PC512 MC 1-12

1.

1 point

What are the FDA approved indications for risedronate?

Osteoporosis

Osteoarthritis

Paget’s Disease

A & C

All of the above

2.

1 point

Which statement is true regarding the mechanism of action of risedronate?

Binds to and activates osteoblasts to promote bone building

Inhibits OPG from binding to RANKL to decrease osteoclast activity

Inhibits farnesyl pyrophosphate synthase to decrease osteoclast activity

Inhibits osteoclast from binding to osteoblasts

3.

1 point

What are COMMON (>10%) adverse effects of risendronate?

Arthralgia

Dyspepsia

Osteonecrosis of the jaw

A & B

None of the above

4.

1 point

What is the approximate half-life of risedronate?

5 days

23 days

123 days

10 years

5.

1 point

Which of the following is true regarding the pharmacokinetics of aclidinium bromide (Tudorza®)?

Aclidinium bromide has a long half-life that accounts for its high bioavailability.

Aclidinium bromide has a rapid onset, a relatively low bioavailability (6%), and is dosed twice a day as an oral inhalation.

Aclidinium bromide is a prodrug and is metabolized to active metabolites.

High plasma level concentrations are achieved at clinical doses; therefore, CYP450 enzymes will not be altered.

6.

1 point

Which of the following regarding the cellular mechanism of action of aclidinium bromide (Tudorza®) is NOT true?

Aclidinium bromide acts on the beta subunit of Gq protein coupled M3 receptor.

Binding of aclidinium bromide causes dephosphorylation of GTP to GDP.

Inactivating the receptor leads to down regulation of phospholipase C.

Bronchiole smooth muscle dilation occurs from inactivating protein kinase C and decreasing intracellular calcium.

7.

1 point

Common adverse reactions (experienced in greater than 1% of patients) of aclidinium bromide (Tudorza®) include:

Tachycardia, headache, and nausea

Diarrhea, headache, and rash

Urinary retention and GI upset

Headache, nasopharyngitis, and cough

8.

1 point

Which of the following explains the main difference between aclidinium bromide (Tudorza®) and Tiotropium bromide
(Spiriva®)?

Spiriva is FDA approved for the long-term maintenance of COPD whereas Tudorza has not been approved yet.

Spiriva is administered in a capsule form via a HandiHaler whereas Tudorza comes as a dose powder inhaler.

Tudorza is structurally different than Spiriva, which is why Tudorza has a different MOA.

Tudorza has a longer half-life than Spiriva, which is why it hasn't been FDA approved yet.

9.

1 point

The common ventricular arrhythmia adverse effect with milrinone is due to which of the following physiological
processes?

Inhibition of PDE V, causing an increase of cAMP and Ca2+ in the cardiac tissue

Stimulation of PDE III, causing a decrease of cAMP and Ca2+ in the cardiac tissue

Inhibition of PDE III, causing an increase of cAMP and Ca2+ in the cardiac tissue

Inhibition of PDE III, causing an increase of cGMP and Ca2+ in the cardiac tissue

10.

1 point

Which of the following is not an adverse effect of milrinone under the category of ventricular arrhythmias?

Ventricular ectopic activity

Torsades de Pointes

Nonsustained ventricular tachycardia

Ventricular fibrillation

11.

1 point

What effect(s) does milrinone have on the cardiovascular system?
I. Increased contraction of the heart
II. Decrease in arterial resistance
III. Increased heart rate

I only

III only

I and II

I, II, and III

12.

1 point

Milrinone causes a ________ of cAMP in the cardiac tissue and an ________ of cAMP in the peripheral vasculature.

Increase/increase

Increase/decrease

Decrease/decrease

Decrease/increase

13.

1 point

Which class of antiarrhythmic does sotalol fall under?

Class II antiarrhythmic

Class III antiarrhythmic

Both A & B

Neither A or B

14.

1 point

Regarding sotalol’s class III anti-arrhythmic activity, which of the following statements is correct?

Sotalol blocks potassium channels and inhibits the efflux of K+ ions.

Sotalol blocks calcium channels and inhibits the efflux of Ca2+ ions.

Sotalol blocks sodium channels and inhibits the efflux of Na+ ions.

Sotalol opens potassium channels and induces the efflux of K+ ions.

15.

1 point

Which of the following statements are TRUE in regards to sotalol

Sotalol is metabolized by the liver and therefore requires hepatic dose adjustment

Sotalol is a class I antiarrhythmic and a beta blocker

It is shown that abrupt withdrawal from sotalol is acceptable

The most common adverse effects are bradycardia , chest pain, palpitation, fatigue, dizziness

16.

1 point

Which of the following is true regarding Sotalol’s mechanism of action?
I. Sotalol exerts its class II antiarrhythmic activity through its beta adrenergic receptor blocking effects leading to a slower a heart rate
II. Sotalol’s beta adrenergic receptor blockage increases the AV nodal conduction and SA nodal pacemaker activity
III. Sotalol exerts its class III antiarrhythmic activity by prolonging the refractory period and duration of the cardiac action potential
IV. Sotalol can inhibit both potassium and sodium channels to prolong the repolarization period

I, II, and III

I and II

I and III

I, III, and IV

17.

1 point

What downstream effect does dabigatran have on the coagulation cascade by inhibiting thrombin?

It activates plasmin to break up already formed clots.

It activates fibrinogen.

It prevents the formation of fibrin.

None of the above

18.

1 point

Dabigatran has an FDA indication for:

reduction of stroke and systemic embolism in patients post knee and hip replacement surgery

treatment of patients with non valvular atrial fibrillation

reduction of stroke and systemic embolism patients with non-valvular atrial fibrillation

treatment of VTE and PE

19.

1 point

What is an important safety counseling point about dabigatran?

The patient should not suddenly stop taking dabigatran on their own because a black box warning for an increased risk of stroke with sudden discontinuation.

The patient should not eat green leafy vegetables while on dabigatran because of an increased risk of bleeding.

The patient should have frequent INR monitoring while on dabigatran.

If the patient overdoses on dabigatran, they should go to the ER to receive the antidote, hirudin.

20.

1 point

Which of the following is TRUE about dabigatran?

Dabigatran has unpredictable PK/PD

Dabigatran, like warfarin, has many drug/food interactions

Dabigatran requires no bridging upon initiation

Dabigatran requires monthly thrombin levels

21.

1 point

Cymbalta (Duloxetine) is indicated for:

diabetic peripheral neuropathy

major depressive disorder

bipolar disorder

A and B

22.

1 point

Duloxetine inhibits the reuptake of which of the following receptors:

Dopamine

Serotonin

Norepinephrine

A and B

B and C

23.

1 point

Common adverse events of Duloxetine is/are:

nausea, dry mouth, and insomnia

hypotension, sedation, increased libido

decreased risk of suicidal thinking

Steven Johnson’s syndrome

24.

1 point

Duloxetine shares a drug class with the following medication(s):

Citalopram

Sertraline

Venlafaxine

Quetiapine

25.

1 point

Carvedilol is most likely to worsen which condition if not titrated properly?

Hypertension

Heart failure

Diabetes mellitus

Ischemic heart disease

26.

1 point

Which of the following is NOT an indication for Carvedilol?

Hypertension

Acute Congestive Heart Failure

Angina Symptoms

Chronic Congestive Heart Failure

27.

1 point

Which of the following is true regarding the cellular mechanism of action of carvedilol?

Carvedilol affects the influx of calcium in cardiac myocytes to increase heartrate

Carvedilol is a selective beta-agonist and only affects beta-2 receptors

Carvedilol is a non-selective alpha and beta antagonist, affecting both beta-1 and beta-2 receptors

Carvedilol is a selective beta-antagonist and only affects beta-1 receptors

28.

1 point

Which of the following is a not an outcome of Carvedilol’s effect on myocardial tissue?

Decrease in Heart Rate

Decrease in Myocardial Oxygen Consumption

Down-regulation of myocardial beta-1-adrenergic receptors

Enhanced coronary artery blood flow

29.

1 point

Which of the following forms of mometasone are metabolized via CYP3A4?

Asmanex

Nasonex

Elocon

A and B

All of the above

30.

1 point

Which of the following is not a MOA of Elocon, Asmanex and Nasonex?

Induce complement system

Prevent scar tissue formation

Inhibit histamine and kinin release

Induce lipocortins

31.

1 point

What is the cellular mechanism by which steroids gain their anti-inflammatory property?

Decrease gene expression encoding for cytokines.

Inhibits acetylcholine reuptake.

Open voltage gated chloride channels.

Bind histamine proteins.

32.

1 point

Which is NOT an available form of mometasone?

Inhaled powder

Lotion

Nasal spray

Transdermal patch

33.

1 point

Which of the following is true?

Mometasone inhalation is approved for use in ages 18 and older.

The adverse effect profile between inhaled corticosteroids such as mometasone, budesonide, beclomethasone, fluticasone proprionate are similar.

Mometasone is not commonly prescribed due to its adverse effect profile

Mometasone is available only in topical dosage form

34.

1 point

Like Chantix, which other agent is also indicated for smoking cessation?

Prozac

Wellbutrin

Zyban

Seroquel

35.

1 point

Varenicline (Chantix) exhibits _______ protein binding and displays _______ levels of absorption and distribution.

high, low

high, high

low, high

low, low

36.

1 point

Which of the following statements is INCORRECT regarding varenicline (Chantix)?

It does not require dosing adjustment in renal impairment

It is not recommended for use in ages less than 18 years old

It does not require dosing adjustment in hepatic impairment

It is tartrate salt and is highly water soluble.

37.

1 point

What receptors do varenicline (Chantix) bind to and is it an agonist or antagonist?

antagonist, alpha4-beta2 nicotinic receptors

agonist, alpha4-beta2 nicotinic receptors

antagonist, alpha4-beta2 muscarinic receptors

agonist, alpha4-beta2 dopaminergic receptors

38.

1 point

Which of the following is true regarding the disease mechanism of COPD?

Smoke and other noxious chemicals causes a decrease in neutrophils and macrophages

Oxidative stress stimulates antiprotease alpha 1-antitrypsin (AAT)

An imbalance in antiprotease alpha 1-antitrypsin (AAT) is only caused by smoke and other noxious chemicals

Proteases stimulate mucus hypersecretion

39.

1 point

What is an advantage of tiotropium bromide compared to other medications in its class?

It is taken twice a day

It is taken once a day

It is short acting

It decreases patient’s compliance

40.

1 point

What is the most commonly reported adverse event linked to dry powder inhalation of tiotropium bromide?

Urinary retention

Constipation

Xerostomia

CNS effects

41.

1 point

Which receptor does tiotropium bromide bind to in the smooth muscle to cause bronchodilation?

M1

M2

M3

M4

42.

1 point

Question 1: Which of the following is the most potent statin?

Simvastatin

Atorvastatin

Rosuvastatin

Lovastatin

43.

1 point

Which of the following is true regarding the functioning of lipoproteins?
I. Chylomicrons function in the exogenous pathway of cholesterol transport
II. HDL redistributes cholesterol only to the Liver
III. Lipoprotein Lipase converts VLDL to IDL and then to HDL

I only

III only

I and II

I and III

I, II, and III

44.

1 point

Which of the following is not a contraindication for the use of rosuvastatin?

active liver disease

renal impairment

breastfeeding

pregnant

45.

1 point

Which of the following is the rate limiting step of cholesterol synthesis?

The conversion of HMG-CoA to mevalonate

The conversion of mevalonate to farnesyl (an intermediate molecule of cholesterol)

The binding of SREBPs to DNA

The binding of LDL to LDL receptors

46.

1 point

What are FDA approved indications for Lyrica?

Postherpetic neuralgia

Diabetic peripheral neuropathy

Partial-onset seizure disorder

Fibromyalgia

All of the above

47.

1 point

What and how are the neurotransmitters effected with the use of Lyrica?

Decrease glutamate

Decrease Substance P

Both A and B

Neither A nor B

48.

1 point

What is the schedule of Lyrica?

Schedule II

Schedule III

Schedule IV

Schedule V

Over the Counter

49.

1 point

What is Lyrica’s most recent approved indication?

Postherpetic neuralgia

Diabetic peripheral neuropathy

Partial-onset seizure disorder

Fibromyalgia

Neuropathic pain/spinal injury