PTCB Pharmacology #2 — Questions and Answers

Question 1: AcipHex contains which proton-pump inhibitor as the active ingredient?

Pantoprazole
Lansoprazole
Rabeprazole (Correct answer)
Omeprazole

Correct answer: Rabeprazole

AcipHex is the brand name for the proton-pump inhibitor rabeprazole. Rabeprazole, like other PPIs, works by reducing the production of stomach acid. It is commonly prescribed to treat conditions such as gastroesophageal reflux disease (GERD) and peptic ulcers.

Question 2: Which of these pharmacokinetic stages is the 'first pass effect'?

Distribution
Metabolism (Correct answer)
Excretion
Absorption

Correct answer: Metabolism

The 'first-pass effect' is a phenomenon of drug metabolism whereby the concentration of a drug is significantly reduced before it reaches the systemic circulation. This typically occurs when a drug is absorbed from the gastrointestinal tract and enters the portal circulation, where it is extensively metabolized by the liver before entering the general bloodstream. Therefore, it is a key aspect of drug metabolism.

Question 3: Which ailment is treated with drugs that inhibit the PDE5 enzyme?

Psoriasis
Erectile dysfunction (Correct answer)
Angina
Asthma / COPD

Correct answer: Erectile dysfunction

Drugs that inhibit the PDE5 enzyme, such as sildenafil (Viagra) and tadalafil (Cialis), are primarily used to treat erectile dysfunction (ED). By blocking phosphodiesterase-5, these medications increase the levels of cyclic guanosine monophosphate (cGMP) in the smooth muscle cells of the penis. This leads to relaxation of these muscles and increased blood flow, facilitating an erection.

Question 4: Which of these medicine classes has been linked to a chronic, dry cough?

5-alpha reductase inhibitors
ACE inhibitors (Correct answer)
Nitrates
Bisphosphonates

Correct answer: ACE inhibitors

Angiotensin-converting enzyme (ACE) inhibitors are a class of medications commonly used to treat high blood pressure and heart failure. A well-known side effect of ACE inhibitors is a persistent, dry cough, which occurs in a significant percentage of patients. This cough is thought to be caused by the accumulation of bradykinin, a substance that ACE inhibitors prevent from being broken down, leading to irritation in the airways.

Question 5: Which of these medications can cause bronchospasm in asthmatics?

SSRIs
Statins
Beta-blockers (Correct answer)
Beta-2 agonists

Correct answer: Beta-blockers

Beta-blockers, especially non-selective ones, can cause bronchospasm in individuals with asthma. These drugs block beta-2 adrenergic receptors, which are found in the smooth muscles of the bronchioles in the lungs. Blocking these receptors can lead to bronchoconstriction, narrowing the airways and exacerbating asthma symptoms.

Question 6: The medicine, Imitrex, is used in the treatment of which condition?

Migraine (Correct answer)
Urinary tract infection
Gout
Acne

Correct answer: Migraine

Imitrex (sumatriptan) is a well-known medication specifically designed to treat migraines. It belongs to a class of drugs called triptans, which work by constricting blood vessels in the brain and blocking pain pathways. This action helps alleviate the severe headache, nausea, and light sensitivity associated with migraine attacks, making it a targeted therapy for this neurological condition.

Question 7: Which area of the body receives drugs supplied via the intrathecal route?

Joint space
Inside of the cheek
Bladder
Spine (Correct answer)

Correct answer: Spine

The intrathecal route of administration involves injecting a drug directly into the spinal canal, specifically into the subarachnoid space surrounding the spinal cord. This method allows medication to bypass the blood-brain barrier and act directly on the central nervous system. It is commonly used for conditions requiring localized drug delivery to the spinal cord or brain, such as certain pain management therapies or chemotherapy.

Question 8: What is the daily limit for purchasing pseudoephedrine?

9 grams
3.6 grams (Correct answer)
5.4 grams
7.2 grams

Correct answer: 3.6 grams

Federal law, specifically the Combat Methamphetamine Epidemic Act of 2005, sets daily and monthly limits on the sale of pseudoephedrine (PSE) and other methamphetamine precursors. The daily limit for an individual purchasing PSE is 3.6 grams. These regulations aim to prevent the diversion of these over-the-counter medications for the illicit production of methamphetamine.

Question 9: A MAO inhibitor is which of the following drugs?

Levodopa
Selegiline (Correct answer)
Theophylline
Entacapone

Correct answer: Selegiline

Selegiline is a selective monoamine oxidase B (MAO-B) inhibitor, primarily used in the treatment of Parkinson's disease and major depressive disorder. It works by blocking the breakdown of dopamine in the brain, thereby increasing its levels and improving motor function or mood. MAO inhibitors are a class of drugs that prevent the action of monoamine oxidase enzymes.

Question 10: If a patient is on which of the following medications, a thyroid-stimulating hormone (TSH) test should be done on a regular basis?

Montelukast
Propranolol
Furosemid
Levothyroxine (Correct answer)

Correct answer: Levothyroxine

Levothyroxine is a synthetic thyroid hormone prescribed to treat hypothyroidism, a condition where the thyroid gland does not produce enough thyroid hormone. Regular thyroid-stimulating hormone (TSH) tests are crucial for patients on levothyroxine to monitor the effectiveness of the treatment. TSH levels indicate whether the thyroid hormone replacement is adequate, ensuring the dosage is appropriate and preventing both under- and overtreatment.

Question 11: A rapid-acting insulin is which of the following medications?

Insulin detemir (Levemir)
Regular Insulin (Humulin)
Insulin lispro ( Humalog) (Correct answer)
Insulin glargine ( Lantus)

Correct answer: Insulin lispro ( Humalog)

Insulin lispro, marketed as Humalog, is classified as a rapid-acting insulin. It has a quick onset of action, typically within 15-30 minutes, and a shorter duration compared to other insulin types. This characteristic makes it ideal for administration just before or with meals to effectively control post-meal blood sugar spikes, mimicking the body's natural insulin response to food.

Question 12: Rx: Tussionex # 12 oz. Sig: ii tsp qd prn for cough 6d. How long will this medication last?

6 days (Correct answer)
12 days
10 days
7 days

Correct answer: 6 days

The prescription states 'ii tsp qd prn for cough 6d'. 'ii tsp' means 2 teaspoons, and 'qd' means once daily. The 'prn for cough 6d' indicates that the medication is to be taken as needed for cough for a duration of 6 days. Therefore, the medication is intended to last for 6 days, assuming the patient takes it daily as prescribed for the specified duration.

Question 13: How many milligrams of Vancomycin are there in 1.25 g of IV solution per 250 mL?

1000 mg
1250 mg (Correct answer)
1200 mg

Correct answer: 1250 mg

To convert grams to milligrams, you multiply the gram value by 1000, as there are 1000 milligrams in 1 gram. Therefore, 1.25 grams of Vancomycin is equal to 1.25 multiplied by 1000 mg, which results in 1250 mg. The volume of the IV solution (250 mL) is extraneous information for this specific unit conversion.

Question 14: As a ratio strength, write 2g of active ingredient in 250 ml of solution.

2:250
1:125 (Correct answer)
1:800

Correct answer: 1:125

A ratio strength expresses the amount of active ingredient relative to the total amount of solution, typically in the same units. Given 2g of active ingredient in 250 ml of solution, the initial ratio is 2:250. To simplify this ratio to its lowest terms, divide both sides by the greatest common divisor, which is 2, resulting in a ratio strength of 1:125.

Question 15: To make 4L of a 1:2000 w/v solution, how much (1:400 w/v) stock solution should be used?

2000 ml
800 ml (Correct answer)
400 ml

Correct answer: 800 ml

This problem requires a dilution calculation using the formula C1V1 = C2V2, where C represents concentration and V represents volume. We want to make 4L (4000 ml) of a 1:2000 solution from a 1:400 stock solution. Plugging in the values: (1/400) * V1 = (1/2000) * 4000 ml. Solving for V1, we get V1 = (4000/2000) * 400 = 2 * 400 = 800 ml. Therefore, 800 ml of the 1:400 w/v stock solution should be used.

Question 16: A doctor orders tetracycline suspension for a patient to take 2 teaspoonfuls four times a day for four days, then 1 teaspoonful four times a day for two days. How many milliliters of the suspension should be delivered to meet the dosing regimen's requirements?

40 ml
200 ml (Correct answer)
160 ml

Correct answer: 200 ml

First, calculate the volume for the first four days: 2 teaspoonfuls (tsp) is 10 mL (since 1 tsp = 5 mL). Taking this four times a day means 40 mL/day. Over four days, this is 40 mL/day * 4 days = 160 mL. Next, calculate the volume for the subsequent two days: 1 teaspoonful is 5 mL, taken four times a day, totaling 20 mL/day. Over two days, this is 20 mL/day * 2 days = 40 mL. Adding these amounts together (160 mL + 40 mL) gives a total of 200 mL needed.

PTCB Pharmacology #2

AcipHex contains which proton-pump inhibitor as the active ingredient?