Manor Compre - Module 4

c

Any substance that binds to a target protein or biological site of action.

a.Receptor

b.Enzyme

c.Ligand

d.Both a & b

b

Alpha-1 agonists that are used as decongestants should not be given for more than 3-5 days due to:

a.Rebound hypertension

b.Rhinitis medicamentosa

c.First dose syncope

d.Both a & b

b

Which of the following drugs activate PPAR-alpha as its mechanism of action?

a.Anacetrapib

b.Gemfibrozil

c.Canagliflozin

d.Troglitazone

d

True about beta-agonists:

i. They bind to ionotropic receptors.

ii. They bind to metabotropic receptors.

iii. They stimulate adenylyl cyclase.

iv. They inhibit adenylyl cyclase.

a. i only

b. ii only

c. i, iii

d. ii, iii

e. ii, iv

c

A patient at the ER presents with septic shock. A confused nurse consults you on what drug to administer, epinephrine or norepinephrine. What would you recommend?

a. Epinephrine because it has almost no affinity to beta-2 receptors

b. Epinephrine because it has the maximum affinity to beta-2 receptors

c. Norepinephrine because it has almost no affinity to beta-2 receptors

d. Norepinephrine because it has the maximum affinity to beta-2 receptors

d

Which of the following tocolytics is not a beta-2 agonist?

a. Ritodrine

b. Isoxuprine

c. Terbutaline

d. Atosiban

e. None of the above

d

Considered to be the most cardioselective beta-blocker

a. Bisoprolol

b. Betaxolol

c. Acebutolol

d. Nevibolol

e. Metoprolol

e

Beta-blockers used for heart failure management, EXCEPT:

a. Bisoprolol

b. Betaxolol

c. Carteolol

d. Metoprolol

e. Two of the above

e

Which of the following monoamine oxidase inhibitors is used for Parkinsonism?

a. Isocarboxazid

b. Phenelzine

c. Tranylcypromine

d. Moclobemide

e. Dasagiline

b

Which dopamine agonist is most likely to be used during hypertensive crisis?

a. Bromocriptine

b. Fenoldopam

c. Entacapone

d. Benztropine

b

Hallucination is one of the positive symptoms experienced by patients with psychosis. What is the most common type of hallucination?

a. Visual

b. Auditory

c. Tactile

d. Olfactory

b

Clozapine is the first second-generation antipsychotic to be developed. The following are true about this drug, EXCEPT:

a. It is the only typical major tranquilizer that is free of extrapyrimidal syndrome.

b. It is the only atypical major tranquilizer that is free of extrapyrimidal syndrome.

c. It is the only typical minor tranquilizer that is free of extrapyrimidal syndrome.

d. It is the only atypical minor tranquilizer that is free of extrapyrimidal syndrome.

b

Considered to be the drug of choice for patients having recurrent seizure attacks without regaining consciousness.

a. Diazepam

b. Lorazepam

c. Carbamazepine

d. Phenytoin

e. Valproic acid

a

Which of the following statements are true regarding the mechanism of action of benzodiazepines and barbiturates?

a. Benzodiazepines increase the frequency of opening of chloride channels

b. Benzodiazepines increase the duration of opening of chloride channels

c. Barbiturates increase the duration of closing of chloride channels

d. Barbiturates increase the frequency of closing of chloride channels

b

Which of the following diuretics is used for catamenial seizure?

a. Dichlorphenamide

b. Acetazolamide

c. Mannitol

d. Spironolactone

d

Phenytoin is a known CYP-450 enzyme inducer. Which of its adverse effects is considered to be the most common and does not need dose adjustment?

a. Gingival hyperplasia

b. Ataxia

c. Diplopia

d. Nystagmus

e.Stevens-Johnson Syndrome

c

The CYP3A4/5/7 is considered to be the 'superfamily' among the isoforms of the CYP-450 enzyme. The substrates of this 'superfamily' are the following, EXCEPT:

a. Macrolides

b. Cortisol

c. TCAs

d. Diazepam

e. Amiodarone

e

Clopidogrel is metabolized via the CYP2C19 enzyme. It has significant interaction with omeprazole, which impairs the said enzyme. To prevent this, _________ can be used instead of omeprazole.

a. Esomeprazole

b. Pantoprazole

c. Lansoprazole

d. Rabeprazole

e. Two of the above

b

A prodrug is a drug that needs to be metabolized first before it can exert its pharmacologic action. Which of the following ACE inhibitors is a prodrug?

a. Captopril

b. Enalapril

c. Enalaprilat

d. Lisinopril

c

Which drug/s is/are incorrectly paired with its metabolite?

i. Epinephrine : homovanillic acid

ii. Dopamine : vanillylmandelic acid

iii. Histamine : N-methylimidazoleacetic acid

iv. Serotonin : 5-hydroxyindoleacetic acid

a. i only

b. iii only

c. i & ii

d. iii & iv

e. ii & iv

d

Analyze the following statement: if reserpine is to adrenergic neurotransmitters, then _________ is to cholinergic neurotransmitters.

a.Metyrosine

b.Hemicholinium

c.Botulinum toxin

d.Vesamicol

d

A patient, who has Parkinson's disease, is on isoniazid therapy. To avoid an adverse effect associated with this, he was prescribed with pyridoxine. Which drug is not recommended for the management of his PD?

a. Sinemet

b. Tagamet

c. Levophed

d. Levodopa

d

Antiviral drug associated with levido reticularis

a.Delavirdine

b.Ritonavir

c.Oseltamivir

d.Amantadine

c

Which of the following local anesthetics is more prone to hydrolysis?

a.Lidocaine

b.Xylocaine

c.Procaine

d.Two of the above

c

Chloramphenicol may be metabolized by several mechanisms. A defect in ______, a Phase I metabolism reaction, of chloramphenicol would lead to _________.

a.Nitro reduction; gray baby syndrome

b.Glucuronidation; gray baby syndrome

c.Nitro reduction; aplastic anemia

d.Glucuronidation; aplastic anemia

a

Acetylation is one of the Phase II metabolisms or conjugation reactions. Which of the following do/es not belong to the group?

a.Asians

b.Caucasians

c.Egyptians

d.Jews

e.Both a & d

a

a.A

b.B

c.Both A & B

d.Neither A nor B

a

True about graph B, EXCEPT:

i. It shows a quantal dose response curve

ii. It shows a graded dose response curve

iii. It shows all-or-none response

iv. It shows response on a continuous scale

v. Efficacy and potency can be determined from this graph

a.i, iii

b.i, iii, v

c.ii, iv

d.ii, iv, v

c

True about the graph above showing the curves for Drugs X, Y, Z:

i. Drug X is the most efficacious and the most potent

ii. Drug X is the most efficacious but the least potent

iii. Drug Z is the most efficacious and the most potent

iv. Drug Z is the most efficacious but the least potent

v. Drug Z has a higher ceiling dose than Drug Y

a.i only

b.iv only

c.i, v

d.ii, v

e.iii, v

b

The following statements about drug antagonism are true, EXCEPT:

a.In competitive antagonism, the potency of the agonist + antagonist curve shifts to the right

b.In competitive antagonism, the efficacy is not achieved.

c.In noncompetitive antagonism, the efficacy of the agonist + antagonist curve shifts downward

d.In noncompetitive antagonism, the potency may still be the same.

a

Morphine is most likely contraindicated with, EXCEPT:

a.Oxycodone

b.Butarphanol

c.Buprenorphine

d.Nalbuphine

e.Pentazocine

b

Naloxone is metabolized via:

a.Nitro reduction

b.Carbonyl reduction

c.Acetylation

d.Sulfation

e.Both a & b

c

NAT2 polymorphism affects the metabolism of the following, EXCEPT:

a.Hydralazine

b.Isoniazid

c.Phenacetin

d.Procainamide

e.Sulfonamide

b

Which of the following graphs is most likely that of an orally administed drug?

a.A

b.B

c.C

d.D

d

A drug with an apparent volume of distribution of 72 L, a clearance of 6.1 L/hr and an oral bioavailability of 65% was ordered for oral administration to a patient. However, only the IV preparation of the drug was available and it was administered every 9 AM and 9 PM. If a steady state of 12 mg/L was desired, what was the drug's maintenace dose?

a.439.20 mg

b.570.96 mg

c.698.31 mg

d.878.40 mg

e.1,351.38 mg

c

The governing principle behind passive diffusion

a.Noyes-Whitney Equation

b. Stoke's Law

c. Fick's Law

d. Raoult's Law

a

Biopharmaceutic process

a.Liberation

b.Absorption

c.Distribution

d.Metabolism

e.Excretion

e

A 75-kg patient is taking a drug with an elimination half-life of 3.6 hours. The drug follows first-order kinetics and has an apparent volume of distribution of 135 mL/kg. What is the total body clearance of the drug?

a.6.48 L/hr

b.3.65 L/hr

c.2.60 L/hr

d.2.00 L/hr

e.1.95 L/hr

e

How much of a 550-mg drug will be eliminated after 5.5 hours if its elimination rate constant is 0.0067 mins-?

a.60.28 mg

b.164.14 mg

c.385.86 mg

d.446.14 mg

e.489.72 mg

c

Sulfonamide and tolbutamide have significant interaction with each other. This interaction is manifested by:

a.Hemorrhage

b.Blood Coagulation

c.Hypoglycemia

d.Hyperglycemia

e.Stevens-Johnson Syndrome

c

Cilostazol, a phosphodiesterase inhibitor, is used in patients with Peripheral Arterial Occlusive Disease (PAOD), where there is stenosis of limb arteries. What does stenosis mean in this context?

a.Clot formation in the arteries

b.Migration of clot in the arteries

c.Narrowing of the arteries

d.Widening of the arteries

c

Which of the following drugs is contraindicated for a patient who has a history of myocardial infarction?

a.Cerebyx

b.Cerebrex

c.Celebrex

d.Celexa

b

Can cause Churg-Strauss syndrome

a.LTD4 agonists

b.LTD4 antagonists

c.LOX inhibitor

d.LOX activator

b

Chronic obstructive pulmonary disease (COPD) may be caused by:

a.Alpha-1 antitrypsin excess

b.Alpha-1 antitrypsin deficiency

c.Elastin formation

d.Two of the above

d

Which of the following is the most likely to be used for pseudoephedrine toxicity?

a.Sodium bicarbonate

b.Sodium carbonate

c.Concentrated sulfuric acid

d.Ammonium chloride

a

The following increases gastric emptying time, EXCEPT:

i. Diabetes Mellitus

ii. Metoclopramide

iii. Fentanyl

iv. Ipratropium

v. Exenatide

a.i, ii

b.i, iii

c.i, v

d.ii, iv, v

e.iii, iv, v

e

Which of the following antidiabetic drugs is least likely to be recommended for patients on Flagyl therapy?

a.Diamicron

b.Diabenese

c.Disulfiram

d.Orinase

e.Two of the above

e

Which of the following drugs must be used with caution in diabetic patients?

a.Salmeterol

b.Cortisol

c.Somatotropin

d.Epinephrine

e.All of the above

b

Onglyza is a DPP4 inhibitor and is used as an oral hypoglycemic agent. What is Onglyza?

a.Sitagliptin

b.Saxagliptin

c.Tolbutamide

d.Chlorpropramide

a

Clinical conditions associated with thyroid hormone deficiency, EXCEPT:

a.Graves disease

b.Hashimoto thyroiditis

c.Myxedema

d.Cretinism

b

Which of the following are most likely observed during primary hypothyroidism?

i. Increased TSH

ii. Decreased TSH

iii. Increased T3/T4

iv. Decreased T3/T4

a.i, iii

b.i, iv

c.ii, iii

d.ii, iv

b

Urofollitropin is a follicle-stimulating hormone analog. Its manufacture involves extraction from:

a.Urine of mice

b.Urine of menopausal women

c.Blood of mice

d.Blood of menopausal women

d

Which non-selective antidiuretic hormone antagonist indicated for SIADH is not recommended for patients taking nitroprusside?

a.Vasopressin

b.Desmopressin

c.Demeclocycline

d.Conivaptan

e.Tolvaptan

c

Tricyclic antidepressant considered to be the drug of choice to manage child enuresis management

a.Amytriptyline

b.Maprotiline

c.Imipramine

d.Amoxapine

e.Doxepin

c

Which of the following is true about the class of diuretics that can be used to treat hypocalcemia?

a.It acts on the thick ascending limb of the Loop of Henle

b.It acts on the thin ascending limb of the Loop of Henle

c.It acts on the distal convoluted tubule

d.It activates the NaCl symport

d

Which diuretic is most likely to be recommended to a patient who is allergic to sulfonamides?

a.Furosemide

b.Bumetanide

c.Torsemide

d.Ethacrynic acid

d

Which diuretic is least likely to be recommended to a patient who is taking kanamycin?

a.Furosemide

b.Bumetanide

c.Torsemide

d.Ethacrynic acid

b

A common adverse effect of the drug Captopril is dry cough. This is because of the accumulation of what autacoid?

a.Prostaglandin

b.Bradykinin

c.Eicosanoid

d.Serotonin

e.Histamine

b

The most potent histamine-2 antagonist

a.Prevacid

b.Pepcid

c.Zantac

d.Prozac

e.Tagamet

b

All of the following selective serotonin reuptake inhibitors (SSRIs) are classified under Pregnancy Category C, EXCEPT:

a.Escitalopram

b.Paroxetine

c.Sertraline

d.Fluvoxamine

c

Fluoxetine is a first-line SSRI for the management of obssesive-compulsive disorder. This drug has a black-box warning for:

a.QT prolongation

b.Agranulocytosis

c.Increased suicidality

d.Stroke

c

Prostaglandin was first isolated from:

a.Urine

b.Sweat

c.Semen

d.Saliva

e.Tears

d

Which of the following is used for primary pulmonary hypertension?

a.Alprostadil

b.Misoprostol

c.Dinoprostone

d.Epoprostenol

e.Latanoprost

b

Inhalational anesthetic of choice for children

a.Nitrous oxide

b.Sevoflurane

c.Enflurane

d.Isoflurane

e.Methoxyflurane

c

What part of the structure of local anesthetic blocks sodium channel?

a.Ester

b.Amide

c.Aromatic ring

d.Aminoalkyl substituent

c

A dentistry student asked you what is the principle behind having epinephrine in lidocaine preparations. How will you explain this to him/her?

a.Epinephrine, a selective direct-acting adrenergic agonist, constricts blood vessels; thus, lidocaine effect will be localized.

b.Epinephrine, a selective indirect-acting adrenergic agonist, constricts blood vessels; thus, lidocaine effect will be localized.

c.Epinephrine, a non-selective direct-acting adrenergic agonist, constricts blood vessels; thus, lidocaine effect will be localized.

d.Epinephrine, a non-selective indirect-acting adrenergic agonist, constricts blood vessels; thus, lidocaine effect will be localized.

B

Amphetamine is under what class of drugs?

a.Direct-acting adrenergic agonist

b.Indirect-acting adrenergic agonist

c.Direct-acting adrenergic antagonist

d.Indirect-acting adrenergic antagonist

c

A patient always include banana in his diet. He was recently prescribed with moclobemide. What is the expected outcome if this patient will not change his diet?

a.Cholinergic crisis

b.Myasthenic crisis

c.Hypertensive crisis

d.Parasympathomimetic crisis

e

The following drugs are not recommended for a hypokalemic patient, EXCEPT:

a.Bumetanide

b.Spirinolactone

c.Digoxin

d.Lisinopril

e.Two of the above

c

The following are observed when a patient has a renal disease, EXCEPT:

i. Increased serum creatinine

ii. Increased creatinine clearance

iii. Decreased serum creatinine

iv. Decreased creatinine clearance

a.i, ii

b.i, iv

c.ii, iii

d.ii, iv

b

Ethosuximide is considered to be the drug of choice for absence seizure. It exerts its effect by interacting with:

a.L-type Ca channel

b.T-type Ca channel

c.L-type Na channel

d.T-type Na channel

c

Cardiac glycoside is

a.Chronotropic

b.Dromotropic

c.Inotropic

d.Nootropic

c

Drugs used as anti-arrythmia under the Class I work by inhibiting voltage-gated sodium channels. The following lists some of the drugs under this class. Which does NOT prolong action potential?

a.Disopyramide

b.Quinidine

c.Phenytoin

d.Procainamide

b

Which beta-blocker is classified under the Class III Anti-arryhthmia?

a.L-sotalol

b.D-sotalol

c.L-esmolol

d.D-esmolol

b

Not recommended for patients with Grave's Disease

a.Bretylium

b.Amiodarone

c.Dofetilide

d.Ibutilide

e.Both c & d

d

Torsades de Pointes is a harmful adverse effect of some antiarrhythmic drugs. What organ is affected by Torsades de Pointes?

a.Liver

b.Brain

c.Kidneys

d.Heart

e.Lungs

b

MOA of polymyxin

a.Cell wall disruption

b.Cell membrane disruption

c.Protein synthesis inhibitor

d.Nucleic acid synthesis inhibitor

a

What will most likely happen when digoxin and ampicillin are coadministered?

a.Enhanced digoxin toxicity

b.Reduced digoxin effectiveness

c.Enhance antimicrobial activity

d.Reduced antimicrobial activity

b

Digoxin toxicity is enhanced by, EXCEPT:

a.Loop diuretics

b.Spironolactone

c.Salbutamol

d.None of the above

b

1,000 units of benzylpenicillin is equivalent to _________:

a.0.006 mcg of Pen G

b.600 mcg of Pen G

c.0.006 mcg of Pen V

d.600 mcg of Pen V

d

True about nitroglycerin transdermal patch, EXCEPT:

a.It must be taken off prior to taking a bath.

b.It may be cut in order to adjust the dose being administered.

c.It must be put on a hairless area.

d.Both a & b

e.Both b & c

b

Most likely common side effect of vasodilators:

a.Decongestion

b.Headache

c.Urinary retention

d.Both a & c

b

Filgrastim is administered for what adverse effect of cancer chemotherapy?

a.Anemia

b.Neutropenia

c.Agranulocytosis

d.Leukocytosis

c

To manage hemorrhagic cystitis due to cyclophosphamide, ___________________ is used.

a.Leucovorin

b.Folinic Acid

c.Mercaptoethanesulfonate sodium

d.Dexrazoxane

c

Tamoxifen, a drug used for breast cancer, becomes an antagonist in the presence of estrogen. Tamoxifen, therefore, is a/an:

a.Irreversible antagonist

b.Noncompetitive antagonist

c.Partial agonist

d.Both a & b

c

Which of the following drugs is used for ADHD?

a.Modafinil

b.Phentermine

c.Methylphenidate

d.Phenylpropanolamine

e.Phenmetrazine

b

ADHD means:

a.Attention deficiency hyperactivity disorder

b.Attention deficit hyperactivity disorder

c.Attention deficiency hyperactivity disease

d.Attention deficit hyperactivity disease

c

The beta-blocker most commonly used as an antidote for caffeine toxicity.

a.Sotalol

b.Timolol

c.Esmolol

d.Nadolol

B

The drug used for Wilson's disease

a.Penicillin

b.Penicillamine

c.Cupramine

d.Deferoxamine

b

Centrally-acting antimuscarinics used to manage Parkinson's Disease, EXCEPT:

a.Trihexyphenidyl

b.Scopolamine

c.Biperidin

d.Benztropine

e.Amantadine

e

The following may be used during cholinergic crisis, EXCEPT:

a.Antihistamines

b.Antipsychotics

c.Tricyclic antidepressants

d.Opioids

e.None of the above

e

Opioid toxicity triad, EXCEPT:

i. Pinpoint pupils

ii. Mydriasis

iii. Respiratory Depression

iv. Comatose

v. Convulsion

a.ii only

b.iv only

c.v only

d.ii, iv

e.ii, v

c

The drug more commonly used for organophosphate toxicity before aging occurs

a.Atropine

b.Physostigmine

c.Pralidoxime

d.Pyridostigmine

d

Which of the following drugs is not effective for the neurologic symptoms of atropine toxicity?

a.Tensilon

b.Eserine physos

c.Mestinon pyridos

d.Prostigmin neost

d

This class of drugs should be used in caution on patients taking a drug that inhibits the nicotinic receptors at the neuromuscular endplate.

a.Calcium channel blockers

b.HMG-CoA reductase inhibitors

c.Statins

d.Both b & c

a

Malignant hyperthermia (MH) is a rare complication which may be due to use of drugs that activate ryanodine receptors. What drug is used to manage MH?

a.Dantrolene

b.Pancuronium

c.Disulfiram

d.Mecamylamine

e

Mivacurium is a:

a.Steroidal, depolarizing, competitive, reversible anti-nicotinic drug

b.Non-steroidal, non-depolarizing, non-competitive, irreversible anti-nicotinic drug

c.Steroidal, non-depolarizing, competitive, irreversible anti-nicotinic drug

d.Non-steroidal, depolarizing, non-competitive, reversible anti-nicotinic drug

e.None of the above

a

True about senolytic drugs

a. Disrupt the aging process

b. Promote the aging process

c. Suppress child's appetite

d. Enhance child's appetite

a

Fomepizole is used to manage toxicity associated with alcohols. What enzyme does it inhibit?

a.Alcohol dehydrogenase

b.Aldehyde dehydrogenase

c.Carboxylic acid dehydrogenase

d.Ketone dehydrogenase

d

A patient is complaining that his constipation is not getting any better despite taking a laxative. The pharmacist, who dispensed the drug, is being accused of selling expired medications. However, upon patient interview, she learns that the patient takes the drug every breakfast with milk. Which of the following is most likely the patient's laxative?

a.Castor oil

b.Senna

c.Psyllium

d.Bisacodyl

e.Mineral oil