Katzung Test 4

Which statement concerning the Barbiturates is most accurate?

(Katzung 12th)

Which statement concerning the pharmacokinetics of antiseizure drugs is

accurate?

(Katzung)

Which statement concerning the proposed mechanisms of action of

anticonvulsant drugs is inaccurate?

(Katzung 11th)

Which statement concerning the proposed mechanisms of action of

anticonvulsant drugs is most accurate?

(Katzung 12th)

With chronic use in seizure states, the adverse effects of this drug include

coarsening of facial features, hirsutism, and gingival hyperplasia.

(Katzung)

With respect to Pramipexole, which of the following is accurate?

(Katzung 12th)

Among NSAIDs, Aspirin is unique because it

(Katzung 11th + 12th)

Which of the following is an analgesic and antipyretic drug that lacks an

anti-inflammatory action?

(Katzung 11th + 12th)

A 16-year-old girl comes to the emergency department suffering from the

effects of an Aspirin overdose. Which of the following syndromes is this patient

most likely to exhibit as a result of this drug overdose?

(Katzung 11th + 12th)

Which of the following drugs is most likely to increase serum concentrations of

conventional doses of Methotrexate, a weak acid that is primarily cleared in the

urine?

(Katzung 11th + 12th)

The main advantage of Ketorolac over Aspirin is that Ketorolac

(Katzung 11th + 12th)

An 18-month-old boy dies from an accidental overdose of Acetaminophen.

Which of the following is the most likely cause of this patient’s death?

(Katzung 11th + 12th)

A 52-year-old woman presented with intense pain, warmth, and redness in the

first toe on her left foot. Examination of fluid withdrawn from the inflamed joint

revealed crystals of uric acid.

In the treatment of this woman’s acute attack of gout, a high dose of

Colchicine will reduce the pain and inflammation. However, many

physicians prefer to treat acute gout with a corticosteroid or Indomethacin

because high doses of colchicine are likely to cause

(Katzung 11th + 12th)

A 52-year-old woman presented with intense pain, warmth, and redness in the

first toe on her left foot. Examination of fluid withdrawn from the inflamed joint

revealed crystals of uric acid.

Over the next 7 mo, the patient had 2 more attacks of acute gout. Her

serum concentration of uric acid was elevated. The decision was made to

put her on chronic drug therapy to try to prevent subsequent attacks.

Which of the following drugs could be used to decrease this woman’s rate

of production of uric acid?

(Katzung 11th + 12th)

A 54-year-old woman presented with signs and symptoms consistent with an

early stage of rheumatoid arthritis. The decision was made to initiate NSAID

therapy.

Which of the following patient characteristics is the most compelling

reason for avoiding Celecoxib in the treatment of her arthritis?

(Katzung 11th + 12th)

A 54-year-old woman presented with signs and symptoms consistent with an

early stage of rheumatoid arthritis. The decision was made to initiate NSAID

therapy.

Although the patient’s disease was adequately controlled with an NSAID and

Methotrexate for some time, her symptoms began to worsen and radiologic

studies of her hands indicated progressive destruction in the joints of several

fingers. Treatment with another second-line agent for rheumatoid arthritis was

considered. Which of the following is a parenterally administered DMARD whose

mechanism of anti-inflammatory action is antagonism of tumor necrosis factor?

(Katzung 11th + 12th)

A 63-year-old man is undergoing radiation treatment as an outpatient for

metastatic bone cancer. His pain has been treated with a fixed combination of

Oxycodone plus Acetaminophen taken orally. Despite increasing doses of the

analgesic combination, the pain is getting worse

The most appropriate oral medication for his increasing pain is

(Katzung 11th and 12th)

A 63-year-old man is undergoing radiation treatment as an outpatient for

metastatic bone cancer. His pain has been treated with a fixed combination of O

xycodone plus Acetaminophen taken orally. Despite increasing doses of the

analgesic combination, the pain is getting worse

It is possible that this patient will have to increase the dose of the analgesic

as his condition progresses as a result of developing tolerance. However,

tolerance will not develop to a significant extent with respect to

(Katzung 11th and 12th)

You are on your way to take an examination and you suddenly get an attack of

diarrhea. If you stop at a nearby drugstore for an over-the-counter opioid with

antidiarrheal action, you will be asking for

(Katzung 11th and 12th)

An emergency department patient with severe pain thought to be of

gastrointestinal origin received 80 mg of meperidine. He subsequently

developed a severe reaction characterized by tachycardia, hypertension,

hyperpyrexia, and seizures. Questioning revealed that the patient had been

taking a drug for a psychiatric condition. Which drug is most likely to be

responsible for this untoward interaction with meperidine?

(Katzung 11th and 12th)

Genetic polymorphisms in certain hepatic enzymes involved in drug metabolism

are established to be responsible for variations in analgesic response to

(Katzung 11th and 12th)

A young male patient is brought to the emergency department in an anxious

and agitated state. He informs the attending physician that he uses “street

drugs” and that he gave himself an intravenous “fix” approximately 12 h ago. He

now has chills and muscle aches and has also been vomiting. His symptoms

include hyperventilation and hyperthermia. The attending physician notes that

his pupil size is larger than normal.

What is the most likely cause of these signs and symptoms?

(Katzung 11th and 12th)

A young male patient is brought to the emergency department in an anxious

and agitated state. He informs the attending physician that he uses “street

drugs” and that he gave himself an intravenous “fix” approximately 12 h ago. He

now has chills and muscle aches and has also been vomiting. His symptoms

include hyperventilation and hyperthermia. The attending physician notes that

his pupil size is larger than normal.

Which drug will be most effective in alleviating the symp- toms experienced by

this patient?

(Katzung 11th and 12th)

Which statement about Nalbuphine is accurate?

(Katzung 11th and 12th)

Which drug does not activate opioid receptors, has been proposed as a

maintenance drug in treatment programs for opioid addicts, and with a single

oral dose, will block the effects of injected heroin for up to 48 h?

(Katzung 11th and 12th)

Which drug is a full agonist at opioid receptors with analgesic activity equivalent

to morphine, a longer duration of action, and fewer withdrawal signs on abrupt

discontinuance than morphine?

(Katzung 11th and 12th)

Your 37-year-old patient has been diagnosed with a rare metastatic carcinoid

tumor. This neoplasm is releasing serotonin, bradykinin, and several unknown

peptides. The effects of serotonin in this patient are most likely to include

(Katzung 11th and 12th)

A 23-year-old woman suffers from recurrent episodes of angioneurotic edema

with release of histamine and other mediators. Which of the following drugs is

the most effective physiologic antagonist of histamine in smooth muscle?

(Katzung 11th)

A 23-year-old woman is admitted to the emergency department with difficulty

breathing. Examination reveals significantly laryngeal edema. Past medical

history indicates that she suffers from recurrent episodes of angioneurotic

edema with release of histamine and other mediators. Which of the following

drugs is the most effective physiologic antagonist of histamine in smooth

muscle?

(Katzung 12th)

A 20-year-old woman is taking over-the-counter Diphenhydramine for severe

hay fever. Which of the following adverse effects is she most likely to report?

(Katzung 11th and 12th)

A laboratory study of new H2 blockers is planned. Which of the following will

result from blockade of H2 receptors?

(Katzung 11th and 12th)

You are asked to consult on a series of cases of drug toxicities. Which of the

following is a recognized adverse effect of Cimetidine?

(Katzung 11th)

An obese 40-year-old many (BMI 31) is being seen in the cardio-pulmonary clinic

for pulmonary hypertension and a cardiac murmur. He took Fenfluramine for

several years in an attempt to reduce his weight. The mechanism by which

Fenfluramine affected appetite is

(Katzung 12th)

A 40-year-old patient is about to undergo cancer chemotherapy with a highly

emetogenic (nausea- and vomiting-causing) drug combination. The antiemetic

drug most likely to be included in her regimen is

(Katzung 11th and 12th)

The hospital Pharmacy Committee is preparing a formulary for staff use. Which

of the following is a correct application of the drug mentioned?

(Katzung 11th and 12th)

A 26-year-old woman presents with amenorrhea and galactorrhea. Her prolactin

level is grossly elevated (200 ng/mL vs normal 20 ng/mL). Which of the following

is most useful in the treatment of hyperprolactinemia?

(Katzung 11th and 12th)

A 28-year-old office worker suffers from intense migraine headaches. Which of

the following is a serotonin agonist useful for aborting an acute migraine

headache?

(Katzung 11th and 12th)

A 33-year-old woman attempted to induce an abortion using ergotamine. She is

admitted to the emergency department with severe pain in both legs. On

examination, her legs are cold and pale with absent arterial pulses. Which of the

following is the most useful antidote for reversing severe ergot-induced

vasospasm?

(Katzung 11th and 12th)