Pharma FinalA

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17. Drug interaction of older MAO inhibitor with tyramine ingested in food:(p. 505)

A. depression B. Hypertensive reactions*** C. hypotension D. mania

18. The following are sites of the major classes of anti-hypertensive drugs, except:(p.158 )

A. Sympathetic nerve terminals

B. -receptors of juxtaglomerular cells that release rennin

C. Hypothalamus

D. Vasomotor center

19. The following statements regarding selection of anti-hypertensive drugs are correct, except: (p. 179)

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 -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

20. The following are the determinants of vascular tone, except:(p. 182)

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

21. The following are the pharmacodynamics of nitroglycerine, except: (p. 184-185)

A. Smooth muscle relaxation

B. Decreased ventricular preload

C. Responsible for a decrease in platelet aggregation

D. Increased cardiac output

22. The following are the pharmacodynamics of NSAIDs, except: (p. 598-599)

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

23. The following are disease-modifying antirheumatic drugs, except: (p. 608)

a. Methotrexate

b. Cyclosporins

c. Corticosteroids

d. Azathioprine

24. 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. ( p. 768 )

A. Cycloserine B. Vancomycin C. Teicoplanin

D. Bacitracin

25. 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: ( p. 774)

A. Chloramphenicol B. Chlortetracycline C. Amikacin D. Penicillins

26. 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: ( p. 778 )

A. Azithromycin B. Linezolid C. Tetracyclines

D. Aminoglycosides

27.

This drug is split by intestinal microflora to yiels sulfapyridine and 5 aminosalicylate and is widely used inulcerative colitis, enteritis and other inflammatory bowel diseases. (p. 794-795)

A. Sulfadoxine B. Sulfamethoxazole C. Sulfasalazine

D. Sulfadiazine

28. Blocks the conversion of cholesterol to pregnanolone and causes reduction in the synthesis of all

hormonally active steroids; used in pts. with breast Ca (page 674)

A. metyrapone B. trilostane C. aminoglutethimide D. spirinolactone


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29. A glucocoorticoid antagonist that is an antifungal imidazole derivative, that is potent and rather

nonselective inhibitor of adrenal and gonadal steroid synthesis: (page 674)

A. aminogluthetimide B. ketoconazole C. trilostane D. mitotane

30. The most widely used mineralocorticoid, with both mineralocorticoid and glucocorticoid activity: (page

672)

A. aldosterone B. deoxycortisone C. fludrocortisone D. cortisone

31. Act as a partial agonist at estrogen receptors in the pituitary, to treat infertility in women by stimulating

ovulation: (page 699)A. tamoxifen B. clomiphene C. danazol D. mifepristone

32. An antiandrogen that prevents synthesis of dihydrotestosterone by inhibiting the activity of 5-

reductase: (page 705)

A. spirinolactone B. cyproterone C. finasteride D. flutamide

33. Effects of progesterone: (page 690)

A. increase basal insulin levels C. promotes breast development

B. promotes blood coaguability D. affects protein metabolism

34. 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: : (page 908)

A. niclosamide B. diethylcarbamazine C. piperazine D. chloroquine

35. A depolarizing muscular blocking agent used as an alternative to mebendazole in the treatment of

ascariasis and enterobiasis: (page 917)

A. piperazine citrate B. pyrantel pamoate C. praziquantel D. primaquine

36. Kills dormant liver forms in malaria: (page 889)

A. piperazine citrate B. pyrantel pamoate C. praziquantel D. primaquine

37. 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: (p. 567)

A. Warfarin

B.

HeparinansC. Coumarin

D. Plasmin

38. This is an antiplatelet drug whose mechanism of action involves inhibition of thromboxane synthesis, thus

consequently, prevention of platelet aggregation & thrombus formation: (p. 574)

A. Clopidogel

B. Ticlopidine

C. Aspirinans

D. Dipyridamole

39. 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?( p. 651)

A.

Methimazole

B. Carbimazole

C. Propylthiouracilans

D. Ipodate

40.Which beta blocker is most widely used to control the symptom of hyperthyroidism? (p. 653)

A. Propranololans

B. Metoprolol

C. Labetalol

D. Guanithidine

41. Drugs that competitively inhibit CYP enzymes cause

a.

Decrease in concentration of the object drugb. Increase in concentration of object drug

c. Decrease efficacy of object drug

d. Irreversible inactivation of the enzyme

42. The mechanism of action of benzodiazepines is explained by:

a. Substitution for GABA

b. Direct activation of GABA receptors

c. Increase duration of GABAgated chloride channel opening

d. Increase frequency of GABAgated chloride channel opening


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43. The use of benzodiazepines in the chronic treatment of seizures is limited because of their

a. high toxicity effects c. tolerance

b. slow absorption d. low therapeutic index

44. Which should be observed to minimize adverse effects of sedative hypnotics?

a. Always give a very low dose.

b. Doses should be given at daytime.

c. Combine two drugs with different toxicities

d.

Efficacy of therapy is based on patients subjective response

45. 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?

a. Bupropion c. citalopram

b. Sertraline d venlafaxine

46. A fly catching movement of the tongue commonly observed as a drawback of all typical antipsychotics is

called

a. lead pipe rigidity c. tardive dyskinesia

b. rabbit syndrome d. akathisia

47. The most hepatotoxic general inhalational anesthetic

a. Nitrous oxide c. isoflurane

b. Sevoflurane d. halothane

48. A 55year old female has post-menopausal osteoporosis. Which is not a recommended drug?

a. Estrogen c. Biphosphonate

b. Calcium d. Calcitonin

49. Corticosteroid with most potent anti-inflammatory activity:

a. Prednisone c. Betamethasone

b. Dexamethasone d. Cortisone

50. Drug of choice (DOC) for endometriosis in young women

a. danazol c. mifepristone

b. leuprolide d. misoprostol

51. The effect of diethylstilbestrol intake taken during pregnancy on female infants:

a. vaginal adenocarcinoma c. cervical polyp

b. endometrial carcinoma d. breast fibroadenoma

52. The most common adverse effect of clomiphene is

a. hot flushes c. constipation

b. hair loss d. headache

53.

A 65year 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?

a. Spironolactone c. Ketoconazole

b. Finasteride d. Flutamide

54. Testosterone therapy may be indicated for the treatment of erectile dysfunction in which of the following

situation?

a. Aged patient c. Alcoholism

b. Hypogonadism d. Depression

55. Major mechanism of action of aspirin as NSAID is

a. Reversible COX inhibitor c. Irreversible PG biosynthesis inhibition

b.

Chemotaxis inhibition d. Downregulation of IL-1

56. Which of the following is the drug of choice for inducing labor

a. Oxytocin c. Methyl ergonovine

b. Misoprostol d. Dinoprostone

57. The primary consideration in all clinical trials is to

a. Determine the safety of the drug

b. Determine the efficacy of the drug

c. Ensure that there is no risk to the subject


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d. Provide for the welfare of the subject

58. According to the Philippine National Drug Formulary (PNDF), complementary drugsare:

A. those drugs italicized in the guide

B. drugs that satisfy the health care needs of majority of population

C. drugs with special pharmacological properties

D. not to be used as an alternative to core drugs

Ans. C.

Philippine National Drug Formulary, 2000 edition, p. 109.Essential Drugs Concept

59. Which of the following is considered a regulated drug?

A. pseudoephedrine C. lysergic acid diethylamide (LSD)

B. meperidine D. cocaine

Ans. A.

Dangerous Drug Board Info Republic Act 6425

Dangerous Drugs

60. Differences in the rate of acetylation of isoniazid among groups of individuals exemplifies.

A. pharmacodynamics C. pharmacogenetics

B. posology D. biochemorphology

Ans. C.

Katzung, 9thedition, pp. 2 and 5.

Pharmacogenetics

61. Absorption of most orally administered drugs occurs in the small intestine. This may be enhancedby:

A. taking agents that accelerate gastric emptying time

B. the presence of food

C. stimulation of hepatic microsomal CYP3A4 enzymes

D. increasing intestinal motility

Ans. A.

Katzung, 9th

edition, pp. 41, 42, 53, and 56.Pharmacokinetics

62. The nicotinic acetylcholine receptors are categorized as to which type?

A. G protein coupled C. kinase-linked

B. ion channel-linked D. nuclear

Ans. B

Katzung, 9thedition pp. 18-23

Pharmacodynamics

63. If a drug has a high distribution volume, it indicates:

A. it is highly bound to plasma proteins

B. the drug is highly retained in the vascular compartment

C. the plasma drug concentration will increase

D. there is extensive tissue uptake

Ans. D.

Katzung, pp. 35 and 47.

Pharmacokinetics

64. The index of safety of a drug decreases as the median toxic dose :

A. decreases and the median effective dose increases

B. increases and the median effective dose decreases

C. and the median effective dose decrease

D. and the median effective dose increase

Ans. A.

Katzung, 9thedition, p. 30.

Pharmacodynamics

65. What is the major second messenger of beta receptor activation that participates in signal transduction?

A. inositol triphosphates C. calcium

B. cAMP D. adenylyl cyclase


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Ans. B.

Katzung, 9thedition, p. 25-27.

Pharmacodynamics

66. In what condition are the drugs phenoxybenzamine and phentolamine useful?

A. pheochromocytoma C. essential hypertension

B. migraine attacks D. benign prostatic hyperplasia

Ans. A.

Katzung, 9thedition, pp. 144-146.Adrenergic Receptor Blockers

67. Acetylcholine acts by:

A. increasing adenylyl cyclase activity

B. decreasing cGMP concentrations

C. activating the IP3, diacylglycerol pathway

D. all of the above

Ans. C

Katzung, 9thedition, p.97

Cholinergic Agonists

68.

Which of the following antihypertensive agents has the bestdocumented evidence for prophylaxis against

migraine attacks?

A. pindolol C. clonidine

B. propranolol D. prazosin

Ans. B.

Katzung, 9thedition, pp. 148 and 156

Adrenoceptor Antagonists

69. Which is a direct effectof nitrates when given in the usual doses for the management of angina?

A. increased preload C. increased cardiac contractility

B. increased afterload D. smooth muscle relaxation

Ans. D.


Vasodilators / CVS Drugs

70. 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?

A. propranolol C. hydralazine

B. guanethidine D. captopril

Ans. B.


Antihypertensive / CVS Drugs

71. The most important pharmacologic action of digitalis in the treatment of heart failure is its ability to:

A. reduce venous pressure C. produce diuresis in edematous patients

B. increase heart rate D. increase myocardial contractile force

Ans. D.


Cardiac Glycosides / CVS Drugs

72.

Side effects of oxytocin use in a woman in labor includes the following, EXCEPT:A. increase in BP C. fetal death

B. uterine rupture D. diuresis

Ans. D.

Katzung 9thedition, p. 621

Hormones and Pituitary glands / Drugs used for Endocrine Disorders

73. An antithyroid drug which may be given to reduce the vascularity of the thyroid gland prior to

thyroidectomy:


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A. RAI C. methimazole

B. PTU D. Lugol's iodine

Ans. D.

Katzung, 9thedition, p. 633

Thyroid & Antithyroid Drugs / Drugs used for Endocrine Disorders

74. Drugs that decrease bone resorption include the following, EXCEPT:

A. calcitonin C. alendronate

B. estrogen D. fluoride

Ans. D.


Agents that affects bone mineral homeostasis

75. Which drug is used as an antiretroviral agent?

A. oseltamivir C. indinavir

B. famciclovir D. ribavirin

Ans. C.


Anti-viral Agents

76. Which of the following enzymes is inhibited by the binding of a beta lactam antimicrobial with penicillin-

binding proteins (PBPs)?

A. beta-lactamase C. peptidyl tranferase

B. transpeptidase D. acetylase

Ans. B.

Katzung, 9thedition, pp. 734-735 and 764.

Beta-lactams / Antimicrobials

77. A poor farm helper from Palawanwas diagnosed to have falciparummalaria by blood smear. The safe,

cost-effective, and readily available agent to prescribe if this farmer has an allergy to sulfonamides is:

A. Fansidar C. chloroquineB. quinine D. mefloquine

Ans. B.


Anti-malarial Drugs / Antiprotozoals

78. Radical cure for malaria is achieved by giving:

A. chloroquine C. mefloquine

B. quinine D. primaquine

Ans. D.

Katzung, 9thedition, p.871

Anti-malarial Drug

79. There is a sudden increase of atypical pneumonia secondary to Mycoplasma, Chlamydia, and Rickettsiain

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:

A. photosensitivity C. superinfection

B. fetal bone defects D. renal failure

Ans. D.

Katzung, 9thedition, pp. 758

Tetracyclines / Antimicrobials

80. Which of the following agents may predispose to the development of pseudomembranous colitis?

A. erythromycin C. vancomycinB. metronidazole D. clidamycin

Ans. D.


Antimicrobials

81. 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?


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A. parenteral penicillin G C. vancomycin

B. chlarithromycin D. gentamicin

Ans. B.

Katzung, 9thedition, pp. 760

Macrolides / Antimicrobials

82. 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:A. pyrantel pamoate C. diethylcarbamazine

B. mebendazole D. niclosamide

Ans. B.

Katzung, 9thedition, pp. 889-895. Harrison, 15thedtition, p. 1249.

Anti-helmintic Drugs

83. Activated charcoal may be used to treat poisoning due to the following EXCEPT:

A. primaquine C. propoxyphene

B. aspirin D. iron overdose

Ans. D.


Management of Poisoned Patient

84. This herbal plant endorsed by the DOH is useful for the relief of muscle pain:

A. Yerba Buena C. Tsaang gubat

B. Akapulko D. Sambong

Ans. A.

DOH Manuals.

Herbal Medicines

85. 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 todiscontinue:

A. all of the 4 drugs and reintroduce one drug at a time

B. ethambutol and refer to an ophthalmologist

C. pyrazinamide and refer to an ophthalmologist

D. ethambutol, reintroduce it after 1 week, and refer to an ophthalmologist

Ans. .


Anti-tuberculosis Drugs

86. Phenytoin is administered intravenously for acute management of seizure, but when given at a rapid

rated can cause

A. generalized seizure C. cardiac arrhythmia

B. gingival hyperplasia D. gastrointestinal disturbances

Answer C.

Goodman and Gilman, 10thedition, p. 530.

Anti-epileptic drugs / CNS Drugs

87. Which anticonvulsant is safe in pregnancy?

A. hydantoin C. valproic acid

B. trimethadione D. none of the above

Answer D.

Katzung, 9th

edition, pp. 398.Anti-epileptic drugs / CNS Drugs

88. Which of the following is a common mechanism of action shared by all NSAIDs?

A. inhibition of arachidonate release from the plasma membrane by ihibiting

phospholipase

B. Inhibition of histamine release by inhibiting mast cell degranulation

C. Inhibition of the production of prostaglandin and thromboxane from arachidonic acid through

inhibition of prostaglandin H synthesis

D. Inhibition of the the formation of leukotrienes by inhibiting lipoxygenase


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Answer: C.

Katzung, 9thedition, pp. 263, 306, 577, and 581

Agents which controls prostaglandin effect / CNS Drugs

89. The primary reason why aspirin has been displaced by NSAIDs as first choice drug of pediatric

rheumatologists is because:

A. poor inflammatory effect and gastric irritation

B. poor inflammatory effect and Reyes syndrome

C. lack of liquid preparation and high toxicity effectD. need for frequent administration and association with Reyes syndrome

Answer D.

Katzung, 9thedition, p. 579-581. Goodman and Gilman, 10thedition, p. 698.

Agents which control prostaglandin effect / CNS Drugs

90. The intravenous anesthetic producing the so-called "dissociative anesthesia"is:

A. fentanyl C. ketamine

B. thiopental D. propofol

Answer: C.

Katzung, 9thedition, pp. 413-414. Goodman and Gilman, 10thedition,

pp. 346-347.

General Anesthetic / CNS Drugs

91. Your patient requests you to give her a sedative-hypnotic that not will not only calmher down or put her

to sleep but will make her forgetthe whole operating room experience as well. To facilitate this request

your drug regimen should include:

A. midazolam C. phenobarbital

B. succinylcholine D. etomidate

Answer: A.

Katzung, 9thedition, p. 413-415.

General Anesthetic / CNS Drugs

B 92. The process by which the amount of drug in the body is reduced after

administration but before entering the systemic circulation is called

A. Excretion

B. First-pass Effect

C. Metabolism

D. First-order elimination

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Page 43

C 93. 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?

A. Pharmacologic antagonist

B.

Partial agonist

C. Chemical antagonist

D. Physiologic antagonist

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Page 16

B 94. A child has swallowed the contents of 2 bottles of a nasal decongestant whose

primary ingredient is a potent, selective adrenoceptor agonist drug. The signs

of alpha activation that may occur in this patient include

A. Bronchodilation

B. Cardioacceleration (tachycardia)

C. Vasodilation

D.

Pupillary dilation (mydriasis)MPL: 0.33

Page 127

A 95. 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

A. Tachycardia and increased cardiac contractility

B. Tachycardia and decreased cardiac output

C. Decreased mean arterial pressure and decreased cardiac contractility


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D. Decreased mean arterial pressure and increased salt and water

excretion by the kidney

MPL: 0.25

Page 170

B 96. 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

A. Bronchospasm

B.

CycloplegiaC. Diarrhea

D. Skeletal muscle spasms

MPL: 1.0

Page 89

D 97. Parathion has which one of the following characteristics?

A. It is less toxic to humans than malathion

B. It is more persistent in the environment than DDT

C. It is poorly absorbed through skin and lungs

D. Its toxicity, if treated early, may be partly reversed by pralidoxime

MPL: 0.5

Page 1029

B 98. 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

A. Atropine

B. Edrophonium

C. Physostigmine

D. Pralidoxime

MPL: 0.25

Page 103

D 99. 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?

A. Blurred vision

B. Dry mouth, constipation

C. Physostigmine

D. Postural hypotension

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Page 116

B 100. Dilation of vessels in muscle, constriction of cutaneous vessels, and positive

inotropic and chronotropic effects on the heart are all actions of

A. Acetylcholine

B. Epinephrine

C. Isoproterenol

D. Metaproterenol

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Page 130

A 101. Adverse effects that limit the use of adrenoceptor blockers include

Heart failure exacerbation from -blockers

A. Impaired blood sugar response with -blockers

B. Increased intraocular pressure with -blockers

C.

Sleep disturbances from -blocking drugsMPL: 0.5

Page 145

C 102. Which of the following binds covalently to the site specified?

A. Atenolol - receptor

B. Carvedilolcardiac receptors

C. Phenoxybenzamine-receptor

D. Pindolol - receptors


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MPL: 1.0

Page 141

B 103 Which one of the following is characteristics of enalapril treatment in patients

with essential hypertension?

A. Competitively blocks angiotensin II at its receptor

B. Decreases angiotensin II concentration in the blood

C. Decreases renin concentration in the blood

D. Increases sodium and decreases potassium in the blood

MPL: 0.5Page 173

A 104 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

A. Captopril

B. Losartan

C. Propranolol

D. Verapamil

MPL: 0.5

Page 172

B 105. Verapamil is associated with all of the following, EXCEPT:

A. Bradycardia

B. Hyperglycemia

C. Increased PR interval

D. Pretibial edema

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Page 172

A 106. The antianginal effect of propranolol may be attributed to which one of the

following?

A. Block of exercise-induced tachycardia

B. Decreased end-diastolic ventricular volume

C.

Dilation of constricted coronary vesselsD. Increased cardiac force

MPL: 0.5

Page 195

B 107. 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

A. Diltiazem

B. Isosorbide dinitrate

C. Propranolol

D.

VerapamilMPL: 0.33

Page 185

B 108. 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

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Page 127

D 109. The mechanism of action of digitalis is associated with

A. A decrease in calcium uptake by the sarcoplasmic reticulum

B. An increase in ATP synthesis

C. A modification of the acting molecule

D. An increase in systolic intracellular calcium levels

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Page 205

B 110. A patient with long-standing diabetic renal disease and hyperkalemia and

recent-onset heart failure requires a diuretic. Which of the following agents


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would be LEAST harmful in a patient with severe hyperkalemia? (pp.256)

A. Amiloride

B. Hydrochlorothiazide

C. Spironolactone

D. Triamterene

MPL: 1.0

Page 256

B 111. Inflammation is a complex tissue reaction that includes the release of cytokines, leukotrienes,

prostaglandins, and peptides. Prostaglandins involved in inflammatory processes are produced fromarachidonic acid by

A. Cyclooxygenase -1

B. Cyclooxygenase-2

C. Lipoxygenase

D. Phospholipase A2

MPL: 0.5

Page 312

B 112. Which of the following situations constitutes an added risk of digoxin toxicity?

A. Administration of captopril

B. Adminstration of quinidine

C.

HypermagnesemiaD. Hyperkalemia

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Page 230

A 113. Successful therapy of heart failure with digoxin will result in which one of

the following?

A. Decreased heart rate

B. Increased afterload

C. Increased aldosterone

D. Increased renin secretion

MPL: 1.0

Page 206

D 114. When used as an antiarrhythmic drug, lidocaine typically

A. increases action potential duration

B. Increases contractility

C. Increases PR interval

D. Reduces abnormal automaticity

MPL: 0.25

Page 235

D 115. Which of the following is a recognized effect of nitric oxide (NO)?

A. Arrhythmia

B. Bronchoconstriction

C.

ConstipationD. Pulmonary vasodilation

MPL: 1.0

Page 329

C 116. One effect that theophylline, nitroglycerin, isoproterenol, and histamine have

in common is

A. Increased gastric acid secretion

B. Direct stimulation of cardiac contractile force

C. Tachycardia

D. Postural hypotension

MPL: 0.25

Page 1023

B 117. Nedocromil has as its major action

A. Block of calcium channels in lymphocytes

B. Block of mediator release from mast cells

C. Block of phosphodiesterase in mast cells and basophils

D. Smooth muscle relaxation in the bronchi

MPL: 0.5

Page 337


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C 118 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

A. Codeine

B. Dextromethorphan

C. Loperamide

D. Diphenoxylate

MPL: 1.0

Page 527

C 119. Conversion of plasminogen to plasmin is brought about by

A. Aminocaproic acid

B. Heparin

C. Reteplase

D. Warfarin

MPL: 0.2

Page 572

D 120. Which of the following pairs of a drug effect and mechanism of action is

accurate?

A. Allopurinol action in gout: inhibits reuptake of uric acid from renal tubular fluid

B.

Etanercept antirheumatic action: inhibits dihydroorotate dehydrogenase, theenzyme in lymphocytes that is required for pyrimidine synthesis

C. Hydroxychloroquine antirheumatic action: a cytotoxic drug that kills rapidly

dividing lymphocytes

D. Indomethacin closure of patent ductus arteriosus: blocks prostaglandin E

production in the ductus arteriosis of the newborn

MPL: 0.4

Page 605

B 121. 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 womans acute attack of

gout, the advantage of using indomethacin instead of colchicines is that indomethacin is

A.

Less likely to cause acute renal failure

B. Less likely to cause severe diarrhea

C. Less likely to precipitate sudden gastrointestinal bleeding

D. More likely to prevent another acute attack

MPL: 0.6

Page 605

A 122. 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

A.

BromocriptineB. Desmopressin

C. Leuprolide

D. Human gonadotropin hormone

MPL: 0.5

Page 468

D 123. Methimazole reduces serum concentration of T3primarily by

A. Accelerating the peripheral metabolism of T3

B. Inhibiting the proteolysis of thyroid-binding globulin

C. Inhibiting the secretion of TSH

D. Preventing the addition of iodine to tyrosine residues on thyroglobulin

MPL: 0.6

Page 651

C 124. Pharmacologic effects of exogenous glucocorticoids include

A. Increased muscle mass

B. Hypoglycemia

C. Inhibition of leukotriene synthesis

D. Improved wound healing

MPL: 0.33

Page 665


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14

D 125. Toxic effects of long-term administration of a glucocorticoid include

A. A lupus-like syndrome

B. Adrenal gland neoplasm

C. Hepatotoxicity

D. Osteoporosis

MPL: 0.33

Page 670

D 126. For patients who have been on long-term therapy with a glucocorticoid and

who now wish to discontinue the drug, gradual tapering of the glucocorticoidis needed to allow recovery of

A. Depressed release of insulin from pancreatic B cells

B. Hematopoiesis in the bone marrow

C. Normal osteoblast function

D. The hypothalamic-pituitary-adrenal system

MPL: 0.6

Page 671

B 127. The estrogen that is used in most combined hormonal contraceptives is

A. Clomiphene

B. Ethinyl estradiol

C. DES

D.

Norgestrel

MPL: 1.0

Page 682

B 128. The most likely complication of insulin therapy in this patient is

A. Dilutional hyponatremia

B. Hypoglycemia

C. Pancreatitis

D. Severe hypertension

MPL: 1.0

Page 721

C 129. A 54-year-old obese patient with type 2 diabetes and a history of alcoholismprobably should not receive metformin because it can increase the risk of

A. A disulfiram-like reaction

B. Excessive weight gain

C. Lactic acidosis

D. Hypoglycemia

MPL: 0.5

Page 728

B 130. Which of the following drugs is MOST likely to cause hypoglycemia when used

as monotherapy in the treatment of type 2 diabetes?

A. Acarbose

B. Glyburide

C.

Miglitol

D. Rosiglitazone

MPL: 0.4

Page 726

D 131. 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

A. Amoxicillin-clavulanate

B. Aztreonam

C. Meropenem

D.

VancomycinMPL: 0.4

Page 768

C 132. The mechanism of antibacterial action of tetracyclines involves

A. Binding to a component of the 50S ribosomal subunit

B. Inhibition of translocase activity

C. Blockade of binding of aminoacyl-tRNA to bacterial ribosomes

D. Selective inhibition of ribosomal peptidyl transferases

MPL: 0.33


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15

Page 776

D 133. 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

A. Clarithromycin

B. Erythromycin

C. Minocycline

D. Linezolid

MPL: 1.0Page 782

D 134. Which of the following adverse effects is most likely to occur with sulfonamides?

A. Neurologic effects, including headache, dizziness, and lethargy

B. Hematuria

C. Fanconis aminoaciduria syndrome

D. Skin reactions

MPL: 0.2

Page 793

C 135. 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

A. Ethambutol

B. Isoniazid

C. Rifampin

D. Pyrazinamide

MPL: 1.0

Page 806

C 136. 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

A.

CaspofunginB. Griseofulvin

C. Nystatin

D. Fluconazole

MPL: 0.25

Page 1049

D 137. Which of the following statements about fluconazole is most accurate?

A. it is highly effective in treatment of aspergillosis

B. It does not penetrate the blood-brain barrier

C. Its oral bioavailability is less than that of ketoconazole

D. It inhibits demethylation of lanosterol

MP[L: 0.25

Page 819

D 138. Which of the following drugs binds to a viral envelope protein preventing the

conformational changes required for the fusion of viral and cellular membranes?

A. Abacavir

B. Adenavir

C. Oseltamivir

D. Enfuvirtide

MPL: 0.33

Page 820

No Question Ans Ref page4

139. Which of the following is NOT an expected effect of muscarinic

agonists instilled into the conjunctival sac?a. Contraction of the smooth muscle of the iris sphincter

b. Contraction of the ciliary muscle

c. Mydriasis

d. Improves aqueous humor outflow in the canal of Schlemm.

C 97

140. Nausea, vomiting, diarrhea, urinary urgency, salivation, sweating,

cutaneous vasodilation and bronchial constriction are caused by an

overdose of:

a. Ipratropium

b. Pirenzepine

D 105


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16

c. Benztropine

d. Pilocarpine

141. In normal individuals and more so in patients with airway disease, the

administration of this agent causes cause some bronchodilation and

reduction in secretion.

a. Atropine

b. Metacholine

c. Carbachol

d. Bethanechol

A 113

142. This agent relieves motion sickness and is as effective as any more

recently introduced agent but causes significant sedation and dry

mouth.

a. Oxybutinin

b. Scopolamine

c. Tolterodine

d. Darifenacin

B 114

143. 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:

a.

Phenylephrineb. Ephedrine

c. Amphetamine

d. Epinephrine

D 137

144. BM, 50 yo female is asthmatic and hypertensive. The following class of

drugs should be avoided as maintenance treatment for her

hypertension.

a. ACE inhibitors

b. Calcium channel blockers

c. Beta-blockers

d. Diuretics

C 156

145. Which of the following CNS neurotransmitters has only an inhibitory

mechanism of action?

a.

GABAb. Acetylcholine

c. Glutamate

d. 5-Hydroxttryptamine

A 341

146. 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?

a. Alprazolam

b. Lorazepam

c. Oxazepam

d. Clorazepate

D 352

147. This drug is a novel hypnotic drug prescribed for patients who have

difficulty in falling asleep. In polysomnography studies of patients withchronic insomnia, this drug reportedly reduced the latency to

persistent sleep with no rebound insomnia or withdrawal symptoms.

a. Remelteon

b. Buspirone

c. Diazempam

d. Triazolam

A 350

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?

a. Flurazepam

b. Clorazepate

c. Zolpidem

d.

None of the above

C 358

148. GM, 30 yo female experiences visual scotomas followed after around

30 minutes by a severe throbbing right-sided headache that would last

48 hours if untreated. Which group of drugs isalmost exclusively

used for this condition?

a. Triptans

b. Propranolol

c. Topiramate

d. Valproate

A 268


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17

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.

a. Paracetamol

b. Tramadol

c. Aspirin

d. All of the above

C 577

150. IT, 60 yo male suffers from excruciatingly painful inflammation of the

big toe after binge eating. The following agents may be helpful except?

a.

Indomethacinb. Colchicine

c. Tolmetin

d. None of the above

C 583

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:

a. hepatotoxicity

b. hypersensitivity lung reaction

c. nausea and mucosal ulcers

d. pseudolymphomatous reactions

C 583584

152. This antihypertensive drug is approximately equipotent to propranolol

in inhibition stimulation of 1-adrenoceptors but 50- to 100-fold less

potent than propranolol in blocking 2-adrenoceptors.

a. Nadolol,

b. Carteolol

c. Pindolol

d. Metoprolol

D 169

153. This antihypertensive agent illustrates how one persons toxicity may

be another persons 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.

a.

Diltiazemb. Hydralazine

c. Minoxidil

d. Methyldopa

C 173

154. This antihypertensive drug may cause severe hypotension in

hypovolemic patients, acute renal failure. Hyperkalemia, dry cough

sometime accompanied by wheezing, and angioedema.

a. Captopril

b. Methyldopa

c. Reserpine

d. Sodium nitroprusside

A 177

155. MF, 45 yo female with evidence of chronic kidney disease was alsodiagnosed with hypertension. Which of the following drugs may be

helpful for both of her conditions>

a. Metoprolol

b. Hydrochlorothiazide

c. Captopril

d. Nifedipine

C 178

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

a. - blockers

b. Diuretics

c. Calcium blockers

d. ACE inhibitors

D 206

157. Chloroquine is effective in the treatment of nonfalciparum and

sensitive falciparum malaria but it causes which of the following

common side effects?

a. pruritus

b. hemolysis

c. alopecia

d. hypotension

A 849

158. The common adverse effects of Quinine in treating falciparum malaria

include the following, except

a. tinnitus

B 851


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18

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?

a. Pyrantel pamoate

b. Praziquantel

c. Mebendazole

d.

Metronidazole

C 868

160. This group of antimicrobials kills bacterial cells interfering with the

transpeptidation reaction of bacterial cell wall synthesis

a. Tetracyclines

b. -lactam antibiotics

c. Macrolides

d. All of the above

B 726

161. The following penicillins are resistant to Staphylococcal beta

lactamases, except

a. Methicicillin

b. Amoxicillin

c.

Nafcillind. Cloxacillin

B 732

162. Which of the following drugs is more stable to bacterial -lactamases?

a. Penicillin G

b. Amoxicillin

c. Cephalexin


C 733734

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.

a. First generation

b.

Second generation

c. Third generation

d. Fourth generation

C 737

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.

a. Cefalexin

b. Amoxicillin-clavulanic acid

c. Minocycline

d. Erythromycin

D 749

165. This agent participates in conversion of diatary folate to

tetrahydrofolate and isomerization of methylmalonyl-CoA to succinylCoA and is effective in the treatment of megaloblastic anemia.

a. Vitamin B12

b. Iron

c. Erythropoietin

d. None of these

A 532

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?

a. Iron

b. Folate

c. Erythropoietin

d. Interleukin

C 537

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.

a. Liothyronine

b. Levothyroxine

c. Methimazole

d. Propylthiouracil

B 628


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19

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. 131Iodine


D 630

169. This agent is a prohormone that serves as a precursor to a number ofbiologically active metabolites, including calcitriol.

a. Calcimimetics

b. Vitamin D

c. Calcitonin

d. None of these

B 710

170. Which of the following is an inscription and translation of a violative

prescription based on the Generics Act of 1988?

a. Paracetamol 500mg tabs ----------------#20

b. Amoxil 500 mg caps ---------------------#21

c. Ponstan (Mefenamic Acid) 500 mg ---#12

d. B an C are violative prescriptions

B Generics Act

of 1988

Basic and Clinical Pharmacology by: Bertram G. Katzung, 10thedition, 2007

_____ 171. All of the following factors can affect the rate and extent of drug absorption EXCEPT

A. lipophilicity C. protein binding

B. intestinal motility D. presence of P glycoprotein transporter

ANS C p.41

_____ 172. Which of the following factors is TRUE regarding drug distribution?

A. All drugs distribute to the same degree in all tissues.

B. The binding of drugs to tissues has no relationship to the distribution of drug in the body.

C. In general, a drug with a higher degree of plasma protein binding will have a lower Vd.

D.

In general, lipophilic drugs distribute to a lesser extent than hydrophilic drugs

ANS C p. 34

_____ 173. The amount of a drug dose that reaches the systemic circulation in the unchanged form is:

A. Bioavailability C. Cmax

B. Clearance D. half-life

ANS A p. 40

_____ 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?

A. The drug binds to the histamine receptor and partially activates it.

B. The drug binds to the histamine receptor but does not activate it.

C. The drug binds to the receptor, but not where histamine binds and prevents the receptor from being

activated.

D. The drug irreversibly binds to the histamine receptor and renders it ineffective.

ANS C p. 16

_____ 175. The rate and extent of absorption of a drug is decreased by:

A. inhibition of P-glycoprotein transporter

B. addition of carbon-nitrogen bond ( quaternary amine )

C. inhibition of gut wall metabolism

D. low ionization constant

ANS B p. 41

_____ 176. At low doses, dobutamine receptor selectivity and activity will primarily result to:

A. bronchodilation C. uterine contraction

B. dilatation of renal bladder vessels D. increase in cardiac

contractility

ANS D p.133

_____ 177. Antiarrythmic with the most marked K-blocking effect


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20

A. lidocaine C. quinidine

B. amiodarone D. verapamil

ANS B pp 228

_____ 178. Blocks the final common pathway of platelet aggregation:

A. ticlopidine C. abciximab

B. clopidogrel D. ASA

_____ 179. Drug interaction seen with concomitant spironolactone and ACE inhibitor useA. ACE inhibitors may decrease renal perfusion decreasing the action of spironolactone in the collecting

tubules

B. Additive afterloader effect

C. Enhanced hyperkalemia*

D. Enhanced vasodilating effect of ACE inhibitors because of inhibition of metabolism by spironolactone

ANS C p. 177

_____ 180. The following anti-hypertensive drug should be used with caution in patients on potassium-sparing

diuretics

A. losartan* C. hydrochlorthiazide

B.

verapamil D. methyldopa

ANS A p. 177

_____ 181. Accumulation of bradykinin due to ACE inhibition is responsible for these adverse effects EXCEPT

one:

A. cough C. angioedema

B. hypotension D. hyperkalemia

ANS D p. 177

_____ 182. The absence of reflex tachycardia with the use of ACE inhibitors is due to

A.

downward resetting of the baroreceptorB. mild decrease in peripheral vascular resistance

C. enhanced sympathetic activity

D. inhibition of RAA system

ANS A p. 176

_____ 183. This adverse effect of nitrates can be prevented by providing nitrate-free interval between

administration

A. dependence C. tolerance

B. hypotension D. tachycardia

ANS D p. 186

_____ 184. Which of the following drug combinations will give the best hemodynamic effects of decreasing

filling pressure and increasing cardiac output in CHF patients?

A. furosemide and dopamine C. captopril and digoxin

B. digoxin and verapamil D. furosemide and digoxin

ANS A p. 208

_____ 185. The drug of choice for converting paroxysmal atrial tachycardia to normal sinus rhythm

A. propranolol C. quinidine

B. adenosine D. flecainide

ANS B p. 231

_____ 186. This class I antiarrhythmic drug has marked negative inotropic action and therefore should not be

used in patient with heart failure

A. quinidine C. disopyramide

B. procainamide D. lidocaine

ANS D p.225

_____ 187. The risk of Torsades des pointes is highest with the use of


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21

A. sotalol C. bretylium

B. flecainide D. amiodarone

ANS D p. 223

_____ 188. Drug-induced lupus is an adverse effect of

A. procainamide C. disopyramide

B. amiodarone D. amiloride

_____ 189. A 60 year old male has dilated cardiomyopathy and is on digoxin. He complains of nausea andvomiting and you think he has digitalis toxicity. Which of the following drugs he is taking most likely

enhanced this?

A. Furosemide* C. spironolactone

B. Carvedilol D. captopril

ANS A p. 204

_____ 190. The positive inotropic action of cardiac glycosides is associated with

A. an increase in ATP synthesis

B. a modification in actin molecule

C. decreased outward flow of calcium*

D. a decrease in calcium uptake by the sarcoplasmic reticulum

ANS C p. 199-202

_____ 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

A. 2* C. 15

B. 10 D. 20

ANS A p. 133

_____ 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 C. captoprilB. Verapamil* D. prazosin

ANS A p. 175; 230

_____ 193. Rapid intravenous administration of this drug may cause respiratory depression:

A. phenytoin C. phenobarbital

B. lamotrigine D. carbamazepine

ANS C p.359

_____ 194. This drug increases free phenytoin levels due to protein binding displacement.

A.

Cimetidine C. chloramphenicol

B. salicylates D. isoniazid

ANS B p.377

_____ 195. Which of the following antidepressants will produce a life-threatening syndrome of hyperthermia,

muscle rigidity and myoclonus when administered with MAO?

A. Fluoxetine C. imipramine

B. trazodone D. clomipramine

ANS A p. 486

_____ 196. Ideally, baseline liver function tests are done prior to giving this anticonvulsantA. topiramate C. valproic acid

B. levetiracetam D. gabapentin

ANS C p. 387

_____ 197. Elimination of this anticonvulsant is enhanced significantly by alkalinization of the urine

A. Phenobarbital C. valproic acid

B. Carbamazepine D. phenytoin


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22

ANS A p.380

_____ 198. Orthostatic hypotension is most common with which of the following antipsychotic agents:

A. Perphenazine C. chlorpromazine

B. Haloperidol D. olanzapine

ANS C p.461

_____ 199. Carbamazepine exerts its antiepileptic effect through

A.

inhibition of low threshold transient Ca++ currentB. inhibition of neurotransmission by NMDA and non-NMDA receptors

C. reduction of Na+ current

D. enhancement of post-synaptic GABA receptor current

ANS C p. 378

_____ 200. Based on the mechanism of action, the following antimicrobial is NOT selectively toxic:

A. piperacillin C. amphotericin B

B. cotrimoxazole D. gentamicin

ANS B p. 763

_____ 201. Which of the following antibiotics is effective against both aerobes and anaerobes?

A. metronidazole C. aztreonam

B. gentamicin D. chloramphenicol

ANS D p. 752

_____ 202. This antibiotic is frequently associated with 8thnerve damage in the offspring if given to pregnant

women, thus classified under pregnancy risk category D

A. Clarithromycin C. ciprofloxacin

B. Tetracycline D. streptomycin

ANS D p. 759

_____ 203. Maculopapular rash with this antibiotic is non-immunologic in nature and does not preclude the use

of chemically related antibiotics in the futureA. Erythromycin C. amoxicillin

B. Cefalexin D. cotrimoxazole

ANS C p. 733

_____ 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

A. Quinine C. mefloquine

B. Primaquine D. chloroquine

ANS D p.846

_____ 205. Mebendazole is effective against the following parasites EXCEPT

A. capillaria philippinensis C. necator americanus

B.

ascaris lumbricoides D. trichuris trichiuria

ANS A p. 872

_____ 206. The following antiviral agents DOES NOT require activation by phosphorylation and it directly inhibits

DNA and RNA polymerases as well as HIV reverse transcriptase

A. penciclovir C. cidofovir

B. acyclovir D. foscarnet

ANS D p. 797

_____ 207. The following adverse reaction to isoniazid is age-related

A.

SLE like syndrome C. neuropathyB. Hemolysis D. hepatitis

ANS D p. 773

_____ 208. A 50 year old male receiving anti-TB treatment develops mono-articular arthritis. Which of the

following could have caused it?

A. pyrazinamide and ethambutol C. ethambutol + streptomycin

B. rifampicin + pyrazinamide D. ethambutol + INH


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23

ANS A pp. 774-775

_____ 209. Of the following, the mechanism of actions of this antifungal does not involve inhibition of cell

membrane synthesis

A. Terbinafine C. flucytosine

B. Fluconazole D. griseofulvin

ANS C p. 784

_____ 210. Aromatase inhibitor used in the treatment of breast cancerA. Tamoxifen C. anastrazole

B. Danazol D. leuprolide

ANS C p. 673

_____ 211. Which of the following statements is TRUE regarding the direct genomic pharmacodynamic action of

glucocorticoids (GC)?

A. GCs diffuse into cell cytoplasm and into nucleus where it binds to glucocorticoid response element

(GRE) and act as transcription factor, upregulating gene transcription

B. GCs diffuse into cell cytoplasm and bind to steroid receptors leading to release of heat shock proteins

and dimerization of steroidreceptor complexes which translocate into nucleus and bind to GRE,

inducing or inhibiting gene transcription

C.

GCs diffuse into cell cytoplasm, binding to steroid receptors, the steroid-receptor complexes then

bind to transcription factor inhibiting synthesis of pro-inflammatory cytokines

D. GCs activate cell membrane enzymes leading to formation 2ndmessenger

ANS B p. 639

_____ 212. The main mechanism of action is to lower post meal glycemic excursion:

A. metformin C. acarbose

B. glipizide D. nateglinide

ANS C p. 700

_____ 213. This drug is an estrogen agonist in the bone but an estrogen antagonist in breast tissue:

A.

raloxifene C. tamoxifenB. alendronate D. calcitonin

ANS A p. 672

_____ 214. This is essential for the antithyroid activity of thioamides:

A. phenyl group C. thiocarbamide group

B. methyl group at 3 D. iodide substituent at 3

ANS C p.625

_____ 215. The main mechanism for its effectiveness in diabetics is the release of endogenous insulin

A. sulfonylurea C. biguanide

B. thiazolidinedione D. alpha glucosidase inhibitor

ANS A p. 694

_____ 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

A. insulin C. sulfonylurea

B. thiazolidinedione D. biguanide

ANS A p. 686

_____ 217. Which of the following glucocorticoids has the least mineralocorticoid effect and is best for

decreasing cerebral edema associated with increased intracranial pressure?

A. Prednisone C. dexamethasone

B. Hydrocortisone D. prednisolone

ANS C p. 641-644

_____ 218. Organophosphate toxicity results from its ability to

A. interrupt heme synthesis

B. inhibit acetycholinesterase

C. compete with brain pyridoxal phosphate

D. react with sulfhydryl groups binding to protein and other enzymes

ANS B p 968


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24

219.A class of proteins that functions as drug receptors that mediate the actions of endogenous chemical

signals such as neurotransmitters and hormones:

A. enzymes

B. regulatory proteins

C. structural proteins

D. transport proteins

Application

Answer: BReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 11

220.Receptor/s coupled to G protein that modulate the production of intracellular second messengers

include/s

A. muscarinic receptor

B. alpha adrenergic receptor

C. leukotriene receptor

D. all of the above

Application

Answer: C

Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 22

221.The neuromuscular blocker succinylcholine acts by:

A. Depolarizing muscle endplate receptors

B. Repolarizing muscle endplate receptors

C. Inhibiting the release of acetylcholine from the nerve ending

D. Blocking the access of acetylcholine at the myoneural junction

Recall

Answer: A


222.

Therapeutic benefit/s of 2receptor agonists include:A. antihypertensive

B. antiglaucoma

C. antidiarrheal

D. all of the above

Application

Answer: D

Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, pp. 130 - 131

223.Non-benzodiazepine that has affinity for the Benzodiazepine receptors:

A. Zolpidem

B. Midazolam

C. Alprazolam

D. All of the above

Recall

Answer: A


224.Sedative-Hypnotic with low solubility and penetrate the brain slowly includes:

A. Phenobarbital

B. Flumazenil

C. Trimethadione

D. Valproic acid

Application

Answer: A


225.The following drugs/substance of abuse are CNS stimulants, EXCEPT:

A. Gamma-hydroxybutyric acid (GHB)

B. Cocaine


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25

C. Amphetamine

D. Methylenedioxy-Methamphetamine (MDMA, Ecstasy)

Recall

Answer: A


226.Characteristic physiologic sign of Cannabis intoxication includes:

A. increased pulse rate

B. pale conjunctivaeC. miotic pupil

D. high blood pressure

Application

Answer: A


227. Which among these intravenous general anesthetics produces a dissociative type of anesthesia?

A. Propofol

B. Ketamine

C. Thiopental

D. Midazolam

Application

Answer: B


228.Painless digital vasospasm is a dose-related complication of long term

treatment with:

A. Levodopa

B. Bromocriptine

C. Selegiline

D. Tolcapone

RecallAnswer: B


229.The peripheral metabolism to Levodopa can be prevented if it is given

concomitantly with:

A. Carbidopa

B. Amantadine

C. Biperiden

D. Bromocriptine

Application

Answer: A

Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition,

p. 449, p. 454

230.An overdose of this opioid causes mydriasis instead of the characteristic miosis of opioid toxicity:

A. Hydromorphone

B. Meperidine

C. Methadone

D. Morphine

Application

Answer: B


231.Which of these group of tissues would be the first to take up appreciable amounts of inhalational

anesthetics?

A. Fat

B. Muscle

C. Vessel-rich

D. Vessel-poor

Recall


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Answer: C


232.A narcotic-addicted patient is given this drug as a substitute to be able to control the withdrawal

symptoms:

A. Hydromorphone

B. Meperidine

C. Methadone

D. Disulfiram

Recall

Answer: C

Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p.510, p. 520

233.The duration of action of the intravenous barbiturate anesthetic thiopental is largely determined by:

A. Spontaneous degradation

B. Hepatic extraction

C. Renal clearance

D. Redistribution

Application

Answer: D


234.This drug inhibits binding of leukotriene D4 to its receptor on target tissues

A. Montelukast

B. Zilenton

C. Ipratropium bromide

D. Omalizumab

Recall

Answer: A


235.

The mechanism of action of corticosteroids in the treatment of bronchial asthma includesA. directly relax airway smooth muscle

B. enhance bronchial reactivity

C. inhibit airway mucosal inflammation

D. prevent release of chemotactic agents

Application

Answer: C


236.A non-steroidal anti-inflammatory drug that irreversibly acetylates and blocks platelet

cycloocygenase is

A. Naproxen

B.

Mefenamic acid

C. Aspirin

D. Ibuprofen

Recall

Answer: C


237.Corticosteroids must be used with great caution in patients with

A. osteoporosis

B. varicella

C. peptic ulcer

D. all of the above

Application

Answer: D


238.The most common adverse effect of Aspirin is

A. gastric upset and ulcers

B. renal toxicity

C. asthma


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D. hepatotoxicity

Recall

Answer: A


239.A uricosuric drug that decreases body pool of urate in patients with

tophaceous gout is

A. Allopurinol

B.

ColchicineC. Probenecid

D. Meloxicam

Recall

Answer: C


240.Sinoatrial and atrioventricular nodal tissue are affected markedly by

A. Diltiazem

B. Verapamil

C. Nifedipine

D. Amlodipine

Recall

Answer: B


241.The beneficial effect of Captopril in patients with heart failure is attributed to:

A. reduction in afterload

B. increased preload

C. increased myocardial contractility

D. all of the above

Application

Answer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 209

242.Beta blockers with membrane-stabilizing action, useful as anti-arrhythmics include:

A. Metoprolol

B. Propranolol

C. Acebutolol

D. All of the above

Recall

Answer: D


243.

Which of the following antiarrhythmic drugs act by blocking sodium channel?

A. Lidocaine

B. Verapamil

C. Sotalol

D. Adenosine

Application

Answer: A


244.Antibiotic/s shown to be effective when applied topically in the treatment of acne vulgaris include/s:

A. Clindamycin

B.

ErythromycinC. Metronidazole

D. All of the above

Application

Answer: D


245.This organophosphate compound is thought to have a cholinesterase inhibitory action which

temporarily paralyzes the adult Schistosoma haematobium worms.

A. Metrifonate


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B. Niclosamide

C. Mebendazole

D. Pyrantel pamoate

Recall

Answer: A


246.Which of these drugs selectively inhibits microtubule synthesis and glucose uptake in nematodes?

A. Piperazine

B. MebendazoleC. Pyrantel pamoate

D. Diethylcarbamazine citrate

Application

Answer: B


247.For onchocerciasis and strongyloidiasis, this drug is the first choice because it causes fewer systemic

and ocular reactions:

A. Diethylcarbamazine citrate

B. Metrifonate

C. Ivermectin

D. Bithionol

Application

Answer: C


248.Most of the serious adverse effects of Penicllins are due to:

A. Blood dyscrasias

B. Hypersensitivity reactions

C. CNS reactions

D. Hepatic impariment

ApplicationAnswer: B


249.The following anti-TB drugs are potentially hepatotoxic, EXCEPT:

A. RIfampin

B. Isoniazid

C. Pyrazinamide

D. Streptomycin

Recall

Answer: D

Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 784-786

250.This Anti-TB is relatively contraindicated in young children whose visual acuity and red-green color

assessment can not be adequately assessed:

A. Isoniazid

B. Rifampin

C. Ethmabutol

D. Pyrazinamide

Recall

Answer: C


251.

This antibacterial is available as a nasal ointment useful in the elimination of nasal carriage ofStaphylococcus aureus:

A. Neomycin

B. Muprocin

C. Polymycin B sulfate

D. Bacitracin

Application

Answer: B



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252.A drug that is used almost solely as an alternative treatment for gonorrhea in patients whose

gonococci are resistant to other drugs is:

A. Ofloxacin

B. Tetracycline

C. Doxycycline

D. Spectinomycin

Recall

Answer: DReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 771

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

Application

Answer: D


254.

The amount of elemental iron per 325 mg tablet of hydrated ferrous sulfate is ___ mg:

A. 36

B. 65

C. 80

D. 106

Application

Answer: B


255.The preparation of choice for thyroid replacement and suppression therapy is:

A. Liothyronine

B. LevothyroxineC. Dessicated thyroid

D. Thyrogloculin

Recall

Answer: B


256.The combination of estrogens and progestins exert their contraceptive effect largely through

A. inhibition of pituitary function

B. production of a mucoid cervical secretion

C. alteration in the motility of the uterine tubes

D. enhancement of the rupture of the ovarian follicle

Application

Answer: A


257.The most dangerous complication of Thioamides is:

A. lupus-like reaction

B. hepatitis

C. agranulocytosis

D. exfoliative dermatitis

Recall

Answer: C


258.The major use of this drug is in the treatment of endometriosis

A. Nifepristone

B. Danazol

C. Tamoxifen

D. Clomiphine

Recall

Answer: B


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259.The best treatment option for an obese patient with NIDDM with associated insulin resistance

syndrome is:

A. Glibenclamide

B. Metformin

C. Repaglimide

D. Acarbose

ApplicationAnswer: B


260.Treatment Regimen III as indicated in the National Tuberculosis Control Program consists of:

A. 2 HRZES

B. 2HRZ / 4HR

C. 2HRZE / 4HR

D. 2HRZES / 1 HREZ / 5HRE

Application

Answer: B

Reference: National TB Control Program, Treatment Regimens

261.The study of the absorption, distribution, metabolism and excretion of drug is known as:

A. Pharmacodynamics

B. Pharmacokinetics

C. Phamacotherapeutics

D. Pharmacology Ans. B p. 5

262.Firstpass effect is more likely to occur with this route of administration :

A.Oral

B.Buccal

C.Sublingual

D.Rectal Ans. A p. 43

263.

Inert binding sites bind a drug without initiating events leading to a drug effect. They are located in:A.True receptors

B.Spare receptors

C.Plasma proteins

D.Ttissue proteins Ans. C p. 5

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:

A. Drug A has a greater efficacy than Drug B

B. Drug B has a greater efficacy than Drug A

C. Drug A is more potent than Drug B

D. Drug B is more potent than Drug A Ans. C p.28

265.Drugs with very high volume of distribution:

A. are completely retained within the vascular compartment

B. have higher concentrations in extravascular tissue

C. are homogeneously distributed in blood

D. have minimum possible volume of distribution Ans.B p.34

266.Bioavailability of a drug is 100% following this route of administration:

A. subcutaneous

B. intramuscular

C. transdermal

D. intravenous Ans. D p.41

267.Drug biotransformation may result in formation of:

A. inactive metabolitesB. reactive intermediates that are toxic to various organs

C. an active substance from a prodrug

D. all of the above Ans. D p. 55-56

268.Selective COX-2 inhibitors differ from nonselective COX inhibitors in that selective COX-2 inhibitors

have no:

A. analgesic-antipyretic and anti-inflammatory effects

B. gastrointestinal side effects

C. effects on platelet aggregation


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D. renal toxicities Ans. B p. 582

269.Pharmacologic effects of alcohol include stimulation of the:

A. central nervous system

B. heart

C. smooth muscles of the blood vessels

D. secretion of gastric acid Ans. D p. 368

270.One of the following general anesthetics with their respective blood:gas partition coefficients is most

soluble in blood:A.Nitrous oxide 0.47

B. Enflurane 1.40

C. Halothane 2.30

D. Methoxyflurane 12.0 Ans. D p. 403

271.Reserpine blocks this step in adrenergic transmission:

A. synthesis of the transmitter

B. incorporation of norepinephrine into the vesicle

C. release of the neurotransmitter

D. reuptake into presynaptic neuron Ans. B p. 169

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:

A. atropine

B. organophosphate

C. opiate

D. ephedrine Ans. B p. 101

273.Therapeutic applications of atropine include/s:

A. peptic ulcer

B. bradycardia caused by myocardial infarction

C. urinary retention

D. constipation Ans. B p. 115

274.Mechanism of action of pralidoxime:

A. competitive antagonism

B. noncompetitive antagonism

C. physiologic antagonism

D. regeneration of the enzyme Ans. D p. 117

275.Compared to norepinephrine, epinephrine has more effects on:

A. alpha 1 receptors

B. alpha 2 receptors

C. beta 1 receptors

D. beta 2 receptors Ans. D p. 133

276.

Drugs like quinidine, procainamide and disopyramide are useful in the treatment of:

A. congestive heart failure C. status asthmaticus

B. thyrotoxicosis D. arrhythmia

Ans. D. pp. 227-229

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:

A. Sodium nitroprusside C. Methyldopa

B. Clonidine D. Aldactone

Ans. A p. 175

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 C. Reduce heart rate

B. Prolong A-V conduction D. All of the aboveAns. D. p. 232

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

Ans. D. p.175

280.In patients with congestive heart failure, the use of angiotensin converting enzyme inhibitors will

increase


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A. peripheral resistance C. salt and water excretion

B. preload D. sympathetic activity

Ans. C p. 209

281.One of the following antianginal agents is contraindicated in patients with vasospastic angina:

A. Propranolol C. Diltiazem

B. Verapamil D. Isosorbide dinitrate

Ans. A. p. 198

282.

Methyldopa as antihyperatensive agent exerts its effect by conversion to alpha-methylnorepinephrine which stimulates centrally this receptor:

A. alpha-1 C. alpha-2

B. Beta-1 D. Beta-2

Ans. C. p. 166

283.Aminopenicillins, Carboxypenicillins and Ureidopenicillins compared to Penicillin G:

A. Are not effective for oral adminsitration

B. Have lesser tendency to cause hypersensitivity reaction

C. Have greater activity against gram-negative bacteria

D. Are resistant to B-lactamse

Ans. C. p. 741

284.Clavulanic acid is added to Ampicillin in order to:

A. Prevent occurrence of diarrhea

B.

Protect the beta-lactam ring from destruction

C. Increase the bioavailability by increasing absorption

D. Increase the pH of gastrointestinal tract

Ans. B. p. 741

285.The most common side effect of erythromycin is:

A. Gastroinetstinal upset

B. red neck syndrome

C. Pseudomembranous colitis

D. Nephrotoxicity Ans. A p. 759

286.Bacterial synergism is produced by the following drug combination:

A. Tetracycline and penicillin G

B.

Cephalexin and gentamycinC. Tetracycline and chloramphenicol

D. Tetracycline and streptomycin Ans. B p. 846

287.This antimicrobial drug may provoke acute gouty arthritis:

A. Pyrazinamide

B. Ethambutol

C. INH

D. PAS Ans. A p. 786

288.This agent is proven effects for influenza A:

A. Riboxinin

B. Acyclovir

C.

Zidoxcedine

D. Amantadine Ans. D p. 824

289.This agent apparently acts as a GABA agonist at the neuromuscular junction and causes flaccid

paralysis of the nematode:

A. Mebendazole

B. Piperazine

C. Bephenrium

D. Pyrantel Ans. B p. 861

290.This antimicrobial agent is also effective for amebic abscesses that fail initial therapy with

metronoidazole:

A.

ChloroquineB. Amodiaquine

C. Mefloquine

D. Primaquine Ans. A p. 867

291.Adverse effects of aminoglycosides include all, EXCEPT:

A. Nephrotoxicity

B. Cardiotoxicity

C. Neuromuscular blockade

D. Ototoxicity Ans. B p. 767


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292.The most common use of estrogen in therpeutics is:

A. Dysfunctional uterine bleeding

B. Chemotherapy in prostatic malignancy

C. Replacement therapy in menopause

D. Component of contraceptice pills Ans. D

293.This is a partial agonist inhibitor of estradiol at the estrogen receptor and used in the palliative

treatment of advanced breast cancer:

A.

DonazolB. Diathylstilbesterol

C. Tamoxifen

D. Mefepristone Ans. C p. 679

294.Clomiphone enhanced pregnancy by:

A. Preparing the uterus for implantation

B. Inhibiting estradiols negative feedback

C. Increasing sperm motility

D. Inhibiting ovulation Ans. B p. 681

295.The most common side effect of insulin is:

A. Lipid deposition

B. Renal dystrophy

C.

Insulin allergy

D. Hypoglycemia Ans. D p. 703

296.Actions of Vit. D include:

A. Antagonism oof parathyroid hormone

B. Promote absorption of calcium and phosphate from the intestine

C. Hasten calcium excretion in the kidney

D. Promotes water excretion Ans. B p. 718

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