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PHARMACOLOGY
1. The pharmacokinetic value that most reliably reflects the amount of drug reaching the target tissue
after oral administration is the:
a.
b.
c.
d.
e.
Peak blood concentration
Time to peak blood concentration
Product of the volume of distribution (Vd) and the first-order rate constant
Volume of distribution
Area under the blood concentration – time curve
2. Which of the following terms is best described as a rapid reduction in the effect of a given dose of a
drug after only one or two doses?
a. Supersensitivity
b. Tachyphylaxis
c. Tolerance
d. Anaphylaxis
e. Synergism
3. What happens to a drug when it binds with plasma proteins?
a. Hepatic metabolism of the drug is increased
b. Potency of drug is increased
c. Pharmacologic activity of the drug is diminished
d. Loss of drug through renal excretion is faster
e. Absorption is increased
4. Which of the following best describes two drugs when they reach the same plasma concentration at
the same rate after oral administration?
a. Potency
b. Bioavailability
c. Therapeutic index
d. Bioequivalence
e. Antagonism
5. If the plasma concentration of a drug declines with “first-order kinetics”, this means that
a. The half-life is the same regardless of plasma concentration
b. The drug is largely metabolized in the liver after oral administration and has low bioavailability
c. The rate of elimination is proportionate to the rate of administration at all times
d. The drug is not distributed outside the vascular system
e. The drug is free and not bound to plasma proteins
6. The steady-state of a drug in the plasma is attained when
a. The half-life of a drug is reached
b. The loading dose is given at once
c. The drug is given every 4 hours
d. The given dose is approximately equal to the amount excreted
e. When the drug is fully metabolized
7. The main site of biotransformation in the body is the:
a. Kidneys
b. Liver
c. GI tract
d. Brain
e. Lungs
8. The interaction between an acetylcholinesterase inhibitor and acetylcholine at the NMJ would be an
example of:
a. Addition
b. Potentiation
c. Competitive antagonism
d. Noncompetitive antagonism
e. Conjugation
9. Which of the following terms is best described as an immunologically mediated reaction to drug
observed soon after administration:
a. Supersensitivity
b. Tachyphylaxis
c. Tolerance
d. Hyposensitivity
e. Anaphylaxis
10. Therapeutic index is defined as which of the following?
a. Median therapeutic effective dose
b. Dose in which 50% of animals treated die
c. Ratio between the minimal and maximal therapeutic dose
d. Ratio between the median toxic dose and the median effective dose
e. Ratio between the minimum non-toxic dose and maximum effective dose
11. Which of the following is therapeutic action of ß-adrenergic receptor blockers in the treatment of
angina pectoris?
a. Dilatation of coronary arteries
b. Decrease in the amount of catecholamines
c. Decrease in the requirement of the myocardium for oxygen
d. Increase in sensitivity to catecholamines
e. Increase in heart rate
12. Which of the following drugs is considered a direct-acting sympathomimetic agent?
a. Ephedrine
b. Phenylephrine
c. Amphetamine
d. Mephentermine
e. Atropine
13. Which of the following mechanisms explains the therapeutic effect of ipratropium bromide in the
management of COPD?
a. Stimulation of mast cell degeneration
b. Stimulation of ß-adrenergic receptors
c. Inhibition of Ach receptors
d. Inhibition of PDE activity
e. Inhibition of inflammation
14. Which of the following statements best describes the pharmacodynamics of nitrates in the treatment of
angina?
a. Increased preload
b. Smooth muscle contraction
c. Vasoconstriction
d. Venorelaxation
15. Pharmacologic effect of ß2 agonists given at therapeutic dose by aerosol is
a. Decreases blood supply
b. Vasoconstriction
c. CNS stimulation
d. Elevates systolic blood pressure
e. Bronchodilation
16. While eating, a 24 year-old suddenly develops dyspnea and hoarseness. You should immediately
administer:
a. IV theophylline
b. IV hydrocortisone
c. IV NSS infusion
d. IM atropine
e. Subcutaneous epinephrine
17. The following are correct concerning the therapeutic dose of epinephrine, EXCEPT:
a. Increases the oxygen need of the body
b. Dilates bronchial muscles
c. Decreases blood sugar
d. Elevates systolic blood pressure
e. Decreases lactic acid contents of the muscle
18. Atropine when given in excessive amounts may cause all of the following EXCEPT:
a. Mental aberration
b. Increased cardiac rate
c. Pupillary constriction
d. Urinary retention
e. Diminished gastric secretion
19. Because of their ability to accelerate parasympatholytic activity, cholinergic agents are not given to
patients with
a. Hypothyroidism
b. Tachycardia
c. Hypotension
d. Asthma
e. Gastrointestinal spasm
20. The calming and anti-emetic properties of this drug together with its atropine-like effect and antihistamine properties, form the basis for its use in preoperative sedation
a. Diazepam
b. Promethazine
c. Bromocriptine
d. Lithium
e. Ephedrine
21. Which of the following is an anti-arrythmic agen that can be given IV for the treatment of malaria?
a. Phenytoin
b. Tamoxifen
c. Quinine
d. Chloroquine
22. Which of the following drugs significantly increases the risk of digitalis toxicity?
a. Nifedipine
b. Lidocaine
c. Captopril
d. Hydrochlorothiazide (HCTZ)
e. Ampicillin
23. Which of the following drugs when withdrawn suddenly can cause hypertensive crisis?
a. Methyldopa
b. Captopril
c. Nifedipine
d. Clonidine
e. Prazosin
24. Which of the following agents exert a positive inotropic effect?
a. Furosemide
b. Epinephrine
c. Digoxin
d. Isoproterenol
e. Norepinephrine
25. Which of the following is a widely used drug in the treatment of gestational hypertension but is
contraindicated in hypertensive patients with coronary artery disease?
a. Hydralazine
b. Nifedipine
c. HCTZ
d. Methyldopa
26. Which route of administration is most likely to subject a drug to a first-pass effect?
a. IV
b. Inhalational
c. Oral
d. Sublingual
e. IM
27. An antiarrhythmic drug known to produce a potentially fatal form of pulmonary fibrosis
a. Lidocaine
b. Amiodarone
c. Sotalol
d. Procainamide
e. Quinidine
28. A drug undergoes glomerular filtration and is now found in the renal tubular fluid. This findings indicate
that the drug
a. Was free and not bound to plasma protein
b. Does not require catabolism
c. Has a quarternary N+
d. Has a Vd of 50,000 liters
29. A patient presents with atrial flutter, a ventricular rate of 150 per min, and a low cardiac output with an
ejection fraction of 20%. The drug of choice for reduction of the ventricular rate
a. Verapamil
b. Quinidine
c. Digoxin
d. Amiodarone
e. Captopril
30. Reserpine decreases arterial pressure by:
a. Interfering with the synthesis of norepinephrine
b. Interfering with the storage of norepinephrine
c. Interfering with the release of norepinephrine
d. Interfering with the metabolism of norepinephrine
e. Direct vasodilation
31. Bronchodilation is NOT a pharmacologic effect of:
a. Theophylline
b. Terbutaline
c. Atropine
d. Salbutamol
e. Neostigmine
32. Which of the following drugs should be used with extra caution in the treatment of hypertension in a
diabetic patient
a. Captopril
b. Guanethidine
c. Propranolol
d. Methyldopa
e. Furosemide
33. Which of the following is common side effect of Cimetidine?
a. Hypertension
b. Androgenic effect
c. Hyperglycemia
d. Inhibition of hepatic metabolism of drugs
e. Increased blood pressure
34. Which of the following is an adverse effect of chronic use of aluminum hydroxide as an antacid?
a. Constipation
b. Flatulence
c. Vomiting
d. Diarrhea
e. Abdominal pain
35. Which of the following is mainstay of non-specific therapy for diarrhea?
a. Atropine
b. Kaolin and pectin
c. Oral rehydration therapy
d. Octreotide
e. Loperamide
36. Which of the following drugs used for the prevention and treatment of gastric ulcers has been
withdrawn from the market because it has been used by many as an abortifacient?
a. Rioprostil
b. Cisapride
c. Misoprostol
d. Sucralfate
e. Ranitidine
37. H1-receptor blocker that is least likely to produce sedation
a. Diphenhydramine
b. Loratadine
c. Promethazine
d. Chlorpheniramine
38. Which is not a diuretic?
a. Furosemide
b. HCTZ
c. Caffeine
d. Propranolol
e. Spironolactone
39. The safest diuretic to prescribe to a patient on Digoxin is:
a. Ethacrynic acid
b. Chlorthiazide
c. Spironolactone
d. Furosemide
e. Mannitol
40. Hyoscine and dicycloverine are
a. Antihypertensives
b. Bronchodilators
c. Antispasmodics
d. Antacids
e. Diuretics
41. Which of the following is the local anesthetic of choice for infiltration anesthesia?
a. Enflurane
b. Lidocaine
c. Procaine
d. Bupivacaine
e. Cocaine
42. Which of the following is the local anesthetic of choice in infiltration anesthesia?
a. It is ultra short-acting by virtue of redistribution
b. It sensitizes the myocardium to endogenous cathecolamines
c. It may cause laryngospasm and bronchospasm
d. It produces little post-anesthetic excitement and vomiting
e. It is given by inhalation
43. Which of the following phenothiazine derivatives has NO neuroleptic properties?
a. Chlorpromazine
b. Fluphenazine
c. Promethazine
d. Thioridazine
44. Which of the following anesthetic agents can induce seizure activity?
a. Nitrous oxide
b. Enflurane
c. Isoflurane
d. Halothane
e. Sevoflurane
45. Which of the following has the lowest incidence of extrapyramidal reactions, but has the highest
incidence of agranulocytosis among antipsychotic agents?
a. Fluphenazine
b. Pimozide
c. Clozapine
d. Molindone
46. Which of the following drugs can cause Stevens-Johnson syndrome, ataxia, and gingival hyperplasia?
a. Phenobarbital
b. Disulfiram
c. Valproic acid
d. Flurazepam
e. Phenytoin
47. Which of the following is commonly used to treat both absence (Petit mal) and generalized tonic-clonic
(Grand Mal) seizure?
a. Phenytoin
b. Valproate
c. Carbamazepine
d. Ethosuximide
e. Phenobarbital
48. Which of the following is not a therapeutically useful effect of the benzodiazepines?
a. Skeletal muscle relaxation
b. Anxiolysis
c. General anesthesia
d. Anticonvulsant
e. Sedative
49. Which of the following is the mechanism of action of effective anti-psychotic agents?
a. Decreases acetylcholine in the CNS
b. Blocks the dopamine receptor sites in the CNS
c. Makes Ach receptors more available in the CNS
d. Facilitates the use of Norepinephrine in the CNS
e. Makes Dopamine more available in the CNS
50. Which of the following drugs is used in the management of ethanol withdrawal, as a preanesthetic
medication and in the treatment of status epilepticus?
a. Diazepam
b. Triazolam
c. Flurazepam
d. Disulfiram
e. Methadone
51. Which of the following is NOT true of paracetamol?
a. Weaker anti-inflammatory effect compared to aspirin
b. Causes inhibition of phospholipase A
c. Can exacerbate gout
d. Can cause hepatotoxicity at higher doses
e. Preferred for viral infections in children
52. Which of the following mechanisms explains the anti-inflammatory effect of aspirin?
a. Stimulation of adrenocorticotrophic hormones
b. Inhibition of prostaglandin synthesis
c. Stimulation of antigen-antibody reactions
d. Peripheral vasoconstriction
e. Secretion of epinephrine
53. Which of the following findings is NOT seen in salicylate intoxication?
a. Hyperventilation
b. Tinnitus
c. Hyperthermia
d. Metabolic acidosis
e. Respiratory alkalosis
54. Which of the following statements regarding the mechanisms of actions of drugs used in gout is
INCORRECT?
a. Indomethacin inhibits urte crystal phagocytosis
b. Allopurinol inhibits oxidation of hypoxanthine
c. Probenecid has uricosuric effects by increasing the secretion of uric acid at the loop of Henle
d. Cochicine acts by selective inhibition of leukocyte microtubular assembly
e. High dose aspirin promote uric acid excretion by acidification of urine
55. Which of the following anti-inflammatory agents is also used to accelerate closure of patent ductus
arteriosus?
a. Aspirin
b. Hydroxychloroquine
c. Indomethacin
d. Dexamethasone
e. Sulfasalazine
56. This drug activates antithrombin III, leading to inactivation of clotting factors
a. dipyridamole
b. aspirin
c. streptokinase
d. warfarin
e. heparin
57. This drug is used in the treatment of neonatal hypoprothrombinemia
a. Heparin
b. Dypiridamole
c. Aspirin
d. Phytomenadione
e. Coumadin
58. The anticoagulant action of heparin can be effectively counteracted by
a. Phytomenadione
b. Protamine
c. Retinoic acid
d. EDTA
59. This drug lowers plasma lipoprotein concentration by inhibition of HMG-CoA reductase
a. Cholestyramine
b. Lovastatin
c. Nicotinic acid
d. Niacin
e. Clofibrate
60. Which of the following antihyperlipidemic agents would reduce circulation cholesterol by acting in the
gastrointestinal tract?
a. Cholestyramine
b. Lovastatin
c. Nicotinic acid
d. Niacin
e. Clofibrate
61. Aside from KCl and NaHCO3, which of the following is included in the treatment of ketoacidosis?
a. Insulin
b. Zinc chloride
c. Calcium chloride
d. Glucagon
e. Epinephrine
63. Which of the following anti-thyroid agents is used to diminish the size and vascularity of the
hyperplastic thyroid gland days before thyroidectomy?
a. Methimazole
b. Iodides
c. Propylthiouracil
d. Liothyrosine
e. Propranolol
64. Which of the following is the mechanism of action of sulfonylureas?
a. Stimulates glycogenolysis
b. Inhibits gluconeogenesis
c. Stimulates secretion of insulin from Beta cells
d. Increases glucose utilization
e. Decrease insulin resistance
65. Which of the following increases lipoprotein catabolism by increasing lipoprotein lipase activity?
a. Lovastatin
b. Probucol
c. Clofibrate
d. Mevastatin
e. Cholestyramine
66. Which one of the following substances should be contraindicated in a patient with thyroid storm?
a. Digitalis and diuretic
b. Large dose of propylthiouracil
c. Large dose of dexamethasone
d. Large dose of isoproterenol
e. Propranolol
67. The following oral hypoglycemic agents have the same mechanism of action EXCEPT:
a. Chlorpropamide
b. Metformin
c. Glyburide
d. Glipizide
e. Tolbutamide
68. What is the preferred treatment of tetany?
a. Saline infusion
b. Insulin
c. Calcium
d. Vitamin D
e. Parathyroid hormone
69. Thromboembolism have been associated with the use of oral contraceptives that have an excess of
a. Estrogen
b. Testosterone
c. Progestin
d. Prostaglandin
e. Aldosterone
70. Corticosteroids are usually indicated in all of the following conditions EXCEPT:
a. Herpes simplex virus
b. Status asthmaticus
c. Nephrotic syndrome
d. Chronic adrenal insufficiency
e. Severe allergic rhinitis
71. The hypoglycemic agent of choice in pregnant women
a.
b.
c.
d.
e.
Biguanide
Sulfonylurea
Acarbose
Insulin
Rosiglitazone
72. Which of the following preparations will induce passive rather than active immunity?
a. Diphtheria antitoxin
b. Typhoid vaccine
c. Measles vaccine
d. Polio vaccine
73. Which of the following drugs is the best treatment for amoebic abscess?
a. Gentamicin
b. Metronidazole
c. Tetracycline
d. Quinacrine
e. Primaquine
74. Which of the following cephalosporins is highly effective against Pseudomonas?
a. Cefazolin
b. Cefuroxime
c. Ceftazidime
d. Cefaclor
e. Ceftriaxone
75. Which of the following statements about vancomycin is correct?
a. It inhibits cell wall synthesis
b. It has significant effects against gram-negative organisms
c. It causes Fanconi’s syndrome
d. It is well absorbed in the GI tract
e. A skin test should be performed before administration
76. The mechanism of action of chloroquine is Plasmodium vivax is based on the elimination of which of
the following forms of the parasite?
a. Secondary tissue schizonts
b. Exoerythrocytic schizonts
c. Erythrocytic stage
d. Asexual forms
e. Liver stages
77. Cotrimoxazole may be used in the following examples EXCEPT:
a. Treatment of typhoid fever
b. Treatment and prophylaxis of Pneumocystis carinii pneumonia
c. Respiratory tract infections due to H. influenzae
d. Treatment of pneumonia due to Pseudomonas aeruginosa
e. Susceptible E. coli in urinary tract infections
78. The following drugs are used in the treatment of tuberculosis, EXCEPT:
a. Ethambutol
b. Rifampicin
c. Thiacetazone
d. Dapsone
e. Cycloserine
79. Recommended for use in the treatment of Legionnaire’s Disease
a. Neomycin
b. Erythromycin
c. Clindamycin
d. Penicillin
e. Amikacin
80. This drug inhibits dihydrofolate reductase
a. Trimethoprim
b. Nitrofurantoin
c. Sulfamethoxazole
d. Ciprofloxacin
e. Vancomycin
81. By which of the following mechanisms do vinca alkaloids work in cancer chemotherapy?
a. Inhibition of function of microtubules
b. Damage and prevention of repair of DNA
c. Inhibition of protein synthesis
d. Inhibition of purine synthesis
e. Inhibition of DNA gyrase
82. Which of the following agents will work by binding to the enzyme dihydrofolate reductase?
a. Vincristine
b. Ifosfamide
c. Cyclophosphamide
d. Bleomycin
e. Methotrexate
83. Busulfan, a useful drug in chronic myelogenous leukemia is
a. An antimetabolite
b. An alkylating agent
c. An antibiotic
d. A hormonal agent
e. An antidote
84. Leucovorin is used to “rescue” normal cells after a massive dose of
a. Fluorouracil
b. Mercaptopurine
c. Cyclophosphamide
d. Methotrexate
e. Amantadine
85. Which of the following is NOT a phase I drug-metabolizing reaction
a. Acetylation
b. Deamination
c. Hydrolysis
d. Oxidation
e. Reduction
86. The following are anti-cancer drugs EXCEPT:
a. Aminopterin
b. Amphoterecin B
c. Actinomycin D
d. Cyclophosphamide
e. Vincristine
87. A factor that is likely to increase the duration of action of a drug that is partially metabolized in the liver
is:
a. Chronic administration of Phenobarbital prior to and during therapy with the drug in question
b. Chronic therapy with Cimetidine prior to and during therapy with the drug in question
c. Displacement from tissue binding sites by another drug
d. Increased cardiac output
e. Chronic administration of Rifampin
88. Which of the following statements regarding Vit B12 is TRUE?
a. It is synthesized in the human body
b. Iron is needed as a cofactor for absorption
c. Deficit may occur following gastrectomy
d. Its deficiency leads to normocytic normochromic anemia
89. Which of the following in NOT a Beta Lactam antibiotic?
a. Cephalosporins
b. Monobactams
c. Carbapenems
d. Quinolones
e. Penicillin
90. Which of the following drugs is a reverse transciptase inhibitor that is useful in the treatment of
hepatitis B infection
a. Amantadine
b. Gancyclovir
c. Lamivudine
d. Interferon
e. Zidovudine
91. In a patient suffering from morphine toxicity, death would most often be due to which of the following
a. Cardiac dysrhythmia
b. Hypotension
c. Hypothermia
d. Respiratory arrest
e. Hypertension
92. Which of the following statements about fetal alcohol syndrome is INCORRECT?
a. Characterized by mid-face hypoplasia
b. Reversible
c. May be due to ethyl alcohol or acetaldehyde
d. Occurs early in pregnancy among women who consume alcohol in excess
93. Phenobarbital most often causes drug interactions by
a. Inhibiting absorption
b. Inducing microsomal enzymes
c. Displacement from binding sites
d. Enhancement of clearance
94. A 53 year-old male arrives at ER after collapsing in a shelter for the homeless. A bottle of Sterno
containing methanol was found next to his body. In trying to arrive at a definitive diagnosis, you recall
that the cardinal sign if methanol poisoning is:
a. Metabolic acidosis
b. Coma
c. Respiratory paralysis
d. Blurred vision
95. Concomitant intake of Metronidazole and alcohol will result in which of the following?
a. Swelling of extremities
b. Blurring of vision
c. Nausea and vomiting
d. Dizziness
96. Urinary tract infections due to Chlamydia trachomatis would NOT respond to which of the following
drugs?
a. Tetracycline
b. Erythromycin
c. Nitrofurantoin
d. Ciprofloxacin
97. Which of the following is the reason why treatment of tuberculosis is by combination drug therapy?
a. Diminish the incidence of cumulative effects
b. Prevent the emergence of drug-resistant strains
c. Decrease the incidence of blood dyscrasias
d. Improve patients’ compliance
98. Which of the following is the beneficial effect of aminophylline in the treatment of asthma?
a. Causes cardiac acceleration
b. Causes diuresis
c. Is more effective than Beta adrenergic agonists
d. Is effective in preventing nocturnal asthma
99. Which of the following characterized local anesthetics?
a. They generally block myelinated fibers before unmyelinated fibers
b. They are generally administered along with epinephrine to prolong its action
c. The primary action is on calcium permeability
d. Does not readily cross the blood-brain barrier
100. Which of the following is most useful for patients with red cell deficiency caused by renal disease or
depression of bone marrow?
a. Erythropoietin
b. Hemosiderin
c. Transferrin
d. Folic Acid
e. Vitamin B12