NAME DAPH 721 - Pharmacology - Exam A Dr.

Gail Galasko October 29, 1997 PART I Choose the most appropriate answer. Each multiple choice question is worth 2 points. 1. Which of the following drugs inhibits cyclooxygenase irreversibly? a. b. c. d. e. 2. acetylsalicylic acid histamine hydrocortisone ibuprofen nitroprusside

A uterine stimulant derived from membrane lipid is a. b. c. d. e. serotonin (5-HT). histamine. prostacyclin (PGI2). prostaglandin E2. angiotensin (AII).

3.

Inflammatory prostaglandins are produced from arachidonic acid by a. b. c. d. e. phospholipase A2. lipoxygenase cyclooxygenase I cyclooxygenase II glutathione-S-transferase

4.

All of the following statements about opioid analgesics are accurate EXCEPT a. b. c. d. e. opioid analgesics have no significant direct effects on the heart. opioid analgesics stimulate the chemoreceptor trigger zone. opioid analgesics relax smooth muscle of the bladder. opioid analgesics decrease intestinal peristalsis. opioid analgesics cross the placental barrier.

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5. Which ONE of the following actions of opioid analgesics is mediated via kappa receptors? a. b. c. d. e. 6. supraspinal analgesia cerebral vascular dilation spinal analgesia euphoria physical dependence

With continued use of strong opioid analgesics, tolerance develops to all of the following effects EXCEPT a. b. c. d. e. sedation. analgesia. pupillary constriction. decreased response to carbon dioxide challenge. euphoria.

7.

Important effects of aspirin include all of the following EXCEPT a. b. c. d. e. reduction of fever. reduction of prostaglandin synthesis in inflamed tissues. respiratory stimulation when taken in toxic dosage. reduction of bleeding tendency. tinnitus and vertigo.

8.

Important effects of ibuprofen include all of the following EXCEPT a. b. c. d. e. reversal of joint destruction in rheumatoid arthritis. reduction of uterine contractions in dysmenorrhea. reduction of fever. analgesic action in headache. reduction of thromboxane synthesis in platelets.

9.

Salicylate intoxication is characterized by all of the following EXCEPT a. b. c. d. e. hypothermia. hyperventilation. metabolic acidosis. respiratory alkalosis. hypoprothrombinemia.

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10.

Which of the following statements is/are correct? a. b. c. d. e. Eicosanoids originate primarily from arachidonic acid. Leukotrienes are products of lipoxygenases. Leukotriene synthesis can be inhibited by glucocorticosteroids. Eicosanoid synthesis results from activation of phospholipase A2. all of the above

11.

Which one of the following statements about prostaglandins is not true? a. b. c. d. e. Prostaglandin synthesis is inhibited by aspirin. Prostaglandins play an important role in inflammation. Prostaglandins are products of cyclooxygenase activity. Prostaglandins sensitize nerve endings to painful stimuli. Prostaglandin E2 causes vasoconstriction.

12.

Acetaminophen is a. b. c. d. e. antipyretic. hepatotoxic in overdose. analgesic. reduces inflammation in patients with arthritis. (a), (b) and (c)

13.

The cause of death with opioid intoxication is a. b. c. d. e. oxygen apnea. cardiac arrest. terminal convulsions. circulatory collapse. respiratory depression.

14.

High dose aspirin may cause a. b. c. d. e. tinnitus. GIT distress. increased respiration. impotence. (a), (b) and (c)

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15. Which of the following is an opioid that has both agonistic and antagonistic activities? a. b. c. d. e. 16. codeine methadone naloxone meperidine pentazocine

Aspirin a. b. c. d. e. is the drug of choice for fever in children. causes GIT ulceration. may prolong gestation or spontaneous labor. increases bleeding time. (b), (c) and (d)

17.

A patient who has been taking large quantities of aspirin might show increased postoperative bleeding because aspirin inhibits a. b. c. d. e. synthesis of thromboxane A2 and prevents platelet aggregation. synthesis of prostacyclin and prevents platelet aggregation. synthesis of prostaglandin and prevents production of blood platelets. thrombin and prevents formation of the fibrin network. G.I. absorption of vitamin K and prevents synthesis of blood clotting factors.

18.

Acetaminophen a. b. c. d. e. acts by inhibiting cyclo-oxygenase. can induce GIT ulcers. is anti-pyretic. acute toxicity causes renal damage. (a) and (c).

19.

Both codeine and acetaminophen are a. b. c. d. e. metabolized to morphine. frequently used to relieve cough. less potent analgesics than morphine. useful for visceral pain. all of the above.

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20.

Dextromethorphen a. b. c. d. e. is analgesic. is addictive. acts centrally to suppress cough. all of the above none of the above

21.

Morphine a. b. c. d. e. increases gastric acid secretion. increases GIT motility. decreases GIT tone. increases biliary tract pressure. All of the above

22.

When administered as oral centrally acting analgesics, which of the following is considered to have the highest dependence liability? a. b. c. d. codeine oxycodone (in Percodan) propoxyphene (Darvon) pentazocine (Talwin) DIRECTIONS: The following section consists of a list of seven lettered options followed by several numbered items. For each numbered item, select the ONE option that is most closely associated with it. Each answer may be selected once, more than once, or not at all. (2 points each) a. b. c. d. e. f. g. Aspirin Acetaminophen Indomethacin Penicillamine Phenacetin Allopurinol Probenecid

23-25.

23.

A potent inhibitor of cyclooxygenase; used to accelerate closure of a patent ductus arteriosus A relatively safe antipyretic drug with no anti-inflammatory action A drug that is metabolized to a hepatotoxic product; the antidote is acetylcysteine.

24. 25.

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