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Defined as any substance that brings out a change in biologic function through its chemical actions.



Substance A is a weak acid with a pKa of 3.5. What is the predicted degree of absorption of the said substance if the stomach has a pH of 2.5?
A. It is predominantly unprotonated thus favoring absorption.
B. It is predominantly protonated thus favoring absorption
C. It is predominantly unprotonated thus it is poorly absorbed
D. It is predominantly protonated thus it is poorly absorbed.
E. pKa and pH of a given substance has no relation to degree of absorption

It is predominantly protonated thus favoring the absorption.

If a substance is a weak acid, its protonated form is more lipid soluble and is likely to cross biologic membranes.

Conversely, if it is unprotonated it is more water soluble and undergoes water clearance.


Dependent factors in drug distribution.

Size or the organ
Blood flow
Protein binding


Drug A was given around 5pm. After 1hr its concentration is 50%, and after the 2nd hr it is down to 25%. What is the expected concentration at around 10pm?
A. 3.125%
B. 6.25%
C. 12.5%
D. 10%
E. 100%

3. 125%

The halflife of the drug is 1 hour. After 5 half lives the concentration is now 3.125%


What type of drug elimination is displayed?

First order elimination

Rate of elimination is proportionate to the drug concentration- first order.


Organophosphate is the most common cause of poisoning worldwide. What is the antidote for organophosphate poisoning?
A. Flumazenil
B. N-Acetylcyteine
C. Naloxone
D. Naltrexone
E. Pralidoxime

E. Pralidoxime

Flumazenil is for Benzodiazepine poisoning;

N-Acetylcysteine is for Acetaminophen poisoning;

Naloxone is for opioid overdose.


Acetylcholine is synthesized from acetyl coa ad choline by the enzyme acetyltransferase. Availability of choline is blocked by this choline transport-inhibiting drug:
A. Vesamicol
B. Neostigmine
C. Pilocarpine
D. Hemicholinium
E. Botulinum

D. Hemicholinium

Vesamicol blocks storage of Ach;
Pilocarpine is a cholinomimetic (direct acting);
Neostigmine also a cholinomimetic (indirect acting);
Botulinum prevents release of Ach.


Drugs used for lethal injection.

Thiopental 5g
Pancuronium 100mg
KCl 100 mEqs


46/M with schizophrenia was prescribed with antipsychotic and has been taking it regularly. 6 mos after commencement of drug therapy, noted significant increase in weight and elevated blood sugar level. What is likely the drug given?
A. Clozapine
B. Quetiapine
C. Chlorpromazine
D. Haloperidol
E. Olanzapine

E. Olanzapine

Clozapine: agranulocytosis; Quetiapine: priapism; Chlorpromazine: EPS, Haloperidol: EPS


Lithium is contraindicated to pregnant due to what harmful effect to the fetus?

Eibstein anomaly to the fetus


Antidote for opioid overdose.



This anti thyroid drug reduces size and vascularity of the thyroid gland.
A. Propanolol
B. Radioactive iodine
C. Lugol's solution
D. Propylthiouracil
E. Methimazole

Lugol's solution or SSKI

Propanolol: controls adrenergic symptoms, and also prevents peripheral conversion of t4 to t3;

Radioactive iodine: causes destruction of thyroid parenchyma;

PTU/Methimazole: inhibits thyroid peroxidase reaction.


Imipinem-cilastatin is often given if other drugs are not effective. Its among the drugs considered to be drugs of last resort. Cilastatin inhibits what enzyme?
A. Beta lactamase
B. Acid hydrolase
C. Dehydropeptidase
D. Phosphodiesterase
E. None of the above


Imipinem-cilastatin has a wide spectrum of activity.

Cilastatin inhibits the enzyme dehydropeptidase thus inhibiting renal metabolism of imipinem.


Trastuzumab is a monoclonal antibody given for breast cancer patients. What is its mechanism or action?
A. It is effective for ER/PR (+) tumors
B. It is effective for HER -2/neu receptor (+) tumors
C. Hemorrhagic cystitis is a significant side effect
D. A and B
E. All of the above

Effective for HER-2/neu receptor (+) tumors

Trastuzumab is for Her2/neu (+) breast cancer. Its siginifcant side effect si congestive heart failure.


Cytokine responsible for muscle breakdown and cachexia.



What drug-teratogenic effect is incorrectly paired?
A. ACE inhibitors- Fetal Renal damage
B. Phenytoin-Fetal Hydantoin syndrome
C. Methimazole-Aplasia cutis congenita
D. Penicillamine-cutis marmorata
E. Warfarin-chondroplasia

D. Penicillamine-cutis marmorata

Penicillamine: cutis laxa.

Warfarin as a teratogen depends upon the timing of drug administration. 1st trimester-chondroplasia.2nd trimester-CNS malformation, 3rd trim-bleeding diathesis.


Which of the following accurately describes sympathetic autonomous nervous system?
A. Sympathetic ganglia is located at the paravertebral area.
B. Preganglionic nerve fibers are long and post ganglionic nerve fibers are short
C. Preganglionic nerve fibers secrete norepinephrine
D. Adrenal medulla secretes 80% norepinephrine
E. All of the above.

A. Sympathetic ganglia is located at the paravertebral area.

Preganglionic fiber is short and postganglionic is long,

Pregang fibers secrete acetylcholine, adrenal medulla secretes 80% epinephrine.


Which of the following is an example of atypical antipsychotic?
A. Haloperidol
B. Chlorpromazine
C. Clozapine
D. Fluphenazine
E. Thioridazine

C. Clozapine

Example of atypicals: Clozapine, olanzapine, risperidone, quetiapine, ziprasidone.


A patient came in at the ED with decreased sensorium, BP 1/1 of 90/60, cardiac rate of 90 an respiratory rate of 10. History revealed that he was in a party minutes prior to confinement. Significant PE was (+) pupillary constriction. What is the likely diagnosis?
A. Opioid overdose
B. Alcohol withdrawal
C. Methamphetamine withdrawal
D. Dehydration
E. None of the above

A. Opioid overdose

Mnemonic for opioid overdose (PCR)
pupillary constriction,
comatose (decreased sensorium),
respiratory depression.