PEBC EVALUATING 2024 NEWEST EXAM 2 VERSIONS
WITH 150 QUESTIONS WITH DETAILED VERIFIED
ANSWERS (100% CORRECT) /ALREADY GRADED A+
Which CYP-interacting drugs increase the levels of propranolol and metoprolol? -
ANSWER: CYP2D6 inhibitors (e.g. amiodarone, paroxetine)
How does digoxin benefit CHF? Atrial fibrillation? - ANSWER: Digoxin is a mild
positive ionotrope to help HF and is a negative chronotrope to help Afib.
Which beta-blocker is more likely to cause CNS side effects, such as depression and
insomnia? Why - ANSWER: Propranolol will have more CNS side effects due to its
greater lipid solubility and ability to cross the BBB.
Name 4 cardioselective beta-blockers. What are the implications of this selectivity? -
ANSWER: Atenolol
Acebutolol
Bisoprolol
Metoprolol
Higher selectivity means less non-cardiac side effects, such as bronchospasm.
Which 2 beta blockers have intrasympathetic activity or ISA? What are the
implications of this? - ANSWER: Pindolol
Acebutolol
This may be preferred beta blocker agents in patients that are already bradycardic at
rest as they have less effect on the heart rate.
The 3 DHP-CCBs. - ANSWER: Amlodipine
Felodipine
Nifedipine
Characteristics side effects of DHP-CCBs. - ANSWER: Ankle edema
Flushing
The 2 non-DHP-CCBs - ANSWER: Diltiazem
Verapamil
Out of the 2 non-DHP CCBs, which one is more likely to cause constipation? -
ANSWER: Verapamil > Diltiazem
Instructions on how to use nitroglycerin SL tablets or spray. - ANSWER: Use 1 spray
or tablet when anginal symptoms occur. Use 1 dose every 5 minutes for a total of 3
doses. If there is no improvement after the first dose or no resolution after 3 doses,
seek medical help (call ambulance)!
Characteristic side effect of nitrates. - ANSWER: Headache!
,How does verapamil interact with digoxin? - ANSWER: Verapamil reduces the renal
clearance of digoxin, increasing digoxin levels.
Where do nitrates have their effect? - ANSWER: Veins! Reduces afterload!
Why must individuals have a 10-12 hour nitrate-free period? - ANSWER: To prevent
tolerance!
Characteristic drug interaction with nitrates. - ANSWER: PDE-5 Inhibitors (sildenafil,
tadalafil, vardenafil)
Definition of syncope - ANSWER: Reversible loss of consciousness not requiring
resuscitative measures or related to a seizure
Non-pharmacological options for vasovagal syncope. - ANSWER: Increased sodium
intake (3-5 grams daily) and fluid intake (2.5 L).
Effects of fludrocortisone. - ANSWER: Potent mineralcorticoid: retains sodium,
increases loss of potassium
Glucocorticoid effects as well
Non-pharmacological choices for orthostatic hypotension - ANSWER: Avoid
hypotensive, volume depleting drugs as much as possible.
Increased sodium and fluid intake.
Elevate head while laying down.
Avoid hemodynamic stress (e.g. getting up too quickly).
Drug(s) that can be used for both vasovagal syncope and orthostatic hypotension. -
ANSWER: Fludrocortisone
Midodrine (?)
MOA of midodrine - ANSWER: Increases venous return through venoconstriction and
arterial constriction to increase blood pressure.
Drugs used for orthostatic hypotension - ANSWER: Fludrocortisone
Indomethacin
Midodrine
Non-selective beta-blockers
Characteristic side effect of midodrine - ANSWER: Supine hypertension
Shivering
What class of drug does midodrine belong to? - ANSWER: Alpha-1 adrenergic
agonists
Most likely pathogen causing osteomyelitis. - ANSWER: Staphylococcus aureus
, What type of dressing for diabetic foot infections are preferred? - ANSWER: Moist
wound dressings
Initial therapy for diabetic foot infections should target which pathogens? - ANSWER:
Staphylococcus aureus
Beta-hemolytic streptococci
Ertapenem is a broad spectrum antibiotic. Describe its activity. - ANSWER: Active
against: Gram-positive, Gram-negative, Anaerobes
INEFFECTIVE against: Pseudomonas aeruginosa, MRSA, enterococci
Difference between imipenem or meropenem and ertapenem in regards to their
activity. - ANSWER: Imipenem and meropenem is active against P. aeruginosa while
ertapenem is not!
True or False: Carbapenems can be used against MRSA. - ANSWER: FALSE!
Activity of first generation cephalosporins. - ANSWER: Mostly gram-positive, some
gram-negative.
Improvements in second generation cephalosporins vs. first generation. - ANSWER:
More activity against gram-negative. Activity against anaerobes.
Difference between cefuroxime and cefoxitin. - ANSWER: Cefuroxime does not have
activity against anaerobes.
Difference between ceftazidime and ceftriaxone in terms of activity. - ANSWER:
Ceftazidime can be used against P. aeruginosa but ceftriaxone cannot!
Notable activity of ciprofloxacin. - ANSWER: Gram-negative bacteria
Pseudomonas aeruginosa
Red man syndrome can occur in which antibiotic? - ANSWER: Vancomycin causes
histamine release if infused in less than 1 hour.
Characteristic activity of vancomycin. - ANSWER: MRSA and other gram positive
bacteria.
Oral drug that has activity against MRSA. - ANSWER: Clindamycin
SMX/TMP
Doxycycline
Activity of metronidazole. - ANSWER: Anaerobes
Characteristic activity of linezolid - ANSWER: MRSA and other gram positive bacteria
WITH 150 QUESTIONS WITH DETAILED VERIFIED
ANSWERS (100% CORRECT) /ALREADY GRADED A+
Which CYP-interacting drugs increase the levels of propranolol and metoprolol? -
ANSWER: CYP2D6 inhibitors (e.g. amiodarone, paroxetine)
How does digoxin benefit CHF? Atrial fibrillation? - ANSWER: Digoxin is a mild
positive ionotrope to help HF and is a negative chronotrope to help Afib.
Which beta-blocker is more likely to cause CNS side effects, such as depression and
insomnia? Why - ANSWER: Propranolol will have more CNS side effects due to its
greater lipid solubility and ability to cross the BBB.
Name 4 cardioselective beta-blockers. What are the implications of this selectivity? -
ANSWER: Atenolol
Acebutolol
Bisoprolol
Metoprolol
Higher selectivity means less non-cardiac side effects, such as bronchospasm.
Which 2 beta blockers have intrasympathetic activity or ISA? What are the
implications of this? - ANSWER: Pindolol
Acebutolol
This may be preferred beta blocker agents in patients that are already bradycardic at
rest as they have less effect on the heart rate.
The 3 DHP-CCBs. - ANSWER: Amlodipine
Felodipine
Nifedipine
Characteristics side effects of DHP-CCBs. - ANSWER: Ankle edema
Flushing
The 2 non-DHP-CCBs - ANSWER: Diltiazem
Verapamil
Out of the 2 non-DHP CCBs, which one is more likely to cause constipation? -
ANSWER: Verapamil > Diltiazem
Instructions on how to use nitroglycerin SL tablets or spray. - ANSWER: Use 1 spray
or tablet when anginal symptoms occur. Use 1 dose every 5 minutes for a total of 3
doses. If there is no improvement after the first dose or no resolution after 3 doses,
seek medical help (call ambulance)!
Characteristic side effect of nitrates. - ANSWER: Headache!
,How does verapamil interact with digoxin? - ANSWER: Verapamil reduces the renal
clearance of digoxin, increasing digoxin levels.
Where do nitrates have their effect? - ANSWER: Veins! Reduces afterload!
Why must individuals have a 10-12 hour nitrate-free period? - ANSWER: To prevent
tolerance!
Characteristic drug interaction with nitrates. - ANSWER: PDE-5 Inhibitors (sildenafil,
tadalafil, vardenafil)
Definition of syncope - ANSWER: Reversible loss of consciousness not requiring
resuscitative measures or related to a seizure
Non-pharmacological options for vasovagal syncope. - ANSWER: Increased sodium
intake (3-5 grams daily) and fluid intake (2.5 L).
Effects of fludrocortisone. - ANSWER: Potent mineralcorticoid: retains sodium,
increases loss of potassium
Glucocorticoid effects as well
Non-pharmacological choices for orthostatic hypotension - ANSWER: Avoid
hypotensive, volume depleting drugs as much as possible.
Increased sodium and fluid intake.
Elevate head while laying down.
Avoid hemodynamic stress (e.g. getting up too quickly).
Drug(s) that can be used for both vasovagal syncope and orthostatic hypotension. -
ANSWER: Fludrocortisone
Midodrine (?)
MOA of midodrine - ANSWER: Increases venous return through venoconstriction and
arterial constriction to increase blood pressure.
Drugs used for orthostatic hypotension - ANSWER: Fludrocortisone
Indomethacin
Midodrine
Non-selective beta-blockers
Characteristic side effect of midodrine - ANSWER: Supine hypertension
Shivering
What class of drug does midodrine belong to? - ANSWER: Alpha-1 adrenergic
agonists
Most likely pathogen causing osteomyelitis. - ANSWER: Staphylococcus aureus
, What type of dressing for diabetic foot infections are preferred? - ANSWER: Moist
wound dressings
Initial therapy for diabetic foot infections should target which pathogens? - ANSWER:
Staphylococcus aureus
Beta-hemolytic streptococci
Ertapenem is a broad spectrum antibiotic. Describe its activity. - ANSWER: Active
against: Gram-positive, Gram-negative, Anaerobes
INEFFECTIVE against: Pseudomonas aeruginosa, MRSA, enterococci
Difference between imipenem or meropenem and ertapenem in regards to their
activity. - ANSWER: Imipenem and meropenem is active against P. aeruginosa while
ertapenem is not!
True or False: Carbapenems can be used against MRSA. - ANSWER: FALSE!
Activity of first generation cephalosporins. - ANSWER: Mostly gram-positive, some
gram-negative.
Improvements in second generation cephalosporins vs. first generation. - ANSWER:
More activity against gram-negative. Activity against anaerobes.
Difference between cefuroxime and cefoxitin. - ANSWER: Cefuroxime does not have
activity against anaerobes.
Difference between ceftazidime and ceftriaxone in terms of activity. - ANSWER:
Ceftazidime can be used against P. aeruginosa but ceftriaxone cannot!
Notable activity of ciprofloxacin. - ANSWER: Gram-negative bacteria
Pseudomonas aeruginosa
Red man syndrome can occur in which antibiotic? - ANSWER: Vancomycin causes
histamine release if infused in less than 1 hour.
Characteristic activity of vancomycin. - ANSWER: MRSA and other gram positive
bacteria.
Oral drug that has activity against MRSA. - ANSWER: Clindamycin
SMX/TMP
Doxycycline
Activity of metronidazole. - ANSWER: Anaerobes
Characteristic activity of linezolid - ANSWER: MRSA and other gram positive bacteria
