Deck 11: Pharmacology

Question 1

All of the following are recommendations that you should make to patients with asthma EXCEPT one. Which one is the EXCEPTION?

A)Bring your inhaler (albuterol) to the dental appointment
B)Rinse after using corticosteroid inhaler
C)Avoid erythromycin
D)Avoid aspirin
E)Avoid acetaminophen

Answer 1

Avoid acetaminophen

Question 2

Which agent reduces serum cholesterol by increasing its use for bile acid synthesis?

A)Niacin
B)Atorvastatin
C)Gemfibrozil
D)Cholestyramine

Answer 2

Cholestyramine

Question 3

Histamine 1 (H1) blocking drugs such as cetirizine are preferred over drugs such as diphenhydramine because they are less sedating. Cetirizine is a nonsedating H1-blocking drug.

A)Both statements are TRUE
B)The first statement is TRUE; the second statement is FALSE
C)The first statement is FALSE; the second statement is TRUE
D)Both statements are FALSE

Answer 3

Both statements are TRUE

Question 4

Patients taking nitroglycerine (NTG) sublingual tablets should be instructed to:

A)Store their NTG in plastic
B)Keep their NTG in the refrigerator
C)Use NTG once every 5 minutes until the anginal attack has stopped
D)Bring their NTG to the dental appointment and make it available to the practitioner in the event that the patient experiences an acute anginal attack

Question 5

Eating a banana or drinking a glass of orange juice when taking a thiazide diuretic will:

A)Deplete calcium
B)Prevent diuresis
C)Replenish potassium
D)Inhibit the drug's metabolism

Question 6

Which of the following is the BEST recommendation you could make to your patient if he required oral prednisone (steroid therapy)?

A)Continue to rinse, swish, and spit after taking your oral tablet
B)Rinse, swish, and swallow after taking your oral tablet
C)Check for any signs of infection, since this medication can mask the signs of infection and can delay wound healing.
D)Be careful, since this drug can cause significant dry mouth

Question 7

Patients using the fluticasone-salmeterol inhaler should be instructed about all of the following EXCEPT one. Which one is the EXCEPTION?

A)Rinse, swish, and spit after each use of the inhaler
B)The inhaler must be discarded 1 month from the date of first use
C)It is a good idea to brush your teeth after each inhaler use
D)This inhaler can be used for acute attacks

Question 8

Though this teenager with asthma does not have emphysema, several of the drugs used to treat asthma are also used to treat emphysema. Which of the following drugs is the better choice for treating emphysema?

A)Albuterol
B)Zileuton
C)Ipratropium
D)Cetirizine

Question 9

Which one of the following drugs can result in oral candidiasis?

A)Cetirizine
B)Ibuprofen
C)Acetaminophen
D)Fluticasone

Question 10

All of the following drugs inhibit platelet function EXCEPT one. Which one is the EXCEPTION?

A)Clopidogrel
B)Dipyridamole
C)Ticlopidine
D)Aspirin

Question 11

Which of the following orally inhaled drugs should the patient bring with him to each appointment in case of an acute asthma attack?

A)Salmeterol
B)Albuterol
C)Flunisolide
D)Ipratropium bromide

Question 12

A myocardial infarction 9 months before an office visit would be considered a CONTRAINDICATION to dental treatment. After 9 months, if treatment is provided, the client should receive prophylactic antibiotic premedication.

A)Both statements are TRUE
B)The first statement is TRUE; the second statement is FALSE
C)The first statement is FALSE; the second statement is TRUE
D)Both statements are FALSE

Question 13

Patients taking doxycycline should be counseled about all of the following EXCEPT one. Which one is the EXCEPTION?

A)Esophageal irritation
B)Photosensitivity
C)Gastrointestinal upset
D)Sedation

Question 14

One of the main differences between angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers is that ACE inhibitors cause a dry, nonproductive cough. Angiotensin receptor blockers do not cause a dry, nonproductive cough.

A)Both statements are TRUE
B)The first statement is TRUE; the second statement is FALSE
C)The first statement is FALSE; the second statement is TRUE
D)Both statements are FALSE

Question 15

Clients taking antihypertensive agents who have been supine for some time should rise from that position slowly. They should dangle their legs over the side of the chair and wiggle them before rising to the standing position.

A)Both statements are true
B)Both statements are false
C)The first statement is true; the second is false
D)The first statement is false; the second is true

Question 16

Albuterol is a bronchodilator that can be administered via a metered dose inhaler. It is recommended for treating an acute asthma attack.

A)Both statements are TRUE
B)Both statements are FALSE
C)The first statement is TRUE; the second is FALSE
D)The first statement is FALSE; the second is TRUE

Question 17

Which of the following drugs could be causing the sore throat and dry mouth?

A)Albuterol
B)Montelukast
C)Multivitamins
D)Doxycycline

Question 18

What is meant by the term essential hypertension?

A)Hypertension of unknown cause
B)Iatrogenic hypertension
C)Hypertension precipitated by another disorder
D)Developing form of hypertension, requiring aggressive therapy

Question 19

Which class of drugs is recommended in persons with diabetes?

A)Beta adrenergic blockers
B)Ca channel blocker
C)Angiotensin-converting enzyme (ACE) inhibitors
D)Anticholinergic agents

Question 20

Which of the following drugs inhibits hydroxymethylglutaryl coenzyme A (HMG CoA) reductase?

A)Pravastatin
B)Ramipril
C)Nifedipine
D)Ezetimibe

Question 21

Both opioid and nonopioid analgesics relieve pain by raising the pain threshold. Raising the pain threshold increases one's reaction to pain.

A)Both statements are TRUE
B)The first statement is TRUE; the second statement is FALSE
C)The first statement is FALSE; the second statement is TRUE
D)Both statements are FALSE

Question 22

Which of the following is the major symptom of opioid overdose?

A)Miosis
B)Respiratory depression
C)Urticaria
D)Mydriasis

Question 23

For pain control, often an opioid analgesic is combined with a nonopioid analgesic. This combination produces an additive analgesic effect with fewer adverse reactions.

A)Both statements are TRUE
B)The first statement is TRUE; the second statement is FALSE
C)The first statement is FALSE; the second statement is TRUE
D)Both statements are FALSE

Question 24

Which of the following drugs should you avoid recommending to a person taking lithium?

A)Aspirin
B)Ibuprofen
C)Acetaminophen
D)Oxycodone

Question 25

Patients should be warned that an acute overdose with acetaminophen can result in damage to the:

A)Eyes
B)Liver
C)Spleen
D)Kidney

Question 26

(N₂O-O₂) is often combined with a halogenated inhalational anesthetic because it:

A)Increases the minimum alveolar concentration (MAC)
B)Decreases the MAC
C)Typically precipitates a toxic reaction
D)Inhibits the metabolism of the halogenated anesthetic

Question 27

Your patient complains of chest pain while sitting in the dental chair. Even though the information is not recorded on his health history or pharmacologic history form, it is a good idea for you to ask if he has taken sildenafil (Viagra) within the last 24 hours. The use of nitroglycerine is contraindicated if sildenafil has been taken within 24 hours because the nitroglycerine-sildenafil combination can precipitate a hypertensive crisis.

A)Both statements are TRUE
B)Both statements are FALSE
C)The first statement is TRUE; the second statement is FALSE
D)The first statement is FALSE; the second statement is TRUE

Question 28

Approximately 90% of dental pain is BEST managed with:

A)Codeine 60 mg
B)Ibuprofen 400 mg
C)Acetaminophen 650 mg
D)Aspirin 650 mg

Question 29

Antianxiety agents are most commonly administered as the oral dose form because the blood levels achieved from the oral administration of the antianxiety agent are very predictable.

A)Both statements are TRUE
B)Both statements are FALSE
C)The first statement is TRUE; the second statement is FALSE
D)The first statement is FALSE; the second statement is TRUE

Question 30

Once a benzodiazepine is absorbed into the systemic circulation, all of the following contribute to the rate at which it reaches its site of action EXCEPT one. Which one is the EXCEPTION?

A)Lipid solubility
B)Protein binding
C)Ionization
D)Client's gender

Question 31

Patients taking ibuprofen should be counseled about all of the following EXCEPT one. Which one is the EXCEPTION?:

A)Gastrointestinal upset
B)Heartburn
C)Sedation
D)Increased risk for bleeding

Question 32

Which of the following is an adverse reaction to codeine?

A)Diarrhea
B)Miosis
C)CNS excitation
D)Hepatotoxicity

Question 33

Which oral antidiabetic agent produces lactic acidosis as a significant adverse effect?

A)Tolbutamide
B)Metformin
C)Repaglinide
D)Acarbose

Question 34

Selective serotonin reuptake inhibitors (SSRIs) tend to produce central nervous system (CNS) stimulation rather than CNS depression. Therefore, SSRIs are less sedating.

A)Both statements are TRUE
B)The first statement is TRUE; the second statement is FALSE
C)The first statement is FALSE; the second statement is TRUE
D)Both statements are FALSE

Question 35

Conscious sedation with N₂O-O₂ is CONTRAINDICATED in a patient with:

A)Diabetes
B)Emotional instability
C)Hypertension
D)Glaucoma

Question 36

Which antidepressant is LEAST likely to cause xerostomia?

A)Bupropion
B)Citalopram
C)Chlorpromazine
D)Amitriptyline

Question 37

Alcohol consumption in combination with acetaminophen stimulates the breakdown of acetaminophen, thereby increasing the toxic potential of acetaminophen use.

A)Both statements are TRUE
B)Both statements are FALSE
C)The first statement is TRUE; the second statement is FALSE
D)The first statement is FALSE; the second statement is TRUE

Question 38

Following the dental procedure, the patient developed itching and urticaria after taking her acetaminophen with codeine. This response MOST likely represents:

A)A pharmacologic action of codeine
B)A hypersensitivity reaction to codeine
C)A placebo effect from receiving codeine
D)A reaction unrelated to codeine administration

Question 39

Patients taking glipizide should be instructed to:

A)Schedule their dental appointments after mealtimes and take their medicine on time
B)Schedule their dental appointments around the time they take their medicine
C)Schedule their dental appointments around mealtimes only
D)Schedule their dental appointment any time, as the timing of the appointment is not a significant factor

Question 40

The patient has begun to inhale nitrous oxide and oxygen (N₂O-O₂) as part of conscious sedation. The BEST way to determine her level of sedation under N₂O-O₂ is:

A)Response to a painful stimulus
B)Percent N₂O being delivered
C)Response to questions
D)Muscle tone

Question 41

The effects of which of the following antihypertensive medications are antagonized by nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen?

A)ACE inhibitors
B)alpha blockers
C)Calcium channel blockers
D)angiotensin receptor blocker

Question 42

A drug effect that is NEITHER predictable NOR dose related is called a:

A)Therapeutic effect
B)Toxic reaction
C)Side effect
D)Allergic reaction

Question 43

Alopecia may be an adverse effect of phenytoin. Carbamazepine can cause hirsutism.

A)Both statements are TRUE
B)Both statements are FALSE
C)The first statement is TRUE; the second statement is FALSE
D)The first statement is FALSE; the second statement is TRUE

Question 44

Prophylaxis for infective endocarditis with an anti-infective agent is indicated for patients who have had:

A)Coronary artery bypass surgery
B)Joint replacement
C)Functional murmur
D)Cardiac pacemaker

Question 45

Which drug should be used as an antibiotic premedication before invasive dental or dental hygiene care for a patient who has a history of congenital heart disease, artificial heart valves, and an allergy to penicillin?

A)Amoxicillin
B)Tetracycline
C)Clindamycin
D)Cephalexin

Question 46

Which organ is involved in the "first pass" effect after oral administration of a drug?

A)Kidney
B)Lungs
C)Liver
D)Spleen

Question 47

All of the following are true with regard to cytochromes P450 EXCEPT one. Which one is the EXCEPTION?

A)Cytochromes P450 are located in the endoplasmic reticulum
B)Cytochromes P450 exist as numerous isozymes
C)Cytochromes P450 are involved in the first-pass effect
D)Cytochromes P450 inactivate drugs through conjugation reactions

Question 48

Which anticonvulsant medication has been documented to cause osteomalacia?

A)Carbamazepine
B)Phenytoin
C)Ethosuximide
D)Gabapentin

Question 49

Which of the following drugs can result in a severe drug interaction with alcohol?

A)Erythromycin
B)Tetracycline
C)Metronidazole
D)Aminoglycosides (e.g., streptomycin)

Question 50

The distribution of a drug across biologic membranes is determined by all of the following EXCEPT one. Which one is the EXCEPTION?

A)Blood flow to the organ
B)Presence of certain barriers
C)Plasma-protein binding capacity
D)Half-life