M4 - Pharmacology

C) Decreased renal blood flow

Full activation of the sympathetic nervous system, as in the fight-or-flight reaction, may occur during maximal exercise. Which of the following effects is likely to occur?
A. Bronchoconstriction
B. Increased intestinal motility
C. Decreased renal blood flow
D. Miosis

D) Varenicline

Which of the following is a direct-acting cholinomimetic that is lipid-soluble and is used to facilitate smoking cessation?
A. Bethanechol
B. Neostigmine
C. Physostigmine
D. Varenicline

D) Respiratory failure

A crop duster pilot has been accidentally exposed to a high concentration of a highly toxic agricultural organophosphate insecticide. If untreated, the cause of death from such expo- sure would probably be
A. Cardiac arrhythmia
B. Gastrointestinal bleeding
C. Heart failure
D. Respiratory failure

C) Epinephrine

A 7-year-old boy with a previous history of bee sting allergy is brought to the emergency department after being stung by 3 bees. If this child has signs of anaphylaxis, what is the treatment of choice?
A. Diphenhydramine
B. Ephedrine
C. Epinephrine
D. Methylprednisolone

D) Prazosin

A 60-year-old man has hypertension and an enlarged prostate, which biopsy shows to be benign prostatic hyperplasia. He complains of urinary retention. Which of the following drugs would be the most appropriate initial therapy?
A. Albuterol
B. Atenolol
C. Metoprolol
D. Prazosin

B) Captopril

A 32-year-old woman with hypertension wishes to become pregnant. Her physician informs her that she will have to switch to another antihypertensive drug. Which of the following drugs is absolutely contraindicated in pregnancy?
A. Atenolol
B. Captopril
C. Methyldopa
D. Prazosin

C) Incessant cough

A significant number of patients started on ACE inhibitor therapy for hypertension are intolerant and must be switched to a different class of drug. What is the most common manifestation of this intolerance?
A. Diarrhea
B. Glaucoma
C. Incessant cough
D. Lupus-like syndrome

C) Bradycardia

A patient with hypertension is to receive a calcium channel blocker. Verapamil is associated with which one of the following?
A. Diarrhea
B. Hypoglycemia
C. Bradycardia
D. Tachycardia

C) Metoprolol

A 45-year-old woman with hyperlipidemia and frequent migraine headaches develops angina of effort. Which of the following is relatively contraindicated because of her migraines?
A. Amlodipine
B. Diltiazem
C. Metoprolol
D. Nitroglycerin

A) Digoxin antibodies

A 5-year-old child is brought to the emergency department with sinus arrest and a ventricular rate of 35 bpm. An empty bottle of his uncle's digoxin was found where he was playing. Which of the following is the drug of choice in treating a severe overdose of digoxin?
A. Digoxin antibodies
B. Lidocaine infusion
C. Magnesium infusion
D. Phenytoin by mouth

A) Adenosine

A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations and shortness of breath. These episodes occasionally terminate spontaneously but often require a visit to the emergency department of the local hospital. Her ECG during these episodes reveals an AV nodal tachycardia. The antiarrhythmic of choice in most cases of acute AV nodal tachycardia is
A. Adenosine
B. Amiodarone
C. Flecainide
D. Propranolol

B) Furosemide plus saline infusion

A 62-year-old man with advanced prostate cancer is admit- ted to the emergency department with mental obtundation. An electrolyte panel shows a serum calcium of 16.5 (normal ∼8.5–10.5 mg/dL). Which of the following therapies would be most useful in the management of severe hypercalcemia?
A. Acetazolamide plus saline infusion
B. Furosemide plus saline infusion
C. Hydrochlorothiazide plus saline infusion
D. Mannitol plus saline infusion

A) Acetazolamide

A graduate student is planning to make a high-altitude climb in South America while on vacation. He will not have time to acclimate slowly to altitude. A drug that is useful in preventing high-altitude sickness is
A. Acetazolamide
B. Amiloride
C. Demeclocycline
D. Desmopressin

B) Glipizide

Which one of the following drugs promotes the release of endogenous insulin?
A. Acarbose
B. Glipizide
C. Metformin
D. Miglitol

D) Lactic acidosis

A 54-year-old obese patient with type 2 diabetes has a history of alcoholism. In this patient, metformin should either be avoided or used with extreme caution because the combination of metformin and ethanol increases the risk of which of the following?
A. A disulfiram-like reaction
B. Excessive weight gain
C. Hypoglycemia
D. Lactic acidosis

C) Eszopiclone

This drug used in the management of insomnia facilitates the inhibitory actions of GABA, but it lacks anticonvulsant or muscle-relaxing properties and has minimal effect on sleep architecture. Its actions are antagonized by flumazenil.
A. Buspirone
B. Chlordiazepoxide
C. Eszopiclone
D. Ramelteon

C) Phenytoin

With chronic use in seizure states, the adverse effects of this drug include coarsening of facial features, hirsutism, and gingival hyperplasia.
A. Carbamazepine
B. Felbamate
C. Phenytoin
D. Phenobarbital

B) Dantrolene

Which of the following drugs is the most effective in the emergency management of malignant hyperthermia?
A. Baclofen
B. Dantrolene
C. Gabapentin
D. Secobarbital

C) Diazepam

Which drug has spasmolytic activity and could also be used in the management of seizures caused by overdose of a local anesthetic?
A. Baclofen
B. Cyclobenzaprine
C. Diazepam
D. Tizanidine

C) Metoprolol

Which of the following drugs is most suitable for management of tremor in a patient who has pulmonary disease?
A. Diazepam
B. Levodopa
C. Metoprolol
D. Propranolol

D) Inject benztropine

A young male patient recently diagnosed as schizophrenic develops severe muscle cramps with torticollis a short time after drug therapy is initiated with haloperidol. The best course of action would be to
A. Add risperidone to the drug regimen
B. Discontinue haloperidol and observe the patient
C. Give oral diphenhydramine
D. Inject benztropine

B) Chlorpromazine

Which of the following drugs is established to be both effective and safe to use in a pregnant patient suffering from bipolar disorder?
A. Carbamazepine
B. Chlorpromazine
C. Lithium
D. Quetiapine

C) Anti-psychotics

Which of the following group of drugs are known to cause extrapyramidal symptoms (EPS)?
A. Narcotics
B. Anti-neoplastics
C. Anti-psychotics
D. Anti-arrythmias

B) Nicotinic receptors

Neuromuscular blockers act mainly on what type of receptors?
A. Beta receptors
B. Nicotinic receptors
C. Alpha receptors
D. Muscarinic receptors

C) Antiemetic

5-HT3 antagonist are used as an ________.
A. Antidiabetic
B. Anticancer
C. Antiemetic
D. Antiasthma

C) Ethosuximide

Which of the following is the drug of choice for absence seizure?
A. Carbamazepine
B. Gabapentin
C. Ethosuximide
D. Phenytoin

D) Irreversibly inhibits cyclooxygenase-1 and 2 enzymes

Which is the mechanism of action of aspirin in exerting its analgesic and anti-inflammatory effect?
A. Irreversibly inhibits cyclooxygenase-2 enzymes
B. Irreversibly inhibits cyclooxygenase-1 enzymes
C. Binds with mu receptors in the brain
D. Irreversibly inhibits cyclooxygenase-1 and 2 enzymes

C) Fluticasone and budesonide

Which of the following are inhaled corticosteroids?
A. Formoterol and dexamethasone
B. Prednisone and budesonide
C. Fluticasone and budesonide
D. Dexamethasone and fluticasone

C) Dextromethorphan

Which of the following drugs is an antitussive?
A. Carbocisteine
B. Acetylcysteine
C. Dextromethorphan
D. Bromhexine

A) Bisacodyl

Which of the following is a stimulant laxative?
A. Bisacodyl
B. Lactulose
C. Docusate
D. Psyllium

D) Type 2 diabetes

Sodium-glucose cotransporter-2 (SGLT2) inhibitors are drugs that are used to treat______.
A. Hypertension
B. Psychosis
C. Hyperthyroidism
D. Type 2 diabetes

D) Drug A is more effective than Drug B

In the essay of antibiotics, which of the following is TRUE if Drug A results to a significantly larger zone of inhibition vs. Drug B at equivalent doses against the same organism?
A. Drug A is safer than Drug B
B. Drug B is more effective than Drug A
C. Drug B is safer than Drug A
D. Drug A is more effective than Drug B

A) Gold

Which of the following elements is used in the treatment of Rheumatoid Arthritis?
A. Gold
B. Magnesium
C. Iron
D. Selenium

A) First

What is the order of reaction in which the concentration of a drug is decreasing at a rate that is proportional to the concentration of the drug remaining?
A. First
B. Zero
C. Third
D. Second

A) More safe

The higher the Therapeutic Index of the drug means that the drug is ______.
A. More safe
B. Less effective
C. More effective
D. Less safe

C) Ototoxicity

Which of the following is the adverse effect associated with Streptomycin?
A. Optic neuritis
B. Hepatitis
C. Ototoxicity
D. Peripheral neuropathy

D) Flumazenil

Which of the following is the antidote for benzodiazepine overdose?
A. Atropine
B. Deferoxamine
C. Naloxone
D. Flumazenil

A) Methanol

Ethanol may be used to manage poisoning due to_____.
A. Methanol
B. Antidepressants
C. Narcotics
D. Carbon monoxide

D) Homatropine

Which of the following is an anticholinergic drug?
A. Pilocarpine
B. Rivastigmine
C. Edrophonium
D. Homatropine

A) Physiologic antagonism

Two drugs that act on the same tissue or organ through independent receptors resulting in effects in opposite directions known as ______
A. Physiologic antagonism
B. Irreversible antagonism
C. Competitive antagonism
D. Chemical antagonism

B) Cockcroft and Gault equation

Which of the following equations is used to compute for the patient's creatinine clearance?
A. Michaelis-Menten equation
B. Cockcroft and Gault equation
C. Harris-Benedict equation
D. Henderson-Hasselbalch equation

B) Somatostatin

Which of the following is also known as the "growth hormone-inhibiting hormone"? Its therapeutic use is targeted on blocking hormone release in endocrinesecreting tumors.
A. Simvastatin
B. Somatostatin
C. Gonadotropin
D. Somatropin

B) Decreased bioavailability of the drug

Decreased oral absorption of a drug due to high stomach pH would result to _____
A. Decreased gastric toxicity of the drug
B. Decreased bioavailability of the drug
C. Increased bioavailability of the drug
D. Increased clearance of the drug

B) Acetylcholine

Which of the following neurotransmitter will be increased by Rivastigmine in the Central Nervous System synapses?
A. Dopamine
B. Acetylcholine
C. Epinephrine
D. Serotonin

C) Vitamin B12

What vitamin can be used to treat cyanide poisoning?
A. Vitamin K
B. Vitamin C
C. Vitamin B12
D. Vitamin B6

D) Zero-order elimination

Which of the following refers to the process that distinguishes the elimination of ethanol from the elimination of most other drugs?
A. First-order elimination
B. Biliary excretion
C. First-pass effect
D. Zero-order elimination

C) Solution

Which of the following dosage forms would be absorbed the FASTEST in the gastrointestinal tract?
A. Capsule
B. Tablet
C. Solution
D. Suspension

B) MAO antidepressants

Which of the following drugs can cause "serotoninergic syndrome" in patients already with an overdose of tricyclic antidepressants?
A. Morphine
B. MAO antidepressants
C. Phenytoin
D. Benzodiazepine

B) Acetylation

Isoniazid undergoes what type of conjugation reaction?
A. Glycine conjugation
B. Acetylation
C. Glucuronidation
D. Methylation

A) Hypoglycemia

Which of the following is the main adverse effect of Insulin?
A. Hypoglycemia
B. Hyperglycemia
C. Bone marrow depression
D. Hepatotoxicity

C) Extravasation

Which of the following is the main physical hazards when administering parenteral drugs with vesicant properties?
A. Hypothermia
B. Air embolism
C. Extravasation
D. Thrombosis

B) Decrease in peristalsis

Which of the following is TRUE regarding the effect of adrenergic agonist on peristalsis?
A. No effect
B. Decrease in peristalsis
C. Effect is either an increase or decreases in peristalsis depending on the agonist
D. Increase in peristalsis

C) Decrease in heart rate

The following are effects of Atropine EXCEPT____________
A. Dryness of the mouth
B. Dilation of pupils
C. Decrease in heart rate
D. Inhibition of sweating

A) Concentration of the drug at the receptor site

The intensity of the pharmacologic action of the drug is MOST dependent on ______
A. Concentration of the drug at the receptor site
B. Onset of action
C. Protein binding
D. Volume of distribution

B) Mimicry of the neurotransmitter at the postsynaptic receptor

What is the mechanism of action of sympathomimetic drugs?
A. Metabolic transformation by the same pathway as the precursor of the neurotransmitter
B. Mimicry of the neurotransmitter at the postsynaptic receptor
C. Prevention of the release of the neurotransmitter
D. Interference with synthesis of the neurotransmitter

D) Aplastic anemia

Which of the following is a known adverse effect associated with the use of chloramphenicol?
A. Staining of the teeth
B. Alopecia
C. Phototoxicity
D. Aplastic anemia

C) Urinary alkalinizer

Which of the following will enhance the excretion of an alkaline poison in the urine?
A. Probenecid
B. Urinary acidifier
C. Urinary alkalinizer
D. Inulin

B) Carvedilol

Which of the following drugs is an example of a mixed adrenergic antagonist?
A. Terazosin
B. Carvedilol
C. Clonidine
D. Hydralazine

A) Higher concentration in the extravascular tissue than in the vascular compartments

Drugs with very HIGH Volume of Distribution are those that have __________
A. Higher concentration in the extravascular tissue than in the vascular compartments
B. Higher concentrations in the vascular compartments than in the extravascular tissue
C. Higher concentrations that will be absorbed after oral administration
D. Shorter elimination half-life

D) If 1 mg Drug A produces the same response as 10 mg of Drug B, Drug A is more potent than drug B

Which of the following statements is CORRECT?
A. The greater the efficacy, the potent the drug
B. If 1 mg drug A produces the same response as 10 mg of Drug B, Drug A is more effective than Drug B
C. In selecting a drug, potency is usually more important than efficacy
D. If 1 mg Drug A produces the same response as 10 mg of Drug B, Drug A is more potent than drug B

B) Amantadine

Which of the following drugs has both antiviral and anti-parkinsonian activity?
A. Oseltamivir
B. Amantadine
C. Ganciclovir
D. Acyclovir

A) Chemical antagonist

A drug was shown to reverse the action of a particular neurotransmitter. It appears to interact directly with the neurotransmitter and not at all with the neurotransmitter's receptors. Which of the following BEST describes the drug?
A. Chemical antagonist
B. Physiologic antagonist
C. Pharmacologic antagonist
D. Partial agonist

D) Toxin CD (LD50 = 0.00001 mg/kg)

Four identical experimental animals were treated with 1 mg of the following toxins. (Refer to the below with their corresponding LD50). Which toxin would most likely cause death to the animals?
A. Toxin EF (LD50= 5 mg/kg)
B. Toxin GH (LD50= 15000 mg/kg)
C. Toxin AB (LD50 = 8000 mg/ kg)
D. Toxin CD (LD50 = 0.00001 mg/kg)

A) Muscarinic antagonists

Which of the following poisons would be indicated for treatment by Physostigmine?
A. Muscarinic antagonists
B. Muscarinic agonists
C. Benzodiazepines
D. Carbamates

A) Alpha-1

What type(s) of receptors are associated with phospholipase C (PLC)?
A. Alpha-1
B. Alpha-2
C. Beta and alpha-1
D. Beta and alpha 2

B) Loading dose= (desired plasma concentration of the drug) X (volume of distribution)

Which of the following correctly describes the formula for an intravenous loading
A. Loading dose = (desired plasma concentration of drug) X (clearance)
B. Loading dose= (desired plasma concentration of the drug) X (volume of distribution)
C. Loading dose= (amount of drug administered) / (initial plasma concentration)
D. Loading dose= (clearance) X (plasma drug concentration)

C) Acetylcholine

Which one of the following acts commonly both on parasympathetic and sympathetic division?
A. Atropine
B. Pilocarpine
C. Acetylcholine
D. Adrenaline

C) beta2-agonist

Which of the following agonists would be used for asthma patients or to delay premature labor?
A. alpha2-agonist
B. alpha1-agonist
C. beta2-agonist
D. beta1-agonist

B) Dantrolene

Which of these drugs is used to treat Neuroleptic Malignant Syndrome
A. Bethanechol
B. Dantrolene
C. Dexamethasone
D. Simvastatin

D) Atomoxetine

A nonstimulant agent that can be used to treat attention-deficit/hyperactivity disorder (ADHD) is
A. Methylphenidate
B. Caffeine
C. Dextroamphetamine
D. Atomoxetine

C) Tamsulosin

Which of the following alpha-blocker drug is used in the treatment of benign hypertrophy of prostate without producing significant hypotension?
A. Doxazosin
B. Phentolamine
C. Tamsulosin
D. Terazosin

C) ACE Inhibitor+ Diuretic

Enalapril + Indapamide
A. ACE Inhibitor+ Calcium Channel Blocker
B. ARB+ Diuretic
C. ACE Inhibitor+ Diuretic
D. ARB + Calcium Channel Blocker

B) Rosuvastatin

Which of the following inhibit HMG-CoA reductase?
A. Nicotinic acid
B. Rosuvastatin
C. Ezetimibe
D. Cholestyramine

A) Aldosterone

Which of these drugs has the highest salt retaining property?
A. Aldosterone
B. Dexamethasone
C. Hydrocortisone
D. Morphine

B) Raloxifene

Which of the following drug is a SERM useful for the treatment of osteoporosis?
A. Alendronate
B. Raloxifene
C. Flutamide
D. Estradiol

B) pancreas

Where does the tumor from Zollinger- Ellison Disease occur?
A. stomach
B. pancreas
C. intestines
D. liver

C) Esomeprazole

Which drug accumulates in parietal cell canaliculi and undergoes conversion to a derivative that irreversibly inhibits H+/K+ ATPase?
A. Cimetidine
B. Diphenoxylate
C. Esomeprazole
D. Metoclopramide

B) Methotrexate

Which of the given is considered the DMARD of 1st choice to treat rheumatoid arthritis?
A. Cyclophosphamide
B. Methotrexate
C. Azathioprine
D. Mycophenolate mofetil

A) cardiotoxicity

The cause of Rofecoxib withdrawal from the market
A. cardiotoxicity
B. hepatotoxicity
C. nephrotoxicity
D. neurotoxicity

A) Decrease uric acid

Febuxostat was used in the treatment regimen of a patient. What was its use?
A. Decrease uric acid
B. Decrease cholesterol in the blood
C. increase urine output
D. decrease heart activity

B) PGE1

A neonate is identified as having atrial septal defect of congenital origin that will require surgical repair. Adequate systemic perfusion requires that the patency of the ductus arteriosus be maintained. Which of the following agents would best accomplish this goal?
A. Indomethacin
B. PGE1
C. PGI2
D. Celecoxib

A) Mesna

A 37-year-old woman recently had a large soft tissue sarcoma surgically resected from her retroperitoneum. She is to receive both radiation and chemotherapy, with cyclophosphamide as part of her chemotherapy. Which agent should be given in conjunction with this drug?
A. Mesna
B. Leucovorin
C. Cilastatin
D. MOPP

C) Bleomycin

A world-class cyclist was diagnosed with metastatic testicular cancer with lesions in both his lung and brain. He forgoes the standard treatment for his condition because he learns one of the drugs typically used for his condition could ultimately compromise his pulmonary function. Which of the following is included in the standard regimen and is associated with his feared complication?
A. Cisplatin
B. Busulfan
C. Bleomycin
D. Cyclophosphamide

A) Glucagon

An 18-month-old boy presented in a semiconscious state with profound hypotension and bradycardia after ingesting a number of his grandmother's metoprolol tablets. In this case, the most appropriate antidote is
A. Glucagon
B. Naloxone
C. Neostigmine
D. Atropine

C) Respiratory rate has normalized

The healthcare provider administered Naloxone for a patient at the Emergency room. Which of the following physical assessment data would be the most important to indicate that the drug has been effective?
A. Absence of fever
B. Seizure activity has stopped
C. Respiratory rate has normalized
D. Chest pain is better

B) Bone marrow suppression

Which of the following can occur in an adult patient treated with chloramphenicol?
A. Gray baby syndrome
B. Bone marrow suppression
C. Nephrotoxicity
D. Disulfiram-like reaction

B) Calcium disodium edetate

Which of this is an example of a Chelating agent?
A. Dextromethorphan
B. Calcium disodium edetate
C. Betamethasone
D. Neostigmine

C) Placebo

The latin phrase "I shall please" is also called
A. Compound
B. Dispense
C. Placebo
D. Mixing

C) mefenamic 500 mg

Which of the following drug is not advertised on the television?
A. paracetamol 500 mg
B. ibuprofen 500 mg
C. mefenamic 500 mg
D. biogesic 500mg

C) Pramipexole: Parkinson's disease

Which one of the following pairs of drug and indication is accurate?
A. Amphetamine: Alzheimer's dementia
B. Bupropion: acute anxiety
C. Pramipexole: Parkinson's disease
D. Fluoxetine: insomnia
E. Ramelteon: attention deficit disorder

C) Saw palmetto

An alternative medicine that is commonly used to treat the urinary symptoms associated with benign prostatic hyperplasia (BPH) is
A. Echinacea
B. Ephedra
C. Saw palmetto
D. Milk thistle

C) Full antagonist

A type of ligand that acts as a full antagonist in the presence of a full agonist
A. Inverse agonist
B. Partial agonist
C. Full antagonist
D. Partial antagonist

D) sternutator

Causes excessive sneezing
A. lacrimator
B. asthenic
C. asphyxiant
D. sternutator

C) Beta blockers

Which of the following is most useful for stage fright?
A. Vasodilators
B. alpha blockers
C. Beta blockers
D. Sedative

C) Absorption

Process by which toxicants cross body membranes and enter the bloodstream
A. Distribution
B. First pass effect
C. Absorption
D. Biotransformation

D) Glargine

Peakless insulin
A. Isophane insulin
B. Lispro
C. Aspart
D. Glargine

B) A measure of how tightly a drug binds to a receptor

What does "affinity" mean?
A. A measure of how tightly a drug binds to plasma proteins
B. A measure of how tightly a drug binds to a receptor
C. A measure of inhibiting potency of a drug
D. A measure of bioavailability of a drug

D) Passive diffusion (lipid diffusion)

The main mechanism of most drugs absorption in GI tract is:
A. Active transport (carrier-mediated diffusion)
B. Filtration (aqueous diffusion)
C. Endocytosis and exocytosis
D. Passive diffusion (lipid diffusion)

D) Less lipid soluble

Biotransformation of the drugs is to render them:
A. Less ionized
B. More pharmacologically active
C. More lipid soluble
D. Less lipid soluble

B) 80 L

The total amount of a drug present in the body at a given time is 2.0 g and its plasma concentration is 25 mcg/mL, calculate its volume of distribution
A. 100 L
B. 80 L
C. 60 L
D. 50 L