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Past papers Flashcards

1
Q

Acetylcholine produces contraction of the smooth muscle of guinea pig ileum. Co-applying atropine with acetylcholine will produce a:

A. change in the apparent efficacy of acetylcholine
B. change in the slope of the acetylcholine concentration response relationship
C. decreased maximal response to acetylcholine
CorrectD. rightward shift in the concentration response curve to acetylcholine

A

d

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2
Q

Pharmacokinetics is the study of the:

A

absorption and metabolism of drugs

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3
Q

The drug Princolol has a pD2 of 12, while Smallicin has a pD2 of 9.

A. Princolol is 3-fold more potent than Smallicin
B. Princolol is 1000-fold more potent than Smallicin
C. Smallicin is 3-fold more potent than Princolol
D. Smallicin is 1000-fold more potent than Princolol

A

b

pD2 (also known as pEC50) is –log (EC50). This means that the larger pD2, the more potent the drug. pD2 units are log10 values, so for every pD2 unit difference, two drugs differ in EC50 by 10 fold. A pD2 difference of 3 means they are 1000-fold different so B is correct. See http://pharmrev.aspetjournals.org/content/55/4/597.full for a list of abbreviations and definitions of terms used in pharmacology.

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4
Q

Aspirin, at low doses, exerts its primary therapeutic action through inhibition of the enzyme:

A

cyclo-oxygenase 1

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5
Q

Theophylline is a(n):

A

adenosine A1 receptor antagonist.

Theophylline is an antagonist of A1 receptors. It is a useful SECONDARY treatment of asthma and can CAUSE dysrhythmia

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6
Q

Diltiazem and nicardipine are both:

A. adenosine A1 receptor antagonists
CorrectB. inhibitors of ion-flux through L-type calcium channels
C. local anaesthetic agents
D. Vaughan Williams class IV antidysrhythmic agents

A

b

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7
Q

Select the principal receptor type that causes depolarisation of postgangiolonic parasympathetic neurones during “rest and digest” responses:

Answers:
A. M1 muscarinic acetylcholine receptors
B. M2 muscarinic acetylcholine receptors
C. M3 muscarinic acetylcholine receptors
CorrectD. Nicotinic acetylcholine receptors

A

d

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8
Q

The anti-asthmatic effect of beclometasone is due to actions at:

Answers:	
A. β-adrenoceptors 
B. histamine receptors
C. intracellular hormone receptors
D. muscarinic acetylcholine receptors
A

c

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9
Q

Enalapril is an inhibitor of, or antagonist at:

A

ACE

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10
Q

Unwanted effects of nicotinic acid include:

A. decreased heptatic triglyceride production
B. impaired glucose tolerance
C. rhabdomyolysis
D. vasoconstriction

A

b

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11
Q

Statement X: Glyceryl trinitrate is a pro-drug
Statement Y: Glyceryl trinitrate must be metabolized by the liver before it can act on the vascular system.

Answers:
A. Statement X is false; statement Y is false
B. Statement X is false; statement Y is true
C. Statement X is true; statement Y is false
D. Statement X is true; statement Y is true AND X is NOT the reason for Y
E. Statement X is true; statement Y is true AND X IS the reason for Y

A

c

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12
Q

Statement X: Epoprostenol causes headache due to its vasodilator actions
Statement Y: Epoprostenol cannot be used for long-term prevention of thrombosis

Answers:
A. Statement X is false; statement Y is false
B. Statement X is false; statement Y is true
C. Statement X is true; statement Y is false
D. Statement X is true; statement Y is true AND X is NOT the reason for Y
E. Statement X is true; statement Y is true AND X IS the reason for Y

A

d

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13
Q

Statement X: Ezetimibe is better-tolerated by patients than colestyramine
Statement Y: Ezetimibe blocks uptake of bile acids but not triglycerides

Answers:
A. Statement X is false; statement Y is false
B. Statement X is false; statement Y is true
C. Statement X is true; statement Y is false
D. Statement X is true; statement Y is true AND X is NOT the reason for Y
E. Statement X is true; statement Y is true AND X IS the reason for Y

A

c

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14
Q

what can be used to treat congestive heart failure?

A

digoxin.

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15
Q

what does digoxin inhibit?

A

sodium/potassium ATPase.

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16
Q

side effects of digoxin?

A

nause and vomiting.

17
Q

which is not ligand gated?

Answers:	
A. GABAA receptor
B. nicotinic acetylcholine receptor
C. strychnine-sensitive glycine receptor 
D. thromboxane receptor
A

d

18
Q

which is not a GRCR?

A. α-adrenoceptor
B. dopamine receptor
C. leukotriene receptor
D. nicotinic acetylcholine receptor

A

d

its ionic

19
Q

what is used to treat cardiac dysrhthymias?

A

beta1 antagonists.
p1 purine receptor agonists
sodium channel blockers

20
Q

what can be used to treat asthma?

A

b2 agonists
adenosine antagonists
leukotriene antagonists.

21
Q

What is a protein superfamily (1 mark)? Give two examples of protein superfamilies (0.5 marks each). Briefly state how protein superfamilies arise (1 mark: guide length of answer, three sentences maximum).

A

A family of homologous proteins that arose from a common ancestor. Examples: GPCR; ligand gated ion channels; CYP (cytochrome P450) enzymes; voltage gated ion channels; nuclear hormone receptors. Arise via duplication of an ancestral gene followed by mutation of the redundant copy. Eventually the mutated redundant copy will become a functionally different protein.

22
Q

Ligand A is an agonist at muscarinic acetylcholine receptors. Ligand B displaces ligand A from its receptor. From this information we can deduce that ligand B is:

Answers:	
A. 
a partial agonist
B. 
an agonist
C. 
an antagonist
D. 
either an agonist, antagonist or partial agonist
A

d

This question is describing a ligand binding experiment in which two drugs compete for the same site. Ligand binding studies do not tell us anything about the efficacy of a drug, so the answer is D.

23
Q

cis adn trans isomerism is what?

A

geometric.

24
Q

A drug that inhibits transport of cholesterol across the brush border of enterocytes is:

Answers:	
A. 
atorvastatin
B. 
colestyramine

ezetimibe
D.
nicotinic acid

A

ezetimibe

All of these are lipid-lowering drugs. Ezetimibe binds to a protein called NPC1L1 on the brush border of enterocytes (cells lining the GI tract) and thereby blocks the uptake of dietary cholesterol. Thus it is the correct answer. Atorvastatin inhibits HmG CoA reductase: the rate limiting enzyme in cholesterol synthesis. Colestyramine sequesters bile acids in the gut, stopping them from being reabsorbed and forcing more cholesterol to be used in their synthesis. The mechanism of nicotinic acid is not well understood.

25
Q

Select a phosphodiesterase inhibitor that is used as a second-line treatment for heart failure:

A. 
dipyrimadole
B. 
dobutamine
C. 
metoprolol
D. 
milrinone
A

d

Dipyridamole is also a phosphodiesterase inhibitor, but it is used as an antithrombosis drug. Dobutamine is a beta1 adrenoceptor agonist with weak beta2 activity. Metoprolol (as its olol suffix should tell you), is a beta blocker (beta1 selective).

26
Q

Thiazide diuretics are often prescribed for the treatment of:

Answers:	
A. 
hypercalcaemia
B. 
hypertension
C. 
hypokalaemia
D. 
hypotension
A

b

Hypercalcaemia is too much calcium (an unwanted effect of the thiazides), hypotension is low blood pressure (another unwanted effect), hypokalaemia is low plasma potassium (another unwanted effect and the reason why potassium sparing diuretics are often prescribed along with the thiazides). This leaves us with hypertension (raised blood pressure): the correct answer.

27
Q

The rising phase (phase 0) of the cardiac muscle action potential is principally mediated by voltage-gated:

calcium channels
Answers:	
A. 
calcium channels
B. 
chloride channels
C. 
potassium channels
D. 
sodium channels
A

d

If we have a look at the action potential of cardiac conducting tissue such as the SA node, it becomes obvious that the main players are sodium,calcium and potassium currents. Sodium channels play two roles. First, there is a slow, spontaneous pacemaker current mediated primarily by sodium channels but with some contribution from calcium (4). This brings the membrane to threshold at regular intervals and triggers action potentials that are carried by fast sodium currents (0). These sodium channels then close (1) and the plateau phase occurs ? primarily calcium mediated (2). Repolarisation occurs due to calcium channel inactivation and activation of potassium channels (3).

28
Q

what is vit K needed for?

A

gamma carboxylation.

29
Q

Statement X: Glyceryl trinitrate cannot pass through cell membranes

Statement Y: Glyceryl trinitrate is ineffective if swallowed

Answers:
A.
Statement X is false; statement Y is false
B.
Statement X is false; statement Y is true
C.
Statement X is true; statement Y is false
D.
Statement X is true; statement Y is true AND X is NOT the reason for Y
E.
Statement X is true; statement Y is true AND X IS the reason for Y

A

b

30
Q

Statement X: Salmeterol is a lipophilic derivative of noradrenaline

Statement Y: Salmeterol is a long-acting β adrenoceptor agonist

Answers:
A.
Statement X is false; statement Y is false
B.
Statement X is false; statement Y is true
C.
Statement X is true; statement Y is false
D.
Statement X is true; statement Y is true AND X is NOT the reason for Y
CorrectE.
Statement X is true; statement Y is true AND X IS the reason for Y

A

e

Salmeterol is indeed a long acting beta2 adrenoceptor agonist, used in the treatment of asthma. It has a lipophilic tail, which extends its duration of action by two mechanisms:

Firstly, it allows the molecule to dissolve into membranes and then leak out over an extended period of time.

31
Q

Statement X: glucocorticoids act on cytoplasmic receptors

Statement Y: inhaled glucocorticoids used to treat asthma have an immediate action

Answers:
A.
Statement X is false; statement Y is false
B.
Statement X is false; statement Y is true
C.
Statement X is true; statement Y is false
D.
Statement X is true; statement Y is true AND X is NOT the reason for Y
E.
Statement X is true; statement Y is true AND X IS the reason for Y

A

c

Glucocorticoids act on nuclear hormone receptors. Despite their name, these receptors are cytoplasmic (they move to the nucleus after binding agonists). In the nucleus, they act on DNA to increase or decrease DNA transcription and thus change the pattern of proteins expressed by the cell. This process is clearly something that takes time and thus such drugs do not have an immediate effect. They can be used to prevent asthma, but not to relieve an acute asthma attack.

32
Q

Statement X: Ezetimibe blocks uptake of bile acids but not triglycerides

Statement Y: Ezetimibe is better-tolerated by patients than colestyramine

Answers:
A.
Statement X is false; statement Y is false
B.
Statement X is false; statement Y is true
C.
Statement X is true; statement Y is false
D.
Statement X is true; statement Y is true AND X is NOT the reason for Y
E.
Statement X is true; statement Y is true AND X IS the reason for Y

A

b

Not so good! Colestyramine an ion exchange resin that binds bile acids preventing their reabsorption. It is poorly tolerated primarily because it needs to be taken in large quantities. Ezetimibe is much more potent (so lower quantities needed) and is thus better tolerated. However, it acts to prevent cholesterol uptake rather than bile acid reuptake, so Y is true but X is false.

33
Q

An antidysrhythmic agent that falls outside the Vaughan Williams classification system is:

Answers:	
A. 
adenosine
B. 
atropine
C. 
digoxin
D. 
flecainide
A

d

All of these drugs are antidysrhythmic agents. Only flecainide (D) fits into the Vaughan Williams system though. It belongs to Class I (sodium channel blockers).

34
Q

List the three MAIN G protein coupled receptor families (0.5 marks for each) and give one example receptor from each family (0.5 marks for each). Your example should be different from the receptor for which the family is named.

A

Family A: rhodopsin family. Adrenoceptors; muscarinic receptors; many other examples
Family B: secretin family. glucagon receptor; calcitonin receptor
Family C: mGluR family. GABAB receptor; calcium sensing receptor

Drugs (10 decks)

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