heart valve o Rheumatic heart valve o Congenital heart formations o Cardiac pacemaker | Cardiac pacemaker |
| Indications for prophylaxis? | 1. Artificial/prosthetic heart valves 2. History of infective endocarditis 3. Certain specific, serious congenital (present from birth) heart conditions, 4. Cardiac transplant that develops a problem in a heart valve |
| Kid had unrepaired cyanotic congenital heart disease with something valves. Whats the premedication? (pedo dose) | Amox 50mg/kg or Clinda 20mg/kg |
| What is the pre-medication dosage for child 44 lbs.? | 1-gram amoxicillin 1 hour prior Tx. 1kg=2.2lbs 44 lbs. = 20Kg X 50mg/Kg = 1000mg = 1g Amoxicillin |
| Pt w/ mitral valve prolapse w/ regurgitation, premedicate? | No |
| Patient's medical tab say he is allergic to Amoxicillin), He needs to be premediated, what do you prescribe? | Clindamycin, 600mg |
| Pt w/ total knee replacement but was taking Amoxicillin for a while; how do you premeditate? | you dont |
| Pt needs antibiotic prophylaxis. He is taking penicillin already, what do you give him? | Clindamycin |
| IE pre-medications why? | benefits of premedication outweigh potential harm associated with penicillin |
| What is IE? | inflammation of the inner layer of the heart, the endocardium |
| When is it appropriate to prescribe antibiotic prophylaxis in patient with previous infective endocarditis? | if consequence of potential infection is detrimental to life |
| Which of these procedures pose a risk for Infective Endocarditis? • Primary teeth shedding • RCT • Some sort of surgery • IA injection | Surgery |
| Know the doses for someone that is allergic to penicillin, what can you give them? | Clarithromycin 500mg Clindamycin 600mg |
| Most bacteriostatic meds works by? | Inhibiting protein synthesis |
| Broad spectrum antibiotics like tetracycline? | increase superinfection and resistance |
| Why don't we use broad spectrum antibiotics? | Produce resistant bacteria; leads to infections |
| Antibiotics are least useful for tx of these periodontal conditions? | LAP, NUG, chronic periodontitis |
| Antibiotic metabolism is affected by chronic tx with what type of drugs? | Benzos |
| Pt is taking an antibiotic, which is metabolized in the liver. Metabolism of this antibiotic is decreased by which drug? a. TCA b. SSRI c. phenothiazine d. diazepam | d. |
| You give antibiotics through IV, patient experience sudden allergic reaction, what's the FIRST thing you do? | Remove the IV line |
| Penicillin, why is this so good to give as an antibiotic? | Low toxicity, cheap |
| What is the effect of Penicillin and Cephalosporin? | Inhibit cell wall synthesis |
| What enzyme is inhibited by penicillin? | Transpeptidase cross-links the peptidoglycan chains for the cell wall |
| Which of the following penicillin would be used to treat a Pseudomonas infection? Nafcillin (Unipen) Amoxicillin (Amoxil) Benzedrine penicillin (Bicillin) Phenoxymethyl penicillin (Pen-Vee K) Ticarcillin (Thar) | Ticarcillin |
| Why do penicillins have decreased effectiveness in abscess? why? | hyaluronidase; it can't penetrate cyst |
| #1 dental antibiotic for an infection within 24hrs is? | Pen VK 1gm booster and 500mg q6h |
| What antibiotic used for endo, pulpal involvement? | PEN VK |
| Cephalosporin has a broader spec than Penecillins (T/F)? | False |
| Broadest antibiotic effect? | Chlortetracycline |
| Tetracycline mechanism of action? | protein synthesis inhibitor (30s) bacteriostatic |
| Doxycycline MOA? What does it inhibit? | act on 50S ribosome and 30s ribosome; inhibits collegenase |
| Which antibiotic is anti-microbial and anti-collagenlyctic? clindamycin, doxycycline, metronidazole, amoxicillin | doxycyline |
| Tetracycline does not do one of the following: reduce host response reduce bacterial infection reduce host collagenase decrease gingival crevicular fluid flow | decrease gingival crevicular fluid flow |
| Minocycline & Doxycycline do what regarding GCF? | Both increase GCF secretion, both released in GCF |
| Mechanism of action of Minocycline in the Arestin? | decrease collagenases |
| What drug has the highest concentration in crevicular fluid? | Tetracycline |
| Which one of the following drug is chelated with C++? | Tetracycline |
| Which drug would inactivate the latter? | Antacids-> Tetracycline |
| What is most affected by tetracycline? | Dentin, causes intrinsic stain |
| What age are you most likely get infection that resulted in enamel hypoplasia or tetracycline staining? | before 4 months in utero for primary birth for permanent |
| What medication do you not give to lactating female? | Codeine and tetracycline |
| Pt allergic to penicillin, what could be cross-reactive? | Cephatriaxone |
| What drug has cross allerginicity with Penicillin? | Cephalosporines |
| Pt is taking tetracycline. Which of the following drugs would be contraindicated? | Penicillin |
| What happens when you have penicillin and decide to prescribe tetracycline with it? | Tetracycline will decrease the efficacy of Penicillin. |
| Penicillin and erythromycin taken together cause: (cidal vs static) •summation •potentiation •antagonists | antagonists |
| Erythromycin like tetracycline is? | bacteriostatic |
| #1 side-effect of erythromycin is? | Stomach upset |
| In lethal doses of erythromycin, what do you see? | GI damage |
| Myasthenia gravis patient, what can't you give them? | Erythromycin |
| If you have maxillary sinusitis, what antibiotic would you give? | Amoxicillin with clavulanic Acid (Augmentin) |
| What the clavulanic acid do when is mixed with amoxicillin (Augmentin)? | decrease sensitivity from b-lactamase (prevents beta lactam degradation by beta lactamase producing bacteria) |
| Augmentin does what? | blocks the action of penicillinase, penicillinase resistant |
| Metronidazole prescribed for? | necrotizing ulcerative gingivitis (NUG) or aggressive periodontitis |
| What color does your pee turn when you take Metronidazole? | red |
| Antibiotic used against only anaerobes parasites (protozoa)? | Metronidazole |
| Clostridium difficile (colon inflammation) is treated with? | metronidazole Unless pt is pregnant or breastfeeding, then use vancomycin. |
| Mechanism of Metronidazole • disrupts cell wall synthesis • enzyme poisoning • fungal protozoa disruption | fungal protozoa disruption |
| Which antibiotic is NOT inhibit cell wall synthesis? • amoxicillin • vancomycin • azithromycin | azithromycin (protein synthesis) |
| Gentamycin (aminoglycosides) side effect? | May cause auditory nerve deafness |
| aminoglycosides can cause? | ototoxicity and nephro toxicity |
| Antibiotic that helps with MRSA? | Vancomycin |
| Which of the following describes clindamycin? a. inhibits cell wall synthesis b. does not penetrate well into bony tissue c. it usually given in combination with erythromycin d. is effective against gram-negative bacteria only e. is effective against most anaerobes | e. |
| Which of the following describes ciprofloxacin (Cipro®)? Inhibits cell wall synthesis. Effective against Pseudomonas aeruginosa. Effective only against anaerobic bacteria. An antibiotic-of-choice for treating otitis media in young children. Effective against oral anaerobes. | Effective against Pseudomonas aeruginosa. |
| Anti-cancer drugs are least likely to cause what? | thromboembolism |
| What's a drug that you can't mix with antibiotics? why? | Methotrexate; wont clear out of the system |
| Methotrexate (MTX) is an? | antifolate drug; inhibits folate reductase |
| Which drug will be used to treat an overdose of methotrexate? | Leucovorin |
| Drug agonists of folic acid? | Sulfa, Trimethoprim, Methotrexate |
| Alkalizing anti-cancer drug called procarbazine causes? | Hepatotoxicity |
| Non-alkylating anti-cancer side effect? | myelosuppression |
| Amantadine is what type of drug? | anti-viral and anti-parkinsonian |
| What anti-viral is used to for all the these: HSV, VZV, CMV? | Valacyclovir |
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