BOARD REVIEW QUESTIONS

SELECT THE BEST ANSWER

1. The action of a drug on the body, including receptor interactions, dose receptors phenomena and mechanism of therapeutic and toxic action is:

A. toxicology C. pharmacogenetics B. pharmacokinetics D. pharmacodynamics*** 2.True of metabolism:

A. aims to make the drug more polar and readily excretable***B. aims to make the drug more effectiveC. aims to make the drug stay in the body longerD. aims to make the drug less toxic

3. If the plasma concentration of drug declines with “first order kinetics” this means that:A. there is only one metabolic path for drug dispositionB. the half life is the same regardless of the plasma concentration***C. the drug is largely metabolized in the liver after oral administration

and has low bioavailabilityD. the drug is not distributed outside the vascular system

4.Distribution of drugs in specific tissues:A. is independent of blood flow to the organB. is independent of the solubility of the drug in that tissueC. depends on the unbound drug concentration gradient between

blood and the tissue***D. has no effect on the half life of the drug

5.A drug that blocks the action of epinephrine at its receptors by occupying those receptors without activating themA. pharmacologic antagonism***B. physiological antagonismC. partial antagonistD. chemical antagonist

6. A drug that binds a reception to produce an effect is called:A. Agonist*** B. Antagonist C. pro-drug D. metabolite

7. Phase of clinical trial that involves “many doctors & many patients”:A. PHASE I B.PHASE II C.PHASE III*** D.PHASE IV

8. The main excitatory transmitter in the CNS s:A. Glutamate*** B. aspartate C. glycine D. GABA

9. A benzodiazepine which is the drug of choice for status epilepticus:A. Flurazepam B. triazolam C. diazepam*** D. midazolam

10. Benzodiazepines binding to the GABA receptors leads to:A. Increased frequency of GABA chloride channel opening***B. Prolonged duration of GABA chloride channel openingC. Decreased frequency of GABA chloride channel openingD. Shortens duration of GABA chloride channel opening

11.Effects of hypnotic sedatives on sleep, EXCEPT:A. decreased sleep latencyB. decrease duration of slow wave sleepC. increase duration of NREM stage 2 sleepD. increase duration of REM sleep***

12. True regarding Ethosuximide:A. inhibits sodium channelB. drug of choice in absence seizures***C. causes neural tube defectsD. all of the above

13. Given orally it causes sedation and also ‘resets the biological clock being used for the purpose to counter jet lag:A. nitric oxide B. melatonin*** C. purines D. arachidonic acid

14. Useful for manic-depressive patients; it has its effect by altering intracellular concentration of inositol triphosphate:A.imipramine B. fluoxetine C. isocarboxacid D. lithium salts***

15.The general mechanism of action of neuroleptic drug is:A. inhibition of GABA receptorsB. increase dopamine activityC. decrease dopamine activity***D. Increase lipid solubility of the drugs

16. This nonselective adrenergic agonist is an effective bronchodilator agent, it is now considered as the drug of choice for anaphylactic shock: A. epinephrine*** C. tertabulline B. isoproterenol D. metaproterenol

17. This mucolytic agent is also used as an antidote for paracetamol poisoning:A. Carbocysteine B. acetylcysteine**** C. bromhexine D. ambroxoll

18.Isoniazid is recommended as a “prophylactic agent for the following, EXCEPT:

A. Who are close contacts of an active case of tuberculosisB. in children whose PPD test is positive within 2 years after a

documented negative skin test(recent converters)C. who are immunocompromised esp HIV infected and AIDS

patientsD. children who are malnourished or with no vitamin supplement****

19.This is the most significant major side effects of isoniazidA. Hepatitis*** C. deafnessB. retro bulbar neuritis D. hemolysis

20. Drug A causes a decrease of blood pressure from 10 –20 mm Hg Drug B causes a decrease of blood pressure from 5 –10 mm Hg Drug C at 5 mg can lower the blood pressure from 10- 20 mm Hg Drug D at 10 mg can lower the blood pressure from 5 –10 mm Hg Therefore:

A. Drug A is more effective than drug BB. Drug C is more potent than drug DC. Drug B and D are equally effective***D. all of the above

21.Which one of the following is NOT an example of drug-drug interactions?

A. drowsiness caused by diphenhydramine*** B. enhanced toxicity of cardiac glycosides when given with thiazide

diuretics C. an increase in the metabolism of oral anticoagulants after

phenobarbital administration D. increased central nervous system depression on administration

of both a barbiturate and narcotic analgesic

22.Given prior to stage performance, this relieves the symptoms of anxiety such as tremors & tachycardia:A. buspirone C. diazepamB. propranolol*** D. phenobarbital

23. Displacement of this drug from plasma protein binding sites by anticoagulants increases its adverse effects, which include nystagmus, diplopia and ataxia & gum hyperplasia:A. valproic acid C. Phenytoin***B. Carbamazepine D. lamotrigine

24. Phenytoin toxic level is above:A. 8 mg/dl C. 40 mg/dl***B. 20 mg/dl D. 100 mg/d

25 Effects of dopamine on the nigrostriatal system is associated with:A. emotions C. endocrine effects B. motor control*** D.. eating control

26. This causes the highest incidence of Extra pyramidal effects:A. chlorpromazine C. haloperidol***B. thiothexine D. clozapine

27. Indicated for osteomyelitis because of its well bone penetration:A. Chloramphenicol C. Spectinomycin B. Clindamycin*** D. gentamycinl

28.Toxic effects of Chloramphenicol except:A. GIT disturbances C. bone marrow depressionB. Vaginal candidiasis*** D. Gray baby syndrome

29.The following agents primarily act on the 30 S ribosomal subunit except:

A. Chlortetracycline C. amikacinB. Netilmicin D. chloramphenicol***

30. The parent compound of all semi synthetic penicillin: A. 6 – aminopenicillanic acid*** C. beta lactam ring

B. 7-aminocephalosporanic acid D. penicilloic acid

31.A fourth generation cephalosporin: A. Cefpirome *** B. Cephalexin C. Cefuroxime D. Trimethoprim

32.The following inhibit cell wall synthesis except:

A. Vancomycin C. Amocycillin B. Clindamycin*** D. Cefuroxime

33.The cephalosporins containing methyl thiotetrazole group include the following, except:

A. Cefuroxime*** B. Cefotetan C. Cefamandole D. Cefoperazone

34.The following are penicillinase resistant except:A. Cloxacillin B Nafcillin C. Amoxicillin*** D. Methicillin

35. The following are the actions of beta lactams except:A. Inhibits transpeptidationB. activation of PBPsC. activation of autolysinsD. inhibits translocation***

36.The only agent in the 2nd generation cephalosporins which can produce sufficient CSF level:

A. Cephalexin C. CefpromB. Cefoperazone D. Cefuroxime***

37.Toxicity that is more pronounced with doxorubicin than with other agents include this potentially irreversible cumulative, dose related :

A. cardio toxicity*** C. neurotoxicityB. nephrotoxicity D. pulmotoxicity

38.An estrogen receptor antagonist which is useful for post-menopausal breast cancer is:

A. megastrol C. flutamideB. tamoxifen *** D. leuprolide

39.The major site of alkylation within DNA of alkylating agents is the ____ position of guanine: A. N1 C. N5 B. N 3 D. N7***

40.TRUE regarding vincristine, EXCEPTA. a spindle poisonB. useful in acute leukemia in childrenC. arrest mitotic cycleD. causes marked bone marrow suppression***

41.This plant alkaloid is popularly used in ovarian and advanced breast cancer; comes

from Western yew and is a mitotic spindle poison: A. etoposide C. Paclitaxel*** B. vincristine D. vinblastine

42. Androgens, estrogens and adrenorecortical hormones all can produce:A. Cardio toxicity C. bone marrow suppressionB. fluid retention *** D. nausea and vomiting

43.This antileprosy drug is useful for both multibacillary and paucibacillary type; may cause hemolysis n G6PD deficient patient:A. clofazimine C. Sulfones***B. Rifampin D. Ofloxaci

44.An adverse effect of sulfonamides in newborns due displacement of bilirubin from binding sites on albumin:A. Photosensitivity C. Hemolytic anemiaB. Crystalluria D. Kernicterus***

45.This sulfonamide penetrates ocular tissues and fluids at high concentrations thus is useful in chlamydia trachomatis infection:A. Sulfacetamide*** C. SulfathiazoleB. Sulfadoxine D. Sulfamethoxazole

46.This alkylating related drug is useful in Hodgkin’s lymphoma. It has leukemogenic, teratogenic and mutagenic activity. It has a disulfiram like effect and has a MAO inhibitor as its metabolite:A. nitrogen mustard C. BusulfanB. procarbazine*** D. melphalan

47.This anticancer is also useful in the treatment of rheumatoid arthritis; its adverse effects can be revered by administration of leucoverin:A. cyclophosphamide C. methotrexate***B. cytarabine D. Melphalan

48.Parkinson’s Disease can be managed with these dopamine agonist except:A. bromocriptine C. pergolideB. ropinirole D. amantadine***

49.This cholesterase inhibitor is useful for minizing violent behaviors in Alzheimer’s Disease:A. physostigmine C. arecolineB. neomycin D. donezepil***

50.The following statements are true in the use of carbidopa in combination with levodopa; EXCEPT:A. reduces the dose needed by about ten foldB. diminishes the peripheral side effectsC. conversion to dopamine is largely preventedD. carbidopa rapidly penetrates the brain ***

51. The risk of ischemic heart disease is directly proportional to the concentration of:A. LDL cholesterol*** C. triglyceridesB. HDL cholesterol D. VLDL cholesterol

52.MG has an elevated serum cholesterol but with normal triglycerides level. You would prescribed the following:A. clofibrate*** C. SimvastatinB. gemfibrozil D. all of the above

53.ZZ has an elevated serum cholesterol and triglycerides. Your choice of hypo lipid agent for ZZ include:A. clofibrate C. niacinB. atorvastatin*** D. all of the above

54. You have prescribed atorvastatin to Mr. Park for his hyperlipedemia. You should advise him to take the drug:A. first thing in the morning C. after breakfastB. last thing before going to bed*** D. any time of the day

55.Atorvastatin causes the following effects EXCEPT:A. decrease hepatic cholesterol synthesisB. increase synthesis of LDL receptorsC. decrease clearance of LDL***D. decrease concentration of LDL cholesterol in plasma

56.Drugs that can be used for the prevention of malaria in travelers, EXCEPT:A. Chloroquine C. mefloquineB. quinine*** D. doxycyline

57.This is an effective luminal amebecidal agent but is not active against tissue trophozoite:A. emetine HCl C. chloroquineB. metronidazole D. diloxanide furoate***

58.This is a broad-spectrum oral antihelminthis which is the drug of choice for the treatment of hydatid disease and cysticercosis:A. Mebendazole C. thiabendazoleB. albendazole*** D. metronidazole

59.Which of the following antimalarial drugs causes a dose-dependent toxic state that includes: flushed and sweaty skin, dizziness, nausea, diarrhea, tinnitus, blurred vision, and impaired hearing?A. Amodiaquine C. pyrimethamineB. Primaquine D. quinine***

60. Antihypertensive agent of choice in a patient with diabetes mellitus and protenuria:A. beta blocker C. diureticsB. ACE inhibitors*** D. calcium channel blockers

61. OF the insulin secretagogues, this is least that cause hypoglycemia as its adverse effect:A. nateglinide*** C. glifizideB. miglitide D. glibenclamide

62. A short acting insulin that can be given intravenously:A. insulin lispro C. insulin ultralenteB. regular insulin*** D. insulin glargine

63. Mechanism of action of nitrates in smooth muscles:A. activated adenyl cyclaseB. inactivates adenyl cyclaseC. activates guanylyl cyclase***D. inactivated guanylyl cyclase

64. The following are drugs with positive inotropic effect, EXCEPT:A digoxin B. hydrochlorothiazide*** C. amrinone D. dobutamine

65. A 21 year old male sustained a severe head in a car accident and found to have an elevated intracranial pressure. CT scanning showed no intracranial hemorrhage. You would start on:A. amiloride*** B. mannitol C. furosemide D. benzthiazide

66. Most common adverse effect associated with diuretics:A. hypotension C. anorexiaB. fluid and electrolyte imbalance*** D. nausea and vomiting

67.Hypokalemia is an adverse effect with the following, Except:A. spironolactone*** C. furosemideB. acetazolamide D. hydrochlorothiazide

68. This binds to a proton pump, H+/K+ATPase located in the luminal membrane of the parietal cells and inhibits it irreversibly:A. ranitidine C. omeprazole***B. Sucralfate D. misoprostol

69. This nonselective cholinergic blocking agent is an antidote for organophosphate pesticides poisoning:A. trimethaphan C. tubocurarineB. nadolol D. atropine***

70.This is the metabolic precursors of noradrenaline and adrenaline which functions as a neurotransmitter in its own right in the brain and possibly also in the periphery:A. norepinephrine C. dopamine***B. epinephrine D. isoprenaline

71 The cholinesterase inhibitor that is used in the diagnosis of myasthenia gravis is:A. edrophonium chloride*** C. physostigmine salicylateB. malathion D. ambinonium hydrochlorid

72. The cholinomimetic that is useful for treating postoperative abdominal distention and gastric atony is:A. Acetylcholine C. CarbacholB. Methacholine D. bethanechol***

73. This drug has a very high affinity for the phosphorus atom in parathion and is often used to treat insecticide toxicity:A. Tubocurarine C. scopolamineB. Trimethaphan D. pralidoxime***

74. Important characteristics of non-depolarizing blocking agents:A. It is reversible by anticholinesterase drugs***B. Produces initial fasciculation and often postoperative muscle painC. It is hydrolyzed by plasma cholinesterase and is normally very

short-actingD. All of the above

75. This IV anesthetic is moderately rapid in its onset and recovery; causes cardiovascular stimulation and increased cerebral blood flow. Emergence reactions impair recovery:A. Etomadate C. midazolam B. ketamine *** D. propolol

76. This inhalational anesthetics has a low blood: gas partition coefficient but is not used for induction of anesthesia because of its pungency, it causes patient to hold their breath?A. sevoflurane C. HalothaneB. Isoflurane D. Desflurane***

77. Most serious toxic reactions to local anesthetics are due to:A. convulsions from excessive blood levels ***B. conversion of hemoglobin to methemoglobinC. its direct effect on the cardiac musclesD. its toxicity to nerve muscles

78.This is not an action of morphine: A. analgesic effect due to stimulation of mu receptors

B. Sedations and euphoria due to the stimulation of mu receptorsC. antitussive effects due to depression o the medullary cough centerD. decrease in circular muscle tone***

79. The clinical use of disulfiram depends on its ability to inhibit this enzyme:A. adenylyl cyclaseB. cytochrome P450 C. alcohol dehydrogenaseD. aldehyde dehydrogenase***

80. This vasoactive peptide dilates arterioles, contracts veins, intestinal, and bronchial smooth muscle, causes diuresis, and is a transmitter in sensory pain neurons:A. endothelins C. substance P***B. bradykinin D. vasoactive intestinal peptide

81. TRUE regarding heparin, EXCEPT:A. primarily given by parenteral routeB. used in pregnancyC. liver is site of action***D. activates anththrombin III

82. This thrombolytic agent is obtained from bacterial cultures; it forms a complex with endogenous plasminogen and provides the conversion of plasminogen to plasmin:A. streptokinase*** C. warfarinB. urokinase D. t-PA

83.The effects of aspirin does not include:A. reduction of feverB. reduction of prostaglandin synthesis in inflamed tissuesC. reduction of bleeding tendency***D. impaired auto regulation of kidney function

84. Actions of thyroxine do not include:A. acceleration of cardiac rateB. increased appetiteC. decreased glomerular filtration rate***D. stimulation of oxygen consumption

85. The following are effects of the glucocorticoid, EXCEPT:A. altered fat depositionB. inhibition of leukotriene synthesisC. increased blood glucoseD. increased skin protein synthesis***

86. All of the following are recognized effects of combined oral contraceptives, except:A. breakthrough bleedingB. increased risk of ovarian cancer***C. decreased risk of endometrial cancerD. increased risk of ischemic strokeE.

87.This guanosine analog is used for treatment of mucocutaneous and genital herpes lesion and for prophylaxis in AIDS:A. acyclovir*** C. Zidovudine B. Amantadine D. Interferon

88. Successful therapy of congestive heart failure with digoxin will result in which one of the following?A. decreased heart rate***B. increased after loadC. increased renin secretion\increased after loadD. increased sympathetic outflow to the heart

89. Succinylcholine are peripherally acting skeletal muscle relaxants that are sometimes used to:A. treat trauma to the spinal cordB. treat neuromuscular diseasesC. act as adjuncts to general anesthesia***D. relieve spasms from traumatic injuries

90. Which of the following statements is true with regards to the therapeutic uses of iron:A. enteric coated tablets are better absorbed than the immediately released tabletB. ferrous and ferric salts differ in their bioavailabilityC. oral ferrous sulfate is the treatment of choice for iron deficiency***D. medicinal iron preparations are relatively non-toxic to children

91. Anti-arrhythmic agent that can be given intravenously in the treatment of malaria:A. phenytoin B. procainanide C. quinidine*** D. chloroquine

92. What is the mechanism of action of cyclosporine as an immunosuppressive agent used in human organ transplantation?A. interferes with DNA synthesis and functionB. inhibits T cell generation in response to transplant antigens***C. intensifies the production of T lymphocytesD. inhibits B cell imunoglobulin production

93 Patients with photophobia , excessive lacrimation, stomatitis, cheilosis and keratitis are usually deficient in:A. ascorbic acid B. cyanocobalamine C. riboflavin*** D. thiamine

94. An anti-thyroid agent that is used days before surgery in order to diminish the size and vascularity the hyperplastic thyroid gland:A. Methimazole C. propylthiouracilB. iodides*** D. liothyronine

95.The drug of choice for the treatment of chronic mucocutaneous candidiasis is:A. amphotericin B C. metronidazoleB. Ketoconazole D. nystatin***

96. The most commonly used antibiotic in topical preparation with a very low incidence of hypersensitivity reaction:A. clotrimazole C. griseofulvinB. bacitracin*** D. cephalexin

97. Which of the following drugs is LEAST likely to be effective in the treatment of an infection caused by S. aureus?

A. amoxycillin *** C. cefazolinB. nafocillin D. oxacillin

98. The physiologic functions of thyroid hormones are characterized by the following, EXCEPT:A. insulin like effectsB. increased oxygen consumption***C. hypolipoproteinemic effectsD. enhanced basal metabolic rate

99. Malignant hyperthermia is used to be one or the causes of death in anesthesia. This is associated with widespread rigidity and enhanced heat production by muscle. Which of the following drugs is used to counter act this effect:A. neostigmine B. atropine C. dantrolene*** D. succinylcholine

100. What do we call drugs that mimic the effects of sympathetic nervous system stimulation?A. antiadrenergics C. adrenergics***B. cholinergics D. anticholinergics

***** ANSWERS TO QUESTIONS

REFERENCES:(1)BASIC & CLINICAL PHARMACOLOGY

8TH EDTIONBERTRAM KATZUNG

(2)BOODMAN & GILMAN’S: THE PHARMACOLOGICAL BASIS OF THERAPEUTICS10TH EDITION EDITED BY HARMAN & LIMBIRD

REVIEW QUESTIONS

DEPARTMENT OF PHARMACOLOGY

FATIMA COLLEGE OF MEDICINEOUR LADY OF FATIMA UNIVERSITY

VALENZUELA CITY