Pharmacology (Course Exam 3)

Proverbs 16:3

a. Pharmacokinetics

1. "What the body does to the drug?"

a. Pharmacokinetics

b. Pharmacodynamics

c. Pharmacotherapeutics

d. Pharmacogenomics

b. Mannitol

2. The following drugs exhibit target-protein actions, except:

a. Digoxin

b. Mannitol

c. PPIs

d. NSAIDs

e. Beta blockers

a. Digoxin

3. Na+-K+-ATPase pump is targeted by:

a. Digoxin

b. Mannitol

c. PPIs

d. NSAIDs

e. Beta blockers ANS:

a. I, II, III, IV

4. Types of receptors include:

I. Ionotropic

II. Metabotropic

III. Kinase-linked

IV. Gene-transcritpion

a. I, II, III, IV

c. I, III, IV

b. I, II, III

d. II, III, IV

a. Type I

5. GABAA receptors are:

a. Type I

b. Type II

c. Type III

d. Type IV

b. Metabotropic receptors

6. Which of the following receptors are also known as G protein-coupled receptors?

a. Ionotropic receptors

b. Metabotropic receptors

c. Kinase-linked receptors

d. Nuclear receptors

b. Affinity with intrinsic activity

7. Which of the following describes an agonist?

a. Affinity without intrinsic activity

b. Affinity with intrinsic activity

c. Avidity

d. Intrinsic activity only

a. Maximum achievable response

8. Which of the following refers to efficacy?

a. Maximum achievable response

b. Lowest dose producing maximum effect

c. Margin of safety

d. Degree of changes in dose with changes in response

d. Mannitol for cerebral edema

9. Which of the following does not facilitate chemical antagonism?

a. Protamine sulfate for heparin toxicity

b. Deferoxamine for iron poisoning

c. Antacids for hyperacidity

d. Mannitol for cerebral edema

a. Efficacy

10. Which of the following parameters is not measured by a certain amount?

a. Efficacy

b. Potency

c. Ceiling Dose

d. TD50

e. ED50

a. Amlodipine 5 mg tablet

11. Most potent:

a. Amlodipine 5 mg tablet

b. Verapamil 80 mg tablet

c. Diltiazem 60 mg tablet

d. Toxic

12. Which of the following does not describe a competitive antagonist?

a. Reversible

b. Surmountable

c. Relatively safer

d. Toxic

b. FALSE

13. Higher therapeutic index implies that a drug requires therapeutic monitoring.

a. TRUE

b. FALSE

d. Nicotinic R

14. In terms of mechanism of transduction, which does not belong?

a. Muscarinic R

b. Beta 1 R

c. Alpha R

d. Nicotinic R

a. Morphine for severe pain

15. Which of the following is the most effective?

a. Morphine for severe pain

b. Codeine for moderate pain

c. Tramadol for mild pain

d. All are equally effective

c. I, II, IV

16. Which of the following hold/s true about the anatomy and physiology of the autonomic nervous system?

I. It contains 2 neurons

II. The first neuron is called the pre-ganglionic neuron

III. It does not have a ganglion

IV. The function is mainly vegetative

a. I, II, III, IV

b. I, II, III

c. I, II, IV

d. II, III, IV

a. Pre-synapse

17. Synthesis, storage and release of neurotransmitters are observed in:

a. Pre-synapse

b. Synaptic cleft

c. Post-synapse

d. All of these

b. NE

18. The main neurotransmitter in the sympathetic, post-ganglionic neuron is:

a. ACh

b. NE

c. VIP

d. ATP

a. Constriction

19. The general effect brought about by the activation of alpha-1 receptors is:

a. Constriction

c. Depression

b. Relaxation

d. No effect

d. Release of renin

20. Activation of beta-1 receptors in the heart, except:

a. Increased strength of myocardial contraction

b. Increased heart rate

c. Increased conduction velocity

d. Release of renin

a. Metabolic transformation by same pathway as precursor of transmitter

21. Which of the following mechanisms is for methyldopa?

a. Metabolic transformation by same pathway as precursor of transmitter

b. Blockade of transport system of adrenergic neurotransmitter

c. Prevention of release of adrenergic neurotransmitter

d. Promotion of exocytosis or displacement of transmitter from storage sites

c. Labetalol

22. Which of the following beta blockers is not applicable to be used for patients with CHF?

a. Bisoprolol

b. Metoprolol

c. Labetalol

d. Carvedilol

a. CVS - positive inotropic effect

23. Which of the following is incorrectly matched regarding the pharmacological effects of acetylcholine?

a. CVS - positive inotropic effect

b. Respiratory Tract - bronchoconctriction

c. Urinary Tract - ureteral persitalsis

d. GI Tract - increased secretory activity of the stomach and intestine

d. Pilocarpine

24. An alkaloid that selectively binds at muscarinic receptors is:

a. Lobeline

b. Nicotine

c. Varenicline

d. Pilocarpine

c. Alzheimer's disease

25. Rivastigmine, galantamine, tacrine and donepezil are used in which of the following condition?

a. Myasthenia gravis

b. Ileus

c. Alzheimer's disease

d. Glaucoma

e. Nicotinic receptors

26. Odd one out re: Sympathetic Nervous System

a. Thoracolumbar

b. Fight/Flight

c. NE

d. Adrenergic

e. Nicotinic receptors

a. Tocolysis

27. The following are cholinergic responses, except:

a. Tocolysis

b. Bowel movement

c. Urination

d. Bronchoconstriction

a. I, II, III, IV

28. Sympathetic responses:

I. Mydriasis

II. Urinary retention

III. Tachycardia

IV. Ileus

a. I, II, III, IV

b. I, II, III

c. II, III, IV

d. I, III, IV

a. Vesamicol

29. Which of the following agents does not target the sympathetic neurotransmitter biosynthesis?

a. Vesamicol

b. Metyrosine

c. Reserpine

d. Guanethedine

e. Tyramine

d. Hyperkalemia

30. The following are effects of beta-2 receptor activation, except:

a. Bronchodilation

b. Vasodilation

c. Tocolysis

d. Hyperkalemia

d. I, III, IV

31. Direct-acting, non-selective sympathomimetics:

I. EPI

II. Dobutamine

III. Dopamine

IV. NE

V. Isoproterenol

a. I, II, III

b. I, II, IV

c. II, III, IV

d. I, III, IV

e. I, IV, V

d. Fenoldopam

32. Which of the following is an dopamine 1 agonist?

a. Phenylephrine

b. Methyldopa

c. Salbutamol

d. Fenoldopam

b. Modafinil

33. Clinically, this agent is useful for narcolepsy:

a. Methyldopa

b. Modafinil

c. Methylphenidate

d. Mephentermine

c. Urinary urgency

34. Clinical uses of alpha blockers, except:

a. Pheochromocytoma

b. Raynaud's Syndrome

c. Urinary urgency

d. ED

a. Propranolol

35. Beta blocker that is C/I in BA patients:

a. Propranolol

b. Metoprolol

c. Nebivolol

d. Atenolol

d. Arecoline

36. An alkaloidal compound that is a direct-acting, non-selective cholinomimetic:

a. Methacholine

b. Carbachol

c. Muscarine

d. Arecoline

a. Echothiophate

37. Which of the following is an irreversible anticholinesterase?

a. Echothiophate

b. Eserine

c. Edrophonium

d. Neostigmine

b. Biperiden

38. Which of the following agents is not a cholinomimetic?

a. Bethanechol

b. Biperiden

c. Physostigmine

d. Nicotine

a. Succinylcholine

39. The following NMBs are curare derivatives, except:

a. Succinylcholine

b. Atracurium

c. Rocuronium

d. Tubocurarine

d. Trihexyphenidyl - Schizophrenia

📌Drugs for Schizoprenia

• Chlorpromazine

• Trifluoperazine

• Thiothixene

40. Which of the following anticholinergic - clinical use is incorrectly paired?

a. Atropine - Sxtic Bradycardia

c. Ipratropium - Brochial Asthma

b. Cyclopentolate - Mydriatic

d. Trihexyphenidyl - Schizophrenia

a. Losartan

41. This antihypertensive medication is teratogenic, thus is contraindicated in pregnancy:

a. Losartan

b. Labetalol

c. Hydralazine

d. Methyldopa

a. Acetazolamide

📌Rationale: Acetazolamide diuretic efficacy is limited because it causes metabolic acidosis as side effect

42. Clinically useful antihypertensive agent, except:

a. Acetazolamide

b. Minoxidil

c. Amlodipine

d. Metoprolol

e. Clonidine

a. Spironolactone

→ NOTE: Spironolactone is potassium‑sparing, non‑sulfonamide, safe alternative in sulfa‑allergic patients.

43. Which of the following diuretics may be given if a patient is allergic to sulfonamides?

a. Spironolactone

b. Furosemide

c. Acetazolamide

d. HCTZ

c. D1 blockade

44. Mechanisms of vasodilation, except:

a. Hyperpolarization

b. Increased cGMP concentration

c. D1 blockade

d. Alpha1 blockade

a. Increased angiotensin II

45. The following are effects brough about by captopril, except:

a. Increased angiotensin II

c. Increased incidence of cough

b. Increased bradykinin

d. Increased risk of fetal anomaly

e. Two of the choices (Metoprolol & Verapamil)

46. Non-vasodilator for angina pectoris:

a. Amlodipine

b. Verapamil

c. ISDN

d. Metoprolol

e. Two of the choices

c. Treatment of Prinzmetal angina (this is the used of CCB)

47. Indications of beta blockers for angina pectoris, except:

a. Treatment of effort angina

b. Tx of reflex tachycardia caused by high-dose nitrates

c. Treatment of Prinzmetal angina

d. Reduction of myocardial oxygen demand

c. Digoxin

48. The following are first-line agents for heart failure, except:

a. Losartan

b. Metoprolol succinate

c. Digoxin

d. Furosemide

e. Carvedilol

a. Digoxin

49. Which of the following agents does not increase cardiac force by enhancing myocardial cAMP?

a. Digoxin

b. Dobutamine

c. Dopamine

d. Inamrinone

e. More than one answer

a. Amiodarone

→NOTE: Amiodarone is Class III antiarrhythmic, prolongs repolarization, not sodium channel blocker.

50. Class I antiarrhythmic, except:

a. Amiodarone

b. Phenytoin

c. Disopyramide

d. Quinidine

e. Propafenone

b. Guanethedine

51. The mechanism of action of this drug is to prevent the normal physiologic release of norepinephrine from postganglionic sympathetic neuron.

a. Methyldopa

b. Guanethedine

c. Mecamylamine

d. Diazoxide

c. Eplerenone

52. This diuretic competitively antagonizes aldosterone.

a. Amiloride

b. Triamterene

c. Eplerenone

d. Bumetanide

c. Nitrates

53. A black-box warning is attached on the labels of PDE5 inhibitors stating that these agents are contraindicated patients taking:

a. Digoxin

b. Diuretics

c. Nitrates

d. β blockers

d. Digoxin increases contractility and decreases heart rate

54. Digoxin promotes a positive inotropic action and a negative chronotropic action. This means that:

a. Digoxin increases contractility and decreases ventricular relaxation and filling

b. Digoxin increases ventricular relaxation and filling and decreases heart rate

c. Digoxin increases heart rate and decreases ventricular relaxation and filling

d. Digoxin increases contractility and decreases heart rate

a. Verapamil

55. Which of the following calcium channel blockers is most useful in arrhythmia therapy?

a. Verapamil

b. Diltiazem

c. Nifedipine

d. Lidocaine

a. Clopidogrel

56. The following are anticoagulants, except:

a. Clopidogrel

b. Apixaban

c. Heparin

d. Warfarin

e. Hirudin

e. None

57. Orally administered, except:

a. Aspirin

b. Apixaban

c. Warfarin

d. Dabigatran

e. None

a. A has an immediate onset of action; B has delayed onset

58. What is the difference between Heparin (A) and Warfarin (B)?

a. A has an immediate onset of action; B has delayed onset

b. A is used for maintenance therapy; B is for emergency

c. A is contraindicated in pregnancy; B is not

d. A targets synthesis of clotting factors; B targets the action

e. More than one answer

c. Tirofiban

59. Which of the following agents is an antiplatelet?

a. Rivaroxaban

b. Hirudin

c. Tirofiban

d. Dabigatran

e. Enoxaparin

a. Ascorbic acid

📌Drugs indicated for Anemia:

• Folic acid

• Iron

• Cyanocobalamin

60. Which of the following is not indicated for anemia?

a. Ascorbic acid

b. Folic acid

c. Iron

d. Cyanocobalamin

e. All are indicated

b. Bile acid sequestrants

61. This/These lipid-lowering agent/s may be useful in digitalis toxicity:

a. HMG-CoA reductase inhibitors

b. Bile acid sequestrants

c. Niacin

d. Fibric acid derivatives

a. Blocking absorption of some vitamins

62. Cholestyramine resin has the prevalent side effect of:

a. Blocking absorption of some vitamins

b. Raising cholesterol levels

c. Causing intoxication

d. Increasing sensitivity to UV light

c. Niacin

63. The most effective agent/s for increasing HDL and the only agent that may reduce lipoprotein (a) is:

a. HMG-CoA reductase inhibitors

b. Bile acid sequestrants

c. Niacin

d. Fibric acid derivatives

d. Fibric acid derivatives

64. First line agent/s in the management of hypertriglyceridemia:

a. HMG-CoA reductase inhibitors

b. Bile acid sequestrants

c. Niacin

d. Fibric acid derivatives

b. Sterol absorption inhibitor

65. Ezetimibe:

a. CETP inhibitor

b. Sterol absorption inhibitor

c. Bile acid sequestrant

d. PPAR activator

b. Psychosis

66. Neuroleptics are used to treat which of the following conditions?

a. Neurosis

b. Psychosis

c. Narcolepsy

d. Parkinsonian disorders

a. GABA

67. The major inhibitory neurotransmitter in the brain:

a. GABA

b. Glycine

c. Glutamate

d. Monoamines

a. Alcapone

→NOTE: Alcapone is not a drug; Entacapone and Tolcapone are true COMT inhibitors.

68. Which is not a COMT inhibitor?

a. Alcapone

b. Entacapone

c. Tolcapone

d. None of the above

c. Phenobarbital

→Rationale: Phenobarbital = GABA-A agonist (increases DURATION of Cl- channel opening) — it is NOT a sodium channel blocker.

69. The following anticonvulsants is not a sodium channel blocker?

a. Valproic acid

b. Carbamazepine

c. Phenobarbital

d. Phenytoin

b. Sedative

70. False statement about Amobarbital:

a. Hypnotic

b. Sedative

c. Barbiturate

d. Intermediate-acting

c. Inhibits growth hormone receptor

71. Which mechanism of action is for pegvisomant?

a. Inhibits release of growth hormone, glucagon, insulin and gastrin

b. Inhibits growth hormone release by 45 times and insulin release by two times more compared to somatostatin

c. Inhibits growth hormone receptor

d. Any of the above

c. Octreotide

72. A somatostatin analog:

a. Pegvisomant

b. Mecasermin

c. Octreotide

d. Somatotropin

b. Anion inhibitors

73. Antithyroid agents such as perchlorate, pertechnetate and thiocyanate are:

a. Thioamides

b. Anion inhibitors

c. Iodides

d. Radioactive agents

a. Betamethasone

📌Rationale:

• Betamethasone is a long acting glucocorticoid

74. Which of the following is not an intermediate-acting glucocorticoid?

a. Betamethasone

b. Triamcinolone

c. Paramethasone

d. Fluprednisolone

c. Insulin glulisine

📌Rationale:
Rapid Acting Insulin include:

“LAG”

• Insulin Lispro

• Insulin Aspart

• Insulin Glulisine

75. Rapid acting insulin preparation:

a. Regular insulin

b. NPH insulin

c. Insulin glulisine

d. Insulin glargine

d. GH (Growth Hormone)

76. Which of the following is not a hypothalamic hormone?

a. TRH

b. CRH

c. GnRH

d. GH

a. Conivaptan

77. This agent is a non-selective vasopressin antagonist for SIADH:

a. Conivaptan

b. Tolvaptan

c. Vasopressin

d. Desmopressin

c. Atosiban

📌Rationale: Atosiban is a oxytocin receptor antagonist used as a tocolytic agent (prevents premature labor)

78. This is not a drug used for diabetes mellitus:

a. Empagliflozin

b. Pioglitazone

c. Atosiban

d. Pramlintide

a. Liothyronine

📌Rationale: Liothyronine is a thyroid hormone SUPPLEMENT,

79. The following are antithyroid agents, except:

a. Liothyronine

b. PTU

c. Methimazole

d. Propranolol

b. Pramlintide

80. Which of the following is parenterally given?

a. Metformin

b. Pramlintide

c. Sitagliptin

d. Dapagliflozin

a. N-acetylcysteine

→NOTE: N‑acetylcysteine is a mucolytic, not mucoregulatory; others regulate mucus secretion properties.

81. Mucoregulatory agents, except:

a. N-acetylcysteine

b. Ambroxol

c. Bromhexine

d. Carbocisteine

d. Codeine

82. Which of the following is considered as the standard of comparison for antitussives?

a. Ambroxol

b. Bromhexine

c. Dextromethorphan

d. Codeine

a. Improve sputum clearance and disrupt mucus plugs

83. Which of the following is the mechanism of action of mucolytics?

a. Improve sputum clearance and disrupt mucus plugs

b. Facilitate removal of mucus and other irritants from the respiratory tract

c. Soothe an irritated throat and bronchial passageway by promoting salivary flow and may produce an antitussive action

d. Inhibit or suppress dry, non-productive cough

c. Montelukast

→NOTE: Montelukast is a leukotriene receptor antagonist, anti‑inflammatory, not a bronchodilator.

84. The following are bronchodilators, except:

a. Theophylline

b. Salbutamol

c. Montelukast

d. Ipratropium

a. Fluticasone MDI

85. Which of the following steroids may cause oral ulcers?

a. Fluticasone MDI

b. Solu-Medrol IV

c. Solu-cortef IV

d. Prednisone PO

a. Aluminum hydroxide

86. Which of the following is an antacid?

a. Aluminum hydroxide

b. Omeprazole

c. Cimetidine

d. Sucralfate

a. Loperamide (antidiarrheal drug)

📌Rationale:

Drugs for constipation include:

• Psyllium

• Bisacodyl

• Senna

• Lactulose

87. Drugs for constipation, except:

a. Loperamide

b. Psyllium

c. Bisacodyl

d. Senna

e. Lactulose

a. Domperidone

88. Prokinetic:

a. Domperidone

b. Loperamide

c. Bisacodyl

d. Lactulose

a. ASA

89. This agent causes ulcer:

a. ASA

b. Sucralfate

c. Omeprazole

d. Cimetidine

d. Aripiprazole

📌Rationale: Aripiprazole is an ANTIPSYCHOTIC DRUG

90. The following are PPIs, except:

a. Omeprazole

b. Esomeprazole

c. Rabeprazole

d. Aripiprazole

d. Eicosanoids, histamine, bradykinin, serotonin

📌Mnemonic: “BESH”

91. Which of the following are autacoid group of drugs?

a. Histamine, serotonin, norepinephrine, acetylcholine

b. Bradykinin, eicosanoids, dopamine, serotonin

c. Serotonin, bradykinin, histamine, dopamine

d. Eicosanoids, histamine, bradykinin, serotonin

c. Both statements are TRUE

92. Ethanolamines are the most sedating antihistamines. Doxylamine is an ethanolamine.

a. First statement is TRUE; the second is FALSE

b. First statement is FALSE; the second is TRUE

c. Both statements are TRUE

d. Both statements are FALSE

a. Semen

93. Prostaglandin was first observed from which specimen?

a. Semen

b. Saliva

c. Sweat

d. Lacrimal fluid

c. Miosis

📌Rationale:

Withdrawal symptoms for NARCOTICS use include:

• Frequent yawning

• Rinorrhea

• Mydriasis

• Hyperventilation

94. Withdrawal symptoms associated with the use of narcotics, except:

a. Frequent yawning

b. Rhinorrhea

c. Miosis

d. Hyperventilation

a. Reduction of analgesia

95. Care should be taken not to administer any partial opioid agonists to patients receiving pure opioid agonist drugs because this may result to:

a. Reduction of analgesia

b. Stimulation of the chemoreceptor trigger zone

c. Cough suppression

d. Anaphylactic reaction

c. Codeine

96. What is the agent of choice in the management of moderate pain?

a. Morphine

b. Tramadol

c. Codeine

d. Naloxone

d. Naproxen

97. Which of the following NSAIDs is used in fever of malignancy?

a. Paracetamol

b. Ibuprofen

c. ASA

d. Naproxen

a. Indomethacin

📌NOTE:

Indomethacin is the NSAID of choice for acute gout attacks, reduces inflammation and pain.

💊Drugs Contraindicated for Gout include:

• Aspirin

• Salicylated

• Tolmetin

98. C/I NSAIDs for gout, except:

a. Indomethacin

b. ASA

c. Tolmetin

d. Salicylates

d. Constipation

📌Rationale:

Triad effects of opoids:

• Respiratory depression

• Pinpoint pupil

• Coma

99. The triad effects of opioids are the following, except:

a. Pinpoint pupils

c. Coma

b. Respiratory depression

d. Constipation

d. Management of inflammation

100. Which of the following is not a use of narcotics?

a. Management of pain

b. Management of acute pulmonary edema

c. Pre-anesthetic agents

d. Management of inflammation