Pharmacology Flashcards
1
Q
This measure relates the dose of the drug required to produce a desired effect to that which produces an undesired effect.
A
therapeutic index
2
Q
This is the fraction of unchanged drug reaching the systemic circulation following administration by any route:
A
Bioavailability
3
Q
In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy.
A
phase 2
4
Q
This is an irreversible inhibitor of GABA aminotransferase and is useful in the treatment of partial seizures and WEST syndrome:
A
vigabatrin
5
Q
Action of Insulin in the liver:
A
increase storage of glucose as glycogen
6
Q
Most common adverse effect of insulin:
A
hypoglycemia
7
Q
Effect of digitalis in the AV node during arrythmias:
A
AV blockade
8
Q
Immediate metabolic precursor of dopamine that penetrates the blood-brain barrier:
A
levodopa
9
Q
The following are true of phenoxybenzamine:
A
B. blocks catecholamine-induced vasoconstriction / D. stimulates histamine (H1) acetylcholine and serotonin receptors
10
Q
Antiarrhythmic drugs that prolong effective refractory period by prolonging action potential duration:
A
Bretylium
11
Q
Antiarrhytmic of choice for suppression of recurrences of ventricular tachycardia & fibrillation after termination of the arrhythmia by cardioversion:
A
Lidocaine
12
Q
The most serious toxic reaction to local anesthetics is:
A
tonic-clonic convulsions
13
Q
Lithium’s most common side effect/s
A
polyuria and subclinical hypothyrodism
14
Q
Most important unwanted effect of anti-psychotics secondary to relative choline deficiency.
A
Tardive dyskinesia
15
Q
Blocks norepinephrine & serotonin reuptake pumps-the “the off switches” of amine transmission
A
tricyclics
16
Q
Drug interaction of older MAO inhibitor with tyramine ingested in food:
A
Hypertensive reactions
17
Q
The following are sites of the major classes of anti-hypertensive drugs, except:
A
Hypothalamus
18
Q
The following statements regarding selection of anti-hypertensive drugs are correct, except:
A
A. ACE inhibitors are particularly useful in diabetic patients with evidence of renal disease. / B. White race responds better to diuretics and calcium channel blockers than to ß-blockers and ACE inhibitors.* / C. Beta-blockers or calcium channel blockers are useful in patients who have angina. / D. Diuretics or ACE inhibitors are useful who also have CHF
19
Q
The following are the determinants of vascular tone, except:
A
a.Increasing cGMP / b.Increasing cAMP in the vascular cells / c.Decreasing intracellular calcium* / d.Stabilizing or preventing depolarization of the vascular smooth muscle cell membrane
20
Q
The following are the pharmacodynamics of nitroglycerine, except:
A
A. Smooth muscle relaxation / B. Decreased ventricular preload / C. Responsible for a decrease in platelet aggregation / D. Increased cardiac output*
21
Q
The following are the pharmacodynamics of NSAIDs, except:
A
A. Mediated chiefly through inhibition of biosynthesis of prostaglandins / B. All NSAIDs inhibit platelet aggregation* / C. All NSAIDs are anagesic, anti-inflammatory and antipyretic / D. They are all gastric irritants as well
22
Q
The following are disease-modifying antirheumatic drugs, except:
A
a. Methotrexate / b. Cyclosporins / c. Corticosteroids* / d. Azathioprine
23
Q
This agent inhibits cell wall synthesis by binding firmly to the D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide. It inhibits the transglycosylase, preventing further elongation of peptidoglycan and cross-linking.
A
Vancomycin
24
Q
This agent is a potent inhibitor of microbial protein synthesis. It binds reversibly to the 50 S subunit of the bacterial ribosome and inhibits peptidyl transferase step of protein synthesis. This agent is active against rickettsiae but not chlamydiae:
A
Chloramphenicol
25
These agents readily bound to calcium deposited in newly formed bone or teeth in young children. When drug is given during pregnancy, it can be deposited in the fetal teeth, leading to fluorescence, discoloration, and enamel dysplasia:
Tetracyclines
26
This drug is split by intestinal microflora to yiels sulfapyridine and 5 aminosalicylate and is widely used in ulcerative colitis, enteritis and other inflammatory bowel diseases.
Sulfasalazine
27
Blocks the conversion of cholesterol to pregnanolone and causes reduction in the synthesis of all hormonally active steroids; used in pts. with breast Ca
aminoglutethimide
28
A glucocoorticoid antagonist that is an antifungal imidazole derivative, that is potent and rather nonselective inhibitor of adrenal and gonadal steroid synthesis:
ketoconazole
29
The most widely used mineralocorticoid, with both mineralocorticoid and glucocorticoid activity:
fludrocortisone
30
Act as a partial agonist at estrogen receptors in the pituitary, to treat infertility in women by stimulating ovulation:
clomiphene
31
An antiandrogen that prevents synthesis of dihydrotestosterone by inhibiting the activity of 5-α reductase:
finasteride
32
Effects of progesterone:
affects protein metabolism
33
Mazzoti reaction, as an adverse effect is seen with the use of this agent, characterized as eosinophilia, rashes due to the release of foreign particles from the dying microfilariae: :
diethylcarbamazine
34
A depolarizing muscular blocking agent used as an alternative to mebendazole in the treatment of ascariasis and enterobiasis:
pyrantel pamoate
35
Kills dormant liver forms in malaria:
primaquine
36
The drug that could accelerate antithrombin activity resulting to blockade of the coagulation cascade at the at the thrombin level, thus preventing the formation of a clot is:
Heparin
37
This is an antiplatelet drug whose mechanism of action involves inhibition of thromboxane synthesis, thus consequently, prevention of platelet aggregation & thrombus formation:
Aspirin
38
Among the thioamide antithyroid drug, which one is preferred for pregnant women because it crosses the placental barrier less readily thus will not affect the fetus?
Propylthiouracil
39
Which beta blocker is most widely used to control the symptom of hyperthyroidism?
Propranolol
40
Drugs that competitively inhibit CYP enzymes cause
Increase in concentration of object drug
41
The mechanism of action of benzodiazepines is explained by:
Increase frequency of GABA – gated chloride channel opening
42
The use of benzodiazepines in the chronic treatment of seizures is limited because of their
tolerance
43
Which should be observed to minimize adverse effects of sedative hypnotics?
Efficacy of therapy is based on patient’s subjective response
44
A 50 y/o male coca cola executive was using fluoxetine for depression but decided to stop taking the drug for it affects his sexual performance and even said “he is getting older”. He is also a tobacco user. What is the next best drug to use?
Bupropion
45
A fly catching movement of the tongue commonly observed as a drawback of all typical antipsychotics is called
tardive dyskinesia
46
The most hepatotoxic general inhalational anesthetic
halothane
47
A 55 – year old female has post-menopausal osteoporosis. Which is not a recommended drug?
Estrogen
48
Corticosteroid with most potent anti-inflammatory activity:
Betamethasone
49
Drug of choice (DOC) for endometriosis in young women
leuprolide
50
The effect of diethylstilbestrol intake taken during pregnancy on female infants:
vaginal adenocarcinoma
51
The most common adverse effect of clomiphene is
hot flushes
52
A 65 – year old married man was found to have greatly enlarged prostate. Which one of the following drug is MOST likely to suppress prostatic growth without affecting libido?
Finasteride
53
Testosterone therapy may be indicated for the treatment of erectile dysfunction in which of the following situation?
Hypogonadism
54
Major mechanism of action of aspirin as NSAID is
Irreversible PG biosynthesis inhibition
55
Which of the following is the drug of choice for inducing labor
Oxytocin
56
The primary consideration in all clinical trials is to
Provide for the welfare of the subject
57
According to the Philippine National Drug Formulary (PNDF), complementary drugs are:
drugs with special pharmacological properties
58
Which of the following is considered a regulated drug?
pseudoephedrine
59
Differences in the rate of acetylation of isoniazid among groups of individuals exemplifies.
pharmacogenetics
60
Absorption of most orally administered drugs occurs in the small intestine. This may be enhanced by:
taking agents that accelerate gastric emptying time
61
The nicotinic acetylcholine receptors are categorized as to which type?
ion channel-linked
62
If a drug has a high distribution volume, it indicates:
there is extensive tissue uptake
63
The index of safety of a drug decreases as the median toxic dose :
decreases and the median effective dose increases
64
What is the major second messenger of beta receptor activation that participates in signal transduction?
cAMP
65
In what condition are the drugs phenoxybenzamine and phentolamine useful?
pheochromocytoma
66
Acetylcholine acts by:
activating the IP3, diacylglycerol pathway
67
Which of the following antihypertensive agents has the best documented evidence for prophylaxis against migraine attacks?
propranolol
68
Which is a direct effect of nitrates when given in the usual doses for the management of angina?
smooth muscle relaxation
69
A college friend consults you regarding the suitability of the therapy his doctor has prescribed for severe hypertension. He complains of postural and exercise hypotension ("dizziness"), some diarrhea, and problems with ejaculation during sex. Which of the following is most likely to produce the effects that your friend has described?
guanethidine
70
The most important pharmacologic action of digitalis in the treatment of heart failure is its ability to:
increase myocardial contractile force
71
Side effects of oxytocin use in a woman in labor includes the following, EXCEPT:
A. increase in BP / B. uterine rupture / C. fetal death / D. Diuresis*
72
An antithyroid drug which may be given to reduce the vascularity of the thyroid gland prior to thyroidectomy:
Lugol's iodine
73
Drugs that decrease bone resorption include the following, EXCEPT:
A. Calcitonin / B. Estrogen / C. Alendronate / D. Fluoride*
74
Which drug is used as an antiretroviral agent?
indinavir
75
Which of the following enzymes is inhibited by the binding of a beta lactam antimicrobial with penicillin-binding proteins (PBPs)?
transpeptidase
76
A poor farm helper from Palawan was diagnosed to have falciparum malaria by blood smear. The safe, cost-effective, and readily available agent to prescribe if this farmer has an allergy to sulfonamides is:
quinine
77
Radical cure for malaria is achieved by giving:
primaquine
78
There is a sudden increase of atypical pneumonia secondary to Mycoplasma, Chlamydia, and Rickettsia in the Pneumonia Ward of a tertiary hospital. Majority of patients were treated with doxycycline. All of the following ADRs are to be watched out for in these patients EXCEPT:
renal failure
79
Which of the following agents may predispose to the development of pseudomembranous colitis?
clidamycin
80
A patient with persistent chronic cough and fever had no response to adequate doses of oral penicillin. The PE showed normal chest findings. Further PE showed bullous myringitis. A chest Xray showed infiltrates in the right lower lobe. Which of the following antimicrobials would be effective?
chlarithromycin
81
A 4 year old boy that has diarrhea and malnutrition was noted to have a mixed parasitic infection of Ascaris, Capillaria philippinensis, and Trichiuris trichiura. The single agent that could be effective for this patient is:
mebendazole
82
Activated charcoal may be used to treat poisoning due to the following EXCEPT:
A. Primaquine / B. Aspirin / C. Propoxyphene / D. iron overdose *
83
This herbal plant endorsed by the DOH is useful for the relief of muscle pain:
Yerba Buena
84
On regular follow-up for tuberculosis, you noticed that the visual acuity of Vilma worsened from 20/20 to 20/50 in both eyes after only three weeks of HRPE. Your approach in management would be to discontinue:
D. ethambutol, reintroduce it after 1 week, and refer to an ophthalmologist
85
Phenytoin is administered intravenously for acute management of seizure, but when given at a rapid rated can cause
cardiac arrhythmia
86
Which anticonvulsant is safe in pregnancy?
A. hydantoin / B. trimethadione / C. valproic acid / D. none of the above*
87
Which of the following is a common mechanism of action shared by all NSAIDs?
Inhibition of the production of prostaglandin and thromboxane from arachidonic acid through inhibition of prostaglandin H synthesis
88
The primary reason why aspirin has been displaced by NSAIDs as first choice drug of pediatric rheumatologists is because:
need for frequent administration and association with Reye’s syndrome
89
The intravenous anesthetic producing the so-called "dissociative anesthesia" is:
ketamine
90
Your patient requests you to give her a sedative-hypnotic that not will not only calm her down or put her to sleep but will make her forget the whole operating room experience as well. To facilitate this request your drug regimen should include:
midazolam
91
The process by which the amount of drug in the body is reduced after administration but before entering the systemic circulation is called
First-pass Effect
92
Which of the following terms best describes an antagonist that interacts directly with the antagonist and not at all, or only incidentally, with the receptor?
Chemical antagonist
93
A child has swallowed the contents of 2 bottles of a nasal decongestant whose primary ingredient is a potent, selective a adrenoceptor agonist drug. The signs of alpha activation that may occur in this patient include
Cardioacceleration (tachycardia)
94
Ms. Green has severe hypertension and is to receive minoxidil. Minoxidil is a powerful arteriolar vasodilator that does not act on autonomic receptors. When used in severe hypertension, its effects would probably include
Tachycardia and increased cardiac contractility
95
Several children at a summer camp were hospitalized with symptoms thought to be due to ingestion of food containing botulinum toxin. The effects of botulinum toxin are likely to include
Cycloplegia
96
Parathion has which one of the following characteristics?
Its toxicity, if treated early, may be partly reversed by pralidoxime
97
Ms. Brown has had myasthenia gravis for several years. She reports to the emergency department complaining of rapid onset of weakness of her hands, diplopia, and difficulty swallowing. She may be suffering from a change in response to her myasthenia therapy, ie, a cholinergic or a myasthenic crisis.The best drug for distinguishing between myasthenic crisis (insufficient therapy) and cholinergic crisis (excessive therapy) is
Edrophonium
98
A 30-year-old man has been treated with several autonomic drugs for 4 weeks. He is now admitted to the emergency department showing signs of drug toxicity. Which of the following signs would distinguish between an overdose of a ganglion blocker versus a muscarinic blocker?
Postural hypotension
99
Dilation of vessels in muscle, constriction of cutaneous vessels, and positive inotropic and chronotropic effects on the heart are all actions of
Epinephrine
100
Adverse effects that limit the use of adrenoceptor blockers include Heart failure exacerbation from b-blockers
Impaired blood sugar response with a-blockers
101
Which of the following binds covalently to the site specified?
Phenoxybenzamine-a receptor
102
Which one of the following is characteristics of enalapril treatment in patients with essential hypertension?
Decreases angiotensin II concentration in the blood
103
A visitor from another city comes to your office complaining of incessant cough. He has diabetes and hypertension and has recently started taking a different antihypertensive medication. The most likely cause of his cough is
Captopril
104
Verapamil is associated with all of the following, EXCEPT:
A. Bradycardia / B. Hyperglycemia* / C. Increased PR interval / D. Pretibial edema
105
The antianginal effect of propranolol may be attributed to which one of the following?
Block of exercise-induced tachycardia
106
A patient is admitted to the emergency department following a drug overdose. He is noted to have a severe tachycardia. He has been receiving therapy for hypertension and angina. A drug that often causes tachycardia is
Isosorbide dinitrate
107
Drugs that have been found to be useful in one or more types of heart failure include all of the following, EXCEPT
A. Na+/K+ ATPase inhibitors / B. Alpha-adrenoceptors agonist* / C. Beta-adrenoceptors antagonists / D. ACE inhibitors
108
The mechanism of action of digitalis is associated with
An increase in systolic intracellular calcium levels
109
A patient with long-standing diabetic renal disease and hyperkalemia and recent-onset heart failure requires a diuretic. Which of the following agents would be LEAST harmful in a patient with severe hyperkalemia?
Hydrochlorothiazide
110
Inflammation is a complex tissue reaction that includes the release of cytokines, leukotrienes, prostaglandins, and peptides. Prostaglandins involved in inflammatory processes are produced from arachidonic acid by
Cyclooxygenase-2
111
Which of the following situations constitutes an added risk of digoxin toxicity?
Adminstration of quinidine
112
Successful therapy of heart failure with digoxin will result in which one of the following?
Decreased heart rate
113
When used as an antiarrhythmic drug, lidocaine typically
Reduces abnormal automaticity
114
Which of the following is a recognized effect of nitric oxide (NO)?
Pulmonary vasodilation
115
One effect that theophylline, nitroglycerin, isoproterenol, and histamine have in common is
Tachycardia
116
Nedocromil has as its major action
Block of mediator release from mast cells
117
You are on your way to take an examination and you suddenly get an attack of diarrhea. If you stop at a nearby drugstore for an over-the-counter opioid with antidiarrheal action, you will be asking for
Loperamide
118
Conversion of plasminogen to plasmin is brought about by
Reteplase
119
Which of the following pairs of a drug effect and mechanism of action is accurate?
Indomethacin closure of patent ductus arteriosus: blocks prostaglandin E production in the ductus arteriosis of the newborn
120
A 52-year-old woman presented with intense pain, warmth, and redness in the first toe on her left foot. Examination of fluid withdrawn from the inflamed joint revealed crystals of uric acid. In the treatment of this woman’s acute attack of gout, the advantage of using indomethacin instead of colchicines is that indomethacin is
Less likely to cause severe diarrhea
121
A 27-year-old woman with amenorrhea, infertility, and galactorrhea was treated with a drug that successfully restored ovulation and menstruation. Before being given the drug, the woman was carefully questioned about previous mental health problems, which she did not have. She was advised to take the drug orally. The drug used to treat this patient was probably
Bromocriptine
122
Methimazole reduces serum concentration of T3 primarily by
Preventing the addition of iodine to tyrosine residues on thyroglobulin
123
Pharmacologic effects of exogenous glucocorticoids include
Inhibition of leukotriene synthesis
124
Toxic effects of long-term administration of a glucocorticoid include
Osteoporosis
125
For patients who have been on long-term therapy with a glucocorticoid and who now wish to discontinue the drug, gradual tapering of the glucocorticoid is needed to allow recovery of
The hypothalamic-pituitary-adrenal system
126
The estrogen that is used in most combined hormonal contraceptives is
Ethinyl estradiol
127
The most likely complication of insulin therapy in this patient is
Hypoglycemia
128
A 54-year-old obese patient with type 2 diabetes and a history of alcoholism probably should not receive metformin because it can increase the risk of
Lactic acidosis
129
Which of the following drugs is MOST likely to cause hypoglycemia when used as monotherapy in the treatment of type 2 diabetes?
Glyburide
130
A patient needs antibiotic treatement for native valve, culture-positive infective entericoccal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with
Vancomycin
131
The mechanism of antibacterial action of tetracyclines involves
Blockade of binding of aminoacyl-tRNA to bacterial ribosomes
132
In patient with culture-positive enterococcal endocarditis who has failed to respond to vancomycin because of resistance, the treatment most likely to be effective is
Linezolid
133
Which of the following adverse effects is most likely to occur with sulfonamides?
Skin reactions
134
On her release from hospital, the patient is advised not to rely solely on oral contraceptives to avoid pregnancy because they may be less effective while she is being maintained on antimycobacterial drugs. The agent most likely to interfere with the action of oral contraceptives is
Rifampin
135
Chemical interactions between this drug and cell membrane components can result in the formation of pores lined by hydrophilic groups present in the drug molecule
Nystatin
136
Which of the following statements about fluconazole is most accurate?
It inhibits demethylation of lanosterol
137
Which of the following drugs binds to a viral envelope protein preventing the conformational changes required for the fusion of viral and cellular membranes?
Enfuvirtide
138
Which of the following is NOT an expected effect of muscarinic agonists instilled into the conjunctival sac?
Mydriasis
139
Nausea, vomiting, diarrhea, urinary urgency, salivation, sweating, cutaneous vasodilation and bronchial constriction are caused by an overdose of:
Pilocarpine
140
In normal individuals and more so in patients with airway disease, the administration of this agent causes cause some bronchodilation and reduction in secretion.
Atropine
141
This agent relieves motion sickness and is as effective as any more recently introduced agent but causes significant sedation and dry mouth.
Scopolamine
142
AL, 25y.o. male patient is brought to the emergency room suffering from bronchospasm, mucous membrane congestion, angioedema, and severe hypotension. The appropriate drug is:
Epinephrine
143
BM, 50 yo female is asthmatic and hypertensive. The following class of drugs should be avoided as maintenance treatment for her hypertension.
Beta-blockers
144
Which of the following CNS neurotransmitters has only an inhibitory mechanism of action?
GABA
145
Which among the following sedative-hypnotic drugs has the longest elimination half-life and is ingested as a prodrug that is hydrolyzed to its active form in the stomach?
Clorazepate
146
This drug is a novel hypnotic drug prescribed for patients who have difficulty in falling asleep. In polysomnography studies of patients with chronic insomnia, this drug reportedly reduced the latency to persistent sleep with no rebound insomnia or withdrawal symptoms.
Remelteon
147
EJ, 35 yo executive often awakens early in the sleep cycle and could hardly go to sleep again. He may probably benefit from which of the following drugs?
Zolpidem
148
GM, 30 yo female experiences visual scotomas followed after around 30 minutes by a severe throbbing right-sided headache that would last 4 – 8 hours if untreated. Which group of drugs isalmost exclusively used for this condition?
Triptans
149
This drug is effective in reducing pain of mild to moderate intensity through its effects on inflammation and because it probably inhibits pain stimuli at a subcortical site.
Aspirin
150
IT, 60 yo male suffers from excruciatingly painful inflammation of the big toe after binge eating. The following agents may be helpful except?
Tolmetin
151
YH, 62 yo female is suffering from rheumatoid arthritis. Her physician strongly believes that this condition causes significant systemic effects which shorten life in addition to the joint disease that reduces mobility and quality of life. He decides to give her metothrexate, the disease-modifying antirheumatic drug (DMARD) of choice for her condition. The most common adverse effects of this drug is:
nausea and mucosal ulcers
152
This antihypertensive drug is approximately equipotent to propranolol in inhibition stimulation of b1-adrenoceptors but 50- to 100-fold less potent than propranolol in blocking b2-adrenoceptors.
Metoprolol
153
This antihypertensive agent illustrates how one person’s toxicity may be another person’s therapy in that it causes hirsutism, which is bothersome in women but a topical formulation is used to stimulate hair growth, which is beneficial for many men.
Minoxidil
154
This antihypertensive drug may cause severe hypotension in hypovolemic patients, acute renal failure. Hyperkalemia, dry cough sometime accompanied by wheezing, and angioedema.
Captopril
155
MF, 45 yo female with evidence of chronic kidney disease was also diagnosed with hypertension. Which of the following drugs may be helpful for both of her conditions>
Captopril
156
GG, 68 yo female teacher has chronic heart failure with left ventricular dysfunction but no edema. The first drug to be used for her are
ACE inhibitors
157
Chloroquine is effective in the treatment of nonfalciparum and sensitive falciparum malaria but it causes which of the following common side effects?
pruritus
158
The common adverse effects of Quinine in treating falciparum malaria include the following, except
a. tinnitus / b. hemoglobinuria* / c. flushing / d. visual disturbances
159
TT, 7yo male public elementary school student develops mixed soil-transmitted helminthic infections. Which of the following drugs is appropriate?
Mebendazole
160
This group of antimicrobials kills bacterial cells interfering with the transpeptidation reaction of bacterial cell wall synthesis
b-lactam antibiotics
161
The following penicillins are resistant to Staphylococcal beta lactamases, except
a. Methicicillin / b. Amoxicillin* / c. Nafcillin / d. Cloxacillin
162
Which of the following drugs is more stable to bacterial b-lactamases?
Cephalexin
163
The class of cephalosporins with expanded gram-negative coverage with some agents being able to cross the blood-brain barrier, but with 2 agents effective vs. P aeruginosa.
Third generation
164
ME, 33 yo male develops pneumonia and was given penicillin but develops allergy. He was given an alternative drug which had to be discontinued because of gastrointestinal intolerance due to direct stimulation of gut motility. This drug is most probably.
Erythromycin
165
This agent participates in conversion of diatary folate to tetrahydrofolate and isomerization of methylmalonyl-CoA to succinyl CoA and is effective in the treatment of megaloblastic anemia.
Vitamin B12
166
BV, 45 year old female suffers from chronic kidney disease due to diabetic nephropathy leading to recurring anemia. Which of the following agents is most useful for this patient?
Erythropoietin
167
TU, 3 yo male has manifest slowing down of bodily functions leading to striking retaration of growth and development leading to very slow growth and some degree of mental retardation. The most satisfactory preparation for replacement therapy in this case is.
Levothyroxine
168
GF, 25 yo female manifests with warm moist skin, sweating, heat intolerance, periorbital edema, retraction of upper lid with wide stare, exopthalmos an diplopia. The management of this condition involves the following, except:
a. Methimazole / b. Thyroidectomy / c. 131 Iodine / d. None of the above*
169
This agent is a prohormone that serves as a precursor to a number of biologically active metabolites, including calcitriol.
Vitamin D
170
Which of the following is an inscription and translation of a violative prescription based on the Generics Act of 1988?
Amoxil 500 mg caps ---------------------#21
171
All of the following factors can affect the rate and extent of drug absorption EXCEPT
A. Lipophilicity / B. intestinal motility / C. protein binding* / D. presence of P glycoprotein transporter
172
Which of the following factors is TRUE regarding drug distribution?
In general, a drug with a higher degree of plasma protein binding will have a lower Vd.
173
The amount of a drug dose that reaches the systemic circulation in the unchanged form is:
Bioavailability
174
A laboratory experiment is being conducted in which an animal is injected with a non-competitive antagonist to the histamine receptor. Which of the following best describes this drug?
The drug binds to the receptor, but not where histamine binds and prevents the receptor from being activated.
175
The rate and extent of absorption of a drug is decreased by:
addition of carbon-nitrogen bond ( quaternary amine )
176
At low doses, dobutamine receptor selectivity and activity will primarily result to:
increase in cardiac contractility
177
Antiarrythmic with the most marked K-blocking effect
amiodarone
178
Blocks the final common pathway of platelet aggregation:
A. Ticlopidine / B. Clopidogrel / C. abciximab /D. ASA
179
Drug interaction seen with concomitant spironolactone and ACE inhibitor use
Enhanced hyperkalemia*
180
The following anti-hypertensive drug should be used with caution in patients on potassium-sparing diuretics
Losartan
181
Accumulation of bradykinin due to ACE inhibition is responsible for these adverse effects EXCEPT one:
A. Cough / B. Hypotension / C. angioedema/ D. hyperkalemia*
182
The absence of reflex tachycardia with the use of ACE inhibitors is due to
downward resetting of the baroreceptor
183
This adverse effect of nitrates can be prevented by providing nitrate-free interval between administration
tachycardia
184
Which of the following drug combinations will give the best hemodynamic effects of decreasing filling pressure and increasing cardiac output in CHF patients?
furosemide and dopamine
185
The drug of choice for converting paroxysmal atrial tachycardia to normal sinus rhythm
adenosine
186
This class I antiarrhythmic drug has marked negative inotropic action and therefore should not be used in patient with heart failure
lidocaine
187
The risk of Torsades des pointes is highest with the use of
amiodarone
188
Drug-induced lupus is an adverse effect of
A. Procainamide / B. Amiodarone / C. disopyramide / D. amiloride
189
A 60 year old male has dilated cardiomyopathy and is on digoxin. He complains of nausea and vomiting and you think he has digitalis toxicity. Which of the following drugs he is taking most likely enhanced this?
Furosemide
190
The positive inotropic action of cardiac glycosides is associated with
decreased outward flow of calcium*
191
A patient in CHF has developed oliguria because of low cardiac output. To improve renal perfusion, dopamine must be given at this dose in ug/kg/min
2
192
A.M. a 55 year old known hypertensive was found to have heart block on ECG. Which of the drugs below should not be given?
A. Spironolactone / B. Verapamil*
193
Rapid intravenous administration of this drug may cause respiratory depression:
phenobarbital
194
This drug increases free phenytoin levels due to protein binding displacement.
salicylates
195
Which of the following antidepressants will produce a life-threatening syndrome of hyperthermia, muscle rigidity and myoclonus when administered with MAO?
Fluoxetine
196
Ideally, baseline liver function tests are done prior to giving this anticonvulsant
valproic acid
197
Elimination of this anticonvulsant is enhanced significantly by alkalinization of the urine
Phenobarbital
198
Orthostatic hypotension is most common with which of the following antipsychotic agents:
chlorpromazine
199
Carbamazepine exerts its antiepileptic effect through
reduction of Na+ current
200
Based on the mechanism of action, the following antimicrobial is NOT selectively toxic:
cotrimoxazole
201
Which of the following antibiotics is effective against both aerobes and anaerobes?
chloramphenicol
202
This antibiotic is frequently associated with 8th nerve damage in the offspring if given to pregnant women, thus classified under pregnancy risk category D
streptomycin
203
Maculopapular rash with this antibiotic is non-immunologic in nature and does not preclude the use of chemically related antibiotics in the future
amoxicillin
204
A 15 year old college student came in because of headache, fever, chills and photophobia. Thick and thin smears showed P. vivax. The oral drug of choice to rid the blood of plasmodia is
chloroquine
205
Mebendazole is effective against the following parasites EXCEPT
A. capillaria philippinensis* / B. ascaris lumbricoides / C. necator americanus / D. trichuris trichiuria
207
The following adverse reaction to isoniazid is age-related
hepatitis
208
A 50 year old male receiving anti-TB treatment develops mono-articular arthritis. Which of the following could have caused it?
pyrazinamide and ethambutol
209
Of the following, the mechanism of actions of this antifungal does not involve inhibition of cell membrane synthesis
flucytosine
210
Aromatase inhibitor used in the treatment of breast cancer
anastrazole
211
Which of the following statements is TRUE regarding the direct genomic pharmacodynamic action of glucocorticoids (GC)?
GCs diffuse into cell cytoplasm and bind to steroid receptors leading to release of heat shock proteins and dimerization of steroid – receptor complexes which translocate into nucleus and bind to GRE, inducing or inhibiting gene transcription
212
The main mechanism of action is to lower post meal glycemic excursion:
acarbose
213
This drug is an estrogen agonist in the bone but an estrogen antagonist in breast tissue:
raloxifene
214
This is essential for the antithyroid activity of thioamides:
thiocarbamide group
215
The main mechanism for its effectiveness in diabetics is the release of endogenous insulin
sulfonylurea
216
The main action as anti-diabetic agent is to stimulate the nuclear receptors that regulate the transcription of genes encoding proteins involved in protein and carbohydrate metabolism
insulin
217
Which of the following glucocorticoids has the least mineralocorticoid effect and is best for decreasing cerebral edema associated with increased intracranial pressure?
dexamethasone
218
Organophosphate toxicity results from its ability to
inhibit acetycholinesterase
219
A class of proteins that functions as drug receptors that mediate the actions of endogenous chemical signals such as neurotransmitters and hormones:
regulatory proteins
220
Receptor/s coupled to G protein that modulate the production of intracellular second messengers include/s
leukotriene receptor
221
The neuromuscular blocker succinylcholine acts by:
Depolarizing muscle endplate receptors
222
Therapeutic benefit/s of a2 receptor agonists include:
A. antihypertensive / B. antiglaucoma / C. antidiarrheal / D. all of the above*
223
Non-benzodiazepine that has affinity for the Benzodiazepine receptors:
Zolpidem
224
Sedative-Hypnotic with low solubility and penetrate the brain slowly includes:
Phenobarbital
225
The following drugs/substance of abuse are CNS stimulants, EXCEPT:
A. Gamma-hydroxybutyric acid (GHB)* / B. Cocaine / C. Amphetamine / D. Methylenedioxy-Methamphetamine (MDMA, Ecstasy)
226
Characteristic physiologic sign of Cannabis intoxication includes:
increased pulse rate
227
Which among these intravenous general anesthetics produces a dissociative type of anesthesia?
Ketamine
228
Painless digital vasospasm is a dose-related complication of long term treatment with:
Bromocriptine
229
The peripheral metabolism to Levodopa can be prevented if it is given concomitantly with:
Carbidopa
230
An overdose of this opioid causes mydriasis instead of the characteristic miosis of opioid toxicity:
Meperidine
231
Which of these group of tissues would be the first to take up appreciable amounts of inhalational anesthetics?
Vessel-rich
232
A narcotic-addicted patient is given this drug as a “substitute” to be able to control the withdrawal symptoms:
Methadone
233
The duration of action of the intravenous barbiturate anesthetic thiopental is largely determined by:
Redistribution
234
This drug inhibits binding of leukotriene D4 to its receptor on target tissues
Montelukast
235
The mechanism of action of corticosteroids in the treatment of bronchial asthma includes
inhibit airway mucosal inflammation
236
A non-steroidal anti-inflammatory drug that irreversibly acetylates and blocks platelet cycloocygenase is
Aspirin
237
Corticosteroids must be used with great caution in patients with
A. osteoporosis / B. varicella / C. peptic ulcer /D. all of the above*
238
The most common adverse effect of Aspirin is
gastric upset and ulcers
239
A uricosuric drug that decreases body pool of urate in patients with tophaceous gout is
Probenecid
240
Sinoatrial and atrioventricular nodal tissue are affected markedly by
Verapamil
241
The beneficial effect of Captopril in patients with heart failure is attributed to:
reduction in afterload
242
Beta blockers with membrane-stabilizing action, useful as anti-arrhythmics include:
A. Metoprolol / B. Propranolol / C. Acebutolol / D. All of the above*
243
Which of the following antiarrhythmic drugs act by blocking sodium channel?
Lidocaine
244
Antibiotic/s shown to be effective when applied topically in the treatment of acne vulgaris include/s:
A. Clindamycin / B. Erythromycin / C. Metronidazole / D. All of the above*
245
This organophosphate compound is thought to have a cholinesterase inhibitory action which temporarily paralyzes the adult Schistosoma haematobium worms.
Metrifonate
246
Which of these drugs selectively inhibits microtubule synthesis and glucose uptake in nematodes?
Mebendazole
247
For onchocerciasis and strongyloidiasis, this drug is the first choice because it causes fewer systemic and ocular reactions:
Ivermectin
248
Most of the serious adverse effects of Penicllins are due to:
Hypersensitivity reactions
249
The following anti-TB drugs are potentially hepatotoxic, EXCEPT:
A. Rifampin / B. Isoniazid / C. Pyrazinamide / D. Streptomycin*
250
This Anti-TB is relatively contraindicated in young children whose visual acuity and red-green color assessment can not be adequately assessed:
Ethmabutol
251
This antibacterial is available as a nasal ointment useful in the elimination of nasal carriage of Staphylococcus aureus:
Muprocin
252
A drug that is used almost solely as an alternative treatment for gonorrhea in patients whose gonococci are resistant to other drugs is:
Spectinomycin
253
Excessive anticoagulant effect results in bleeding from Warfarin can be reversed by:
A. discontinuance of the drug / B. administration of Vitamin K / C. administration of fresh frozen plasma / D. all of the above*
254
The amount of elemental iron per 325 mg tablet of hydrated ferrous sulfate is ___ mg:
65
255
The preparation of choice for thyroid replacement and suppression therapy is:
Levothyroxine
256
The combination of estrogens and progestins exert their contraceptive effect largely through
inhibition of pituitary function
257
The most dangerous complication of Thioamides is:
agranulocytosis
258
The major use of this drug is in the treatment of endometriosis
Danazol
259
The best treatment option for an obese patient with NIDDM with associated insulin resistance syndrome is:
Metformin
260
Treatment Regimen III as indicated in the National Tuberculosis Control Program consists of:
2HRZ / 4HR
261
The study of the absorption, distribution, metabolism and excretion of drug is known as:
Pharmacokinetics
262
First – pass effect is more likely to occur with this route of administration :
Oral
263
Inert binding sites bind a drug without initiating events leading to a drug effect. They are located in:
Plasma proteins
264
Drug A at a dose of 100 mg. produces the same effect as drug B at a dose of 1000 mg. One of the following statements is correct regarding the two drugs:
Drug A is more potent than Drug B
265
Drugs with very high volume of distribution:
have higher concentrations in extravascular tissue
266
Bioavailability of a drug is 100% following this route of administration:
intravenous
267
Drug biotransformation may result in formation of:
A. inactive metabolites / B. reactive intermediates that are toxic to various organs/ C. an active substance from a prodrug / D. all of the above*
268
Selective COX-2 inhibitors differ from nonselective COX inhibitors in that selective COX-2 inhibitors have no:
gastrointestinal side effects
269
Pharmacologic effects of alcohol include stimulation of the:
secretion of gastric acid
270
One of the following general anesthetics with their respective blood:gas partition coefficients is most soluble in blood:
Methoxyflurane 12.0
271
Reserpine blocks this step in adrenergic transmission:
incorporation of norepinephrine into the vesicle
272
A 24 year old male was brought to the emergency room after having allegedly drank poison. He had constricted pupils, was noted to have salivation and sweating, wheezing, vomiting and diarrhea: The poison must have been:
organophosphate
273
Therapeutic applications of atropine include/s:
bradycardia caused by myocardial infarction
274
Mechanism of action of pralidoxime:
regeneration of the enzyme
275
Compared to norepinephrine, epinephrine has more effects on:
beta 2 receptors
276
Drugs like quinidine, procainamide and disopyramide are useful in the treatment of:
arrhythmia
277
A 65-year old male was admitted at the intensive care unit disoriented with a blood pressure of 220/120. Which of the following drugs will be most appropriate:
Sodium nitroprusside
278
Propranolol and other beta-adrenergic receptor antagonist have the following effect/s on the heart that makes them useful as antiarryhthmic agents:
A. Depress automaticity / B. Prolong A-V conduction / C. Reduce heart rate/ D. All of the above*
279
All of the following are true of sodium nitroprusside EXCEPT:
A. The gold standard for use in hypertensive crisis / B. Mechanism of vasodilating effects similar to nitrates / C. Sensitive to light / D. Metabolite is pharmacologically inert*
280
In patients with congestive heart failure, the use of angiotensin converting enzyme inhibitors will increase
salt and water excretion
281
One of the following antianginal agents is contraindicated in patients with vasospastic angina:
Propranolol
282
Methyldopa as antihyperatensive agent exerts its effect by conversion to alpha-methylnorepinephrine which stimulates centrally this receptor:
alpha-2
283
Aminopenicillins, Carboxypenicillins and Ureidopenicillins compared to Penicillin G:
Have greater activity against gram-negative bacteria
284
Clavulanic acid is added to Ampicillin in order to:
Protect the beta-lactam ring from destruction
285
The most common side effect of erythromycin is:
Gastroinetstinal upset
286
Bacterial synergism is produced by the following drug combination:
Cephalexin and gentamycin
287
This antimicrobial drug may provoke acute gouty arthritis:
Pyrazinamide
288
This agent is proven effects for influenza A:
Amantadine
289
This agent apparently acts as a GABA agonist at the neuromuscular junction and causes flaccid paralysis of the nematode:
Piperazine
290
This antimicrobial agent is also effective for amebic abscesses that fail initial therapy with metronoidazole:
Chloroquine
291
Adverse effects of aminoglycosides include all, EXCEPT:
A. Nephrotoxicity / B. Cardiotoxicity* / C. Neuromuscular blockade / D. Ototoxicity
292
The most common use of estrogen in therpeutics is:
Component of contraceptice pills
293
This is a partial agonist inhibitor of estradiol at the estrogen receptor and used in the palliative treatment of advanced breast cancer:
Tamoxifen
294
Clomiphone enhanced pregnancy by:
Inhibiting estradiol’s negative feedback
295
The most common side effect of insulin is:
Hypoglycemia
296
Actions of Vit. D include:
Promote absorption of calcium and phosphate from the intestine
297
The following antiviral agents DOES NOT require activation by phosphorylation and it directly inhibits DNA and RNA polymerases as well as HIV reverse transcriptase
Foscarnet
