Clinical Pharmacology

Clinical Pharmacology

Clinical Pharmacology

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L. Z.

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L. Z.

About these flashcards

This flashcard set covers advanced clinical pharmacology topics at the university level, focusing on drug effects, patient responses, and treatment optimization. It delves into pharmacokinetic phases, adverse drug reactions, pharmacogenomics, and pharmacoeconomic analyses. Medical students and healthcare professionals will benefit from understanding drug interactions, dosage adjustments, and therapeutic monitoring to improve patient outcomes and manage costs effectively.

Flashcards

165

Students

2

Language

English

Category

Medical

Level

University

Created / Updated

17.05.2020 / 14.06.2020

Increased risk of depression in the elderly may be associated with the use of:

A) valproic acid

B) tobramycin

C) nifedipine

D) Digoxin

A) valproic acid

B) tobramycin

C) nifedipine

D) Digoxin

Inadvisable and inconsistent with the principles of optimizing the use of analgesics is pairing:

A) opioid short - and long-acting

B) NSAIDs short - and long-acting

C) the NSAIDs and paracetamol

D) an opioid and an NSAID

A) opioid short - and long-acting

B) NSAIDs short - and long-acting

C) the NSAIDs and paracetamol

D) an opioid and an NSAID

Poor CYP2D6 phenotype of oxidation can cause:

A) a drug-induced hemolytic anemia caused by deficient dehydrogenase glucose-6-phosphate

B) the loss of analgesic effect of codeine

C) clozapine treatment resistance

D) an earlier onset of Alzheimer's

A) a drug-induced hemolytic anemia caused by deficient dehydrogenase glucose-6-phosphate

B) the loss of analgesic effect of codeine

C) clozapine treatment resistance

D) an earlier onset of Alzheimer's

Drug metabolism may be affected

A) in all liver diseases listed below

B) acute viral hepatitis

C) obstructive jaundice

D) advanced liver cirrhosis

A) in all liver diseases listed below

B) acute viral hepatitis

C) obstructive jaundice

D) advanced liver cirrhosis

During interpretation of child-pugh score, 8-9 points (liver dysfunction) requires dose reduction of liver-metabolised drugs by

A) 10%

B) 25%

C) 50%

D) 75%

A) 10%

B) 25%

C) 50%

D) 75%

Reduction (decreased surface) of gastrointestinal tract can cause:

A) increase of absorption of etambutol and chinidine

B) increase of elimination of propranolol

C) decrease of absorption of etambutol and chinidine

D) increase of distribution of paracetamol

A) increase of absorption of etambutol and chinidine

B) increase of elimination of propranolol

C) decrease of absorption of etambutol and chinidine

D) increase of distribution of paracetamol

Iatrogenic response (effect):

A) Response where a drug causes a disease-like state; for example antipsychotics can cause a Parkins

B) Rare adverse drug response resulting from a genetic predisposition; for exapmle, lack of drug metabolizing enzymes

C) Unwanted effects of drugs that appear at normal doses required for therapeutic response

D) Autoimmune reaction like a rash

A) Response where a drug causes a disease-like state; for example antipsychotics can cause a Parkins

B) Rare adverse drug response resulting from a genetic predisposition; for exapmle, lack of drug metabolizing enzymes

C) Unwanted effects of drugs that appear at normal doses required for therapeutic response

D) Autoimmune reaction like a rash

What drugs does alpha-1- acid glycopprotein bind?

A) acidic drugs

B) with long half-life

C) most basic

D) high molecular

A) acidic drugs

B) with long half-life

C) most basic

D) high molecular

This can reduce the efficacy of oral contraceptives and should not be used together:

A) Digoxin

B) Ketoconazole

C) Ciclosporin

D) Rifampicin

A) Digoxin

B) Ketoconazole

C) Ciclosporin

D) Rifampicin

ketoconazole and itraconazole are potent inhibitors of which P450?

A) 2C9

B) 2D6

C) 3A4

D) 2C18

A) 2C9

B) 2D6

C) 3A4

D) 2C18

In the mechanistic classification of adverse drug reactions, which of the following statements best describes type A (augmented):

A) Reactions who biological characteristics can be predicted based on chemical structure of the drug

B) Reaction predictable from the known pharmacology of the drug, usually dose-

C) Reaction not predictable from the known pharmacology of the drug, usually independent o fits primary biological effect

D) Reaction occurs many years after treatment following exposure to another drug

A) Reactions who biological characteristics can be predicted based on chemical structure of the drug

B) Reaction predictable from the known pharmacology of the drug, usually dose-

C) Reaction not predictable from the known pharmacology of the drug, usually independent o fits primary biological effect

D) Reaction occurs many years after treatment following exposure to another drug

what physiologic change associated with normal aging may affect Mr. Jones, 80 year old, clinical response to amiodarone?

s

A) Prolonged half-life of lipid-soluble drugs due to a higher relative composition of body fat compared to younger individual

B) Less water = lower volume of distribution

C) Lower serum proteins (like albumin) increase the concentrations of unbound (free

D) Slowed phase 1, cytochrome P450, reactions

A) Prolonged half-life of lipid-soluble drugs due to a higher relative composition of body fat compared to younger individual

B) Less water = lower volume of distribution

C) Lower serum proteins (like albumin) increase the concentrations of unbound (free

D) Slowed phase 1, cytochrome P450, reactions

Which type of pharmacoeconomic analysis uses Quality adjusted life years as an outcome?

A) Cost-benefit (CBA)

B) Cost-utility (CUA)

C) Cost-minimization (CMA)

D) Cost-effectiveness (CEA)

A) Cost-benefit (CBA)

B) Cost-utility (CUA)

C) Cost-minimization (CMA)

D) Cost-effectiveness (CEA)

A 36-year old female wishes to become pregnant with her second child. Her first child was born with spina bifida. Which of the following is the most appropriate folic acid recommendation for this patient:

A) Folic acid 4 mg orally daily starting at 10 weeks gestations

B) Folic acid 0.4 mg with a multivitamin orally daily starting 3 months before pregnancy

C) Folic acid 4 mg with a multivitamin orally daily starting 3 months before pregnancy

D) Not folic acid supplement is required

A) Folic acid 4 mg orally daily starting at 10 weeks gestations

B) Folic acid 0.4 mg with a multivitamin orally daily starting 3 months before pregnancy

C) Folic acid 4 mg with a multivitamin orally daily starting 3 months before pregnancy

D) Not folic acid supplement is required

Who is most at risk of developing adverse drug reactions?

A) A K, male, age 35, no further disease

B) B C, male age 55, hypertension, cataract, IBS

C) G C, female, age 87, taking insulin, metoprolol, inslapamide, ASA, Simvastatin,

D) A, b, c

A) A K, male, age 35, no further disease

B) B C, male age 55, hypertension, cataract, IBS

C) G C, female, age 87, taking insulin, metoprolol, inslapamide, ASA, Simvastatin,

D) A, b, c

Best formula for calculating the GFR for patients with severe renal deficiency?

A) Jellife equation

B) Cockroft and gualt equation

C) Modification of diet in renal disease (MDRD) formula

D) CKD-EPI (chronic kidney disease epidemiology collaboration)

A) Jellife equation

B) Cockroft and gualt equation

C) Modification of diet in renal disease (MDRD) formula

D) CKD-EPI (chronic kidney disease epidemiology collaboration)

Which of the following is not a side effect of the cholonireceptor blocker (Atropine)?

A) Increased pulse

B) Urinary retention

C) Constipation

D) Mydriasis

Keyboard commands:

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= for-/backward,

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A) Increased pulse

B) Urinary retention

C) Constipation

D) Mydriasis

Which of the following is not a side effect of the diuretics (loop diuretics)?

A) Alkalosis

B) nausea

C) hypotension

D) potassium deficits

Keyboard commands:

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= for-/backward,

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A) Alkalosis

B) nausea

C) hypotension

D) potassium deficits

Which is the most effective method of managing polypharmacy?

A) Use a brown-bag review of medications at each office visit, to ensure an ... med list

B) Limit your patients' medication list to no more than 4 medicines

C) Regularly assess patient adherence to the medication regimen

D) A and C

Keyboard commands:

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= for-/backward,

= scroll

A) Use a brown-bag review of medications at each office visit, to ensure an ... med list

B) Limit your patients' medication list to no more than 4 medicines

C) Regularly assess patient adherence to the medication regimen

D) A and C

Theophylline levels increased with:

A) smoking

B) Phenytoin

C) Cimetidine

D) Magnesium

Keyboard commands:

= turn,

= for-/backward,

= scroll

A) smoking

B) Phenytoin

C) Cimetidine

D) Magnesium

Which is the best example of polypharmacy?

A) Your patient is filling her medications at more than 1 drugstore

B) Your patient is taking more than 2 medications

C) Your patient is taking more than 9 medications

D) Your patient is taking a potentially inappropriate combination of medicine

A) Your patient is filling her medications at more than 1 drugstore

B) Your patient is taking more than 2 medications

C) Your patient is taking more than 9 medications

D) Your patient is taking a potentially inappropriate combination of medicine

Which of the following is NOT a side effect of the ACE inhibitor (Captopril)?

A) rash

B) angioedema

C) cough

D) congestion

A) rash

B) angioedema

C) cough

D) congestion

Which of the following is not an effect of the drug (Isoflurane)?

A) Elevated lipid levels

B) nausea

C) increased blood flow to the brain

D) decreased respiratory function

A) Elevated lipid levels

B) nausea

C) increased blood flow to the brain

D) decreased respiratory function

Which of the following is NOT true regarding the half-life of a drug?

A) A half-life can be decreased in patient with renal disease

B) half-life does not change throughout a patient's life

C) liver diseases can increase half-life

D) biological half-life determines the dosage range of the drug

A) A half-life can be decreased in patient with renal disease

B) half-life does not change throughout a patient's life

C) liver diseases can increase half-life

D) biological half-life determines the dosage range of the drug

Which of the following are true of nonprescription drugs?

A) They are referred to as over-the counter-drugs

B) they can be taken without risk to the patient

C) they should be taken only as directed on the label

D) A, C

A) They are referred to as over-the counter-drugs

B) they can be taken without risk to the patient

C) they should be taken only as directed on the label

D) A, C

Drug distribution process in group of pregnant women differs from healthy adults due to:

A) Increased volume of blood plasma and extravascular fluids

B) Decreased drug binding ability of plasma albumins

C) Decreased volume of blood plasma and extravascular fluids

D) A and B

A) Increased volume of blood plasma and extravascular fluids

B) Decreased drug binding ability of plasma albumins

C) Decreased volume of blood plasma and extravascular fluids

D) A and B

Among antibiotics these groups are recommended to use in pregnancy:

A) penicillins and cephalosporins

B) quinolons

C) aminoglycosides

D) tetracyclines

A) penicillins and cephalosporins

B) quinolons

C) aminoglycosides

D) tetracyclines

Antibiotic resistance can spread from

A) bacteria to bacteria

B) patient to patient

C) animals to patients

D) A, B and C

A) bacteria to bacteria

B) patient to patient

C) animals to patients

D) A, B and C

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Flashcards

A 36-year old female wishes to become pregnant with her second child. Her first child was born with spina bifida. Which of the following is the most appropriate folic acid recommendation for this patient:

A) Folic acid 4 mg orally daily starting at 10 weeks gestations

B) Folic acid 0.4 mg with a multivitamin orally daily starting 3 months before pregnancy

C) Folic acid 4 mg with a multivitamin orally daily starting 3 months before pregnancy

D) Not folic acid supplement is required

Who is most at risk of developing adverse drug reactions?

A) A K, male, age 35, no further disease

B) B C, male age 55, hypertension, cataract, IBS

C) G C, female, age 87, taking insulin, metoprolol, inslapamide, ASA, Simvastatin,

D) A, b, c

What is not a limitation of clinical trials?

A) To small number of patients

B) To strict conditions

C) To heterogenous groups

D) To brief

E) To narrow indication

Best formula for calculating the GFR for patients with severe renal deficiency?

A) Jellife equation

B) Cockroft and gualt equation

C) Modification of diet in renal disease (MDRD) formula

D) CKD-EPI (chronic kidney disease epidemiology collaboration)

Which of the pharmacokinetic phases are influenced by renal impairment

A) Absorption

B) Distribution

C) Metabolism

D) Excretion

E) B, d

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