TEST BANK for Understanding Pharmacology for Health Professionals 6e (Global Edition). Susan Turley by StudyGuide

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 1 Introduction to Pharmacology 1.1

Multiple Choice Questions

1) Pharmacology is the study of . A) how drugs are dispensed B) pills and how to give them C) drugs and their interactions with living organisms D) plants, herbs, minerals, and animals Answer: C Explanation: A) The dispensing of drugs is only a small part of the field of pharmacology. B) Pharmacology does this, but includes much more. C) This is the correct definition. D) Some drugs come from these sources, but it is not the focus of pharmacology. 2) The word pharmacology comes from . A) the Dutch word droog B) the Greek word pharmakon C) the Greek word prophylaxis D) the Latin word medicina Answer: B Explanation: A) The Dutch word droog is where we get the word drug. B) Correct. Pharmacology comes from the Greek word pharmakon. C) The Greek word prophylaxis means to keep guard before. D) The Latin word medicina is where we get the word medicine or medication. 3) Drugs have three medical uses. Which of the following is NOT one of those uses? A) Drugs can provide evidence that a disease is present. B) Drugs can treat symptoms, signs, and diseases. C) Drugs can prevent disease. D) Drugs can cause symptoms, signs, and diseases. Answer: D Explanation: A) Diagnose: This is one of the three medical uses for drugs. B) Treat: This is one of the three medical uses for drugs. C) Prevent: This is one of the three medical uses for drugs. D) Correct. This is true, but it is not one of the medical uses for a drug.

4) The use of drugs during x-ray procedures and other medical tests to show evidence of a disease is known as ________. A) a preventive use B) a diagnostic use C) treating symptoms and signs of a disease D) None of the above Answer: B Explanation: A) The preventive use of drugs does not occur during a radiologic procedure. B) Correct. A diagnostic use does show evidence of a disease. C) Drugs used during radiologic procedures are not treating a disease. D) One of these answers is correct. 5) The medicinal use of foxglove to make the drug digoxin (Lanoxin) is an example of a modern drug derived from ________. A) an animal B) a mineral C) a plant D) a trace element Answer: C Explanation: A) Foxglove is not an animal. B) Foxglove is not a mineral. C) Correct. Foxglove is a plant. D) Foxglove is not a trace element. 6) The drug Premarin, a female hormone replacement used to treat the symptoms of menopause, is derived from ________. A) pregnant mares' urine B) margarine and oils C) the lanolin from processed sheep's wool D) powdered rose hips Answer: A Explanation: A) Correct. The drug name Premarin is taken from the phrase pregnant mares' urine. B) Premarin is not derived from margarine and oils. C) Premarin is not derived from lanolin from processed sheep's wool. D) Premarin is not derived from powdered rose hips.

7) Which of the following has NEVER been the source of a drug used to treat diabetes mellitus? A) ground-up beef pancreas B) the saliva of Gila monsters C) ground-up pork pancreas D) lanolin from sheep Answer: D Explanation: A) Ground-up animal pancreas was a source of insulin for treating diabetes mellitus the past. B) The saliva of the Gila monster is a source of the antidiabetic drug Byetta. C) Ground-up pig pancreas was a source of insulin for treating diabetes mellitus in the past. D) Correct. Lanolin is a topical drug; it is not used to treat diabetes mellitus. 8) In the past, without the use of computers, designing a new drug was ________. A) a quick process, done by just repositioning molecules B) a slow process of trial and error C) not done, because drug companies didn't know about molecular structures D) easy to do, by using models of wood and wire Answer: B Explanation: A) Without the use of computers, designing a new drug was not a quick process. B) Correct. Without computers, drug design was a slow process in the past. C) Even before computers, drug companies knew about molecular structures. D) Manipulating wood and wire models was slow. 9) Which drug was NOT created using molecular manipulation? A) the antibiotic drug ampicillin B) the antianxiety drug diazepam (Valium) C) human insulin (Humulin) D) the antihistamine fexofenadine (Allegra) Answer: C Explanation: A) Ampicillin was created from penicillin by molecular manipulation. B) Diazepam (Valium) was created from chlordiazepoxide by molecular manipulation. C) Correct. Human insulin (Humulin) was created by recombinant DNA technology, not molecular manipulation. D) Fexofenadine (Allegra) was created from another antihistamine drug by molecular manipulation.

10) Information from the human genome has led to the development of the subspecialty area of ________ in research and drug design. A) pharmacogenetics B) pharmacogenomics C) pharmacology D) A and B Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) Pharmacology existed before the human genome was discovered. D) Correct. 11) Prescription drugs are defined as those drugs that ________. A) meet clinical trial requirements and are approved by the FDA B) are stronger than what is allowed for over-the-counter use C) are not safe to use except under professional medical supervision D) contain addictive properties that prevent over-the-counter use Answer: C Explanation: A) This is not a correct description of a prescription drug. B) This is not a correct description of a prescription drug. C) Correct. This is the definition of a prescription drug. D) This is not a correct description of a prescription drug. 12) Which of the following statements concerning schedule drugs is TRUE? A) Schedule I drugs can be included—in small doses—in over-the-counter drugs. B) Schedule I drugs have the highest potential for abuse and addiction, while Schedule V drugs have the lowest. C) Schedule V drugs are not available under any circumstances, even with a prescription. D) Schedule V drugs have the highest potential for abuse and addiction, while Schedule I drugs have the lowest. Answer: B Explanation: A) Schedule I drugs have no currently accepted medical use. B) Correct. This is true. C) It is Schedule I drugs, not Schedule V drugs, that are not available under any circumstances. Schedule V drugs are available. D) It is Schedule I drugs that have the highest potential for abuse and addiction, while Schedule V drugs have the lowest.

13) The Orphan Drug Act was passed to ________. A) facilitate the development of new drugs to treat rare diseases B) make drug companies responsible for drug substitution and mislabeling that caused deaths C) require drug companies to provide an accurate list of the drug's ingredients D) speed up the approval process of new drugs Answer: A Explanation: A) Correct. This is a true statement. B) This occurred in the 1912 amendment to The Food and Drugs Act of 1906, not the Orphan Drug Act. C) This occurred in the 1912 amendment to The Food and Drugs Act of 1906, not the Orphan Drug Act. D) This occurred in The Food and Drug Administration (FDA) Modernization Act, not the Orphan Drug Act. 14) When analgesic drugs are used to control arthritis pain, this is an example of the ________ use of drugs. A) therapeutic B) pharmacologic C) preventive D) diagnostic Answer: A Explanation: A) Correct. The therapeutic use is to treat the symptom of the disease. B) The pharmacologic use of drugs is too broad a concept and would include every drug and every use. C) Analgesic drugs are not used to prevent pain. D) Analgesic drugs are not used to diagnose pain. 15) One drug used to treat Alzheimer's disease was originally derived from ________. A) yams B) periwinkle C) daffodils D) autumn crocus Answer: C Explanation: A) Some estrogen hormone replacement therapy drugs are derived from yams. B) The drug vincristine to treat cancer is derived from periwinkle. C) Correct. Galantamine (Razadyne) from daffodils is used to treat Alzheimer disease. D) Colchicine to treat gout is derived from the autumn crocus.

16) Original plant sources of some commonly used drugs include all of the following EXCEPT ________. A) oak tree B) rose hips C) hot pepper plant D) opium poppy Answer: A Explanation: A) Correct. No drugs have been developed from the oak tree. B) Rose hips are an original plant source for vitamin C. C) The hot pepper plant is an original plant source of capsaicin for topical pain relief. D) The opium poppy is an original plant source for morphine. 17) From the moment of its discovery or creation, every drug has a ________ name that is assigned by the International Union of Pure and Applied Chemistry (IUPAC). A) brand B) chemical C) generic D) trade Answer: B Explanation: A) The brand name, or trade name, is created by the drug company, not IUPAC. B) Correct. C) The drug company, working together with the United States Adopted Names (USAN) Council, not the IUPAC, determines a drug's generic name. D) The trade name, or brand name, is created by the drug company, not IUPAC. 18) Which of the following drug names would have a trademark ™ after it? A) chemical name B) generic name C) molecular structure D) trade name Answer: D Explanation: A) A drug's chemical name is assigned by the IUPAC, not trademarked. B) The generic name is not trademarked. C) A drug's molecular structure, is a structure, not a name. D) Correct. The trade name from the drug company would be trademarked.

19) Which of the following is NOT the same as the proprietary name of a drug? A) generic name B) brand name C) trade name D) None of the above Answer: A Explanation: A) Correct. B) The brand name is another name for the proprietary name. C) The trade name is another name for the proprietary name. D) One of the answers is correct. 20) Drugs can be created or designed in all of the following ways, EXCEPT ________. A) from substances in nature B) using dietary supplements C) by computer D) by recombinant DNA technology Answer: B Explanation: A) Drugs are created from substances in nature. B) Correct. Dietary supplements are already a type of drug. C) Drugs are created by computer molecular manipulation. D) Drugs are created by recombinant DNA technology. 21) The drug digoxin (Lanoxin) that is used today to treat congestive heart failure was derived from the ________. A) foxglove plant B) belladonna plant C) opium poppy flower D) French lilac flower Answer: A Explanation: A) Correct. B) This drug was not derived from the belladonna plant. C) This drug was not derived from the opium poppy flower. D) This drug was not derived from the French lilac flower.

22) Recombinant DNA technology involves ________. A) using enzymes to cut apart segments of DNA gene splicing B) cloning a large supply of DNA segments C) transferring the segments from the host to the recipient D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 23) The United States Adopted Names (USAN) Council ________. A) gives the final approval for marketing of a drug B) works with the drug company to determine the generic name for a drug C) selects the generic and trade names for all drugs D) names all new chemical and molecular substances Answer: B Explanation: A) The FDA, not the USAN, gives final approval for marketing of a drug. B) Correct. C) The USAN does not select the trade names for drugs. D) The International Union of Pure and Applied Chemistry (IUPAC), not the USAN, assigns the chemical name. 24) The government agency responsible for regulating the manufacturing and dispensing of controlled substances is called the ________. A) Drug Enforcement Administration (DEA) B) Food and Drug Administration (FDA) C) United States Pharmacopeia D) Schedule Drug Agency Answer: A Explanation: A) Correct. B) The Food and Drug Administration (FDA) reviews drugs during clinical trials and evaluates their safety. C) The United States Pharmacopeia is a book that lists all the drugs that are approved. D) There is no such governmental agency.

25) Which of the following statements is FALSE? A) A chemical name only has one generic drug name associated with it. B) The trade name is specifically designed to be easy for patients to remember. C) Drug companies follow standard spelling rules for their trade name drugs. D) There is often a common suffix for generic drugs that belong to the same drug category. Answer: C Explanation: A) This statement is true. B) This statement is true. C) Correct. Trade name drugs can be difficult to spell because drug companies are not required to follow any standard spellings. D) This statement is true. 26) A Schedule divides drugs by their ________. A) cost to the patient B) potential for physical dependence C) potential for psychological dependence D) B and C Answer: D Explanation: A) A Schedule is not related to the cost of a drug. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 27) An example of a Schedule I drug is ________. A) aspirin B) Ambien C) LSD D) morphine Answer: C Explanation: A) Aspirin is not a Schedule drug. It is an over-the-counter drug with no potential for addiction. B) Ambien is a Schedule IV drug, not a Schedule I drug. C) Correct. LSD is a Schedule I drug. D) Morphine is a Schedule II drug.

28) The Controlled Substances Act created ________ categories of drugs based on their potential for addiction. A) seven B) three C) five D) ten Answer: C Explanation: A) There are not seven categories of controlled substances. B) There are not three categories of controlled substances. C) Correct. There are five categories of controlled substances. D) There are not ten categories of controlled substances. 29) Which name accurately describes the molecular structure of a drug and distinguishes it from all other drugs? A) brand name B) chemical name C) generic name D) trade name Answer: B Explanation: A) The brand name does not to describe molecular structure. B) Correct. C) The generic name does not describe molecular structure. D) The trade name does not describe molecular structure. 30) The first recombinant DNA technology drug to be approved by the FDA was ________. A) an over-the-counter drug B) a vaccine to prevent influenza C) a drug from pregnant mares' urine D) human insulin Answer: D Explanation: A) Recombinant DNA technology is not used to produce over-the-counter drugs. B) The influenza vaccine was not the first recombinant DNA drug. C) The drug from pregnant mares' urine, a natural source (not recombinant DNA technology), is Premarin. D) Correct. Human insulin (Humulin) was the first FDA-approved recombinant DNA drug.

31) The belladonna plant was the original source of the drugs ________ that are still used today. A) atropine and digoxin B) aspirin and morphine C) atropine and scopolamine D) colchicine and morphine Answer: C Explanation: A) Atropine is from the belladonna plant, but digoxin is from the foxglove plant. B) Aspirin is from the willow tree, and morphine is from the opium poppy. C) Correct. Atropine and scopolamine are from the belladonna plant. D) Colchicine is from the autumn crocus, and morphine is from the opium poppy plant. 32) Rose hips from the rose plant are still used today as a natural source of ________. A) morphine B) vitamin C C) insulin D) All of the above Answer: B Explanation: A) Morphine is from the opium poppy plant. B) Correct. Vitamin C dietary supplement is from rose hips. C) Insulin is not derived from rose hips. D) Rose hips are the natural source for only one of these drugs. 33) All of the following are minerals that are used in drugs or as dietary supplements EXCEPT ________. A) iron B) calcium C) gold D) cinchona bark Answer: D Explanation: A) Iron is a mineral that is used as a dietary supplement. B) Calcium is a mineral that is used as a dietary supplement. C) Gold is used in a drug for rheumatoid arthritis, not a dietary supplement. D) Correct. This is a plant, not a mineral.

34) Jamie Alvarez is going to fly in an airplane for the first time. She is afraid she might experience motion sickness, so she has decided to first take the over-the-counter drug Dramamine. This is an example of the ________ use of a drug. A) preventive B) therapeutic C) diagnostic D) All of the above Answer: A Explanation: A) Correct. Taking a drug to prevent motion sickness is preventative. B) A therapeutic drug is taken once the motion sickness has already occurred. C) A diagnostic drug helps diagnose an illness, not prevent it. D) Dramamine only falls under one of these uses of drugs, not all of them. 35) In the year 2000, the Human Genome Project ________. A) identified the double-helix structure of DNA B) mapped all 3.2 billion parts of the human genome C) became another name for gene replacement therapy D) determined what the names of new DNA drugs should be Answer: B Explanation: A) The double-helix structure was discovered by Watson and Crick in 1962. B) Correct. C) The Human Genome Project is not another name for gene replacement therapy. D) The Human Genome Project is not related to the naming of drugs. 36) The majority of drugs are used to control, improve, or cure symptoms, signs of disease. This is known as a ________ use. A) preventive B) diagnostic C) prescription D) therapeutic Answer: D Explanation: A) Drugs for preventive use are taken before symptoms and diseases occur. B) Drugs for diagnostic use do not control, improve, or cure symptoms or diseases. C) Prescription drugs are not the only kinds of drugs used to cure symptoms or diseases. D) Correct.

37) A prescription drug can be obtained with a ________. A) written prescription from a physician or physician's assistant B) verbal order from a dentist C) written prescription or verbal order from a healthcare professional whose license permits this D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 38) Which of these ancient peoples practiced pharmacology? A) Egyptians B) Chinese C) Native Americans of North America and Aztec Indians of Mexico D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 39) If you had lived during the 1700s and 1800s, it would not have been unusual for you to ________. A) have taken a drug that contained opium, heroin, or cocaine B) be addicted without knowing it after taking a drug for a common disease C) take a drug whose addictive ingredients were not listed on the label D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

40) The chemical name of a drug ________. A) is too lengthy and complicated for everyday use by healthcare professionals B) is only used by researchers and consumers C) is the same as the generic name of the drug D) All of the above Answer: A Explanation: A) This is true. B) The chemical name is only used by drug companies and researchers, never by consumers. C) The chemical name is not the same as the generic name of a drug. D) Only one of the answers is correct. 41) Which of the following are examples of drugs discovered in the environment? A) capsaicin from the hot pepper plant B) an anticancer drug from yew tree needles C) cephalosporin antibiotic drugs from a fungus in a sewer outlet D) All were discovered in the environment. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 42) A dextrorotary drug ________. A) is an isomer B) has a molecular structure rotated to the right C) includes the drug dextromethorphan for coughing D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

43) The FDA will allow a prescription drug to be reclassified as an over-the-counter (OTC) drug if ________. A) the prescription drug is too dangerous to use at its higher doses B) a patient can easily diagnose and monitor his/her own condition C) there is enough public pressure after a drug tragedy D) All of the above Answer: B Explanation: A) If a prescription drug is too dangerous, the FDA will remove it from the market, not reclassify it as an over-the-counter drug. B) Correct. The patient must be able to easily diagnose and self-monitor self when taking an OTC drug. C) This is not one of the reasons for reclassifying a prescription drug as an OTC drug. D) One of these is a reason for reclassifying, but not all of them. 44) All of the following are advantages to reclassifying a prescription drug to be an over-the-counter drug (OTC), EXCEPT ________. A) the cost of the OTC drug will be lower B) the patient will have better access to quick treatment C) there will be a greater chance for drug-drug interactions D) the patient will need fewer doctor visits for prescription refills Answer: C Explanation: A) This is an advantage for OTC drugs. B) This is an advantage for OTC drugs. C) Correct. This is a disadvantage, not an advantage, of OTC drugs. D) This is an advantage for OTC drugs. 45) The Controlled Substances Act of 1970 did all of the following, EXCEPT ________. A) regulate controlled substances B) introduce the word narcotic C) divide potentially addictive drugs into categories D) regulate Schedule drugs Answer: B Explanation: A) The Controlled Substances Act did do this. B) Correct. The word narcotic was introduced by The Harrison Narcotics Act of 1914. C) The Controlled Substances Act did do this. D) The Controlled Substances Act did do this.

46) When designing a drug, a computer can do all of the following EXCEPT ________. A) display the molecular structure of any drug in its database B) identify chemicals that would probably not be successful in treating a particular disease C) rotate any molecule in three dimensions D) transfer DNA segments to a host Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. This is only done with recombinant DNA technology. 47) Pharmacology includes all of the following interrelated topics, EXCEPT ________. A) philosophy and religion B) chemistry and genetics C) patient education D) legislation and technology Answer: A Explanation: A) Correct. Pharmacology does not include these topics. B) Pharmacology includes these topics. C) Pharmacology includes this topic. D) Pharmacology includes these topics. 48) The process of combining of substances from plants, animals, and minerals to form a single drug is known as ________. A) molecular pharmacology B) personalized medicine C) compounding D) human genome Answer: C Explanation: A) This does not describe molecular pharmacology B) This does not describe personalized medicine. C) Correct. This does describe the process of compounding. D) This does not describe the human genome.

49) Which of the following is true about drugs in the Middle Ages? A) Some of the drug ingredients were based on medical lore and superstition. B) Some of the drug ingredients were therapeutic. C) Some of the drug ingredients were worthless or even harmful. D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 50) The mineral gold is used in a drug to treat ________. A) diabetes mellitus B) rheumatoid arthritis C) mineral deficiency D) baldness Answer: B Explanation: A) Gold is not used to treat diabetes mellitus. B) Correct. The gold compound drug auranofin (Ridaura) is used to treat rheumatoid arthritis. C) Gold is not used to treat a mineral deficiency. D) Gold is not used to treat baldness. 51) Which substances have been created as drugs through recombinant DNA technology? A) clotting factors B) erythropoietin C) human growth factor D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

52) Slight molecular changes to a drug can significantly affect all of the following EXCEPT its ________. A) absorption and metabolism B) half-life C) therapeutic effect and side effects D) cost Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. Molecular changes do not correlate to a drug's cost. 53) The drug exenatide (Byetta), used to treat diabetes mellitus, is derived from ________. A) coal mining B) the saliva of the Gila monster C) the venom of the cone snail D) recombinant DNA technology Answer: B Explanation: A) Topical coal tar drugs for psoriasis are derived from coal mining. B) Correct. C) Prialt, not Byetta, is derived from venom of the cone snail. D) Byetta was not created with recombinant DNA technology. 54) A designer drug ________. A) has a chemical structure similar to a Schedule I or II drug B) is known as an analog C) is created to avoid prosecution under existing drug laws. D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

55) The Federal Analogue Act of 1986 made it easier to prosecute those who produced and sold ________. A) prescription drugs B) designer drugs C) over-the-counter drugs D) Schedule drugs Answer: B Explanation: A) This Act does not deal with prescription drugs. B) Correct. The Federal Analogue Act targets designer drugs. C) This Act does not deal with over-the-counter drugs. D) This Act does not deal with Schedule drugs. 56) A comprehensive list of all drugs and their ingredients and uses was known as ________. A) a recipe B) pharmacology C) a pharmacopoeia D) an apothecary Answer: C Explanation: A) A recipe is a list of ingredients, but for just one drug. B) Pharmacology is a study area, not a list. C) Correct. D) An apothecary is an older word for a drug store. 57) The federal government classifies marijuana as an illegal Schedule ________ drug. A) I B) II C) III D) IV Answer: A Explanation: A) Correct. Marijuana is a Schedule I drug. B) Schedule II drugs are not illegal. C) Schedule III drugs are not illegal. D) Schedule IV drugs are not illegal.

58) Pharmacies today do compounding for all of the following reasons EXCEPT ________. A) to flavor a medication B) to create a new generic drug C) to remove ingredients that cause an allergy to a patient D) to change the form of a drug for a patient who cannot swallow tablets. Answer: B Explanation: A) This is a reason to do compounding. B) Correct. A pharmacist cannot create a new generic drug. C) This is a reason to do compounding. D) This is a reason to do compounding. 59) Once the FDA gives final approval for a generic drug, the drug company creates a ________. A) chemical name B) generic name C) molecular name D) trade name Answer: D Explanation: A) The chemical name is assigned by the IUPAC, not the drug company. B) The generic name is developed by both the drug company and the U.S. Adopted Names Council before the FDA gives final approval for marketing. C) A drug does not have a molecular name, but uses a chemical name instead to describe the drug's molecular structure. D) Correct. 60) The trade name of the drug Lithobid was selected to indicate ________. A) the name of the drug company B) how often the drug is to be given C) the amount of the active ingredient D) the disease the drug is used to treat Answer: B Explanation: A) The name Lithobid does not indicate the name of the drug company. B) Correct. Lithobid indicates how often the drug is to be taken (b.i.d., twice a day). C) The name Lithobid does not indicate the amount of the active ingredient. D) The name Lithobid does not indicate the disease the drug is used to treat.

61) All of the following are reasons why the trade names of some drugs are spelled in a certain way. Identify the reason that is NOT true. A) The spelling of the trade name indicates the duration of time before the drug expires. B) The spelling of the trade name indicates the drug's source. C) The spelling of the trade name indicates the disease or symptoms being treated. D) The spelling of the trade name indicates how often the drug should be taken. Answer: A Explanation: A) Correct. The spelling does NOT indicate the duration of time before expiration. B) The spelling of some trade names DO indicate the drug's source. C) The spelling of some trade names DO indicate the disease process the drug is used to treat. D) The spelling of some trade names DO indicate how often the drug should be taken. 62) The first monoclonal antibody drug was developed in ________. A) 1896 B) 1936 C) 1986 D) 2021 Answer: C Explanation: A) The first monoclonal antibody drug was developed later than this. B) The first monoclonal antibody drug was developed later than this. C) Correct. D) The first monoclonal antibody drug was developed before this. 63) All of the following are reasons why the trade names of some drugs are spelled in a certain way. Identify the reason that is NOT true. A) The spelling of the trade name indicates the length of the drug's patent. B) The spelling of the trade name indicates the drug's source. C) The spelling of the trade name indicates the disease process being treated. D) The spelling of the trade name indicates how often the drug should be taken. Answer: A Explanation: A) Correct. The drug patent is NOT reflected in the drug name spelling. B) The spelling of some trade names DO indicate the drug's source. C) The spelling of some trade names DO indicate the disease process the drug is used to treat. D) The spelling of some trade names DO indicate how often the drug should be taken.

64) The trade name of the drug Lithobid was selected to indicate ________. A) the name of the drug company B) how often the drug is to be given C) the amount of the active ingredient D) the disease the drug is used to treat Answer: B Explanation: A) The name Lithobid does not indicate the name of the drug company B) Correct. C) The name Lithobid does not indicate the amount of the active ingredient D) The name Lithobid does not indicate the disease the drug is used to treat. 65) The trade names of these drugs all indicate a double-strength dose, a controlled-delivery dose, or a long-acting dose of a drug, EXCEPT ________. A) Bactrim DS B) Cortizone-5 C) Cardizem, CD D) Ritalin LA Answer: B Explanation: A) This trade name indicates a double-strength drug. B) Correct. This shows the drug's strength, but it is not double strength. C) This trade name indicates a controlled-release drug. D) This trade name indicates a long-acting drug. 66) All of these trade names indicate what part of the body or what disease or symptoms the drug is used to treat, EXCEPT ________. A) Sudafed B) Pepcid C) Boniva D) Lipitor Answer: A Explanation: A) Correct. Sudafed just keeps some recognizable parts generic drug name. B) Pepcid indicates that the drug is used to treat peptic ulcers. C) Boniva indicates that the drug strengthens the bone. D) Lipitor indicates that the drug is used to decrease blood lipids.

67) Over-the-counter drugs ________. A) do not require a prescription and can be purchased by any adult B) do not require a prescription and can be purchased by anyone C) require a prescription and can be purchased by any adult D) require a prescription and can be purchased by anyone Answer: A Explanation: A) Correct. B) While nonprescription drugs do not require a prescription, they can only be purchased by an adult. C) Nonprescription drugs do not require a prescription. D) Nonprescription drugs do not require a prescription. 68) All of the following are types of pharmacies, EXCEPT ________. A) ambulatory B) compounding C) satellite D) formulary Answer: D Explanation: A) This is a type of pharmacy. B) This is a type of pharmacy. C) This is a type of pharmacy. D) Correct. This is a list of approved drugs, not a type of pharmacy. 69) Medication therapy management ________. A) helps a patient understand the drugs they are being treated with B) is a service provided by the pharmacist C) prevents medication errors and improve patient compliance D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 1.2

True/False Questions

1) The discipline of pharmacology impacts a student's chosen career as well as his/her personal life as a consumer. Answer: TRUE 2) In common usage, the word drug can be used interchangeably with the word medicine. Answer: TRUE

3) The Egyptians applied moldy bread to abrasions, a practice that we now know actually had some therapeutic basis. Answer: TRUE 4) The opium poppy was used to create morphine to treat severe pain. Answer: TRUE 5) An isomer is a drug molecule with the same number and types of atoms as another drug, but has those atoms arranged in a different way. Answer: TRUE 6) Multivitamin supplements contain minerals such as calcium, iron, gold, copper, and zinc. Answer: FALSE Explanation: Gold is only found in the drug auranofin (Ridaura), which is used to treat rheumatoid arthritis. 7) The isolation of potassium from water in 1800s marked the beginning of modern drug therapy using chemically pure ingredients. Answer: FALSE Explanation: It was the isolation of morphine from opium, not potassium from water. 8) In the 1800s, pharmacists had to prepare drug, such as syrup bases and hand-rolled suppositories. Answer: TRUE 9) Drugs in the 1700s and 1800s often listed an addictive ingredient on its label, and consumers knew to avoid this. Answer: FALSE Explanation: Addictive ingredients were not mentioned on drug labels and many became addicted. 10) The Dietary Supplements and Health and Education Act of 1994 made the FDA responsible for regulating herbal products and dietary supplements and liable for claims against those products. Answer: FALSE Explanation: The Act allowed the FDA to set up guidelines, but not regulate herbal products and dietary supplements. The Act made drug companies liable for claims against their herbal products and dietary supplements. 11) The FDA regulates prescription drugs, but not over-the-counter (OTC) drugs. Answer: FALSE Explanation: The FDA regulates both prescription and OTC drugs. 12) Prescription drugs can only be obtained with a written order or a verbal order from a healthcare provider whose license permits this. Answer: TRUE 24 Copyright © 2022 Pearson Education, Inc.

13) An OTC drug is defined as a drug that can be purchased without a prescription but requires the consumer to have a laboratory test first. Answer: FALSE Explanation: An OTC drug is defined as one that can be purchased without a prescription and is generally considered safe for consumers to use if the label's directions and warnings are followed carefully and all warnings are heeded. 14) The FDA regulates prescription drugs, but the DEA regulates over-the-counter drugs. Answer: FALSE Explanation: The FDA regulates both prescription and OTC drugs. 15) The FDA only allows physicians to prescribe FDA-approved drugs to patients. Answer: FALSE Explanation: The FDA allows licensed healthcare providers, such as a physician, physician's assistants, nurse practitioner, or dentist, to prescribe investigational drugs. 16) In order to prevent childhood diseases, the American Academy of Pediatrics issues an annual immunization schedule listing the immunizations to be given to children before they enroll in school. Answer: TRUE 17) A drug or a medicine can be thought of as any nonfood chemical substance that affects the mind or the body. Answer: TRUE 18) The word drug can mean a medicine, but it can also refer to illegal or street drugs. Answer: TRUE 19) The 1994 Dietary Supplement Health and Education Act gives the FDA the authority to regulate dietary supplements as drugs. Answer: FALSE Explanation: The FDA does not have this authority. 20) A drug's label and package must show the drug's assigned Schedule. Answer: TRUE 21) As they did in the early 1900s, pharmacists today daily prepare the drugs they dispense, and they also provide patient information and education. Answer: FALSE Explanation: The pharmacist usually does not prepare drugs any more. 22) The marijuana plant is sold as the prescription drug Marinol. Answer: FALSE Explanation: Marinol is a synthetic drug whose action is similar to marijuana.

23) The FDA has standards for the spelling of trade name drug, and drug companies must follow those standards. Answer: FALSE Explanation: There are no standards for the spelling of trade name drugs. 24) Traditional Chinese herbal remedies have not been found to be effective or therapeutic according to Western standards of medicine. Answer: FALSE Explanation: It has been found that 45 percent of traditional Chinese herbal remedies are therapeutic according to Western medicine standards. 25) We know from reading the newspaper that cocaine is available illegally as a street drug, but topical cocaine is also a Schedule II drug with legitimate medical uses. Answer: TRUE 26) The manufacturing, storage, dispensing, and disposal of controlled substances are strictly regulated by both federal and state laws. Answer: TRUE 27) Pharmacology is one of the oldest branches of medicine. Answer: TRUE 28) A Schedule drug is also known as a controlled substance. Answer: TRUE 29) Many drugs still in use today were originally taken from plant, animal, or mineral sources many years ago. Answer: TRUE 30) The Orphan Drug Act facilitates the development of new drugs to treat patients who are poor and needy and cannot afford medical care. Answer: FALSE Explanation: This Act facilitates the development of new drugs to treat rare diseases that affect fewer than 200,000 people. 31) By law, the over-the-counter version of a prescription drug can only contain one half the strength of the prescription drug. Answer: FALSE Explanation: The OTC drug is usually at a lower dose or strength but not specifically one half. 32) The United States Pharmacopoeia was first published in 1820. Answer: TRUE 33) Gene replacement therapy creates a person's missing or nonfunctioning gene. Answer: TRUE

34) Pharmacies in each state and the pharmacists working in them must be licensed by that state. Answer: TRUE 35) A contraceptive drug is used to diagnose pregnancy. Answer: FALSE Explanation: A contraceptive drug is used to prevent pregnancy. 36) Mold is the original plant source for penicillin, the first antibiotic drug. Answer: TRUE 37) The first law that regulated drugs with the potential for abuse and dependence was The Harrison Narcotics Act of 1914. Answer: TRUE 38) The suffix -olol is common to generic beta-blocker drugs. Answer: TRUE 39) A satellite pharmacy is one that is located on the International Space Station. Answer: FALSE Explanation: Large hospitals have a central pharmacy but also smaller satellite pharmacies in different locations throughout the hospital. 40) A hospital pharmacy can dispenses drugs to anyone who has a prescription. Answer: FALSE Explanation: A hospital pharmacy only dispenses drugs to patients who are being treated in the hospital. 41) Some pharmacies today still do compounding of drugs. Answer: TRUE 42) Long-term care facilities have their own in-house pharmacy on site. Answer: FALSE Explanation: Skilled nursing facilities and long-term care facilities do not have in-house pharmacies; instead, a pharmacy supply company delivers their drugs, which are kept at each nurses' station or patient care unit. 43) The National Association of Boards of Pharmacy (NABP) accredits online pharmacies who fill prescriptions over the Internet. Answer: TRUE 44) Robots and automated dispensing systems are used in hospitals to fill prescriptions. Answer: TRUE 45) A pharmacy technician is another name for a pharmacist with technical training. Answer: FALSE Explanation: A pharmacy technician is an assistant who performs pharmacy-related tasks under the direction of a pharmacist. 27 Copyright © 2022 Pearson Education, Inc.

46) The suffix -mab is common to every generic monoclonal antibody drug. Answer: TRUE 47) A chemical name usually has two or more generic drug names associated with it. Answer: FALSE Explanation: A chemical name only has one generic name related to it. 48) It is illegal to give a controlled substance to any person without that person's knowledge. Answer: TRUE 49) Medical marijuana is helpful in treating patients with HIV/AIDS and nausea and vomiting from chemotherapy drugs. Answer: TRUE 50) The National Association of Boards of Pharmacy accredits online pharmacies. Answer: TRUE 51) If a prescription is filled by a pharmacy technician, it is then be checked for accuracy by a pharmacist. Answer: TRUE 52) An outpatient pharmacy is also known as drug store. Answer: FALSE Explanation: An outpatient pharmacy is also known as an ambulatory pharmacy. 53) Each pharmacy is required to be licensed by the state where it is located. Answer: TRUE 1.3

Short Answer Questions

1) The word ________ is derived from a Dutch word that means "dry," and it refers to the use of dried herbs and plants as the first medicines. Answer: drug 2) The administration of a preventive drug is known as ________, from a Greek word meaning "to keep guard before." Answer: prophylaxis 3) The symbol ________, which comes from the Latin word recipere, meaning "to take or receive," indicates a prescription for a drug (originally one whose recipe contained one or more ingredients). Answer: Rx 4) Controlled substances are divided into five categories or ________ based on their potential for physical and psychological dependence. Answer: Schedules 28 Copyright © 2022 Pearson Education, Inc.

5) The word ________ refers to a drug that is administered for its value as a preventive, diagnostic, or therapeutic agent. Answer: medicine 6) The abbreviation FDA stands for the ________. Answer: Food and Drug Administration 7) A drug's generic name always begins with a/an ________ letter. Answer: lowercase 8) The topical drug ________ was the first prescription drug approved for use as an over-the-counter drug. Answer: hydrocortisone 9) Define these abbreviations. DEA ________ DS ________ FDA ________ LA ________ OTC ________ rDNA ________ Answer: Drug Enforcement Administration; double strength; Food and Drug Administration; long acting; over-the-counter; recombinant DNA. 10) Today's modern pharmacy began originally as a storehouse for dried plants and herbs that was known then as a/an ________. Answer: apothecary 11) We can remember what the drug auranofin (Ridaura) contains, because the "au" in both drug names stands for the chemical symbol Au and for the mineral ________. Answer: gold 12) ________ is the knowledge of how genetic makeup of different people affects their responses to drugs. Answer: Pharmacogenetics 13) A hospital pharmacy is also known as a/an ________ pharmacy. Answer: inpatient 14) The first drug to be made by recombinant DNA technology was human insulin, and its trade name was ________. Answer: Humulin 15) Deciphering the human ________ in 2000 opened up the field of possibility of using genes as drug therapy. Answer: genome 29 Copyright © 2022 Pearson Education, Inc.

16) Many states have passed laws to legalize or decriminalize the use of ________ for medical purposes, even though the federal government bans it as a Schedule I drug. Answer: marijuana 17) The antidiabetic drug exenatide (Byetta) comes from the ________ of the Gila monster poisonous lizard. Answer: saliva 18) An outpatient pharmacy in a clinic is also known as a/an ________ pharmacy. Answer: ambulatory 19) ________ is the computerized creation and transmission of a prescription from a healthcare provider to the pharmacy. Answer: E-prescribing 20) Pharmacy ________ is the use of a computerized database to store drug information and automate its retrieval. Answer: informatics 21) A/An ________ is a healthcare professional who manages a pharmacy and dispenses medications. Answer: pharmacist 22) Darlene Ellis has been prescribed the drug Nasalcrom. From the trade name of the drug, you can tell that the drug is used to treat this part of her body: ________. Answer: nose 23) A/An ________ drug is a prescription drug that has the potential for abuse or addiction. Answer: Schedule 24) Darlene Ellis has been prescribed the drug Nasalcrom. From the trade name of the drug, you can tell that the drug is used to treat this part of her body: ________. Answer: nose 25) Define these abbreviations. Fe ________ K ________ LA ________ SR ________ Answer: iron, potassium, long-acting, slow-release 26) The abbreviation Rx stands for the Latin word recipere, meaning "to ________." Answer: take 27) A hospital pharmacy is also known as a/an ________ pharmacy. Answer: inpatient 30 Copyright © 2022 Pearson Education, Inc.

28) A large hospital may have a large central pharmacy as well as several smaller ________ pharmacies. Answer: satellite 29) The use of a computerized database to store drug information and automate its retrieval when needed is known as pharmacy ________. Answer: informatics 1.4

Matching Questions

Match the examples with their correct medical use. A) prevent diseases B) diagnose disease C) treat symptoms, signs, conditions, and diseases 1) vaccinations given to immunize children 2) radiopaque dye used during x-ray procedures 3) antibiotics to kill bacteria and cure an infection 4) insulin to treat diabetes mellitus 5) contraceptive pills taken to avoid pregnancy Answers: 1) A 2) B 3) C 4) C 5) A

Match the drug name with its discovery process. A) a totally new chemical is derived from molecular manipulation of a drug that is already in use B) a totally new chemical created through genetic DNA manipulation C) a totally new chemical substance discovered in the environment, from plants, animals, or the soil 6) diazepam 7) ampicillin 8) fexofenadine (Allegra) 9) human insulin (Humulin) 10) streptomycin 11) zinconotide (Prialt) Answers: 6) A 7) A 8) A 9) B 10) C 11) C 1.5

Essay Questions

1) The FDA approves a prescription drug being reclassified as an over-the-counter drug if certain criteria are met. Describe all four of the criteria that need to be met. Answer: The FDA approves a prescription drug being reclassified as an OTC drug if the following criteria are met: (1) the indication for the drug's OTC use is similar to its use as a prescription drug, (2) the patient can easily diagnose and monitor his or her own condition when using the OTC drug, (3) the OTC drug has a low rate of side effects/toxicity and a low potential for abuse, and (4) use of the OTC drug does not require the patient to have any special monitoring or ongoing tests. 2) Provide a brief comparison between the definitions of these words: drug, medicine, and prescription drug. Answer: The word drug means dry and refers to the use of dried herbs and plants as the first medicines. The Latin word for drug is medicina, from which we derive the words medicine and medication. A drug is any nonfood chemical substance that affects the mind or the body. The word medicine refers to a drug that is deliberately administered for its medicinal value as a preventive, diagnostic, or therapeutic agent. In common usage, the word drug can be used interchangeably with the word medicine, but drug can also refer to chemical substances that do not have a preventive, diagnostic, or therapeutic use (example: an illegal or street drug).

3) Describe the historical development of the apothecary, the first hospital-based pharmacy, and the first drug store operated by a registered pharmacist. Answer: The first apothecary shop was established in the United States in 1729, the first hospital-based pharmacy in 1751, and the first drug store operated by a registered pharmacist in 1823. 4) What are the three arguments made by those who oppose reclassification of prescription drugs to become over-the-counter drugs? Answer: Opponents to reclassification use these arguments: (1) consumers may actually pay more because health insurance plans will not reimburse for OTC drugs, (2) the excessive use of OTC drugs may increase the number of adverse drug-drug interactions, and (3) consumers may try to treat a serious illness with an OTC drug instead of visiting their healthcare providers for appropriate treatment with a prescription drug.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 2 Drug Testing, Drug Forms, and Drug Measurements 2.1

Multiple Choice Questions

1) A solid drug form that contains the active drug (as a dried powder) plus inert ingredients to provide bulk and a standardized size is known as a/an ________. A) capsule B) ointment C) tablet D) emulsion Answer: C Explanation: A) A capsule comes in two forms, either a gelatin shell or a two-piece, hard shell, not a solid drug form. B) An ointment is a semisolid emulsion of oil and water, not a solid drug form C) Correct. D) An emulsion is a type of solution, not a solid drug form. 2) What type of tablet has an indented line running across it so that it can be easily broken into equal pieces? A) caplet B) enteric C) scored D) troche Answer: C Explanation: A) Caplets are coated tablets in the form of an elongated capsule. They do not have an indented line running across them. B) An enteric tablet is covered with a special coating that resists stomach acid. An enteric tablet does not have an indented line running across it. C) Correct. D) A troche is an elongated tablet that disintegrates to release the drug topically in the mouth. It does not have an indented line running across it. 3) A drug's trade name will often include abbreviations such as CR, LA, SR, or XL. These abbreviations indicate which type of tablet? A) caplets B) enteric C) slow-release D) troche Answer: C Explanation: A) These abbreviations do not indicate that the drug is a caplet. B) These abbreviations do not indicate that the drug is enteric. C) Correct. D) These abbreviations do not indicate that the drug is a troche. 1 Copyright © 2022 Pearson Education, Inc.

4) Which drug form comes in two different varieties: a soft gelatin shell and a two-piece hard shell? A) capsule B) cream C) ointment D) tablet Answer: A Explanation: A) Correct. B) A cream is a semisolid emulsion of oil and water. It does not have a shell. C) An ointment is a semisolid emulsion of oil and water. It does not have a shell. D) A tablet is a solid drug form that contains the active drug. There are several types of tablets, but none have a shell. 5) The powder form of a drug can be administered in several different ways. Which of the following is NOT one of the routes of administration used for a powdered drug form? A) inhaled into the lungs B) inserted into a body cavity C) sprayed on skin D) sprinkled topically Answer: B Explanation: A) Powdered drugs do come in a canister that is activated and the powder is inhaled into the lungs. B) Correct. This is not a route of administration used for a powdered drug form. C) Powdered drugs can be sprayed onto the skin. D) Powdered drugs can be sprinkled topically onto the skin. 6) Which of the following is NOT a type of solution? A) syrup B) elixir C) foam D) suspension Answer: D Explanation: A) A syrup is a type of solution. B) An elixir is a type of solution. C) A foam is a type of solution. D) Correct. Suspensions are not a type of solution.

7) Which of the following statements is NOT a description of one of the forms of solutions? A) The drug is in fat globules dispersed uniformly throughout a water base. B) The drug is in a thickened water base with added sugar and flavoring. C) The drug is fine, undissolved particles that settle to the bottom upon standing. D) The drug is in a water and alcohol base. Answer: C Explanation: A) This describes an emulsion, which is a solution. B) This describes a syrup, which is a solution. C) Correct. This describes a suspension, which is NOT a solution. D) This describes a tincture, which is a solution. 8) Syrups are ________. A) sour and more viscous than elixirs B) sour and thinner than elixirs C) sweeter and more viscous than elixirs D) sweeter and thinner than elixirs Answer: C Explanation: A) Syrups are not sour. B) Syrups are sweet and they are thicker than elixirs. C) Correct. D) Syrups are sweet, but they are not thinner than elixirs. 9) Foams are ________. A) solutions that contain a drug in a water base B) expanded by tiny aerosol bubbles C) expelled from a container when they are used D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

10) A drug in the form of a suppository is used to treat patients with ________. A) diarrhea B) eye infections C) heart disease D) vomiting Answer: D Explanation: A) Patients with diarrhea are not treated with suppositories. B) Eye infections are treated with special topical ophthalmic drops or oral drugs, not suppositories. C) Suppositories are not used to treat heart disease. D) Correct. 11) Which of the following is NOT a specialized type of tablet? A) caplet B) effervescent C) lozenge D) elixir Answer: D Explanation: A) Caplets are a specialized type of tablet. B) Effervescent tablets are a specialized type of tablet. C) A lozenge is a specialized form of tablet. D) Correct. 12) The word viscous is used to describe a liquid drug. The word viscous means ________. A) clear or transparent B) thick or nonwatery C) powdered D) watery or thin Answer: B Explanation: A) Viscous does not mean "clear or transparent." B) Correct. C) Viscous does not mean powdered. D) Aqueous, not viscous, means "watery or thin."

13) Some over-the-counter drugs used to treat coughs are in the drug form of a/an ________ that coats the mucous membranes. A) elixir B) ampule C) syrup D) tincture Answer: C Explanation: A) Elixirs are not specifically used to treat coughs. B) An ampule is a drug container, not a drug form. C) Correct. D) Tinctures are never taken internally. 14) When a tablet is scored across its top surface, that indicates ________. A) that it contains a Schedule drug B) the mark of a particular drug company C) that it contains a double-strength dose D) that it can be broken into two or more doses Answer: D Explanation: A) Schedule drugs are not all scored across their tops. B) A scored tablet is not the mark of a particular drug company. C) A double-strength tablet is not scored across its top. D) Correct. 15) Enteric-coated tablets ________. A) provide a slow release of the drug B) are made to dissolve in the stomach C) are made to dissolve in the small intestine D) are coated so they are easy to swallow Answer: C Explanation: A) Slow-release tablets, not enteric-coated tablets, provide a slow release of the drug. B) Enteric-coated tablets are specifically made not to dissolve in the stomach. C) Correct. D) Enteric-coated tablets are coated, but the reason is not so that they are easy to swallow.

16) A solution containing fine, undissolved particles of a drug that settle to the bottom of the container is called a/an ________. A) suspension B) elixir C) spray D) liquid Answer: A Explanation: A) Correct. B) An elixir is a solution that has no particles in it. . C) A spray is a solution that has no particles in it. D) A liquid is a solution that has no particles in it. 17) Monica Thompson's antacid drug bottle has this printed on the label: "Shake Well Before Using." That is because this drug is a/an ________. A) suspension B) emulsion C) syrup D) troche Answer: A Explanation: A) Correct. A drug in the form of a suspension must be shaken before using. B) An emulsion does not need to be shaken before use. C) A syrup does not need to be shaken before use. D) A troche does not need to be shaken before use. 18) An emulsifying agent is added to the drug form of a cream ________. A) in order to keep the oil and water mixed together B) in order to create an new drug form of an ointment C) so that the cream can be used topically in the eye D) so that it will exert a systemic effect Answer: A Explanation: A) Correct. B) Ointments are not created from creams. C) Only specially formulated ointments, not creams, can be used in the eye. D) Creams exert only a local, not a systemic, effect.

19) The powdered form of a drug can be found in these drug forms, EXCEPT in a/an ________. A) canister B) ampule C) capsule D) vial Answer: B Explanation: A) Powdered drugs do come in canisters. B) Correct. An ampule always contains a liquid, not a powered, drug. C) Powdered drugs do come in capsules. D) Vials contain either solutions or powdered drugs. 20) The word aqueous means ________, while the word viscous means ________. A) topical; skin B) liquid; solid C) intravenous; oral D) watery; thick Answer: D Explanation: A) These two words are not related to the words aqueous and viscous. B) These two drug forms are not related to the words aqueous and viscous. C) These two routes of administration are not related to the words aqueous and viscous. D) Correct. 21) Your friend asks you if you can identify the name of the drug he is taking. He shows you a purple capsule with 3 gold bands around the end. You tell him that this is the trade name drug ________. A) Fosamax B) Valium C) Cialis D) Nexium Answer: D Explanation: A) Fosamax has a bone-shaped imprint on the tablet. B) Valium has a cut-out "V" in its center. C) Cialis is a mustard-colored teardrop-shaped tablet with a "C" on it. D) Correct.

22) Which of the following drug trade names is NOT in the form of a pellet, wafer, or insert? A) Muse B) Nexium C) Gliadel D) Mirena Answer: B Explanation: A) Muse is in the form of a pellet. B) Correct. Nexium is in the form of a purple capsule with gold bands around one end. C) Gliadel is in the form of a wafer. D) Mirena is in the form of a T-shaped insert. 23) What trade name drug used to treat severe pain comes in the drug form of a lozenge? A) Actiq lollipop B) Cepacol lozenge C) Alka-Seltzer D) Adderall XR Answer: A Explanation: A) Correct. B) Cepacol is a lozenge for a sore throat, not severe pain. C) Alka-Seltzer is an effervescent tablet, not a lozenge. D) Adderall XR is an extended-release capsule, not a lozenge. 24) Diltiazem (Cardizem) for angina comes in a capsule form that is ________. A) swallowed whole B) crushed and the vapors inhaled C) sprinkled on applesauce and swallowed D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is not true for diltiazem (Cardizem). C) This is true, but it is not the only correct answer. D) Correct.

25) A film is a thin, dissolvable drug form about the size of a postage stamp that is given by the ________ route of administration. A) buccal B) topical C) sublingual D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) A film is not applied topically. C) This is true, but it is not the only correct answer. D) Correct. 26) Transdermal patches are used for all of the following, EXCEPT ________. A) treat a vaginal yeast infection B) treat chronic pain C) help a person stop smoking D) prevent vomiting after chemotherapy Answer: A Explanation: A) Correct. Transdermal patches are NOT used to treat vaginal yeast infections. B) Transdermal patches are used to do this. C) Transdermal patches are used to do this. D) Transdermal patches are used to do this. 27) Which of the following drug forms is inhaled? A) an anesthetic gas B) a buccal film C) liquids to treat asthma D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) A buccal film is placed between the teeth and the cheek. C) This is true, but it is not the only correct answer. D) Correct.

28) Solutions include ________. A) elixirs and syrups B) foams C) tinctures D) All of the above. Answer: D Explanation: A) Elixirs and syrups are solutions. B) Foams are solutions. C) Tinctures are solutions. D) Correct. 29) Solutions never need to be ________ because the drug concentration is the same in every part of the solution, even after prolonged standing. A) refrigerated B) inspected C) mixed or shaken D) tested Answer: C Explanation: A) This is not true of a solution. B) This is not true of a solution. C) Correct. D) This is not true of a solution. 30) All of the following are drug forms, EXCEPT ________. A) pellets B) wafers and films C) inserts and gases D) binders and fillers Answer: D Explanation: A) These are drug forms. B) These are drug forms. C) These are drug forms. D) Correct. These are inert ingredients in a tablet, not drug forms.

31) All of the following relate to a drug being placed in the mouth, EXCEPT ________. A) oral B) systemic C) buccal D) sublingual Answer: B Explanation: A) This is true. B) Correct. Systemic refers to where the drug acts (throughout the body), not where it is placed. C) This is true. D) This is true. 32) As a result of a national tragedy, Congress passed The Food, Drug, and Cosmetic Act of 1938. One important part of this Act ________. A) required manufacturers to list their drugs in the United States Pharmacopeia or National Formulary B) made it mandatory that drugs had a pleasing taste and odor C) required accurate labeling of drugs to prevent substitutions or mislabeling of ingredients D) required drug manufacturer to prove the drug was safe Answer: D Explanation: A) This is not true. B) This was part of the reason for the national tragedy, not a result. The makers of the drug sulfonamide tested the taste and odor, but this is not what the Act said. C) This is not true. D) Correct. 33) Currently, the burden of proof for showing that a drug is safe before it can be marketed is the responsibility of the ________. A) drug manufacturer B) consumer C) healthcare provider D) Food and Drug Administration (FDA) Answer: A Explanation: A) Correct. B) The consumer cannot prove that a drug is safe before it is marketed. C) The healthcare provider cannot prove that a drug is safe before it is marketed. D) The FDA approves a drug for marketing only after it has been proven safe.

34) Drug legislation was passed in the early 1900s to protect the public from ________. A) drug companies B) prescription drugs C) worthless or dangerous drugs D) the government Answer: C Explanation: A) This is not true. B) It was not until the Durham-Humphrey Amendment of 1951 that prescription drugs were defined. C) Correct. D) The government was the one who passed this protective legislation. 35) The first federal drug law was the ________. A) Food, Drug, and Cosmetic Act B) Dietary Supplements and Health and Education Act C) Pure Food and Drug Act D) Food and Drug Administration Modernization Act Answer: C Explanation: A) This was not the first federal drug law. B) This was not the first federal drug law. C) Correct. D) This was not the first federal law. 36) The 1951 Durham-Humphrey Amendment to the Food, Drug, and Cosmetic Act defined ________ drugs as those drugs that could only be given to patients under the care of a physician. A) dangerous B) prescription C) Schedule D) All of the above Answer: B Explanation: A) The Durham-Humphrey Amendment did not mention dangerous drugs. B) Correct. C) Schedule drugs were defined by the Controlled Substances Act, not the Durham-Humphrey Amendment. D) The Durham-Humphrey Amendment did not mention dangerous or Schedule drugs.

37) Which of the following involves using a drug on several hundred or several thousand ill patients in exactly the same way as it will be used once it is on the market? A) clinical trials, phase I B) clinical trials, phase II C) clinical trials, phase III D) in vivo testing Answer: C Explanation: A) During phase I, only 10 to 100 healthy volunteers are used to study a drug. B) In phase II, the drug is only given to 50 to 500 patients who actually have the disease that the drug is intended to treat. C) Correct. D) In vivo testing is a general designation for any testing done on animals and humans. 38) Each drug is assigned a 10-digit identification number with three segments separated by hyphens. Which of the following is NOT information that can be obtained from this 10-digit identification number? A) the name of the drug manufacturer B) the drug category C) the drug's specific strength/dose D) the package size and type Answer: B Explanation: A) The first segment of the 10-digit code does identify the drug manufacturer. B) Correct. C) The second segment of the 10-digit code does identify the drug's specific strength/dose. D) The third segment of the 10-digit code does identify the drug's package size and type. 39) In clinical trials, the control group receives the ________. A) trade name drug B) placebo C) chemical name drug D) generic name drug Answer: B Explanation: A) The control group does not receive the trade name drug. B) Correct. C) The control group does not receive the chemical name drug. D) The control group does not receive the generic name drug.

40) The patent on a new drug is in effect for ________ years. A) 5 B) 12 C) 17 D) 23 Answer: C Explanation: A) A drug patent is not in effect for five years. B) A drug patent is not in effect for 12 years. C) Correct. D) A drug patent is not in effect for 23 years. 41) There are ________ phases of human testing in clinical drug trials for new drugs. A) two B) three C) five D) seven Answer: B Explanation: A) This is not true. B) Correct. C) This is not true. D) This is not true. 42) In vivo testing is ________. A) testing that is done in test tubes B) similar to in vitro testing C) done prior to in vitro testing D) None of the above Answer: D Explanation: A) In vivo testing is not done in test tubes. B) In vivo testing is not similar to in vitro testing. C) In vivo testing is not done prior to in vitro testing. D) Correct. In vivo testing is done in live animals or humans. 43) Inert ingredients in a drug ________. A) include binders and fillers B) can affect drug bioavailability C) include preservatives and antioxidants D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 14 Copyright © 2022 Pearson Education, Inc.

44) What does the therapeutic index indicate? A) the therapeutic potential of a new drug B) the margin of safety between the therapeutic and toxic doses C) the drug's effectiveness and likely approval by the FDA D) the bioavailability of the drug Answer: B Explanation: A) The therapeutic potential for the drug is evaluated by the drug company and the FDA; it is not related to the therapeutic index. B) Correct. C) The drug's effectiveness likely approval by the FDA is only partly related to the therapeutic index. D) The therapeutic index relates to the drug's margin of safety, not its bioavailability. 45) What incentive does the FDA give to drug companies that agree to do clinical trials of their drugs on children? A) a cash-back refund B) speeding up the process for getting a trademark for the drug C) a six-month extension on the new drug patent D) allowing the drug companies to market the drug to children Answer: C Explanation: A) The FDA does not give a cash-back refund to drug companies. B) A trademark is issued by the U.S. Patent Office, not the FDA. C) Correct. D) Drugs are not marketed to children. 46) An example of a placebo is ________. A) an injection of sterile normal saline B) a genetically engineered drug C) a sugar pill D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) A placebo is not a genetically engineered drug. C) This is true, but it is not the only correct answer. D) Correct.

47) Which of the following statements is FALSE? A) Double-blind clinical trials always use a placebo. B) The researcher, but not the patient, knows who receives the placebo. C) A placebo exerts no pharmacologic effect. D) A placebo has no therapeutic effect. Answer: B Explanation: A) This is a true statement. B) Correct. Even the researcher does not know which patients receive the placebo. C) This is a true statement. D) This is a true statement. 48) The FDA evaluates a drug before approving it. This evaluation includes a review of all of the following EXCEPT ________. A) the drug company's documentation B) consumer comments about the drug C) risks associated with the drug D) the benefits of the drug Answer: B Explanation: A) The FDA reviews the drug company's documentation. B) Correct. The FDA does not review consumer comments; the drug has not yet been marketed to consumers. C) The FDA reviews the drug's risks. D) The FDA reviews the drug's benefits. 49) Why would a healthcare provider give the patient a free sample of a drug? A) to give away what the drug representatives gave them B) to help patients save money C) to allow the patient to try a limited supply to see if it worked D) to fulfill FDA requirements Answer: C Explanation: A) This is not the reason. B) This is not the reason. C) Correct. D) There are no FDA requirements about free drug samples.

50) A moisture-absorbing packet of silica gel, known as ________, is added to a drug container to keep tablets or capsules from deteriorating or losing strength. A) the half-life B) a placebo C) a blister pack D) a desiccant Answer: D Explanation: A) The half-life is a period of time, not a substance. B) A placebo does not keep tablets from deteriorating. C) A blister pack only protects one tablet from moisture, not the entire drug container. D) Correct. 51) The half-life of a drug can be increased because of ________. A) liver or kidney disease B) particulate matter C) animal studies D) the presence of desiccant Answer: A Explanation: A) Correct. B) Particulate matter does not affect the half-life. C) Animal studies help determine the half-life but do not increase it. D) Desiccant absorbs moisture from the drug; it does not increase its half-life. 52) A drug tablet may include all of the following, EXCEPT ________. A) binders and fillers B) desiccant C) preservatives D) antioxidants and buffers Answer: B Explanation: A) A tablet can contain binders and fillers. B) Correct. Desiccant is NOT part of the tablet; it is placed in the drug bottle. C) A tablet can contain preservatives. D) A tablet can contain antioxidants and buffers. 2.2

True/False Questions

1) Foam is expanded by tiny aerosol bubbles when it is expelled from the container. Answer: TRUE 2) The main purpose of a scored tablet is so that the tablet can be easily broken into pieces to produce an accurate, increased dose. Answer: FALSE Explanation: The pieces provide an accurate, REDUCED dose. 17 Copyright © 2022 Pearson Education, Inc.

3) An enteric-coated tablet is covered with a special coating that resists the alkaline environment of the stomach acid but dissolves in the acid environment of the small intestine. Answer: FALSE Explanation: The stomach has an acid environment, not an alkaline one. 4) Both ointments and creams are semisolid emulsions of oil and water. In ointments, the main ingredient is water; in creams, the main ingredient is oil. Answer: FALSE Explanation: The main ingredient in ointments is oil. The main ingredient in creams is water. 5) Both ointments and creams can be applied topically to either the skin or the eyes. Answer: FALSE Explanation: Only specially formulated ointments can be applied to the eyes. 6) A lotion is a suspension of a drug in an oil base. Answer: FALSE Explanation: It is in a water base, not an oil base. 7) Creams are absorbed into the skin and exert a local, not systemic, drug effect. Answer: TRUE 8) Solutions don't ever need to be mixed or shaken, as the drug concentration is always the same in every part of the solution, even after prolonged standing. Answer: TRUE 9) Syrups are solutions that contain the drug in a thickened water base with added sugar and flavorings, but they do not contain alcohol. Answer: TRUE 10) Gels are solutions that contain fine, undissolved particles dispersed uniformly throughout a thickened water base. Answer: TRUE 11) The drugs in transdermal patches are designed to have only a topical, local effect on the skin in that area. Answer: FALSE Explanation: The drug in a transdermal patch is designed to exert a systemic effect throughout the body. 12) Before a drug can receive final approval by the FDA, the drug company must clearly state in what form or forms the drug will be manufactured. Answer: TRUE 13) Some drugs are ineffective if they are given in a particular drug form or they can seriously injure the patient if administered in the wrong drug form. Answer: TRUE 18 Copyright © 2022 Pearson Education, Inc.

14) Regardless of what drug company manufactures a drug in tablet form, all tablets must be either round or oval shaped. Answer: FALSE Explanation: Tablets are round, oval, square, oblong, or even triangular or baseball-diamond shaped. 15) Ointments used in the eye must be specially formulated so that they do not cause irritation when applied to the eye. Answer: TRUE 16) Lotions are absorbed into the skin and exert a system effect on the body, and not just a localized effect. Answer: FALSE Explanation: Lotions only a exert a local effect. 17) A powder is a finely ground form of a drug that can be found within capsules. Answer: TRUE 18) Intralipid intravenous fat solution is an example of an emulsion. Answer: TRUE 19) A transdermal patch consists of a drug reservoir, a porous membrane through which the drug can pass, and an adhesive layer to hold it to the skin. Answer: TRUE 20) Suppositories can be given by the oral, vaginal, inhalation, or rectal routes. Answer: FALSE Explanation: Suppositories are given by the vaginal or rectal routes. 21) Because it is easy to confuse different drugs, the Food and Drug Administration (FDA) advises patients who take more than one drug to be able to tell them apart by size, shape, color, imprint, or drug form. Answer: TRUE 22) A vial can be used only once, and the unused drug must be discarded, because it contains no preservative. Answer: FALSE Explanation: It is an ampule, not a vial, that can be used only once. 23) Patients often take a drug out of its original packaging and then have to ask the pharmacist to identify the tablets or capsules for them. Answer: TRUE 24) A scored tablet can be easily and accurately divided into equal doses, depending on the number of score marks on the tablet. Answer: TRUE 19 Copyright © 2022 Pearson Education, Inc.

25) Once a drug has received its final approval from the FDA, its ingredients, doses, manufacturing process, labeling, and packaging cannot be changed. Answer: TRUE 26) The advertising of both prescription and OTC drugs is regulated by the FDA. Answer: FALSE Explanation: The FDA regulates prescription drug advertising. The marketing and advertising of over-the-counter drugs are regulated by the Federal Trade Commission. 27) Before approving a new drug, the FDA must weigh the inherent risks of the drug against its potential benefits. Answer: TRUE 28) No matter how a drug was originally discovered or designed, it must be thoroughly tested by the FDA before it can be marketed. Answer: FALSE Explanation: It must be thoroughly tested by the drug company; the FDA only reviews the drug company's testing. 29) Generic drugs that are in the same drug form and drug strength–even if they are from different drug companies–must contain exactly the same amount of active ingredient and be administered in the same way that the FDA already approved. Answer: TRUE 30) The animal phase of drug testing precedes testing on humans. Answer: TRUE 31) The pharmacodynamics of a drug are determined during the human phase of drug testing. Answer: FALSE Explanation: The pharmacodynamics are determined during the animal phase. 32) The higher the number of the therapeutic index, the more desirable it is, because it indicates that the drug has a wide margin of safety. Answer: TRUE 33) While it is physiologically impossible for a placebo to exert any pharmacological effect, patients often report a decrease in certain types of symptoms after taking a placebo. Answer: TRUE 34) In a double-blind study, every patient receives both the drug being tested and a placebo. Answer: FALSE Explanation: Double-blind means neither the researcher nor the patient knows whether the patient received the drug being tested or a placebo.

35) In a double-blind study, the researcher is the only one who knows which patients are taking a drug and which patients are taking a placebo. Answer: FALSE Explanation: Even the researcher does not know. 36) A drug company may evaluate thousands of different chemicals before finding one that moves successfully through all phases of testing and is finally approved by the FDA for release and marketing. Answer: TRUE 37) It is not uncommon for a patient who is given a therapeutic dose of digoxin (Lanoxin) to exhibit symptoms of toxicity because of the drug's low therapeutic index. Answer: TRUE 38) Drugs that are successfully tested in animals will always perform well when given to humans. Answer: FALSE Explanation: Animal studies do not always show how well a drug will perform in humans. Penicillin is an example. 39) A drug can be approved to treat one thing and then its therapeutic effect or even its side effects can become a new clinical indication for that drug. Answer: TRUE 40) The label of a drug does not need to contain an expiration date printed on it, because drugs never expire. Answer: FALSE Explanation: Drugs do expire, and the expiration date is changes as new batches of the drug are manufactured. 41) Direct-to-consumer advertisements of drugs are heavily weighted toward prescription drugs for chronic diseases that require long-term treatment. Answer: TRUE 2.3

Short Answer Questions

1) A/an ________ tablet is one that is dissolved in a glass of water before being swallowed (e.g., Alka-Seltzer for a head cold). Answer: effervescent 2) Some over-the-counter drugs come as a/an ________, a drug form that is never swallowed, but is allowed to slowly disintegrate into a liquid form that releases the drug topically in the mouth and throat. Answer: lozenge

3) A/An ________ is a solution that contains the drug in a water and alcohol base with added sugar and flavoring. It is commonly used for pediatric and elderly patients who cannot swallow tablets or capsules. Answer: elixir 4) A/An ________ is a solution that contains the drug in a water and alcohol base, but is never taken internally. Answer: tincture 5) A/An ________ is composed of a solid base of glycerin or cocoa butter containing the drug. They are administered rectally or vaginally. Answer: suppository 6) A/An ________ is an oblong tablet that has a base of sugar and disintegrates into a paste to release the drug topically in the mouth. Answer: troche 7) In written prescriptions, the word tablet is sometimes abbreviated as ________ or ________. Answer: tab, tabs 8) In written prescriptions, the word capsule is sometimes abbreviated as ________ or ________. Answer: cap, caps 9) A/An ________ is a small, slender glass container with a main body and a narrow, indented neck, and an extended top that contains a liquid drug. Answer: ampule 10) Define these abbreviations and short forms. LA ________ SR ________ XL ________ ER ________ tab ________ cap ________ Answer: long acting, slow release, extended length, extended release, tablet, capsule 11) The viscosity of a drug form refers to its ________. Answer: thickness 12) When animal studies are completed, the drug company submits an IND application to the FDA. The abbreviation IND stands for ________ ________ ________. Answer: Investigational New Drug 13) There are three phases of human testing, which together are known as ________ ________ ________. Answer: clinical drug trials 22 Copyright © 2022 Pearson Education, Inc.

14) A/An ________ is a substance that has no pharmacologic effect and is used in double-blind studies during phase III clinical trials. Answer: placebo 15) Once phase III is completed, the drug company submits all of its documentation on the drug to the FDA in the form of an NDA. The abbreviation NDA stands for ________ ________ ________. Answer: New Drug Application 16) DTC marketing has become common, with drug advertisements appearing frequently in magazines and on television. The abbreviation DTC stands for ________ ________ ________. Answer: direct to consumer 17) Sometimes, the inert ingredients of a drug can affect its ________, particularly a drug with a low therapeutic index. Answer: bioavailability 18) Define these abbreviations. FDA ________ DTC ________ TI ________ IND ________ NDC ________ Answer: Food and Drug Administration, direct-to-consumer [marketing], therapeutic index, Investigational New Drug, National Drug Code 19) When volunteers answer a newspaper ad for a clinical drug trial, it is mandatory that they sign an informed ________ to participate in the trial. Answer: consent 20) A single dose of a drug can be placed in an individually sealed ________ ________ that contains a bubble of clear plastic over the capsule or tablet. Answer: blister pack 21) The marketing and advertising of over-the-counter drugs is regulated by the ________ ________ ________. Answer: Federal Trade Commission

2.4

Matching Questions

Match the drug name in Column 1 with its drug form in Column 2. A) enteric-coated tablet B) insert C) pellet D) foam E) syrup F) capsule G) T-shaped insert H) cream I) ointment J) gel 1) Lacrisert 2) Ecotrin 3) hydrocortisone 4) Kenalog 5) Mirena 6) Muse 7) Mirvaso 8) Nexium 9) Robitussin 10) Rogaine Answers: 1) B 2) A 3) H 4) I 5) G 6) C 7) J 8) F 9) E 10) D

Match the terms with their proper definitions. A) Relative margin of safety between the dose that produces a therapeutic effect and the dose that produces a toxic effect in animals B) The time required for drug levels in the blood to decrease from 100 percent to 50 percent. C) Number of animals who responded or did not respond to a drug at a particular dose. 11) frequency distribution curve 12) half-life 13) therapeutic index (TI) Answers: 11) C 12) B 13) A 2.5

Essay Questions

1) Briefly explain how a transdermal patch delivers a drug dose to the patient. Answer: A transdermal patch consists of a multilayered disk containing a drug reservoir, a porous membrane, and an adhesive layer to hold it to the skin. The porous membrane regulates the amount of drug entering the skin, releasing small amounts over time. 2) Drugs that come in the forms of ointments, creams, and lotions have various characteristics. Describe the characteristic feel, appearance, and consistency for just one of these three drug forms. Answer: (one of the following) Ointment: Greasy feel, clear appearance, firm consistency Cream: Nongreasy feel, opaque/milky appearance, semiliquid Lotion: Nongreasy feel, opaque/milky, liquid 3) Many over-the-counter drugs for pain are not manufactured in capsule form. Explain why. Answer: After Tylenol capsules were purposely contaminated with cyanide, now drug companies manufacture their over-the-counter drugs for pain in a tablet or caplet form, rather than a capsule, to prevent tampering with the contents. 4) Describe the difference between an emulsion and an emulsifying agent. Answer: Emulsions are solutions that contain fat globules dispersed uniformly throughout a water base. An emulsifying agent is added to a cream to keep the oil and water ingredients mixed together. 5) Briefly explain the difference between in vivo testing and in vitro testing. Answer: Chemical analysis of a drug done in a laboratory in test tubes is known as in vitro testing. Testing carried out in animals or humans is known as in vivo testing.

6) Briefly explain how a double-blind study is performed using a control group, a placebo, and drug group. Answer: Double-blind studies with the drug and a placebo are performed, in which neither the patients nor the physician-investigators know which patients are receiving the drug and which patients (the control group) are receiving the drug.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 3 Prescriptions and Using Drugs Therapeutically 3.1

Multiple Choice Questions

1) Prescription drugs can be ordered by all of the following EXCEPT ________. A) pharmacist B) doctor of osteopathy C) podiatrist D) nurse practitioner Answer: A Explanation: A) Correct. The pharmacist does not order drugs. B) This is true. C) This is true. D) This is true. 2) A prescription can be written by all of the following, EXCEPT ________. A) a physician or dentist B) a podiatrist or optometrist C) a nurse D) a physician's assistant or nurse practitioner Answer: C Explanation: A) A physician or dentist can write a prescription. B) podiatrist or optometrist can write a prescription. C) Correct. D) A physician's assistant or nurse practitioner can write a prescription. 3) A prescription is used to convey an order for a drug to ________. A) another healthcare provider B) the patient C) the pharmacist D) None of the above Answer: C Explanation: A) One healthcare provider does not write a prescription to another healthcare provider. B) A healthcare provider does not write a prescription to the patient, but for the patient. C) Correct. D) One of these answers is correct.

4) What are the different types of prescriptions? A) verbal order B) handwritten C) electronic D) All of the above. Answer: D Explanation: A) This is a type of prescription. B) This is a type of prescription. C) This is a type of prescription. D) Correct. 5) Which of the following components must be included in a prescription? A) the patient's name B) drug name C) quantity to be dispensed D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 6) What type of order does not originate with the healthcare provider, but with the hospital pharmacy? A) automatic stop orders B) medication orders C) standing orders D) verbal orders Answer: A Explanation: A) Correct. B) Medication orders originate with the healthcare provider. C) Standing orders originate with the healthcare provider. D) Verbal orders originate with the healthcare provider.

7) Prescriptions for drugs (except Schedule drugs) are valid for how long from the date on the prescription form? A) seven days B) three months C) one year D) varies from state to state Answer: C Explanation: A) This is not correct. B) This is not correct. C) Correct. D) This is not correct. 8) Which of the following should NOT be used when writing a drug name on a prescription? A) abbreviation B) chemical name C) generic name D) A and B Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) Incorrect. The generic drug name is often used. D) Correct. 9) All drug orders in the hospital carry an automatic stop order that is activated whenever a patient ________. A) is transferred to another nursing unit B) goes to surgery C) is discharged to home D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct statement. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct statement. D) Correct.

10) Which type of medication order is carried out before a healthcare provider's signature is obtained? A) electronic order B) standing order C) verbal order D) written order Answer: C Explanation: A) An electronic order is carried out after it has been signed. B) A standing order is carried out after it has been signed. C) Correct. A verbal order is carried out; the healthcare provider signs it later. D) A written order is carried out after it has been signed. 11) In a prescription or medication order, after the drug name and the drug strength, the next thing that would be the written is the ________. A) drug form B) healthcare provider's signature C) patient's age and weight D) unique Rx number Answer: A Explanation: A) Correct. B) The signature is at the end of the prescription form. C) If included, the patient's age and weight are at the beginning of a prescription form. D) The unique Rx number is assigned by the pharmacist, not written on the prescription or medication order. 12) All of the following are identifying information about the prescriber that is preprinted on a prescription form, EXCEPT ________. A) the physician's office phone number B) the physician's DEA number C) the physician's name D) the physician's office address Answer: B Explanation: A) This is preprinted on the prescription form. B) Correct. This is NOT included on the prescription form. C) This is preprinted on the prescription form. D) This is preprinted on the prescription form.

13) Official prescription forms used to prescribe Schedule II drugs have all of the following security features, EXCEPT ________. A) an imprinted seal B) the physician's DEA number C) a control number D) special ink Answer: B Explanation: A) They do include this security feature. B) They do not include this; it is added by the healthcare provider. C) They do include this security feature. D) They do include this security feature. 14) If a prescription is photocopied, and the word "VOID" becomes visible on the photocopy, this would tell you that the prescription was ________. A) for a drug not authorized by the patient's insurance company B) for an over-the-counter drug C) expired and could not be filled by the pharmacist D) an unauthorized photocopy of an official prescription form for a Schedule drug Answer: D Explanation: A) This is not true statement. B) Over-the-counter drugs do not require a prescription. C) This is not a true statement. D) Correct. 15) To obtain a refill of a prescription drug, the patient must ________. A) have authorization from the healthcare provider B) provide the pharmacy with the unique Rx number C) seek information and counseling from the pharmacist D) A and B Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) Pharmacists provide information and counseling, but this is not required before refilling a prescription. D) Correct.

16) Which of the following statements is TRUE? A) Fifty percent of drugs for chronic disease are not taken as prescribed. B) Some people have to choose between food and drugs because of the high cost of drugs. C) Some people do not take a drug as prescribed, but only when they have symptoms. D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct statement. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct. 17) A prescription tells the quantity of the capsules to be dispensed, and that number should equal the number of days of treatment multiplied by the ________. A) number of doses to be taken each day B) patient's years of age C) patient's pounds of weight D) DEA number Answer: A Explanation: A) Correct. B) The patient's age does not affect this. C) The patient's weight does not affect this. D) The DEA number is not related to the number of capsules. 18) When a prescription includes Latin abbreviations, these are ________. A) placed on the label of the prescription bottle. B) translated by the healthcare provider before writing the prescription C) translated by the pharmacist into English D) All of the above Answer: C Explanation: A) Latin abbreviations are not placed on the label of the prescription bottle. B) These are not translated; they are part of the prescription. C) Correct. D) There is only one correct answer.

19) Which of the following statements is TRUE? A) Unused drugs can be flushed down the toilet. B) Unused Schedule drugs can be taken to a hospital emergency room. C) Mix unused drugs with kitty litter or coffee-grounds in plastic bag in the trash. D) Pharmacies will not accept unused drugs that need to be disposed of. Answer: C Explanation: A) False. They should not be flushed down the toilet as they go into the ground water. B) False. Hospitals do not dispose of unused Schedule drugs. C) Correct. D) False. Some pharmacies will accept a customer's unused drugs and dispose of them. 20) Medication therapy management ________. A) helps manage a patient's drug therapy B) facilitates communication between the physician, pharmacist, and patient C) prevents medication errors and improve patient compliance D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 21) A drug that is able to unlock or activate a receptor and produce an effect is known as a/an ________ drug. A) agonist B) antagonist C) blocker D) synergist Answer: A Explanation: A) Correct. B) Antagonists (blockers) are drugs that can fit a receptor, but cannot unlock or activate the receptor. C) Antagonists (blockers) are drugs that can fit a receptor, but cannot unlock or activate the receptor. D) Synergism refers to the combined effect of two drugs, not one.

22) The reason for which a drug was prescribed by the healthcare provider is known as the drug's ________. A) adverse effect B) drug reaction C) side effect D) therapeutic effect Answer: D Explanation: A) The main reason is not for an adverse effect. B) The main reason is not for a drug reaction. C) The main reason is not for a side effect. D) Correct. 23) A toxic effect of a prescribed drug results when ________. A) the drug company did not perform clinical trials for that drug B) the healthcare provider decreased the drug dose in elderly patients C) the serum level of a drug goes below the therapeutic level D) the serum level of a drug rises above the therapeutic level Answer: D Explanation: A) The drug company always does clinical trials before a drug can be approved and prescribed. B) If the dose was decreased, there is less chance there will be a toxic effect. C) With a serum level below therapeutic level, there is little chance of a toxic effect. D) Correct. 24) Which of the following increases the likelihood of a drug-drug interaction? A) pharmacogenetics B) polypharmacy C) side effects D) therapeutic effects Answer: B Explanation: A) Pharmacogenetics is concerned with genetics, not drug-drug interactions. B) Correct. C) A drug's side effects do not increase the likelihood of a drug-drug interaction. D) A drug's therapeutic effect does not increase the likelihood of a drug-drug interaction.

25) Adrenergic receptors include ________. A) alpha1 and alpha2 receptors B) beta1 and beta2 receptors C) alpha1, alpha2, beta1, beta2, and beta3 receptors D) H1 and H2 receptors Answer: C Explanation: A) This is only part of the correct answer. B) This is only part of the correct answer. C) Correct. This is a complete list of adrenergic receptors. D) Histamine receptors are not adrenergic receptors. 26) A list of the common side effects of a new drug is developed ________. A) as a new drug is prescribed B) when a new drug is reported C) after a drug is approved by the FDA D) as a new drug is being tested Answer: D Explanation: A) The list of side effects is not developed as a new drug is prescribed. B) This is nonspecific. There are many reports on drugs. C) The list of side effects is developed before a new drug is approved by the FDA. D) Correct. 27) When the immune system identifies a foreign substance (an antigen) and releases antibodies, this stimulates the release of ________, which produces mild-to-severe allergic symptoms. A) acetylcholine B) epinephrine C) histamine D) norepinephrine Answer: C Explanation: A) Acetylcholine, a neurotransmitter, is not involved in an allergic reaction. B) Epinephrine, a neurotransmitter, is not involved in an allergic reaction. C) Correct. D) Norepinephrine, a neurotransmitter, is not involved in an allergic reaction.

28) Receptors interact with body substances. Which of the following is NOT one of those body substances? A) enzymes B) hormones C) neurotransmitters D) antigens Answer: D Explanation: A) Receptors do interact with enzymes. B) Receptors do interact with hormones. C) Receptors do interact with neurotransmitters. D) Correct, Antigens are foreign substances from outside the body, not body substances. 29) An antagonist drug ________. A) fits into a receptor but does not activate it B) is similar to inserting the wrong key in a lock C) keeps other drugs from activating the receptor D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 30) A common side effect of opioid drugs used to treat severe pain is ________. A) depression B) nausea and vomiting C) loss of hair D) constipation Answer: D Explanation: A) Opioid drugs do not have a side effect of depression. B) Opioid drugs do not have a side effect of nausea and vomiting. C) Opioid drugs do not have a side effect of loss of hair. D) Correct.

31) Which of the following is NOT one of the therapeutic effects of drugs? A) improve disease symptoms B) diagnose a disease C) change the therapeutic index of a disease D) prevent a disease Answer: C Explanation: A) This is a therapeutic effect of drugs. B) This is a therapeutic effect of drugs. C) Correct. This is not a therapeutic effect. D) This is a therapeutic effect of drugs. 32) The systemic effect of a drug is felt ________. A) where the healthcare provider intended it to be B) throughout the body C) at the site of administration D) in a target organ Answer: B Explanation: A) This is not a complete meaning of systemic. B) Correct. C) A systemic effect is felt throughout the body, not just at the site of administration. D) A systemic effect is felt throughout the body, not just in a target organ. 33) Symptoms of an allergic reaction are based on the release of ________. A) an antigen B) an antibody C) anaphylaxis D) histamine Answer: D Explanation: A) An antigen is a foreign substance; it is not released. B) An antibody is released by the immune system, but it does not cause an allergic reaction. C) Anaphylaxis is a severe allergic reaction, but it is not released. D) Correct.

34) When a drug has a narrow margin of safety between the therapeutic dose and the toxic dose, that drug has a low ________. A) first-pass effect B) drug idiosyncrasy C) therapeutic index D) level of adverse effects Answer: C Explanation: A) The first-pass effect occurs in the liver and is not related to the margin of safety. B) A drug idiosyncrasy is based on an individual's unique reaction and is not related to the margin of safety. C) Correct. D) Adverse effects of drug are not always related to the margin of safety. 35) A drug that can unlock or activate a receptor is known as a/an ________. A) anaphylaxis B) antagonist C) neurotransmitter D) agonist Answer: D Explanation: A) Anaphylaxis is a severe allergic reaction, not a drug. B) An antagonist drug does not unlock or activate a receptor. C) A neurotransmitter is a body substance, not a drug. D) Correct. 36) Which pair of drugs listed below, if taken together, is an example of the drug-drug interaction known as synergism? A) alcohol and a tranquilizer drug B) Tylenol and codeine C) potassium-wasting diuretic drug and potassium-sparing diuretic drug D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

37) An idiosyncratic drug reaction is ________. A) based on the patient's genetic makeup B) a side effect C) based on an allergic reaction D) All of the above, Answer: A Explanation: A) Correct. B) An idiosyncratic drug reaction is not a side effect. C) An idiosyncratic drug reaction is not based on an allergic reaction. D) Only one of the above statements is correct. 38) The therapeutic effect of a drug can be directed toward ________. A) bacteria B) a target organ C) cancer cells D) All of the above. Answer: D Explanation: A) This is a true statement, but it is not the only correct answer. B) This is a true statement, but it is not the only correct answer. C) This is a true statement, but it is not the only correct answer. D) Correct. 39) A drug-drug interaction in which two drugs combine to produce an effect greater than the intended effect of either drug is called ________. A) antagonism B) receptor C) anaphylaxis D) synergism Answer: D Explanation: A) Antagonism occurs when two drugs produce a lesser effect than either drug. B) A receptor is a structure on a cell membrane, not a drug-drug interaction. C) Anaphylaxis is a severe allergic reaction, not a drug-drug interaction D) Correct.

40) The abbreviation h.s. means ________. A) before meals B) after meals C) at bedtime D) nothing by mouth Answer: C Explanation: A) Before meals is abbreviated as a.c. B) After meals is abbreviated as p.c. C) Correct. D) Nothing by mouth is abbreviated as n.p.o. or NPO. 41) Pilot Mark Adams is flying a plane today, but his allergies are giving him a runny nose and red, watery eyes. What is the most important fact he should know? A) The antihistamine drug side effect of drowsiness can be used as a therapeutic effect to treat insomnia. B) An allergic reaction involves an antibody and an antigen that combine and release histamine. C) Some antihistamine drugs cause a side effect of drowsiness that is undesirable in persons who must drive or operative machinery. D) The perfect drug would have a complete therapeutic effect and no side effects. Answer: C Explanation: A) This is true, but it is not the most important fact he needs to know. B) This is true, but it is not the most important fact he needs to know. C) Correct. D) This is true, but it is not the most important fact he needs to know. 42) The same drug given by a different route can exert either a local or a systemic effect. An example of this is ________. A) Topical diphenhydramine (Benadryl) relieves skin itching and oral diphenhydramine (Benadryl) relieves skin itching, nasal stuffiness, and red, watery eyes. B) An antihistamine drug that, when taken with grapefruit juice, can cause the adverse effect of heart arrhythmias. C) Topical lidocaine (Xylocaine) is gargled for anesthesia in the mouth and intravenous lidocaine (Xylocaine) is used to treat ventricular fibrillation (heart arrhythmias). D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not related to the question of local and systemic effects. C) This is true, but it is not the only correct answer. D) Correct.

43) The therapeutic effect of an antagonist or blocker drug is to bind to the receptor and block ________ from activating the receptor. A) hormones B) neurotransmitters C) other drugs D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 44) Which statement about cholinergic receptors is FALSE? A) The adjective cholinergic is derived from the word acetylcholine. B) Cholinergic receptors are also known as adrenergic receptors. C) Cholinergic receptors are part of the parasympathetic division of the nervous system. D) Cholinergic receptors are activated by the neurotransmitter acetylcholine. Answer: B Explanation: A) This is a true statement. B) Correct. Cholinergic and adrenergic are two different types of receptors. C) This is a true statement. D) This is a true statement. 45) Side effects can be ________. A) mild and temporary B) moderate and annoying C) severe enough that the drug must be stopped D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

46) Toxic effects are more common in older patients whose ________ are less able to metabolize and excrete a drug. A) lungs and stomach B) liver and kidneys C) stomach and intestines D) brain and central nervous system Answer: B Explanation: A) The lungs and stomach do not metabolize and excrete a drug. B) Correct. C) The stomach and intestines do not metabolize and excrete a drug. D) The brain and central nervous system do not metabolize and excrete a drug. 47) When toxic effects occur, the healthcare provider can respond by ________. A) decreasing the dose of the drug B) lengthening the time between doses C) discontinuing the drug D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 48) The antibiotic drug gentamicin is known to exert a toxic effect on the ear. This is known as ________. A) nephrotoxicity B) liver toxicity C) ototoxicity D) brain toxicity Answer: C Explanation: A) Nephrotoxicity is toxicity of the kidney. B) Gentamicin is not known to cause liver toxicity. C) Correct. Ot/o- means "ear." D) Gentamicin is not known to cause brain toxicity.

49) What common problems of the elderly lead to missed drug doses and overdoses? A) vision problems B) memory problems C) taking multiple drugs on different schedules D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 50) When the antibiotic drug tetracycline is taken with an antacid, these two drugs ________. A) form an insoluble compound that prevents a therapeutic effect B) cause a side effect of severe diarrhea C) produce an allergic reaction to each other D) have synergism cause an increased therapeutic effect of each drug Answer: A Explanation: A) Correct. B) These two drugs do not cause severe diarrhea. C) These two drugs do not produce an allergic reaction. D) These drugs create an insoluble compound that prevents either drug from exerting a therapeutic effect. This is an example of antagonism, not synergism 51) Housewife Shannon McGee is taking an MAO inhibitor drug for depression. She knows she should not eat any foods that are high in tyramine to avoid getting hypertension and a headache. She should avoid all of these foods, EXCEPT ________. A) chocolate and bananas B) aged cheeses C) meat D) alcohol Answer: C Explanation: A) Chocolate and bananas should be avoided by patients taking an MAO inhibitor drug. B) Aged cheeses should be avoided by patients taking an MAO inhibitor drug. C) Correct. Meat can be eaten by patients taking an MAO inhibitor drug. D) Alcohol should be avoided by patients taking an MAO inhibitor drug.

52) A drug error can occur because one of the "seven rights of drug administration" was not followed, such as ________. A) the nurse does not check the patient's identification band B) the pharmacy does not carry that particular drug C) the patient has been transferred to surgery D) All of the above. Answer: A Explanation: A) Correct. B) This is not one of the seven rights of drug administration. C) This is not one of the seven rights of drug administration. D) Not all of these answers are included in the seven rights of drug administration. 53) A drug dose for a pediatric patient is calculated on the basis of ________. A) age B) height C) weight D) total body surface area Answer: C Explanation: A) A pediatric drug dose is not calculated based on age. B) A pediatric drug dose is not calculated based on height. C) Correct. D) Chemotherapy drugs, not pediatric drugs, are calculated on the basis of total body surface area. 54) The opposite of drug-drug antagonism is ________. A) allergy B) ototoxicity C) pharmacodynamics D) synergism Answer: D Explanation: A) Allergy is not related to drug antagonism. B) This is a toxic drug reaction; it is not the opposite of anything. C) This does not involve two drugs. D) Correct.

55) Which of these things does an antagonist drug do? A) occupies and blocks a receptor B) does not activate the receptor C) keeps other drugs from activating the receptor D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 56) The side effects of anticholinergic drugs are remembered with the abbreviation ABCD. The D stands for ________. A) drug B) diarrhea C) dry mouth D) depression Answer: C Explanation: A) The D does not stand for drug. B) The D does not stand for diarrhea. C) Correct. The D stands for dry mouth. D) The D does not stand for depression. 57) A black box warning in the drug's package insert is used to call attention to ________. A) side effects B) adverse reactions C) antagonism D) All of the above. Answer: B Explanation: A) The black box warning is not for side effects. B) Correct. C) The black box warning is not for antagonism. D) Only one of the answers is correct.

58) "Tall Man" letters (capital letters within a drug name) are used to ________. A) distinguish it from other look-alike drug names B) call attention to possible side effects C) tell which drug company produced the drug D) All of the above Answer: A Explanation: A) Correct. B) This is not what "Tall Man" letters are used for. C) This is not what "Tall Man" letters are used for. D) There is only one correct answer. 59) The doses for chemotherapy drugs ________. A) are based on the patient's total body surface area B) are customized to maximize drug effectiveness while minimizing side effects C) are based on age D) A and B Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is not true. D) Correct. 60) The use of "Tall Man" letters on a drug's label is encouraged by ________. A) Healthcare professionals B) The Food and Drug Administration C) The Institute for Safe Medication Practices D) B and C Answer: D Explanation: A) Healthcare professionals use "Tall Man" letters to pick the right drug, but they do not encourage its use. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

61) Which of the following is NOT one of the steps involved in the drug cycle? A) absorption B) distribution C) metabolism D) secretion Answer: D Explanation: A) Absorption is one of the steps involved in the drug cycle. B) Distribution is one of the steps involved in the drug cycle. C) Metabolism is one of the steps involved in the drug cycle. D) Correct. Excretion, not secretion, is the fourth step in the drug cycle. 62) When a drug is applied directly to the skin, eyes, or ears, it is administered via the ________ route. A) oral B) sublingual C) topical D) transdermal Answer: C Explanation: A) The oral route of administration is giving drugs through the mouth. B) The sublingual route of administration is giving drugs underneath the tongue. C) Correct. D) The transdermal route of administration is applied to the skin, but not to the eyes and ears. 63) Which is the most convenient route of administration and the one most commonly used? A) injection B) oral C) rectal D) tablets Answer: B Explanation: A) Injection is not the most common or convenient route of administration. B) Correct. C) Rectal is not the most common route of administration. D) Tablets are a form of a drug, not a route of administration.

64) Which route of administration would be chosen if the patient is vomiting and a drug cannot be given by injection? A) intradermal B) parenteral C) rectal D) sublingual Answer: C Explanation: A) Intradermal is a type of injection. B) Parenteral administration is all routes, including injection. C) Correct. D) The sublingual administration route delivers drugs by placing them under the tongue. This cannot be done if the patient is vomiting. 65) Which of the following is NOT considered part of the parenteral route of administration? A) intradermal B) intramuscular C) endotracheal D) intravenous Answer: C Explanation: A) Intradermal is one of the parenteral routes of administration. B) Intramuscular is one of the parenteral routes of administration. C) Correct. This is not a parenteral route of administration. D) Intravenous is one of the parenteral routes of administration. 66) Absorption involves three steps. Which of the following is NOT one of those three steps? A) absorb B) disintegrate C) dissolve D) excrete Answer: D Explanation: A) Absorb is one of the three steps of absorption. B) Disintegrate is one of the three steps of absorption. C) Dissolve is one of the three steps of absorption. D) Correct

67) The process of drug metabolism is accomplished in the ________, the principal organ of metabolism. A) intestines B) kidneys C) liver D) stomach Answer: C Explanation: A) The intestines are not the principal organ of metabolism. B) The kidneys are not the principal organ of metabolism. C) Correct. D) The stomach is not the principal organ of metabolism. 68) A drug can be administered intravenously in three different ways. Which of the following is NOT one of those three ways? A) by I.V. push B) by I.V. piggyback C) by continuous infusion D) by keep the vein open (KVO) Answer: D Explanation: A) I.V. push is a type of intravenous drug administration. B) I.V. piggyback is a type of intravenous drug administration. C) Continuous infusion is a type of intravenous drug administration. D) Correct. Keep the vein open does not involve administration of a drug. 69) Oral drugs that are in a liquid form do NOT go through which of the following steps? A) absorption B) disintegration C) dissolving D) excretion Answer: B Explanation: A) Oral drugs in a liquid form do go through absorption from the stomach. B) Correct. The liquid does NOT need to disintegrate. C) Oral drugs in a liquid form do go through dissolving into the surrounding body fluids. D) All drugs go through excretion.

70) Which method of drug administration is used during emergency resuscitation? A) intra-articular B) endotracheal C) intravesical D) intramuscular Answer: B Explanation: A) The intra-articular route is used to administer a drug into a joint once every few weeks or months, not in an emergency. B) Correct. C) This route is used for the administration of chemotherapy drugs into the bladder to treat bladder cancer, which is not an emergency. D) Intramuscular injection is into a muscle and the drug must then be absorbed; this is not suitable for an emergency. 71) Following drug administration, most drugs go through a well-defined sequence of steps before being excreted from the body. Which of the following is the correct order of those steps? A) absorption, distribution, metabolism, excretion B) distribution, metabolism, absorption, excretion C) excretion, metabolism, distribution, absorption D) metabolism, distribution, absorption, excretion Answer: A Explanation: A) Correct. B) Absorption is out of order in this sequence. C) Excretion and absorption are out of order in this sequence. D) Absorption and distribution are out of order in this sequence. 72) The memory aid NAVEL (naloxone, atropine, Valium, epinephrine, lidocaine) helps you remember which drugs can be administered ________. A) through an endotracheal tube B) nasally C) buccally D) topically Answer: A Explanation: A) Correct. B) There is no memory aid to tell which drugs can be administered nasally. C) There is no memory aid to tell which drugs can be administered buccally. D) There is no memory aid to tell which drugs can be administered topically.

73) The intravenous route is used to do all of the following. A) correct a decreased level of body fluids, blood, electrolytes, or glucose B) provide nutritional support for those who cannot eat C) administer drugs D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 74) Which of the following routes CANNOT be used to administer drugs when the patient is unconscious? A) oral B) rectal C) intravenous D) nasogastric Answer: A Explanation: A) Correct! The oral route requires that the patient be alert and able to swallow. B) The rectal route can be used when the patient is unconscious. C) The intravenous route can be used when the patient is unconscious. D) The nasogastric route can be used when the patient is unconscious. 75) Sublingual administration of a drug involves placing it ________. A) on the skin B) under the tongue C) in the vagina D) under the skin Answer: B Explanation: A) This describes topical, not sublingual, administration. B) Correct. C) This is not sublingual administration D) This describes intradermal, not sublingual, administration.

76) The subcutaneous injection is used to administer ________. A) insulin for diabetes mellitus B) heparin C) allergy shots D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 77) Which route of administration is commonly abbreviated as PO? A) oral B) parenteral C) rectal D) inhalation Answer: A Explanation: A) Correct. B) There is no official abbreviation for the parenteral route. C) There is no official abbreviation for the rectal route. D) There is no official abbreviation for the inhalation route. 78) The first-pass effect describes the ________. A) metabolism of drugs by enzymes in the stomach B) metabolism of drugs by enzymes in the liver C) absorption of drugs by the stomach D) excretion of drugs by the kidneys Answer: B Explanation: A) The first-pass effect does not involve the stomach. B) Correct. C) The first-pass effect does not involve the stomach. D) The first-pass effect does not involve the kidneys. 79) Which of the following statements is FALSE? A) Different forms of a drug are appropriate for different routes of administration. B) Intradermal injection injects the drug into the subcutaneous fat. C) Some drugs are ineffective or harmful when administered by the wrong route. D) All of these statements are true. Answer: B Explanation: A) This statement is true. B) Correct. Intradermal injects a liquid drug just below the epidermis of the skin. C) This statement is true. D) One of these statements is false. 26 Copyright © 2022 Pearson Education, Inc.

80) All of the following are accepted sites for an intramuscular injection in adults, EXCEPT ________. A) ventrogluteal B) subcutaneous C) deltoid D) dorsogluteal Answer: B Explanation: A) This is an accepted intramuscular injection site. B) Correct. Subcutaneous is a different type of injection than intramuscular. C) This is an accepted intramuscular injection site. D) This is an accepted intramuscular injection site. 81) When a drug is given by inhalation, it is absorbed ________. A) through the stomach and intestine B) through the nasal cavity C) through alveoli into the lungs D) through the breast milk Answer: C Explanation: A) Oral drugs are absorbed through the stomach and intestine. B) Drugs given by the nasal route are absorbed in the nasal cavity. C) Correct. D) Drugs are excreted in the breast milk; this is not related to inhalation. 82) The drug dose for an older patient is decreased because of the patient's decreased ________. A) need for medication B) activity levels C) mental ability to administer correct doses D) liver and kidney function Answer: D Explanation: A) This is not a true statement. B) A decreased activity level is not related to drug doses for older persons. C) Drug doses are not decreased for an older person just because they have a decreased mental ability. D) Correct.

83) Drugs circulate in the blood bound to ________. A) red blood cells B) white blood cells C) albumin D) antigens Answer: C Explanation: A) Drugs do not bind to red blood cells. B) Drugs do not bind to white blood cells. C) Correct. D) Drugs do not bind to antigens. 84) The process of metabolism is also known as ________. A) biotransformation B) disintegration C) distribution D) parenteral Answer: A Explanation: A) Correct. B) Disintegration is one of the steps in absorption, not metabolism. C) Distribution is just one of the parts of metabolism. D) Parenteral is a route of administration, not part of metabolism. 85) The intravesical route of administration is used to insert a drug into the ________. A) lungs B) vagina C) spinal cord D) bladder Answer: D Explanation: A) The intravesical route is not in the lungs. B) The intravesical route is not in the vagina. C) The intravesical route is not in the spinal cord. D) Correct.

86) Only drugs given by ________ administration entirely bypass the step of absorption. A) endotracheal B) subcutaneous C) oral D) intravenous Answer: D Explanation: A) Drugs given by an endotracheal tube must still be absorbed from the lungs into the blood. B) Drugs given by the subcutaneous route must still be absorbed from the fatty tissue into the blood. C) Drugs given by oral route must still be absorbed from the intestine into the blood. D) Correct. 87) The intradermal route of administration is used for ________. A) giving intravenous fluids B) allergy skin tests C) Mantoux test for tuberculosis D) B and C Answer: D Explanation: A) The intravenous route, not the intradermal route, is used for intravenous fluids. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 88) Trace amounts of a drug are excreted in which of the following? A) saliva and tears B) breast milk C) sweat D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 3.2

True/False Questions

1) The electronic health record has reduced errors related to illegible handwriting in a prescription. Answer: TRUE 2) The use of generic rather than trade name drugs can result in considerable savings to consumers. Answer: TRUE 3) Prescriptions for controlled substances require the physician's DEA number. Answer: TRUE 29 Copyright © 2022 Pearson Education, Inc.

4) Only the drug's trade name can be used when writing a prescription. Answer: FALSE Explanation: Either the drug's generic name or its trade name can be written on the prescription unless the healthcare provider requests "Dispense as written," and then the trade name drug is used. 5) Childproof caps were introduced in 1984 as a public safety measure. Answer: TRUE 6) When a hospital patient is discharged home, the attending physician at the hospital provides prescriptions that the patient or a family member can take to a local pharmacy to be filled. Answer: TRUE 7) Over-the-counter drugs must have a written prescription from a physician or dentist. Answer: FALSE Explanation: Over-the-counter drugs never need a prescription. 8) A healthcare provider can write an order for a Schedule drug for a patient in the hospital because the providers DEA certificate is on file with the hospital's credentialing department. Answer: TRUE 9) Writing an abbreviation of a drug name on a prescription form saves time and avoids confusion. Answer: FALSE Explanation: Abbreviations of drug names are avoided because they may be misread. 10) One advantage of an electronic prescription is that it can be sent electronically directly to the pharmacy. Answer: TRUE 11) Prescriptions written for prescription drugs require that the physician include his/her DEA number. Answer: FALSE Explanation: Only prescriptions for Schedule drugs require the healthcare provider's DEA number. 12) A prescription is a medicolegal document that gives instructions on what drug to dispense to a patient. Answer: TRUE 13) The pharmacist indicates how many times the patient is permitted to refill the prescription. Answer: FALSE Explanation: The healthcare provider indicates the number of refills, not the pharmacist.

14) Once a pharmacist receives a prescription, he/she assigns a unique prescription number (Rx #) that is printed on the label of the prescription bottle. Answer: TRUE 15) In addition to standing orders when a patient enters the hospital, a physician would also write more specific medication orders for drugs to treat the patient's other current medical needs. Answer: TRUE 16) The physician does NOT need to provide his/her DEA number when writing a medication order for a controlled substance if the patient is in the hospital. Answer: TRUE 17) The healthcare provider must prescribe a drug strength that corresponds exactly to the strength in which the drug is manufactured. Answer: TRUE 18) A prescription for a Schedule II drug is valid for 6 months from the date of the prescription. Answer: FALSE Explanation: A prescription for a Schedule II drug is only valid for 7 days. 19) When a drug has been approved by the FDA to treat a specific disease, the healthcare provider cannot prescribe it to treat a different disease. Answer: FALSE Explanation: The healthcare provider has the right to make an informed clinical decision that a certain drug may be able to help the patient. This is an off-label use. 20) Two of the jobs of the pharmacist working in the hospital is to dispense drugs to the nursing unit and consult with healthcare providers about the patient's care. Answer: TRUE 21) The medicine cabinet in the bathroom is a good place to store drugs. Answer: FALSE Explanation: The bathroom has heat and moisture that can degrade drugs. 22) The Consumer Products Safety Commission defines the meaning of "child-resistant" prescription bottle caps. Answer: TRUE 23) The abbreviation Sig. in a prescription refers to the signature line where the physician signs. Answer: FALSE Explanation: It indicates that directions on how to use the drug will follow. 24) Prescriptions for Schedule drugs require the healthcare provider's DEA number. Answer: TRUE

25) Child-resistant caps for prescription bottles were introduced in 1984 as a public safety measure. Answer: TRUE 26) Over-the-counter drugs must have a written prescription from a physician or dentist. Answer: FALSE Explanation: Over-the-counter drugs never need a prescription. 27) The pharmacist will dispense the generic equivalent of a drug unless the physician specifically requests the trade name and writes DAW on the prescription. Answer: TRUE 28) Adrenergic receptors are activated by the neurotransmitter acetylcholine from the parasympathetic division of the nervous system. Answer: FALSE Explanation: Adrenergic receptors are activated by epinephrine and norepinephrine, not acetylcholine. 29) All drugs have a target organ where they exert their effect. Answer: FALSE Explanation: The drug's therapeutic effect is not always directed to a target organ. 30) An adverse drug reaction is not as common as a side effect. Answer: TRUE 31) An allergic reaction is caused by the release of histamine. Answer: TRUE 32) A patient may take several doses of a drug without having an allergic reaction, but later develop an allergic reaction to that drug. Answer: TRUE 33) One drug can act as a master key to unlock several different receptors in different organs. Answer: TRUE 34) Most drugs are associated with at least one or two frequently observed side effects. Answer: TRUE 35) Once a drug is approved by the FDA, its advertisements, prescribing information, and package inserts must list the side effects. Answer: TRUE 36) No drug is entirely safe and without potential side effects. Answer: TRUE

37) Healthcare providers, patients, consumers, or the DEA can report adverse drug reaction to the FDA. Answer: FALSE Explanation: The DEA does not report adverse drug reactions. 38) Before FDA approval, the drug company must show that a drug does not produce a toxic effect when administered in a therapeutic dose. Answer: TRUE 39) Once a patient is sensitized to a particular drug, only a full dose of that drug will trigger an allergic reaction. Answer: FALSE Explanation: Once sensitized, even a small dose can cause an allergic reaction. 40) A patient who is allergic to one drug in a drug category can safely take other drugs belonging to that drug category. Answer: FALSE Explanation: Other drugs in that group that have a similar chemical structure can cause an allergic reaction and hypersensitivity. 41) The standard adult drug dose can be given to all adults. Answer: FALSE Explanation: The standard adult dose is appropriate for most adults, but older, extremely thin, or extremely obese patients fall outside of this range and need a dose adjustment. 42) The way to optimize the therapeutic effect of a drug and minimize the occurrence of an adverse drug reaction is to take the drug exactly as prescribed. Answer: TRUE 43) An allergic reaction to a drug will occur if the blood level of the drug is at a toxic level. Answer: FALSE Explanation: A toxic blood level produces a toxic effect, not an allergic reaction. 44) Lidocaine, when given intravenously, exerts a systemic effect. Answer: TRUE 45) A vitamin A-type drug used to treat severe acne was associated with the adverse effect of suicide. Answer: TRUE 46) A severe side effect is as adverse drug effect. Answer: TRUE 47) When an antibiotic drug is prescribed, its therapeutic effect is directed toward a target organ. Answer: FALSE Explanation: Its therapeutic effect is towards bacteria. 33 Copyright © 2022 Pearson Education, Inc.

48) All drugs approved by the FDA are entirely safe and without potential side effects and risks. Answer: FALSE Explanation: No drug is entirely safe and without side effects. 49) The adverse effects of a particular drug are more common than the side effects of that drug. Answer: FALSE Explanation: Adverse effects are not as common as side effects. 50) The knowledge and use of drugs to produce a therapeutic effect in the body is known as pharmacotherapy. Answer: TRUE 51) Chemically similar drugs can unlock and activate the same receptor. Answer: TRUE 52) Muscarinic and nicotinic are two types of cholinergic receptors. Answer: TRUE 53) Drugs that block H2 receptors in the stomach are used to decrease acid production. Answer: TRUE 54) Drugs taken orally usually exert a local effect. Answer: FALSE Explanation: Oral drugs exert a systemic effect. 55) Older drugs, such as aspirin, that have been widely used over a long period of time remain on the market because they have no side effects. Answer: FALSE Explanation: Aspirin is one of the oldest and most widely used drugs but it can cause serious side effects, such as gastric bleeding and an ulcer. 56) Some adverse effects are so unusual that it takes years before a cause-and-effect relationship can be established. Answer: TRUE 57) It is the FDA that tells a drug company to include a black box warning in the drug's Medication Guide, and magazine or television advertisements. Answer: TRUE 58) It has been estimated that for every dollar spent on prescription drugs, another dollar is spent to treat adverse reactions caused by those drugs. Answer: TRUE 59) Polypharmacy increases the chances of having a drug-drug or drug-food interaction. Answer: TRUE

60) Only after a drug is actually administered to the patient can the healthcare professional document that in the patient's electronic health record. Answer: TRUE 61) Patients with poor kidney function due to disease can have a significantly decreased rate of drug excretion, Answer: TRUE 62) Before a drug can receive final approval by the FDA, the drug company must state what routes of administration are safe and effective for that drug. Answer: TRUE 63) A drug can be effective and therapeutic, regardless of the route by which it is administered. Answer: FALSE Explanation: If not given by the correct route, a drug can be ineffective or harmful. 64) The topical route of administration of drugs always has a systemic effect on the body. Answer: FALSE Explanation: Topical drugs exert only a local effect. 65) The sublingual route of drug administration provides a faster therapeutic effect than the oral route. Answer: TRUE 66) The inhalation route of drug administration involves the inhaling a drug that is in a gas, liquid, or powder form. Answer: TRUE 67) Systemic absorption of a drug via the rectal route of administration is unpredictable. Answer: TRUE 68) The therapeutic effect of a drug given intravenously takes a while to be seen in the body as it has to travel through the systemic circulation. Answer: FALSE Explanation: The therapeutic effect of an intravenous drug is seen immediately or within hours. 69) Pregnant women are advised not to take any drugs, even over-the-counter drugs, except when prescribed by their healthcare provider. Answer: TRUE 70) The blood-brain barrier is a protective barrier between the brain and the blood vessels around the brain, and no drug can penetrate this barrier. Answer: FALSE Explanation: Some drugs are able to pass through. 71) Different forms of a drug are appropriate for different routes of administration. Answer: TRUE 35 Copyright © 2022 Pearson Education, Inc.

72) Tablets, capsules, and liquids are all given by the oral route. Answer: TRUE 73) Many drugs are administered via the buccal route. Answer: FALSE Explanation: Only a few drugs are given by the buccal route. 74) A tablet is not swallowed if it is given by the sublingual route. Answer: TRUE 75) When the healthcare provider writes the words "Dispense as written" on a prescription form that means that the pharmacist must fill it with a generic drug. Answer: FALSE Explanation: "Dispense as written" means the healthcare provider wants a trade name drug to be dispensed, not the generic substitute drug. 76) The abbreviation Sig. on a prescription form tells the pharmacist the quantity of drug to be dispensed. Answer: FALSE Explanation: Sig. tells the pharmacist what to write on the label. 77) The FDA can recall a drug if it does not remain stable until its expiration date. Answer: TRUE 3.3

Short Answer Questions

1) A/an ________ prescription is typed into the medical office's software system, and the healthcare provider's digital signature is automatically imprinted at the bottom of the prescription. Answer: electronic 2) A/An ________ ________ is the written record of a physician's order to the pharmacist to dispense a drug to a patient who is in the hospital or other healthcare facility. Answer: medication order 3) For Schedule drugs, the physician's assigned federal DEA number must be included for the prescription to be valid. The abbreviation DEA stands for ________ ________ ________. Answer: Drug Enforcement Agency 4) Verbal orders are also known as ________ orders. Answer: telephone 5) ________ orders contain common orders that are the same for any patient who has that specific disease or is scheduled for that surgical procedure. Answer: standing 36 Copyright © 2022 Pearson Education, Inc.

6) Define these abbreviations. DAW ________ DEA ________ Disp. ________ ERx ________ MTM ________ Answer: dispense as written; Drug Enforcement Agency; dispense; e-prescribing (or electronic prescribing); medication therapy management 7) The use of electronic prescription has reduced drug errors related to ________ handwriting. Answer: illegible 8) When a pharmacist cannot read a healthcare provider's handwritten prescription, the pharmacist should ________ the provider to confirm the drug and dose. Answer: call 9) When the physician's electronic signature is automatically imprinted at the bottom of a prescription, this is known as an ________ prescription, and the process is known as ________. Answer: electronic; e-prescribing. 10) A/An ________ order means that the physician wants the drug to be dispensed and administered immediately. Answer: stat 11) After receiving a medication order for a patient in the hospital, the pharmacist checks the hospital's drug ________ to be sure the pharmacy stocks that drug. Answer: formulary 12) Drug effects are initiated through ________, protein molecules that are located on the cell membranes of every cell. Answer: receptors 13) Some drugs bind to a certain receptor but cannot actually unlock or activate the receptor to produce an effect. These are known as ________ drugs or blocker drugs. Answer: antagonist 14) The most severe symptoms of an allergic reaction are collectively known as ________, which can lead to a type of shock. Answer: anaphylaxis 15) A drug ________is not a side effect and is not based on an allergic reaction. It is an individual's unique reaction to a drug based on that person's genetic makeup. Answer: idiosyncrasy 16) ________ occurs when two drugs combine to produce an effect that is greater than the independent effect of each drug. Answer: Synergism 37 Copyright © 2022 Pearson Education, Inc.

17) ________ occurs when two drugs combine to produce an effect that is less than the intended effect for either drug. Answer: Antagonism 18) An allergy is a reaction that occurs when the body's immune system identifies a foreign substance, such as drug, which is known as a/an ________, and initiates an antibody response against it. Answer: antigen 19) ________ is the study of how a person's genetic makeup affects his or her response to a drug. Answer: Pharmacogenetics 20) A/An ________ drug acts like a key and unlocks and activates a receptor, which is like the lock. Answer: agonist 21) Drugs that block H1 receptors are known as ________ drugs. Answer: antihistamine 22) Drugs like nasal sprays and topical creams and ointments usually exert a/an ________ drug effect. Answer: local 23) The FDA usually does not take a/an ________ drug that is used to treat cancer off the market because of its side effects, because the cancer is a life-threatening condition and the side effects are not. Answer: chemotherapy 24) ADR stands for ________ ________ ________. Answer: adverse drug reaction 25) The antibiotic drug ciprofloxacin has a black box warning because it can cause the unusual adverse effect of a/an ________ rupture. Answer: tendon 26) ________ is a toxic effect on the kidneys that is caused by the antibiotic drug gentamicin. Answer: Nephrotoxicity 27) In the hospital, patients who are allergic to something are given a/an ________ allergy alert bracelet to wear. Answer: red 28) ________ is when a patient takes five or more drugs daily. Answer: Polypharmacy

29) It is the ________ who applies warning labels to the prescription bottle to warn the patient of possible drug-drug interactions or side effects. Answer: pharmacist 30) Some "statin" drugs cannot be taken with ________ juice because it causes a toxic level of the drug. Answer: grapefruit 31) Once a drug is administered, it goes through the four steps of the ________ ________. Answer: drug cycle 32) The ________ route of administration differs from the topical route in that the drug is applied to the skin, but the therapeutic effects are felt systemically, not just at the site of administration. Answer: transdermal 33) ________ administration involves placing the drug under the tongue and allowing it to slowly disintegrate and dissolve. Answer: Sublingual 34) ________ administration involves placing the drug between the cheek and the lower teeth on one side of the mouth and allowing it to slowly dissolve. Answer: Buccal 35) ________ is the study of how drugs move through the body in the processes of absorption, distribution, metabolism, and excretion. Answer: Pharmacokinetics 36) As a drug enters the blood, some of the drug binds to circulating plasma proteins, such as ________. Answer: albumin 37) The process of metabolism is also known as ________ because the drug is gradually transformed as it is metabolized. Answer: biotransformation 38) Give the medical abbreviation for each of these medical words or phrases. Intramuscular ________ Intravenous ________ Subcutaneous ________ Right eye ________ Left ear ________ Both eyes ________ Answer: IM or I.M.; IV or I.V.; subQ or SQ or subcu; O.D.; A.S.; O.U. 39) Only ________ drugs can be given through a nasogastric tube. Answer: liquid 39 Copyright © 2022 Pearson Education, Inc.

40) For subcutaneous administration of a liquid drug, the needle of the syringe is inserted at a/n ________ degree angle. Answer: 45 41) An intramuscular injection must be given into a muscle that is large enough that the needle will not accidentally injure a nearby ________. Answer: nerve 42) Adding a drug to a small IV bag whose tubing is connected to the main IV tubing is known as IV ________. Answer: piggyback 43) The intra-articular route is used to administer a drug into a/an ________. Answer: joint 44) The ________ route administers a drug into the cerebrospinal fluid and is used to produce regional spinal anesthesia during childbirth. Answer: epidural 45) The ________ is the principal organ for drug metabolism. Answer: liver 46) A/An ________ is a medicolegal document written by a physician or other qualified healthcare provider to a community pharmacist to dispense a drug. Answer: prescription 47) The abbreviation DEA stands for ________ ________ ________. Answer: Drug Enforcement Agency 48) The abbreviation DAW stands for ________ ________ ________. Answer: Dispense as written. 49) ________ orders are a group of specific standardized orders that pertain to a protocol of treatment related to a disease or a surgical procedure. Answer: Standing 50) Prescriptions for ________ drugs must be written on a special prescription form that has security features like a control number, special ink, and an imprinted seal. Answer: Schedule 51) A healthcare provider can prescribe a drug that the FDA has not approved for that patient's disease. This is known as a/an ________ use Answer: off-label

52) The drug manufacturer's drug bottle comes with a preprinted patient ________ ________ that describes the drug's indications, dosages, side effects, etc. Answer: Medication Guide 53) The pharmacist provides patients with assistance to prevent medication errors and improve patient compliance. This service is known as ________ ________ ________. Answer: medication therapy management 54) In a hospital, used needles and syringes are disposed of in specially marked red containers known as ________ containers. Answer: sharps 3.4

Matching Questions

Match the type of information in Column 1 with the place where that information appears in Column 2. A) is not written or typed on either the prescription form or the order sheet in the hospital B) is written/typed on both a prescription form and on an order sheet in the hospital C) is only written/typed on a prescription form 1) date 2) DEA number 3) drug form 4) preprinted identifying information about the prescriber 5) quantity to be dispensed 6) healthcare provider's signature 7) preprinted identifying information about the patient 8) abbreviation Rx Answers: 1) B 2) C 3) B 4) C 5) B 6) B 7) A 8) C

Match the abbreviations in Column 1 with their definitions in Column 2. A) three times a day B) before meals C) at bedtime D) every day E) as needed 9) a.c. 10) h.s. 11) p.r.n. 12) q.d. 13) t.i.d. Answers: 9) B 10) C 11) E 12) D 13) A Match the routes of administration in Column 1 with their definitions in Column 2. A) within the bladder B) between the cheek and the teeth C) within the muscle D) within the vein (the blood) E) within the skin F) apart from the intestine G) in the fatty tissue under the skin 14) intradermal 15) intramuscular 16) intravenous 17) parenteral 18) subcutaneous 19) buccal 20) intravesical Answers: 14) E 15) C 16) D 17) F 18) G 19) B 20) A

3.5

Essay Questions

1) A patient's body weight is sometimes (but not always) included on a prescription form. Explain why this information might be useful to include. Answer: Weight is important to know when the patient is older, extremely thin, extremely obese, or is a child. The dose of the drug may need to be adjusted if an adult patient's weight is very low or very high. Pediatric doses, especially for premature babies and infants, are calculated based on body weight, not the age. Because the weight of the child increases regularly, the drug dose needs to be recalculated periodically when a child is on long-term drug therapy. 2) When a healthcare provider prescribes a drug's strength, there is a limitation as to what can be written in the order. Describe what that limitation is, giving an example to justify your explanation. Answer: The provider must prescribe a drug strength that corresponds exactly to the strength in which the drug is manufactured. Example: If the drug is manufactured in 25 mg and 50 mg tablets, the provider cannot write a prescription for an 80 mg tablet. However, if the drug is manufactured as a scored tablet, the provider can write a prescription for exactly one-half of the amount in one tablet. 3) Explain why many healthcare providers prescribe a trade name drug rather than the generic equivalent, even though the generic equivalent costs less for the patient. Answer: Many healthcare providers prefer to rely on the proven therapeutic effect of a trade name drug, especially for certain critical drugs, such as digoxin (Lanoxin) for congestive heart failure and phenytoin (Dilantin) for seizures. 4) How can the patient keep taking his/her prescribed drugs when he/she is discharged from the hospital to another healthcare facility, such as a nursing home? Answer: The hospital provider lists all of the patient's drugs in the hospital's discharge summary. That is sent to the other healthcare facility, and the healthcare provider there must reorder the patient's drugs. 5) Briefly explain the difference between the local effect of a drug and the systemic effect of a drug. Answer: A local drug effect is limited to the site of administration and to those tissues immediately surrounding the site. A systemic drug effect is one that is felt throughout the body. 6) Many drugs (such as antihistamine drugs) have both a therapeutic effect and side effects. Side effects can either be undesirable or beneficial. Describe how antihistamine drugs can have a side effect that is both undesirable and beneficial. Answer: Antihistamine drugs, when given orally to treat allergies, produce drowsiness. This side effect is undesirable, particularly in patients who must drive or operate machinery. However, this side effect of drowsiness can become the therapeutic effect when an antihistamine drug is used to treat insomnia. Because of this use, antihistamine drugs are a common ingredient in over-the-counter sleep aids.

7) Some side effects of a drug are common. Name several of the common side effect associated with the gastrointestinal system,. Answer: Common gastrointestinal side effects of many drugs include anorexia (lack of appetite), nausea, vomiting, or diarrhea. 8) Discuss what can happen and why when a patient drinks grapefruit juice when taking a "statin" drug. Answer: Grapefruit juice blocks an enzyme that normally breaks down part of the "statin" drug dose in the intestine before it even enters the blood. When grapefruit blocks this enzyme, more of the "statin" drug enters the blood, and this can produce a toxic effect with a blood level of the "statin" drug that is 15 times higher than the therapeutic dose. 9) Name the seven rights of drug administration. Answer: The right drug, the right drug form, the right drug dose, the right route of administration, the right time, the right patient, and the right documentation. 10) Describe the three times that the healthcare professional should check the drug name against the drug order. Answer: When the drug is taken from the medication cart, when it is poured or placed in a cup, and before giving it to the patient. 11) List three disadvantages associated with the oral route of drug administration. Answer: It is difficult for some patients to swallow the largest tablets and capsules. The oral route cannot be used for patients who are unconscious or vomiting. Some drugs are inactivated by stomach acid and cannot be given orally. 12) Describe how your own personal unused drugs can be disposed of properly. Answer: Crush or dissolve the drug in water and then put it in with coffee-grounds, kitty litter, or another inedible substance. Put it in a plastic bag, seal it, and put it in the trash.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 4 Gastrointestinal Drugs 4.1

Multiple Choice Questions

1) Which of the following is NOT an area where a peptic ulcer can form? A) duodenum B) esophagus C) colon D) stomach Answer: C Explanation: A) Peptic ulcers can form in the duodenum. B) Peptic ulcers can form in the esophagus. C) Correct. Peptic ulcers do not form in the colon D) Peptic ulcers can form in the stomach. 2) Antacid drugs are weak ________. A) acids that exert a therapeutic effect by neutralizing hydrochloric acid B) acids that exert a therapeutic effect by neutralizing pepsin C) bases that exert a therapeutic effect by neutralizing hydrochloric acid D) bases that exert a therapeutic effect by neutralizing pepsin Answer: C Explanation: A) Antacid drugs neutralize acid, so they would not be acids themselves. B) Antacid drugs neutralize acids, so they would not be acids themselves. C) Correct. Antacid drugs are weak bases. D) Antacid drugs neutralize hydrochloric acid, not pepsin. 3) Which of the following statements is FALSE? A) H2 blocker drugs block histamine receptors on the parietal cells of the stomach. B) The parietal cells of the stomach release histamine. C) The parietal cells of the stomach produce hydrochloric acid. D) H2 blocker drugs block histamine receptors. Answer: B Explanation: A) This statement is true. B) Correct. The parietal cells release hydrochloric acid, not histamine. C) This statement is true. D) This statement is true.

4) Antidiarrheal drugs produce a therapeutic effect by ________. A) absorbing extra water from diarrhea stools B) slowing the frequency of contractions (peristalsis) in the intestines C) absorbing extra water from diarrhea stools or slowing peristalsis in the intestines D) using osmotic pressure to attract water into the stool Answer: C Explanation: A) This is true, but it is not the entire answer. B) This is true, but it is not the entire answer. C) Correct. Antidiarrheal drugs have these two actions. D) This describes the action of a laxative drug, not an antidiarrheal drug. 5) The rectal route of administration is used________. A) to give an antiemetic drug to patients who are actively vomiting. B) to treat hemorrhoids topically C) to treat inflammatory bowel disease D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. Every statement is correct. 6) Gastric stimulant drugs increase the frequency of gastric emptying and are used to treat ________. A) gastroesophageal reflux disease B) constipation C) H. pylori infection D) obesity Answer: A Explanation: A) Correct. Gastric stimulant drugs are used to treat gastroesophageal reflux disease. B) Gastric stimulant drugs are not used to treat constipation. C) Gastric stimulant drugs are not used to treat H. pylori infection. D) Gastric stimulant drugs are not used to treat obesity.

7) Which of the following can stimulate the chemoreceptor trigger zone and vomiting center in the brain? A) antiemetic drugs B) chemotherapy drugs C) hydrochloric acid D) laxative drugs Answer: B Explanation: A) Antiemetic drugs are used to treat vomiting; they do not stimulate it. B) Correct. Chemotherapy drugs stimulate the chemoreceptor trigger zone and vomiting center. C) Hydrochloric acid does not stimulate the vomiting center. D) Laxative drugs do not stimulate the vomiting center. 8) Which drug acts binds to the surface of a duodenal ulcer, forming a protective layer or "bandage" that allows the ulcer to heal? A) esomeprazole (Nexium) B) orlistat (Alli, Xenical) C) Helidac D) sucralfate (Carafate) Answer: D Explanation: A) Esomeprazole does not form a protective layer on a peptic ulcer. B) Orlistat is used to treat obesity, not a peptic ulcer. C) Helidac is used to treat H. pylori infection, not a peptic ulcer. D) Correct. Sucralfate (Carafate) forms a "bandage" over an ulcer. 9) Successful treatment of an H. pylori infection involves the use of a combination of drugs that include all of the following, EXCEPT ________. A) an antibiotic/antiprotozoal drug B) a bismuth drug C) a proton pump inhibitor drug D) an antacid drug Answer: D Explanation: A) These drugs ARE used to treat H. pylori infection. B) This drug IS used to treat H. pylori infection. C) This drug IS used to treat H. pylori infection. D) Correct. Antacid drugs are not used to treat H. pylori infection.

10) GERD is treated with all of the following drugs EXCEPT ________. A) antacid drugs B) appetite suppressant drugs C) H2 blocker drugs D) gastric stimulant drugs Answer: B Explanation: A) Antacid drugs ARE used to treat GERD. B) Correct. Appetite suppressant drugs are used to treat obesity. C) H2 blocker drugs ARE used to treat GERD. D) Gastric stimulant drugs ARE used to treat GERD. 11) Anticholinergic drugs block the action of acetylcholine and this ________. A) decreases the rate of peristalsis in the intestine B) stimulate the rate of peristalsis to move food through the intestine C) absorbs excess water from the intestine D) stimulate the release of hydrochloric acid in the stomach Answer: A Explanation: A) Correct. Anticholinergic drugs decrease peristalsis in the stomach B) This is not the effect of anticholinergic drugs. C) This is not the effect of anticholinergic drugs. D) Acetylcholine is not related to the release of hydrochloric acid. 12) Which category of laxative drug has the most natural and safest action? A) bulk-forming laxative drugs B) chloride channel activator laxative drugs C) osmotic laxative drugs D) stool softener laxative drugs Answer: A Explanation: A) Correct. Bulk-forming laxative drugs are the most natural and safest. B) Chloride channel activator laxative drugs do not have the most natural and safest action of all laxative drugs. C) Osmotic laxative drugs do not have the most natural and safest action of all laxative drugs. D) Stool softener laxative drugs do not have the most natural and safest action of all laxative drugs.

13) Chloride channel activator laxative drugs, such as lubiprostone (Amitiza), stimulate chloride channels in the mucosa of the intestinal wall. This causes ________. A) the release of hydrochloric acid in the stomach B) a "bandage" to form over a gastric ulcer C) fluid to flow into the intestines to soften the stool D) lipase in the diet to be excreted in the stool rather than absorbed Answer: C Explanation: A) Chloride channel laxative drugs do not cause the release of hydrochloric acid. B) This describes the action of sucralfate (Carafate), not chloride channel laxative drugs. C) Correct. Chloride channel activator laxative drugs have this action. D) This describes lipase inhibitor drugs, not chloride channel laxative drugs. 14) A proton pump inhibitor drug can be used to treat all of the following GI diseases, EXCEPT ________. A) GERD B) gastric and peptic ulcers C) obesity D) H. pylori infections Answer: C Explanation: A) Proton pump inhibitor drugs ARE used to treat GERD. B) Proton pump inhibitor drugs ARE used to treat gastric and peptic ulcers. C) Correct. Proton pump inhibitor drugs are not used to treat obesity. D) Proton pump inhibitor drugs ARE used to treat H. pylori infections. 15) Appetite suppressant drugs are also known as ________ drugs. A) proton pump inhibitor B) absorbent C) antacid D) anorexiant Answer: D Explanation: A) Appetite suppressant drugs are not known as proton pump inhibitor drugs. B) Appetite suppressant drugs are not known as absorbent drugs. C) Appetite suppressant drugs are not known as antacid drugs. D) Correct. Appetite suppressant drugs are also known as anorexiant drugs.

16) All of these drugs and substances irritate the mucous membranes and can cause an ulcer, EXCEPT ________. A) aspirin B) NSAIDs C) antiemetic drugs D) alcohol and caffeine Answer: C Explanation: A) Aspirin does irritate the mucous membrane. B) Nonsteroidal anti-inflammatory drugs (NSAIDs) do irritate the mucous membranes. C) Correct. Antiemetic drugs do not irritate the mucous membranes or cause an ulcer. D) Alcohol and caffeine do irritate the mucous membranes. 17) A drawback to the use of home remedies such as sodium bicarbonate and baking soda to treat heartburn is their ________. A) ineffectiveness B) high cost C) high sodium content D) inability to neutralize acid Answer: C Explanation: A) These are effective home remedies for heartburn. B) These home remedies for heartburn are not expensive. C) Correct. Sodium bicarbonate and baking soda have a high sodium content. D) These home remedies do neutralize acid. 18) All of the following trade names are antiemetic drugs, EXCEPT ________. A) Alli, Xenical B) Dramamine C) Marinol, Syndros D) Transderm-Scop Answer: A Explanation: A) Correct. This is NOT an antiemetic drug. It is a weight loss drug. B) Dramamine is an antiemetic drug. C) Marinol and Syndros are antiemetic drugs. D) Transderm-Scop is an antiemetic drug.

19) All of the following are bulk-producing laxative drugs, EXCEPT ________. A) psyllium B) Metamucil C) Mylanta D) Fibercon Answer: C Explanation: A) Psyllium is a bulk-producing laxative drug. B) Metamucil is a bulk-producing laxative drug. C) Correct. Mylanta is a combination antacid drug. D) Fibercon is a bulk-producing laxative drug. 20) The suffix -tidine is common to generic ________ drugs. A) antacid B) antidiarrheal C) H2 blocker D) stool softener laxative Answer: C Explanation: A) The suffix -tidine is not common to antacid drugs. B) The suffix -tidine is not common to antidiarrheal drugs. C) Correct. The suffix -tidine is common to H2 blocker drugs. D) The suffix -tidine is not common to stool softener laxative drugs. 21) Which of the following statements is FALSE? A) The trade name of famotidine is Pepcid. B) The HB in Tagamet HB stands for histamine blocker. C) The AC in Pepcid AC stands acid control or it may refer to the Latin phrase ante cibum. D) Calcium-containing antacids should not replace calcium intake in the diet. Answer: B Explanation: A) This is a true statement. B) Correct. The HB stands for heartburn. C) This is a true statement. D) This is a true statement. 22) All of the following are laxative drugs EXCEPT ________. A) Milk of Magnesia B) bisacodyl (Correctol, Dulcolax) C) lubiprostone (Amitiza) D) mesalamine (Asacol, Lialda) Answer: D Explanation: A) Milk of Magnesia is a laxative drug. B) Bisacodyl is a laxative drug. C) This is a chloride channel activator laxative drug. D) Correct. Mesalamine (Asacol, Lialda) is used to treat ulcerative colitis. 7 Copyright © 2022 Pearson Education, Inc.

23) Trade names for the laxative drug docusate include ________. A) Colace, Surfak B) Asacol, Delzicol C) Donnatal, Librax D) Tums, MOM Answer: A Explanation: A) Correct. These are trade names for docusate. B) These are 5-ASA drugs, not laxative drugs. C) Donnatal and Librax are combination drugs for irritable bowel syndrome. D) Tums and MOM are antacid drugs, not laxative drugs. 24) Which of the following is an H2 blocker drug? A) esomeprazole (Nexium) B) famotidine (Pepcid) C) metoclopramide (Reglan) D) diphenhydramine (Benadryl) Answer: B Explanation: A) Esomeprazole is not an H2 blocker drug. B) Correct. Famotidine (Pepcid) is an H2 blocker drug. C) Metoclopramide is not an H2 blocker drug. D) Diphenhydramine is not an H2 blocker drug. 25) Cimetidine is the generic name for the trade name drug ________. A) Maalox B) Prilosec C) Cytotec D) Tagamet Answer: D Explanation: A) Maalox is not a trade name for cimetidine. B) Prilosec is not a trade name for cimetidine. C) Cytotec is not a trade name for cimetidine. D) Correct. Cimetidine (Tagamet).

26) Which of the following statements is FALSE? A) Simethicone is an antiflatulent drug. B) Simethicone is used to treat intestinal gas. C) Simethicone changes the surface tension of air bubbles in the GI tract. D) Simethicone is used to treat diarrhea. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. Simethicone is not used to treat diarrhea. 27) Di-Gel, Gelusil, and Rolaids are all examples of ________. A) H2 blocker drugs B) irritant/stimulant laxative drugs C) combination antacid drugs D) antiemetic drugs Answer: C Explanation: A) These are not H2 blocker drugs. B) These are not irritant/stimulant laxative drugs. C) Correct. These are combination antacid drugs. D) These are not antiemetic drugs. 28) Which of the following statements is TRUE? A) Proton pump inhibitor drugs are used to treat diarrhea. B) The proton pump is located in the intestine. C) Proton pump inhibitor drugs are the drug of choice for appetite suppression and weight loss. D) The proton pump is an enzyme involved in the production of hydrochloric acid. Answer: D Explanation: A) Proton pump drugs are not used to treat diarrhea. B) The proton pump is located in the stomach, not the intestine. C) Proton pump drugs are not used for weight loss. D) Correct. 29) The suffix -prazole is common to generic ________. A) proton pump inhibitor drugs B) appetite suppressant drugs C) antacid drugs D) bulk-producing laxative drugs Answer: A Explanation: A) Correct. The suffix -prazole is common to proton pump inhibitor drugs. B) The suffix -prazole is not common to generic appetite suppressant drugs. C) The suffix -prazole is not common to generic antacid drugs. D) The suffix -prazole is not common to generic bulk-producing laxative drugs. 9 Copyright © 2022 Pearson Education, Inc.

30) Gastric stimulant drugs ________. A) are used to treat GERD B) include metoclopramide (Reglan) C) cause the stomach to empty more frequently D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 31) All of the following can contribute to gastric and peptic ulcer formation, EXCEPT ________. A) aspirin and nonsteroidal anti-inflammatory drugs B) antibiotic drugs C) the use of alcohol D) the use of caffeine Answer: B Explanation: A) These can contribute to ulcer formation. B) Correct. Antibiotic drugs do not contribute to ulcer formation. C) This can contribute to ulcer formation. D) This can contribute to ulcer formation. 32) A unique characteristic of Transderm-Scop is that it is ________. A) the first FDA-approved weight loss drug B) a transdermal skin patch worn behind the ear C) effective for both heartburn and motion sickness D) given orally Answer: B Explanation: A) Alli is the first over-the-counter FDA-approved weight loss drug, not Transderm-Scop. B) Correct. This drug is a transdermal skin patch. C) This drug is not used to treat heartburn. D) This drug is not given orally.

33) Crohn disease ________. A) affects the ileum and colon B) is also known as regional enteritis C) is characterized by inflammation, ulcers, and "skip areas" D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 34) Which of the following is a combination trade name drug that contains an anti-infective drug (bismuth), an antibiotic drug (tetracycline), and an antiprotozoal drug (metronidazole) and is used to treat H. pylori infection of the stomach? A) Xenical B) Helidac C) AcipHex D) Tums Answer: B Explanation: A) Xenical is not used to treat H. pylori infection. B) Correct. Helidac is used to treat H. pylori infection. C) AcipHex is not used to treat H. pylori infection. D) Tums is not used to treat H. pylori infection. 35) All of the following are trade name proton pump inhibitor drugs, EXCEPT ________. A) Lomotil B) Prilosec C) Nexium D) Prevacid Answer: A Explanation: A) Correct. Lomotil is a combination antidiarrheal drug. B) Prilosec is a proton pump inhibitor drug. C) Nexium is a proton pump inhibitor drug. D) Prevacid is a proton pump inhibitor drug.

36) Which of the following antidiarrheal drugs is a Schedule III opioid drug? A) paregoric B) Pepto-Bismol C) Cipro D) lactase Answer: A Explanation: A) Correct. Paregoric is an opioid drug. B) Pepto-Bismol is not a Schedule drug. C) Cipro is not a Schedule drug. D) Lactase is not a Schedule drug. 37) All of the following are 5-aminosalicylic acid drugs used to treat ulcerative colitis, EXCEPT ________. A) mesalamine (Asacol, Lialda, Pentasa) B) balsalazide (Colazal) C) sulfasalazine (Azulfidine) D) linaclotide (Linzess) Answer: D Explanation: A) These are 5-aminosalicylic acid drugs. B) These are 5-aminosalicylic acid drugs. C) These are 5-aminosalicylic acid drugs. D) Correct. Linaclotide (Linzess) is a GC-C agonist drug used to treat IBS with constipation. 38) Which of the following statements is TRUE? A) The weight loss drug Alli can cause fatty stools that pass involuntarily. B) Orlistat was the first prescription drug approved by the FDA for weight loss. C) Lipase inhibitor drugs inhibit fats from being absorbed in the small intestine. D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 39) All of the following drug categories are used to treat Crohn disease and ulcerative colitis, EXCEPT ________. A) interleukin inhibitor drugs B) corticosteroid drugs C) tumor necrosis factor blocker drugs. D) appetite suppressant drugs Answer: D Explanation: A) These drugs are used to treat Crohn disease and ulcerative colitis. B) These drugs are used to treat Crohn disease and ulcerative colitis. C) These drugs are used to treat Crohn disease and ulcerative colitis. D) Correct. Appetite suppressant drugs are not used to treat Crohn disease and ulcerative colitis. 12 Copyright © 2022 Pearson Education, Inc.

40) Janie Wallace is taking an appetite suppressant drug. She should be aware of which of these statements? A) Appetite suppressant drugs should be in conjunction with lifestyle changes and dietary restrictions. B) Appetite suppressant drugs should be taken only on a short-term basis. C) These are Schedule III and IV drugs with the potential for addiction. D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 41) All of the following statements are true, EXCEPT ________. A) Helicobacter pylori are helical (spiral) bacteria. B) Helicobacter pylori have flagella (thin, whiplike tails). C) Helicobacter pylori are the cause of some gastric ulcers that do not heal. D) Helicobacter pylori infections are treated with lipase inhibitor drugs. Answer: D Explanation: A) This statement is true. B) This statement is true. C) This statement is true. D) Correct. Lipase inhibitor drugs are used for weight loss, not to treat infection. 42) Irritable bowel syndrome, characterized by cramping and diarrhea alternating with constipation, is treated with all of the following categories of drugs EXCEPT ________. A) GC-C agonist drugs B) antacid drugs C) antispasmodic drugs D) opioid receptor agonist drugs Answer: B Explanation: A) Irritable bowel syndrome is treated with GC-C agonist drugs. B) Correct. Antacid drugs are not used to treat irritable bowel syndrome. C) Irritable bowel syndrome is treated with antispasmodic drugs. D) Irritable bowel syndrome is treated with opioid receptor agonist drugs.

43) Combination antacid drugs contain each of the following as an active ingredient, EXCEPT ________. A) calcium carbonate B) aspirin C) sodium bicarbonate D) magnesium hydroxide. Answer: B Explanation: A) This is an ingredient in antacid drugs. B) Correct. Combination antacid drugs do not contain aspirin as it irritates the stomach. C) This is an ingredient in antacid drugs. D) This is an ingredient in antacid drugs. 44) Which of the following is NOT a trade name for the generic drug mesalamine that is used to treat ulcerative colitis? A) Linzess B) Asacol C) Pentasa D) Lialda Answer: A Explanation: A) Correct. Linzess is the trade name for linaclotide. B) This IS a trade name for mesalamine. C) This IS a trade name for mesalamine. D) This IS a trade name for mesalamine. 45) The generic drug lubiprostone, a chloride channel activator drug used to treat irritable bowel syndrome, is related to the well-known trade name drug ________. A) Tagamet B) Zelnorm C) Amitiza D) Mylanta Answer: C Explanation: A) Tagamet is the trade name for cimetidine, not lubiprostone. B) Zelnorm is not a trade name for lubiprostone. C) Correct. Amitiza is the trade name for lubiprostone. D) Mylanta is not a trade name for lubiprostone.

46) Lifestyle changes for treating GERD include all of the following EXCEPT ________. A) eating small, frequent meals B) avoiding spicy and fermented foods and alcohol C) sleeping with the head of the bed up D) avoiding a fatty meal Answer: D Explanation: A) This is a lifestyle change for GERD. B) This is a lifestyle change for GERD. C) This is a lifestyle change for GERD. D) Correct. This is a lifestyle change needed when taking lipase inhibitor drugs, not for GERD. 47) All of the following are corticosteroid drugs used to treat inflammatory bowel disease EXCEPT ________. A) hydrocortisone (Colocort, Cortef, Cortenema) B) methylprednisolone (Depo-Medrol, Medrol) C) budesonide (Entocort) D) ustekinumab (Stelara) Answer: D Explanation: A) This is a corticosteroid drug. B) This is a corticosteroid drug. C) This is a corticosteroid drug. D) Correct. This is an interleukin inhibitor drug. 4.2

True/False Questions

1) Ulcerative colitis is a chronic disease of the esophagus and stomach. Answer: FALSE Explanation: Ulcerative colitis is in the colon, not the esophagus and stomach. 2) Peptic ulcers begin with irritation or infection of the mucous membranes. Answer: TRUE 3) Simethicone relieves gas trapped in the GI tract because of its action as an antacid drug. Answer: FALSE Explanation: Simethicone is an antiflatulent (anti-gas) drug, not an antacid. 4) Opioid drugs are commonly used for moderate-to-severe pain, but have a side effect of causing constipation which is used as the therapeutic effect in treating diarrhea. Answer: TRUE 5) Corticosteroid drugs used to treat Crohn disease and ulcerative colitis have a powerful anti-inflammatory effect. Answer: TRUE

6) The suffix -tidine is common to generic H2 blocker drugs. Answer: TRUE 7) Appetite suppressant drugs for obesity are chemically similar to amphetamine drugs, but are less addictive than amphetamine drugs. Answer: TRUE 8) Patients who are actively vomiting and cannot take oral drugs can be given antiemetic drugs in the form of a rectal suppository. Answer: TRUE 9) Lipase inhibitor drugs chemically bond to the enzyme lipase to improve its ability to break down dietary fat in the intestines. Answer: FALSE Explanation: These drug bond to lipase and keep it from breaking down dietary fat. 10) Patients taking appetite suppressant drugs for obesity may develop dependence and withdrawal symptoms if these drugs are discontinued abruptly, because these are Schedule III and Schedule IV drugs. Answer: TRUE 11) Cimetidine (Tagamet) was the first H2 blocker drug to be approved by the FDA. Answer: TRUE 12) A drug that blocks a receptor (such as an H2 blocker drug) is known as an antagonist drug. Answer: TRUE 13) The trade name AcipHex refers to the drug's effect on the acid content and pH level of the stomach. Answer: TRUE 14) Anticholinergic drugs are used to treat diarrhea because they increase the frequency of peristalsis in the intestines. Answer: FALSE Explanation: Anticholinergic drugs decrease the frequency of peristalsis. 15) Famotidine (Pepcid) became the first prescription H2 blocker drug to be approved by the FDA for over-the-counter use to be purchased by consumers. Answer: TRUE 16) A patient with a bleeding ulcer is immediately given an intravenous antacid drug in the emergency room. Answer: FALSE Explanation: The patient is immediately given an intravenous H2 blocker drug.

17) Stool softener laxative drugs act as emulsifiers that allow fat and water to mix together to soften the stool. Answer: TRUE 18) Prostaglandin drugs are used to prevent or treat peptic ulcers that were caused by the patient taking nonsteroidal anti-inflammatory drugs (NSAIDs) for chronic pain. Answer: TRUE 19) The lipase inhibitor drug orlistat (Alli, Xenical) causes fat-soluble vitamins (A, D, E, and K) to be excreted in the stool. Answer: TRUE 20) Prescription weight-loss drugs are safe and free of side effects. Answer: FALSE Explanation: Some of these drugs have caused strokes, disease of the heart valves, and cancer and have been taken off the market. 21) Dulcolax is an osmotic laxative drug. Answer: FALSE Explanation: Dulcolax is an irritant/stimulant laxative drug. 22) Diphenhydramine (Benadryl) is the only FDA-approved prescription drug for treating the nausea and vomiting of pregnancy. Answer: FALSE Explanation: The combination drug Diclegis is the only FDA-approved prescription drug for treating the nausea and vomiting of pregnancy. 23) Cannabinoid drugs, which are a synthetic version of marijuana, are used to treat nausea and vomiting caused by chemotherapy drugs. Answer: TRUE 24) The use of calcium-containing antacid drugs is a good way for women to get the calcium they need in their diets. Answer: FALSE Explanation: Antacid drugs should not take the place of adequate calcium intake in the diet. 25) Phenothiazine derivative drugs belong to the antipsychotic drug category, but they are also used to treat nausea and vomiting. Answer: TRUE 26) Histamine activates receptors on the parietal cells in the stomach, causing them to produce hydrochloric acid. Answer: TRUE 27) Proton pump drugs can decrease the amount of hydrochloric acid produced in the stomach for a longer period of time than H2 blocker drugs. Answer: TRUE 17 Copyright © 2022 Pearson Education, Inc.

28) Traveler’s diarrhea can be caused by a bacterial or protozoal infection. Answer: TRUE 29) A GI cocktail that contains an anesthetic drug, an antacid drug, and a weight loss drug is given to a patient who has a bleeding peptic ulcer. Answer: FALSE Explanation: A GI cocktail contains an anesthetic drug, an antacid drug, and an antispasmodic drug. 4.3

Short Answer Questions

1) Peptic ulcers in the stomach are specifically known as ________ ulcers. Answer: gastric 2) The suffix -mab is common to ________ ________ drugs. Answer: monoclonal antibody 3) ________ drugs are used to control the nausea and vomiting that is associated with many different diseases or chemotherapy. Answer: Antiemetic 4) The abbreviation MOM stands for the generic antacid drug name ________. Answer: Milk of Magnesia 5) GERD occurs when stomach acid flows back into the esophagus causing irritation, inflammation, and pain. The abbreviation GERD stands for ________. Answer: gastroesophageal reflux disease 6) Another name for an irritant/stimulant laxative drug that stimulates peristalsis is a/an ________ drug. Answer: cathartic 7) Opioid drugs for the relief of severe, chronic pain have an unfortunate intestinal side effect of causing ________. Answer: constipation 8) The abbreviation NSAID stands for the drug category known as ________ ________ ________. Answer: nonsteroidal anti-inflammatory drugs 9) In 1977, the first H2 blocker drug was approved. Its trade name, ________ was formed from a combination of syllables from the words antagonist and the generic drug name cimetidine. Answer: Tagamet

10) Maggie Floyd informs you that she is taking "the purple pill" for her GERD, but she can't remember the name of it. ________ is the trade name of the drug is she taking. Answer: Nexium 11) The drug hydrocortisone (Cortifoam) is an aerosol foam that is placed in the rectum to treat ________. Answer: hemorrhoids 12) In the phrase antiemetic drug, the word part emet/o- means ________. Answer: vomiting 13) The common name for gastroesophageal reflux disease (GERD) is ________. Answer: heartburn 14) Helicobacter pylori are spiral ________ that have thin, whiplike tails; they cause gastric ulcers. Answer: bacteria 15) A/An ________ drug is used to prevent or treat intestinal gas. Answer: antiflatulent 16) ________ causes red, itchy eyes, but it also stimulates the production of hydrochloric acid in the stomach. Answer: Histamine 17) The HB in the drug Tagamet HB stands for ________. Answer: heartburn 18) The antacid drugs Alka-Seltzer contains sodium bicarbonate. When used as an old home remedy for indigestion and heartburn, sodium bicarbonate is known as ________ ________. Answer: baking soda 19) The unusual internal capitalization of the trade name drug AcipHex reflects the drug’s action to lower the ________ of the stomach. Answer: pH 20) ________ drugs directly stimulate the vomiting center, and without antiemetic therapy, a patient might discontinue this lifesaving therapy. Answer: Chemotherapy 21) The A-D in the anticholinergic trade name drug Imodium A-D means ________. Answer: anti-diarrheal 22) In the over-the-counter drug Pepto-Bismol, Pepto refers to the adjective peptic, and Bismol refers to the drug ________. Answer: bismuth 19 Copyright © 2022 Pearson Education, Inc.

4.4

Matching Questions

Match the drug categories in Column 2 with their correct generic and trade name drugs in Column 1. A) antihistamine drug for vomiting B) bulk-forming laxative drug C) serotonin 5-HT3 receptor blocker drug for vomiting D) proton pump inhibitor drug E) anticholinergic drug for diarrhea F) tumor necrosis factor blocker drug G) stool softener laxative drug H) gastric stimulant drug I) appetite suppressant drug J) lipase inhibitor drug 1) liraglutide (Saxenda) 2) docusate (Colace, Surfak) 3) adalimumab (Humira) 4) loperamide (Imodium A-D) 5) metoclopramide (Reglan) 6) psyllium (Metamucil) 7) omeprazole (Prilosec) 8) orlistat (Alli, Xenical) 9) dimenhydrinate (Dramamine) 10) ondansetron (Zofran) Answers: 1) I 2) G 3) F 4) E 5) H 6) B 7) D 8) J 9) A 10) C 4.5

Essay Questions

1) Describe how peptic ulcers develop and name the drug categories used to treat them. Answer: Peptic ulcers begin when irritation or infection of the mucous membranes that strips away the protective mucus from the surface of the mucous membrane. Then the action of pepsin, a protein-digesting enzyme, begins to break down the underlying mucous membrane, forming an ulcer. Peptic ulcers are treated with H2 blocker drugs, proton pump inhibitor drugs, prostaglandin drugs, surface protectant drugs, and drugs to treat Helicobacter pylori infection. 20 Copyright © 2022 Pearson Education, Inc.

2) Describe how bulk-forming laxative drugs are different from irritant/stimulant laxative drugs. Answer: Bulk-forming laxative drugs contain indigestible dietary fiber that absorbs and holds water in the intestines to create a bulkier stool that stimulates peristalsis. Irritant/stimulant laxative drugs act directly on the intestinal mucosa to stimulate peristalsis. 3) What unusual adverse effect does the weight-loss drug orlistat (Alli, Xenical) produce, and what special precautions do patients need to take when they are taking this drug? Answer: The drug has an unusual adverse effect. Because it decreases the absorption of fats, it produces stools that are fatty and can pass involuntarily if the person eats a fatty meal. First-time users are advised to bring a change of clothes with them.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 5 Analgesic and Musculoskeletal Drugs 5.1

Multiple Choice Questions

1) Aspirin and NSAID drugs pain and inflammation by inhibiting the production of ________. A) antibodies B) osteoblasts C) prostaglandins D) progesterone Answer: C Explanation: A) There are no antibodies produced in osteoarthritis. B) Drugs used to treat osteoarthritis do not inhibit the production of osteoblasts. C) Correct. D) Progesterone is a female hormone that plays a role in osteoporosis, not osteoarthritis. 2) Which of the statements about nonsteroidal anti-inflammatory drugs (NSAIDs) is TRUE? A) NSAIDs have less of a tendency than salicylate drugs to cause stomach irritation and ulcers. B) NSAIDs have a different effect than the drugs ibuprofen (Advil) and naproxen (Aleve.) C) NSAIDs are more likely than salicylate drugs to cause gastric irritation and ulcers. D) NSAIDs are a subcategory of COX-2 inhibitor drugs. Answer: A Explanation: A) Correct. B) The category of NSAIDs includes Advil and Aleve, so their effects would be the same. C) NSAIDS are less likely, not more, to cause gastric irritation and ulcers. D) The other way around. COX-2 drugs are a subcategory of NSAIDs. 3) The hormone cortisol, from which corticosteroid drugs are derived, is secreted by ________. A) the cortex of the adrenal gland B) osteoclasts in the bone C) prostaglandins when there is inflammation D) inflammation in the joints Answer: A Explanation: A) Correct. B) Osteoclasts do not secrete cortisol. C) Prostaglandins to not secrete cortisol. D) Inflammation in the joints does not secrete cortisol.

4) Because of the side effects associated with their prolonged oral use, ________ are only prescribed for a short time to treat the acute inflammation of osteoarthritis. A) gold compound drugs B) NSAIDs C) corticosteroid drugs D) muscle relaxant drugs Answer: C Explanation: A) Gold compound drugs are not used to treat osteoarthritis. B) NSAIDs are used to treat osteoarthritis for long periods of time. C) Correct. D) Muscle relaxant drugs are not used to treat osteoarthritis. 5) The normal balance between new bone deposition and bone breakdown is maintained by which of the following? A) exercise and exposure to the sun B) parathyroid hormone and calcitonin hormone C) calcium and vitamin D in the diet D) All of the above Answer: D Explanation: A) These do help maintain this normal balance. B) These hormones do help maintain this normal balance. C) These do help maintain this normal balance. D) Correct. 6) Rheumatoid arthritis is ________. A) an autoimmune response of the body's own immune system B) an allergic reaction C) a bacterial infection D) an adverse effect from a drug Answer: A Explanation: A) Correct. B) Rheumatoid arthritis is not an allergic reaction. C) Rheumatoid arthritis is not a bacterial infection. D) Rheumatoid arthritis is not an adverse drug effect.

7) Which of these drugs has the most powerful anti-inflammatory effect to treat flare-ups of osteoarthritis and rheumatoid arthritis? A) ibuprofen (Advil, Motrin) B) acetaminophen (Tylenol) C) hydrocortisone (Cortef) D) zoledronic acid (Reclast) Answer: C Explanation: A) This drug has an anti-inflammatory effect, but not the most powerful. B) This drug does not have any anti-inflammatory effect. C) Correct. D) This drug is for osteoporosis; it has no anti-inflammatory effect. 8) Which of the following statements is TRUE concerning acetaminophen? A) It inhibits the COX enzymes and decreases prostaglandins. B) It is used to treat the inflammation of osteoarthritis. C) It is a type of NSAID. D) All of the above statements are true. Answer: A Explanation: A) Correct. This is a true statement. B) False. It cannot be used to treat inflammation. C) False. Acetaminophen is not chemically related to NSAIDs. D) Only one of the statements is true. 9) All of the following are muscle relaxant drugs, EXCEPT ________. A) metaxalone (Skelaxin) B) alendronate (Fosamax) C) methocarbamol (Robaxin) D) diazepam (Valium) Answer: B Explanation: A) This is a muscle relaxant drug. B) Correct. This is for osteoporosis; it is not a muscle relaxant drug. C) This is a muscle relaxant drug. D) This is a muscle relaxant drug.

10) Which of the following statements is FALSE? A) Calcitonin causes calcium in the blood to deposit in the bones. B) Recombinant DNA technology makes a hormone from salmon into a drug for osteoporosis. C) The SERM drug raloxifene (Evista) is the only SERM drug used for osteoporosis. D) Osteoporosis is more common in men than in women. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. Osteoporosis is more common in women. 11) Ibuprofen belongs to what category of drugs? A) salicylate B) aspirin C) skeletal muscle relaxant drug D) NSAID Answer: D Explanation: A) Ibuprofen does not belong to the salicylate category of drugs. B) There is no aspirin category of drugs. C) Ibuprofen does not belong to the muscle relaxant category of drugs. D) Correct. 12) Miacalcin, Fosamax, Actonel, and Boniva are all used to treat ________. A) muscle spasm B) osteoarthritis C) osteoporosis D) pain and inflammation Answer: C Explanation: A) These drugs are not used to treat muscle spasm. B) These drugs are not used to treat osteoarthritis. C) Correct. D) These drugs are not used to treat pain and inflammation.

13) William Ruckles has severe rheumatoid arthritis. His healthcare provider prescribed ________, an oral gold compound drug. A) auranofin (Ridaura) B) raloxifene (Evista) C) naproxen (Aleve, Naprosyn) D) capsaicin (Aspercreme Icy Hot PM) Answer: A Explanation: A) Correct. B) This selective estrogen receptor modulator (SERM) drug is used to treat osteoporosis, not rheumatoid arthritis. C) This NSAID is used to treat osteoarthritis, not rheumatoid arthritis. D) Capsaicin is used topically, not orally, to treat osteoarthritis, not rheumatoid arthritis. 14) Rheumatoid arthritis is treated with ________. A) acetaminophen B) gold compound drugs C) calcium supplements D) muscle relaxant drugs Answer: B Explanation: A) Acetaminophen is not used because it is not effective against inflammation. B) Correct. C) These drugs are used to treat osteoporosis, not rheumatoid arthritis. D) These drugs are not used to treat rheumatoid arthritis. 15) The suffix -profen is common to generic ________. A) gold compound drugs B) nonsteroidal anti-inflammatory drugs C) monoclonal antibody drugs D) drugs used to treat fibromyalgia Answer: B Explanation: A) The suffix -profen is not common to gold compound drugs. B) Correct. C) The suffix -profen is not common to monoclonal antibody drugs. D) The suffix -profen is not common to drugs used to treat fibromyalgia.

16) Risk factors for osteoporosis include all of the following, EXCEPT ________. A) lack of exercise B) Caucasian or Asian race C) weight-bearing joints D) smoking and alcohol use Answer: C Explanation: A) Lack of exercise is a risk factor for osteoporosis. B) Caucasian or Asian race is a risk factor for osteoporosis. C) Correct. This is a factor in osteoarthritis, not osteoporosis. D) Smoking and alcohol use are risk factors for osteoporosis. 17) Which of the following drugs can be injected into a joint? A) betamethasone (Celestone Soluspan) B) triamcinolone (Kenalog) C) hyaluronic acid (Hyalgan, Synvisc) D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 18) Which of the following statements about hyaluronic acid (Hyalgan, OrthoVisc, Supartz FX, Synvisc) is TRUE? A) Hyaluronic acid is secreted by osteoblasts in the bone. B) Hyaluronic acid is derived from chili pepper plants. C) It is also used as a gel-type filler that is injected under the skin to minimize wrinkles. D) This drug is taken orally to treat osteoarthritis. Answer: C Explanation: A) False. It is a compound in the synovial fluid of the joint. B) False. It is derived from the combs of chickens. C) Correct. D) False. This drug is injected into the joint.

19) All of these are combination drugs used to treat osteoarthritis because they contain an NSAID drug and a drug to protect the stomach, EXCEPT ________. A) Aspercreme Pain Relief B) Arthrotec C) Duexis D) Vimovo Answer: A Explanation: A) Correct. This is a topical drug and it does not contain that combination of ingredients to treat osteoarthritis. B) This is a combination drug with those ingredients. C) This is a combination drug with those ingredients. D) This is combination drug with those ingredients. 20) Osteoporosis is treated with all of the following categories of drugs, EXCEPT ________. A) RANKL inhibitor drugs B) NSAIDs C) bisphosphonate drugs D) calcitonin hormone drugs Answer: B Explanation: A) These drugs are used to treat osteoporosis. B) Correct. These drug are used to treat osteoarthritis, not osteoporosis. C) These drugs are used to treat osteoporosis. D) These drugs are used to treat osteoporosis. 21) Disease-modifying antirheumatic drugs for rheumatoid arthritis include all of the following categories of drugs, EXCEPT ________. A) Janus-associated kinase inhibitor drugs B) Monoclonal antibody drugs C) Biologic drugs D) Bisphosphonate drugs Answer: D Explanation: A) These drugs are used to treat rheumatoid arthritis. B) These drugs are used to treat rheumatoid arthritis. C) These drugs are used to treat rheumatoid arthritis. D) Correct. These drugs are used to treat osteoporosis, not rheumatoid arthritis.

22) Disease-modifying antirheumatic drugs for rheumatoid arthritis act in all of the following ways, EXCEPT ________. A) they stop joint damage B) they decrease inflammation caused by interleukins and tumor necrosis factor C) they inhibit the action of cytokines, interferon, and the JAK enzyme pathway D) None of the above Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. 23) Bridget Maurer is taking a DMARD for her rheumatoid arthritis. That drug might include any of the following drugs, EXCEPT ________. A) raloxifene (Evista) or teriparatide (Forteo) B) abatacept (Orencia) or adalimumab (Humira) C) azathioprine (Imuran) or upadacitinib (Rinvoq) D) etanercept (Enbrel) or golimumab (Simponi) Answer: A Explanation: A) Correct. These drugs are used to treat osteoporosis, not rheumatoid arthritis. B) These DMARD drugs are used to treat rheumatoid arthritis. C) These DMARD drugs are used to treat rheumatoid arthritis. D) These DMARD drugs are used to treat rheumatoid arthritis. 24) Which of these trade name drugs is NOT used to replace synovial fluid in the joint to treat osteoarthritis? A) Skelaxin B) Hyalgan C) Synvisc D) hyaluronic acid Answer: A Explanation: A) Correct. This is a muscle relaxant drug. B) This drug is used for synovial fluid replacement. C) This drug is used for synovial fluid replacement. D) This drug is used for synovial fluid replacement.

25) Which bone resorption inhibitor drugs for osteoporosis are given intravenously once a year at a clinic? A) ibandronate (Boniva) B) alendronate (Binosto, Fosamax) C) zoledronic acid (Reclast) D) raloxifene (Evista) Answer: C Explanation: A) Boniva is given orally, not intravenously. B) Fosamax is given orally, not intravenously. C) Correct. D) Evista is not a bone resorption inhibitor drug. 26) Which of the following is NOT a therapeutic effect associated with all salicylate analgesic drugs? A) analgesic B) anticoagulant C) anti-inflammatory D) antipyretic Answer: B Explanation: A) This is a therapeutic effect of all salicylate analgesic drugs. B) Correct. Only aspirin has this therapeutic effect. C) This is a therapeutic effect of all salicylate analgesic drugs. D) This is a therapeutic effect of all salicylate analgesic drugs. 27) The two distinct therapeutic effects of acetaminophen are ________. A) analgesic and anti-inflammatory B) analgesic and antipyretic C) anti-inflammatory and anticoagulant D) antipyretic and anti-inflammatory Answer: B Explanation: A) Acetaminophen has no anti-inflammatory effect. B) Correct. C) Acetaminophen has neither of these effects. D) Acetaminophen has no anti-inflammatory effect.

28) NSAIDs have an analgesic and anti-inflammatory effect because they inhibit ________. A) opiate receptors B) endorphins C) prostaglandins D) serotonin Answer: C Explanation: A) NSAIDs do not act on opiate receptors. B) NSAIDS do not inhibit endorphins. C) Correct. D) NSAIDs do not inhibit serotonin. 29) Non-opioid drugs are only effective for treating ________. A) mild pain B) mild-to-moderate pain C) moderately severe pain D) severe pain Answer: B Explanation: A) This is not the correct answer. B) Correct. C) This is not the correct answer. D) This is not the correct answer. 30) Acetaminophen is categorized as a/an ________. A) opioid drug B) nonsalicylate analgesic drug C) NSAID D) salicylate drug Answer: B Explanation: A) Acetaminophen is not an opioid drug. B) Correct. C) Acetaminophen is not an NSAID. D) Acetaminophen is not a salicylate drug.

31) All of the following are good reasons to use a non-opioid analgesic drug as the first step in pain control, EXCEPT ________. A) these drugs are available over-the-counter B) these drugs can control severe pain. C) these drugs are inexpensive and can be purchased without a prescription D) these drugs are non-addicting Answer: B Explanation: A) This is a good reason to use a non-opioid analgesic drug. B) Correct. Non-opioid analgesic drugs cannot control severe pain. C) This is a good reason to use a non-opioid analgesic drug. D) This is a good reason to use a non-opioid analgesic drug. 32) The mechanism by which acetaminophen relieves pain is ________. A) by blocking dopamine receptors B) by binding to opioid receptors C) by affecting the hypothalamus of the brain D) by inhibiting the enzymes COX-1 and COX-2 Answer: D Explanation: A) Acetaminophen does not block dopamine receptors. B) Acetaminophen does not bind to opioid receptors. C) Acetaminophen affects the hypothalamus, but to decrease the temperature, not treat pain. D) Correct. 33) Which of the following combination non-opioid analgesic drugs contains aspirin and caffeine (a stimulant drug)? A) Anacin B) Percogesic C) Vanquish D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) Percogesic contains acetaminophen, not aspirin. C) This is true, but it is not the only correct answer. D) Correct.

34) The ideal analgesic drug would ________. A) cause no dependence or addiction B) provide maximum pain relief C) produce no side effects D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 35) Which of the following is NOT one of the different types of opioid receptors that are stimulated by opioid analgesic drugs? A) mu B) kappa C) schedule D) delta Answer: C Explanation: A) This is a type of an opioid receptor. B) This is a type of an opioid receptor. C) Correct. This is a category of drugs, not a type of opioid receptor. D) This is a type of an opioid receptor. 36) The word salicylate refers to ________ drugs, which were originally derived from the bark of the willow tree (the Latin word salix means "willow"). A) prostaglandins B) opioid C) aspirin D) analgesic Answer: C Explanation: A) Prostaglandins are natural substances in the body, not drugs. B) Opioid drugs were not derived from willow bark. C) Correct. D) Not all analgesic drugs were derived from willow bark.

37) Which of the following is a common side effect of opioid drugs? A) decreased white blood count B) dizziness C) stomach ulcer D) constipation Answer: D Explanation: A) This is not a common side effect of opioid drugs. B) Dizziness is not a side effect of opioid drugs. C) Stomach ulcer is not a common side effect of opioid drugs. D) Correct. 38) Which of the following is the only COX-2 inhibitor drug currently on the market? A) meperidine (Demerol) B) piroxicam (Feldene) C) celecoxib (Celebrex) D) acetaminophen (Tylenol) Answer: C Explanation: A) This is an opioid drug, not a COX-2 inhibitor drug. B) This is a nonsteroidal anti-inflammatory drug, not a COX-2 inhibitor drug. C) Correct. D) This is a nonsalicylate analgesic drug, not a COX-2 inhibitor drug. 39) Which of the following drugs is derived from the venom of the cone snail that lives in the coral reefs around the Philippines? A) oxycodone (OxyContin) B) celecoxib (Celebrex) C) ziconotide (Prialt) D) meperidine (Demerol) Answer: C Explanation: A) Oxycodone (OxyContin) is not derived from the cone snail. B) Celecoxib (Celebrex) is not derived from the cone snail. C) Correct. D) Meperidine (Demerol) is not derived from the cone snail.

40) The opioid drug known as the "lollipop" that is used to treat pain is ________. A) fentanyl (Actiq) B) morphine (MS Contin) C) fentanyl (Duragesic) D) naproxen (Aleve, Naprosyn) Answer: A Explanation: A) Correct. B) Morphine (MS Contin) is not known as the "lollipop." C) This is fentanyl, but it is a transdermal patch, not a "lollipop." D) Naproxen (Aleve, Naprosyn) is not an opioid drug. 41) Which of the following pairs of analgesic drugs are in the form of a transdermal patch? A) diclofenac (Flector) B) ibuprofen (Advil, Motrin IB) C) fentanyl (Duragesic) D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This drug does not come as a transdermal patch. C) This is true, but it is not the only correct answer. D) Correct. 42) Which of the following statements is FALSE? A) Some opioid drugs have a stronger potential for addiction than other opioid drugs. B) The symbol S with Roman numerals on the drug label indicates that this is a Schedule drug. C) Prescription opioid drugs are assigned to Schedules (Schedule II to IV). D) Schedule II drugs are highly addictive. Answer: B Explanation: A) This is a true statement. B) Correct. The symbol C, not S, indicates a Schedule drug or a "controlled substance." C) This is a true statement. D) This is a true statement. 43) Methadone is used to treat recovering narcotic drug addicts because ________. A) it prevents the addict from experiencing withdrawal symptoms B) it does not produce a high degree of euphoria like other opioid drugs C) it slowly decreases the addict's psychological dependence on opioid drugs. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 14 Copyright © 2022 Pearson Education, Inc.

44) The phrase low-dose aspirin refers to ________. A) the 81-mg dose of aspirin B) the trade name drug that is made by Bayer C) what is taken to prevent a second heart attack or stroke D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) Aspirin was first introduced by the drug company Bayer, but now it is only one of many drug companies that make low-dose aspirin. C) This is true, but it is not the only correct answer. D) Correct. 45) Aspirin taken regularly for many years can lead to the development of ________. A) cataracts B) cancer C) addiction D) migraine headaches Answer: A Explanation: A) Correct. B) Long-term aspirin use decreases the risk of some types of cancer. C) Aspirin is not addictive because it is not a Schedule drug. D) Long-term aspirin use is not linked to migraine headaches. 46) Which of these combination trade name drugs contains the generic drugs acetaminophen and oxycodone and is a Schedule II drug? A) Endocet B) Lortab C) Vicodin D) Percogesic Answer: A Explanation: A) Correct. Endocet contains acetaminophen and oxycodone. B) Lortab is a combination drug that contains acetaminophen, but not oxycodone. C) Vicodin is a combination drug that contains acetaminophen, but not oxycodone. D) Percogesic is a combination drug that contains acetaminophen, but not oxycodone.

47) A non-opioid drug is often combined with an opioid drug because ________. A) the opioid drug can relieve severe pain B) it treats the two components of pain (stimulation of nerve endings and pain heightened by anxiety) C) the non-opioid drug provides a foundation of pain relief upon which the opioid drug can build D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 48) Euphoria from opioid drugs is a heightened state of ________. A) well-being B) happiness C) excitement D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 49) All of the following drugs are used to treat osteoarthritis, EXCEPT ________. A) muscle relaxant drugs B) acetaminophen C) NSAID D) corticosteroid drugs Answer: A Explanation: A) Correct. These drugs are not used to treat osteoarthritis. B) Acetaminophen is used to treat osteoarthritis. C) NSAIDs are used to treat osteoarthritis. D) Corticosteroid drugs are used to treat osteoarthritis.

50) All of the following are the trade names of nonsteroidal anti-inflammatory drugs, EXCEPT ________. A) Daypro and Advil B) Aleve and Relafen DS C) Voltaren and Motrin IB D) Skelaxin and Soma Answer: D Explanation: A) These are nonsteroidal anti-inflammatory drugs. B) These are nonsteroidal anti-inflammatory drugs. C) These are nonsteroidal anti-inflammatory drugs. D) Correct. These are muscle relaxant drugs, not NSAIDs. 51) Muscle relaxant drugs specifically relieve muscle ________. A) inflammation B) pain C) spasms and stiffness D) All of the above. Answer: C Explanation: A) Muscle relaxant drugs do not relieve inflammation. B) Muscle relaxant drugs do not relieve pain. C) Correct. D) Only one answer is correct. 52) Which of the following are used to treat fibromyalgia? A) pregabalin (Lyrica) B) GABA analog drugs C) duloxetine (Cymbalta, Drizalma Sprinkle) D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

53) ________ is also known as degenerative joint disease. A) Fibromyalgia B) Rheumatoid arthritis C) Osteoarthritis D) Osteoporosis Answer: C Explanation: A) Fibromyalgia is not known as degenerative joint disease. B) Rheumatoid arthritis is not known as degenerative joint disease. C) Correct. D) Osteoporosis is not known as degenerative joint disease. 54) Gold compound drugs ________. A) are used to treat osteoporosis B) contain actual gold C) have names that often contain the letters RA, the chemical symbol for gold. D) A and B Answer: B Explanation: A) Gold drugs are used to treat rheumatoid arthritis, not osteoporosis. B) Correct. C) Au, not RA, is the chemical symbol for gold. D) There is only one correct answer. 55) Only ________ drugs can reverse the cartilage and bone damage that has already occurred in the joints of patients with osteoarthritis. A) corticosteroid drugs B) NSAIDs C) acetaminophen D) None of the above. Answer: D Explanation: A) This is not true. B) This is not true. C) This is not true. D) Correct. There are no drugs that can reverse the cartilage and bone damage of osteoarthritis once it has occurred.

56) The symptoms and cause of fibromyalgia include all of the following EXCEPT ________. A) trigger points and a genetic predisposition B) overreaction to pain C) wear and tear in the joints D) poor sleep, fatigue, depression Answer: C Explanation: A) This is true. B) This is true. C) Correct. Wear and tear in the joints is a symptom of osteoarthritis. D) This is true. 57) Which joints are the first to exhibit signs of osteoarthritis with pain, inflammation, and swelling. A) hips and knees B) lower back C) fingers and toes D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 58) The combining form oste/o- (as in osteoarthritis and osteoporosis) means ________. A) disease B) bone C) pain D) muscle Answer: B Explanation: A) It does not mean disease. B) Correct. C) It does not mean pain. D) It does not mean muscle.

59) N-type calcium channel blocker drugs ________. A) are used to treat severe chronic pain B) are given by the intrathecal route to nerves around the spinal column C) are administered by an external infusion device D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true but it is not the only correct answer. D) Correct. 60) All of these special security precautions are taken for an opioid drug prescription to prevent alterations and forgeries, EXCEPT ________. A) it must include the healthcare provider's DEA number B) it uses a control number and special ink C) "Void" becomes visible if someone tries to photocopy or fax it D) None of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 61) Theft of a controlled substance is reported to ________. A) Drug Enforcement Agency B) Prescription drug monitoring program C) American Association of Retired Persons D) All of the above. Answer: A Explanation: A) Correct. B) Only one answer is correct. C) Only one answer is correct. D) Only one answer is correct.

62) Prescription drug monitoring programs ________. A) help identify patients who are obtaining opioid drugs from multiple providers B) are electronic databases C) track prescriptions for all controlled substances written in that state D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 63) All of the following are true about neuromuscular blocker drugs, EXCEPT ________. A) they are also known as muscle relaxant drugs B) they are derived from the neurotoxin that causes botulism C) they are injected to treat muscle spasticity D) they are used to minimize deep wrinkles Answer: A Explanation: A) Correct. Muscle relaxant drugs and neuromuscular blocker drugs are two different categories of drugs. B) This is a true statement. C) This is a true statement. D) This is a true statement. 64) Which of the following trade name drugs is a neuromuscular blocker drug? A) abobotulinumtoxin A (Dysport) B) diazepam (Valium) C) tizanidine (Zanaflex) D) All of these are neuromuscular blocker drugs. Answer: A Explanation: A) Correct. B) This is a muscle relaxant drug, not a neuromuscular blocker drug. C) This is a muscle relaxant drug, not a neuromuscular blocker drug. D) Only one answer is correct.

65) Which is FALSE about RANKL inhibitor drugs? A) They are monoclonal antibody drugs. B) They keep the cytokine RANKL from activating receptors on osteoclasts. C) They prevent the loss of bone seen in osteoarthritis. D) They prevent bone breakdown. Answer: C Explanation: A) This is a true statement. B) This is a true statement. C) Correct. RANKL inhibitor drugs treat osteoporosis, not osteoarthritis. D) This is a true statement. 66) Denosumab (Prolia) and romosozumab (Evenity) belong to which drug category? A) PDMP B) RANKL C) DEA D) SERM Answer: B Explanation: A) A prescription drug monitoring program is not a drug category. B) Correct. C) The Drug Enforcement Agency is not a drug category. D) This is a drug category, but these drugs do not belong to it. 67) All of the following are trade names for combination drugs for osteoporosis, EXCEPT ________. A) Arthrotec B) Prempro C) CombiPatch D) Duavee Answer: A Explanation: A) Correct. This is a combination drug, but it is not used for osteoporosis. B) This is a combination drug for osteoporosis. C) This is a combination drug for osteoporosis. D) This is a combination drug for osteoporosis. 5.2

True/False Questions

1) Mature bone is a hard, unchanging substance. Answer: FALSE Explanation: It is hard, but it is a changing, living tissue. 2) Acetaminophen cannot treat inflammation, so it is not used to treat osteoarthritis. Answer: FALSE Explanation: It is the preferred treatment for the pain of osteoarthritis, even though it cannot treat the inflammation. 22 Copyright © 2022 Pearson Education, Inc.

3) Because acetaminophen has no anti-inflammatory action, it is no longer used to treat the pain associated with osteoarthritis. Answer: FALSE Explanation: Acetaminophen cannot treat inflammation, but it is the preferred first treatment for the pain of osteoarthritis. 4) NSAIDs are structurally similar enough to aspirin that patients who are allergic to aspirin should not take NSAIDs. Answer: TRUE 5) Drugs that are derivatives of hyaluronic acid are injected into the joints of patients with osteoarthritis to improve the viscosity and lubricating qualities of the synovial fluid. Answer: TRUE 6) The category of salicylate drugs used to treat pain includes aspirin. Answer: TRUE 7) Nonsteroidal anti-inflammatory drugs inhibit both the COX-1 and COX-2 enzymes. Answer: FALSE Explanation: Aspirin and acetaminophen inhibit both COX-1 and COX-2 enzymes, but NSAIDs only inhibit COX-2. 8) Some corticosteroid drugs are given as intra-articular injections into a joint affected by osteoarthritis. Answer: TRUE 9) Two types of bone cells are constantly at work: Osteoclasts deposit new bone and osteoblasts break down and remove areas of old or damaged bone. Answer: FALSE Explanation: This is a false statement. Osteoblasts deposit new bone, and osteoclasts break down old bone. 10) Calcitonin-salmon is the drug form of the body hormone calcitonin. This drug is extracted from salmon fish and undergoes recombinant DNA technology. Answer: TRUE 11) Muscle relaxant drugs are useful in treating the pain and inflammation of muscle strains, sprains, and "pulled muscles." Answer: FALSE Explanation: These drugs only relieve spasm and stiffness but cannot relieve pain or inflammation. 12) Acetaminophen is a nonsalicylate analgesic drug that is not related to aspirin or any of the other salicylate drugs. Answer: TRUE 23 Copyright © 2022 Pearson Education, Inc.

13) The topical drug capsaicin is a natural substance derived from chili pepper plants; it makes the skin and joint less sensitive to pain by decreasing nerve signals from sensory nerves. Answer: TRUE 14) Oral gold compound drugs inhibit the immune response and can reverse joint damage that has already occurred in patients with rheumatoid arthritis. Answer: FALSE Explanation: These drugs inhibit the immune response but cannot reverse joint damage that has already occurred. 15) Naproxen (Aleve, Naprosyn) belongs to the drug category of nonsteroidal anti-inflammatory drugs that are used to treat osteoarthritis. Answer: TRUE 16) Some of the similarities between aspirin and acetaminophen are that they both relieve pain and they both can cause upset stomach and stomach irritation. Answer: FALSE Explanation: Acetaminophen does not cause the stomach irritation that aspirin does. 17) Because NSAIDs are structurally different than aspirin, patients who are allergic to aspirin can safely take NSAIDs. Answer: FALSE Explanation: NSAIDs are structurally similar to aspirin and patients who are allergic to aspirin should not take NSAIDs. 18) The regular use of aspirin for many years can cause cataracts in the eyes. Answer: TRUE 19) Acetaminophen is the non-opioid component in most combination opioid and non-opioid analgesic drugs for pain. Answer: TRUE 20) Older adults who regularly take an aspirin or NSAID or aspirin are less likely to develop Alzheimer disease. Answer: TRUE 21) Diclofenac (Flector) comes as a transdermal patch to treat pain systemically and as a topical gel (Voltaren) to treat pain in specific locations. Answer: TRUE 22) Acetaminophen and aspirin can be used to prevent a heart attack or stroke because they have an anticoagulant effect. Answer: FALSE Explanation: Acetaminophen does not have the anticoagulant effect that aspirin has, and so it cannot be used to prevent a heart attack or stroke.

23) Aspirin was the first drug to have a plastic safety seal on top of each drug bottle to prevent tampering. Answer: FALSE Explanation: Tylenol was the first. 24) Heroin was a semi-synthetic opioid drug introduced in 1898 to treat severe pain, but it is now a Schedule I drug with no medical uses. Answer: TRUE 25) Two of the trade names of the well-known NSAID ibuprofen are Advil and Aleve. Answer: FALSE Explanation: Aleve is a trade name of naproxen, not ibuprofen. 26) Some opioid drugs are more psychologically addicting than others. Answer: TRUE 27) Methotrexate (Otrexup) is the first choice of DMARDs for treating rheumatoid arthritis that is not controlled by NSAIDs. Answer: TRUE 28) The drug diazepam (Valium) is an antianxiety drug, not a muscle relaxant drug, but it has a side effect of muscular relaxation. Answer: TRUE 29) The drug ibandronate (Boniva) has a unique bone-shaped indentation on its tablet. Answer: FALSE Explanation: This describes a tablet of Fosamax, not Boniva. 30) Two COX-2 inhibitor drugs were taken off the market because of an increased risk of heart attacks and stroke. Celecoxib (Celebrex) is the only one COX-2 inhibitor drug currently on the market. Answer: TRUE 31) Janus-associated kinase inhibitor drugs are used to treat fibromyalgia. Answer: FALSE Explanation: These drugs are used to treat rheumatoid arthritis. 32) The suffix -nib is common to generic Janus-associated kinase inhibitor drugs. Answer: TRUE 33) The suffixes -dronate and -dronic are common to generic bisphosphonate drugs for osteoporosis. Answer: TRUE 34) The female hormone estradiol normally inhibits the action of osteoclasts that break down bone; the level of estradiol declines during menopause. Answer: TRUE 25 Copyright © 2022 Pearson Education, Inc.

35) It was the Food and Drug Administration that set a deadline for all drug companies to convert to tamper-resistance packaging. Answer: TRUE 36) Aspirin and NSAIDs inhibit the formation of prostaglandins that normally protect the gastric mucosa. Answer: TRUE 37) OxyContin, the trade name for morphine , is a Schedule II drug with a high potential for abuse and is a popular drug of abuse that is sold on the street. Answer: FALSE Explanation: The trade name for OxyContin is oxycodone, not morphine. 38) The opioid drugs codeine and hydrocodone are used to treat pain but also have an antitussive effect to treat coughing. Answer: TRUE 5.3

Short Answer Questions

1) The SERM category of drugs is used to treat osteoporosis. The abbreviation SERM stands for ________ ________ receptor modulator drugs. Answer: selective estrogen 2) A/An ________ is a drug that has a similar effect to the original natural hormone (example: calcitonin salmon). Answer: analog 3) ________, also known as acetylsalicylic acid (ASA), is the most well-known drug in the salicylate drug category. Answer: aspirin 4) The abbreviation NSAID stands for ________ anti-inflammatory drug. Answer: nonsteroidal 5) Osteoarthritis is also known as ________ joint disease. Answer: degenerative 6) The trade name drug ________ was the first drug to have a plastic safety seal on the top of each drug bottle to prevent tampering prior to purchase by the consumer. Answer: Tylenol 7) The suffix ________ is common to generic nonsteroidal anti-inflammatory drugs. Answer: -profen

8) Opioid drugs relieve pain and produce a sense of well-being or ________, which is why these drugs can lead to addiction. Answer: euphoria 9) Opioid analgesic drugs were previously known as ________ drugs. Answer: narcotic 10) The suffix -mab is common to generic ________ ________ drugs. Answer: monoclonal antibody 11) The disease-modifying antirheumatic drug tofacitinib for rheumatoid arthritis has a well-known trade name drug of ________. Answer: Xeljanz 12) Osteoporosis is thinning of the ________ at the cellular level. Answer: bone 13) The phrase "low-impact fractures" is associated with the disease of ________. Answer: osteoporosis 14) ________ analgesic drugs include aspirin (acetylsalicylic acid) and other chemically related drugs. Answer: Salicylate 15) Aspirin prolongs the clotting time of the blood by inhibiting thromboxane, a substance in the blood that causes ________ to aggregate, which is one of the first steps in forming a blood clot. Answer: platelets 16) A/An ________ drug, like a salicylate drug or an opioid drug, is a drug that is used to treat pain. Answer: analgesic 17) With their ________ effect, aspirin acts on the hypothalamus, the temperature-regulating center of the brain, to reduce fever. Answer: antipyretic 18) The combination analgesic drug Fioricet has the letters cet in its trade name, which gives a clue that it contains the generic analgesic drug ________. Answer: acetaminophen 19) The salicylate drug aspirin has a therapeutic effect that is not shared by any of the other salicylate drugs: an ________ effect. Answer: anticoagulant 20) ________ are the body's own natural pain relievers. Answer: Endorphins 27 Copyright © 2022 Pearson Education, Inc.

21) The generic drug ________ is well known for its use in treating recovering opioid drug addicts who are treated at outpatient clinics. Answer: Methadone 22) The well-known generic opioid analgesic drug meperidine is related to the trade name drug ________. Answer: Demerol 23) Drugs that have the potential to cause addiction have a specific alphabet letter that is a large ________ printed on the label with Roman numerals inside of it. Answer: C 24) Bone resorption inhibitor drugs are also known as bisphosphonate drugs because of their effect on calcium and________ in the bone. Answer: phosphorus 25) When you hear the phrase "trigger points," you think of a symptom of the disease of ________. Answer: fibromyalgia 26) The American College of Rheumatology recommends the drug ________ as the drug of choice for treating mild-to-moderate pain associated with osteoarthritis when there is no inflammation involved. Answer: acetaminophen 27) The only COX-2 inhibitor drug that is currently on the market is celecoxib, and its trade name is ________. Answer: Celebrex 28) Lay persons often refer to intra-articular injections of corticosteroid drugs as "________ shots," but they are not because the drug cortisone can only be given orally. Answer: cortisone 29) The suffixes -lone and -sone are common to generic ________ drugs. Answer: corticosteroid 30) ________ cause pain when they are released from damaged tissues. Answer: Prostaglandins 31) Because of the side effects of the prolonged use of oral corticosteroid drugs, they can only be used on a short-term basis and must be given with a/an ________ dose. Answer: tapering 32) Pain that is ________ continues for 3 months or longer. Answer: chronic

33) Based on its chemical name, acetaminophen is sometimes abbreviated as ________. Answer: APAP 34) In the drug name MS Contin, the "MS" stands for ________ ________. Answer: morphine sulfate 35) Morphine was first isolated from the sap of the opium ________. Answer: poppy 36) Before healthcare providers can give a prescription for a Schedule drug, they must first be registered with the federal agency whose name is abbreviated as ________. Answer: DEA (Drug Enforcement Agency) 37) The abbreviation PDMP stands for ________ ________ ________ ________. Answer: prescription drug monitoring program 5.4

Matching Questions

Match the analgesic drug names in Column 1 to the drug category names in Column 2. A) salicylate analgesic drug with anticoagulant effect B) opioid analgesic drug in a nasal spray form C) salicylate drug without an anticoagulant effect D) nonsalicylate analgesic drug E) opioid analgesic drug F) nonsteroidal anti-inflammatory drug 1) acetaminophen (Tylenol) 2) aspirin (Bayer Aspirin, Ecotrin) 3) hydromorphone (Dilaudid, Exalgo) 4) ibuprofen (Advil, Motrin IB) 5) fentanyl (Lazanda) 6) magnesium salicylate (Doan's) Answers: 1) D 2) A 3) E 4) F 5) B 6) C

Match the drug names in Column 1 to the drug category names in Column 2. A) salicylate analgesic drug B) bone resorption inhibitor drug C) gold compound drug D) SERM drug E) DMARD F) nonsteroidal anti-inflammatory drug G) corticosteroid drug H) muscle relaxant drug I) estrogen derivative drug J) COX-2 inhibitor drug 7) magnesium sulfate (Doan's) 8) auranofin (Ridaura) 9) celecoxib (Celebrex) 10) carisoprodol (Soma, Vanadom) 11) methylprednisolone (Medrol) 12) golimumab (Simponi) 13) conjugated estrogens (Premarin) 14) ibandronate (Boniva) 15) ibuprofen (Advil, Motrin) 16) raloxifene (Evista) Answers: 7) A 8) C 9) J 10) H 11) G 12) E 13) I 14) B 15) F 16) D 5.5

Essay Questions

1) Explain why osteoporosis is common in postmenopausal women. Answer: Estradiol, the female hormone secreted by the ovaries, inhibits the action of osteoclasts that break down bone. In postmenopausal women, the decreasing level of estradiol allows osteoclasts to break down more bone and the decreasing level of progesterone no longer stimulates new bone formation.

2) Explain why the joints of the hips, knees, and lower back and the joints of the fingers and toes are the first to have signs of osteoarthritis; also explain how the process and symptoms of osteoarthritis progress. Answer: The weight-bearing joints (hips, knees, and lower back), as well as those joints that are used constantly (fingers and toes), are the first to exhibit symptoms of osteoarthritis. The cartilage pad degenerates. The smooth cartilage around the bone ends becomes roughened and then wears away. Then the bone ends rub together, causing inflammation, pain, and swelling. The damaged bone ends form bony spurs that further irritate the adjacent tissues. 3) Explain how opioid analgesic drugs work. Answer: Opioid analgesic drugs relieve pain by binding to opioid receptors in the brain and blocking pain impulses coming from nerves in the body. There are several different types of opioid receptors and opioid analgesic drugs stimulate all or some of the receptors. 4) What is the reason that a person with the aches and pains of a viral illness should not be given aspirin? Answer: The use of aspirin to treat the aches and pains of a viral illness has been linked to the occurrence of Reye's syndrome. Reye's syndrome causes liver damage, an increased blood level of ammonia, and inflammation of the brain. 5) Why is acetaminophen not recommended for a patient at risk for a heart attack or stroke? Answer: Acetaminophen does not have the anticoagulant effect that aspirin has, and so acetaminophen cannot be used to prevent a heart attack or stroke. 6) Explain how prostaglandins play a role in causing pain and inflammation. Answer: When body tissue is damaged, the fluid within the cells is released and the COX enzymes convert this fluid to prostaglandins. The prostaglandins then stimulate pain receptors in the area. The greater the amount of tissue damage, the more prostaglandins are produced and the greater the pain. 7) Explain why acetaminophen is one of the most common drugs involved in a drug overdose. Answer: About 60 million Americans take acetaminophen each week, and many take it several times each day. They may not realize that acetaminophen is also present in combination analgesic drugs. They often exceed the maximum daily dose for acetaminophen because the combination drug is labeled as containing APAP, instead of the more familiar name of acetaminophen.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 6 Respiratory Drugs 6.1

Multiple Choice Questions

1) Which of the following is NOT one of the effects of second-generation antihistamine drugs? A) They produce drowsiness. B) They decrease itching and redness. C) They dry up secretions. D) They shrink edematous mucous membranes. Answer: A Explanation: A) Correct. They do NOT produce drowsiness. B) They do decrease itching and redness. C) They do dry up secretions. D) They do shrink edematous mucous membranes. 2) Examples of antigens include all of the following, EXCEPT ________. A) pollen and plants B) animal dander C) foods D) None of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 3) Antitussive drugs act by decreasing ________. A) coughing B) sneezing C) sputum production D) edema and inflammation Answer: A Explanation: A) Correct. Antitussive drugs decrease coughing. B) Antihistamine drugs, not antitussive drugs, do this. C) Antitussive drugs do not decrease sputum production. D) Antitussive drugs do not decrease edema and inflammation.

4) Which of the following is NOT a route of administration for decongestant drugs? A) inhaled with an inhaler B) topically as a nasal spray C) orally as a tablet D) topically as nose drops Answer: A Explanation: A) Correct. Antihistamine drugs are not administered with an inhaler. B) This is a true statement. C) This is a true statement. D) This is a true statement. 5) Allen Southerby has allergic rhinitis. He takes a mast cell stabilizer drug that does all of the following, EXCEPT ________. A) prevents edema of the nasal mucous membranes B) breaks up thick mucus so it can be expelled from the lungs C) prevents the release of histamine D) decreases sneezing Answer: B Explanation: A) This is a true statement, B) Correct. Expectorant drugs do this, not mast cell stabilizer drugs. C) This is a true statement. D) This is a true statement. 6) Antihistamine drugs are prescribed to stop the release of histamine. Histamine causes all of the following effects in the mucous membranes, EXCEPT ________. A) bacterial infection B) vasodilation C) redness and itching D) swelling Answer: A Explanation: A) Correct. Histamine does NOT cause infection. B) Histamine does cause vasodilation. C) Histamine does cause redness and itching. D) Histamine does swelling.

7) Corticosteroid drugs given intranasally to treat allergic symptoms in the ________. A) lungs B) mouth C) nose D) throat Answer: C Explanation: A) This is not true. B) This is not true. C) Correct. D) This is not true. 8) Which of the following is an opioid antitussive drug? A) benzonatate (Tessalon Perles) B) codeine C) dextromethorphan (Delsym, Robitussin) D) All of the above. Answer: B Explanation: A) This is not an opioid antitussive drug. B) Correct. C) This is not an opioid antitussive drug. D) Only one of the answers is correct. 9) Sympathomimetic bronchodilator drugs ________. A) mimic the action of epinephrine on beta2 receptors around the bronchioles B) cause the bronchioles to dilate and this increases the flow of air C) mimic the action of the sympathetic division of the nervous system D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 10) Leukotriene receptor blocker drugs are used to prevent and treat ________. A) asthma B) productive coughs C) respiratory infections D) tuberculosis Answer: A Explanation: A) Correct. B) Leukotriene receptor blocker drugs are not used to treat productive coughs. C) Leukotriene receptor blocker drugs are not used to treat respiratory infections. D) Leukotriene receptor blocker drugs are not used to treat tuberculosis. 3 Copyright © 2022 Pearson Education, Inc.

11) The well-known leukotriene receptor blocker generic drug montelukast is related to the trade name drug ________. A) Spiriva B) Combivent C) Singulair D) Pulmicort Answer: C Explanation: A) Spiriva is not related to montelukast. B) This is a combination drug that does not contain montelukast. C) Correct. D) This is a corticosteroid drug that is not related to montelukast. 12) Nicotine drugs to stop smoking ________. A) provide a gradual withdrawal from nicotine B) contain a decreasing supply of nicotine C) are in the drug forms of chewing gum, lozenge, nasal spray, inhaler, or transdermal patch D) All of the above. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. 13) The well-known bronchodilator generic drug albuterol is related to which trade name drug? A) Severent Diskus B) Ventolin HFA C) Proventil HFA D) B and C Answer: D Explanation: A) This is the trade name for salmeterol, not albuterol. B) This not the only correct answer. C) This is not the only correct answer. D) Correct.

14) Corticosteroid drugs ________. A) mimic the action of histamine on mast cells B) stimulate the inflammation from the immune response C) dilate the bronchioles D) suppress the inflammation associated with the immune response Answer: D Explanation: A) Corticosteroid drugs mimic the action of cortisol, not histamine. B) Corticosteroid drugs suppress, not stimulate, inflammation from the immune response. C) Corticosteroid drugs do not dilate the bronchioles. D) Correct. 15) Leukotriene receptor blocker drugs ________. A) block the action of leukotriene at the receptor level B) cause airway edema, bronchospasm, inflammation and mucus production C) are used to treat asthma D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) These are symptoms caused by the substance leukotriene. C) This is true, but it is not the only correct answer. D) Correct. 16) Nicotine ________. A) inhibits the frontal cortex of the brain B) stimulates the limbic lobe of the brain C) increases alertness and provides a feeling of pleasure D) B and C Answer: D Explanation: A) Nicotine does not inhibit the frontal cortex. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct. 17) Bronchodilator drugs are used to treat which of the following diseases? A) asthma and COPD B) influenza C) tuberculosis D) pneumonia Answer: A Explanation: A) Correct. B) Bronchodilator drugs are not used to treat influenza. C) Bronchodilator drugs are not used to treat tuberculosis D) Bronchodilator drugs are not used to treat pneumonia. 5 Copyright © 2022 Pearson Education, Inc.

18) Tuberculosis is ________. A) spread by airborne droplets expelled by coughing B) caused by a gram-negative bacterium C) spread by contact with an infected patient's blood D) treated with regular antibiotic drugs Answer: A Explanation: A) Correct. B) Tuberculosis is caused by a gram-positive, not gram-negative bacterium. C) Tuberculosis is not spread by contact with an infected patient's blood. D) Tuberculosis is treated with special antitubercular antibiotic drugs. 19) All of the following are categories of bronchodilator drugs, EXCEPT ________. A) monoclonal antibody B) sympathomimetic C) beta2-agonist D) anticholinergic Answer: A Explanation: A) Correct. There are no monoclonal antibody bronchodilator drugs. B) This is a category of bronchodilator drugs. C) This is a category of bronchodilator drugs. D) This is a category of bronchodilator drugs. 20) Asthma ________. A) has symptoms of bronchoconstriction and wheezing B) is a viral infection of the lungs C) is a type of reactive airway disease D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) Asthma is not a viral infection. C) This is true, but it is not the only correct answer. D) Correct.

21) Tuberculosis is caused by ________. A) a gram-positive bacterium B) a bacterium with a waxy coating around its bacterial wall C) Mycobacterium tuberculosis D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 22) ________ is a substance produced in response to an inhaled antigen, and it causes airway edema, bronchoconstriction, inflammation, and mucus production. A) A mast cell B) Leukotriene C) Expectorant D) Cortisol Answer: B Explanation: A) A mast cell is a cell, not a substance. B) Correct. C) Expectorant is a type of drug, not a substance. D) Cortisol is a hormone; it does not produce these symptoms.

23) All of the following are categories of bronchodilator drugs, EXCEPT ________. A) PDE enzyme inhibitor drugs B) Anticholinergic drugs C) Monoclonal antibody drugs D) Beta2-agonist drugs Answer: C Explanation: A) This is a category of bronchodilator drugs. B) This is a category of bronchodilator drugs. C) Correct. D) This is a category of bronchodilator drugs.

24) All of the following are bronchodilator drugs, EXCEPT ________. A) levalbuterol (Xopenex) B) theophylline (Elixophyllin, Theo-24) C) ipratropium (Atrovent) D) prednisolone (Orapred, Pediapred) Answer: D Explanation: A) This is a beta2-agonist bronchodilator drug. B) This is a PDE enzyme inhibitor bronchodilator drug. C) This is an anticholinergic bronchodilator drug. D) Correct. This is a corticosteroid, not a bronchodilator, drug. 25) A Handihaler device ________. A) punctures a capsule of a bronchodilator drug B) is used with the trade name drug Spiriva C) is a powdered drug D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 26) Metered-dose inhalers are L-shaped devices that deliver the prescribed drug dose in ________. A) drops B) units C) puffs D) inches Answer: C Explanation: A) Metered-dose inhalers do not use drops. B) Metered-dose inhalers do not use units. C) Correct. D) Metered-dose inhalers do not use inches.

27) Bobby Whittaker has childhood asthma and takes a corticosteroid drug to prevent asthma attacks. Which drug is he taking? A) ipratropium (Atrovent HFA) B) budesonide (Pulmicort) C) zileuton (Zyflo) D) ethambutol (Myambutol) Answer: B Explanation: A) This is an anticholinergic drug for COPD, not a corticosteroid drug. B) Correct. C) This is a leukotriene receptor blocker, not a corticosteroid drug. D) This is an antitubercular drug, not a corticosteroid drug. 28) Rachel McVey has been smoking for 10 years but wants to quit. All of these drugs are used to stop smoking, EXCEPT ________. A) Chantix B) Proventil C) Nicoderm CQ D) Nicotrol Answer: B Explanation: A) This is a stop smoking drug. B) Correct. Proventil is a bronchodilator drug, not a stop smoking drug. C) This is a stop smoking drug. D) This is a stop smoking drug. 29) The bronchodilator drug tiotropium (Spiriva) is administered with a/an ________ that crushes a capsule containing the powered drug. A) Twisthaler device B) Handihaler device C) L-shaped metered-dose inhaler D) endotracheal tube Answer: B Explanation: A) Spiriva is not administered with a Twisthaler device. B) Correct. C) Spiriva is not administered with a metered-dose inhaler. D) Spiriva is not administered with an endotracheal tube.

30) Which of the following is a combination drug used to treat asthma and COPD? A) Advair Discus B) Breo Ellipta C) Symbicort D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 31) Which of the following statements is FALSE? A) Tuberculosis is caused by a bacterium that has a waxy outer coating. B) The tuberculosis bacterium has not yet developed resistance to antitubercular drugs. C) Drug treatment for tuberculosis involves a combination of drugs over a period of 9 months. D) When tuberculosis patients will not take their medication, the state can make them remain in their homes except for doctor visits. Answer: B Explanation: A) This statement is true. B) Correct. This statement is false. C) This statement is true. D) This statement is true. 32) Which of these suffixes is common to generic beta2-agonist bronchodilator drugs? A) -terol B) -sonide C) -amine D) -lukast Answer: A Explanation: A) Correct. B) This is common to generic corticosteroid drugs. C) This is common to generic first-generation antihistamine drugs. D) This is common to generic leukotriene formation inhibitor drugs.

33) Which of the following phrases is related to tuberculosis? A) metered-dose inhaler B) directly observed therapy C) nicotine receptors D) mast cells Answer: B Explanation: A) This is not related to tuberculosis. B) Correct. C) This is not related to tuberculosis. D) This is not related to tuberculosis. 34) An expectorant drug ________. A) is only prescribed for a productive cough B) reduces the viscosity (thickness) of mucus C) allows patients to cough up sputum more easily D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 35) INH is an abbreviation that is related to a/an ________ drug. A) corticosteroid drug B) mast cell stabilizer drug C) antitubercular drug D) anticholinergic drug Answer: C Explanation: A) INH is not related to a corticosteroid drug. B) INH is not related to a mast cell stabilizer drug. C) Correct. D) INH is not related to an anticholinergic drug. 36) Which form of a drug works the fastest to relieve an asthma attack? A) inhaled liquid B) tablet C) capsule D) All of the above. Answer: A Explanation: A) Correct. B) This does not work the fastest. C) This does not work the fastest. D) Only one answer is correct. 11 Copyright © 2022 Pearson Education, Inc.

37) Nicotine drugs to stop smoking come in which of the following drug forms? A) chewing gum B) transdermal patch C) nasal spray D) All of the above. Answer: D Explanation: A) Nicotine stop smoking drugs do come as chewing gum. B) Nicotine stop smoking drugs do come as a transdermal patch. C) Nicotine stop smoking drugs do come as a nasal spray. D) Correct. 38) The abbreviation DOT is related to ________. A) corticosteroid drugs B) inhalers for asthma C) tuberculosis D) smoking Answer: C Explanation: A) DOT stands for directly observed therapy; it is not related to corticosteroid drugs. B) DOT stands for directly observed therapy; it is not related to inhalers for asthma. C) Correct. D) DOT stands for directly observed therapy; it is not related to smoking. 39) Which patients can benefit from using an expectorant drug? A) Those who smoke. B) Those who have COPD. C) Those who have tuberculosis or pneumonia. D) All of the above. Answer: D Explanation: A) Smoking produces excessive mucus for an expectorant drug to treat. B) COPD produces excessive mucus for an expectorant drug to treat. C) Tuberculosis and pneumonia both produce excessive mucus for an expectorant drug to treat. D) Correct.

40) Which of these drugs is NOT used to help patients stop smoking? A) The antidepressant drug bupropion B) nicotine drugs C) The antihistamine drug levocetirizine. D) The nicotine blocker drug varenicline (Chantix) Answer: C Explanation: A) This drug is used to help stop smoking. B) These drugs are used to help stop smoking. C) Correct. This antihistamine drug is not used to help stop smoking. D) This drug is used to help stop smoking 41) Which of these sound-alike trade name drugs is a mast cell stabilizer drug? A) Nasacort B) Nasonex C) NasalCrom D) All of the above. Answer: C Explanation: A) This is a corticosteroid drug. B) This is a corticosteroid drug. C) Correct. D) There is only one correct answer. 42) The well-known generic antihistamine drug loratadine is related to the trade name drug ________. A) Claritin B) Tavist Allergy C) Nasacort D) These are all trade names of the antihistamine drug loratadine. Answer: A Explanation: A) Correct. B) This is the trade name for clemastine, not loratadine. C) This is the trade name for triamcinolone, not loratadine. D) There is only one correct answer.

43) The well-known second-generation generic antihistamine drug fexofenadine is related to the trade name drug ________. A) Astepro B) Chlor-Trimeton Allergy C) Allegra D) None of these is the trade name for fexofenadine. Answer: C Explanation: A) This is related to the antihistamine drug azelastine, not fexofenadine. B) This is the trade name for the first-generation antihistamine chlorpheniramine, not fexofenadine. C) Correct. D) There is a correct answer. 44) Asthma can be triggered by which of the following? A) emotional stress B) allergens or smoke C) exercise D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 45) Drug categories used to treat chronic obstructive pulmonary disease (COPD) include all of the following, EXCEPT ________. A) corticosteroid drugs B) anticholinergic drugs C) expectorant drugs D) decongestant drugs Answer: D Explanation: A) These drugs are used to treat COPD. B) These drugs are used to treat COPD. C) These drugs are used to treat COPD. D) Correct. Decongestant drugs are not used to treat COPD.

46) The chances of contracting COVID-19 are based on which of the following? A) the variant strains that are present B) the length of time of contact C) the amount of ventilation in the immediate environment D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 6.2

True/False Questions

1) If a patient's immune system is strong, a tuberculosis infection can remain dormant for years without causing symptoms. Answer: TRUE 2) Expectorant drugs are prescribed for a nonproductive cough. Answer: FALSE Explanation: Expectorant drugs are only prescribed for a productive cough. 3) Corticosteroid drugs dilate the bronchioles, and so they can be used to treat an acute attack of asthma. Answer: FALSE Explanation: Corticosteroid drugs do not dilate the bronchioles, so they cannot be used to treat an acute asthma attack. 4) Corticosteroid drugs have a decongestant effect and an antihistamine effect. Answer: FALSE Explanation: They have no decongestant or antihistamine effect. 5) The suffixes -clidinium and -tropium are common to generic anticholinergic bronchodilator drugs. Answer: TRUE 6) A spacer connected to a metered-dose inhaler helps the patient coordinate the steps needed to use the inhaler correctly. Answer: TRUE 7) Mucinex is the trade name for the generic drug guaifenesin. Answer: TRUE 8) For the drug Nicoderm CQ, the CQ stands for Committed Quitters. Answer: TRUE

9) The monoclonal antibody drug omalizumab (Xolair) is a powder that is inhaled to prevent an acute asthma attack. Answer: FALSE Explanation: This is a drug for asthma, but it is given by subcutaneous injection. 10) Mast cell stabilizer drugs prevent mast cells in the nose from releasing histamine and causing edema of the mucous membranes and sneezing. Answer: TRUE 11) The suffixes -terol and -terenol are common to nicotine drugs. Answer: FALSE Explanation: These are suffixes common to beta2-agonist bronchodilator drugs. 12) Nicotine addiction is the most common form of chemical dependence. Answer: TRUE 13) With the newest advances in pharmacology, tuberculosis that was resistant to drugs has become a thing of the past. Answer: FALSE Explanation: Multidrug-resistant tuberculosis is resistant to some antitubercular drugs. 14) Corticosteroid drugs for asthma mimic the action of the hormone cortisol, which is produced in the lungs. Answer: FALSE Explanation: Cortisol is produced in the cortex of the adrenal gland. 15) Bronchodilator drugs relax the layer of smooth muscle that surrounds the air passageways, allowing the bronchi and bronchioles to dilate to increase airflow. Answer: TRUE 16) Nicotine is not an addictive substance, but it just the pleasure that smoking gives that makes it difficult to quit smoking. Answer: FALSE Explanation: Nicotine is an addictive substance the stimulation of the limbic lobe to provide pleasure are two effects that make it difficult to quit. 17) In the past, asthma inhalers used to contain HFA, a propellant that was banned as a pollutant under the U.S. Clean Air Act. Now asthma inhalers contain the propellant CFC. Answer: FALSE Explanation: Inhalers used to contain the propellant CFC, which was banned and replaced by HFA. 18) The suffixes -lone, -sone, -solide, and -sonide are common to generic corticosteroid drugs. Answer: TRUE

19) Because TB is a public health problem, patients with tuberculosis who are noncompliant with taking their antitubercular drugs can be ordered to remain in their homes or even sent to jail. Answer: TRUE 20) The abbreviation MDI refers to a device that contains a bronchodilator or corticosteroid drug used to treat asthma. Answer: TRUE 21) The abbreviation IHN stands for the drug isoniazid. Answer: TRUE 22) The well-known generic corticosteroid drug mometasone is related to the trade name drug Asmanex. Answer: TRUE 23) The tuberculosis bacterium has developed varying degrees of resistance to most antitubercular drugs. Answer: TRUE 24) If the patient has a productive cough, an antitussive drug should be prescribed. Answer: FALSE Explanation: Antitussive drugs are not used to treat a productive cough. 25) The two types of antitussive drugs are opioid and non-opioid. Answer: TRUE 26) Dexamethasone is an FDA-approved corticosteroid drug that is given intravenously to treat patients with COVID-19. Answer: TRUE 27) Seasonal episodes of influenza are caused by a bacterium. Answer: FALSE Explanation: Influenza ("the flu") is caused by a virus, not a bacterium. 28) Antiviral drugs, such as oseltamivir (Tamiflu) are a adequate substitute for getting an annual influenza vaccination. Answer: FALSE 6.3

Short Answer Questions

1) ________ drugs act by inhibiting the body's immune response. They decrease inflammation and edema of the mucous membranes of the sinuses, nose, and throat. Answer: Corticosteroid 2) During an allergic reaction, histamine is released from ________ cells. Answer: mast 17 Copyright © 2022 Pearson Education, Inc.

3) The nasal spray drug oxymetazoline (Afrin) belongs to the ________ category of drugs. Answer: decongestant 4) The drug dextromethorphan (Delsym, Robitussin, Triaminic) is categorized as a non-opioid ________ drug. Answer: antitussive 5) The well-known generic antihistamine drug diphenhydramine is related to the trade name drug ________. Answer: Benadryl 6) Antitussive drugs act by suppressing the ________ center in the brain. Answer: cough 7) ________ drugs are used to treat dry, nonproductive coughs. Answer: Antitussive 8) Mast cell stabilizer drugs stabilize the cell membrane of mast cells and prevent them from releasing ________ during the lymphatic system's response to an antigen. Answer: histamine 9) The suffix -phylline is common to generic PDE enzyme inhibitor ________ drugs. Answer: bronchodilator 10) ________ drugs reduce the viscosity or thickness of mucus (sputum) so that the patient can more easily cough it up. Answer: Expectorant 11) A ________ inhaler is an inhaler device that contains a quick-acting bronchodilator drug to quickly relieve a patient with acute asthma symptoms. Answer: rescue 12) For drugs given by an inhaler device, the prescribed dose is measured as the number of ________ or actuations. Answer: puffs 13) An MDI is an L-shaped device used to administer drugs. The abbreviation MDI stands for ________ ________ ________. Answer: metered-dose inhaler 14) The abbreviation DOT stands for ________ ________ therapy. Answer: directly observed 15) A Twisthaler device contains a corticosteroid drug in the form of a/an ________ to treat asthma. Answer: powder 18 Copyright © 2022 Pearson Education, Inc.

16) The abbreviation MDRTB stands for ________ ________ tuberculosis. Answer: Multidrug resistant 17) A/An ________ is a long plastic chamber attached to a metered-dose inhaler. Answer: spacer 18) The suffix ________ is common to generic monoclonal antibody drugs. Answer: -mab 19) Treatment of tuberculosis must be continued for a full ________ months with a combination of antitubercular drugs. Answer: nine 20) Epinephrine from the sympathetic nervous system causes the bronchioles to ________ (widen), and this increases the flow of air. Answer: dilate 21) To minimize the chance of resistant strains of tuberculosis, a combination of ________ antitubercular drugs are given together at the same time. Answer: three 22) Antitubercular drugs must be taken for a total of ________ months. Answer: 9 23) Decongestant drugs act as ________ to reduce blood flow to mucous membranes in the nose, sinuses, and throat. Answer: vasoconstrictors 24) Palforzia is the trade name for an allergen-specific immunotherapy drug that treats patients who have an allergy to ________. Answer: peanuts 25) ________ is a severe systemic allergic reaction to foods or insect bites in patients with severe allergies. Answer: Anaphylaxis. 26) First-generation antihistamine drugs are effective in treating allergies, but they have a significant side effect of ________. Answer: drowsiness 27) The two components of chronic obstructive pulmonary disease are chronic bronchitis and ________. Answer: emphysema 28) Some drugs for COVID-19 are available under an EUA from the FDA. EUA stands for ________ ________ ________. Answer: Emergency Use Authorization 19 Copyright © 2022 Pearson Education, Inc.

6.4

Matching Questions

Match the drug categories in Column 2 with their drug names in Column 1. A) expectorant drug B) antitubercular drug C) monoclonal antibody drug D) drug to stop smoking E) beta2-agonist bronchodilator drug F) corticosteroid drug G) mast cell stabilizer drug H) PDE enzyme inhibitor bronchodilator drug I) leukotriene receptor blocker drug J) combination of two bronchodilator drug 1) albuterol (Proventil, HFA, Ventolin HFA) 2) theophylline (Elixophyllin, Theo-24) 3) Combivent Respimat 4) cromolyn (NasalCrom) 5) guaifenesin (Mucinex) 6) isoniazid (INH) 7) dupilumab (Dupixent) 8) fluticasone (Flonase) 9) varenicline (Chantix) 10) zafirlukast (Accolate) Answers: 1) E 2) H 3) J 4) G 5) A 6) B 7) C 8) F 9) D 10) I

Match the drug categories in Column 2 with their drug names in Column 1. A) non-opioid antitussive drug B) allergen extract drug C) corticosteroid drug for asthma D) corticosteroid drug for the nose E) first-generation antihistamine drug F) second-generation antihistamine drug G) decongestant drug H) mast cell stabilizer drug 11) oxymetazoline (Afrin, Dristan, Duration) 12) cetirizine (Zyrtec) 13) benzonatate (Tessalon Perles) 14) fluticasone (Flonase) 15) fluticasone (Flovent HFA) 16) diphenhydramine (Benadryl) 17) cromolyn (Nasalcrom) 18) grass pollen allergen (Oralair) Answers: 11) G 12) F 13) A 14) D 15) C 16) E 17) H 18) B 6.5

Essay Questions

1) Why are antihistamine drugs included in combination drugs for the common cold? Answer: Even though antihistamine drugs are not effective against the bacteria and viruses that cause the common cold, they are still sometimes included in these combination drugs because they have a drying effect on the mucous membranes that is helpful in treating a runny nose from a common cold. 2) What is the memory tip to help remember that the corticosteroid drug Rhinocort is used in the nose? Answer: The trade name Rhinocort is derived from rhin/o- and -cort. Rhin/o- is a combining form that means "nose." The suffix -cort is a shortened form of corticosteroid. Memory tip: It is a rhinoceros that has the large horn on its nose.

3) Briefly explain why a common side effect of intranasal corticosteroid drugs is the development of nasal infections or colds. Answer: The nose is an important site where white blood cells from the lymphatic system attack and kill bacteria and viruses in inhaled air. Because intranasal corticosteroid drugs suppress the immune response as they decrease inflammation, these drugs cause a common side effect of nasal infections and colds. 4) How does the Centers for Disease Control and Prevention (CDC) select what viruses will be present this year in the annual flu shot? Why does this have to be done each year? Answer: The CDC selects those strains of the influenza virus that are most prevalent in Asia and other parts of the world to be included in the flu vaccine that will be offered in the Unites States the following fall (before the start of flu season). Flu viruses mutate constantly, and so the influenza vaccine must be reformulated each year. 5) Explain why resistant strains of tuberculosis develop and what is done to minimize the chance of this occurring. Answer: Resistant strains develop when the patient is not compliant and does not take the antitubercular drug for the prescribed length of time of 9 months. To minimize the chance of resistant strains, antitubercular drugs are given in a combination of 3 antitubercular drugs, and patients must continue drug treatment for a full nine months. 6) What can be done to protect the public's health when a person with tuberculosis refuses to be compliant with the treatment? Answer: Patients who refuse (or unable to be) compliant may be required to participate in directly observed therapy (DOT), in which the patient must come to the clinic each day and be observed taking each dose. Noncompliant patients can be ordered to remain in their homes (except for doctor visits) or even sent to jail where their treatment is continued.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 7 Cardiovascular Drugs 7.1

Multiple Choice Questions

1) Which category of drugs promotes the excretion of sodium and water in the urine to lower the blood pressure? A) ACE inhibitor drugs B) beta-blocker drugs C) diuretic drugs D) digitalis drugs Answer: C Explanation: A) These drugs lower the blood pressure but not by excreting sodium and water. B) These drugs lower the blood pressure but not by excreting sodium and water. C) Correct. D) These drugs are not used to lower the blood pressure. 2) If the serum cholesterol level is too high, bile acid sequestrant drugs ________. A) bind with receptors in the liver so that cholesterol is not formed B) bind with bile to form an insoluble complex that is excreted in the feces C) change bile so that the cholesterol in it can be excreted by the kidneys D) inhibit cholesterol formation so that none is in the bile Answer: B Explanation: A) Bile acid sequestrant drugs do not keep cholesterol from being formed. B) Correct. C) Cholesterol is not excreted by the kidneys. D) Bile acid sequestrant drugs do not inhibit cholesterol formation. 3) Nitrate drugs ________. A) constrict the coronary arteries and decrease the flow of oxygenated blood B) constrict the coronary arteries and increase the flow of oxygenated blood C) dilate the coronary arteries and decrease the flow of oxygenated blood D) dilate the coronary arteries and increase the flow of oxygenated blood to the heart muscle Answer: D Explanation: A) Nitrate drugs do not constrict the coronary arteries. B) Nitrate drugs do not constrict the coronary arteries. C) Nitrate drugs do dilate the coronary arteries but this increases blood flow. D) Correct.

4) When the drug atropine is used to treat bradycardia, its action is to ________. A) block the movement of calcium ions to allow the coronary arteries to dilate B) block the effect of acetylcholine which normally causes a decreased heart rate C) have a negative chronotropic effect D) lower the cholesterol level Answer: B Explanation: A) This action does not treat bradycardia. B) Correct. C) This effect slows the heart rate, which is not desirable for bradycardia. D) Atropine does not affect the cholesterol level. 5) Beta-blocker drugs used to treat hypertension block beta1 receptors in the heart and keep the receptors from being stimulated by ________. A) acetylcholine B) angiotensin C) epinephrine D) calcium Answer: C Explanation: A) Acetylcholine does not stimulate beta1 receptors in the heart. B) Angiotensin does not stimulate beta1 receptors in the heart. C) Correct. D) Calcium does not stimulate beta1 receptors in the heart. 6) ________ drugs, that relax smooth muscle and cause the arteries in the arms and legs to dilate, are used to treat hypertension. A) Antiarrhythmic B) Diuretic C) Peripheral vasodilator D) All of the above. Answer: C Explanation: A) Antiarrhythmic drugs are used to treat arrhythmias, not hypertension. B) Diuretic drugs are used to treat hypertension, but not with this action. C) Correct. D) Only one answer is correct.

7) Calcium channel blocker drugs block the movement of calcium ions into smooth muscles in the blood vessels. This results in all of the following, EXCEPT ________. A) the heart contracts less frequently B) the arteries dilate C) the blood pressure is lowered D) hypertension is treated Answer: A Explanation: A) Correct. Calcium channel blocker drugs do not slow the heart rate. B) This is one of the results. C) This is one of the results. D) This is one of the results. 8) In addition to being used to treat hypertension and angina pectoris, the beta-blocker drug propranolol (Inderal) is also used to do all of the following, EXCEPT ________. A) treat atrial fibrillation B) treat digoxin drug toxicity C) treat essential familial tremor D) prevent migraine headaches Answer: B Explanation: A) Propranolol is used to treat atrial fibrillation. B) Correct. C) Propranolol is used to treat essential familial tremor. D) Propranolol is used to prevent migraine headaches. 9) All of these substances are part of the body's own natural blood pressure-regulating system, EXCEPT ________. A) angiotensin I B) renin C) triglycerides D) angiotensin II Answer: C Explanation: A) Angiotensin I is part of the body's own natural blood pressure-regulating system. B) Renin is part of the body's own natural blood pressure-regulating system. C) Correct. D) Angiotensin II is part of the body's own natural blood pressure-regulating system.

10) James Raucher has had asthma since he was a child. When he turned 60, he also developed hypertension. His healthcare provider prescribed a cardioselective beta-blocker drug to treat his hypertension because cardioselective beta-blocker drugs ________. A) are the best choice for older adults with hypertension B) are less likely to cause an allergic reaction than other beta-blocker drugs C) dilate the arteries but allow the bronchi to remain open D) are more effective than other beta-blocker drugs for treating hypertension Answer: C Explanation: A) Cardioselective beta-blocker drugs can be given to any adult with hypertension. B) Cardioselective beta-blocker drugs are not more likely to cause an allergic reaction than other beta-blocker drugs. C) Correct. D) Cardioselective beta-blocker drugs are not more effective in treating hypertension than other beta-blocker drugs. 11) Which of the following statements is FALSE? A) Congestive heart failure was first treated with dried foxglove plant leaves. B) The Latin name of foxglove is Digitalis lanata because the flowers resembled digits or fingers. C) The two trade names of digoxin are Lopid and Lanoxin. D) The drug digoxin (Lanoxin) is the only digitalis drug that is on the market. Answer: C Explanation: A) This statement is true. B) This statement is true. C) Correct. Lopid is the trade name for gemfibrozil, not digoxin. D) This statement is true. 12) The suffix ________ is common to generic beta-blocker drugs. A) -azosin B) -dipine C) -olol D) -pril Answer: C Explanation: A) The suffix -azosin is not common to generic beta-blocker drugs. B) The suffix -dipine is not common to generic beta-blocker drugs. C) Correct. D) The suffix -pril is not common to generic beta-blocker drugs.

13) Which of the following is a digitalis drug used to treat congestive heart failure? A) digoxin (Digitek, Digox, Lanoxin) B) nadolol (Corgard) C) digoxin immune Fab (DigiFab) D) valsartan (Diovan) Answer: A Explanation: A) Correct. B) This is a beta-blocker drug, not a digitalis drug. C) Digoxin immune Fab is used to treat digoxin toxicity. D) Valsartan (Diovan) is not a digitalis drug. 14) What is one of the trade names of the generic beta-blocker drug propranolol? A) Xylocaine B) Coreg C) Inderal D) Tenormin Answer: C Explanation: A) Xylocaine is not the trade name of propranolol. B) Coreg is not the trade name of propranolol. C) Correct. D) Tenormin is not the trade name of propranolol. 15) Which of the following drugs is to treat congestive heart failure? A) foxglove B) nitroglycerin C) digoxin D) herbs Answer: C Explanation: A) Foxglove is a plant, not a drug. B) Nitroglycerin is not used to treat congestive heart failure. C) Correct. D) Herbs are not used to treat congestive heart failure. 16) All of the following are trade names for calcium channel blocker drugs, EXCEPT ________. A) Tenoretic B) Procardia C) Cardizem D) Calan Answer: A Explanation: A) Correct. This is a combination beta-blocker and diuretic drug. B) Procardia is a calcium channel blocker drug. C) Cardizem is a calcium channel blocker drug. D) Calan is a calcium channel blocker drug. 5 Copyright © 2022 Pearson Education, Inc.

17) All of the following are HMG-CoA reductase inhibitors to treat an elevated level of cholesterol, EXCEPT ________. A) atorvastatin (Lipitor) B) lomitapide (Juxtapid) C) fluvastatin (Lescol XL) D) rosuvastatin (Crestor) Answer: B Explanation: A) Lipitor is used to treat an elevated level of cholesterol. B) Correct. This drug is used to treat an elevated level of cholesterol, but it is not an HMG-CoA reductase inhibitor. C) Lescol XL is used to treat a high level of cholesterol. D) Crestor is used to treat an elevated level of cholesterol. 18) The trade names for nitroglycerin include all of the following, EXCEPT ________. A) Norvasc B) Nitro-Bid C) Minitran D) Nitrostat Answer: A Explanation: A) Correct. Norvasc is a calcium channel blocker for hypertension. B) Nitro-Bid is a trade name for nitroglycerin. C) Minitran is a trade name for nitroglycerin. D) Nitrostat is a trade name for nitroglycerin. 19) Nitroglycerin is available in all of the following drug forms, EXCEPT ________. A) intravenous drug B) sublingual tablet or spray C) inhaled powder D) transdermal patch Answer: C Explanation: A) Nitroglycerin is available as an intravenous drug. B) Nitroglycerin is available as a sublingual tablet or spray. C) Correct. D) Nitroglycerin is available as a transdermal patch.

20) All of the following are beta-blocker drugs, EXCEPT ________. A) atenolol (Tenormin) B) esmolol (Brevibloc) C) metoprolol (Kapspargo, Lopressor, Toprol) D) aliskiren (Tekturna) Answer: D Explanation: A) This is a beta-blocker drug. B) This is a beta-blocker drug. C) This is a beta-blocker drug. D) Correct. This is a renin inhibitor drug, not a beta-blocker drug. 21) An elevated level of triglycerides in the blood can be caused by which of the following? A) sugar B) egg yolks and butter C) oils and margarine D) A and C Answer: D Explanation: A) Dietary intake of sugar can cause elevated triglycerides. B) These foods cause elevated cholesterol, not triglycerides. C) Dietary intake of oils and margarine can cause elevated triglycerides. D) Correct. 22) The trade name for the antiarrhythmic generic drug lidocaine is ________. A) Xylocaine B) Lipitor C) Tekturna D) Inderal Answer: A Explanation: A) Correct. B) Lipitor is the trade name for the generic drug atorvastatin, not lidocaine. C) Tekturna is the trade name for the generic drug aliskiren, not lidocaine. D) Inderal is the trade name for the generic drug propranolol, not lidocaine. 23) Which of the following drugs is NOT an ACE inhibitor drug used to treat hypertension? A) benazepril (Lotensin) B) telmisartan (Micardis) C) lisinopril (Prinivil, Qbrelis, Zestril) D) ramipril (Altace) Answer: B Explanation: A) Benazepril (Lotensin) is an ACE inhibitor drug. B) Correct. This is an angiotensin II receptor blocker drug. C) Lisinopril (Prinivil, Qbrelis, Zestril) is an ACE inhibitor drug. D) Ramipril (Altace) is an ACE inhibitor drug. 7 Copyright © 2022 Pearson Education, Inc.

24) Types of cardiac arrhythmias include all of the following, EXCEPT ________. A) hyperlipidemia B) bradycardia C) atrial fibrillation D) ventricular tachycardia Answer: A Explanation: A) Correct. Hyperlipidemia is not an arrhythmia. B) Bradycardia is a cardiac arrhythmia. C) Atrial fibrillation is a cardiac arrhythmia. D) Ventricular fibrillation is a cardiac arrhythmia. 25) Which of the following statements is TRUE concerning digitalis drugs? A) It has a positive inotropic effect. B) It has a negative chronotropic effect. C) They contain chains of glucose sugars known as glycosides. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 26) Symptoms of digoxin toxicity include all of the following, EXCEPT ________. A) heart rate below 60 beats per minute B) a myocardial infarction C) nausea and vomiting D) hallucinations or yellow-green halos around lights Answer: B Explanation: A) This is a symptom of digitalis toxicity. B) Correct. This is not a symptom of digoxin toxicity. C) These are symptoms of digitalis toxicity. D) This is a symptom of digitalis toxicity.

27) All of the following trade name drugs are used to treat an elevated level of cholesterol, EXCEPT ________. A) Zocor B) Zetia C) Ziac D) Welchol Answer: C Explanation: A) Zocor is used to treat an elevated level of cholesterol. B) Zetia is used to treat an elevated level of cholesterol. C) Correct. Ziac is a combination drug for hypertension. D) Welchol is used to treat an elevated level of cholesterol. 28) Which of the following does NOT belong to the drug category of calcium channel blockers to treat hypertension? A) amlodipine (Norvasc) B) nifedipine (Procardia) C) verapamil (Calan SR, Verelan) D) prazosin (Minipress) Answer: D Explanation: A) Amlodipine (Norvasc) is a calcium channel blocker drug. B) Nifedipine (Procardia) is a calcium channel blocker drug. C) Verapamil (Calan SR, Verelan is a calcium channel blocker drug. D) Correct. Prazosin (Minipress) is an alpha1 receptor blocker for hypertension. 29) How are symptoms of digitalis toxicity treated? A) by giving the drug less frequently B) by decreasing the amount of the dose of the drug C) by administering an antidote drug to decrease a toxic level in the blood. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

30) ________ drugs are also known as "statin" drugs. A) HMG-CoA reductase inhibitor drugs B) calcium channel blocker drugs C) beta-blocker drugs D) digitalis drugs Answer: A Explanation: A) Correct. B) Calcium channel blocker drugs are not known as "statin" drugs. C) Beta-blocker drugs are not known as "statin" drugs. D) These are not known as "statin" drugs. 31) Drugs used to treat angina pectoris include all of the following, EXCEPT ________. A) antiarrhythmic drugs B) nitrate drugs C) beta-blocker drugs D) calcium channel blocker drugs Answer: A Explanation: A) Correct. B) Nitrate drugs are used to treat angina pectoris. C) Beta-blocker drugs are used to treat angina pectoris. D) Calcium channel blocker drugs are used to treat angina pectoris. 32) Very low-density lipoproteins (VLDL) carry ________ in the blood. A) triglycerides B) sodium C) the hormone epinephrine D) cholesterol Answer: A Explanation: A) Correct. B) Very low-density lipoproteins do not carry sodium. C) Very low-density lipoproteins do not carry epinephrine. D) Very low-density lipoproteins do not carry cholesterol.

33) All of the following categories of drugs are used to treat congestive heart failure, EXCEPT ________. A) digitalis drugs and diuretic drugs B) ACE inhibitor drugs and HCN channel inhibitor drugs C) "statin" drugs and SGLT2 inhibitor drugs D) alpha-/beta-blocker drugs Answer: C Explanation: A) These drug categories are used to treat congestive heart failure. B) These drugs are used to treat congestive heart failure. C) Correct. SGLT2 inhibitor drugs are used to treat congestive heart failure, but "statin" drugs are not. D) These drugs are used to treat congestive heart failure. 34) HDL, LDL, and VLDL are ________. A) types of lipoproteins B) carrier molecules C) types of "good cholesterol" D) A and B Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) "Good cholesterol" is only related to HDL. D) Correct. 35) Which of the following contribute to heart disease? A) Smoking B) Obesity and sedentary lifestyle C) diabetes mellitus D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

36) Lifestyle changes are the first treatment recommended for which of the following diseases? A) arrhythmias B) hypertension C) hyperlipidemia D) B and C Answer: D Explanation: A) Lifestyle changes are not used to treat arrhythmias. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 37) The well-known generic name drug rosuvastatin that is used to treat hypercholesterolemia is related to the trade name drug ________. A) Corgard B) Crestor C) Cardizem D) All of the above. Answer: B Explanation: A) This is related to the generic drug nadolol, not rosuvastatin. B) Correct. C) This is related to the generic drug diltiazem, not rosuvastatin. D) Only one answer is correct. 38) Over-the-counter, low-dose, 81-mg tablets of this drug should be taken daily by patients who have had a myocardial infarction or stroke. A) foxglove plant B) aspirin C) sheep antibodies D) All of the above. Answer: B Explanation: A) This is a plant, not an over-the-counter drug. B) Correct. C) This not an over-the-counter drug. D) Only one answer is correct.

39) The pain of angina pectoris occurs for all of the following reasons, EXCEPT ________. A) the coronary arteries are affected by hypertension B) the coronary arteries are narrowed because of plaque on their walls C) the coronary arteries are blocked by a blood clot D) the coronary arteries are constricted from smoking Answer: A Explanation: A) Correct. Hypertension is in the arteries, not the coronary arteries. B) This is a reason for angina pectoris. C) This is a reason for angina pectoris. D) This is a reason for anginal pectoris. 40) Which two trade names of diltiazem can be taken in the unique way of opening their capsules and sprinkling the contents on a spoonful of applesauce? A) Accupril and Altace B) Taztia XT and Tiazac C) NitroMist and Nitrostat D) Plavix and Prinivil Answer: B Explanation: A) These trade names are not related to diltiazem. B) Correct. C) These trade names are related to nitroglycerin, not diltiazem. D) These trade names are not related to diltiazem. 41) Which of the following are P2Y12 receptor antagonist drugs to treat a myocardial infarction? A) ticagrelor (Brilinta) B) clopidogrel (Plavix) C) prasugrel (Effient) D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct statement. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct.

42) Which of the following is an action of alpha-/beta-blocker drugs used to treat congestive heart failure? A) It blocks the action of norepinephrine at alpha receptors. B) It blocks the action of epinephrine at beta receptors. C) It decreases the blood pressure and the heart rate. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true but it is not the only correct answer. D) Correct. 43) Which of the following categories of drugs is used to treat congestive heart failure? A) SGLT2 inhibitor drugs B) Diuretic drugs C) HCN channel inhibitor drugs D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 44) Esmolol (Brevibloc) is used to treat ________. A) cardiac arrhythmias B) hyperlipidemia C) hypertension D) All of the above. Answer: A Explanation: A) Correct. B) This drug is not used to treat hyperlipidemia. C) This drug is not used to treat hypertension. D) There is only one correct answer.

45) Which of the following is an emergency situation in which the heart muscle is quivering and not pumping any blood? A) Heart block B) Ventricular fibrillation C) Asystole D) Atrial fibrillation Answer: B Explanation: A) This does not describe heart block. B) Correct. C) This does not describe asystole. D) This does not describe atrial fibrillation. 46) Bile acid sequestrant drugs that are used to treat hyperlipidemia include all of these drugs, EXCEPT ________. A) colestipol (Colestid) B) gemfibrozil (Lopid) C) cholestyramine (Prevalite, Questran) D) colesevelam (Welchol) Answer: B Explanation: A) This is a bile acid sequestrant drug. B) Correct. This is a fibric acid drug, not a bile acid sequestrant drug. C) This is a bile acid sequestrant drug. D) This is a bile acid sequestrant drug. 7.2

True/False Questions

1) Hyperlipidemia includes both hypercholesterolemia and hypertriglyceridemia. Answer: TRUE 2) HMG-CoA reductase inhibitor drugs block HMG-CoA, an enzyme that is needed for the production of cholesterol by the liver. Answer: TRUE 3) A high level of HDL is undesirable. Answer: FALSE Explanation: A high level of HDL ("good cholesterol") is desirable. 4) By blocking an enzyme, ACE inhibitor drugs cause blood vessels to dilate, and this decreases the blood pressure. Answer: TRUE 5) Lipitor was the first statin drug on the market. Answer: TRUE

6) Antiarrhythmic drugs that are used to treat ventricular fibrillation can also be given during a cardiac arrest. Answer: FALSE Explanation: Antiarrhythmic drugs have no therapeutic effect if the heart has already stopped beating. 7) Digoxin has a positive inotropic effect in treating congestive heart failure because it causes a stronger, more forceful contraction of the heart muscle cells. Answer: TRUE 8) The pain of angina pectoris occurs when heart muscle must contract too often. Answer: FALSE Explanation: Anginal pain occurs when heart muscle does not receive enough oxygenated blood through the coronary arteries. 9) Beta-blocker drugs block the action of epinephrine at beta receptors in the heart. Answer: TRUE 10) After a myocardial infarction, drugs can be given to improve heart function, and the heart muscle cells will repair themselves. Answer: FALSE Explanation: Once heart muscle cells die, the body does not repair or replace them. 11) Chris Zanzone has just been told that he has hyperlipidemia. Drug therapy is the first choice of treatment for hyperlipidemia. Answer: FALSE Explanation: Lifestyle changes are first, followed by drug therapy. 12) The suffix -sartan is common to generic angiotensin II receptor blocker drugs. Answer: TRUE 13) HMG-CoA reductase inhibitor drugs are used to treat hypercholesterolemia. Answer: TRUE 14) Digitalis drugs often causes toxicity because they have a low therapeutic index and a short half-life. Answer: FALSE Explanation: They have a long half-life. 15) Oatmeal cereal in the diet can reduce the cholesterol level in the blood. Answer: TRUE 16) Oat fiber has the same therapeutic effect as bile acid sequestrant drugs for lowering the cholesterol level in the blood. Answer: TRUE

17) Bile acid sequestrant drugs are used to treat the pain of angina pectoris. Answer: FALSE Explanation: They are used to treat hypercholesterolemia. 18) Lopressor HCT is a combination drug that contains the diuretic drug hydrochlorothiazide and the beta-blocker drug metoprolol. Answer: TRUE 19) The American Heart Association state that a normal blood pressure is 120/80 mm Hg. Answer: TRUE 20) Generic HMG-CoA reductase inhibitor drugs have a common suffix of -statin. Answer: TRUE 21) Oatmeal can lower the cholesterol in the blood because its oat fiber binds to bile and keeps it from being reabsorbed back into the blood. Answer: TRUE 22) Hypertension is a risk factor for developing hyperlipidemia. Answer: FALSE Explanation: Hypertension is a risk factor for developing a heart attack or stroke. 23) Heart disease is the leading cause of death in the United States. Answer: TRUE 24) Anticoagulant drugs can stop a blood clot from forming in the coronary arteries. Answer: TRUE 25) Acute coronary syndrome includes any condition that causes a sudden reduction in the flow of blood to the heart, such as a myocardial infarction. Answer: TRUE 26) Daily low-dose aspirin is recommended for everyone, even healthy individuals who have not had a heart attack or stroke. Answer: FALSE Explanation: This was once thought to be true, but daily low-dose aspirin is not recommended for healthy individuals because of the side effect of gastrointestinal bleeding. 27) Digitalis drugs affect the epinephrine and angiotensin levels in the heart muscle cells. Answer: FALSE Explanation: Digitalis drugs affect the sodium and calcium levels in the heart muscle cells. 28) Diuretic drugs are used to treat the edema associated with congestive heart failure. Answer: TRUE

29) A diagnosis of hypertension is confirmed only after several blood pressure measurements taken over time. Answer: TRUE 30) The majority of sodium intake comes from salt added to food eaten each day. Answer: FALSE Explanation: According to the CDC, seventy percent of dietary sodium comes from processed foods and restaurant foods. 31) The DASH diet is a lifestyle change for lowering the cholesterol intake from foods. Answer: FALSE Explanation: The DASH diet stands for Dietary Approaches to Stop Hypertension. 32) Alpha2 receptor agonist drugs for hypertension stimulate alpha2 receptors in the brain to decrease the amount of norepinephrine in the blood. Answer: TRUE 33) Cholesterol and triglycerides are both produced by the liver. Answer: TRUE 34) Eskimos have less heart disease than Americans, even though they only eat animal protein, because their diet contains cold-water fish and omega-3 fatty acids. Answer: TRUE 35) Omega-3 fatty acid drugs are used to treat hypertension. Answer: FALSE Explanation: They are used to treat hyperlipidemia. 36) Oats have been certified by the American Heart Association as a "heart-healthy" food. Answer: TRUE 7.3

Short Answer Questions

1) The abbreviation HTN stands for ________. Answer: hypertension 2) Diuretic drugs used to treat hypertension do this by promoting the excretion of ________ and water in the urine, which lowers the blood pressure. Answer: sodium 3) To be transported through the blood, cholesterol and triglycerides must bind to carrier molecules, which are known as ________. Answer: lipoproteins 4) ________ drugs are also known as cardiac glycoside drugs because they have a molecular structure that consists of chains of glucose sugar known as glycosides. Answer: Digitalis 18 Copyright © 2022 Pearson Education, Inc.

5) Nitroglycerin for angina pectoris is in the category of ________ drugs. Answer: nitrate 6) ________ hypertension is the most common type of hypertension, but its exact cause is unknown. Answer: Essential 7) Beta1 receptors located in the ________. Answer: heart 8) Combination drugs used to treat hypertension often contain the diuretic drug hydrochlorothiazide, and this is shown because the trade name of the drug contains the abbreviation ________. Answer: HCT 9) Cholesterol is produced by the ________, and it also comes from dietary intake of certain foods. Answer: liver 10) Digoxin immune Fab to treat digoxin toxicity is an antigen-binding fragment drug obtained from ________ that have been treated to produce antibodies against the molecular structure of the drug digoxin. Answer: sheep 11) The peripheral vasodilator drug minoxidil is used to treat hypertension, but it is also applied topically under the trade name ________ to treat thinning hair and baldness. Answer: Rogaine 12) The abbreviation HTN stands for ________. Answer: hypertension 13) The phrase stepped-care approach is related to the treatment of ________. Answer: hypertension 14) The well-known generic beta-blocker drug propranolol is related to the trade name drug ________. Answer: Inderal 15) The phrase "statin drugs" brings to mind the category of drugs used to treat high ________. Answer: cholesterol 16) When heart muscle cells die, this is called a myocardial ________. Answer: infarction

17) The P2Y12 receptor antagonist drug clopidogrel (Plavix) should not be taken with ________ or ________ juice because its effectiveness will decrease. Answer: grapefruit; grapefruit 18) Left-sided congestive heart failure causes a backup of blood in the ________, which results in congestion and ________ edema. Answer: lungs; pulmonary 19) The suffix ________ is common to generic ACE inhibitor drugs. Answer: -pril 20) Medical conditions, such as bradycardia, atrial fibrillation, and ventricular tachycardia, are treated with ________ drugs. Answer: antiarrhythmic 21) Cardiac arrhythmias are caused by abnormalities in the ________ impulses of the heart's conduction system. Answer: electrical 22) ________ occurs when there is a complete absence of a heartbeat of pulse and no electrical activity of the heart's conduction system, as seen on an EKG. Answer: Asystole 23) ________ is when the lumen (internal opening) in an artery increases in size, and the blood pressure in the artery decreases. Answer: Vasodilation 24) ________ was the first grain specifically approved by the FDA to advertise a health benefit that was related to heart disease. Answer: Oats

7.4

Matching Questions

Match the name of the drug categories for hypertension in Column 2 to the antihypertensive drug names in Column 1. A) angiotensin II receptor blocker drug B) ACE inhibitor drug C) calcium channel blocker drug D) peripheral vasodilator drug E) beta-blocker drug 1) diltiazem (Cardizem, Cartia, Tiazac) 2) hydralazine 3) losartan (Cozaar) 4) nebivolol (Bystolic) 5) quinapril (Accupril) Answers: 1) C 2) D 3) A 4) E 5) B

Match the name of the heart arrhythmia in Column 2 to the antiarrhythmic drug name that is used to treat it in Column 1. A) bradycardia B) heart block C) atrial fibrillation D) ventricular fibrillation E) ventricular tachycardia 6) adenosine (Adenocard) 7) lidocaine (Xylocaine) 8) atropine 9) digoxin (Digitek, Digox, Lanoxin) 10) isoproterenol (Isuprel) Answers: 6) E 7) D 8) A 9) C 10) B

7.5

Essay Questions

1) Explain how the effect of cardioselective beta-blocker drugs differs from that of regular beta-blocker drugs. What type of patients are cardioselective beta-blocker drugs specifically used to treat? Answer: Regular beta-blocker drugs block epinephrine at beta1 receptors and this causes the heart rate to decrease and the force of the contraction to decrease. But regular beta-blocker drugs also block beta2 receptors, and that causes smooth muscle around the bronchioles to constrict. Cardioselective beta-blocker drugs are more selective in their effect and only block beta1 receptors in the heart and not beta2 receptors in the bronchioles. Patients who have both hypertension and asthma are specifically given cardioselective beta-blocker drugs. 2) Describe the lifestyle changes that are suggested to patients before they are started on a drug for hypertension. Answer: Patients with hypertension are asked to lose weight, decrease stress, increase physical activity, stop smoking, and restrict the use of salt. 3) Describe the three ways that a patient can be treated who has symptoms of digoxin toxicity. Answer: The amount of the dose can be decreased, the frequency of the dose can be decreased, or an antidote drug is administered to decrease the toxic level in the blood. 4) Describe the difference between lisinopril (Zestril) and Zestoretic. Answer: Lisinopril (Zestril) is an ACE inhibitor drug used to treat hypertension and congestive heart failure. Zestoretic is a combination drug for hypertension that contains the generic ACE inhibitor drug lisinopril and the diuretic drug hydrochlorothiazide. 5) Describe how nitroglycerin, taken as a sublingual tablet, can act quickly to treat the pain of angina pectoris. Answer: Nitroglycerin is taken as a sublingual tablet that dissolves under the tongue. The drug then moves into the blood vessels under the tongue and into the blood where it circulates to the myocardium to relieve the pain of angina pectoris.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 8 Hematologic Drugs 8.1

Multiple Choice Questions

1) A blood clot forms after a complex series of steps involving all of the following substances, EXCEPT ________. A) clotting factors B) platelets C) white blood cells D) fibrin strands Answer: C Explanation: A) Clotting factors are involved in the steps of blood clotting. B) Platelets are involved in the steps of blood clotting. C) Correct. White blood cells are not involved with blood clotting. D) Fibrin strands are involved in blood clotting. 2) Warfarin (Coumadin, Jantoven) ________. A) is measured in milligrams B) is given orally C) works differently than heparin D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 3) ________ drugs bind to fibrin strands in the clot, then convert plasminogen in the clot to plasmin, an enzyme that destroys the fibrin strands to dissolve a blood clot. A) Anticoagulant B) Platelet aggregation inhibitor C) Factor Xa inhibitor D) Tissue plasminogen activator Answer: D Explanation: A) Anticoagulant drugs cannot dissolve a blood clot. B) Platelet aggregation inhibitor drugs do not bind to fibrin strands. C) Factor Xa inhibitor drugs do not bind to fibrin strands. D) Correct.

4) The formation of many clotting factors is dependent on the presence of ________. A) fibrin B) plasminogen C) vitamin K D) thrombin Answer: C Explanation: A) Fibrin is involved in the formation of a blood clot, not in the formation of clotting factors. B) Plasminogen is involved in the formation of a blood clot, not in the formation of the clotting factors. C) Correct. D) Thrombin is involved in the formation of a blood clot, not in the formation of clotting factors. 5) Heparin is composed of large molecules that are not easily absorbed. Only about ________ of a dose is absorbed to exert a therapeutic effect. A) 0 to 10 percent B) 20 to 30 percent C) 40 to 50 percent D) 50 to 60 percent Answer: B Explanation: A) This number is not correct. B) Correct. C) This number is not correct. D) This number is not correct. 6) Doses of heparin are always measured in ________. A) intravenous B) milligrams C) milliliters D) units Answer: D Explanation: A) This is a route of administration, not a dose measurement. B) Heparin is not measured in milligrams. C) Heparin is not measured in milliliters. D) Correct.

7) While she was in the hospital, Renee Waters was receiving subcutaneous heparin administered by a nurse. Now that she is being discharged home, her healthcare provider has switched her to what other drug? A) an intravenous anticoagulant drug B) intravenous heparin C) an oral anticoagulant drug D) oral heparin Answer: C Explanation: A) An intravenous anticoagulant drug is not appropriate for a home setting. B) Intravenous heparin is not appropriate for a home setting. C) Correct. D) Heparin cannot be administered orally. 8) Anemia is caused by all of the following, EXCEPT ________. A) a decreased amount of vitamin K B) blood loss C) increased destruction of red blood cells D) side effects of some drugs Answer: A Explanation: A) Correct. Vitamin K plays a role in blood clotting, not anemia. B) This is a cause of anemia. C) This is a cause of anemia. D) This is a cause of anemia. 9) Anticoagulant drugs are used to ________ a blood clot. A) dissolve B) enhance C) prevent D) treat Answer: C Explanation: A) Anticoagulant drugs cannot dissolve a blood clot. B) Anticoagulant drugs do not enhance a blood clot. C) Correct. D) Anticoagulant drugs cannot treat a blood clot.

10) The first prescription anticoagulant drug available was ________. A) folic acid B) heparin C) thrombin inhibitor drug D) warfarin Answer: B Explanation: A) Folic acid was not the first anticoagulant drug. B) Correct. C) This was not the first anticoagulant drug. D) Warfarin was not the first anticoagulant drug. 11) Tissue plasminogen activator (tPA) drugs are given at the time of a ________ to dissolve a blood clot that has already formed. A) myocardial infarction B) stroke C) pulmonary embolism D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct statement. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct. 12) Anemia can be due to insufficient amounts of all of the following, EXCEPT ________. A) folic acid B) iron C) thrombin D) vitamin B12 Answer: C Explanation: A) Anemia can be due to insufficient amounts of folic acid. B) Anemia can be due to insufficient amounts of iron. C) Correct. D) Anemia can be due to insufficient amounts of iron.

13) Which of the following statements about protamine sulfate is TRUE? A) Protamine sulfate is a low molecular weight heparin drug. B) Protamine sulfate is used to treat a heparin overdose. C) Protamine sulfate is used to treat anemia. D) Protamine sulfate is an anticoagulant drug. Answer: B Explanation: A) It is not a low molecular weight heparin drug. B) Correct. C) It is not used to treat anemia. D) It is not an anticoagulant drug.

14) All of the following drugs are able to dissolve a blood clot, EXCEPT ________. A) darbepoetin alfa (Aranesp) B) alteplase (Activase, Cathflo Activase) C) reteplase (Retavase) D) tenecteplase (TNKase) Answer: A Explanation: A) Correct. Darbepoetin is used to treat anemia, not dissolve a blood clot. B) Alteplase (Activase, Cathflo Activase) can dissolve a blood clot. C) Reteplase (Retavase) can dissolve a blood clot. D) Tenecteplase (TNKase) can dissolve a blood clot. 15) Hemophiliac patients are given ________. A) units of whole blood B) blood products (plasma, packed red blood cells) C) clotting factors D) All of the above. Answer: D Explanation: A) This is a true, but it is not the only correct answer. B) This is a true, but it is not the only correct answer. C) This is a true, but it is not the only correct answer. D) Correct.

16) All of the following are factor Xa inhibitor drugs, EXCEPT ________. A) aspirin (Bayer, Ecotrin, St. Joseph) B) apixaban (Eliquis) C) rivaroxaban (Xarelto) D) betrixaban (Bevyxxa) Answer: A Explanation: A) Correct. This is an antiplatelet drug, not a factor Xa inhibitor drug. B) This is a factor Xa inhibitor drug. C) This is a factor Xa inhibitor drug. D) This is a factor Xa inhibitor drug. 17) All of the generic drugs that have ________ in their names are iron supplements that are used to treat iron deficiency anemia. A) aggregation B) inhibitor C) enzyme D) ferric or ferrous Answer: D Explanation: A) The word aggregation is not related to iron supplement drugs. B) The word inhibitor is not related to iron supplement drugs. C) The word enzyme is not in the generic name of iron supplement drugs. D) Correct. 18) The suffix ________ is common to generic heparin and low molecular weight heparin drugs. A) -rudin B) -parin C) -ase D) All of the above. Answer: B Explanation: A) The suffix -rudin is not common to generic heparin drugs. B) Correct. C) The ending -ase is common to enzymes, not generic heparin drugs. D) There is only one correct answer.

19) Hemophilia A is ________. A) the most common type of hemophilia B) caused by a lack of folic acid to build red blood cells C) caused by the lack of clotting factor VIII D) A and C Answer: D Explanation: A) This is true, but it is not the only correct statement. B) Folic acid is not related to hemophilia. C) This is true, but it is not the only correct statement. D) Correct. 20) Which of the following statements about low molecular weight heparins is FALSE? A) Nearly the entire dose of low molecular weight heparin can be absorbed. B) Some low molecular weight heparins are measured in units and some are measured in milligrams. C) Low molecular weight heparins have a larger molecular size than heparin. D) Low molecular weight heparins were created by breaking apart the original heparin molecule. Answer: C Explanation: A) This statement is true. B) This statement is true. C) Correct. Their molecular size is smaller, not larger than heparin. D) This statement is true. 21) All of the following anticoagulant drugs can be given orally EXCEPT ________. A) heparin B) warfarin (Coumadin, Jantoven) C) aspirin D) clopidogrel (Plavix) Answer: A Explanation: A) Correct. Heparin is only given subcutaneously or intravenously. B) Warfarin (Coumadin, Jantoven) is given orally. C) Aspirin is given orally. D) This is given orally.

22) Patients taking warfarin (Coumadin, Jantoven) for long-term anticoagulant drug therapy need to be sure they do not eat too much of which kinds of foods? A) leafy green vegetables B) liver, lentils, and hummus C) soy milk, tofu, and chickpeas D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 23) All of the following are direct thrombin inhibitor drugs, EXCEPT ________. A) apixaban (Eliquis) B) bivalirudin (Angiomax) C) desirudin D) dabigatran (Pradaxa) Answer: A Explanation: A) Correct. This is a factor Xa inhibitor, not a direct thrombin inhibitor drug. B) This is a thrombin inhibitor drug. C) This is a direct thrombin inhibitor drug. D) This is a direct thrombin inhibitor drug. 24) Which of the following is NOT true of phytonadione (Mephyton)? A) It is a vitamin K drug. B) It is used to treat patients with an overdose of anticoagulant drug. C) It is used to prevent hemorrhage in newborn babies. D) It is a one-time intramuscular injection to temporarily correct the vitamin deficiency until 6 weeks of age. Answer: B Explanation: A) This is a true statement. B) Correct. This is not true. C) This is a true statement. D) This is a true statement.

25) Which of the following is a low molecular weight heparin drug? A) dalteparin (Fragmin) B) heparin C) enoxaparin (Lovenox) D) A and C Answer: D Explanation: A) This is a low-molecular weight heparin drug. B) Heparin is different from a low molecular weight heparin drug. C) This is a low molecular weight heparin drug. D) Correct. 26) Anemia can be caused by all of the following, EXCEPT ________. A) a lack of vitamin K B) radiation or chemotherapy drugs that damage the red bone marrow C) blood loss due to trauma or hemophilia D) increased destruction of red blood cells Answer: A Explanation: A) Correct. A lack of vitamin K is related to blood clotting, not anemia. B) This is a true statement. C) This is a true statement. D) This is a true statement. 27) Which of the following is an example of the drug effect of antagonism? A) changing from intravenous heparin in the hospital to an oral anticoagulant drug upon discharge home B) giving a vitamin K drug to a newborn after birth to prevent hemorrhage C) taking warfarin with a meal of leafy green vegetables and tofu D) All of the above. Answer: C Explanation: A) This is not an example of antagonism. B) This is not an example of antagonism. C) Correct. These foods will decrease the therapeutic effect of warfarin. D) Only one of the answers is an example of antagonism.

28) In the drugs ferrous fumarate (Ferrocite) and ferrous gluconate (Ferrotabs), the word ferrous tells you that these drugs contain ________. A) folic acid B) iron C) thrombin D) erythropoietin Answer: B Explanation: A) These drugs do not contain folic acid. B) Correct. C) These drugs do not contain thrombin. D) These drugs do not contain erythropoietin. 29) The generic antiplatelet drug clopidogrel is related to the well-known trade name drug ________. A) Epogen B) Eliquis C) Plavix D) Coumadin Answer: C Explanation: A) This trade name is related to epoetin alfa, not clopidogrel. B) This trade name is related to apixaban, not clopidogrel. C) Correct. D) This trade name is related to warfarin, not clopidogrel. 30) Which of the following is TRUE about aspirin? A) It can treat headaches and minor pain. B) It can prevent a blood clot in patients who have heart disease or a stroke. C) It is the least expensive antiplatelet drug. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

31) The formed elements of the blood include all of the following, EXCEPT ________. A) plasma B) white blood cells C) red blood cells D) platelets Answer: A Explanation: A) Correct. The plasma is not a formed element of the blood. B) White blood cells are formed elements. C) Red blood cells are formed elements. D) Platelets are formed elements. 32) Anticoagulant drugs keep a blood clot from forming in patients with ________. A) atrial fibrillation and heart attack B) stroke C) arteriosclerosis D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 33) Which of the following is NOT a source of vitamin K? A) Leafy green vegetables B) Bacteria in the intestine C) Stores in the liver D) Grains Answer: C Explanation: A) This is a source of vitamin K. B) This is a source of vitamin K. C) Correct. Although liver is a dietary source of vitamin K, the liver itself is not a source of vitamin K. D) This is a source of vitamin K.

34) Anticoagulant drugs include all of the following categories, EXCEPT ________. A) heparin drugs B) thrombolytic drugs C) factor Xa inhibitor drugs D) vitamin K antagonist drugs Answer: B Explanation: A) These are anticoagulant drugs. B) Correct. C) These are anticoagulant drugs. D) These are anticoagulant drugs. 35) In which situation might a person develop folic acid deficiency anemia? A) A person with sickle cell disease B) A person with chronic alcoholism C) A person taking the antiseizure drug phenytoin (Dilantin) D) All of these. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 36) A lack of vitamin B12 can lead to what kind of anemia? A) Sickle cell anemia B) Pernicious anemia C) Folic acid deficiency anemia D) Iron deficiency anemia. Answer: B Explanation: A) Vitamin B12 is not related to this type of anemia. B) Correct. C) Vitamin B12 is not related to this type of anemia. D) Vitamin B12 is not related to this type of anemia. 37) Which of the following is TRUE about cyanocobalamin? A) It cannot be given orally because the stomach has no intrinsic factor to absorb it. B) As Nascobal, it can be given by nasal spray. C) It can be given by subcutaneous or intramuscular injection. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 12 Copyright © 2022 Pearson Education, Inc.

8.2

True/False Questions

1) The liver produces clotting factors I through VIII. Answer: FALSE Explanation: The liver produces clotting factors V, VII, IX, X, XI, and XIII. 2) Heparin inhibits clotting factors IX and X that are produced in the liver. Answer: TRUE 3) Heparin can only be given subcutaneously or intravenously. Answer: TRUE 4) Antiplatelet drugs prevent platelets from binding to the site of tissue injury and clumping together to begin the formation of a clot. Answer: TRUE 5) Platelet aggregation inhibitor drugs are under the larger category of anticoagulant drugs. Answer: TRUE 6) Thrombin inhibitor drugs bind to receptors on both circulating thrombin and thrombin already incorporated in a blood clot. Answer: TRUE 7) Factor Xa inhibitor drugs exert their main effect on thrombin and platelets. Answer: FALSE Explanation: These drugs have no effect on thrombin or platelets. 8) Anticoagulant drugs can prevent a blood clot from forming, prevent a blood clot from enlarging, and are effective in dissolving a blood clot once it has formed. Answer: FALSE Explanation: Anticoagulant cannot dissolve a blood clot that has already formed. 9) Protamine sulfate, a heparin antagonist drug, is used to treat heparin overdose or to reverse the therapeutic effect of heparin given during surgery. Answer: TRUE 10) Hemophilia is an inherited genetic abnormality that causes a deficiency of a specific clotting factor. Answer: TRUE 11) The anticoagulant drug warfarin blocks vitamin C to keep the liver from using it to produce clotting factors. Answer: FALSE Explanation: Warfarin blocks vitamin K.

12) Thrombolytic drugs revolutionized the treatment of myocardial infarction and stroke because they were the first drug category that could dissolve a blood clot. Answer: TRUE 13) Darbepoetin alfa, epoetin alfa, and epoetin beta are erythropoiesis-stimulating drugs created using recombinant DNA technology. Answer: TRUE 14) The anticoagulant drug warfarin (Coumadin, Jantoven) can dissolve blood clots that have already formed. Answer: FALSE Explanation: Only thrombolytic drugs, not anticoagulant drugs, can dissolve a blood clot. 15) Factor Xa inhibitor drugs are used to prevent blood clots after joint replacement surgery. Answer: TRUE 16) Anticoagulant drugs are given during hemodialysis for patients in renal failure. Answer: TRUE 17) Aspirin prolongs the clotting time by inhibiting thromboxane, a substance normally released from platelets that causes platelet aggregation. Answer: TRUE 18) Garlic has its own natural anticoagulant effect that increases the therapeutic effect of the drug warfarin. Answer: TRUE 19) Anticoagulant drugs are used during hemodialysis. Answer: TRUE 20) There is no factor V in the list of clotting factors. Answer: FALSE Explanation: There is a factor V. There is no factor VI. 21) Clotting factors are activated in their numerical order as they contribute to the formation of a blood clot. Answer: FALSE Explanation: Although the factors have a numerical order, they are not activated in this order during the formation of a blood clot. 22) Clopidogrel was the first antiplatelet drug approved by the FDA. Answer: TRUE 23) Leucovorin is a chemotherapy drug, but it is also used to treat folic acid deficiency anemia. Answer: TRUE

24) The FDA requires food manufacturers to add folic acid to their flour and grain products to prevent the incidence of neural tube defects in newborns. Answer: TRUE 25) The oral vitamin B12 dietary supplement can be used to treat pernicious anemia. Answer: FALSE Explanation: Oral cyanocobalamin vitamin B12 is an OTC dietary supplement that cannot be used to treat pernicious anemia. 26) The drug hydroxyurea (Droxia, Siklos) is used to treat sickle cell anemia because it increases the water content of the red blood cells to keep them rounder and less prone to sickle. Answer: TRUE 8.3

Short Answer Questions

1) Platelets stick to damaged tissue to form clumps, and this process is known as platelet ________. Answer: aggregation 2) The suffix ________ (which means "enzyme") is common to both the generic and trade name tissue plasminogen activator drugs. Answer: -ase 3) ________ (an abbreviation) drugs are used to dissolve a blood clot. Answer: tPA 4) The chemical symbol for iron is ________. Answer: Fe 5) The abbreviation DVT stands for ________ ________ ________. Answer: deep venous thrombosis 6) The abbreviation tPA stands for ________. Answer: tissue plasminogen activator 7) Anemia is a decrease in the number of ________ blood cells being produced. Answer: red 8) The suffix -rudin is common to generic direct ________ inhibitor drugs. Answer: thrombin 9) A drug-food interaction in which the food decreases the therapeutic effect of the drug is known as ________. Answer: antagonism

10) The most well-known antiplatelet drug that is inexpensive and can be purchased over-the-counter is the drug ________. Answer: aspirin 11) The suffix -xaban is common to generic ________ ________ inhibitor drugs. Answer: factor Xa 12) ________ is a natural anticoagulant in the body that is released by basophils (a type of white blood cell). Answer: Heparin 13) Using a drug to lyse (break down) a blood clot that has already formed is the process known as ________. Answer: thrombolysis 14) Folic acid is a/an ________ vitamin that is needed to produce red blood cells. Answer: B 15) ________ factor is made by the stomach and is needed for the body to absorb vitamin B12. Answer: Intrinsic 16) Sickle cell anemia is caused by a genetic abnormality of the ________ molecule in red blood cells. Answer: hemoglobin

8.4

Matching Questions

Match the drug categories in Column 2 with their drug names in Column 1. A) warfarin B) erythropoiesis-stimulating drug for anemia C) over-the-counter iron dietary supplement D) factor Xa inhibitor drug E) low molecular weight heparin drug F) antiplatelet drug G) drug used to treat hemophilia H) combination of two antiplatelet drugs I) tissue plasminogen activator drug J) direct thrombin inhibitor drug 1) clopidogrel (Plavix) 2) ferrous sulfate 3) Aggrenox 4) bivalirudin (Angiomax) 5) Coumadin 6) enoxaparin (Lovenox) 7) epoetin alfa (Epogen, Procrit, Retacrit) 8) fondaparinux (Arixtra) 9) reteplase (Retavase) 10) factor VIIa (NovoSeven, Sevenfact) Answers: 1) F 2) C 3) H 4) J 5) A 6) E 7) B 8) D 9) I 10) G 8.5

Essay Questions

1) Describe the four different ways that different anticoagulant drugs work to prevent a blood clot from forming. Answer: Some anticoagulant drugs prevent platelets from binding to a site of injury, inhibit the various clotting factors, inhibit vitamin K that the liver needs to make clotting factors, or they inhibit the action of thrombin.

2) Name five foods cause an antagonist drug-food interaction in patients who are taking warfarin (Coumadin, Jantoven). How does this antagonism happen? Answer: Leafy green vegetables (broccoli, Brussels sprouts, asparagus, spinach, bok choi, kale, parsley, turnip greens), lentils, liver, garbanzo beans (chickpeas), hummus, green tea, and soy products (soy milk, tofu). These foods all contain vitamin K that can decrease the therapeutic effect of warfarin. (antagonism). 3) What does the trade name Fragmin tell us? Answer: That this low molecular weight drug is a fragment of the molecule of regular heparin. 4) Why must any drug to treat pernicious anemia be given by a route of administration that bypasses the stomach? Answer: In pernicious anemia, the stomach no longer produces intrinsic factor, which the body needs in order to absorb vitamin B12. Cyanocobalamin is given by subcutaneous or intramuscular injection or by nasal spray.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 9 Anti-Infective Drugs 9.1

Multiple Choice Questions

1) Generic ________ drugs have the common prefixes of cef- and ceph-. A) antiviral B) cephalosporin C) fluoroquinolone D) protease inhibitor drugs Answer: B Explanation: A) Antiviral drugs do not have these prefixes. B) Correct. C) Fluoroquinolone antibiotic drugs do not have these prefixes. D) Protease inhibitor drugs do not have these prefixes. 2) The suffix ________ is common to generic tetracycline antibiotic drugs. A) -cillin B) -mycin C) -navir D) -cycline Answer: D Explanation: A) The suffix -cillin is not common to generic tetracycline drugs. B) The suffix -mycin is not common to generic tetracycline drugs. C) The suffix -navir is not common to generic tetracycline drugs. D) Correct. 3) Aminoglycoside drugs are effective against ________. A) viruses B) parasites C) gram-negative and gram-positive bacteria D) fungi Answer: C Explanation: A) Aminoglycoside antibiotic drugs are not effective against viruses. B) Aminoglycoside antibiotic drugs are not effective against parasites. C) Correct. D) Aminoglycoside antibiotic drugs are not effective against fungi.

4) Which of the following is NOT a category of antibiotic drug used to treat bacterial infections? A) carbapenem drugs B) monobactam drugs C) protease inhibitor drugs D) quinolone drugs Answer: C Explanation: A) Carbapenem drugs are antibiotic drugs to treat bacterial infections. B) Monobactam drugs are antibiotic drugs to treat bacterial infections. C) Correct. These are antiretroviral drugs to treat HIV, not bacteria. D) Quinolone drugs are antibiotic drugs to treat bacterial infections. 5) Nucleotide analog reverse transcriptase inhibitor drugs act in the same way as ________, except that they contain a slightly modified molecular structure. A) aminoglycoside drugs B) fusion inhibitor drugs C) nucleoside reverse transcriptase inhibitor drugs D) protease inhibitor drugs Answer: C Explanation: A) Aminoglycoside drugs do not act in the same way as nucleotide reverse transcriptase inhibitor drugs. B) Fusion inhibitor drugs do not act in the same way as nucleotide analog reverse transcriptase inhibitor drugs. C) Correct. D) Protease inhibitor drugs do not act in the same way as nucleotide analog reverse transcriptase inhibitor drugs. 6) The fusion protein inhibitor drug enfuvirtide (Fuzeon) for HIV can only be administered ________. A) by inhalation B) orally C) subcutaneously D) topically Answer: C Explanation: A) Fusion inhibitor drugs cannot be administered by inhalation. B) Fusion inhibitor drugs cannot be administered orally. C) Correct. D) Fusion inhibitor drugs cannot be administered topically.

7) Which type of antibiotic drug does NOT cause a bacterium to die by affecting the cell wall around the bacterium? A) carbapenem antibiotic drugs B) glycopeptide antibiotic drugs C) fluoroquinolone antibiotic drugs D) monobactam antibiotic drugs Answer: C Explanation: A) Carbapenem antibiotic drugs do affect the cell wall around a bacterium. B) Glycopeptide antibiotic drugs do affect the cell wall around a bacterium. C) Correct. Fluoroquinolone antibiotic drugs inhibit an enzyme essential to bacterial DNA reproduction. D) Monobactam antibiotic drugs do affect the cell wall of the bacterium. 8) Which category of drugs used to treat HIV binds directly to the enzyme reverse transcriptase to keep it from converting viral RNA to viral DNA? A) fusion inhibitor drugs B) non-nucleoside reverse transcriptase inhibitor drugs C) aminoglycoside drugs D) protease inhibitor drugs Answer: B Explanation: A) Fusion inhibitor drugs do not bind to reverse transcriptase. B) Correct. C) Aminoglycoside drugs are not used to treat HIV. D) Protease inhibitor drugs do not bind to reverse transcriptase. 9) Which of the following statements is FALSE? A) Some penicillin drugs cannot be given orally because they are inactivated by gastric acid. B) Third-generation cephalosporin drugs are the most effective against bacteria that produce penicillinase. C) The fungus from which the first cephalosporin drugs were developed was discovered in a sewer outlet near an island off the coast of Italy. D) Patients taking aminoglycoside antibiotic drugs are given vision tests and blood tests to monitor for signs of toxicity. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. Patients are given hearing tests for ototoxicity and blood tests for kidney function.

10) Which cephalosporin drugs are the most effective against bacteria that produce penicillinase? A) first-generation cephalosporin drugs B) second-generation cephalosporin drugs C) third-generation cephalosporin drugs D) All generation cephalosporin drugs are equally effective. Answer: C Explanation: A) First-generation cephalosporin drugs are not the most effective. B) Second-generation drugs are not the most effective. C) Correct. D) Only one answer is correct. 11) Which drug for HIV is ONLY available as part of a combination drug, not as an individual drug? A) abacavir B) lopinavir C) tenofovir D) zidovudine Answer: B Explanation: A) Abacavir (Ziagen) is available as an individual drug. B) Correct. Lopinavir is only available in a combination drug. C) Tenofovir (Viread) is available as an individual drug. D) Zidovudine (Retrovir) is available as an individual drug. 12) Which of the following statements is FALSE? A) The discovery of penicillin antibiotic drugs came before the discovery of sulfonamide antibiotic drugs. B) Sulfonamide drugs interfere with the growth of some bacteria that make their own folic acid. C) A human cell has a cell membrane, while a bacterium has a cell wall. D) Antibiotic drugs that can kill a variety of different types of bacteria are known as broad spectrum antibiotic drugs. Answer: A Explanation: A) Correct. Sulfonamide drugs were in use before penicillin drugs were discovered. B) This is a true statement. C) This is a true statement. D) This is a true statement.

13) Which of the following is NOT a third-generation cephalosporin antibiotic drug? A) tenofovir (Viread) B) ceftazidime (Fortaz, Tazicef) C) cefixime (Suprax) D) ceftriaxone Answer: A Explanation: A) Correct. This is a nucleotide reverse transcriptase inhibitor drug. B) This is a third-generation cephalosporin drug. C) This is a third-generation cephalosporin drug. D) This is a third-generation cephalosporin drug. 14) Which of the following statements is FALSE? A) A viral infection cannot be treated with an antibiotic drug. B) The American Academy of Pediatrics states that educating parents is the single most important issue in reducing the overprescription of antibiotic drugs. C) Eighty percent of all antibiotic drugs are given to humans; antibiotic use in animals is less frequent. D) Antibiotic drugs have been widely prescribed for conditions that did not need antibiotic drugs, such as the common cold or the flu. Answer: C Explanation: A) This is a true statement. B) This is a true statement. C) Correct. Eighty percent of all antibiotic drugs are given to animals, not humans. D) This is a true statement. 15) The aminoglycoside antibiotic drug neomycin is used as a bowel prep before intestinal surgery because ________. A) it is given orally but remains in the intestine to kill bacteria B) it is given intravenously and acts systemically C) it not absorbed into the blood D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) It is not given intravenously. C) This is true, but it is not the only correct answer. D) Correct.

16) On a culture and sensitivity laboratory test, a large ring of inhibition means that ________. A) the specimen from the patient did not contain any bacteria B) the antibiotic drug in that disk was able to kill the bacteria C) the laboratory technician did not swab the Petri dish correctly with the patient's specimen D) All of the above. Answer: B Explanation: A) A large ring of inhibition does not mean this. B) Correct. C) A large ring of inhibition does not mean this. D) There is only one correct answer. 17) All of the following are fluoroquinolone antibiotic drugs, EXCEPT ________. A) ciprofloxacin (Cipro) B) erythromycin (EryPed, Ery-Tab) C) levofloxacin (Levaquin) D) moxifloxacin (Avelox) Answer: B Explanation: A) This is a fluoroquinolone antibiotic drug. B) Correct. This is a macrolide antibiotic, not a fluoroquinolone antibiotic drug. C) This is a fluoroquinolone antibiotic drug. D) This is a fluoroquinolone antibiotic drug. 18) The drug Augmentin ________. A) is a combination drug B) contains the generic drugs amoxicillin and clavulanate C) contains a substance that inactivates the bacterial enzyme penicillinase D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

19) Which of the following statements is FALSE? A) Zidovudine (Retrovir) for HIV and AIDS was originally known as azidothymidine which is how it got the abbreviation AZT. B) The word retrovirus is a shortened form of the phrase reverse transcriptase plus the word virus. C) The human immunodeficiency virus is a retrovirus. D) Now there are several categories of drugs that are able to kill HIV. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. There are still no drugs that can kill HIV. 20) Which of the following statements is FALSE? A) A person infected with HIV can have no symptoms for some time, but is still able to transmit HIV to others. B) The body uses erythrocytes, a type of red blood cell, to fight viral infections. C) The viral load is the total number of viruses in the blood and lymphocytes. D) HIV can be transmitted by a blood transfusion. Answer: B Explanation: A) This is a true statement. B) Correct. The body uses lymphocytes, not erythrocytes, to fight viral infections. C) This is a true statement. D) This is a true statement. 21) Which of the following drug categories is NOT used to treat HIV? A) carbapenem drugs B) protease inhibitor drugs C) fusion protein inhibitor drugs D) integrase inhibitor drugs Answer: A Explanation: A) Correct. Carbapenems are antibiotic drugs; they are not used to treat HIV. B) Protease inhibitor drugs are used to treat HIV. C) Fusion protein inhibitor drugs are used to treat HIV. D) Integrase inhibitor drugs are used to treat HIV.

22) Which of the following is NOT a protease inhibitor drug used to treat HIV? A) indinavir (Crixivan) B) delavirdine (Rescriptor) C) nelfinavir (Viracept) D) saquinavir (Invirase) Answer: B Explanation: A) This is a protease inhibitor drug. B) Correct. This is a non-nucleoside reverse transcriptase inhibitor drug, not a protease inhibitor drug. C) This is a protease inhibitor drug. D) This is a protease inhibitor drug. 23) Which of these drugs is NOT a non-nucleoside reverse transcriptase inhibitor drug to treat HIV? A) delavirdine (Rescriptor) B) efavirenz (Sustiva) C) linezolid (Zyvox) D) nevirapine (Viramune) Answer: C Explanation: A) This drug is a non-nucleoside reverse transcriptase inhibitor drug. B) This drug is a non-nucleoside reverse transcriptase inhibitor drug. C) Correct. This is an oxazolidinone antibiotic drug. D) This drug is a nonnucleoside reverse transcriptase inhibitor drug. 24) All of the following are trade name cephalosporin drugs, EXCEPT ________. A) Keflex B) Maxipime C) Bicillin L-A D) Teflaro Answer: C Explanation: A) Cephalexin (Keflex) is a cephalosporin drug. B) Cefepime (Maxipime) is a cephalosporin drug. C) Correct. Penicillin G benzathine (Bicillin L-A) is a penicillin antibiotic drug. D) Ceftaroline (Teflaro) is a cephalosporin drug.

25) The phrase culture and sensitivity means ________. A) culture of the antibiotic drug and sensitivity to it B) culture of the prescribed drug and type of bacteria sensitive to it C) culture of the bacteria and its sensitivity to temperature D) culture of the bacteria and its sensitivity to antibiotic drugs Answer: D Explanation: A) In a culture and sensitivity, the antibiotic drug is not cultured. B) In a culture and sensitivity, the prescribed drug is not cultured. C) In a culture and sensitivity, the sensitivity to temperature is not tested. D) Correct. 26) Which trade name drug belongs to the penicillin category of antibiotic drugs? A) Norvir B) Pfizerpen C) Vibramycin D) Cleocin Answer: B Explanation: A) This is a protease inhibitor antiretroviral drug, not a penicillin antibiotic drug. B) Correct. C) This is a tetracycline antibiotic, not a penicillin antibiotic drug. D) This is a lincosamide antibiotic, not a penicillin antibiotic drug. 27) The ________ group of antibiotic drugs can cause permanent discoloration of teeth. A) penicillin B) cephalosporin C) aminoglycoside D) tetracycline Answer: D Explanation: A) Penicillin drugs do not cause permanent discoloration of the teeth. B) Cephalosporin drugs do not cause permanent discoloration of the teeth. C) Aminoglycoside drugs do not cause permanent discoloration of the teeth. D) Correct. 28) The ________ category of antibiotic drugs can cause ototoxicity and nephrotoxicity. A) penicillin B) cephalosporin C) aminoglycoside D) tetracycline Answer: C Explanation: A) Penicillin drugs do not cause ototoxicity or nephrotoxicity. B) Cephalosporin drugs do not cause ototoxicity or nephrotoxicity. C) Correct. D) Tetracycline drugs do not cause ototoxicity or nephrotoxicity. 9 Copyright © 2022 Pearson Education, Inc.

29) Sulfonamide drugs are ________. A) a type of antibiotic drug B) bactericidal and kill bacteria C) used to treat HIV D) part of the penicillin category of drugs Answer: A Explanation: A) Correct. B) They are bacteriostatic, not bactericidal. C) Sulfonamide drugs are not used to treat HIV. D) Sulfonamide drugs are not penicillin drugs. 30) To which category of antibiotic drugs does ciprofloxacin (Cipro) belong? A) penicillins B) fluoroquinolones C) tetracyclines D) fusion inhibitors Answer: B Explanation: A) Ciprofloxacin (Cipro) does not belong to the penicillin category. B) Correct. C) Ciprofloxacin (Cipro) does not belong to the tetracycline category. D) Fusion inhibitor drugs are not a category of antibiotic drugs. 31) The generic drugs sulfamethoxazole and trimethoprim are in a combination drug that inhibits back-to-back steps that bacteria use to build their cellular proteins. This trade name drug is ________. A) Bactrim B) Kaletra C) Keflex D) Cefotan Answer: A Explanation: A) Correct. B) This is a combination drug but it does not contain these two generic drugs. C) Keflex is not a combination drug. D) Cefotan is not a combination drug.

32) Which of the following statements is FALSE? A) Fungi and yeast are closely related to each other. B) The HIV virus belongs to a category of viruses known as retroviruses. C) The common cold can be prevented with antiviral drugs or a vaccine. D) Pentamidine (Nebupent, Pentam) is used to treat Pneumocystis jiroveci pneumonia. Answer: C Explanation: A) This is a true statement. B) This is a true statement. C) Correct. This is a false statement. D) This is a true statement. 33) Which of the following sentences is FALSE about Pneumocystis jiroveci pneumonia? A) It is a bacterial infection of the lungs. B) It is the most common serious infection and complication of AIDS. C) It a common childhood infection that lies dormant in small cysts. D) It is treated with antifungal/antiprotozoal drugs. Answer: A Explanation: A) Correct. It is caused by a fungus, not a bacterium B) This is a true statement. C) This is a true statement. D) This is a true statement. 34) Patients with an allergy to penicillin may also show an allergy to what other category of antibiotic drugs? A) cephalosporin drugs B) antiviral drugs C) antifungal drugs D) antiretroviral drugs Answer: A Explanation: A) Correct. Cephalosporin drugs are structurally similar to penicillins. B) Penicillins and antiviral drugs are not structurally similar. C) Penicillin and antifungal drugs are not structurally similar. D) Penicillins and antiretroviral drugs are not structurally similar.

35) Why can't tetracycline be given to pregnant or nursing women? A) Because it causes nausea and vomiting. B) Because it causes a cross-allergy with penicillin drugs. C) Because it stains the baby's developing permanent teeth. D) Because it is only effective against gram-negative bacterial infections. Answer: C Explanation: A) Tetracycline does not cause nausea and vomiting. B) Tetracycline does not provoke a cross-allergy with penicillin drugs. C) Correct. D) Tetracycline is effective against a wide variety of bacteria. 36) Which trade name is a combination penicillin antibiotic drug? A) Pfizerpen B) Cipro C) Zosyn D) Truvada Answer: C Explanation: A) This is not a combination drug. B) This is not a combination drug. C) Correct. D) This is a combination drug, but not a penicillin antibiotic drug. 37) All of the following are related to HIV and AIDS, EXCEPT ________. A) CD4 receptors and helper T lymphocytes B) highly active antiretroviral therapy (HAART) C) opportunistic infections D) culture and sensitivity Answer: D Explanation: A) These are related to HIV and AIDS. B) This is related to HIV and AIDS. C) These is related to HIV and AIDS. D) Correct. This lab test is only related to bacteria, not to HIV or AIDS.

38) Which of the following drug categories is used to prevent or treat a Mycobacterium avium-intracellulare complex (MAC) infection in AIDS patients? A) Aminoglycoside antibiotic drugs B) Macrolide antibiotic drugs C) Antitubercular drugs D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 39) Both fungi and yeasts ________. A) are one-celled organisms B) grow in a warm, moist, dark environment C) can cause opportunistic infections in persons with AIDS D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 40) Drugs used to treat HIV do all of the following, EXCEPT ________. A) decrease the viral load B) delay the onset of AIDS C) cure HIV D) avoid the complications of opportunistic infections. Answer: C Explanation: A) HIV drugs do this. B) HIV drugs do this. C) Correct. HIV drugs do not do this. D) HIV drugs do this.

41) HIV can be transmitted in all of the following ways, EXCEPT ________. A) by sexual intercourse B) to a fetus via the placenta or to a baby via breast milk C) by a fungal infection D) by an accidental needlestick Answer: C Explanation: A) HIV can be transmitted this way. B) HIV can be transmitted this way. C) Correct. HIV is a retrovirus, not a fungal infection. D) HIV can be transmitted this way. 42) Candida albicans infections of the mouth are also known as ________. A) monilia B) oral candidiasis C) thrush D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 43) The directions "swish and swallow" pertain to all of the following EXCEPT ________. A) an adult who is taking an oral antiyeast drug. B) the drug coating the oral cavity, pharynx, and esophagus C) an infant with oral thrush D) an adult with AIDS and oral candidiasis Answer: C Explanation: A) This does pertain to "swish and swallow." B) This does pertain to "swish and swallow." C) Correct. An infant is given an oral yeast drug through a nipple. D) This does apply to "swish and swallow."

44) The label of the antiyeast drug nystatin says "Shake well before using" because it is in the drug form of a ________. A) liquid B) nasal spray C) suspension D) topical ointment Answer: C Explanation: A) Not all liquids need to be shaken before using. B) Nystatin does not come in the form of a nasal spray. C) Correct. A suspension has fine, undissolved particles of the drug. A suspension must be shaken before measuring the dose to that the drug particles are evenly suspended rather than settled at the bottom. D) Nystatin does not come in the form of a topical ointment. 45) Yeasts ________. A) are one-celled organisms B) are closely related to fungi C) grow easily in the warm, moist, dark environment of the mouth D) All of the above. Answer: D Explanation: A) This is a true statement, but it is not the only correct answer. B) This is a true statement, but it is not the only correct answer. C) This is a true statement, but it is not the only correct answer. D) Correct. 46) The drug nystatin (Bio-Statin) is categorized as a topical ________. A) antibiotic drug B) antiviral drug C) antiyeast drug D) corticosteroid drug Answer: C Explanation: A) Nystatin is not an antibiotic drug. B) Nystatin is not an antiviral drug. C) Correct. D) Nystatin is not a corticosteroid drug.

47) The presence of what causes a diagnosis of HIV to change to a diagnosis of AIDS? A) A very low CD4 lymphocyte count. B) A systemic bacterial infection C) An HIV-related opportunistic infection D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is not always related to HIV and AIDS. C) This is true, but it is not the only correct answer. D) Correct. 48) The lymphatic system ________. A) is a separate pathway from the cardiovascular system B) has an immune response to defend the body against infectious diseases C) works with white blood cells in the blood D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 49) Pathogens include all of the following, EXCEPT ________. A) bacteria and viruses B) cancer cells C) fungi and yeasts D) retroviruses Answer: B Explanation: A) Pathogens do include this. B) Correct. C) Pathogens do include this. D) Pathogens do include this. 50) All of the following are categories of antibiotic drugs, EXCEPT ________. A) fusion protein inhibitor drugs B) fluoroquinolone drugs C) sulfonamide drugs D) aminoglycoside drugs Answer: A Explanation: A) Correct. This is a category of antiretroviral drugs, not antibiotic drugs. B) This is an antibiotic drug category. C) This is an antibiotic drug category. D) This is an antibiotic drug category. 16 Copyright © 2022 Pearson Education, Inc.

51) The macrolide antibiotic erythromycin ________. A) comes as eye drops and eye ointment B) can be given by the oral or intravenous routes C) is a topical drug used to treat acne. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 52) A beta-lactam ring molecular structure is common to ________. A) cephalosporin antibiotic drugs B) monobactam antibiotic drugs C) penicillin antibiotic drugs D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 53) The 2020 National Action Plan for Combating Antibiotic-Resistant Bacteria includes all of the following, EXCEPT ________. A) develop rapid diagnostic tests to identify antibiotic-resistant bacteria B) allow pediatricians to prescribe antibiotic drugs at the parents' request. C) develop new antibiotic drugs. D) improve international collaboration to control antibiotic-resistant bacteria Answer: B Explanation: A) This is a true statement. B) Correct. C) This is a true statement. D) This is a true statement.

54) All of the following are enzymes that HIV has that help it infect a helper T lymphocyte and reproduce itself, EXCEPT ________. A) beta lactamase B) protease C) reverse transcriptase D) integrase Answer: A Explanation: A) This is a bacterial enzyme, not an HIV enzyme. B) This is true. C) This is true. D) This is true. 55) Fusion protein inhibitor drugs used to treat HIV include all of the following categories, EXCEPT ________. A) GP120 attachment inhibitor drugs B) postattachment inhibitor drugs C) protease inhibitor drugs D) drugs that block HIV when it tries to bind (fuse) with CD4 receptors. Answer: C Explanation: A) This is a category of fusion inhibitor drugs. B) This is a category of fusion inhibitor drugs. C) Correct. These are not fusion inhibitor drugs. D) This is a category of fusion inhibitor drugs. 56) Which of the following is an AIDS-related infection or disease? A) AIDS wasting syndrome B) cytomegalovirus retinitis C) Pneumocystis jiroveci pneumonia D) All of the above. Answer: D Explanation: A) This is an AIDS-related disease. B) This is an AIDS-related infection. C) This is an AIDS-related infection. D) Correct. 9.2

True/False Questions

1) Atripla and Combivir are combination drugs used to treat HIV. Answer: TRUE 2) Sulfonamide drugs are only effective against viruses. Answer: FALSE Explanation: This is a false statement. These are antibiotic drugs that inhibit the growth of bacteria. 18 Copyright © 2022 Pearson Education, Inc.

3) The designation of first-generation, second-generation, or third-generation indicates when a cephalosporin drug was first discovered or first marketed. Answer: FALSE Explanation: The generation refers to how effective they are against certain types of bacteria. 4) Fluoroquinolone antibiotic drugs kill bacteria by inhibiting an enzyme that is essential to bacterial DNA replication, causing the double-strand DNA to break. Answer: TRUE 5) Monobactam antibiotic drugs are effective against all gram-negative and gram-positive bacteria. Answer: FALSE Explanation: They are only effective against aerobic gram-negative bacteria. 6) Drugs prescribed for patients with AIDS wasting syndrome are used to stimulate the appetite, build muscle mass, and treat extreme weight loss. Answer: TRUE 7) Fungi and yeasts can cause disease topically, locally, or systemically. Answer: TRUE 8) Kaposi sarcoma is a rare cancer that can develops in patients with the severe bacterial infection of MRSA. Answer: FALSE Explanation: This cancer develops in patients with HIV, not MRSA. 9) Patients with HIV/AIDS can develop widespread and serious systemic yeast and fungal infections. Answer: TRUE 10) Drugs to treat human immunodeficiency virus are known as antiviral drugs. Answer: FALSE Explanation: These drugs are known as antiretroviral drugs, not antiviral drugs, because HIV is a retrovirus. 11) A MAC infection is most commonly seen in patients in the later stages of AIDS. Answer: TRUE 12) Sulfonamide drugs are a type of antibiotic drug that inhibit the growth of bacteria. Answer: TRUE 13) Antibiotic drugs are prescribed for patients with colds caused by a virus. Answer: FALSE Explanation: This is a false statement. Antibiotic drugs cannot treat a virus.

14) Combination drug therapy for HIV uses two or more antibiotic drugs from the same or different drug categories. Answer: FALSE Explanation: It uses two or more antiretroviral, not antibiotic, drugs. 15) Antibiotic drugs are only effective against bacterial infections. Answer: TRUE 16) There are two kinds of bacteria: anaerobic and aerobic. Answer: TRUE 17) Fluoroquinolone antibiotic drugs include a black box warning that they can cause the unusual adverse drug effect of the rupture of a tendon. Answer: TRUE 18) Vancomycin belongs to the glycopeptide category of antibiotic drugs. Answer: TRUE 19) Glycopeptide drugs are effective against methicillin-resistant Staphylococcus aureus. Answer: TRUE 20) Once a patient is sensitized to a particular drug, even a small dose can trigger a severe allergic reaction. Answer: TRUE 21) Suppressor T lymphocytes have CD8 receptors on their cell membranes, and so they cannot be infected by HIV. Answer: TRUE 22) Inside a lymphocyte, HIV uses its enzyme reverse transcriptase to change its viral RNA into viral DNA. Answer: TRUE 23) The suffix -conazole is common to generic integrase inhibitor drugs. Answer: FALSE Explanation: The suffix -tegravir is common to generic antiyeast/antifungal drugs, not integrase inhibitor drugs. 24) "Swish and swallow" is the way an adult is told to take the oral suspension of a drug used to treat oral candidiasis. Answer: TRUE 25) Antibiotics drugs are the drug of choice to cure the common cold. Answer: FALSE Explanation: They are not effective for the common cold because it is caused by a virus, not a bacterium. 20 Copyright © 2022 Pearson Education, Inc.

9.3

Short Answer Questions

1) Sulfonamide antibiotic drugs do not kill bacteria, they only inhibit the growth of bacteria. This means they are only ________. Answer: bacteriostatic 2) Sulfonamide drugs are commonly referred to as ________ drugs. Answer: sulfa 3) Penicillin antibiotic drugs are similar to each other in that most have the molecular structure of a/an ________ ring. Answer: beta-lactam 4) Antibiotic drugs that are effective against many different types of bacteria are known as ________ spectrum antibiotic drugs. Answer: broad 5) The suffix -cillin is common to generic ________ antibiotic drugs. Answer: penicillin 6) ________ antibiotic drugs are divided into five generations. Answer: Cephalosporin 7) The suffix -navir is common to ________ inhibitor drugs. Answer: protease 8) ________ is an enzyme produced by penicillin-resistant bacteria. Answer: Penicillinase 9) Aminoglycoside antibiotic drugs can cause a severe adverse drug effect of toxicity to the nerve for hearing and balance. This adverse effect is known as ________. Answer: ototoxicity 10) Dronabinol (Marinol), a Schedule III cannabinoid drug used to treat AIDS wasting syndrome, is unusual in that it is derived from ________. Answer: marijuana 11) The abbreviation AIDS stands for ________ ________ syndrome. Answer: acquired immunodeficiency 12) The abbreviation VRSA stands for ________-resistant Staphylococcus aureus. Answer: vancomycin 13) The well-known HIV and AIDS drug zidovudine is related to the trade name drug ________. Answer: Retrovir

14) A/An ________ ribbon is the universal symbol of the fight against HIV and AIDS. Answer: red 15) Topical antiyeast drugs are used to treat a Candida albicans yeast infection in the mouth, which is also known as oral candidiasis, ________, or monilia. Answer: thrush 16) The abbreviation HAART stands for highly active ________ therapy. Answer: antiretroviral 17) Antibiotic drugs are not used to treat the common cold because it is usually caused by a/an ________. Answer: virus 18) Some categories of antibiotic drugs are ________, meaning that they can limit the growth and reproduction of bacteria. Answer: bacteriostatic 19) The suffixes -micin and -mycin are common to generic ________ antibiotic drugs. Answer: aminoglycoside 20) The cephalosporin category of antibiotic drugs includes ________ generations. Answer: five 21) The abbreviation MRSA stands for ________-resistant Staphylococcus aureus. Answer: methicillin 22) Bacteria become resistant to antibiotic drugs by mutations in their own ________. Answer: genes 23) Over time, in a person who is HIV positive, large numbers of CD4 lymphocytes become infected and the person becomes ________. Answer: immunocompromised

9.4

Matching Questions

Match the drug category name in Column 2 with the drug name in Column 1. A) aminoglycoside antibiotic drug B) protease inhibitor drug C) nucleoside reverse transcriptase inhibitor drug D) penicillin antibiotic drug E) macrolide antibiotic drug F) tetracycline antibiotic drug G) fluoroquinolone antibiotic drug H) antifungal drug I) carbapenem antibiotic drug J) cephalosporin drug 1) amoxicillin 2) azithromycin (Zithromax) 3) cefixime (Suprax) 4) ciprofloxacin (Cipro) 5) meropenem (Merrem) 6) doxycycline (Vibramycin) 7) fluconazole (Diflucan) 8) indinavir (Crixivan) 9) lamivudine (Epivir) 10) amikacin (Arikayce) Answers: 1) D 2) E 3) J 4) G 5) I 6) F 7) H 8) B 9) C 10) A 9.5

Essay Questions

1) Briefly explain how penicillin antibiotic drugs work and why they are not harmful to human cells. Answer: Penicillin drugs kill bacteria. They disrupt the cell wall around the bacterium, and this causes it to die. Human cells have a cell membrane rather than a cell wall, and so they are not harmed by penicillin drugs.

2) Explain what penicillinase is and how it works. Answer: Penicillinase is a bacterial enzyme produced by penicillin-resistant bacteria. It breaks apart the beta-lactam ring chemical structure in cephalosporin and penicillin drugs. 3) Explain why the number of drugs in the category of sulfonamide antibiotic drugs has declined. Answer: Sulfonamide antibiotic drugs are only bacteriostatic, in that they inhibit the growth of bacteria but cannot actually kill them. The number of drugs in this category has declined because of the preferred use of other antibiotic drugs that kill bacteria. 4) Describe how to administer the oral suspension of a topical antiyeast drug to treat an infant with a yeast infection of the mouth. Answer: An infant with oral thrush is given an oral suspension of nystatin. The drug container must be shaken before a dose is measured, as nystatin is a suspension. The entire dose is placed in an unattached nipple, and the infant sucks on the nipple until the dose is gone. The drug is not mixed with milk or formula in a bottle because it needs to adhere to the mucous membranes of the oral cavity in order to be effective. 5) Explain why it is necessary to shake the antiyeast drug nystatin before measuring the dose. Answer: Nystatin comes in the form of an oral suspension. The instructions say, "Shake well before using." A suspension contains fine, undissolved particles of a drug suspended in a water base. Shaking assures that the drug particles are evenly distributed, rather than settled at the bottom of the drug container. 6) Explain how doing a culture and sensitivity test helps the healthcare provider know which antibiotic drug to prescribe. Answer: A specimen from the infected area is obtained and sent to the laboratory for a culture and sensitivity test. The laboratory technician streaks the specimen across a culture medium that promotes the growth of bacteria. Then the bacteria are spread on a Petri dish with antibiotic disks. Over time, some disks show a large, clear ring—a zone of inhibition—around them where the antibiotic drug has killed the bacteria. The healthcare provider selects the antibiotic disk with the largest clear ring around it and prescribes that antibiotic drug to treat the patient's infection. 7) Explain why tetracycline drugs are not given to pregnant women, nursing mothers, or children under eight years of age. Answer: Tetracycline drugs can cause discoloration of the permanent teeth; therefore, they are not prescribed for pregnant women (to protect the fetus's developing teeth), nursing mothers, or for children under age 8 (whose permanent teeth are still developing). 8) Explain why the nasal swab has been found to reduce postoperative infections with MRSA. Answer: Because MRSA bacteria can colonize the nose, an antiseptic drug is used to swab inside the nose of patients before they to into surgery. This has been found to kill MRSA and other nasal bacteria.

9) Give reasons why a patient might stop taking an antibiotic drug prematurely and what the result of doing this can be. Answer: An antibiotic drug must be taken until the entire prescription is completely gone. Some patients stop taking their antibiotic drug when they begin to feel better. The antibiotic drug has weakened the bacteria but has not had enough time to kill all of them. Stopping an antibiotic drug prematurely contributes to the development of resistant bacterial strains.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 10 Urinary Drugs 10.1

Multiple Choice Questions

1) When the blood levels of glucose and electrolytes are sufficient, ________. A) not much is excreted in the urine because these nonwaste substances need to be conserved B) the kidneys stop filtering these nonwasted substances C) excess is excreted in the urine D) greater amounts are reabsorbed from the tubules back into the blood Answer: C Explanation: A) If the levels are sufficient, nonwasted substances do not need to be conserved. B) The kidneys continuously filter the blood. C) Correct. If the blood levels are sufficient, the excess is excreted in the urine. D) If the levels are sufficient, the kidney does not absorb greater amounts from the tubules back into the blood. 2) Diuretic drugs ________. A) allow sodium and potassium to enter the tubules B) allow sodium and potassium to be reabsorbed from the tubules into the blood C) keep sodium and potassium from being reabsorbed from the tubules back into the blood D) keep sodium and potassium from leaving the blood and entering the kidney Answer: C Explanation: A) This is a normal process, not the action of diuretic drugs. B) This is a normal process, not the action of diuretic drugs. C) Correct. This is the action of diuretic drugs. D) Nothing keeps sodium and potassium from leaving the blood and entering the kidney. 3) Which of the following is NOT one of the diseases treated with diuretic drugs? A) edema associated with congestive heart failure B) hypertension C) renal failure D) urinary tract infection Answer: D Explanation: A) Diuretic drugs ARE used to treat the edema associated with congestive heart failure. B) Diuretic drugs ARE used to treat hypertension. C) Diuretic drugs ARE used to treat renal failure. D) Correct. An antibiotic drug, not a diuretic drug, is used treat an infection.

4) The drugs chlorothiazide (Diuril) , hydrochlorothiazide (HCTZ), and metolazone are examples of which category of diuretic drugs? A) potassium-sparing diuretic drugs B) loop diuretic drugs C) thiazide diuretic drugs D) All of the above Answer: C Explanation: A) These drugs are not potassium-sparing diuretic drugs. B) These drugs are not loop diuretic drugs. C) Correct. These drugs are thiazide diuretic drugs. D) These drugs only belong to one category of diuretic drugs. 5) The drugs ethacrynic acid (Edecrin) and furosemide (Lasix) are examples of which category of diuretic drugs? A) carbonic anhydrase inhibitor diuretic drugs B) loop diuretic drugs C) potassium chloride drugs D) potassium-sparing diuretic drugs Answer: B Explanation: A) Carbonic anhydrase inhibitor drugs are only used to treat the eye. B) Correct. These are loop diuretic drugs. C) Potassium chloride drugs are not diuretic drugs. D) These drugs are not potassium-sparing diuretic drugs. 6) Combination diuretic drugs combine ________. A) a carbonic anhydrase inhibitor diuretic drug and a potassium chloride drug B) two loop diuretic drugs C) urinary antispasmodic drug with an antibiotic drug D) potassium-sparing diuretic drug with a thiazide diuretic drug Answer: D Explanation: A) Potassium chloride is not a diuretic drug. B) Combination diuretic drugs contain two different categories of diuretic drugs. C) Neither of these is a diuretic drug. D) Correct. These two drug categories are used in combination diuretic drugs.

7) Urinary tract infections (UTIs) are treated with drugs that are specifically effective against ________. A) gram-negative bacteria B) burning, urgency and pain C) gram-positive bacteria D) viruses Answer: A Explanation: A) Correct. Urinary antibiotic drugs are effective against gram-negative bacteria. B) Burning, urgency, and pain may be present with a urinary tract infection, but are not the main focus of drug treatment. C) Gram-positive bacteria are not a frequent cause of UTIs. D) Urinary tract infections are caused by bacteria, not by viruses. 8) Anticholinergic drugs used to treat overactive bladder block the action of ________ to relax the smooth muscle and decrease bladder contractions. A) acetylcholine B) alpha1-receptors C) PDE5 enzyme D) All of the above Answer: A Explanation: A) Correct. Anticholinergic drugs block the action of acetylcholine. B) Alpha1-receptor blocker drugs are used to treat benign prostatic hypertrophy, not overactive bladder. C) PDE5 enzyme inhibitor drugs are used to treat benign prostatic hypertrophy, not overactive bladder. D) There is only one correct answer. 9) Potassium chloride drugs are frequently prescribed for patients taking ________. A) drugs for overactive bladder B) fluoroquinolone antibiotic drugs C) a loop or a thiazide diuretic drug D) potassium-sparing diuretic drugs Answer: C Explanation: A) Drugs to treat overactive bladder do not cause the loss of potassium. B) These drugs are used to treat urinary tract infections and do not cause the loss of potassium. C) Correct. Loop and thiazide diuretic cause the loss of potassium. D) These drugs "spare" potassium and so potassium chloride drugs are not needed.

10) Which of the following is NOT a common side effect of anticholinergic drugs? A) dry mouth B) constipation C) drowsiness and blurred vision D) kidney stones Answer: D Explanation: A) This is an anticholinergic side effect. B) This is an anticholinergic side effect. C) This is an anticholinergic side effect. D) Correct. Kidney stones are not a side effect of anticholinergic drugs. 11) All of the following drug categories are diuretic drugs, EXCEPT ________. A) aminoglycoside B) thiazide C) loop D) potassium-sparing Answer: A Explanation: A) Correct. This is an antibiotic drug category, not a diuretic drug. B) Thiazide diuretic drugs do belong to the category of diuretic drugs. C) Loop diuretic drugs do belong to the category of diuretic drugs. D) Potassium-sparing drugs do belong to the category of diuretic drugs. 12) Diuretic drugs are commonly used to treat ________. A) bladder spasm B) hypertension C) kidney stones D) urinary tract infections Answer: B Explanation: A) Diuretic drugs are not used to treat bladder spasm. B) Correct. Diuretic drugs are used to treat hypertension. C) Diuretic drugs are not used to treat kidney stones. D) Diuretic drugs are not used to treat urinary tract infections. 13) What do the trade name drugs K-Tab, Klor-Con, and Micro-K have in common? A) They are thiazide diuretic drugs. B) They are potassium chloride drugs. C) They are used to treat erectile dysfunction. D) They are measured in units. Answer: B Explanation: A) These drugs are not thiazide diuretic drugs. B) Correct. They are potassium chloride drugs. C) These drugs are not used to treat erectile dysfunction. D) These drugs are measured in milliequivalents, not units. 4 Copyright © 2022 Pearson Education, Inc.

14) The generic drug furosemide is related to the well-known trade name drug ________. A) Botox B) Lasix C) HCTZ D) Pyridium Answer: B Explanation: A) This is not the trade name of furosemide. B) Correct. Furosemide (Lasix) is a diuretic drug. C) This is the abbreviation for hydrochlorothiazide, not furosemide. D) This is not the trade name of furosemide. 15) Combination trade name drugs that contain both a potassium-sparing diuretic drug and a thiazide diuretic drug include all of the following drugs, EXCEPT ________. A) Proscar B) Aldactazide C) Dyazide D) Maxzide Answer: A Explanation: A) Correct. Proscar is NOT a combination diuretic drug. B) This is a combination thiazide and potassium-sparing diuretic drug. C) This is a combination thiazide and potassium-sparing diuretic drug. D) This is a combination thiazide and potassium-sparing diuretic drug. 16) Symptoms of BPH include all of the following EXCEPT ________. A) urinary tract infection B) difficulty urinating C) decreased urinary stream D) urinary hesitancy Answer: A Explanation: A) Correct. BPH is not associated with a urinary tract infection. B) This is a symptom of BPH. C) This is a symptom of BPH. D) This is a symptom of BPH.

17) Which of the following drugs is used to treat benign prostatic hypertrophy? A) triamterene (Dyrenium) B) potassium chloride (Micro-K) C) tamsulosin (Flomax) D) solifenacin (Vesicare) Answer: C Explanation: A) This diuretic drug is not used to treat benign prostatic hypertrophy. B) This drug is not used to treat benign prostatic hypertrophy. C) Correct. Tamsulosin (Flomax) is an alpha1-receptor blocker drug for BPH. D) This anticholinergic drug is used to treat overactive bladder, not benign prostatic hypertrophy. 18) Which of these drug pairs is used to treat urinary tract infections? A) Macrobid and Macrodantin B) Micro-K and K-Tab C) Flomax and Rapaflo D) Cialis and Uristat Answer: A Explanation: A) Correct. These are trade names for the urinary antibiotic nitrofurantoin. B) These trade names are potassium chloride drugs. C) These trade name drugs are used to treat BPH. D) These drugs are not used to treat urinary tract infections. 19) The primary cause of urinary tract infections is ________. A) bladder spasms B) kidney stones C) gram-positive bacteria D) gram-negative bacteria Answer: D Explanation: A) Bladder spasms do not cause urinary tract infections. B) Kidney stones do not cause urinary tract infections. C) Gram-positive bacteria do not cause urinary tract infections. D) Correct. Gram-negative bacteria cause urinary tract infections.

20) Madeline, age 60, has difficulty with overactive bladder, urinary urgency, and occasional urinary incontinence. Which drug did her healthcare provider prescribe for her? A) Toviaz B) Pyridium C) Micro-K D) Urecholine Answer: A Explanation: A) Correct. Fesoterodine (Toviaz) is used to treat overactive bladder. B) Pyridium is a urinary analgesic drug, not for overactive bladder. C) Micro-K is not used to treat overactive bladder. D) Urecholine is for urinary retention, not overactive bladder. 21) Which electrolyte should be given in conjunction with some diuretic drugs? A) sodium B) saw palmetto C) potassium D) All of the above Answer: C Explanation: A) Sodium is an electrolyte, but it is not taken with some diuretic drugs. B) Saw palmetto is not an electrolyte. C) Correct. Potassium is given with loop diuretic drugs and thiazide diuretic drugs. D) There is only one correct answer. 22) Patients taking a thiazide or a loop diuretic drug but not taking a potassium chloride drug could develop which of the following adverse effects? A) hypokalemia B) cardiac arrhythmias C) a very low level of potassium in the blood D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

23) All of the following categories of drugs are used to treat urinary tract infections, EXCEPT ________. A) folic acid antagonist drugs B) 5-alpha reductase inhibitor drugs C) cephalosporin drugs D) fluoroquinolone antibiotic drugs Answer: B Explanation: A) These are used to treat urinary tract infections. B) Correct. These drugs are used to treat BPH. C) These are used to treat urinary tract infections. D) These are used to treat urinary tract infections. 24) Cranberries are effective against urinary tract infections because ________. A) the fructose in them prevents bacteria from adhering to the bladder wall B) they increase the acidity of the urine C) they suppress the growth of bacteria because bacteria prefer an alkaline environment D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 25) Urinary tract analgesic drugs ________. A) treat burning and painful urination B) kill bacteria to treat urinary tract infections C) treat urinary spasms caused by kidney stones D) All of the above Answer: A Explanation: A) Correct. Urinary tract analgesic drugs treat pain and burning from urinary tract infections. B) Urinary tract analgesic drugs only treat the pain associated with a urinary tract infection, not the infection itself. C) Urinary tract analgesic drugs do not treat urinary spasms. D) There is only one correct answer.

26) Phenazopyridine (Pyridium) turns the urine a ________ color. A) blue B) green C) red-orange D) All of the above Answer: C Explanation: A) Pyridium does not turn the urine a blue color. B) Pyridium does not turn the urine a green color. C) Correct. D) There is only one correct answer. 27) The combining form vesic/o-, as used in the trade name drug Vesicare, means ________. A) water B) nephron C) potassium D) bladder Answer: D Explanation: A) The combining form vesic/o- does not mean "water." B) The combining form vesic/o- does not mean "kidney." C) The combining form vesic/o- does not mean "potassium." D) Correct. Vesic/o- means "bladder." 28) All of the following statements are true, EXCEPT ________. A) Folic acid antagonist drugs are used to treat urinary tract infections. B) Folic acid antagonist drugs stimulate the formation of folic acid in bacterial cells. C) Some bacteria need folic acid to synthesize their own DNA and proteins. D) All of the above statements are true. Answer: B Explanation: A) This statement is true. B) Correct. This is false because these drugs block the formation of folic acid that the bacteria need to reproduce. C) This statement is true. D) There is one false statement.

29) The trade name drug for overactive bladder that can catch on fire if applied while smoking is ________. A) Myrbetriq B) Botox C) Lasix D) Gelnique Answer: D Explanation: A) Myrbetriq does not catch on fire. B) Botox does not catch on fire. C) Lasix is not used for overactive bladder. D) Correct. Gelnique can catch on fire as it is a gel applied to the skin. 30) Which of the following statements about benign prostatic hypertrophy is FALSE? A) The male hormone testosterone is acted on by an enzyme in prostate gland. B) Because the prostate is enlarged, there are symptoms of a urinary tract infection. C) It is dihydrotestosterone that causes the prostate gland to enlarge. D) Benign prostatic hypertrophy is a benign, not cancerous process. Answer: B Explanation: A) This is a true statement. B) Correct. This statement is false, as there is no urinary tract infection with BPH. C) This is a true statement. D) This is a true statement. 31) This prescription drug was the first nonsurgical treatment for benign prostatic hypertrophy. A) saw palmetto B) spironolactone (Aldactone) C) finasteride (Proscar) D) tolterodine (Detrol) Answer: C Explanation: A) Saw palmetto is used to treat BPH, but it is not a prescription drug. B) Spironolactone (Aldactone) is a diuretic drug; it is not used to treat benign prostatic hypertrophy. C) Correct. D) Tolterodine (Detrol) is used to treat overactive bladder, not benign prostatic hypertrophy.

32) Alkalizing drugs are used to treat nephrolithiasis because they ________ A) relax smooth muscle to allow the stone to pass more easily B) inhibit the enzyme xanthine oxidase C) create a more alkaline urine that decreases the chance that crystals will form stones. D) All of the above Answer: C Explanation: A) This is the action of alpha1 receptor blocker drugs, not alkalizing drugs. B) This is the action of xanthin oxidase inhibitor drugs, not alkalizing drugs. C) Correct. This is how alkalizing drugs work. D) Only one of the above answers is correct. 33) When Edward Smith mentions to you that he takes a "water pill" each day for his congestive heart failure, you know that he is referring to the general category of ________ drugs. A) potassium chloride B) diuretic C) antibiotic D) overactive bladder Answer: B Explanation: A) Potassium chloride drugs are not known as "water pills." B) Correct. Lay persons often refer to diuretic drugs as "water pills." C) Antibiotic drugs are not known as "water pills." D) Drugs for overactive bladder are not known as "water pills." 34) Patients taking potassium chloride drugs should avoid which dietary sources of potassium? A) salt substitutes B) bananas C) nuts D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. All of these potassium-containing foods should be avoided.

35) All of the following are combination diuretic drugs that contain hydrochlorothiazide, EXCEPT ________. A) Aldactazide B) Maxzide C) Micro-K D) Dyazide Answer: C Explanation: A) Aldactazide does contain hydrochlorothiazide. B) Maxzide does contain hydrochlorothiazide. C) Correct. This drug contains potassium chloride, not hydrochlorothiazide. D) Dyazide does contain hydrochlorothiazide. 36) Potassium chloride drugs come in all of the following drug forms, EXCEPT ________. A) effervescent tablets B) powder C) ointment D) liquid Answer: C Explanation: A) Potassium chloride drugs do come as effervescent tablets. B) Potassium chloride drugs do come as a powder. C) Correct. Potassium chloride does not come as an ointment. D) Potassium chloride drugs do come as a liquid. 37) Which of the following is an antibiotic drug used to treat urinary tract infections? A) methenamine (Hiprex) B) metolazone C) bethanechol (Urecholine) D) oxybutynin (Oxytrol) Answer: A Explanation: A) Correct. This is an antibiotic drug. B) This is a diuretic drug, not an antibiotic drug. C) This drug is used to treat urinary retention, not infection. D) This drug is used to treat overactive bladder, not infection.

38) Which of the following trade name anticholinergic drugs is used to treat overactive bladder? A) Enablex B) Vesicare C) Ditropan D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. All are used to treat overactive bladder. 39) Which drug is injected into the bladder muscle to treat overactive bladder? A) onabotulinumtoxin A (Botox) B) dutasteride (Avodart) C) darifenacin (Enablex) D) silodosin (Rapaflo) Answer: A Explanation: A) Correct. Botox is injected into the bladder muscle. B) This drug is not used to treat overactive bladder. C) This drug is used to treat overactive bladder, but it is given orally, not injected. D) This drug is used to treat BPH, not overactive bladder. 40) Patients with nephrolithiasis should avoid foods high in oxalates. These foods include ________. A) chocolate B) nuts and soy C) fish and meat D) All of the above Answer: D Explanation: A) Chocolate is high in oxalates. B) Nuts and soy are high in oxalates. C) Fish and meat are high in oxalates. D) Correct. All of these foods are high in oxalates.

41) All of the following are true about saw palmetto, EXCEPT ________. A) it has not been shown to be effective for benign prostatic hypertrophy B) it comes from a palm tree in the southeastern United States C) its fruit was used by the Seminole Indians to treat genitourinary disease D) it is a prescription drug. Answer: D Explanation: A) This is true. B) This is true. C) This is true. D) Correct. It is an over-the-counter dietary supplement, not a prescription. 42) Which of the following are anticholinergic drugs that are used to treat overactive bladder? A) Detrol B) Enablex C) Oxytrol D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. All of these are anticholinergic drugs for overactive bladder. 10.2

True/False Questions

1) The kidneys continuously filter the circulating blood, extracting waste products of cellular metabolism and excreting them in the urine. Answer: TRUE 2) The kidneys either conserve or excrete waste products, depending on the body's need. Answer: FALSE Explanation: The kidneys excrete all waste products and either excrete or reabsorb the other substances, as the body needs. 3) Diuretic drugs are divided into several different categories based on the site of the drug's action in the nephron. Answer: TRUE 4) Loop diuretic drugs get their name because they act on the nephron loop. Answer: TRUE 5) Potassium-sparing diuretic drugs act to "spare" potassium ions by increasing their excretion in the urine. Answer: FALSE Explanation: These drugs help "spare" potassium by decreasing their excretion in the urine. 14 Copyright © 2022 Pearson Education, Inc.

6) Fluoroquinolone antibiotic drugs can only be used to treat urinary tract infections. Answer: FALSE Explanation: They also treat many other types of infection. 7) Some antibiotic drugs treat urinary tract infections by changing into ammonia and formaldehyde in the urine, and this kills bacteria. Answer: TRUE 8) The combination antibiotic drug Bactrim contains drugs that block two steps in the synthesis of folic acid by bacteria. Answer: TRUE 9) Urinary tract analgesic drugs exert a local pain-relieving effect on the mucous membranes of the urinary tract, even though these drugs are given orally. Answer: TRUE 10) A 5-alpha reductase inhibitor needs to be taken for 6 months before it can be determined if it is effective in decreasing the size of an enlarged prostate gland. Answer: TRUE 11) The neurotoxin of the bacterium Clostridium botulinum is the main cause of UTIs. Answer: FALSE Explanation: Escherichia coli is the main cause of UTIs. 12) Pyridium is prescribed to treat the pain of urinary tract infections or urinary surgery. Answer: TRUE 13) The prostate gland is a doughnut-shaped gland that surrounds the urethra in females. Answer: FALSE Explanation: The prostate gland is only in males. 14) The only PDE5 enzyme inhibitor drugs used to treat benign prostatic hypertrophy is tadalafil (Cialis); the other drugs are used to treat erectile dysfunction. Answer: TRUE 15) Finasteride (Proscar) is used to treat benign prostatic hypertrophy, but it is also used to treat male pattern baldness as the trade name drug Propecia. Answer: TRUE 16) Cranberries increase the amount of potassium in the urine, which is why they are effective in preventing urinary tract infections. Answer: FALSE Explanation: They increase the acidity of the urine which suppresses bacterial growth. 17) The drug packaging for dutasteride and finasteride warn women of childbearing age not to touch broken or crushed tablets as this can cause birth defects in a male fetus. Answer: TRUE 15 Copyright © 2022 Pearson Education, Inc.

18) Most patients prefer taking liquid potassium chloride drugs because of their pleasant taste. Answer: FALSE Explanation: Patients often object to the taste of liquid potassium chloride drugs. 19) Diuretic drugs increase the flow of urine and can treat hypertension and edema associated with congestive heart failure. Answer: TRUE 20) Patients who have had one kidney stone have a 50% chance of developing more. Answer: TRUE 21) The common condition of kidney stones is known by the medical name hypokalemia. Answer: FALSE Explanation: Kidney stones is known as nephrolithiasis. 22) Jalyn is a combination drug that contains the generic drugs dutasteride and tamsulosin and is used to treat benign prostatic hypertrophy. Answer: TRUE 23) Gelnique is in the drug form of a topical skin gel that works systemically to treat overactive bladder. Answer: TRUE 24) The suffix -asteride is common to generic cephalosporin antibiotic drugs for urinary tract infections. Answer: FALSE Explanation: The suffix -asteride is common to 5-alpha reductase inhibitor drugs for BPH. 10.3

Short Answer Questions

1) As electrolytes are excreted, they hold water to them by means of ________ pressure and this increases the volume of urine. Answer: osmotic 2) ________ diuretic drugs block sodium and potassium from being reabsorbed from the distal convoluted tubule back into the blood. Answer: Thiazide 3) Normally, ________, a hormone produced by the adrenal glands, allows potassium ions to excreted in the urine. Answer: aldosterone 4) The presence of the letter ________ in every trade name of a potassium chloride drug refers to the symbol for the chemical element of potassium. Answer: K 16 Copyright © 2022 Pearson Education, Inc.

5) Urinary tract ________ drugs relax the smooth muscle in the wall of the urinary tract to treat spasms caused by kidney stones or infections. Answer: antispasmodic 6) Potassium chloride drugs doses are measured in mEq. The abbreviation mEq stands for ________. Answer: milliequivalent 7) There are several types of drugs used to treat UTIs. The abbreviation UTI stands for ________. Answer: urinary tract infection 8) BPH is common in men over age 50, with the incidence increasing with age. The abbreviation BPH stands for ________ ________ ________. Answer: benign prostatic hypertrophy 9) The abbreviation HCTZ stands for the generic diuretic drug name ________. Answer: hydrochlorothiazide 10) The suffix -semide is common to generic ________ diuretic drugs. Answer: loop 11) The important electrolyte ________ is often excreted in excessive amounts in the urine by loop diuretic drugs. Answer: potassium 12) When Edward Smith mentions to you that he takes a water pill each day for his congestive heart failure, you know he is referring to the general category of ________ drugs. Answer: diuretic 13) The loss of potassium due to a diuretic drug can cause the adverse effect of ________, a very low level of potassium in the blood. Answer: hypokalemia 14) The ________ is the functional unit of the kidney and the site or urine production. Answer: nephron 15) The fruit and juice of the ________ are a natural way to prevent and treat urinary tract infections. Answer: cranberry 16) The trade name drug Urispas is used to treat ________ of the smooth muscles that line the urinary tract. Answer: spasms 17) The kidneys are located in the ________ space. Answer: retroperitoneal 17 Copyright © 2022 Pearson Education, Inc.

18) ________ are positively or negatively charged molecules (such as sodium and potassium). Answer: Electrolytes 10.4

Matching Questions

Match the drug categories in Column 2 with their correct generic and trade name drugs in Column 1. A) folic acid antibiotic drug B) 5-alpha reductase inhibitor drug C) anticholinergic drug for overactive bladder D) urinary analgesic drug E) PDE5 inhibitor drug F) urinary antispasmodic drug G) alpha1-receptor blocker drug H) potassium-sparing diuretic drug I) xanthine oxidase inhibitor drug J) loop diuretic drug 1) dutasteride (Avodart) 2) silodosin (Rapaflo) 3) furosemide (Lasix) 4) allopurinol (Aloprim, Zyloprim) 5) hyoscyamine (Anaspaz) 6) trimethoprim (TMP) 7) phenazopyridine (Pyridium) 8) tadalafil (Cialis) 9) spironolactone (Aldactone} 10) tolterodine (Detrol) Answers: 1) B 2) G 3) J 4) I 5) F 6) A 7) D 8) E 9) H 10) C

10.5

Essay Questions

1) What is the difference between a potassium-sparing diuretic drug and a potassium chloride drug? Answer: Potassium-sparing diuretic drugs help potassium be reabsorbed from the distal convoluted tubule and collecting back into the blood; thus, they "spare" (conserve) potassium and keep it from being excreted in the urine. Potassium chloride (KCl) drugs are frequently prescribed for patients taking a thiazide diuretic drug or a loop diuretic drug in order to avoid excessive loss of the electrolyte potassium. 2) Her physician has placed Nancy Jones on a thiazide diuretic drug, and she is taking it; but she does not like to take multiple drugs and so has decided not to take the prescribed potassium chloride drug. She states she will just eat a banana each day instead. What information would you, as a healthcare professional, want to share with her? Answer: Although foods, such as bananas, are rich in potassium, dietary sources alone are usually not enough to replenish the loss of potassium. Patients who take a thiazide diuretic drug or a loop diuretic drug should also take an oral potassium chloride drug so that they do not develop hypokalemia. 3) Discuss three reasons why cranberry juice is effective in preventing and treating urinary tract infections. Answer: Cranberries are acidic, and they temporarily increase the acidity of the urine; this suppresses the growth of bacteria because bacteria prefer an alkaline environment. Also, cranberry juice contains the simple sugar fructose, which acts as an anti-adhesion factor that keeps bacteria from adhering to the bladder wall.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 11 Reproductive Drugs 11.1

Multiple Choice Questions

1) Which of the following is NOT the action of drugs used to prevent pregnancy? A) They change the hormonal environment so that the ovary does not produce or release a mature ovum. B) They prevent the production of spermatozoa in the male. C) They keep a fertilized ovum from implanting within the uterus. D) They inhibit spermatozoa from entering the uterus Answer: B Explanation: A) This is a drug action to prevent pregnancy. B) Correct. The drugs do not prevent the production of spermatozoa in the male. C) This is a drug action to prevent pregnancy. D) This is a drug action to prevent pregnancy. 2) Monophasic oral contraceptive drugs have a ________. A) fixed dose of a progestins drug and a varying dose of an estrogens drug B) fixed dose of both a progestins drug and an estrogens drug C) varying dose of a progestins drug and a fixed dose of an estrogens drug D) varying dose of both a progestins drug and an estrogens drug Answer: B Explanation: A) This does not describe monophasic oral contraceptive drugs. B) Correct. C) This does not describe monophasic oral contraceptive drugs. D) This does not describe monophasic oral contraceptive drugs. 3) Ovulation-stimulating drugs ________. A) stimulate a nonovulating ovary to release several mature ova B) are used to treat anovulation C) are a treatment for polycystic ovary syndrome D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

4) Few drugs are prescribed during pregnancy, particularly during the ________ trimester because of the increased risk of causing birth defects in the developing fetus. A) first B) second C) third D) fourth Answer: A Explanation: A) Correct. B) This is not correct. C) This is not correct. D) Only one answer is correct. 5) Intrauterine devices, such as Mirena, contain ________. A) a progestins drug levonorgestrel B) an estrogens drug ethinyl estradiol C) both an estrogens drug and a progestins drug D) neither an estrogens drug nor a progestins drug Answer: A Explanation: A) Correct. B) Intrauterine devices do not contain an estrogens drug. C) Intrauterine devices do not contain these drugs. D) Implantable contraceptive drugs do contain a progestins drug. 6) Which of these diseases is NOT treated with ovulation-stimulating drugs? A) preterm labor B) female infertility C) polycystic ovary syndrome D) failure to ovulate and anovulation Answer: A Explanation: A) Correct. B) This is treated with ovulation-stimulating drugs. C) This is treated with ovulation-stimulating drugs. D) This is treated with ovulation-stimulating drugs.

7) The sexually transmitted disease acquired immunodeficiency syndrome is caused by ________. A) herpes simplex virus, type 2 B) Neisseria gonorrhoeae C) Treponema pallidum D) HIV Answer: D Explanation: A) This causes genital herpes. B) This causes gonorrhea. C) This causes syphilis. D) Correct. 8) When the cervix does not dilate and become thinner during labor, which type of drug can be given? A) dinoprostone (Cervidil, Prepidil, Prostin E2) B) a prostaglandin drug C) an opioid drug D) A and B Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) An opioid drug is used to treat the pain of labor and delivery. D) Correct. 9) Drugs used to treat postpartum bleeding ________. A) keep the ovary from producing an ovum B) keep the cervix from dilating C) stimulate the uterine muscle to contract D) stimulate the cervix to dilate Answer: C Explanation: A) These drugs do not affect the ovary. B) These drugs do not keep the cervix from dilating. C) Correct. D) These drugs do not stimulate the cervix to dilate.

10) Which of these problems would cause the healthcare provider to give a woman a uterine stimulant drug? A) weak uterine contractions (uterine inertia) B) preeclampsia that required a rapid delivery for safety C) prolonged labor D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 11) Which of the following drug form or route of administration is NOT used for contraceptive drugs? A) intravenous injection B) oral tablets C) transdermal patch D) vaginal ring Answer: A Explanation: A) Correct. No contraceptive drugs are given intravenously. B) An oral contraceptive drug does come as oral tablets. C) An oral contraceptive drug does come as a transdermal patch. D) A contraceptive drug does come as a vaginal ring. 12) Women in labor may be given a uterine stimulant drug if they are experiencing ________. A) dysmenorrhea B) uterine inertia C) dilation and effacement of the cervix D) a vaginal yeast infection Answer: B Explanation: A) Dysmenorrhea occurs during menstruation, not during labor. B) Correct. C) Dilation and effacement of the cervix is a normal part of labor. D) A vaginal yeast infection does not occur during labor.

13) Which of the following statements about the trade name drug Plan B One Step is FALSE? A) It is taken orally. B) It belongs to the category of progestin-only contraceptive drugs. C) It is taken before sexual intercourse to prevent pregnancy. D) It contains levonorgestrel. Answer: C Explanation: A) This is a true statement. B) This is a true statement. C) Correct. It is taken only after unprotected sexual intercourse has occurred. D) This is a true statement. 14) Which of the following words is associated with contraceptive drugs? A) tocolytic B) biphasic C) folic acid D) hormone replacement therapy Answer: B Explanation: A) This word is associated with labor, not contraceptive drugs. B) Correct. Biphasic oral contraceptive drugs. C) Folic acid is a vitamin, not a contraceptive drug. D) This phrase is associated with menopause, not contraceptive drugs. 15) All of the following are true about oral contraceptive drugs, EXCEPT ________. A) they contain a spermicide that kills sperm B) they suppress the release of FSH and LH so that a mature ovum never develops C) they cause changes in the cervical mucosa that inhibit spermatozoa D) they keep a fertilized ovum from implanting in the endometrium Answer: A Explanation: A) Correct. This describes a vaginal contraceptive drug, not an oral contraceptive drug. B) This is a true statement. C) This is a true statement. D) This is a true statement.

16) The estrogen content in oral contraceptive drugs can cause all of the following serious adverse drug effects, EXCEPT ________. A) blood clots B) infertility C) stroke D) heart attack Answer: B Explanation: A) Oral contraceptive drugs can cause blood clots. B) Correct. Infertility is not an adverse effect of oral contraceptive drugs. C) Oral contraceptive drugs can cause a stroke. D) Oral contraceptive drugs can cause a heart attack. 17) In addition to being an oral contraceptive drug, YAZ is also approved by the FDA for treating ________. A) the skin condition of acne B) premature labor C) vaginal yeast infections D) sexually transmitted diseases Answer: A Explanation: A) Correct. B) YAZ is not approved by the FDA for treating premature labor. C) YAZ is not approved by the FDA for treating vaginal yeast infections. D) YAZ is not approved by the FDA for treating sexually transmitted diseases. 18) All of the following are true about dysmenorrhea, EXCEPT ________. A) it is treated with NSAIDs B) it is a cause of female infertility C) it is caused by an increase in prostaglandins D) it is also known as painful menstrual cramps Answer: B Explanation: A) This is a true statement. B) Correct. Dysmenorrhea is not related to female infertility. C) This is a true statement. D) This is a true statement.

19) Which of the following is true about Mirena? A) It is a T-shaped contraceptive device. B) It is implanted into the uterus. C) It contains the progestins drug levonorgestrel D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 20) Premarin is ________. A) used to prevent pregnancy B) used to replace the decreased level of estradiol hormone in menopause C) made from the urine of pregnant mares. D) B and C Answer: D Explanation: A) Premarin is not used to prevent pregnancy. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 21) Drugs such as clotrimazole (Gyne-Lotrimin, Mycelex) and miconazole (Monistat, Vagistat) are used to treat ________. A) infections caused by Candida albicans B) infections caused by Treponema pallidum C) dysmenorrhea D) infertility Answer: A Explanation: A) Correct. B) These drugs are not used to treat syphilis caused by Treponema pallidum. C) These drugs are not used to treat dysmenorrhea. D) These drugs are not used to treat infertility.

22) Which of the following drugs is NOT used to treat the pain of dysmenorrhea? A) naproxen (Aleve, Naprosyn, Pamprin) B) celecoxib (Celebrex) C) ibuprofen (Advil, Motrin) D) urofollitropin (Bravelle) Answer: D Explanation: A) These drugs are used to treat dysmenorrhea. B) These drugs are used to treat dysmenorrhea. C) These drugs are used to treat dysmenorrhea. D) Correct. This is an ovulation-stimulating drug, not a drug for dysmenorrhea. 23) Metronidazole (MetroGel-Vaginal) is used to treat ________. A) syphilis B) vaginal infections C) menopause symptoms of vaginal dryness D) endometriosis Answer: B Explanation: A) MetroGel-Vaginal is not used to treat syphilis. B) Correct. C) MetroGel-Vaginal is not used to treat vaginal dryness. D) Metro-Gel is not used to treat endometriosis. 24) Which of these is a combination hormone drug for menopause is in the form of a transdermal patch? A) Celebrex B) Climara C) CombiPatch D) B and C Answer: D Explanation: A) Celebrex is used to treat dysmenorrhea, not menopause. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct. Both of these are transdermal patches.

25) All of the following trade name drugs are given to women in menopause as estrogen hormone replacement therapy, EXCEPT ________. A) Climara B) Menest C) Kyleena D) Vivelle-Dot Answer: C Explanation: A) Estradiol (Climara) is given as estrogen hormone replacement therapy. B) Esterified estrogens (Menest) is given as estrogen hormone replacement therapy. C) Correct. Kyleena is an intrauterine device, not a hormone replacement therapy. D) Estradiol (Vivelle-Dot) is given as estrogen hormone replacement therapy. 26) Which of the following sexually transmitted diseases is treated with an antibiotic drug? A) HIV and AIDS B) genital herpes C) candidiasis D) gonorrhea and syphilis Answer: D Explanation: A) HIV and AIDS are treated with antiretroviral drugs, not antibiotic drugs. B) Genital herpes is treated with antiviral drugs, not antibiotic drugs. C) Candidiasis is a yeast infection, not a sexually transmitted disease. D) Correct. 27) Simone and Raymond Jones have been trying to start a family for two years without success. Their healthcare provider has suggested that Simone might benefit from a drug to stimulate ovulation. This drug could be any of the following, EXCEPT ________. A) urofollitropin (Bravelle) B) follitropin alfa (Gonal-f) C) clotrimazole (Gyne-Lotrimin) D) human chorionic gonadotropin (Novarel, Pregnyl) Answer: C Explanation: A) This is an ovulation-stimulating drug. B) This is an ovulation-stimulating drug. C) Correct. This drug is used to treat vaginal yeast infections. D) This is an ovulation-stimulating drug.

28) Drugs should be avoided during pregnancy, but which of these drugs is prescribed for pregnant women? A) Drugs for chronic diseases such as hypertension or diabetes B) Iron and folic acid C) Prenatal vitamins D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 29) Which of the following statements is TRUE? A) In monophasic oral contraceptive drugs, 7 tablets in a 28-day pill pack contain an analgesic drug. B) Most healthcare providers prescribe an oral contraceptive drug that contains as low a dose of estrogens drug as possible. C) The drug oxytocin (Pitocin) is used to stop premature labor. D) The risks of serious adverse effects while taking an oral contraceptive drug increase for women who smoke or are older than 55 years of age. Answer: B Explanation: A) This is a false statement. Oral contraceptive drugs never contain an analgesic drug. B) Correct. This is a true statement. C) This is a false statement. This drug is used to induce labor contractions. D) This is a false statement. Serious adverse effects increase for patients who smoke or are older than 35 years, not 55 years, of age. 30) Which one of the following pairs of trade names is NOT a monophasic oral contraceptive drug? A) Gianvi and Norinyl B) Jolessa and YAZ C) Ortho-Novum and Beyaz D) Estrostep Fe and Ortho Tri-Cyclen Answer: D Explanation: A) These are monophasic oral contraceptive drugs. B) These are monophasic oral contraceptive drugs. C) These are monophasic oral contraceptive drugs. D) These are both triphasic, not monophasic, oral contraceptive drugs.

31) Which of the following statements is FALSE? A) The prefix tri- in the trade name of some oral contraceptive drugs indicates three phases. B) NuvaRing is a contraceptive transdermal patch. C) The oral contraceptive drug Seasonique only produces four menstrual periods each year. D) The first oral contraceptive pill was introduced in 1960. Answer: B Explanation: A) This is a true statement. B) Correct. This is a false statement. It is a contraceptive vaginal ring. C) This is a true statement. D) This is a true statement. 32) The contraceptive drugs Twirla and Xulane are in the drug form of a ________. A) pill pack B) vaginal ring C) intrauterine device D) transdermal patch Answer: D Explanation: A) These drugs are not pill packs. B) These drugs are not vaginal rings. C) These drugs are not intrauterine devices. D) Correct. 33) Of the following trade name drugs, which one is NOT a prostaglandin drug used to help the cervix dilate and efface during labor? A) Cervidil B) Skyla C) Prostin E2 D) Prepidil Answer: B Explanation: A) Cervidil is used for this purpose. B) Correct. Skyla is an intrauterine device to prevent pregnancy. C) Prostin E2 is used for this purpose. D) Prepidil is used for this purpose.

34) Which of the following drugs is NOT used to treat endometriosis? A) doxycycline (Doryx) B) goserelin (Zoladex) C) leuprolide (Lupaneta, Lupron Depot) D) nafarelin (Synarel) Answer: A Explanation: A) This is an antibiotic drug used to treat gonorrhea, not endometriosis. B) These drugs are used to treat endometriosis. C) These drugs are used to treat endometriosis. D) These drugs are used to treat endometriosis. 35) Which of the following combination drugs is NOT used to treat the symptoms of menopause? A) Jolivette B) Activella C) Femhrt D) Prempro Answer: A Explanation: A) This is a progestins-only oral contraceptive drug. B) This is a combination drug used to treat menopause. C) This is a combination drug used to treat menopause. D) This is a combination drug used to treat menopause. 36) A 28-day pill pack of an oral contraceptive drug consists of 21 combined-hormone tablets and 7 tablets that ________. A) are inert B) may contain sugar C) may contain iron D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

37) After the tragedy with thalidomide and fetal deformities, the FDA did not approve any drug to treat the nausea and vomiting associated with pregnancy until 2013 then they approved the combination drug ________. A) Enpresse B) Diclegis C) Loestrin D) Celebrex Answer: B Explanation: A) This is a tricyclic oral contraceptive drug; it is not used to treat nausea and vomiting. B) Correct. C) This is a monophasic oral contraceptive drug; it is not used to treat nausea and vomiting. D) This is used to treat dysmenorrhea, not nausea and vomiting. 38) The thalidomide drug tragedy occurred in the late 1950s when this drug ________. A) was used to treat nausea and vomiting in pregnant women B) caused babies to be born with seal limbs C) was prescribed in Europe, but not the United States D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 39) The combination drugs to treat the nausea and vomiting of pregnancy are ________. A) Viagra B) Bonjesta C) Diclegis D) B and C Answer: D Explanation: A) Viagra is used to treat erectile dysfunction in men, not pregnancy. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

40) Drugs used to treat morning sickness contain ________. A) an antihistamine and vitamin B6 B) an ovulation-stimulating drug and folic acid C) an iron drug and an oral contraceptive drug D) progesterone and estrogen Answer: A Explanation: A) Correct. B) Drugs for morning sickness do not contain this C) Drugs for morning sickness do not contain this. D) Drugs for morning sickness do not contain this. 41) Which of the following is TRUE about Seasonique? A) It is a biphasic oral contraceptive drug. B) The woman has a menstrual period only four times a year. C) It is an extended-cycle oral contraceptive drug. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 42) Which intrauterine device contains copper to prevent pregnancy? A) Paragard B) Liletta C) Skyla D) Annova Answer: A Explanation: A) Correct. Paragard is an intrauterine device wrapped in copper wire. B) This is a hormonal intrauterine device. C) This is a hormonal intrauterine device. D) Annova is a contraceptive vaginal ring, not an intrauterine device. 43) What category of drugs is used to treat menopause? A) Estrogen hormone replacement therapy B) PDE5 inhibitor drugs C) Selective estrogen receptor modulator drugs D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) These drugs are used to treat erectile dysfunction, not menopause. C) This is true, but it is not the only correct answer. D) Correct. 14 Copyright © 2022 Pearson Education, Inc.

44) All of the following drugs are used to treat genital herpes, EXCEPT ________. A) acyclovir (Zovirax) B) metronidazole (Flagyl) C) famciclovir D) valacyclovir (Valtrex) Answer: B Explanation: A) These drugs are used to treat genital herpes. B) Correct. These drugs are used to treat trichomoniasis, not genital herpes. C) This drug is used to treat genital herpes. D) This drug is used to treat genital herpes. 45) Which of the following drugs is NOT used to treat erectile dysfunction? A) sildenafil (Viagra) B) tadalafil (Cialis) C) interferon alfa-2b (Intron A) D) vardenafil (Levitra, Staxyn) Answer: C Explanation: A) These drugs are used to treat erectile dysfunction. B) These drugs are used to treat erectile dysfunction. C) Correct. These drugs are used to treat genital warts, not erectile dysfunction. D) These drugs are used to treat erectile dysfunction. 46) What is unusual about the drug alprostadil (Muse)? A) It is a prostaglandin drug for erectile dysfunction. B) It is a pellet that must be inserted into the urethra. C) It must be injected into the side of the penis. D) All of the above. Answer: B Explanation: A) This is true, but it is not unusual. B) Correct. C) This describes the prostaglandin drugs Caverject or Edex, not Muse. D) Only one answer is correct. 11.2

True/False Questions

1) Biphasic oral contraceptive drugs have one phase that provides a fixed dose of a progestins drug and a fixed dose of an estrogens drug. Answer: FALSE Explanation: Biphasic has two, not one, phase.

2) Progestin-only contraceptive drugs only contain a progestins drug, but these drugs are equally as effective in preventing pregnancy as other oral contraceptive drugs. Answer: FALSE Explanation: They are slightly less effective. 3) Progestin-only oral contraceptive drugs are useful for mothers who are breastfeeding because they do not interfere with milk production. Answer: TRUE 4) Herbal supplements have been tested and found to be safe for use during pregnancy. Answer: FALSE Explanation: Most herbal supplements have not been proven to be safe during pregnancy. 5) The ovaries are endocrine glands that secrete the hormones estradiol and progesterone. Answer: TRUE 6) Progestins are the primary female hormone. Answer: FALSE Explanation: Estradiol, not progestins, are the primary female hormone. 7) The hormone progesterone drugs from the corpus luteum prepares the endometrium to accept a fertilized ovum. Answer: TRUE 8) Oral contraceptive drugs exert a hormonal influence to prevent pregnancy; they are 100 percent effective, if taken as directed. Answer: FALSE Explanation: They are 99% effective, if taken as directed. 9) The types of oral contraceptive drugs are divided into four groups: one-phasic, two-phasic, three-phasic, and four-phasic. Answer: FALSE Explanation: The four groups are monophasic, biphasic, triphasic, and four-phasic. 10) Melissa Radike has endometriosis. To treat her symptoms, her healthcare provider prescribed a hormone drug because it will suppress her menstrual cycle for several months, during which time the endometrial implants of endometriosis will shrink and fade. Answer: TRUE 11) Some antiyeast drugs require the patient insert the drug vaginally for 7 days or just 3 days, but the antiyeast drug tioconazole requires just one day of treatment. Answer: TRUE 12) Ovulation-stimulating drugs are appropriate for patients who have anovulation (failure to ovulate). Answer: TRUE 16 Copyright © 2022 Pearson Education, Inc.

13) There currently are no drugs approved by the FDA to specifically stop the uterine contractions of preterm labor. Answer: FALSE Explanation: There is one progestins drug approved to decrease the incidence of preterm birth. 14) Sonjalee Williams is taking an oral contraceptive drug. She knows this will help protect her from becoming pregnant and from contracting a sexually transmitted disease. Answer: FALSE Explanation: Oral contraceptive drugs do not protect against sexually transmitted diseases, including HIV. 15) Patients taking oral contraceptive drugs should avoid taking the herb St. John's wort for depression because it can decrease the chance of getting pregnant. Answer: FALSE Explanation: It can increase, not decrease, the chance of getting pregnant. 16) Breads, cereals, and pastas have supplemental iron added to them to decrease the risk of a fetus developing neural tube defects. Answer: FALSE Explanation: Folic acid, not iron, is added. 17) The FDA issued a warning that oral contraceptive drugs that contain the progestins drug drospirenone have a 75% increased risk of causing blood clots compared to other oral contraceptive drugs. Answer: TRUE 18) According to the National Institutes of Health, 67% of women who take oral contraceptive drugs use a monophasic oral contraceptive drug. Answer: TRUE 19) The four-phasic oral contraceptive drug Natazia is also approved by the FDA for treating heavy menstrual bleeding. Answer: TRUE 20) Many antiepileptic drug used to treat seizures can decrease the effectiveness of oral contraceptive drugs. Answer: TRUE 21) Liletta is the smallest intrauterine device and is appropriate for inserting through the narrow cervix of women who have never given birth. Answer: FALSE Explanation: Skyla is the smallest intrauterine device.

11.3

Short Answer Questions

1) Premature labor contractions can be inhibited by using drugs that relax the uterine muscle. These drugs are known as ________ drugs. Answer: tocolytic 2) During labor, the hormone ________ (secreted by the posterior pituitary gland) stimulates the uterus to contract. Answer: oxytocin 3) ________ or painful menstrual cramps is caused by an increase in prostaglandins that causes the uterus to contract painfully. Answer: Dysmenorrhea 4) The suffix -azole is common to drugs used to treat the ________ infection of candidiasis. Answer: yeast 5) The symptoms of menopause can be treated by HRT. The abbreviation HRT stands for ________ ________ therapy. Answer: hormone replacement 6) Infertility drugs are often used as part of an ART program. The abbreviation ART stands for ________ ________ technology. Answer: assisted reproductive 7) Vaginal yeast infections are caused by Candida albicans, and the infection is known as ________. Answer: candidiasis 8) The trade name Quartette tells you that this is a/an ________-phasic oral contraceptive drug. Answer: four 9) The abbreviation OCP stands for ________ ________ pill. Answer: oral contraceptive 10) The drug thalidomide, which caused the birth defect of seal limbs, or phocomelia, was taken in the late 1950s by pregnant women in Europe to treat their symptoms of ________ ________. Answer: morning sickness 11) Prostaglandins secreted by the placenta help widen and thin the cervix as labor begins. This process is known as cervical ________. Answer: ripening 12) In a 28-day pack of an oral contraceptive drug, the tablets for the last 7 days are ________ sugar tablets containing no hormone drug. Answer: inert 18 Copyright © 2022 Pearson Education, Inc.

13) Biphasic oral contraceptive drugs have ________ phases of hormone tablets in each pill pack. Answer: two 14) Using an extended-cycle oral contraceptive drugs means a woman has ________ menstrual periods each year. Answer: four 15) The abbreviation STD stands for ________ ________ disease. Answer: sexually transmitted 16) ________ is the inability to become pregnancy after having regular sexual intercourse for one year. Answer: Infertility 17) The hormone ________ causes the endometrium of the uterus to thicken prior to menstruation in preparation to receive a fertilized ovum. Answer: estradiol 18) A/An ________ is a type of vaginal contraceptive drug that kills sperm. Answer: spermicide 19) Intrauterine devices are effective in preventing pregnancy because they contain either a hormone or the mineral ________. Answer: copper 20) The FDA has ________ pregnancy categories that indicate a drug's potential to cause birth defects. Answer: five 21) The tocolytic drug hydroxyprogesterone (Makena) is used to stop ________ labor contractions. Answer: premature 22) Laminaria is a natural product that is used to dilate the cervix; it is made from Japanese ________. Answer: seaweed

11.4

Matching Questions

Match the drug category name in Column 2 with its generic and drug names in Column 1. A) estrogen hormone replacement for menopause B) triphasic oral contraceptive drug C) drug for nausea and vomiting during pregnancy D) drug for male infertility E) drug for vaginal yeast infection F) progestin-only subcutaneous contraceptive implant G) four-phasic oral contraceptive drug H) drug to cause an abortion I) drug for endometriosis J) monophasic oral contraceptive drug 1) carboprost (Hemabate) 2) Diclegis 3) esterified estrogens (Menest) 4) follitropin alfa (Gonal-f) 5) norethindrone (Aygestin) 6) etonogestrel (Nexplanon) 7) clotrimazole (Gyne-Lotrimin) 8) Ortho-Novum 7/7/7 9) Quartette 10) YAZ Answers: 1) H 2) C 3) A 4) D 5) I 6) F 7) E 8) B 9) G 10) J

11.5

Essay Questions

1) Explain how endometriosis develops and how endometrial implants in the abdominal cavity continue to enlarge. Answer: Endometriosis develops when endometrial tissue from the uterus travels through the uterine tubes and implants on the outer surface of the ovaries, other abdominal organs, and the walls of the pelvic cavity. This occurs when endometrial tissue sloughs off during menstruation but is forced upward through the uterine tubes by uterine contractions (because of the retroflexed position of the uterus). During each menstrual cycle, this tissue thickens and then sloughs off, forming more implants in the abdominal cavity. 2) Explain why opioid drugs to treat the pain of labor and delivery are not given by the oral route of administration. Answer: They are administered by the subcutaneous, intramuscular, or intravenous routes because the pain of labor may cause the woman to vomit and a drug given by the oral route would not be effect. 3) Describe three effects that oral contraceptive drugs have to prevent pregnancy. Answer: Oral contraceptive drugs contain progestins and estrogens hormones. These take the place of the body's natural progesterone and estradiol. These drugs suppress the release of FSH and LH from the anterior pituitary gland, and so a mature ovum is never developed or released. Oral contraceptive drugs also cause changes in the cervical mucosa that inhibit male spermatozoa from entering the uterus. They also cause changes in the endometrium of the uterus that keep a fertilized ovum from implanting. 4) List two benefits of the long-term use of HRT to treat menopause. List six diseases that can result from the long-term use of estrogens as drugs in HRT. Answer: The benefits of hormone replacement therapy include a reduced risk of osteoporosis and a decrease in the blood cholesterol level. However, long-term use of estrogens in HRT is associated with an increased risk of breast cancer, endometrial cancer, blood clots, stroke, heart attack, and dementia. 5) When ovulation-stimulating drugs cause several mature ova to be released from the ovary at the same time and the woman undergoes in vitro fertilization, how does this cause legal, ethical, and moral issues? Answer: When in vitro fertilization uses only some of the fertilized ova, the rest are frozen in liquid nitrogen tanks. One study estimated that there are 1.4 million frozen embryos in fertility clinics in the United States. This creates legal, ethical, and moral issues of what to do with these fertilized ova. 6) Describe the circumstance in which the drug oxytocin (Pitocin) would NOT be used to induce labor in a pregnant woman. Answer: Oxytocin (Pitocin) is not used when prolonged labor is due to cephalopelvic disproportion in which the baby's skull is too large to fit through the mother's bony pelvis.

7) Describe the phases associated with triphasic contraceptive drugs. Answer: Triphasic oral contraceptive drugs have three phases of hormone tablets in each pill pack. Each phase consists of combined-hormone doses of a progestins drug and an estrogens drug in one tablet. The amounts of the hormones and the length of each phase vary from one phase to the next. 8) Why do some women prefer using a 28-day pill pack OCP? Answer: Because of the consistency of taking an oral contraceptive pill (tablet) every single day. 9) If you were an animal rights activist, why would you be against the drug Premarin? Answer: The trade name Premarin indicates the source of the drug: pregnant mares' urine. Animal rights activists claim that the horse is treated inhumanely by being confined to a stall with a catheter in its bladder to collect the urine.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 12 Neurologic Drugs 12.1

Multiple Choice Questions

1) Hydantoin drugs for epilepsy prevent the neurons from sending out impulses too rapidly or repeatedly by ________. A) blocking receptors in the brain B) regulating sodium ions and sodium channels C) depressing the motor cortex of the brain and raising the seizure threshold D) increasing the amount of the neurotransmitter GABA Answer: B Explanation: A) Hydantoin drugs do not block receptors in the brain. B) Correct. C) Succinimide drugs, not hydantoin drugs, depress the motor cortex of the brain and raise the seizure threshold. D) Hydantoin drugs do not increase the amount of the neurotransmitter GABA. 2) Benzodiazepine drugs treat anxiety and are also used to treat which of the following diseases? A) epilepsy B) dementia C) insomnia D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) Benzodiazepine drugs are not used to treat dementia. C) This is true, but it is not the only correct answer. D) Correct. 3) COMT is the main enzyme that metabolizes the drug ________ in the blood. A) acetylcholine B) dopamine C) GABA D) levodopa Answer: D Explanation: A) Acetylcholine is metabolized by acetylcholinesterase, and it is a neurotransmitter, not a drug. B) Dopamine is a neurotransmitter, not a drug. C) GABA is a neurotransmitter, not a drug. D) Correct.

4) Drug therapy for Parkinson disease corrects the imbalance between what two neurotransmitters in the brain? A) acetylcholine and acetylcholinesterase B) acetylcholine and dopamine C) dopamine and epinephrine D) epinephrine and acetylcholine Answer: B Explanation: A) The imbalance is not between acetylcholine and acetylcholinesterase. B) Correct. C) The imbalance is not between dopamine and epinephrine. D) The imbalance is not between epinephrine and acetylcholine. 5) Combination sleep aid drugs contain an analgesic drug (acetaminophen, ibuprofen, naproxen) to treat the pain associated with insomnia and diphenhydramine, which is a/an ________ drug. A) analgesic B) antihistamine C) antidepressant D) barbiturate Answer: B Explanation: A) Diphenhydramine is not an analgesic drug. B) Correct. C) Diphenhydramine is not an antidepressant drug. D) Diphenhydramine is not a barbiturate drug. 6) Benzodiazepine antianxiety drugs are used to treat anxiety but also have a/an ________ effect that makes them useful in treating insomnia. A) antiepileptic B) sedative C) blood-brain D) long-term memory Answer: B Explanation: A) Benzodiazepine drugs do not have an antiepileptic effect. B) Correct. C) Benzodiazepine drugs do not have a blood-brain effect. D) Benzodiazepine drugs do not have a long-term memory effect.

7) Which of the following drug categories are used to treat neuropathy and neuralgia? A) SNRI drugs for depression B) antiepileptic drugs C) opioid analgesic drugs D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 8) Which of these is NOT a category of hypnotic drugs used to treat insomnia? A) COMT inhibitor drugs B) benzodiazepine antianxiety drugs C) antidepressant drugs D) melatonin receptor agonist drugs Answer: A Explanation: A) Correct. COMT inhibitor drugs are used to treat Parkinson disease, not insomnia. B) This drug category is used to treat insomnia. C) This drug category is used to treat insomnia. D) This drug category is used to treat insomnia. 9) Which drug can be used to treat simple partial seizures, complex partial seizures, and tonic-clonic seizures? A) carbamazepine (Epitrol, Tegretol) B) clonazepam (Klonopin) C) phenytoin (Dilantin D) zaleplon (Sonata) Answer: C Explanation: A) This is drug is not used to treat these types of seizures. B) This drug is used to treat other types of seizures than these. C) Correct. D) This drug is used to treat insomnia, not seizures.

10) How does the drug memantine (Namenda) work to treat Alzheimer disease? A) It binds to NMDA receptors and stops them from being overstimulated by the neurotransmitter glutamate. B) It stimulates dopamine receptors. C) It is an antihistamine drug that has a hypnotic/sedative effect. D) All of the above. Answer: A Explanation: A) Correct. B) This drug action is related to Parkinson disease, not Alzheimer disease. C) This drug action is related to insomnia, not Alzheimer disease. D) There is only one correct answer. 11) Honoria Williams has epilepsy characterized by grand mal seizures. Which of the following drugs would be prescribed for her? A) phenytoin (Dilantin) B) aducanumab (Aduhelm) C) ropinirole (Requip) D) duloxetine (Cymbalta, Drizalma Sprinkle) Answer: A Explanation: A) Correct. B) This drug is used to treat Alzheimer disease, not epilepsy. C) This drug is used to treat Parkinson disease, not epilepsy. D) This drug is used to treat neuropathy and neuralgia, not epilepsy. 12) Temazepam (Restoril) and triazolam (Halcion) are both benzodiazepine antianxiety drugs that are used to treat ________. A) Parkinson disease B) Alzheimer disease C) absence seizures D) insomnia Answer: D Explanation: A) These drugs are not used to treat Parkinson disease. B) These drugs are not used to treat Alzheimer disease. C) These drugs are not used to treat absence seizures. D) Correct.

13) The nonbarbiturate hypnotic/sedative drug zolpidem has one trade name drug that is specially designed as a "get-back-to-sleep" pill for people who wake up in the middle of the night and can't get back to sleep. That trade name is ________. A) Sonata B) Intermezzo C) Cogentin D) Keppra Answer: B Explanation: A) Sonata is used to treat insomnia, but it is not a trade name for zolpidem. B) Correct. C) Cogentin is used to treat Parkinson disease, not insomnia. D) Keppra is used to treat epilepsy, not insomnia. 14) All of the following statements about drugs for Parkinson disease are true, EXCEPT ________. A) the higher doses of Parkinson drugs produce more side effects. B) patients must sometimes take a drug holiday C) dopamine given as a drug cannot cross the blood-brain barrier D) succinimide drugs are particularly effective for Parkinson disease Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. These drugs are used to treat epilepsy, not Parkinson disease. 15) The symptoms of Parkinson disease include which of the following? A) memory loss, difficulty making decisions, loss of the sense of taste and smell B) jerking muscle contractions, tongue-biting, incontinence C) nerve pain, tingling, burning in the extremities D) muscle rigidity, tremors, slowing of voluntary movements Answer: D Explanation: A) These are symptoms of Alzheimer disease, not Parkinson disease. B) These are symptoms of tonic-clonic seizures, not Parkinson disease. C) These are symptoms of neuropathy and neuralgia, not Parkinson disease. D) Correct.

16) All of the following combination drugs contain carbidopa and levodopa and are used to treat Parkinson disease, EXCEPT ________. A) Depakene B) Duodopa C) Rytary D) Sinemet Answer: A Explanation: A) Correct. This is not a combination drug, and it is not used to treat Parkinson disease. B) This is a combination drug used to treat Parkinson disease. C) This is a combination drug used to treat Parkinson disease. D) This is a combination drug used to treat Parkinson disease. 17) The trade name for the generic drug phenytoin that is used to treat seizures is ________. A) Dilantin B) Exelon C) Neupro D) Aricept Answer: A Explanation: A) Correct. B) Exelon is used to treat Alzheimer disease, not seizures. C) Neupro is used to treat neuropathy, not seizures. D) Aricept is used to Alzheimer disease, not seizures.

18) All of the following are trade name drugs to treat insomnia, EXCEPT ________. A) Lunesta B) Rozerem C) Keppra D) Ambien Answer: C Explanation: A) Lunesta is used to treat insomnia. B) Rozerem is used to treat insomnia. C) Correct. Keppra is used to treat seizures, not insomnia. D) Ambien is used to treat insomnia.

19) When a drug prescribed for Parkinson disease causes increasing side effects, the healthcare provider can ________. A) initiate a drug holiday B) prescribe an antidote C) prescribe a high dose D) All of the above. Answer: A Explanation: A) Correct. B) There is no antidote for drugs used to treat Parkinson disease. C) This would only cause more side effects. D) There is only one correct answer. 20) Which of the following is NOT categorized as a neuralgia or neuropathy? A) multiple sclerosis B) diabetic neuropathy C) postherpetic pain from shingles D) phantom limb pain Answer: A Explanation: A) Correct. B) Diabetic neuropathy is a type of neuralgia or neuropathy. C) Postherpetic neuralgia from shingles is a type of neuralgia or neuropathy. D) Phantom limb pain is a type of neuralgia or neuropathy. 21) Which of the following statements is TRUE about levodopa? A) It can be given in very small oral doses and still be effective. B) The drug levodopa is the metabolic precursor of acetylcholine. C) It cannot penetrate the blood-brain barrier. D) None of these statements are true. Answer: D Explanation: A) This is not true. Levodopa must be given in large doses to be effective. B) This is not true. The drug levodopa is the metabolic precursor of dopamine, not acetylcholine. C) This is not true. Levodopa can penetrate the blood-brain barrier. D) Correct.

22) Which of the following statements about donepezil (Aricept) is FALSE? A) It is the most prescribed drug for Alzheimer disease. B) It was originally derived from a strain of daffodil bulbs. C) It is approved by the FDA for treating all stages of Alzheimer disease. D) It belongs to the category of acetylcholinesterase inhibitor drugs. Answer: B Explanation: A) This is a true statement. B) Correct. Galantamine, not donepezil, is from daffodils. C) This is a true statement. D) This is a true statement. 23) Which of the following is NOT a symptom of some type of an epileptic seizure? A) unconsciousness B) vacant staring and repetitive blinking C) difficulties with memory, judgment, and reasoning D) tongue-biting and incontinence Answer: C Explanation: A) Unconsciousness is a symptom of a tonic-clonic seizure. B) These are symptoms of absence seizures. C) Correct. This is associated with Alzheimer disease, not seizures. D) This is a symptom of a tonic-clonic seizure. 24) Which of the following statements is FALSE? A) Phenytoin (Dilantin), for epilepsy, is one of the oldest drugs on the market. B) The benzodiazepine drug triazolam (Halcion), for insomnia, should not be taken with grapefruit or grapefruit juice. C) Carbidopa has no therapeutic effect of its own unless it is taken with levodopa. D) Aducanumab (Aduhelm) is the newest drug for Parkinson disease. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. This is false. This is the newest drug for Alzheimer disease.

25) A seizure can be triggered by which of the following? A) drugs or alcohol B) stress C) flashing lights D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 26) Topiramate (Topamax, Trokendi) is used to treat which of the following diseases? A) seizures B) insomnia C) migraine headaches D) A and C Answer: D Explanation: A) This is true, but it is not the only use. B) These drugs are not used to treat insomnia. C) This is true, but it is not the only use. D) Correct. 27) The choice of drug therapy to treat epilepsy depends on ________. A) the proper classification of the type of seizure B) the patient's clinical symptoms C) the patient's EEG pattern D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct statement. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct.

28) Which of the following statements about multiple sclerosis is FALSE? A) It is caused by a herpes virus infection that reappears at times of stress. B) It is an autoimmune disease with antibodies against the myelin covering around nerves. C) There is progressive interruption of electrical signals between the brain and spinal cord. D) Symptoms include double vision, large muscle weakness, uncoordinated gait, muscle spasticity, and nerve pain. Answer: A Explanation: A) Correct. This describes singles, not multiple sclerosis. B) This is a true statement. C) This is a true statement. D) This is a true statement. 29) Which of the following is NOT a type of epileptic seizure? A) dementia B) grand mal C) psychomotor D) focal motor Answer: A Explanation: A) Correct. Dementia is not a type of epileptic seizure. B) Grand mal (tonic-clonic) is a type of epileptic seizure. C) Psychomotor (complex partial) is a type of epileptic seizure. D) Focal motor (simple partial) is a type of epileptic seizure. 30) Which statement about status epilepticus is FALSE? A) It is a state of prolonged, continuous seizure activity. B) It consists of frequently repeated seizures without the patient regaining consciousness. C) It is an irreversible, progressive disease that leads to dementia. D) It is a medical emergency because it can cause brain damage. Answer: C Explanation: A) This is a true statement. B) This is a true statement. C) Correct. This does not describe status epilepticus. D) This is a true statement.

31) Which of the following diseases is characterized by beta-amyloid plaques and tau neurofibrillary tangles? A) grand mal seizures B) insomnia C) Parkinson disease D) Alzheimer disease Answer: D Explanation: A) This does not describe grand mal seizures. B) This does not describe insomnia. C) This does not describe Parkinson disease. D) Correct. 32) ________ is the only drug for Alzheimer disease that comes in the form of a transdermal patch. A) Memantine (Namenda) B) Topiramate (Topamax, Trokendi XR) C) Rivastigmine (Exelon) D) Betamethasone (Celestone) Answer: C Explanation: A) This drug is used to treat Alzheimer disease, but it is not a transdermal patch. B) This drug is used to treat epilepsy, not Alzheimer disease. C) Correct. D) This drug is used to multiple sclerosis, not Alzheimer disease. 33) The drug pregabalin (Lyrica) is used to treat what diseases? A) neuralgia B) epilepsy C) neuropathy D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

34) In what drug form is the insomnia drug zolpidem manufactured? A) a tablet (Ambien) B) a sublingual tablet (Intermezzo) C) an oral spray (Zolpimist) D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 35) The well-known generic drug donepezil to treat Alzheimer disease is related to the trade name drug ________. A) Neurontin B) Valium C) Aricept D) Cymbalta Answer: C Explanation: A) This is the trade name for gabapentin for neuralgia, not donepezil. B) This is the trade name for diazepam for epilepsy, not donepezil. C) Correct. D) This is the trade name for the duloxetine for neuralgia, not donepezil. 36) The drug pramipexole (Mirapex) is used to treat Parkinson disease and restless legs syndrome, but it is associated with what adverse drug reaction? A) compulsive shopping and gambling B) sexual activity C) binge eating D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

37) In preventing or treating migraine headaches, ergotamine drugs stimulate all of the following receptors, EXCEPT ________. A) dopamine B) epinephrine C) norepinephrine D) serotonin Answer: B Explanation: A) Ergotamine drugs do stimulate dopamine receptors. B) Correct. C) Ergotamine drugs do stimulate norepinephrine receptors. D) Ergotamine drugs do stimulate serotonin receptors. 38) All of these are serotonin receptor agonist drugs used to treat migraine headaches, EXCEPT ________. A) benztropine (Cogentin) B) sumatriptan (Imitrex) C) rizatriptan (Maxalt) D) zolmitriptan (Zomig) Answer: A Explanation: A) Correct. B) This is a serotonin receptor agonist drug. C) This is a serotonin receptor agonist drug. D) This is a serotonin receptor agonist drug. 39) Sumatriptan (Imitrex) for migraine headaches comes in which of these drug forms? A) an oral tablet B) device that contains the powdered drug C) a nasal spray D) All of the above. Answer: D Explanation: A) It does come in this drug form. B) It does come in this drug form. C) It does come in this drug form. D) Correct.

40) Barbiturate drugs are prescribed to treat ________. A) insomnia B) dementia C) epilepsy D) A and C Answer: D Explanation: A) This is true, but it is not the only correct statement. B) Barbiturate drugs are not prescribed to treat dementia. C) This is true, but it is not the only correct statement. D) Correct. 41) Antidepressant drugs are used to treat which of the following conditions? A) Alzheimer disease B) insomnia C) nerve pain D) B and C Answer: D Explanation: A) Antidepressant drugs are not used to treat Alzheimer disease. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 42) All of the following are drug categories that are used to treat epilepsy, EXCEPT ________. A) GABA analog drugs B) Ergotamine drugs C) Carbonic anhydrase inhibitor drugs D) Benzodiazepine drugs Answer: B Explanation: A) These drugs are used to treat epilepsy. B) Correct. Ergotamine drugs are used to treat migraine headaches, not epilepsy. C) These drugs are used to treat epilepsy. D) These drugs are used to treat epilepsy. 43) All of these drugs are used to treat epilepsy, EXCEPT ________. A) oxcarbazepine (Oxtellar XR) B) aducanumab (AduHelm) C) levetiracetam (Keppra) D) lamotrigine (Lamictal) Answer: B Explanation: A) This drug is used to treat epilepsy. B) Correct. This drug is used to treat Alzheimer disease, not epilepsy. C) This drug is used to treat epilepsy. D) This drug is used to treat epilepsy. 14 Copyright © 2022 Pearson Education, Inc.

44) What are the causes of dementia? A) drug abuse B) cerebrovascular accident/stroke C) chronic alcoholism D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 45) The newest category of drugs used to treat Alzheimer disease is ________. A) anti-amyloid monoclonal antibody drugs B) acetylcholinesterase inhibitor drugs C) NMDA receptor antagonist drugs D) benzodiazepine antianxiety drugs Answer: A Explanation: A) Correct. B) These drugs are used, but they are not the newest. C) These drugs are used, but they are not the newest. D) These drugs are not used to treat Alzheimer disease. 46) What is the goal of treatment for drug therapy for Parkinson disease? A) Take a drug holiday as often as possible B) Minimize "off time" and maximize "on time" episodes C) Restore the balance between acetylcholine and dopamine D) B and C Answer: D Explanation: A) This is not a goal of drug therapy for Parkinson disease. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

47) Which trade name drug comes as a nasal spray and is used to treat epilepsy? A) Migranal B) Valtoco C) Comtan D) Decadron Answer: B Explanation: A) Migranal is a nasal spray, but it is used to treat migraine headaches. B) Correct. C) This drug is not a nasal spray and is used to treat Parkinson disease. D) This drug is not a nasal spray and is used to treat multiple sclerosis. 48) GABA analog drugs are used to treat ________. A) epilepsy B) Alzheimer disease C) insomnia D) All of the above. Answer: A Explanation: A) Correct. B) These drugs are not used to treat Alzheimer disease. C) These drugs are not used to treat insomnia. D) Only one answer is correct. 49) Trade names associated with the generic drug gabapentin include ________. A) Neurontin B) Gralise C) Horizant D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 50) There is a decreased level of acetylcholine in the brain in patients with ________. A) insomnia B) Alzheimer disease C) restless legs syndrome D) multiple sclerosis Answer: B Explanation: A) This is not correct. B) Correct. C) This is not correct. D) This is not correct. 16 Copyright © 2022 Pearson Education, Inc.

51) All of the following drug categories are used to treat Alzheimer disease, EXCEPT ________. A) acetylcholinesterase inhibitor drugs B) corticosteroid drugs C) anti-amyloid monoclonal antibody drugs D) NMDA receptor antagonist drugs Answer: B Explanation: A) These drugs are used to treat Alzheimer disease. B) Correct. These drugs are used to treat multiple sclerosis C) These drugs are used to treat Alzheimer disease. D) These drugs are used to treat Alzheimer disease. 52) Which of the following drug categories is used to treat Parkinson disease? A) carbidopa drugs B) COMT inhibitor drugs C) dopamine agonist drugs D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 53) Which of the following drug categories is used to treat multiple sclerosis? A) corticosteroid drugs B) interferon drugs C) acetylcholinesterase inhibitor drugs D) A and B Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) These drugs are used to treat Alzheimer disease, not multiple sclerosis. D) Correct.

54) Which of the following trade name drugs is NOT used to prevent migraine headaches? A) Aimovig B) Emgality C) Dilantin D) Amerge Answer: C Explanation: A) This drug is used to prevent migraine headaches. B) This drug is used to prevent migraine headaches. C) Correct. Dilantin is used to prevent epilepsy, not migraine headaches. D) This drug is used to prevent migraine headaches. 12.2

True/False Questions

1) Barbiturate drugs are used as sleeping pills to treat insomnia for a short period of time. Answer: TRUE 2) Hydantoin drugs regulate the flow of sodium ions in the cell membrane of neurons in the motor cortex of the brain. Answer: TRUE 3) Dopamine agonist drugs for Parkinson disease directly stimulate dopamine receptors to produce an effect that is similar to that of neurotransmitter acetylcholine. Answer: FALSE Explanation: Their action is similar to that of the neurotransmitter dopamine. 4) The drug phenytoin (Dilantin) has been used for many years and is effective in treating all types of seizures. Answer: FALSE Explanation: No one drug is effective against all types of seizures. 5) When MAO inhibitor drugs for Parkinson disease inhibit the enzyme MAO, this results in a decreased amount of dopamine. Answer: FALSE Explanation: When MAO is inhibited, it results in an increased amount of dopamine. 6) Over-the-counter sleep aids contain an antihistamine drug that uses the drug's side effect of drowsiness as the therapeutic effect to induce sleep. Answer: TRUE 7) The suffix -suximide is common to generic succinimide drugs used to treat Alzheimer disease. Answer: FALSE Explanation: These drugs are not used to treat Parkinson disease, not Alzheimer disease.

8) Melatonin, a hormone that regulates the 24-hour sleep-wake cycle, is available as a prescription drug. Answer: FALSE Explanation: Melatonin is only an over-the-counter dietary supplement. 9) Tonic-clonic seizures are also known as grand mal seizures. Answer: TRUE 10) Serotonin receptor agonist drugs are used to prevent migraine headaches from occurring. Answer: FALSE Explanation: These drugs are used to treat a migraine headache once it has occurred. 11) One of the benefits of ergotamine drugs for migraine headaches is that they constrict the arteries in the brain without significantly reducing blood flow to the brain. Answer: TRUE 12) Beta-blocker drugs keep the blood vessels constricted and this prevents the vasodilation that begins a migraine headache. Answer: FALSE Explanation: Beta-blocker drugs keep the arteries dilated to prevent vasoconstriction. 13) Antidepressant drugs have been found helpful in preventing migraine headaches. Answer: FALSE Explanation: Antidepressant drugs are used to treat insomnia, not migraine headaches. 14) Caffeine is a stimulant drug that is included in combination analgesic drugs used to treat migraine headaches. Answer: TRUE 15) Beta-blocker drugs keep the blood vessels constricted and this prevents the initial vasodilation that begins a migraine headache. Answer: FALSE Explanation: Beta-blocker drugs keep the arteries dilated. Initial vasoconstriction, not vasodilation, begins a migraine headache. 16) COMT inhibitor drugs used to treat epilepsy inhibit the enzyme COMT. Answer: FALSE Explanation: COMT inhibitor drugs are used to treat Parkinson disease, not epilepsy. 17) Ergotamine drugs for migraine headaches were derived a fungus that affects grasses. Answer: TRUE 18) Some antiepileptic drugs can decrease the effectiveness of oral contraceptive drugs that are used to prevent pregnancy. Answer: TRUE

19) Research suggests there is a link between Alzheimer disease and diabetes mellitus. Answer: TRUE 20) Researchers say that taking a daily dose of a nonsteroidal anti-inflammatory drug (NSAID) can decrease the chance of getting Alzheimer disease by 60%. Answer: TRUE 21) Acetylcholine is at an increased level in patients who have Alzheimer disease. Answer: FALSE Explanation: It is at a decreased, not an increased level. 22) Drugs for Alzheimer disease are able to reverse the destruction of neurons that has occurred. Answer: FALSE Explanation: These drugs cannot reverse any destruction of neurons that has already occurred. 23) Drug therapy for Parkinson disease seeks to improve the motor symptoms, the nonmotor symptoms, and the quality of life. Answer: TRUE 24) Dopamine precursor drugs are used to treat "off episodes" when a patient is already taking carbidopa and levodopa. Answer: TRUE 25) Tardive dyskinesia is a drug side effect of long-term (4 to 10 years) treatment with levodopa. Answer: TRUE 12.3

Short Answer Questions

1) The category of ________ drugs for epilepsy act neurons in the motor cortex of the brain to regulate the flow of sodium ions through sodium channels. Answer: hydantoin 2) The trade name drug ________ is a reference to the Latin word that means "moon." Answer: Lunesta 3) The medical word ________ means "nerve pain." Answer: neuralgia 4) Certain drugs for Alzheimer disease inhibit the enzyme acetylcholinesterase. This drug action raises the amount of ________ in the synapse between neurons in the brain. Answer: acetylcholine 5) ________/sedative drugs that are used on a short-term basis to treat insomnia get their name from the Greek word hypnos that means "sleep." Answer: Hypnotic

6) The suffixes -azepam and -olam are common to generic benzodiazepine drugs that are used to treat ________. Answer: insomnia 7) The drug advertisement for the drug pregabalin (________) shows a patient's resting on a prickly cactus, and another ad shows thumbtacks pricking the feet to show the sensations of neuralgia Answer: Lyrica 8) Drugs used to treat seizures are known as antiseizure, anticonvulsant, or ________ drugs because this medical condition is characterized by seizures or convulsions. Answer: antiepileptic 9) Alzheimer disease is the most common form of ________. Answer: dementia 10) The well-known generic drug phenytoin that has been used for years to treat epilepsy is related to the trade name drug ________. Answer: Dilantin 11) The anticholinesterase inhibitor drug galantamine (Razadyne ER) was originally derived from what flower bulb? Answer: daffodil 12) Melatonin, a hormone secreted by the ________ gland in the brain, regulates the 24-hour sleep-wake cycle. Answer: pineal 13) The suffix -triptan is common to generic ________ receptor agonist drugs used to treat migraine headaches. Answer: serotonin 14) ________ is a neurotransmitter that normally constricts the arteries in the brain. Prior to a migraine headache, there is an elevated level of this substance. Answer: Serotonin 15) The combination drug Cafergot that is used to treat migraine headaches contains ergotamine and ________. Answer: caffeine 16) ________ occurs when a group of neurons spontaneously and repeatedly sends out electrical signals in an abnormal, uncontrolled way. Answer: Epilepsy 17) The ________ cranial nerve that travels from the skull to the jaws, cheeks, eyes, and forehead releases neuropeptides that cause a migraine headache. Answer: trigeminal 21 Copyright © 2022 Pearson Education, Inc.

18) ________ is defined as any change in memory that impairs a person's daily functioning. Answer: Dementia 19) Parkinson disease and Alzheimer disease are progressive ________ diseases. Answer: neurodegenerative 20) The ________ ________ test is being used to detect Alzheimer disease because the olfactory cortex that detect smells is one of the first areas to be affected. Answer: peanut butter 21) The more ________ that are destroyed the greater the degree of cognitive impairment and loss of memory in dementia and Alzheimer disease. Answer: neurons 22) A/An ________ patch helps control the symptoms of Parkinson disease for an entire day. Answer: transdermal 23) Abobotulinumtoxin A and incobotulinumtoxin A are neuromuscular drugs that are used to treat the muscle spasticity associated with ________ ________. Answer: multiple sclerosis 24) ________ is characterized by difficulty falling asleep, awakening during the night, and/or difficulty getting back to sleep. Answer: Insomnia 25) ________ is a herpesvirus infection, originally from chickenpox, that reappears in older adults during times of illness or stress. Answer: Shingles

12.4

Matching Questions

Match the name of the drug category and its use in Column 2 with the drug name in Column 1. A) barbiturate drug for epilepsy B) acetylcholinesterase inhibitor drug for Alzheimer disease C) orexin receptor antagonist drug for insomnia D) MAO inhibitor drug for Parkinson disease E) nonbarbiturate hypnotic/sedative drug for insomnia F) hydantoin drug for epilepsy G) dopamine agonist drug for Parkinson disease H) corticosteroid drug for multiple sclerosis I) drug for neuralgia and neuropathy J) benzodiazepine drug for epilepsy 1) clonazepam (Klonopin) 2) methylprednisolone (Medrol, Solu-Medrol) 3) phenobarbital 4) lemborexant (Dayvigo) 5) ethotoin (Peganone) 6) pramipexole (Mirapex) 7) pregabalin (Lyrica) 8) rasagiline (Azilect) 9) rivastigmine (Exelon) 10) zaleplon (Sonata) Answers: 1) J 2) H 3) A 4) C 5) F 6) G 7) I 8) D 9) B 10) E

Match the name of the drug category and its use in Column 2 with the drug name in Column 1. A) SNRI drug for neuropathy and neuralgia B) beta-blocker drug for migraine headaches C) neuromuscular blocking drug for migraine headaches D) CGRP receptor antagonist drugs for migraine headaches E) carbonic anhydrase inhibitor drug for epilepsy F) nonsteroidal anti-inflammatory drug G) ergotamine drugs for migraine headaches H) drug for restless legs syndrome and Parkinson disease I) serotonin receptor agonist drug for migraine headaches J) succinimide drug for epilepsy 11) onabotulinumtoxin A (Botox) 12) duloxetine (Cymbalta, Drizalma Sprinkle) 13) almotriptan (Axert) 14) ropinirole (Requip) 15) acetazolamide (Diamox Sequels) 16) propranolol (Inderal) 17) dihydroergotamine (Migranal) 18) ibuprofen (Advil Migraine) 19) ethosuximide (Zarontin) 20) ubrogepant (Ubrelvy) Answers: 11) C 12) A 13) I 14) H 15) E 16) B 17) G 18) F 19) J 20) D 12.5

Essay Questions

1) Describe how a healthcare provider decides which drug to use for a patient with epilepsy. Answer: The choice of drug therapy for epilepsy depends on the proper classification of the type of seizure. This is based on the patient's clinical symptoms and brain-waves patterns, as shown on the electroencephalography (EEG). Each type of epilepsy displays a specific EEG pattern during a seizure.

2) Explain what a drug holiday is and what disease it is related to. Answer: A drug holiday is related to Parkinson disease. When the dose can no longer be increased or the side effects become intolerable, the healthcare provider will gradually withdraw the drug and place the patient on a drug holiday for a few days. When the drug is again initiated, the patient is able to respond to lower doses of the drug. 3) Describe the unusual adverse effect associated with the nonbarbiturate hypnotic/sedative drug zolpidem (Ambien) that is used to treat insomnia. Answer: Some patients taking zolpidem (Ambien) have reported unusual adverse effects of not being aware or remembering while working, eating, and even while driving. This usually occurs when a patient takes Ambien but continues to stay awake or takes Ambien but does not get a full 8 hours of sleep before becoming active.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 13 Psychiatric Drugs 13.1

Multiple Choice Questions

1) Which drug category enhances the effect of the neurotransmitter GABA to treat generalized anxiety disorder? A) benzodiazepine drugs B) major tranquilizer drugs C) phenothiazine drugs D) tricyclic antidepressant drugs Answer: A Explanation: A) Correct. B) These drugs are used to treat psychosis, not anxiety and neurosis. C) These drugs are used to treat psychosis, not anxiety. D) These drugs are used to treat depression, not anxiety and neurosis. 2) Robert Crawford has been a drug addict for six months. Now, he is increasing the amount of the drug he takes but is still not getting the "high" he craves. This is because he is now experiencing ________. A) dependence B) euphoria C) tolerance D) All of the above Answer: C Explanation: A) Dependence occurs quickly. B) Euphoria is the "high" that is experienced by addicts. C) Correct. Tolerance is a decreasing effect even with increasing amounts of the drug. D) These effects do not all occur at the same time. 3) Which of the following is one of the drug categories used to treat psychosis and schizophrenia? A) tricyclic antidepressant drugs B) lithium drugs C) selective serotonin reuptake inhibitor drugs D) phenothiazine drugs Answer: D Explanation: A) These drugs are used to treat depression. B) These drugs are used to treat bipolar disorder, not psychosis and schizophrenia. C) These drugs are used to treat obsessive-compulsive disorder and depression. D) Correct. These drugs are used to treat psychosis and schizophrenia.

4) Tricyclic antidepressant drugs are so named because of the ________. A) three cycles of metabolism that they undergo before being excreted B) three hormones (dopamine, serotonin, and acetylcholine) that are affected by these drugs C) triple action of these drugs in the limbic system, motor cortex, and hypothalamus in the brain D) triple-ring configuration of the chemical structure of the drug Answer: D Explanation: A) The name tricyclic is not based on metabolism. B) The name tricyclic is not based on hormones. C) The name tricyclic drugs is not based on a triple action. D) Correct. These drugs have a triple-ring in their chemical structure 5) Patients with obsessive-compulsive disorder (OCD) exhibit ________. A) persistent, uncontrollable thoughts B) anxiety C) excessive, repetitive actions D) All of the above Answer: D Explanation: A) OCD is characterized by these types of thoughts (obsessions) B) OCD has component of anxiety caused by obsessions. C) OCD is characterized by these types of actions (compulsions) D) Correct. All of the above are present with OCD. 6) Panic disorder is treated with ________. A) benzodiazepine antianxiety drugs B) selective serotonin reuptake inhibitor drugs C) serotonin/norepinephrine reuptake inhibitor drugs D) All of the above Answer: D Explanation: A) These drugs are used to treat panic disorder B) These drugs are used to treat panic disorder C) These drugs are used to treat panic disorder D) Correct. 7) Which of the following is TRUE of tardive dyskinesia? A) It includes hoarding, checking, and arranging. B) It is a severe side effect of first-generation antipsychotic drugs. C) It includes involuntary, repetitive movements of the face, lips, eyes, tongue, and extremities. D) B and C Answer: D Explanation: A) This is true of obsessive-compulsive disorder, not tardive dyskinesia. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 2 Copyright © 2022 Pearson Education, Inc.

8) Dry mouth, blurry vision, constipation, and urinary retention that are common to tricyclic antidepressant drugs are ________ side effects. A) anticholinergic B) antianxiety C) minor tranquilizer D) monoamine oxidase Answer: A Explanation: A) Correct. B) These are not antianxiety side effects. C) These are not minor tranquilizer side effects. D) These are not monoamine oxidase side effects. 9) Posttraumatic stress disorder is treated with drugs from the ________ category. A) selective serotonin reuptake inhibitor B) tetracyclic C) acetylcholine D) PMDD Answer: A Explanation: A) Correct. B) These antidepressant drugs are not used to treat posttraumatic stress disorder. C) Acetylcholine is a neurotransmitter, not a drug category. D) PMDD stands for premenstrual dysphoric disorder; it is not a drug category. 10) Which of the following is NOT a benzodiazepine drug used to treat generalized anxiety disorder? A) alprazolam (Xanax) B) diazepam (Valium) C) lithium D) clorazepate (Tranxene-T) Answer: C Explanation: A) This is a benzodiazepine drug used to treat anxiety. B) This is a benzodiazepine drug used to treat anxiety. C) Correct. Lithium is an antipsychotic drug. D) This is a benzodiazepine drug used to treat anxiety.

11) Which of the following statements is FALSE? A) Depression is caused by an increased level of norepinephrine in the brain. B) Monoamine oxidase (MAO) is an enzyme in the body that breaks down monoamine neurotransmitters. C) Fluoxetine (Prozac) is used to treat depression, panic disorder, obsessive-compulsive disorder, posttraumatic stress disorder, and the eating disorder bulimia. D) Under the trade name Sarafem, fluoxetine (Prozac, Sarafem) is used to treat premenstrual dysphoric disorder in women. Answer: A Explanation: A) Correct. Mania, not depression, is caused by an increased level of norepinephrine. B) This is a true statement. C) This is a true statement. D) This is a true statement. 12) The symptoms of delusions, hallucinations, inappropriate mood, bizarre behaviors, and a loss of touch with realty are characteristic of ________. A) psychosis B) generalized anxiety disorder C) depression D) panic attacks Answer: A Explanation: A) Correct. These are psychotic symptoms. B) These are not symptoms of generalized anxiety disorder. C) These are not symptoms of depression. D) These are not symptoms of panic attacks. 13) Before World War II and before the introduction of antipsychotic drugs, schizophrenic patients were treated by ________. A) exposure to malaria to produce fever and delirium B) injection with insulin to cause convulsions and coma C) electroshock therapy D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct statement. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct.

14) Which of the following is NOT a symptom of neurosis? A) nervousness, anxiety, and anxiousness B) loss of touch with reality C) apprehension and vague, unsubstantiated fears D) heightened startle reflex and irritability Answer: B Explanation: A) These are symptoms of neurosis. B) Correct. This is a symptom of psychosis, not neurosis. C) These are symptoms of neurosis. D) These are symptoms of neurosis. 15) Which one of the following trade name drugs is NOT used to treat ADHD? A) Strattera B) Daytrana C) Prozac D) Concerta Answer: C Explanation: A) Strattera is used to treat ADHD. B) Daytrana is a transdermal patch that is used to treat ADHD. C) Correct. This drug is not used to treat ADHD. D) Concerta is used to treat ADHD. 16) Drugs used to treat neurosis are called ________. A) antianxiety drugs B) anxiolytic drugs C) minor tranquilizer drugs D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 17) Drugs used to treat psychosis are called ________. A) benzodiazepine drugs B) antipsychotic drugs C) major tranquilizer drugs D) B and C Answer: D Explanation: A) These drugs are used to treat anxiety, not psychosis. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 5 Copyright © 2022 Pearson Education, Inc.

18) Select the pair of drugs in which each drug is used to treat the same type of mental illness. A) Valium and Abilify B) Cymbalta and Effexor C) Lithium and Xanax D) Zyprexa and Antabuse Answer: B Explanation: A) Valium is used to treat neurosis, but Abilify is used to treat psychosis. B) Correct. Cymbalta and Effexor are both used to treat depression. C) Lithium is used to treat bipolar disorder, but Xanax is used to treat panic disorder. D) Zyprexa is used to treat bipolar disorder and psychosis, but Antabuse is used to prevent drinking alcohol. 19) The words MAO, tricyclic, and tetracyclic all refer to what type of drugs? A) antianxiety drugs B) antipsychotic drugs C) antidepressant drugs D) drugs for ADHD Answer: C Explanation: A) These words do not refer to antianxiety drugs. B) These words do not refer to antipsychotic drugs. C) Correct. These words refer to categories of antidepressant drugs. D) These words do not refer to drugs for ADHD. 20) Maurice Smith is recovering from an addiction to a narcotic drug. Which of the following statements is FALSE? A) Addiction is a state of complete physical and psychological dependence on a drug. B) Recovering heroin or cocaine addicts can take their methadone drug treatment at home or at work. C) Opiates is another name for narcotic drugs. D) The withdrawal process can be painful, both emotionally and physically. Answer: B Explanation: A) This is a true statement. B) Correct. They cannot take it in an unsupervised environment, it must be in a methadone clinic. C) This is a true statement. D) This is a true statement.

21) Recovering alcoholic patients who take disulfiram (Antabuse) must ________. A) be warned about the adverse effects before starting the drug B) give their consent to treatment with this drug C) avoid alcoholic beverages, cough syrups, and mouthwashes D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct statement. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct. 22) Which of the following statements about ADHD is TRUE? A) It affects girls five times more often than boys. B) It was previously known as posttraumatic stress disorder. C) It is treated with stimulant drugs that exert a paradoxical effect. D) Once a child is diagnosed with ADHD, the symptoms will continue into adulthood. Answer: C Explanation: A) This is a false statement. It is two times more common in boys than girls. B) This is a false statement. C) Correct. Stimulant drugs have a paradoxical effect on ADHD. D) This is a false statement. Many children outgrow the symptoms by late childhood. 23) What mental illnesses is the drug haloperidol (Haldol) used to treat? A) anxiety and neurosis B) psychosis and ADHD C) bipolar disorder and depression D) addiction and ADHD Answer: B Explanation: A) Haldol is not used to treat anxiety or neurosis. B) Correct. Haldol is used to treat psychosis and ADHD. C) Haldol is not used to treat bipolar disorder and depression. D) Haldol is not used to treat addiction and ADHD. 24) Which suffix is common to generic tricyclic antidepressant drugs? A) -quilizer B) -ipramine C) -triptyline D) B and C Answer: D Explanation: A) This is not the suffix of a generic tricyclic antidepressant drug. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 7 Copyright © 2022 Pearson Education, Inc.

25) PTSD is caused by all of the following, EXCEPT ________. A) social anxiety B) terrorist attacks and war C) natural disasters D) rape and kidnapping Answer: A Explanation: A) Correct. Social anxiety is not related to PTSD. B) PTSD IS caused by terrorist attacks and war. C) PTSD IS caused by natural disasters. D) PTSD IS caused by rape and kidnapping. 26) Panic disorder ________. A) is treated with antianxiety drugs B) has a severe, overwhelming fear when there is no immediate danger C) can cause intense physical symptoms that mimic a heart attack D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct 27) The trade name of the benzodiazepine antianxiety drug alprazolam is ________. A) Paxil B) Zoloft C) Pristiq D) Xanax Answer: D Explanation: A) Paxil is a selective serotonin reuptake inhibitor drug. B) Zoloft is a selective serotonin reuptake inhibitor drug. C) Pristiq is a serotonin/norepinephrine reuptake inhibitor drug. D) Correct. Alprazolam (Xanax).

28) Feelings of guilt, helplessness, hopelessness, and worthlessness are common to patients who have ________. A) ADHD B) depression C) psychosis D) All of the above Answer: B Explanation: A) These are not symptoms of ADHD. B) Correct. These are all symptoms of depression. C) These are not symptoms of psychosis. D) Only one answer is correct. 29) The psychiatric disease SAD ________. A) is another form of psychosis B) occurs in the winter when there is little sunshine C) is treated with Wellbutrin D) B and C Answer: D Explanation: A) This is not true. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 30) Which of the following is a trade name for the ADHD generic drug methylphenidate? A) Concerta B) Ritalin C) Daytrana D) All of the above Answer: D Explanation: A) This is true, but it is not the only answer. B) This is true, but it is not the only answer. C) This is true, but it is not the only answer. D) Correct.

31) Mental illnesses include all of the following EXCEPT ________. A) attention-deficit/hyperactivity disorder B) psychosis C) addiction-related disorders D) neurotransmitter disorder Answer: D Explanation: A) Mental illnesses do include this. B) Mental illnesses do include this. C) Mental illnesses do include this. D) Correct! Abnormal levels of neurotransmitter cause mental illness, but there is no neurotransmitter disorder. 32) The trade name for the generic serotonin/norepinephrine reuptake inhibitor drug escitalopram is ________. A) Anafranil B) Prozac C) Latuda D) Lexapro Answer: D Explanation: A) Anafranil is the trade name for clomipramine, not escitalopram. B) Prozac is the trade name for fluoxetine, not escitalopram. C) Latuda is the trade name for lurasidone, not escitalopram. D) Correct. Lexapro is the trade name for escitalopram. 33) All of the following are dopamine system stabilizer drugs for psychosis EXCEPT ________. A) aripiprazole (Abilify) B) brexpiprazole (Rexulti) C) cariprazine (Vraylar) D) dextroamphetamine (Dexedrine) Answer: D Explanation: A) This is a dopamine system stabilizer drug. B) This is a dopamine system stabilizer drug. C) This is a dopamine system stabilizer drug. D) Correct. This is an amphetamine drug for ADHD.

34) Which of the following is TRUE concerning social anxiety disorder? A) It causes anxiety when in a crowd or at a party. B) It includes fear of public speaking. C) Symptoms include nausea and inability to think clearly. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 35) All of the following drug categories are used to treat depression EXCEPT ________. A) tetracyclic drugs B) monoamine oxidase inhibitor drugs C) serotonin reuptake inhibitor/antagonist drugs D) antiepileptic drugs Answer: D Explanation: A) These drugs are used to treat depression. B) These drugs are used to treat depression. C) These drugs are used to treat depression. D) Correct. Antiepileptic drugs are used to treat bipolar disorder, not depression. 36) Prescription drug monitoring programs (PDMPs) are ________. A) to identify patients obtaining opioid drugs from several providers B) a way to improve noncompliance in patients taking antipsychotic drugs C) a federal government database D) All of the above. Answer: A Explanation: A) Correct. B) PDMPs track opioid drugs not antipsychotic drugs. C) PDMPs are state databases, not federal. D) There is only one correct answer. 37) Why would healthcare providers give a patient a free sample of a drug? A) to give away what the drug representatives gave to them B) to help patients save money C) to let patients try a limited supply to see if the drug is effective D) to fulfill FDA requirements Answer: C Explanation: A) This is not the reason. B) This is not the reason. C) Correct. D) There are no FDA requirements about free drug samples. 11 Copyright © 2022 Pearson Education, Inc.

13.2

True/False Questions

1) Benzodiazepine antianxiety drugs affect emotional behavior by enhancing the effect of GABA and the limbic system of the brain. Answer: TRUE 2) Antipsychotic drugs decrease psychotic symptoms of hostility, agitation, and paranoia without causing confusion or sedation. Answer: TRUE 3) Tricyclic antidepressants are prescribed before other antidepressants because they do not cause side effects of dry mouth, blurred vision, constipation, and urinary retention. Answer: FALSE Explanation: This is a false statement. They do cause these side effects. 4) MAO inhibitor drugs are the drug of choice for initiating treatment for depression. Answer: FALSE Explanation: This is a false statement. These drugs are only used to treat depression that has not responded to other drugs. 5) Drugs used to treat manic-depressive disorder lessen the severity and frequency of the mood swings. Answer: TRUE 6) Although it doesn't seem to make sense to give an amphetamine drug to a patient who is hyperactive, it works because the amphetamine stimulant drug has a paradoxical effect and actually reduces impulsive behavior. Answer: TRUE 7) Benzodiazepine drugs bind to several different receptors in the intestine to provide sedation and also to decrease muscle tension that comes with anxiety. Answer: FALSE Explanation: Benzodiazepine drugs act on GABA, a neurotransmitter in the brain. 8) Tricyclic antidepressant drugs are so named because the tablet releases different amounts of the drug during three distinct phases of time. Answer: FALSE Explanation: This is a false statement. They have a triple-ring configuration of their chemical structure. 9) Bipolar disorder is characterized by two opposite emotions of mania and anxiety. Answer: FALSE Explanation: This is a false statement. The two poles are mania and depression.

10) Obsessive-compulsive disorder is characterized by mood swings between two poles. Answer: FALSE Explanation: This is a false statement. It is characterized by thoughts that cause repetitive actions. 11) The original drug was a wormer for livestock, and minor changes in its chemical structure created phenothiazine antipsychotic drugs. Answer: TRUE 12) Minor tranquilizer drugs are major tranquilizers that are given at a lower dose. Answer: FALSE Explanation: This is a false statement. Minor tranquilizer drugs are a separate drug category used to treat neurosis. 13) The generic antidepressant drug bupropion (Wellbutrin) is an antidepressant, but it has also been used as a non-nicotine aid to help patients stop smoking. Answer: TRUE 14) Benzodiazepine antianxiety Schedule IV drugs such as alprazolam (Xanax) and clonazepam (Klonopin) are used to treat panic disorder. Answer: TRUE 15) Premenstrual dysphoric disorder is another name for posttraumatic stress disorder in women. Answer: FALSE Explanation: Premenstrual dysphoric disorder occurs only in women and has different symptoms than posttraumatic stress disorder. 16) The FDA approved the first ingestible drug tracking system Abilify MyCite to assure compliance with taking antipsychotic medication. Answer: TRUE 13.3

Short Answer Questions

1) The treatment of neurosis involves the use of antianxiety drugs, which are also known as ________ drugs or minor tranquilizer drugs. Answer: anxiolytic 2) The suffixes -azepam, -azepate, -azepoxide, and -azolam, are common to generic ________ drugs. Answer: benzodiazepine 3) The treatment of psychosis involves the use of antipsychotic drugs, which are also known as ________ tranquilizer drugs. Answer: major 4) Antidepressant drugs are also known as ________-elevating drugs. Answer: mood 13 Copyright © 2022 Pearson Education, Inc.

5) SSRI drugs are often prescribed to treat depression. The abbreviation SSRI stands for selective ________ reuptake inhibitor drugs. Answer: serotonin 6) The neurotransmitters epinephrine, norepinephrine, dopamine, and serotonin are collectively known as ________ because of their chemical structure. Answer: monoamines 7) After a brief period of abuse, an addict experiences ________ (the need for the drug to prevent withdrawal symptoms). Answer: dependence 8) The well-known generic drug diazepam is related to the trade name drug ________. Answer: Valium 9) The abbreviation ADHD means ________. Answer: attention-deficit/ hyperactivity disorder 10) In the past, the disease that is abbreviated as ________ was known as combat fatigue or shell shock. Answer: PTSD 11) Drugs used to treat psychosis and schizophrenia are known as ________ drugs. Answer: antipsychotic 12) Panic disorder is characterized by a sudden, overwhelming anxiety and fear known as panic ________. Answer: attacks 13) The antidepressant drug duloxetine is related to the trade name drug ________. Answer: Cymbalta 14) First-generation antipsychotic drugs have a high risk of causing a set of side effects known as ________ side effects. Answer: extrapyramidal 15) The selective serotonin reuptake inhibitor drug generic antidepressant drug vilazodone is related to the trade name drug ________ that has an interesting spelling. Answer: Viibryd 16) The only transdermal patch that can give long-lasting control of ADHD is known by the trade name of ________. Answer: Daytrana 17) The adrenal gland secretes ________ that triggers the "fight-or-flight" response to danger. Answer: epinephrine 14 Copyright © 2022 Pearson Education, Inc.

18) ________ in the brain are chemicals that relay messages from one neuron to the next in the brain. Answer: Neurotransmitters 19) The neurotransmitter that is important psychologically in creating the "high" craved by addicts is ________. Answer: dopamine 20) A decreased level of the neurotransmitter ________ may cause depression. Answer: serotonin 21) ________ is the most common form of psychosis. Answer: Schizophrenia 22) When a patient develops symptoms of tardive dyskinesia when taking an antipsychotic drug, the healthcare provider may recommend the patient take a drug ________ for a few weeks. Answer: holiday

13.4

Matching Questions

Match the drug name in Column 1 to its drug category in Column 2. A) tricyclic antidepressant drug B) drug used as a deterrent to prevent drinking of alcohol C) MAO inhibitor drug for depression D) SSRI drug for depression E) central nervous system stimulant drug for ADHD F) benzodiazepine drug for anxiety G) SNRI drug for depression H) second-generation antipsychotic drug I) dopamine system stabilizer for psychosis J) antidepressant drug that affects serotonin 1) alprazolam (Xanax) 2) brexpiprazole (Rexulti) 3) citalopram (Celexa) 4) disulfiram (Antabuse) 5) duloxetine (Cymbalta) 6) olanzapine (Zyprexa) 7) trimipramine (Surmontil) 8) isocarboxazid (Marplan) 9) methylphenidate (Ritalin) 10) vortioxetine (Trintellix) Answers: 1) F 2) I 3) D 4) B 5) G 6) H 7) A 8) C 9) E 10) J 13.5

Essay Questions

1) Describe how tricyclic antidepressants work, specifically stating their action on neurotransmitters. Answer: Tricyclic antidepressant (TCA) drugs block the reuptake of the neurotransmitters norepinephrine and serotonin in the brain. This allows these neurotransmitters to bind with receptors and prolongs their actions until they are eventually broken down. This corrects the low levels of these neurotransmitters that are found in patients with depression.

2) Describe what methadone is and how it must be given to addicts. Answer: Methadone, a Schedule II drug, is an opioid drug that does not produce the degree of euphoria of other opioid drugs. It prevents withdrawal symptoms as it slowly decreases the addict's psychological dependence. 3) Patients taking MAO inhibitor drugs should be warned against eating foods that are high in tyramine because this can cause violent headaches and severe hypertension. Name four of these foods. Answer: Foods that must be avoided while taking an MAO inhibitor drug include cheese, yogurt, red wine, beer, liquor, liver, anchovies, caviar, sauerkraut, sausage, bologna, salami, avocados, overripe fruit, figs, dried fruits, bananas, raspberries, fava beans, meat tenderizer, soy sauce, ginseng, coffee, tea, colas, and chocolate. 4) Describe the unique drug-delivery technology of a tablet of Concerta, the methylphenidate stimulant drug used to treat ADHD. Answer: Concerta comes as an oblong extended-release (ER) tablet that has a patented drug-delivery technology. One end of the tablet contains a tiny hole through which part of the drug's dose is released immediately. Then, the other end of the tablet absorbs fluid from the intestines, forcing the rest of the drug dose through the hole over the next 12 hours. 5) Describe what is unique about the drug form of Zyprexa Zydis and why it is helpful in treating psychotic patients. Answer: Zyprexa Zydis is the trade name for a special tablet form of olanzapine that dissolves in the mouth within 5 to 15 seconds. Because of their mental illness, many psychotic patients are noncompliant in taking their drugs, as they do not understand the importance of the drugs or they feel someone is trying to poison them. One study found that up to 75% of schizophrenic patients do not take their drugs regularly, or not at all (noncompliance). Psychotic patients commonly refuse a drug or hide a tablet between their cheek and teeth and later discard it. This new drug form helps assure patient compliance, as the entire dose dissolves quickly in the mouth.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 14 Endocrine Drugs 14.1

Multiple Choice Questions

1) Which of the following is TRUE about human insulin regular (Afrezza)? A) It is a powder that is inhaled B) It is a long-acting human insulin drug. C) It can be given by an insulin pump. D) All of the above. Answer: A Explanation: A) Correct. B) This is not true. It is a rapid, not a long-acting, insulin drug. C) This is not true. It cannot be given by an insulin pump. D) There is only one correct answer. 2) Hyperthyroidism can be caused by all of the following, EXCEPT ________. A) secretion of too little T3 and T4 hormones B) a benign tumor (nodule) C) an autoimmune disorder that makes antibodies that stimulate TSH receptors D) thyroid enlargement (goiter) Answer: A Explanation: A) Correct. This describes hypothyroidism, not hyperthyroidism. B) Hyperthyroidism can be caused by this. C) Hyperthyroidism can be caused by this. D) Hyperthyroidism can be caused by this. 3) Insulin decreases the blood glucose level by ________. A) binding with glucose, rendering it ineffective B) competing with glucose receptors on cell membranes C) transporting glucose into the cells D) inhibiting the production of glucose Answer: C Explanation: A) Insulin does not make glucose ineffective. B) Insulin does not compete with glucose. C) Correct. D) Insulin does not inhibit the production of glucose.

4) Which type of diabetes mellitus was previously known as insulin-dependent diabetes mellitus (IDDM)? A) gestational diabetes mellitus B) type 1 diabetes mellitus C) type 2 diabetes mellitus D) uncontrolled diabetes mellitus Answer: B Explanation: A) Gestational diabetes insipidus is not previously known as type 1. B) Correct. C) Type 2 diabetes mellitus was previously known as adult-onset diabetes mellitus. D) This is not a type of diabetes mellitus. 5) The size of the crystals of insulin determines ________. A) which type of diabetes mellitus it can be used to treat B) whether it is a human insulin drug or an insulin analog drug C) how quickly the insulin can act in the body to lower the blood glucose level D) which cells will be able to utilize glucose Answer: C Explanation: A) The size of the crystals does not determine which type of diabetes mellitus it can be used to treat. B) The size of the crystals is not related to this. C) Correct. D) The size of the crystals does not determine which cells will utilize glucose. 6) An insulin syringe always ________. A) has an orange cap B) is calibrated in units C) is calibrated in milliliters (mL) or cubic centimeters (cc) D) A and B Answer: D Explanation: A) This is a true statement, but it is not the only correct answer. B) This is a true statement, but it is not the only correct answer. C) This is not a true statement. D) Correct.

7) Which of the following is TRUE of alpha-glucoside inhibitor antidiabetic drugs? A) They do not increase insulin production from the pancreas.. B) They inhibit an enzyme from the pancreas and one from the intestine. C) A decreased amount of glucose enters the blood from digested food. D) All of the above. Answer: D Explanation: A) This is a true statement, but it is not the only correct answer. B) This is a true statement, but it is not the only correct answer. C) This is a true statement, but it is not the only correct answer. D) Correct. 8) Which of the following is NOT one of the ways in which biguanide antidiabetic drugs work? A) They decrease the absorption of glucose from the intestine B) They improve the sensitivity of cells to any insulin that is there. C) They stimulate the pancreas to secrete more insulin. D) They decrease the release of stored glycogen from the liver Answer: C Explanation: A) Biguanide antidiabetic drugs do work in this way. B) Biguanide antidiabetic drugs do work in this way. C) Correct. Biguanide antidiabetic drugs do not do this. D) Biguanide antidiabetic drugs do work in this way. 9) Which of the following is TRUE about colesevelam (WelChol)? A) It is the only drug in the drug category of bile acid sequestrant antidiabetic drugs. B) Bile acid sequestrant drugs are used to treat type 1 diabetes mellitus. C) It is used to treat diabetes mellitus and to lower an elevated cholesterol level. D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is not true. C) This is true, but it is not the only correct answer. D) Correct.

10) Which of the following is NOT one of the ways in which amylin mimetic antidiabetic drugs work? A) They decrease the absorption of glucose from the intestine B) They slow the gastric emptying time. C) They suppress the release of glycogen from the liver D) They work in the brain to suppress the appetite Answer: A Explanation: A) Correct. Biguanide, not amylin mimetic antidiabetic drugs, work in this way. B) These drugs do work in this way. C) These drugs do work in this way. D) These drugs do work in this way. 11) Which of the following is a type of rapid-acting insulin analog drug? A) insulin aspart (Fiasp, NovoLog) B) insulin glulisine (Apidra) C) insulin lispro (Admelog, Humalog, Lyumjev) D) All of the above. Answer: D Explanation: A) This is a rapid-acting insulin analog drug. B) This is a rapid-acting insulin analog drug. C) This is a rapid-acting insulin analog drug. D) Correct. 12) Rapid-acting insulin drugs begin to lower the blood glucose level within ________. A) 5-15 minutes B) 1 hour C) 2 hours D) 3 hours Answer: A Explanation: A) Correct. B) This is not their onset of action time. C) This is not their onset of action time. D) This is not their onset of action time.

13) Former President John F. Kennedy had ________, which gave his skin an unusual, bronzed and tanned appearance. A) hyperthyroidism B) Addison disease C) diabetes mellitus, type 2 D) gestational Answer: B Explanation: A) Former President John F. Kennedy did not have hyperthyroidism. B) Correct. C) Former President John F. Kennedy did not have diabetes mellitus, type 2. D) Former President John F. Kennedy did not have gestational diabetes. 14) Insulin drug categories include which of the following? A) rapid-acting insulin B) intermediate-acting insulin C) long-acting insulin D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 15) Which of the following is NOT part of the endocrine system? A) the intestine B) the pituitary gland C) the pancreas D) the adrenal glands Answer: A Explanation: A) Correct. The intestine is not a part of the endocrine system. B) The pituitary gland is a part of the endocrine system. C) The pancreas is a part of the endocrine system. D) The adrenal glands are a part of the endocrine system.

16) Insulin plays an essential role in glucose ________. A) secretion B) excretion C) metabolism D) All of the above. Answer: C Explanation: A) Insulin does not play a role in glucose secretion. B) Insulin does not play a role in glucose excretion. C) Correct. D) Only one of answer is correct. 17) What do these drugs—insulin aspart (NovoLog) and insulin glulisine (Apidra)—have in common? A) They were created using recombinant DNA technology. B) They are insulin analog drugs. C) They are rapid-acting insulin drugs. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 18) All of the following are sulfonylurea antidiabetic drugs, EXCEPT ________. A) glipizide (Glucotrol) B) chlorpropamide C) glyburide (Glynase) D) exenatide (Bydureon, Byetta) Answer: D Explanation: A) This is a sulfonylurea antidiabetic drug. B) This is a sulfonylurea antidiabetic drug. C) This is a sulfonylurea oral antidiabetic drug. D) Correct. This is a GLP-1 receptor agonist, not a sulfonylurea antidiabetic drug.

19) The first drug ever created using recombinant DNA technology was ________. A) NPH insulin B) human insulin (Humulin) C) prednisone (Deltasone) D) levothyroxine (Levoxyl, Synthroid) Answer: B Explanation: A) NPH insulin was not the first recombinant DNA technology drug. B) Correct. C) This was not the first recombinant DNA technology drug. D) This was not the first recombinant DNA technology drug. 20) Which statement about long-acting insulin drugs is FALSE? A) Their therapeutic effect lasts up to 24 hours. B) This type of insulin has a neutral pH and added zinc. C) This type of insulin is given by subcutaneous injection. D) They are used to treat type 1 and type 2 diabetes mellitus. Answer: B Explanation: A) This is a true statement. B) Correct. This describes Human insulin lispro and NPH insulin. C) This is a true statement. D) This is a true statement. 21) Which of the following statements is FALSE? A) Insulin doses are measured in units. B) Regular insulin is also known as short-acting insulin. C) NPH insulin contains protamine and zinc. D) Subcutaneous insulin injects are only needed to treat type 1 diabetes mellitus. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. This statement is false. Subcutaneous insulin injections are sometimes needed to control type 2 diabetes mellitus.

22) Insulin does all of the following, EXCEPT ________. A) stimulates the pancreas to secrete its hormones B) transports glucose in the blood C) binds with an insulin receptor on the cell membrane D) transports glucose into the cell Answer: A Explanation: A) Correct. The pancreas secretes insulin; the pancreas is not stimulated by insulin. B) Insulin does do this. C) Insulin does do this. D) Insulin does do this. 23) All of these are thyroid supplement drugs to treat hypothyroidism, EXCEPT ________. A) oxandrolone (Oxandrin) B) liothyronine (Cytomel, Triostat) C) levothyroxine (Levoxyl, Synthroid) D) liotrix (Thyrolar) Answer: A Explanation: A) Correct. This is an anabolic steroid drug; it is not used to treat hypothyroidism. B) This drug is used to treat hypothyroidism. C) This drug is used to treat hypothyroidism. D) This drug is used to treat hypothyroidism. 24) Patients with type 1 diabetes mellitus must inject insulin. Which of these sites is suitable for a subcutaneous injection? A) the upper arms B) thighs C) abdomen D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

25) The thyroid supplement drug for hypothyroidism that contains both T3 and T4 is called ________. A) liotrix (Thyrolar) B) methimazole (Tapazole) C) liothyronine (Cytomel, Triostat) D) All of the above. Answer: A Explanation: A) Correct. B) This drug is used to treat hyperthyroidism, not hypothyroidism. C) This drug is used to treat hypothyroidism, but it contains only T3. D) Only one answer is correct. 26) All of the following are categories of noninsulin oral antidiabetic drugs, EXCEPT ________. A) SGLT2 inhibitor drugs B) biguanide drugs C) corticosteroid drugs D) alpha-glucosidase inhibitor drugs Answer: C Explanation: A) These are a category of noninsulin oral antidiabetic drugs. B) These are a category of noninsulin oral antidiabetic drugs. C) Correct. D) These are a category of noninsulin oral antidiabetic drugs. 27) GLP-1 receptor agonist antidiabetic drugs include all of the following, EXCEPT ________. A) dulaglutide (Trulicity) B) pioglitazone (Actos) C) liraglutide (Saxenda, Victoza) D) semaglutide (Ozempic, Rybelsus) Answer: B Explanation: A) This is a GLP-1 receptor agonist antidiabetic drug. B) Correct. This is a thiazolidinedione antidiabetic drug. C) This is a GLP-1 receptor agonist antidiabetic drug. D) This is a GLP-1 receptor agonist antidiabetic drug.

28) Insulin can be administered ________. A) by an insulin syringe or insulin pen B) intravenously C) by an insulin pump with an adhesive pad with a needle in it D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 29) An insulin pump sounds an audible alarm if the ________. A) patient's blood sugar is too low B) insulin reservoir is empty C) tubing is blocked D) B and C Answer: D Explanation: A) An insulin pump delivers insulin, but does not monitor the patient's blood sugar. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 30) All of the following are corticosteroid drugs, EXCEPT ________. A) dexamethasone (Decadron) B) prednisolone (Orapred, Pediapred C) betamethasone (Celestone) D) rosiglitazone (Avandia) Answer: D Explanation: A) This is a corticosteroid drug. B) This is a corticosteroid drug. C) This is a corticosteroid drug. D) Correct. This is a thiazolidinedione antidiabetic drug. 31) Which of the following statements is FALSE? A) Thyroid desiccated is from ground-up and dried pig thyroid glands. B) Hyperthyroidism is treated with liothyronine (Cytomel, Triostat). C) Some drugs contain both T3 and T4 hormones. D) The drug name levothyroxine shows that its molecules are rotated to the left (lev/o-). Answer: B Explanation: A) This is a true statement. B) Correct. This drug is used to treat hypothyroidism, not hyperthyroidism. C) This is a true statement. D) This is a true statement. 10 Copyright © 2022 Pearson Education, Inc.

32) In the trade name of an insulin drug Humulin R, the letter R stands for ________. A) recombinant DNA technology B) rapid-onset diabetes mellitus C) regular D) None of the above. Answer: C Explanation: A) The letter R does not stand for recombinant DNA technology. B) There is no such disease. C) Correct. D) One of the answers is correct. 33) Which of the following is TRUE about biguanide antidiabetic drug metformin? A) It is given orally. B) It is the only drug in the category of biguanides. C) It is often used in combination drugs. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 34) Drugs used to treat delayed puberty in females include all of the following, EXCEPT ________. A) conjugated estrogens (Premarin) B) methimazole (Tapazole) C) esterified estrogens (Menest) D) estradiol (Alora, Climara, Delestrogen, Estrace) Answer: B Explanation: A) These drugs are used to treat delayed female puberty. B) Correct. This drug is used to treat hyperthyroidism, not delayed female puberty. C) These drugs are used to treat delayed female puberty. D) These drugs are used to treat delayed female puberty.

35) Which of the following statements about Addison's disease is FALSE? A) Its symptoms include fatigue, weight loss, and decreased ability to tolerate stress, disease, or surgery. B) It is an autoimmune disease. C) The adrenal cortex secretes too much cortisol hormone. D) It causes an unusual, bronzed and tanned color to the skin. Answer: C Explanation: A) This is a true statement. B) This is a true statement. C) Correct. The adrenal gland is destroyed by antibodies and does not secrete enough cortisol. D) This is a true statement. 36) Roberta Clark must take high doses of a prescribed corticosteroid drug. Over time, she might develop ________. A) a moon face B) reddened cheeks C) buffalo hump D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 37) Anabolic steroid drugs can be used legally in all of the following ways, EXCEPT ________. A) to promote muscle mass and strength after trauma B) to treat bone pain in patients with osteoporosis C) to increase the muscle mass in amateur and professional athletes D) to promote weight gain after infection or surgery Answer: C Explanation: A) This is a legal use of anabolic steroid drugs. B) This is a legal use of anabolic steroid drugs. C) Correct. This is illegal. D) This is a legal use of anabolic steroid drugs.

38) The well-known generic thyroid hormone drug levothyroxine is related to the trade name drugs of Levoxyl and ________. A) Victoza B) Synthroid C) Onglyza D) Farxiga Answer: B Explanation: A) Victoza is used to treat diabetes mellitus, not thyroid disease. B) Correct. C) Onglyza is used to treat diabetes mellitus, not thyroid disease. D) Farxiga is used to treat diabetes mellitus, not thyroid disease. 39) Former President George H. W. Bush and First Lady Barbara Bush had the endocrine disorder of ________. A) diabetes mellitus B) Addison disease C) hyperthyroidism D) All of the above. Answer: C Explanation: A) They did not have diabetes mellitus. B) They did not have Addison disease. C) Correct. D) They only had one type of endocrine disorder. 40) The cortex of the adrenal gland secretes all of these hormones, EXCEPT ________. A) androgens B) cortisol C) aldosterone D) insulin Answer: D Explanation: A) It does secrete androgens. B) It does secrete cortisol. C) It does secrete aldosterone. D) Correct. The adrenal gland cortex does not secrete insulin.

41) The islets of Langerhans are located in the________. A) ovaries B) pancreas C) adrenal glands D) thyroid gland Answer: B Explanation: A) The islets of Langerhans are not located in the ovaries. B) Correct. C) The islets of Langerhans are not located in the adrenal glands. D) The islets of Langerhans are not located in the thyroid gland. 42) Somatostatin ________. A) inhibits the secretion of the hormone insulin B) is located in delta cells of the islets of Langerhans C) inhibits the secretion of glucagon D) All of the above. Answer: D Explanation: A) This is an action of somatostatin. B) This is an action of somatostatin. C) This is an action of somatostatin. D) Correct. 43) When the pancreas does not produce any insulin, this is known as ________ diabetes mellitus. A) gestational B) type 2 C) type 1.5 D) type 1 Answer: D Explanation: A) This is not gestational diabetes mellitus. B) This is not type 2 diabetes mellitus. C) This is not type 1.5 diabetes mellitus D) Correct.

44) All of the following are true concerning type 2 diabetes mellitus, EXCEPT ________. A) the patient is obese B) there is insulin resistance and too little insulin produced C) it occurs only in pregnant women D) the sensitivity of insulin receptors is decreased Answer: C Explanation: A) This is a true statement. B) This is a true statement. C) Correct. This is not true. D) This is a true statement. 45) Which of the following is true about diabetes mellitus type 1.5? A) It is also known as latent autoimmune diabetes mellitus. B) It has characteristics of type 1 and type 2 diabetes mellitus. C) It does not improve with lifestyle or diet changes. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 46) Diabetes mellitus type 2 is first treated with lifestyle and diet changes that include all of the following, EXCEPT ________. A) an insulin pump B) exercise C) calorie control of carbohydrates and fats D) weight control Answer: A Explanation: A) Correct. B) This is one of those changes. C) This is one of those changes. D) This is one of those changes.

47) All of the following are complications of untreated or uncontrolled diabetes mellitus, EXCEPT ________. A) hyperthyroidism B) arteriosclerosis C) retinopathy D) nephropathy Answer: A Explanation: A) Correct. B) This is a complication of untreated or uncontrolled diabetes mellitus. C) This is a complication of untreated or uncontrolled diabetes mellitus. D) This is a complication of untreated or uncontrolled diabetes mellitus. 48) Which of the following is NOT an SGLT2 inhibitor antidiabetic drug? A) nateglinide (Starlix) B) canagliflozin (Invokana) C) dapagliflozin (Farxiga) D) empagliflozin (Jardiance) Answer: A Explanation: A) Correct. This is a meglitinide antidiabetic drug. B) This is an SGLT2 inhibitor antidiabetic drug. C) This is an SGLT2 inhibitor antidiabetic drug. D) This is an SGLT2 inhibitor antidiabetic drug. 14.2

True/False Questions

1) Type 2 diabetes mellitus is first treated with insulin, but an oral antidiabetic drug may be added later, if needed. Answer: FALSE Explanation: Type 2 diabetes mellitus is first treated with lifestyle changes. 2) The meglitinide antidiabetic drugs increases the sensitivity of body cells to insulin produced and suppresses the release of stored glucose from the liver. Answer: FALSE Explanation: Meglitinide antidiabetic drugs increase the flow of calcium into beta cells and this stimulates them to secrete more insulin. 3) Drugs used to treat hypothyroidism act by supplementing existing levels of T3 and/or T4. Answer: TRUE 4) The preferred treatment for Cushing syndrome is surgery to remove the tumor; drugs are not prescribed. Answer: FALSE Explanation: It is treated with drugs that inhibit cortisol secretion.

5) Intermediate-acting insulin drugs have a faster onset but a longer effect than rapid-acting insulin drugs. Answer: FALSE Explanation: They have a slower onset. 6) Amylin mimetic antidiabetic drugs are given orally and are only used to treat type 1 diabetes mellitus. Answer: FALSE Explanation: These drugs are given by subcutaneously and are mostly used to treat type 2 diabetes mellitus. 7) The pancreas of a patient with type 2 diabetes mellitus is still producing insulin, but in a smaller amount than normal. Answer: TRUE 8) Sulfonylurea antidiabetic drugs stimulate the beta cells of the pancreas to secrete more insulin. Answer: TRUE 9) GLP-1 and GIP are hormones that are secreted into the blood by the small intestine after food is eaten. They stimulate the pancreas to make more insulin. Answer: TRUE 10) On an insulin drug label, U-100 means 100 units per milliliter (mL). Answer: TRUE 11) Beef and pork based insulin drugs are available in the United States. Answer: FALSE Explanation: These were discontinued because of the risk of transmitting "mad cow disease" to humans. 12) The trade name drugs Humalog Mix 75/25 and Novolin 70/30 are combination drugs that contain a mixture of two insulin drugs, with the numbers showing the percentage of each type of insulin. Answer: TRUE 13) Untreated or uncontrolled diabetes mellitus eventually leads to the diabetic complications of diabetic retinopathy, diabetic neuropathy, arteriosclerosis, ketoacidosis, and even death. Answer: TRUE 14) The thyroid gland secretes the hormones T3 and T4. Decreased levels of these hormones cause hyperthyroidism. Answer: FALSE Explanation: Decreased levels cause hypothyroidism. 15) Because the insulin molecule is broken down by digestive enzymes, insulin can never be given orally. Answer: TRUE 17 Copyright © 2022 Pearson Education, Inc.

16) All insulin drugs on the market today are created by recombinant DNA technology. Answer: TRUE 17) The suffix -gliptin is common to generic DPP-4 inhibitor antidiabetic drugs. Answer: TRUE 18) The glucose level in the blood decreases after a meal. Answer: FALSE Explanation: The glucose level in the blood increases after a meal. 19) Women who have had gestational diabetes are more prone to develop type 2 diabetes mellitus later. Answer: TRUE 20) When an insulin analog drug is created, one or more of the amino acids is replaced, and the name of the insulin analog drug often reflects that change. Answer: TRUE 21) Addison disease occurs when the adrenal gland cortex secretes too little corticosteroid drug. Answer: FALSE Explanation: The adrenal gland cortex secretes too little cortisol. A corticosteroid drug replaces that lack of cortisol. 22) A subcutaneous injection of insulin must be injected at a 90-degree angle into the fat layer beneath the skin. Answer: FALSE Explanation: It must be injected at a 45-degree angle. 23) An advantage of an insulin pump is that it can provide continuous small doses of insulin that mimic the secretions of the pancreas. Answer: TRUE 14.3

Short Answer Questions

1) An insulin syringe's calibration is unique, because it is measured in ________, a standardized measurement for insulin doses. Answer: units 2) The ________ category of oral antidiabetic drugs are structurally similar to, and derived their name from, sulfonamide anti-infective drugs, but they do not have any anti-infective action. Answer: sulfonylurea 3) The medulla of the adrenal gland secretes the hormones ________ and ________. Answer: epinephrine, norepinephrine

4) Intermediate-acting insulin drugs have a/an ________ appearance because of the present of protamine. Answer: cloudy 5) Addison disease occurs when the adrenal gland cortex secretes too little ________. Answer: cortisol 6) Insulin is secreted by ________ cells in the islets of Langerhans in the pancreas. Answer: beta 7) Type 2 diabetes was previously known as non-insulin-dependent diabetes mellitus or ________-onset diabetes mellitus. Answer: adult 8) The abbreviation rDNA means that an insulin drug was created by ________ DNA technology. Answer: recombinant 9) An insulin is most commonly injected via the ________ route. Answer: subcutaneous 10) The process of using a different site for each insulin injection is known as site ________. Answer: rotation 11) When the adrenal gland cortex secretes too much of the hormone cortisol, this causes ________ syndrome. Answer: Cushing 12) The well-known antidiabetic drug exenatide (trade name ________) is a synthetic version of a hormone found in the saliva of the poisonous Gila monster, a lizard that lives in the southwestern United States and in Mexico. Answer: Byetta 13) Endocrine glands are all alike in that they secrete ________ into the blood. Answer: hormones 14) Anabolic steroid drugs are classified as Schedule ________ drugs. Answer: III 15) After being injected, ________-acting insulin drugs begin to lower the blood glucose level within 5 to 15 minutes. Answer: rapid 16) The trade name Humalog indicates that this is an insulin ________ drug that has undergone an additional step in processing so that it is structurally similar, but not identical, to the human insulin molecule. Answer: analog 19 Copyright © 2022 Pearson Education, Inc.

17) The illegal use of two or more anabolic steroid drugs by athletes is known as ________. Answer: stacking 18) The well-known generic oral antidiabetic drug metformin is related to the trade name drugs Fortamet, Glumetza, Riomet, and ________. Answer: Glucophage 19) When a/an ________ gland malfunctions, it secretes either too little or too much of its hormone. Answer: endocrine 20) The endocrine system consists of many glands that secrete ________ into the blood. Answer: hormones 21) Drugs to treat hyperthyroidism block the use of ________ that is needed by the thyroid gland to produce its hormones. Answer: iodine 22) An insulin syringe always has a/an ________ cap. Answer: orange 23) The biguanide drug metformin was derived from the French ________ plant. Answer: lilac 24) Type 1 diabetes mellitus is an/an ________ disorder in which beta cells are destroyed and no insulin is produced. Answer: autoimmune 25) ________ is a state of equilibrium of the body's internal environment that the endocrine system helps to maintain. Answer: Homeostasis 26) ________ cells in the islets of Langerhans secrete the hormone insulin. Answer: Beta 27) Insulin causes excess glucose in the blood to be stored as ________ in the liver and muscles. Answer: glycogen 28) Glucose is metabolized in the cell to provide ________. Answer: energy 29) The alpha cells of the pancreas secrete the hormone glucagon, which breaks down stored glycogen into ________. Answer: glucose

30) ________ diabetes mellitus only occurs in a woman who is pregnant. Answer: Gestational 31) All human insulin drugs on the market today were created using ________ DNA technology. Answer: recombinant 32) Regular human insulin is short in its duration of action, and so ________ and ________ are added to slow its onset and extend its duration of action. Answer: protamine, zinc 33) A/An ________ is a chemical that differs slightly from the original in structure. Answer: analog 34) Corticosteroid drugs are prescribed in a ________ dose. Answer: tapering

14.4

Matching Questions

Match the drug category in Column 2 with its drug names in Column 1. A) amylin mimetic antidiabetic drug B) short-acting human insulin drug C) biguanide antidiabetic drug D) GLP-1 receptor agonist antidiabetic drug E) bile acid sequestrant antidiabetic drug F) meglitinide antidiabetic drug G) DPP-4 inhibitor antidiabetic drugs H) drug for hypothyroidism I) drug for hyperthyroidism J) intermediate-acting human insulin drug K) sulfonylurea antidiabetic drug 1) colesevelam (WelChol) 2) exenatide (Byduron, Byetta) 3) glipizide (Glucotrol) 4) human insulin isophane (Humulin N) 5) human insulin regular (Humulin R, Myxredin, Novolin R) 6) methimazole (Tapazole) 7) levothyroxine (Levoxyl, Synthroid) 8) metformin (Fortamet, Glucophage, Glumetza, Riomet) 9) sitagliptin (Januvia) 10) pramlintide (SymlinPen) 11) repaglinide (Prandin) Answers: 1) E 2) D 3) K 4) J 5) B 6) I 7) H 8) C 9) G 10) A 11) F 14.5

Essay Questions

1) New insulin drugs have been created using recombinant DNA technology. Briefly explain the process involved for creating insulin drugs using recombinant DNA technology. Answer: This process inserts the gene from human insulin into bacteria, which then multiply rapidly and produce large amounts of the insulin drug. 22 Copyright © 2022 Pearson Education, Inc.

2) Describe three advantages and one disadvantage of an insulin analog drug over the original human insulin molecule. Answer: The advantages of insulin analog drugs include flexibility so that the patient can more easily comply with treatment—fewer injections are needed, there is less chance of a sudden drop in blood sugar (hypoglycemia), and there is increased patient satisfaction. Disadvantages include that insulin analog drugs cost more than human insulin drugs. 3) Briefly discuss why beef and pork insulins are no longer on the market in the United States. Answer: Human insulin drugs were originally from beef or pork pancreases. It was found that they could transmit bovine spongiform encephalopathy (a fatal disease in cows, also called "mad cow disease," that has been linked to outbreaks of a fatal neurologic disorder in humans known as new variant Creutzfeldt-Jakob disease.) 4) Describe how the insulin analog drugs insulin aspart and insulin glargine have been structurally changed from the original molecule of human insulin. Answer: A molecule of human insulin consists chain of amino acids. When insulin analog drugs are created, one or more of the amino acids is changed. For insulin aspart, the amino acid proline is replaced by aspartic acid. For insulin glargine, the amino acid asparagine is replaced by glycine and two molecules of the amino acid arginine. 5) At one time, there was a clear division between insulin drugs that were injected subcutaneously and oral antidiabetic drugs that were taken orally. Why did this terminology have to be changed. Answer: This terminology had to be changed to avoid confusion when amylin mimetic drugs were introduced because they were also given subcutaneously like insulin. Oral antidiabetic drugs were split into two drug categories and renamed non-insulin oral antidiabetic drugs and noninsulin subcutaneous antidiabetic drugs. 6) Explain why colesevelam (WelChol), which is used to treat an elevated level of cholesterol in the blood, is also used to treat type 2 diabetes mellitus. Answer: Bile acid sequestrant drugs like colesevelam (Welchol) are used to treat an elevated level of cholesterol in the blood. However, they also increase the hormone GLP-1 that stimulates the pancreas to secrete insulin. This improves blood glucose control in patients with type 2 diabetes mellitus.

Understanding Pharmacology for Health Professionals, 6e (Turley) Chapter 15 Integumentary and Ophthalmic Drugs 15.1

Multiple Choice Questions – Integumentary Drugs

1) Which of the following trade names is related to the generic drug coal tar? A) Micatin B) Neutrogena T/Gel C) Skyrizi D) Vibramycin Answer: B Explanation: A) This is an antifungal drug, not a coal tar drug. B) Correct. C) This drug is used to treat psoriasis, but it is an immunosuppressant, not a coal tar drug. D) This drug is an antibiotic used to treat acne vulgaris; it is not a coal tar drug. 2) Of the following drugs, which is an oral vitamin A-type drug that is the only one that is used to treat severe cystic acne vulgaris, not common acne vulgaris? A) adapalene (Differin) B) isotretinoin (Claravis) C) desoximetasone (Topicort) D) tretinoin (Retin-A) Answer: B Explanation: A) This is a topical drug for common acne vulgaris. B) Correct. This is an oral vitamin A-type drug for severe cystic acne. C) This is a topical corticosteroid drug, not an oral drug for severe cystic acne. D) This is a topical drug for common acne vulgaris. 3) Which of the following is NOT one of the therapeutic effects of coal tar drugs for psoriasis? A) cleanse away dead tissue B) correct abnormal keratinocytes C) decrease itching D) increase the rate of epithelial cell production Answer: D Explanation: A) Coal tar drugs do cleanse away dead skin (keratolytic effect). B) Coal tar drugs do correct abnormal keratinocytes. C) Coal tar drugs do decrease itching for psoriasis. D) Correct. These drugs decrease, not increase, the rate of epithelial cell production.

4) Which of the following is NOT a common suffix for generic corticosteroid drugs? A) -lone B) -onide C) -mab D) -asone Answer: C Explanation: A) This is a common suffix for generic corticosteroid drugs. B) This is a common suffix for generic corticosteroid drugs. C) Correct. This is a common suffix for monoclonal antibody drugs, not corticosteroids. D) This a common suffix for generic corticosteroid drugs. 5) Which of the following is NOT a category of drugs used to treat wrinkles? A) filler drugs B) muscle relaxant drugs C) neuromuscular blocker drugs D) vitamin-A type drugs Answer: B Explanation: A) Filler drugs are used to treat wrinkles. B) Correct. Muscle relaxant drugs are not used to treat wrinkles. C) Neuromuscular blocker drugs are used to treat wrinkles. D) Vitamin-A type drugs are used to treat wrinkles. 6) Which drug category is NOT used topically to treat psoriasis? A) antihistamine drugs B) psoralen drugs C) coal tar drugs D) vitamin D analog drugs Answer: A Explanation: A) Correct. Antihistamine drugs are not used to treat psoriasis. B) Psoralen drugs are used to treat psoriasis C) Coal tar drugs are used to treat psoriasis D) Vitamin D analog drugs are used to treat psoriasis.

7) Which of the following is a topical antibiotic drug used to treat superficial bacterial skin infections? A) desoximetasone (Topicort) B) methoxsalen (Oxsoralen Ultra) C) bacitracin D) ketoconazole (Nizoral A-D, Xologel) Answer: C Explanation: A) This is a topical corticosteroid drug, not an antibiotic drug. B) This is an oral psoralen drug, not an antibiotic drug. C) Correct. This is a topical antibiotic drug. D) This is a topical antifungal drug. 8) Which of the following is a topical combination drug that contains several generic antibiotic drugs? A) Polysporin B) Lotrimin Ultra C) gentamicin D) Valtrex Answer: A Explanation: A) Correct. Polysporin contains several topical antibiotic drugs. B) Lotrimin Ultra is not a combination drug and is an antifungal drug. C) Gentamicin is an antibiotic, but it is not a combination antibiotic drug. D) Valtrex is an antiviral drug, not a combination antibiotic drug. 9) Which of the following is the antiviral drug that is used both topically and orally to treat herpes simplex virus type 1 and herpes simplex virus type 2 infections? A) acyclovir (Zovirax) B) permethrin (Elimite, Nix) C) lidocaine (Lidoderm Patch) D) clotrimazole (Desenex) Answer: A Explanation: A) Correct. This drug is used to treat both types of herpes simplex virus infections. B) This drug is used to treat the parasitic infection of scabies, not a viral infection. C) This drug is to treat the pain of shingles, not the underlying viral infection. D) This is an antifungal drug, It is not used to treat a viral infection.

10) Topical coal tar drugs have been used since the 1800s to treat ________. A) acne vulgaris B) psoriasis C) fungal infections D) scabies Answer: B Explanation: A) Coal tar drugs are not used to treat acne vulgaris. B) Correct. Topical coal tar drugs are used to treat psoriasis. C) Coal tar drugs are not used to treat fungal infections. D) Coal tar drugs are not used to treat scabies. 11) Topical corticosteroid drugs are used to treat inflammation and itching from all of the following, EXCEPT ________. A) eczema B) poison ivy C) psoriasis D) alopecia Answer: D Explanation: A) Topical corticosteroid drugs are used to treat eczema. B) Topical corticosteroid drugs are used to treat poison ivy. C) Topical corticosteroid drugs are used to treat psoriasis. D) Correct. Topical corticosteroid drugs are not used to treat alopecia. 12) All of the following pairs of trade names are topical corticosteroid drugs, EXCEPT ________. A) Cloderm and Psorcon B) Topicort and Halog C) Luxiq and Kenalog D) Lotrimin Ultra and Loprox Answer: D Explanation: A) Cloderm and Psorcon are topical corticosteroid drugs. B) Topicort and Halog are topical corticosteroid drugs. C) Luxiq and Kenalog are topical corticosteroid drugs. D) Correct. These are topical antifungal, not corticosteroid, drugs.

13) The topical drug used to treat male pattern baldness is ________. A) minoxidil (Rogaine) B) capsaicin (Zostrix-HP) C) diphenhydramine (Benadryl, Ziradryl) D) metronidazole (MetroCream, MetroGel) Answer: A Explanation: A) Correct. This topical drug is used to treat alopecia. B) This drug is used to treat the pain of shingles, not male pattern baldness. C) This is a topical antihistamine for inflammation, not alopecia. D) This is an antibiotic drug; it is not used to treat male pattern baldness. 14) Which of the following generic dermatologic drugs is correctly matched to its trade name? A) coal tar: Retin-A B) miconazole: Lidoderm Patch C) fluticasone: Cutivate D) botulinum toxin type A: Topicort Answer: C Explanation: A) This is not a correct match. Retin-A is a vitamin A retinoid drug. B) This is not a correct match. Lidoderm Patch treats the pain of shingles. C) Correct. Fluticasone (Cutivate). D) This is not a correct match. Topicort is a topical corticosteroid drug. 15) Scabies is caused by mites that bury under the skin; this skin problem is treated with ________. A) bacitracin B) permethrin (Elimite) C) intradermal corticosteroid drug injection D) coal tar drugs Answer: B Explanation: A) This topical antibiotic drug is not used to treat scabies. B) Correct. C) Scabies is not treated with topical drugs, not intradermal injections. D) Coal tar drugs are not used to treat scabies.

16) Acne rosacea is treated topically with all of the following drug categories, EXCEPT ________. A) alpha2 receptor agonist drugs B) apremilast (Otezla) C) minocycline (Monocin, Solodyn) D) metronidazole (MetroCream, Metrogel) Answer: B Explanation: A) These drugs are used to treat acne rosacea. B) Correct. These immunosuppressant drugs are used to treat psoriasis, not acne rosacea. C) These antibiotic drugs are used to treat acne rosacea. D) These antibiotic/antipruritic drugs are used to treat acne rosacea. 17) All of the following drug categories are used topically to treat acne vulgaris, EXCEPT ________. A) keratolytic drugs B) antibiotic drugs C) antiviral drugs D) androgen receptor inhibitor drugs Answer: C Explanation: A) These drugs are used topically to treat acne vulgaris. B) These drugs are used topically to treat acne vulgaris. C) Correct. Antiviral drugs are not used to treat acne vulgaris. D) These drugs are used topically to treat acne vulgaris. 18) Which of the following is NOT a topical antifungal drug? A) ketoconazole (Nizoral A-D, Xologel) B) tolnaftate (Tinactin) C) sulconazole (Exelderm) D) valacyclovir (Valtrex) Answer: D Explanation: A) This is a topical antifungal drug. B) This is a topical antifungal drug. C) This is a topical antifungal drug. D) Correct. This is not a topical antifungal, it is an antiviral drug.

19) An antipruritic drug is used to treat ________. A) fungal infections B) burns C) itching D) bacterial infections Answer: C Explanation: A) An antipruritic drug is not used to treat fungal infections. B) An antipruritic drug is not used to treat burns. C) Correct. An antipruritic drug is used to treat itching. D) An antipruritic drug is not used to treat bacterial infections. 20) Which of the following drugs is used topically to treat cold sores from a herpes simplex virus type 1 infection on the mouth? A) erythromycin B) desoximetasone (Topicort) C) docosanol (Abreva) D) hydrocortisone (Locoid) Answer: C Explanation: A) This antibiotic drug is not used to treat viral infections. B) This corticosteroid drug is not used to treat viral infections. C) Correct. This antiviral drug is used to treat cold sores. D) This corticosteroid drug is not used to treat viral infections. 21) ________ injections in the skin of the face help to minimize wrinkles. A) Coal tar drugs B) Vitamin A retinoid drugs C) Vitamin D analog drugs D) Neuromuscular blocking drugs Answer: D Explanation: A) Coal tar drugs are used to treat psoriasis, not wrinkles. B) Vitamin A retinoid drugs are for acne vulgaris, not skin wrinkles. C) Vitamin D analog drugs are for psoriasis, not skin wrinkles. D) Correct. Neuromuscular blocking drugs are injected to treat skin wrinkles.

22) Which of the following statements is TRUE? A) Corticosteroid drugs mimic the action of cortisol hormone secreted by the adrenal gland cortex. B) Hydrocortisone, introduced in 1952, was the first topical corticosteroid drug. C) Hydrocortisone was the first prescription topical corticosteroid approved in a nonprescription strength for over-the-counter sales. D) All of the above. Answer: D Explanation: A) This is true, but it is not the only correct statement. B) This is true, but it is not the only correct statement. C) This is true, but it is not the only correct statement. D) Correct. All statements are correct. 23) To close the enlarged skin pores of acne vulgaris, a drug with an ________ effect is used. A) antibiotic B) antipruritic C) astringent D) antifungal Answer: C Explanation: A) An antibiotic drug does not close enlarged skin pores. B) An antipruritic drug is for itching. C) Correct. An astringent drug shrinks enlarged skin pores. D) An antifungal drug does not shrink enlarged skin pores. 24) Which of the following statements is FALSE? A) A keratolytic action removes dead skin and oil. B) Some oral contraceptive drugs have been found to be effective in treating acne vulgaris. C) Coal tar drugs have been used to treat common warts since the 1800s. D) Diphenhydramine (Benadryl, Ziradryl) is a topical antihistamine drug. Answer: C Explanation: A) This is a true statement. B) This is a true statement. C) Correct. Coal tar drugs are only used to treat psoriasis, not warts. D) This is a true statement.

25) Which of the following is NOT a type of fungal infection of the skin? A) jock itch B) ringworm C) scabies D) athlete's foot Answer: C Explanation: A) Jock itch is a fungal infection of the skin. B) Ringworm is a fungal infection of the skin. C) Correct. Scabies is not a fungal infection; it is a parasite infection. D) Athlete's foot is a fungal infection of the skin. 26) Which of the following statements is FALSE about acne vulgaris? A) Comedos is another name for the whiteheads of acne. B) It is the form of acne that is commonly seen during adolescence. C) It is characterized by excessive amounts of oil from sebaceous glands. D) White blood cells come to the infected area and form pustules. Answer: A Explanation: A) Correct. Comedos are blackheads, not whiteheads. B) This is a true statement. C) This is a true statement. D) This is a true statement. 27) Isotretinoin, the oral vitamin A drug for severe cystic acne, has been linked to the unusual and severe adverse effect of ________. A) birth defects if taken by a pregnant woman B) itching C) suicide D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) Itching is not a severe adverse effect. C) This is true, but it is not the only correct answer. D) Correct. Both birth defects and suicide are severe adverse effects of this drug.

28) Which of the following statements about psoriasis is FALSE? A) It exhibits an abnormally deceased rate of epithelial cell division. B) It can be treated with coal tar, which is an over-the-counter drug. C) It is a chronic, autoimmune skin disorder. D) It is characterized by scaly, raised, silvery-red patches on the skin. Answer: A Explanation: A) Correct. The epithelial cell division rate is abnormally increased, not decreased. B) This is a true statement. C) This is a true statement. D) This is a true statement. 29) Which of the following drugs is NOT a monoclonal antibody drug used to treat severe psoriasis? A) sulconazole (Exelderm) B) adalimumab (Humira) C) ustekinumab (Stelara) D) infliximab (Remicade) Answer: A Explanation: A) Correct. This is this an antifungal drug; it is not used for psoriasis. B) This is a monoclonal antibody drug used to treat severe psoriasis. C) This is a monoclonal antibody drug used to treat severe psoriasis. D) This is a monoclonal antibody drug used to treat severe psoriasis. 30) PUVA uses ________ to treat psoriasis. A) ultraviolet wavelength A light B) the psoralen drug methoxsalen (Oxsoralen) C) photochemotherapy D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. PUVA includes all of these.

31) Which of the following is treated with topical antibiotic drugs? A) infected superficial abrasions and cuts B) infection associated with acne vulgaris C) ringworm D) A and B Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) Ringworm is treated with an antifungal, not antibiotic drug. D) Correct. 32) Which of the following is a filler drug that is used to plump the skin and minimize wrinkles ________? A) hyaluronic acid (Juvederm, Restylane) B) onabotulinumtoxin A (Botox, Botox Cosmetic) C) tretinoin (Renova) D) salicylic acid (Compound W) Answer: A Explanation: A) Correct. This is a filler drug. B) This is a neuromuscular blocker drug to relax wrinkles. C) This is a vitamin A retinoid drug, not a filler drug. D) This is a keratolytic drug to treat human papillomavirus. 33) Which of the following statements is FALSE? A) Hyaluronic acid is derived from the habanero hot pepper plant. B) Onabotulinumtoxin A is injected into forehead muscles to treat migraine headaches. C) Lice feed on blood and their bites cause itching. D) Mites and lice are parasites that cause infection in the skin. Answer: A Explanation: A) Correct. Capsaicin, not hyaluronic acid, is from the habanero hot pepper plant. B) This is a true statement. C) This is a true statement. D) This is a true statement.

34) Which of the following statements is FALSE? A) Scabies in humans is caused by the same parasite that causes mange in dogs. B) Lay persons often refer to pediculosis as crabs. C) Lice eggs are known as nits. D) Scabies and pediculosis are both treated with permethrin, a topical anesthetic drug. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. They are treated with a topical antiparasitic drug, not an anesthetic drug. 35) The topical keratolytic drug salicylic acid is used to treat ________. A) acne vulgaris B) corns and calluses C) human papillomavirus warts D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 36) Which of the following trade name drugs is related to the generic drug miconazole? A) Naftin B) Desenex C) Micatin D) Valtrex Answer: C Explanation: A) Naftin is the trade name for naftifine, not miconazole. B) Desenex is the trade name for clotrimazole, not miconazole. C) Correct. D) Valtrex is the trade name for valacyclovir, an antiviral drug. 37) Lice can be transmitted in which of the following ways? A) Hairbrushes, hats, and combs B) Coughing and sneezing C) Sexual intercourse D) Both A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) Lice are not transmitted by coughing and sneezing. C) This is true, but it is not the only correct answer. D) Correct. 12 Copyright © 2022 Pearson Education, Inc.

38) Which oral drug is used to treat severe toenail fungal infections? A) ketoconazole (Extina, Nizoral A-D, Xolegel) B) desonide (DesOwen, Tridesilon) C) griseofulvin D) All of the above Answer: C Explanation: A) Ketoconazole is a topical antifungal drug, not used orally for toenail fungus. B) Desonide is a topical corticosteroid drug, not used for toenail fungus. C) Correct. D) Only one answer is correct. 15.1

Multiple Choice Questions – Ophthalmic Drugs

1) Topical antibiotic drugs for bacterial eye infections ________. A) block nutrients so the bacteria cannot reproduce B) disrupt the cell walls of the bacteria C) insert a toxin into the bacteria D) interfere with DNA synthesis in the bacterium Answer: B Explanation: A) Topical antibiotic drugs do not block nutrients. B) Correct. C) Topical antibiotic drugs do not insert a toxin. D) Topical antibiotic drugs do not interfere with DNA synthesis. 2) Topical antiviral drugs for viral eye infections, such as acyclovir (Avaclyr), act by ________. A) disrupting the cell wall of a virus B) inhibiting the growth of viral cells C) inhibit the virus from binding to a cell's DNA and reproducing D) injecting a toxin into the virus Answer: C Explanation: A) Topical antiviral drugs do not disrupt the cell wall of a virus. B) Topical antiviral drugs do not inhibit the growth of viral cells. C) Correct. D) Topical antiviral drugs do not inject a toxin into the virus.

3) Which of the following categories of drugs is NOT used to treat allergy symptoms in the eyes? A) ophthalmic topical antihistamine drugs B) ophthalmic topical decongestant drugs C) ophthalmic topical mast cell stabilizer drugs D) ophthalmic topical miotic drugs Answer: D Explanation: A) Topical antihistamine drugs are used to treat allergy symptoms in the eyes. B) Topical decongestant drugs are used to treat allergy symptoms in the eyes. C) Topical mast cell stabilizer drugs are used in treating allergy symptoms in the eyes. D) Correct. Miotic drugs are used to treat glaucoma. 4) Which drugs used to treat glaucoma by blocking an enzyme that is active in the production of aqueous humor? A) mast cell stabilizer drugs B) beta-blocker drugs C) carbonic anhydrase inhibitor drugs D) antibiotic ophthalmic drugs Answer: C Explanation: A) These drugs are used to treat eye allergies, not glaucoma. B) Beta-blocker drugs for glaucoma do not block an enzyme. C) Correct. These drugs block the enzyme carbonic anhydrase. D) These drugs treat a bacterial infection, not glaucoma. 5) In order to examine the interior of the eye, the patient would be given eye drops containing what type of drug? A) mydriatic drug B) antibiotic drug C) antihistamine drug D) corticosteroid drug Answer: A Explanation: A) Correct. A mydriatic drug dilates the pupil. B) An antibiotic drug is not used to examine the interior of the eye. C) An antihistamine drug is not used to examine the interior of the eye. D) A corticosteroid drug is not used to examine the interior of the eye.

6) Mydriatic drugs ________. A) constrict the pupil B) dilate the pupil C) decrease the flow of aqueous humor D) All of the above Answer: B Explanation: A) Miotic drugs, not mydriatic drugs, constrict the pupil. B) Correct. Mydriatic drugs dilate the pupil. C) Mydriatic drugs do not decrease the flow of aqueous humor. D) Only one of these answers is correct. 7) All of the following drugs are used to treat glaucoma, EXCEPT ________. A) brinzolamide (Azopt) B) latanoprost (Xalatan) C) timolol (Timoptic) D) gentamicin (Gentak) Answer: D Explanation: A) Brinzolamide (Azopt) is used to treat glaucoma. B) Latanoprost (Xalatan) is used to treat glaucoma. C) Timolol (Timoptic) is used to treat glaucoma. D) Correct. Gentamicin (Gentak) is used to treat infection, not glaucoma. 8) All of the following are beta-blocker drugs used to treat glaucoma, EXCEPT ________. A) carteolol B) betaxolol (Betoptic S) C) prednisolone (Omnipred, Pred Forte) D) timolol (Betamol, Timoptic) Answer: C Explanation: A) This IS a beta-blocker drug used to treat glaucoma. B) This IS a beta-blocker drug used to treat glaucoma. C) Correct. This is a corticosteroid drug, not a beta-blocker drug. D) This IS a beta-blocker drug used to treat glaucoma.

9) Which of the following statements is FALSE? A) A mydriatic drug constricts the pupil. B) Mast cell stabilizer drugs prevent mast cells from releasing histamine. C) Hydroxypropyl cellulose is placed in the pocket between the surface of the eye and the lower eyelid. D) The antiviral drug ganciclovir (Zirgan) treated herpes simplex infection in the eyes. Answer: A Explanation: A) Correct. A mydriatic drug dilates, not constricts, the pupil. B) This is a true statement. C) This is a true statement. D) This is a true statement. 10) Which of the following statements is TRUE? A) Dry eye syndrome is called xerophthalmia. B) Paremyd is a combination of two different mydriatic drugs. C) Bimatoprost has a side effect of causing hair and eyelashes to grow. D) The main symptom of glaucoma is decreased intraocular pressure. Answer: D Explanation: A) This is a true statement. B) This is a true statement. C) This is a true statement. D) Correct. Glaucoma has increased, not decreased, intraocular pressure. 11) Miotic drugs for glaucoma have the same effect as the neurotransmitter ________. A) aqueous humor B) acetylcholine C) epinephrine D) vitreous humor Answer: B Explanation: A) Aqueous humor is a fluid, not a neurotransmitter. B) Correct. C) Miotic drugs for glaucoma do not have the same effect as epinephrine. D) Vitreous humor is a fluid, not a neurotransmitter.

12) When a foreign substance, such as pollen or animal dander enters the eye, antibodies from the immune system are active and mast cells release ________. A) acetylcholine B) epinephrine C) histamine D) All of the above Answer: C Explanation: A) Acetylcholine is not the basis of an allergic reaction. B) Epinephrine is not the basis of an allergic reaction. C) Correct. Histamine is released from mast cells. D) Only one answer is correct. 13) Which of the following drugs is NOT used to treat glaucoma? A) pilocarpine (Isopto Carpine) B) travoprost (Travatan Z) C) cyclopentolate (Cyclogyl) D) betaxolol (Betoptic S) Answer: C Explanation: A) This drug is used to treat glaucoma. B) This drug is used to treat glaucoma. C) Correct. This is a mydriatic drug; it is not used to treat glaucoma. D) This drug is used to treat glaucoma. 14) Topical ophthalmic NSAIDs are commonly used after cataract or corneal surgery to ________. A) dilate the pupil B) prevent eye infection C) increase the outflow of aqueous humor D) treat pain and inflammation Answer: D Explanation: A) Mydriatic drugs, not topical NSAIDs, are used to dilate the pupil. B) Topical NSAIDs do not prevent eye infection. C) Topical NSAIDs do not increase the outflow of aqueous humor. D) Correct. Topical NSAIDs treat both pain and inflammation in the eye.

15) Which of the following is NOT a topical antibiotic drug used to treat bacterial infections of the eye? A) ciprofloxacin (Ciloxan) B) levofloxacin C) brinzolamide (Azopt) D) ofloxacin (Ocuflox) Answer: C Explanation: A) This is a topical antibiotic drug. B) This is a topical antibiotic drug. C) Correct. This is used to treat glaucoma, not bacterial infections in the eye. D) This is a topical antibiotic drug. 16) Which of the following statements is TRUE? A) Topical ophthalmic drugs are only available as ophthalmic ointments. B) Topical drugs used in the eye are specially formulated to be physiologically similar to eye fluids and tears. C) Oral and ophthalmic generic and trade name antibiotic drugs have the same names for consistency. D) Tobramycin is placed in the eyes of newborn infants to prevent infection from gonorrhea and chlamydia, two sexually transmitted diseases. Answer: B Explanation: A) This is false. They are also formulated as liquid eye drops. B) Correct. This is a true statement. C) This is false. The generic names are the same but the trade names are different. D) This is false. Erythromycin, not tobramycin, is placed in newborns' eyes. 17) Which of the following is NOT a topical corticosteroid drug used to treat eye inflammation? A) dexamethasone (Maxidex. Ozurdex) B) ketorolac (Acular, Acuvail) C) fluorometholone (Flarex, FML Forte) D) prednisolone (Omnipred, Pred Forte) Answer: B Explanation: A) This is a topical corticosteroid drug. B) Correct. This is a nonsteroidal anti-inflammatory drug, not a corticosteroid drug. C) This is a topical corticosteroid drug. D) This is a topical corticosteroid drug.

18) Xerophthalmia can be caused by ________. A) the aging process B) inflammation that causes lack of tear production C) a side effect of certain drugs D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct. 19) The prostaglandin agonist drug bimatoprost, which used to treat glaucoma, has a side effect of causing ________. A) increased pigmentation of the iris B) eye allergies C) growth of hair and eyelashes D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This drug does not cause allergies. C) This is true, but it is not the only correct answer. D) Correct. 20) The drug verteporfin (Visudyne) is ________. A) used to block fragile blood vessels in the macula and retina so they do not leak B) is a phototherapy drug that is given intravenously C) is activated by a red laser light D) All of the above Answer: D Explanation: A) This is true, but it is not the only correct answer. B) This is true, but it is not the only correct answer. C) This is true, but it is not the only correct answer. D) Correct.

21) All of the following drug categories are used to treat glaucoma, EXCEPT ________. A) vascular endothelial growth factor inhibitor drugs B) Rho kinase inhibitor drugs C) prostaglandin analog drugs D) docosanoid drugs Answer: A Explanation: A) Correct. Vascular endothelial growth factor inhibitor drugs treat macular degeneration, not glaucoma. B) These drugs are used to treat glaucoma. C) These drugs are used to treat glaucoma. D) These drugs are used to treat glaucoma. 15.2

True/False Questions – Integumentary Drugs

1) Oral antibiotic drugs, such as doxycycline (Vibramycin) and tetracycline, provide topical treatment for cases of severe acne vulgaris. Answer: FALSE Explanation: This is a false statement. These drugs provide systemic treatment, not topical. 2) Acitretin (Soriatane) is an oral vitamin A-type drug used to treat psoriasis. Answer: TRUE 3) The topical retinoid drug tretinoin (Retin-A) is used to treat acne vulgaris and, under the trade name Renova, is used to treat skin wrinkles. Answer: TRUE 4) Topical vitamin D-type drugs for psoriasis stimulate vitamin D receptors in the keratinocytes and this increases the abnormal cell growth. Answer: FALSE Explanation: This is a false statement. These drugs decrease, not increase, abnormal cell growth. 5) Topical or oral drugs used to treat the herpes simplex virus type 1 interfere with cellular DNA synthesis and keep the herpes virus from reproducing. Answer: TRUE 6) Ointments are the most common type of drug used to treat acne vulgaris because they can unclog the pores. Answer: FALSE Explanation: This is a false statement. Ointments clog the skin pores. 7) Oral antibiotic drugs for acne vulgaris travel through the blood to kill bacteria in the deeper layers of the skin. Answer: TRUE

8) Vitamin A-type drugs as well as vitamin D-type drugs are used to treat psoriasis. Answer: TRUE 9) The prescription drug interferon alfa-2b (Intron A) is applied topically or injected into a lesion to treat genital warts. Answer: TRUE 10) All topical corticosteroid drugs used to treat inflammation and itching are over-the-counter drugs. Answer: FALSE Explanation: This is a false statement. All topical corticosteroid drugs are prescription drugs. Hydrocortisone is also an OTC drug. 11) Widespread dermatitis, inflammation, or allergic skin conditions are treated with topical antihistamine drugs. Answer: FALSE Explanation: This is a false statement. These are treated with oral corticosteroid drugs. 12) The drug Botox is the same toxin produced by Clostridium botulinum type A, the bacterium that causes food poisoning. Answer: TRUE 13) The drugs capsaicin (Zostrix-HP) and lidocaine (Lidoderm Patch) are used to treat the skin infection of shingles, caused by herpes varicella-zoster virus. Answer: FALSE Explanation: This is a false statement. They cannot treat the infection; they only treat the pain from the infection. 14) The alpha2 receptor agonist drug brimonidine (Mirvaso) is used topically to treat acne rosacea. Answer: TRUE 15) Chronic hair loss only occurs in men, beginning in middle age. Answer: FALSE Explanation: Both men and women can have thinning hair and alopecia. 16) The parasitic skin infections of scabies and lice can both be transmitted by sexual intercourse. Answer: TRUE 17) Herpes zoster virus infection causes chickenpox and then shingles in later life. Answer: TRUE

15.2

True/False Questions – Ophthalmic Drugs

1) Topical antibiotic drugs for eye infections are useful for treating both bacterial and viral infections of the eye. Answer: FALSE Explanation: This is a false statement. Antibiotic drugs are not effective against viruses. 2) The topical antiviral drug trifluridine is specifically effective against herpes simplex virus infections in the eye. Answer: TRUE 3) Nonsteroidal anti-inflammatory drugs, not corticosteroid drugs, are used to treat inflammation in the eyelid, cornea, conjunctiva, or tear duct. Answer: FALSE Explanation: This is a false statement. Corticosteroid drugs are used to treat this. 4) Beta-blocker drugs used to treat glaucoma have no effect on pupil size and therefore do not cause the blurred vision or night blindness associated with some other glaucoma drugs. Answer: TRUE 5) Alpha2 receptor agonist drugs for glaucoma stimulate receptors and increase the production of aqueous humor. Answer: FALSE Explanation: This is a false statement. These drugs decrease the production of aqueous humor. 6) For infections in the eyes, only topical ophthalmic antibiotic drugs are used because oral antibiotic drugs are not effective in treating eye infections. Answer: FALSE Explanation: This is a false statement. Both topical and oral drugs are used. 7) Miotic drugs for glaucoma have the same action as epinephrine, a neurotransmitter for the sympathetic division of the nervous system. Answer: FALSE Explanation: They mimic the action of acetylcholine, not epinephrine. 8) Drugs used to treat glaucoma decrease the elevated intraocular pressure which, if left untreated, can lead to blindness. Answer: TRUE 9) The drug Cosopt is a combination drug for glaucoma; it contains a carbonic anhydrase inhibitor drug (dorzolamide) and a beta-blocker drug (timolol). Answer: TRUE 10) Topical decongestant drugs constrict the blood vessels in the cornea to reduce redness. Answer: TRUE

11) Topical ophthalmic drugs can be interchangeable with topical drugs for the skin when they both contain the same generic drug ingredient. Answer: FALSE Explanation: This is a false statement. They are not interchangeable. 12) Without the use of topical drugs to dilate the pupil (mydriasis) and keep it dilated (cycloplegia), it would be impossible to perform an examination of the internal structures of a patient's eye. Answer: TRUE 13) The similar suffix on each of the drugs acyclovir and ganciclovir tells you these are corticosteroid drugs. Answer: FALSE Explanation: The suffix is common to antiviral, not corticosteroid drugs for the eye. 14) Lacrisert is a trade name for an insert that is placed inside the lower eyelid to treat dry eye syndrome. Answer: TRUE 15) The suffix -zolamide is common to generic carbonic anhydrase inhibitor drugs. Answer: TRUE 16) VEGF inhibitor drugs are injected into the vitreous humor to treat macular degeneration because they keep abnormal blood vessels from forming within the eye. Answer: TRUE 15.3

Short Answer Questions – Integumentary Drugs

1) The over-the-counter drug salicylic acid (Clearasil, Propa pH, Stri-Dex) is a/an ________ drug that removes oil and dead skin to cleanse the pores. Answer: keratolytic 2) Topical antibiotic drugs that inhibit the growth of bacteria on the skin have a/an ________ effect. Answer: bacteriostatic 3) Drugs used to treat acne vulgaris that are structurally similar to vitamin A are known as ________ drugs. Answer: retinoid 4) The suffix -conazole is common to generic ________ drugs. Answer: antifungal 5) Topical antihistamine drugs inhibit inflammation, redness, and itching due to the release of histamine during an allergic reaction. These drugs are also known as ________ drugs (based on the Latin word that means itching). Answer: antipruritic 23 Copyright © 2022 Pearson Education, Inc.

6) Severe psoriasis is treated with an oral psoralen drug in combination with ________ light. Answer: ultraviolet 7) The AF in some trade name drugs, such as Lotrimin AF, stands for ________. Answer: antifungal 8) The eggs of parasitic lice are known as ________. Answer: nits 9) Herpes simplex virus type 2 infection is also known as ________ herpes. Answer: genital 10) The Food and Drug Administration requires that oral isotretinoin drug literature include a/an ________ ________ warning about adverse drug effects. Answer: black box 15.3

Short Answer Questions – Ophthalmic Drugs

1) NSAIDs are used after cataract or corneal surgery to treat the pain and ________ associated with surgery. Answer: inflammation 2) Drugs that are often the first prescribed to treat glaucoma stimulate ________ receptors, which increases the outflow of aqueous humor and decreases the intraocular pressure. Answer: prostaglandin 3) The ________ plant was the original source of the mydriatic drug atropine. Answer: belladonna 4) The suffix ________ is common to generic beta-blocker drugs used to treat glaucoma. Answer: -lol 5) Most states either recommend or require a topical antibiotic drug be applied to the eyes of newborn infants to prevent the possibility of infection and possible blindness from the sexually transmitted disease of ________. Answer: gonorrhea 6) One category of drugs used to treat glaucoma blocks ________, an enzyme that normally destroys acetylcholine. Answer: cholinesterase 7) Dilating the pupils, a process known as ________, is done prior to an eye examination or surgery. Answer: mydriasis

8) Topical ________ drugs are used in the eye to treat inflammation because they suppress the immune system's local inflammatory response. Answer: corticosteroid 9) Mast cell stabilizer drugs block the release of ________ from mast cells and relieve allergy symptoms in the eyes. Answer: histamine 10) Brinzolamide (Azopt) is a carbonic anhydrase inhibitor drug that blocks the enzyme that produces ________ humor. Answer: aqueous 11) A mydriatic drug that produces ________ paralyzes the muscles of accommodation of the eye so that the pupil remains fixed and dilated. Answer: cycloplegia 12) The eye disease of xerophthalmia is also known as ________ eyes syndrome. Answer: dry 13) The drug hydroxypropyl cellulose (Lacrisert) is a dissolving ________ that is used to treat dry eye syndrome. Answer: insert 14) Mast cell stabilizer drugs for eye allergies prevent mast cells from releasing ________. Answer: histamine 15) The similar suffix on each of the generic ophthalmic drugs of ciprofloxacin, gatifloxacin, and ofloxacin tells that these are all ________ drugs. Answer: antibiotic

15.4

Matching Questions – Integumentary Drugs

Integumentary Drugs I. Match the drug in Column 1 with its drug category in Column 2. A) drug used to treat alopecia B) topical keratolytic drug for warts C) topical antifungal drug D) oral immunomodulator drug for psoriasis E) topical anesthetic drug F) drug for herpes simplex type 1 and 2 G) drug used to treat acne rosacea H) topical combination antibiotic drug I) topical corticosteroid drug J) topical drug for acne vulgaris and psoriasis 1) lidocaine (Lidocaine Patch) 2) etanercept (Enbrel) 3) Polysporin 4) fluocinolone (Caprex, Synalar) 5) ketoconazole (Extina, Nizoral A-D, Xologel) 6) brimonidine (Mirvaso) 7) finasteride (Propecia) 8) salicylic acid (Compound W, Dr. Scholl) 9) tazarotene (Tazorac) 10) valacyclovir (Valtrex)

Answers: 1) E 2) D 3) H 4) I 5) C 6) G 7) A 8) B 9) J 10) F

15.4

Matching Questions – Ophthalmic Drugs

Ophthalmic Drugs O. Match the drug name in Column 1 with the drug category in Column 2. A) topical mydriatic drug B) beta-blocker drug used to treat glaucoma C) carbonic anhydrase inhibitor drug for glaucoma D) topical mast cell stabilizer drug for eye allergies E) topical antibiotic drug for bacterial eye infections F) topical antihistamine drug for eye allergies G) prostaglandin F agonist drug for glaucoma H) topical corticosteroid drug for eye inflammation I) topical NSAID drug for eye inflammation J) vascular endothelial growth factor inhibitor drug for macular degeneration 1) azelastine (Optivar) 2) timolol (Betimol, Timoptic) 3) ciprofloxacin (Ciloxan) 4) dexamethasone (Maxidex, Ozurdex) 5) dorzolamide (Trusopt) 6) ketorolac (Acular, Acuvail) 7) latanoprost (Xalatan, Xelpros) 8) tropicamide (Mydriacyl) 9) ketotifen (Claritin Eye, Zaditor) 10) ranibizumab (Lucentis) Answers: 1) F 2) B 3) E 4) H 5) C 6) I 7) G 8) A 9) D 10) J 15.5

Essay Questions – Integumentary Drugs

1) Describe how the oral drug finasteride (Propecia) and the topical drug minoxidil (Rogaine) each works in different ways to treat thinning hair. Answer: The oral drug finasteride, a 5-alpha reductase inhibitor, blocks an enzyme that helps produce DHT, and this lowers the level of DHT to normal. The topical drug minoxidil is a peripheral dilator that dilates arteries in the scalp to increase the blood flow and stimulate hair growth. 27 Copyright © 2022 Pearson Education, Inc.

2) Why are several topical antibiotic drugs combined in a topical antibiotic ointment? Answer: Using several different topical antibiotic drugs together provides more complete coverage against various types of bacterial skin infections. 3) Describe how the topical antibiotic drug bacitracin was discovered and how it was named. Answer: Bacitracin was developed from a strain of Bacillus subtilis, a bacterium found growing in fluid draining from a wound in a patient named Margaret Tracy. The drug name bacitracin is a combination of the bacterium's name and the patient's name: Bacillus subtilis + Tracy + in. 4) Describe how onabotulinumtoxin A (Botox, Botox Cosmetic) is used to treat wrinkles and the origin of its name. Answer: It is a neuromuscular blocker drug given by intramuscular injection contains a neurotoxin that inhibits acetylcholine and paralyzes the muscle to relax wrinkle lines between the eyebrows or around the eyes, nose, and mouth. The trade name Botox is made up of the initial letters of botulinum toxin. 5) Describe why finasteride (Propecia) is not approved to treat hair loss in women and what precautions they must take. Answer: The oral drug finasteride (Propecia) is not approved for hair loss in women because of its connection with the male hormone testosterone. Women are also warned not to handle finasteride tablets when they are pregnant because of the risk of birth defects that could occur in a male fetus. 15.5

Essay Questions – Ophthalmic Drugs

1) Describe the difference between age-related (dry) macular degeneration and wet macular degeneration. Answer: In age-related or dry macular degeneration, the macula deteriorates with age. In wet macular degeneration, abnormal blood vessels grow under the macula because of an abnormal level of vascular endothelial growth factor. These abnormal blood vessels are fragile and they leak fluid, causing the macula to lift away from the retina with a resulting loss of vision. 2) Compare the different therapeutic effect of miotic drugs to that of mydriatic drugs. Answer: Miotic drugs cause the pupil to constrict and this increases the outflow of aqueous humor and decreases the intraocular pressure to treat glaucoma. Mydriatic drugs are used to dilate the pupil and paralyze the muscles of accommodation; they are used to treat inflammation of the iris and uveal tract of the eye and prior to performing an eye examination. 3) Describe how a healthcare professional administers a topical liquid eye drug to a patient. Answer: To administer a topical ophthalmic liquid drug to the patient's eye, pull down the lower eyelid so that the drop of drug does not touch the sensitive cornea as it goes into the sac between the eye and the lower eyelid. Then, as the patient blinks, the drug is distributed across the eye.