Pharmacology Study Questions

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1. A 45-year-old woman has had recurrent episodes of atrial fibrillation. She is receiving phenytoin and quinidine to control the atrial fibrillation. She is also taking a low dose of diazepam for insomnia and estrogen replacement therapy. You learn today that she has been receiving ciprofloxacin for a urinary track infection. The reason for her appointment today is that she has been having ringing in the ears, headache, nausea, and blurred vision. She tells you that she is also having trouble hearing the television. You suspect drug toxicity. The most likely agent is

(A) Ciprofloxacin

(B) Estrogen

(C) Phenytoin

(D) Diazepam

(E) Quinidine

2. You are asked to treat a 55-year-old patient for continuing ventricular arrhythmias. The patient is receiving timolol drops for glaucoma, daily insulin injections for diabetes mellitus, and an ACE inhibitor for hypertension. You decide to use phenytoin instead of procainamide because of what pharmacological effect of procainamide?

(A) The local anesthetic effect of procainamide would potentiate diabetes.

(B) The anticholinergic effect of procainamide would aggravate glaucoma.

(C) The hypertensive effects of procainamide would aggravate the hypertension.

(D) The local anesthetic effect of procainamide would aggravate the hypertension.

(E) The cholinergic effects of procainamide would aggravate the diabetes.

3. Exercise-induced ventricular tachycardia in persons without overt cardiac disease is an example of delayed after-depolarizations and is characterized by an increase in intracellular ionized calcium. This type of arrhythmia is known to often respond well to which of the following combinations?

(A) p-Blocker and ACE inhibitor

(B) Calcium channel antagonist and ACE inhibitor

(C) a-Blocker and ACE inhibitor

(D) p-Blocker and calcium channel antagonist

(E) a-Blocker and calcium channel antagonist

4. Antiarrhythmic drugs are classified in four main groups based on their predominant mechanism of action. Antiarrhythmic agents in which class suppress abnormal automaticity and permit the sino-atrial node to again assume the role of the dominant pacemaker?

5. Although most antiarrhythmic drugs (and indeed most drugs) are chemically synthesized, some compounds that occur endogenously in humans are useful. Indicate which of the following agents occurs endogenously and is a useful antiarrhythmic agent.

(A) Phenytoin

(B) Digoxin

(C) Adenosine

(D) Quinine

(E) Lidocaine

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