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DRILLS > M4 DRILLS > Flashcards

M4 DRILLS Flashcards

1
Q

Which of the following is TRUE regarding acidic drugs?

I. They exist mainly in the ionized form at the stomach.

II. They exist in a non-ionized form at an acidic environment.

III. They exist mainly in the polar form in an acidic urine.

A.
I

B.
III

C.
II

D.
I, II and III

A

C

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2
Q

When a weak acid drug is in an acidic medium, what usually happens?

A.
The drug becomes unionized and has a higher chance of being absorbed

B.
The drug becomes ionized and has a higher chance of being absorbed

C.
The drug becomes unionized and has a lesser chance of being absorbed

D.
The drug becomes ionized and has a lesser chance of being absorbed

E.
Nothing happens

A

A The drug becomes unionized and has a higher chance of being absorbed

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3
Q

Which of the following is an INCORRECT pairing?

A.
Hepatitis: Pyrazinamide

B.
Optic neuritis: Ethambutol

C.
Ototoxicity: Rifampicin

D.
Peripheral neuropathy: Isoniazid

A

C. Ototoxicity: Rifampicin

BEQ21 – AE of streptomycin is ototoxicity

These are pairings of adverse effects and anti-TB drugs. Ototoxicity (irreversible cochlear and vestibular dysfunction) is associated with Streptomycin. Rifampicin can cause red-orange discoloration of secretions.

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4
Q

Which of the following is/are characteristic/s of Type B ADR?

I. unpredictable

II. unrelated to the mechanism of action of drug

III. dose-dependent

IV. common

A.
I and II

B.
III and IV

C.
II

D.
I, II, III and IV

A

A

BEQ21

Type B ADR is a rare, unpredictable, unrelated to the pharmacological action of the drug and not dose dependent. It also depends on patient’s susceptibility to the adverse reaction. While dose-dependent and common refer to Type A ADR.

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5
Q

Poisons may enter the human body through which the following routes of exposure.

I. Orally by ingestion

II. By inhalation

III. From mother to infant via transplacental route

A.
I and II

B.
I and III

C.
II and III

D.
I, II and III

A

D

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6
Q

Which of the following are water-soluble vitamins?

I. Vitamin A

II. Vitamin B

III. Vitamin C

IV. Vitamin D

A.
I and II

B.
III and IV

C.
II and III

D.
II, III and IV

A

C

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7
Q

Which of the following acts by inhibiting the action of 5-alpha-reductase?

A.
Flutamide

B.
Finasteride

C.
Nandrolone

D.
Danazol

A

B.

Flutamide – androgen receptor blocker (also Bicalutamide)

Nandrolone and Danazol – testosterone analogs

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8
Q

Pharmacokinetic variations in Drug Metabolizing Enzymes (DME) are considered significant if _____.

Active metabolites are formed
The drug has a very wide margin of safety
The parent drug is prodrug that requires activation by DME

A.
I and III

B.
I, II and III

C.
III

D.
II

A

A I and III

DME is highly considered for drugs with narrow TI or margin of safety

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9
Q

The enzyme capacity in newborns and infants is reduced. What possible effects would this have on clearance and elimination half-life of drugs?

A.
Increase in clearance and decrease in elimination half life

B.
Increase in clearance and increase in elimination half life

C.
Decrease in clearance and decrease in elimination half-life

D.
Decrease in clearance and increase in elimination half-ife

A

D

Decrease in clearance and increase in elimination half-ife

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10
Q

Abrupt discontinuation of beta blockers can lead to rebound hypertension or tachycardia.

This is due to:

A.
Receptor upregulation

B.
An increase in excretion of active drug

C.
Receptor dowregulation

D.
Inactivation of counterregulatory physiologic response

A

A

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11
Q

Which would be the pair that best gives an example for physiologic antagonism?

A.
Acetylcholine and Atropine

B.
Heparin and Protamine sulfate

C.
Ferrous sulfate and Deferoxamine

D.
Histamine and Epinephrine

A

Ans: D

Histamine (acts on H receptors) and Epinephrine (acts on α1 and β2 receptors to manage the anaphylactic shock and bronchoconstriction caused by histamine) (aka Functional Antagonism)

Acetylcholine and Atropine – Pharmacologic Antagonism (both attach to the same receptor, with atropine blocking ACh)

Heparin and Protamine sulfate – Chemical Antagonism (protamine ionizes heparin, making it more water-soluble and thus, more excretable)

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12
Q

Describes the concept of dissolution in the absorption of orally administered medications

A.
Fick’s Law of Diffusion

B.
Noyes-Whitney Equation for Dissolution

C.
Fick’s Law of Dissolution

D.
Noyes-Whitney Equation for Diffusion

A

Ans: B

Noyes-Whitney Equation for Dissolution

Fick’s Law of Diffusion – describes the concept of diffusion in passive transport

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13
Q

Which of the following would be best regarded as a factor that affects the distribution of a drug?

A.
Cardiac Output

B.
Gastric Emptying Time

C.
Dose of the Drug

D.
Degree of Perfusion of the Intestines

A

Ans: A. Cardiac Output

The rest of the choices are factors that affect the ABSORPTION of a drug.

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14
Q

Which of the following statements regarding protein binding is true?

A.
Protein bound drugs are distributed throughout the body and used

B.
Protein binding helps the body eliminate drugs

C.
Protein bound drugs are metabolized in the liver

D.
Both A and C

E.
None

A

Ans: E. None

All of the statements refer to a free drug or an unbound drug

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15
Q

Drug metabolism usually results in a product that is

A.
More lipid soluble

B.
More water soluble

C.
More likely to be reabsorbed by the kidneys

D.
More likely to distribute intracellularly

A

Ans: B. more water soluble

BEQ21

Biotransformation
● less lipid soluble
● more water soluble

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16
Q

Always true for carrier-mediated transport

A.
Requires ATP

B.
Solvent-driven through opposite-charged pore lining

C.
Works against concentration gradient

D.
Follows Michaelis-Menten kinetics when saturated

E.
A and C

A

Ans: D

Follows Michaelis-Menten kinetics when saturated

A & C: Carrier-mediated, but only if active transport

B: Convective transport

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17
Q

Digoxin inhibits Na+/K+ ATPase pump. What kind of transport protein is Na+/K+ ATPase pump?

A.
Ion pair

B.
Active, Primary

C.
Active, Secondary

D.
Active, Antiport

E.
Convective through opposite-charged pore lining

A

Ans: B

ATPase: Active transport

Active transport: Uses energy source to move molecules across membrane against their gradient

Primary active transport: Directly uses ATP as energy source; May generate an electrochemical gradient

Secondary / Cotransport: Uses electrochemical gradient (by 1o active transport); I.e. Symport / Antiport

Ion pair: Same direction vs Opposite direction PiSo; Non-energy requiring (+/- = netural)

Convective: Ionized sulfonamide

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18
Q

The displacement of drug from protein binding site causes

A.
Decrease intensity of pharmacological response

B.
Decrease side effects

C.
toxicity

D.
all of the above

A

C

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19
Q

A drug was withdrawn from the market due to reports of cardiac arrythmia caused by unusually high level of the said drug. Which of the following BEST explains this effect?

A.
Intake of drugs that enhances its excretion

B.
Intake of drugs that are used to treat cardiac arrythmia

C.
Intake of drugs that enhances its metabolism

D.
Intake of drugs that inhibits its metabolism

A

B

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20
Q

Which of the following statements are true?

A.
Excretion through kidneys requires the drug to be nonpolar

B.
A drug undergoes biliary excretion when its molecular weight is less than 400

C.
Renal excretion is more dominant

D.
Both A and C

E.
All of the choices

A

Ans: C

Excretion through kidneys require polar or water-soluble drugs

Biliary Excretion requires drug with a mw of more than 400

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21
Q

Adrenergic peripheral responses are mediated by what type of receptors?

Alpha receptor
Beta-receptor
Muscarinic receptors

A.
I and II

B.
I, II and III

C.
II and III

D.
I and III

A

A

Note:

Muscarinic Receptors

Recall that eccrine sweat glands contain “sympathetic-cholinergic” receptors, stimulated by ACh but produces vasodilation and sweat release. This is a M receptor despite the term “sympathetic”
because “adrenergic” and “sympathetic” are NOT synonymous.

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22
Q

Which of the following is TRUE regarding the effect of adrenergic agonist on peristalsis?

A.
No effect

B.
Decrease in peristalsis

C.
Effect is either an increase or decrease in peristalsis

D.
Increase in peristalsis

A

B

Recall fight or flight versus rest and digest

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23
Q

Which receptor is responsible for tocolysis?

A.
Alpha-1

B.
Beta-1

C.
Beta-2

D.
Beta-3

E.
Nm

A

Ans: C. (Beta-2) Piloerection = goosebumps

Beta-1: (+) inotropism, chronotropism, dromotropism

Beta-2: bronchodilation, relaxation of uterus

Beta-3: lipolysis, relaxation of detrussor muscle of bladder

Nm: skeletal muscle contractions

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24
Q

Phenylephrine is a/an .

A.
Adrenergic antagonist

B.
Cholinergic agonist

C.
Adrenergic agonist

D.
Cholinergic antagonist

A

C

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25
Q

Tamsulosin acts selectively on what type of receptor?

A.
Beta-2

B.
Alpha-1

C.
Beta-1

D.
Alpha-2

A

B

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26
Q

Which of the following neurotransmitter will be increased by Rivastigmine in the Central Nervous System synapses?

A.
Dopamine

B.
Acetylcholine

C.
Epinephrine

D.
Serotonin

A

B

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27
Q

Telenzepine is used for the treatment of peptic ulcers. What receptor does it target?

A.
M1

B.
M2

C.
M3

D.
Nm

E.
Nn

A

A

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28
Q

Which of the following drugs induces α1 receptor selectively?

I. Naphazoline
II. Clonidine
III. Methoxamine
IV. Isoproterenol

A.
I only

B.
II, III

C.
II only

D.
I, III

E.
I, II, III, IV

A

Ans: D. I, III

Clonidine is a selective α2 agonist drug

Isoproterenol is a nonselective β agonist drug

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29
Q

All of the drugs listed are SABA drugs, but which one is for inhalation only?

A.
Salbutamol

B.
Metaproterenol

C.
Pirbuterol

D.
Terbutaline

A

Ans: C. Pirbuterol

Salbutamol – Inhalational, PO

Metaproterenol – Inhalational, PO

Terbutaline – Inhalational, PO, SQ

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30
Q

What is the action of ephedrine on the sympathetic nervous system?

A.
Direct action at alpha-1, beta-1, and beta-2 adrenergic receptors

B.
Indirect action by increasing the exocytosis of norepinephrine

C.
Mixed direct action at alpha-1, beta-1, and beta-2 adrenergic receptors and indirect action by increasing the exocytosis of norepinephrine

D.
Indirect action by inhibition of norepinephrine reuptake

A

Ans: C. Mixed action (Direct: α1, β1, β2 activation; Indirect: increased NE exocytosis)

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31
Q

Which parasympathomimetic drug is likely to cause oropharyngeal cancer?

A.
Neostigmine

B.
Edrophonium

C.
Pilocarpine

D.
Arecoline

A

Ans: D. Arecoline

Arecoline is parasympathomimetic drug found on areca nut. Research shows that this is either due to arecoline or due to nitrosamine constituents

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32
Q

Which of the following is most likely to be used in the management of Alzheimer’s disease?

A.
Physostigmine

B.
Neostigmine

C.
Rivastigmine

D.
Pyridostigmine

A

Ans: C

Rivastigmine (CNS-acting anticholinesterase; other e.g.: Tacrine, Donepezil, Galantamine)

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33
Q

Which of the following is a depolarizing neuromuscular blocker?

A.
Tubocurarine

B.
Pancuronium

C.
Succinylcholine

D.
Hexamethonium

A

Ans: C. Succinylcholine

Tubocurarine – non-depolarizing isoquinoline neuromuscular blocker (also -curiums)

Pancuronium – non-depolarizing steroidal neuromuscular blocker (also other -curoniums)

Hexamethonium – ganglionic blocker (also Trimethaphan and Mecamylamine)

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34
Q

Which of the following is an effect not produced by Atropine?

A.
Bronchodilation

B.
Miosis

C.
Flushing

D.
Decreased sweating

A

Ans: B. Miosis

Atropine causes mydriasis instead of miosis

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35
Q

Nondepolarizing, neuromuscular blockers are competitive drugs used for skeletal muscle relaxation during surgeries or for patients with spastic disorders. Which of the following are nondepolarizing, steroidal, neuromuscular blockers?

Atracurium
Mivacurium
Rocuronium
Vecuronium

A.
I, II

B.
II, III

C.
III, IV

D.
I, II, III, IV

A

Ans: C. III, IV

Nondepolarizing, steroidal, neuromuscular blockers end with “curonium”

Nondepolarizing, isoquinoline, neuromuscular blockers end with “curium”

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36
Q

Correct use of pralidoxime

A.
Attempt to regenerate inhibited acetylcholinesterase.

B.
Dispense as the only antidote to poisoned farmer who was not properly guided by haciendero-management about proper dithane and malathion use.

C.
Carefully administer after the aging process.

D.
AOTA

E.
NOTA

A

Ans: A. AChase regenerator

Pralidoxime: Chemical antagonist with an oxime group which combines with phosphorus of AChase inhibitors

Atropine: Physiologic antagonist that treats organophosphate poisoning by blocking acetylcholine action at the receptors; May be used even after aging process

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37
Q

Which is/are incorrectly paired?

A.
Metyrosine at rate-limiting step: Hemicholinium at rate-limiting step

B.
Reserpine : Vesamicol

C.
Guanethidine : Botulinum toxin

D.
AOTA

E.
NOTA

A

Ans: E. NOTA

A: Metyrosine inhibits RLS tyrosine hydroxylation in catecholamine synthesis: Hemicholinium blocks RLS choline re/uptake in acetylcholine synthesis

B: Storage vesicle

C: Release

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38
Q

Which of the following NSAIDs is correctly paired?

A.
Indomethacin – Pyrrole alkanoic acid

B.
Tolmetin – Pyrrole alkanoic acid

C.
Ibuprofen – Fenamate

D.
Diclofenac – Fenamate

E.
NOTA

A

Ans: B. Tolmetin – Pyrrole alkanoic acid

Indomethacin: Indole

Ibuprofen: Propionate

Diclofenac: Phenyl acetic acid / acetate

Mefenamic acid: Fenamate

-ac / -pro-&raquo_space; -fen-

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39
Q

A selective COX-2 inhibitor

A.
Celecoxib

B.
Indomethacin

C.
Meloxicam

D.
Phenylbutazon

A

Ans: C. Meloxicam

Celecoxib and other -coxibs – SPECIFIC COX-2 inhibitors

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40
Q

This is a naturally occurring prostaglandin used to induce labor and cervical ripening.

A.
Dinoprostone

B.
Latanoprost

C.
Misoprostol

D.
Alprostadil

E.
All of the choices

A

Ans: A. Dinoprostone

Latanoprost – for the mgt of glaucoma

Misoprostol – a synthetic prostaglandin medication used as cytoprotectant

Alprostadil – used for erectile dysfunction

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41
Q

Celecoxib is a specific COX2 inhibitor, what does this imply?

A.
Celecoxib inhibits both COX1 and COX2

B.
Celecoxib inhibits COX2 only, thus increasing the risk of gastritis

C.
Celecoxib inhibits COX2 only, but it does not create a significant difference from nonselective COX inhibitors.

D.
Celecoxib inhibits COX2 only, thus preventing risk of gastritis.

E.
None

A

Ans: D. Celecoxib inhibits COX2 only, thus preventing risk of gastritis.

A COX2 inhibitor selectively inhibits COX2 only, thus reducing the risk for gastritis but increases the risk for thrombotic events

42
Q

The only NSAID that is not a weak acid.

A.
Ketorolac

B.
Ibuprofen

C.
Sulindac

D.
Nabumetone

E.
None

A

Ans: D. Nabumetone

Nabumetone is a nonacidic NSAID prodrug that is rapidly metabolized in the liver to the active metabolite, 6-methoxy-2-naphthyl acetic acid.

43
Q

Which of the following is useful in treating ascites and pulmonary edema? The principal site of action of this drug is on the thick ascending limb of Henle’sloop.

A.
Hydrochlorothiazide

B.
Acetazolamide

C.
Spironolactone

D.
Furosemide

A

Ans: D. (Furosemide)

BEQ

Thick ascending limb of Henle’s loop - This is a buzz phrase for diuretics.

44
Q

Adenosine is classified as a/an,

A.
diuretic

B.
tocolytic

C.
antidiabetic medicine

D.
antiarrhythmic agent

A

D

45
Q

Which of the following is an antihypertensive medication most likely to be used by pregnant women?

A.
Candesartan

B.
Lisinopril

C.
Labetalol

D.
Clonidine

A

Ans: C. Labetalol

Antihypertensive drugs for pregnant women:

⮚ Methyldopa

⮚ Hydralazine

⮚ Labetalol

⮚ Nifedipine

“Mother Hates Labor and Nifedipine”

46
Q

Which of the following conditions would increase the risk of digoxin toxicity?

A.
Increased levels of potassium ions in the blood

B.
Increased levels of magnesium ions in the blood

C.
Increased levels of calcium ions in the blood

D.
Hyperbaric oxygen therapy

A

Ans: C. Increased levels of calcium ions in the blood (Hypercalcemia)

Conditions that would increase risk of digoxin toxicity:

⮚ Hypo – K, Mg, O (hypokalemia, hypomagnesemia, hypoxia)

Hyper – Ca (hypercalcemia)

47
Q

Which drug/s increase/s body lithium levels?

A.
Acetazolamide

B.
Xanthines

C.
Mannitol

D.
Hydrochlorothiazide

E.
AOTA

A

Ans: D. Hydrochlorothiazide

↑[Li]: Na+ loss / Natriuretic: Thiazides, ACEis, NSAIDs

↓ [Li]: Na+ supplement / Aquaretic: Acetazolamide (Carbonic anhydrase diuretics), Xanthines, Osmotic diuretics

48
Q

Which of the following would most likely be used for a patient with a non-productive cough?

A.
Acetylcysteine

B.
Bromhexine

C.
Guaifenesin

D.
Dextromethorphan

A

Ans: D. Dextromethorphan (other examples of cough suppressants/antitussives: Levodropropizine, Butamirate citrate, Codeine, Noscapine)

Other choices are used for productive cough.

49
Q

Which of the following is most likely to be administered as an MDI?

A.
Ipratropium

B.
Theophylline

C.
Montelukast

A

Ans: A. Ipratropium – is available as a metered dose inhaler (MDI) (e.g., Atrovent®)

Theophylline – oral

Montelukast – oral

Aminophylline – parenteral (IV)

50
Q

Which of the following is most likely to be inhaled to control a bronchial asthma attack?

A.
Prednisone

B.
Hydrocortisone

C.
Fluticasone

D.
Methylprednisolone

A

Ans: C. Fluticasone

Prednisone – oral

Hydrocortisone – parenteral (IV)

Methylprednisolone – oral or parenteral (IV)

51
Q

LTD4 receptor antagonist

A.
Zafirlukast

B.
Montelukast

C.
Zilueton

D.
A and B

A

D (lukasts)

52
Q

This drug is used as an alternative to Warfarin for stroke prophylaxis except for patients with prosthetic heart valves.

A.
Lepirudin

B.
Bivalirudin

C.
Argatroban

D.
Dabigatran

E.
None

A

Ans: D. Dabigatran

Lepirudin and Argatroban – for Heparin Induced thrombocytopenia

Bivalirudin – prevent thrombosis post angioplasty

53
Q

Which factor/s can cause an increased risk of thrombosis?

Phenobarbital
Cephalosporins
Chronic liver diseases
Hyperthyroidism
Hypothyroidism

A.
I, V

B.
II, V

C.
I, III, IV

D.
II, III, IV

E.
III, IV, V

A

Ans: A. I, V

Decreased PT-INR (risk: thrombosis):

● Enzyme inducers like Phenobarbital

● Cholestyramine

● Green leafy vegetables

● Diuretics

● Hypothyroidism

Increased PT-INR (risk: bleeding)

● Enzyme inhibitors

● Cephalosporins

● Other antithrombotics

● Hyperthyroidism

● Chronic liver diseases

54
Q

Which of the following is the antidote for opioid poisoning?

A.
Antropine

B.
Flumazenil

C.
Deferoxamine

D.
Naloxone

A

D

55
Q

Nizatidine acts on which receptor?

A.
H1 receptor

B.
H2 receptor

C.
H3 receptor

D.
H4 receptor

A

Ans: B. H2 receptor (antagonizes H2)

Other examples of H2 antagonists: Cimetidine, Famotidine, Ranitidine

56
Q

Among the drugs listed below, which of the following is used for cold medications?

A.
Cyproheptadine

B.
Meclizine

C.
Diphenhydramine

D.
Brompheniramine

E.
None

A

Ans: D. Brompheniramine

Cyproheptadine is an antihistamine with an additional anticholinergic and antiserotonergic effect.

Meclizine is used for motion sickness

Diphenhydramine is used for the management of dystonic crisis

57
Q

The following statements regarding H2 antihistamines are not true, except:

A.
Cimetidine is an antihistamine with significant enzyme inhibition and can help people with low libido.

B.
Famotidine is an H2 antagonist drug more potent than Cimetidine

C.
Nizatidine has a variety of dosage forms including IV infusions

D.
All of the statements are false

A

Ans: B. Famotidine is an H2 antagonist drug more potent than Cimetidine

Cimetidine may contribute to the loss of libido in rare cases.

Nizatidine has only oral dosage forms

58
Q

Alosetron is a 5-HT3 antagonist drug, what is its clinical significance?

A.
It is used to manage nausea and vomiting induced by chemotherapy

B.
It is used to manage irritable bowel syndrome with predominant diarrhea

C.
It is used to manage irritable bowel syndrome with predominant constipation

D.
It is used to manage migraine

E.
Both b and c

A

Ans: B. It is used to manage irritable bowel syndrome with predominant diarrhea

A. This is the indication of other 5-HT3 antagonist drugs like Ondansetron

C. This is the indication of Tegaserod, a 5-HT4 partial agonist

D. This is the indication of 5-HT1b/1d drugs like Sumatriptan, and also to Ergotamine

59
Q

Four milligrams of Methimazole would approximately be equivalent to

A.
0.4 mg of propylthiouracil

B.
4 mg of propylthiouracil

C.
20 mg of propylthiouracil

D.
40 mg propylthiouracil

A

Ans: D. 40 mg of PTU (Methimazole is more potent than PTU by approximately 10x)

PTU dose = Methimazole dose x 10

PTU dose = 4 mg x 10

PTU dose = 40 mg

60
Q

Which of the following is the main adverse effect of Insulin?

A.
Hypoglycemia

B.
Hyperglycemia

C.
Bone marrow depression

D.
Hepatotoxicity

A

Ans: A. (Hypoglycemia)

BEQ

Recall MOA, desired effect, main ADR which all converge to hypoglycemia. Be careful however for choices that are outside of the polar opposites.

61
Q

The following statements are true about thioamides, EXCEPT:

A.
Methimazole is teratogenic and causes aplasia cutis, while PTU is safe for use in pregnancy.

B.
Thioamides are inhibitors of thyroid peroxidase

C.
5 mg is the equivalent methimazole dose of 50 mg PTU

D.
PTU has an additional mechanism which is inhibition of proteolysis.

A

Ans: D. PTU has an additional mechanism which is inhibition of proteolysis.

This inhibits peripheral deiodination

62
Q

Repaglinide is believed to work by

A.
Decreasing hepatic gluconeogenesis

B.
Stimulating the release of insulin from the pancreas

C.
Increasing hepatic gluconeogenesis

D.
Reducing glucagon secretion from the pancreas

A

Ans: B. Stimulating the release of insulin from the pancreas

Repaglinide is an insulin secretagogue.

63
Q

This antidiabetic drug may cause an adverse effect of lactic acidosis

A.
Rosiglitazone

B.
Metformin

C.
Miglitol

D.
Sitagliptin

E.
Chlorpropramide

A

Ans: B. Metformin

Rosiglitazone – may cause cardiovascular events

Miglitol – may cause flatulence

Sitagliptin – may cause an increase in pancreatic size

Chlorpropramide – may cause hypoglycemia, weight gain and cholestatic jaundice

64
Q

Peak-less insulin

A.
Insulin Lispro

B.
NPH

C.
Insulin Aspart

D.
Insulin Glargine

A

D

65
Q

Which of the following statements regarding thioamides (methimazole and propylthiouracil) are true?

I. Both agents inhibit iodoperoxidase

II. Aside from inhibition of iodide oxidation, propylthiouracil also inhibits peripheral deiodination of T4 to T3

III. Propylthiouracil is generally preferred because of its longer duration of action, more rapid efficacy, and lower incidence of side effects

IV. Methimazole is the treatment of choice when therapy is indicated during the first trimester of pregnancy

A.
I, III, IV

B.
I, II

C.
II, IV

D.
II, III, IV

A

Ans: B. I, II

III - Propylthiouracil is generally preferred because of its longer duration of action, more rapid efficacy, and lower incidence of side effects

Methimazole is generally preferred because of its longer duration of action, more rapid efficacy, and lower incidence of side effects

IV - Methimazole is the treatment of choice when therapy is indicated during the first trimester of pregnancy

Propylthiouracil is the treatment of choice when therapy is indicated during the first trimester of pregnancy

66
Q

Gabapentin is used for what indication?

A.
Antidote for lead poisoning

B.
Antiarrythmia

C.
Anticonvulsant

D.
Anticancer

A

C

67
Q

Nefazodone, a second generation antidepressant, has been withdrawn due to what adverse effect?

A.
Hepatotoxicity

B.
Nephrotoxicity

C.
Cardiotoxicity

D.
Aplastic anemia

A

A

68
Q

Phenytoin is effective for the treatment of all of the following types of seizures except

A.
Generalized tonic-clonic

B.
Simple partial

C.
Complex partial

D.
Absence

E.
Grand mal

A

Ans: D. Phenytoin is not effective for absence (petit mal) seizures

DOC for absence seizures: Ethosuximide

69
Q

Considered to be the drug of choice for patients having recurrent seizure attacks without regaining consciousness.

A.
Carbamazepine

B.
Phenytoin

C.
Lorazepam

D.
Diazepam

A

Ans: C. Lorazepam

Lorazepam is the DOC for Status epilepticus.

70
Q

Metronidazole is effective against these type of organism except

A.
Aerobic

B.
Anaerobic

C.
Protozoan

D.
None of the above- Metronidazole is effective against all of the organism stated above

A

Ans: A. Aerobic

MOA of Metronidzaole: generates nitroso free radical to damage and degrade DNA

71
Q

Prussian blue is used to chelate

A.
Thallium

B.
Cesium

C.
Cyanide

D.
A and B

E.
B and C

A

D

72
Q

Type B adverse drug reactions are

I. Dose-dependent

      Serious and life-threatening

II. Responsible for majority of ADRs

III. A function of patient susceptibility

A.
I, III

B.
I, II

C.
II, III

D.
II, IV

A

D

73
Q

Increased digoxin toxicity is seen in which of the following conditions?

A.
Hypokalemia

B.
Hypocalcemia

C.
Hyperkalemia

D.
Hypermagnesemia

E.
B, C, & D

A

Ans: A. HypOkalemia

Digoxin toxicity:

HypoKMgO2, Hypercalcemia

● Hypokalemia

● Hypomagnesemia

● Hypoxia

74
Q

If the patient was inadvertently given penicillin in spite of the documented allergy, which of the following will BEST describe the incident?

A.
Medication Error – Omission Error

B.
Adverse Drug Reaction – Type A

C.
Medication Error – Commission Error

D.
Adverse Drug Reaction – Type B

A

Ans: C. (Medication Error – Commission Error)

BEQ

Recall Types A-F of ADRs. This question is looking for medication errors, NOT mechanisms of ADRs.

75
Q

Which of the following is the adverse effect associated with Streptomycin?

A.
Peripheral

B.
Ototoxicity

C.
Optic neuritis

D.
Hepatitis

A

B

76
Q

Benzodiazepine overdose is managed by the use of __________.

A.
Atropine

B.
Naloxone

C.
Flumazenil

D.
Deferoxamine

A

Ans: C. Flumazenil

BEQ21

Rationale:
Atropine – cholinesterase inhibitors poisoning; naloxone – opioid poisoning; deferoxamine – iron poisoning.

77
Q

Ethanol may be used for ________ poisoning.

A.
opioids

B.
methanol

C.
benzodiazepines

D.
carbon monoxide

A

B

78
Q

Salicylate poisoning is best managed by _______.

A.
Emetic agents

B.
Gastric lavage

C.
Urinary alkalinization

D.
Urinary acidification

A

C

79
Q

Drug X is reported to reverse the action of another drug by interacting directly with the drug and not with its receptors. Which of the following mechanism of antagonism best describes Drug A?

A.
Chemical antagonism

B.
Mechanical antagonism

C.
Pharmacologic antagonism

D.
Physiologic antagonism

A

D

80
Q

Which of the following is an adverse effect associated with the use of chloramphenicol?

A.
Phototoxicity

B.
Aplastic anemia

C.
Alopecia

D.
Staining of teeth

A

B

81
Q

Which of the following drugs are associated with pulmonary toxicity?

A.
Bleomycin

B.
Methotrexate

C.
Doxorubicin

D.
Cisplatin

A

A

82
Q

Which of the following adverse effects is associated with Ethambutol?

A.
Optic neuritis

B.
Peripheral neuropathy

C.
Hepatitis

D.
Ototoxicity

A

A

83
Q

Which of the following refers to the process that distinguishes the elimination of ethanol from the elimination of the most other drugs?

A.
First-order elimination

B.
Biliary excretion

C.
First-pass effect

D.
Zero-order elimination

A

D

84
Q

Pharmaceutical equivalent drugs products must have the same ____.

Therapeutically active drug ingredient/s
Salt or ester
Dosage form and strength

A.
I, II and III

B.
I

C.
II

D.
III

A

A

85
Q

According to pH partition hypothesis, a weak acidic drug will not be absorbed from the intestines because:

A.
The drug will exist primarily in the unionized, more lipid soluble form

B.
The drug will exist primarily in the ionized, more water-soluble form

C.
Weak acids are more soluble in acid medium

D.
The ionic form of the drug facilitates absorption

A

B

86
Q

Which of the following is TRUE if there is a significant difference between the oral and parenteral doses of the same drug; for example oral dose (tablet) is 40 mg vs. IV dose of 4 mg?

A.
Drug preparation has fast rate of dissolution

B.
Drug has very good absorption at the GI tract

C.
Drug undergoes significant first pass effect

D.
Drug preparation has fast disintegration rate.

A

C

87
Q

Which of the following is not an example of cholinergic agent?

A.
Ipratropium

B.
Neostigmine

C.
Dicyclomine

D.
Betanechol

A

C

88
Q

Which of the following is the mechanism of action of anticholinergics?

I. Enhances the sympathetic nervous system

II. Enhances parasympathetic nervous system

III. Enhances the action of acetylcholine at the neuromuscular junction

A

A

89
Q

Which of the following is an anticholinergic drug?

A.
Pilocarpine

B.
Homatropine

C.
Neostigmine

D.
Rivastigmine

A

B

90
Q

Physostigmine can managed poisoning with which of the following drugs?

A.
Muscarinic agonists

B.
Muscarinic antagonists

C.
Beta-blockers

D.
Organophosphates

A

B

91
Q

Royal jelly, a popular nutritional supplement form honeybee has been reported to cause which of the following adverse effects?

A.
Hepatotoxicity

B.
CNS depression

C.
CNS stimulation

D.
Anaphylaxis

A

D

92
Q

Which of the following can be used for methanol poisoning?

A.
Succimer

B.
Atropine

C.
Fomepizole

D.
Flumazenil

A

C

93
Q

Which of the following toxidromes are consistent with organophosphate insecticides?

I. Bronchodilation

II. Profuse sweating

III. Drooling

A

B

94
Q

Which should be administered to the patient who presents symptoms of organophosphate poisoning?

A.
Neostigmine

B.
Atropine

C.
Glucagon

D.
Flumazenil

A

Ans: B. Atropine

BEQ21

Pralidoxime can also be given within 72 hours of poisoning to regenerate acetylcholinesterase enzymes.

95
Q

Which of the following is NOT true about the effect of significant organ dysfunction on pharmacokinetic variables?

A.
renal insufficiency increases clearance of renally-excreted drugs

B.
cardiac impairment decreases cardiac output resulting to reduction of volume of distribution

C.
Liver dysfunction may result to inability of transforming the drug to its active metabolite

D.
hepatic impairment prolongs half-life of drugs that are highly dependent on the liver for elimination

A

Ans: A. renal insufficiency increases clearance of renally-excreted drugs

BEQ21

Renal impairment decreases clearance of drugs primarily dependent on the kidney for elimination

96
Q

Which of the following factors can prolong duration of a drug?

I. Decreased protein binding

II. Greater tubular reabsorption

III. Reduced polarity

A.
I and II

B.
II and III

C.
I and III

D.
I, II and III

A

B

97
Q

Dobutamine acts selectively on what type of receptor?

A.
Alpha-1

B.
Alpha-2

C.
Beta-1

D.
Beta-2

A

Ans: C. Beta-1

Selective a1 agonists: Phenylephrine, oxymetazoline

Selective a2 agonists: clonidine, guanfacine, guanabenz, methyldopa

Selective b1 agonists: Dobutamine, Dopamine

Selective b2 agonists: SABA and LABA

98
Q

Pharmacokinetic curve

A

Pkin curve: conc vs time

Pdy curve: Response or #Responder vs log dose

99
Q

True about graph B, EXCEPT:

It shows a quantal dose response curve
It shows a graded dose response curve
It shows all-or-none response
It shows response on a continuous scale
Efficacy and potency can be determined from this graph

A.
i, iii

B.
i, iii, v

C.
ii, iv

D.
ii, iv, v

A

A

100
Q

True about the graph above showing the curves for Drugs X, Y, Z:

Drug X is the most efficacious and the most potent
Drug X is the most efficacious but the least potent
Drug Z is the most efficacious and the most potent
Drug Z is the most efficacious but the least potent
Drug Z has a higher ceiling dose than Drug Y

A.
i only

B.
iv only

C.
i, v

D.
ii, v

E.
iii, v

A

C

Efficacy – ceiling effect, max achieved response (Emax)

Potency – dose producing 50% of ceiling effect (EC50)

Ceiling Dose – smallest dose producing ceiling effect

DRILLS (8 decks)

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