Pharma Compre Samplex

PHARMACOLOGY Basic & Edition) 1.

2.

3.

Clinical

Pharmacology

by

Katzung

8 th

This measure relates the dose of the drug required to produce a desired effect to that which produces an undesired effect. (p. 8) A. therapeutic index*** B. Idiosyncratic effect C. Tolerance D. Potency This is the fraction of unchanged drug reaching the systemic circulation following administration by any route:(p. 41) A. Absorption B. First Pass Effect C. Bioavailability*** D. Bioequivalence In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy. (p. 72) A. Phase 1 B. phase 2*** C. phase 3 D. phase 4

4.

In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy. (p. 72) A. Phase 1 B. phase 2*** C. phase 3 D. phase 4

5.

This is an irreversible inhibitor of GABA aminotransferase and is useful in the treatment of partial seizures and WEST syndrome: (p. 404) A. vigabatrin **** C. lamotrigine B. tiagabine

D. gabapentin

6.

Action of Insulin in the liver: (p. 717) A, increase storage of glucose as glycogen** B. increase glycogenolysis C.Increase ketogenesis D.increase gluconeogenesis

7.

Most common adverse effect of insulin: (p. 721) A. hypoglycemia C. lipodystrophy B. allergy D. bleeding

8.

Effect of digitalis in the AV node during arrythmias: (p. 207) A. prolonged PR interval B. AV blockade C. bradycardia D. prolonged QT interval 9.

Immediate metabolic precursor of dopamine that penetrates the blood-brain barrier: (p.464) A. carbidopa B. levodopa C. selegiline D. ropinorole

10. The following are true of phenoxybenzamine: (p. 141) A. causes reversible blockade of alpha receptors B. blocks catecholamine-induced vasoconstriction C. significantly reduces blood pressure in supine individuals D. stimulates histamine (H1) acetylcholine and serotonin receptors 11. Antiarrhythmic drugs that prolong effective refractory period by prolonging action potential duration: (p. 239) A. Bepridil B. Bretylium C. Esmolol D. Lidocaine 12. Antiarrhytmic of choice for suppression of recurrences of ventricular tachycardia & fibrillation after termination of the arrhythmia by cardioversion: (p. 240) A. Adenosine B. Esmolol C. Lidocaine D. Procainamide 13.

The most serious toxic reaction to local anesthetics is: (p. 441) A. circumoral numbness C. nystagmus B. metabolic acidosis D. tonic-clonic convulsions

14. Lithium’s most common side effect/s (p. 491) A.polyuria and subclinical hypothyrodism*** C.polyuria and polydipsia B.polydipsia and subclinical hypothyroidism D. Polyuria and polyphagia

15. Most important unwanted psychotics secondary to deficiency.(p. 488) A. Akathisia Tardive dyskinesia**** B. Parkinsonian syndrome rabbit syndrome

effect of antirelative choline C. D.

Perioral

16. Blocks norepinephrine & serotonin reuptake pumps-the “the off switches” of amine transmission (p. 503) A. MAO inhibitors B. tricyclics*** C. SSRI D. heterocyclics 17. Drug interaction of older MAO inhibitor with tyramine ingested in food:(p. 505) A. depression B. Hypertensive reactions*** C. hypotension D. mania 18. The following are sites of the major classes of anti-hypertensive drugs, except:(p.158 ) A. Sympathetic nerve terminals B. ß-receptors of juxtaglomerular cells that release rennin C. Hypothalamus D. Vasomotor center 19. The following statements regarding selection of anti-hypertensive drugs are correct, except: (p. 179) A. ACE inhibitors are particularly useful in diabetic patients with evidence of renal disease. B. White race responds better to diuretics and calcium channel blockers than to ßblockers and ACE inhibitors. C. Beta-blockers or calcium channel blockers are useful in patients who have angina. D. Diuretics or ACE inhibitors are useful who also have CHF 20. The following are the determinants of vascular tone, except:(p. 182) a.Increasing cGMP b.Increasing cAMP in the vascular cells c.Decreasing intracellular calcium d.Stabilizing or preventing depolarization of the vascular smooth muscle cell membrane 21. The following are the pharmacodynamics of nitroglycerine, except: (p. 184-185) A. Smooth muscle relaxation B. Decreased ventricular preload C. Responsible for a decrease in platelet aggregation D. Increased cardiac output 22. The following are the pharmacodynamics of NSAIDs, except: (p. 598-599) A. Mediated chiefly through inhibition of biosynthesis of prostaglandins B. All NSAIDs inhibit platelet aggregation C. All NSAIDs are anagesic, antiinflammatory and antipyretic D. They are all gastric irritants as well 23. The following are disease-modifying antirheumatic drugs, except: (p. 608) a. Methotrexate b. Cyclosporins c. Corticosteroids d. Azathioprine 24. This agent inhibits cell wall synthesis by binding firmly to the D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide. It inhibits the transglycosylase, preventing further elongation of peptidoglycan and cross-linking. ( p. 768 ) A. Cycloserine B. Vancomycin C. Teicoplanin D. Bacitracin 25. This agent is a potent inhibitor of microbial protein synthesis. It binds reversibly to the 50 S subunit of the bacterial ribosome and inhibits peptidyl transferase step of protein synthesis. 1

This agent is active against rickettsiae but not chlamydiae: ( p. 774) A. Chloramphenicol B. Chlortetracycline C. Amikacin D. Penicillins 26. These agents readily bound to calcium deposited in newly formed bone or teeth in young children. When drug is given during pregnancy, it can be deposited in the fetal teeth, leading to fluorescence, discoloration, and enamel dysplasia: ( p. 778 ) A. Azithromycin B. Linezolid C. Tetracyclines D. Aminoglycosides 27. This drug is split by intestinal microflora to yiels sulfapyridine and 5 aminosalicylate and is widely used in ulcerative colitis, enteritis and other inflammatory bowel diseases. (p. 794-795) A. Sulfadoxine B. Sulfamethoxazole C. Sulfasalazine D. Sulfadiazine 28. Blocks the conversion of cholesterol to pregnanolone and causes reduction in the synthesis of all hormonally active steroids; used in pts. with breast Ca (page 674) A. metyrapone B. trilostane C. aminoglutethimide D. spirinolactone 29. A glucocoorticoid antagonist that is an antifungal imidazole derivative, that is potent and rather nonselective inhibitor of adrenal and gonadal steroid synthesis: (page 674) A. aminogluthetimide B. ketoconazole C. trilostane D. mitotane 30. The most widely used mineralocorticoid, with both mineralocorticoid and glucocorticoid activity: (page 672) A. aldosterone B. deoxycortisone C. fludrocortisone D. cortisone 31. Act as a partial agonist at estrogen receptors in the pituitary, to treat infertility in women by stimulating ovulation: (page 699) A. tamoxifen B. clomiphene C. danazol D. mifepristone 32. An antiandrogen that prevents synthesis of dihydrotestosterone by inhibiting the activity of 5-α reductase: (page 705) A. spirinolactone B. cyproterone C. finasteride D. flutamide 33. Effects of progesterone: (page 690) A. increase basal insulin levels C. promotes breast development B. promotes blood coaguability D. affects protein metabolism 34. Mazzoti reaction, as an adverse effect is seen with the use of this agent, characterized as eosinophilia, rashes due to the release of foreign particles from the dying microfilariae: : (page 908) A. niclosamide B. diethylcarbamazine C. piperazine D. chloroquine 35. A depolarizing muscular blocking agent used as an alternative to mebendazole in the treatment of ascariasis and enterobiasis: (page 917) A. piperazine citrate B. pyrantel pamoate C. praziquantel D. primaquine 36. Kills dormant liver forms in malaria: (page 889) A. piperazine citrate B. pyrantel pamoate C. praziquantel D. primaquine 37. The drug that could accelerate antithrombin activity resulting to blockade of the coagulation cascade at the at the thrombin level, thus preventing the formation of a clot is: (p. 567) A. Warfarin B. Heparin – ans C. Coumarin D. Plasmin 38. This is an antiplatelet drug whose mechanism of action involves inhibition of thromboxane synthesis, thus consequently, prevention of

platelet 574) A. B. C. D.

aggregation & thrombus formation: (p. Clopidogel Ticlopidine Aspirin – ans Dipyridamole

39. Among the thioamide antithyroid drug, which one is preferred for pregnant women because it crosses the placental barrier less readily thus will not affect the fetus?( p. 651) A. Methimazole B. Carbimazole C. Propylthiouracil – ans D. Ipodate 40. Which beta blocker is most widely used to control the symptom of hyperthyroidism? (p. 653) A. Propranolol – ans B. Metoprolol C. Labetalol D. Guanithidine 41. Drugs that competitively inhibit CYP enzymes cause a. Decrease in concentration of the object drug b. Increase in concentration of object drug c. Decrease efficacy of object drug d. Irreversible inactivation of the enzyme 42. The mechanism of action of benzodiazepines is explained by: a. Substitution for GABA b. Direct activation of GABA receptors c. Increase duration of GABA – gated chloride channel opening d. Increase frequency of GABA – gated chloride channel opening 43. The use of benzodiazepines in the chronic treatment of seizures is limited because of their a. high toxicity effects c. tolerance b. slow absorption d. low therapeutic index 44. Which should be observed to minimize adverse effects of sedative hypnotics? a. Always give a very low dose. b. Doses should be given at daytime. c. Combine two drugs with different toxicities d. Efficacy of therapy is based on patient’s subjective response 45. A 50 y/o male coca cola executive was using fluoxetine for depression but decided to stop taking the drug for it affects his sexual performance and even said “he is getting older”. He is also a tobacco user. What is the next best drug to use? a. Bupropion c. citalopram b. Sertraline d venlafaxine 46. A fly catching movement of the tongue commonly observed as a drawback of all typical antipsychotics is called a. “lead pipe” rigidity c. tardive dyskinesia b. “rabbit “ syndrome d. akathisia 47. The most hepatotoxic general anesthetic a. Nitrous oxide c. isoflurane b. Sevoflurane d. halothane

inhalational

48. A 55 – year old female has post-menopausal osteoporosis. Which is not a recommended drug? a. Estrogen c. Biphosphonate b. Calcium d. Calcitonin 2

49. Corticosteroid with most potent anti-inflammatory activity: a. Prednisone c. Betamethasone b. Dexamethasone d. Cortisone

60. Differences in the rate of acetylation of isoniazid among groups of individuals exemplifies. A. pharmacodynamics C. pharmacogenetics B. posology D. biochemorphology

50. Drug of choice (DOC) for endometriosis in young women a. danazol c. mifepristone b. leuprolide d. misoprostol

Ans. C. Katzung, 9th edition, pp. 2 and 5. Pharmacogenetics

51. The effect of diethylstilbestrol intake taken during pregnancy on female infants: a. vaginal adenocarcinoma c. cervical polyp b. endometrial carcinoma d. breast fibroadenoma 52. The most common adverse effect of clomiphene is a. hot flushes c. constipation b. hair loss d. headache 53. A 65 – year old married man was found to have greatly enlarged prostate. Which one of the following drug is MOST likely to suppress prostatic growth without affecting libido? a. Spironolactone c. Ketoconazole b. Finasteride d. Flutamide 54. Testosterone therapy may be indicated for the treatment of erectile dysfunction in which of the following situation? a. Aged patient c. Alcoholism b. Hypogonadism d. Depression 55. Major mechanism of action of aspirin as NSAID is a. Reversible COX inhibitor c. Irreversible PG biosynthesis inhibition b. Chemotaxis inhibition d. Down – regulation of IL-1 56. Which of the following is the drug of choice for inducing labor a. Oxytocin c. Methyl ergonovine b. Misoprostol d. Dinoprostone 57. The primary consideration in all clinical trials is to a. Determine the safety of the drug b. Determine the efficacy of the drug c. Ensure that there is no risk to the subject d. Provide for the welfare of the subject 58. According to the Philippine National Drug Formulary (PNDF), complementary drugs are: A. those drugs italicized in the guide B. drugs that satisfy the health care needs of majority of population C. drugs with special pharmacological properties D. not to be used as an alternative to core drugs Ans. C. Philippine National Drug Formulary, 2000 edition, p. 109. Essential Drugs Concept 59. Which of the following is considered a regulated drug? A. pseudoephedrine C. lysergic acid diethylamide (LSD) B. meperidine D. cocaine Ans. A. Dangerous Drug Board Info – Republic Act 6425 Dangerous Drugs

61. Absorption of most orally administered drugs occurs in the small intestine. This may be enhanced by: A. taking agents that accelerate gastric emptying time B. the presence of food C. stimulation of hepatic microsomal CYP3A4 enzymes D. increasing intestinal motility Ans. A. Katzung, 9th edition, pp. 41, 42, 53, and 56. Pharmacokinetics 62. The nicotinic acetylcholine categorized as to which type? A. G protein coupled kinase-linked B. ion channel-linked nuclear

receptors

are C. D.

Ans. B Katzung, 9th edition pp. 18-23 Pharmacodynamics 63. If a drug has a high distribution volume, it indicates: A. it is highly bound to plasma proteins B. the drug is highly retained in the vascular compartment C. the plasma drug concentration will increase D. there is extensive tissue uptake Ans. D. Katzung, pp. 35 and 47. Pharmacokinetics 64. The index of safety of a drug decreases as the median toxic dose : A. decreases and the median effective dose increases B. increases and the median effective dose decreases C. and the median effective dose decrease D. and the median effective dose increase Ans. A. Katzung, 9th edition, p. 30. Pharmacodynamics 65. What is the major second messenger of beta receptor activation that participates in signal transduction? A. inositol triphosphates C. calcium B. cAMP D. adenylyl cyclase Ans. B. Katzung, 9th edition, p. 25-27. Pharmacodynamics 66. In what condition are the drugs phenoxybenzamine and phentolamine useful? A. pheochromocytoma C. essential hypertension B. migraine attacks D. benign prostatic hyperplasia Ans. A. Katzung, 9th edition, pp. 144-146. Adrenergic Receptor Blockers 67. Acetylcholine acts by: A. increasing adenylyl cyclase activity B. decreasing cGMP concentrations C. activating the IP3, diacylglycerol pathway D. all of the above Ans. C Katzung, 9th edition, p.97 3

Cholinergic Agonists 68. Which of the following antihypertensive agents has the best documented evidence for prophylaxis against migraine attacks? A. pindolol C. clonidine B. propranolol D. prazosin Ans. B. Katzung, 9th edition, pp. 148 and 156 Adrenoceptor Antagonists 69. Which is a direct effect of nitrates when given in the usual doses for the management of angina? A. increased preload C. increased cardiac contractility B. increased afterload D. smooth muscle relaxation Ans. D. Katzung, 9th edition, p. 190. Vasodilators / CVS Drugs 70. A college friend consults you regarding the suitability of the therapy his doctor has prescribed for severe hypertension. He complains of postural and exercise hypotension ("dizziness"), some diarrhea, and problems with ejaculation during sex. Which of the following is most likely to produce the effects that your friend has described? A. propranolol C. hydralazine B. guanethidine D. captopril Ans. B. Katzung, 9th edition, p. 166. Antihypertensive / CVS Drugs 71. The most important pharmacologic action of digitalis in the treatment of heart failure is its ability to: A. reduce venous pressure C. produce diuresis in edematous patients B. increase heart rate D. increase myocardial contractile force Ans. D. Katzung, 9th edition, p. 205. Cardiac Glycosides / CVS Drugs 72. Side effects of oxytocin use in a woman in labor includes the following, EXCEPT: A. increase in BP C. fetal death B. uterine rupture D. diuresis Ans. D. Katzung 9th edition, p. 621 Hormones and Pituitary glands / Drugs used for Endocrine Disorders 73. An antithyroid drug which may be given to reduce the vascularity of the thyroid gland prior to thyroidectomy: A. RAI C. methimazole B. PTU D. Lugol's iodine Ans. D. Katzung, 9th edition, p. 633 Thyroid & Antithyroid Drugs Endocrine Disorders

/

Drugs

used

for

74. Drugs that decrease bone resorption include the following, EXCEPT: A. calcitonin C. alendronate B. estrogen D. fluoride Ans. D. Katzung, 9th edition, p. 719 Agents that affects bone mineral homeostasis

75. Which drug is used as an antiretroviral agent? A. oseltamivir C. indinavir B. famciclovir D. ribavirin Ans. C. Katzung, 9th edition, p. 820 Anti-viral Agents 76. Which of the following enzymes is inhibited by the binding of a beta lactam antimicrobial with penicillin-binding proteins (PBPs)? A. beta-lactamase C. peptidyl tranferase B. transpeptidase D. acetylase Ans. B. Katzung, 9th edition, pp. 734-735 and 764. Beta-lactams / Antimicrobials 77. A poor farm helper from Palawan was diagnosed to have falciparum malaria by blood smear. The safe, cost-effective, and readily available agent to prescribe if this farmer has an allergy to sulfonamides is: A. Fansidar C. chloroquine B. quinine D. mefloquine Ans. B. Katzung, 9th edition, p. 869 Anti-malarial Drugs / Antiprotozoals 78. Radical cure for malaria is achieved by giving: A. chloroquine C. mefloquine B. quinine D. primaquine Ans. D. Katzung, 9th edition, p.871 Anti-malarial Drug 79. There is a sudden increase of atypical pneumonia secondary to Mycoplasma, Chlamydia, and Rickettsia in the Pneumonia Ward of a tertiary hospital. Majority of patients were treated with doxycycline. All of the following ADRs are to be watched out for in these patients EXCEPT: A. photosensitivity C. superinfection B. fetal bone defects D. renal failure Ans. D. Katzung, 9th edition, pp. 758 Tetracyclines / Antimicrobials 80. Which of the following agents may predispose to the development of pseudomembranous colitis? A. erythromycin C. vancomycin B. metronidazole D. clidamycin Ans. D. Katzung, 9th edition, p. 761 Antimicrobials 81. A patient with persistent chronic cough and fever had no response to adequate doses of oral penicillin. The PE showed normal chest findings. Further PE showed bullous myringitis. A chest Xray showed infiltrates in the right lower lobe. Which of the following antimicrobials would be effective? A. parenteral penicillin G C. vancomycin B. chlarithromycin D. gentamicin Ans. B. Katzung, 9th edition, pp. 760 Macrolides / Antimicrobials 82. A 4 year old boy that has diarrhea and malnutrition was noted to have a mixed parasitic infection of Ascaris, Capillaria philippinensis, and 4

Trichiuris trichiura. The single agent that could be effective for this patient is: A. pyrantel pamoate C. diethylcarbamazine B. mebendazole D. niclosamide Ans. B. Katzung, 9th edition, pp. 889-895. edtition, p. 1249. Anti-helmintic Drugs

Harrison, 15th

83. Activated charcoal may be used to treat poisoning due to the following EXCEPT: A. primaquine C. propoxyphene B. aspirin D. iron overdose Ans. D. Katzung, 9th edition, p. 989 Management of Poisoned Patient 84. This herbal plant endorsed by the DOH is useful for the relief of muscle pain: A. Yerba Buena C. Tsaang gubat B. Akapulko D. Sambong Ans. A. DOH Manuals. Herbal Medicines 85. On regular follow-up for tuberculosis, you noticed that the visual acuity of Vilma worsened from 20/20 to 20/50 in both eyes after only three weeks of HRPE. Your approach in management would be to discontinue: A. all of the 4 drugs and reintroduce one drug at a time B. ethambutol and refer to an ophthalmologist C. pyrazinamide and refer to an ophthalmologist D. ethambutol, reintroduce it after 1 week, and refer to an ophthalmologist Ans. . Katzung, 9th edition, p. 786. Anti-tuberculosis Drugs 86. Phenytoin is administered intravenously for acute management of seizure, but when given at a rapid rated can cause A. generalized seizure C. cardiac arrhythmia B. gingival hyperplasia D. gastrointestinal disturbances Answer C. Goodman and Gilman, 10th edition, p. 530. Anti-epileptic drugs / CNS Drugs 87. Which anticonvulsant is safe in pregnancy? A. hydantoin C. valproic acid B. trimethadione D. none of the above Answer D. Katzung, 9th edition, pp. 398. Anti-epileptic drugs / CNS Drugs

88. Which of the following is a common mechanism of action shared by all NSAIDs? A. inhibition of arachidonate release from the plasma membrane by ihibiting phospholipase B. Inhibition of histamine release by inhibiting mast cell degranulation C. Inhibition of the production of prostaglandin and thromboxane from arachidonic acid through inhibition of prostaglandin H synthesis D. Inhibition of the the formation of leukotrienes by inhibiting lipoxygenase Answer: C. Katzung, 9th edition, pp. 263, 306, 577, and 581

Agents which controls prostaglandin effect / CNS Drugs 89. The primary reason why aspirin has been displaced by NSAIDs as first choice drug of pediatric rheumatologists is because: A. poor inflammatory effect and gastric irritation B. poor inflammatory effect and Reye’s syndrome C. lack of liquid preparation and high toxicity effect D. need for frequent administration and association with Reye’s syndrome Answer D. Katzung, 9th edition, p. 579-581. Goodman and Gilman, 10th edition, p. 698. Agents which control prostaglandin effect / CNS Drugs 90. The intravenous anesthetic producing the socalled "dissociative anesthesia" is: A. fentanyl C. ketamine B. thiopental D. propofol Answer: C. Katzung, 9th edition, pp. 413-414. Gilman, 10th edition, pp. 346-347. General Anesthetic / CNS Drugs

Goodman and

91. Your patient requests you to give her a sedativehypnotic that not will not only calm her down or put her to sleep but will make her forget the whole operating room experience as well. To facilitate this request your drug regimen should include: A. midazolam C. phenobarbital B. succinylcholine D. etomidate Answer: A. Katzung, 9th edition, p. 413-415. General Anesthetic / CNS Drugs B 92. The process by which the amount of drug in the body is reduced after administration but before entering the systemic circulation is called A. Excretion B.

First-pass Effect

C. Metabolism D. First-order elimination MPL: 0.33 Page 43 C 93. Which of the following terms best describes an antagonist that interacts directly with the antagonist and not at all, or only incidentally, with the receptor? A. Pharmacologic antagonist B. Partial agonist C. Chemical antagonist D. Physiologic antagonist MPL: 0.33 Page 16 B 94. A child has swallowed the contents of 2 bottles of a nasal decongestant whose primary ingredient is a potent, selective  adrenoceptor agonist drug. The signs of alpha activation that may occur in this patient include A. Bronchodilation B.

Cardioacceleration

(tachycardia)

C. Vasodilation D. Pupillary dilation (mydriasis) MPL: 0.33 Page 127 A 95. Ms. Green has severe hypertension and is to receive minoxidil. Minoxidil is a powerful arteriolar vasodilator that does not act on autonomic receptors. When used in severe hypertension, its effects would probably include 5

A.

Tachycardia and increased cardiac contractility B. Tachycardia and decreased cardiac output C. Decreased mean arterial pressure and decreased cardiac contractility D. Decreased mean arterial pressure and increased salt and water excretion by the kidney MPL: 0.25 Page 170 B 96. Several children at a summer camp were hospitalized with symptoms thought to be due to ingestion of food containing botulinum toxin. The effects of botulinum toxin are likely to include A. Bronchospasm B.

Cycloplegia

C. Diarrhea D. Skeletal muscle spasms MPL: 1.0 Page 89 D 97. Parathion has which one of the following characteristics? A. It is less toxic to humans than malathion B. It is more persistent in the environment than DDT C. It is poorly absorbed through skin and lungs D. Its toxicity, if treated early, may be partly reversed by pralidoxime MPL: 0.5 Page 1029 B 98. Ms. Brown has had myasthenia gravis for several years. She reports to the emergency department complaining of rapid onset of weakness of her hands, diplopia, and difficulty swallowing. She may be suffering from a change in response to her myasthenia therapy, ie, a cholinergic or a myasthenic crisis. The best drug for distinguishing between myasthenic crisis (insufficient therapy) and cholinergic crisis (excessive therapy) is A. Atropine B.

Edrophonium

C. Physostigmine D. Pralidoxime MPL: 0.25 Page 103 D 99. A 30-year-old man has been treated with several autonomic drugs for 4 weeks. He is now admitted to the emergency department showing signs of drug toxicity. Which of the following signs would distinguish between an overdose of a ganglion blocker versus a muscarinic blocker? A. Blurred vision B.

Dry mouth, constipation

C. Physostigmine D. Postural hypotension MPL: 0.33 Page 116

6

B 100. Dilation of vessels in muscle, constriction of cutaneous vessels, and positive inotropic and chronotropic effects on the heart are all actions of A. Acetylcholine B.

B 107. A patient is admitted to the emergency department following a drug overdose. He is noted to have a severe tachycardia. He has been receiving therapy for hypertension and angina. A drug that often causes tachycardia is A. Diltiazem

Epinephrine

B.

C. Isoproterenol D. Metaproterenol MPL: 0.5 Page 130 A 101. Adverse effects that limit the use of adrenoceptor blockers include Heart failure exacerbation from blockers A. Impaired blood sugar response with -blockers B. Increased intraocular pressure with -blockers C. Sleep disturbances from -blocking drugs MPL: 0.5 Page 145 C 102. Which of the following binds covalently to the site specified? A. Atenolol -  receptor B. Carvedilol – cardiac  receptors C. Phenoxybenzamine- receptor D. Pindolol -  receptors MPL: 1.0 Page 141 B 103 Which one of the following is characteristics of enalapril treatment in patients with essential hypertension? A. Competitively blocks angiotensin II at its receptor B. Decreases angiotensin II concentration in the blood C. Decreases renin concentration in the blood D. Increases sodium and decreases potassium in the blood MPL: 0.5 Page 173 A 104 A visitor from another city comes to your office complaining of incessant cough. He has diabetes and hypertension and has recently started taking a different antihypertensive medication. The most likely cause of his cough is A. Captopril B.

Losartan

C. Propranolol D. Verapamil MPL: 0.5 Page 172 B 105. Verapamil is associated with all of the following, EXCEPT: A. Bradycardia B.

Hyperglycemia

C. Increased PR interval D. Pretibial edema MPL: 0.2 Page 172 A 106. The antianginal effect of propranolol may be attributed to which one of the following? A. Block of exercise-induced tachycardia B. Decreased end-diastolic ventricular volume C. Dilation of constricted coronary vessels D. Increased cardiac force MPL: 0.5 Page 195

Isosorbide dinitrate

C. Propranolol D. Verapamil MPL: 0.33 Page 185 B 108. Drugs that have been found to be useful in one or more types of heart failure include all of the following, EXCEPT A. Na+/K+ ATPase inhibitors B.

Alpha-adrenoceptors agonist

C. Beta-adrenoceptors antagonists D. ACE inhibitors MPL: 1.0 Page 127 D 109. The mechanism of action of digitalis is associated with A.

A decrease in calcium uptake by the sarcoplasmic reticulum B. An increase in ATP synthesis C. A modification of the acting molecule D. An increase in systolic intracellular calcium levels MPL: 0.33 Page 205 B 110. A patient with long-standing diabetic renal disease and hyperkalemia and recent-onset heart failure requires a diuretic. Which of the following agents would be LEAST harmful in a patient with severe hyperkalemia? (pp.256) A. Amiloride B.

Hydrochlorothiazide

C. Spironolactone D. Triamterene MPL: 1.0 Page 256 B

111. Inflammation is a complex tissue reaction that includes the release of cytokines, leukotrienes, prostaglandins, and peptides. Prostaglandins involved in inflammatory processes are produced from arachidonic acid by A. Cyclooxygenase -1 B.

Cyclooxygenase-2

C. Lipoxygenase D. Phospholipase A2 MPL: 0.5 Page 312 B 112. Which of the following situations constitutes an added risk of digoxin toxicity? A.

Administration of captopril

B.

Adminstration of quinidine

C. Hypermagnesemia D. Hyperkalemia MPL: 0.33 Page 230 A 113. Successful therapy of heart failure with digoxin will result in which one of the following? A. Decreased heart rate B.

Increased afterload

C. D.

Increased aldosterone Increased renin secretion 7

MPL: 1.0 Page 206 D 114. When used as an antiarrhythmic drug, lidocaine typically A. increases action potential duration B.

Increases contractility

C. Increases PR interval D. Reduces abnormal automaticity MPL: 0.25 Page 235 D 115. Which of the following is a recognized effect of nitric oxide (NO)? A. Arrhythmia B.

Bronchoconstriction

C. Constipation D. Pulmonary vasodilation MPL: 1.0 Page 329 C 116. One effect that theophylline, nitroglycerin, isoproterenol, and histamine have in common is A. Increased gastric acid secretion B. Direct stimulation of cardiac contractile force C. Tachycardia D. Postural hypotension MPL: 0.25 Page 1023 B

117.

Nedocromil 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 MPL: 0.5 Page 337 C 118 You are on your way to take an examination and you suddenly get an attack of diarrhea. If you stop at a nearby drugstore for an over-the-counter opioid with antidiarrheal action, you will be asking for A. Codeine B.

Dextromethorphan

C. Loperamide D. Diphenoxylate MPL: 1.0 Page 527 C

119. Conversion of plasminogen to plasmin is brought about by A. Aminocaproic acid B.

Heparin

C. Reteplase D. Warfarin MPL: 0.2 Page 572 D 120. Which of the following pairs of a drug effect and mechanism of action is accurate? A. Allopurinol action in gout: inhibits reuptake of uric acid from renal tubular fluid B. Etanercept antirheumatic action: inhibits dihydroorotate dehydrogenase, the enzyme in lymphocytes that is required for pyrimidine synthesis C. Hydroxychloroquine antirheumatic action: a cytotoxic drug that kills rapidly dividing lymphocytes

D.

Indomethacin closure of patent ductus arteriosus: blocks prostaglandin E production in the ductus arteriosis of the newborn MPL: 0.4 Page 605

B 121. A 52-year-old woman presented with intense pain, warmth, and redness in the first toe on her left foot. Examination of fluid withdrawn from the inflamed joint revealed crystals of uric acid. In the treatment of this woman’s acute attack of gout, the advantage of using indomethacin instead of colchicines is that indomethacin is A. Less likely to cause acute renal failure B. Less likely to cause severe diarrhea C. Less likely to precipitate sudden gastrointestinal bleeding D. More likely to prevent another acute attack MPL: 0.6 Page 605 A 122. A 27-year-old woman with amenorrhea, infertility, and galactorrhea was treated with a drug that successfully restored ovulation and menstruation. Before being given the drug, the woman was carefully questioned about previous mental health problems, which she did not have. She was advised to take the drug orally. The drug used to treat this patient was probably A. Bromocriptine B.

Desmopressin

C. Leuprolide D. Human gonadotropin hormone MPL: 0.5 Page 468 D 123. Methimazole reduces concentration of T3 primarily by

serum

A.

Accelerating the peripheral metabolism of T3 B. Inhibiting the proteolysis of thyroidbinding globulin C. Inhibiting the secretion of TSH D. Preventing the addition of iodine to tyrosine residues on thyroglobulin MPL: 0.6 Page 651 C 124. Pharmacologic glucocorticoids include

effects

of

A.

Increased muscle mass

B.

Hypoglycemia

exogenous

C. Inhibition of leukotriene synthesis D. Improved wound healing MPL: 0.33 Page 665 D 125. Toxic effects of long-term administration of a glucocorticoid include A. A “lupus-like” syndrome B. Adrenal gland neoplasm C. Hepatotoxicity D. Osteoporosis MPL: 0.33 Page 670 D 126. For patients who have been on long-term therapy with a glucocorticoid and who now wish to discontinue the drug, gradual tapering of the glucocorticoid is needed to allow recovery of A. Depressed release of insulin from pancreatic B cells 8

B. C. D.

Hematopoiesis in the bone marrow Normal osteoblast function The hypothalamic-pituitary-adrenal system MPL: 0.6 Page 671 B 127. The estrogen that is used in most combined hormonal contraceptives is A. Clomiphene B.

Ethinyl estradiol

B.

Hypoglycemia

C. Pancreatitis D. Severe hypertension MPL: 1.0 Page 721

Neurologic effects, including headache, dizziness, and lethargy B. Hematuria C. Fanconi’s aminoaciduria syndrome D. Skin reactions MPL: 0.2 Page 793 C 135. On her release from hospital, the patient is advised not to rely solely on oral contraceptives to avoid pregnancy because they may be less effective while she is being maintained on antimycobacterial drugs. The agent most likely to interfere with the action of oral contraceptives is A. Ethambutol

B 130. Which of the following drugs is MOST likely to cause hypoglycemia when used as monotherapy in the treatment of type 2 diabetes? A. Acarbose B.

D 131. A patient needs antibiotic treatement for native valve, culture-positive infective entericoccal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with A. Amoxicillin-clavulanate Aztreonam

C. Meropenem D. Vancomycin MPL: 0.4 Page 768

C 136. Chemical interactions between this drug and cell membrane components can result in the formation of pores lined by hydrophilic groups present in the drug molecule A. Caspofungin B.

D 137. Which of the following statements about fluconazole is most accurate? A. it is highly effective in treatment of aspergillosis B. It does not penetrate the bloodbrain barrier C. Its oral bioavailability is less than that of ketoconazole D. It inhibits demethylation of lanosterol MP[L: 0.25 Page 819 D 138. Which of the following drugs binds to a viral envelope protein preventing the conformational changes required for the fusion of viral and cellular membranes? A. Abacavir B.

A.

D 133. In patient with culture-positive enterococcal endocarditis who has failed to respond to vancomycin because of resistance, the treatment most likely to be effective is

Griseofulvin

C. Nystatin D. Fluconazole MPL: 0.25 Page 1049

C 132. The mechanism of antibacterial action of tetracyclines involves Binding to a component of the 50S ribosomal subunit B. Inhibition of translocase activity C. Blockade of binding of aminoacyltRNA to bacterial ribosomes D. Selective inhibition of ribosomal peptidyl transferases MPL: 0.33 Page 776

Isoniazid

C. Rifampin D. Pyrazinamide MPL: 1.0 Page 806

Glyburide

C. Miglitol D. Rosiglitazone MPL: 0.4 Page 726

B.

B.

Excessive weight gain

C. Lactic acidosis D. Hypoglycemia MPL: 0.5 Page 728

Erythromycin

A.

C 129. A 54-year-old obese patient with type 2 diabetes and a history of alcoholism probably should not receive metformin because it can increase the risk of A. A disulfiram-like reaction B.

B.

D 134. Which of the following adverse effects is most likely to occur with sulfonamides?

B 128. The most likely complication of insulin therapy in this patient is Dilutional hyponatremia

Clarithromycin

C. Minocycline D. Linezolid MPL: 1.0 Page 782

C. DES D. Norgestrel MPL: 1.0 Page 682

A.

A.

No 139.

140.

Adenavir

C. Oseltamivir D. Enfuvirtide MPL: 0.33 Page 820 Question Which of the following is NOT an expected effect of muscarinic instilled into the conjunctival sac? a. Contraction of the smooth muscle of the iris sphincter b. Contraction of the ciliary muscle c. Mydriasis d. Improves aqueous humor outflow in the canal of Schle Nausea, vomiting, diarrhea, urinary urgency, salivation, s cutaneous vasodilation and bronchial constriction are cause overdose of: a. Ipratropium b. Pirenzepine c. Benztropine d. Pilocarpine 9

141.

142.

143.

144.

145.

146.

147.

147.

148.

149.

150.

151.

In normal individuals and more so in patients with airway disease, most the common adverse effects of this drug is: administration of this agent causes cause some bronchodilation and a. hepatotoxicity reduction in secretion. b. hypersensitivity lung reaction a. Atropine c. nausea and mucosal ulcers b. Metacholine d. pseudolymphomatous reactions c. Carbachol 152. This antihypertensive drug is approximately equipotent to pro d. Bethanechol in inhibition stimulation of 1-adrenoceptors but 50- to 100potent than propranolol in blocking 2-adrenoceptors. a. Nadolol, This agent relieves motion sickness and is as effective as any more b. Carteolol recently introduced agent but causes significant sedation and dry c. Pindolol mouth. d. Metoprolol a. Oxybutinin 153. This antihypertensive agent illustrates how one person’s toxic b. Scopolamine be another person’s therapy in that it causes hirsutism, w c. Tolterodine bothersome in women but a topical formulation is used to s d. Darifenacin hair growth, which is beneficial for many men. AL, 25y.o. male patient is brought to the emergency room suffering a. Diltiazem from bronchospasm, mucous membrane congestion, angioedema, and b. Hydralazine severe hypotension. The appropriate drug is: c. Minoxidil a. Phenylephrine d. Methyldopa b. Ephedrine c. Amphetamine d. Epinephrine BM, 50 yo female is asthmatic and hypertensive. The following class of drugs should be avoided as maintenance treatment for her hypertension. a. ACE inhibitors 154. This antihypertensive drug may cause severe hypoten b. Calcium channel blockers hypovolemic patients, acute renal failure. Hyperkalemia, dr c. Beta-blockers sometime accompanied by wheezing, and angioedema. d. Diuretics a. Captopril Which of the following CNS neurotransmitters has only an inhibitory b. Methyldopa mechanism of action? c. Reserpine a. GABA d. Sodium nitroprusside b. Acetylcholine 155. MF, 45 yo female with evidence of chronic kidney disease w c. Glutamate diagnosed with hypertension. Which of the following drugs d. 5-Hydroxttryptamine helpful for both of her conditions> Which among the following sedative-hypnotic drugs has the longest a. Metoprolol elimination half-life and is ingested as a prodrug that is hydrolyzed to b. Hydrochlorothiazide its active form in the stomach? c. Captopril a. Alprazolam d. Nifedipine b. Lorazepam 156. GG, 68 yo female teacher has chronic heart failure with left ve c. Oxazepam dysfunction but no edema. The first drug to be used for her are d. Clorazepate a. - blockers This drug is a novel hypnotic drug prescribed for patients who have b. Diuretics difficulty in falling asleep. In polysomnography studies of patients with c. Calcium blockers chronic insomnia, this drug reportedly reduced the latency to persistent d. ACE inhibitors sleep with no rebound insomnia or withdrawal symptoms. 157. Chloroquine is effective in the treatment of nonfalciparum and s a. Remelteon falciparum malaria but it causes which of the following comm b. Buspirone effects? c. Diazempam a. pruritus d. Triazolam b. hemolysis EJ, 35 yo executive often awakens early in the sleep cycle and could c. alopecia hardly go to sleep again. He may probably benefit from which of the d. hypotension following drugs? 158. The common adverse effects of Quinine in treating falciparum a. Flurazepam include the following, except b. Clorazepate a. tinnitus c. Zolpidem b. hemoglobinuria d. None of the above c. flushing d. visual disturbances 159. TT, 7yo male public elementary school student develops mi transmitted helminthic infections. Which of the following appropriate? a. Pyrantel pamoate b. Praziquantel GM, 30 yo female experiences visual scotomas followed after around c. Mebendazole 30 minutes by a severe throbbing right-sided headache that would last d. Metronidazole 4 – 8 hours if untreated. Which group of drugs isalmost160. exclusively This group of antimicrobials kills bacterial cells interfering used for this condition? transpeptidation reaction of bacterial cell wall synthesis a. Triptans a. Tetracyclines b. Propranolol b. -lactam antibiotics c. Topiramate c. Macrolides d. Valproate d. All of the above This drug is effective in reducing pain of mild to moderate intensity through its effects on inflammation and because it probably inhibits 161. The following penicillins are resistant to Staphylococc pain stimuli at a subcortical site. lactamases, except a. Paracetamol a. Methicicillin b. Tramadol b. Amoxicillin c. Aspirin c. Nafcillin d. All of the above d. Cloxacillin IT, 60 yo male suffers from excruciatingly painful inflammation of the 162. Which of the following drugs is more stable to bacterial -lactam big toe after binge eating. The following agents may be helpful except? a. Penicillin G a. Indomethacin b. Amoxicillin b. Colchicine c. Cephalexin c. Tolmetin d. None of the above d. None of the above YH, 62 yo female is suffering from rheumatoid arthritis. Her physician strongly believes that this condition causes significant systemic effects 163.mobility The class of cephalosporins with expanded gram-negative c which shorten life in addition to the joint disease that reduces with some agents being able to cross the blood-brain barrier, bu and quality of life. He decides to give her metothrexate, the diseaseagents effective vs. P aeruginosa. modifying antirheumatic drug (DMARD) of choice for her condition. The a. First generation 10

164.

165.

166.

167.

168.

A. Bioavailability b. Second generation C. Cmax c. Third generation B. Clearance d. Fourth generation D. half-life ME, 33 yo male develops pneumonia and was given penicillin but develops allergy. He was given an alternative drug which had to be ANS A p. 40 discontinued because of gastrointestinal intolerance due to direct stimulation of gut motility. This drug is most probably. _____ 174. A laboratory experiment is being conducted a. Cefalexin in which an animal is injected with a nonb. Amoxicillin-clavulanic acid competitive antagonist to the histamine receptor. c. Minocycline Which of the following best describes this drug? d. Erythromycin This agent participates in conversion of diatary folate A.to The drug binds to the histamine receptor and tetrahydrofolate and isomerization of methylmalonyl-CoA to succinyl partially activates it. B. The drug binds to the histamine receptor but CoA and is effective in the treatment of megaloblastic anemia. does not activate it. Vitamin B12 a. C. The drug binds to the receptor, but not Iron b. where histamine binds and prevents the Erythropoietin c. receptor from being activated. None of these d. BV, 45 year old female suffers from chronic kidney disease dueD.to The drug irreversibly binds to the histamine diabetic nephropathy leading to recurring anemia. Which of the receptor and renders it ineffective. following agents is most useful for this patient? ANS C p. 16 a. Iron b. Folate _____ 175. The rate and extent of absorption of a drug c. Erythropoietin is decreased by: d. Interleukin A. inhibition of P-glycoprotein transporter of carbon-nitrogen bond TU, 3 yo male has manifest slowing down of bodily functions leadingB.to addition striking retaration of growth and development leading to very slow ( quaternary amine ) C. inhibition of gut wall metabolism growth and some degree of mental retardation. The most satisfactory D. low ionization constant preparation for replacement therapy in this case is. a. Liothyronine ANS B p. 41 b. Levothyroxine c. Methimazole _____ 176. At low doses, dobutamine receptor d. Propylthiouracil selectivity and activity will primarily result to: A. bronchodilation C. uterine contraction B. dilatation of renal bladder vessels D. increase in cardiac con trac tilit GF, 25 yo female manifests with warm moist skin, sweating, heat y intolerance, periorbital edema, retraction of upper lid with wide stare, ANS D p.133 exopthalmos an diplopia. The management of this condition involves

the following, except: _____ 177. Antiarrythmic with the most marked Ka. Methimazole blocking effect b. Thyroidectomy A. lidocaine c. 131 Iodine C. quinidine d. None of the above 169. This agent is a prohormone that serves as a precursor to a numberB.of amiodarone D. verapamil biologically active metabolites, including calcitriol. a. Calcimimetics ANS B pp 228 b. Vitamin D c. Calcitonin _____ 178. Blocks the final common pathway of d. None of these platelet aggregation: 170. Which of the following is an inscription and translation of a violative A. ticlopidine prescription based on the Generics Act of 1988? C. abciximab a. Paracetamol 500mg tabs ----------------#20 B. clopidogrel b. Amoxil 500 mg caps ---------------------#21 D. ASA c. Ponstan (Mefenamic Acid) 500 mg ---#12 d. B an C are violative prescriptions _____ 179. Drug interaction seen with concomitant spironolactone and ACE inhibitor use Basic and Clinical Pharmacology by: Bertram G. A. ACE inhibitors may decrease renal perfusion th Katzung, 10 edition, 2007 decreasing the action of spironolactone in the collecting tubules _____ 171. All of the following factors can affect the B. Additive afterloader effect rate and extent of drug absorption EXCEPT C. Enhanced hyperkalemia* A. lipophilicity D. Enhanced vasodilating effect of ACE C. protein binding inhibitors because of inhibition of B. intestinal motility metabolism by spironolactone D. presence of P glycoprotein transporter ANS C p. 177

ANS C p.41 _____ 172. Which of the following factors is TRUE regarding drug distribution? A. All drugs distribute to the same degree in all tissues. B. The binding of drugs to tissues has no relationship to the distribution of drug in the body. C. In general, a drug with a higher degree of plasma protein binding will have a lower Vd. D. In general, lipophilic drugs distribute to a lesser extent than hydrophilic drugs ANS C p. 34 _____

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

_____

180. The following anti-hypertensive drug should be used with caution in patients on potassiumsparing diuretics A. losartan* C. hydrochlorthiazide B. verapamil D. methyldopa ANS A p. 177

_____

181. Accumulation of bradykinin due to ACE inhibition is responsible for these adverse effects EXCEPT one: A. cough C. angioedema 11

B.

hypotension D. hyperkalemia

ANS C p. 199-202

ANS D p. 177 _____ 182. The absence of reflex tachycardia with the use of ACE inhibitors is due to A. downward resetting of the baroreceptor B. mild decrease in peripheral vascular resistance C. enhanced sympathetic activity D. inhibition of RAA system

_____

ANS A p. 176 _____

183. This adverse effect of nitrates can be prevented by providing nitrate-free interval between administration A. dependence C. tolerance B. hypotension D. tachycardia

ANS A p. 133 _____

ANS D p. 186 _____

184. Which of the following drug combinations will give the best hemodynamic effects of decreasing filling pressure and increasing cardiac output in CHF patients? A. furosemide and dopamine C. captopril and digoxin B. digoxin and verapamil D. furosemide and digoxin ANS A p. 208

_____

185. The drug of choice for converting paroxysmal atrial tachycardia to normal sinus rhythm A. propranolol C. quinidine B. adenosine D. flecainide ANS B p. 231

_____

_____ 187. The risk of Torsades des pointes is highest with the use of A. sotalol C. bretylium B. flecainide D. amiodarone

_____ 193. Rapid intravenous administration of this drug may cause respiratory depression: A. phenytoin C. phenobarbital B. lamotrigine D. carbamazepine ANS C p.359 _____ 194. This drug increases free phenytoin levels due to protein binding displacement. A. Cimetidine C. chloramphenicol B. salicylates D. isoniazid ANS B p.377 _____

188. Drug-induced lupus is an adverse effect of A. procainamide C. disopyramide B. amiodarone D. amiloride

_____

189. A 60 year old male has dilated cardiomyopathy and is on digoxin. He complains of nausea and vomiting and you think he has digitalis toxicity. Which of the following drugs he is taking most likely enhanced this? A. Furosemide* C. spironolactone B. Carvedilol D. captopril ANS A p. 204

_____ 190. The positive inotropic action of cardiac glycosides is associated with A. an increase in ATP synthesis B. a modification in actin molecule C. decreased outward flow of calcium* D. a decrease in calcium uptake by the sarcoplasmic reticulum

195. Which of the following antidepressants will produce a life-threatening syndrome of hyperthermia, muscle rigidity and myoclonus when administered with MAO? A. Fluoxetine C. imipramine B. trazodone D. clomipramine ANS A p. 486

_____ 196. Ideally, baseline liver function tests are done prior to giving this anticonvulsant A. topiramate C. valproic acid B. levetiracetam D. gabapentin ANS C p. 387

ANS D p. 223 _____

192. A.M. a 55 year old known hypertensive was found to have heart block on ECG. Which of the drugs below should not be given? A. Spironolactone C. captopril B. Verapamil* D. prazosin ANS A p. 175; 230

186. This class I antiarrhythmic drug has marked negative inotropic action and therefore should not be used in patient with heart failure A. quinidine C. disopyramide B. procainamide D. lidocaine ANS D p.225

191. A patient in CHF has developed oliguria because of low cardiac output. To improve renal perfusion, dopamine must be given at this dose in ug/kg/min A. 2* C. 15 B. 10 D. 20

_____

197. Elimination of this anticonvulsant is enhanced significantly by alkalinization of the urine A. Phenobarbital C. valproic acid B. Carbamazepine D. phenytoin ANS A p.380

_____

198. Orthostatic hypotension is most common with which of the following antipsychotic agents: A. Perphenazine C. chlorpromazine B. Haloperidol D. olanzapine ANS C p.461

_____ 199. Carbamazepine exerts its antiepileptic effect through A. inhibition of low threshold transient Ca++ current 12

B.

inhibition of neurotransmission by NMDA and non-NMDA receptors C. reduction of Na+ current D. enhancement of post-synaptic GABA receptor current ANS C p. 378

B.

ANS A pp. 774-775 _____

_____ 200. Based on the mechanism of action, the following antimicrobial is NOT selectively toxic: A. piperacillin C. amphotericin B B. cotrimoxazole D. gentamicin ANS B p. 763 _____ 201. Which of the following antibiotics is effective against both aerobes and anaerobes? A. metronidazole C. aztreonam B. gentamicin D. chloramphenicol

_____ 210. Aromatase inhibitor used in the treatment of breast cancer A. Tamoxifen C. anastrazole B. Danazol D. leuprolide ANS C p. 673

_____

202. This antibiotic is frequently associated with 8th nerve damage in the offspring if given to pregnant women, thus classified under pregnancy risk category D A. Clarithromycin C. ciprofloxacin B. Tetracycline D. streptomycin ANS D p. 759

_____

203. Maculopapular rash with this antibiotic is non-immunologic in nature and does not preclude the use of chemically related antibiotics in the future A. Erythromycin C. amoxicillin B. Cefalexin D. cotrimoxazole ANS C p. 733

_____

204. A 15 year old college student came in because of headache, fever, chills and photophobia. Thick and thin smears showed P. vivax. The oral drug of choice to rid the blood of plasmodia is A. Quinine C. mefloquine B. Primaquine D. chloroquine ANS D p.846 against

the

_____

206. The following antiviral agents DOES NOT require activation by phosphorylation and it directly inhibits DNA and RNA polymerases as well as HIV reverse transcriptase A. penciclovir C. cidofovir B. acyclovir D. foscarnet

ANS C p. 700 _____

ANS D p. 773 _____

208. A 50 year old male receiving anti-TB treatment develops mono-articular arthritis. Which of the following could have caused it? A. pyrazinamide and ethambutol C. ethambutol + streptomycin

213. This drug is an estrogen agonist in the bone but an estrogen antagonist in breast tissue: A. raloxifene C. tamoxifen B. alendronate D. calcitonin ANS A p. 672

_____ 214. This is essential for the antithyroid activity of thioamides: A. phenyl group C. thiocarbamide group B. methyl group at 3’ D. iodide substituent at 3’ ANS C p.625 _____

215. The main mechanism for its effectiveness in diabetics is the release of endogenous insulin A. sulfonylurea C. biguanide B. thiazolidinedione D. alpha glucosidase inhibitor ANS A p. 694

_____

216. The main action as anti-diabetic agent is to stimulate the nuclear receptors that regulate the transcription of genes encoding proteins involved in protein and carbohydrate metabolism A. insulin C. sulfonylurea B. thiazolidinedione D. biguanide

ANS D p. 797 _____ 207. The following adverse reaction to isoniazid is age-related A. SLE like syndrome C. neuropathy B. Hemolysis D. hepatitis

211. Which of the following statements is TRUE regarding the direct genomic pharmacodynamic action of glucocorticoids (GC)? A. GCs diffuse into cell cytoplasm and into nucleus where it binds to glucocorticoid response element (GRE) and act as transcription factor, upregulating gene transcription B. GCs diffuse into cell cytoplasm and bind to steroid receptors leading to release of heat shock proteins and dimerization of steroid – receptor complexes which translocate into nucleus and bind to GRE, inducing or inhibiting gene transcription C. GCs diffuse into cell cytoplasm, binding to steroid receptors, the steroid-receptor complexes then bind to transcription factor inhibiting synthesis of pro-inflammatory cytokines D. GCs activate cell membrane enzymes leading to formation 2nd messenger ANS B p. 639

_____ 212. The main mechanism of action is to lower post meal glycemic excursion: A. metformin C. acarbose B. glipizide D. nateglinide

ANS A p. 872 _____

209. Of the following, the mechanism of actions of this antifungal does not involve inhibition of cell membrane synthesis A. Terbinafine C. flucytosine B. Fluconazole D. griseofulvin ANS C p. 784

ANS D p. 752

_____ 205. Mebendazole is effective following parasites EXCEPT A. capillaria philippinensis C. necator americanus B. ascaris lumbricoides D. trichuris trichiuria

rifampicin + pyrazinamide D. ethambutol + INH

ANS A p. 686 13

_____

217. Which of the following glucocorticoids has the least mineralocorticoid effect and is best for decreasing cerebral edema associated with increased intracranial pressure? A. Prednisone C. dexamethasone B. Hydrocortisone D. prednisolone ANS C p. 641-644

_____ 218. Organophosphate toxicity results from its ability to A. interrupt heme synthesis B. inhibit acetycholinesterase C. compete with brain pyridoxal phosphate D. react with sulfhydryl groups binding to protein and other enzymes

224.Sedative-Hypnotic with low solubility penetrate the brain slowly includes: A. Phenobarbital B. Flumazenil C. Trimethadione D. Valproic acid

Application Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 354 225.The following drugs/substance of abuse are CNS stimulants, EXCEPT: A. Gamma-hydroxybutyric acid (GHB) B. Cocaine C. Amphetamine D. Methylenedioxy-Methamphetamine (MDMA, Ecstasy)

ANS B p 968 219.A class of proteins that functions as drug receptors that mediate the actions of endogenous chemical signals such as neurotransmitters and hormones: A. enzymes B. regulatory proteins C. structural proteins D. transport proteins Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 11 220.Receptor/s coupled to G protein that modulate the production of intracellular second messengers include/s A. muscarinic receptor B. alpha adrenergic receptor C. leukotriene receptor D. all of the above

Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 520 226.Characteristic physiologic intoxication includes: A. increased pulse rate B. pale conjunctivae C. miotic pupil D. high blood pressure

Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 437

Cannabis

Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 415 228.Painless digital vasospasm is a dose-related complication of long term treatment with: A. Levodopa B. Bromocriptine C. Selegiline D. Tolcapone Recall Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 453

Application Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, pp. 130 - 131

Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 360

of

227. Which among these intravenous general anesthetics produces a dissociative type of anesthesia? A. Propofol B. Ketamine C. Thiopental D. Midazolam

222.Therapeutic benefit/s of 2 receptor agonists include: A. antihypertensive B. antiglaucoma C. antidiarrheal D. all of the above

223.Non-benzodiazepine that has affinity for the Benzodiazepine receptors: A. Zolpidem B. Midazolam C. Alprazolam D. All of the above

sign

Application Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 526

Application Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 22 221.The neuromuscular blocker succinylcholine acts by: A. Depolarizing muscle endplate receptors B. Repolarizing muscle endplate receptors C. Inhibiting the release of acetylcholine from the nerve ending D. Blocking the access of acetylcholine at the myoneural junction

and

229.The peripheral metabolism to Levodopa can be prevented if it is given concomitantly with: A. Carbidopa B. Amantadine C. Biperiden D. Bromocriptine

Application Answer: A Reference: KATZUNG, Pharmacology, ninth edition, p. 449, p. 454

Basic

and

Clinical

230.An overdose of this opioid causes mydriasis instead of the characteristic miosis of opioid toxicity: A. Hydromorphone B. Meperidine C. Methadone D. Morphine Application Answer: B 14

Reference: KATZUNG, Pharmacology, ninth edition, p. 511

Basic

and

Clinical

231.Which of these group of tissues would be the first to take up appreciable amounts of inhalational anesthetics? A. Fat B. Muscle C. Vessel-rich D. Vessel-poor Recall Answer: C Reference: KATZUNG, Pharmacology, ninth edition, p. 405

Basic

and

Clinical

232.A narcotic-addicted patient is given this drug as a “substitute” to be able to control the withdrawal symptoms: A. Hydromorphone B. Meperidine C. Methadone D. Disulfiram Recall Answer: C Reference: KATZUNG, Basic and Pharmacology, ninth edition, p.510, p. 520

Clinical

233.The duration of action of the intravenous barbiturate anesthetic thiopental is largely determined by: A. Spontaneous degradation B. Hepatic extraction C. Renal clearance D. Redistribution Application Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 412 234.This drug inhibits binding of leukotriene D4 to its receptor on target tissues A. Montelukast B. Zilenton C. Ipratropium bromide D. Omalizumab Recall Answer: A Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 330

Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 652 238.The most common adverse effect of Aspirin is A. gastric upset and ulcers B. renal toxicity C. asthma D. hepatotoxicity Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 581 239.A uricosuric drug that decreases body pool of urate in patients with tophaceous gout is A. Allopurinol B. Colchicine C. Probenecid D. Meloxicam Recall Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 598 240.Sinoatrial and atrioventricular nodal tissue are affected markedly by A. Diltiazem B. Verapamil C. Nifedipine D. Amlodipine Recall Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 196 241.The beneficial effect of Captopril in patients with heart failure is attributed to: A. reduction in afterload B. increased preload C. increased myocardial contractility D. all of the above Application Answer: A Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 209

Clinical

Clinical

235.The mechanism of action of corticosteroids in the treatment of bronchial asthma includes A. directly relax airway smooth muscle B. enhance bronchial reactivity C. inhibit airway mucosal inflammation D. prevent release of chemotactic agents

242.Beta blockers with membrane-stabilizing action, useful as anti-arrhythmics include: A. Metoprolol B. Propranolol C. Acebutolol D. All of the above

Recall Application Answer: D Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, Reference: KATZUNG, Basic and Clinical Pharmacology, ninth ninth edition, p. 151 edition, p. 328 243.Which of the following antiarrhythmic drugs act by blocking sodium channel? 236.A non-steroidal anti-inflammatory drug that A. Lidocaine irreversibly acetylates and blocks platelet B. Verapamil cycloocygenase is C. Sotalol A. Naproxen D. Adenosine B. Mefenamic acid C. Aspirin Application D. Ibuprofen Answer: A Reference: KATZUNG, Basic and Clinical Recall Pharmacology, ninth edition, p. 226 Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, 244.Antibiotic/s shown to be effective when ninth edition, p. 577 applied topically in the treatment of acne vulgaris include/s: 237.Corticosteroids must be used with great A. Clindamycin caution in patients with B. Erythromycin A. osteoporosis C. Metronidazole B. varicella D. All of the above C. peptic ulcer Application D. all of the above Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, Application ninth edition, p. 1017 Answer: D 15

245.This organophosphate compound is thought to have a cholinesterase inhibitory action which temporarily paralyzes the adult Schistosoma haematobium worms. A. Metrifonate B. Niclosamide C. Mebendazole D. Pyrantel pamoate Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 891 246.Which of these drugs selectively inhibits microtubule synthesis and glucose uptake in nematodes? A. Piperazine B. Mebendazole C. Pyrantel pamoate D. Diethylcarbamazine citrate Application Answer: B Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 891

Clinical

247.For onchocerciasis and strongyloidiasis, this drug is the first choice because it causes fewer systemic and ocular reactions: A. Diethylcarbamazine citrate B. Metrifonate C. Ivermectin D. Bithionol Application Answer: C Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 890 248.Most of the serious adverse Penicllins are due to: A. Blood dyscrasias B. Hypersensitivity reactions C. CNS reactions D. Hepatic impariment

Clinical

effects

Application Answer: B Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 741

of

patients whose gonococci are resistant to other drugs is: A. Ofloxacin B. Tetracycline C. Doxycycline D. Spectinomycin Recall Answer: D Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 771

Clinical

253.Excessive anticoagulant effect results in bleeding from Warfarin can be reversed by: A. discontinuance of the drug B. administration of Vitamin K C. administration of fresh frozen plasma D. all of the above Application Answer: D Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 552

Clinical

254.The amount of elemental iron per 325 mg tablet of hydrated ferrous sulfate is ___ mg: A. 36 B. 65 C. 80 D. 106 Application Answer: B Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 531

Clinical

255.The preparation of choice for thyroid replacement and suppression therapy is: A. Liothyronine B. Levothyroxine C. Dessicated thyroid D. Thyrogloculin Recall Answer: B Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 630

Clinical

Clinical

256.The combination of estrogens and progestins exert their contraceptive effect largely through 249.The following anti-TB drugs are potentially A. inhibition of pituitary function hepatotoxic, EXCEPT: B. production of a mucoid cervical A. RIfampin secretion B. Isoniazid C. alteration in the motility of the C. Pyrazinamide uterine tubes D. Streptomycin D. enhancement of the rupture of the ovarian follicle Recall Application Answer: D Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth Reference: KATZUNG, Basic and Clinical Pharmacology, edition, p. 784-786 ninth edition, p. 673 250.This Anti-TB is relatively contraindicated in young children whose visual acuity and red-green color assessment can not be adequately assessed: A. Isoniazid B. Rifampin C. Ethmabutol D. Pyrazinamide Recall Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 785 251.This antibacterial is available as a nasal ointment useful in the elimination of nasal carriage of Staphylococcus aureus: A. Neomycin B. Muprocin C. Polymycin B sulfate D. Bacitracin Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 1016 252.A drug that is used almost solely as an alternative treatment for gonorrhea in

257.The most dangerous complication Thioamides is: A. lupus-like reaction B. hepatitis C. agranulocytosis D. exfoliative dermatitis Recall Answer: C Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 633

of

Clinical

258.The major use of this drug is in the treatment of endometriosis A. Nifepristone B. Danazol C. Tamoxifen D. Clomiphine Recall Answer: B Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 680

Clinical

259.The best treatment option for an obese patient with NIDDM with associated insulin resistance syndrome is: A. Glibenclamide 16

B. C. D.

Metformin Repaglimide Acarbose

Application Answer: B Reference: KATZUNG, Basic and Pharmacology, ninth edition, p. 708

Clinical

260.Treatment Regimen III as indicated in the National Tuberculosis Control Program consists of: A. 2 HRZES B. 2HRZ / 4HR C. 2HRZE / 4HR D. 2HRZES / 1 HREZ / 5HRE Application Answer: B Reference: Treatment Regimens

National

TB

Control

Program,

261.The study of the absorption, distribution, metabolism and excretion of drug is known as: A. Pharmacodynamics B. Pharmacokinetics C. Phamacotherapeutics D. Pharmacology Ans. B p. 5

262.First – pass effect is more likely to occur with this route of administration : A.Oral B.Buccal C.Sublingual D.Rectal Ans. A p. 43 263.Inert binding sites bind a drug without initiating events leading to a drug effect. They are located in: A.True receptors B.Spare receptors C.Plasma proteins D.Ttissue proteins Ans. C p. 5

Drug B

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

Drug A

B. Drug B has a greater efficacy than

C. Drug A is more potent than Drug B D. Drug B is more potent than Drug A Ans. C p.28 265.Drugs with very high volume of distribution: A. are completely retained within the vascular compartment B. have higher concentrations in extravascular tissue C. are homogeneously distributed in blood D. have minimum possible volume of distribution Ans.B p.34

268.Selective COX-2 inhibitors differ from nonselective COX inhibitors in that selective COX-2 inhibitors have no: A. analgesic-antipyretic and antiinflammatory effects B. gastrointestinal side effects C. effects on platelet aggregation D. renal toxicities Ans. B p. 582 269.Pharmacologic effects of alcohol include stimulation of the: A. central nervous system B. heart C. smooth muscles of the blood vessels D. secretion of gastric acid Ans. D p. 368 270.One of the following general anesthetics with their respective blood:gas partition coefficients is most soluble in blood: A.Nitrous oxide 0.47 B. Enflurane 1.40 C. Halothane 2.30 D. Methoxyflurane 12.0 Ans. D p. 403 271.Reserpine blocks this step in adrenergic transmission: A. synthesis of the transmitter B. incorporation of norepinephrine into the vesicle C. release of the neurotransmitter D. reuptake into presynaptic neuron Ans. B p. 169 272.A 24 year old male was brought to the emergency room after having allegedly drank poison. He had constricted pupils, was noted to have salivation and sweating, wheezing, vomiting and diarrhea: The poison must have been: A. atropine B. organophosphate C. opiate D. ephedrine Ans. B p. 101 273.Therapeutic applications of atropine include/s: A. peptic ulcer B. bradycardia caused by myocardial infarction C. urinary retention D. constipation Ans. B p. 115 274.Mechanism of action of pralidoxime: A. competitive antagonism B. noncompetitive antagonism C. physiologic antagonism D. regeneration of the enzyme Ans. D p. 117 275.Compared to norepinephrine, epinephrine has more effects on: A. alpha 1 receptors B. alpha 2 receptors C. beta 1 receptors D. beta 2 receptors Ans. D p. 133

266.Bioavailability of a drug is 100% following this route of administration: A. subcutaneous B. intramuscular C. transdermal D. intravenous Ans. D p.41

276.Drugs like quinidine, procainamide and disopyramide are useful in the treatment of: A. congestive heart failure C. status asthmaticus B. thyrotoxicosis D. arrhythmia

267.Drug biotransformation may result in formation of: A. inactive metabolites B. reactive intermediates that are toxic to various organs C. an active substance from a prodrug D. all of the above Ans. D p. 5556

Ans. D. pp. 227-229 277.A 65-year old male was admitted at the intensive care unit disoriented with a blood pressure of 220/120. Which of the following drugs will be most appropriate: A. Sodium nitroprusside C. Methyldopa B. Clonidine D. Aldactone 17

Ans. A p. 175 278.Propranolol and other beta-adrenergic receptor antagonist have the following effect/s on the heart that makes them useful as antiarryhthmic agents: A. Depress automaticity C. Reduce heart rate B. Prolong A-V conduction D. All of the above Ans. D. p. 232 279.All of the following are true of sodium nitroprusside EXCEPT: A. The gold standard for use in hypertensive crisis B. Mechanism of vasodilating effects similar to nitrates C. Sensitive to light D. Metabolite is pharmacologically inert Ans. D. p.175 280.In patients with congestive heart failure, the use of angiotensin converting enzyme inhibitors will increase A. peripheral resistance C. salt and water excretion B. preload D. sympathetic activity Ans. C p. 209 281.One of the following antianginal agents is contraindicated in patients with vasospastic angina: A. Propranolol C. Diltiazem B. Verapamil D. Isosorbide dinitrate Ans. A. p. 198 282.Methyldopa as antihyperatensive agent exerts its effect by conversion to alphamethylnorepinephrine which stimulates centrally this receptor: A. alpha-1 C. alpha-2 B. Beta-1 D. Beta-2 Ans. C. p. 166 283.Aminopenicillins, Carboxypenicillins and Ureidopenicillins compared to Penicillin G: A. Are not effective for oral adminsitration B. Have lesser tendency to cause hypersensitivity reaction C. Have greater activity against gramnegative bacteria D. Are resistant to B-lactamse A ns. C. p. 741 284.Clavulanic acid is added to Ampicillin in order to: A. Prevent occurrence of diarrhea B. Protect the beta-lactam ring from destruction C. Increase the bioavailability by increasing absorption D. Increase the pH of gastrointestinal tract Ans . B. p. 741 285.The most common side effect erythromycin is: A. Gastroinetstinal upset B. C. D.

of

“red neck” syndrome Pseudomembranous colitis Nephrotoxicity Ans. A p. 759 286.Bacterial synergism is produced by the following drug combination: A. Tetracycline and penicillin G B. Cephalexin and gentamycin

C. D.

Tetracycline and chloramphenicol Tetracycline and streptomycin Ans. B p. 846

287.This antimicrobial drug may provoke acute gouty arthritis: A. Pyrazinamide B. Ethambutol C. INH D. PAS Ans. A p. 786 288.This agent is proven effects for influenza A: A. Riboxinin B. Acyclovir C. Zidoxcedine D. Amantadine Ans. D p. 824

289.This agent apparently acts as a GABA agonist at the neuromuscular junction and causes flaccid paralysis of the nematode: A. Mebendazole B. Piperazine C. Bephenrium D. Pyrantel Ans. B p. 861 290.This antimicrobial agent is also effective for amebic abscesses that fail initial therapy with metronoidazole: A. Chloroquine B. Amodiaquine C. Mefloquine D. Primaquine Ans. A p. 867 291.Adverse effects of aminoglycosides include all, EXCEPT: A. Nephrotoxicity B. Cardiotoxicity C. Neuromuscular blockade D. Ototoxicity Ans. B p. 767 292.The most common use of estrogen in therpeutics is: A. Dysfunctional uterine bleeding B. Chemotherapy in prostatic malignancy C. Replacement therapy in menopause D. Component of contraceptice pills Ans. D 293.This is a partial agonist inhibitor of estradiol at the estrogen receptor and used in the palliative treatment of advanced breast cancer: A. Donazol B. Diathylstilbesterol C. Tamoxifen D. Mefepristone Ans. C p. 679 294.Clomiphone enhanced pregnancy by: A. Preparing the uterus for implantation B. Inhibiting estradiol’s negative feedback C. Increasing sperm motility D. Inhibiting ovulation Ans. B p. 681 295.The most common side effect of insulin is: A. Lipid deposition B. Renal dystrophy C. Insulin allergy

18

D.

Hypoglycemia

Ans.

D p. 703 296.Actions of Vit. D include: A. Antagonism oof parathyroid hormone B. Promote absorption of calcium and phosphate from the intestine C. Hasten calcium excretion in the kidney D. Promotes water excretion Ans. B p. 718

19