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103 Cards in this Set
- Front
- Back
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What is the primary mechanism of acquired resistance to penicillin?
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production of β-lactamase
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Which has better acid stability and absorption?
-penicillin G -penicillin V |
penicillin V
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Which of the following is not stable in an acidic medium?
- cloxacillin - dicloxacillin - nafcillin - oxacillin |
nafcillin
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Which has better acid stability, absorption, and half-life?
- amoxicillin - ampicillin |
amoxicillin
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What kind of penicillins are amoxicillin and ampicllin?
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aminopenicillins
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What kind of penicillins are carbenicillin, piperacillin, and ticarcillin?
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β-lactamase sensitive penicillins
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What kind of penicillins are cloxacillin, dicloxacillin, flucloxacillin, methicillin, nafcillin, and oxacillin?
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β-lactamase resistant penicillins
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What is the most common side effect of penicillin?
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hypersensitivity
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What is the mechanism of action for penicillins?
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inhibition of PBPs --> structural irregularities --> cell lysis
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What is the mechanism of action for cephalosporins?
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inhibition of PBPs --> inhibits cross-linking of peptidoglycan --> cell lysis
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What kind of bacteria are first generation cephalosporins effective against?
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Gram positives
(only modest against Gram negatives) |
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What kind of bacteria are second generation cephalosporins effective against?
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better for Gram negatives but worse for Gram positives compared to first generation
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What kind of bacteria are third generation cephalosporins effective against?
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better for Gram negatives (like Enterobactericeae) but worse for Gram positives compared to second generation
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What kind of bacteria are fourth generation cephalosporins effective against?
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greater spectrum of activity than third generation, and increased stability against β-lactamase
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Which bacteria are β-lactamase resistant penicillins especially effective against?
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Staphylococcus aureus
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What is the mechanism of action for β-lactam antibiotics?
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bind to PBPs --> disrupt cell wall synthesis --> cell lysis
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What kind of antibiotics are clavulanic acid and sulbactam?
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β-lactamase inhibitors
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What is the mechanism of action of vancomycin?
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inhibition of cell wall polymerization
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Which is vancomycin effective against?
- Gram negatives - Gram positives |
Gram positives
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Why are aminoglycosides effective against bacteria, while not affecting mammalial proteins?
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difference in ribosomal subunits
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What kind of drugs are gentamicin, neomycin, and streptomycin?
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aminoglycosides
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What is the mechnism of resistance for aminoglycosides?
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modification of ribosomal binding site
metabolites competing with aminoglycosides |
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Compared to other drugs, aminoglycosides have relatively low cytotoxicity.
- True - False |
False
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Which of the following have the side effect of ototoxicity?
- aminoglycosides - cephalosporins - penicillins |
aminoglycosides
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What is the mechnism of action for macrolides?
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bind reversibly with 50s ribosomal subunit to inhibit translocation of peptide chain to P site
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What are the mechanisms of resistance for macrolides?
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efflux pumps
esterases that decrease drug binding mutation in 50s subunit |
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Which of the following macrolides has the poorest absorption and acid stability?
- azithromycin - clarithromycin - erythromycin |
erythromycin
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Which macrolide mainly accumulates in phagocytes?
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clarithromycin
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Which of the following macrolide is eliminated in urine?
- clarithromycin - erythromycin |
clarithromycin
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Which macrolide has the best activity, especially against S. pyogenes and S. pneumonia?
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clarithromycin
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What is the first choice aminoglycoside drug?
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gentamicin
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What is the mechanism of action for tetracyclines?
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compete with tRNA for A site on 50s ribosomal subunit
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What is the mechanism of resistance for tetracyclines?
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increased efflux of tetracycline
R protection proteins dislodge the drug from ribosomes |
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The absorption of which type of drugs is impaired by dairy products?
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tetracyclines
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Which is better absorbed?
- doxycycline - tetracycline |
doxycycline
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What are some important side effects of tetracyclines?
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GI irritation
photosensitivity tooth discoloration |
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Gray baby syndrome (neonatal toxicity) is a side effect of which drug?
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chloramphenicol
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Which metal(s) is 2, 3-dimercaptosuccinic acid (Succimer) a chelating agent for, and what is its route of administration?
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lead
mercury oral administration |
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Which metal(s) is 2, 3-dimercaptoproponol (BAL, Dimercaprol) a chelating agent for, and what is its route of administration?
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lead
mercury IM administration |
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Which metal(s) is EDTA a chelating agent for, and what is its route of administration?
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lead
IV administration |
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Which metal(s) is penicillamine a chelating agent for, and what is its route of administration?
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lead
mercury arsenic oral administration |
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Which metal(s) is deferoxamine a chelating agent for, and what is its route of administration?
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iron
IM, slow IV, or oral (under rare circumstance) administration |
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Toxicity from which metal inhibits heme biosynthesis?
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lead
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Toxicity from which metal inhibits a1-antitrypsin, leading to emphysema and nephrotoxicity?
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cadmium
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Toxicity from which metal precipitates proteins, causing necrosis and inhibition of enzymes?
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mercury
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Toxicity from which metal increases vascular permeability and inhibits anaerobic & oxidative phosphorylation?
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arsenic
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Why can't EDTA be given via IV?
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it can't cross the cell membrane
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Why is EDTA given as calcium disodium salt?
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to balance the calcium level
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What is the difference between diabetes mellitus Type 1 and Type 2?
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Type 1: severe or absolute insulin deficiency
Type 2: resistance to insulin action combined with relative deficiency in insulin secretion |
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Which of the following describes insulin lispro, insulin glulisine, and insulin aspart?
- Intermediate acting - Long acting - Rapid acting, short duration - Short acting, rapid onset |
rapid acting, short duration
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Which of the following describes regular insulin with zinc?
- Intermediate acting - Long acting - Rapid acting, short duration - Short acting, rapid onset |
short acting, rapid onset
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Which of the following describes isophane insulin suspension (NPH) and lente insulin?
- Intermediate acting - Long acting - Rapid acting, short duration - Short acting, rapid onset |
intermediate acting
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Which of the following describes insulin detemir and insulin glargine?
- Intermediate acting - Long acting - Rapid acting, short duration - Short acting, rapid onset |
long acting
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What is the rationale for using mixed insulin therapy?
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provides tighter glycemic control and combines rapid & intermediate acting insulins
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Sulfonylureas and medlitinides are which type of drugs?
- antihyperglycemic - hypoglycemic |
hypoglycemic
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Biguanides, thiazolidinediones, and α-glucosidase inhibitors are which type of drugs?
- antihyperglycemic - hypoglycemic |
antihyperglycemic
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What kind of drugs are tolazamide, glipizide, and glyburide?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
sulfonylureas (hypoglycemic drugs)
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What kind of drugs are nateglinide and repaglinide?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
meglitinides (hypoglycemic drugs)
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What kind of drug is metformin?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
biguanide (antihyperglycemic drug)
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What kind of drugs are pioglitazone and rosiglitazone?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
thiazolidinediones (antihyperglycemic drugs)
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What kind of drug is acarbose?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
α-glucosidase inhibitor (antihyperglycemic drug)
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Which of the following increase insulin secretion to treat Type 2 diabetes mellitus?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
meglitinides
sulfonylureas |
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Which of the following increase insulin sensitivity to treat Type 2 diabetes mellitus?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
thiazolidinediones
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Which of the following decrease glucose absorption to treat Type 2 diabetes mellitus?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
biguanides
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Which of the following block enzymes which process complex sugar digestion, in order to treat Type 2 diabetes mellitus?
- α-glucosidase inhibitors - biguanides - meglitinides - sulfonylureas - thiazolidinediones |
α-glucosidase inhibitors
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What kind of drugs are apomorphine and ipecac?
- antidiarrheal - antiemetic - laxatives & cathartics - proemetic - prokinetic |
proemetic
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What kind of drugs are bethanachol, metoclopramide, and erythromycin?
- antidiarrheal - antiemetic - laxatives & cathartics - proemetic - prokinetic |
prokinetic
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What are proemetic drugs primarily used to treat?
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oral poisoning
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What are prokinetic drugs primarily used to treat?
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gastroparesis or lack of motility in upper GI tract
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Which of the following is both a prokinetic and antiemetic drug?
- bethanachol - erythromycin - metoclopramide - ondansetron - scopalamine |
metoclopramide
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What kind of drugs are diphenhydramine, meclzine, scopalamine, metclopramide, promethazine, ondansetron, dronabinol, and marijuana?
- antidiarrheal - antiemetic - laxatives & cathartics - proemetic - prokinetic |
antiemetic
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What kind of drugs are kaopectate, metamucil, bismith salycilate, loperamide, diphenoxylate, difenoxin, and octreotide?
- antidiarrheal - antiemetic - laxatives & cathartics - proemetic - prokinetic |
antidiarrheal
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What kind of drugs are dietary fiber, methylcellulose, psyllium seed husk, magnesium salts, phosphates, glycerin, bisacodyl, castor oil, senna, and cascara?
- antidiarrheal - antiemetic - laxatives & cathartics - proemetic - prokinetic |
laxatives & cathartics
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Antacids are only useful for episodic treatment of indigestion, but not chronic disease.
- True - False |
True
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The most effective treatment strategies for GERD and PUD involve multiple therapeutic approaches.
- True - False |
True
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Which of the following H2 histamine antagonists is a potent inhibitor of CYP?
- cimetidine - famotidine - nizatidine - ranitidine |
cimetidine
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What kind of drugs are the current drugs of choice in combination regimens for GERD and PUD?
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proton pump inhibitors
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What class of immunosuppressants are prednisone and prednisolone?
- corticosteroids - cytotoxic agents - T-cell suppressants |
corticosteroids
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What class of immunosuppressants are cyclophosphamide and azathioprine?
- corticosteroids - cytotoxic agents - T-cell suppressants |
cytotoxic agents
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What class of immunosuppressants are cyclosporin and tacrolimus?
- corticosteroids - cytotoxic agents - T-cell suppressants |
T-cell suppressants
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What is the mechanism of action for nucleoside analogs?
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compete with native nucleosides for incorporation into viral DNA, then inhibit viral DNA polymerase and cause DNA chain termination
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What kind of drugs are acyclovir, ganciclovir, idoxuridine, and vidarabine?
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nucleoside analogs
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What are nucleoside analogs used to treat?
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herpes
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What are amantidine and rimantadine used to treat?
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influenza
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Amantidine and rimantadine are nucleoside analogs.
- True - False |
False
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Nucleoside reverse transcriptase inhibitors (NRTIs) are active against chronically infected cells.
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False
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What kind of drugs are zidovudine, didanosine, zalcitabine, stavudine, and ribavirin?
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nucleoside reverse transcriptase inhibitors (NRTIs)
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NRTIs competitively inhibit HIV-1 & HIV-2 reverse transcriptase.
- True - False |
True
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NNRTIs competitively inhibit HIV-1 and HIV-2 reverse transcriptase.
- True - False |
False
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What kind of drugs are nevirapine, delavirdine, and efavirenz?
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non-nucleoside reverse transcriptase inhibitors (NNRTIs)
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What kind of drugs are saquinavir and ritonavir?
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protease inhibitors
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What are protease inhibitors used to treat?
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HIV infeciton
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What are NRTIs and NNRTIs used to treat?
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HIV infection
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What is the mechanism of action of local anesthetics?
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they reversibly bind to voltage-gated sodium channels, blocking sodium influx, which blocks action potential and nerve conduction
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Where are ester-linked anesthetics metabolized?
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in the blood by plasma pseudocholinesterase
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Where are amide-linked anesthetic metabolized?
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in the liver
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What are four ester-linked anesthetics?
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cocaine
procaine tetracaine benzocaine |
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What are three amide-linked anesthetics?
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lidocaine
mepivacaine bupivacaine |
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Why are vasoconstrictors often added to local anesthetic preparations?
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reduce their absorption, thus prolonging anesthetic effect and reducing systemic toxicity
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What is the mechanism of action of alkylating drugs?
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form bonds with reactive amines and phosphates on DNA, which makes the strands unable to uncoil and separate, thus preventing duplication
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What is the mechanism of action of antimetabolites?
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interfere with DNA synthesis by producing false nucleotides
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What are the toxic side effects of alkylating agents used against cancer?
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bone marrow suppression and ulcers
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What kind of drugs are mechlorethamine, cyclophosphamide, chlorambucil, melphalan, and bis-chloroethyl nitrosourea (BCNU)?
- alkylating agents - antimetabolites |
alkylating agents
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