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State Educational Institution

of the Higher Professional Education


VOLGOGRAD STATE MEDICAL UNIVERSITY
of Federal Agency for Public Health and Social Development
Pharmacology Department

MULTIPLE-CHOICE TESTS
IN
PHARMACOLOGY

VOLOGOGRAD
2006
2

ГОСУДАРСТВЕННОЕ ОБРАЗОВАТЕЛЬНОЕ УЧРЕЖДЕНИЕ


ВЫСШЕГО ПРОФЕССИОНАЛЬНОГО ОБРАЗОВАНИЯ
ВОЛГОГРАДСКИЙ ГОСУДАРСТВЕННЫЙ
МЕДИЦИНСКИЙ УНИВЕРСИТЕТ
ФЕДЕРАЛЬНОГО АГЕНСТВА ПО ЗДРАВООХРАНЕНИЮ И
СОЦИАЛЬНОМУ РАЗВИТИЮ
КАФЕДРА ФАРМАКОЛОГИИ

В.А. КОСОЛАПОВ, М.В. ЧЕРНИКОВ, О.Ю. ГРЕЧКО,


И.Н. ИЕЖИЦА, А.Ф. КУЧЕРЯВЕНКО

ТЕСТОВЫЕ ВОПРОСЫ ПО ФАРМАКОЛОГИИ

УЧЕБНОЕ ПОСОБИЕ

Под редакцией Член-корреспондента РАМН, заслуженного деятеля науки


РФ, доктора медицинских наук, профессора А.А. Спасова и кандидата
филологических наук В.В. Жура

Рекомендовано к печати

УЧЕБНО-МЕТОДИЧЕСКИМ ОБЪЕДИНЕНИЕМ ПО МЕДИЦИНСКОМУ И


ФАРМАЦЕВТИЧЕСКОМУ ОБРАЗОВАНИЮ ВУЗОВ РОССИИ
В КАЧЕСТВЕ УЧЕБНОГО ПОСОБИЯ ДЛЯ ИНОСТРАННЫХ СТУДЕНТОВ
МЕДИЦИНСКИХ ВУЗОВ, ОБУЧАЮЩИХСЯ НА АНГЛИЙСКОМ ЯЗЫКЕ
ОТ ________ УМО-_____

Волгоград 2006
3

УДК 615(07)

ТЕСТОВЫЕ ВОПРОСЫ ПО ФАРМАКОЛОГИИ:


Учебное пособие / В.А. КОСОЛАПОВ, М.В. ЧЕРНИКОВ, О.Ю. ГРЕЧКО, И.Н.
ИЕЖИЦА, А.Ф. КУЧЕРЯВЕНКО / Под ред. АА. Спасова, В.В Жура. –
Волгоград, 2005. –___с.

РЕЦЕНЗЕНТЫ:
Зав. кафедрой фармакологии и биофармации ФУВ ВолгМУ,
д.м.н., профессор И.Н. Тюренков
Зав. кафедрой фармакологии фармацевтического факультета Московской
медицинской академии им. Сеченова, профессор, д.м.н. Р.Н. Аляутдин
Зав. кафедрой фармакологии Саратовского медицинского университета,
д.м.н., профессор А.А. Свистунов

© Волгоградский государственный медицинский университет 2006


4
Contents

Chapter Pages
(1) GENERAL PRINCIPLES OF PHARMACOLOGY............................................................................................... 5
PART I PHARMACOKINETICS ........................................................................................................................................ 5
PART II PHARMACODYNAMICS.................................................................................................................................... 8
(2) AGENTS, CONTROLLING THE FUNCTIONS OF THE PERIPHERAL NERVOUS SYSTEM ................. 12
PART I LOCAL ANESTHETICS .............................................................................................................................................. 12
PART II CHOLINOMIMETIC DRUGS ...................................................................................................................................... 16
PART III CHOLINORECEPTOR BLOCKING DRUGS ................................................................................................................. 19
PART IV ADRENORECEPTOR ACTIVATING DRUGS ............................................................................................................... 24
PART V ADRENORECEPTOR ANTAGONIST DRUGS ............................................................................................................... 29
(3) AGENTS, CONTROLLING THE FUNCTIONS OF THE CENTRAL NERVOUS SYSTEM........................ 34
PART I HYPNOTIC DRUGS ................................................................................................................................................... 34
PART II ANTISEIZURE DRUGS ............................................................................................................................................. 38
PART III ANTIPARKINSONIAN AGENTS................................................................................................................................ 41
PART IV ETHYL ALCOHOL .................................................................................................................................................. 44
PART V NARCOTIC ANALGESICS......................................................................................................................................... 46
PART VI NON-NARCOTIC ANALGESICS ............................................................................................................................... 49
PART VII ANTIPSYCHOTIC AGENTS .................................................................................................................................... 51
PART VIII ANTIDEPRESSANT AGENTS ................................................................................................................................ 54
PART IX ANXIOLYTIC AGENTS ........................................................................................................................................... 57
PART X CNS STIMULANTS ................................................................................................................................................. 60
PART XI DRUGS OF ABUSE ................................................................................................................................................. 63
PART XII GENERAL ANESTHETICS ...................................................................................................................................... 65
(4) ORGANOTROPIC AGENTS.................................................................................................................................. 68
PART I DRUGS ACTING ON RESPIRATORY SYSTEM .............................................................................................................. 68
PART II DRUGS USED IN GASTROINTESTINAL DISEASES ...................................................................................................... 70
PART III DRUGS ACTING ON HEMATOPOIETIC SYSTEM........................................................................................................ 73
PART IV DRUGS USED IN DISORDERS OF COAGULATION ..................................................................................................... 74
PART V DRUGS USED FOR TREATMENT OF HEART FAILURE ................................................................................................ 76
PART VI ANTIARRHYTHMIC AGENTS .................................................................................................................................. 78
PART VII DRUGS FOR ANGINA PECTORIS TREATMENT ....................................................................................................... 80
PART VIII ANTIHYPERTENSIVE DRUGS............................................................................................................................... 83
PART IX HYPERTENSIVE (ANTI-HYPOTENSIVE) DRUGS. DRUGS INFLUENCING CEREBRAL BLOOD FLOW. ANTI-MIGRAINE
AGENTS ................................................................................................................................................................................ 85

(5) METABOLIC PROFILE DRUGS .......................................................................................................................... 88


PART I HYPOTHALAMIC & PITUITARY HORMONES, THYROID & ANTITHYROID DRUGS ..................................................... 88
PART II PANCREATIC HORMONES & ANTIDIABETIC DRUGS ............................................................................................... 91
PART III THE GONADAL HORMONES & INHIBITORS ........................................................................................................... 93
PART IV GLUCOCORTICOID, STEROIDAL & NONSTEROIDAL ANTI-INFLAMMATORY DRUGS .............................................. 95
PART V IMMUNOTROPIC & ANTIALLERGIC AGENTS .......................................................................................................... 98
PART VI VITAMINS, VITAMIN-LIKE COMPOUNDS, ANTIVITAMINS, ENZYMES & ANTIENZYMES ...................................... 104
PART VII ANTIHYPERLIPIDEMIC DRUGS & DRUGS USED IN THE TREATMENT OF GOUT .................................................. 110
PART VIII AGENTS THAT AFFECT BONE MINERAL HOMEOSTASIS .................................................................................. 114
PART IX MINERALOCORTICOID, MINERALOCORTICOID ANTAGONISTS, DIURETICS, PLASMA EXPANDERS ...................... 120
(6) CHEMOTHERAPEUTIC DRUGS....................................................................................................................... 124
PART I ANTIBIOTICS .................................................................................................................................................... 124
PART II SYNTHETIC ANTIBACTERIAL DRUGS ....................................................................................................... 129
PART III ANTIPROTOZOAL AND ANTHELMINTIC DRUGS................................................................................... 132
PART IV ANTIVIRAL AGENTS. AGENTS FOR CHEMOTHERAPY OF CANCER .................................................. 135
5
(1) GENERAL PRINCIPLES OF PHARMACOLOGY

PART I PHARMACOKINETICS
001. Pharmacokinetics is:
a) The study of biological and therapeutic effects of drugs
b) The study of absorption, distribution, metabolism and excretion of drugs
c) The study of mechanisms of drug action
d) The study of methods of new drug development
002. What does “pharmacokinetics” include?
a) Complications of drug therapy
b) Drug biotransformation in the organism
c) Influence of drugs on metabolism processes
d) Influence of drugs on genes
002. What does “pharmacokinetics” include?
a) Pharmacological effects of drugs
b) Unwanted effects of drugs
c) Chemical structure of a medicinal agent
d) Distribution of drugs in the organism
003. What does “pharmacokinetics” include?
a) Localization of drug action
b) Mechanisms of drug action
c) Excretion of substances
d) Interaction of substances
004. The main mechanism of most drugs absorption in GI tract is:
a) Active transport (carrier-mediated diffusion)
b) Filtration (aqueous diffusion)
c) Endocytosis and exocytosis
d) Passive diffusion (lipid diffusion)
005. What kind of substances can’t permeate membranes by passive diffusion?
a) Lipid-soluble
b) Non-ionized substances
c) Hydrophobic substances
d) Hydrophilic substances
006. A hydrophilic medicinal agent has the following property:
a) Low ability to penetrate through the cell membrane lipids
b) Penetrate through membranes by means of endocytosis
c) Easy permeation through the blood-brain barrier
d) High reabsorption in renal tubules
007. What is implied by «active transport»?
a) Transport of drugs trough a membrane by means of diffusion
b) Transport without energy consumption
c) Engulf of drug by a cell membrane with a new vesicle formation
d) Transport against concentration gradient
008. What does the term “bioavailability” mean?
a) Plasma protein binding degree of substance
b) Permeability through the brain-blood barrier
c) Fraction of an uncharged drug reaching the systemic circulation following any route administration
d) Amount of a substance in urine relative to the initial doze
009. The reasons determing bioavailability are:
a) Rheological parameters of blood
b) Amount of a substance obtained orally and quantity of intakes
c) Extent of absorption and hepatic first-pass effect
d) Glomerular filtration rate
010. Pick out the appropriate alimentary route of administration when passage of drugs through liver is minimized:
a) Oral
b) Transdermal
c) Rectal
d) Intraduodenal
011. Which route of drug administration is most likely to lead to the first-pass effect?
a) Sublingual
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b) Oral
c) Intravenous
d) Intramuscular
012. What is characteristic of the oral route?
a) Fast onset of effect
b) Absorption depends on GI tract secretion and motor function
c) A drug reaches the blood passing the liver
d) The sterilization of medicinal forms is obligatory
013. Tick the feature of the sublingual route:
a) Pretty fast absorption
b) A drug is exposed to gastric secretion
c) A drug is exposed more prominent liver metabolism
d) A drug can be administrated in a variety of doses
014. Pick out the parenteral route of medicinal agent administration:
a) Rectal
b) Oral
c) Sublingual
d) Inhalation
015. Parenteral administration:
a) Cannot be used with unconsciousness patients
b) Generally results in a less accurate dosage than oral administration
c) Usually produces a more rapid response than oral administration
d) Is too slow for emergency use
016. What is characteristic of the intramuscular route of drug administration?
a) Only water solutions can be injected
b) Oily solutions can be injected
c) Opportunity of hypertonic solution injections
d) The action develops slower, than at oral administration
017. Intravenous injections are more suitable for oily solutions:
a) True
b) False
018. Correct statements listing characteristics of a particular route of drug administration include all of the following EXCEPT:
a) Intravenous administration provides a rapid response
b) Intramuscular administration requires a sterile technique
c) Inhalation provides slow access to the general circulation
d) Subcutaneous administration may cause local irritation
019. Most of drugs are distributed homogeneously.
a) True
b) False
020. Biological barriers include all except:
a) Renal tubules
b) Cell membranes
c) Capillary walls
d) Placenta
021. What is the reason of complicated penetration of some drugs through brain-blood barrier?
a) High lipid solubility of a drug
b) Meningitis
c) Absence of pores in the brain capillary endothelium
d) High endocytosis degree in a brain capillary
022. The volume of distribution (Vd) relates:
a) Single to a daily dose of an administrated drug
b) An administrated dose to a body weight
c) An uncharged drug reaching the systemic circulation
d) The amount of a drug in the body to the concentration of a drug in plasma
023. For the calculation of the volume of distribution (Vd) one must take into account:
a) Concentration of a substance in plasma
b) Concentration of substance in urine
c) Therapeutical width of drug action
d) A daily dose of drug
024. A small amount of the volume of distribution is common for lipophylic substances easy penetrating through barriers and
widely distributing in plasma, interstitial and cell fluids:
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a) True
b) False
025. The term “biotransformation” includes the following:
a) Accumulation of substances in a fat tissue
b) Binding of substances with plasma proteins
c) Accumulation of substances in a tissue
d) Process of physicochemical and biochemical alteration of a drug in the body
026. Biotransformation of the drugs is to render them:
a) Less ionized
b) More pharmacologically active
c) More lipid soluble
d) Less lipid soluble
027. Tick the drug type for which microsomal oxidation is the most prominent:
a) Lipid soluble
b) Water soluble
c) Low molecular weight
d) High molecular weight
028. Pick out the right statement:
a) Microsomal oxidation always results in inactivation of a compound
b) Microsomal oxidation results in a decrease of compound toxicity
c) Microsomal oxidation results in an increase of ionization and water solubility of a drug
d) Microsomal oxidation results in an increase of lipid solubility of a drug thus its excretion from the organism is facilitated
029. Stimulation of liver microsomal enzymes can:
a) Require the dose increase of some drugs
b) Require the dose decrease of some drugs
c) Prolong the duration of the action of a drug
d) Intensify the unwanted reaction of a drug
030. Metabolic transformation (phase 1) is:
a) Acetylation and methylation of substances
b) Transformation of substances due to oxidation, reduction or hydrolysis
c) Glucuronide formation
d) Binding to plasma proteins
031. Biotransformation of a medicinal substance results in:
a) Faster urinary excretion
b) Slower urinary excretion
c) Easier distribution in organism
d) Higher binding to membranes
032. Conjugation is:
a) Process of drug reduction by special enzymes
b) Process of drug oxidation by special oxidases
c) Coupling of a drug with an endogenous substrate
d) Solubilization in lipids
033. Which of the following processes proceeds in the second phase of biotransformation?
a) Acetylation
b) Reduction
c) Oxidation
d) Hydrolysis
034. Conjugation of a drug includes the following EXCEPT:
a) Glucoronidation
b) Sulfate formation
c) Hydrolysis
d) Methylation
035. Metabolic transformation and conjugation usually results in an increase of a substance biological activity:
a) True
b) False
036. In case of liver disorders accompanied by a decline in microsomal enzyme activity the duration of action of some drugs
is:
a) Decreased
b) Enlarged
c) Remained unchanged
d) Changed insignificantly
8
037. Half life (t ½) is the time required to:
a) Change the amount of a drug in plasma by half during elimination
b) Metabolize a half of an introduced drug into the active metabolite
c) Absorb a half of an introduced drug
d) Bind a half of an introduced drug to plasma proteins
038. Half life (t ½) doesn’t depend on:
a) Biotransformation
b) Time of drug absorption
c) Concentration of a drug in plasma
d) Rate of drug elimination
039. Elimination is expressed as follows:
a) Rate of renal tubular reabsorption
b) Clearance speed of some volume of blood from substance
c) Time required to decrease the amount of drug in plasma by one-half
d) Clearance of an organism from a xenobiotic
040. Elimination rate constant (Kelim) is defined by the following parameter:
a) Rate of absorption
b) Maximal concentration of a substance in plasma
c) Highest single dose
d) Half life (t ½)
041. The most rapid eliminated drugs are those with high glomerular filtration rate and actively secreted but aren’t passively
reabsorbed:
a) True
b) False
042. Systemic clearance (CLs) is related with:
a) Only the concentration of substances in plasma
b) Only the elimination rate constant
c) Volume of distribution, half life and elimination rate constant
d) Bioavailability and half life

PART II PHARMACODYNAMICS
001. Pharmacodynamics involves the study of following EXCEPT:
a) Biological and therapeutic effects of drugs
b) Absorption and distribution of drugs
c) Mechanisms of drug action
d) Drug interactions
002. Pharmacodynamics involves the study of following?
a) Mechanisms of drug action
b) Biotransformation of drugs in the organism
c) Distribution of drugs in the organism
d) Excretion of drug from the organism
003. Pharmacodynamics involves the following?
a) Information about main mechanisms of drug absorption
b) Information about unwanted effects
c) Information about biological barriers
d) Information about excretion of a drug from the organism
004. Pick out the answer which is the most appropriate to the term “receptor”
a) All types of ion channels modulated by a drug
b) Enzymes of oxidizing-reducing reactions activated by a drug
c) Active macromolecular components of a cell or an organism which a drug molecule has to combine with in
order to elicit its specific effect
d) Carriers activated by a drug
005. What does “affinity” mean?
a) A measure of how tightly a drug binds to plasma proteins
b) A measure of how tightly a drug binds to a receptor
c) A measure of inhibiting potency of a drug
d) A measure of bioavailability of a drug
006. Target proteins which a drug molecule binds are:
a) Only receptors
b) Only ion channels
c) Only carriers
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d) All of the above
007. An agonist is a substance that:
a) Interacts with the receptor without producing any effect
b) Interacts with the receptor and initiates changes in cell function, producing various effects
c) Increases concentration of another substance to produce effect
d) Interacts with plasma proteins and doesn’t produce any effect
008. If an agonist can produce maximal effects and has high efficacy it’s called:
a) Partial agonist
b) Antagonist
c) Agonist-antagonist
d) Full agonist
009. If an agonist can produce submaximal effects and has moderate efficacy it’s called:
a) Partial agonist
b) Antagonist
c) Agonist-antagonist
d) Full agonist
010. An antagonist is a substance that:
a) Binds to the receptors and initiates changes in cell function, producing maximal effect
b) Binds to the receptors and initiates changes in cell function, producing submaximal effect
c) Interacts with plasma proteins and doesn’t produce any effect
d) Binds to the receptors without directly altering their functions
011. A competitive antagonist is a substance that:
a) Interacts with receptors and produces submaximal effect
b) Binds to the same receptor site and progressively inhibits the agonist response
c) Binds to the nonspecific sites of tissue
d) Binds to one receptor subtype as an agonist and to another as an antagonist
012. The substance binding to one receptor subtype as an agonist and to another as an antagonist is called:
a) Competitive antagonist
b) Irreversible antagonist
c) Agonist-antagonist
d) Partial agonist
013. Irreversible interaction of an antagonist with a receptor is due to:
a) Ionic bonds
b) Hydrogen bonds
c) Covalent bonds
d) All of the above
014. Mechanisms of transmembrane signaling are the following EXCEPT:
a) Transmembrane receptors that bind and stimulate a protein tyrosine kinase
b) Gene replacement by the introduction of a therapeutic gene to correct a genetic effect
c) Ligand-gated ion channels that can be induced to open or close by binding a ligand
d) Transmembrane receptor protein that stimulates a GTP-binding signal transducer protein (G-protein) which in turn
generates an intracellular second messenger
015. Tick the second messenger of G-protein-coupled (metabotropic) receptor:
a) Adenylyl cyclase
b) Sodium ions
c) Phospholipase C
d) cAMP
016. Tick the substance which changes the activity of an effector element but doesn’t belong to second messengers:
a) cAMP
b) cGMP
c) G–protein
d) Calcium ions
017. The increase of second messengers’ (cAMP, cGMP, Ca2+ etc.) concentration leads to:
a) Inhibition of intracellular protein kinases and protein phosphorylation
b) Proteinkinases activation and protein phosphorylation
c) Blocking of interaction between a receptor and an effector
d) Antagonism with endogenous ligands
018. Tick the substances whose mechanisms are based on interaction with ion channels
a) Sodium channel blockers
b) Calcium channel blockers
c) Potassium channels activators
10
d) All of the above
019. All of the following statements about efficacy and potency are true EXCEPT:
a) Efficacy is usually a more important clinical consideration than potency
b) Efficacy is the maximum effect of a drug
c) Potency is a comparative measure, refers to the different doses of two drugs that are needed to produce the same
effect
d) The ED50 is a measure of drug’s efficacy
020. Give the definition for a therapeutical dose:
a) The amount of a substance to produce the minimal biological effect
b) The amount of a substance to produce effects hazardous for an organism
c) The amount of a substance to produce the required effect in most patients
d) The amount of a substance to accelerate an increase of concentration of medicine in an organism
021. Pick out the correct definition of a toxic dose:
a) The amount of substance to produce the minimal biological effect
b) The amount of substance to produce effects hazardous for an organism
c) The amount of substance to produce the necessary effect in most of patients
d) The amount of substance to fast creation of high concentration of medicine in an organism
022. Which effect may lead to toxic reactions when a drug is taken continuously or repeatedly?
a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis
023. What term is used to describe a more gradual decrease in responsiveness to a drug, taking days or weeks to develop?
a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis
024. What term is used to describe a decrease in responsiveness to a drug which develops in a few minutes?
a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis
025. Tachyphylaxis is:
a) A drug interaction between two similar types of drugs
b) Very rapidly developing tolerance
c) A decrease in responsiveness to a drug, taking days or weeks to develop
d) None of the above
026. Drug resistance is a term used to describe the loss of effectiveness of antimicrobial or antitumour drugs. This
consideration is:
a) True
b) False
027. Tolerance and drug resistance can be a consequence of:
a) Drug dependence
b) Increased metabolic degradation
c) Depressed renal drug excretion
d) Activation of a drug after hepatic first-pass
028. Tolerance and drug resistance can be a consequence of:
a) Change in receptors, loss of them or exhaustion of mediators
b) Increased receptor sensitivity
c) Decreased metabolic degradation
d) Decreased renal tubular secretion
029. Tolerance develops because of:
a) Diminished absorption
b) Rapid excretion of a drug
c) Both of the above
d) None of the above
030. Dependence is often associated with tolerance to a drug, a physical abstinence syndrome, and psychological
dependence (craving). This consideration is:
a) True
b) False
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031. The situation when failure to continue administering the drug results in serious psychological and somatic disturbances is
called?
a) Tachyphylaxis
b) Sensibilization
c) Abstinence syndrome
d) Idiosyncrasy
032. What is the type of drug-to-drug interaction which is connected with processes of absorption, biotransformation,
distribution and excretion?
a) Pharmacodynamic interaction
b) Physical and chemical interaction
c) Pharmaceutical interaction
d) Pharmacokinetic interaction
033. What is the type of drug-to-drug interaction which is the result of interaction at receptor, cell, enzyme or organ level?
a) Pharmacodynamic interaction
b) Physical and chemical interaction
c) Pharmaceutical interaction
d) Pharmacokinetic interaction
034. What phenomenon can occur in case of using a combination of drugs?
a) Tolerance
b) Tachyphylaxis
c) Accumulation
d) Synergism
035. If two drugs with the same effect, taken together, produce an effect that is equal in magnitude to the sum of the effects of
the drugs given individually, it is called as:
a) Antagonism
b) Potentiation
c) Additive effect
d) None of the above
036. What does the term “potentiation” mean?
a) Cumulative ability of a drug
b) Hypersensitivity to a drug
c) Fast tolerance developing
d) Intensive increase of drug effects due to their combination
037. The types of antagonism are:
a) Summarized
b) Potentiated
c) Additive
d) Competitive
038. The term “chemical antagonism” means that:
a) two drugs combine with one another to form an inactive compound
b) two drugs combine with one another to form a more active compound
c) two drugs combine with one another to form a more water soluble compound
d) two drugs combine with one another to form a more fat soluble compound
039. A teratogenic action is:
a) Toxic action on the liver
b) Negative action on the fetus causing fetal malformation
c) Toxic action on blood system
d) Toxic action on kidneys
040. Characteristic unwanted reaction which isn’t related to a dose or to a pharmacodynamic property of a drug is called:
a) Idiosyncrasy
b) Hypersensitivity
c) Tolerance
d) Teratogenic action
041. Idiosyncratic reaction of a drug is:
a) A type of hypersensitivity reaction
b) A type of drug antagonism
c) Unpredictable, inherent, qualitatively abnormal reaction to a drug
d) Quantitatively exaggerated response
042. Therapeutic index (TI) is:
a) A ratio used to evaluate the safety and usefulness of a drug for indication
b) A ratio used to evaluate the effectiveness of a drug
12
c) A ratio used to evaluate the bioavailability of a drug
d) A ratio used to evaluate the elimination of a drug

(2) AGENTS, CONTROLLING THE FUNCTIONS OF THE PERIPHERAL NERVOUS SYSTEM

PART I Local anesthetics


001. Local anesthetics produce:
a) Analgesia, amnesia, loss of consciousness
b) Blocking pain sensation without loss of consciousness
c) Alleviation of anxiety and pain with an altered level of consciousness
d) A stupor or somnolent state
002. A good local anesthetic agent shouldn’t cause:
a) Local irritation and tissue damage
b) Systemic toxicity
c) Fast onset and long duration of action
d) Vasodilatation
003. Most local anesthetic agents consist of:
a) Lipophylic group (frequently an aromatic ring)
b) Intermediate chain (commonly including an ester or amide)
c) Amino group
d) All of the above
004. Which one of the following groups is responsible for the duration of the local anesthetic action?
a) Intermediate chain
b) Lipophylic group
c) Ionizable group
d) All of the above
005. Indicate the local anesthetic agent, which has a shorter duration of action:
a) Lidocaine
b) Procaine
c) Bupivacaine
d) Ropivacaine
006. Which one of the following groups is responsible for the potency and the toxicity of local anesthetics?
a) Ionizable group
b) Intermediate chain
c) Lipophylic group
d) All of the above
007. Indicate the drug, which has greater potency of the local anesthetic action:
a) Lidocaine
b) Bupivacaine
c) Procaine
d) Mepivacaine
008. Ionizable group is responsible for:
a) The potency and the toxicity
b) The duration of action
c) The ability to diffuse to the site of action
d) All of the above
009. Which one of the following local anesthetics is an ester of benzoic acid?
a) Lidocaine
b) Procaine
c) Ropivacaine
d) Cocaine
010. Indicate the local anesthetic, which is an ester of paraaminobenzoic acid:
a) Mepivacaine
b) Cocaine
c) Procaine
d) Lidocaine
011. Which of the following local anesthetics is an acetanilide derivative?
a) Tetracaine
b) Lidocaine
c) Cocaine
d) Procaine
13
012. Indicate the local anesthetic, which is a toluidine derivative:
a) Lidocaine
b) Bupivacaine
c) Prilocaine
d) Procaine
013. Which of the following local anesthetics is a thiophene derivative?
a) Procaine
b) Ultracaine
c) Lidocaine
d) Mepivacaine
014. Local anesthetics are:
a) Weak bases
b) Weak acids
c) Salts
d) None of the above
015. For therapeutic application local anesthetics are usually made available as salts for the reasons of:
a) Less toxicity and higher potency
b) Higher stability and greater lipid solubility
c) Less local tissue damage and more potency
d) More stability and greater water solubility
016. Which of the following statements is not correct for local anesthetics?
a) In a tissue they exist either as an uncharged base or as a cation
b) A charged cationic form penetrates biologic membranes more readily than an uncharged form
c) Local anesthetics are much less effective in inflamed tissues
d) Low ph in inflamed tissues decreases the dissociation of nonionized molecules
017. Which one of the following statements about the metabolism of local anesthetics is incorrect?
a) Metabolism of local anesthetics occurs at the site of administration
b) Metabolism occurs in the plasma or liver but not at the site of administration
c) Ester group of anesthetics like procaine, are metabolized systemically by pseudocholinesterase
d) Amides such as lidocaine, are metabolized in the liver by microsomal mixed function oxidases
018. Indicate the anesthetic agent of choice in patient with a liver disease:
a) Lidocaine
b) Bupivacaine
c) Procaine
d) Etidocaine
019. Which of the following local anesthetics is preferable in patient with pseudocholinesterase deficiency?
a) Procaine
b) Ropivacaine
c) Tetracaine
d) Benzocaine
020. The primary mechanism of action of local anesthetics is:
a) Activation of ligand-gated potassium channels
b) Blockade of voltage-gated sodium channels
c) Stimulation of voltage-gated N-type calcium channels
d) Blockade the GABA-gated chloride channels
021. Which of the following local anesthetics is more water-soluble?
a) Tetracaine
b) Etidocaine
c) Procaine
d) Bupivacaine
022. Indicate the local anesthetic, which is more lipid-soluble:
a) Bupivacaine
b) Lidocaine
c) Mepivacaine
d) Procaine
023. The more lipophylic drugs:
a) Are more potent
b) Have longer duration of action
c) Bind more extensively to proteins
d) All of the above
024. Which of the following fibers is the first to be blocked?
14
a) Type A alpha fibers
b) B and C fibers
c) Type A beta fibers
d) Type A gamma fibers
025. Indicate the function, which the last to be blocked:
a) Pain, temperature
b) Muscle spindles
c) Motor function
d) Touch, pressure
026. Which of the following fibers participates in high-frequency pain transmission?
a) Type A delta and C fibers
b) Type A alpha fibers
c) Type B fibers
d) Type A beta fibers
027. Which of the following local anesthetics is an useful antiarrhythmic agent?
a) Cocaine
b) Lidocaine
c) Bupivacaine
d) Ropivacaine
028. Indicate the route of local anesthetic administration, which is associated with instillation within epidural or subarachnoid
spaces:
a) Topical anesthesia
b) Infiltrative anesthesia
c) Regional anesthesia
d) Spinal anesthesia
029. The choice of a local anesthetic for specific procedures is usually based on:
a) The duration of action
b) Water solubility
c) Capability of rapid penetration through the skin or mucosa with limited tendency to diffuse away from the site of
application
d) All of the above
030. Which of the following local anesthetics is a short-acting drug?
a) Procaine
b) Tetracaine
c) Bupivacaine
d) Ropivacaine
031. Indicate the local anesthetic, which is a long-acting agent:
a) Lidocaine
b) Bupivacaine
c) Procaine
d) Mepivacaine
032. The anesthetic effect of the agents of short and intermediate duration of action can not be prolonged by adding:
a) Epinephrine
b) Norepinephrine
c) Dopamine
d) Phenylephrine
033. A vasoconstrictor does not:
a) Retard the removal of drug from the injection site
b) Hence the chance of toxicity
c) Decrease the blood level
d) Reduce a local anesthetic uptake by the nerve
034. Vasoconstrictors are less effective in prolonging anesthetic properties of:
a) Procaine
b) Bupivacaine
c) Lidocaine
d) Mepivacaine
035. Which of the following local anesthetics is only used for surface or topical anesthesia?
a) Cocaine
b) Tetracaine
c) Procaine
d) Bupivacaine
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036. Indicate the local anesthetic, which is mainly used for regional nerve block anesthesia:
a) Dibucaine
b) Bupivacaine
c) Tetracaine
d) Cocaine
037. Which of the following local anesthetics is used for infiltrative and regional anesthesia?
a) Procaine
b) Lidocaine
c) Mepivacaine
d) All of the above
038. Indicate the local anesthetic, which is used for spinal anesthesia:
a) Tetracaine
b) Cocaine
c) Dibucaine
d) Bupivacaine
039. Which of the following local anesthetics is called a universal anesthetic?
a) Procaine
b) Ropivacaine
c) Lidocaine
d) Bupivacaine
040. Most serious toxic reaction to local anesthetics is:
a) Seizures
b) Cardiovascular collapse
c) Respiratory failure
d) All of the above
041. Correct statements concerning cocaine include all of the following EXCEPT:
a) Cocaine is often used for nose and throat procedures
b) Limited use because of abuse potential
c) Myocardial depression and peripheral vasodilatation
d) Causes sympathetically mediated tachycardia and vasoconstriction
042. Which of the following local anesthetics is more cardiotoxic?
a) Procaine
b) Bupivacaine
c) Lidocaine
d) Mepivacaine
043. Most local anesthetics can cause:
a) Depression of abnormal cardiac pacemaker activity, excitability, conduction
b) Depression of the strength of cardiac contraction
c) Cardiovascular collapse
d) All of the above
044. Which one of the following local anesthetics causes methemoglobinemia?
a) Prilocaine
b) Procaine
c) Lidocaine
d) Ropivacaine
045. Procaine has all of the following properties EXCEPT:
a) It has ester linkage
b) Its metabolic product can inhibit the action of sulfonamides
c) It readily penetrates the skin and mucosa
d) It is relatively short-acting
046. Correct statements concerning lidocaine include all of the following EXCEPT:
a) It is an universal anesthetic
b) It has esteratic linkage
c) It widely used as an antiarrhythmic agent
d) It is metabolized in liver
047. Which of the following local anesthetics is more likely to cause allergic reactions?
a) Lidocaine
b) Bupivacaine
c) Procaine
d) Ropivacaine
048. Tetracaine has all of the following properties EXCEPT:
16
a) Slow onset
b) Low potency
c) Long duration
d) High toxicity
049. Correct statements concerning bupivacaine include all of the following EXCEPT:
a) It has low cardiotoxicity
b) It has amide linkage
c) It is a long-acting drug
d) An intravenous injection can lead to seizures

PART II Cholinomimetic drugs


001. Acetylcholine is not a specific neurotransmitter at:
a) Sympathetic ganglia
b) Sympathetic postganglionic nerve endings
c) Parasympathetic ganglia
d) Parasympathetic postganglionic nerve endings
002. Muscarinic receptors are located in:
a) Autonomic ganglia
b) Skeletal muscle neuromuscular junctions
c) Autonomic effector cells
d) Sensory carotid sinus baroreceptor zone
003. Indicate the location of M2 cholinoreceptor type:
a) Heart
b) Glands
c) Smooth muscle
d) Endothelium
004. The symptoms of mushroom poisoning include all of the following EXCEPT:
a) Salivation, lacrimation, nausea, vomiting
b) Dryness of mouth, hyperpyrexia, hallucination
c) Headache, abdominal colic
d) Bradycardia, hypotension and shock
005. Which of the following cholinomimetics activates both muscarinic and nicotinic receptors?
a) Lobeline
b) Pilocarpine
c) Nicotine
d) Bethanechol
006. Indicate a cholinomimetic agent, which is related to direct-acting drugs:
a) Edrophonium
b) Physostigmine
c) Carbachol
d) Isoflurophate
007. Characteristics of carbachol include all of the following EXCEPT:
a) It decreases intraocular pressure
b) It causes mydriasis
c) It exerts both nicotinic and muscarinic effects
d) It is resistant to acethylcholiesterase
008. Acetylcholine is not used in clinical practice because:
a) It is very toxic
b) The doses required are very high
c) It is very rapidly hydrolyzed
d) It is very costly
009. Parasympathomimetic drugs cause:
a) Bronchodilation
b) Mydriasis
c) Bradycardia
d) Constipation
010. Which of the following direct-acting cholinomimetics is mainly muscarinic in action?
a) Bethanechol
b) Carbachol
c) Acetylcholine
d) None of the above
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011. Which of the following direct-acting cholinomimetics has the shortest duration of action?
a) Acetylcholine
b) Methacholine
c) Carbachol
d) Bethanechol
012. Bethanechol has all of the following properties EXCEPT:
a) It is extremely resistant to hydrolysis
b) Purely muscarinic in its action
c) It is used for abdominal urinary bladder distention
d) It exerts both nicotinic and muscarinic effects
013. A M-cholinimimetic agent is:
a) Carbachol
b) Pilocarpine
c) Acetylcholine
d) Bethanechol
014. Characteristics of pilocarpine include all of the following EXCEPT:
a) It is a tertiary amine alkaloid
b) It causes miosis and a decrease in intraocular pressure
c) Causes a decrease in secretory and motor activity of gut
d) It is useful in the treatment of glaucoma
015. Which of the following cholinomimetics is a plant derivative with lower potency than nicotine but with a similar spectrum
of action?
a) Lobeline
b) Pilocarpine
c) Carbochol
d) Acetylcholine
016. Which of the following cholinomimetics is indirect-acting?
a) Lobeline
b) Edrophonium
c) Pilocarpine
d) Carbachol
017. The mechanism of action of indirect-acting cholinomimetic agents is:
a) Binding to and activation of muscarinic or nicotinic receptors
b) Inhibition of the hydrolysis of endogenous acetylcholine
c) Stimulation of the action of acetylcholinesterase
d) Releasing acetylcholine from storage sites
018. Indicate a reversible cholinesterase inhibitor:
a) Isoflurophate
b) Carbochol
c) Physostigmine
d) Parathion
019. Which of the following cholinesterase inhibitors is irreversible?
a) Physostigmine
b) Edrophonium
c) Neostigmine
d) Isoflurophate
020. Indicate cholinesterase activator:
a) Pralidoxime
b) Edrophonium
c) Pilocarpine
d) Isoflurophate
021. Isofluorophate increases all of the following effects except:
a) Lacrimation
b) Bronchodilation
c) Muscle twitching
d) Salivation
022. Indicate a cholinesterase inhibitor, which has an additional direct nicotinic agonist effect:
a) Edrophonium
b) Carbochol
c) Neostigmine
d) Lobeline
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023. Сholinesterase inhibitors do not produce:
a) Bradycardia, no change or modest fall in blood pressure
b) Increased strength of muscle contraction, especially in muscles weakened by myasthenia gravis
c) Miosis and reduction of intraocular pressure
d) Dramatic hypertension and tachycardia
024. Which of the following cholinomimetics is commonly used in the treatment of glaucoma?
a) Pilocarpine
b) Lobeline
c) Acethylcholine
d) Neostigmine
025. Indicate the organophosphate cholinesterase inhibitor, which can be made up in an aqueous solution for ophthalmic use
and retains its activity within a week:
a) Physoctigmine
b) Edrophonium
c) Echothiophate
d) Neostigmine
026. Which of the following cholinomimetics is most widely used for paralytic ileus and atony of the urinary bladder?
a) Lobeline
b) Neostigmine
c) Pilocarpine
d) Echothiophate
027. Chronic long-term therapy of myasthenia is usually accomplished with:
a) Edrophonium
b) Neostigmine
c) Echothiophate
d) Carbachol
028. Which of the following cholinomimetics is a drug of choice for reversing the effects of nondepolarizing neuromuscular
relaxants?
a) Echothiophate
b) Physostigmine
c) Edrophonium
d) Pilocarpine
029. Indicate the reversible cholinesterase inhibitor, which penetrates the blood-brain barrier:
a) Physostigmine
b) Edrophonium
c) Neostigmine
d) Piridostigmine
030. Which of the following cholinomimetics is used in the treatment of atropine intoxication?
a) Neostigmine
b) Carbochol
c) Physostigmine
d) Lobeline
031. The symptoms of excessive stimulation of muscarinic receptors include all of the following EXCEPT:
a) Abdominal cramps, diarrhea
b) Increased salivation, excessive bronchial secretion
c) Miosis, bradycardia
d) Weakness of all skeletal muscles
032. The excessive stimulation of muscarinic receptors by pilocarpine and choline esters is blocked competitively by:
a) Edrophonium
b) Atropine
c) Pralidoxime
d) Echothiophate
033. The toxic effects of a large dose of nicotine include all of the following EXCEPT:
a) Hypotension and bradycardia
b) Convulsions, coma and respiratory arrest
c) Skeletal muscle depolarization blockade and respiratory paralysis
d) Hypertension and cardiac arrhythmias
034. The dominant initial sights of acute cholinesterase inhibitors intoxication include all of the following except:
a) Salivation, sweating
b) Mydriasis
c) Bronchial constriction
19
d) Vomiting and diarrhea
035. Which of the following drugs is used for acute toxic effects of organophosphate cholinesterase inhibitors?
a) Atropine
b) Pilocarpine
c) Pralidoxime
d) Edrophonium

PART III Cholinoreceptor blocking drugs


001. The group of nicotinic receptor-blocking drugs consists of:
a) Ganglion-blockers
b) Atropine-similar drugs
c) Neuromuscular junction blockers
d) Both a and c
002. M3 receptor subtype is located:
a) In the myocardium
b) In sympathetic postganglionic neurons
c) On effector cell membranes of glandular and smooth muscle cells
d) On the motor end plates
003. Which of the following drugs is both a muscarinic and nicotinic blocker?
a) Atropine
b) Benztropine
c) Hexamethonium
d) Succinylcholine
004. Indicate a muscarinic receptor-blocking drug:
a) Scopolamine
b) Pipecuronium
c) Trimethaphan
d) Pilocarpine
005. Which of the following agents is a ganglion-blocking drug?
a) Homatropine
b) Hexamethonium
c) Rapacuronium
d) Edrophonium
006. Indicate the skeletal muscle relaxant, which is a depolarizing agent:
a) Vencuronium
b) Scopolamine
c) Succinylcholine
d) Hexamethonium
007. Which of the following drugs is a nondepolarizing muscle relaxant?
a) Pancuronium
b) Succinylcholine
c) Hexamethonium
d) Scopolamine
008. Indicate the drug, which is rapidly and fully distributed into CNS and has a greater effect than most other antimuscarinic
agents?
a) Atropine
b) Scopolamine
c) Homatropine
d) Ipratropium
009. The effect of the drug on parasympathetic function declines rapidly in all organs EXCEPT:
a) Eye
b) Heart
c) Smooth muscle organs
d) Glands
010. The mechanism of atropine action is:
a) Competitive ganglion blockade
b) Competitive muscarinic blockade
c) Competitive neuromuscular blockade
d) Noncompetitive neuromuscular blockade
011. The tissues most sensitive to atropine are:
20
a) The salivary, bronchial and sweat glands
b) The gastric parietal cells
c) Smooth muscle and autonomic effectors
d) The heart
012. Atropine is highly selective for:
a) M1 receptor subtype
b) M2 receptor subtype
c) M3 receptor subtype
d) All of the above
013. Which of the following antimuscarinic drugs is often effective in preventing or reversing vestibular disturbances,
especially motion sickness?
a) Atropine
b) Ipratropium
c) Scopolamine
d) Homatropine
014. Atropine causes:
a) Miosis, a reduction in intraocular pressure and cyclospasm
b) Mydriasis, a rise in intraocular pressure and cycloplegia
c) Miosis, a rise in intraocular pressure and cycloplegia
d) Mydriasis, a rise in intraocular pressure and cyclospasm
015. Patients complain of dry or “sandy” eyes when receiving large doses of:
a) Atropine
b) Hexamethonium
c) Pilocarpine
d) Carbachol
016. All of the following parts of the heart are very sensitive to muscarinic receptor blockade except:
a) Atria
b) Sinoatrial node
c) Atrioventricular node
d) Ventricle
017. Atropine causes:
a) Bradycardia, hypotension and bronchoconstriction
b) Tachycardia, little effect on blood pressure and bronchodilation
c) Decrease in contractile strength, conduction velocity through the AV node
d) Tachycardia, hypertensive crisis and bronchodilation
018. Atropine is frequently used prior to administration of inhalant anesthetics to reduce:
a) Muscle tone
b) Secretions
c) Nausea and vomiting
d) All of the above
019. Atropine is now rarely used for the treatment of peptic ulcer because of:
a) Slow gastric empting and prolongation of the exposure of the ulcer bed to acid
b) Low efficiency and necessity of large doses
c) Adverse effects
d) All of the above
020. Which of the following antimuscarinic drugs is a selective M1 blocker?
a) Atropine
b) Scopolamine
c) Pirenzepine
d) Homatropine
021. Atropine causes:
a) Spasmolitic activity
b) Intestinal hypermotility
c) Stimulation of contraction in the gut
d) Stimulation of secretory activity
022. Which of the following drugs is useful in the treatment of uterine spasms?
a) Carbachol
b) Vecuronium
c) Atropine
d) Edrophonium
023. Atropine may cause a rise in body temperature (atropine fever):
21
a) In adults
b) In pregnant women
c) In infants and children
d) All of the above
024. The pharmacologic actions of scopolamine most closely resemble those of:
a) Hexamethonium
b) Atropine
c) Succinylcholine
d) Pilocarpine
025. Compared with atropine, scopolamine has all of the following properties EXCEPT:
a) More marked central effect
b) Less potent in decreasing bronchial, salivary and sweat gland secretion
c) More potent in producing mydriasis and cycloplegia
d) Lower effects on the heart, bronchial muscle and intestines
026. Which of the following drugs is useful in the treatment of Parkinson′s disease?
a) Benztropine
b) Edrophonium
c) Succinylcholine
d) Hexamethonium
027. Indicate the antimuscarinic drug, which is used as a mydriatic:
a) Pilocarpine
b) Neostigmine
c) Homatropine
d) Ipratropium
028. Which of the following agents is used as an inhalation drug in asthma?
a) Atropine
b) Ipratropium
c) Lobeline
d) Homatropine
029. Which of the following agents is most effective in regenerating cholinesterase associated with skeletal muscle
neuromuscular junctions?
a) Suscinilcholine
b) Pralidoxime
c) Pirenzepine
d) Propiverine
030. Indicate an antimuscarinic drug, which is effective in the treatment of mushroom poising:
a) Pralidoxime
b) Pilocarpine
c) Homatropine
d) Atropine
031. Antimuscarinics are used in the treatment of the following disorders EXCEPT:
a) Motion sickness
b) Glaucoma
c) Hyperhidrosis
d) Asthma
032. The atropine poisoning includes all of the following symptoms EXCEPT:
a) Mydriasis, cycloplegia
b) Hyperthermia, dry mouth, hot and flushed skin
c) Agitation and delirium
d) Bradicardia, orthostatic hypotension
033. The treatment of the antimuscarinic effects can be carried out with:
a) Neostigmine
b) Hexametonium
c) Homatropine
d) Acetylcholine
034. Contraindications to the use of antimuscarinic drugs are all of the following except:
a) Glaucoma
b) Myasthenia
c) Bronchial asthma
d) Paralytic ileus and atony of the urinary bladder
035. Hexamethonium blocks the action of acethylcholine and similar agonists at:
22
a) Muscarinic receptor site
b) Neuromuscular junction
c) Autonomic ganglia
d) Axonal transmission
036. The applications of the ganglion blockers have disappeared because of all of the following reasons EXCEPT:
a) Orthostatic hypotension
b) Lack of selectivity
c) Homeostatic reflexes block
d) Respiratory depression
037. Which of the following agents is a short-acting ganglion blocker?
a) Homatropine
b) Trimethaphane
c) Hexamethonium
d) Pancuronium
038. Indicate the ganglion-blocking drug, which can be taken orally for the treatment of hypertension?
a) Mecamylamine
b) Scopolamine
c) Trimethaphane
d) Vecocuronium
039. The systemic effects of hexamethonium include all of the following EXCEPT:
a) Reduction of both peripheral vascular resistance and venous return
b) Partial mydriasis and loss of accommodation
c) Constipation and urinary retention
d) Stimulation of thermoregulatory sweating
040. Ganglion blocking drugs are used for the following emergencies EXCEPT:
a) Hypertensive crises
b) Controlled hypotension
c) Cardiovascular collapse
d) Pulmonary edema
041. Agents that produce neuromuscular blockade act by inhibiting:
a) Interaction of acetylcholine with cholinergic receptors
b) Release of acetylcholine from prejunctional membrane
c) Packaging of acetylcholine into synaptic vesicles
d) Reuptake of acetylcholine into the nerve ending
042. Skeletal muscle relaxation and paralysis can occur from interruption of functions at several sites, including all of the
following EXCEPT:
a) Nicotinic acethylcholine receptors
b) Muscarinic acethylcholine receptors
c) The motor end plate
d) Contractile apparatus
043. Nondepolarisation neuromuscular blocking agents:
a) Block acetylcholine reuptake
b) Prevent access of the transmitter to its receptor and depolarization
c) Block transmission by an excess of a depolarizing agonist
d) All of the above
044. Which of the following drugs has “double-acetylcholine” structure?
a) Rocuronium
b) Carbachol
c) Atracurium
d) Succylcholine
045. Indicate the long-acting neuromuscular blocking agent:
a) Rapacuronium
b) Mivacurium
c) Tubocurarine
d) Rocuronium
046. Which of the following neuromuscular blocking drugs is an intermediate-duration muscle relaxant?
a) Vecuronium
b) Tubocurarine
c) Pancuronium
d) Rapacuronium
047. Indicate the nondepolarizing agent, which has the fastest onset of effect?
23
a) Succinylcholine
b) Rapacuronium
c) Pancuronium
d) Tubocurarine
048. Indicate the neuromuscular blocker, whose breakdown product readily crosses the blood-brain barrier and may cause
seizures:
a) Pancuronium
b) Succinylcholine
c) Tubocurarine
d) Atracurium
049. Which competitive neuromuscular blocking agent could be used in patients with renal failure?
a) Atracurium
b) Succinylcholine
c) Pipecuronium
d) Doxacurium
050. Indicate the nondepolarizing agent, which has short duration of action:
a) Succinylcholine
b) Tubocurarine
c) Mivacurium
d) Pancuronium
051. Which depolarizing agent has the extremely brief duration of action?
a) Mivacurium
b) Rapacuronium
c) Rocuronium
d) Succinylcholine
052. Neuromuscular blockade by both succinylcholine and mivacurium may be prolonged in patients with:
a) Renal failure
b) An abnormal variant of plasma cholinesterase
c) Hepatic disease
d) Both b and c
053. Depolarizing agents include all of the following properties EXCEPT:
a) Interact with nicotinic receptor to compete with acetylcholine without receptor activation
b) React with the nicotinic receptor to open the channel and cause depolarisation of the end plate
c) Cause desensitization, noncompetive block manifested by flaccid paralysis
d) Cholinesterase inhibitors do not have the ability to reverse the blockade
054. Which of the following neuromuscular blockers causes transient muscle fasciculations?
a) Mivacurium
b) Pancuronium
c) Succinylcholine
d) Tubocurarine
055. Indicate muscles, which are more resistant to block and recover more rapidly:
a) Hand
b) Leg
c) Neck
d) Diaphragm
056. Which neuromuscular blocking agent has the potential to cause the greatest release of histamine?
a) Succylcholine
b) Tubocurarine
c) Pancuronium
d) Rocuronium
057. Which of the following muscular relaxants causes hypotension and bronchospasm?
a) Vecuronium
b) Succinylcholine
c) Tubocurarine
d) Rapacuronium
058. Indicate the neuromuscular blocker, which causes tachycardia:
a) Tubocurarine
b) Atracurium
c) Pancuronium
d) Succinylcholine
059. Which of the following neuromuscular blocking agents cause cardiac arrhythmias?
24
a) Vecuronium
b) Tubocurarine
c) Rapacuronium
d) Succinylcholine
060. Effects seen only with depolarizing blockade include all of the following EXCEPT:
a) Hypercaliemia
b) A decrease in intraocular pressure
c) Emesis
d) Muscle pain
061. Which neuromuscular blocking agent is contraindicated in patients with glaucoma?
a) Tubocurarine
b) Succinylcholine
c) Pancuronium
d) Gallamine
062. Indicate the following neuromuscular blocker, which would be contraindicated in patients with renal failure:
a) Pipecuronium
b) Succinylcholine
c) Atracurium
d) Rapacuronium
063. All of the following drugs increase the effects of depolarizing neuromuscular blocking agents EXCEPT:
a) Aminoglycosides
b) Antiarrhythmic drugs
c) Nondepolarizing blockers
d) Local anesthetics
064. Which of the following diseases can augment the neuromuscular blockade produced by nondepolarizing muscle
relaxants?
a) Myasthenia gravis
b) Burns
c) Asthma
d) Parkinsonism
065. Indicate the agent, which effectively antagonizes the neuromuscular blockade caused by nondepolarizing drugs:
a) Atropine
b) Neostigmine
c) Acetylcholine
d) Pralidoxime

PART IV Adrenoreceptor activating drugs


001. Sympathetic stimulation is mediated by:
a) Release of norepinephrine from nerve terminals
b) Activation of adrenoreceptors on postsynaptic sites
c) Release of epinephrine from the adrenal medulla
d) All of the above
002. Characteristics of epinephrine include all of the following EXCEPT:
a) It is synthesized into the adrenal medulla
b) It is synthesized into the nerve ending
c) It is transported in the blood to target tissues
d) It directly interacts with and activates adrenoreceptors
003. Which of the following sympathomimetics acts indirectly?
a) Epinephrine
b) Norepinephrine
c) Ephedrine
d) Methoxamine
004. Indirect action includes all of the following properties EXCEPT:
a) Displacement of stored catecholamines from the adrenergic nerve ending
b) Inhibition of reuptake of catecholamines already released
c) Interaction with adrenoreceptors
d) Inhibition of the release of endogenous catecholamines from peripheral adrenergic neurons
005. Catecholamine includes following EXCEPT:
a) Ephedrine
b) Epinephrine
c) Isoprenaline
25
d) Norepinephrine
006. Epinephrine decreases intracellular camp levels by acting on:
a) α1 receptor
b) α2 receptor
c) beta1 receptor
d) beta2 receptor
007. Which of the following statements is not correct?
a) ALFA receptors increase arterial resistence, whereas beta2 receptor promote smooth muscle relaxation
b) The skin and splanchic vessels have predominantly alfa receptors
c) Vessels in a skeletal muscle may constrict or dilate depending on whether alfa or beta2 receptors are activated
d) Skeletal muscle vessels have predominantly alfa receptors and constrict in the presence of epinephrine and
norepinephrine
008. Direct effects on the heart are determined largely by:
a) Alfa1 receptor
b) Alfa2 receptor
c) Beta1 receptor
d) Beta2 receptor
009. Which of the following effects is related to direct beta1-adrenoreceptor stimulation?
a) Bronchodilation
b) Vasodilatation
c) Tachycardia
d) Bradycardia
010. Distribution of alfa adrenoreceptor subtypes is associated with all of the following tissues except those of:
a) Heart
b) Blood vessels
c) Prostate
d) Pupillary dilator muscle
011. Beta adrenoreceptor subtypes is contained in all of the following tissues EXCEPT:
a) Bronchial muscles
b) Heart
c) Pupillary dilator muscle
d) Fat cells
012. In which of the following tissues both alfa and beta1 adrenergic stimulation produces the same effect?
a) Blood vessels
b) Intestine
c) Uterus
d) Bronchial muscles
013. The effects of sympathomimetics on blood pressure are associated with their effects on:
a) The heart
b) The peripheral resistance
c) The venous return
d) All of the above
014. A relatively pure alfa agonist causes all of the following effects EXCEPT:
a) Increase peripheral arterial resistance
b) Increase venous return
c) Has no effect on blood vessels
d) Reflex bradycardia
015. A nonselective beta receptor agonist causes all of the following effects EXCEPT:
a) Increase cardiac output
b) Increase peripheral arterial resistance
c) Decrease peripheral arterial resistance
d) Decrease the mean pressure
016. Which of the following statement is not correct?
a) Αlfa agonists cause miosis
b) Αlfa agonists cause mydriasis
c) Beta antagonists decrease the production of aqueous humor
d) Αlfa agonists increase the outflow of aqueous humor from the eye
017. A bronchial smooth muscle contains:
a) Αlfa1 receptor
b) Αlfa2 receptor
c) Beta 1 receptor
26
d) Beta 2 receptor
018. All of the following agents are beta receptor agonists EXCEPT:
a) Epinephrine
b) Isoproterenol
c) Methoxamine
d) Dobutamine
019. Which of the following drugs causes bronchodilation without significant cardiac stimulation?
a) Isoprenaline
b) Terbutaline
c) Xylometazoline
d) Methoxamine
020. Αlfa-receptor stimulation includes all of the following effects EXCEPT:
a) Relaxation of gastrointestinal smooth muscle
b) Contraction of bladder base, uterus and prostate
c) Stimulation of insulin secretion
d) Stimulation of platelet aggregation
021. Beta1 receptor stimulation includes all of the following effects EXCEPT:
a) Increase in contractility
b) Bronchodilation
c) Tachycardia
d) Increase in conduction velocity in the atrioventricular node
022. Beta2 receptor stimulation includes all of the following effects EXCEPT:
a) Stimulation of renin secretion
b) Fall of potassium concentration in plasma
c) Relaxation of bladder, uterus
d) Tachycardia
023. Hyperglycemia induced by epinephrine is due to:
a) Gluconeogenesis (beta2)
b) Inhibition of insulin secretion (alfa)
c) Stimulation of glycogenolysis (beta2)
d) All of the above
024. Which of the following effects is associated with beta3-receptor stimulation?
a) Lipolysis
b) Decrease in platelet aggregation
c) Bronchodilation
d) Tachycardia
025. Which of the following statements is not correct?
a) Epinephrine acts on both alfa- and beta-receptors
b) Norepinephrine has a predominantly beta action
c) Methoxamine has a predominantly alfa action
d) Isoprenaline has a predominantly beta action
026. Indicate the drug, which is a direct-acting both alfa- and beta-receptor agonist:
a) Norepinephrine
b) Methoxamine
c) Isoproterenol
d) Ephedrine
027. Which of the following agents is an alfa1 alfa2 beta1 beta2 receptor agonist?
a) Methoxamine
b) Albuterol
c) Epinephrine
d) Norepinephrine
028. Indicate the direct-acting sympathomimetic, which is an alfa1 alfa2 beta1 receptor agonist:
a) Isoproterenol
b) Ephedrine
c) Dobutamine
d) Norepinephrine
029. Which of the following agents is an alfa1-selective agonist?
a) Norepinephrine
b) Methoxamine
c) Ritodrine
d) Ephedrine
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030. Indicate the alfa2-selective agonist:
a) Xylometazoline
b) Epinephrine
c) Dobutamine
d) Methoxamine
031. Which of the following agents is a nonselective beta receptor agonist?
a) Norepinephrine
b) Terbutaline
c) Isoproterenol
d) Dobutamine
032. Indicate the beta1-selective agonist:
a) Isoproterenol
b) Dobutamine
c) Metaproterenol
d) Epinephrine
033. Which of the following sympathomimetics is a beta2-selective agonist?
a) Terbutaline
b) Xylometazoline
c) Isoproterenol
d) Dobutamine
034. Indicate the indirect-acting sympathomimetic agent:
a) Epinephrine
b) Phenylephrine
c) Ephedrine
d) Isoproterenol
035. Epinephrine produces all of the following effects EXCEPT:
a) Positive inotropic and chronotropic actions on the heart (beta1 receptor)
b) Increase peripheral resistance (alfa receptor)
c) Predominance of alfa effects at low concentration
d) Skeletal muscle blood vessel dilatation (beta2 receptor)
036. Epinephrine produces all of the following effects EXCEPT:
a) Decrease in oxygen consumption
b) Bronchodilation
c) Hyperglycemia
d) Mydriasis
037. Epinephrine is used in the treatment of all of the following disorders EXCEPT:
a) Bronchospasm
b) Anaphylactic shock
c) Cardiac arrhythmias
d) Open-angle glaucoma
038. Compared with epinephrine, norepinephrine produces all of the following effects EXCEPT:
a) Similar effects on beta1 receptors in the heart and similar potency at an alfa receptor
b) Decrease the mean pressure below normal before returning to the control value
c) Significant tissue necrosis if injected subcutaneously
d) Increase both diastolic and systolic blood pressure
039. Norepinephrine produces:
a) Vasoconstriction
b) Vasodilatation
c) Bronchodilation
d) Decresed potassium concentration in the plasma
040. Which of the following direct-acting drugs is a relatively pure alfa agonist, an effective mydriatic and decongestant and
can be used to raise blood pressure?
a) Epinephrine
b) Norepinephrine
c) Phenylephrine
d) Ephedrine
041. Characteristics of methoxamine include all of the following EXCEPT:
a) It is a direct-acting alfa1-receptor agonist
b) It increases heart rate, contractility and cardiac output
c) It causes reflex bradycardia
d) It increases total peripheral resistance
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042. Which of the following agents is an alfa2-selective agonist with ability to promote constriction of the nasal mucosa?
a) Xylometazoline
b) Phenylephrine
c) Methoxamine
d) Epinephrine
043. Indicate the sympathomimetic, which may cause hypotension, presumably because of a clonidine-like effect:
a) Methoxamine
b) Phenylephrine
c) Xylometazoline
d) Isoproterenol
044. Isoproterenol is:
a) Both an alfa- and beta-receptor agonist
b) beta1-selective agonist
c) beta2-selective agonist
d) Nonselective beta receptor agonist
045. Isoproterenol produces all of the following effects EXCEPT:
a) Increase in cardiac output
b) Fall in diastolic and mean arterial pressure
c) Bronchoconstriction
d) Tachycardia
046. Characteristics of dobutamine include all of the following EXCEPT:
a) It is a relatively beta1-selective synthetic catecholamine
b) It is used to treat bronchospasm
c) It increases atrioventricular conduction
d) It causes minimal changes in heart rate and systolic pressure
047. Characteristics of salmeterol include all of the following EXCEPT:
a) It is a potent selective beta2 agonist
b) It causes uterine relaxation
c) It stimulates heart rate, contractility and cardiac output
d) It is used in the therapy of asthma
048. Characteristics of ephedrine include all of the following EXCEPT:
a) It acts primarily through the release of stored cathecholamines
b) It is a mild CNS stimulant
c) It causes tachyphylaxis with repeated administration
d) It decreases arterial pressure
049. Ephedrine causes:
a) Miosis
b) Bronchodilation
c) Hypotension
d) Bradycardia
050. Compared with epinephrine, ephedrine produces all of the following features EXCEPT:
a) It is a direct-acting sympathomimetic
b) It has oral activity
c) It is resistant to MAO and has much longer duration of action
d) Its effects are similar, but it is less potent
051. Which of the following sympathomimetics is preferable for the treatment of chronic orthostatic hypotension?
a) Epinephrine
b) Norepinephrine
c) Ephedrine
d) Salmeterol
052. Indicate the sympathomimetic drug, which is used in a hypotensive emergency:
a) Xylometazoline
b) Ephedrine
c) Terbutaline
d) Phenylephrine
053. Which of the following sympathomimetics is preferable for the emergency therapy of cardiogenic shock?
a) Epinephrine
b) Dobutamine
c) Isoproterenol
d) Methoxamine
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054. Indicate the sympathomimetic agent, which is combined with a local anesthetic to prolong the duration of infiltration
nerve block:
a) Epinephrine
b) Xylometazoline
c) Isoproterenol
d) Dobutamine
055. Which of the following sympathomimetics is related to short-acting topical decongestant agents?
a) Xylometazoline
b) Terbutaline
c) Phenylephrine
d) Norepinephrine
056. Indicate the long-acting topical decongestant agents:
a) Epinephrine
b) Norepinephrine
c) Phenylephrine
d) Xylometazoline
057. Which of the following topical decongestant agents is an alfa2-selective agonist?
a) Phenylephrine
b) Xylometazoline
c) Ephedrine
d) Epinephrine
058. Indicate the sympathomimetic, which may be useful in the emergency management of cardiac arrest:
a) Methoxamine
b) Phenylephrine
c) Epinephrine
d) Xylometazoline
059. Which of the following sympathomimetics is used in the therapy of bronchial asthma?
a) Formoterol
b) Norepinephrine
c) Methoxamine
d) Dobutamine
060. Indicate the agent of choice in the emergency therapy of anaphylactic shock:
a) Methoxamine
b) Terbutaline
c) Norepinephrine
d) Epinephrine
061. Which of the following sympathomimetics is an effective mydriatic?
a) Salmeterol
b) Phenylephrine
c) Dobutamine
d) Norepinephrine
062. The adverse effects of sympathomimetics include all of the following EXCEPT:
a) Drug-induced parkinsonism
b) Cerebral hemorrhage or pulmonary edema
c) Myocardial infarction
d) Ventricular arrhythmias

PART V Adrenoreceptor antagonist drugs


001. Which of the following drugs is a nonselective alfa receptor antagonist?
a) Prazosin
b) Phentolamine
c) Metoprolol
d) Reserpine
002. Indicate the alfa1-selective antagonist:
a) Phentolamine
b) Dihydroergotamine
c) Prazosin
d) Labetalol
003. Which of the following agents is an alfa2–selective antagonist?
a) Yohimbine
b) Tamsulosin
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c) Tolazoline
d) Prazosin
004. Indicate the irreversible alfa receptor antagonist:
a) Tolazoline
b) Labetalol
c) Prazosin
d) Phenoxybenzamine
005. Which of the following drugs is an nonselective beta receptor antagonist?
a) Metoprolol
b) Atenolol
c) Propranolol
d) Acebutolol
006. Indicate the beta1-selective antagonist:
a) Propranolol
b) Metoprolol
c) Carvedilol
d) Sotalol
007. Which of the following agents is a beta2–selective antagonist?
a) Tolazolin
b) Pindolol
c) Ergotamin
d) Butoxamine
008. Indicate the beta adrenoreceptor antagonist, which has partial beta–agonist activity:
a) Propranolol
b) Metoprolol
c) Pindolol
d) Betaxolol
009. Which of the following drugs is a reversible nonselective alfa, beta antagonist?
a) Labetalol
b) Phentolamine
c) Metoprolol
d) Propranolol
010. Indicate the indirect-acting adrenoreceptor blocking drug:
a) Tolazoline
b) Reserpine
c) Carvedilol
d) Prazosin
011. The principal mechanism of action of adrenoreceptor antagonists is:
a) Reversible or irreversible interaction with adrenoreceptors
b) Depletion of the storage of catecholamines
c) Blockade of the amine reuptake pumps
d) Nonselective MAO inhibition
012. Characteristics of alfa-receptor antagonists include all of the following EXCEPT:
a) They cause a fall in peripheral resistance and blood pressure
b) They cause epinephrine reversal (convert a pressor response to a depressor response)
c) Bronchospasm
d) They may cause postural hypotension and reflex tachycardia
013. Which of the following drugs is an imidazoline derivative and a potent competitive antagonist at both alfa1 and alfa2
receptors?
a) Prazosin
b) Labetalol
c) Phenoxybenzamine
d) Phentolamine
014. Characteristics of phentolamine include all of the following EXCEPT:
a) Reduction in peripheral resistance
b) Stimulation of responses to serotonin
c) Tachycardia
d) Stimulation of muscarinic, H1 and H2 histamine receptors
015. The principal mechanism of phentolamine-induced tachycardia is:
a) Antagonism of presynaptic alfa2 receptors enhances norepinephrine release, which causes cardiac
stimulation via unblocked beta receptors
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b) Baroreflex mechanism
c) Direct effect on the heart by stimulation of beta1 receptors
d) Inhibition of transmitter reuptake at noradrenergic synapses
016. Nonselective alfa-receptor antagonists are most useful in the treatment of:
a) Asthma
b) Cardiac arrhythmias
c) Pheochromocytoma
d) Chronic hypertension
017. The main reason for using alfa-receptor antagonists in the management of pheochromocytoma is:
a) Inhibition of the release of epinephrine from the adrenal medulla
b) Blockade of alfa2 receptors on vascular smooth muscle results in epinephrine stimulation of unblocked alfa2
receptors
c) Direct interaction with and inhibition of beta2 adrenoreceptors
d) Antagonism to the release of renin
018. Which of the following drugs is useful in the treatment of pheochromocytoma?
a) Phenylephrine
b) Propranolol
c) Phentolamine
d) Epinephrine
019. Indicate adrenoreceptor antagonist agents, which are used for the management of pheochromocytoma:
a) Selective beta2-receptor antagonists
b) Nonselective beta-receptor antagonists
c) Indirect-acting adrenoreceptor antagonist drugs
d) Αlfa-receptor antagonists
020. The principal adverse effects of phentolamine include all of the following EXCEPT:
a) Diarrhea
b) Bradycardia
c) Arrhythmias
d) Myocardial ischemia
021. Indicate the reversible nonselective alfa-receptor antagonist, which is an ergot derivative:
a) Ergotamine
b) Prazosin
c) Phenoxybenzamine
d) Carvedilol
022. Indicate an alfa-receptor antagonist, which binds covalently to alfa receptors, causing irreversible blockade of long
duration (14-48 hours or longer):
a) Phentolamine
b) Phenoxybenzamine
c) Ergotamine
d) Prazosin
023. Compared with phentolamine, prazosin has all of the following features EXCEPT:
a) Irreversible blockade of alfa receptors
b) Highly selective for alfa1 receptors
c) The relative absence of tachycardia
d) Persistent block of alfa1 receptors
024. Which of the following statements is not correct?
a) There are at least three subtypes of alfa1 receptors, designated alfa1a, alfa1b and alfa1d
b) ALFA1a subtype mediates prostate smooth muscle contraction
c) ALFA1b subtype mediates vascular smooth muscle contraction
d) ALFA1a subtype mediates both vascular and prostate smooth muscle contraction
025. Indicate an alfa1 adrenoreceptor antagonist, which has great selectivity for alfa1a subtype:
a) Prazosin
b) Tamsulosin
c) Phenoxybenzamine
d) Phentolamine
026. Subtype-selective alfa1 receptor antagonists such as tamsulosin, terazosin, alfusosin are efficacious in:
a) Hyperthyroidism
b) Cardiac arrhythmias
c) Benign prostatic hyperplasia (BPH)
d) Asthma
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027. Indicate an alfa receptor antagonist, which is an efficacious drug in the treatment of mild to moderate systemic
hypertension:
a) Phentolamine
b) Tolazoline
c) Ergotamine
d) Prazosin
028. Which of the following alfa receptor antagonists is useful in reversing the intense local vasoconstriction caused by
inadvertent infiltration of norepinephrine into subcutaneous tissue during intravenous administration?
a) Propranolol
b) Phentolamine
c) Tamsulosin
d) Ergotamine
029. Beta-blocking drugs-induced chronically lower blood pressure may be associated with theirs effects on:
a) The heart
b) The blood vessels
c) The renin-angiotensin system
d) All of the above
030. Characteristics of beta-blocking agents include all of the following EXCEPT:
a) They occupy beta receptors and competitively reduce receptor occupancy by catecholamines or other beta agonists
b) They do not cause hypotension in individuals with normal blood pressure
c) They induce depression and depleted stores of catecholamines
d) They can cause blockade in the atrioventricular node
031. Beta-receptor antagonists have all of the following cardiovascular effects EXCEPT:
a) The negative inotropic and chronotropic effects
b) Acute effects of these drugs include a fall in peripheral resistance
c) Vasoconstriction
d) Reduction of the release of renin
032. Beta-blocking agents have all of the following effects except:
a) Increase plasma concentrations of HDL and decrease of VLDL
b) Bronchoconstriction
c) Decrease of aqueous humor prodaction
d) “membrane-stabilizing” action
033. Beta-receptor antagonists cause:
a) Stimulation of lipolysis
b) Stimulation of gluconeogenesis
c) Inhibition of glycogenolysis
d) Stimulation of insulin secretion
034. Propranolol has all of the following cardiovascular effects EXCEPT:
a) It decreases cardiac work and oxygen demand
b) It reduces blood flow to the brain
c) It inhibits the renin secretion
d) It increases the atrioventricular nodal refractory period
035. Propranolol-induced adverse effects include all of the following EXCEPT:
a) Bronchoconstriction
b) “supersensitivity” of beta-adrenergic receptors (rapid withdrawal)
c) Hyperglycemia
d) Sedation, sleep disturbances, depression and sexual dysfunction
036. Propranolol is used in the treatment all of the following diseases EXCEPT:
a) Cardiovascular diseases
b) Hyperthyroidism
c) Migraine headache
d) Bronchial asthma
037. Metoprolol and atenolol:
a) Are members of the beta1-selective group
b) Are nonselective beta antagonists
c) Have intrinsic sympathomimetic activity
d) Have an anesthetic action
038. Which of the following beta receptor antagonists is preferable in patients with asthma, diabetes or peripheral vascular
diseases?
a) Propranolol
b) Metoprolol
33
c) Nadolol
d) Timolol
039. Indicate a beta receptor antagonist, which has very long duration of action:
a) Metoprolol
b) Propranolol
c) Nadolol
d) Pindolol
040. Indicate a beta1-selective receptor antagonist, which has very long duration of action:
a) Betaxolol
b) Sotalol
c) Nadolol
d) Metoprolol
041. Which of the following drugs is a nonselective beta-blocker without intrinsic sympathomimetic or local anesthetic activity
and used for the treatment of life-threatening ventricular arrhythmias?
a) Propranolol
b) Oxprenolol
c) Sotalol
d) Atenolol
042. Indicate a beta receptor antagonist with intrinsic sympathomimetic activity:
a) Propranolol
b) Oxprenolol
c) Metoprolol
d) Carvedilol
043. Pindolol, oxprenolol have all of the following properties EXCEPT:
a) They are nonselective beta antagonists
b) They have no partial agonist activity
c) They are less likely to cause bradycardia and abnormalities in plasma lipids
d) They are effective in hypertension and angina
044. Which of the following drugs has both alfa1-selective and beta-blocking effects?
a) Labetalol
b) Betaxolol
c) Propranolol
d) Timolol
045. Characteristics of carvedilol include all of the following EXCEPT:
a) It is a beta1-selective antagonist
b) It has both alfa1-selective and beta-blocking effects
c) It attenuates oxygen free radical-initiated lipid peroxidation
d) It inhibits vascular smooth muscle mitogenesis
046. Indicate the adrenoreceptor antagonist drug, which is a rauwolfia alkaloid:
a) Prazosin
b) Propranolol
c) Reserpine
d) Phentolamine
047. Characteristics of reserpine include all of the following EXCEPT:
a) It inhibits the uptake of norepinephrine into vesicles and MAO
b) It decreases cardiac output, peripheral resistance and inhibits pressor reflexes
c) It may cause a transient sympathomimetic effect
d) It depletes stores of catecholamines and serotonin in the brain
048. Indicate a beta-blocker, which is particularly efficacious in thyroid storm:
a) Pindolol
b) Sotalol
c) Phentolamine
d) Propranolol
049. Beta-receptor blocking drugs are used in the treatment all of the following diseases EXCEPT:
a) Hypertension, ischemic heart disease, cardiac arrhythmias
b) Glaucoma
c) Pheochromocytoma
d) Hyperthyroidism
050. Beta-blocker-induced adverse effects include all of the following EXCEPT:
a) Bronchoconstriction
b) Depression of myocardial contractility and excitability
34
c) “supersensitivity” of beta-receptors associated with rapid withdrawal of drugs
d) Hyperglycemia

(3) AGENTS, CONTROLLING THE FUNCTIONS OF THE CENTRAL NERVOUS SYSTEM

PART I Hypnotic drugs


001. Hypnotic drugs are used to treat:
a) Psychosis
b) Sleep disorders
c) Narcolepsy
d) Parkinsonian disorders
002. Hypnotic drugs should:
a) Reduce anxiety and exert a calming effect
b) Induce absence of sensation
c) Produce drowsiness, encourage the onset and maintenance of sleep
d) Prevent mood swings in patients with bipolar affective disorders
003. Which of the following chemical agents are used in the treatment of insomnia?
a) Benzodiazepines
b) Imidazopyridines
c) Barbiturates
d) All of the above
004. Select a hypnotic drug, which is a benzodiazepine derivative:
a) Zolpidem
b) Flurazepam
c) Secobarbital
d) Phenobarbitone
005. Tick a hypnotic agent – a barbituric acid derivative:
a) Flurazepam
b) Zaleplon
c) Thyopental
d) Triazolam
006. Select a hypnotic drug, which is an imidazopyridine derivative:
a) Pentobarbital
b) Temazepam
c) Zolpidem
d) Chloral hydrate
007. Which of the following hypnotic agents is absorbed slowly?
a) Phenobarbital
b) Flurazepam
c) Triazolam
d) Temazepam
008. Which of the following barbiturates is an ultra-short-acting drug?
a) Secobarbital
b) Amobarbital
c) Thiopental
d) Phenobarbital
009. Indicate the barbituric acid derivative, which has 4-5 days elimination half-life:
a) Secobarbital
b) Thiopental
c) Phenobarbital
d) Amobarbital
010. Indicate the hypnotic benzodiazepine, which has the shortest elimination half-life:
a) Temazepam
b) Triazolam
c) Flurazepam
d) Diazepam
011. Which of the following hypnotic drugs is more likely to cause cumulative and residual effects?
a) Zolpidem
b) Temazepam
c) Phenobarbital
d) Triazolam
35
012. Which of the following hypnotic drugs increases the activity of hepatic drug-metabolizing enzyme systems?
a) Phenobarbital
b) Zolpidem
c) Flurazepam
d) Zaleplon
013. Hepatic microsomal drug-metabolizing enzyme induction leads to:
a) Barbiturate tolerance
b) Cumulative effects
c) Development of physical dependence
d) “hangover” effects
014. Hypnotic benzodiazepines are more powerful enzyme inducers than barbiturates.
a) True
b) False
015. Indicate the hypnotic drug, which does not change hepatic drug-metabolizing enzyme activity?
a) Flurazepam
b) Zaleplon
c) Triazolam
d) All of the above
016. Barbiturates increase the rate of metabolism of:
a) Anticoagulants
b) Digitalis compounds
c) Glucocorticoids
d) All of the above
017. Which of the following agents inhibits hepatic metabolism of hypnotics?
a) Flumasenil
b) Cimetidin
c) Phenytoin
d) Theophylline
018. Which of the following factors can influence the biodisposition of hypnotic agents?
a) Alterations in the hepatic function resulting from a disease
b) Old age
c) Drug-induced increases or decreases in microsomal enzyme activities
d) All of the above
019. Which of the following hypnotics is preferred for elderly patients?
a) Phenobarbital
b) Flurozepam
c) Temazepam
d) Secobarbital
020. Which of the following hypnotics is preferred in patients with limited hepatic function?
a) Zolpidem
b) Amobarbital
c) Flurozepam
d) Pentobarbital
021. Indicate the mechanism of barbiturate action (at hypnotic doses):
a) Increasing the duration of the GABA-gated Cl- channel openings
b) Directly activating the chloride channels
c) Increasing the frequency of Cl- channel opening events
d) All of the above
022. Imidazopyridines are:
a) Partial agonists at brain 5-TH1A receptors
b) Selective agonists of the BZ1 (omega1) subtype of BZ receptors
c) Competitive antagonists of BZ receptors
d) Nonselective agonists of both BZ1 and BZ2 receptor subtypes
023. Which of the following hypnotic agents is a positive allosteric modulator of GABAA receptor function?
a) Zaleplon
b) Flurazepam
c) Zolpidem
d) All of the above
024. Indicate a hypnotic drug - a selective agonist at the BZ1 receptor subtype:
a) Flurazepam
b) Zolpidem
36
c) Triazolam
d) Flumazenil
025. Which of the following hypnotic agents is able to interact with both BZ1 and BZ2 receptor subtypes?
a) Zaleplon
b) Phenobarbital
c) Flurazepam
d) Zolpidem
026. Indicate the competitive antagonist of BZ receptors:
a) Flumazenil
b) Picrotoxin
c) Zolpidem
d) Temazepam
027. Flumazenil blocks the actions of:
a) Phenobarbital
b) Morphine
c) Zolpidem
d) Ethanol
028. Indicate the agent, which interferes with GABA binding:
a) Flurazepam
b) Bicuculline
c) Thiopental
d) Zolpidem
029. Which of the following agents blocks the chloride channel directly?
a) Secobarbital
b) Flumazenil
c) Zaleplon
d) Picrotoxin
030. Which of the following agents is preferred in the treatment of insomnia?
a) Barbiturates
b) Hypnotic benzodiazepines
c) Ethanol
d) Phenothiazide
031. Barbiturates are being replaced by hypnotic benzodiazepines because of:
a) Low therapeutic index
b) Suppression in REM sleep
c) High potential of physical dependence and abuse
d) All of the above
032. Which of the following benzodiazepines is used mainly for hypnosis?
a) Clonozepam
b) Lorazepam
c) Flurazepam
d) Midazolam
033. Indicate the main claim for an ideal hypnotic agent:
a) Rapid onset and sufficient duration of action
b) Minor effects on sleep patterns
c) Minimal “hangover” effects
d) All of the above
034. Which stage of sleep is responsible for the incidence of dreams?
a) REM sleep
b) Slow wave sleep
c) Stage 2NREM sleep
d) All of the above
035. During slow wave sleep (stage 3 and 4 NREM sleep):
a) Dreams occur
b) The secretion of adrenal steroids is at its highest
c) Somnambulism and nightmares occur
d) The secretion of somatotropin is at its lowest
036. All of the hypnotic drugs induce:
a) Increase the duration of REM sleep
b) Decrease the duration of REM sleep
c) Do not alter the duration of REM sleep
37
d) Increase the duration of slow wave sleep
037. Which of the following hypnotic drugs causes least suppression of REM sleep?
a) Flumazenil
b) Phenobarbital
c) Flurazepam
d) Secobarbital
038. Although the benzodiazepines continue to be the agents of choice for insomnia, they have:
a) The possibility of psychological and physiological dependence
b) Synergistic depression of CNS with other drugs (especially alcohol)
c) Residual drowsiness and daytime sedation
d) All of the above
039. Hypnotic benzodiazepines can cause:
a) A dose-dependent increase in both REM and slow wave sleep
b) Do not change sleep patterns
c) A dose-dependent decrease in both REM and slow wave sleep
d) A dose-dependent increase in REM sleep and decrease in slow wave sleep
040. Which one of the following hypnotic benzodiazepines is more likely to cause rebound insomnia?
a) Triazolam
b) Flurazepam
c) Temazepam
d) All of the above
041. Which of the following hypnotic benzodiazepines is more likely to cause “hangover” effects such as drowsiness,
dysphoria, and mental or motor depression the following day?
a) Temazepam
b) Triazolam
c) Flurazepam
d) None of the above
042. Indicate the hypnotic drug, which binds selectively to the BZ1 receptor subtype, facilitating GABAergic inhibition:
a) Thiopental
b) Zolpidem
c) Flurazepam
d) Phenobarbital
043. Which of the following statements is correct for zolpidem?
a) Causes minor effects on sleep patterns
b) The risk of development of tolerance and dependence is less than with the use of hypnotic benzodiazepines
c) Has minimal muscle relaxing and anticonvulsant effects
d) All of the above
044. Which agent exerts hypnotic activity with minimal muscle relaxing and anticonvulsant effects?
a) Flurazepam
b) Triazolam
c) Zaleplon
d) None of the above
045. Zolpidem and zaleplon have effectiveness similar to that of hypnotic benzodiazepines in the management of sleep
disorders.
a) True
b) False
046. Which of the following hypnotic drugs is used intravenously as anesthesia?
a) Thiopental
b) Phenobarbital
c) Flurazepam
d) Zolpidem
047. Indicate the usual cause of death due to overdose of hypnotics:
a) Depression of the medullar respiratory center
b) Hypothermia
c) Cerebral edema
d) Status epilepticus
048. Toxic doses of hypnotics may cause a circulatory collapse as a result of:
a) Blocking alfa adrenergic receptors
b) Increasing vagal tone
c) Action on the medullar vasomotor center
d) All of the above
38
PART II Antiseizure drugs
001. The mechanism of action of antiseizure drugs is:
a) Enhancement of GABAergic (inhibitory) transmission
b) Diminution of excitatory (usually glutamatergic) transmission
c) Modification of ionic conductance
d) All of the above mechanisms
002. Which of the following antiseizure drugs produces enhancement of GABA-mediated inhibition?
a) Ethosuximide
b) Carbamazepine
c) Phenobarbital
d) Lamotrigine
003. Indicate an antiseizure drug, which has an impotent effect on the T-type calcium channels in thalamic neurons?
a) Carbamazepin
b) Lamotrigine
c) Ethosuximide
d) Phenytoin
004. Which of the following antiseizure drugs produces a voltage-dependent inactivation of sodium channels?
a) Lamotrigine
b) Carbamazepin
c) Phenytoin
d) All of the above
005. Indicate an antiseizure drug, inhibiting central effects of excitatory amino acids:
a) Ethosuximide
b) Lamotrigine
c) Diazepam
d) Tiagabine
006. The drug for partial and generalized tonic-clonic seizures is:
a) Carbamazepine
b) Valproate
c) Phenytoin
d) All of the above
007. Indicate an anti-absence drug:
a) Valproate
b) Phenobarbital
c) Carbamazepin
d) Phenytoin
008. The drug against myoclonic seizures is:
a) Primidone
b) Carbamazepine
c) Clonazepam
d) Phenytoin
009. The most effective drug for stopping generalized tonic-clonic status epilepticus in adults is:
a) Lamotrigine
b) Ethosuximide
c) Diazepam
d) Zonisamide
010. Select the appropriate consideration for phenytoin:
a) It blocks sodium channels
b) It binds to an allosteric regulatory site on the GABA-BZ receptor and prolongs the openings of the Cl-channels
c) It effects on Ca2+ currents, reducing the low-threshold (T-type) current
d) It inhibits GABA-transaminase, which catalyzes the breakdown of GABA
011. Phenytoin is used in the treatment of:
a) Petit mal epilepsy
b) Grand mal epilepsy
c) Myoclonic seizures
d) All of the above
012. Dose-related adverse effect caused by phenytoin is:
a) Physical and psychological dependence
b) Exacerbated grand mal epilepsy
c) Gingival hyperplasia
d) Extrapyramidal symptoms
39
013. Granulocytopenia, gastrointestinal irritation, gingival hyperplasia, and facial hirsutism are possible adverse effects of:
a) Phenobarbital
b) Carbamazepin
c) Valproate
d) Phenytoin
014. The antiseizure drug, which induces hepatic microsomal enzymes, is:
a) Lamotrigine
b) Phenytoin
c) Valproate
d) None of the above
015. The drug of choice for partial seizures is:
a) Carbamazepin
b) Ethosuximide
c) Diazepam
d) Lamotrigine
016. The mechanism of action of carbamazepine appears to be similar to that of:
a) Benzodiazepines
b) Valproate
c) Phenytoin
d) Ethosuximide
017. Which of the following antiseizure drugs is also effective in treating trigeminal neuralgia?
a) Primidone
b) Topiramat
c) Carbamazepine
d) Lamotrigine
018. The most common dose-related adverse effects of carbamazepine are:
a) Diplopia, ataxia, and nausea
b) Gingival hyperplasia, hirsutism
c) Sedation, physical and psychological dependence
d) Hemeralopia, myasthenic syndrome
019. Indicate the drug of choice for status epilepticus in infants and children:
a) Phenobarbital sodium
b) Clonazepam
c) Ethosuximide
d) Phenytoin
020. Barbiturates are used in the emergency treatment of status epilepticus in infants and children because of:
a) They significantly decrease of oxygen utilization by the brain, protecting cerebral edema and ischemia
b) Short onset and duration of action
c) They do not have effect on sleep architecture
d) All of the above
021. Which of the following antiseizure drugs binds to an allosteric regulatory site on the GABA-BZ receptor, increases the
duration of the Cl-channels openings:
a) Diazepam
b) Valproate
c) Phenobarbital
d) Topiramate
022. Adverse effect caused by phenobarbital is:
a) Physical and phychological dependence
b) Exacerbated petit mal epilepsy
c) Sedation
d) All of the above
023. Which of the following antiseizure drugs is a prodrug, metabolized to phenobarbital?
a) Phenytoin
b) Primidone
c) Felbamate
d) Vigabatrin
024. Indicate the antiseizure drug, which is a phenyltriazine derivative:
a) Phenobarbital
b) Clonazepam
c) Lamotrigine
d) Carbamazepin
40
025. Lamotrigine can be used in the treatment of:
a) Partial seizures
b) Absence
c) Myoclonic seizures
d) All of the above
026. The mechanism of vigabatrin′s action is:
a) Direct action on the GABA receptor-chloride channel complex
b) Inhibition of GABA aminotransferase
c) NMDA receptor blockade via the glycine binding site
d) Inhibition of GABA neuronal reuptake from synapses
027. Indicate an irreversible inhibitor of GABA aminotransferase (GABA-T):
a) Diazepam
b) Phenobarbital
c) Vigabatrin
d) Felbamate
028. Tiagabine:
a) Blocks neuronal and glial reuptake of GABA from synapses
b) Inhibits GABA-T, which catalyzed the breakdown of GABA
c) Blocks the T-type Ca2+ channels
d) Inhibits glutamate transmission at AMPA/kainate receptors
029. The mechanism of both topiramate and felbamate action is:
a) Reduction of excitatory glutamatergic neurotransmission
b) Inhibition of voltage sensitive Na+ channels
c) Potentiation of GABAergic neuronal transmission
d) All of the above
030. The drug of choice in the treatment of petit mal (absence seizures) is:
a) Phenytoin
b) Ethosuximide
c) Phenobarbital
d) Carbamazepin
031. The dose-related adverse effect of ethosuximide is:
a) Gastrointestinal reactions, such as anorexia, pain, nausea and vomiting
b) Exacerbated grand mal epilepsy
c) Transient lethargy or fatigue
d) All of the above
032. Valproate is very effective against:
a) Absence seizures
b) Myoclonic seizures
c) Generalized tonic-clonic seizures
d) All of the above
033. The drug of choice in the treatment of myoclonic seizures is:
a) Valproate
b) Phenobarbital
c) Phenytoin
d) Felbamate
034. The reason for preferring ethosuximide to valproate for uncomplicated absence seizures is:
a) More effective
b) Valproate′s idiosyncratic hepatotoxicity
c) Greater CNS depressant activity
d) All of the above
035. The mechanism of valproate action is:
a) Facilitation glutamic acid decarboxylase, the enzyme responsible for GABA synthesis and inhibition of GABA-
aminotransferase, the enzyme responsible for the breakdown of GABA (enhance GABA accumulation)
b) Inhibition of voltage sensitive Na+ channels
c) Inhibition of low threshold (T-type) Ca2+ channels
d) All of the above
036. Indicate the antiseizure drug, which is a sulfonamide derivative, blocking Na+ channels and having additional ability to
inhibit T-type Ca2+ channels:
a) Tiagabine
b) Zonisamide
c) Ethosuximide
41
d) Primidone
037. Indicate the antiseizure drug – a benzodiazepine receptor agonist:
a) Phenobarbital
b) Phenytoin
c) Carbamazepine
d) Lorazepam
038. Which of the following antiseizure drugs acts directly on the GABA receptor-chloride channel complex?
a) Vigabatrin
b) Diazepam
c) Gabapentin
d) Valproate
039. Benzodiazepine΄s uselfulness is limited by:
a) Tolerance
b) Atropine-like symptoms
c) Psychotic episodes
d) Myasthenic syndrome
040. A long-acting drug against both absence and myoclonic seizures is:
a) Primidone
b) Carbamazepine
c) Clonazepam
d) Phenytoin
041. Which of the following antiseizure drugs may produce teratogenicity?
a) Phenytoin
b) Valproate
c) Topiramate
d) All of the above
042. The most dangerous effect of antiseizure drugs after large overdoses is:
a) Respiratory depression
b) Gastrointestinal irritation
c) Alopecia
d) Sedation

PART III Antiparkinsonian agents


001. Which neurons are involved in parkinsonism?
a) Cholinergic neurons
b) GABAergic neurons
c) Dopaminergic neurons
d) All of the above
002. The pathophysiologic basis for antiparkinsonism therapy is:
a) A selective loss of dopaminergic neurons
b) The loss of some cholinergic neurons
c) The loss of the GABAergic cells
d) The loss of glutamatergic neurons
003. Which of the following neurotransmitters is involved in Parkinson′s disease?
a) Acetylcholine
b) Glutamate
c) Dopamine
d) All of the above
004. The concentration of dopamine in the basal ganglia of the brain is reduced in parkinsonism.
a) True
b) False
005. Principal aim for treatment of Parkinsonian disorders is:
a) To restore the normal balance of cholinergic and dopaminergic influences on the basal ganglia with antimuscarinic
drugs
b) To restore dopaminergic activity with levodopa and dopamine agonists
c) To decrease glutamatergic activity with glutamate antagonists
d) All of the above
006. Indicate the drug that induces parkinsonian syndromes:
a) Chlorpromazine
b) Diazepam
42
c) Triazolam
d) Carbamazepine
007. Which of the following drugs is used in the treatment of Parkinsonian disorders?
a) Phenytoin
b) Selegiline
c) Haloperidol
d) Fluoxetine
008. Select the agent, which is preferred in the treatment of the drug-induced form of parkinsonism:
a) Levodopa
b) Bromocriptine
c) Benztropine
d) Dopamine
009. Which of the following agents is the precursor of dopamine?
a) Bromocriptine
b) Levodopa
c) Selegiline
d) Amantadine
010. The main reason for giving levodopa, the precursor of dopamine, instead of dopamine is:
a) Dopamine does not cross the blood-brain barrier
b) Dopamine may induce acute psychotic reactions
c) Dopamine is intensively metabolized in humans
d) All of the above
011. Indicate a peripheral dopa decarboxylase inhibitor:
a) Tolcapone
b) Clozapine
c) Carbidopa
d) Selegiline
012. The mechanism of carbidopa′s action is:
a) Stimulating the synthesis, release, or reuptake of dopamine
b) Inhibition of dopa decarboxilase
c) Stimulating dopamine receptors
d) Selective inhibition of catecol-O-methyltransferase
013. Carbidopa is unable to penetrate the blood-brain barrier, it acts to reduce the peripheral conversion of levodopa to
dopamine.
a) True
b) False
014. When carbidopa and levodopa are given concomitantly:
a) Levodopa blood levels are increased, and drug half-life is lengthened
b) The dose of levodopa can be significantly reduced (by 75%), also reducing toxic side effects
c) A shorter latency period precedes the occurrence of beneficial effects
d) All of the above
015. Which of the following preparations combines carbidopa and levodopa in a fixed proportion?
a) Selegiline
b) Sinemet
c) Tolkapone
d) Biperiden
016. Which of the following statements is correct for levodopa?
a) Tolerance to both beneficial and adverse effects develops gradually
b) Levodopa is most effective in the first 2-5 years of treatment
c) After 5 years of therapy, patients have dose-related dyskinesias, inadequate response or toxicity
d) All of the above
017. Gastrointestinal irritation, cardiovascular effects, including tachycardia, arrhythmias, and orthostatic hypotension, mental
disturbances, and withdrawal are possible adverse effects of:
a) Amantadine
b) Benztropine
c) Levodopa
d) Selegiline
018. Which of the following agents is the most helpful in counteracting the behavioral complications of levodopa?
a) Tolkapone
b) Clozapine
c) Carbidopa
43
d) Pergolide
019. Which of the following vitamins reduces the beneficial effects of levodopa by enhancing its extracerebral metabolism?
a) Pyridoxine
b) Thiamine
c) Tocopherol
d) Riboflavin
020. Which of the following drugs antagonizes the effects of levodopa because it leads to a junctional blockade of dopamine
action?
a) Reserpine
b) Haloperidol
c) Chlorpromazine
d) All of the above
021. Levodopa should not be given to patients taking:
a) Bromocriptine
b) Monoamine oxydase A inhibitors
c) Carbidopa
d) Nonselective beta-adrenergic antagonists
022. Indicate D2 receptor agonist with antiparkinsonian activity:
a) Sinemet
b) Levodopa
c) Bromocriptine
d) Selegiline
023. Which of the following antiparkinsonian drugs has also been used to treat hyperprolactinemia?
a) Benztropine
b) Bromocriptine
c) Amantadine
d) Levodopa
024. Indicate a selective inhibitor of monoamine oxidase B:
a) Levodopa
b) Amantadine
c) Tolcapone
d) Selegiline
025. Which of the following statements is correct?
a) MAO-A metabolizes dopamine; MAO-B metabolizes serotonin
b) MAO-A metabolizes norepinephrine and dopamine; MAO-B metabolizes serotonin
c) MAO-A metabolizes norepinephrine and serotonin; MAO-B metabolizes dopamine
d) MAO-A metabolizes dopamine; MAO-B metabolizes norepinephrine and serotonin
026. Treatment with selegilin postpones the need for levodopa for 3-9 months and may retard the progression of Parkinson′s
disease.
a) True
b) False
027. The main reason for avoiding the combined administration of levodopa and an inhibitor of both forms of monoamine
oxidase is:
a) Respiratory depression
b) Hypertensive emergency
c) Acute psychotic reactions
d) Cardiovascular collapse and CNS depression
028. Indicate selective catechol-O-methyltransferase inhibitor, which prolongs the action of levodopa by diminishing its
peripheral metabolism:
a) Carbidopa
b) Clozapine
c) Tolcapone
d) Rasagiline
029. Which of the following antiparkinsonian drugs is an antiviral agent used in the prophylaxis of influenza A2?
a) Selegiline
b) Sinemet
c) Pergolide
d) Amantadine
030. The mechanism of amantadine action is:
a) Stimulating the glutamatergic neurotransmission
b) Blocking the excitatory cholinergic system
44
c) Inhibition of dopa decarboxilase
d) Selective inhibition of catechol-O-methyltransferase
031. Which of the following antiparkinsonism drugs is an anticholinergic agent?
a) Amantadine
b) Selegilin
c) Trihexyphenidyl
d) Bromocriptine
032. Mental confusion and hallucinations, peripheral atropine-like toxicity (e.g. Cycloplegia, tachycardia, urinary retention, and
constipation) are possible adverse effects of:
a) Sinemet
b) Benztropine
c) Tolkapone
d) Bromocriptine
033. Indicate the antiparkinsonism drug which should be avoided in patients with glaucoma:
a) Selegilin
b) Levodopa
c) Bromocriptine
d) Trihexyphenidyl

PART IV Ethyl alcohol


001. Alcohol may cause:
a) CNS depression
b) Vasodilatation
c) Hypoglycemia
d) All of the above
002. Alcohol:
a) Increases body temperature
b) Decreases body heat loss
c) Increases body heat loss
d) Does not affect body temperature
003. It is undesirable to take alcohol before going outdoors when it extremely cold, but it may be harmless to take some after
coming into a warm place from the cold.
a) True
b) False
004. The most common medical complication of alcohol abuse is:
a) Liver failure including liver cirrhosis
b) Tolerance and physical dependence
c) Generalized symmetric peripheral nerve injury, ataxia and dementia
d) All of the above
005. Effect of moderate consumption of alcohol on plasma lipoproteins is:
a) Raising serum levels of high-density lipoproteins
b) Increasing serum concentration of low-density lipoproteins
c) Decreasing the concentration of high-density lipoproteins
d) Raising serum levels of very low-density lipoproteins
006. Which of the following metabolic alterations may be associated with chronic alcohol abuse?
a) Hyperglycemia
b) Increased serum concentration of phosphate
c) Severe loss of potassium and magnesium
d) Decreased serum concentration of sodium
007. Alcohol potentiates:
a) SNS depressants
b) Vasodilatators
c) Hypoglycemic agents
d) All of the above
008. Which of the following drugs is most commonly used for causing a noxious reaction to alcohol by blocking its
metabolism?
a) Naltrexone
b) Disulfiram
c) Diazepam
d) Morphine
45
009. Which of the following agents is an inhibitor of aldehyde dehydrogenase?
a) Fomepizole
b) Ethanol
c) Disulfiram
d) Naltrexone
010. Indicate the drug, which alters brain responses to alcohol:
a) Naltrexone
b) Disulfiram
c) Amphetamine
d) Chlorpromazine
011. Which of the following agents is an opioid antagonist?
a) Amphetamine
b) Naltrexone
c) Morphine
d) Disulfiram
012. Alcohol causes an acute increase in the local concentrations of:
a) Dopamine
b) Opioid
c) Serotonine
d) All of the above
013. Management of alcohol withdrawal syndrome contains:
a) Restoration of potassium, magnesium and phosphate balance
b) Thiamine therapy
c) Substituting a long-acting sedative-hypnotic drug for alcohol
d) All of the above
014. Indicate the drug, which decreases the craving for alcohol or blunts pleasurable “high” that comes with renewed drinking:
a) Disulfiram
b) Amphetamine
c) Naltrexone
d) Diazepam
015. The symptoms resulting from the combination of disulfiram and alcohol are:
a) Hypertensive crisis leading to cerebral ischemia and edema
b) Nausea, vomiting
c) Respiratory depression and seizures
d) Acute psychotic reactions
016. The combination of disulfiram and ethanol leads to accumulation of:
a) Formaldehyde
b) Acetate
c) Formic acid
d) Acetaldehyde
017. The combination of naltrexone and disulfiram should be avoided since both drugs are potential hepatotoxins.
a) True
b) False
018. Indicate the “specific” modality of treatment for severe methanol poisoning:
a) Dialysis to enhance removal of methanol
b) Alkalinization to counteract metabolic acidosis
c) Suppression of metabolism by alcohol dehydrogenase to toxic products
d) All of the above
019. Which of the following agents may be used as an antidote for ethylene glycol and methanol poisoning?
a) Disulfiram
b) Fomepizol
c) Naltrexone
d) Amphetamine
020. The principal mechanism of fomepizol action is associated with inhibition of:
a) Aldehyde dehydrogenase
b) Acethylholinesterase
c) Alcohol dehydrogenase
d) Monoamine oxidase
46
PART V Narcotic analgesics
001. Narcotics analgesics should:
a) Relieve severe pain
b) Induce loss of sensation
c) Reduce anxiety and exert a calming effect
d) Induce a stupor or somnolent state
002. Second-order pain is:
a) Sharp, well-localized pain
b) Dull, burning pain
c) Associated with fine myelinated A-delta fibers
d) Effectively reduced by non-narcotic analgesics
003. Chemical mediators in the nociceptive pathway are all of the following EXCEPT:
a) Enkephalins
b) Kinins
c) Prostaglandins
d) Substance P
004. Indicate the chemical mediator in the antinociceptive descending pathways:
a) BETA-endorphin
b) Met- and leu-enkephalin
c) Dynorphin
d) All of the above
005. 5. Which of the following mediators is found mainly in long descending pathways from the midbrain to the dorsal horn?
a) Prostaglandin E
b) Dynorphin
c) Enkephalin
d) Glutamate
006. Select the brain and spinal cord regions, which are involved in the transmission of pain?
a) The limbic system, including the amygdaloidal nucleus and the hypothalamus
b) The ventral and medial parts of the thalamus
c) The substantia gelatinosa
d) All of the above
007. Mu (μ) receptors are associated with:
a) Analgesia, euphoria, respiratory depression, physical dependence
b) Spinal analgesia, mydriasis, sedation, physical dependence
c) Dysphoria, hallucinations, respiratory and vasomotor stimulation
d) Analgesia, euphoria, respiratory stimulation, physical dependence
008. Which of the following opioid receptor types is responsible for euphoria and respiratory depression?
a) Kappa-receptors
b) Delta-receptors
c) Mu-receptors
d) All of the above
009. Indicate the opioid receptor type, which is responsible for dysphoria and vasomotor stimulation:
a) Kappa-receptors
b) Delta-receptors
c) Mu-receptors
d) All of the above
010. Kappa and delta agonists:
a) Inhibit postsynaptic neurons by opening K+ channels
b) Close a voltage-gated Ca2+ channels on presynaptic nerve terminals
c) Both a and b
d) Inhibit of arachidonate cyclooxygenase in CNS
011. Which of the following supraspinal structures is implicated in pain-modulating descending pathways?
a) The midbrain periaqueductal gray
b) The hypothalamus
c) The aria postrema
d) The limbic cortex
012. Indicate the neurons, which are located in the locus ceruleus or the lateral tegmental area of the reticular formation:
a) Dopaminergic
b) Serotoninergic
c) Nonadrenergic
d) Gabaergic
47
013. Which of the following analgesics is a phenanthrene derivative?
a) Fentanyl
b) Morphine
c) Methadone
d) Pentazocine
014. Tick narcotic analgesic, which is a phenylpiperidine derivative:
a) Codeine
b) Dezocine
c) Fentanyl
d) Buprenorphine
015. Which of the following opioid analgesics is a strong mu receptor agonist?
a) Naloxone
b) Morphine
c) Pentazocine
d) Buprenorphine
016. Indicate the narcotic analgesic, which is a natural agonist:
a) Meperidine
b) Fentanyl
c) Morphine
d) Naloxone
017. Select the narcotic analgesic, which is an antagonist or partial mu receptor agonist:
a) Fentanyl
b) Pentazocine
c) Codeine
d) Methadone
018. Which of the following agents is a full antagonist of opioid receptors?
a) Meperidine
b) Buprenorphine
c) Naloxone
d) Butorphanol
019. The principal central nervous system effect of the opioid analgesics with affinity for a mu receptor is:
a) Analgesia
b) Respiratory depression
c) Euphoria
d) All of the above
020. Which of the following opioid analgesics can produce dysphoria, anxiety and hallucinations?
a) Morphine
b) Fentanyl
c) Pentazocine
d) Methadone
021. Indicate the opioid analgesic, which has 80 times analgesic potency and respiratory depressant properties of morphine,
and is more effective than morphine in maintaining hemodynamic stability?
a) Fentanyl
b) Pentazocine
c) Meperidine
d) Nalmefene
022. Which of the following opioid analgesics is used in combination with droperidol in neuroleptanalgesia?
a) Morphine
b) Buprenorphine
c) Fentanyl
d) Morphine
023. Fentanyl can produce significant respiratory depression by:
a) Inhibiting brain stem respiratory mechanisms
b) Suppression of the cough reflex leading to airway obstruction
c) Development of truncal rigidity
d) Both a and c
024. Most strong mu receptor agonists cause:
a) Hypertension
b) Increasing the pulmonary arterial pressure and myocardial work
c) Cerebral vasodilatation, causing an increase in intracranial pressure
d) All of the above
48
025. Which of the following opioid analgesics can produce an increase in the pulmonary arterial pressure and myocardial
work?
a) Morphine
b) Pentazocine
c) Meperidine
d) Methadone
026. Morphine causes the following effects EXCEPT:
a) Constipation
b) Dilatation of the biliary duct
c) Urinary retention
d) Bronchiolar constriction
027. Therapeutic doses of the opioid analgesics:
a) Decrease body temperature
b) Increase body temperature
c) Decrease body heat loss
d) Do not affect body temperature
028. Which of the following opioid analgesics is used in obstetric labor?
a) Fentanyl
b) Pentazocine
c) Meperidine
d) Buprenorphine
029. Indicate the opioid analgesic, which is used for relieving the acute, severe pain of renal colic:
a) Morphine
b) Naloxone
c) Methadone
d) Meperidine
030. Which of the following opioid analgesics is used in the treatment of acute pulmonary edema?
a) Morphine
b) Codeine
c) Fentanyl
d) Loperamide
031. The relief produced by intravenous morphine in dyspnea from pulmonary edema is associated with reduced:
a) Perception of shortness of breath
b) Patient anxiety
c) Cardiac preload (reduced venous tone) and afterload (decreased peripheral resistance)
d) All of the above
032. Rhinorrhea, lacrimation, chills, gooseflesh, hyperventilation, hyperthermia, mydriasis, muscular aches, vomiting,
diarrhea, anxiety, and hostility are effects of:
a) Tolerance
b) Opioid overdosage
c) Drug interactions between opioid analgesics and sedative-hypnotics
d) Abstinence syndrome
033. The diagnostic triad of opioid overdosage is:
a) Mydriasis, coma and hyperventilation
b) Coma, depressed respiration and miosis
c) Mydriasis, chills and abdominal cramps
d) Miosis, tremor and vomiting
034. Which of the following opioid agents is used in the treatment of acute opioid overdose?
a) Pentazocine
b) Methadone
c) Naloxone
d) Remifentanyl
035. Indicate the pure opioid antagonist, which has a half-life of 10 hours:
a) Naloxone
b) Naltrexone
c) Tramadol
d) Pentazocine
036. In contrast to morphine, methadone:
a) Causes tolerance and physical dependence more slowly
b) Is more effective orally
c) Withdrawal is less severe, although more prolonged
49
d) All of the above
037. Which of the following opioid analgesics is a partial mu receptor agonist?
a) Morphine
b) Methadone
c) Buprenorphine
d) Sufentanyl
038. Indicate a partial mu receptor agonist, which has 20-60 times analgesic potency of morphine, and a longer duration of
action:
a) Pentazocine
b) Buprenorphine
c) Nalbuphine
d) Naltrexone
039. Which of the following opioid analgesics is a strong kappa receptor agonist and a mu receptor antagonist?
a) Naltrexone
b) Methadone
c) Nalbuphine
d) Buprenorphine
040. Which of the following drugs has weak mu agonist effects and inhibitory action on norepinephrine and serotonin reuptake
in the CNS?
a) Loperamide
b) Tramadol
c) Fluoxetine
d) Butorphanol

PART VI Non-narcotic analgesics


001. Non-narcotic analgesics are mainly effective against pain associated with:
a) Inflammation or tissue damage
b) Trauma
c) Myocardial infarction
d) Surgery
002. Non-narcotic agents cause:
a) Respiratory depression
b) Antipyretic effect
c) Euphoria
d) Physical dependence
003. Non-narcotic analgesics are all of the following drugs EXCEPT:
a) Paracetamol
b) Acetylsalicylic acid
c) Butorphanol
d) Ketorolac
004. Select the non-narcotic drug, which is a paraaminophenol derivative:
a) Analgin
b) Aspirin
c) Baclophen
d) Paracetamol
005. Which of the following non-narcotic agents is salicylic acid derivative?
a) Phenylbutazone
b) Ketamine
c) Aspirin
d) Tramadol
006. Tick pirazolone derivative:
a) Methylsalicylate
b) Analgin
c) Paracetamol
d) Ketoralac
007. Which one of the following non-narcotic agents inhibits mainly cyclooxygenase (COX) in CNS?
a) Paracetamol
b) Ketorolac
c) Acetylsalicylic acid
d) Ibuprofen
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008. Most of non-narcotic analgetics have:
a) Anti-inflammatory effect
b) Analgesic effect
c) Antipyretic effect
d) All of the above
009. Indicate the non-narcotic analgesic, which lacks an anti-inflammatory effect:
a) Naloxone
b) Paracetamol
c) Metamizole
d) Aspirin
010. Correct statements concerning aspirin include all of the following EXCEPT:
a) It inhibits mainly peripheral COX
b) It does not have an anti-inflammatory effect
c) It inhibits platelet aggregation
d) It stimulates respiration by a direct action on the respiratory center
011. For which of the following conditions could aspirin be used prophylactically?
a) Noncardiogenic pulmonary edema
b) Peptic ulcers
c) Thromboembolism
d) Metabolic acidosis
012. All of the following are undesirable effects of aspirin EXCEPT:
a) Gastritis with focal erosions
b) Tolerance and physical addiction
c) Bleeding due to a decrease of platelet aggregation
d) Reversible renal insufficiency
013. Characteristic findinds of salicylism include:
a) Headache, mental confusion and drowsiness
b) Tinnitus and difficulty in hearing
c) Hyperthermia, sweating, thirst, hyperventilation, vomiting and diarrhea
d) All of the above
014. Analgin usefulness is limited by:
a) Agranulocytosis
b) Erosions and gastric bleeding
c) Methemoglobinemia
d) Hearing impairment
015. Methemoglobinemia is possible adverse effect of:
a) Aspirin
b) Paracetamol
c) Analgin
d) Ketorolac
016. Correct the statements concerning ketorolac include all of the following EXCEPT:
a) It inhibits COX
b) It is as effective as morphine for a short-term relief from moderate to severe pain
c) It has a high potential for physical dependence and abuse
d) It does not produce respiratory depression
017. Indicate the nonopioid agent of central effect with analgesic activity:
a) Reserpine
b) Propranolol
c) Clopheline
d) Prazosin
018. Select the antiseizure drug with an analgesic component of effect:
a) Carbamazepine
b) Ethosuximide
c) Phenytoin
d) Clonazepam
019. Which of the following nonopioid agents is an antidepressant with analgesic activity?
a) Fluoxetine
b) Moclobemide
c) Tranylcypramine
d) Amitriptyline
020. Tick mixed (opioid/non-opioid) agent:
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a) Paracetamol
b) Tramadol
c) Sodium valproate
d) Butorphanol

PART VII Antipsychotic agents


001. Neuroleptics are used to treat:
a) Neurosis
b) Psychosis
c) Narcolepsy
d) Parkinsonian disorders
002. Most antipsychotic drugs:
a) Strongly block postsynaptic d2receptor
b) Stimulate postsynaptic D2 receptor
c) Block NMDA receptor
d) Stimulate 5-HT2 receptor
003. Which of the following dopaminergic systems is most closely related to behavior?
a) The hypothalamic-pituitary system
b) The extrapyramidal system
c) The mesolimbic and mesofrontal systems
d) The chemoreceptor trigger zone of the medulla
004. Hyperprolactinemia is caused by blockade of dopamine in:
a) The chemoreceptor trigger zone of the medulla
b) The pituitary
c) The extrapiramidal system
d) The mesolimbic and mesofrontal systems
005. Parkinsonian symptoms and tarditive dyskinesia are caused by blockade dopamine in:
a) The nigrostriatal system
b) The mesolimbic and mesofrontal systems
c) The chemoreceptor trigger zone of the medulla
d) The tuberoinfundibular system
006. Extrapyramidal reactions can be treated by:
a) Levodopa
b) Benztropine mesylate
c) Bromocriptine
d) Dopamine
007. Which of the following statements is true?
a) D1 postsynaptic receptors are located in striatum
b) D2 pre- and postsynaptic receptors are located in striatum and limbic areas
c) D4 postsynaptic receptors are located in frontal cortex, mesolimbic system
d) All of the above
008. Which of the following antipsychotic drugs is typical?
a) Clozapine
b) Quetiapine
c) Haloperidol
d) Olanzapine
009. Indicate the atypical antipsychotic drug:
a) Haloperidol
b) Clozapine
c) Thioridazine
d) Thiothixene
010. Atypical antipsychotic agents (such as clozapine) differ from typical ones:
a) In reduced risks of extrapyramidal system dysfunction and tardive dyscinesia
b) In having low affinity for D1 and D2 dopamine receptors
c) In having high affinity for D4 dopamine receptors
d) All of the above
011. Tardive dyskinesia is the result of:
a) Degeneration of dopaminergic and cholinergic fibers
b) Hyperactive dopaminergic state in the presence of dopamine blockers
c) Degeneration of histaminergic fibers
d) Supersensitivity of cholinergic receptors in the caudate-putamen
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012. Which of the following antipsychotic drugs has high affinity for D4 and 5-HT2 receptors?
a) Clozapine
b) Fluphenazine
c) Thioridazine
d) Haloperidole
013. Indicate the antipsychotic drug, which is a phenothiazine aliphatic derivative:
a) Thiothixene
b) Risperidone
c) Chlorpromazine
d) Clozapine
014. Indicate the antipsychotic drug, which is a butyrophenone derivative:
a) Droperidol
b) Thioridazine
c) Sertindole
d) Fluphenazine
015. Indicate the antipsychotic drug, which is a thioxanthene derivative:
a) Haloperidol
b) Clozapine
c) Chlorpromazine
d) Thiothixene
016. Indicate the antipsychotic agent – a dibenzodiazepine derivative:
a) Fluphenazine
b) Clozapine
c) Risperidone
d) Droperidol
017. The strong antiemetic effect of the phenothiazine derivatives is due to dopamine receptor blockade:
a) In the chemoreceptor trigger zone of the medulla
b) Of the receptors in the stomach
c) The medullar vomiting centre
d) All of the above
018. Phenothiazine derivatives are able to:
a) Alter temperature-regulating mechanisms producing hypothermia
b) Decrease levels of prolactin
c) Increase corticotrophin release and secretion of pituitary growth hormone
d) Decrease appetite and weight
019. Most phenothiazine derivatives have:
a) Antihistaminic activity
b) Anticholinergic activity
c) Antidopaminergic activity
d) All of the above
020. Indicate the antipsychotic drug having significant peripheral alpha-adrenergic blocking activity:
a) Haloperidol
b) Chlorpromazine
c) Clozapine
d) Risperidone
021. Indicate the antipsychotic drug having a muscarinic-cholinergic blocking activity:
a) Chlorpromazine
b) Clorprothixene
c) Risperidone
d) Haloperidol
022. Indicate the antipsychotic drug having H1-antihistaminic activity:
a) Clozapine
b) Chlorpromazine
c) Olanzapine
d) All of the above
023. Parkinson′s syndrome, acute dystonic reactions, tardive dyskinesia, antimuscarinic actions, orthostatic hypotension,
galactorrhea are possible adverse effects of:
a) Haloperidol
b) Clozapine
c) Chlorpromazine
d) Risperidone
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024. Orthostatic hypotension can occur as a result of:
a) The central action of phenothiazines
b) Inhibition of norepinephrine uptake mechanisms
c) Alpha adrenoreceptor blockade
d) All of the above
025. Adverse peripheral effects, such as loss of accommodation, dry mouth, tachycardia, urinary retention, constipation are
related to:
a) Alpha adrenoreceptor blockade
b) Muscarinic cholinoreceptor blockade
c) Supersesitivity of the dopamine receptor
d) Dopamine receptor blockade
026. Which of the following phenothiazine derivatives is a potent local anesthetic?
a) Fluphenazine
b) Thioridazine
c) Chlorpromazine
d) None of the above
027. Which of the following phenothiazine derivatives may produce cardiac toxicity, including ventricular arrhythmias, cardiac
conduction block, and sudden death?
a) Thioridazine
b) Chlorpromazine
c) Perphenazine
d) Fluphenazine
028. Which of the following antipsychotic agents is preferable in patients with coronary and cerebrovascular disease?
a) Chlorpromazine
b) Fluphenazine
c) Haloperidol
d) Perphenazine
029. Which of the following antipsychotic agents is used in combination with an opioid drug fentanyl in neuroleptanalgesia?
a) Haloperidol
b) Droperidol
c) Chlorpromazine
d) Clozapine
030. The mechanism of haloperidol antipsychotic action is:
a) Blocking D2 receptors
b) Central alpha-adrenergic blocking
c) Inhibition of norepinephrine uptake mechanisms
d) All of the above
031. Which of the following statements is correct for clozapine?
a) Has potent anticholinergic activity
b) Has high affinity for D1 and D2 dopamine receptors
c) Produces significant extrapyramidal toxicity
d) Is related to typical antipsychotic agents
032. Which of the following antipsychotic drugs has the high risk of potentially fatal agranulocytosis and risk of seizures at
high doses?
a) Haloperidol
b) Risperidone
c) Clozapine
d) Chlorpromazine
033. Which of the following antipsychotic drugs has high affinity for D2 and 5-HT2 receptors?
a) Droperidol
b) Clozapine
c) Thiothixene
d) Risperidone
034. Lithium carbonate is useful in the treatment of:
a) Petit mal seizures
b) Bipolar disorder
c) Neurosis
d) Trigeminal neuralgia
035. The drug of choice for manic-depressive psychosis is:
a) Imipramine
b) Chlordiazepoxide
54
c) Isocarboxazid
d) Lithium carbonate
036. The lithium mode of action is:
a) Effect on electrolytes and ion transport
b) Effect on neurotransmitters
c) Effect on second messengers
d) All of the above
037. Which of the following statements is correct for lithium?
a) Stimulate dopamine and beta-adrenergic receptors
b) Decrease catecholamine-related activity
c) Stimulate the development of dopamine receptor supersensitivity
d) Decrease cholinergic activity
038. Which of the following adverse effects is associated with lithium treatment?
a) Cardiovascular anomalies in the newborn
b) Thyroid enlargement
c) Nephrogenic diabetes insipidus
d) All of the above

PART VIII Antidepressant agents


001. The principal mechanism of action of antidepressant agents is:
a) Stabilization of dopamine and beta-adrenergic receptors
b) Inhibition of the storage of serotonin and epinephrine in the vesicles of presynaptic nerve endings
c) Blocking epinephrine or serotonin reuptake pumps
d) Stimulation of alfa2-norepinephrine receptors
002. Which of the following agents is related to tricyclic antidepressants?
a) Nefazodon
b) Amitriptyline
c) Fluoxetine
d) Isocarboxazid
003. Indicate the second-generation heterocyclic drug:
a) Maprotiline
b) Imipramine
c) Phenelzine
d) Fluoxetine
004. Which of the following agents is related to the third-generation heterocyclic antidepressants?
a) Amitriptyline
b) Maprotiline
c) Nefazodone
d) Tranylcypromine
005. Which of the following antidepressants is a selective serotonin reuptake inhibitor?
a) Phenelzine
b) Desipramine
c) Maprotiline
d) Fluoxetine
006. Which of the following antidepressant agents is a selective inhibitor of norepinephrine reuptake?
a) Fluvoxamine
b) Maprotiline
c) Amitriptyline
d) Tranylcypromine
007. Indicate the antidepressant, which blocks the reuptake pumps for serotonin and norepinephrine:
a) Amitriptyline
b) Fluoxetine
c) Maprotiline
d) Phenelzine
008. Which of the following antidepressants is an unselective MAO blocker and produces extremely long-lasting inhibition of
the enzyme?
a) Moclobemide
b) Tranylcypramine
c) Selegiline
d) Fluoxetine
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009. Indicate the irreversible MAO inhibitor, which is a hydrazide derivative:
a) Moclobemide
b) Selegiline
c) Tranylcypramine
d) Phenelzine
010. Which of the following MAO inhibitors has amphetamine-like activity and is related to nonhydrazide derivatives:
a) Phenelzine
b) Moclobemide
c) Tranylcypramine
d) All of the above
011. Which of the following antidepressants is a selective short-acting MAO-A inhibitor?
a) Maprotiline
b) Amitriptyline
c) Moclobemide
d) Selegiline
012. Monoamine Oxydase A:
a) Is responsible for norepinephrine, serotonin, and tyramine metabolism
b) Is more selective for dopamine
c) Metabolizes norepinephrine and dopamine
d) Deaminates dopamine and serotonin
013. Which synapses are involved in depression?
a) Dopaminergic synapses
b) Serotoninergic synapses
c) Cholinergic synapses
d) All of the above
014. Block of which type of Monoamine Oxydase might be more selective for depression?
a) MAO-A
b) MAO-B
c) Both MAO-A and MAO-B
d) MAO-C
015. The principal mechanism of MAO inhibitor action is:
a) Blocking the amine reuptake pumps, which permits to increase the concentration of the neurotransmitter at the
receptor site
b) Blocking a major degradative pathway for the amine neurotransmitters, which permits more amines to
accumulate in presynaptic stores
c) Inhibition the storage of amine neurotransmitters in the vesicles of presynaptic nerve endings
d) Antagonism of alfa2-norepinephrine receptors
016. The irreversible MAO inhibitors have a very high risk of developing:
a) Respiratory depression
b) Cardiovascular collapse and CNS depression
c) Hypertensive reactions to tyramine ingested in food
d) Potentially fatal agranulocytosis
017. The most dangerous pharmacodynamic interaction is between MAO inhibitors and:
a) Selective serotonin reuptake inhibitors
b) Tricyclics
c) Sympathomimetics
d) All of the above
018. Serotonin syndrome is a result of:
a) Increased stores of monoamine
b) Significant accumulation of amine neurotransmitters in the synapses
c) Both a and b
d) Depleted stores of biogenic amines
019. The therapeutic response to antidepressant drugs is usually over a period of:
a) 2-3 days
b) 2-3 weeks
c) 24 hours
d) 2-3 month
020. Which of the following antidepressants may have latency period as short as 48 hours?
a) Tranylcypromine
b) Imipramine
c) Fluoxetine
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d) Amitrityline
021. Which of the following features do MAO inhibitors and tricyclic antidepressants have in common?
a) Act postsynaptically to produce their effect
b) Can precipitate hypotensive crises if certain foods are ingested
c) Increase levels of biogenic amines
d) Are useful for the manic phase of bipolar disorder
022. Tricyclic antidepressants are:
a) Highly selective serotonin reuptake inhibitors
b) Monoamine oxidase inhibitors
c) Selective norepinephrine reuptake inhibitors
d) Mixed norepinephrine and serotonin reuptake inhibitors
023. Which of the following autonomic nervous system effects is common for tricyclic antidepressants?
a) Antimuscarinic action
b) Antihistaminic action
c) Alfa adrenoreceptor-blocking action
d) All of the above
024. Indicate an effective antidepressant with minimal autonomic toxicity:
a) Amitrityline
b) Fluoxetine
c) Imipramine
d) Doxepin
025. Fluoxetine has fewer adverse effects because of:
a) Mixed norepinephrine and serotonin reuptake inhibition
b) Depleted stores of amine neurotransmitters
c) Minimal binding to cholinergic, histaminic, and alfa-adrenergic receptors
d) All of the above
026. Which of the following tricyclic and heterocyclic antidepressants has the greatest sedation?
a) Doxepin
b) Amitriptyline
c) Trazodone
d) All of the above
027. Which of the following tricyclic and heterocyclic agents has the least sedation?
a) Protriptyline
b) Trazodone
c) Amitriptyline
d) Mitrazapine
028. Indicate a tricyclic or a heterocyclic antidepressant having greatest antimuscarinic effects:
a) Desipramine
b) Amitriptyline
c) Trazodone
d) Mirtazapine
029. Indicate a tricyclic or a heterocyclic antidepressant having least antimuscarinic effects:
a) Trazodone
b) Buprorion
c) Mirtazapine
d) All of the above
030. Which of the following antidepressants has significant alfa2-adrenoreceptor antagonism?
a) Amitriptyline
b) Nefazodone
c) Mirtazapine
d) Doxepin
031. Indicate the main claim for an ideal antidepressant agent:
a) A faster onset of action
b) Fewer adverse sedative and autonomic effects
c) Fewer toxicity when overdoses are taken
d) All of the above
032. Sedation, peripheral atropine-like toxicity (e.g. Cycloplegia, tachycardia, urinary retention, and constipation), orthostatic
hypotension, arrhythmias, weight gain and sexual disturbances are possible adverse effects of:
a) Sertaline
b) Amitriptyline
c) Phenelsine
57
d) Bupropion
033. Which of the following drugs is least likely to be prescribed to patients with prostatic hypertrophy, glaucoma, coronary
and cerebrovascular disease?
a) Amitriptyline
b) Paroxetine
c) Bupropion
d) Fluoxetine
034. Indicate the antidepressant agent, which is a phenyltolylpropylamine derivative:
a) Paroxetine
b) Maprotiline
c) Fluoxetine
d) Amitriptyline
035. The mechanism of fluoxetine action includes:
a) Selective inhibition of serotonine uptake in the CNS
b) Little effect on central norepinephrine or dopamine function
c) Minimal binding to cholinergic, histaminic, and alfa-adrenergic receptors
d) All of the above
036. Which of the following antidepressants is used for treatment of eating disorders, especially buliemia?
a) Amitriptyline
b) Fluoxetine
c) Imipramine
d) Tranylcypromine
037. Sertaline and paroxetine are similar to fluoxetine in the mechanism of action and therapeutic use, sertaline is less likely
to interact adversely with other drugs.
a) True
b) False
038. A highly selective serotonine reuptake inhibitor is:
a) Sertaline
b) Paroxetine
c) Fluoxetine
d) All of the above

PART IX Anxiolytic agents


001. Anxiolytics are used to treat:
a) Neurosis
b) Psychosis
c) Narcolepsy
d) Bipolar disorders
002. Anxiolytic agents should:
a) Relieve pain
b) Reduce anxiety and exert a calming effect
c) Improve mood and behavior in patient with psychotic symptoms
d) Produce drowsiness, encourage the onset and maintenance of a state of sleep
003. Anxiolytics are also useful for:
a) Treatment of epilepsy and seizures
b) Insomnia
c) Muscle relaxation in specific neuromuscular disorders
d) All of the above
004. Indicate the agents of choice in the treatment of most anxiety states:
a) Barbiturates
b) Benzodiazepines
c) Lithium salts
d) Phenothiazines
005. The choice of benzodiazepines for anxiety is based on:
a) A relatively high therapeutic index
b) Availability of flumazenil for treatment of overdose
c) A low risk of physiologic dependence
d) All of the above
006. Which of the following anxiolitics is a benzodiazepine derivative:
a) Buspirone
58
b) Clordiazepoxide
c) Meprobamate
d) Chloral hydrate
007. Indicate the benzodiazepine, which has the shortest elimination half-life:
a) Quazepam
b) Triazolam
c) Diazepam
d) Clorazepate
008. Which of the following benzodiazepines has the shortest duration of action?
a) Triazolam
b) Clorazepate
c) Prazepam
d) Clordiazepoxide
009. Which of the following benzodiazepines is less likely to cause cumulative and residual effects with multiple doses?
a) Clorazepate
b) Quazepam
c) Lorazepam
d) Prazepam
010. Anxiolytic dosage reduction is recommended:
a) In patients taking cimetidine
b) In patients with hepatic dysfunction
c) In elderly patients
d) All of the above
011. Which of the following benzodiazepines is preferred for elderly patients?
a) Clorazepate
b) Clordiazepoxide
c) Triazolam
d) Prazepam
012. Which of the following anxiolytics is preferred in patient with limited hepatic function?
a) Buspirone
b) Quazepam
c) Diazepam
d) Chlordiazepoxide
013. Indicate the mechanism of hypnotic benzodiazepine action:
a) Increasing the duration of the GABA-gated Cl- channel openings
b) Directly activating the chloride channels
c) Increasing the frequency of Cl- channel opening events
d) All of the above
014. Which of the following anxiolytics is a partial agonist of brain 5-HT1A receptors?
a) Buspirone
b) Alprozolam
c) Chlorazepat
d) Lorazepam
015. Indicate the competitive antagonist of BZ receptors:
a) Flumazenil
b) Buspirone
c) Picrotoxin
d) Diazepam
016. Indicate the agent, which interferes with GABA binding:
a) Chlordiazepoxide
b) Bicuculline
c) Thiopental
d) Picrotoxin
017. Antianxiety agents have:
a) Sedative and hypnotic activity
b) Muscle relaxing and anticonvulsant effects
c) Amnesic properties
d) All of the above
018. Which of the following disadvantages does not limit using benzodiazepines as antianxiety agents?
a) Tendency to develop psychologic dependence
b) A high risk of drug interactions based on liver enzyme induction
59
c) Synergic CNS depression with concomitant use of other drugs
d) The formation of active metabolites
019. Indicate the anxiolitic agent, which relieves anxiety without causing marked sedative effects:
a) Diazepam
b) Chlordiazepoxid
c) Buspirone
d) Clorazepate
020. Which of the following anxiolytics has minimal abuse liability?
a) Oxazepam
b) Buspirone
c) Flumazenil
d) Alprazolam
021. In contrast to benzodiazepines, buspirone:
a) Interact directly with gabaergic system
b) Has more marked hypnotic, anticonvulsant, or muscle relaxant properties
c) Causes less psychomotor impairment and does not affect driving skills
d) Has maximal abuse liability
022. Which of the following sedative-hypnotic drugs does not potentiate the CNS depressant effects of ethanol,
phenothiazines, or tricyclic antidepressants?
a) Buspirone
b) Phenobarbital
c) Diazepam
d) Chloralhydrate
023. Limitation of buspirone is:
a) A low therapeutic index
b) An extremely slow onset of action
c) A high potential of development of physical dependence
d) Impairment of mentation or motor functions during working hours
024. Which drugs may be used as antianxiety agents?
a) BETA-blocking drugs
b) Clonidine - a partial agonist of alfa2 receptors
c) Tricyclic antidepressants
d) All of the above
025. Which of the following benzodiazepines is more likely to cause “hangover” effects such as drowsiness, dysphoria, and
mental or motor depression the following day?
a) Oxazepam
b) Triazolam
c) Clorazepat
d) Lorazepam
026. Additive CNS depression can be predicted if benzodiazepines are used with:
a) Ethanol
b) Morphine
c) Clorpromazine
d) All of the above
027. Which dosage of benzodiazepines for 60-90 days may produce severe withdrawal symptoms?
a) 50-60 mg/d
b) Less than 400 mg/d
c) More than 800 mg/d
d) Less than 40 mg/d
028. Restlessness, anxiety, orthostatic hypotension, generalized seizures, severe tremor, vivid hallucination, and psychosis
are possible symptoms of:
a) Tolerance
b) Withdrawal
c) Drug interactions between barbiturate and diazepam
d) None of the above
029. Flumazenil is used to:
a) Reverse the CNS depressant effects of hypnotic benzodiazepines overdose
b) Hasten recovery following use of hypnotic benzodiazepines in anesthetic and diagnostic procedure
c) Reverse benzodiazepine-induced respiratory depression
d) All of the above
030. Flumazenil given intravenously:
60
a) Has intermediate onset and duration of action about 2 hours
b) Acts rapidly but has a short half-life
c) Has an effect lasting 3-5 hours
d) Has duration of action longer than 6 hours

PART X CNS stimulants


001. Agents, stimulating CNS are all of the following except:
a) Fluoxetine
b) Clozapine
c) Nootropil
d) Sydnocarb
002. Which of the following CNS stimulants are the agents of selective effect?
a) Analeptics
b) General tonics
c) Psychostimulants
d) Actoprotectors
003. Indicate CNC stimulating drugs, which are the agents of general action:
a) Nootropic agents
b) Analeptics
c) Psychostimulants
d) Antidepressants
004. Which of the following agents belongs to psychostimulants?
a) Meridil
b) Camphor
c) Piracetam
d) Pantocrin
005. Indicate the nootropic agent:
a) Sydnocarb
b) Eleuterococci extract
c) Fluoxetine
d) Piracetam
006. Which of the following agents is a respiratory analeptic?
a) Piracetam
b) Sydnocarb
c) Bemegride
d) Pantocrin
007. Indicate the CNC stimulating drug, which belongs to adaptogens:
a) Amphetamine
b) Eleuterococci extract
c) Caffeine
d) Sydnocarb
008. Actoprotectors are:
a) Stimulators, improving physical efficiency
b) Cognition enhancers, improving the highest integrative brain function
c) Stimulants, raising non-specific resistance towards stresses
d) Agents, stimulating the bulbar respiratory and vasomotor centers
009. Adaptogens cause:
a) Improvment of efficiency using physical loads and acceleration of recovery after the load
b) Stimulation of respiratory and vasomotor centers
c) Temporary relief of the feeling of tiredness, facilitating the professional work and fighting somnolence
d) Increased resistance towards stress situations and adaptation to extreme conditions
010. Indicate the CNS stimulants, which mitigate conditions of weakness or lack of tone within the entire organism or in
particular organs?
a) Psychostimulants
b) Analeptics
c) General tonics
d) Antidepressants
011. Which of the following agents is a general tone-increasing drug of plant origin?
a) Meridil
b) Eleuterococci′s extract
c) Pantocrin
61
d) Caffeine
012. Indicate a general tone-increasing drug, which is an agent of animal origin?
a) Pantocrin
b) Amphetamine
c) Sydnocarb
d) Camphor
013. Amphetamine:
a) Is a powerful stimulant of the CNS
b) Stimulates the medullar respiratory center and has an analeptic action
c) Increases motor and speech activity, mood, decreases a sense of fatigue
d) All of the above
014. The mechanism of amphetamine action is related to:
a) Direct catecholamiergic agonist action
b) Inhibition of monoamine oxydase
c) Increasing a release of catecholaminergic neurotransmitters
d) All of the above
015. Indicate the CNS stimulant, which is a piperidine derivative:
a) Meridil
b) Amphetamine
c) Caffeine
d) Sydnophen
016. Which of the following CNS psychostimulants is a sydnonymine derivative?
a) Caffeine
b) Sydnocarb
c) Meridil (methylphenidate hydrochloride)
d) Amphetamine
017. Sydnocarb causes:
a) Decreased sense of fatigue, it facilitates the professional work and fights somnolence
b) The feeling of prosperity, relaxation and euphoria
c) Influx of physical and mental forces, locomotive and speech excitation
d) Peripheral sympathomimetic action
018. Indicate the psychostimulant, which is a methylxantine derivative:
a) Caffeine
b) Sydnocarb
c) Amphetamine
d) Meridil
019. Which of the following psychostimulants acts centrally mainly by blocking adenosine receptors?
a) Meridil
b) Caffeine
c) Amphetamine
d) Sydnophen
020. Principal properties of caffeine include all of the following EXEPT:
a) Cardiac analeptic (increase the rate and the force of the cardiac contraction)
b) Adaptogenic (rise non-specific resistance towards stresses and adapt to extraordinary challenges)
c) Psychoanaleptic (decrease the feeling of tiredness, facilitates the professional work and fights somnolence)
d) Respiratory analeptic (stimulate the bulbar respiratory center)
021. Caffeine can produce all of the following effects except:
a) Coronary vasodialation
b) Relaxation of bronchial and biliary tract smooth muscles
c) Vasodialation of cerebral vessels
d) Reinforcement of the contractions and increase of the striaated muscle work
022. Caffeine does not cause:
a) Inhibition of gastric secretion
b) Hyperglycemia
c) Moderate diuretic action
d) Increase in free fatty acids
023. Therapeutic uses of caffeine include all of the following EXCEPT:
a) Cardiovascular collapse and respiratory insufficiency
b) Migraine
c) Somnolence
d) Gastric ulceration
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024. Adverse effects of caffeine include all of the following EXCEPT:
a) Arrhythmias
b) Insomnia
c) Hypotension
d) Psychomotor excitation
025. Principal properties of cordiamine include all of the following EXCEPT:
a) Cardiac analeptic
b) Respiratory analeptic
c) Coronarodilatator
d) Significant abuse potential
026. Сharacteristics of cordiamine include all of the following EXCEPT:
a) It stimulates the CNS and facilitates the movement coordination
b) It is a respiratory analeptic of mixed action (stimulates both the medullar respiratory center and chemoreceptor of
carotid sinus zone)
c) It decreases the aortic and coronary flow
d) It counteracts the central depression produced by other drugs (barbiturates)
027. Cordiamine is useful in the treatment of:
a) Hypotension
b) Coronary insufficiency
c) Respiratory insufficiency
d) All of the above
028. Respiratory and cardiac analeptics are all of the following agents EXCEPT:
a) Cordiamine
b) Bemegride
c) Caffeine
d) Camphor
029. Bemegride:
a) Stimulates the medullar respiratory center (central effect)
b) Stimulates hemoreceptors of carotid sinus zone (reflector action)
c) Is a mixed agent (both central and reflector effects)
d) Is a spinal analeptic
030. Which of the following CNS stimulants belongs to nootropics?
a) Camphor
b) Pantocrin
c) Sydnocarb
d) Piracetam
031. Characteristics of nootropics include all of the following EXCEPT:
a) Selective influence on the brain
b) Improvement the ability to communicate with peers
c) Decline in the highest integrative brain functions
d) Increase in energetic exchange of the brain cells
032. Which of the following statements concerning nootropics is not correct?
a) They improve the highest integrative brain functions (memory, learning, understanding, thinking and the capacity for
concentration)
b) They stimulate the bulbar respiratory center
c) They stimulate existing neuronal synapses to optimum performance (adaptive capacity)
d) They stimulate existing neuronal synapses to damaging influences, such as disturbances of the energy and
neurotransmitter metabolism or ischemia (protective capacity)
033. Features of piracetam include all of the following EXCEPT:
a) It is a GABA derivative
b) It does not influence the neuro-vegetative function
c) Improvement begins in the 3′rd week
d) It has a high potential of toxicity
034. Piracetam can produce all of the following effects EXCEPT:
a) Antipsychotic
b) Anticonvulsant
c) Psychometabolic
d) Antihypoxic
035. Piracetam is widely used for the treatment of:
a) Senile dementia
b) Asthenia
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c) Chronic alcoholism
d) All of the above
036. Indicate the CNS stimulant, which is used in pediatric medicine, as it improves the communication with the child,
increases the ability to study and communication with peers, improves school-performance?
a) Meridil
b) Piracetam
c) Bemegride
d) Amphetamine
037. Which of the following CNS stimulants is used for the cerebral stroke treatment?
a) Pantocrin
b) Sydnocarb
c) Piracetam
d) Caffeine

PART XI Drugs of abuse


001. Psychologic dependence is:
a) Decreased responsiveness to a drug following repeated exposure
b) A combination of certain drug-specific symptoms that occur on sudden discontinuation of a drug
c) Compulsive drug-seeking behavior
d) All of the above
002. Tolerance is associated with:
a) An ability to compensate for the drug effect
b) Increased disposition of the drug after chronic use
c) Compensatory changes in receptors, effector enzymes, or membrane actions of the drug
d) All of the above
003. Addiction is associated with the existence of:
a) Psychological dependence
b) Physiological dependence
c) Tolerance
d) All of the above
004. Substances causing narco- and glue sniffings are all of the following EXCEPT :
a) Stimulants
b) Antipsychotic drugs
c) Psychedelics
d) Sedative drugs
005. Which of the following abused drugs do not belong to sedative agents?
a) Barbiturates
b) Tranquilizers
c) Cannabinoids
d) Opioids
006. Psychedelics are all of following agents EXCEPT:
a) Cocaine
b) LSD
c) Marijuana
d) Volatile substances (glues, solvents, volatile nitrites and nitrous oxide)
007. In contrast to morphine, heroin is:
a) Used clinically
b) More addictive and fast-acting
c) More effective orally
d) Less potent and long-acting
008. Symptoms of opioid withdrawal begin 8-10 hours after the last dose.
a) True
b) False
009. The acute course of opioid withdrawal may last:
a) 3-4 days
b) 7-10 days
c) 3-4 weeks
d) 26-30 weeks
010. Indicate the sedative-hypnotic agent, which has the highest abuse potential:
a) Buspirone
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b) Diazepam
c) Phenobarbital
d) Zolpidem
011. Characteristics of barbiturate intoxication (2-3 dose) include all of the following EXCEPT:
a) Pleasant feelings of the “blow” in the head, vertigo, myasthenia, stupor
b) Perceptual distortion of surroundings, disorders of thinking, behavior
c) Locomotive, speech excitation, sharp swings from a cheerful mood to an aggressive state
d) Sleep with the subsequent weakness and headaches
012. Barbiturate abstinent syndrome is shown by:
a) Crisis by 3 day of abstention
b) Anxiety, mydriasis, myasthenia, muscular convulsions, vomiting, diarrhea
c) Psychosis as delirium (color visual and auditory hallucinations)
d) All of the above
013. Which one of the following tranquilizers belongs to strong euphorizing agents?
a) Mebicarum
b) Buspirone
c) Diazepam
d) Chlordiazepoxide
014. Tranquilizers intoxication (5-10 tablets) features include:
a) Euphoria, burst of energy, increase in motor activity, wave warmth all over the body
b) Visual hallucinations, a distorted feelling of time and space
c) Physical bliss, body lightness, a wish to fly, motionlessness
d) Synaesthesia (the sounds can be tensed, the colors can be heard)
015. Which of the following abused drugs is related to stimulants?
a) Cocaine
b) Amphetamine
c) Caffeine
d) All of the above
016. Cocaine exerts its central action by:
a) Inhibiting phosphodiesterase
b) Increasing a release of catecholaminergic neurotransmitters, including dopamine
c) Inhibiting dopamine and norepinephrine reuptake
d) Altering serotonin turnover
017. “Crack” is a derivative of:
a) Opium
b) LSD
c) Cocaine
d) Cannabis
018. Cocaine intoxication appears by:
a) Short clouding of consciousness, lightness of body and a feeling of flight
b) Wave warmth all over the body, physical bliss, motionlessness
c) Clear consciousness, improved mood, influx of physical and spiritual forces, locomotive and speech excitation,
reappraisal of personality
d) All of the above
019. Which of the following stimulants is related to psychedelics?
a) “ecstasy” (methylenedioxymethamphetamine)
b) Cocaine
c) “crack” (cocaine free base)
d) Caffeine
020. Cocaine may cause:
a) Powerful vasoconstrictive reactions resulting in myocardial infarctions
b) The multiple brain perfusion defects
c) Spontaneous abortion during pregnancy
d) All of the above
021. Characteristics of cocaine abstinent syndrome include all of the following phases EXCEPT:
a) Feeling of depression, irritability, confusion, insomnia (the first 3 days)
b) Depression, apathy, excessive appetite, a wish to sleep (the subsequent 1-2 days)
c) Psychosis as color visual and auditory hallucinations (for 3 day)
d) New attack of depression, anxiety, irritability, dullness, intense thirst for cocaine (after 1-5 days improvement)
022. Overdoses of cocaine are usually rapidly fatal from:
a) Respiratory depression
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b) Arrhythmias
c) Seizures
d) All of the above
023. Which of the following agents is related to hallucinogens?
a) Heroin
b) LSD
c) Cocaine
d) Opium
024. LSD produces:
a) Mood swings
b) Impaired memory, difficulty in thinking, poor judgment
c) Perceptual distortion
d) All of the above
025. LSD decreases in brain:
a) 5-HT2 receptor densities
b) GABAA-benzodiazepine receptor densities
c) Adrenergic receptor densities
d) D2 receptor densities
026. Which of the following agents is related to cannabis?
a) Heroin
b) Ecstasy
c) Hashish
d) Crack
027. The early stage of cannabis intoxication is characterized by:
a) Euphoria, uncontrolled laugher
b) Alteration of time sense, depersonalization
c) Sharpened vision
d) All of the above
028. Which of the following physiologic signs is a characteristic of cannabis intoxication?
a) Bradycardia
b) Reddening of the conjunctiva
c) Miosis
d) Nausea and vomiting
029. Industrial solvent inhalation causes:
a) Quick intoxication, lasting only 5-15 minutes
b) Euphoria, relaxed “drunk” feeling
c) Disorientation, slow passage of time and possible hallucinations
d) All of the above
030. Indicate the drugs of choice for reversing the withdrawal syndrome:
a) Benzodiazepines
b) Neuroleptics
c) Antidepressants
d) All of the above

PART XII General anesthetics


001. The state of “general anesthesia” usually includes:
a) Analgesia
b) Loss of consciousness, inhibition of sensory and autonomic reflexes
c) Amnesia
d) All of the above
002. Inhaled anesthetics and intravenous agents having general anesthetic properties:
a) Directly activate GABAA receptors
b) Facilitate GABA action but have no direct action on GABAA receptors
c) Reduce the excitatory glutamatergic neurotransmission
d) Increase the duration of opening of nicotine-activated potassium channels
003. Indicate the anesthetic, which is an inhibitor of NMDA glutamate receptors:
a) Thiopental
b) Halothane
c) Ketamine
d) Sevoflurane
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004. An ideal anesthetic drug would:
a) Induces anesthesia smoothly and rapidly and secure rapid recovery
b) Posses a wide margin of safety
c) Be devoid of adverse effects
d) All of the above
005. Which of the following general anesthetics belongs to inhalants?
a) Thiopental
b) Desfluran
c) Ketamine
d) Propofol
006. Indicate the anesthetic, which is used intravenously:
a) Propofol
b) Halothane
c) Desflurane
d) Nitrous oxide
007. Which of the following inhalants is a gas anesthetic?
a) Halothane
b) Isoflurane
c) Nitrous oxide
d) Desflurane
008. Sevoflurane has largely replaced halothane and isoflurane as an inhalation anesthetic of choice because:
a) Induction of anesthesia is achieved more rapidly and smoothly
b) Recovery is more rapid
c) It has low post- anesthetic organ toxicity
d) All of the above
009. The limitation of sevoflurane is:
a) High incidence of coughing and laryngospasm
b) Chemically unstable
c) Centrally mediated sympathetic activation leading to a rise of BP and HR
d) Hepatotoxicity
010. Which of the following inhalants lacks sufficient potency to produce surgical anesthesia by itself and therefore is
commonly used with another inhaled or intravenous anesthetic?
a) Halothane
b) Sevoflurane
c) Nitrous oxide
d) Desflurane
011. Which of the following inhaled anesthetics has rapid onset and recovery?
a) Nitrous oxide
b) Desflurane
c) Sevoflurane
d) All of the above
012. Indicate the inhaled anesthetic, which reduces arterial pressure and heart rate:
a) Isoflurane
b) Halothane
c) Desflurane
d) Nitrous oxide
013. Which of the following inhaled anesthetics causes centrally mediated sympathetic activation leading to a rise in blood
pressure and heart rate?
a) Desflurane
b) Sevoflurane
c) Nitrous oxide
d) Isofurane
014. Indicated the inhaled anesthetic, which decreases the ventilatory response to hypoxia:
a) Sevoflurane
b) Nitrous oxide
c) Desflurane
d) Halothane
015. Which of the following inhaled anesthetics is an induction agent of choice in patient with airway problems?
a) Desfurane
b) Nitrous oxide
c) Halothane
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d) None of the above
016. Indicate the inhaled anesthetic, which causes the airway irritation:
a) Nitrous oxide
b) Sevoflurane
c) Halothane
d) Desflurane
017. Which of the following inhaled anesthetics increases cerebral blood flow least of all?
a) Sevoflurane
b) Nitrous oxide
c) Isoflurane
d) Desflurane
018. Indicate the inhaled anesthetic, which should be avoided in patients with a history of seizure disorders:
a) Enflurane
b) Nitrous oxide
c) Sevoflurane
d) Desflurane
019. Which of the following inhaled anesthetics can produce hepatic necrosis?
a) Soveflurane
b) Desflurane
c) Halothane
d) Nitrous oxide
020. Indicated the inhaled anesthetic, which may cause nephrotoxicity:
a) Halothane
b) Soveflurane
c) Nitrous oxide
d) Diethyl ether
021. Which of the following inhaled anesthetics decreases metheonine synthase activity and causes megaloblastic anemia?
a) Desflurane
b) Halothane
c) Nitrous oxide
d) Soveflurane
022. Unlike inhaled anesthetics, intravenous agents such as thiopental, etomidate, and propofol:
a) Have a faster onset and rate of recovery
b) Provide a state of conscious sedation
c) Are commonly used for induction of anesthesia
d) All of the above
023. Indicate the intravenous anesthetic, which is an ultra-short-acting barbiturate:
a) Fentanyl
b) Thiopental
c) Midazolam
d) Ketamine
024. Indicate the intravenous anesthetic, which is a benzodiazepine derivative:
a) Midazolam
b) Thiopental
c) Ketamin
d) Propofol
025. Which of the following agents is used to accelerate recovery from the sedative actions of intravenous benzodiazepines?
a) Naloxone
b) Flumazenil
c) Ketamine
d) Fomepizole
026. Neuroleptanalgesia has all of the following properties EXCEPT:
a) Droperidol and fentanyl are commonly used
b) It can be used with nitrous oxide to provide neuroleptanesthesia
c) Hypertension is a common consequence
d) Confusion and mental depression can occur as adverse effects
027. Which of the following intravenous anesthetics has antiemetic actions?
a) Thiopental
b) Propofol
c) Ketamine
d) Fentanyl
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028. Indicate the intravenous anesthetic, which causes minimal cardiovascular and respiratory depressant effects:
a) Propofol
b) Thiopental
c) Etomidate
d) Midazolam
029. Indicate the intravenous anesthetic, which produces dissociative anesthesia:
a) Midazolam
b) Ketamine
c) Fentanyl
d) Thiopental
030. Ketamine anesthesia is associated with:
a) Cardiovascular stimulation
b) Increased cerebral blood flow, oxygen consumption and intracranial pressure
c) Disorientation, sensory and perceptual illusions, and vivid dreams following anesthesia
d) All of the above

(4) ORGANOTROPIC AGENTS

PART I Drugs acting on respiratory system


001. Following drugs directly activate the respiratory center EXCEPT:
a) Bemegride
b) Caffeine
c) Aethymizole
d) Cytiton
002. The mechanism of Cytiton action is:
a) Direct activation of the respiratory center
b) The reflex mechanism
c) The mixed mechanism
d) None of the above
003. Indicate the drug belonging to antitussives of narcotic type of action:
a) Glaucine hydrochloride
b) Aethylmorphine hydrochloride
c) Tusuprex
d) Libexine
004. Tick out the drug belonging to non-narcotic antitussives:
a) Libexine
b) Tusuprex
c) Codeine
d) Aethylmorphine hydrochloride
005. Indicate the expectorant with the reflex mechanism:
a) Sodium benzoate
b) Derivatives of Ipecacucnha and Thermopsis
c) Trypsin
d) Ambroxol
006. Tick the antitussive agent with a peripheral effect:
a) Codeine
b) Tusuprex
c) Libexine
d) Glaucine hydrochloride
007. Chymotrypsin is an agent containing free sulfhydryl groups. It’s:
a) True
b) False
008. All of these drugs contain free sulfhydryl groups EXCEPT:
a) Acetylcysteine
b) Ambroxol
c) Bromhexin
d) Trypsin
009. Which of the following drugs is proteolytic enzyme?
a) Potassium iodide
b) Desoxiribonuclease
c) Carbocysteine
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d) Acetylcysteine
010. All of the following drugs destroy disulfide bonds of proteoglycans, which causes depolymerization and reduction of
viscosity of sputum, EXCEPT:
a) Acetylcysteine
b) Ambroxol
c) Desoxiribonuclease
d) Bromhexin
011. Which of these groups of drugs is used for asthma treatment?
a) Methylxanthines
b) M-cholinoblocking agents
c) Beta2 - stimulants
d) All of above
012. Tick the drug belonging to non-selective beta2-adrenomimics:
a) Salbutamol
b) Isoprenaline
c) Salmeterol
d) Terbutaline
013. Select the side-effect characteristic for non-selective beta2-adrenomimics:
a) Depression of the breathing centre
b) Tachycardia
c) Peripheral vasoconstriction
d) Dry mouth
014. Pick out the bronchodilator drug related to xanthine:
a) Atropine
b) Orciprenaline
c) Adrenaline
d) Theophylline
015. Pick out the bronchodilator drug belonging to sympathomimics:
a) Isoprenaline
b) Ephedrine
c) Atropine
d) Salbutamol
016. The property of prolonged theophyllines is the prevention of night asthmatic attacks. It’s:
a) True
b) False
017. The mechanism of methylxanthines action is:
a) Inhibition of the enzyme phosphodiesterase
b) Beta2 -adrenoreceptor stimulation
c) Inhibition of the production of inflammatory cytokines
d) Inhibition of M-cholinoreceptors
018. Which of the following M-cholinoblocking agents is used especially as an anti-asthmatic?
a) Atropine
b) Ipratropium
c) Platiphylline
d) Metacin
019. Indicate the side effect of Theophylline:
a) Bradycardia
b) Increased myocardial demands for oxygen
c) Depression of respiratory centre
d) Elevation of the arterial blood pressure
020. All of the following drugs are inhaled glucocorticoids EXCEPT:
a) Triamcinolone
b) Beclometazone
c) Sodium cromoglycate
d) Budesonide
021. Choose the drug belonging to membranestabilizing agents:
a) Zileutin
b) Sodium cromoglycate
c) Zafirlucast
d) Montelucast
022. Tick the drug which is a 5-lipoxygenase inhibitor:
70
a) Budesonide
b) Sodium cromoglycate
c) Zileutin
d) Beclometazone
023. Zileutin prevents the production of leukotrienes. This statement is:
a) True
b) False
024. Indicate the drug which is a leucotriene receptor antagonist:
a) Sodium cromoglycate
b) Zafirlucast
c) Zileutin
d) Triamcinolone
025. Zafirlucast prevents aspirin-sensitive asthma. This consideration is:
a) True
b) False

PART II Drugs used in gastrointestinal diseases


001. Tick the main approach of peptic ulcer treatment:
a) Neutralization of gastric acid
b) Eradication of Helicobacter pylori
c) Inhibition of gastric acid secretion
d) All the above
002. Gastric acid secretion is under the control of the following agents EXCEPT:
a) Histamine
b) Acetylcholine
c) Serotonin
d) Gastrin
003. Indicate the drug belonging to proton pump inhibitors:
a) Pirenzepine
b) Ranitidine
c) Omeprazole
d) Trimethaphan
004. All of the following agents intensify the secretion of gastric glands EXCEPT:
a) Pepsin
b) Gastrin
c) Histamine
d) Carbonate mineral waters
005. Which of the following drugs is an agent of substitution therapy?
a) Gastrin
b) Hydrochloric acid
c) Hystamine
d) Carbonate mineral waters
006. Choose the drug which is a H2-receptor antagonist:
a) Omeprazole
b) Pirenzepine
c) Carbenoxolone
d) Ranitidine
007. All of the following drugs are proton pump inhibitors EXCEPT:
a) Pantoprozole
b) Omeprazole
c) Famotidine
d) Rabeprazole
008. Indicate the drug belonging to M1-cholinoblockers:
a) Cimetidine
b) Ranitidine
c) Pirenzepin
d) Omeprazole
009. Which of the following drugs may cause reversible gynecomastia?
a) Omeprazole
b) Pirenzepine
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c) Cimetidine
d) Sucralfate
010. Cimetidine has no effect on hepatic drug metabolism. It’s
a) True
b) False
011. Tick the drug forming a physical barrier to HCL and Pepsin:
a) Ranitidine
b) Sucralfate
c) Omeprazole
d) Pirenzepine
012. Which drug is an analog of prostaglandin E1?
a) Misoprostole
b) De-nol
c) Sucralfate
d) Omeprazole
013. Select the drug stimulating the protective function of the mucous barrier and the stability of the mucous membrane
against damaging factors:
a) De-nol
b) Sucralfate
c) Misoprostol
d) Omeprazole
014. Antacids are weak bases that react with gastric hydrochloric acid to form salt and water. It’s
a) True
b) False
015. Most of drugs are antacids EXCEPT:
a) Misoprostol
b) Maalox
c) Mylanta
d) Almagel
016. Indicate the drug that cause metabolic alkalosis:
a) Sodium bicarbonate
b) Cimetidine
c) Pepto-Bismol
d) Carbenoxolone
017. Choose the drug that causes constipation:
a) Sodium bicarbonate
b) Aluminium hydroxide
c) Calcium carbonate
d) Magnesium oxide
018. All of the following drugs stimulate appetite EXCEPT:
a) Vitamins
b) Bitters
c) Fepranone
d) Insulin
019. Ethyl alcohol is an agent decreasing appetite. It’s:
a) True
b) False
020. Select an anorexigenic agent affecting serotoninergic system:
a) Fenfluramine
b) Fepranone
c) Desopimone
d) Masindole
021. All of the following drugs intensify gastrointestinal motility EXCEPT:
a) Papaverine
b) Metoclopramide
c) Domperidone
d) Cisapride
022. Metoclopramide is a potent dopamine antagonist.It’s
a) True
b) False
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023. Choose an emetic drug of central action:
a) Ipecacuanha derivatives
b) Promethazine
c) Tropisetron
d) Apomorphine hydrochloride
024. Tick the mechanism of Metoclopramide antiemetic action:
a) H1 and H2-receptor blocking effect
b) M-cholinoreceptor stimulating effect
c) D2-dopamine and 5-HT3-serotonin receptor blocking effect
d) M-cholinoblocking effect
025. Select the emetic agent having a reflex action:
a) Ipecacuanha derivatives
b) Apomorphine hydroclorid
c) Chlorpromazine
d) Metoclopramide
026. All of the following drugs are antiemetics EXCEPT:
a) Metoclopramide
b) Ondansetron
c) Chlorpromazine
d) Apomorphine hydrochloride
027. Indicate an antiemetic agent which is related to neuroleptics:
a) Metoclopramide
b) Nabilone
c) Tropisetron
d) Prochlorperazine
028. All of these drugs reduce intestinal peristalsis EXCEPT:
a) Loperamide
b) Cisapride
c) Methyl cellulose
d) Magnesium aluminium silicate
029. Indicate the laxative drug belonging to osmotic laxatives:
a) Docusate sodium
b) Bisacodyl
c) Phenolphthalein
d) Sodium phosphate
030. The mechanism of stimulant purgatives is:
a) Increasing the volume of non-absorbable solid residue
b) Increasing motility and secretion
c) Altering the consistency of the feces
d) Increasing the water content
031. Choose the drug irritating the gut and causing increased peristalsis:
a) Phenolphthalein
b) Methyl cellulose
c) Proserine
d) Mineral oil
032. All of the following drugs stimulate bile production and bile secretion EXCEPT:
a) Chenodiol
b) Cholenszyme
c) Oxaphenamide
d) Cholosas
033. Tick the stimulant of bile production of vegetable origin:
a) Oxaphenamide
b) Papaverine
c) Cholenzyme
d) Cholosas
034. Select the drug which inhibits peristalsis:
a) Castor oil
b) Bisacodyl
c) Loperamide
d) Sorbitol
035. Choose the drug affecting the biliary system and relaxing Oddy sphincter:
73
a) Cholosas
b) Oxaphenamide
c) No-spa
d) Cholenzyme

PART III Drugs acting on hematopoietic system


001. Following drugs stimulate erythrogenesis EXCEPT:
a) Iron dextran
b) Vitamine B12
c) Methotrexate
d) Folic acid
002. Choose the drug depressing erythrogenesis:
a) Radioactive phosphorus 32
b) Ferrous sulfate
c) Molgramostim
d) Folic acid
003. Which drug does not influence leucopoiesis?
a) Filgrastim
b) Erythropoetin
c) Doxorubicin
d) Methotrexate
004. Iron deficiency anemia leads to pallor, fatigue, dizziness, exertional dyspnea and other symptoms of tissue ischemia. It’s:
a) True
b) False
005. All of the following drugs used for iron deficiency anemia EXCEPT:
a) Ferrous sulfate
b) Folic acid
c) Ferrous gluconate
d) Ferrous fumarate
006. Tick the drug for parenteral iron therapy:
a) Ferrous sulfate
b) Fercoven
c) Ferrous lactate
d) Ferrous fumarate
007. Indicate the drug which increases absorption of iron from intestine:
a) Cyanocobalamin
b) Folic acid
c) Ascorbic acid
d) Erythropoetin
008. The drugs used for oral administration EXCLUDE:
a) Ferrous sulfate
b) Fercoven
c) Ferrous lactate
d) Ferrous fumarate
009. Pernicious anemia is developed due to deficiency of:
a) Erythropoetin
b) Vitamin B12
c) Iron
d) Vitamin B6
010. Select the drug used for pernicious anemia:
a) Ferrous lactate
b) Cyanocobalamin
c) Iron dextran
d) Ferrous gluconate
011. An adverse effect of oral iron therapy is:
a) Anemia
b) Thrombocytopenia
c) Headache
d) Constipation
012. Choose the drug which contains cobalt atom:
74
a) Folic acid
b) Iron dextran
c) Cyanocobalamine
d) Ferrous gluconate
013. Tick the drug used in aplastic anemia:
a) Fercoven
b) Cyanocobalamine
c) Epoetin alpha
d) Folic acid
014. Folic acid is recommended for treatment of megaloblastic anemia. This statement is:
a) True
b) False
015. Select the drug of granulocyte colony-stimulating factor:
a) Filgrastim
b) Methotrexate
c) Erythropoetin
d) Doxorubicin

PART IV Drugs used in disorders of coagulation


001. All of the following physiologic reactions are involved in the control of bleeding EXCEPT:
a) Platelet adhesion reaction
b) Platelet release reaction
c) Activation of the antifibrinolytic system
d) Triggering of the coagulation process
002. Which of the following substances is synthesized within vessel walls and inhibits thrombogenesis?
a) Thromboxane A2 (TXA2)
b) Prostacyclin (PGI2)
c) Prostaglandin ((PGE)
d) None of the above
003. All of the following groups of drugs are for thrombosis treatment EXCEPT:
a) Anticoagulant drugs
b) Antifibrinolitic drugs
c) Fibrinolitic drugs
d) Antiplatelet drugs
004. Pick out the drug belonging to anticoagulants of direct action:
a) Aspirin
b) Heparin
c) Dicumarol
d) Phenprocoumon
005. Which of the following drugs has low-molecular weight?
a) Dicumarol
b) Enoxaparin
c) Phenprocoumon
d) Heparin
006. Indicate the drug belonging to antagonists of heparin:
a) Aspirin
b) Dicumarol
c) Dalteparin
d) Protamine sulfate
007. Tick the drug used as an oral anticoagulant:
a) Heparin
b) Daltreparin
c) Dicumarol
d) Enoxaparin
008. All of the following drugs are indirect acting anticoagulants EXCEPT:
a) Dicumarol
b) Warfarin
c) Dalteparin
d) Phenindione
009. Which of the following drugs belongs to coumarin derivatives?
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a) Heparin
b) Enoxaparin
c) Dalteparin
d) Warfarin
010. Heparin is effective when administred orally. This consideration is:
a) True
b) False
011. All of these drugs are antiplatelet agents EXCEPT:
a) Aspirin
b) Urokinase
c) Ticlopidine
d) Clopidogrel
012. The use of heparin is recommended for treatment of deep venous thrombosis. This statement is:
a) True
b) False
013. Mechanism of aspirin action is:
a) Converts inactive plasminogen into active plasmin
b) Inhibits COX and thus thromboxane synthesis
c) Enhances the interaction between antitrombin III and both thrombin and the factors involved in the intrinsic clotting
cascade
d) Inhibits the glycoprotein IIb/IIIa complex
014. Which doses of Aspirin may be more effective in inhibiting Tromboxane A2?
a) Low
b) High
015. Which of the following drugs is an inhibitor of platelet glycoprotein IIb/IIIa receptors?
a) Aspirin
b) Clopidogrel
c) Ticlopidine
d) Abciximab
016. Ticlopidine is an inhibitor of ADP-induced platelet aggregation. It’s:
a) True
b) False
017. Which of the following drugs is fiibrinolytic?
a) Ticlopidine
b) Streptokinase
c) Aspirin
d) Warfarin
018. Mechanism of urokinase action is an inhibition of Thromboxane A2. This statement is:
a) True
b) False
019. Fibrinolytic drugs are used for following EXCEPT:
a) Central deep venous thrombosis
b) Multiple pulmonary emboli
c) Heart failure
d) Acute myocardial infarction
020. Indicate the drug belonging to fibrinoliytic inhibitors:
a) Aminocapronic acid
b) Ticlopidine
c) Streptokinase
d) Vitamin K
021. Aminocapronic acid is a drug of choice for treatment of:
a) Acute myocardial infarction
b) Bleeding from fibrinolytic therapy
c) Heart failure
d) Multiple pulmonary emboli
022. Tranexamic acid is an analog of aminocapronic acid. It’s:
a) True
b) False
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PART V Drugs used for treatment of heart failure
001. All of the following are normally involved in the pathogenesis of heart failure EXCEPT:
a) A cardiac lesion that impairs cardiac output
b) An increase in peripheral vascular resistance
c) A decrease in preload
d) An increase in sodium and water retention
002. All of the following are compensatory mechanisms that occur during the pathogenesis of congestive heart failure
EXCEPT:
a) An increase in ventricular end-diastolic volume
b) An increase in the concentration of plasma catecholamines
c) An increase in vagal tone
d) Increased activity of the renin-angiotensin-aldosterone system
003. All of the following are recommended at the initial stages of treating patients with heart failure EXCEPT:
a) Reduced salt intake
b) Verapamil
c) ACE inhibitors
d) Diuretics
004. All of the following agents belong to cardiac glycosides EXCEPT:
a) Digoxin
b) Strophantin K
c) Amrinone
d) Digitoxin
005. The non-glycoside positive inotropic drug is:
a) Digoxin
b) Strophantin K
c) Dobutamine
d) Digitoxin
006. Sugar molecules in the structure of glycosides influence:
a) Cardiotonic action
b) Pharmacokinetic properties
c) Toxic properties
d) All of the above
007. Aglycone is essential for:
a) Plasma protein binding
b) Half-life
c) Cardiotonic action
d) Metabolism
008. Choose the derivative of the plant Foxglove (Digitalis):
a) Digoxin
b) Strophantin K
c) Dobutamine
d) Amrinone
009. All of the following statements regarding cardiac glycosides are true EXCEPT:
a) They inhibit the Na+/K+-ATPase and thereby increase intracellular Ca++ in myocardial cells
b) They cause a decrease in vagal tone
c) Children tolerate higher doses of digitalis than do adults
d) The most frequent cause of digitalis intoxication is concurrent administration of diuretics that deplete K+
010. An important action of digitalis is to increase vagal tone. It’s:
a) True
b) False
011. Digoxin is thought to increase intracellular concentrations of calcium in myocardial cells by indirectly slowing the action of
the sodium-calcium exchanger. This consideration is:
a) True
b) False
012. Compare the half-life of digoxin and the half-life of digitoxin:
a) Digoxin is greater than digitoxin
b) Digitoxin is greater than digoxin
013. All of the following statements regarding cardiac glycosides are true EXCEPT:
a) They inhibit the activity of the Na+/K+-ATPase
b) They decrease intracellular concentrations of calcium in myocytes
77
c) They increase vagal tone
d) They have a very low therapeutic index
014. All of the following statements regarding cardiac glycosides are true EXCEPT:
a) Digoxin is a mild inotrope
b) Digoxin increases vagal tone
c) Digoxin has a longer half-life than digitoxin
d) Digoxin acts by inhibiting the Na+/K+ ATPase
015. The most cardiac manifestation of glycosides intoxication is:
a) Atrioventricular junctional rhythm
b) Second-degree atrioventricular blockade
c) Ventricular tachycardia
d) All the above
016. The manifestations of glycosides intoxication are:
a) Visual changes
b) Ventricular tachyarrhythmias
c) Gastrointestinal disturbances
d) All the above
017. For digitalis-induced arrhythmias the following drug is favored:
a) Verapamil
b) Amiodarone
c) Lidocaine
d) Propanolol
018. In very severe digitalis intoxication the best choice is to use:
a) Lidocaine
b) Digibind (Digoxin immune fab)
c) Oral potassium supplementation
d) Reducing the dose of the drug
019. All of the following statements regarding cardiac glycoside-induced ventricular tachyarrhythmias are true EXCEPT:
a) Lidocaine is a drug of choice in treatment
b) Digibind should be used in life-threatening cases
c) They occur more frequently in patients with hyperkalemia than in those with hypokalemia
d) They are more likely to occur in patients with a severely damaged heart
020. This drug is a selective beta-1 agonist:
a) Digoxin
b) Dobutamine
c) Amrinone
d) Dopamine
021. Tolerance to this inotropic drug develops after a few days:
a) Amrinone
b) Amiodarone
c) Dobutamine
d) Adenosine
022. This drug inhibits breakdown of cAMP in vascular smooth muscle:
a) Digoxin
b) Dobutamine
c) Amrinone
d) Dopamine
023. This drug is useful for treating heart failure because it increases the inotropic state and reduces afterload:
a) Amiodarone
b) Amrinone
c) Propanolol
d) Enalapril
024. This drug acts by inhibiting type III cyclic nucleotide phosphodiesterase:
a) Amiodarone
b) Milrinone
c) Propanolol
d) Enalapril
025. All of the following statements regarding inhibitors of type III phosphodiesterase are true EXCEPT:
a) They raise cAMP concentrations in cardiac myocytes
b) They reduce afterload
c) They show significant cross-tolerance with beta-receptor agonists
78
d) They are associated with a significant risk for cardiac arrhythmias
026. All of the following drugs are used in the treatment of severe congestive heart failure EXCEPT:
a) Verapamil
b) Digoxin
c) Dobutamine
d) Dopamine
027. Drugs most commonly used in chronic heart failure are:
a) Cardiac glycosides
b) Diuretics
c) Angiotensin-converting enzyme inhibitors
d) All the above
028. All of the following statements concerning angiotensin converting enzyme (ACE) inhibitors are true EXCEPT:
a) They act by inhibiting the ability of renin to convert angiotensinogen to angiotensin I.
b) Enalapril is a prodrug that is converted to an active metabolite
c) They reduce secretion of aldosterone
d) They can produce hyperkalemia in combination with a potassium-sparing diuretic
029. All of the following effects of ACE inhibitors may be useful in treating heart failure EXCEPT:
a) They decrease afterload
b) They increase circulating catecholamine levels
c) They reduce reactive myocardial hypertrophy
d) They increase myocardial beta-1 adrenergic receptor density
030. All of the following statements concerning the use of angiotensin-converting enzyme (ACE) inhibitors in the treatment of
heart failure are true EXCEPT:
a) They improve hemodynamics by decreasing afterload
b) They can increase plasma cholesterol levels
c) They may slow the progression of heart failure by preventing myocardial and vascular remodeling
d) They are effective first-line agents in the treatment of chronic heart failure

PART VI Antiarrhythmic agents


001. This drug is a Class IA antiarrhythmic drug:
a) Sotalol
b) Propranolol
c) Verapamil
d) Quinidine
002. This drug is a Class IC antiarrhythmic drug:
a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
003. This drug is a Class IC antiarrhythmic drug:
a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
004. This drug is a Class II antiarrhythmic drug:
a) Flecainide
b) Propranolol
c) Lidocaine
d) Verapamil
005. This drug is a Class III antiarrhythmic drug:
a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
006. This drug prolongs repolarization:
a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
007. This drug is a Class IV antiarrhythmic drug:
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a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
008. This drug is used in treating supraventricular tachycardias:
a) Digoxin
b) Dobutamine
c) Amrinone
d) Dopamine
009. This drug is associated with Torsades de pointes.
a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
010. This drug has beta-adrenergic blocking activity:
a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
011. This drug is useful in terminating atrial but not ventricular tachycardias:
a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
012. This is a drug of choice for acute treatment of ventricular tachycardias:
a) Flecainide
b) Sotalol
c) Lidocaine
d) Verapamil
013. The calcium channel blockers have direct negative inotropic effects because they reduce the inward movement of
calcium during the action potential. Thic consideration is:
a) True
b) False
014. Common unwanted effects of the dihydropyridines are due to vasodilation. It’s:
a) True
b) False
015. Verapamil is a more potent vasodilator than nifedipine. This statement is:
a) True
b) False
016. This drug is contraindicated in patients with moderate to severe heart failure:
a) Nifedipine
b) Verapamil
c) Both of the above
d) None of the above
017. This drug is an effective bronchodilator:
a) Nifedipine
b) Verapamil
c) Both of the above.
d) None of the above
018. This drug is used intravenously to terminate supraventricular tachycardias:
a) Nifedipine
b) Verapamil
c) Both of the above
d) None of the above
019. This drug has a little or no direct effect on chronotropy and dromotropy at normal doses
a) Nifedipine
b) Diltiazem
c) Verapamil
d) All of the above
020. Verapamil has a significant effect on automaticity in the SA node. It’s:
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a) True
b) False
021. This drug acts by inhibiting slow calcium channels in the SA and AV nodes:
a) Quinidine
b) Adenosine
c) Flecainide
d) Diltiazem
022. All of the following statements regarding verapamil are true EXCEPT:
a) It blocks L-type calcium channels
b) It increases heart rate
c) It relaxes coronary artery smooth muscle
d) It depresses cardiac contractility
023. All of the following calcium channel blockers are useful in the treatment of cardiac arrhythmias EXCEPT:
a) Bepridil
b) Diltiazem
c) Verapamil
d) Nifedipine
024. All of the following are common adverse effects of calcium channel blockers EXCEPT:
a) Skeletal muscle weakness
b) Dizziness
c) Headache
d) Flushing
025. Tick the adverse reactions characteristic for lidocaine:
a) Agranulocytosis, leucopenia
b) Extrapyramidal disorders
c) Hypotension, paresthesias, convulsions
d) Bronchospasm, dyspepsia

PART VII Drugs for Angina Pectoris treatment


001. Angina pectoris is:
a) Severe constricting chest pain, often radiating from the precordium to the left shoulder and down the arm,
due to insufficient blood supply to the heart that is usually caused by coronary disease
b) An often fatal form of arrhythmia characterized by rapid, irregular fibrillar twitching of the ventricles of the heart instead
of normal contractions, resulting in a loss of pulse
c) The cardiovascular condition in which the heart ability to pump blood weakens
d) All of the above
002. All these drug groups useful in angina both decrease myocardial oxygen requirement (by decreasing the determinations
of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm), EXCEPT:
a) Nitrates and nitrite drugs (Nitroglycerin, Isosorbide dinitrate)
b) Calcium channel blockers (Nifedipine, Nimodipine)
c) Beta-adrenoceptor-blocking drugs (Atenolol, Metoprolol)
d) Potassium channel openers (Minoxidil)
003. This drug group useful in angina decreases myocardial oxygen requirement (by decreasing the determinations of oxygen
demand) and does not increase myocardial oxygen delivery (by reversing coronary arterial spasm):
a) Nitrates and nitrite drugs (Nitroglycerin, Isosorbide dinitrate)
b) Myotropic coronary dilators (Dipyridamole)
c) Potassium channel openers (Minoxidil)
d) Beta-adrenoceptor-blocking drugs (Atenolol, Mtoprolol)
004. This drug group useful in angina increase myocardial oxygen delivery (by reversing coronary arterial spasm) and does
not decrease myocardial oxygen requirement (by decreasing the determinations of oxygen demand):
a) Beta-adrenoceptor-blocking drugs (Atenolol, Metoprolol):
b) Myotropic coronary dilators (Dipyridamole)
c) Calcium channel blockers (Nifedipine, Nimodipine)
d) Potassium channel openers (Minoxidil)
005. Which of the following statements concerning nitrate mechanism of action is True?
a) Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in to vascular smooth muscle
target tissues
b) Nitric oxide (NO) is an effective activator of soluble guanylyl cyclase and probably acts mainly through this mechanism
c) Nitrates useful in angina decrease myocardial oxygen requirement (by decreasing the determinations of oxygen
demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm)
d) All of the above
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006. Which of the following nitrates and nitrite drugs are long-acting?
a) Nitroglycerin, sublingual
b) Isosorbide dinitrate, sublingual (Isordil, Sorbitrate)
c) Amyl nitrite, inhalant (Aspirols, Vaporole)
d) Sustac
007. Which of the following nitrates and nitrite drugs is a short-acting drug?
a) Nitroglycerin, 2% ointment (Nitrol)
b) Nitroglycerin, oral sustained-release (Nitrong)
c) Amyl nitrite, inhalant (Aspirols, Vaporole)
d) Sustac
008. Which of the following nitrates and nitrite drugs is used for prevention of angina attack?
a) Nitroglycerin, 2% ointment (Nitrol)
b) Nitroglycerin, oral sustained-release (Nitrong)
c) Isosorbide mononitrate (Ismo)
d) All of the above
009. Duration of nitroglycerin action (sublingual) is:
a) 10-30 minutes
b) 6-8 hours
c) 3-5 minutes
d) 1.5-2 hours
010. The following statements concerning mechanism of nitrate beneficial clinical effect are true, EXCEPT?
a) Decreased myocardial oxygen requirement
b) Relief of coronary artery spasm
c) Improved perfusion to ischemic myocardium
d) Increased myocardial oxygen consumption
011. Side effect of nitrates and nitrite drugs are, EXCEPT:
a) Orthostatic hypotension, tachycardia
b) GI disturbance
c) Throbbing headache
d) Tolerance
012. The following statements concerning mechanism of calcium channel blockers’ action are true, EXCEPT:
a) Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in vascular smooth
muscle target tissues
b) Calcium channel blockers bind to L-type calcium channel sites
c) Calcium channel blockers useful in angina decrease myocardial oxygen requirement (by decreasing the
determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing coronary arterial spasm)
d) Calcium channel blockers decrease transmembrane calcium current associated in smooth muscle with long-lasting
relaxation and in a cardiac muscle with a reduction in contractility
013. Which of the following antianginal agents is a calcium channel blocker?
a) Nitroglycerin
b) Dipyridamole
c) Minoxidil
d) Nifedipine
014. Which of the following cardiovascular system effects refers to a calcium channel blocker?
a) The reduction of peripheral vascular resistance
b) The reduction of cardiac contractility and, in some cases, cardiac output
c) Relief of coronary artery spasm
d) All of the above
015. Main clinical use of calcium channel blockers is:
a) Angina pectoris
b) Hypertension
c) Supraventricular tachyarrhythmias
d) All of the above
016. Which of the following antianginal agents is a myotropic coronary dilator:
a) Dipyridamole
b) Validol
c) Atenolol
d) Alinidine
017. Which of the following antianginal agents is a beta-adrenoceptor-blocking drug:
a) Dipyridamole
b) Validol
82
c) Atenolol
d) Alinidine
018. The following agents are cardioselective beta1-adrenoceptor-blocking drugs labeled for use in angina, EXCEPT:
a) Metoprolol
b) Talinolol
c) Atenolol
d) Propranolol
019. Which of the following statements concerning beta-adrenoceptor-blocking drugs are true:
a) These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation
and in a cardiac muscle with a reduction in contractility
b) These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
c) Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate,
blood pressure, and contractility – which decrease myocardial oxygen requirements at rest and during
exercise
d) These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in stabilizing
the membrane potential of excitable cells near the resting potential
020. Which of the following antianginal agents refers to reflex coronary dilators:
a) Dipyridamole
b) Validol
c) Atenolol
d) Alinidine
021. Which of the following statements concerning Validol is true:
a) Validol has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
b) At sublingual administration the effect is produced in five minutes and 70 % of the preparation is released in 3 minutes
c) It is used in cases of angina pectoris, motion sickness, nausea, vomiting when seasick or airsick and headaches due
to taking nitrates
d) All of the above
022. Which of the following antianginal agents is the specific bradycardic drug:
a) Dipyridamole
b) Validol
c) Atenolol
d) Alinidine
023. Following statements concerning specific bradycardic agents (Falipamil, Alinidine) are true, EXCEPT:
a) Bradycardic drugs have a moderate reflex and vascular dilative action caused by the stimulation of sensitive
nerve endings
b) The predominant effect of bradycardic drugs is a decrease in heart rate without significant changes in arterial pressure
c) The protective effect of bradycardic drugs is likely due to a reduced O2 demand
d) Specific bradycardic agents are used in the management of a wide range of cardiovascular disorders, including sinus
tachyarrhythmias and angina pectoris
024. Which of the following statements concerning Dipyridamole is true?
a) Dipyridamole is an agent that blocks the reabsorption and breakdown of adenosine that results in an increase of
endogenous adenosine and vasodilatation
b) The drug causes relative hypoperfusion of myocardial regions served by coronary arteries with haemodynamically
significant stenoses
c) Dipyridamole is a platelet aggregation inhibitor
d) All of the above
025. Which of the following antianginal agents is a potassium channel opener:
a) Dipyridamole
b) Validol
c) Atenolol
d) Minoxidil
026. Which of the following statements concerning potassium channel openers is true?
a) These agents decrease transmembrane calcium current associated in a smooth muscle with long-lasting relaxation
and in a cardiac muscle with a reduction in contractility
b) These agents has a moderate reflex and vascular dilative action caused by the stimulation of sensitive nerve endings
c) Beneficial effects of these agents are related primarily to their hemodynamic effects – decreased heart rate, blood
pressure, and contractility – which decrease myocardial oxygen requirements at rest and during exercise
d) These agents increase the permeability of K channels, probably ATP-dependent K channels, that results in
stabilizing the membrane potential of excitable cells near the resting potential
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PART VIII Antihypertensive drugs
001. This drug reduces blood pressure by acting on vasomotor centers in the CNS:
a) Labetalol
b) Clonidine
c) Enalapril
d) Nifedipine
002. All of the following are central acting antihypertensive drugs EXCEPT:
a) Methyldopa
b) Clonidine
c) Moxonidine
d) Minoxidil
003. A ganglioblocking drug for hypertension treatment is:
a) Hydralazine
b) Tubocurarine
c) Trimethaphan
d) Metoprolol
004. Pick out the sympatholythic drug:
a) Labetalol
b) Prazosin
c) Guanethidine
d) Clonidine
005. Tick the drug with nonselective beta-adrenoblocking activity:
a) Atenolol
b) Propranolol
c) Metoprolol
d) Nebivolol
006. Choose the selective blocker of beta-1 adrenoreceptors:
a) Labetalol
b) Prazosin
c) Atenolol
d) Propranolol
007. Pick out the drug – an alpha and beta adrenoreceptors blocker:
a) Labetalol
b) Verapamil
c) Nifedipine
d) Metoprolol
008. This drug inhibits the angiotensin-converting enzyme:
a) Captopril
b) Enalapril
c) Ramipril
d) All of the above
009. This drug is a directly acting vasodilator:
a) Labetalol
b) Clonidine
c) Enalapril
d) Nifedipine
010. Pick out the diuretic agent for hypertension treatment:
a) Losartan
b) Dichlothiazide
c) Captopril
d) Prazosin
011. This drug blocks alpha-1 adrenergic receptors:
a) Prazosin
b) Clonidine
c) Enalapril
d) Nifedipine
012. This drug activates alpha-2 adrenergic receptors:
a) Labetalol
b) Phentolamine
c) Clonidine
d) Enalapril
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013. This drug is an inhibitor of renin synthesis:
a) Propranolol
b) Enalapril
c) Diazoxide
d) Losartan
014. This drug is a non-peptide angiotensin II receptor antagonist:
a) Clonidine
b) Captopril
c) Losartan
d) Diazoxide
015. This drug is a potassium channel activator:
a) Nifedipine
b) Saralasin
c) Diazoxide
d) Losartan
016. All of the following statements regarding angiotensin II are true EXCEPT:
a) It is a peptide hormone
b) It stimulates the secretion of aldosterone
c) Angiotensin I is almost as potent as angiotensin II
d) It is a potent vasoconstrictor
017. This drug is contraindicated in patients with bronchial asthma:
a) Propranolol
b) Clonidine
c) Enalapril
d) Nifedipine
018. This drug is converted to an active metabolite after absorption:
a) Labetalol
b) Clonidine
c) Enalapril
d) Nifedipine
019. This drug routinely produces some tachycardia:
a) Propranolol
b) Clonidine
c) Enalapril
d) Nifedipine
020. All of the following statements regarding vasodilators are true EXCEPT:
a) Hydralazine causes tachycardia
b) Nifedipine is a dopamine receptor antagonist
c) Nitroprusside dilates both arterioles and veins
d) Minoxidil can cause hypertrichosis
021. All of the following statements regarding verapamil are true EXCEPT:
a) It blocks L-type calcium channels
b) It increases heart rate
c) It relaxes coronary artery smooth muscle
d) It depresses cardiac contractility
022. Choose the unwanted effects of clonidine:
a) Parkinson’s syndrome
b) Sedative and hypnotic effects
c) Agranulocytosis and aplastic anemia
d) Dry cough and respiratory depression
023. The reason of beta-blockers administration for hypertension treatment is:
a) Peripheral vasodilatation
b) Diminishing of blood volume
c) Decreasing of heart work
d) Depression of vasomotor center
024. An endogenous vasoconstrictor that can stimulate aldosterone release from suprarenal glands:
a) Angiotensinogen
b) Angiotensin I
c) Angiotensin II
d) Angiotensin-converting enzyme
025. Choose the group of antihypertensive drugs which diminishes the metabolism of bradykinin:
85
a) Ganglioblockers
b) Alfa-adrenoblockers
c) Angiotensin-converting enzyme inhibitors
d) Diuretics
026. Hydralazine (a vasodilator) can produce:
a) Seizures, extrapyramidal disturbances
b) Tachycardia, lupus erhythromatosis
c) Acute hepatitis
d) Aplastic anemia
027. Choose the vasodilator which releases NO:
a) Nifedipine
b) Hydralazine
c) Minoxidil
d) Sodium nitroprusside
028. The reason of diuretics administration for hypertension treatment is:
a) Block the adrenergic transmission
b) Diminishing of blood volume and amount of Na+ ions in the vessels endothelium
c) Depression of rennin-angiotensin-aldosterone system
d) Depression of the vasomotor center
029. Tick the diuretic agent – aldosterone antagonist:
a) Furosemide
b) Spironolactone
c) Dichlothiazide
d) Captopril
030. Tick the diuretic agent having a potent and rapid effect:
a) Furosemide
b) Spironolactone
c) Dichlothiazide
d) Indapamide

PART IX Hypertensive (anti-hypotensive) drugs. Drugs influencing cerebral blood flow. Anti-migraine agents
001. The main principle of shock treatment is:
a) To increase the arterial pressure
b) To increase the peripheral vascular resistance
c) To increase the cardiac output
d) To improve the peripheral blood flow
002. Pick out the drug which increases cardiac output:
a) Noradrenalin
b) Methyldopa
c) Phenylephrine
d) Angiotensinamide
003. Tick the synthetic vasoconstrictor having an adrenomimic effect:
a) Noradrenalin
b) Adrenalin
c) Phenylephrine
d) Angiotensinamide
004. Indicate the vasoconstrictor of endogenous origin:
a) Ephedrine
b) Phenylephrine
c) Xylomethazoline
d) Angiotensinamide
005. Which type of receptors can be activated by angiotensinamide:
a) Adrenergic receptors
b) Cholinergic receptors
c) Dopaminergic receptors
d) Angiotensin’s receptors
006. General unwanted effects of vasoconstrictors is:
a) Increase of arterial pressure
b) Increase of cardiac output
c) Decrease of peripheral blood flow
d) Increase of blood volume
86
007. For increasing blood pressure in case of low cardiac output the following agents must be used:
a) Ganglioblockers
b) Vasoconstrictors
c) Positive inotropic drugs
d) Diuretics
008. Tick the positive inotropic drug of glycoside structure:
a) Dopamine
b) Digoxin
c) Dobutamine
d) Adrenalin
009. Tick the positive inotropic drug of non-glycoside structure:
a) Digitoxin
b) Digoxin
c) Dobutamine
d) Strophanthin
010. Dopamine at low doses influences mainly:
a) Alfa-adrenoreceptors (leads to peripheral vasoconstriction)
b) Dopamine receptors (leads to vasodilation of renal and mesenterial vessels)
c) Beta-1 adrenoreceptors (leads to enhanced cardiac output)
d) All of the above
011. Dopamine at medium doses influences mainly:
a) Alfa-adrenoreceptors (leads to peripheral vasoconstriction)
b) Dopamine receptors (leads to vasodilation of renal and mesenterial vessels)
c) Beta-1 adrenoreceptors (leads to enhanced cardiac output)
d) All of the above
012. Dopamine in high doses influences mainly the:
a) Alfa-adrenoreceptors (leads to peripheral vasoconstriction)
b) Dopamine’s receptors (leads to vasodilation of renal and mesenterial vessels)
c) Beta-1 adrenoreceptors (leads to enhancing of cardiac output)
d) All of the above
013. Tick the group of drugs for treatment of shock with hypovolaemia (reduced circulating blood volume):
a) Positive inotropic drugs
b) Vasoconstrictors
c) Plasmoexpanders
d) Analeptics and tonics
014. Tick the group of drugs for chronic hypotension treatment:
a) Positive inotropic drugs
b) Vasoconstrictors
c) Plasmoexpanders
d) Analeptics and tonics
015. Indicate the group of drugs influencing the cerebral flow:
a) Ca-channel blockers
b) Derivatives of GABA
c) Derivatives of Vinca minor plant
d) All the above
016. Tick the drug influencing the blood flow which is related to antiplatelet agents:
a) Heparin
b) Aspirin
c) Pyracetam
d) Tanakan
017. Which of the following drugs is related to anticoagulants and may be useful in disorders of cerebral circulation?
a) Aspirin
b) Cinnarizine
c) Nicergoline
d) Heparin
018. Indicate the drugs which are Ca-channel blockers influencing the brain blood flow:
a) Aminalon, Picamilon
b) Nimodipine, Cinnarizine
c) Heparin, Warfarin
d) Vinpocetine, Nicergoline
019. Indicate the drugs influencing the blood flow in the brain - derivatives of GABA:
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a) Aminalon, Picamilon
b) Nimodipine, Cinnarizine
c) Heparin, Warfarin
d) Vinpocetine, Nicergoline
020. Indicate the drug - Vinca minor alcaloid:
a) Nicergoline
b) Warfarin
c) Cinnarizine
d) Vinpocetine
021. Tick the drug – a derivative of Ergot:
a) Nicergoline
b) Warfarin
c) Cinnarizine
d) Vinpocetine
022. Indicate the nootropic agent useful in disorders of brain circulation:
a) Aspirin
b) Pyracetam
c) Warfarin
d) All the above
023. What is the main action of GABA derivatives in disorders of brain circulation?
a) Decrease of vessel permeability
b) Stimulation of the metabolic processes in neurons
c) Brain vessel constriction
d) Intracranial pressure increase
024. Choose the appropriate mechanism of vinpocetine action:
a) It dilates cerebral vessels and improves blood supply
b) It constricts cerebral vessels and decreases blood supply
c) It stimulates GABA-receptors and thus increases cerebral metabolic processes
d) It constricts peripheral vessels and increases blood pressure
025. Antiaggregants are used in disorders of brain circulation for:
a) Stimulation of the metabolic processes in neurons
b) Dilation of cerebral vessels
c) Improving the microcirculation in cerebral tissue
d) All the above
026. Migraine is a disorder connected with:
a) Thrombosis of cerebral vessels
b) Brain hemorrhage
c) Dysfunction of regulation of cerebral vessel tonus
d) Malignant growth in brain
027. Main agents for acute migraine attack treatment are Ergot and indol derivatives and NSAID’s. The consideration is:
a) True
b) False
028. The following Indol derivative is used for treatment of acute migraine attack:
a) Paracetamol
b) Sumatriptan
c) Ergotamine
d) Metoclopramide
029. The following Ergot derivative is used for treatment of acute migraine attack:
a) Paracetamol
b) Sumatriptan
c) Ergotamine
d) Metoclopramide
030. The derivative of lysergic acid for migraine attack prevention is:
a) Metoclopramide
b) Methysergide
c) Sumatriptan
d) Ergotamine
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(5) METABOLIC PROFILE DRUGS

PART I Hypothalamic & Pituitary Hormones, Thyroid & Antithyroid Drugs


001. Hormones are:
a) Products of endocrine gland secretion
b) Mediators of inflammatory process
c) By-products of tissue metabolism
d) Product of exocrine gland secretion
002. Select an endocrine drug which is an amino acid derivative:
a) Insulin
b) Hydrocortisone
c) Calcitonin
d) Thyroxine
003. Select an endocrine drug which is a peptide derivative:
a) Oxitocin
b) Prednisolone
c) Nandrolone
d) Progesterone
004. Select an endocrine drug which is a steroidal derivative:
a) Gonadorelin
b) Insulin
c) Levothyroxine
d) Hydrocortisone
005. Hormone analogues are:
a) Naturally occurring substances but slightly different from hormones
b) Naturally occurring substances but less efficacious than hormones
c) Naturally occurring substances having the same structure but different pharmacological properties than hormones
d) Synthetic compounds, which resemble the naturally occurring hormones
006. Regarding the mechanism of action of hormones, indicate the FALSE statement:
a) Hormones interact with the specific receptors in the wall of the cells
b) Cyclic AMP acts as a second messenger system
c) They stimulate adenylcyclase enzyme
d) Many hormones owe their effect to primary actions on subcellular membrane.
007. Hypothalamic and pituitary hormones (and their synthetic analogs) have pharmacologic applications in three areas,
EXCEPT the following:
a) As replacement therapy for hormone deficiency states
b) As drug therapy for a variety of disorders using pharmacologic doses to elicit a hormonal effect that is not present at
physiologic a blood levels
c) As a diagnostic tool for performing stimulation tests to diagnose hypo- or hyperfunctional endocrine states
d) As food supplements
008. Which of the following hormones is produced by the hypothalamic gland?
a) Growth hormone-releasing hormone (GHRH)
b) Follicle-stimulating hormone (FSH)
c) Aldosterone
d) Estradiol
009. Which of the following hormones is produced by the anterior lobe of the pituitary?
a) Thyrotropin-releasing hormone (TRH)
b) Corticotropin-releasing hormone (CRH)
c) Growth hormone (somatotropin, GH)
d) Growth hormone-releasing hormone (GHRH)
010. The posterior pitutary does NOT secret:
a) Vasopressin
b) Oxytocin
c) Growth hormone
d) All of the above
011. Which of the following organs is a target for prolactin?
a) Liver
b) Adrenal cortex
c) Thyroid
d) Mammary gland
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012. Which of the following organ hormones is a target for growth hormone (somatotropine, GH)?
a) Glucocorticoids
b) Insulin-like growth factors (IGF, somatomedins)
c) Triiodthyronine
d) Testosterone
013. All of the following statements about growth hormone are true, EXCEPT:
a) It may stimulate the synthesis or release of somatomedins
b) Low levels of insulin-like growth factor (IGF)-1 are associated with dwarfism
c) Hypersecretion can result in acromegaly
d) It is contraindicated in subjects with closed epiphyses
014. Correct statements about adrenocorticotropic hormone (ACTH) include all of the following, EXCEPT:
a) Endogenous ACTH is also called corticotropin
b) ACTH stimulates the synthesis of corticosteroids
c) ACTH is most useful clinically as a diagnostic tool in adrenal insufficiency
d) The oral route is the preferred rout of administration
015. The hypothalamic control exists for the thyroid gland. This consideration is:
a) True
b) False.
016. Indications of bromocriptine are following, EXCEPT:
a) Prolactin-secreting adenomas
b) Amenorrhea-Galactorrhea
c) Prolactin deficiency
d) Acromegaly
017. Currently used dopamine agonists decreasing pituitary prolactin secretion are following:
a) Bromocriptine
b) Cabergoline
c) Pergolide
d) All of the above
018. Indications of oxitocin are following:
a) Labor and augment dysfunctional labor for conditions requiring early vaginal delivery
b) Incompleted abortion
c) For control of pospartum uterine hemorrhage
d) All of the above
019. Indications of vasopressin are following:
a) Diabetes mellitus
b) Hypertension
c) Pituitary diabetes insipidus
d) Incompleted abortion
020. Vasopressin possesses the following:
a) Antidiuretic property
b) Vasodilatation property
c) Release of a thyroid hormone into the plasma
d) Diuretic property
021. Oxytocin produces the following effects:
a) It causes contraction of the uterus
b) It assists the progress of spermatozoa into the uterine cavity
c) It brings about milk ejection from the lactating mammary gland
d) All of the above
022. Vasopressin causes a pressor effect by:
a) Releasing noradrenaline from the nerve terminals
b) Releasing and activating renin-angiotensin system
c) A direct action on smooth muscles of the blood vessels
d) All of the above mechanisms
023. Which of the following statements is true
a) Hypothyroidism is a syndrome resulting from deficiency of thyroid hormones and is manifested largely by a
reversible slowing down of all body functions
b) Hypothyroidism is the clinical syndrome that results when tissues are exposed to high levels of thyroid hormone
024. Which of the following hormones is produced by the thyroid gland?
a) Thyroxine
b) Thyroid-stimulating hormone
c) Thyrotropin-releasing hormone
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d) Thyroglobulin.
025. Which of the following hormones is produced by the thyroid gland?
a) Thyroid-stimulating hormone
b) Thyrotropin-releasing hormone
c) Triiodothyronine
d) Thyroglobulin.
026. Thyroid stimulating hormone regulates the following:
a) Iodine uptake
b) Biosynthesis of iodothyroglobulin
c) Release of thyroid hormone into the plasma
d) All of the above.
027. Thyroid hormones produce various pharmacological effects. Indicate the wrong statement(s).
a) Decline of the basal metabolic rate in the body
b) Increase in the rate and force of contraction of the heart
c) Increase in the blood cholestrol level
d) Increase in the heat production
028. Synthesis and release of thyroid hormones are controlled by:
a) Anterior pituitary alone
b) Hypothalamus alone
c) Blood levels of thyroid hormones alone
d) All of the above
029. Thyrotrophin stimulates the following processes:
a) Concentration of iodine by thyroid follicles
b) Iodination of thyroglobulin
c) Release of thyroxine and triidothyronine
d) De-iodination of thyroid hormones.
030. The rate of secretion of thyrotropin is controlled by:
a) The amount of iodine in the thyroid gland
b) The amount of thyroid hormones in the thyroid gland
c) The concentration of thyroid hormones in blood
d) The concentration of catecholamines in blood
031. Indications of thyroid hormones are following, EXCEPT:
a) Cretinism
b) Myxoedema
c) Hashimoto's disease
d) For treatment of simple obesity
032. The common side effect of thyroid hormones is following:
a) Increases in basal metabolic rate
b) Angina pectoris
c) Tremors
d) Exopthalmos
033. Currently used antithyroid drugs include the following, EXCEPT:
a) Propylthiouracil (PTU)
b) Diatrizoate sodium (Hypaque)
c) Methimazole (Tapazole)
d) Potassium perchlorate
034. In an area where goitre is endemic, which of the following drugs is used?
a) Iodide 1 part in 100000
b) Propylthiouracil 200 mg daily
c) Methimazole 40 mg daily
d) Any of the above can be used.
035. Iodide preparations can be used in following situations, EXCEPT:
a) In thyroid disorders
b) In granulomatous lesions e.g. Syphilis
c) As an antiseptic
d) In iodism
036. Daily administration of large doses (several milligrammes) of iodides to a thyrotoxic patient causes:
a) Involution of the thyroid which reaches a maximum in two weeks
b) Increased vascularity of the thyroid gland
c) Decreased storage of the colloid in the thyroid gland
d) Thyroid gland growing firm and less vascular
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037. Radioiodines (I131 and I132) is suitable for:
a) Elderly patients (over 45 years)
b) Pregnant women
c) Nursing mothers
d) Younger patients
038. Radioiodines in the body emit:
a) Mainly β radiations
b) Mainly γ radiations
c) β and γ radiations equally.
d) Do not emit any radiation, therefore, are safe

PART II Pancreatic Hormones & Antidiabetic Drugs


001. Secretory products of pancreatic β-cells are:
a) Glucagon, proglucagon
b) Insulin, C-peptide, proinsulin, islet amyloid polypeptide (IAPP)
c) Somatostatin
d) Pancreatic polypeptide (PP)
002. Insulin is:
a) A glycoprotein with a molecular weight of 6000
b) A small protein with a molecular weight of 5808 having disulphide linkage
c) A fructoolygosaccharide
d) A catecholamine
003. Insulin is a polypeptide hence:
a) It is resistant to destruction by gastric juice
b) It is destroyed by gastric juice
c) It is not a polypeptide
d) It is metabolized immediately by cellular enzymes
004. Bovine insulin is less antigenic than porcine. This consideration is:
a) True
b) False
005. Insulin causes reduction in blood sugar level by the following mechanisms, EXCEPT:
a) Increased glucose uptake in the peripheral tissue
b) Reduction of breakdown of glycogen
c) Diminished gluconeogenesis
d) Decreased glucose absorption from the gut
006. Which of the following is true for glucagon?
a) Stimulates gluconeogenesis in the liver
b) Stimulates the secretion of insulin by beta cells
c) Inhibits glucose utilization by skeletal muscle
d) Inhibits uptake of aminoacids by cells.
007. Insulin can not be administered by:
a) Oral route
b) Intravenous route
c) Subcutaneous route
d) Intramuscular route.
008. Sources of human insulin production are:
a) Recombinant DNA techniques by inserting the proinsulin gene into E. coli or yeast
b) Postmortem insulin extraction from human autopsy pancreas
c) All of the above
d) None of the above
009. The primary reason for a physician to prescribe human insulin is that:
a) It has a faster onset of action than other insulins
b) It has a shorter duration of action than other insulins
c) It can be given to patients who have an allergy to animal insulins
d) It is more effective in preventing the complications of diabetes than animal insulins
010. Correct statements about crystalline zinc (regular) insulin include all of the following, EXCEPT:
a) It can serve as replacement therapy for juvenile-onset diabetes
b) It can be administered intravenously
c) It is a short-acting insulin
d) It can be administered orally
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011. Diabetic coma is treated by the administration of:
a) Lente insulin
b) Glucose
c) Crystalline insulin
d) Oral anti-diabetic drugs.
012. Sulphonylureas act by:
a) Reducing the absorption of carbohydrate from the gut
b) Increasing the uptake of glucose in peripheral tissues
c) Reducing the hepatic gluconeogenesis
d) Stimulating the beta islet cells of pancreas to produce insulin
013. Sulphonylureas are effective in totally insulin deficient patients. This consideration is:
a) True
b) False
014. Currently used second-generation sulfonylureas include the following, EXCEPT:
a) Glyburide (Glibenclamide)
b) Glipizide (Glydiazinamide)
c) Glimepiride (Amaril)
d) Tolbutamide (Orinase)
015. Currently used oral hypoglycemic thiazolidinediones include the following, EXCEPT
a) Pioglitazone (Actos)
b) Rosiglitazone (Avandia)
c) Troglitazone (Rezulin)
d) All of the above
016. Thiazolidinediones act by:
a) Diminishing insulin resistance by increasing glucose uptake and metabolism in muscle and adipose tissues
b) Reducing the absorption of carbohydrate from the gut
c) Stimulating the beta islet cells of pancreas to produce insulin
d) All of the above
017. Currently used alpha-glucosidase inhibitors include the following, EXCEPT:
a) Pioglitazone (Actos)
b) Acarbose (Precose)
c) Miglitol (Glyset)
d) All of the above
018. Alpha-glucosidase inhibitors act by:
a) Diminishing insulin resistance by increasing glucose uptake and metabolism in muscle and adipose tissues
b) Competitive inhibiting of intestinal alpha-ghucosidases and modulating the postprandial digestion and
absorption of starch and disaccharides
c) Reducing the absorption of carbohydrate from the gut
d) Stimulating the beta islet cells of pancreas to produce insulin
019. Potency of action of
a) Miglitol is six times higher than that of acarbose
b) Acarbose is more than that of miglitol
c) Miglitol and acarbose is equal
d) Oral hypoglycemic agents depend on the severity of hyperglycemia
020. Which of the following oral hypoglycaemic drugs stimulates both synthesis and release of insulin from beta islet cells:
a) Glibenclamide
b) Phenformin
c) Buformine
d) Metformin
021. Currently used oral hypoglycemic biguanides include the following, EXCEPT:
a) Repaglinide (Prandin)
b) Metformin
c) Phenformine
d) Glipizide
022. The action of insulin is potentiated by:
a) Sulphonylureas
b) Glucagon
c) Biguanides
d) None of the above
023. Duration of action of:
a) Tolbutamide is more than that of chlorpropamide
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b) Chlorpropamide is more than that of tolbutamide
c) Tolbutamide and chlorpropamide is equal
d) Oral hypoglycemic agents depend on the severity of hyperglycemia
024. Side effects of sulphonylureas are less than those of biguanides. This considerations is:
a) True
b) False
025. Biguanides are used in the following conditions, EXCEPT:
a) As a supplement to sulphonylurea, where it is insufficient to give good results
b) In over weight diabetics
c) To reduce insulin requirements
d) In case of hyperglycemic shock
026. Which of the following agents is/are important hormonal antagonists of insulin in the body?
a) Glucagon
b) Adrenal steroids
c) Adrenaline
d) All of the above
027. Glucagon is:
a) A glycoprotein with a molecular weight of 6000
b) A peptide – identical in all mammals – consisting of a single chain of 29 amino acids
c) A a fructoolygosaccharide
d) A small protein with a molecular weight of 5808 having disulphide linkage
028. Which of the following statements is FALSE?
a) Glucagon is synthesized in the A cells of the pancreatic islets of Langerhans.
b) Glucagon is a peptide – identical in all mammals – consisting of a single chain of 29 amino acids
c) Glucagon is extensively degraded in the liver and kidney as well as in plasma, and at its tissue receptor sites.
d) Half-life of glucagon is between 6 and 8 hours, which is similar to that of insulin
029. Glucagon can be used in the following situations, EXCEPT:
a) Severe hypoglycemia
b) Severe hyperglycemia
c) Endocrine diagnosis
d) Beta-blocker poisoning
030. Main complications of insulin therapy include the following:
a) Hypoglycemia
b) Insulin allergy
c) Lipodystrophy at an injection site
d) All of the above

PART III The Gonadal Hormones & Inhibitors


001. The major natural estrogens produced by women are following, EXCEPT:
a) Estradiol (Estradiol-17β, E2)
b) Estron (E1)
c) Ethinyl estradiol
d) Estriol (E3)
002. Which of the following statements about estrogens are True:
a) Estrogens are required for normal sexual maturation and growth of the female
b) Estrogens decrease the rate of resorption of bone
c) Estrogens enhance the coagulability of blood
d) All of the above
003. The major synthetic estrogens are following, EXCEPT:
a) Dienestrol
b) Diethylstilbestrol
c) Benzestrol
d) Estradiol
004. Which of the following statements about estrogens are True:
a) Estradiol binds strongly to an α2-globulin and albumin with lower affinity
b) Estradiol is converted by liver and other tissues to estron and estriol and their 2-hydroxylated derivatives and
conjugated metabolites and excreted in the bile
c) Estrone and estriol have lower affinity for the estrogen receptors than estradiol
d) All of the above
005. Indications of synthetic estrogens are following, EXCEPT:
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a) Primary hypogonadism
b) Postmenopausal hormonal therapy
c) Hormonal contraception
d) For treatment of simple obesity
006. Main complications of estrogens’ therapy include the following:
a) Postmenopausal uterine bleeding
b) Breast tenderness
c) Hyperpigmentation
d) All of the above
007. Main contraindications of estrogens’ therapy include the following:
a) Estrogen-dependent neoplasmas such as carcinoma of the endometrium or carcinoma of the breast
b) Undiagnosed genital bleeding
c) Liver disease
d) All of the above
008. Tamoxifen is:
a) Antiprogestin
b) Antiandrogen
c) Antiestrogen
d) Androgen
009. Progesterone is secreted by:
a) Ovarian follicles
b) Corpus luteum
c) Granulosa and theca cells
d) All of the above
010. The major natural progestin is:
a) Estradiol
b) Estron
c) Progesterone
d) Estriol
011. Which of the following statements about progestins is True:
a) Progesterone is rapidly absorbed following administration by any route
b) In the liver, progesterone is metabolized to pregnanediol and conjugated with glucuronic acid.
c) Significant amounts of progestins and their metabolites are excreted in the urine
d) All of the above
012. The normal ovary produces small amount of androgens, including testosterone, androstenedione, and
degydroepiandrosterone. This consideration is:
a) True
b) False
013. Noncontraceptive clinical uses of progestins are following:
a) Hormone replacement therapy
b) Dysmenorrhea
c) Endometriosis
d) All of the above
014. Estrogens possess immunomodulator properties, but progestins do immunodepressant ones. Is it TRUE or FALSE?
a) True
b) False
015. Mifepristone (RU-486) is:
a) Antiprogestin
b) Antiandrogen
c) Antiestrogen
d) Androgen
016. Mifepristone (RU-486) is used as a contraceptive and abortifacient. This consideration is:
a) True
b) False
017. Actions of mifepristone (RU-486) include:
a) Inhibition of ovulation during the follicular phase by blocking hypothalamic-pituitary progesterone receptors, which
suppresses midcycle gonadotropin release
b) During the luteal phase, inhibition of progesterone action on the uterus, which induces prostaglandin release from the
endometrium
c) Termination of pregnancy by facilitating luteolysis, menstruation, uterine motility, softening of the cervix, and
detachment of the embryo.
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d) All of the above
018. All of the following statements about oral contraceptives are true, EXCEPT:
a) The “combination pill” contains both estrogen and progestin
b) Ethinyl estradiol and mestranol are commonly used in oral contraceptives
c) The “minipill” contains progestin alone
d) The “triphasic pill” contains estrogen, progestin, and luteinizing hormine (LH)

PART IV Glucocorticoid, Steroidal & Nonsteroidal Anti-Inflammatory Drugs


001. Glucocorticoids are hormonal steroids:
a) Having an important effect on intermediary metabolism, cardiovascular function, growth, and immunity
b) Having principally salt-retaining activity
c) Having androgenic or estrogenic activity
d) All of the above
002. Inflammation is:
a) A localized protective reaction of a tissue to irritation, injury, or infection, characterized by pain, redness,
swelling, and sometimes loss of function
b) A deficiency of the normal immune response.
c) A reaction resulting from an immune reaction produced by an individual's white blood cells or antibodies acting on the
body's own tissues or extracellular proteins.
d) All of the above
003. An acute, transient phase, of inflammation is characterized by:
a) Local vasodilatation and increased capillary permeability (phase of damage)
b) Infiltration of leucocytes and phagocytic cells (phase of exudation)
c) Tissue degeneration and fibrosis occurrence (phase of proliferation)
d) All of the above
004. A delayed, subacute phase, of inflammation is characterized by:
a) Local vasodilatation and increased capillary permeability (phase of damage)
b) Infiltration of leucocytes and phagocytic cells (phase of exudation)
c) Tissue degeneration and fibrosis occurrence (phase of proliferation)
d) All of the above
005. A chronic, proliferative phase, of inflammation is characterized by:
a) Local vasodilatation and increased capillary permeability (phase of damage)
b) Infiltration of leucocytes and phagocytic cells (phase of exudation)
c) Tissue degeneration and fibrosis occurrence (phase of proliferation)
d) All of the above
006. The following substances are considered to be referred to as eicosanoids:
a) Prostaglandins
b) Leukotrienes
c) Thromboxanes
d) All of the above
007. Correct statements about cortisol (hydrocortisone) include all of the following, EXCEPT:
a) Cortisol is synthesized from cholesterol
b) ACTH governs cortisol secretion
c) Most cortisol is inactivated in the liver
d) The half-life of cortisol in the circulations is normally about 60-90 hours.
008. Correct statements about glucocorticoids include all of the following, EXCEPT:
a) Effects of glucocorticoids are mediated by widely distributed glucocorticoid receptors that are members of the
superfamily of nuclear receptors.
b) Glucocorticoids have dose-related metabolic effects on carbohydrate, protein, and fat metabolism.
c) Glucocorticoids have pro-inflammatory effects.
d) Glucocorticoids have catabolic effects in lymphoid and connective tissue, muscle, fat, and skin.
009. Physiologic doses of glucocorticoid can result in:
a) Increased liver glycogen stores, gluconeogenesis and lipolysis
b) Maintenance of cardiovascular function (by potentiation of norepinephrine) and skeletal muscle function
c) Increased hemoglobin synthesis, resulting in elevated of red blood cell count
d) All of the above
010. Which of the following glucocorticoids is a short- to medium-acting drug?
a) Prednisolon
b) Dexamethasone
c) Triamcinolone
d) All of the above
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011. Which of the following glucocorticoids is an intermediate-acting drug?
a) Cortisone
b) Triamcinolone
c) Butamethasone
d) All of the above
012. Which of the following glucocorticoids is a long-acting drug?
a) Prednisolon
b) Dexamethasone
c) Triamcinolone
d) All of the above
013. Which of the following glucocorticoids have one fluoride atom in its chemical structure?
a) Prednisolon
b) Fluocinolone
c) Triamcinolone
d) All of the above
014. Which of the following glucocorticoids have two fluoride atoms in its chemical structure?
a) Prednisolon
b) Dexamethasone
c) Fluocinolone
d) Triamcinolone
015. Which of the following glucocorticoids has no fluoride atoms in its chemical structure?
a) Prednisolon
b) Dexamethasone
c) Fluocinolone
d) Triamcinolone
016. Anti-inflammatory effect of glucocorticoids is caused by
a) Reducing the prostaglandin and leukotriene which results from inhibition of phospholipase A2
b) Reducing macrophages migration into the site of inflammation
c) Decreasing capillary permeability
d) All of the above
017. Which of the following statements concerning the anti-inflammatory effect of glucocorticoids is TRUE?
a) Anti-inflammatory effect of glucocorticoids results from inhibition of cyclooxygenase
b) Anti-inflammatory effect of glucocorticoids results from inhibition of phospholipase A2 and reducing
prostaglandin and leukotriene synthesis
c) Induction of cyclooxygenase II expression which results in reducing amount of an enzyme available to produce
prostoglandins
d) All of the above
018. Immunosupressive effect of glucocorticoids is caused by:
a) Reducing concentration of lymphocytes (T and B cells) and inhibiting function of tissue macrophages and
other antigen-presenting cells
b) Suppression of cyclooxygenase II expression which results in reducing amount of an enzyme available to produce
prostoglandins
c) Activation of phospholipase A2 and reducing prostaglandin and leukotriene synthesis.
d) All of the above
019. Which of the following statements concerning the anti-inflammatory effect of NSAIDs are TRUE?
a) Anti-inflammatory effect of NSAIDs results from inhibition of cyclooxygenase
b) Anti-inflammatory effect of NSAIDs results from inhibition of phospholipase A2 and reducing prostaglandin and
leukotriene synthesis
c) Anti-inflammatory effect of NSAIDs results from induction of cyclooxygenase II expression which results in reducing
the amount of an enzyme available to produce prostoglandins
d) All of the above
020. Indication of glucocorticoids is:
a) Chronic (Addison’s disease) and acute adrenocortical insufficiency
b) Organ transplants (prevention and treatment of rejection – immunosuppression)
c) Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis).
d) All of the above
021. Indications of glucocorticoids are following, EXCEPT:
a) Gastrointestinal diseases (inflammatory bowel disease)
b) Postmenopausal hormonal therapy
c) Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis)
d) Skin diseases (atopic dermatitis, dermatoses, localized neurodermatitis)
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022. Serious side effects of glucocorticoids include the following, EXCEPT:
a) Acute peptic ulcers
b) Iatrogenic Cushing’s syndrome (rounding, puffiness, fat deposition and plethora alter the appearance of the face –
moon faces)
c) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo)
d) Hypomania or acute psychosis
023. Serious side effects of glucocorticoids include the following:
a) Adrenal suppression
b) Insomnia, behavioral changes (primarily hypomania)
c) Rounding, puffiness, fat deposition and plethora alter the appearance of the face – moon faces
d) All of the above
024. Selective COX-2 inhibitors are safer than nonselective COX-1 inhibitors but without loss of efficacy. This consideration is:
a) True
b) False
025. The constitutive COX-2 isoform tends to be homeostatic in function, while COX-1 is induced during inflammation and
tends to facilitate the inflammatory response. The consideration is:
a) True
b) False
026. Which of the following property combinations is peculiar to the majority of NSAIDs?
a) Antihistaminic, antipyretic, analgesic
b) Immunodepressive, anti-inflammatory, analgesic
c) Antipyretic, analgesic, anti-inflammatory
d) Anti-inflammatory, immunodepressive, antihistaminic
027. Which of the following NSAIDs is a propionic acid derivative?
a) Ibuprofen
b) Indomethacin
c) Metamizole (Analgin)
d) Diclofenac
028. Which of the following NSAIDs is an indol derivative?
a) Ibuprofen
b) Indomethacin
c) Meclofenamic acid
d) Diclofenac
029. Which of the following NSAIDs is a pyrazolone derivative?
a) Ibuprofen
b) Indomethacin
c) Metamizole (Analgin)
d) Diclofenac
030. Which of the following NSAIDs is a fenamate derivative?
a) Phenylbutazone
b) Indomethacin
c) Meclofenamic acid
d) Diclofenac
031. Which of the following NSAIDs is an oxicam derivative?
a) Piroxicam
b) Indomethacin
c) Meclofenamic acid
d) Diclofenac
032. Which of the following NSAIDs is a selective COX-2 inhibitor?
a) Piroxicam
b) Indomethacin
c) Celecoxib
d) Diclofenac
033. Which of the following NSAIDs is a nonselective COX inhibitor
a) Piroxicam
b) Rofecoxib
c) Celecoxib
d) All of the above
034. The following statements concerning aspirin are true, EXCEPT:
a) In contrast to most other NSAIDs, aspirin irreversibly inhibits COX
b) Aspirin interferes with the chemical mediators of the kallikrein system
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c) Aspirin inhibits phospholipase A2
d) Aspirin inhibits tromboxane A2 formation
035. Indication for aspirin administration are the following, EXCEPT:
a) Inflammatory conditions
b) Decreasing the incidence of transient ischemic attack, unstable angina, coronary artery thrombosis with myocardial
infarction, and thrombosis after coronary artery bypass grafting
c) Relieving severe visceral pain, e.g. myocardial infarction, cancer pain condition, renal or biliary colic
d) Reducing elevated body temperature
036. Side effects of aspirin include following:
a) Gastric upset (intolerance)
b) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo)
c) Gastric ulcers and upper gastrointestinal bleeding
d) All of the above
037. Serious side effects of metamizole (analgin) include the following:
a) Agranulocytosis, aplastic anemia
b) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo)
c) Iatrogenic Cushing’s syndrome (rounding, puffiness, fat deposition and plethora alter the appearance of the face –
moon faces)
d) All of the above
038. Side effects of indometacin include the following:
a) Abdominal pain, diarrhea, gastrointestinal hemorrhage and pancreatitis
b) Dizziness, confusion and depression
c) Trombocytopenia
d) All of the above
039. Ketoprofen is a propionic acid derivative that inhibits both cyclooxygenase (nonselectively) and lipoxygenase. This
statement is:
a) True
b) False
040. Ketorolac is an NSAID that is promoted for systemic use as an anti-inflammatory, not as an analgesic drug. This
statement is:
a) True
b) False
041. Which of the following drugs is a 5-lipoxygenase (5-LOG) inhibitor?
a) Ibuprofen
b) Zileuton (Zyflo)
c) Metamizole (Analgin)
d) Diclofenac
042. Which of the following drugs is a leucotreine D4 receptor (LTD4) blocker?
a) Ibuprofen
b) Zileuton (Zyflo)
c) Zafirleukast (Accolate)
d) Diclofenac
043. Which of the following drugs is a thromboxane A2 receptor (TXA2) antagonist?
a) Sulotroban
b) Zileuton (Zyflo)
c) Zafirleukast (Accolate)
d) Diclofenac

PART V Immunotropic & Antiallergic Agents


001. Immune system is the integrated body system of organs, tissues, cells, and cell products that differentiates self from
nonself and neutralizes potentially pathogenic organisms or substances. This consideration is:
a) True
b) False
002. Antigen is any of various substances, including toxins, bacteria, and the cells of transplanted organs, that when
introduced into the body stimulate the production of antibodies. It is also called an allergen or immunogen. This
consideration is:
a) True
b) False
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003. Antibody is a protein substance produced in the blood or tissues in response to a specific antigen, such as a bacterium
or a toxin that destroys or weakens bacteria and neutralizes organic poisons, thus forming the basis of immunity. This
consideration is:
a) True
b) False
004. Innate immunity refers to:
a) Antigen-nonspecific defense mechanisms that a host uses immediately or within several hours after exposure
to an antigen. This is the immunity one is born with and is the initial response by the body to eliminate
microbes and prevent infection
b) Antigen-specific defense mechanisms that take several days to become protective and are designed to react with and
remove a specific antigen. This is the immunity one develops throughout life
005. Adaptive (acquired) immunity refers to:
a) Antigen-nonspecific defense mechanisms that a host uses immediately or within several hours after exposure to an
antigen. This is the immunity one is born with and is the initial response by the body to eliminate microbes and prevent
infection
b) Antigen-specific defense mechanisms that take several days to become protective and are designed to react
with and remove a specific antigen. This is the immunity one develops throughout life
006. Allergic reaction is:
a) A local or generalized reaction of an organism to internal or external contact with a specific allergen to which
the organism has been previously sensitized
b) A localized protective reaction of tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and
sometimes a loss of function
007. Immediate allergy reaction (type I allergic reaction) is:
a) An allergic or immune response that begins within a period lasting from a few minutes to about an hour after
exposure to an antigen to which the individual has been sensitized
b) An allergic reaction that becomes apparent only hours after contact
c) An allergic reaction that results from the formation of antigen-antibody complexes between a foreign antigen and IgM
or IgG immunoglobulins. (It occurs during blood transfusion reactions and in hemolytic disease of the newborn)
d) An allergic reaction that is due to the presence of elevated levels of antigen-antibody complexes that cause tissue
damage
008. Delayed allergy reaction (type IV allergic reaction) is:
a) An allergic or immune response that begins within a period lasting from a few minutes to about an hour after exposure
to an antigen to which the individual has been sensitized
b) An allergic reaction that becomes apparent only hours after contact
c) An allergic reaction that results from the formation of antigen-antibody complexes between a foreign antigen and IgM
or IgG immunoglobulins. (It occurs during blood transfusion reactions and in hemolytic disease of the newborn)
d) An allergic reaction that is due to the presence of elevated levels of antigen-antibody complexes that cause tissue
damage
009. Immunodeficiency:
a) A localized protective reaction of tissue to irritation, injury, or infection, characterized by pain, redness, swelling, and
sometimes a loss of function
b) A disorder or deficiency of the normal immune response
c) A disease resulting from an immune reaction produced by an individual's white blood cells or antibodies acting on the
body's own tissues or extracellular proteins
d) All of the above
010. Anaphylactic shock is a severe, sometimes fatal allergic reaction characterized by a sharp drop in blood pressure,
urticaria, and breathing difficulties that is caused by exposure to a foreign substance, such as a drug or bee venom,
after preliminary or sensitizing exposure. This consideration is:
a) True
b) False
011. H1 histamine receptor subtype is distributed in:
a) Smooth muscle, endothelium and brain
b) Gastric mucosa, cardiac muscle, mast cells and brain
c) Presynaptically in brain, mesenteric plexus and other neurons
d) All of the above
012. H2 histamine receptor subtype is distributed in:
a) Smooth muscle, endothelium and brain
b) Gastric mucosa, cardiac muscle, mast cells and brain
c) Presynaptically in brain, mesenteric plexus and other neurons
d) All of the above
013. Most tissue histamine is sequestered and bound in:
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a) Granules in mast cells or basophils
b) Cell bodies of histaminergic neurons
c) Enterochromaffin-like cell of the fondus of the stomach
d) All of the above
014. These categories of histamine H1 antagonists are noted for sedative effects, EXCEPT:
a) Piperidines; i.e. Loratadine, Fexofenadine
b) Ethanolamines (aminoalkyl ethers); i.e. Dimedrol, Clistin
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Diprazine, Promethazine
015. Which category of histamine H1 antagonists is noted for the best antiemetic action?
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Ethanolamines (aminoalkyl ethers); i.e. Doxylamine
c) Piperazines; i.e. Hydroxyzine, Cyclizine
d) Ethylenediamines; i.e. Suprastine
016. These categories of histamine H1 antagonists are noted for the anticholinergic effect, EXCEPT:
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Piperazines; i.e. Hydroxyzine, Cyclizine
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Diprazine, Promethazine
017. Which category of histamine H1 antagonists is noted for the alpha-adrenoreceptor-blocking effect?
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Ethanolamines (aminoalkyl ethers); i.e. Doxylamine, Dimedrol
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Diprazine, Promethazine
018. Which category of histamine H1 antagonists is noted for the highest local anesthetic effect?
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Piperidines; i.e. Loratadine, Fexofenadine
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Promethazine
019. Which category of histamine H1 antagonists is recognized for as second-generation antihistamines?
a) Alkylamines (propylamines); i.e. Brompheniramine
b) Piperidines; i.e. Loratadine, Fexofenadine
c) Ethylenediamines; i.e. Suprastine
d) Phenothiazines; i.e. Promethazine
020. These histamine H1 antagonists are recognized for as second-generation antihistamines, EXCEPT:
a) Astemizole
b) Loratadine (Claritin)
c) Cetirizine (Zyrtec)
d) Suprastine
021. Which of histamine H1 antagonists is noted for the serotonin-blocking effect?
a) Brompheniramine
b) Cyproheptadine
c) Suprastine
d) Dimedrol
022. Which of the following histamine H1 antagonists is a long-acting (up to 24-48 h) antihistamine drug?
a) Diazoline
b) Diprazine
c) Suprastine
d) Dimedrol
023. Which of histamine H1 antagonists is noted for the ulcerogenic effect?
a) Diazoline
b) Loratadine
c) Suprastine
d) Dimedrol
024. Indication for administration of histamine H1 antagonists is:
a) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria)
b) Motion sickness and vestibular disturbances
c) Nausea and vomiting in pregnancy (“morning sickness”)
d) All of the above
025. Indications for administration of histamine H1 antagonists are the following EXCEPT:
a) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria)
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b) Management of seizure states
c) Nausea and vomiting in pregnancy (“morning sickness”)
d) Treatment of sleep disorders
026. Side effect of first-generation histamine H1 antagonists is:
a) Aplastic anemia
b) Vomiting, tinnitus, decreased hearing
c) Sedation
d) Gastric ulcers and upper gastrointestinal bleeding
027. For those first-generation histamine H1 antagonists that cause significant sedation, addition of other drugs that cause
central nervous system depression produces additive effects and is contraindicated while driving or operating
machinery. This consideration is:
a) True
b) False
028. Immunosuppressive drug is any of a variety of substances used to prevent production of antibodies, protein produced by
the immune system in response to the presence in the body of antigens: foreign proteins or polysaccharides such as
bacteria, bacterial toxins, viruses, or other cells or proteins. This consideration is:
a) True
b) False
029. Immunosupressive effect of glucocorticoids is caused by
a) Reducing concentration of lymphocytes (T and B cells) and inhibiting function of tissue macrophages and
other antigen-presenting cells
b) Suppression of cyclooxygenase II expression that results in reducing amount of an enzyme available to produce
prostoglandins
c) Activation of phospholipase A2 and reducing prostaglandin and leukotriene synthesis
d) All of the above
030. Antiallergic effect of glucocorticoids is caused by:
a) Suppression of leukocyte migration and stabilizing lysosomal membranes
b) Reverse the capillary permeability associated with histamine release
c) Suppression of the immune response by inhibiting antibody synthesis
d) All of the above
031. The Immunosuppressive agent is:
a) Corticosteroids
b) Cyclosporine
c) Tacrolimus (FK 506)
d) All of the above
032. Class of cyclosporine A is:
a) Interferons
b) Immunosuppressive agents
c) Monoclonal antibodies
d) Immunoglobulins
033. Mechanism of action of cyclosporine A is:
a) Complement-mediated cytolysis of T lymphocytes
b) ADCC towards T lymphocytes
c) Inhibits calcineurin
d) Compete for Fc receptors with autoantibodies
034. Side effect of cyclosporine A is:
a) Tremor
b) GI disturbance
c) Hepatotoxicity
d) All of the above
035. Side effect of cyclosporine A is:
a) Tremor
b) Anorexia
c) Chills
d) Myalgia
036. Side effect of cyclosporine A is:
a) Diarrhea
b) Headache
c) GI disturbance
d) Immunosuppression
037. Indication of cyclosporine A is:
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a) Secondary immunodeficiency
b) Hairy cell leukemia
c) Primary immunodeficiency
d) Idiopathic nephrotic syndrome
038. Half-life of cyclosporine A is:
a) 25-35 minutes
b) 21 days
c) 4 - 16 hours
d) 19 hours
039. Class of I.V. IgG preparation is:
a) Monoclonal antibodies
b) Immunosuppressive agents
c) Interferons
d) Immunoglobulins
040. Mechanism of action of I.V. IgG preparation is:
a) Inhibits CD3 receptor
b) Inhibits calcineurin
c) Complement-mediated cytolysis of T lymphocytes
d) Compete for Fc receptors with autoantibodies
041. Half-life of I.V. IgG preparation is:
a) 25-35 minutes
b) 19 hours
c) 4 - 16 hours
d) 21 days
042. Indication for I.V. IgG preparation administration is:
a) Kaposi's sarcoma
b) Acute rejection of organ transplant
c) Condyloma acuminatum
d) Prophylaxis of certain infections
043. Cytotoxic agents are the following EXCEPT:
a) Azathioprine
b) Cyclosporine
c) Leflunomide
d) Cyclophosphamide
044. Class of sirolimus (rapamycin) is:
a) Immunoglobulins
b) Interferons
c) Immunosuppressive agents
d) Monoclonal antibodies
045. Mechanism of action of sirolimus (rapamycin) is:
a) Anti-idiotype antibodies against autoantibodies
b) Modulation of CD3 receptor from the cell surface
c) Inhibits calcineurin
d) ADCC towards T lymphocytes
046. Monoclonal antibodies is:
a) Trastuzumab
b) Rituximab
c) OKT-3
d) All of the above
047. Class of OKT-3 is:
a) Immunosuppressive agents
b) Monoclonal antibodies
c) Interferons
d) Immunoglobulins
048. Half-life of OKT-3 is:
a) 18-24 hours
b) 25-35 minutes
c) 4 - 16 hours
d) 21 days
049. The indication for interferon gamma administration is:
a) Idiopathic nephrotic syndrome
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b) Hepatitis C virus infection
c) Chronic granulomatous disease
d) Hairy cell leukemia
050. The side effect of interferon gamma is:
a) Hypertension
b) Pulmonary edema
c) Nephrotoxicity
d) Fatigue
051. Half-life of interferon gamma is:
a) 21 days
b) 19 hours
c) 4 - 16 hours
d) 25-35 minutes
052. Half-life of interferon alpha is:
a) 18-24 hours
b) 4-16 hours
c) 25-35 minutes
d) 21 days
053. The indication for interferon alpha administration is:
a) Hepatitis C virus infection
b) Kaposi's sarcoma
c) Condyloma acuminatum
d) All of the above
054. Indication for interferon alpha administration is:
a) Autoimmune diseases
b) Rheumatoid arthritis
c) Organ transplantation
d) Hepatitis C virus infection
055. Indication for interferon alpha administration is:
a) Prophylaxis of sensitization by Rh antigen
b) Rheumatoid arthritis
c) Kaposi's sarcoma
d) Chronic granulomatous disease
056. Class of tacrolimus (FK-506) is:
a) Immunoglobulins
b) Immunosuppressive agents
c) Interferons
d) Monoclonal antibodies
057. Mechanism of action of tacrolimus (FK-506) is:
a) Inhibits CD3 receptor
b) Complement-mediated cytolysis of T lymphocytes
c) Substitution for patient's defiecient immunoglobulins
d) Inhibits calcineurin
058. Immunomodulating agent is:
a) Sirolimus (rapamycin)
b) Levamisole
c) Tacrolimus (FK 506)
d) All of the above
059. Immunomodulating agents are the following EXEPT:
a) Cytokines
b) Levamosole
c) BCG (Bacille Calmette-Guérin)
d) Tacrolimus (FK-506)
060. Mechanism of action of levamisole is:
a) Inhibits CD3 receptor
b) Complement-mediated cytolysis of T lymphocytes
c) Substitution for patient's defiecient immunoglobulins
d) Increase the number of T-cells
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PART VI Vitamins, Vitamin-like Compounds, Antivitamins, Enzymes & Antienzymes
001. Vitamins are:
a) Inorganic nutrients needed in small quantities in the body
b) Organic substances needed in very large quantities in the body
c) Any of various fat-soluble or water-soluble organic substances essential in minute amounts for normal
growth and activity of the body and obtained naturally from plant and animal foods
d) Products of endocrine gland secretion
002. Vitamin-like compounds are:
a) A number of compounds, whose nutritional requirements exist at specific periods of development,
particularly neonatal development, and periods of rapid growth
b) Inorganic nutrients needed in small quantities in body
c) Organic substances needed in very large quantities in body
d) Products of endocrine gland secretion
003. Antivitamins are:
a) Any of various fat-soluble or water-soluble organic substances essential in minute amounts for normal growth and
activity of the body and obtained naturally from plant and animal foods
b) Substances that prevent vitamins from exerting their typical metabolic effects
c) Any of numerous proteins or conjugated proteins produced by living organisms and functioning as specialized
catalysts for biochemical reactions
d) Nonprotein organic substances that usually contain a vitamin or mineral and combine with a specific apoenzyme to
form an active enzyme system
004. Coenzymes are:
a) Any of various fat-soluble or water-soluble organic substances essential in minute amounts for normal growth and
activity of the body and obtained naturally from plant and animal foods
b) Substances that prevent vitamins from exerting their typical metabolic effects
c) Any of numerous proteins or conjugated proteins produced by living organisms and functioning as specialized
catalysts for biochemical reactions
d) Nonprotein organic substances that usually contain a vitamin or mineral and combines with a specific
apoenzyme to form an active enzyme system
005. Antienzymes are:
a) Agents, especially an inhibitory enzymes or an antibodies to enzymes, that retard, inhibit, or destroy enzymic
activity
b) Substances that prevent vitamins from exerting their typical metabolic effects
c) Any of numerous proteins or conjugated proteins produced by living organisms and functioning as specialized
catalysts for biochemical reactions
d) Nonprotein organic substances that usually contain a vitamin or mineral and combines with a specific apoenzyme to
form an active enzyme system
006. Hypovitaminosis is an insufficiency of one or more essential vitamins. This consideration is:
a) True
b) False
007. Hypervitaminosis is any of various abnormal conditions in which the physiological effect of a vitamin is produced to a
pathological degree by excessive intake of the vitamin. This consideration is:
a) True
b) False
008. Select a fat-soluble vitamin:
a) Ascorbic acid
b) Tocopherol
c) Thiamine
d) Riboflavin
009. Select a water-soluble vitamin:
a) Vitamin A
b) Vitamin E
c) Vitamin D
d) Vitamin B1
010. Which of the following vitamins can be also synthesized from a dietary precursor?
a) Vitamin С
b) Vitamin A
c) Vitamin B1
d) Vitamin B6
011. Which of the following vitamins resembles with hormone
a) Vitamin К
105
b) Vitamin A
c) Vitamin D
d) Vitamin E
012. Beri-beri is caused by the deficiency of:
a) Riboflavin
b) Ascorbic acid
c) Nicotinic acid
d) Thiamine
013. Beri-beri is
a) Disease caused by a deficiency of thiamine, endemic in eastern and southern Asia, and characterized by
neurological symptoms, cardiovascular abnormalities, and edema. It is also called endemic neuritis
b) Inflammation at the corners of the mouth caused by a deficiency of riboflavin, associated with a wrinkled or fissured
epithelium that does not involve the mucosa
c) A disorder of the lips often due to riboflavin deficiency and other B-complex vitamin deficiencies and characterized by
fissures, especially in the corners of the mouth
d) All of the above
014. Deficiency symptom of riboflavin is:
a) Cheilitis – inflammation of the lips or of a lip, with redness and the production of fissures radiating from the angles of
the mouth
b) Cheilosis – a disorder of the lips characterized by fissures, especially in the corners of the mouth
c) Angular stomatitis, associated with a wrinkled or fissured epithelium that does not involve the mucosa
d) All of the above
015. All of the following statements concerning vitamin A functions are true EXCEPT:
a) Transmission of light stimuli to the brain, via combination with a specific protein, opsin, to form a visual pigment,
rhodopsin, in the retina of the eye
b) Regulation of cell growth and differentiation in epithelium, connective tissues (including bone and cartilage) and
hematopoietic tissues by retinoic acid, a highly bioactive metabolite of retinol
c) Retinoic acid is especially important during embryogenesis
d) Acts as a hormone involved in regulation of calcium and phosphorus homeostasis
016. Deficiency symptom of vitamin A is:
a) Night blindness – lessened ability to see in dim light
b) Xerophthalmia and keratomalacia
c) Various epithelial tissue defects, leading to decreased resistance to infective diseases, male and female infertility
d) All of the above
017. Xerophthalmia is:
a) Extreme dryness of the conjunctiva resulting from a disease localized in the eye or from systemic deficiency
of vitamin A
b) A condition, usually in children with vitamin A deficiency, characterized by softening and subsequent ulceration and
perforation of the cornea
c) A condition of the eyes in which vision is normal in daylight or other strong light but is abnormally weak or completely
lost at night or in dim light and that results from vitamin A deficiency
d) All of the above
018. Keratomalacia is:
a) Extreme dryness of the conjunctiva resulting from a disease localized in the eye or from systemic deficiency of vitamin
A
b) A condition, usually in children with vitamin A deficiency, characterized by softening and subsequent
ulceration and perforation of the cornea
c) A visual defect marked by the inability to see as clearly in bright light as in dim light
d) All of the above
019. Night blindness (Hemeralopia, Nyctalopia) is
a) Extreme dryness of the conjunctiva resulting from a disease localized in the eye or from systemic deficiency of vitamin
A
b) A condition, usually in children with vitamin A deficiency, characterized by softening and subsequent ulceration and
perforation of the cornea
c) A condition of the eyes in which vision is normal in daylight or other strong light but is abnormally weak or
completely lost at night or in dim light and that results from vitamin A deficiency
d) All of the above
020. All of the following statements concerning vitamin E functions are true, EXCEPT:
a) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain
reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable
b) Antisterility and antiabortion factor
c) Specifically required for synthesis of prothrombin and several other clotting factors
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d) An essential for oxidative processes regulation
021. Which of the following statements concerning vitamin B1 functions are true:
a) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain
reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable
b) An essential coenzyme for oxidative decarboxylate of alpha-keto acids, most important being conversion of
pyruvate to acetyl coenzyme A
c) Specifically required for synthesis of prothrombin and several other clotting factors
d) Essential constituent of the flavoproteins, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD)
022. All of the following statements concerning vitamin B2 functions are true EXCEPT:
a) Essential constituent of flavoproteins, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD)
b) Plays key roles in hydrogen transfer reactions associated with glycolysis, TCA cycle and oxidative phosphorylation
c) An essential coenzyme for oxidative decarboxylate of alpha-keto acids, most important being conversion of
pyruvate to acetyl coenzyme A
d) Deficiency symptoms are cheilitis, cheilosis and angular stomatitis
023. Which of the following statements concerning vitamin PP (B3, niacin) functions are true:
a) Active group of the coenzymes nicotinamide-adenine dinucleotide (NAD) and nicotinamide-adenine
phosphate (NADP)
b) An essential coenzyme for oxidative decarboxylate of alpha-keto acids, most important being conversion of pyruvate to
acetyl coenzyme A
c) Specifically required for synthesis of prothrombin and several other clotting factors
d) Essential constituent of flavoproteins, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD)
024. Which of the following statements concerning pyridoxine (vitamin B6) functions are true:
a) Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and
decarboxylation of amino acids in more than 50 different enzyme systems
b) Active group of the coenzymes nicotinamide-adenine dinucleotide (NAD) and nicotinamide-adenine phosphate
(NADP)
c) Essential constituent of flavoproteins, flavin mononucleotide (FMN) and flavin adenine dinucleotide (FAD)
d) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain
reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable
025. Which of the following statements concerning pantothinic acid functions are true:
a) Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and decarboxylation
of amino acids in more than 50 different enzyme systems
b) Essential constituent of coenzyme A, the important coenzyme for acyl transfer in the TCA cycle and de novo
fatty acid synthesis
c) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain
reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable
d) Coenzyme for several reactions involving CO2 fixation into various compounds e.g. acetyl CoA to malonyl CoA (acetyl
CoA carboxylase) – initial step in de novo fatty acid synthesis; propionyl CoA to methylmalonyl CoA (propionyl CoA
carboxylase), pyruvate to oxaloacetate (pyruvate carboxylase)
026. Which of the following statements concerning biotin functions are true:
a) Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and decarboxylation
of amino acids in more than 50 different enzyme systems
b) Essential constituent of coenzyme A, the important coenzyme for acyl transfer in the TCA cycle and de novo fatty acid
synthesis
c) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain
reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable
d) Coenzyme for several reactions involving CO2 fixation into various compounds e.g. acetyl CoA to malonyl
CoA (acetyl CoA carboxylase) – initial step in de novo fatty acid synthesis; propionyl CoA to methylmalonyl
CoA (propionyl CoA carboxylase), pyruvate to oxaloacetate (pyruvate carboxylase)
027. Which of the following statements concerning vitamin B12 (cyanocobalamin) functions are true:
a) Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and decarboxylation
of amino acids in more than 50 different enzyme systems
b) Essential constituent of coenzyme A, the important coenzyme for acyl transfer in the TCA cycle and de novo fatty acid
synthesis
c) Coenzyme for numerous metabolic reaction, including transformation of methylamlonyl CoA to succinyl CoA
in the metabolism of propionate; DNA synthesis (acts in concert with folic acid); transmethylation e.g.
methionine synthesis from homocysteine
d) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain
reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable
028. Which of the following statements concerning folic acid (folacin) functions are true:
a) Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and decarboxylation
of amino acids in more than 50 different enzyme systems
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b) Essential constituent of coenzyme A, the important coenzyme for acyl transfer in the TCA cycle and de novo fatty acid
synthesis
c) Carrier of one-carbon (e.g. methyl) groups that are added to, or removed from, metabolites such as histidine,
serine, methionine, and purines
d) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain
reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable
029. Which of the following statements concerning vitamin C functions are true:
a) Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and decarboxylation
of amino acids in more than 50 different enzyme systems
b) Essential constituent of coenzyme A, the important coenzyme for acyl transfer in the TCA cycle and de novo fatty acid
synthesis
c) Carrier of one-carbon (e.g. methyl) groups that are added to, or removed from, metabolites such as histidine, serine,
methionine, and purines
d) Has antioxidant properties and is required for various hydroxylation reactions e.g. proline to hydroxypoline
for collagen synthesis
030. Dermatitis, diarrhoea and dementia are characteristics of:
a) Dry beriberi
b) Pyridoxine deficiency
c) Scurvy
d) Pellagra
031. Pellagra is:
a) A disease caused by a deficiency of niacin in the diet and characterized by skin eruptions, digestive and
nervous system disturbances, and eventual mental deterioration
b) Inflammation of several nerves at one time caused by a deficiency of thiamin, marked by paralysis, pain, and muscle
wasting. Also called multiple neuritis or polyneuritis
c) A severe form of anemia most often affecting elderly adults, caused by a failure of the stomach to absorb vitamin B12
and characterized by abnormally large red blood cells, gastrointestinal disturbances, and lesions of the spinal cord.
Also called pernicious anemia, malignant anemia
d) All of the above
032. Pernicious anemia is:
a) A severe form of anemia most often affecting elderly adults, caused by a failure of the stomach to absorb
vitamin B12 and characterized by abnormally large red blood cells, gastrointestinal disturbances, and lesions
of the spinal cord
b) A form of anemia in which the capacity of the bone marrow to generate red blood cells is defective, caused by a bone
marrow disease or exposure to toxic agents, such as radiation, chemicals, or drugs
c) Anemia characterized by a decrease in the concentration of corpuscular hemoglobin
d) All of the above
033. Rickets is:
a) A deficiency disease resulting from a lack of vitamin D or calcium and from insufficient exposure to sunlight,
characterized by defective bone growth and occurring chiefly in children
b) A disease occurring primarily in adults that results from a deficiency in vitamin D or calcium and is characterized by a
softening of the bones with accompanying pain and weakness
c) A disease characterized by a decrease in bone mass and density, occurring especially in postmenopausal women,
resulting in a predisposition to fractures and bone deformities such as a vertebral collapse
d) All of the above
034. Scurvy is:
a) A disease caused by deficiency of vitamin C and characterized by spongy bleeding gums, bleeding under the
skin, and weakness
b) Extreme dryness of the conjunctiva resulting from a disease localized in the eye or from systemic deficiency of vitamin
A
c) A disease caused by deficiency of niacin in the diet and characterized by skin eruptions, digestive and nervous system
disturbances, and eventual mental deterioration
d) All of the above
035. Which of the following vitamins is given along with isoniazide in treatment of tuberculosis?
a) Nicotinic acid
b) Riboflavin
c) Pyridoxine
d) Ascorbic acid
036. Which of the following vitamins is also known as an antisterility factor?
a) Vitamin E
b) Vitamin B6
c) Vitamin B1
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d) Vitamin К
037. Mega doses of which vitamin are some time beneficial viral respiratory infections
a) Vitamin С
b) Vitamin A
c) Vitamin К
d) Vitamin PP
038. Which of the following vitamins improves megaloblast anemia but does not protect the neurological manifestations of
pernicious anemia?
a) Vitamin B12
b) Vitamin BC
c) Vitamin PP
d) Vitamin D
039. Vitamin К enhances the anticoagulant property of coumarins. This statement is:
a) True
b) False
040. Loosening of teeth, gingivitis and hemorrhage occur in the deficiency of:
a) Vitamin К
b) Vitamin В1
c) Vitamin B6
d) Vitamin C
041. Ingestion of polar bear liver may cause acute poisoning of:
a) Vitamin D
b) Vitamin E
c) Vitamin A
d) Vitamin C
042. Which of the following antivitamins prevent a vitamin B6 from exerting its typical metabolic effects?
a) Isoniazide
b) Ethanol
c) Carbamazepine
d) All of the above
043. Which of the following antivitamins prevent a vitamin A from exerting its typical metabolic effects?
a) Lipooxidase
b) Oral contraceptives
c) Antibiotics
d) All of the above
044. Which of the following antivitamins prevent a vitamin K from exerting its typical metabolic effects?
a) Cholestiramine
b) Coumarins
c) Antibiotics
d) All of the above
045. Which of the following coenzymes is of vitamin origin?
a) Riboxine
b) Coenzyme Q10
c) Piridixal-5-phosphate
d) Lipoic acid
046. Which of the following coenzymes is not of vitamin origin?
a) Coenzyme Q10
b) Magnesium
c) Carnitine
d) All of the above
047. These substances are vitamin-like compounds, EXСEPT:
a) Choline
b) Vitamin PP
c) Vitamin U (methylmethioninesulfonil chloride)
d) Orotate acid
048. Which of the following substances is a vitamin-like compound?
a) Ascorbic acid
b) Taurine
c) Thiamine
d) Riboflavin
049. Which of the following antienzymes is a proteolysis inhibitor?
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a) Contrical
b) Sulbactam
c) Aminocaproic acid
d) Disulfiram
050. Which of the following antienzymes is a beta-lactamase inhibitor?
a) Clavulanic acid
b) Sulbactam
c) Tazobactam
d) All of the above
051. Which of the following antienzymes is a fibrinolysis inhibitor?
a) Clavulanic acid
b) Sulbactam
c) Aminocaproic acid
d) Disulfiram
052. Which of the following antienzymes is an aldehyde dehydrogenase inhibitor?
a) Tazobactam
b) Sulbactam
c) Aminocaproic acid
d) Disulfiram
053. Which of the following antienzymes is a cholinesterase inhibitor?
a) Physostigmine
b) Selegiline
c) Aminocaproic acid
d) Disulfiram
054. Which of the following antienzymes is a monoamine oxidase (MAO) inhibitor:
a) Physostigmine
b) Selegiline
c) Acetazolamide
d) Disulfiram
055. Which of the following antienzymes is a carbonic anhydrase inhibitor:
a) Physostigmine
b) Selegiline
c) Aminocaproic acid
d) Acetazolamide
056. Which of the following antienzymes is a xantine oxidase inhibitor?
a) Physostigmine
b) Allopurinol
c) Aminocaproic acid
d) Acetazolamide
057. Which of the following antienzymes is an aromatase inhibitor used in cancer therapy?
a) Physostigmine
b) Allopurinol
c) Aminocaproic acid
d) Aminoglutethimide
058. Which of the following enzymes improves GIT functions (replacement therapy):
a) Pepsin
b) Urokinase
c) L-asparaginase
d) Lydaze
059. Which of the following enzymes has fibrinolytic activity?
a) Pepsin
b) Urokinase
c) L-asparaginase
d) Lydaze
060. Which of the following enzymes is used in cancer therapy?
a) Pepsin
b) Urokinase
c) L-asparaginase
d) Lydaze
061. Which of the following statements concerning nutritional supplement (dietary supplement) are True:
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a) Nutritional supplements are intended to supplement the diet and bear or contain one or more of the following dietary
ingredients: a vitamin, a mineral, an herb or other botanical, an amino acid, a dietary substance for human use to
supplement the diet by increasing the total daily intake (e.g., enzymes or tissue from organ or glands), a concentrate,
such as a meal replacement or energy bar, a metabolite, constituent, or extract
b) Nutritional supplements are regulated as foods, and not as drugs
c) Nutritional supplements are not pre-approved on their safety and efficacy, unlike drugs
d) All of the above

PART VII Antihyperlipidemic Drugs & Drugs Used In the Treatment of Gout
001. Lipoprotein is:
a) A conjugated protein having a lipid component; the principal means for transporting lipids in the blood
b) Any of various fat-soluble or water-soluble organic substances essential in minute amounts for normal growth and
activity of the body and obtained naturally from plant and animal foods
c) Product of endocrine gland secretion
d) Mediators of inflammatory process
002. Very low density lipoprotein (VLDL) is:
a) A lipoprotein containing a very large proportion of lipids to protein and carrying most cholesterol from the
liver to the tissues
b) A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of
atherosclerosis and coronary artery disease. It is also called beta-lipoprotein
c) A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a decreased
risk of atherosclerosis and coronary artery disease. It is also called alpha-lipoprotein
d) Large lipoprotein particle that is created by the absorptive cells of the small intestine. It transports lipids to adipose
tissue where they are broken down by lipoprotein lipase
003. Low-density lipoprotein (LDL) is:
a) A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of
atherosclerosis and coronary artery disease. It is also called beta-lipoprotein
b) A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a decreased
risk of atherosclerosis and coronary artery disease. It is also called alpha-lipoprotein
c) A lipoprotein containing a very large proportion of lipids to protein and carrying most cholesterol from the liver to the
tissues
d) Large lipoprotein particle that is created by the absorptive cells of the small intestine. It transports lipids to adipose
tissue where they are broken down by lipoprotein lipase
004. High-density lipoprotein (HDL) is:
a) A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a
decreased risk of atherosclerosis and coronary artery disease. It is also called alpha-lipoprotein
b) A lipoprotein containing a very large proportion of lipids to protein and carrying most cholesterol from the liver to the
tissues
c) A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of
atherosclerosis and coronary artery disease. It is also called beta-lipoprotein
d) Large lipoprotein particle that is created by the absorptive cells of the small intestine. It transports lipids to adipose
tissue where they are broken down by lipoprotein lipase
005. Chylomicron is:
a) A lipoprotein that contains relatively small amounts of cholesterol and triglycerides and is associated with a decreased
risk of atherosclerosis and coronary artery disease. It is also called alpha-lipoprotein
b) A lipoprotein containing a very large proportion of lipids to protein and carrying most cholesterol from the liver to the
tissues
c) A lipoprotein that contains relatively high amounts of cholesterol and is associated with an increased risk of
atherosclerosis and coronary artery disease. It is also called beta-lipoprotein
d) Large lipoprotein particle that is created by the absorptive cells of the small intestine. It transports lipids to
adipose tissue where they are broken down by lipoprotein lipase
006. Hyperlipoproteinemia is a condition marked by an abnormally high level of lipoproteins in the blood. This consideration is:
a) True
b) False
007. Hypertriglyceridemia denotes high blood levels of triglycerides. It has been associated with atherosclerosis, even in the
absence of hypercholesterolemia (high cholesterol levels). This consideration is:
a) True
b) False
008. Hypercholesterolemia (or hypercholesteremia) is an abnormally high concentration of cholesterol in the blood. This
consideration is:
a) True
b) False
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009. Which of the following consideration about type I familial hyperlipoproteinemia is True:
a) Type I familial hyperlipoproteinemia marked by the increased serum concentrations of chylomicrons and
triglycerides, which decrease if the diet becomes fat free, decreased concentrations of high- and low-density
lipoproteins, which increase if the diet is fat free, and decreased tissue lipoprotein lipase activity
b) Type I familial hyperlipoproteinemia characterized by increased serum concentrations of chylomicrons, pre-low-density
lipoproteins, and triglycerides that are considered to be the result of a combination of fat and carbohydrate-induced
hyperlipemia
010. Familial chylomicronemia (type I) is caused by deficiency in lipoprotein lipase activity. This consideration is:
a) True
b) False
011. The Coronary Primary Prevention Trial (CPPT) demonstrated that treatment with a lipid-lowering drug could reduce the
risk of death due to coronary heart disease. This consideration is:
a) True
b) False
012. Women taking probucol (Lorelco) should wait for 6 months after cessation of therapy before becoming pregnant. This
consideration is:
a) True
b) False
013. Nicotinic acid (Niacin) plus a bile acid-binding resin has not proven effective in combating hyperlipidemia. This
consideration is:
a) True
b) False
014. The ideal therapy for patients with elevated levels of cholesterol would lower the serum concentration of LDL-cholesterol
while raising the concentration of HDL-cholesterol. This consideration is:
a) True
b) False
015. Agents, which lower levels of LDL-cholesterol, tend to promote regression of atherosclerotic plaques. This consideration
is:
a) True
b) False
016. Clofibrate (Atromid-S) is the drug of choice for treatment of broad-beta hyperlipidemia (type III). This consideration is:
a) True
b) False
017. One advantage of gemfibrozil (Lopid) is that, in addition to lowering blood levels of most lipids, it raises the level of HDL
cholesterol. This consideration is:
a) True
b) False
018. Probucol (Lorelco) appears to increase clearance of LDL cholesterol by a non-receptor mediated mechanism. This
consideration is:
a) True
b) False
019. All of the following statements concerning cholestyramine (Questran) are true, EXCEPT:
a) It would not be a good choice for treating patients with familial hypertriglyceridemia (type IV)
b) It is not well tolerated by patients
c) It works by directly binding cholesterol in the blood
d) It is an effective drug for treatment of types IIa and IIb hyperlipidemia
020. All of the following statements concerning drugs which inhibit cholesterol synthesis are true, EXCEPT:
a) They work in part by increasing the rate of LDL clearance from the plasma
b) They are the most effective single agents for lowering LDL-cholesterol
c) When used with a bile-acid binding resin, they can lower LDL-cholesterol by 50% or more
d) No special monitoring is required in patients receiving one of them
021. All of the following statements concerning nicotinic acid (Niacin) are true, EXCEPT:
a) It reduces the rate of synthesis of VLDL
b) Sustained-release preparations of this drug are largely free of side effects
c) Almost all patients taking the traditional dosage form of this drug experience uncomfortable flushing
d) It should not be used with antihypertensives
022. All of the following statements concerning drugs which inhibit cholesterol synthesis are true, EXCEPT:
a) When used alone, they are the most effective agents for lowering LDL cholesterol
b) They are often effective in patients in whom a diet, with or without a bile acid-binding resin or niacin, has failed
c) Lovastatin (Mevacor) plus a resin causes regression of coronary lesions in about one third of treated patients
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d) Members of this drug class are generally not as well tolerated as the older bile acid-binding resins
023. All of the following statements concerning drugs which inhibit cholesterol synthesis are true, EXCEPT:
a) These drugs should not be used in pregnant women or children
b) These drugs often cause myopathy if used in combination with cyclosporine (Sandimmune)
c) Failure to discontinue the drug after myopathy has been detected can cause acute renal failure
d) Several of these drugs tend to lengthen the sleep cycle
024. All of the following statements concerning the fibric acid derivatives are true, EXCEPT:
a) Clofibrate (Atromid-S) is the drug of choice for therapy of Type III hyperlipidemia
b) Gemfibrozil (Lopid) increases HDL cholesterol while lowering LDL cholesterol
c) Gemfibrozil (Lopid) has been shown to reduce mortality associated with a heart disease
d) Gemfibrozil (Lopid) is generally well tolerated
025. All of the following statements concerning the bile acid-binding resins are true, EXCEPT:
a) They decrease total cholesterol and LDL
b) They are contraindicated in patients with hypertriglyceridemia
c) When used alone, they do not slow the progression of atherosclerotic lesions
d) They are the drugs of choice for therapy of type II hyperlipidemia when used either alone or in combination with
selected agents
026. All of the following statements concerning nicotinic acid (Niacin) are true, EXCEPT:
a) Both triglycerides and LDL cholesterol are reduced by this drug
b) The drug acts by directly decreasing the rate of synthesis of apoproteins
c) Doses higher than 3 gm/day are no longer used because of possible disturbances of hepatic or pancreatic functions
d) Most patients taking this drug experience uncomfortable cutaneous flushing, itching, and/or rashes
027. All of the following statements concerning the general principles of therapy with lipid-lowering drugs are true EXCEPT:
a) Therapy with a lipid-lowering drug should be always accompanied by an appropriate diet
b) A lipid-lowering diet should be discontinued if it fails to decrease the levels of plasma LDL cholesterol by at
least 10%
c) Lipid-lowering drugs should only be administered after at least 3 months of prior dietary therapy
d) Some combinations of lipid-lowering drugs are synergistic
028. The cholesterol synthesis inhibitors increase the rate of clearance of LDL cholesterol from the plasma. This
consideration is:
a) True
b) False
029. Lovastatin (Mevacor) plus a bile-acid binding resin causes regression of coronary lesions in about one third of treated
patients. This consideration is:
a) True
b) False
030. The cholesterol synthesis inhibitors are better tolerated than most other lipid-lowering agents. This consideration is:
a) True
b) False
031. Selected liver and muscle enzymes should be monitored during the use of any cholesterol synthesis inhibitors because
of possible toxic effects. This consideration is:
a) True
b) False
032. The bile acid-binding resins act by directly binding cholesterol and facilitating its excretion. This consideration is:
a) True
b) False
033. Nicotinic acid (Niacin) acts by increasing the rate of catabolism of VLDL. This consideration is:
a) True
b) False
034. Gemfibrozil (Lopid) can cause dizziness and syncope when used with antihypertensives. This consideration is:
a) True
b) False
035. Gemfibrozil (Lopid) increases concentrations of HDL cholesterol more than clofibrate (Atromid-S). This consideration is:
a) True
b) False
036. The bile acid-binding resins can bind many drugs and vitamins and reduce their absorption. This consideration is:
a) True
b) False
037. When used alone, the bile acid-binding resins are contraindicated in patients with hypertriglyceridemia. This
consideration is:
113
a) True
b) False
038. Combinations of lipid-lowering drugs are likely to be synergistic if they work at different steps in the same pathway. This
consideration is:
a) True
b) False
039. Reduction in plasma triglycerides and LDL cholesterol concentrations with gemfibrozil treatment is greater than reduction
in plasma cholesterol and LDL cholesterol concentrations with gemfibrozil treatment. This consideration is:
a) True
b) False
040. Patients with homozygous familial hypercholesterolemia (type IIa) lack any functional LDL receptors on their
hepatocytes. This consideration is:
a) True
b) False
041. Effects of drugs in lowering blood cholesterol levels are additive with those of diet. This consideration is:
a) True
b) False
042. HMG-CoA reductase inhibiting drugs can cause muscle breakdown, especially when used in combination with a
cyclosporine. This consideration is:
a) True
b) False
043. Probucol (Lorelco) reduces the risk of atherosclerosis by stimulating the rate of clearance of LDL by receptor-mediated
pathways. This consideration is:
a) True
b) False
044. Clofibrate (Atromid-S) is generally regarded as superior to gemfibrozil.
a) True
b) False
045. Niacin’s most common side effects can be reduced by pretreatment with aspirin and/or by taking the drug at the end of
meals. This consideration is:
a) True
b) False
046. The major side effect of cholestyramine is hepatotoxicity. This consideration is:
a) True
b) False
047. The statins are dependent on the presence of LDL receptors on hepatocytes in order to exert their effect. This
consideration is:
a) True
b) False
048. This drug increases lipoprotein lipase (LPL) activity in adipose tissue:
a) Cholestyramine (Questran)
b) Lovastatin (Mevacor)
c) Nicotinic acid (Niacin)
d) Gemfibrozil (Loprol)
049. This drug both inhibits an enzyme and indirectly enhances clearance of low density lipoproteins (LDL):
a) Cholestyramine (Questran)
b) Lovastatin (Mevacor)
c) Nicotinic acid (niacin)
d) Probucol (Lorelco)
050. This drug binds bile acids in the GI tract:
a) Cholestyramine (Questran)
b) Nicotinic acid (niacin)
c) Gemfibrozil (Loprol)
d) Probucol (Lorelco)
051. This drug may block oxidation of low density lipoproteins (LDL):
a) Lovastatin (Mevacor)
b) Nicotinic acid (niacin)
c) Gemfibrozil (Loprol)
d) Probucol (Lorelco)
052. This drug weakly stimulates synthesis of very low density lipoproteins (VLDL):
114
a) Cholestyramine (Questran)
b) Lovastatin (Mevacor)
c) Gemfibrozil (Loprol)
d) Probucol (Lorelco)
053. Flushing caused by this drug can be reduced by taking it after meals and/or by pretreatment with aspirin:
a) Lovastatin (Mevacor)
b) Nicotinic acid (niacin)
c) Gemfibrozil (Loprol)
d) Probucol (Lorelco)
054. This drug can cause muscle damage, especially when used with any of several drugs including erythromycin:
a) Cholestyramine (Questran)
b) Lovastatin (Mevacor)
c) Gemfibrozil (Loprol)
d) Probucol (Lorelco)
055. This drug decreases blood levels of high density lipoproteins (HDL):
a) Lovastatin (Mevacor)
b) Nicotinic acid (niacin)
c) Gemfibrozil (Loprol)
d) Probucol (Lorelco)
056. This fibric acid derivative increases blood levels of high density lipoproteins (HDL):
a) Cholestyramine (Questran)
b) Lovastatin (Mevacor)
c) Gemfibrozil (Loprol)
d) Probucol (Lorelco)
057. Gout is a familial metabolic disease characterized by recurrent episodes of acute arthritis due to deposits of monosodium
urate in joints and cartilage. This consideration is:
a) True
b) False
058. Probenecid and sulfinpyrazone are uricosuric drugs employed to decrease the body pool of urate in patients with
tophaceous gout or in those with increasingly frequent gouty attacks. This consideration is:
a) True
b) False
059. Which of the following drugs is an uricosuric agent:
a) Allopurinol
b) Sulfinpyrazone
c) Colchicine
d) Indomethacin
060. Uricosuric drugs are the following, EXCEPT:
a) Probenecid
b) Sulfinpyrazone
c) Colchicine
d) Aspirin (at high dosages)
061. Which of the following drugs used in the treatment of gout acts by preventing the migration of granulocytes:
a) Allopurinol
b) Sulfinpyrazone
c) Colchicine
d) Indomethacin
062. Which of the following drugs used in the treatment of gout has as its primary effect the reduction of uric acid synthesis
a) Allopurinol
b) Sulfinpyrazone
c) Colchicine
d) Indomethacin
063. Characteristics of probenecid include all of the following, EXCEPT:
a) It promotes the renal tubular secretion of penicillin
b) It is useful in the treatment of gout
c) At appropriate doses, it promotes the excretion of uric acid
d) The metabolic products of probenecid are uricosuric

PART VIII Agents That Affect Bone Mineral Homeostasis


001. Action of the parathyroid hormone is:
115
a) Increased calcium and phosphate absorption in intestine (by increased 1,25-dihydroxyvitamin D3 production)
b) Decreased calcium excretion and increased phosphate excretion in kidneys
c) In bone, calcium and phosphate resorption increased by high doses. Low doses may increase bone formation.
d) All of the above
002. The parathyroid hormone increases serum calcium and decreases serum phosphate. This consideration is:
a) True
b) False.
003. The following statements about the parathyroid hormone are true, EXCEPT:
a) The parathyroid hormone (PTH) is a single-chain peptide hormone composed of 84 amino acids
b) The parathyroid hormone increases calcium and phosphate absorption in intestine (by increased 1,25-
dihydroxyvitamin D3 production)
c) The parathyroid hormone increases serum calcium and decreases serum phosphate
d) The parathyroid hormone increases calcium excretion and decreases phosphate excretion in kidneys
004. Which of the following statements about calcitonin is true:
a) Calcitonin secreted by parafollicular cells of the mammalian thyroid is a single-chain peptide hormone with 32 amino
acids
b) Effects of calcitonin are to lower serum calcium and phosphate by acting on bones and kidneys.
c) Calcitonin inhibits osteoclastic bone resorption.
d) All of the above
005. Mechanism of action of calcitonin is:
a) Inhibits hydroxyapatite crystal formation, aggregation, and dissolution
b) Raises intracellular cAMP in osteoclasts
c) Activates bone resorption
d) Inhibits macrophages
006. Indications for calcitonin administration are the following, EXCEPT:
a) Hypercalcemia
b) Paget's disease
c) Hypophosphatemia
d) Osteoporosis
007. Side effect of calcitonin is:
a) Hypercalcemia
b) Metastatic calcifications
c) Tetany
d) GI toxicity
008. Side effect of calcitonin is:
a) Pruritus
b) Hypotension
c) Fractures
d) Hypocalcemia
009. Glucocorticoid hormones alter bone mineral homeostasis:
a) By antagonizing vitamin D-stimulated intestinal calcium transport
b) By stimulating renal calcium excretion
c) By increasing parathyroid hormone stimulated bone resorption
d) By all of the above
010. Estrogens can prevent accelerated bone loss during the immediate postmenopausal period and at least transiently
increase bone in the postmenopausal subject. This consideration is:
a) True
b) False
011. Action of vitamin D3 is:
a) Increased calcium and phosphate absorption by 1,25-dihydroxyvitamin D3
b) Calcium and phosphate excretion may be decreased by 25-hydroxyvitamin D3 and 1,25-dihydroxyvitamin D3
c) Increased calcium and phosphate resorption by 1,25-dihydroxyvitamin D3; bone formation may be increased by 25,24-
dihydroxyvitamin D3
d) All of the above
012. Vitamin D3 increases serum calcium and phosphate. This consideration is:
a) True
b) False
013. Route of administration of vitamin D3 is:
a) Subcutaneous
b) Oral
c) Intravenous
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d) Intranasal
014. Side effect of vitamin D3 is:
a) Defective bone mineralization
b) Metastatic calcifications
c) Hepatic toxicity
d) Nephrolithiasis
015. Indication of vitamin D3 is:
a) Hypercalcemia
b) Paget's disease
c) Hypophosphatemia
d) Osteomalacia
016. 25-hydroxyvitamin D3 (calcifediol) is less effective than 1,25-dihydroxyvitamin D3 (calcitriol) in stimulating intestinal
calcium transport, so that hypercalcemia is less of a problem with calcifediol. This consideration is:
a) True
b) False
017. Route of administration of 25-hydroxyvitamin D3 (calcifediol) is:
a) Oral
b) Subcutaneous
c) Intravenous
d) Intranasal
018. Indication for 25-hydroxyvitamin D3 (calcifediol) administration is:
a) Primary hyperparathyroidism
b) Rickets
c) Hypercalcemia
d) Failure of vitamin D formation in skin
019. Side effect of 25-hydroxyvitamin D3 (calcifediol) is:
a) Hypercalcemia
b) Pruritus
c) GI toxicity
d) All of the above
020. Indications for 1,25-dihydroxyvitamin D3 (calcitriol) administration are the following, EXCEPT:
a) Hypocalcemia in chronic renal failure
b) Vitamin D-dependent rickets
c) Malabsorption of vitamin D from intestine
d) Elevated skeletal turnover
021. Indication for 1,25-dihydroxyvitamin D3 (calcitriol) administration is:
a) Vitamin D resistance
b) Elevated skeletal turnover
c) Hypercalcemia of malignancy
d) Hypophosphatemia
022. The following statement refers to 1,25-dihydroxyvitamin D3 (calcitriol):
a) When rapidity of action is required, 1,25-dihydroxyvitamin D3 (calcitriol), 0.25-1 μg daily, is the vitamin D metabolite of
choice, since it is capable of raising serum calcium within 24-48 hours
b) Calcitriol also raises serum phosphate, though this action is usually not observed early in treatment
c) Undergoes enterohepatic circulation
d) All of the above
023. Which of the following statements refers to 1,25-dihydroxyvitamin D3 (calcitriol):
a) The combined effect of calcitriol and all other vitamin D metabolites and analogs on both calcium and
phosphate makes careful monitoring of the level of these minerals especially important to avoid ectopic
calcification
b) Does not undergo enterohepatic circulation
c) Toxic to osteoclasts
d) Bioavailability increases with the administered dose
024. Route of administration of 1,25-dihydroxyvitamin D3 (calcitriol) is:
a) Subcutaneous
b) Intravenous
c) Intranasal
d) Oral
025. Commercially available analogs of 1,25-dihydroxyvitamin D3 (calcitriol) are:
a) Doxercalciferol (Hectoral)
b) Paricalcitol (Zemplar)
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c) All of the above
d) None of the above
026. Side effect of dihydrotachysterol is:
a) Hepatic toxicity
b) General malaise
c) Lymphocytopenia
d) Hypertension
027. Route of administration of dihydrotachysterol is:
a) Intravenous
b) Subcutaneous
c) Oral
d) Intranasal
028. Which of the following statements refers to cholecalciferol:
a) Frequent monitoring of both calcium and phosphorus serum levels is necessary in case of intravenous administration
b) Has potent anti-osteoclast activity – mechanism unknown
c) Can usually lower serum calcium levels in 48 hours
d) Mechanism of action: 1. Genomic effects 2. Cytoplasmic effects
029. Indication for cholecalciferol administration is:
a) Hypercalcemia
b) Parathyroid hormone deficiency
c) Primary hyperparathyroidism
d) Malabsorption of vitamin D from intestine
030. Route of administration of cholecalciferol is:
a) Subcutaneous
b) Intranasal
c) Intravenous
d) Oral
031. The unwanted effect of cholecalciferol is:
a) Defective bone mineralization
b) Lymphocytopenia
c) CNS toxicity
d) Metastatic calcifications
032. The unwanted effect of dihydrotachysterol is:
a) Tetany
b) Anorexia
c) CNS toxicity
d) Lymphocytopenia
033. Indication for dihydrotachysterol administration is:
a) Parathyroid hormone resistance
b) Paget's disease
c) Increased osteolysis
d) Hypophosphatemia
034. Conditions associated with hypophosphatemia include:
a) Primary hyperparathyroidism
b) Vitamin D deficiency
c) Idiopathic hypercalciuria
d) All of the above.
035. The long-term effects of hypophosphatemia include proximal muscle weakness and abnormal bone mineralization
(osteomalacia). This consideration is:
a) True
b) False
036. Recommended phosphorus daily allowance is:
a) 900-1200 mg
b) 600-900 g
c) 25 g
d) 1.5-4 mg
037. Interactions with other drugs of phosphorus is:
a) Amiloride: decrease renal excretion
b) Glucocorticoids: decrease absorption
c) Loop diuretics: increase renal excretion
d) Calcitonin: increases renal excretion
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038. Indication for pamidronate administration is:
a) Failure of vitamin D formation in skin
b) Hypoparathyroidism
c) Elevated skeletal turnover
d) Hypercalcemia
039. Route of administration of pamidronate is:
a) Oral
b) Subcutaneous
c) Intranasal
d) Intravenous
040. Correct statements about pamidronate include all of the following, EXCEPT:
a) Because it causes gastric irritation, pamidronate is not available as an oral preparation
b) Skeletal half-life is 24 h
c) Fever and lymphocytopenia are reversible
d) Can be irritable to the esophagus if not washed promptly to the stomach
041. Route of administration of alendronate is:
a) Intravenous
b) Subcutaneous
c) Oral
d) Intranasal
042. Correct statements about alendronate include all of the following, EXCEPT:
a) Can be irritable to the esophagus if not washed promptly to the stomach
b) 1st generation biphosphonate
c) Reduces osteoclast activity without significantly affecting osteoblasts; useful in the treatment of Paget's disease
d) More potent than EHDP; has a wider therapeutic window
043. Indications of alendronate are the following, EXCEPT:
a) Hypoparathyroidism
b) Glucocorticoid-induced osteoporosis
c) Paget's disease
d) Syndromes of ectopic calcification
044. Indication for etidronate administration is:
a) Malabsorption of vitamin D from intestine
b) Paget's disease
c) Vitamin D deficiency in a diet
d) Hypercalciuria
045. Indications for etidronate administration are the following, EXEPT:
a) Paget's disease
b) Osteoporosis
c) Hypophosphatemia
d) Hypercalcemia
046. Which of the following statements refers to etidronate:
a) Reduces osteoclast activity without significantly affecting osteoblasts; useful in treatment of Paget's disease
b) Serum phosphorus concentrations should be monitored at least daily in case of oral administration
c) 2nd generation biphosphonate (amino-biphosphonate)
d) Bioavailability increases with the administered dose
047. Correct statements about etidronate include all of the following, EXCEPT:
a) Skeletal half-life is hundreds of days
b) Bioavailability increases with the administered dose
c) 2nd generation biphosphonate (amino-biphosphonate)
d) 1st generation biphosphonate.
048. Unwanted effect of etidronate is:
a) Anorexia
b) Defective bone mineralization
c) Hypercalcemia
d) Cardiac arrhythmias
049. The major causes of hypocalcemia in the adult are:
a) Hypoparathyroidism
b) Vitamin D deficiency
c) Renal failure and malabsorption
d) All of the above
050. The major causes of hypercalcemia in the adult are the following, EXCEPT :
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a) Hyperparathyroidism
b) Cancer with or without bone metastases
c) Renal failure and malabsorption
d) Hypervitaminosis D
051. Which of the following statements refers to calcium:
a) Recommended Ca daily allowance for males: 1. 1-10 years: 800 mg 2. 11-18 years: 1200 mg 3. 19-50 years: 1000 mg
4. > 51 years: 1000 mg
b) Ca chloride is very irritating and can cause necrosis if extravasated
c) In achlorhydric patients calcium carbonate should be given with meals to increase absorption or patient switched to
calcium citrate, which is somewhat better absorbed
d) All of the above
052. Indication for calcium administration is:
a) Failure of formation of vitamin D in skin
b) Malabsorption of vitamin D from intestine
c) Hypercalcemia of malignancy
d) Vitamin D deficiency
053. Which of the calcium preparations is the most preferable for IV injection
a) Calcium gluceptate (0.9 meq calcium/mL)
b) Calcium gluconate (0.45 meq calcium/mL)
c) Calcium chloride (0.68-1.36 meq calcium/mL)
d) All of the above
054. Which of the oral calcium preparations is often the preparation of choice:
a) Calcium carbonate (40% calcium)
b) Calcium lactate (13% calcium)
c) Calcium phosphate (25% calcium)
d) Calcium citrate (17% calcium)
055. Interactions with other drugs of calcium is:
a) Ethanol: decreases absorption
b) Loop diuretics: increase renal excretion
c) Glucocorticoids: stimulate renal excretion
d) All of the above
056. Correct statements about magnesium include all of the following, EXCEPT:
a) Magnesium is mainly an intracellular cation, and is the fourth most abundant cation in the body
b) The recommended dietary amounts of magnesium have been set at 6 mg/kg day (350-400 mg)
c) The most common specific causes encountered in clinical practice are: diet, alcoholism (drinking), diarrhea and
malabsorption, diabetes mellitus, diuretics, and drugs such as aminoglycosides and amphotericin
d) It is a physiological calcium agonist
057. Recommended magnesium daily allowance is:
a) 350-400 mg
b) 6-9 g
c) 25 g
d) 1.5-4 mg
058. The major causes of hypomagnesaemia are:
a) Insufficient dietary intake, e.g. malnutrition
b) Abnormal gastrointestinal loss, e.g. severe diarrhea or chronic alcoholism
c) Abnormal renal loss, e.g. diabetes mellitus or during therapy with some kind of drugs such as amphotericin B,
gentamicin, cisplatin, cardiac glycosides, distal and loop diuretics
d) All of the above
059. Which of the magnesium preparation is the most preferable for I.V. injection
a) Magnesium sulfate
b) Magnesium chloride
c) Magnesium glutamate
d) All of the above
060. Which of the oral magnesium preparations is often the preparation of choice:
a) Magnesium lactate
b) Magnesium oxide
c) MagneB6 (Mg pidolate / Mg lactate + pyridoxine hydrochloride)
d) All of the above.
061. Correct statements about fluoride include all of the following, EXCEPT:
a) Fluoride is effective for the prophylaxis of dental caries
b) Fluoride is accumulated by bone and teeth, where it may stabilize the hydroxyapatite crystal
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c) Subjects living in areas with naturally fluoridated water (1-2 ppm) had more dental caries and fewer vertebral
compression fractures than subjects living in nonfluoridated water areas
d) Chronic exposure to very high level of fluoride dust in the inspired air results in crippling fluorosis, characterized by
thickening of the cortex of long bones and bony exostoses.
062. Recommended fluoride daily allowance is:
a) 1.5-4 mg
b) 600-900 g
c) 25 g
d) 350-400 mg
063. Which of the following statements refers to gallium nitrate:
a) It is approved by the FDA for the management of hypercalcemia of malignancy
b) This drug acts by inhibiting bone resorption
c) Because of potential nephrotoxicity, patients should be well-hydrated and have good renal output before starting the
infusion
d) All of the above
064. Which of the following statements refers to plicamycin (formerly mithramycin):
a) Duration of action is usually several days
b) Mechanism of cytotoxic action appears to involve its binding to DNA, possibly through an antibiotic-Mg2+ complex.
c) The drug causes plasma calcium levels to decrease, apparently through an action on osteoclasts that is independent
of its action on tumor cells and useful in hypercalcemia.
d) All of the above.
065. Unwanted effects of plicamycin (formerly mithramycin) are the following, EXEPT:
a) Thrombocytopenia
b) GI toxicity
c) Bleeding disorders
d) Fractures
066. Unwanted effect of plicamycin (formerly mithramycin) is:
a) Diarrhea
b) Myelosuppression
c) Nephrolithiasis
d) Metastatic calcifications
067. Indication for plicamycin (formerly mithramycin) administration is:
a) Testicular cancers refractory to standard treatment
b) Paget’s disease
c) Hypercalcemia of malignancy
d) All of the above
068. Route of administration of plicamycin is:
a) Intravenous
b) Subcutaneous
c) Intranasal
d) Oral

PART IX Mineralocorticoid, Mineralocorticoid Antagonists, Diuretics, Plasma Expanders


001. Mineralocorticoid effects cause:
a) Increased catabolism
b) Increased Na retension and К excretion
c) Increased gluconeogenesis
d) Deposition of fat on shoulders, face and abdomen
002. Which of the following synthetic steroids shows predominantly mineralocorticoid action?
a) Hydrocortisone
b) Spironolactone
c) Dexamethasone
d) Fludrocortisone
003. The major mineralocorticoids are the following, EXCEPT:
a) Aldosterone
b) Deoxycorticosterone
c) Fludrocortisone
d) Hydrocortisone
004. Which of the following statements about spironolactone is TRUE?
a) Spironolactone reverses many of the manifestations of aldosteronism
b) Spironilactone is also an androgen antagonist and as such is used in the treatment of hirsutism in wormen
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c) Spironolactone is useful as a diuretic
d) All of the above
005. All of the following statements regarding diuretics are true, EXCEPT:
a) Carbonic anhydrase inhibition leads to increased reabsorption of NaHCO3
+ - + + -
b) Loop diuretics decrease Na reabsorption at the loop of Henle by competing for the Cl site on the Na /K /2Cl
cotransporter
c) In general, the potency of a diuretic is determined by where it acts in the renal tubule
d) Hydrochlorothiazide decreases urinary calcium excretion
006. The drug inhibits the ubiquitous enzyme carbonic anhydrase:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (HydroDiuril)
d) Spironolactone (Aldactone)
007. The drug acts by competitively blocking NaCl cotransporters in the distal tubule:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (HydroDiuril)
d) Spironolactone (Aldactone)
008. The drug acts at the proximal tubule:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (HydroDiuril)
d) Spironolactone (Aldactone)
009. The drug acts by competing with aldosterone for its cytosolic receptors:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (HydroDiuril)
d) Spironolactone (Aldactone)
010. The drug is a potassium-sparing diuretic that blocks Na+ channels in the collecting tubules:
a) Acetazolamide (Diamox)
b) Amiloride (Midamor)
c) Furosemide (Lasix)
d) Hydrochlorothiazide (HydroDiuril)
011. Chronic use of this drug can lead to distal tubular hypertrophy, which may reduce its diuretic effect:
a) Acetazolamide (Diamox)
b) Amiloride (Midamor)
c) Furosemide (Lasix)
d) Hydrochlorothiazide (HydroDiuril)
012. The drug has a steroid-like structure which is responsible for its anti-androgenic effect:
a) Amiloride (Midamor)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (HydroDiuril)
d) Spironolactone (Aldactone)
013. Sustained use of this drug results in increased plasma urate concentrations:
a) Furosemide (Lasix)
b) Acetazolamide (Diamox)
c) Both of the above
d) Neither of the above
014. The drug can be used to treat glaucoma:
a) Furosemide (Lasix)
b) Acetazolamide (Diamox)
c) Both of the above
d) Neither of the above
015. The drug can cause ototoxicity:
a) Furosemide (Lasix)
b) Acetazolamide (Diamox)
c) Both of the above
d) Neither of the above
016. The drug acts only on the lumenal side of renal tubules:
a) Furosemide (Lasix)
b) Acetazolamide (Diamox)
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c) Both of the above
d) Neither of the above
017. The drug can promote sodium loss in patients with low (e.g., 40 ml/min) glomerular filtration rates:
a) Furosemide (Lasix)
b) Acetazolamide (Diamox)
c) Both of the above
d) Neither of the above
018. The drug needs aldosterone present in order to be effective:
a) Hydrochlorothiazide (HydroDiuril)
b) Amiloride (Midamor)
c) Both of the above
d) Neither of the above
019. The drug can be used to treat nephrogenic diabetes insipidus:
a) Hydrochlorothiazide (HydroDiuril)
b) Amiloride (Midamor)
c) Both of the above
d) Neither of the above
020. The drug is sometimes part of fixed-dose combinations used to treat essential hypertension:
a) Hydrochlorothiazide (HydroDiuril)
b) Amiloride (Midamor)
c) Both of the above
d) Neither of the above
021. The drug should never be administered to patients taking potassium supplements:
a) Hydrochlorothiazide (HydroDiuril)
b) Amiloride (Midamor)
c) Furosemide (Lasix)
d) Neither of the above
022. The drug decreases calcium excretion in urine:
a) Hydrochlorothiazide (HydroDiuril)
b) Amiloride (Midamor)
c) Furosemide (Lasix)
d) Acetazolamide (Diamox)
023. The drug acts by competitively blocking the Na+/K+/2Cl- cotransporter:
a) Loop diuretics
b) Thiazide diuretics
c) Potassium-sparing diuretics
d) Carbonic anhydrase inhibitors
024. The drug acts at the proximal tubule:
a) Loop diuretics
b) Thiazide diuretics
c) Potassium-sparing diuretics
d) Carbonic anhydrase inhibitors
025. The drug acts in the distal convoluted tubule:
a) Loop diuretics
b) Thiazide diuretics
c) Potassium-sparing diuretics
d) Carbonic anhydrase inhibitors
026. The drug acts in the collecting tubules:
a) Loop diuretics
b) Thiazide diuretics
c) Potassium-sparing diuretics
d) Carbonic anhydrase inhibitors
027. The drug is the most potent diuretic:
a) Loop diuretics
b) Thiazide diuretics
c) Potassium-sparing diuretics
d) Carbonic anhydrase inhibitors
028. The drug acts by competitively blocking the NaCl cotransporter:
a) Loop diuretics
b) Thiazide diuretics
c) Potassium-sparing diuretics
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d) Carbonic anhydrase inhibitors
029. The drug inhibits sodium and chloride transport in the cortical thick ascending limb and the early distal tubule:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (Hydrodiuril)
d) Amiloride (Midamor)
030. The drug can cause ototoxicity:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (Hydrodiuril)
d) Amiloride (Midamor)
031. The drug blocks the sodium/potassium/chloride cotransporter in the thick ascending loop of Henle:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (Hydrodiuril)
d) Amiloride (Midamor)
032. The drug is one of the most potent diuretics:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (Hydrodiuril)
d) Amiloride (Midamor)
033. The drug is usually given in combination with a thiazide diuretic:
a) Acetazolamide (Diamox)
b) Furosemide (Lasix)
c) Hydrochlorothiazide (Hydrodiuril)
d) Amiloride (Midamor)
034. All of the following statements regarding diuretics are true EXCEPT:
a) Furosemide (Lasix) can increase the likelihood of digitalis toxicity
b) Chlorthalidone (Hygroton) can decrease the excretion of lithium
c) Ibuprofen can increase the antihypertensive effect of chlorthalidone
d) Chlorthalidone has a longer duration of action than furosemide
035. The drug is the least potent diuretic:
a) Osmotic diuretics
b) Loop diuretics
c) Thiazide diuretics
d) Potassium-sparing diuretics
036. These agents must be given parenterally because they are not absorbed when given orally:
a) Osmotic diuretics
b) Loop diuretics
c) Thiazide diuretics
d) Potassium-sparing diuretics
037. These drugs may be used in the treatment of recurrent calcium nephrolithiasis:
a) Osmotic diuretics
b) Loop diuretics
c) Thiazide diuretics
d) Potassium-sparing diuretics
038. Furosemide (Lasix) acts at this nephron site:
a) Proximal convoluted tubule
b) Ascending thick limb of the loop of Henle
c) Distal convoluted tubule
d) Collecting duct
039. Metolazone (Mykrox) acts at this nephron site:
a) Proximal convoluted tubule
b) Ascending thick limb of the loop of Henle
c) Distal convoluted tubule
d) Collecting duct
040. Acetazolamide (Diamox) acts at this nephron site:
a) Proximal convoluted tubule
b) Ascending thick limb of the loop of Henle
c) Distal convoluted tubule
d) Collecting duct
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041. Spironolactone (Aldactone) acts at this nephron site:
a) Proximal convoluted tubule
b) Ascending thick limb of the loop of Henle
c) Distal convoluted tubule
d) Collecting duct
042. Amiloride (Midamone) acts at this nephron site:
a) Proximal convoluted tubule
b) Ascending thick limb of the loop of Henle
c) Distal convoluted tubule
d) Collecting duct
043. The drug competitively blocks chloride channels and prevents movement of sodium, potassium, and chloride into the
renal tubular cells:
a) Furosemide (Lasix)
b) Acetazolamide (Diamox)
c) Triamterene (Dyrenium)
d) Mannitol (Osmitrol)
044. The drug acts by affecting the tubular fluid composition in a non-receptor mediated fashion:
a) Furosemide (Lasix)
b) Acetazolamide (Diamox)
c) Triamterene (Dyrenium)
d) Mannitol (Osmitrol)
045. The drug is a blood substitute having haemodynamical activity:
a) Polyglucinum
b) Haemodesum
c) Sodium chloridum isotonic for injections
d) "Disolum", "Trisolum"
046. This drug is a desintoxicative plasma substitute:
a) Polyglucinum
b) Haemodesum
c) Sodium chloridum isotonic for injections
d) "Disolum", "Trisolum"
047. This drug is a controller of water-salt and acid-basic state:
a) Polyglucinum
b) Haemodesum
c) Glucose isotonic for injections
d) "Disolum", "Trisolum"

(6) CHEMOTHERAPEUTIC DRUGS

PART I ANTIBIOTICS
001. What does the term “antibiotics” mean:
a) Non-organic or synthetic substances that selectively kill or inhibit the growth of other microorganisms
b) Substances produced by some microorganisms and their synthetic analogues that selectively kill or inhibit
the growth of another microorganisms
c) Substances produced by some microorganisms and their synthetic analogues that inhibit the growth of organism cells
d) Synthetic analogues of natural substances that kill protozoa and helminthes
002. General principles of anti-infective therapy are:
a) Clinical judgment of microbiological factors
b) Definitive identification of a bacterial infection and the microorganism’s susceptibility
c) Optimal route of administration, dose, dosing frequency and duration of treatment
d) All of the above
003. Minimal duration of antibacterial treatment usually is:
a) Not less than 1 day
b) Not less than 5 days
c) Not less than 10-14 days
d) Not less than 3 weeks
004. Rational anti-microbial combination is used to:
a) Provide synergism when microorganisms are not effectively eradicated with a single agent alone
b) Provide broad coverage
c) Prevent the emergence of resistance
d) All of the above
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005. Mechanisms of bacterial resistance to anti-microbial agents are the following, EXCEPT:
a) Active transport out of a microorganism or/and hydrolysis of an agent via enzymes produced by a microorganism
b) Enlarged uptake of the drug by a microorganism
c) Modification of a drug’s target
d) Reduced uptake by a microorganism
006. The statement, that some microorganisms can develop alternative metabolic pathways for rendering reactions inhibited
by the drug, is:
a) True
b) False
007. All of the following drugs are antibiotics, EXCEPT:
a) Streptomycin
b) Penicillin
c) Co-trimoxazole
d) Chloramphenicol
008. Bactericidal effect is:
a) Inhibition of bacterial cell division
b) Inhibition of young bacterial cell growth
c) Destroying of bacterial cells
d) Formation of bacterial L-form
009. Which of the following groups of antibiotics demonstrates a bactericidal effect?
a) Tetracyclines
b) Macrolides
c) Penicillins
d) All of the above
010. Bacteristatic effect is:
a) Inhibition of bacterial cell division
b) Inhibition of young bacterial cells growth
c) Destroying of bacterial cells
d) Formation of bacterial L-form
011. Which of the following groups of antibiotics demonstrates a bacteristatic effect:
a) Carbapenems
b) Macrolides
c) Aminoglycosides
d) Cephalosporins
012. Which of the following antibiotics contains a beta-lactam ring in their chemical structure :
a) Penicillins
b) Cephalosporins
c) Carbapenems and monobactams
d) All groups
013. Tick the drug belonging to antibiotics-macrolides:
a) Neomycin
b) Doxycycline
c) Erythromycin
d) Cefotaxime
014. Tick the drug belonging to antibiotics-carbapenems:
a) Aztreonam
b) Amoxacillin
c) Imipinem
d) Clarithromycin
015. Tick the drug belonging to antibiotics-monobactams:
a) Ampicillin
b) Bicillin-5
c) Aztreonam
d) Imipinem
016. Tick the drug belongs to antibiotics-cephalosporins:
a) Streptomycin
b) Cefaclor
c) Phenoxymethilpenicillin
d) Erythromycin
017. Tick the drug belonging to lincozamides:
a) Erythromycin
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b) Lincomycin
c) Azithromycin
d) Aztreonam
018. Tick the drug belonging to antibiotics-tetracyclines:
a) Doxycycline
b) Streptomycin
c) Clarithromycin
d) Amoxacillin
019. All of antibiotics are aminoglycosides, EXCEPT:
a) Gentamycin
b) Streptomycin
c) Clindamycin
d) Neomycin
020. Tick the drug belonging to nitrobenzene derivative:
a) Clindamycin
b) Streptomycin
c) Azithromycin
d) Chloramphenicol
021. Tick the drug belonging to glycopeptides:
a) Vancomycin
b) Lincomycin
c) Neomycin
d) Carbenicillin
022. Antibiotics inhibiting the bacterial cell wall synthesis are:
a) Beta-lactam antibiotics
b) Tetracyclines
c) Aminoglycosides
d) Macrolides
023. Antibiotic inhibiting bacterial RNA synthesis is:
a) Erythromycin
b) Rifampin
c) Chloramphenicol
d) Imipinem
024. Antibiotics altering permeability of cell membranes are:
a) Glycopeptides
b) Polymyxins
c) Tetracyclines
d) Cephalosporins
025. All of the following antibiotics inhibit the protein synthesis in bacterial cells, EXCEPT:
a) Macrolides
b) Aminoglycosides
c) Glycopeptides
d) Tetracyclines
026. Biosynthetic penicillins are effective against:
a) Gram-positive and gram-negative cocci, Corynebacterium diphtheria, spirochetes, Clostridium gangrene
b) Corynebacterium diphtheria, mycobacteries
c) Gram positive cocci, viruses
d) Gram negative cocci, Rickettsia, mycotic infections
027. Which of the following drugs is a gastric acid resistant:
a) Penicillin G
b) Penicillin V
c) Carbenicillin
d) Procain penicillin
028. Which of the following drugs is penicillinase resistant:
a) Oxacillin
b) Amoxacillin
c) Bicillin-5
d) Penicillin G
029. All of the following drugs demonstrate a prolonged effect, EXCEPT:
a) Penicillin G
b) Procain penicillin
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c) Bicillin-1
d) Bicillin-5
030. Mechanism of penicillins’ antibacterial effect is:
a) Inhibition of transpeptidation in the bacterial cell wall
b) Inhibition of beta-lactamase in the bacterial cell
c) Activation of endogenous proteases, that destroy bacterial cell wall
d) Activation of endogenous phospholipases, which leads to alteration of cell membrane permeability
031. Pick out the beta-lactamase inhibitor for co-administration with penicillins:
a) Clavulanic acid
b) Sulbactam
c) Tazobactam
d) All of the above
032. Cephalosporines are drugs of choice for treatment of:
a) Gram-positive microorganism infections
b) Gram-negative microorganism infections
c) Gram-negative and gram-positive microorganism infections, if penicillins have no effect
d) Only bacteroide infections
033. Carbapenems are effective against:
a) Gram-positive microorganisms
b) Gram-negative microorganisms
c) Only bacteroide infections
d) Broad-spectum
034. All of the following antibiotics are macrolides, EXCEPT:
a) Erythromycin
b) Clarithromycin
c) Lincomycin
d) Roxythromycin
035. Tetracyclins have following unwanted effects:
a) Irritation of gastrointestinal mucosa, phototoxicity
b) Hepatotoxicity, anti-anabolic effect
c) Dental hypoplasia, bone deformities
d) All of the above
036. Tick the drug belonging to antibiotics-aminoglycosides:
a) Erythromycin
b) Gentamycin
c) Vancomycin
d) Polymyxin
037. Aminoglycosides are effective against:
a) Gram positive microorganisms, anaerobic microorganisms, spirochetes
b) Broad-spectum, except Pseudomonas aeruginosa
c) Gram negative microorganisms, anaerobic microorganisms
d) Broad-spectum, except anaerobic microorganisms and viruses
038. Aminoglycosides have the following unwanted effects:
a) Pancytopenia
b) Hepatotoxicity
c) Ototoxicity, nephrotoxicity
d) Irritation of gastrointestinal mucosa
039. Choose the characteristics of chloramphenicol:
a) Broad-spectum. Demonstrates a bactericidal effect.
b) Influences the Gram-positive microorganisms. Demonstrates a bactericidal effect.
c) Influences the Gram-negative microorganisms. Demonstrates a bactericidal effect.
d) Broad-spectum. Demonstrates a bacteristatic effect.
040. Chloramphenicol has the following unwanted effects:
a) Nephrotoxicity
b) Pancytopenia
c) Hepatotoxicity
d) Ototoxicity
041. Choose the characteristics of lincozamides:
a) Broad-spectum. Demonstrates a bactericidal effect.
b) Influence mainly the anaerobic organisms, Gram negative cocci.
c) Broad-spectum. Demonstrates a bacteristatic effect.
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d) Influence mainly the anaerobic organisms, Gram positive cocci.
042. Lincozamides have the following unwanted effect:
a) Nephrotoxicity
b) Cancerogenity
c) Pseudomembranous colitis
d) Irritation of respiratory organs
043. Choose the characteristics of vancomicin:
a) It is a glycopeptide, inhibits cell wall synthesis active only against Gram-negative bacteria
b) It is a glycopeptide, that alters permeability of cell membrane and is active against anaerobic bacteria
c) It is a beta-lactam antibiotic, inhibits cell wall synthesis active only against Pseudomonas aeruginosa
d) It is a glycopeptide, inhibits cell wall synthesis and is active only against Gram-positive bacteria.
044. Vancomicin has the following unwanted effects:
a) Pseudomembranous colitis
b) Hepatotoxicity
c) “Red neck” syndrome, phlebitis
d) All of the above
045. Which of the following drugs is used for systemic and deep mycotic infections treatment:
a) Co-trimoxazol
b) Griseofulvin
c) Amphotericin B
d) Nitrofungin
046. Which of the following drugs is used for dermatomycosis treatment:
a) Nystatin
b) Griseofulvin
c) Amphotericin B
d) Vancomycin
047. Which of the following drugs is used for candidiasis treatment:
a) Griseofulvin
b) Nitrofungin
c) Myconazol
d) Streptomycin
048. All of the following antifungal drugs are antibiotics, EXCEPT:
a) Amphotericin B
b) Nystatin
c) Myconazol
d) Griseofulvin
049. Mechanism of Amphotericin B action is:
a) Inhibition of cell wall synthesis
b) Inhibition of fungal protein synthesis
c) Inhibition of DNA synthesis
d) Alteration of cell membrane permeability
050. Azoles have an antifungal effect because of:
a) Inhibition of cell wall synthesis
b) Inhibition of fungal protein synthesis
c) Reduction of ergosterol synthesis
d) Inhibition of DNA synthesis
051. Which of the following drugs alters permeability of Candida cell membranes:
a) Amphotericin B
b) Ketoconazole
c) Nystatin
d) Terbinafine
052. Amfotericin B has the following unwanted effects:
a) Psychosis
b) Renal impairment, anemia
c) Hypertension, cardiac arrhythmia
d) Bone marrow toxicity
053. Tick the drug belonging to antibiotics having a polyene structure:
a) Nystatin
b) Ketoconazole
c) Griseofulvin
d) All of the above
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054. All of the following drugs demonstrate a fungicidal effect, EXCEPT:
a) Terbinafin
b) Amfotericin B
c) Ketoconazole
d) Myconazol
055. Characteristics of polyenes are following, except:
a) Alter the structure and functions of cell membranes
b) Broad-spectrum
c) Fungicidal effect
d) Nephrotoxicity, hepatotoxicity
056. Characteristics of Amfotericin B are following, EXCEPT:
a) Used for systemic mycosis treatment
b) Poor absorption from the gastro-intestinal tract
c) Does not demonstrate nephrotoxicity
d) Influences the permeability of fungus cell membrane

PART II SYNTHETIC ANTIBACTERIAL DRUGS


001. Sulfonamides are effective against:
a) Bacteria and Chlamidia
b) Actinomyces
c) Protozoa
d) All of the above
002. Mechanism of sulfonamides’ antibacterial effect is:
a) Inhibition of dihydropteroate reductase
b) Inhibition of dihydropteroate synthase
c) Inhibition of cyclooxygenase
d) Activation of DNA gyrase
003. Combination of sulfonamides with trimethoprim:
a) Decreases the unwanted effects of sulfonamides
b) Increases the antimicrobial activity
c) Decreases the antimicrobial activity
d) Increases the elimination of sulfonamides
004. Sulfonamide potency is decreased in case of co-administration with:
a) Oral hypoglycemic agents
b) Local anesthetics – derivatives of paraaminobenzoic acid
c) Local anesthetics – derivatives of benzoic acid
d) Non-narcotic analgesics
005. The following measures are necessary for prevention of sulfonamide precipitation and crystalluria:
a) Taking of drinks with acid pH
b) Taking of drinks with alkaline pH
c) Taking of saline drinks
d) Restriction of drinking
006. Resorptive sulfonamides have the following unwanted effects on blood system:
a) Hemolytic anemia
b) Thrombocytopenia
c) Granulocytopenia
d) All of the above
007. Mechanism of Trimethoprim’ action is:
a) Inhibition of cyclooxygenase
b) Inhibition of dihydropteroate reductase
c) Inhibition of dihydropteroate synthase
d) Inhibition of DNA gyrase
008. Sulfonamides have the following unwanted effects:
a) Hematopoietic disturbances
b) Crystalluria
c) Nausea, vomiting and diarrhea
d) All of the above
009. Tick the drug, which is effective against mycobacteria only:
a) Isoniazid
b) Streptomycin
c) Rifampin
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d) Kanamycin
010. Tick the antimycobacterial drug belonging to first-line agents:
a) PAS
b) Isoniazid
c) Kanamycin
d) Pyrazinamide
011. Tick the antimycobacterial drug, belonging to second-line agents:
a) Isoniazid
b) PAS
c) Rifampin
d) Streptomycin
012. Tick the antimycobacterial drug, belonging to antibiotics:
a) Isoniazid
b) PAS
c) Ethambutol
d) Rifampin
013. Tick the antimycobacterial drug – hydrazide of isonicotinic acid:
a) Rifampin
b) Isoniazid
c) Ethambutol
d) Pyrazinamide
014. Mechanism of Izoniazid action is:
a) Inhibition of protein synthesis
b) Inhibition of mycolic acids synthesis
c) Inhibition of RNA synthesis
d) Inhibition of ADP synthesis
015. Mechanism of Rifampin action is:
a) Inhibition of mycolic acids synthesis
b) Inhibition of DNA dependent RNA polymerase
c) Inhibition of topoisomerase II
d) Inhibition of cAMP synthesis
016. Mechanism of Cycloserine action is:
a) Inhibition of mycolic acids synthesis
b) Inhibition of RNA synthesis
c) Inhibition of cell wall synthesis
d) Inhibition of pyridoxalphosphate synthesis
017. Mechanism of Streptomycin action is:
a) Inhibition of cell wall synthesis
b) Inhibition of protein synthesis
c) Inhibition of RNA and DNA synthesis
d) Inhibition of cell membranes permeability
018. Rifampin has the following unwanted effect:
a) Dizziness, headache
b) Loss of hair
c) Flu-like syndrome, tubular necrosis
d) Hepatotoxicity
019. Isoniazid has following unwanted effect:
a) Cardiotoxicity
b) Hepatotoxicity, peripheral neuropathy
c) Loss of hair
d) Immunotoxicity
020. Ethambutol has the following unwanted effect:
a) Cardiotoxicity
b) Immunetoxicity
c) Retrobulbar neuritis with red-green color blindness
d) Hepatotoxicity
021. Streptomycin has the following unwanted effect:
a) Cardiotoxicity
b) Hepatotoxicity
c) Retrobulbar neuritis with red-green color blindness
d) Ototoxicity, nephrotoxicity
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022. Mechanism of aminosalicylic acid action is:
a) Inhibition of mycolic acids synthesis
b) Inhibition of folate synthesis
c) Inhibition of DNA dependent RNA polymerase
d) Inhibition of DNA gyrase
023. All of the following agents are the first-line antimycobacterial drugs, EXCEPT:
a) Rifampin
b) Pyrazinamide
c) Isoniazid
d) Streptomycin
024. All of the following antimycobacterial drugs have a bactericidal effect, EXCEPT:
a) Pyrazinamide
b) Streptomycin
c) Rifampin
d) Isoniazid
025. Combined chemotherapy of tuberculosis is used to:
a) Decrease mycobacterium drug-resistance
b) Increase mycobacterium drug-resistance
c) Decrease the antimicrobal activity
d) Decrease the onset of antimycobacterial drugs biotransformation:
026. Tick the antibacterial drug – a nitrofurane derivative:
a) Nitrofurantoin
b) Trimethoprim
c) Ciprofloxacin
d) Nystatin
027. Tick the antibacterial drug – a nitroimidazole derivative:
a) Clavulanic acid
b) Metronidazole
c) Nitrofurantoin
d) Doxycycline
028. Tick the antibacterial drug – a quinolone derivative:
a) Nitrofurantoin
b) Nalidixic acid
c) Streptomycin
d) Metronidazole
029. Tick the antibacterial drug – a fluoroquinolone derivative:
a) Chloramphenicol
b) Nitrofurantoin
c) Nalidixic acid
d) Ciprofloxacin
030. Tick the indications for nitrofuranes:
a) Infections of respiratory tract
b) Infections of urinary and gastro-intestinal tracts
c) Syphilis
d) Tuberculosis
031. Tick the unwanted effects of nitrofuranes:
a) Nausea, vomiting
b) Allergic reactions
c) Hemolytic anemia
d) All of the above
032. Tick the indications for Metronidazole:
a) Intra-abdominal infections, vaginitis, enterocolitis
b) Pneumonia
c) As a disinfectant
d) Influenza
033. Tick the unwanted effects of Metronidazole:
a) Nausea, vomiting, diarrhea, stomatitis
b) Hypertension
c) Disturbances of peripheral blood circulation
d) All of the above
034. The mechanism of fluoroquinolones’ action is:
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a) Inhibition of phospholipase C
b) Inhibition of DNA gyrase
c) Inhibition of bacterial cell synthesis
d) Alteration of cell membrane permeability
035. Fluoroquinolones are active against:
a) Gram negative microorganisms only
b) Mycoplasmas and Chlamidiae only
c) Gram positive microorganisms only
d) Variety of Gram-negative and positive microorganisms, including Mycoplasmas and Chlamidiae
036. Tick the unwanted effects of fluoroquinolones:
a) Hallucinations
b) Headache, dizziness, insomnia
c) Hypertension
d) Immunetoxicity
037. Tick the indications for fluoroquinolones:
a) Infections of the urinary tract
b) Bacterial diarrhea
c) Infections of the urinary and respiratory tract, bacterial diarrhea
d) Respiratory tract infections
038. The drug of choice for syphilis treatment is:
a) Gentamycin
b) Penicillin
c) Chloramphenicol
d) Doxycycline

PART III ANTIPROTOZOAL AND ANTHELMINTIC DRUGS


001. Tick the drug used for malaria chemoprophylaxis and treatment:
a) Chloroquine
b) Quinidine
c) Quinine
d) Sulfonamides
002. Tick the drug used for amoebiasis treatment:
a) Nitrofurantoin
b) Iodoquinol
c) Pyrazinamide
d) Mefloquine
003. Tick the drug used for trichomoniasis treatment:
a) Metronidazole
b) Suramin
c) Pyrimethamine
d) Tetracycline
004. Tick the drug used for toxoplasmosis treatment:
a) Chloroquine
b) Tetracyclin
c) Suramin
d) Pyrimethamine
005. Tick the drug used for balantidiasis treatment::
a) Azitromycin
b) Tetracycline
c) Quinine
d) Trimethoprim
006. Tick the drug used for leishmaniasis treatment:
a) Pyrimethamine
b) Albendazole
c) Sodium stibogluconate
d) Tinidazole
007. Tick the antimalarial drug belonging to 8-aminoquinoline derivatives:
a) Doxycycline
b) Quinidine
c) Primaquine
d) Chloroquine
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008. All of the following antimalarial drugs are 4-quinoline derivatives, EXCEPT:
a) Chloroquine
b) Mefloquine
c) Primaquine
d) Amodiaquine
009. Tick the antimalarial drug belonging to pyrimidine derivatives:
a) Mefloquine
b) Pyrimethamine
c) Quinidine
d) Chloroquine
010. Tick the drug used for trypanosomosis treatment:
a) Melarsoprol
b) Metronidazole
c) Tetracyclin
d) Quinidine
011. Tick the antimalarial drug having a gametocidal effect:
a) Mefloquine
b) Primaquine
c) Doxycycline
d) Sulfonamides
012. All of the following antimalarial drugs influence blood schizonts, EXCEPT:
a) Mefloquine
b) Chloroquine
c) Primaquine
d) Quinidine
013. Tick the antimalarial drug influencing tissue schisonts:
a) Mefloquine
b) Chloroquine
c) Quinidine
d) Primaquine
014. Tick the group of antibiotics having an antimalarial effect:
a) Aminoglycosides
b) Tetracyclins
c) Carbapenems
d) Penicillins
015. Tick the amebecide drug for the treatment of an asymptomatic intestinal form of amebiasis:
a) Chloroquine
b) Diloxanide
c) Emetine
d) Doxycycline
016. Tick the drugs for the treatment of an intestinal form of amebiasis:
a) Metronidazole and diloxanide
b) Diloxanide and streptomycin
c) Diloxanide and Iodoquinol
d) Emetine and metronidazole
017. Tick the drug for the treatment of a hepatic form of amebiasis:
a) Diloxanide or iodoquinol
b) Tetracycline or doxycycline
c) Metronidazole or emetine
d) Erythromycin or azitromycin
018. Tick the luminal amebecide drug:
a) Metronidazole
b) Emetine
c) Doxycycline
d) Diloxanide
019. Tick the drug of choice for the treatment of extraluminal amebiasis:
a) Iodoquinol
b) Metronidazole
c) Diloxanide
d) Tetracycline
020. Tick the drug, blocking acetylcholine transmission at the myoneural junction of helminthes:
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a) Levamisole
b) Mebendazole
c) Piperazine
d) Niclosamide
021. Tick niclosamide mechanism of action:
a) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and death of helminthes
b) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes
c) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake
d) Inhibiting oxidative phosphorylation in some species of helminthes
022. Tick praziquantel mechanism of action:
a) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes
b) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake
c) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and death of
helminthes
d) Inhibiting oxidative phosphorylation in some species of helminthes
023. Tick piperazine mechanism of action:
a) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake
b) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes
c) Inhibiting oxidative phosphorylation in some species of helminthes
d) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and death of helminthes
024. Tick the drug, a salicylamide derivative:
a) Praziquantel
b) Piperazine
c) Mebendazole
d) Niclosamide
025. Tick mebendazole mechanism of action:
a) Inhibiting oxidative phosphorylation in some species of helminthes
b) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and death of helminthes
c) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake
d) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes
026. Tick the drug, inhibiting oxidative phosphorylation in some species of helminthes:
a) Niclosamide
b) Piperazine
c) Praziquantel
d) Mebendazole
027. Tick the drug for neurocysticercosis treatment:
a) Praziquantel
b) Pyrantel
c) Piperazine
d) Bithionol
028. Tick the drug for nematodosis (roundworm invasion) treatment:
a) Niclosamide
b) Praziquantel
c) Bithionol
d) Pyrantel
029. Tick the drug for cestodosis (tapeworm invasion) treatment:
a) Piperazine
b) Praziquantel
c) Pyrantel
d) Ivermectin
030. Tick the drug for trematodosis (fluke invasion) treatment:
a) Bithionol
b) Ivermectin
c) Pyrantel
d) Metronidazole
031. Tick the drug, a benzimidazole derivative:
a) Praziquantel
b) Mebendazole
c) Suramin
d) Pyrantel
032. Tick the broad spectrum drug for cestodosis, trematodosis and cycticercosis treatment:
135
a) Piperazine
b) Ivermectine
c) Praziquantel
d) Pyrantel
033. Tick the drug for ascaridosis and enterobiosis treatment:
a) Bithionol
b) Pyrantel
c) Praziquantel
d) Suramin
034. Tick the drug for strongiloidosis treatment:
a) Niclosamide
b) Praziquantel
c) Bithionol
d) Ivermectin
035. Tick the drug for echinococcosis treatment:
a) Suramin
b) Mebendazole or Albendazole
c) Piperazine
d) Iodoquinol

PART IV ANTIVIRAL AGENTS. AGENTS FOR CHEMOTHERAPY OF CANCER


001. All of the following antiviral drugs are the analogs of nucleosides, EXCEPT:
a) Acyclovir
b) Zidovudine
c) Saquinavir
d) Didanozine
002. Tick the drug, a derivative of adamantane:
a) Didanozine
b) Rimantadine
c) Gancyclovir
d) Foscarnet
003. Tick the drug, a derivative of pyrophosphate:
a) Foscarnet
b) Zidovudine
c) Vidarabine
d) Acyclovir
004. Tick the drug, inhibiting viral DNA synthesis:
a) Interferon
b) Saquinavir
c) Amantadine
d) Acyclovir
005. Tick the drug, inhibiting uncoating of the viral RNA:
a) Vidarabine
b) Rimantadine
c) Acyclovir
d) Didanozine
006. Tick the drug, inhibiting viral reverse transcriptase:
a) Zidovudine
b) Vidarabine
c) Rimantadine
d) Gancyclovir
007. Tick the drug, inhibiting viral proteases:
a) Rimantadine
b) Acyclovir
c) Saquinavir
d) Zalcitabine
008. Tick the drug of choice for herpes and cytomegalovirus infection treatment:
a) Saquinavir
b) Interferon alfa
c) Didanozine
d) Acyclovir
136
009. Tick the drug which belongs to nonnucleoside reverse transcriptase inhibitors:
a) Zidovudine
b) Vidarabine
c) Nevirapine
d) Gancyclovir
010. All of the following antiviral drugs are antiretroviral agents, EXCEPT:
a) Acyclovir
b) Zidovudine
c) Zalcitabine
d) Didanozine
011. Tick the drug used for influenza A prevention:
a) Acyclovir
b) Rimantadine
c) Saquinavir
d) Foscarnet
012. Tick the drug used for HIV infection treatment, a derivative of nucleosides:
a) Acyclovir
b) Zidovudine
c) Gancyclovir
d) Trifluridine
013. Tick the antiviral drug which belongs to endogenous proteins:
a) Amantadine
b) Saquinavir
c) Interferon alfa
d) Pencyclovir
014. Tick the drug which belongs to nucleoside reverse transcriptase inhibitors:
a) Didanosine
b) Gancyclovir
c) Nevirapine
d) Vidarabine
015. All of the following antiviral drugs are anti-influenza agents, EXCEPT:
a) Acyclovir
b) Amantadine
c) Interferons
d) Rimantadine
016. Tick the unwanted effects of zidovudine:
a) Hallucinations, dizziness
b) Anemia, neutropenia, nausea, insomnia
c) Hypertension, vomiting
d) Peripheral neuropathy
017. Tick the unwanted effects of intravenous acyclovir infusion:
a) Renal insufficiency, tremors, delerium
b) Rash, diarrhea, nausea
c) Neuropathy, abdominal pain
d) Anemia, neutropenia, nausea, insomnia
018. Tick the drug that can induce peripheral neuropathy and oral ulceration:
a) Acyclovire
b) Zalcitabine
c) Zidovudine
d) Saquinavir
019. Tick the unwanted effects of didanozine:
a) Hallucinations, dizziness, insomnia
b) Anemia, neutropenia, nausea
c) Hypertension, vomiting, diarrhea
d) Peripheral neuropathy, pancreatitis, diarrhea, hyperuricemia
020. Tick the unwanted effects of indinavir:
a) Hypotension, vomiting, dizziness
b) Nephrolithiasis, nausea, hepatotoxicity
c) Peripheral neuropathy, pancreatitis, hyperuricemia
d) Anemia, neutropenia, nausea
021. Tick the drug that can induce nausea, diarrhea, abdominal pain and rhinitis:
137
a) Acyclovire
b) Zalcitabine
c) Zidovudine
d) Saquinavir
022. All of the following effects are disadvantages of anticancer drugs, EXCEPT:
a) Low selectivity to cancer cells
b) Depression of bone marrow
c) Depression of angiogenesis
d) Depression of immune system
023. Rational combination of anticancer drugs is used to:
a) Provide synergism resulting from the use of anticancer drugs with different mechanisms combination
b) Provide synergism resulting from the use of anticancer drugs with the same mechanisms combination
c) Provide stimulation of immune system
d) Provide stimulation of cell proliferation
024. Tick the anticancer alkylating drug, a derivative of chloroethylamine:
a) Methotrexate
b) Cisplatin
c) Cyclophosphamide
d) Carmustine
025. Tick the anticancer alkylating drug, a derivative of ethylenimine:
a) Mercaptopurine
b) Thiotepa
c) Chlorambucil
d) Procarbazine
026. Tick the group of hormonal drugs used for cancer treatment:
a) Mineralocorticoids and glucocorticoids
b) Glucocorticoids and gonadal hormones
c) Gonadal hormones and somatotropin
d) Insulin
027. Tick the anticancer alkylating drug, a derivative of alkylsulfonate:
a) Fluorouracil
b) Carboplatin
c) Vinblastine
d) Busulfan
028. Tick the anticancer drug of plant origin:
a) Dactinomycin
b) Vincristine
c) Methotrexate
d) Procarbazine
029. Action mechanism of alkylating agents is:
a) Producing carbonium ions altering protein structure
b) Producing carbonium ions altering DNA structure
c) Structural antagonism against purine and pyrimidine
d) Inhibition of DNA-dependent RNA synthesis
030. Tick the anticancer drug, a pyrimidine antagonist:
a) Fluorouracil
b) Mercaptopurine
c) Thioguanine
d) Methotrexate
031. Methotrexate is:
a) A purine antagonist
b) A folic acid antagonist
c) An antibiotic
d) An alkylating agent
032. Tick the antibiotic for cancer chemotherapy:
a) Cytarabine
b) Doxorubicin
c) Gentamycin
d) Etoposide
033. Fluorouracil belongs to:
a) Antibiotics
138
b) Antimetabolites
c) Plant alkaloids
d) Bone marrow growth factor
034. Tick the action mechanism of anticancer drugs belonging to plant alkaloids:
a) Inhibition of DNA-dependent RNA synthesis
b) Cross-linking of DNA
c) Mitotic arrest at a metaphase
d) Nonselective inhibition of aromatases
035. General contraindications for anticancer drugs are:
a) Depression of bone marrow
b) Acute infections
c) Severe hepatic and/or renal insufficiency
d) All of the above
036. Action mechanism of methotrexate is:
a) Inhibition of dihydrofolate reductase
b) Activation of cell differentiation
c) Catabolic depletion of serum asparagine
d) All of the above
037. Tick the anticancer drug belonging to inorganic metal complexes:
a) Dacarbazine
b) Cisplatin
c) Methotrexate
d) Vincristine
038. Tick the indication for estrogens in oncological practice:
a) Leukemia
b) Cancer of prostate
c) Endometrial cancer
d) Brain tumors
039. Enzyme drug used for acute leukemia treatment:
a) Dihydrofolate reductase
b) Asparaginase
c) Aromatase
d) DNA gyrase
040. All of the following drugs are derivatives of nitrosoureas, EXCEPT:
a) Carmustine
b) Vincristine
c) Lomustine
d) Semustine
041. Tick the group of drugs used as subsidiary medicines in cancer treatment:
a) Cytoprotectors
b) Bone marrow growth factors
c) Antimetastatic agents
d) All of the above
042. Tick the estrogen inhibitor:
a) Leuprolide
b) Tamoxifen
c) Flutamide
d) Anastrozole
043. Tick the antiandrogen drug:
a) Flutamide
b) Aminoglutethimide
c) Tamoxifen
d) Testosterone
044. Tick the drug belonging to aromatase inhibitors:
a) Octreotide
b) Anastrozole
c) Flutamide
d) Tamoxifen
045. Tick the drug belonging to gonadotropin-releasing hormone agonists:
a) Leuprolide
b) Tamoxifen
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c) Flutamide
d) Anastrozole
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Module:

1. The drug acts by competitively blocking the NaCl cotransporter:

Loop diuretics

Thiazide diuretics

Potassium-sparing diuretics

Carbonic anhydrase inhibitors

2. Choose the drug which is a H2-receptor antagonist:

Omeprazole

Pirenzepine

Carbenoxolone

Ranitidine

3. Select the side-effect characteristic for non-selective beta2-adrenomimics:

Depression of the breathing center

Tachycardia

Peripheral vasoconstriction

Dry mouth

4. All of the following statements regarding cardiac glycosides are true EXCEPT:

They inhibit the Na+/K+-ATPase and thereby increase intracellular Ca++ in myocardial cells

They cause a decrease in vagal tone

Children tolerate higher doses of digitalis than do adults

The most frequent cause of digitalis intoxication is concurrent administration of diuretics that
deplete K

5. All of the following drugs are proton pump inhibitors EXCEPT:

Pantoprozole

Omeprazole

Famotidine

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Rabeprazole

6. Tick out the drug belonging to non-narcotic antitussives:

Libexine

Tusuprex

Codeine

Aethylmorphine hydrochloride

7. Which of the following M-cholinoblocking agents is used especially as an anti-asthmatic?

Atropine

Ipratropium

Platiphylline

Metacin

8. This drug is a directly acting vasodilator:

Labetalol

Clonidine

Enalapril

Nifedipine

9. The drug acts at the proximal tubule:

Loop diuretics

Thiazide diuretics

Potassium-sparing diuretics

Carbonic anhydrase inhibitors

10. Tolerance to this inotropic drug develops after a few days:

Amrinone

Amiodarone

Dobutamine

Adenosine

11. Pick out the bronchodilator drug related to xanthine:

Atropine
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Orciprenaline

Adrenaline

Theophylline

12. Which of the following nitrates and nitrite drugs is a short-acting drug?

Nitroglycerin, 2% ointment (Nitrol)

Nitroglycerin, oral sustained-release (Nitrong)

Amyl nitrite, inhalant (Aspirols, Vaporole)

Sustac

13. All of the following statements concerning the use of angiotensin-converting enzyme (ACE)
inhibitors in the treatment of heart failure are true EXCEPT:

They improve hemodynamics by decreasing afterload

They can increase plasma cholesterol levels

They may slow the progression of heart failure by preventing myocardial and vascular remodeling

They are effective rst-line agents in the treatment of chronic heart failure

14. Sustained use of this drug results in increased plasma urate concentrations:

Furosemide (Lasix)

Acetazolamide (Diamox)

Both of the above

Neither of the above

15. Indicate the drug belonging to antitussives of narcotic type of action:

Glaucine hydrochloride

Aethylmorphine hydrochloride

Tusuprex

Libexine

16. Most of drugs are antacids EXCEPT:

Misoprostol

Maalox

Mylanta

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Almagel

17. This drug is an inhibitor of renin synthesis:

Propranolol

Enalapril

Diazoxide

Losartan

18. Which of the following statements concerning nitrate mechanism of action is True?

Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in to
vascular smooth muscle target tissues

Nitric oxide (NO) is an effective activator of soluble guanylyl cyclase and probably acts mainly
through this mechanism

Nitrates useful in angina decrease myocardial oxygen requirement (by decreasing the
determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing
coronary arterial spasm)

All of the above

19. Angina pectoris is:

Severe constricting chest pain, often radiating from the precordium to the left shoulder and down
the arm, due to insu cient blood supply to the heart that is usually caused by coronary disease

An often fatal form of arrhythmia characterized by rapid, irregular brillar twitching of the
ventricles of the heart instead of normal contractions, resulting in a loss of pulse

The cardiovascular condition in which the heart ability to pump blood weakens

All of the above

20. Select the emetic agent having a re ex action:

Ipecacuanha derivatives

Apomorphine hydroclorid

Chlorpromazine

Metoclopramide

21. All of the following statements regarding cardiac glycoside-induced ventricular


tachyarrhythmias are true EXCEPT:

Lidocaine is a drug of choice in treatment

Digibind should be used in life-threatening cases

They occur more frequently in patients with hyperkalemia than in those with hypokalemia

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They are more likely to occur in patients with a severely damaged heart

22. Tick the drug belonging to non-selective beta2-adrenomimics:

Salbutamol

Isoprenaline

Salmeterol

Terbutaline

23. Select the drug which inhibits peristalsis:

Castor oil

Bisacodyl

Loperamide

Sorbitol

24. The drug acts by competitively blocking NaCl cotransporters in the distal tubule:

Acetazolamide (Diamox)

Furosemide (Lasix)

Hydrochlorothiazide (HydroDiuril)

Spironolactone (Aldactone)

25. The following agents are cardioselective beta1-adrenoceptor-blocking drugs labeled for use in
angina, EXCEPT:

Metoprolol

Talinolol

Atenolol

Propranolol

26. Choose the unwanted effects of clonidine:

Parkinson’s syndrome

Sedative and hypnotic effects

Agranulocytosis and aplastic anemia

Dry cough and respiratory depression

27. This drug inhibits the angiotensin-converting enzyme:

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Captopril

Enalapril

Ramipril

All of the above

28. This drug inhibits breakdown of cAMP in vascular smooth muscle:

Digoxin

Dobutamine

Amrinone

Dopamine

29. Indicate the expectorant with the re ex mechanism:

Sodium benzoate

Derivatives of Ipecacucnha and Thermopsis

Trypsin

Ambroxol

30. All of the following drugs are antiemetics EXCEPT:

Metoclopramide

Ondansetron

Chlorpromazine

Apomorphine hydrochloride

31. Choose the drug that causes constipation:

Sodium bicarbonate

Aluminium hydroxide

Calcium carbonate

Magnesium oxide

32. Which of the following antianginal agents refers to re ex coronary dilators:

Dipyridamole

Validol

Atenolol

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Alinidine

Total questions: 40; Correctly answered: 27; correct incorrect skipped


Percentage of correct: 67.5%; Skipped question: 0;
33. All of the following drugs destroy disul de bonds ofanswer answer
proteoglycans, which causes question
Assessment: fair and reduction of viscosity of sputum, EXCEPT:
depolymerization

Acetylcysteine

Ambroxol

Desoxiribonuclease

Bromhexin

34. Pick out the sympatholythic drug:

Labetalol

Prazosin

Guanethidine

Clonidine

35. The drug should never be administered to patients taking potassium supplements:

Hydrochlorothiazide (HydroDiuril)

Amiloride (Midamor)

Furosemide (Lasix)

Neither of the above

36. Tick the antitussive agent with a peripheral effect:

Codeine

Tusuprex

Libexine

Glaucine hydrochloride

37. Choose the vasodilator which releases NO:

Nifedipine

Hydralazine

Minoxidil

Sodium nitroprusside

38. This drug group useful in angina increase myocardial oxygen delivery (by reversing coronary
arterial spasm) and does not decrease myocardial oxygen requirement (by decreasing the

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determinations of oxygen demand):

Beta-adrenoceptor-blocking drugs (Atenolol, Metoprolol)

Myotropic coronary dilators (Dipyridamole)

Calcium channel blockers (Nifedipine, Nimodipine)

Potassium channel openers (Minoxidil)

39. All of the following statements regarding verapamil are true EXCEPT:

It blocks L-type calcium channels

It increases heart rate

It relaxes coronary artery smooth muscle

It depresses cardiac contractility

40. Which of the following antianginal agents is a calcium channel blocker?

Nitroglycerin

Dipyridamole

Minoxidil

Nifedipine

Test System1

test.edu.kg/s/modules/ 8/8
GENERAL PHARMACOLOGY

1. All of the following are general mechanisms of drug permeation Except

A. Aqueous diffusion

B. Aqueous hydrolysis+

C. Lipid diffusion

D. Pinocytosis or endocytosis

2. If the plasma concentration of a drug declines with “first-order kinetics”, this means that

A. There is only one metabolic path for drug disposition

B. The half-life is the same regardless of the plasma concentration+

C. The drug is largely metabolized in the liver after oral administration and has low
bioavailability elimination

D. The rate of elimination is proportionate to the rate of administration at all times

3. Regarding termination of drug action

A. Drug must be exerted from the body to terminate their action

B. Metabolism of drugs always increases their water solubility

C. Metabolism of drugs always abolishes their pharmacologic activity

D. Hepatic metabolism and renal excretion are the two most important mechanisms involved +

4. Distribution of drugs to specific tissues

A. Is independent of blood flow to the organ

B. Is independent of the solubility of the drug in that tissue

C. Depends on the unbound drug concentration gradient between blood and tissue+

D. Is increased for drugs that are strongly bound to plasma proteins


5. A physical process by which a weak acid becomes less water-soluble and more lipid-
soluble at low ph is

A. Distribution

B Elimination

C. First pass- effect

D. Protonation+

6. Dose-response curves are used for drug evaluation in the animal laboratory and in the
clinic, Quantal dose-response curves are often

A. Used for determining the therapeutic index of a drug+

B. Used for determining the maximal efficacy of a drug

C. Invalid in the presence of inhibitors of the drug being studied

D. Obtained from the study of intact subject but not from isolated tissue preparations

7. The following are excreted faster in basic urine

A. Weak acids+

B. Strong acids

C. Weak Bases

D. None of the above

8. Which of the following statements about spare receptors is most correct ?

A. Spare receptors, in the absence of drug, are sequestered in the cytoplasm

B. Spare receptors will be detected if the intracellular effect of drug-receptor interaction lasts
longer than the drug-receptor interaction itself +

C. Spare receptors influence the maximal efficacy of the drug-receptor system

D. Spare receptors activate the effector machinery of the cell without the need for a drug
9. Which of the following terms best describes an antagonist that interacts directly with the
agonist and not at all or only incidentally, with the receptor

A. Pharmacological antagonist

B. Partial agonist

C. Physiological antagonist

D. Chemical antagonist+

10. Which of the following terms best describes a drug that blocks the action of epinephrine
at its receptors by occupying those receptors without activating them

A. Pharmacological antagonist+

B. Partial agonist

C. Physiological antagonist

D. Chemical antagonist

11. Which of the following provides information about the variation in sensitivity of the
drug within the population studied

A. Maximal efficacy

B. Therapeutic index

C. Drug potency

D. Quantal dose-response curve +

12. Which of the following most accurately describes the transmembrane signaling process
involved in steroid hormone action

A. Action on a membrane spanning tyrosine kinase

B. Activation of a G protein which activates or inhibits adenyl cyclase

C. Diffusion into the cytoplasm and binding to an intracellular receptor +

D. Diffusion of “STAT” molecules across the Membrane


13. Which of the following is a phase II drug metabolizing reaction

A. Acetylation +

B. Deamination

C. Hydrolysis

D. Oxidation

14. Which of the following drugs may inhibit the hepatic microsomal P450 responsible for
warfarin metabolism

A. Cimetidine +

B. Ethanol

C. Phenobarbital

D. Procainamide

15. With regard to clinical trials of new drugs, which of the following is most correct

A. Phase I involves the study of a small number of normal volunteers by highly trained clinical
pharmacologists +

B. Phase II involves the use of the new drug in a large number of patients (100-5000) who have
the disease to be treated

C. Phase III involves the determination of the drug’s therapeutic index by the cautious induction
of toxicity

D. Chemical antagonist

16. Animal testing of potential new therapeutic agents

A. Extends over a time period of at least 3 years in order to discover late toxicities +

B. Requires the use of at least two primate species, e.g. Monkey and baboon

C. Requires the submission of histopathologic slides and specimens to the FDA for government
evaluation
D. Has good predictability for drug allergy-type reactions

17. The “dominant lethal” test involves the treatment of a male adult animal with a
chemical before mating; the pregnant female is later examined for fetal death and
abnormalities. The dominant lethal test therefore is a test of

A. Teratogenicity

B. Mutagenicity +

C. Carcinogenicity

D. All of the above

18. The Ames test is a method for detecting

A. Carcinogenesis in rodents

B. Carcinogenesis in primates

C. Teratogenesis in any mammalian species

D. Mutagenesis in bacteria +

19. “Nicotinic” sites include all of the following except

A. Bronchial smooth muscle +

B. Adrenal medullary cells

C. Parasympathetic ganglia

D. Skeletal muscle

20. A good example of chemical antagonism

A. Heparin & Protamine +

B. Protamine & Zinc

C. Heparin & Prothrombin

D. All the above


21. Which of the following agents is a prodrug that is much less toxic in mammals than in
insects

A. Acetylcholine +

B. Bethanechol

C. Physostigmine

D. Pilocarpine

22. Phenylephrine causes

A. Constriction of vessels in the nasal mucosa +

B. Increased gastric secretion and motility

C. Increased skin temperature

D. Miosis

23. Pretreatment with propranolol will block which one of the following

A. Methacholine-induced tachycardia +

B. Nicotine-induced hypertension

C. Norepinephrine-induced bradycardia

D. Phenylephrine-induced mydriasis

24. Most drug receptors are

A. Small molecules with a molecular weight between 100 and 1000

B. Lipids arranged in a bilayer configuration

C. Proteins located on cell membranes or in the cytosol +

D. DNA molecules

25. With regard to distribution of a drug from the blood into tissues

A. Blood flow to the tissue is an important determinant


B. Solubility of the drug in the tissue is an important determinant

C. Concentration of the drug in the blood is an important determinant

D. All of the above are important determinants +

26. The pH value is calculated mathematically as the

A. Log of the hydroxyl ion (OH–) concentration

B. Negative log of the OH– concentration

C. Log of the hydrogen ion (H+) concentration

D. Negative log of the H+ concentration+

27. Which property is classified as colligative?

A. Solubility of a solute

B. Osmotic pressure +

C. Hydrogen ion (H+) concentration

D. Dissociation of a solute

28. The colligative properties of a solution are related to the

A. pH of the solution

B. Number of ions in the solution

C. Total number of solute particles in the solution +

D. Number of unionized molecules in the solution

29. The pH of a buffer system can be calculated with the

A. Noyes – Whitney equation

B. Henderson – Hasselbalch equation +

C. Michaelis – Menten equation

D. Yong equation
30. Which mechanism is most often responsible for chemical degradation?

A. Racemization

B. Photolysis

C. Hydrolysis +

D. Decarboxylation

31. Which equation is used to predict the stability of a drug product at room temperature
from experiments at accelerated temperature?

A. The stokes equation

B. The Yong equation

C. The Arrhenius equation +

D. The Michaelis – Menten equation

32. Based on the relation between the degree of ionization and the solubility of a weak acid,
the drug aspirin (pKa 3.49) will be most soluble at

A. pH 1.0

B. pH 2.0

C. pH 3.0

D. pH 6.0 +

33. The particle size of the dispersed solid in a suspension is usually greater than

A. 0.5 µm +

B. 0.4 µm

C. 0.3 µm

D. 0.2 µm

34. In the extemporaneous preparation of a suspension, levigating is used to


A. Reduce the zeta potential

B. Avoid bacterial growth

C. Reduce particle size +

D. Enhance viscosity

35. Active transport differs from facilitated transport in following ways, except

A. Carrier is involved +

B. It is against concentration gradient

C. Energy is required

D. All of the above

36. Vanishing cream is an ointment that may be classified as

A. A water –soluble base

B. An oleaginous base

C. An absorption base

D. An emulsion base +

37. Rectal suppositories intended for adult use usually weigh approximately

A. 1g

B. 2g +

C. 3g

D. 4g

38. In the fusion method of making cocoa butter suppositories which substance is most
likely to be used to lubricate the mold?

A. Mineral oil +

B. Propylene glycol
C. Cetyl alcohol

D. Stearic acid

39. A very fine powdered chemical is defined as one that

A. Completely passes through a # 80 sieve

B. Completely passes through a # 120 sieve +

C. Completely passes through a # 20 sieve

D. Passes through a # 60 sieve and not more than 40% through a # 100 sieve

40. Which technique is typically used to mill camphor?

A. Trituration

B. Levigation

C. Pulverization and intervention +

D. Geometric dilution

41. Which type of paper best protects a divided hygroscopic powder?

A. Waxed paper +

B. Glassine

C. White bond

D. Blue bond

42. Which capsule size has the smallest capacity?

A. 5 +

B. 4

C. 1

43. The shells of soft gelatin capsules may be made elastic or plastic–like by the addition of

A. Sorbitol +
B. Povidone

C. Polyethylene glycol

D. Lactose

44. Nonionic surface-active agents used as synthetic emulsifiers include

A. Tragacanth +

B. Sodium lauryl sulphate

C. Sorbitan esters(spans)

45. A ceramic mortar may be preferable to a glass mortar when

A. A volatile oil is added to a powder mixture

B. Colored substances (dyes) are mixed into a powder

C. Comminution is desired in addition to mixing +

46. Divided powders may be dispensed in

A. Individual-dose packets +

B. A bulk container

C. A perforated, sifter –type container

47. Agents that may be used to coat enteric coated tablets include

A. Hydroxypropyl methyl cellulose


B. Carboxymethyl cellulose
C. Cellulose acetate phthalate +
48. Active transport of a substance across biological membrane has the following
characteristics except
A. It is specific
B It is pH dependent +
C It is saturable
D It requires metabolic energy
49. Bioavailability of drug refers to
A. Percentage of administered dose that reaches systemic circulation in the unchanged form +
B. Ratio of oral to parental dose
C. Ratio of orally administered drug to that excreted in the feces
D. Ratio of drug excreted unchanged in urine to that excreted as metabolites

50. Factor which can affect the absorption of drug is


A. Dissolution rate
B. Particle Size
C. Lipid Solubility
D. All the above +

51. Excipients are

A. Pharmacologically inert substances


B. Used to mask an unpleasant taste
C. Used to increase solubility or stability to the agent
D. Employed to add bulk to the active agent used in small quantities +

52. All the below mentioned drugs cause enzyme inhibition in man except one

A. Acetazolamide

B. Allopurinol

C. Meprobamate +

D. Disulfiram
53. All the below mentioned drugs cause enzyme induction in man except one

(a) Phenytoin
(c) Griseofulvine

(b) Phenobarbitone
(d) Enalapril +
54. A common oral problem caused by herpes simplex type I virus (HSV-1) is
A. Aphthous ulcers
B. Canker sores
C. Aphthous stomatitis
D. Fever blisters +
55. The definition of a surfactant (an ingredient in toothpaste) can best be described by
which of the following statements
A. Prevents drying of the preparation
B. Removes debris by its detergent action and causes foaming, which is usually desired by the
patient +
C. Physically removes plaque and debris
D. Determines the texture, dispersiveness, and appearance of the product

56. Which is not a risk factor for hyperphosphatemia and death from sodium phosphate
enemas when used in children?
A. Renal insufficiency
B. Hirschsprung’s disease
C. Anorectal malformations
D. Children between the ages of 6 and 12 years +

57. Which of the following factors is associated with an increased risk of noncompliance in
the elderly?
A. Polypharmacy +
B. Hypertension
C. Male gender
D. Living with a spouse in an isolated environment
E. Expensive medications

58. The principal difference between competitive and non-competitive inhibition is


A. Extent of receptor site blocking
B. Whether inhibition occurs
C. Extent of enzyme3 inhibition +
D. Degree of agonism
59. Drug administrated through which of the following routes is mot likely to be subjected
to first-pass metabolism:
A. Oral +
B. Sublingual
C. Subcutaneous
D. Rectal
60. Many receptors use distinct hetero _________ GTPä-binding regulatory proteins
A. Tetrameric
B. Trimeric +
C. Dimeric
D. Monomeric

61. Alkalization of urine hastens the excretion of


A. Weakly basic drugs
B. Weakly acidic drugs +
C. Strong electrolytes
D. Nonpolar drugs

62. Majority of drugs cross biological membranes primarily by


A. Weakly basic drugs +
B. Weakly acidic drugs
C. Strong electrolytes
D. Nonpolar drugs
63. The most important factor which governs diffusion of drugs across capillaries other
than those in the brain is
A. Blood flow through the capillary +
B. Lipid solubility of the drug
C. pKa value of the drug
D. pH of the medium
64. Active transport of a substance across biological membrane has the following
characteristics except
A. It is specific
B. It is pH dependent +
C. It is saturable
65. Bioavailability differences among oral formulations of a drug are most likely to occur if
the drug
A. Is freely water soluble
B. Is completely absorbed
C. Is incompletely absorbed +
D. Undergoes little first-pass metabolism

66. An antagonist has


(a) Intrinsic activity and no affinity
(b) Only intrinsic activity and no affinity
(c) No intrinsic activity and no affinity
(d) Affinity same as agonist and devoid of intrinsic activity +

67. The most important factor governing absorption of a drug from intact skin is
A. Molecular weight of the drug
B. Site of application
C. Lipid solubility of the drug +
D. Nature of the base used in the formulation

68. Redistribution is a feature of


A. Highly plasma protein bound drugs
B. Depot preparations
C. Poorly lipid soluble drugs
D. Highly lipid soluble drugs +
69. Weakly acidic drugs
A. Are bound primarily to a1 acid glycoprotein in plasma
B. Are excreted faster in alkaline urine +
C. Are highly ionized in the gastric juice
D. Do not cross blood—brain barrier
70. High plasma protein binding
A. Increases the volume of distribution of the drug
B. Facilitates glomerular filtrtion of the drug
B. Minimizes drug interactions
D. Generally makes the drug long acting +

71. Biotransformation of drugs is primarily directed to


A. Activate the drug
B. Inactivate the drug
C. Convert lipid soluble drugs into nonlipid soluble metabolites+
D. Convert nonlipid soluble drugs into lipid soluble metabolites

72. drug may be best administered by:


(a) Oral route
(b) Inhalation +
(c) Sublingual route
(d) Intrathecal route

73. Which of the following cytochrome P450 isoenzymes is involved in the metabolism of a
large number of drugs in human beings and has been implicated in some dangerous drug
interactions:
A. CYP 3A4 +
B. CYP 2C9
C. CYP 2E1
D. CYP 1A2

74. The most commonly occurring conjugation reaction for drugs and their metabolites is
A. Glucuronidation +
B. Acetylation
C. Methylation
D. Glutathione conjugation
75. G-protein coupled receptors span the plasma membrane as a bundle of _____ alpha
helices
A. One
B. Three
C. Seven +
D. Ten
76. Which of the following drug metabolizing reactions is entirely nonmicrosomal
A. Glucuronide conjugation
B. Acetylation +
C. Oxidation
D. Reduction
77. Induction of drug metabolizing enzymes involves
A. A conformational change in the enzyme protein to favor binding of substrate molecules
B. Expression of enzyme molecules on the surface of hepatocytes
C. Enhanced transport of substrate molecules into hepatocytes
D. Increased synthesis of enzyme protein +
78. Drugs which undergo high degree of First-pass metabolism in liver
A. Have oral bioavailability
B. Are excreted primarily in bile
C. Are contraindicated in liver disease
D. Exhibit zero order kinetics of elimination +
79. Glomerular filtration of a drug is affected by its
A. Lipid solubility
B. Plasma protein binding +
C. Degree of ionization
D. Rate of tubular secretion
80. If a drug undergoes net tubular secretion, its renal clearance will be
A. More than the glomerular filtration rate +
B. Equal to the glomerular filtration rate
C. Less than the glomerular filtration rate
81. Which of the following is not a primary/ fundamental, but a derived pharmacokinetic
parameter
A. Bio-availability
B. Volume of distribution
C. Clearance
D. Plasma half life +
82. If a drug is eliminated by first order Kinetics
A. constant amount of the drug will be eliminated per unit time
B. Its clearance value will remain constant +
C. Its elimination half-life will increase with dose
D. It will be completely eliminated from the body in 2 x half-life period

83. If a drug has a constant bio-availability and first order elimination, its maintenance
dose rate will be directly proportional to its
A. Volume of distribution
B. Plasma protein binding
C. Lipid solubility
D. Total body clearance +

84. The following dose of a drug is governed by its


A. Aqueous diffusion
B. Aqueous hydrolysis
C. Lipid diffusion +
D. Pinocytosis or endocytosis

85. Monitoring plasma drug concentration is useful while using


A. Antihypertensive drugs
B. Levodopa
C. Lithium carbonate +
D. MAO inhibitors
86. Microsomal enzyme induction has one of the following features
A. Takes about one week to develop
B. Results in increased affinity of the enzyme for the substrate +
C. It is irreversible
D. Can be used to treat acute drug poisonings
87. Which of the following is a competitive type of enzyme inhibitor
A. Acetazolamide
B. Disulfiram
C. Physostigmine +
D. Theophylline
88. What is true in relation to drug receptors
A. All drugs act through specific receptors
B. All drug receptors are located on the surface of the target cells
C. Agonists induce a conformational change in the receptor +
D. Partial agonists have low affinity for the Receptor

89. A partial agonist can antagonize the effects of a full agonist because it has
A. High affinity but low intrinsic activity +
B. Low affinity but high intrinsic activity
C. No affinity and low intrinsic activity
D. High affinity but no intrinsic activity

90. Receptor agonists possess


A. Result in increased smooth endoplasmic reticulum
B. Result in increased rough endoplasmic reticulum
C. Result in decreased enzymes in the soluble cytoplasmic fraction +
E. Require 3–4 months to reach completion

91. Agonists affect the receptor molecule in the following manner

A. Alter its amino acid sequence

B. Denature the receptor protein


C. Alter its folding or alignment of subunits +

D. Induce covalent bond formation

92. Receptors perform the following function/Functions

A. Ligand recognition

B. Signal transduction

C. Both ligand recognition and signal transduction n+

D. Disposal of agonists and antagonists

93. Which of the following receptor types has 7 helical membrane, spanning amino acid
segments with 3 extracellular and 3 intracellular loops

A. Tyrosine protein kinase receptor

B. Gene expression regulating receptor

C. Intrinsic ion channel containing receptor

D. G protein coupled receptor +

94. Which of the following is a G protein coupled receptor

A. Muscarinic cholinergic receptor +

B. Nicotinic cholinergic receptor

C. Glucocorticoid receptor

D. Insulin receptor

95. Placebo effects result presumably from the

A. Physician-patient relationship

B. Mental set up imparted by the therapeutic settings

C. Mental set up imparted by the physician


D. All of the above +

96. All of the following sub serve as intracellular second messengers in receptor mediated
signal transduction except

A. Cyclic AMP

B. Inositol trisphosphate

C. Diacyl glycerol

D. G protein +

97. A receptor which itself has enzymatic property is

A. Insulin receptor +

B. Progesterone receptor

C. Thyroxine receptor

D. Glucagon receptor

98. Down regulation of receptors can occur as a consequence of

A. Continuous use of agonists +

B. Continuous use of antagonists

C. Chronic use of CNS depressants

D. Denervation

99. When therapeutic effects decline both below and above a narrow range of doses, a drug
is said to exhibit

A. Ceiling effect

B. Desensitization

C. Therapeutic window phenomenon +

D. Nonreceptor mediated action


100. ‘Drug efficacy’ refers to

A. The range of diseases in which the drug is beneficial

B. The maximal intensity of response that can be produced by the drug +

C. The therapeutic dose range of the drug

D. The therapeutic index of the drug

101. Tachyphylaxis is

A. A drug interaction between two similar types of drugs

B. Rapidly developing tolerance+

C. A synergism between two types of drugs

D. None of the above

102.Drug A in a dose of 10 mg produces same response as with 100 mg of drug B

A. Drug A is 10 times more potent than drug B +

B. Drug B is 10 times more potent than drug A

C. Drug A is 10 times more efficacious than drug B

D. Both are equally potent

103. Teratogenicity is

A. The acute reaction to drugs

B. Intolerance to drugs

C. Tumour forming action of the drugs

D. Malformation of the fetus +

104. The chances of foetal malformation with a teratogenic drug is maximum

A. During first trimester of pregnancy +

B. During second trimester of pregnancy


C. During third trimester of pregnancy

D. When given just prior to the labor

105. Phocomelia is a known teratogenic effect of

A. Anticancer drugs

B. Antiviral drugs

C. Antiepileptic drugs

D. Thalidomide +

106. Which of the following drugs are known to cause toxic cataract?

A. Chloroquine

B. Ergot

C. Phenothiazine

D. All of the above +

107. The passage of drugs into the foetus from placenta

A. Is by active transport

B. Is by passive diffusion +

C. Is by carrier mediated transport

D. By any of the above methods

108. Idiosyncrasy reaction of a drug is

A. A type of hypersensitivity reaction

B. A type of drug antagonism

C. Unpredictable, inherent, qualitatively abnormal reaction of a drug +

D. Quantitatively exaggerated response


109. Two drugs having similar effects are termed as

A. Heterergic drugs

B. Isomer drugs +

C. Homergic drugs

D. Antagonistic drugs

110. AntagonisticAntagonism between barbiturate and amphetamine is termed as

A. Non-competitive antagonism

B. Physiological antagonism +

C. Competitive antagonism

D. Synergism

111. Which one of the following is an example of physical or chemical interaction?

A. Warfarin plus salicylates–prolongation of anticoagulant effect and bleeding tendency

B. Methotrexate plus sulfonamides–pancytopenia

C. Heparin plus protamine–reversal of heparin effect +

D. Sulfonamides plus salicylate–sulfa toxicity

112. First order kinetics of the drugs is called when

A. A constant fraction of the drug is removed in per unit time +

B. A constant amount of the drug is removed in per unit time

C. Total amount of the drug is removed in one hour

D. Total amount of the drug is removed in first passage through the kidneys

113. For the drugs which follow first order kinetics, after 4 half life the elimination will be
approximately

A. 40%
B. 94% +

C. 25%

D. 4%

114. Passive diffusion of a drug across cell membrane is low when its molecular mass is
greater than

A. 50–100 Da

B. 100–200 Da +

C. 200–300 Da

D 300–400 Da

115. Passage of drug across most capillary endothelial membranes is dependent upon

A. Lipid solubility +

B. pH gradient

C. Blood flow

D. All of the above

116. Following receptors are membrane proteins, except

A. Receptors for fast neurotransmitters, coupled directly to an ion channel

B. Receptors for many hormones and slow transmitters, coupled to effector system

C. Receptor for insulin and various growth factors, which are directly linked to tyrosine kinase

D. Receptors for steroid hormone +

117. pH difference between extracellular and intracellular fluid is

A. Nil

B. 0.2

C. 0.4 +
D. 0.8
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM

1. Substance secreted into the blood by a neuron is


A. Neurohormone +
B. Neuromodulator
C. Neuromediator
D. Neurotransmitter
2. Which of the following is a leukotriene receptor blocker?
A. Alprostadil
B. Aspirin
C. Ibuprofen
D. Zafirlukast +
3. The primary endogenous substrate for nitric oxide synthase is
A. Acetylcholine
B. Angiotensinogen
C. Arginine +
D. Citruline
4. Which one of the following chemicals does not satisfy the criteria for a
neurotransmitter role in the CNS?
A. Acetylcholine
B. Dopamine
C. Glycine
D. Nitric Oxide +
5. Neurotransmitters may
A. Increase chloride conductance to cause inhibition +
B. Increase potassium conductance to cause excitation
C. Increase sodium conductance to cause inhibition
D. Increase calcium conductance to cause inhibition
6. Which of the following chemicals is most likely to function as a neurotransmitter in
hierarchical systems?
A. Dopamine
B. Glutamate +
C. Metenkephalin
D. Norepinephrine
7. Suramin is an antagonist of ________ receptors
A. Purine +
B. Somatostanin
C. Neuropeptide Y
D. Neurotensin
8. Induction of various forms of synaptic plasticity is more closely associated with
_____ receptors
A. AMPA
B. Kainate
C. NMDA +
D. All of the above
9. Which one of the following drugs may increase anticoagulant effects by
displacement of warfarin from plasma protein binding sites and is inactive until
converted in the body to an active metabolite?
A. Buspirone
B. Chloral hydrate +
C. Clorazepate
D. Secobarbital
10. This hypnotic drug facilitates the inhibitory actions of GABA, but it lacks
anticonvulsant or muscle relaxing properties and has minimal effect on sleep
architecture.
A. Buspirone
B. Diazepam
C. Flurazepam
D. Zaleplon +
11. Following is GABAA agonist
A. Muscimol +
B. Baclofen
C. Bicuculline
D. None of the above
12. Chronic use of ethanol is reported to increase
A. Alcohol dehydrogenase
B. Aldehyde dehydrogenase
C. Microsomal ethanol-oxidizing system activity +
D. Monoamine oxidase
13. Following is glycine antagonists
A. Quisqualate
B. Taurine
C. Strychnine +
D. â-alanine
14. Withdrawal of antiseizure drugs can cause increased seizure frequency and
severity. Withdrawal is least likely to be a problem with
A. Clonazepam
B. Diazepam
C. Ethosuximide +
D. Phenobarbital
15. With chronic use in seizure states, the adverse effects of this drug include coarsening
of facial features, hirsutism, gingival hyperplasia, and osteomalacia.
A. Carbamazepine
B. Ethosuximide
C. Gabapentin
D. Phenytoin +
16. The most likely mechanism involved in the antiseizure activity of carbamazepine is
A. Block of sodium ion channels +
B. Block of calcium ion channels
C. Facilitation of GABA actions on chloride ion channels
D. Glutamate receptor antagonism
17. Which one of the following statements
about phenytoin is accurate?
A. Displaces sulfonamides from plasma proteins
B. Drug of choice in myoclonic seizures
C. Half-life is increased if used with phenobarbital
D. Toxicity may occur with only small increments in dose +
18. Following is GABAB agonist
A. Muscimol
B. Baclofen +
C. Picrotoxin
D. Bicuculline
19. Following is GABAA antagonist
A. Muscimol
B. Bicuculline +
C. Strychnine
D. Baclofen
20. The inhalation anaesthetic with the fastest onset of action is
A. Enflurane
B. Isoflurane
C. Nitric oxide
D. Nitrous oxide +
21. Which of the following was the first compound to be identified Pharmacologically
as a transmitter in the CNS?
A. Glycine
B. Glutamate
C. Acetylcholine +
D. Norepinephrine
22. You have a vial containing 4 mL of a 2% solution of lidocaine. How much lidocaine
is present in 1 mL?
A. 2 mg
B. 8 mg
C. 20 mg +
D. 80 mg
23. Respiratory depression following use of this agent may be reversed by
administration of flumazenil
A Desflurane
B. Fentanyl
C. Ketamine
D. Midazolam +
24. Use of this agent is associated with a high incidence of disorientation, sensory and
perceptual illusions, and vivid dreams during recovery from anaesthesia
A. Diazepam
B. Fentanyl
C. Ketamine +
D. Midazolam
25. Epinephrine added to a solution of lidocaine for a peripheral nerve block will
A. Increase the risk of convulsions
B. Increase the duration of anaesthetic action of the local anaesthetic +
C. Both (A) and (B)
D. Neither (A) nor (B)
26. Characteristics of nondepolarizing neuromuscular blockade include which one of
the following?
A. Block of post tetanic potentiation
B. Histamine blocking action
C. Poorly sustained titanic tension +
D. Significant muscle fasciculations during onset of block
27. Which of the following does not cause skeletal muscle contractions or twitching
A. Acetylcholine
B. Nicotine
C. Strychnine
D.Vecuronium +
28. Which one of the following is most effective in the management of malignant
hyperthermia?
A. Baclofen
B. Dantrolene +
C. Haloperidol
D. Succinylcholine
29. Following is a G-protein coupled receptor
A. AMPA
B. Kainate
C. NMDA
D. Metabotropic +
30. Which one of the following drugs has caused hyperkalaemia leading to cardiac
arrest in patients with neurologic disorders?
A. Baclofen
B. Dantrolene
C. Succinylcholine +
D. Tubocurarine
31. Following is an excitatory amino acid receptor antagonist?
A. Phencyclidine +
B. Quisqualate
C. Homocysteate
D. Kainate
32. Which one of the following drugs has spasmolytic activity and could also be used in
the management of seizures caused by overdose of a local anaesthetic?
A. Baclofen
B. Cyclobenzaprine
C. Dantrolene
D. Diazepam +
33. Which one of the following drugs given preoperatively will prevent postoperative
pain caused by succinylcholine?
A. Baclofen
B. Dantrolene
C. Diazepam
D. Tubocurarine +
34.The major reason why carbidopa is of value in parkinsonism is that the compound
A. Crosses the blood-brain barrier
B. Inhibits monoamine oxidase type A
C. Inhibits aromatic L-amino acid decarboxylase +
D. Is converted to the false neurotransmitter carbidopamine
35.Great caution must be exercised in the use of this drug (or drugs from the same
class) in parkinsonian patients who have prostatic hypertrophy or obstructive
gastrointestinal disease
A. Benztropine +
B. Carbidopa
C. Levodopa
D. Ropinirole
36. Which of the following statements about pramipexole is accurate?
A. Activates dopamine D2 receptors
B. Commonly a first-line therapy for Parkinson’s disease
C. May cause postural hypotension
D. All of the above +
37. Which one of the following statements about the action of phenothiazines is
accurate?
A. They activate muscarinic receptors
B. They are antiemetic +
C. They decrease serum prolactin levels
D. They elevate the seizure threshold
38. Choose the correct statement from the following?
A. Muscimol is GABAB selective
B. Bicuculline is GABAA agonist
C. Picrotoxin blocks chloride channels associated with GABAA receptors +
D. Baclofen is GABAA agonist
39.Following is the main inhibitory transmitter in the brain
A. Dopamine
B. Norepinephrine
C. Glycine
D. GABA +
40. Established clinical uses of this drug include enuresis and chronic pain
A. Bupropion
B. Fluvoxamine
C. Imipramine +
D. Phenelzine
41. Which one of the following drugs is most likely to increase plasma levels of
alprazolam, theophylline, and warfarin
A. Desipramine
B. Fluvoxamine +
C. Imipramine
D. Nefazodone
42. Which one of the following actions of opioid analgesics is mediated via activation of
kappa receptors?
A. Cerebral Vascular dilation
B. Decreased uterine tone
C. Euphoria
D. Sedation +
43. ______ antagonists are known to attenuate some of the actions of alcohol.
A. GABAA +
B. GABAB
C. NMDA
D. Glycine
44. Which one of the following effects is unlikely to occur during treatment with
amitriptyline?
A. Alpha adrenoceptor blockade
B. Elevation of the seizure threshold +
C. Mydriasis
D. Sedation
E. Urinary retention
45.Which one of the following drugs is most likely to be of value in obsessive compulsive
disorders (OCD)
A. Amitriptyline
B. Bupropion
C. Clomipramine +
D. Desipramine
46. Compared with other antidepressant drugs, mirtazapine has the distinctive ability to
act as an antagonist of
A. Alpha2 adrenoceptors +
B. Beta adrenoceptors
C. D2 receptors
D. NE transporters
47.Which one of the following signs or symptoms is likely to occur with marijuana
A. Bradycardia
B. Conjunctival reddening +
C. Hypertension
D. Increased psychomotor performance
48. The antihypertensive effects of captopril can be antagonized (reduced) by
A. Angiotensin II receptor blockers
B. Loop diuretics
C. NSAIDS +
D. Sulfonylurea hypoglycemics
49. The primary site of action of tyramine is
A. Ganglionic receptors
B. Gut and liver catechol–O–methyltransferase
C. Postganglionic sympathetic nerve terminals +
D. Preganglionic sympathetic nerve terminals
50. Which one of the following drugs has been used in ophthalmology, but causes
mydriasis and cycloplegia lasting more than 24 hours?
A. Atropine +
B. Echothiophate
C. Edrophonium
D. Ephedrine
E. Tropicamide
51. The antihypertensive drug most likely to aggravate angina pectoris is
A. Clonidine
B. Guanethidine
C. Hydralazine +
D. Methyldopa
52. This agent is currently a first-choice drug in the management of absence seizures as
well as partial, primary generalized, and tonic-colonic seizures.
A. Carbamazepine
B. Clonazepam
C. Ethosuximide
D. Valproic acid +
53.The phenothiazines have a variety of actions at different receptor types. However,
they do not appear to interact with receptors for
A. Dopamine
B. Histamine
C. Nicotine +
D. Norepinephrine
54. A psychiatric patient taking medications develops a tremor, thyroid enlargement,
and leucocytosis. The drug he is taking is most likely to be
A. Clomipramine
B. Haloperidol
C. Imipramine
D. Lithium +
55. Diuretics that increase the delivery of poorly absorbed solute to the thick ascending
limb of the nephron include
A. Furosemide
B. Indapamide
C. Mannitol +
D. Spironolactone
56. Following is used in methanol poisoning
A. Disulfiram
B. Naltrexone
C. Ethanol +
D. None of the above
57. A drug that is used in the treatment of parkinsonism and will also attenuate
reversible extrapyramidal side effects of neuroleptics is
A. Amantadine
B. Levodopa
C. Pergolide
D. Trihexyphenidyl +
58.Which of the following is a common effect of muscarinic stimulant drugs?
A. Decreased peristalsis
B. Decreased secretion by salivary glands
C. Hypertension
D. Miosis +
59. Four stages of general anaesthesia are distinctly seen with the use of
A. Halothane
B. Diethyl ether +
C. Nitrous oxide
D. Enflurane
60. Infusion of phentolamine into the cerebrospinal fluid of an experimental animal will
prevent the blood pressure – lowering action of
A. Clonidine +
B. Enalapril
C. Guanethidine
D. Reserpine
61. A drug suitable for producing a brief (5 to 15 minute) increase in cardiac vagal tone
is
A. Digoxin
B. Edrophonium +
C. Ergotamine
D. Pralidoxime
62. Propranolol and hydralazine have which of the following effects in common?
A. Decreased cardiac force
B. Decreased cardiac output
C. Decreased mean arterial blood pressure +
D. Increased systemic vascular resistance
63. Toxicities of local anaesthetics do not include
A. Cardiovascular arrhythmias and collapse (bupivacaine)
B. Convulsions (lidocaine)
C. Dizziness, sedation (lidocaine)
D. Hypertensive emergencies, strokes (procaine) +
64. Benzodiazepines are least effective in
A. Alcohol withdrawal syndromes
B Balanced anaesthesia regimens
C. Initial management of phencyclidine overdose
D. Obsessive – compulsive disorders +
65. Which one of the following drugs exerts its anticonvulsant effects by blocking
sodium channels in neuronal membranes
A. Acetazolamide
B. Carbamazepine +
C. Diazepam
D. Gabapentin
66. Cocaine intoxication has become a common problem in hospital emergency rooms.
Which one of the following drugs is not likely to be of any value in the management of
cocaine overdose?
A. Dantrolene
B. Diazepam
C. Lidocaine
D. Naltrexone +
67. Which one of the following agents used in hypertension is a prodrug that is
converted to its active form in the brain?
A. Clonidine
B. Doxazosin
C. Methyldopa +
D. Nitroprusside
68. The introduction of this drug may represent a novel approach to the treatment of
major depressive disorders since it appears to act as an antagonist at alpha2
adrenoceptors in the CNS
A. Amoxapine
B. Bupropion
C. Citalopram
D. Mirtazapine +
69. Which one of the following pairs of drugs: indication is accurate
A. Amphetamine: Alzheimer’s dementia
B. Bupropion: Acute anxiety
C. Fluoxetine: Insomnia
D. Ropinirole: Parkinson’s disease +
70. Following general anaesthetic is not metabolized
A. Halothane
B. Ether
C. Isoflurane
D. Nitrous oxide +
71. The appropriate chemical classification for meperidine is
A. Phenylpropylamines
B. Piperazines
C. 4-phenylpiperidines +
72. Which of the following neuromuscular blocking agents can cause muscarinic
responses such as bradycardia and increased glandular secretions?
A. Tubocurarine
B. Succinycholine
C. Pancuronium
D. Decamethonium +
73. Which of the following drugs is a volatile substance that is administered by
inhalation?
A. Thiopental
B. Halothane +
C. Alprazolam
D. Buspirone
74. The brief duration of action of an ultrashort acting barbiturate is due to a
A. Slow rate of metabolism in the liver
B. Low lipid solubility, resulting in a minimal concentration in the brain
C. High degree of binding to plasma proteins
D. Slow rate of excretion by the kidneys +
75. Which of the following agents would not be an alternative to Phenobarbital in the
treatment of partial seizures?
A. Trimethadione +
B. Gabapentin
C. Felbamate
D. Lamotrigine
E. None of the above
76. Which of the following diuretics is most similar in chemical structure to the
antihypertensive agent diazoxide?
A. Furosemide
B. Spironolactone
C. Mannitol
D. Chlorothiazide +
78. Following is an example of ideal anaesthetic
A. Ether
B. Halothane
C. Thiopental
D. None of the above +
79. An action common to most general anaesthetic
A. Increase in the cellular threshold of firing +
B. Potentiation of spontaneous and evoked activity of neurons
C. Inhibition of effects of glutamate
D. None of the above
80. All of the following adverse effects are associated with the use of levodopa except
A. Sialorrhea
B. Orthostatic hypotension
C. Delusions, confusion, and depression
D. Livedo reticularis +
81. The activity of which of the following drugs is dependent on a p-phenyl – N –
alkylpiperidine moiety
A. Phenobarbital
B. Chlorpromazine
C. Diazepam
D. Meperidine +
82. Parenteral calcium is used as an antidote for which of the following situations
A. Verapamil overdoses
B. Hyperkalaemia
C. Cocaine intoxication
D. Verapamil overdoses and hyperkalaemia +
83.Which of the following benzodiazepines is expected to cause the least amount of
adverse effects in the elderly?
A. Chlordiazepoxide
B. Diazepam
C. Flurazepam
D. Oxazepam +
84. The use of morphine in the patient who has had a myocardial infarction (MI)
centres around three distinct pharmacologic properties. Which of the following choices
includes these properties
A. Relief of pain, relief of anxiety, and increased oxygen supply
B. Relief of anxiety, after load reduction, increased preload
C. Relief of anxiety, preload reduction, and relief of pain +
D. Vagomimetic effect, relief of anxiety, respiratory depression
85. Ophthalmic agents contraindicated in glaucoma patients include which of the
following substances?
A. Antioxidants
B. Antipruritic
C. Decongestants +
D. Emollients
86.. Which of the following drugs is excepted to cause anticholinergic adverse effects in
the elderly?
A. Propoxyphene
B. Ciprofloxacin
C. Amitriptyline +
D. Propranolol
87.Reflex tachycardia, headache, and postural hypotension are adverse effects that limit
the use of which of the following antihypertensive agents?
A. Prazosin
B. Captopril
C. Methyldopa
D. Hydralazine +
88. Following is inverse agonist of benzodiazepine receptors
A. Flumazenil
B. β-Carbolines +
C. Chlordiazepoxide
D. Glutethimide
89. Which anticonvulsant drug requires therapeutic monitoring of Phenobarbital serum
levels as well as its own serum levels
A. Phenytoin
B. Primidone +
C. Clonazepam
D. Ethotoin
90. Zolpidem belongs to following class of drugs
A. Benzodiazepines
B. Carbamates
C. Imidazopyridines +
D. None of the above
91. What are the most common adverse effects of anticonvulsive drugs?
A. headache and dizziness
B. Gastrointestinal symptoms
C. Alternation of cognition and mentation
D. All of the above +
92. What are the important elements in considering treatment strategies for Parkinson’s
patients?
A. Age
B. Clinical presentation of disease
C. Sex
D. Etiology of the disease +
93. Which of the following anticonvulsants is contraindicated in patients with a
history of hypersensitivity to tricyclic antidepressants?
A. Phenytoin
B. Ethosuximide
C. Acetazolamide
D. Carbamazepine +
94. Which of the following agents should not be used concurrently with levodopa?
A. Diphenhydramine
B. Benztropine
C. Amantadine
D. Monoamine oxidase (MAO) inhibitors +
95. A patient with major depression should receive antidepressant therapy for at least
A. 2 weeks
B. 6 weeks
C. 2 months
D. 6 months +
96. Which of the following atypical antipsychotics would be the least sedating?
A. Quetiapine
B. Risperidone +
C. Olanzapine
D. Clozapine
97. Which of the following mood stabilizers would be most appropriate in a patient with
liver disease?
A. Lithium +
B. Valproic acid
C. Carbamazepine
D. None of the above
98. Ethinamate is _________ derivative
A. Phenothiazine
B. Urethane +
C. Piperidine
D. Tertiary alcohol
99. Which of the following factors may reduce lithium concentrations?
A. Dehydration
B. Pregnancy +
C. Reduced sodium intake
D. Nonsteroidal anti – inflammatory drugs
100. Morphine stimulates
A. Biliary and pancreatic secretions
B. Nonpropulsive rhythmic contractions of small intestine of man +
C. Propulsive contractions in small intestine of man
D. Propulsive peristaltic waves in colon
101. A drug that produces increased contraction of the sphincter iridis by local
application is a
A. Parasympathimimetic drug +
B. Parasympatholytic drug
C. Sympathomimetic drug
D. Sympatholytic drug
102. Which of the following should not be administered to a patient with myasthenia
gravis
A. Prostigmine
B. Digitalis
C. Atropine
D. Curare +
103. The toxicity of methanol is due to its conversion in the body to
A. Acetaldehyde
B. Formic acid and formaldehyde +
C. Ethyl alcohol
D. Carbonic acid
104. One of epinephrine’s actions on the heart is
A. Acceleration due to depression of the vagus
B. Increase in refractory period
C. Depression of the SA node
D. Increase in the concentration of the enzyme phosphorylase A +
105. Epinephrine HCl has little or no effect on
A. Unbroken skin
B. Conjunctiva
C. Precapillary sphincter
D. Nasal mucosa +
106. Acetylcholine has both muscarinic and nicotinic actions. The muscarinic action can
be blocked by
A. Epinephrine
B. Atropine +
C. Nicotine
D. Curare
107. Which of the following is the fastest acting anticoagulant
A. Warfarin (Coumadin)
B. Heparin +
C. Ouabain
D. Protamine sulfate
108. Phencyclidine is a non-competitive antagonist of
A. Kainate
B. AMPA
C. NMDA +
D. All of the above
109. Parkinsonism is probably due to
A. Too little dopamine in the brain +
B. Too little levodopa in the brain
C. Too little acetylcholine in the brain
D. Too much levodopa in the brain
110. A prominent toxic effect of local anaesthetics is
A. CNS stimulation +
B. CNS depression
C. Tachycardia
D. Local ischemia
111. Which of the following could be used as an antidote for curare poisoning
A. Neostigmine +
B. Atropine
C. Homatropine
D. Hexamethonium
112. Cigarette smoking increases the side effects of
A. Narcotic analgesics
B. Analeptics
C. Antidepressants
D. Oral contraceptives +
113. Which of the following may increase seizure activity in epileptic patients
A. Ethotoin
B. Phenobarbital
C. Trihexyphenidyl
D. Amantadine +
114. Trazodone (Desyrel) is used primarily as a (an)
A. Analgesic
B. Cardiotonic
C. Tranquilizer
D. Antidepressant +
115. Propofol
A. Enhances the neuromuscular blockade of tubocurarine
B. Causes marked postoperative confusion
C. Can produce involuntary movements during its use +
D. Has a delayed recovery after induction
116. A common side effect of ephedrine is
A. Rashes
B. Nervousness +
C. Blood dyscrasia
D. Drowsiness
117. Thiazide diuretics may produce an increase in blood levels of uric acid and
A. Potassium
B. BUN
C. Urea
D. Glucose +
118. Symptoms of schizophrenia are produced by following agents, except
A. Amphetamine
B. Apomorphine
C. Bromocriptine
D. Reserpine +
119. Select the anticholinesterase drug that is being used to afford symptomatic
improvement in Alzheimer’s disease
A. Echothiophate
B. Tacrine +
C. Demecarium
D. Ambenonium
120. Pilocarpine is used in
A. Glaucoma +
B. Paralytic ileus
C. Urinary retention
D. All of the above
121. Select the longer acting ocular betablocker
A. Timolol
B. Betaxolol
C. Carteolol
D. Levobunolol +
122.Which of the following is a prodrug of adrenaline used topically in glaucoma
A. Phenylephrine
B. Dipivefrine +
C. Phenylpropanolamine
D. Dorzolamide
123. Which of the following diuretics is most effective in acute congestive glaucoma
A. Indapamide
B. Amiloride
C. Mannitol +
D. Furosemide
124. Local anaesthetics block nerve conduction by
A. Blocking all cation channels in the neuronal membrane
B. Hyperpolarizing the neuronal membrane
C. Interfering with depolarization of the neuronal membrane +
D. Both (b) and (c)
125. Which of the following diseases is worsened by propranolol
A. Glaucoma
B. Raynaud’s disease +
C. Benign prostatic hypertrophy
D. Parkinsonism
126. Diazepam is used as a muscle relaxant for
A. Deep intra-abdominal operation
B. Tracheal intubation
C. Tetanus +
D. Diagnosis of myasthenia gravis
127. Which sensation is blocked first by low concentrations of a local anaesthetic
A. Temperature
B. Pain +
C. Touch
D. Deep pressure
128. Following are the MAO-inhibitors, except
A.Tranylcypromine
B. Nomifensine +
C. Moclobemide
D. Isocarboxid
129. Which of the following is a poor surface anaesthetic
A. Procaine +
B. Lidocaine
C. Tetracaine
D. Benoxinate
130. The local anaesthetic having high cardiotoxic and arrhythmogenic potential is
(a) Lidocaine
(b) Procaine
(c) Bupivacine +
(d) Chloroprocaine
131. The calcium channel blocker used for prophylaxis of migraine but not for angina
pectoris is
A. Verapamil
B. Diltiazem
C. Flunarizine +
D. Amlodipine
132. In which of the following techniques the concentration of the local anaesthetic
required is the lowest
A. Infiltration anaesthesia +
B. Field block anaesthesia
C. Nerve block anaesthesia
D. Spinal anaesthesia
133. Captopril produces greater fall in blood pressure in
A. Diuretic treated patients +
B. Patients having low plasma rennin activity
C. Sodium replete normotensive individuals
D. Untreated CHF patients
134. Enalapril differs from captopril in that
A. It blocks angiotensin II receptors
B. It does not produce cough as a side effect
C. It is less liable to cause abrupt first dose hypotension +
D. It has a shorter duration of action
135. Spinal anaesthesia is not suitable for
A. Vaginal delivery
B. Lower segment caesarean section
C. Prostatectomy
D. Operations on mentally ill patients +
136. Following is a MAO-inhibitor and also has anti-tubercular activity
A. Iproniazid +
B. Phenelzine
C. Moclobemide
D Isocarboxid
137. Which of the following is true of nitrous oxide?
A. It irritates the respiratory mucosa
B. It has poor analgesic action
C. It is primarily used as a carrier and adjuvant to other anaesthetics +
D. It frequently induces post anaesthetic nausea and retching
138. The factor that effects rate of elimination of general anaesthetics is
A. Pulmonary ventilation
B. Blood flow
C. Solubility in blood and tissue
D. All of the above +
139. Which of the following is a sign of deep anaesthesia?
A. Appearance of tears in eyes
B. Resistance to passive inflation of lungs
C. Fall in blood pressure +
D. Patient makes swallowing movements
140. Which inhalational general anaesthetic is metabolized in the body to a significant
extent
A. Sevoflurane
B. Isoflurane
C. Ether
D. Halothane +
141. The drug/drugs used mainly for induction
of general anaesthesia is/are
A. Thiopentone sodium +
B. Fentanyl + droperidol
C. Ketamine
D. All of the above
142. Following agent potentiates actions of
GABA
A. Volatile anaesthetics
B. Barbiturates +
C. Propofol
D. All of the above
143. Which of the following drugs is routinely used in preanesthetic medication for
prolonged operations
A. Atropine
B. Morphine
C. Promethazine
D. Ranitidine +
144. Hypnotic benzodiazepines increase the period of time spent in the following stage
of sleep
A. Stage II +
B. Stage III
C. Stage IV
D. REM stage
145. The primary mechanism of action of benzodiazepines is
A. Dopamine antagonism
B. Adenosine antagonism
C. Opening of neuronal chloride channels
D. Facilitation of GABA–mediated chloride influx +
146. The following drug is used to reverse the CNS depression produced by diazepam
A. Nikethamide
B. Doxapram
C. Physostigmine
D. Flumazenil +
147. Which of the following is not a CNS depressant but increases the tendency to
fall asleep at night?
A. Pyridoxine
B. Methaqualone
C. Melatonin +
D. Ethanol
148. The following antiepileptic drug is also effective in manic-depressive illness
A. Ethosuccimide
B. Primidone
C. Phenobarbitone
D. Carbamazepine +
149. The preferred drug for status epilepticus is
A. Intravenous diazepam +
B. Intravenous phenytoin sodium
C. Intramuscular phenobarbitone
D. Rectal paraldehyde
150. The most effective single drug in parkinsonism is
A. Bromocriptine
B. Selegiline
C. Levodopa D. +
D. Biperiden
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM

1. In the autonomic regulation of blood pressure


A. Cardiac output is maintained constant at the expense of other hemodynamic variables
B. Elevation of blood pressure results in elevated aldosterone secretion
C. Baroreceptor nerve fibres decrease firing rate when arterial pressure increases
D. Stroke volume and mean arterial blood pressure are the primary direct determinants of
cardiac output +

2. The autonomic nervous system is also known as


A. Visceral
B. Vegetative
C. Involuntary nervous system +
D. All of the above
3. Full activation of the sympathetic nervous system, as in maximal exercise, can
produce all of the following responses except
A. Bronchial relaxation
B. Decreases intestinal motility
C. Increased renal blood flow +
D. Mydriasis
4. The neurotransmitter agent that is normally released in the sinoatrial node of the
heart in response to a blood pressure increase is
A. Acetylcholine +
B. Dopamine
C. Epinephrine
D. Glutamate
5. A direct-acting cholinomimetic that is lipid-soluble and often used in the treatment of
glaucoma is
A. Acetylcholine
B. Bethanechol
C. Physostigmine
D. Pilocarpine +
6.Which of the following agents is a prodrug that is much less toxic in mammals than in
insects
A. Acetylcholine
B. Bethanechol
C. Physostigmine C +
D. Pilocarpine
7. Atropine overdose may cause which one of the following
A. Gastrointestinal smooth muscle cramping
B. Increased cardiac rate +
C. Increased gastric secretion
D. Pupillary constriction
8.The synaptic pre-ganglionic neurons have their cell bodies in the lateral horn of the
grey matter of the
A.Thoracic segment only
B. Lumbar segment only
C. Both (a) and (b) +
D. None of the above
9. Which one of the following can be blocked by atropine?
A. Decreased blood pressure caused by hexamethonium
B. Increased blood pressure caused by nicotine
C. Increased skeleton muscle strength caused by neostigmine
D. Tachycardia caused by infusion of acetylcholine +
10. ‘Fight or flight’ state can be described as
A.Sympathetic active; para-sympathetic quiescent +
B. Sympathetic active; para-sympathetic active
C. Sympathetic quiescent; para-sympathetic active
11. In male sex organs _______ system is responsible for erection.
A. Sympathetic
B. Parasympathetic +
C. Norepinephrine
D. None of the above
12. Rest and digest’ state can be described as
A. Sympathetic active; para-sympathetic quiescent
B. Sympathetic active; para-sympathetic active
C. Sympathetic quiescent; para-sympathetic active +
13. Reserpine, an alkaloid derived from the root of Rauwolfia serpentine
A. Can be used to control hyperglycaemia
B. Can cause severe depression of mood +
C. Can decrease gastrointestinal secretion and motility
D. Has no cardiac effects
14. Following enzyme is involved in the synthesis of acetylcholine

A. Choline acetyl transferase +


B. Acetyl cholinesterase
C. Both (a) and (b)
D. None of the above

15. Following is an antagonist of ganglion type nicotinic receptors


A. Tubercurarine
B. αbungarotoxin
C. Trimethaphan +
D. All of the above
16. Oxytremorine is a selective agonist of muscarinic _______ receptors
A. M1 +
B. M2
C. M3
D. M4
17. A drug that is useful in glaucoma and high-altitude sickness is
A. Acetazolamide +
B. Amiloride
C. Demeclocycline
E. Desmopressin
18. Cromolyn has as its major action
A. Block of calcium channels in lymphocytes
B. Block of mediator release from mast cells +
C. Block of phosphodiesterase in mast cells and basophils
D. Smooth muscle relaxation in the bronchi
19. Which one of the following is least likely to be useful in the therapy of hypercalcemia
A. Calcitonin
B. Glucocorticoids
C. Plicamycin
D. Thiazide diuretics +
20. Characteristics of Vitamin D and its metabolites include which one of the following
A. Act to decrease serum levels of calcium
B. Activation of their Vitamin D receptors increases cellular CAMP
C. Calcitriol is the major derivative responsible for increasing intestinal absorption of
phosphate +
D. Metabolites of Vitamin D increase renal excretion of calcium
21. Action of norepinephrine and epinephrine are terminated by
A. Reuptake into nerve terminal
B. Dilution by diffusion and uptake at extraneuronal site
C. Metabolic transformation
D. All of the above +
22. Typical results of beta-receptor activation include which one of the following
A. Hypoglycaemia
B. Lipolysis +
C. Glycogen synthesis
D. Decreased skeletal muscle tremor
23. Drugs that block the α receptor on effector cells at adrenergic nerve endings
A. Antagonize the effects of isoproterenol on the heart rate
B. Antagonize some of the effects of epinephrine on the blood pressure +
C. Antagonize the effects of epinephrine on adenylyl cyclase
D. Cause mydriasis
24. Yohimbine is an antagonist of ______ receptors.
A. α1
B. α2 +
C. both (a) and (b)
D. None of the above
25. Which of the following organs is innervated only by parasympathetic nerves
A. Iris muscles
B. Ciliary muscle +
C. Sweat glands
D. Splenic capsule
26. α1 – receptors are coupled with _______ G protein.
A. Gs
B. Gi
C. Gq +
D. Go
27. Hyoscine differs from atropine in that it
A. Exerts depressant effects on the CNS at relatively low doses +
B. Exerts more potent effects on the heart than on the eye
C. Is longer acting
D. Has weaker antimotion sickness activity
28. Which of the following anticholinergic drugs is primarily used in preanesthetic
medication and during surgery
A. Glycopyrrolate +
B. Pipenzolate methyl bromide
C. Isopropamide
D. Dicyclomine
29. Glycopyrrolate is the preferred antimuscarinic drug for use before and during
surgery because
A. It is potent and fast acting
B. It has no central action
C. It has antisecretory and vagolytic actions
D. All of the above +
30. The cardiac muscarinic receptors
A. Are of the M1 subtype
B. Are of the M2 subtype +
C. Are selectively blocked by pirenzepine
D. Function through the PIP2 → IP3/DAG pathway

31. The most suitable mydriatic for a patient of corneal ulcer is


A. Atropine sulphate +
B. Homatropine
C. Cyclopentolate
D. Tropicamide
32. The most effective antidote for belladonna poisoning is
A. Neostigmine
B. Physostigmine +
C. Pilocarpine
D. Methacholine
33. Atropine is contraindicated in
A. Cyclic AMP
B. Inositol trisphosphate
C. Diacyl glycerol
D. G protein +
34. Select the correct statement from the following about α 1 – adrenergic receptor
agonists
A. Isoproterenol > epinephrine ≥ norepinephrine +
B. Epinephrine > isoproterenol > norepinephrine
C. Isoproterenol = epinephrine ≥ norepinephrine
D. Epinephrine ≥ norepinephrine > isoproterenol
35. The most efficacious inhibitor of catecholamine synthesis in the body is
A. α - methyl – p – tyrosine +
B. α methyldopa
C. α methyl - norepinephrine
D. Pyrogallol
36. Adrenaline raises blood glucose level by the following actions except
A. Inducing hepatic glycogenolysis
B. Inhibiting insulin secretion from pancreatic β cells
C. Augmenting glucagons secretion from pancreatic α cells
D. Inhibiting peripheral glucose utilization +
37. Noradrenaline is administered by
A. Subcutaneous injection
B. Intramuscular injection
C. Slow intravenous infusion +
D. All of the above routes
38. Dobutamine differs from dopamine in that
A. It does not activate peripheral dopaminergic receptors +
B. It does not activate adrenergic β receptors
C. It causes pronounced tachycardia
D. It has good blood-brain barrier penetrability
39. Ephedrine is similar to adrenaline in the following feature
A.Potency
B. Inability to penetrate blood-brain barrier
C. Duration of action
D. Producing both α and β adrenergic effects +
40.Choose the correct statement from the following about α1 – adrenergic receptor
agonists
A. Norepinephrine > isoproterenol > epinephrine
B Norepinephrine < epinephrine > isoproterenol
C Epinephrine≥ norepinephrine >> isoproterenol +
D Epinephrine > isoproterenol > norepinephrine
41. A sympathomimetic amine that acts almost exclusively by releasing noradrenaline
from the nerve endings is
A. Ephedrine
B. Dopamine
C. Isoprenaline
D. Tyramine +
42. Low doses of adrenaline dilate the following vascular bed
A. Cutaneous
C. Renal
B. Mucosal
D. Skeletal muscle +
43. α2–adrenergic receptors are associated with following except
A. Increase in phospholipase C activity
B. Increase in potassium channel conductance
C. Decrease in calcium channel conductance
D. Increase in adenylyl cyclase activity +
44. While undergoing a surgical procedure a patient develops hypotension. Which of the
following drugs can be injected intramuscularly to raise his BP
A. Noradrenaline
B. Isoprenaline
C. Mephentermine +
D. Isoxsuprine
45. Vasoconstrictors should not be used in
A. Neurogenic shock
B. Haemorrhagic shock
C. Secondary shock +
D. Hypotension due to spinal anaesthesia
46. The drug which produces vasoconstriction despite being an α adrenergic blocker is
A. Phenoxybenzamine
B. Ergotamine +
C. Dihydroergotoxine
D. Tolazoline
47. Prazosin is an effective antihypertensive while nonselective α adrenergic blockers
are not because
A. It is the only orally active α blocker
B. It improves plasma lipid profile
C. It does not concurrently enhance noradrenaline release +
D. It improves urine flow in males with prostatic hypertrophy
48. Phenylephrine
A. Mimics the transmitter at post-synaptic receptors +
B. Displaces transmitter from axonal terminal
C. Inhibits synthesis of transmitter
D. None of the above
49. A β adrenergic blocker that is primarily eliminated unchanged by renal excretion is
A. Propranolol
B. Metoprolol
C. Alprenolol
D. Atenolol +
50. In a patient of myocardial infarction, βadrenergic blockers are used with the
following aim/aims:
A. To reduce the incidence of reinfarction
B. To prevent cardiac arrhythmias
C. Myocardial salvage
D. All of the above +
51. The β-adrenergic blocker which possesses both β-1 selectivity as well as intrinsic
sympathomimetic activity is
A. Alprenolol
B. Atenolol
C. Acebutolol +
D. Metoprolol
52. Propranolol can be used to allay anxiety associated with
A. Chronic neurotic disorder
B. Schizophrenia
C. Short-term stressful situation +
D. Endogenous depression
53. Propranolol does not block the following action of adrenaline
A. Bronchodilation
B. Lipolysis
C. Muscle tremor
D. Mydriasis +
54. The site of action of d-tubocurarine is
A. Spinal internuncial neurone
B. Motor nerve ending
C. Muscle end-plate +
D. Sodium channels in the muscle fibre
55. The fall in blood pressure caused by d- tubocuranine is due to
A. Reduced venous return.
B. Ganglionic blockade
C. Histamine release
D. All of the above +
56. The neuromuscular blocker having prominent antivagal action is
A. Pancuronium
B. Vecuronium
C. Atracurium
D. Gallamine triethiodide +
57. Neuromuscular blocking drugs do not produce central actions because
A. Nicotinic receptors are not present in the brain
B. They do not cross the blood-brain barrier +
C. They are sequestrated in the periphery by tight binding to the skeletal muscles
D. They do not ionize at the brain pH
58. Pancuronium differs from tubocurarine in that
A. It is a depolarizing blocker
B. Its action is not reversed by neostigmine
C. It can cause rise in BP on rapid I.V. injection +
D. It causes marked histamine release
59. Muscarinic receptors are G-protein coupled receptors, causing
A. Inactivation of phospholipase C
B. Activation of adenylyl cyclase
C. Activation of potassium or inhibition of calcium channels +
D. All of the above
60. Postoperative muscle soreness may be side effect of the following neuromuscular
blocker
A. d-tubocurarine
B. Succinylcholine +
C. Pancuronium
D. Atracurium
61. Following drug enhances the evoked release of acetylcholine
A. 4-aminopyridine +
B. Vesamicol
C. Magnesium ion
D. None of the above
62. Select the ergot compound which is primarily used for dementia
A. Bromocriptine
B. Ergotamine
C. Codergocrine +
D. Methysergide
63. Following muscarinic agonist is susceptible to hydrolysis by cholinesterase
A. Carbachol
B. Methacholine +
C. Bethanechol
D. Muscarine
64. Stimulation of exocrine glands by muscarinic agonist leads to
A. Sweating
B. Salivation
C. Bronchial secretions
D. All of the above +
65. β blockers are contraindicated in
A. Prophylaxis of anxiety states
B. Hyperthyroidism
C. Hypertrophic obstructive cardiomyopathy
D. Peripheral vascular disease +
66. β blockers are better avoided in
A. Bronchial asthma +
B. Pheochromocytoma
C. Myocardial infarction
D. Migraine
67. Preferential beta 1 adrenergic blocking agent is

A. Propranolol
B. Atenolol +
C. Penbutolol
D. Oxprenolol
68. Prazosin
A. Produces preferential alpha1 adrenergic receptor blockade +
B. Has a half-life of 24 hours
C. Can worsen lipid profile in hypertensive patients
D. Does not depress the baroreceptor function
69. The drug that produces neuromuscular blockade by persistent depolarization is
A. D-tubocurarine
B. Gallamine
C. Pancuronium
D. Decamethonium +
70. Agents that block neuromuscular transmission of acetyl choline acts via
A. Inhibiting acetyl choline synthesis
B. Inhibiting acetyl choline release
C. Inhibiting post-synaptic action of acetyl choline
D. All of the above +
71. The skeletal muscle relaxant causing significant release of histamine is
A. Pancuronium
B. Atracurium
C. Gallamine
D. D-tubocurarine +
72. β blockers
A. Relieve symptoms of thyrotoxicosis +
B. Should not be used along with carbimazole
C. Reduce the synthesis of hormones in the gland
D. Should not be given before thyroid surgery
73.The antimuscarinic agent preferred in the management of motion sickness is
A. Atropine methonitrate
B. Scopolamine +
C. Homatropine methyl bromide
D. Ipratropium bromide

74. Side effect which is observed only with the use of β blockers and not with other
sympathetic blocking agents
A. Sedation and drowsiness +
B. Congestive heart failure
C. Bronchoconstriction
D. Reflex tachycardia
75. Following agent inhibits the release of acetyl choline
A. Magnesium ion +
B. Triethylcholine
C. Vesamicol
D. All of the above
76. Which of the following drugs has highest α agonist activity
A. Epinephrine +
B. Norepinephrine
C. Ephedrine
D. Amphetamine
77. Atropine is antagonist to which type of muscarinic
A. M1 +
B. M2
C. M3
D. M4
78. Following are irreversible anti-cholinesterase, except
A. Parathion
B. Pyridostigmine +
C. Dyflos
D. Ecothiopate
79.The ciliary muscle of iris has predominant
A. Sympathetic innervation
B. Parasympathetic innervation +
C. Somatic innervation
D. Mixture of all the above
80. Following is a short-acting anti-cholinesterase
A. Neostigmine
B. Pyridostigmine
C. Edrophonium +
D. Physostigmine

81. The antibiotic that may accentuate the neuromuscular blockade produced by d-
tubocurarine is
(a) Pencillin G

(b) Erythromycin

(c) Streptomycin +

(d) Chloramphenicol
82. Centrally acting skeletal muscle relaxant is
(a) Carisoprodol +
(b) Dantrolene
(c) Gallamine
(d) Succinylcholine
83. The organ extremely sensitive to the action of atropine is
(a) Gastric glands
(b) Salivary glands +
(c) Urinary bladder muscle
(d) Heart
1) Beta blocker which has peripheral vasodilation effect is:
a) atenolol
b) acebutolol
c) metoprolol
d) labitolol
e) +carvedilol

2) T-half of a drug can determine all the following:


a) +closing interval
b) elimination time
c) +therapeutic dosage
d) steady plasma conc.

3) Phototoxicity is commonest with:


a) +doxycycline
b) minocycline
c) prostacycline
d) oxytetracycline

4) Gout is precipitate by all except:


a) frusemide
b) thiazide
c) PYZ
d) +sulfinpyrazone

5) Effect of parasympathetic (muscarinic ) on heart is:


a) refractory period is decresed
b) +conduction is decresed
c) forse of attrial contraction is increased
d) P_R interval is increased

6) Call of the following antibiotics act on cell wall except:


a) ampicilinc
b) +griseofulvin
c) bacitracin
d) none

7) CNS stimulant action of nikethamide has .target cells mainly in:


a) +medulla
b) mid brain
c) pons
d) cerebral cortex

8) Nicotinic receptor are seen in:


a) +sk. Muscle
b) cardiac mus.
c) Visceral smooth mus.
d) Salivary gland

9) Sparfloxacin and tarfinadine can cause


a) nephropathy
b) +ventricular arrhythmia
c) myopathy
d) all

1
10) Dapsone is used in:
a) erythema
b) SLE
c) Lichen planus
d) +Dermatitis herpetiformis

11) Cyclosporine A inhibites:


a) +T cells
b) CD8
c) CD4
d) В cells

12) Increase renal blood flow is caused by:


a) +dopamine
b) dobutamine
c) ]adrenaline
d) Non adrenaline

13) True abt. Lente insulin:


a) +made of 3 parts zinc suspension (amorphorous) and 7 parts zinc suspension (crystalline)
b) duration of action is 36 hrs.
c) clear alkaline solution
d) none

14) Which of the following is fluroquinolone:


a) +pefloxacin
b) cefotaxime
c) urodopenicilline
d) none

15) Metoprolol is the member of:


a) a1 selective group
b) a2- selective group
c) +β1-selective group
d) β2- selective group

16) The principal adverse effect of phentolamine are related to:


a) Gastric secretion
b) Brochi constriction
c) Smooth muscle dilation
d) +Cardiac stimulation

17) Adverse effect of neuromuscular blocking drugs:


a) Hypokalemia
b) +Hyperkalemia
c) Hypomagnemia
d) Hypermagnemia

18) The crossing the blood-brain barrier of trimethaphan is:


a) +Absent
b) Poor
c) Good
d) Excellent

2
19. Direct action of physostigmine on cholinoceptors is:
a. +Absent
b. Poor
c. Good
d. Excellent

19) Lipid soluble agents of anticholiesterase have more marked effect on:
a) Skeletal muscles
b) Nicotinic
c) Eye
d) +CNS

20) High doses of parasympathomimetic drugs may produce:


a) Constriction of arteries and dilation of veins
b) Constriction of veins and dilation of arterials
c) Constriction of veins and arterials
d) +Dilation of veins and arterials

21) Topical instillation of atropine causes:


a) +miosis
b) mydriases
c) abolition of light reflex
d) cycloplegia

22) Remission inducing drug for Rh arthritis include:


a) aspirin
b) +gold thiol
c) ibuprofen
d) all

23) Not used in H. pylori gastritis is a:


a) +cisapride
b) clarithromycin
c) metronidazole
d) colloidal bismuth

24) Protein binding of a drug helps in:


a) distribution
b) +prolonged half life
c) limiting metabolism
d) all

25) Аll the drug can be given in pt. with bronchial asthma except:
a) timolol eyedrop
b) acetaminophen
c) ketorolac
d) +nefopam

26) Opioids act by:


a) cellular hyper polarization
b) reduced neurotransmitter reuptake
c) +reduced level of subst. P
d) evoking glutamate release

3
27) Storage of Fe is:
a) heamoglobine
b) myoglobone
c) +feritinine
d) heamosiderin

28) Thiazides is:


a) Torsemide
b) dichlorphenamide
c) Acetazolamide
d) +Chlorthalidone

29) Isoproterenol has duration of action:


a. 30-60 minutes
b. +60-90 minute
c. 90-120 minute
d. 120-150 minute

30) Pre/post ganglionic fibre ratio of sympathetic nervous system:


a) +1:1-1:2
b) 1:2-1:3
c) 1:3-1:4
d) 1:4 —1:4

31) Muscarinic receptors have been divided into


a) 3 subtypes
b) 4 subtypes
c) +5 subtypes
d) 6 subtypes

32) M-cholinomimetics:
a) Galantamine
b) +Aceclydine
c) Pentamine
d) Carbacholine

33) Response of eyes to the parasympathomimetic drugs:


a) Mydriasis
b) +Miosis
c) Increases of intraocular tension
d) Relax of accommodation

34) Irreversible anticholiesterases:


a) Physostigmine
b) +Phosphacol
c) Neostigmine
d) Edrophonium

35) Which of the following is an osmotic diuretics:


a) +urea
b) metolazone
c) bumetanide
d) d-acetazolamide

4
36) Therapeutic index of a drag is a indicator of:
a) potency
b) safety
c) +toxicity
d) efficacy

37) Tachyphylaxis is a:
a) +acute tolerance
b) chronic tolerance
c) both
d) none

38) Drug used in anaphylaxis is:


a) nor epinephrine
b) +epinephrine
c) dopamine
d) antihistaminic

39) Breast feeding is not contraindicated when the mother is taking the following medication except:
a) theophyline
b) cloromphenicol
c) metronidazole
d) cimetidine

40) Antacids are:


a) physical antagonist
b) chemical antagonist
c) +reversible antagonist
d) irreversible antagonist

41) The toxic effects of a large dose of nicotine is:


a) Salivation
b) Nausea
c) +Convulsions
d) Cutaneous vasodilation

42) Excessive doses of lidocaine cause:


a) Paresthesias
b) +Hypotension
c) Hypertension
d) Disorientation

43) The CNS effect of nicotine:


a) +Tremors
b) Diarrhea
c) Hypotension
d) Decrease of hear rate

44) In what stage of anesthesia may occur the regular respiration and relaxation of the skeletal muscle:
a) Analgesia
b) Excitement
c) +Surgical anesthesia
d) Medullary paralysis

5
45) Heparin therapy is monitored by:
a. ВТ
b. CT
c. +PT
d. All of the above

46) Which of the following drug is useful in dissolving gall bladder stone:
a) +chenodoxycholic acid
b) lactulose
c) clofibrate
d) none

47) Tetracycline can cause all except:


a) +gray baby syndrome
b) hepatotoxicity
c) pain on injection
d) fanconis anaemia

48) Sulfonamide derivates is:


a) +Torsemide
b) dichlorphenamide
c) Acetazolamide
d) Chlorthalidone

49) Methacholine usually could be used in treatment of:


a. +Glaucoma
b. Bronchial constriction
c. Hypertension
d. Hypotension

50. Neostigmine CNS effect is:


a. +Absent
b. Poor
c. Good
d. Excellent

51. Atropine is highly selective for:


a. a-receptors
b. β-receptors
c. +m-receptors
d. n-receptors

52. Good administration for trimethaphan is:


a. Oral
b. Subcutaneous
c. Intramuscular
d. +Intravenous

53. The duration of action of succinyicnoline is


a. + 5-10 minutes
b. 10-20 minutes
c. 20-30 minutes
d. 30-40 minutes

6
54. Location of β-1 receptors:
a. Bronchi
b. Urinary tract
c. Uterus
d. +Heart

55. Irreversible antagonist drug is:


a. +Phenoxybenzamine
b. Prazosine
c. Labetalol
d. Phentolamine

56. Botulinus toxin influence on the release of acetylcholine


a. Induce
b. Increase
c. +Inhibit
d. Doesn’t influence

57. Nicotinic receptors have been divided into


a. +2 subtypes
b. 3 subtypes
c. 4 subtypes
d. 5 subtypes

58. Physostigmine is well absorbed from


a. Oral administration
b. Intravenous
c. Intramuscular
d. +All sites

59. Effect of atropine on the iris persists:


a. 12-24 hours
b. 24-48 hours
c. 48-72 hours
d. +More than 72 hours

60. The crossing the blood-brain barrier of trimethaphan is:


a. +Absent
a. Poor
b. Good
c. Excellent

61. Selective antagonist for the β receptors


a. Yohimbine
b. Clonidine
c. Methoxamine
d. +Prazosin

62. The principal adverse effect of phentolamine are related to


a. Gastric secretion
b. Brochi constriction
c. Smooth muscle dilation
d. +Cardiac stimulation

7
63. A half-life of esmolol is:
a. +5-10 minutes
b. 10-30 minutes
c. 30-40 minutes
d. 40-50 minutes

64. Metoprolol is the member of:


a. a1-selective group
b. a2- selective group
c. + β1 selective group
d. β2 selective group

65. Uses of a-blockers is not:


a. Pheochromocytoma
b. Diabetes
c. Thyrotoxicosis
d. +Cardiac arrhythmias

66. Clinical pharmacology includes


a) Pharmacokinetics and pharfnacodynamics
b) Treatment of systemic infection
c) Science of compounding and dispending drug
d) +Application of pharmacological information

67. Activates a receptor to produce an effect similar to physiological signal:


a. Antagonist
b. +Agonist
c. Inverse agonist
d. Partial agonist

68. Cross the placenta barrier


a) Chlordiazepoxide
b) Diazepam
c) Prazepam
d) +All

69. ADH is located in:


a. Spleen
b. Liver
c. +Kidney
d. All

70. Opioid drugs include:


a. Full agonist
b. Partial agonist
c. Antagonist
d. +All

71. Most opioid analgetics are well absorbed:


a. Subcutaneous
b. Intramuscular
c. Oral
d. +All

8
72. Opioids localize in higher concentration in tissues except:
a. +Brain
b.Liver
c. Muscle
d. Lungs

73. Action of opioids is:


a. +Decrease of alveolar PCO2
b. Suppression of cough
c. Mydriasis
d. Diarrhea

74. Adverse effect of opioids is except:


a. Respiratory depression
b. Nausea
c. Vomiting
d. +Decrease intracranial pressure

75. Clinical use of opioid analgesics:


a. Constipation
b. Arrhythmia
c. +Cough
d. All

76. The maximal blood levels of local anesthetics


a. +Intercostals
b. Caudal
c. Epidural
d. Brachial plexus

77. The primary mechanism of action of local anesthetics is blockade of:


a. Ion channels
b. Potassium channels
c. Chlorium channels
d. +Sodium channels

78. Undergo extensive first pass metabolism in liver except:


a. +Nitroglycerine
b. Isosorbide mononitrate
c. Isosorbide dinitrate
d. Eiythrityl tetranitrate

79. The local anesthetics are converted in:


a. Kidney
b. +Liver
c. Lungs
d. Brain

80. Nitrates may be used except:


a. Angina pectoris
b. Biliaric colic
c. Esophageal spasm
d. +Bradicardia

9
81. Doses of dilthiazem:
a. 10-30 mg
b. +30-60 mg
c. 60-90 mg
d. 90-120 mg

82. The highest blood levels in the following order:


a. +Intercostals
a. Caudal
b. Branchial plexus
b. Sciatic nerve

83. Antiadrenergic agent is:


a. Amiadarone
b. Verapamile
c. +Propranolol
d. Propafenon

84. Agent widening AP is:


a. +Amiadarone
b. Verapamil
c. Propranolol
d. Propafenon

85. Calcium channel blocker is:


a. Amiadarone
b. +Verapamile
c. Propranolol
d. Propafenon

86. Membrane stabilizing agent is:


a) Amiadarone
b) +Verapamile
c) Propranolol
d) Propafenon

87. Excessive doses of lidocaine cause:


a. Paresthesias
b. +Hypotension
c. Hypertension
d. Disorientation

88. How many percents of mexiletine metabolized in liver:


a. 30%
b. 60%
c. +90%
d. 100%

89. The targets for benzodiazepine action is:


a. a-aminobutyric acid
b. β-aminobutyric acid
c. + γ-aminobutyric acid
d. 5-aminobutyric acid

10
90. Intermediate-acting benzodiazepines:
a. Clorazepam
b. +Alprazolam
c. Oxazepam
d. Flurazepam

91. Mechanism of action of methylxanthines


+Translocation of extracellular calcium
Translocation of intracellular calcium
Increase in cAMP
Decrease in cAMP
Decrease in GMP

92. The methylxanthines are well absorbed


a. +Orally
b. Subcutaneously
c. Intramuscular
d. Intravenously

93. The lowest blood levels in the following order:


a. Intercostals
b. Caudal
c. Branchial plexus
d. +Sciatic nerve

94. The highest blood levels in the following order:


a. +Intercostals
b. Caudal
c. Branchial plexus
d. Sciatic nerve

95. May occur the regular respiration and relaxation of the skeletal muscles:
a. Analgesia
b. Excitement
c. + Surgical anesthesia
d. Medullary paralysis

96. SGRIs block the up-take of serotonin leading to :


a. decrease concentration
b.+ Increase concentration
c. Inhibit the receptor
d. is not influence

97. Tick drus is forming a physical barrier to HCL :


a. Ranitidine
b. +Sucralfate
c. Omeprazole
d. Pirenzepine

98. Iindicate the drug that cause metabolic alkalosis:


a. +Sodium bicarbonate
b. Cimetidine
c. Pepto-Bismol
d. Carbenoxolone

11
99. The drug can be used to treat glaucoma:
a. Furosemide (Lasix)
b. +Acetazolamide (Diamox)
c. Both of the above
d. Neither of the above

100. Bactericidal effect is:


a) Inhibition of bacterial cell division
b) Inhibition of young bacterial cell growth
c) +Destroying of bacterial cells
d) Formation of bacterial L-form

101. Tick the drug belonging to antibiotics-tetracycline:


a. +Doxycycline
b. Streptomycin
c. Clarithromycin
d. Amoxacilhn

102. Tick the drug belongs to antibiotics-cephalosporin:


a. Streptomycin
b. +Cefaclor
c. Phenoxymethylpenicillin
d. Erythromycin

103. This drug reduces blood pressure by acting on vasomotor centers in the CNS:
a. Labetalol
b. +Clonidine
c. Enalapril
d. Nifedipine

104. Pick out the drug an alpha- and beta-adrenoreceptors blocker:


a. +Labetalol
b. Verapamil
c. Nifedipine
d. Metoprolol

105. This drug is converted to an active metabolite after absorption:


a) Labetalol
b) Clonidine
c) +Enalapril
d) Nifedipine

106. Indicate an agent, which is related to direct-acting drugs:


a) Edrophonium
b) Physostigmine
c) +Carbachol
d) Isoflurophate

107. All of these drugs reduce intestinal peristalsis EXCEPT:


a. Loperamide
b. +Cisapride
c. Methyl cellulose
d. Magnesium aluminium silicate

12
108. This drug acts by inhibiting type III cyclic nucleotide phosphodiesterase:
a. Amiodarone
b. +Milrinone
c. Propanolol
d. Enalapril

109. Drug is favored for digitalis-induced arrhythmias:


a. Verapamil
b. Amiodarone
c. + Lidocaine
d. Propanolol

110. Tick the drug belonging to non-selective beta-2 adrenomimetics:


a. Salbutamol
b. +Isoprenaline
c. Salmeterol
d. Terbutaline

111. Which of the following M-choiinoblocking agents is used especially as an anti-asthmatic?


a. Atropine
b. +Ipratropium
c. Platiphylline
d. metacin

112. A teratogenic action is:


a. Toxic action on the liver
b. +Negative action on the fetus causing fetal malformation
c. Toxic action on blood system
d. Toxic action on kidneys

113. What term is used to describe a decrease in responsiveness to a drug which develops in a few
minutes?
a. Refractoriness
b. Cumulative effect
c. Tolerance
d. +Tachyphylaxis

114. If an agonist can produce sub maximal effects and has moderate efficacy it's called:
a. +Partial agonist
b. Antagonist
c. Agonist-antagonist
d. Full agonist

115. Tachyphylaxis is:


A drug interaction between two similar types of drugs:
a. +Very rapidly developing tolerance
b. A decrease m responsiveness to a drug, taking days or weeks to develop
c. None of the above

116. Idiosyncratic reaction of a drug is:


a. A type of hypersensitivity reaction
b. A type of drug antagonism
c. +Unpredictable, inherent, qualitatively abnormal reaction to a drug
d. Quantitatively exaggerated response

13
117. Tick the second messenger of G-protein-coupled (metabotropic) receptor:
a. Adenylyl cyclase
b. Sodium ions
c. Phospholipase С
d. +cAMP

119. What does the term “potentiation” mean?


a. Cumulative ability of a drug
b. Hypersensitivity to a drug
c. Fast tolerance developing
d. +intensive increase of drug effects due to their combination

120. If an agonist can produce sub maximal effects and has high efficacy it's called:
a. Partial agonist
b. Antagonist
c. Agonist-antagonist
d. +Full agonist

121. What kind of substances can't permeate membranes by passive diffusion?


a. Lipid-soluble
b. Non-ionized substances
c. Hydrophobic substances
d. +Hydrophilic substances

122. Which of the following is more potent:


a) cimetidine
b) ranitidine
c) nizatidine
d) +famotidine

123. Indicate the laxative drug belonging to osmotic laxatives:


a. Docusate sodium
b. Bisacodyl
c. Phenolpnthalein
d. +Sodium phosphate

124. The mechanism of methylxanthines action is:


a) +Inhibition of the enzyme phosphodiesterase
b) Beta-2 adrenoreceptor stimulation
c) Inhibition of the production of inflammatory cytokines
d) Inhibition or M-cholinorcceptors

125. The drug is the most potent diuretic:


a. +Loop diuretics
b. Thiazide diuretics
c. Potassium-sparing diuretics
d. Carbonic anhydrase inhibitors

126. The drugs is used in the treatment of recurrent Ca nephrolithiasis:


a. Osmotic diuretics
b. +Loop diuretics
c. Thiazide diuretics
d. Potassium-sparing diuretics

14
127. Duration of nitroglycerin action (sublingual) is:
a) +10-30 minutes
b) 6-8 hours
c) 3-5 minutes
d) 1.5-2 hours

128. All of the following agents are cardiac glycosides EXCEPT:


a. Digoxin
b. Strophantin К
c. +Amrinone
d. Digitoxin

129. This drug inhibits breakdown of cAMP in vascular smooth muscle:


a. Digoxin
b. Dobutamine
c. +Amrinone
d. Dopamine

130. Catecholamine includes following EXCEPT:


a. +Ephedrine
b. Epinephrine
c. Isoprcnalinc
d. Norepinephrine

131. Indicate the beta-1 selective agonist:


a. Isoproterenol
b. +Dobutamine
c. Metaproterenol
d. Epinephrine

132. Which of the following is preferable for the emergency therapy of cardiogenic shock?
a. Epinephrine
b. +dobutamine
c. Isoproterenol
d. Mcthoxamine

133. Which of the following drugs is an nonselective beta receptor antagonist?


a) Metoprolol
b) Atenolol
c) +Propranolol
d) Acebutolol

134. Which of the following drugs is useful in the treatment of pheochromocytoma?


a. Phenylephrine
b. Propranolol
c. +Phentolamine
d. Epinephrine

135. All of the following drugs are antibiotics, EXCEPT:


a. Streptomycin
b. Penicillin
c. +Co-trimoxazole
d. Chloramphenicol

15
1. Which of the following acts indirectly ?
a. Epinephrine
b. Norepinephrine
c. +Ephedrine
d. d) Methoxamine

2. Indicate the alfa 2-selective agonist:


a. +Xylometazoline
b. Epinephrine
c. Dobutamine
d. Methoxamine

3. Epinephrine produces all of the following effects except:


a. Bronchodilation
b. +Decrease in oxvgen consumption
c. Hvperglvcemia
d. Mydrias'is

4. Indicate the drug, which may be useful in the emergency management of cardiac arrest:
a. ethoxamine
b. Phenylephrine
c. +Epinephrine
d. Xylometazoline

5. Indicate the beta-l selective antagonist:


a. Propranolol
b. +Metoprolol
c. Carvedilol
d. Sotalol

6. Non selective alfa-receptor antagonists are most useful in the treatment of:
a. Asthma
b. Cardiac arrhythmias
c. +Pheochromocvtoma
d. Chronic hypertension

7.This drug is a Class 1C antiarrhythmic drug:


a. +Flecainide
b. Sotalol
c. Lidocaine
d. Verapamil

8. This drug is associated with Torsades de pointes.


a. Flecainide
b. +Sotalol
c. Lidocaine
d. Verapamil

9. This drug is used intravenously to terminate supraventricular tachycardias:


a. Nifedipine
b. +Verapamil
c. Both of the above
d. None of the above

10. Bactericidal effect is:


a. Inhibition of young bacterial cell growth
1
b. Inhibition of bacterial cell division
c. +Destroying of bacterial cells
d. Formation of bacterial L-form

11. Tick the drug belonging to antibiotics-macrolides:


a. Neomycin
b. Doxicycline
c. +Erythromycin
d. Cefotaxime

12. Tick the drug belonging to antibiotics-tetracyclmes:


a. +Doxycycline
b. Streptomycin
c. Clarithromycin
d. Amoxacillin

13. Antibiotic inhibiting bacterial RNA synthesis is:


a. Erythromycin
b. +Rifampin
c. Chloramphenicol
d. Imipinem

14. Which of the following agents is related to tricyclic antidepressants ?


a. Nefazolan
b. +Amitriptyline
c. Fluoxetine
d. Isocarboxazid

15. Indicate an effective antidepressant with minimal autonomic toxicity:


a. Amitntyline
b. +Fluoxetine
c. Imipramine
d. Doxepin

16. A ganglioblocking drug for hypertension treatment is:


a. Hydralazine
b. Tubocurarin
c. +Trimethaphan
d. Metoprolol

17. This drug inhibits the angiotensin-converting enzyme:


a. Captopril
b. Enalapril
c. Ramipril
d. +All of the above

18. This drug is an inhibitor of rennin synthesis:


a. +Propranolol
b. Enalapril
c. Diazoxide
d. Losartan
19. This drug routinely produces some tachycardia:
a. +Nifedipine
b. Clonidin
c. Enalapril
d. Propranolol

2
20. Which of the following agents is the precursor of dopamine ?
a) Bromocriptine
b) +Levodopa
c) Selegiline
d) Amantadine

21. Indicate a selective inhibitor of monoamine oxidase B:


a) Levodopa
b) Amantadine
c) Tolcapone
d) +Selegiline

22. Which of the following benzodiazepines has the shortest duration of action?
a) +Triazolam
b) Clorazepate
c) Prazepam
d) Clordiazepoxide

23. Which of the following anxiolytics has minimal abuse liability ?


a) Oxazepam
b) +Buspirone
cj Flumazenil
d) Alprazolam

24. Which of the following direct-acting is mainly muscarinic in action ?


a) +Bethanechol
b) Carbacbol
c) Acetylcholine
d) None of the above

25. Which of the following cholinesterase inhibitors is irreversible?


a) Physostigmine
b) Edrophonium
c) Neostigmine
d) +Isoflurophate

26. Chronic long-term therapy of myasthenia is usually accomplished with:


a) Edrophonium
b) +Neostigmine
c) Echothiophate
d) Carbachol

27. Indicate the skeletal muscle relaxant, which is a depolarizing agent:


a) Vencuronium
b) Scopolamine
c) +Succinylcholine
d) Hexamethonium
28. Which of the following drugs is a selective M l blocker ?
a. Atropine
b. Scopolamine
c. +Pirenzepme
d. Homatropine

29. Indicate a drug, which is effective in the treatment of mushroom poising:


a)Pralldoxime

3
b) Pilocarpine
c) Homatropine
d) +Atropine

30. Which of the following drug is an intermediate-duration muscle relaxant?


a) +Vecuronium
b) Tubocurarine
c) Pancuronium
d) Rapacuronium

31. Which of the following muscular relaxants causes hypotension and bronchospasm ?
a. Vecuronium
b. Succinvlcholine
c. +Tubocurarine
d. Rapacuronium

32. The drug is a K+ -sparing diuretic that blocks Na+ channels in the collecting tubules:
a. Acetazolamide (Diamox}
b. +Amiloride (Midamor)
c. Furosemide (Lasix)
d. Hydrochlorothiazide (HydroDiuril)

33. The drug acts only on the luminal side of renal tubules:
a. +Furosemide (Lasix)
b. Acetazolamide (Dianiox)
c. Both of the above
d. Neither of the above

34. The drug acts at the proximal tubule:


a. Loop diuretics
b. Thiazide diuretics
c. Potassium-sparing diuretics
d. +Carbonic anhvdrase inhibitors

35. The drug is one of the most potent diuretics:


a. Acetazolamide (Diamox)
b. +Furosemide (Lasix)
c. Hydrochlorothiazide (Hydrodiuril)
d. Aniiloride (Midamor)

36. Furosemide acts at the nephron site:


a. Proximal convoluted tubule
b. +Ascending thick limb of the loop of Henle
c. Distal convoluted tubule
d. Collecting duct

37. Which of the following nitrates are long-acting?


a. Nitroglycerin
b. Isosoroide dinitrat
c. Amyl nitrite
d. +Sustac

38. The following agents are cardioselective beta-1 blocking drugs except:
a. +Propranolol

4
b. Talinolol
c. Atenolol
d. Metaprolol

39. Drug is used in digitalis intoxication:


a) Lidocaine
b) +Digibind (Digoxin immune fab)
c) Oral potassium supplementation
d) Reducing the dose ol the drug

40. All of the following drugs are used in CHF


a. Digoxin
b. Dobutamine
c. +Verapamil
d. Dopamine

41. Which of the following inhaled anesthetics is an induction agent of choice in patient
with airway problems ?
a. Desfurane
b. Nitrous oxide
c. +Halothane
d. None of the above

42. Which of the following intravenous anesthetics has antiemetic actions?


a. Thiopental
b. +Propofol
c. Ketamine
d. Fentanyl

43. Pick out the bronchodilator drug related to xanthine:


a) Atropine
b) Orciprenaline
b) Adrenaline
d) +Theophylline

44. All of the following drugs are inhaled glucocorticoids except:


a) Triamcinolone
b) Beclometazone
c) +Sodium cromoglycate
dj Budesonide

45. Indicate the drug belonging to proton pump inhibitors:


a) Pirenzepme
b) Ranitidine
c) +Omenprazole
d) T rimethaphan

46. Which of the following drugs may cause reversible gynecomastia?


a. Omeprazole
b. Pirenzepine
c. +Cimetidine
d. Sucralfate

5
47. Choose the drug that causes constipation:
a) Sodium bicarbonate
b) +Aluminium hvdroxide
c) Calcium carbonate
d) Magnesium oxide

48. Indicate an antiemetic agent which is related to neuroleptics:


a. Metoclopramide
b. Nabilone
c. Tropisetron
d. +Prochlorperazine

49. Which of the following is not an adverse effect of ranitidine:


a) headache
b) +gynecomastia
c) dizziness
d) confusion

50. What does “pharmacokinetics" include?


a. Complications of drug therapj
b. +Drug biotransformation in the organism
c. Influence of drugs on metabolism processes
d. Influence of drugs on genes

51. All of the following agents are beta-receptor agonists except:


a. Epinephrine
b. Isoproterenol
c. +Methoxamine
d. Dobutamine

52. Which of the following is a beta-2 selective agonist?


a. +Terbutaline
b. Xylometazoline
c. Isoproterenol
d. Dobutamine

53. Isoproterenol produces all of the following effects except:


a) Increase in cardiac output
b) Fall in diastolic and mean arterial pressure
c) +Bronchoconstriction
d) Tachycardia

54.1ndicate the alfa-1 selective antagonist:


a. Phentolamine
b. Dihydroergotamine
c. +Prazosin
d. Labetalol

55. Indicate the beta antagonist, which has partial beta-agonist activity:
a. Prooranolol
b. Meioprolol
c. +Pindolol
d. Betaxolol

6
56. The adverse effects of phentolamine include all of the following EXCEPT:
a. Diarrhea
b. +Bradycardia
c. Arrhythmias
d. Myocardial ischemia

57. This drug is a Class II antiarrhythmic drug:


a. Flecainide
b. +Propranolol
c. Lidocaine
d. Verapamil

58. This drug is used in treating supraventricular tachycardias:


a)+Digoxin
b) Dobutamine
c) Amiinone
d) Dopamine

59. This is a drug of choice for acute treatment of ventricular tachycardias:


a) Flecainide
b) Sotalol
c) +Lidocaine
d) Verapamil

60. All of the following are common adverse effects of Ca channe blockers EXCEPT:
a. +Skeletal muscle weakness
b. Dizziness
c. Headache
d. Flushing

61. Bacteriostatic effect is:


a) +Inhibition of bacterial cell division
b) Inhibition of young bacterial cells growth
c) Destroying of bacterial cells
d) Formation of bacterial L-form

62. Tick the drug belonging to antibiotics-monobactams:


a) Ampicillin
b) Bicillin-5
c) +Aztreonam
d) Imipinem

63. Tick the drug belonging to nitrobenzene derivative:


a. Clindamycin
b. Streptomycin
c. Azithromycin
d. +Chloramphenicol

64. Antibiotics altering permeability of cell membranes are:


a. Glvcopeptides
b. +Polymyxins
c. Tetracvclines
d. Cephalosporins

7
65. Which of the following atuidepressants is a selective serotonin reuptake inhibitor?
a) Phenelzine
b) Desipramine
c) Maprotiline
d) +Fluoxetine

66. Which of the following antidepressants is used for treatment of eating disorders,
especially buliemia ?
a. Amitriptvline
b. +Fluoxetine
c. Imipramihe
d. Tranylcypromine

67. Pick out the sympatholytic drug:


a. aj Labetalol
b. Prazosin
c. + Guanethidine
d. Clonidine

68. Choose the selective blocker of beta-1 adrenoreceptors:


a. Labetalol
b. Prazosin
c. +Atenolol
d. Propranolol

69. This drug blocks alpha-1 adrenergic receptors:


a. +Prazosin
b. Clonidine
c. Enalapril
d. Nifedipine

70. This drug is contraindicated in patients with bronchial asthma:


a. +Propranolol
b. Clonidine
c. Enalapril
d. Nifedipme

71. Tick the diuretic agent - aldosterone antagonist:


a. Furosemide
b. +Spironolactone
c. Dichloiiiiazide
d. Captopril

72. Indicate the agents of choice in the treatment of most anxiety states:
a. Barbiturates
b. +Benzodiazepines
c. Lithium salts
d. Phenothiazines

73. Which of the following anxiolytics is preferred in patient with limited hepatic function?
a. +Buspirone
b. Quazepam
c. Diazepam
d. Chlordiazep oxide

8
74. Muscarinic receptors are located in:
a. Autonomic ganglia
b. Skeletal muscle neuromuscular junctions
c. +Autonomic effector cells
d. Sensorv carotid sinus baroreceptor zone

75. Which of the following direct-acting drug has the shortest duration of action?
a. +Acetylcholine
b. Metnacholine
c. Carbachol
d. Bethanechol

76. Indicate cholinesterase activator:


a. +Pralidoxime
b. Edrophonium
c. Pilocarpine
d. Isoflurophate

77. Indicate the reversible cholinesterase inhibitor, which penetrates the blood-brain barrier:
a. +Physostigmine
b. Edrophonium
c. Neostigmine
d. Piridostigmine

78. Which of the following agents is a ganglion-blocking drug?


a. Homatropine
b. +Hexametnonium
c. Rapacuronium
d. Edrophonium

79. Atropine is used prior to premedication to reduce:


a. Muscle tone
b. +Secretions
c. Nausea and vomiting
d. All of the above

80. Which of the following agents is used as an inhalation drug in asthma?


a. Atropine
b. +Ipratropium
c. Lobelme
d. Homatronine

81. Indicate the long-acting neuromuscular blocking agent:


a. Rapacuronium
b. Mivacurium
c. +Tubocurarine
d. Rocuronium

82. Which of the following neuromuscular blockers causes transient muscle fasciculations?
a. Mivacurium
b. Pancuronium
c. +Succinvlcholine
d. Tubocurarine

9
83. The drug acts at the proximal tubule:
a. +Acetazolamiae (Diamoxj
b. Furosemide (Lasix)
c. Hydrochlorothiazide (HydroDiuril)
d. Spironolactone (Aldactone)

84. The drug can be used to treat glaucoma:


a. Furosemide (Lasix)
b. +Acetazolamide (Dianiox)
c. Both of the above
d. Neither of the above

85. The drug decreases calcium excretion in urine:


a. +Hydrochlorothiazide (HydroDiuril)
b. Amiloride (Midamor)
c. Furosemide (Lasix)
d. Acetazolamide (Diamox)

86. The drug acts in the collecting tubules:


a. Loop diuretics
b. Thiazide diuretics
c. +Potassium-sparing diuretics
d. Carbonic annydrase inhibitors

87. The drug is the least potent diuretic:


a. Osmotic diuretics
b. Loop diuretics
c. Thiazide diuretics
d. +Potassium-sparing diuretics

88. Acetazolamide acts at this nephron site


a. +Proximal convoluted tubule
b. Ascending thick limb of the loop Henle
c. Distal convoluted tubule
d. Collecting duct

89. Which of the following is a Ca channel blocker ?


a. Nitroglycerin
b. Dipyndamole
c. Minoxidil
d.+ Nifedipine

90. All of the following are used in CHF except:


a. Reduced salt intake
b. +Verapamil
c. ACE inhibitors
d. Diuretics

91. This drug is a selective beta-1 agonist:


a. Digoxin
b. +Dobutamine
c. Amrinone
d. Dopamine

92. Indicate drug, which is an inhibitor of NMDA glutamate receptors:


a. Thiopental

10
b. Halothane
c. +Ketamine
d. Sevoflurane

93. Which of the following inhaled anesthetic can produce hepatic necrosis?
a. Soveflurane
b. Desfluane
c. +Halothane
d. Nitrous oxide

94. Indicate the intravenous anesthetic, which is a benzodiazepine derivative:


a. +Midazolam
b. Thiopental
c. Ketamin
d. Propofol

95. Pick out the bronchodilator drug belonging to sympathomimics:


a. Isonrenaline
b. +Epnedrine
c. Atropine
d. Salbutamol

96. Choose the drug belonging to membrane stabilizing agents:


a. Zileutin
b. +Sodium cromoglycate
c. Zafirlucast
d. Montelucast

97. All of the following agents intensify the secretion of gastric glands ЕХСЕРT.
a. +Pepsin
b. Gastrin
c. Histamine
d. Carbonate mineral waters

98. Tick the drug forming a physical barrier HC1 and pepsin:
a. Ranitidine
b. +Sucralfate
c. Omeprazole
d. Pirenzepine

99. Indicate the drug that cause metabolic alkalosis:


a. +Sodium bicarbonate
b. Cimetidine
c. Pepto-Bismol
d. Carbenoxolone

100. Indicate the beta-1 selective antagonist:


a) Propranolol
b) +Metoprolol
c) Garvedilol
d) Sotalol
101. This drug is an inhibitor of renin synthesis:
a.+Propranolol
b. Enalapril
c. Diazoxide
d. Losartan

11
102. This drug routinely produces some tachycardia:
a. Propranolol
b. Clonidine
c. Enalapril
d. +Nifedipine

103. Which drugs is a selective Ml blocker?


a. Atropine
b. +Scopolamine
c. Pircnzepine
d. Homatropine

104. Indicate a drug, which is effective in the treatment of mushroom poising:


a. Pralidoxime
b. Pilocarpine
c. Homatropine
d. +Atropine

105. The drug is a K+-sparing diuretic that blocks Na+ channels inlhe collecting tubules:
a. Acetazolamide (Diamox)
b. +Amiloride (Midamor)
c. Furosemide (Lasix)
d. Hydrochlorothiazide (HydroDiuril)

106. Indicate the drug belonging to proton pump inhibitors:


a) Pircnzepine
b) Ranitidine
c) +Omeprazole
d) Trimcthaphan

107. Which of the following drugs may cause reversible gynecomastia?


a) Omeprazole
b) Pircnzepine
c) +Cimetitfine
d) Sucralfate

108. Choose the drug that causes constipation:


a) Sodium bicarbonate
b) +Aluminium hydroxide
c) Calcium carbonate
d) Magnesium oxide

109. Furosemide acts at the nephron site:


a. Proximal convoluted tubule
b. +Ascending thick limb of the loop of Henle
c. Distal convoluted tubule
d. collecting duct

110. A bronchial smooth muscle contains:


a. Alfa-1 receptor
b. Alfa-2 receptor
c. Beta-1 receptor
d. + Beta-2 reccptor

12
111. Which drug is a non selective β-receptor agonist?
a. Norepinephrine
b. Terbutaline
c. +Isoproterenol
d. Dobutamine

112. Sustained use of this drug results in increased plasma urate concentrations:
a) +Furosemide (Lasix)
b) Acetazolamide (Diamox)
c) Both of the above
d) Neither of the above

113. This drug is a Class IB antiarrhythmic drug:


a. Flecainide
b. Sotalol
c. +Lidocaine
d. Verapamil

114. Tick the drug belongs to antibiotics-cephalosporins:


a. Streptomycin
b. +Ceficlor
c. Phenoxymcthilpenicillin
d. Erythromycin

115. Which of the following drugs is a nonselective alfa receptor antagonist?


a. Prazosin
b. +Phentolamine
c. Metoprolol
d. Reserpine

116. Which of the following groups of antibiotics shows a bacteristatic effect:


a. Carbapenems
b. +Macrolides
c. Aminoglycosides
d. Cephafos'porins

117. All of the following agents are cardiac glycosides EXCEPT:


a. Digoxin
b. Strophantin К
c. +Amrinone
d. Digitoxin

118. Amiloride acts ai this nephron site:


a. Proximal convoluted tubule
b. Ascending thick limb of the loop of Henle
c. Distal convoluted tubule
d. +Collecting duct

119. Indicate the drug which is a leucotrienc receptor antagonist:


a. Sodium cromoglycatc
b. +Zafirlucast
c. Zileutin
d. Triamcinolone

13
120. Choose the drug which is a H2-receptor antagonist:
a. Omeprazole
b. Pirenzepme
c. Carbenoxolonc
d. +Ranitidine

121. Which drug is an analog of prostaglandin El?


a. +Misoprostole
b. De-nol
c. Sucralfate
d. Omeprazole

122. Tick the mechanism of metoclopramide antiemetic action:


a. HI and H2-receptor blocking effect
b. M-cholinoreceptor stimulating effect
c. +D2-dopaniine and 5-HT3-serotonin receptor blockina effect
d. M-choiinoblocking effect

123. All of these drugs reduce intestinal peristalsis EXCEPT:


a. Loperamide
b. +Cisapride
c. Methyl cellulose
d. Magnesium aluminium silicate

124. All drugs inhibit cell wall synthesis, except:


a. Carbapenems.
b. Monobactams.
c. Cephamycins.
d. +Nitrofurantoin

125. This drug is a Class III antianhythmic drug:


a. Flecainide
b. +Sotalol
c. docaine
d. Verapamil

126. Minimal duration of antibacterial treatment is:


a. Not less than 1 day
b. +Not less than 5 days
c. Not less than 10-I4 days
d. Not less than 3 weeks

127. Which antibiotics contains a β-lactam ring in their chemical structure:


a. Penicillins
b. Cephalosporins
c. Carbapenems and monobactams
d. +All groups

128. The mode of action may be:


a) +specific and nonspecific
b) selective and nonselective
c) reversible and irreversible
d) metabolic and fimctional

14
129. All of the following antibiotics inhibit the protein synthesis in bacterial cells, EXCEPT:
a. Macrolides
b. Aminoglycosides
c. +Glycopcptides
d. Tetracyclincs

130. All are true about digoxin except:


a.+Causes bradycardia
b.Acts by inhibiting Na+K+ ATPase
c. It is 95 % plasma protein bound
d. Primarily excreted unchanged by glomerular filtration acting

131. All of the following are central antihypertensive drugs EXCEPT:


a. Methyldopa
b. Clonidine
c.Moxonidine
d. +Minoxidil

132. This drug is a directly acting vasodilator:


a. Labetalol
b. Clonidine
c. Enalapril
d. +Nifedipine

133. This drug is a potassium channel activator:


a) Nifedipine
b) Saralasin
c) +Diazoxide
d) Losartan

134. Which of the following is commonly used in the treatment of glaucoma?


a. +Pilocarpine
b.Lobeline
c. Acethylcholine
d. Neostigmine

135. Indicate muscles, which are more resistant to block and recover more rapidly:
a. Hand
b. Leg
c. Neck
d. +Diaphragm

136. Tick the drug, inhibiting viral DNA synthesis:


a) Interferon
b) Saquinavir
c) Amantadine
d)+Acyclovir

137. The drug interaction with different cellular and subcellular structures can result in their
a)stimulation
b)+depression
c)decreasing
d)stabilization

15
138. Tick the anticancer drug, a pyrimidine antagonist:
a) Fluorouracil
b) +Mercaptopurine
c) Thioguanine
d) Methotrexate

139. Geriatric pharmacology studies the peculiarities of action and clinical use of drugs in
a) children
b) pregnant women
c) nursing women
d) +elderly

140. Tick the second messenger of G-protein-coupled (metallotropic) receptor:


a. Adenylyl cyclase
b. Sodium ions
c. Phosnholipase С
d. +сАМР

150. Which drug is a proton pump inhibitor?


a. Cimetidme
b. Ranitidine
c. Pirenzcpin
d. +Omeprazole

151. Choose an emetic drug of central action:


a. +Ipecacuanha derivatives
b. Promethazine
c. Tropisetron
d. Apomorphine hydrochloride

152. Therapeutic index is indicator of:


a) Safety
b) +Efficacy
c) Potency
d) Toxicity

153. Morphine causes all, EXCEPT:


a) Peripheral vasodilatation
b) Decrease intracranial tension
c) Nausea and vomiting
d) +Decrease in gastrointestinal secretion

154. What kind of substances can’t permeate membranes by passive diffusion?


a. Lipid-soluble
b. Non-ionized substances
c. Hydrophobic substances
d. +Hydrophilic substances

155. Tachyphylaxis is:


a. A drug interaction between two similar types of drugs
b. +Very rapidly developing tolerance
c. A decrease in responsiveness to a drug, taking days or weeks to develop
d. None of the above

16
156. Pharmacology is a science about
a)chemistry
b)physiology.
c)+medicinal preparations
d)pharmaceutical business

157. A teratogenic action is:


a. Toxic action on the liver
b. +Negative action on the fetus causing fetal malformation
c. Toxic action on blood system
d. Toxic action on kidneys

158. Which of the following agents is an selective agents is an alfa-l selective agonist?
a. Norepinephrine
b. +Methoxamine
c. Ritodrine
d. Ephedrine

159. Indicate the indirect-acting agent:


a. Epinephrine
b. Phenylephrine
c. +Ephedrine
d. Isoproterenol

160. Which of the following is related to short acting topical decongestant agents ?
a. Xylometazoline
b. Terbutaline
c. +Phenylephrine
b. Norepinephrine

161. Which of the following agents is an alfa 2-selective antagonist ?


a. +Yohimbine
b. Tamsulosin
c. Tolazoline
d. Prazosin

162. Which of the following drugs is a reversible nonselective alfa-, beta-antagonist?


a. + Labetalol
b. Phentolamine
c. Metoorolol
d. Propranolol

163. This drug is a Class 1A antiarrhythmic drug:


a. Sotalol
b. Propranolol
c. Verapamil
d. +Quinidine

164. This drug prolongs repolarization:


a. Flecainide
b. +Sotalol
c. Lidocaine
d. Verapamil

17
165. This drug has beta-adrenergic blocking activity:
a. Flecainide
b. +Sotalol
c. Lidocaine
d. Verapamil

166. This drug acts to inhibiting slow Ca channels in the SA and AV nodes:
a. Quinidine
b. Adenosine
c. Fleeainide
d. +Diltiazem

167. Which of the following groups of antibiotics shows a bactericidal effect?


a. Tetracyclines
b. Macrolides
c. +Penicillins
d. All of the above

168. Tick the drug belonging to antibiotics - carbapenems:


a. Aztreonam
b. Amoxacillin
c. +Imipinem
d. Clarithromycin

169. Tick the drug belonging to lincozamides:


a. Erythromycin
b. +Lincomvcm
c. Azithromycin
d. Aztreonam

170. Tick the drug belonging to glycopeptides:


a. +Vancomycin
b. Lincomycin
c. Neomycm
d. Carbenicillin

171. Which of the following drugs is a gastric acid resistant:


a. Penicillin G
b. +Penicillin V
c. Carbenicillin
d. Procain penicillin

I72. Indicate the antidepressant, which blocks the reuptake pumps for serotonin and norepinephrine:
a. +Amitriptyline
b. Fluoxetine
c. Maprotiline
d. Phenelzine

173. A highly selective serotonine reuptake inhibitor is:


a. Sertaline
b. Paroxetine
c. Fluoxetine.
d. +All of the above

18
174. Tick the drug with nonselective beta-adrenoblocking activity:
a. Atenolol
b. +Propranolol
c. Metoprolol
d. Nebivolol
175. Pick out the diuretic agent for hvpertension treatment:
a. Losartan
b. +Dichlothiazide
c. Captcpril
d. Prazosin
176. This drug is a non-peptide angiotensin II receptor antagonist:
a. Clonidine
b. Captopril
c. +Losartan
d. Diazoxide

177. Choose the vasodilator which releases NO:


a. Nifedipine
b. Hydralazine
c. Minoxidil
d. +Sodium nitroprusside

178. Indicate a peripheral dopa decarboxvlase inhibitor:


a. Tolcapone
b. Clozapine
c. + Carbiaopa
d. Selegiline

179. Indicate D2 receptor agonist with antiparkinsonian activity:


a. Sinemet
b. Levodopa
c. +Bromocriptine
d. Selegiline

180. Which of the following anxylotics is a benzodiazepine derivative:


a. Buspirone
b. +Clordiazepoxide
c. Meprobamate
d. Chloral hydrate

181. Indicate the competitive antagonist of β-2 receptors:


a. +Flumazenil
b. Buspirone
c. Picrotoxin
d. Diazenam

182. Which of the following activates both muscarinic and nicotinic receptors ?
a. Lobeline
b. Pilocarpine
c. Nicotine
d. +Bethanechol

19
183. The M-cholinimimetic agent is:
a. Carbachol
b. +Pilocarpine
c. Acetylcholine
d. Betfianechol

184. Isofluorophate increases all of the following effects except:


a. Lacrimation
b. +Bronchodilation
c. Muscle twitching
d. Salivation

185. Which of the following cholinomimetics is used in the treatment of atropine intoxication?
a. Neostigmine
b. Carbochol
c. +Physostigmine
d. Lobeline

186. Which of the following drugs is effective in motion sickness?


a. Atropine
b. Ipratropium
c. +Scopolamine
d. Homatropine

187. Which of the following drugs is useful in the treatment of uterine spasms?
a. Carbachol
b. Vecuronium
c. +Atropine
d. Edrophonium

188. Antimuscarinics are used in the treatment of the following disorders EXCEPT:
a. Motion sickness
b. +Glaucoma
c. Hyperhidrosis
d. Asthma

189. Indicate the nondepolarizing agent, which has short duration of action:
a. Succinylcholine
b. Tubocurarine
c. +Mivacurium
d. Pancuronium

190. The drug inhibits the ubiquitous enzyme carbonic anhydrase:


a. +Acetazolamide (Diamoxj
b. Furosemide (Lasix]
c. Hydrochlorothiazide (HydroDiuril)
d. Spironolactone (Aldactone)

191. The drug acts by competing with aldosterone for its cytosotic receptors:
a. Acetazolamide (Diamoxj
b. Furosemide (Lasix)
c. Hydrochlorothiazide (HydroDiuril)
d. +Spironolactone (Aldactone)

20
192. The drug can cause ototoxicity:
a. +Furosemide (Lasix)
b. Acetazolamide (Diamox)
c. Both of the above
d. Neither of the above

193. The drug acts by competitively blocking the Na+/K+/2Cl- cotransporter:


a. +Loop diuretics
b. Thiazide diuretics
c. cl Potassium-sparing diuretics
d. Carbonic anhydrase inhibitors

194. The drug acts by competitively blocking the NaCI cotransporter:


a. Loop diuretics
b. +Thiazide diuretics
c. Potassium-sparing diuretics
d. Carbonic anhydrase inhibitors

195. These agents must be given parenterally because they are not absorbed w'hen given
orally:
a. + Osmotic diuretics
b. Loon diuretics
c. Thiazide diuretics
d. Potassium-sparing diuretics

196. Spironolactone acts at this nephron site:


a. Proximal convoluted tubule
b. Ascending thick limb of the loop of Henle
c. Distal convoluted tubule
d. +Collecting duct

197. Main clinical use of Ca channel blockers is:


a. Angina pectoris
b. Hypertension
c. Supraventricular tachyarrhythmia
d. +All of the above

198. The non-glycoside positive inotropic drug is:


a. Digoxin
b. Strophantin К
c. +Dobutamine
d. Digitoxin

199. Tolerance to this drug develops after a few days:


a. Amrinone
b. Amiodarone
c. +Dobutamine
d. Adenosine

200. Which of the following general anesthetics belongs to inhalants ?


a. Thiopental
b. +Desfluran
c. Ketamine
d. Propoftol

21
201. Indicated the inhaled anesthetic, which may cause nephrotoxicity:
a. Halothane
b. +Soveflurane
c. Nitrous oxide
d. Diethvl ether

202. Which of these groups of drugs is used for asthma treatment ?


a. Methylxanthines
b. M-cholinoblocking agents
c. Beta-2 stimulants
d. +All of above

203. Select the side-effect characteristic for non-selective beta-2 adrenomimetics:


a. Depression of the breathing centre
b. +Tachycardia
c. Peripheral vasoconstriction
d. Dry mouth

204. Indicate the side effect of theophylline:


a. Bradycardia
b. +Increased myocardial demands for oxygen
c. Depression of respiratory centre
d. Elevation of the arterial blood pressure

205. Gastric acid secretion is under the control the following agents EXCEPT:
a. Histamine
b. Acetylcholine
c. +Serotonin
d. Gastrin

206. All of the following drugs are proton pump inhibitors except:
a. Pantoprozole
b. Omeprazole
c. +Famotidine
d. Rabeprazole

207. Most of drugs are antacids EXCEPT:


a. +Misoprostol
b. Maalox
c. Mylanta
d. Almagel

208. This drug is related to short-acting topical decongestant:


a. Xylometazoline
b. Terbutaline
c. +Phenylephrine
d. Norepinephrine

209. This drug is a Class IA antiarrhythmic drug:


a. Sotalol
b. Propranolol
c. Verapamil
d. +Quinidine

22
210. This drug acts by inhibiting slow Ca channels in the SA and AV nodes:
a. Quinidine
b. Adenosine
c. Fleeainide
d. +Diltiazem

211. Which of the following groups of antibiotics shows a bactericidal effect?


a. Tetracyclines
b. Macrolides
c. Penicillins
d. +All of the above

212. Most of drugs are antacids EXCEPT:


a. +Misoprostol
b. Maalox
c. Mvlanta
d. Almagel

213. Side effects of anticancer drugs are all, EXCEPT:


a. Low selectivity to cancer cells
b. Depression of bone marrow
c. Depression of angiogenesis
d. +Depression of immune system

214. Main clinical use of Ca channel blockers is:


a. Angina pectoris
b. Hypertension
c. Supraventricular tachyarrhythmias
d. +All of the above

215. Which drug is a H2-receptor antagonist:


a. Omeprazole
b. Pirenzepine
c. Carbenoxolone
d. +Ranitidine

23
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM

1. In the autonomic regulation of blood pressure


A. Cardiac output is maintained constant at the expense of other hemodynamic variables
B. Elevation of blood pressure results in elevated aldosterone secretion
C. Baroreceptor nerve fibres decrease firing rate when arterial pressure increases
D. Stroke volume and mean arterial blood pressure are the primary direct determinants of
cardiac output +

2. The autonomic nervous system is also known as


A. Visceral
B. Vegetative
C. Involuntary nervous system +
D. All of the above
3. Full activation of the sympathetic nervous system, as in maximal exercise, can
produce all of the following responses except
A. Bronchial relaxation
B. Decreases intestinal motility
C. Increased renal blood flow +
D. Mydriasis
4. The neurotransmitter agent that is normally released in the sinoatrial node of the
heart in response to a blood pressure increase is
A. Acetylcholine +
B. Dopamine
C. Epinephrine
D. Glutamate
5. A direct-acting cholinomimetic that is lipid-soluble and often used in the treatment of
glaucoma is
A. Acetylcholine
B. Bethanechol
C. Physostigmine
D. Pilocarpine +
6.Which of the following agents is a prodrug that is much less toxic in mammals than in
insects
A. Acetylcholine
B. Bethanechol
C. Physostigmine C +
D. Pilocarpine
7. Atropine overdose may cause which one of the following
A. Gastrointestinal smooth muscle cramping
B. Increased cardiac rate +
C. Increased gastric secretion
D. Pupillary constriction
8.The synaptic pre-ganglionic neurons have their cell bodies in the lateral horn of the
grey matter of the
A.Thoracic segment only
B. Lumbar segment only
C. Both (a) and (b) +
D. None of the above
9. Which one of the following can be blocked by atropine?
A. Decreased blood pressure caused by hexamethonium
B. Increased blood pressure caused by nicotine
C. Increased skeleton muscle strength caused by neostigmine
D. Tachycardia caused by infusion of acetylcholine +
10. ‘Fight or flight’ state can be described as
A.Sympathetic active; para-sympathetic quiescent +
B. Sympathetic active; para-sympathetic active
C. Sympathetic quiescent; para-sympathetic active
11. In male sex organs _______ system is responsible for erection.
A. Sympathetic
B. Parasympathetic +
C. Norepinephrine
D. None of the above
12. Rest and digest’ state can be described as
A. Sympathetic active; para-sympathetic quiescent
B. Sympathetic active; para-sympathetic active
C. Sympathetic quiescent; para-sympathetic active +
13. Reserpine, an alkaloid derived from the root of Rauwolfia serpentine
A. Can be used to control hyperglycaemia
B. Can cause severe depression of mood +
C. Can decrease gastrointestinal secretion and motility
D. Has no cardiac effects
14. Following enzyme is involved in the synthesis of acetylcholine

A. Choline acetyl transferase +


B. Acetyl cholinesterase
C. Both (a) and (b)
D. None of the above

15. Following is an antagonist of ganglion type nicotinic receptors


A. Tubercurarine
B. αbungarotoxin
C. Trimethaphan +
D. All of the above
16. Oxytremorine is a selective agonist of muscarinic _______ receptors
A. M1 +
B. M2
C. M3
D. M4
17. A drug that is useful in glaucoma and high-altitude sickness is
A. Acetazolamide +
B. Amiloride
C. Demeclocycline
E. Desmopressin
18. Cromolyn has as its major action
A. Block of calcium channels in lymphocytes
B. Block of mediator release from mast cells +
C. Block of phosphodiesterase in mast cells and basophils
D. Smooth muscle relaxation in the bronchi
19. Which one of the following is least likely to be useful in the therapy of hypercalcemia
A. Calcitonin
B. Glucocorticoids
C. Plicamycin
D. Thiazide diuretics +
20. Characteristics of Vitamin D and its metabolites include which one of the following
A. Act to decrease serum levels of calcium
B. Activation of their Vitamin D receptors increases cellular CAMP
C. Calcitriol is the major derivative responsible for increasing intestinal absorption of
phosphate +
D. Metabolites of Vitamin D increase renal excretion of calcium
21. Action of norepinephrine and epinephrine are terminated by
A. Reuptake into nerve terminal
B. Dilution by diffusion and uptake at extraneuronal site
C. Metabolic transformation
D. All of the above +
22. Typical results of beta-receptor activation include which one of the following
A. Hypoglycaemia
B. Lipolysis +
C. Glycogen synthesis
D. Decreased skeletal muscle tremor
23. Drugs that block the α receptor on effector cells at adrenergic nerve endings
A. Antagonize the effects of isoproterenol on the heart rate
B. Antagonize some of the effects of epinephrine on the blood pressure +
C. Antagonize the effects of epinephrine on adenylyl cyclase
D. Cause mydriasis
24. Yohimbine is an antagonist of ______ receptors.
A. α1
B. α2 +
C. both (a) and (b)
D. None of the above
25. Which of the following organs is innervated only by parasympathetic nerves
A. Iris muscles
B. Ciliary muscle +
C. Sweat glands
D. Splenic capsule
26. α1 – receptors are coupled with _______ G protein.
A. Gs
B. Gi
C. Gq +
D. Go
27. Hyoscine differs from atropine in that it
A. Exerts depressant effects on the CNS at relatively low doses +
B. Exerts more potent effects on the heart than on the eye
C. Is longer acting
D. Has weaker antimotion sickness activity
28. Which of the following anticholinergic drugs is primarily used in preanesthetic
medication and during surgery
A. Glycopyrrolate +
B. Pipenzolate methyl bromide
C. Isopropamide
D. Dicyclomine
29. Glycopyrrolate is the preferred antimuscarinic drug for use before and during
surgery because
A. It is potent and fast acting
B. It has no central action
C. It has antisecretory and vagolytic actions
D. All of the above +
30. The cardiac muscarinic receptors
A. Are of the M1 subtype
B. Are of the M2 subtype +
C. Are selectively blocked by pirenzepine
D. Function through the PIP2 → IP3/DAG pathway

31. The most suitable mydriatic for a patient of corneal ulcer is


A. Atropine sulphate +
B. Homatropine
C. Cyclopentolate
D. Tropicamide
32. The most effective antidote for belladonna poisoning is
A. Neostigmine
B. Physostigmine +
C. Pilocarpine
D. Methacholine
33. Atropine is contraindicated in
A. Cyclic AMP
B. Inositol trisphosphate
C. Diacyl glycerol
D. G protein +
34. Select the correct statement from the following about α 1 – adrenergic receptor
agonists
A. Isoproterenol > epinephrine ≥ norepinephrine +
B. Epinephrine > isoproterenol > norepinephrine
C. Isoproterenol = epinephrine ≥ norepinephrine
D. Epinephrine ≥ norepinephrine > isoproterenol
35. The most efficacious inhibitor of catecholamine synthesis in the body is
A. α - methyl – p – tyrosine +
B. α methyldopa
C. α methyl - norepinephrine
D. Pyrogallol
36. Adrenaline raises blood glucose level by the following actions except
A. Inducing hepatic glycogenolysis
B. Inhibiting insulin secretion from pancreatic β cells
C. Augmenting glucagons secretion from pancreatic α cells
D. Inhibiting peripheral glucose utilization +
37. Noradrenaline is administered by
A. Subcutaneous injection
B. Intramuscular injection
C. Slow intravenous infusion +
D. All of the above routes
38. Dobutamine differs from dopamine in that
A. It does not activate peripheral dopaminergic receptors +
B. It does not activate adrenergic β receptors
C. It causes pronounced tachycardia
D. It has good blood-brain barrier penetrability
39. Ephedrine is similar to adrenaline in the following feature
A.Potency
B. Inability to penetrate blood-brain barrier
C. Duration of action
D. Producing both α and β adrenergic effects +
40.Choose the correct statement from the following about α1 – adrenergic receptor
agonists
A. Norepinephrine > isoproterenol > epinephrine
B Norepinephrine < epinephrine > isoproterenol
C Epinephrine≥ norepinephrine >> isoproterenol +
D Epinephrine > isoproterenol > norepinephrine
41. A sympathomimetic amine that acts almost exclusively by releasing noradrenaline
from the nerve endings is
A. Ephedrine
B. Dopamine
C. Isoprenaline
D. Tyramine +
42. Low doses of adrenaline dilate the following vascular bed
A. Cutaneous
C. Renal
B. Mucosal
D. Skeletal muscle +
43. α2–adrenergic receptors are associated with following except
A. Increase in phospholipase C activity
B. Increase in potassium channel conductance
C. Decrease in calcium channel conductance
D. Increase in adenylyl cyclase activity +
44. While undergoing a surgical procedure a patient develops hypotension. Which of the
following drugs can be injected intramuscularly to raise his BP
A. Noradrenaline
B. Isoprenaline
C. Mephentermine +
D. Isoxsuprine
45. Vasoconstrictors should not be used in
A. Neurogenic shock
B. Haemorrhagic shock
C. Secondary shock +
D. Hypotension due to spinal anaesthesia
46. The drug which produces vasoconstriction despite being an α adrenergic blocker is
A. Phenoxybenzamine
B. Ergotamine +
C. Dihydroergotoxine
D. Tolazoline
47. Prazosin is an effective antihypertensive while nonselective α adrenergic blockers
are not because
A. It is the only orally active α blocker
B. It improves plasma lipid profile
C. It does not concurrently enhance noradrenaline release +
D. It improves urine flow in males with prostatic hypertrophy
48. Phenylephrine
A. Mimics the transmitter at post-synaptic receptors +
B. Displaces transmitter from axonal terminal
C. Inhibits synthesis of transmitter
D. None of the above
49. A β adrenergic blocker that is primarily eliminated unchanged by renal excretion is
A. Propranolol
B. Metoprolol
C. Alprenolol
D. Atenolol +
50. In a patient of myocardial infarction, βadrenergic blockers are used with the
following aim/aims:
A. To reduce the incidence of reinfarction
B. To prevent cardiac arrhythmias
C. Myocardial salvage
D. All of the above +
51. The β-adrenergic blocker which possesses both β-1 selectivity as well as intrinsic
sympathomimetic activity is
A. Alprenolol
B. Atenolol
C. Acebutolol +
D. Metoprolol
52. Propranolol can be used to allay anxiety associated with
A. Chronic neurotic disorder
B. Schizophrenia
C. Short-term stressful situation +
D. Endogenous depression
53. Propranolol does not block the following action of adrenaline
A. Bronchodilation
B. Lipolysis
C. Muscle tremor
D. Mydriasis +
54. The site of action of d-tubocurarine is
A. Spinal internuncial neurone
B. Motor nerve ending
C. Muscle end-plate +
D. Sodium channels in the muscle fibre
55. The fall in blood pressure caused by d- tubocuranine is due to
A. Reduced venous return.
B. Ganglionic blockade
C. Histamine release
D. All of the above +
56. The neuromuscular blocker having prominent antivagal action is
A. Pancuronium
B. Vecuronium
C. Atracurium
D. Gallamine triethiodide +
57. Neuromuscular blocking drugs do not produce central actions because
A. Nicotinic receptors are not present in the brain
B. They do not cross the blood-brain barrier +
C. They are sequestrated in the periphery by tight binding to the skeletal muscles
D. They do not ionize at the brain pH
58. Pancuronium differs from tubocurarine in that
A. It is a depolarizing blocker
B. Its action is not reversed by neostigmine
C. It can cause rise in BP on rapid I.V. injection +
D. It causes marked histamine release
59. Muscarinic receptors are G-protein coupled receptors, causing
A. Inactivation of phospholipase C
B. Activation of adenylyl cyclase
C. Activation of potassium or inhibition of calcium channels +
D. All of the above
60. Postoperative muscle soreness may be side effect of the following neuromuscular
blocker
A. d-tubocurarine
B. Succinylcholine +
C. Pancuronium
D. Atracurium
61. Following drug enhances the evoked release of acetylcholine
A. 4-aminopyridine +
B. Vesamicol
C. Magnesium ion
D. None of the above
62. Select the ergot compound which is primarily used for dementia
A. Bromocriptine
B. Ergotamine
C. Codergocrine +
D. Methysergide
63. Following muscarinic agonist is susceptible to hydrolysis by cholinesterase
A. Carbachol
B. Methacholine +
C. Bethanechol
D. Muscarine
64. Stimulation of exocrine glands by muscarinic agonist leads to
A. Sweating
B. Salivation
C. Bronchial secretions
D. All of the above +
65. β blockers are contraindicated in
A. Prophylaxis of anxiety states
B. Hyperthyroidism
C. Hypertrophic obstructive cardiomyopathy
D. Peripheral vascular disease +
66. β blockers are better avoided in
A. Bronchial asthma +
B. Pheochromocytoma
C. Myocardial infarction
D. Migraine
67. Preferential beta 1 adrenergic blocking agent is

A. Propranolol
B. Atenolol +
C. Penbutolol
D. Oxprenolol
68. Prazosin
A. Produces preferential alpha1 adrenergic receptor blockade +
B. Has a half-life of 24 hours
C. Can worsen lipid profile in hypertensive patients
D. Does not depress the baroreceptor function
69. The drug that produces neuromuscular blockade by persistent depolarization is
A. D-tubocurarine
B. Gallamine
C. Pancuronium
D. Decamethonium +
70. Agents that block neuromuscular transmission of acetyl choline acts via
A. Inhibiting acetyl choline synthesis
B. Inhibiting acetyl choline release
C. Inhibiting post-synaptic action of acetyl choline
D. All of the above +
71. The skeletal muscle relaxant causing significant release of histamine is
A. Pancuronium
B. Atracurium
C. Gallamine
D. D-tubocurarine +
72. β blockers
A. Relieve symptoms of thyrotoxicosis +
B. Should not be used along with carbimazole
C. Reduce the synthesis of hormones in the gland
D. Should not be given before thyroid surgery
73.The antimuscarinic agent preferred in the management of motion sickness is
A. Atropine methonitrate
B. Scopolamine +
C. Homatropine methyl bromide
D. Ipratropium bromide

74. Side effect which is observed only with the use of β blockers and not with other
sympathetic blocking agents
A. Sedation and drowsiness +
B. Congestive heart failure
C. Bronchoconstriction
D. Reflex tachycardia
75. Following agent inhibits the release of acetyl choline
A. Magnesium ion +
B. Triethylcholine
C. Vesamicol
D. All of the above
76. Which of the following drugs has highest α agonist activity
A. Epinephrine +
B. Norepinephrine
C. Ephedrine
D. Amphetamine
77. Atropine is antagonist to which type of muscarinic
A. M1 +
B. M2
C. M3
D. M4
78. Following are irreversible anti-cholinesterase, except
A. Parathion
B. Pyridostigmine +
C. Dyflos
D. Ecothiopate
79.The ciliary muscle of iris has predominant
A. Sympathetic innervation
B. Parasympathetic innervation +
C. Somatic innervation
D. Mixture of all the above
80. Following is a short-acting anti-cholinesterase
A. Neostigmine
B. Pyridostigmine
C. Edrophonium +
D. Physostigmine

81. The antibiotic that may accentuate the neuromuscular blockade produced by d-
tubocurarine is
(a) Pencillin G

(b) Erythromycin

(c) Streptomycin +

(d) Chloramphenicol
82. Centrally acting skeletal muscle relaxant is
(a) Carisoprodol +
(b) Dantrolene
(c) Gallamine
(d) Succinylcholine
83. The organ extremely sensitive to the action of atropine is
(a) Gastric glands
(b) Salivary glands +
(c) Urinary bladder muscle
(d) Heart
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM

1. Substance secreted into the blood by a neuron is


A. Neurohormone +
B. Neuromodulator
C. Neuromediator
D. Neurotransmitter
2. Which of the following is a leukotriene receptor blocker?
A. Alprostadil
B. Aspirin
C. Ibuprofen
D. Zafirlukast +
3. The primary endogenous substrate for nitric oxide synthase is
A. Acetylcholine
B. Angiotensinogen
C. Arginine +
D. Citruline
4. Which one of the following chemicals does not satisfy the criteria for a
neurotransmitter role in the CNS?
A. Acetylcholine
B. Dopamine
C. Glycine
D. Nitric Oxide +
5. Neurotransmitters may
A. Increase chloride conductance to cause inhibition +
B. Increase potassium conductance to cause excitation
C. Increase sodium conductance to cause inhibition
D. Increase calcium conductance to cause inhibition
6. Which of the following chemicals is most likely to function as a neurotransmitter in
hierarchical systems?
A. Dopamine
B. Glutamate +
C. Metenkephalin
D. Norepinephrine
7. Suramin is an antagonist of ________ receptors
A. Purine +
B. Somatostanin
C. Neuropeptide Y
D. Neurotensin
8. Induction of various forms of synaptic plasticity is more closely associated with
_____ receptors
A. AMPA
B. Kainate
C. NMDA +
D. All of the above
9. Which one of the following drugs may increase anticoagulant effects by
displacement of warfarin from plasma protein binding sites and is inactive until
converted in the body to an active metabolite?
A. Buspirone
B. Chloral hydrate +
C. Clorazepate
D. Secobarbital
10. This hypnotic drug facilitates the inhibitory actions of GABA, but it lacks
anticonvulsant or muscle relaxing properties and has minimal effect on sleep
architecture.
A. Buspirone
B. Diazepam
C. Flurazepam
D. Zaleplon +
11. Following is GABAA agonist
A. Muscimol +
B. Baclofen
C. Bicuculline
D. None of the above
12. Chronic use of ethanol is reported to increase
A. Alcohol dehydrogenase
B. Aldehyde dehydrogenase
C. Microsomal ethanol-oxidizing system activity +
D. Monoamine oxidase
13. Following is glycine antagonists
A. Quisqualate
B. Taurine
C. Strychnine +
D. â-alanine
14. Withdrawal of antiseizure drugs can cause increased seizure frequency and
severity. Withdrawal is least likely to be a problem with
A. Clonazepam
B. Diazepam
C. Ethosuximide +
D. Phenobarbital
15. With chronic use in seizure states, the adverse effects of this drug include coarsening
of facial features, hirsutism, gingival hyperplasia, and osteomalacia.
A. Carbamazepine
B. Ethosuximide
C. Gabapentin
D. Phenytoin +
16. The most likely mechanism involved in the antiseizure activity of carbamazepine is
A. Block of sodium ion channels +
B. Block of calcium ion channels
C. Facilitation of GABA actions on chloride ion channels
D. Glutamate receptor antagonism
17. Which one of the following statements
about phenytoin is accurate?
A. Displaces sulfonamides from plasma proteins
B. Drug of choice in myoclonic seizures
C. Half-life is increased if used with phenobarbital
D. Toxicity may occur with only small increments in dose +
18. Following is GABAB agonist
A. Muscimol
B. Baclofen +
C. Picrotoxin
D. Bicuculline
19. Following is GABAA antagonist
A. Muscimol
B. Bicuculline +
C. Strychnine
D. Baclofen
20. The inhalation anaesthetic with the fastest onset of action is
A. Enflurane
B. Isoflurane
C. Nitric oxide
D. Nitrous oxide +
21. Which of the following was the first compound to be identified Pharmacologically
as a transmitter in the CNS?
A. Glycine
B. Glutamate
C. Acetylcholine +
D. Norepinephrine
22. You have a vial containing 4 mL of a 2% solution of lidocaine. How much lidocaine
is present in 1 mL?
A. 2 mg
B. 8 mg
C. 20 mg +
D. 80 mg
23. Respiratory depression following use of this agent may be reversed by
administration of flumazenil
A Desflurane
B. Fentanyl
C. Ketamine
D. Midazolam +
24. Use of this agent is associated with a high incidence of disorientation, sensory and
perceptual illusions, and vivid dreams during recovery from anaesthesia
A. Diazepam
B. Fentanyl
C. Ketamine +
D. Midazolam
25. Epinephrine added to a solution of lidocaine for a peripheral nerve block will
A. Increase the risk of convulsions
B. Increase the duration of anaesthetic action of the local anaesthetic +
C. Both (A) and (B)
D. Neither (A) nor (B)
26. Characteristics of nondepolarizing neuromuscular blockade include which one of
the following?
A. Block of post tetanic potentiation
B. Histamine blocking action
C. Poorly sustained titanic tension +
D. Significant muscle fasciculations during onset of block
27. Which of the following does not cause skeletal muscle contractions or twitching
A. Acetylcholine
B. Nicotine
C. Strychnine
D.Vecuronium +
28. Which one of the following is most effective in the management of malignant
hyperthermia?
A. Baclofen
B. Dantrolene +
C. Haloperidol
D. Succinylcholine
29. Following is a G-protein coupled receptor
A. AMPA
B. Kainate
C. NMDA
D. Metabotropic +
30. Which one of the following drugs has caused hyperkalaemia leading to cardiac
arrest in patients with neurologic disorders?
A. Baclofen
B. Dantrolene
C. Succinylcholine +
D. Tubocurarine
31. Following is an excitatory amino acid receptor antagonist?
A. Phencyclidine +
B. Quisqualate
C. Homocysteate
D. Kainate
32. Which one of the following drugs has spasmolytic activity and could also be used in
the management of seizures caused by overdose of a local anaesthetic?
A. Baclofen
B. Cyclobenzaprine
C. Dantrolene
D. Diazepam +
33. Which one of the following drugs given preoperatively will prevent postoperative
pain caused by succinylcholine?
A. Baclofen
B. Dantrolene
C. Diazepam
D. Tubocurarine +
34.The major reason why carbidopa is of value in parkinsonism is that the compound
A. Crosses the blood-brain barrier
B. Inhibits monoamine oxidase type A
C. Inhibits aromatic L-amino acid decarboxylase +
D. Is converted to the false neurotransmitter carbidopamine
35.Great caution must be exercised in the use of this drug (or drugs from the same
class) in parkinsonian patients who have prostatic hypertrophy or obstructive
gastrointestinal disease
A. Benztropine +
B. Carbidopa
C. Levodopa
D. Ropinirole
36. Which of the following statements about pramipexole is accurate?
A. Activates dopamine D2 receptors
B. Commonly a first-line therapy for Parkinson’s disease
C. May cause postural hypotension
D. All of the above +
37. Which one of the following statements about the action of phenothiazines is
accurate?
A. They activate muscarinic receptors
B. They are antiemetic +
C. They decrease serum prolactin levels
D. They elevate the seizure threshold
38. Choose the correct statement from the following?
A. Muscimol is GABAB selective
B. Bicuculline is GABAA agonist
C. Picrotoxin blocks chloride channels associated with GABAA receptors +
D. Baclofen is GABAA agonist
39.Following is the main inhibitory transmitter in the brain
A. Dopamine
B. Norepinephrine
C. Glycine
D. GABA +
40. Established clinical uses of this drug include enuresis and chronic pain
A. Bupropion
B. Fluvoxamine
C. Imipramine +
D. Phenelzine
41. Which one of the following drugs is most likely to increase plasma levels of
alprazolam, theophylline, and warfarin
A. Desipramine
B. Fluvoxamine +
C. Imipramine
D. Nefazodone
42. Which one of the following actions of opioid analgesics is mediated via activation of
kappa receptors?
A. Cerebral Vascular dilation
B. Decreased uterine tone
C. Euphoria
D. Sedation +
43. ______ antagonists are known to attenuate some of the actions of alcohol.
A. GABAA +
B. GABAB
C. NMDA
D. Glycine
44. Which one of the following effects is unlikely to occur during treatment with
amitriptyline?
A. Alpha adrenoceptor blockade
B. Elevation of the seizure threshold +
C. Mydriasis
D. Sedation
E. Urinary retention
45.Which one of the following drugs is most likely to be of value in obsessive compulsive
disorders (OCD)
A. Amitriptyline
B. Bupropion
C. Clomipramine +
D. Desipramine
46. Compared with other antidepressant drugs, mirtazapine has the distinctive ability to
act as an antagonist of
A. Alpha2 adrenoceptors +
B. Beta adrenoceptors
C. D2 receptors
D. NE transporters
47.Which one of the following signs or symptoms is likely to occur with marijuana
A. Bradycardia
B. Conjunctival reddening +
C. Hypertension
D. Increased psychomotor performance
48. The antihypertensive effects of captopril can be antagonized (reduced) by
A. Angiotensin II receptor blockers
B. Loop diuretics
C. NSAIDS +
D. Sulfonylurea hypoglycemics
49. The primary site of action of tyramine is
A. Ganglionic receptors
B. Gut and liver catechol–O–methyltransferase
C. Postganglionic sympathetic nerve terminals +
D. Preganglionic sympathetic nerve terminals
50. Which one of the following drugs has been used in ophthalmology, but causes
mydriasis and cycloplegia lasting more than 24 hours?
A. Atropine +
B. Echothiophate
C. Edrophonium
D. Ephedrine
E. Tropicamide
51. The antihypertensive drug most likely to aggravate angina pectoris is
A. Clonidine
B. Guanethidine
C. Hydralazine +
D. Methyldopa
52. This agent is currently a first-choice drug in the management of absence seizures as
well as partial, primary generalized, and tonic-colonic seizures.
A. Carbamazepine
B. Clonazepam
C. Ethosuximide
D. Valproic acid +
53.The phenothiazines have a variety of actions at different receptor types. However,
they do not appear to interact with receptors for
A. Dopamine
B. Histamine
C. Nicotine +
D. Norepinephrine
54. A psychiatric patient taking medications develops a tremor, thyroid enlargement,
and leucocytosis. The drug he is taking is most likely to be
A. Clomipramine
B. Haloperidol
C. Imipramine
D. Lithium +
55. Diuretics that increase the delivery of poorly absorbed solute to the thick ascending
limb of the nephron include
A. Furosemide
B. Indapamide
C. Mannitol +
D. Spironolactone
56. Following is used in methanol poisoning
A. Disulfiram
B. Naltrexone
C. Ethanol +
D. None of the above
57. A drug that is used in the treatment of parkinsonism and will also attenuate
reversible extrapyramidal side effects of neuroleptics is
A. Amantadine
B. Levodopa
C. Pergolide
D. Trihexyphenidyl +
58.Which of the following is a common effect of muscarinic stimulant drugs?
A. Decreased peristalsis
B. Decreased secretion by salivary glands
C. Hypertension
D. Miosis +
59. Four stages of general anaesthesia are distinctly seen with the use of
A. Halothane
B. Diethyl ether +
C. Nitrous oxide
D. Enflurane
60. Infusion of phentolamine into the cerebrospinal fluid of an experimental animal will
prevent the blood pressure – lowering action of
A. Clonidine +
B. Enalapril
C. Guanethidine
D. Reserpine
61. A drug suitable for producing a brief (5 to 15 minute) increase in cardiac vagal tone
is
A. Digoxin
B. Edrophonium +
C. Ergotamine
D. Pralidoxime
62. Propranolol and hydralazine have which of the following effects in common?
A. Decreased cardiac force
B. Decreased cardiac output
C. Decreased mean arterial blood pressure +
D. Increased systemic vascular resistance
63. Toxicities of local anaesthetics do not include
A. Cardiovascular arrhythmias and collapse (bupivacaine)
B. Convulsions (lidocaine)
C. Dizziness, sedation (lidocaine)
D. Hypertensive emergencies, strokes (procaine) +
64. Benzodiazepines are least effective in
A. Alcohol withdrawal syndromes
B Balanced anaesthesia regimens
C. Initial management of phencyclidine overdose
D. Obsessive – compulsive disorders +
65. Which one of the following drugs exerts its anticonvulsant effects by blocking
sodium channels in neuronal membranes
A. Acetazolamide
B. Carbamazepine +
C. Diazepam
D. Gabapentin
66. Cocaine intoxication has become a common problem in hospital emergency rooms.
Which one of the following drugs is not likely to be of any value in the management of
cocaine overdose?
A. Dantrolene
B. Diazepam
C. Lidocaine
D. Naltrexone +
67. Which one of the following agents used in hypertension is a prodrug that is
converted to its active form in the brain?
A. Clonidine
B. Doxazosin
C. Methyldopa +
D. Nitroprusside
68. The introduction of this drug may represent a novel approach to the treatment of
major depressive disorders since it appears to act as an antagonist at alpha2
adrenoceptors in the CNS
A. Amoxapine
B. Bupropion
C. Citalopram
D. Mirtazapine +
69. Which one of the following pairs of drugs: indication is accurate
A. Amphetamine: Alzheimer’s dementia
B. Bupropion: Acute anxiety
C. Fluoxetine: Insomnia
D. Ropinirole: Parkinson’s disease +
70. Following general anaesthetic is not metabolized
A. Halothane
B. Ether
C. Isoflurane
D. Nitrous oxide +
71. The appropriate chemical classification for meperidine is
A. Phenylpropylamines
B. Piperazines
C. 4-phenylpiperidines +
72. Which of the following neuromuscular blocking agents can cause muscarinic
responses such as bradycardia and increased glandular secretions?
A. Tubocurarine
B. Succinycholine
C. Pancuronium
D. Decamethonium +
73. Which of the following drugs is a volatile substance that is administered by
inhalation?
A. Thiopental
B. Halothane +
C. Alprazolam
D. Buspirone
74. The brief duration of action of an ultrashort acting barbiturate is due to a
A. Slow rate of metabolism in the liver
B. Low lipid solubility, resulting in a minimal concentration in the brain
C. High degree of binding to plasma proteins
D. Slow rate of excretion by the kidneys +
75. Which of the following agents would not be an alternative to Phenobarbital in the
treatment of partial seizures?
A. Trimethadione +
B. Gabapentin
C. Felbamate
D. Lamotrigine
E. None of the above
76. Which of the following diuretics is most similar in chemical structure to the
antihypertensive agent diazoxide?
A. Furosemide
B. Spironolactone
C. Mannitol
D. Chlorothiazide +
78. Following is an example of ideal anaesthetic
A. Ether
B. Halothane
C. Thiopental
D. None of the above +
79. An action common to most general anaesthetic
A. Increase in the cellular threshold of firing +
B. Potentiation of spontaneous and evoked activity of neurons
C. Inhibition of effects of glutamate
D. None of the above
80. All of the following adverse effects are associated with the use of levodopa except
A. Sialorrhea
B. Orthostatic hypotension
C. Delusions, confusion, and depression
D. Livedo reticularis +
81. The activity of which of the following drugs is dependent on a p-phenyl – N –
alkylpiperidine moiety
A. Phenobarbital
B. Chlorpromazine
C. Diazepam
D. Meperidine +
82. Parenteral calcium is used as an antidote for which of the following situations
A. Verapamil overdoses
B. Hyperkalaemia
C. Cocaine intoxication
D. Verapamil overdoses and hyperkalaemia +
83.Which of the following benzodiazepines is expected to cause the least amount of
adverse effects in the elderly?
A. Chlordiazepoxide
B. Diazepam
C. Flurazepam
D. Oxazepam +
84. The use of morphine in the patient who has had a myocardial infarction (MI)
centres around three distinct pharmacologic properties. Which of the following choices
includes these properties
A. Relief of pain, relief of anxiety, and increased oxygen supply
B. Relief of anxiety, after load reduction, increased preload
C. Relief of anxiety, preload reduction, and relief of pain +
D. Vagomimetic effect, relief of anxiety, respiratory depression
85. Ophthalmic agents contraindicated in glaucoma patients include which of the
following substances?
A. Antioxidants
B. Antipruritic
C. Decongestants +
D. Emollients
86.. Which of the following drugs is excepted to cause anticholinergic adverse effects in
the elderly?
A. Propoxyphene
B. Ciprofloxacin
C. Amitriptyline +
D. Propranolol
87.Reflex tachycardia, headache, and postural hypotension are adverse effects that limit
the use of which of the following antihypertensive agents?
A. Prazosin
B. Captopril
C. Methyldopa
D. Hydralazine +
88. Following is inverse agonist of benzodiazepine receptors
A. Flumazenil
B. β-Carbolines +
C. Chlordiazepoxide
D. Glutethimide
89. Which anticonvulsant drug requires therapeutic monitoring of Phenobarbital serum
levels as well as its own serum levels
A. Phenytoin
B. Primidone +
C. Clonazepam
D. Ethotoin
90. Zolpidem belongs to following class of drugs
A. Benzodiazepines
B. Carbamates
C. Imidazopyridines +
D. None of the above
91. What are the most common adverse effects of anticonvulsive drugs?
A. headache and dizziness
B. Gastrointestinal symptoms
C. Alternation of cognition and mentation
D. All of the above +
92. What are the important elements in considering treatment strategies for Parkinson’s
patients?
A. Age
B. Clinical presentation of disease
C. Sex
D. Etiology of the disease +
93. Which of the following anticonvulsants is contraindicated in patients with a
history of hypersensitivity to tricyclic antidepressants?
A. Phenytoin
B. Ethosuximide
C. Acetazolamide
D. Carbamazepine +
94. Which of the following agents should not be used concurrently with levodopa?
A. Diphenhydramine
B. Benztropine
C. Amantadine
D. Monoamine oxidase (MAO) inhibitors +
95. A patient with major depression should receive antidepressant therapy for at least
A. 2 weeks
B. 6 weeks
C. 2 months
D. 6 months +
96. Which of the following atypical antipsychotics would be the least sedating?
A. Quetiapine
B. Risperidone +
C. Olanzapine
D. Clozapine
97. Which of the following mood stabilizers would be most appropriate in a patient with
liver disease?
A. Lithium +
B. Valproic acid
C. Carbamazepine
D. None of the above
98. Ethinamate is _________ derivative
A. Phenothiazine
B. Urethane +
C. Piperidine
D. Tertiary alcohol
99. Which of the following factors may reduce lithium concentrations?
A. Dehydration
B. Pregnancy +
C. Reduced sodium intake
D. Nonsteroidal anti – inflammatory drugs
100. Morphine stimulates
A. Biliary and pancreatic secretions
B. Nonpropulsive rhythmic contractions of small intestine of man +
C. Propulsive contractions in small intestine of man
D. Propulsive peristaltic waves in colon
101. A drug that produces increased contraction of the sphincter iridis by local
application is a
A. Parasympathimimetic drug +
B. Parasympatholytic drug
C. Sympathomimetic drug
D. Sympatholytic drug
102. Which of the following should not be administered to a patient with myasthenia
gravis
A. Prostigmine
B. Digitalis
C. Atropine
D. Curare +
103. The toxicity of methanol is due to its conversion in the body to
A. Acetaldehyde
B. Formic acid and formaldehyde +
C. Ethyl alcohol
D. Carbonic acid
104. One of epinephrine’s actions on the heart is
A. Acceleration due to depression of the vagus
B. Increase in refractory period
C. Depression of the SA node
D. Increase in the concentration of the enzyme phosphorylase A +
105. Epinephrine HCl has little or no effect on
A. Unbroken skin
B. Conjunctiva
C. Precapillary sphincter
D. Nasal mucosa +
106. Acetylcholine has both muscarinic and nicotinic actions. The muscarinic action can
be blocked by
A. Epinephrine
B. Atropine +
C. Nicotine
D. Curare
107. Which of the following is the fastest acting anticoagulant
A. Warfarin (Coumadin)
B. Heparin +
C. Ouabain
D. Protamine sulfate
108. Phencyclidine is a non-competitive antagonist of
A. Kainate
B. AMPA
C. NMDA +
D. All of the above
109. Parkinsonism is probably due to
A. Too little dopamine in the brain +
B. Too little levodopa in the brain
C. Too little acetylcholine in the brain
D. Too much levodopa in the brain
110. A prominent toxic effect of local anaesthetics is
A. CNS stimulation +
B. CNS depression
C. Tachycardia
D. Local ischemia
111. Which of the following could be used as an antidote for curare poisoning
A. Neostigmine +
B. Atropine
C. Homatropine
D. Hexamethonium
112. Cigarette smoking increases the side effects of
A. Narcotic analgesics
B. Analeptics
C. Antidepressants
D. Oral contraceptives +
113. Which of the following may increase seizure activity in epileptic patients
A. Ethotoin
B. Phenobarbital
C. Trihexyphenidyl
D. Amantadine +
114. Trazodone (Desyrel) is used primarily as a (an)
A. Analgesic
B. Cardiotonic
C. Tranquilizer
D. Antidepressant +
115. Propofol
A. Enhances the neuromuscular blockade of tubocurarine
B. Causes marked postoperative confusion
C. Can produce involuntary movements during its use +
D. Has a delayed recovery after induction
116. A common side effect of ephedrine is
A. Rashes
B. Nervousness +
C. Blood dyscrasia
D. Drowsiness
117. Thiazide diuretics may produce an increase in blood levels of uric acid and
A. Potassium
B. BUN
C. Urea
D. Glucose +
118. Symptoms of schizophrenia are produced by following agents, except
A. Amphetamine
B. Apomorphine
C. Bromocriptine
D. Reserpine +
119. Select the anticholinesterase drug that is being used to afford symptomatic
improvement in Alzheimer’s disease
A. Echothiophate
B. Tacrine +
C. Demecarium
D. Ambenonium
120. Pilocarpine is used in
A. Glaucoma +
B. Paralytic ileus
C. Urinary retention
D. All of the above
121. Select the longer acting ocular betablocker
A. Timolol
B. Betaxolol
C. Carteolol
D. Levobunolol +
122.Which of the following is a prodrug of adrenaline used topically in glaucoma
A. Phenylephrine
B. Dipivefrine +
C. Phenylpropanolamine
D. Dorzolamide
123. Which of the following diuretics is most effective in acute congestive glaucoma
A. Indapamide
B. Amiloride
C. Mannitol +
D. Furosemide
124. Local anaesthetics block nerve conduction by
A. Blocking all cation channels in the neuronal membrane
B. Hyperpolarizing the neuronal membrane
C. Interfering with depolarization of the neuronal membrane +
D. Both (b) and (c)
125. Which of the following diseases is worsened by propranolol
A. Glaucoma
B. Raynaud’s disease +
C. Benign prostatic hypertrophy
D. Parkinsonism
126. Diazepam is used as a muscle relaxant for
A. Deep intra-abdominal operation
B. Tracheal intubation
C. Tetanus +
D. Diagnosis of myasthenia gravis
127. Which sensation is blocked first by low concentrations of a local anaesthetic
A. Temperature
B. Pain +
C. Touch
D. Deep pressure
128. Following are the MAO-inhibitors, except
A.Tranylcypromine
B. Nomifensine +
C. Moclobemide
D. Isocarboxid
129. Which of the following is a poor surface anaesthetic
A. Procaine +
B. Lidocaine
C. Tetracaine
D. Benoxinate
130. The local anaesthetic having high cardiotoxic and arrhythmogenic potential is
(a) Lidocaine
(b) Procaine
(c) Bupivacine +
(d) Chloroprocaine
131. The calcium channel blocker used for prophylaxis of migraine but not for angina
pectoris is
A. Verapamil
B. Diltiazem
C. Flunarizine +
D. Amlodipine
132. In which of the following techniques the concentration of the local anaesthetic
required is the lowest
A. Infiltration anaesthesia +
B. Field block anaesthesia
C. Nerve block anaesthesia
D. Spinal anaesthesia
133. Captopril produces greater fall in blood pressure in
A. Diuretic treated patients +
B. Patients having low plasma rennin activity
C. Sodium replete normotensive individuals
D. Untreated CHF patients
134. Enalapril differs from captopril in that
A. It blocks angiotensin II receptors
B. It does not produce cough as a side effect
C. It is less liable to cause abrupt first dose hypotension +
D. It has a shorter duration of action
135. Spinal anaesthesia is not suitable for
A. Vaginal delivery
B. Lower segment caesarean section
C. Prostatectomy
D. Operations on mentally ill patients +
136. Following is a MAO-inhibitor and also has anti-tubercular activity
A. Iproniazid +
B. Phenelzine
C. Moclobemide
D Isocarboxid
137. Which of the following is true of nitrous oxide?
A. It irritates the respiratory mucosa
B. It has poor analgesic action
C. It is primarily used as a carrier and adjuvant to other anaesthetics +
D. It frequently induces post anaesthetic nausea and retching
138. The factor that effects rate of elimination of general anaesthetics is
A. Pulmonary ventilation
B. Blood flow
C. Solubility in blood and tissue
D. All of the above +
139. Which of the following is a sign of deep anaesthesia?
A. Appearance of tears in eyes
B. Resistance to passive inflation of lungs
C. Fall in blood pressure +
D. Patient makes swallowing movements
140. Which inhalational general anaesthetic is metabolized in the body to a significant
extent
A. Sevoflurane
B. Isoflurane
C. Ether
D. Halothane +
141. The drug/drugs used mainly for induction
of general anaesthesia is/are
A. Thiopentone sodium +
B. Fentanyl + droperidol
C. Ketamine
D. All of the above
142. Following agent potentiates actions of
GABA
A. Volatile anaesthetics
B. Barbiturates +
C. Propofol
D. All of the above
143. Which of the following drugs is routinely used in preanesthetic medication for
prolonged operations
A. Atropine
B. Morphine
C. Promethazine
D. Ranitidine +
144. Hypnotic benzodiazepines increase the period of time spent in the following stage
of sleep
A. Stage II +
B. Stage III
C. Stage IV
D. REM stage
145. The primary mechanism of action of benzodiazepines is
A. Dopamine antagonism
B. Adenosine antagonism
C. Opening of neuronal chloride channels
D. Facilitation of GABA–mediated chloride influx +
146. The following drug is used to reverse the CNS depression produced by diazepam
A. Nikethamide
B. Doxapram
C. Physostigmine
D. Flumazenil +
147. Which of the following is not a CNS depressant but increases the tendency to
fall asleep at night?
A. Pyridoxine
B. Methaqualone
C. Melatonin +
D. Ethanol
148. The following antiepileptic drug is also effective in manic-depressive illness
A. Ethosuccimide
B. Primidone
C. Phenobarbitone
D. Carbamazepine +
149. The preferred drug for status epilepticus is
A. Intravenous diazepam +
B. Intravenous phenytoin sodium
C. Intramuscular phenobarbitone
D. Rectal paraldehyde
150. The most effective single drug in parkinsonism is
A. Bromocriptine
B. Selegiline
C. Levodopa D. +
D. Biperiden
GENERAL PHARMACOLOGY

1. All of the following are general mechanisms of drug permeation Except

A. Aqueous diffusion

B. Aqueous hydrolysis+

C. Lipid diffusion

D. Pinocytosis or endocytosis

2. If the plasma concentration of a drug declines with “first-order kinetics”, this means that

A. There is only one metabolic path for drug disposition

B. The half-life is the same regardless of the plasma concentration+

C. The drug is largely metabolized in the liver after oral administration and has low
bioavailability elimination

D. The rate of elimination is proportionate to the rate of administration at all times

3. Regarding termination of drug action

A. Drug must be exerted from the body to terminate their action

B. Metabolism of drugs always increases their water solubility

C. Metabolism of drugs always abolishes their pharmacologic activity

D. Hepatic metabolism and renal excretion are the two most important mechanisms involved +

4. Distribution of drugs to specific tissues

A. Is independent of blood flow to the organ

B. Is independent of the solubility of the drug in that tissue

C. Depends on the unbound drug concentration gradient between blood and tissue+

D. Is increased for drugs that are strongly bound to plasma proteins


5. A physical process by which a weak acid becomes less water-soluble and more lipid-
soluble at low ph is

A. Distribution

B Elimination

C. First pass- effect

D. Protonation+

6. Dose-response curves are used for drug evaluation in the animal laboratory and in the
clinic, Quantal dose-response curves are often

A. Used for determining the therapeutic index of a drug+

B. Used for determining the maximal efficacy of a drug

C. Invalid in the presence of inhibitors of the drug being studied

D. Obtained from the study of intact subject but not from isolated tissue preparations

7. The following are excreted faster in basic urine

A. Weak acids+

B. Strong acids

C. Weak Bases

D. None of the above

8. Which of the following statements about spare receptors is most correct ?

A. Spare receptors, in the absence of drug, are sequestered in the cytoplasm

B. Spare receptors will be detected if the intracellular effect of drug-receptor interaction lasts
longer than the drug-receptor interaction itself +

C. Spare receptors influence the maximal efficacy of the drug-receptor system

D. Spare receptors activate the effector machinery of the cell without the need for a drug
9. Which of the following terms best describes an antagonist that interacts directly with the
agonist and not at all or only incidentally, with the receptor

A. Pharmacological antagonist

B. Partial agonist

C. Physiological antagonist

D. Chemical antagonist+

10. Which of the following terms best describes a drug that blocks the action of epinephrine
at its receptors by occupying those receptors without activating them

A. Pharmacological antagonist+

B. Partial agonist

C. Physiological antagonist

D. Chemical antagonist

11. Which of the following provides information about the variation in sensitivity of the
drug within the population studied

A. Maximal efficacy

B. Therapeutic index

C. Drug potency

D. Quantal dose-response curve +

12. Which of the following most accurately describes the transmembrane signaling process
involved in steroid hormone action

A. Action on a membrane spanning tyrosine kinase

B. Activation of a G protein which activates or inhibits adenyl cyclase

C. Diffusion into the cytoplasm and binding to an intracellular receptor +

D. Diffusion of “STAT” molecules across the Membrane


13. Which of the following is a phase II drug metabolizing reaction

A. Acetylation +

B. Deamination

C. Hydrolysis

D. Oxidation

14. Which of the following drugs may inhibit the hepatic microsomal P450 responsible for
warfarin metabolism

A. Cimetidine +

B. Ethanol

C. Phenobarbital

D. Procainamide

15. With regard to clinical trials of new drugs, which of the following is most correct

A. Phase I involves the study of a small number of normal volunteers by highly trained clinical
pharmacologists +

B. Phase II involves the use of the new drug in a large number of patients (100-5000) who have
the disease to be treated

C. Phase III involves the determination of the drug’s therapeutic index by the cautious induction
of toxicity

D. Chemical antagonist

16. Animal testing of potential new therapeutic agents

A. Extends over a time period of at least 3 years in order to discover late toxicities +

B. Requires the use of at least two primate species, e.g. Monkey and baboon

C. Requires the submission of histopathologic slides and specimens to the FDA for government
evaluation
D. Has good predictability for drug allergy-type reactions

17. The “dominant lethal” test involves the treatment of a male adult animal with a
chemical before mating; the pregnant female is later examined for fetal death and
abnormalities. The dominant lethal test therefore is a test of

A. Teratogenicity

B. Mutagenicity +

C. Carcinogenicity

D. All of the above

18. The Ames test is a method for detecting

A. Carcinogenesis in rodents

B. Carcinogenesis in primates

C. Teratogenesis in any mammalian species

D. Mutagenesis in bacteria +

19. “Nicotinic” sites include all of the following except

A. Bronchial smooth muscle +

B. Adrenal medullary cells

C. Parasympathetic ganglia

D. Skeletal muscle

20. A good example of chemical antagonism

A. Heparin & Protamine +

B. Protamine & Zinc

C. Heparin & Prothrombin

D. All the above


21. Which of the following agents is a prodrug that is much less toxic in mammals than in
insects

A. Acetylcholine +

B. Bethanechol

C. Physostigmine

D. Pilocarpine

22. Phenylephrine causes

A. Constriction of vessels in the nasal mucosa +

B. Increased gastric secretion and motility

C. Increased skin temperature

D. Miosis

23. Pretreatment with propranolol will block which one of the following

A. Methacholine-induced tachycardia +

B. Nicotine-induced hypertension

C. Norepinephrine-induced bradycardia

D. Phenylephrine-induced mydriasis

24. Most drug receptors are

A. Small molecules with a molecular weight between 100 and 1000

B. Lipids arranged in a bilayer configuration

C. Proteins located on cell membranes or in the cytosol +

D. DNA molecules

25. With regard to distribution of a drug from the blood into tissues

A. Blood flow to the tissue is an important determinant


B. Solubility of the drug in the tissue is an important determinant

C. Concentration of the drug in the blood is an important determinant

D. All of the above are important determinants +

26. The pH value is calculated mathematically as the

A. Log of the hydroxyl ion (OH–) concentration

B. Negative log of the OH– concentration

C. Log of the hydrogen ion (H+) concentration

D. Negative log of the H+ concentration+

27. Which property is classified as colligative?

A. Solubility of a solute

B. Osmotic pressure +

C. Hydrogen ion (H+) concentration

D. Dissociation of a solute

28. The colligative properties of a solution are related to the

A. pH of the solution

B. Number of ions in the solution

C. Total number of solute particles in the solution +

D. Number of unionized molecules in the solution

29. The pH of a buffer system can be calculated with the

A. Noyes – Whitney equation

B. Henderson – Hasselbalch equation +

C. Michaelis – Menten equation

D. Yong equation
30. Which mechanism is most often responsible for chemical degradation?

A. Racemization

B. Photolysis

C. Hydrolysis +

D. Decarboxylation

31. Which equation is used to predict the stability of a drug product at room temperature
from experiments at accelerated temperature?

A. The stokes equation

B. The Yong equation

C. The Arrhenius equation +

D. The Michaelis – Menten equation

32. Based on the relation between the degree of ionization and the solubility of a weak acid,
the drug aspirin (pKa 3.49) will be most soluble at

A. pH 1.0

B. pH 2.0

C. pH 3.0

D. pH 6.0 +

33. The particle size of the dispersed solid in a suspension is usually greater than

A. 0.5 µm +

B. 0.4 µm

C. 0.3 µm

D. 0.2 µm

34. In the extemporaneous preparation of a suspension, levigating is used to


A. Reduce the zeta potential

B. Avoid bacterial growth

C. Reduce particle size +

D. Enhance viscosity

35. Active transport differs from facilitated transport in following ways, except

A. Carrier is involved +

B. It is against concentration gradient

C. Energy is required

D. All of the above

36. Vanishing cream is an ointment that may be classified as

A. A water –soluble base

B. An oleaginous base

C. An absorption base

D. An emulsion base +

37. Rectal suppositories intended for adult use usually weigh approximately

A. 1g

B. 2g +

C. 3g

D. 4g

38. In the fusion method of making cocoa butter suppositories which substance is most
likely to be used to lubricate the mold?

A. Mineral oil +

B. Propylene glycol
C. Cetyl alcohol

D. Stearic acid

39. A very fine powdered chemical is defined as one that

A. Completely passes through a # 80 sieve

B. Completely passes through a # 120 sieve +

C. Completely passes through a # 20 sieve

D. Passes through a # 60 sieve and not more than 40% through a # 100 sieve

40. Which technique is typically used to mill camphor?

A. Trituration

B. Levigation

C. Pulverization and intervention +

D. Geometric dilution

41. Which type of paper best protects a divided hygroscopic powder?

A. Waxed paper +

B. Glassine

C. White bond

D. Blue bond

42. Which capsule size has the smallest capacity?

A. 5 +

B. 4

C. 1

43. The shells of soft gelatin capsules may be made elastic or plastic–like by the addition of

A. Sorbitol +
B. Povidone

C. Polyethylene glycol

D. Lactose

44. Nonionic surface-active agents used as synthetic emulsifiers include

A. Tragacanth +

B. Sodium lauryl sulphate

C. Sorbitan esters(spans)

45. A ceramic mortar may be preferable to a glass mortar when

A. A volatile oil is added to a powder mixture

B. Colored substances (dyes) are mixed into a powder

C. Comminution is desired in addition to mixing +

46. Divided powders may be dispensed in

A. Individual-dose packets +

B. A bulk container

C. A perforated, sifter –type container

47. Agents that may be used to coat enteric coated tablets include

A. Hydroxypropyl methyl cellulose


B. Carboxymethyl cellulose
C. Cellulose acetate phthalate +
48. Active transport of a substance across biological membrane has the following
characteristics except
A. It is specific
B It is pH dependent +
C It is saturable
D It requires metabolic energy
49. Bioavailability of drug refers to
A. Percentage of administered dose that reaches systemic circulation in the unchanged form +
B. Ratio of oral to parental dose
C. Ratio of orally administered drug to that excreted in the feces
D. Ratio of drug excreted unchanged in urine to that excreted as metabolites

50. Factor which can affect the absorption of drug is


A. Dissolution rate
B. Particle Size
C. Lipid Solubility
D. All the above +

51. Excipients are

A. Pharmacologically inert substances


B. Used to mask an unpleasant taste
C. Used to increase solubility or stability to the agent
D. Employed to add bulk to the active agent used in small quantities +

52. All the below mentioned drugs cause enzyme inhibition in man except one

A. Acetazolamide

B. Allopurinol

C. Meprobamate +

D. Disulfiram
53. All the below mentioned drugs cause enzyme induction in man except one

(a) Phenytoin
(c) Griseofulvine

(b) Phenobarbitone
(d) Enalapril +
54. A common oral problem caused by herpes simplex type I virus (HSV-1) is
A. Aphthous ulcers
B. Canker sores
C. Aphthous stomatitis
D. Fever blisters +
55. The definition of a surfactant (an ingredient in toothpaste) can best be described by
which of the following statements
A. Prevents drying of the preparation
B. Removes debris by its detergent action and causes foaming, which is usually desired by the
patient +
C. Physically removes plaque and debris
D. Determines the texture, dispersiveness, and appearance of the product

56. Which is not a risk factor for hyperphosphatemia and death from sodium phosphate
enemas when used in children?
A. Renal insufficiency
B. Hirschsprung’s disease
C. Anorectal malformations
D. Children between the ages of 6 and 12 years +

57. Which of the following factors is associated with an increased risk of noncompliance in
the elderly?
A. Polypharmacy +
B. Hypertension
C. Male gender
D. Living with a spouse in an isolated environment
E. Expensive medications

58. The principal difference between competitive and non-competitive inhibition is


A. Extent of receptor site blocking
B. Whether inhibition occurs
C. Extent of enzyme3 inhibition +
D. Degree of agonism
59. Drug administrated through which of the following routes is mot likely to be subjected
to first-pass metabolism:
A. Oral +
B. Sublingual
C. Subcutaneous
D. Rectal
60. Many receptors use distinct hetero _________ GTPä-binding regulatory proteins
A. Tetrameric
B. Trimeric +
C. Dimeric
D. Monomeric

61. Alkalization of urine hastens the excretion of


A. Weakly basic drugs
B. Weakly acidic drugs +
C. Strong electrolytes
D. Nonpolar drugs

62. Majority of drugs cross biological membranes primarily by


A. Weakly basic drugs +
B. Weakly acidic drugs
C. Strong electrolytes
D. Nonpolar drugs
63. The most important factor which governs diffusion of drugs across capillaries other
than those in the brain is
A. Blood flow through the capillary +
B. Lipid solubility of the drug
C. pKa value of the drug
D. pH of the medium
64. Active transport of a substance across biological membrane has the following
characteristics except
A. It is specific
B. It is pH dependent +
C. It is saturable
65. Bioavailability differences among oral formulations of a drug are most likely to occur if
the drug
A. Is freely water soluble
B. Is completely absorbed
C. Is incompletely absorbed +
D. Undergoes little first-pass metabolism

66. An antagonist has


(a) Intrinsic activity and no affinity
(b) Only intrinsic activity and no affinity
(c) No intrinsic activity and no affinity
(d) Affinity same as agonist and devoid of intrinsic activity +

67. The most important factor governing absorption of a drug from intact skin is
A. Molecular weight of the drug
B. Site of application
C. Lipid solubility of the drug +
D. Nature of the base used in the formulation

68. Redistribution is a feature of


A. Highly plasma protein bound drugs
B. Depot preparations
C. Poorly lipid soluble drugs
D. Highly lipid soluble drugs +
69. Weakly acidic drugs
A. Are bound primarily to a1 acid glycoprotein in plasma
B. Are excreted faster in alkaline urine +
C. Are highly ionized in the gastric juice
D. Do not cross blood—brain barrier
70. High plasma protein binding
A. Increases the volume of distribution of the drug
B. Facilitates glomerular filtrtion of the drug
B. Minimizes drug interactions
D. Generally makes the drug long acting +

71. Biotransformation of drugs is primarily directed to


A. Activate the drug
B. Inactivate the drug
C. Convert lipid soluble drugs into nonlipid soluble metabolites+
D. Convert nonlipid soluble drugs into lipid soluble metabolites

72. drug may be best administered by:


(a) Oral route
(b) Inhalation +
(c) Sublingual route
(d) Intrathecal route

73. Which of the following cytochrome P450 isoenzymes is involved in the metabolism of a
large number of drugs in human beings and has been implicated in some dangerous drug
interactions:
A. CYP 3A4 +
B. CYP 2C9
C. CYP 2E1
D. CYP 1A2

74. The most commonly occurring conjugation reaction for drugs and their metabolites is
A. Glucuronidation +
B. Acetylation
C. Methylation
D. Glutathione conjugation
75. G-protein coupled receptors span the plasma membrane as a bundle of _____ alpha
helices
A. One
B. Three
C. Seven +
D. Ten
76. Which of the following drug metabolizing reactions is entirely nonmicrosomal
A. Glucuronide conjugation
B. Acetylation +
C. Oxidation
D. Reduction
77. Induction of drug metabolizing enzymes involves
A. A conformational change in the enzyme protein to favor binding of substrate molecules
B. Expression of enzyme molecules on the surface of hepatocytes
C. Enhanced transport of substrate molecules into hepatocytes
D. Increased synthesis of enzyme protein +
78. Drugs which undergo high degree of First-pass metabolism in liver
A. Have oral bioavailability
B. Are excreted primarily in bile
C. Are contraindicated in liver disease
D. Exhibit zero order kinetics of elimination +
79. Glomerular filtration of a drug is affected by its
A. Lipid solubility
B. Plasma protein binding +
C. Degree of ionization
D. Rate of tubular secretion
80. If a drug undergoes net tubular secretion, its renal clearance will be
A. More than the glomerular filtration rate +
B. Equal to the glomerular filtration rate
C. Less than the glomerular filtration rate
81. Which of the following is not a primary/ fundamental, but a derived pharmacokinetic
parameter
A. Bio-availability
B. Volume of distribution
C. Clearance
D. Plasma half life +
82. If a drug is eliminated by first order Kinetics
A. constant amount of the drug will be eliminated per unit time
B. Its clearance value will remain constant +
C. Its elimination half-life will increase with dose
D. It will be completely eliminated from the body in 2 x half-life period

83. If a drug has a constant bio-availability and first order elimination, its maintenance
dose rate will be directly proportional to its
A. Volume of distribution
B. Plasma protein binding
C. Lipid solubility
D. Total body clearance +

84. The following dose of a drug is governed by its


A. Aqueous diffusion
B. Aqueous hydrolysis
C. Lipid diffusion +
D. Pinocytosis or endocytosis

85. Monitoring plasma drug concentration is useful while using


A. Antihypertensive drugs
B. Levodopa
C. Lithium carbonate +
D. MAO inhibitors
86. Microsomal enzyme induction has one of the following features
A. Takes about one week to develop
B. Results in increased affinity of the enzyme for the substrate +
C. It is irreversible
D. Can be used to treat acute drug poisonings
87. Which of the following is a competitive type of enzyme inhibitor
A. Acetazolamide
B. Disulfiram
C. Physostigmine +
D. Theophylline
88. What is true in relation to drug receptors
A. All drugs act through specific receptors
B. All drug receptors are located on the surface of the target cells
C. Agonists induce a conformational change in the receptor +
D. Partial agonists have low affinity for the Receptor

89. A partial agonist can antagonize the effects of a full agonist because it has
A. High affinity but low intrinsic activity +
B. Low affinity but high intrinsic activity
C. No affinity and low intrinsic activity
D. High affinity but no intrinsic activity

90. Receptor agonists possess


A. Result in increased smooth endoplasmic reticulum
B. Result in increased rough endoplasmic reticulum
C. Result in decreased enzymes in the soluble cytoplasmic fraction +
E. Require 3–4 months to reach completion

91. Agonists affect the receptor molecule in the following manner

A. Alter its amino acid sequence

B. Denature the receptor protein


C. Alter its folding or alignment of subunits +

D. Induce covalent bond formation

92. Receptors perform the following function/Functions

A. Ligand recognition

B. Signal transduction

C. Both ligand recognition and signal transduction n+

D. Disposal of agonists and antagonists

93. Which of the following receptor types has 7 helical membrane, spanning amino acid
segments with 3 extracellular and 3 intracellular loops

A. Tyrosine protein kinase receptor

B. Gene expression regulating receptor

C. Intrinsic ion channel containing receptor

D. G protein coupled receptor +

94. Which of the following is a G protein coupled receptor

A. Muscarinic cholinergic receptor +

B. Nicotinic cholinergic receptor

C. Glucocorticoid receptor

D. Insulin receptor

95. Placebo effects result presumably from the

A. Physician-patient relationship

B. Mental set up imparted by the therapeutic settings

C. Mental set up imparted by the physician


D. All of the above +

96. All of the following sub serve as intracellular second messengers in receptor mediated
signal transduction except

A. Cyclic AMP

B. Inositol trisphosphate

C. Diacyl glycerol

D. G protein +

97. A receptor which itself has enzymatic property is

A. Insulin receptor +

B. Progesterone receptor

C. Thyroxine receptor

D. Glucagon receptor

98. Down regulation of receptors can occur as a consequence of

A. Continuous use of agonists +

B. Continuous use of antagonists

C. Chronic use of CNS depressants

D. Denervation

99. When therapeutic effects decline both below and above a narrow range of doses, a drug
is said to exhibit

A. Ceiling effect

B. Desensitization

C. Therapeutic window phenomenon +

D. Nonreceptor mediated action


100. ‘Drug efficacy’ refers to

A. The range of diseases in which the drug is beneficial

B. The maximal intensity of response that can be produced by the drug +

C. The therapeutic dose range of the drug

D. The therapeutic index of the drug

101. Tachyphylaxis is

A. A drug interaction between two similar types of drugs

B. Rapidly developing tolerance+

C. A synergism between two types of drugs

D. None of the above

102.Drug A in a dose of 10 mg produces same response as with 100 mg of drug B

A. Drug A is 10 times more potent than drug B +

B. Drug B is 10 times more potent than drug A

C. Drug A is 10 times more efficacious than drug B

D. Both are equally potent

103. Teratogenicity is

A. The acute reaction to drugs

B. Intolerance to drugs

C. Tumour forming action of the drugs

D. Malformation of the fetus +

104. The chances of foetal malformation with a teratogenic drug is maximum

A. During first trimester of pregnancy +

B. During second trimester of pregnancy


C. During third trimester of pregnancy

D. When given just prior to the labor

105. Phocomelia is a known teratogenic effect of

A. Anticancer drugs

B. Antiviral drugs

C. Antiepileptic drugs

D. Thalidomide +

106. Which of the following drugs are known to cause toxic cataract?

A. Chloroquine

B. Ergot

C. Phenothiazine

D. All of the above +

107. The passage of drugs into the foetus from placenta

A. Is by active transport

B. Is by passive diffusion +

C. Is by carrier mediated transport

D. By any of the above methods

108. Idiosyncrasy reaction of a drug is

A. A type of hypersensitivity reaction

B. A type of drug antagonism

C. Unpredictable, inherent, qualitatively abnormal reaction of a drug +

D. Quantitatively exaggerated response


109. Two drugs having similar effects are termed as

A. Heterergic drugs

B. Isomer drugs +

C. Homergic drugs

D. Antagonistic drugs

110. AntagonisticAntagonism between barbiturate and amphetamine is termed as

A. Non-competitive antagonism

B. Physiological antagonism +

C. Competitive antagonism

D. Synergism

111. Which one of the following is an example of physical or chemical interaction?

A. Warfarin plus salicylates–prolongation of anticoagulant effect and bleeding tendency

B. Methotrexate plus sulfonamides–pancytopenia

C. Heparin plus protamine–reversal of heparin effect +

D. Sulfonamides plus salicylate–sulfa toxicity

112. First order kinetics of the drugs is called when

A. A constant fraction of the drug is removed in per unit time +

B. A constant amount of the drug is removed in per unit time

C. Total amount of the drug is removed in one hour

D. Total amount of the drug is removed in first passage through the kidneys

113. For the drugs which follow first order kinetics, after 4 half life the elimination will be
approximately

A. 40%
B. 94% +

C. 25%

D. 4%

114. Passive diffusion of a drug across cell membrane is low when its molecular mass is
greater than

A. 50–100 Da

B. 100–200 Da +

C. 200–300 Da

D 300–400 Da

115. Passage of drug across most capillary endothelial membranes is dependent upon

A. Lipid solubility +

B. pH gradient

C. Blood flow

D. All of the above

116. Following receptors are membrane proteins, except

A. Receptors for fast neurotransmitters, coupled directly to an ion channel

B. Receptors for many hormones and slow transmitters, coupled to effector system

C. Receptor for insulin and various growth factors, which are directly linked to tyrosine kinase

D. Receptors for steroid hormone +

117. pH difference between extracellular and intracellular fluid is

A. Nil

B. 0.2

C. 0.4 +
D. 0.8
1) Beta blocker which has peripheral vasodilation effect is:
a) atenolol
b) acebutolol
c) metoprolol
d) labitolol
e) +carvedilol

2) T-half of a drug can determine all the following:


a) +closing interval
b) elimination time
c) +therapeutic dosage
d) steady plasma conc.

3) Phototoxicity is commonest with:


a) +doxycycline
b) minocycline
c) prostacycline
d) oxytetracycline

4) Gout is precipitate by all except:


a) frusemide
b) thiazide
c) PYZ
d) +sulfinpyrazone

5) Effect of parasympathetic (muscarinic ) on heart is:


a) refractory period is decresed
b) +conduction is decresed
c) forse of attrial contraction is increased
d) P_R interval is increased

6) Call of the following antibiotics act on cell wall except:


a) ampicilinc
b) +griseofulvin
c) bacitracin
d) none

7) CNS stimulant action of nikethamide has .target cells mainly in:


a) +medulla
b) mid brain
c) pons
d) cerebral cortex

8) Nicotinic receptor are seen in:


a) +sk. Muscle
b) cardiac mus.
c) Visceral smooth mus.
d) Salivary gland

9) Sparfloxacin and tarfinadine can cause


a) nephropathy
b) +ventricular arrhythmia
c) myopathy
d) all

1
10) Dapsone is used in:
a) erythema
b) SLE
c) Lichen planus
d) +Dermatitis herpetiformis

11) Cyclosporine A inhibites:


a) +T cells
b) CD8
c) CD4
d) В cells

12) Increase renal blood flow is caused by:


a) +dopamine
b) dobutamine
c) ]adrenaline
d) Non adrenaline

13) True abt. Lente insulin:


a) +made of 3 parts zinc suspension (amorphorous) and 7 parts zinc suspension (crystalline)
b) duration of action is 36 hrs.
c) clear alkaline solution
d) none

14) Which of the following is fluroquinolone:


a) +pefloxacin
b) cefotaxime
c) urodopenicilline
d) none

15) Metoprolol is the member of:


a) a1 selective group
b) a2- selective group
c) +β1-selective group
d) β2- selective group

16) The principal adverse effect of phentolamine are related to:


a) Gastric secretion
b) Brochi constriction
c) Smooth muscle dilation
d) +Cardiac stimulation

17) Adverse effect of neuromuscular blocking drugs:


a) Hypokalemia
b) +Hyperkalemia
c) Hypomagnemia
d) Hypermagnemia

18) The crossing the blood-brain barrier of trimethaphan is:


a) +Absent
b) Poor
c) Good
d) Excellent

2
19. Direct action of physostigmine on cholinoceptors is:
a. +Absent
b. Poor
c. Good
d. Excellent

19) Lipid soluble agents of anticholiesterase have more marked effect on:
a) Skeletal muscles
b) Nicotinic
c) Eye
d) +CNS

20) High doses of parasympathomimetic drugs may produce:


a) Constriction of arteries and dilation of veins
b) Constriction of veins and dilation of arterials
c) Constriction of veins and arterials
d) +Dilation of veins and arterials

21) Topical instillation of atropine causes:


a) +miosis
b) mydriases
c) abolition of light reflex
d) cycloplegia

22) Remission inducing drug for Rh arthritis include:


a) aspirin
b) +gold thiol
c) ibuprofen
d) all

23) Not used in H. pylori gastritis is a:


a) +cisapride
b) clarithromycin
c) metronidazole
d) colloidal bismuth

24) Protein binding of a drug helps in:


a) distribution
b) +prolonged half life
c) limiting metabolism
d) all

25) Аll the drug can be given in pt. with bronchial asthma except:
a) timolol eyedrop
b) acetaminophen
c) ketorolac
d) +nefopam

26) Opioids act by:


a) cellular hyper polarization
b) reduced neurotransmitter reuptake
c) +reduced level of subst. P
d) evoking glutamate release

3
27) Storage of Fe is:
a) heamoglobine
b) myoglobone
c) +feritinine
d) heamosiderin

28) Thiazides is:


a) Torsemide
b) dichlorphenamide
c) Acetazolamide
d) +Chlorthalidone

29) Isoproterenol has duration of action:


a. 30-60 minutes
b. +60-90 minute
c. 90-120 minute
d. 120-150 minute

30) Pre/post ganglionic fibre ratio of sympathetic nervous system:


a) +1:1-1:2
b) 1:2-1:3
c) 1:3-1:4
d) 1:4 —1:4

31) Muscarinic receptors have been divided into


a) 3 subtypes
b) 4 subtypes
c) +5 subtypes
d) 6 subtypes

32) M-cholinomimetics:
a) Galantamine
b) +Aceclydine
c) Pentamine
d) Carbacholine

33) Response of eyes to the parasympathomimetic drugs:


a) Mydriasis
b) +Miosis
c) Increases of intraocular tension
d) Relax of accommodation

34) Irreversible anticholiesterases:


a) Physostigmine
b) +Phosphacol
c) Neostigmine
d) Edrophonium

35) Which of the following is an osmotic diuretics:


a) +urea
b) metolazone
c) bumetanide
d) d-acetazolamide

4
36) Therapeutic index of a drag is a indicator of:
a) potency
b) safety
c) +toxicity
d) efficacy

37) Tachyphylaxis is a:
a) +acute tolerance
b) chronic tolerance
c) both
d) none

38) Drug used in anaphylaxis is:


a) nor epinephrine
b) +epinephrine
c) dopamine
d) antihistaminic

39) Breast feeding is not contraindicated when the mother is taking the following medication except:
a) theophyline
b) cloromphenicol
c) metronidazole
d) cimetidine

40) Antacids are:


a) physical antagonist
b) chemical antagonist
c) +reversible antagonist
d) irreversible antagonist

41) The toxic effects of a large dose of nicotine is:


a) Salivation
b) Nausea
c) +Convulsions
d) Cutaneous vasodilation

42) Excessive doses of lidocaine cause:


a) Paresthesias
b) +Hypotension
c) Hypertension
d) Disorientation

43) The CNS effect of nicotine:


a) +Tremors
b) Diarrhea
c) Hypotension
d) Decrease of hear rate

44) In what stage of anesthesia may occur the regular respiration and relaxation of the skeletal muscle:
a) Analgesia
b) Excitement
c) +Surgical anesthesia
d) Medullary paralysis

5
45) Heparin therapy is monitored by:
a. ВТ
b. CT
c. +PT
d. All of the above

46) Which of the following drug is useful in dissolving gall bladder stone:
a) +chenodoxycholic acid
b) lactulose
c) clofibrate
d) none

47) Tetracycline can cause all except:


a) +gray baby syndrome
b) hepatotoxicity
c) pain on injection
d) fanconis anaemia

48) Sulfonamide derivates is:


a) +Torsemide
b) dichlorphenamide
c) Acetazolamide
d) Chlorthalidone

49) Methacholine usually could be used in treatment of:


a. +Glaucoma
b. Bronchial constriction
c. Hypertension
d. Hypotension

50. Neostigmine CNS effect is:


a. +Absent
b. Poor
c. Good
d. Excellent

51. Atropine is highly selective for:


a. a-receptors
b. β-receptors
c. +m-receptors
d. n-receptors

52. Good administration for trimethaphan is:


a. Oral
b. Subcutaneous
c. Intramuscular
d. +Intravenous

53. The duration of action of succinyicnoline is


a. + 5-10 minutes
b. 10-20 minutes
c. 20-30 minutes
d. 30-40 minutes

6
54. Location of β-1 receptors:
a. Bronchi
b. Urinary tract
c. Uterus
d. +Heart

55. Irreversible antagonist drug is:


a. +Phenoxybenzamine
b. Prazosine
c. Labetalol
d. Phentolamine

56. Botulinus toxin influence on the release of acetylcholine


a. Induce
b. Increase
c. +Inhibit
d. Doesn’t influence

57. Nicotinic receptors have been divided into


a. +2 subtypes
b. 3 subtypes
c. 4 subtypes
d. 5 subtypes

58. Physostigmine is well absorbed from


a. Oral administration
b. Intravenous
c. Intramuscular
d. +All sites

59. Effect of atropine on the iris persists:


a. 12-24 hours
b. 24-48 hours
c. 48-72 hours
d. +More than 72 hours

60. The crossing the blood-brain barrier of trimethaphan is:


a. +Absent
a. Poor
b. Good
c. Excellent

61. Selective antagonist for the β receptors


a. Yohimbine
b. Clonidine
c. Methoxamine
d. +Prazosin

62. The principal adverse effect of phentolamine are related to


a. Gastric secretion
b. Brochi constriction
c. Smooth muscle dilation
d. +Cardiac stimulation

7
63. A half-life of esmolol is:
a. +5-10 minutes
b. 10-30 minutes
c. 30-40 minutes
d. 40-50 minutes

64. Metoprolol is the member of:


a. a1-selective group
b. a2- selective group
c. + β1 selective group
d. β2 selective group

65. Uses of a-blockers is not:


a. Pheochromocytoma
b. Diabetes
c. Thyrotoxicosis
d. +Cardiac arrhythmias

66. Clinical pharmacology includes


a) Pharmacokinetics and pharfnacodynamics
b) Treatment of systemic infection
c) Science of compounding and dispending drug
d) +Application of pharmacological information

67. Activates a receptor to produce an effect similar to physiological signal:


a. Antagonist
b. +Agonist
c. Inverse agonist
d. Partial agonist

68. Cross the placenta barrier


a) Chlordiazepoxide
b) Diazepam
c) Prazepam
d) +All

69. ADH is located in:


a. Spleen
b. Liver
c. +Kidney
d. All

70. Opioid drugs include:


a. Full agonist
b. Partial agonist
c. Antagonist
d. +All

71. Most opioid analgetics are well absorbed:


a. Subcutaneous
b. Intramuscular
c. Oral
d. +All

8
72. Opioids localize in higher concentration in tissues except:
a. +Brain
b.Liver
c. Muscle
d. Lungs

73. Action of opioids is:


a. +Decrease of alveolar PCO2
b. Suppression of cough
c. Mydriasis
d. Diarrhea

74. Adverse effect of opioids is except:


a. Respiratory depression
b. Nausea
c. Vomiting
d. +Decrease intracranial pressure

75. Clinical use of opioid analgesics:


a. Constipation
b. Arrhythmia
c. +Cough
d. All

76. The maximal blood levels of local anesthetics


a. +Intercostals
b. Caudal
c. Epidural
d. Brachial plexus

77. The primary mechanism of action of local anesthetics is blockade of:


a. Ion channels
b. Potassium channels
c. Chlorium channels
d. +Sodium channels

78. Undergo extensive first pass metabolism in liver except:


a. +Nitroglycerine
b. Isosorbide mononitrate
c. Isosorbide dinitrate
d. Eiythrityl tetranitrate

79. The local anesthetics are converted in:


a. Kidney
b. +Liver
c. Lungs
d. Brain

80. Nitrates may be used except:


a. Angina pectoris
b. Biliaric colic
c. Esophageal spasm
d. +Bradicardia

9
81. Doses of dilthiazem:
a. 10-30 mg
b. +30-60 mg
c. 60-90 mg
d. 90-120 mg

82. The highest blood levels in the following order:


a. +Intercostals
a. Caudal
b. Branchial plexus
b. Sciatic nerve

83. Antiadrenergic agent is:


a. Amiadarone
b. Verapamile
c. +Propranolol
d. Propafenon

84. Agent widening AP is:


a. +Amiadarone
b. Verapamil
c. Propranolol
d. Propafenon

85. Calcium channel blocker is:


a. Amiadarone
b. +Verapamile
c. Propranolol
d. Propafenon

86. Membrane stabilizing agent is:


a) Amiadarone
b) +Verapamile
c) Propranolol
d) Propafenon

87. Excessive doses of lidocaine cause:


a. Paresthesias
b. +Hypotension
c. Hypertension
d. Disorientation

88. How many percents of mexiletine metabolized in liver:


a. 30%
b. 60%
c. +90%
d. 100%

89. The targets for benzodiazepine action is:


a. a-aminobutyric acid
b. β-aminobutyric acid
c. + γ-aminobutyric acid
d. 5-aminobutyric acid

10
90. Intermediate-acting benzodiazepines:
a. Clorazepam
b. +Alprazolam
c. Oxazepam
d. Flurazepam

91. Mechanism of action of methylxanthines


+Translocation of extracellular calcium
Translocation of intracellular calcium
Increase in cAMP
Decrease in cAMP
Decrease in GMP

92. The methylxanthines are well absorbed


a. +Orally
b. Subcutaneously
c. Intramuscular
d. Intravenously

93. The lowest blood levels in the following order:


a. Intercostals
b. Caudal
c. Branchial plexus
d. +Sciatic nerve

94. The highest blood levels in the following order:


a. +Intercostals
b. Caudal
c. Branchial plexus
d. Sciatic nerve

95. May occur the regular respiration and relaxation of the skeletal muscles:
a. Analgesia
b. Excitement
c. + Surgical anesthesia
d. Medullary paralysis

96. SGRIs block the up-take of serotonin leading to :


a. decrease concentration
b.+ Increase concentration
c. Inhibit the receptor
d. is not influence

97. Tick drus is forming a physical barrier to HCL :


a. Ranitidine
b. +Sucralfate
c. Omeprazole
d. Pirenzepine

98. Iindicate the drug that cause metabolic alkalosis:


a. +Sodium bicarbonate
b. Cimetidine
c. Pepto-Bismol
d. Carbenoxolone

11
99. The drug can be used to treat glaucoma:
a. Furosemide (Lasix)
b. +Acetazolamide (Diamox)
c. Both of the above
d. Neither of the above

100. Bactericidal effect is:


a) Inhibition of bacterial cell division
b) Inhibition of young bacterial cell growth
c) +Destroying of bacterial cells
d) Formation of bacterial L-form

101. Tick the drug belonging to antibiotics-tetracycline:


a. +Doxycycline
b. Streptomycin
c. Clarithromycin
d. Amoxacilhn

102. Tick the drug belongs to antibiotics-cephalosporin:


a. Streptomycin
b. +Cefaclor
c. Phenoxymethylpenicillin
d. Erythromycin

103. This drug reduces blood pressure by acting on vasomotor centers in the CNS:
a. Labetalol
b. +Clonidine
c. Enalapril
d. Nifedipine

104. Pick out the drug an alpha- and beta-adrenoreceptors blocker:


a. +Labetalol
b. Verapamil
c. Nifedipine
d. Metoprolol

105. This drug is converted to an active metabolite after absorption:


a) Labetalol
b) Clonidine
c) +Enalapril
d) Nifedipine

106. Indicate an agent, which is related to direct-acting drugs:


a) Edrophonium
b) Physostigmine
c) +Carbachol
d) Isoflurophate

107. All of these drugs reduce intestinal peristalsis EXCEPT:


a. Loperamide
b. +Cisapride
c. Methyl cellulose
d. Magnesium aluminium silicate

12
108. This drug acts by inhibiting type III cyclic nucleotide phosphodiesterase:
a. Amiodarone
b. +Milrinone
c. Propanolol
d. Enalapril

109. Drug is favored for digitalis-induced arrhythmias:


a. Verapamil
b. Amiodarone
c. + Lidocaine
d. Propanolol

110. Tick the drug belonging to non-selective beta-2 adrenomimetics:


a. Salbutamol
b. +Isoprenaline
c. Salmeterol
d. Terbutaline

111. Which of the following M-choiinoblocking agents is used especially as an anti-asthmatic?


a. Atropine
b. +Ipratropium
c. Platiphylline
d. metacin

112. A teratogenic action is:


a. Toxic action on the liver
b. +Negative action on the fetus causing fetal malformation
c. Toxic action on blood system
d. Toxic action on kidneys

113. What term is used to describe a decrease in responsiveness to a drug which develops in a few
minutes?
a. Refractoriness
b. Cumulative effect
c. Tolerance
d. +Tachyphylaxis

114. If an agonist can produce sub maximal effects and has moderate efficacy it's called:
a. +Partial agonist
b. Antagonist
c. Agonist-antagonist
d. Full agonist

115. Tachyphylaxis is:


A drug interaction between two similar types of drugs:
a. +Very rapidly developing tolerance
b. A decrease m responsiveness to a drug, taking days or weeks to develop
c. None of the above

116. Idiosyncratic reaction of a drug is:


a. A type of hypersensitivity reaction
b. A type of drug antagonism
c. +Unpredictable, inherent, qualitatively abnormal reaction to a drug
d. Quantitatively exaggerated response

13
117. Tick the second messenger of G-protein-coupled (metabotropic) receptor:
a. Adenylyl cyclase
b. Sodium ions
c. Phospholipase С
d. +cAMP

119. What does the term “potentiation” mean?


a. Cumulative ability of a drug
b. Hypersensitivity to a drug
c. Fast tolerance developing
d. +intensive increase of drug effects due to their combination

120. If an agonist can produce sub maximal effects and has high efficacy it's called:
a. Partial agonist
b. Antagonist
c. Agonist-antagonist
d. +Full agonist

121. What kind of substances can't permeate membranes by passive diffusion?


a. Lipid-soluble
b. Non-ionized substances
c. Hydrophobic substances
d. +Hydrophilic substances

122. Which of the following is more potent:


a) cimetidine
b) ranitidine
c) nizatidine
d) +famotidine

123. Indicate the laxative drug belonging to osmotic laxatives:


a. Docusate sodium
b. Bisacodyl
c. Phenolpnthalein
d. +Sodium phosphate

124. The mechanism of methylxanthines action is:


a) +Inhibition of the enzyme phosphodiesterase
b) Beta-2 adrenoreceptor stimulation
c) Inhibition of the production of inflammatory cytokines
d) Inhibition or M-cholinorcceptors

125. The drug is the most potent diuretic:


a. +Loop diuretics
b. Thiazide diuretics
c. Potassium-sparing diuretics
d. Carbonic anhydrase inhibitors

126. The drugs is used in the treatment of recurrent Ca nephrolithiasis:


a. Osmotic diuretics
b. +Loop diuretics
c. Thiazide diuretics
d. Potassium-sparing diuretics

14
127. Duration of nitroglycerin action (sublingual) is:
a) +10-30 minutes
b) 6-8 hours
c) 3-5 minutes
d) 1.5-2 hours

128. All of the following agents are cardiac glycosides EXCEPT:


a. Digoxin
b. Strophantin К
c. +Amrinone
d. Digitoxin

129. This drug inhibits breakdown of cAMP in vascular smooth muscle:


a. Digoxin
b. Dobutamine
c. +Amrinone
d. Dopamine

130. Catecholamine includes following EXCEPT:


a. +Ephedrine
b. Epinephrine
c. Isoprcnalinc
d. Norepinephrine

131. Indicate the beta-1 selective agonist:


a. Isoproterenol
b. +Dobutamine
c. Metaproterenol
d. Epinephrine

132. Which of the following is preferable for the emergency therapy of cardiogenic shock?
a. Epinephrine
b. +dobutamine
c. Isoproterenol
d. Mcthoxamine

133. Which of the following drugs is an nonselective beta receptor antagonist?


a) Metoprolol
b) Atenolol
c) +Propranolol
d) Acebutolol

134. Which of the following drugs is useful in the treatment of pheochromocytoma?


a. Phenylephrine
b. Propranolol
c. +Phentolamine
d. Epinephrine

135. All of the following drugs are antibiotics, EXCEPT:


a. Streptomycin
b. Penicillin
c. +Co-trimoxazole
d. Chloramphenicol

15
1. Which of the following acts indirectly ?
a. Epinephrine
b. Norepinephrine
c. +Ephedrine
d. d) Methoxamine

2. Indicate the alfa 2-selective agonist:


a. +Xylometazoline
b. Epinephrine
c. Dobutamine
d. Methoxamine

3. Epinephrine produces all of the following effects except:


a. Bronchodilation
b. +Decrease in oxvgen consumption
c. Hvperglvcemia
d. Mydrias'is

4. Indicate the drug, which may be useful in the emergency management of cardiac arrest:
a. ethoxamine
b. Phenylephrine
c. +Epinephrine
d. Xylometazoline

5. Indicate the beta-l selective antagonist:


a. Propranolol
b. +Metoprolol
c. Carvedilol
d. Sotalol

6. Non selective alfa-receptor antagonists are most useful in the treatment of:
a. Asthma
b. Cardiac arrhythmias
c. +Pheochromocvtoma
d. Chronic hypertension

7.This drug is a Class 1C antiarrhythmic drug:


a. +Flecainide
b. Sotalol
c. Lidocaine
d. Verapamil

8. This drug is associated with Torsades de pointes.


a. Flecainide
b. +Sotalol
c. Lidocaine
d. Verapamil

9. This drug is used intravenously to terminate supraventricular tachycardias:


a. Nifedipine
b. +Verapamil
c. Both of the above
d. None of the above

10. Bactericidal effect is:


a. Inhibition of young bacterial cell growth

1
b. Inhibition of bacterial cell division
c. +Destroying of bacterial cells
d. Formation of bacterial L-form

11. Tick the drug belonging to antibiotics-macrolides:


a. Neomycin
b. Doxicycline
c. +Erythromycin
d. Cefotaxime

12. Tick the drug belonging to antibiotics-tetracyclmes:


a. +Doxycycline
b. Streptomycin
c. Clarithromycin
d. Amoxacillin

13. Antibiotic inhibiting bacterial RNA synthesis is:


a. Erythromycin
b. +Rifampin
c. Chloramphenicol
d. Imipinem

14. Which of the following agents is related to tricyclic antidepressants ?


a. Nefazolan
b. +Amitriptyline
c. Fluoxetine
d. Isocarboxazid

15. Indicate an effective antidepressant with minimal autonomic toxicity:


a. Amitntyline
b. +Fluoxetine
c. Imipramine
d. Doxepin

16. A ganglioblocking drug for hypertension treatment is:


a. Hydralazine
b. Tubocurarin
c. +Trimethaphan
d. Metoprolol

17. This drug inhibits the angiotensin-converting enzyme:


a. Captopril
b. Enalapril
c. Ramipril
d. +All of the above

18. This drug is an inhibitor of rennin synthesis:


a. +Propranolol
b. Enalapril
c. Diazoxide
d. Losartan
19. This drug routinely produces some tachycardia:
a. +Nifedipine
b. Clonidin
c. Enalapril
d. Propranolol

2
20. Which of the following agents is the precursor of dopamine ?
a) Bromocriptine
b) +Levodopa
c) Selegiline
d) Amantadine

21. Indicate a selective inhibitor of monoamine oxidase B:


a) Levodopa
b) Amantadine
c) Tolcapone
d) +Selegiline

22. Which of the following benzodiazepines has the shortest duration of action?
a) +Triazolam
b) Clorazepate
c) Prazepam
d) Clordiazepoxide

23. Which of the following anxiolytics has minimal abuse liability ?


a) Oxazepam
b) +Buspirone
cj Flumazenil
d) Alprazolam

24. Which of the following direct-acting is mainly muscarinic in action ?


a) +Bethanechol
b) Carbacbol
c) Acetylcholine
d) None of the above

25. Which of the following cholinesterase inhibitors is irreversible?


a) Physostigmine
b) Edrophonium
c) Neostigmine
d) +Isoflurophate

26. Chronic long-term therapy of myasthenia is usually accomplished with:


a) Edrophonium
b) +Neostigmine
c) Echothiophate
d) Carbachol

27. Indicate the skeletal muscle relaxant, which is a depolarizing agent:


a) Vencuronium
b) Scopolamine
c) +Succinylcholine
d) Hexamethonium
28. Which of the following drugs is a selective M l blocker ?
a. Atropine
b. Scopolamine
c. +Pirenzepme
d. Homatropine

29. Indicate a drug, which is effective in the treatment of mushroom poising:


a) Pralldoxime

3
b) Pilocarpine
c) Homatropine
d) +Atropine

30. Which of the following drug is an intermediate-duration muscle relaxant?


a) +Vecuronium
b) Tubocurarine
c) Pancuronium
d) Rapacuronium

31. Which of the following muscular relaxants causes hypotension and bronchospasm ?
a. Vecuronium
b. Succinvlcholine
c. +Tubocurarine
d. Rapacuronium

32. The drug is a K+ -sparing diuretic that blocks Na+ channels in the collecting tubules:
a. Acetazolamide (Diamox}
b. +Amiloride (Midamor)
c. Furosemide (Lasix)
d. Hydrochlorothiazide (HydroDiuril)

33. The drug acts only on the luminal side of renal tubules:
a. +Furosemide (Lasix)
b. Acetazolamide (Dianiox)
c. Both of the above
d. Neither of the above

34. The drug acts at the proximal tubule:


a. Loop diuretics
b. Thiazide diuretics
c. Potassium-sparing diuretics
d. +Carbonic anhvdrase inhibitors

35. The drug is one of the most potent diuretics:


a. Acetazolamide (Diamox)
b. +Furosemide (Lasix)
c. Hydrochlorothiazide (Hydrodiuril)
d. Aniiloride (Midamor)

36. Furosemide acts at the nephron site:


a. Proximal convoluted tubule
b. +Ascending thick limb of the loop of Henle
c. Distal convoluted tubule
d. Collecting duct

37. Which of the following nitrates are long-acting?


a. Nitroglycerin
b. Isosoroide dinitrat
c. Amyl nitrite
d. +Sustac

38. The following agents are cardioselective beta-1 blocking drugs except:
a. +Propranolol

4
b. Talinolol
c. Atenolol
d. Metaprolol

39. Drug is used in digitalis intoxication:


a) Lidocaine
b) +Digibind (Digoxin immune fab)
c) Oral potassium supplementation
d) Reducing the dose ol the drug

40. All of the following drugs are used in CHF


a. Digoxin
b. Dobutamine
c. +Verapamil
d. Dopamine

41. Which of the following inhaled anesthetics is an induction agent of choice in patient with
airway problems ?
a. Desfurane
b. Nitrous oxide
c. +Halothane
d. None of the above

42. Which of the following intravenous anesthetics has antiemetic actions?


a. Thiopental
b. +Propofol
c. Ketamine
d. Fentanyl

43. Pick out the bronchodilator drug related to xanthine:


a) Atropine
b) Orciprenaline
b) Adrenaline
d) +Theophylline

44. All of the following drugs are inhaled glucocorticoids except:


a) Triamcinolone
b) Beclometazone
c) +Sodium cromoglycate
dj Budesonide

45. Indicate the drug belonging to proton pump inhibitors:


a) Pirenzepme
b) Ranitidine
c) +Omenprazole
d) T rimethaphan

46. Which of the following drugs may cause reversible gynecomastia?


a. Omeprazole
b. Pirenzepine
c. +Cimetidine
d. Sucralfate

5
47. Choose the drug that causes constipation:
a) Sodium bicarbonate
b) +Aluminium hvdroxide
c) Calcium carbonate
d) Magnesium oxide

48. Indicate an antiemetic agent which is related to neuroleptics:


a. Metoclopramide
b. Nabilone
c. Tropisetron
d. +Prochlorperazine

49. Which of the following is not an adverse effect of ranitidine:


a) headache
b) +gynecomastia
c) dizziness
d) confusion

50. What does “pharmacokinetics" include?


a. Complications of drug therapj
b. +Drug biotransformation in the organism
c. Influence of drugs on metabolism processes
d. Influence of drugs on genes

51. All of the following agents are beta-receptor agonists except:


a. Epinephrine
b. Isoproterenol
c. +Methoxamine
d. Dobutamine

52. Which of the following is a beta-2 selective agonist?


a. +Terbutaline
b. Xylometazoline
c. Isoproterenol
d. Dobutamine

53. Isoproterenol produces all of the following effects except:


a) Increase in cardiac output
b) Fall in diastolic and mean arterial pressure
c) +Bronchoconstriction
d) Tachycardia

54.1ndicate the alfa-1 selective antagonist:


a. Phentolamine
b. Dihydroergotamine
c. +Prazosin
d. Labetalol

55. Indicate the beta antagonist, which has partial beta-agonist activity:
a. Prooranolol
b. Meioprolol
c. +Pindolol
d. Betaxolol

6
56. The adverse effects of phentolamine include all of the following EXCEPT:
a. Diarrhea
b. +Bradycardia
c. Arrhythmias
d. Myocardial ischemia

57. This drug is a Class II antiarrhythmic drug:


a. Flecainide
b. +Propranolol
c. Lidocaine
d. Verapamil

58. This drug is used in treating supraventricular tachycardias:


a)+Digoxin
b) Dobutamine
c) Amiinone
d) Dopamine

59. This is a drug of choice for acute treatment of ventricular tachycardias:


a) Flecainide
b) Sotalol
c) +Lidocaine
d) Verapamil

60. All of the following are common adverse effects of Ca channe blockers EXCEPT:
a. +Skeletal muscle weakness
b. Dizziness
c. Headache
d. Flushing

61. Bacteriostatic effect is:


a) +Inhibition of bacterial cell division
b) Inhibition of young bacterial cells growth
c) Destroying of bacterial cells
d) Formation of bacterial L-form

62. Tick the drug belonging to antibiotics-monobactams:


a) Ampicillin
b) Bicillin-5
c) +Aztreonam
d) Imipinem

63. Tick the drug belonging to nitrobenzene derivative:


a. Clindamycin
b. Streptomycin
c. Azithromycin
d. +Chloramphenicol

64. Antibiotics altering permeability of cell membranes are:


a. Glvcopeptides
b. +Polymyxins
c. Tetracvclines
d. Cephalosporins

7
65. Which of the following atuidepressants is a selective serotonin reuptake inhibitor?
a) Phenelzine
b) Desipramine
c) Maprotiline
d) +Fluoxetine

66. Which of the following antidepressants is used for treatment of eating disorders, especially
buliemia ?
a. Amitriptvline
b. +Fluoxetine
c. Imipramihe
d. Tranylcypromine

67. Pick out the sympatholytic drug:


a. aj Labetalol
b. Prazosin
c. + Guanethidine
d. Clonidine

68. Choose the selective blocker of beta-1 adrenoreceptors:


a. Labetalol
b. Prazosin
c. +Atenolol
d. Propranolol

69. This drug blocks alpha-1 adrenergic receptors:


a. +Prazosin
b. Clonidine
c. Enalapril
d. Nifedipine

70. This drug is contraindicated in patients with bronchial asthma:


a. +Propranolol
b. Clonidine
c. Enalapril
d. Nifedipme

71. Tick the diuretic agent - aldosterone antagonist:


a. Furosemide
b. +Spironolactone
c. Dichloiiiiazide
d. Captopril

72. Indicate the agents of choice in the treatment of most anxiety states:
a. Barbiturates
b. +Benzodiazepines
c. Lithium salts
d. Phenothiazines

73. Which of the following anxiolytics is preferred in patient with limited hepatic function?
a. +Buspirone
b. Quazepam
c. Diazepam
d. Chlordiazep oxide

8
74. Muscarinic receptors are located in:
a. Autonomic ganglia
b. Skeletal muscle neuromuscular junctions
c. +Autonomic effector cells
d. Sensorv carotid sinus baroreceptor zone

75. Which of the following direct-acting drug has the shortest duration of action?
a. +Acetylcholine
b. Metnacholine
c. Carbachol
d. Bethanechol

76. Indicate cholinesterase activator:


a. +Pralidoxime
b. Edrophonium
c. Pilocarpine
d. Isoflurophate

77. Indicate the reversible cholinesterase inhibitor, which penetrates the blood-brain barrier:
a. +Physostigmine
b. Edrophonium
c. Neostigmine
d. Piridostigmine

78. Which of the following agents is a ganglion-blocking drug?


a. Homatropine
b. +Hexametnonium
c. Rapacuronium
d. Edrophonium

79. Atropine is used prior to premedication to reduce:


a. Muscle tone
b. +Secretions
c. Nausea and vomiting
d. All of the above

80. Which of the following agents is used as an inhalation drug in asthma?


a. Atropine
b. +Ipratropium
c. Lobelme
d. Homatronine

81. Indicate the long-acting neuromuscular blocking agent:


a. Rapacuronium
b. Mivacurium
c. +Tubocurarine
d. Rocuronium

82. Which of the following neuromuscular blockers causes transient muscle fasciculations?
a. Mivacurium
b. Pancuronium
c. +Succinvlcholine
d. Tubocurarine

9
83. The drug acts at the proximal tubule:
a. +Acetazolamiae (Diamoxj
b. Furosemide (Lasix)
c. Hydrochlorothiazide (HydroDiuril)
d. Spironolactone (Aldactone)

84. The drug can be used to treat glaucoma:


a. Furosemide (Lasix)
b. +Acetazolamide (Dianiox)
c. Both of the above
d. Neither of the above

85. The drug decreases calcium excretion in urine:


a. +Hydrochlorothiazide (HydroDiuril)
b. Amiloride (Midamor)
c. Furosemide (Lasix)
d. Acetazolamide (Diamox)

86. The drug acts in the collecting tubules:


a. Loop diuretics
b. Thiazide diuretics
c. +Potassium-sparing diuretics
d. Carbonic annydrase inhibitors

87. The drug is the least potent diuretic:


a. Osmotic diuretics
b. Loop diuretics
c. Thiazide diuretics
d. +Potassium-sparing diuretics

88. Acetazolamide acts at this nephron site


a. +Proximal convoluted tubule
b. Ascending thick limb of the loop Henle
c. Distal convoluted tubule
d. Collecting duct

89. Which of the following is a Ca channel blocker ?


a. Nitroglycerin
b. Dipyndamole
c. Minoxidil
d.+ Nifedipine

90. All of the following are used in CHF except:


a. Reduced salt intake
b. +Verapamil
c. ACE inhibitors
d. Diuretics

91. This drug is a selective beta-1 agonist:


a. Digoxin
b. +Dobutamine
c. Amrinone
d. Dopamine

92. Indicate drug, which is an inhibitor of NMDA glutamate receptors:


a. Thiopental

10
b. Halothane
c. +Ketamine
d. Sevoflurane

93. Which of the following inhaled anesthetic can produce hepatic necrosis?
a. Soveflurane
b. Desfluane
c. +Halothane
d. Nitrous oxide

94. Indicate the intravenous anesthetic, which is a benzodiazepine derivative:


a. +Midazolam
b. Thiopental
c. Ketamin
d. Propofol

95. Pick out the bronchodilator drug belonging to sympathomimics:


a. Isonrenaline
b. +Epnedrine
c. Atropine
d. Salbutamol

96. Choose the drug belonging to membrane stabilizing agents:


a. Zileutin
b. +Sodium cromoglycate
c. Zafirlucast
d. Montelucast

97. All of the following agents intensify the secretion of gastric glands ЕХСЕРT.
a. +Pepsin
b. Gastrin
c. Histamine
d. Carbonate mineral waters

98. Tick the drug forming a physical barrier HC1 and pepsin:
a. Ranitidine
b. +Sucralfate
c. Omeprazole
d. Pirenzepine

99. Indicate the drug that cause metabolic alkalosis:


a. +Sodium bicarbonate
b. Cimetidine
c. Pepto-Bismol
d. Carbenoxolone

100. Indicate the beta-1 selective antagonist:


a) Propranolol
b) +Metoprolol
c) Garvedilol
d) Sotalol
101. This drug is an inhibitor of renin synthesis:
a. +Propranolol
b. Enalapril
c. Diazoxide
d. Losartan

11
102. This drug routinely produces some tachycardia:
a. Propranolol
b. Clonidine
c. Enalapril
d. +Nifedipine

103. Which drugs is a selective Ml blocker?


a. Atropine
b. +Scopolamine
c. Pircnzepine
d. Homatropine

104. Indicate a drug, which is effective in the treatment of mushroom poising:


a. Pralidoxime
b. Pilocarpine
c. Homatropine
d. +Atropine

105. The drug is a K+-sparing diuretic that blocks Na+ channels inlhe collecting tubules:
a. Acetazolamide (Diamox)
b. +Amiloride (Midamor)
c. Furosemide (Lasix)
d. Hydrochlorothiazide (HydroDiuril)

106. Indicate the drug belonging to proton pump inhibitors:


a) Pircnzepine
b) Ranitidine
c) +Omeprazole
d) Trimcthaphan

107. Which of the following drugs may cause reversible gynecomastia?


a) Omeprazole
b) Pircnzepine
c) +Cimetitfine
d) Sucralfate

108. Choose the drug that causes constipation:


a) Sodium bicarbonate
b) +Aluminium hydroxide
c) Calcium carbonate
d) Magnesium oxide

109. Furosemide acts at the nephron site:


a. Proximal convoluted tubule
b. +Ascending thick limb of the loop of Henle
c. Distal convoluted tubule
d. collecting duct

110. A bronchial smooth muscle contains:


a. Alfa-1 receptor
b. Alfa-2 receptor
c. Beta-1 receptor
d. + Beta-2 reccptor

12
111. Which drug is a non selective β-receptor agonist?
a. Norepinephrine
b. Terbutaline
c. +Isoproterenol
d. Dobutamine

112. Sustained use of this drug results in increased plasma urate concentrations:
a) +Furosemide (Lasix)
b) Acetazolamide (Diamox)
c) Both of the above
d) Neither of the above

113. This drug is a Class IB antiarrhythmic drug:


a. Flecainide
b. Sotalol
c. +Lidocaine
d. Verapamil

114. Tick the drug belongs to antibiotics-cephalosporins:


a. Streptomycin
b. +Ceficlor
c. Phenoxymcthilpenicillin
d. Erythromycin

115. Which of the following drugs is a nonselective alfa receptor antagonist?


a. Prazosin
b. +Phentolamine
c. Metoprolol
d. Reserpine

116. Which of the following groups of antibiotics shows a bacteristatic effect:


a. Carbapenems
b. +Macrolides
c. Aminoglycosides
d. Cephafos'porins

117. All of the following agents are cardiac glycosides EXCEPT:


a. Digoxin
b. Strophantin К
c. +Amrinone
d. Digitoxin

118. Amiloride acts ai this nephron site:


a. Proximal convoluted tubule
b. Ascending thick limb of the loop of Henle
c. Distal convoluted tubule
d. +Collecting duct

119. Indicate the drug which is a leucotrienc receptor antagonist:


a. Sodium cromoglycatc
b. +Zafirlucast
c. Zileutin
d. Triamcinolone

13
120. Choose the drug which is a H2-receptor antagonist:
a. Omeprazole
b. Pirenzepme
c. Carbenoxolonc
d. +Ranitidine

121. Which drug is an analog of prostaglandin El?


a. +Misoprostole
b. De-nol
c. Sucralfate
d. Omeprazole

122. Tick the mechanism of metoclopramide antiemetic action:


a. HI and H2-receptor blocking effect
b. M-cholinoreceptor stimulating effect
c. +D2-dopaniine and 5-HT3-serotonin receptor blockina effect
d. M-choiinoblocking effect

123. All of these drugs reduce intestinal peristalsis EXCEPT:


a. Loperamide
b. +Cisapride
c. Methyl cellulose
d. Magnesium aluminium silicate

124. All drugs inhibit cell wall synthesis, except:


a. Carbapenems.
b. Monobactams.
c. Cephamycins.
d. +Nitrofurantoin

125. This drug is a Class III antianhythmic drug:


a. Flecainide
b. +Sotalol
c. docaine
d. Verapamil

126. Minimal duration of antibacterial treatment is:


a. Not less than 1 day
b. +Not less than 5 days
c. Not less than 10-I4 days
d. Not less than 3 weeks

127. Which antibiotics contains a β-lactam ring in their chemical structure:


a. Penicillins
b. Cephalosporins
c. Carbapenems and monobactams
d. +All groups

128. The mode of action may be:


a) +specific and nonspecific
b) selective and nonselective
c) reversible and irreversible
d) metabolic and fimctional

14
129. All of the following antibiotics inhibit the protein synthesis in bacterial cells, EXCEPT:
a. Macrolides
b. Aminoglycosides
c. +Glycopcptides
d. Tetracyclincs

130. All are true about digoxin except:


a. +Causes bradycardia
b.Acts by inhibiting Na+K+ ATPase
c. It is 95 % plasma protein bound
d. Primarily excreted unchanged by glomerular filtration acting

131. All of the following are central antihypertensive drugs EXCEPT:


a. Methyldopa
b. Clonidine
c.Moxonidine
d. +Minoxidil

132. This drug is a directly acting vasodilator:


a. Labetalol
b. Clonidine
c. Enalapril
d. +Nifedipine

133. This drug is a potassium channel activator:


a) Nifedipine
b) Saralasin
c) +Diazoxide
d) Losartan

134. Which of the following is commonly used in the treatment of glaucoma?


a. +Pilocarpine
b. Lobeline
c. Acethylcholine
d. Neostigmine

135. Indicate muscles, which are more resistant to block and recover more rapidly:
a. Hand
b. Leg
c. Neck
d. +Diaphragm

136. Tick the drug, inhibiting viral DNA synthesis:


a) Interferon
b) Saquinavir
c) Amantadine
d) +Acyclovir

137. The drug interaction with different cellular and subcellular structures can result in their
a) stimulation
b) +depression
c) decreasing
d) stabilization

15
138. Tick the anticancer drug, a pyrimidine antagonist:
a) Fluorouracil
b) +Mercaptopurine
c) Thioguanine
d) Methotrexate

139. Geriatric pharmacology studies the peculiarities of action and clinical use of drugs in
a) children
b) pregnant women
c) nursing women
d) +elderly

140. Tick the second messenger of G-protein-coupled (metallotropic) receptor:


a. Adenylyl cyclase
b. Sodium ions
c. Phosnholipase С
d. +сАМР

150. Which drug is a proton pump inhibitor?


a. Cimetidme
b. Ranitidine
c. Pirenzcpin
d. +Omeprazole

151. Choose an emetic drug of central action:


a. +Ipecacuanha derivatives
b. Promethazine
c. Tropisetron
d. Apomorphine hydrochloride

152. Therapeutic index is indicator of:


a) Safety
b) +Efficacy
c) Potency
d) Toxicity

153. Morphine causes all, EXCEPT:


a) Peripheral vasodilatation
b) Decrease intracranial tension
c) Nausea and vomiting
d) +Decrease in gastrointestinal secretion

154. What kind of substances can’t permeate membranes by passive diffusion?


a. Lipid-soluble
b. Non-ionized substances
c. Hydrophobic substances
d. +Hydrophilic substances

155. Tachyphylaxis is:


a. A drug interaction between two similar types of drugs
b. +Very rapidly developing tolerance
c. A decrease in responsiveness to a drug, taking days or weeks to develop
d. None of the above

16
156. Pharmacology is a science about
a) chemistry
b) physiology.
c) +medicinal preparations
d) pharmaceutical business

157. A teratogenic action is:


a. Toxic action on the liver
b. +Negative action on the fetus causing fetal malformation
c. Toxic action on blood system
d. Toxic action on kidneys

158. Which of the following agents is an selective agents is an alfa-l selective agonist?
a. Norepinephrine
b. +Methoxamine
c. Ritodrine
d. Ephedrine

159. Indicate the indirect-acting agent:


a. Epinephrine
b. Phenylephrine
c. +Ephedrine
d. Isoproterenol

160. Which of the following is related to short acting topical decongestant agents ?
a. Xylometazoline
b. Terbutaline
c. +Phenylephrine
b. Norepinephrine

161. Which of the following agents is an alfa 2-selective antagonist ?


a. +Yohimbine
b. Tamsulosin
c. Tolazoline
d. Prazosin

162. Which of the following drugs is a reversible nonselective alfa-, beta-antagonist?


a. + Labetalol
b. Phentolamine
c. Metoorolol
d. Propranolol

163. This drug is a Class 1A antiarrhythmic drug:


a. Sotalol
b. Propranolol
c. Verapamil
d. +Quinidine

164. This drug prolongs repolarization:


a. Flecainide
b. +Sotalol
c. Lidocaine
d. Verapamil

17
165. This drug has beta-adrenergic blocking activity:
a. Flecainide
b. +Sotalol
c. Lidocaine
d. Verapamil

166. This drug acts to inhibiting slow Ca channels in the SA and AV nodes:
a. Quinidine
b. Adenosine
c. Fleeainide
d. +Diltiazem

167. Which of the following groups of antibiotics shows a bactericidal effect?


a. Tetracyclines
b. Macrolides
c. +Penicillins
d. All of the above

168. Tick the drug belonging to antibiotics - carbapenems:


a. Aztreonam
b. Amoxacillin
c. +Imipinem
d. Clarithromycin

169. Tick the drug belonging to lincozamides:


a. Erythromycin
b. +Lincomvcm
c. Azithromycin
d. Aztreonam

170. Tick the drug belonging to glycopeptides:


a. +Vancomycin
b. Lincomycin
c. Neomycm
d. Carbenicillin

171. Which of the following drugs is a gastric acid resistant:


a. Penicillin G
b. +Penicillin V
c. Carbenicillin
d. Procain penicillin

I72. Indicate the antidepressant, which blocks the reuptake pumps for serotonin and norepinephrine:
a. +Amitriptyline
b. Fluoxetine
c. Maprotiline
d. Phenelzine

173. A highly selective serotonine reuptake inhibitor is:


a. Sertaline
b. Paroxetine
c. Fluoxetine.
d. +All of the above

18
174. Tick the drug with nonselective beta-adrenoblocking activity:
a. Atenolol
b. +Propranolol
c. Metoprolol
d. Nebivolol
175. Pick out the diuretic agent for hvpertension treatment:
a. Losartan
b. +Dichlothiazide
c. Captcpril
d. Prazosin
176. This drug is a non-peptide angiotensin II receptor antagonist:
a. Clonidine
b. Captopril
c. +Losartan
d. Diazoxide

177. Choose the vasodilator which releases NO:


a. Nifedipine
b. Hydralazine
c. Minoxidil
d. +Sodium nitroprusside

178. Indicate a peripheral dopa decarboxvlase inhibitor:


a. Tolcapone
b. Clozapine
c. + Carbiaopa
d. Selegiline

179. Indicate D2 receptor agonist with antiparkinsonian activity:


a. Sinemet
b. Levodopa
c. +Bromocriptine
d. Selegiline

180. Which of the following anxylotics is a benzodiazepine derivative:


a. Buspirone
b. +Clordiazepoxide
c. Meprobamate
d. Chloral hydrate

181. Indicate the competitive antagonist of β-2 receptors:


a. +Flumazenil
b. Buspirone
c. Picrotoxin
d. Diazenam

182. Which of the following activates both muscarinic and nicotinic receptors ?
a. Lobeline
b. Pilocarpine
c. Nicotine
d. +Bethanechol

19
183. The M-cholinimimetic agent is:
a. Carbachol
b. +Pilocarpine
c. Acetylcholine
d. Betfianechol

184. Isofluorophate increases all of the following effects except:


a. Lacrimation
b. +Bronchodilation
c. Muscle twitching
d. Salivation

185. Which of the following cholinomimetics is used in the treatment of atropine intoxication?
a. Neostigmine
b. Carbochol
c. +Physostigmine
d. Lobeline

186. Which of the following drugs is effective in motion sickness?


a. Atropine
b. Ipratropium
c. +Scopolamine
d. Homatropine

187. Which of the following drugs is useful in the treatment of uterine spasms?
a. Carbachol
b. Vecuronium
c. +Atropine
d. Edrophonium

188. Antimuscarinics are used in the treatment of the following disorders EXCEPT:
a. Motion sickness
b. +Glaucoma
c. Hyperhidrosis
d. Asthma

189. Indicate the nondepolarizing agent, which has short duration of action:
a. Succinylcholine
b. Tubocurarine
c. +Mivacurium
d. Pancuronium

190. The drug inhibits the ubiquitous enzyme carbonic anhydrase:


a. +Acetazolamide (Diamoxj
b. Furosemide (Lasix]
c. Hydrochlorothiazide (HydroDiuril)
d. Spironolactone (Aldactone)

191. The drug acts by competing with aldosterone for its cytosotic receptors:
a. Acetazolamide (Diamoxj
b. Furosemide (Lasix)
c. Hydrochlorothiazide (HydroDiuril)
d. +Spironolactone (Aldactone)

20
192. The drug can cause ototoxicity:
a. +Furosemide (Lasix)
b. Acetazolamide (Diamox)
c. Both of the above
d. Neither of the above

193. The drug acts by competitively blocking the Na+/K+/2Cl- cotransporter:


a. +Loop diuretics
b. Thiazide diuretics
c. cl Potassium-sparing diuretics
d. Carbonic anhydrase inhibitors

194. The drug acts by competitively blocking the NaCI cotransporter:


a. Loop diuretics
b. +Thiazide diuretics
c. Potassium-sparing diuretics
d. Carbonic anhydrase inhibitors

195. These agents must be given parenterally because they are not absorbed w'hen given
orally:
a. + Osmotic diuretics
b. Loon diuretics
c. Thiazide diuretics
d. Potassium-sparing diuretics

196. Spironolactone acts at this nephron site:


a. Proximal convoluted tubule
b. Ascending thick limb of the loop of Henle
c. Distal convoluted tubule
d. +Collecting duct

197. Main clinical use of Ca channel blockers is:


a. Angina pectoris
b. Hypertension
c. Supraventricular tachyarrhythmia
d. +All of the above

198. The non-glycoside positive inotropic drug is:


a. Digoxin
b. Strophantin К
c. +Dobutamine
d. Digitoxin

199. Tolerance to this drug develops after a few days:


a. Amrinone
b. Amiodarone
c. +Dobutamine
d. Adenosine

200. Which of the following general anesthetics belongs to inhalants ?


a. Thiopental
b. +Desfluran
c. Ketamine
d. Propoftol

21
201. Indicated the inhaled anesthetic, which may cause nephrotoxicity:
a. Halothane
b. +Soveflurane
c. Nitrous oxide
d. Diethvl ether

202. Which of these groups of drugs is used for asthma treatment ?


a. Methylxanthines
b. M-cholinoblocking agents
c. Beta-2 stimulants
d. +All of above

203. Select the side-effect characteristic for non-selective beta-2 adrenomimetics:


a. Depression of the breathing centre
b. +Tachycardia
c. Peripheral vasoconstriction
d. Dry mouth

204. Indicate the side effect of theophylline:


a. Bradycardia
b. +Increased myocardial demands for oxygen
c. Depression of respiratory centre
d. Elevation of the arterial blood pressure

205. Gastric acid secretion is under the control the following agents EXCEPT:
a. Histamine
b. Acetylcholine
c. +Serotonin
d. Gastrin

206. All of the following drugs are proton pump inhibitors except:
a. Pantoprozole
b. Omeprazole
c. +Famotidine
d. Rabeprazole

207. Most of drugs are antacids EXCEPT:


a. +Misoprostol
b. Maalox
c. Mylanta
d. Almagel

208. This drug is related to short-acting topical decongestant:


a. Xylometazoline
b. Terbutaline
c. +Phenylephrine
d. Norepinephrine

209. This drug is a Class IA antiarrhythmic drug:


a. Sotalol
b. Propranolol
c. Verapamil
d. +Quinidine

22
210. This drug acts by inhibiting slow Ca channels in the SA and AV nodes:
a. Quinidine
b. Adenosine
c. Fleeainide
d. +Diltiazem

211. Which of the following groups of antibiotics shows a bactericidal effect?


a. Tetracyclines
b. Macrolides
c. Penicillins
d. +All of the above

212. Most of drugs are antacids EXCEPT:


a. +Misoprostol
b. Maalox
c. Mvlanta
d. Almagel

213. Side effects of anticancer drugs are all, EXCEPT:


a. Low selectivity to cancer cells
b. Depression of bone marrow
c. Depression of angiogenesis
d. +Depression of immune system

214. Main clinical use of Ca channel blockers is:


a. Angina pectoris
b. Hypertension
c. Supraventricular tachyarrhythmias
d. +All of the above

215. Which drug is a H2-receptor antagonist:


a. Omeprazole
b. Pirenzepine
c. Carbenoxolone
d. +Ranitidine

23
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Copyright © 2008, New Age International (P) Ltd., Publishers
Published by New Age International (P) Ltd., Publishers

All rights reserved.


No part of this ebook may be reproduced in any form, by photostat, microfilm,
xerography, or any other means, or incorporated into any information retrieval
system, electronic or mechanical, without the written permission of the publisher.
All inquiries should be emailed to rights@newagepublishers.com

ISBN (13) : 978-81-224-2926-8

PUBLISHING FOR ONE WORLD


NEW AGE INTERNATIONAL (P) LIMITED, PUBLISHERS
4835/24, Ansari Road, Daryaganj, New Delhi - 110002
Visit us at www.newagepublishers.com
This book is dedicated to
My Parents, Late Shri G. C. Naidu and
Parents,
Smt. G. Lalitha
For their untiring efforts and hardwork in bringing me up to what all I
am today.

Prof. Dr. G. Vidya Sagar


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SNIPPETS

Very useful book for students preparing for GATE & USMLE. Recommended reading.
Dr. Sanjay Pai
Al-Ameen college of Pharmacy
Bangalore.

I found the book absorbing, questions are well framed.


Dr. Gabhe
C.U Shah College of Pharmacy,
Mumbai.

Good Reference for PG medical entrance. Recommended reading.


Dr. Kaushik Shah
M.S.(Gen. Surgery)
Rana Hospital, Mandvi

This book will be of good use for students appearing for Competitive exams.
Presentation of the matter is good.
Prof. Y. Madhusudhan Rao
Univ. College of Pharmaceutical Sciences
Kakatiya University, Warangal.
FOREWORD

Medical & Pharmacy are fast growing professions with a wide range of opportunities open to the students after a basic
degree. These professions play a vital role in health care management.
This book will be of immense value for students to develop themselves as the meritorious & motivated candidates for
admission to post graduate courses like M.D., M.S. & M.Pharm.
I compliment the author for his pains-taking efforts in mobilizing a very large number of good MCQs from a vast
subject like Pharmacology. Adequate coverage of all topics is done.
I feel that this book will be a very useful companion for professional PG entrance examinations. I strongly recom-
mend this book to college library collection

PROF. DR. KANTIBHAI GOR


Vice Chancellor
K. S. K. V. Kachchh University
Bhuj - Kutch.
ACKNOWLEDGEMENTS

I acknowledge the help rendered by the following well wishers during the preparation of the manuscript.
• Dr. Ananta Naik Nagappa
Professor, Pharmacy practice, Manipal College of Pharm. Sciences, Manipal, Karnataka.
• Dr. K. R. Mahadik
Principal, Bharati Vidyapeeth Deemed University’s College of Pharmacy, Pune.
• Prof. Vijay Raghunath Patil
Principal, Tapi Valley Education Society’s College of Pharmacy
Faizpur, Maharashtra.
• Dr. Havigiray R. Chitme
Professor of Pharmacology, Oman medical College, Oman
• Dr. Chandrakant S. Magdum
Vice Principal, Shri Appasaheb Birnale College of Pharmacy,
Sangli, Maharashtra.
• Dr. B. P. Nagori
Director, Lachchoo Memorial College of Pharmacy,
Jodhpur.
My sincere thanks are due to Mr. Ojas M. Suroo, Lecturer, Computer Science of my institute for his meticulous
typing the manuscript and the final format of the book.
Finally, I would like to place on record the generous help rendered by New age International (P) Limited,
Publishers in bringing out this book.

Prof. Dr. G.Vidya Sagar.


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CONTENTS

Preface (xi)

CHAPTER 1 1
General Pharmacology

CHAPTER 2 29
Drugs Acting on Central Nervous System

CHAPTER 3 85
Drugs Acting on Autonomous Nervous System

CHAPTER 4 103
Vitamins & Minerals

CHAPTER 5 107
Analgesics & Antipyretics

CHAPTER 6 121
Cardiovascular Drugs

CHAPTER 7 135
Drugs Used in Respiratory Disorders

CHAPTER 8 143
Antibiotics

CHAPTER 9 157
Drugs Used in Gastrointestinal Tract Disorders

CHAPTER 10 165
Oxytocics & Uterine Muscle Relaxants

CHAPTER 11 167
Chemotherapy
xiv

CHAPTER 12 193
Drugs used in Endocrine disorders (Hormones)

CHAPTER 13 207
ANTIDIABETICS

CHAPTER 14 211
Anticoagulants

CHAPTER 15 215
Antihyperlipedemic agents

CHAPTER 16 217
Antacids

CHAPTER 17 221
Antiemetics

CHAPTER 18 223
Match the Following
CHAPTER 1
GENERAL PHARMACOLOGY

1. All of the following are general (e) Distribution of a drug out of the bloodstream
mechanisms of drug permeation Except terminates the drug’s effect
(a) Aqueous diffusion 4. Distribution of drugs to specific tissues
(b) Aqueous hydrolysis
(a) Is independent of blood flow to the organ
(c) Lipid diffusion
(b) Is independent of the solubility of the drug in
(d) Pinocytosis or endocytosis that tissue
(e) Special carrier transport (c) Depends on the unbound drug concentration
2. If the plasma concentration of a drug gradient between blood and tissue
declines with “first-order kinetics”, this (d) Is increased for drugs that are strongly bound
means that to plasma proteins
(a) There is only one metabolic path for drug (e) Has no effect on the half-life of the drug
disposition
5. A physical process by which a weak acid
(b) The half-life is the same regardless of the becomes less water-soluble and more
plasma concentration lipid-soluble at low pH is
(c) The drug is largely metabolized in the liver
(a) Distribution (b) Elimination
after oral administration and has low
bioavailability elimination (c) First-pass effect (d) Permeation
(d) The rate of climination is proportionate to (e) Protonation
the rate of administration at all times 6. Dose-response curves are used for drug
(e) The drug is not distributed outside the evaluation in the animal laboratory and
vascular system in the clinic, Quantal dose-response
curves are often
3. Regarding termination of drug action
(a) Used for determining the therapeutic index
(a) Drug must be exerted from the body to
terminate their action of a drug
(b) Metabolism of drugs always increases their (b) Used for determining the maximal efficacy
water solubility of a drug
(c) Metabolism of drugs always abolishes their (c) Invalid in the presence of inhibitors of the
pharmacologic activity drug being studied
(d) Hepatic metabolism and renal excretion are (d) Obtained from the study of intact subject but
the two most important mechanisms involved not from isolated tissue preparations
2 MCQs IN PHARMACOLOGY

(e) Used to determine the statistical variation (a) Maximal efficacy


(standard deviation) of the maximal response (b) Therapeutic index
to the drug. (c) Drug potency
7. The following are excreted faster in basic (d) Grade dose-response curve
urine (e) Quantal dose-response curve
(a) Weak acids (b) Strong acids 12. Which of the following most accurately
(c) Weak Bases (d) None of the above describes the transmembrane signaling
process involved in steroid hormone
8. Which of the following statements about action ?
spare receptors is most correct ?
(a) Action on a membrane spanning tyrosine
(a) Spare receptors, in the absence of drug, are kinase
sequestered in the cytoplasm
(b) Activation of a G protein which activates or
(b) Spare receptors will be detected if the inhibits adenyl cyclase
intracellular effect of drug-receptor interaction (c) Diffusion into the cytoplasm and binding to
lasts longer than the drug-receptor interaction an intracellular receptor
itself
(d) Diffusion of “STAT” molecules across the
(c) Spare receptors influence the maximal membrane
efficacy of the drug-receptor system
(e) Opening of transmembrane ion channels
(d) Spare receptors activate the effector
machinery of the cell without the need for a 13. Which of the following is a phase II drug-
drug metabolizing reaction ?
(e) Spare receptors may be detected by the (a) Acetylation (b) Deamination
finding that the EC50 is greater than the Kd (c) Hydrolysis (d) Oxidation
for the agonist (e) Reduction
9. Which of the following terms best 14. Which of the following drugs may inhibit
describes an antagonist that interacts the hepatic microsomal P450 responsible
directly with the agonist and not at all or for warfarin metabolism
only incidentally, with the receptor ? (a) Cimetidine (b) Ethanol
(a) Pharmacological antagonist (c) Phenobarbital (d) Procainamide
(b) Partial agonist (e) Rifampin
(c) Physiological antagonist
15. With regard to clinical trials of new drugs,
(d) Chemical antagonist which of the following is most correct ?
(e) Noncompetitive antagonist
(a) Phase I involves the study of a small number
10. Which of the following terms best of normal volunteers by highly trained clinical
describes a drug that blocks the action of pharmacologists
epinephrine at its receptors by occupying (b) Phase II involves the use of the new drug in a
those receptors without activating them ? large number of patients (100-5000) who
have the disease to be treated
(a) Pharmacological antagonist
(c) Phase III involves the determination of the
(b) Partial agonist
drug’s therapeutic index by the cautious
(c) Physiological antagonist induction of toxicity
(d) Chemical antagonist (d) Chemical antagonist
(e) Noncompetitive antagonist (e) Phase II requires the use of a positive control
11. Which of the following provides information (a known effective drug) and a placebo
about the variation in sensitivity of the drug 16. Animal testing of potential new
within the population studied ? therapeutic agents
GENERAL PHARMACOLOGY 3

(a) Extends over a time period of at least 3 years (c) Physostigmine (d) Pilocarpine
in order to discover late toxicities (e) Neostigmine
(b) Requires the use of at least two primate 22. Phenylephrine causes
species, eg. Monkey and baboon
(a) Constriction of vessels in the nasal mucosa
(c) Requires the submission of histopathologic
(b) Increased gastric secretion and motility
slides and specimens to the FDA for
government evaluation (c) Increased skin temperature
(d) Has good predictability for drug allergy-type (d) Miosis
reactions (e) All of the above
(e) May be abbreviated in the case of some very 23. Pretreatment with propranolol will block
toxic agents used in cancer which one of the following ?

17. The “dominant lethal” test involves the (a) Methacholine-induced tachycardia
treatment of a male adult animal with a (b) Nicotine-induced hypertension
chemical before mating; the pregnant (c) Norepinephrine-induced bradycardia
female is later examined for fetal death (d) Phenylephrine-induced mydriasis
and abnormalities. The dominant lethal
24. Most drug receptors are
test therefore is a test of
(a) Small molecules with a molecular weight
(a) Teratogenicity between 100 and 1000
(b) Mutagenicity (b) Lipids arranged in a bilayer configuration
(c) Carcinogenicity (c) Proteins located on cell membranes or in the
(d) All of the above cytosol
(e) None of the above (d) DNA molecules
(e) RNA molecules
18. The Ames test is a method for detecting
25. With regard to distribution of a drug from
(a) Carcinogenesis in rodents
the blood into tissues
(b) Carcinogenesis in primates
(a) Blood flow to the tissue is an important
(c) Teratogenesis in any mammalian species
determinant
(d) Teratogenesis in primates
(b) Solubility of the drug in the tissue is an
(e) Mutagenesis in bacteria
important determinant
19. “Nicotinic” sites include all of the (c) Concentration of the drug in the blood is an
following except important determinant
(a) Bronchial smooth muscle (d) Size (volume) of the tissue is an important
(b) Adrenal medullary cells determinant
(c) Parasympathetic ganglia (e) All of the above are important determinants
(d) Skeletal muscle
26. The pH value is calculated mathematically
(e) Sympathetic ganglia
as the
20. A good example of chemical antagonism (a)

Log of the hydroxyl ion (OH ) concentration
(a) Heparin & Protamine (b)

Negative log of the OH concentration
(b) Protamine & Zinc (c)
+
Log of the hydrogen ion (H ) concentration
(c) Heparin & Prothrombin +
(d) Negative log of the H concentration
(d) All the above + –
(e) Ratio of H /OH concentration
21. Which of the following agents is a pro-
drug that is much less toxic in mammals 27. Which property is classified as colligative?
than in insects ? (a) Solubility of a solute
(a) Acetylcholine (b) Bethanechol (b) Osmotic pressure
4 MCQs IN PHARMACOLOGY

(c) Hydrogen ion (H+) concentration (c) 0.3 µm (d) 0.2 µm


(d) Dissociation of a solute (e) 0.1 µm
(e) Miscibility of the liquids
34. In the extemporaneous preparation of a
28. The colligative properties of a solution are suspension, levigation is used to
related to the (a) Reduce the zeta potential
(a) pH of the solution (b) Avoid bacterial growth
(b) Number of ions in the solution (c) Reduce particle size
(c) Total number of solute particles in the solution (d) Enhance viscosity
(d) Number of unionized molecules in the (e) Reduce viscosity
solution
35. Active transport differs from facilitated
(e) pKa of the solution
transport in following ways, except
29. The pH of a buffer system can be (a) Carrier is involved
calculated with the (b) It is against concentration gradient
(a) Noyes – Whitney equation (c) Energy is required
(b) Henderson – Hasselbalch equation (d) All of the above
(c) Michaelis – Menten equation
36. Vanishing cream is an ointment that may
(d) Yong equation
be classified as
(e) Stokes equation
(a) A water –soluble base
30. Which mechanism is most often (b) An oleaginous base
responsible for chemical degradation? (c) An absorption base
(a) Racemization (b) Photolysis (d) An emulsion base
(c) Hydrolysis (d) Decarboxylation (e) An oleic base
(e) Oxidation
37. Rectal suppositories intended for adult
31. Which equation is used to predict the use usually weigh approximately
stability of a drug product at room (a) 1g (b) 2g
temperature from experiments at
(c) 3g (d) 4g
accelerated temperature?
(e) 5g
(a) The stokes equation
(b) The Yong equation 38. In the fusion method of making cocoa
butter suppositories,which substance is
(c) The Arrhenius equation
most likely to be used to lubricate the mold?
(d) The Michaelis – Menten equation
(e) The Hixson – Crowell equation (a) Mineral oil (b) Propylene glycol
(c) Cetyl alcohol (d) Stearic acid
32. Based on the relation between the degree
(e) Magnesium silicate
of ionization and the solubility of a weak
acid, the drug aspirin (pKa 3.49) will be 39. A very fine powdered chemical is defined
most soluble at as one that
(a) pH 1.0 (b) pH 2.0 (a) Completely passes through a # 80 sieve
(c) pH 3.0 (d) pH 4.0 (b) Completely passes through a # 120 sieve
(e) pH 6.0 (c) Completely passes through a # 20 sieve
33. The particle size of the dispersed solid in (d) Passes through a # 60 sieve and not more
a suspension is usually greater than than 40% through a # 100 sieve
(e) Passes through a # 40 sieve and not more
(a) 0.5 µm (b) 0.4 µm
than 60% through a # 60 sieve
GENERAL PHARMACOLOGY 5

40. Which technique is typically used to mill (b) Carboxymethyl cellulose


camphor? (c) Cellulose acetate phthalate
(a) Trituration
48. For each tablet processing problem listed
(b) Levigation
below, select the most likely reason for
(c) Pulverization and intervention the condition
(d) Geometric dilution
(a) Excessive moisture (1) Picking
(e) Attrition
in the granulation
41. Which type of paper best protects a (b) Entrapment of air (2) Mottling
divided hygroscopic powder? (c) Tablet friability (3) Capping
(a) Waxed paper (b) Glassine (d) Degraded drug (4) Sticking
(c) White bond (d) Blue bond (e) Tablet hardness
(e) Vegetable parchment
49. For each description of a comminution
42. Which capsule size has the smallest procedure below, select the process that
capacity? it best describes
(a) 5 (b) 4
(a) Trituration
(c) 1 (d) 0
(b) Spatulation
(e) 000
(c) Levigation
43. The shells of soft gelatin capsules may (d) Pulverization by intervention
be made elastic or plastic–like by the
(e) Tumbling
addition of
(1) Rubbing or grinding a substance in a
(a) Sorbitol
mortar that has a rough inner surface
(b) Povidone
(2) Reducing and subdividing a substance
(c) Polyethylene glycol by adding an easily removable solvent
(d) Lactose
(3) adding a suitable agent to form a paste
(e) pKa of the solution and then rubbing or grinding the paste
44. Nonionic surface-active agents used as in mortar
synthetic emulsifiers include
50. Match the drug product below with the
(a) Tragacanth type of controlled-release dosage form
(b) Sodium lauryl sulphate that it represents
(c) Sorbitan esters(spans)
(a) Matrix device (1) Biphenamine
45. A ceramic mortar may be preferable to a Capsules
glass mortar when (b) Ion-exchange (2) Thorazine
(a) A volatile oil is added to a powder mixture resin complex Spansule Capsules
(b) Colored substances (dyes) are mixed into a (c) Hydrocolloid (3) Valrelease
powder system
(c) Comminution is desired in addition to mixing (d) Osmotic system (4) Slow - K
46. Divided powders may be dispensed in (e) Coated granules
(a) Individual-dose packets 51. The route of drug administration that
(b) A bulk container gives the most rapid onset of the phar-
(c) A perforated, sifter –type container macological effect is
47. Agents that may be used to coat enteric (a) Intramuscular injection
coated tablets include (b) Intravenous injection
(a) Hydroxypropyl methyl cellulose (c) Intradermal injection
6 MCQs IN PHARMACOLOGY

(d) Peroral administration (b) Glomerular filtration rate (GFR)


(e) Subcutaneous injection (c) Active renal secretion
52. Acidic drugs mainly bind to plasma (d) Passive renal absorption
(e) Drug metabolism rate
(a) Albumin
(b) á1 – acid glycoprotein 59. The earliest evidence that a drug is stored
(c) Both (a) and (b) in tissue is
(d) None of the above (a) An increase in plasma protein binding
53. After peroral administration, drugs
generally are absorbed best from the (b) A large apparent volume of distribution (VD)
(a) Buccal cavity (b) Stomach (c) A decrease in the rate of formation of
metabolites by the liver
(c) Duodenum (d) Ileum
(e) Rectum (d) An increase in the number of side effects
produced by the drug
54. The passage of drug molecules from a (e) A decrease in the amount of free drug
region of high drug concentration to a excreted in the urine
region of low drug concentration is
known as 60. The intensity of the pharmacologic action
(a) Active transport (b) Bioavailability of a drug is most dependent on the
(c) Biopharmaceutics (d) Simple diffusion (a) Concentration of the drug at the receptor site
(e) Pinocytosis (b) Elimination half-life (t½) of the drug
55. What equation describes the rate of drug (c) Onset time of the drug after oral
dissolution from a tablet? administration
(d) Minimum toxic concentration (MTC) of the
(a) Fick’s law
drug in plasma
(b) Henderson – Hasselbach equation
(e) Minimum effective concentration (MEC)
(c) Law of mass action
of the drug in the body
(d) Michaelis – Menten equation
(e) Noyes Whitney equation 61. Drug that show nonlinear pharmacoki-
netics have which property?
56. Dose dumping is a problem in the
formulation of (a) A constant ratio of drug metabolites is formed
as the administered dose increases
(a) Compressed tablets
(b) The elimination half-life (t½) increases as the
(b) Modified- release drug products
administered dose increases
(c) Hard gelatin capsules
(c) The area under the plasma drug
(d) Soft gelatin capsules concentration versus time curve (AUC)
(e) Suppositories increases in direct proportion to an increase
57. The rate of drug bioavailability is most in the administered dose
rapid when the drug is formulated as a (d) Both low and high doses follow first-order
(a) Controlled – release product elimination kinetics
(b) Hard gelatin capsule (e) The steady-state drug concentration increases
in direct proportion to the dosing rate
(c) Compressed tablet (d) Solution
(e) Suspension 62. The loading dose (DL) of a drug is usually
based on the
58. Creatinine clearance is used as a mea-
surement of (a) Total body clearance (ClT) of the drug
(a) Renal excretion rate (b) Percentage of drug bound to plasma proteins
GENERAL PHARMACOLOGY 7

(c) Fraction of drug excreted unchanged in the urine 68. The principle of superposition in designing
(d) Apparent volume of distribution (VD) and multiple-dose regimens assumes that
desired drug concentration in plasma (a) Each dose affects the next subsequent dose
(e) Area under the plasma drug concentration causing nonlinear elimination
versus time curve (AUC) (b) Each dose of drug is eliminated by zero-order
63. The renal clearance of insulin is used as elimination
a measurement of (c) Steady-state plasma drug concentration are
(a) Effective renal blood flow reached at approximately 10 half-lives
(b) Rate of renal drug excretion
(d) Early doses of drug do not affect subsequent
(c) Intrinsic enzyme activity
doses
(d) Active renal secretion
(e) The fraction of drug absorbed is equal to
(e) Glomerular filtration rate (GFR) the fraction of drug eliminated
64. All of the following statements about 69. Which equation is true for a zero-order
plasma protein binding of a drug are true reaction rate of drug ?
except
(a) dA/dt = - k (b) t½= 0.693/k
(a) Displacement of a drug from plasma protein
binding sites results in a transient increased (c) A = A0e -kt
volume of distribution (VD) 70. Which of the following functional groups
(b) Displacement of a drug from plasma protein is most susceptible to hydrolysis ?
binding sites makes more free drug available
(a) R – CO – R (b) R – COOR
for glomerular filtration
(c) R – O - R (d) R – NH- CH3
(c) Displacement of a potent drug that is normally
more than 95% bound may cause toxicity (e) R – COOH
(d) Albumin is the major protein involved in 71. Monomer units of proteins are known as
protein binding of drugs
(a) Monosaccharides (b) Prosthetic groups
(e) Drugs that are highly bound to plasma
(c) Amino acids (d) Purines
proteins generally have a greater V D
compared with drugs that are highly bound (e) Nucleosides
to tissue proteins 72. Glucose is a carbohydrate that cannot be
65. _______ is expressed in both the intestinal hydrolyzed into a simpler substance. It is
epithelium and the kidney. best described as
(a) CYP2D6 (b) CYP1A1/2 (a) A sugar (b) A monosaccharide
(c) CYP3A4 (d) CYP2E1 (c) A disaccharide (d) A polysaccharide
(e) An oligosaccharide
66. The initial distribution of a drug into tissue
is determined chiefly by the 73. All of the following carbohydrates are
(a) Rate of blood flow to tissue considered to be polysaccharides except
(b) Glomerular filtration rate (GFR) (a) Heparin (b) Starch
(c) Stomach emptying time (c) Glycogen (d) Maltose
(d) Affinity of the drug for tissue (e) Cellulose
(e) Plasma protein binding of the drug
74. Which of the following compounds are
67. Which tissue has the greatest capacity to considered the building blocks of nucleic
bio-transform drugs? acids ?
(a) Brain (b) Kidney (a) Nucleotides (b) Nucleosides
(c) Liver (d) Lung (c) Monosaccharides (d) Purines
(e) Skin (e) Amino acids
8 MCQs IN PHARMACOLOGY

75. Which of the following terms best 83. Which class of antibody has the longest
describes a co-factor that is firmly bound serum half-life and opsonizes antigens for
to an apoenzyme? phagocytosis through two different
(a) Holoenzyme (b) Prosthetic group pathways?
(c) Coenzyme (d) Transferase (a) Immunoglobulin G (IgG)
(e) Heteropolysaccharide (b) Immunoglobulin M(IgM)
76. Enzymes that uncouple peptide linkages (c) Immunoglobulin A (IgA)
are best classified as (d) Immunoglobulin E (IgE)
(a) Hydrolases (b) Ligases 84. Urticaria that appears rapidly after the
(c) Oxidoreductases (d) Transferases ingestion of food usually indicates which
(e) Isomaerases type of hypersensitivity reaction?

77. The sugar that is inherent in the nucleic (a) Type I (b) Type II
acids RNA and DNA is (c) Type III (d) Type IV
(a) Glucose (b) Sucrose 85. A patient receives long-term, high-dose
(c) Ribose (d) Digitoxose therapy with a sulfonamide. After
(e) Maltose approximately 3 weeks of therapy, the
patient has a low-grade fever, rash, and
78. N-oxidation will be involved with the muscle and joint pain. Which type of
metabolism of following drugs, except hypersensitivity accounts for these
(a) Dapsone (b) Meperidine symptoms?
(c) Phenytoin (d) Chlorpheniramine (a) Type I (b) Type II
79. Which of the following statements (c) Type III (d) Type IV
describes plasmids? They
86. CD4+T cells specifically recognize antigens
(a) Are single – stranded DNA molecules in which form?
(b) Carry optional gene(s) (a) Bound to major histocompatibility (MHC)
(c) Carry genes essential for growth class I molecules on the surface of any body
(d) Are always found in linear form cell
80. Bacteria that grow at temperatures as (b) In free, soluble form in extracellular fluids
high as 550C are known as (c) Bound to MHC class II molecules on the
surface of special antigen-presenting cells
(a) Psychrophiles (b) Thermophiles
(APCs)
(c) Mesophiles (d) Auxotrophs
87. Which of the following statements
81. Which of the following organisms can use
concerning a drug receptor is true?
only molecular oxygen as the final
acceptor? (a) It mediates the nonspecific action of volatile
anesthetics
(a) Obligate anaerobes
(b) Facultative anaerobes (b) Its expression is induced only by exogenously
added drugs
(c) Obligate aerobes
(c) It can bind endogenous ligand to produce
(d) Strict anaerobes
physiological activity
82. A declining growth rate occurs during (d) It mediates the cathartic activity of
which of the following phases of bacterial magnesium citrate
cell growth? (e) Down-regulation of receptor level can lead
(a) Lag phase (b) Exponential phase to sensitization of the target cell to the
(c) Stationary phase (d) Death phase receptor agonist.
GENERAL PHARMACOLOGY 9

88. Which of the following acids has the (c) All drugs are excreted more rapidly in an
highest degree of ionization in an alkaline urine.
aqueous solution?
94. Which of the following drugs is
(a) Aspirin pKa = 3.5 considered to be the agent of choice for
(b) Indomethacin pKa = 4.5 anaphylactic reactions?
(c) Warfarin pKa = 5.1 (a) Edrophonium (b) Ipratropium
(d) Ibuprofen pKa = 5.2 (c) Ambenonium (d) Propantheline
(e) Phenobarbital pKa = 7.4 (e) Homatropine
89. Which of the following salts forms an 95. Which of the following drugs is considred
aqueous solution that is alkaline to to be the agent of choice for anaphylactic
litmus? reactions?
(a) Sodium chloride (a) Clonidine (b) Isoproterenol
(b) Benzalkonium chloride (c) Epinephrine (d) Phenylephrine
(c) Meperidine hydrochloride (e) Terbutaline
(d) Cefazolin sodium
96. Which of the following emissions from the
(e) Chlordiazepoxide hydrochloride decay of radionuclides is most commonly
90. Hydrolysis reaction are involved with the used in nuclear medicine imaging?
metabolism of following drugs, except (a) X-ray (b) Beta
(a) Procaine (b) Diazepam (c) Alpha (d) Gamma
(c) Aspirin (d) Lidocaine (e) Positron

91. Flurazepam has pKa of 8.2. What 97. Which of the following radionuclides is
percentage of flurazepam will be ionized mot commonly used in nuclear pharmacy
at a urine pH of 5.2? practice?

(a) 0.1% (b) 1% (a) 67


GA (b) 201
TI
(c) 50% (d) 99% (c) 99m
TC (d) 123
I
(e) 99.9% (e) 133
Xe

92. Precipitation may occur when mixing 98. Which of the following radionuclides is
aqueous solutions of meperidine hydro- generator produced?
chloride with which of the following (a) 99m
TC (b) 201
TI
solutions? (c) 67
GA (d) 133
Xe
(a) Sodium bicarbonate injection (e) 123
I
(b) Atropine sulfate injection 99. Abrasives, ingredients in dentifrices, are
(c) Sodium chloride injection noted for which of the following actions?
93. The excretion of a weakly acidic drug (a) Providing flavor
generally is more rapid in alkaline urine (b) Cleansing via a foaming detergent action
than in acidic urine. This process occurs (c) Removing plaque and debris
because (d) Preventing dental caries
(a) A weak acid in alkaline media will exist (e) Adding thickness to the product
primarily in its ionized form, which cannot
be reabsorbed easily 100. The appropriate pH range for ophthalmic
products is
(b) A weak acid in alkaline media will exist in
its lipophilic form, which cannot be (a) 2.0 – 3.0 (b) 4.0 – 6.0
reabsorbed easily. (c) 6.0 – 8.0 (d) 8.0 – 10.0
10 MCQs IN PHARMACOLOGY

101. Which type of contact lens can most easily (a) Renal insufficiency
be ruined by the absorption of chemicals? (b) Hirschsprung’s disease
(a) Hard lenses (b) Soft lenses (c) Anorectal malformations
(c) Gas-permeable lenses (d) Children between the ages of 6 and 12 years
102. All of the following desensitizing agents 107. Which of the following factors is as-
are recommended for sensitive teeth sociated with an increased risk of non-
except compliance in the elderly?
(a) 10% carbamide peroxide (a) Polypharmacy
(b) 5% potassium nitrate (b) Hypertension
(c) Dibasic sodium citrate (c) Male gender
(d) 10% strontium chloride hexahydrate (d) Living with a spouse in an isolated environment
(e) Expensive medications
103. Carbamide peroxide appears to soften
earwax by 108. The principal difference between compet-
(a) Causing oxygen to be released, which itive and non-competitive inhibition is
loosens the wax (a) Extent of receptor site blocking
(b) Stimulating fluid secretion in the ear canal (b) Whether inhibition occurs
(c) Actually dissolving the ear wax (c) Extent of enzyme inhibition
(d) Decreasing lipid content of the wax (d) Degree of agonism
(e) None of the above (e) None of the above
104. A common oral problem caused by 109. Drug administrated through which of the
herpes simplex type I virus (HSV-1) is following routes is mot likely to be
(a) Aphthous ulcers subjected to first-pass metabolism:
(b) Canker sores (a) Oral (b) Sublingual
(c) Aphthous stomatitis (c) Subcutaneous (d) Rectal
(d) Fever blisters
110. Many receptors use distinct hetero
(e) Thrush _________ GTPä-binding regulatory
105. The definition of a sur factant (an proteins
ingredient in toothpaste) can best be (a) Tetrameric (b) Trimeric
described by which of the following (c) Dimeric (d) Monomeric
statements? Surfactant
111. Alkalinization of urine hastens the
(a) Prevents drying of the preparation
excretion of
(b) Removes debris by its detergent action and
(a) Weakly basic drugs
causes foaming, which is usually desired by
the patient (b) Weakly acidic drugs
(c) Physically removes plaque and debris (c) Strong electrolytes
(d) Determines the texture, dispersiveness, and (d) Nonpolar drugs
appearance of the product 112. Majority of drugs cross biological
(e) Adds flavor to the preparation which makes membranes primarily by
it more appealing to the patient
(a) Weakly basic drugs
106. Which is not a risk factor for hyper- (b) Weakly acidic drugs
phosphatemia and death from sodium (c) Strong electrolytes
phosphate enemas when used in
(d) Nonpolar drugs
children?
GENERAL PHARMACOLOGY 11

113. The most important factor which governs (a) Are bound primarily to a1 acid glycoprotein
diffusion of drugs across capillaries other in plasma
than those in the brain is (b) Are excreted faster in alkaline urine
(a) Blood flow through the capillary (c) Are highly ionized in the gastric juice
(b) Lipid solubility of the drug (d) Do not cross blood—brain barrier
(c) pKa value of the drug 120. High plasma protein binding
(d) pH of the medium (a) Increases the volume of distribution of the
114. Active transport of a substance across drug
biological membrane has the following (b) Facilitates glomerular filtrtion of the drug
characteristics except (c) Minimizes drug interactions
(a) It is specific (d) Generally makes the drug long acting
(b) It is pH dependent 121. Biotransformation of drugs is primarily
(c) It is saturable directed to
(d) It requires metabolic energy (a) Activate the drug
115. Bioavailability differences among oral (b) Inactivate the drug
formulations of a drug are most likely to (c) Convert lipid soluble drugs into nonlipid
occur if the drug soluble metabolites
(d) Convert nonlipid soluble drugs into lipid
(a) Is freely water soluble
soluble metabolites
(b) Is completely absorbed
(c) Is incompletely absorbed 122. A prodrg is
(d) Undergoes little first-pass metabolism (a) The prototype member of a class of drugs
(b) The oldest member of a class of drugs
116. Bioavailability of drug refers to
(c) An inactive drug that is transformed in the
(a) Perecentage of administered dose that body to an active metabolite
reaches systemic circulation in the (d) A drug that is stored in body tissues and is
unchanged form then gradually released in the circulation
(b) Rario of oral to parental dose
123. Which of the following cytochrome P450
(c) Ratio of orally administered drug to that
isoenzymes is involved in the metabolism
excreted in the faeces
of a large number of drugs in human
(d) Ratio of drug excreted unchanged in urine beings and has been implicated in some
to that excreted as metabolites dangerous drug interactions:
117. The most important factor governing (a) CYP 3A4 (b) CYP 2C9
absorption of a drug from intact skin is (c) CYP 2E1 (d) CYP 1A2
(a) Molecular weight of the drug 124. The most commonly occurring conjugation
(b) Site of application reaction for drugs and their metabolites is
(c) Lipid solubility of the drug (a) Glucuronidation
(d) Nature of the base used in the formulation (b) Acetylation
118. Redistribution is a feature of (c) Methylation
(d) Glutathione conjugation
(a) Highly plasma protein bound drugs
(b) Depot preparations 125. G-protein coupled receptors span the
(c) Poorly lipid soluble drugs plasma membrane as a bundle of _____
alpha helices
(d) Highly lipid soluble drugs
(a) One (b) Three
119. Weakly acidic drugs
(c) Seven (d) Ten
12 MCQs IN PHARMACOLOGY

126. Which of the following drug metabolizing (a) A constant amount of the drug will be
reactions is entirely nonmicrosomal eliminated per unit time
(a) Glucuronide conjugation (b) Its clearance value will remain constant
(b) Acetylation (c) Its elimination half-life will increase with dose
(c) Oxidation (d) It will be completely eliminated from the body
(d) Reduction in 2 x half-life period

127. Induction of drug metabolizing enzymes 133. If a drug has a constant bio-availability
involves and first order elimination, its main-
tainance dose rate will be directly
(a) A conformational change in the enzyme proportional to its
protein to favor binding of substrate
molecules (a) Volume of distribution
(b) Expression of enzyme molecules on the (b) Plasma protein binding
surface of hepatocytes (c) Lipid solubility
(c) Enhanced transport of substrate molecules (d) Total body clearance
into hepatocytes
134. The following dose of a drug is governed
(d) Increased synthesis of enzyme protein by its
128. Drugs which undergo high degree of first- (a) Aqueous diffusion
pass metabolism in liver (b) Aqueous hydrolysis
(a) Have oral bioavailability (c) Lipid diffusion
(b) Are excreted primarily in bile (d) Pinocytosis or endocytosis
(c) Are contraindicated in liver disease
135. Monitoring plasma drug concentration is
(d) Exhibit zero order kinetics of elimination useful while using
129. Glomerular filtration of a drug is affected (a) Antihypertensive drugs
by its (b) Levodopa
(a) Lipid solubility (c) Lithium carbonate
(b) Plasma protein binding (d) MAO inhibitors
(c) Degree of ionization
136. Microsomal enzyme induction has one of
(d) Rate of tubular secretion the following features
130. If a drug undergoes net tubular secretion, (a) Takes about one week to develop
its renal clearance will be (b) Results in increased affinity of the enzyme
(a) More than the glomerular filtration rate for the substrate
(b) Equal to the glomerular filtration rate (c) It is irreversible
(c) Less than the glomerular filtration rate (d) Can be used to treat acute drug poisonings
(d) Equal to the rate of urine formation 137. Which of the following is a competitive
131. Which of the following is not a primary/ type of enzyme inhibitor
fundamental, but a derived pharmaco- (a) Acetazolamide (b) Disulfiram
kinetic parameter (c) Physostigmine (d) Theophyline
(a) Bio-availability
138. What is true in relation to drug receptors
(b) Volume of distribution
(a) All drugs act through specific receptors
(c) Clearance
(b) All drug receptors are located on the surface
(d) Plasma half life
of the target cells
132. If a drug is eliminated by first order (c) Agonists induce a conformational change in
kinetics the receptor
GENERAL PHARMACOLOGY 13

(d) Partial agonists have low affinity for the 145. Placebo effects result presumably from
receptor the
139. A partial agonist can antagonize the (a) Physician-patient relationship
effects of a full agonist because it has (b) Mental set up imparted by the therapeutic
(a) High affinity but low intrinsic activity settings
(b) Low affinity but high intrinsic activity (c) Mental set up imparted by the physician
(c) No affinity and low intrinsic activity (d) All of the above
(d) High affinity but no intrinsic activity 146. All of the following subserve as
140. Receptor agonists possess intracellular second messengers in
receptor mediated signal transduction
(a) Result in increased smooth endoplasmic except
reticulum
(a) Cyclic AMP
(b) Result in increased rough endoplasmic reticulum
(b) Inositol trisphosphate
(c) Result in decreased enzymes in the soluble
cytoplasmic fraction (c) Diacyl glycerols
(d) Require 3–4 months to reach completion (d) G protein

141. Agonists affect the receptor molecule in 147. A receptor which itself has enzymatic
the following manner property is
(a) Alter its amino acid sequence (a) Insulin receptor
(b) Denature the receptor protein (b) Progesterone receptor
(c) Alter its folding or alignment of subunits (c) Thyroxine receptor
(d) Induce covalent bond formation (d) Glucagon receptor

142. Receptors perform the following function/ 148. Down regulation of receptors can occur
functions as a consequence of
(a) Ligand recognition (a) Continuous use of agonists
(b) Signal transduction (b) Continuous use of antagonists
(c) Both ligand recognition and signal (c) Chronic use of CNS depressants
transduction (d) Denervation
(d) Disposal of agonists and antagonists
149. When therapeutic effects decline both
143. Which of the following receptor types has below and above a narrow range of
7 helical membrane, spanning amino acid doses, a drug is said to exhibit
segments with 3 extracellular and 3
(a) Ceiling effect
intracellular loops
(b) Desensitization
(a) Tyrosine protein kinase receptor
(c) Therapeutic window phenomenon
(b) Gene expression regulating receptor
(d) Nonreceptor mediated action
(c) Intrinsic ion channel containing receptor
(d) G protein coupled receptor 150. ‘Drug efficacy’ refers to

144. Which of the following is a G protein (a) The range of diseases in which the drug is
coupled receptor beneficial
(b) The maximal intensity of response that can
(a) Muscarinic cholinergic receptor
be produced by the drug
(b) Nicotinic cholinergic receptor
(c) The therapeutic dose range of the drug
(c) Glucocorticoid receptor
(d) The therapeutic index of the drug
(d) Insulin receptor
14 MCQs IN PHARMACOLOGY

151. If the dose-response curves of a drug for 158. A fixed dose combination preparation
producing different actions are widely meant for internal use must not contain
separated on the dose axis, the drug is the following class of drug
(a) Highly potent (b) Highly efficacious (a) Thiazide diuretic
(c) Highly toxic (d) Highly selective (b) Fluoroquinolone antimicrobial
152. The therapeutic index of a drug is a (c) Corticosteroid
measure of its (d) H2 blocker
(a) Safety (b) Potency 159. Interindividual variations in equieffective
(c) Efficacy (d) Dose variability doses of a drug are most marked if it is
153. If the effect of combination of two drugs disposed by
is equal to the sum of their individual (a) glomerular filtration
effects, the two drugs are exhibiting (b) Tubular secretion
(a) Potentiation (b) Synergism (c) Both (a) and (b)
(c) Cross tolerance (d) Antagonism (d) Hepatic metabolism
154. The antagonism between adrenaline and 160. The pharmacokinetics of drugs in the
histamine is called ‘Physiological anta- neonate differs from that in adults,
gonism’ because because their
(a) Both are physiologically present in the body (a) Intestinal transit is fast
(b) They act on physiological receptors (b) Glomerular filtration rate is high
(c) Both affect many physiological processes (c) Tubular transport mechanisms are not well
(d) They have opposite physiological effects developed
155. A drug ‘R’ producing no response by itself (d) Drug metabolizing enzymes are overactive
causes the log dose-response curve of
161. Pharmacodynamic tolerance may involve
another drug ‘S’ to shift to the right in a
changes in _____of drug receptors
parallel manner without decreasing the
maximal response : Drug ‘R’ is a (a) Number (b) Affinity
(a) Partial agonist (c) Function (d) All the above
(b) Inverse agonist 162. Drug metabolism can be induced by the
(c) Competitive antagonist following factors except
(d) Noncompetitive antagonist (a) Cigarette smoking
156. A drug which does not produce any (b) Acute alcohol ingestion
action by itself but decreases the slope (c) Exposure to insecticides
of the log dose-response curve and
(d) Consumption of characoal boiled meat
suppresses the maximal response to
another drug is a 163. Which of the following is true of placebos
(a) Physiological antagonist (a) Placebo is a dummy medication
(b) Competitive antagonist (b) Placebo is the inert material added to the
(c) Noncompetitive antagonist drug for making tablets
(d) Partial agonist (c) Placebos do not produce any effect
157. A drug which is generally administered (d) All patients respond to placebos
in standard doses without the need for 164. In patients of hepatic cirrhosis
dose individualization is
(a) The extent of change in pharmacokinetics of
(a) Insulin (b) Mebendazole drugs can be predicted from the values of
(c) Prednisolone (d) Digoxin liver function tests
GENERAL PHARMACOLOGY 15

(b) High doses of furosemide can be safely used (a) Chloroquine (b) Warfarin sodium
(c) Metformin is the preferred oral hypoglycaemic (c) Dicyclomine (d) Methyldopa
(d) Disposition of atenolol is not significantly
171. Select the drug which has been found to
affected
be a strong human teratogen
165. An undersireable effect of a drug that (a) Isoniazid (b) Isotretinoin
occurs at therapeutic doses and can be (c) Hydralazine (d) Propylthiouracil
predicted from its pharmacological
actions is called 172. Oral route
(a) Side effect (b) Toxic effect (a) Yields better absorption than parenteral
(c) Allergic reaction (d) Idiosyncrasy administration for majority of drugs
(b) Should be avoided in the recumbent position
166. Which of the following is a type II
(c) Has no demerit
(unpredictable) adverse drug reaction
(d) Produces quick onset of action
(a) Side effect
(b) Toxic effect 173. Intramuscular route
(c) Idiosyncrasy (a) Always produces faster absorption than oral
(d) Physical dependence route
(b) Can be used to inject mild irritants
167. A ‘toxic effect’ differs from a ‘side effect’
(c) In a child is made into the gluteus maximus
in that
muscle
(a) It is not a pharmacological effect of the drug (d) Can be used to inject a volume of 15 ml
(b) It is a more intense pharmacological effect
that occurs at high dose or after prolonged 174. Advantage of sublingual route include the
medication following except
(c) It must involve drug induced cellular injury (a) It has a rapid onset of action
(d) It involves host defence mechanisms (b) Spitting out the tablet can terminate its action
(c) Its usefulness is limited to treat local conditions
168. Which of the following statements is true
in relation to ‘drug toxicity’ and ‘poisoning’ (d) It avoids first pass hepatic metabolism

(a) The two terms are synonymous 175. First pass metabolism
(b) When a toxic effect requires specific (a) Can increase the oral bio-availability of the
treatment, it is called poisoning drug
(c) A toxic effect which endangers life by (b) Occurs only in the liver
markedly affecting vital functions is called (c) Is higher on intravenous administration
poisoning
(d) Necessitates high oral dose for certain drugs
(d) Toxicity is caused by drugs while poisoning
is caused by other harmful chemicals 176. Bio-transformation

169. The most vulnerable period of pregnancy (a) Renders the drug more lipid soluble
for the causation of foetal malformations (b) Can be altered by drugs
due to drugs is (c) Is necessary for all drugs for their elimination
(a) 18–55 days of gestation (d) Takes place only in the liver
(b) 56–84 days of gestation 177. Entry of a drug in the central nervous
(c) Second trimester system is enhanced if the drug is
(d) 36 weeks onwards (a) Ionized
170. Which of the following is a proven human (b) More lipid soluble
teratogen (c) Given intravenously
(d) Highly plasma protein bound
16 MCQs IN PHARMACOLOGY

178. Kinetic processes of elimination for a (a) In aqueous solution


large number of drugs is (b) In suspension
(a) First order (c) In oily solution
(b) First order followed by zero order (d) In solid form
(c) Zero order followed by first order 185. Alcohol is rapidly absorbed from the
(d) Zero order intestine because
179. A drug is said to be potent when (a) It is lipid soluble and non-electrolyte
(a) It produces maximal response (b) It is lipid soluble and highly ionised
(b) The amount needed to produce a certain (c) It is absorbed by active transport
response is less (d) It is not absorbed quickly
(c) It produces minimal/no side effects 186. After intramuscular injection, the drugs
(d) It has a rapid onset of action
(a) In oily solution are more rapidly absorbed
180. Spare receptors are often found among (b) In aqueous solution are more rapidly
drugs that elicit absorbed
(a) Smooth muscle contraction (c) Suspended in various repository vehicles are
more rapidly absorbed
(b) Smooth muscle relaxation
(d) All solutions are rapidly absorbed
(c) Secretion
(d) Cardiac stimulation 187. Bio-availability of a drug is

181. What is the best criterian for judging the (a) The percentage of drug released from a
therapeutic superiority of a drug over its formulation that becomes available for
congeners? biological effect
(b) The percentage of drug that is ionized from
(a) Potency
a formulation
(b) Wide range of activity
(c) The net amount of actual therapeutic agent
(c) Efficacy present in the formulation
(d) Variability (d) The dose of a drug by which 50% animals
182. pKa of a compound show signs of toxicity

(a) Is the pH of solution at which the compound 188. The absorption time of a drug can be
is 50% ionized reduced by
(b) Is the pH of compound at which it is 50% (a) Making a more soluble salt – for oral
ionized (b) By using hyaluronidase – for injection
(c) Is the time in which the compound is ionized (c) By using vesoconstrictor substances
(d) Is the time in which total compound is ionized (d) By giving combination of drugs
183. Pharmacokinetics is 189. Reduction of heavy metal toxicity by
(a) The study of absorption, distribution, dimercaprol is an exmple of
metabolism and excretion of drugs (a) Chemical antagonist
(b) The study of biological and therapeutic effects (b) Physiological antagonist
of the drugs (c) Pharmacokinetic antagonist
(c) The method of development of new (d) Antagonism by receptor block
pharmacological agent
190. Which of the following drugs is primarily
(d) The study of carcinogenic activity of a new
stored in the natural fat of the body
drug
(a) Primaquine (b) Acetyl salicylic acid
184. In which form the drug is absorbed more
(c) Thiopentone (d) Vitamin C
rapidly?
GENERAL PHARMACOLOGY 17

191. Bio-transformation of the drugs is to 198. The receptor concept was first introduced
render them by
(a) Less lipid soluble (a) J.N. Langley in 1878
(b) More protein bound (b) Paul Ehrlich in 1926
(c) Less ionized (c) Somonis in 1964
(d) Less protein bound (d) Wakesman in 1826
192. Drug metabolism occurs chiefly in 199. True tolerance develops because of
(a) Liver (b) Brain (a) Diminition in absorption
(c) Spleen (d) Kidneys (b) Rapid excretion of the drug
193. For renal excretion the factors important (c) Both of the above
are (d) None of the above
(a) Extent of plasma protein binding of drugs 200. Two drugs binding to the same receptors
(b) Glomerular filtration rate is
(c) Active renal tubular reabsorption (a) Chemical antagonism
(d) All of the above (b) Pharmacokinetic antagonism
194. If tubular urine is made more acid (c) Competitive antagonism
(d) Non-competitive antagonism
(a) Excretion of weak acid is reduced
(b) Excretion of weak acid is increased 201. Tachyphylaxis is
(c) Excretion of weak base is increased (a) A drug interaction between two similar types
(d) Excretion of weak base is reduced of drugs
(b) Rapidly developing tolerance
195. Simultaneous administration of two
drugs may – (select the false statement) (c) A synergism between two types of drugs
(a) Show an additive effect (d) None of the above
(b) Produce synergism 202. Drug A in a dose of 10 mg produces same
(c) Result in antagonism response as with 100 mg of drug B
(d) Produce any of above phenomena (a) Drug A is 10 times more potent than drug B
196. The advantages of bio-assay over (b) Drug B is 10 times more potent than drug A
chemical assay include – (select false (c) Drug A is 10 times more efficacious than
statement) drug B
(a) It is cheaper (d) Both are equally potent
(b) The active principal does not have to be (e) Both are equally efficacious
known 203. Teratogenicity is
(c) The active principal does not have to be in a
(a) The acute reaction to drugs
pure state
(b) Intolerance to drugs
(d) The sensitivity may be greater
(c) Tumour forming action of the drugs
197. In presence of competitive antagonist (d) Malformation of the foetus
(a) The maximum response of agonist can never
204. The chances of foetal malformation with
be achieved
a teratogenic drug is maximum
(b) The maximum can be achieved by increasing
the concentration activity (a) During first trimester of pregnancy
(c) Maximum can be achieved only if the (b) During second trimester of pregnancy
antagonist is having intrinsic activity (c) During third trimester of pregnancy
(d) None of the above (d) When given just prior to the labor
18 MCQs IN PHARMACOLOGY

205. Phocomelia is a known teratogenic effect 212. Which one of the following is an example
of of physical or chemical interaction?
(a) Anticancer drugs (a) Warfarin plus salicylates–prolongation of
(b) Antiviral drugs anticoagulant effect and bleeding tendency
(c) Antiepileptic drugs (b) Methotrexate plus sulfonamides–pancytopenia
(d) Thalidomide (c) Heparin plus protamine–reversal of heparin
effect
206. Which of the following drugs are known
(d) Sulfonamides plus salicylate–sulfa toxicity
to cause toxic cataract?
(a) Chloroquine (b) Ergot 213. First order kinetics of the drugs is called
when
(c) Phenothiazine (d) Naphthalene
(e) All of the above (a) A constant fraction of the drug is removed in
per unit time
207. The passage of drugs into the foetus from (b) A constant amount of the drug is removed in
placenta per unit time
(a) Is by active transport (c) Total amount of the drug is removed in one
(b) Is by passive diffusion hour
(c) Is by carrier mediated transport (d) Total amount of the drug is removed in first
(d) By any of the above methods passage through the kidneys

208. Idiosyncrasy reaction of a drug is 214. For the drugs which follow first order
kinetics, after 4 half life the elimination
(a) A type of hypersensitivity reaction
will be approximately
(b) A type of drug antagonism
(a) 40% (b) 94%
(c) Unpredictable, inherent, qualitatively
abnormal reaction of a drug (c) 25% (d) 4%
(d) Quantitatively exaggerated response 215. Passive diffusion of a drug across cell
209. Two drugs having similar effects are membrane is low when its molecular
termed as mass is greater than

(a) Heterergic drugs (a) 50–100 Da (b) 100–200 Da


(b) Isomer drugs (c) 200–300 Da (d) 300–400 Da
(c) Homergic drugs 216. Passage of drug across most capillary
(d) Antagonistic drugs endothelial membranes is dependent
upon
210. If the combined effect of two drugs acting
by the same mechanism is equal to the (a) Lipid solubility (b) pH gradient
allegebric sum of their individual effect, (c) Blood flow (d) All of the above
it is called as
217. Following receptors are membrane
(a) Antagonism (b) Additive effect proteins, except
(c) Potentiation (d) None of the above (a) Receptors for fast neurotransmitters, coupled
211. Antagonism between barbiturate and directly to an ion channel
amphetamine is termed as (b) Receptors for many hormones and slow
transmitters, coupled to effector system
(a) Non-competitive antagonism
(c) Receptor for insulin and various growth
(b) Physiological antagonism
factors, which are directly linked linked to
(c) Competitive antagonism
tyrosine kinase
(d) Synergism
(d) Receptors for steroid hormone
GENERAL PHARMACOLOGY 19

218. pH difference between extracellular and 227. The hepatic enzyme inducer naringenin
intracellular fluid is is present in
(a) Nil (b) 0.2 (a) Tobacco smoke (b) Grape juice
(c) 0.4 (d) 0.8 (c) Alcohol (d) Apple Juice
219. Which type of drugs penetrate CNS better 228. In gene tranfer which metal particle is
(a) Lipid soluble (b) Weak acids often used
(c) Weak bases (d) All equally (a) Iron (b) Gold
220. Acidic drugs mostly bind to plasma (c) Platinum (d) Mobybdenum
(a) Albumin (b) Globulin 229. Slow reacting substance of anaphylaxis
(c) Glycoprotein (d) None of the above refers to
221. The number of P 450 gene families (a) LTC4 (b) LTD4
identified in human being is (c) Both of the above (d) None of the above
(a) 4 (b) 8 230. Drugs producing allergic reaction
(c) 12 (d) 16 generally act as
222. The majority of drug biotransformation (a) Complete antigens
occurs by which cytochrome family (b) Haptens
(a) CYP1 (b) CYP2 (c) Antibodies
(c) CYP3 (d) None of the above (d) Mediators
223. Nonlinearity in pharmacokinetics of a 231. An addicting drug which produces little
drug is due to saturation of or no physical dependence is
(a) Protein binding (a) Amphetamine (b) Methadone
(b) Hepatic metabolism (c) Phenobarbitone (d) Diazepam
(c) Active renal transport
(d) All of the above 232. Which of the following statements
regarding therapeutic window is correct ?
224. Which of the following disease is due to
(a) The ratio of LD50 to the ED50
G protein receptor malfunction
(b) The Dosage range between the minimum
(a) Precocious puberty effective therapeutic concentration and the
(b) Retinitis pigmentosa minimum toxic concentration
(c) Malignant hyperthyroidism (c) Both the above
(d) All of the above (d) None of the above
225. The pharmacokinetic alternations in 233. Which of the following statements
elderly are due to
regarding acid –base balance is not
(a) Reduction in lean body mass and total body correct ?
water
(a) it is an essential balance between the amount
(b) Increase in percentage of body fat of carbonic acid and biocarbonate in blood.
(c) Reduced cytochrome P450 enzymes
(b) It must be kept constant so that the hydrogen
(d) All of the above in concentration in the blood plasma is in
226. The effect of enzyme induction is greatest turn kept constant
when the drug is given (c) Any deviation in the balance can have a
(a) Digoxin (b) Furosemide profound effect on physiological function
(c) Enalapril (d) Amrinone (d) All the above
(e) None of the above
20 MCQs IN PHARMACOLOGY

234. During liver disease the metabolism and (b) Bioavailabiligy


elimination of which of the following (c) Bioequivalence
drugs is decreased
(d) Fixed Dose combination
(a) Morphine (e) All the above
(b) Pentobarbitone (f) None of the above
(c) Propanolol
(d) All the above 240. Following statement is true about
receptors linked directly to ion channels
(e) None of the above
(a) These receptors are involved mainly in fast
235. In celiac disease oral absorption of which synaptic transmission
of the following drugs is decreased
(b) These are monomeric proteins containing
(a) Amoxycillin one transmembrane segment
(b) Cephalexin (c) Ligand binding and channel opening occur
(c) Cotrimoxazole on a minute time-scale
(d) All the above (d) All of the above
236. Which people are said to be slowest 241. Route of administration suitable for
acetylators because they metabolize emergency and permits titration of the
isoniazid by the process of acetylation dosage as well is
very slowly
(a) Oral (b) Intravenous
(a) Canadian Eskimos
(c) Intramuscular (d) Subcutaneous
(b) Indians
(e) All the above (f) None of the above
(c) Asiatic Jews
(d) Chinese 242. The disadvantage of oral route is
(e) Europeans (a) Vomiting as a result of gastrointestinal
(f) all the above irritation
(b) Destruction of some drugs by the digestive
237. Which people are said to be fastest
acetylators because they metabolize enzyme and non-favorable gastric pH
isoniazid by the process of acetylation (c) Irregularities in the absorption in the presence
very quickly of the food and other drugs
(a) Canadian Eskimos (d) Patient non-compliance
(b) Indians (e) All the above
(c) Asiatic Jews (f) None of the above
(d) Chinese 243. Drugs which have a tendency to accumu-
(e) Europeans late in the body fat mostly have
(f) all the above (a) Extremely high lipid-water partition co-
238. Clearance of which of the following drugs efficient
is reduced parallel to decrease in the (b) Extremely low lipid-water partition co-efficient
creatine clearance (c) None of the above
(a) Aminoglycosides (b) Digoxin
244. Once the drug enters the blood, the rate
(c) Phenobarbitone (d) All the above
at which it subsequently penetrates the
(e) None of the above tissues and other body fluids depends on
239. Pharmaceutical factors which can modify (a) Capillary permeability
the effect of drug are (b) Extent of plasma protein and tissue binding
(a) Formulation type (c) Transport mechanism
GENERAL PHARMACOLOGY 21

(d) All the above (a) Oxidation (b) Reduction


(e) None of the above (c) Acetylation (d) All the above
245. Factor which can effect the absorption of 252. The metabolic reaction which makes the
drug is metabolite of codeine more Pharmaco-
(a) Dissolution rate (b) Particle Size logically potent analgesic is
(c) Lipid Solubility (d) All the above (a) Dealkylation (b) Oxidation
(e) None of the above (c) Deamination (d) All the above
246. The movement of drug molecules across 253. Prodrug
the cell membrane is by (a) Facilitates absorption and distribution of
(a) Diffusion through the lipid drugs with poor lipid solubility
(b) Diffusing through aqueous pores that traverse (b) Increases the duration of action of drugs that
the lipid are rapidly eliminated
(c) Combination with a carrier molecule which (c) Promotes Site specific delivery of drugs
acts as a catalyst (d) All the above
(d) Pinocytosis
(e) All the above 254. The removal of oxygen or an alteration
in a drug which leads to a decrease in
(f) None of the above the proportion of oxygen in the drug
247. Which of the following responses develops compound is known as
to drugs due to antigen-antibody reaction ? (a) Oxidation (b) Reduction
(a) Toxic response (c) Hydrolysis (d) All the above
(b) Idiosyncratic response
255. Excipients are
(c) Allergic response
(a) Pharmacologically inert substances
(d) None of the above
(b) Used to mask an unpleasant taste
248. The microsomal oxidation of drugs is (c) Used to increase solubility or stability to the
carried out through a larger or smaller agent
extent in
(d) Employed to add bulk to the active agent
(a) Liver (b) Kidney used in small quantities
(c) Lung (d) small intestine (e) All the aboves
(e) all of the above
256. Bio-assay is used to
249. The mechanism of Biotransformation of
(a) Determine the relationship between the dose
Aspirin to Salicylic acid and Acetic acid is
administered and the magnitude of response
(a) Oxidation (b) Reduction
(b) Determine the potency of a new agent
(c) Hydrolysis (d) None of the above compared with that of an established drug
250. Which one of the statements regarding (c) Determine the relationship between the doses
microsomal enzymes is not correct producing a desired effect and those eliciting
(a) They lack specificity undesirable or toxic effect
(b) Capable of metabolizing substances of (d) All the above
different structure (e) None of the above
(c) Only catalyze reaction of compounds which 257. Which of the following endogenous
are lipid insoluble compounds undergo methylation ?
(d) All the above
(a) Histamine (b) Estradiol
251. Which one of the following is a Phase II – (c) Thyroxine (d) All the above
Drug metabolizing reaction (e) None of the above
22 MCQs IN PHARMACOLOGY

258. Which one of the following statements structure of drugs and the effects that
regarding glucuronide conjugation is not they produce
correct (a) Paracelsus (b) William Harvey
(a) The most frequently occurring reactions (c) James Blake (d) Rudolf Buccheim
(b) The conjugating agent is glucuronic acid, (e) None of the above
C6H10O6
264. The great scientist who explained the
(c) The glucuronide are rapidly eliminated in the
circulation of the blood to the world which
urine
signaled of the beginning of the scientific
(d) The glucuronides are also secreted in the bile, study of the medical sciences was
but this does not always lead to their
elimination in the feces (a) Paracelsus (b) William Harvey
(e) All the above (c) James Blake (d) Rudolf Buccheim
(e) None of the above
(f) None of the above
265. All the below mentioned drugs cause
259. Which of the following therapeutic sys-
enzyme inhibition in man except one
tems provides continuous, unattended,
controlled drug input for a long period (a) Acetazolamide (b) Allopurinol
without gastrointestinal or hepatic drug (c) Meprobamate (d) Disulfiram
inactivation prior to systemic circulation ? (e) Selegiline
(a) Parenteral (b) Oral 266. All the below mentioned drugs cause
(c) Transdermal (d) All the above enzyme induction in man except one
(c) None of the above (a) Phenytoin (b) Phenobarbitone
260. The translocation of a solute from one (c) Griseofulvine (d) Enalapril
side of a biologic barrier to the other side (e) Rifampicin
and the transferred solute appearing in
the same form on both side of the 267. Cimetidine potentiates the action of
biological barrier is known as propranol, theophylline, warfarin and
phenytoin because
(a) Bioavailability (b) Biotransport
(a) It causes deficiency of G - 6–PD
(c) Bioequivalence (d) None of the
(b) It blocks the H2 – histaminergic receptors
261. Guanine nucleotides bind to the ______ (c) It is an inhibitor of microsomal P–450
subunit of G-proteins
(d) None of the above
(a) α (b) β
268. The incidence of adverse drug reaction
(c) γ (d) All the above
rises with age in the adult, especially after
262. Pharmacodynamics include 65 years because of
(a) The biological effects produced by chemicals (a) The increasing number of drugs they need
(b) The site/s and mechanism by which the to take because they tend to have multiple
biological effects are produced diseases
(c) The factors that effect the safety and (b) Poor compliance with dosing regimens
effectiveness of the agent (c) Bodily changes of aging that require
(d) All the above modification of dosage regimens
(e) None of the above (d) All the above
(e) None of the above
263. The person who set forth the principles
that drugs are effective only after 269. Agranulocytosis is
reaching a responsive tissue and that (a) Virtual absence from the blood of white cells
there is a relationship between the known as neutrophils
GENERAL PHARMACOLOGY 23

(b) It is a life-threatening conditions that results (b) Drugs with low safety margin
from toxic damage to the bone-marrow by (c) Drugs activated in the body
some drugs (d) Hit and run drugs
(c) Can be treated with antibiotics and
sometimes transfusion of white blood cells 275. During competitive equilibrium type of
antagonism
(d) All the above
(a) Equilibrium constant (Km) is unchanged, but
270. Characteristically following oral admin- total number of binding sites (Vmax) is reduced
istration to a man, drugs (b) Equilibrium constant (Km) is increased and
(a) Are absorbed readily when in the unionized total number of binding sites (Vmax) is reduced
rather than in the ionized form (c) Equilibrium constant (Km) is increased and
(b) Are absorbed primarily in the intestine total number of binding sited (Vmax) remain
(c) Cross membranes mainly by simple diffusion unchanged
(d) With high lipid solubility readily penetrate (d) None of the above
into CNS 276. Addition of oxygen or negatively charged
(e) All the above radical and removal of hydrogen or
positively charged radical is known as
271. Competitive antagonists
(a) Reduction (b) Oxidation
(a) Dissociate from receptors faster than their
(c) Acetylation (d) Hydrolysis
respective agonists
(e) None of the above
(b) Alter the shape of the log dose response
curve of an agonist 277. Pharmacopoeia includes list of esta-
(c) According to the rate theory have low blished drugs and medicinal preparation
dissociation rate constants with the description of their
(d) Initiate the opposite cellular response to (a) Physical properties
receptor occupancy to that obtained by the (b) Identification test
agonist (c) Purification test
(e) All the above (d) Potency test
272. A non-competitive antagonist (e) All the above
(a) Alters the mechanism of action of an agonist 278. Claude Bernard is known as
(b) Alters the potency of an agonist (a) Father of Medicine
(c) Shifts the dose-response curve of an agonist (b) Father of Pharmacognosy
to the right (c) Father of Polypharmacy
(d) Decreases the maximum response to an (d) Father of Pharmacology
agonist
(e) Father of Experimental Medicine
(e) None of the above
279. Oswald Schmiedeberg is known as
273. Repeated administration of a drug may
(a) Father of Medicine
(a) Increase its own metabolism
(b) Father of Pharmacognosy
(b) Increase the metabolism of other drugs (c) Father of Polypharmacy
(c) Increase the metabolism of endogenous (d) Father of Pharmacology
compounds
(e) Father of Experimental Medicine
(d) All the above
(e) None of the above 280. Catalytic conversion of GTP to GDP is
carried out by _____ subunit of G-proteins
274. Plasma concentration is useful for
(a) α (b) β
(a) Drugs with high safety margin (c) γ (d) All the above
24 MCQs IN PHARMACOLOGY

281. Theophrastus is known as 288. Acetylcholine and atropine action on the


(a) Father of Medicine muscarinic receptors is a classical exam-
ple of
(b) Father of Pharmacognosy
(a) Competitive antagonism
(c) Father of Polypharmacy
(b) Non-competitive antagonism
(d) Father of Pharmacology
(c) Non-equilibrium antagonism
(e) Father of Experimental Medicine
(d) Physiological antagonism
282. Hippocrates is known as (e) Chemical antagonism
(a) Father of Medicine
289. Biological half-life of is calculated as
(b) Father of Pharmacognosy
(a) t ½ = 0.693 x CL/Vd
(c) Father of Polypharmacy
(b) t ½ = 0.693 x K/ln2
(d) Father of Pharmacology
(c) t ½ = 0.693 x Vd/CL
(e) Father of Experimental Medicine
(d) t ½ = 0.693 x ln2/K
283. When a drug lacking effect of its own (e) None of the above
increases the effects of the second active
drug [0 +1= >1]; such an effect is called 290. Following statement is true regarding
therapeutic index
(a) Additive effect (b) Synergism
(a) It is based on animal toxicity data
(c) Potentiation
(b) It reflects forms of toxicity that are important
284. When two drugs with the same effect clinically
produce an effect greater than the sum (c) It takes into account idiosyncratic toxic reaction
of the effects of individual drugs [1 + 1>2]; (d) All the above
such an effect is called
291. Ocuserts are
(a) Additive effect (b) Synergism
(c) Potentiation (a) Placed under the eyelid
(b) Intrauterine contraceptives
285. Weak acids ionize more in (c) Monoclonal antibodies
(a) Alkaline pH (b) Acidic pH (d) None of the aboves
(c) Not dependent of pH
292. Nitroglycerin is given in angina pectoris
286. Theophylline has shorter half life in by sublingual route because:
infants and children because (a) Liver is by-passed
(a) Renal tubular secretor y mechanism is (b) Can be spat after desired effect
deficient (c) Rapid absorption
(b) Immaturity of the nephron (d) Non irritant and lipid soluble drug
(c) Immaturity of the blood-brain barrier (e) All the above
(d) Reduced plasma - protein binding
293. Volatile drug may be best administered
(e) Liver size larger on a body weight basis by:
287. An antagonist has (a) Oral route (b) Inhalation
(a) Intrinsic activity and no affinity (c) Sublingual route (d) Intrathecal route
(b) Only intrinsic activity and no affinity (e) Rectal route
(c) No intrinsic activity and no affinity 294. A desired clinical response may be
(d) Affinity same as agonist and devoid of delayed altered or blocked by:
intrinsic activity (a) A drug that does not go into solution
(e) None of the above (b) A drug that does not get to its site of action
GENERAL PHARMACOLOGY 25

(c) Abnormal pharmacogenetics (a) Topical (b) Oral


(d) Lack of absorption from site of administration (c) Parenteral
(e) All the above
302. Parenteral administration of a drug refers
295. Following compartment constitutes the to the giving of a preparation, except
largest percentage (a) Orally
(a) Plasma (b) Intestinal fluid (b) Intradermally
(c) Intracellular fluid (d) Fat (c) Intramuscularly
296. The duration of action of a drug is de- (d) Intravenously
pendent of its 303. Pharmacokinetics consIders
(a) Plasma and tissue binding
(a) The way in which the body affects a drug by
(b) Metabolism the process of absorption, distribution,
(c) Tubular filtration and secretion metabolism and excretion
(d) All the above (b) The effects of the drug on the body and the
mode of drug action.
297. When a drug has a low therapeutic
index, that drug should be (c) The proportion of administered drug that is
available to have an effect.
(a) Used mostly orally
(d) The removal of the drug by the liver before it
(b) Used mostly intravenously
has become available
(c) Considered a potentially toxic substance
(d) Given only in submilligram doses 304. If gut motility is increased then
(a) Drug absorption is decreased
298. A drug is being metabolized by zero-
order kinetics. This indicates that (b) Drug absorption is increased
(c) Drug absorption is not effected
(a) A constant amount of drug is being
catabolised each hour 305. The rate of drug absorption is greatest in
(b) A constant fraction of drug is being
(a) The small intestine
catabolised each hour
(b) The large intestine
(c) A drug is water soluble substance
(c) The stomach
(d) The time required to catabolise half of the
drug is independent of the initial con- 306. Drug distribution may depend on tissue
centration of the drug perfusion
299. Drugs interact with their receptors sites (a) Highly vascular organs rapidly acquire a
by forming drug
(a) Ionic bonds (b) Highly vascular organs acquire a drug slowly
(b) Hydrogen bonds (c) Levels of a drug in bone may rise quickly
due to its high vascularity
(c) Van der Waals bond
(d) All the above (d) Levels of a drug in bone may rise slowly due
to its reduced
300. The main route of administration of a
drug to produce a local effect is 307. Most drugs and metabolites are excreted
by
(a) Topical (b) Oral
(a) The kidneys
(c) Parenteral
(b) The bile
301. The main routes of administration of a (c) The lungs
drug is to provide a systemic effect.
(d) Perspiration, saliva and tears
Identify the wrong answer
26 MCQs IN PHARMACOLOGY

308. Pharmacodynamics considers: (a) Steroids (b) Vitamin D


(a) The way in which the body affects the drug (c) Retinoids (d) all the above
(b) The effects of the drug on the body and the 311. Factors affecting a client’s response to a
mode of drug action
drug include all the following except:
(c) Drug metabolism
(a) A body weight i.e. the larger the individual,
309. A drug that binds to a cell receptor and the larger the area for drug distribution
causes a response is called an:
(b) Body fat –A loss of body fat stores means
(a) Agonist less drug available for activity
(b) Antagonist (c) Body fat–An increase in body fat means
(c) Receptor blocker greater sequestering in body fat and less drug
310. Receptors for _________ are DNA-binding activity
proteins (d) The presence of certain foods

ANSWERS

1. b 2. b 3. d 4. c 5. e 6. a
7. a 8. b 9. d 10. a 11. e 12. c
13. a 14. a 15. a 16. a 17. b 18. e
19. a 20. a 21. a 22. a 23. a 24. c
25. e 26. d 27. b 28. c 29. b 30. c
31. c 32. e 33. a 34. c 35. a 36. d
37. b 38. a 39. b 40. c 41. a 42. a
43. a 44. a 45. c 46. a 47. c
48. 1. a, 2. d, 3. b, 4. a 49. 1. a, 2. d, 3. c 50. 1. b, 2. e, 3. c, 4. a
51. b 52. b 53. c 54. d 55. d 56. b
57. d 58. b 59. b 60. a 61. b 62. d
63. e 64. e 65. c 66. a 67. c 68. d
69. a 70. b 71. c 72. b 73. d 74. a
75. b 76. a 77. c 78. c 79. b 80. b
81. c 82. d 83. a 84. a 85. c 86. c
87. c 88. a 89. d 90. b 91. e 92. a
93. a 94. b 95. c 96. d 97. c 98. a
99. c 100. c 101. b 102. a 103. a 104. d
105. b 106. d 107. a 108. c 109. a 110. b
111. b 112. a 113. a 114. b 115. c 116. a
117. c 118. d 119. b 120. d 121. c 122. c
123. a 124. a 125. c 126. b 127. d 128. a
GENERAL PHARMACOLOGY 27

129. b 130. a 131. d 132. b 133. d 134. c


135. c 136. b 137. c 138. c 139. a 140. c
141. c 142. c 143. d 144. a 145. d 146. d
147. a 148. a 149. c 150. b 151. d 152. a
153. b 154. d 155. c 156. c 157. b 158. c
159. d 160. c 161. d 162. b 163. a 164. d
165. a 166. c 167. b 168. c 169. a 170. b
171. b 172. b 173. b 174. c 175. d 176. b
177. b 178. a 179. b 180. a 181. b 182. a
183. a 184. a 185. a 186. b 187. a 188. a
189. a 190. b 191. a 192. a 193. d 194. a
195. d 196. a 197. b 198. a 199. d 200. c
201. b 202. a 203. d 204. a 205. d 206. d
207. b 208. c 209. b 210. b 211. b 212. c
213. a 214. b 215. b 216. c 217. d 218. c
219. a 220. a 221. c 222. c 223. d 224. d
225. d 226. a 227. b 228. b 229. c 230. b
231. a 232. b 233. e 234. d 235. a 236. e
237. a 238. d 239. e 240. a 241. b 242. d
243. a 244. d 245. d 246. 5 247. c 248. e
249. c 250. c 251. c 252. a 253. d 254. b
255. d 256. b 257. d 258. f 259. c 260. b
261. a 262. d 263. c 264. b 265. c 266. d
267. c 268. d 269. d 270. e 271. c 272. d
273. d 274. b 275. c 276. b 277. e 278. e
279. d 280. a 281. b 282. a 283. c 284. b
285. a 286. e 287. d 288. a 289. c 290. a
291. a 292. e 293. b 294. e 295. c 296. d
297. c 298. a 299. d 300. a 301. a 302. a
303. a 304. a 305. a 306. a & d 307. a 308. b
309. a 310. d 311. a & d
28 MCQs IN PHARMACOLOGY

EXPLANATIONS FOR ANSWERS

7. a because of enhanced disassociation weak acids 180. a Spare receptors are generally found whenever
are excreted faster in basic (not acidic) urine. a receptor acts catalytically and not
20. a Chemical antagonism does not involve any stoichiometrically. Hence, they are generally
receptors. Protamine is a positively charged found among drugs, which elicit smooth muscle
protein at physiological pH and thus contraction.
antagonizes the effects of Heparin which is 189. a Dimercaprol interacts directly with heavy metals
negatively charged at physiological pH. in blood and tissue fluids and prevents binding
35. a Facilitated diffusion differs from active transport of heavy metals to cellular constituents.
in that it does not require energy source and it Dimercaprol forms an inactive complex with
carries the transport in the direction of heavy metals.
electrochemical gradient. 200. c Two drugs binding to the same receptor is an
52. a Glycoprotein binds to basic drugs and albumin example of competitive antagonism and effect
binds to many acidic drugs and a small number of one drug can be decreased by increasing
of basic drugs. the concentration of other drug.
65. c CYP3A4 is involved in the metabolism of 217. d Receptors for steroid hormones are intracellular
majority of drugs and is also expressed DNA – binding proteins, which regulate gene
extrahepatically. In fact, poor bioavailability of transcription.
many drugs is attributed to the drug metabolism 240. a Receptors linked directly to ion channels are
by CYP3A4 in gastrointestinal tract. involved in the fast synaptic transmission e.g.
78. c N-oxidation is involved in the metabolism of nicotinic acetylcholine receptor. This receptor is
dapsone, meperidine and chloramphenicol. a pentamer i.e. it is made up of five poly-peptide
Metabolism of phenytoin involves oxidative N- subunits.
dealkylation. 261. a In G-protein coupled receptors, agonist-receptor
110. b Many receptors use heterotrimeric GTP-binding complex enhances GTP binding to the α subunit,
regulatory proteins. The subunits are designated mainly by dissociating already bound GDP.
as β, α and α and their classification is based 280. a The termination of agonist-receptor coupling in
on á subunits. a G-protein-coupled receptor is because of
125. c G-protein coupled receptors are hydrophobic conversion of GTP to GDP by a GTPase that is
proteins and span the plasma membrane in intrinsic to α subunit.
seven á-helical segments. 290. a Therapeutic index is the range between minimal
145. d Placebo effect is a desired response to a therapy and maximal concentration required to elicit
without drug. Placebo effect is mainly because desired response.
of various psychological reasons e.g. physician- 295. c intracellular fluid comprises 35%, whereas
patient relationship, mental set up affected by contribution of other compartments is far less
surroundings and positive mental set up because e.g. plasma – 5%; interstitial fluid – 16%; fat –
of known and trusted physician. 20% and transcellular fluid – 2%.
161. d Pharmacodynamic tolerance involves multiple 310. d Receptors for steroids, vitamin D, retinoids and
mechanism such as number, affinity and function also thyroid hormones are DNA-binding
of receptors. proteins, which regulate transcription of genes.
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 29

CHAPTER 2
DRUGS ACTING ON CENTRAL
NERVOUS SYSTEM

1. A-50-year-old man has a history of (a) Acetylcholine (b) Citruline


frequent episodes of renal colic with high- (c) Isoproterenol (d) Nitroglycerin
calcium renal stones. The most useful
(e) Nitroprusside
agent in the treatment of recurrent
calcium stones is 6. The primary endogenous substrate for
(a) Mannitol (b) Furosemide nitric oxide synthase is
(c) Spironolactone (d) Hydrochlorothiazide (a) Acetylcholine (b) Angiotensinogen
(e) Acetazolamide (c) Arginine (d) Citruline
2. Which of the following drugs is correctly (e) Heme
associated with its site of action and
maximal diuretic efficacy? 7. Which of the following is a recognized
effect of nitric oxide?
(a) Thiazides–distal convoluted tubute–10% of
filtered Na+ (a) Arrhythmia
(b) Spironolactone–proximal convoluted tubule (b) Bronchoconstriction
–40% (c) Constipation
(c) Bumetanide–thick ascending limb–15% (d) Inhibition of acute graft rejection
(d) Metolazone–collecting tubule–2% (e) Pulmonary vasodilation
(e) All of the above
8. cAMP is an example of
3. Substance secreted into the blood by a
neuron is (a) Neurohormone (b) Neuromodulator
(a) Neurohormone (b) Neuromodulator (c) Neuromediator (d) Neurotransmitter
(c) Neuromediator (d) Neurotransmitter 9. One effect that theophylline, nitroglycerin,
4. Which of the following is a leukotriene isoproterenol, and histamine have in
receptor blocker? common is

(a) Alprostadil (b) Aspirin (a) Direct stimulation of cardiac contractile force
(c) Ibuprofen (d) LTC4 (b) Tachycardia
(e) Zafirlukast (c) Increased gastric acid secretion
5. A molecule that stimulates nitric oxide (d) Postural hypotension
synthase, especially the eNOS isoform, is (e) Throbbing headache
30 MCQs IN PHARMACOLOGY

10. Which one of the following chemicals 16. Suramin is an antagonists of ________
does not satisfy the criteria for a receptors
neurotransmitter role in the CNS? (a) Purine (b) Somatostanin
(a) Acetylcholine (b) Dopamine (c) Neuropeptide Y (d) Neurotensin
(c) Glycine (d) Nitric Oxide
17. Which one of the following statements
(e) Substance P
best describes the mechanism of action
11. Neurotransmitters may of benzodiazepines?
(a) Increase chloride conductance to cause (a) Benzodiazepines activate GABAB receptors
inhibition in the spinal cord
(b) Increase potassium conductance to cause (b) Their inhibition of GABA transminase leads
excitation to increased levels of GABA
(c) Increse sodium conductance to cause (c) Benzodiazepines block glutamate receptors
inhibition in hierarchical neuronal pathways in the
(d) Increase calcium conductance to cause brain
inhibition (d) They increase the frequency of opening of
(e) Exert all of the above actions chloride ion channels that are coupled to
GABAA receptors
12. Which of the following chemicals is most (e) They are direct-acting GABA receptor
likely to function as a neurotransmitter agonists in the CNS
in hierarchical systems?
18. Which one of the following statements
(a) Dopamine (b) Glutamate
about the use of triazolam in this elderly
(c) Metenkephalin (d) Norepinephrine patient is accurate?
(e) Serotonin
(a) Ambulatory dysfunction does not occur in
13. Activation of metabotropic receptors elderly patients taking one-half of the
located presynaptically causes inhibition conventional adult dose
by decreasing the inward flux of (b) Hypertension is a common adverse effects
(a) Calcium (b) Chloride of benzodiazepines in patients over 70 years
of age
(c) Potassium (d) Sodium
(c) Over-the-counter cold medications may
(e) None of the above
antagonize the hypnotic effects of the drug
14. This compound decrease the functional
activities of several CNS neurotransmit- (d) She may experience amnesia, especially if
ters, including dopamine, norepineph- she also drinks alcoholic beverages
rine, and serotonin. At high doses it may (e) Triazolam is distinctive in that it does not
cause parkinsonism-like extrapyramidal cause rebound insomnia on abrupt
system dysfunction. discontinuance
(a) Amphetamine (b) Baclofen
19. The most likely explanation for the
(c) Diazepam (d) Ketamine increased sensitivity of elderly patients
(e) Reserpine to a single dose of triazolam and other
sedative-hypnotic drugs is
15. This amine neurotransmitter is found in
high concentration in cell bodies in the (a) Changes in brain function that accompany
pons and brain stem; at some sites, the aging process
release of transmitter is autoregulated via (b) Decreased renal function
presynaptic inhibition. (c) Increased cerebral blood flow
(a) Acetylcholine (b) Dopamine (d) Decreased hepatic metabolism of lipid-
(c) Glutamate (d) Norepinephrine soluble drugs
(e) Substance P (e) Changes in plasma protein binding
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 31

20. Induction of various forms of synaptic (a) Additive CNS depression


plasticity is more closely associated with (b) Antagonism of sedative or hypnotic actions
______ receptors
(c) Competition for plasma protein binding
(a) AMPA (b) Kainate (d) Induction of liver drug-metabolizing enzymes
(c) NMDA (d) All of the above (e) Inhibition of liver drug-metabolizing enzymes
21. Which one of the following drugs may 26. A 42-year-old man with a history of
increase anticoagulant effects by alcoholism is brought to the emergency
displacement of warfarin from plasma
room in a confused and delirious state. He
protein binding sites and is inactive until
has truncal ataxia and ophthalmoplegia.
converted in the body to an active
The most appropriate immediate course of
metabolite?
action is to administer.
(a) Buspirone (b) Chloral hydrate
(a) Chlordiazepoxide (b) Disulfiram
(c) Clorazepate (d) Secobarbital
(c) Folic acid (d) Lorazepam
(e) Zaleplon
(e) Thiamine
22. Which one of the following drugs has
been used in the management of alcohol 27. Which one of the following statements
withdrawal states and in maintenance about the bio-disposition of ethanol is
treatment of patient with tonic-clonic or accurate?
partial seizure states? Its chronic use may (a) Ethanol is absorbed at all levels of the
lead to an increased metabolism of gastrointestinal tract
warfarin and phenytoin. (b) Acetic acid is the initial product of ethanol
(a) Chlordiazepoxide (b) Meprobamate metabolism
(c) Phenobarbital (d) Triazolam (c) After an intravenous dose, plasma levels of
(e) Zolpidem ethanol are lower in women than in men
(d) The elimination of ethanol follows first-order
23. A 40-year-old patient with liver
kinetics
dysfunction is scheduled for a surgical
procedure. Lorazepam can be used for (e) Alcohol dehydrogenase exhibits genetic
preanesthetic sedation in this patient variability
without concern for excessive CNS
28. Following is GABAA agonist
depression because the drug is
(a) Muscimol (b) Baclofen
(a) A selective anxiolytic like buspirone
(c) Bicuculline (d) None of the above
(b) Actively secreted in the renal proximal tubule
(c) Conjugated extrahepatically 29. Chronic use of ethanol is reported to
(d) Eliminated via the lungs increase
(e) Reversible by administration of naloxone (a) Alcohol dehydrogenase
24. This hypnotic drug facilitates the (b) Aldehyde dehydrogenase
inhibitory actions of GABA, but it lacks (c) Microsomal ethanol-oxidizing system activity
anticonvulsant or muscle relaxing (d) Monoamine oxidase
properties and has minimal effect on (e) NADH dehydrogenase
sleep architecture.
30. The chronic abuse of alcohol predisposes
(a) Buspirone (b) Diazepam
to hepatic damage following overdose of
(c) Flurazepam (d) Phenobarbital
acetaminophen because ethanol
(e) Zaleplon
(a) Blocks acetaminophen metabolism
25. The most frequent type of drug interaction (b) Causes thiamine deficiency
that occurs in patients using drugs of the
(c) Displaces acetaminophen from plasma
sedative hypnotic class is
proteins
32 MCQs IN PHARMACOLOGY

(d) Induces liver drug-metabolizing enzymes 36. Withdrawal of antiseizure drugs can
(e) Inhibits renal clearance of acetaminophen cause increased seizure frequency and
severity. Withdrawal is least likely to be
31. The activity of this enzyme is specifically a problem with
decreased in the Wernicke-Korsakoff
syndrome (a) Clonazepam (b) Diazepam
(c) Ethosuximide (d) Phenobarbital
(a) Alcohol dehydrogenase
(e) Phenytoin
(b) Cytochrome P450
(c) L-Aromatic amino acid decarboxylase 37. A young femal patient who suffers from
(d) NADH dehydrogenase bipolar affective disorder (BAD) has been
(e) Pyruvate dehydrogenase managed with lithium. If she becomes
pregnant, which one of the following
32. Following is glycine antagonists drugs is likely to be effective in bipolar
(a) Quisqualate (b) Taurine affective disorder with minimal risk of
(c) Strychnine (d) â-alanine teratogenicity?
(a) Carbamazepine (b) Clonazepam
33. Which one of the following statements
concerning the pharmacokinetics of (c) Phenytoin (d) Valproic acid
antiseizure drugs is accurate? (e) None of the above
(a) At high doses, phenytoin elimination follows 38. The most likely mechanism involved in
first-order kinetics the antiseizure activity of carbamazepine
(b) Valporic acid may increase the activity of is
hepatic ALA synthase and the synthesis of (a) Block of sodium ion channels
porphyrins
(b) Block of calcium ion channels
(c) The administration of phenytoin to patients
in methadone maintenance programs has led (c) Facilitation of GABA actions on chloride ion
to symptoms of opioid overdose, including channels
respiratory depression (d) Glutamate receptor antagonism
(d) Although ethosuximide has a half-life of (e) Inhibition of GABA transaminase
approximately 40 hours, the drug is usually
39. Which one of the following statements
taken twice a day
about phenytoin is accurate?
(e) Treatment with vigabatrin may reduce the
effectiveness of oral contraceptives (a) Displaces sulfonamides from plasma proteins
(b) Drug of choice in myoclonic seizures
34. With chronic use in seizure states, the
(c) Half-life is increased if used with pheno-
adverse effects of this drug include
barbital
coarsening of facial features, hirsutism,
gingival hyperplasia, and osteomalacia. (d) Isoniazid (INH) decreases steady state blood
levels of phenytoin
(a) Carbamazepine (b) Ethosuximide
(e) Toxicity may occur with only small increments
(c) Gabapentin (d) Phenytoin
in dose
(e) Valproic acid
40. Which one of the following statements
35. Which one of the following statements concerning nitrous oxide is accurate?
about vigabatrin is accurate?
(a) It continues to be a useful component of
(a) Blocks neuronal reuptake of GABA anesthesia protocols because of its lack of
(b) Drug of choice in absence seizures cardiovascular depression
(c) Is established to be teratogenic in humans (b) Megaloblastic anemia is a common adverse
(d) Life-threatening skin disorders may occur effect in patients exposed to nitrous oxide
(e) Visual field defects occur in up to one-third for periods longer than 2 hours
of patients (c) It is the most potent of the inhaled
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 33

anaesthetics receive other anaesthetics


(d) There is a direct association between the use (a) Enflurane (b) Ketamine
of nitrous oxide and malignant hyperthermia (c) Morphine (d) Propofol
(e) More than 30% of nitrous oxide is eliminated (e) Remifentanil
via hepatic metabolism
48. The pKa of lidocaine is 7.9. In infected
41. Following is GABAB agonist tissue at pH 6.9, the fraction in the ionized
(a) Muscimol (b) Baclofen form will be
(c) Picrotoxin (d) Bicuculline (a) 1% (b) 10%
42. Following is GABAA antagonist (c) 50% (d) 90%
(e) 99%
(a) Muscimol (b) Bicuculline
(c) Strychnine (d) Baclofen 49. Which of the following statements about
nerve blockade with local anaesthetics
43. The inhalation anesthetic with the fastest
is most correct?
onset of action is
(a) Block is faster in onset in infected tissues
(a) Enflurane (b) Isoflurane
(b) Block is faster in onset in unmyelinated fibers
(c) Nitric oxide (d) Nitrogen dioxide
(c) Block is slower in onset in hypocalcemia
(e) Nitrous oxide
(d) Block is faster in onset in hyperkalemia
44. An intravenous bolus dose of thiopental (e) Block is slower in onset in the periphery of a
usually leads to loss of onsciousness nerve bundle than in the center of a bundle
within 10–15 seconds. If no further drugs
are administered, the patient will regain 50. Which of the following was the first com-
consciousness in just a few minutes. The pound to be identified Pharmacologically
reason for this, that thiopental is as a transmitter in the CNS ?
(a) A good substrate for renal tubular secretion (a) Glycine (b) Glutamate
(b) Exhaled rapidly (c) Acetulcholine (d) Norepinephrine
(c) Rapidly metabolized by hepatic enzymes 51. You have a vial containing 4 mL of a 2%
(d) Redistributed from brain to other body tissues solution of lidocaine. How much lidocaine
(e) Secreted in the bile is present in 1 mL?
(a) 2 mg (b) 8 mg
45. Respiratory depression following use of
this agent may be reversed by adminis- (c) 20 mg (d) 80 mg
tration of flumazenil (e) 200 mg
(a) Desflurane (b) Fentanyl 52. Which one of the following statements
(c) Ketamine (d) Midazolam about the toxicity of local anaesthetics is
(e) Propofol most correct?

46. Use of this agent is associated with a high (a) Serious cardiovascular reactions are more likely
incidence of disorientation, sensory and to occur with tetracaine than with bupivacaine
perceptual illusions, and vivid dreams (b) Cyanosis may occur following injection of
during recovery from anesthesia large doses of lidocaine, especially in
patients with pulmonary disease
(a) Diazepam (b) Fentanyl
(c) Intravenous injection of local anaesthetics may
(c) Ketamine (d) Midazolam
stimulate ectopic cardiac pacemaker activity
(e) Thiopental
(d) In overdosage, hyper ventilation (with
47. Postoperative vomiting is uncommon oxygen) is helpful to correct acidosis and
with this intravenous agent; patients are lower extracellular potassium
able to ambulate sooner than those who (e) Most local anaesthetics cause vasoconstriction
34 MCQs IN PHARMACOLOGY

53. Epinephrine added to a solution of (a) Diazepam (b) Pancuronium


lidocaine for a peripheral nerve block will (c) Tizanidine (d) Tubocurarine
(a) Increase the risk of convulsions (e) Vecuronium
(b) Increase the duration of anesthetic action of 60. Which one of the following drugs has
the local anesthetic caused hyperkalemia leading to cardiac
(c) Both (A) and (B) arrest in patients with neurologic
(d) Neither (A) nor (B) disorders?
(e) None of the above (a) Baclofen (b) Dantrolene
54. A child requires multiple minor surgical (c) Succinylcholine (d) Tubocurarine
procedures in the nasopharynx. Which (e) Vecuronium
of the following drugs has high surface 61. Following is an excitatory amino acid
activity and vasoconstrictor actions that receptor antagonist?
reduce bleeding in mucous membrane?
(a) Phencyclidine (b) Quisqualate
(a) Benzocaine (b) Bupivacaine
(c) Homocysteate (d) Kainate
(c) Cocaine (d) Lidocaine
(e) Procaine 62. Which one of the following drugs has
spasmolytic activity and could also be
55. Characteristics of nondepolarizing used in the management of seizures
neuromuscular blockade include which caused by overdose of a local anesthetic?
one of the following? (a) Baclofen (b) Cyclobenzaprine
(a) Block of posttetanic potentiation (c) Dantrolene (d) Diazepam
(b) Histamine blocking action (e) Tizanidine
(c) Poorly sustained titanic tension
63. Which one of the following drugs given
(d) Significant muscle fasciculations during onset preoperatively will prevent postoperative
of block pain caused by succinylcholine?
(e) Stimulation of autonomic ganglia (a) Baclofen (b) Dantrolene
56. Which of the following does not cause (c) Diazepam (d) Lidocaine
skeletal muscle contactions or twitching? (e) Tubocurarine
(a) Acetylcholine (b) Nicotine 64. As the physician, you could tell the patient
(c) Strychnine (d) Succinylcholine (and close family members) all of the
(e) Vecuronium following things about levodopa except?

57. Which one of the following is most (a) Taking the drug in divided doses will
effective in the management of malignant decrease nausea and vomiting
hyperthermia? (b) He should be careful when he stands up
because he may get dizzy
(a) Baclofen (b) Dantrolene
(c) Uncontrollable muscle jerks may occur
(c) Haloperidol (d) Succinylcholine
(d) A net-like reddish to blue discoloration of
(e) Vecuronium the skin is a likely side effect of the medication
58. Following is a G-protein coupled receptor (e) The drug will probably improve his symptoms
for a period of time but not indefinitely
(a) AMPA (b) Kainate
(c) NMDA (d) Metabotropic 65. As the physician who is prescribing
levodopa, you will note that the drug
59. Which one of the following drugs is most
often associated with hypotension caused (a) Causes less severe behavioral side effects if
by histamine release? given with carbidopa
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 35

(b) Fluctuates in its effectiveness with increasing (c) The primar y therapeutic benefit of
frequency as treatment continues antimuscarinic drugs in parkinsonism is their
(c) Prevents extrapyramidal adverse effects of ability to reliever bradykinesia
antipsychotic drugs (d) Dopamine receptor against should not be
(d) Protects against cancer in patients with used in Parkinson’s disease prior to a trial of
melanoma levodopa
(e) Has toxic effects that include pulmonary (e) The concomitant use of selegiline may
infiltrates increase the peripheral adverse effects of
levodopa
66. The major reason why carbidopa is of
value in parkinsonism is that the 70. A previously healthy 50-year-old woman
compound begins to suffer from slowed mentation
(a) Crosses the blood-brain barrier and develops writhing movement of her
tongue and hands. In addition, she has
(b) Inhibits monoamine oxidase type A
delusions of being persecuted. The
(c) Inhibits aromatic L-amino acid decarboxylase woman has no past history of psychiatric
(d) Is converted to the false neurotransmitter or neurologic disorders. The most
carbidopamine appropriate drug for treatment is
(e) Inhibits monoamine oxidase type B
(a) Amantadine (b) Bromocriptine
67. Which one of the following statements (c) Haloperidol (d) Levodopa
about bromocriptine is accurate? (e) Trihexyphenidyl
(a) It should not be administered to patients
71. Great caution must be exercised in the
taking antimuscarinic drugs
use of this drug (or drugs from the same
(b) Effectiveness in Parkinson’s disease requires class) in parkinsonian patients who have
its metabolic conversion to an active prostatic hypertrophy or obstructive
metabolite gastrointestinal disease
(c) The drug is contraindicated in patients with
(a) Benztropine (b) Carbidopa
a history of psychosis
(c) Levodopa (d) Ropinirole
(d) The drug should not be administered to
patients already taking levodopa (e) Selegiline
(e) Mental disturbances occur more commonly 72. Which of the following statements about
with levodopa than with bromocriptine pramipexole is accurate?
68. A 72-year-old patient with parkinsonism (a) Activates dopamine D2 receptors
presents with swollen feet. They are red, (b) Commonly a first-line therapy for Parkinson’s
tender, and very painful. You could clear disease
up these symptoms within a few days if (c) May cause postural hypotension
you told the patient to stop taking
(d) Not an ergot derivative
(a) Amantadine (b) Benztropine
(e) All of the above
(c) Bromocriptine (d) Levodopa
(e) Selegiline 73. Tolcapone may be of value in patient
being treated with levodopa–carbidopa
69. Concerning the drugs used in because it
parkinsonism, which of the following
(a) Activates catechol – O – methyltransferease
statements is accurate?
(b) Decreases formation of 3 – O – methyldopa
(a) Levodopa causes mydriasis and can
(c) Inhibits monoamine oxidase type B
precipitate an attack of acute glaucoma
(d) Inhibits dopamine reuptake
(b) Useful therapeutic effects of amantadine
continue for several years (e) Releases dopamine from nerve endings
36 MCQs IN PHARMACOLOGY

74. Concerning hypotheses for the patho- (c) Give oral diphenydramine
physiologic basis of schizophrenia, which (d) Switch the patient to fluphenazine
one of the following statements is accu-
(e) Inject benztropine
rate?
(a) Positron emission tomography has shown 78. Which one of the following statements
decreased dopamine receptors in the brains about the action of phenothiazines is
of both untreated and drug-treated accurate?
schizophrenics (a) They activate muscarinic receptors
(b) Drugs that block dopamine receptors are (b) They are antiemetic
useful for alleviating psychotic symptoms in (c) They decrease serum prolactin levels
parkinsoniam patients
(d) They elevate the seizure threshold
(c) The clinical potency of many antipsychotic
(e) They raise blood pressure
drugs correlates well with their beta
adrenoceptor-blocking actions 79. Within days of starting haloperidol treat-
(d) Drug-induced psychosis can occur without ment for a psychatric disorder, a young
activation of brain dopamine receptors male patient developed severe general-
(e) All effective antipsychotic drugs have high ized muscle rigidity and a high fever. In
affinity for dopamine D2 receptors the emergency room he was incoherent,
with increased heart rate, hypotension,
75. Choose the correct statement from the and diaphoresis, Laboratory studies in-
following? dicated acidosis, leukocytosis, and in-
(a) Muscimol is GABAB selective creased creatine kinase. The most likely
(b) Bicuculline is GABAA agonist reason for these symptoms is that the pa-
(c) Picrotoxin blocks chloride channels tient was suffering from
associated with GABAA receptors (a) Agranulocytosis
(d) Baclofen is GABAA agonist (b) A severe bacterial infection
76. A 30-year-old male patient is on drug (c) Neuroleptic malignant syndrome
therapy for a psychiatric problem. He (d) Spastic retrocollis
complains that he feels “flat” and that (e) Tardive dyskinesia
he gets confused at times. He has been
gaining weight and has lost his sex drive. 80. Following is the main inhibitor y
As he moves his had, you notice a slight transmitter in the brain
tremor. He tells you that since he has been (a) Dopamine (b) Norepinephrine
on medication he is always thirsty and (c) Glycine (d) GABA
frequently has to urinate. The drug he is
most likely to be taking is 81. Concerning the proposed mechanisms of
(a) Clonazepam (b) Clozapine action of antidepressant drugs, which one
of the following statements is accurate?
(c) Haloperidol (d) Lithium
(e) Trifluoperazine (a) Bupropion is an effective inhibitor of NE and
5-HT transporters
77. A young male patient diagnosed as (b) Chronic treatment with an antidepressant often
schizophrenic develops severe muscle leads to the up-regulation of adrenoceptors
cramps with torticollis a short time after
(c) Elevation in amine metabolites in cere-
drug therapy is intiated with haloperidol.
brospinal fluid is characteristic of most
The best course of action would be to
depressed patients prior to drug therapy
(a) Add clozapine to the drug regimen
(d) MAO inhibitors used as antidepressants
(b) Discontinue haloperidol and observe the selectively decrease the metabolism of
patient norepinephrine
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 37

(e) The acute effect of most tricyclics is to block 87. Established clinical uses of this drug
the neuronal reuptake of both norepinephrine include enuresis and chronic pain
and serotonin in the CNS (a) Bupropion (b) Fluvoxamine
82. Which one of the following effects is (c) Imipramine (d) Phenelzine
unlikely to occur during treatment with (e) Selegiline
amitriptyline?
88. Which one of the following drugs is most
(a) Alpha adrenoceptor blockade likely to increase plasma levels of
(b) Elevation of the seizure threshold alprazolam, the ophyline, and warfarin
(c) Mydriasis (a) Desipramine (b) Fluvoxamine
(d) Sedation (c) Imipramine (d) Nefazodone
(e) Urinary retention (e) Venlafaxine
83. A 54-year-old male patient was using 89. Which one of the following actions of
fluoxetine for depression but decided to opioid analgesics is mediated via
stop taking the drug. When questioned, activation of kappa receptors?
he said that it affected his sexual
(a) Cerebral Vascular dilation
performance and that “he wasn’t getting
(b) Decreased uterine tone
any younger.” You notice that he is a used
of tobacco products. If you decide to (c) Euphoria
reinstitute drug therapy in this patient, (d) Sedation
the best choice would be (e) Psychologic dependence
(a) Amoxapine (b) Bupropion 90. ______ antagonists are known to
(c) Imipramine (d) Sertraline attenuate some of the actions of alcohol.
(e) Venlafaxine (a) GABAA (b) GABAB
84. Regarding maprotiline, which one of the (c) NMDA (d) Glycine
following statements is accurate?
91. Which one of the following statements
(a) Blocks serotonin reuptake selectively about propoxyphene is accurate?
(b) Cause hypertension (a) Analgesia equivalent to oxycodone
(c) Raises the seizure threshold (b) Antagonist at mu receptors
(d) Sedation occurs commonly (c) Causes dose-limiting diarrhea
(e) Has a tricyclic structure (d) Highly effective cough suppressant
85. Which one of the following drugs is most (e) Seizures have occurred in overdose
likely to be of value in obsessive 92. A young male patient is brought to the
compulsive disorders (OCD)? emergency room of a hospital suffering
(a) Amitriptyline (b) Bupropion from an overdose of cocaine following
(c) Clomipramine (d) Desipramine intravenous administration. His symp-
toms are unlikely to include
(e) Mirtazapine
(a) Agitation (b) Bradycardia
86. Compared with other antidepressant
(c) Hyperthermia (d) Myocardial infarct
drugs, mirtazapine has the distinctive
(e) Seizures
ability to act as an antagonist of
(a) Alpha2 adrenoceptors 93. Which one of the following statements
(b) Beta adrenoceptors about hallucinogens is accurate?
(c) D2 receptors (a) Mescaline and related hallucinogens are
thought to exert their CNS actions through
(d) NE transporters
dopaminergic systems in the brain
(e) 5-HT transporters
38 MCQs IN PHARMACOLOGY

(b) Teratogenic effects are known to occur with (c) Hyperuricemia


the use of LSD during pregnancy (d) Liver damage
(c) Scopolamine is unique among hallucinogens (e) Severe cardiac arrhythmia
in that animals will self-administer it
98. Alcohol drinking is associated with which
(d) Dilated pupils, tachycardia, tremor and
of the following changes in serum lipid
increased alertness are characteristic effects
concentrations?
of psilocybin
(e) Phencyclidine can be anticipated to cause (a) Decreased HDL cholesterol
dry mouth and urinary retention (b) Decreased IDL cholesterol
(c) Decreased VLDL cholesterol
94. Which one of the following signs or symp-
toms is likely to occur with marijuana? (d) Increased LDL cholesterol
(e) Increased triglyceride
(a) Bradycardia
(b) Conjunctival reddening 99. A patient suffering from a depressive
(c) Hypertension disorder is being treted with imipramine.
If he uses diphenhydramine for allergic
(d) Increased psychomotor performance
rhinitis, a drug interaction is likely to
(e) Mydriasis
occur because
95. This agent has sedative and amnestic (a) Diphehydramine inhibits imipramine
properties. Small doses added to metabolism
alcoholic beverages are not readily (b) Both drugs block reuptake of norepinephrine
detected by taste and have been used in released from sympathetic nerve endings
“date rape” attacks. The drug is
(c) Imipramine inhibits the metabolism of
chemically related to a brain inhibitory
diphenydramine
neurotransmitter. Which one of the
following most closely resembles the (d) Both drugs block muscarinic receptors
description given? (e) The drugs compete with each other for renal
elimination
(a) Amyl nitrite
(b) Flunitrazepam 100. If phenelzine is administered to a patient
(c) Gamma-hydroxybutyrate taking fluoxetine, the most likely result
is
(d) Hashish
(e) Metcathinone (a) Antagonism of the antidepressant action of
fluoxetine
96. The patient is started on gemfibrozil. The (b) A decrease in the plasma levels of fluoxetine
major mechanism of action of gemfibrozil
(c) Hypertensive crisis
is
(d) Priapism
(a) Increased excretion of bile acid salts
(e) Agitation, muscle rigidity, hyperthermia,
(b) Increased expression of high-affinity LDL seizures
receptors
(c) Increased lipid hydrolysis by lipoprotein 101. The antihypertensive effects of captopril
lipase can be antagonized (reduced) by
(d) Inhibition of secretion of VLDL by the liver (a) Angiotensin II receptor blockers
(e) Reduction of secretion of HDL by the liver (b) Loop diureties
(c) NSAIDS
97. When used as monotherapy, a major
toxicity of gemfibrozil is increased risk of (d) Sulfonylurea hypoglycemics
(e) Thiazides
(a) Bloating and constipation
(b) Cholelithiasis 102. Which one of the following drugs most
resembles the psychoactive constituent(s)
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 39

of St. John’s wort in terms of proposed 109. Recreational use of drugs sometimes
mechanism of action? leads to dependence. Which of the
(a) Alprazolam (b) Fluoxetine following is least likely to cause physical
dependence?
(c) Levodopa (d) Methylphenidate
(e) Selegine (a) Alcohol is excitatory in nature
(b) Alcohol has a direct stimulatory effect on
103. The primary site of action of tyramine is sexual responsiveness
(a) Ganglionic receptors (c) Alcohol is teratogenic
(b) Gut and liver catechol–O–methyltransferase (d) Alcohol increases ADA production
(c) Postganglionic sympathetic nerve terminals
110. This agent is currently a first-choice drug
(d) Preganglionic sympathetic nerve terminals in the management of absence seizures
(e) Vascular smooth muscle cell receptors as well as partial, primary generalized,
and tonic-clonic seizures.
104. Which one of the following drugs has
been used in ophthalmology, but causes (a) Carbamazepine (b) Clonazepam
mydriasis and cycloplegia lasting more (c) Ethosuximide (d) Phenytoin
than 24 hours? (e) Valproic acid
(a) Atropine (b) Echothiophate 111. If one patient is taking amitriptyline and
(c) Edrophonium (d) Ephedrine another patient is taking chlorpromazine,
(e) Tropicamide they are both likely to experience
105. The antihypertensive drug most likely to (a) Excessive salivation
aggravate angina pectoris is (b) Extrapyramidal dysfunction
(a) Clonidine (b) Guanethidine (c) Gynecomastia
(c) Hydralazine (d) Methyldopa (d) Increased gastrointestinal motility
(e) Propranolol (e) Postural hypotension

106. After an intravenous bolus injection of 112. The phenothiazines have a variety of
lidocaine, the major factors determining actions at different receptor types.
the initial plasma concentration are However, they do not appear to interact
with receptors for
(a) Dose and clearance
(a) Dopammine (b) Histamine
(b) Dose and apparent volume of distribution
(c) Nicotine (d) Norepinephrine
(c) Apparent volume of distribution and
(e) Muscarine
clearance
(d) Clearance and half-life 113. A psychiatric patient taking medications
(e) Half-life and dose develops a tremor, thyroid enlargement,
and leukocytosis. The drug he is taking
107. Diuretics that increase the delivery of is most likely to be
poorly absorbed solute to the thick
(a) Clomipramine (b) Haloperidol
ascending limb of the nephron include
(c) Imipramine (d) Lithium
(a) Furosemide (b) Indapamide
(e) Sertraline
(c) Mannitol (d) Spironolactone
(e) All of the above 114. The mechanism of action of benzodiaz-
epines is
108. Following is used in methanol poisoning (a) Activation of GABAB receptors
(a) Disulfiram (b) Naltrexone (b) Antagonism of glycine receptors in the spinal
(c) Ethanol (d) None of the above cord
40 MCQs IN PHARMACOLOGY

(c) Blockade of the action of glutamic acid 120. the consumption of shellfish harvested
(d) Increased GABA mediated chloride ion during a “red tide” (due to a large
conductance population of a dinoflagellate species) is
(e) Inhibition of GABA aminotranferase not recommended. This is because the
shellfish are likely to contain
115. A drug that is used in the treatment of
(a) Arsenic (b) Botulinum toxins
parkinsonism and will also attenuate
(c) Cyanide (d) Saxitoxin
reversible extrapyramidal side effects of
neuroleptics is (e) Tetrodotoxin
(a) Amantadine (b) Levodopa 121. A 35-year-old female who has never
(c) Pergolide (d) Selegiline been pregnant suffers each month from
(e) Trihexyphenidyl pain, discomfort, and mood depression
at the time of menses. She may benefit
116. The characteristics of one-daily dosing from the use of this selective inhibitor of
with aminoglycosides compared with the reuptake of serotonin.
conventional dosing protocols (every 6-12
(a) Amitriptyline (b) Bupropion
hours) include
(c) Mirtazapine (d) Paroxetine
(a) Decreased drug uptake into the renal cortex
(e) Trazodone
(b) Higher peak serum drug levels to MIC ratios
(c) Postantibiotic actions 122. Which of the following is a common effect
of muscarinic stimulant drugs?
(d) All of the above
(e) None of the above (a) Decreased peristalsis
(b) Decreased secretion by salivary glands
117. A young mother is breast-feeding her 2-
(c) Hypertension
month-old infant. Which one of the
(d) Inhibition of sweat glands
following drug situations involving the
mother is most likely to be safe for the (e) Miosis
nursing infant? 123. Four stages of general anesthesia are
(a) Doxycycline, for Lyme disease distinctly seen with the use of
(b) Metronidazole, for trichomoniasis (a) Halothane (b) Diethyl ether
(c) Nystatin, for a yeast infection (c) Nitrous oxide (d) Enflurane
(d) Phentermine, used for weight reduction
124 Infusion of phenotolamine into the
(e) Triazolam, used as a sleeping pill
cerebrospinal fluid of an experimental
118. Cocaine intoxication has become a animal will prevent the bood pressure –
common problem in hospital emergency lowering action of
rooms. Which one of the following drugs (a) Clonidine (b) Enalapril
is not likely to be of any value in the (c) Guanethidine (d) Reserpine
management of cocaine overdose?
(e) Trimethaphan
(a) Dantrolene (b) Diazepam
125. A drug suitable for producing a brief (5
(c) Lidocaine (d) Naltrexone
to 15 minute) increase in cardiac vagal
(e) Nitroprusside
tone is
119. Which one of the following agents used (a) Digoxin (b) Edrophonium
in hypertension is a prodrug that is (c) Ergotamine (d) Pralidoxime
converted to its active form in the brain?
(e) Pyridostigmine
(a) Clonidine (b) Doxazosin
126. Propranolol and hydralazine have which
(c) Methyldopa (d) Nitroprusside
of the following effects in common?
(e) Verapamil
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM 41

(a) Decreased cardiac force thought processes, suffers from paranoia,


(b) Decreased cardiac output and “hears voices”. The drug most likely
(c) Decreased mean arterial blood pressure to be responsible for her condition is
(d) Increased systemic vascular resistance (a) Gamma-hydroxybutyrate (GHB)
(e) Tachycardia (b) Hashish
(c) Heroin
127. Toxicities of local anaesthetics do not
(d) Marijuana
include
(e) Methamphetamine
(a) Cardiovascular arrhythmias and collapse
(bupivacaine) 132. Mental retardation, microcephaly, and
(b) Convulsions (lidocaine) underdevelopment of the mid face region
(c) Dizziness, sedation (lidocaine) in an infant is associated with chronic
maternal abuse of
(d) Hypertensive emergencies, strokes (procaine)
(e) Methemoglobinemia (a) Amphetamine (b) Cocaine
(c) Ethanol (d) Mescaline
128. Benzodiazepines are least effective in
(e) Phencyclidine
(a) Alcohol withdrawal syndromes
133. After ingestion of a meal that included
(b) Balanced anesthesia regimens
sardines, cheese, and red wine, a patient
(c) Initial management of phencyclidine taking an antidepressant drug experi-
overdose ences a hypertensive crisis. The drug most
(d) Obsessive – compulsive disorders likely to be responsible is
(e) Social phobias (a) Bupropion (b) Fluoxetine
129. Which one of the following drugs exerts (c) Imipramine (d) Phenelzine
its anticonvulsant effects by blocking (e) Trazodone
sodium channels in neuronal membranes?
134. A woman taking haloperidol develops a
(a) Acetazolamide (b) Carbamazepine spectrum of adverse effects that include
(c) Diazepam (d) Gabapentin the amenorrheagalactorrhea syndrome
(e) Vigabatrin and extrapyramidal dysfunction,
including bradykinesia, muscle rigidity,
130. Regarding the pharmacodynamic actions
and tremor at rest. Her psychiatrist
of local anaesthetics, which one of the
prescribes a newer antipsychotic drug
following statements is most accurate?
that improves both positive and negative
(a) All local anaesthetics with ester bonds are symptoms of schizopherenia with few of
vasodilators the side effects that result from dopamine