Flashcards in Pharmacology 1-200 Deck (200)
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1
In the stomach, aspirin will exist predominantly as the ______________ form.
A. Hydrophilic, ionized, polar
B. Lipophilic, unionized, non-polar
C. Hydrophilic, unionized, non-polar
D. Lipophilic, ionized, polar
E. Hydrophilic, unionized, polar
B
Review the Henderson-Hasselbach equation. Aspirin (acetylsalicyclic acid) is acidic in nature. In an acidic environment like the stomach, it will exist predominantly as the lipid-soluble, unionized, non-polar form
2
In the CHOP regimen for non-Hodgkin's lymphoma, which chemotherapeutic drug acts by inhibiting the mitotic spindle?
A. Cyclophosphamide
B. Hydroxyurea
C. Oncovin
D. Prednisone
E. Doxorubicin
C
Oncovin is vincristine.
3
A patient with leprosy is taking a drug that casts a red color to the skin. He is probably taking:
A. Dapsone
B. Rifampin
C. Clofazimine
D. Ethambutol
E. Phenylbutazone
C
Rifampin causes red discoloration of body fluids but not the skin.
4
What part of the pharmacokinetics of penicillin is affected by the drug probenecid?
A. Glomerular filtration
B. Tubular reabsorption
C. Tubular secretion
D. Hepatic uptake
E. Protein-binding with albumin
C
Probenecid raises plasma concentration of penicillin by inhibiting its tubular secretion in the renal tubules.
5
Hoffman elimination is exhibited by:
A. Succinylcholine
B. Diazepam
C. Phenobarbital
D. Phenytoin
E. Atracurium
E
Hoofman elimination aka exhaustive methylation
6
In a patient suffering from organophosphate poisoning with a cardiac rate of 45, what drug should be given?
A. Neostigmine
B. Atropine
C. Epinephrine
D. Pancuronium
E. Edrophonium
B
Because of its antimuscarinic effect on the heart, atropine (the antidote for organophosphate poisoning) has a positive chronotropic effect.
7
Patients receiving cyclophosphamide should also be given:
A. Mesna
B. Leucovorin
C. Vitamin B6
D. Thiamine
E. Amifostine
A
Leucovorin for methotrexate. Pyridoxine for isoniazid. Thiamine for alcoholics.
8
Which statement is correct regarding the aminoglycosides?
A. They work in anaerobic conditions.
B. They exhibit concentrationdependent killing.
C. Most drugs of this class are myelosuppresive.
D. They cannot be given to patients allergic to penicillins.
E. They are acidic in nature.
B
Aminoglycosides only work in arebic conditions. They do not have crossreactivity with the penicillins. Most drugs are nephrotoxic and ototoxic.
9
What is the second messenger system for the receptors blocked by metoprolol?
A. cAMP
B. IP3
C. DAG
D. cGMP
E. PLC
A
Beta-2 receptors are coupled to the cAMP second messenger system.
10
In the treatment of Parkinson's disease, what drug is given with levodopa to increase the drug's bioavailability?
A. Entacapone
B. Selegiline
C. Carbidopa
D. Fluoxetine
E. Pyridoxine
C
Carbidopa peripherally inhibits the enzyme DOPA decarboxylase, the enzyme that converts DOPA to dopamine. Dopamine itself is unable to cross the blood-brain barrier but DOPA can. Inhibition of the enzyme results in more DOPA available to enter the CNS. Within the CNS, DOPA is converted to dopamine by the same enzyme. However, it is not inhibited by carbidopa at this location
11
Which drug used in the treatment of depression possess a tricyclic ring?
A. Imipramine
B. Fluoxetine
C. Trazodone
D. Venlafaxine
E. Bupropion
A
Imipramine is a tricyclic antidepressant.
12
Which antiretroviral drug acts through the M2 ion channel?
A. Efavirenz
B. Nevirapine
C. AZT
D. Amantadine
E. Indinavir
D
Amantadine is also effective for influenza.
13
Drug X has greater affinity for albumin than Drug Y. Considering all other parameters are the same, what significant drug-drug interaction is expected to take place when both drugs are administered simultaneously?
A. Drug X will have a higher plasma concentration than Drug Y.
B. Drug Y will not be filtered by the renal glomerulus.
C. Drug Y will not be available to interact with its receptors in the tissues.
D. The free plasma drug concentration of Drug Y will increase.
E. Drug X can exert its full biologic activity.
D
Only the free, unbound drug can interact with receptors, exert biologic activity, and be excreted by the kidneys.
14
Dissociative anesthesia is effectively achieved by the combination of:
A. Thiopental, diazepam, ketamine
B. Ketamine, nitrous oxide, fentanyl
C. Succinylcholine, thiopental, diazepam
D. Nitrous oxide, halothane, fentanyl
E. Succinylcholine, halothane, thiopental
B
15
Among the inhaled anesthetics, nitrous oxide has the _______ MAC and the ______ potency.
A. Lowest, lowest
B. Lowest, highest
C. Highest, lowest
D. Highest, highest
E. Intermediate, intermediate
C
The MAC is a measure of an inhaled anesthetic's potency. The relationship is inverse.
16
Which properties of digoxin make it an effective treatment in cases of heart failure?
A. Positive inotrope, positive chronotrope
B. Positive inotrope, negative chronotrope
C. Negative inotrope, negative chronotrope
D. Negative inotrope, positive chronotrope
E. None of the above
B
Digoxin also slows AV conduction (negative dromotrope)
17
In anticoagulation, warfarin therapy is usually overlapped with heparin for the first 1-2 days. Why is this so?
A. To achieve supraoptimal anticoagulation during critical periods of illness as warfarin and heparin have synergistic effects.
B. To prevent bleeding as heparin partially counteracts warfarin's hemorrhagic property.
C. Warfarin is metabolized slowly thus leading to a delay in anticoagulation if heparin is not also given.
D. To compensate for warfarin's initial prothrombotic property.
E. Heparin decreases the clearance of warfarin thus achieving greater plasma drug concentration of warfarin.
D
Warfarin acts by vitamin K anatagonism. The initial prothrombotic effect of warfarin is because the synthesis of protein S, an anticoagulant, also depends on vitamin K. Thus, protein S levels decline initially and the effect of protein C (for which it serves as a co-factor) is also diminshed.
18
A commercial product for colds contain the following: Phenylephrine, chlorpheniramine, and paracetamol. Which acts as the decongestant?
A. Paracetamol
B. Chlorpheniramine
C. Phenylephrine
D. Both chlorpheniramine and phenylephrine
E. This product does not contain a decongestant.
C
Phenylephrine constricts blood vessels through stimulation of adrenergic receptors. This acts as a decongestant
19
Which antimalarial drug should not be given to a patient with glucose-6- phosphate dehydrogenase deficiency?
A. Chloroquine
B. Quinine
C. Atovaquoneproquanil
D. Mefloquine
E. Primaquine
E
20
What drug should be given to an immunocompromised patient with CMV retinitis?
A. Acyclovir
B. Vidarabine
C. Indinavir
D. Ganciclovir
E. AZT
D
Ganciclovir is the drug of choice for CMV. Foscarnet is an alternative.
21
What is the pharmacologic basis of using Timolol in open angle glaucoma?
A. Increaed outflow via dilatation of uveoscleral veins
B. It leads to opening of trabecular meshwork
C. It suppresses the ciliary epithelium from producing aqueous humor
D. lt decrease production of aqueous humor by decreasing levels of bicarbonate through cAMP mediated pathway.
E. none of the above
C
MOA: letter A- alpha agonist and epinephrine; B- Cholinomimetics ( physostigmine, pilocarpine) D- there is no such thing cAMP dependent decrease in bicarbonate; however inhibition of Carbonic anhydrase leads to decrease humor production via decreased bicarbonate levels.
22
A 7 yo male was brought to ER secondary to symptoms suggestive of botulinum toxin ingestion, which of the following are likely included in the symptoms of the patient?
A. Muscle fasciculation
B. Bronchoconstriction
C. Increased bowel movement
D. blurred near vision
E. hypertension
D
Botulinum toxin inhibits the release of vesicular contents from all types of cholinergic nerve endings. Since both ganglionic/autonomic and peripheral motor synapse are affected. Patient will present with hypotension and lack of muscular contraction. Blurred near vision is a result of paralysis of ciliary muscle aka cycloplegia
23
Which of the following will increase the arrythmogenic side effect of digoxin?
A. Decrease sympathetic discharge
B. Increase serum Potassium
C. Decrease serum Calcium
D. Increase Parasympathetic discharge
E. None of the above
D
hypokalemia, hypomagnesemia, hypercalcemia, and increase vagal tone increases the risk for digoxin induced arrhytmia
24
Which of the following is correct regarding isosorbide mononitrate?
A. Can be use along with PDE inhibitors compared to other forms of nitroglycerin
B. It has a similar mechanism of action with Nitroprusside by phosphorylation of myosin light chain phosphate
C. It has no direct effect on cardiac muscle
D. the primary mechanism for decrease in BP is due to decrease in afterload
E. B and C are correct
C
ISMN is the oral form of nitroglycerin. Its mechanism is by activating guanylyl cyclase causing an increase in cGMP eventually leading dephosphorylation of MLC. Its antihypertensive effect is primarily via venodilation. It has no direct inotropic or chronotropic effect to the heart. all forms of nitroglycerin should not concomitantly use with anyform of PDEI ( sildenafil) since it will cause profound hypotension and hypoperfusion of critical organs
25
This drug when given IV and supraphysiologic dose will cause conduction block on AV node via increasing K efflux?
A. Verapamil IV
B. Adenosine
C. Fleicanide
D. Amiodarone
E. None of the above
B
Verapamil can also decrease AV node conduction however via blocking L type Ca channels and not K channels. Fleicanide is a class IC drug that affects primarily Na channels present in both atria and ventricles. Amiodarone is the most efficacious of all antiarrhythmic drug since it blocks Na, Ca, K and Beta receptors. the question is specific on its action in reference to AV node. the best answer is adenosine.
26
Which of the following drugs can cause prolonged QT interval leading to Torsade de Pointes arrhytmia?
A. Esmolol
B. Propafenone
C. Procainamide
D. Verapamil
E. None of the above
C
antiarrhytmic drugs that affects the K channel at phase 3 causes prolongation of Action Potential leading prolonged QT interval. These drugs are of the Class IA and III. Class IA drugs - procainamide, quinidine, disopyramide. Class IIIIbutilide, sotalol, dofetilide
27
Which in the following drugs is classified as 5HT1D agonist?
A. Tegaserod
B. Ketanserin
C. Ondansetron
D. Naratriptan
E. None of the above
D
Naratriptan and its prototype Sumatriptan are 5HT 1D agonist use for the treatment of acute migraine and cluster headache. Tegaserod indicated for constipation is a 5HT4 partial agonist.Ondansetron is a 5-HT3 antagonist ise for antiemesis in post operative and postchemotherapy patients. Ketanserin is a 5HT2 antagonist use for controlling the systemic effects of carcinoid syndrome.
28
The primary indication of Epoprostenol?
A. Open angle glaucoma - increase outflow of aqueous humor
B. Severe pulmonary hypertension
C. Postpartum bleeding
D. All of the above
E. None of the above
B
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE last aug 2014. Epoprostenol is a Prostacyclin analog use for dialysis to prevent platelet aggregation and also for pulmonary hypertension. Latanoprost or PGF2a analog is the one use for glaucoma. Misoprostol or RU 486 (PGE1 analog) has an off label indication for induction of labor. it primarily acts as an abortifacient
29
What is the site of action of corticosteroids in terms of its antiinflammatory effect?
A. Cyclooxygenase 1 and 2
B. Phospholipase C
C. Phospholipase A2
D. Thromboxane synthase
E. All of the above
C
Corticosteroids exerts its anti inflammatory effect by inhibiting the Phospholipase A2 enzyme which is responsible for generation of arachidonic acid from membrane lipids. Phospholipase C is not connected with corticosteroids and its function is to generate IP3 and DAG. Cyclooxygenase and thromboxane synthase is primarily inhibit by Coxibs and NSAIDS
30
