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Pharmocology for PT
Review for pharmo final exam
Terms in this set (139)
What is the function of the Thyroid Gland?
It synthesizes two primary horomones: thyroxine and triiodothyronine.
What regulates the production of thyroid horomones?
The hypothalamic-pituitary system
How does the hypothalamic-pituitary system control the production of thyroid horomones?
The hypothalamus releases thyrotropin-releasing horomone(TRH) which stimulates the anterior pituitary gland to release thyroid-stimulating horomone(TSH) that travels via systemic circulation to stimulate production of thyroxine and triiodothyronine.
What are the physiological effects of thyroid horomones?
Thermogenesis, growth & development, cardiovascular effects, and metabolic effects.
How many categories of thyroid disorders are there?
2 primary categories: hyperthyroidism and hypothyroidism
What are drugs that directly inhibit thyroid horomone synthesis?
Diuretics ____ the excretion of water by ____ the sodium reabsorption at the kidneys
Patients who overdose on diuretics
may become hypnatremic, hypokalemic and may lose too much fluid from the vascular system
Beta blockers are cardio selective if they bind preferentially to
beta 1 receptors
A sudden severe life-threatening drop in blood pressure (autonomic crisis) should be treated with
Nitric oxide can be used to reduce vascular resistance and to decrease arterial pressure in specific hypertensive syndromes because it...
directly inhibits the contraction of vascular smooth muscle
Angiotensin converting enzyme (ACE) can help ___ blood pressure by ____the formation of angiotensin II
Systemic heat (Hubbard tank) should be avoided in patients taking ___ drugs because the combo of these two interventions will cause excessive hypotension
Calcium channel blockers can help reduce high blood pressure by
inhibiting vascular smooth muscle contraction
When standing up suddenly patients taking antihypertensive meds my be more susceptible to a sudden ___ in blood pressure: commonly known as ...
decrease; orthostatic hypotension
Nitrates such as nitroglycerin exert their primary beneficial effects in patients with angina pectoris because these drugs ___ myocardial oxygen demand by vasodilating the ___
decrease: peripheral vasculature
Nitroglycerin patches are typically used intermittently to prevent
Beta blockers help prevent angina pectoris in certain patients because these drugs
decrease myocardial oxygen demand
Angina pectoris can be permanently resolved (cured) in most patients after short term (2 wks) use of...
None of the above: antianginal drugs do not cure this disease they only treat symptoms of myocardial ischemia
Which of the following drug categories is NOT used to treat cardiac arrhythmias
chloride channel blockers (there is no such thing)
Beta blockers are effective in treating certain cardiac arrhythmias because they ___ the excitatory effects of ___ on the heart
decrease;catecholamines (epinephrine and norepinephrine)
Depending on the dose and route of administration, lidocaine (Xylocaine) and similar drugs can be used as local anesthetics or cardiac antirrhythmic drugs because they affect the excitability of ___ ion channels
Cardiac glycosides such as digitalis are used to treat heart failure because these drugs exert:
positive inotropic effect
All of the following types of drugs will decrease cardiac workload in people with heart failure except
Alpha-1 stimulants (there is no such thing)
In people with heart failure, the best drugs for reducing fluid accumulation and congestion in the lungs and peripheral tissues are
Oral anticoagulants such as warfarin (Coumadin) decrease the production of several clotting factors in the liver by interfering with the regeneration of
Because of its ability to inhibit platelet activity, aspirin is used to prevent:
(A & B) myocardial infarction and ischemic stroke
Drugs that decrease the viscosity of respiratory secretions are known as ____, whereas drugs that facilitate the production and ejection of mucus are known as ___
Which of the following drugs will promote bronchodilation
Xanthine derivatives such as theophyllines
To minimize muscle wasting, bone loss, and other side effects associated with anti-inflammatory steroids (glucocorticoids) its preferred that these drugs be administered ____ to control airway inflammation in asthma and chronic obstructive pulmonary disease (COPD)
Drugs that inhibit the production or effects of Leukotrienes are helpful in treating bronchospastic disease because
a) leukotrienes are especially important in mediating the airway inflammation that underlies bronchoconstrictive disease b) these drugs can be combined with other drugs (glucocorticoids and beta agonists) to provide optimal management in specific patients with asthma and COPD c) these drugs are generally safe and well tolerated d) ALL THE ABOVE
Certain drugs are not able to pass from blood stream into CNS capillaries known as:
blood brain barrier
Drugs used to relax the patient and promote sleep are:
Benzodiazephines such as diazepam (valium) act by increasing inhibitory effects of neurotransmitter:
Hang over effect and other residual symptoms that occur the morning after a person has taken a sedative hypnotic can often be resolved by:
a)lowering the dose of sedative-hypnotic b) switching to a drug that has a shorter half-life c) switching to a newer agent (zolpidem, zaleplon) which tends to have milder side residual effects d) ALL OF THE ABOVE e)none of the above
When certain sedatives are suddenly discontinued, sleep disturbances may increase this situation commonly known as:
When used to treat anxiety disorders, buspirone (BuSpar) acts by increasing the effects of _____ in certain areas of the brain, whereas traditional antianxiety drugs, such as diazepam (Valium), increase the inhibitory effects of _______ in the central nervous system:
Upon reaching the brain most antidepressant drugs affect:
Amine neurotransmitters such as norepinephrine and serotonin
Tricyclic antidepressant effects, tricyclic antidepressants such as amitriptyline (Elavil, others) and nortriptyline (Aventyl, Pamelor) may be used in treating:
Chronic pain syndromes
The cornerstone of drug treatment for bipolar disorder (manic-depression) consists of:
Pts who begin antidepressant drug therapy often experience a delay of at least _______ before they notice a decrease in depression:
Newer or "atypical" antipsychotics are often preferred because:
they have a reduced risk of causing motor side effects
Antipsychotics are often used in Alzheimer disease or other causes of dementia:
to keep control of aggression and agitation
Tardive dyskinesia is often the most feared motor side effect of antipsychotic drugs because:
it may be irreversible
Barbituates are considered to be very safe and effective in the treatment of seizures, but the use is often limited because of their strong tendency to produce:
Benzodiazepines such as clonazepam are effective in controlling certain seizures because they increase inhibitory effects of ________ in CNS:
Gamma amino-butyric acid (GABA)
Newer or "second gen." anti-seizure drugs are helpful in Tx certain patients because:
a)newer agents generally have milder side effects that traditional antiseizure drugs b)newer agents have favorable pharmocokinetic characteristics(absorption, distribution, metabolism and so forth) c) newer agents can be combined with a traditional antseizure drug to provide adequate seizure control in pts who dont respond to a single antiseizure agent d)ALL OF THE ABOVE e) none of the above
It appears anti-seizure meds can be successfully discontinued in a large percentage of patients:
a) have been free of seizures for at least 2 yrs while on meds b) have a normal neurological exam prior to withdrawl c) were relatively young when the seizures started d)ALL OF THE ABOVE e)none of the above, antiseizure drugs can never be discontinued under any circumstances
Parkinson's disease typically occurs because of the slow, progressive degeneration of specific _______-secreting neurons in the ______________.
Dopamine; basal ganglia
Levodopa administration can help resolve the symptoms of Parkinson disease, but this drug can also cause:
a) Gastrointestinal problems, b) cardiac arrhythmias c)postural hypotension d) dyskinesias e)ALL OF THE ABOVE
The use of specific drugs to prevent, treat, or diagnose a disease is known as
The study of how the body deals with a drug in terms of the way the drug is absorbed, distributed, and eliminated is known as
The generic name of a drug is also known as:
Official, nonproprietary, tends to be somewhat shorter, and often derived from the chemical name (all of the above)
If there is no existing patent for a drug, or if the patent has expired, the same drug may be marketed by separate drug companies under different:
The generic form of a drug is considered as safe and effective as the original, brand name product if the generic form___________ as the brand-name drug.
underwent testing to establish it has the same type and amount of active ingredient, same administration route, same pharmacokinetic profile, and the same therapeutic effects
During drug trying and approval, the drug is usually tested in a relatively small sample (200-300 people) with specific disease or pathologic condition during?
Phase 2 clinical trials
Drugs that can be purchased directly by the consumer without a prescription are also known as:
Over the counter drugs
The point at which there is no further increase in response to a drug even if the dosage continues to be increased is known as the drugs:
Ceiling effect and max efficacy (A & B)
When two drugs are compared, the drug that requires a lower does to produce the same effect as a higher dose of the second drug is said to
Be more potent
When evaluating drug safety, the dose that causes 50% of subjects to exhibit a specific adverse effect is known as the
Median Toxic Dose
All of the following are parental routes of drug administration routes of drug administration except the _________ route.
(Parental = all methods of drug administration that DO NOT use the gastrointestinal tract)
Lontophoresis, phonophoresis, and medicated patches all use the __________ route to administer drugs.
This first-pass effect is of particular concern when drugs are administered
The extent to which a drug reaches the systemic circulation is referred to as
The primary site for drug storage in the body is
Drug metabolism occurring when a drug is changed chemically following administration is also known as
Biotransformation usually results in an altered version of the original compound known as
The primary location for drug metabolism (biotransformation) is the:
Prolonged administration of therapeutic drugs and other substances (alcohol & nicotine) may enhance the liver's ability to metabolize certain drugs, thus decreasing their therapeutic effect. This process is:
Drugs and their metabolites are excreted from the body primarily by
The amount of time required for 50% of the remaining drug to be eliminated from the body is known as:
Primary location for receptors that recognize drug and endogenous compounds
Acetylcholine receptors located on the postsynaptic membrane of the skeletal neuromuscular junction is an example of a membrane receptor that:
Functions as an ion channel or pore
Drugs that binds to receptor and directly initiates a change in the function of the cell is refered to as:
Drugs can alter CNS neurotransmission by affecting neurotransmitter:
synthesis, release, reuptake, degredation
The source of the naturally occurring opioid analgesics is
Drugs such as butotphanol (stadol), nalbuphine (nubain), and pentazocine (talwin) may stimulate certain opioid receptors while blocking or only partially activating others. These drugs
a) may produce adequate analgesia with less risk of side effects such as respiratory depression. B) may have fewer addictive qualities than strong opioids such as morphine c) may produce more psychotropic effects (hallucinations, vivid dreams) than other opioids d) are known as mixed agonist-antagonists
Opioid drugs exert their effects on afferent pain pathways by binding to neuronal receptors that in turn
(A & B) provide an analgesic effect, decrease the excitability of the afferent sensory neurons
When used to treat pain, opioids can be administered by all of the following routes except
(orally, rectally, injection, IV, infusion)
In addition to their use as analgesics, opioid drugs can be administered
a) as a pre-op medication b) as a general anesthetic c) as a cough suppressant d) to treat severe diarrhea e) ALL THE ABOVE
NSAIDs such as aspirin exhibit all of the following effects except
the ability to increase bronchodilation in conditions such as asthma
Aspirin and other NSAIDs exert their primary therapeutic by interfering with the biosynthesis of
NSAIDs exert their therapeutic effects by ___ the _____ enzyme
Which of the following conditions is not normally treated with aspirin or other NSAIDs
In addition to its analgesic and anti-inflammatory effects it appears that regular use of low dose aspirin may also help prevent:
a) heart attack b) ischemic strokes c) colorectal cancer d) ALL THE ABOVE
The most common problem associated with NSAIDs such as aspirin is:
In theory, a COX 2 selective drug such as celecoxb (Celebrex) will be less likely to cause gastric irritation because:
COX 2 drugs do not inhibit the production of beneficial prostaglandins in the stomach
Aspirin and acetaminophen are different because
acetaminophen does not have anti-inflammatory effects
By producing analgesic and anti-inflammatory effects, ____ is/are usually considered the first line of defense in treating RA
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Anti-inflammatory steroids (glucocorticoids) are often effective in controlling inflammation in RA but prolonged use of large systemic doses can cause
a) osteoporosis b) muscle wasting c) hypertension d) Diabetes Mellitus e) ALL THE ABOVE
Early and aggressive use of ____ can slow the progression of RA in many patients before there is extensive damage to affected joints
Disease modifying Antirheumatic drugs
All of the following drugs are considered "disease modifying" Antirheumatic drugs except:
NSAIDs such as aspirin
Because they may supply key ingredients needed for the production of articular cartilage and synovial fluid, some patients with osteoarthritis use dietary supplements such as
glucosamine and chondroitin
Intrathecal administration of baclofen typically refers to drug delivery into
Botulinum toxin is used to treat spasticity by injecting this drug
directly into spastic muscle
Proton pump inhibitors such as omeprazole (Prilosec) and esomeprazole (Nexium) are useful in reducing gastric acid secretion because they
inhibit the enzyme that secretes acid from gastric parietal cells into the lumen of the stomach
In many patients with gastric ulcers, antibacterial drugs are often combined with proton pump inhibitors to help eliminate _____ infection as a potentiating factor in ulcer formation
Natural and synthetic opioid drugs _____ gastrointestinal motility and therefore useful in treating ____
Tendon pain and inflammation (tendopathy) which can be severe and ultimately lead to tendon rupture, may be caused by
fluoroguinolones such as ofloxacin (floxin)
Rehabilitation interventions that use UV irradiation (UV lights) should be used cautiously in people taking antibacterial drugs because antibacterial drugs may cause
The steroids released from the adrenal cortex include
glucocorticosteroids and mineralicorticocoids
Glucocorticoids have pharmacologic effects that increase
carbohydrate metabolism, antiinflammatory and antiallergenic properties
Glucocorticoids have pharmacologic effects that inhibit
Glucocorticoids have pharmacologic effects that decrease
growth and resistance to infection
Glucocorticoids are used for
anti-inflammatory, antiallergenic, autoimmune, erosive lichen planus, pemphigus, pemphigoid
Mineralocorticoids control fluid and electrolyte imbalance by ___ sodium retention and ___ potassium loss
The two main side effects of mineralocoticoids are edema and hypertension, due to these drugs increasing ____
sodium and water retention
Glucocorticoids and Mineralocorticoids are the two principal groups of
Glucocorticoids are used to evaluate and treat
Glucocorticoids help restore normal function in conditions of
adrenal cortical hypofunction
Exogenous glucocorticoids, like ___ help to resolve the symptoms of non-endocrine problems by supressing ___
___ disease is a primary insufficiency of glucocorticoids because ___ is causing a lack in production
Addison disease, the adrenal cortex
Secondary insufficiency is diminished adrenal cortex function that is caused by things like ___
insufficient release of ACTH from the anterior pituitary
Glucocorticoids and mineralocorticoids may be used as ___ after adrenal cortical hypersecretion is resolved through an adrenalectomy or destruction of the pituitary. This is seen with ___ syndrome.
Replacement therapy, Cushing
What effects do glucocorticoids have that cause them to be prescribed for anti-inflammation or as an immunosupressor?
They treat the symptom of inflammation, but are not a cure for non-endocrine conditions.
For P.T. Treatments, therapists need to know about long-term glucocorticoid usage because this can cause applicable side effects such as breakdown of ___ ___
supporting tissues (wasting of bone, muscles, tendons, ligaments and skin....very fragile pt.'s)
Mineralocorticoids are steroid horomones produced by the adrenal cortex. What is the principal mineralocorticoid in the human body?
Aldosterone maintains ___ and ___ balance in the body
mineralocorticoids have two phases of effects: ___ and ___
rapid phase and delayed but prolonged phase
What are the 4 main side effects of mineralocorticoids agonists?
Hypertension, peripheral edema, weight gain, hypokalemia
Mineralocorticoids agonists are primarily used as ___ to treat HTN and heart failure, but may threaten life because they are classified as potassium-sparingwhich could cause ___
There are two types of mineralocorticoid agonists: ___ and ___. Which one affects sex horomones?
spironolactone(aldactone) and eplerenone(inspra), spironolactone
biphosphonates are one of the primary treatments for osteoperosis because is reduces bone resorption by__
being absorbed into calcium crystals to inhibit osteoclast activity
___ replaces normal pancreatic hormone production and is crucial in maintaining normal glucose levels & proper metabolic function due to absent beta cell function in pt.s with IDDM
Without exogenous insulin, the health of pt. is severely compromised resulting in ___
neurovascular & meteabolic derangements.
Pt. s w/ ___ require supplemental insulin because other interventions don't work (exercise/diet. other drugs)
type 2 diabetes (NIDDM)
Insulin used to be derived from ___ but it differs from human insulin by ___
animal sources (beef & pork), differing amino acids
Human insulin takes effect ___ than endogenous insulin released from pancreatic beta cells
True or False: Insulin is suitable for oral administration
Insulin is administered via ___ and___ in emergency situations
subcutaneous injection, intravenously
Intensive insulin therapy can be associated w/ a somewhat greater risk of ___ if insulin dosage does not match the pt.s needs throughout day
What is the primary problem associated w/ insulin administration?
If you know a pt. has missed a meal and/or you are having them perform strenuous activity, you need to be watching for the signs of ___
What are the signs and symptoms of Hypoglycemia?
What should you do if you notice symptoms like headache/ fatigue/ hunger/ tachycardia/ sweating/ anxiety /confusion in your diabetic pt?
ingest food containing glucose (soft drinks/fruit juice/glucose tablets)
What is the oldest & largest group of oral antidiabetic drugs?
sulfonylureas(act directly on beta cells to release insulin)
___ is used to treat hypoglycemia induced by insulin or other agents by mobilizing the release of glucose from hepatic glycogen stores
Glucagon is administered via ___, ___, ___
Other drugs used to manage diabetes include, ___, ___, ___, and non-pharmacoloic interventions of ___, ___, ___
Glucagon-like peptide 1, Immunosupressants, Aldose reductase inhibitors and diet/weight, exercise, tissue transplants/gene thrapy
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