The $25000 Drug Pyramid Part II Quiz

Answer: NSAIDs (Non-steroidal anti-inflammatory drugs)

Ibuprofen comes in 200, 400, 600, and 800mg tablets, as well as an oral suspension. NSAIDs are very useful for relieving the pain and inflammation associated with arthritis and other conditions or injuries. Some other NSAIDs are ketorolac (Toradol), sulindac (Clinoril), meloxicam (Mobic), and naproxen (Aleve). NSAIDs should be taken with food, and never more than the prescribed dose, as they can have negative side effects (sometimes serious) on the digestive system.

Answer: Diphenhydramine (Benadryl)

Diphenhydramine may also be used in the short-term treatment of anxiety or insomnia, but patients can develop a tolerance fairly quickly to the sedating effects of antihistamines. In addition to the 25mg capsules already mentioned, diphenhydramine is available as 50mg capsules, an injection (50mg/ml), tablets (25 and 50mg), and an elixir (often cherry flavored, 12.5mg/5ml). My personal favorite is the topical cream. I always keep a tube handy, as it instantly relieves the itchy red little bug bite bumps I'm always getting.

The little creepy-crawlies around here seem to love to feast on me for some reason.

Answer: Hypothyroidism

Hypothyrodism is the condition resulting from insufficient thyroid hormone in the body, causing metabolic problems. The symptoms can include weight gain, fatigue, constipation, depression, and bradycardia (slow heart rate). The hormone levothyroxine, when given as a drug, helps to regulate the body's metabolism and restore the proper balance.

Another drug for hypothyrodism is Armour Thyroid, available as tablets measured in "grains" - a grain being approximately equivalent to 60mg. (The actual measurement is closer to 65mg, but Armour Thyroid labels their 1/2 grain doses as 30mg, 1 grain doses as 60mg, etc.)

Answer: Docusate (Colace)

Laxatives are categorized by their mechanisms of action. Docusate is a stool softener that is easily recognizable as a bright red capsule or a red oral liquid. Other types of laxatives include bulk-forming agents, osmotic agents, bowel evacuants, saline laxatives, and stimulants.

When deciding on an over-the-counter medication for constipation or any condition, always carefully read and follow the directions and warnings on the package, and ask your doctor or pharmacist if you are unsure of anything.

Answer: Nystatin (Mycostatin)

Topical or oral fungal infections are nuisances indeed, but a fungus inside the body and in the bloodstream is cause for alarm - these systemic infections can be life threatening, and call for some heavy-duty I.V. drugs like amphotericin B (AmBisome), and micafungin (Mycamine).

The "Myco" in Mycostatin may have helped you on this question, if you already knew that the prefix "myco-" is derived from a Greek word meaning "fungus." Nystatin might have a "statin" in its name, but don't be misled into believing it's a statin drug for low cholesterol - it is antifungal only.

Answer: Anxiety

Benzodiazepines are not only anxiolytics, but have they many other uses, such as pre-anesthetic sedation, anticonvulsant, and the treatment of insomnia and panic attacks. You can easily spot them in a lineup, since their generic names end in -pam or -lam.

They are potentially habit-forming, and are therefore controlled substances in the U.S. Some other drugs in this class are alprazolam (Xanax), triazolam (Halcion), midazolam (Versed), and diazepam (Valium).

Answer: Beta blockers

Beta blockers are frequently included in drug therapy for hypertension (high blood pressure). The generic names of drugs in this class usually end in -olol. Some other beta blockers are metoprolol (Lopressor, Toprol XL), carvedilol (Coreg), and (notice the "beta" in this last one) labetalol (Normodyne).

Answer: Nimodipine (Nimotop)

Drugs that stop emesis (vomiting) usually treat nausea as well. Since patients suffering from N&V (nausea and vomiting) can't always keep everything down (including pills and water for swallowing the pills), alternative dosage forms are usually available. Ondansetron comes in injectable form, as well as orally disintegrating tablets that melt in the mouth and start working immediately. Promethazine is available as a suppository.

Dronabinol is a lovely little relative of marijuana. Don't get too excited - it is ONLY given to cancer patients suffering from N&V related to chemotherapy treatments. Pharmacy personnel everywhere struggle mightily when handling this drug, as the capsules are perfectly spherical - believe me, these things BOUNCE and ROLL! It once took me two hours to find a dropped dose, and yes, I was under suspicion until it was found!

Incidentally, nimodipine - the odd one out - is given to help the brain recover from the trauma of a stroke.

Answer: Angiotensin II-receptor antagonist / diuretic

Drugs whose generic names end in "-artan" are usually angiotensin II-receptor antagonists. Diovan HCT is prescribed for hypertension. Each ingredient works in a different way to lower the patient's blood pressure.

Many combination drugs may be dispensed as their separate ingredients (convenient for pharmacies for a number of reasons, but often less convenient for patients). Some combinations, though, are almost always dispensed as a single drug. Two examples are carbidopa-levodopa (an anti-Parkinson's agent) and sulfamethoxazole-trimethoprim (an antibiotic).

Answer: Lactulose (Constulose)

Lactulose is a liquid laxative, as the treatment for hepatic encephalopathy is to induce diarrhea. The theory is that the faster material moves through the digestive system, the less time bacteria will have to convert that material to harmful toxins.

If you answered all ten questions correctly, congratulations are in order... But I'm afraid the only prizes are bragging rights and/or 100 FunTrivia points (plus bonus points, where applicable). The $25000 was, sadly, a metaphorical prize contrived to provide additional structure to this quiz. At any rate, I hope you enjoyed the quiz and learned something new.

Clarification of some details in this quiz were provided by Don A. Ballington and Mary M. Laughlin's Pharmacology for Technicians, 3rd edition, and Harold M. Silverman's The Pill Book, 12th edition. Thanks also to Robert A. for the inspiration for question 10.