Clinical Pharmacology and Therapeutics: Questions for Self by Timothy G K Mant, Lionel D Lewis, James M Ritter, Albert

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By Timothy G K Mant, Lionel D Lewis, James M Ritter, Albert Ferro

So that you imagine you may have a deal with on healing administration? How medicines paintings and engage with one another, how the physique handles them and the way medicines are assessed?

This self-assessment quantity lets you research, revise and try out your self on all facets of scientific pharmacology and therapeutics. 4 assorted query varieties are supplied to check your wisdom during this very important region - a number of selection questions, prolonged matching questions, 'best of fives' and problem-solving questions. specified explanatory solutions be certain this booklet solves your queries in addition to offering crucial revision for these all-important exams.

Test your wisdom with Clinical Pharmacology and Therapeutics: Questions for Self Assessment and never basically increase your examination procedure yet develop into a greater prescriber.

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Extra info for Clinical Pharmacology and Therapeutics: Questions for Self Assessment, Third edition

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G. g. g. procyclidine): a) Are predominantly used in parkinsonism caused by antipsychotic drugs b) Are least effective in the treatment of tremor c) Are ineffective in the management of post-encephalitic parkinsonism d) Must not be used with levodopa e) May cause confusion in the elderly 109 The following enhance central dopaminergic activity: a) b) c) d) e) Inhibition of MAO-B Bromocriptine Apomorphine Haloperidol Intravenous dopamine 110 Levodopa: a) b) c) d) e) Can enter nerve terminals Is oxidized by MAO to form dopamine Is antagonized by ropinirole Metabolism is reduced by entacapone May cause dystonic reactions 111 Levodopa: a) b) c) d) e) Is the amino acid precursor of dopamine Improves bradykinesia and rigidity more than tremor Levodopa therapy should be initiated with a loading dose Should be taken on an empty stomach Involuntary movements and psychiatric complications are common unwanted effects 112 Bromocriptine: a) b) c) d) e) Stimulates release of endogenous dopamine Stimulates postsynaptic D2 receptors Should not be prescribed until there is inadequate response to levodopa Has an antiemetic action Inhibits the release of prolactin from the pituitary 113 Selegiline: a) b) c) d) e) Selectively inhibits MAO-B The most common adverse effect is postural hypotension Is principally eliminated unchanged in the urine Cannot be prescribed concurrently with levodopa Cannot be prescribed concurrently with amantadine MULTIPLE CHOICE QUESTIONS 114 The following drugs reduce spasticity in patients with upper motor neuron lesions: a) b) c) d) e) Donepezil Riluzole Diazepam Baclofen Dantrolene 115 Tardive dyskinesia: a) Occurs in about 15 per cent of patients treated with phenothiazines for over 2 years b) Stopping treatment results in slow improvement in approximately 40 per cent of patients c) Dyskinesia may initially worsen after discontinuing treatment d) Consists of rapid involuntary movements of the limbs e) Is treated with botulinum toxin A 116 In myasthenia gravis: a) b) c) d) e) Therapy is usually initiated with neostigmine Thymectomy may be beneficial Corticosteroids and azathioprine reduce circulating T cells There is increased sensitivity to atenolol Corticosteroids can worsen or improve weakness 117 Severe weakness in a patient with myasthenia gravis may be potentiated by: a) b) c) d) e) Spontaneous deterioration in the natural history of the disease Excessive anticholinesterase drug Acute infection Aminoglycosides Fluoxetine 118 In Alzheimer’s disease: a) Donepezil can slow down the progression of mild and moderate Alzheimer’s disease b) Rivastigmine acts through reversible inhibition of acetylcholinesterase c) Adverse effects associated with donepezil, rivastigmine and galantamine include nausea, vomiting and diarrhoea d) Overdose with donepezil is likely to be associated with tachycardia e) Associated depression may be treated with a selective serotonin reuptake inhibitor 45 46 CHAPTER 2 NERVOUS SYSTEM 119 The following drugs are effective in partial seizures with or without secondary generalized tonic clonic seizures: a) b) c) d) e) Carbamazepine Valproate Topiramate Lamotrigine Ethosuximide 120 The following adverse effects are associated with sodium valproate therapy: a) b) c) d) e) Tremor Nausea, vomiting and abdominal pain Ventricular tachycardia Thrombocytosis Hair loss (temporary) 121 The following are recognized adverse effects associated with phenytoin therapy: a) b) c) d) e) Ataxia Dysarthria Acne Hyperkalaemia Macrocytic anaemia 122 The pharmacokinetics of phenytoin are characterized by: a) Wide interindividual variation b) Less than 10 per cent systemic bioavailability if taken by mouth with food c) Two populations – fast and slow acetylators d) The half-life is not affected by dose e) Once-daily dosing is adequate 123 Carbamazepine: a) b) c) d) e) Inhibits GABA transaminase Inhibits its own metabolism Is effective in temporal lobe epilepsy Inhibits the metabolism of warfarin Modified-release tablets significantly lessen the incidence of doserelated side-effects 124 The following adverse effects are associated with carbamazepine therapy: a) b) c) d) e) Trigeminal neuralgia Sedation Dizziness Diplopia Hyponatraemia MULTIPLE CHOICE QUESTIONS 125 Sodium valproate: a) Is a dopamine antagonist b) Is indicated in tonic–clonic epilepsy c) Blood concentration should be monitored frequently during treatment d) Rarely causes hepatic necrosis e) Is safe in pregnancy 126 Vigabatrin: a) b) c) d) e) Is a structural analogue of GABA Increases the brain concentration of GABA Can cause visual field defects May cause hallucinations and paranoia Is excreted unchanged in bile 127 The following antiepileptics induce the metabolism of oestrogen and can lead to unwanted pregnancies in women using oral contraception: a) b) c) d) e) Carbamazepine Phenytoin Sodium valproate Phenobarbital Lamotrigine 128 An 18-year-old man is admitted to casualty in status epilepticus.

It can cause an SLE-like syndrome, which is more common in slow acetylators. An intravenous preparation is available to treat hypertensive crises in pregnancy – Rifampicin is a broad-spectrum antibiotic used in tuberculosis and Legionnaire’s disease – Carbamazepine autoinduces its metabolism and is an anticonvulsant – St John’s wort, a herbal remedy, may be purchased without a prescription. It is a potent, broad-spectrum CYP450 enzyme inducer – Phenobarbital is an anticonvulsant – Penicillin is predominantly eliminated unchanged in the urine Drug interactions secondary to hepatic enzyme induction and inhibition are clinically significant when there is a close correlation between plasma concentration and effect, and a steep dose response curve.

Condoms must be used if partner of male patient (ribavirin excreted in semen) is pregnant 43 a) b) c) d) False False True False Non-drug treatment (reassurance, small frequent meals and advice on posture) should be pursued in the first instance – Misoprostol, an analogue of prostaglandin E1, causes abortion e) True 44 a) True b) False c) False d) False e) False – This is also true for the low molecular weight heparins (which are often the anticoagulants of choice in pregnancy) – Warfarin is a teratogen and is associated with a high incidence of haemorrhagic complications in late pregnancy – Pethidine, which is commonly used as an analgesic during delivery, can cause apnoea of the newborn which is reversed with naloxone 45 a) b) c) d) e) False True True True False Epilepsy in pregnancy can lead to fetal and maternal morbidity/mortality through convulsions.

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