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[Ther 201} E1 > Samplex 2016 > Flashcards

Samplex 2016 Flashcards

1
Q

The following falls under the realm of medical pharmacology?

A. Use of vaccine for prevention of a disease
B. Use of drug for diagnosis of disease
C. Use of antibiotics for treatment of infections
D. AOTA

A

D

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2
Q

Nicotinic subunit receptor responsible for gate opening upon Ach binding

A. Alpha
B. Beta
C. Gamma
D. Delta

A

A

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3
Q

A patient with asthma presented with bronchoconstriction. Which drug will cause a delayed but prolonged effect?

A. Glucocorticoid on GPCR
B. Beta blocker on GPCR
C. Anticholinergic on cyto/nuclear receptor
D. Glucocorticoid on cyto/nuclear receptor

A

D

A and C are not likely since there GCs act on cyto/nuclear receptors while BBs and ACs act on GPCRs. BBs do act on GPCRs but the action is short and fast

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4
Q

Anesthetics that work similarly with tubocurarine induce skeletal muscle relaxation through the following

A. Inhibit exit of Na through NaCh receptor
B. Allow exit
C. Inhibiting the entry of sodium across the cell membranes of the nicotinic acetylcholine receptor
D. Allow exit

A

C

It inhibits ENTRY to prevent depolarization which causes muscle contraction

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5
Q

Action of mannitol is specific for this receptor:

A. Ionotrophic
B. Metabotrophic
C. GPCR
D. None of the above

A

D

Mannitol is non-receptor mediated. It works by exerting an osmotic effect, not by binding to receptors.

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6
Q

What effect does an allosteric activator exert on a drug?

A. Decrease the efficacy of a drug
B. Increase in the efficacy of the drug
C. Effect depends on the drug
D. None of the above

A

B

Allosteric activators bind on the same receptor but different site to improve the effect of another drug

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7
Q

Binding of acetylcholine its receptors triggers this cellular event:

A. The opening of sodium channels
B. Chloride ion enters cell
C. Hyperpolarization of the membrane
D. G-protein is activated

A

A

From SIM on the Mechanism of Drug Action and Signalling Mechanisms. Acetylcholine is the main NT at the NMJ which causes opening of Na channels leading to depolarization, and muscle contraction

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8
Q

What type of receptors does the mineralocoticod aldosterone bind to?

A. Ion channel
B. GPCR
C. Tyrosine kinase linked
D. Cytoplasmic/nuclear

A

D

GCs act on cytoplasmic/nuclear receptors. Another example is thyroid hormones

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9
Q

The following are proposed mechanisms for the development of tolerance and desensitization, except:

A. Endocytosis of receptors
B. Phosphorylation of G protein-coupled receptors
C. Changes in components of response distal to the receptor
D. Exocytosis of the receptor-vesicle complex

A

D

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10
Q

Tamoxifen is a partial agonist of estrogen. As a partial agonist, it will have the following properties:

A. Agonist in the breast, but anti-estrogenic in the bone and uterus
B. Agonist in the uterus and the bone, but anti-estrogenic in the breast
C. Agonist in the ovaries, but anti-estrogenic in the breast
D. B and C

A

B

Used to treat breast cancer, can prevent osteoporosis (more on raloxifene)

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11
Q

Avastatin marketed in 2011. Dr. de Dios wants to show its safety to her ovarian cancer patients. She did clinical study to 50 Filipino patients to collect adverse reactions to Avastatin. What phase is this?

A. Phase I
B. Phase 2
C. Phase 3
D. Phase 4

A

D

Phase 4 is POST-marketing phase

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12
Q

Using the relationship between volume of distribution, clearance, elimination rate constant, and half life, find out what happens to the half life of a drug if clearance is decreased by 50%

A. Half life will be increased by 50%
B. Half life will be increased by 100%
C. Half life will be decreased by 50%
D. Half life will be decreased by 100%

A

B

Ke = Cl/Vd
Ke = ln 2/ t0.5
ln 2/ t0.5 = Cl/Vd
t0.5 = Ln 2 X Vd/Cl
if Cl’ = 0.5 Cl
t0.5’ = ln 2 X Vd / 0.5 Cl
t0.5’ = 2 t0.5
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13
Q

Using the relationship between volume of distribution, clearance, elimination rate constant, and half life, find out what happens to the half life of a drug if the volume of distribution increase by 50% and clearance are simultaneously decreased by 50%

A. Half life will be increased by 50%
B. Half life will be decreased by 50%
C. No change

A

C

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14
Q

Using the relationship between volume of distribution, clearance, elimination rate constant, and half life, find out what happens to the half life of a drug if the volume of distribution and clearance are simultaneously decreased by 50% no change

A. Half life will be increased by 50%
B. Half life will be decreased by 50%
C. No change

A

C

Ke = Cl/Vd
Ke = ln 2/ t0.5
ln 2/ t0.5 = Cl/Vd
t0.5 = Ln 2 X Vd/Cl
if Cl’ = 0.5 Cl, and Vd’ = 0.5 Vd
t0.5’ = ln 2 X 0.5Vd / 0.5 Cl
t0.5’ = t0.5
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15
Q

In the first order compartment model, half life is equivalent to:

A. ln2/Vd
B. (ln2)(Vd)/CL
C. ln2(CL)/Vd

A

B

(Volume of distribution × ln2)/ Clearance   
Ke = Cl/Vd
Ke = ln 2/ t0.5
ln 2/ t0.5 = Cl/Vd
t0.5 = Ln 2 X Vd/Cl
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16
Q

You want to give your patient 2.4 g of drug X per day. If the computed maximum dosing interval is 12.5 hours, which of the following is/are appropriate dosing regimens?

A.	 1.2 grams every 12 hrs
B.	 800 grams every 8 hours
C.	600 grams every 4 hours
D.	A & B
E.	All of the above
A

D

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17
Q

For drug X, 120 grams of IV bolus was given. The computed Area Under the Curve (AUC) is 100 AUC units. The oral dose of 150 mg drug X produces 75 AUC units. What is the absolute oral bioavailability?

A. 25%
B. 30%
C. 50%

A

C

BA = (AUC/dose)oral / (AUC/dose)IV
BA = (75/150)/(100/120)
BA = 60%
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18
Q

True or False: CYP 450 enzymes are called phase 2 metabolic enzymes

A

F

CYP 450 enzymes are called phase 1 metabolic enzymes.since they are oxidoreductases, Redox reactions are under phase I reactions

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19
Q

True or False: If drug X is metabolized into an inactive metabolite, and its inactive metabolite is excreted by the kidney, its mode of elimination is by metabolism and excretion.

A

F

Its mode of elimination is by metabolism only

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20
Q

True or False: In a one compartment model that followed first order input and first order elimination, elimination starts after mass excretion

A

F

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21
Q

True or False: If clearance of drug X is decreased by half, one needs to decrease its loading dose by 50%

A

F

Loading dose is dependent on Vd
DL = Cp X Vd
Maintenance dose is dpendent on Cl
DM = Cl X Cl X T

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22
Q

True or False: Receptors can create new function by binding.

A

F

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23
Q

Receptors which regulate biochemical and physiological functions are in themselves subject to regulatory homeostatic control, which come in the form of:

A. Upregulation
B. Downregulation or desensitization
C. Both

A

C

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24
Q

The semilogarithmic graded dose response curve has the following characteristics:

A. It is a sigmoid curve
B. It consists of 4 parameters: slope, potency, variability, maximal effect
C. The magnitude of the response decreases with greater concentration of the unbound drug at the receptor site
D. A & B only

A

D

The magnitude of the response INCREASES with greater concentration of the unbound drug at the receptor site

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25
Q

True or False: The protein binding of a drug is subject to competition that would be critically important in drug interaction if the percentage binding is 80% or above

A

T

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26
Q

The apparent volume of distribution is:

A. Physiological
B. Relatively low for weakly acidic drugs
C. Relatively high for weakly basic drugs
D. Can range from 8-500L or even 35,000
E. All except A

A

E

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27
Q

Of all the hepatic cyclic proteins forming binds the more that it is responsible for the greatest number of drugs is:

A. CYP 3A
B. CYP 450
C. CYP 27A1
D. CYP 1B1

A

A

, specifically CYP 3A4, CYP 2D6 naman ang most affected by genetic polymorphisms

28
Q

In order for 99% of a drug to be cleared , how many half lives must pass?

A

10

29
Q

True or False. Absolute bioavailability is determined when there are no intravenous data regarding a drug is available.

A

F

30
Q

True or False. Incomplete absorption and hepatic metabolism cause bioavailability of an oral drug to be less than 1.

A

T

31
Q

Therapeutically equivalent drugs have the following characteristics except

A. Same manufacturing processor, packaging, and expiration date
B. Same molar dose
C. Same effects

A

A

A refers to PHARMACEUTICALLY equivalent preparations

32
Q

The following parameter is used to assess and measure the extent of absorption of a drug by a particular route

A.	Elimination
B.	AUC
C.	Cmax
D.	Tmax
E.    Half life
A

B

33
Q

Risk is a product of the following except:

A. Safety
B. Toxicity
C. Exposure

A

A

Risk is equal to the product of toxicity and exposure
Safety is the relative absence of risk

34
Q

Potential stages in the development of toxicity include the following except:

A. Delivery
B. Interaction with the target molecule
C. Cellular dysfunction and injury
D. Dysrepair

A

NA

35
Q

The destruction of cell maintenances involves:

A. Destruction of ATP synthesis
B. Dysregulation of gene expression
C. Direct Injury
D. Dysregulation of ongoing cellular activity

A

A

36
Q

Oxidative stress is an example of which mechanism of toxic action:

A. Impairment of internal maintenance
B. Impairment of external maintenance
C. Toxication
D. Alteration of regulatory or maintenance function of the cell

A

A

37
Q

Actions of endocrine-disrupting substances are classified as:

A. Impaired internal maintenance
B. Impaired external maintenance
C. Dysregulation of gene expression
D. Dysregulation of ongoing cellular activity

A

C

38
Q

The stage of disrepair includes the following except:

A. Apoptosis
B. Necrosis
C. Fibrosis
D. Cancer

A

A

39
Q

The kind of exposure that is the most effective for the toxicant to enter the body is:

A. Intramuscular
B. Subcutaneous
C. Inhalational
D. Ingestional

A

C

: C, mas direct sa bloodstream. Kung may choice na IV, go tayo sa IV!

40
Q

In enterohepatic recirculation, the drug is converted back into this form:

A. Hydrophilic
B. Lipophilic
C. Hydrophobic
D. Lipophobic

A

B

Lipophilic, so that it can be reabsorbed easily

41
Q

The study of toxicokinetics can be used to predict the following:

A. plasma drug concentration
B. Amount of drug absorbed
C. Predicted time for substance to reach the different compartments
D. All of the above

A

D

42
Q

True or False: Pharmacokinetic interactions involve the reactions of drugs that result in the alteration of the ability of the metabolizing enzyme systems.

A

T

43
Q

Bakit kailangan pag-aralan ang pharmacokinetics?

A. Upang malaman ang angkop na dosage, optimum drug concentration
B. Upang mabigay sa pasyente ang pinakmataas na antas ng serbisyong pangkalusugan
C. Lahat ng nasa itaas

A

C

44
Q

Drug elimination is said to be first order if

A. The log plasma concentration - time curve is linear
B. The amount of drug eliminated per unit time is constant
C. the amount eliminated per unit time varies with the amount remaining
D. A and C only/AOTA

A

D

The amount of drug eliminated per unit time is constant → refers to ZERO order kinetics. In first order kinetics, the fraction of drug eliminated per unit time is constant

45
Q

With repeated dosing or continued inclusion of a drug, the steady state is achieved when:

A. The dosing rate is equal to the rate of elimination
B. When the time elapsed after the 1st dose have reached 5 times its half life
C. Both
D. Neither

A

C

46
Q

The apparent volume of distribution of a drug is defined as:

A. The volume to which a drug appears to distribute itself with the concentration equal to that of plasma after equilibration has been attained
B. Equivalent to the plasma volume when all of a drug is bound to plasma proteins
C. Both
D. Neither

A

C

47
Q

Clearance of a drug is defined as:

A

The volume that is cleared of a drug per unit time.

48
Q

Ang pagkakaugnay ng clearance, volume of distribution at elimination rate constant

A.	CL = Ke x Vd
B.	↓ Ke = ↑ CL if Vd doesn’t change
C.	↑ Vd = ↓ CL if Ke doesn’t change
D.	AOTA
E.	A & B only
A

A

. Clearance = elimination rate constant × volume of distribution
↓ Ke = ↓CL if Vd doesn’t change
↑ Vd = ↑CL if Ke doesn’t change

49
Q

Compartmental model analysis is appropriate when:

A. Analyzing drugs administered through the parenteral route
B. Assuming that there is a direct relationship between the drug concentration and the absolute elimination rate
C. Analyzing drugs that operate on a narrow therapeutic range
D. All of the above

A

B

50
Q

True of the two compartment pharmacokinetic model:

A. The rapid initial decline of drug concentration in the plasma is mainly due to distribution and not elimination
B. Drug elimination occurs even before distribution to the compartment is completed
C. The initial secretion phase is important to consider for drugs
D. All of the above

A

D

51
Q

When the semilogarithmic plasma concentration time is linear from time 0 to infinity after a single IV administration of a drug, the following are true:

A. One compartmental model is appropriate for this drug
B. Two compartmental model drug can’t be used
C. Biological half-life can be graphically determined
D. All of the above
E. A & C only

A

E

52
Q

A delayed adverse drug reaction to fertility drugs.

A. Ovarian cancer
B. Uterine benign tumor
C. Both

A

A

53
Q

Drugs that should be avoided by patients with hepatic problems because of higher risk of bleeding

A

warfarin and indomethacin

54
Q

OA with CHF… Digitalis is notorious for causing:

A. Hyponatremia
B. Hypokalemia
C. Hypocalcemia
D. None of the above

A

B

55
Q

Antibiotics that can give rise to drug fever

A

Rifampicin and carbamezepine

56
Q

Serum sickness is more likely to occur in:

A

Rabies vaccine and IV glucose

57
Q

Adverse drug reaction from the new genetically engineered insulin

A

Seizures. Due to hypoglycaemia from higher blood concentrations of insulin due to change of pharmacokinetics

58
Q

The most common form of dermatological manifestation of allergic drug reactions:

A. Melasma
B. Angioedema
C. Morbiliform rash
D. Papular rash

A

C

59
Q

A fatal result of drug-drug interaction of imidazoles and antihistamines causes:

A

Torsades de pointes

60
Q

Pharmacogenetic variations that may appear as unusual response to a drug:

A. Warfarin resistance
B. Hemolytic anemia after taking acetanilide
C. Malignant hyperthermia following use of halothane
D. All of the above

A

C

may be due to G6PD deficiency
The antidote for malignant hyperthermia following use of halothane is dantroline

61
Q

Genetic abnormality noted with Fish odor syndrome.

A

N-oxidation trimethylamine is genetically controlled. A problem in this mechanism leads to the accumulation of TMA. This leads to the fish odor syndrome.

62
Q

The prodrug used in pharmacogenetic study of CYP 2D6:

A. Deprisoprine
B. Parathion
C. Dihydropyrimidine dehydrogenase
D. Nortiptyline

A

A

63
Q

Increased risk for cancer is associated with the following genes:

A. NAT 1
B. NAT 2
C. Both

A

B

64
Q

Which of the following is the most common type of polymorphism in the human genome?

A. Deletions
B. Single Nucleotide Polymorphisms (SNP)
C. Chimera gene

A

B

65
Q

Administration of 6-mercaptopurine will have what undesirable effect?

A

Profound myelosuppression

66
Q

An atypical ADH (alcohol dehydrogenase) variant of the beta 2 subunit is responsible for:

A. a lower ethanol Vmax for the atypical enzyme
B. a lower plasma level of the acetaldehyde metabolite
C. a higher Km for homozygous B2B2
D. a higher intracellular activity of the alcohol dehydrogenase enzyme

A

C

[Ther 201} E1 (5 decks)

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