Pharmacology Exam 5 Ch.19-24 (Online Questions)

Human menopausal gonadotropin containing follicle-stimulating hormone and luteinizing hormone is commercially available as menotropins (Pergonal). This preparation is used primarily for: A. Developing muscles by bodybuilders and athletes B. Treating prolactin-secreting adenomas, acromegaly, and Parkinson's disease C. Treating infertility by stimulating ovarian follicle development D. Treating some clotting disorders such as hemophilia A and von Willebrand's disease

C. Treating prolactin-secreting adonomas, acromegaly, and Parkinson's disease Human menopausal gonadotropin containing follicle-stimulating hormone and luteinizing hormone is commercially available as menotropins (Pergonal) and is used in infertility by simulating ovarian follicle development. REF: p. 250

The primary use of adrenocorticosteroids in dentistry is for treatment of: A. Plaque control and treatment of gingivitis B. Antiinfective against periodontal disease C. Treatment of oral lesions associated with inflammatory diseases D. Pain control for oral lesions

C. Treatment of oral lesions associated with inflammatory diseases Topical and systemic use of adrenocorticosteroids in dentistry is for treatment of ral lesions associated with inflammatory disease

What is the safest analgesic to use during pregnancy? A. Aspirin B. Ibuprofen C. Opioids D. Acetaminophen

D. Acetaminaphen In normal doses, acetaminophen is considered safe during pregnancy. Aspirin and ibuprofen taken in the third trimester can prolong gestation, complicate delivery, decreases placental efficiency, and increase the risk of hemorrhage to both mother and baby; premature closure of the patent ductus arterious may also occur. Opioids given near term may cause respiratory depression in the infant or, in an addicted mother, withdrawal symptoms after birth.

Inhaled corticosteroids are the most effective long-term treatment for control of symptoms in all patients with: A. Mild asthma B. Moderate asthma C. Severe persistent asthma D. All of the above E. a and b only

D. All of the above Inhaled corticosteroids are the most effective long-term treatment for control of symptoms in all patients with mild, moderate, or severe persistent asthma; they also improve pulmonary function, preventing symptoms and severity of asthma and reducing the need for emergency room visits. REF: p. 28

Which of the following drugs may change insulin requirements and should be used with caution? A. Epinephrine, glucocorticoids, and nonsteroidal antiinflammatory drugs B. General anesthetics C. Antihistamines, glucocorticoids, and opioid analgesics D. Epinephrine, glucocorticoids, and opioid analgesics

D. Epiephrin, glucocorticoids, and opioid analgesics Epinephrine, glucocorticoids, and opioid analgesics should be used with caution in diabetic patients because these drugs can increase or decrease insulin requirements. REF: p. 254

What adverse effects are linked to chronic nitrous oxide exposure and the pregnant dental health care worker? A. Premature closure of the patent ductus arterious B. Increased gestational time C. Increased hemorrhage during labor and delivery D. Increased incidence of spontaneous abortion E. Increased difficulty in conception

D. Increased incidence of spontaneous abortion Health care workers chronically exposed to trace amounts of nitrous oxide have a significantly higher incidence of spontaneous abortion and birth defects in their children, regardless of whether the man or woman was exposed. Dental health care workers should be careful in limiting the environmental exposure to nitrous oxide to the lowest possible levels.

All of the following medications are known teratogens except one. Which one is the exception? A. Thalidomide B. Isotretinoin (Vitamin A analogues) C. Antineoplastic agents D. Lidocaine E. Tetracycline

D. Lidocaine Thalidomide, isotretinoin, antineoplastic agents, tetracyclines, oral anticoagulants, lithium, and many other medications are known teratogens. Lidocaine is considered a U.S. Food and Drug Administration (FDA) category B medication, which is considered to have no teratogenic effects.

All of the following can be used as antacids except: A. Sodium bicarbonate B. Calcium carbonate C. Aluminum salts D. Mineral oil

D. Mineral oil Sodium bicarbonate, calcium carbonate, aluminum and magnesium salts, and magnesium-aluminum hydroxide gels are the active ingredients in all other antacids. REF: pp. 285-286

Antitussives are used in symptomatic relief of: A. Asthma B. COPD C. Cystic fibrosis D. Nonproductive cough E. Productive cough

D. Nonproductive cough Antitussives may be opioids or related agents used for the symptomatic relief of nonproductive cough.

All of the following drugs are H2-receptor blockers except one. Which one is the exception? A. Cimetidine (Tagamet) B. Famotidine (Pepcid) C. Ranitidine (Zantac) D. Omeprazole (Prilosec) E. Nizatidine (Axid)

D. Omeprazole (Prilosec) Prilosec) is a proton pump inhibitor, and the others choices are H2-receptor blockers.

Mrs. Jones has been up all night with a toothache and visits your office for an emergency extraction. She seems a little groggy and tells you that she took some medicine left over from her husband's back surgery, but it did not help, and she is still suffering. After reclining her in the dental chair and administering local anesthetic and giving her two OxyContin for the pain, her breathing slows and she becomes unresponsive to verbal commands. What is the most likely cause of her symptoms? A. Local anesthetic overdose B. Hypoglycemia C. Hyperglycemia D. Opioid overdose E. Cardiac arrest

D. Opioid overdose Mrs. Jones is suffering from an opioid overdose caused by self-medication with her husband's drugs and the OxyContin the dentist gave her. The most common symptoms of overdose from the opioids are shallow and slow respiration and pinpoint pupils. Local anesthetic toxicity would cause central nervous system excitation. The drug of choice for opioid overdose is an opioid antagonist, such as naloxone (Narcan).

The most commonly prescribed oral corticosteroid is: A. Hydrocortisone B. Triamcinolone acetonide (Kenalog in Orabase) C. Betamethasone dipropionate D. Prednison

D. Prednisone

What treatment should Susan receive? A. Inhaler containing β2-agonist such as albuterol B. Pure (100%) oxygen C. Parenteral epinephrine 1:1000 D. Intravenous corticosteroids and intramuscular diphenhydramine E. All of the above

E. All of the above

What treatment considerations should be made by the dental health care worker for patients with asthma? A. Minimal stress is induced during the appointment. B. Patients should be asked to bring their fast-acting β2-agonist inhalers with them to the appointments. C. Observe and question the patient before the appointment to prevent acute asthma attack. D. Advise the patient to reduce environmental pollution, such as strong perfumes. E. All of the above F. a and c only

E. All of the above All of the considerations listed will help prevent an acute asthma attack during a dental appointment. REF: p. 277

What are the oral manifestations of patients with excessive levels of circulating thyroid hormone? A. Early tooth eruption B. Rapidly progressing periodontal disease C. Marked loss of the alveolar process D. Diffuse demineralization of the mandible E. All of the above F. a, b, and c only

E. All of the above Excess circulating thyroid hormones can produce a condition called thyrotoxicosis, which can have oral manifestations such as accelerated tooth eruption, rapid alveolar bone loss, and rapidly progressing periodontal disease. REF: p. 252

Alkylating agents are most effective in which stage of cell-cycle reproduction? A. G1 (postmitotic stage) B. S (period of DNA synthesis) C. G2 (premitotic stage) D. M (mitosis stage) E. All stages

E. All stages The alkylating agents are classified as cell cycle-independent antineoplastic agents because they interfere with malignant cells during all phases of the reproductive cycle and the resting stage (G0). REF: pp. 270-271

All of the following drugs are used as laxatives except one. Which one is the exception? A. Bulk laxatives B. Lubricants C. Stimulants D. Stool softeners (emollients) E. Antiemetics F. Osmotic (saline) laxatives

E. Antiemetics Antiemetics are drugs used to induce vomiting and to prevent vomiting are used for certain gastrointestinal tract problems.

All of the following are symptoms of hypoglycemia except one. Which one is the exception? A. Hunger, dizziness, tremors B. Diaphoresis, cold, clammy skin C. Nausea, mental confusion D. Tachycardia, decreased respiration E. Bradycardia, increased respiration

E. Bradycardia, increased respiration The patient with hypoglycemia has a rapid pulse and decreased respiration. He or she may become very talkative and may appear confused or even intoxicated. Hunger, dizziness, weakness, and tremors may occur. The patient may break out in a "cold sweat," become nauseated, and may lapse into unconsciousness or seizures.

__________ is used only for the prophylaxis of asthma and not for treatment of an acute attack by preventing the antigen-induced release of histamine, leukotrienes, and other substances from sensitized mast cells. A. Beclomethasone (Beconase, Vancenase) B. Zileuton (Zyflo) C. Fluticasone (Flovent) D. Zafirlukast (Accolate) E. Cromolyn (Intal, Nasalcrom)

E. Cromolyn (intal, Nasalcrom) Cromolyn (Intal, Nasalcrom) is a drug that is effective only for the prophylaxis of asthma and not for treatment of an acute attack.

All of the following medical conditions can lead to convulsions except one. Which one is the exception? A. Hypoglycemia B. Epilepsy C. Toxic reaction to local anesthetic D. Psychogenic shock E. Hyperglycemia

E. Hyperglycemia Patients who have extremely high plasma levels of glucose will lapse into a coma. All of the other conditions can lead to convulsions, including psychogenic shock, which is loss of consciousness caused by anxiety or fear. REF: p. 292

All of the following antiinfective agents are considered safe during pregnancy except one. Which one is the exception? A. Amoxicillin B. Erythromycin C. Cephalosporin D. Clindamycin E. Metronidazole

E. Metronidazole In animals, metronidazole can produce birth defects. Therefore, although it could be used carefully during the first trimester, encountering a dental situation in which the risk to the fetus would not be greater than the benefit to the mother would be difficult.

Sublingual nitroglycerin is used in all of the following situations except one. Which one is the exception? A. Premedication before a stressful dental appointment B. Treatment of acute angina attack C. Treatment of myocardial infarction D. All of the above E. a and b only

E. a and b only Premedication with sublingual nitroglycerin before a stressful dental situation may prevent an acute anginal attack and may be used to treat an acute anginal attack. Once a myocardial infarction has occurred, sublingual nitroglycerin alone is insufficient to treat the condition.

Advantages of proton pump inhibitors over H2-receptor blockers in the treatment of gastric ulcers include: A. More rapid healing B. Tolerance does not occur C. Lower cost D. All of the above E. a and b only

E. a and b only Proton-pump inhibitors heal ulcers more rapidly than H2-receptor blockers or any other drug. Tolerance does not occur with proton-pump inhibitors because of the increased gastric-mediated histamine release cannot overcome proton pump blockade

Which of the following is an advantage of the metered-dose inhaler (MDI)? A. Medication is delivered directly to bronchiole, reducing the total dose and systemic adverse effects. B. The bronchodilator effect is greater than the comparable dose by mouth. C. Inhaler dose is very accurate. D. Onset of action is rapid and predictable compared with dose by mouth. E. MDIs are compact, portable, sterile, and are easily used by the patient. F. All of the above

F. All of the above The MDI is the preferred route of delivery for most asthma drugs because of the advantages listed. REF: p. 279

Which anticholinergic drug s used in the management of COPD? A. Ipratropium bromide (Atrovent) B. Theophylline (Theo-Dur, Slo-Bid) C. Tiotropium bromide (Spiriva) D. Omalizumab (Xolair) E. b and d F. a and c

F. a and c Ipratropium bromide (Atrovent) is a short-acting anticholinergic available for oral inhalation for people with COPD. Tiotropium bromide (Spiriva) is an inhaled long-acting anticholinergic drug that is used to treat COPD.

Medications used in the management of emphysema include which of the following? A. Anticholinergics B. β-Adrenergic agonists C. Corticosteroids D. Xanthines E. All of the above F. a, b, and d only

F. a, b, and d only Anticholinergics are the first-line treatment, but β-adrenergic agonists and xanthines are also used to produce bronchodilation in these patients. Some patients receive a combination metered-dose inhaler with an anticholinergic drug and a β2-agonist. REF: p. 278

Antitussive agents that are commonly used today include: A. Opioids B. Codeine-containing compounds C. Pseudoephedrine D. Dextromethorphan E. All of the above F. a, b, and d only

F. a, b, and d only Opioids are the most effective, but because of their addicting properties, other agents are often used. Codeine-containing cough preparations are commonly used, but their histamine-releasing properties may precipitate bronchospasm. Dextromethorphan (identified by the DM in cough medicines such as Robitussin DM), an opioid-like compound, suppresses the cough reflex by its direct effect on the cough center.

When cells produce leukotrienes in response to inflammation, which of the following physiologic actions occurs? A. Bronchoconstriction B. Bronchodilation C. Increased mucus secretion and mucosal edema D. Increased bronchial hyperreactivity E. Decreased bronchial hyperreactivity F. a, c, and d G. b and e only

F. a, c, and d Leukotrienes are produced by inflammatory cells and cause bronchoconstriction, increased mucus secretion, mucosal edema, and increased bronchial hyperreactivity. REF: p. 281

What is the primary mechanism of action in inhaled corticosteroids in asthma treatment? A. Bronchodilation B. Reduction of inflammation, secretions and swelling C. Immediate benefit in acute asthma attack D. Reduce hyperreactive airway E. a and b only F. b and d only

F. b and d only Inhaled corticosteroids are useful in reducing inflammation, secretions, and swelling in the lungs after an asthma attack. Although the steroids produce no immediate benefit in an acute asthmatic attack, they speed recovery and decrease morbidity in these patients. They also reduce hyperreactive airways. REF: p. 281

Who is at highest risk for developing osteonecrosis of the jaw? A. Patients taking oral bisphosphonates for osteonecrosis B. Patients taking intravenous bisphosphonates for cancer C. Patients taking oral bisphosphonates who have routine dental care D. Patients taking intravenous bisphosphonates who have dental extractions E. All of the above F. b and d only

F. b and d only Over 90% of all cases of osteonecrosis have been reported in patients with cancer who are receiving intravenous bisphosphonates. The incidence is much lower for patients taking oral bisphosphonates for osteoporosis, with less than 1 case per 100,000 per year. Most of the cases of osteonecrosis of the jaw occur after tooth extractions and other dental procedures that traumatize the jaw. REF: p. 273

Mr. Hypertensive is your dental patient and complains of severe chest pain and pressure in his chest. He takes three doses of his sublingual nitroglycerin tablets but receives no relief. What should you do next? A. Give him another nitroglycerin tablet. B. Determine he is having a myocardial infarction and call 911for transport to the hospital. C. Administer oxygen. D. Administer an aspirin tablet and an opioid narcotic. E. All of the above F. b, c, and d only

F. b, c, and d only A myocardial infarction can be differentiated from an anginal attack if no relief occurs after three administrations of sublingual nitroglycerin. Treatment includes administration of oxygen, an aspirin tablet, an opioid analgesic, and transfer to a hospital

Oral findings in children with hypothyroidism include: A. Early tooth eruption, malocclusion, and decreased periodontal disease B. Poorly shaped teeth and carious lesions C. Inflamed or pale and enlarged gingiva D. Delayed tooth eruption, malocclusion, and increased periodontal disease E. a, b, c F. b, c, d

F. b, c, d Children with hypothyroidism or cretinism may have delayed tooth eruption, malocclusion, increased periodontal disease, poorly shaped teeth with carious lesions, and gingival changes, including inflammation or pale color and enlargement. REF: p. 251

Dental considerations for patients with hyperthyroidism include all of the followingexcept one. Which one is the exception? A. Decreased sensitivity to pain, decreased tolerance to central nervous system depressants B. Increased sensitivity to pain, increased tolerance to central nervous system depressants C. Cardiac dose of epinephrine used carefully D. Preoperative sedation for stress management E. a, b, c F. b, c, d

F. b, c, d Hyperthyroidism causes increased sensitivity to pain and increased tolerance to central nervous system depressants. Sensitivity to catecholamines such as epinephrine is also increased. Therefore the cardiac dose of epinephrine should be used carefully. These patients are very sensitive to stress; thus stress should be kept to a minimum, and use of preoperative sedation for stress management should be considered. REF: p. 252

What are the primary etiologies of gastric ulcers? A. Stress B. Spicy foods C. The organism Helicobacter pylori D. Chronic use of the nonsteroidal antiinflammatory drugs (NSAIDs), especially in elderly adults E. All of the above F. c and d

F. c and d Most ulcers are related in some way to infection of the organism H. pylori. NSAID-induced ulcers occur commonly in the elderly because NSAIDs inhibit synthesis of prostaglandins, which are cytoprotective to the stomach

What is the treatment of choice for syncope? A. Administration of epinephrine 1:1000 B. Placing the patient's head between the legs C. Inhalation of spirits of ammonia D. Administration of insulin E. Placing the patient in the Trendelenburg position F. c and e

F. c and e Syncope can be treated by administration of spirits of ammonia by inhalation (smelling salts) and increasing blood flow to the brain by placing the patient in the Trendelenburg position with the head lower than the feet.

What is the treatment of choice for a convulsion that is not self-limiting? A. Administering epinephrine 1:1000 B. Administering sublingual glucose gel C. Protecting the patient from self-harm D. Turning the patient's head to the side to prevent aspiration E. Administering intravenous diazepam F. c, d, and e

F. c, d, and e Convulsions are usually self-limiting; thus protecting patients from harming themselves and turning their head to the side to prevent aspiration of vomitus is usually sufficient. If the seizure does not stop or one seizure follows another in rapid succession, serious harm can occur and is treated with intravenous administration of diazepam.

What actions should be taken by the dental hygienist to prevent osteonecrosis in the patient taking bisphosphonates? A. Perform dental procedures before starting bisphosphonate therapy. B. Perform surgical procedures using minimal bone manipulation. C. Support any surgical procedures with local and systemic antibiotics. D. Remove necrotic bone with as little trauma as possible. E. Recommend a bisphosphonate-free holiday before dental procedures. F. All of the above G. a, b, c, and d only

G. a, b, c and d only All of the actions above, except a bisphosphonate-free holiday before dental procedures, should be taken to help prevent osteonecrosis. Bisphosphonates stay in the bone for years; therefore stopping the medication briefly will not prevent osteonecrosis. REF: p. 257

Fetal alcohol syndrome (FAS) is associated with excessive maternal intake of alcohol during pregnancy and produces which of the problems in infants born to these mothers? A. Excessive growth B. Growth retardation C. Central nervous system abnormalities D. Facial dysmorphology E. Lethargy and excessive sleep F. a, c, and d G. b, c, and d

G. b, c, and d FAS involves prenatal and postnatal growth retardation, central nervous system abnormalities (neurologic or intellectual), and facial dysmorphologic abnormalities, including microcephaly, microphthalmia or short palpebral fissures, and flat maxillary area or a thin lip. These infants exhibit more tremors, hypertonia, restlessness, crying, and abnormal reflexes compared with infants whose mothers did not drink.

Corticosteroids that are commonly used in inhaler devices include: A. β2-agonists B. Beclomethasone C. Triamcinolone D. Fluticasone E. Prednisone F. all of the above G. b, c, and d only

G. b, c, and d only Common inhalers contain the corticosteroids beclomethasone, triamcinolone, and fluticasone (Flovent). Patients taking these corticosteroids have a significant improvement in pulmonary function along with a decrease in wheezing, tightness, and cough. REF: p. 281

What special considerations should be made for dental appointments for patients with diabetes? A. Dental appointments should be made at mealtimes. B. Dental appointments should not interfere with meals. C. Stress-reduction protocol should be observed. D. Oral surgery should be performed first thing in the morning after nothing by mouth after midnight. E. Oral surgery should be performed 1½ to 2 hours after a normal breakfast and has taken the regular diabetes medication. F. a, b, and e G. b, c, e

G. b, c, e Dental appointments for diabetics should not interfere with meals and involve minimal stress. If the diabetes is under control, oral surgery should be performed within 2 hours of a normal breakfast and medications. REF: p. 254

Which of the following drugs are categorized as leukotriene modifiers? A. Beclomethasone (Beconase, Vancenase) B. Zileuton (Zyflo) C. Fluticasone (Flovent) D. Zafirlukast (Accolate) E. Montelukast (Singulair) F. All of the above G. b, d, and e only

G. b, d, and e only Zileuton (Zyflo) prevents the synthesis of the leukotrienes. Zafirlukast (Accolate) and montelukast (Singulair) are leukotriene-receptor antagonists. They are not as effective as the corticosteroid inhalers.

True or False: Diabetic neuropathy can affect the oral cavity by causing pain and burn of the tongue and other oral structures. Amitriptyline, carbamazepine, phenytoin, and metoclopramide are used to manage the symptoms.

The first statement is TRUE The second statement is FALSE Amitriptyline, carbamazepine, phenytoin, and capsaicin are used to manage the pain and burning connected with diabetic neuropathy. Unfortunately, these medications cause the gastrointestinal tract to lose muscle tone (diabetic gastroparesis). Metoclopramide is used to treat this condition. REF: pp. 254-255

True or False: Oral corticosteroids, such as prednisone, are sometimes indicated for severely asthmatic patients and even for patients with moderate asthma, especially during respiratory infections. Adverse reactions are similar to inhaled corticosteroids.

The first statement is TRUE The second statement is FALSE Control of severe and even moderate asthma may require an oral corticosteroid, especially in the presence of a respiratory infection. Adverse effects are more severe than inhaled corticosteroids, and prolonged systemic use can result in adrenal suppression, poor wound healing, and immunosuppression

True or False: According to the FDA, medications can be categorized according to safety during pregnancy. Drugs considered safest during pregnancy are rated category X.

The first statement is TRUE The second statement is FALSE The FDA has developed pregnancy categories A, B, C, D, and X. Each drug that is the subject of FDA regulation for pregnancy labeling is given a category based on its known potential for risk. Category A is the safest, and category X should not be used in pregnant women

True or False: Hyperventilation is triggered by emotional upset associated with dental treatment. The treatment for hyperventilation is to administer 100% oxygen.

The first statement is True The second statement is FALSE Patients who are extremely anxious or apprehensive about dental treatment may hyperventilate or breathe very rapidly. Once the determination has been made that the patient is hyperventilating, 100% oxygen should not be used; rather, the patient should be encouraged to take slow deep breaths, to hold the breath, or to "rebreathe" into a paper bag or cupped hands.

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Chapter 19

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Chapter 21:

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Chapter 23:

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Chapter 20:

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Chapter 22:

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The normal adult secretion of cortisol (hydrocortisone) is approximately _____ mg daliy.

20 Without stress, the normal adult secretes apporoximately 20 mg of hydrocortisone daily. Secretion can increase up to 10 times in situations of extreme stress.

Nasal decongestants are β-adrenergic agonists whose primary action is: A. Constriction of the blood vessels of the nasal mucous membranes B. Dilation of the blood vessels of the nasal mucous membranes C. Bronchodilation D. Sedation

A. Constriction of the blood vessels of the nasal mucous membranes Many nasal decongestants such as pseudoephedrine (Sudafed, Sucrets, in Actifed) and phenylephrine (Neo-Synephrine, Sinex, Allerest) are available over the counter. Their primary action is constricting the blood vessels of the nasal mucous membranes.

1. What is the most critical period in fetal development? A. First trimester B. Second trimester C. Third trimester D. Birth

A. First trimester During the first trimester, the organs in the fetus are forming. This trimester is considered the most critical time for birth defects.

The relative antiinflammatory and salt-retaining activity of synthetic corticosteroids in compared with which corticosteroid? A. Hydrocortisone B. Triamcinolone acetonide (Kenalog in Orabase) C. Betamethasone dipropionate D. Prednisone

A. Hydrocortisone When the relative antiinflammatory and salt-retaining activity and an equivalent oral dose are given, hydrocortisone is arbitrarily assigned the value of 1 for each activity. The other agents are then give values in relation to those of hydrocortisone.

All of the following are important considerations in the management of dental patients taking steroids except one. Which one is the exception? A. Infections are more likely to occur, and healing may be delayed. B. Hypotension may occur, expecially with high mineralocorticoid action. C. Patients using inhaled corticosteroids should rinse after inhaler use. D. Osteoporosis may occur in patients taking long-term steroids. E. Tissue is more fragile and should be hadled carefully.

A. Infections are more likely to occur, and healing may be delayed. The blood pressure of patients taking corticosteroids should be measured because these agents can exacerbate hypertension. The more mineralocorticoid action is, the more likely the agent is to raise blood pressure.

Which two classes of drugs are used to reduce acid in gastroesophageal reflux disease? A. Proton pump inhibitors and H2-blockers B. Proton pump inhibitors and H1-blockers C. Antibiotics and antacids

A. Proton pump inhibitors and H2-blockers H2-blockers and the proton pump inhibitors reduce or eliminate the stomach's acid. REF: p. 283

Which drug regimen is currently being used to treat peptic ulcers? A. Proton pump inhibitors or H2-blocker and antibiotics B. Calcium channel blockers and antibiotics C. Antacids and proton pump inhibitors

A. Proton pump inhibitors or H2-blocker and antibiotics Ulcers are now be treated by using a combination of one or more antibiotics and an H2-blocker or a proton pump inhibitor to reduce the acid in the stomach.

Epinephrine must be included in the dental office emergency kit for treatment of all of the following except one. Which one is the exception? A. Shock B. Cardiac arrest C. Anaphylaxis D. Acute asthmatic attack

A. Shock Epinephrine should not be used in treatment of shock because it can cause decreased venous return with increased ischemia and can precipitate ventricular fibrillation. Epinephrine is included in the dental office emergency kit for the treatment of cardiac arrest, anaphylaxis, or acute asthmatic attack.

Systemically administered steroids are often effective in the treatement of oral lesions caused by all of the following conditions except one. Which one is the exception? A. herpes simplex B. lichen planus C. erythema muliforme D. pemphigus E. benign mucous membrane pemphigoid

A. herpes simplex systemically administered steroids are used in the treatment of oral lesions associated with noninfectious inflammatory disease, including erythema multiforme, lichen planus, pemphigus, desquamative gingivitis, and benign mucous membrane pemphigoid. They would be contraindicated in the treatment of infectious disease, such as herpes, as a result of suppression of the immune response

Adverse drug reactions of corticosteroids include all of the following except one. Which one is the exception? A. weight loss, muscle growth B. increased resistance to infections C. changes in behavior and personality D. peptic ulcers E. hypertension

A. weight loss, muscle growth Round puffy (moon) face, buffalo hum (fat deposited on back of the neck), truncal obesity, weight gain, and muscle wasting give patients the appearance of Chushing's syndrome

What special considerations should be made regarding hypothyroid patients and medications? A. Decreased sensitivity to opioids and sedatives requires dose level increases. B. Abnormal sensitivity to opioids and sedatives requires dose level reduction. C. No changes are needed to opioid or sedative dose levels.

B. Abnormal sensitivity to opioids and sedatives requires dose level reduction Hypothyroid patients do not respond well to stress and tend to be abnormally sensitive to all central nervous system depressants, including the opioids and sedatives; therefore the dose level should be reduced. REF: p. 251

The most serious risk to the patient who has been on long term corticosteroids during a stressful dental appointment is: A. infections in which healing may be delayed B. Adrenal crisis C. Increased predisposition to periodontal disease D. Oral candidiasis

B. Adrenal crisis When patients take long term corticosteroids, suppresion of the hypothalamic-pituitary-adrenal axis occures. Suppression prevents the body from quickly responding to stress with release of hydrocortisone. Without the proper response to stress, adrenal crisis is possible. Dental appointment may cause sufficient stress for a patient to trigger adrenal crisis. Additional steroids may be indicated in dental procedures that may produce severe stress.

Oral adverse effects of chronic use of inhaled corticosteroids include the following: A. Xerostomia B. Candidiasis C. Aphthous stomatitis D. Herpetic lesions

B. Candidiasis Candidiasis of the oral cavity can result from the chronic use of an inhalation corticosteroid, and patients using oral corticosteroid inhalers should be advised to rinse the mouth with water after inhaler use to minimize the risk of candidiasis. REF: p. 281

What are the primary side effects associated with the methylxanthines? A. Bradycardia, sedation, and central nervous system depression B. Central nervous system stimulation, cardiac stimulation, increased gastric secretion, and diuresis C. Hepatotoxicity, gastrointestinal motility, and tremors

B. Central nervous system stimulation, cardiac stimulation, increased gastric secretion, and diuresis Side effects associated with the methylxanthines include central nervous system stimulation (nervousness and insomnia), cardiac stimulation, increased gastric secretion, and diuresis.

What is the most common adverse reaction associated with insulin? A. Hyperglycemic reaction B. Hypoglycemic reaction C. Allergic reaction D. Idiosyncratic reaction

B. Hypoglycemic reaction The most common adverse reaction associated with insulin is hypoglycemic reactions. The patient can unintentionally overdose on insulin, fail to eat or not eat enough to balance out the insulin, increase their exercise or stress level, or suffer from an infection. Allergic reactions to insulin may occur, but they are not the most commonly insulin adverse reaction. REF: p. 257

Pituitary deficiency (hypopituitarism) can produce all of the following symptoms except one. Which one is the exception? A. Loss of secondary sex characteristics B. Increased metabolism C. Dwarfism D. Hypothyroidism E. Addison's disease F. Retarded dental development

B. Increased metabolism Pituitary deficiency (hypopituitarism) can produce a loss of secondary sex characteristics, decreased metabolism, dwarfism, diabetes insipidus, hypothyroidism, Addison's disease, loss of pigmentation, thinning and softening of the skin, decreased libido, and retarded dental development. REF: pp. 249-250

What is the primary mechanism of most antineoplastic agents? A. Inhibiting slowly growing cells B. Inhibiting rapidly growing cells C. Inhibiting only neoplastic cell growth

B. Inhibiting rapidly growing cells Antineoplastic agents target rapidly growing cells, such as neoplastic cells. Unfortunately, most antineoplastic agents are nonselective for tumor tissue and normal tissue, and rapidly growing normal cells may also be destroyed. REF: p. 272

__________ is indicated in the management of NSAID-induced ulcers, with the mechanism of action of increasing gastric mucus and inhibiting gastric acid secretion. A. Sucralfate (Carafate) B. Misoprostol (Cytotec) C. Metoclopramide (Reglan) D. Cimetidine (Tagamet) E. Simethicone (Mylicon, Gas-X)

B. Misoprostol (Cytotec) Misoprostol (Cytotec) is indicated in the management of NSAID-induced ulcers, by increasing gastric mucus and inhibiting gastric acid secretion.

All of the following are oral antidiabetic agents except one. Which one is the exception? A. Biguanides B. Oral insulin C. Sulfonylureas D. Nonsulfonylurea secretagogues E. α-Glucosidase inhibitors F. Thiazolidinediones

B. Oral insulin No oral insulin formulations have been developed because insulin is usually administered by subcutaneous injection because its large molecular size prevents it from being absorbed from the gastrointestinal tract, although a nasal spray is available. All of others are oral antidiabetic hypoglycemic agents. REF: pp. 257-259

What is the safest time for the pregnant patient to receive dental treatment? A. First trimester B. Second trimester C. Third trimester D. After birth

B. Second trimester The second trimester is best time for the patient to elective dental treatment. The patient is most comfortable during this trimester. During the first trimester, the patient may experience nausea or feel ill because of morning sickness; during the third trimester, the weight of the baby makes lying in one position for any length of time difficult for the mother.

The first line of defense in an intermittent asthma attack would be: A. Long-acting β2-agonists B. Short-acting β2-agonists C. Corticosteroids D. Mucolytics

B. Short-acting β2-agonists The first line of treatment for intermittent asthma is a short-acting β2-agonist, and they are the drugs of choice for the emergency treatment of an acute attack of asthma. REF: p. 279

What action does smoking have on gastric acid secretion? A. Smoking decreases gastric acid secretion. B. Smoking increases gastric acid secretion. C. Smoking does not affect gastric acid secretion.

B. Smoking increases gastric acid secretion. Smoking increases acid production and reduces the effect of the H2-blockers; therefore smoking cessation assistance should be offered to dental patients who smoke.

Medications used in the treatment of aspiration include: A. Succinylcholine, positive pressure oxygen B. Steroids, antibiotics, aminophylline C. β2-Agonist such as albuterol

B. Steroids, antibiotics, aminophylline Treatment of aspiration includes the use of suction, intubation, and ventilatory assistance. Medications used include steroids, antibiotics, and aminophylline. If drug-induced laryngospasm occurs, succinylcholine, a neuromuscular blocking agent, and positive-pressure oxygen are the treatments of choice.

What is the most common emergency encountered in the dental office? A. Hypoglycemia B. Syncope C. Seizures D. Heart attack E. Asthma attack

B. Syncope The most common emergency encountered in the dental office in syncope or fainting. The anxiety and fear that many patients have toward the dental office can precipitate syncope. Prevention of syncope by the dental health care worker can be accomplished by exhibiting a calm, confident demeanor and reducing patient apprehension.

A medication or drug that produces a defect in fetal development is called a(an): A. Abortifacient B. Teratogen C. Phocomelia D. Syndactyly

B. Teratogen Medications that produce fetal malformations or defects in developments are called teratogens. Abortifacients are drugs that cause spontaneous abortions or miscarriages. Phocomelia is a malformation of hands or feet that are poorly developed and that may have been caused by ingestion of the drug thalidomide during pregnancy. Syndactyly is the congenital fusion of one or more fingers or toes.

Treatment of aphthous ulcers or stomatitis is usually accomplished with which of the following topical corticosteroids? A. hydrocrtisone B. triamcinolone acetonide (Kenalog in Orabase) C. betamethasone dipropionate

B. triamcinolon acetonide (Kenalog in Orabase) Triamcinolone acetonide (Kenalog in Orabase) has been successfully used in treatment of aphthhous stomatitis. Other topical steroids, such as flucinonide and fluocinolone, can be used topically.

True or False: Expectorants are drugs that destroy or dissolve mucus from the respiratory passages. Mucolytics promote the removal of exudate or mucus.

Both statements are FALSE Expectorants are drugs that promote the removal of exudate or mucus from the respiratory passages, by either liquefying the mucous to decrease its viscosity or increasing bronchial secretions. Mucolytics are enzymes that are able to digest mucus, decreasing its viscosity.

True or False: Use of benzodiazepines in the first trimester is considered safe. Use in the third trimester has been linked to increased risk of cleft palate and lip and neural tube defects.

Both statements are FALSE First-trimester use of the benzodiazepines (chlordiazepoxide and diazepam) has been reported to increase the risk of congenital malformations. Cleft palate and lip and neural tube defects have been seen during the first trimester only, given that this period of fetal development is when they would occur. Chronic ingestion of benzodiazepines may produce physical dependence in the infant.

True or False: The ventilation drive in normal persons is stimulated by elevated levels of the partial pressure of oxygen, and the partial pressure of carbon dioxide can vary widely. In patients with COPD, a gradual rise in the partial pressure oxygen over time causes the ventilation drive to be triggered by an increase in carbon dioxide.

Both statements are FALSE The ventilation drive in normal persons is stimulated by elevated levels of the partial pressure of carbon dioxide, and the partial pressure of oxygen can vary widely. In patients with COPD, compromised ventilation causes a gradual rise in the partial pressure of carbon dioxide, which, over time, causes the ventilation drive to be triggered by a decrease in oxygen. This factor is important because if these patients are given more than 3 L/min of oxygen, their respiratory drive may be removed, and apnea could occur.

True or False: Intravenous aminophylline and rapidly absorbed oral liquid preparations are used to manage acute asthmatic attacks and status asthmaticus. Theophylline should be limited to patients whose asthma is not controlled with other agents.

Both statements are TRUE Although these drugs may be used in emergency situations such as a severe asthma attack or status asthmaticus, weighing the risk of theophylline toxicity against the potential therapeutic benefit severely limits its use.

Which of the following neoplastic diseases are highly sensitive to chemotherapy? A. Liver, pancreatic, lung, renal cancer, and melanoma B. Head and neck cancer, squamous cell carcinoma, endometrial cancer, neuroblastoma, prostate, bladder, and colorectal cancer C. Acute lymphocytic leukemia, acute myelocytic leukemia, breast cancer, Burkitt's lymphoma, Ewing's sarcoma, Hodgkin's disease, and oat cell cancers

C. Acute lymphocytic leukemia, acute myelocytic leukemia, breast cancer, Burkitt's lymphoma, Ewing's sarcoma, Hodgkin's disease, and oat cell cancers These cancers are highly sensitive to chemotherapy, whereas cancers of the head and neck, squamous cells, endometrium, neuroblastoma, and prostate, bladder, and colorectal cancer are moderately sensitive to chemotherapy. Liver, pancreatic, lung, renal cancers and melanomas are relatively insensitive to chemotherapy. REF: p. 270

Susan, your patient, starts to have difficulty breathing, and her pulse is rapid and weak. On taking her blood pressure, it is 80/40 mm Hg, although it was 120/80 mm Hg at the start of the dental appointment, and she lapses into unconsciousness. Her medical history indicates she has had multiple surgeries to repair a spinal cord defect (spina bifida). What is the most likely reason for her symptoms? A. Asthmatic attack in response to latex gloves B. Hyperventilation C. Anaphylactic shock in response to latex gloves

C. Anaphylactic shock in response to latex gloves Susan is probably experiencing an anaphylactic reaction to latex gloves, which is not uncommon among persons who have had multiple surgeries for spina bifida. Her reaction began shortly after exposure to your

The primary group of drugs used to treat COPD is the __________, causing __________. A. Cholinergics, bronchodilation B. Anticholinergics, bronchoconstriction C. Anticholinergics, bronchodilation D. Methylxanthines, bronchodilation

C. Anticholinergics, bronchodilation Inhaled anticholinergic drugs appear to inhibit vagally mediated reflexes by antagonizing the action of acetylcholine, causing bronchodilation.

What is the primary indication for used of leukotriene modifiers? A. Emphysema B. Mild asthma C. Asthma that is not controlled by β2-agonists and corticosteroid inhalers D. Upper respiratory infections E. Chronic bronchitis

C. Asthma that is not controlled by β2-agonists and corticosteroid inhalers Leukotriene modifiers are used to manage patients with asthma that is not controlled by β2-agonists and corticosteroid inhalers.

The most potent corticosteroid, based on relative maximal potency, is: A. Hydrocortisone B. Triancinolone acetonide C. Betamethasone dipropionate

C. Betamethasone dipropionate The weakest corticosteroid is hydrocortisone, an intermediate-potency corticosteroid is triamcinolone acetonide, and the most potent is augmented betamethasone dipropionate

The action of sympathomimetic or adrenergic agonists in treatment of respiratory diseases is: A. Vasoconstriction of arterioles B. Increased blood pressure in lungs C. Bronchodilation by β-receptors of lungs D. Increased secretions

C. Bronchodilation by β-receptors of lungs Sympathomimetic or adrenergic agonists produce bronchodilation by stimulation of the β-receptors in the lungs. Selective β2-agonists produce fewer cardiac side effects because they produce less stimulation of the β-receptors in the heart (β1). REF: p. 279

All of the following medication groups are used in treatment of asthma except one. Which one is the exception? A. β-Adrenergic agonists B. Xanthines C. Cholinergic agents D. Cromolyn E. Corticosteroids F. Leukotriene-altering agents

C. Cholinergic agents Anticholinergic agents are used to treat asthma, along with all of the other medications listed. REF: p. 277

1. All of the following factors contribute to the increasing numbers of emergencies occurring in dental offices except one. Which one is the exception? A. The aging of the population, with increased retained dentition as they age B. Dental administration of more complex drug regimens C. Failure to follow standards of care D. Longer, more complex dental procedures E. More medically compromised patients seeking dental treatment

C. Failure to follow standards of care Even when standards of care are followed, the aging population—with increased demand for dental population, with longer and more complex dental procedures, and with complex medical issues—have increased the number of medical emergencies seen in dental offices.

Which would be the most appropriate action if the diabetic dental patient is having an adverse reaction and the dental professional is unable to distinguish if it is an insulin reaction (hypoglycemia) or hyperglycemia? A. Administer insulin. B. Activate emergency medical services, and wait for their arrival. C. Give small amounts of sugar orally to the conscious patient. D. Proceed with the treatment.

C. Give small amounts of sugar orally to the conscious patient. Because distinguishing hypoglycemia (low glucose) from hyperglycemia (high glucose) is often difficult, the best course of action is to give the patient a small amount of sugar, which will effectively to treat hypoglycemia and will produce little additional harm if hyperglycemia is present. Insulin should not be administered in a dental office emergency; the patient should be taken to a hospital emergency room immediately. REF: p. 256

What is the most accurate measure of the patients' glucose control? A. Serum glucose B. Urinanalysis C. Glycosylated hemoglobin

C. Glycosylated hemoglobin Although serum glucose and urinanalysis can give indicators of glucose control, they are not the best reflections of the patient's overall glucose control. The glycosylated hemoglobin reflects the glucose control over a 2- to 3-month period; thus it more accurately measures the patient's overall serum glucose control. REF: p. 256

What is the most common medical emergency in the diabetic patient? A. Syncope B. Hyperglycemia C. Hypoglycemia D. Coma

C. Hypoglycemia Hypoglycemia is the most common medical emergency in the diabetic patient, and the most common cause of hypoglycemia is an excessive dose of insulin. If patients inject their insulin but do not eat or eat a small quantity, their blood sugar can drop dangerously low.

All of the following are adverse drug effects of cimetidine (Tagamet) except one. Which one is the exception? A. Slurred speech B. Delusions and confusion C. Increased sperm count and increased sexual potency D. Headache E. Gynecomastia

C. Increased sperm count and increased sexual potency Cimetidine binds with the androgen receptors; it produces antiandrogenic effects such as reduction in sperm count and sexual dysfunction (e.g., impotence).

Cimetidine interacts with other medications, resulting in a delay in elimination and an increase in serum levels of some drugs, possibly producing toxicity by the following mechanism: A. Inhibition of the first-pass effect B. Inhibition of glomerular filtration C. Inhibition of liver microsomal enzymes D. Inhibition of biliary excretion

C. Inhibition of liver microsomal enzymes Cimetidine inhibits liver microsomal enzymes responsible for the hepatic metabolism of some drugs (cytochrome P-450 oxidase system), resulting in a delay in elimination and an increase in serum levels of some drugs, possibly producing toxicity.

While obtaining a patient's medication history, the dental hygienist learns that the client takes cimetidine (Tagamet) as prescribed to treat a peptic ulcer. The dental hygienist continues gathering medication history data to assess for potential drug interactions. What is the most likely scenario if lidocaine local anesthetic (LA) is administered? A. LA is ineffective in therapeutic doses. B. LA may cause systemic toxicity in therapeutic doses. C. LA may cause systemic toxicity in large doses. D. No change in efficacy of LA. E. Allergic reaction may occur.

C. LA may cause systemic toxicity in large doses. Cimetidine inhibits liver microsomal enzymes responsible for the hepatic metabolism of lidocaine by the cytochrome P-450 oxidase system, resulting in a delay in elimination and an increase in serum levels, possibly producing toxicity, especially in large doses.

Stimulation of motility of the upper gastrointestinal tract and increasing the tone of the lower esophageal sphincter is the required for relief of symptoms of diabetic gastroparesis and the usual drug indicated for this action is: A. Sucralfate (Carafate) B. Misoprostol (Cytotec) C. Metoclopramide (Reglan) D. Cimetidine (Tagamet) E. Simethicone (Mylicon, Gas-X)

C. Metoclopramide (Reglan) Metoclopramide is indicated for the relief of symptoms associated with diabetic gastroparesis (gastric stasis) and improves delayed gastric emptying time.

Which of the following medications is often given concomitantly with antithyroid agents to prevent tachycardia and tremors? A. Propylthiouracil B. Methimazole C. Propranolol D. Radioactive iodine

C. Propranolol Propranolol is a β-blocker used with antithyroid agents (propylthiouracil and methimazole) to prevent the tachycardia and tremors that accompany these medications. REF: p. 252

In __________, patients have persistent life-threatening bronchospasm despite drug therapy. A. COPD B. Chronic bronchitis C. Status asthmaticus D. Intermittent asthma E. Emphysema

C. Status asthmaticus Status asthmaticus is a life-threatening condition in which bronchospasm persists despite treatment. REF: p. 277

True or False: Asthma is characterized by irreversible airway obstruction and is associated with a reduction in expiratory airflow, whereas chronic obstructive pulmonary disease (COPD) is characterized by reversible airway obstruction, such as in chronic bronchitis or emphysema.

A. Both parts of the statement are TRUE Asthma is characterized by reversible airway obstruction, and COPD is characterized by irreversible airway obstruction. REF: pp. 276-278

When using a local anesthetic with epinephrine during pregnancy, which of the following statements is most correct? A. A greater-than-normal dose should be used to compensate for fetal metabolism. B. A smaller-than-normal dose should be used to protect the fetus. C. No change in the dose is necessary. D. Epinephrine should never be used during pregnancy.

B. A smaller-than-normal dose should be used to protect the fetus. Small doses of epinephrine, administered carefully, have similar effect to naturally produced catecholamines. Large doses could produce adverse effects in the fetus, including anoxia from vasoconstriction. With short procedures, local anesthetics without epinephrine are preferred.

A deficiency of adrenocorticosteroids is called A. Cushing's syndrome B. Addison's disease C. Myxedema D. Cretinism

B. Addison's disease Addison's disease is a condition produced by a deficiency of adrenocorticosteroids

__________, which is administered either by injection or intranasally, is used to induce labor, control postpartum hemorrhage, and induce postpartum lactation. A. Vasopressin (Pitressin) B. Oxytocin (Pitocin, Syntocinon) C. Bromocriptine (Parlodel) D. Levothyroxine

B. Oxytocin (Pitocin, Syntocinon) Oxytocin (Pitocin, Syntocinon) can by given parenterally or intranasally to induce labor and postpartum lactation and control postpartum hemorrhage. REF: p. 251

True or False: Management of normal breathing function is best achieved with treatment of short-acting β2-agonists, and no danger of overuse of these medications has been found.

Both parts of the statement is FALSE Short-acting β2-agonists should be used primarily for the treatment of acute problems, not for the management of normal breathing function, because overuse can lead to airway hyperresponsiveness and decreased lung response to these agents. REF: p. 279

True or False: An FDA pregnancy category C drug means that animal studies have failed to demonstrate a risk to the fetus, and adequate studies have been conducted in pregnant women to demonstrate the drug's safety.

Both parts of the statements are FALSE

True or False: Many indications for the use of laxatives exist. Therefore overuse is common and does not have any harmful adverse effects.

Both statements are FALSE Although a few indications for the use of laxatives exist, overuse is common and habituation can result.

True or False: The most common antiinfective agent used in dentistry is tetracycline. Authorities generally agree that tetracycline is safe to use during pregnancy.

Both statements are FALSE Amoxicillin is the most common antiinfective used in dentistry today and is considered safe during pregnancy. All tetracyclines are contraindicated during pregnancy because of the potential for adversely affecting the fetus's developing teeth

True or False: Combining H2-blockers with antacids has a definite therapeutic advantage. In fact, antacids increase their absorption and should be administered within 1 hour of H2-blockers.

Both statements are FALSE Combining H2-blockers with antacids has no therapeutic advantage; in fact, antacids inhibit their absorption and should not be administered within hour of H2-blockers. H2-blockers should be administered with meals and at bedtime.

True or False: The diabetic coma is commonly seen in the dental setting. The treatment of choice is administration of injected insulin.

Both statements are FALSE Diabetic coma is rarely seen in the dental office because the patient is usually too ill to come in for a dental appointment. Treatment with insulin should occur only in a hospital setting after laboratory results reveal blood glucose levels.

True or False: Adrenocorticosteriods are usually divided into two major groups: the glucocorticoids, which affect water and electrolyte composition of the body, and the mineralocorticoids, which affect intermediate carbohydrate metabolism

Both statements are FALSE The glucocorticoids affect intermediate carbohydrate metabolism, and the mineralocorticoids affect the water and electrolyte composition of the body.

The mechanism of action for treatment of asthma of the class of recombinant humanized monoclonal antibody is: A. Bronchodilation in conjunction with the β-adrenergic agonists B. Blockage of effects of release of leukotrienes C. Prevents immunoglobulin E from binding to mast cells and basophils

C. Prevents immunoglobulin E from binding to mast cells and basophils Omalizumab (Xolair) is a recombinant humanized monoclonal antibody that prevents immunoglobulin E from binding to mast cells and basophils, preventing the release of inflammatory mediators after allergen exposure.

Which components of asthma must be treated to control the disease? A. Inflammation B. Bronchodilation C. Bronchoconstriction D. Alveolar destruction E. all of the above F. a and c only

F. a and c only When asthma is treated, both inflammation and bronchoconstriction must be treated for the disease to be controlled. REF: p. 277

The xanthines and methylxanthines include which of the following medications? A. Theophylline (Theo-Dur, Slo-Bid) B. Caffeine C. Theobromine D. Anticholinergics E. All of the above F. a, b, and

F. a, b, and c The xanthines and methylxanthines consist of theophylline (Theo-Dur, Slo-Bid), caffeine, and theobromine

Disadvantages of the MDI include: A. Difficulty of correct use, especially for children B. Potential for abuse C. Required additional patient education for proper use D. Variable and unpredictable dose E. All of the above F. a, b, and c only

F. a, b, c only The MDI can be abused and needs additional patient education and training for proper use, especially with children. REF: p. 279

COPD is associated with which of the following? A. Chronic bronchitis B. Smoking C. Asthma D. Emphysema E. Decreased sputum production F. All of the above G. a, b, and d only

G. a, b, and d only COPD is characterized by irreversible airway obstruction, which occurs with either chronic bronchitis or emphysema. Smoking is associated with almost all COPD, as is increased sputum production. REF: p. 278

Adverse effects of the short-acting β2-agonists include: A. Bradycardia B. Tachycardia C. Central nervous system depression D. Nervousness E. Insomnia F. a, c, and e only G. b, d, and e only

G. b, d, and e only Side effects of the short-acting β2-agonists include nervousness, tachycardia, and insomnia. REF: p. 279

True or False: Few drugs given to the mother can pass into the breast milk. The amount of drug that appears in the milk depends on the plasma concentration of the drug, lipid solubility, degree of ionization, and binding to plasma proteins.

The first statement is FALSE The second statement is TRUE Almost all drugs given to the mother can pass into the breast milk in varying concentrations, depending on the plasma concentration of the drug, lipid solubility, degree of ionization, and binding to plasma proteins.

True or False: The adverse reactions of leukotriene modifiers include irritation of the stomach mucosa, headache, and alteration of liver function tests. Fortunately, very few drug interactions occur with these drugs.

The first statement is TRUE The second statement is FALSE Adverse reactions of leukotriene modifiers include stomach mucosal irritation, headaches, and alteration of liver function tests. Multiple drug interactions occur when these drugs are taken.

True or False: Long-acting β2-agonists improve lung function, decrease symptoms, and reduce exacerbations and rescue use of short-acting β2-agonists. They are also recommended as monotherapy for asthma.

The first statement is TRUE The second statement is FALSE Long-acting β2-agonists carry a "black box" warning about a higher risk of asthma-related deaths and are best administered in a fixed-dose combination in the same inhaler with an inhaled corticosteroid. REF: p. 279