Test Bank for Applied Pharmacology for The Dental Hygienist 6th Edition By Elena Bablines haveles – Digital Download File

Haveles: Applied Pharmacology for the Dental Hygienist, 6^th Edition

 

Chapter 03: Adverse Reactions

 

Test Bank

 

MULTIPLE CHOICE

 

1. A genetically related abnormal drug response is called a/an:

 

1. Toxic reaction
2. Idiosyncratic reaction
3. Side effect
4. Drug allergy

 

ANS: b

Correct: An idiosyncratic reaction is a genetically related abnormal drug response.

Incorrect choices: A toxic reaction is an adverse drug reaction that is an extension of the pharmacologic effect of the drug. Side effects are dose-related effects on nontarget organs. Drug allergy refers to the interaction of the immune system with the drug. None of these incorrect choices are limited to describing abnormal or genetically related responses.

 

REF: pp. 28-29

 

2. A drug effect that is neither predictable nor dose related is called a:

 

1. Therapeutic effect
2. Toxic reaction
3. Side effect
4. Drug allergy
5. Both b and d

 

ANS: d

Correct: Unlike other adverse reactions, allergic reactions are neither predictable nor dose related.

Incorrect choices: Approved pharmaceuticals are available for use because they produce a predictable and dose-related therapeutic response. Toxic reactions and side effects are dose-related effects, the former on the target organ and the latter on nontarget organs. They might be surprising when they arise, for instance, in patients who are especially sensitive to a drug’s effects. However, they are predictable based on the drug’s dose-response relationship.

 

REF: pp. 28-29

 

 

 

3. The following choices refer to adverse reactions involving exaggerated effects on target tissues except:

 

1. Overreaction of a sensitive patient
2. Administration of too large a dose
3. Caused by a nontherapeutic action of a drug
4. Possibly resulting from liver or kidney disease

 

ANS: c

Correct: This answer is typical of an adverse effect caused by action on nontarget tissues.

Incorrect choices: Exceptional sensitivity to a normal dose and administration of too large a dose for a patient are common actions that lead to exaggerated effect. Liver or kidney disease may reduce metabolism or excretion, respectively.

 

REF: p. 29

 

4. A dose-related reaction that produces undesirable effects caused by the action on nontarget organs is called:

 

1. Therapeutic effect
2. Toxic reaction
3. Side effect
4. Drug allergy

 

ANS: c

Correct: A side effect is a predictable, dose-related drug effect that acts on nontarget organs.

Incorrect choices: Therapeutic effect is the desired effect of the drug. Toxic reaction is a predictable, dose-related drug effect that acts on nontarget organs and produces an adverse reaction. In a drug allergy, the immune system of an individual responds to a drug, resulting in a allergic reaction. Drug reactions are not dose related or predictable.

 

REF: p. 29

 

5. An agent for which data are insufficient in animals or women to ensure safety during pregnancy would be classified in which U.S. Food and Drug Administration category for teratogenic drugs?

 

1. X
2. A
3. C
4. B

 

ANS: c

Correct: Some older drugs may be classified as C because data are insufficient to place them in higher categories.

Incorrect choices: X means never use if someone might get pregnant. A means best or least teratogenic. B means that no demonstrated risk to the fetus in laboratory animals has been found or that animal studies show a risk that cannot be substantiated by studies in pregnant women.

 

REF: pp. 29-30

 

6. The greatest risk to the fetus from exposure to drugs occurs:

 

1. Just before birth
2. During the third trimester
3. During the second trimester
4. Before pregnancy status is known

 

ANS: d

Correct: Early in pregnancy (first trimester) the organs in the fetus are forming, which is considered the most critical time for teratogenicity.

Incorrect choices: Drugs at these stages may affect the newborn, but the fetus is fully developed. Fetal organogenesis has already occurred, therefore critical stages in fetal development have passed.

 

REF: pp. 29-30

 

7. An acute, life-threatening allergic reaction characterized by hypotension, bronchospasm, laryngeal edema, and cardiac arrhythmias is what type of hypersensitivity?

 

1. Type I
2. Type II
3. Type III
4. Type IV

 

ANS: a

Correct: Type I hypersensitivity, or immediate-type hypersensitivity, is a rapidly produced response targeting the bronchioles, the respiratory system, and the skin. Types II, III, and IV reactions are all slower than type I reactions.

Incorrect choices: Type II hypersensitivity causes cytolytic reactions, such as hemolytic anemia. Type III hypersensitivity is a reaction in which soluble antibody-antigen complexes are formed, causing arthralgia, urticarial skin eruptions, and so forth, with little or no lung involvement. Type IV hypersensitivity, or delayed-type hypersensitivity, is generally manifested as skin eruptions.

 

REF: pp. 30-31

 

8. Which hypersensitivity reaction causes antibody-antigen (immune complex) deposition?

 

1. Type I
2. Type II
3. Type III
4. Type IV

 

ANS: c

Correct: Type III hypersensitivity is a reaction in which soluble antibody-antigen complexes are formed and deposited, causing arthralgia, urticarial skin eruptions, and so forth.

Incorrect choices: Type I hypersensitivity, or immediate-type hypersensitivity, involves drug antigen or allergen binding to immunoglobulin E (IgE) antibodies on inflammatory cells. Type II hypersensitivity causes cytolytic reactions, such as hemolytic anemia. Type IV hypersensitivity, or delayed-type hypersensitivity, generally manifests as skin eruptions.

 

REF: pp. 30-31

 

9. Which hypersensitivity reaction is termed delayed-type hypersensitivity and is mediated by sensitized T-lymphocytes and macrophages?

 

1. Type I
2. Type II
3. Type III
4. Type IV

 

ANS: d

Correct: Type IV hypersensitivity, or delayed-type hypersensitivity, generally manifests as skin eruptions, such as in poison ivy.

Incorrect choices: Type I hypersensitivity, or immediate-type hypersensitivity, involves drug antigen or allergen binding to IgE antibodies on inflammatory cells. Type II hypersensitivity causes cytolytic reactions, such as hemolytic anemia. Type III hypersensitivity is a reaction in which soluble antibody-antigen complexes are formed and deposited, causing arthralgia, urticarial skin eruptions, and so forth.

 

REF: pp. 30-31

 

10. Type __________ hypersensitivity is mediated by IgE antibodies.

 

1. I
2. II
3. III
4. IV

 

ANS: a

Correct: Type I hypersensitivity, or immediate-type hypersensitivity, involves drug antigen or allergen binding to IgE antibodies on inflammatory cells.

Incorrect choices: Type II hypersensitivity causes cytolytic reactions, such as hemolytic anemia. Type III hypersensitivity is a reaction in which soluble antibody-antigen complexes are formed and deposited, causing arthralgia, urticarial skin eruptions, and so forth. Type IV hypersensitivity, or delayed-type hypersensitivity, generally manifests as skin eruptions, such as in poison ivy.

 

REF: pp. 30-31

 

11. Approximately 10% of male African Americans develop a severe hemolytic anemia when given the antimalarial drug primaquine. Such a response is categorized as a(n):

 

1. Idiosyncratic reaction
2. Drug side effect
3. Genetically determined abnormal reaction
4. Allergic reaction
5. Both a and c

 

ANS: e

Correct: Primaquine-induced hemolytic anemia is a genetically determined abnormal reaction, also known as a drug idiosyncrasy.

Incorrect choices: Idiosyncratic reactions are not drug side effects; they are genetically related abnormal drug responses. Idiosyncratic reactions might involve an immune mechanism but are not considered allergic responses, such as type I through type IV hypersensitivity reactions.

 

REF: pp. 30-31

 

12. A dose of a drug that kills 50% of experimental animals is termed:

 

1. ED₅₀
2. Minimally effective dose
3. LD₅₀
4. Therapeutic index

 

ANS: c

Correct: By definition, the LD₅₀ is the median lethal dose, that is, a dose level that leads to death in 50% of the animals tested.

Incorrect choices: ED₅₀ is the median effective dose, a dose that produces a therapeutic effect in 50% of the subjects tested. A minimally effective dose should not cause death unless death is the desired endpoint. In this case, the incidence of death should be lower to be designated minimal. The therapeutic index is the ratio of LD₅₀ to ED₅₀.

 

REF: pp. 31-32

 

 

13. In an assessment of drug action for a certain therapeutic agent, results indicate that the ED₅₀ is 3 mg/kg, and the LD₅₀ is 300 mg/kg. What is the therapeutic index for this agent?

 

1. 3
2. 300
3. 0.01
4. 100

 

ANS: d

Correct: One must divide the LD₅₀ value by the ED₅₀ value. The LD₅₀ value (300) divided by the ED₅₀ value (3) equals 100.

 

REF: pp. 31-32

 

14. Although drug A and drug B have the same ED₅₀, drug B has a wider therapeutic index; therefore drug A has a greater LD₅₀ than drug B.

 

1. Both parts of the statement are true.
2. Both parts of the statement are false.
3. The first part of the statement is true, the second part is false.
4. The first part of the statement is false, the second part is true.

 

ANS: c

Correct: The therapeutic index is the ratio of the LD₅₀ to ED₅₀. A wide therapeutic index means a greater difference between the LD₅₀ and the ED₅₀ and therefore a greater ratio. If drug B has a wider therapeutic index than drug A and the two drugs have an equivalent ED₅₀, then the LD₅₀ of drug B must be greater.

 

REF: pp. 31-32

 

TRUE/FALSE

 

15. Drug allergy and a side effect are two examples of dose-related responses.

 

ANS: False

Correct: A side effect of a drug may be dose related, but drug allergy is neither predictable nor dose related.

 

REF: p. 29

 

16. Tetracycline, nonsteroidal antiinflammatory drugs (NSAIDs), and the benzodiazepines are safe to administer to a pregnant patient.

 

ANS: False

Correct: Tetracycline, NSAIDs, and the benzodiazepines are examples of drugs used in dentistry that are contraindicated during pregnancy.

 

REF: p. 30

 

17. The greater the therapeutic index is, the greater the toxicity will be.

 

ANS: False

Correct: The therapeutic index is the ratio of the LD₅₀ to ED₅₀. The smaller the ratio is, the closer the LD₅₀ is to the ED₅₀ and therefore the closer a deadly dose is to the therapeutic dose. Therefore the lesser the therapeutic index is, the greater the toxicity will be.

 

REF: p. 32

Haveles: Applied Pharmacology for the Dental Hygienist, 6^th Edition

 

Chapter 05: Nonopioid (Nonnarcotic) Analgesics

 

Test Bank

 

MULTIPLE CHOICE

 

1. Pain:

 

1. Brings people to the dental office
2. Keeps people from the dental office
3. Can be effectively treated with inactive pills (placebos)
4. All of the above

 

ANS: d

Correct: Pain is often the issue that brings the patient to the dental office. Conversely, pain can be the factor that keeps the patient from seeking dental care at the appropriate time. Because many patients respond when given a placebo, the inclusion of a placebo is required for any acceptable analgesic clinical trials.

 

REF: p. 49

 

2. The pain threshold varies greatly in individuals because of different perception of pain.

 

1. Both parts of the statements are true.
2. Both parts of the statements are false.
3. The first part of the statement is true, the second part is false.
4. The first part of the statement is false, the second part is true.

 

ANS: c

Correct: The pain threshold does vary greatly in individuals. However, this variation is because of widely different reactions to pain.

 

REF: p. 49

 

3. Which of the following raises the pain threshold?

 

1. Emotional instability
2. Sympathy
3. Sleep
4. Both a and c
5. Both b and c

 

ANS: e

Correct: A decrease in the pain threshold (a greater reaction to pain) has been said to be associated with emotional instability, anxiety, fatigue, youth, certain nationalities, women, and fear and apprehension. The pain threshold is raised by sleep, sympathy, activities, and analgesics.

 

REF: p. 49

 

4. Synonyms for nonopioid analgesics include:

 

1. Narcotic
2. Central
3. Antipyretic
4. Strong

 

ANS: c

Correct: Nonopioid analgesics are also called nonnarcotic, peripheral, mild, and antipyretic.

Incorrect choices: Opioid analgesics are called narcotic, central, or strong analgesics.

 

REF: p. 50

 

5. Pain relief by nonopioid analgesics is mediated via action:

 

1. At the central nervous system (CNS)
2. At the peripheral nervous system
3. Both centrally and peripherally
4. None of the above

 

ANS: b

Correct: Nonopioid analgesics act primarily at the peripheral nerve endings, although their antipyretic effect is mediated centrally.

 

REF: p. 50