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Pharmacology Exams for Grade 2002 Parkistan students (1) Choice questions Type A (only one answer is correct) 1. Which of the following statements is correct? A. weak bases are absorbed efficiently across the epithelial cells of the stomach B. coadministration of atropine speeds the absorption of a second drug C. drugs showing large Vd can be efficiently removed by dialysis of the plasma D. stressful emotions can lead to a slowing of drug absorption E. if the Vd for a drug is small, most of the drug is in the extraplasmic space 2. Which of the following is true for a drug whose elimination from plasma shows first-order kinetics? A. the half-life of the drug is proportional to the drug concentration in plasma B. the amount eliminated per unit time is constant C. the rate of elimination is proportional to the plasma concentration D. elimination involves a rate-limiting enzymic reaction operating at its maximal velocity(Vm) E. a plot of drug concentration versus time is a straight line 3. All of the following statements are true except A. aspirin(pKa=3.5) is 90% in its lipid-soluble, protonated form at pH=2.5 B. the basic drug promethazine (pKa=9.1) is more ionized at pH=7.4 than at pH=2. C. absorption of a weakly basic drug is likely to occur faster from the intestine than from the stomach D. acidification of the urine accelerates the secretion of a weak base, pKa = 8 E. unchanged molecules more readily cross cell membranes than charged molecules 4. Which of the following statements is correct A. if 10mg of drug A produces the same response as 100mg of drug B, drug A is more efficacious than drug B. B. the greater the efficacy, the greater the potency of a drug C. in selecting a drug, potency is usually more important than efficacy D. a competitive antagonist increases ED50 E. variation in response to a drug among different individuals is most likely to occur with a drug showing a large therapeutic index 5. Drugs showing zero-order kinetics of elimination A. are more common than those showing first order kinetics B. decrease in concentration expontially with time C. have a half-life independent of dose D. show a plot of drug concentration versus time that is linear E. show a constant fraction of the drug eliminated per unit time 6. The drugs that can pass across the blood brain barrier are A. small in molecular weight and ionized drugs B. small in molecular weight and nonionized drugs C. large in molecular weight and ionized drugs D. large in molecular weight and nonionized drugs E. all of above are not true 7. A drug eliminated with first-order kinetics, the concentration of the drug in plasma is 100mg/L at 9 am after administration of a single dose, and at 6 pm the drug plasma concentration is 12.5 mg/L. So, its t1/2 is A. 4h B. 5h C. 6h D. 3h E. 12h 8. The maximal effect of a drug is called A. potency B. efficacy C. affinity D. toxic effect E. margin of safety 9. Which of the following drugs has the largest therapeutic index ? A. Drug A LD50=150mg, ED50=100mg B. Drug B LD50=100mg, ED50=50mg C. Drug C LD50=250mg, ED50=100mg D. Drug D LD50=300mg, ED50=50mg E. Drug E LD50=300mg, ED50=150mg 10. Among the following drugs, which will be excreted most quickly in acidic urine? A. a weak acid drug with pKa of 5.5 B. a weak base drug with pKa of 7.5 C .a weak base drug with pKa of 4.5 D. a weak acid drug with pKa of 3.5 E. a weak base drug with pKa of 6.5 11. The mechanism of treating phenobarbital poisoning with bicarbonate sodium is that it A. neutralizes Phenobarbital B. stimulates Phenobarbital transference from the brain to the plasma C. alkalinizes urine fluid, prevents Phenobarbital from reuptaking, and stimulates excretion of drug D. both B and C are right E. both A and C are right 12. A drug is administered in a single dose of 50 mg, after a period of time the plasma drug concentration is found to be 1mg/L.The apparent volume of distribution is A. 10L B. 20L C. 30L D .40L E .50L 13. After repeated administration of phenobarbital sodium, the patients complain the drug is less useful, this phenomenon is called A. tolerance B. resistance C. dependence D. side reaction E. residual effect 14. The study of the time course of absorption, distribution, metabolism and excretion of drugs in the body is called A. pharmacology B. pharmacokinetics C. pharmacodynamics D. pharmacy E. pharmaceutics 15. The pharmacological mechanism of side effect is A. overdose B. low in selectivity C. hypersensitivity D. administration of drug for a long time E. low in patient’s liver and kidney function 16. The half-life is A. the time that the concentration of the drug in plasma declines by 50% B. the time that the amount of the drug in the body declines by 50% C. the time that half amount of the drug in the body are metabolized D. the time that the effects of the drug decline in a half E. all of above are wrong 17. Property of a partial agonist is A. high affinity and high intrinsic activity B. low affinity and low intrinsic activity C. high affinity and low intrinsic activity D. low affinity and high intrinsic activity E. high affinity and no intrinsic activity 18. Aspirin is a weak acid with pKa of 3.5, what percentage of lipid-soluble form will be in the stomach juice with pH of 2.5 A. 0.99% B. 9% C. 9.09% D. 90.9% E. 99.9% 19. A narcotics addict is brought to the hospital in deep coma. His friends state that he took a large dose of morphine 6 hours earlier. An immediate blood analysis shows a morphine blood level of 0.25mg/L. Assuming the pharmacokinetic parameter of morphine in this patient are Vd = 200L and half-life time equal to 3 hours, how much morphine did the patient were injected 6 hours earlier? A. 25mg B. 50mg C. 100mg D. 200mg E. too few date to predict 20. The bioavailability is A. the quantity of drug absorbed after oral administration B. the rate of drug absorbed after oral administration C. the ratio of AUC(oral)/AUC(intravenous) C. the ratio of AUC (intravenous)/AUC(oral) D. the area under curve of oral administration E. the area under curve of intravenous administration 21. A weak basic drug has pKa = 9, if the medium in which it is dissolved has a pH=7, what will be ratio of the concentrations of ionized to unionized forms of the base? A. 100:1 B. 1:100 C. 10:1 D. 1000:1 E. 1:1 22. The first-pass effect occurs most often after which route of drug administration A. sublingual B. subcutaneous C. intravenous D. intramuscular E. oral 23. Therapeutic action for propranolol does NOT INCLUDE A. atrial fibrillation B. A-V block C. hypertension D. hyperthyroidism E. angina pectoris 24. The effect of pilocarpine on eye is A. miosis, increase intraocular pressure, accommodation of paralysis B. miosis, decrease intraocular pressure, accommodation of spasm C. mydiasis, decrease intraocular pressure, accommodation of paralysis D. mydiasis, increase intraocular pressure, accommodation of spasm E. mydiasis, increase intraocular pressure, accommodation of paralysis 25. The correct statement about epinephrine is that A. inhibition of CNS is very strong B. influence on metabolism is weak C. it can produce tachycardia D. it is only administered by iv E. it can only activate agonist 26. The intoxication of tubocurarine can be antagonized by A. atropine B. adrenaline C. neostigmine D. dopamine E. ephedrine 27. Patients with myasthenia gravis are more effectively treated with A. epinephrine B. propranolol C. neostigmine D. atropine E. pilocarpine 28. β-antagonists can NOT be used in the treatment of A.hypertension B.bronchial asthma C.tachycardia D.angina pectoris E.hyperthyroidism 29. The main mechanism of atropine in the treatment of shock is A.inhibiting vagus nerve to stimulate heart B.dilating vessels and improving microcirculation C.dilating bronchiole D.stimulating CNS and improving respiratory E. dilating coronary and renal vessels 30. which is NOT the indication of phentolamine? A.shock B.diagnosis of pheochromacytoma C.male sexual dysfunction D.primary hypertension E.peripheral vascular occlusive disorders 31. The released NE is disposed mainly by A.the metabolism in the liver B.enzymatic inactivation C.reuptake by the neuronal terminal D.hydrolysis E. MAO and COMT in the circulation 32. Soon after for a nap, a 4-year-old child is found convulsing. Flush and fever are apparent. The heart rate is 170/min, and the pupils are markedly dilated. Drug intoxication is suspected. The most probable cause is A.an organophosphate-containing insecticide B.FeSO4 C.amphetamine-containing diet pills D.pilocarpine-containing eye drops E.atropine-containing medication 33. Which of the following drugs can be used in treatment of glaucoma? A. neostigmine B. pilocarpine C. phentolamine D. norepinephrine E. atropine 34. Which one is NOT the mechanism for epinephrine in the treatment of allergic shock? A. cardiac stimulation B. vasoconstriction to increase blood pressure C. reduce the release of allergic substance D. bronchial dilation E. improve microcirculation 35. Which of the following therapeutic projects would be used in the treatment of patient with serious organophosphate intoxication? A.atropine + norepinephrine B.atopine+ neostigmine C.atropine + pralidoxime iodide D.atropine + epinephrine E.atropine + morphine 36. The main route of inactivation of Ach is that A.it is destroyed by MAO B.it is destroyed by COMT C.it is retaken into the cytoplasm D.it is hydrolyzed by cholinesterase E.A+B 37. Epinephrine is used in local anesthetic solution in order to A.offset arrhythmic effect on the heart B.increase the potency of the local anesthetic C.offset negative inotropic actions on the heart D.reduce the rate of absorption of the local anesthetic and prolong its duration E.all of them 38. The elevated blood pressure caused by epinephrine may be reversed by A.propranolol B.phentolamine C.norepinephrine D.nicotine E.atropine 39. Atropine has the following effects EXCEPT A.mydiasis B.spasm of accommodation C.increase intraocular pressure D.decrease salivary secretion E.stimulation of CNS in larger dose 40. Which is correct description about the β-adrenoceptor effect? A.both cardiac excitation and bronchial dilation belong to β1 effect B.both cardiac excitation and bronchial dilation belong to β2 effect C.both cardiac excitation and vascular dilation belong to β1 effect D.both cardiac excitation and vascular dilation belong to β2 effect E.both vascular dilation and bronchial dilation belong to β2 effect 41. Scopolamine is contraindicated in patients with A.glaucoma B.gastrospasm C.organophosphate poisoning D.infectious shock E.parkinsonism 42. d-tubocurarine can mainly block A. N1-receptor B. N2-receptor C. M-receptor D. β1-receptor E. β2-receptor 43. Which of the following does NOT belong to muscarinic actions caused by M-receptor activation? A. Heart depression B. Vessel dilation C. Smooth muscle contraction D. Glands secretion increased E. Mydriasis 44. Which of the following is the drug of choice in the treatment of cardiac arrest? A. Atropine B. Epinephrine C. Norepinephrine D. Isoprenalin E. Lidocaine 45. Which of the following is the drug of choice in the treatment of open-angle glucoma? A. Pilocarpine B. Neostigmine C. Epinephrine D. Timolol E. Atropine Type X(Multiple-choice questions) 46. an antagonist A. has similar receptor binding affinity to the agonist B. has similar efficacy to the agonist C. is always competitive D. has low intrinsic activity E. will shift the agonists dose-response curve to the right 47.Factor(s) affecting distribution of a drug include(s) A. binding of the drug to plasma proteins B. pH of body fluids C. blood brain barrier D. affinity to certain tissues E. pKa of the drug 48. Which of the following would be expected in a severe case of organophosphate poisoning? A. salivation B. tremor of skeletal muscle C. dry skin D. bronchoconstriction E. coma 49. When you treat a patient with atropine, which of the following side effects would be endure? A. dry mouth B. tachycardia C. mydriasis D. urinary retention E. fever 50. Which of the following receptors locate(s) on the vessels? A. α-receptor B. N2-receptor C. M-receptor D. β1-receptor E. β2-receptor Pharmacology Exams for Grade 2002 Pakistan students (1) Choice questions Type A (only one answer is correct) 51. The main reason for the combination use of L-dopa with carbidopa is A. to increase the absorption of L-dopa B. to inhibit L-dopa decarboxylation in the periphery C. to inhibit MAO D. to inhibit COMT E. to increase L-dopa converting to dopamine directly 52. Morphine can NOT be used for the treatment of A. asthmatic bronchitis B. cardiac asthma C. serious simple diarrhea D. pain caused by cancer E. cardiac infarction with normal blood pressure 53.Which is the first choice for status epilepticus A. magnesium sulfate B. carbamazepine C. ethosuximide D. diazepam E. phenylbutazone 54.Which one of the following analgesic drugs can be used for artificial hibernation? A. morphine B. methadone C. pethdine D. fetanyl E. anadol 55.Which is the first choice for absence seizure A. phenytoin B. Phenobarbital C. ethosuximide D. diazepam E. sodium valproate 56.The drug of choice to treat trigeminal neuralgia is A. diazepam B. carbamazepine C. phenobarbital D. ethosuximide E. primidone 57.In the following statements about benzodiazepines,which is INCORRECT? A. they can induce tolerance after long time use B. they can induce exterapyramidal symptoms C. they can excreted through breast milk D. they can cause respiration depression in large dose E. they can also cause muscle relaxation 58.Which of the following statements about phenytoin sodium is NOT true A. has a sedative effect B. can be used for patients with epilepsy C. can be used to treat patients with arrhymia D. can be used to manage patients with trigeminal neuralgia E. can cause gingival hyperplasia 59. Which of the following is the drug of choice for the treatment of grand mal epilepsy? A. Phenobarbital B. phenytoin sodium C. sodium valproate D. diazepam E. ethosuximide 60. A drug that can be used in the treatment of parkinsonism and also attenuate the reversible extrapyramidal side effects of chlorpromazine is A. amantadine B. levodopa C. artane D. bromocriptine E. selegiline 61.Antiparkisonium agents do not include A. amantadine B. clopromazine C. levodopa D. artane E. bromocriptine 62. A drug that has not only anti-parkision’s effect but also anti-viral effect is A. levodopa B. amantadine C. artane D. bromocriptine E. selegiline 63.Which of the following statements about morphine is INCORRECT? A. It is used therapeutically to relieve pain caused by severe head injury B. Its withdraw symptoms can be relieved by methadone C. It causes constipation D. It is most effective by parenteral administration E. It rapidly enters all body tissuses, including the fetus of a pregnant woman 64.Which of the following drugs can be used to treat cardiac asthma? A. Chlorpromazine B. pethidine C. phenytoin sodium D. levodopa E. artane 65.All of the following actions of morphine are true EXCEPT A. dilating pupil B. inhibition of respiration C. constipation D. boosting of tension of the bladder sphincter E. sedation 66.The mechanism of antidepressant action of imipramine is A. blockade of M-receptor in CNS B. blockade of NE and 5-HT reuptake centrally C. stimulation of reticular ascending activating system D. blockade of α-receptor E. promoting release of 5-HT 67.All of the following actions of benzodiezepine are true EXCEPT A. antianxiety B. Sedation C. Hypnosis D. Muscle relaxant E. analgesia 68.The shared mechanism of NSAIDs’ effect is to A. inhibit the enzyme Phospholipids A2 (PLA2) B. block β-receptor C. inhibit the enzyme cyclo-oxygenase (COX) D. release NO E. block α-receptor 69.Which effect Acetaminophen(Paracetamol) do not have compared with aspirin? A. Antipyretic effect B. Analgesic effect C. Anti-inflammatory effect D. inhibiting activity of the heart E. causing low blood pressure 70. The reason aspirin can cause gastric ulcer is that A. it inhibits production of protective PGI2 B. it is potent alkaline drug C. it is very poisonous D. it dialates small vessels E. it damages the mucosa of stomach 71. Which drug can be used in artificial hibernation? A. parocetamol B. aspirin C. adrenaline D. chlorpromazine E. atropine 72. Mechanism of anti-inflammatory effect of NSAIDs is to A. inhibit biosynthesis of PGs in centre nervous system B. promote biosynthesis of PGs in centre nervous system C. inhibit biosynthesis of PGs in inflammatory sites D. promote biosynthesis of PGs in inflammatory sites E. promote biosynthesis of LTs (Leukotiens)in inflammatory sites Type X(Multiple-choice questions) 73.Which are the side effects of chlorpromazine? A. akathisia B. parkinson’s syndrome C. postural hypotension D. tardive dyskinesia E. acute dystonia 74. The advantages of benzodiezepines compared with babiturates are A. the rebound insomnia upon discontinuance of drugs is lighter B. do not induce hepatic enzyme C. dependence is light D. higher treatment index E. side effects are lighter 75. Aspirin can be used in A. headache B. fever C. inflammation D. preventing thrombosis E. asthma Answers for examination 1. D 2. C 3. B 4. D 5. D 6. B 7. D 8. B 9. D 10. B E 13. A 14. B 15. B 16. A 17. C 18. D 19. D 20. C E 23. B 24. B 25. C 26. C 27. C 28. B 29. B 30. D E 33. B 34. E 35. C 36. D 37. D 38. B 39. B 40. E B 43. E 44. B 45. D 46. ADE 47. ABCDE 48. ABDE 50. ACE 51-55. BADCC 56-60. BBABC 61-65. BBABA 66-67 BE 70A 71 D 72 C 73. ABCDE 74.ABCDE 75. ABCD 11. D 12. 21. A 22. 31. C 32. 41. A 42. 49. ABCDE 68C 69C