Quizzes

All of the following would be advantages of a solution vehicle compared to a suspension vehicle for ocular drugs EXCEPT: A. Increased corneal contact time B. Decreased irritation C. Decreased interference with vision D. Increased compliance

A

Bronchiolar smooth muscle tone is controlled by all of the following systems and transmitters, EXCEPT: A. Norepinephrine release at the nerve end. B. Acetylcholine release at the nerve end. C. Neurokinin A release at the nerve end. D. Epinephrine circulating in the plasma.

A

Considering ocular pharmacokinetics, which of the following statements is TRUE? A. Inflamed conjunctival vessels will absorb more drug than un-inflamed vessels B. Tears turnover at a rate of about 1% per minute C. Most of a drop applied to the eye has a good chance of being absorbed into the eye D. Net drug movement is a one-way pathway into the lens

A

Contamination of fluorescein sodium products can be prevented (or at least greatly diminished) by all of the following EXCEPT: A. increasing the concentration from 0.25% to 2.0% B. compounding with a compatible preservative like chlorobutanol or heat sterilization C. compounding as a single unit dose solution D. compounding as a single unit dose impregnated filter paper strip

A

If I give a young child 1 drop of atropine 1% in each eye, twice a day, for two days, how much is the total amount of atropine that I have given? A. 4.0 mg B. 1.0 mg C. 2.0 mg D. 8.0 mg E. 0.5 mg

A

The hall mark or characteristic features of bronchial asthma include all of the following EXCEPT: A. Increased production of carbon dioxide by the bronchiolar smooth muscle. B. Edema and mucus secretion in the brochioles as a response to inflammation. C. Hyperresponsiveness of the brochiolar smooth muscle to stimuli. D. Inflammatory changes in the bronchioles.

A

What effect would you expect a decreasing concentration of protein in the tears to have on corneal absorption of a drug in the tear film? A. Increase absorption B. No change in absorption C. Decreased absorption

A

What is the mechanism of action for the antiplatelet activity of aspirin? A. Inhibits thromboxane A2 synthesis B. Prevents ADP binding to its receptor site C. Prevents prostacyclin binding to its receptor site D. Inhibits vitamin K synthesis

A

Which best describes the mechanism of action for warfarin? A. Warfarin blocks the carboxylation synthesis step that allows Ca2+ binding to coagulation factors B. Warfarin inhibits the active coagulation factors directly C. Warfarin prevents the activation of coagulation factors by binding to the Ca2+ binding site

A

Which of the following about sulfacetamide is true? A. Has a high risk of causing allergic hypersensitivity B. Unlikely to lead to resistance C. Only commercially available in solution D. MOA is to block protein synthesis

A

Which of the following bacteria is not a common cause of acute conjunctivitis? A. Pseudomonas B. Haemophilus C. Streptococcus D. Staphylococcus

A

Which of the following best describes the MOA for Oseltamivir (Tamiflu)? A. Inhibits neuraminidase enzyme to block release B. Blocks the M2 protein to prevent assembly C. Blocks phosphate binding to nucleotides, preventing DNA synthesis D. Inhibits cytochrome P-450 enzymes, preventing protein synthesis

A

Which of the following best describes the MOA for bacitracin? A. Blocks transfer of peptidoglycans to disrupt cell wall synthesis B. Causes an inhibition of the enzyme that breaks down peptidoglycans C. Causes a disruption in the cell membrane D. Blocks the synthesis of proteins

A

Which of the following concerning ciprofloxacin is false? A. When treating an ulcer, it causes frequent corneal damage B. Broad spectrum antibiotic C. For topical use, it is available as an ointment or solution D. MOA is to inhibit DNA gyrase

A

Which of the following concerning moxifloxacin (Vigamox and Moxeza) is true? A. Broad spectrum of activity B. For topical use, it is available as an ointment or solution C. Increased absorption time of the ointment occurs because of xanthan gum D. MOA is to inhibit peptidoglycan synthesis

A

Which of the following drugs is available for the topical treatment of HSV keratitis? A. Ganciclovir (Zirgan) B. Famciclovir (Famvir) C. Cidofovir (Vistide) D. Acyclovir (Zovirax)

A

Which of the following drugs is most likely to have a significant age-related difference in its therapeutic actions in the elderly patient? A. diazepam - sedative/hypnotic B. hydrochlorothiazide - hypertension C. ranibizumab - age-related macular degeneration D. ketorolac - anti-inflammatory

A

Which of the following drugs works to decrease triglyceride and VLDL via the PPAR receptor activation? A. Gemfibrozil (Lopid) B. Colestipol (Colestid) C. Niacin D. Cholestyramine (Questran) E. Dabigatran (Pradaxa)

A

Which of the following is a "classic" toxicity seen with the penicillins? A. Allergic hypersensitivity B. Nephrotoxicity C. Tendinitis D. Aplastic anemia E. Ototoxicity

A

Which of the following is an indication for fluorescein use? A. To stain the bed of an HSV ulcer B. as an aid in fitting soft contact lenses C. All of these are uses D. as an aid in looking at choroidal vasculature

A

Which of the following is not a step in the multiplication cycle of the typical virus particle? A. Production of new host cell enzymes B. Release of viral particles C. Biosynthesis of viral components D. Maturation or assembly of new virus E. Adsorption or binding to the cell

A

Which of the following is the most likely MOA for lodoxamide? A. Blocks Ca2+ influx into cells B. Blocks the synthesis of cyclooxygenase C. Binds to Na+ receptors, increasing Na+ influx D. Increases activity of lymphocytes

A

Which of the following statements about amiodarone (Cordarone) is false? A. Blocks both Na+ and Ca2+ channels B. Only used for resistant arrhythmia C. Increases AP duration D. Causes whirl like corneal deposits

A

Which of the following pharmacokinetic statements is TRUE? A. Increasing drug concentration will decrease absorption B. Local anesthetics decrease corneal absorption C. Punctal occlusion decreases systemic absorption D. A drug with a positive charge would easily diffuse through the epithelial cornea

C

Which of the following statements about the clinical correlates with corneal absorption is FALSE? A. In general, older patients have increased corneal absorption related to decreased tear production B. A local anesthetic should increase corneal absorption C. In any situation where there is hypersecretion of tears, there would be better corneal absorption D. The typical dry eye patient would have better corneal absorption

C

Which of the following statements concerning bacitracin is false? A. Only available as an ointment for ocular use B. Has a low incidence of resistance development C. MOA is to block protein synthesis D. Most effective against Staphylococcus

C

Which of the following statements concerning bacitracin is true? A. Has a high incidence of resistance development B. MOA is to block protein synthesis C. Only available as an ointment D. Most effective against Haemophilus

C

Which of the following statements concerning garamycin (gentamicin) is false? A. Cross allergic hypersensitivity to aminoglycosides is common B. Even in the fortified concentration, it is likely to cause corneal toxicity C. It is the best possible aminoglycoside against Pseudomonas D. Resistance is likely through plasmid mediated increase in metabolism

C

Which of the following statements concerning the use of the anti-inflammatory agents in the elderly patient is true? A. Use of a compound like diclofenac could cause the elderly patient an increased risk of osteoporosis. B. While some of the anti-inflammatory agents can increase the risk of osteoporosis development, this condition is unlikely to change the elderly patient's quality of life. C. While management of inflammation is not very different in the old versus the young, the elderly seem to be more susceptible to gastrointestinal irritation and ulceration from the NSAIDs. D. Because the clearance of prednisone is altered in the elderly, they are at a greater risk of developing bleeding abnormalities with its use.

C

A patient presents to your office with herpes simplex epithelial keratitis. Which of these drugs is not indicated in his treatment? A. Foscarnet (Foscavir) B. Acyclovir (Zovirax) C. Valacyclovir (Valtrex) D. Famciclovir (Famvir)

A

What is the amount of drug in 2 drops of 0.5% tropicamide? A. 10 mg B. 5 mg C. 1.0 mg D. 0.5 mg

D

Class 1 antiarrhythmics work by blocking the conductance (flow) of which ion? A. Cl- B. Na+ C. K+ D. Ca2+

B

Which of the following statements about the clinical correlates with corneal absorption is FALSE? A. In any situation where there is hypersecretion of tears, there would be better corneal absorption B. In general, older patients have increased corneal absorption related to decreased tear production C. A local anesthetic should increase corneal absorption D. The typical dry eye patient would have better corneal absorption

A

Which of the following statements concerning allergic rhinitis is FALSE? A. Treatment of allergic rhinitis depends on what form you have, seasonal or perennial. B. Symptoms can include; runny nose, watery eyes, itching, and redness. C. Perennial allergic rhinitis is often associated with pet dander. D. Seasonal allergic rhinitis is seen only at certain times of the year.

A

Which of the following statements concerning garamycin (gentamicin) is true? A. Resistance is likely through plasmid mediated increase in metabolism B. Even in the fortified concentration, it is unlikely to cause corneal toxicity C. Cross allergic hypersensitivity to aminoglycosides is rare D. It is the best possible aminoglycoside against Pseudomonas

A

Which of the following statements concerning the use of the antidepressants in the elderly is true? A. The tricyclic antidepressants, while more effective for severe depression, also cause a wide variety of toxicities that may be particularly harmful to the elderly patient. B. The antidepressant drug paroxetine is generally thought to have the same toxicity profile as the drug amitriptyline. C. Because depression seems to be a frequent symptom of old age, most patients are appropriately diagnosed and appropriately treated. D. There is thought to be a significant difference in the way the elderly respond to antidepressant drug therapy compared to the young patient.

A

Which of the following statements concerning the use of the sedative/hypnotics in the elderly is true? A. Elderly patients may have an increased sensitivity to the sedative/hypnotics leading to increased risks of daytime sedation and ataxia. B. Most of the changes in efficacy of sedatives seen in the elderly have been clearly shown to be due to a decrease in the number of receptors for the sedative drugs. C. The use of a barbiturate as a sedative agent would not be expected to have an increased effect in the elderly, like we see in them when we give them the benzodiazepines. D. Since the elderly often have a decrease in metabolic rates, lorazepam elimination will be significantly decreased in most elderly patients.

A

Which of the following would NOT be expected to help lower lipid levels? A. Losartan (Cozaar) B. Gemfibrozil (Lopid) C. Cholestyramine (Questran) D. Rosuvastatin (Crestor) E. Niacin

A

Considering the many mechanisms for bacterial resistance development, which are most likely related to plasmid mediated resistance? (select 2) A. Produce an enzyme that will destroy the antibacterial agent B. Alter a normal metabolic step to avoid the antibacterial action C.Create a protein that will slow the removal of the antibiotic from the bacterial cell D. A change in the antibacterial binding site to prevent its action

A and B

Which three of the following drug classes would have good bactericidal activity against a gram (-) rod? (select 3) A. Extended spectrum penicillins (PCNs) B. Sulfa drugs C. Fluoroquinolones D. Aminoglycosides E. Tetracyclines

A, C, D

Which three of the following statements concerning polymyxin B are true? (select 3) A. MOA is to disrupt membrane permeability B. Generally considered bacteriostatic C. Most effective against gram (-) rods D. Resistance is a frequent problem during treatment E. Toxicities with topical ocular use are rare

A, C, E

Which 3 of the following drugs/drug classes acts by inhibition of cell wall synthesis? (select 3) A. Penicillins B. Sulfonamides C. Erythromycin D. Cephalosporins E. Aminoglycosides F. Bacitracin

A, D, F

Class 1 antiarrhythmics produce all the following changes in the cellular excitability except A. Increasing the conduction time B. Decreasing membrane responsiveness C. Increasing the conduction velocity D. Increasing the threshold for excitation

C

All of the following might be reasonable uses for topically applied fluorescein sodium EXCEPT: A. to demonstrate corneal epithelial defects B. as an aid in fitting soft contact lenses C. to demonstrate the patency of the lacrimal drainage system D. as an aid in Goldmann tonometry E. as an aid in determining a penetrating corneal wound

B

All of the following would be advantages of a solution vehicle compared to a suspension vehicle for ocular drugs EXCEPT: A. Decreased interference with vision B. Increased corneal contact time C. Increased compliance D. Decreased irritation

B

Because various physiologic characteristics tend to decline with age, which of the following is true? A. The cardiac index (a measure of cardiac output) is expected to decline in patients over 75 years old by about 75%. B. By age 75, on average, a patient will lose 50% of their maximal breathing capacity. C. Almost all patients (95%) 75 years of age show a significant decrease in creatinin clearance. D. Measures of kidney function, such as glomerular filtration, decline on average about 60% in patients that live to 70 years of age.

B

Consider all the preservative agents we discussed and choose which one is NOT correctly matched with a statement about it. A. BAC: not compatible with soft contact lenses since it can accumulate in/on them during the soaking periods (repeated overnight soaks). B. Chlorobutanol: very effective bactericidal agent used frequently in soft contact lens cold chemical disinfection systems. C. Dymed (polyaminopropyl biguanide): a newer agent that is so large a molecule it does not accumulate in the matrix of soft contact lenses and is thus safe for soaking. D. Thimerosal: an effective preservative and cold chemical disinfectant of soft contact lenses because it contains an organic mercurial portion which acts to denature proteins.

B

Considering ocular pharmacokinetics, which of the following statements is FALSE? A. Inflamed conjunctival vessels will absorb more drug than un-inflamed vessels B. Most of a drop applied to the eye has a good chance of being absorbed into the eye C. Drug movement can occur into and out of the lens D. Tears turnover at a rate of about 15% per minute

B

Considering ocular pharmacokinetics, which of the following statements is FALSE? A. Tears turnover at a rate of about 15% per minute B. Most of a drop applied to the eye has a good chance of being absorbed into the eye C. Inflamed conjunctival vessels will absorb more drug than un-inflamed vessels D. Drug movement can occur into and out of the lens

B

Considering ocular pharmacokinetics, which of the following statements is TRUE? A. Once a drug leaves the cornea it can't get back in B. The tear turnover is the main determinant of corneal contact time C. A drug in the blood can enter the aqueous by backflow through the canal of Schlemm D. Ocular drugs are actively transported into the cornea

B

In the normal physiology and pathology of the respiratory system, what role do the NANC inputs play? A. An important part of the NANC inputs comes from the release of epinephrine from the adrenal medulla. B. Nitric oxide is a transmitter in the NANC system and can cause bronchodilation C. Neurokinin A is generally believed to control or decrease cough. D. Substance P is a normal transmitter for bronchodilation.

B

Phase 0 (zero) of the cardiac muscle fiber AP is caused by A. Outward rush of K+ B. Inward rush of Na+ C. Outward rush of Cl- D. Inward rush of Ca2+

B

Resistance to an antiviral drug is thought to occur through which of the following mechanisms? A. Enhanced ability of the virus to survive outside of the host cell B. Alteration of the drug binding site through mutational events C. Activation of immune mechanisms to reject the drug from the virus D. Increased metabolism of the antiviral drug within the virus particle

B

What effect would you expect a decreasing concentration of protein in the tears to have on corneal absorption of a drug in the tear film? A. Decreased absorption B. Increase absorption C. No change in absorption

B

What is the main difference between Restasis and Cequa? A. Restasis targets genes responsible for T-cells while Cequa does not B. Cequa is more concentrated in solution than Restasis C. Cequa works better than Restasis according to studies D. Restasis comes in an ointment form while Cequa does not

B

What is thought to be the major mechanism of action for the beneficial effects of the anti-inflammatory steroids in the management of bronchial asthma? A. Enhancing the immune mechanisms in the body to increase resistance to infections. B. Decreasing the synthesis of many of the inflammatory cytokine mediators. C. Inhibition of the bronchoconstriction caused by irriatant chemicals. D. Stimulation of the synthesis of cell membranes that do not contain inflammatory mediators.

B

When comparing the advantages of a solution vehicle to a suspension vehicle for ocular drugs, the solution vehicle advantage is A. Decreased compliance B. Decreased irritation C. Increased corneal contact time D. Increased interference with vision

B

When considering the rational principles which guide our best practices in the treatment of elderly patients, which of the following is true? A. Once you have tried the drug in the patient, it is ok to increase or decrease dosages as often as once a day. B. Without knowing all the drugs that the patient is taking, it would be hard to properly treat the patient's symptomatic complaints. C. If the expected drug effect (therapeutic benefit) does not occur after the first administration, you should switch to a new drug class. D. While important, a thorough drug history is rarely reliable in patients over the age of 75.

B

Which of the following agents is not one of the new direct antagonists of factor Xa or thrombin? A. Apixaban (Eliquis) B. Dalteparin (Fragmin) C. Dabigatran (Pradaxa) D. Rivaroxaban (Xarelto)

B

Which of the following drugs/drug classes would not have good bactericidal activity against a gram (+) cocci? A. Fluoroquinolones B. Erythromycin C. Penicillins D. Bacitracin

B

Which of the following groups of HIV drugs is thought to block viral DNA insertion into the host DNA? A. Reverse transcriptase inhibitors B. Integrase inhibitors C. Protease inhibitors D. Fusion blockers

B

Which of the following is a concerning toxicity seen with the fluoroquinolones? A. Aplastic anemia B. Tendinitis C. Nephrotoxicity D. Ototoxicity E. Allergic hypersensitivity

B

Which of the following is a general mechanism for one of the anti-arrhythmic drugs? A. Causing a change in the resting membrane potential to increase heart rate B. Altering ion fluxes in the cardiac cells via blocking channels C. Causing a change in the ATP utilization of the cell D. Causing a change in the action potential to decrease cardiac output

B

Which of the following is not a side effect that could occur with heparin use? A. Thrombocytopenia B. Gastric ulcer C. Allergic hypersensitivity D. Hemorrhage E. Depletion of ATIII

B

Which of the following pharmacokinetic statements is FALSE? A. Punctal occlusion decreases systemic absorption B. Local anesthetics decrease corneal absorption C. Increasing drug concentration will increase absorption D. A lipid soluble drug would easily diffuse through the epithelial cornea

B

Which of the following is not a periocular injection site? A. Retrobulbar B. Subtenon's C. Intracameral D. Subconjunctival

C

Which of the following statement concerning the use of drugs to treat diabetes mellitus in the elderly is true? A. If cost were an issue for the treatment of your elderly patient, a good choice are the gliptins which work well and are the least expensive agents. B. While treatment of the elderly patient is not much different than the younger patient, the treatment of the elderly must also take into account any comorbid conditions in the elderly patient. C. Taking all things into consideration, an elderly patient with diabetes is no more likely to have any other pathologies than a younger patient. D. The elderly patient is seemingly at a greater risk for developing hypoglycemia, so treatment should generally avoid the drug metformin.

B

Which of the following statements about cystic fibrosis is FALSE? A. Chronic hypoxia in the blood leads to a rounding of the fingers and toes called clubbing. B. The disease causes production of thin watery secretions that can "drown" the patient. C. Patients often develop a "barrel" chest, due to the extreme difficulty in breathing. D. This is a progressive genetic disorder, passed on to children from both the mom and dad.

B

Which of the following statements about nitroglycerin (NTG) is false? A. NTG dilates resistance vessels B. NTG decreases heart rate C. NTG decreases cardiac work D. NTG dilates capacitance vessels

B

Which of the following statements best describes the MOA for the drug omalizumab (Xolair)? A. It binds to muscarinic receptors to prevent bronchospasm. B. It binds to circulating IgE, thus preventing them from activating allergic inflammatory reactions. C. It blocks the synthesis of leukotrienes and prevents inflammation. D. It stimulates the release of epinephrine leading to bronchodilation.

B

Which of the following statements concerning the condition of cystic fibrosis is TRUE? A. The genetic defect that causes cystic fibrosis actually causes and increase in sodium channel proteins. B. Physiotherapy is very helpful to relieve symptoms related to sticky mucous. C. The drug dornase alpha (Pulmozyme) seems to help by causing bronchodilation. D. Mucolytic agents like N-acetylcysteine are extremely effective for all patients.

B

Which of the following statements concerning the use of drugs that alter cardiac rate and rhythm in the elderly is true? A. Because the use of anti-arrhythmic agents is essentially the same, regardless of age, the first choice for treatment of atrial fibrillation is with a class 1a anti-arrhythmic agent without a dose adjustment. B. Digoxin is useful in the treatment of some cardiac arrhythmias, but can also cause significant ocular toxicities, such as color vision disturbances. C. The most frequent cardiac rhythm disturbance seen in the elderly is a chronic ventricular fibrillation. D. Another effective anti-arrhythmic group would be the beta blockers, however, elderly patients are more prone to cataractogenesis from these agents.

B

Your patient has an ulcer which has been shown to be caused by a gram (-) infection. Which of the following antibacterial agents would be most effective against it? A. Doxycycline (Vibramycin) B. Cefdinir (Omnicef) C. Azithromycin (Z-Pak, Azasite) D. Amoxicillin

B

Which two (2) would be clinically useful in treating an arrhythmia? A. Lisinopril (Zestril) B. Diltiazem (Cardizem) C. Nitroglycerin D. Digoxin E. Bumetanide (Bumex)

B and D

Which 2 of the following are expected to have a broad spectrum of activity? (select 2) A. Bacitracin B. Trimethoprim C. Tobramycin D. Azithromycin E. Doxycycline F. Polymyxin B

B and E

Which 3 of the following are expected to have bactericidal activity? (select 3) A. Azithromycin B. Bacitracin C. Polymyxin B D. Tobramycin E. Doxycycline F. Trimethoprim

B, C, D

Which three of the following statements concerning polymyxin B are false? (select 3) A. Most effective against gram (-) rods B. Generally considered bacteriostatic C. MOA is to disrupt membrane permeability D. Likely to cause kidney damage even with topical ocular use E. Resistance is a frequent problem during treatment

B, D, E

All of the following factors would be expected to encourage bacterial resistance development except: A. Treatment of an AIDS patient with a bacteriostatic antibacterial agent B. Treatment with suboptimal doses C. Treatment with a loading dose and then continued treatment with a lower maintenance dose D. Treatment for a day or two and then stop treatment

C

All the following provide anti-inflammatory effects except for: A. DHA B. Loteprednol C. HP Guar D. Tobradex

C

Considering the normal depolarization wave in the heart, which of the following statements is true? A. Impulses must go from the SA node to the AV node through bundle branches B. Impulses from the AV node travel directly into the ventricular muscle cells C. Impulses from the Purkinje fibers spread the depolarizing wave throughout the ventricular muscle D. Impulses travel from atrial muscle directly to ventricular muscle

C

Considering the pharmacokinetics of aging, which of the following statements is true? A. When studying metabolic drug elimination in the elderly patient, most drugs get metabolized more quickly. B. There have been a number of studies showing specific alterations in the absorptive capacity from the GIT, related solely to the aging process. C. About 67% of patients age 65 or more will show a decrease in the GFR of up to 30%. D. When you consider the distribution of drugs in the elderly, we generally find greater lean to fat body ratios than in young patients.

C

For pharmacological vehicles, ointments A. are a highly water soluble vehicle B. are easily contaminated compared to drops C. have longer contact time than suspensions D. increase the breakdown of drugs they contain

C

If a patient begins taking the over-the-counter medication cimetidine (Tagamet), to treat ulcers, which of the following might be possible concerning a drug the patient is already taking? A. An increase in the toxicity from large amounts of grapefruit juice. B. An increase in the elimination of the tricyclic antidepressant, amitriptyline. C. An increase in the blood levels of simvastatin, possibly increasing simvastatin toxicity. D. A decrease in the anticonvulsant actions of the drug phenytoin.

C

Plaque formation in vessels is caused by high levels of A. Triglycerides and VLDL B. Cholesterol and HDL C. Cholesterol, triglycerides, and LDL D. Cholesterol and LDL E. Cholesterol and VLDL

C

The benefit of an ocular preparation like Timoptic XE is A. Decreased interference with vision B. Increased risk of systemic toxicities C. Increased corneal contact time D. Decreased compliance

C

The best way to avoid emphysema, or to treat it if you already have it, is: A. to simply breath more deeply B. to treat the patient with inhaled antibiotics C. to stop smoking D. to break up mucous plugs with an expectorant

C

The clinical usefulness of Viroptic is against which of the following? A. Influenza A B. Herpes Zoster (Varicella) C. Herpes Simplex D. Adenovirus E. HIV

C

The effectiveness of benzalkonium chloride as a disinfectant will be decreased by all the following EXCEPT: A. anionic detergents - soaps B. combination with fluorescein sodium C. combination with ethylene diamine tetraacetic acid (EDTA) D. clumping of bacteria E. adsorption onto organic mater

C

The main mechanism for resistance to penicillins (PCNs) can be overcome with the addition of which agent? A. Sulfamethoxazole B. Ticarcillin C. Clavulinic acid D. Beta-lactamase E. Tetracycline

C

The main reason we do not prescribe the tetracycline class of ABs to young children is: A. The immature liver of these patients cannot handle the elimination of these drugs B. They are minimally effective against the common pediatric infections C. This class of ABs causes damage to developing bones and teeth D. These ABs can prevent normal CNS development

C

Topical ocular antibacterial drugs are usually quite effective for all of the following reasons except A. minimal resistance development B. low systemic absorption C. activity against only one bacteria at a time D. low risk of toxicity

C

What is the main toxicity with the preservative benzalkonium chloride? A. Cause corneal pigment deposits B. To decrease corneal absorption C. Damage the corneal epithelium D. Cause miosis

C

What makes acyclovir so much less toxic in humans? A. Easily inhibited by antibodies B. Rapidly metabolized to inactive products C. Only activated in virus infected cells D. Actively removed from normal cells

C

Which of the following agents has not proven to be very effective in the treatment of chronic bronchitis? A. oxygen B. mucokinetic agents C. beta adrenergic blockers D. inhaled antimuscarinics

C

Which of the following bacteria is the most frequent cause of acute conjunctivitis in kids? A. Streptococcus B. Staphylococcus C. Haemophilus D. Moraxella E. Pseudomonas

C

Which of the following best describes the MOA for fluoroquinolones? A. Block the protein synthesis process B. Block cell wall synthesis C. Block enzyme DNA gyrase D. Create holes in the plasma membrane E. Blocks a metabolic step in the synthesis of folic acid

C

Which of the following best describes the basic mechanism for the corticosteroids used in treating asthma such as fluticasone (Flovent)? A. Bind to a cell membrane receptor causing a 2nd messenger to increase cAMP B. Bind to the ribosome to increase Na+ influx C. Bind to a cytosolic receptor and then increase DNA transcription and translation D. Bind to the mRNA to increase protein synthesis

C

Which of the following concerning erythromycin is true? A. Broad spectrum antibiotic B. Can cause fetal malformations C. For topical ocular use, it is only available as an ointment D. Unlikely to allow resistance development

C

Which of the following general statements about ocular bacteria is true? A. Ocular bacteria are difficult to identify B. Bacterial infections will cause an increase in ocular eosinophils C. Most pathogenic cocci are gram + D. Minor self-limiting infections should all be cultured

C

Which of the following groups of anti HIV drugs works by blocking "maturation" or assembly of the virus? A. Reverse transcriptase inhibitors B. Integrase inhibitors C. Protease inhibitors D. Fusion blockers

C

Which of the following is a 1st generation cephalosporin agent good mainly against gram (+) organisms? A. Cefuroxime B. Cefaclor C. Cephalexin (Keflex) D. Ceftriaxone (Rocephin) E. Cefdinir

C

Which of the following is not a gram (-) bacillus? A. Moraxella B. Pseudomonas C. Neisseria D. Haemophilus

C

Which of the following treatment options would not be expected to help a patient with bronchial asthma? A. Administration of an inhaled bronchodilator. B. Removal of the eliciting agents. C. Administration of an inhaled antibiotic. D. Administration of an inhaled anti-inflammatory steriod. E. Administration of an oral brochodilating agent.

C

Which of the following would not be considered one of the "ideal" characteristics for an antibacterial drug? A. Abundantly available B. Minimal toxicities C. No active metabolites D. Very cost effective E. Ability to penetrate to all tissues

C

Which of the following would not be expected as a contributing factor in the development of an adverse drug reaction? A. Taking a drug that decreases the elimination of a drug(s) you are already taking. B. Not reporting over-the-counter drugs the patient might be taking. C. Bringing all your meds with you when you visit the doctor. D. Increasing the number of medications the patient must take.

C

Which of the following would not be steps in the mechanism through which nitroglycerin causes vasodilation? A. Activate guanylate cyclase B. NTG is converted to NO C. Decrease cGMP formation D. Phosphorylate myosin light chain kinase

C

Which two (2) of the following would be a drug used in the prophylactic treatment of coronary artery disease? A. Losartan (Cozaar) B. Furosemide (Lasix) C. Metoprolol (Lopressor) D. Verapamil (Calan)

C and D

Considering ocular pharmacokinetics, which of the following statements is TRUE? A. Net drug movement is a one-way pathway into the lens B. Tears turnover at a rate of about 1% per minute C. Most of a drop applied to the eye has a good chance of being absorbed into the eye D. Inflamed conjunctival vessels will absorb more drug than un-inflamed vessels

D

For pharmacological vehicles, ointments A. are a highly water soluble vehicle B. increase the breakdown of drugs they contain C. are easily contaminated compared to drops D. have longer contact time than suspensions

D

Giving nitroglycerin (sublingually) relieves angina pain because A. It increases blood flow to the microvascular endocardium B. It decreases heart rate C. It decreases force of contraction D. It decreases work load of the heart

D

In the extrinsic coagulation cascade, which of the following factors is not involved? A. Factor II B. Factor X C. Factor VII D. Factor IX

D

Pravastatin (Pravachol) acts through which of the following mechanisms of action? A. Speeds the excretion into the bile for the bile acids and cholesterol B. Blocks GIT absorption of cholesterol C. Inhibits the activity of lipoprotein lipase D. Inhibits a key enzyme in the liver synthesis of cholesterol

D

Pulmonary disease can lead to all the following symptoms EXCEPT: A. Wheezing B. Pulmonary hypertension C. Pulmonary edema D. Central depression E. Shortness of breath F. Coughing

D

The most successful form of treatment for perennial allergic rhinitis is: A. bursts of short-term treatment with high dose steroids. B. a combination of a mast cell stabilizer and an antihistamine. C. treatment with decongestants and beta blockers. D. removal of the eliciting agent (antigen).

D

The reason a drug like ipratropium (Atrovent) is effective in the management of some asthmatic patients is best described by which of the following statements? A. It acts directly on the cholinergic receptors as an agonist increasing secretory activity. B. It blocks the beta adrenergic receptors to prevent bronchodilation. C. It stimulates bronchodilation through actions on the adenosine receptors on the bronchioles. D. It blocks the bronchospam seen with stimulation of muscarinic receptors.

D

What is believed to be the MOA for the benefit of Restasis in the treatment of dry eye? A. Prevents protein degradation B. Increases Na+ content of tears C. Blocks collagenase enzymes D. Causes an anti-immune effect

D

When considering the combination product Advair (salmeterol and flutacasone) what is the biggest disadvantage of this product compared to using the individual drugs salmeterol (Servent) and fluticasone (Flovent)? A. Using the combo product could cause the patient to suffer bronchospasm that would not be relieved quickly. B. When combined these two drugs have a high risk of kidney failure not seen when they are used separately. C. It is possible for a person to be allergic to the combination drugs, but not the individual drugs. D. The combo drug is a fixed dose of each separate drug, not allowing dosage adjustment.

D

When considering the use of fluorescein sodium, which of the following statements is TRUE? A. If combined with benoxinate, fluorescein must be in a concentration of 2.0% to overcome quenching. B. When used for tonometry, if the concentration of fluorescein falls well below 0.25%, the measured IOP will be higher than the actual IOP value. C. Aqueous humor secretion rates can be determined with in the first 30 seconds after an i.v. fluorescein injection. D. Oral administration of fluorescein could be used for evaluating certain retinal vascular problems, such as cystoid macular edema.

D

When looking at examples of changes in pharmacokinetics in the elderly population, which of the following is true? A. If aging causes a decrease in P-450 based metabolism, you would expect the hepatic clearance of oxazepam to be slowed. B. The excretion of simvastatin would be expected to increase in the elderly patient. C. The frequent use of antacids (calcium containing) could lead to an increase in gastric emptying and an increase in the absorption of tetracycline (an antibiotic). D. Patients that have reduced renal function should be given reduced doses of ketorolac, a non-steroidal anti-inflammatory drug.

D

Which dual activity drug would you choose for your patient that has allergic conjunctivitis? A. emedastine (Emadine) B. Naphcon A C. cromolyn sodium (Crolom) D. ketotife (Zaditor or Alaway)

D

Which of the following agents is NOT correctly matched with its pharmacologic class? A. azelastine: antihistamine B. Alrex: anti-inflammatory steroid C. naphazoline: decongestant D. Xibrom: mast-cell stabilizer

D

Which of the following agents is correctly matched with it's proposed mechanism of action? A. zafirlukast (Accolate): adenosine receptor antagonist B. budesonide (Pulmicort): humanized IgE antibody C. albuterol (Proventil): inhibitor of adenyl cyclase enzyme D. beclomethasone (QVAR): anti-inflammatory steroid E. tiotropium (Spiriva): lipoxygenase enzyme inhibitor

D

Which of the following agents only blocks H1 receptors? A. Pheniramine B. Azelastine C. Olopatadine D. Cetirizine

D

Which of the following best describes the MOA for garamycin (gentamicin)? A. Causes an inhibition of the enzyme that breaks down peptidoglycans B. Blocks transfer of peptidoglycans to disrupt cell wall synthesis C. Causes a disruption in the cell membrane D. Blocks the synthesis of proteins

D

Which of the following drugs or groups of drugs has the broadest spectrum of activity? A. Bacitracin B. Aminoglycosides C. Penicillin D. Fluoroquinolones E. Polymyxin B

D

Which of the following is not a "cause" of hyperlipidemia? A. Sedentary life style B. Oral contraceptive use C. Diabetes D. Hypertension E. High fat diet

D

Which of the following preservatives is not correctly matched with its mechanism of action: A. Polyquad: solubilizes the cell membrane B. EDTA: bind free metals C. Chlorhexidine: inhibit cation and ATP transport D. Sofzia: causes antioxidant damage to cell membrane

D

Which of the following statements concerning drugs useful in the treatment of Alzheimer's disease (AD) is true? A. A new anti-AD drug that works differently than the older treatments is memantine, which seems to increase the availability of norepinephrine at the synapse. B. The cholinomimetic agents used in AD can also improve heart block which is sometimes also seen in the elderly patient. C. Actions of the acetylcholinesterase inhibitors systemically can include; dry mouth, constipation, and a decreased frequency of micturition. D. By increasing the availability of ACh, the anti-cholinesterase agents can also cause significant bradycardia.

D

Which of the following statements concerning the use of the antihypertensive agents in the elderly patient is true? A. The use of the calcium channel blockers is probably the best drug choice for all elderly patients. B. While the effects of the antihypertensive agents are essentially the same in both elderly and young patients, an increased volume of distribution in the elderly makes these drugs less effective in the older patient. C. While hydrochlorothiazide can be an effective antihypertensive agent in the young patient, the general decrease in cardiac output in the older patient makes this drug a poor choice. D. One of the biggest risks with any antihypertensive treatment is that decreasing blood pressure will increase the risk of fainting and falling in the elderly patient.

D

Which of the following would be a likely toxicity from the administration of Nitroglycerin? A. Blanching of skin B. Hypertension due to tachycardia C. Bradycardia due to hypotension D. Headache

D

Which of the following would be expected to have the greatest sedative effects? A. Cetirizine (Zyrtec) B. Fexofenadine (Allegra) C. Desloratadine (Clarinex) D. Diphenhydramine (Benadryl)

D

Which of the following would not be a mechanism we described for the development of bacterial resistance? A. Alter a normal metabolic step to avoid the antibacterial action B. Change in the antibacterial binding site to prevent its action C. Produce an enzyme that will destroy the antibacterial agent D. Bacteria becomes allergic to the antibacterial agent

D

Low levels of HDL is considered a problem in atherosclerosis because HDL is protective since it transports A. Triglycerides from the intestine to the liver for storage. B. Triglycerides from the liver to adipose cell for storage. C. Cholesterol from the intestine to the liver for storage. D. Cholesterol from the liver to peripheral cell membranes for storage. E. Cholesterol from peripheral cells to the liver for storage.

E

Which of the following chemicals is NOT an effective cold chemical disinfectant for commercial use in soft contact lenses? A. thimerosal/chlorhexidine B. Polyquad C. hydrogen peroxide D. Dymed (polyhexamethyline biguanide) E. sorbic acid/sorbate

E

Which of the following drugs has both Na+ and K+ channel blocking activity? A. Verapamil (Isoptin) B. Sotalol C. Lidocaine (Xylocaine) D. Amiodarone (Cordarone) E. Disopyramide (Norpace)

E

Which of the following agents would not be considered a clinically effective inhaled anti-inflammatory steroid? A. beclomethasone (QVAR) B. flunisolide (AeroBid) C. mometasone (Asmanex) D. ciclesonide (Alvesco) E. fluticasone (Flovent) F. zileuton (Zyflo CR)

F