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Pharm Exam 3
All Self Tests
| Question | Answer |
|---|---|
| Can dental patients with cardiovascular disease safely be treated in the office? | Yes |
| Which cardiovascular disease/condition is NOT a contraindication to elective dental treatment? | Implanted pacemaker |
| Why do the majority of patients with cardiovascular disease benefit from the use of local anesthetics containing vasoconstrictors? | Vasoconstrictor use promotes pain management, reducing the release of endogenous epinephrine. |
| What is NOT a symptom of left ventricular heart failure? | Pulmonary Edema |
| What are symptoms of left ventricular heart failure? | Pitting/Pedal edema, Dyspnea/Orthopnea, The need to have dental treatment performed in a semireclined position. |
| What were the first drugs used for the treatment of heart failure? | Cardiac Glycosides |
| Digoxin has a ____ therapeutic index. | Narrow |
| Even a slight change in dose, absorption, or metabolism can trigger toxic symptoms. What medication is this referring to? | Digoxin |
| Digoxin toxicity includes all signs and symptoms except what? | Xerostomia |
| The AHA and American College of Cardiology recommends this group of drugs for all patients with symptomatic heart failure & asymptomatic patients with decreased left ventricular ejection fraction or a history of MI: | Angiotensin-converting enzyme inhibitors (ACEI) |
| Which categories of medications are used in the treatment of heart failure? | Cardiac Glycosides |
| What structure is termed the pacemaker of the heart, directing the rate of automaticity of all of the other cardiac cells? | Sinoatrial node |
| What is the most commonly used drug for management of acute angina episodes? | Nitroglycerin |
| What are the most common side effects of thiazide diuretics? | Hypokalemia and Hyperuricemia |
| Sublingual nitroglycerin should be administered with the patient sitting or supine. This is due to what adverse drug effect? | Hypotenstion |
| Which medication is contraindicated with aspirin? | Warfarin |
| A side effect of chronic unproductive cough is associated with which medication group? | Angiotensin-converting enzyme inhibitors (ACEIs) |
| What is NOT a medication used in the management of hypertension? | Lidocaine hydrochloride |
| What is NOT a drug used to control arrhythmias? | Nitroglycerin |
| What is the primary mechanism of antiarrhythmic drugs? | Depressing the parts of the heart that are beating abnormally |
| What is NOT a category of lipid-lowering drugs? | Calcium channel blockers |
| Gingival enlargement is an adverse reaction associated with what drug? | Calcium channel blockers |
| Warfarin (Coumadin) has which mechanisms of action? | Vitamin K antagonist |
| The primary advantage of the anticoagulant factor Xa inhibitors drugs such as Rivaroxaban over warfarin is what? | No INR monitoring is required |
| Pt. comes into the clinic for SRP. She has deep vein thrombosis (DVT) and is taking warfarin. Her INR is 2.5. What does NOT need to be done? | Delay treatment until the patient hasn't taken warfarin for 2 days. |
| Which drug is the first choice of therapy for most patients with atherosclerotic heart disease and elevated cholesterol values? | HMG CoA reductase inhibitors (Statins) |
| B-Adrenergic blocking agents suffix | -olol |
| Angiotensin receptor blocker suffix | -artin |
| Angiotensin-converting enzyme inhibitors suffix | -pril |
| 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitor suffix | -statin |
| What is the primary use of adrenocorticosteroids in dentistry? | For treatment of oral lesions associated with noninfectious inflammatory diseases. |
| Do glucocorticoids affect the water and electrolyte composition of the body? | No |
| Do mineralocorticoids affect intermediate carbohydrate metabolism? | No |
| The normal adult secretion of cortisol (hydrocortisone) is approx. _______mg daily. | 20mg |
| A deficiency of adrenocorticosteroid can result in which condition? | Addison Disease |
| Adverse drug reactions of corticosteroids do NOT include what? | Weight loss and hypotension |
| Based on relative potency/efficacy, which topical adrenocorticosteroid is the strongest, having the most anti-inflammatory action? | Betamethasone dipropionate (Diprolene) |
| Systemically administered steroids are often effective in the treatment of all oral conditions except what? | Herpes simplex |
| Treatment of aphthous ulcers or stomatitis is usually accomplished with which topical cortocosteroid? | Triamcinolone acetonide (Kenalog in Orabase) |
| The relative anti-inflammatory and salt-retaining activity of synthetic corticosteroids is compared to which corticosteroid? | Hydrocortisone |
| What is NOT a consideration for dental patients taking steroids? | Hypotension may occur, especially with high mineralocorticoid action. |
| What is the most serious risk to the patient who has been on long-term corticosteroids during a stressful dental appointment? | Adrenal crisis |
| What is the most commonly prescribed oral corticosteroid? | Prednisone |
| T/F: Adrenocorticosteroids are used in dentistry to treat oral lesions associated with noninfectious inflammatory diseases. | True |
| T/F: Dentists may prescribe these drugs to slow the progression of periodontal disease. | False - can contribute to periodontal disease |
| T/F: The anti-inflammatory action of glucocorticoids results in an increase in the concentration of neutrophils and a decrease in the lymphocytes (T and B cells), monocytes, eosinophils, and basophils. | True |
| T/F: Steroids induce production of interleukin-2, migration inhibition factor, and macrophage inhibition factor. | False |
| Systemic effects of steroids occur when they are administered in all of the dose forms except which form? | Topically |
| What is not a special consideration that should be made to manage dental appointments for patients with diabetes? | Dental appointments should be made at meal times -- they should NOT |
| Which drugs may change insulin requirements and should be used with caution? | All -- Gen. anesthetics, glucocorticoids, epi, opioids, aspirin |
| T/F: Diabetic neuropathy can affect the oral cavity by causing pain and burning of the tongue and other oral structures. | True |
| T/F: Amitriptyline, carbamazepine, phenytoin, and metoclopramide are used to manage the symptoms. | False |
| What is the most accurate measure of a patients' glucose control? | Glycosylated hemoglobin (A1C) |
| A patient with Type 1 diabetes is having an adverse reaction. If they hygienist is unable to distinguish between hypoglycemic or hyperglycemic, which action is most appropriate? | Give small amounts of sugar orally to the conscious patient |
| What is the most common adverse reaction associated with insulin? | Hypoglycemic reaction |
| What is NOT an oral antidiabetic agent? | Oral insulin -- doesn't exist |
| T/F: Insulins vary widely in their chemical formulation | False |
| T/F: The two formulations of human insulin vary slightly from insulin secreted by healthy persons | False |
| T/F: Insulin can only be used to treat Type 1 diabetes | False |
| T/F: Oral antidiabetic agents are used for both Type 1 and 2 diabetes. | False |
| Patients with uncontrolled diabetes have increased susceptibility to all oral conditions except what? | Attrition due to bruxism |
| Of the 10 groups of oral agents used to treat Type 2 diabetes, only one group are AKA oral hypoglycemic agents. Which groups has this designation? | Sulfonylureas |
| Pituitary deficiency or hypopituitarism, can produce all symptoms except what? | Increased metabolism |
| Hyman menopausal gonadotropin containing follicle-stimulating hormone (FSH) and luteinizing hormone (LH) in commercially available as menotropins (Pergonal). What is the primary use of this preparation? | Treatment of infertility by stimulating ovarian follicle development |
| What is administered either by injection or intranasally, is used to induce labor, control postpartum hemorrhage, and induce postpartum lactation? | Oxytocin (Pitocin, Syntocinon) |
| Oral findings in children with hypothyroidism does NOT include what? | Early tooth eruption, marked loss of alveolar process, and rapidly progressing periodontal disease. |
| What special considerations should be made when medications are indicated for hypothyroid patients? | Abnormal sensitivity to opioids and sedatives requires dose level reduction. |
| Oral manifestations of patients with excessive levels of circulating thyroid hormone does NOT include what? | Delayed tooth eruption |
| What is NOT a dental consideration for patients with hyperthyroidism? | Decreased sensitivity to pain and decreased tolerance to CNS depressants. |
| Which medication is often given concomitantly with antithyroid agents to prevent tachycardia and tremors? | Propanolol |
| Estrogens can be used to treat all conditions except what? | Hypertension |
| T/F: Changes in sex hormone levels during the female life cycle have no effect on the gingiva. This is because conscientious plaque control can prevent inflammatory changes in the gingiva. | False, False |
| The addition of _______ to oral estrogens can prevent the increased risk of uterine cancer in postmenopausal women. | Medroxyprogesterone |
| What is the MOST serious adverse effect associated with oral hormonal contraceptives? | Carcinogenicity and increased clotting tendency |
| T/F: Concurrent use of systemic antibiotics and oral hormonal contraceptives may reduce the effectiveness of the contraceptives. | True |
| T/F: It is recommended that patients be advised to substitute topical antibiotics for systemic antibiotics to avoid contraception failure. | False |
| Which medications could have adverse drug interactions when taken with oral contraceptives? | All -- Penicillin, Tetracycline, Acetaminophen, Benzos |
| T/F: Androgenic steroids are used medically in the treatment of breast cancer or for replacement therapy in patients with testosterone deficiency. | True |
| T/F: These drugs have low risk of adverse drug events and are considered extremely safe | False |
| T/F: Ulcers and Gastroesophageal reflux disease (GERD) are common gastrointestinal tract diseases. | True |
| T/F: With the discovery of the etiology of ulcers, the incidence of ulcers in the population has increased. | False |
| Which gastrointestinal disease is the most prevalent among the U.S. population? | GERD |
| All medications are used for treatment of GERD except what? | Antibiotics |
| A hygienist should make all the these suggestions to the patient with peptic ulcer disease or GERD except what? | Use aspirin or NSAIDs to alleviate the discomfort of the disease. |
| What is the MOA of histamine2-receptor blockers in the treatment of GERD? | Block and inhibit basal and nocturnal gastric acid secretion by competitive inhibition at the site of the H2 receptors of the parietal cells of the stomach |
| Which lifestyle changes would NOT be recommended for the patient with GERD? | Eat 3 meals with no snacks |
| Mr. J had an MI a year ago. He is currently on warfarin, cimetidine, lisinopril, metoprolol, and diltiazem. He is having extractions of his lower teeth to be fitted for a denture. What are the possible implications on his tx. based on his med history? | Increased bleeding response, increased toxicity response to local anesthesia |
| Which medications would be safer than cimetidine for Mr. J based on his other medications of warfarin, lisinopril, metoprolol, and diltiazem? | All are correct |
| T/F: Proton pump inhibitors (PPIs) heal ulcers more rapidly than H2-receptor blockers or any other medication. Unfortunately, their usefulness is limited due to the rapid development of tolerance to the PPIs. | True, False |
| What is NOT an adverse effect of long-term use of PPI? | Acute gastritis |
| Which medication is indicated for relief of symptoms associated with diabetic gastroparesis? | Metoclopramide (Reglan) |
| What is NOT a type of laxative? | Isotonic solutions |
| Which classes of laxatives are used to treat opioid-induced constipation in patients with chronic noncancerous pain? | Chloride channel activator, Mu receptor antagonists |
| Which classes of drugs are considered antidiarrheal drugs? | Opioids, adsorbents |
| Phenothiazines, such as prochlorperazine, have all actions except what? | Antidiarrheal |
| T/F: The first line of therapy for IBD is the use of immunosuppressant drugs. | False |
| T/F: IBD patients who smoke should be encouraged to quit as soon as possible. | False |
| All categories of drugs are commonly used orally to treat nausea and vomiting associated with cancer chemotherapy except what? | Diphenhydramine/Benadryl |
| T/F: Anti-tumor necrosis factor (TNF) inhibitors are useful in the treatment of ulcerative colitis. These drugs are linked with an increased risk of infection, especially tuberculosis, and may raise the risks for hepatitis and blood problems. | True, True |
| T/F: Asthma is characterized by irreversible airway obstruction and is associated with a reduction in expiratory airflow. | False - COPD |
| T/F: COPD is characterized by reversible airway obstruction, such as in chronic bronchitis or emphysema. | False - Asthma |
| What medication is NOT used in the treatment of asthma? | Cholinergic agents |
| Which components of asthma must be treated to control the disease? | Inflammation and Bronchoconstriction (A and C) |
| In ______, patient have persistent life-threatening bronchospasm despite drug therapy. | Status asthmaticus |
| What treatment considerations should the dental health care worker make for patients with asthma? | ALL OF THE ABOVE |
| COPD is associated with which factors/conditions? | Chronic bronchitis, Smoking, and Emphysema (A, B, and D) |
| Which medications are used in the management of emphysema? | All of the above |
| T/F: The ventilation drive for breathing in healthy persons is stimulated by elevated levels of the partial pressure of oxygen (PaO2), and the partial pressure of carbon dioxide (PaCO2) can vary widely without stimulating ventilation. | False |
| T/F: In patients with COPD, a gradual rise in the partial pressure oxygen (PaO2) over time causes the ventilation drive to be triggered by an increase in carbon dioxide. | False |
| Which are the advantages of the metered-dose inhaler (MDI)? | Only A, B, D, and E |
| What is NOT a medication currently delivered by MDIs? | Xanthines |
| What is the action of sympathomimetic or adrenergic agonists in treatment of respiratory diseases? | Bronchodilation by stimulation of B receptors of lungs |
| Adverse effects of the short-acting B2 agonists include what? | B, C, D, and F only |
| T/F: Long-acting β2 agonists improve lung function, decrease symptoms, and reduce exacerbations and rescue use of short-acting β2 agonists. They are recommended as monotherapy for asthma. | True, False |
| What is the first line of defense for an intermittent asthma attack? | Short-acting B2 agonists |
| T/F: Patients with mild persistent asthma can BEST achieve of normal breathing function with treatment of short-acting β2 agonists. | False |
| T/F: Short-acting β2-agonists, such as albuterol, may be administered by inhalation (metered dose or nebulization with an air compressor) or orally (tablet or liquid). | True |
| Inhaled corticosteroids are the most effective long-term treatment for control of symptoms in which conditions? | Mild, Moderate, and Severe persistent asthma (all of the above) |
| Which corticosteroid is used orally, rather than in inhaler devices? | Prednisone |
| Which is the primary MOA of inhaled corticosteroids in asthma treatment? | Reduction of inflammation, secretions, and swelling |
| T/F: Oral corticosteroids such as prednisone are sometimes indicated for severely asthmatic patients and for patients with moderate asthma, especially during respiratory infections. Adverse reactions are similar to inhaled corticosteroids. | True, False |
| What is NOT an adverse oral effect of chronic use of inhaled corticosteroids? | Aphthous stomatitis |
| When cells produce leukotrienes (LTs) in response to inflammation, which physiologic action occurs? | Bronchoconstriction, increased bronchial hyperreactivity, increased mucous secretions, and edema |
| Which is the primary indication for use of leukotriene modifiers (LTs)? | Asthma that is not controlled by B2 agonists and corticosteroid inhalers |
| Which drugs are categorized as leukotriene modifiers? | Zileuton (Zyflo), Zafirlukast (Accolate), and Montelukast (Singulair) |
| T/F: The adverse reactions of leukotriene modifiers include irritation of the stomach mucosa, headache, and alteration of liver function tests. Fortunately, few drug interactions occur with these drugs. | True, False |
| _____ 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. | Cromolyn (Intal, Nasalcrom) |
| The xanthines and methylxanthines include which medications? | Caffeine, Theophylline, and Theobromine (A, B, and C) |
| Which are the primary side effects associated with the methylxanthines? | CNS stimulation, tachycardia, increased gastric secretion, and diuresis |
| Which drug is the first line treatment for COPD? | Ipratropium bromide |
| Which inhaled antimuscarinic drugs are used in the management of COPD? | Ipratropium bromide and Theophylline (A and B) |
| What is the MOA of the class of recombinant humanized monoclonal antibodies in the treatment of asthma? | Prevention of immunoglobulin E from binding to mast cells and basophils |
| Nasal decongestants are a-adrenergic agonists whose primary action is what? | Constriction of the blood vessels of the nasal mucous membranes. |
| T/F: Expectorants are drugs that destroy or dissolve mucus from the respiratory passages | False - Mucolytics |
| T/F: Mucolytics promote the removal of exudate or mucus. | False - Expectorants |
| Antitussives are used in symptomatic relief of what? | Nonproductive cough |
| Antitussive agents that are commonly used today include what? | Opioids, Dextromethorphan, and Codeine-containing compounds (A, C, and D) |
| What is NOT an effect of H1-agonists? | Vasoconstriction |
| T/F: H1-receptors are primarily responsible for stimulating gastric acid secretion. | False - H1 receptors |
| T/F: The H2-receptors are primarily related to vasodilation, increased capillary permeability, bronchoconstriction, and pain/itching at the nerve endings. | False - H2 receptors |
| First generation H1-blockers have all actions except what? | Cholinergic |
| Which patients are most likely to have CNS excitation when taking antihistamines? | Patients taking a larger than usual dose and young children/elderly (B and D) |
| Which actions of H1-blockers have the greatest potential adverse effect for the oral health of the patient? | Anticholinergic |
| Which group of medications is often combined with H1 antihistamines? | Decongestants (Adrenergic agents) |
| T/F: Intranasal administration of corticosteroids is less effective than oral administration. | False - very effective |
| T/F: Corticosteroids administered intranasally have few adverse effects. | False |
| Which H1-blocker causes the most sedation and is used as an OTC sleep aid? | Diphenhydramine (Benadryl) |
| What mechanism reduces sedation in the second generation of H1-blockers? | Failure to penetrate the blood-brain barrier |
| All these medications are non-sedating H1-receptor antagonists except what? | Diphenhydramine (Benadryl) |
| T/F: Intranasal corticosteroids are considered first-line therapy for treatment of moderate to severe allergic rhinitis. The onset of action is within minutes of drug administration. | True, False - onset is 12 hours |
| Which agent approved for treatment of seasonal and perennial allergic rhinitis has the MOA of serving as a leukotriene receptor antagonist (LTRA)? | Montelukast (Singular) |
| Alkylating agents are most effective in which stage of cell-cycle reproduction? | All stages |
| T/F: The primary MOA of antineoplastic agents is to interfere with some function of the neoplastic or malignant cell (chemo). | True |
| T/F: Chemo is effective in almost all malignancies | False |
| Who is at LOWEST risk for developing osteonecrosis of the jaw? | Patients taking oral bisphosphonates who have routine dental care |
| Which action should NOT be taken by the hygienist to prevent Medication-Related Osteonecrosis of the JAW (MRONJ)? | Recommend a bisphosphonate-free holiday before dental procedures. |
| Which neoplastic diseases are highly sensitive to chemotherapy? | Acute leukemias, Breast cancer, Burkitt lymphoma, Ewing sarcoma, Hodgkin disease, Oat cell cancers, and Wilms' tumor |
| T/F: The current philosophy for use of antineoplastic agents involves treating the initial stages of the disease gradually. This approach decreases the number of adverse effects for the patient. | False, False |
| What is an advantage of mixing several chemotherapeutic agents when treating neoplastic cells? | Greater scope of action due to different mechanisms |
| Which medications can be used to treat GI problems such as nausea, stomatitis, oral ulcerations, vomiting, and hemorrhagic diarrhea caused by chemotherapy? | Metoclopramide, phenothiazines, scopolamine, and metoclopramide. |
| What is NOT an oral adverse effect associated with antineoplastic agents? | Gingival enlargement |
| Which treatments can provide temporary relief from the symptoms of oral mucositis? | All are correct |
| When is the most appropriate time for oral hygiene or dental procedures in the patient taking antineoplastic agents? | Before treatment and the first few days of the treatment cycle |
| Which body cells are LEAST susceptible to the adverse effects of antineoplastic agents? | Muscle, bone, and nerve cells |
| T/F: Patients with autoimmune conditions and patients who have received organ transplants may be given antineoplastic drugs. | True |
| T/F: The drugs are given in higher doses than used in cancer treatment and are used to boost the immune system. | False - Lower doses to manage autoimmune diseases |
| T/F: Bone marrow suppression or myelosuppression is a frequent adverse drug effect of chemotherapy due to the rapidly dividing blood cells produced in this tissue. | True |
| The decrease in bone marrow activity results in reduced production of blood cells, and can cause all of these conditions except; which is the exception? | Polycythemia vera |
Created by:
jridder25