advanced Pharm study guide for test 2

Question

What is the significance of bradykinin in the RAAS system

Answer 1

it is a peptide needed for the release of aldosterone by the adrenal gland

Answer 2

It is a peptide that causes blood vessels to constrict, raising blood pressure

Answer 3

it causes contraction of non-vascular smooth muscle

Answer 4

it is broken down by angiotensin converting enzyme causing vasodilation and mild dieresis

Answer 5

Amilodipine

Answer 6

blocks Renin from stimulating the release of Angiotensinogen

Answer 7

blocks Angiotensinogen conversion to Angiotensin I

Answer 8

Blocks Angiotensin I conversion to Angiotensin II

Answer 9

blocks Angiotensin II conversion to aldosterone

Answer 10

thiazide diuretics

Answer 11

angiotensin receptor blockers (ARBs)

Answer 12

Calcium Channel Blockers (CCBs)

Answer 13

angiotensin converting enzyme inhibitors (ACE inhibitors)

Answer 14

they are potassium wasting and must be monitored for hypokalema

Answer 15

they have little negative effect on lipids or sexual function

Answer 16

African-Americans & low-renin hypertensives are extremely sensitive to monotherapy

Answer 17

they increase the effectiveness of NSAIDs

Answer 18

Angioedema <1%

Answer 19

<1% neutropenia & agranulocytosis

Answer 20

Hyperkalemia

Answer 21

Proteinuria & glomerulonephritis

Answer 22

37yo Caucasian male with Hx of MI, and kidney failure

Answer 23

57yo Asian Female currently taking spironolactone

Answer 24

49yo caucasian female with Hx of DM, HF and MIx3

Answer 25

46yo African American male with Hx of DM, HTN and kidney stones

Answer 26

ACEIs affect the myocardial oxygen demand but not the myocardial oxygen supply

Answer 27

ACEIs affect the myocardial oxygen supply but not the myocardial oxygen demand

Answer 28

ACEIs affect both the myocardial oxygen supply and the myocardial oxygen demand

Answer 29

ACEIs and ARBs are contraindicated in treating heart failure related to CAD

Answer 30

all ACEIs are prodrugs and do not need to be metabolized, excretion is from the kidneys.

Answer 31

ACEI's are metabolized in the avieoli of the lungs, excretion is primarily by GI tract with the capsule being whole but hollow

Answer 32

all ACEI's are prodrugs and converted to active metabolites in the liver, The kidney is the primary organ of excretion

Answer 33

ACI's are prodrugs and converted to active metabolites in the liver, excretion is primarily by GI tract with the capsule being whole but hollow

Answer 34

Hypertensive Proteinuric Diabetes

Answer 35

Bilateral renal artery stenosis

Answer 36

Postmyocardial Infarction

Answer 37

Controlling isolated systolic hypertension (ISH)

Answer 38

Prevent the rise of BP with age

Answer 39

reduction in Cardio vascular risk

Answer 40

Improve control of HTN to below 140/90 mm Hg in adults and below 150/90 in those greater than age 60

Answer 41

greater affinity for vascular ca+ channels than cardiac Ca+2 channels

Answer 42

greater affinity for cardiac Ca+2 channels than vascular ca+ channels

Answer 43

Blocks L-type calcium channels producing vasoconstriction

Answer 44

Has an intrinsic natriuretic effect requiring the use of a diuretic

Answer 45

Reflex tachycardia

Answer 46

Constipation

Answer 47

Bradycardia

Answer 48

Digoxin, with a half life of 36-48 hours

Answer 49

Cardizem, with a half life of 3-4 hours

Answer 50

Amlodipine, with a half-life of 30 to 50 hours

Answer 51

isradipine with a half life of 1.5-2 hours

Answer 52

opens the ATPase pump allowing free flow of Na+ and Ca+

Answer 53

inhibits the ATPase pump preventing Na+ from leaving the cell

Answer 54

Blocks L-type calcium channels producing vasodilation

Answer 55

inhibits the ATPase pump preventing Ca+ from leaving the cell

Answer 56

The principal tissue reservoir is skeletal muscle, Dosing should be based on lean muscle mass

Answer 57

The principal tissue reservoir is adipose tissue, Dosing should be based on BMI%

Answer 58

The principal tissue reservoir is the CNS and dosing should be based on CSF results

Answer 59

there is not a principal tissue reservoir, dosage is determined by weight in Kg.

Answer 60

Renal Impairment

Answer 61

AV blocks or uncontrolled ventricular arrhythmias

Answer 62

Atrial Fibrillation

Answer 63

idiopathic hypertrophic subaortic stenosis (IHSS)

Answer 64

Paroxysmal Supraventricular Tachycardia

Answer 65

serum levels of 4.5 ng/mL.

Answer 66

the patient presents with severe anorexia, nausea, vomiting, and diarrhea

Answer 67

ST-T wave changes on the a 12-lead ECG

Answer 68

pt presents with severe nausea, vomiting, and serum levels of 2.3 ng/mL.

Answer 69

blockade of Central Nervous System (CNS) effects on the heart

Answer 70

prolongation of the effective refractory period

Answer 71

sodium channel blockade

Answer 72

blockade of the calcium channel

Answer 73

antiarrhythmics are already in their metabolized form after absorption and are deactivated by the liver.

Answer 74

All antiarrhythmics are metabolized and excreated from the GI tract

Answer 75

all antiarrhythmics are prodrugs and do not need to be metabolized

Answer 76

All antiarrhythmics are metabolized By the liver

Answer 77

by providing more nitric oxide (NO) to vascular endothelium and arterial smooth muscle, resulting in vasodilation.

Answer 78

cause targeted relaxation of large veins resulting in decreased pre-load

Answer 79

Arterial dilation is more common with lower doses and can result in a decrease in systemic arterial pressure

Answer 80

Arterial dilation is more common with higher doses and can result in an increase in systemic arterial pressure

Answer 81

33yo female c/o migraine with HR111 bp 200/120

Answer 82

75yo male c/o chest pain that has not improved, HR 63 bp 110/65

Answer 83

45yo male car vs tree, c/o dizziness, chest pain and nausea. had MI 2 years ago. HR110 BP185/96

Answer 84

35yo female with weakness to one side of her body, difficulty speaking and pain in the jaw that radiates to her back

Answer 85

Significant clinical improvement of PVD can rarely be seen with monotherapy

Answer 86

Peripheral alpha1 antagonists and central alpha2 agonists can be used to treat resistant HTN and PVD.

Answer 87

monotherapy is recommended to show Significant clinical improvement of PVD without associated ADRs

Answer 88

act by direct relaxation and dilation of arteriolar smooth muscle, thereby decreasing PVR

Answer 89

BUN/creatinine

Answer 90

Lipid Panel

Answer 91

increased LDL, decreased HDL, high VLDL

Answer 92

High VLDL, increased HDL, Decreased LDL

Answer 93

increased HDL, increased LDL, low VLDL

Answer 94

decreased LDL, increased HDL, low VLDL

Answer 95

Furosemide (Lasix)

Answer 96

spironolactone (Aldactone)

Answer 97

hydrochlorothiazide (HCTZ)

Answer 98

a white crystalline precipitate to form in the superficial portion of the cornea.

Answer 99

localized ocular toxicity

Answer 100

itching/swelling of the face/tongue/throat

Answer 101

Increased Ocular Pressure in narrow-angle glaucoma

Answer 102

Keratometry

Answer 103

retinoscope

Answer 104

opthalmoscope

Answer 105

Tonometry device

Answer 106

azithromycin

Answer 107

erythromycin

Answer 108

polymyxin B

Answer 109

gentamicin

Answer 110

it is incompatible with silver-containing preparations

Answer 111

must have tonometry available

Answer 112

it has a high hypersensitivity rate

Answer 113

may cause localized ocular toxicity

Answer 114

staphylococcal

Answer 115

streptococcal

Answer 116

Haemophilus

Answer 117

Staphylococcus aureus

Answer 118

Pseudomonas aeruginosa

Answer 119

high-dose amoxicillin

Answer 120

parenteral antibiotics (ceftriaxone)

Answer 121

ophthalmic/otitc antibiotics

Answer 122

erythromycin ointment

Answer 123

intense redness of the eye, Watery/mucus discharge from the eye, fever blister on or near the eye; examination with woodslamp

Answer 124

Swelling of the lymph nodes in front of the ears, fever, slight Pinkness of the eye; referral to ophthalmologist

Answer 125

burning, gritty sensation to the eye, lesion close to or on the eye, fever; referral to ophthalmologist

Answer 126

Crustiness around the eyelids upon waking in the morning, cough, fever; ocular assessment with ophthalmoscope

Answer 127

irrigation was being performed too forcefully

Answer 128

the irrigation solution was not warmed

Answer 129

irrigation solution has bypassed the ear drum and is interfering with the middle ear

Answer 130

the patient is having a seizure

Answer 131

have metabolic, anti-inflammatory, and growth-suppressing effects

Answer 132

high levels of cortisol can cause decreased memory recall, anxiety and disturbed sleep patterns

Answer 133

Glucocorticoids decrease blood glucose concentration by stimulating glycogenesis in the liver

Answer 134

Corticosteroids can raise your risk of infections due to the wide range of effects on the immune system

Answer 135

mean arterial pressure

Answer 136

Total peripheral resistance

Answer 137

end-diastolic volume (EDV) - end-systolic volume (ESV)

Answer 138

HR times stroke volume

Answer 139

Total peripheral resistance

Answer 140

Cardiac output

Answer 141

mean arterial pressure divided by ejection fraction

Answer 142

end-diastolic volume (EDV) - end-systolic volume (ESV)

Answer 143

total peripheral resistance

Answer 144

heart rate

Answer 145

Stroke volume

Answer 146

mean arterial pressure

Answer 147

excitation of efferent nerves in the SNS results in decreased heart rate,

Answer 148

Inhibition of efferent nerves in the SNS that innervate cardiac and vascular smooth muscle results in increased heart rate

Answer 149

Inhibition of efferent nerves in the SNS that innervate cardiac and vascular smooth muscle results in vasodilation of peripheral arterioles

Answer 150

excitation of efferent nerves in the SNS that innervate cardiac and vascular smooth muscle

Answer 151

baroreceptors; aorta

Answer 152

Mechanoreceptors; carotid arteries

Answer 153

Nociceptors; arch of the aorta

Answer 154

Mechanoreceptors; kidneys

Answer 155

to treat anginal chest pain and return to normal activities

Answer 156

reduce the risks of stroke

Answer 157

reduce the risks of MI

Answer 158

smooth muscle and cardiac relaxation

Answer 159

Reduces preload

Answer 160

Increases afterload

Answer 161

Inhibit platelet aggregation

Answer 162

leads to the mediation of smooth muscle relaxation

Answer 163

Have a negative chronotropic and inotropic effect and ↓ afterload, Decreases myocardial oxygen consumption, Increases myocardial perfusion

Answer 164

decreases peripheral vascular resistance and thereby MOD, as the heart has decreased afterload

Answer 165

cause arterial smooth muscle relaxation, which results in peripheral vasodilation, decreased afterload,

Answer 166

Has antianginal and anti-ischemic effects that do not depend on reduction in heart rate or blood pressure

Answer 167

Nitroglycerin

Answer 168

Nifedipide (Procardia)

Answer 169

Diltiazem (Cardizem)

Answer 170

Chest pain is present for the first few hours in the morning, in cold weather or after meals

Answer 171

Angina that occurs when walking 1-2 blocks on level ground, or by climbing 1 flight of stairs

Answer 172

Angina that occurs with strenuous, rapid exertion. Ordinary physical activity like walking upstairs does not cause angina

Answer 173

Chest pain that occurs at rest

Answer 174

Chest pain is present for the first few hours in the morning, in cold weather or after meals

Answer 175

Angina that occurs when walking 1-2 blocks on level ground, or by climbing 1 flight of stairs

Answer 176

Angina that occurs with strenuous, rapid exertion. Ordinary physical activity like walking upstairs does not cause angina

Answer 177

Chest pain that occurs at rest

Answer 178

Chest pain is present for the first few hours in the morning, in cold weather or after meals

Answer 179

Chest pain that occurs at rest

Answer 180

Angina that occurs with strenuous, rapid exertion. Ordinary physical activity like walking upstairs does not cause angina

Answer 181

Angina that occurs when walking 1-2 blocks on level ground, or by climbing 1 flight of stairs

Answer 182

Chest pain is present for the first few hours in the morning, in cold weather or after meals

Answer 183

Chest pain that occurs at rest

Answer 184

Angina that occurs with strenuous, rapid exertion. Ordinary physical activity like walking upstairs does not cause angina

Answer 185

Angina that occurs when walking 1-2 blocks on level ground, or by climbing 1 flight of stairs

Answer 186

ACEI and beta-adrenergic blockers

Answer 187

ACEI and CCB

Answer 188

BB and CCB

Answer 189

Nitrates and BB

Answer 190

it can be used to identify and distinguish between systolic dysfunction and preserved systolic function.

Answer 191

can show Cephalization of the vascular supply

Answer 192

can show left-ventricular hypertrophy and axis deviation

Answer 193

used to rule out pulmonary embolism

Answer 194

low-output failure

Answer 195

high-output failure

Answer 196

Systolic dysfunction

Answer 197

Diastolic dysfunction

Answer 198

carvedilol

Answer 199

Digoxin decreases contractility by decreasing intracellular calcium and inhibiting the sodium-potassium-ATPase pump

Answer 200

Digoxin increases heart rate by increasing intracellular calcium and inhibiting the sodium-potassium-ATPase pump

Answer 201

Digoxin increases contractility by increasing intracellular calcium and inhibiting the sodium-potassium-ATPase pump

Answer 202

Digoxin decreases heart rate by increasing intracellular calcium and inhibiting the sodium-potassium-ATPase pump

Answer 203

A1C ≥6.5%

Answer 204

FPG ≥126 mg/dL

Answer 205

plasma glucose ≥200 mg/dL

Answer 206

classic symptoms of hyperglycemia and a random plasma glucose ≥200 mg/dL

Answer 207

Typically diagnosed early in life

Answer 208

the bodies compensatory insulin production mechanisms reduce the onset of clinical symptoms for many years

Answer 209

90% to 95% of cases are diagnosed before the age of 30.

Answer 210

If the disease progresses without treatment hypoglycemia, coma and death can occur.

Answer 211

2 hour postprandial plasma glucose less than 180 mg/dL

Answer 212

Hemoglobin A1c less than 5%

Answer 213

Random urine albumin/Cr less than 30mcg/mg creatinine

Answer 214

Preprandial plasma glucose 70 to 130 mg/dL

Answer 215

less than 130/80, 140/80 for patients with DM, hypertension

Answer 216

less than 120/60, 130/80 for patients with DM, hypertension

Answer 217

less than 140/80, 145/85 for patients with DM, hypertension

Answer 218

less than 130/80, 150/90 for patients with DM, hypertension

Answer 219

HDL >100mg/dl, LDL <50mg/dl, triglicerides less than 150mg/dl

Answer 220

HDL >150mg/dl, LDL <100mg/dl, triglicerides less than 50mg/dl

Answer 221

HDL >50mg/dl, LDL <100mg/dl, triglicerides less than 150mg/dl

Answer 222

HDL >100mg/dl, LDL <150mg/dl, triglicerides less than 50mg/dl

Answer 223

individual patient variables (race, weight, pregnant etc.)

Answer 224

current AHA guidelines

Answer 225

Desiered gylcemic target

Answer 226

type of diabetes

Answer 227

severity of the hyper/hypo glycemia

Answer 228

Thiazolidinediones (TZDs)

Answer 229

Rapid-Acting (RAI)

Answer 230

Short-acting Insulin

Answer 231

Intermediate-Acting (IAI)

Answer 232

Long-Acting (LAI)

Answer 233

Rapid-Acting (RAI)

Answer 234

Short-acting Insulin

Answer 235

Intermediate-Acting (IAI)

Answer 236

Long-Acting (LAI)

Answer 237

Rapid-Acting (RAI)

Answer 238

Short-acting Insulin

Answer 239

Intermediate-Acting (IAI)

Answer 240

Long-Acting (LAI)

Answer 241

Rapid-Acting (RAI)

Answer 242

Short-acting Insulin

Answer 243

Intermediate-Acting (IAI)

Answer 244

Long-Acting (LAI)

Answer 245

10-20mg/dl

Answer 246

60-90mg/dl

Answer 247

20-60mg/dl

Answer 248

10-40mg/dl

Answer 249

alcohol use, increases hyperglycemia

Answer 250

Beta blockers mask hypoglycemic symptoms

Answer 251

Short-acting Insulin onset of action is 1 to 1.5 hours, and its duration is 12 to 24 hours

Answer 252

Rapid-Acting (RAI) duration of action is 4 to 6 hours

Answer 253

Inhalation method

Answer 254

Abdominal site

Answer 255

upper outer area of the arm

Answer 256

front and outer sides of the thighs

Answer 257

delays insulin breakdown, and may require less insulin units

Answer 258

they have improved insulin sensitivity, will require less insulin

Answer 259

increases renal clearance, requiring more insulin than baseline

Answer 260

insulin can potentiate effects of antidiuretic hormone

Answer 261

Excessive production of glucose by the liver

Answer 262

rapid intestinal glucose dumping

Answer 263

Insufficient production of endogenous insulin

Answer 264

Decreased tissue insensitivity to insulin

Answer 265

20yo female who had ambulatory surgery 3 days ago

Answer 266

11yo male with HTN

Answer 267

9yo female HTN and HF

Answer 268

18yo male who is currently taking a sulfonylurea

Answer 269

a piece of hard candy held between the cheek

Answer 270

sugar packets

Answer 271

Thiazolidinediones

Answer 272

Alpha-Glucosidase Inhibitors

Answer 273

Biguanides

Answer 274

Dipeptidyl Peptidase-4

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advanced Pharm study guide for test 2

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