pharma q bank 80 p Flashcards
(Question ID: 444) A 74-year-old man with a long history of type 2 diabetes complained to his physician of diffcult urination. Further examination led to the diagnosis of a disorder, and treatment with bethanechol improved the symptoms. Which of the following was most likely the patient’s disorder?
a Prostatic hyperplasia
b Impaired diuresis
c Detrusor hyperreflexia
d Neurogenic atony of the bladder
e Urinary tract infection
Neurogenic atony of the bladder
(Question ID: 51) A 65-year-old woman who had been admitted to the hospital with a myocardial infarction developed ventricular tachycardia and received an intravenous injection of lidocaine. Her cardiologist knew that the dose given must be within the range of doses that have a high probability of therapeutic success. Which of the following terms best defines this range?
a) Intrinsic activity
b) Efficacy
c) Potency
d) Therapeutic index
e) Therapeutic window
f) Response variability
Therapeutic window
(Question ID: 83) A 2-year-old boy was admitted to the emergency department after a generalized tonic-colonic seizure. His mother reported that the boy apparently ingested several tablets of propranolol, a β-blocker, which he had found in his father’s dresser drawer. Vital signs on admission were blood pressure 85/50 mm Hg, heart rate 40 beats per minute (bpm), respiratory rate 20/min. The boy received an intramuscular injection of glucagon, a hormone that activates glucagon receptors in the heart, causing a significant increase in heart contractility. Which of the following terms best defines the antagonism between glucagon and β-blockers?
a) Chemical
b) Functional
c) Competitive
d) Pharmacokinetic
e) Pharmacological
Competitive
(Question ID: 90) During a phase 1 clinical trial, four different oral dosage forms of the same dose of a drug were administered to a healthy volunteer on four separate occasions. The plasm a concentration-time curves are plotted. Which of the following features best explains why formulation W produces the largest plasma concentration-time curve of the drug? (picture 90)
a) Highest absorption through gut wall
b) Lowest first-pass effect
c) Lowest hepatic clearance
d) Highest volume of distribution
e) Lowest drug elimination
[Y]Highest absorption through gut wall
(Question ID: 223) A graph of the therapeutic index of warfarin is shown in the following figure. Which of the following statements is true? (picture 223)
a) The therapeutic window is large
b) There is a small window of desired effect of this medication
c) Unwanted adverse events are unlikely with this agent
d) Unwanted adverse events are unlikely dose related
[Y]There is a small window of desired effect of this medication
(Question ID: 224) A 7-year-old girl recently diagnosed with persistent asthma started treatment with inhaled albuterol “as needed.” Which of the following adverse effects was most likely to occur during the therapy?
a) Atrioventricular block
b) Restlessness
c) Sleepiness
d) Postural hypotension
e) Ventricular tachycardia
[Y]Restlessness
(Question ID: 225) An 8-year-old boy was in an ophthalmologist’s office for the first time and received ophthalmic drops of a drug to prepare his eyes for measurement of refractive errors. A half hour later, he showed mental confusion, restlessness, incoherence, and hallucinatory behavior. His pulse rate was 120 bpm. Which of the following drugs most likely caused the patient’s adverse effects?
a) Phenylephrine
b) Epinephrine
c) Atropine
d) Timolol
e) Pilocarpine
[Y]Atropine
(Question ID: 226) A 63-year-old man underwent surgery to remove a laryngeal carcinoma. Before surgery, the anesthesiologist administered a drug intramuscularly to decrease bronchial secretions and to prevent bradycardia due to manipulation of the vagus nerve. Which of the following drugs would be most appropriate in this situation?
a) Ipratropium
b) Dopamine
c) Atropine
d) Isoproterenol
e) Epinephrine
[Y]Atropine
(Question ID: 227) A 25-year-old man experienced severe motion sickness whenever he traveled by air or sea. He felt much better after using a transdermal patch to apply a drug before traveling. Blockade of which of the following receptors most likely mediated the therapeutic effect of the drug in the patient’s disorder?
a) H1 histaminergic
b) β2 adrenergic
c) D2 dopaminergic
d) 5-HT3 serotoninergic
e) M1 cholinergic
f) Nn cholinergic
[Y]M1 cholinergic
(Question ID: 228) A 5-year-old girl who was on vacation in Venezuela with her parents was admitted to the local hospital with fever (103.7°F, 39.8°C), mental confusion, restlessness, and hallucinatory behavior. History revealed that the girl had eaten some honey bought from a local vendor. Physical examination revealed mydriasis; dry, hot, and red skin; and a distended abdomen. A diagnosis of atropine poisoning was made, and an appropriate therapy was started. Which of the following molecular actions most likely contributed to the atropine induced hyperthermia in this patient?
a) Skin vasoconstriction
b) Blockade of prostaglandin synthesis in the hypothalamus
c) Uncoupling of oxidative phosphorylation in skeletal muscle
d) Blockade of muscarinic receptors in the hypothalamus
e) Blockade of muscarinic receptors of sweat glands
e) [Y]Blockade of muscarinic receptors of sweat glands
(Question ID: 229) An 85-year-old male resident of a nursing facility complained of frequent urinary urges that often resulted in urine leakage. Darifenacin was prescribed to manage the patient’s incontinence. Which of the following actions most likely mediate the therapeutic effect of the drug?
a) Decreased bladder internal sphincter tone
b) Relaxation of the prostate capsule
c) Contraction of the detrusor muscle
d) Decreased diuresis
e) increased compliance of the bladder
[Y]Increased compliance of the bladder
(Question ID: 230) A 25-year-old woman complained to her physician of excessive axillary sweating and a sweaty forehead, primarily when she was anxious or excited. The woman stated that the symptoms were very disturbing and asked for a treatment. The physician prescribed glycopyrrolate cream, to apply to the affected areas. Blockade of which of the following receptors most likely mediated the therapeutic effect of the drug in the patient’s disorder?
a) β2 adrenergic
b) Nn cholinergic
c) D1 dopaminergic
d) α2 adrenergic
e) M3 muscarinic
[Y]M3 muscarinic
(Question ID: 231) A 23-year-old man complained to his physician of photophobia and difficulty in reading the newspaper. A few days earlier, the man had started using a nasal spray of ipratropium to manage profuse rhinorrhea associated with a cold. Which of the following molecular actions most likely mediated the adverse effects of the drug?
a) Blockade of M3 muscarinic receptors
b) Activation of M3 muscarinic receptors
c) Activation of M3 muscarinic receptors
d) Activation of β2 adrenoceptors
e) Blockade of α1 adrenoceptors
f) Activation of α1 adrenoceptors
[Y]Blockade of M3 muscarinic receptors
(Question ID: 232) A 42-year-old man came to the clinic for a follow-up visit 2 months after being diagnosed with essential hypertension. Therapy with propranolol and hydrochlorotiazide was started at the time of diagnosis. His blood pressure remained poorly controlled, and he admitted he had been taking the pills only once in a while, because of a disturbing adverse effect. Which of the following was most likely the effect mentioned by the patient?
a) Palpitations
b) Sexual dysfunction
c) Migraine headache
d) Tremor
e) Anginal pain
[Y]Sexual dysfunction
(Question ID: 233) A 31-year-old man was brought to the emergency department after the police found him shouting and acting irrationally in the street. The man admitted that for the past few hours he had been using amphetamines that he had obtained from a new dealer. He was agitated and anxious and exhibited psychotic behavior. Vital signs were blood pressure 230/150 mm Hg, heart rate 160 bpm, respirations 20/min. An emergency therapy was started, and the patient was treated with intravenous diazepam, but 30 minutes later his blood pressure was still 210/130. Which of the following pairs of drugs would be appropriate to include in the patient’s treatment at this time?
a) Phentolamine followed by propranolol
b) Clonidine followed by albuterol
c) Metyrosine followed by neostigmine
d) Bethanechol followed by phenylephrine
[Y]Phentolamine followed by propranolol
(Question ID: 234) A 55-year-old woman presented to a clinic because of a gradual onset of a scratchy sensation on both eyes and extreme dryness of the mouth and lips. Lab tests showed elevated levels of antibodies against gamma globulin. A diagnosis of Sjögren syndrome was made, and a drug was prescribed to relieve the patient’s xerostomia. Which of the following drugs was most likely administered?
a) Acetylcholine
b) Phenylephrine
c) Prazosin
d) Donepezil
e) Pilocarpine
[Y]Pilocarpine
(Question ID: 236) A 33-year-old man recently diagnosed with pheochromocytoma was scheduled for surgery. The week before the operation he received a treatment with a drug that acts by decreasing catecholamine biosynthesis. Which of the following drugs was most likely administered?
a) Phenoxybenzamine
b) Propranolol
c) Metyrosine
d) Dexamethasone
e) Levothyroxine
[Y]Phenoxybenzamine
(Question ID: 235) A 51-year-old woman presented to the clinic with a 1 month history of palpitations, insomnia, nervousness, fatigue, diarrhea, and heat intolerance. The physical examination revealed hyperreflexia, lid lag, and mild tremor. Vital signs were blood pressure 160/60, heart rate 95 bpm. Which of the following drugs was most likely appropriately included in the therapeutic management of this patient?
a) Albuterol
b) Propranolol
c) Labetalol
d) Prazosin
e) Phenoxybenzamine
[Y]Propranolol
(Question ID: 237) Five new antihypertensive drugs were tested in healthy volunteers. All of the drugs were found to be equally effective in controlling hypertension. The minimum effective plasma concentrations and the minimum toxic plasma concentrations were determined for each drug. Which of the drugs has the highest probability of therapeutic success? (picture 237)
a) Drug P
b) Drug Q
c) Drug R
d) Drug S
e) Drug T
[Y]Drug Q
Question ID: 238) The figure below depicts the concentration−time curve of a new drug after a single intravenous dose of 20 mg was administered to a laboratory animal. Which of the following drugs does the new agent most resemble? (picture 238)
a) Atropine
b) Propranolol
c) Ethanol
d) Phenylephrine
e) Clonidine
[Y]Ethanol
(Question ID: 239) A researcher who is interested in creating an anticholinergic agent that would be useful in patients with irritative bladder symptoms would be interested in targeting which of the following receptors?
a) M1
b) M2
c) M3
d) M4
e) M5
[Y]M3
(Question ID: 240) A 47-year-old man is given atropine to decrease dental secretions during a root canal procedure. This agent is most likely to have an effect on which of the following target organs/glands?
a) Adrenal medulla
b) Kidney
c) Pilomotor muscles
d) Salivary glands
e) Sweat glands
[Y]Salivary glands
(Question ID: 241) A 58-year-old woman with a history of myasthenia gravis presents to the emergency department complaining of generalized abdominal pain. Her current medications include nifedipine and neostigmine. Her caretaker reports that her bottle of neostigmine is empty but was full earlier in the day. Which of the following findings is likely in this patient?
a) Bronchodilation
b) Constipation
c) Dizziness
d) Hypotension
e) Xerostomia
[Y]Hypotension
(Question ID: 242) A 73-year-old man presents to his primary care physician complaining of a weak stream and nocturia four times at night. He is very sensitive to the medication side effects and is reluctant to take medications for this reason. Physical examination reveals a mildly enlarged prostate. Treatment of this condition may involve the use of which of the following agents to minimize side effects?
a) Alfuzosin
b) Doxazosin
c) Prazosin
d) Tamsulosin
e) Terazosin
[Y]Tamsulosin
(Question ID: 243) A group of teenage boys comes to the emergency department after ingesting a plant they heard would make them high. One member of the group still had some plant parts in his pocket, which you use to identify deadly nightshade that contains compounds metabolized to atropine. Which of the following is an effect of atropine?
a) Bronchospasm
b) Lacrimation
c) Mydriasis
d) Salivation
e) Urination
[Y]Mydriasis
(Question ID: 244) A 32-year-old man presents to his primary care physician because of a 2-week history of nasal stuffiness, cough, and sinus pain. He is prescribed with phenylephrine. He must be aware of which of the following potential adverse effects?
a) Constipation
b) Diarrhea
c) Epistaxis
d) Hypertension
e) Tinnitus
[Y]Hypertension
(Question ID: 245) Researchers are studying the intracellular effects of certain hormones and neurotransmitters on their respective receptors. After exposing a culture of cells to a catecholamine solution, they saw an increase in the intracellular calcium concentration. Stimulation of which of the following receptors would cause this?
a) Alpha 1-Adrenergic
b) Alpha 2-Adrenergic
c) Beta 1-Adrenergic
d) Beta 2-Adrenergic
e) Dopaminergic-1 (D1
[Y]Alpha 1-Adrenergic
(Question ID: 246) A patient takes an oral sympathomimetic agent for regulation of heart rate. This agent is taken orally. Which of the following systemic effects is likely a result of this medication?
a) Bronchoconstriction
b) Hypotension
c) Pupillary constriction
d) Tachycardia
e) Urinary frequency
[Y]Tachycardia
(Question ID: 247) A 6-month-old male infant is hospitalized for nausea, vomiting, fevers, and failure to tolerate oral medications. He is placed on Phenergan per rectum once daily to treat the nausea and vomiting. Which of the following statements is true about this route of administration?
a) Allows destruction of the medication by gastric enzymes
b) Maximal biotransformation of the drug by the liver
c) Rectal administration of medications is well accepted
d) Rectal irritation following administration is uncommon
e) Useful if patient is unconscious or vomiting
[Y]Useful if patient is unconscious or vomiting
(Question ID: 248) A researcher is studying the bioavailability of commonly used antimuscarinics to treat irritable bowel syndrome. Medication A is administered in a 100 mg daily dose orally and 60 mg of the drug is absorbed from the gastrointestinal tract unchanged. Thus, the bioavailability of Medication A is
a) 50%
b) 60%
c) 70%
d) 80%
e) 90%
[Y]60%
(Question ID: 249) A 38-year-old woman presents to the ophthalmologist for a routine eye examination. She is given intraocular pilocarpine. She was supposed to be administered two drops in each eye for the examination. Unfortunately, the eyedrops were administered by a new technician who inadvertently administered 10 drops of pilocarpine in each eye. Which of the following agents should be immediately given to the patient?
a) Atropine
b) Carbachol
c) Donepezil
d) Galantamine
e) Rivastigmine
[Y]Atropine
(Question ID: 250) A medical student is performing a summer research project evaluating the pharmacologic effects of atropine at varying doses. Doses are extrapolated from normal human doses of this agent. Slow infusion of this agent to a steady state dose of 0.5 mg would be expected to produce which of the following effects?
a) Bradykinesia
b) Coma
c) Dilation of the pupils
d) Dry mouth
e) Tachycardia
[Y]Dry mouth
(Question ID: 251) A medical student is involved in a summer research project evaluating the potencies of the a-adrenergic agonists at different receptor sites. Which of the following a-adrenergic agonists would be expected to have the strongest potency at the a-receptor?
a) Acetylcholine
b) Epinephrine
c) Isoproterenol
d) Metanephrine
e) Norepinephrine
[Y]Norepinephrine
(Question ID: 252) A new autonomic drug was administered locally in the conjunctival sac of a healthy volunteer during a phase 1 clinical
trial. Twenty minutes later, measurement of several eye parameters gave the following results:
Pupillary diameter: decreased
Lens curvature: increased
Intraocular pressure: decreased
Which of the following receptors did the drug most likely activate?
a) α1
b) α2
c) Nm
d) M3
e) β2
[Y]M3
(Question ID: 253) A 77-year-old woman was found to have elevated intraocular pressure during a routine eye examination. History indicated that she had recently been taking several antimuscarinic medications to treat her bladder hyperreflexia. The ophthalmologist told her that he believed the increased intraocular pressure was an adverse effect of those medications. Which of the following ocular actions most likely mediated this adverse effect?
a) Relaxation of the ciliary muscle
b) Increased aqueous humor production
c) Dilation of ciliary body vessels
d) Relaxation of the radial muscle of the iris
e) Decreased episcleral aqueous humor outflow
f) Relaxation of the tarsal muscle
[Y]Relaxation of the ciliary muscle
(Question ID: 254) A 77-year-old man suffering from chronic obstructive pulmonary disease had been taking ipratropium by inhalation. Shortly after inadvertently spraying the medication on his face, which of the following effects did the patient most likely experience?
a) Urge incontinence
b) Drowsiness
c) Salivation
d) Atrioventricular (AV) block
e) Difficulty in near vision
f) Hallucinations
[Y]Hallucinations
(Question ID: 255) Which of the following cholinomimetics is used in the treatment of atropine intoxication?
a) Neostigmine
b) Carbochol
c) Physostigmine
d) Lobeline
[Y]Physostigmine
(Question ID: 256) Subtype-selective alpha 1 receptor antagonists such as tamsulosin, terazosin, alfusosin are efficacious in:
a) Hyperthyroidism
b) Cardiac arrhythmias
c) Benign prostatic hyperplasia (BPH)
d) Asthma
[Y]Benign prostatic hyperplasia (BPH)
(Question ID: 257) Beta 1 receptor stimulation includes all of the following effects EXCEPT:
a) Increase in contractility
b) Bronchodilation
c) Tachycardia
d) Increase in conduction velocity in the atrioventricular node
[Y]Bronchodilation
(Question ID: 258) A 14-year-old girl suffering from seasonal rhinitis started a therapy with loratadine, a drug that binds to H1 histamine receptors. Which of the following terms describes a characteristic of loratadine binding to the H1 receptor?
a) Intrinsic activity
b) Affnity
c) Stereoselectivity
d) Potency
e) Variability
f) Maximal efficacy
[Y]Stereoselectivity
(Question ID: 259) Selective beta-1 blockers are preferred over nonselective beta blockers in some patients because they
a) Cause less cardiodepression
b) [Y]Are less likely to cause bronchoconstriction
c) Are more effective for migraine prophylaxis
d) Are more effective as an antiarrhythmics
e) Have greater prophylactic value post-MI
Are less likely to cause bronchoconstriction
(Question ID: 260) What term is used to describe a decrease in responsiveness to a drug which develops in a few minutes?
a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis
[Y]Tachyphylaxis
(Question ID: 261) Indicate the location of M2 cholinoreceptor type:
a) Heart
b) Glands
c) Smooth muscle
d) Endothelium
[Y]Heart
(Question ID: 262) Epinephrine produces all of the following effects EXCEPT:
a) Positive inotropic and chronotropic actions on the heart (beta1 receptor)
b) Increase peripheral resistance (alpha 1 receptor)
c) Predominance of alpha effects at low concentration
d) Skeletal muscle blood vessel dilatation (beta 2 receptor)
[Y]Predominance of alpha effects at low concentration
(Question ID: 263) Which of the following sympathomimetics is an effective mydriatic?
a) Salmeterol
b) Phenylephrine
c) Dobutamine
d) Norepinephrine
[Y]Phenylephrine
(Question ID: 264) Clonidine works by:
a) Activating beta 1-adrenergic receptors
b) Activating alpha 1-adrenergic receptors
c) Activating beta 2-adrenergic receptors
d) Activating alpha 2-adrenergic receptors
e) Blocking beta-adrenergic receptors
[Y]Activating alpha 2-adrenergic receptors
(Question ID: 265) A new autonomic drug was given intravenously to dog during a lab experiment. It was found that the drug was able to increase cholinergic transmission in both the peripheral and central nervous systems. Which of the following drugs does the new agent most resemble?
a) Acetylcholine
b) Carbachol
c) Bethanechol
d) Neostigmine
e) Physostigmine
[Y]Physostigmine
(Question ID: 266) Which of the following statements is most correct regarding the termination of drug action?
a) Drugs must be excreted from the body to terminate their action
b) Metabolism of drugs always increases their water
c) Metabolism of drugs always abolishes their pharmacologic activity
d) Hepatic metabolism and renal excretion are the two most important mechanisms involved
e) Distribution of a drug out of the bloodstream terminates the drug’s effects
[Y]Hepatic metabolism and renal excretion are the two most important mechanisms involved