TEST BANK for Understanding Pharmacology for Health Professionals 5th Edition by Turley Susan. ISBN-

Understanding Pharmacology For Health Professionals 5th Edition Turley Test Bank Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 1 Introduction to Pharmacology and the History of Drugs 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) While pharmacology includes these items, the field of pharmacology covers much more.

D) Some drugs come from these sources, but it is not the focus of the study of pharmacology.

2) The word pharmacology comes from .

A) the Dutch word droog and a suffix meaning the study of B) the Greek word pharmakon and a suffix meaning the study of C) the Greek word prophylaxis and a suffix meaning to study D) the Latin word medicina and a suffix meaning the study of Answer: B Explanation: A) The Dutch word droog is where we get the word drug, not pharmacology.

C) The Greek word prophylaxis means to keep guard before. Prophylaxis is used as a preventive method.

D) The Latin word medicina is where we get the word medicine or medication, not pharmacology.

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) This IS one of the three medical uses for drugs.

B) This IS one of the three medical uses for drugs.

C) This IS one of the three medical uses for drugs.

4) The use of drugs during radiological 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.

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 derived from an animal.

B) Foxglove is not derived from a mineral.

D) Foxglove is not derived from 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: 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) 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 WAD a source of insulin for treating diabetes mellitus in the past.

8) It took a national tragedy to force a much-needed update of the Food and Drugs Act of 1906.

The drug that caused this national tragedy was .

A) Ayer's Cherry Pectoral, which was used to treat respiratory ailments B) Cocaine Toothache Drops, which was used to treat toothache pain C) sulfonamide, an anti-infective drug D) thalidomide, which was used to treat morning sickness Answer: C Explanation: A) This drug did not cause the national tragedy, but was an example of a drug that contained an addictive substance.

B) This drug did not cause the national tragedy, but was an example of a drug that contained an addictive substance.

D) This drug caused tragedy in the 1950s in Europe, but was not approved for use in the United States.

9) As a result of a national tragedy, Congress passed The Food, Drug, and Cosmetic Act of 1938.

One of the key parts 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) stated that the government no longer needed proof of fraud to stop the sale of a drug Answer: D Explanation: A) It was an amendment to The Food and Drugs Act of 1912 that stated that only drugs listed in these volumes could be prescribed.

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 not the safety of the drug.

C) This was an amendment to The Food and Drugs Act of 1912 that ensured this, not the Food, Drug, and Cosmetic Act of 1938.

10) In response to criticism that some drugs are available in other countries long before they are available in the U.S., which act was passed in 1997?

A) Compassionate Use IND B) Emergency Treatment Investigational New Drug (IND) C) Food and Drug Administration (FDA) Modernization Act D) Health Insurance Portability and Accountability Act (HIPAA) Answer: C Explanation: A) The Compassionate Use IND involved drugs for a life-threatening diseases; it did not involve a time lag.

B) The Emergency Treatment Investigational New Drug involved drugs for a life-threatening diseases; it did not involve a time lag.

D) HIPAA deals with privacy and insurance, not a time lag.

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.

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.

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: 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: 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.

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: 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) What common ingredient of topical skin drugs is derived from the purified fat of processed sheep's wool?

A) vitamin C B) calcium C) aspirin D) lanolin Answer: D Explanation: A) Vitamin C is derived from rose hips.

B) Calcium is a mineral.

C) Aspirin was derived from willow bark.

18) Which drugs were introduced in the decade of the 1990s?

A) penicillin (first antibiotic drug), Benadryl (first antihistamine drug), cortisone (first corticosteroid drug) B) Thorazine (first antipsychotic drug), hydrocortisone (first topical corticosteroid drug), polio vaccine C) Inderal (first beta-blocker drug), Tagamet (first H2 blocker drug), levodopa (for Parkinson's disease) D) Proscar (for benign prostatic hypertrophy), Nicoderm (for stopping smoking), Viagra (for erectile dysfunction) Answer: D Explanation: A) Penicillin was introduced in 1941; Benadryl was introduced in 1945, and cortisone was introduced in 1948.

B) Thorazine was introduced in 1952, hydrocortisone was introduced in 1952, and the polio vaccine was introduced in 1955.

C) Inderal was introduced in 1967, Tagamet was introduced in 1977, and levodopa was introduced in 1970.

19) Penicillin was first introduced about the year .

A) 1850 B) 1900 C) 1940 D) 2000 Answer: C Explanation: A) Penicillin was introducN edUR mSuIN chGT laBte.Cr OthMan 1850.

B) Penicillin was introduced much later than 1900.

D) Penicillin was introduced much earlier than 2000.

20) Aspirin was first introduced about the year A) 1750 B) 1900 C) 1960 D) 2000 Answer: B Explanation: A) Aspirin was introduced in 1899.

C) Aspirin was introduced much earlier than 1960.

D) Aspirin was introduced much earlier than 2000.

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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: 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) The first monoclonal antibody drug (Orthoclone OKT3) was developed in A) 1896 B) 1936 C) 1986 D) 2010 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.

D) The first monoclonal antibody drug was developed before this.

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23) Which drug was historically introduced first?

A) Tagamet for peptic ulcers (first H2 blocker drug) B) Morphine for pain, from the opium poppy C) Humulin (human insulin) (first recombinant DNA technology drug) D) AZT (first drug for HIV) Answer: B Explanation: A) Tagamet was introduced in 1977.

B) It was introduced in 1806.

C) Humulin (human insulin) was introduced in 1982.

D) AZT was introduced in 1987.

24) The government agency responsible for regulating the manufacturing and dispensing of NURS . INGTB.COM 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: 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) Currently, the burden of proof for showing that a drug is safe before it can be marketed is the responsibility of the .

A) drug company B) consumer C) physician D) Food and Drug Administration (FDA) Answer: A Explanation: B) The consumer cannot prove that a drug is safe before it is marketed.

C) The physician 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.

26) A schedule defines drugs by their .

A) classification or category B) potential for physical dependence C) potential for psychological dependence D) B and C Answer: D Explanation: A) A schedule is a classification or category, but not a definition.

B) This is true, but it is not the only correct answer.

C) This is true, but it is not the only correct answer.

27) An example of a Schedule I drug is .

A) aspirin B) Ambien C) LSD D) all of the above 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.

D) Aspirin and Ambien are not Schedule I drugs.

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.

D) There are not ten categories of controlled substances.

29) In response to the tragedy of babies born with seal limbs because of thalidomide, this legislation required drugs to be both safe and effective before being marketed.

A) Food and Drug Modernization Act of 1997 B) Kefauver-Harris Amendment of 1962 C) Food, Drug, and Cosmetic Act of 1938 D) The Food and Drugs Act of 1906 Answer: B Explanation: A) The FDA Modernization Act of 1997 came much later than the thalidomide tragedy.

C) The Food, Drug, and Cosmetic Act of 1938 came before the thalidomide tragedy.

D) The Food and Drugs Act of 1906 came before the thalidomide tragedy.

30) Complete this inscription that is commonly seen on the drug package: "Caution: Federal law prohibits ."

A) the use of Schedule I drugs B) the regulation of prescription drugs C) dispensing by a nurse D) dispensing without a prescription Answer: D Explanation: A) Schedule I drugs are not available under any circumstances and are not mentioned on drug package labels.

B) This is not on the drug package. The Food and Drug Administration (FDA) regulates prescription drugs.

C) Drug package labels do not refer to nurses.

31) The belladonna plant was the original source of the drugs that are still used today.

A) atropine and digoxin B) ephedrine 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) Ephedrine is from the Ephedra shrub, and morphine is from the opium poppy plant.

D) Colchicine is from the autumn crocus, and morphine is from the opium poppy plant.

32) Powdered rose hips from the rose plaNnUt RaSreINsGtiTllBu.CseOdMtoday 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.

C) Insulin is not derived from rose hips.

D) Powdered 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.

D) This is a plant, not a mineral.

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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 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: B) Dramamine is not used to treat nausea and vomiting once it has occurred.

C) Dramamine is not used to diagnose motion sickness.

D) Dramamine only falls under one of these uses of drugs, not all of them.

35) The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is concerned with the of patient medical and drug information.

A) accuracy B) identity C) security D) all of the above Answer: C Explanation: A) HIPAA does not address the accuracy of patient medical and drug information.

B) HIPAA does not address the identify of patient medical and drug information.

D) HIPAA only addresses the security of patient medical and drug information.

36) The majority of drugs are used to coN ntUroRlS, IiNmGpTrBo.vCeO, M or cure symptoms, signs, and diseases of a physiological or psychological nature. This is categorized 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 cure symptoms or diseases.

C) Prescription drugs are not the only kinds of drugs used to cure symptoms or diseases.

37) A prescription drug can be obtained with a .

A) written prescription from a physician 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.

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.

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, morphine, 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.

40) Drug legislation was passed in the early 1900s to protect the public from .

A) unscrupulous drug sellers B) prescription drugs C) worthless, mislabeled, and dangerous drugs D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) It was not until the Durham-Humphrey Amendment of 1951 that prescription drugs were defined.

C) This is true, but it is not the only correct answer.

41) 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 Drugs 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.

D) This was not the first federal law.

42) 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.

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.

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.

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-thecounter 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 is 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) This is a disadvantage 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) It did do this.

B) The word narcotic was introduced by The Harrison Narcotics Act of 1914.

C) It did do this.

D) It did do this.

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46) In 1853, Dr. Alexander Wood of Scotland created the first A) polio vaccine B) prescription drug C) hypodermic syringe D) antibiotic drug Answer: C Explanation: A) The first polio vaccine was introduced in 1955.

B) A prescription drug was not defined by law until 1951.

D) The first antibiotic drug was not introduced until 1941.

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47) Pharmacology includes all of the following interrelated topics, EXCEPT A) philosophy and religion B) molecular chemistry and genetics C) patient education D) legislation and technology Answer: A Explanation: A) Pharmacology does not cover these topics.

B) Pharmacology does cover these topics.

C) Pharmacology does cover this topic.

D) Pharmacology does cover these topics.

48) The combining of several ingredients to form a single drug is known as A) molecular pharmacology B) personalized medicine C) compounding D) human genome Answer: C 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 50) The mineral gold is used 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.

C) Gold is not used to treat a mineral deficiency.

D) Gold is not used to treat baldness.

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51) The thalidomide drug tragedy occurred in the late 1950s when the 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.

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52) Which organization requires that a hospital develop its own list of acceptable medical and drug abbreviations to avoid drug errors?

A) Drug Enforcement Agency B) Joint Commission C) Medicare D) Food and Drug Administration Answer: B Explanation: A) The DEA does not require this.

C) Medicare does not require this.

D) The FDA does not require this.

53) States that allow healthcare providers to prescribe controlled substances first require them to register at the federal level with .

A) the Drug Enforcement Agency B) Medicare C) Joint Commission D) the Food and Drug Administration Answer: A Explanation: B) Medicare does not deal with controlled substances.

C) The Joint Commission does not deal with controlled substances.

D) The FDA does not deal with controlled substances.

54) Designer drugs .

A) are created by slightly modifying the molecular structure of a Schedule I or II drug.

B) are also known as analog drugs C) are 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.

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.

C) This Act does not deal with over-the-counter drugs.

D) This Act does not deal with legal schedule drugs.

56) A list of all drugs being used, their ingredients, their uses, and how to prepare them 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.

D) An apothecary is a storehouse of drugs, not a list.

57) The apothecary system of measurement included all of the following, EXCEPT A) drams B) milliliters C) grains D) scruples Answer: B Explanation: A) Drams were part of the apothecary system.

B) Millimeters are not part of the apothecary system.

C) Grains were part of the apothecary system.

D) Scruples were part of the apothecary system.

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58) The first drug ever approved by the FDA to treat the nausea and vomiting of pregnancy was .

A) AZT B) thalidomide C) Diclegis D) Viagra Answer: C Explanation: A) AZT was the first drug used to treat HIV. B) Thalidomide was never approved by the FDA after it caused seal limb deformities in fetuses in Europe.

D) Viagra is used to treat erectile dysfunction in men.

59) The FDA Safety and Administration Act allowed the FDA to .

A) impose penalties for not having inspection of drugs imported from outside the U.S. B) include a provision for "breakthrough therapy" C) speed up review of a drug that was clearly better than others already on the market 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.

60) According to the federal Controlled Substances Act of 1870, marijuana is an illegal Schedule drug.

A) I B) II C) III D) IV Answer: A Explanation: B) Schedule II drugs are not illegal.

C) Schedule III drugs are not illegal.

D) Schedule IV drugs are not illegal.

61) An important patient safety issue was solved in 1984 with the introduction of A) drug legislation B) the human genome C) childproof caps for drugs D) orphan drugs Answer: C Explanation: A) There was no specific drug legislation for patient safety in 1984.

B) This does not have to do with patient safety.

D) Orphan drugs treat rare diseases.

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1.2 True/False Questions 1) The discipline of pharmacology impacts a student's chosen career as well as his/her personal life.

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 has been used for centuries as a recreational drug to cause euphoria and is also used to treat severe pain.

Answer: TRUE

5) Some estrogen replacement therapy drugs are derived from yams.

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 1806 by a German pharmacist marked the beginning of modern drug treatment using chemically pure ingredients.

Answer: FALSE Explanation: It was the isolation of morphine, not potassium.

8) In the early 1900s, pharmacists used cocoa butter as an ingredient in making 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: Consumers did not recognize the name of addictive ingredients and many became addicted.

10) The Dietary Supplements and Health and Education Act of 1994 made the FDA responsible for regulating all herbal products and dietary supplements.

Answer: FALSE Explanation: The Act makes drug companies liable for claims against their herbal products and dietary supplements according to FDA guidelines.

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 13) An OTC drug is defined as a drug 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.

Answer: TRUE 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 that are already on the market.

Answer: FALSE Explanation: The FDA allows physicians 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) On a written prescription for a schedule drug, the physician must include his/her DEA number.

Answer: TRUE 21) As they did in the early 1900s, pharmacists today still daily prepare the drugs they dispense, and they also have the added duties of dispensing those drugs and providing patient education and information.

Answer: FALSE Explanation: The pharmacist usually does not prepare drugs any more.

22) The marijuana plant is sold as the prescription drugs Cesamet and Marinol.

Answer: FALSE Explanation: These drugs are synthetic drugs that are similar to marijuana.

23) Legend drugs are also known as over-the-counter drugs.

Answer: FALSE Explanation: Legend drugs are also known as prescription drugs.

24) Traditional Chinese herbal remedies have not been found to be effective or therapeutic according to Western standards of medicine.

Answer: FALSE Explanation: They have been found to be therapeutic.

25) We know from reading the newspaper that cocaine is available illegally as a street drug, but 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) Before approving a new drug, the FDA must weigh the inherent risks of the drug against its potential benefits.

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: It 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 have one half the strength of the prescription drug.

Answer: FALSE Explanation: The OTC drug sometimes has the same strength as the prescription drug.

32) The United States Pharmacopoeia was officially adopted for use in the United States with the passage of the Food and Drug Administration Modernization Act. Answer: FALSE Explanation: The United States Pharmacopoeia was adopted in 1907 with the passage of the National Food and Drugs Act. 33) Medicare Part D is a federal program to pay part of the cost of prescription drugs for senior citizens.

Answer: TRUE 34) Pharmacies in each state and the pharmacists working in them must be licensed by that state.

Answer: TRUE 35) The first oral contraceptive pill was introduced in 2000.

Answer: FALSE Explanation: It was introduced in 1960.

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 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 to keep guard before.

Answer: prophylaxis

, from a Greek word meaning

3) The symbol , which comes from the Latin word recipere, meaning to take, indicates a prescription for a drug (originally one whose recipe contained one or more ingredients).

Answer: Rx 4) The Controlled Substance Act divided potentially addictive drugs into five categories or based on their potential for physical and psychological dependence.

Answer: five 5) The word refers to a drug that is deliberately administered for its medicinal value as a preventive, diagnostic, or therapeutic agent.

Answer: medicine 6) The abbreviation FDA stands for the Answer: Food and Drug Administration

.

7) The abbreviation IND, as used in the Emergency Treatment IND or Compassionate Use IND, stands for .

Answer: investigational new drug 8) In 1983, the topical prescription drug use as an over-the-counter drug.

Answer: hydrocortisone

_ was the first prescription drug approved for

9) Define these abbreviations.

DEA IND FDA OTC Answer: Drug Enforcement Administration, Investigational New Drug, Food and Drug Administration, over-the-counter

10) Today's modern pharmacy began as a storehouse for dried plants and herbs that was known as an .

Answer: apothecary 11) We can remember that the drug auranofin (Ridaura) is used to treat rheumatoid arthritis because the "au" in its drugs names stand for the chemical symbol Au for the mineral Answer: gold 12) In 1796, Dr. Edward Jenner created the first vaccination, which was given to prevent the disease of .

Answer: smallpox 13) In 1922, the first drug to treat diabetes mellitus was introduced, which was the drug .

Answer: insulin 14) The first drug to be made by recombinant DNA technology was introduced in 1982; it was human insulin, and its trade name was .

Answer: Humulin 15) Deciphering the human pharmacology.

Answer: genome

in 2000 opened up the field of gene therapy in

16) Despite the Supreme Court ruling that marijuana is an illegal drug, what two states have passed laws allowing marijuana to be sold for both medical and recreational uses.

Answer: Colorado, Washington state 17) The antidiabetic drug exenatide (Byetta) comes from the poisonous lizard.

Answer: saliva

of the Gila monster

.

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 prevent pregnancy Answers: 1) A 2) B 3) C 4) C 5) A 1.5 Essay Questions 1) The FDA approves a prescription drug being reclassified as an over-the-counter drug if one of four criteria are met. List two of the fourNcUriRteSrIN iaGtThB at.CnOeM eds 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) List and describe one of the incentives given to drug companies under the Orphan Drug Act to encourage them to develop drugs for rare diseases.

Answer: The Orphan Drug Act provided special financial incentives to a drug company including federal grants to offset drug development costs, a tax credit that allowed the drug manufacturer to deduct up to 75% of the cost of clinical trials, a streamlined process for obtaining FDA approval, and exclusive marketing rights for seven years.

3) 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).

4) What was the Supreme Court's decision concerning marijuana in May 2001?

Answer: Supreme Court heard a case that sought an exemption from the federal law for cases of medical necessity, and the American Medical Association (AMA) supported this exemption.

However, the Supreme Court ruled that the federal drug law that bans the manufacture and distribution of marijuana allows for no exceptions.

5) Describe the historical development of the apothecary, the first hospital-based pharmacy, and the first drug store operated by a registered pharmacist.

Answer: German King Frederic II of Germany ordered that the physicians and apothecaries be two separate professions. The first apothecary shop was established in Iraq in 754 AD. In the United States, the first apothecary shop was established in 1729, the first hospital-based pharmacy in 1751, and the first drug store operated by a registered pharmacist in 1823.

6) Describe the two ways that the FDA current regulates the use of the drug thalidomide that caused seal-limb deformity in unborn children.

Answer: The FDA regulates the use of thalidomide in two ways: (1) by limiting the number of physicians who can prescribe it and (2) by requiring women taking the drug not to have sexual intercourse or to use two forms of birth control (so that there is no risk of them giving birth to a child with phocomelia).

7) Describe 3 ways in which schedule drugs can be secured in a hospital or physician's office.

Answer: For security, schedule drugs are stored separately from other drugs and are kept in a double-locked box or cabinet in the physician's office or on the nursing unit in the hospital.

Access is restricted to those healthcare pNroUfResSsIN ioGnTaB ls.CwOhMo are licensed to handle controlled substances. Many facilities use an automated controlled substances device that dispenses and counts all controlled substances. Facilities that do not use an automated device must keep a log for each schedule drug. Any drug that is wasted or not actually administered to the patient must be accounted for and noted on the log. At the end of each nursing shift or each day, the log is independently verified as accurate by two healthcare professionals who are licensed to handle controlled substances. Discrepancies in the count of a controlled substance are investigated immediately.

8) What are the three arguments made by those who oppose reclassification of prescription drugs to become over-the-counter drugs.

Answer: Opponents to reclassification have these arguments: (1) consumers may actually pay more because health insurance plans will not reimburse for OTC drug purchases, (2) excessive use of OTC drugs may increase the number of adverse drug-drug interactions, and (3) consumers may try to self-medicate serious illnesses instead of visiting their physicians for appropriate treatment.

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 2 Drug Design, Testing, Manufacturing, and Marketing 2.1 Multiple-Choice Questions 1) 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.

C) The generic name does not describe molecular structure.

D) The trade name does not describe molecular structure.

2) In the distant 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.

GTaBb.o CuOtM C) Even before computers, drug companNieUsRkSnIN ew molecular structures.

D) There was only one way that was known.

3) Using computers to design new drugs involves , which is the study of the chemical structures of drugs and their actions at the molecular level within a cell.

A) genetics B) molecular pharmacology C) pharmacodynamics D) recombinant DNA technology Answer: B Explanation: A) Genetics is the basis for gene therapy, not designing new drugs at the molecular level.

C) Pharmacodynamics has to do with drug effects based on time and dose; it does not involve computers.

D) Recombinant DNA technology uses enzymes in test tubes, not computers, to create new drugs.

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4) In 1982, which drug became the first recombinant DNA technology drug to be approved by the FDA? A) the semisynthetic penicillin known as ampicillin, which was fermented in vats B) diazepam (Valium) C) human insulin (Humulin) D) Taxol (chemotherapy drug) Answer: C Explanation: A) Penicillin and ampicillin were not created by recombinant DNA technology.

B) Diazepam (Valium) was created from the molecular structure of chlordiazepoxide, not by recombinant DNA technology.

D) Taxol was originally derived from the needles of the Pacific yew tree, not from recombinant DNA technology.

5) Information from the human genome has led to the development of the subspecialty areas of in research and drug design.

A) pharmacogenetics and pharmacogenomics B) pharmacodynamics and pharmacology C) recombinant DNA technology and computers D) pharmacology and stem cell therapy Answer: A Explanation: B) Pharmacology is not a subspecialty area of research and drug design.

C) Information on the human genome has not led to the development of either recombinant DNA technology or computers.

D) Pharmacology is not a subspecialty aN reUaRoSfIN reGsTeaBr.cChOM and drug design.

6) From the moment of its discovery or design, 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 assigned by the IUPAC. 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 assigned by the IUPAC.

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7) Which of the following is registered with the U.S. Patent Office as a registered trademark?

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 the U.S. Patent Office.

B) The drug company, working together with the United States Adopted Names (USAN) Council, not the U.S. Patent Office, determines a drug's generic name.

C) A drug's molecular structure is part of the drug's makeup, and is not registered as a trademark.

8) 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, about 10 to 100 healthy volunteers are used to study a drug.

C) In phase II, the drug is given to about 50 to 500 patients who actually have the disease that the drug is intended to treat.

D) In vivo testing is a general designation for any testing done on animals and humans.

9) Each drug is assigned a 10-digit code,NbUrRoSkIeNnGuTpBi.C ntOoMthree segments. Which of the following is NOT information that can be obtained from the 10-digit code?

A) the name of the drug company 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 company.

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.

10) Once the FDA gives final approval for drug marketing, 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.

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11) The drug name that is a registered trademark is the .

A) generic name B) chemical name C) trade name D) all of the above Answer: C Explanation: A) The generic name is not a registered trademark.

B) The chemical name is not a registered trademark.

D) Only one of the answers is correct.

12) 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) 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.

13) 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 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.

14) Drugs can be created or designed using all of the following techniques, EXCEPT A) discovery in nature B) observing the toxic effects C) computer-aided design D) recombinant DNA technology Answer: B Explanation: A) Drugs ARE created by discovery in nature.

B) The presence of toxic effects of a drug does not lead to a drug being created or designed.

C) Drugs ARE created by computer-aided design.

D) Drugs ARE created by recombinant DNA technology.

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.

15) 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.

C) The control group does not receive the chemical name drug.

D) The control group does not receive the generic name drug.

16) 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.

D) A drug patent is not in effect for 23 years.

17) There are phases of human testing for new drugs.

A) two B) three C) five D) seven Answer: B Explanation: A) There are more than two phases to human testing.

C) There are fewer than five phases to human testing.

D) There are fewer than seven phases to human testing.

18) Recombinant DNA technology involves .

A) gene splicing B) genetic engineering C) human DNA spliced into a bacterial cell 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.

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19) 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.

20) Inert ingredients in a drug .

A) include fillers to shape a tablet B) can affect drug bioavailability C) also include binders 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.

21) 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 foNrUaRllSdINruGgTsB.COM 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.

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.

22) Which of the following statements is FALSE? A) There is only one generic drug name related to a specific chemical name.

B) The trade name is specifically designed to be easy for physicians and patients to remember.

C) The drug's original trade name can be used by other companies after the patent expires.

D) The spellings of generic drugs that belong to the same drug category often reflect their similar chemical structure.

Answer: C Explanation: A) This statement is true.

B) This statement is true.

C) This is a false statement Only the drug company that created that trade name can use that trade name.

D) This statement is true.

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23) What does the therapeutic index indicate?

A) the therapeutic potential for this 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 and is not related to the therapeutic index.

C) The therapeutic index relates to the drug's margin of safety, not whether the drug will be effective and approved.

D) The therapeutic index relates to the drug's margin of safety, not its bioavailability.

24) The first recombinant DNA technology drug approved by the FDA was .

A) an over-the-counter drug B) a drug for HIV 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 first drug for HIV was AZT, but it was not produced by recombinant DNA technology.

C) The drug from pregnant mares' urine, a natural source (not recombinant DNA technology), is Premarin.

D) Human insulin (Humulin) was the first.

25) This drug contains a double-strength dose, as shown by its trade name.

A) Bactrim DS B) Kay Ciel C) Pronestyl-SR D) Tylenol w/ Codeine No. 2 Answer: A Explanation: B) This trade name indicates the ingredients in the drug–potassium (K) and chloride (Cl).

C) This trade name indicates that this is a sustained-release drug (SR).

D) This trade name indicates the amount of a particular active ingredient (codeine).

26) The Human Genome Project .

A) led to the development of computer-aided design of drugs B) mapped all 3.2 billion parts of the human genome C) is the third part of clinical testing after in vivo testing D) determined what the names of new genetic drugs should be Answer: B Explanation: A) Computer-aided design of drugs was in use before the Human Genome Project was undertaken.

C) The Human Genome Project is not part of clinical trials testing.

D) The Human Genome Project is not related to the naming of drugs.

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27) 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: 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.

28) All of these trade names reflect the disease that the drugs are used to treat, EXCEPT .

A) Sudafed B) Pepcid C) Azmacort D) Rythmol Answer: A Explanation: A) Sudafed is simplification of the generic name.

B) This DOES reflect the disease that the drug is used to treat: peptic ulcers.

C) This does reflect the disease that the drug is used to treat: asthma.

D) This does reflect the disease that the drug is used to treat: an irregular heart rhythm.

TBp.aCnOiM 29) What incentive does the FDA give toNU drRuSgINcG om es 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. D) Drugs are not marketed to children.

30) 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 a drug that has no therapeutic effect. Genetically engineered drugs always have a therapeutic effect.

C) This is true, but it is not the only correct answer.

8

31) A moisture-absorbing packet of silica gel, known as , is something that would be added to a drug container to keep tablets from deteriorating.

A) the half-life B) a placebo C) an isomer 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) An isomer does not keep tablets from deteriorating.

32) Post-marketing surveillance .

A) is a type of direct-to-consumer advertising B) is performed by the Federal Trade Commission C) involves adding a National Drug Code to each drug package D) is done by the drug company and the FDA to monitor drug safety Answer: D Explanation: A) Direct-to-consumer advertising is not related to post-marketing surveillance.

B) The Federal Trade Commission regulates the advertising of over-the-counter drugs, but does not do post-marketing surveillance.

C) There is a National Drug Code on each drug package, but it is not related to post-marketing surveillance.

33) All of the following are examples ofNnUeR wSdINruGgTsBd.CisOcM overed in the environment, EXCEPT .

A) a placebo used in double-blind studies B) a chemotherapy drug derived from yew tree needles C) cephalosporin antibiotic drugs from a fungus in a sewer outlet D) an antituberculosis drug from the stomach of a sick chicken Answer: A Explanation: A) A placebo is not discovered in the environment.

B) This is an example of a drug discovered in the environment.

C) This is an example of a drug discovered in the environment.

D) This is an example of a drug discovered in the environment.

34) A dextrorotary drug .

A) is an isomer B) has a right-facing image for its molecular structure C) example is that of dextromethorphan 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.

9

35) When designing drugs, a computer can .

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, which saves time and money C) rotate any molecule in three dimensions on the computer screen 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.

36) Using recombinant DNA technology, which substance has been made into a recombinant DNA technology drug?

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.

37) Slight molecular changes to a drug can significantly affect its A) absorption and metabolism B) half-life C) Therapeutic effect and 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.

.

38) The FDA evaluates a drug before approving it. This evaluation includes a review of .

A) the drug company's documentation B) consumer comments about the drug C) drug's risks and benefits D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) The FDA does not review consumer comments before approving a drug.

C) This is true, but it is not the only correct answer.

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39) Why would a physician give a 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.

D) There are no FDA requirements about free drug samples.

40) What can the FDA do when it receives reports of adverse drug effects for a particular drug?

A) The FDA can red flag a drug.

B) The FDA can have the drug company expand the warning label on the drug.

C) The FDA can withdraw the drug from the market.

D) B and C Answer: D Explanation: A) There is no such procedure as a red flag.

B) This is true, but it is not the only correct answer.

C) This is true, but it is not the only correct answer.

41) The drug Byetta, which is used to treat diabetes mellitus, is derived from A) coal mining B) saliva of the Gila monster C) venom of the cone snail D) recombinant DNA technology Answer: B Explanation: A) Coal tar, not Byetta, is derived from coal mining.

C) Prialt, not Byetta, is derived from venom of the cone snail.

D) Byetta was not created with recombinant DNA technology.

42) The first drug to be created with recombinant DNA technology was A) Humulin insulin B) Allegra C) rDNA D) hydrochlorothiazide Answer: A Explanation: B) Allegra was not created with recombinant DNA technology.

C) This is not a drug; it is an abbreviation for recombinant DNA technology.

D) This drug was not created with recombinant DNA technology.

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.

.

43) The trade name K-Lyte/Cl tells us that this drug contains A) iron and glucose B) potassium and chloride C) a double strength dose of the drug D) chloride and snail venom Answer: B Explanation: A) It does not contain iron and glucose.

C) It does not contain a double-strength dose.

D) It does not contain chloride and snail venom.

.

44) 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: 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.

45) Pharmacokinetics involves .

A) absorption of a drug B) distribution of a drug C) metabolism of a drug 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.

46) 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) 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.

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.

2.2 True/False Questions 1) An isomer is a drug that has the same chemical formula as another drug, but has those atoms arranged in a different way.

Answer: TRUE 2) Once a drug has received its final approval from the FDA, its ingredients, doses, manufacturing process, labeling, and packaging cannot be changed.

Answer: TRUE 3) The advertising of both prescription and OTC drugs is regulated by the FDA. Answer: FALSE Explanation: The marketing and advertising of over-the-counter drugs are regulated by the Federal Trade Commission.

4) The FDA has standards for the spelling of trade name drug, and drug companies must follow them.

Answer: FALSE Explanation: There are no standards for the spelling of trade name drugs.

5) 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 testeNdUbRySItN heGTdB ru.CgOcM ompany, not the FDA. 6) Generic drugs and trade name 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.

Answer: TRUE 7) A drug company is protected by a 17-year patent on any new drug that is approved by the FDA. However, part of the 17-year patent period is used up during the testing process.

Answer: TRUE 8) Once a drug has been approved by the FDA, the drug can continue to be marketed indefinitely because it has received FDA approval.

Answer: FALSE Explanation: Just because a drug has been approved does not guarantee it will remain on the market over time.

9) Many drugs still in use today were originally taken from plant, animal, or mineral sources hundreds or even thousands of years ago.

Answer: TRUE

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10) The Recombinant DNA Advisory Committee is a group of physicians and pharmacists who review the clinical trials of genetically engineered new drugs and make recommendations to the FDA. Answer: TRUE 11) The animal phase of drug testing precedes testing on humans.

Answer: TRUE 12) The pharmacodynamics of a drug are tested during the human phase of drug testing.

Answer: FALSE Explanation: The pharmacodynamics are tested during the animal phase.

13) 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 14) 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 15) In a double-blind study, every patient receives both the drug and a placebo.

Answer: FALSE Explanation: Double-blind means neither the physician or the patient knows whether he/she gets the drug of a placebo.

16) In a double-blind study, the physician-investigator is the only one who knows which patients are taking a drug and which patients are taking a placebo.

Answer: FALSE Explanation: Even the physician-investigator does not know.

17) A placebo uses the power of suggestion to produce changes in the body that mimic the pharmacologic action of an actual drug.

Answer: TRUE 18) 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 19) Individual genes from DNA can be manipulated to create drugs.

Answer: TRUE 20) The Human Genome Project allowed drug researchers to begin gene therapy to replace defective genes in the body.

Answer: TRUE

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21) The ending -olol is common to generic beta-blocker drugs.

Answer: TRUE 22) It is not uncommon for a patient who is given a therapeutic dose of digoxin (Lanoxin) to exhibit symptoms of toxicity.

Answer: TRUE 23) 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.

24) A drug can be approved to treat one thing and then, after further clinical trials, can also be approved to treat something completely different.

Answer: TRUE 25) 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.

26) Advertisements of drugs to consumers are heavily weighted toward prescription drugs for chronic diseases that require long-term treatment.

Answer: TRUE 27) MedWatch is the FDA safety information and adverse event reporting system on the Internet.

Answer: TRUE 2.3 Short Answer Questions 1) When animal studies are completed, the drug company submits an IND application to the FDA. The abbreviation IND stands for .

Answer: Investigational New Drug 2) There are three phases of human testing, which together are known as Answer: clinical drug trials

.

3) A , a drug that has no pharmacologic effect, is often used in double-blind studies during phase III clinical trials.

Answer: placebo 4) Once phase III is completed, the drug company submits all of its documentation on the drug to the FDA in the form of a NDA. The abbreviation NDA stands for _.

Answer: New Drug Application

15

5) DTC marketing has become common, beginning with magazine ads and moving to television.

The abbreviation DTC stands for .

Answer: direct to consumer 6) The of the active drug ingredient can be particularly crucial in drugs with a low therapeutic index.

Answer: bioavailability 7) Define these abbreviations.

FDA DTC TI IND NDC rDNA Answer: Food and Drug Administration, direct-to-consumer [marketing], therapeutic index, Investigational New Drug, National Drug Code, recombinant DNA 8) 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 9) When the FDA removes a drug from the market because of manufacturing defects, this is known as a drug .

Answer: recall 10) is the knowledge of how genetic makeup of different people affects their responses to drugs.

Answer: pharmacogenetics 11) The trade name is also known as the and customer loyalty.

Answer: brand

name because it implies brand recognition

12) Define these abbreviations.

Fe K LA SR Answer: iron, potassium, long-acting, slow-release 13) When volunteers answer a newspaper ad for a clinical drug trial, it is mandatory that they give informed to participate in the trial.

Answer: consent

16

14) A single dose of a drug can be placed in an individually sealed bubble of clear plastic over the capsule or tablet.

Answer: blister pack

that contains a

15) The marketing and advertising of over-the-counter drugs is regulated by the Answer: Federal Trade Commission

17

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2.4 Matching Questions Group A Match the terms with their proper definitions.

A) shows the number of animals who responded or do not respond to a drug and at what doses.

B) the dose at which 50 percent of the animals tested had toxic levels of the drug C) the time required for drug levels in the serum to decrease from 100 percent to 50 percent.

D) relative margin of safety between the dose that produces a therapeutic effect and the dose that produces a lethal effect in animals E) the dose at which 50 percent of the animals tested show a therapeutic response to the drug 1) frequency distribution curve 2) half-life 3) median effective dose (ED50) 4) median toxicity dose (TD50) 5) therapeutic index (TI) Answers: 1) A 2) C 3) E 4) B 5) D Group B Match the drug name with its discovery process.

A) a totally new chemical derived from molecular manipulation of a drug that is already in use B) a totally new chemical substance discovered in the environment, from plants, animals, or the soil C) a totally new chemical created through genetic DNA manipulation 6) diazepam 7) Aranesp 8) fexofenadine (Allegra) 9) human insulin (Humulin) 10) streptomycin Answers: 6) A 7) A 8) A 9) C 10) B

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2.5 Essay Questions 1) The FDA sometimes removes certain batches of drugs from the market because of manufacturing defects. Name three manufacturing defects that would be the reasons for a drug recall.

Answer: 1. The drug does not contain the correct amount of active ingredient. 2. The drug does not remain stable until its expiration date. 3. The drug is contaminated with particulate matter from the manufacturing process.

2) 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.

3) 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.

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 3 Drug Forms 3.1 Multiple-Choice Questions 1) A solid drug form that contains the active drug (as a dried powder) plus inert ingredients to provide bulk 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 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.

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.

D) These abbreviations do not indicate that the drug is a troche.

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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: 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 are in a shell.

5) The powdered 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 (Serevent Diskus).

B) This is not a route of administration used for a powdered drug form.

C) Powdered drugs can be sprayed onto the skin (Tinactin).

D) Powdered drugs can be sprinkled topN icUalRlySIoNnGtToBt.hCeOsM kin (Tinactin).

6) Which of the following is NOT a type of solution?

A) mousse B) elixir C) foam D) suspension Answer: D Explanation: A) A mousse is a type of solution.

B) An elixir is a type of solution.

C) A foam is a type of solution.

D) 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) This describes a suspension, NOT a solution.

D) This describes a tincture, which is a solution.

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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 thick.

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.

10) Suppositories are 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.

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.

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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.

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 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.

D) Tinctures are never taken internally.

14) When a tablet is scored across its top surface, that indicates A) that it contains a narcotic drug B) the mark of a particular drug companN y URSINGTB.COM C) that it contains a double-strength dose D) that it can be broken into two or more doses Answer: D Explanation: A) Narcotic 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.

.

that

.

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.

D) Enteric-coated tablets are coated, but the reason is not so that they are easy to swallow.

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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: B) An elixir is a solution and the dissolved drug does not settle to the bottom of the container.

C) A spray is a solution that does not settle to the bottom of the container.

D) A liquid is a solution that does not settle to the bottom of the container.

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: 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 theNdUrRuSgIN foGrTmBo.CfOaMcream .

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: 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 all of these, EXCEPT A) a canister B) an ampule C) a capsule D) a vial Answer: B Explanation: A) Powdered drugs do come in canisters.

B) An ampule always contains a liquid drug.

C) Powdered drugs are in some capsules.

D) Vials contain either solutions or powdered drugs.

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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.

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 drug .

A) Fosamax B) Zantac C) Cialis D) Nexium Answer: D Explanation: A) Fosamax has a bone shaped imprint on the tablet.

B) Zantac is a pink, baseball-diamond-shaped tablet.

C) Cialis is a mustard-colored teardrop-shaped tablet.

22) Which of the following drug trade names is NOT in the form of a bead, wafer, or device?

A) Septopal B) Nexium C) Gliadel D) Mirena Answer: B Explanation: A) Septopal is in the form of beads.

B) It is 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 device.

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) MetroGel Answer: A Explanation: B) Cepacol is a lozenge, but it is used for a sore throat, not severe pain.

C) This is an effervescent tablet, not a lozenge.

D) MetroGel is in the form of a gel, not a lozenge.

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24) Valproic acid (Depakote), a drug used to treat seizures, comes in a capsule form that is .

A) swallowed B) crushed and the vapors inhaled C) placed under the tongue and allowed to dissolve D) sprinkled on applesauce and swallowed Answer: D Explanation: A) Most capsules are swallowed, but this drug's capsule is not.

B) This describes the capsule for the drug amyl nitrite, not valproic acid.

C) This is not true for valproic acid.

25) A film is a thin drug form about the size of a postage stamp that is given by the route of administration.

A) transbuccal 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.

26) Transdermal patches are used for all of the following, EXCEPT .

A) treat a vaginal yeast infection B) treat severe, chronic pain C) relieve the urge to smoke D) prevent angina attacks in patients with heart disease Answer: A Explanation: A) 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 are inhaled?

A) an anesthetic gas B) a transbuccal film C) amyl nitrite powder for cardiac pain D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) Transbuccal means placed inside the cheek.

C) This is true, but it is not the only correct answer.

7

28) Solutions in which the drug is dissolved in sterile water or saline A) are effervescent tablets B) are injected into the blood or body tissues C) need to be shaken before using D) are inhaled Answer: B Explanation: A) Solutions are not tablets.

C) Solutions never need to be shaken.

D) Solutions are not inhaled.

.

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) injected C) mixed D) prescribed Answer: C Explanation: A) This does not correlate with prolonged standing.

B) This does not correlate with prolonged standing.

D) This does not correlate with prolonged standing.

30) All of the following are drug forms, EXCEPT A) pellets and beads B) wafers and films C) gases and T-shaped devices D) binders and fillers Answer: D Explanation: A) These are drug forms.

B) These are drug forms.

C) These are drug forms.

D) These are inert ingredients in a tablet, not a drug form.

.

31) All of the following relate to a drug being placed by mouth, EXCEPT A) oral B) systemic C) transbuccal D) sublingual Answer: B Explanation: A) This does relate to a drug being taken by mouth.

B) Systemic refers to where the drug acts (throughout the body).

C) This does relate to a drug placed in the mouth, inside the cheek.

D) This does relate to a drug placed in the mouth, under the tongue.

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3.2 True/False Questions 1) Both a foam and a mousse are expanded by tiny aerosol bubbles when they are 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.

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) Specially formulated ointments and creams can both 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 do not contain alcohol.

Answer: TRUE 10) Gels are solutions that contain fine, undissolved particles dispersed uniformly throughout a thickened water base.

Answer: TRUE

9

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 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) The drug form pastille is also known as a troche.

Answer: TRUE 20) 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 21) Suppositories can be given by the oral, vaginal, or rectal route.

Answer: TRUE

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22) 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 23) 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.

24) 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 25) A scored tablet can be easily and accurately divided into equal doses, depending on the number of score marks on the tablet.

Answer: TRUE 26) A dose of the ointment form of nitroglycerin is measured between ruler lines on a paper.

Answer: TRUE 3.3 Short Answer Questions 1) A/an tablet is one that is disNsUoR lvSeIdNGinTB a .gClOaM ss of water before being swallowed (e.g., Alka-Seltzer for a head cold).

Answer: effervescent 2) Some over-the-counter drugs come as a , 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) 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 is a solution that contains the drug in a water and alcohol base, but is never taken internally.

Answer: tincture 5) A is composed of a solid base of glycerin or cocoa butter containing the drug. They are usually used rectally and vaginally, but they can be administered orally.

Answer: suppository 6) A is a coated tablet in the form of an elongated capsule.

Answer: capsule 11

7) A 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 or pastille 8) In written prescriptions, the word tablet is sometimes abbreviated as Answer: tab, tabs 9) In written prescriptions, the word capsule is sometimes abbreviated as _ .

Answer: cap, caps 10) This drug form, a name for a troche.

Answer: pastille

or

.

or

, is a French word that means little lump of bread, and is another

11) An is a small, slender glass container with a main body and a narrow, indented neck, and an extended top.

Answer: ampule 12) Define these abbreviations and short forms.

LA SR XL ER tab cap Answer: long acting, slow release, extended length, extended release, tablet, capsule 13) The viscosity of a drug form refers to its Answer: thickness

.

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3.4 Matching Questions Match the drug name in Column 1 with its drug form in Column 2.

A) gel B) syrup C) capsule D) foam E) enteric-coated tablet F) ointment G) suspension H) lotion I) pellet, bead, or wafer J) cream 1) calamine 2) Ecotrin 3) hydrocortisone 4) Kenalog 5) Maalox 6) Muse 7) MetroGel 8) Nexium 9) Robitussin 10) Rogaine Answers: 1) H 2) E 3) J 4) F 5) G 6) I 7) A 8) C 9) B 10) D

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3.5 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. The patch releases a small amount of drug over a long period of time, usually for 1 to 2 days 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: ointment or cream or lotion.

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 no longer manufactured in capsule form. Explain why.

Answer: Most 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 .CO water base. An emulsifying agent is addeNdUtRoSaINcGreTaBm toMkeep the oil and water ingredients mixed together.

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 4 Routes of Administration and the Drug Cycle 4.1 Multiple-Choice Questions 1) 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.

2) 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.

C) The sublingual route of administratioN n UisRgSIN iviGnTgBd.C ruOgM s underneath the tongue.

D) The transdermal route of administration is applied to the skin, but not to the eyes and ears.

3) 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.

C) Rectal is not the most common route of administration.

D) Tablets are a form of a drug, not a route of administration.

4) Which route of administration is chosen when 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.

D) The sublingual administration route delivers drugs by placing them under the tongue. This cannot be done if the patient is vomiting.

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5) In actual clinical use, which of the following is NOT considered to be 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) This is not a parenteral route of administration.

D) Intravenous is one of the parenteral routes of administration.

6) For most drug forms, absorption involved three steps. Which of the following is NOT one of the three steps of absorption?

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.

D) Dissolve is one of the three steps of absorption.

7) The process of drug metabolism is accNoUmRpSlIiNshGeTdB.iCnOthMe , 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.

D) The stomach is not the principal organ of metabolism.

8) An intravenous drug can be administered in three different ways. Which of the following is NOT one of the three types of intravenous drug administration?

A) bolus B) I.V. piggyback C) I.V. infusion D) port Answer: D Explanation: A) Bolus is a type of intravenous drug administration.

B) I.V. piggyback is a type of intravenous drug administration.

C) I.V. infusion is a type of intravenous drug administration.

D) A port is a rubber stopper in the intravenous tubing, not a type of intravenous drug administration.

2

9) 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 have to go through absorption from the stomach.

B) The liquid does NOT need to disintegrate.

C) Oral drugs in a liquid form do have to dissolve into the surrounding body fluids.

D) All drugs go through excretion.

10) Which method of drug administration is only used during emergency resuscitation?

A) intra-articular B) intracardiac 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.

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.

11) 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: 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.

12) Drugs given orally are absorbed from the intestines into the blood of the portal vein. Before this vein empties into the general circulation, it passed through the .

A) intestines B) kidney C) liver D) skin Answer: C Explanation: A) The portal vein does not pass through the intestines.

B) The portal vein does not pass through the kidney.

D) The portal vein does not pass through the skin.

3

13) Patients with kidney disease and elderly patients with a decreased level of kidney function due to aging are prescribed .

A) lower doses of drugs B) higher doses of drugs C) the same dose of drugs D) different routes of administration Answer: A Explanation: B) Because of the poor kidney function, higher doses of drugs would be toxic.

C) An adjustment in the drug dose must be made for patients with renal disease and decreased kidney function.

D) The route of administration is not going to change the fact that the drug still has to be excreted by the kidneys.

14) 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: 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.

15) All of the following are drugs that are given intravenously, EXCEPT A) chemotherapy drugs B) peritoneal dialysis fluids for patients with kidney failure C) diazepam (Valium) to control continuous epileptic seizures D) thiopental (Pentothal) for the induction of general anesthesia Answer: B Explanation: A) Chemotherapy drugs are given intravenously.

C) Valium is given intravenously.

D) thiopental (Pentothal) is given intravenously.

.

16) Which of these are special words related to the intravenous route of administration?

A) piggyback and port B) bolus and push C) infusion and drip 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.

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17) Any liquid drug that can be given by the oral route can also be given by any of these routes, EXCEPT .

A) jejunostomy B) nasogastric C) transdermal D) gastrostomy Answer: C Explanation: A) A liquid drug can be given via the jejunostomy route.

B) A liquid drug can be given by the nasogastric route.

C) The transdermal route requires a transdermal patch.

D) A liquid drug can be given by the gastrostomy route.

18) Which of the following routes CANNOT be used to administer drugs to an unconscious patient?

A) oral B) rectal C) intravenous D) none of the above Answer: A Explanation: A) The oral route requires that the patient be alert and able to swallow.

B) The rectal route is used when the patient is unconscious.

C) The intravenous route can be used when the patient is unconscious.

D) One of the answers is correct.

19) 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) On the skin is topical administration.

C) In the vagina is vaginal administration.

D) Under the skin is intradermal administration.

.

20) Which of the following drugs is given by subcutaneous injection?

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.

5

21) Which route of administration is commonly abbreviated as PO? A) oral B) parenteral C) rectal D) inhalation Answer: A Explanation: 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.

22) Parenteral administration of a drug commonly includes all of the following routes, EXCEPT .

A) intramuscular B) intravenous C) oral D) subcutaneous Answer: C Explanation: A) The parenteral route includes intramuscular administration.

B) The parenteral route includes intravenous administration.

C) The oral route is not considered parenternal administration.

D) The parenteral route includes subcutaneous administration.

23) The first-pass effect describes the .

A) metabolism of drugs by the stomach B) metabolism of drugs by 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.

C) The first-pass effect does not involve the stomach.

D) The first-pass effect does not involve the kidneys.

24) 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 when administered by a certain route.

D) Drugs may seriously injury the patient if administered by the wrong route.

Answer: B Explanation: A) This statement is true.

B) Subcutaneous, not intradermal, injects the drug into the fat.

C) This statement is true.

D) This statement is true.

6

25) Which of the following statements is FALSE? A) Each route of administration has distinct advantages and disadvantages.

B) Tablets, capsules, and liquids can all given orally.

C) When you are administering a topical drug, as you face the patient, your right-hand side corresponds to the patient's right-hand side.

D) Topical ophthalmic ointment is specially formulated to be nonirritating to the eye; it is not interchangeable with topical ointments used on the skin.

Answer: C Explanation: A) This statement is true.

B) This statement is true.

C) Your right-hand side corresponds to the patients left-hand side.

D) This statement is true.

26) Which of the following statements is FALSE? A) All syringes are calibrated in units.

B) When an intradermal injection is positioned correctly, the tip of the needle is still visible through the epidermis.

C) An intramuscular injection is placed in the belly (area of greatest mass) of the muscle.

D) Drugs injected intramuscularly are absorbed more quickly than with subcutaneous administration.

Answer: A Explanation: A) Only insulin syringes are calibrated in units.

B) This is a true statement.

C) This statement is true.

D) This is a true statement.

27) 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) 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.

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28) All of the following drugs are administered topically, EXCEPT .

A) nitroglycerin (Nitrostat) tablets B) antibiotic ointment for a skin injury C) eye drops for glaucoma D) antibiotic drops for an ear infection Answer: A Explanation: A) Nitroglycerin is administered topically as a spray, but that is the trade name NitroMist, not Nitrostat.

B) This is an example of a topical drug.

C) This is an example of a topical drug.

D) This is an example of a topical drug.

29) Which of the following drugs is manufactured as a transdermal patch?

A) Serevent, a bronchodilator drug for asthma B) Monistat for a yeast infection C) synthetic lung surfactant to treat respiratory distress in premature infants D) Nicoderm CQ to stop smoking Answer: D Explanation: A) Serevent comes as a powder, not as a transdermal patch.

B) Monistat comes as a cream, not a transdermal patch.

C) Surfactant is given via an endotracheal tube.

30) When a drug is given by inhalation, it is absorbed .

A) through the stomach and intestine B) through the nasal cavity C) through the lungs D) through the breast milk Answer: C Explanation: A) Oral drugs, not inhaled drugs, are absorbed through the stomach and intestine.

B) Drugs given by the nasal route, not inhaled drugs, are absorbed in the nasal cavity.

D) Drugs are excreted in the breast milk, and this is not related to drugs given by inhalation.

31) Drugs that are not absorbed after oral administration .

A) are metabolized in the stomach B) can be used to treat diseases of the stomach or intestine C) are not therapeutically effective D) are excreted in the urine Answer: B Explanation: A) The stomach is not the site of drug metabolism.

C) Drugs not absorbed after oral administration can be therapeutically effective.

D) Drugs that are not absorbed never enter the blood and so are never excreted in the urine.

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32) Drug doses for an elderly patient are 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) Elderly patients usually have an increased need for medication, not a decreased need.

B) A decreased activity level is not directly related to drug doses for an elderly person.

C) Drug doses are not decreased for an elderly person just because they have a decreased mental ability.

33) Drugs circulate in the blood bound to .

A) red blood cells B) white blood cells C) albumin D) plasma Answer: C Explanation: A) Drugs do not bind to red blood cells.

B) Drugs do not bind to white blood cells.

D) Plasma is a liquid and does not bind to drugs.

34) All of the following drugs are given via the rectal route of administration, EXCEPT .

A) Monistat cream for a yeast infection B) Tylenol suppositories for a fever C) Anusol cream for hemorrhoids D) Proctofoam-HC for ulcerative colitis Answer: A Explanation: A) Monistat is used for vaginal infections, not rectal.

B) This drug is given by rectal administration.

C) This drug is given by rectal administration.

D) This drug is given by rectal administration.

35) An equivalent word for metabolism is .

A) biotransformation B) metabolite C) distribution D) parenteral Answer: A Explanation: B) A metabolite is what results after metabolism takes place.

C) Distribution is a different step in the drug cycle than metabolism.

D) Parenteral is a route of administration and is not part of the drug cycle.

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36) The intravesical route of administration is used to administer chemotherapy drugs into the .

A) lungs B) abdomen 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 abdomen.

C) The intravesical route is not in the spinal cord.

37) 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.

38) As a drug leaves the blood and moveNsUtR hrSoIN ugGhTBal.C lO thM e body tissues, it comes in contact with .

A) receptors B) the blood-brain barrier C) placenta D) all of the above Answer: A Explanation: B) The blood-brain barrier is not in all the body tissues.

C) The placenta is only present in pregnant women.

D) Only one of these is correct, not all of them.

39) Which of the following drugs is not absorbed following oral administration, but has a therapeutic effect in the stomach or intestines?

A) Carafate, an antiulcer drug B) Metamucil for constipation C) neomycin antibiotic to kill bacteria in the intestine before surgery 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.

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40) Which drug is inactivated by stomach acid and cannot be taken orally?

A) tetracycline antibiotic drug B) MAO inhibitor drugs for depression C) penicillin antibiotic drug D) all of the above Answer: C Explanation: A) Tetracycline cannot be taken orally because it combines with certain foods.

B) These drugs cannot be taken orally because they combine with certain foods.

D) There is only one correct answer.

41) The intradermal route of administration is used for .

A) give intravenous fluids B) allergy skin tests C) Mantoux test for tuberculosis D) B and C Answer: D Explanation: A) The intravenous 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.

42) Why are drugs absorbed slowly after subcutaneous administration?

A) because there are only a few blood vessels in the subcutaneous layer B) because fat metabolizes a drug quickly C) because the fat layer is so deep D) all of the above Answer: A Explanation: B) Fat does not metabolize a drug quickly C) If a drug is injected into this layer, it does not matter how deep it is, only what it is made of.

D) Only one answer is correct.

43) All of the following are true about a saline lock, EXCEPT .

A) it allows intravenous access without the need for a continuously infusing I.V. fluid B) it keeps the vein free of clots C) it uses an I.V. bag and an infusion pump D) it is a way to administer intravenous drugs on an intermittent basis Answer: C Explanation: A) This IS true about a saline lock.

B) This IS true about a saline lock.

C) A saline lock does not use an infusion pump.

D) This IS true about a saline lock.

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44) Which of the following is an intravenous drug that is known to be very irritating and can cause blisters if it accidentally goes into the subcutaneous tissue?

A) implantable port B) vesicant C) gastrostomy D) parenteral Answer: B Explanation: A) This is a device, not an intravenous drug.

C) This is a route of administration, not an intravenous drug.

D) This is a route of administration, not an intravenous drug.

45) Which route of administration is used to put a chemotherapy drug directly into the area of a cancerous tumor?

A) intra-articular B) umbilical artery C) epidural D) intra-arterial Answer: D Explanation: A) This route is used to put a drug into a joint.

B) This route is only used in newborn infants.

C) This route is only used to produce regional spinal anesthesia during childbirth or to treat severe pain.

SIhNiG 46) Trace amounts of a drug are excretedNU inRw chTBo.fCtOhM e 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.

4.2 True/False Questions 1) Before a drug can receive final approval by the FDA, the drug company must clearly state what routes of administration have been found to be safe and effective.

Answer: TRUE 2) 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 cause injury.

3) Some drugs are approved for use via more than one route and are manufactured in different drug forms appropriate for those different routes.

Answer: TRUE 12

4) The topical route of administration of drugs always has a systemic effect on the body.

Answer: FALSE Explanation: Most topical drugs exert only a local effect.

5) The sublingual route of drug administration provides a faster therapeutic effect than the oral route.

Answer: TRUE 6) While the nasal administration of a drug is done topically, some nasal spray drugs act systemically throughout the body.

Answer: TRUE 7) The inhalation route of drug administration involves the inhaling of a drug that is in a gas, liquid, or powder form.

Answer: TRUE 8) Systemic absorption of a drug via the rectal route of administration is slow and often unpredictable.

Answer: TRUE 9) Although other organs are involved to a limited degree, the principal organ of drug excretion is the kidney.

Answer: TRUE 10) 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.

11) Only intravenous injections entirely bypass the step of absorption because the drug is administered directly into a vein and immediately enters the blood.

Answer: TRUE 12) The umbilical route is used to administer intravenous fluids and draw blood, but is not generally used to give drugs.

Answer: TRUE 13) Pregnant women are advised to only take drugs that are prescribed by their healthcare provider.

Answer: TRUE 14) Absorption involves the movement of a drug from the site of administration through the tissues and into the blood.

Answer: TRUE

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15) The blood-brain barrier is a protective barrier between the brain and the capillary walls of blood vessels around the brain, and no drug can penetrate this barrier.

Answer: FALSE Explanation: Some drugs are able to pass through.

16) Each year, many infants are born addicted to drugs that their mothers took, or they are born with birth defects due to the action of drugs taken by their mothers.

Answer: TRUE 17) The names Broviac, Hickman, and Groshong are all associated with types of endotracheal tubes.

Answer: FALSE Explanation: These are special catheters for chemotherapy drugs.

18) The intra-articular route of administration is used to administer a chemotherapy drug directly into the area of a cancerous tumor.

Answer: FALSE Explanation: The intra-arterial, not the intra-articular, route is used to do this.

19) Following topical administration of a drug, the drug form does not need to undergo disintegration as it quickly dissolves in the tissue fluids of the skin.

Answer: TRUE 20) The presence or absence of food in tN heUR GSIIN trG acTtBc.C anOM reduce the absorption of a drug from 30 percent to as much as 80 percent.

Answer: TRUE 21) Different forms of a drug are appropriate for different routes of administration.

Answer: TRUE 22) Giving a drug by the wrong route can make the drug ineffective or or can injure the patient or even cause death.

Answer: TRUE 23) Ointment used topically on the skin can also be used in the eye, when needed.

Answer: FALSE Explanation: Topical ophthalmic ointment is specially formulated to nonirritating to the eye.

24) Tablets, capsules, and liquids are all given by the oral route.

Answer: TRUE 25) A tablet is not swallowed if it is given by the sublingual route.

Answer: TRUE 26) Many drugs are administered via the buccal route.

Answer: FALSE Explanation: Few drugs are given by the buccal route.

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27) The word nasogastric means pertaining to the nose and lungs.

Answer: FALSE Explanation: Nasogastric means pertaining to the nose and stomach.

28) For intradermal administration of a liquid drug, the syringe is inserted at a 90-degree angle.

Answer: FALSE Explanation: It is inserted at a 10- to 15-degree angle.

29) Some drugs cannot be given by intramuscular injection because they are not water soluble and would form precipitates in the muscle tissue.

Answer: TRUE 30) The intravenous route is used to administer drugs, fluids, or blood and maintain venous access between drug doses.

Answer: TRUE 31) The intracardiac route is only used to give a drug during an emergency resuscitation.

Answer: TRUE 4.3 Short Answer Questions 1) Once a drug is administered, it goes through the four steps of the Answer: drug cycle

.

2) 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 3) The oral route of drug administration is abbreviated as Answer: PO or p.o.

or

.

4) administration involves placing the drug under the tongue and allowing it to slowly dissolve.

Answer: sublingual 5) administration involves placing the drug in the pocket between the cheek and the lower teeth on one side of the mouth and allowing it to slowly dissolve.

Answer: Buccal 6) is the study of how drugs move through the body in the process of absorption, distribution, metabolism, and excretion.

Answer: Pharmacokinetics 7) As a drug enters the blood, some of the drug binds to circulating plasma proteins, such as .

Answer: albumin 15

8) The process of metabolism is also known as because the drug is gradually transformed or metabolized from its original active form to a less active, or even inactive, form.

Answer: biotransformation 9) Some drugs are actually administered in an inactive form and remain inactive until they are metabolized. This type of drug is classified as a .

Answer: prodrug 10) 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. 11) Only Answer: liquid

drugs can be given through a nasogastric tube.

12) For subcutaneous administration of a liquid drug, the needle of the syringe is inserted at a degree angle.

Answer: 45 13) An intramuscular injection must be given into a muscle that is large enough that the needle will not accidentally injure a nearby .

Answer: nerve 14) Adding a drug to a very small I.V. bag whose tubing is connected to the main I.V. tubing is known as I.V. .

Answer: piggyback 15) An infusion is a device to precisely and automatically infuse a volume of intravenous fluid and drug over a specific length of time.

Answer: pump 16) is when intravenous fluid and/or drug is accidentally administered into the subcutaneous tissue, instead of into the vein.

Answer: Extravasation 17) The intra-articular route is used to administer a drug into a Answer: joint

.

18) The route is used to produce regional spinal anesthesia during childbirth.

Answer: epidural 16

19) The Answer: liver

is the principal organ for drug metabolism.

4.4 Matching Questions Group A Match the routes of administration in Column 1 with their definitions in Column 2.

A) pertaining to below the skin B) pertaining to the cheek C) pertaining to within the muscle D) pertaining to within the skin E) pertaining to apart from the intestine F) pertaining to within the bladder 1) intradermal 2) intramuscular 3) intravenous 4) parenteral 5) subcutaneous 6) buccal 7) intravesical Answers: 1) D 2) C 3) C 4) E 5) A 6) B 7) F

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Group B Match the abbreviations in Column 1 with their definitions in Column 2.

A) keep the vein open B) left eye C) right eye D) both ears E) left ear F) right ear 8) A.D. 9) A.S. 10) A.U. 11) O.D. 12) O.S. 13) KVO Answers: 8) F 9) E 10) D 11) C 12) B 13) A 4.5 Essay Questions 1) List three disadvantages associated with the oral route of drug administration.

Answer: (select 3 from this list) 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. Some drugs are metabolized so quickly by the liver that a therapeutic blood level cannot be achieved.

Some drugs cannot be taken with certain foods and beverages because they combine chemically to form an insoluble complex.

Some drugs cannot be taken with certain foods because they produce severe adverse effects.

2) Briefly explain the difference between water-soluble and fat-soluble drugs.

Answer: A water-soluble drug is excreted in the urine because of its attraction to the water content of urine. A fat-soluble drug is more attracted to the lipid (fat) structure of the renal tubule wall than to the urine, and so most of it passes through the renal tubule, into a nearby capillary, and returns to the blood.

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3) Some drugs are not absorbed at all following oral administration. However, nonabsorption of a drug via the oral route can be turned into a therapeutic advantage. Give an example and explain why this is a therapeutic advantage.

Answer: (select 1 from this list) Neomycin can be given orally to exert its antibiotic effect solely in the intestinal tract to kill intestinal bacteria prior to abdominal surgery. Carafate, an antiulcer drug, is not absorbed following oral administration, but that is acceptable because its therapeutic effect is to bind directly to a stomach ulcer and form a protective coating so that the ulcer can heal. Another drug, Metamucil, also is not absorbed, but passes through the intestines, where it binds with water to increase stool bulk and exert its therapeutic effect to relieve constipation.

4) Explain how to administer a liquid drug to an infant.

Answer: For oral administration of a drug to an infant, the liquid drug is mixed with a small amount of formula and given orally through the nipple which has been removed from the bottle of formula.

5) Describe how the drug testosterone (Axiron) is applied and what precautions need to be observed.

Answer: The topical hormone drug testosterone (Axiron) is applied only to the underarms.

Because this drug is a male hormone, the instructions advise the patient to do the following to avoid transferring the drug to another person (particularly to a female or a child): the patient is to wash his hands after applying the drug and put on clothing right away to cover the area where the drug was applied.

6) Describe how to administer a topical ophthalmic liquid drug to a patient's eye.

Answer: Administer a topical ophthalmic liquid drug to the patient's eye by pulling down the lower eyelid and asking the patient to look up, 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. As the patient blinks, the drug is distributed across the eye.

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 5 Using Drugs Therapeutically 5.1 Multiple-Choice Questions 1) 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: 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.

2) A drug's main reason for which it was prescribed by a physician or other healthcare provider is known as a/an .

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.

3) A toxic effect of a prescribed drug results when .

A) the drug company did not perform clinical trials for that drug B) the physician decreased the drug dose in elderly patients C) the blood level of a drug is below the therapeutic level D) the blood 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 prescribed.

B) If the dose was decreased, there is less chance there will be a toxic effect.

C) With a blood level below therapeutic level, there is less chance there will be a toxic effect.

1

4) 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.

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.

5) 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 true, but it is not the only correct answer.

B) This is true, but it is not the only correct answer.

D) Histamine receptors are not adrenergic receptors.

6) A list of the common side effects of a new drug is developed .

A) after 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 developed before a new drug is prescribed.

B) This is nonspecific. Reports on drugs are given during clinical trials as well as after they are approved to be marketed.

C) The list of side effects is developed before a new drug is approved by the FDA. 7) When an antigen combines with an antibody, this stimulates the release of , which produces mild-to-severe allergic symptoms, depending on the amount released.

A) acetylcholine B) epinephrine C) histamine D) norepinephrine Answer: C Explanation: A) Acetylcholine, a neurotransmitter of the parasympathetic division of the nervous system is not involved in an allergic reaction.

B) Epinephrine, a neurotransmitter of the sympathetic division of the nervous system, is not involved in an allergic reaction.

D) Norepinephrine, a neurotransmitter of the sympathetic division of the nervous system, is not involved in an allergic reaction.

2

8) The measurement system for drug doses includes the minim, grain, scruple, and dram.

A) apothecary B) drops C) metric D) units Answer: A Explanation: B) Drops are a drug measurement, but are not one of the measurements of the apothecary system.

C) The metric measurement system does not include the minim, grain, scruple, and dram.

D) Units are a drug measurement, but are not one of the measurements of the apothecary system.

9) Which measurement system is officially known as the International System of Units (SI)?

A) apothecary B) drops C) metric D) units Answer: C Explanation: A) The apothecary system is not known by any other name.

B) The drops measurement is not a measurement system.

D) The unit measurement is not a measurement system.

10) When a cube is formed that is 1 centimeter long on each side, it becomes a measurement of volume that is abbreviated as .

A) cm B) mg C) kg D) cc Answer: D Explanation: A) The abbreviation cm means centimeter, a measure of length, not volume.

B) The abbreviation mg means milligram, a measure of weight, not volume.

C) The abbreviation kg means kilogram, a measure of weight, not volume.

D) Cubic centimeter is a measurement of volume.

11) The abbreviation used to designate the measurement of drops is A) cm B) gtt C) mEq D) mL Answer: B Explanation: A) The abbreviation cm stands for centimeter, not drops.

C) The abbreviation mEq stands for milliequivalent, not drops.

D) The abbreviation mL stands for milliliter, not drops.

3

.

12) Receptors are specifically designed to bind to 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) Enzymes are body substances that bind to receptors.

B) Hormones are body substances that bind to receptors.

C) Neurotransmitters are body substances that bind to receptors.

D) Antigens are foreign substances, not body substances.

13) An antagonist drug _ .

A) occupies but does not activate a receptor 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.

14) A common side effect of narcotic drugs used to treat severe pain is A) depression B) nausea and vomiting C) loss of hair D) constipation Answer: D Explanation: A) Narcotic drugs do not commonly cause depression.

B) Narcotic drugs do not commonly cause nausea and vomiting.

C) Narcotic drugs do not commonly cause loss of hair.

15) A milliequivalent is of an equivalent.

A) 1/100 B) 1/1,000 C) 1/100,000 D) 1/1,000,000,000 Answer: B Explanation: A) The combining form mill/i- means one thousand.

C) The combining form mill/i- means one thousand.

D) The combining form mill/i- means one thousand.

4

.

16) Which of the following is NOT one of the therapeutic effects of drugs?

A) controlling or improving disease symptoms B) diagnosing a disease C) changing the therapeutic index of a disease D) preventing a disease Answer: C Explanation: A) This IS a therapeutic effect of drugs.

B) This IS a a therapeutic effect of some drugs.

C) Diseases do not have a therapeutic index.

D) This IS a therapeutic effect of drugs.

17) The systemic effect of a drug is felt .

A) where the physician intended it to be felt B) throughout the body C) at the site of administration D) in a target organ Answer: B Explanation: A) A systemic effect is felt where the physician intended but also in other areas throughout the body.

C) A systemic effect is felt throughout the body.

D) A systemic effect is felt throughout the body.

18) 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 in response to an antigen, but it does not cause an allergic reaction itself.

C) Anaphylaxis is a severe allergic reaction, but it is not released.

19) When a drug has a narrow margin of safety between the correct dose and the toxic dose, that drug is said to have 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.

D) A drug with a narrow margin of safety would have a high (not low) level of adverse effects.

5

20) 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 an allergic reaction, not a drug.

B) An antagonist drug does not unlock a receptor.

C) A neurotransmitter is a body substance, not a drug.

.

21) 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.

22) Which system of drug measurement is used for nearly all drug doses?

A) apothecary B) household C) metric D) ratio Answer: C Explanation: A) The apothecary measurement system has been nearly discontinued.

B) Household measurement is not a system and is used only by people in their homes.

D) Ratio measurement is not a system and is only used for measuring some drugs.

23) An idiosyncratic drug reaction is .

A) based on the patient's genetic makeup B) a common side effect C) based on an allergic reaction D) all of the above Answer: A Explanation: B) An idiosyncratic drug reaction is not a common side effect.

C) An idiosyncratic drug reaction is not based on an allergic reaction.

D) Only one of the above statements is correct.

6

24) The therapeutic effect of a drug is usually exerted .

A) as a side effect B) toward a target organ C) as an adverse effect D) by the release of histamine Answer: B Explanation: A) The therapeutic effect is usually not a side effect.

C) The therapeutic effect of a drug is not an adverse effect.

D) An allergic reaction, not a therapeutic effect, releases histamine.

25) A drug-drug interaction in which two drugs combine to produce an effect greater than the independent effect of each 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 an interaction.

C) Anaphylaxis is a severe allergic reaction.

26) The drug that is measured in inches on a marked piece of applicator paper and used to treat angina pectoris is known as .

A) nitroglycerin ointment B) topical corticosteroid C) insulin D) Maalox Answer: A Explanation: B) Topical corticosteroid drugs are measured in percentages, not inches.

C) Insulin drugs are measured in units, not inches.

D) The antacid drug Maalox is measured in mL or cc, not inches.

27) All of the following are metric measurements, EXCEPT A) grain B) milligram C) cubic centimeter D) milliliter Answer: A Explanation: A) This is an apothecary system measurement.

B) Milligram is a metric measurement.

C) Milligram is a metric measurement.

D) Milliliter is a metric measurement.

7

.

28) Which of the following statements is TRUE? A) Household measurement of a drug using a tablespoon is accurate.

B) Insulin is measured in units.

C) Penicillin is measured in inches.

D) Electrolyte drugs are measured in ratios.

Answer: B Explanation: A) Household measurement is an inaccurate measurement.

C) The only drug measured in inches is nitroglycerin ointment.

D) Doses of electrolyte drugs are measured in milliequivalents.

29) 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.

D) Nothing by mouth is abbreviated as n.p.o. or NPO. 30) Nitroglycerin ointment is applied with specially marked paper that is measured in A) millimeters B) inches C) milligrams D) size of dose ordered Answer: B Explanation: A) The specially marked paper is measured in inches, not millimeters.

C) The specially marked paper used to measure nitroglycerin ointment is not measured in milligrams.

D) The size of the dose ordered is not specific enough.

31) Which type of drug listed below is NOT measured in units?

A) insulin B) vitamins C) penicillin D) vitamin Answer: B Explanation: A) All insulin drugs are measured in units.

B) Vitamins are measured in International Units.

C) Some penicillins are measured in units.

D) Some vitamins are measured in units.

8

.

32) Pilot Mark Adams is flying a plane today, but his fall allergy symptoms 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) 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.

D) This is true, but it is not the most important fact he needs to know.

33) The same drug given by a different route can exert either a local or a systemic effect. An example of this is .

A) topical Benadryl that relieves skin itching and oral Benadryl that 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 that is gargled for anesthesia in the mouth and intravenous lidocaine that is used to treat cardiac arrhythmias D) A and C Answer: D Explanation: A) This is true, but it is noN tU thReSoIN nlGyTcBo.CrrOeM ct answer.

B) This is true, but it does not relate to the question of local and systemic effects.

C) This is true, but it is not the only correct answer.

34) 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) enzymes 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.

9

35) 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) Cholinergic and adrenergic are two different types of receptors.

C) This is a true statement.

D) This is a true statement.

36) 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.

37) Toxic effects are more common in elderly 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.

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.

38) When toxic effects occur, the physician 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.

10

.

39) The antibiotic drugs gentamicin and kanamycin are known to exert toxic effects 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 and kanamycin are not known to cause liver toxicity.

C) Ot/o- means ear.

D) Gentamicin and kanamycin are not known to cause brain toxicity.

40) 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.

41) When the antibiotic drug tetracycline is taken with an antacid, these two drugs A) form an insoluble compound that preN veUnRtsSIaNtGhTeBra.CpO euMtic effect B) cause a side effect of severe diarrhea C) produce an allergic reaction with each other D) have synergism and an increased therapeutic effect of each drug Answer: A Explanation: 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 not an example of synergy.

.

42) 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) Meat can be eaten by patients taking an MAO inhibitor drug.

D) Alcohol should be avoided by patients taking an MAO inhibitor drug.

11

43) A drug error can occur because one of the "seven rights of drug administration" is 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: 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.

44) 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.

D) Chemotherapy drugs, not pediatric drugs, are calculated on the basis of total body surface area.

45) The opposite of drug-drug antagonism is .

A) allergy B) otoxicity C) chronotherapy D) synergism Answer: D Explanation: A) Allergy is not related to drug antagonism.

B) This is a toxic drug reaction, but not the opposite of anything.

C) This does not involve two drugs.

46) Pharmacodynamics is the mechanism by which drugs produce their effects (desired or undesired) based on .

A) time B) knowledge C) dose D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) Knowledge is not the mechanism by which drugs produce their effects.

C) This is true, but it is not the only correct answer.

12

47) 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.

48) The side effects of anticholinergic drugs are remembered with the abbreviations ABCD. The D stands for .

A) drug B) diarrhea C) dry mouth D) depression Answer: C Explanation: A) A drug is not a side effect.

B) The D does not stand for diarrhea.

D) The D does not stand for depression.

49) A black box warning in the drug's package insert is used to call attention to A) side effects B) fatal adverse reactions C) antagonism D) all of the above Answer: B Explanation: A) The black box warning is not for side effects.

C) The black box warning is not for antagonism.

D) Only one of the answers is correct.

50) Which of the following is an example of a paradoxical drug effect?

A) pollen and antibodies combine to produce an allergy B) antibiotic drug producing ototoxicity C) a drug for irritable bowel being taken off the market D) amphetamine stimulant drugs used to decrease hyperactivity in children Answer: D Explanation: A) This is an example of an allergic reaction.

B) This is an example of a toxic effect.

C) This is not a paradoxical drug effect.

13

.

51) The metric system was officially endorsed as the exclusive system for drug measurement in the U.S. by the .

A) Food and Drug Administration B) International System of Units C) American Medical Association D) all of the above Answer: C Explanation: A) The FDA did not endorse the metric system.

B) This is a system of measurement itself.

D) There is only one correct answer.

52) Which of the following is NOT a type of drug measurement?

A) milliequivalent B) pharmacotherapy C) ratio D) inch Answer: B Explanation: A) This IS a type of drug measurement.

B) This is a knowledge of drugs, not a measurement.

C) This IS a type of drug measurement.

D) This IS a type of drug measurement.

53) "Tall Man" letters (capital letters within drug names) are used to NG A) distinguish it from other look-alike drNuUgRnSaIm eTs B.COM B) call attention to possible side effects C) tell which drug company produced the drug D) all of the above Answer: A Explanation: 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.

54) The doses for chemotherapy drugs .

A) are based on the patient's total body surface area B) are customized to maximize effectiveness while minimizing side effects C) are expressed as mg/m2 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.

14

.

5.2 True/False Questions 1) 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.

2) All drugs have a target organ where they exert their effect.

Answer: FALSE Explanation: the therapeutic effect is not always directed to a target organ.

3) An adverse effect is a type of severe side effect.

Answer: TRUE 4) An allergic reaction is a type of side effect caused by the release of histamine.

Answer: TRUE 5) 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 6) One drug can act as a master key to unlock several different receptors in different organs.

Answer: TRUE 7) Most drugs are associated with at least one or two side effects (sometimes more) that arefrequently observed after administration.

Answer: TRUE 8) Once a drug is approved by the FDA and on the market, its advertisements, informational literature, prescribing information, and package inserts for the drug must list the side effects.

Answer: TRUE 9) Once a drug has been approved by the FDA, if there are reports of severe adverse effects, the drug cannot be taken off the market.

Answer: FALSE Explanation: The FDA can take the drug off the market.

10) Physicians, pharmacists, and the DEA can report adverse drug effects to the FDA. Answer: FALSE Explanation: Physicians and pharmacists can report adverse drug effect; the DEA does not.

11) 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

15

12) 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.

13) A patient who is allergic to one drug can safely take other drugs belonging to that drug group.

Answer: FALSE Explanation: Other drugs in that group have a similar molecular structure.

14) Certain ethnic groups, such as those of Asian, Jewish, and African descent, have well-known idiosyncratic reactions to certain drugs.

Answer: TRUE 15) When administered simultaneously, some drugs interact with each other in a particular way that either accentuates or diminishes the action of each.

Answer: TRUE 16) Drugs given by weight are measured in kilograms, milligrams, and micrograms.

Answer: FALSE Explanation: Kilograms are used to measure the patient's weight. Milligrams and micrograms are for drug doses.

17) The standard adult drug dose can be NgU ivReSnINtoGaTlBl .aCdOuMlts, including elderly, very thin, or very obese patients.

Answer: FALSE Explanation: The standard adult dose is appropriate for most adults.

18) The way to optimize the therapeutic effect of a drug and minimize the occurrence of adverse or toxic effects is to take the drug exactly as prescribed.

Answer: TRUE 19) An allergic reaction to a drug will only 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.

20) Drugs given intravenously exert a systemic effect.

Answer: TRUE 21) A drug used to treat severe cystic acne has been associated with the adverse effect of suicide.

Answer: TRUE 22) Severe side effects are also known as adverse effects.

Answer: TRUE

16

23) When antibiotic drugs are prescribed, their therapeutic effect is directed toward a target organ.

Answer: FALSE Explanation: Their therapeutic effect is towards bacteria.

24) One milliliter (mL) and one cubic centimeter (cc) can be used interchangeably as measurements of drug doses.

Answer: TRUE 25) Drugs given subcutaneously exert either a local or a systemic effect, depending on the type of drug.

Answer: TRUE 26) 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.

27) 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.

28) The knowledge and use of drugs to produce a therapeutic effect in the body is known as pharmacotherapy.

Answer: TRUE 29) Chemically similar drugs can unlock and activate the same receptor.

Answer: TRUE 30) Muscarinic and nicotinic are two types of cholinergic receptors.

Answer: TRUE 31) Drugs that block H2 receptors in the stomach are used to decrease acid production.

Answer: TRUE 32) Drugs taken orally usually exert a local effect.

Answer: FALSE Explanation: Oral drugs exert a systemic effect.

33) Drugs that have been widely used over a long period of time have remained on the market because they never have any side effects.

Answer: FALSE Explanation: Aspirin is one of the oldest and most widely used drugs but it can cause serious side effects.

34) An adverse effect may become apparent only after a drug has been on the market for some time and prescribed to large numbers of patients.

Answer: TRUE 17

35) It is the FDA that tells a drug company when they must put a black box warning in their drug's literature, package inserts, and advertisements.

Answer: TRUE 36) 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 37) A patient who is taking a prescription drug and an herbal supplement would not experience a drug-drug interaction.

Answer: FALSE Explanation: Herbal supplements can cause a drug-drug interaction.

38) Polypharmacy increases the chances of having a drug-drug interaction.

Answer: TRUE 39) Doses in the metric system are usually expressed in fractions.

Answer: FALSE Explanation: Doses in the metric system are never expressed in fractions.

40) The exact value of a unit varies from drug to drug.

Answer: TRUE 41) Only after a drug is actually administered to the patient can the healthcare professional document that in the patient's medical record.

Answer: TRUE 42) If a healthcare professional followed the seven rights of drug administration, it is acceptable practice for another person to actually give the drug.

Answer: FALSE Explanation: Never administer a drug prepared by another person.

43) Chronotherapy tries to coordinate giving a drug with the patient's own biological rhythms.

Answer: TRUE 5.3 Short Answer Questions 1) Drug effects are initiated through of every cell.

Answer: receptors

, protein molecules located on the cell membranes

2) Some drugs bind to a certain receptor but cannot actually unlock or activate the receptor to produce an effect. These drugs are known as drugs or blocker drugs.

Answer: antagonist

18

3) The most severe symptoms of an allergic reaction are collectively known as can lead to a type of shock.

Answer: anaphylaxis

, which

4) A drug is a type of drug reaction that is not a side effect and is not based on an allergic reaction. It is an individual's unique reaction to a drug and it differs from side effects commonly associated with that drug.

Answer: idiosyncrasy 5) occurs when two drugs combine to produce an effect that is greater than the independent effect of each drug.

Answer: Synergism 6) occurs when two drugs combine to produce an effect that is less than the intended effect for either drug.

Answer: Antagonism 7) The therapeutic effect of a drug can be directed toward the specific area of the body that has the disease, which would be toward a _ in a patient with congestive heart failure.

Answer: target organ 8) When a drug with a low (a narrow margin of safety between the therapeutic dose and the toxic dose) is administered, it is not uncommon to see toxic symptoms.

Answer: therapeutic index 9) An allergy is a reaction that occurs when the body's immune system identifies a foreign substance such as drug (known as an ) and initiates an antibody response against it.

Answer: antigen 10) is the study of how the genetic makeup of different people affects their response to certain drugs.

Answer: Pharmacogenetics 11) An drug acts like a key and unlocks and activates a receptor, which is like the lock.

Answer: agonist 12) Drugs that block H1 receptors are known as _ Answer: antihistamine

drugs.

13) Drugs like nasal sprays and topical creams and ointments usually exert only a effect.

Answer: local

drug

14) The FDA usually does not take a drug used to treat cancer off the market because of side effects, because the cancer is a life-threatening condition.

Answer: chemotherapy 19

15) ADR stands for .

Answer: adverse drug reaction 16) The antibiotic drug ciprofloxacin can cause the unusual adverse reaction of rupture.

Answer: tendon 17) Patients taking cholesterol-lowering drugs, such as Lipitor, Mevacor, and Zocor, need to have period function tests done.

Answer: liver 18) is a toxic effect on the kidneys that is caused by the antibiotic drugs gentamicin and kanamycin.

Answer: Nephrotoxicity 19) In the hospital, allergic patients are given an allergy alert Answer: bracelet

to wear.

20) A patient who develops malignant hyperthermia is an example of a drug Answer: idiosyncrasy

.

21) One way to prevent drug-drug and drug-food interactions is to have the pharmacist do a profile for the patient.

Answer: medication 22) is when a patient takes more than one drug on a daily basis.

Answer: Polypharmacy 23) The applies warning labels to the prescription bottle to warn the patient of possible drug-drug interactions.

Answer: pharmacist 24) Some antihistamine drugs cannot be taken with arrhythmia.

Answer: grapefruit juice

because they cause a heart

25) Most drug doses in the United States are measured in the Answer: metric

system.

26) A small ceramic or stone bowl and a rod that are used to grind ingredients into drugs are known as a and .

Answer: mortar, pestle 27) A dose of insulin is always measured in Answer: units

.

20

28) Drug doses that are given more frequently than prescribed can result in a level.

Answer: toxic 5.4 Matching Questions Group A Match the measurement systems with the drug example.

A) electrolyte solution B) eye and ear medications C) nitroglycerin ointment D) insulin E) corticosteroid ointments 1) drops 2) inches 3) milliequivalent 4) percentage 5) units Answers: 1) B 2) C 3) A 4) E 5) D Group B Match the abbreviations in Column 1 with their definitions in Column 2.

A) every day B) before meals C) at bedtime D) three times a day E) as needed 6) a.c.

7) h.s.

8) p.r.n.

9) q.d.

10) t.i.d.

Answers: 6) B 7) C 8) E 9) A 10) D 21

drug

5.5 Essay Questions 1) 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.

2) 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 significant drowsiness. This side effect is undesirable, particularly in patients who must drive or operate machinery. However, this side effect of drowsiness can be utilized as the therapeutic effect when an antihistamine drug is incorporated into a drug that is used to treat insomnia. Because of this use, antihistamine drugs are a common ingredient in over-the-counter sleep aids.

3) Some side effects of a drug are common. For the two body systems and one drug category listed here, give common side effect associated with each: the gastrointestinal system, the central nervous system, chemotherapy drugs.

Answer: Common gastrointestinal side effects of many drugs include anorexia (lack of appetite), nausea, vomiting, or diarrhea. Common central nervous system drug side effects include drowsiness, excitement, and depression. Common side effects of chemotherapy drugs include nausea, vomiting, chills, fever, loss of haNirU, RaSnIdNG deTpBr.eCsOsiMon of the bone marrow.

4) Discuss what can happen and why when a patient drinks grapefruit juice when taking a "statin" drug.

Answer: Grapefruit juice blocks an enzyme in the intestine that normally breaks down part of the "statin" drug dose before it even enters the blood, and so a much greater amount of the active drug enters the blood; this can produce a toxic effect with a blood level of the "statin" drug that is 15 times higher than the therapeutic dose.

5) 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.

6) 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 or shelf in the medication room, as it is being poured or placed in a paper cup, and before giving it to the patient.

22

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 6 The Prescription 6.1 Multiple-Choice Questions 1) A prescription is handwritten by the physician on a single preprinted sheet.

A) computerized B) electronic C) verbal D) written Answer: D Explanation: A) A computerized prescription is done on the computer, not handwritten.

B) Electronic prescriptions are generated by the computer.

C) Verbal prescriptions are not handwritten; they are given over the telephone.

2) Which type of prescription is typed into the medical office's computer system, a copy printed out, and then signed by the physician and given to the patient?

A) computerized B) electronic C) verbal D) written Answer: A Explanation: B) Electronic prescriptions are generated by a computer, but are not signed by the physician; an electronic signature is autoNmUaRtiScIaNlG lyTiBm.CpOriM nted on the bottom of the prescription.

C) Verbal prescriptions are not typed into a medical office's computer system, but are provided over the telephone or in person.

D) Written prescriptions are not typed into the medical office's computer system, but are handwritten.

3) Which type of prescription is generated by a computer and not signed by the physician?

A) computerized B) electronic C) verbal D) written Answer: B Explanation: A) Computerized prescriptions are printed out and signed by the physician.

C) Verbal prescriptions are not generated by a computer.

D) Written prescriptions are signed by the physician and are not generated by a computer.

1

4) A pharmacist can fill a prescription without having it on a prescription form and without a physician's signature for which of the following types of drugs?

A) drugs that are not controlled substances B) Schedule I drugs C) Schedule II drugs D) Schedule III drugs Answer: A Explanation: B) Schedule I drugs are illegal to prescribe.

C) Schedule II drugs are controlled substances and require a written and signed prescription.

D) Schedule III drugs are controlled substances and require a written and signed prescription.

5) What is the name given to a group of specific orders that are preprinted on a hospital's physician's order sheet? They often pertain to a protocol of treatment related to a specific disease or surgical procedure.

A) automatic stop orders B) medication orders C) standing orders D) verbal orders Answer: C Explanation: A) Automatic stop orders originate from the hospital pharmacy and are not preprinted on the physician's order sheet.

B) Medication orders are individually written on the physician's order sheet, not preprinted as a group.

D) Verbal orders are orders given verbalNlyU, RnSoItNpGrTepBr.CinOteMd as group on the physician's order sheet.

6) What type of order does not originate with the physician, but with the hospital pharmacy?

A) automatic stop orders B) medication orders C) standing orders D) verbal orders Answer: A Explanation: B) Medication orders originate with the physician.

C) Standing orders originate with the physician.

D) Verbal orders originate with the physician.

7) Prescriptions for most drugs (except schedule drugs) are valid for how long from the date on the prescription form?

A) seven days B) three months C) six months D) varies from state to state Answer: D Explanation: A) This is not correct.

B) This is not correct.

C) This is not correct.

2

8) Prescriptions for Schedule III through Schedule V drugs are valid for how long from the date on the prescription form?

A) seven days B) three months C) varies from state to state D) one year Answer: C Explanation: A) This is not correct.

B) This is not correct.

D) This is not correct.

9) Prescriptions for Schedule II drugs are valid for how long from the date on the prescription form?

A) varies from state to state B) three months C) six months D) one year Answer: A Explanation: B) This is not correct.

C) This is not correct.

D) This is not correct.

10) Which of the following is NOT used when writing a drug name on a prescription?

A) abbreviation B) chemical name C) generic name D) trade name Answer: B Explanation: A) While abbreviations of drug names should be avoided because they can be misread, they can be used.

C) The generic name is often used when writing the drug's name on a prescription.

D) The trade name is often used when writing the drug's name on a prescription.

11) Which of the following is NOT one of the things included in the directions for use that appears on a prescription?

A) the amount of the dose B) the drug form C) the frequency of the dose D) the route of administration Answer: B Explanation: A) The amount of the dose is included in the directions, such as take two tablets before bedtime.

B) This is on the prescription form, but it is not directions for use.

C) The frequency of the dose is included in the directions, such as take one tablet three times a day.

D) The route of administration is included in the direction, such as take one tablet by mouth.

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12) 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.

13) 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) is NOT included on the preprinted form. It is written in by the physician.

C) This is preprinted on the prescription form.

D) This is preprinted on the prescription form.

14) Nonprescription (over-the-counter) dNrU ugRsSINGTB.COM 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: 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.

15) Several ethical concerns have been raised about online pharmacies that offer "prescription drugs without a prescription." Which of the following statements is NOT one of the ethical concerns about these types of online pharmacies.

A) These pharmacies do not carry all types of drugs.

B) These pharmacies are an easy source of drugs for addicts.

C) Some of the drugs could come from foreign countries with poor quality control.

D) The patient is not actually examined by a physician before being given a prescription.

Answer: A Explanation: B) This IS one of the ethical concerns.

C) This IS one of the ethical concerns.

D) This IS one of the ethical concerns.

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16) Which type of medication order is carried out before a physician'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.

D) A written order is carried out after it has been signed.

17) A legitimate Internet pharmacy A) advertises that it will provide prescription drugs without a prescription B) can be an easy source of drugs for an addict C) calls the doctor to verify the validity of a prescription before filling it D) all of the above Answer: C Explanation: A) An unscrupulous Internet pharmacy, not a legitimate one, will provide prescription drugs without a prescription.

B) An unscrupulous Internet pharmacy, not a legitimate one, is an easy source of drugs for an addict.

D) There is only one correct answer.

18) 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: D Explanation: A) A physician or dentist can write a prescription.

B) podiatrist or optometrist can write a prescription.

D) A physician's assistant or nurse practitioner can write a prescription.

19) A prescription form is used to convey to a written record of a physician's order of a drug for a patient.

A) another physician B) the pharmacist C) the patient D) none of the above Answer: B Explanation: A) the physician does not write a prescription to another physician.

C) the physician does not write a prescription to the patient, but for the patient.

D) One of these answers is correct.

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20) 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) physician's signature C) patient's age and weight D) the unique Rx number Answer: A Explanation: B) the physician's 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 in the prescription or medication order.

21) Official prescription forms used to prescribe Schedule II drugs already have all of the following security features, EXCEPT .

A) an imprinted seal B) the physician's DEA number C) a control number D) thermochromatic ink Answer: B Explanation: A) official prescription forms for schedule drugs DO have an imprinted seal.

B) This is not already on the form; it is added by the physician.

C) official prescription forms for schedule drugs DO have a control number.

D) official prescription forms for schedule drugs DO use thermochromatic ink.

22) If a handwritten prescription was photocopied, and the word "VOID" became visible on the photocopy, this would tell you that the prescription was .

A) not valid B) for an over-the-counter drug C) expired and would not be filled by the pharmacist D) an unauthorized photocopy of an official prescription form for a Schedule II drug Answer: D Explanation: A) This is not true statement.

B) Physicians do not write prescriptions for over-the-counter drugs as they can be purchased without a prescription.

C) This is not a true statement.

23) To obtain a refill of a prescription drug, the patient must .

A) rewrite the prescription B) provide the pharmacy with the unique Rx number C) seek information and counseling from the pharmacist D) request a childproof safety cap Answer: B Explanation: A) The patient cannot write or rewrite a prescription.

C) Pharmacists provide information and counseling, but this is required before refilling a prescription.

D) The pharmacist may offer a childproof cap, but it is not required before getting a refill of the prescription.

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24) According to the National Association of Chain Drug Stores, many seniors are because of expensive drug costs.

A) relying on their primary care physician to give them drug samples B) cutting down on the frequency of drug doses C) doing without their drugs 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.

25) Which of the following are ways to prevent the theft of prescription pads?

A) Store extra pads in a locked drawer.

B) The physician should not sign the prescription form until he/she writes the prescription.

C) The physician should carry the prescription pad with him/her.

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.

26) For a patient seen in a physician's office, the prescription shows the quantity of the drug that is to be dispensed, and that total number equals the length of treatment multiplied by the .

A) number of doses to be taken each day B) the number of hospital days C) the patient's weight D) the DEA number Answer: A Explanation: B) This patient is not in the hospital.

C) The patient's weight does not affect this.

D) The DEA number is a federal physician number for prescribing drugs.

27) When a prescription includes Latin abbreviations, these are _ A) placed on the label of the prescription bottle.

B) translated by the physician before he writes the prescription C) translated by the pharmacist into English D) all of the above Answer: C Explanation: A) These are not placed on the label.

B) These are not translated, and they do appear on the prescription.

D) There is only one correct answer.

7

.

28) 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) This is a list of approved drugs, not a type of pharmacy.

.

29) is particularly useful to remote locations where there is no local pharmacy.

A) Pharmacoinformatics B) Pill imaging technology C) Telepharmacy D) all of the above Answer: C Explanation: A) This is using a computerized database that is useful in any location.

B) This creates a full-color image of a drug and is useful in any location.

D) There is only correct answer.

30) Medication therapy management .

A) helps manage a patient's drug therapy B) facilitates communication between thNe UpRhSyIsNicGiaTnB,.CpOhM armacist, 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.

31) Who pays the pharmacist when he/she performs medication therapy management?

A) Food and Drug Administration B) Patient Protection and Affordable Care Act C) Drug Enforcement Agency D) pharmacoinformatics Answer: B Explanation: A) The FDA does not pay for medication therapy management.

C) The DEA does not pay for medication therapy management.

D) This is a computer system, not a payment system.

8

32) Which of the following statements is TRUE? A) Unused drugs can be flushed down the toilet.

B) Unused narcotic drugs can be taken to a hospital emergency room.

C) Mixing unused drugs with kitty liter or coffee-grounds is a good way to dispose of them.

D) Pharmacies will not accept unused drugs that need to be disposed of.

Answer: C Explanation: A) They should not be flushed as they go into the ground water.

B) Hospitals do not dispose of unused narcotic drugs.

D) Most pharmacies will accept unused drugs.

6.2 True/False Questions 1) 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.

2) Some unscrupulous Internet pharmacies obtain their drugs from foreign countries where the quality and purity of the drugs may be compromised.

Answer: TRUE 3) All states have passed laws that say that a physician must write a prescription that is legible and can be read.

Answer: FALSE B..COM Explanation: Only some states have pasN seUdRtShIaNtGlaTw 4) The hospital's Pharmacy Committee decides how many days any medication order for a scheduled drug will continue to be filled until the pharmacy automatically stops it.

Answer: TRUE 5) The use of generic rather than trade name drugs can result in considerable savings to consumers.

Answer: TRUE 6) Prescriptions for controlled substances require the physician's DEA number.

Answer: TRUE 7) Handwritten prescriptions can be written in ink or pencil, as long as they are legible.

Answer: FALSE Explanation: They must be written in ink.

8) 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.

9) Childproof caps were introduced in 1984 as a public safety measure.

Answer: TRUE 9

10) When a hospital patient is discharged home, the attending physician at the hospital provides individual prescriptions that the patient can take to a local pharmacy to be filled.

Answer: TRUE 11) 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.

12) No physician is allowed to write a medication order for a hospital patient unless he/she is already an approved member of the hospital's medical staff.

Answer: TRUE 13) For the sake of convenience for patients in severe pain, the physician should pre-sign some blank prescription forms ahead of time for a schedule drug.

Answer: FALSE Explanation: It is against federal law for a physician to pre-sign blank prescription forms for a schedule drug.

14) On a medication order screen on the computer for a patient in the hospital, the physician must enter both the date and the time of drug orders.

Answer: FALSE Explanation: Date and time are automatically added by the computer.

15) Most prescription forms come with aNlUaR rgSeINpGreTpBr.iCnOteMd Rx just to the left of the area where the prescription itself will be handwritten.

Answer: TRUE 16) Writing an abbreviation of a drug name on a prescription form or physician's order sheet is common and saves time and avoids confusion.

Answer: FALSE Explanation: Abbreviations of drug names are avoided because they may be misread.

17) One advantage of a computerized or an electronic prescription is that the prescription can be faxed directly to the pharmacy.

Answer: TRUE 18) The DEA number consists of 9 characters, the first two of which are A, B, or C for physicians and M for other practitioners.

Answer: TRUE 19) Prescriptions written for prescription drugs require that the physician include his/her DEA number.

Answer: FALSE Explanation: Prescriptions for drugs that are not controlled substances do not require the physician's DEA number.

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20) If a prescription is filled by a pharmacy technician, it must then be checked for accuracy by a pharmacist.

Answer: TRUE 21) The hospital pharmacist will dispense the generic equivalent of a drug unless the physician specifically requests the trade name.

Answer: TRUE 22) A prescription is a medicolegal document. It contains medical information and it can be used as evidence in a court of law.

Answer: TRUE 23) The physician's name (and/or the name of the medical group), office address, and phone number are preprinted on both prescription forms in the office and on the physician's order sheets in the hospital.

Answer: FALSE Explanation: These are on the prescriptions forms in the office but are not on physician's order sheets in the hospital.

24) The patient's first and last name are handwritten or typed on a physician's order sheet in the hospital.

Answer: FALSE Explanation: Patient identifying information automatically appears on the computer screen with the physician's order sheet.

25) The abbreviation Rx is printed on both the prescription form and on the physician's order sheet.

Answer: FALSE Explanation: A large Rx appears on the prescription form but never on the physician's order sheet in the hospital.

26) Even though a prescription is submitted by the patient to the pharmacy to be filled, the prescription itself remains the property of the prescribing physician.

Answer: FALSE Explanation: Once submitted to the pharmacy, the prescription becomes the property of the pharmacy.

27) 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 28) Verbal orders for a patient in the hospital can be given over the phone to a licensed nurse.

Since the order is verbal, the nurse does not need to write or type it on the physician's order sheet.

Answer: FALSE Explanation: The nurse does need to write or type the drug order on the physician's order sheet.

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29) 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 30) In the past, prescriptions were actually recipes listing several ingredients to be crushed and mixed by the pharmacist before dispensing.

Answer: TRUE 31) 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 32) In some large hospitals, pharmacy technicians are the ones who verify the drug and the dose that was prescribed, fill the prescription, and send it to the patient, without needing the help of the pharmacist.

Answer: FALSE Explanation: The filled prescription is always checked for accuracy by a pharmacist.

33) Legitimate Internet pharmacies have a seal on the home page of their Website that says "Verified Internet Pharmacy Provider Site."

Answer: TRUE 34) It is not uncommon for people to steal prescriptions pads from a physician's office.

Answer: TRUE 35) A weekend might be an example of when the physician would need to give a verbal prescription over the telephone to the pharmacist.

Answer: TRUE 36) Some drugs come in several different drug forms, and so the exact drug form must be specified on the prescription or medication order.

Answer: TRUE 37) When a physician writes a medication order on the physician's order sheet in the hospital, he/she signs his/her name directly below the last order, not at the bottom of the page.

Answer: TRUE 38) No refills are permitted for Schedule II drugs.

Answer: TRUE 39) For a patient in the hospital, the physician does not tell the pharmacy how many times to refill the prescription.

Answer: TRUE 40) The cost of prescription drugs has been a major factor in rising healthcare costs.

Answer: TRUE 12

41) When a drug has been approved by the FDA to treat a specific disease, the physician cannot prescribe it to treat a different disease.

Answer: FALSE Explanation: The physician can do this; it is known as off-label use.

42) An outpatient pharmacy is also known as an ambulatory pharmacy.

Answer: TRUE 43) A compounding pharmacy is a business that prepares, mixes, and packages drug ingredients under sterile conditions.

Answer: TRUE 44) The FDA says that it is illegal to import drugs from another country into the United States for personal use.

Answer: TRUE 45) One of the jobs of the pharmacist working in the hospital is to consult with physicians on site about the patient's care.

Answer: TRUE 46) The medicine cabinet in the bathroom is a good place to store drugs.

Answer: FALSE URoSisIN Explanation: The bathroom has heat andNm tuGreTBth.CaO t cMan break down drugs.

47) In general, there are fewer prescriptions written for generic drugs now than were written in 2012.

Answer: FALSE Explanation: There are more prescriptions for generic drugs now.

6.3 Short Answer Questions 1) A is a handwritten, computerized, electronic, or verbal order from a physician (or other qualified healthcare provider) to a pharmacist, giving instructions as to how to dispense a drug to a specific patient who has been diagnosed with a condition that requires drug therapy.

Answer: prescription 2) A 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) When a licensed nurse receives this type of order, they write it in the chart and mark it as a V.O. The abbreviation V.O. stands for .

Answer: verbal order 4) The etiology of the word Answer: prescription

comes from a Latin word meaning a written order.

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5) The abbreviation Rx stands for the Latin word recipere, meaning Answer: to take

.

6) The abbreviation Sig. stands for the Latin word signetur, meaning Answer: write on the label 7) The abbreviation NR on a prescription form stands for Answer: no refills

.

.

8) 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 9) Verbal orders are also known as Answer: telephone orders

.

10) contain common orders that are the same for any patient who has that specific disease or is scheduled for that surgical procedure.

Answer: standing orders 11) Define these abbreviations.

CPOE DAW DEA Disp.

ERx MAR MTM NR V.O. Answer: computerized physician order entry; dispense as written; Drug Enforcement Agency; dispense; e-prescribing (or electronic prescribing); medication administration record; medication therapy management; no refills; voice order 12) The use of computerized physician order entry has reduced drug errors related to handwriting.

Answer: illegible 13) When a pharmacist cannot read a physician's handwritten prescription, the pharmacist should the physician.

Answer: call 14) When the physician's electronic signature is automatically imprinted at the bottom of a prescription, this is known as prescribing, and is abbreviated as _ .

Answer: electronic, eRx 14

15) A immediately.

Answer: stat

order means that the physician wants the drug to be dispensed and administered

16) No physician is permitted to write medication orders for a patient in the hospital unless he/she is already an approved member of the hospital's medical .

Answer: staff 17) Some insurance plans mandate that the pharmacist fill each prescription with a drug.

Answer: generic 18) A drug is a list of all of the drugs that are approved for use in a hospital or by an insurance company.

Answer: formulary 19) A hospital pharmacy is also known as a/an Answer: inpatient

pharmacy.

20) A large hospital may have a large central pharmacy as well as several smaller pharmacies.

Answer: satellite 21) The use of a computerized database N toUsRtoSIrN e GdTruBg.CiOnfMormation and automate its retrieval when need is known as .

Answer: pharmacoinformatics 22) The Consumer Products Safety Commission note that there are no "childproof" caps for drugs, only "child " caps.

Answer: resistant 23) A medication therapy management comprehensive review of all of a patient's medications is done or as needed for patient's with complex medical issues.

Answer: annually

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6.4 Matching Questions Match the type of information in Column 1 with the place where that information appears in Column 2.

A) appears only on a physician's order sheet B) appears on both a prescription and on a physician's order form C) appears only on a prescription form 1) date of the order 2) DEA number 3) drug form 4) preprinted identifying information about the prescriber 5) quantity to be dispensed 6) physician's signature 7) preprinted identifying information about the patient 8) abbreviation Rx Answers: 1) B 2) C 3) B 4) C 5) C 6) B 7) A 8) C 6.5 Essay Questions 1) A patient's age and weight are sometimes (but not always) included on a prescription form.

Explain why this information might be useful to include.

Answer: Age is more important when the patient is a child. Prescriptions for children who are younger than 5 years of age should give an accurate age in years and months. It is mandatory to include the age of the patient in any prescription written for a Schedule II drug. The doses of some drugs may need to be adjusted if an adult patient's weight is very low or very high.

2) When a physician orders a drug's strength, there is limitation as to what can be written in the order. Describe what that limitation is, giving an example to justify your explanation.

Answer: The physician 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 physician cannot write a prescription for an 80 mg tablet. However, if the drug is manufactured as a scored tablet, the physician can write a prescription for exactly one-half of the amount in one tablet.

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3) There are several different ways that a physician can specify that he/wants a trade name drug rather than a generic equivalent to be dispensed. Give examples of two ways in which this can be done.

Answer: If the physician wants the prescription filled with a trade name drug, he/she must specifically indicate that either by writing or typing the trade name and checking a preprinted box that says "dispense as written" ("DAW") or by writing or checking a box for "No substitution" or "Do not substitute" or "Brand Necessary" or "Brand Medically Necessary."

4) Why is the abbreviation Rx NOT preprinted on physician order sheets?

Answer: The Rx abbreviation is not on a medication order sheet because that sheet is used to order other types of treatments and services (example: physical therapy, social services) in addition to drugs.

5) Describe four ways to prevent the theft of prescription pads from the medical office.

Answer: Store extra prescription pads in a locked drawer or closet. Have the physician carry just one prescription pad on his/her person from examining room to examining room. Never leave a prescription pad on the counter or in an unlocked drawer in the examining room. The physician should sign the prescription form only at the time he/she writes the prescription.

6) Explain why many physicians prefer to prescribe a trade name drug for certain drugs rather than the generic equivalent, even though the generic equivalent costs less for the patient.

Answer: Many physicians prefer to rely on the proven therapeutic effect of a trade name drug.

7) Describe what happens to a patient's dNrU ugRsSIwNhGeTnBt.hCeOM patient is discharged from the hospital to another healthcare facility, such as a nursing home.

Answer: If the patient is discharged to another healthcare facility (such as a nursing home), the physician lists all of the patient's drugs in the discharge summary. The discharge summary is faxed to the other healthcare facility, and the attending physician at that facility must reorder the patient's drugs.

17

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 7 Urinary Drugs 7.1 Multiple-Choice Questions 1) When the blood levels of sodium and potassium are sufficient, .

A) not much is excreted in the urine because sodium and potassium need to be conserved B) the kidney stops filtering sodium and potassium 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, sodium and potassium do not need to be conserved.

B) The kidneys continuously filter the circulating blood.

D) If the levels are sufficient, the kidney does not need to 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 actioNnUoRfSdINiuGrTetBi.cCdOrM ugs.

D) This is a normal process, not the action of diuretic drugs.

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) An antibiotic drug, not a diuretic drug is used treat an infection.

1

4) The drugs chlorothiazide (Diuril), hydrochlorothiazide (HCTZ, Microzide), and metolazone (Zaroxolyn) are examples of which category of diuretic drugs?

A) carbonic anhydrase diuretic drugs B) loop diuretic drugs C) osmotic diuretic drugs D) thiazide diuretic drugs Answer: D Explanation: A) These drugs are not carbonic anhydrase diuretic drugs.

B) These drugs are not loop diuretic drugs.

C) These drugs are not osmotic 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) These drugs are not carbonic anhydrase inhibitor 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/an .

NiGthTB A) carbonic anhydrase inhibitor diureticNdUruRgSIw a.C poOtM assium supplement B) loop diuretic drug with a folic acid antagonist drug C) antispasmodic drug with an antibiotic drug D) thiazide diuretic drug with a potassium-sparing diuretic drug Answer: D Explanation: A) Potassium supplement is not a diuretic drug.

B) Folic acid antagonist drug is not a diuretic drug.

C) Neither of these is a diuretic drug.

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: 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.

2

8) 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 D) all of the above Answer: A Explanation: B) Alpha1-receptor blocker drugs are used to treat benign prostatic hypertrophy (BPH), not overactive bladder.

C) The PDE5 enzyme is inhibited by drugs that are used to treat erectile dysfunction, 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) flouroquinolone anti-infective drugs C) thiazide and loop diuretic drugs 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.

D) These drugs "spare" potassium and so potassium chloride drugs are not needed. .COM 10) Which of the following categories ofNdUrRuSgIsNiGs TNBO T taken orally?

A) androgen inhibitor drugs B) potassium chloride drugs C) PDE5 inhibitor drugs D) prostaglandin E1 drugs Answer: D Explanation: A) Androgen inhibitor drugs are taken orally.

B) Potassium chloride drugs are taken orally.

C) PDE5 inhibitor drugs are taken orally.

D) These drugs are either injected into the penis or inserted into the urethra.

11) All of the following types of drugs belong to the category of diuretic drugs, EXCEPT .

A) androgen inhibitor B) thiazide C) loop D) potassium-sparing Answer: A Explanation: A) This is 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.

3

12) Diuretic drugs are commonly used to treat .

A) bladder spasm B) hypertension C) kidney stones D) urinary tract infection Answer: B Explanation: A) Diuretic drugs are not used to treat bladder spasm.

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, K-Dur, and K-Lyte 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.

C) These drugs are not used to treat erectile dysfunction.

D) These drugs are measured in milliequivalents, not units.

14) The generic drug furosemide is related to the well-known trade name drug A) Viagra B) Lasix C) HCTZ D) Pyridium Answer: B Explanation: A) This is not the trade name of furosemide.

C) This is not the trade name of furosemide.

D) This is not the trade name of furosemide.

.

15) Combination trade name drugs that contain both a thiazide diuretic drug and a potassiumsparing diuretic drug include all of the following drugs, EXCEPT .

A) Proscar B) Aldactazide C) Dyazide D) Maxzide Answer: A Explanation: A) 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.

4

16) This drug pellet is inserted into the urethra and produces an erection in patients with erectile dysfunction.

A) Caverject B) Klorvess C) Detrol D) Muse Answer: D Explanation: A) Caverject is injected into the penis; it is not a pellet.

B) Klorvess is not used to treat erectile dysfunction.

C) Detrol is not used to treat erectile dysfunction.

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 drug is not used to treat benign prostatic hypertrophy.

B) This drug is not used to treat benign prostatic hypertrophy.

D) This drug is not used to treat benign prostatic hypertrophy.

18) Which of these drug pairs is used to treat urinary tract infections?

A) Macrobid and Macrodantin) B) Klorvess and K-Tab C) Flomax and Hytrin D) Cialis and Levitra Answer: A Explanation: B) These drugs are not used to treat urinary tract infections.

C) These drugs are not used to treat urinary tract infections.

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.

5

20) Madeline, age 60, has difficulty with overactive bladder, urinary urgency, and occasional urinary incontinence. Which drug did her physician prescribe for her?

A) Sanctura B) Urogesic C) Micro-K D) Viagra Answer: A Explanation: B) Urogesic is not used to treat overactive bladder.

C) Micro-K is not used to treat overactive bladder.

D) Viagra is used to treat erectile dysfunction in men.

21) Which electrolyte must 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 does not need to be taken in conjunction with some diuretic drugs.

B) Saw palmetto is not an electrolyte.

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 adNvU erRsSeIeNfGfeTcBts.C?OM 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.

23) All of the following categories of drugs are used to treat urinary tract infections, EXCEPT .

A) folic acid antagonist drugs B) prostaglandin E1 drugs C) cephalosporin drugs D) fluoroquinolone antibiotic drugs Answer: B Explanation: A) These ARE used to treat urinary tract infections.

B) These drugs are used to treat erectile dysfunction.

C) These ARE used to treat urinary tract infections.

D) These ARE used to treat urinary tract infections.

6

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.

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: B) Urinary tract analgesic drugs only treat the pain associated with a urinary tract infection, not the infection itself.

D) There is only one correct answer.

26) The trade name drug 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.

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.

7

.

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 DNA and proteins.

D) All of the above statements are true.

Answer: B Explanation: A) This statement IS true.

B) 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 only one false statement.

29) Drug inserts and advertisements for PDE5 inhibitor drugs warn men to go to the emergency room .

A) if they develop urinary incontinence B) if they have an erection lasting longer than four hours C) before they switch from one type of PDE5 inhibitor drug to another D) if they develop a low level of potassium Answer: B Explanation: A) PDE5 inhibitor drugs do not cause urinary incontinence.

C) Patients cannot switch drugs unless they have consulted with the physician and the physician writes a prescription for the other drug.

D) PDE5 inhibitor drugs do not cause a low level of potassium.

30) Which of the following statements about benign prostatic hypertrophy is FALSE? A) The male hormone testosterone is acted on by an enzyme in prostatic cells.

B) Because the prostate is enlarged, there are symptoms of a urinary tract infection.

C) Testosterone in the prostate gland is converted to dihydrotestosterone.

D) Benign prostatic hypertrophy is a benign, not cancerous process.

Answer: B Explanation: A) This IS a true statement.

B) This statement IS false.

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 (BPH).

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 an over-the-counter drug.

B) Spironolactone (Aldactone) is a diuretic drug; it is not used to treat benign prostatic hypertrophy.

D) Tolterodine (Detrol) is used to treat overactive bladder, not benign prostatic hypertrophy.

8

32) Which of the following statements is TRUE? A) Dutasteride and finasteride are androgen inhibitor drugs.

B) The packaging and drug inserts for androgen inhibitor drugs warn women not to handle these drugs.

C) Androgen inhibitor drugs, if handled by the pregnant mother, can cause birth defects in a male fetus.

D) All of the above statements are true.

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.

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) erectile dysfunction D) overactive bladder Answer: B Explanation: A) Potassium supplement drugs are not known as water pills.

C) Erectile dysfunction drugs are not known as water pills.

D) Drugs for overactive bladder are not known as water pills.

34) Thiazide diuretic drugs have to be prNeU scRrSibIN edGTcB ar.C efOuM lly because they can decrease the effect of other drugs the patient is taking. Which drugs should not be taken with thiazide diuretic drugs?

A) insulin B) chemotherapy drugs C) anticoagulant 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.

35) All of the following are combination 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) This drug contains potassium chloride, not hydrochlorothiazide.

D) Dyazide DOES contain hydrochlorothiazide.

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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) 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, Urex) B) metolazone (Zaroxolyn) C) bethanechol (Urecholine) D) oxybutynin (Oxytrol) Answer: A Explanation: B) This is a diuretic drug.

C) This drug is used to treat urinary tract spasm.

D) This drug is used to treat overactive bladder.

38) Which of the following trade name drugs is used to treat overactive bladder?

A) Enablex B) Vesicare C) Sanctura 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.

39) Which drug is injected to treat overactive bladder?

A) onabotulinumtoxin A (Botox) B) vardenafil (Levitra) C) alprostadil (Caverject) D) sildosin (Rapaflo) Answer: A Explanation: B) Levitra is not injected.

C) This drug is injected to treat erectile dysfunction, not overactive bladder.

D) This drug is not injected.

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.

40) The generic drug sildenafil is related to the well-known trade name drug A) saw palmetto B) Viagra C) Flomax Answer: B Explanation: A) Saw palmetto is not a trade name drug.

C) Flomax is used to treat benign prostatic hypertrophy.

.

41) All of the following are true about saw palmetto, EXCEPT .

A) it is used to treat 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) It is an over-the-counter dietary supplement that can be purchased without 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.

7.2 True/False Questions 1) The kidneys continuously filter the circulating blood, extracting waste products of metabolism, water, glucose, and electrolytes from the blood.

Answer: TRUE 2) The kidneys either excrete or reabsorb 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

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4) Loop diuretic drugs get their name because they only act on the nephron loop.

Answer: FALSE Explanation: Loop diuretic drugs act at the proximal convoluted tubules, the nephron loop, and the distal convoluted tubule, but they derive their name from their effect at the nephron loop.

5) Potassium-sparing diuretic drugs act to "spare" potassium by keeping it in the blood and not letting it enter the tubules.

Answer: FALSE Explanation: These drugs help potassium be reabsorbed back into the blood at the proximal distal tubule and nephron loop.

6) Quinolone antibiotic drugs are only used to treat urinary tract infections.

Answer: TRUE 7) Some antibiotic drugs treat urinary tract infections by changing into ammonia and formaldehyde in the urine, and this kills bacteria.

Answer: TRUE 8) Combination antibiotic drugs, such as Bactrim or Septra, are used to treat urinary tract infections. The two drugs they contain work to block two steps in the synthesis of folic acid by bacteria.

Answer: TRUE 9) Urinary tract analgesic drugs exert a lN ocUaRl SpIaNiG n-TrBe.lCieOvM ing effect on the mucous membranes of the urinary tract, even though these drugs are given orally.

Answer: TRUE 10) An androgen inhibitor drug needs to be taken for 6 to 12 months before it can be determined if it is effective in decreasing the size of an enlarged prostrate gland.

Answer: TRUE 11) Androgen inhibitor drugs treat benign prostatic hypertrophy by inhibiting a hormone that is present in the urinary tracts of both males and females.

Answer: FALSE Explanation: The hormone testosterone is only present in males.

12) Pyridium is prescribed to treat the pain of urinary tract infections.

Answer: TRUE 13) Androgen inhibitor drugs and alpha1-receptor blocker drugs are categories of drugs used to treat benign prostatic hypertrophy.

Answer: TRUE 14) PDE5 inhibitor drugs, such as Viagra, Cialis, and Levitra, can cause a temporary loss of the ability to see blue/green colors.

Answer: TRUE 12

15) Finasteride is used to treat benign prostatic hypertrophy (as the trade name drug Proscar), but 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) Thiazide diuretic drugs can cause adverse drug reactions if given with some types of anticoagulant drugs, insulin, or chemotherapy drugs.

Answer: TRUE 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) The combination antibiotic and anti-infective drugs Bactrim and Septra are prescribed for urinary tract infections and infection of the prostate gland (prostatitis).

Answer: TRUE 20) Viagra is injected into the penis to treat a patient with erectile dysfunction.

Answer: FALSE Explanation: Viagra is an oral drug; CavNeUrjReScItNoGrTEBd.CexOM are injected into the penis.

21) Prostaglandin E1 drugs cause vasodilation to treat erectile dysfunction, but they are also used to keep open a patent ductus arteriosus to sustain life in a newborn with a congenital heart defect.

Answer: TRUE 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 gel and is used to treat overactive bladder.

Answer: TRUE 24) The ending -afil is common to generic PDE5 inhibitor drugs that are used to treat erectile dysfunction.

Answer: TRUE

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7.3 Short Answer Questions 1) As excess electrolytes (such as sodium and potassium) are excreted, they hold water to them by means of pressure and this increases the volume of urine.

Answer: osmotic 2) diuretic drugs act at the nephron loop and the distal convoluted tubule in the nephron. There, they block sodium and potassium from being reabsorbed from the tubule back into the blood.

Answer: Thiazide 3) Normally, , a hormone, allows potassium to excreted in the urine.

Answer: aldosterone 4) The presence of the letter in every trade name of a potassium supplement refers to the symbol for the chemical element of potassium.

Answer: K 5) Urinary tract _ drugs relax the smooth muscle in the wall of the urinary tract to treat spasms caused by infection, catheterization, or kidney stones.

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 ending -asteride is common to generic Answer: androgen 11) The important electrolyte to the action of some diuretic drugs.

Answer: hydrochlorothiazide

.

inhibitor drugs.

is often excreted in excessive amounts in the urine due

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 14

13) The loss of potassium due to a diuretic drug can cause the adverse effect of low level of potassium in the blood.

Answer: hypokalemia

, a very

14) The trade name NegGram was selected by the drug company because the drug is effective against grambacteria in the urine.

Answer: negative 15) The fruit and juice of the infections.

Answer: cranberry

are a natural way to prevent and treat urinary tract

16) The trade name drugs Urispas, Anaspaz, and Cystospaz are all used to treat urinary tract.

Answer: spasm

15

of the

7.4 Matching Questions Match the drugs in Column 1 with their correct drug category in Column 2.

A) potassium-sparing diuretic drug B) alpha1-receptor blocker drug C) PDE5 inhibitor drug D) quinolone antibiotic drug E) urinary tract analgesic drug F) potassium chloride drug G) urinary tract antispasmodic drug H) loop diuretic drug I) androgen inhibitor drug J) overactive bladder drug 1) dutasteride (Avodart) 2) terazosin (Hytrin) 3) furosemide (Lasix) 4) K-Dur 5) L-hyoscyamine (Anaspaz, Cystospaz) 6) nalidixic acid (NegGram) 7) phenazopyridine (Pyridium, Urogesic) 8) sildenafil (Viagra) 9) spironolactone (Aldactone) 10) tolterodine (Detrol) Answers: 1) I 2) B 3) H 4) F 5) G 6) D 7) E 8) C 9) A 10) J

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7.5 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 proximal convoluted tubule and nephron loop 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) Erectile dysfunction is the inability of a man to achieve and maintain an erection during sexual intercourse. Explain the steps involved in obtaining an erection, and explain how drugs are used to treat erectile dysfunction.

Answer: Sexual stimulation in the male activates the chemical cGMP, which relaxes smooth muscle in the arteries of the penis. This increases blood flow to the penis, and creates an erection.

Afterwards, the enzyme PDE5 metabolizes cGMP, and the erection subsides. PDE5 inhibitor drugs inhibit the enzyme PDE5 and so cGMP is not metabolized and the erection is sustained.

Prostaglandin E1 drugs act locally to relax the smooth muscle in the arteries of the penis, increase blood flow to the penis and create an erection.

3) 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 GT you, as a healthcare professional, want toNU shRaSrIeNw itBh.ChO erM ?

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.

4) 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.

17

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 8 Gastrointestinal Drugs 8.1 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.

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.

D) Antacid drugs neutralize hydrochloricNU acRiSdI,NnGoTt Bp.eCpOsM in.

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 H. pylori.

C) The parietal cells of the stomach release hydrochloric acid.

D) H2 blocker drugs block the action of histamine on receptors.

Answer: B Explanation: A) This statement is true.

B) The parietal cells release hydrochloric acid.

C) 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.

D) This describes the action of a laxative drug, not an antidiarrheal drug.

1

5) The generic drug 5-aminosalicylic acid .

A) decreases intestinal inflammation by blocking the production of hydrochloric acid B) decreases intestinal inflammation by blocking the production of prostaglandins C) increases intestinal peristalsis by blocking the production of hydrochloric acid D) decrease intestinal peristalsis by blocking the production of prostaglandins.

Answer: B Explanation: A) 5-aminosalicylic acid does not block the production of hydrochloric acid.

C) Aminosalicylic acid does not affect peristalsis.

D) Aminosalicylic acid does not affect peristalsis.

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: 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 irritate the intestinal mucosa and 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.

C) Hydrochloric acid does not stimulate the vomiting center.

D) Laxative drugs do not stimulate the vomiting center.

8) Which drug acts topically on the actual surface of the ulcer, forming a protective layer or "bandage" that allows a peptic ulcer to heal?

A) esomeprazole (Nexium) B) lorcaserin (Belviq) C) Helidac D) sucralfate (Carafate) Answer: D Explanation: A) Nexium does not form a protective layer on a peptic ulcer.

B) Belviq is used to treat obesity, not peptic ulcers.

C) Helidac is used to treat H. pylori infection.

2

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) These drugs ARE used to treat H. pylori infection.

D) These drugs are not used to treat H. pylori infection.

10) GERD is treated with .

A) antacid drugs B) appetite suppressant drugs C) H2 blocker drugs D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) These drugs are not used to treat gastroesophageal reflux disease.

C) This is true, but it is not the only correct answer.

11) Anticholinergic drugs block the action of acetylcholine and this A) decreases the rate of peristalsis in theNiU ntReSsItN inGeTB.COM 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: 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-producing laxative drugs B) chloride channel laxative drugs C) osmotic laxative drugs D) stool softener laxative drugs Answer: A Explanation: B) Chloride channel 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.

3

13) Chloride channel 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.

D) This describes what lipase inhibitor drugs do, not chloride channel laxative drugs.

14) Proton pump inhibitor drugs can be used to treat all of the following GI diseases, EXCEPT .

A) GERD B) 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 peptic ulcers.

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.

16) All of the drugs and substances below 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 can cause an ulcer.

B) Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause an ulcer.

D) Alcohol and caffeine can cause an ulcer.

4

17) A drawback to the use of the antacid drugs sodium bicarbonate, Alka-Seltzer, and baking soda is their .

A) ineffectiveness B) high cost C) high sodium content D) inability to neutralize acid Answer: C Explanation: A) These are effective antacid drugs.

B) These are home remedies or over-the-counter drugs that are not expensive.

D) These drugs do neutralize acid.

18) All of the following trade names are antiemetic drugs used to treat motion sickness, EXCEPT .

A) Qsymia B) Dramamine C) Antivert D) Transderm-Scop Answer: A Explanation: A) This is NOT an antiemetic drug. It is a weight loss drug.

B) Dramamine is an antiemetic drug used for motion sickness.

C) Antivert is an antiemetic drug used for motion sickness.

D) Transderm-Scop is an antiemetic drug used for motion sickness.

19) All of the following are bulk-producN inUgRlSaIxNaGtiTvBe.C drOuM gs, EXCEPT A) Fiberall B) Metamucil C) Mylanta D) FiberCon Answer: C Explanation: A) Fiberall is a bulk-producing laxative drug.

B) Metamucil is a bulk-producing laxative drug.

D) Fiberall 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.

D) The suffix -tidine is not common to stool softener laxative drugs.

5

.

21) Which of the following statements is FALSE? A) Zantac is available in a 150 mg dose both as a prescription drug and as an OTC drug.

B) The HB in Tagamet HB stands for histamine blocker.

C) The AC in Pepcid AC stands acid control or may refer to the Latin phrase ante cibum.

D) An over-the-counter drug can be purchased without a prescription and is safe for consumers to use if the directions are followed.

Answer: B Explanation: A) This is a true statement.

B) This statement is false. 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) Perdiem C) lubiprostone (Amitiza) D) mesalamine (Asacol, Lialda) Answer: D Explanation: A) Milk of magnesia is a laxative drug.

B) Perdiem is a laxative drug.

C) This is a chloride channel laxative drug.

D) This drug is used to treat ulcerative colitis.

.

23) Another trade name for the laxative dNrUuRgSdIN ocGuTsBa.tCeO(M Colace) is A) Surfak B) Antivert C) Qsymia D) Tums Answer: A Explanation: B) Antivert is not a laxative drug.

C) Qsymia is not a laxative drug.

D) Tums is an antacid drug, not a laxative drug.

24) All of the following are H2 blocker drugs, EXCEPT A) Zantac B) Pepcid C) Transderm-Scōp D) Axid Answer: C Explanation: A) Zantac is an H2 blocker drug.

B) Pepcid is an H2 blocker drug.

D) Axid is an H2 blocker drug.

6

.

.

25) Cimetidine is the generic name for the trade name drug .

A) Maalox B) Nexium C) opium D) Tagamet Answer: D Explanation: A) Maalox is a trade name combination drug that contains aluminum, magnesium, and simethicone, not cimetidine.

B) Nexium is the trade name drug for esomeprazole, not cimetidine.

C) Opium is not a trade name drug.

26) Which of the following statements is FALSE? A) Simethicone is available as an individual drug or in combination with antacid drugs.

B) Simethicone is used to treat flatulence and gas.

C) Simethicone changes the surface tension of air bubbles trapped 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) This is a false statement.

27) Di-Gel, Gelusil, and Rolaids are all examples of A) H2 blocker drugs B) irritant laxative drugs C) combination antacid drugs D) antiemetic drugs Answer: C Explanation: A) These are not H2 blocker drugs.

B) These are not irritant laxative 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 system that produces hydrochloric acid.

Answer: D Explanation: A) This statement is false.

B) This statement is false.

C) This statement is false.

7

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: 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.

30) Gastric stimulant drugs .

A) are used to treat GERD B) include metoclopramide (Reglan) C) increase the frequency of gastric emptying 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.

31) All of the following can contribute to 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.

C) This can contribute to ulcer formation.

D) This can contribute to ulcer formation.

.

32) A unique characteristic of Transderm-Scōp is that it is .

A) the first FDA-approved weight loss drug B) worn as a patch 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-Scōp.

C) This drug is not used to treat heartburn.

D) This drug is not given orally.

8

33) The trade name of the generic drug cimetidine is .

A) Nexium B) Pepcid C) Amitiza D) Tagamet Answer: D Explanation: A) The trade name of cimetidine is not Nexium.

B) The trade name of cimetidine is not Pepcid.

C) The trade name of cimetidine is not Amitiza.

34) Which of the following is a combination 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.

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 proton pump inhibitor drugs, EXCEPT A) Lomotil B) Prilosec C) Nexium D) Prevacid Answer: A Explanation: 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 contains the Schedule III narcotic drug opium?

A) paregoric B) Pepto-Bismol C) bismuth D) Lomotil Answer: A Explanation: B) Pepto-Bismol does not contain opium.

C) Bismuth is an anti-infective drug, not an antidiarrheal drug.

D) Lomotil does not contain opium.

9

37) All of the following are 5-aminosalicylic acid drugs used to treat ulcerative colitis, EXCEPT .

A) mesalamine (Asacol, Lialda, Pentasa, Rowasa) B) balsalazide (Colazal) C) sulfasalazine (Azulfidine) D) loraserin (Belviq) Answer: D Explanation: A) These are 5-aminosalicylic acid drugs.

B) These are 5-aminosalicylic acid drugs.

C) These are 5-aminosalicylic acid drugs.

38) Which of the following statements is TRUE? A) The weight loss drug Alli can cause fatty stools that pass involuntarily.

B) The prescription drug Xenical contains the same drug as the over-the-counter drug Alli.

C) Alli belongs to the lipase inhibitor category of 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.

39) All of the following categories of drugs are used to treat Crohn's disease, EXCEPT .

A) monoclonal antibody drugs B) corticosteroid drugs C) antispasmodic drugs D) appetite suppressant drugs Answer: D Explanation: A) Monoclonal antibody drugs are used to treat Crohn's disease.

B) Corticosteroid drugs are used to treat Crohn's disease.

C) Antispasmodic drugs are used to treat Crohn's disease.

40) Janie Wallace is taking an appetite suppressant drug. She should be aware of which of these statements?

A) Appetite suppressant drugs should be used in conjunction with dietary restrictions.

B) Appetite suppressant drugs should be taken only on a short-term basis.

C) Patients may develop drug dependence and experience withdrawal symptoms if the drugs are discontinued abruptly.

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.

10

41) All of the following statements are true, EXCEPT .

A) Helicobacter pylori are helical (spiral) bacteria.

B) Helicobacter pylori have flagella (thin, whip-like tails).

C) Helicobacter pylori are the cause of some gastric ulcers.

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.

42) Irritable bowel syndrome, characterized with cramping and diarrhea alternating with constipation, is treated with all of the following categories of drugs EXCEPT .

A) antianxiety drugs B) antacid drugs C) antispasmodic drugs D) antidiarrheal drugs and laxative drugs Answer: B Explanation: A) Irritable bowel syndrome is treated with antianxiety drugs.

C) Irritable bowel syndrome is treated with antispasmodic drugs.

D) Irritable bowel syndrome is treated with both antidiarrheal drugs and laxative drugs.

43) The drug category of antacid drugs contains each of the following as an active ingredient, EXCEPT .

A) calcium carbonate B) attapulgite C) aluminum hydroxide D) magnesium hydroxide.

Answer: B Explanation: A) This IS an ingredient in antacid drugs.

B) Attapulgite is an ingredient in drugs used to treat diarrhea.

C) This IS an ingredient in antacid drugs.

D) This IS an ingredient in antacid drugs.

44) Which of the following trade names are NOT related to the generic drug mesalamine that is used to treat ulcerative colitis?

A) linaclotide (Linzess) B) Asacol C) Pentasa D) Rowasa Answer: A Explanation: A) This drug is used to treat irritable bowel syndrome, not ulcerative colitis.

B) This IS a trade name for mesalamine.

C) This IS a trade name for mesalamine.

D) This IS a trade name for mesalamine.

11

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) Antivert C) Amitiza D) Mylanta Answer: C Explanation: A) Tagamet is the trade name for cimetidine.

B) Antivert is not used to treat irritable bowel syndrome.

D) Mylanta is not used to treat irritable bowel syndrome.

46) Besides being used to treat H. pylori infections in gastric ulcers, what other disease is the generic drug metronidazole used to treat?

A) acne rosacea of the facial skin B) vaginal bacteriosis C) pelvic inflammatory 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.

8.2 True/False Questions 1) Ulcerative colitis is a chronic disease of the esophagus and stomach.

Answer: FALSE 2) All peptic ulcers begin with irritation of the mucous membranes caused by hydrochloric acid.

Answer: TRUE 3) Simethicone relieves gas trapped in the GI tract because of its action as an antacid drug.

Answer: FALSE 4) Narcotic drugs are most commonly used for pain relief, but have a common side effect of causing constipation which is used as the therapeutic effect in treating diarrhea.

Answer: TRUE 5) The drug 5-aminosalicylic acid and topical corticosteroid drugs are both used to treat ulcerative colitis, but 5-aminosalicylic acid can treat severe inflammation because it has a powerful anti-inflammatory effect.

Answer: FALSE Explanation: This is a false statement. It is corticosteroid drugs that have the powerful antiinflammatory effect.

6) The ending -tidine is common to generic H2 blocker drugs.

Answer: TRUE 12

7) Appetite suppressant drugs for obesity are chemically related 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: This is a false statement. 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 prescription drug to be approved by the FDA for over-the-counter use.

Answer: FALSE Explanation: This is a false statement. Cimetidine (Tagamet) was the first prescription H2 blocker developed, but famotidine (PepcNidU)RwSIaNs GthTeB.fCirOstMto be approved for over-the-counter use.

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 slow the frequency of peristalsis in the intestines.

Answer: TRUE 15) The antidiarrheal drug attapulgite is an absorbent drug that contains an aluminummagnesium compound taken from clay soil.

Answer: TRUE 16) A patient with a bleeding ulcer is immediately given an intravenous antacid drug in the emergency room.

Answer: FALSE Explanation: This is a false statement. Antacid drugs are only given orally, not intravenously.

The first drug given for a bleeding ulcer is an H2 blocker drug.

13

17) Stool softener laxative drugs act as emulsifiers that allow fat and water to mix together to soften the stool.

Answer: TRUE 18) The prescription drug Antivert to treat vertigo takes the anti- part of its name from the word antibiotic, which shows its drug action.

Answer: FALSE Explanation: This is a false statement. The anti- in Antivert stands for antiemetic.

19) The over-the-counter weight loss drug Alli contains the same drug as the prescription weight-loss drug Xenical, but at a lower dose.

Answer: TRUE 20) Consumers think of weight-loss drugs as being safe and free of side effects, and they are.

Answer: FALSE Explanation: This is a false statement. Some of these drugs have caused strokes and disease of the heart valves and been taken off the market.

21) Dulcolax as a liquid is the generic drug magnesium hydroxide, but Dulcolax as an entericcoated tablet or suppository is the generic drug bisacodyl.

Answer: TRUE 22) The endings -salamine, -salazide, and -salazine are common to generic 5-aminosalicyclic acid drugs.

Answer: TRUE 23) Simethicone is often included in combination antacid drugs because it relieves flatulence and breaks up air bubbles trapped in the GI tract.

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: This is a false statement. Antacid drugs should not take the place of adequate calcium intake in the diet.

25) The AR in the trade name Axid AR stands for anti-reflux.

Answer: FALSE Explanation: This is a false statement. It stands for acid reducer.

26) Histamine is released in the stomach, where it stimulates the production of hydrochloric acid.

Answer: TRUE 27) The final step in acid production in the gastric parietal cell involves a structure known as the proton pump.

Answer: TRUE 14

28) Diarrhea can be caused by a bacterial infection due to the bacterium Helicobacter pylori.

Answer: FALSE Explanation: This is a false statement. Helicobacter pylori causes gastric and duodenal ulcers.

29) A GI cocktail is given to a patient who has a bleeding peptic ulcer.

Answer: TRUE 8.3 Short Answer Questions 1) Peptic ulcers in the stomach are specifically known as Answer: gastric 2) The ending -mab is common to Answer: monoclonal antibody

ulcers.

drugs.

3) drugs are used to control the nausea and vomiting that is associated with many different diseases.

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 n UGRESRINDGsTtBa.nCdOsMfor .

Answer: gastroesophageal reflux disease 6) is a sensation of lightheadedness, dizziness, and whirling caused by irritation or infection in the inner ear that upsets the balance and stimulates the vomiting center.

Answer: Vertigo 7) The antacid drugs Alka-Mints, Chooz, Maalox Antacid Barrier, Titralac Extra Strength, and Tums Ultra contain only carbonate as their active ingredient.

Answer: calcium 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 created. Its trade name, combination of syllables from the words antagonist and cimetidine.

Answer: Tagamet

was formed from a

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

15

11) The drug hydrocortisone (Cortifoam) is an aerosol foam that is placed in the rectum to treat the disease of .

Answer: ulcerative colitis 12) In the phrase antiemetic drug, the combining form emet/o- means to Answer: vomit 13) The other name for gastroesophageal reflux disease (GERD) is Answer: heartburn 14) Helicobacter pylori are helical (spiral) Answer: bacteria

. .

that have thin, whip-like tails.

15) An drug absorbs excess water from diarrhea stools.

Answer: absorbent 16) A baseball diamond-shaped tablet with a large "Z' imprinted on it is the trade name H2 blocker drug .

Answer: Zantac 17) The HB in the drug Tagamet HB stands for Answer: heartburn

.

NrUoRm So IN-S GeTlB 18) The antacid drugs Alka-Seltzer and B tz.C erOcMontain sodium bicarbonate. When use as an old home remedy for indigestion and heartburn, sodium bicarbonate is known as .

Answer: Baking soda

19) An is another name for a drug that blocks a receptor.

Answer: antagonist 20) If a peptic ulcer persists for more than one treatment for a possible Helicobacter pylori infection.

Answer: month

, the patient is told to seek medical

21) The A-D in the anticholinergic trade name drug Imodium A-D means Answer: antidiarrheal

.

22) In the over-the-counter drug Pepto-Bismol, Pepto refers to the adjective peptic, and Bismol refers to the drug .

Answer: bismuth

16

8.4 Matching Questions Match the drugs in Column 1 with their correct drug categories in Column 2.

A) appetite suppressant drug B) bulk-producing laxative drug C) H2 blocker drug D) monoclonal antibody drug E) lipase inhibitor drug F) antiemetic drug G) proton pump inhibitor drug H) anticholinergic drug I) gastric stimulant drug J) stool softener laxative drug 1) lorcaserin (Belviq) 2) docusate (Colace, Surfak) 3) adalimumab (Humira) 4) loperamide (Imodium A-D) 5) metoclopramide (Reglan) 6) methylcellulose (Benefiber, Citrucel) 7) omeprazole (Prilosec) 8) orlistat (Alli, Xenical) 9) dimenhydrinate (Dramamine) 10) ranitidine (Zantac) Answers: 1) A 2) J 3) D 4) H 5) I 6) B 7) G 8) E 9) F 10) C

17

8.5 Essay Questions 1) Describe how peptic ulcers develop and name the drug categories used to treat them.

Answer: All peptic ulcers begin with irritation of the mucous membranes caused by hydrochloric acid 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 membrane. Antacid drugs, all of the H2 blocker drugs, and some of the proton pump inhibitor drugs.

2) Describe how bulk-producing laxative drugs are different from irritant/stimulant laxative drugs.

Answer: Bulk-producing 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) Describe two of the four criteria that were met in order for the FDA to approve prescription H2 blocker drugs to be released as over-the-counter drugs.

Answer: These are the four FDA criteria: (1) The indication for the drug's OTC use is similar to its use as a prescription drug, (2) the patient can easily 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 testing.

4) What unusual adverse effect does the NwUeRigShIN t-GloTsBs.C drOuM g Alli produce, and what special precautions does a patient need to do when they are taking?

Answer: The drug has an unusual adverse effect. Because Alli acts to decrease the absorption of 25% of the fat in the diet, it produces stools that are fatty and can pass involuntarily. The drug company advises to wear dark pants or bring a change of clothes to work.

18

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 9 Musculoskeletal Drugs 9.1 Multiple-Choice Questions 1) Drugs used to treat osteoarthritis reduce 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.

D) Progesterone is a female hormone that plays a role in osteoporosis, not osteoarthritis.

2) NSAIDs (nonsteroidal anti-inflammatory drugs) .

A) are less likely than aspirin to cause gastric irritation or ulcers B) have a different effect than the drugs naproxen (Aleve) and oxaprozin (Daypro) C) are more likely than aspirin to cause gastric irritation or ulcers D) are used to treat both humans and animals in the drug carprofen (Rimadyl).

Answer: A Explanation: B) The category of NSAIDs includes Aleve and Daypro, so their effects would be the same.

C) NSAIDS have less of tendency, not more, to cause gastric irritation or ulcers than aspirin.

D) The NSAID carprofen (Rimadyl) is only used to treat animals, not humans.

3) The hormone cortisol, from which corticosteroid drugs are produced, 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: 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, prescribed to treat the acute symptoms of osteoarthritis for a limited time.

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.

D) Muscle relaxant drugs are not used to treat osteoarthritis.

1

are only

.

5) The normal balance (homeostasis) between new bone deposition and bone resorption (breakdown) is maintained by all of the following, EXCEPT .

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.

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: 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?

A) ibuprofen (Advil, Motrin) B) acetaminophen (Tylenol) C) hydrocortisone (Cortef, Solu-Cortef) D) zoledronic acid (Reclast, Zometa) 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.

D) This drug for osteoporosis has no anti-inflammatory effect.

8) Which of the following statements is TRUE concerning acetaminophen?

A) It inhibits the action of prostaglandins.

B) It is used to treat osteoarthritis.

C) It is an NSAID. D) All of the above statements are true.

Answer: B Explanation: A) Acetaminophen does not inhibit the production of prostaglandins.

C) Acetaminophen is not an NSAID. D) Only one of the statements is true.

2

9) All of the following are skeletal muscle relaxant drugs, EXCEPT A) metaxalone (Skelaxin) B) alendronate (Fosamax) C) methocarbamol (Robaxin) D) cyclobenzaprine (Flexeril) Answer: B Explanation: A) This IS a skeletal muscle relaxant drug.

B) This is a bone resorption inhibitor drug, not a skeletal muscle relaxant.

C) This IS a skeletal muscle relaxant drug.

D) This IS a skeletal muscle relaxant drug.

.

10) The long-term use of hormone replacement therapy to treat menopause and the symptoms of osteoporosis carries with it the risk of .

A) myocardial infarction B) stroke C) breast and endometrial cancer 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.

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 skeletal muscle relaxant category of drugs.

12) Miacalcin, Fosamax, Actonel, and Zometa 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.

D) These drugs are not used to treat pain and inflammation.

3

_.

13) William Ruckles has severe rheumatoid arthritis. His physician prescribed , an oral gold compound drug.

A) auranofin (Ridaura) B) raloxifene (Evista) C) naproxen (Aleve, Naprosyn) D) capsaicin (Capsin, Zostrix) Answer: A Explanation: 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.

C) These drugs are used to treat osteoporosis, not rheumatoid arthritis.

D) These drugs are not used to treat rheumatoid arthritis.

15) The ending -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 ending -profen is not common to gold compound drugs.

C) The ending -profen is not common to monoclonal antibody drugs.

D) The ending -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) weightbearing and constant movement of 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) This is a factor in osteoarthritis, not osteoporosis.

D) Smoking and alcohol use ARE risk factors for osteoporosis.

4

.

17) Which of the following drugs is injected into a joint?

A) betamethasone (Celestone) B) triamcinolone (Aristospan Intra-articular) 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.

18) Which of the following statements about hyaluronic acid (Hyalgan, Synvisc) is TRUE? A) Hyaluronic acid is secreted osteoblasts in the bone.

B) It 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) It is secreted by the synovial membrane of the joint.

B) It is derived from the combs of chickens.

D) This drug is injected into the joint.

19) All of the following are topical drugs used to treat the pain of osteoarthritis, EXCEPT .

A) Aspercreme B) capsaicin (Capsin, Icy Hot) C) Ascriptin D) Bengay Answer: C Explanation: A) This is a topical combination drug used to treat the pain of osteoarthritis.

B) This is a topical drug used to treat the pain of osteoarthritis.

C) This is an oral combination drug used to treat osteoarthritis.

D) This is a topical combination drug used to treat the pain of osteoarthritis.

20) Osteoporosis is treated with all of the following types of drugs, EXCEPT A) selective estrogen receptor modulator drugs B) NSAIDS C) bone resorption inhibitor drugs D) calcium supplements Answer: B Explanation: A) SERM drugs are used to treat osteoporosis.

B) This drug is not used to treat osteoporosis.

C) Bone resorption inhibitor drugs are used to treat osteoporosis.

D) Calcium supplements are used to treat osteoporosis.

5

.

21) The therapeutic effect of etanercept (Enbrel) in treating rheumatoid arthritis is that it suppresses the immune response and blocks .

A) tumor necrosis factor B) bone resorption C) the hormone calcitonin D) all of the above Answer: A Explanation: B) Enbrel does not block bone resorption C) Enbrel does not block the hormone calcitonin.

D) Only one answer is correct.

22) Bridget Maurer is taking a monoclonal antibody drug for her rheumatoid arthritis. That drug might include any of the following drugs, EXCEPT .

A) abatacept (Orencia) B) adalimumab (Humira) C) infliximab (Remicade) D) golimumab (Simponi) Answer: A Explanation: A) This is not a monoclonal antibody drug, although it is used to treat rheumatoid arthritis.

B) This IS a monoclonal antibody drug.

C) This IS a monoclonal antibody drug.

D) This IS a monoclonal antibody drug.

23) Which of these drugs is NOT used for synovial fluid replacement?

A) Flexeril B) Hyalgan C) Synvisc D) hyaluronic acid Answer: A Explanation: A) This is a skeletal 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.

24) Which bone resorption inhibitor drug must be given intravenously?

A) ibandronate (Boniva) B) alendronate (Fosamax) C) zoledronic acid (Reclast, Zometa) D) raloxifene (Evista) Answer: C Explanation: A) Boniva is given orally.

B) Fosamax is given orally.

D) Evista is not a bone resorption inhibitor drug.

6

25) All of the following drugs are used to treat osteoarthritis, EXCEPT A) muscle relaxant drugs B) salicylate drugs C) NSAID and COX-2 inhibitor drugs D) corticosteroid drugs Answer: A Explanation: A) These drugs are not used to treat osteoarthritis.

B) Salicylate drugs are used to treat osteoarthritis.

C) NSAID and COX-2 inhibitor drugs are used to treat osteoarthritis.

D) Corticosteroid drugs are used to treat osteoarthritis.

.

26) All of the following are the trade names of nonsteroidal anti-inflammatory drugs, EXCEPT .

A) Daypro and Advil B) Aleve and Clinoril C) Voltaren and Motrin D) Skelexin and Flexeril 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) These are the trade names of skeletal muscle relaxant drugs.

NG 27) Muscle relaxant drugs specifically reNliUeR vSeIm uTscBl.eCOM .

A) inflammation and loss of function B) pain and inflammation C) spasms and stiffness D) malignant hyperthermia Answer: C Explanation: A) Muscle relaxant drugs do not relieve inflammation and loss of function.

B) Muscle relaxant drugs do not relieve pain and inflammation.

D) Muscle relaxants do not relieve inflammation and loss of function.

28) Which of the following drugs is used to treat fibromyalgia?

A) The anticonvulsant drug pregabalin (Lyrica) B) The antidepressant drug duloxetine (Cymbalta) C) The local anesthetic drug lidocaine (Xylocaine) injected into trigger points 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.

7

29) drugs come in a special arrangement of oral tablets whose number continually decreases each day until the treatment is finished after one week.

A) Bone resorption inhibitor B) Hyaluronic acid C) Calcium supplement D) corticosteroid Answer: D Explanation: A) These drugs do not come as a decreasing dose over a week.

B) This drug is not an oral tablet; it is injected into the joint.

C) These drugs do not come in a decreasing dose over a week.

30) 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.

D) Osteoporosis is not known as degenerative joint disease.

31) Drugs used to treat osteoarthritis include those that reduce pain and inflammation. Which of the following categories of drugs do not reduce the pain and inflammation of osteoarthritis?

A) COX-2 inhibitor drugs B) gold compound drugs C) NSAIDs D) salicylate drugs Answer: B Explanation: A) COX-2 inhibitor drugs are used to reduce the pain and inflammation of osteoarthritis.

C) NSAIDs are used to reduce the pain and inflammation of osteoarthritis.

D) Salicylate drugs are used to reduce the pain and inflammation of osteoarthritis.

32) Gold compound drugs .

A) inhibit macrophages from the immune system B) contain real gold C) have names that often contain the letters RA, the chemical symbol for gold.

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) Au is the chemical symbol for gold.

8

33) Only drugs can reverse the cartilage and bone damage that has already occurred in the joints of patients with osteoarthritis.

A) corticosteroid drugs B) COX-2 inhibitor drugs and NSAIDs C) monoclonal antibody drugs D) There are no drugs that can reverse the cartilage and bone damage of osteoarthritis once it has occurred.

Answer: D Explanation: A) Corticosteroid drugs cannot reverse the cartilage and bone damage that has occurred in the joints due to osteoarthritis.

B) COX-2 inhibitor drugs and NSAIDs cannot reverse the cartilage and bone damage that has occurred in the joints due to osteoarthritis.

C) Monoclonal antibody drugs cannot reverse the cartilage and bone damage that has occurred in the joints due to osteoarthritis.

34) The cause of fibromyalgia is .

A) overproduction of prostaglandins B) muscle spasms in the neck, back, and hips C) wear and tear in the joints D) unknown Answer: D Explanation: A) The cause of fibromyalgia is not known.

B) The cause of fibromyalgia is not known.

URoSfIN C) Wear and tear in the joints is a symptN om oG stTeB o.aCrO thM ritis. The cause of fibromyalgia is not known.

35) 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) The weightbearing joints (hips, knees, lower back) and the joints used constantly (fingers and toes) are the first to show osteoarthritis.

9

36) 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.

C) It does not mean pain.

D) It does not mean muscle.

.

37) All of these drugs are combination drugs used to treat osteoporosis. Which one is available as a transdermal patch?

A) Prempro B) ClimaraPro C) Activella D) Femhrt Answer: B Explanation: A) This drug is given orally.

C) This drug is given orally.

D) This drug is given orally.

9.2 True/False Questions 1) Mature bone is a hard, unchanging suN bsUtaRnScIN e.GTB.COM Answer: FALSE 2) Some hormone replacement drugs used to treat menopause are also indicated for the prevention of osteoporosis.

Answer: TRUE 3) Because acetaminophen has no anti-inflammatory action, it is no longer used treat the pain associated with osteoarthritis.

Answer: FALSE Explanation: This is a false statement. Acetaminophen cannot treat inflammation, but it is the preferred first treatment for osteoarthritis for pain relief.

4) NSAIDs are structurally similar enough to aspirin that some 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 lubricating qualities of the synovial fluid.

Answer: TRUE 6) The category of salicylate drugs used to treat osteoarthritis includes aspirin, one of the oldest drugs known to man.

Answer: TRUE 10

7) Nonsteroidal anti-inflammatory drugs inhibit both the COX-1 and COX-2 enzymes.

Answer: TRUE 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 derived from salmon fish.

Answer: TRUE 11) Muscle relaxant drugs are useful in treating the pain and inflammation of osteoarthritis of muscle strains, sprains, and "pulled muscles."

Answer: FALSE Explanation: This is a false statement. These drugs relieve spasm and stiffness but cannot relieve pain or inflammation.

12) Chondroitin, a substance found in the dietary supplement Osteo Bi-Flex, helps cartilage retain its water content.

Answer: TRUE 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 can reverse joint damage that has already occurred in patients with rheumatoid arthritis.

Answer: FALSE Explanation: This is a false statement. These drugs 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) The NSAID diclofenac (Voltaren) was the first prescription topical skin gel approved by the FDA for treating the pain of osteoarthritis.

Answer: TRUE

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17) The immunomodulator drug leflunomide (Arava), which is used to treat rheumatoid arthritis, is not given to patients with decreased liver function because it has a very long half-life.

Answer: TRUE 18) The drug diazepam (Valium) is used for muscle relaxation, but it is really an antianxiety drug, not a skeletal muscle relaxant drug.

Answer: TRUE 19) In women, parathyroid hormone, calcitonin hormone, calcium in the diet, vitamin D, exercise, and the hormones estradiol and progesterone help prevent rheumatoid arthritis.

Answer: FALSE Explanation: This is a false statement. These substances help prevent osteoporosis.

20) Indomethacin (Indocin), a drug used to treat osteoarthritis, is also given intravenously to newborn infants to close a persistent patent ductus arteriosus heart defect, an abnormality in the fetal circulation.

Answer: TRUE 21) The drug ibandronate (Boniva) has a unique bone-shaped indentation on its tablet.

Answer: FALSE Explanation: This is a false statement. This describes Fosamax, not Boniva.

22) Two COX-2 inhibitor drugs were taken off the market because of an increased risk of heart attacks and strokes. Only one COX-2 inhNiU biRtoSrINisGTcuBr.C reOnM tly on the market.

Answer: TRUE 23) The joints have a large number of pain receptors, and damage to the joints can cause chronic, severe pain.

Answer: TRUE 24) Janus kinase (JAK) inhibitor drugs are used to treat fibromyalgia.

Answer: FALSE Explanation: This is a false statement. These drugs are used to treat rheumatoid arthritis.

25) The endings -dronate and -dronic are common to generic bone resorption inhibitor drugs that are used to treat osteoporosis.

Answer: TRUE 26) The bone resorption inhibitor drug ibandronate (Boniva) is advertised as the osteoporosis drug that is easiest to remember to take because it is taken just once a month.

Answer: TRUE

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9.3 Short Answer Questions 1) A drug category used to treat osteoporosis is called SERM. The abbreviation SERM stands for drugs.

Answer: selective estrogen receptor modulator 2) The antacid Tums, which uses calcium to neutralize stomach acid, has advertised that it has a secondary effect of calcium supplementation for women to prevent .

Answer: osteoporosis 3) , also known as acetylsalicylic acid (ASA), is the most well-known drug in the salicylate category.

Answer: aspirin 4) The abbreviation NSAID stands for .

Answer: nonsteroidal anti-inflammatory drug 5) Acetaminophen is not used to treat osteoarthritis because it cannot treat Answer: inflammation

.

6) COX-2 inhibitor drugs selectively inhibit the COX-2 enzyme, an enzyme that plays a role in the production of that cause the pain and inflammation of osteoarthritis.

Answer: prostaglandins 7) Bone resorption inhibitor drugs are also known as bisphosphonate drugs because of their effect on (a component of bone).

Answer: phosphorus 8) When you hear the phrase "trigger point injections," you think of a drug being used to treat the disease of .

Answer: fibromyalgia 9) 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 10) The only COX-2 inhibitor drug that is currently on the market is celecoxib, and its trade name is .

Answer: Celebrex 11) Physicians and laypersons often refer to intra-articular injections of corticosteroid drugs as " shots," but they are not because that drug can only be given orally.

Answer: cortisone 12) The endings -lone and -sone are common to generic Answer: corticosteroid 13

drugs.

13) The ending -mab is common to generic Answer: monoclonal

drugs.

14) The Janus kinase inhibitor drug tofacitinib is related to the well-known trade name drug .

Answer: Xeljanz 15) Osteoporosis is thinning of the Answer: bone

at the cellular level.

16) The phrase "low-impact fractures" is associated with the disease of Answer: osteoporosis 17) In the combination drug Femhrt, used to treat osteoporosis, the hrt stands for Answer: hormone replacement therapy

.

.

18) Dantrolene (Dantrium) is a skeletal muscle relaxant drug, but it is best known for being used to treat malignant , a life-threatening condition that occurs during surgery in genetically predisposed individuals.

Answer: hyperthermia

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9.4 Matching Questions Match the drugs in Column 1 to the drug category in Column 2.

A) monoclonal antibody drug B) bone resorption inhibitor drug C) gold compound drug D) muscle relaxant drug E) salicylate drug F) corticosteroid drug G) nonsteroidal anti-inflammatory drug H) SERM drug I) COX-2 inhibitor drug J) estrogen drug 1) magnesium sulfate (Doan's) 2) auranofin (Ridaura) 3) celecoxib (Celebrex) 4) cyclobenzaprine (Flexeril) 5) methylprednisolone (Medrol) 6) golimumab (Simponi) 7) estropipate (Ogen) 8) ibandronate (Boniva) 9) ibuprofen (Advil, Motrin) 10) raloxifene (Evista) Answers: 1) E 2) C 3) I 4) D 5) F 6) A 7) J 8) B 9) G 10) H

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9.5 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. When the estradiol level naturally declines during menopause, the action of osteoclasts increases, and the rate of bone resorption (breakdown) accelerates, causing osteoporosis.

2) Salicylate drugs, such as aspirin, are irritating to the stomach. Describe two precautions that some drug companies have taken to reduce this irritation.

Answer: Some drug companies take precautions to reduce this irritation. Ecotrin is manufactured as an enteric-coated tablet that does not dissolve in the stomach; it dissolves only when it comes in contact with the higher pH environment of the duodenum. Aspirin can also be combined with an antacid drug, 3) Explain how prostaglandins play a role in causing the pain and inflammation of osteoarthritis and rheumatoid arthritis.

Answer: Prostaglandins play a role in causing pain and inflammation. There are two types of the enzyme cyclooxygenase (COX): COX-1 is involved in a process that continually produces prostaglandins that protect the mucous membranes in the stomach. COX-2 is activated when there is tissue damage, and it converts arachidonic acid (a fatty acid) into prostaglandins that cause pain and inflammation. Lipoxygenase (LOX) is an enzyme that uses a different pathway; it activates an oxidation chemical reaction to change arachidonic acid into prostaglandins that cause pain and inflammation and into othNeUrRsSuIbNsGtaTnBc.eCsOtM hat directly damage cartilage and produce inflammation.

4) Explain why the immunomodulator drug leflunonmide (Arava) for rheumatoid arthritis cannot be given to patients who have decreased liver function.

Answer: Leflunomide (Arava) has a very long half-life. Traces of the drug can still be found in the body six months after the last does. If this drug is given to a patient with decreased liver function, it would cause a toxic blood level of the drug.

5) 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, and what those signs are.

Answer: The weightbearing joints (hips, knees, and lower back), as well as those joints that are used constantly (fingers and toes), are the first to exhibit signs of osteoarthritis, which include pain, inflammation, and swelling.

6) Eugenia Wedridge is in menopause, is having hot flashes, and is worried about developing osteoporosis. She is thinking about using hormone replacement therapy to take care of all of these problems. What can you tell her about the risks of hormone replacement therapy?

Answer: In the past, hormone replacement therapy was commonly used for extended periods of time to treat the symptoms of menopause (hot flashes, vaginal dryness) in postmenopausal women, with a secondary effect of preventing osteoporosis. Now, however, it is known that these hormone drugs can increase the risk of endometrial cancer, breast cancer, stroke, and myocardial infarction. Hormone replacement therapy now has a limited use in the long-term treatment of osteoporosis in postmenopausal women.

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7) Describe the difference between the sources of these three musculoskeletal drugs: flavocoxid (Limbrel), hyaluronic acid (Hyalgan, Synvisc), and capsaicin (Capsin, Icy Hot).

Answer: Flavocoxid (Limbrel) is from plant antioxidants in fruits and vegetables plus the mineral zinc. Hyaluronic acid (Hyalgan, Synvisc) is from the combs of chickens. Capsaicin (Capsin, Icy Hot) is from chili pepper plants.

8) Explain why corticosteroid drugs come in a special arrangement of tablets whose number continually decreases each day for a week.

Answer: Oral corcorticosteroid drugs come in a special arrangement of tablets whose number continually decreases each day until treatment is finished after one week. This is because this corticosteroid drug temporarily suppresses the production of natural cortisol from the cortex of the adrenal gland. The large dose on day one relieves the acute symptoms of inflammation. Then the dose is reduced each day (but never stopped abruptly) so that the adrenal gland cortex begins to produce cortisol again.

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 10 Respiratory Drugs 10.1 Multiple-Choice Questions 1) 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.

2) Leukotriene receptor blocker drugs are used to prevent and treat .

A) asthma B) productive coughs C) respiratory infections D) tuberculosis Answer: A Explanation: 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 arNeUnRoStIN usGeTdBt.oCOtrM eat tuberculosis.

3) 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.

D) This is a corticosteroid drug that is not related to montelukast.

4) Nicotine antagonist drugs to stop smoking .

A) block nicotine receptors from being activated by inhaled nicotine B) contain a decreasing supply of nicotine to provide a gradual withdrawal C) provide nicotine in a chewing gum, nasal spray or transdermal patch D) act as antidepressant drugs in the brain Answer: A Explanation: B) This describes nicotine drugs, not nicotine antagonist drugs.

C) This describes nicotine drugs, not nicotine antagonist drugs.

D) Nicotine antagonist drugs do not act as antidepressant drugs in the brain.

1

5) The well-known bronchodilator generic drug albuterol is related to which two trade name drugs?

A) Xopenex and Serevent Diskus B) Zyflo and Singulair C) Proventil HFA and Ventolin HFA D) Mucinex and Humibid Answer: C Explanation: A) These are not related to the generic drug albuterol.

B) These are not related to the generic drug albuterol.

D) These are not related to the generic drug albuterol.

6) Corticosteroid drugs _ .

A) mimic the action of histamine on mast cells B) stimulate the inflammatory response of the immune system C) dilate the bronchioles D) suppress the inflammatory response of the immune system Answer: D Explanation: A) Corticosteroid drugs do not mimic the action of histamine.

B) Corticosteroid drugs do not stimulate the inflammatory response of the immune system.

C) Corticosteroid drugs do not dilate the bronchioles.

7) Leukotriene receptor blocker drugs .

A) block the action of leukotriene at the receptor level B) inhibit the production of leukotriene C) block the airway edema, bronchospasm, and inflammation caused by the substance leukotriene D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) Leukotriene formation inhibitor drugs do this, not leukotriene receptor blocker drugs.

C) This is true, but it is not the only correct answer.

8) 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.

2

9) Bronchodilator drugs are used to treat all of the following diseases, EXCEPT .

A) asthma B) COPD C) emphysema D) pneumonia Answer: D Explanation: A) Bronchodilator drugs are used to treat asthma.

B) Bronchodilator drugs are used to treat chronic obstructive pulmonary disease (COPD).

C) Bronchodilator drugs are used to treat emphysema.

D) Bronchodilator drugs are not used to treat pneumonia.

10) 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: B) Tuberculosis is caused by a gram-positive bacterium.

C) Tuberculosis is not spread by contact with an infected patient's blood.

D) Tuberculosis is treated with special antitubercular antibiotic drugs.

11) All of the following are categories of bronchodilator drugs, EXCEPT A) monoclonal antibody B) sympathomimetic C) xanthine D) anticholinergic Answer: A Explanation: B) This is a category of bronchodilator drugs.

C) This is a category of bronchodilator drugs.

D) This is a category of bronchodilator drugs.

12) Which of the following changes in the lungs does NOT occur with asthma?

A) The air passageways are narrowed (bronchoconstriction).

B) There is an excessive amount of mucus production.

C) There is a bacterial infection.

D) The mucous membranes are swollen.

Answer: C Explanation: A) This does occur with asthma.

B) This does occur with asthma.

D) This does occur with asthma.

3

.

13) 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.

14) is a substance produced in response to an inhaled antigen, and it causes airway edema, bronchospasm, and inflammation.

A) A mast cell B) Leukotriene C) Sputum D) Cortisol Answer: B Explanation: A) A mast cell is a cell, not a substance.

C) Sputum is mucus. It does not cause airway edema, bronchospasm, and inflammation.

D) This does not describe cortisol.

15) All of the following are bronchodilator drugs, EXCEPT A) levalbuterol (Xopenex) B) dyphylline (Lufyllin) C) ipratropium (Atrovent) D) prednisolone (Orapred, Pediapred) Answer: D Explanation: A) This is a beta-agonist bronchodilator drug.

B) This is a xanthine bronchodilator drug.

C) This is an anticholinergic bronchodilator drug.

D) This is a corticosteroid drug.

16) A Handihaler device .

A) punctures a capsule of a bronchodilator drug B) is used with the trade name drug Spiriva C) does not have a dose counter like metered-dose inhalers do 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.

4

.

17) Metered-dose inhalers 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.

D) Metered-dose inhalers do not use inches.

.

18) Bobby Whittaker has childhood asthma and takes a corticosteroid drug to prevent asthma attacks. Which drug is he taking?

A) ipratropium (Atrovent) B) budesonide (Pulmicort) C) zileuton (Zyflo) D) ethambutol (Myambutol) Answer: B Explanation: A) Atrovent is not a corticosteroid drug.

C) Zyflo is not a corticosteroid drug.

D) Myambutol is not a corticosteroid drug.

19) Which two drugs are currently used to treat tuberculosis?

A) isoniazid and rifampin B) streptomycin and Spirva C) levofloxacin (Levaquin) and Lufyllin D) INH and Zyban Answer: A Explanation: B) Streptomycin is used to treat tuberculosis, but Spiriva is not.

C) Levaquin is used to treat tuberculosis, but Lyfyllin is not.

D) INH is used to treat tuberculosis, but Zyban is not.

20) 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) Zyban C) Nicoderm CQ D) Proventil Answer: D Explanation: A) This is a stop smoking drug.

B) This is a stop smoking drug.

C) This is a stop smoking drug.

D) Proventil is a bronchodilator drug, not a stop smoking drug.

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21) The bronchodilator drug tiotropium (Spiriva) is administered via a/an a capsule containing the powered drug.

A) Discus inhaler device B) HandiHaler device C) metered-dose inhaler D) endotracheal tube Answer: B Explanation: A) Spiriva is not administered via a Discus inhaler device.

C) Spiriva is not administered via a metered-dose inhaler.

D) Spiriva is not administered via an endotracheal tube.

that crushes

22) Which of the following is a combination drug used to treat asthma?

A) Advair B) Breo Ellipta C) IsonaRif 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 combination drug is used to treat tuberculosis.

23) All of the following combination drugs are used to treat tuberculosis, EXCEPT A) IsonaRif B) Singular C) Rifamate D) Rifater Answer: B Explanation: A) This is a combination drug used to treat tuberculosis.

B) This drug is used to treat asthma.

C) This is a combination drug used to treat tuberculosis.

D) This is a combination drug used to treat tuberculosis.

24) The corticosteroid drug prednisolone (Oraped, Pediapred) is given A) orally B) by inhaler C) subcutaneously D) all of the above Answer: A Explanation: B) This drug is not given by endotracheal tube.

C) This drug is not given subcutaneously.

D) This drug is only given orally.

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.

_.

25) 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 any 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 attorney general can order them to remain in their homes except for doctor visits.

Answer: B Explanation: A) This statement is true.

C) This statement is true.

D) This statement is true.

26) Which of these suffixes is common to generic beta-agonist bronchodilator drugs?

A) -terol B) -sonide C) -solone D) -lukast Answer: A Explanation: B) This is common to generic corticosteroid drugs.

C) This is common to generic corticosteroid drugs.

D) This is common to generic leukotriene receptor blocker drugs.

27) 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.

C) This is not related to tuberculosis.

D) This is not related to tuberculosis.

28) 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.

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29) INH is an abbreviation that is related to a drug.

A) corticosteroid drug B) mast cell stabilizer drug C) antitubercular drug D) leukotriene receptor blocker drug Answer: C Explanation: A) INH is not related to a corticosteroid drug.

B) INH is not related to a mast cell stabilizer drug.

D) INH is not related to this drug.

30) Which form of a drug can work the fastest to relieve an asthma attack?

A) inhaled liquid B) tablet C) capsule D) all of the above Answer: A Explanation: B) This does not work the fastest.

C) This does not work the fastest.

D) Only one answer is correct.

31) The drug dornase alfa (Pulmozyme) is used to break up very thick mucus in patients with what disease?

A) cystic fibrosis B) tuberculosis C) pneumonia 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.

32) Drugs to stop smoking come in all of the following drug forms, EXCEPT A) chewing gum B) transdermal patch C) metered-dose inhaler D) nasal spray Answer: C Explanation: A) Stop smoking drugs DO come as chewing gum.

B) Stop smoking drugs DO come as a transdermal patch.

D) Stop smoking drugs DO come as a nasal spray.

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10.2 True/False Questions 1) Mast cell stabilizer drugs are only effective in preventing asthma attacks, not in treating them once they have occurred.

Answer: TRUE 2) If a patient's immune system is strong, a tuberculosis infection can remain dormant for years without causing symptoms.

Answer: TRUE 3) Expectorant drugs are prescribed for a nonproductive cough.

Answer: FALSE 4) Corticosteroid drugs dilate the bronchioles, and so they can be used to treat an acute attack of asthma.

Answer: FALSE 5) Mast cell stabilizer drugs can be inhaled, sprayed in the nose, or given by injection.

Answer: FALSE Explanation: This is a false statement. These drugs are only inhaled.

6) Besides nicotine drugs and nicotine antagonist drugs, other drugs--such as the antidepressant drug bupropion (Zyban) and clonidine (Catapres) that is used to treat hypertension--are also used to persons to stop smoking.

Answer: TRUE 7) The ending -tropium is common to generic anticholinergic bronchodilator drugs.

Answer: TRUE 8) A spacer connected to a metered-dose inhaler helps the patient coordinate the steps needed to use the inhaler correctly.

Answer: TRUE 9) Mucinex is the prescription form of the generic drug guaifenesin.

Answer: FALSE Explanation: This is a false statement. Mucinex is the over-the-counter form of guaifenesin.

10) For the drug Nicoderm CQ, the CQ stands for Committed Quitters, a behavior modification program sponsored by the drug company.

Answer: TRUE 11) The monoclonal antibody drug omalizumab (Xolair) is a powder that is inhaled to prevent an acute asthma attack.

Answer: FALSE Explanation: This is a false statement. This drug is given by subcutaneous injection.

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12) Mast cell stabilizer drugs prevent mast cells from releasing histamine and causing bronchospasm in patients with asthma due to allergies.

Answer: TRUE 13) The ending -terol is common to nicotine antagonist drugs.

Answer: FALSE Explanation: This is a false statement. This ending is common to beta-agonist bronchodilator drugs.

14) Nicotine addiction is the most common form of chemical dependence.

Answer: TRUE 15) With the newest advances in pharmacology, tuberculosis that was resistant to regular antibiotic drugs has become a thing of the past.

Answer: FALSE Explanation: This is a false statement. Tuberculosis is still resistant to regular antibiotic drugs.

16) Corticosteroid drugs mimic the action of the hormone cortisol, which is produced in the lungs.

Answer: FALSE Explanation: This statement is false. Cortisol is produced in the cortex of the adrenal gland.

17) Bronchodilator drugs relax the smooth muscle that surrounds the bronchi, allowing the bronchi to dilate to increase air flow.

Answer: TRUE 18) Nicotine is not an addictive substance, but it just the pleasure that smoking gives that makes it difficult to quit smoking.

Answer: FALSE 19) 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: This is a false statement. Inhalers used to contain CFC, which was replaced by HFA. 20) The endings -solide, -solone, and -sonide are common to generic corticosteroid drugs.

Answer: TRUE 21) In some cities, patients with tuberculosis can be ordered to go to jail if they are noncompliant with taking their antitubercular drugs.

Answer: TRUE 22) The abbreviation MDI refers to a device that contains a bronchodilator or corticosteroid drug used to treat asthma.

Answer: TRUE Explanation: MDI stands for metered-dose inhaler.

10

23) The abbreviation IHN stands for the drug isoniazid.

Answer: TRUE 24) The well-known generic corticosteroid drug mometasone is related to the trade name drug Asmanex.

Answer: TRUE 25) Cigarette smoking is the leading preventable cause of death in the United States.

Answer: TRUE 10.3 Short Answer Questions 1) Monoclonal antibody drugs bind with E (IgE) and keep it from attaching to receptors on mast cells and basophils and triggering the release of histamine.

Answer: immunoglobulin 2) Mast cell stabilizer drugs stabilize the cell membrane of mast cells and prevent them from releasing during the immune system's response to an antigen.

Answer: histamine 3) The ending -phylline is common to generic xanthine Answer: bronchodilator

drugs.

Mucus (sputum) so that the patient can 4) drugs reduce the viscosity oNrUtRhSicIkNnGeTsBs .oCfOm more easily cough it up.

Answer: Expectorant

5) A inhaler is an inhaler device that contains a quick-acting bronchodilator drug to quickly relieve a patient with acute asthma symptoms.

Answer: rescue 6) Most corticosteroid drugs are given by an inhaler device and the dose is prescribed in numbers of or actuations.

Answer: puffs 7) An MDI is an L-shaped device used to administer drugs. The abbreviation MDI stands for .

Answer: metered-dose inhaler 8) The abbreviation DOT stands for Answer: directly observed therapy

.

9) A Twisthaler device uses a drug in the form of a Answer: powder 10) The abbreviation MDRTB stands for Answer: Multidrug resistant tuberculosis

to treat asthma.

.

11

11) A is a long plastic chamber attached to a metered-dose inhaler.

Answer: spacer 12) The common ending at the end of generic monoclonal antibody drugs is Answer: mab 13) Treatment of tuberculosis must be continued for a full of antitubercular drugs.

Answer: nine

.

months with a combination

14) Reversible obstructive airway disease is also known by the more common disease name of .

Answer: asthma 15) Epinephrine from the sympathetic division of the nervous system causes the bronchioles to (widen) and this increases the flow of air.

Answer: dilate 16) A Twisthaler device is held in a lungs.

Answer: horizontal

position and the powdered drug is inhaled into the

12

10.4 Matching Questions Match the drugs in Column 1 with their drug category in Column 2.

A) nicotine antagonist drug B) drug for tuberculosis C) xanthine bronchodilator drug D) beta-agonist bronchodilator drug E) monoclonal antibody drug F) mast cell stabilizer drug G) expectorant drug H) leukotriene receptor blocker drug I) corticosteroid drug J) combination bronchodilator drug 1) albuterol (Proventil, HFA, Ventolin HFA) 2) theophylline (Elixophyllin) 3) Combivent 4) cromolyn (Intal) 5) guaifenesin (Humibid, Mucinex, Robitussin) 6) isoniazid (INH) (Nydrazid) 7) omalizumab (Xolair) 8) flunisolide (AeroBid) 9) varenicline (Chantix) 10) zafirlukast (Accolate) Answers: 1) D 2) C 3) J 4) F 5) G 6) B 7) E 8) I 9) A 10) H

13

10.5 Essay Questions 1) 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. To minimize the chance of resistant strains, antitubercular drugs are given in combination, and patients must continue drug treatment for a full nine months 2) Discuss how nicotine drugs and nicotine antagonist drugs differ in their therapeutic effects and their approach to helping patients stop smoking.

Answer: Nicotine drugs provide a gradual withdrawal from nicotine, which diminishes the craving and helps people to successfully stop smoking. Nicotine antagonist drugs bind to nicotine receptors and block them from being activated by inhaled nicotine.

14

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 11 Cardiovascular Drugs 11.1 Multiple-Choice Questions 1) Hypertension is characterized by an increase in .

A) the systolic blood pressure B) the diastolic blood pressure C) the systolic and/or diastolic blood pressure D) blood cholesterol Answer: C Explanation: A) This is correct, but it is not the only correct answer.

B) This is correct, but it is not the only correct answer.

D) Hypertension is related to pressure, not cholesterol.

2) 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 pressureNbUuRt SnIoNtGbTyBe.CxOcrMeting sodium and water.

D) These drugs are not used to lower the blood pressure.

3) 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.

C) Cholesterol is not excreted by the kidneys.

D) Bile acid sequestrant drugs do not inhibit cholesterol formation.

4) 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.

1

5) To decrease the pain of angina pectoris, beta-blocker drugs .

A) decrease the heart rate, which decreases the myocardium's need for oxygen B) decrease the heart rate, which increases the myocardium's need for oxygen C) increase the heart rate, which decreases the myocardium's need for oxygen D) increase the heart rate, which increases the myocardium's need for oxygen Answer: A Explanation: B) Decreasing the heart rate does not increase the myocardium's need for oxygen.

C) Beta-blocker drugs do not increase the heart rate.

D) Beta-blocker drugs do not increase the heart rate.

6) When the drug atropine is used to treat bradycardia, its action is to A) block the movement of calcium to allow the coronary arteries to dilate B) block acetylcholine receptors in the heart so that the heart rate increases C) have a negative chronotropic effect D) lower the cholesterol level Answer: B Explanation: A) This action does not treat bradycardia.

C) This action slows the heart, which is not desirable in bradycardia.

D) The cholesterol level is not related to bradycardia.

.

7) Beta-blocker drugs used to treat hypertension block all beta receptors in the heart and keep them from binding to .

A) acetylcholine B) angiotensin C) epinephrine D) calcium Answer: C Explanation: A) Beta-blocker drugs do not block acetylcholine.

B) Beta-blocker drugs do not block angiotensin.

D) Beta-blocker drugs do not block calcium.

8) drugs relax smooth muscle in the walls of the arteries, cause the arteries to dilate, and 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 with this action.

D) Only one answer is correct.

2

9) Calcium channel blocker drugs block the movement of calcium ions into the heart muscle and 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) lowering the cholesterol level Answer: D Explanation: A) This is one of the results.

B) This is one of the results.

C) This is one of the results.

10) 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 flutter and fibrillation B) treat digitalis drug toxicity C) treat essential familial tremor D) prevent migraine headaches Answer: B Explanation: A) Propranolol is used to treat atrial flutter and fibrillation.

C) Propranolol is used to treat that.

D) Propranolol is used to prevent migraine headaches.

11) 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.

D) Angiotensin II is part of the body's own natural blood pressure-regulating system.

3

12) James Raucher has had asthma since he was a child. When he turned 60, he also developed hypertension. His physician 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) are more effective than other beta-blocker drugs for treating hypertension D) are better than other beta-blocker drugs in keeping the bronchi open and treating patients with hypertension and lung disease Answer: D Explanation: A) Cardioselective beta-blocker drugs can be given to any person with hypertension, regardless of the age.

B) Cardioselective beta-blocker drugs are no more likely to cause an allergic reaction than other beta-blocker drugs.

C) Cardioselective beta-blocker drugs are not more effective in treating hypertension than other beta-blocker drugs.

13) Which of the following statements is FALSE? A) Congestive heart failure was first treated with dried foxglove plant.

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) Lopid is the trade name for gemfibrozil, not digoxin.

D) This statement is true.

14) The ending _ 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.

D) The suffix -pril is not common to generic beta-blocker drugs.

15) Which of the following is a digitalis drug used to treat congestive heart failure?

A) digoxin (Lanoxin) B) nadolol (Corgard) C) digoxin immune Fab (Digibind, DigiFab) D) valsartan (Diovan) Answer: A Explanation: B) Nadolol (Corgard) is a beta-blocker drug.

C) Digoxin immune Fab is not used to treat congestive heart failure D) Valsartan (Diovan) is not a digitalis drug.

4

16) What is the trade name of the generic beta-blocker drug propranolol?

A) Xylocaine B) Mavik C) Inderal D) Tenormin Answer: C Explanation: A) Xylocaine is not the trade name of propranolol.

B) Mavik is not the trade name of propranolol.

D) Tenormin is not the trade name of propranolol.

17) The generic drug used to treat congestive heart failure is 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.

D) Herbs are not used to treat congestive heart failure.

.

18) All of the following are trade name calcium channel blocker drugs, EXCEPT A) Xylocaine B) Procardia C) Cardizem D) Calan Answer: A Explanation: B) Procardia is a calcium channel blocker drug.

C) Cardizem is a calcium channel blocker drug.

D) Calan is a calcium channel blocker drug.

19) All of the following trade name drugs are used to treat an elevated level of cholesterol, EXCEPT .

A) Lipitor B) Lopid C) Lanoxin D) Crestor Answer: C Explanation: A) Lipitor is used to treat elevated level of cholesterol.

B) Lopid is used to treat an elevated level of cholesterol.

D) Crestor is used to treat an elevated level of cholesterol.

5

.

20) The trade names for nitroglycerin include all of the following, EXCEPT A) Zocor B) Nitro-Bid C) Minitran D) Nitrostat Answer: A Explanation: 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.

21) An elevated level of cholesterol in the blood can be due to A) a genetic disorder B) eating foods of animal origin C) dietary intake of egg yolks, cream, and lard 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.

.

22) Nitroglycerin is available in all of the following drug forms, EXCEPT A) topical ointment B) sublingual tablet or spray C) inhaled powder D) transdermal patch Answer: C Explanation: A) Nitroglycerin is available as a topical ointment.

B) Nitroglycerin is available in these drug forms.

D) Nitroglycerin is available as a transdermal patch.

23) All of the following are beta-blocker drugs, EXCEPT A) betaxolol (Kerlone) B) bisoprolol (Zebeta) C) metoprolol (Lopressor, Toprol) D) hydralazine (Apresoline) Answer: D Explanation: A) Betaxolol (Kerlone) is a beta-blocker drug.

B) Bisoprolol (Zebeta) is a beta-blocker drug.

C) Metoprolol (Lopressor, Toprol) is a beta-blocker drug.

6

.

.

.

24) An elevated level of triglycerides can be caused by all of the following, EXCEPT A) excessive dietary intake of sugar B) excessive dietary intake of meat C) excessive dietary intake of oils and margarine D) all of the above Answer: B Explanation: A) Excessive dietary intake of sugar can cause elevated triglycerides.

C) Excessive dietary intake of oils and margarine can cause elevated triglycerides.

D) Only one of the answers is correct.

25) The trade name for the antiarrhythmic generic drug lidocaine is A) Xylocaine B) Lipitor C) Tekturna D) Inderal Answer: A Explanation: B) Lipitor is the trade name for the generic drug atorvastatin.

C) Tekturna is the trade name for the generic drug aliskiren.

D) Inderal is the trade name for the generic drug propranolol.

.

26) Which of the following drugs is NOT an ACE inhibitor drug used to treat hypertension?

A) benazepril (Lotensin) B) telmisartan (Micardis) C) lisinopril (Prinivil, Zestril) D) captopril (Capoten) Answer: B Explanation: A) Benazepril (Lotensin) is an ACE inhibitor drug.

C) Lisinopril (Prinivil, Zestril) is an ACE inhibitor drug.

D) Captopril (Capoten) is an ACE inhibitor drug.

27) Types of cardiac arrhythmias include all of the following, EXCEPT A) hyperlipidemia B) bradycardia C) atrial flutter D) fibrillation Answer: A Explanation: B) Bradycardia is a cardiac arrhythmia.

C) Atrial flutter is a cardiac arrhythmia.

D) Fibrillation is a cardiac arrhythmia.

7

.

.

28) Which of the following statements is TRUE concerning digitalis drugs?

A) They have a positive inotropic effect.

B) They have 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.

29) Symptoms of digitalis toxicity include all of the following, EXCEPT A) pulse rate below 60 beats per minute B) a myocardial infarction C) nausea, vomiting, and diarrhea D) yellow-green halos around lights Answer: B Explanation: A) This is a symptom of digitalis toxicity.

C) These are symptoms of digitalis toxicity.

D) This is a symptom of digitalis toxicity.

.

30) All of the following trade name drugs are used to treat an elevated level of cholesterol, EXCEPT .

A) Zocor B) Zetia C) Lopressor 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.

D) WelChol is used to treat an elevated level of cholesterol.

31) Which of the following does NOT belong to the drug category of calcium channel blockers?

A) amlodipine (Norvasc) B) nifedipine (Adalat, Procardia) C) isradipine (DynaCirc) D) prazosin (Minipress) Answer: D Explanation: A) Amlodipine (Norvasc) is a calcium channel blocker drug.

B) Nifedipine (Adalat, Procardia) is a calcium channel blocker drug.

C) Isradipine (DynaCirc) is a calcium channel blocker drug.

8

32) How are symptoms of digitalis toxicity treated?

A) By giving the drug less frequently B) By decreasing the dose of the drug C) by administering an antidote drug to reverse the toxic level.

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.

33) 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: 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."

34) 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: 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.

.

35) Suzi Choi is a professional golfer. She takes a beta-blocker drug to help ease the performance anxiety she feels when she has to play in front of large crowds or in a televised golf tournament. The beta-blocker drug relieves all of the following symptoms, EXCEPT .

A) arrhythmias B) cold extremities C) inability to concentrate D) dry mouth and tremors Answer: A Explanation: B) Beta-blocker drugs do relieve cold extremities caused by performance anxiety.

C) Beta-blocker drugs do relieve an inability to concentrate caused by performance anxiety.

D) Beta-blocker drugs do relieve dry mouth and tremors caused by performance anxiety.

9

36) Very low-density lipoproteins carry _ in the blood.

A) triglycerides B) sodium C) the hormone epinephrine D) cholesterol Answer: A Explanation: 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.

37) Which of the following is a combination drug that contains two drugs that both lower the serum cholesterol level?

A) Lopid B) Nitro-Dur C) Vytorin D) Rythmol Answer: C Explanation: A) Lopid is not a combination drug.

B) Nitro-Dur is not a combination drug.

D) Rythmol is not a combination drug.

38) All of the following categories of drugs are used to treat congestive heart failure, EXCEPT .

A) digitalis drugs B) ACE inhibitor drugs C) "statin drugs" D) diuretic drugs Answer: C Explanation: A) Digitalis drugs are used to treat congestive heart failure.

B) ACE inhibitor drugs are used to treat congestive heart failure.

D) Diuretic drugs are used to treat congestive heart failure.

39) 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.

10

40) 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.

41) The well-known generic name drug rosuvastatin that is used to treat hypercholesterolemia is related to the trade name drug .

A) Capoten B) Crestor C) Cardizem D) all of the above Answer: B Explanation: A) This is related to the generic drug captopril.

C) This is related to the generic drug diltiazem.

D) Only one answer is correct.

42) Over-the-counter, low-dose, 81-mg tablets of this anticoagulant drug are taken daily by patients with heart disease who have had a heart attack or stroke.

A) red yeast B) aspirin C) sheep antibodies D) all of the above Answer: B Explanation: A) This is not an anticoagulant drug for heart disease.

C) These are not an anticoagulant drug.

D) Only one answer is correct.

11.2 True/False Questions 1) Hyperlipidemia is a category that includes both hypercholesterolemia and hypertriglyceridemia.

Answer: TRUE 2) HMG-CoA reductase inhibitor drugs block HMG-CoA reductase, an enzyme that is involved in the production of cholesterol in the body.

Answer: TRUE 3) A high level of HDL is undesirable.

Answer: FALSE Explanation: This is a false statement. A high level of HDL ("good cholesterol") is desirable.

11

4) By blocking an enzyme, ACE inhibitor drugs cause blood vessels to dilate, and this decreases the blood pressure.

Answer: TRUE 5) In patients with angina pectoris, anticoagulant drugs and thrombin inhibitor drugs are prescribed to prevent a blood clot that would cause a myocardial infarction.

Answer: TRUE 6) Drugs that are used to treat ventricular fibrillation are also used when the heart has already stopped beating (cardiac arrest).

Answer: FALSE Explanation: This is a false statement. These drugs have no effect if the heart has already stopped beating.

7) Alcoholic beverages contain sugar that is converted into triglycerides by the body.

Answer: TRUE 8) Digitalis drugs have a positive inotropic effect in treating congestive heart failure because they cause a stronger, more forceful contraction of the heart muscle cells.

Answer: TRUE 9) The pain of angina pectoris occurs when heart muscle cells die.

Answer: FALSE Explanation: This is a false statement. ANnUgRinSaINoGcTcuBr.Cs OhM eart muscle cells receive too little oxygenated blood. when 10) All beta receptors are stimulated by the hormone epinephrine in response to stress or danger.

Answer: TRUE 11) In 1967 when it was approved by the FDA, propranolol became the first drug in the betablocker category.

Answer: TRUE 12) After a myocardial infarction, drugs can be given to improve heart function and reverse the cells that have died.

Answer: FALSE Explanation: This is a false statement. Drugs can improve heart function but cannot reverse the cells that have died.

13) Chris Zanzone has just discovered that he has hyperlipidemia. Drug therapy, not lifestyle changes, is the first choice of treatment for hyperlipidemia.

Answer: FALSE Explanation: This is a false statement. Lifestyle changes are first.

14) The suffix -sartan is common to generic angiotensin II receptor blocker drugs.

Answer: TRUE 12

15) Alpha-1-blocker drugs are used to treat hypertension because they block alpha1 receptors located in the arteries and veins.

Answer: TRUE 16) HMG-CoA reductase inhibitor drugs are used to treat hypercholesterolemia.

Answer: TRUE 17) Digitalis drugs often causes toxicity because they have a short half-life.

Answer: FALSE Explanation: This is a false statement. They have a long half-life.

18) Oatmeal in the diet is an effective way to reduce the cholesterol level of the blood.

Answer: TRUE 19) Nesiritide (Natrecor), a drug used to treat congestive heart failure, is manufactured from E. coli bacteria, using recombinant DNA technology.

Answer: TRUE 20) Bile acid sequestrant drugs are used to treat the pain of angina pectoris.

Answer: FALSE Explanation: This is a false statement. They are used to treat hypercholesterolemia.

21) Inderide is a combination drug that contains the beta-blocker drug propranolol and the diuretic drug hydrochlorothiazide.

Answer: TRUE 22) The American Heart Association recommends eating fish and taking fish oil supplements that contain omega-3 fatty acids to reduce cholesterol and triglyceride levels.

Answer: FALSE Explanation: This is a false statement. It only recommends eating fish.

23) Normal blood pressure is defined as 120/80 mm Hg. Answer: TRUE 24) All generic HCG-CoA reductase inhibitor drugs have a common ending of -statin.

Answer: TRUE 25) Oatmeal can lower the cholesterol in the blood because its oat fiber binds to bile and keeps it from being reabsorbed into the blood.

Answer: TRUE

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11.3 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 water in the urine, which lowers the blood pressure.

Answer: sodium

and

3) To be transported through the blood, cholesterol and triglycerides must bind to certain 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 5) is the most frequently prescribed nitrate drug used to treat angina pectoris.

Answer: Nitroglycerin 6) The generic drug used to treat ventricular fibrillation and that is also used as an anesthetic drug is known as lidocaine and its trade name is .

Answer: Xylocaine 7) Hypertension is caused by arteriosclerosis or kidney failure, but no identifiable cause.

Answer: essential 8) Beta receptors located in the Answer: heart

hypertension has

are designated as beta1 receptors.

9) 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 10) Cholesterol is produced by the Answer: liver

and also comes from dietary intake from foods.

11) Digoxin immune Fab, which is used to treat digitalis 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 12) The peripheral vasodilator drug minoxidil is used to treat hypertension, but it is also used topically under the trade name Rogaine to treat .

Answer: thinning hair and baldness 14

13) The abbreviation HTN stands for Answer: hypertension

.

14) The abbreviation ACE stands for Answer: angiotensin-converting enzyme

.

15) The phrase stepped-care approach is related to the treatment of Answer: hypertension

.

16) The well-known generic beta-blocker drug propranolol is related to the trade name drug .

Answer: Inderal 17) The phrase "statin drugs" brings to mind the category of drugs used to treat high Answer: cholesterol

15

.

11.4 Matching Questions Group A Match the name of the drug for hypertension in Column 1 to its drug category in Column 2.

A) ACE inhibitor drug B) angiotensin II receptor blocker drug C) beta-blocker drug D) calcium channel blocker drug E) peripheral vasodilator drug 1) diltiazem (Cardizem) 2) hydralazine (Apresoline) 3) losartan (Cozaar) 4) propranolol (Inderal) 5) quinapril (Accupril) Answers: 1) D 2) E 3) B 4) C 5) A Group B Match the drug name in Column 1 with the arrhythmia it is used to treat in Column 2.

A) ventricular tachycardia B) ventricular fibrillation C) bradycardia D) atrial flutter and fibrillation E) heart block 6) adenosine (Adenocard) 7) lidocaine (Xylocaine) 8) atropine 9) digoxin (Lanoxin) 10) isoproterenol (Isuprel) Answers: 6) A 7) B 8) C 9) D 10) E

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11.5 Essay Questions 1) Explain how the effect of cardioselective beta-blocker drugs differs from that of regular betablocker drugs. What type of patient are cardioselective beta-blocker drugs specifically used to treat?

Answer: Regular beta-blocker drugs slow the heart rate and cause the blood vessels to dilate to treat hypertension. But these drugs also cause the bronchioles to constrict. Cardioselective betablocker drugs are more selective in their effect and only slightly block beta2 receptors in the bronchioles. Patients who have hypertension and lung disease are specifically given cardioselective beta-blocker drugs.

2) What lifestyle changes are suggested to patients before they would be started on a drug for hypertension.

Answer: Patients with hypertension are asked to restrict the use of salt in cooking and at the table, or the physician may prescribe a low-salt diet to limit total dietary sodium intake. In addition, the patient may be asked to lose weight, increase physical activity, and stop smoking.

3) Describe the three ways that a patient is treated who has symptoms of digitalis toxicity.

Answer: The dose of the digitalis drug is decreased, the digitalis drug is given less frequently, or an antidote drug is administered to reverse the toxic level.

4) Describe the two ways (one normal and one unique) that a patient can take a capsule of diltiazem (Cardizem).

Answer: The extended-release capsule cNaUnRbSeINtaGkTeBn.CoO raM lly or it can be opened and the powder inside sprinkled on a spoonful of applesauce and then swallowed.

5) Describe the difference between lisinopril (Zestril) and Zestoretic.

Answer: Lisinopril (Zestril) is an ACE inhibitor drug used to treat hypertension. Zestoretic is a combination drug that contains the generic ACE inhibitor drug lisinopril and the diuretic drug hydrochlorothiazide.

6) Describe how nitroglycerin is taken as a sublingual tablet and why this can act quickly to treat angina pectoris.

Answer: Nitroglycerin is taken as a sublingual tablet that is placed under the tongue and allowed to dissolve. The drug then moves into the large blood vessels beneath the tongue and into the blood where it can immediately begin to ease the pain of angina pectoris.

17

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 12 Hematologic Drugs 12.1 Multiple-Choice Questions 1) Blood coagulates to form a blood clot through a complex series of steps involving all of the following substances, EXCEPT .

A) clotting factors B) platelets C) white blood cells D) thromboplastin Answer: D Explanation: A) Clotting factors are involved in the steps of blood clotting.

B) Platelets are involved in the steps of blood clotting.

D) Thromboplastin is involved in the steps of blood clotting.

2) Warfarin (Coumadin, Jantoven) is .

A) measured in milligrams B) given orally C) given intravenously 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 corrN ecUtRaSnIsNwGeTrB. .COM C) This is true, but it is not the only correct answer.

3) drugs bind to fibrin strands in the clot, convert plasminogen in the clot to plasmin (fibrinolysin), an enzyme that breaks apart fibrin and the clot.

A) Anticoagulant B) Platelet aggregation inhibitor C) Factor Xa inhibitor D) Thrombolytic Answer: D Explanation: A) Anticoagulant drugs do not bind to fibrin strands.

B) Platelet aggregation inhibitor drugs do not bind to fibrin strands.

C) Factor Xa inhibitor drugs do not bind to fibrin strands.

1

4) The formation of many clotting factors is dependent on the presence of .

A) fibrin B) plasminogen C) thrombin D) vitamin K Answer: D 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) 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 a dose actually exerts 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.

C) This number is not correct.

D) This number is not correct.

of

NUR.SINGTB.COM 6) Heparin is always measured in A) grains B) milligrams C) milliliters D) units Answer: D Explanation: A) Heparin is not measured in grains.

B) Heparin is not measured in milligrams.

C) Heparin is not measured in milliliters.

7) While she was in the hospital, Renee Waters was receiving subcutaneous heparin administered by a nurse. Now that she is being discharged home, the physician 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) Intravenous anticoagulant drugs are not appropriate for a home setting.

B) Intravenous heparin is not appropriate for a home setting.

D) Heparin cannot be administered orally.

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8) Some platelet aggregation inhibitor drugs block a receptor (glycoprotein IIb/IIIA) on platelets, and this prevents fibrinogen (clotting factor I) from binding to .

A) heparin B) plasminogen (clotting factor II) C) its receptor D) vitamin K Answer: C Explanation: A) Platelet aggregation inhibitor drugs do not affect heparin.

B) Platelet aggregation inhibitor drugs do not affect plasminogen.

D) Platelet aggregation inhibitor drugs do not affect vitamin K. 9) One cause of anemia is due to a decrease in the in the blood.

A) amount of vitamin K B) number of clotting factors C) number of red blood cells D) volume of blood Answer: C Explanation: A) Vitamin K plays a role in blood clotting, not anemia.

B) Clotting factors play a role in blood clotting, not anemia.

D) The volume of blood is not the cause of anemia.

10) 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.

D) Anticoagulant drugs cannot treat a blood clot.

11) The first prescription anticoagulant drug available was A) folic acid B) heparin C) thrombin inhibitor drugs D) warfarin Answer: B Explanation: A) Folic acid was not the first anticoagulant drug.

C) These were not the first anticoagulant drug.

D) Warfarin was not the first anticoagulant drug.

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.

12) The platelet aggregation inhibitor drug dipyridamole (Persantine) is given along with other anticoagulant drugs to preventing platelets from _ .

A) adhering to artificial heart valves B) forming blood clots after a myocardial infarction C) causing anemia D) inhibiting vitamin K Answer: A Explanation: B) Dipyridamole does not keep blood clots from forming after a myocardial infarction.

C) Platelets do not cause anemia.

D) Platelets do not inhibit vitamin K. 13) Cathflo Activase is used to .

A) break up a clot that has formed in a urinary catheter B) break up a clot that has formed in a central venous catheter or intravenous line C) prevent a clot from forming in a central line D) to do hemodialysis Answer: B Explanation: A) Cathflo Activase is not used in urinary catheters.

C) Cathflo Activase does not prevent blood clots from forming.

D) Cathflo Activase is not used with hemodialysis.

14) Tissue plasminogen activator (tPA) drugs are given at the time of 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.

15) 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.

D) Anemia can be due to insufficient amounts of iron.

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to dissolve a

.

16) All of the following statements about protamine sulfate are 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.

C) It is not used to treat anemia.

D) It is not an anticoagulant drug.

17) 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: 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.

18) 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.

19) All of the following are platelet aggregation inhibitor drugs, EXCEPT A) aspirin (Bayer, Ecotrin) B) apixaban (Eliquis) C) ticlopidine (Ticlid) D) dipyridamole (Persantine) Answer: B Explanation: A) This is a platelet aggregation inhibitor drug.

B) This is a factor Xa inhibitor drug.

C) This is a platelet aggregation inhibitor drug.

D) This is a platelet aggregation inhibitor drug.

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.

20) All of the generic drugs that have or iron in their name are iron supplements that are used to treat iron deficiency anemia.

A) aggregation B) inhibitor C) enzyme D) 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.

21) The ending _ is common to generic name heparin and low molecular weight heparin drugs.

A) -rudin B) -parin C) -ase D) all of the above Answer: B Explanation: A) The ending -rudin is not common to generic name heparin drugs.

C) The ending -ase is not common to generic name heparin drugs.

D) There is only one correct answer.

22) 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.

23) Which of the following statements about low molecular weight heparins is FALSE? A) Low molecular weight heparins are prepared from cows' or pigs' intestines.

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 from the original heparin molecule.

Answer: C Explanation: A) This statement is true.

B) This statement is true.

C) Their molecular size is smaller.

D) This statement is true.

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24) 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: B) Warfarin (Coumadin, Jantoven) is given orally.

C) Aspirin is given orally.

D) This is given orally.

.

25) 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) beef liver C) soybeans, soy milk, and tofu 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.

26) All of the following are thrombin inhibitor drugs, EXCEPT A) apixaban (Eliquis) B) bivalirudin (Angiomax) C) desirudin (Ipravask) D) lepirudin (Refludan) Answer: A Explanation: B) Bivalirudin (Angiomax) is a thrombin inhibitor drug.

C) Desirudin (Ipravask) is a thrombin inhibitor drug.

D) Lepirudin (Refludan) is a thrombin inhibitor drug.

27) Which of the following is 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 hemorrhagic disease of the newborn.

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.

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.

28) All of the following are low molecular weight heparin drugs, EXCEPT A) heparin B) tinzaparin (Innohep) C) dalteparin (Fragmin) D) enoxaparin (Lovenox) Answer: A Explanation: B) This is a low molecular weight heparin drug.

C) This is a low molecular weight heparin drug.

D) This is a low molecular weight heparin drug.

.

29) Anemia can be caused by all of the following, EXCEPT .

A) a lack of vitamin K B) radiation or chemotherapy drugs that damage the bone marrow C) blood loss due to trauma or hemophilia D) increased destruction of red blood cells Answer: A Explanation: B) Radiation or chemotherapy drugs can damage the red bone marrow and cause anemia.

C) Anemia can be caused by this.

D) Anemia can be caused by this.

30) 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 hemorrhagic disease C) taking an anticoagulant drug with a meal of leafy green vegetables D) all of the above Answer: C Explanation: A) This is not an example of antagonism.

B) This is not an example of antagonism.

D) Only one of the answers is an example of antagonism.

31) A platelet aggregation inhibitor drug would be given in all of the following situations, EXCEPT .

A) to prevent hemorrhagic disease after a newborn's birth B) to prevent a blood clot after a myocardial infarction or stroke C) to prevent a blood clot during angioplasty or cardiac valve surgery D) to treat patients with acute coronary syndrome Answer: A Explanation: B) This IS a situation where a platelet aggregation inhibitor drug is given.

C) This IS a situation where a platelet aggregation inhibitor drug is given.

D) This IS a situation where a platelet aggregation inhibitor drug is given.

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32) In the drugs ferrous fumarate (Ferro-Sequels and ferrous gluconate (Fergon), 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.

C) This drug does not contain thrombin.

D) This drug does not contain erythropoietin.

33) The abbreviation LMWH is associated with the drug A) rivaroxaban (Xarelto) B) ferrous sulfate C) factor VIII D) heparin Answer: D Explanation: A) It is not associated with this drug.

B) It is not associated with this drug.

C) It is not associated with this drug.

.

34) The generic platelet aggregation inhibitor drug clopidogrel is related to the well-known trade name drug .

A) Trental B) Eliquis C) Plavix D) Coumadin Answer: C Explanation: A) This is not related to the generic drug clopidogrel.

B) This is not related to the generic drug clopidogrel.

D) This is not related to the generic drug clopidogrel.

35) Besides being an antiplatelet drug, aspirin has other effects that include A) relieving pain B) reducing fever C) reducing inflammation 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.

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.

12.2 True/False Questions 1) The liver produces clotting factors I through VIII. Answer: FALSE Explanation: This is a false statement. The liver produces clotting factors I through XIII. 2) Heparin inhibits clotting factor X in the liver, which stops the series of steps needed to form a blood clot.

Answer: TRUE 3) Heparin can only be given subcutaneously or intravenously.

Answer: TRUE 4) Platelet aggregation inhibitor drugs prevent platelets from binding to the site of injury or from clumping together to begin the formation of a clot.

Answer: TRUE 5) Platelet aggregation inhibitor drugs are classified 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 or platelets.

Answer: FALSE Explanation: This is a false statement. They have no effect on thrombin or platelets.

8) Anticoagulant drugs can prevent blood clots from forming, prevent blood clots from enlarging, and are effective in dissolving blood clots once they have formed.

Answer: FALSE Explanation: This is a false statement. Anticoagulant cannot break apart a blood clot.

9) Protamine sulfate, a heparin antagonist drug, is used to treat heparin overdose or to reverse the 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 drug Coagulin-B is the actual cellular gene that directs the liver to produce clotting factor IX. Answer: TRUE

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12) The anticoagulant drug warfarin blocks vitamin C to keep the liver from producing clotting factors.

Answer: FALSE Explanation: This is a false statement. Warfarin blocks vitamin K. 13) Thrombolytic enzyme drugs revolutionized the treatment of myocardial infarction and stroke because they were the first drugs that could actually dissolve a clot.

Answer: TRUE 14) Darbepoetin alfa, epoetin alfa, and epoetin beta are erythropoietin-like drugs created with recombinant DNA technology.

Answer: TRUE 15) The anticoagulant drug warfarin (Coumadin, Jantoven) can dissolve clots that have already formed.

Answer: FALSE 16) A saline or heparin lock is a device that provides immediate intravenous access for administering intravenous drugs without the need to have intravenous fluids running continuously.

Answer: TRUE 17) Factor Xa inhibitor drugs are used to prevent blood clots in patients undergoing joint replacement surgery or abdominal surgeN ryU. RSINGTB.COM Answer: TRUE 18) Anticoagulant drugs are given during hemodialysis for patients with chronic kidney failure.

Answer: TRUE 19) Aspirin prolongs the clotting time by inhibiting thromboxane, a substance in the blood that causes platelet aggregation.

Answer: TRUE 12.3 Short Answer Questions 1) Platelets stick to damaged tissue to form clumps, and this process is known as platelet .

Answer: aggregation 2) The ending of thrombolytic drugs.

Answer: -ase 3) The tPA drugs can Answer: dissolve

(which means enzyme) is common to both the generic and trade names

(break apart) a blood clot once it has formed.

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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 Answer: red

_ blood cells (erythrocytes).

8) The ending -rudin is common to generic Answer: thrombin

inhibitor drugs.

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-thecounter is the drug .

Answer: aspirin

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12.4 Matching Questions Match the drug names in Column 1 with their drug category in Column 2.

A) over-the-counter iron supplement B) tissue plasminogen activator drug C) erythropoietin-like drug for anemia D) factor Xa inhibitor drug E) platelet aggregation inhibitor drug F) thrombin inhibitor drug G) warfarin H) low molecular weight heparin drug I) drug used to treat hemophilia J) combination aspirin and platelet aggregation inhibitor drug 1) clopidogrel (Plavix) 2) ferrous sulfate 3) Aggrenox 4) bivalirudin (Angiomax) 5) Coumadin 6) enoxaparin (Lovenox) 7) epoetin alfa (Epogen, Procrit) 8) fondaparinux (Arixtra) 9) reteplase (Retavase) 10) factor VIIa (NovoSeven) Answers: 1) E 2) A 3) J 4) F 5) G 6) H 7) C 8) D 9) B 10) I

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12.5 Essay Questions 1) Describe the five different ways that different anticoagulant drugs work to prevent a blood clot from forming.

Answer: Some anticoagulant drugs inhibit the action of clotting factors in the blood, or they inhibit the formation of those clotting factors in the liver. Other anticoagulant drugs prevent platelets from adhering to the site of injury or prevent platelets from clumping together to begin the formation of a clot. Still other anticoagulant drugs decrease the viscosity (thickness) of the blood and increase red blood cell flexibility to promote the flow of blood.

2) Discuss what foods cause an antagonist drug-food interaction in patients taking warfarin (Coumadin, Jantoven). What one food causes a synergism drug-food interaction?

Answer: Leafy green vegetables (broccoli, Brussels sprouts, spinach, bok choi, kale, parsley, turnip greens), beef liver, garbanzo beans (chickpeas), and soy products (soybeans, soy milk, tofu) contain large amounts of vitamin K that can decrease the therapeutic effect of an anticoagulant drug (antagonism). On the other hand, garlic has its own natural anticoagulant effect that increases the therapeutic effect of an anticoagulant drug (synergism).

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 13 Gynecologic and Obstetric Drugs 13.1 Multiple-Choice Questions 1) Which of the following is NOT the action of a drug used to prevent pregnancy?

A) changing the hormonal environment so that the ovary does not produce or release a mature ovum B) preventing the production of spermatozoa in the male C) keeping a fertilized ovum from implanting in the endometrium D) killing spermatozoa from the male Answer: B Explanation: A) This IS the action of a drug used to prevent pregnancy.

B) The drugs do not prevent sperm in the male from being produced.

C) This IS the action of a drug used to prevent pregnancy.

D) This IS the action of a drug used to prevent pregnancy.

2) Monophasic oral contraceptive drugs have a .

A) fixed dose of a progestins drug and a varying dose of an estrogen drug B) fixed dose of both a progestins drug and an estrogen drug C) varying dose of a progestins drug and a fixed dose of an estrogen D) varying dose of both a progestins drug and an estrogen drug Answer: B Explanation: A) Monophasic oral contraNcUeR ptSiIvNeGdTrBu.gCsOdMo not have a varying dose of an estrogen drug.

C) Monophasic oral contraceptive drugs do not have a varying dose of a progestins drug.

D) Monophasic oral contraceptive drugs have a fixed dose of both a progestins drug and an estrogen drug.

3) Ovulation-stimulating drugs stimulate .

A) a non-ovulating ovary to release a single mature ovum B) a non-ovulating ovary to release several mature ova C) an ovulating ovary to release a single mature ovum D) an ovulating ovary to release several mature ova Answer: B Explanation: A) Ovulation-stimulating drugs stimulate a non-ovulating ovary to release several nature ova.

C) Ovulation-stimulating drugs are not prescribed when the ovaries are able to ovulate on their own.

D) Ovary-stimulating drugs are not prescribed when the ovaries are able to ovulate on their own.

1

4) Few drugs are prescribed during pregnancy, particularly during the because of the increased risk of causing birth defects in the developing fetus.

A) first B) second C) third D) fourth Answer: A Explanation: B) This is not correct.

C) This is not correct.

D) There are only three trimesters during a pregnancy.

trimester

5) Amenorrhea and abnormally heavy menstruation are both treated with _ drugs that act directly on the endometrium to restore a normal menstrual cycle.

A) analgesic B) antibiotic C) hormone replacement therapy D) progestins Answer: D Explanation: A) Analgesic drugs are not used to treat amenorrhea and abnormal uterine bleeding.

B) Antibiotic drugs are not used to treat amenorrhea and abnormal uterine bleeding.

C) Hormone replacement therapy drugs are used to treat menopause, not amenorrhea and abnormal uterine bleeding.

6) The implantable forms of contraceptive drugs, such as Mirena, contain _ .

A) only a progestins drug B) only an estrogen drug C) both an estrogen drug and a progestins drug D) neither an estrogen drug nor a progestins drug Answer: A Explanation: B) Implantable contraceptive drugs do not contain an estrogen drug.

C) Implantable contraceptive drugs do not contain an estrogen drug.

D) Implantable contraceptive drugs do contain a progestins drug.

7) Which of these diseases is NOT treated with ovulation-stimulating drugs?

A) preterm labor B) infertility C) polycystic ovary syndrome D) hormonal imbalance and anovulation Answer: A Explanation: B) This IS treated with ovulation-stimulating drugs.

C) This IS treated with ovulation-stimulating drugs.

D) This IS treated with ovulation-stimulating drugs.

2

8) 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.

9) When the cervix does not dilate and become thinner during labor, which type of drug can be given?

A) an analgesic drug B) an estrogen drug C) an ovulation-stimulating drug D) a prostaglandin drug Answer: D Explanation: A) Analgesic drugs are only used to treat labor pain.

B) Estrogen drugs do not cause the cervix to dilate.

C) Ovulation-stimulating drugs are used to treat infertility.

10) Drugs used to treat postpartum bleeding .

URSINGTB.COM A) keep the ovary from producing an ovN um B) keep the cervix from dilating C) stimulate the cervix to dilate D) stimulate the uterine muscle to contract Answer: D Explanation: A) Drugs used to treat postpartum bleeding do not affect the ovary.

B) Drugs used to treat postpartum bleeding do not keep the cervix from dilating.

C) Drugs used to treat postpartum bleeding do not stimulate the cervix to dilate.

11) Which of these problems would cause the physician to give a woman a uterine stimulant drug?

A) weak uterine contractions (uterine inertia) B) preeclampsia C) diabetes mellitus that necessitated a rapid delivery for the safety of the mother and fetus 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.

3

12) Which of the following drug forms or routes of administration are NOT used for contraceptive drugs?

A) intravenous injection B) oral tablets C) transdermal patch D) vaginal ring Answer: A Explanation: A) No contraceptive drugs are given intravenously.

B) Oral contraceptive drugs DO come in the form of a tablet.

C) The contraceptive drug Ortho Evra is a transdermal patch.

D) The contraceptive drug NuvaRing is a ring that is inserted into the vagina.

13) 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.

C) Dilation and effacement of the cervix is a normal part of labor and is not treated with a drug.

D) A vaginal yeast infection is not treated with a uterine stimulant drug.

14) Which of the following statements about the trade name drug Plan B 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) This statement is false because it is taken only after sexual intercourse has occurred.

D) This IS a true statement.

15) 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 contraception.

B) Biphasic oral contraceptive drugs.

C) Folic acid is a vitamin, not a contraceptive drug.

D) This phrase is associated with menopause, not contraception.

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16) All of the following are true about oral contraceptive drugs, EXCEPT .

A) They contain progestins, the primary female hormone.

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) Estadiol, not progestins, is the primary female hormone.

B) This is a true statement.

C) This is a true statement.

D) This is a true statement.

17) 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 a blood clot.

B) 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. .CA OZ Mis also approved by the FDA for 18) In addition to being an oral contracepNtUivReSIdNruGgT,BY treating .

A) premenstrual dysphoric disorder B) premature labor C) vaginal yeast infections D) sexually transmitted diseases Answer: A Explanation: 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.

19) The various symptoms of premenstrual syndrome (PMS) are treated with combination drugs that contain all of the following types of drugs, EXCEPT .

A) a sedative drug B) a progestins drug for contraception C) a diuretic drug for fluid retention D) an analgesic drug for pain Answer: B Explanation: A) Combination drugs for PMS do contain a sedative drug.

C) Combination drugs for PMS do contain a diuretic drug for fluid retention.

D) Combination drugs for PMS do contain an analgesic drug for pain.

5

20) Which of the following is true about Mirena?

A) It is a T-shaped contraceptive device.

B) It is inserted 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.

21) Premarin is _.

A) used to prevent pregnancy B) used to replace 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.

22) 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 palliNdUuR mSINGTB.COM C) dysmenorrhea D) infertility Answer: A Explanation: B) Gyne-Lotrimin and Monistat are not used to treat infections caused by Treponema pallidum.

C) Gyne-Lotrimin and Monistat are not used to treat dysmenorrhea.

D) Gyne-Lotrimin and Monistat are not used to treat infertility.

23) The triphasic group of oral contraceptive drugs specifically has .

A) 35 mcg of estrogen in every tablet B) 21 pills for a 28-day cycle C) three phases of varying hormone doses D) three different types of female hormones in each tablet Answer: C Explanation: A) Triphasic oral contraceptive drugs do not have 35 mcg of estrogen in every tablet.

B) All types of oral contraceptive drugs, not just triphasic oral contraceptive drugs, come in this form.

D) Triphasic oral contraceptive drugs contain two different female hormones.

6

24) Which of the following drugs is NOT used to treat the pain of dysmenorrhea?

A) naproxen (Aleve, Midol) B) diclofenac (Cataflam, Flector, Voltaren) C) ibuprofen (Advil, Motrin) D) Ortho-Novum Answer: D Explanation: A) This drug IS used to treat dysmenorrhea.

B) This drug IS used to treat dysmenorrhea.

C) This drug IS used to treat dysmenorrhea.

25) Metronidazole (MetroGel-Vaginal) is used to treat .

A) syphilis B) bacterial vaginosis C) vaginal yeast infections D) endometriosis Answer: B Explanation: A) MetroGel-Vaginal is not used to treat syphilis.

C) MetroGel-Vaginal is not used to treat vaginal yeast infections.

D) It is not used to treat endometriosis.

26) All of the following trade name drugs are given to women in menopause as hormone replacement therapy, EXCEPT .

A) Climara B) Menest C) Pitocin D) Vivelle Answer: C Explanation: A) Estradiol (Climara) IS given as hormone replacement therapy.

B) Esterified estrogens (Menest) IS given as hormone replacement therapy.

D) Estradiol (Vivelle) IS given as hormone replacement therapy.

27) Which of the following sexually transmitted diseases are treated with antibiotic drugs?

A) HIV and AIDS B) genital herpes C) candidiasis D) gonorrhea and syphilis Answer: D Explanation: A) HIV and AIDS are treated with oral 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.

7

28) Simone and Raymond Jones have been trying to start a family for two years without success.

The doctor 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) clomiphene (Clomid) C) clotrimazole (Gyne-Lotrimin, Mycelex) D) human chorionic gonadotropin (Pregnyl, Profasi) Answer: C Explanation: A) This drug IS used to stimulate ovulation and treat infertility.

B) This drug IS used to stimulate ovulation and treat infertility.

C) This drug is used to treat vaginal yeast infections.

D) This drug IS used to stimulate ovulation and treat infertility.

29) The trade name drugs Ponstel and Motrin are commonly used to treat what disease?

A) chlamydia vaginal infections B) menopause C) labor and delivery D) dysmenorrhea Answer: D Explanation: A) Ponstel and Motrin are not used to treat chlamydia vaginal infections.

B) Ponstel and Motrin are not used to treat menopause.

C) Ponstel and Motrin are not used to treat labor and delivery.

Ch OiM 30) Drugs should be avoided during pregNnUaRnScIyN, GbTuB t .w ch of these drugs is prescribed for pregnant women?

A) Drugs to continue treating chronic diseases such as hypertension and diabetes mellitus 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.

8

31) Which of the following statements is TRUE? A) In monophasic oral contraceptive drugs, 7 of the tablets in a 28-day pill pack contain an analgesic drug.

B) Most physicians prescribe an oral contraceptive drug that contains as low a dose of estrogen as possible—35 mcg of estrogen in each tablet.

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 patients who smoke or are older than 55 years of age.

Answer: B Explanation: A) This statement is false. Oral contraceptive drugs never contain an analgesic drug.

C) This statement is false. This drug is used to start labor contractions.

D) Serious adverse effects increase for patients who smoke or are older than 35 years, not 55 years, of age.

32) Which one of the following pairs of trade names is NOT a monophasic oral contraceptive drug?

A) Gianvi and Ovral B) Seasonale and YAZ C) Alesse and Beyaz D) Cyclessa and Ortho Tri-Cyclen Answer: D Explanation: A) These ARE monophasic oral contraceptive drugs.

B) These ARE monophasic oral contraceNpUtiRvSeIN drGuTgBs..COM C) These ARE monophasic oral contraceptive drugs.

D) These are both triphasic oral contraceptive drugs.

33) Which was the first oral contraceptive drug that could eliminate all menstrual periods?

A) YAZ B) MetroGel-Vaginal C) Lybrel D) Seasonique Answer: C Explanation: A) YAZ is an oral contraceptive drug, but it does not eliminate all menstrual periods.

B) MetroGel-Vaginal is not an oral contraceptive drug.

D) Seasonique is an extended-cycle oral contraceptive pill but it causes 4 menstrual periods a year.

9

34) Which of the following statements is FALSE? A) The prefix tri- in the trade name of some oral contraceptive drugs indicates three phases.

B) The trade name Ortho-Novum 10/11 indicates that this is a monophasic oral contraceptive drug.

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.

C) This is a true statement.

D) This is a true statement.

35) The contraceptive drug Ortho Evra is in the form of a A) pill pack B) vaginal ring C) T-shaped intrauterine device D) transdermal patch Answer: D Explanation: A) Ortho Evra does not come as a pill pack.

B) Ortho Evra does not come as a vaginal ring.

C) Ortho Evra does not come as a T-shaped intrauterine device.

.

36) Of the following trade name prostaglandin drugs, which one is NOT used to help the cervix dilate and efface during labor?

A) Cervidil B) Cyclessa C) Cytotec D) Prepidil Answer: B Explanation: A) Cervidil IS used to help the cervix dilate and efface during labor.

B) This is an oral contraceptive drug.

C) Cytotec IS used to help the cervix dilate and efface during labor.

D) Prepidil IS used to help the cervix dilate and efface during labor.

37) Which of the following drugs is NOT used to treat endometriosis?

A) follitropin beta (Follistim) B) goserelin (Zoladex) C) leuprolide (Lupron Depot) D) nafarelin (Synarel) Answer: A Explanation: A) This is an ovulation-stimulating drug; it is not used to treat endometriosis.

B) Goserelin (Zoladex) IS used to treat endometriosis.

C) Leuprolide (Lupron Depot) IS used to treat endometriosis.

D) Nafarelin (Synarel) IS used to treat endometriosis.

10

38) Besides being used to treat endometriosis, danazol is also used to treat which other diseases?

A) syphilis B) fibrocystic disease of the breast C) dysmenorrhea D) preterm labor Answer: B Explanation: A) Danazol is not used to treat syphilis.

C) Danazol is not used to treat dysmenorrhea.

D) Danazol is not used to treat preterm labor.

39) Premenstrual syndrome (PMS) is characterized by all of the following, EXCEPT A) dysmenorrhea B) severe depression C) breast tenderness D) bloating and fluid retention Answer: B Explanation: A) PMS IS characterized by dysmenorrhea.

B) These are symptoms of premenstrual dysphoric disorder, not premenstrual syndrome.

C) PMS IS characterized by breast tenderness.

D) PMS IS characterized by bloating and fluid retention.

.

40) Which of the following combination drugs is NOT used to treat the symptoms of menopause?

A) Seasonique B) Activella C) Femhrt D) Prempro Answer: A Explanation: A) This is a biphasic oral contraceptive drug.

B) Activella IS a combination drug used to treat menopause.

C) Femhrt IS a combination drug used to treat menopause.

D) Prempro IS a combination drug used to treat menopause.

41) A 28-day pill pack of an oral contraceptive drug consists of 21 tablets that contain hormones 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.

11

42) Which of these drugs have an unofficial "unlabeled use" (but legal) to treat preterm labor?

A) terbutaline, a bronchodilator drug used to treat asthma B) magnesium sulfate, a drug used to prevent and treat seizures C) folic acid 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 vitamin is given during pregnancy.

43) 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) Cyclessa B) Diclegis C) Ocella D) Midol Answer: B Explanation: A) This is an oral contraceptive drugs.

C) This is an oral contraceptive drug.

D) This is used to treat dysmenorrhea.

44) The well-known generic drug oxytocin that is a uterine stimulant drug used to stimulate the GTeBd.C uterus and induce labor is related to the tNraUdReSnINam ruOgM .

A) Cervidil B) Estrostep C) Prempro D) Pitocin Answer: D Explanation: A) Cervidil dilates the cervix; it does not stimulate the uterus.

B) Estrostep is a triphasic oral contraceptive drug.

C) Prempro is used to treat menopause.

45) The over-the-counter trade name drug Remifemin is advertised to relieve the symptoms of menopause. It contains the herb known as .

A) black cohosh B) snakeroot C) bugbane 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.

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13.2 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 estrogen drug.

Answer: FALSE Explanation: This is a false statement. 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 combination oral contraceptive drugs.

Answer: FALSE Explanation: This is a false statement. They are slightly less effective.

3) Progestin-only oral contraceptive drugs are useful for mothers who are breastfeeding because the drug does not interfere with milk production.

Answer: TRUE 4) Ovulation-stimulating drugs are not appropriate for patients with infertility due to blocked uterine tubes or problems that require surgical intervention.

Answer: TRUE 5) Progesterone drugs prepare the endometrium to receive fertilized ova, and are used in conjunction with other drugs for infertility in women.

Answer: TRUE 6) Climara Pro and CombiPatch to treat menopause, and Ortho Evra to prevent pregnancy all come in the drug form of a transdermal patch.

Answer: TRUE 7) Antidepressant drugs are usually used to treat depression, but can also be used to treat the hot flashes that occur with menopause.

Answer: TRUE 8) Oral contraceptive drugs exert a hormonal influence to prevent pregnancy and are 100 percent effective if taken as directed.

Answer: FALSE Explanation: This is a false statement. They are 99% effective.

9) The types of oral contraceptive drugs are one-phasic, two-phasic, three-phasic, and fourphasic.

Answer: FALSE Explanation: This is a false statement. They are monophasic, biphasic, triphasic, and fourphasic.

10) Melissa Radike has endometriosis. To treat her symptoms, her physician 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 13

11) PMDD includes all the symptoms of PMS plus an added symptom of endometriosis.

Answer: FALSE Explanation: This is a false statement. The added symptom is severe depression.

12) Some antiyeast drugs require the patient insert the drug vaginally for 7 days or just 3 days, but antiyeast drug tioconazole only needs to be inserted vaginally just one time.

Answer: TRUE 13) The contraceptive effect of some progestins-only implanted contraceptive devices can last from three to five years.

Answer: TRUE 14) Ovulation-stimulating drugs are appropriate for patients who have anovulation (failure to ovulate).

Answer: TRUE 15) There currently are no drugs approved by the FDA to specifically stop preterm labor.

Answer: TRUE Explanation: Some drugs are used to stop preterm labor but this is an unlabeled use of the drug at the physician's discretion.

16) Sonjalee Williams is taking an oral contraceptive drug. She knows this will help protect her from becoming pregnant and from contraNcUtiRnSgINaGsTexBu.CaOllM y transmitted disease.

Answer: FALSE Explanation: This is a false statement. An oral contraceptive drug does not protect against sexually transmitted diseases.

17) Patients taking oral contraceptive drugs should avoid taking the herb St. John's wort for depression because it can increase the chance of getting pregnant.

Answer: TRUE 18) The drugs Glucophage and Avandia are used to treat type 2 diabetes mellitus, but they are also used to stimulate ovulation in patients with polycystic ovaries.

Answer: TRUE 19) Breads, cereals, and pastas have supplemental iron added to them to decrease the risk of babies being born with neural tube defects in women of childbearing age.

Answer: FALSE Explanation: This is a false statement. Folic acid, not iron, is added.

20) Carboprost (Hemabate) is used to treat postpartum hemorrhage caused by abnormal uterine muscle relaxation.

Answer: TRUE

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13.3 Short Answer Questions 1) Premature labor contractions can be inhibited by using uterine-relaxing drugs. These drugs are known as drugs.

Answer: tocolytic 2) To induce labor, the hormone (secreted by the posterior pituitary gland) and the drug Pitocin both work in the same way to bind to receptors on the smooth muscle of the uterus, causing the uterus to contract.

Answer: oxytocin 3) (painful menstrual cramps) is caused by an increase in prostaglandins that causes the uterus to contract painfully.

Answer: Dysmenorrhea 4) The ending -azole is common to drugs used to treat the Answer: yeast

infection of candidiasis.

5) The symptoms of menopause can be treated by HRT. The abbreviation HRT stands for .

Answer: hormone replacement therapy 6) Infertility drugs are often used as part of an ART program. The abbreviation ART stands for .

Answer: assisted reproductive technology 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 Answer: four 9) The abbreviation BCP stands for Answer: birth control pills

-phasic oral contraceptive drug.

.

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 to widen and thin the cervix as labor begins.

They cause smooth muscle fibers in the cervix to dilate and the collagen fibers to break down.

This process of dilatation and effacement is known as cervical .

Answer: ripening

15

12) In a 28-day pack of an oral contraceptive drug, the tablets for the last 7 days are tablets containing no hormone drug.

Answer: inert 13) The first FDA-approved prescription drug for treating the hot flashes of menopause that was not a hormone drug was paroxetine ( ).

Answer: Brisdelle 14) The numbers next to these trade name drugs tell you that Ortho-Novum 10/11 is a oral contraceptive drug and Ortho-Novum 7/7/7 is a oral contraceptive drug.

Answer: biphasic, triphasic 15) Lybrel is a continuous oral contraceptive drug and this means the woman has menstrual periods each year.

Answer: no (zero) 16) The abbreviation STD stands for Answer: sexually transmitted disease

.

16

13.4 Matching Questions Match the drug name in Column 1 with its drug category in Column 2.

A) triphasic oral contraceptive drug B) drug for endometriosis C) drug for abnormal menstruation D) estrogen hormone replacement therapy drug E) progestin-only contraceptive implant F) ovulation-stimulating drug for infertility G) drug for vaginal yeast infection H) monophasic oral contraceptive drug I) herbal OTC drug for menopause J) drug for postpartum bleeding 1) carboprost (Hemabate) 2) medroxyprogesterone (Provera) 3) estradiol (Climara, Estraderm, Vivelle) 4) follitropin alfa (Gonal-f) 5) norethindrone (Aygestin) 6) levonorgestrel (Mirena) 7) nystatin 8) Ortho-Novum 7/7/7 9) Remifemin 10) YAZ Answers: 1) J 2) C 3) D 4) F 5) B 6) E 7) G 8) A 9) I 10) H

17

13.5 Essay Questions 1) The long-term use of HRT can be beneficial, but it is also associated with some risk. Name one benefit and one risk associated with long-term use of HRT. Answer: The benefits of hormone replacement therapy include treating vaginal dryness, hot flashes, and fatigue of menopause. It may also reduce the risk of osteoporosis and keep cholesterol level low. However, estrogen is a drug associated with an creased risk of breast and endometrial cancer, blood clots, stroke, heart attack, and dementia.

2) When ovulation-stimulating drugs cause several mature ova to be released from the ovary at the same time, how does this eventually cause an ethical and moral dilemma?

Answer: Some obstetricians recommend elective removal of one or more of the growing fetuses prior to delivery, but this creates an ethical and moral dilemma.

3) 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.

4) Describe the circumstances 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.

5) How are the symptoms of premenstrual syndrome (PMS) different from those of premenstrual dysphoric disorder?

Answer: PMS is characterized by dysmenorrhea, breast tenderness, edema from fluid retention ("bloating"), and mild mood changes. Premenstrual dysphoric disorder (PMDD) includes the symptoms of PMS as well s severe depression. It is considered a psychiatric disorder.

6) Describe each of the three phases associated with triphasic contraceptive drugs.

Answer: Phase 1 has a fixed dose of a progestins drug plus a fixed dose of an estrogen drug.

Phases 2 and 3 vary the levels of the progestins drug and the estrogen drug, going up or down or staying the same from one phase to the next.

7) 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.

8) Seasonique belongs to what category of drugs? Also explain why patients taking it only have four menstrual periods a year.

Answer: Seasonique is a biphasic oral contraceptive drug that belongs to the category of extended-cycle oral contraceptive pills. The hormone tablets are taken continuously for 3 months, followed by 7 inert tablets. That means that the patient has a menstrual period only 4 times a year–just once a season.

18

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 14 Endocrine Drugs 14.1 Multiple-Choice Questions 1) Which type of insulin is also known as insulin regular?

A) insulin derived from animals B) intermediate-acting insulin C) long-acting insulin D) rapid-acting insulin Answer: D Explanation: A) How the insulin is derived does not indicate whether it called regular or not.

B) Intermediate-acting insulin is not known as regular insulin.

C) Long-acting insulin is not known as regular insulin.

2) Antithyroid drugs used to treat hyperthyroidism act by .

A) inhibiting the production of T3 and T4 in the parathyroid gland B) inhibiting the production of T3 and T4 in the thyroid gland C) stimulating the production of T3 and T4 in the parathyroid gland D) stimulating the production of T3 and T4 in the thyroid gland.

Answer: B Explanation: A) T3 and T4 do not come from the parathyroid gland.

C) Antithyroid drugs do not stimulating N thUeRpSrIoNdGuTcBti.oCnOM of T3 and T4.

D) Antithyroid drugs do not stimulate the production of T3 and T4.

3) Insulin lowers the blood glucose level by .

A) binding with glucose, rendering it ineffective B) competing with glucose receptors on cell membranes C) enabling cells to utilize glucose D) inhibiting the production of glucose Answer: C Explanation: A) Insulin does not make glucose ineffective.

B) Insulin does not compete with glucose.

D) Insulin does not inhibit the production of glucose.

4) Which type of diabetes was previously known as insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes?

A) diabetes insipidus B) type 1 diabetes mellitus C) type 2 diabetes mellitus D) all of the above Answer: B Explanation: A) Diabetes insipidus is not a type of diabetes mellitus.

C) Type 2 diabetes mellitus was previously known as non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes mellitus.

D) Only one of the answers is correct.

1

5) The size of the crystals of insulin determines .

A) if the insulin can be used to treat type 1 or type 2 diabetes mellitus B) how many hours the therapeutic effect continues 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 the length of the therapeutic effect.

D) The size of the crystals does not determine which cells will utilize glucose.

6) A syringe calibrated in units can be used to administer .

A) any antidiabetic drug if it is in a liquid form B) any type of drug in a liquid form.

C) only insulin D) only rapid-acting insulin drugs Answer: C Explanation: A) A syringe calibrated in units cannot be used to administer any antidiabetic drug except insulin.

B) A syringe calibrated in units cannot be used to administer any type of drug in a liquid form.

D) A syringe calibrated in units can be used to administer more than just rapid-acting insulin drugs.

7) Oral antidiabetic drugs are used to treN atUpRaStIiN enGtTs Bw.CitOhM .

A) diabetes insipidus B) both type 1 and type 2 diabetes mellitus C) type 1 diabetes mellitus only D) type 2 diabetes mellitus only Answer: D Explanation: A) Oral antidiabetic drugs are not used to treat diabetes insipidus.

B) Oral antidiabetic drugs are not effective in treating type 1 diabetes mellitus.

C) Oral antidiabetic drugs are not effective in treating type 1 diabetes mellitus.

8) The alpha-glucosidase inhibitor category of oral antidiabetic drugs .

A) inhibits the action of certain enzymes that digest carbohydrates B) inhibits the production of insulin in the islets of Langerhans of the pancreas C) prolongs the action of insulin on insulin receptors D) stimulates the beta cells of the pancreas Answer: A Explanation: B) These drugs do not inhibit the production of insulin by the pancreas.

C) These drugs do not prolong the action of insulin on insulin receptors.

D) These drugs do not stimulate the beta cells of the pancreas.

2

9) Which of the following is NOT one of the ways in which biguanide oral antidiabetic drugs work?

A) by decreasing the absorption of glucose from the intestine B) by improving the ability of body cells to use any insulin that is secreted C) by slowing the rate at which food leaves the stomach D) by decrease the release of stored glucose from the liver Answer: C Explanation: A) Biguanide oral antidiabetic drugs DO decrease the absorption of glucose from the intestine into the blood.

B) Biguanide oral antidiabetic drugs DO improve the ability of cells to use the insulin that is produced.

C) Biguanide oral antidiabetic drugs do not do this.

D) Biguanide oral antidiabetic drugs DO decrease the release of stored glucose from the liver.

10) Which category of oral antidiabetic drugs used to treat type 2 diabetes mellitus was first approved to treat an elevated level of cholesterol in the blood?

A) intermediate-acting insulin drugs B) bile acid sequestrant antidiabetic drugs C) sulfonylurea oral antidiabetic drugs D) incretin mimetic antidiabetic drugs Answer: B Explanation: A) Intermediate-acting insulin drugs were not first approved to treat an elevated level of cholesterol C) Sulfonylurea oral antidiabetic drugs wNeUrRe SnIoNtGfTirBs.tCaOpM proved to treat an elevated level of cholesterol.

D) Incretin mimetic antidiabetic drugs were not used to treat an elevated level of cholesterol.

11) Which of the following is NOT one of the ways in which amylin analog antidiabetic drugs work?

A) by decreasing the absorption of glucose from the intestine B) by slowing the rate at which food leaves the stomach C) by stopping the release of stored glucose from the liver D) by working in the brain to decrease the appetite Answer: A Explanation: A) These drugs do NOT work in this way.

B) This IS one of the ways in which amylin analog antidiabetic drugs work.

C) This IS one of the ways in which amylin analog antidiabetic drugs work.

D) This IS one of the ways in which amylin analog antidiabetic drugs work.

3

12) Which of the following is a type of rapid-acting insulin drug?

A) insulin aspart (NovoLog) B) insulin glulisine (Apidra) C) insulin lispro (Humalog) D) all of the above Answer: D Explanation: A) This is a rapid-acting insulin drug.

B) This is a rapid-acting insulin drug.

C) This is a rapid-acting insulin drug.

13) Rapid-acting insulin drugs begin to lower the blood glucose level in .

A) 15 minutes B) one hour C) two hours D) three hours Answer: A Explanation: B) Rapid-acting insulin drugs begin to lower the blood glucose level in less time than one hour.

C) Rapid-acting insulin drugs begin to lower the blood glucose level in less time than two hours.

D) Rapid-acting insulin drugs begin to lower the blood glucose level in less time than three hours.

14) drugs are prescribed for AIDS patients to counteract the loss of muscle mass and strength that occurs with AIDS wasting sNyUnRdSroINmGeT. B.COM A) Antidiabetic B) Corticosteroid C) Growth hormone replacement D) Anabolic steroid Answer: D Explanation: A) Antidiabetic drugs are not prescribed for AIDS wasting syndrome.

B) Corticosteroid drugs are not prescribed for AIDS wasting syndrome.

C) Growth hormone replacement drugs are not prescribed for AIDS wasting syndrome.

15) Former President John F. Kennedy had , which gave his skin an unusually bronzed and tanned appearance.

A) hyperthyroidism B) Addison's disease C) diabetes mellitus, type 2 D) acromegaly Answer: B Explanation: A) Former President John F. Kennedy did not have hyperthyroidism.

C) Former President John F. Kennedy did not have diabetes mellitus, type 2.

D) Former President John F. Kennedy did not have acromegaly.

4

16) 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.

17) 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: B) The pituitary gland IS a part of the endocrine system.

C) The pancreas IS part of the endocrine system.

D) The adrenal glands ARE part of the endocrine system.

18) Insulin plays a role in glucose (sugar) .

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.

D) Only one of the answers is correct.

19) 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.

5

20) The drug radioactive sodium iodide 131 .

A) emits low-level radiation B) destroys thyroid tissue to treat hyperthyroidism C) is used to treat thyroid cancer 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) It is used to treat hyperthyroidism.

21) All of the following trade name drugs are used to treat diabetes mellitus, EXCEPT .

A) Humulin N insulin B) Synthroid C) Starlix D) DiaBeta Answer: B Explanation: A) Humulin insulin IS used to treat diabetes mellitus.

B) Synthroid is used to treat hypothyroidism.

C) Starlix IS used to treat diabetes mellitus.

D) DiaBeta IS used to treat diabetes mellitus.

22) All of the following are trade names for sulfonylurea oral antidiabetic drugs, EXCEPT .

A) glipizide (Glucotrol) B) chlorpropamide C) glyburide (DiaBeta, Glynase) D) exenatide (Byetta) Answer: D Explanation: A) Glipizide (Glucotrol) IS a sulfonylurea oral antidiabetic drug.

B) Chlorpropamide IS a sulfonylurea oral antidiabetic drug.

C) Glyburide (DiaBeta, Glynase) IS a sulfonylurea oral antidiabetic drug.

D) This is an incretin mimetic antidiabetic drug.

23) The first drug ever created using recombinant DNA technology was .

A) NPH insulin B) Humulin insulin C) insulin glargine (Lantus) D) triamcinolone (Kenalog) Answer: B Explanation: A) NPH insulin was not the first recombinant DNA technology drug.

C) Insulin glargine (Lantus) was not the first recombinant DNA technology drug.

D) Triamcinolone (Kenalog) was not the first recombinant DNA technology drug.

6

24) Which statement about long-acting insulin drugs is FALSE? A) Their therapeutic effect lasts 24 hours.

B) This type of insulin has large insulin crystals and added zinc.

C) This type of insulin is never used in combination with other insulin drugs.

D) This type of insulin is cloudy.

Answer: D Explanation: A) This is a true statement.

B) This is a true statement.

C) This is a true statement.

D) This insulin is always clear.

25) Which of the following statements is FALSE? A) Insulin doses are measured in units.

B) Regular insulin is also known as rapid-acting insulin.

C) NPH insulin contains protamine and zinc.

D) Type 2 diabetes mellitus is also known as juvenile diabetes.

Answer: D Explanation: A) This IS a true statement.

B) This IS a true statement.

C) This IS a true statement.

D) Type 1 diabetes mellitus is known as juvenile diabetes.

26) Insulin does all of the following, EXCEPT .

A) stimulates the pancreas to secrete horNmUoRnSeIsNGTB.COM B) carries glucose to the cell C) binds with an insulin receptor on the cell membrane D) transports glucose into the cell Answer: A Explanation: A) The pancreas secretes insulin; the pancreas is not stimulated by insulin.

B) Insulin DOES transport glucose to the cell.

C) Insulin DOES bind with an insulin receptor on the cell membrane.

D) Insulin DOES transport glucose into the cell.

27) All of these are thyroid supplement drugs that are used to treat hypothyroidism, EXCEPT .

A) oxandrolone (Oxandrin) B) liothyronine (Cytomel, Triostat) C) levothyroxine (Synthroid) D) liotrix (Thyrolar) Answer: A Explanation: A) 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.

7

28) Patients with type 1 diabetes mellitus inject insulin once or several times a day at various sites in which of these places on the body?

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.

29) When a patient with type 1 diabetes mellitus injects insulin, a longer needle (1/2 inch or 5/8 inch) must be inserted at a degree angle so that the insulin is not injected into the muscle layer.

A) 10 B) 45 C) 90 D) 130 Answer: B Explanation: A) Insulin is not injected at a 10-degree angle.

C) Insulin is not injected at a 90-degree angle.

D) Insulin is not injected at a 130-degree angle.

30) The thyroid supplement drug for hypNoUthRySrIoNiG diTsBm.CtOhM at 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: B) Methimazole (Tapazole) is used to treat hyperthyroidism, not hypothyroidism.

C) Liothyronine (Cytomel, Triostat) is a thyroid supplement drug, but it contains only T3.

D) Only one of the answers is correct.

31) Each of the following is a category of oral antidiabetic drugs, EXCEPT A) sulfonylurea drugs B) biguanide drugs C) corticosteroid drugs D) alpha-glucosidase inhibitor drugs Answer: C Explanation: A) Sulfonylurea drugs are a category of oral antidiabetic drugs.

B) Biguanide drugs are a category of oral antidiabetic drugs.

D) Alpha-glucosidase inhibitor drugs are a category of oral antidiabetic drugs.

8

.

32) Glucagon-like peptide 1 receptor agonist drugs is a drug category that is also known as antidiabetic drugs.

A) Thyroxine B) Glucocorticoid hormones C) incretin mimetic D) anabolic steroid Answer: C Explanation: A) Thyroxine is not an antidiabetic drug.

B) Glucocorticoid hormones are not antidiabetic drugs.

D) Anabolic steroid drugs are not antidiabetic drugs.

33) Insulin can be administered via a/an .

A) insulin syringe B) portable insulin pump C) implantable computerized insulin pump 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.

34) Besides an antidiabetic drug, what lifestyle activities are important for managing diabetes mellitus?

A) exercise B) a diet with a controlled amount of calories from carbohydrates and fats C) weight control 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.

35) 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.

9

36) All of the following are corticosteroid drugs, EXCEPT A) dexamethasone B) prednisolone (Orapred, Pediapred C) betamethasone (Celestone) D) octreotide (Sandostatin) Answer: D Explanation: A) Dexamethasone IS a corticosteroid drug.

B) Prednisolone (Pediapred, Prelone) is a corticosteroid drug.

C) Betamethasone (Celestone) is a corticosteroid drug.

.

37) Which of the following statements is FALSE? A) Increased growth hormone in adults causes acromegaly.

B) Hyperthyroidism can be treated with Synthroid.

C) "Stacking" is using two or more anabolic steroids drugs at the same time.

D) The drug name levothyroxine shows that its molecular structure is rotated to the left (levo-).

Answer: B Explanation: A) This IS a true statement.

B) Synthroid is used to hypothyroidism.

C) This IS a true statement.

D) This IS a true statement.

38) In the name of an insulin drug, the letter R stands for .

A) recombinant DNA technology drug 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 drug.

B) There is no such disease.

D) One of the answers is correct.

39) All of the following are trade name combination oral antidiabetic drugs, EXCEPT A) Januvia B) Glucovance C) Avandamet D) Metaglip Answer: A Explanation: A) This is not a combination oral antidiabetic drug.

B) Glucovance is a combination oral antidiabetic drug.

C) Avandamet is a combination oral antidiabetic drug.

D) Metaglip is a combination oral antidiabetic drug.

10

.

40) Growth hormone replacement drugs include all of the following, EXCEPT A) sermorelin (Geref) B) methimazole (Tapazole) C) somatrem (Protropin) D) somatropin (Humatrope, Nutropin) Answer: B Explanation: A) Sermorelin (Geref) is a growth hormone replacement drug.

B) It is used to treat hyperthyroidism, not growth problems.

C) Somatrem (Protropin) is a growth hormone replacement drug.

D) Somatropin (Humatrope, Nutropin) is a growth hormone replacement drug.

41) Drugs used to treat diabetes insipidus act as replacement therapy for A) thyroid hormone B) corticosteroids C) growth hormone D) antidiuretic hormone Answer: D Explanation: A) Diabetes insipidus is not treated with thyroid hormone.

B) Diabetes insipidus is not treated with corticosteroids.

C) Diabetes insipidus is not treated with growth hormone.

.

.

42) 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 a bronzed color to the skin.

Answer: C Explanation: A) This is a true statement.

B) This is a true statement.

C) The adrenal gland is destroyed by antibodies and does not secrete enough cortisol.

D) This is a true statement.

43) 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.

11

44) Anabolic steroid drugs can be used legally in all of the following ways, EXCEPT A) to promote weight gain after surgery or trauma B) to increase the red blood cell (RBC) count to treat anemia C) to increase the muscle mass in professional athletes D) to treat loss of muscle mass in patients with AIDS Answer: C Explanation: A) This is a legal use of anabolic steroid drugs.

B) This is a legal use of anabolic steroid drugs.

D) This is a legal use of anabolic steroid drugs.

.

45) The well-known generic thyroid hormone drug levothyroxine is related to the trade name drug .

A) Victoza B) Synthroid C) Onglyza D) Farxiga Answer: B Explanation: A) Victoza is used to treat diabetes mellitus.

C) Onglyza is used to treat diabetes mellitus.

D) Farxiga is used to treat diabetes mellitus.

46) The well-known generic oral antidiabetic drug glyburide is related to the trade name drugs of Glynase and .

A) DiaBeta B) Avandia C) Humulin N D) AndroGel Answer: A Explanation: B) Avandia is an oral antidiabetic drug, but it is not related to the generic drug glyburide.

C) This is an insulin drug, not an oral antidiabetic drug.

D) This is an androgen drug, not an 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: This is a false statement. Type 2 is first treated with an oral antidiabetic drug.

2) Intermediate-acting insulin drugs contain added protamine and zinc to prolong the therapeutic effect of the insulin.

Answer: TRUE 3) The meglitinide oral antidiabetic drugs increases the sensitivity of the cell to insulin produced by the pancreas and suppresses the release of stored glucose from the liver.

Answer: FALSE 12

4) Drugs used to treat hypothyroidism act by supplementing existing levels of T3 and/or T4.

Answer: TRUE 5) Drugs used to treat acromegaly decrease the secretion of growth hormone or block growth hormone from activating receptors on cells in the body.

Answer: TRUE 6) The preferred treatment for Cushing's syndrome is surgery to remove the tumor, not prescribing drugs.

Answer: TRUE 7) Intermediate-acting insulin drugs have a faster onset but a longer effect than rapid-acting insulin drugs.

Answer: FALSE Explanation: This is a false statement. They have a slower onset.

8) Incretin mimetic antidiabetic drugs are given orally and are only used to treat type 1 diabetes mellitus.

Answer: FALSE Explanation: This is a false statement. These drugs are given by subcutaneous injection.

9) Antithyroid drugs are used to treat hyperthyroidism.

Answer: TRUE 10) The pancreas of a patient with type 2 diabetes mellitus is still producing insulin, but in a smaller amount than normal.

Answer: TRUE 11) Sulfonylurea oral antidiabetic drugs stimulate the beta cells of the pancreas to secrete more insulin.

Answer: TRUE 12) Drugs used to treat hypothyroidism are obtained from natural sources, such as desiccated (dried) animal pancreas, or they are synthetically manufactured.

Answer: FALSE Explanation: This is a false statement. They are from animal thyroid glands, not pancreas.

13) The drug insulin was first introduced in the 1960s.

Answer: FALSE Explanation: This is a false statement. The first insulin drug was extracted in 1922.

14) Oral antidiabetic drugs can increase the number of insulin receptors on body cells.

Answer: TRUE

13

15) GLP-1 and GIP are hormones that are released into the blood by the small intestine after food is eaten. They stimulate the pancreas to make more insulin.

Answer: TRUE 16) On an insulin drug label, U-100 means 100 units/mL. Answer: TRUE 17) To make NPH intermediate-acting insulin, protamine and zinc are added. Protamine was originally taken from the semen of a river trout.

Answer: TRUE 18) One drug used to treat diabetes insipidus–desmopressin (DDAVP, Stimate)–is given by he subcutaneous or intramuscular route or in the form of an intranasal spray.

Answer: TRUE 19) Beef, beef/pork, and pork insulin drugs are available in the United States.

Answer: FALSE 20) In the trade name Humalog Mix 75/25 or Novolin 70/30, the first number given is the percentage of rapid-acting insulin in that combination insulin drug.

Answer: FALSE Explanation: This is a false statement. The first number is the percentage of intermediate-acting insulin.

21) Untreated or uncontrolled diabetes mellitus eventually leads to the diabetic complications of diabetic retinopathy, diabetic neuropathy, arteriosclerosis, ketoacidosis, and even death.

Answer: TRUE 22) The thyroid gland secretes the hormones T3 and T4. Decreased levels of these hormones cause hyperthyroidism.

Answer: FALSE Explanation: This is a false statement. Decreased levels cause hypothyroidism.

23) Oral antidiabetic drugs are a unique drug form of insulin.

Answer: FALSE Explanation: This is a false statement. Oral antidiabetic drugs are not insulin.

24) Because the insulin molecule is broken down by digestive enzymes, insulin can never be given orally.

Answer: TRUE 25) All insulin drugs on the market today are created by recombinant DNA technology.

Answer: TRUE 26) The ending -gliptin is common to generic DPP-4 inhibitor oral antidiabetic drugs.

Answer: TRUE 14

14.3 Short Answer Questions 1) An insulin syringe's calibration is unique, because it is calibrated in measurement for insulin doses.

Answer: units

, a standardized

2) The category of oral antidiabetic drugs are structurally derived from sulfonamide anti-infective drugs, but they do not have any anti-infective action.

Answer: sulfonylurea 3) One category of antidiabetic drugs is based on the action of , substances in the body that stimulate GLP receptors on the beta cells of the pancreas to secrete insulin when blood glucose levels are high.

Answer: incretins 4) In diabetes insipidus, there are insufficient levels of ADH. The abbreviation ADH stands for .

Answer: antidiuretic hormone 5) Glucocorticoid hormones are powerful anti-inflammatory hormones secreted by the adrenal cortex. These are also available as drugs that are known as drugs because they act in the same way as the natural hormones from the adrenal cortex and their chemical structure is that of a steroid.

Answer: corticosteroid 6) Insulin is secreted by Answer: beta

cells in the islets of Langerhans in the pancreas.

7) Type 2 diabetes was previously known as NIDDM. This abbreviation stands for Answer: non-insulin-dependent diabetes mellitus 8) The abbreviation rDNA means that an insulin drug was created by technology.

Answer: recombinant 9) Insulin is always injected via the Answer: subcutaneous

.

DNA

route.

10) The process of using a different site for each insulin injection is known as site Answer: rotation 11) When a tumor in the adrenal gland cortex causes it to secrete too much of the hormone cortisol, this causes syndrome.

Answer: Cushing's

15

.

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) In adults, hypersecretion of growth hormone by the anterior pituitary gland causes a widening and enlargement of the facial features, hands, and feet.

Answer: acromegaly 14) Anabolic steroid drugs are classified as Schedule Answer: III

drugs.

15) After being injected, rapid-acting insulin drugs begin to lower the blood glucose level in just minutes.

Answer: 15 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 17) The illegal use of two or more anabolic steroid drugs by athletes to increase muscle mass, strength, and endurance is known as .

Answer: stacking 18) The well-known generic oral antidiabetic drug metformin is related to the trade name drug .

Answer: Glucophage

16

,

14.4 Matching Questions Match the drug in Column 1 with its drug category in Column 2.

A) sulfonylurea oral antidiabetic drug B) drug for diabetes insipidus C) biguanide oral antidiabetic drug D) drug for hypothyroidism E) rapid-acting insulin drug F) intermediate-acting insulin G) bile acid sequestrant drug H) incretin mimetic antidiabetic drug I) DPP-4 inhibitor oral antidiabetic drug J) drug for hyperthyroidism 1) colesevelam (WelChol) 2) exenatide (Byetta) 3) glipizide (Glucotrol, Glucotrol XL) 4) Humulin N 5) Humulin R 6) methimazole (Tapazole) 7) levothyroxine (Synthroid) 8) metformin (Glucophage, Glucophage XR) 9) sitagliptin (Januvia) 10) vasopressin (Pitressin) Answers: 1) G 2) H 3) A 4) F 5) E 6) J 7) D 8) C 9) I 10) B

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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 for human insulin into bacteria which then multiply rapidly and produce large amounts of the drug.

2) Briefly discuss why beef and beef/pork insulins are no longer on the market in the United States.

Answer: Beef and beef/pork insulin drugs are no longer on the market in the United States because of the risk that they might transmit bovine spongiform encephalopathy (a fatal disease in cows) that has been linked to outbreaks of a fatal neurologic disorder in humans known as new variant Creutzfeldt-Jakob disease.

3) Describe how the insulin analog drugs insulin aspart and insulin glargine have been structurally changed from a molecule of human insulin.

Answer: A molecule of human insulin consists of an A and a B 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 aspartic acid replaces an amino acid on the B chain. For insulin glargine, the amino acid glycine replaces an amino acid on the A chain and arginine is added to the B chain.

4) Describe what precautions a patient should take who is using the topical drug testosterone (Axiron) and why is this necessary to do.

NaUlR Answer: Because this drug is a topical m e ShIoNrGmToBn.Ce,OtM he instructions advise the patient to do the following things to avoid transferring the drug to another person (particularly to a female or a child): the patient is to wash his hands after applying the drug and is to put on clothing right away to cover the underarm area.

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 15 Neurologic Drugs 15.1 Multiple-Choice Questions 1) Hydantoin drugs for epilepsy prevent the neurons from sending out impulses too rapidly or repeatedly by .

A) acting on different types of receptors throughout the body B) affecting the flow of sodium in and out of the cell C) depressing the motor cortex of the brain and raising the seizure threshold D) inhibiting the conduction of nerve impulses in the cerebral cortex and motor areas of the brain Answer: B Explanation: A) Hydantoin drugs do not work on different types of receptors throughout the body.

C) Hydantoin drugs do not depress the motor cortex of the brain and raise the seizure threshold.

D) Hydantoin drugs do not inhibit the conduction of nerve impulses in the cerebral cortex and motor areas of the brain.

2) Because of how benzodiazepine drugs act on different receptors throughout the body and affect the brain, memory, emotion, and muscles, these drugs are useful in treating which of the following diseases?

A) epilepsy B) restless legs syndrome C) insomnia 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.

3) Catechol-O-methyltransferase (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 cholinesterase, and it is a neurotransmitter, not a drug.

B) Dopamine is a neurotransmitter, not a drug.

C) GABA is a neurotransmitter, not a drug.

1

4) Drug therapy for Parkinson's disease corrects an imbalance in what two neurotransmitters in the brain?

A) acetylcholine and cholinesterase B) acetylcholine and dopamine C) dopamine and epinephrine D) epinephrine and acetylcholine Answer: B Explanation: A) The imbalance is not between acetylcholine and cholinesterase.

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) to treat pain that causes 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.

C) Diphenhydramine is not an antidepressant drug.

D) Diphenhydramine is not a barbiturate drug.

6) Benzodiazepine drugs are used to treat anxiety but also have a hypnotic effect to treat insomnia because they enhance the actioNnUoRfStIhNeGnTeBu.rCoOtrM ansmitter .

A) dopamine B) acetylcholine C) epinephrine D) GABA Answer: D Explanation: A) Benzodiazepine drugs do not enhance the action of the neurotransmitter dopamine.

B) Benzodiazepine drugs do not enhance the action of acetylcholine.

C) Benzodiazepine drugs do not enhance the action of epinephrine.

7) COMT inhibitor drugs used for Parkinson's disease inhibit the enzyme COMT. This enzyme normally .

A) metabolizes the drug levodopa in the blood B) decreases the tremors and rigidity of Parkinson's disease C) inhibits the action of acetylcholine D) blocks levodopa from crossing the blood-brain barrier Answer: A Explanation: B) The enzyme COMT does not decrease the tremors and rigidity of Parkinson's disease C) The enzyme COMT does not inhibit the action of acetylcholine.

D) The enzyme COMT does not block levodopa from crossing the blood-brain barrier.

2

8) Some drugs used to treat neuropathy and neuralgia also elevate the mood, and so they are helpful in treating the that can come with chronic pain.

A) epilepsy B) Parkinson's disease C) dementia D) depression Answer: D Explanation: A) Epilepsy does not come with chronic pain.

B) Parkinson's disease does not come with chronic pain.

C) Dementia does not come with chronic pain.

9) Which of these is NOT a category of hypnotic drugs used to treat insomnia?

A) Melatonin receptor agonist drugs B) benzodiazepine antianxiety drugs C) nonbarbiturate drugs hypnotic/sedative drugs D) COMT inhibitor drugs Answer: D Explanation: A) These drugs ARE used to treat insomnia.

B) These drugs ARE used to treat insomnia.

C) These drugs ARE used to treat insomnia.

D) These drugs are NOT used to treat Parkinson's disease.

10) Which drug can be used to treat three types of seizures (tonic-clonic seizures, complex partial seizures) and status epilepticus?

A) carbamazepine (Tegretol) B) clonazepam (Klonopin) C) phenytoin (Dilantin D) zaleplon (Sonata) Answer: C Explanation: A) Carbamazepine is only used to treat tonic-clonic seizures and complex partial seizures.

B) Clonazepam is only used to treat absence seizures.

D) This drug is used to treat insomnia, not seizures.

11) How does the drug memantine (Namenda) work to treat Alzheimer's disease.

A) It blocks NMDA receptors that are overstimulated by the amino acid 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: B) This is related to Parkinson's disease, not Alzheimer's disease.

C) This is related to insomnia, not Alzheimer's disease.

D) There is only one correct answer.

3

12) Honoria Williams has epilepsy characterized by grand mal seizures. Which of the following drugs would be prescribed for her?

A) phenytoin (Dilantin) B) tacrine (Cognex) C) ropinirole (Requip) D) duloxetine (Cymbalta) Answer: A Explanation: B) This drug is used to treat Alzheimer's disease, not epilepsy.

C) This drug is used to treat Parkinson's disease, not epilepsy.

D) This drug is used to treat neuropathy, not epilepsy.

13) Temazepam (Restoril) and triazolam (Halcion) are both benzodiazepine drugs that are used to treat .

A) Parkinson's disease B) Alzheimer's disease C) absence seizures D) insomnia Answer: D Explanation: A) These drugs are not used to treat Parkinson's disease.

B) These drugs are not used to treat Alzheimer's disease.

C) These drugs are not used to treat absence seizures.

14) The nonbarbiturate hypnotic/sedative drug zolpidem has one trade drug that is specially Oa Mke up in the middle of the night. That designed as a "get-back-to-sleep" pill forNpUeRoSpIlNeGwThBo.Cw 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.

C) Cogentin is used to treat Parkinson's disease, not insomnia.

D) Keppra is used to treat epilepsy, not insomnia.

15) All of the following statements about drugs for Parkinson's disease are true, EXCEPT .

A) The higher doses of Parkinson's drugs often cause 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's disease.

Answer: D Explanation: A) This is a true statement.

B) This is a true statement.

C) This is a true statement.

D) These drugs are used to treat epilepsy, not Parkinson's disease.

4

16) The symptoms of Parkinson's disease include which of the following?

A) forgetfulness, difficulty making decisions, personality changes B) muscle jerking, tongue biting, incontinence C) nerve pain, numbness, tingling, burning in the extremities D) muscle rigidity, tremors, slowing of voluntary movements Answer: D Explanation: A) These are symptoms of Alzheimer's disease.

B) These are symptoms of tonic-clonic seizures.

C) These are symptoms of neuropathy and neuralgia.

17) All of the following combination drugs containing carbidopa and levodopa are used to treat Parkinson's disease, EXCEPT .

A) Depakene B) Stalevo C) Parcopa D) Sinemet Answer: A Explanation: A) This is not a combination drug and it is not used to treat Parkinson's disease.

B) Stalevo is a combination drug used to treat Parkinson's disease.

C) Parcopa is a combination drug used to treat Parkinson's disease.

D) Sinemet is a combination drug used to treat Parkinson's disease.

18) The trade name for the generic drug phenytoin that is used to treat seizures is A) Dilantin B) Symmetrel C) Neurontin D) Aricept Answer: A Explanation: B) Symmetrel is not used to treat seizures.

C) Neurontin is not used to treat seizures.

D) Aricept is not used to treat seizures.

19) All of the following are trade names for drugs used to treat insomnia, EXCEPT A) Lunesta B) Rozerem C) Keppra D) Ambien Answer: C Explanation: A) Lunesta IS a nonbarbiturate drug used to treat insomnia.

B) Rozerem is a melatonin receptor agonist drug used to treat insomnia.

C) This trade name drug is used to treat seizures.

D) Ambien is a nonbarbiturate drug used to treat insomnia.

5

.

.

20) Joey Childress, age eight, has absence seizures (petit mal) and is being treated with an antiseizure drug. He most likely is taking .

A) diazepam (Valium) B) ethosuximide (Zarontin) C) gabapentin (Neurontin) D) carbamazepine (Tegretol) Answer: B Explanation: A) Diazepam (Valium) is not used to treat absence seizures.

C) Gabapentin (Neurontin) is not used to treat seizures.

D) Sinemet is not used to treat seizures.

21) When a drug prescribed for Parkinson's disease causes increasing side effects, the physician .

A) initiates a drug holiday B) prescribes an antidote Answer: A Explanation: A) Drugs used to treat Parkinson's disease are not addictive.

B) There is no antidote for drugs used to treat Parkinson's disease.

22) Which of the following is NOT categorized as a neuralgia or neuropathy?

A) multiple sclerosis B) restless legs syndrome C) postherpetic neuralgia from shingles D) phantom limb pain Answer: A Explanation: B) Restless legs syndrome 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.

23) Which of the following statements is TRUE about levodopa?

A) It can be given in very small oral doses to be effective.

B) It is the metabolic precursor of acetylcholine.

C) It cannot cross the blood-brain barrier.

D) All of these statements are false.

Answer: D Explanation: A) Levodopa must be given in large doses to be effective.

B) Levodopa is the metabolic precursor of dopamine.

C) Levodopa can cross the blood-brain barrier.

6

24) Which of the following statements about donepezil (Aricept) is FALSE? A) It is the most prescribed drug for Alzheimer's disease.

B) It was originally derived from an unusual strain of daffodil bulbs.

C) It is approved by the FDA for treating all stages of Alzheimer's disease.

D) It belongs to the category of cholinesterase inhibitor drugs.

Answer: B Explanation: A) This is a true statement.

B) Galantamine, not donepezil, is from daffodils.

C) This is a true statement.

D) This is a true statement.

25) 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 Answer: C Explanation: A) Unconsciousness IS a symptom of a tonic-clonic seizure.

B) These ARE symptoms of absence seizures.

C) This is associated with Alzheimer's disease, not seizures.

D) This IS a symptom of a tonic-clonic seizure.

26) Which of the following statements is FALSE? A) Phenytoin (Dilantin), which is used toNU trReaStINeG piTleBp.CsO y,Mis one of the oldest drugs on the market.

B) The benzodiazepine drug triazolam (Halcion) that is used to treat insomnia should not be taken with grapefruit juice.

C) Carbidopa has no therapeutic effect of its own unless it is taken with levodopa.

D) Trazodone (Oleptra) is the most commonly prescribed sleeping pill.

Answer: D Explanation: A) This IS s a true statement.

B) This IS a true statement.

C) This IS a true statement.

27) If a patient taking zolpidem (Ambien) experiences working, eating, or driving without being aware or remembering it, it is usually because .

A) the patient did not get a full eight hours of sleep before becoming active B) the drug is strongly addictive C) the patient is having an absence seizure D) the patient has developed dementia from taking Ambien Answer: A Explanation: B) Ambien is a Schedule IV drug with a low potential for addiction.

C) These symptoms from Ambien are not related to epilepsy.

D) Ambien does not cause dementia

7

28) Topiramate (Topamax, Trokendi) is used to treat which of the following diseases?

A) seizures and migraine headaches B) bipolar disorder and bulimia C) alcohol and cocaine dependence and as an aid to stop smoking D) all of the above Answer: D Explanation: A) This is true, but it is not the only use.

B) This is true, but it is not the only use.

C) This is true, but it is not the only use.

29) 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.

30) Which of the following statements about multiple sclerosis is FALSE? A) It is caused by a herpes virus infection that reappears in the elderly or at times of stress.

B) It is an autoimmune disease with antibodies against the myelin covering of certain nerves. .CeOeM C) There is interruption of the nerve conN duUcRtSioIN nGbTeBtw n the brain and spinal cord.

D) Symptoms include double vision, large muscle weakness, uncoordinated gait, muscle spasticity, and neuralgia.

Answer: A Explanation: B) This is a true statement.

C) This is a true statement.

D) This is a true statement.

31) Which of the following is NOT a type of epileptic seizure?

A) dementia B) grand mal C) psychomotor D) focal motor Answer: A Explanation: B) Grand mal (or tonic-clonic) is a type of epileptic seizure.

C) Psychomotor (complex partial) is a type of epileptic seizure.

D) Simple partial (focal motor) is a type of epileptic seizure.

8

32) 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) This does not describe status epilepticus.

D) This is a true statement.

33) Which of the following diseases is characterized by amyloid protein and neurofibrillary tangles?

A) grand mal seizures B) insomnia C) Parkinson's disease D) Alzheimer's disease Answer: D Explanation: A) Grand mal seizures are not characterized by beta-amyloid plaques and neurofibrillary tangles.

B) Insomnia is not characterized by beta-amyloid plaques and neurofibrillary tangles.

C) Parkinson's disease is not characterized by beta-amyloid plaques and neurofibrillary tangles.

34) is the only drug for AlzheN imUeRrS'sINdG isTeBas.CeOthMat comes in the form of a transdermal patch.

A) Memantine (Namenda) B) Galantamine (Razadyne) C) Rivastigmine (Exelon) D) Donepezil (Aricept) Answer: C Explanation: A) This drug is used to treat Alzheimer's disease, but it is not a transdermal patch.

B) This drug is used to treat Alzheimer's disease, but it is not a transdermal patch.

D) This drug is used to treat Alzheimer's disease, but it is not a transdermal patch.

35) 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.

9

36) What drug form does the insomnia drug zolpidem come in?

A) an extended-release tablet (Ambien CR) B) a sublingual tablet (Intermezzo) C) an oral spray (Zopimist) 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.

37) Which of the following are over-the-counter trade name drugs used to treat insomnia.

A) Unisom and Sominex B) Compoz and Nytol C) Sominex and Advil PM 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.

38) The well-known generic drug donepezil to treat Alzheimer's disease is related to the trade name drug .

A) Neurontin B) Valium C) Aricept D) Cymbalta Answer: C Explanation: A) This is not a trade name for donepezil.

B) This is not a trade name for donepezil.

D) This is not a trade name for donepezil.

39) The Parkinson's disease pramipexole (Mirapex) 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.

10

15.2 True/False Questions 1) Barbiturate drugs are commonly prescribed as sleeping pills to treat insomnia.

Answer: FALSE Explanation: This is a false statement. Barbiturate drugs are used infrequently for insomnia.

2) Hydantoin drugs act on the cell membrane of neurons in the motor cortex of the brain.

Answer: TRUE 3) Sulfonamide drugs are used to treat bacterial infections, although the sulfonamide drug Zonegran is only used as an anticonvulsant drug to treat epilepsy.

Answer: TRUE 4) Dopamine agonist drugs for Parkinson's disease directly stimulate dopamine receptors to produce an effect that is similar to that of dopamine.

Answer: TRUE 5) The drug phenytoin (Dilantin) has been used for many years and is effective in treating all types of seizures.

Answer: FALSE Explanation: This is a false statement. No drug is effective against all types of seizures.

6) When MAO inhibitor drugs for Parkinson's disease inhibit the enzyme MAO, this results in a decreased amount of dopamine.

Answer: FALSE Explanation: This is a false statement. It results in an increased amount of dopamine.

7) 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 8) The ending -suximide is common to generic succinimide drugs used to treat Alzheimer's disease.

Answer: FALSE Explanation: This is a false statement. These drugs are not used to treat Alzheimer's disease.

9) When a barbiturate drug is used to treat epilepsy, it is said to have a long-acting antihistamine effect and an anticonvulsant effect.

Answer: FALSE Explanation: This is a false statement. It has a long-acting sedative effect. Its antihistamine effect is only used to treat insomnia, not epilepsy.

10) Melatonin, a hormone that regulates the wake-sleep cycle, is available as a prescription drug.

Answer: FALSE Explanation: This is a false statement. Melatonin itself is an over-the-counter dietary supplement.

11

11) Tonic-clonic seizures are also known as grand mal seizures.

Answer: TRUE 12) No drug currently on the market is able to reverse the underlying destruction of neurons associated with Alzheimer's disease.

Answer: TRUE 15.3 Short Answer Questions 1) The category of motor cortex of the brain.

Answer: hydantoin

drugs for epilepsy act on the cell membranes of neurons in the

2) The advertisement for the trade name drug shows a large, pale moth that only comes out at night flying in a bedroom window and putting a person to sleep.

Answer: Lunesta 3) The medical word Answer: neuralgia

means nerve pain.

4) Certain drugs for Alzheimer's disease inhibit the enzyme down acetylcholine); this raises the amount of acetylcholine.

Answer: cholinesterase

(which normally breaks

5) drugs that are used to induce sleep and treat insomnia get their name from the Greek word hypnos that means sleep.

Answer: Hypnotic (or hypnotic/sedative) 6) The endings -azepam and -azepate are common to generic benzodiazepine drugs that are used to treat .

Answer: epilepsy 7) One drug advertisement for the trade name drug shows a patient's resting on a prickly cactus, and another ad shows ants crawling on the feet to show the sensations of neuralgia Answer: Lyrica 8) The ending Answer: -barbital

is common to many generic barbiturate drugs.

9) Drugs used to treat epilepsy are known as by seizures or convulsions.

Answer: anticonvulsant

drugs because epilepsy is characterized

10) Alzheimer's disease is the most common form of Answer: dementia 12

.

11) The well-known generic drug phenytoin that has been used for years to treat epilepsy is related to the trade name drug .

Answer: Dilantin 12) The cholinesterase inhibitor drug galantamine (Razadyne) was originally derived from what flower bulb?

Answer: daffodil 13) Melatonin, a hormone secreted by the cycle.

Answer: pineal

gland, regulates the 24-hour wake-sleep

13

15.4 Matching Questions Match the name of the drug in Column 1 with its drug category and use in Column 2.

A) cholinesterase inhibitor drug for Alzheimer's disease B) barbiturate drug for epilepsy C) nonbarbiturate hypnotic/sedative drug for insomnia D) hydantoin drug for epilepsy E) benzodiazepine drug for insomnia F) MAO inhibitor drug for Parkinson's disease G) corticosteroid drug for multiple sclerosis H) drug for neuralgia and neuropathy I) dopamine agonist drug for Parkinson's disease J) barbiturate drug for insomnia 1) clonazepam (Klonopin) 2) methylprednisolone (Medrol) 3) phenobarbital (Luminal) 4) secobarbital (Seconal) 5) phenytoin (Dilantin) 6) pramipexole (Mirapex) 7) pregabalin (Lyrica) 8) rasagiline (Azilect) 9) rivastigmine (Exelon) 10) zolpidem (Ambien) Answers: 1) E 2) G 3) B 4) J 5) D 6) I 7) H 8) F 9) A 10) C

14

15.5 Essay Questions 1) Describe how a physician decides what drug therapy 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, and this is based on the patient's clinical seizure symptoms and the brain-waves pattern on the electroencephalography (EEG) test. 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: When the dose can no longer be increased or the side effects become intolerable, the physician will gradually withdraw the drug, placing the patient on a drug holiday for a few days.

A drug holiday is related to Parkinson's disease.

3) Describe the unusual adverse effect associated with the nonbarbiturate hypnotic/sedative drug zolpidem (Ambien)?

Answer: Some patients taking zolpidem (Ambien) have reported the unusual adverse drug effect of amnesia (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 eight hours of sleep before becoming active.

15

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 16 Psychiatric Drugs 16.1 Multiple-Choice Questions 1) Which drugs are the most commonly prescribed drugs for the treatment of anxiety and neurosis?

A) benzodiazepine drugs B) dibenzapine drugs C) phenothiazine drugs D) tricyclic antidepressant drugs Answer: A Explanation: B) These drugs are not used to treat anxiety and neurosis.

C) These drugs are used not used to treat anxiety and neurosis.

D) These drugs are not used to treat 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 and is the need for the drug to prevent withdrawal symptoms.

B) Euphoria is the "high" that is experienced by addicts.

D) These effects do not all occur at the same time.

3) Which of the following is NOT one of the drug categories used to treat psychosis and schizophrenia?

A) benzisoxazole B) lithium C) dipenzapine D) phenothiazine Answer: B Explanation: A) Benzisoxazole IS a drug category used to treat psychosis and schizophrenia.

B) This is a generic drug, not a drug category.

C) Dipenzapine IS a drug category used to treat psychosis and schizophrenia.

D) Phenothiazine IS a drug category used to treat psychosis and schizophrenia.

1

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 of tricyclic drugs is not based on metabolism.

B) The name of tricyclic drugs is not based on hormones.

C) The name of tricyclic drugs is not based on a triple action.

5) Obsessive-compulsive disorder (OCD) is best treated with .

A) antianxiety and antidepressant drugs B) antianxiety and anticonvulsant drugs C) anticonvulsant and antipsychotic drugs D) antidepressant and antipsychotic drugs Answer: D Explanation: A) OCD has components of anxiety, but is not treated with antianxiety drugs.

B) OCD has component of anxiety, but is not treated with antianxiety or with anticonvulsant drugs.

C) OCD is not treated with anticonvulsant drugs.

6) Panic disorder is treated with various types of .

A) antianxiety and antidepressant drugs B) antianxiety and anticonvulsant drugs C) addictive and antipsychotic drugs D) antidepressant and antipsychotic drugs Answer: A Explanation: B) Panic disorder is not treated with anticonvulsant drugs.

C) Panic disorder is not treated with addictive or antipsychotic drugs.

D) Panic disorder is not treated with antipsychotic drugs.

7) Which of the following is TRUE of tardive dyskinesia?

A) It includes B) It is a side effect of 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 NOT true of 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.

2

8) The side effects of dry mouth, dry eyes, blurred vision, constipation, and urinary retention that are common to tricyclic antidepressant drugs are because these drugs inhibit the action of the neurotransmitter .

A) dopamine B) epinephrine C) acetylcholine D) monoamine oxidase Answer: C Explanation: A) Tricyclic drugs have no effect on dopamine.

B) Tricyclic drugs have no effect on epinephrine.

D) Tricyclic drugs have no effect on monoamine oxidase.

9) Professional actors, musicians, singers, and others in the public eye who experience temporary stage performance anxiety take this beta-blocker drug to block the physical effects of the excess epinephrine.

A) citalopram (Celexa) B) bupropion (Aplenzin, Wellbutrin) C) propranolol (Inderal) D) venlafaxine (Effexor) Answer: C Explanation: A) Citalopram (Celexa) is an antidepressant drug, not a beta-blocker drug.

B) bupropion (Aplenzin, Wellbutrin) is an antidepressant drug, not a beta-blocker drug.

D) Venlafaxine is an antidepressant drug, not a beta-blocker drug.

10) Posttraumatic stress disorder is treated with any of the drugs from the antidepressant drug category.

A) SSRI B) tetracylic C) acetylcholine D) PMDD Answer: A Explanation: B) These antidepressant drugs are not used to treat posttraumatic stress disorder.

C) Acetylcholine is not a drug category. disorder.

D) Premenstrual dysphoric disorder is not a drug category.

11) Which of the following is NOT a benzodiazepine drug used to treat anxiety?

A) alprazolam (Xanax) B) diazepam (Valium) C) lithium D) clorazepate (Tranxene T-tab) Answer: C Explanation: A) This IS a benzodiazepine drug used to treat anxiety.

B) This IS a benzodiazepine drug used to treat anxiety.

C) Lithium is an antipsychotic drug.

D) This IS a benzodiazepine drug used to treat anxiety.

3

12) Which of the following statements is FALSE? A) The FDA required drug companies to put a warning label on many antidepressant drugs because they could cause acne, especially in teens and young adults.

B) Monoamine oxidase (MAO) is an enzyme in the body that breaks down monoamine neurotransmitters.

C) The antidepressant drug Prozac is also used to treat obsessive-compulsive disorder, panic disorder, premenstrual dysphoric disorder, and the eating disorder bulimia.

D) The drug fluoxetine (Prozac) is also used to treat premenstrual dysphoric disorder in women under the trade name Sarafem.

Answer: A Explanation: A) These drugs can cause suicide, not acne.

B) This is a true statement.

C) This is a true statement.

D) This is a true statement.

13) Which of the following statements about duloxetine (Cymbalta) is FALSE? A) It is a serotonin and norepinephrine reuptake inhibitor (SNRI) drug.

B) It is used to treat depression, diabetic neuropathy, and fibromyalgia.

C) It is used to treat withdrawal from heroin and cocaine.

D) It comes in the form of a delayed-release capsule.

Answer: C Explanation: A) This is a true statement.

B) This is a true statement.

C) It is not used for this.

D) This is a true statement.

14) The psychotic symptoms of delusions, hallucinations, and bizarre behaviors are based on .

A) a decreased level of dopamine B) overproduction of dopamine C) hypersensitivity of dopamine receptors D) B and C Answer: D Explanation: A) Psychotic symptoms are not based on a decreased level of dopamine.

B) This is true, but it is not the only correct answer.

C) This is true, but it is not the only correct answer.

15) 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.

4

16) Which of the following is NOT a symptom of neurosis?

A) anxiety and anxiousness B) loss of touch with reality C) apprehension and tension D) vague, unsubstantiated fears Answer: B Explanation: A) Anxiety and anxiousness are symptoms of neurosis.

C) Apprehension and tension are symptoms of neurosis.

D) Vague, unsubstantiated fears are symptoms of neurosis.

17) Which one of the following 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) This drug is used to treat depression.

D) Concerta is used to treat ADHD. 18) 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.

19) Drugs used to treat psychosis are called all of the following, EXCEPT A) benzodiazepine drugs B) neuroleptic drugs C) major tranquilizer drugs D) antipsychotic drugs Answer: A Explanation: A) These are used to treat anxiety.

B) Drugs used to treat psychosis are called neuroleptic drugs.

C) Drugs used to treat psychosis are called major tranquilizer drugs.

D) Drugs used to treat psychosis are called antipsychotic drugs.

5

.

20) 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 anxiety, but Abilify is used to treat psychosis.

C) Lithium is used to treat manic-depressive disorder, but Xanax is used to treat anxiety.

D) Zyprexa is used to treat psychosis, but Antabuse is used to prevent drinking alcohol.

21) 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.

D) These words do not refer to drugs for ADHD. 22) All of the following statements about anorexia nervosa are true, EXCEPT A) The patient is of a normal weight.

B) It is a psychiatric illness.

C) The patient diets to the point of starvaNtU ioRnSbINuG t sTtBil.lCfOeM els fat.

D) The patient denies being too thin.

Answer: A Explanation: A) This is not true.

B) This is a true statement.

C) This is a true statement.

D) This is a true statement.

.

23) Marice 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 addicts can take their methadone drug in an unsupervised environment.

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) They cannot take it in an unsupervised environment.

C) This is a true statement.

D) This is a true statement.

6

24) Which of the following was a drawback of methylphenidate (Ritalin)?

A) Its therapeutic effect only lasted four hours.

B) A dose had to be taken at breakfast, lunch, and in the afternoon.

C) It was embarrassing to children to have to take a dose during school.

D) All of the above were drawbacks.

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.

25) 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.

.

26) 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.

OM C) It is not a disease, but it is a delay in bNrUaR inSIdNeG veTlBo.pCm ent.

D) Once a child is diagnosed with ADHD, the symptoms will continue into adulthood.

Answer: C Explanation: A) This is a false statement. It affects boys more than girls.

B) This is a false statement.

D) This is a false statement. Most children outgrow the symptoms by late childhood.

27) What mental illness is the drug haloperidol (Haldol) used to treat?

A) anxiety B) psychosis C) neurosis D) ADHD Answer: B Explanation: A) Haldol is not used to treat anxiety.

C) Haldol is not used to treat neurosis.

D) Haldol is not used to treat ADHD.

7

28) Which ending is common to generic tricyclic antidepressant drugs?

A) -quilizer B) -ipramine C) -triptyline D) B and C Answer: D Explanation: A) This is not an ending of a generic 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.

29) PTSD is caused by all of the following, EXCEPT .

A) performance anxiety B) trauma and war C) natural disasters D) rape and physical/mental abuse Answer: A Explanation: A) Performance anxiety is a temporary stage fright limited to that occasion.

B) PTSD IS caused by trauma and war.

C) PTSD IS caused by natural disasters.

D) PTSD IS caused by these things.

30) Panic disorder .

A) is treated with antianxiety and antidepressant drugs B) has a sudden, overwhelming fear wheNnUtRhSeIrN e GisTnBo.CiOmMmediate 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.

31) The trade name of the antianxiety generic drug alprazolam is A) Paxil B) Zoloft C) Pristiq D) Xanax Answer: D Explanation: A) Paxil is an antidepressant drug.

B) Zoloft is an antidepressant drug.

C) Pristiq is an antidepressant drug.

8

_.

32) Which of the following statements about obsessive-compulsive disorder is FALSE? A) It involves repetitive actions to relieve anxiety.

B) The patient cleans, checks, hoards, or labels things for hours.

C) The patient knows the behavior is excessive but cannot stop doing it.

D) It is treated with antianxiety drugs to relive the anxiety.

Answer: D Explanation: A) This is a true statement.

B) This is a true statement.

C) This is a true statement.

D) This is a false statement.

33) 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 common to ADHD. C) These are not common to psychosis.

D) Only one answer is correct.

34) The psychiatric disease SAD .

A) is another form of depression 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.

35) 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.

9

16.2 True/False Questions 1) Benzodiazepine drugs affect emotional behavior by their action on 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) Phenothiazine drugs for psychosis block norepinephrine, dopamine, histamine, and serotonin receptors in the brain.

Answer: TRUE 4) Although just slightly different in chemical structure, tetracyclic antidepressant drugs have a much stronger antidepressant effect than tricyclic antidepressant drugs.

Answer: FALSE Explanation: This is a false statement. They have a similar therapeutic effect.

5) Tricyclic antidepressants are prescribed 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.

6) 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.

7) Drugs used to treat manic-depressive disorder lessen the severity and frequency of the mood swings.

Answer: TRUE 8) The narcotic agonist-antagonist drug buprenorphine (Buprenex, Subutex) is used to treat withdrawal symptoms while it also blocks the high that an addict would get.

Answer: TRUE 9) 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 10) Benzodiazepine drugs bind to several different receptors in the brain to provide sedation and also to decrease muscle tension that comes with anxiety.

Answer: TRUE

10

11) 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.

12) 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.

13) 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.

14) The original parent drug for the phenothiazine category of antipsychotic drugs was first manufactured as a wormer for livestock.

Answer: TRUE 15) Minor tranquilizer drugs are not used as often as major tranquilizer drugs for treating anxiety and neurosis because they are older, less effective drugs.

Answer: FALSE Explanation: This is a false statement. Minor tranquilizer drugs are used as often and they are extremely effective drugs for neurosis.

16) The generic antidepressant drug bupropion is available under the trade name Wellbutrin but also under the trade name Zyban which is used to help patients stop smoking.

Answer: TRUE 17) Benzodiazepine antianxiety Schedule IV drugs such as alprazolam (Xana) and clonazepam (Klonopin) are the most effective in treating panic disorder.

Answer: TRUE 16.3 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 endings -azolam, -azepoxide, -azepate, and -azepam, are common to generic drugs.

Answer: benzodiazepine 3) The treatment of psychosis involves the use of antipsychotic drugs, which are also known as drugs or major tranquilizer drugs.

Answer: neuroleptic 11

4) Antidepressant drugs are also known as Answer: mood

-elevating drugs.

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 withdrawal symptoms).

Answer: dependence

(the need for the drug to prevent

8) The well-known generic drug diazepam is related to the trade name drug Answer: Valium

.

9) The book Nation: Young and Depressed in America described one woman's experience with depression and this drug.

Answer: Prozac 10) The abbreviation ADHD means .

Answer: attention-deficit hyperactivity dNiUsoRrSdIeNrGTB.COM 11) In the past, the disease that is abbreviated as _ shock.

Answer: PTSD

was known as combat fatigue or shell

12) Drugs used to treat psychosis and schizophrenia are known as Answer: antipsychotic 13) Panic disorder is also known as panic Answer: attacks

_ drugs.

.

14) The well-known antidepressant drug duloxetine is related to the trade name drug Answer: Cymbalta 15) The well-defined range of side effects of antipsychotic drugs is collectively known as side effects.

Answer: extrapyramidal 16) The abbreviation 5-HT is another name for the neurotransmitter Answer: serotonin

12

.

.

17) The well-known generic antidepressant drug escitalopram is related to the trade name drug .

Answer: Lexapro 18) The only transdermal patch that can give long-lasting control of ADHD is known by the trade name of .

Answer: Daytrana 16.4 Matching Questions Match the drug name in Column 1 to its drug category in Column 2.

A) benzodiazepine drug for anxiety B) MAO inhibitor drug for depression C) SSRI drug for depression D) phenothiazine drug for psychosis E) stimulant drug for ADHD F) drug used as a deterrent to prevent drinking of alcohol G) dibenzapine drug for psychosis H) SNRI drug for depression I) tetracyclic antidepressant drug J) tricyclic antidepressant drug 1) alprazolam (Xanax) 2) chlorpromazine (Thorazine) 3) citalopram (Celexa) 4) disulfiram (Antabuse) 5) duloxetine (Cymbalta) 6) olanzapine (Zyprexa) 7) doxepin (Sinequan) 8) isocarboxazid (Marplan) 9) methylphenidate (Ritalin) 10) mirtazapine (Remeron) Answers: 1) A 2) D 3) C 4) F 5) H 6) G 7) J 8) B 9) E 10) I

13

16.5 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 neurons in the brain. This allows the norepinephrine and serotonin 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. Also, tricyclic antidepressant drugs increase the sensitivity of receptors on the neurons to both norepinephrine and serotonin.

2) Describe what methadone is and how it must be given to addicts.

Answer: Methadone, a Schedule II drug, is a narcotic agonist drug that does not produce the degree of euphoria of other narcotic drugs, but because it has no antagonist effect, it cannot be given in an unsupervised environment, and so recovering addicts must go to a clinic to obtain a daily dose of methadone.

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 at least four of these foods.

Answer: Foods that must be avoided while taking an MAO inhibitor drug include cheese of all types, yogurt, red wine, beer, sherry, all liquors, liver, anchovies, caviar, sauerkraut, sausage, bologna, salami, avocados, overripe fruit, figs and dried fruits, bananas, raspberries, fava beans, meat tenderizer, soy sauce, ginseng, coffNeU e,RtSeIaN, GcoTlBa.sC,OaM nd chocolate. I 4) Describe the unique drug-delivery technology of a tablet of Concerta, the stimulant drug used to treat ADHD. Answer: Concerta comes as an oblong 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 Zyprexa 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.

14

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 17 Dermatologic Drugs 17.1 Multiple-Choice Questions 1) Which of the following trade names is related to the generic drug coal tar?

A) Balnetar B) Neutrogena T/Gel C) Zetar 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.

2) Of the following vitamin A-type drugs, which is the only one that is used to treat severe cystic acne vulgaris, not common acne vulgaris?

A) adapalene (Differin) B) isotretinoin (Claravis) C) tazarotene (Tazorac) D) tretinoin (Retin-A) Answer: B Explanation: A) Adapalene is only used to treat acne vulgaris.

C) Tazarotene is only used to treat acne N vuUlRgSaIrN isG. TB.COM D) Tretinoin is only used to treat acne vulgaris.

3) Which of the following is NOT one of the effects of coal tar drugs used to treat 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.

B) Coal tar drugs DO correct abnormalities of keratinocytes for psoriasis.

C) Coal tar drugs DO decrease itching for psoriasis.

D) These drugs do NOT increase epithelial cell production.

4) Which of the following is NOT an ending common to generic corticosteroid drugs?

A) -olone B) -onide C) -oid D) -asone Answer: C Explanation: A) The ending -olone is common to generic corticosteroid drugs.

B) The ending -onide is a common suffix to generic corticosteroid drugs.

C) This ending means resembles.

D) The ending -asone is common to generic corticosteroid drugs.

1

5) Which of the following is NOT one of the types of drug used to treat wrinkles?

A) filler drugs B) muscle relaxant drugs C) topical drugs for debridement D) topical vitamin-A type drugs Answer: C Explanation: A) Filler drugs ARE used to treat wrinkle.

B) Muscle relaxant drugs ARE used to treat wrinkles.

D) Topical vitamin-A type drugs ARE used to treat wrinkles.

6) Which of the following is NOT a category of topical drugs used to treat psoriasis?

A) antihistamine drugs B) corticosteroid drugs C) coal tar drugs D) vitamin A-type and vitamin D-type drugs Answer: A Explanation: A) These are not used to treat psoriasis.

B) Corticosteroid drugs ARE used to treat psoriasis C) Coal tar drugs ARE used to treat psoriasis D) Vitamin A-type and vitamin D-type 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) C) mupirocin (Bactroban) D) ketoconazole (Nizoral A-D, Xologel) Answer: C Explanation: A) This is a corticosteroid drug.

B) This drug is used to treat psoriasis.

D) This is an antifungal drug.

8) Which of the following is a topical combination drug that contains three different generic antibiotic drugs?

A) Cortisporin B) Lotrimin C) Neosporin D) Caladryl Answer: C Explanation: A) Cortisporin contains an antibiotic drug (neomycin) and a corticosteroid drug (hydrocortisone) B) Butenafine (Lotrimin Ultra) is not a combination drug.

D) Caladryl is a combination drug but does not contain antibiotic drugs.

2

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) crotamiton (Eurax) C) benzocaine (Dermoplast) D) ciclopirox (Loprox, Penlac Nail Lacquer) Answer: A Explanation: B) This drug is used to treat scabies, not viruses.

C) This is an anesthetic drug. It is not used to treat viruses.

D) This is an antifungal drug, It is not used to treat viruses.

10) Topical coal tar drugs are used to treat .

A) acne B) psoriasis C) fungal infections D) scabies Answer: B Explanation: A) Coal tar drugs are not used to treat acne.

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) an insect bite B) poison ivy C) psoriasis D) alopecia Answer: D Explanation: A) Topical corticosteroid drugs ARE used to treat an insect bite.

B) Topical corticosteroid drugs ARE used to treat poison ivy.

C) Topical corticosteroid drugs ARE used to treat psoriasis.

12) All of the following pairs of trade names are corticosteroid drugs, EXCEPT A) Cloderm and Lidex B) Topicort and Halog C) Decadron and Kenalog D) Lotrimin and Penlac Answer: D Explanation: A) Cloderm and Lidex ARE trade name corticosteroid drugs.

B) Topicort and Halog ARE trade name corticosteroid drugs.

C) Decadron and Kenalog ARE trade name corticosteroid drugs.

D) These are antifungal, not corticosteroid, drugs.

3

.

13) The topical drug used to treat male pattern baldness is .

A) minoxidil (Rogaine) B) capsaicin (Zostrix) C) finasteride (Propecia) D) metronidazole (MetroGel) Answer: A Explanation: B) Capsaicin (Zostrix) is not used to treat male pattern baldness.

C) Finasteride (Propecia) is used to treat male pattern baldness, but it is an oral, not topical, drug.

D) Metronidazole (MetroCream, MetroGel) 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: Xylocaine C) fluticasone: Cutivate D) botulinum toxin type A: Topicort Answer: C Explanation: A) This is not a correct match.

B) This is not a correct match.

D) This is not a correct match.

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) a coal tar drug Answer: B Explanation: A) This antibiotic drug is not used to treat scabies.

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) alpha receptor agonist drugs B) pyrithione zinc (Denorex, Head and Shoulders) C) antibiotic drugs D) corticosteroid drugs Answer: B Explanation: A) These drugs ARE used to treat acne rosacea.

B) This drug is used to treat psoriasis.

C) These drugs ARE used to treat acne rosacea.

D) These drugs ARE used to treat acne rosacea.

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17) All of the following drugs are used topically to treat acne vulgaris, EXCEPT .

A) salicylic acid (Clearasil, Fostex, Stridex) B) benzoyl peroxide (Benzac, Desquam, PanOxyl) C) metronidazole (MetroCream, MetroGel) D) clindamycin (Cleocin T) Answer: C Explanation: A) Salicylic acid (Clearasil, Fostex, Stri-Dex) IS used topically to treat acne vulgaris.

B) Benzoyl peroxide (Benzac, Desquam, PanOxyl) IS used topically to treat acne vulgaris.

C) This is an antibiotic drug used to treat acne rosacea.

D) Clindamycin (Cleocin T) IS used topically to treat acne vulgaris.

18) Some drugs used to treat fungal infections are also used to treat yeast infections because .

A) both types of drugs come in the same strength of doses B) fungi are closely related (biologically) to yeasts.

C) they are both over-the-counter drugs D) all of the above Answer: B Explanation: A) This is not the reason why the same drugs are used to treat fungal and yeast infections.

C) This is not the reason why the same drugs are used to treat fungal and yeast infections.

D) Only one of these answers is correct.

19) Which of the following is NOT a topical antifungal drug?

A) ketoconazole (Nizoral A-D, Xologel) B) tolnaftate (Aftate, Tinactin, Ting) C) valacyclovir (Valtrex) D) sulconazole (Exelderm) Answer: C Explanation: A) This IS an antifungal drug.

B) This IS an antifungal drug.

C) This is an antiviral drug.

D) This IS an antifungal drug.

20) 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.

D) An antipruritic drug is not used to treat bacterial infections.

5

21) 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 (Eryderm, Emgel) B) desoximethasone (Topicort) C) docosanol (Abreva) D) EMLA 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.

D) This anesthetic drug is not used to treat viral infections.

22) injections in the skin of the face help to minimize wrinkles.

A) Coal tar B) Retin-A C) Dovonex D) Botox Answer: D Explanation: A) Coal tar drugs are given topically, not by injection.

B) Tretinoin (Retin-A) is given topically, not by injection.

C) Dovonex is given topically, not by injection.

23) EMLA, Cetacaine, and Xylocaine are all trade name topical A) anesthetic B) corticosteroid C) antibiotic D) antiviral Answer: A Explanation: B) These are not corticosteroid drugs.

C) These are not antibiotic drugs.

D) These are not antiviral drugs.

drugs.

24) 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 topical corticosteroid approved in a nonprescription strength for over-the-counter sales.

D) all of the above statements are true.

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.

6

25) To shrink the enlarged pores of acne vulgaris, a drug with an A) antibiotic B) antipruritic C) astringent D) antifungal Answer: C Explanation: A) This drug effect does not shrink the enlarged pores.

B) This drug effect does not shrink the enlarged pores.

D) This drug effect does not shrink the enlarged pores.

effect is used.

26) Which of the following statements is FALSE? A) A keratolytic action removes dead skin and oil and cleanses the pores.

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) Coal tar drugs are only used to treat psoriasis.

D) This is a true statement.

27) 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) Scabies is a parasite infection.

D) Athlete's foot ISa fungal infection of the skin.

28) Which of the following statements is FALSE about acne vulgaris?

A) Comedos is another name for whiteheads of acne.

B) It is the form of acne that is commonly seen during adolescence.

C) It is characterized by large amounts of oil that harden and enlarge the pores.

D) White blood cells come to the area and form pustules.

Answer: A Explanation: A) Comedos are blackheads.

B) This IS a true statement.

C) This IS a true statement.

D) This IS a true statement.

7

29) Isotretinoin 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) This is not an unusual and severe adverse effect.

C) This is true, but it is not the only correct answer.

30) Which of the following statements about psoriasis is FALSE? A) It is a chronic, autoimmune skin disorder.

B) It can be treated with coal tar which is an over-the-counter drug.

C) It exhibits an abnormally deceased rate of epithelial cell division.

D) It is characterized by scaly, raised, silvery-red patches on the skin.

Answer: C Explanation: A) This IS a true statement.

B) This IS a true statement.

C) The cell division rate is increased, not decreased.

D) This IS a true statement.

31) 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: 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.

32) PUVA uses _ to treat psoriasis.

A) ultraviolet wavelength A light B) the psoralen drug methoxsalen (Oxsoralen) C) phototherapy 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.

8

33) Which of the following is treated with topical antibiotic drugs?

A) infected superficial abrasions and cuts B) skin infections associated with acne vulgaris C) infected superficial skin burns 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.

34) All of the following are considered to be filler drugs that are used to plump the skin and minimize wrinkles, EXCEPT .

A) hyaluronic acid (Juvederm, Restylane) B) botulinum toxin type A (Botox, Dysport) C) human collagen (CosmoDerm, CosmoPlast) D) poly-L-lactic acid (Sculptra) Answer: B Explanation: A) This IS a filler drug.

B) This is a muscle relaxant drug used to treat wrinkles.

C) This IS a filler drug.

D) This IS a filler drug.

35) Which of the following statements is FALSE? A) Hyaluronic acid is derived from the hNaU baRnSeIN roGhToBt.CpOepMper plant.

B) Botox parties, where patients gather to enjoy food and drinks and get Botox injections, are quite popular.

C) Actinic keratoses are raised, rough areas of skin caused by chronic sun exposure.

D) Mites and lice are parasites that cause infection in the skin.

Answer: A Explanation: A) Capsaicin 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.

36) Which of the following statements is FALSE? A) Scabies in humans is caused by the same parasite that causes mange in dogs.

B) Laypersons often refer to pediculosis as crabs.

C) Lice eggs are known as nits.

D) Scabies and pediculosis are treated with 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) They are treated with a topical anti-parasite drug.

9

37) The topical keratolytic drug salicylic acid is used to treat A) acne vulgaris B) corns and calluses C) 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.

.

38) Which of the following trade name drugs is related to the generic drug miconazole?

A) Lotrimin AF B) Desenex C) Micatin 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.

17.2 True/False Questions 1) Oral antibiotic drugs, such as doxycycline (Vibramycin, Vibra-Tabs) and tetracycline (Sumycin), provide topical treatment forNcUaR seSsINoGf TseBv.CeO reMacne vulgaris.

Answer: FALSE Explanation: This is a false statement. These drugs provide systemic treatment.

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. It decreases, not increases 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) Topical anesthetic drugs provide brief periods of anesthesia to a limited depth in the skin by blocking the movement of sodium ions across the cell membrane and affecting nerve impulses.

Answer: TRUE 10

7) Because of their content, ointments are the most common type of drug that is used to treat acne vulgaris because they can unclog the pores.

Answer: FALSE Explanation: This is a false statement. Ointments clog the pores.

8) Oral antibiotic drugs for acne vulgaris travel through the blood to kill bacteria in the deeper layers of the skin.

Answer: TRUE 9) Oral drugs used to treat acne rosacea include the antibiotic drug tetracycline (Sumycin).

Answer: FALSE Explanation: This is a false statement. Tetracycline is used to treat acne vulgaris, not acne rosacea.

10) Both topical and oral vitamin A-type drugs as well as topical and oral vitamin D-type drugs are used to treat psoriasis.

Answer: FALSE Explanation: This is a false statement. Only topical vitamin-D type drugs are used to treat psoriasis.

11) The prescription drug interferon alfa-2b (Intron A) is applied topically or injected into a lesion treat genital warts.

Answer: TRUE 12) 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, except hydrocortisone, are prescription drugs.

13) Severe hives or 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.

14) The drug Botox is the same toxin produced by Clostridium botulinum, the bacterium that causes food poisoning.

Answer: TRUE 15) Some topical drugs for inflammation and itching contain oatmeal to soothe the skin and decrease itching.

Answer: TRUE

11

16) The drugs capasaicin (Capsin, Zostrix) and lidocaine (Lidoderm Patch) are used to treat the skin infection caused by herpes varicella-zoster virus.

Answer: FALSE Explanation: This is a false statement. They cannot treat the infection, only the pain from the infection.

17) The alpha receptor agonist drug brimonidine (Mirvaso) is used topically to treat acne rosacea.

Answer: TRUE 18) Silver sulfadiazine (Silvadene) used topically to treat burns actually contains the chemical element of silver in an ion form.

Answer: TRUE 17.3 Short Answer Questions 1) The over-the-counter drug salicylic acid (Clearasil, Fostex, Stri-Dex) is a removes oil and dead skin to cleanse the pores.

Answer: keratolytic

drug that

2) Topical anti-infective or antibiotic drugs inhibit the growth of bacteria (which is called a effect) or they kill bacteria (which is called a bactericidal action).

Answer: bacteriostatic 3) Drugs used to treat acne vulgaris that are structurally similar to vitamin A or are structurally similar to metabolites of vitamin A, are known as drugs.

Answer: retinoid 4) The ending -conazole is common to generic Answer: antifungal

drugs.

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 6) The ending -caine is common to generic Answer: anesthetic

drugs.

7) Topical drugs for contain enzymes that dissolve necrotic tissue and scar tissue and allow new tissue to begin to form at the base of a burn, skin ulcer, or wound.

Answer: debridement 8) Severe psoriasis is treated with a psoralen drug in combination with Answer: ultraviolet

12

light.

9) The AF in some trade name drugs, such as Lotrimin AF, stands for Answer: antifungal

.

10) The topical generic drug of colloidal oatmeal that is used to treat inflammation and itching is related to the well-known trade name of _.

Answer: Aveeno 11) Widespread use of antibacterial compounds and the routine use of antibiotic drugs in animal feed are believed to have contributed to the rise of antibiotic-resistant .

Answer: bacteria 17.4 Matching Questions Match the drug in Column 1 with its drug category in Column 2.

A) topical combination anesthetic drug B) topical corticosteroid drug C) topical drug for warts D) drug used to treat alopecia E) drug used for herpes simplex type 1 and 2 F) drug used to treat acne rosacea G) topical antifungal drug H) oral immunomodulator drug for psoriasis I) vulgaris and psoriasis J) combination antibiotic/corticosteroid drug 1) EMLA (lidocaine, prilocaine) 2) etanercept (Enbrel) 3) Cortisporin 4) hydrocortisone (Dermolate, Westcort) 5) ketoconazole (Nizoral A-D, Xologel) 6) brimonidine (Mirvaso) 7) minoxidil (Rogaine) 8) salicylic acid (Compound W, Dr. Scholl's) 9) tazarotene (Tazorac) 10) valacyclovir (Valtrex) Answers: 1) A 2) H 3) J 4) B 5) G 6) F 7) D 8) C 9) I 10) E 13

17.5 Essay Questions 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 blocks an enzyme that helps produce DHT, and this lowers the level of DHT to near normal. The topical drug minoxidil dilates arteries in the scalp to increase the blood flow and stimulate hair growth.

2) 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.

3) Describe how Botox is used to treat wrinkles and the origin of its name.

Answer: The toxin in Botox relaxes the underlying muscle, and this allows the skin to become smooth. Botox is used to treat frown lines between the eyebrows or around the mouth. Botox was first used to treat wrinkles in 1999 by a Canadian dermatologist. The trade name Botox is made up of the initial letters of botulinum toxin.

4) 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 advised not to take finasteride.

They are also warned not to handle finasNteUrR idSeINtaGbTleBt.sCO wM hen they are pregnant because of the risk of birth defects that could occur in a male fetus.

14

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 18 Ophthalmic Drugs 18.1 Multiple-Choice Questions 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.

C) Topical antibiotic drugs do not insert a toxin.

D) Topical antibiotic drugs do not interfere with DNA synthesis.

2) Topical sulfonamide drugs are used to treat bacterial infections of the eye because they .

A) are antibiotic drugs B) are anti-infective drugs C) kill bacteria D) are anti-inflammatory drugs Answer: B Explanation: A) Topical sulfonamide drugs are not antibiotic drugs.

C) Topical sulfonamide drugs do not killNbUaRcSteINriGa.TB.COM D) Topical sulfonamide drugs are not anti-inflammatory drugs.

3) Topical antiviral drugs for viral eye infections, such as trifluridine (Viroptic), act by .

A) disrupting the cell wall of a virus B) inhibiting the growth of viral cells C) inhibiting viral DNA from 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.

D) Topical antiviral drugs do not inject a toxin into the virus.

1

4) Which of the following categories of drugs is NOT used to treat allergy symptoms in the eyes?

A) topical antihistamine drugs B) topical decongestant drugs C) topical mast cell stabilizer drugs D) topical prostaglandin F agonist 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) These drugs are used to treat glaucoma.

5) 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) anesthetic ophthalmic drugs Answer: C Explanation: A) These drugs are not used to treat glaucoma.

B) Beta-blocker drugs for glaucoma do not block an enzyme.

D) These drugs do not block an enzyme.

6) In order to examine the interior of theNeUyRe,StIhNeGpTaBt.iCeO ntMwould be given eye drops containing what type of drug?

A) mydriatic drug B) antibiotic drug C) antihistamine drug D) corticosteroid drug Answer: A Explanation: B) Antibiotic drugs are not used to examine the interior of the eye.

C) Antihistamine drugs are not used to examine the interior of the eye.

D) Corticosteroid drugs are not used to examine the interior of the eye.

7) 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) Mydriatic drugs do not constrict the pupil.

C) Mydriatic drugs do not decrease the flow of aqueous humor.

D) Only one of these answers is correct.

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8) 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) Azopt IS used to treat glaucoma.

B) Xalatan IS used to treat glaucoma.

C) Timoptic IS used to treat glaucoma.

D) This antibiotic drug is not used to treat glaucoma.

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9) All of the following are beta-blocker drugs used to treat glaucoma, EXCEPT A) carteolol B) betaxolol (Betoptic) C) prednisolone (Omnipred, red Forte) D) timolol (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) This is not a beta-blocker drug.

D) This is a beta-blocker drug used to treat glaucoma.

10) 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) Silver nitrate placed in a newborn's eyes can interfere with mother-child bonding.

D) The antiviral drug implant Vitrasert is effective against viral infections.

Answer: A Explanation: A) A mydriatic drug dilates the pupil.

B) This IS a true statement.

C) This IS a true statement.

D) This IS a true statement.

11) Which of the following statements is TRUE? A) Botox is derived from the same bacterium that causes botulism (food poisoning).

B) Strabismus is caused by an abnormal constriction of the pupil.

C) Blepharospasm is spasm of the pupil of the eye.

D) The main symptom of glaucoma is decreased intraocular pressure.

Answer: A Explanation: B) Strabismus is not caused by an abnormal constriction of the pupil.

C) It is spasm of the lid.

D) The main symptom of glaucoma is increased, not decreased, intraocular pressure.

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12) 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.

C) Miotic drugs for glaucoma do not have the same effect as epinephrine.

D) Vitreous humor is a fluid, not a neurotransmitter.

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13) The drug tetracaine is used in the eye to .

A) increase the flow of aqueous humor B) dilate the pupil and paralyze the muscles of accommodation C) provide topical anesthesia during eye examinations and for short surgical procedures D) treat glaucoma Answer: C Explanation: A) Tetracaine does not affect aqueous humor.

B) Tetracaine does not dilate the pupil and paralyze the muscles of accommodation.

D) Tetracaine is not used to treat glaucoma.

14) When a foreign substance, such as pollen or animal dander enters the eye, antibodies from the immune system are active and is released.

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.

D) Only one answer is correct.

15) Which of the following drugs is NOT used to treat glaucoma?

A) pilocarpine (Pilocar) B) Cosopt (dorzolamide, timolol) 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) This is a mydriatic drug.

D) This drug IS used to treat glaucoma.

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16) The topical drug natamycin (Natacyn) is used to treat .

A) bacterial infections of the eye B) fungal infections of the eyelids and eye C) parasitic infections of the eyelids and eye D) viral infections of the eyelids and eye Answer: B Explanation: A) Natamycin is not used to treat bacterial infections.

C) Natamycin is not used to treat parasitic infections.

D) Natamycin is not used to treat viral infections.

17) The drug fluocinolone (Retisert) is a .

A) corticosteroid drug that is injected into the eye B) corticosteroid drug that is inserted into the eye as an implant C) nonsteroidal anti-inflammatory drug that is inserted into the eye as an implant D) nonsteroidal anti-inflammatory drug that is injected into the eye Answer: B Explanation: A) Fluocinolone is a corticosteroid drug but it is not injected into the eye.

C) Fluocinolone is not a nonsteroidal anti-inflammatory drug.

D) Fluocinolone is not a non-steroidal anti-inflammatory drug.

18) Topical NSAIDs, commonly used in conjunction with cataract or LASIK surgery, A) dilate the pupil B) prevent eye infection C) increase the outflow of aqueous humoNrURSINGTB.COM D) treat pain and inflammation Answer: D Explanation: A) Topical NSAIDs do not dilate the pupil.

B) Topical NSAIDs do not prevent eye infection.

C) Topical NSAIDs do not increase the outflow of aqueous humor.

19) Which of the following is NOT a topical antibiotic drug used to treat bacterial infections of the eye?

A) ciprofloxacin (Ciloxan) B) levofloxacin (Quixin) C) metipranolol (OptiPranolol) D) ofloxacin (Ocuflox) Answer: C Explanation: A) This IS a topical antibiotic drug.

B) This IS a topical antibiotic drug.

C) This is a beta-blocker drug.

D) This IS a topical antibiotic drug.

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20) Which of the following statements is FALSE? A) Sulfonamide drugs and antibiotic drugs both kill bacteria to treat eye infections.

B) Topical drugs used in the eye are specially formulated to be physiologically similar to eye fluids and tears.

C) Some topical generic antibiotic drugs for the eye are also available as oral generic antibiotic drugs, but the trade names are different.

D) Topical erythromycin is placed in the eyes of newborn infants to prevent infection from gonorrhea and chlamydia, two sexually transmitted diseases.

Answer: A Explanation: A) Sulfonamide drugs inhibit but do not kill bacteria.

B) This is a true statement.

C) This is a true statement.

D) This is a true statement.

21) Which of the following is NOT a topical corticosteroid drug used to treat eye inflammation?

A) dexamethasone (Maxidex) B) diclofenac (Voltaren) C) fluorometholone (Flarex) D) prednisolone (Omnipred, Pred Forte) Answer: B Explanation: A) This IS a topical corticosteroid drug.

B) This is a nonsteroidal anti-inflammatory drug.

C) This IS a topical corticosteroid drug.

D) This IS a topical corticosteroid drug.

22) Xerophthalmia can be caused by _ .

A) old age 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.

23) The prostaglandin F agonist drug bimatoprost, which used to treat glaucoma, has an unusual side effect of causing .

A) increased pigmentation of the iris B) xerophthalmia 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.

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24) 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.

18.2 True/False Questions 1) Topical antibiotic drugs for eye infections are useful in treating both bacterial infections of the eye 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 (Viroptic) is specifically effective against herpes simplex virus, type 1 and type 2.

Answer: TRUE 3) The drug ganciclovir (Vitrasert) is an implant that is placed within the lens of the eye.

Answer: FALSE Explanation: This is a false statement. ItNiUs RpSlaINceGdTB in.CtO heMposterior cavity of the eye.

4) Nonsteroidal anti-inflammatory drugs, but 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.

5) 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 6) Alpha receptor stimulator drugs for glaucoma constrict the pupil and decrease the outflow of aqueous humor.

Answer: FALSE Explanation: This is a false statement. These drugs constrict the pupil and increase the outflow of aqueous humor.

7) 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.

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8) All carbonic anhydrase inhibitor drugs used to treat glaucoma must be given orally in order to be effective.

Answer: FALSE Explanation: This is a false statement. Some drugs in this category are given orally.

9) Miotic drugs for glaucoma mimic the action of epinephrine, a neurotransmitter for the sympathetic division of the nervous system.

Answer: FALSE Explanation: They mimic the action of acetylcholine from the parasympathetic nervous system.

10) Some drugs used to treat cataracts decrease the elevated intraocular pressure which, if left untreated, can lead to blindness.

Answer: FALSE Explanation: This is a false statement. It is glaucoma that has an increased intraocular pressure, not cataracts.

11) 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 12) Anesthetic ophthalmic drugs are administered topically.

Answer: TRUE 13) The drug sulfacetamide (AK-Sulf, SN ulUstReSrI)NisGTcoBn.CsO idM ered to be a topical antibiotic drug.

Answer: FALSE Explanation: This is a false statement. It is a topical anti-infective drug.

14) Topical decongestant drugs constrict the blood vessels in the cornea to reduce redness.

Answer: TRUE 15) Topical ophthalmic drugs are interchangeable with topical drugs for the skin because they both contain the same drug ingredient.

Answer: FALSE Explanation: This is a false statement. They are not interchangeable.

16) Botulinum toxin type A (Botox, Dysport) is injected into eye muscles to paralyze them and treat strabismus; it is also injected into the muscles of the face to treat skin wrinkles.

Answer: TRUE 17) Without the use of topical mydriatic drugs, it would be impossible to perform an examination of the internal structures of a patient's eye.

Answer: TRUE

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18.3 Short Answer Questions 1) NSAIDs are used after cataract or corneal surgery to treat the pain and _ with surgery.

Answer: inflammation 2) The well-known generic drug cyclosporine is related to the trade name drug used to treat dry eyes syndrome.

Answer: Restasis

associated

that is

3) Some drugs for glaucoma stimulate F receptors, which increases the outflow of aqueous humor and decreases the intraocular pressure.

Answer: prostaglandin 4) The plant was the original source of the mydriatic drugs atropine and scopolamine.

Answer: belladonna 5) The ending Answer: -lol

is common to generic beta-blocker drugs used to treat glaucoma.

6) Most states either recommend or require a topical anti-infective 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 7) The first drugs to be developed to treat glaucoma were drugs, which cause the pupil to constrict, and this increases the outflow of aqueous humor and lowers the intraocular pressure.

Answer: miotic 8) One category of drugs used to treat glaucoma inhibits destroys acetylcholine.

Answer: cholinesterase 9) Dilating the pupils, a process known as surgery.

Answer: mydriasis

, an enzyme that normally

, is done prior to an eye examination or

10) Topical drugs are used in the eye to treat inflammation because they suppress the immune system's local inflammatory response.

Answer: corticosteroid 11) Mast cell stabilizer drugs block the release of eyes.

Answer: histamine

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and relieve allergy symptoms in the

12) Brinzolamide (Azopt) is a carbonic anhydrase inhibitor drug that blocks the enzyme that produces humor.

Answer: aqueous 13) A drug that produces cycloplegia is one that paralyzes the muscles of that the pupil remains fixed and dilated.

Answer: accommodation

of the eye so

14) The well-known generic antihistamine drug olopatadine for the eyes is related to the trade name drugs of Pataday and .

Answer: Patanol 15) The eye disease of xerophthalmia is also known as Answer: dry 16) The drug Lacrisert is a dissolving Answer: implant

eyes syndrome.

that is used to treat dry eyes syndrome.

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18.4 Matching Questions Match the drug name in Column 1 with the drug category in Column 2.

A) topical antibiotic drug for bacterial eye infections B) prostaglandin F agonist drug for glaucoma C) topical NSAID drug for eye inflammation D) beta-blocker drug used to treat glaucoma E) topical mast cell stabilizer drug for eye allergies F) topical corticosteroid drug for eye inflammation G) topical decongestant drug for eye allergies H) monoclonal antibody drug for macular degeneration I) topical antihistamine drug for eye allergies J) carbonic anhydrase inhibitor drug for glaucoma 1) azelastine (Optivar) 2) timolol (Timoptic) 3) ciprofloxacin (Ciloxan) 4) dexamethasone (Maxidex) 5) dorzolamide (Trusopt) 6) ketorolac (Acular) 7) latanoprost (Xalatan) 8) phenylephrine (Mydfrin) 9) pemirolast (Alamast) 10) ranibizumab (Lucentis) Answers: 1) I 2) D 3) A 4) F 5) J 6) C 7) B 8) G 9) E 10) H

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18.5 Essay Questions 1) Describe the two ways that drugs used to treat simple (open-angle) glaucoma can work.

Answer: Drugs for chronic simple (open-angle) glaucoma act in one of two ways: (1) they decrease the amount of aqueous humor circulating in the anterior and posterior chambers (to decrease the intraocular pressure) and/or (2) they constrict the pupil (miosis) and this opens the angle between the iris and the trabecular meshwork (to allow the aqueous humor to flow freely 2) 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.

3) Describe the 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.

4) Name the two different topical drugs used in the eyes of newborns to prevent blindness from gonorrhea, and describe their advantages and disadvantages.

Answer: Anti-infective drugs used for thNiU s RaSreINeGryTtBh.rCoOmMycin ointment or silver nitrate liquid solution. Although silver nitrate has been commonly used for years and is the least expensive of the two drugs, it has several drawbacks. Silver nitrate produces conjunctival irritation/swelling, which may interfere with mother-child bonding, and it is ineffective in preventing eye infections due to Chlamydia (another sexually transmitted disease). Erythromycin ointment is more expensive, but it does not produce eye irritation and is effective against Chlamydia.

5) 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.

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 19 Ears, Nose, and Throat (ENT) Drugs 19.1 Multiple-Choice Questions 1) Which of the following is NOT one of the effects of second generation antihistamine drugs?

A) produce drowsiness B) decrease itching and redness C) dry up secretions D) shrink mucous membranes Answer: A Explanation: A) They do NOT produce drowsiness.

B) They do decrease itching and redness.

C) They do dry up secretions.

D) They do shrink mucous membranes.

2) The corticosteroid drug triamcinolone (Kenalog in Orabase) is prescribed to treat mouth ulcers and inflammation. It comes in the drug form of a/an .

A) gel B) liquid C) ointment D) paste Answer: D Explanation: A) This drug does not comNeUaRsSaINgGelT.B.COM B) This drug does not come as a liquid.

C) This drug does not come as an ointment.

3) Antitussive drugs decrease .

A) coughing B) sneezing C) sputum production D) edema and inflammation Answer: A Explanation: A) Antitussive drugs decrease coughing by suppressing the cough center in the brain.

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.

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4) Which of the following is NOT a route of administration for decongestant drugs?

A) intravenously as a liquid B) topically as a nasal spray C) orally as a tablet D) topically as nose drops Answer: A Explanation: B) Decongestant drugs are administered by nasal spray.

C) Decongestant drugs are administered orally.

D) Decongestant drugs are administered topically as nose drops.

5) Allen Southerby has allergic rhinitis. He takes a mast cell stabilizer drug, and that drug acts to .

A) decrease inflammation and edema of mucous membranes B) break up mucus that must be expelled from the lungs C) prevent the release of histamine to prevent edema of mucous membranes D) constrict blood vessels to reduce blood flow to edematous mucous membranes Answer: C Explanation: A) A mast cell stabilizer drug does not decrease inflammation and edema of mucous membranes.

B) A mast cell stabilizer drug does not break up mucus in the lungs.

D) A mast cell stabilizer drug does not constrict blood vessels to reduce blood flow to edematous mucous membranes.

6) The sulfonamide anti-infective drug sN ulUfaRdSiIaNzGinTeBi.C s OuM sed to treat otitis media. It is given .

A) by intramuscular injection B) intravenously C) orally D) topically Answer: C Explanation: A) Sulfadiazine is not given by intramuscular injection.

B) Sulfadiazine is not given intravenously.

D) Sulfadiazine is not given topically.

7) Antihistamine drugs are prescribed to stop the release of histamine. Histamine causes all of the following, EXCEPT .

A) bacterial infection B) irritation of tissues C) pain and itching D) vasodilation Answer: A Explanation: A) Histamine does NOT cause infection.

B) Histamine DOES directly irritate tissues.

C) Histamine DOES cause pain and itching.

D) Histamine DOES cause vasodilation causing red, swollen mucous membranes.

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8) Antitussive drugs are prescribed .

A) for nonproductive coughs B) for productive coughs C) to relieve congestion and inflammation D) to dry mucous membrane secretions Answer: A Explanation: B) Antitussive drugs are not prescribed for a productive cough.

C) Antitussive drugs do not relieve congestion.

D) Antitussive drugs do not dry secretions.

9) Antihistamine drugs are .

A) only available as over-the-counter drugs B) only available as prescription drugs C) available as both as over-the-counter and prescription drugs D) Schedule III drugs Answer: C Explanation: A) Antihistamine drugs are available as over-the-counter and by prescription.

B) Antihistamine drugs are available over-the-counter and by prescription.

D) There are no antihistamine drugs that are schedule drugs.

10) Corticosteroid drugs used intranasally to treat allergies can cause A) nosebleeds B) yeast infections C) sore throat 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.

11) Topical corticosteroid drugs are used to treat inflammation in A) the nose B) the ears C) the mouth D) the nose, ears, and mouth 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.

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12) The drug nystatin (Mycostatin, Nilstat) 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.

D) Nystatin is not a corticosteroid drug.

.

13) You can tell from the name of this drug, that ofloxacin (Floxin Otic) is used in the A) nose B) ears C) mouth D) nose, ears, and mouth Answer: B Explanation: A) Floxin Otic is not used in the nose.

B) The adjective otic means pertaining to the ear.

C) Floxin Otic is not used in the mouth.

D) Floxin Otic is only used in one of these locations.

14) The drug ofloxacin (Floxin Otic) is used to treat .

A) nasal congestion and stuffiness B) a nonproductive cough C) an ear infection D) a yeast infection of the mouth Answer: C Explanation: A) Ofloxacin is an antibiotic not a decongestant drug.

B) Ofloxacin is an antibiotic not an antitussive drug.

D) Floxin Otic means it is used in the ear, not in the mouth.

15) Which of the following is a narcotic antitussive drug?

A) benzonatate (Tessalon) B) hydrocodone (Hycodan) C) dextromethorphan (Robitussin, Vicks 44) D) all of the above Answer: B Explanation: A) Tessalon is not a narcotic antitussive drug.

C) Dextromethorphan is not a narcotic antitussive drug.

D) Only one of the answers is correct.

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16) Which of the following statements is FALSE? A) Prescription cough syrups that contain a controlled substance can be addicting.

B) The DEA reports that prescription cough syrups are available from some online pharmacies that do not verify the prescriptions sent to them.

C) The nonnarcotic antitussive drug dextromethorphan is commonly available over the counter, but is not abused by teenagers.

D) The combination drug Tussionex contains an antihistamine drug and a narcotic antitussive drug.

Answer: C Explanation: A) This IS a true statement.

B) This IS a true statement.

C) This is a false statement. Teenagers do abuse dextromethorphan.

D) This IS a true statement.

17) Which of the following statements concerning antihistamine drugs is FALSE? A) They block H1 receptors.

B) They are not included in combination drugs for treating the common cold.

C) They are useful for treating allergies.

D) Newer antihistamine drugs produce less drowsiness.

Answer: B Explanation: A) This IS a true statement.

B) Antihistamine drugs ARE included in combination drugs for the common cold.

C) This IS a true statement.

D) This IS a true statement.

18) 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.

19) The trade name for the well-known generic drug diphenhydramine is A) Afrin B) Sudafed PE C) Benadryl D) Zyrtec Answer: C Explanation: A) Afrin is not the trade name for diphenhydramine.

B) Sudafed is not the trade name for diphenhydramine.

D) Zyrtec is not the trade name for diphenhydramine.

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20) The label of the antiyeast drug nystatin (Mycostatin) 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 (Mycostatin) does not come in the form of a nasal spray.

D) Nystatin (Mycostatin) does not come in the form of a topical ointment.

21) Corticosteroid drugs applied intranasally (topically inside the nose) include all of the following trade names, EXCEPT .

A) Beconase B) Rhinocort C) Omnaris D) Afrin Answer: D Explanation: A) Beclomethasone (Beconase) is a corticosteroid drug that is applied intranasally.

B) Budesonide (Rhinocort) is a corticosteroid drug that is applied intranasally.

C) ciclesonide (Omnaris) is a corticosteroid drug that is applied intranasally.

D) Afrin is applied intranasally, but it is a decongestant drug, not a corticosteroid drug.

22) An otic solution should only be usedNiU nRthSeINGTB.COM .

A) mouth B) ear C) nose D) It can be used in the mouth, ears, or nose.

Answer: B Explanation: A) An otic solution is not used in the mouth.

C) An otic solution is not used in the nose.

D) There is only one correct answer.

23) Which of the following statements is TRUE? A) Antihistamine drugs are effective in treating bacteria or viruses that cause the common cold.

B) The symptoms of allergies and colds are similar but the cause is different.

C) During both allergies and colds, there is a release of histamine.

D) All of the above are true statements.

Answer: B Explanation: A) This is a false statement.

C) This is a false statement.

D) Only one of the statements is true.

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24) All of the following are trade name antihistamine drugs, EXCEPT A) Clarinex B) Allegra C) Mycostatin D) Tavist Answer: C Explanation: A) Clarinex IS an antihistamine drug.

B) Allegra IS an antihistamine drug.

C) This is an antiyeast drug.

D) Tavist IS an antihistamine drug.

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25) Which of the following pairs does NOT contain two trade name decongestant drugs?

A) Afrin and Duration B) Dimetapp and Triaminic C) Sudafed and Otrivin D) Astelin and Tavist Allergy Answer: D Explanation: A) Afrin and Duration are decongestant drugs.

B) Dimetapp and Triaminic are decongestant drugs.

C) Sudafed and Otrivin are decongestant drugs.

D) These are antihistamine drugs, not decongestant drugs.

26) 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.

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27) "Swish and swallow" would be instructions given to an adult patients on how to take .

A) oral corticosteroid drugs B) oral antiyeast drugs C) decongestant nasal sprays D) oral antihistamine drugs Answer: B Explanation: A) This does not apply to corticosteroid drugs.

C) This does not apply to decongestant nasal sprays.

D) This does not apply to antihistamine drugs.

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28) Which is a trade name for the well-known generic antitussive drug dextromethorphan?

A) codeine B) Robitussin C) Xylocaine D) Allegra Answer: B Explanation: A) Codeine is not a trade name drug.

C) This is not an antitussive drug.

D) This is not an antitussive drug.

29) Which of these sound-alike trade name drugs is a mast cell stabilizer drug?

A) Nasacort B) Nasonex C) Nasalcrom D) All of these are mast cell stabilizer drugs.

Answer: C Explanation: A) This is a corticosteroid drug.

B) This is a corticosteroid drug.

D) There is only one correct answer.

30) The well-known generic antihistamine drug loratadine is related to the trade name drug .

A) Claritin B) Floxin C) Hycodan D) These are all trade names of the antihistamine drug loratadine.

Answer: A Explanation: B) This is an antibiotic, not an antihistamine, drug.

C) This is an antitussive, not an antihistamine, drug.

D) There is only one correct answer.

19.2 True/False Questions 1) To treat swelling of the mucous membranes in the nose, sinuses, and throat, decongestant drugs act as vasodilators to increase blood flow to those areas.

Answer: FALSE Explanation: This is a false statement. They act as vasoconstrictors to reduce blood flow.

2) Corticosteroid drugs have a decongestant effect and an antihistamine effect.

Answer: FALSE Explanation: This is a false statement. They have no decongestant or antihistamine effect.

3) 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.

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4) Sulfonamide drugs are a type of anti-infective drug that inhibits the growth of bacteria.

Answer: TRUE 5) Some over-the-counter narcotic antitussive drugs contain codeine or hydrocodone.

Answer: FALSE Explanation: This is a false statement. Narcotic antitussive drugs are prescription drugs.

6) Expectorant drugs are used to treat the same types of coughs as are antitussive drugs.

Answer: FALSE Explanation: This is a false statement. Expectorant drugs are for a cough that is producing mucus. Antitussive drugs are for a nonproductive cough.

7) Corticosteroid drugs are administered by an intranasal route to treat allergic and nonallergic rhinitis.

Answer: TRUE 8) Swimmer's ear, external otitis, and otitis media are treated topically with a solution of an antibiotic drug in the external ear canal.

Answer: TRUE 9) Decongestant drugs are commonly prescribed for colds and allergies.

Answer: TRUE 10) Decongestant drugs are available oveNrU-tRhSeI-NcoGuTnBt.eCrOaM nd by prescription.

Answer: TRUE 11) Antibiotics drugs are the drug of choice to cure the common cold.

Answer: FALSE Explanation: This is a false statement. They are not effective for the common cold because it is caused by a virus.

12) Corticosteroid drugs are used to treat moderate-to-severe common colds that are unresponsive to other drugs.

Answer: FALSE Explanation: This is a false statement. They are not used to treat the common cold.

13) "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 14) The antihistamine drug hydroxyzine (Vistaril) is given preoperatively to decrease oral secretions prior to endotracheal intubation.

Answer: TRUE 15) The nonnarcotic drug dextromethorphan is an antitussive drug.

Answer: TRUE 9

16) If the patient has a productive cough, an antitussive drug should be prescribed.

Answer: FALSE Explanation: This is a false statement. Antitussive drugs are not used to treat a productive cough.

19.3 Short Answer Questions 1) drugs act by inhibiting the body's immune response. They decrease inflammation and edema of the mucous membranes of the ears, nose, and throat.

Answer: Corticosteroid 2) Antibiotic drugs are prescribed when a cold or sore throat is caused by a bacterial infection, particularly by the bacteria that cause strep throat.

Answer: streptococci 3) 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 4) During an allergic reaction, histamine is released from Answer: mast

cells.

5) The nasal spray drug oxymetazoline (Afrin 12-Hour, Duration) belongs to the category of drugs.

Answer: decongestant 6) The drug ofloxacin (Floxin Otic) belongs to the Answer: antibiotic

category of drugs.

7) The drug sulfisoxazole (Gantrisin Pediatric) is categorized as a type of anti-infective drug.

Answer: sulfonamide

_ drug, which is a

8) The drug dextromethorphan (Robitussin, Vicks 44) is categorized as a/an Answer: antitussive 9) The abbreviation ENT stands for Answer: ears, nose, and throat

.

10) The abbreviation DM stands for Answer: dextromethorphan

.

11) The well-known generic drug diphenhydramine is related to the trade name drug Answer: Benadryl 12) Antitussive drugs act by suppressing the Answer: cough

center in the brain.

10

drug.

.

19.4 Matching Questions Match the drug name in Column 1 with the drug category in Column 2. Note: Each drug category in Column 2 will be used five times.

A) antihistamine drug B) corticosteroid drug for the nose C) corticosteroid drug for the mouth D) mast cell stabilizer drug E) decongestant drug F) antiyeast drug G) anesthetic drug H) antitussive drug I) antibiotic drug J) allergen extract drug 1) oxymetazoline (Afrin 12-Hour, Duration) 2) triamcinolone (Kenalog in Orabase) 3) cetirizine (Zyrtec) 4) ofloxacin (Floxin Otic) 5) benzonatate (Tessalon) 6) dyclonine (Sucrets) 7) fluticasone (Flonase, Veramyst) 8) cromolyn (Nasalcrom) 9) clotrimazole (Mycelex) 10) grass pollen allergen (Oralair) Answers: 1) E 2) C 3) A 4) I 5) H 6) G 7) B 8) D 9) F 10) J

11

19.5 Essay Questions 1) Briefly explain how antitussive drugs work and when they are, and are not, prescribed.

Answer: Antitussive drugs decrease coughing by suppressing the cough center in the brain or by anesthetizing stretch receptors in the respiratory tract. They are prescribed to control dry, nonproductive coughs. Antitussive drugs are not used to treat a productive cough.

2) What is the memory tip that helps you 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 ending -cort refers to 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 air coming into the lungs is filtered and white blood cells from the immune system attack and kill bacteria and viruses in inhaled air. Because corticosteroid drugs suppress the immune system as they decrease inflammation, these drugs cause a common side effect of nasal infection and colds.

4) Describe how to administer and how not to administer the oral suspension of a topical antiyeast drug to treat an infant with oral candidiasis.

Answer: An infant with oral candidiasis is given an oral suspension of the drug. The entire dose is placed in an unattached nipple, and theNU inRfSanINt GsuTcBk.Cs OoM n the nipple until the dose is gone. The drug is not mixed with milk or formula in a bottle because the infant might not drink the entire bottle and would not get the full dose of the drug. Also, the drug should not be diluted with milk or formula because it needs to adhere to the mucous membranes of the oral cavity in order to be effective.

12

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 20 Analgesic Drugs 20.1 Multiple-Choice Questions 1) Which of the following is NOT a therapeutic effect associated with all salicylate drugs?

A) analgesic B) anticoagulant C) anti-inflammatory D) antipyretic Answer: B Explanation: A) This is one of the three therapeutic effects of salicylate analgesic drugs.

B) Only aspirin has this therapeutic effect.

C) This is one of the three therapeutic effects of salicylate analgesic drugs.

D) This is one of the three therapeutic effects of salicylate analgesic drugs.

2) 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 an anti-inflammatory effect.

C) Acetaminophen has neither of these eNffUeRctSsI.NGTB.COM D) Acetaminophen has no anti-inflammatory effect.

3) NSAID drugs have .

A) a greater tendency than salicylate drugs to cause stomach irritation and ulcers B) less of a tendency than salicylate drugs to cause stomach irritation and ulcers C) the same tendency as salicylate drugs to cause stomach irritation and ulcers D) no tendency to cause stomach irritation and ulcers Answer: B Explanation: A) This is not correct.

C) This is not correct.

D) This is not correct.

4) 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.

C) Ergotamine drugs DOO stimulate norepinephrine receptors.

D) Ergotamine drugs DO stimulate serotonin receptors.

1

5) NSAIDs have an analgesic 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.

D) NSAIDs do not inhibit serotonin.

6) Ergotamine drugs .

A) are used to prevent and treat migraine headaches B) constrict the arteries in the brain C) are derived from a fungus 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.

7) Nonnarcotic drugs are only effective for A) mild pain B) mild-to-moderate pain C) moderately severe pain D) severe pain Answer: B Explanation: A) This is not correct.

C) This is not correct.

D) This is not correct.

.

8) Acetaminophen is categorized as a .

A) narcotic drug B) nonsalicylate analgesic drug C) NSAID D) salicylate drug Answer: B Explanation: A) Acetaminophen is not a narcotic drug.

C) Acetaminophen is not an NSAID. D) Acetaminophen is not a salicylate drug.

2

.

9) All of the following are good reasons to use a nonnarcotic analgesic drug as the first step in pain control, EXCEPT .

A) these drugs are available over-the-counter and can be purchased without a prescription.

B) these drugs can control severe pain.

C) these drugs are inexpensive and can be purchased without a prescription.

D) these drugs are not addictive Answer: B Explanation: A) This is a good reason to use these drugs as a first step.

C) This is a good reason to use these drugs as a first step.

D) This is a good reason to use these drugs as a first step.

10) The mechanism by which acetaminophen relieves pain is A) by blocking dopamine receptors B) by inhibiting prostaglandins 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 inhibit prostaglandins.

C) Acetaminophen does not metabolize neurotransmitters.

.

11) Which of the following combination analgesic drugs does NOT contain an antacid?

A) Bufferin B) Ascriptin C) Alka-Seltzer with Aspirin D) Tylenol w/ Codeine No. 3 Answer: D Explanation: A) Bufferin does contain aspirin B) Ascriptin does contains aspirin.

C) Alka-Seltzer with Aspirin does contain aspirin.

D) This combination drug contains acetaminophen, not aspirin.

12) 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.

3

13) Which of the following is NOT of the different types of opioid receptors that are stimulated by narcotic 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) This is a type of drug, not a type of opioid receptor.

D) This IS a type of an opioid receptor.

14) Which generic narcotic drug is often included in a combination drug with a non-narcotic drug?

A) cocaine B) morphine C) meperidine D) codeine Answer: D Explanation: A) Cocaine is not used in combination analgesic drugs.

B) Morphine is not used in combination analgesic drugs.

C) Meperidine is not used in combination analgesic drugs.

15) Ibuprofen belongs to what category oNfUdRrSuIgNsG?TB.COM A) nonnarcotic analgesic drugs B) ergotamine drugs C) narcotic analgesic drugs D) nonsteroidal anti-inflammatory drugs Answer: D Explanation: A) Ibuprofen is not a nonnarcotic analgesic drug.

B) Ibuprofen is not an ergotamine drug.

C) Ibuprofen is not a narcotic analgesic drug.

16) is a beta-blocker drug approved for preventing migraine headaches.

A) atenolol (Tenormin) B) metoprolol (Lopressor, Toprol) C) propranolol (Inderal) 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.

4

17) The origin of the word morphine comes from the Greek word A) morphology, meaning the structure of the drug B) Morpheus, the mythical Greek god of dreams C) amorphous, an adjective meaning without form D) none of the above Answer: B Explanation: A) This is not the origin of the word morphine.

C) This is not the origin of the word morphine.

D) One of the answers is correct.

.

18) The word salicylate refers to drugs, which were originally derived from the bark of the willow (the Latin word salix means willow).

A) aspirin B) narcotic C) analgesic D) prostaglandins Answer: A Explanation: B) Narcotic drugs were not derived from the willow.

C) Not all analgesic drugs were derived from the willow.

D) These are natural substances in the body, not drugs.

19) Which of the following is a common side effect of narcotic drugs?

A) decreased white blood count B) sedation C) stomach ulcer D) constipation Answer: D Explanation: A) This is not a common side effect of narcotic drugs.

B) Sedation is a therapeutic effect, not a common side effect of narcotic drugs.

C) This is not a common side effect of narcotic drugs.

20) Which of the following is a COX-2 inhibitor drug?

A) Darvon B) Demerol C) Celebrex D) Tylenol Answer: C Explanation: A) Darvon is not a COX-2 inhibitor drug.

B) Demerol is not a COX-2 inhibitor drug.

D) Tylenol is not a COX-2 inhibitor drug.

5

21) 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.

D) Meperidine (Demerol) is not derived from the cone snail.

22) The narcotic drug known as the "lollipop" used to treat the pain of cancer is A) fentanyl (Actiq) B) morphine (MS Contin) C) Empirin w/ Codeine combination drug D) naproxen (Aleve, Naprosyn) Answer: A Explanation: B) Morphine (MS Contin) is not known as the "lollipop."

C) This is not known as the "lollipop."

D) Naproxen (Aleve, Naprosyn) is not a narcotic drug.

23) All of these drugs are used to treat migraine headaches, EXCEPT A) methadone (Dolophine, Methadose) B) topramate (Topamax) C) rizatriptan (Maxalt) D) Cafergot (ergotamine, caffeine) Answer: A Explanation: A) This drug is not used to treat migraine headaches.

B) Topramate (Topamax) is used to treat migraine headaches.

C) Rizatriptan (Maxalt) is used to treat migraine headaches.

D) Cafergot is a combination drug that is used to treat migraine headaches.

.

.

24) In which of the following pairs of drugs do both drugs come in the form of transdermal patches?

A) oxaprozin (Daypro) and diclofenac (Flector) B) pentazocine (Talwin) and sumatriptan (Imitrex) C) diclofenac (Flector) and fentanyl (Duragesic) D) celecoxib (Celebrex) and Vicodin (acetaminophen, hydrocodone) Answer: C Explanation: A) Only one of these drugs comes as a transdermal patch.

B) Neither of these drugs comes as a transdermal patch.

D) Neither of these drugs comes as a transdermal patch.

6

25) Aspirin and NSAIDs .

A) inhibit the COX-1 enzyme B) disrupt the protective action that prostaglandins have on the stomach C) inhibit the COX-2 enzyme 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) Aspirin and NSAIDs do not inhibit the COX-2 enzyme.

26) The first prescription analgesic skin gel approved by the FDA for treating the pain of osteoarthritis was .

A) Voltaren B) Indocin C) Bayer Aspirin D) Empirin w/ Codeine Answer: A Explanation: B) Indocin does not come as a topical gel.

C) Aspirin does not come as a topical gel.

D) Empirin w/ Codeine does not come as a topical gel.

27) Which of the following statements is FALSE? A) Some narcotic drugs have a stronger potential for addiction than other narcotic drugs.

B) The symbol S on the drug label indicaNtU esRtShIaNtGtThB is.CisOaMSchedule drug.

C) Narcotic drugs are assigned to schedules (Schedule II to IV).

D) All narcotic drugs (except nalbuphine and tramadol) are schedule drugs.

Answer: B Explanation: A) This IS a true statement.

B) The symbol "C" indicates a Schedule drug or a "controlled" substance.

C) This IS a true statement.

D) This IS a true statement.

28) Methadone is used to treat recovering narcotic drug addicts because A) it prevents the addict from experiencing withdrawal symptoms B) it does not produce euphoria like other narcotic drugs C) it slowly decreases the addict's psychological dependence on narcotic 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.

7

.

29) The phrase low-dose aspirin refers to _.

A) the 81 mg dose of aspirin B) the trade name drug that is only made by Bayer C) aspirin that is taken to prevent heart attacks and strokes D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) Many drug companies make low-dose aspirin.

C) This is true, but it is not the only correct answer.

30) Aspirin taken regularly for many years can lead to the development of .

A) cataracts B) cancer C) addiction D) migraine headaches Answer: A Explanation: B) Long-term aspirin use is not linked to cancer.

C) Aspirin is not addictive because it is not a narcotic drug.

D) Long-term aspirin use is not linked to migraine headaches. Acetaminophen does not inhibit prostaglandins.

31) Which of the following categories of drugs is NOT used to treat migraine headaches?

A) antidepressant drugs B) beta-blocker drugs C) nonsalicylate analgesic drugs D) serotonin receptor agonist drugs Answer: C Explanation: A) This category of drugs is used to treat migraine headaches.

B) This category of drugs is used to treat migraine headaches.

C) Nonsalicylate analgesic drugs (acetaminophen) are not used to treat migraine headaches.

D) This category of drugs is used to treat migraine headaches.

32) Tylenol w/ Codeine No. 3 contains mg of codeine.

A) 30 B) 3 C) 300 D) 3000 Answer: A Explanation: B) This is not the correct number.

C) This is not the correct number.

D) This is not the correct number.

8

33) The combination drug Cafergot used to treat migraine headaches contains A) a beta-blocker drug and aspirin B) ergotamine and caffeine C) a narcotic and a nonnarcotic drug D) morphine and an antidepressant Answer: B Explanation: A) Cafegot does not contain these drugs.

C) Cafergot does not contain these drugs.

D) Cafergot does not contain these drugs.

.

34) Sumatriptan (Imitrex) for migraine headaches comes in which of these drug forms?

A) a tablet B) a liquid to be injected subcutaneously C) a nasal spray D) A and C Answer: D Explanation: A) It does come in this drug form.

B) It does not come in this drug form.

C) It does come in this drug form.

35) Which of these combination trade name drugs contains the generic drugs acetaminophen and oxycodone?

A) Maxalt B) Lortab C) Vicodin D) Percocet Answer: D Explanation: A) This is not a combination drug.

B) Lortab is a combination drug and does contain acetaminophen, but not oxycodone.

C) Vicodin is a combination drug and does contain acetaminophen, but contains hydrocodone.

36) A nonnarcotic drug is often combined with a narcotic drug because .

A) the narcotic drug is a Schedule drug that can relieve severe pain B) it treats the two components of pain (stimulation of nerve endings and pain heightened by anxiety) C) The nonnarcotic drug provides a foundation of pain relief upon which the narcotic 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.

9

20.2 True/False Questions 1) Acetaminophen is a nonsalicylate analgesic drug that is not related to aspirin or any of the other salicylate drugs.

Answer: TRUE 2) Some of the similarities between aspirin and acetaminophen are that they both relieve pain, but they both can cause upset stomach and stomach irritation.

Answer: FALSE Explanation: This is a false statement. Acetaminophen does not cause the stomach irritation that aspirin does.

3) Because NSAIDs are structurally different than aspirin, patients who are allergic to aspirin can safely take NSAIDs. Answer: FALSE Explanation: This is a false statement. NSAIDs are structurally similar to aspirin and patients who are allergic to aspirin should not take NSAIDs. 4) Serotonin receptor agonist drugs are used to prevent migraine headaches from occurring.

Answer: FALSE Explanation: This is a false statement. These drugs are used to treat a migraine headache once it has occurred.

5) One of the benefits of ergotamine druN gsUfRoSrINmGigTrBa.iCnOeMheadaches is that they constrict the arteries in the brain without significantly reducing blood flow.

Answer: TRUE 6) The regular use of aspirin can cause stomach ulcers and long-term use can cause cataracts.

Answer: TRUE 7) Beta-blocker drugs keep the blood vessels constricted and this prevents the vasodilation that begins a migraine headache.

Answer: FALSE Explanation: This is a false statement. Beta-blocker drugs keep the arteries dilated.

8) Antidepressant drugs have been found helpful in preventing migraine headaches.

Answer: TRUE 9) A common side effect of narcotic drugs is an antitussive effect, and this is used as a therapeutic effect by including narcotic drugs in some cough syrups.

Answer: TRUE 10) Calcium channel blocker drugs used to prevent migraine headaches block the movement of calcium ions and, with less calcium in the cells, the smooth muscles relax, and the arteries remain dilated.

Answer: TRUE 10

11) Caffeine is a stimulant drug that is included in combination analgesic drugs used to treat migraine headaches.

Answer: TRUE 12) The drugs nalbuphine (Nubain) and tramadol (Ultram) are narcotic drugs used to treat moderate-to-severe pain but they are not schedule drugs and so they have no potential for addiction.

Answer: TRUE 13) Elderly people who regularly take an NSAID or aspirin are less likely to develop Alzheimer's disease.

Answer: TRUE 14) Diclofenac is the only nonsteroidal anti-inflammatory drug that can be given orally, topically as a gel, or as a transdermal patch.

Answer: TRUE 15) Acetaminophen does not have an anti-inflammatory effect or an anticoagulant effect.

Answer: TRUE 16) Aspirin was the first drug to have a plastic safety seal on top of each drug bottle.

Answer: FALSE Explanation: This is a false statement. Tylenol was the first.

17) Heroin was used extensively to treat pain during the Civil War, but it is now a Schedule I drug with no medical uses.

Answer: TRUE 18) The well-known generic drug ibuprofen is related to the trade names of Advil and Aleve.

Answer: FALSE Explanation: This is a false statement. Aleve is related to the generic drug naproxen.

20.3 Short Answer Questions 1) The ending Answer: -profen

is common to generic nonsteroidal anti-inflammatory drugs.

2) The ending -triptan is common to headaches.

Answer: serotonin

receptor agonist drugs used to treat migraine

3) Narcotic drugs produce a sense of well-being or , which is what causes some narcotic drugs to be more psychologically addicting than others.

Answer: euphoria

11

4) Aspirin prolongs the clotting time of the blood by inhibiting thromboxane, a substance in the blood that normally causes to aggregate and form a blood clot.

Answer: platelets 5) A/an drug, like a salicylate drug or a narcotic drug, is a drug that provides relief from pain.

Answer: analgesic 6) With their Answer: antipyretic

effect, salicylate drugs reduce fever by acting on the hypothalamus.

7) 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 8) The difference between Tylenol w/ Codeine, Tylenol w/ Codeine No. 2, Tylenol w/ Codeine No. 3, and Tylenol w/ Codeine No. 4 is the amount of they contain.

Answer: codeine 9) The trade name MS Contin contains the abbreviation MS, which stands for the generic drug , and Contin, which refers to the fact that the drug provides continuous pain relief as a controlled-release tablet.

Answer: morphine sulfate 10) The combination drug Fioricet has the letters cet in its trade name, which gives a clue that it contains the generic analgesic drug .

Answer: acetaminophen 11) The abbreviation NSAID stands for Answer: Nonsteroidal anti-inflammatory drug

.

12) The salicylate drug aspirin has a therapeutic effect that is not shared by any of the other salicylate drugs. That is a/an effect.

Answer: anticoagulant 13) are the body's own natural pain relievers.

Answer: Endorphins 14) is well known for its use in treating recovering narcotic drug addicts at outpatient clinics.

Answer: Methadone 15) The well-known generic narcotic drug meperidine is related to the trade name drug .

Answer: Demerol

12

16) Drugs that have the potential to cause addiction have an alphabet letter that is a large printed on the label with Roman numerals inside of it.

Answer: C 17) aspirin is combined with an antacid drug to decrease acidity and protect the stomach.

Answer: Buffered 20.4 Matching Questions Match the analgesic drug names in Column 1 with the drug category in Column 2.

A) antidepressant drug for migraine headaches B) salicylate analgesic drug with anticoagulant effect C) serotonin receptor agonist drug for migraine headaches D) ergotamine drugs for migraine headaches E) calcium channel blocker drugs for migraine headaches F) narcotic analgesic drug G) salicylate analgesic drug H) beta-blocker drug for migraine headaches I) nonsteroidal anti-inflammatory drug J) nonsalicylate analgesic drug 1) acetaminophen (Tylenol) 2) aspirin (Bayer Aspirin, Ecotrin, Empirin) 3) almotriptan (Axert) 4) amitriptyline 5) hydromorphone (Dilaudid) 6) atenolol (Tenormin) 7) dihydroergotamine (Migranal) 8) ibuprofen (Advil, Motrin IB) 9) magnesium salicylate (Doan's) 10) diltiazem (Cardizem) Answers: 1) J 2) B 3) C 4) A 5) F 6) H 7) D 8) I 9) G 10) E

13

20.5 Essay Questions 1) Explain how narcotic analgesic drugs work.

Answer: Narcotic 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 narcotic analgesic drugs stimulate all or some of the receptors.

2) 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 serum level of ammonia, and encephalitis.

3) 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.

4) If the generic drug oxycodone and its trade name OxyContin both contain the same narcotic drug, why do drug addicts prefer to abuse OxyContin?

Answer: Addicts use OxyContin because it is a controlled-release tablet that contains up to 10 times more narcotic drug than other forms of oxycodone. The time-release formula is meant to control severe pain for 12 hours, but addicts crush the tablet and snort the powder (or dissolve the tablet and inject the liquid intravenously) to produce an immediate "high."

14

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 21 Anti-Infective Drugs 21.1 Multiple-Choice Questions 1) Generic drugs have beginnings of cef- and ceph-.

A) antiviral B) cephalosporin C) fluoroquinolone D) protease inhibitor drugs Answer: B Explanation: A) Antiviral drugs do not begin with this.

C) Fluoroquinolone antibiotic drugs do not begin with this.

D) Protease inhibitor drugs do not begin with this.

2) The ending is common to generic tetracycline antibiotic drugs.

A) -cillin B) -mycin C) -navir D) -cycline Answer: D Explanation: A) The ending -cillin is not common to generic tetracycline drugs.

B) The ending -mycin is not common to generic tetracycline drugs.

C) The ending -navir is not common to gNeUnRerSiIcNtGeTtrBa.cCyOcM line drugs.

3) Aminoglycoside drugs are primarily effective against .

A) viruses B) parasites C) gram-negative bacteria and some 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.

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 a category of antibiotic drugs that kill bacteria.

B) Monobactam drugs ARE a category of antibiotic drugs that kill bacteria.

C) These are antiretroviral drugs used to treat HIV, not bacteria.

D) Quinolone drugs ARE antibiotic drugs that kill bacteria.

1

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 are antibiotic drugs and are not effective against viruses.

B) Fusion inhibitor drugs do NOT act in the same way as nucleotide analog reverse transcriptase inhibitor drugs.

D) Protease inhibitor drugs do NOT act in the same way as nucleotide analog reverse transcriptase inhibitor drugs.

6) Fusion inhibitor drugs for HIV and AIDS 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.

D) Fusion inhibitor drugs cannot be administered topically.

.

NT URcSaIuNsG 7) Which type of antibiotic drug does NO eTaBb.CaO ctM erium to die by interfering with the structure of its cell wall?

A) carbapenem antibiotic drugs B) cephalosporin antibiotic drugs C) fluoroquinolone antibiotic drugs D) monobactam antibiotic drugs Answer: C Explanation: A) Carbapenem antibiotic drugs DO disrupt the cell wall around a bacterium.

B) Cephalosporin antibiotic drugs DO disrupt the cell wall around a bacterium.

C) These drugs inhibit an enzyme essential to bacterial DNA reproduction.

D) Monobactam antibiotic drugs DO disrupt the cell wall of the bacterium.

8) Which category of drugs used to treat HIV binds directly to the enzyme reverse transcriptase?

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.

C) Aminoglycoside drugs are not used to treat HIV. D) Protease inhibitor drugs do NOT bind to reverse transcriptase.

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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 produced was discovered in a sewer outlet on an island off the coast of Italy.

D) Patients taking aminoglycoside antibiotic drugs are given vision tests and blood tests for cholesterol levels 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) Patients are given hearing tests for otoxicity and blood tests for kidney function.

10) Out of all of the drugs listed, which is 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 drugs are not as effective as third-generation drugs against bacteria that produce penicillinase.

B) Second-generation drugs are not as efNfeUcRtiSvIN e GasTBth.CirOdM -generation drugs against bacteria that produce penicillinase.

D) First and second-generation cephalosporin drugs are not as effective as third-generation cephalosporin drugs against bacteria that produce penicillinase.

11) Which protease inhibitor drug for HIV and AIDS 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 a separate drug.

C) Tenofovir (Viread) is available as a separate drug.

D) Zidovudine (Retrovir) is available as a separate drug.

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12) Which of the following statements is FALSE? A) Before the introduction of penicillin drugs, sulfa drugs were the only anti-infective drugs available to treat bacterial infections.

B) Sulfonamide drugs interfere with the growth of some bacteria that must manufacture their own folic acid.

C) A human cell has a cell wall like a bacterium.

D) Antibiotic drugs that can kill a variety of different types of bacteria are known as broad spectrum antibiotic drugs.

Answer: C Explanation: A) This IS a true statement.

B) This IS a true statement.

C) A human cell has a cell membrane, not a cell wall.

D) This IS a true statement.

13) Which of the following is NOT a third-generation cephalosporin antibiotic drug?

A) tenofovir (Viread) B) cefdinir (Omnicef) C) cefixime (Suprax) D) ceftriaxone (Rocephin) Answer: A Explanation: 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 overuse of antibiotic drugs.

C) So far, only a few bacteria have developed resistance to antibiotic drugs.

D) Antibiotic drugs have been widely prescribed for conditions that did not need antibiotic drugs, and traces of antibiotic drugs given to animals show up in the meat.

Answer: C Explanation: A) This IS a true statement.

B) This IS a true statement.

C) Many, not few, bacteria have developed resistant strains that cannot be treated with antibiotic drugs.

D) This IS a true statement.

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15) Which of these pairs of drugs consists of two aminoglycoside antibiotic drugs that are given orally as a bowel prep before surgery because they are not absorbed from the intestine into the blood?

A) kanamycin, neomycin B) minocycline, tetracycline C) cefaclor, cefuroxime D) ampicillin, ticarcillin Answer: A Explanation: B) These are tetracycline, not aminoglycoside, drugs.

C) These are cephalosporin, not aminoglycoside, drugs.

D) These are penicillin, not aminoglycoside, drugs.

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 bacterium 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.

C) This answer is NOT correct.

D) There is only one correct answer.

17) Which of the following two antibiotic drugs are used to prevent the common, late-stage complication of Mycobacterium avium-iN ntUrR acSeINllG ulTaBr.eCiOnM fection in AIDS patients?

A) nystatin, fluconazole B) nelfinavir, retonavir C) azithromycin, clarithromycin D) oseltamivir, zanamivir Answer: C Explanation: A) These are antiyeast/antifungal, NOT antibiotic, drugs.

B) These are antiretroviral, NOT antibiotic, drugs.

D) These are antiviral, not antibiotic, drugs.

18) All of the following are fluoroquinolone antibiotic drugs, EXCEPT A) ciprofloxacin (Cipro) B) erythromycin (Ery-Tab) C) levofloxin (Levaquin) D) ofloxacin (Floxin) Answer: B Explanation: A) Cipro IS a fluoroquinolone antibiotic drug.

B) this is a macrolide antibiotic drug.

C) This IS a fluoroquinolone antibiotic drug.

D) This IS a fluoroquinolone antibiotic drug.

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19) If a patient is taking the macrolide antibiotic drug azithromycin (Zithromax) and develops an allergic reaction, why might that reaction last long and be severe?

A) Because the macrolide antibiotic drugs are known to cause severe allergic reactions.

B) Because patients on this drug develop a cross-allergy to penicillin drugs.

C) Because this drug has a long half-life and stays in the blood.

D) Because this drug causes ototoxicity and nephrotoxicity.

Answer: C Explanation: A) This is a false statement.

B) This is a false statement.

D) This is a false statement.

20) The drug Augmentin .

A) is a combination drug B) contains the generic drugs amoxicillin and clavulanate potassium C) contains a substance that inactivates the enzyme penicillinase produced by some bacteria D) all of the above Answer: D Explanation: A) That is true, but it is not the only correct answer.

B) That is true, but it is not the only correct answer.

C) This is true, but it is not the only correct answer.

21) 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 (HIV) is a retrovirus.

D) Clinical testing to approve AZT for treating AIDS took several years and was prolonged because of a number of patient deaths.

Answer: D Explanation: A) This IS a true statement.

B) This IS a true statement.

C) This IS a true statement.

D) This is a false statement. It was approved just months after the new drug application was filed.

22) Which of the following is NOT one of the symptoms of an HIV infection?

A) a decreased in the number of T lymphocytes B) fatigue, fever, and night sweats C) diarrhea and weight loss D) an opportunistic infection Answer: D Explanation: A) This IS one of the symptoms of an HIV infection.

B) These ARE symptoms of an HIV infection.

C) These ARE symptoms of an HIV infection.

D) An opportunistic infection comes later and is a symptom of AIDS. 6

23) Which of the following statements is TRUE? A) A person infected with HIV usually remains without symptoms for four to five years.

B) Drugs used to treat HIV inhibit the growth of the retrovirus, but are unable to kill it.

C) The viral load is the total number of viruses in the blood and lymphocytes.

D) All of the above statements are true.

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.

24) Which of the following drug categories is NOT used to treat HIV and AIDS? A) macrolide drugs B) protease inhibitor drugs C) fusion inhibitor drugs D) integrase inhibitor drugs Answer: A Explanation: A) These antibiotic drugs are not used to treat HIV and AIDS. B) Protease inhibitor drugs ARE used to treat HIV and AIDS. C) Fusion inhibitor drugs ARE used to treat HIV and AIDS. D) Integrase inhibitor drugs ARE used to treat HIV and AIDS. 25) Which of the following is NOT a protease inhibitor drug used to treat HIV and AIDS? A) indinavir (Crixivan) B) delavirdine (Rescriptor) C) nelfinavir (Viracept) D) saquinavir (Invirase) Answer: B Explanation: A) Indinavir (Crixivan) IS a protease inhibitor drug used to treat HIV and AIDS. B) This is a non-nucleoside reverse transcriptase inhibitor drug.

C) Nelfinavir (Viracept) IS a protease inhibitor drug used to treat HIV and AIDS. D) Saquinavir (Fortovase, Invirase) IS a protease inhibitor drug used to treat HIV and AIDS. 26) Drugs are used to treat opportunistic infections in AIDS patients because their immune systems are unable to defend against infections.

A) bacterial B) fungal C) viral 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.

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27) Which of the following drugs does NOT belong to the non-nucleoside reverse transcriptase inhibitor drug category used to treat HIV and AIDS? A) delavirdine (Rescriptor) B) efavirenz (Sustiva) C) nevirapine (Viramune) D) amantadine (Symmetrel) Answer: D Explanation: A) This drug IS a nonnucleoside reverse transcriptase inhibitor drug.

B) This drug IS a nonnucleoside reverse transcriptase inhibitor drug.

C) This drug IS a nonnucleoside reverse transcriptase inhibitor drug.

D) This drug is used to treat an influenza virus infection.

28) All of the following are trade name cephalosporin drugs, EXCEPT A) Keflex B) Ceclor C) Amoxil D) Claforan Answer: C Explanation: A) Cephalexin (Keflex) IS a cephalosporin drug.

B) Cefaclor (Ceclor) IS a cephalosporin drug.

C) Amoxicillin (Amoxil) is a penicillin antibiotic drug.

D) Cefotaxime (Claforan) IS a cephalosporin drug.

29) One trade name for the tetracycline aNnUtiRbSioINtiGc TdBru.CgOdMoxycycline is A) Vibramycin B) Cipro C) Zithromax D) Lamisil Answer: A Explanation: B) Ciprofloxacin (Cipro) is a fluoroquinolone antibiotic drug.

C) Azithromycin (Zithromax) is a macrolide antibiotic drug.

D) Terbinafine (Lamisil) is an antifungal drug.

30) 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.

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31) Which pair of drugs belongs to the penicillin category of antibiotic drugs?

A) Crixivan, Norvir B) Amoxil, Pfizerpen C) Omnicef, Zinacef D) Cipro, Levaquin Answer: B Explanation: A) These are protease inhibitor drugs for HIV and AIDS. C) These are cephalosporin, not penicillin, antibiotic drugs.

D) These are cephalosporin, not penicillin, antibiotic drugs.

32) Which of the following statements is FALSE? A) Annual vaccination with a flu shot prevents a person from getting the flu for that year.

B) Flu shots contain either the whole virus, a part of the virus, or a surface antigen from the virus.

C) The two most common and dangerous flu families are influenza A and influenza B viruses.

D) Each year, the CDC selects the most prevalent strains of influenza to include in the flu vaccine.

Answer: A Explanation: A) A person who is vaccinated can still get the flu from other strains of the virus not included in the flu vaccine.

B) This IS a true statement.

C) This IS a true statement.

D) This IS a true statement.

33) 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.

34) 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.

D) Tetracycline drugs do not cause ototoxicity or nephrotoxicity.

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35) Sulfonamide drugs are .

A) also known as sulfa drugs B) a type of antibiotic drug C) used to treat HIV D) a member of the penicillin category drugs Answer: A Explanation: B) Sulfonamide drugs are not antibiotic drugs.

C) Sulfonamide drugs are not used to treat HIV. D) Sulfonamide drugs are not penicillin drugs.

36) 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.

C) Ciprofloxacin (Cipro) does not belong to the tetracycline category.

D) Fusion inhibitor drugs are not a category of antibiotic drugs.

37) The generic drugs trimethoprim and sulfamethoxazole are both in a combination drug that is marketed under the two trade names of .

A) Bactrim and Retrovir B) Septra and Rocephin C) Omnicef and NegGram D) Bactrim and Septra Answer: D Explanation: A) Retrovir is not a combination drug.

B) Rocephin is not a combination drug.

C) Neither of these drugs is a combination drug.

38) Which of the following statements is FALSE? A) Fungi and yeast are related and are treated with many of the same antifungal or antiyeast drugs.

B) The AIDS virus belongs to a category of viruses known as retroviruses.

C) AIDS is not fatal if treatment is begun early in the disease.

D) Pentamidine (NebuPent, Pentam 300) is used to treat Pneumocystis jiroveci pneumonia.

Answer: C Explanation: A) This IS a true statement.

B) This IS a true statement.

C) AIDS is eventually fatal.

D) This IS a true statement.

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39) Which of the following sentences is FALSE? A) Pneumocystis jiroveci pneumonia affects about 75% of all AIDS patients.

B) This pneumonia is the most common infection of AIDS and it can be life-threatening.

C) This pneumonia seldom causes symptoms in healthy individuals.

D) Pneumocystis jiroveci is a bacterium.

Answer: D Explanation: A) This IS a true statement.

B) This IS a true statement.

C) This IS a true statement.

D) It is a protozoan, not a bacterium.

40) Antifungal drugs are effective against all of the following diseases, EXCEPT .

A) athlete's foot B) jock itch C) bacterial infections D) onychomycosis Answer: C Explanation: A) Antifungal drugs ARE effective against athlete's foot.

B) Antifungal drugs ARE effective against jock itch.

D) Antifungal drugs ARE effective against onychomycosis, a fungal infection of the nails.

41) 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) nucleoside reverse transcriptase inhibitor drugs Answer: A Explanation: B) Penicillin and antiviral drugs are not related.

C) Penicillin and antifungal drugs are not related.

D) Penicillin and these drugs are not related.

42) Why can't tetracycline be given to pregnant or nursing women?

A) Because it causes nausea and vomiting.

B) Because it provokes 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.

D) Tetracycline is effective against a wide variety of bacteria.

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43) The well-known generic fluoroquinolone antibiotic drug ciprofloxacin is related to the trade name drug .

A) Pfizerpen B) Cipro C) Zosyn D) Tamiflu Answer: B Explanation: A) This is a penicillin drug, not a fluoroquinolone antibiotic drug.

C) This is a combination penicillin drug, not a fluoroquinolone antibiotic drug.

D) This is an antiviral drug, not a fluoroquinolone antibiotic drug.

44) 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 ARE related to HIV and AIDS. D) This lab test is related to bacteria only, not HIV retrovirus.

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21.2 True/False Questions 1) Atripla and Combivir are combination drugs used to treat HIV and AIDS. Answer: TRUE 2) The goal of drug therapy is to suppress HIV replication as much as possible for as long as possible.

Answer: TRUE 3) Sulfonamide drugs are only effective against viruses.

Answer: FALSE Explanation: This is a false statement. These drugs inhibit the growth of bacteria.

4) The designation of first-generation, second-generation, or third-generation indicates when a cephalosporin drug was first discovered or first marketed.

Answer: FALSE Explanation: This is a false statement. It refers to how effective they are against certain types of bacteria.

5) Macrolide antibiotic drugs kill bacteria by inhibiting an enzyme that the bacteria need in order to reproduce.

Answer: FALSE Explanation: This is a false statement. These drugs interfere with RNA and protein synthesis in bacteria.

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6) Nucleoside reverse transcriptase inhibitor drugs inhibit viral transcriptase from building a strand of viral DNA. Answer: TRUE 7) Monobactam antibiotic drugs are effective against all gram-negative and gram-positive bacteria.

Answer: FALSE Explanation: This is a false statement. They are only effective against gram-negative bacteria.

8) Drugs prescribed for patients with AIDS wasting syndrome are used to stimulate the appetite, build muscle mass, and treat extreme weight loss.

Answer: TRUE 9) Fungi can cause disease topically or systemically, and drugs used to treat fungi can be administered either topically or systemically with oral or intravenous drugs.

Answer: TRUE 10) Drugs used to treat Mycobacterium avium-intracellulare complex (MAC) infections include aminoglycoside antibiotic drugs, macrolide antibiotic drugs, and antitubercular drugs.

Answer: TRUE 11) When a fungal infection involves the nail bed and the nail becomes misshapen, thickened, and discolored, then it must be treated with topical antifungal drugs that act systemically.

Answer: FALSE Explanation: This is a false statement. It must be treated with oral antifungal drugs that act systemically.

12) Kaposi's sarcoma and Burkitt's lymphoma are rare cancers that can develop in patients with the life-threatening bacterial infection of MRSA. Answer: FALSE Explanation: This is a false statement. These rare cancers develop in patients with HIV, not MRSA. 13) Patients with HIV/AIDS can develop widespread and extremely serious fungal infections.

Answer: TRUE 14) Tetracycline drugs are used to treat a wide variety of gram-negative and gram-positive bacterial infections, as well as the sexually transmitted diseases of gonorrhea and syphilis.

Answer: TRUE 15) Doxycycline (Vibramycin, Vibra-Tabs) is used to treat a wide variety of gram-negative and gram-positive bacterial infections and also the infections of Lyme disease, malaria, and anthrax from bioterrorism.

Answer: TRUE

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21.3 Short Answer Questions 1) drugs are not categorized as antibiotic drugs because they only inhibit the growth of bacteria but do not actually kill bacteria.

Answer: Sulfonamide 2) Sulfonamide drugs are also known as Answer: sulfa

drugs.

3) Penicillin antibiotic drugs all share the common molecular structure of a Answer: beta-lactam

ring.

4) Antibiotic drugs that are able to kill a variety of different types of bacteria are known as spectrum or extended-spectrum antibiotic drugs.

Answer: broad 5) The ending -cillin is common to generic Answer: penicillin

antibiotic drugs.

6) antibiotic drugs are further divided into first-generation, second-generation, thirdgeneration, fourth-generation, and fifth-generation drugs.

Answer: Cephalosporin 7) The ending -navir is common to Answer: protease

NURSIiNnG hiTbBit.C orOdMrugs.

8) Some resistant bacteria produce the enzyme beta lactamase, which is also known as .

Answer: penicillinase 9) In 2006, the FDA approved the drug contain three different AIDS drugs.

Answer: Atripla

, which was the first combination drug to

10) Aminoglycoside antibiotic drugs can cause a severe adverse effect on hearing and balance, which is known as .

Answer: ototoxicity 11) Dronabinol, a Schedule III drug used to treat AIDS wasting syndrome, is unusual in that it is derived from .

Answer: marijuana 12) The abbreviation AIDS stands for .

Answer: acquired immunodeficiency syndrome 13) The trade name drugs Tamiflu and Flumadine are used to treat Answer: influenza 14

virus infection.

14) The abbreviation VRSA stands for Answer: vancomycin

-resistant Staphylococcus aureus.

15) The well-known HIV and AIDS drug zidovudine is related to the trade name drug Answer: Retrovir 21.4 Matching Questions Match the drug name in Column 1 with the drug category in Column 2.

A) carbapenem antibiotic drug B) cephalosporin drug C) macrolide antibiotic drug D) antifungal drug E) fluoroquinolone antibiotic drug F) protease inhibitor drug G) nucleoside reverse transcriptase inhibitor drug H) aminoglycoside antibiotic drug I) penicillin antibiotic drug J) tetracycline antibiotic drug 1) amoxicillin (Amoxil, Trimox) 2) azithromycin (Zithromax, ZMax) 3) cefdinir (Omicef) 4) ciprofloxacin (Cipro) 5) doripenem (Doribax) 6) doxycycline (Vibramycin, Vibra-Tabs) 7) fluconazole (Diflucan) 8) indinavir (Crixivan) 9) lamivudine (Epivir) 10) tobramycin (TOBI) Answers: 1) I 2) C 3) B 4) E 5) A 6) J 7) D 8) F 9) G 10) H

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21.5 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 against penicillin drugs.

Answer: Penicillinase is an enzyme produced by penicillin-resistant bacteria. It inactivates penicillin drugs by breaking apart their chemical structure at the site of the beta-lactam ring.

3) Explain what the two focuses are for drug therapy for AIDS. Answer: Drug therapy for AIDS focuses on the use of drugs to suppress the retrovirus, as well as drugs to treat any secondary opportunistic infections that develop.

4) Describe the steps that are involved in performing and interpreting the results of a culture and sensitivity test.

Answer: The physician collects a specimen of the infected area and sends it to a laboratory for a culture and sensitivity test. In the laboratory, the specimen (urine, blood, mucus, pus, saliva, etc.) is swabbed onto a Petri dish. The dish is allowed to incubate and grow colonies of the bacterium.

The results show the bacterial colonies, and these are used to identify what bacterium (or different kinds of bacteria) is causing the infection. That bacterium is then swabbed onto another Petri dish, and disks impregnated with diNfU feRreSnINt G anTtBib.CioOtM ic drugs are placed on the surface of the culture. The Petri dish is incubated to allow the bacterium to grow. The antibiotic drugs that are effective against that bacterium will have a large zone of inhibition (clear ring) around their disk where the bacterium was not able to grow.

5) The macrolide antibiotic drug azithromycin (Zithromax) has a half life of 68 hours. What are the advantages and disadvantages associated with this long half life?

Answer: This extended therapeutic effect is good because it allows the patient to take azithromycin just once a day for five days, while most other antibiotic drugs have a shorter halflife and must be taken two or three times a day for seven days or more. Also, the patient is less likely to forget to take a dose, which is important when taking an antibiotic drug. However, if the patient has an allergic reaction to azithromycin, that reaction will last longer and can be severe because the drug stays in the blood so long.

6) The presence of what two things causes a diagnosis of HIV to change to be a diagnosis of AIDS? Answer: The presence or absence of the following indicators determines a diagnosis of an HIV infection versus a diagnosis of AIDS. • CD4 lymphocyte count below 200 cells/mm3 (normal is 500-1500 cells/mm3) • Presence of an opportunistic infection or disease

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7) Describe what damage tetracycline drugs can do to the teeth and what precautions are taken to prevent this from happening.

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).

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 22 Chemotherapy Drugs 22.1 Multiple-Choice Questions 1) Which of the following is NOT one of the three categories of antimetabolite chemotherapy drugs?

A) folic acid blocker chemotherapy drugs B) nitrosourea chemotherapy drugs C) purine analog chemotherapy drugs D) pyrimidine analog chemotherapy drugs Answer: B Explanation: A) Folic acid blocker chemotherapy drugs ARE a category of antimetabolite chemotherapy drugs.

B) This belongs to the category of alkylating chemotherapy drugs.

C) Purine analog chemotherapy drugs ARE a category of antimetabolite chemotherapy drugs.

D) Pyrimidine analog chemotherapy drugs ARE a category of antimetabolite chemotherapy drugs.

2) To kill cancer cells, alkylating chemotherapy drugs cause alkylation, a chemical reaction in which an alkyl group .

A) allows microtubules to form but not function properly B) binds to antigens on the surface of cancer cells .CO C) is substituted for a hydrogen moleculN e UinRtShIN e GDTNBA ofMa cancer cell D) inhibits the release of hormones to create an environment where cancer cells cannot grow Answer: C Explanation: A) Alkylating chemotherapy drugs do not affect microtubules.

B) Alkylating chemotherapy drugs do not bind to antigens on the surface of cancer cells.

D) Alkylating chemotherapy drugs do not affect the hormonal environment.

3) Androgen hormone chemotherapy drugs are used to treat .

A) breast cancer in females B) prostate gland cancer in men C) leukemia in both men and women D) all of the above Answer: A Explanation: B) Androgen hormone chemotherapy drugs are not used to treat prostate gland cancer.

C) Androgen hormone chemotherapy drugs are not used to treat leukemia.

D) Androgen hormone chemotherapy is not used to treat all of the above.

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4) Gonadotropin-releasing hormone (GnRH) chemotherapy drugs block GnRH receptors on the anterior pituitary gland, so that the anterior pituitary gland does not secrete .

A) estradiol B) luteinizing hormone C) progesterone D) testosterone Answer: B Explanation: A) The anterior pituitary gland does not secrete estradiol.

C) The anterior pituitary gland does not secrete progesterone.

D) The anterior pituitary gland does not secrete testosterone.

5) Chemotherapy enzyme drugs are used to treat .

A) breast cancer in females B) all types of cancer C) leukemia D) testicular cancer in men Answer: C Explanation: A) Chemotherapy enzyme drugs are not used to treat breast cancer.

B) Chemotherapy enzyme drugs are not used to treat all types of cancer.

D) Chemotherapy enzyme drugs are not used to treat testicular cancer.

6) Anti-androgen hormone chemotherapy drugs bind to and block receptors in .

A) breast tissue B) liver tissue C) lung tissue D) prostate gland tissue Answer: D Explanation: A) Anti-androgen hormone chemotherapy drugs do not block receptors in breast tissue.

B) Anti-androgen hormone chemotherapy drugs do not block receptors in liver tissue.

C) Anti-androgen hormone chemotherapy drugs do not block receptors in lung tissue.

7) Which of the following does NOT belong to the drug category of mitosis inhibitor chemotherapy drugs?

A) podophyllotoxin chemotherapy drugs B) kinase inhibitor chemotherapy drugs C) topoisomerase chemotherapy drugs D) vinca alkaloid chemotherapy drugs Answer: B Explanation: A) Podophyllotoxin chemotherapy drugs ARE a type of mitosis chemotherapy drug.

B) This is its own separate drug category.

C) Topoisomerase chemotherapy drugs ARE a type of mitosis chemotherapy drug.

D) Vinca alkaloid chemotherapy drugs ARE a type of mitosis chemotherapy drug.

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8) Platinum chemotherapy drugs contain the precious metal platinum that .

A) binds to tubulin in the microtubules B) changes folic acid into a metabolite C) creates cross-links in DNA strands D) interferes with cellular metabolism Answer: C Explanation: A) Platinum chemotherapy drugs do not bind to tubulin in the microtubules.

B) Platinum chemotherapy drugs do not change folic acid into a metabolite.

D) Platinum chemotherapy drugs do not interfere with cellular metabolism.

9) Which chemotherapy drug is structurally related to vitamin A? A) immunomodulator chemotherapy drugs B) corticosteroid drugs C) monoclonal antibody drugs D) retinoid and rexinoid chemotherapy drugs Answer: D Explanation: A) Immunomodulator chemotherapy drugs are not structurally related to vitamin A. B) Corticosteroid drugs are not structurally relate to vitamin A. C) Monoclonal antibody drugs are not structurally related to vitamin A. 10) Which of these drug categories is created using recombinant DNA technology?

A) Platinum chemotherapy drugs B) Monoclonal antibody chemotherapy dNrUuR gsSINGTB.COM C) Granulocyte colony-stimulating factor drugs D) B and C Answer: D Explanation: A) These are not created using recombinant DNA technology.

B) This is true, but it is not the only correct answer.

C) This is true, but it is not the only correct answer.

11) Immunomodulator chemotherapy drugs modulate or regulate .

A) antigens involved in the differentiation of cells B) DNA and/or RNA C) receptors on the cell wall of cancer cells D) the immune system so that it can kill cancer cells.

Answer: D Explanation: A) Immunomodulator chemotherapy drugs do not regulate antigens.

B) Immunomodulator chemotherapy drugs do not regulate DNA and/or RNA. C) Immunomodulator drugs do not regulate receptors.

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12) The selection of an appropriate chemotherapy drug is based on .

A) the type of cancer B) the stage of the cancer C) the type of cancer and the stage of the cancer D) where the cancer is located Answer: C 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.

D) The selection of an appropriate chemotherapy drug is not based on the location of the cancer.

13) Which of the following endings is common to generic purine analog chemotherapy drugs?

A) -rabine B) -poside C) -ribine D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) This ending is common to generic podophyllotoxin chemotherapy drugs.

C) The is true, but it is not the only correct answer.

14) In order to treat cancer, the physician must .

A) determine the type of cancer B) determine the stage of the cancer C) wait for a remission 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 a true statement.

15) The first chemotherapy drug was .

A) nitrogen mustard B) methotrexate C) cisplatin D) interferon Answer: A Explanation: B) Methotrexate was not the first chemotherapy drug.

C) Cisplatin was not the first chemotherapy drug.

D) Interferon was not the first chemotherapy drug.

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16) Antimetabolite chemotherapy drugs act in all of the following ways, EXCEPT A) take the place of purine in a cancer cell's DNA B) bind to antigens on the surface of cancer cells C) interfere with the role that folic plays in cell metabolism D) take the place of pyrimidine so the cancer cell cannot build DNA Answer: B Explanation: A) Purine analog antimetabolite chemotherapy drugs do this.

B) They do not do this.

C) Folic acid blocker antimetabolite chemotherapy drugs do this.

D) Pyrimidine analog antimetabolite chemotherapy drugs do this.

.

17) All of the following are examples of chemotherapy antibiotic drugs, EXCEPT A) conjugated estrogens (Premarin) B) bleomycin C) doxorubicin (Adriamycin) D) dactinomycin (Cosmegen) Answer: A Explanation: A) This is an anti-androgen hormone chemotherapy drug.

B) Bleomycin is a chemotherapy antibiotic drug.

C) Doxorubicin (Adriamycin) is a chemotherapy antibiotic drug.

D) Dactinomycin (Cosmegen) is a chemotherapy antibiotic drug.

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18) The drug epoetin alfa (Epogen, Procrit) is used to stimulate the production of patients with cancer.

A) white blood cells B) interferon C) nitrogen mustard D) red blood cells Answer: D Explanation: A) Epoetin alfa does not stimulate the production of white blood cells.

B) Epoetin alfa does not stimulate the production of interferon.

C) Epoetin alfa does not stimulate the production of nitrogen mustard.

in

19) Select the statement that is FALSE. A) Chemotherapy drugs often cause nausea and vomiting.

B) Nitrogen mustard gas was first used in chemical warfare.

C) Some chemotherapy drugs come from the periwinkle plant.

D) Interferon is released when the cell is invaded by cancer.

Answer: D Explanation: A) This is a true statement.

B) This is a true statement.

C) This is a true statement.

D) Interferon is produced by macrophages.

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20) Select the statement that is FALSE. A) Chemotherapy protocols are designated by acronyms.

B) A remission occurs when cancer cells stop reproducing.

C) Corticosteroids are a chemotherapy drugs.

D) Certain cancers come from tissues that are influenced by the female hormones estradiol and progesterone.

Answer: C Explanation: A) This is a true statement.

B) This is a true statement.

C) These drugs are not chemotherapy drugs.

D) This is a true statement.

21) All of the following are categories of hormone chemotherapy drugs, EXCEPT A) aromatase inhibitor B) anti-androgen C) progestin D) demethylating Answer: D Explanation: A) These ARE hormone chemotherapy drugs.

B) These ARE hormone chemotherapy drugs.

C) These ARE hormone chemotherapy drugs.

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22) Which of the following statements is FALSE? A) The stage of the cancer indicates wheNthUeRrStIhNeGcTaBn.cCeOr M has spread beyond the original or primary site and metastasized to secondary sites.

B) Uncontrolled cell division and metastasis are identifying characteristics of cancer cells.

C) Benign and malignant neoplasms are classified as cancer.

D) A treatment that is appropriate for one type of cancer is usually not appropriate for a different type of cancer.

Answer: C Explanation: A) This is a true statement.

B) This is a true statement.

D) This is a true statement.

23) Adjuvant therapy .

A) can include chemotherapy or radiation therapy B) helps to eradicate any remaining tumor cells C) is given after surgery to remove a tumor 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.

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24) Which of the following statements is FALSE? A) A remission occurs when cancer cells stop actively reproducing.

B) All patients have a complete remission following chemotherapy.

C) If the tumor increased in size while the patient was being treated, this is called failed chemotherapy.

D) If a patient fails chemotherapy, the physician will try a new combination of chemotherapy drugs.

Answer: B Explanation: A) This IS a true statement.

B) Some have a complete remission; others have a partial remission.

C) This is a true statement.

D) This is a true statement.

25) Which of the following is a pyrimidine analog chemotherapy drug?

A) capecitabine (Xeloda) B) mechlorethamine (Mustargen) C) doxorubicin (Adriamycin) D) testosterone (Delatestryl) Answer: A Explanation: B) Mechlorethamine (Mustargen) is not a pyrimidine analog chemotherapy drug.

C) Doxorubicin (Adriamycin) is not a pyrimidine analog chemotherapy drug.

D) Testosterone (Delatestryl) is not a pyrimidine analog chemotherapy drug.

26) All of the following are nitrosourea cNhUeRmSoIN thGeTraBp.CyOdM rugs, EXCEPT A) carmustine (BiCNU, Gliadel) B) lomustine (CeeNU) C) streptozocin (Zanosar) D) bicalutamide (Casodex) Answer: D Explanation: A) Carmustine (BiCNU) IS a nitrosourea chemotherapy drug.

B) Lomustine (CeeNU) IS a nitrosourea chemotherapy drug.

C) Streptozocin (Zanosar) IS a nitrosourea chemotherapy drug.

D) This is an anti-androgen, not a nitrosurea, chemotherapy drug.

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27) Which of the following drugs belong to the category of hormone chemotherapy drugs?

A) estrogen chemotherapy drugs B) androgen chemotherapy drugs C) selective estrogen receptor modulator D) all of the above Answer: D Explanation: A) These DO belong to the category of hormone chemotherapy drugs.

B) These DO belong to the category of hormone chemotherapy drugs.

C) These DO belong to the category of hormone chemotherapy drugs.

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28) Some cancers have receptors on the surface of their cells that are stimulated by A) radiation B) mitosis C) hormones D) microtubules Answer: C Explanation: A) Cancer cell receptors are not stimulated by radiation.

B) Mitosis is the process of cell division, not a type of receptor.

D) Microtubules occur during cell division; they are not a type of receptor.

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29) Podophyllotoxin chemotherapy drugs are derived from .

A) the soil B) the root of the Mayapple plant C) folic acid D) a drug used for chemical warfare Answer: B Explanation: A) Podophyllotoxin chemotherapy drugs are not derived from the soil.

C) Podophyllotoxin chemotherapy drugs are not derived from folic acid.

D) Podophyllotoxin chemotherapy drugs are not derived from a drug used for chemical warfare.

30) Vinca alkaloid chemotherapy drugs .

A) bind to tubulin in the microtubules B) are derived from the periwinkle plant C) are used to treat different kinds of canNcUeR r SINGTB.COM 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.

31) Which of the following statements is FALSE? A) Platinum is a precious metal that is mostly mined in South Africa.

B) Interleukin is released when a cell is invaded by a virus.

C) Chemotherapy enzyme drugs are enzymes that break down the amino acid asparagine.

D) There are vitamin A receptors on cancer cells and retinoid chemotherapy drugs bind to them.

Answer: B Explanation: A) This is a true statement B) Interleukin stimulates lymphocytes to attack cancer cells.

C) This is a true statement.

D) This is a true statement.

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32) During treatment with chemotherapy drugs, .

A) a cancer patient can experience a complete remission B) the tumor can increase in size and form new metastatic lesions C) the patient is given palliative care 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) Palliative care is only given after chemotherapy drugs have failed.

33) Palliative care for cancer patients includes all of the following, EXCEPT A) chemotherapy drugs B) analgesic drugs and pain management C) counseling D) emotional support Answer: A Explanation: A) Palliative care is given because the cancer is no longer treatable.

B) These ARE done in palliative care.

C) This IS done in palliative care.

D) This IS done in palliative care.

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34) The well-known generic chemotherapy antibiotic drug doxorubicin is related to the trade name drug .

A) it has no trade name associated with iNt.URSINGTB.COM B) Adriamycin C) Leukeran D) Myleran Answer: B Explanation: A) This is a false statement.

C) This trade name is not associated with doxorubicin.

D) This trade name is not associated with doxorubicin.

22.2 True/False Questions 1) Purine is a molecule that forms the base for the amino acids adenine and guanine in the DNA molecule.

Answer: TRUE 2) Folic acid blocker chemotherapy drugs act as an antagonist in that they complete with folic acid for the same enzyme.

Answer: TRUE 3) Cancers that arise from tissue that is influenced by a male or female sex hormone are treated with a chemotherapy drug that has the same hormonal effect.

Answer: FALSE Explanation: This is a false statement. They are treated with a chemotherapy drug that has the opposite hormonal effect.

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4) Mitosis inhibitor drugs affect dividing cells and keep them from completing the process of cell division.

Answer: TRUE 5) Androgen hormone drugs are used to treat breast cancer because they stimulate estradiol receptors in breast tissue.

Answer: FALSE Explanation: This is a false statement. They are used to treat metastatic breast cancer but it is because they create a male hormonal environment.

6) Corticosteroid drugs are given to decrease the tissue inflammation caused by chemotherapy drugs.

Answer: TRUE 7) Interleukin chemotherapy drugs are only used to treat leukemia.

Answer: FALSE Explanation: This is a false statement. They are used to treat different types of cancer.

8) Monoclonal antibody drugs selectively bind to specific antigens on the surface of cancer cell walls.

Answer: TRUE SIoNle GcTuBle .CsOoM 9) Nitrosourea chemotherapy drugs contN aiUnRm f nitroso and urea.

Answer: TRUE

10) The ending -platin is common to generic platinum chemotherapy drugs.

Answer: TRUE 11) Chemotherapy drugs target rapidly dividing cancer cells. However, their effects are also felt in other areas where cells normally divide rapidly, such as in the mucous membranes.

Answer: TRUE 12) The pyrimidine analog chemotherapy drug cytarabine was developed from a substance found in Caribbean sea sponges.

Answer: TRUE 13) Corticosteroid drugs are used to treat anemia caused by chemotherapy drugs.

Answer: TRUE 14) Chemotherapy antibiotic drugs are used to treat cancer and are also used to bacterial infections as regular antibiotic drugs.

Answer: FALSE Explanation: This is a false statement. They drugs are not interchangeable with regular antibiotic drugs.

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15) Leucovorin rescue occurs before methotrexate chemotherapy.

Answer: FALSE Explanation: This is a false statement. It occurs after chemotherapy to rescue the patient from the toxic effects of methotrexate.

16) The extent of cancer progression is referred to as the stage.

Answer: TRUE 17) Chemotherapy drugs are most effective when begun when there are many cancer cells present in the body.

Answer: FALSE Explanation: This is a false statement. They are effective in the early stages of cancer when there are fewer cancer cells present.

18) The well-known generic pyrimidine analog chemotherapy drug capecitabine is related to the trade name drug Xeloda.

Answer: TRUE 19) Interleukin stimulates lymphocytes to attack cancer cells.

Answer: TRUE 22.3 Short Answer Questions 1) Drugs used to treat cancers or malignaNnUt RnSeIoNpGlaTsBm.CsOaM re chemotherapy drugs and are also known as drugs.

Answer: antineoplastic 2) A/an is a drug that is created by slightly modifying the molecular structure of another substance.

Answer: analog 3) The ending -lutaminde is common to antiAnswer: androgen

hormone chemotherapy drugs.

4) Estrogen hormone chemotherapy drugs are used to provide treatment for advanced breast cancer and/or advanced prostatic cancer; this is a treatment that provides relief from symptoms but is not intended to cure.

Answer: palliative 5) A neoplasm is a new growth of cells that may be Answer: benign

or malignant.

6) When a patient receives a chemotherapy drug that is known to be toxic to a particular organ, the patient is also given a drug to protect that organ from toxicity. This drug exerts a effect to protect that organ.

Answer: cytoprotective 11

7) Mesna protects the Answer: bladder

from toxicity due to the chemotherapy drug ifosfamide.

8) Estrogen hormone drugs act in a similar way to the main female hormone produced by follicles of the ovary.

Answer: estradiol 9) Folic acid is a cell.

Answer: B

, which is

vitamin whose metabolite is important in DNA production in the

10) To determine the type of cancer, a specimen is drawn to examine blood cells.

Answer: biopsy

is taken from the tumor site or a blood

11) The generic drugs vinblastine, vincristine, and vinorelbine all belong to the category of alkaloid chemotherapy drugs.

Answer: vinca 12) Topoisomerase is a/an stress during cell division.

Answer: enzyme

that creates a break in a single strand of DNA to relieve

13) Docetaxel (Taxotere) belongs to the NcaUtRegSIoNryGToBf .COM Answer: taxane

chemotherapy drugs.

14) Interferon is produced by macrophages that engulfed a hepatitis different types of cancer.

Answer: virus 15) Adjuvant therapy refers to chemotherapy or _ surgery to remove a tumor.

Answer: radiation

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, as well as

therapy given after a patient has had

22.4 Matching Questions Match the drug name in Column 1 with the drug category in Column 2.

A) folic acid blocker chemotherapy drug B) antiemetic drug used with chemotherapy C) granulocyte-colony stimulator factor drug D) gonadotropin-releasing hormone chemotherapy drug E) purine analog chemotherapy drug F) kinase inhibitor chemotherapy drug G) chemotherapy antibiotic drug H) taxane chemotherapy drug I) chemotherapy protocol J) pyrimidine analog chemotherapy drug 1) aprepitant (Emend) 2) capecitabine (Xeloda) 3) doxorubicin (Adriamycin) 4) filgrastim (Neupogen) 5) goserelin (Zoladex) 6) imatinib (Gleevec) 7) MACC 8) methotrexate (Trexall) 9) paclitaxel (Onxol) 10) cladribine (Leustatin) Answers: 1) B 2) J 3) G 4) C 5) D 6) F 7) I 8) A 9) H 10) E

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22.5 Essay Questions 1) Describe which types of normal cells in the body are affected by chemotherapy drugs and why they are affected.

Answer: Some normal cells in the body also divide rapidly (like cancer cells). These include cells lining the GI tract, hair cells, and blood cells).

2) Explain what a chemotherapy protocol is and what advantage it offers over a single chemotherapy drug.

Answer: A chemotherapy protocol combines the effectiveness of several chemotherapy drugs and directs them against one specific type of cancer. The advantage of a protocol is that it uses the most successful drugs while minimizing the side effects that would be caused by a large dose of just a single chemotherapy drug.

3) Give three reasons why chemotherapy drugs cause the side effects of nausea and vomiting.

Answer: Chemotherapy drug affect the rapidly dividing cells in the mucous membrane of the GI tract, causing irritation. They also directly stimulate the vomiting center in the brain. They also cause the release of serotonin in the small intestine, which stimulates the vomiting reflex.

4) Cancer is a Latin word meaning crab. Explain how cancer resembles a crab.

Answer: Cancer metastasizes or spreads outward from the original site like the legs of a crab spread out from its body.

5) Describe how chemotherapy drugs areNU prReSpIaNrG edTBin.CaOsMpecial sterile environment.

Answer: In preparing chemotherapy drugs, pharmacists must maintain sterile technique to protect the immunocompromised cancer patient from infection. Working under a laminar flow hood maintains a sterile work environment, as the surrounding air is constantly passed through a filter to remove all bacteria, viruses, etc.

6) Describe how the first chemotherapy drug–nitrogen mustard–was discovered and what cancer it was used to treat.

Answer: The discovery of the first chemotherapy drug–nitrogen mustard–came about by accident. During the 1940s, researchers who were reviewing medical records from World War I noticed that Allied soldiers who were exposed to the chemical weapon nitrogen mustard gas had a decreased number of WBCs. It was thought that this adverse effect could be used as a therapeutic effect in patients with leukemia whose WBC counts are abnormally elevated.

7) What was the original source of taxane chemotherapy drugs, and why did that source change?

Answer: Paclitaxel was the first of the taxane chemotherapy drugs, which were so named because they were originally derived from the bark of the Pacific yew tree whose scientific name is Taxus brevifolia. This yew tree, which only grows in the Pacific Northwest, is small and grows slowly, and collection of the bark kills the tree. Now, the needles of European and Himalayan yews are used because they contain 10 times more paclitaxel and harvesting of the needles does not kill the trees.

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8) What happened when the drug thalidomide was used to treat morning sickness that almost ended any use of this drug?

Answer: Thalidomide was used in the 1950s in Europe to treat morning sickness in pregnant women, but it caused the severe birth defect of phocomelia ("seal limbs") in their babies. It was withdrawn from the market in 1961, and would have become an obscure footnote in medical history; however, it was discovered to be useful in treating cancer.

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Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 23 Vaccines 23.1 Multiple-Choice Questions 1) The immune response involves a coordinated effort between which body parts?

A) the blood B) the brain C) the lymphatic system D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) The brain is not involved in the immune response.

C) This is true, but it is not the only correct answer.

2) Which of the following microorganisms can be pathogens?

A) bacteria B) viruses and protozoa C) fungi and yeasts 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 corrN ecUtRaSnIsNwGeTrB. .COM 3) Which type of white blood cell specifically engulfs and destroys bacteria?

A) interferon B) immunoglobulins C) neutrophils D) lymphocytes Answer: C Explanation: A) This is not a type of white blood cell.

B) This is not a type of white blood cell.

D) These white blood cells destroy viruses.

4) Each of the following is a type of lymphocyte, EXCEPT A) monocytes B) NK (natural killer) cells) C) B cells D) memory T cells Answer: A Explanation: B) This IS a type of lymphocyte.

C) This IS a type of lymphocyte.

D) This IS a type of lymphocyte.

1

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5) Monocytes do all of the following, EXCEPT .

A) produce interferon B) engulf and destroy bacteria and virus-infected cells coated with antigens C) produce tumor necrosis factor D) produce endotoxins Answer: D Explanation: A) Monocytes DO produce interferon.

B) Monocytes DO do this.

C) Monocytes DO do this.

D) Only bacteria produce endotoxins.

6) What role does interferon play in the immune response?

A) It produces an antiviral substance.

B) It keeps viruses from spreading throughout the body C) It stimulates NK cells to kill virus-infected cells.

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.

7) Which antibody is produced the very first time that the body encounters a bacterium or virus?

A) IgM B) IgG C) IgA D) all of the above Answer: A Explanation: B) This is not produced the first time the body encounters a bacterium or virus.

C) This is not produced the first time the body encounters a bacterium or virus.

D) Only one answer is correct!

8) Immunoglobulin A is found in .

A) tears and saliva B) antigens C) mucous membranes of the nose, lungs, and intestines D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) Antigens are only in bacteria.

C) This is true, but it is not the only correct answer.

2

9) Which immunoglobulin can pass from the mother's blood through the placenta to the fetus?

A) immunoglobulin A B) immunoglobulin G C) both immunoglobulin A and immunoglobulin G D) all of the above Answer: B Explanation: A) This immunoglobulin cannot do that.

C) Neither of these immunoglobulins can do that.

D) There is only one correct answer.

10) When does passive immunity, naturally acquired, occur?

A) after exposure to a disease B) after vaccination C) after being given an immune globulin drug.

D) in the mother's uterus Answer: D Explanation: A) It does not occur after exposure to a disease.

B) It does not occur after vaccination.

C) It does not occur after this.

11) An example of a drug that provides passive immunity, artificially acquired, is A) a vaccine B) polio virus vaccine C) hepatitis immune globulin D) all of the above Answer: C Explanation: A) A vaccine does not provide this.

D) There is only one correct answer.

12) Which type of immunity is the basis for vaccines and vaccination.

A) passive immunity, naturally acquired B) passive immunity, artificially acquired C) active immunity, naturally acquired D) active immunity, artificially acquired Answer: D Explanation: A) This is not the basis for vaccines and vaccination.

B) This is not the basis for vaccines and vaccination.

C) This is not the basis for vaccines and vaccination.

3

.

13) The use commercially prepared infant formulas instead of breast milk has been linked to which of the following?

A) eczema and allergies B) obesity 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.

14) The word that describes the ability of a pathogen to invade a person and produce disease is the word .

A) virulent B) inactivated C) acquired D) passive Answer: A Explanation: B) This word does not match that description.

C) This word does not match that description.

D) This word does not match that description.

15) If a vaccine contains a dead (killed) bacterium or virus, what is it that provokes a response from the patient's immune system?

A) bacterial toxins B) NK cells C) lymphocytes D) antigens on the bacterium surface Answer: D Explanation: A) Toxins do not provoke an immune response.

B) NK cells do not provoke an immune response.

C) Lymphocytes do not provoke an immune response.

16) Which of the following common diseases is caused by a virus?

A) anthrax B) herpes zoster C) pertussis D) pneumococcal pneumonia Answer: B Explanation: A) This disease is not caused by a virus.

C) This disease is not caused by a virus.

D) This disease is not caused by a virus.

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17) In a conjugate vaccine, a polysaccharide from the wall of a bacterium is joined to a to create a vaccine.

A) valence B) booster shot C) protein carrier D) adenovirus Answer: C Explanation: A) It is not joined to a valence.

B) It is not joined to a booster shot.

D) It is not joined to an adenovirus.

18) Gardasil is a vaccine that contains 4 different strains of the human papillomavirus.

A) monovalent B) bivalent C) trivalent D) quadrivalent Answer: D Explanation: A) This does not describe a monovalent vaccine.

B) This does not describe a bivalent vaccine.

C) This does not describe a trivalent vaccine.

19) Which of the following statements is FALSE? A) The measles, mumps, and rubella vaccines are given together as a conjugate vaccine.

B) A booster shot can be the second, thirNdU, R orSIfNoG urTtB h .C vaOcM cine injection after the initial vaccine.

C) Aluminum is added to some vaccines to stimulate a better immune response.

D) The influenza vaccine is prepared using chicken eggs.

Answer: A Explanation: A) They are given together as a combined vaccine.

B) This IS a true statement.

C) This IS a true statement.

D) This IS a true statement.

20) Which of the following vaccines is made using egg proteins that can cause an allergic reaction?

A) influenza vaccine B) MMR vaccine C) polio vaccine 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 vaccine does not contain egg proteins.

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21) All of the following, EXCEPT , provide short-term (temporary) immunity against a disease that the patient has already been exposed to and does not have their own antibodies for.

A) hepatitis immune globulin B) rabies immune globulin C) influenza vaccine D) tetanus immune globulin Answer: C Explanation: A) This does provide temporary immunity.

B) This does provide temporary immunity.

D) This does provide temporary immunity.

22) Inserting a vaccine into the body is known as .

A) immunization B) vaccination C) inoculation 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.

23) The Vaccine Adverse Event Reporting System is sponsored by A) the Centers for Disease Control and Prevention B) the drug manufacturer C) the Food and Drug Administration D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) It is not sponsored by the drug manufacturer.

C) This is true, but it is not the only correct answer.

.

24) Which organizations publish the recommended immunization schedules for children and adults?

A) Centers for Disease Control and Prevention B) American Academy of Pediatrics C) American Academy of Family Physicians 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.

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25) Which name is associated with the discovery of the polio vaccine?

A) Edward Jenner B) President Franklin Roosevelt C) Jonas Salk D) Centers for Disease Control and Prevention Answer: C Explanation: A) He discovered the smallpox vaccine.

B) He had polio; he did not discover the polio vaccine.

D) This organization did not discover the polio vaccine.

26) Which of the following statements is TRUE about anthrax?

A) It is caused by a bacterium and is spread by spores B) The first vaccine was developed by Louis Pasteur in 1881.

C) It can be used in terrorist attacks as a biological weapon.

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.

27) Which of the following statements is FALSE? A) The diphtheria vaccine is usually combined with the tetanus and polio vaccine.

B) Diphtheria is a bacterial respiratory infection that can also cause heart and nerve damage because of the bacterial toxin it producesN. URSINGTB.COM C) Hepatitis A infections only last a short time and most patients recover completely.

D) Hepatitis A is prevalent in underdeveloped countries in the world.

Answer: A Explanation: A) It is combined with tetanus and pertussis vaccine.

B) This IS a true statement.

C) This IS a true statement.

D) This IS a true statement.

28) Which trade names are associated with the hepatitis A vaccine?

A) Havrix, Vaqta B) Cervarix, Gardasil C) FluMist, Fluzone D) Menactra, Menomume Answer: A Explanation: B) These are NOT associated with the hepatitis A vaccine.

C) These are NOT associated with the hepatitis A vaccine.

D) These are NOT associated with the hepatitis A vaccine.

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29) How is hepatitis B passed to another person?

A) exposure to blood from drug addicts sharing needles B) exposure to vaginal secretions during sexual activity C) exposure when a breastfeeding infant has an infected mother 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.

30) Prior to being employed, healthcare workers are vaccinated against hepatitis B with the trade name drug .

A) Zostavax B) HepaGam B C) Recombivax HB D) all of the above Answer: C Explanation: A) This vaccine is not for hepatitis B. B) This is an immune globulin given after exposure to hepatitis B. D) There is only one correct answer.

31) Which statement is FALSE? A) In most cases, the body's immune response is sufficient to prevent widespread infection in the body.

B) Older persons need a low-dose version of the flu vaccine to stimulate their weaker immune systems.

C) If a pathogen is present in high concentrations, it can overwhelm the body's defenses.

D) When a pathogen is particularly virulent and can multiply rapidly, it can overwhelm the body's defenses.

Answer: B Explanation: A) This IS a true statement.

B) They need a high-dose version of the flu vaccine.

C) This IS a true statement.

D) This IS a true statement.

32) Which of the following statements is TRUE about HPV? A) It causes genital warts, a sexually transmitted disease.

B) It causes cervical cancer in women.

C) The vaccine is recommended for sexually active adults.

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 a false statement.

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33) Which of the following statements is FALSE? A) The flu virus mutates constantly.

B) The flu vaccine is reformulated each year.

C) A pharmacist at a supermarket pharmacy can give you a flu shot.

D) The most prevalent strains of flu in Europe are used to make the U.S. flu vaccine.

Answer: D Explanation: A) This IS a true statement.

B) This IS a true statement.

C) This IS a true statement.

D) The most prevalent strains in Asia are used.

34) A vaccine for HIV is difficult to develop because A) there are not enough people to test the vaccine on.

B) the virus mutates frequently C) there is not enough funding for this research D) all of the above Answer: B Explanation: A) This is a false statement.

C) This is a false statement.

D) Only one answer is correct.

.

23.2 True/False Questions 1) All bacteria are harmful to the body aN ndUR caSuINseGTdB is.eCaOsM e.

Answer: FALSE Explanation: This is a false statement. Millions of bacteria live in the intestines and are beneficial to the body.

2) Immunoglobulins is another name for the body's antibodies against disease.

Answer: TRUE 3) Bacteria contain DNA and so they are able to reproduce themselves in the tissues and blood of the body.

Answer: TRUE 4) Cytotoxic T lymphocytes produce toxic granules to kill cells that are infected with a virus.

Answer: TRUE 5) Endotoxins are produced by certain gram-positive bacteria.

Answer: FALSE Explanation: This is a false statement. It is produced by gram-negative bacteria.

6) Antibodies are produced by B lymphocytes.

Answer: TRUE 7) Immunoglobulin A is in areas where pathogens first enter the body.

Answer: TRUE 9

8) Immunoglobulin M provides what is known as active immunity.

Answer: FALSE Explanation: This is a false statement. IgG provides active immunity.

9) Acquired immunity is part of a person's genetic makeup.

Answer: FALSE Explanation: This is a false statement. Natural immunity is in the genetic makeup.

10) Passive immunity, naturally acquired, lasts for the first few months of a newborn's life.

Answer: TRUE 11) In all states, pharmacists are allowed to give flu shots to adults.

Answer: TRUE 12) At 5 years of age, a child's immune system begins to produce its own antibodies.

Answer: FALSE Explanation: This is a false statement. This begins at 18 months of age.

13) Vaccines stimulate the patient's immune system to develop antibodies against a disease it has never encountered.

Answer: TRUE 14) Commercially produced infant formuNlUasRSdIoNnGoTtBc.CoO ntM ain antibodies and so they do not provide immunity against disease.

Answer: TRUE 15) Another name for the disease rubella is German measles.

Answer: TRUE 16) Vaccines that contain just a single type of antigen or a single strain of one pathogen are said to be multivalent.

Answer: FALSE Explanation: This is a false statement. They are monovalent.

17) The advantage of a combined vaccine is that several vaccines can be given as a single dose to avoid multiple injections of childhood immunizations.

Answer: TRUE 18) Thimerosal has been removed from all vaccines manufactured in the United States.

Answer: FALSE Explanation: This is a false statement. The inactivated influenza virus vaccine still contains it.

19) Most vaccinations are given by the intramuscular route.

Answer: TRUE

10

20) Most vaccines cannot be given orally because they are not absorbed from the intestines.

Answer: TRUE 21) A vaccinated child still can occasionally get the disease they were vaccinated against.

Answer: TRUE 22) According to the World Health Organization, vaccines are currently available to present 600 different diseases.

Answer: FALSE Explanation: This is a false statement. There are vaccines for 25 diseases.

23) The anthrax vaccine is important because anthrax can be used in terrorist attacks as a biological weapon.

Answer: TRUE 24) Diphtheria is a bacterial disease that causes a gray membrane across the throat that can cause suffocation.

Answer: TRUE 25) Haemophilus influenza type b is a virus that causes severe influenza.

Answer: FALSE Explanation: This is a false statement. This is a bacterium that causes pneumonia.

26) The Hib vaccine is related to the pathNoUgReSnINHGaTeB m.CoO phMilus influenza type b.

Answer: TRUE 27) A patient with chronic hepatitis B infection is a carrier of the disease and can infect others, even if they have no symptoms.

Answer: TRUE 28) If a healthcare worker is stuck by a contaminated needle, he/she may be exposed to hepatitis B. Answer: TRUE 29) The hepatitis B vaccine is given after a healthcare worker has been stuck with a used needle that is contaminated with blood.

Answer: FALSE Explanation: This is a false statement. The vaccine is given prior to employment.

30) Herpes zoster skin lesions (shingles) are caused by the same virus that causes varicella (chickenpox) in childhood.

Answer: TRUE 31) The herpes zoster vaccine is given in a series of booster shots to all children.

Answer: FALSE Explanation: This is a false statement. It is only given to persons 50 years of age or older.

11

32) Gardasil is a quadrivalent vaccine that is recommended for girls and boys, ages 9 to 26, to prevent human papillomavirus infection.

Answer: TRUE 33) The CDC recommends annual flu shots for all persons, beginning at 6 months of life andevery year throughout life.

Answer: TRUE 34) Persons over age 65 need a special high-dose influenza vaccine because more inactivated viruses are needed to adequately stimulate the weaker immune system in patients of this age.

Answer: TRUE 35) Of all of the different strains of influenza, the H5N1 strain is the most virulent.

Answer: TRUE 36) Measles is a highly contagious viral disease that can be caught just be breathing the air where someone with measles coughed 2 hours before.

Answer: TRUE 37) Freshman living in dormitories at college are recommended to have the herpes vaccine.

Answer: FALSE Explanation: This is a false statement. They are recommended to have the meningococcal meningitis vaccine.

38) All adults age 50 or older and particularly those living in long-term care facilities should receive the pneumococcal pneumonia vaccine.

Answer: TRUE 39) The only cancer vaccine that is available is designed to treat (not prevent) cancer of the prostate gland in men.

Answer: TRUE 23.3 Short Answer Questions 1) Vaccines are drugs that are used to prevent certain can be fatal or cause serious disabilities.

Answer: contagious 2) Microorganisms that cause disease are known as Answer: pathogens

(easily transmitted) diseases that

.

3) are protein molecules on a bacterium or virus that the immune system identifies as being foreign.

Answer: Antigens 4) There are Answer: five or 5

types of white blood cells that play a role in the body's immune response.

12

5) Because viruses only contain themselves.

Answer: RNA

, they must enter body cells in order to reproduce

6) It is that coat a bacterium or a virus-infected cell and mark it for destruction.

Answer: antibodies 7) IgA is found in Answer: colostrum 8) Immunoglobulin Answer: G

, the first milk produced by breastfeeding mother.

is the most abundant of all of the immunoglobulins.

9) is the state of the body's own immune system being able to identify and kill diseaseproducing pathogens.

Answer: Immunity 10) Antibodies from the mother's colostrum provide temporary immunity to diseases the mother had for the first months of the newborn's life.

Answer: 18 11) A is a drug that is produced and administered to prevent the occurrence of a specific bacterial or viral disease.

Answer: vaccine 12) In a/an (killed) vaccine, the bacteria or viruses are intact but cannot cause disease.

Answer: inactivated 13) The hepatitis B surface antigen vaccine is an example of a vaccine form that contains one part of the virus, and that part is known as a .

Answer: subunit 14) The disease measles is caused by a Answer: virus 15) The disease tetanus is caused by a Answer: bacterium

.

.

16) Another name for the varicella virus is Answer: chickenpox

.

17) Vaccines that contain three different types of antigens or pathogens are said to be Answer: trivalent 18) Adults should receive a tetanus vaccine booster shot every Answer: 10 13

years.

.

19) The only vaccine that is given by the intranasal route is the Answer: influenza

vaccine.

20) The abbreviation CDC stands for .

Answer: Centers for Disease Prevention and Control 21) The abbreviation MMR and the trade name drug M-M-R II are both related to the vaccine.

Answer: measles, mumps and rubella 22) A bacterial or viral disease that causes a sudden, unexpected outbreak among many people is known as a/an .

Answer: epidemic 23) Adenovirus is a respiratory illness, and its vaccine is only approved for use in the Answer: military

.

24) Hepatitis A is caused by exposure to water or food that contains the virus because it is contaminated with the of a person who is already infected with hepatitis A. Answer: feces 25) The abbreviation DTaP stands for .

Answer: diphtheria, tetanus, and pertussNisURSINGTB.COM 26) The abbreviation HBV stands for Answer: hepatitis B virus

.

27) The painful skin blisters caused by the herpes zoster virus are known as Answer: shingles

.

28) The influenza vaccine with the trade name of given by the intranasal route as a nasal spray.

Answer: FluMist

is the only flu vaccine that can be

29) Meningococcal meningitis can kill a person in Answer: 24

hours.

30) The disease boys).

Answer: mumps

_ is characterized by swelling of the salivary glands and the testicles (in

14

23.4 Matching Questions Match the item name in Column 1 with the description in Column 2.

A) Vaccine that contains a bacterial toxin B) reformulated in February of each year C) Vaccine that contains only bacterial or viral antigens D) Occurs after exposure to a disease-causing pathogen E) whooping cough F) Weakened G) Contains immunoglobulin A H) Caused by a virus I) viral disease of the spinal cord J) Caused by a bacterium 1) IgM 2) attenuated 3) toxoid 4) colostrum 5) pertussis 6) diphtheria 7) influenza vaccine 8) polio 9) hepatitis A 10) subunit Answers: 1) D 2) F 3) A 4) G 5) E 6) J 7) B 8) I 9) H 10) C

15

23.5 Essay Questions 1) Why were vaccines developed?

Answer: Because some diseases were highly contagious and posed a public health threat, or their symptoms were severe (often requiring hospitalization), or the disease could cause permanent disability or even death.

2) Discuss the many factors in the past and up to the 1980s that led the move away from breastfeeding (with the beneficial antibodies it provided in the mother's milk).

Answer: Bottle feeding of cow's milk became widely used when rubber nipples and glass bottles could be sanitized and milk could be stored in an icebox to prevent the growth of bacteria.

Pediatricians recommended the use of condensed milk and evaporated milk. The availability of infant formulas and the trend for women to work outside the home led to a decline in breastfeeding.

3) Describe why maternal antibodies in breast milk move into the baby's body.

Answer: For the first few days of life, the newborn's intestinal tract is more permeable and allows these maternal antibodies to be absorbed directly into the blood.

4) Describe the three ways in which an attenuated (weakened) vaccine is created.

Answer: The pathogen can be grown in several different cultures to weaken it. It can be grown at temperatures that do not allow it to reproduce easily. It can be subjected to DNA/RNA mutations to weaken it.

5) Describe how an inactivated vaccine is created and how it works.

Answer: This form of vaccine contains a pathogen that is grown in a culture and then inactivated (killed) with heat or chemicals. Antigens on the outside of the bacterium or virus are not destroyed and these provoke an immune response.

6) Discuss what thimerosal is, what it is used for in a vaccine, and what three pediatric diseases it was thought to be linked to.

Answer: Thimerosal is a mercury-containing compound that is used as a preservative in vaccines. It was thought to be linked to attention-deficit hyperactivity disorder, speech delay, and autism 7) What is the correct site of administration of a vaccine for infants from newborn to 35 months of age. What are 2 important characteristics that the site of administration must have?

Answer: Infants from newborn to 35 months should receive immunizations by intramuscular injection in the outer aspect of the thigh muscle. The site of administration must have a muscle large enough to absorb the amount of the liquid drug and have enough bulk to it so that the needle will not accidentally injure a nearby nerve.

8) Discuss the reasons why children still need to be vaccinated in the United States.

Answer: Most vaccine-preventable diseases have been nearly controlled. Unvaccinated children can become ill because those bacteria and viruses still exist in the environment. Also, travelers from other countries where there are disease outbreaks can bring the disease to the United States.

Without vaccination, the disease can be severe and sometimes fatal.

16

9) Explain why an outbreak of measles occurred in the United States in 2014.

Answer: Measles is highly contagious. The outbreak happened in persons who had never been vaccinated, in infants who were too young to be vaccinated, and was transmitted by persons who traveled to countries where measles is not well controlled.

17

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 24 Anesthetic Drugs 24.1 Multiple-Choice Questions 1) Ether is no longer used for all of the following reasons, EXCEPT which one?

A) It caused severe postoperative vomiting.

B) It had an unpleasant odor.

C) It was an inhaled gas.

D) It was highly explosive Answer: C Explanation: A) This is one of the reasons.

B) This is one of the reasons.

C) This was NOT one of the reasons it is no longer used.

D) This is one of the reasons.

2) The first three inhaled general anesthetic drugs introduced were A) ether, nitrous oxide, chloroform B) atropine, Pentothal, Ethrane C) Xylocaine, ether, thiopental D) nitrous oxide, lidocaine, Vistaril Answer: A Explanation: B) Not all of these are inhaled anesthetic drugs.

C) Not all of these are inhaled anestheticNdUrRuSgIsN. GTB.COM D) These were not the first inhaled general anesthetic drugs.

_.

3) Drugs for the induction of anesthesia are .

A) given intravenously B) provide a rapid loss of consciousness C) are used to relax the abdominal muscles 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) Drugs for the induction of anesthesia do not relax the abdominal muscles.

4) Which anticholinergic drug is given preoperatively to decrease oral secretions and facilitate endotracheal intubation?

A) halothane B) pentobarbital C) atropine D) morphine Answer: C Explanation: A) Halothane is no longer on the market.

B) Pentobarbital is not an anticholinergic drug.

D) Morphine is not an anticholinergic drug.

1

5) Narcotic drugs are used .

A) preoperatively to relieve pain and provide sedation B) to induce general anesthesia C) in combination with other drugs to help maintain general anesthesia 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.

6) Regional anesthesia is also known as anesthesia.

A) spinal B) nerve block C) general D) all of the above Answer: B Explanation: A) Regional anesthesia is not the same as spinal anesthesia.

C) Regional anesthesia is not the same as general anesthesia.

D) Only one answer is correct.

7) Which of the following is true about barbiturate drugs used to produce general anesthesia?

A) They produce unconsciousness as the way to take away pain.

B) They have a strong analgesic effect.

C) They can be used alone to produce geNnUerRaSlIaNnGeTsB th.CesOiM a if the procedure is less than 15 minutes long.

D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) This is not true. These drugs have no analgesic effect.

C) This is true, but it is not the only correct answer.

8) The most widely used topical, local, regional, and spinal anesthetic drug is A) procaine (Novocaine) B) bupivacaine (Marcaine C) tetracaine (Pontocaine) D) lidocaine (Xylocaine) Answer: D Explanation: A) This is not the most widely used anesthetic drug.

B) This is not the most widely used anesthetic drug.

C) This is not the most widely used anesthetic drug.

2

.

9) The local anesthetic drugs bupivacaine and lidocaine are available with or without the vasoconstrictor in the solution.

A) atropine B) curare C) epinephrine D) all of the above Answer: C Explanation: A) These drugs do not contain atropine in the solution.

B) These drugs do not contain curare in the solution.

D) Only one answer is correct.

10) Which of the following statements is FALSE? A) The South American Indians chewed coca bush leaves for their euphoric effect.

B) Cocaine is derived from coca bush leaves.

C) Cocaine, the first topical anesthetic drug, was introduced in 1880.

D) The first public demonstration of general anesthesia was performed with inhaled nitrous oxide.

Answer: D Explanation: A) This IS a true statement.

B) This IS a true statement.

C) This IS a true statement.

D) It was performed with ether, not nitrous oxide.

11) If a local anesthetic drug that containNeUdReSpIiNnGepThBr.C inOeMfor vasoconstriction was used to do surgery on the tip of the nose, that might result in .

A) excessive local vasoconstriction B) necrosis C) skin sloughing 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.

12) Which of the following is NOT a definition of anesthesia: Anesthesia is the absence of .

A) feeling B) pain C) perception D) sensation Answer: C Explanation: A) Anesthesia is the absence of feeling.

B) Anesthesia is the absence of pain.

D) Anesthesia is the absence of sensation.

3

13) Which of the following drugs is used to reverse the effects of neuromuscular blocker drugs used during general anesthesia?

A) atracurium (Tracrium) B) edrophonium (Enlon, Reversol) C) succinylcholine (Quelicin) D) vecuronium (Norcuron) Answer: B Explanation: A) This IS a neuromuscular blocker drug.

C) This IS a neuromuscular blocker drug.

D) This IS a neuromuscular blocker drug.

14) Topical anesthetic drugs do NOT come in which of the following drug forms?

A) creams B) gas C) gels D) ointments Answer: B Explanation: A) Topical anesthetic drugs are available in the form of a cream.

C) Topical anesthetic drugs are available in the form of a gel.

D) Topical anesthetic drugs are available in the form of an ointment.

15) The combination drug Duocaine contains the generic anesthetic drugs A) bupivacaine and lidocaine B) atracurium and succinylcholine C) meperidine and morphine D) diazepam and lorazepam Answer: A Explanation: B) These are not generic anesthetic drugs.

C) These are not generic anesthetic drugs.

D) These are not generic anesthetic drugs.

.

16) Which of the following is the most widely used topical, local, regional, and spinal anesthetic drug?

A) lidocaine B) mepivacaine C) ropivacaine D) tetracaine Answer: A Explanation: B) Mepivacaine is not the most widely used anesthetic drug.

C) Ropivacaine is not the most widely used anesthetic drug.

D) Tetracaine is not the most widely used anesthetic drug.

4

17) The addition of epinephrine to some local anesthetic drugs A) binds to dopamine receptors in the cell wall B) prolongs the anesthetic effect of the drug C) decreases blood pressure and heart rate D) inhibits the release of prostaglandins to decrease pain Answer: B Explanation: A) Epinephrine does not bind to dopamine receptors.

C) Epinephrine does not decrease the heart rate and blood pressure.

D) Epinephrine has no effect on the release of prostaglandins.

.

18) For many years, synthetic substitutes for the topical anesthetic drug cocaine were sought.

This ultimately led to the discovery of what drug that was the prototype of local anesthetic drugs?

A) chlorpromazine B) fentanyl C) procaine (Novacaine) D) meperidine (Demerol) Answer: C Explanation: A) Chlorpromazine is not a local anesthetic drug.

B) Fentanyl is not a local anesthetic drug.

D) Meperidine is not a local anesthetic drug.

19) In 1920, what technique was perfected that allowed greater control of patient ventilation and anesthetic administration during surgicalNpUrRoScIeNdG urTeBs.?COM A) anesthetic reversal drugs B) endotracheal intubation C) inhalation route of administration D) subcutaneous administration of local anesthesia Answer: B Explanation: A) Anesthetic reversal drugs are not a technique.

C) The inhalation route of anesthesia was not perfected in 1920.

D) The subcutaneous administration of local anesthesia was not perfected in 1920.

20) Used by South American Indians to dip their arrows in, what drug introduced in the 1940s was the first neuromuscular blocker drug to be used during general anesthesia and was especially helpful in performing abdominal surgery?

A) atropine B) curare C) desflurane (Suprane) D) pentobarbital Answer: B Explanation: A) Atropine is not a neuromuscular blocker drug.

C) Desflurane is not a neuromuscular blocker drug.

D) Pentobarbital is not a neuromuscular blocker drug.

5

21) Some liquid anesthetic drugs contain methylparaben, which is A) anesthetic drug with antibiotic and antifungal effects B) neuromuscular drug with antibiotic and antifungal effects C) preservative with antibiotic and antifungal effects D) barbiturate drug with antibiotic and antiviral effects Answer: C Explanation: A) Methylparaben is not an anesthetic drug.

B) Methylparaben is not a neuromuscular drug.

D) Methylparaben is not a barbiturate drug.

.

22) Which of the following types of drugs are NOT used preoperatively to decrease anxiety and produce sedation?

A) anticholinergic drugs B) antihistamine drugs C) barbiturate drugs D) neuromuscular blocker drugs Answer: D Explanation: A) Anticholinergic drugs are used preoperatively to decrease anxiety and produce sedation.

B) Antihistamine drugs are used preoperatively to decrease anxiety and produce sedation.

C) Barbiturate drugs are used preoperatively to decrease anxiety and produce sedation.

23) While most of the narcotic drugs given preoperatively to relieve pain and provide sedation GTnBa.rCcO are Schedule II drugs, but which is a SchNeUdR ulSeINIV oM tic drug?

A) meperidine (Demerol) B) morphine (Duramorph) C) oxymorphone (Opana) D) pentazocine (Talwin) Answer: D Explanation: A) Meperidine (Demerol) is a Schedule II drug.

B) Morphine (Duramorph) is a Schedule II drug.

C) Oxymorphone (Opana) is a Schedule II drug.

24) A local anesthetic drug with epinephrine can be used during surgery to repair a laceration on the .

A) ear B) finger C) forearm D) tip of the nose Answer: C Explanation: A) The use of an anesthetic drug with epinephrine is contraindicated in the ear.

B) The use of an anesthetic drug with epinephrine is contraindicated in the finger.

D) The use of an anesthetic drug with epinephrine is contraindicated in the tip of the nose.

6

25) All of the following are inhaled general anesthetic gases, EXCEPT A) desflurane (Suprane) B) fentanyl (Sublimaze) C) enflurane (Ethrane) D) nitrous oxide Answer: B Explanation: A) Suprane IS an inhaled general anesthetic gas.

C) Ethrane IS an inhaled general anesthetic gas.

D) Nitrous oxide IS an inhaled general anesthetic gas.

.

26) What effect do antihistamine drugs have when given preoperatively?

A) They decrease anxiety.

B) They provide sedation.

C) They dry up oral secretions.

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.

24.2 True/False Questions 1) Antihistamine drugs are given preoperatively to decrease anxiety, provide sedation, as well as to dry up oral secretions.

Answer: TRUE 2) Anticholinergic drugs are given preoperatively to block the body's own acetylcholine and relax the abdominal muscles prior to abdominal surgery.

Answer: FALSE Explanation: This is a false statement. They decrease secretions to facilitate endotracheal intubation.

3) Narcotic drugs are given preoperatively to relieve pain and provide sedation.

Answer: TRUE 4) Drugs used for the induction of anesthesia are generally given by inhalation.

Answer: FALSE Explanation: This is a false statement. Drugs for induction of anesthesia are generally given intravenously.

5) Neuromuscular blocker drugs used during general anesthesia are given intramuscularly to block nerve transmissions throughout the body.

Answer: FALSE Explanation: This is a false statement. They are given intravenously, not intramuscularly.

6) Local anesthesia is used during minor procedures, such as biopsies or during dental surgery.

Answer: TRUE 7

7) Regional anesthesia is used during surgery on an extremity to provide anesthesia for that region.

Answer: TRUE 8) Inhaled gases for anesthesia are used to induce or maintain general anesthesia, and they are all schedule drugs.

Answer: FALSE Explanation: This is a false statement. These are not schedule drugs.

9) Skeletal muscle relaxation is particularly important during abdominal surgery when the muscles of the abdominal wall must relax in order to allow adequate visualization of the operative field that is within the abdominal cavity.

Answer: TRUE 10) The use of epinephrine is contraindicated in certain areas of the body because the blood supply there is limited.

Answer: TRUE 11) Barbiturate drugs have no analgesic effect of their own at all.

Answer: TRUE 12) Nitrous oxide was first used at social parties and known as laughing gas before it was recognized as an anesthetic drug.

Answer: TRUE 13) The advantage of using an antianxiety drug preoperatively to relieve anxiety and produce sedation is that the patient is still able to respond to commands but has little memory of the procedure.

Answer: TRUE 14) The various types of intravenous drugs used for induction and maintenance of anesthesia are Schedule II, III, or IV drugs, and so it is very easy for a patient to become addicted to these.

Answer: FALSE Explanation: This is a false statement. The short duration of their use eliminates the possibility of the patient becoming addicted.

8

24.3 Short Answer Questions 1) For anesthesia, an anesthetic drug is given by subcutaneous injection into the skin to anesthetize a small area of skin and adjacent subcutaneous tissue.

Answer: local 2) For anesthesia, an anesthetic drug is given by subcutaneous injection near a nerve plexus (group of nerves) and its branches.

Answer: regional 3) For anesthesia, an anesthetic drug is given by injection into the subarachnoid space between the vertebrae of the lumbar region of the back.

Answer: spinal 4) For anesthesia, an anesthetic drug is given by injection into the epidural space; the drug then moves into the subarachnoid space to provide anesthesia.

Answer: epidural 5) The ending is common to anesthetic drugs used to produce local, regional, spinal, or epidural anesthetic drugs.

Answer: -caine 6) The drugs hydroxyzine (Vistaril) and promethazine (Phenergan) are preoperatively to decrease anxiety.

Answer: antihistamine 7) The drugs diazepam, lorazepam (Ativan), and midazalom are preoperatively to relieve anxiety and provide sedation.

Answer: antianxiety

drugs given

drugs given

8) The drugs pentobarbital and secobarbital (Seconal) are to produce sedation.

Answer: barbiturate

drugs given preoperatively

9) The trade name of the well-known anesthetic generic name drug lidocaine is Answer: Xylocaine 10) The abbreviation MPF stands for methylparabens Answer: free

9

.

.

24.4 Matching Questions Group A Match the type of anesthesia in Column 1 with its route of administration in Column 2.

A) general anesthesia B) regional nerve block C) epidural or spinal anesthesia D) topical application of an anesthetic drug E) subcutaneous local injection 1) Anesthesia in one body part.

2) Anesthesia with unconsciousness 3) Anesthesia in the skin and deeper tissues 4) Anesthesia in the trunk and lower extremities 5) Anesthesia on the skin Answers: 1) B 2) A 3) E 4) C 5) D Group B Match the anesthesia drug name in Column 1 with the drug category in Column 2.

A) neuromuscular blocker drug B) barbiturate drug for general anesthesia C) narcotic drug to induce and maintain general anesthesia D) anticholinergic drug E) inhaled general anesthetic drug 6) atropine 7) methohexital (Brevital) 8) propofol (Diprivan) 9) rocuronium (Zemuron) 10) sevoflurane (Ultane) Answers: 6) D 7) B 8) C 9) A 10) E

10

24.5 Essay Questions 1) Briefly explain the mechanism by which an anesthetic drug produces topical, local, regional, epidural, or spinal anesthesia. (Note: The mechanism is the same for all of these types of anesthesia.)

Answer: Topical, local, regional, epidural, or spinal anesthesia is obtained when an anesthetic drug blocks the flow of sodium ions across the membranes of nerve cells, thereby blocking the production of nerve impulses that convey the message of pain.

2) Why is epinephrine sometimes combined with lidocaine (Xylocaine) when it is used as a local anesthetic drug?

Answer: Epinephrine (Adrenalin) is a powerful vasoconstrictor that decreases blood flow to the tissue. This therapeutic effect prolongs the anesthetic effect.

3) Describe why some anesthetic drugs contain MPF but some do not.

Answer: Methylparaben is a preservative with antibiotic and antifungal effects that is often added to liquid anesthetic drugs that are in vials or ampules. Some patients have an immediate and severe allergic reaction to methylparaben, and so it has been eliminated from some anesthetic drugs and those are labeled as MPF (methylparaben free).

4) Describe the controversy surrounding the barbiturate drug thiopental (Pentothal) and why this drug is no longer available.

Answer: Thiopental (Pentothal) was used for many years during executions of prisoners on death row. Some drug companies stoppeNdUpRroSIdNuGciTnBg.CthOeMdrug because the company's shareholders objected to executions on moral grounds and were concerned about public opinion and legal risks.

11

Understanding Pharmacology for Health Professionals, 5e (Turley) Chapter 25 Emergency Drugs, Intravenous Fluids, and Blood Products 25.1 Multiple-Choice Questions 1) TPN is also known as .

A) hyperalimentation solution B) intravenous lipids C) total parenteral nutrition D) A and C Answer: D Explanation: A) This is true, but it is not the only correct answer.

B) TPN is not known as intravenous lipids.

C) This is true, but it is not the only correct answer.

2) Basic life support measures .

A) are known as cardiac resuscitation B) involve mechanically circulating the blood C) involve mechanically inflating the lungs with air 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 corrN ecUtRaSnIsNwGeTrB. .COM 3) The word refers to the anticoagulant that is commonly used to preserve whole blood and prolong its refrigerated shelf life.

A) crystalloid B) anaphylactic C) antagonist D) citrated Answer: D Explanation: A) Crystalloid is not an anticoagulant for whole blood.

B) Anaphylactic is not an anticoagulant for whole blood.

C) Antagonist is not an anticoagulant for whole blood.

4) Narcan is a narcotic drug drug that is given for an overdose of a narcotic drug.

A) antagonist B) agonist C) antidote D) all of the above Answer: A Explanation: B) Narcan is not an agonist drug.

C) Narcan is not an antidote drug.

D) Only one of the answers is correct.

1

5) Which of the following is a symptom of an overdose of a narcotic drug?

A) unconsciousness B) hypotension C) respiratory depression 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.

6) Toddler Darlene has eaten many tablets from her mother's bottle of acetaminophen. She could experience damage to her .

A) heart B) liver C) eyes D) brain Answer: B Explanation: A) Acetaminophen overdose does not affect the heart.

C) Acetaminophen overdose does not affect the eyes.

D) Acetaminophen overdose does not affect the brain.

7) Of the following drugs, which can be administered by intracardiac injection?

A) atropine and lidocaine B) epinephrine and calcium chloride C) lidocaine and whole blood D) sodium bicarbonate and intravenous fluids Answer: B Explanation: A) These drugs are not administered by intracardiac injection.

C) These are not administered by intracardiac injection.

D) These are not administered by intracardiac injection.

8) Lidocaine is the drug of choice and indicated for the management of life-threatening .

A) asystole B) anaphylaxis C) metabolic acidosis D) ventricular fibrillation Answer: D Explanation: A) Lidocaine has no therapeutic effect if the heart is already in asystole.

B) Lidocaine is not used to treat anaphylaxis.

C) Lidocaine is not used to treat metabolic acidosis.

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9) Which of the following drugs is used specifically to treat bradycardia other slow heart rate arrhythmias, such as heart block?

A) atropine B) calcium chloride C) epinephrine D) sodium bicarbonate Answer: A Explanation: B) Calcium chloride is not used to treat bradycardia.

C) Epinephrine is not used to treat bradycardia.

D) Sodium bicarbonate is not used to treat bradycardia.

10) During resuscitation, which of the following statements about epinephrine is FALSE? A) In ventricular fibrillation, epinephrine makes the heart muscle able to respond to the electrical impulse of a defibrillator.

B) If the heart has stopped beating, epinephrine can stimulate heart contractions.

C) Epinephrine also maintains the blood pressure to improve the chances of a successful resuscitation.

D) Epinephrine can reverse the metabolic acidosis that occurs when the heart stops.

Answer: D Explanation: A) This is a true statement.

B) This is a true statement.

C) This is a true statement.

D) Epinephrine cannot treat metabolic acidosis.

11) Which drug is given to stimulate the myocardium to contract more forcefully and may even stimulate a contraction when the heart is in asystole and has failed to respond to epinephrine?

A) atropine B) calcium chloride C) lidocaine D) sodium bicarbonate Answer: B Explanation: A) Atropine is not given when the heart is in asystole.

C) Lidocaine is not given when the heart is in asystole.

D) Sodium bicarbonate does not stimulate contraction of the heart.

12) Which of the following do vasopressor drugs NOT do during a resuscitation?

A) They maintain blood flow to the kidneys.

B) They stimulate alpha receptors in the blood vessels to produce vasoconstriction and raise blood pressure.

C) They stimulate beta1 receptors to increase the heart rate.

D) They correct the decreased pH of the blood.

Answer: D Explanation: A) They DO maintain blood flow to the kidneys.

B) They DO stimulate alpha receptors to raise the blood pressure.

C) They DO stimulate beta1 receptors to increase the heart rate.

D) They do not affect the pH of the blood.

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13) Which of the following is NOT one of the three ways that drugs work in treating overdoses, suicide attempts, or an accidental poisoning?

A) binding the ingested drug to another substance to make it inert B) inactivating the drug in the blood by using antagonist drugs C) metabolizing the drug in the blood, liver, or kidneys D) removing the drug from the stomach Answer: C Explanation: A) This is one of the ways.

B) This is one of the ways.

C) This is not one of the ways that drugs treat these problems.

D) This is one of the ways.

14) Which I.V. fluid contains the same two electrolytes in the same physiologic proportion as those in tissue fluid?

A) D5W B) crystalloid C) 0.9% NaCl D) whole blood Answer: C Explanation: A) The contents of D5W are not like tissue fluid.

B) The contents of crystalloid are not like tissue fluid.

D) Whole blood is not an I.V. fluid.

15) PRBCs have an advantage over whoN leUbRlSoIoNdGiTnBt.hCaOt M they can be given .

A) to any patient without cross-matching B) during emergency resuscitation C) without causing fluid overload D) without the risk of causing a transfusion reaction Answer: C Explanation: A) PRBCs need to be cross-matched before being transfused.

B) Drugs, rather than PRBCs, are given during emergency resuscitation.

D) PRBCs do cause a transfusion reaction if they are not typed and cross-matched before administration.

16) A crash cart .

A) is available in every patient area in a hospital B) contains emergency drugs and resuscitative equipment C) is in nursing homes, physician offices, and clinics 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.

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17) Cryoprecipitate .

A) is prepared by freezing and then slowing thawing plasma B) contains all of the clotting factors C) is another name for albumin D) is used during emergency resuscitation Answer: A Explanation: B) It only contains some of the clotting factors C) It is not related to albumin.

D) It is not used during resuscitation.

18) Which of the following is NOT one of the risks associated with intracardiac injection of drugs?

A) anaphylaxis B) cardiac tamponade C) coronary artery laceration D) pneumothorax Answer: A Explanation: A) This is not associated with intracardiac injection.

B) This IS a risk associated with the intracardiac injection of drugs.

C) This IS a risk of intracardiac injection of drugs.

D) This IS a risk of intracardiac injection of drugs.

19) The most commonly used intravenous fluids contain .

A) dextrose B) electrolytes C) dextrose, electrolytes, or a combination of both D) lipids Answer: C 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.

D) Intravenous lipids are not a common intravenous fluid.

20) Intravenous fluids contain what type of sugar to provide energy to the patient?

A) electrolytes B) glucose C) dextrose D) saline Answer: C Explanation: A) Electrolytes are not a type of sugar.

B) Glucose is the sugar found in the blood.

D) Saline is not a type of sugar.

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21) A 0.9 percent solution of sodium chloride is also known as A) Ringer's lactate B) D5W C) TPN D) normal saline Answer: D Explanation: A) This is not true.

B) This is not true.

C) This is not true.

.

22) Total parenteral nutrition contains all of the following ingredients, EXCEPT A) electrolytes B) vitamins and minerals C) fats D) essential amino acids Answer: C Explanation: A) Total parenteral nutrition does contain electrolytes.

B) Total parenteral nutrition does contain vitamins and minerals.

C) Only lipid solutions contain fats.

D) Total parenteral nutrition does contain essential amino acids.

23) All of the following are cross-matched, EXCEPT A) whole blood B) fresh frozen plasma C) packed red blood cells D) platelets Answer: B Explanation: A) Whole blood is cross-matched.

C) Packed red blood cells are cross-matched.

D) Platelets are cross-matched.

.

.

24) A patient in cardiac arrest would be given drugs to resuscitate him/her by all of the following routes, EXCEPT .

A) intracardiac B) intravenous C) oral D) endotracheal tube Answer: C Explanation: A) The intracardiac route is used during cardiac arrest.

B) The intravenous route is used during cardiac arrest.

D) The endotracheal tube route is used during cardiac arrest.

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25) Which drug is used to treat an overdose of a narcotic drug?

A) epinephrine (Adrenalin) B) naloxone (Narcan) C) calcium chloride D) lidocaine (Xylocaine) Answer: B Explanation: A) Epinephrine (Adrenalin) is not used to treat an overdose of a narcotic drug.

C) Calcium chloride is not used to treat an overdose of a narcotic drug.

D) Lidocaine (Xylocaine) is not used to treat an overdose of a narcotic drug.

26) Activated charcoal is classified as a/an drug.

A) adsorbent B) vasopressor C) antianxiety drug antagonist D) emetic Answer: A Explanation: B) Activated charcoal is not a vasopressor drug.

C) Activated charcoal is not an antianxiety tranquilizer antagonist drug.

D) Activated charcoal is not an emetic drug.

27) Which of the following statements is FALSE? A) Digoxin has a low therapeutic index and a long half-life.

B) It is not uncommon for elderly patients to experience digoxin toxicity.

C) Digoxin immune fab (Digibind, DigiFNaUbR)SiIsNaGnTaBn.CtiO doMte drug for digoxin toxicity.

D) Digoxin immune Fab is a drug derived from cow antibodies.

Answer: D Explanation: A) This is a true statement.

B) This is a true statement.

C) This is a true statement.

D) It is derived from sheep antibodies.

28) Ethylene glycol .

A) is also known as antifreeze B) can be abused recreationally or swallowed accidentally C) can cause central nervous system damage, blindness or death 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.

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25.2 True/False Questions 1) Intracardiac injection is used frequently to treat many different diseases.

Answer: FALSE Explanation: This is a false statement. It is used infrequently.

2) Ipecac syrup can only be given to a patient who is conscious.

Answer: TRUE 3) Basic life support with cardiopulmonary resuscitation involves the use of drug therapy.

Answer: FALSE Explanation: This is a false sentence. Drug therapy is only given with advanced cardiac life support.

4) Laypersons think that donating a unit of blood is about equal to donating a pint of blood, but they are not at all equal.

Answer: FALSE Explanation: This is a false statement. They are nearly equal.

5) Histamine is released in massive amounts during anaphylaxis.

Answer: TRUE 6) Lidocaine (Xylocaine) has no effect when given during resuscitation if the heart has already stopped.

Answer: TRUE 7) An ampule can be used only once and the remaining, unused drug must be discarded because it contains no preservative.

Answer: TRUE 8) Intravenous lipids contain about 30 percent more calories per gram than intravenous dextrose.

Answer: TRUE 9) The sodium bicarbonate that is used to treat metabolic acidosis during resuscitation is the same drug that is given orally as an antacid to neutralize excess acid in the stomach and treat an upset stomach and heartburn.

Answer: TRUE 10) Ipecac syrup can be a drug of abuse in patients with bulimia who use it to induce vomiting.

Answer: TRUE 11) An ampule has a rubber stopper in its top so that multiple doses of the drug can be withdrawn at different times.

Answer: FALSE Explanation: This is a false statement. This describes a vial, not an ampule.

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12) All donated blood is tested for syphilis, hepatitis, and HIV according to guidelines established by the Food and Drug Administration.

Answer: TRUE 13) Glucose is the form of sugar that is used in intravenous fluids.

Answer: FALSE Explanation: This is a false statement. Dextrose is used in intravenous fluids.

14) PRBCs are a concentrated preparation of RBCs in a small amount of plasma.

Answer: TRUE 15) Plasma and plasma volume expanders do not contain any blood cells.

Answer: TRUE 16) Plasma needs to be typed and cross-matched prior to administration because of the risk associated with transfusion reactions.

Answer: FALSE Explanation: This is a false statement. It does not need to be typed and cross-matched.

17) FFP contains all of the plasma proteins, but it does not contain any clotting factors.

Answer: FALSE Explanation: This is a false statement. It contains clotting factors.

18) The routes of administration for emeNrgUeRnScIyNG drTuBg.C s OarMe the same routes that are commonly used to administer other drugs.

Answer: FALSE Explanation: This is a false statement. They are different routes because the drug must take immediate effect.

19) If the heart has completely stopped beating (asystole), epinephrine can actually stimulate contractions of the heart.

Answer: TRUE 20) Adsorbent drugs can be administered at any time after an overdose of a drug of an accidental ingestion of a toxic substance.

Answer: FALSE Explanation: This is a false statement. An adsorbent drug is not effective if the toxic substance has already been absorbed from the stomach into the blood.

21) Dextrose and electrolyte intravenous fluids are used to maintain fluid and electrolyte balance and supply calories, but they are unable to completely meet long-term needs.

Answer: TRUE 22) When epinephrine (Adrenalin) is used to treat anaphylaxis, it constricts the blood vessels to restore a normal blood pressure and relaxes bronchial smooth muscle to allow adequate air flow.

Answer: TRUE 9

23) The well-known generic drug naloxone that is used to treat an overdose of a narcotic drug, is related to the trade name drug Narcan.

Answer: TRUE 25.3 Short Answer Questions 1) Whole blood and red blood cells have a refrigerated shelf life of Answer: 42 2) The well-known generic drug epinephrine has a trade name of Answer: Adrenalin

days.

.

3) What acronym helps you remember which emergency drugs can be given by endotracheal tube? .

Answer: NAVEL 4) The abbreviation stands for the federal organization that is responsible for the safety of blood and blood products in the United States.

Answer: FDA 5) Patients preparing to have surgery can donate a unit of their own blood in advance so they can receive it during surgery. This is known as a/an blood transfusion.

Answer: autologous 6) Drugs used to treat an acetaminophen drug overdose act to protect the of acetaminophen toxicity.

Answer: liver

, the main site

7) When a patient is in ventricular fibrillation, the drug lidocaine slows the electrical impulses of the heart by inhibiting the flow of into the myocardial cell.

Answer: sodium 8) To treat bradycardia, the drug vagus nerve.

Answer: atropine 9) Ipecac syrup is classified as a/an Answer: emetic

blocks the action of acetylcholine released from the

drug, because it induces vomiting.

10) An overdose of a narcotic drug can be reversed by giving intravenously a narcotic drug intravenously.

Answer: antagonist 11) is the name of a general category that refers to any intravenous fluid that provides dextrose and sodium chloride alone or in combination with other electrolytes.

Answer: Crystalloid 10

12) To meet the dietary fat requirements of a patient who cannot eat, a separate intravenous solution of may be ordered.

Answer: lipids 13) Another name for the intravenous fluid of physiologic salt solution is normal Answer: saline 14) Most emergency drugs are given while the patient is in the Department.

Answer: ambulance 15) The "E" in the acronym NAVEL stands for the drug Answer: epinephrine

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.

or in the Emergency

(Adrenalin).

25.4 Matching Questions Match the drug in Column 1 with the type of overdose or poison it is used to treat in Column 2.

A) total parenteral nutrition B) anticoagulant in whole blood C) acetaminophen overdose D) maximum drug effect in shortest time E) drugs for pediatric patients via endotraecheal tube F) sodium and chloride G) ethylene glycol and methanol poisoning H) narcotic drug overdose I) lead, mercury, arsenic toxicity J) tricyclic-type antidepressant overdose 1) hyperalimentation solution 2) acetylcysteine (Acetadote 3) nalmefene (Revex) 4) physostigmine 5) succimer (Chemet) 6) I.V. push 7) fomepizole (Antizol) 8) electrolytes 9) LEAN 10) citrate Answers: 1) A 2) C 3) H 4) J 5) I 6) D 7) G 8) F 9) E 10) B

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25.5 Essay Questions 1) Describe how the endotracheal tube route of drug administration is used to give emergency drugs and how the drugs are able to move into the blood.

Answer: Drugs are administered by placing them into an endotracheal tube. As the lungs are mechanically ventilated, the drug solution is propelled into the lungs, where it is absorbed by the lung tissue and rapidly enters the blood. A 2) Briefly explain why sodium bicarbonate is used in resuscitation and why some say that its use should be limited.

Answer: During cardiac arrest, the pH of the blood decreases rapidly and the effectiveness of any emergency drug is great diminished. Sodium bicarbonate corrects this acidosis and brings the pH of the blood back within a normal range. There is controversy as to its true effectiveness.

It may actually increase acidosis. The American Heart Association guidelines recommend using it only after other measures have failed.

3) When an alcoholic drinks methanol (wood alcohol) instead of ethanol (liquor), what happens to it in the body that makes it a poison?

Answer: In the body, methanol is metabolized into formaldehyde, a toxic chemical that is used by pathologists to preserve biopsied tissue specimens.

4) Briefly explain when type and cross-match are done and why they are done.

Answer: Before whole blood can be given to the patient as a transfusion, the patient and the unit of blood must both be typed (for blood tyNpUeR)SaInNdGcTrBo.sCsOmMatched (to each other) to assure compatibility and avoid a transfusion reaction (hemolysis of red blood cells due to incompatibility of blood types).

5) Why is the intravenous fluid half normal saline written as 0.45% instead of as 0.5%?

Answer: Half normal saline also contains sodium and chloride, but at half the concentration of normal saline. Half normal saline is written as 0.45% (not 0.5%), because 0.45% is one-half of 0.9%.

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