39
PHARMACOLOGY Basic & Clinical Pharmacology by Katzung 8 th Edition) 1. This measure relates the dose of the drug required to produce a desired effect to that which produces an undesired effect. (p. 8) A. therapeutic index*** B. Idiosyncratic effect C. Tolerance D. Potency 2. This is the fraction of unchanged drug reaching the systemic circulation following administration by any route:(p. 41) A. Absorption B. First Pass Effect C. Bioavailability*** D. Bioequivalence 3. In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy. (p. 72) A. Phase 1 B. phase 2*** C. phase 3 D. phase 4 4. In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy. (p. 72) A. Phase 1 B. phase 2*** C. phase 3 D. phase 4 5. This is an irreversible inhibitor of GABA aminotransferase and is useful in the treatment of partial seizures and WEST syndrome: (p. 404) A. vigabatrin **** C. lamotrigine B. tiagabine D. gabapentin 6. Action of Insulin in the liver: (p. 717) A, increase storage of glucose as glycogen** B. increase glycogenolysis C.Increase ketogenesis D.increase gluconeogenesis 7. Most common adverse effect of insulin: (p. 721) A. hypoglycemia*** C. lipodystrophy B. allergy D. bleeding 8. Effect of digitalis in the AV node during arrythmias: (p. 207) A. prolonged PR interval B. AV blockade C. bradycardia D. prolonged QT interval 9. Immediate metabolic precursor of dopamine that penetrates the blood-brain barrier: (p.464) A. carbidopa B. levodopa C. selegiline D. ropinorole 10. The following are true of phenoxybenzamine: (p. 141) A. causes reversible blockade of alpha receptors B. blocks catecholamine-induced vasoconstriction C. significantly reduces blood pressure in supine individuals D. stimulates histamine (H 1 ) acetylcholine and serotonin receptors 11. Antiarrhythmic drugs that prolong effective refractory period by prolonging action potential duration: (p. 239) A. Bepridil B. Bretylium C. Esmolol D. Lidocaine 12. Antiarrhytmic of choice for suppression of recurrences of ventricular tachycardia & fibrillation after termination of the arrhythmia by cardioversion: (p. 240) A. Adenosine B. Esmolol C. Lidocaine D. Procainamide 13. The most serious toxic reaction to local anesthetics is: (p. 441) A. circumoral numbness C. nystagmus B. metabolic acidosis D. tonic-clonic convulsions 14. Lithium’s most common side effect/s (p. 491) A.polyuria and subclinical hypothyrodism*** C.polyuria and polydipsia

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PHARMACOLOGY

Basic & Clinical Pharmacology by Katzung 8th Edition)

1. This measure relates the dose of the drug required to produce a desired effect to that which produces an undesired effect. (p. 8)A. therapeutic index*** B. Idiosyncratic effect C. Tolerance D. Potency

2. This is the fraction of unchanged drug reaching the systemic circulation following administration by any route:(p. 41) A. Absorption B. First Pass Effect C. Bioavailability*** D. Bioequivalence

3. In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy. (p. 72)A. Phase 1 B. phase 2*** C. phase 3 D. phase 4

4. In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy. (p. 72)A. Phase 1 B. phase 2*** C. phase 3 D. phase 4

5. This is an irreversible inhibitor of GABA aminotransferase and is useful in the treatment of partial seizures and WEST syndrome: (p. 404)

A. vigabatrin **** C. lamotrigineB. tiagabine D. gabapentin

6. Action of Insulin in the liver: (p. 717)A, increase storage of glucose as glycogen**B. increase glycogenolysisC.Increase ketogenesisD.increase gluconeogenesis

7. Most common adverse effect of insulin: (p. 721)A. hypoglycemia*** C. lipodystrophyB. allergy D. bleeding

8. Effect of digitalis in the AV node during arrythmias: (p. 207)A. prolonged PR interval B. AV blockade C. bradycardia D. prolonged QT interval

9. Immediate metabolic precursor of dopamine that penetrates the blood-brain barrier: (p.464)A. carbidopa B. levodopa C. selegiline D. ropinorole

10. The following are true of phenoxybenzamine: (p. 141)A. causes reversible blockade of alpha receptorsB. blocks catecholamine-induced vasoconstrictionC. significantly reduces blood pressure in supine individualsD. stimulates histamine (H 1) acetylcholine and serotonin receptors

11. Antiarrhythmic drugs that prolong effective refractory period by prolonging action potential duration: (p. 239)A. Bepridil B. Bretylium C. Esmolol D. Lidocaine

12. Antiarrhytmic of choice for suppression of recurrences of ventricular tachycardia & fibrillation after termination of the arrhythmia by cardioversion: (p. 240)A. Adenosine B. Esmolol C. LidocaineD. Procainamide

13. The most serious toxic reaction to local anesthetics is: (p. 441)A. circumoral numbness C. nystagmusB. metabolic acidosis D. tonic-clonic convulsions

14. Lithium’s most common side effect/s (p. 491)A.polyuria and subclinical hypothyrodism*** C.polyuria and polydipsiaB.polydipsia and subclinical hypothyroidism D. Polyuria and polyphagia

15. Most important unwanted effect of anti-psychotics secondary to relative choline deficiency.(p. 488)A. Akathisia C. Tardive dyskinesia****B. Parkinsonian syndrome D. Perioral rabbit syndrome

16. Blocks norepinephrine & serotonin reuptake pumps-the “the off switches” of amine transmission (p. 503) A. MAO inhibitors B. tricyclics*** C. SSRI D. heterocyclics

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 terminalsB. ß-receptors of juxtaglomerular cells that release rennin

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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 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

20. The following are the determinants of vascular tone, except:(p. 182)a.Increasing cGMPb.Increasing cAMP in the vascular cellsc.Decreasing intracellular calciumd.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 relaxationB. Decreased ventricular preloadC. Responsible for a decrease in platelet aggregationD. Increased cardiac output

22. The following are the pharmacodynamics of NSAIDs, except: (p. 598-599)A. Mediated chiefly through inhibition of biosynthesis of prostaglandinsB. All NSAIDs inhibit platelet aggregation C. All NSAIDs are anagesic, anti-inflammatory and antipyreticD. They are all gastric irritants as well

23. The following are disease-modifying antirheumatic drugs, except: (p. 608)a. Methotrexateb. Cyclosporinsc. 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. TeicoplaninD. 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. TetracyclinesD. Aminoglycosides

27. 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. (p. 794-795)A. Sulfadoxine B. Sulfamethoxazole C. SulfasalazineD. 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

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-α 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

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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. WarfarinB. Heparin – ans C. CoumarinD. 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. ClopidogelB. TiclopidineC. Aspirin – ans 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. MethimazoleB. CarbimazoleC. Propylthiouracil – ans D. Ipodate

40. Which beta blocker is most widely used to control the symptom of hyperthyroidism? (p. 653)A. Propranolol – ans B. MetoprololC. LabetalolD. Guanithidine

41. Drugs that competitively inhibit CYP enzymes causea. Decrease in concentration of the object drugb. Increase in concentration of object drugc. Decrease efficacy of object drugd. Irreversible inactivation of the enzyme

42. The mechanism of action of benzodiazepines is explained by:a. Substitution for GABAb. Direct activation of GABA receptorsc. Increase duration of GABA – gated chloride channel opening d. Increase frequency of GABA – gated chloride channel opening

43. The use of benzodiazepines in the chronic treatment of seizures is limited because of theira. high toxicity effects c. toleranceb. 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 toxicitiesd. Efficacy of therapy is based on patient’s 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. citalopramb. Sertraline d venlafaxine

46. A fly catching movement of the tongue commonly observed as a drawback of all typical antipsychotics is calleda. “lead pipe” rigidity c. tardive dyskinesiab. “rabbit “ syndrome d. akathisia

47. The most hepatotoxic general inhalational anesthetic

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a. Nitrous oxide c. isofluraneb. Sevoflurane d. halothane

48. A 55 – year old female has post-menopausal osteoporosis. Which is not a recommended drug?a. Estrogen c. Biphosphonateb. Calcium d. Calcitonin

49. Corticosteroid with most potent anti-inflammatory activity:a. Prednisone c. Betamethasoneb. Dexamethasone d. Cortisone

50. Drug of choice (DOC) for endometriosis in young womena. danazol c. mifepristoneb. leuprolide d. misoprostol

51. The effect of diethylstilbestrol intake taken during pregnancy on female infants:a. vaginal adenocarcinoma c. cervical polypb. endometrial carcinoma d. breast fibroadenoma

52. The most common adverse effect of clomiphene isa. hot flushes c. constipationb. hair loss d. headache

53. 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?

a. Spironolactone c. Ketoconazoleb. 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. Alcoholismb. Hypogonadism d. Depression

55. Major mechanism of action of aspirin as NSAID isa. Reversible COX inhibitor c. Irreversible PG biosynthesis inhibitionb. Chemotaxis inhibition d. Down – regulation of IL-1

56. Which of the following is the drug of choice for inducing labora. Oxytocin c. Methyl ergonovineb. Misoprostol d. Dinoprostone

57. The primary consideration in all clinical trials is toa. Determine the safety of the drugb. Determine the efficacy of the drugc. Ensure that there is no risk to the subjectd. Provide for the welfare of the subject

58. According to the Philippine National Drug Formulary (PNDF), complementary drugs are: 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 6425Dangerous 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, 9th edition, pp. 2 and 5.Pharmacogenetics

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

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A. taking agents that accelerate gastric emptying time B. the presence of food C. stimulation of hepatic microsomal CYP3A4 enzymes D. increasing intestinal motilityAns. 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. BKatzung, 9th edition pp. 18-23Pharmacodynamics

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, 9th edition, 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

Ans. B. Katzung, 9th edition, 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, 9th edition, pp. 144-146.Adrenergic Receptor Blockers

67. Acetylcholine acts by:A. increasing adenylyl cyclase activityB. decreasing cGMP concentrationsC. activating the IP3, diacylglycerol pathwayD. all of the above

Ans. CKatzung, 9th edition, p.97Cholinergic Agonists

68. Which of the following antihypertensive agents has the best documented evidence for prophylaxis against migraine attacks? A. pindolol C. clonidine B. propranolol D. prazosin

Ans. B. Katzung, 9th edition, pp. 148 and 156Adrenoceptor Antagonists

69. Which is a direct effect of nitrates when given in the usual doses for the management of angina?A. increased preload C. increased cardiac contractilityB. increased afterload D. smooth muscle relaxation

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Ans. D. Katzung, 9th edition, p. 190.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. hydralazineB. guanethidine D. captopril

Ans. B. Katzung, 9th edition, p. 166.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 patientsB. increase heart rate D. increase myocardial contractile force

Ans. D. Katzung, 9th edition, p. 205.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 deathB. uterine rupture D. diuresis

Ans. D. Katzung 9th edition, p. 621Hormones 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:A. RAI C. methimazoleB. PTU D. Lugol's iodine

Ans. D. Katzung, 9th edition, p. 633Thyroid & Antithyroid Drugs / Drugs used for Endocrine Disorders

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

A. calcitonin C. alendronateB. estrogen D. fluoride

Ans. D. Katzung, 9th edition, p. 719Agents that affects bone mineral homeostasis

75. Which drug is used as an antiretroviral agent?A. oseltamivir C. indinavirB. famciclovir D. ribavirin

Ans. C. Katzung, 9th edition, p. 820Anti-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, 9th edition, pp. 734-735 and 764.Beta-lactams / Antimicrobials

77. 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:

A. Fansidar C. chloroquine B. quinine D. mefloquine

Ans. B. Katzung, 9th edition, p. 869Anti-malarial Drugs / Antiprotozoals

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78. Radical cure for malaria is achieved by giving: A. chloroquine C. mefloquine B. quinine D. primaquineAns. D. Katzung, 9th edition, p.871Anti-malarial Drug

79. 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:

A. photosensitivity C. superinfection B. fetal bone defects D. renal failure

Ans. D. Katzung, 9th edition, pp. 758Tetracyclines / Antimicrobials

80. Which of the following agents may predispose to the development of pseudomembranous colitis? A. erythromycin C. vancomycin B. metronidazole D. clidamycin

Ans. D. Katzung, 9th edition, p. 761 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?

A. parenteral penicillin G C. vancomycin B. chlarithromycin D. gentamicin

Ans. B. Katzung, 9th edition, pp. 760Macrolides / 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, 9th edition, pp. 889-895. Harrison, 15th edtition, 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. Katzung, 9th edition, p. 989Management 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 to discontinue:

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. . Katzung, 9th edition, p. 786.Anti-tuberculosis Drugs

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

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A. generalized seizure C. cardiac arrhythmia B. gingival hyperplasia D. gastrointestinal disturbances

Answer C. Goodman and Gilman, 10th edition, 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 phospholipaseB. Inhibition of histamine release by inhibiting mast cell degranulationC. Inhibition of the production of prostaglandin and thromboxane from arachidonic acid through inhibition of

prostaglandin H synthesisD. Inhibition of the the formation of leukotrienes by inhibiting lipoxygenase

Answer: C. Katzung, 9th edition, pp. 263, 306, 577, and 581Agents 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 Reye’s syndrome C. lack of liquid preparation and high toxicity effect D. need for frequent administration and association with Reye’s syndrome

Answer D. Katzung, 9th edition, p. 579-581. Goodman and Gilman, 10th edition, 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, 9th edition, pp. 413-414. Goodman and Gilman, 10th edition, pp. 346-347.General Anesthetic / CNS Drugs

91. 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:

A. midazolam C. phenobarbital B. succinylcholine D. etomidate Answer: A. Katzung, 9th edition, 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. ExcretionB. First-pass EffectC. MetabolismD. First-order eliminationMPL: 0.33

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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 antagonistB. Partial agonistC. Chemical antagonistD. Physiologic antagonistMPL: 0.33

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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. VasodilationD. Pupillary dilation (mydriasis)MPL: 0.33

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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 includeA. Tachycardia and increased cardiac contractilityB. Tachycardia and decreased cardiac outputC. Decreased mean arterial pressure and decreased cardiac contractilityD. Decreased mean arterial pressure and increased salt and water

excretion by the kidneyMPL: 0.25Page 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. BronchospasmB. CycloplegiaC. DiarrheaD. Skeletal muscle spasmsMPL: 1.0Page 89

D 97. Parathion has which one of the following characteristics? A. It is less toxic to humans than malathionB. It is more persistent in the environment than DDTC. It is poorly absorbed through skin and lungsD. Its toxicity, if treated early, may be partly reversed by pralidoximeMPL: 0.5Page 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. AtropineB. EdrophoniumC. PhysostigmineD. PralidoximeMPL: 0.25Page 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 visionB. Dry mouth, constipationC. PhysostigmineD. Postural hypotensionMPL: 0.33Page 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. AcetylcholineB. EpinephrineC. IsoproterenolD. MetaproterenolMPL: 0.5

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A 101. Adverse effects that limit the use of adrenoceptor blockers include Heart failure exacerbation from -blockers

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A. Impaired blood sugar response with -blockersB. Increased intraocular pressure with -blockersC. Sleep disturbances from -blocking drugsMPL: 0.5

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C 102. Which of the following binds covalently to the site specified? A. Atenolol - receptor

B. Carvedilol – cardiac receptorsC. Phenoxybenzamine- receptorD. Pindolol - receptorsMPL: 1.0Page 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 receptorB. Decreases angiotensin II concentration in the bloodC. Decreases renin concentration in the bloodD. Increases sodium and decreases potassium in the bloodMPL: 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 isA. CaptoprilB. LosartanC. PropranololD. VerapamilMPL: 0.5Page 172

B 105. Verapamil is associated with all of the following, EXCEPT: A. BradycardiaB. Hyperglycemia C. Increased PR intervalD. Pretibial edemaMPL: 0.2Page 172

A 106. The antianginal effect of propranolol may be attributed to which one of the following? A. Block of exercise-induced tachycardiaB. Decreased end-diastolic ventricular volumeC. Dilation of constricted coronary vesselsD. Increased cardiac forceMPL: 0.5Page 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. DiltiazemB. Isosorbide dinitrateC. PropranololD. VerapamilMPL: 0.33Page 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 inhibitorsB. Alpha-adrenoceptors agonistC. Beta-adrenoceptors antagonistsD. ACE inhibitorsMPL: 1.0Page 127

D 109. The mechanism of action of digitalis is associated with A. A decrease in calcium uptake by the sarcoplasmic reticulumB. An increase in ATP synthesisC. A modification of the acting moleculeD. An increase in systolic intracellular calcium levels

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MPL: 0.33Page 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

would be LEAST harmful in a patient with severe hyperkalemia? (pp.256)A. AmilorideB. HydrochlorothiazideC. SpironolactoneD. TriamtereneMPL: 1.0Page 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 from arachidonic acid by

A. Cyclooxygenase -1B. Cyclooxygenase-2C. LipoxygenaseD. Phospholipase A2 MPL: 0.5Page 312

B 112. Which of the following situations constitutes an added risk of digoxin toxicity? A. Administration of captoprilB. Adminstration of quinidineC. HypermagnesemiaD. HyperkalemiaMPL: 0.33Page 230

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

A. Decreased heart rateB. Increased afterloadC. Increased aldosteroneD. Increased renin secretionMPL: 1.0Page 206

D 114. When used as an antiarrhythmic drug, lidocaine typically A. increases action potential durationB. Increases contractilityC. Increases PR intervalD. Reduces abnormal automaticityMPL: 0.25Page 235

D 115. Which of the following is a recognized effect of nitric oxide (NO)? A. ArrhythmiaB. BronchoconstrictionC. ConstipationD. Pulmonary vasodilationMPL: 1.0Page 329

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

A. Increased gastric acid secretionB. Direct stimulation of cardiac contractile forceC. TachycardiaD. Postural hypotensionMPL: 0.25Page 1023

B 117. Nedocromil has as its major action A. Block of calcium channels in lymphocytesB. Block of mediator release from mast cellsC. Block of phosphodiesterase in mast cells and basophilsD. Smooth muscle relaxation in the bronchiMPL: 0.5Page 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. CodeineB. DextromethorphanC. LoperamideD. DiphenoxylateMPL: 1.0Page 527

C 119. Conversion of plasminogen to plasmin is brought about by A. Aminocaproic acidB. HeparinC. ReteplaseD. WarfarinMPL: 0.2Page 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 fluidB. Etanercept antirheumatic action: inhibits dihydroorotate dehydrogenase, the

enzyme in lymphocytes that is required for pyrimidine synthesisC. Hydroxychloroquine antirheumatic action: a cytotoxic drug that kills rapidly

dividing lymphocytesD. Indomethacin closure of patent ductus arteriosus: blocks prostaglandin E

production in the ductus arteriosis of the newbornMPL: 0.4Page 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 woman’s acute attack of gout, the advantage of using indomethacin instead of colchicines is that indomethacin is A. Less likely to cause acute renal failureB. Less likely to cause severe diarrheaC. Less likely to precipitate sudden gastrointestinal bleedingD. More likely to prevent another acute attackMPL: 0.6Page 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. DesmopressinC. LeuprolideD. Human gonadotropin hormoneMPL: 0.5Page 468

D 123. Methimazole reduces serum concentration of T3 primarily by A. Accelerating the peripheral metabolism of T3 B. Inhibiting the proteolysis of thyroid-binding globulinC. Inhibiting the secretion of TSHD. Preventing the addition of iodine to tyrosine residues on thyroglobulinMPL: 0.6Page 651

C 124. Pharmacologic effects of exogenous glucocorticoids include A. Increased muscle massB. HypoglycemiaC. Inhibition of leukotriene synthesisD. Improved wound healingMPL: 0.33Page 665

D 125. Toxic effects of long-term administration of a glucocorticoid include A. A “lupus-like” syndromeB. Adrenal gland neoplasmC. Hepatotoxicity

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D. OsteoporosisMPL: 0.33Page 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 glucocorticoid

is needed to allow recovery of A. Depressed release of insulin from pancreatic B cellsB. Hematopoiesis in the bone marrowC. Normal osteoblast functionD. The hypothalamic-pituitary-adrenal systemMPL: 0.6Page 671

B 127. The estrogen that is used in most combined hormonal contraceptives is A. ClomipheneB. Ethinyl estradiolC. DESD. NorgestrelMPL: 1.0Page 682

B 128. The most likely complication of insulin therapy in this patient is A. Dilutional hyponatremiaB. HypoglycemiaC. PancreatitisD. Severe hypertensionMPL: 1.0Page 721

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

A. A disulfiram-like reactionB. Excessive weight gainC. Lactic acidosisD. HypoglycemiaMPL: 0.5Page 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. AcarboseB. GlyburideC. MiglitolD. RosiglitazoneMPL: 0.4Page 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-clavulanateB. AztreonamC. MeropenemD. VancomycinMPL: 0.4Page 768

C 132. The mechanism of antibacterial action of tetracyclines involves A. Binding to a component of the 50S ribosomal subunitB. Inhibition of translocase activityC. Blockade of binding of aminoacyl-tRNA to bacterial ribosomesD. Selective inhibition of ribosomal peptidyl transferasesMPL: 0.33Page 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. ClarithromycinB. ErythromycinC. Minocycline

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D. LinezolidMPL: 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 lethargyB. HematuriaC. Fanconi’s aminoaciduria syndromeD. Skin reactionsMPL: 0.2Page 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 tointerfere with the action of oral contraceptives is A. EthambutolB. IsoniazidC. RifampinD. PyrazinamideMPL: 1.0Page 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. GriseofulvinC. NystatinD. FluconazoleMPL: 0.25Page 1049

D 137. Which of the following statements about fluconazole is most accurate? A. it is highly effective in treatment of aspergillosisB. It does not penetrate the blood-brain barrierC. Its oral bioavailability is less than that of ketoconazoleD. It inhibits demethylation of lanosterolMP[L: 0.25Page 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. AbacavirB. AdenavirC. OseltamivirD. EnfuvirtideMPL: 0.33

Page 820No 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 sphincterb. Contraction of the ciliary musclec. Mydriasisd. 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. Ipratropiumb. Pirenzepinec. Benztropined. Pilocarpine

D 105

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. Atropineb. Metacholinec. Carbachold. Bethanechol

A 113

142. This agent relieves motion sickness and is as effective as any more recently B 114

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introduced agent but causes significant sedation and dry mouth.a. Oxybutininb. Scopolaminec. Tolterodined. Darifenacin

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. Ephedrinec. Amphetamined. 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 inhibitorsb. Calcium channel blockersc. Beta-blockersd. Diuretics

C 156

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

a. GABAb. Acetylcholinec. Glutamated. 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. Alprazolamb. Lorazepamc. Oxazepamd. 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 with chronic insomnia, this drug reportedly reduced the latency to persistent sleep with no rebound insomnia or withdrawal symptoms.

a. Remelteonb. Buspironec. Diazempamd. 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. Flurazepamb. Clorazepatec. Zolpidemd. 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 4 – 8 hours if untreated. Which group of drugs isalmost exclusively used for this condition?

a. Triptansb. Propranololc. Topiramated. Valproate

A 268

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. Paracetamolb. Tramadolc. Aspirind. 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. Colchicinec. Tolmetin

C 583

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d. None of the above151. 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. hepatotoxicityb. hypersensitivity lung reactionc. nausea and mucosal ulcers

d. pseudolymphomatous reactions

C 583 –584

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. Carteololc. Pindolold. Metoprolol

D 169

153. This antihypertensive agent illustrates how one person’s toxicity may be another person’s therapy in that it causes hirsutism, which is bothersome in women but a topical formulation is used to stimulate hair growth, which is beneficial for many men.

a. Diltiazemb. Hydralazinec. Minoxidild. 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. Captoprilb. Methyldopac. Reserpined. Sodium nitroprusside

A 177

155. MF, 45 yo female with evidence of chronic kidney disease was also diagnosed with hypertension. Which of the following drugs may be helpful for both of her conditions>

a. Metoprololb. Hydrochlorothiazidec. Captoprild. 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. - blockersb. Diureticsc. Calcium blockersd. 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. pruritusb. hemolysisc. alopeciad. hypotension

A 849

158. The common adverse effects of Quinine in treating falciparum malaria include the following, except

a. tinnitusb. hemoglobinuriac. flushingd. visual disturbances

B 851

159. TT, 7yo male public elementary school student develops mixed soil-transmitted helminthic infections. Which of the following drugs is appropriate?

a. Pyrantel pamoateb. Praziquantel c. Mebendazoled. Metronidazole

C 868

160. This group of antimicrobials kills bacterial cells interfering with the B 726

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transpeptidation reaction of bacterial cell wall synthesisa. Tetracyclinesb. -lactam antibioticsc. Macrolidesd. All of the above

161. The following penicillins are resistant to Staphylococcal beta lactamases, except

a. Methicicillinb. Amoxicillinc. Nafcillind. Cloxacillin

B 732

162. Which of the following drugs is more stable to bacterial -lactamases?a. Penicillin Gb. Amoxicillinc. Cephalexind. None of the above

C 733 – 734

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 generationb. Second generationc. Third generationd. 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. Cefalexinb. Amoxicillin-clavulanic acidc. Minocyclined. Erythromycin

D 749

165. This agent participates in conversion of diatary folate to tetrahydrofolate and isomerization of methylmalonyl-CoA to succinyl CoA and is effective in the treatment of megaloblastic anemia.

a. Vitamin B12

b. Ironc. Erythropoietind. 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. Ironb. Folatec. Erythropoietind. 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. Levothyroxinec. Methimazoled. Propylthiouracil

B 628

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. Methimazoleb. Thyroidectomyc. 131 Iodined. None of the above

D 630

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

a. Calcimimetics b. Vitamin Dc. Calcitonind. 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 ----------------#20b. Amoxil 500 mg caps ---------------------#21c. Ponstan (Mefenamic Acid) 500 mg ---#12d. B an C are violative prescriptions

B Generics Act of 1988

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

_____ 171. All of the following factors can affect the rate and extent of drug absorption EXCEPTA. lipophilicity C. protein bindingB. 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. CmaxB. 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 transporterB. addition of carbon-nitrogen bond ( quaternary amine )C. inhibition of gut wall metabolismD. low ionization constant

ANS B p. 41

_____ 176. At low doses, dobutamine receptor selectivity and activity will primarily result to:A. bronchodilation C. uterine contractionB. dilatation of renal bladder vessels D. increase in cardiac

contractilityANS D p.133

_____ 177. Antiarrythmic with the most marked K-blocking effectA. lidocaine C. quinidineB. amiodarone D. verapamil

ANS B pp 228

_____ 178. Blocks the final common pathway of platelet aggregation:A. ticlopidine C. abciximabB. 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 tubulesB. Additive afterloader effectC. Enhanced hyperkalemia*D. Enhanced vasodilating effect of ACE inhibitors because of inhibition of metabolism by spironolactone

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ANS C p. 177

_____ 180. The following anti-hypertensive drug should be used with caution in patients on potassium-sparing diureticsA. losartan* C. hydrochlorthiazideB. 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. angioedemaB. hypotension D. hyperkalemia

ANS D p. 177

_____ 182. The absence of reflex tachycardia with the use of ACE inhibitors is due toA. downward resetting of the baroreceptorB. mild decrease in peripheral vascular resistanceC. enhanced sympathetic activityD. inhibition of RAA system

ANS A p. 176

_____ 183. This adverse effect of nitrates can be prevented by providing nitrate-free interval between administrationA. dependence C. toleranceB. 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 digoxinB. digoxin and verapamil D. furosemide and digoxin

ANS A p. 208

_____ 185. The drug of choice for converting paroxysmal atrial tachycardia to normal sinus rhythmA. propranolol C. quinidineB. 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 failureA. quinidine C. disopyramideB. procainamide D. lidocaine

ANS D p.225

_____ 187. The risk of Torsades des pointes is highest with the use ofA. sotalol C. bretyliumB. flecainide D. amiodarone

ANS D p. 223

_____ 188. Drug-induced lupus is an adverse effect ofA. procainamide C. disopyramideB. amiodarone D. amiloride

_____ 189. A 60 year old male has dilated cardiomyopathy and is on digoxin. He complains of nausea and vomiting and you think he has digitalis toxicity. Which of the following drugs he is taking most likely enhanced this?A. Furosemide* C. spironolactoneB. Carvedilol D. captopril

ANS A p. 204

_____ 190. The positive inotropic action of cardiac glycosides is associated withA. an increase in ATP synthesisB. a modification in actin moleculeC. decreased outward flow of calcium*D. a decrease in calcium uptake by the sarcoplasmic reticulum

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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/minA. 2* C. 15B. 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. phenobarbitalB. lamotrigine D. carbamazepine

ANS C p.359

_____ 194. This drug increases free phenytoin levels due to protein binding displacement.A. Cimetidine C. chloramphenicolB. 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. imipramineB. trazodone D. clomipramine

ANS A p. 486

_____ 196. Ideally, baseline liver function tests are done prior to giving this anticonvulsantA. topiramate C. valproic acidB. levetiracetam D. gabapentin

ANS C p. 387

_____ 197. Elimination of this anticonvulsant is enhanced significantly by alkalinization of the urineA. Phenobarbital C. valproic acidB. Carbamazepine D. phenytoin

ANS A p.380

_____ 198. Orthostatic hypotension is most common with which of the following antipsychotic agents:A. Perphenazine C. chlorpromazineB. Haloperidol D. olanzapine

ANS C p.461

_____ 199. Carbamazepine exerts its antiepileptic effect throughA. inhibition of low threshold transient Ca++ currentB. inhibition of neurotransmission by NMDA and non-NMDA receptorsC. reduction of Na+ currentD. enhancement of post-synaptic GABA receptor currentANS C p. 378

_____ 200. Based on the mechanism of action, the following antimicrobial is NOT selectively toxic:A. piperacillin C. amphotericin BB. cotrimoxazole D. gentamicin

ANS B p. 763

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

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A. metronidazole C. aztreonamB. gentamicin D. chloramphenicol

ANS D p. 752

_____ 202. This antibiotic is frequently associated with 8th nerve damage in the offspring if given to pregnant women, thus classified under pregnancy risk category DA. Clarithromycin C. ciprofloxacinB. Tetracycline D. streptomycinANS 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. amoxicillinB. Cefalexin D. cotrimoxazoleANS 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 isA. Quinine C. mefloquineB. Primaquine D. chloroquineANS D p.846

_____ 205. Mebendazole is effective against the following parasites EXCEPTA. capillaria philippinensis C. necator americanusB. 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 transcriptaseA. penciclovir C. cidofovirB. acyclovir D. foscarnet

ANS D p. 797

_____ 207. The following adverse reaction to isoniazid is age-relatedA. 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 + streptomycinB. rifampicin + pyrazinamide D. ethambutol + INH

ANS A pp. 774-775

_____ 209. Of the following, the mechanism of actions of this antifungal does not involve inhibition of cell membrane synthesisA. Terbinafine C. flucytosineB. Fluconazole D. griseofulvin

ANS C p. 784

_____ 210. Aromatase inhibitor used in the treatment of breast cancerA. Tamoxifen C. anastrazoleB. 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 transcriptionB. GCs diffuse into cell cytoplasm and bind to steroid receptors leading to release of heat shock proteins and dimerization

of steroid – receptor complexes which translocate into nucleus and bind to GRE, inducing or inhibiting gene transcription

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 2nd messengerANS B p. 639

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_____ 212. The main mechanism of action is to lower post meal glycemic excursion:A. metformin C. acarboseB. 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. calcitoninANS A p. 672

_____ 214. This is essential for the antithyroid activity of thioamides:A. phenyl group C. thiocarbamide groupB. 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 insulinA. sulfonylurea C. biguanideB. thiazolidinedione D. alpha glucosidase inhibitorANS 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 metabolismA. 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. dexamethasoneB. Hydrocortisone D. prednisolone

ANS C p. 641-644

_____ 218. Organophosphate toxicity results from its ability toA. interrupt heme synthesisB. inhibit acetycholinesteraseC. compete with brain pyridoxal phosphateD. react with sulfhydryl groups binding to protein and other enzymes

ANS B p 968

219. A class of proteins that functions as drug receptors that mediate the actions of endogenous chemical signals such as neurotransmitters and hormones:

A. enzymesB. regulatory proteinsC. structural proteinsD. transport proteins

ApplicationAnswer: 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/sA. muscarinic receptorB. alpha adrenergic receptorC. leukotriene receptorD. all of the above

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

221. The neuromuscular blocker succinylcholine acts by:A. Depolarizing muscle endplate receptorsB. Repolarizing muscle endplate receptorsC. Inhibiting the release of acetylcholine from the nerve ending D. Blocking the access of acetylcholine at the myoneural junction

RecallAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 437

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222. Therapeutic benefit/s of 2 receptor agonists include:A. antihypertensiveB. antiglaucomaC. antidiarrhealD. all of the above

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

223. Non-benzodiazepine that has affinity for the Benzodiazepine receptors:A. ZolpidemB. MidazolamC. AlprazolamD. All of the above

RecallAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 360

224. Sedative-Hypnotic with low solubility and penetrate the brain slowly includes:A. PhenobarbitalB. FlumazenilC. TrimethadioneD. Valproic acid

ApplicationAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 354

225. The following drugs/substance of abuse are CNS stimulants, EXCEPT:A. Gamma-hydroxybutyric acid (GHB)B. CocaineC. AmphetamineD. Methylenedioxy-Methamphetamine (MDMA, Ecstasy)

RecallAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 520

226. Characteristic physiologic sign of Cannabis intoxication includes:A. increased pulse rateB. pale conjunctivaeC. miotic pupilD. high blood pressure

ApplicationAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 526

227. Which among these intravenous general anesthetics produces a dissociative type of anesthesia?A. Propofol B. Ketamine C. Thiopental D. Midazolam

ApplicationAnswer: BReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 415

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

A. LevodopaB. BromocriptineC. SelegilineD. Tolcapone

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RecallAnswer: BReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 453

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

A. CarbidopaB. AmantadineC. BiperidenD. Bromocriptine

ApplicationAnswer: AReference: 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. HydromorphoneB. MeperidineC. MethadoneD. Morphine

ApplicationAnswer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 511

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

RecallAnswer: CReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 405

232. A narcotic-addicted patient is given this drug as a “substitute” to be able to control the withdrawal symptoms:A. HydromorphoneB. MeperidineC. MethadoneD. Disulfiram

RecallAnswer: CReference: 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

ApplicationAnswer: DReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 412

234. This drug inhibits binding of leukotriene D4 to its receptor on target tissuesA. MontelukastB. ZilentonC. Ipratropium bromideD. Omalizumab

RecallAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 330

235. The mechanism of action of corticosteroids in the treatment of bronchial asthma includesA. directly relax airway smooth muscleB. enhance bronchial reactivityC. inhibit airway mucosal inflammationD. prevent release of chemotactic agents

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ApplicationAnswer: CReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 328

236. A non-steroidal anti-inflammatory drug that irreversibly acetylates and blocks platelet cycloocygenase isA. NaproxenB. Mefenamic acidC. AspirinD. Ibuprofen

RecallAnswer: CReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 577

237. Corticosteroids must be used with great caution in patients withA. osteoporosisB. varicellaC. peptic ulcerD. all of the above

ApplicationAnswer: DReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 652

238. The most common adverse effect of Aspirin isA. gastric upset and ulcersB. renal toxicityC. asthmaD. hepatotoxicity

RecallAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 581

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

A. AllopurinolB. ColchicineC. ProbenecidD. Meloxicam

RecallAnswer: CReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 598

240. Sinoatrial and atrioventricular nodal tissue are affected markedly byA. DiltiazemB. VerapamilC. NifedipineD. Amlodipine

RecallAnswer: BReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 196

241. The beneficial effect of Captopril in patients with heart failure is attributed to:A. reduction in afterloadB. increased preloadC. increased myocardial contractility D. all of the above

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

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

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D. All of the above

RecallAnswer: DReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 151

243. Which of the following antiarrhythmic drugs act by blocking sodium channel?A. LidocaineB. VerapamilC. SotalolD. Adenosine

ApplicationAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 226

244. Antibiotic/s shown to be effective when applied topically in the treatment of acne vulgaris include/s:A. ClindamycinB. ErythromycinC. MetronidazoleD. All of the above

ApplicationAnswer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 1017

245. This organophosphate compound is thought to have a cholinesterase inhibitory action which temporarily paralyzes the adult Schistosoma haematobium worms.

A. Metrifonate B. Niclosamide C. Mebendazole D. Pyrantel pamoate

RecallAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 891

246. Which of these drugs selectively inhibits microtubule synthesis and glucose uptake in nematodes?A. Piperazine B. Mebendazole C. Pyrantel pamoate D. Diethylcarbamazine citrate

ApplicationAnswer: BReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 891

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

A. Diethylcarbamazine citrateB. Metrifonate C. Ivermectin D. Bithionol

ApplicationAnswer: CReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 890

248. Most of the serious adverse effects of Penicllins are due to: A. Blood dyscrasiasB. Hypersensitivity reactionsC. CNS reactionsD. Hepatic impariment

ApplicationAnswer: BReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 741

249. The following anti-TB drugs are potentially hepatotoxic, EXCEPT:A. RIfampinB. IsoniazidC. PyrazinamideD. Streptomycin

Recall

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Answer: DReference: 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. IsoniazidB. RifampinC. EthmabutolD. Pyrazinamide

RecallAnswer: CReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 785

251. This antibacterial is available as a nasal ointment useful in the elimination of nasal carriage of Staphylococcus aureus:A. NeomycinB. MuprocinC. Polymycin B sulfateD. Bacitracin

ApplicationAnswer: BReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 1016

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. OfloxacinB. Tetracycline

C. Doxycycline D. Spectinomycin

RecallAnswer: 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 drugB. administration of Vitamin KC. administration of fresh frozen plasmaD. all of the above

ApplicationAnswer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 552

254. The amount of elemental iron per 325 mg tablet of hydrated ferrous sulfate is ___ mg:A. 36 B. 65 C. 80 D. 106

ApplicationAnswer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 531

255. The preparation of choice for thyroid replacement and suppression therapy is:A. LiothyronineB. LevothyroxineC. Dessicated thyroidD. Thyrogloculin

RecallAnswer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 630

256. The combination of estrogens and progestins exert their contraceptive effect largely throughA. inhibition of pituitary functionB. production of a mucoid cervical secretionC. alteration in the motility of the uterine tubesD. enhancement of the rupture of the ovarian follicle

ApplicationAnswer: AReference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 673

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257. The most dangerous complication of Thioamides is:A. lupus-like reactionB. hepatitisC. agranulocytosisD. exfoliative dermatitis

RecallAnswer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 633

258. The major use of this drug is in the treatment of endometriosisA. NifepristoneB. DanazolC. TamoxifenD. Clomiphine

RecallAnswer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 680

259. The best treatment option for an obese patient with NIDDM with associated insulin resistance syndrome is:A. GlibenclamideB. MetforminC. RepaglimideD. Acarbose

ApplicationAnswer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 708

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

ApplicationAnswer: BReference: National TB Control Program, Treatment Regimens

261.The study of the absorption, distribution, metabolism and excretion of drug is known as:A. PharmacodynamicsB. PharmacokineticsC. PhamacotherapeuticsD. Pharmacology Ans. B p. 5

262. First – pass effect is more likely to occur with this route of administration :A.OralB.BuccalC.SublingualD.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 receptorsB.Spare receptorsC.Plasma proteinsD.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 AC. Drug A is more potent than Drug BD. 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 compartmentB. have higher concentrations in extravascular tissueC. are homogeneously distributed in blood D. have minimum possible volume of distribution Ans.B p.34

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266. Bioavailability of a drug is 100% following this route of administration:A. subcutaneousB. intramuscularC. 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 organsC. an active substance from a prodrugD. 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 effectsB. gastrointestinal side effectsC. effects on platelet aggregationD. renal toxicities Ans. B p. 582

269. Pharmacologic effects of alcohol include stimulation of the:A. central nervous systemB. heartC. smooth muscles of the blood vesselsD. 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 0.47B. Enflurane 1.40C. Halothane 2.30D. Methoxyflurane 12.0 Ans. D p. 403

271. Reserpine blocks this step in adrenergic transmission:A. synthesis of the transmitterB. incorporation of norepinephrine into the vesicleC. release of the neurotransmitterD. 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. atropineB. organophosphateC. opiateD. ephedrine Ans. B p. 101

273. Therapeutic applications of atropine include/s:A. peptic ulcerB. bradycardia caused by myocardial infarctionC. urinary retentionD. constipation Ans. B p. 115

274. Mechanism of action of pralidoxime:A. competitive antagonismB. noncompetitive antagonismC. physiologic antagonismD. regeneration of the enzyme Ans. D p. 117

275. Compared to norepinephrine, epinephrine has more effects on:A. alpha 1 receptorsB. alpha 2 receptorsC. beta 1 receptorsD. 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 asthmaticusB. thyrotoxicosis D. arrhythmia

Ans. D. pp. 227-229277. 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. MethyldopaB. Clonidine D. Aldactone

Ans. A p. 175278. Propranolol and other beta-adrenergic receptor antagonist have the following effect/s on the heart that makes them

useful as antiarryhthmic agents:

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A. Depress automaticity C. Reduce heart rateB. Prolong A-V conduction D. All of the above

Ans. D. p. 232279. All of the following are true of sodium nitroprusside EXCEPT:

A. The gold standard for use in hypertensive crisisB. Mechanism of vasodilating effects similar to nitratesC. Sensitive to lightD. Metabolite is pharmacologically inert

Ans. D. p.175280. In patients with congestive heart failure, the use of angiotensin converting enzyme inhibitors will increase

A. peripheral resistance C. salt and water excretionB. 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. DiltiazemB. 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-2B. Beta-1 D. Beta-2

Ans. C. p. 166283. Aminopenicillins, Carboxypenicillins and Ureidopenicillins compared to Penicillin G:

A. Are not effective for oral adminsitrationB. Have lesser tendency to cause hypersensitivity reactionC. Have greater activity against gram-negative bacteriaD. Are resistant to B-lactamse

Ans. C. p. 741284. Clavulanic acid is added to Ampicillin in order to:

A. Prevent occurrence of diarrheaB. Protect the beta-lactam ring from destruction C. Increase the bioavailability by increasing absorptionD. Increase the pH of gastrointestinal tract

Ans. B. p. 741

285. The most common side effect of erythromycin is:A. Gastroinetstinal upsetB. “red neck” syndromeC. Pseudomembranous colitisD. Nephrotoxicity Ans. A p. 759

286. Bacterial synergism is produced by the following drug combination:A. Tetracycline and penicillin GB. Cephalexin and gentamycinC. Tetracycline and chloramphenicolD. Tetracycline and streptomycin Ans. B p. 846

287. This antimicrobial drug may provoke acute gouty arthritis:A. PyrazinamideB. EthambutolC. INHD. PAS Ans. A p. 786

288. This agent is proven effects for influenza A:A. RiboxininB. AcyclovirC. ZidoxcedineD. 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. MebendazoleB. PiperazineC. BephenriumD. Pyrantel Ans. B p. 861

290. This antimicrobial agent is also effective for amebic abscesses that fail initial therapy with metronoidazole:A. ChloroquineB. AmodiaquineC. MefloquineD. Primaquine Ans. A p. 867

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291. Adverse effects of aminoglycosides include all, EXCEPT:A. NephrotoxicityB. CardiotoxicityC. Neuromuscular blockadeD. Ototoxicity Ans. B p. 767

292. The most common use of estrogen in therpeutics is:A. Dysfunctional uterine bleedingB. Chemotherapy in prostatic malignancyC. Replacement therapy in menopauseD. 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. DiathylstilbesterolC. TamoxifenD. Mefepristone Ans. C p. 679

294. Clomiphone enhanced pregnancy by:A. Preparing the uterus for implantation B. Inhibiting estradiol’s negative feedbackC. Increasing sperm motilityD. Inhibiting ovulation Ans. B p. 681

295. The most common side effect of insulin is:A. Lipid depositionB. Renal dystrophyC. Insulin allergyD. Hypoglycemia Ans. D p. 703

296. Actions of Vit. D include:A. Antagonism oof parathyroid hormoneB. Promote absorption of calcium and phosphate from the intestineC. Hasten calcium excretion in the kidneyD. Promotes water excretion Ans. B p. 718