Module 4 Pharmacology - Pharmacokinetics - Toxicology Flashcards
The ECG of the patient with Digoxin as his treatment in the therapeutic dose range would likely
to show:
A. Widening of the QRS complex
B. Elevation of the ST segment
C. Prolongation of the QT interval
D. Prolongation of the PR interval
Prolongation of the PR interval
The major segment of the nephron where the diuretic action of the thiazides took place
A. Cortical collecting tubule
B. Medullary collecting tubule
C. Distal convoluted tubule
D. Proximal convulated tubule
Distal convoluted tubule
The following statement/s are true for the Carbonic anhydrase inhibitors:
I. Depresses HCO3- reabsorption in the cortical collecting tubule.
II. Depresses HCO3- reabsorption in the proximal convoluted tubule.
III. Causes significant hyperchloremic metabolic acidosis
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
II and III only
What segments of nephron where the diuretic action of Spironolactone took place?
A. Cortical collecting tubule
B. Thick ascending limb of Henle’s
loop.
C. Thin ascending limb of Henle’s
loop.
D. Medullary collecting duct
Cortical collecting tubule
The activity of propranolol in the treatment of angina pectoris is the result of this mechanism
A. Decreased requirement for myocardial oxygen
B. Increased sensitivity to catecholamines
C. Reduced production of catecholamines
D. Dilation of the coronary vasculature
Decreased requirement for myocardial oxygen
A 56 year old male patient, with hypertension and DM type 2. He managed his diabetes by
insulin. What antihypertensive drug should not be used on his case?
A. Captopril
B. Propranolol
C. Methyldopa
D. Hydralazine
Propranolol
A drug given intravenously results in an AUC of 600 ug/mL-hr. If the same dose of drug is given
orally and the resulting AUC is 300 ug/mL-hr, what percentage of the oral dose reaches the
bloodstream?
A. 50 %
B. 30 %
C. 20 %
D. 60 %
E. 100 %
50 %
The time required to reach the minimum effective drug concentration in the blood is known as:
A. Duration of action
B. Frequency
C. Onset of action
D. Half-life
E. Intensity of action
Onset of action
The phenomenon where a drug could exist in more than one crystal form
A. Thixothrophy
B. Complexation
C. Polymorphism
D. Amorphism
E. Solvate formation
Polymorphism
The following statement/s are true for Potassium-sparing diuretics:
I. Inhibition of Na+ influx through ion channels in the luminal membrane
II. Inhibition by direct pharmacologic antagonism of mineralocorticoid receptors.
III. Renal K+ wasting may occur
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I,II and III
The following statement/s are true for Quinidine.
I. Prolongs the QRS duration
II. Induction of torsade de pointes arrhythmia
III. Shortens the action potential duration by nonspecific blockade of K+ channels.
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I and II only
The following drug is considered to be the most effective in the prevention of ischemic episodes in patients with angina.
A. Sodium nitroprusside
B. Isosorbide dinitrate
C. Propranolol
D. Amlodipine
Propranolol
The diuretic agent that conserves the K+ ions in the body
A. Triamterene
B. Bumetanide
C. Hydrochlorothiazide
D. Furosemide
Triamterene
A case of a 60 year-old male patient with developed gynecomastia and erectile dysfunction due to the treatment of this particular diuretic agent.
A. Hydrochlorothiazide
B. Spironolactone
C. Triamterene
D. Furosemide
Spironolactone
The following statements are true for Lidocaine.
I. Extensive first-pass hepatic metabolism
II. Plasma clearance is increased in liver damage
III. Volume of distribution is decreased in liver damage
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I only
The following are the results of vasodilating activity of Sodium nitroprusside
I. Activation of guanylyl cyclase
II. Increased intracellular cGMP
III. Decreased intracellular cGMP
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I and II only
The following are the mechanism of actions of most of the drugs with vasodilating actions
I. Increasing cGMP
II. Promoting depolarization of the vascular smooth muscles
III. Increasing intracellular Ca2+
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I only
What is the administration rate of theophylline, representing 0.8 of the administered dose,
when aminophylline is infused at 75 mg/hr?
A. 40 mg/h
B. 60 mg/h
C. 50 mg/h
D. 70 mg/h
60 mg/h
Four hours following the IV administration of a drug, a patient (70 kg) was found to have a
plasma concentration of 5.6 mcg/ml. Assuming the Vd is 10 % of body weight, what is the
amount of drug in mg, present in body fluids?
A. 35.7
B. 39.2
C. 37.5
D. 32.9
39.2
The rate of zero-order reactions
A. changes constantly
B. holds only for light catalyzed reactions
C. is independent of temperature
D. holds only for radioactive compounds
E. in independent of concentration
in independent of concentration
What will result if the distribution of drugs is slower than the processes of biotransformation
and elimination?
A. high blood levels of drug
B. potentiation
C. low blood levels of drug
D. failure to attain diffusion equilibrium
E. synergism
failure to attain diffusion equilibrium
Which of the following drugs undergoes marked hydrolysis in the GI tract?
A. ASA
B. Hydrocortisone
C. Penicillin G
D. Chlortetracycline
E. Acetaminophen
Penicillin G
Which of the following factors may make it necessary to give lower doses of drugs to geriatric patients?
A. reduced enzyme activity
B. reduced kidney function
C. enhanced absorption
D. A and B only
E. A, B and C
A and B only
A prime consideration in biopharmaceutics is a drug “bioavailability” which refers to the relative amount of drug that reaches the relative amount of drug that reaches the
A. small intestine
B. liver
C. stomach
D. kidneys
E. systemic circulation
systemic circulation
Differences in bioavailability are most frequently observed with drug products administered by which one of the following routes?
A. Subcutaneous
B. sublingual
C. Intravenous
D. Intramuscular
E. Oral
Oral
The “F” value for a drug product is ideally compared to its
A. absolute bioavailability
B. relative bioavailability
C. dosing rate
D. route of administration
E. clearance rate
absolute bioavailability
Gastric emptying is slowed by all of the following EXCEPT:
A. vigorous exercise
B. hunger
C. fatty foods
D. emotional stress
E. hot meals
hunger
What factor besides the desired steady-state concentration (Css) is most important for
determining an infusion rate of parenteral solution?
A. half-life of the drug
B. total clearance
C. metabolism rate
D. volume of distribution
E. renal elimination
total clearance
What is the effect of combining Digoxin to Verapamil?
A. Verapamil may enhance the AV-blocking effect of Digoxin
B. Verapamil may increase the metabolism of Digoxin
C. Increased effects of Verapamil
D. Decreased serum concentration of Digoxin
Verapamil may enhance the AV-blocking effect of Digoxin
The following are the mechanism of actions of Guanethidine
I. Inhibits the release of norepinephrine from sympathetic nerve endings
II. Increases sensitivity to the hypertensive effects of amines
III. Replaces norephinephrine stores in the nerve endings
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I,II and III
The patient was given a Mannitol 100g for the treatment of his oliguria. From the following,
which is the least likely to be associated with the effect of Mannitol.
A. Effectiveness as non-electrolytic, osmotically active particles
B. Capacity to be freely filtered
C. Ability to be metabolically altered to an active form
D. Retention of water in the tubular fluid
Ability to be metabolically altered to an active form
The following are the mechanism of clinical effects of Calcium channel blockers:
I. Increases atrioventricular nodal conduction
II. Decrease in left ventricular wall stress
III. Increases myocardial oxygen delivery in patients with vasospastic angina
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
II and III only
The rationale of the beta blocker agents as a management for angina pectoris
I. Increase in diastolic perfusion time that may increase coronary perfusion
II. Decreased heart rate, blood pressure and contractility
III. Increase in end-diastolic volume and ejection time.
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I and II only
Which of the following diuretics caused hyperglycemia, hypomagnesemia and hyperuricemia?
A. Spironolactone
B. Furosemide
C. Acetazolamide
D. Hydrochlorothiazide
Acetazolamide
Prophylactic drug for paroxysmal atrial tachycardia
A. Verapamil
B. Nifedipine
C. Procainamide
D. Adenosine
Verapamil
Patient has an angina pectoris treated with sublingual nitroglycerin. Which of the following is involved in the mechanism of actions of nitroglycerin?
A. Phosphorylation of light chains of myosin
B. alpha-adrenergic activity
C. cGMP
D. Phosphodiesterase activity
cGMP
Which of the following is/are the clinical uses of Captopril?
I. Congestive heart failure
II. Prevention of LV dysfunction following MI
III. Diabetic nephropathy
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I,II and III
Patient has hypertension and diabetic nephropathy. His medication is Losartan. What would be the mechanism of action for his medication?
A. Interacts irreversibly at the AT1 and AT2 receptors
B. Have effect on bradykinin metabolism
C. Increases excretion of chloride, magnesium, uric acid, calcium, and phosphate.
D. Decreases urinary flow rate
Increases excretion of chloride, magnesium, uric acid, calcium, and phosphate.
The following statements are true about the mechanism of actions of Carvedilol in the
treatment of CHF EXCEPT
A. Decreased pulmonary capillary wedge pressure
B. Decreased systemic vascular resistance
C. Decreased stroke volume index
D. Decreased right arterial pressure (RAP)
Decreased stroke volume index
Which of the following beta blockers could be administered on a once a day dose?
I. Carvedilol
II. Bisoprolol
III. Betaxolol
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
II and III only
This mode of hepatocyte death is associated with cell shrinkage, nuclear fragmentation and lack of inflammation.
A. apoptosis
B. necrosis
C. hepatosis
D. steatosis
apoptosis
The first clinically useful chelating agent:
A. penicillamine
B. deferoxamine
C. BAL
D. EDTA
BAL
Chemical name of British Anti-Lewisite:
A. 2,3-dimercaptopropanol
B. 2,3-dimercapto-1-propanesulfonic acid
C. dimethylcysteine
D. ethylene diamine tetraacetic acid
2,3-dimercaptopropanol
A hydrolytic product of penicillin for the removal of copper in persons with Wilson’s Disease
A. EDTA
B. BAL
C. Penicillamine
D. Deferoxamine
Penicillamine
An orally active chelating agent alternative for persons who have developed a sensitivity to
penicillamine
A. Triethylene tetramine
B. DTPA
C. BAL
D. Deferoxamine
Triethylene tetramine
In cases of chlorinated hydrocarbon ingestion, the following medication(s) is(are) given:
I. activated charcoal
II. epinephrine
III. diazepam
A. I only
B. II only
C. I and II only
D. I and III only
E. I,II and III
I and III only
Which among the following sulfonylureas achieves blood glucose lowering at the lowest dose.
A. Tolbutamide
B. Glyburide
C. Glipizide
D. Glimepiride
Glimepiride
These are drugs which are ligand of peroxisome proliferator-activated receptor-gamma (PPAR-
gamma)
A. Thiazolidinediones
B. meglitinides
C. Sulfonylurea
D. None of the Above
Thiazolidinediones
Which among the following is/are the cause/s of hypoglycemia with patients under tight
glycemic control?
I. Delay in taking a meal
II. Inadequate carbohydrate consumed
III. Unusual physical exertion
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I,II and III
What is the first incretin therapy to become available in the treatment of diabetes.
A. Sitagliptin
B. Pramlintide
C. Exenatide
D. Rosiglitazone
Exenatide
Which of the following diuretic agent has no effect or no changes in K+ urinary electrolytes?
A. Hydrochlorothiazide
B. Spironolactone
C. Furosemide
D. Acetazolamide
Spironolactone
What electrolyte is primarily decreased in the combination of ethacrynic acid and cardiac
glycosides?
A. Magnesium
B. Calcium
C. Potassium
D. Chloride
Potassium
What is the coagulation factor released by Desmopressin?
A. Factor VIII
B. Factor X
C. Factor IX
D. Factor X
Factor VIII
A folic acid antagonist that binds to the active catalytic site of dihydrofolate reductase,
interfering with the synthesis of the reduced form that accepts one-carbon units.
A. methotrexate
B. cisplatin
C. mercaptopurine
D. allopurinol
methotrexate
Methotrexate also has important applications in the treatment of:
A. Tuberculosis
B. Congestive Heart Failure
C. Rheumatoid arthritis
D. Infections
Rheumatoid arthritis
The first of the thiopurine series found useful as an anticancer drug
A. Cisplatin
B. Fluorouracil
C. Methotrexate
D. Mercaptopurine
Mercaptopurine
Frequently used with chemotherapy in hematologic cancers to prevent hyperuricemia after tumor cell lysis.
A. Allopurinol
B. Fluorouracil
C. Cisplatin
D. Mercaptopurine
Allopurinol
Enzyme responsible for cutting and religating single DNA strands. Inhibition of this enzyme
results in DNA damage.
A. Topoisomerase I
B. Aromatase
C. Topoisomerase II
D. Asparaginase
Topoisomerase I
Natural products that interfere with the activity of Topoisomerase I.
A. Vincristine
B. Camptothecins
C. Podophyllotoxins
D. Taxanes
Camptothecins
An alkaloid ester derived from the Western Yew (Taxus brevifolia) and the European Yew (Taxus
baccata)
A. Cisplatin
B. Vincristine
C. Paclitaxel
D. Podophyllotoxins
Paclitaxel
Used in combination with surgery and vincristine in the adjuvant treatment of Wilm’s tumor
A. Doxorubicin
B. Plicamycin
C. Dactinomycin
D. Mitomycin
Dactinomycin
Major dose-limiting toxicity of Dactinomycin:
A. Alopecia
B. Bone marrow depression
C. Vomiting
D. Thrombocytopenia
Bone marrow depression
Formerly known as Mithramycin, isolated from Streptomyces plicatus:
A. Plicamycin
B. Doxorubicin
C. Dactinomycin
D. Mitomycin
Plicamycin
The statements about esmolol includes which of the following?
I. Beta1-selective blocker metabolized by hydrolysis of red blood cell esterases.
II. Used in hypertension with associated tachycardia
III. Longer half-lives
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I and II only
The mechanism of actions of felodipine include which of the following?
I. Inhibits calcium ions from entering the “slow channels” or select voltage-sensitive areas of vascular smooth muscle and myocardium during depolarization
II. Relaxation of coronary vascular smooth muscle and coronary vasodilation
III. Increases myocardial oxygen delivery in patients with vasospastic angina.
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I,II and III
The mechanisms of actions of ramipril include which of the following?
I. Must undergo enzymatic saponification by esterases in the liver to its
biologically active metabolite
II. Effects of ramipril result from the high-affinity, competitive, reversible binding
of ramiprilat
III. Vasoactive kallikreins may be increased in conversion to active hormones by
ACE inhibitors
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I and II only
The mechanisms of actions of pindolol include which of the following?
I. Has positive inotropic and chronotropic effects and can significantly increase AV
nodal conduction.
II. Blocks both beta1- and beta2-receptors and has mild intrinsic sympathomimetic
activity
III. Augmentive action of antidepressants thought to be mediated via a serotonin
1A autoreceptor antagonism.
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
II and III only
What are the mechanisms of actions of antihypertensive activities of valsartan?
I. Produces indirect antagonism of the angiotensin II (AT2) receptors
II. Displaces angiotensin II from the AT1 receptor by antagonizing AT1-induced
vasoconstriction.
III. Produces direct antagonism of the angiotensin II (AT2) receptors
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
II and III only
The mechanisms of actions of clopidogrel include which of the following?
I. Irreversibly blocks the P2Y12 component of ADP receptors on the platelet
surface
II. Prevents activation of the GPIIb/IIIa receptor complex
III. Increase platelet aggregation
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I and II only
What is the safest 1st generation sulfonylurea for elderly diabetics
A. Chlorpropamide
B. Tolbutamide
C. Tolazamide
D. None of the Above
Tolbutamide
Which among the following insulin is the most recently developed long acting insulin analog that has a dose dependent onset of action of 1-2 hours and duration of action of more than 24 hours?
A. NPH insulin
B. Insulin glargine
C. Insulin detemir
D. None of the above
Insulin detemir
Treatment of choice for acid ingestion:
A. use of emetics and lavage
B. dilution or therapy with milk or water immediately after ingestion
C. use of alkaline substances
D. AOTA
dilution or therapy with milk or water immediately after ingestion
Treatment of choice for alkali ingestion:
A. dilution or therapy with milk or water immediately after ingestion
B. vinegar and lemon juice
C. both
D. NOTA
vinegar and lemon juice
The following may be given for patients with salicylate poisoning
I. Activated charcoal
II. Sodium bicarbonate
III. Acetazolamide
A. I only
B. II only
C. I and II only
D. I and III only
E. I,II,III
I and II only
The first-line antimycobacterial agent which, if given in high doses, indicates periodic
assessment of visual acuity and red-green color discrimination.
A. Streptomycin
B. Ethambutol
C. Pyrazinamide
D. Rifampicin
Ethambutol
Urinary tract infection caused by Chlamydia trachomatis on a pregnant patient is best treated with
A. Co-trimoxazole
B. Levofloxacin
C. Erythromycin
D. Tetracycline
Erythromycin
Ciprofloxacin is used for the treatment of chronic UTI. If a patient appears unresponsive to the antibiotic, which of the following agents is most likely the cause?
A. Aspirin
B. Sodium bicarbonate
C. Phenytoin
D. Ferrous sulfate
Ferrous sulfate
Urethral discharge which when cultured shows Neiserria gonorrhoeae should be treated with
A. Ceftriaxone
B. Co-trimoxazole
C. Benzathine penicillin G
D. Amikacin
Ceftriaxone
Pseudomonas aeruginosa is found in urine cultures and blood cultures of a patient with acute pyelonephritis. Combined therapy should be instituted with an aminoglycoside and which of the following?
A. Vancomycin
B. Azithromycin
C. Piperacillin
D. Clavulanic acid
Piperacillin
Which of the following agents used to treat chronic UTI could cause acute alcohol intolerance?
A. Moxifloxacin
B. Cefotetan
C. Co-trimoxazole
D. Tetracycline
Cefotetan
Trichomoniasis, manifested by itching in the vulval area, is preferably treated with
A. Metronidazole
B. Pyrimethamine
C. Doxycycline
D. Pentamidine
Metronidazole
Clarithromycin, used in combination with other agents for the treatment of duodenal ulcers,
inactivates which enzyme?
A. Na+, K+-ATPase
B. Na+, K+, Cl- co-transporter
C. Cytochrome P450
D. Dihydrofolate reductase
Cytochrome P450
Pneumonia characterized by a sputum culture that is positive for a ß-lactamase-positive
staphylococcal strain should be treated with which penicillin?
A. Carbenicillin
B. Ticarcillin
C. Oxacillin
D. Ampicillin
Oxacillin
Which antiviral agent should be administered to an immunocompromised patient with herpes
simplex keratitis?
A. Amantadine
B. Indinavir
C. Zidovudine
D. Trifluridine
Trifluridine
A geriatric patient develops fever and a cough that produces blood-tinged sputum. Gram-
positive cocci in clusters are found in a sputum smear. A chest x-ray shows increased density in the right upper lobe. Which of the following penicillins is most likely to be ineffective?
A. Cloxacillin
B. Nafcillin
C. Oxacillin
D. Ticarcillin
Ticarcillin
Administration of neostigmine might potentiate the neuromuscular blockade produced by
which of the following agents?
A. Succinylcholine
B. Dantrolene
C. Tubocurarine
D. Hemicholinium
Succinylcholine
A patient who has “spasm of accommodation,” miosis, increased gut motility, excessive salivation and increased sweating may have been given a therapeutic dose of which one of the
following?
A. a ganglionic blocking drug
B. a muscarinic blocking drug
C. an anticholinesterase drug
D. Beta-adrenergic blocking drug
an anticholinesterase drug
The dopamine hypothesis of schizophrenia includes
I. Drugs that increase dopaminergic activity, such as levodopa, amphetamines,
and apomorphine, neither aggravate schizophrenia nor produce psychosis de
novo in some patients
II. Many antipsychotic drugs strongly block post-synaptic D2 receptor in the CNS,
especially the mesolimbic-frontal system
III. Successful treatment of schizophrenic patients has been reported to change the
amount of homovanillic acid (HVA), a metabolite of dopamine, in cerebrospinal
fluid, plasma and urine
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
II and III only
Which one of the following is a drug of choice in the treatment of “wide angle” glaucome
A. Nadolol
B. Timolol
C. Yohimbine
D. Metoprolol
Metoprolol
Stimulation of the vagus nerve in the neck will slow the heart rate directly. Which of the
following drugs would inhibit the response to vagal stimulation?
A. Atropine
B. Pilocarpine
C. Bethanecol
D. Methacholine
Atropine
Which one of the following drugs most likely would be expected to produce tachycardia,
orthostatic hypotension and inhibition of ejaculation?
A. Amphetaine
B. Propranolol
C. Phenoxybenzamine
D. Cocaine
Phenoxybenzamine
Lithium is closely related to sodium in its properties. How does lithium affect electrolytes and
ion transport?
I. It can substitute for Na in generating action potentials and in Na+ - Na+
exchange across the membranes.
II. Li+ - Na+ exchange is gradually slowed after Lithium is introduced into the body.
III. At therapeutic concentrations, it significantly affect the Na+ or Ca+2 exchange
process or the Na+ or K+ ATPase pump
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I and II only
Propranolol most likely would be contraindicated in the treatment of which one of the following conditions?
A. Glaucoma
B. Nasal congestion
C. Hypertension
D. Asthma
Asthma
Which one of the following drugs acts primarily to inhibit reuptake of norepinephrine?
A. Imipramine
B. Tyramine
C. Prazosin
D. Ritodrine
Imipramine
Which is/are true regarding the effects of Epinephrine
I. Increase in cardiac output and coronary blood flow
II. Breakdown of muscle glycogen
III. Bronchiolar constriction
A. I only
B. II only
C. I and II only
D. II and III only
I and II only
With which of the following conditions would atropine most likely be contraindicated?
A. Myasthenia gravis
B. Asthma
C. Hypertension
D. Glaucoma
Glaucoma
The therapeutic effectiveness of neostigmine in myasthenia gravis is thought to be due to
A. Its ability to protect the muscle endplate against acetylcholine
B. Its ability to inactivate acetyl cholinesterase
C. Its ability to increase the rate synthesis of acetylcholine
D. Its stimulant action on the motor nerve terminals at the motor endplate
Its ability to inactivate acetyl cholinesterase
Dobutamine:
I. Useful primarily as a Beta1-receptor agonist
II. Is refractory to inactivation by MAO
III. produces dilation of renal blood vessels
A. I only
B. II only
C. I and II only
D. II and III only
E. I,II and III
I only
Which of the following is the most accurate statement?
A. alpha- adrenoreceptor sympathomimetic agonists are used to reduce mucous membrane
congestion
B. alpha- adrenoreceptor agonists are used to treat bronchospasms
C. beta- adrenoreceptor agonists are used to reduce surgical bleeding
D. beta2 adrenoreceptor agonist agents are used to prolong local anesthesia
alpha- adrenoreceptor sympathomimetic agonists are used to reduce mucous membrane
congestion
Local anesthetic block
A. the release of NT from primary afferents in the spinal cord
B. the processing of painful information in the thalamus
C. the initiation of pain impulses in the periphery
D. the propagation of pain impulses along axons
the propagation of pain impulses along axons
