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Flashcards in Pharmacology Deck (296):
1

This measure relates the dose of the drug required to produce a desired effect to that which produces an undesired effect.

therapeutic index

2

This is the fraction of unchanged drug reaching the systemic circulation following administration by any route:

Bioavailability

3

In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy.

phase 2

4

This is an irreversible inhibitor of GABA aminotransferase and is useful in the treatment of partial seizures and WEST syndrome:

vigabatrin

5

Action of Insulin in the liver:

increase storage of glucose as glycogen

6

Most common adverse effect of insulin:

hypoglycemia

7

Effect of digitalis in the AV node during arrythmias:

AV blockade

8

Immediate metabolic precursor of dopamine that penetrates the blood-brain barrier:

levodopa

9

The following are true of phenoxybenzamine:

B. blocks catecholamine-induced vasoconstriction / D.   stimulates histamine (H1) acetylcholine and serotonin receptors

10

Antiarrhythmic drugs that prolong effective refractory period by prolonging action potential duration:

Bretylium

11

Antiarrhytmic of choice for suppression of recurrences of ventricular tachycardia & fibrillation after termination of the arrhythmia by cardioversion:

Lidocaine

12

The most serious toxic reaction to local anesthetics is:

tonic-clonic convulsions

13

Lithium’s most common side effect/s

polyuria and subclinical hypothyrodism

14

Most important unwanted effect of anti-psychotics secondary to relative choline deficiency.

Tardive dyskinesia

15

Blocks norepinephrine & serotonin reuptake pumps-the “the off switches” of amine transmission

tricyclics

16

Drug interaction of older MAO inhibitor with tyramine ingested in food:

Hypertensive reactions

17

The following are sites of the major classes of anti-hypertensive drugs, except:

Hypothalamus

18

The following statements regarding selection of anti-hypertensive drugs are correct, except:

A. ACE inhibitors are particularly useful in diabetic patients with evidence of renal disease. / B. White race responds better to diuretics and calcium channel blockers than to ß-blockers and ACE inhibitors.* / C. Beta-blockers or calcium channel blockers are useful in patients who have angina. / D. Diuretics or ACE inhibitors are useful who also have CHF

19

The following are the determinants of vascular tone, except:

a.Increasing cGMP / b.Increasing cAMP in the vascular cells / c.Decreasing intracellular calcium* / d.Stabilizing or preventing depolarization of the vascular smooth muscle cell membrane

20

The following are the pharmacodynamics of nitroglycerine, except:

A. Smooth muscle relaxation / B. Decreased ventricular preload / C. Responsible for a decrease in platelet aggregation / D. Increased cardiac output*

21

The following are the pharmacodynamics of NSAIDs, except:

A.      Mediated chiefly through inhibition of biosynthesis of prostaglandins / B.      All NSAIDs inhibit platelet aggregation* / C.      All NSAIDs are anagesic, anti-inflammatory and antipyretic / D.      They are all gastric irritants as well

22

The following are disease-modifying antirheumatic drugs, except:

a.    Methotrexate / b.    Cyclosporins / c.    Corticosteroids* / d.    Azathioprine

23

This agent inhibits cell wall synthesis by binding firmly to the D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide. It inhibits the transglycosylase, preventing further elongation of peptidoglycan and cross-linking.

Vancomycin

24

This agent is a potent inhibitor of microbial protein synthesis. It binds reversibly to the 50 S subunit of the bacterial ribosome and inhibits peptidyl transferase step of protein synthesis. This agent is active against rickettsiae but not chlamydiae:

Chloramphenicol

25

These agents readily bound to calcium deposited in newly formed bone or teeth in young children. When drug is given during pregnancy, it can be deposited in the fetal teeth, leading to fluorescence, discoloration, and enamel dysplasia:

Tetracyclines

26

This drug is split by intestinal microflora to yiels sulfapyridine and 5 aminosalicylate and is widely used in ulcerative colitis, enteritis and other inflammatory bowel diseases.

Sulfasalazine

27

Blocks the conversion of cholesterol to pregnanolone and causes reduction in the synthesis of all hormonally active steroids; used in pts. with breast Ca

aminoglutethimide

28

A glucocoorticoid antagonist that is an antifungal imidazole derivative, that is potent and rather nonselective inhibitor of adrenal and gonadal steroid synthesis:

ketoconazole

29

The most widely used mineralocorticoid, with both mineralocorticoid and glucocorticoid activity:

fludrocortisone

30

Act as a partial agonist at estrogen receptors in the pituitary, to treat infertility in women by stimulating ovulation:

clomiphene

31

An antiandrogen that prevents synthesis of dihydrotestosterone by inhibiting the activity of 5-α reductase:

finasteride

32

Effects of progesterone:

affects protein metabolism

33

Mazzoti reaction, as an adverse effect is seen with the use of this agent, characterized as eosinophilia, rashes due to the release of foreign particles from the dying microfilariae: :

diethylcarbamazine

34

A depolarizing muscular blocking agent used as an alternative to mebendazole in the treatment of ascariasis and enterobiasis:

pyrantel pamoate

35

Kills dormant liver forms in malaria:

primaquine

36

The drug that could accelerate antithrombin activity resulting to blockade of the coagulation cascade at the at the thrombin level, thus preventing the formation of a clot is:

Heparin

37

This is an antiplatelet drug whose mechanism of action involves inhibition of thromboxane synthesis, thus consequently, prevention of platelet aggregation & thrombus formation:

Aspirin

38

Among the thioamide antithyroid drug, which one is preferred for pregnant women because it crosses the placental barrier less readily thus will not affect the fetus?

Propylthiouracil

39

Which beta blocker is most widely used to control the symptom of hyperthyroidism?

Propranolol

40

Drugs that competitively inhibit CYP enzymes cause

Increase in concentration of object drug

41

The mechanism of action of benzodiazepines is explained by:

Increase frequency of GABA – gated chloride channel opening

42

The use of benzodiazepines in the chronic treatment of seizures is limited because of their

tolerance

43

Which should be observed to minimize adverse effects of sedative hypnotics?

Efficacy of therapy is based on patient’s subjective response

44

A 50 y/o male coca cola executive was using fluoxetine for depression but decided to stop taking the drug for it affects his sexual performance and even said “he is getting older”. He is also a tobacco user. What is the next best drug to use?

Bupropion

45

A fly catching movement of the tongue commonly observed as a drawback of all typical antipsychotics is called

tardive dyskinesia

46

The most hepatotoxic general inhalational anesthetic

halothane

47

A 55 – year old female has post-menopausal osteoporosis. Which is not a recommended drug?

Estrogen

48

Corticosteroid with most potent anti-inflammatory activity:

Betamethasone

49

Drug of choice (DOC) for endometriosis in young women

leuprolide

50

The effect of diethylstilbestrol intake taken during pregnancy on female infants:

vaginal adenocarcinoma

51

The most common adverse effect of clomiphene is

hot flushes

52

A 65 – year old married man was found to have greatly enlarged prostate. Which one of the following drug is MOST likely to suppress prostatic growth without affecting libido?

Finasteride

53

Testosterone therapy may be indicated for the treatment of erectile dysfunction in which of the following situation?

Hypogonadism

54

Major mechanism of action of aspirin as NSAID is

Irreversible PG biosynthesis inhibition

55

Which of the following is the drug of choice for inducing labor

Oxytocin

56

The primary consideration in all clinical trials is to

Provide for the welfare of the subject

57

According to the Philippine National Drug Formulary (PNDF), complementary drugs are:

drugs with special pharmacological properties

58

Which of the following is considered a regulated drug?

pseudoephedrine

59

Differences in the rate of acetylation of isoniazid among groups of individuals exemplifies.

pharmacogenetics

60

Absorption of most orally administered drugs occurs in the small intestine. This may be enhanced by:

taking agents that accelerate gastric emptying time

61

The nicotinic acetylcholine receptors are categorized as to which type?

ion channel-linked

62

If a drug has a high distribution volume, it indicates:

there is extensive tissue uptake

63

The index of safety of a drug decreases as the median toxic dose :

decreases and the median effective dose increases

64

What is the major second messenger of beta receptor activation that participates in signal transduction?

cAMP

65

In what condition are the drugs phenoxybenzamine and phentolamine useful?

pheochromocytoma

66

Acetylcholine acts by:

activating the IP3, diacylglycerol pathway

67

Which of the following antihypertensive agents has the best documented evidence for prophylaxis against migraine attacks?

propranolol

68

Which is a direct effect of nitrates when given in the usual doses for the management of angina?

smooth muscle relaxation

69

A college friend consults you regarding the suitability of the therapy his doctor has prescribed for severe hypertension. He complains of postural and exercise hypotension ("dizziness"), some diarrhea, and problems with ejaculation during sex. Which of the following is most likely to produce the effects that your friend has described?

guanethidine

70

The most important pharmacologic action of digitalis in the treatment of heart failure is its ability to:

increase myocardial contractile force

71

Side effects of oxytocin use in a woman in labor includes the following, EXCEPT:

A. increase in BP / B. uterine rupture / C. fetal death / D. Diuresis*

72

An antithyroid drug which may be given to reduce the vascularity of the thyroid gland prior to thyroidectomy:

Lugol's iodine

73

Drugs that decrease bone resorption include the following, EXCEPT:

A. Calcitonin / B. Estrogen / C. Alendronate / D. Fluoride*

74

Which drug is used as an antiretroviral agent?

indinavir

75

Which of the following enzymes is inhibited by the binding of a beta lactam antimicrobial with penicillin-binding proteins (PBPs)?

transpeptidase

76

A poor farm helper from Palawan was diagnosed to have falciparum malaria by blood smear. The safe, cost-effective, and readily available agent to prescribe if this farmer has an allergy to sulfonamides is:

quinine

77

Radical cure for malaria is achieved by giving:

primaquine

78

There is a sudden increase of atypical pneumonia secondary to Mycoplasma, Chlamydia, and Rickettsia in the Pneumonia Ward of a tertiary hospital. Majority of patients were treated with doxycycline. All of the following ADRs are to be watched out for in these patients EXCEPT:

renal failure

79

Which of the following agents may predispose to the development of pseudomembranous colitis?

clidamycin

80

A patient with persistent chronic cough and fever had no response to adequate doses of oral penicillin. The PE showed normal chest findings. Further PE showed bullous myringitis. A chest Xray showed infiltrates in the right lower lobe. Which of the following antimicrobials would be effective?

chlarithromycin

81

A 4 year old boy that has diarrhea and malnutrition was noted to have a mixed parasitic infection of Ascaris, Capillaria philippinensis, and Trichiuris trichiura. The single agent that could be effective for this patient is:

mebendazole

82

Activated charcoal may be used to treat poisoning due to the following EXCEPT:

A. Primaquine / B. Aspirin / C. Propoxyphene / D. iron overdose *

83

This herbal plant endorsed by the DOH is useful for the relief of muscle pain:

Yerba Buena

84

On regular follow-up for tuberculosis, you noticed that the visual acuity of Vilma worsened from 20/20 to 20/50 in both eyes after only three weeks of HRPE. Your approach in management would be to discontinue:

D. ethambutol, reintroduce it after 1 week, and refer to an ophthalmologist

85

Phenytoin is administered intravenously for acute management of seizure, but when given at a rapid rated can cause

cardiac arrhythmia

86

Which anticonvulsant is safe in pregnancy?

A. hydantoin / B. trimethadione / C. valproic acid / D. none of the above*

87

Which of the following is a common mechanism of action shared by all NSAIDs?

Inhibition of the production of prostaglandin and thromboxane from arachidonic acid through inhibition of prostaglandin H synthesis

88

The primary reason why aspirin has been displaced by NSAIDs as first choice drug of pediatric rheumatologists is because:

need for frequent administration and association with Reye’s syndrome

89

The intravenous anesthetic producing the so-called "dissociative anesthesia" is:

ketamine

90

Your patient requests you to give her a sedative-hypnotic that not will not only calm her down or put her to sleep but will make her forget the whole operating room experience as well. To facilitate this request your drug regimen should include:

midazolam

91

The process by which the amount of drug in the body is reduced after administration but before entering the systemic circulation is called

First-pass Effect

92

Which of the following terms best describes an antagonist that interacts directly with the antagonist and not at all, or only incidentally, with the receptor?

Chemical antagonist

93

A child has swallowed the contents of 2 bottles of a nasal decongestant whose primary ingredient is a potent, selective a adrenoceptor agonist drug. The signs of alpha activation that may occur in this patient include

Cardioacceleration (tachycardia)

94

Ms. Green has severe hypertension and is to receive minoxidil. Minoxidil is a powerful arteriolar vasodilator that does not act on autonomic receptors. When used in severe hypertension, its effects would probably include

Tachycardia and increased cardiac contractility

95

Several children at a summer camp were hospitalized with symptoms thought to be due to ingestion of food containing botulinum toxin. The effects of botulinum toxin are likely to include

Cycloplegia

96

Parathion has which one of the following characteristics?

Its toxicity, if treated early, may be partly reversed by pralidoxime

97

Ms. Brown has had myasthenia gravis for several years. She reports to the emergency department complaining of rapid onset of weakness of her hands, diplopia, and difficulty swallowing. She may be suffering from a change in response to her myasthenia therapy, ie, a cholinergic or a myasthenic crisis.The best drug for distinguishing between myasthenic crisis (insufficient therapy) and cholinergic crisis (excessive therapy) is

Edrophonium

98

A 30-year-old man has been treated with several autonomic drugs for 4 weeks. He is now admitted to the emergency department showing signs of drug toxicity. Which of the following signs would distinguish between an overdose of a ganglion blocker versus a muscarinic blocker?

Postural hypotension

99

Dilation of vessels in muscle, constriction of cutaneous vessels, and positive inotropic and chronotropic effects on the heart are all actions of

Epinephrine

100

Adverse effects that limit the use of adrenoceptor blockers include Heart failure exacerbation from b-blockers

Impaired blood sugar response with a-blockers

101

Which of the following binds covalently to the site specified?

Phenoxybenzamine-a receptor

102

Which one of the following is characteristics of enalapril treatment in patients with essential hypertension?

Decreases angiotensin II concentration in the blood

103

A visitor from another city comes to your office complaining of incessant cough. He has diabetes and hypertension and has recently started taking a different antihypertensive medication. The most likely cause of his cough is

Captopril

104

Verapamil is associated with all of the following, EXCEPT:

A.   Bradycardia / B.    Hyperglycemia* / C.    Increased PR interval / D.    Pretibial edema

105

The antianginal effect of propranolol may be attributed to which one of the following?

Block of exercise-induced tachycardia

106

A patient is admitted to the emergency department following a drug overdose. He is noted to have a severe tachycardia. He has been receiving therapy for hypertension and angina. A drug that often causes tachycardia is

Isosorbide dinitrate

107

Drugs that have been found to be useful in one or more types of heart failure include all of the following, EXCEPT

A.   Na+/K+ ATPase inhibitors / B.    Alpha-adrenoceptors agonist* / C.    Beta-adrenoceptors antagonists / D.    ACE inhibitors

108

The mechanism of action of digitalis is associated with

An increase in systolic intracellular calcium levels

109

A patient with long-standing diabetic renal disease and hyperkalemia and recent-onset heart failure requires a diuretic. Which of the following agents would be LEAST harmful in a patient with severe hyperkalemia?

Hydrochlorothiazide

110

Inflammation is a complex tissue reaction that includes the release of cytokines, leukotrienes, prostaglandins, and peptides. Prostaglandins involved in inflammatory processes are produced from arachidonic acid by

Cyclooxygenase-2

111

Which of the following situations constitutes an added risk of digoxin toxicity?

Adminstration of quinidine

112

Successful therapy of heart failure with digoxin will result in which one of the following?

Decreased heart rate

113

When used as an antiarrhythmic drug, lidocaine typically

Reduces abnormal automaticity

114

Which of the following is a recognized effect of nitric oxide (NO)?

Pulmonary vasodilation

115

One effect that theophylline, nitroglycerin, isoproterenol, and histamine have in common is

Tachycardia

116

Nedocromil has as its major action

Block of mediator release from mast cells

117

You are on your way to take an examination and you suddenly get an attack of diarrhea. If you stop at a nearby drugstore for an over-the-counter opioid with antidiarrheal action, you will be asking for

Loperamide

118

Conversion of plasminogen to plasmin is brought about by

Reteplase

119

Which of the following pairs of a drug effect and mechanism of action is accurate?

Indomethacin closure of patent ductus arteriosus: blocks prostaglandin E production in the ductus arteriosis of the newborn

120

A 52-year-old woman presented with intense pain, warmth, and redness in the first toe on her left foot. Examination of fluid withdrawn from the inflamed joint revealed crystals of uric acid. In the treatment of this woman’s acute attack of gout, the advantage of using indomethacin instead of colchicines is that indomethacin is

Less likely to cause severe diarrhea

121

A 27-year-old woman with amenorrhea, infertility, and galactorrhea was treated with a drug that successfully restored ovulation and menstruation. Before being given the drug, the woman was carefully questioned about previous mental health problems, which she did not have. She was advised to take the drug orally. The drug used to treat this patient was probably

Bromocriptine

122

Methimazole reduces serum concentration of T3 primarily by

Preventing the addition of iodine to tyrosine residues on thyroglobulin

123

Pharmacologic effects of exogenous glucocorticoids include

Inhibition of leukotriene synthesis

124

Toxic effects of long-term administration of a glucocorticoid include

Osteoporosis

125

For patients who have been on long-term therapy with a glucocorticoid and who now wish to discontinue the drug, gradual tapering of the glucocorticoid is needed to allow recovery of

The hypothalamic-pituitary-adrenal system

126

The estrogen that is used in most combined hormonal contraceptives is

Ethinyl estradiol

127

The most likely complication of insulin therapy in this patient is

Hypoglycemia

128

A 54-year-old obese patient with type 2 diabetes and a history of alcoholism probably should not receive metformin because it can increase the risk of

Lactic acidosis

129

Which of the following drugs is MOST likely to cause hypoglycemia when used as monotherapy in the treatment of type 2 diabetes?

Glyburide

130

A patient needs antibiotic treatement for native valve, culture-positive infective entericoccal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with

Vancomycin

131

The mechanism of antibacterial action of tetracyclines involves

Blockade of binding of aminoacyl-tRNA to bacterial ribosomes

132

In patient with culture-positive enterococcal endocarditis who has failed to respond to vancomycin because of resistance, the treatment most likely to be effective is

Linezolid

133

Which of the following adverse effects is most likely to occur with sulfonamides?

Skin reactions

134

On her release from hospital, the patient is advised not to rely solely on oral contraceptives to avoid pregnancy because they may be less effective while she is being maintained on antimycobacterial drugs. The agent most likely to interfere with the action of oral contraceptives is

Rifampin

135

Chemical interactions between this drug and cell membrane components can result in the formation of pores lined by hydrophilic groups present in the drug molecule

Nystatin

136

Which of the following statements about fluconazole is most accurate?

It inhibits demethylation of lanosterol

137

Which of the following drugs binds to a viral envelope protein preventing the conformational changes required for the fusion of viral and cellular membranes?

Enfuvirtide

138

Which of the following is NOT an expected effect of muscarinic agonists instilled into the conjunctival sac?

Mydriasis

139

Nausea, vomiting, diarrhea, urinary urgency, salivation, sweating, cutaneous vasodilation and bronchial constriction are caused by an overdose of:

Pilocarpine

140

In normal individuals and more so in patients with airway disease, the administration of this agent causes cause some bronchodilation and reduction in secretion.

Atropine

141

This agent relieves motion sickness and is as effective as any more recently introduced agent but causes significant sedation and dry mouth.

Scopolamine

142

AL, 25y.o. male patient is brought to the emergency room suffering from bronchospasm, mucous membrane congestion, angioedema, and severe hypotension. The appropriate drug is:

Epinephrine

143

BM, 50 yo female is asthmatic and hypertensive. The following class of drugs should be avoided as maintenance treatment for her hypertension.

Beta-blockers

144

Which of the following CNS neurotransmitters has only an inhibitory mechanism of action?

GABA

145

Which among the following sedative-hypnotic drugs has the longest elimination half-life and is ingested as a prodrug that is hydrolyzed to its active form in the stomach?

Clorazepate

146

This drug is a novel hypnotic drug prescribed for patients who have difficulty in falling asleep. In polysomnography studies of patients with chronic insomnia, this drug reportedly reduced the latency to persistent sleep with no rebound insomnia or withdrawal symptoms.

Remelteon

147

EJ, 35 yo executive often awakens early in the sleep cycle and could hardly go to sleep again. He may probably benefit from which of the following drugs?

Zolpidem

148

GM, 30 yo female experiences visual scotomas followed after around 30 minutes by a severe throbbing right-sided headache that would last 4 – 8 hours if untreated. Which group of drugs isalmost exclusively used for this condition?

Triptans

149

This drug is effective in reducing pain of mild to moderate intensity through its effects on inflammation and because it probably inhibits pain stimuli at a subcortical site.

Aspirin

150

IT, 60 yo male suffers from excruciatingly painful inflammation of the big toe after binge eating. The following agents may be helpful except?

Tolmetin

151

YH, 62 yo female is suffering from rheumatoid arthritis. Her physician strongly believes that this condition causes significant systemic effects which shorten life in addition to the joint disease that reduces mobility and quality of life. He decides to give her metothrexate, the disease-modifying antirheumatic drug (DMARD) of choice for her condition. The most common adverse effects of this drug is:

nausea and mucosal ulcers

152

This antihypertensive drug is approximately equipotent to propranolol in inhibition stimulation of b1-adrenoceptors but 50- to 100-fold less potent than propranolol in blocking b2-adrenoceptors.

Metoprolol

153

This antihypertensive agent illustrates how one person’s toxicity may be another person’s therapy in that it causes hirsutism, which is bothersome in women but a topical formulation is used to stimulate hair growth, which is beneficial for many men.

Minoxidil

154

This antihypertensive drug may cause severe hypotension in hypovolemic patients, acute renal failure. Hyperkalemia, dry cough sometime accompanied by wheezing, and angioedema.

Captopril

155

MF, 45 yo female with evidence of chronic kidney disease was also diagnosed with hypertension. Which of the following drugs may be helpful for both of her conditions>

Captopril

156

GG, 68 yo female teacher has chronic heart failure with left ventricular dysfunction but no edema. The first drug to be used for her are

ACE inhibitors

157

Chloroquine is effective in the treatment of nonfalciparum and sensitive falciparum malaria but it causes which of the following common side effects?

pruritus

158

The common adverse effects of Quinine in treating falciparum malaria include the following, except

a. tinnitus / b. hemoglobinuria* / c. flushing / d. visual disturbances

159

TT, 7yo male public elementary school student develops mixed soil-transmitted helminthic infections. Which of the following drugs is appropriate?

Mebendazole

160

This group of antimicrobials kills bacterial cells interfering with the transpeptidation reaction of bacterial cell wall synthesis

b-lactam antibiotics

161

The following penicillins are resistant to Staphylococcal beta lactamases, except

a. Methicicillin / b. Amoxicillin* / c. Nafcillin / d. Cloxacillin

162

Which of the following drugs is more stable to bacterial b-lactamases?

Cephalexin

163

The class of cephalosporins with expanded gram-negative coverage with some agents being able to cross the blood-brain barrier, but with 2 agents effective vs. P aeruginosa.

Third generation

164

ME, 33 yo male develops pneumonia and was given penicillin but develops allergy. He was given an alternative drug which had to be discontinued because of gastrointestinal intolerance due to direct stimulation of gut motility. This drug is most probably.

Erythromycin

165

This agent participates in conversion of diatary folate to tetrahydrofolate and isomerization of methylmalonyl-CoA to succinyl CoA and is effective in the treatment of megaloblastic anemia.

Vitamin B12

166

BV, 45 year old female suffers from chronic kidney disease due to diabetic nephropathy leading to recurring anemia. Which of the following agents is most useful for this patient?

Erythropoietin

167

TU, 3 yo male has manifest slowing down of bodily functions leading to striking retaration of growth and development leading to very slow growth and some degree of mental retardation. The most satisfactory preparation for replacement therapy in this case is.

Levothyroxine

168

GF, 25 yo female manifests with warm moist skin, sweating, heat intolerance, periorbital edema, retraction of upper lid with wide stare, exopthalmos an diplopia. The management of this condition involves the following, except:

a. Methimazole / b. Thyroidectomy / c. 131 Iodine / d. None of the above*

169

This agent is a prohormone that serves as a precursor to a number of biologically active metabolites, including calcitriol.

Vitamin D

170

Which of the following is an inscription and translation of a violative prescription based on the Generics Act of 1988?

Amoxil 500 mg caps ---------------------#21

171

All of the following factors can affect the rate and extent of drug absorption EXCEPT

A.      Lipophilicity / B.      intestinal motility / C. protein binding* / D. presence of P glycoprotein transporter

172

Which of the following factors is TRUE regarding drug distribution?

In general, a drug with a higher degree of plasma protein binding will have a lower Vd.

173

The amount of a drug dose that reaches the systemic circulation in the unchanged form is:

Bioavailability

174

A laboratory experiment is being conducted in which an animal is injected with a non-competitive antagonist to the histamine receptor. Which of the following best describes this drug?

The drug binds to the receptor, but not where histamine binds and prevents the receptor from being activated.

175

The rate and extent of absorption of a drug is decreased by:

addition of carbon-nitrogen bond ( quaternary amine )

176

At low doses, dobutamine receptor selectivity and activity will primarily result to:

increase in cardiac contractility

177

Antiarrythmic with the most marked K-blocking effect

amiodarone

178

Blocks the final common pathway of platelet aggregation:

A.      Ticlopidine / B.      Clopidogrel / C. abciximab /D. ASA

179

Drug interaction seen with concomitant spironolactone and ACE inhibitor use

Enhanced hyperkalemia*

180

The following anti-hypertensive drug should be used with caution in patients on potassium-sparing diuretics

Losartan

181

Accumulation of bradykinin due to ACE inhibition is responsible for these adverse effects EXCEPT one:

A.      Cough / B.      Hypotension / C. angioedema/ D. hyperkalemia*

182

The absence of reflex tachycardia with the use of ACE inhibitors is due to

downward resetting of the baroreceptor

183

This adverse effect of nitrates can be prevented by providing nitrate-free interval between administration

tachycardia

184

Which of the following drug combinations will give the best hemodynamic effects of decreasing filling pressure and increasing cardiac output in CHF patients?

furosemide and dopamine

185

The drug of choice for converting paroxysmal atrial tachycardia to normal sinus rhythm

adenosine

186

This class I antiarrhythmic drug has marked negative inotropic action and therefore should not be used in patient with heart failure

lidocaine

187

The risk of Torsades des pointes is highest with the use of

amiodarone

188

Drug-induced lupus is an adverse effect of

A.      Procainamide / B.      Amiodarone / C. disopyramide / D. amiloride

189

A 60 year old male has dilated cardiomyopathy and is on digoxin. He complains of nausea and vomiting and you think he has digitalis toxicity. Which of the following drugs he is taking most likely enhanced this?

Furosemide

190

The positive inotropic action of cardiac glycosides is associated with

decreased outward flow of calcium*

191

A patient in CHF has developed oliguria because of low cardiac output. To improve renal perfusion, dopamine must be given at this dose in ug/kg/min

2

192

A.M. a 55 year old known hypertensive was found to have heart block on ECG. Which of the drugs below should not be given?

   A.  Spironolactone / B.      Verapamil*

193

Rapid intravenous administration of this drug may cause respiratory depression:

phenobarbital

194

This drug increases free phenytoin levels due to protein binding displacement.

salicylates

195

Which of the following antidepressants will produce a life-threatening syndrome of hyperthermia, muscle rigidity and myoclonus when administered with MAO?

Fluoxetine

196

Ideally, baseline liver function tests are done prior to giving this anticonvulsant

valproic acid

197

Elimination of this anticonvulsant is enhanced significantly by alkalinization of the urine

Phenobarbital

198

Orthostatic hypotension is most common with which of the following antipsychotic agents:

chlorpromazine

199

Carbamazepine exerts its antiepileptic effect through

reduction of Na+ current

200

Based on the mechanism of action, the following antimicrobial is NOT selectively toxic:

cotrimoxazole

201

Which of the following antibiotics is effective against both aerobes and anaerobes?

chloramphenicol

202

This antibiotic is frequently associated with 8th nerve damage in the offspring if given to pregnant women, thus classified under pregnancy risk category D

streptomycin

203

Maculopapular rash with this antibiotic is non-immunologic in nature and does not preclude the use of chemically related antibiotics in the future

amoxicillin

204

A 15 year old college student came in because of headache, fever, chills and photophobia. Thick and thin smears showed P. vivax. The oral drug of choice to rid the blood of plasmodia is

chloroquine

205

Mebendazole is effective against the following parasites EXCEPT

A.      capillaria philippinensis* / B.      ascaris lumbricoides / C. necator americanus / D. trichuris trichiuria

207

The following adverse reaction to isoniazid is age-related

hepatitis

208

A 50 year old male receiving anti-TB treatment develops mono-articular arthritis. Which of the following could have caused it?

 pyrazinamide and ethambutol

209

Of the following, the mechanism of actions of this antifungal does not involve inhibition of cell membrane synthesis

flucytosine

210

Aromatase inhibitor used in the treatment of breast cancer

anastrazole

211

Which of the following statements is TRUE regarding the direct genomic pharmacodynamic action of glucocorticoids (GC)?

GCs diffuse into cell cytoplasm and bind to steroid receptors leading to release of heat shock proteins and dimerization of steroid – receptor complexes which translocate into nucleus and bind to GRE, inducing or inhibiting gene transcription

212

The main mechanism of action is to lower post meal glycemic excursion:

acarbose

213

This drug is an estrogen agonist in the bone but an estrogen antagonist in breast tissue:

raloxifene

214

This is essential for the antithyroid activity of thioamides:

thiocarbamide group

215

The main mechanism for its effectiveness in diabetics is the release of endogenous insulin

 sulfonylurea

216

The main action as anti-diabetic agent is to stimulate the nuclear receptors that regulate the transcription of genes encoding proteins involved in protein and carbohydrate metabolism

insulin

217

Which of the following glucocorticoids has the least mineralocorticoid effect and is best for decreasing cerebral edema associated with increased intracranial pressure?

dexamethasone

218

Organophosphate toxicity results from its ability to

  inhibit acetycholinesterase

219

A class of proteins that functions as drug receptors that mediate the actions of endogenous chemical signals such as neurotransmitters and hormones:

regulatory proteins

220

Receptor/s coupled to G protein that modulate the production of intracellular second messengers include/s

  leukotriene receptor

221

The neuromuscular blocker succinylcholine acts by:

Depolarizing muscle endplate receptors

222

Therapeutic benefit/s of a2 receptor agonists include:

A. antihypertensive / B. antiglaucoma / C. antidiarrheal / D. all of the above*

223

Non-benzodiazepine that has affinity for the Benzodiazepine receptors:

Zolpidem

224

Sedative-Hypnotic with low solubility and penetrate the brain slowly includes:

Phenobarbital

225

The following drugs/substance of abuse are CNS stimulants, EXCEPT:

A. Gamma-hydroxybutyric acid (GHB)* / B. Cocaine / C. Amphetamine / D. Methylenedioxy-Methamphetamine (MDMA, Ecstasy)

226

Characteristic physiologic sign of Cannabis intoxication includes:

increased pulse rate

227

Which among these intravenous general anesthetics produces a dissociative type of anesthesia?

Ketamine

228

Painless digital vasospasm is a dose-related complication of long term treatment with:

Bromocriptine

229

The peripheral metabolism to Levodopa can be prevented if it is given concomitantly with:

Carbidopa

230

An overdose of this opioid causes mydriasis instead of the characteristic miosis of opioid toxicity:

Meperidine

231

Which of these group of tissues would be the first to take up appreciable amounts of inhalational anesthetics?

Vessel-rich

232

A narcotic-addicted patient is given this drug as a “substitute” to be able to control the withdrawal symptoms:

Methadone

233

The duration of action of the intravenous barbiturate anesthetic thiopental is largely determined by:

Redistribution

234

This drug inhibits binding of leukotriene D4 to its receptor on target tissues

Montelukast

235

The mechanism of action of corticosteroids in the treatment of bronchial asthma includes

  inhibit airway mucosal inflammation

236

A non-steroidal anti-inflammatory drug that irreversibly acetylates and blocks platelet cycloocygenase is

  Aspirin

237

Corticosteroids must be used with great caution in patients with

A. osteoporosis / B. varicella / C. peptic ulcer /D. all of the above*

238

The most common adverse effect of Aspirin is

gastric upset and ulcers

239

A uricosuric drug that decreases body pool of urate in patients with tophaceous gout is

  Probenecid

240

Sinoatrial and atrioventricular nodal tissue are affected markedly by

Verapamil

241

The beneficial effect of Captopril in patients with heart failure is attributed to:

reduction in afterload

242

Beta blockers with membrane-stabilizing action, useful as anti-arrhythmics include:

A.   Metoprolol / B.   Propranolol / C.   Acebutolol / D.   All of the above*

243

Which of the following antiarrhythmic drugs act by blocking sodium channel?

Lidocaine

244

Antibiotic/s shown to be effective when applied topically in the treatment of acne vulgaris include/s:

A.   Clindamycin / B.   Erythromycin / C.   Metronidazole / D.   All of the above*

245

This organophosphate compound is thought to have a cholinesterase inhibitory action which temporarily paralyzes the adult Schistosoma haematobium worms.

 Metrifonate

246

Which of these drugs selectively inhibits microtubule synthesis and glucose uptake in nematodes?

Mebendazole

247

For onchocerciasis and strongyloidiasis, this drug is the first choice because it causes fewer systemic and ocular reactions:

Ivermectin

248

Most of the serious adverse effects of Penicllins are due to:

Hypersensitivity reactions

249

The following anti-TB drugs are potentially hepatotoxic, EXCEPT:

A. Rifampin / B. Isoniazid / C. Pyrazinamide / D. Streptomycin*

250

This Anti-TB is relatively contraindicated in young children whose visual acuity and red-green color assessment can not be adequately assessed:

  Ethmabutol

251

This antibacterial is available as a nasal ointment useful in the elimination of nasal carriage of Staphylococcus aureus:

  Muprocin

252

A drug that is used almost solely as an alternative treatment for gonorrhea in patients whose gonococci are resistant to other drugs is:

Spectinomycin

253

Excessive anticoagulant effect results in bleeding from Warfarin can be reversed by:

A. discontinuance of the drug / B. administration of Vitamin K / C. administration of fresh frozen plasma / D. all of the above*

254

The amount of elemental iron per 325 mg tablet of hydrated ferrous sulfate is ___ mg:

65

255

The preparation of choice for thyroid replacement and suppression therapy is:

Levothyroxine

256

The combination of estrogens and progestins exert their contraceptive effect largely through

inhibition of pituitary function

257

The most dangerous complication of Thioamides is:

agranulocytosis

258

The major use of this drug is in the treatment of endometriosis

Danazol

259

The best treatment option for an obese patient with NIDDM with associated insulin resistance syndrome is:

Metformin

260

Treatment Regimen III as indicated in the National Tuberculosis Control Program consists of:

2HRZ / 4HR

261

The study of the absorption, distribution, metabolism and excretion of drug is known as:

 Pharmacokinetics

262

First – pass effect is more likely to occur with this route of administration :

Oral

263

Inert binding sites bind a drug without initiating events leading to a drug effect. They are located in:

Plasma proteins

264

Drug A at a dose of 100 mg. produces the same effect as drug B at a dose of 1000 mg. One of the following statements is correct regarding the two drugs:

Drug A is more potent than Drug B

265

Drugs with very high volume of distribution:

have higher concentrations in extravascular tissue

266

Bioavailability of a drug is 100% following this route of administration:

intravenous

267

Drug biotransformation may result in formation of:

A. inactive metabolites / B. reactive intermediates that are toxic to various organs/ C. an active substance from a prodrug / D. all of the above*

268

Selective COX-2 inhibitors differ from nonselective COX inhibitors in that selective COX-2 inhibitors have no:

gastrointestinal side effects

269

Pharmacologic effects of alcohol include stimulation of the:

secretion of gastric acid

270

One of the following general anesthetics with their respective blood:gas partition coefficients is most soluble in blood:

Methoxyflurane 12.0

271

Reserpine blocks this step in adrenergic transmission:

incorporation of norepinephrine into the vesicle

272

A 24 year old male was brought to the emergency room after having allegedly drank poison. He had constricted pupils, was noted to have salivation and sweating, wheezing, vomiting and diarrhea: The poison must have been:

organophosphate

273

Therapeutic applications of atropine include/s:

bradycardia caused by myocardial infarction

274

Mechanism of action of pralidoxime:

regeneration of the enzyme

275

Compared to norepinephrine, epinephrine has more effects on:

beta 2 receptors

276

Drugs like quinidine, procainamide and disopyramide are useful in the treatment of:

arrhythmia

277

A 65-year old male was admitted at the intensive care unit disoriented with a blood pressure of 220/120. Which of the following drugs will be most appropriate:

Sodium nitroprusside

278

Propranolol and other beta-adrenergic receptor antagonist have the following effect/s on the heart that makes them useful as antiarryhthmic agents:

A. Depress automaticity / B. Prolong A-V conduction / C. Reduce heart rate/ D. All of the above*

279

All of the following are true of sodium nitroprusside EXCEPT:

A.    The gold standard for use in hypertensive crisis / B.     Mechanism of vasodilating effects similar to nitrates / C.     Sensitive to light / D.    Metabolite is pharmacologically inert*

280

In patients with congestive heart failure, the use of angiotensin converting enzyme inhibitors will increase

salt and water excretion

281

One of the following antianginal agents is contraindicated in patients with vasospastic angina:

Propranolol

282

Methyldopa as antihyperatensive agent exerts its effect by conversion to alpha-methylnorepinephrine which stimulates centrally this receptor:

alpha-2

283

Aminopenicillins, Carboxypenicillins and Ureidopenicillins compared to Penicillin G:

Have greater activity against gram-negative bacteria

284

Clavulanic acid is added to Ampicillin in order to:

Protect the beta-lactam ring from destruction

285

The most common side effect of erythromycin is:

   Gastroinetstinal upset

286

Bacterial synergism is produced by the following drug combination:

    Cephalexin and gentamycin

287

This antimicrobial drug may provoke acute gouty arthritis:

   Pyrazinamide

288

This agent is proven effects for influenza A:

   Amantadine

289

This agent apparently acts as a GABA agonist at the neuromuscular junction and causes flaccid paralysis of the nematode:

    Piperazine

290

This antimicrobial agent is also effective for amebic abscesses that fail initial therapy with metronoidazole:

   Chloroquine

291

Adverse effects of aminoglycosides include all, EXCEPT:

A.    Nephrotoxicity / B.     Cardiotoxicity* / C.     Neuromuscular blockade / D.    Ototoxicity

292

The most common use of estrogen in therpeutics is:

Component of contraceptice pills

293

This is a partial agonist inhibitor of estradiol at the estrogen receptor and used in the palliative treatment of advanced breast cancer:

Tamoxifen

294

Clomiphone enhanced pregnancy by:

Inhibiting estradiol’s negative feedback

295

The most common side effect of insulin is:

Hypoglycemia

296

Actions of Vit. D include:

Promote absorption of calcium and phosphate from the intestine

297

The following antiviral agents DOES NOT require activation by phosphorylation and it directly inhibits DNA and RNA polymerases as well as HIV reverse transcriptase

Foscarnet