Katzung Pharmacology chap16 questions

10.A 33-year-old woman attempted to induce an abortion using ergotamine. Her legs became cold with absent arterial pulses. Which of the following is the most useful antidote for reversing severe ergot-induced vasospasm?

A very powerful vasodilator is necessary to reverse ergotinduced vasospasm; nitroprusside is such a drug Answer: nitroprusside

7. The hospital Pharmacy Committee is preparing a formulary for staff use. Which of the following is a correct application of the drug mentioned? (A) Alosetron: for obstetric bleeding (B) Cetirizine: for hay fever (C) Ergonovine: for Alzheimer's disease (D) Ondansetron: for acute migraine headache (E) Ranitidine: for Parkinson's disease

Alosetron is indicated in irritable bowel syndrome. Ergonovine is used in uterine bleeding. Ondansetron is useful for chemotherapy-induced emesis. Cetirizine is used in the treatment of hay fever. Answer : (B)

8. A 26-year-old woman presents with amenorrhea and galactorrhea. Her prolactin level is grossly elevated. Which of the following is most useful in the treatment of hyperprolactinemia?

Bromocriptine is an effective dopamine agonist in the CNS with the advantage of oral activity. The drug inhibits prolactin secretion by activating pituitary dopamine receptors. Answer: Bromocriptine

4. A laboratory study of new H2 blockers is planned. Which of the following will result from blockade of H2 receptors?

H2 receptors are Gs-protein-coupled receptors, like β adrenoceptors. Blockade of this system will cause a decrease in cAMP. Answer: Decreased cAMP in gastric mucosa

3. A 20-year-old woman is taking diphenhydramine for severe hay fever. Which of the following adverse effects is she most likely to report?

H1 blockers do not activate muscarinic receptors, mediate vasoconstriction, or cause uterine cramping. They do not cause nervousness or anxiety. Diphenhydramine is a potent sedative. Answer: sedation

6. A 40-year-old patient is about to undergo cancer chemotherapy with a highly emetogenic (nausea- and vomiting-causing) drug combination. The antiemetic drug most likely to be included in her regimen is

Ondansetron and other 5-HT3 antagonists have significant antiemetic effects. Diphenhydramine and prednisone are also used for this purpose. Answer: Ondansetron

1. Your 37-year-old patient has been diagnosed with a rare metastatic carcinoid tumor. This neoplasm is releasing serotonin, bradykinin, and several unknown peptides. The effects of serotonin in this patient are most likely to include which one of the following?

Serotonin causes bronchospasm, but the other effects listed are not observed. Carcinoid is associated with diarrhea and hypertension. Answer: Episodes of bronchospasm

9. A 28-year-old office worker suffers from intense migraine headaches. Which of the following is a serotonin agonist useful for aborting an acute migraine headache?

Sumatriptan, an agonist at 5-HT1D receptors, is indicated for prevention or treatment of migraine and cluster headaches. Ergotamine (not on the list) is also effective for acute migraine but is produced by the fungus Claviceps purpurea Answer : Sumatriptan

5. You are asked to consult on a series of cases of drug toxicities. Which of the following is a recognized adverse effect of cimetidine?

The older H1 blockers, not H2 blockers, cause blurred vision, orthostatic hypotension, and sleepiness. Neither group typically causes diarrhea. Cimetidine (unlike other H2 blockers) is a potent CYP3A4 inhibitor. Answer:P450 hepatic enzyme inhibition

2. A 23-year-old woman suffers from recurrent episodes of angioneurotic edema with release of histamine and other mediators. Which of the following drugs is the most effective physiologic antagonist of histamine in smooth muscle?

The smooth muscle effects of histamine are mediated mainly by H1 receptors. Cetirizine is a pharmacologic antagonist of histamine. Granisetron is a 5-HT3 antagonist. Sumatriptan is a 5-HT1D agonist. Ranitidine is a histamine antagonist but blocks the H2 receptor in the stomach and the heart, not H1 receptors in smooth muscle. Epinephrine has a physiologic antagonist action that reverses histamine's effects on smooth muscle. Answer: Epi