Systemic Pharm - Final Material

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  • 1/30 Questions

    Which statement is not true?

    • When prescribing anticoagulant and antiplatelet medications dosing adjustments may be needed in patients with compromised renal function, and dose determination is often based on patient weight as well as indication.
    • Anticoagulant and antiplatelet medications are commonly prescribed after joint replacement surgeries
    • Low molecular weight heparins are used for the prevention of deep vein thrombosis, but are contraindicated in patients with unstable angina or non-Q-wave myocardial infarction.
    • Anticoagulant and antiplatelet medications are usually administered subcutaneously
    • Enoxaparin/Lovenox is an example of an anticoagulant
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About This Quiz

This quiz titled 'Systemic Pharm - Final Material' assesses knowledge on pharmacological treatments and drug interactions, focusing on conditions like hyperlipidemia and acute angina. It evaluates understanding of drug side effects, contraindications, and appropriate dosages, crucial for healthcare professionals.

Systemic Pharm - Final Material - Quiz

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  • 2. 

    Which of the following statements is not true?

    • Aspirin/NSAIDs and Clopidogrel/Plavix may cause GI ulceration, bleeding and stomach upset.

    • Ocular side effects are uncommon in Clopidogrel/Plavix, while reports of blurred vision occur with some NSAIDs

    • NSAIDs and arthritic doses of ASA can decrease the effects of antihypertensive medications

    • Aspirin reduces the risk of AMI, stroke and TIAs

    • Clopidogrel/Plavix is used for the reduction of thrombotic events after recent AMI, or recent stroke. It can also be used to treat peripheral arterial disease, unstable angina and non-Q wave MI

    Correct Answer
    A. Ocular side effects are uncommon in Clopidogrel/Plavix, while reports of blurred vision occur with some NSAIDs
    Explanation
    Clopidogrel/Plavix - cataracts and conjunctivitis with clopidogrel and conjunctival bleeding with ticlopidine

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  • 3. 

    Which of the following drugs is the standard of care in the treatment of Hyperlipidemia?

    • Calcium channel antagonist

    • HMG-CoA Reductase Inhibitors

    • ACE-Inhibitors

    • Serotonin Receptor Agonists "Triptans"

    Correct Answer
    A. HMG-CoA Reductase Inhibitors
    Explanation
    Calcium channel antagonists are used in the treatment of angina prophylaxis, hypertension
    ACE-Inhibitors: Hypertension, CHF, MI
    Serotonin Receptor Agonists "Triptans" - Migraine treatment
    HMG-CoA Reductase Inhibitors: "-Statins" e.g. Fluvastatin, Simvastatin, Rosuvastatin

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  • 4. 

    Which of the following drugs must be used with caution if used in conjunction with statins?

    • Ezetimibe/Zetia

    • Fenofibrate/Tricor

    • Niacin/Nicotinic acids

    • Gemfibrozil/Lopid

    • All of the above medications must be used with caution in conjunction with statins

    Correct Answer
    A. All of the above medications must be used with caution in conjunction with statins
    Explanation
    pg. 92

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  • 5. 

    Your patient Nancy Nut has come into your office for her yearly exam. During the case history she mentions that she's been experiencing headaches, flushing and she's been having difficulty controlling her diabetes. She tells you that at her doctor's appointment 3 months ago they told her she had hyperlipidemia. She lost her insurance and couldn't fill the prescription written for her. She decided to go to Trader Joe's and buy some pills she read about on the Mayo clinic. She says that she takes double the amount recommended because she thought it would fix her condition twice as fast. What drug did she buy and is dosing inappropriately?

    • Furosemide/Lasix

    • Niacin/Nicotinic acid

    • Hydrochlorothiazide/HydroDiuril

    • Warfarin/Coumadin

    • Montelukast/Singulair

    Correct Answer
    A. Niacin/Nicotinic acid
    Explanation
    Furosemide/Lasix - for edema, hypertension, hypercalcemia ( can cause blurred vision )
    Hydrochlorothiazide/HydroDiuril - for Edema and hypertension ( can cause dry eye )

    Warfarin/Coumadin - for deep vein thrombosis, atrial fibrillation, pulmonary embolism, also used in patients after heart valve replacement, and in some patients with rheumatic or ischemic heart disease

    Montelukast/Singulair - for chronic asthma prevention/maintenance

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  • 6. 

    Although Adverse drug reactions include headache, flushing, orthostatic hypotension, tachycardia, peripheral edema, dizziness, N/V and blurred vision this drug is still the drug of choide for acute angina. Extended release preparations and patches of this drug may be used for angina prophylaxis. The IV form may be used for unstable angina, heart failure, AMI. However hypotensive effects are increased when taken with other medications that lower blood pressure. What is this drug?

    • Digoxin/Lanoxin

    • Nitroglycerin

    • Hydrocodone/Vicodin

    • Celecoxib/Celebrex

    • Cyclobenzaprine/Flexeril

    Correct Answer
    A. Nitroglycerin
    Explanation
    Digoxin/Lanoxin - for congestive heart failure, atrial fibrillation, atrial flutter, paroxysmal atrial tachycardia. Blurred or yellow vision

    Hydrocodone/Vicodin - used for moderate pain/analgesic; in our scope of practice; ADE: blurred vision, diplopia, miosis, nystagmus

    Celecoxib/Celebrex - Arthritis pain and inflammation; ADE; blurred vision, cataracts, conjunctival hemorrhage, conjunctivitis, eye pain, increased IOP, vitreous floaters

    Cyclobenzaprine/Flexeril - musculoskeletal pain; ADE: Blurred vision

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  • 7. 

    Which of the following drugs is does not cause any ocular side effects?

    • Clopidogrel/Plavix

    • Tiotropium/Spiriva

    • Metformin/Glucophage

    • Systemic corticosteroids/prednisone/methylprednisolone

    • Phenytoin/Dilantin

    Correct Answer
    A. Metformin/Glucophage
    Explanation
    Clopidogrel/Plavix - cataracts and conjunctivitis

    Tiotropium/Spiriva - Blurred vision and caution in narrow angle glaucoma

    Systemic corticosteroids/prednisone/methylprednisolone - Blurred vision and change in IOP; caution when being used in GLC and cataracts

    Phenytoin/Dilantin - Nystagmus, blurred vision and diplopia

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  • 8. 

    Which statement is not true?

    • Ocular anti-inflammatory agents carry an increased risk of infection, cataracts, corneal/scleral perforation, and glaucoma. Therefore when prescribing these medications you should always monitor IOPs and gradually taper when discontinuing.

    • Systemic sedating antihistamines are contraindicated in narrow angle glaucoma, BPH, some patients with peptic ulcer disease and in patients with bladder obstructions

    • It is estimated that 2-10% of patients who are allergic to Fluoroquinolones will also be allergic to Sulfonamides due to structure similarities. Reactions may range from rash to anaphylaxis.

    • Overuse of antihistamines/anti-allergy preparations for the eye can cause rebound dilation of blood vessels. You should recommend to your patients that they avoid using while wearing soft contact lenses. Recommend that the patient wait 10minutes after use to insert their contact lenses

    • Taking frequent or routin doses of aspirin or NSAIDs can blunt or lower the effect of antihypertensive medication therapy in individuals with high blood pressure

    Correct Answer
    A. It is estimated that 2-10% of patients who are allergic to Fluoroquinolones will also be allergic to Sulfonamides due to structure similarities. Reactions may range from rash to anaphylaxis.
  • 9. 

    Which of the following statements is not true?

    • Acetylsalicyclic acid(ASA/Aspirin) and Acetaminophen (APAP/Tylenol)are examples of non-opiate analgesic medications

    • Acetaminophen(APAP/Tylenol) relieves mild to moderate pain, reduces fever, reduces inflammation, and reduces blood clotting.

    • Acetaminophen is metabolized hepatically and therefore the total cumulative doses administered must be monitored. If metabolic pathways become saturated by exceeding recommended doses, life-threatening hepatotoxicity can occur.

    Correct Answer
    A. Acetaminophen(APAP/Tylenol) relieves mild to moderate pain, reduces fever, reduces inflammation, and reduces blood clotting.
    Explanation
    pg. 108

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  • 10. 

    Which of the following drugs is the drug of choice for anticonvulsants in an emergency. This drug is used for status epilepticus, anxiety, insomia, seizures, sedation, and can also be used as a muscle relaxant. ADEs include CNS depression, respiratory depresion. Vague visual disturbances have been reported. 

    • Levodopa/Carbidopa

    • Benzodiazepine

    • Phenothiazines

    • Metoclopramide/Reglan

    Correct Answer
    A. Benzodiazepine
    Explanation
    Levodopa/Carbidopa - For Parkinson's, ADEs include hypotension, arrhythmias, blepharospasm and oculogyric crisis in dystonia

    Phenothiazines - for psychiatric disorders. ADEs include blurred vision, corneal and lenticular changes, epithelial kertopathy, pigmentary retinopathy

    Mnemonic; Ben and Pam I am = Benzodiazepines; Diazepam, alprazolam, oxazepam, temazepam, triazolam

    Metoclopramide/ Reglan - use includes reflux esophagitis, duodenal ulcers, gastroparesis, slow gastric emptying time, ADE includes CNS effects, diarrhea, constipation, occasionally extrapyramidal symtoms from dopamine antagonism. Can cause unspecified visual disturbances

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  • 11. 

    Histamine -1 receptors : stimulation of H1 receptors results in _______ ( bronchodilation or bronchoconstriction)

    Correct Answer
    bronchoconstriction
    Explanation
    Stimulation of H1 receptors results in bronchoconstriction. H1 receptors are found in the smooth muscles lining the bronchial tubes. When these receptors are stimulated by histamine, it causes the smooth muscles to contract, leading to narrowing of the airways and difficulty in breathing. This can result in symptoms such as wheezing and shortness of breath, commonly seen in conditions like asthma and allergies.

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  • 12. 

    Which of the following statements regarding antihistamines are not true?

    • Histamine is stored in, and released from mast cells, basophils, and CNS neurons

    • Physiologic effects of histamine include vasodilation, localized reddening, edema and flare, increased heart rate and contractility.

    • First generation drugs include Meclizine/bonine, diphenhydramine/Bendryl and chlorpheniramine/Chlor-Trimeton

    • H2 receptor antagonists/H2 blockers are used to prevent/treat allergic reactions, prevent /treat motion sickness. However they are no longer used to treat insomnia or as adjunct therapy for parkinson's disease.

    Correct Answer
    A. H2 receptor antagonists/H2 blockers are used to prevent/treat allergic reactions, prevent /treat motion sickness. However they are no longer used to treat insomnia or as adjunct therapy for parkinson's disease.
    Explanation
    H2 receptor antagonists (H2 blockers) - are used for the prevention and treatment of peptic ulcer disease ( pud) and the treatment of GERD, used for stress ulcer prevention in hospitals as well as duodenal and gastric ulcers.

    pg. 123

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  • 13. 

    Which receptor is located in the bronchi and in the liver and upon stimulation results in coronary and peripheral vasodilation and bronchodilation.

    • Beta-1 receptor

    • Beta-2 receptor

    • Alpha-1 receptor

    • Alpha-2 receptor

    Correct Answer
    A. Beta-2 receptor
    Explanation
    The beta-2 receptor is located in the bronchi and liver and when stimulated, it causes coronary and peripheral vasodilation and bronchodilation. This receptor is primarily found in smooth muscle tissues and is responsible for relaxing the smooth muscles in the bronchi, leading to bronchodilation. Additionally, stimulation of the beta-2 receptor causes vasodilation in the coronary and peripheral blood vessels, resulting in increased blood flow to these areas.

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  • 14. 

    Which receptor is located in the myocardial tissue and in the cardiac conduction system. Stimulation of this receptor results in increased cardiac contractility and heart rate.

    • Beta-1 receptor

    • Beta-2 receptor

    • Alpha-1 receptor

    • Alpha-2 receptor

    Correct Answer
    A. Beta-1 receptor
    Explanation
    Alpha receptors - are present in the neurons in the vascular smooth muscle tissue. Alpha-1 receptors are found in the myocardium and in alpha-2 receptors are found in larger blood vessles (skin,mucosa,gut,kidney). Stimulation leads to arteriolar vasoconstriction.

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  • 15. 

    Lidocaine/Xylocaine is used to treat what condition?

    • Musculoskeletal pain

    • Ventricular arrhythmias

    • ADD and narcolepsy

    • Parkinson's disease

    Correct Answer
    A. Ventricular arrhythmias
    Explanation
    Other drugs used for the Tx of Ventricular arrhythmias
    Mexiletine/Mexitil
    Propafenone/Rythmol
    Amiodarone

    Sotalol/Betapace is for ventricular tachycardia

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  • 16. 

    Which of the following drugs can be used as an alternative to morphine? There maybe more than one option listed below.

    • Oxycodone/Oxycontin

    • Codeine

    • Hydrocodone

    • Hydromorphone

    Correct Answer(s)
    A. Oxycodone/Oxycontin
    A. Hydromorphone
    Explanation
    Hydrocodone - alternative to codeine

    All the medications that are alternatives for morphine and codeine cause blurred vision, diplopia, miosis and nystagmus

    All of

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  • 17. 

    Fentanyl is an analgesic drug that is considered more potent than morphine. It is commonly used as preoperative/anesthetic agents. It is also used in the treatment of severe pain management.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Ocular side effects include: blurred vision, diplopia, miosis and nystagmus

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  • 18. 

    This drug is a centrally acting muscle relaxant. ADEs include several CNS, GI and cardiac ADEs. Ocular side effects include glaucoma, optic neuritis and blurred vision. This drug can be used to treat spasticity related to MS and spinal cord injuries. What drug is this?

    • Gabapentin/Neurontin

    • Chlorpheniramine/Chlor-Trimeton

    • Tizanidine/Zanaflex

    • Selegiline/Eldepryl

    Correct Answer
    A. Tizanidine/Zanaflex
    Explanation
    Gabapentin/Neurontin - Epilepsy and neuropathic pain
    Selegiline/Eldepryl - Parkinsons Disease
    Chlorpheniramine/Chlor-Trimeton - First generation Antihistamine H1 blocker

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  • 19. 

    Systemic sedating antihistamines are contraindicated in narrow angle glaucoma, BpH, some patients with peptic ulcer disease and in patients with bladder obstruction.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    Systemic sedating antihistamines can cause adverse effects in individuals with certain medical conditions. Narrow angle glaucoma, BPH (benign prostatic hyperplasia), peptic ulcer disease, and bladder obstruction are conditions where the use of these antihistamines is contraindicated. This means that it is not recommended to use these medications in individuals with these conditions as it can worsen their symptoms or cause complications. Therefore, the statement "Systemic sedating antihistamines are contraindicated in narrow angle glaucoma, BPH, some patients with peptic ulcer disease and in patients with bladder obstruction" is true.

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  • 20. 

    Which of the following is a physiologic effect of histamine being released into the system

    • Vasoconstriction

    • Localized reddening, edema and flare

    • Bronchodilation

    • Decreased heart rate and contractility

    Correct Answer
    A. Localized reddening, edema and flare
    Explanation
    Physiologic effects of histamine release: Vasodilation, localized reddening, edema and flare, bronchoconstriction, increased heart rate and contractility, pain and itching and gastric acid secretion

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  • 21. 

    Select the false statement regarding H2 Receptor Antagonists/H2 Blockers

    • H2 Blockers are used in the prevention and treatment of peptic ulder disease (PUD), and the treatment of gastroesophageal reflux disease (GERD).

    • Examples of H2 Blockers include famotidine/Pepcid and Ranitidine/Zantac

    • Stimulation of H2 receptors will decrease gastric acid secretion and decrease vasodilation

    • H2 blockers typically increase gastric acid secretion and increase vasodilation

    Correct Answer
    A. H2 blockers typically increase gastric acid secretion and increase vasodilation
    Explanation
    Overuse can cause rebound dilation of blood vessels. Recommend avoiding while wearing soft contact lenses. Wait 10 minutes after use before inserting contact lenses.

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  • 22. 

    This drug is the drug of choice for the treatment of anemia of chronic renal failure, and reduction of blood transfusions in surgical patients. This drug may exacerbate hypertension, thrombotic events, MI, pulmonary embolism, stroke, edema and HA.

    • Epoetin/Procrit

    • Glimepiride/Amaryl

    • Pilocarpine/Salagen

    • Olanzapine/Zyprexa

    Correct Answer
    A. Epoetin/Procrit
    Explanation
    Glimepiride/Amaryl - Tx of type II diabetes
    Pilocarpine/Salagen - Used for treating open-angle glaucoma, causes miosis and changes aqueous outflow.

    Olanzapine/Zyprexa - used in Tx of acute bipolar mania, schizophrenia, psychotic disorders

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  • 23. 

    Antipsychotic agents often have ADEs. Which of the following is not an ADE?

    • Altered blood glucose levels

    • Hypotension

    • Weight gain

    • Sedation and anticholinergic effects

    • All of the abover are possible ADEs

    Correct Answer
    A. All of the abover are possible ADEs
    Explanation
    Antipsychotic agents often have adverse drug events (ADEs), which refer to negative side effects that can occur when taking the medication. The given answer states that all of the options listed (altered blood glucose levels, hypotension, weight gain, sedation and anticholinergic effects) are possible ADEs. This means that all of these side effects can potentially occur when taking antipsychotic agents.

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  • 24. 

    Drugs for affective Disorders are used to treat typical and atypical depression as well as bipolar disorder. The goal is to identify medications that will decrease the symptoms without causing significant ADEs or undesirable long-term effects.

    • True

    • False

    Correct Answer
    A. True
    Explanation
    The statement is true because drugs for affective disorders, such as typical and atypical depression as well as bipolar disorder, are indeed used to decrease the symptoms associated with these conditions. The goal of these medications is to find a balance where they effectively treat the symptoms without causing significant adverse drug events (ADEs) or undesirable long-term effects.

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  • 25. 

    This medication is used for the Tx of agitation in acute bipolar mania, schizophrenia, and psychotic disorders. Ocular side effects include amblyopia, conjunctivitis, glaucoma, eye hemorrhage.

    • Haloperidol/Haldol

    • Olanzapine/Zyprexa

    • Ranitidine/Zantac

    • Esomeprazole/Nexium

    Correct Answer
    A. Olanzapine/Zyprexa
    Explanation
    Haloperidol/Haldol - Psychotic disorders, Tourette's syndrome - Blurred vision
    Ranitidine/Zantac - Tx for GERD, PUD, dyspepsia and other GI conditions
    Esomeprazole/Nexium - ( PPI); Tx for GERD, prevention and Tx of ulcers; blurred vision and conjunctivitis

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  • 26. 

    Select the proton pump inhibitors can interact with ampicillins (decrease ampicillin absoprtion).

    • Omeprazole

    • Olsalazine/Dipentum

    • Lanoprazole

    • Escitalopram/Lexapro

    • Aripiprazole/Abilify

    Correct Answer(s)
    A. Omeprazole
    A. Lanoprazole
    Explanation
    Olsalazine/Dipentum - Used in the Tx of inflammatory bowel syndrome, ulcerative colitis, Crohns disease, rare reports of blurred vision

    Escitalopram/Lexapro - SSRI Tx for affective disorders; blurred vision, nystagmus and vision abnormalities

    Aripiprazole/Abilify - Tx for schizophreniaand dementia associated associated psychosis

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  • 27. 

    This drug is used in the Tx of psychiatric disorders and causes blurred vision, corneal and lenticular changes, epithelial keratopathy and pigmentary retinopathy.

    • Phenothiazines

    • Atomoxetine/Strattera

    • Phenobarbital/Luminal

    • Lamotrigine/Lamictal

    Correct Answer
    A. Phenothiazines
    Explanation
    Atomoxetine/Strattera - Tx for ADD,narcolepsy: Mydriasis

    Phenobarbital/Luminal - Tx tonic-clonic and some absence seizures and febrile seizures

    Lamotrigine/Lamictal - Tx for epilepsy and maintenance therapy of bipolar disorder. Ocular side effect: nystagmus, vision changes, amblyopia

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  • 28. 

    Which of the following proton pump inhibitors can interact with amoxicillin and clarithromycin thus increasing esomeprazole levels? This particular drug can also cause blurred vision and conjunctivitis

    • Omeprazole/Prilosec

    • Esomeprazole/Nexium

    • Oxazepam/Serax

    • Olanzapine/Zyprexa

    Correct Answer
    A. Esomeprazole/Nexium
    Explanation
    Omeprazole/Prilosec - interacts with ampicillins to decrease ampicillin absorption

    Oxazepam/Serax - Tx cot anxiety and ETOH withdrawal, blurry vision (can reverse effects of benzodiasepines with Flumazemil/Romazicon)

    Olanzapine/Zyprexa - Tx for agitation in acute bipolar mania, schizophrenia, psychotic disorders; OSE: Amblyopia, conjunctivitis, GLC, eye hemorrhage

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  • 29. 

    Which of the following statements is false regarding antacids?

    • ADEs can include electrolyte imbalance, constipation, diarrhea. Electrolyte related toxcities are also possible in patients with severe renal impairment

    • Both magnesium and aluminum containing antacids will cause constipation when used as a single active ingredient.

    • Antacids typically contain one or more of the following components: calcium,aluminum, and magnesium

    • Magnesium containing antacids will often cause diarrhea when used as a single active ingredient for example in Magnesium hydroxide/Milk of Magnesia

    Correct Answer
    A. Both magnesium and aluminum containing antacids will cause constipation when used as a single active ingredient.
    Explanation
    The statement that is false regarding antacids is that both magnesium and aluminum containing antacids will cause constipation when used as a single active ingredient. In reality, magnesium containing antacids, such as Magnesium hydroxide/Milk of Magnesia, often cause diarrhea when used as a single active ingredient.

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  • 30. 

    Which Serotoni-Norepinephrine Reuptake Inhibitors (SNRIs) has ocular side effects that include blurred vision, vision abnormalities, cataracts, mydriasis and eye hemorrhaging?

    • Sertraline/Zoloft

    • Diazepam/Valium

    • Carbamazepine/Tegretol

    • Venlafaxin/Effexor

    Correct Answer
    A. Venlafaxin/Effexor
    Explanation
    Sertraline/Zoloft - this is a SSRI - vision abnormalities, cataracts, blindness, oculogyric crisis, optic neuritis

    Diazepam/Valium - Tx of epileptic seizures, sedation, muscle relaxant, , anxiety, ETOH withdrawal; BLUR

    Carbamazepine/Tegretol - Epilepsy, Trigeminal neuralgia, bipolar, neuropathic pain from shingles; blur and diplopia

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  • Current Version
  • Jul 13, 2023
    Quiz Edited by
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  • Feb 07, 2012
    Quiz Created by
    Mchllmijares

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