Question 1

Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the:

Accepted Answer

A)  Symptoms are severe 
B)  Patient has not responded to other therapies 
C)  Patient has concurrent hypertension 
D)  Left ventricular dysfunction is diagnosed 
A)  Symptoms are severe 
B)  Patient has not responded to other therapies 
C)  Patient has concurrent hypertension 
D)  Left ventricular dysfunction is diagnosed

Question 2

You are treating a patient with a diagnosis of Alzheimer's disease. The patient's wife mentions difficulty with transportation to the clinic. Which medication is the best choice?

Accepted Answer

A)  Donepezil 
B)  Tacrine 
C)  Doxazosin 
D)  Verapamil 
A)  Donepezil 
B)  Tacrine 
C)  Doxazosin 
D)  Verapamil

Question 3

Adherence is improved when a drug can be given once daily. Which of the following drugs can be given once daily?

Accepted Answer

A)  Tacrine 
B)  Donepezil 
C)  Memantine 
D)  Pyridostigmine 
A)  Tacrine 
B)  Donepezil 
C)  Memantine 
D)  Pyridostigmine

Question 4

Taking which drug with food maximizes it bioavailability?

Accepted Answer

A)  Donepezil 
B)  Galantamine 
C)  Rivastigmine 
D)  Memantine 
A)  Donepezil 
B)  Galantamine 
C)  Rivastigmine 
D)  Memantine

Question 5

Bethanechol:

Accepted Answer

A)  Increases detrusor muscle tone to empty the bladder 
B)  Decreases gastric acid secretion to treat peptic ulcer disease 
C)  Stimulates voluntary muscle tone to improve strength 
D)  Reduces bronchial airway constriction to treat asthma 
A)  Increases detrusor muscle tone to empty the bladder 
B)  Decreases gastric acid secretion to treat peptic ulcer disease 
C)  Stimulates voluntary muscle tone to improve strength 
D)  Reduces bronchial airway constriction to treat asthma

Question 6

Nicotine replacement therapy (NRT):

Accepted Answer

A)  Is widely distributed in the body only when the gum products are used 
B)  Does not cross the placenta and so is safe for pregnant women 
C)  Delays healing of esophagitis and peptic ulcers 
D)  Has no drug interactions when a transdermal patch is used 
A)  Is widely distributed in the body only when the gum products are used 
B)  Does not cross the placenta and so is safe for pregnant women 
C)  Delays healing of esophagitis and peptic ulcers 
D)  Has no drug interactions when a transdermal patch is used

Question 7

Patients who need to remain alert are taught to avoid which drug due to its antimuscarinic effects?

Accepted Answer

A)  Levothyroxine 
B)  Prilosec 
C)  Dulcolax 
D)  Diphenhydramine 
A)  Levothyroxine 
B)  Prilosec 
C)  Dulcolax 
D)  Diphenhydramine

Question 8

There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include:

Accepted Answer

A)  Dizziness and headache 
B)  Nausea 
C)  Decreased salivation 
D)  Fasciculations of voluntary muscles 
A)  Dizziness and headache 
B)  Nausea 
C)  Decreased salivation 
D)  Fasciculations of voluntary muscles

Question 9

Beta blockers are the drugs of choice for exertional angina because they:

Accepted Answer

A)  Improve myocardial oxygen supply by vasodilating the coronary arteries 
B)  Decrease myocardial oxygen demand by decreasing heart rate and vascular resistance 
C)  Both 1 and 2 
D)  Neither 1 nor 2 
A)  Improve myocardial oxygen supply by vasodilating the coronary arteries 
B)  Decrease myocardial oxygen demand by decreasing heart rate and vascular resistance 
C)  Both 1 and 2 
D)  Neither 1 nor 2

Question 10

Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic?

Accepted Answer

A)  Donepezil 
B)  Memantine 
C)  Rivastigmine 
D)  Galantamine 
A)  Donepezil 
B)  Memantine 
C)  Rivastigmine 
D)  Galantamine

Question 11

Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of the following drug classes?

Accepted Answer

A)  Histamine 2 blockers 
B)  Quinolones 
C)  Serotonin re-uptake inhibitors 
D)  All of the above 
A)  Histamine 2 blockers 
B)  Quinolones 
C)  Serotonin re-uptake inhibitors 
D)  All of the above

Question 12

Which of the following adverse effects are less likely in a beta1-selective blocker?

Accepted Answer

A)  Dysrhythmias 
B)  Impaired insulin release 
C)  Reflex orthostatic changes 
D)  Decreased triglycerides and cholesterol 
A)  Dysrhythmias 
B)  Impaired insulin release 
C)  Reflex orthostatic changes 
D)  Decreased triglycerides and cholesterol

Question 13

Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?

Accepted Answer

A)  Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action. 
B)  Additive antimuscarinic effects may occur with antihistamines. 
C)  Cholinergic blockers may decrease the sedative effects of hypnotics. 
D)  Cholinergic blockers are contraindicated with antipsychotics. 
A)  Drugs with a narrow therapeutic range given orally may not stay in the GI tract long enough to produce an action. 
B)  Additive antimuscarinic effects may occur with antihistamines. 
C)  Cholinergic blockers may decrease the sedative effects of hypnotics. 
D)  Cholinergic blockers are contraindicated with antipsychotics.

Question 14

Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to:

Accepted Answer

A)  Apply the transdermal disk at least 4 hours before the antiemetic effect is desired. 
B)  Swallow the tablet 1 hour before traveling where motion sickness is possible. 
C)  Place the tablet under the tongue and allow it to dissolve. 
D)  Change the transdermal disk daily for maximal effect. 
A)  Apply the transdermal disk at least 4 hours before the antiemetic effect is desired. 
B)  Swallow the tablet 1 hour before traveling where motion sickness is possible. 
C)  Place the tablet under the tongue and allow it to dissolve. 
D)  Change the transdermal disk daily for maximal effect.

Question 15

Clinical dosing of Bethanechol:

Accepted Answer

A)  Begins at the highest effective dose to obtain a rapid response 
B)  Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is achieved 
C)  Requires dosing only once daily 
D)  Is the same for both the oral and parenteral route 
A)  Begins at the highest effective dose to obtain a rapid response 
B)  Starts at 5 mg to 10 mg PO and is repeated every hour until a satisfactory clinical response is achieved 
C)  Requires dosing only once daily 
D)  Is the same for both the oral and parenteral route

Question 16

To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should do all of the following EXCEPT:

Accepted Answer

A)  Take the dose at bedtime 
B)  Sit up slowly and dangle their feet before standing 
C)  Monitor their blood pressure and skip a dose if the pressure is less than 120/80 
D)  Weigh daily and report weight gain of greater than 2 pounds in one day 
A)  Take the dose at bedtime 
B)  Sit up slowly and dangle their feet before standing 
C)  Monitor their blood pressure and skip a dose if the pressure is less than 120/80 
D)  Weigh daily and report weight gain of greater than 2 pounds in one day

Question 17

Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?

Accepted Answer

A)  Extend the dosage interval. 
B)  Decrease the dose by 75%. 
C)  Take no action because this value is expected in the older adult. 
D)  Schedule a serum creatinine level to validate the CrCl value. 
A)  Extend the dosage interval. 
B)  Decrease the dose by 75%. 
C)  Take no action because this value is expected in the older adult. 
D)  Schedule a serum creatinine level to validate the CrCl value.

Exam 14: Drugs Affecting the Autonomic Nervous System

Beta blockers have favorable effects on survival and disease progression in heart failure. Treatment should be initiated when the:

You are treating a patient with a diagnosis of Alzheimer's disease. The patient's wife mentions difficulty with transportation to the clinic. Which medication is the best choice?

Adherence is improved when a drug can be given once daily. Which of the following drugs can be given once daily?

Taking which drug with food maximizes it bioavailability?

Bethanechol:

Nicotine replacement therapy (NRT):

Patients who need to remain alert are taught to avoid which drug due to its antimuscarinic effects?

There is a narrow margin between first appearance of adverse reaction to AChE inhibitors and serious toxic effects. Adverse reactions that require immediate action include:

Beta blockers are the drugs of choice for exertional angina because they:

Which of the following drugs used to treat Alzheimer's disease is not an anticholinergic?

Carvedilol is heavily metabolized by CYP2D6 and 2C9, resulting in drug interactions with which of the following drug classes?

Which of the following adverse effects are less likely in a beta1-selective blocker?

Several classes of drugs have interactions with cholinergic blockers. Which of the following is true about these interactions?

Scopolamine can be used to prevent the nausea and vomiting associated with motion sickness. The patient is taught to:

Clinical dosing of Bethanechol:

To reduce potential adverse effects, patients taking a peripherally acting alpha1 antagonist should do all of the following EXCEPT:

Richard is 70 years old and has a history of cardiac dysrhythmias. He has been prescribed nadolol. You do his annual laboratory work and find a CrCl of 25 ml/min. What action should you take related to his nadolol?

The Role of the Nurse Practitioner

Review of Basic Principles of Pharmacology

Rational Drug Selection

Legal and Professional Issues in Prescribing

Adverse Drug Reactions

Factors That Foster Positive Outcomes

Cultural and Ethnic Influences in Pharmacotherapeutics

An Introduction to Pharmacogenomics

Nutrition and Nutraceuticals

Herbal Therapy and Nutritional Supplements

Information Technology and Pharmacotherapeutics

Pharmacoeconomics

Over-The-Counter Medications

Drugs Affecting the Central Nervous System

Drugs Affecting the Cardiovascular and Renal Systems

Drugs Affecting the Respiratory System

Drugs Affecting the Hematopoietic System

Drugs Affecting the Immune System

Drugs Affecting the Gastrointestinal System

Drugs Affecting the Endocrine System

Drugs Affecting the Reproductive System

Drugs Affecting the Integumentary System

Drugs Used in Treating Infectious Diseases

Drugs Used in Treating Inflammatory Processes

Drugs Used in Treating Eye and Ear Disorders

Anemia

Chronic Stable Angina and Low-Risk Unstable Angina

Anxiety and Depression

Asthma and Chronic Obstructive Pulmonary Disease

Contraception

Dermatologic Conditions

Diabetes Mellitus

Gastroesophageal Reflux and Peptic Ulcer Disease

Headaches

Heart Failure

Human Immunodeficiency Virus Disease and Acquired Immunodeficiency Syndrome

Hormone Replacement Therapy and Osteoporosis

Hyperlipidemia

Hypertension

Hyperthyroidism and Hypothyroidism

Pneumonia

Smoking Cessation

Sexually Transmitted Infections and Vaginitis

Tuberculosis

Upper Respiratory Infections, Otitis Media, and Otitis Externa

Urinary Tract Infections

Women As Patients

Men As Patients

Children As Patients

Geriatric Patients

Pain Management: Acute and Chronic Pain

Filters

Which of the following adverse effects are less likely in a beta₁-selective blocker?

To reduce potential adverse effects, patients taking a peripherally acting alpha₁ antagonist should do all of the following EXCEPT: