CH-13 Gynecologic and Obstetric Drugs – Understanding Pharmacology for Health Professionals : Exam Guide

Chapter 13: Gynecologic and Obstetric Drugs 1. Which of the following is NOT the action of a drug used to prevent pregnancy? a. Changing the hormonal environment so that the ovary does not release a mature ovum b. Preventing the production of spermatozoa in the male c. Keeping a fertilized ovum from implanting in the endometrium d. Killing spermatozoa from the male Answer: b. Preventing the production of spermatozoa in the male Correct Feedback: There are no drugs used to prevent pregnancy that can prevent the production of spermatozoa in the male. Drugs used to prevent pregnancy act in one of several different ways: They change the hormonal environment of the female reproductive tract so that a mature ovum is not produced or released by the ovary, they kill spermatozoa from the male, or they keep a fertilized ovum from implanting in the endometrium. a. Changing the hormonal environment so that the ovary does not release a mature ovum Incorrect Feedback: This is the action of a drug used to prevent pregnancy. c. Keeping a fertilized ovum from implanting in the endometrium Incorrect Feedback: This is the action of a drug used to prevent pregnancy. d. Killing spermatozoa from the male Incorrect Feedback: This is the action of a drug used to prevent pregnancy. 2. Monophasic oral contraceptive drugs have a ________. a. fixed dose of a progestin and a varying dose of an estrogen b. fixed dose of a progestin and a fixed dose of an estrogen c. varying dose of a progestin and a fixed dose of an estrogen d. varying dose of both a progestin and an estrogen Answer: b. fixed dose of a progestin and a fixed dose of an estrogen Correct Feedback: A monophasic oral contraceptive drug has one phase of treatment with fixed doses of a progestin and an estrogen in each hormone tablet. a. fixed dose of a progestin and a varying dose of an estrogen Incorrect Feedback: Monophasic oral contraceptive drugs do not have a varying dose of an estrogen. c. varying dose of a progestin and a fixed dose of an estrogen Incorrect Feedback: Monophasic oral contraceptive drugs do not have a varying dose of a progestin. d. varying dose of both a progestin and an estrogen Incorrect Feedback: Monophasic oral contraceptive drugs do not have a varying dose of both a progestin and an estrogen. 3. Ovulation-stimulating drugs stimulate ______. a. a non-ovulating ovary to release a single mature ovum b. a non-ovulating ovary to release several mature ova c. an ovulating ovary to release a single mature ovum d. an ovulating ovary to release several mature ova Answer: b. a non-ovulating ovary to release several mature ova Correct Feedback: Ovulation-stimulating drugs stimulate a non-ovulating ovary to develop multiple follicles and then release several mature ova. a. a non-ovulating ovary to release a single mature ovum Incorrect Feedback: Ovulation-stimulating drugs stimulate a non-ovulating ovary but not to release just a single mature ovum. c. an ovulating ovary to release a single mature ovum Incorrect Feedback: Ovulation-stimulating drugs are not prescribed when the ovaries are able to ovulate on their own. d. an ovulating ovary to release several mature ova Incorrect Feedback: Ovary-stimulating drugs are not prescribed when the ovaries are able to ovulate on their own. 4. Few drugs are prescribed during pregnancy, particularly during the ______ trimester because of the increased risk of causing birth defects in the developing fetus. a. first b. second c. third d. first and second Answer: a. first Correct Feedback: Few drugs are prescribed during pregnancy, particularly during the first trimester, because of the increased risk of causing birth defects in the developing fetus. b. second Incorrect Feedback: This is not correct. c. third Incorrect Feedback: This is not correct. d. first and second Incorrect Feedback: This is not correct. 5. Amenorrhea and abnormal uterine bleeding are treated with ________ drugs that act directly on the endometrium to restore a normal menstrual cycle. a. analgesic b. antibiotic c. hormone replacement therapy d. progestin Answer: d. progestin Correct Feedback: Amenorrhea (the absence of menstruation) and abnormal uterine bleeding are treated with progestin drugs that act directly on the tissues of the endometrium to restore a normal menstrual cycle. a. analgesic Incorrect Feedback: Analgesic drugs are not used to treat amenorrhea and abnormal uterine bleeding. b. antibiotic Incorrect Feedback: Antibiotic drugs are not used to treat amenorrhea and abnormal uterine bleeding. c. hormone replacement therapy Incorrect Feedback: Hormone replacement therapy drugs are not used to treat amenorrhea and abnormal uterine bleeding. 6. The implantable forms of contraceptive drugs, such as Mirena, contain ________. a. only progestin b. only estrogen c. both estrogen and progestin d. neither estrogen nor progestin Answer: a. only progestin Correct Feedback: These progestin-only (etonogestrel, levonorgestrel, progesterone) contraceptive drugs are contained within an implant that is inserted under the skin or within a T-shaped device that is inserted into the uterus: Implanon, Mirena, Progestasert. b. only estrogen Incorrect Feedback: Implantable contraceptive drugs do not contain only estrogen. c. both estrogen and progestin Incorrect Feedback: Implantable contraceptive drugs do not contain both estrogen and progestin. d. neither estrogen nor progestin Incorrect Feedback: Implantable contraceptive drugs do contain progestin. 7. Which of the following is NOT one of the ways in which drugs are used to treat infertility? a. They prevent the ovaries from growing follicles. b. They correct hormonal imbalances. c. They prepare the endometrium to receive a fertilized ovum. d. They stimulate the ovaries to produce ova. Answer: a. They prevent the ovaries from growing follicles. Correct Feedback: Drugs used to treat infertility either stimulate the ovaries to produce ova, prepare the endometrium to receive a fertilized ovum, or correct hormonal imbalances. b. They correct hormonal imbalances. Incorrect Feedback: Drugs used to treat infertility do correct hormonal imbalances. c. They prepare the endometrium to receive a fertilized ovum. Incorrect Feedback: Drugs used to treat infertility do prepare the endometrium to receive a fertilized ovum. d. They stimulate the ovaries to produce ova. Incorrect Feedback: Drugs used to treat infertility do stimulate the ovaries to produce ova. 8. Drugs used to treat premature labor act on beta2 receptors in the smooth muscle of the uterus to ________. a. decrease the frequency of uterine contractions b. increase both the frequency and strength of uterine contractions c. decrease the strength of uterine contractions d. a and c Answer: d. a and c Correct Feedback: Drugs used to treat premature labor act on beta2 receptors in the smooth muscle of the uterus to decrease the frequency and strength of uterine contractions. a. decrease the frequency of uterine contractions Incorrect Feedback: This is true, but it is not the only correct answer. b. increase both the frequency and strength of uterine contractions Incorrect Feedback: Drugs used to treat premature labor do not increase the frequency and strength of uterine contractions. c. decrease the strength of uterine contractions Incorrect Feedback: This is true, but it is not the only correct answer. 9. When the cervix does not dilate and thin during labor, which type of drug can be given? a. an analgesic drug b. an estrogen drug c. an ovulation-stimulating drug d. a prostaglandin drug Answer: d. a prostaglandin drug Correct Feedback: When the cervix does not dilate and thin during labor, prostaglandin drugs may be given. a. an analgesic drug Incorrect Feedback: Analgesic drugs do not dilate and thin the cervix. b. an estrogen drug Incorrect Feedback: Estrogen drugs do not dilate and thin the cervix. c. an ovulation-stimulating drug Incorrect Feedback: Ovulation-stimulating drugs do not dilate and thin the cervix. 10. Drugs used to treat postpartum bleeding ________. a. inhibit the ovary from producing an ovum b. inhibit the cervix from dilating c. stimulate the cervix to contract d. stimulate the uterine muscle to contract Answer: d. stimulate the uterine muscle to contract Correct Feedback: Drugs used to treat postpartum bleeding stimulate the uterine muscle to contract. a. inhibit the ovary from producing an ovum Incorrect Feedback: Drugs used to treat postpartum bleeding do not affect the ovary. b. inhibit the cervix from dilating Incorrect Feedback: Drugs used to treat postpartum bleeding do not inhibit the cervix from dilating. c. stimulate the cervix to contract Incorrect Feedback: Drugs used to treat postpartum bleeding do not stimulate the cervix to contract. 11. Primary hypothalamic amenorrhea is treated with a drug that mimics the action of GnRH and stimulates the release of ______. a. estrogen and progestin from the anterior pituitary gland b. estrogen and progestin from the ovary c. FSH and LH from the anterior pituitary gland d. FSH and LH from the ovary Answer: c. FSH and LH from the anterior pituitary gland Correct Feedback: Primary hypothalamic amenorrhea—the absence of menstruation due to decreased levels of gonadotropin-releasing hormone (GnRH)—is treated with a drug that mimics the action of GnRH and stimulates the release of FSH (follicle-stimulating hormone) and LH (luteinizing hormone) from the anterior pituitary gland. a. estrogen and progestin from the anterior pituitary gland Incorrect Feedback: Estrogen and progestin do not come from the anterior pituitary gland. b. estrogen and progestin from the ovary Incorrect Feedback: Estrogen and progestin are not used to treat primary hypothalamic amenorrhea. d. FSH and LH from the ovary Incorrect Feedback: FSH and LH do not come from the ovary. 12. Which one of the following drug forms or routes of administration is NOT used for contraceptive drugs? a. intravenous injection b. oral tablets c. transdermal patch d. vaginal ring Answer: a. intravenous injection Correct Feedback: Contraceptive drugs are not given by intravenous injection. b. oral tablets Incorrect Feedback: Most contraceptive drugs do come in the form of oral tablets in pill packs. c. transdermal patch Incorrect Feedback: The contraceptive drug Ortho Evra comes in the form of a transdermal patch. d. vaginal ring Incorrect Feedback: The contraceptive drug NuvaRing comes in the form of ring that is inserted into the vagina. 13. Women in labor may be given a uterine stimulant drug if they are experiencing ______. a. dysmenorrhea b. effacement of the cervix c. a vaginal yeast infection d. uterine inertia Answer: d. uterine inertia Correct Feedback: Women in labor may be given a uterine stimulant if their uterine contractions are too weak (uterine inertia) to produce delivery or if complications such as preeclampsia or diabetes mellitus necessitate induction of labor for the safety of the mother. a. dysmenorrhea Incorrect Feedback: Women in labor experience uterine contractions but this is not termed dysmenorrhea (painful menstrual cramps). b. effacement of the cervix Incorrect Feedback: Effacement (thinning) of the cervix is not treated with a uterine stimulant drug. c. a vaginal yeast infection Incorrect Feedback: A vaginal yeast infection is not treated with a uterine stimulant drug. 14. All of the following are true about the trade name drug Plan B EXCEPT ______. a. It is taken orally. b. It is a progestin-only contraceptive drug. c. It is taken before unprotected intercourse to prevent pregnancy. d. It contains levonorgestrel. Answer: c. It is taken before unprotected intercourse to prevent pregnancy. Correct Feedback: Plan B is a progestin-only (levonorgestrel) contraceptive drug taken orally but only after (not before) unprotected intercourse to prevent pregnancy. a. It is taken orally. Incorrect Feedback: This is a true statement. b. It is a progestin-only contraceptive drug. Incorrect Feedback: This is a true statement. d. It contains levonorgestrel. Incorrect Feedback: This is a true statement. 15. Which of the following IS a type of oral contraceptive drug? a. tocolytic b. biphasic c. folic acid d. all of the above Answer: b. biphasic Correct Feedback: : Oral contraceptive drugs are divided into three groups: monophasic, biphasic, and triphasic. a. tocolytic Incorrect Feedback: Tocolytic drugs are not a type of oral contraceptive drug. c. folic acid Incorrect Feedback: Folic acid is not a type of oral contraceptive drug. d. all of the above Incorrect Feedback: Only one of the above is an oral contraceptive drug. 16. All of the following are true about oral contraceptive drugs EXCEPT ______. a. They contain progestins, the primary female hormone. b. They suppress the release of FSH and LH so that a mature ovum never develops. c. They cause changes in the cervical mucosa that inhibit spermatozoa. d. They keep a fertilized ovum from implanting in the endometrium. Answer: a. They contain progestins, the primary female hormone. Correct Feedback: Estradiol is the primary female hormone. b. They suppress the release of FSH and LH so that a mature ovum never develops. Incorrect Feedback: This is a true statement. c. They cause changes in the cervical mucosa that inhibit spermatozoa. Incorrect Feedback: This is a true statement. d. They keep a fertilized ovum from implanting in the endometrium. Incorrect Feedback: This is a true statement. 17. All oral contraceptive drugs can cause the following serious side effects EXCEPT ______. a. blood clots b. infertility c. stroke d. heart attack Answer: b. infertility Correct Feedback: Oral contraceptive drugs can have serious adverse effects such as blood clots, stroke, and heart attack because of their estrogen content, but they do not cause infertility. a. blood clots Incorrect Feedback: Blood clots are a serious adverse effect of oral contraceptive drugs. c. stroke Incorrect Feedback: Stroke is a serious adverse effect of oral contraceptive drugs. d. heart attack Incorrect Feedback: Heart attack is a serious adverse effect of oral contraceptive drugs. 18. In addition to being an oral contraceptive drug, YAZ is also approved by the FDA for treating ______. a. acne and premenstrual dysphoric disorder b. dysmenorrhea and premature labor c. vaginal yeast infections and preventing pregnancy d. acne and the sexually transmitted disease gonorrhea Answer: a. acne and premenstrual dysphoric disorder Correct Feedback: YAZ is the only oral contraceptive drug that is approved by the FDA for treating acne and premenstrual dysphoric disorder. b. dysmenorrhea and premature labor Incorrect Feedback: YAZ is not approved by the FDA for treating dysmenorrhea and premature labor. c. vaginal yeast infections and preventing pregnancy Incorrect Feedback: YAZ is not approved by the FDA for treating vaginal yeast infections. d. acne and the sexually transmitted disease gonorrhea Incorrect Feedback: YAZ is not approved by the FDA for treating the sexually transmitted disease gonorrhea. 19. The various symptoms of premenstrual syndrome (PMS) are treated with combination drugs that contain all of the following types of drugs EXCEPT ______. a. an antihistamine drug for a sedative effect b. a progestins drug for contraception c. a diuretic drug for fluid retention d. an analgesic drug for pain Answer: b. a progestins drug for contraception Correct Feedback: PMS is treated with combination drugs that contain an analgesic drug for dysmenorrhea, a diuretic drug to treat fluid retention, and an antihistamine drug with a weak diuretic effect and a sedative effect. a. an antihistamine drug for a sedative effect Incorrect Feedback: Combination drugs for PMS do contain an antihistamine drug for a sedative effect. c. a diuretic drug for fluid retention Incorrect Feedback: Combination drugs for PMS do contain a diuretic drug for fluid retention. d. an analgesic drug for pain Incorrect Feedback: Combination drugs for PMS do contain an analgesic drug for the pain of dysmenorrhea. 20. Which of the following is true about Mirena? a. It is a T-shaped contraceptive device. b. It irritates the endometrium to prevent implantation of a fertilized ovum. c. It contains levonorgestrel that suppresses the release of FSH and LH so a mature ovum is never released. d. All of the above statements are true. Answer: d. All of the above statements are true. Correct Feedback: The Mirena contraceptive drug is contained within a Tshaped intrauterine device. The shape of the device irritates the endometrium to prevent implantation of a fertilized ovum. The device reservoir contains the progestin drug levonorgestrel, which suppresses the release of FSH and LH from the anterior pituitary gland, and so a mature ovum is never developed or released. a. It is a T-shaped contraceptive device. Incorrect Feedback: This is true, but it is not the only correct answer. b. It irritates the endometrium to prevent implantation of a fertilized ovum. Incorrect Feedback: This is true, but it is not the only correct answer. c. It contains levonorgestrel that suppresses the release of FSH and LH so a mature ovum is never released. Incorrect Feedback: This is true, but it is not the only correct answer. 21. Premarin is used to _______. a. prevent pregnancy b. replace estrogen hormone in menopause c. treat vaginal yeast infections d. abort a pregnancy Answer: b. replace estrogen hormone in menopause Correct Feedback: Premarin is conjugated estrogens used to correct deficiency of estrogen for menopause. a. prevent pregnancy Incorrect Feedback: Premarin is not used to prevent pregnancy. c. treat vaginal yeast infections Incorrect Feedback: Premarin is not used to treat vaginal yeast infections. d. abort a pregnancy Incorrect Feedback: Premarin is not used to abort a pregnancy. 22. Drugs such as clotrimazole (Gyne-Lotrimin, Mycelex) and miconazole (Monistat, Vagistat) are used to treat ______. a. infections caused by Candida albicans b. infections caused by Treponema pallidum c. dysmenorrhea d. infertility Answer: a. infections caused by Candida albicans Correct Feedback: Vaginal yeast infections are treated with these over-thecounter topical drugs: clotrimazole (Gyne-Lotrimin, Mycelex) and miconazole (Monistat 3, Monistat 7, Vagistat-3). b. infections caused by Treponema pallidum Incorrect Feedback: Gyne-Lotrimin and Monistat are not used to treat infections caused by Treponema pallidum. c. dysmenorrhea Incorrect Feedback: Gyne-Lotrimin and Monistat are not used to treat dysmenorrhea. d. infertility Incorrect Feedback: Gyne-Lotrimin and Monistat are not used to treat infertility. 23. The triphasic group of oral contraceptive drugs has ______. a. 35 mcg of estrogen in every tablet b. 21 pills for a 28-day cycle c. three phases of varying hormone doses d. fixed amounts of estrogen and varying amounts of progesterone Answer: c. three phases of varying hormone doses Correct Feedback: A triphasic oral contraceptive drug has three (tri-) phases of varying doses of hormones. a. 35 mcg of estrogen in every tablet Incorrect Feedback: Triphasic oral contraceptive drugs do not have 35 mcg of estrogen in every tablet. b. 21 pills for a 28-day cycle Incorrect Feedback: All types of oral contraceptive drugs, not just triphasic oral contraceptive drugs, come in this form. d. fixed amounts of estrogen and varying amounts of progesterone Incorrect Feedback: Triphasic oral contraceptive drugs do not have fixed amounts of estrogen and varying amounts of progesterone. 24. Which of the following drugs is NOT used to treat the pain of dysmenorrhea? a. naproxen (Aleve, Midol) b. diclofenac (Cataflam, Flector, Voltaren) c. ibuprofen (Advil, Motrin) d. fluoxetine (Sarafem) Answer: d. fluoxetine (Sarafem) Correct Feedback: Fluoxetine (Sarafem) is an antidepressant drug usually used to treat depression, but also used to treat premenstrual dysphoric disorder and the hot flashes of menopause. a. naproxen (Aleve, Midol) Incorrect Feedback: This drug is used to treat dysmenorrhea. b. diclofenac (Cataflam, Flector, Voltaren) Incorrect Feedback: This drug is used to treat dysmenorrhea. c. ibuprofen (Advil, Motrin) Incorrect Feedback: This drug is used to treat dysmenorrhea. 25. Metronidazole (MetroGel-Vaginal) is used to treat _______. a. syphilis b. bacterial vaginosis c. gonorrhea d. all of the above Answer: b. bacterial vaginosis Correct Feedback: Bacterial vaginal infections (bacterial vaginosis) are caused by several different bacteria, including Haemophilus, Gardnerella, and Corynebacterium. Metronidazole (MetroGel-Vaginal) is a topical anti-infective drug used to treat bacterial vaginal infections. a. syphilis Incorrect Feedback: MetroGel-Vaginal is not used to treat syphilis. c. gonorrhea Incorrect Feedback: MetroGel-Vaginal is not used to treat gonorrhea. d. all of the above Incorrect Feedback: MetroGel-Vaginal is not used to treat all of these diseases. 26. All of the following drugs can be given to women in menopause as hormone replacement therapy to replace estrogen EXCEPT ______. a. Climara b. Menest c. Pitocin d. Vivelle Answer: c. Pitocin Correct Feedback: Normally, the hormone oxytocin (produced by the posterior pituitary gland) stimulates the uterus by binding to special oxytocin receptors on the smooth muscle cells of the uterus. The drug oxytocin (Pitocin) works in the same way to increase both the frequency and strength of uterine contractions. a. Climara Incorrect Feedback: Estradiol (Climara) is given as hormone replacement therapy. b. Menest Incorrect Feedback: Esterified estrogens (Menest) is given as hormone replacement therapy. d. Vivelle Incorrect Feedback: Estradiol (Vivelle) is given as hormone replacement therapy. 27. Which of the following sexually transmitted diseases are treated with antibiotic drugs? a. HIV and AIDS b. Genital warts and genital herpes c. Chlamydia and candidiasis d. gonorrhea and syphilis Answer: d. gonorrhea and syphilis Correct Feedback: Oral antibiotic drugs from several different categories (penicillins, cephalosporins, tetracyclines, fluoroquinolones) are effective in treating gonorrhea. Oral antibiotic drugs from several different categories (penicillins, tetracyclines) are effective in treating syphilis. HIV, AIDS, and genital herpes are treated with antiviral drugs. a. HIV and AIDS Incorrect Feedback: HIV and AIDS are not treated with antibiotic drugs. b. Genital warts and genital herpes Incorrect Feedback: Genital warts and genital herpes are not treated with antibiotic drugs. c. Chlamydia and candidiasis Incorrect Feedback: Candidiasis is not a sexually transmitted disease. 28. All of the following types of drugs are used to treat premenstrual dysphoric disorder EXCEPT _______. a. the oral contraceptive drug YAZ b. the antianxiety drug alprazolam (Xanax) c. the antidepressant drug sertraline (Zoloft) d. the combination hormone replacement drug Combipatch Answer: d. the combination hormone replacement drug Combipatch Correct Feedback: Combipatch is a combination hormone replacement drug used to treat menopause. PMDD is considered a mood disorder caused by an alteration in the level of brain neurotransmitters. The antianxiety drugs alprazolam and buspirone and the antidepressant drugs citalopram, clomipramine, desipramine, fluoxetine, nortriptyline, paroxetine, and sertraline are used to treat premenstrual dysphoric disorder. The oral contraceptive drug YAZ has also been approved to treat premenstrual dysphoric disorder. a. the oral contraceptive drug YAZ Incorrect Feedback: The oral contraceptive YAZ is used to treat premenstrual dysphoric disorder. b. the antianxiety drug alprazolam (Xanax) Incorrect Feedback: The antianxiety drug alprazolam (Xanax) is used to treat premenstrual dysphoric disorder. c. the antidepressant drug sertraline (Zoloft) Incorrect Feedback: The antidepressant drug sertraline (Zoloft) is used to treat premenstrual dysphoric disorder. 29. MICRhoGAM or RhoGAM is given after birth to the mother if the _______. a. fetus is Rh-positive and the mother is Rh-negative b. fetus is Rh-positive and the mother is Rh-positive c. fetus is Rh-negative and the mother is Rh-negative d. fetus is Rh-negative and the mother is Rh-positive Answer: a. fetus is Rh-positive and the mother is Rh-negative Correct Feedback: MICRhoGAM or RhoGAM are immunoglobulin drugs that are given to an Rh-negative mother after the birth of an Rh-positive infant. These drugs prevent the mother from making antibodies during any subsequent pregnancies with an Rh-positive fetus. b. fetus is Rh-positive and the mother is Rh-positive Incorrect Feedback: RhoGAM is not given in this situation. c. fetus is Rh-negative and the mother is Rh-negative Incorrect Feedback: RhoGAM is not given in this situation. d. fetus is Rh-negative and the mother is Rh-positive Incorrect Feedback: RhoGAM is not given in this situation. 30. Simone and Raymond Jones have been attempting to start their family for two years without success. The doctor has suggested that Simone might benefit from a drug to stimulate ovulation. This drug could be any of the following EXCEPT _______. a. urofollitropin (Bravelle) b. clomiphene (Clomid) c. medroxyprogesterone (Depo-Sub Q Provera) d. human chorionic gonadotropin (Pregnyl, Profasi) Answer: c. medroxyprogesterone (Depo-Sub Q Provera) Correct Feedback: This progestin-only contraceptive drug is injected subcutaneously and its contraceptive effect lasts for three months: medroxyprogesterone (Depo-Sub Q Provera). a. urofollitropin (Bravelle) Incorrect Feedback: This drug is used to stimulate ovulation and treat infertility. b. clomiphene (Clomid) Incorrect Feedback: This drug is used to stimulate ovulation and treat infertility. d. human chorionic gonadotropin (Pregnyl, Profasi) Incorrect Feedback: This drug is used to stimulate ovulation and treat infertility. 31. Ponstel and Motrin are commonly prescribed to provide relief from what female problem? a. chlamydia vaginal infections b. menopause c. labor and delivery d. dysmenorrhea Answer: d. dysmenorrhea Correct Feedback: Dysmenorrhea is treated with over-the-counter or prescription analgesic drugs (nonsteroidal anti-inflammatory drugs [NSAIDs] or COX-2 inhibitor drugs) that inhibit the action of prostaglandins; these include ibuprofen (Advil, Motrin) and mefenamic acid (Ponstel). a. chlamydia vaginal infections Incorrect Feedback: Ponstel and Motrin are not used to treat Chlamydia vaginal infections. b. menopause Incorrect Feedback: Ponstel and Motrin are not used to treat menopause. c. labor and delivery Incorrect Feedback: Ponstel and Motrin are not used to treat labor and delivery. 32. Drugs should be avoided during pregnancy, but which of these drugs are prescribed for pregnant women? a. Drugs to continue treating chronic diseases such as hypertension b. Iron and folic acid c. Prenatal vitamins d. all of the above Answer: d. all of the above Correct Feedback: Few drugs are prescribed during pregnancy, particularly during the first trimester, because of the increased risk of causing birth defects in the developing fetus. Drugs for chronic diseases, such as hypothyroidism, diabetes mellitus, or hypertension, or antibiotic drugs for acute infections, are given during pregnancy to protect the health of both the mother and fetus. a. Drugs to continue treating chronic diseases such as hypertension Incorrect Feedback: This is true, but it is not the only correct answer. b. Iron and folic acid Incorrect Feedback: This is true, but it is not the only correct answer. c. Prenatal vitamins Incorrect Feedback: This is true, but it is not the only correct answer. 33. Which of the following statements is TRUE? a. In monophasic oral contraceptive drugs, 7 of the tablets in a 28-day pill pack contain an analgesic drug. b. Most physicians prescribe an oral contraceptive drug that contains 35 mcg of estrogen or less in each tablet. c. The drug oxytocin (Pitocin) is used to stop premature labor. d. The risks of serious adverse effects while taking an oral contraceptive drug increase for patients who smoke or are older than 55 years of age. Answer: b. Most physicians prescribe an oral contraceptive drug that contains 35 mcg of estrogen or less in each tablet. Correct Feedback: Because of the risks of blood clots, stroke, and heart attack, most physicians choose to prescribe an oral contraceptive drug that contains 35 mcg of estrogen or less in each tablet. The risk of these adverse effects increases significantly for patients who are older than 35 years of age and who smoke. a. In monophasic oral contraceptive drugs, 7 of the tablets in a 28-day pill pack contain an analgesic drug. Incorrect Feedback: This statement is not true. c. The drug oxytocin (Pitocin) is used to stop premature labor. Incorrect Feedback: This statement is not true. d. The risks of serious adverse effects while taking an oral contraceptive drug increase for patients who smoke or are older than 55 years of age. Incorrect Feedback: The risk increases for patients who smoke or are older than 35 years, not 55 years, of age. 34. Which one of the following pairs of trade names are NOT monophasic oral contraceptive drugs? a. Norinyl and Ovral b. Seasonale and YAZ c. Alesse and Demulen d. Cyclessa and Ortho Tri-Cyclen Answer: d. Cyclessa and Ortho Tri-Cyclen Correct Feedback: Feedback: Cyclessa and Ortho Tri-Cyclen are triphasic oral contraceptive drugs. a. Norinyl and Ovral Incorrect Feedback: These are trade name monophasic oral contraceptive drugs. b. Seasonale and YAZ Incorrect Feedback: These are trade name monophasic oral contraceptive drugs. c. Alesse and Demulen Incorrect Feedback: These are trade name monophasic oral contraceptive drugs. 35. Which was the first oral contraceptive drug that could eliminate all menstrual periods? a. YAZ b. MetroGel-Vaginal c. Lybrel d. Seasonique Answer: c. Lybrel Correct Feedback: Lybrel was the first oral contraceptive drug to eliminate menstrual periods. It comes as a 28-day pill pack in which every tablet contains fixed doses of a progestin and an estrogen. There are no tablets without hormones, and so the endometrium remains intact and menstruation does not occur. Lybrel was approved by the FDA in 2007. a. YAZ Incorrect Feedback: YAZ is an oral contraceptive drug, but it does not eliminate menstrual periods. b. MetroGel-Vaginal Incorrect Feedback: MetroGel-Vaginal is not an oral contraceptive drug. d. Seasonique Incorrect Feedback: Seasonique is an oral contraceptive drug, but it does not eliminate all menstrual periods. 36. Which of the following statements is FALSE? a. The prefix tri- in the trade name of some oral contraceptive drugs indicates three phases. b. The trade name Ortho-Novum 10/11 indicates that this is a monophasic oral contraceptive drug. c. The oral contraceptive drugs Seasonale and Seasonique only produce four menstrual periods each year. d. Besides oral contraceptive drugs, other nondrug types of contraception include a diaphragm, a cervical cap, rhythm, or abstinence. Answer: b. The trade name Ortho-Novum 10/11 indicates that this is a monophasic oral contraceptive drug. Correct Feedback: A biphasic oral contraceptive drug has two (bi-) phases with changing doses of a progestin but a fixed dose of an estrogen. For some biphasic oral contraceptive drugs, this is reflected in the trade name of the drug; for example, Ortho-Novum 10/11. a. The prefix tri- in the trade name of some oral contraceptive drugs indicates three phases. Incorrect Feedback: This is a true statement. c. The oral contraceptive drugs Seasonale and Seasonique only produce four menstrual periods each year. Incorrect Feedback: This is a true statement. d. Besides oral contraceptive drugs, other nondrug types of contraception include a diaphragm, a cervical cap, rhythm, or abstinence. Incorrect Feedback: This is a true statement. 37. The hormone contraceptive drug Ortho Evra is in the form of a ______. a. pill pack b. vaginal ring c. T-shaped intrauterine device d. transdermal patch Answer: d. transdermal patch Correct Feedback: Some contraceptive drugs provide daily fixed doses of a progestin and an estrogen, but they are not given orally. Instead, they are in the form of a ring (NuvaRing) that is inserted in the vagina or a transdermal patch (Ortho Evra) that is applied to the skin. a. pill pack Incorrect Feedback: Ortho Evra does not come as a pill pack. b. vaginal ring Incorrect Feedback: Ortho Evra does not come as a vaginal ring. c. T-shaped intrauterine device Incorrect Feedback: Ortho Evra does not come as a T-shaped intrauterine device. 38. Of the following trade name prostaglandin drugs, which one is NOT used to help the cervix dilate and efface during labor? a. Cervidil b. Celebrex c. Cytotec d. Prepidil Answer: b. Celebrex Correct Feedback: When the cervix does not dilate and thin during labor, these prostaglandin drugs can be given: dinoprostone (Cervidil, Prepidil), misoprostol (Cytotec). a. Cervidil Incorrect Feedback: Cervidil is used to help the cervix dilate and efface during labor. c. Cytotec Incorrect Feedback: Cytotec is used to help the cervix dilate and efface during labor. d. Prepidil Incorrect Feedback: Prepidil is used to help the cervix dilate and efface during labor. 39. Which of the following drugs is NOT used to treat endometriosis? a. follitropin beta (Follistim) b. goserelin (Zoladex) c. leuprolide (Lupron Depot) d. nafarelin (Synarel) Answer: a. follitropin beta (Follistim) Correct Feedback: Ovulation-stimulating drugs used to treat infertility, not endometriosis, include follitropin beta (Follistim). b. goserelin (Zoladex) Incorrect Feedback: Goserelin (Zoladex) is used to treat endometriosis. c. leuprolide (Lupron Depot) Incorrect Feedback: Leuprolide (Lupron Depot) is used to treat endometriosis. d. nafarelin (Synarel) Incorrect Feedback: Nafarelin (Synarel) is used to treat endometriosis. 40. Danazol is used to treat all of the following EXCEPT ______. a. endometriosis b. fibrocystic disease of the breast c. dysmenorrhea d. gynecomastia in males Answer: c. dysmenorrhea Correct Feedback: Danazol is used to treat endometriosis. Danazol is also used to treat fibrocystic breast disease, precocious puberty, and gynecomastia in males. a. endometriosis Incorrect Feedback: Danazol is used to treat endometriosis. b. fibrocystic disease of the breast Incorrect Feedback: Danazol is used to treat fibrocystic disease of the breast. d. gynecomastia in males Incorrect Feedback: Danazol is used to treat gynecomastia in males. 41. Premenstrual syndrome (PMS) is characterized by all of the following EXCEPT ______. a. dysmenorrhea b. depression and anxiety c. breast tenderness d. bloating and fluid retention Answer: b. depression and anxiety Correct Feedback: Premenstrual syndrome (PMS) is characterized by dysmenorrhea, breast tenderness, edema from fluid retention (“bloating”), and mild mood changes. It is premenstrual dysphoric disorder (PMDD) that is characterized by depression and anxiety. a. dysmenorrhea Incorrect Feedback: PMS is characterized by dysmenorrhea. c. breast tenderness Incorrect Feedback: PMS is characterized by breast tenderness. d. bloating and fluid retention Incorrect Feedback: PMS is characterized by bloating and fluid retention. 42. Which of the following combination drugs is NOT used to treat the symptoms of menopause? a. Alesse b. Activella c. Femhrt d. Prempro Answer: a. Alesse Correct Feedback: Alesse is a monophasic oral contraceptive drug. b. Activella Incorrect Feedback: Activella is a combination drug used to treat menopause. c. Femhrt Incorrect Feedback: Femhrt is a combination drug used to treat menopause. d. Prempro Incorrect Feedback: Prempro is a combination drug used to treat menopause. 43. A 28-day pill pack of an oral contraceptive drug consists of 21 tablets that contain hormones and 7 tablets that _______. a. are inert b. contain sugar c. contain iron d. all of the above Answer: d. all of the above Correct Feedback: Monophasic oral contraceptive drugs in a 28-day pill pack contain 21 hormone tablets with fixed doses of progestin and estrogen hormones, followed by 7 inert sugar tablets that contain no hormones (but may contain supplemental iron) to complete a 28-day menstrual cycle. a. are inert Incorrect Feedback: This is true, but it is not the only correct answer. b. contain sugar Incorrect Feedback: This is true, but it is not the only correct answer. c. contain iron This is true, but it is not the only correct answer. 44. Which of these drugs have an unofficial “unlabeled use” (but legal) to treat preterm labor? a. terbutaline, a bronchodilator drug b. magnesium sulfate, a drug used to prevent seizures c. indomethacin, a nonsteroidal anti-inflammatory drug d. all of the above Answer: d. all of the above Correct Feedback: Currently, there is no drug specifically approved by the FDA to treat preterm labor. Other drugs that inhibit contractions of the uterus have been used and are still being used to treat preterm labor. These are prescribed at the physician’s discretion, and this is known as an “unlabeled use” as it is unofficial, but legal. Such drugs include terbutaline (FDA-approved bronchodilator drug used to treat asthma), magnesium sulfate (FDA-approved drug used to treat seizures caused by toxemia during pregnancy), isoxsuprine (FDA-approved vasodilator drug), and indomethacin (FDA-approved nonsteroidal antiinflammatory drug). a. terbutaline, a bronchodilator drug Incorrect Feedback: This is true, but it is not the only correct answer. b. magnesium sulfate, a drug used to prevent seizures Incorrect Feedback: This is true, but it is not the only correct answer. c. indomethacin, a nonsteroidal anti-inflammatory drug Incorrect Feedback: This is true, but it is not the only correct answer. 45. Drugs used to produce an abortion can be given in all of the following ways EXCEPT ______. a. orally b. injected into the amniotic fluid c. as a vaginal suppository d. by inhalation Answer: d. by inhalation Correct Feedback: Drugs used to produce an abortion are given by various routes: carboprost is injected intramuscularly, dinoprostone is given as a vaginal suppository, mifepristone and misoprostol are given orally, and urea is injected into the amniotic fluid. None are given by inhalation. a. orally Incorrect Feedback: Some drugs used to produce an abortion are given orally. b. injected into the amniotic fluid Incorrect Feedback: Some drugs used to produce an abortion are given injected into the amniotic fluid. c. as a vaginal suppository Incorrect Feedback: Some drugs used to produce an abortion are given as a vaginal suppository. 46. For biphasic oral contraceptive drugs, the first phase of the pill pack provides a fixed dose of a progestin and the second phase provides a fixed dose of an estrogen. Answer: False Feedback: Biphasic oral contraceptive drugs have two phases of hormone tablets in each pill pack. The first phase provides fixed doses of a progestin (desogestrel, levonorgestrel, norethindrone) and an estrogen (ethinyl estradiol); the second phase provides an increased dose of a progestin but the same dose of an estrogen in each hormone tablet. 47. Progestin-only contraceptive drugs only contain progestin, but they are equally as effective in preventing pregnancy as combination oral contraceptive drugs. Answer: False Feedback: These oral contraceptive drugs only contain a progestin (norethindrone, norgestrel). They are slightly less effective in preventing pregnancy than combination oral contraceptive drugs, particularly if the patient forgets to take even one daily tablet. 48. Progestin-only oral contraceptive drugs are useful for mothers who are breastfeeding because the drug does not interfere with milk production. Answer: True Feedback: Progestin-only contraceptive drugs are also useful for mothers who have just given birth and want to breastfeed, as the drug does not interfere with milk production. 49. Ovulation-stimulating drugs are not appropriate for patients with infertility due to blocked fallopian tubes or problems that require surgical intervention. Answer: True Feedback: Ovulation-stimulating drugs are appropriate for patients with anovulation (failure to ovulate), but are not appropriate for patients with infertility due to blocked fallopian tubes or problems that require surgical intervention. 50. Progesterone drugs prepare the endometrium to receive fertilized ova, and are used in conjunction with other drugs for infertility in women. Answer: True Feedback: This progesterone drug prepares the endometrium to receive fertilized ova. This drug is used in conjunction with other drugs for infertility in women. 51. Drugs that produce abortion cause the uterus to contract strongly enough to spontaneously abort a fetus and also cause the cervix to dilate. Answer: True Feedback: Drugs that produce abortion cause the uterus to contract strongly enough to spontaneously abort a fetus while they also cause the cervix to dilate. 52. Antidepressant drugs are usually used to treat depression, but can also be used to treat the hot flashes that occur with menopause. Answer: True Feedback: Antidepressant drugs are usually used to treat depression, but are also used to treat the hot flashes of menopause. 53. Oral contraceptive drugs exert a hormonal influence to prevent pregnancy and are 100 percent effective if taken as directed. Answer: False Feedback: Oral contraceptive drugs (OCPs) or birth control pills exert a hormonal influence to prevent pregnancy and are 99 percent effective, if taken as directed. 54. Spermicidal drugs for contraception are inserted in the vagina after sexual intercourse to prevent pregnancy by killing spermatozoa. Answer: False Feedback: Spermicidal drugs for contraception are over-the-counter drugs that are inserted in the vagina prior to intercourse to kill spermatozoa and prevent pregnancy. 55. Melissa Radike has endometriosis. To treat her symptoms, her physician prescribed a hormone drug because it will suppress her menstrual cycle for several months, during which time the endometrial implants of endometriosis will shrink and fade. Answer: True Feedback: Hormone drugs are used to suppress the menstrual cycle for several months, during which time the endometrial implants shrink and fade. 56. Antianxiety drugs are often prescribed to treat PMDD because it is considered a mood disorder, which is caused by an alteration in the level of brain neurotransmitters. Answer: True Feedback: PMDD is considered a mood disorder caused by an alteration in the level of brain neurotransmitters. The antianxiety drugs alprazolam and buspirone and the antidepressant drugs citalopram, clomipramine, desipramine, fluoxetine, nortriptyline, paroxetine, and sertraline are used to treat premenstrual dysphoric disorder. 57. The drug clonidine (Catapres) that is commonly used to treat hypertension is also used to treat the hot flashes of menopause. Answer: True Feedback: Clonidine (Catapres) stimulates alpha2 receptors in the brain and is used to treat the hot flashes of menopause. It is also used to treat many other conditions, most commonly hypertension. 58. The contraceptive effect of some implanted contraceptive devices can last up for to five years. Answer: True Feedback: Progestin-only contraceptive drugs are contained within an implant that is inserted under the skin or within a T-shaped device that is inserted into the uterus. The contraceptive effect lasts from one to five years depending on the amount of drug in the device. 59. Ovulation stimulating drugs are appropriate for patients who have anovulation (failure to ovulate). Answer: True Feedback: Ovulation-stimulating drugs are appropriate for patients with anovulation (failure to ovulate). 60. There currently are no drugs approved by the FDA to specifically stop preterm labor. Answer: True Feedback: Currently, there is no drug specifically approved by the FDA to treat preterm labor. 61. Sonjalee Williams is taking an oral contraceptive drug. She knows this will help protect her from becoming pregnant and from contracting a sexually transmitted disease. Answer: False Feedback: All oral contraceptive drugs also carry the warning that they do not protect against sexually transmitted diseases, including HIV. 62. Patients taking oral contraceptive drugs should avoid taking the herb St. John’s wort for depression because it can increase the chance of getting pregnant. Answer: True Feedback: The herb St. John’s wort, which is often taken for depression, can cause serum hormone levels to decrease in patients taking oral contraceptive drugs, and this increases the chance of pregnancy. 63. The drugs Glucophage and Avandia are used to treat type 2 diabetes mellitus, but they are also used to stimulate ovulation in patients with polycystic ovaries. Answer: True Feedback: These drugs are used to treat type 2 diabetes mellitus. They are also used to stimulate ovulation in women with polycystic ovaries: metformin (Glucophage), rosiglitazone (Avandia). 64. Breads, cereals, and pastas have supplemental iron added to them to decrease the risk of babies being born with neural tube defects in women of childbearing age. Answer: True Feedback: Folic acid significantly decreases the incidence of babies who have neural tube defects (spina bifida, myelomeningocele). Since 1988, some breads, cereals, and pastas have had supplemental folic acid added to them for this reason. 65. Carboprost (Hemabate) is used to abort a fetus, but it is also used to treat postpartum hemorrhage and save the life of a mother after delivery. Answer: True Feedback: Carboprost is used to abort a fetus and terminate the pregnancy, but it is also used to treat postpartum hemorrhage and save the life of the mother after delivery. 66. Postpartum bleeding is due to relaxation, dilation, and effacement of the cervix. Answer: False Feedback: Postpartum bleeding is due to uterine relaxation or atony, which results in increased bleeding at the site of placental separation. 67. Premature labor contractions can be inhibited by using uterine-relaxing drugs. These drugs are known as ________ drugs. Answer: tocolytic Feedback: Premature labor contractions can be inhibited by using uterine-relaxing drugs. These drugs are known as tocolytic drugs. 68. Normally the hormone ________ (produced by the posterior pituitary gland) stimulates the smooth muscle of the uterus to increase both the frequency and strength of uterine contractions. Answer: oxytocin Feedback: Normally the hormone oxytocin (produced by the posterior pituitary gland) stimulates the uterus by binding to special receptors on the smooth muscle cells of the uterus. The drug by the same name works in the same way to increase both the frequency and strength of uterine contractions. 69. ________ (painful menstrual cramps) is caused by an increase in prostaglandins that causes the uterus to contract painfully. Answer: Dysmenorrhea Feedback: Dysmenorrhea (painful menstrual cramps) is caused by an increase in prostaglandins that causes the uterus to contract painfully. 70. Many drugs used to treat candidiasis end in the suffix ________. Answer: –azole Feedback: Many drugs used to treat candidiasis end in the suffix –azole. 71. The symptoms of menopause can be treated by HRT. The abbreviation HRT stands for ________. Answer: hormone replacement therapy Feedback: The symptoms of menopause can be treated by hormone replacement therapy (HRT). 72. Infertility drugs are often used as part of an ART program. The abbreviation ART stands for ________. Answer: assisted reproductive technology Feedback: These drugs are often used as part of a program of assisted reproductive technology (ART). 73. Vaginal yeast infections are caused by Candida albicans, and the infection is known as _________. Answer: candidiasis Feedback: Vaginal yeast infections are caused by Candida albicans, and the infection is known as candidiasis. 74. Many OB/GYN drugs alter or inhibit FSH. The abbreviation FSH stands for _______. Answer: follicle-stimulating hormone Feedback: Normally, the anterior pituitary gland secretes folliclestimulating hormone (FSH), which stimulates a follicle in the ovary to develop a mature ovum. 75. The abbreviation OCP stands for _________. Answer: oral contraceptive pill Feedback: Oral contraceptive pills (OCPs) or birth control pills exert a hormonal influence to prevent pregnancy. 76. The drug thalidomide which caused the birth defect of seal limbs or phocomelia was taken in the late 1950s by pregnant women in Europe to treat their ______. Answer: morning sickness Feedback: In the late 1950s, the drug thalidomide was developed in West Germany and used extensively to treat morning sickness. The FDA refused to approve its use in the United States without further studies. Before these additional studies could be completed, evidence against the safety of the drug began to accumulate. Over 8,000 babies were born in Europe with deformed extremities (“seal limbs,” or phocomelia). 77. Prostaglandins secreted by the placenta help to widen and thin the cervix as labor begins. They cause smooth muscle fibers in the cervix to dilate and the collagen fibers to break down. This process of dilatation and effacement is known as cervical ______. Answer: ripening Feedback: Prostaglandins secreted by the placenta help to widen and thin the cervix as labor begins. They cause smooth muscle fibers in the cervix to dilate and the collagen fibers to break down. This process of dilatation and effacement is known as cervical ripening. 78. 1. carboprost (Hemabate) A. drug for abnormal menstruation 2. danazol B. drug for endometriosis 3. estradiol (Climara, Estraderm, Evamist, Vivelle) C. estrogen hormone replacement therapy drug 4. follitropin alfa (Gonal-f) D. herbal OTC drug for menopause 5. norethindrone (Aygestin) E. monophasic oral contraceptive drug 6. Mirena F. ovulation-stimulating drug for infertility 7. nystatin G. drug for postpartum bleeding 8. Ortho-Novum 7/7/7 H. progestin-only contraceptive 9. Remifemin I. triphasic oral contraceptive drug 10. YAZ J. drug for vaginal yeast infection Answer: G Answer: B Answer: C Answer: F Answer: A Answer: H Answer: J Answer: I Answer: D Answer: E Feedback: These drugs and their categories are found throughout the chapter. 79. Explain the three phases associated with triphasic oral contraceptive drugs. Answer: Triphasic oral contraceptive drugs have three phases of hormone tablets in each pill pack. The first phase provides fixed doses of a progestin (desogestrel, levonorgestrel, norethindrone, norgestimate) and an estrogen (ethinyl estradiol); in the second phase, either one or both of the hormone doses increases in each hormone tablet; in the third phase, either one or both of the hormone doses increases or decreases in each hormone tablet in the pill pack. 80. The long-term use of HRT can be beneficial, but it is also associated with some risk. Name one benefit and one risk associated with long-term use of HRT. Answer: The long-term use of hormone replacement therapy may also reduce the risk of osteoporosis and keep cholesterol levels low; however, it is also associated with an increased risk of breast and endometrial cancer, blood clots, stroke, heart attack, and dementia. 81. When ovulation-stimulating drugs cause several mature ova to be released from the ovary at the same time, how does this eventually cause an ethical and moral dilemma? Answer: Ovulation-stimulating drugs cause several mature ova to be released from the ovary at the same time. This increases the chances that an infertile woman will become pregnant. However, a pregnancy with multiple babies can endanger the life of the mother and/or the babies. Some obstetricians recommend elective removal of one or more of the growing fetuses prior to delivery, but this creates an ethical and moral dilemma. 82. If you were an animal rights activist, why would you be against the drug Premarin? Answer: The trade name Premarin indicates the source of the drug: pregnant mares’ urine. Animal rights activists claim that the horse is treated inhumanely by being confined to a stall with a catheter in its bladder to collect the urine. 83. Describe the circumstances in which the drug oxytocin (Pitocin) would NOT be used to induce labor in a pregnant woman. Answer: Oxytocin (Pitocin) is not used when prolonged labor is due to cephalopelvic disproportion in which the baby’s skull is too large to fit through the mother’s bony pelvis. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268