General pharmacology Retake 26/07/2023

Sugammadex is a new drug that reverses the action of rocuronium and certain other skeletal musclerelaxing agents (nondepolarizing neuromuscular blocking agents). It appears to interact directly with the rocuronium molecule and not at all with the rocuronium receptor. Which of the following terms best describes sugammadex?

You are the only physician in a clinic that is cut off from the outside world by violent storms, flooding, and landslides. A 15-year-old girl is brought to the clinic with severe asthmatic wheezing. Because of the lack of other drugs, you decide to use intravenous theophylline for treatment. The pharmaco- kinetics of theophylline include the following average param- eters: Vd 35 L; CL 48 mL/min; half-life 8 h. If an intravenous infusion of theophylline is started at a rate of 0.48 mg/min, how long would it take to reach 93.75% of the final steady- state concentration?

Which drug used in the maintenance treatment of patients with tonic- clonic or partial seizure states increasef many drugs including both phenytoin and warfarin?

A 20-year-old male patient scheduled for hernia surgery was anesthetized with halothane and nitrous oxide; tubocurarine was provided for skeletal muscle relaxation. The patient rapidly developed tachycardia and became hypertensive. Generalized skeletal muscle rigidity was accompanied by marked hyperthermia. Laboratory values revealed hyperkalemia and acidosis. This unusual complication of anesthesia is most likely to be caused by

A significant number of patients started on ACE inhibitor therapy for hypertension are intolerant and must be switched to a different class of drug. What is the most common manifestation of this intolerance?

Actions and clinical uses of muscarinic cholinoceptor agonists include which one of the following?

A child requires multiple minor surgical procedures involving the nasopharynx. Which drug has high surface local anesthetic activity and intrinsic vasoconstrictor actions that reduce bleeding in mucous membranes?

Oral medications are popular for the treatment of asthma in children because young children may have difficulty with the proper use of aerosol inhalers. Which of the following is an orally active inhibitor of leukotriene receptors?

On her release from the hospital, the patient is advised not to rely solely on oral contraceptives to prevent pregnancy because they may be less effective while she is being maintained on antimycobacterial drugs. The agent most likely to interfere with the action of oral contraceptives is

A 19-year-old college student has well-controlled asthma but on reporting to the college health clinic, complains of a sore throat. On examination, he has typical signs of thrush, a fungal infection with Candida albicans. The asthma controller medication most likely to be associated with Candida infection is:

Which of the following drugs is the most effective in the emergency management of malignant hyperthermia?

A 17-year-old patient complains that he develops wheezing and severe shortness of breath whenever he takes aspirin for headache. Increased levels of which of the following may be responsible, in part, for some cases of aspirin hypersensitivity?

The primary mechanism of resistance of Gram-positive organisms to macrolide antibiotics including erythromycin is

Tolcapone may be of value in patients being treated with levodopa- carbidopa because it

A 46-year-old male patient has Cushing’s syndrome due to an adrenal tumor. Which of the following drugs would be expected to reduce the signs and symptoms of this man’s disease?

Which of the following is an antagonist at NK1 receptors and is used to prevent or reduce chemotherapy-induced nausea and vomiting?

If ampicillin and piperacillin are used in combination in the treatment of infections resulting from Pseudomonas aeruginosa, antagonism may occur. The most likely explanation is that

Certain drugs can cause severe hypotension when combined with nitrates. Which of the following interacts with nitroglycerin by inhibiting the metabolism of cGMP?

A 28-year-old office worker suffers from intense migraine headaches. Which of the following is a serotonin 5-HT1D/1B agonist useful for aborting an acute migraine headache?

Which of the following agents, when used in combination with other anti- HIV drugs, permits dose reductions?

A 4-year-old child is brought to the hospital after ingesting pills that a parent had used for bacterial dysentery when traveling outside the United States. The child has been vomiting for more than 24 h and has had diarrhea with green stools. She is now lethargic with an ashen color. Other signs and symptoms include hypothermia, hypotension, and abdominal distention. The drug most likely to be the cause of this problem is

Flumazenil will counteract the action of each of the following drugs :except

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?

A 73-year-old man with a history of a recent change in his treatment for moderately severe hypertension is brought to the emergency department because of a fall at home. Which of the following drug groups is most likely to cause postural hypotension and thus an increased risk of falls?

A 23-year-old woman is admitted to the emergency department with difficulty breathing. Examination reveals significant 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?

A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations and shortness of breath. These episodes occasionally terminate spontaneously but often require a visit to the emergency department of the local hospital. Her ECG during these episodes reveals an AV nodal tachycardia. Which of the following drugs would be most suitable for prophylaxis of future episodes of acute AV nodal tachycardia?

#Foucous:- prophylaxis !!!!!

A 60-year-old woman comes to the emergency department with atypical chest pain. Her ECG reveals ventricular tachycardia with rare normal sinus beats, and ST-segment elevation. Troponin C levels are markedly increased, suggesting myocardial damage. A diagnosis of myocardial infarction is made, and the woman is admitted to the cardiac intensive care unit. Her arrhythmia will probably be treated initially with:

All of the following factors influence the action of local anesthetics :except

A 56-year-old man has hypertension and an enlarged prostate, which biopsy shows to be benign prostatic hyperplasia. He complains of urinary retention. Which of the following drugs would be the most appropriate initial therapy?

Which of the following is a direct-acting cholinomimetic that is lipid- soluble and is used to facilitate smoking cessation?

Which of the following is the best-documented mechanism of beneficial action of cardiac glycosides?

Which of the following has been shown to prolong life in patients with chronic congestive failure in spite of having a negative inotropic effect on cardiac contractility?

A 60-year-old patient complains of paresthesias and occasional nausea associated with one of the drugs she is taking. She is found to have hyperchloremic metabolic acidosis. She is probably taking

The pharmacokinetic process or property that distinguishes the elimination of ethanol and high doses of phenytoin and aspirin from the elimination of most other drugs is called

A 65-year-old woman with impaired renal function and a necrotic ulcer in the sole of her right foot is admitted to the ward from the emergency department. She has longstanding type 2 diabetes mellitus and you wish to examine her retinas for possible vascular changes. Which of the following drugs is a good choice when pupillary dilation—but not cycloplegia—is desired?

A patient with parkinsonism is being treated with levodopa. He suffers from irregular, involuntary muscle jerks that affect the proximal muscles of the limbs. Which of the following statements about these symptoms is most accurate?

A 38-year-old man is being treated for HIV-induced acquired immunodeficiency syndrome (AIDS). When abacavir therapy is begun, he develops a severe skin rash. Which of the following pharmacogenomic diagnoses might explain this skin rash?

A 65-year-old woman has been admitted to the coronary care unit with a left ventricular myocardial infarction. She develops acute severe heart failure with marked pulmonary edema, but no evidence of peripheral edema. Which one of the following drugs would be most useful?

A 9-year-old child is having learning difficulties at school. He has brief lapses of awareness with eyelid fluttering that occur every 5–10 min. Electroencephalogram (EEG) studies reveal brief 3-Hz spike and wave discharges appearing synchronously in all leads. Which drug would be effective in this child without the disadvantages of excessive sedation or tolerance development?

With chronic use in seizure states, the adverse effects of this drug include coarsening of facial features, hirsutism, and gingival hyperplasia.

Which of the following is an accepted therapeutic indication for the use of antimuscarinic drugs?

An NO-containing molecule that releases nitric oxide in the blood is:

Certain drugs can cause severe hypotension when combined with nitrates. Which of the following interacts with nitroglycerin by inhibiting the metabolism of cGMP?

A 32-year-old woman with hypertension wishes to become pregnant. Her physician informs her that she will have to switch to another antihypertensive drug. Which of the following drugs is absolutely contraindicated in pregnancy?

A 54-year-old man comes to the emergency department with acute chest pain, nausea, sweating, and shortness of breath. The patient has a history of recreational drug use and reports using cocaine, heroin, and alcohol earlier in the day. Temperature is 36.1°C (97°F), pulse is 101/min, respirations are 22/min, and blood pressure is 150/100 mm Hg. The medication typically used to treat this acute condition is currently contraindicated for this patient. Which of the following physiologic responses would occur if the contraindicated Beta blocker) medication were given?

Which one of the following is characteristic of nifedipine treatment in patients with essential hypertension?

Which of the following is a leukotriene receptor blocker?

After several cycles of chemotherapy, the patient was found to have a high resting pulse rate. A noninvasive radionuclide scan revealed evidence of cardiomyopathy. The drug that is most likely responsible for the cardiac toxicity is:

A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations and shortness of breath. These episodes occasionally terminate spontaneously but often require a visit to the emergency department of the local hospital. Her ECG during these episodes reveals an AV nodal tachycardia. The antiarrhythmic of choice in most cases of acute AV nodal tachycardia is

A 38-year-old man who is obese complains of an extremely painful, swollen metatarsophalangeal joint of his left big toe. He has had two similar attacks in the past 4 years. The physician prescribes febuxostat. Which of the following describes febuxostat's mecha-nism of action?

A 36-year-old man with multiple medical problems including diabetes, hypertension, and morbid obesity is hospitalized for treatment of a vancomycin-resistant Enterobacter infection. Recent blood cultures are positive. He is given quinupristin/dalfopristin intrave-nously through the antecubital vein. Which of the following sequelae is most likely?

Ampicillin and amoxicillin are in thesame group of penicillins.However, there are important differences.Which of the following beststates how amoxicillin differs fromampicillin?

A 69-year-old man is admitted to the hospital for management of a pulmonary embolus for which he receives heparin. Five days later, he reports bilateral leg swelling and pain. Ultrasonography reveals bilateral occlusive thrombi in the popliteal veins.Platelet count is 27,000/mm3, prothrombin time is 12 sec, and activated partial thromboplastin time is 65 sec. His heparin is discontinued. Administration of which of the following medications is the best next step in treatment (for the patient without monitoring) ?

A 29-year-old woman is undergoing an elective laparoscopic cholecystectomy. After being sedated, she is given a muscle relaxant intravenously. Just after administration of this drug, the patient's arms and legs twitch briefly. Which of the following drugs was most likely administered?

A 36-year-old man with multiple medical problems including diabetes, hypertension, and morbid obesity is hospitalized for treatment of a vancomycin-resistant Enterobacter infection. Recent blood cultures are positive. He is given quinupristin/dalfopristin intravenously through the antecubital vein. Which of the following sequelae is most likely?

A 44-year-old man comes to the clinic using crutches due to the abrupt onset of an exquisitely painful, swollen, erythematous, and warm right metatarsophalangeal. Two months ago, he developed mild peripheral edema and was started on a new medication that may cause decreased urine calcium excretion. On physical examination, his right toe is tender, erythematous, and warm to the touch. Which of the following antihypertensive medications was most likely responsible for this patient’s findings?

A 50-year-old man has a history of frequent episodes of renal colic with calcium-containing renal
stones. A careful workup indicates that he has a defect in proximal tubular calcium reabsorption, which results in high concentrations of calcium salts in the tubular urine. The most useful diuretic agent in the treatment of recurrent calcium stones is

Patient with hypertension he has symptoms like inflammation and pain in the pig tone what is the drug that he used: افهم

patient with pulmonary disease and have high blood pressure and high pulse which drug is contraindicated? افهم

Patient have high blood pressure and Renal failure which drug should not be given. افهم

Drug prophylaxis for av tachycardia:

Patient is having epilepsy and take drug for seizures also work in voltage-gated calcium:

Patient is take anti epileptic drug (valporic acid) put symptoms are not relief which drug can be used for partial seizures:

Mechanism of digoxin : increase in ejection fraction

Patient have epilepsy and take over dose of diazepam the symptoms relief with flumazenil
explained this on a curve:

Antipsychotic drugs (ALZHEIMER )that in supine position increase blood pressure in siting positive decrease BP:

Inticancer drug that inhibits myosis:

Pregnant Woman experience hemorrhage she has given petamethasone which is mechanism of this drug :

Patients is taking drug for arrhythmias he developed pulmonary disease:

Patient how is taking antipsychotic drug - and his mother have history of anxiety disorder developed muscle rigidity what drug he used that caused this symptoms?

Grapes fruit Which drug should not take with which anticoagulants drug :