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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
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