MODULE 4 - PHARMACOLOGY

Instruction:
1. Detach one (1) answer sheet from the bottom of your Examinee Answer sheet set
2. :ULWHWKHVXEMHFWWLWOH´PharmacologyµRQWKHER[SURYLGHG
3. 6KDGH6HW%R[´$µRQ\RXUDQVZHUVKHHWLI\RXUWHVWERRNOHWLV6HW$6HW´%µLI\RXUWHVWERRNOet is Set B

1. The most predominant plasma protein

a. Albumin d. all of the above
b. Alpha-acid glycoprotein e. None of the above
c. Actin
2. The major sites of drug elimination
a. liver and kidneys d. liver and skin
b. kidneys and lungs e. none of the above
c. lungs and liver
3. The most important parameter used in therapeutic drug monitoring
a. half life d. volume of distribution
b. elimination rate constant e. none of the above
c. clearance
4. Elimination rate
a. The ratio of the amount of a drug in the body to its plasma concentration
b. Clearance multiplied by the plasma concentration
c. The fraction of the administered dose of the drug that reaches the systemic circulation
d. The time it takes for the amount or concentration of a drug to 50% of its initial measurement
e. none of the above
5. Absorption by diffusion across the cell membrane is best represented by
a. Henderson-Hasselbalch equation d. )LFN·V/DZ
b. 'DOWRQ·V/DZ e. None of the above
c. Michaelis-Menten equation
6. Which of the following follows capacity-limited kinetics?
Hours after drug Plasma Plasma
administration concentration concentration
(mg/dL) of (mg/dL) of
DRUG A DRUG B
0 hour 500 200
2 hours 300 100
4 hours 100 50
6 hours 0 25

a. Drug A c. Drugs A and B

b. Drug B d. None of the above
7. The following factor(s) affect the passive transport of drugs through the cell membrane:
a. Lipid-water partition coefficient
b. Magnitude of the concentration gradient across the membrane
c. Difference of pH across the membrane
d. A and B only
e. A, B and C
8. The following statements are true EXCEPT:
a. The rate of absorption of a drug from the intestine will be greater than that from the stomach because of
the large surface area.
b. Venous drainage from the mouth is to the superior vena cava. Drugs administered sublingually are not
subjected to first-pass metabolism.
c. Absorption in the gastrointestinal tract is favoured when the drug is in the non-ionized and more
hydrophilic form.
d. Any factor that accelerates gastric emptying will be likely to increase the rate of drug absorption
e. None of the above
MODULE 4 - PHARMACOLOGY

9. the plasma, drugs such as phenytoin, salicylates & disopyramide are extensively bound to:
a. Alpha-immunoglobulin d. Gamma-globulin
b. Alpha1-acid glycoprotein e. None of the above
c. Albumin
10. Enzyme induction of a cytochrome P450 enzyme results in
a. Accelerated substrate metabolism
b. Decrease in pharmacologic action of the inducer
c. Decrease in pharmacologic action of the co-administered drug
d. A and B
e. A, B and C
11. The following are established inducers of CYP3A4 isozyme EXCEPT
a. Phenobarbital d. Ketoconazole
b. Rifampin e. None of the above
c. Carbamazepine
12. All of the following are reasons that elderly patients are more susceptible to drug-induced cognitive
changes, EXCEPT:
a. they are more likely to take multiple drugs.
b. they may have hepatic dysfunction.
c. they may have renal dysfunction.
d. they are more sensitive to CNS effects of drugs.
e. they have increased metabolic rates for producing psychoactive metabolites
13. This type of chemical bond is very strong and often results in irreversible receptor binding under biologic
conditions.
a. Hydrogen bond d. Hydrophobic bond
b. Covalent bond e. Electrostatic bond
c. Van del Waals forces
14. A drug that promotes activation of a receptor with 80% Emax is termed a/an
a. Antagonist d. Partial agonist
b. Inverse agonist e. None of the above
c. Full agonist
15. When a weak acid (pKa = 3.9) is exposed to an acidic environment (pH 2), which form of the drug is
predominant?
a. lipid soluble d. A and B
b. hydrophilic e. B and C
c. water soluble
16. Which of the following is an effector molecule for metabotropic receptors?
a. cyclic adenosine monophosphate d. Adenylyl cyclase
b. Inositol triphosphate e. Calcium
c. cyclic guanosine monophosphate
17. The ratio of lipid-soluble form to water-soluble form for a weak acid or a weak base in relation to pH is
expressed by
a. )LFN·V/DZ d. Henderson-Hasselbalch equation
b. Lipid:aqueous partition coefficient e. Michaelis-Menten equation
c. +HQU\·V/DZ
18. The following are sites for drug metabolism
a. Liver d. A, B and C
b. Plasma e. none of the above
c. Intestine
19. This refers to the occurrence of unusual drug response that is infrequently observed in most patients.
a. Hyporeactivity d. Tolerance
b. Idiosyncrasy e. Hyperreactivity
c. Tachyphylaxis
20. Basic signaling mechanism for testosterone, estrogen and other drugs with a steroid nucleus
a. a. interaction with a G-protein coupled receptor
b. interaction with an nuclear receptor
c. interaction with a receptor coupled with an ion channel
d. interaction with a receptor bound to tyrosine kinase
e. none of the above
MODULE 4 - PHARMACOLOGY

21. The following are true about the administration of loading dose
a. Administration of loading dose raises the plasma drug concentration to the target concentration
b. Administration of loading dose is useful for drugs that have long half lives
c. Administration of loading dose is useful for drugs that require a long time to achieve steady state
concentration.
d. For most drugs, the loading dose can be given as a single dose
e. all of the above
22. Which of the following is CORRECT
I. Covalent bonding of one drug with a receptor usually results in reversible
competitive antagonism with another drug
II. Increasing the amount of an agonist would not surmount irreversible competitive
antagonism
III. An antagonist that binds to an allosteric site that inactivates a receptor leads to
non-competitive antagonism with the agonist.

a. Only I is correct d. I, II and III are correct

b. Only I and II are correct e. None of the above
c. Only II and III are correct
23. The efferent preganglionic autonomic neuron of the sympathetic nervous system release:
a. Norepinephrine d. A and B
b. Epinephrine e. A, B and C
c. Acetylcholine
24. The following are TRUE regarding the cholinergic transmission of the autonomic nervous system EXCEPT:
a. Muscarinic receptors are G-protein coupled receptors
b. Activation of the muscarinic (m3) receptors lead to increased intracellular levels of IP3 and DAG
c. Activation of the muscarinic (m2) receptors in the heart lead to negative inotropy and chronotropy
d. Activation of the muscarinic (m3) receptors in the gastrointestinal tract smooth muscles lead to
increased peristalsis
e. Activation of the muscarinic (m3) receptors in the bronchial smooth muscles lead to bronchodilation
25. Pilocarpine, a cholinomimetic alkaloid,
a. is used to lower intraocular pressure
b. is cleaved by acetylcholinesterase
c. selectively binds to nicotinic receptors
d. inhibits secretions such as sweat, tears, saliva
e. none of the above
26. The following are systemic effects of atropine:
a. Mydriasis d. A and B only
b. Decreased salivation e. A, B and C
c. Bradycardia
27. All of the following statements concerning phenylephrine are correct, EXCEPT:
a. It is an alpha agonist that causes vasoconstriction
b. It is a synthetic direct acting agonist
c. It is used to prevent bronchospasm
d. It causes mydriasis when applied topically to the eye
e. It is used as a nasal decongestant
28. AJ is a 24 year old, married female, who is planning to become pregnant in the near future. AJ has no medical
conditions, no allergies, and is not currently taking any medications. What vitamin supplement should the
pharmacist recommend to AJ to prevent neural tube defects in her baby?
a. Niacin d. Pyridoxine
b. Vitamin D e. Ferrous sulfate
c. Folic acid
29. Which among the following is not an effect seen in Diazepam therapy?
a. Sedation and depression of cognitive function
b. Promotion of epileptiform CNS activity, leading to seizures
c. Decreased sleep latency
d. Anesthesia, at higher doses
e. Muscle relaxation
MODULE 4 - PHARMACOLOGY
30. An inhibitor of aldehyde dehydrogenase that was used in the treatment of chronic alchoholism. This agent
causes flushing, sweating, vomiting and hypotension upon co-administration with ethanol.
a. Naltrexone d. Morphine
b. Acamprosate e. Disulfiram
c. Phenytoin
31. The following are adverse effects attributed to phenytoin administration
a. Gingival hyperplasia d. A and B
b. Hirsutism e. A, B and C
c. Diplopia and ataxia
32. This stage of anesthesia is characterized by irregular respiration, both in volume and rate. At this stage, vomiting
and retching may occur if the patient is stimulated.
a. Stage I (stage of analgesia
b. Stage II (stage of excitement)
c. Stage III (stage of surgical anesthesia)
d. Stage IV (stage of respiratory depression)
e. None of the above
33. Which of the following is a long-acting amide anesthetic?
a. Procaine d. Bupivacaine
b. Benzocaine e. Cocaine
c. Tetracaine
34. The dry mouth and sedation commonly seen in Imipramine therapy is
a. dXHWRWKLVWULF\FOLFDQWLGHSUHVVDQW·VDELOLW\WRDFWLYDWHKLVWDPLQH+UHFHSWRUV
b. dXHWRWKLVWULF\FOLFDQWLGHSUHVVDQW·s ability to antagonize muscarinic (m3) receptors
c. dXHWRWKLVWULF\FOLFDQWLGHSUHVVDQW·Vability to antagonize adrenergic (alpha-1) receptors
d. dXHWRWKLVWULF\FOLFDQWLGHSUHVVDQW·s ability to activate adrenergic (beta-1) receptors
e. none of the above
35. This slow-acting agonist of the mu (µ)-receptor is used in the substitution therapy for opioid addicts since
tolerance and physical dependence develop more slowly with methadone than with morphine, and withdrawal
signs and symptoms are milder than those of morphine.
a. Heroin c. Fentanyl
b. Hydromorphone d. All of the above
c. Methadone
36. The following clinical parameters should be monitored when using Methotrexate in the treatment of
inflammatory bowel disease.
a. Leukocyte count d. A and B only
b. Red blood cell count and haemoglobin e. A, B and C
c. Serum creatinine and hepatic
transaminases
37. The following statements are true regarding Simvastatin
a. It exerts its effect by causing partial inhibition of HMG-Co reductase.
b. It is preferably administered at night because cholesterol synthesis occurs at this time.
c. Elevation of hepatic transaminases occur in some patients
d. A and B only
e. A, B and C
38. Digoxin
a. is a cardiac glycoside derived from belladonna plant
b. exerts its effect by activating the Na+,K+-ATP-ase of the cardiac myocyte
c. may cause arrhythmia as an adverse effect.
d. A and B only
e. A, B and C
39. The following are adverse effects expected to be seen in calcium channel blockers therapy
a. Orthostatic hypotension d. Bradycardia
b. Edema e. All of the above
c. Flushing of skin
40. The following are effects of cocaine EXCEPT
a. Euphoria d. Tachycardia
b. Hypotension e. None of the above
c. Vasoconstriction
 MODULE 4 - PHARMACOLOGY

41. The following events would lead to effective control of seizures

a. increased glutamate transmission d. all of the above
b. increased GABA transmission e. none of the above
c. increased sodium influx
42. Mechanism of action of Zonisamide, a sulfonamide derivative, as an anticonvulsant
a. its ability to promote GABA transmission
b. its ability to inhibit sodium channels
c. its ability to promote NMDA-mediated glutamate transmission
d. all of the above
e. none of the above
43. Which of the following drugs is useful in the treatment of status epilepticus
a. Phenobarbital d. Valproic acid
b. Diazepam e. Primidone
c. Carbamazepine
44. Primidone is a
a. Benzodiazepine d. Barbiturate
b. Nipecotic derivative e. None of the above
c. Opioid derivative
45. Gingival hyperplasia is an occurrence seen with the administration of which anticonvulsant?
a. Phenobarbital d. Gabapentin
b. Phenytoin e. Valproic acid
c. Carbamazepine
46. The central analgesic effect of morphine and its analogues are due to
a. Activation of glutamate NMDA c. Activation of mu receptor
receptor d. Activation of kappa receptor
b. Inhibition of mu receptor e. None of the above
47. Which of the following is a full opioid agonist?
a. Fentanyl d. None of the above
b. Pentazocine e. Naloxone
c. Codeine
48. Hepatotoxicity is seen in which anesthetic agent use
a. Nitrous oxide d. Desflurane
b. Enflurane e. None of the above
c. Halothane
49. Which of the following is not effective in partial seizures
a. Phenytoin d. Lamotrigine
b. Ethosuximide e. None of the above
c. Carbamazepine
50. Diuretics such as hydrochlorothiazide and chlorothiazide exert their effect by
a. Inhibiting NaCl reabsorption in the proximal convoluted tubule
b. Inhibiting NaCl reabsorption in the distal convoluted tubule
c. Inhibiting NaCl reabsorption in the loop of Henle
d. Inhibiting NaCl reabsorption in the collecting tubule
e. Promoting osmotic diuresis
51. This potassium sparing diuretic exerts its effect by directly interfering with sodium entry through the epithelial
channels of the collecting tubules:
a. Spironolactone d. A and B only
b. Eplerenone e. A, B and C
c. Triamterene
52. Amiodarone is categorized as class __ in the Vaughan-Williams classification of anti-arrhythmics
a. Class Ia d. Class III
b. Class Ib e. Class IV
c. Class Ic
MODULE 4 - PHARMACOLOGY

53. AD is a 58 year old male with diabetes, angina and erectile dysfunction. His physician consults the pharmacist in
order to decide if AD would be a good candidate for sildenafil. The use of sildenafil is CONTRAINDICATED for AD
if he takes:
a. isosorbide 5-mononitrate d. ASA
b. metoprolol e. enalapril
c. glyburide
54. A patient with stage I hypertension who has bronchospastic airway disease and who is non-compliant would be
best treated with which of the following beta-blocking agents?
a. timolol d. acebutolol (Sectral®)
b. penbutolol (Levatol®) e. propranolol (Inderal®)
c. esmolol (Brevibloc®)
55. The following agents used in the treatment of heart failure cause positive inotropic effect EXCEPT
a. Dobutamine d. Digoxin
b. Prenalterol e. Inamnirone
c. Propranolol
56. A 65-year-old man presents with stage I hypertension. He has diabetes mellitus and chronic kidney disease and
is intolerant to lisinopril. Which of the following agents would be an appropriate selection for initial treatment in
this patient based on WKHJXLGHOLQHVIURPWKH´(LJKW Report of the Joint National Committee on Detection,
Evaluation, and TreatmenWRI+LJK%ORRG3UHVVXUHµ-1&-8)?
a. chlorothiazide (Various) d. candesartan (Atacand®)
b. propanolol (Inderal®) e. clonidine (Catapres®)
c. nitroprusside (Nitropress®)
57. In an otherwise healthy 50 year old adult with stage I hypertension (BP 145/90 mmHg), recommended initial
antihypertensive therapy would be

I. chlorthalidone (Various)
II. metoprolol (Lopressor®)
III. bisoprolol (Zebeta®)

A if I only is correct D if II and III are correct

B if III only is correct E if I, II, and III are correct
C if I and II are correct
58. This 5-lipooxygenase inhibitor has been shown to reduce the frequency of asthma exacerbations in outpatient
clinical trials
a. Monteleukast d. Cromolyn
b. Epinephrine e. Terbutaline
c. Zileuton
59. The following are effective in the treatment of asthma
a. Cholinomimetic agents d. B and C
b. Beta-2-adrenergic agonists e. A B and C
c. Methylxanthines
60. In the event of heparin over dosage, discontinuance of heparin and the administration of this drug is indicated:
a. Donepezil d. Vitamin K (phytonadione)
b. Acamprosate e. Danaparoid
c. Protamine sulfate
61. Which among the following is not an alkylating agent?
a. Chlorambucil d. Cyclophosphamide
b. Cisplatin e. Methotrexate
c. Busulfan
62. This is the only non-acid non-steroidal anti-inflammatory agent
a. Meloxicam d. Nabumetone
b. Ketorolac e. Celecoxib
c. Acetylsalicylic acid
63. Gastrointestinal absorption of the following penicillins is impaired by food, except for
a. Penicillin V d. Oxacillin
b. Nafcillin e. Dicloxacillin
c. Amoxicillin
MODULE 4 - PHARMACOLOGY

64. Which of the following is not a second generation cephalosphorin

a. Cefaclor d. Cefoperazone
b. Cefamandole e. Cefotetan
c. Cefuroxime
65. The beta-lactamase produced by the following organisms are susceptible to the effect of clavulanic acid,
tazobactam and sulbactam EXCEPT the beta-lactamase produced by:
a. Staphylococcus sp. d. Pseudomonas aeruginosa
b. Haemophilus influenza e. Salmonella sp.
c. Neisseria gonorrheae
66. The most common reason for the discontinuance of erythromycin therapy
a. Photodermatitis d. Hepatotoxicity
b. Enamel dysplasia e. Gastrointestinal intolerance
c. Aplastic anemia
67. This bacteriostatic agent exerts its effect by preventing bacterial protein synthesis by binding to the 30s
ribosomal subunit
a. Erythromycin d. Chloramphenicol
b. Minocycline e. Vancomycin
c. Clindamycin
68. Which among the following is susceptible to the hydrolysis by beta-lactamase?
a. Cloxacillin d. Nafcillin
b. Ciprofloxacin e. none of the above
c. Penicillin G
69. Which among the following statements about ampicillin is FALSE?
a. Its activity is enhanced by sulbactam
b. It causes rash as an adverse effect
c. It eradicates most strains of Methicillin-resistant Staphylococcus aureus (MRSA) strains
d. Pseudomembranous colitis may occur with its use
e. None of the above
70. The most common adverse effect of the penicillins
a. Gastrointestinal adverse effects d. None of the above
b. Steven Johnson syndrome e. All of the above
c. Hypersensitivity
71. The mechanism of action of Chloramphenicol
a. Binding 50s ribosomal subunit Æ protein synthesis inhibition
b. Binding 30s ribosomal subunit Æ protein synthesis inhibition
c. Inhibition of folic acid synthesis
d. Inhibition of cell wall synthesis
e. None of the above
72. Ceftazidime
I. Second generation cephalosporin
II. Can cross the blood-brain barrier
III. Bactericidal against Pseudomonas aeruginosa

a. only I d. only I and III

b. only II e. I, II and III
c. only II and III
73. Steven-Johnson syndrome, a disease manifested by severe mucosal desquamation, is an adverse effect
associated mostly to which of the following drugs
a. Isoniazid d. Sulfonamides
b. Imepenem e. None of the above
c. Aztreonam
74. Among the fluoroquinolones, the agent that has the greatest activity against Gram negative and Gram positive
organisms is:
a. Ciprofloxacin d. Gatifloxacin
b. Levofloxacin e. Moxifloxacin
c. Norfloxacin
MODULE 4 - PHARMACOLOGY

75. True about Imipenem

a. Cellwall synthesis inhibitor with activity against Gram negative organisms
b. Its bioavailability is enhanced by cilastatin
c. Administered intravenously
d. All of the above
e. None of the above
76. Adverse effect seen in Vancomycin administration EXCEPT
a. Pain at the site of injection d. Hypersensitivity
b. Nephrotoxicity e. None of the above
c. Gray baby syndrome
77. Bacteriostatic agent/s
I. Trimethoprim
II. Ceftriaxone
III. Ciprofloxacin

a. only A d. only A and C

b. only A and B e. A, B and C
c. only B and C
78. Which of the following inhibits peptidoglycan synthesis
a. Gentamicin d. Amikacin
b. Daptomycin e. Streptomycin
c. Kanamycin
79. Chloramphenicol is primarily metabolized by which enzyme system?
a. Phase I (hydrolysis by CYP3A4) d. all of the above
b. Phase II (substitution by CYP1A2) e. none of the above. It is excreted
c. Phase II (conjugation) unchanged
80. Fluoroquinolones may be given for the following EXCEPT
a. treatment of E. coli infection of the urinary tract
b. treatment of AIDS patient with Mycobacterium avium infection
c. treatment of Pseudomonas infection
d. treatment of methicillin resistant Staphylococcus aureus
e. none of the above
81. Doxycycline is contraindicated in
a. pregnant women d. all of the above
b. children less than 8 years of age e. none of the above
c. lactating women
82. Drugs usually active against penicillinase-producing Staphylococcus aureus include which of the following?
I. piperacillin²tazobactam
II. amoxicillin²clavulanate
III. nafcillin

a. if I only is correct d. if III only is correct

b. if I and II are correct e. if II and III are correct
c. if I, II, and III are correct
83. BC has an upper respiratory infection. Two years ago, she experienced an episode of bronchospasm after
penicillin therapy. Current cultures are positive for a strain of Streptococcus pneumoniae that is sensitive to all
of the following drugs. Which of these drugs would be the best choice for this patient?
a. Amoxicillin/clavulanate d. Cefaclor
b. Telithromycin e. Loracarbef
c. Ampicillin
84. DG is a 27 year old male who comes to the pharmacy seeking advice because, for the past 24 hours, he has
experienced abdominal cramping, mild fever and frequent, loose stools with some blood loss. DS thinks it may
be related to the antibiotic he has been taking for a dental abscess. Current medications include: clindamycin
150 mg QID x10 days, started 8 days ago, and losartan 25 mg daily for hypertension, started 3 months ago. The
most appropriate pharmacist response is that these symptoms:
a. are expected, transient side-effects of clindamycin;; treat symptoms and
continue medications.
b. may indicate an interaction between clindamycin and losartan;; pharmacist call
MODULE 4 - PHARMACOLOGY
to dentist is warranted.
c. may indicate clindamycin-related pseudomembranous colitis;; seek immediate
medical attention.
d. may indicate losartan-related pseudomembranous colitis;; seek immediate
medical attention.
e. DUHSUREDEO\XQUHODWHGWR'6·VPHGLFDWLRQVWUHDWIor flu symptoms and follow-
up if no improvement is seen

85. The following are TRUE regarding fluoroquinolones

a. They are fluorinated derivatives of nalidixic acid
b. They exert their effect by inhibiting DNA gyrase
c. They are contraindicated in patients less than 18 years of age
d. A and B only
e. A, B and C
86. Sulfamethoxazole
a. is an oral non-absorbable sulfonamide
b. exerts its effect by inhibiting dihydrofolate reductase
c. exhibits synergism with trimethoprim
d. is a protein synthesis inhibitor
e. may be administered to patients with G6PD deficiency
87. The most active drug among the first line anti-TB agents
a. Rifampicin d. Ethambutol
b. Isoniazid e. Pyrazinamide
c. Streptomycin
88. This antifungal agent used in the treatment of mucocutaneous infections exerts its effect by being a fungicidal
keratophile and an inhibitor of squalene epoxidase.
a. Nystatin d. Terbinafine
b. Miconazole e. Amphotericin B
c. Griseofulvin
89. The following are indications for Metronidazole administration
a. Giardiasis d. A and B only
b. Trichomoniasis e. A, B and C
c. Amebiasis
90. Clinical poisoning secondary to accidental exposure to toxic/poisonous substance
a. Poisoning
b. Intoxication
c. Overdosing
d. All of the above
91. Which of the following is NOT a sulfonylurea?
a. Tolbutamide d. Repaglinide
b. Glyburide e. Glipizide
c. Chlorpropramide
92. Situation that can cause coma and/or convulsion
a. oxygen depletion d. shock
b. alcohol intoxication e. All of the above
c. trauma
93. Liotrix
a. Synthetic levothyroxine
b. Synthetic triidothyronine
c. Combination of T3 and T4
d. Radioactive iodine
e. None of the above
94. Primary decontamination agent for dermal exposure to HF
a. Blue vitriol d. Ca gluconate
b. Castor oil e. All of the above
c. Mineral oil
MODULE 4 - PHARMACOLOGY

95. Component of universal antidote, EXCEPT;;

a. tannic acid d. None of the above
b. MgO e. All of the above
c. activated charcoal
96. BAL is contraindicated for poisoning of all the following metals, EXCEPT;;
a. Se d. As
b. Fe e. None of the above
c. Cd
97. Flucytosine is readily converted to active metabolites that are capable of inhibiting:
a. Topoisomerase II d. ergosterol synthesis
b. DNA and RNA synthesis e. None of the above
c. microtubule synthesis
98. An antidote for ethylene glycol poisoning that converts formic acid to carbon dioxide
a. ethanol d. leucoverin
b. hemodialysis e. fomepizol
c. thiamine
99. Toxic product of Carbon tetrachloride after heating in acidic medium
a. COCl3 d. All of the above
b. Phosgene e. None of the above
c. Chloroform
100. Ingestion of NaOH can result to
a. Coagulation necrosis d. all of the above
b. Liquefaction necrosis e. none of the above
c. Inhibition of SOD