Pharmacology Flashcards
This measure relates the dose of the drug required to produce a desired effect to that which produces an undesired effect.
therapeutic index
This is the fraction of unchanged drug reaching the systemic circulation following administration by any route:
Bioavailability
In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy.
phase 2
This is an irreversible inhibitor of GABA aminotransferase and is useful in the treatment of partial seizures and WEST syndrome:
vigabatrin
Action of Insulin in the liver:
increase storage of glucose as glycogen
Most common adverse effect of insulin:
hypoglycemia
Effect of digitalis in the AV node during arrythmias:
AV blockade
Immediate metabolic precursor of dopamine that penetrates the blood-brain barrier:
levodopa
The following are true of phenoxybenzamine:
B. blocks catecholamine-induced vasoconstriction / D. stimulates histamine (H1) acetylcholine and serotonin receptors
Antiarrhythmic drugs that prolong effective refractory period by prolonging action potential duration:
Bretylium
Antiarrhytmic of choice for suppression of recurrences of ventricular tachycardia & fibrillation after termination of the arrhythmia by cardioversion:
Lidocaine
The most serious toxic reaction to local anesthetics is:
tonic-clonic convulsions
Lithium’s most common side effect/s
polyuria and subclinical hypothyrodism
Most important unwanted effect of anti-psychotics secondary to relative choline deficiency.
Tardive dyskinesia
Blocks norepinephrine & serotonin reuptake pumps-the “the off switches” of amine transmission
tricyclics
Drug interaction of older MAO inhibitor with tyramine ingested in food:
Hypertensive reactions
The following are sites of the major classes of anti-hypertensive drugs, except:
Hypothalamus
The following statements regarding selection of anti-hypertensive drugs are correct, except:
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
The following are the determinants of vascular tone, except:
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
The following are the pharmacodynamics of nitroglycerine, except:
A. Smooth muscle relaxation / B. Decreased ventricular preload / C. Responsible for a decrease in platelet aggregation / D. Increased cardiac output*
The following are the pharmacodynamics of NSAIDs, except:
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
The following are disease-modifying antirheumatic drugs, except:
a. Methotrexate / b. Cyclosporins / c. Corticosteroids* / d. Azathioprine
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.
Vancomycin
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:
Chloramphenicol
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
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
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
A glucocoorticoid antagonist that is an antifungal imidazole derivative, that is potent and rather nonselective inhibitor of adrenal and gonadal steroid synthesis:
ketoconazole
The most widely used mineralocorticoid, with both mineralocorticoid and glucocorticoid activity:
fludrocortisone
Act as a partial agonist at estrogen receptors in the pituitary, to treat infertility in women by stimulating ovulation:
clomiphene
An antiandrogen that prevents synthesis of dihydrotestosterone by inhibiting the activity of 5-α reductase:
finasteride
Effects of progesterone:
affects protein metabolism
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
A depolarizing muscular blocking agent used as an alternative to mebendazole in the treatment of ascariasis and enterobiasis:
pyrantel pamoate
Kills dormant liver forms in malaria:
primaquine
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
This is an antiplatelet drug whose mechanism of action involves inhibition of thromboxane synthesis, thus consequently, prevention of platelet aggregation & thrombus formation:
Aspirin
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
Which beta blocker is most widely used to control the symptom of hyperthyroidism?
Propranolol
Drugs that competitively inhibit CYP enzymes cause
Increase in concentration of object drug
The mechanism of action of benzodiazepines is explained by:
Increase frequency of GABA – gated chloride channel opening
The use of benzodiazepines in the chronic treatment of seizures is limited because of their
tolerance
Which should be observed to minimize adverse effects of sedative hypnotics?
Efficacy of therapy is based on patient’s subjective response
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
A fly catching movement of the tongue commonly observed as a drawback of all typical antipsychotics is called
tardive dyskinesia
The most hepatotoxic general inhalational anesthetic
halothane
A 55 – year old female has post-menopausal osteoporosis. Which is not a recommended drug?
Estrogen
Corticosteroid with most potent anti-inflammatory activity:
Betamethasone
Drug of choice (DOC) for endometriosis in young women
leuprolide
The effect of diethylstilbestrol intake taken during pregnancy on female infants:
vaginal adenocarcinoma
The most common adverse effect of clomiphene is
hot flushes
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
Testosterone therapy may be indicated for the treatment of erectile dysfunction in which of the following situation?
Hypogonadism
Major mechanism of action of aspirin as NSAID is
Irreversible PG biosynthesis inhibition
Which of the following is the drug of choice for inducing labor
Oxytocin
The primary consideration in all clinical trials is to
Provide for the welfare of the subject
According to the Philippine National Drug Formulary (PNDF), complementary drugs are:
drugs with special pharmacological properties
Which of the following is considered a regulated drug?
pseudoephedrine
Differences in the rate of acetylation of isoniazid among groups of individuals exemplifies.
pharmacogenetics
Absorption of most orally administered drugs occurs in the small intestine. This may be enhanced by:
taking agents that accelerate gastric emptying time
The nicotinic acetylcholine receptors are categorized as to which type?
ion channel-linked
If a drug has a high distribution volume, it indicates:
there is extensive tissue uptake
The index of safety of a drug decreases as the median toxic dose:
decreases and the median effective dose increases
What is the major second messenger of beta receptor activation that participates in signal transduction?
cAMP
In what condition are the drugs phenoxybenzamine and phentolamine useful?
pheochromocytoma
Acetylcholine acts by:
activating the IP3, diacylglycerol pathway
Which of the following antihypertensive agents has the best documented evidence for prophylaxis against migraine attacks?
propranolol
Which is a direct effect of nitrates when given in the usual doses for the management of angina?
smooth muscle relaxation
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
The most important pharmacologic action of digitalis in the treatment of heart failure is its ability to:
increase myocardial contractile force
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*
An antithyroid drug which may be given to reduce the vascularity of the thyroid gland prior to thyroidectomy:
Lugol’s iodine
Drugs that decrease bone resorption include the following, EXCEPT:
A. Calcitonin / B. Estrogen / C. Alendronate / D. Fluoride*
Which drug is used as an antiretroviral agent?
indinavir
Which of the following enzymes is inhibited by the binding of a beta lactam antimicrobial with penicillin-binding proteins (PBPs)?
transpeptidase
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
Radical cure for malaria is achieved by giving:
primaquine
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
Which of the following agents may predispose to the development of pseudomembranous colitis?
clidamycin
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
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
Activated charcoal may be used to treat poisoning due to the following EXCEPT:
A. Primaquine / B. Aspirin / C. Propoxyphene / D. iron overdose *
This herbal plant endorsed by the DOH is useful for the relief of muscle pain:
Yerba Buena
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
Phenytoin is administered intravenously for acute management of seizure, but when given at a rapid rated can cause
cardiac arrhythmia
Which anticonvulsant is safe in pregnancy?
A. hydantoin / B. trimethadione / C. valproic acid / D. none of the above*
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
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
The intravenous anesthetic producing the so-called “dissociative anesthesia” is:
ketamine
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
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
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
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)
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
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
Parathion has which one of the following characteristics?
Its toxicity, if treated early, may be partly reversed by pralidoxime
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
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
Dilation of vessels in muscle, constriction of cutaneous vessels, and positive inotropic and chronotropic effects on the heart are all actions of
Epinephrine
Adverse effects that limit the use of adrenoceptor blockers include Heart failure exacerbation from b-blockers
Impaired blood sugar response with a-blockers
Which of the following binds covalently to the site specified?
Phenoxybenzamine-a receptor
Which one of the following is characteristics of enalapril treatment in patients with essential hypertension?
Decreases angiotensin II concentration in the blood
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
Verapamil is associated with all of the following, EXCEPT:
A.Bradycardia / B. Hyperglycemia* / C. Increased PR interval / D. Pretibial edema
The antianginal effect of propranolol may be attributed to which one of the following?
Block of exercise-induced tachycardia
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
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
The mechanism of action of digitalis is associated with
An increase in systolic intracellular calcium levels
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
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
Which of the following situations constitutes an added risk of digoxin toxicity?
Adminstration of quinidine
Successful therapy of heart failure with digoxin will result in which one of the following?
Decreased heart rate
When used as an antiarrhythmic drug, lidocaine typically
Reduces abnormal automaticity
Which of the following is a recognized effect of nitric oxide (NO)?
Pulmonary vasodilation
One effect that theophylline, nitroglycerin, isoproterenol, and histamine have in common is
Tachycardia
Nedocromil has as its major action
Block of mediator release from mast cells
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
Conversion of plasminogen to plasmin is brought about by
Reteplase
