Exam 1: Magalong Flashcards
1
Q
The following falls under the realm of medical pharmacology?
A. Use of vaccine for prevention of a disease
B. Use of drug for diagnosis of disease
C. Use of antibiotics for treatment of infections
D. AOTA
A
D. AOTA
2
Q
Which does not describe a drug?
A. It is a chemical with known structure.
B. It usually binds to regulatory molecules.
C. It is specific with its actions.
D. It activates or inhibits normal body processes.
A
C. It is specific with its actions.
3
Q
A drug can do the following things:
a. can modulate a new cellular function
b. can create a cellular function
c. exert a spectrum of pharmacological actions and effects
d. a and c
e. AOTA
A
D. A and C
(a. can modulate a new cellular function
c. exert a spectrum of pharmacological actions and effects)
4
Q
Which best describes a drug? A. with absolute specificity B. Brings changes in biological function through chemical action C. Needs to bind to receptor D. Create new function
A
B. Brings changes in biological function through chemical action
5
Q
Which is true of the history of pharmacology?
A. In the 7th century, herbal medicine emerged.
B. Advancements in the knowledge of physiology and chemistry led to better evidence for therapeutic claims.
C. In recent years, biotechnology has emerged as a major basis of pharmacology.
D. Biopharmaceutics is the use of genetic information in the manufacture of drugs.
A
C. In recent years, biotechnology has emerged as a major basis of pharmacology.
6
Q
Which of the following is correct?
A. Pharmacokinetics is what the drug does to the body.
B. Pharmacodynamics is what the body does to the drug.
C. Selectivity is reciprocal.
D. There are drugs that are completely specific to a particular receptor.
A
C. Selectivity is reciprocal.
7
Q
The WHO defines essential medicines as:
A. All drugs produced by local manufacturers.
B. Drugs that answer the priority health care needs of the community.
C. Drugs intended to be used to modify or to explore physiological system or pathological states fo the benefit of the recipient.
D. All the expensive drugs.
A
B. Drugs that answer the priority health care needs of the community.
8
Q
Which is TRUE of Drug Action?
A. All drug molecules exert a chemical influence on cells initially through receptors.
B. Specificity of drug receptor interaction is reciprocal.
C. Occupation of receptor always transforms the receptor to an active conformational state.
D. Drug is effective if it affects the most number of tissues and cells as possible.
A
B. Specificity of drug receptor interaction is reciprocal.
9
Q
Compared to the sigmoid curve of a full agonist in the log dose vs. effect curve, the partial agonist: A. will shift parallel to the right B. will shift parallel to the left C. Emax will be higher D. Emax will be lower
A
D. Emax will be lower
10
Q
Compared to the sigmoid curve of a full agonist in the log dose vs. effect curve, the presence of a competitive antagonist will: A. shift to the right B. shift to the left C. Emax will be higher D. Emax will be lower
A
A. shift to the right
11
Q
Which receptor modulates the allergic receptor
A. Beta adrenergic receptor
B. Histamine-1 receptor
C. Opiate receptor
D. Angiotensin converting enzyme converting receptor
A
B. Histamine-1 receptor
12
Q
Which receptors activate the sympathetic nervous system (epinephrine)?
A. Beta adrenergic receptor
B. Histamine-1 receptor
C. Opiate receptor
D. Angiotensin converting enzyme converting receptor
A
A. Beta adrenergic receptor
13
Q
Which receptors mimic the action of narcotics in the CNS (morphine)
A. Beta adrenergic receptor
B. Histamine-1 receptor
C. Opiate receptor
D. Angiotensin converting enzyme converting receptor
A
C. Opiate receptor
14
Q
Which receptors usually control the rate of Angiotensin conversion to its active form Angiotensin II
A. Beta adrenergic receptor
B. Histamine-1 receptor
C. Opiate receptor
D. Angiotensin converting enzyme converting receptor
A
D. Angiotensin converting enzyme converting receptor
15
Q
Covalent bonds are usually irreversible.
A. True
B. False
A
A. True
16
Q
Agonist binding has both affinity and efficacy, antagonist binding also has both affinity and efficacy.
A. True
B. False
A
B. False
17
Q
T/F
Antagonists have no affinity and no efficacy
A
F.
Antagonists have affinity and no efficacy
18
Q
If spare receptors are present, the agonist can still reach maximum effect in the presence of noncompetitive antagonist.
A. True
B. False
A
A. True
19
Q
True of digoxin A. Bioavailability is 75% B. Half life is 40 hours C. 2/3 is unchanged excreted in kidney D. Inhibits Na-K ATPase pump
A
Samplex Answer: D. Inhibits Na-K ATPase pump.
JV’s Answer: All are true
Bioavailability of digoxin is 60-80%
Half life is 36-48 hours
50-70% is excreted unchanged in the urine
Digoxin binds to a site on the extracellular aspect of the α-subunit of the Na+/K+ ATPase pump in the membranes of heart cells (myocytes) and decreases its function.
20
Q
Study of the the drug effects on population. A. Biopharmaceutics B. Pharmacogenetics C. Pharmacogenomics D. Pharmacoepidemiology
A
D. Pharmacoepidemiology
21
Q
Deals with the development of new drug delivery systems and new dosage forms. A. Biopharmaceutics B. Pharmacogenetics C. Pharmacogenomics D. Pharmacoepidemiology
A
A. Biopharmaceutics
22
Q
Deals with genetically mediated variations in drug responses. A. Biopharmaceutics B. Pharmacogenetics C. Pharmacogenomics D. Pharmacoepidemiology
A
B. Pharmacogenetics
23
Q
The use of genetic information to guide the choice of drug therapy on an individual basis A. Biopharmaceutics B. Pharmacogenetics C. Pharmacogenomics D. Pharmacoepidemiology
A
C. Pharmacogenomics
24
Q
Allosteric activator causes effects: A. Greater than agonist alone B. Less than agonist alone C. Equal to agonist alone D. Opposite the action of agonist
A
A. Greater than agonist alone
25
```
What effect does an allosteric activator exert on a drug?
A. Decrease the efficacy of a drug
B. Increase in the efficacy of the drug
C. Effect depends on the drug
D. None of the above
```
B. Increase in the efficacy of the drug
26
```
The most important concept in pharmacodynamics is the
A. Therapeutic triangle
B. Scatchard plot
C. semi-log dose response curve
D. presence of agonist/antagonist
E. All of the above
```
C. semi-log dose response curve
27
The Scatchard plot
A. Is a graphic representation used in the analysis of binding phenomena in which concentration of bound ligand divided by that of the free ligand bound ligand is plotted against concentration of bound ligand
B. Is a straight line plot for one binding site (may also represent several binding sites) where the x axis intercept is B (bound drug) and the slope is -1/Kd (negative reciprocal of the dissociation/association constant)
C. Defines an equation for calculating the affinity constant of a ligand with a protein or receptor
D. Is a curve of B/F (bound ligand/free ligand) versus B (bound ligand)
E. All of the above
E. All of the above
28
Components of the Therapeutic Triangle or Pharmacotherapy-Psychotherapy Triangle
A Physician
A Nonmedical Psychotherapist
A Patient
29
The most popular method to linearize binding data. It is the graphic information on ligand affinity (KD) and the density of receptors (BMAX).
Scatchard Plot
30
Term used to refer to a drug which exhibits some properties of an agonist and some properties of an antagonist, an example of which are opiods.
Agonist-antagonist
31
The Scatchard plot
a. defines an equation for calculating the affinity constant of a ligand with a receptor
b. it is a graphic representation for the analysis of binding phenomena in which the bound-ligand concentration divided by the free ligand-concentration is plotted versus the bound-ligand concentration
c. is a plot of bound-ligand/free-ligand (B/F) versus the bound-ligand (B)
d. may be represented by a straight line for one binding site where the x-axis intercept is the bound-ligand (B) while the slope is the negative reciprocal of the dissociation/association constant (-1/Kd)
e. all of the above
e. all of the above
32
The log-dose effect relationship shows:
a. a hyperbolic curve
b. a sigmoid curve
c. the four characteristics – potency, efficacy, slope and variability
d. a and c
e. b and c
E. B and C
The log-dose effect relationship shows a sigmoid curve and the four characteristics – potency, efficacy, slope and variability.
33
Graded dose-response curve at logarithmic scale:
A. Hyperbola
B. Sigmoid
C. 4 parameters: efficacy, potency, slope, variability
D. AOTA
E. B & C only
E. B & C only
34
The graded dose-response curve as represented by the semi-logarithmic curve
a. is a sigmoid curve
b. is a hyperbolic curve
c. consists of 4 parameters: efficacy, potency, slope and variability
d. a and c
e. b and c
d. a and c
35
The semilogarithmic graded dose response curve has the following characteristics:
A. It is a sigmoid curve
B. It consists of 4 parameters: slope, potency, variability, maximal effect
C. The magnitude of the response decreases with greater concentration of the unbound drug at the receptor site
D. A & B only
D. A & B only
36
Classes of drugs are best described according to:
a. source whether natural or synthetic
b. chemical structure
c. therapeutic use and therapeutic effect
d. all of the above
e. b and c
c. therapeutic use and therapeutic effect
37
What is the usual basis used to classify drugs?
Drug action
38
While receptors regulate biochemical and physiological activity, they are themselves subject to regulatory and homeostatic controls like
a. upregulation due to continued stimulation of cells with agonists
b. down regulation due to covalent bonding or relocalization or destruction of receptors
c. upregulation due to synthesis of new receptors
d. aota
e. b and c
e. b and c
39
Receptors which regulate biochemical and physiological functions are in themselves subject to regulatory and homeostatic controls which come in the form of
a. up regulation or hyperactivity or supersensitivity due to the synthesis of new receptors
b. up regulation due to continued stimulation of cells with agonists
c. down regulation or desensitization/refractoriness due to covalent bonding or relocalization or destruction of receptors
d. all of the above
e. a and c only
e. a and c only
40
Receptors which regulate biochemical and physiological functions are in themselves subject to regulatory homeostatic control, which come in the form of:
A. Upregulation
B. Downregulation or desensitization
C. Both
C. Both
41
True of competitive and noncompetitive agonists
a. reversible and irreversible respectively
b. have intrinsic activity only
c. have affinity only
d. have both affinity and intrinsic activity
e. a and d
e. a and d
42
The most important properties of any drug product is/are:
a. efficacy and safety
b. efficacy, safety and quality
c. efficacy, potency and safety
d. cost, efficacy, potency, safety, quality
b. efficacy, safety and quality
43
The three most important properties of a drug product are
A. efficacy, safety, quality
B. efficacy, lack of significant toxicity and quality
C. potency, safety and quality
D. a and b
E. a and c
D. a and b
| “lack of significant toxicity” is synonymous to safety, making choice A and B identical
44
The Quantal dose response curve has the following:
a. usually a Gaussian/ normal curve
b. always shows dose and response
c. affected by frequency, rate and dose of drug
d. describes low, middle, and high dose
e. all of the above
e. all of the above
45
The quantal dose-response curve is:
A. An all or none relationship that defines the population frequency of drug response to varying dose
B. The variables are the dose and the response
C. A sigmoid curve
D. Stimulates a bioavailability curve
A. An all or none relationship that defines the population frequency of drug response to varying dose
46
The quantal dose-response curve
a. defines the population frequency of response to drugs
b. has the shape of a normal or Gaussian curve
c. the dose and response are constantly present
d. the variability lies in the frequency of the population responding to a low, middle or high dose
e. AOTA
e. AOTA
47
Margin of safety is measured by
a. Therapeutic index which is the ratio of toxic dose 50 over effective dose 50
b. Standard safety margin utilizing 100 experimental animals
c. Standard safety margin utilizing 1000 experimental animals
d. Distance between the minimum effective dose and the maximum effective dose which is just a hairline away from the minimum toxic dose
E. ALL OF THE ABOVE
E. ALL OF THE ABOVE
48
Of all the different kinds of adverse effects, one or all of those listed below that can be desirable depending on the circumstances surrounding the patient
a. idiosyncracy
b. tolerance
c. side effect
d. tachyphylaxis
e. all of the above
c. side effect
49
A drug receptor
A. Mediates all drug actions and effects
B. Binding to a drug is independent of the law of mass action
C. Mediates the actions of pharmacologic agonists and antagonists
D. A macromolecular component of a cell with stereospecificity and with which a ligand interacts in a lock-and-key fashion
E. All of the above
D. A macromolecular component of a cell with stereospecificity and with which a ligand interacts in a lock-and-key fashion
50
Relates the dose of a drug required to produce a desired effect to that which produces an undesired effect.
Therapeutic index
51
Usually caused by genetic differences in drug metabolism or by immunologic mechanisms.
a. idiosyncracy
b. tolerance
c. side effect
d. tachyphylaxis
e. all of the above
A. Idiosyncracy
52
A decrease in responsiveness to a drug as a result of continuous usage
a. idiosyncracy
b. tolerance
c. side effect
d. tachyphylaxis
e. all of the above
b. tolerance
53
Effects of a drug that occur via a pathway that is to one side of the principal action of the drug.
a. idiosyncracy
b. tolerance
c. side effect
d. tachyphylaxis
e. all of the above
C. Side effect
54
The rapid diminishing of responsiveness after the administration of a drug
a. idiosyncracy
b. tolerance
c. side effect
d. tachyphylaxis
e. all of the above
d. tachyphylaxis
55
A drug receptor
A. Mediates all drug actions and effects
B. Binding to a drug is independent of the law of mass action
C. Mediates the actions of pharmacologic agonists and antagonists
D. A macromolecular component of a cell with stereospecificity and with which a ligand interacts in a lock-and-key fashion
E. All of the above
D. A macromolecular component of a cell with stereospecificity and with which a ligand interacts in a lock-and-key fashion
56
Receptors
a. are responsible for the selectivity of drug action
b. mediate the actions of pharmacologic agonists and antagonists
c. are generally macromolecular molecules which possess stereospecificity
d. largely determine the quantitative relations between drug dose or concentration and pharmacologic effects
e. all of the above
e. all of the above
57
While receptors regulate biochemical and physiological functions, they are in themselves subject to regulatory and homeostatic controls; such regulation comes in the form of:
A. Up regulation due to continued stimulation of cells with antagonists
B. Down regulation or desensitization/ refractoriness due to relocalization or destruction of receptors
C. Up regulation or hyperreactivity or supersensitivity due to covalent bonding
D. All of the above
B. Down regulation or desensitization/ refractoriness due to relocalization or destruction of receptors
58
What does continued stimulation of cells with antagonists lead to?
Down-regulation
59
What does covalent bonding lead to?
Down-regulation
60
Potency:
A. Is defined as drug effectiveness with respect to dose
B. Its importance begins where ease of administration ends
C. Starts to decline when shelf-life is exceeded
D. All of the above
E. A and B only
D. All of the above
61
Potency
a. the importance begins after the ease of administration ends
b. may decrease after the shelf-life due to degradation of the parent compound
c. can be defined as the location of the drug-response curve along the horizontal axis
d. AOTA
e. NOTA
d. AOTA
62
Potency is:
A. Effectiveness of drug relative to dose
B. Importance is considered where ease of administration ends
C. Sigmoid on the horizontal axis
D. B & C
E. All of the above
E. All of the above
63
Refers to the concentration (EC50) or dose (ED50) of a drug required to produce 50% of that drug’s maximal effect
Potency
64
Efficacy
a. is synonymous with potency
b. drug effectiveness with respect to dose
c. corresponds to the plateau in a semi-log dose response curve
d. AOTA
e. a and c
e. a and c
65
```
Efficacy is:
A. Maximal effect observed in a drug
B. Drug effectiveness with respect to dose
C. Less important than potency
D. A and B only
E. A and C only
```
A. Maximal effect observed in a drug
66
The greatest effect (Emax) an agonist can produce if the dose is taken to very high levels. Efficacy is determined mainly by the nature of the drug and the receptor and its associated effector system.
Efficacy
67
Which is clinically more important: efficacy or potency?
Efficacy
68
About competitive and non-competitive antagonism
a. agonists possess affinity and intrinsic activity while antagonists possess only affinity
b. are irreversible and reversible respectively
c. non-competitive antagonism can still be reversed by using more of the agonist
d. AOTA
e. a and c
a. agonists possess affinity and intrinsic activity while antagonists possess only affinity
69
Non-receptor mediated drug reactions may consist of
a. colligative effects
b. counterfeit incorporation effects
c. neutralization of gastric acid by an antacid
d. AOTA
e. a and c
d. AOTA
70
```
Which receptor has the fastest response time?
A. Ion channel
B. G-protein coupled receptors
C. Tyrosine kinase linked receptors
D. Intracellular receptors
```
A. Ion channel
71
Among the different receptors through which drugs act, the action on the target tissue is quickest/fastest with the:
a. GPCR
b. Ion channel/Ionophore
c. Nuclear receptors
d. Tyrosine kinase
b. Ion channel/Ionophore
72
```
Which one of the following receptors takes hours to days to effect a cellular response?
A. Ion channel
B. G-protein coupled receptors
C. Tyrosine kinase linked receptors
D. Intracellular receptors
```
D. Intracellular receptors
73
G-protein coupled receptors are the most common receptor acted on by drugs?
A. True
B. False
A. True
74
```
The action of this drug is mediated by G-protein coupled receptor (GPCR)?
A. insulin
B. estrogen
C. mannitol
D. salbutamol
```
D. salbutamol
75
```
The action of this drug is mediated by intracellular nuclear receptors
A. insulin
B. estrogen
C. mannitol
D. salbutamol
```
B. estrogen
76
```
The action of this drug is mediated by enzyme-linked receptors
A. insulin
B. estrogen
C. mannitol
D. salbutamol
```
A. insulin
77
```
For Epinephrine to achieve ionotropic and chronotropic effects, it must react with which type of receptors?
A. Ion channel-linked receptors
B. GPCR
C. Cytosolic receptor
D. Enzyme-linked receptors
```
B. GPCR
78
```
Action of Mannitol is mediated by this type of receptor:
A. Ionotropic
B. Metabotropic
C. GPCK
D. NOTA
```
D. NOTA
| Mannitol is not receptor mediated. It is not absorbed by renal tubules.
79
```
Binding of acetylcholine to nicotinic cholinergic receptor triggers this cellular event:
A. Sodium enters the cell.
B. Chloride ion enters the cell.
C. Hyperpolarization of the membrane
D. G-protein is activated.
```
A. Sodium enters the cell.
80
```
Nicotinic subunit receptor responsible for gate opening upon Ach binding
A. Alpha
B. Beta
C. Gamma
D. Delta
```
A. Alpha
81
```
Binding of acetylcholine its receptors triggers this cellular event:
A. The opening of sodium channels
B. Chloride ion enters cell
C. Hyperpolarization of the membrane
D. G-protein is activated
```
A. The opening of sodium channels
82
Binding of Salbutamol to beta-2 adrenergic receptor triggers this intracellular event:
A. Chloride ion enters the cell
B. Conversion of ATP to cAMP
C. Increase membrane conductance to potassium ions
D. Selective gene expression
B. Conversion of ATP to cAMP
83
Binding of atropine to cholinergic receptor in bronchial smooth muscles triggers the physiologic response:
A. Sequestration of calcium by ER
B. Binding of cytosolic calcium to calmodulin
C. Myosin and actin interaction inhibited
D. GDP is replaced by GTP in the alpha-subunit of G protein
C. Myosin and actin interaction inhibited
84
This drug blocks muscarinic Ach receptors which are G protein coupled, inhibiting myosin and actin interaction.
Atropine
85
Agonist-GABA interaction results to:
A. Opening of voltage-gated sodium channel
B. Hyperpolarization of plasma membrane
C. Generation of action potential
D. Release of calcium from ER and mitochondria
B. Hyperpolarization of plasma membrane
86
Binding of insulin to its membrane-bound receptor leads to this cellular response
A. Facilitated diffusion of potassium across plasma membrane
B. Phosphorylation of effector proteins
C. Signal transduction and amplification by generating cAMP and Ca2+
D. Hyperpolarization of the plasma membrane
B. Phosphorylation of effector proteins
87
```
Binding of estrogen to cytosolic receptor is the target of antineoplasm intervention
A. Inhibit cellular division
B. Apoptosis
C. Necrosis
D. Inhibit pleomorphic activity
```
A. Inhibit cellular division
88
```
Which of the following mechanisms is not involved in desensitization/tolerance?
A. Endocytosis
B. Relocalization of receptors
C. Compensation
D. Exocytosis
```
D. Exocytosis
89
The usual mechanism associated with G-protein-coupled receptors
A. Facilitated diffusion of potassium across plasma membrane
B. Phosphorylation of effector proteins
C. Signal transduction and amplification by generating cAMP and Ca2+
D. Hyperpolarization of the plasma membrane
C. Signal transduction and amplification by generating cAMP and Ca2+
90
Commonly associated with ion channel receptors
A. Facilitated diffusion of potassium across plasma membrane
B. Phosphorylation of effector proteins
C. Signal transduction and amplification by generating cAMP and Ca2+
D. Hyperpolarization of the plasma membrane
A & D
91
```
Binding of estrogen to cytosolic receptor is the target of antineoplasm intervention
A. Inhibit cellular division
B. Apoptosis
C. Necrosis
D. Inhibit pleomorphic activity
```
A. Inhibit cellular division
92
What drug are tumor cells dependent on for transcription of genes that code for growth factors and other proteins needed for anchorage, growth and proliferation?
Estrogen
93
```
Which of the following mechanisms is not involved in desensitization/tolerance?
A. Endocytosis
B. Relocalization of receptors
C. Compensation
D. Exocytosis
```
D. Exocytosis
94
Mechanisms by which desensitization happen
Endocytosis and phosphorylation
95
```
The mode of action of this drug is mediated by a membrane-bound receptor with catalytic activity (tyrosine kinase induced autophosphorylation.
A. Terbutaline
B. Insulin
C. Mannitol
D. Diazepam
```
A. Terbutaline
96
```
This drug is considered as an osmotic diuretic
A. Terbutaline
B. Insulin
C. Mannitol
D. Diazepam
```
C. Mannitol
97
```
This drug is a GABA agonist, acting on ion-linked receptors.
A. Terbutaline
B. Insulin
C. Mannitol
D. Diazepam
```
D. Diazepam
98
This drug acts on tyrosine kinase-linked receptors
B. Insulin
99
```
The molecular action of glucocorticoids is mediated by:
A. GPCR
B. Ion channel/ionophore
C. Nuclear receptors
D. Tyrosine kinase
```
C. Nuclear receptors
100
```
Binding of beta blockers (eg. Propanolol) to beta receptors
A. Bronchodilation
B. Bronchoconstriction
C. Tachycardia
D. Positive ionotropic response
```
B. Bronchoconstriction
101
Drugs that bind to beta-adrenoceptors and thereby block the binding of norepinephrine and epinephrine to these receptors, inhibiting normal sympathetic effects.
Beta blockers
102
What adverse effect may happen in asthmatic patients when beta blockers are administered?
Bronchoconstriction
103
These drugs prolong the conductance of chloride ion channels of GABA-A receptors, thereby increasing the efficiency of neurotransmitter GABA.
Benzodiazepines
104
The mode of action of this drug is mediated by a membrane-bound receptor with catalytic activity
a. Terbutaline
b. Insulin
c. Mannitol
d. Diazepam
b. Insulin
105
The type of receptor that mediates the action of insulin is:
a. Ion channel linked receptor
b. GPCR
c. (Tyrosine) Kinase-linked receptor
d. Cytosolic receptor
c. (Tyrosine) Kinase-linked receptor
106
A patient with asthma presented with bronchoconstriction. Which drug will cause a delayed but prolonged effect?
A. Glucocorticoid on GPCR
B. Beta blocker on GPCR
C. Anticholinergic on cyto/nuclear receptor
D. Glucocorticoid on cyto/nuclear receptor
D. Glucocorticoid on cyto/nuclear receptor
107
Anesthetics that work similarly with tubocurarine induce skeletal muscle relaxation through the following
A. Inhibit exit of Na through NaCh receptor
B. Allow exit
C. Inhibiting the entry of sodium across the cell membranes of the nicotinic acetylcholine receptor
D. Allow exit
C. Inhibiting the entry of sodium across the cell membranes of the nicotinic acetylcholine receptor
108
```
What type of receptors does the mineralocoticod aldosterone bind to?
A. Ion channel
B. GPCR
C. Tyrosine kinase linked
D. Cytoplasmic/nuclear
```
D. Cytoplasmic/nuclear
109
Tamoxifen is a partial agonist of estrogen. As a partial agonist, it will have the following properties:
A. Agonist in the breast, but anti-estrogenic in the bone and uterus
B. Agonist in the uterus and the bone, but anti-estrogenic in the breast
C. Agonist in the ovaries, but anti-estrogenic in the breast
D. B and C
B. Agonist in the uterus and the bone, but anti-estrogenic in the breast
110
Benzodiazepine, after binding to its target receptor, causes what changes?
A. Separation of the Gsa subunit from Gb and Gγ protein subunits
B. Autophosphorylation of the beta subunit of the receptor
C. Direct opening of ionophore channel causing exit of sodium
D. Conformational change of GABA receptor causing improved GABA binding
D. Conformational change of GABA receptor causing improved GABA binding
