Pacop pink Flashcards
(187 cards)
1
Q
Cimetidine, Ketoconazole, and Allopurinol share a common pharmacokinetic property that predisposes patients taking other drugs concomitantly with any of these agents to toxicity. What is this property?
A
Enzyme inhibition
2
Q
Biotransformation of orally administered drugs occurring primarily in the liver that reduces the amount of drug finally entering the systemic circulation is often referred to as __________.
A
First pass effect
3
Q
The preganglionic fibers of the sympathetic nervous system originate from which roots?
A
Thoracolumbar
4
Q
What neurotransmitter is released by preganglionic fibers as a response to sympathetic stimulation?
A
AcH
5
Q
What is the dominant ganglionic receptor found in most sympathetic fibers?
A
Nicotinic
6
Q
What is the neurotransmitter mainly released by postganglionic parasympathetic fibers?
A
AcH
7
Q
Which of the following non-adrenergic, non-cholinergic neurotransmitters is involved in the action of the enteric nervous system?
A
ATP
8
Q
In synaptic neurotransmission, which of the following ions plays a significant role in neurotransmitter release
A
Ca
9
Q
The primary mechanism of neurotransmitter release is accomplished by what process?
A
Exocytosis
10
Q
What is the amino acid precursor in the synthesis of catecholamines?
A
Tyr
11
Q
In the biosynthesis of Norepinephrine, what step is considered rate-limiting?
A
Tyr to DOPA
12
Q
Which of the following substances exert a negative feedback control on Tyrosine Hydroxylase which serves as the mechanism for moment-to-moment regulation of the rate catecholamine synthesis?
A
NE
13
Q
Reserpine, an alkaloid from Rauwolfia, can lower the blood pressure and depress the CNS. What enzyme of the biosynthetic pathway is inhibited by Reserpine to bring about these effects?
A
Storage in vesicle
14
Q
What is the main final metabolite of Norepinephrine
and Epinephrine which when abnormally elevated is often used as marker of pheochrytomocytoma
A
3 methoxy 4 hydromandelic acid
15
Q
Which of the following is an expected response to alpha1 adrenoceptor stimulation?
A
GIT Sphincter constrict
16
Q
Male px wish to buy otc cold meds. Which data should prevent you from dispensing?
I. Px taking Nifedipine GITTS
II. Px on Tranylcypromine
III. px elderly w/ urinary hesitancy, intermittency, and freq
A
I and III
17
Q
Stimulation of Alpha-1 receptors leads to the formation of important secondary messengers that promote
calcium release and activation of protein kinase C. These secondary messengers responsible for the effects of alpha-1 stimulation include which of the following?
A
ITP
18
Q
In which of the following clinical conditions are the agonists of the alpha-1adrenoceptors found to be useful?
I. Nasal congestion
II. HYPOTN
III. Symptomatic Brady
A
I and II
19
Q
Which of the following effects can be attributed to alpha-2 receptor stimulation?
I. Vasodilation
II. Catecholamine release
III. Vasoconstriction
A
I, II, III
20
Q
A given adrenergic agent induces uterine relaxation and bronchial smooth muscler elaxation.These effects can be attributed to
A
B2 agonist
21
Q
What is the dominant adrenergic receptor in the heart?
A
B1 agonist
22
Q
Which of the following effects is/are consistent with the systemic use of the drug Clonidine?
I. Initial transient increase in bp
II. First dose effect
III. lowering of bp
A
I and III
23
Q
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. Inhibit Histamine release by B2 activation
II. A1 activation lead to vasoconstriction
III. B2 activation lead to bronchodil
A
I, II, III
24
Q
The activity of this drug is attributed to its metabolite which is a false neurotransmitter at the central nervous system
A
Methyldopa
25
Which of the following inotropic agents is most useful for patient with acute heart failure complicated by acute reduction in creatinine clearance?
DA
26
As an inotropic agent, Norepinephrine (Levophed) has been shown in some small clinical trials to be most useful in which of the following conditions?
Septic shock
27
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 immuno-hemolytic anemia
III. Toxic doses are associated with hepatotoxicity
I, II, III
28
What are known clinical use of b2 agonist
I. Management of premature labor
II. Part of intervention for hyperkalemia
III. Bronchial asthma
I, II, III
29
Accepted ID of Epi
Local vasoconstrictor
30
Clinical use of D1 agonist Fenodolpan
Acute tx of HTN
31
Ff adrenergic most useful for hypodynamic septic shock with hypotn
I. DA
II. Dobutamine
III. NE
I and III
32
Guanfacine and Guanabenz are primarily agonist at
Presynaptic A2
33
Indication of terbutaline
I. SC for recalcitrant acute exacerbation of bronchial asthma
II. Increase HR in symptomatic Bradycardia
III. Adjunct of malignant HTN
I and II
34
Which primarily stimulates B1 receptors
Dobutamine
35
Px complains of muscle weakness after several doses of Salbu nebulization. This condition can be attributed to
Hypokalemia induced salbu therapy
36
BB that has similar vasodilation similar to prazosin
Labetalol
37
BB that is cardioselective
Esmolol
38
Rebound tachycardia and HTN are expected complications of abrupt withdrawal of BB therapy. Which of the ff has the least likelihood of causing rebound
Labetalol
39
BB with shortest DOA
Esmolol
40
Whiich BB has been proven to be useful in mngmt of stable CHF
I. Carvedilol
II. Bisoprolol
III. Mesoprolol
I, II, III
41
In which are BB found to be useful
I. Hypothyroidism
II. Raynauds phenomenon
III. Initial therapy of pheochromocytoma
I
42
In which are bb used with caution or avoided?
I. Px with COPD/asthma
II. Px with peripheral vascular disease
III. Px with MI
I and II
43
Methylphenidate and Dextroamphetamine are centrally acting sympathomimetics which have found use in which of the following conditions?
ADHD
44
Which of the following effects is are consistent with direct stimulation of the muscarinic receptors?
I. Peripheral vasodilation
II. Relaxation of ciliary muscles
III. Negative dromotropic
I and III
45
What is the physiologic event that follows stimulation of the NM type cholinergic receptors?
Sodium influx
46
Bethanecol is clinically used for which of the following conditions?
Urinary retention
47
What is/are the clinical use/s of Edrophonium (Tensilon)?
I. Reverse NM blockers
II. Atropine overdose
III. mngmt of organophospate px
I
48
Tacrine, Donepezil, Rivastigmine and Galantamine are indicated for which of the following condition?
Alzheimers
49
Used for mngmt of glaucoma
I. Pilocarpine-physostigmine combi
II. Ecothiophate
III. Demecarium
I, II, III
50
Which of the following findings maybe consistent with an overdose of or accidental exposure to an organophosphate
Emesis
51
Which of the following effects can be attributed to atropine?
Blockade of vagal slowing of heart
52
In comparison to other antimuscarinic agents, Scopolamine is expected to exert significant CNS effects due to:
3” amine
53
Ipratropium, Oxytropium, and Tiotropium and antimuscarinic agents that are most useful as
Relaxant of bronchial muscles
54
Oxynutinin, Dicyclomine, and Glycopyrrolate are clinically useful for which of the following conditions?
GIT hypermotility and urinary incontinence
55
In most patients admitted to atropine overdose, most poison control experts recommend which of the following measures as primary management?
I. Temperature control with cooling blankets
II. Physostigmine as initial therapy
III. Diazepam for seizure control
I and III
56
Poisoning resulting from ingestion of high dose quarternary antimuscarinic agents can be best managed with which of the following agents?
Neostigmine
57
Which of the following is/are important contraindication to the use of antimuscarinic agents or drugs with atropine-like properties?
I. History of prostatic hyperplasia
II. Glaucoma
III. Hypertension
I and III
58
Trimethaphan is expected to produce which of the following effects?
Hypotension
59
What is the mechanism of skeletal muscle paralysis produced by Succinylcholine?
Sustained depolarization of the motor end plate making it unresponsive to other impulses upon repolarization cannot easily depolarized
60
Which of the following findings is consistent with the skeletal muscle relaxant effect of Pancuronium and Rocuronium?
Antagonized by neostigmine
61
Which of the following inhilational anesthetics produces greatest augmentation of the effect of neuromuscular blockers?
Isoflurane
62
Anaphylactoid reaction may be seen as a side effect with which of the following neuromuscular blockers?
Tubocurarine
63
Which of the following statements correctly describes the side effects of succinylcholine?
I. Negative chonotropic and inotropic effects which can be attenuated by atropine
II. Increase risk of emesis among diabetics and obese patients
III. Hyperkalemia when given to burn or trauma patients or patients with close head injury
I, II, III
64
Which of the following mechanism may explain the ability of beta-blockers to reduce blood pressure in hypertension?
Inhibit renin release
65
Which of the following equations describe the factors that contribute to blood pressure?
BP = CO X TPR
66
Which of the following mechanism explains the blood pressure-lowering effect of thiazide diuretics?
I. Reduction in blood volume and cardiac output
II. Increased vascular compliance
III. Decreased proximal tubular reabsorption of water and sodium
I and II
67
Which of the following drugs inhibit enzyme carbonic anhydrase?
Dichlorphenamide
68
Which side effect of chlorthalidone is prominent especially among the elderly when Chlorthalidone is given at a dose of at leats 50mg/day and significantly reduced when doses are maintained below 50mg/day?
Hyponatremia
69
Why combine amiloride and HCTZ
Minimize hypokalemia due to HCTZ
70
The action of the drug Eplerenone most closely resembles which of the following agents?
Spironolactone
71
Which of the following agents exhibits pharmacodynamic interaction with the thiazide diuretics leading to a reduced diuretic effect?
Enalapril
72
Which of the following mechanism explain the effects of the drug Torsemide and Bumetanide?
Inhibition of NaKCl2
73
ID of Spironolactone
I. Adjunct in mngmt of CHF
II. Cohns Syndrome
III.Nephrogenic Diabtes Insidipus
I and II
74
Which of the following is/are accepted indication/s for the drug Furosemide?
I. Infusion-diuresis in hypercalcemia
II. Oliguric acute renal failure
III. Acute pulmonary edema
I, II, III
75
Which of the following agents is primarily indicated for the management of increased intracranial pressure
Mannitol
76
Which of the following agents is most useful for the management of nephrolithiasis due to idiopathic hypercalciuria?
HCTZ
77
Which of the following statements correctly describes the characteristics of Indapamide as a drug for hypertension?
I. Its diuretic effect is self-limiting, and may not account for its hypertensive effect after about 2-4 weeks of therapy
II. Long-term use leads to improved blood vessel compliance
III. Has modest vasodilating property
I, II, III
78
Which of the following agents maybe associated with ototoxicity which may have increased risk of occuring when patient also recieve aminoglycoside antibiotic?
Furosemide
79
MOA of methyldopa
Molecule converted to a-methyldopamine and a-norephineprine which stimulate a2 receptors
80
Most frequent use of methyldopa
Sedation
81
A 45 years old female in clonidine 1.0mg/day for thee last ffour weeks was brought to the hospital for 1 day history of nervousness, tachycardia and abrupt increase in her blood pressure to 180/130mmHg. Her last intake of clonidine was last 2 days prior to admission. Which of the following is/are appropriate interventions that you can suggest for the patient?
I. Start propanolol 50mg BID
II. Re institue clonidine 1mg/day
III. Start labetalol 200mg/d
II and III
82
Which of the following side effects is/ are common to the three drugs: Hydralazine, Diazoxide, and Minoxidil?
Reflex tachycardia
83
In which subset of patients should Hydralazine be avoided or used with caution?
Px with ischemic heart disease
84
Which of the following drugs if combined with Minoxidil may minimize latter drug’s side effect?
Metoprolol + chlortalidone
85
In the management of Pparoxysmal hypertension in pheochromocytoma, which of the following drugs is the
most appropriate initial therapy?
Phentolamine
86
Orthostatic hypotension and syncope are manifestations of a phenomenon associated with the first dose of which agent?
Doxazosin
87
Constipation, Urinary retention, tachycardia, mydriasis and anhidrosis are expected effects based on the mechanism of action of which of the following drugs?
Trimetaphan
88
Which of the following drugs may be used safely for the control of hypertension in pregnant patients with pre-eclampsia?
I. Magnesium Sulfate
II. Methyldopa
III. Hydralazine
II and III
89
Which of the following mechanisms explains the action of the drug Sodium Nitropusside?
Activation of guanyl cyclase increase cgmp
90
CWhich of the following agents is pure anteriolar vasodilator?
Diaxozide
91
Which of the following agents can be used for hypertensive emergencies
I. Enalapril
II. Diazoxide
III. Sodium nitropusside
I, II, III
92
The decrease in arterial tone due to vasorelaxant action of sodium nitropusside is associated with
Increase cgmp
93
Whgich of the following effects can be attributed to Angiotensin II?
I. Stimulate release of Nitric Oxide
II. Stimulate synthesis and release of Aldosterone
III. Stimulate release of NE
II and III
94
Advantage of ARB with ACEi
No dry cough
95
Which of the following ACE-Inhibitors require hydrolysis to the active metabolite/s in the body to produce effects?
I. Enalapril
II. Ramipril
III. Perindropil
I, II, III
96
In which of the following conditions are ACE-inhibitors found to be clinically useful as first-line treatment?
I. Angina pectoris
II. CHF
III. Diabetic nephropathy
II and III
97
The efficacy of ACE-inhibitors in the management of hypertension may be reduced in the presence of certain drugs such as ___________?
Ibuprofen
98
In which subset of patients which are ACE-inhibitors avoided as treatment option?
I. Px with bilateral renal artery stenosis
II. Px with hyperkalemia
III. Pregnant in 2nd and 3rd trimester
I, II, III
99
Which of the following calcium channel blockers has greater activity on calcium channels in myocardial tissues than calcium channels in the vascular smooth muscles?
Verapamil
100
What is the mechanism of action of the diydropyridine calcium channel blockers?
Inhibit the L-type calcium channels in the arteriolar smooth muscles
101
In the long-term management of hypertensiion, which of the following agents is/are considered as appropriate maintenance therapy?
I. Regular Nifedipine capsules
II. Enalapril tablets
III. Indapamide tablets
II and III
102
What is the most common side effect of Enalapril?
Coughs
103
Which of the following anti-hypertensive agents is the most appropriate for elderly male patients with benign prostatic hyperplasia?
Prazosin
104
Which of the following anti-hypertensive agents may be more appropriate to use for diabetic patients with evidence of renal disease?
enalapril
105
Chinese patients are most likely to be more sensitive to effects of which of the following drugs for hypertension that lower doses may have to be used?
metropolol
106
In the management of hypertensive emergencies, which of the following goals or interventions is/are correct?
I. Rapid normalization of the blood pressure within 24 hours
II. Lowering of the mean arterial pressure by about 25%
III. Initiation of oral hypertensives early as soon adequate blood pressure lowering has been achieved
II and III
107
Which of the following are important considerations regarding the proper handling of Nitroglycerin tablets
I. Formulations used in the medicine are explosive
II. Sublingual tablets lose their potency when stored in plastic containers
III. These are sensitive to light
II
108
Which of the availabe nitrovasodilators has a bioavailabilty of about 100%?
ISMN
109
Which of the following statements most closely describes the primary mechanism of action of the nitrovasodilator?
Denitrification by glutathione S-transferase leads to release of nitrite ion which is then converted to nitric oxide, a molecule that activates guanylyl cyclase leading to increase cGMP
110
Which of the following tissues exhibit the greatest sensitivity to nitrovasodilators at the lowest effective doses?
Veins
111
Which of the following statements correctly explains the primary mechanism of relief of angina pectoris with the use of nitrovasodilators when given at usual doses?
Peripheral dilation of the veins leading to reduction in cardiac preload and myocardial oxygen demand
112
Which of the following agents classified as nitrovasodilators is useful in the management of cyanide poisoning?
amyl nitrite
113
This side effect of nitrovasodilators is explained in part by the depletion of sulfhydryl moieties in vascular
smooth muscles with continuous use of the drugs, and may be partly reversed bysulfhydryl-regenerating
compunds.
tolerance
114
Which of the following agents is/are considered useful as single agent in the acute treatment of vasospastic angina pectoris?
I. Nitrovasodilators
II. Beta-blockers
III. Calcium channel blockers
I and II
115
What is the primary limitation with the use of Dihydropyridine CCB management of angina pectoris?
reflex tahcycardia
116
What is the most important role of beta-blockers in the management of angina pectoris
reduce myocardial oxygen demand by reducing perfusion time making it useful for chronic stable angina
117
Which of the following drugs or drug combination is/are useful in the management of chronic stable angina pectoris?
I. Regular release Nifedipine capsule
II. Metoprolol tablet
III. Metoprolol tablet + Diltiazem tablet
II
118
What is the principal mechanism of action of cardiac Glycosides?
Inhibit NaKATPase
119
What is the principal mechanism of action of cardiac Glycosides?
In about 10% of patients, use of antibiotics can lead to increased oral bioavailability
120
Which of the following is/are mechanical effects of digoxin on myocardial tissues
I. Increase in contractility of myocardial tissues
II. Increase in conduction velocity in the AV node
III. A positive inotropic effect
I and III
121
Which of the following is/are expected electrical effect/s of digoxin on myocardial tissues?
I. Decrease in the refractory period of atrial muscles
II. Increase in the refractory period of the AV node
III. A positive inotropic effect
I, II, III
122
Which of the following condition may augment the effect of digitalis glycosides in myoccardial tissues?
I. Concurrent use of captopril
II. Reduced oxygenation of myocardial tissues
III. Concurrent administration of calcium gluconate
II and III
123
Which of the following is/are the primary indication/s of Digitalis Glycosides?
I. First line drug for the initial management of CHF
II. Useful in controlling the rate of ventricular response in atrial fibrillation
III. Useful in pregnant patients with CHF
II and III
124
What is the major mechanism of interaction between Digoxin and Quinidine?
Decrease renal clearance of digoxin
125
A 50 years old male patient with CHF was started on the following medications: digoxin 0.25 mg OD,
Hydralazine 10mg BID, furosemide 20mg OD, and ISMN 60mg OD. 1 week after initiating therapy, the
patient was admitted for blurring of vision and palpitation. He feels nauseated and has problems
discriminating colors. Which of the following sourses of action is appropriate?
DC digoxin and furo and check serum K level
126
Which of the following intervention may be appropriate in the management of severe cases of digitalis intoxication such as in children and in suicidal overdose?
I. Administration of digoxin immune fab
II. Aadministration of KCl
III. Administration of MgSO4
I
127
What is considdered as the toxic plasma concentration of digoxin?
>2ng/mL
128
What is the primary use of drugs like Inamirone and Milrinone?
I. Alternative to digoxin in patients with chronic CHF
II. Management for acute heart failure
III. Management of exacerbation of chronic CHF
II and III
129
What is the mechanism of action of Inamrinone and Milrinone in the management of heart failure?
increase level of cAMP by inhibiting PDE III
130
Inotropic activity oh the heart in CHF can be increased by which of the following agents?
I. Bipyridines
II. ACE inhibitors
III. Beta-1 agonists
I and III
131
Which of the following agents for the heart failure may be associated with arrythmia, thrombocytopenia,
and hepatotoxicity which limit their use in patients with chronic CHF?
bypridine
132
Which of the following statements correctly describe/s the appropriate use of drugs for CHF
I. Beta-blockers when used for patients with stable CHF can be given at doses similar to the dose used for hypertension
II. ACE inhibitor dose must be carefully titrated to the maximum allowable or tolerable dose
III. Spironolactone has been found to be most useful as initial drug therapy for CHF even prior to the use of ACE inhibitors or casodilators
II
133
Which of the following drugs or drug combinations can reduce both the cardiac preload and afterload in CHF?
I. Hydralazine + Nitrovasodilators
II. Beta-blockers + Loop diuretics
III. Loop diuretics + Digitalis
I
134
Which of the following drugs or drug combinations can reduce both the cardiac preload and afterload in CHF?
I. Hydralazine + Nitrovasodilators
II. Beta-blockers + Loop diuretics
III. Loop diuretics + Digitalis
II
135
Which of the following drugs is a sodium channel blockers that can prolong the duration of the action potential and dissociates from the channel with intermediate kinetics?
Quinidine
136
Which of the following drugs is a sodium channel blockers which has no significant effect on the duration of the action potential and dissociate from the channel with slow kinetics?
Flecainide
137
Which of the following beta-blockers have been found to be most useful as anti-arrythmic agent/s?
I. Esmolol
II. Metoprolol
III. Propanolol
I and III
138
Which of the following anti-arrythmic agents has been associated with lupus-like side effects?
Procainamide
139
What is the drug of choice for the management of sustained ventricular arrythmia associated with acute myocardial infarction?
Lidocaine
140
What is the preferred drug for the management of ACUTE episodes of supraventricular tachycardia?
Adenosine
141
What is the preferred drug for the management of CHRONIC paroxysmal supreventricular tachycardia?
Verapamil
142
What is the primary mechnism of action of the drug Amiodarone?
prolong action potential by blocking K channel
143
What side effect/s may be expected with the use of Amiodarone?
I. Hypothyroidism or Htperthyroidism
II. Fatal pulmonary fibrosis
III. Symptomatic bradycardia and heart block particularly in patients with atrioventricular nodal
disease
I, II, III
144
Measurement of the serum ALT prior to and during therapy of arrythmia is indicated when which of the following drugs for arrythmia is/are used?
amiodarone
145
Which of the following calcium channel blockers is most useful in arrythmia therapy?
Verapamil
146
Which of the following effects can be attributed to histamine binding to its H1 receptor?
I. Extravascular smooth muscle contraction
II. Vascular smooth muscle contraction
III. Gastric acid secretion
I
147
The triple response of Lewis following intradermal injection of Histamine includes which of the following?
I. Sensory nerve ending stimulation producing flare
II. Erythema caused by contraction of vascular smooth muscles
III. Endothelian cell contraction leading to exudation of fluids
I and III
148
Which of the following effects may be expected as a direct consequence of blockade of the H1 receptots
I. Sedation
II. Resolution of initial allergic response
III. Anti-nausea and Anti-emetic effect (anti-motion sickness)
II
149
Dimenhydrinate and Diphenhydramine are H1 antihistamines that belong to what chemical class of agents?
ethanolamine
150
Which of the following agents is used primarily for its sedating property as the active ingredient of an OTC sleeping aid called Unisom?
Doxylamine
151
What class of H1-antihistamines include drugs that sre used as components of OTC “cold” medications
alkylamines
152
What is the active metabolite of hydroxyzine which is also available as an H1-antihistamine without
significant sedating side-effect?
cetirizine
153
Which of the following H1 anti-histamine chemical groups possess significant atropine-like effect?
ethanolamine
154
Which of the following H1-antihistamines has significant blocking effects on 5-HT receptors?
cryoheptadine
155
Which of the following H1-antihistamines has significant anti-cholinergic effect to be useful for the
management of dytonia and pseudoparkinsonism associated with the use of neuroleptic agents?
diphenhydramine
156
Which of the following H1-antihistamines can block sodium channels in excitable membranes bringing
about local anesthetic effect?
diphenhydramine
157
What is the primary mechanism of action of the drug Ondansetron and Granisetron?
antagonist at 5HT3 receptor
158
What is the clinical use of the drugs Ondansetron and Granisetron?
anti emetic
159
What is the clinical use of the drugs Ondansetron and Granisetron?
Tx of acute migraine attack
160
Sumatriptan is contrindicated in which subset of patients?
Px with acute ischemic heart disease
161
Which of the following statements is/are correct regarding Arachidonic acid?
I. It is 20-carbon known as eicosapentaenoic acid
II. It is mobilized from phospholipids by the enzyme phospholipase A2
III. It is released from phospholipids by the action of the enzymes phopholipase C and Diglyceride
lipase
II and III
162
Which of the following eicosanoids is a product of the metabolism of Arachidonic acid by the
cyclooxygenase enzyme?
PG
163
Which of the following correctly differentiate/s COX-1 from COX-2 isozymes?
I. COX-1 is widely distributed and constitutively expressed
II. COX-1 is expressed upon stimulation by sytokines and growth factors
III. COX-2 is expressed by inflammatory and immune cells
I and III
164
Epoprostenol, a drug that is being used in the management of primary pulmonary hypertension is an analogue of which eicosanoid?
PGI2
165
Which of the following eicosanoids has an analogue that is primary indicated as cytoprotectant in peptic
ulcer disease?
PGE1
166
Which of the following effects is caused by Prostacylin?
Vasodilation of blood vessel
167
What is the primary indication of the prostaglandin analogue Latanoprost?
Mngmt of glaucoma
168
Which of the following statement correctly describes the effects of glucocorticosteroids in eicosanoid
synthesis?
I. Dexamethasone inhibits the expression of the COX-2 gene
II. Glucocorticosteroids inhibit the synthesis of annexins leading to decreased activity of
Phospholipase C
III. Glucocorticosteroid
I and III
169
Which of the following drugs classified as NSAIDs inhibit/s the COX-1 more than the COX-2 isozymes?
Indomethacin
170
Which of the following drugs classified as NSAIDs inhibit/s the COX-2 morre than the COX-1 isozymes?
Celecoxib
171
Which of the following statement/s is correctly describe/s the pharmacokinetics of Aspirin?
I. Aspirin can be absorbed in the stomach and the small intestines in the hydrolyzed form
II. Elimination of aspirin can be best descrined as following a Michaelis-Menten kinetics
III. Acidification of the urine facilitates renal elimination of Salicylates
II
172
Which of the following mechanisms may play a role of anti-inflammatory effect of Aspirin?
I. Decreased synthesis of prostaglandins
II. Inhibition of neutrophil migration and adherence
III. Stabilize iysosomes of neutrophils
I, II, III
173
At what usual adult dose of aspirin is its anti-inflammatory effect observed?
3.2 - 4g/day
174
What is the principal mechanism which can explain anti-pyretic effect of Aspirin?
CNS inhibition response to interleukin-1
175
Which of the following statements is/are correct regarding the anti-platelet aggregation effect of Aspirin?
I. Discontinuation of Aspirin immediatel rrestores platelet aggregation in matter of 1-2 days
II. The mechanism involves irreversible actylation of the cyclooxygenase enzyme in platelets
III. The effect is clinically significant in all dose ranges for Aspirin
II
176
Which of the following statements must be considered with regard to the effect of Aspirin and other NSAIDs on the gastric mucosa?
I. The risk of GI intolerance can be reduced if Aspirin or any other NSAIDs is taken with meals
II. With Aspirin, the risk of erosive gastritis is obsereved only when Aspirin is given at doses >0.325g/day
III. Gastric irritation is most prominent among NSAIDs that inhibit COX-1 more than COX-2
I and III
177
Which of the following drug is currently considered as the preferred drug to prevent erosive gastritis in
patient at risk of developing this side effect when NSAIDs have to be given to the patient?
Omeprazole
178
In salicylate poisoning, serum salicylate levels of 50-80mg/dL can present with which of the followingclinical findings?
I. Hyperthermia
II. Respiratory alkalosis
III. Tinnitus and Vertigo
II and III
179
A number of the NSAIDs cannot be given to patients with Gouty Arthritis as these may precipitate an acute attack of gout or induce uric acid stone formation. Which of the following NSAIDs should not be given to patient with gout?
Tolmetin
180
Which of the following NSAIDs with minimal anti-inflammatory activity is/are primarily indicated as analgesic especially in the management of post-operative pain?
I. Diclofenac
II. Ketorolac
III. Etodolac
II and III
181
All the know NSAIDs are weak acids. Which of the following drugs is the only exception?
Nabumetone
182
Which of the following statement/s is/are correct regarding Mefenamic Acid, a popular NSAID?
I. It is more toxic than Aspirin
II. The drug should not be used for more than 1 week
III. It should not be given to children
I, II, III
183
What is the most important toxicity associated with pyrazolone derivatives like Phenylbutazone which necessitated the withdrawal of a number of these drugs from the market?
hematologic toxicities
184
Which of the following NSAIDs is most useful as an analgesic and has been used successfully to replace morphine in some situation involving mild to moderate post surgical pain? When used with an opioid, it may decrease the opioid requirement by as much as 25-50%.
Ketorolac
185
What is the primary advantage of drugs like Celecoxib and etericoxib?
less ulceration
186
A number of drugs classified as specific COX-2 inhibitors like Rofecoxib (Vioxx) have been withdrawn from the market or are marketed with “black box” warning. What is the primary reason for such actions to be taken against these drugs?
Increase risk of thrombosis and cardiac death
187
Which of the following statement/s is/are correct regarding the drug Methotrexate when used for rheumatoid arthritis?
I. The primary mechanism of action involves inhibition of AICAR (aminomidazolecarboxamide) transformylase and thymydylate synthase
II. Toxicity of the drug may be minimized with the use of Leucovorin
III. The drug is contraindicated in pregnancy
I, II, III
