Module 4 Pharmacology - Pharmacokinetics - Toxicology Flashcards by Janina Joya

The ECG of the patient with Digoxin as his treatment in the therapeutic dose range would likely
to show:
A. Widening of the QRS complex
B. Elevation of the ST segment
C. Prolongation of the QT interval
D. Prolongation of the PR interval

Prolongation of the PR interval

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The major segment of the nephron where the diuretic action of the thiazides took place
A. Cortical collecting tubule
B. Medullary collecting tubule
C. Distal convoluted tubule
D. Proximal convulated tubule

Distal convoluted tubule

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The following statement/s are true for the Carbonic anhydrase inhibitors:
I. Depresses HCO3- reabsorption in the cortical collecting tubule.
II. Depresses HCO3- reabsorption in the proximal convoluted tubule.
III. Causes significant hyperchloremic metabolic acidosis

A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III

II and III only

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What segments of nephron where the diuretic action of Spironolactone took place?
A. Cortical collecting tubule
B. Thick ascending limb of Henle’s
loop.
C. Thin ascending limb of Henle’s
loop.
D. Medullary collecting duct

Cortical collecting tubule

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The activity of propranolol in the treatment of angina pectoris is the result of this mechanism
A. Decreased requirement for myocardial oxygen
B. Increased sensitivity to catecholamines
C. Reduced production of catecholamines
D. Dilation of the coronary vasculature

Decreased requirement for myocardial oxygen

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A 56 year old male patient, with hypertension and DM type 2. He managed his diabetes by
insulin. What antihypertensive drug should not be used on his case?
A. Captopril
B. Propranolol
C. Methyldopa
D. Hydralazine

Propranolol

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A drug given intravenously results in an AUC of 600 ug/mL-hr. If the same dose of drug is given
orally and the resulting AUC is 300 ug/mL-hr, what percentage of the oral dose reaches the
bloodstream?
A. 50 %
B. 30 %
C. 20 %
D. 60 %
E. 100 %

50 %

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The time required to reach the minimum effective drug concentration in the blood is known as:
A. Duration of action
B. Frequency
C. Onset of action
D. Half-life
E. Intensity of action

Onset of action

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The phenomenon where a drug could exist in more than one crystal form
A. Thixothrophy
B. Complexation
C. Polymorphism
D. Amorphism
E. Solvate formation

Polymorphism

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The following statement/s are true for Potassium-sparing diuretics:

I. Inhibition of Na+ influx through ion channels in the luminal membrane
II. Inhibition by direct pharmacologic antagonism of mineralocorticoid receptors.
III. Renal K+ wasting may occur

A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III

I,II and III

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The following statement/s are true for Quinidine.
I. Prolongs the QRS duration
II. Induction of torsade de pointes arrhythmia
III. Shortens the action potential duration by nonspecific blockade of K+ channels.

A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III

I and II only

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The following drug is considered to be the most effective in the prevention of ischemic episodes in patients with angina.
A. Sodium nitroprusside
B. Isosorbide dinitrate
C. Propranolol
D. Amlodipine

Propranolol

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The diuretic agent that conserves the K+ ions in the body
A. Triamterene
B. Bumetanide
C. Hydrochlorothiazide
D. Furosemide

Triamterene

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A case of a 60 year-old male patient with developed gynecomastia and erectile dysfunction due to the treatment of this particular diuretic agent.
A. Hydrochlorothiazide
B. Spironolactone
C. Triamterene
D. Furosemide

Spironolactone

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The following statements are true for Lidocaine.
I. Extensive first-pass hepatic metabolism
II. Plasma clearance is increased in liver damage
III. Volume of distribution is decreased in liver damage

A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III

I only

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The following are the results of vasodilating activity of Sodium nitroprusside

I. Activation of guanylyl cyclase
II. Increased intracellular cGMP
III. Decreased intracellular cGMP

A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III

I and II only

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The following are the mechanism of actions of most of the drugs with vasodilating actions

I. Increasing cGMP
II. Promoting depolarization of the vascular smooth muscles
III. Increasing intracellular Ca2+

A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III

I only

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What is the administration rate of theophylline, representing 0.8 of the administered dose,
when aminophylline is infused at 75 mg/hr?

A. 40 mg/h
B. 60 mg/h
C. 50 mg/h
D. 70 mg/h

60 mg/h

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Four hours following the IV administration of a drug, a patient (70 kg) was found to have a
plasma concentration of 5.6 mcg/ml. Assuming the Vd is 10 % of body weight, what is the
amount of drug in mg, present in body fluids?

A. 35.7
B. 39.2
C. 37.5
D. 32.9

39.2

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The rate of zero-order reactions
A. changes constantly
B. holds only for light catalyzed reactions
C. is independent of temperature
D. holds only for radioactive compounds
E. in independent of concentration

in independent of concentration

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What will result if the distribution of drugs is slower than the processes of biotransformation
and elimination?
A. high blood levels of drug
B. potentiation
C. low blood levels of drug
D. failure to attain diffusion equilibrium
E. synergism

failure to attain diffusion equilibrium

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Which of the following drugs undergoes marked hydrolysis in the GI tract?
A. ASA
B. Hydrocortisone
C. Penicillin G
D. Chlortetracycline
E. Acetaminophen

Penicillin G

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Which of the following factors may make it necessary to give lower doses of drugs to geriatric patients?
A. reduced enzyme activity
B. reduced kidney function
C. enhanced absorption
D. A and B only
E. A, B and C

A and B only

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A prime consideration in biopharmaceutics is a drug “bioavailability” which refers to the relative amount of drug that reaches the relative amount of drug that reaches the
A. small intestine
B. liver
C. stomach
D. kidneys
E. systemic circulation

systemic circulation

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Differences in bioavailability are most frequently observed with drug products administered by which one of the following routes? A. Subcutaneous B. sublingual C. Intravenous D. Intramuscular E. Oral

Oral

The "F" value for a drug product is ideally compared to its A. absolute bioavailability B. relative bioavailability C. dosing rate D. route of administration E. clearance rate

absolute bioavailability

Gastric emptying is slowed by all of the following EXCEPT: A. vigorous exercise B. hunger C. fatty foods D. emotional stress E. hot meals

hunger

What factor besides the desired steady-state concentration (Css) is most important for determining an infusion rate of parenteral solution? A. half-life of the drug B. total clearance C. metabolism rate D. volume of distribution E. renal elimination

total clearance

What is the effect of combining Digoxin to Verapamil? A. Verapamil may enhance the AV-blocking effect of Digoxin B. Verapamil may increase the metabolism of Digoxin C. Increased effects of Verapamil D. Decreased serum concentration of Digoxin

Verapamil may enhance the AV-blocking effect of Digoxin

The following are the mechanism of actions of Guanethidine I. Inhibits the release of norepinephrine from sympathetic nerve endings II. Increases sensitivity to the hypertensive effects of amines III. Replaces norephinephrine stores in the nerve endings A. I only B. II only C. I and II only D. II and III only E. I,II and III

I,II and III

The patient was given a Mannitol 100g for the treatment of his oliguria. From the following, which is the least likely to be associated with the effect of Mannitol. A. Effectiveness as non-electrolytic, osmotically active particles B. Capacity to be freely filtered C. Ability to be metabolically altered to an active form D. Retention of water in the tubular fluid

Ability to be metabolically altered to an active form

The following are the mechanism of clinical effects of Calcium channel blockers: I. Increases atrioventricular nodal conduction II. Decrease in left ventricular wall stress III. Increases myocardial oxygen delivery in patients with vasospastic angina A. I only B. II only C. I and II only D. II and III only E. I,II and III

II and III only

The rationale of the beta blocker agents as a management for angina pectoris I. Increase in diastolic perfusion time that may increase coronary perfusion II. Decreased heart rate, blood pressure and contractility III. Increase in end-diastolic volume and ejection time. A. I only B. II only C. I and II only D. II and III only E. I,II and III

I and II only

Which of the following diuretics caused hyperglycemia, hypomagnesemia and hyperuricemia? A. Spironolactone B. Furosemide C. Acetazolamide D. Hydrochlorothiazide

Acetazolamide

Prophylactic drug for paroxysmal atrial tachycardia A. Verapamil B. Nifedipine C. Procainamide D. Adenosine

Verapamil

Patient has an angina pectoris treated with sublingual nitroglycerin. Which of the following is involved in the mechanism of actions of nitroglycerin? A. Phosphorylation of light chains of myosin B. alpha-adrenergic activity C. cGMP D. Phosphodiesterase activity

cGMP

Which of the following is/are the clinical uses of Captopril? I. Congestive heart failure II. Prevention of LV dysfunction following MI III. Diabetic nephropathy A. I only B. II only C. I and II only D. II and III only E. I,II and III

I,II and III

Patient has hypertension and diabetic nephropathy. His medication is Losartan. What would be the mechanism of action for his medication? A. Interacts irreversibly at the AT1 and AT2 receptors B. Have effect on bradykinin metabolism C. Increases excretion of chloride, magnesium, uric acid, calcium, and phosphate. D. Decreases urinary flow rate

Increases excretion of chloride, magnesium, uric acid, calcium, and phosphate.

The following statements are true about the mechanism of actions of Carvedilol in the treatment of CHF EXCEPT A. Decreased pulmonary capillary wedge pressure B. Decreased systemic vascular resistance C. Decreased stroke volume index D. Decreased right arterial pressure (RAP)

Decreased stroke volume index

Which of the following beta blockers could be administered on a once a day dose? I. Carvedilol II. Bisoprolol III. Betaxolol A. I only B. II only C. I and II only D. II and III only E. I,II and III

II and III only

This mode of hepatocyte death is associated with cell shrinkage, nuclear fragmentation and lack of inflammation. A. apoptosis B. necrosis C. hepatosis D. steatosis

apoptosis

The first clinically useful chelating agent: A. penicillamine B. deferoxamine C. BAL D. EDTA

BAL

Chemical name of British Anti-Lewisite: A. 2,3-dimercaptopropanol B. 2,3-dimercapto-1-propanesulfonic acid C. dimethylcysteine D. ethylene diamine tetraacetic acid

2,3-dimercaptopropanol

A hydrolytic product of penicillin for the removal of copper in persons with Wilson's Disease A. EDTA B. BAL C. Penicillamine D. Deferoxamine

Penicillamine

An orally active chelating agent alternative for persons who have developed a sensitivity to penicillamine A. Triethylene tetramine B. DTPA C. BAL D. Deferoxamine

Triethylene tetramine

In cases of chlorinated hydrocarbon ingestion, the following medication(s) is(are) given: I. activated charcoal II. epinephrine III. diazepam A. I only B. II only C. I and II only D. I and III only E. I,II and III

I and III only

Which among the following sulfonylureas achieves blood glucose lowering at the lowest dose. A. Tolbutamide B. Glyburide C. Glipizide D. Glimepiride

Glimepiride

These are drugs which are ligand of peroxisome proliferator-activated receptor-gamma (PPAR- gamma) A. Thiazolidinediones B. meglitinides C. Sulfonylurea D. None of the Above

Thiazolidinediones

Which among the following is/are the cause/s of hypoglycemia with patients under tight glycemic control? I. Delay in taking a meal II. Inadequate carbohydrate consumed III. Unusual physical exertion A. I only B. II only C. I and II only D. II and III only E. I,II and III

I,II and III

What is the first incretin therapy to become available in the treatment of diabetes. A. Sitagliptin B. Pramlintide C. Exenatide D. Rosiglitazone

Exenatide

Which of the following diuretic agent has no effect or no changes in K+ urinary electrolytes? A. Hydrochlorothiazide B. Spironolactone C. Furosemide D. Acetazolamide

Spironolactone

What electrolyte is primarily decreased in the combination of ethacrynic acid and cardiac glycosides? A. Magnesium B. Calcium C. Potassium D. Chloride

Potassium

What is the coagulation factor released by Desmopressin? A. Factor VIII B. Factor X C. Factor IX D. Factor X

Factor VIII

A folic acid antagonist that binds to the active catalytic site of dihydrofolate reductase, interfering with the synthesis of the reduced form that accepts one-carbon units. A. methotrexate B. cisplatin C. mercaptopurine D. allopurinol

methotrexate

Methotrexate also has important applications in the treatment of: A. Tuberculosis B. Congestive Heart Failure C. Rheumatoid arthritis D. Infections

Rheumatoid arthritis

The first of the thiopurine series found useful as an anticancer drug A. Cisplatin B. Fluorouracil C. Methotrexate D. Mercaptopurine

Mercaptopurine

Frequently used with chemotherapy in hematologic cancers to prevent hyperuricemia after tumor cell lysis. A. Allopurinol B. Fluorouracil C. Cisplatin D. Mercaptopurine

Allopurinol

Enzyme responsible for cutting and religating single DNA strands. Inhibition of this enzyme results in DNA damage. A. Topoisomerase I B. Aromatase C. Topoisomerase II D. Asparaginase

Topoisomerase I

Natural products that interfere with the activity of Topoisomerase I. A. Vincristine B. Camptothecins C. Podophyllotoxins D. Taxanes

Camptothecins

An alkaloid ester derived from the Western Yew (Taxus brevifolia) and the European Yew (Taxus baccata) A. Cisplatin B. Vincristine C. Paclitaxel D. Podophyllotoxins

Paclitaxel

Used in combination with surgery and vincristine in the adjuvant treatment of Wilm's tumor A. Doxorubicin B. Plicamycin C. Dactinomycin D. Mitomycin

Dactinomycin

Major dose-limiting toxicity of Dactinomycin: A. Alopecia B. Bone marrow depression C. Vomiting D. Thrombocytopenia

Bone marrow depression

Formerly known as Mithramycin, isolated from Streptomyces plicatus: A. Plicamycin B. Doxorubicin C. Dactinomycin D. Mitomycin

Plicamycin

The statements about esmolol includes which of the following? I. Beta1-selective blocker metabolized by hydrolysis of red blood cell esterases. II. Used in hypertension with associated tachycardia III. Longer half-lives A. I only B. II only C. I and II only D. II and III only E. I,II and III

I and II only

The mechanism of actions of felodipine include which of the following? I. Inhibits calcium ions from entering the "slow channels" or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization II. Relaxation of coronary vascular smooth muscle and coronary vasodilation III. Increases myocardial oxygen delivery in patients with vasospastic angina. A. I only B. II only C. I and II only D. II and III only E. I,II and III

I,II and III

The mechanisms of actions of ramipril include which of the following? I. Must undergo enzymatic saponification by esterases in the liver to its biologically active metabolite II. Effects of ramipril result from the high-affinity, competitive, reversible binding of ramiprilat III. Vasoactive kallikreins may be increased in conversion to active hormones by ACE inhibitors A. I only B. II only C. I and II only D. II and III only E. I,II and III

I and II only

The mechanisms of actions of pindolol include which of the following? I. Has positive inotropic and chronotropic effects and can significantly increase AV nodal conduction. II. Blocks both beta1- and beta2-receptors and has mild intrinsic sympathomimetic activity III. Augmentive action of antidepressants thought to be mediated via a serotonin 1A autoreceptor antagonism. A. I only B. II only C. I and II only D. II and III only E. I,II and III

II and III only

What are the mechanisms of actions of antihypertensive activities of valsartan? I. Produces indirect antagonism of the angiotensin II (AT2) receptors II. Displaces angiotensin II from the AT1 receptor by antagonizing AT1-induced vasoconstriction. III. Produces direct antagonism of the angiotensin II (AT2) receptors A. I only B. II only C. I and II only D. II and III only E. I,II and III

II and III only

The mechanisms of actions of clopidogrel include which of the following? I. Irreversibly blocks the P2Y12 component of ADP receptors on the platelet surface II. Prevents activation of the GPIIb/IIIa receptor complex III. Increase platelet aggregation A. I only B. II only C. I and II only D. II and III only E. I,II and III

I and II only

What is the safest 1st generation sulfonylurea for elderly diabetics A. Chlorpropamide B. Tolbutamide C. Tolazamide D. None of the Above

Tolbutamide

Which among the following insulin is the most recently developed long acting insulin analog that has a dose dependent onset of action of 1-2 hours and duration of action of more than 24 hours? A. NPH insulin B. Insulin glargine C. Insulin detemir D. None of the above

Insulin detemir

Treatment of choice for acid ingestion: A. use of emetics and lavage B. dilution or therapy with milk or water immediately after ingestion C. use of alkaline substances D. AOTA

dilution or therapy with milk or water immediately after ingestion

Treatment of choice for alkali ingestion: A. dilution or therapy with milk or water immediately after ingestion B. vinegar and lemon juice C. both D. NOTA

vinegar and lemon juice

The following may be given for patients with salicylate poisoning I. Activated charcoal II. Sodium bicarbonate III. Acetazolamide A. I only B. II only C. I and II only D. I and III only E. I,II,III

I and II only

The first-line antimycobacterial agent which, if given in high doses, indicates periodic assessment of visual acuity and red-green color discrimination. A. Streptomycin B. Ethambutol C. Pyrazinamide D. Rifampicin

Ethambutol

Urinary tract infection caused by Chlamydia trachomatis on a pregnant patient is best treated with A. Co-trimoxazole B. Levofloxacin C. Erythromycin D. Tetracycline

Erythromycin

Ciprofloxacin is used for the treatment of chronic UTI. If a patient appears unresponsive to the antibiotic, which of the following agents is most likely the cause? A. Aspirin B. Sodium bicarbonate C. Phenytoin D. Ferrous sulfate

Ferrous sulfate

Urethral discharge which when cultured shows Neiserria gonorrhoeae should be treated with A. Ceftriaxone B. Co-trimoxazole C. Benzathine penicillin G D. Amikacin

Ceftriaxone

Pseudomonas aeruginosa is found in urine cultures and blood cultures of a patient with acute pyelonephritis. Combined therapy should be instituted with an aminoglycoside and which of the following? A. Vancomycin B. Azithromycin C. Piperacillin D. Clavulanic acid

Piperacillin

Which of the following agents used to treat chronic UTI could cause acute alcohol intolerance? A. Moxifloxacin B. Cefotetan C. Co-trimoxazole D. Tetracycline

Cefotetan

Trichomoniasis, manifested by itching in the vulval area, is preferably treated with A. Metronidazole B. Pyrimethamine C. Doxycycline D. Pentamidine

Metronidazole

Clarithromycin, used in combination with other agents for the treatment of duodenal ulcers, inactivates which enzyme? A. Na+, K+-ATPase B. Na+, K+, Cl- co-transporter C. Cytochrome P450 D. Dihydrofolate reductase

Cytochrome P450

Pneumonia characterized by a sputum culture that is positive for a ß-lactamase-positive staphylococcal strain should be treated with which penicillin? A. Carbenicillin B. Ticarcillin C. Oxacillin D. Ampicillin

Oxacillin

Which antiviral agent should be administered to an immunocompromised patient with herpes simplex keratitis? A. Amantadine B. Indinavir C. Zidovudine D. Trifluridine

Trifluridine

A geriatric patient develops fever and a cough that produces blood-tinged sputum. Gram- positive cocci in clusters are found in a sputum smear. A chest x-ray shows increased density in the right upper lobe. Which of the following penicillins is most likely to be ineffective? A. Cloxacillin B. Nafcillin C. Oxacillin D. Ticarcillin

Ticarcillin

Administration of neostigmine might potentiate the neuromuscular blockade produced by which of the following agents? A. Succinylcholine B. Dantrolene C. Tubocurarine D. Hemicholinium

Succinylcholine

A patient who has "spasm of accommodation," miosis, increased gut motility, excessive salivation and increased sweating may have been given a therapeutic dose of which one of the following? A. a ganglionic blocking drug B. a muscarinic blocking drug C. an anticholinesterase drug D. Beta-adrenergic blocking drug

an anticholinesterase drug

The dopamine hypothesis of schizophrenia includes I. Drugs that increase dopaminergic activity, such as levodopa, amphetamines, and apomorphine, neither aggravate schizophrenia nor produce psychosis de novo in some patients II. Many antipsychotic drugs strongly block post-synaptic D2 receptor in the CNS, especially the mesolimbic-frontal system III. Successful treatment of schizophrenic patients has been reported to change the amount of homovanillic acid (HVA), a metabolite of dopamine, in cerebrospinal fluid, plasma and urine A. I only B. II only C. I and II only D. II and III only E. I,II and III

II and III only

Which one of the following is a drug of choice in the treatment of "wide angle" glaucome A. Nadolol B. Timolol C. Yohimbine D. Metoprolol

Metoprolol

Stimulation of the vagus nerve in the neck will slow the heart rate directly. Which of the following drugs would inhibit the response to vagal stimulation? A. Atropine B. Pilocarpine C. Bethanecol D. Methacholine

Atropine

Which one of the following drugs most likely would be expected to produce tachycardia, orthostatic hypotension and inhibition of ejaculation? A. Amphetaine B. Propranolol C. Phenoxybenzamine D. Cocaine

Phenoxybenzamine

Lithium is closely related to sodium in its properties. How does lithium affect electrolytes and ion transport? I. It can substitute for Na in generating action potentials and in Na+ - Na+ exchange across the membranes. II. Li+ - Na+ exchange is gradually slowed after Lithium is introduced into the body. III. At therapeutic concentrations, it significantly affect the Na+ or Ca+2 exchange process or the Na+ or K+ ATPase pump A. I only B. II only C. I and II only D. II and III only E. I,II and III

I and II only

Propranolol most likely would be contraindicated in the treatment of which one of the following conditions? A. Glaucoma B. Nasal congestion C. Hypertension D. Asthma

Asthma

Which one of the following drugs acts primarily to inhibit reuptake of norepinephrine? A. Imipramine B. Tyramine C. Prazosin D. Ritodrine

Imipramine

Which is/are true regarding the effects of Epinephrine I. Increase in cardiac output and coronary blood flow II. Breakdown of muscle glycogen III. Bronchiolar constriction A. I only B. II only C. I and II only D. II and III only

I and II only

With which of the following conditions would atropine most likely be contraindicated? A. Myasthenia gravis B. Asthma C. Hypertension D. Glaucoma

Glaucoma

The therapeutic effectiveness of neostigmine in myasthenia gravis is thought to be due to A. Its ability to protect the muscle endplate against acetylcholine B. Its ability to inactivate acetyl cholinesterase C. Its ability to increase the rate synthesis of acetylcholine D. Its stimulant action on the motor nerve terminals at the motor endplate

Its ability to inactivate acetyl cholinesterase

Dobutamine: I. Useful primarily as a Beta1-receptor agonist II. Is refractory to inactivation by MAO III. produces dilation of renal blood vessels A. I only B. II only C. I and II only D. II and III only E. I,II and III

I only

Which of the following is the most accurate statement? A. alpha- adrenoreceptor sympathomimetic agonists are used to reduce mucous membrane congestion B. alpha- adrenoreceptor agonists are used to treat bronchospasms C. beta- adrenoreceptor agonists are used to reduce surgical bleeding D. beta2 adrenoreceptor agonist agents are used to prolong local anesthesia

alpha- adrenoreceptor sympathomimetic agonists are used to reduce mucous membrane congestion

Local anesthetic block A. the release of NT from primary afferents in the spinal cord B. the processing of painful information in the thalamus C. the initiation of pain impulses in the periphery D. the propagation of pain impulses along axons

the propagation of pain impulses along axons

Module 4 Pharmacology - Pharmacokinetics - Toxicology Flashcards

(100 cards)