MODULE 4, PHARMACOLOGY & TOXICOLOGY (BLUE PACOP), PHARMACOLOGY (GREEN PACOP), TOXICOLOGY (GREEN PACOP), BIOPHARMACEUTICS (GREEN PACOP)

An administration of one drug leads to a shift in the log dose-response curve of another drug to the left a range in the maximal efficacy, this is called:

a. Agonism

b. Partial agonism

c. Non-competitive antagonism

d. Competitive antagonism

e. Potentiation

e. Potentiation

Voltage-gated ion channels serve as site of actions for drugs such as I. Diltiazem and Nifedipine

II. Lidocaine and Procaine

III. Captopril and Losartan

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

b. I and II

Whiich of the following drug groups have mechanisms of aaction that involve binding to enzymes as target protiens

a. Benzodiazepines

b. Barbiturates

c. Calcium channel blockers

d. Non-steroidal anti-inflammatory agents

e. Phenothiazine antipsychotics

d. Non-steroidal anti-inflammatory agents

The action of this drug is dependent on a colligative property

a. Mannitol

b. Cocaine

c. Reserpine

d. Furosemide

e. Losartan

a. Mannitol

Drugs with mechanism of action that involves Tubulin-binding leading to loss of function of the structural protien include

a. Cyclosporine

b. Neostigmine

c. Colchicine

d. Glibenclamide

e. Metformin

c. Colchicine

What type of protien is primarily targeted by Digitalis glycosides when they exert their effect on the heart?

a. Receptors

b. Ion channels

c. Enzymes

d. Transporters

e. Structural protiens

d. Transporters

Which of the following features cahracterize nicotinic, GABA-A, and Glutamate receptors?

a. Thay control the movements of ions and out of the cell

b. Their action is mediated bysecondary messengers

c. They all have excitatory effect on the cell membrane

d. They are located on the cytoplasm

a. Thay control the movements of ions and out of the cell

Which of the following drugs bind to receptors located at the cell membrane?

a. Thyroid hormone

b. Prednisone

c. Estrogen

d. Insulin

e. Vitamin D

d. Insulin

Cyclic Adenosine Monophophate (cAMP) is generated as a secondary messenger by the action of the enzyme Adenylyl Cyclase. The substrate for the synthesis of cAMP is

a. AMD

b. ADP

c. ATP

d. GTP

e. Adenosine

c. ATP

Stimulation of Beta-adrenoceptor, a G-protien-linked receptor involves a generation of a secondary messenger known as

a. IP3

b. cGTP

c. DAG

d. cAMP

e. Calcium ions

d. cAMP

What is the mechanism of action of Sildenafil, a drug popularly known as viagra?

a. Inhibits phosphodiesterase (PDE) leading to increase cAMP

b. Inhibits PDE leading to increase cGMP

c. Stimulates adenylyl cyclase leading to increase cAMP

d. Stimulates guanylyl cyclase leading to increase cGMP

e. Inhibits phosphodiesterase leading to increase cGMP

b. Inhibits PDE leading to increase cGMP

Drugs that activate the phospholipase C-inositol phosphate system such as alpha-adrenergic agonists like phenylephrine primarily cause an increase in the intracellular levels of which ion?

a. Calcium

b. Magnesium

c. Sodium

d. Potassium

e. Chloride

a. Calcium

Which of the following stetements characterizes competitive antagonism?

a. There is a shift of the agonist log concentration-effect curve to the right and downwards

b. There is a shift of the agonist log concentration-effect curve to the right without a change on the slope or amplitude

c. There is an exponential relationship between dose ratio and antagonist concentration

d. There is no competition for the binding sites

e. There is a shift of the agonist log-concentration effect curve to the left without a change in slope and amplitude

b. There is a shift of the agonist log concentration-effect curve to the right without a change on the slope or amplitude

The minimum dose that produces the maximum achievable response is known as

a. Potency

b. ED50

c. LD50

d. Ceiling dose

e. Minimum effective dose

d. Ceiling dose

The medium dose, or the dose of the drug that produces half of the maximum achievable response is called

a. Potency

b. LD50

c. Therapeutic index

d. Ceiling dose

e. Binding constant

a. Potency

What is described by the equation given as follows: Response=f (EN total . Xa / (Xa + Ka)

a. Relationship between occupancy of receptor and the dose of the drug

b. Relationship between occupancy of receptor and response to the drug

c. Relationship between the dose of the drug and the response to the drug

d. Relationship between the number of receptors and the dose of the drug

e. Relationship between the response to the drug and the transducer function of the tissues

b. Relationship between occupancy of receptor and response to the drug

Competitive antagonist of the receptors of Dopamine and Benzodiazepine are expected to produced which effect?

a. Reversal of the intrinsic activity of the receptors

b. Maintain the consitutive activity of the receptors

c. Stimulate the constitutive activity of the receptors

d. Stimulate the constitutive activity of the recptorsin the absence of any ligand

e. Produce a negative efficacy

b. Maintain the consitutive activity of the receptors

The PT-INR of a patient with Warfarin has been maintained at 2.5 for the last 3 months. 1 week earlier, the patient was given Phenobarbital. What can be expected with the PT-INR of the patient?

a. Increased PT-INR

b. Decreased PT-INR

c. Maintained PT-INR

b. Decreased PT-INR

Phenobarbital when given to a patient on chronic warfarin is classified as

a. Pharmacodynamic antagonist

b. Pharmacokinetic antagonist

c. Physiologic antagonist

d. Synergistic agonist

e. Additive agonist

b. Pharmacokinetic antagonist

Digibind which effetively terminates the action of Digitalis glycosides is classified as what type of antagonist?

a. Pharmacodynamic antagonist

b. Pharmacokinetic antagonist

c. Physiologic antagonist

d. Chemical antagonist

e. Non-competitive antagonist

d. Chemical antagonist

Omeprazole can inhibiy gastric acid secretion induced by Histamine and Acetylcholine. It is thus classified as what type of antagonist?

a. Pharmacodynamic antagonist

b. Pharmacokinetic antagonist

c. Physiologic antagonist

d. Chemivall antagonist

e. Non-competitive antagonist

c. Physiologic antagonist

Which of the following mechanism may explain the development of tolerance to drugs?

a. Increase in the quantity of mediators

b. Decreased metabolic degradation of the active drug

c. Decreased excretion or extrusion of drugs from cells

d. Downregulation of receptors

e. Inactivation of counterregulatory physiologic response

b. Decreased metabolic degradation of the active drug

The prerequisite that drugs must be present in aqueous solution for them to be absorbed is true if the drugs are absorbed by which mechanism?

I. Passive transport

II. Carrier-mediated transport

III. Pinocytosis

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

b. I and II

According to the Fick's Diffusion Equation, the rate of transport of a drug by passive diffusion is

a. Independent of the concentration gradient

b. Inversely proportional to the membrane surface area

c. Inversele proportional to the membrane thickness

d. Inversely proportional to the partition coefficient

e. Independent of the diffusion constant of drug

c. Inversele proportional to the membrane thickness

Which of the following feature common to all carrier-mediated transport processes?

a. Movement is along a concentration gradient

b. Involves non-specific binding to carriers

c. Can be characterized by allosteric inhibition

d. Displays a Michaelis-Menten Kinetics

e. Non-energy requiring

d. Displays a Michaelis-Menten Kinetics

Which of the following substances may be absorbed significantly by pinocytosis

a. Vitamin K

b. Cyanocobalamin

c. Cardiac glycosides

d. Quarternary ammonium compounds

e. Inorganic and organic electrolytes

a. Vitamin K

100ml of aqueous solutionof a given drug has a concentration of 25%.50ml of Octanol was added and after equlibration, the concentration of the drug in the aqueous layer was 5%. What is the apparent lipid-water partition coefficient of the drug?>

a. 0.2

b. 2

c. 4

d. 6

e. 8

e. 8

For drugs that are given constant rate, the time to reach steady rate state concentration dependent on

a. Rate of administration

b. Biologic half-life

c. Volume distribution

d. Peak plasma concentration achieved

e. Amount of the drug in the body

b. Biologic half-life

A given drug has a biologic half life of 4 hours. How much of the drug will remain in the body 12 hours after a single dose?

a. 75%

b. 50%

c. 25%

d. 12.5%

e. 6.25%

d. 12.5%

In compartmental analysis of serum drug concentration versus time plots, which of the following findings confirm a one compartment model of drug behavior?

a. An AUC above the explorated line that is less than 10% of the total AUC

b. An AUC above the explorated line that is less than 5% of the total AUC

c. Slope of the last 3 terminal points differing by more than 10% for the slope of the first 3 terminal points

d. Slope of the 3 terminal points differing by less than 20% from the slope of the 3 terminal points

e. Cmax that is above the line explorated from the terminal points

b. An AUC above the explorated line that is less than 5% of the total AUC

What should be the rate of infusion of Theophylline if the desired plasma concentration is 10ug/mL in a 70 kg patient?Theophylline has a clearance of 0.6mL/minute per kg body weight.

a. 6ug/min

b. 4.2ug/min

c. 17ug/min

d. 420ug/min

e. 1167ug/min

d. 420ug/min

A given drug with a half life of 8 hours is being administered at 100mg every 8 hours. What is the amount remaining in the body after 32nd hour, just before administering the next dose?

a. 50mg

b. 75mg

c. 87.5mg

d. 93.75mg

e. 100mg

d. 93.75mg

What is the con centration at steady state of Phenobarbital if the drug is given to a 60kg patient as a 65mg tablet once daily with a bioavailability of 90%? The drug has volume distribution of 0.5liters/KBW and t1/2 of 100hrs

a. 0.10mg/L

b. 1.50mg/L

c. 11.70mg/L

d. 22.20mg/L

e. 48.20mg/L

c. 11.70mg/L

A 47 year old female diabetic is maintained on Tolbutamide for control of her hyperglycemia. Her fasting blood sugar is maintained at 102mg%. Three days prior to admission, she self-medicated with Indomethacin due to a joint pain. She was admitted at the emergency room unconscious and difficult to arouse. What laboratory finding may be consistent with the history of the patient?

a. Capillary blood glucose of 20mg/dL

b. Capillary blood glucose of 400mg/dL

c. ALT level that is 3x elevated

d. ALT level that is 6x elevated

e. Platelet level of 100,000/ul

a. Capillary blood glucose of 20mg/dL

A drug molecule does not possess biologic activity by itself but it converted in the body to an active metabolite is called a/an

a. Orphan drug

b. Prodrug

c. Prototype drug

d. Parent drug

e. Metabolic drug

b. Prodrug

Astemizole and Terfenadine have been withdrawn from the market because of their intrinsic cardiotoxicity. Tha risk of cardiotoxicity is increased with concominant intake of Grapefruit juiceor Erythromycin. The explanation for this interaction is

a. Displacemnet from the protien binding of Astemizole or Terfenadine by Grapefruit juice of Erythromycin

b. Decreased urinary excretion of Astemizole and Terfenadine

c. Inhibtion of the CYP3A4 enzyme by Grapejuice or Erythromycin

d. Increased absorption of Astemizole or Terfenadine

e. Induction of metabolism of Astemizole and terfenadineby Grapefruit juice or Erythromycin

c. Inhibtion of the CYP3A4 enzyme by Grapejuice or Erythromycin

Paients who are poor Debrisoquin metabolizers have decreased activity of which enzyme system

a. CYP 1A2

b. CYP 2C9

c. CYP 2D6

d. CYP 2C19

e. CYP 3A4

c. CYP 2D6

A patient has been assessed to have poor Debrisoquin metabolizing capability. Which of the following drugs will have an increased likelihood of causing toxicity in this patient?

a. Thioridazine

b. Amiodarone

c. Acetaminophen

d. Warfarin

e. Theophylline

a. Thioridazine

What is considered as dominant phase I metaabolic reaction?

a. Oxidation

b. Reduction

c. Hydrolysis

d. Glucuronidation

e. Acetylation

a. Oxidation

Chloramphenicol when given to a nenonate or premature baby causes cardiovascular collapse manifestin as the so-called "Gray Baby Syndrome" This toxicity in such subsets of the patients is due to what age-related biologic feature?

a. Decreased protien binding

b. Decreased urinary excretion of the metabolite

c. Deficiency of Glucuronosyl acyl transferase

d. Increased metabolism by nitro-reduction

e. Increased volume of distribution

c. Deficiency of Glucuronosyl acyl transferase

Cimetidine, Ketoconazole, and Allopurinol share a common pharmacokinetic property that predisposes patients taking other drugs concominantly with any of these agents to toxicity. What is this property?

a. Inhibition of tubular secretion

b. Increased systemic absorption

c. Protien binding dsiplacement

d. Enzyme induction

e. Enzyme inhibition

e. Enzyme inhibition

Biotransformation of orally administerd drugs occuring primarily in the liver that reduces the amount of drug finally entering the systemic circulation is often referred to as __________.

a. Enterohepatic recirculation

b. Gastric emptying

c. Elimination

d. First-pass effect

e. Enzyme induction

d. First-pass effect

Charcoal-broiled foods, cruciferous vegetables and omeprazole induce the metabolism of drugs like tomoxifen, acetaminophen, theophylline and warfarin. This effect is due to induction of which CYP isoform?

a. CYP1A2

b. CYP2A6

c. CYP2C9

d. CYP2D6

e. CYP4A4

a. CYP1A2

In a patient with hepatic encelopathy, which of the following agents may lead tosevere drug toxicity even when given at usual doses?

a. Diazepam

b. Oral Neomycin

c. Lactulose

d. Propanolol

e. IV Gentamicin

a. Diazepam

Which of the following features charcterizes the autonomic nervous system

a. Single neuron transmission

b. 0

c. Effects are under volitional control

d. Conveys outpus from the CNS to the skeletal muscles

e. Terminal neurotransmitter is mainly Serotonin

b. 0

The preganglionic fibers of the sympathetic nervous system originate from which roots?

a. Cranial nerves III, VII, IX, X

b. Sacral roots S1- S4

c. Cervical roots C1-C7

d. Thoracolumbar roots

d. Thoracolumbar roots

What neurotransmitter is released by preganglionic fibers as a response to sympathetic stimulation?

a. Acetylcholine

b. Norepinephrine

c. Epinephrine

d. Serotonin

e. Dopamine

a. Acetylcholine

What is the dominant ganglionic receptor found in most sympathetic fibers?

a. Alpha-1

b. Alpha-1

c. Beta-1

d. Nicotinic

e. Muscarinic

d. Nicotinic

What is the neurotransmitter mainly released by postganglionic parasympathetic fibers?

a. Acetylcholine

b. Norepinephrine

c. Epinephrine

d. 5-Hydroxyryptamine

e. Dopamine

a. Acetylcholine

Which of the following non-adrenergic, non-cholinergic neurotransmitters is involved in the action of the enteric nervous system?

a. ATP

b. Dopamine

c. GABA

d. Glutamate

e. Glycine

a. ATP

In synaptic neurotransmission, which of the following ions plays a significant role in neurotransmitter release

a. Sodium

b. Potassium

c. Magnesium

d. Calcium

e. Chloride

d. Calcium

The primary mechanism of neuro transmitter release is accomplished by what process?

a. Diffusion

b. Carrier-mediated

c. Active transport

d. Facilitated transport

e. Exocytosis

e. Exocytosis

What is the amino acid precursor in the synthesis of catecholamines?

a. Phenylalanine

b. Glycine

c. Tyrosine

d. Tryptamine

e. Glutamic acid

c. Tyrosine

In the biosynthesis of Norepinephrine, what step is considered rate-limiting?

a. Active uptake of Tyrosine

b. Conversion of tyrosine to dihydroxyphenylalanine

c. Conversion of DOPA to dopamine

d. Uptake of Dopamine in presynaptic storage vesicles

e. Conversion of Norepinephrine to Epinephrine

b. Conversion of tyrosine to dihydroxyphenylalanine

Which of the following substances exert a negative feedback control on Tyrosine Hydroxylase which serves as the mechanis for moment-to-moment regulation of the rate catecholamine synthesis?

a. Dopamine

b. Acetylcholine

c. DOPA

d. Epinephrine

e. Norepinephrine

e. Norepinephrine

Reserpine, an alkaloid from Rauwolfia, can lower the blood pressure and depress the CNS. What enzyme or part of the biosynthetic pathway is inhibited by Reserpine to bring about these effects?

a. DOPA decarboxylase

b. Storage of catecholamines in the presynaptic vesicles

c. Release of Norepinephrine from presynaptic terminals

d. MAO enzymes

e. Uptake-1 mechanism

b. Storage of catecholamines in the presynaptic vesicles

What is the most important mechansim of termination of effects of released Norepinephrine which is the target of action of tricyclic antidepressants and Cocaine

a. Degradation of COMT

b. Degradation of MAO

c. Sequestration into cells

d. Reuptake into the presynaptic terminal

e. Binding to presynaptic alpha-2 receptors

d. Reuptake into the presynaptic terminal

What is the main final metabolite of Norepinephrine and Epinephrine which when abnormally elevated is often used as a marker for the disease Pheochromocytoma?

a. Dihydroxymandelic acid

b. 3-Methoxy-4 hydromandelic acid

c. 3-Methoxy-4 hydroxyphenylglycol

d. 3,4-Dihydroxyphenylglycol

e. Normetanephrine

b. 3-Methoxy-4 hydromandelic acid

Which of the following is an expected respose to alpha-1 adrenoceptor stimulation?

a. Uterine smooth muscle relaxation

b. Gastrointestinal sphincter constriction

c. Ciliary muscle relaxation

d. Gastrointestinal wall smoothe muscle contraction

e. Platelet aggregation

b. Gastrointestinal sphincter constriction

A male patient wishes to purchase an over-the-counter tablet for colds. Which of the following data you gathered during an initial interview of the patient should prevent you from dispensing the medication?

I. The patient is currently taking Nifedipine GITTS

II. The patient is currently on Tranylcypromine

III. The patient is an elderly with history of urinary hesitancy, intermittency, and frequency

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

d. I and III

Stimulation of Alpha-1 receptors leads to the formation of important secondary messengers that promote calcium release and activation of protien kinase C. These secondary messengers responsible for the effects of alpha-1 stimulation include which of the following?

a. Inositol triphosphate

b. Cyclic adenosine monophophate

c. Adenosine triphosphate

d. Cyclic guanosine monophosphate

e. Adenosine diphosphate

a. Inositol triphosphate

In which of the following clincal conditions are the agonists of the alpha-1 adrenoceptors found to be useful?

I. Nasal congestion

II. Hypotension

III. Sympomatic bradycardia

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

b. I and II

Which of the following effects can be attributed to alpha-2 receptor stimulation?

I. Vasodilation

II. Inhibition of catecholamine release

III. Vasoconstriction

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

e. I, II, and III

A given adrenergic agent induces uterine relaxation and bronchial smooth muscle relaxation. These effects can be attributed to:

a. Alpha-1 stimulation

b. Alpha-2 stimulation

c. Beta-1 inhibition

d. Beta-1 stimulation

e. Beta-2 stimulation

e. Beta-2 stimulation

What is the dominant adrenergic receptor in the heart?

a. Dopamine-1

b. Alpha-1

c. Alpha-2

d. Beta-1

e. Beta-2

d. Beta-1

Which of the following effects is/are consistent with the systemic use of the drug Clonidine?

I. Initial transient increase in blood pressure

II. "First-dose" phenomenon

III. Lowering of the blood pressure

a. I only

b. I and II

c. III only

d. I and III

e. I. II, and III

d. I and III

In terms of mechanism of action, which of the following drugs most closely resembles that of Clonidine?

a. Phenylphrine

b. Reserpine

c. Guanethidine

d. Methyldopa

e. Amlodipine

d. Methyldopa

Epinephrine is considered as the first line for the management of anaphylaxis and anaphylactic shock. Which of the following explain/s the mechanism of action of Epinephrine in anaphylaxis and anaphylactic shock?

I. Inhibition of Histamine release by beta-2 receptor activation

II. Alpha-1 activation leading to vasoconstriction

III. Beta-2 activation leading to bronchodilation

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

e. I, II, and III

The activity of this drug is attributed to its metabolite which is a false neurotransmitter at the central nervous system

a. Guanethidine

b. Methyldopa

c. Propanolol

d. Labetalol

e. Phenylpropanolamine

b. Methyldopa

Which of the following inotropic agents is most useful for paatient with acute heart failure complicated by acute reduction in creatinine clearance?

a. Epinephrine

b. Norepinephrine

c. Dopamine

d. Dobutamine

e. Digitalis

c. Dopamine

In the adrenal medulla, norepinephrine is converted to epinephrine by the action of which enzyme?

a. DOPA decarboxylase

b. Tyrosine hydroxylase

c. Cathecol-0- nethyl transferase

d. Monoamine oxidase

e. Phenylethylamine N-methyl transferase

e. Phenylethylamine N-methyl transferase

As an inotropic agent, Norepinephrine (Levophed) has been shown in some small clinical trials to be most useful in which of the following conditions?

a. Cardiogenic shock

b. Septic shock

c. Acute renal failure

d. Acute myocarditis

e. Dilated cardiomyopathy

b. Septic shock

Which of the following statements is/are true regarding the drug methyldopa

I. Is current clinical use is in the management of hypertension in pregnancy

II. It is associated with warm antibody type of immunohemolytic anemia

III. Toxic doses are associated with hepatotoxicity

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

e. I, II, and III

What are known clinical uses beta-2 agonists?

I. In the management of premature labor

II. As part of the interventions employed for hyperkalemia

III. Management of bronchial asthma

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

e. I, II, and III

Which of the following agents is classified as a selective direct-acting beta-2 agonist?

a. Propanolol

b. Mathoxamine

c. Isoxsuphrine

d. Prazosin

e. Ephedrine

c. Isoxsuphrine

During the conduct of ACLS, what is the recommended dosing ofor Epinephrine in adults?

a. 1mg every 3-5 minutes

b. 3mg every 3-5 minutes

c. Escalating dose, staring at 1mg then increasing by 1mg every 3-5 minutes

d. 10ml of a 1:1000 solution every 3-5 minutes

a. 1mg every 3-5 minutes

Which of the following is an accepted indication for Epinephrine?

a. Bronchodilator for intermittent bronchial asthma

b. Local vasoconstrictor

c. Anti-arrythmic for supraventricular tachycardia

d. Tocolytic agent for premature labor

e. Inotropic for cardiogenic shock

b. Local vasoconstrictor

A dominant alpha-1 agonist effect is expected when Epinephrine is given as an IV infusion at what doses?

a. <10ng/kg/min

b. 10-50ng/kg/min

c. 10-80ng/kg/min

d. At least 120ng/kg/min

d. At least 120ng/kg/min

What is the clinical use of the Dopamine-1 agonist Fenoldopan?

a. Chronic treatment of Congestive Heart Failure

b. Acute treatment of Pheochromocytoma

c. Acute treatment of Hypertension

d. Chronis treatment of Supraventricular Tachycardia

e. Acute treatment of Congestive Heart failure

c. Acute treatment of Hypertension

Which of the following adrenergic agents is/are most useful for hypodynamic septic shock with hypotension

I. Dopamine

II. Dobutamine

III. Norepinephrine

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

d. I and III

At what dose should Dopamine be given as IV infusion to produce a predominantly dopaminergic effect?

a. 0.5 ug/kg/min

b. 5-10ug/kg/min

c. 10-20ug/kg/min

d. 20-50ug/kg/min

e. >50ug/kg/min

a. 0.5 ug/kg/min

Guanfacine and Guanabenz are primarily agonists at what receeptors?

a. Muscarinic-1

b. Nicotinic-N

c. Presynaptic alpha-2

d. Postsynaptic alpha-2

e. Alpha-1

c. Presynaptic alpha-2

Which of the following is/are correct clinical indication for the drug Terbutaline

I. Subcutaneously given as management of recalcitrant acute exacerbations of bronchial asthma

II. To increase heart rate in symptomatic bradycardia

III. Adjunct treatment of malignant hypertension

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

b. I andII

Which of the following drugs primarily stimulates beta-1 receptors?

a. Dobutammine

b. Ritodrine

c. Yohimbine

d. Phenoxybenzamine

e. Oxymetazoline

a. Dobutammine

A new drug is currently being developed whose mechanism of action is stimulation of the beta-3 receptors. In which condition will this drug have most likely usefulness?

a. Obesity

b. Bronchial asthma

c. Hypertension

d. Shock

e. Acute renal failure

a. Obesity

A patient complains of muscle weakness after several doses of Salbutamol nebulization. This condition can be attributed to _______________?

a. Hypokalemia induced by Salbutamol therapy

b. Hypocalcemia induced by Salbutamol therapy

c. Metabolic alkalosis due to bronchial asthma

d. Decreased firing of neuromuscular junction fibers as a direct effect of Salbutamol

e. Respiratory alkalosis due to bronchial asthma

a. Hypokalemia induced by Salbutamol therapy

Which of the following beta-blockers also has peripheral vasodilating effect similar to Prasozin?

a. Propanolol

b. Betaxolol

c. Nadolol

d. Bisoprolol

e. labetalol

e. labetalol

Which of the following beta-blockers is considered cardio selective? a. Labetalol

b. propanolol

c. pindolol

d. Esmolol

e. Timolol

d. Esmolol

Rebound tachycardia and hypertension are expected complications of abrupt withdrawal of beta-blocker therapy. Which of the followingagents has the least likelihood of causing rebound effects when withdrawn?

a. Labetalol

b. Propanolol

c. Pindolol

d. Metropolol

e. Timolol

a. Labetalol

Which of the following beta-blockers has the shortest duration of action (half-life = 10 minutes) making is useful for administration as continuous IV infusion with rapid achievemnet of a steady state concentration

a. Metoprolol

b. Esmolol

c. Atenolol

d. Propanolol

e. Pindolol

b. Esmolol

Which of the following beta-blockers has/have been proven in clinical trials to be useful in the management os stable congestive heart failure

I. Carvedilol

II. Bisoprolol

III. Metoprolol

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

e. I, II, and III

In which of the following conditions are beta-blockers found to be useful? I. Hypothyroidism II. Raynaud's Phenomenon III. Initial therapy in Pheochromocytoma

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

a. I only

Among diabetic patients using insulin or oral hypoglycemic agents (OHAs) why are beta-blockers are used with special caution if not totally avoided?

a. Beta-blockers can induce hyperglycemia

b. Beta-blockers can mask hypoglemic symptoms

c. Beta-blockers can attenuate effect of insulin and OHAs

d. Beta-blockers can induce insulin or OHA failure

e. Beta-blockers can increase the risk of renal failure

b. Beta-blockers can mask hypoglemic symptoms

In which subset/s of patients are beta-blockers used with caution if not avoided?

I. Patients with bronchospastic disease like COPD and bronchial asthma

II. Patients with peripheral vascular disease especially vasospastic type

III. Patients with recent myocardial infarction

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

b. I and II

A 44-year old patient is started a week ago on the following medications: Metoprolol 100mg BIB, Diltiazem 30mb tablet BID and Indapamide 1.5 mg OD for poorly controlled hypertension and chronic stable angina pectoris. She is now admitted at the ICU for dizziness and two episodes of syncope. Her heart rate was 45 beats/min. What course of action would you suggest?

a. Continue her medication and suggest for a 12-lead ECG

b. Stop Metoprolol and request for a 12-lead ECG

c. Stop Diltiazem and request for a 12-lead ECG

d. Stop indapamide and Diltiazem and request for a 12-lead ECG as well as serum potassium measurement

e. Stop Metoprolol and Diltiazem and request for a 12-lead ECG

e. Stop Metoprolol and Diltiazem and request for a 12-lead ECG

Methylphenidate and Dextroamphetamine are centrally acting sympathomimetics which have found use in which of the following conditions?

a. Manic-depression

b. Alcohol withdrawal

c. Attention deficit hyperactivity disorder

d. Generalized anxiety disorder

e. Hypotensive epidoses

c. Attention deficit hyperactivity disorder

Which of the following effects is are consistent with direct stimulationof the muscarinic receptors?

I. Peripheral vasodilation

II. Relaxation of the ciliary muscles

III. Negative dromotropic effect

a. I only

b. I and II

c. III only

d. I and III

e. I, II, and III

d. I and III

The effect of muscarinic receptor activation in tissues like the exocrine glands and the extravascular smooth muscles have been linked with the generation of which second messenger molecule?

a. IP3

b. cAMP

c. cGMP

d. ATP

e. Adenosine

a. IP3

What is thw physiologic event that follows stimulation of the NM type cholinergic receptors?

a. Opening of inward chloride channels

b. Opening of outward potassium channels

c. Opening of inward sodium channels

d. Opening of the outward calcium channels

e. Opening of the outward sodium channels

c. Opening of inward sodium channels

Bethanecol is clinically used for which of the following conditions?

a. Urinary retention in neurogenic bladder

b. Intestinal obstruction

c. Chronic glaucoma

d. Supraventicular tachycardia

e. Congestive heart failure

a. Urinary retention in neurogenic bladder