Assignment:
Choose the best answer+short reason
1. A patient is prescribed drug for the treatment of his prostate cancer that blocks testosterone from binding to its intracellular receptor. Which of the following drugs has this mechanism of action?
A. Flutamide
B. Tamoxifen
C. Leuprolide
D. Sunitinib
2. Major serious effect associated with the long-term use of an aluminum-containing antacid include:
A. Dementia
B. Diarrhea
C. Kidney stones
D. Phosphate depletion
E. Severe alkalosis
3. Which of the statements best describes why patient who fail to respond to first-line chemotherapy have a decreased likelihood of a response to a second-line regimen?
A. Decreased performance status of patient
B. Tumor cell resistance caused by multidrug resistance gene
C. Tumor cell resistance caused by selection of resistant clones
D. Increased tumor burden
E. All of the above
4. A 29-year-old woman develops an exfoliate rash with painful joints, anemia, and nephritis while being treated for a first episode of a urinary tract infection. Which of the following drugs is responsible for these effects?
A. Ciprofloxacin
B. Polymyxin B
C. Trimethoprim-Sulfamethoxazole
D. Nitrofurantoin
5. Which of the following medications, when taken prior to eating, is especially effective for correcting postprandial hyperglycemia after a high-carbohydrate meal, so that hypoglycemia post dosing is minimized?
A. Acarbose
B. Glyburide
C. Glitazone
D. Tolbutamide
6. Which of the following best describes the outcome resulting from the use of 17alpha-alkylated testosterone to enhance athletic performance?
A. Decreased hepatotoxicity compared with testosterone esters
B. Decreased spermatogenesis
C. Reduced effects on serum lipid levels compared with testosterone esters
D. Cannot be converted to DHT, which reduces effects on prostate size
7. Which one of the following is most likely to interfere with cytochrome P450 metabolism?
A. Cimetidine
B. Ranitidine
C. Sucralfate
D. Metoclorpramide
8. A 28-year-old patient is newly diagnosed with active TB. Which of the following drug combinations should be initiated in this patient?
A. Ethambutol, pyrazinamide, rifampin, streptomycin
B. Ethambutol, isoniazid, rifampin, streptomycin
C. Ethambutol, pyrazinamide, rifampin, streptomycin
D. Isoniazid, rifampin, pyrazinamide, ethambutol
9. A 21-year-old student presents to ED reporting with chest pain and non-productive cough that began 1 week ago. His symptoms are progressing, and he now has a low-grade fever, productive cough, weakness, hemoptysis and anorexia. Chest X-ray reveals an infiltrate in an upper left lobe of the lungs. Culture of the infiltrate reveals fungal elements of Blastomyces dermatitidis. The patient was started on an intravenous antifungal. Two weeks later patient's serum creatinine is significantly elevated. Which of the following was most likely prescribed for this patient?
A. Clotrimazole
B. Itraconazole
C. Colloidal amphotericine B
D. Voriconazole
10. An HIV-infected patient develops rapidly progressing cryptococcal meningitis.
He was hospitalized and treated with Amphotericin B and flucytosine.
What therapy would you recommend after his release from the hospital for prophylactic therapy?
A. Clotrimazole
B. Fluconazole
C. Metronidazole
D. Itraconazole
11. Antibiotics are commonly administered before surgical procedures. Which of the following statements best describes the guidelines for perioperative antimicrobial prophylaxis?
A. Administer the antibiotic just prior the procedure
B. Begin antibiotic prophylaxis at least 24 hours before surgery
C. Select the broadest spectrum antibiotic for complete coverage
D. Use antibiotic combinations as opposed to monotherapy.
12. When using combination antibiotic therapy, it is important to administer drugs that work synergistically as possible. Which of the following represents a combination with known synergism?
A. A beta-lactam and an aminoglycoside
B. A penicillin and a cephalosporin
C. Two drugs in which the second drug will displace the first from plasma protein-binding sites.
D. Two drugs that are eliminated by different routes
E. Two drugs that work on the same step in a metabolic pathway.
13. A 29-year-old Asian woman is being treated for a vancomycin-resistant enterococcus infection. She is also taking a serotonin inhibitor for depression. Which of the following antibiotics should be avoided in this case?
A. Chloramphenicol
B. Gentamicin
C. Linezolid
D. Telitromycin
E. None of these
14. An antibiotic is administered once daily in the intensive care unit to treat sepsis caused by an abdominal wound. Serum and urine concentrations of the drug are monitored during the course of therapy. Ten days after therapy is discontinued, the drug is still detectable in urine. Which of the following antibiotics was administered?
A. Azithromycin
B. Chloramphenicol
C. Doxycyclin
D. Gentamicin
15. Protease inhibitors are primarily metabolized by the P450 system, and the metabolism of other drugs can be altered in patients taking them. Which of the following drugs has the greatest potential for drug-drug interactions?
A. Ritonavir
B. Saquinavir
C. Stavudine
D. Zalcitabine
Case-based activities.
Case 1. A 58-year women is unconscious and was taken to the nearest emergency room from her work place.
Her blood glucose: 50 mg/dL.
Her son explains that she was taking a new medication prescribed 3 week ago (once a day during breakfast) prescribed for her Type 2 diabetes. If this is a drug that commonly can cause hypoglycemia give your opinion to which class of drugs it may belong.
Case 2. A 47-year old man with a history of severe allergy to penicillin is hospitalized and undergoes the treatment for bacterial meningitis.
After 5 days of treatment he complains of severe headache, visual disturbances and general malaise.
His blood test shows a severe anemia.
Which one of the following drugs may be responsible for this adverse reaction?
A. Doxycycline
B. Gentamicin
C. Amoxicillin
D. Azithromycin
E. Chloramphenicol
F. Tetracyclines
Case 3. A 67-year old man has been treated for prostate cancer. He is receiving a drug that blocks testosterone from binding to its intracellular receptor.
Which of the following has this mechanism of action:
A. Tamoxifen
B. Flutamide
C. Leuprolide
D. Fulvestrant
E. Interleukin-2
Case 4. Opioids cross the placental barrier, and a newborn of opioid-dependent mother will undergo withdrawal within 6-12 hours of birth.
The long-term consequences of prenatal opioid dependence are poorly understood, but it may be best practice to maintain the mother on methadone and treat the infant with opioid rather than withdraw the mother before child delivery.
Give some examples of drugs that can be used to reverse withdrawal and which medications can be used for opioid dependence treatment?½ page +references
1. A 27-year old student started to receive combination therapy for tuberculosis. Which of the following would interfere with her use of contraceptives?
A. Isoniazid
B. Rifampin
C. Ethambutol
D. Pyrazinamide
2. Briefly describe the proposed mechanism of CNS depression by benzodiazepines. Give examples of most commonly used benzodiazepines. What side effects or clinical problems have to be monitored?