MOSBY PHARMA Flashcards

Question

25. All of the following are characteristics of xylitol EXCEPT one. Which one is the EXCEPTION? A. It inhibits the attachment of biofilm to teeth. B. It prevents the transmission of oral bacteria from mother to child. C. It reduces the levels of Streptococcus mutans in saliva and plaque. D. It is bactericidal to Streptococcus mutans in saliva and plaque.

Answer 1

ANS: D The mechanism of xylitol’s anticaries action is bacteriostatic (D), not bactericidal (D). The main strains of S. mutans and S. sanguis cannot metabolize xylitol, and this effect is potentiated with the addition of sorbitol. Xylitol has been found to inhibit the attachment of biofilm to teeth (A), prevent the transmission of oral bacteria from mother to child (B), and reduce the levels of S. mutans in saliva and plaque (C).

Answer 2

ANS: A Verapamil (Calan, Isoptin) (A) is a common calcium channel blocker. Furosemide (Lasix) (B) is a loop diuretic. Warfarin (Coumadin) (C) is an oral anticoagulant. Lovastatin (Mevacor) (D) is a hydroxymethylglutaryl coenzyme A reductase inhibitor

Answer 3

ANS: E Carbamazepine (Tegretol) is used in the treatment of trigeminal neuralgia (A) and other chronic pain syndromes (C) in addition to some seizure disorders (E). Parkinson disease (B) is treated with dopamine agonists and anticholinergics, but carbamazepine is not used in its treatment. Choice D does not contain the correct components.

Answer 4

ANS: C Bipolar depression (C) is commonly treated with lithium (Eskalith, Lithobid). Antipsychotics are the drugs of choice for the treatment of schizophrenia (A). Migraine headaches (B) are treated with propranol, and a variety of other medicines. Anxiety disorder (D) and obsessive– compulsive disorder (E) are treated with antidepressants.

Answer 5

ANS: B Glucocorticoids may exacerbate infections such as herpetic gingivostomatitis (B), which is a viral infection, and therefore are contraindicated for infectious oral lesions. Pemphigus vulgaris (A), erythema multiforme (C), and desquamative gingivitis (D) are all noninfectious oral lesions, which are effectively treated with systemically administered steroids.

Answer 6

ANS: C Substance P (B) is an autocoid that stimulates secretion from salivary glands. Histamine (A) and bradykinin (D) do not have the ability to stimulate salivary gland secretion. Pilocarpine (B) does stimulate secretion from salivary glands, but it is a parasympathetic agonist, not an autocoid.

Answer 7

ANS: D Naloxone (Narcan) (D), an opioid receptor antagonist, reverses the actions of other opioids. Flumazenil (Romazicon) (A), a benzodiazepine receptor antagonist, may not have any impact on the opioid overdose. Prochlorperazine (Compazine) (B) is one of a class of antipsychotic medications prescribed for treatment of nausea and vomiting and may exacerbate the symptoms of opioid overdose. Intravenous diphenhydramine (Benadryl) (C) is an antihistamine that may reverse some of the actions of the overdose, but it is not the best drug choice.

Answer 8

ANS: A Rosiglitazone (Avandia) (A) may take up to 6 to 14 weeks to achieve its maximum effect. Tolbutamide (Orinase) (B) and glimepiride (Amaryl) (D) work much faster than rosiglitazone. Exenatide (Byetta) (C) is not an oral antidiabetic agent; it is administered through subcutaneous injection.

Answer 9

ANS: B Prochlorperazine (Compazine) (B) is a phenothiazine (antiemetic drug), which is used to control nausea and vomiting. Omeprazole (Prilosec) (A) is a proton pump inhibitor used in the treatment of excessive stomach acid, not as an antiemetic. Cisplatin (Platinol) (C) is an antineoplastic agent. Codeine (D) is a narcotic analgesic, and nausea and vomiting are some of its side effects.

Answer 10

ANS: A Omalizumab (Xolair) (A) is the first of a new class of medications used to treat allergen-induced asthma. Cromolyn (Intal, Nasalcrom) (B) is effective only for the prophylaxis of asthma. Fluticasone (Flovent) (C) is an inhaled corticosteroid used to control symptoms in patients with mild, moderate, or severe persistent asthma, but not specifically allergen-induced asthma. Zileuton (Zyflo) (D) is a 5-lipoxygenase inhibitor, which prevents the synthesis of leukotrienes.

Answer 11

ANS: B Lidocaine (Xylocaine) (C) is a category B drug (no evidence of risk in humans) and is the best drug choice for the pregnant patient. Mepivacaine (Carbocaine) (A), bupivacaine (Marcaine) (C), and articaine (Septocaine) (D) are all pregnancy category C drugs; that is, there is a risk of fetal harm if the drug is administered.

Answer 12

ANS: C Lidocaine (Xylocaine) binds to and blocks sodium channels (C), which results in inhibition of nerve membrane depolarization and prevention of nerve conduction to the central nervous system (CNS), causing reversible anesthesia. Local anesthetics such as lidocaine are often termed “sodium channel blockers.” Dopamine (A) and serotonin receptors (D) are targets of several drugs that work on the CNS. Chloride channels (B) are targets of many sedatives.

Answer 13

ANS: B Metronidazole (Flagyl) is used clinically for two reasons: (1) treatment of certain parasitic diseases and (2) treatment of infections caused by anaerobic bacteria. Periodontal disease (B) typically involves anaerobic bacteria. Metronidazole is not effective against fungi such as Candida albicans and may increase the risk of oral candidiasis (A). Aphthous stomatitis (C) usually does not require medication. Xerostomia (dry mouth) (D) is not helped by metronidazole; the drug does not stimulate salivary flow. Metronidazole is not effective against Herpes simplex virus, the causative agent of cold sores (herpes labialis) (E).

Answer 14

ANS: C A dosage of 0.04mg (C) epinephrine, found in two cartridges of lidocaine (Xylocaine) (2%) with 1:100,000 epinephrine, is the safest dose for patients with cardiovascular disease and is even termed “the cardiac dose.” In the past, vasoconstrictors were avoided in patients with cardiovascular disease (A) because of the drug’s sympathetic nervous system effects in raising heart rate and blood pressure. Research has shown, however, that patients may produce far higher amounts of endogenous epinephrine if anesthesia is insufficient, so it is safer to control the dose. Doses of 0.4mg (B) and 0.2mg (D) of a vasopressor are high enough to have an adverse effect on the cardiovascular system in a patient with disease.

Answer 15

ANS: B Cevimeline (Evoxac) (B) stimulates muscarinic cholinergic receptors, directly stimulating saliva secretion from the salivary gland cells. Amitriptyline (Elavil) (A), an antidepressant drug that blocks muscarinic receptors, would decrease salivary flow. Oxymetazoline (Afrin) (C) stimulates alpha 2-adrenergic receptors and has much less effect on salivary flow compared with cevimeline. Salmeterol (Serevent) (D) stimulates beta 2-adrenergic receptors and has little effect on salivary flow rate.

Answer 16

ANS: C Lisinopril (Prinivil) is an angiotensin-converting enzyme (ACE) inhibitor, with multiple indications in treatment of cardiovascular conditions. ACE inhibitors do not have a significant effect on hypercholesterolemia (C). Lisinopril reduces the load on the heart by vasodilation, which makes it useful in treating heart failure (A) by reducing the risk of deleterious vascular and cardiac remodeling. By inhibiting the production of angiotensin II, lisinopril reduces blood pressure in hypertensive patients (B). It is also indicated for patients with arrhythmias (D) and recent myocardial infarctions (E) to reduce the likelihood of subsequent cardiac events

Answer 17

ANS: B In high doses, acetaminophen may be converted to toxic radicals, which damage the liver (B). Patients with preexisting liver disease, those with alcoholism, and others are more susceptible. Acetaminophen poisoning accounts for a large number of emergency visits to the hospital, as well as many deaths as a result of liver damage. Although kidney damage (A) has been associated with the use of nonnarcotic analgesics, these disorders have usually occurred after long-term chronic use and when combinations of these types of drugs have been used. Acetaminophen does not have noticeable sedative (C) properties. It does not worsen asthma (D) unless an allergic reaction to acetaminophen occurs, which is rare. There is no known link between acetaminophen and bladder infections (E), since the drug has no major effect on structures in the urinary tract

Answer 18

ANS: E Only aspirin (E) irreversibly inhibits cyclooxygenase, which inhibits the synthesis of thromboxane A2 , and inhibits platelet aggregation for the life of the platelet (7–10 days). Nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (A) and naproxen (B) may also affect blood clotting but do so only for a short time because they reversibly inhibit cyclooxygenase and inhibit the synthesis of thromboxane A2 . Acetaminophen (C) has a minor effect on blood clotting in most cases. Codeine (D) has no major effect on blood clotting mechanisms, including platelet aggregation.

Answer 19

ANS: B Prednisone (Deltasone) (B), a glucocorticoid, has several mechanisms that make it a potent antiinflammatory drug used in a variety of settings. Inhibition of phospholipase A2 , a key enzyme in the inflammatory prostanoid and leukotriene pathway is a primary antiinflammatory action. Alendronate (Fosamax) (A) is a bisphosphonate that is used to reduce bone turnover. Atenolol (Tenormin) (C) is a beta-adrenergic receptor blocker that has a number of cardiovascular effects but not an antiinflammatory effect. Raloxifene (Evista) (D) is an estrogen receptor agonist–antagonist, more commonly known as a selective estrogen receptor modulator (SERM), with a beneficial effect in the treatment of postmenopausal osteoporosis, but no antiinflammatory action. Fluoxetine (Prozac) (E) is a selective serotonin reuptake inhibitor (SSRI), whose action in the brain mediates its antidepressant effect.

Answer 20

ANS: C HMG CoA reductase is an important enzyme in the synthesis of cholesterol in the liver (C). Drugs such as Lovastatin (Mevacor) and other “statins” reduce plasma cholesterol by this mechanism. Statins have a less direct effect on cardiac arrhythmias (A) and hypertension (B), although lowering plasma cholesterol often has a beneficial effect in patients receiving these agents. Statins have little if any effect on fungal organisms (D). Statins do not treat the inflammation or the pain of osteoarthritis (E).

Answer 21

ANS: D The pain described is consistent with trigeminal neuralgia (tic douloureux) because of the type of pain, the location of the pain involving cranial nerve V, and the fact that a neurologist made the diagnosis. Carbamazepine (Tegretol) (D) is a drug commonly used to treat trigeminal neuralgia. It is effective in inhibiting nerve conduction by blocking neuronal sodium channels, and this also makes it useful to treat certain types of seizure disorders. Oxycodone (Percodan, Percocet) (A) and dihydrocodeine (Synalgos DC) (B) are both opioids and are useful in treating pain but are less effective in treating the neuropathic type pain described here. Celecoxib (Celebrex) (C) is a cyclooxygenase-2 (COX-2) inhibitor and is used as an antiinflammatory and analgesic agent. Acetaminophen (Tylenol) (E) is not particularly effective in treating neuropathic pain

Answer 22

ANS: A Amoxicillin (Amoxil) (A), like other penicillins, inhibits the enzyme transpeptidase, which catalyzes cross-linking in bacterial cell walls. Clindamycin (Cleocin) (B), clarithromycin (Biaxin) (C), and gentamicin (Garamycin) (E) all inhibit ribosomal protein synthesis in bacteria. Ciprofloxacin (Cipro) (D) inhibits deoxyribonucleic acid (DNA) function by inhibiting DNA enzymes.

Answer 23

ANS: A Sweating (A) is the most common complaint of patients taking muscarinic cholinergic receptor agonists such as pilocarpine (Salagen) for the treatment of xerostomia. Although innervated by the sympathetic nervous system, sweat glands have muscarinic receptors that respond to postganglionic cholinergic nerves, resulting in increased secretion and these receptors also respond to pilocarpine. Cholinergic postganglionic nerves are otherwise rare in the sympathetic nervous system. Although tachycardia (B) is a possibility because of vasodilation, the vasodilation is usually mild or nonexistent with the oral doses used in this situation. Muscarinic receptor stimulation would tend to have very mild effects opposite to urinary retention (C) and constipation (E). Hypertension (D) is not likely to occur with the effect of pilocarpine, since cholinergic agonists usually decrease blood pressure and slow heart rate.

Answer 24

ANS: D Acetylcholine (D) is the major neurotransmitter in ganglia and carries the stimulatory message from the preganglionic neuron to the postganglionic neuron. Acting on nicotinic cholinergic receptors linked to sodium channels, acetylcholine causes a rapid excitatory postsynaptic potential. Dopamine (A), norepinephrine (C), or both are released from interneurons in sympathetic ganglia, but they cause an inhibitory postsynaptic potential. Epinephrine (B) plays no major role in preganglionic transmission. Serotonin (E) may have a minor role in neurotransmission in some ganglia, but only in a delayed response in the postganglionic neurons.

Answer 25

ANS: D Diphenhydramine (Benadryl) (D) is an antihistamine that blocks histamine H1 receptors and inhibits the above effects of histamine on nerves and blood vessels. Chlorthalidone (Hygroton) (A) is a thiazidetype diuretic. Doxazosin (Cardura) (B) is an alpha 1-adrenergic receptor blocker. Candesartan (Atacand) (C) is an angiotensin II receptor blocker. Isoproterenol (Isuprel) (E) is a nonselective beta-adrenergic receptor agonist. These drugs are typically used in the treatment of hypertension but have no or minimal effects on acute responses to histamine because they do not block histamine receptors or alleviate acute inflammation

Answer 26

ANS: B Metoprolol (Lopressor) (B) is a selective beta 1-adrenergic receptor blocker. Beta-blockers are contraindicated in asthma because by blocking the beta 2-adrenergic receptors in the lung, bronchoconstriction may occur. Selective beta 1-adrenergic receptor blockers have primarily cardiac effects and are less likely to cause bronchoconstriction than nonselective beta-adrenergic receptor blockers. These drugs should still be used with caution in patients with asthma, since these drugs have no direct benefit in the relief of asthma symptoms. Fluticasone (Flonase) (A) is a glucocorticoid, with an antiinflammatory effect in the lung, reducing the inflammatory component of asthma. Salmeterol (Serevent) (C) is a long-acting beta 2-adrenergic receptor agonist, which causes bronchodilation. Ipratropium (Atrovent) (D) is an antimuscarinic, anticholinergic drug that blocks the bronchoconstricting effect of acetylcholine that is released in the lung. Montelukast (Singulair) (E) is a cysteinyl leukotriene 1 receptor blocker. Cysteinyl leukotrienes are inflammatory mediators that contribute to bronchoconstriction.

Answer 27

ANS: E Erythromycin inhibits the liver enzymes (the cytochromes) needed to metabolize many drugs, including theophylline (E). The symptoms described are consistent with theophylline toxicity, which occurred when failure to metabolize theophylline caused the plasma levels to rise to harmful levels. Erythromycin does not affect renal excretion of other drugs (A). Erythromycin may cause severe gastrointestinal distress but does not enhance absorption of other drugs (B). Theophylline does not affect cell affinity for erythromycin (C), or decrease its excretion (D). Because of the low therapeutic index of theophylline, another choice of antibiotic would be better.

Answer 28

ANS: E Potencies of traditional antipsychotic drugs such as thioridazine are correlated with their affinities for D2 dopamine receptors (E). Blocking the reuptake of norepinephrine and serotonin (A) is the mechanism of action of several antidepressants. Blocking sodium channels in the central nervous system (CNS) (B) is a mechanism of action of several antiepileptic drugs such as phenytoin. Blocking calcium channels in the CNS (C) is a characteristic of several antiepileptic drugs used in the treatment of absence (petit mal) seizures. Most sedatives act by enhancing the effect of GABA (D), an inhibitory neurotransmitter, on chloride channels

Answer 29

ANS: C Phentolamine is a drug that causes reversal of sodium channel blockage (C), shortening the time of soft tissue anesthesia following a dental procedure. The mechanism is related to its ability to block the vasoconstriction resulting from alpha-adrenergic receptor stimulation caused by epinephrine and norepinephrine. The resulting vasodilation leads to more rapid removal of the local anesthetic from the area of injection after the phentolamine is injected. Reversal of calcium channel blockage (A) is not an action of phentolamine (OraVerse). Calcium channel blockage (B) is the action of hypertensive medications such as verapamil (Calan, Isoptin). Blockage of sodium channels (D) is the action of the local anesthetic agent, not phentolamine.

Answer 30

ANS: B Sumatriptan (Imitrex, Alsuma) is an agonist at serotonin 5HT1B/1D receptors. Sumatriptan and other triptans cause constriction of intracranial blood vessels, reduce pain fiber activity, and reduce inflammation associated with migraine headaches (B). The triptans have little effect at other receptors and the mechanism of action of sumatriptan has little benefit in the treatment of other disorders. Sumatriptan does little to change cholesterol metabolism (A) or to reduce bronchoconstriction in asthma attacks (C). Sumatriptan has no obvious benefit on ion channel activity in the heart (D) and may even be associated with certain arrhythmias. Sumatriptan has no activity on opioid receptors (E).

Answer 31

ANS: A Amoxicillin (Amoxil) (A) is the penicillin with a broadest spectrum of action and is called an “extendedspectrum” penicillin because it has greater activity compared with the other penicillins listed against gram-negative bacilli. Clavulanic acid (in Augmentin) (B) is not a penicillin, although its structure resembles penicillin with a beta-lactam ring, it has little antibacterial effect by itself. It is a beta-lactamase inhibitor and is added to amoxicillin to prevent amoxicillin’s destruction by bacterial penicillinases. Dicloxacillin (Dynapen) (C) is a narrow-spectrum penicillin but is resistant to some penicillinases. Penicillin G (Pfizerpen) (D) and penicillin V (Penicillin VK) (E) have both have essentially the same narrow spectrum of action against many grampositive bacteria and some gram-negative cocci. Although less active than penicillin G and penicillin V, dicloxacillin’s resistance to penicillinase makes it useful in the treatment of infections caused by penicillinaseproducing Staphylococcus aureus

Answer 32

ANS: E Warfarin (Coumadin) (E) competitively inhibits vitamin K epoxide reductase, acting as a vitamin K antagonist. This action leads to inhibition of carboxylation of prothrombin factors VII, IX, and X, as well as other factors leading to reduced coagulation capacity. The other drugs listed act on elements in blood. Aspirin (A) and clopidogrel (Plavix) (C) are inhibitors of platelet aggregation; aspirin, due to its effect on cyclooxygenase, inhibits the production of thromboxane A2 , and clopidogrel inhibits the effect of adenosine diphosphate on platelets. Alteplase (t-PA, Activase) (B) binds to fibrin and leads to the hydrolysis and breakup of fibrin. Heparin (D) reduces blood clotting by accelerating the activity of antithrombin III and by other mechanisms.

Answer 33

ANS: C NO is not an effective skeletal muscle relaxant (C) even at higher anesthetic doses. NO has significant analgesic effects (A). It is noted for rapid induction (B) because of its low blood-to-gas solubility coefficient. NO is heavier than air (D) and may accumulate at floor level under conditions of poor ventilation or conditions of poor scavenging. It is odorless (E) and tasteless to the patient.

Answer 34

ANS: E Paroxetine (Paxil) (E) is an antidepressant that primarily blocks the reuptake of serotonin in the brain. Amitriptyline (Elavil) (A), also an antidepressant, blocks both serotonin and norephinephrine reuptake mechanisms nonselectively. The mechanism of bupropion (Wellbutrin) (B) is not as well understood, although reuptake of dopamine may play a role. Haloperidol (Haldol) (C) is an antipsychotic drug that blocks the dopamine receptors. Lithium (Eskalith) (D) is used in treatment of the manic phase of bipolar disease or manic-depressive illness.

Answer 35

ANS: E Vancomycin (Vancocin) (E) is the antibiotic indicated for the treatment of S. Aureus. It is active in the presence of penicillinases produced by S. aureus and other mechanisms of resistance to beta-lactams. MRSA is largely resistant to clarithromycin (Biaxin) (B). Dicloxacillin (Dynapen) (C) is very similar to methicillin and is ineffective against this infection. Resistance by MRSA also extends to other betalactam antibiotics such as cephalexin (Keflex) (A) and penicillin V (Pen-Vee-k) (D)

Answer 36

ANS: B Curare-type drugs are competitive blockers of the nicotinic type of cholinergic receptors in the skeletal neuromuscular junction (B). Activation of chloride channels (A), either through GABA or independently of GABA, is the mechanism that applies to many sedative hypnotics that have some ability to relax skeletal muscle. Reducing blood flow (C) is not relevant to the action of any muscle relaxer. Reducing calcium release from intracellular stores (D) is the mechanism of action of dantrolene (Dantrium), which is not a curare-type drug. Blocking ganglionic transmission (E) would be ineffective in causing skeletal muscle relaxation because skeletal muscles are innervated by somatic nerves, which do not have ganglia

Answer 37

ANS: D A drug that causes an adverse reaction in the developing fetus is termed teratogenic effect (D). The FDA has ranked drugs into five pregnancy categories: A, B, C, D, and X, ranked from least risky to most risky. A side effect (A) is a dose-related reaction that is not part of the desired therapeutic effect. A toxic effect (B) is an extension of the pharmacologic effect resulting from the drug’s excessive and harmful effect on the target organ. The therapeutic effect (C) is the desired drug effect on target organs. An idiosyncratic effect or reaction (E) is a genetically related abnormal drug response that is atypical compared with that in the general population.

Answer 38

ANS: E Prednisone (Deltasone) (E), as well as other glucocorticosteroids, promotes a negative calcium balance by decreasing calcium absorption from the gastrointestinal (GI) tract. They also increase osteoclast activity and decrease osteoblast activity in bone and have other mechanisms as well. These effects may, and often do, lead to osteoporosis. Alendronate (Fosamax) (A) is a bisphosphonate, and bisphosphonates bind to bone remodeling surfaces, reducing the number and activity of osteoclasts. This is useful in treating certain bone loss disorders such as osteoporosis and Paget disease. Estrogens, including ethinyl estradiol (Estinyl) (B) and conjugated estrogens (Premarin) (C), increase osteoblast activity, which then suppresses the action of osteoclasts. Raloxifene (Evista) (D) is a selective estrogen receptor modulator (SERM), which has a similar beneficial effect on bone. It is more selective than ethinyl estradiol or conjugated estrogens in its ability to stimulate estrogen receptors.

Answer 39

ANS: B Bupivacaine (Marcaine) (B) is chemically similar to mepivacaine but with an additional substitution that is highly lipid soluble. This change increases the potency and duration of the action of bupivacaine for up to 8 hours of analgesia, making it the longest-acting local anesthetic that is commonly used in dentistry. Articaine (Septocaine) (A) has a duration of action of 3 to 4 hours, making it an intermediate-acting local anesthetic. Lidocaine (Xylocaine) without epinephrine (C) and mepivacaine (Carbocaine) (D) have a short duration of 30 to 90 minutes of analgesia. Prilocaine (Citanest) (E) without epinephrine has an intermediate duration of 2 to 4 hours of analgesia

Answer 40

ANS: D Metoprolol (Lopressor) (D), blocks beta 1-adrenergic receptors in the juxtaglomerular cells of the kidney’s afferent arterioles, inhibiting the release of renin. Renin catalyzes the conversion of angiotensinogen to angiotensin I, which causes vasoconstriction, and stimulates aldosterone release. Aldosterone promotes sodium retention in the kidney, further raising blood pressure by vasoconstriction. Blocking the renin– angiotensin pathway reduces blood pressure and the demand on the heart, making this class of drugs important in the treatment of hypertension and heart failure. Candesartan (Atacand) (A) and enalapril (Vasotec) (C) also inhibit this pathway but do so “downstream” from renin release: Enalapril inhibits angiotensin-receptor-enzyme (ACE); and candesartan blocks the angiotensin II receptor. Digoxin (Lanoxin) (B) stimulates the heart directly, increasing its force of contraction. It does so by inhibiting the sodium– potassium pump (Na+,K+–adenosine triphosphatase [ATPase]) in the plasma membranes of cardiac cells. Nifedipine (Procardia) (E) is a calcium channel blocker, which reduces the contraction of cardiac muscle and increases vasodilation of the arteries—two methods of reducing blood pressure. This action is not linked to renin release

Answer 41

ANS: B Cimitidine (Tagamet) is a prototype of the H2 -receptor antagonists which inhibit secretion of gastric acid by competitive inhibition of the H2 -receptors of the parietal cells of the stomach. One of the most serious adverse effects of cimitidine is its ability to inhibit liver microsomal enzymes via the cytochrome P-450 enzymes, slowing the elimination of some drugs in blood plasma. This may lead to increased drug levels and toxicity (B), even when drugs such as lidocaine are given in therapeutic doses. The clinician should exercise caution and use the lowest possible dose of local anesthetic in patients on cimetidine. Concurrent administration of cimitidine (Tagamet) would not negate lidocaine’s local anesthetic properties (A). The efficacy of lidocaine would be increased with administration of cimitidine (Tagamet) (C). Allergic reactions to lidocaine are rare, and cimitidine (Tagamet) does not increase these types of reactions (D)

MOSBY PHARMA Flashcards

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