PHAR100 FINAL

Which ancient drug originates from rye? 

Ergot

Which statement is correct about ancient drugs?

Something about how the Ebers Papyrus was used in Ancient Egypt to document drugs

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A question about preclinical (phase 1) studies 

Studies conducted in animals to determine mechanism of action and other stuff 

A question about phase 3 clinical trials

They are used to determine safety and efficacy by using a large population.

What would be the target population for a phase 3 clinical trial about some specific severe form of a disease

Patients between ages of like 20 and 73 with the specific severe form of the disease

In drug development, Phase 4 clinical trials:

* Are also referred to as post-market surveillance
* Are used to establish bioequivalence between two products containing the same active drug
* Apply exclusively to generic drugs
* Compare drug responses in a non-human primate species to those in humans

Are also referred to as post-market surveillance

Your friend asks you whether you think generic drugs really work well as brand name drugs. To assure her that they do, which of the following would you explain to your friend?

* The generic name of a drug is usually the same as the brand name of that drug so that tells you that they are equivalent
* If a drug is marketed by more than one company, it may have only one brand propriety/name, so it is just as good
* Drug products manufactured by different drug companies always have the same active ingredient and the same fillers and binders
* The generic and brand name version of a drug are compared to ensure they are bioequivalent

The generic name of a drug is usually the same as the brand name of that drug so that tells you that they are equivalent

The therapeutic range for Drug Y in blood is 15ug/mL. The drug concentration of Drug Y in your patient’s blood is found to be 50ug/mL. The appropriate course of action would be:

* Decrease the dose of Drug Y for the patient
* Increase the dose of Drug Y for the patient
* Keep the same dose of Drug Y for the patient
* Immediately stop Drug Y and switch to a less efficacious drug for the patient

Decrease the dose of Drug Y for the patient

Which of the following best describes the binding of an antagonist to a receptor

* It binds to the receptor but does not produce an effect
* It binds to a site adjacent to the receptor but does not produce an effect
* It binds to the receptor and prevents a response
* It binds to the receptor and produces a maximal effect for that biological system

It binds to the receptor but does not produce an effect

The dose of the drug where a response is first seen is best described as:

* The receptor threshold dose
* The potency of the drug
* The ED50 for the drug
* The plateau effect

The receptor threshold dose

Two patients (A and B) take 100 mg of the same drug orally. The drug is excreted by the kidneys after biotransformation by the liver. Thirty minutes after taking the drugs the patients have similar drug concentrations in the blood. Two hours after taking the drug patient A has 4 times the drug concentration in the blood compared to patient B. Which of the following statements is the best explanation for this observation?

* Patient B is able to metabolize the drug faster than patient A
* Patient B is suffering from kidney failure, which impairs drug excretion
* Patient B has impaired liver function
* Patient B consumed several glasses of water and the increased urine output increased drug excretion

Patient B consumed several glasses of water and the increased urine output increased drug excretion

Which one of the following statements regarding routes of administration is correct?

* The absorption of a drug after subcutaneous injection is more rapid than that following intravenous administration
* Administration of a drug by the rectal route invariably leads to 100% absorption of the drug
* Lipid soluble drugs and other chemicals can be absorbed through the skin
* One disadvantage of the intravenous route of administration is that it is useful for small volumes (10ml) of solutions, but not larger volumes

Lipid soluble drugs and other chemicals can be absorbed through the skin

Which organ is most responsible for the conversion of a drug to an inactive substance?

* Kidney
* Liver
* Intestine
* Adrenal glands 

Liver

Drug A has a therapeutic index of 2, while Drug B has a therapeutic index of 20. From this information, one can conclude that:

* Drug A is more likely to have a drug-food interaction than Drug B
* Drug B is safer than Drug A
* Drug A is more effective than Drug B
* Drug B is more potent than Drug A

Drug B is safer than Drug A

The over-sedation that occurs after administration of an overdose of benzodiazepine is best categorized as:

* An extension of the therapeutic response
* An extension of a secondary response
* An idiosyncratic drug reaction
* A drug allergy

An extension of the therapeutic response

A patient is given a monoamine oxidase inhibitor for the treatment of depression. The patient loves old cheese and has a meal of old cheese and crackers. The patient is admitted to the Emergency Room with severe hypertension (high blood pressure). Which one of the following is the most likely reason for the hypertension?

* The old cheese inhibited the cytochrome P-450 in the liver from metabolizing the tyramine in the cheese
* The tyramine in the old cheese inhibited the monoamine oxidase from metabolizing other drugs
* The monoamine oxidase inhibitor blocked the breakdown of tyramine and the excess tyramine caused the hypertension
* The tyramine in the old cheese inhibited the renal (kidney) excretion of the monoamine oxidase inhibitor

The monoamine oxidase inhibitor blocked the breakdown of tyramine and the excess tyramine caused the hypertension

Which one of the following statements regarding drug interactions is correct?

* One drug cannot interfere with the absorption of another drug, as absorption is an independent process for each drug
* One drug may increase the mechanism of action of another drug
* One drug cannot affect the excretion of another drug
* One drug may alter the rate of biotransformation of a second drug by the liver

One drug may alter the rate of biotransformation of a second drug by the liver

The molecular structural component of a cell where a neurotransmitter exerts a response is best described as:

* The axon
* The cell body
* The receptors
* The dendrites

The receptors

Which of the following statements regarding neurotransmission is correct?

* Neurotransmission is a slow process
* The neurotransmitter acetylcholine is excitatory in the brain
* Neurotransmitter activity is always terminated by enzymatic breakdown in the synaptic cleft
* The major excitatory neurotransmitter of the brain is GABA

The neurotransmitter acetylcholine is excitatory in the brain

The limbic system is closely associated with the hypothalamus. Which one of the following statements regarding the limbic system is correct?

* It is responsible for motor coordination
* It is the centre that acts as a relay centre to the cerebral cortex
* It is a small gland at the base of the brain that secretes hormones
* It is the reward centre of the brain and contains dopaminergic neurons

It is the reward centre of the brain and contains dopaminergic neurons

Which one of the following statements predicts that a drug is likely to have low misuse potential?

* The drug can be injected
* The drug has a low potential to cause immediate harm
* The drug is readily available
* The drug has low-reinforcing properties

The drug has low-reinforcing properties

An individual is showing signs of risky use, tolerance, and impaired control of a popular recreational drug. You are concerned that the individual may have developed which of the following:

* Misuse liability
* Overdose
* Withdrawal
* Substance use disorder

Substance use disorder

With respect to tolerance, which of the following statements is correct?

* The dose of a drug must be decreased to obtain the same magnitude of pharmacological effect that was first achieved
* Physiological responses to a drug (e.g., constipation and euphoria) do not always develop tolerance at the same time
* Tolerance develops to all CNS drugs but cannot develop to drugs that don’t target the brain
* Repeated administration of a given dose of drug will always produce the same effect 

Physiological responses to a drug (e.g., constipation and euphoria) do not always develop tolerance at the same time

Which one of the following statements correctly describes the mechanism of action of amphetamines?

* Amphetamines block the breakdown of dopamine and norepinephrine in the synaptic cleft
* Amphetamines block the reuptake of dopamine and norepinephrine from the synaptic cleft
* Amphetamines are taken up into the neuron and block the packaging of dopamine and norepinephrine into vesicles, thus increasing their release from the neuron
* Amphetamines block the destruction of dopamine and norepinephrine in the neuron, enhancing the amount that is released into the synaptic cleft

Amphetamines are taken up into the neuron and block the packaging of dopamine and norepinephrine into vesicles, thus increasing their release from the neuron

Which of the following correctly describes the drug-drug interaction of caffeine and nicotine?

* Nicotine improved the distribution of caffeine, thus increasing its duration of action
* Nicotine increases the metabolism of caffeine
* Caffeine improved the absorption of nicotine in the lungs
* Both drugs are excreted by the same organ, and thus compete

Nicotine increases the metabolism of caffeine

Which of the following best describes cocaine?

* CNS depressant
* CNS stimulant
* Sedative-hypnotic
* Antipsychotic

CNS stimulant

Which one of the following statements regarding nicotine’s potential for misuse and substance use disorder is correct?

* The chemical nicotine cannot itself cause a substance use disorder
* Withdrawal from nicotine results in short-term increased cognition and energy
* Tolerance to nicotine does not occur to a great extent
* Nicotine is a powerful CNS depressant and has a high degree of misuse liability

Tolerance to nicotine does not occur to a great extent

An athlete administers a drug daily to boost performance. The results produced by the drug are increased stamina but no increase in muscle mass. Long distance running endurance is enhanced. The drug is most likely?

* An anabolic steroid
* A benzodiazepine
* Erythropoietin
* A diuretic

Erythropoietin

An elite athlete has been caught using a performance-enhancing drug. The effects of this drug were that it increased the excretion of water through the kidney. The performance-enhancing drug most likely used was:

* Erythropoietin
* A benzodiazepine
* An anabolic steroid
* A diuretic

A diuretic

Which of the following are the major use of barbiturates?

* Seizures
* Insomnia
* Depression
* Hyperactivity

Seizures

When comparing benzodiazepines to barbiturates, benzodiazepines have:

* Fewer therapeutic uses
* Higher inherent harmfulness
* Greater risk of addiction
* Lower misuse potential

Lower misuse potential

Which one of the following statements regarding classes of sedative-hypnotics is correct? 

* The benzodiazepine-like drugs are benzodiazepine antagonists
* Benzodiazepines can decrease aggression
* All barbiturates are long-acting drugs
* Flumazenil is a barbiturate antagonist

Benzodiazepines can decrease aggression

You have a bottle of medication, but the identifying drug label has worn off. The list of effects of the drug is still present on the bottle and includes a full spectrum of dose-dependent CNS depression, respiratory depression, low therapeutic index, and suppression of REM sleep. Based on the list of these effects, you can predict that the drug falls into which class of drugs?

* Barbiturates
* Cocaine
* Benzodiazepines
* Amphetamines

Barbiturates

Which of the following sedative-hypnotic drugs bind to the serotonin receptor?

* Barbiturates
* Benzodiazepine-like drugs (e.g., zopiclone)
* Buspirone
* Benzodiazepines

Buspirone

Which one of the statements regarding alcohol pharmacokinetics is correct?

* Alcohol is slowly absorbed from the stomach and small intestine
* Alcohol distributes only to the central nervous system
* Alcohol absorption is impacted by stomach emptying time

Alcohol absorption is impacted by stomach emptying time

Which of the following are key characteristics of the withdrawal syndrome experienced by those with severe alcohol use disorder?

* Sedation and severe pain
* High fever and hair loss
* Anxiety, heart palpitations, and seizures
* Congestion and liver failure 

Anxiety, heart palpitations, and seizures

A friend tells you that she cannot consume alcohol as it causes unpleasant side effects, such as flushed face and headache. What is the most likely explanation for your friend’s intolerance to alcohol?

* Very rapid absorption of alcohol from the gastrointestinal tract
* Rapid conversion of alcohol to acetaldehyde by alcohol dehydrogenase
* Rapid conversion of acetaldehyde to acetate by aldehyde dehydrogenase
* Very slow excretion of alcohol by the kidneys

Rapid conversion of alcohol to acetaldehyde by alcohol dehydrogenase

Which of the following statements best describes the mechanism of action of the endogenous cannabinoid, anandamide?

* It is released from the presynaptic neuron and binds to CB1 receptors on the post-synaptic membrane
* It is released from the presynaptic membrane and binds to chloride channels, enhancing GABA activity
* It is released from the postsynaptic membrane and binds to CB1 receptors on the presynaptic membrane, inhibiting the release of excitatory neurotransmitters
* It is released from the presynaptic neuron and acts on CB1 receptors located on the post-synaptic membrane

It is released from the postsynaptic membrane and binds to CB1 receptors on the presynaptic membrane, inhibiting the release of excitatory neurotransmitters

Which of the following describes the effects of cannabis use on fertility?

* Increased sperm count
* Increased sex drive
* Increased risk of cognitive deficits in babies exposed during therapy
* Reduced estrogen and increased testosterone in females

Increased risk of cognitive deficits in babies exposed during therapy

Which one of the following statements about cannabis is correct?

* The active ingredients in cannabis bind to the adrenergic receptor
* The active ingredient in cannabis is slowly metabolized such that a user may test positive days after smoking cannabis
* Cannabis use has no effect on motor coordination
* Cannabis, unlike ethanol, does not impair cognitive function

The active ingredient in cannabis is slowly metabolized such that a user may test positive days after smoking cannabis

Which one of the following statements regarding opioids is correct?

* They cause diarrhea in the patient
* They are effective cough suppressants
* They cause addiction, but not withdrawal
* They produce central nervous system excitation

They are effective cough suppressants

Buprenorphine is specifically useful in the treatment of opioid use disorder because:

* It is short-acting
* It prevents withdrawal symptoms
* It increases sedation, so people don’t use other opioids
* It is given intravenously

It prevents withdrawal symptoms

Your 12-year-old cousin is prescribed penicillin to treat an ear infection. She asks you “Why does penicillin kill a bacteria cell but not a human cell?” Which one of the following statements is the best response to her question?

* Penicillin is toxic to all cells, but there are many  more human cells than bacterial cells
* Penicillin is taken up by the bacterial cells but not the human cells
* Penicillin is active against Gram positive bacteria, but human cells are Gram negative
* Penicillin inhibits formation of cell walls, which bacteria have, and human cells do not have

Penicillin inhibits formation of cell walls, which bacteria have, and human cells do not have

Which of the following is the target for the antibacterial action of the tetracyclines?

* Mitochondria
* Folic and synthesis
* Cell walls
* Protein synthesis

Protein synthesis

The use of antibiotics in combination is usually not recommended. Which one of the following circumstances is an accepted use of two or more antibiotics to treat an infection?

* Treatment of a mild respiratory infection
* Treatment of a severe infection where the organism has been defined
* Treatment of a severe infection with more than one invading organism
* Treatment of a chronic infection where the invading organism is well defined

Treatment of a severe infection with more than one invading organism

Which one of the following statements best describes the selective toxicity of sulfonamides?

* Sulfonamides interfere with the conversion of PABA to folic acid in bacteria, but mammalian cells use preformed folic acid
* Sulfonamides replace folic acid in bacteria, but not in mammalian cells
* Sulfonamides interfere with the synthesis of cell walls in bacteria
* Sulfonamides inhibit the uptake of folic acid by bacteria, but not mammalian cells

Sulfonamides interfere with the conversion of PABA to folic acid in bacteria, but mammalian cells use preformed folic acid

Which one of the following statements best describes the mechanism of action of the imidazole antifungals (e.g., ketoconazole)?

* Inhibition of fungal nucleic acid synthesis
* Inhibition of cholesterol synthesis in the fungal membrane
* Binding to ergosterol in the cell membrane, causing a leaky membrane
* Inhibition of a fungal P450, thereby inhibiting the synthesis of ergosterol.

Inhibition of a fungal P450, thereby inhibiting the synthesis of ergosterol.

Acyclovir is selectively toxic to viruses such as herpes simplex virus because:

* It must be converted to an active form by the virus
* It inhibits only viral RNA within infected cells
* It blocks the enzyme that allows the spread of the virus
* It interferes with the attachment of the virus to cells

It must be converted to an active form by the virus

Male hormonal contraceptives have not yet reached the Canadian market because:

* Estrogen based contraceptives increased sex drive too much
* Androgen based contraceptives prevented the growth of facial hair
* Attempts to inhibit spermatogenesis have been largely unsuccessful
* Not enough males could be recruited into clinical trials

Attempts to inhibit spermatogenesis have been largely unsuccessful

The mechanism and site of action of the combined estrogen-progestin contraceptives is best described as:

* Directly inhibiting the release of follicle-stimulating hormone from the hypothalamus
* Directly inhibiting the release of luteinizing hormone from the hypothalamus
* Directly inhibiting the release of gonadotropin-releasing hormone from the hypothalamus
* Directly inhibiting the release of follicle releasing hormone from the anterior pituitary

Directly inhibiting the release of gonadotropin-releasing hormone from the hypothalamus

Which one of the following adverse effects has limited the use of oral contraceptives containing a progestin as the sole active ingredient?

* Breakthrough bleeding
* Nausea
* Blood clots
* Decreased sex drive

Blood clots

Which one of the following over-the-counter drugs is correctly matched with its mechanism of action?

* Decongestants - constricts blood vessels in the nose
* Internal analgesic - activates prostaglandin synthesis
* Cough suppressants - increases mucous secretion in the lung
* Proton-pump inhibitors - block histamine receptors in the stomach

Decongestants - constricts blood vessels in the nose

Reyes syndrome is a significant adverse event that is associated with which one of the following internal analgesics?

* Acetaminophen
* Ibuprofen
* Acetylsalicylic acid
* Naproxen

Acetylsalicylic acid

The adverse event most commonly observed in an elderly population due to excess use of over-the-counter laxatives is:

* Dehydration and electrolyte imbalance
* Fluid in the lungs
* Liver damage
* Dermatitis (skin rash)

Dehydration and electrolyte imbalance

You have recently had your wisdom teeth extracted and are looking for an appropriate over-the-counter analgesic; however, most nonsteroidal anti-inflammatory analgesics give you a terribly upset stomach. Therefore the best choice for you from the list below would be?

* Acetylsalicylic acid
* Ibuprofen
* Naproxen
* Acetaminophen

Acetaminophen

Which one of the following statements regarding herbal products is correct?

* A number of herbal products have been shown to cause interactions with prescribed drugs
* All herbal products on the Canadian market have been fully tested for effectiveness
* Most herbal products contain one single active ingredient
* All herbal products lack toxicity as they are naturally sourced

A number of herbal products have been shown to cause interactions with prescribed drugs

Which one of the following herbal drugs is correctly matched with its proposed use?

* Valerian - migraine headaches
* Echinacea - common cold
* Devil’s claw - anxiety states
* St. John’s Wort - enhances memory and concentration

Echinacea - common cold

Which one of the following statements correctly identifies the most commonly proposed use of the listed herbal?

* Aloe vera for the treatment of migraine
* Devil’s Claw as an anti-inflammatory
* Ginseng as an antidepressant
* Echinacea for wound healing

Devil’s Claw as an anti-inflammatory

A family friend, who suffers from depression, tells you that she has been prescribed an antidepressant; however, she also decided to take St. John’s Wort. You tell her this is inappropriate because:

* St. John’s Wort will inhibit the beneficial effects of the prescribed antidepressant
* St John’s Wort and the prescribed antidepressant may have additive effects
* St. John’s Wort is ineffective and is of no value
* The prescribed antidepressant is ineffective, and she should take only St. John’s Wort

St John’s Wort and the prescribed antidepressant may have additive effects

A pregnant individual is prescribed iron and vitamin supplements. Their physician is careful to select a vitamin product with folic acid. Why is folic acid supplementation important during pregnancy

* It prevents neural tube defects in the fetus
* It is required for the prevention of night blindness in the newborn
* It has a major role in the development of bones and teeth
* It has an antioxidant role in the developing fetus

It prevents neural tube defects in the fetus

Which of the following statements regarding vitamins is correct?

* Water soluble vitamins are more toxic than fat soluble vitamins
* Controlled clinical trials have shown that vitamin C can produce a 50% reduction in the incidence of the common cold
* An adequate intake of vitamin D is required to prevent scurvy
* Individuals doing hard physical work under extreme conditions may require a greater intake of vitamins

Individuals doing hard physical work under extreme conditions may require a greater intake of vitamins

Your employment requires you to spend the next winter in the high arctic, where there is limited access to fresh produce and the sun. You can take 2 vitamins with you. Which two would you select?

* B-Complex and Vitamin D
* Vitamin D and Vitamin C
* Vitamin D and Vitamin E
* Vitamin A and Vitamin C

Vitamin D and Vitamin C

Which one of the following statements regarding vitamin E is correct?

* Vitamin E deficiency is a common problem among Canadians
* Vitamin E is required for the synthesis of red blood cells
* Vitamin E deficiency during pregnancy is associated with development of cleft palate in the neonate
* Vitamin E is essential for a number of biochemical reaction and fungal antioxidant

Vitamin E is essential for a number of biochemical reaction and fungal antioxidant

A key limitation in estimating toxicity of food additives in humans is that:

* Exposure to food additives is generally over a lifetime, which is hard to replicate in laboratory studies
* Children are exposed to food additives, and we do not have models to predict toxicities in children
* Animal models do not provide useful information with respect to predicting human effects
* Carcinogenicity testing systems are lacking, making it difficult to predict if a food additive has to potential to be carcinogenic

Exposure to food additives is generally over a lifetime, which is hard to replicate in laboratory studies

Which food additive is used to prevent the oxidation of fruit?

* Sodium nitrie
* Sulphur dioxide
* Ascorbic acid
* Sodium chloride

Ascorbic acid

Which of the following statements regarding food additives is correct?

* Food additives are substances intended for human consumption and must have nutritive value
* Food additives must be naturally occurring compounds to ensure lack of toxicity
* One reason for adding food additives to food is to improve the flavour
* All known food colouring agents are safe and approved by all governmental agencies

One reason for adding food additives to food is to improve the flavour

You are preparing a sandwich from packaged ham. The ham is a nice pink colour, and you check the label. Which one of the following food additives imparts the pink colour?

* Ascorbic acid
* Vitamin E
* Smoke
* Sodium nitrite

Sodium nitrite

Paraquat, a widely used herbicide, is very toxic when ingested. The main target organ of paraquat is?

* Heart
* Liver
* Lungs
* Bladder

**Lungs**

Organophosphorus insecticides act by:

* Antagonizing muscarinic receptors
* Irreversibly inhibiting acetylcholinesterase
* Binding to and activating muscarinic receptors
* Competitively inhibiting monoamine oxidase

Irreversibly inhibiting acetylcholinesterase

Which one of the following statements regarding bisphenol A is correct?

* Bisphenol A has no reproductive or developmental effects
* Bisphenol A has estrogen-like activity
* Because of its rapid degradation, bisphenol A is not an environmental concern
* The general population is at large risk of bisphenol A toxicity

Bisphenol A has estrogen-like activity

An 18-month-old child is brought to the hospital and the mother tells you that the child has lost their appetite, has been irritable, and always appears tired. She tells you that they live in an old house that has not been renovated in over 70 years. Tests show that the child is anemic (decreased red blood cells) and has difficulty walking. Which one of the following do you suspect?

* Mercury poisoning from the old pipes in the house
* Bisphenol A poisoning from baby bottles
* Lead poisoning from old paint
* Agent orange poisoning from food grown in the garden

Lead poisoning from old paint

Which one of the following statements regarding pharmaceuticals in the environment is correct?

* A main source of human exposure to pharmaceuticals in the environment is the air we breathe
* There are well developed regulations controlling the amount of pharmaceuticals in our drinking water
* Pharmaceuticals in the environment pose a greater risk for adverse effects on fish than on human population
* The sewage treatment plants of major North American cities effectively remove all drugs from the effluent before discharge into the water ways

Pharmaceuticals in the environment pose a greater risk for adverse effects on fish than on human population

The major source of antibiotics in the environment is:

* Manufacturing processes
* Treatment of pets
* Flushing unused antibiotics into sewage
* Use in agriculture

Use in agriculture

Your relative recently read a newspaper article which stated that statins are found in rivers and lakes that are sources of drinking water. How would you most appropriately reassure your relative that the statins in the drinking water will not pose a risk to their health?

* You state that statins lower blood lipids and they would be of benefit for them
* You would use the minimum therapeutic dose concept and show them that exposure to statins in drinking water is minimal
* You would tell them that the water treatment plant effectively removes all pharmaceuticals that are in raw water
* You would tell them that the statins could be detrimental to their health and that they should use bottled spring water

You would use the minimum therapeutic dose concept and show them that exposure to statins in drinking water is minimal

How do chemicals change cells to cause cancer?

* Chemicals can bind to enzymes in the cell allowing for growth
* Chemicals can bind irreversibly with DNA, damaging the DNA such that cell growth is enhanced
* Chemicals can bind to receptors that stimulate cell division
* Chemicals usually alter the protection against viruses that are then able to produce cancer

Chemicals can bind irreversibly with DNA, damaging the DNA such that cell growth is enhanced

Combination chemotherapy is standard practice for the treatment of cancer. One of the reasons for this is because:

* It is cost prohibitive to utilize a single chemotherapeutic for the entire treatment course
* The adverse effects experienced during chemotherapy are minimized with combination therapy
* The potency of the chemotherapy is decreased when used in combination
* Cancer cells are more likely to mutate when combination therapy is employed

The adverse effects experienced during chemotherapy are minimized with combination therapy

What class of chemotherapeutic drugs is correctly matched with its mechanism of action?

* Alkylating agents - bind to DNA and thereby damage DNA
* Mitotic inhibitors - block hormone receptors
* Hormone antagonists - disrupt microtubule formation
* Biologicals - enhance cell replication

Alkylating agents - bind to DNA and thereby damage DNA

Which one of the following statements about carcinogens is correct?

* A procarcinogen will prevent cancer
* An ultimate carcinogen requires metabolic activation before it can cause cancer
* A carcinogen must be able to inhibit cell replication in order to cause cancer
* A procarcinogen requires metabolic activation before it can cause a cancer

A procarcinogen requires metabolic activation before it can cause a cancer