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SINGLE CHOISE The study of drugs and their effects is called: a) physiology b) anatomy c) medicinology d) pharmacology e) pharmacy Solid form of a drug is: a) solution b) ointment c) suspension d) tablet e) ampoules Whitch of the following is not a liquid form? a) tinture b) suspension c) solution d) powder e) syrup An example of a semisolid form would be: a) tablet b) capsules c) suspension d) powder e) cream Liquid form of a drug in which a partile of a drug are not completely dissolved: a) suspension b) ointment c) capsule d) tablet e) gel What is considered the brand name? a) paracetamol b) acamol c) non opioid analgesic d) "off label" use e) inhibit cyclooxygenase Xenobiotics are considered: a) Endogenous b) Exogenous c) Inorganic poisons d) Toxins e) Ligands Pharmacokinetics is: 1 a) The study of biological and therapeutic effects of drugs b) The study of absorption, distribution, metabolism and excretion of drugs c) The study of mechanisms of drug action d) The study of methods of new drug development e) The study of pharmacological effects of drugs What does "pharmacokinetics" include? a) Localization of drug action b) Mechanisms of drug action c) Biotransformatin of drugs d) Interaction of substances e) Side effects of drugs Pharmacokinetics is the effect of the ____ and pharmacodynamics is the effect of the_______: a) Drug on the body; Body on the drug b) Drug on a drug; Drug on a drug c) Body on the drug; Drug on a drug d) Body on the drug; Drug on the body e) Drug on a drug; Body on the drug How is called the pharmacokinetic index, that shows the fraction of an administered dose of unchanged drug that reaches the systemic circulation? a) Bioavailability b) Dosage c) Bioinequivalence d) Drug absorption e) Bioequivalence Which of the following statement is correct for bioavailability? a) The ratio of a drug that reaches the systemic circulation and make an effect. b) The time it takes for the amount or concentration of a drug to fall to 50 % c) The ratio of the rate of elimination of a drug to its concentration in plasma. d) The fraction of the administrated dose of unchanged drug that reaches the systemic circulation. e) the ability of the administered drug metabolites to cause undesirable physiological effects. For intravenous (IV) dosages, what is the bioavailability assumed to be? a) 0% b) 25% c) 50% d) 75% e) 100% Weak acids are excreted faster in _____urine and weak bases are excreted faster in _____urine: a) Acidic; Alkaline b) Alkaline; Acidic c) Acidic; Neutral d) Neutral; Alkaline e) Alkaline; Neutral 2 The principle of drug manipulation for excretion of a drug out of the renal tubule can be accomplished by: a) Acidifying the urinary pH b) Adjusting the urinary pH to protonate weakly acidic drugs c) Adjusting the urinary pH to unprotonate weakly basic drugs d) Adjusting the urinary pH to ionize the drug e) By neutralizing the urinary pH What organ is responsible for metabolism in the "first pass effect"? a) Brain b) Heart c) Kidney d) Liver e) Spleen What type of drug would be needed to enter the brain and CNS? a) Hydrophilic b) Hydrophobic c) Lipophilic d) Lipophobic e) Large molecular weight Which of the enteral administration routes has the largest first-pass effect? a) SL (sublingual) b) Buccal c) Rectal d) Oral e) IV (intravenous) All administration ways listed below are parenteral but one: a) Intravenous b) Subcutaneous c) Peroral d) intramuscular e) subarachnoidal More slowly effect appears after: a) intravenous administration b) per oral administration c) subcutaneous administration d) intramuscularly administration e) inhaled administration More rapid effect appears after: a) subcutaneous administration b) intramuscularly administration c) intravenous administration d) per oral administration e) intrarectal administration Which of the administration routes is not often used, is painful, and has a risk of infection and adhesion? 3 a) EPI (epidural) b) IA (intraarterial) c) IP (intraperitoneal) d) IV (intravenous) e) SL (sublingual) Which organ or tissue would receive drug slowly? a) Liver b) Brain c) Fat d) Muscle e) Kidney What type of drugs can cross the blood-brain barrier (BBB)? a) Large and lipid-soluble b) Large and lipid-insoluble c) Small and lipid-soluble d) Small and lipid-insoluble e) Small and ionized Name the simplest way of drugs penetration through membrane? a) Filtration b) Pinocytosis c) Active transport d) Facilitated-difuzion e) Co-transport Name the way of the penetration through the membrane that needs energy: a) filtration b) active transport c) facilitated diffusion d) simple diffusion e) filtration& simple diffusion Which location can accumulate lipid-soluble drugs, has little or no receptors, and can hold distributed drugs like barbiturates? a) Liver b) Kidney c) Brain d) Fat e) Fetus Which location has high blood flow and is a site of excretion? a) Liver b) Kidney c) Brain d) Fat e) Fetus Elderly patients often have ____ muscle mass and thus a(n) ____ Vd (volume of distribution): a) More; Increased 4 b) More; Decreased c) Less; Increased d) Less; Decreased e) Less, Unchanged Most drugs are active in their ____ form and inactive in their ____ form: a) Non-polar; Polar b) Polar; Non-polar c) Water-soluble; Lipid-soluble d) Lipid-insoluble; Water-insoluble e) Neutral; Neutral Which of the metabolically active tissues is the principle organ for drug metabolism? a) Skin b) Kidneys c) Lungs d) Liver e) GI Tract What is the goal of the P450 system (microsomes pinched off from endoplasmic reticulum)? a) Only metabolism of substances b) Only detoxification of substances c) Metabolism of substances & Detoxification of substances d) Decreasing pH of compartments containing substances e) Increasing pH of compartments containing substances Intrinsic activity is a drug's ability to elicit: a) Strong receptor binding b) Weak receptor binding c) Response d) Excretion e) Distribution What is the object of pharmacovigilance? a) Evaluation of pharmacokinetic parameters for new drugs. b) Determining the therapeutic index c) Monitoring of drugs introduced into therapeutic, especially side effects. d) Intensive therapeutic studies of the 3rd stage on clinical evaluation. e) Drugs interactions. The main mechanism of most drugs absorption in GI tract is: a) Active transport (carrier-mediated diffusion) b) Filtration (aqueous diffusion) c) Endocytosis d) Passive diffusion (lipid diffusion) e) Exocytosis What determines the degree of movement of a drug between body compartments? a) Partition constant b) Degree of ionization c) pH 5 d) Size e) All of the above Which of these physical chemical properties from medicaments are essential for filtration (crossing of channel membranes) as a means of crossing through cellular membranes? a) Lipid solubility b) Water solubility c) Coefficienct of lipid/big water partition d) small pKa e) Affinity for a transportable system Name the way of the penetration through the membrane that needs the energy: a) Filtration b) Pinocytosis c) Facilitated difuzion d) Simple diffusion e) Facilitated difuzion& Simple difuzion What is a pharmacodynamic process? a) The drug is readily deposited in fat tissue b) Movement of drug from the gut into general circulation c) Drug metabolites are removed in the urine d) The drug causes dilation of coronary vessels e) Alteration of the drug by liver enzymes If a medication is intended to be administered per os, how is it typically administered? a) Oraly b) Inhaled c) Rectally d) Injected e) Vaginaly What is characteristic of the oral route? a) Fast onset of effect b) Absorption depends on GI tract secretion and motor function c) A drug reaches the blood passing the liver d) The sterilization of medicinal forms is obligatory e) Bypassing the hepatic barrier in the first - pass What is characteristic of the intramuscular route of drug administration? a) Only water solutions can be injected b) Oily solutions can be injected c) No need in sterillity d) The action develops slower, than at oral administration e) Oily solutions can't be injected Tick the feature of the sublingual route: a) Pretty fast absorption b) A drug is exposed to gastric secretion c) A drug is exposed more prominent liver metabolism d) A drug can be administrated in a variety of doses e) Absorption depends on GI tract secretion 6 Pick out the parenteral route of medicinal agent administration: a) Rectal b) Oral c) Sublingual d) Inhalation e) Through gastric tube Pick out the enteral route of medicinal agent administration: a) rectal b) intravenous c) subcutanous d) inhalation e) transdermal The volume of distribution (Vd) relates: a) Single to a daily dose of an administrated drug b) An uncharged drug reaching the systemic circulation c) An administrated dose to a body weight d) The amount of a drug in the body to the concentration of a drug in plasma e) Process of physicochemical and biochemical alteration of a drug in the body The term "biotransformation" includes the following: a) Accumulation of substances in a fat tissue b) Binding of substances with plasma proteins c) Accumulation of substances in a tissue d) Process of physicochemical and biochemical alteration of a drug in the body e) The amount of a drug in the body to the concentration of a drug in plasma If a drug is 80% bound to blood elements or plasma proteins, what part is considered the free form? a) 20% b) 40% c) 50% d) 80% e) 100% Specify the aim of microsomal oxidation: a) Microsomal oxidation always results in inactivation of a compound b) Microsomal oxidation results in a decrease of compound toxicity c) Microsomal oxidation results in an increase of ionization and water solubility of a drug d) Microsomal oxidation results in an increase of lipid solubility of a drug e) Microsomal oxidation takes pleace just in the kidney Metabolic transformation (phase 1) is: a) Acetylation and methylation of substances b) Transformation of substances due to oxidation, reduction or hydrolysis c) Glucuronide formation d) Binding to plasma protein e) Elimination through kidney Which of the following processes proceeds in the second phase of biotransformation? 7 a) Acetylation b) Oxidation, c) Reduction d) Hydrolysis e) Elimination through kidney Conjugation is: a) Process of drug reduction by special enzymes b) Process of drug oxidation by special oxidases c) Coupling of a drug with an endogenous substrate d) Solubilization in lipids e) Reduction and oxidation by special enzymes Pick out the answer which is the most appropriate to the term "receptor": a) Free molecules that caries the drug to the CNS b) Enzymes of oxidizing-reducing reactions activated by a drug c) Active macromolecular components of a cell or an organism which a drug molecule has to combine with in order to elicit its specific effect d) All types of ion channels modulated by a drug e) Second mesangers that participate in genes trasncription What does "affinity" mean? a) A measure of how tightly a drug binds to plasma proteins b) A measure of how tightly a drug binds to a receptor c) A measure of inhibiting potency of a drug d) A measure of bioavailability of a drug e) A measure of plasmatic concentraton of a drug Which of the drug permeation mechanisms uses the HendersonHasselbalch equation for the ratio of solubility for the weak acid or weak base? a) Pinocytosis b) Lipid diffusion c) Endocytosis and exocytosis d) Aqueous diffusioт e) Carrier molecules What is implied by «active transport»? a) Transport of drugs trough a membrane by means of diffusion b) Transport without energy consumption c) Engulf of drug by a cell membrane with a new vesicle formation d) Transport against gradient of concentration e) Filtration through the membrane pores If an agonist can produce submaximal effects and has moderate efficacy it's called: a) Partial agonist b) Antagonist c) Agonist-antagonist d) Full agonist e) Full antagonist Which of the ion is increased in intracellular concentration due to second messengers such as IP3? 8 a) K+ b) Ca++ c) Cld) Na+ e) Mg++ Which of the following affirmations define an agonist action? a) metabolic phenomena are being triggered by activating specific and on calcium- calmodulin or calcium-phopholipid dependent phosphates. b) a chemical that binds to a receptor and activates the receptor to produce a biological response c) interaction between the drug and body molecules. d) interaction between a drug and plasmatic proteins. e) intensity of an effect, expressed through a maximal effect. Describe definition of an agonist? a) A drug directed at parasites infecting the patient b) A drug that binds to a receptor and inhibits or opposes cellular activity c) A drug that binds to a receptor and stimulates cellular activity d) A specific regulatory molecule in the biologic system where a drug interacts e) Any substance that brings about a change in biologic function through its chemical action The substance binding to one receptor subtype as an agonist and to another as an antagonist is called: a) Competitive antagonist b) Irreversible antagonist c) Agonist-antagonist d) Partial agonist e) Chemical agonist The situation when failure to continue administering the drug results in serious psychological and somatic disturbances is called? a) Tachyphylaxis b) Sensibilization c) Abstinence syndrome d) Idiosyncrasy e) Tolerance Idiosyncratic reaction of a drug is: a) A type of hypersensitivity reaction b) A type of drug antagonism c) Unpredictable, inherent, qualitatively abnormal reaction to a drug d) Quantitatively exaggerated response e) Toxic reaction after drug administration Tachyphylaxis refers to definition? a) Responsiveness increased rapidly after administration of a drug b) Responsiveness decreased rapidly after administration of a drug (rapid tolerance) c) Responsiveness increased rapidly after maintenance of a drug (hypersensitiv) d) Responsiveness decreased rapidly after maintenance of a drug (desensitize) e) Responsiveness decreased slowly after administration of a drug 9 Which of effect refers to an increased intensity of response to a drug? a) Idiosyncratic b) Hyporeactive c) Hyperreactive d) Allergy e) Tolerance In case of liver disorders accompanied by a decline in microsomal enzyme activity the duration of action of some drugs is: a) Decreased b) Enlarged c) Remained unchanged d) Changed insignificantly e) Decreased insignificantly Which drugs inhibit hepatic enzymes? a) nicotine b) prednisone c) erythromycin d) penicillin e) fenobarbital Which is an example of a drug acting directly through receptors? a) Mannitol for subarachnoid hemmorhage b) Cancer chemotherapeutic agents c) Epinephrine for increasing heart rate and blood pressure d) Rezerpine to decreases high pressure e) Protamine soulphate binds stoichiometrically to heparin anticoagulants Half life (t½ ) is the time required to: a) Change the amount of a drug in plasma by half during elimination b) Metabolize a half of an introduced drug into the active metabolite c) Absorbed a half of an introduced drug d) Bind a half of an introduced drug to plasma proteins e) Total duration of treatment Which is the median effective dose, or the dose at which 50% of the individuals exhibit the specified quantal response? a) LD50 b) ED50 c) EC50 d) TD50 e) T.I. What is considered the therapeutic index in animal studies? a) T.I. = TD50 / ED50 b) T.I. = LD50 / ED50 c) T.I. = ED50 / TD50 d) T.I. = ED50 / LD50 e) T.I. = TD50 / ED50 & T.I. = LD50 / ED50 10 The therapeutic index for humans is: a) the ratio of therapeutically doses to the minimum toxic doses. b) dose which produce the therapeutically effect c) is the ratio of the TD50 to the ED 50 d) the doses which makes more favorable effects e) the most quantity of the drug that produces maximum effect without side effects. What is the most relevant use of therapeutic index? a) Guide for toxicity in therapeutic the setting b) Multiple measures of effectiveness are possible c) Measure of impunity with which an overdose may be tolerated d) Toxicities may be idiosyncratic (e.g. propranolol in asthmatics) e) Used just in bioequivalence study Describes minimal effective concentration (MEC)? a) The minimal drug plasma concentration to reach therapeutic levels b) The minimal drug plasma concentration to interact with receptors c) The minimal drug plasma concentration to enter tissues d) The minimal drug plasma concentration to produce effect e) The minimal drug plasma concentration that can be detected If a patient misses three doses of their daily drug, which is the best solution? a) Prescribe a higher dosage pill so missed doses will have less effect b) Setup an appointment to have the patient evaluated c) Do nothing and continue normal regimen d) Wait 3 more days (week total) then return to normal regimen e) Take a 4x dose at the next dose time What type of study for an Investigational New Drug involves neither the investigators or subjects knowing if the drug or placebo is being given? a) Single-blind study b) Double-blind study c) Placebo d) Positive-control e) Crossover study What clinical trial phase is conducted with several hundred to thousands of volunteer patients suffering from the condition the investigational drug treats? a) Phase 1 b) Phase 2 c) Phase 3 d) Phase 4 e) bioequivalence study What clinical trial phase is conducted with up to several hundred patients suffering from the condition the investigational drug is designed to treat? a) Phase 1 b) Phase 2 c) Phase 3 d) Phase 4 e) bioequivalence study 11 What clinical trial phase involves submitting a New Drug Application, monitoring, and reporting by clinicians using the drug? a) Phase 1 b) Phase 2 c) Phase 3 d) Phase 4 e) bioequivalence study What clinical trial phase is “first-in-man studies”, conducted in a small group of healthy volunteer? a) Phase 1 b) Phase 2 c) Phase 3 d) Phase 4 e) bioequivalence study Name clinical study used to assess the expected in vivo biological equivalence of two proprietary preparations of a drug: a) Phase 1 clinical study b) Phase 2 clinical study c) Phase 3 clinical study d) Phase 4 clinical study e) bioequivalence study Name liquid volatile anesthetics: a) Propanidid b) Nitrous oxide c) Thiopental d) Ketamine e) Halothane How to prevent reflex bradycardia during anesthesia? a) By atropine injection b) By diazepam injection c) By halothane injection d) By decreasing dose of the anesthetic agent e) By epinephine injection Which is characteristic for surgical stage with diethyl ether anesthesia? a) analgesia b) combative behavior c) medullary paralysis d) eyes initially rolling, then becoming fixed e) excitement Which anesthetic cause "dissociative anesthesia": a) Diethyl ether b) Halothane c) Ketamine d) Sodium hydroxybutyrate e) Nitrous oxide 12 Which drug can be used for controlled hypotension during anesthesia: a) Trimethafan b) Diazepam c) Atropine d) Flumazenil e) Sodium hydroxybutyrate Name drug used for all type of local anesthesia: a) Cocaine b) Tetracaine c) Procaine d) Lidocaine e) Bumecaine Which local anesthetic has ability to constrict vessels? a) Cocaine b) Tetracaine c) Procaine d) Lidocaine e) Bumecaine Which local anesthetic can be used for ventricular arrythmias? a) Cocaine b) Tetracaine c) Procaine d) Lidocaine e) Bumecaine Name organic astringent: a) Zinc oxide b) Silver nitrate c) Lead acetate d) Tannin e) Cooper sulphate Choose astringent drug: a) menthol b) tanninum c) carbosem d) mucilago amyli e) medicas E All the preparations listed below are sedatives but one: a) natrium bromide b) preparations made of valerian c) amphetamine d) diphenhydramine e) barbital Name indication of disulfiram: a) Alcoholic coma b) Acute alcohol poisoning 13 c) Withdrawal syndrome d) Delirium tremens e) Used to support the treatment of chronic alcoholism Name flumazenil mechanism of action: a) Blocks competitivly benzodiazepins receptors b) Blocks GABAB receptors c) Increases benzodiazepins metabolism d) Decreases benzodiazepins metabolism e) Has GABA-mimetic action Name diazepam mechanism of action: a) Blocks benzodiazepins receptors b) Blocks GABAB receptors c) Blocks GABAA receptors d) GABAA receptors activation and hyperpolarization e) GABAA receptors activation and depolarization What drug does manifest the minimal action on the rapid faze of sleeping: a) phenobarbital b) pentobarbital c) nitrazepam d) barbital e) cyclobarbita Hypnotic drugs are used to treat: a) psychoses b) sleep disoders c) narcolepsy d) Parkinsonian disorders e) acute mania What explains the anxiolytic action caused by diazepam? a) interaction with adrenoreceptors b) interaction with cholinoreceptors c) interaction with benzodiazepinic receptors d) interaction with opioid receptors e) interaction with serotonine receptors Mechanism of barbiturates tolerance: a) Induction of microsomal enzymes b) Inhibition of microsomal enzymes c) Decreased absorption in GI tract d) Increased elimination through kidney e) Receptors desensitization The mechanism of action of benzodiazepines is: a) Activation of GABA receptors b) Antagonism of glycine receptors in the spinal cord c) Blockade of the action of glutamic acid d) Inhibition of GABA aminotransferase e) Activation of M cholynoreceptors 14 GABA A receptors (ligand-gate ) involve the movement of what ion across the membrane? a) K+ b) Ca++ c) Cld) Na+ e) Mg++ Name antagonist of benzodiazepines: a) unitiol b) naloxone c) tramadol d) protamine sulphate e) flumazenil Which of the below listed drugs manifest a minimum action upon fast sleep phase? a) fenobarbital b) pentobarbital c) chloral hydrate d) barbital e) oxazepam Choose opioid receptor antagonist: a) Morphine b) Codeine c) Omnopon d) Naltrexone e) Talamonal Morphine has each the effects listed EXCEPT: a) myosis b) constipation c) bradycardia d) hypothermia e) hyperthermia Name agonist-antagonist of opiod receptors: a) Metamisol b) Naltrexone c) Tramadol d) Pentazocine e) Omnopon Signs of opioid poisoning are, EXCEPT: a) Miosis b) Falling in body temperature c) Increased body temperature d) Respiratory depression e) Hypotension Name antagonist of opiod analgesics: 15 a) Metamisol b) Naloxone c) Tramadol d) Pentazocine e) Omnopon Choose GABA-receptor agonist with analgesic properties: a) Diphenhydramine b) Carbamazepine c) Ketamine d) Baclofen e) Paracetamol Choose α2-agonist with analgesic properties: a) Diphenhydramine b) Carbamazepine c) Ketamine d) Clonidine e) Paracetamol Choose drug with analgesic properties administered by inhalation: a) Nitrous oxide b) Diphenhydramine c) Carbamazepine d) Ketamine e) Halothane The main effects of non-opioid analgesics are, EXCEPT: a) anti-inflammatory b) antiagregant c) antipyretic d) somnolence e) analgesic Morphine causes following effects, EXCEPT: a) Analgesic b) Euphoria c) Stimulation of the vagal center d) Stimulation of the cough center e) Segmentation of the intestine The diagnostic triad of opioid overdosage is: a) Mydriasis, coma and hyperventilation b) Coma, depressed respiration and miosis c) Miosis, tremor and hypertermia d) Mydriasis, chills and abdominal cramps e) Mydriasis, tremor and vomiting Which of the following agents is used in the treatment of acute opioid overdose? a) Pentazocine b) Methadone c) Naloxone 16 d) Remifentanyl e) Buprenorphine All of the following are opium derivatives EXCEPT: a) codeine b) thebaine c) morphine d) paracetamol e) papaverine Each of the findings listed is characteristic of opioid poisoning EXCEPT: a) Coma b) Miosis of the pupils c) Bradycardia d) Low body temperature e) Mydriasis Each of the findings listed is characteristic of opioid poisoning EXCEPT: a) Coma b) Myosis c) Depressed respiration d) Flaccidity of skeletal muscles e) Elevated body temperature Indicate the pure opioid antagonist: a) Morphine b) Naltrexone c) Tramadol d) Pentazocine e) Tramadol Which of the following drugs has weak µ agonist effects and inhibitory action on norepinephrine and serotonin reuptake in the CNS? a) Loperamide b) Tramadol c) Fluoxetine d) Butorphanol e) Nalbuphine What is the difference of trimeperidine from morphine? a) Analgesic activity is inferior by up to 2-4 times b) Causes nausea more frequent than morphine c) Inhibits respiratory center to higher degree d) Duration of analgesic effect is longer e) Is administered in lower dose Alkaloid from Papaver somniferum is: a) nalbuphine b) thalamonal c) pentazocine d) morphine e) sufentanyl 17 Which antiepileptic drug causes hyperplastic gingivitis? a) Phenobarbital b) Phenytoin c) Carbamazepine d) Ethosuximide e) Sodium valproate Which one of the following drugs exerts its anticonvulsant effects by blocking sodium chanels in neuronal membranes? a) Phenobarbital b) Valproic acid c) Diazepam d) Chlorpromazine e) Magnesium sulphate Which one of the following drugs exerts its anticonvulsant effects by blocking sodium chanels in neuronal membranes? a) Acetazolamide b) Carbamazepine c) Diazepam d) Gabapentin e) Vigabatrin Which of the following drugs is useful in the treatment of Parkinson′s disease? a) Pilocarpine b) Trihexyphenidyl c) Edrophonium d) Succinylcholine e) Hexamethonium Antiparkinsonic drugs are: a) Primidone + Phenytoin + Ethsuximide b) Phenibut + Baclofen + Mefedol c) Lorazepam + Flurazepam + Zopiclon d) Madopar + Selegeline + Trihexyphenidyl e) Diazepam + Lamotridgine + Valproic acid Effective in treating of extrapyramidal disorders caused by antipsychotic drugs: a) carbidopa b) trihexyphenidyl c) haloperidol d) amantidine e) levodopa Name catechol-O-methyltransferase inhibitor: a) Carbidopa b) Benserazide c) Sinemet d) Entacapone e) Selegiline 18 Choose antagonist of glutamate NMDA-receptors: a) Carbidopa b) Benserazide c) Sinemet d) Amantadine e) Selegeline Name trihexyphenidyl side effects: a) Intestinal spasm b) Bradycardia c) Tachycardia d) Miosis e) Hypersalivation Select antipsychotic drugs: a) Diazepam, Ethosuximide, Carbamasepine b) Phenobarbital, Barbital, Chloralhidrate c) Levodopa, Trihexyphenidyl, Amantadine d) Levomepromazine, Chlorpromasine, Droperidol e) Omnopon, Morphine, Fentanyl The phenothiazines have a variety of actions at different receptors types. However, they do NOT appear to interact with receptors: a) Dopamine b) Histamine c) Nicotine d) Adrenoreceptors e) Muscarine A 50-yer-old patient has periodically a period of depression follow by psychosis. Choose the drug to prevent this disorder: a) Amitriptyline b) Lithium carbonate c) Levomepromasine d) Nootropil e) Vallerian Effective in treating acute dystonia caused by antipsychotic drugs: a) carbidopa b) trihexyphenidyl c) haloperidol d) madopar e) levodopa Chlorpromazine would not be appropriate drug management of: a) Acute mania b) The amenorrhea-galactorrhea syndrome c) CNS stimulants intoxication d) Schizoaffective disorders e) Bipolar disorders If one patient is taking amitriptyline and another patient is taking chlorpromazine, they 19 are both likely to experience: a) Excessive salivation b) Extrapyramidal dysfunction c) Gynecomastia d) Increased gastrointestinal motility e) Postural hypotension The following neuroleptic drug has sympatholytic activity: a) Reserpine b) Sulpiride c) Risperidone d) Chlorprothixene e) Haloperidol The main effect of neuroleptics is: a) antiagregant b) antidopaminic c) cholinomimetic d) adrenomimetic e) GABA-ergic. The following neuroleptic drug blocks both D2 and 5-HT2A receptors: a) Risperidone b) Sulpiride c) Droperidol d) Chlorprothixene e) Haloperidol Name atypical antipsychotic drug: a) Droperidol b) Pimozid c) Clozapine d) Chlorprothixene e) Haloperidol Parkinsonian symptoms and tarditive dyskinesia are caused by blockade dopamine in: a) The nigrostriatal system b) The mesolimbic and mesofrontal systems c) The chemoreceptor trigger zone of the medulla d) The tubero-infundibular system e) The scheletal muscle Select antiparkinsonic drugs: a) Diazepam, Ethosuximide, Carbamasepine b) Phenobarbital, Barbital, Chloralhidrate c) Levodopa, Trihexyphenidyl, Amantadine d) Levomepromazine, Chlorpromasine, Droperidol e) Phenobarbital, Diazepam, Nitrazepam Many therapeutically useful drugs act via brain dopaminergic systems. Which one of the following mechanism exacerbates Parkinson's disease? a) Inhibition of dopamine reuptake 20 b) Increase in dopamine synthesis c) Activation of dopamine receptors d) Inhibition of dopamine metabolism e) Blockade of dopamine receptors The drug that increase amount of dopamine in Parkinson's disease: a) bromocriptine b) levodopa c) selegeline d) amantadine e) trihexyphenidyl Select peripheral DOPA decarboxylase inhibitor: a) Amantadine. b) Trihexyphenidyl c) Carbidopa. d) Selegiline. e) Bromocriptine. Select nootropics (smart drugs) from the combinations: a) Carbamazepine + Chlorpromazine +Haloperidol b) Pyracetam + Meclofenoxat + Picamilone c) Caffeine + Mesocarb + Methamphetamine d) Nialamide + Maprotiline + Amitriptyline e) Amphetamine + Sibutramine + Mezocarb Which of the following can cause ""serotonin syndrome": a) Fluoxetine b) Amitriptyline c) Pipofezin d) Imipramine e) Maprotiline Mechanism of action of tricycle antidepressants:: a) Stimulation of GABA system b) Increasing of beta adrenoreceptors activity c) M-cholinoreceptors block d) Inhibition of mediators reuptake on the presynaptic membrane level e) MAO inhibition The following drug blocks selectively neuronal uptake of norepinephrine: a) Fluoxetine b) Amitriptyline c) Pipofezin d) Imipramine e) Maprotiline The following drug blocks selectively MAO-A: a) Fluoxetine b) Amitriptyline c) Moclobemide d) Imipramine 21 e) Maprotiline What is the principal mechanism of action of Tricyclic antidepressants? a) exit receptors b) diminishes monoaminoxidase activation c) inhibits neuronal reuptake of monoamines d) activates monoaminoxidase e) stimulates neuronal reuptake of monoamines Which kind of substance is psychostimulants? a) piracetam b) baclofen c) amphetamine d) valproaic acid e) prometazine Following groups are psychoanaleptics: a) neuroleptics, sedatives, tranquilisators b) adaptogenes, neuroleptics, nootropes c) psychostimulants, antidepressants, adaptogenes d) psychosomimetics, antidepressants e) analgesic, neuroleptics, sedatives Name the nootropic agent: a) Caffeine b) Fluoxetine c) Eleuterococci extract d) Piracetam e) Sydnocarb What amino acids is converted into catecholamines (NE, Epi, Dopamine)? a) Valine b) Lysine c) Proline d) Tyrosine e) Alanine Which location contains choline from phosphatidylcholine? a) Milk b) Liver c) Eggs d) Peanuts e) Blood plasma Which of the mediator is broken down by MAO-B (monoamine oxidasmore than the others? a) Serotonin b) Norepinepherine c) Dopamine d) Histamine e) Achetylcholine 22 Which of the adrenergic receptor subtypes relaxes smooth muscle and causes liver glycogenolysis and gluconeogenesis? a) α1 (Gq/Gi/Go) b) α2 (Gi/Go) c) β1 (Gs) d) β2 (Gs) e) β3 (Gs) Which of the adrenergic receptor subtypes causes vascular smooth muscle contraction and genitourinary smooth muscle contraction? a) α1 (Gq/Gi/Go) b) α2 (Gi/Go) c) β1 (Gs) d) β2 (Gs) e) β3 (Gs) Which of the adrenergic receptor subtypes increases cardiac chronotropy (ratand inotropy (contractility), increases AV-node conduction velocity, and increases rennin secretion in renal juxtaglomerular cells? a) α1 (Gq/Gi/Go) b) α2 (Gi/Go) c) β1 (Gs) d) β2 (Gs) e) β3 (Gs) Which of the adrenergic receptor subtypes decreases insulin secretion from pancreatic βcells, decreases nerve cell norepinephrine release, and contracts vascular smooth muscle? a) α1 (Gq/Gi/Go) b) α2 (Gi/Go) c) β1 (Gs) d) β2 (Gs) e) β3 (Gs) Which of the adrenergic receptor activation mechanisms is involved with ephedrine, amphetamine, and tyramine? a) Direct binding to the receptor b) Promoting release of norepinephrine c) Inhibiting reuptake of norepinephrine d) Inhibiting inactivation of norepinephrine e) Stimulation of monoaminoxydase Which of the adrenergic receptor activation mechanisms is involved with MAO inhibitors? a) Direct binding to the receptor b) Promoting release of norepinephrine c) Inhibiting reuptake of norepinephrine d) Inhibiting inactivation of norepinephrine e) Activation of COMT Which of the adrenergic receptor activation mechanisms is involved with tricyclic antidepressants? a) Direct binding to the receptor 23 b) Promoting release of norepinephrine c) Inhibiting reuptake of norepinephrine d) Inhibiting inactivation of norepinephrine e) Activation of COMT At the adrenergic presynapse, what does α2 do? a) Stimulates NE release b) Inhibits NE release c) Stimulates ACh release d) Vasoconstrcition e) No effect β2 stimulation leads to an increase in the cellular uptake of what ion, and thus a decrease in plasma concentration of that ion? a) K+ b) Ca++ c) Cld) Na+ e) Mg++ Dopamine receptor activation (D1) dilates renal blood vessels at low dose. At higher doses (treatment for shock), which of the adrenergic receptors is activated? a) α1 b) α2 c) β1 d) β2 e) β3 Supraselective beta1 adrenergic receptor antagonist: a) esmolol b) metoprolol c) nebivolol d) propranolol e) timolol Primary therapeutic use for central alpha2 selective adrenergic agonists: a) management of arrhythmias b) management of renal insufficiency c) management of intraoperative hypotensive states d) management of hypertension e) management of Raynaud's phenomenon Receptors that mediate most of epinephrine's cardiac effects: a) beta1 adrenergic b) beta2 adrenergic c) dopaminergic d) alpha1-adrenergic e) alpha2-adrenergic Concerning low-dose dopamine: interaction with this receptor causes renal, mesenteric, and coronary vasodilation: a) beta1 adrenergic receptors 24 b) beta2 adrenergic receptors c) dopamine D1 receptors d) alpha-adrenergic e) prostaglandin receptors Beta adrenergic receptor blockers:effects on the heart: a) increase heart rate b) increase contractility c) reduce contractility d) increase automatism e) no change Primary mechanism by which norepinephrine acutely increases BP: a) increases intravascular volume b) increases heart rate c) vasoconstriction at precapillary resistance muscles and veins d) increases angiotensin II plasma levels e) increases renine levels Muscarinic ACh receptors and adrenergic receptors are associated with which of the receptors? a) Intracellular receptors for lipid soluble ligands b) Transmembrane receptors with enzymatic cytosolic domains c) G-protein coupled receptors d) Ligand-gated ion channels e) Non of the above Nicotinic N2 receptors are the ____ subtype and nicotinic N1 receptors are the ____ subtype: a) Neuronal; Muscular b) Muscular; Neuronal c) Nodal; Neuronal d) Neuronal; Nodal e) Sympathetic; Parasympathetic Name beta 2 adrebomimetic drug: a) Phenylephrine b) Epinepherine c) Oxymetazoline d) Isoprenaline e) xSalbutamol Name the α1 drug of choice for retinal exams and surgery, giving mydiasis (dilation of iris)? a) Ephedrine b) Epinepherine c) Oymetazoline d) Isoproterenol e) Phenylephrine Name drug used in hypotension: a) Clonidine 25 b) Methyldopa c) Guanabenz d) Guanfacine e) Epinephrine Name group of drugs that is used for asthma patients or to delay premature labor? a) α2-agonist b) α1-agonist c) β3-agonist d) β2-agonist e) β1-agonist Which of the agonists would be used for cardiogenic shock, cardiac arrest, heart block, or heart failure? a) α1-agonist b) α2-agonist c) β1-agonist d) β2-agonist e) β3-agonist Name β-antagonist? a) Terbutaline b) Ritodrine c) Salmeterol d) Metoprolol e) Phenylepherine Prior to an operation to remove a pheochromocytoma (neuroendocrine tumor of the medulla of the adrenal glands), which of the group should be given to the patient? a) α-agonist b) α-blocker c) β-agonist d) β-blocker e) α, β -agonist Name contraindication for β-blocker therapy? a) Hypotension b) Angina pectoris c) Arrhythmias d) Myocardial infarction e) Glaucoma Which of the β-blockers is used for decreasing aqueous humor secretions from the ciliary body? a) Propranolol b) Nadolol c) Carvedilol d) Timolol e) Metoprolol Blocking α2 presynaptic receptors will do which of the changing in the mediator release? a) Stimulate NE release 26 b) Inhibit NE release c) Stimulate DA release d) Inhibit DA release e) No effect Which of the effect is the most likely to occur with parenteral administration of a α1agonist drug? a) Hypotension b) Hypertension c) Tissue necrosis d) Vasodilation e) Lipolysis Which of the adrenergic agonist can have dose-related withdrawal syndrome if the drug is withdrawn to quickly, leading to rebound hypertension? a) α1-agonist b) α2-agonist c) β1-agonist d) β2-agonist e) β3-agonist Which of the adrenergic agonists can have sedation and xerostomia (dry mouth) in 50% of patients starting therapy, sexual dysfunction in males, nauseas, dizziness, and sleep disturbances? a) α1-agonist b) α2-agonist c) β1-agonist d) β2-agonist e) β3-agonist Which of the adrenergic agonists can cause hyperglycemia in diabetics? a) α2-agonist b) α1-agonist c) β3-agonist d) β2-agonist e) β1-agonist Angina pectoris, tachycardia, and arrhythmias are possible adverse effects of which of the adrenergic agonists? a) α2-agonist b) α1-agonist c) β3-agonist d) β2-agonist e) β1-agonist If a patient is taking MAO inhibitors and ingests tyramine (red wine, aged cheese), which of the acute responses is most likely? a) Stimulation of NE release b) Inhibition of NE release c) Stimulation of ACh release d) Inhibition of ACh release e) No response due to MAO inhibitor 27 Major adverse affects of the α1 blockade include reflex tachycardia and which of the other? a) Orthostatic tachycardia b) Orthostatic bradycardia c) Orthostatic hypertension d) Orthostatic hypotension e) Increased cardiac output Which of the effect would be intensified with the α2 blockade? a) Reflex tachycardia b) Reflex bradycardia c) Orthostatic hypertension d) No effect e) Platelet clotting Name the most severe adverse effect that has been associated with β1-blockers: a) Atrial fibrillation b) Reflex tachycardia c) Hypertention d) Angina pectory e) AV block Which of the groups of patients is most at risk for adverse effect seen in β2-blockers? a) Asthmatics b) Congestive heart failure patients c) Trauma patients d) Myocardial infarction e) Patients with deep vein thromboses (DVTs) Administration of which drug can be detrimental in diabetics and also can lead to masking of tachycardia, which is indicative of hypoglycemia? a) α1-blocker b) α2-blocker c) β1-blocker d) β2-blocker e) β3-blocker Influx of what ion causes ACh release into the synaptic cleft, prior to ACh being terminated by acetylcholinesterase (AChE)? a) K+ b) Ca++ c) Cld) Na+ e) H+ Best description of the drug nicotine is: a) Muscular subtype nicotinic agonist b) Muscular subtype nicotinic antagonist c) Neuronal subtype nicotinic agonist d) Neuronal subtype nicotinic antagonist e) Non of above 28 With receptors are acting by Pilocarpine? a) α1 adrenoreceptrs b) α2 adrenoreceptrs c) N Cholynoreceptors d) β2 adrenoreceptrs e) M cholynoreceptors What is pilocarpine most commonly used for? a) For decreasing heart rate b) To decrease blood pressure (vasodilation) c) For urinary retention d) Decreasing intraocular pressure e) For erectile dysfunction What type of drugs are atropine, scopolamine, and pirenzepine? a) Acetylcholine agonists b) Acetylcholine antagonists c) Muscarinic agonists d) Muscarinic antagonists e) Acetylcholinesterase inhibitors What drug is a natural alkaloid found in Atropa belladonna (deadly nightshade)? a) Bethanechol b) Pilocarpine c) Pirenzepine d) Scopolamine e) Atropine What two clinical results of atropine facilitate opthalmoscopic examination? a) Mydriasis (iris dilation) and increased lacrimation b) Cycloplegia (ciliary paralysis) and miosis (iris constriction) c) Miosis and increased lacrimation d) Mydriasis and cycloplegia e) Xerophthalmia (dry eyes) and miosis Name an adverse affect of atropine? a) Increased salivation b) Blurred vision c) Bradycardia d) Diaphoresis (sweating) e) Decreased intraocular pressure Which drug is used for motion sickness? (injection, oral, or transdermal patch): a) Atropine b) Scopolamine c) Homatropine d) Tropicamide e) Pirenzepine Name correct drugs: mydriatics/cycloplegics, ____ last 7-10 days (longest) and ____ last 6 hours (shor): 29 a) Atropine; Scopolamine b) Scopolamine; Homatropine c) Homatropine; Tropicamide d) Tropicamide; Atropine e) Atropine; Tropicamide Which from reversible cholinesterase inhibitors is mostly used for atropine intoxication? a) Neostigmine b) Physostigmine c) Endrophonium d) Donepezil e) Pyridostigmine Which from reversible cholinesterase inhibitors is used for anesthesia? a) Neostigmine b) Physostigmine c) Endrophonium d) Donepezil e) Pyridostigmine Which from reversible cholinesterase inhibitors is used for Alzheimer disease? a) Neostigmine b) Physostigmine c) Endrophonium d) Donepezil e) Pyridostigmine Which drug is used for dyagnosis of Myasthenia Gravis (MG)? a) Atropine b) Endrophonium c) Homatropine d) Tropicamide e) Physostigmine In smooth muscle and glandular tissue, ACh binds to what muscarinic receptor, leading to the DAG cascade? a) M1 b) M2 c) M3 d) M4 e) M5 In the heart and inines, what muscarinic receptor inhibits adenylyl cyclase activity? a) M1 b) M2 c) M3 d) M4 e) M5 Which of the following is a common effect of muscarinic stimulant drugs? a) Decreased peristalsis b) Decreased secretion by salivary glands 30 c) Hypertension d) Relaxation of ciliary muscle e) Bradycardia Name drug which causes hypersecretion of exocrine drugs: a) Atropine b) Scopolamine c) Pilocarpine d) Ephedrine e) Tropicamide Name drug used in intoxication with Sorin: a) Pilocarpine b) Neostigmine c) Atropine d) Aceclidine e) Galantamine The main symptoms in intoxication with Amanita Palidum and organophosphates are: a) bronchospasm + bradycardia + miosis b) myasthenia + olyguria + hyposalivation c) sphincters constriction + bronchodilation d) hypomotility + tachycardia + cycloplegia e) mydriasis + olyguria + hyposalivation Which of the following direct-acting cholinomimetics has the shortest duration of action? a) Acetylcholine b) Methacholine c) Carbachol d) Bethanechol e) Atropine Name the M-cholinimimetic agent: a) Carbachol b) Pilocarpine c) Acetylcholine d) Bethanechol e) Atropine Neostigmine acts through blocking: a) cholinetransferase b) acetyl-CoA c) adenylatecyclase d) acetylcholinesterase e) phosphodiesterase Which of the following cholinomimetics is a plant derivative with lower potency than nicotine but with a similar spectrum of action? a) Lobeline b) Pilocarpine c) Carbachol d) Acetylcholine 31 e) Atropine Which one of the following drugs has been used in ophthalmology, but causes intaoculary hypotension: a) Atropine b) Echothiophate c) Pilocarpine d) Ephedrine e) Tropicamide The mechanism of action of indirect-acting cholinomimetic agents is: a) Binding to and activation of muscarinic or nicotinic receptors b) Inhibition of the hydrolysis of endogenous acetylcholine c) Stimulation of the action of acetylcholinesterase d) Releasing acetylcholine from storage sites e) Decrease releasing of acetylcholine from storage sites Indicate a reversible cholinesterase inhibitor: a) Dipiroxime b) Carbachol c) Galantamine d) Pilocarpine e) Aceclidine Which of the following cholinesterase inhibitors is irreversible? a) Physostigmine b) Galantamine c) Neostigmine d) Armine e) Pilocarpine By using cholinomimetics following effects might be established: a) rise of cardiac contraction frequency b) vasoconstriction c) bronchospasm d) decrease of renal secretion e) relaxation of smooth muscle in gastrointestinal tract Which of the following is a common effect of cholinomimetic drugs? a) Decreased peristalsis b) Decreased secretion by salivary glands c) Hypertention d) Inhibitoon of sweat glands e) Spasm of accommodation Indications of cholinomimetics include following states EXCEPT: a) intoxication with Atropine b) glaucoma c) myasthenia d) stimulation of the respiration e) bronchial asthma 32 Cholinomimetics have follow effects EXCEPT: a) bradyckardia b) bronchospasm c) xerosthomia d) lacrimation e) miosis Indicate the location of M2 cholinoreceptor type: a) Heart b) Glands c) Smooth muscle d) Endothelium e) Eye smooth muscle The symptoms of mushroom poisoning include all of the following EXCEPT: a) Salivation, lacrimation, nausea, vomiting b) Dryness of mouth, hyperpyrexia, hallucination c) Headache, abdominal colic d) Bradycardia, hypotension and shock e) Nausea, vomiting, bradycardia Select the drug that you will administrate in intoxication with mushrooms and organophosphates: a) Pilocarpine b) Neostigmine c) Atropine d) Cizaprid e) Tubocurarine Which of the following cholinomimetic activates both muscarinic and nicotinic receptors? a) Lobeline b) Pilocarpine c) Nicotine d) Acetylcholine e) Aceclidine Indicate a cholinomimetic agent, which is related to direct-acting drugs: a) Edrophonium b) Physostigmine c) Carbachol d) Dipiroxime e) Atropine Which of the following is a common effect of muscarinic stimulant drugs? a) Decreased peristalsis b) Decreased secretion by salivary glands c) Hypertention d) Inhibitoon of sweat glands e) Miosis Choose the broncholitic mechanism of atropine: a) Excitement of M-cholinoreceptors of the smooth muscle of bronchi 33 b) β2 adrenoreceptors stimulation in the smooth muscle of bronchi c) Stimulation of N-cholinoreceptors of the smooth muscle of bronchi d) Inhibition of adenosine-receptors e) Blocking of M-cholinoreceptors of the smooth muscle of bronchi Patients complain of dry or "sandy" eyes when receiving large doses of: a) Atropine b) Hexamethonium c) Pilocarpine d) Carbachol e) Lobeline Choose drug used in motion sickness: a) Tropicamide b) Ipratropium c) Scopolamine d) Homatropine e) Oxitropium The pharmacologic actions of scopolamine most closely resemble those of: a) Hexamethonium b) Atropine c) Succinylcholine d) Pilocarpine e) Aceclidine Compared with atropine, scopolamine has all of the following properties EXCEPT: a) More marked central effect b) Less potent in decreasing bronchial, salivary and sweat gland secretion c) More potent in producing mydriasis and cycloplegia d) Lower effects on the heart e) Lower effect on the bronchial muscle and intestines Indicate the drug, which is rapidly distributed into CNS and has a greater effect than most other antimuscarinic agents? a) Pilocarpine b) Scopolamine c) Homatropine d) Ipratropium e) Oxitropium The mechanism of atropine action is: a) Competitive ganglion blockade b) Competitive muscarinic blockade c) Competitive neuromuscular blockade d) Noncompetitive neuromuscular blockade e) Inhibition of cholinesterase Indicate following preparation, which provokes the longest term effect of mydriasis: a) Scopolamine b) Ephedrine c) Platyphylline 34 d) Epinephrine e) Atropine Which of the following drugs is used for acute toxic effects of mushrooms poisoning? a) Atropine b) Pilocarpine c) Pralidoxime d) Aceclidine e) Edrophonium The main symptoms in intoxication with mushrooms and organophosphates are: a) sphincters constriction + mydriasis + bronchodilation b) myasthenia + olyguria + hyposalivation c) bradycardia + bronchospasm + miosis d) hypomotility + tachycardia + cycloplegia e) olyguria + cycloplegia+ tachycardia M3 receptor subtype is located: a) In the myocardium b) In sympathetic postganglionic neurons c) On effector cell membranes of glandular and smooth muscle cells d) On the motor end plates e) In parasympathetic ganglia The treatment of the antimuscarinic effects can be carried out with: a) Neostigmine b) Hexametonium c) Homatropine d) Scopolamine e) Acetylcholine What phenomena of atropine is being used to establish a diagnose in ophthalmology? a) miosis b) mydriasis c) spasm of acommodation d) circular iris muscle contraction e) intraocular pressure growth The remedy used in intoxication with organophosphates: a) cizaprid b) armine c) phenytoin d) pylocarpine e) atropine Which of the following drugs has been used in ophthalmology, but causes mydriasis and cycloplegia lasting more than 24 hours? a) Atropine b) Echothiophate c) Edrophonium d) Ephedrine e) Tropicamide 35 Which one of the following drugs has been used in ophthalmology, but causes mydriasis and cycloplegia lasting more than 24 hourrs? a) Plathyphylline b) Atropine c) Scopolamine d) Izoprenaline e) Echothiophate Atropine has the effects EXCEPT: a) dry moth b) mydriasis c) hypersalivation d) tachycardia e) atony of smooth muscle Choose the broncholitic mechanism of atropine:: a) Blockage of M- cholinoreceptors of the smooth muscle of bronchi b) Excitement of beta2 adrenoreceptors of the smooth muscle of bronchi c) Stimulation of adenilatcyclase d) Direct action on the smooth muscle of bronchi e) Excitement of M cholinoreceptors of the smooth muscle of bronchi Which one of the following statements about scopolamine is false? a) It has depressant actions on CNS b) It may cause hallucinations c) It is poorly distributed across the placenta to the fetus and across blood-brain barrier d) It may prevent motion sickness and vertigo when applied as a patch to the skin e) It is from the same group with atropine. Choose the drug belonging to selective beta2-adrenomimics: a) x Salbutamol b) Isoprenaline c) Salmeterol d) Terbutaline e) Hexoprenaline Select the side-effect characteristic for non-selective beta-adrenomimics: a) Depression of the breathing centre b) Tachycardia c) Peripheral vasoconstriction d) Dry mouth e) Miosis Which of the following M-cholinoblocking agents is used especially as an anti-asthmatic? a) Atropine b) Ipratropium c) Platiphylline d) Metacin e) Pirenzepine Which of the following M-cholinoblocking agents is used mostly as intestinal 36 spasmolytic? a) Atropine b) Ipratropium c) Platiphylline d) Metacin e) Pirenzepine The main effects of ganglion-blocking drugs are, EXCEPT: a) vasodilatation and hypotension b) hyposecretion c) increase of intraoculary pression d) bronchospasm e) relaxation of the smooth muscles and contraction of the sphincters Tubocurarine blocks the action of acethylcholine and similar agonists at: a) Muscarinic receptor site b) Neuromuscular junction c) Parasimpathetic ganglia d) Axonal transmission e) Simpathetic ganglia Which of the following agents is a short-acting ganglion blocker? a) Homatropine b) Trimethaphane c) Hexamethonium d) Pancuronium e) Atropine Ganglion blocking drugs are used for the following states EXCEPT: a) Hypertensive crises b) Controlled hypotension c) Cardiovascular collapse d) Pulmonary edema e) Malignant hypertension The shortest duration hypotensive activity is characteristic for: a) Reserpine b) Guanethidine c) Treperium iodide d) Tropaphen e) Propranolol Agents that produce neuromuscular blockade act by inhibiting: a) Interaction of acetylcholine with cholinergic receptors b) Release of acetylcholine from prejunctional membrane c) Packaging of acetylcholine into synaptic vesicles d) Reuptake of acetylcholine into the nerve ending e) Metabolism of acetylcholine Which of the following drugs has "double-acetylcholine" structure? a) Tubocurarine b) Carbachol 37 c) Atropine d) Atracurium e) Suxamethonium Indicate the depolarizing agent: a) Suxamethonium b) Tubocurarine c) Vecuronium d) Atracurium e) Pancuronium Neuromuscular blockade by suxamethonium may be prolonged in patients with: a) Renal failure b) An abnormal variant of plasma cholinesterase c) Cardiac failure d) Acute hypotension e) Gastric ulcer Which of the following drugs is a nondepolarizing muscle relaxant? a) Pancuronium b) Succinylcholine c) Hexamethonium d) Scopolamine e) Atropine Which of the following neuromuscular blockers causes transient muscle fasciculations? a) Atracurium b) Pancuronium c) Suxamethonium d) Tubocurarine e) Atropine Depolarizing agents include all of the following properties EXCEPT: a) Interact with nicotinic receptor to compete with acetylcholine without receptor activation b) React with the nicotinic receptor to open the channel and cause depolarisation of the end plate c) Cause desensitization, noncompetive block manifested by flaccid paralysis d) Cholinesterase inhibitors do not have the ability to reverse the blockade e) Can caused transient muscle fasciculations Which neuromuscular blocking agent has the potential to cause the greatest release of histamine? a) Suxamethonium b) Tubocurarine c) Pancuronium d) Vecuronium e) Atracurium Which of the following muscular relaxants causes hypotension and bronchospasm? a) Vecuronium b) Suxamethonium c) Tubocurarine 38 d) Pancuronium e) Atracurium Indicate the neuromuscular blocker, which causes tachycardia: a) Tubocurarine b) Atracurium c) Pancuronium d) Suxamethonium e) Vecuronium Which neuromuscular blocking agent is contraindicated in patients with glaucoma? a) Tubocurarine b) Suxamethonium c) Pancuronium d) Vecuronium e) Atracurium Indicate the agent, which effectively antagonizes the neuromuscular blockade caused by nondepolarizing drugs: a) Atropine b) Neostigmine c) Acetylcholine d) Pralidoxime e) Scopolamine Which of the following neuromuscular blocking agents cause cardiac arrhythmias? a) Vecuronium b) Atracurium c) Tubocurarine d) Pipecuronium e) Suxamethonium Witch substance can be mostly used in acute rhinitis? a) clonidine b) nafasoline c) salbutamol d) izoprenaline e) phenylefrine Which of the following effects is associated with beta3-receptor stimulation? a) Lipolysis b) Decrease in platelet aggregation c) Bronchodilation d) Tachycardia e) Hyperglicemia Indicate the beta1-selective agonist: a) Isoproterenol b) Dobutamine c) Metoprolol d) Epinephrine e) Ephedrine 39 Mechanism of action of Clonidine: a) Inhibition of rennin-angiotensine system b) Activation of β-adrenoreceptors c) Activation of alfa2-presynaptic adrenoreceptors d) Blockage of alfa2 adrenoreceptors e) Inhibition of cholinergyc system Select the drug that acts on the bronchi selectively: a) Epinephrine b) Ephedrine c) Norepinephrine d) Salbutamol e) Izoprenaline Which of the following agents is an alfa1-selective agonist? a) Norepinephrine b) Fenilephrine c) Ritodrine d) Ephedrine e) Epinephrine By what mechanism does clonidine lower blood pressure? a) Decreased heart rate by direct action on S-A node b) Direct action on the emetic center causing nausea and vomiting c) Direct action on blood vessels causing vasodilatation d) Stimulation of α2-adrenoreceptors with inhibition of noradrenaline release e) None of the above Location of beta 2 adrenoreceptors includes following places EXCEPTS: a) Vessels b) Presynaptic membrane c) Liver d) Bronchi e) Juxtaglomerular cells Sympathetic stimulation is mediated by: a) Release of norepinephrine from nerve terminals b) Activation of adrenoreceptors on postsynaptic sites c) Release of epinephrine from the adrenal medulla d) N-cholinoreceptors stimulation in sympathetic ganglia e) All of the above Which of the following sympathomimetics acts indirectly? a) Epinephrine b) Norepinephrine c) Ephedrine d) Naphasoline e) Fenilephrine What is the mechanism of action of ephedrine? a) inhibit eliberation of acetylcholine 40 b) stimulate eliberation of acetylcholine c) stimulate eliberation of norepinephrine d) inhibit eliberation of norepinephrine e) doesn't have an effect on eliberation of neurotransmitters Phenylephrine causes: a) Constriction of vessels in the nasal mucosa b) Increased gastric secretion and motility c) Increased skin temperature d) Miosis e) All of the above Direct effects on the heart are determined largely by: a) Alfa1 receptor b) Alfa 2 receptor c) Beta1 receptor d) Beta 2 receptor e) Beta 3 receptor What kind of drug is contraindicated in the pregnancy because of stimulation of the delivery? a) alcohol b) salbutamol c) indomethacine d) furosemide e) ergometrine In which of the following tissues both alfa and beta adrenergic stimulation produces the same effect? a) Blood vessels b) Intestine c) Uterus d) Bronchial muscles e) Platelets The effects of sympathomimetics on blood pressure are associated with their effects on: a) The heart b) The peripheral resistance c) The venous return d) Juxtaglomerular apparatus e) All of the above Beta adrenoreceptor subtypes is contained in all of the following tissues EXCEPT: a) Bronchial muscles b) Heart c) Pupillary dilator muscle d) Fat cells e) Juxtaglomerular apparatus Which of the following drugs is a nonselective beta-blocker without intrinsic sympathomimetic or local anesthetic activity and used for the treatment of lifethreatening ventricular arrhythmias? 41 a) Propranolol b) Oxprenolol c) Nadolol d) Sotalol e) Atenolol Which of the following drugs is a reversible nonselective alfa, beta antagonist? a) Labetalol b) Phentolamine c) Metoprolol d) Propranolol e) Prasosine Select the mechanism of action of propranolol: a) stimulation of beta1-adenoreceptors b) blockage of beta2 adrenoreceptors c) blockage of alpha, beta adrenoreceptors d) blockage of beta1, beta2 adrenoreceptors e) stimulation of M, N cholynoreceptors Which of the following beta receptor antagonists is preferable in patients with asthma, diabetes or peripheral vascular diseases? a) Propranolol b) Metoprolol c) Nadolol d) Sotalol e) Timolol Indicate the indirect-acting adrenoreceptor blocking drug: a) Tolazoline b) Reserpine c) Carvedilol d) Prazosin e) Propranolol Name property of salbutamol: a) neselective Beta-adrenomimetic b) selective action on Beta2-adrenergic recetors c) marked cardiac effects d) positive marked inotropic, batmotropic, chronotropic and dromotropic e) rise of bronchial and uteral tonus. Location of beta2 adrenoreceptors includes following places EXCEPT:: a) vessels b) ciliary muscle c) liver d) bronchi e) juxtaglomerular cells Select the mechanism of action of propranolol: a) stimulation of β1- adrenoreceptors b) blockage of β 2 adrenoreceptors 42 c) stimulation of α1- adrenoreceptors d) blockage of α,β adrenoreceptors e) blockage of β1, β 2 adrenoreceptors Select the mechanism of action of metoprolol: a) blockage of β1, β 2 adrenoreceptors b) blockage of αβ adrenoreceptors c) blockage of β 1 adrenoreceptors d) stimulation of β2 adrenoreceptors e) stimulation of β1 adrenoreceptors Name beta adrenoblocker drug: a) neostigmine b) hydralazine c) propranolol d) atropine e) clonidine What type of drug is propranolol? a) Anticonvulsive b) Antihypertensive c) Antihistamine d) Antinauseant e) Antipyretic What would be contraindicated for propranolol? a) Hypertension b) Essential tremoк c) Angina d) Tachycardia e) Asthma Select the mechanism of action of metoprolol: a) stimulation of β2 adrenoreceptors b) blockage of β1 adrenoreceptors c) blockage of α,β adrenoreceptors d) blockage of β1, β 2 adrenoreceptors e) stimulation of α1- adrenoreceptors Indirect action includes all of the following properties EXCEPT: a) Displacement of stored catecholamines from the adrenergic nerve ending b) Inhibition of reuptake of catecholamines already released c) Interaction with adrenoreceptors d) Inhibition of the release of endogenous catecholamines from peripheral adrenergic neurons e) MAO inhibition From witch group is phentolamine? a) non-selective α-blocker b) selective α1-blockers c) selective 1-blockers d) selective 2-blockers 43 e) Non-selective -blocker Mechanism of action of prazosin : a) Alpha-1 receptor blocker b) Beta-1 receptor blocker c) Phosphodiesterase inhibitor d) Calcium channel blocker e) Alpha-2 receptor blocker Indicate the reversible nonselective alfa-receptor antagonist, which is an ergot derivative: a) Ergotamine b) Prazosin c) Phenoxybenzamine d) Fenilephrine e) Carvedilol Nonselective alfa-receptor antagonists are most useful in the treatment of: a) Asthma b) Cardiac arrhythmias c) Urinary retention d) Pheochromocytoma e) Chronic hypertension Indicate the adrenoreceptor antagonist drug, which is a rauwolfia alkaloid: a) Prazosin b) Propranolol c) Sotalol d) Reserpine e) Phentolamine Which one of the following statements about sympatholytics is fals? a) Affect noradrenaline synthesis b) Affect noradrenaline release c) Affect noradrenalne reuptake d) Bind covalently to the alfa- receptor an produce an irreversible effect e) Inhibit influx of Ca 2+ through presynaptic membrane and inhibit in this way mediators release What is the drug of choice for an anaphylactic reaction? a) Adenosine b) Atropine c) Epinephrine d) Dobutamine e) Midazolam Name the sympatholythic drug: a) Labetalol b) Prazosin c) Guanethidine d) Clonidine e) Propranolol 44 With one of the following statements about sympatholytics is fals?: a) block alfa, beta adrenoreceptors b) affect noradrenaline release c) affect noradrenalne uptake. d) affect noradrenaline synthesis e) inhibit the flux of Ca 2+ through presynaptic membrane and inhibit in this way mediators release Specify the level of action of sympatholitics: a) blockage of alfa adrenoreceptors b) stimulation of adrenoreceptors c) act on the presynaptic level. d) adrenaline destruction e) blockage of beta adrenoreceptors The agent is from sympatholitics group: a) prazosine b) hydralazine c) diazoxide d) propranolol e) reserpine Dopamine-mediated renal vasodilation is caused by which receptor(s) system(s): a) Beta2 adrenergic receptors b) Beta1 adrenergic receptors c) Dopamine D1 and D2 postsynaptic receptors d) Muscarinic receptors e) Leukotriene receptors Drugs prescribed to relax the smooth muscles of the bronchial tubes are called: a) Bronchospastics b) Bronchodilators c) Broncoconstrictors d) Anticonvulsants e) Muscle relaxants What is the mechanism of action of trypsin? a) Direct action on the bronchial glands. b) fluidification of sputum, depolymerization of proteins. c) Stimulates bronchial muscles and ciliated epithelium. d) Rising secretion and fluidification of sputum. e) Intensive secretion of reflexive bronchial glands. What is the indication for chymotrypsin? a) pregnancy b) purulent and necrotic processes c) enterobiosis d) duodenal ulcer e) angina pectoris Indicate the drug belonging to antitussive of narcotic type of action: a) Glaucine hydrochloride 45 b) Aethylmorphine hydrochloride c) Noscapine d) Oxeladine e) Pentoxiverine Which of the following drugs are being used as expectorants? a) potassium chloride b) magnesium sulfate c) sodium sulfate d) potassium iodide e) calcium carbonate Mechanism of action of bromhexine? a) breaks off S-S groups and bind with them. In this way decrease viscosity of the bronchi mucus. b) irritates gastric mycousa membrane and increase bronchi secretions c) inhibits cough center in the bulb d) breaks off mucopolysaharide and mucoproteic groups. Also it stimulates secretion of surfactant. e) stimulates CNS in subcortical lever and bulb. Indicate the expectorant with the reflex mechanism: a) Sodium benzoate b) Derivatives of Ipecacucnha and Thermopsis c) Trypsin d) Ambroxol e) Acetylcistein Which of the following drugs is proteolytic enzyme? a) Potassium iodide b) Desoxiribonuclease c) Carbocysteine d) Acetylcysteine e) Sodium benzoate Mechanism of broncholytic action of isoprenaline: a) blocking of M-cholinoreceptors from smooth muscles of the bronchi b) direct influence on the smooth muscles of the bronchi c) excitment of beta-adrenoreceptors of smooth muscles of the bronchi. d) depression of phosphodiesterase activity e) non f the above Choose the drug that block leucotriene receptors: a) Budesonide b) Sodium cromoglycate c) Zileuton d) Beclometazone e) Zafirlucast Drug used in asthma that often cause tachycardia and tremor include: a) beclomethasone b) cromoglycate sodium 46 c) ipratropium d) isoprenaline e) all of the above Which of the following drugs is a 5-lipoxygenase (5-LOX) inhibitor? a) Ibuprofen b) Zileuton c) Methamizole d) Diclofenac e) Zafirlukast Name the drug belonging to membranestabilizing agents: a) Zileutin b) Sodium cromoglycate c) Zafirlucast d) Montelucast e) Aminophylline Choose pharmacodynamic particularity of aminophylline: a) inhibits respiratory center in bulb b) biliary motility depression c) bronchial relaxation d) decreasing cardiac activity e) increased mast cell degranulation Name drug contraindicated in patients with bronchial asthma: a) Propranolol b) Clonidine c) Enalapril d) Nifedipine e) Salmeterol Which drug is a leukotriene receptor antagonist D4 (LTD4)? a) ibuprofen b) zileuton c) zafirleukast d) diclofenac e) aspirin Which drug is an inhibitor of 5-lipoxygenase (5-LOG)? a) zafirlukast b) zileuton c) beclomethasone d) montelukast e) terbutaline Mechanism of action of aminophylline consists in:: a) stimulates phosphodiesterase b) decreasing of intracellular сAMP c) rising of mast cells degranulation d) xblock of adenozinic receptors e) inhibition of hyaluronidase 47 Mechanism of action of aminophylline: a) phosphodiesterase stimulation b) phosphodiesterase inhibition c) increasing of mast. degranulation d) modification of membrane permeability for Ca+ e) inhibition of hyaluronidase Name the main therapeutic effect of methylxanthine drugs such as aminophylline: a) Vasoconstriction in many vessels b) Decrease in the amount of camp in mast cells c) Bronchodilation d) Activation of the enzyme phosphodiesterase e) Sedation A drug useful in the treatment of asthma but lacking bronckodilator effect is: a) Sodium Cromoglycate b) Ephedrine c) Isoprenaline d) Metoprolol e) Salbutamol Select the drug that acts selectively on the Beta 2 receptors of the bronchi: a) epinephrine b) ephedrine c) norepinephrine d) salbutamol e) izoprenaline What is therapeutic effect of ethanol in pulmonary edema? a) dehydration b) analgesia c) antispume effects d) decreasing of the arterial tension in the small circulation e) stimulation of the respiratory center What kind of action have morphine in pulmonary edema? a) Dehydration b) Diuretic c) Antispume d) Decreasing of the arterial pressure in the small circulation e) Sedative action. Witch kind of action will be in ganglioblockers administration in pulmonary edema? a) dehydration b) diuretic action c) anti-spume action d) antihypertension action e) sedative action The main effect of ganglion blocking drugs in pulmonary edema is: a) dehydration b) hypotensive 48 c) bronchodilation d) antiallergic e) anti-foaming With one of the following statements about ethanol is false? a) xdoesn’t cross the biological barrier b) the drug is distributed to most body tissues c) its volume of distribution is equivalent to that of total body water. d) is rapidly and completely absorbed e) causes withdrawn syndrome What kind of the remedies is used in bronchial asthma? a) Propranolol b) Naphasoline c) Dobutamine d) Salmeterol e) Norepinephrine Pharmacodynamics of disodium chromoglycate: a) Bronchospasmolitic b) Stabilization of the mast cell membrane. c) Antihistaminic d) Antispastic e) Anntiinflamatory Mechanism of action of sodium cromoglycate: a) produce a lymphopenia, particularly of T lymphocytes by destribution of cell into the lymphoid tissue b) produces mast cell stabilization (depression of release of histamine, neuropeptides, antagonism of tachykinin receptors, inhibition of PAF interaction with platelets and eosinophils) c) blocks H1 histaminoreceptors d) alteration of lymphocyte function e) stimulate beta2 adrenoreceptors of bronchi What kind of drug is used in bronchial asthma? a) propranolol b) nafasoline c) doputamine d) ozagrel e) norepinephrine A drug useful in the treatment of asthma but lacking bronchodilator effect is: a) Salbutamol b) Fenoterol c) Nedocromil d) Ephedrine e) Isoprenaline Drug used in asthma often causing tachycardia and tremor is: a) Beclomethasone b) Cromolyn sodium 49 c) Ipratropium d) Orciprenaline e) All of the above What is therapeutic effect of ethanol in pulmonary edema? a) Dehydration b) Analgesia c) Anti-foaming effects d) Decreasing of the arterial tension in the small circulation e) Stimulation of the respiratory center Which of the following anti-asthmatic drugs may worsen gastric ulcer? a) epinephrine b) prednisolone c) salbutamol d) isoprenaline e) disodium cromoglycate This drug acts by inhibiting nucleotide phosphodiesterase type III: a) Amiodarone b) Milrinone c) Propanolol d) Enalapril e) Valsartan This drug should probably not be administered to a patient with congestive heart failure because the drug may further reduce contractility; the drug should probably also not be prescribed to an asmatic since the drug may increase bronchiolar smooth muscle tone: a) Digoxin b) Terbutaline c) Propranolol d) Atropine e) Doxazosine Initial drug(s) for management of mild to moderate heart failure: a) Parenteral inotropic drugs, e.g. dobutamine b) Hydralazine c) Furosemide d) Captopril e) Torasemide Which one of the following drugs predictably prolongs the PR interval and increases cardiac contractility? a) Digoxin b) Lidocaine c) Propranolol d) Quinidine e) Verapamil A positive cardiac inotropic agent? a) Amrinone b) Amiodarone 50 c) Atenolol d) Salbutamol e) Mannitol Longest acting from digitals: a) Digoxin b) Digitoxin c) Both d) Neither Name positive inotropic drug of glycoside structure: a) Dopamine b) Digoxin c) Dobutamine d) Adrenalin e) Methyldopa Diuretic most likely to cause hypokalemia: a) Triamterene b) Amiloride c) Spironolactone d) Furosemide e) Acetazolamide Choose the drug with longest duration of action? a) strophantine b) celanide c) corglicon d) digoxine e) digitoxine An elderly male patient has essential hypertension, congestive heart failure, and type I insulin-dependent diabetes. His congestive failure developed secondary to coronary vascular disease associated with hyperlipidemia. What antihypertensive drug(s) may be most appropriate for this patient? a) Chlorothiazide b) Captopril c) Propranolol d) Metoprolol e) Hexamethonium A drug devoid of negative inotropic effects and is effective in the treatment of cardiac insufficiency: a) amantadine b) papaverine c) digoxine d) clonidine e) metoprolol The primary cause of digitalis toxicity is: a) Intracellular calcium overload b) Intracellular potassium overload 51 c) Increased parasympathetic activity d) Increased adrenocorticosteroid levels e) All of the above In the therapy of congestive heart failure, the most important pharmacologic action of digitalis is its ability to: a) produce diuresis in edematous patients b) reduce venous pressure c) increase myocardial contractile force d) increase heart rate e) decrease pacemaker automaticity in cells of the bundle of His A positive cardiac inotropic agent: a) Amrinone b) Furosemide c) Propranolol d) Salbutamol e) Neostigmine Glycosides are indicated in: a) Cardiac right blockade b) Ventricular tachyarrhythmias c) Atrio-ventricular blocks d) Supraventricular tachyarrhythmias e) W.P.W. syndrome. Potentiate hypokalemia associated with digoxin therapy: a) insulin b) spironolactone c) furosemide d) indomethacine e) imipramine Antihypertensive: action based on inhibition of norepinephrine release from adrenergic nerve endings: a) Propranolol b) Guanethidine c) Hexamethonium d) Phentolamine e) Prazosine A severe hypertensive crisis is treated with: a) epinephrine b) salbutamol c) trimetaphan d) diazepam e) tubocurarine The drug with the most useful effects in the treatment of inoperable metastatic pheochromocytoma secreting mostly norepinephrine is: a) clonidine b) minoxidil c) phentolamine 52 d) propranolol e) reserpine Which of these following antihypertensives are an alpha 1- adrenoblocker? a) Hydralazine b) Propranolol c) Hydrochlorothiazide d) Nifedipine e) Prazosin Name the hypotensive remedy from beta- adrenoblokers?: a) Hydrochlorthyazide b) Methyldopa c) Clonidine d) Hydralazine e) Metoprolol Vasoconstriction, aldosterone secretion, and renin release suppression occur upon activation of the renin-angiotensin-aldosterone system. How would captopril affect these responses? a) Blocks all three b) Blocks only vasoconstriction c) Blocks all except vasoconstriction d) Blocks only renin release e) No effect Side effects of this antihypertensive agent includes tachycardia, angina, reversible lupuslike syndrome: a) Propranolol b) Hexamethonium c) Hydralazine d) Diazoxide e) Metoprolol Following preparation groups belong to antihypertensive drugs but one exception: a) alpha- adrenoblockers b) alpha- adrenomimetics c) beta- adrenoblockers d) alpha-2-central adrenomimetics e) sympatholytics Principal mechanisms by which beta adrenergic receptor blockade decreases BP: a) Vasodilation-- arteriolar b) Vasodilation -- venular c) Reduced heart rate and reduced myocardial contractility d) Blockade of angiotensin II receptors e) Decreased central sympathetic outflow Antihypertensive drugs belonging to the same class: a) Doxazosin, prazosin, metoprolol b) Nifedipine, verapamil, diltiazem c) Clonidine, guanabenz, terazosin d) Lisinopril, fosinopril, guanadrel 53 e) Propranolol, labetalol, dinoprostol Select Ca channel-blocking drugs: a) nifedipine + diltiazem + verapamil b) trinitrolong + nitrong + isosorbide dinitrat c) minoxidil + pinacidil + nicorandil d) aminophylline + xantinol nicotinates + carbocromen e) dipyridamol + lidoflazine Name hypotensive remedy, which act on the renin-angiogenesis system: a) propranolol b) spironolactone c) bendazole d) captopril e) hydrochlorothiazide Place of action of clonidine: a) Inhibition of rennin-angiotensine system b) Activation of beta adrenoreceptors c) Activation of alpha2 presynaptic adrenoreceptors d) Blockage of alpha2 adrenoreceptors e) Inhibition of cholinergyc system By what mechanism does clonidine lower the blood pressure?: a) Decreased heart rate by direct action on S-A node b) Direct action on the emetic center causing nausea and vomiting c) Direct action on blood vessels causing vasodilatation d) Stimulation of alfa2 adrenoreceptors with inhibition of noradrenaline realizing e) None of the above This antihypertensive compound will inhibit both α-and β-receptor functions: a) Atenolol b) Labetalol c) Both d) Neither Choose the drug which increases cardiac output: a) Norepinephrine b) Methyldopa c) Phenylephrine d) Angiotensinamide e) Diazoxide Indicate the vasoconstrictor of endogenous origin: a) Ephedrine b) Phenylephrine c) Xylomethazoline d) Angiotensinamide e) Profetur Choose the synthetic vasoconstrictor having an adrenomimic effect: a) Norepinephrine 54 b) Epinephrine c) Phenylephrine d) Angiotensinamide e) Atropine General unwanted effects of vasoconstrictors are: a) Increase of arterial pressure b) Increase of cardiac output c) Decrease of peripheral blood flow d) Increase of blood volume e) Dispnoe Which statement describes the pathway of nitric oxide (NO)? a) Stimulates guanylyl cyclase, increase cGMP concentration, vasodilation b) Stimulates guanylyl cyclase, decreases cGMP concentration, vasodilation c) Stimulates guanylyl cyclase, increase cGMP concentration, vasoconstriction d) Inhibits guanylyl cyclase, increase cGMP concentration, vasodilation e) Inhibits guanylyl cyclase, decreases cGMP concentration, vasoconstriction By what mechanism does nitroglycerine lower the blood pressure? a) Direct action on the emetic center causing nausea and vomiting b) Direct action on blood vessels causing vasodilatation c) Decreased heart rate by direct action on S-A node d) Stimulation of α 2 adrenoreceptors with inhibition of noradrenaline realizing e) None of the above Which type of receptors can be activated by angiotensinamide: a) Adrenergic alpha-1 receptors b) Cholinergic receptors c) Dopaminergic receptors d) Angiotensin's receptors e) Adrenergic beta-1 receptors For increasing blood pressure in case of low cardiac output the following agents must be used: a) Ganglioblockers b) Vasoconstrictors c) Positive inotropic drugs d) Diuretics e) M-cholinomimetics Name the unwanted effects of clonidine: a) Parkinson's syndrome b) Sedation, dry mouth, and hypotension c) Gray baby syndrom d) Agranulocytosis and aplastic anemia e) Psychostimulant effect A severe hypertensive crisis is treated with: a) atropine b) levodopa c) benzohexonium d) diazepam 55 e) amphetamine The longest anti-hypotensive action can be observed by administrating of: a) epinephrine b) phenylephrine c) dopamine d) norepinephrine e) isoturon Indicate hypotensive beta-adreno blocker remedy: a) hydrochlorothiazide b) methyldopa c) clonidine d) hydralazine e) metoprolol Antiarrhythmic drug with antimalarial and antipyretic effects: a) Tocainide b) Procainamide c) Metoprolol d) Quinidine gluconate e) Lidocaine Choose the drugs from Group IB antiarrhythmic drugs: a) quinidine, ajmaline, procainamide b) flecainide, encainide, propafenone c) phenytoine, lidocaine, mexiletine d) verapamil, galapamil, diltiazem e) amiodarone, adenosine Preferred in the treatment of Wolff-Parkinson-White (WPW) syndrome: a) Morphine b) Carbamazepine c) Amantadine d) Verapamil e) Nifedipine Antiarrhythmic drug: long-term use associated with a lupus-related side effect: a) Quinidine gluconate b) Propranolol c) Procainamide d) Verapamil e) Adenosine Preferred for acute management of angina: a) Nitroprusside sodium b) Hydralazine c) Sublingual nitroglycerin d) Propranolol e) Minoxidil Name antianginous mechanism ov validol: 56 a) musculotropic coronarodilatory action b) reflectory coronarodilatory action c) inotropic negativ effect d) peripheral vessels dilation e) stimulation of cardiac contractility Which of the following antianginal agents is a myotropic coronary dilator: a) Dipyridamole b) Validol c) Atenolol d) Alinidine e) Nitroglycerine Which of the following antianginal agents refers to reflex coronary dilators: a) Dipyridamole b) Validol c) Atenolol d) Alinidine e) Nitroglycerine Mechanism of action of diltiazem : a) Phosphodiesterase inhibitor b) Blockade of calcium channels c) Alpha-1 receptor antagonists d) Beta-1 receptor antagonist e) Beta-2 receptor agonist Witch antiarrhythmic is for the first choice in ventricular arrhythmias in myocardial infarction? a) Quinudine b) Amiodarone c) Lidocaine d) Propranolol e) Niphedipine Which of the following is most useful in the treatment of obesity? a) Bromocriptine b) Cimetidine c) Ergotamine d) Ondansetron e) Sibutramine Indicate the serotonin antagonists preventing vomiting? a) scopolamine b) ondansetron c) diphenhydramine d) atropine e) droperidol Which of the following drugs may cause reversible gynecomastia? a) Omeprazole b) Pirenzepine 57 c) Cimetidine d) Sucralfate e) Pirenzepine What vitamine belongs to cytoprotective gastric mucosa? a) Choline b) Orotic acid c) Pangamic acid d) 5- methyl methionine (sulfonium chloride) e) Polyphenol All of the following agents intensify the secretion of gastric glands except: a) Pepsin b) Gastrin c) Histamine d) Somatostatin e) Prostaglandin E Name the drug that causes metabolic alkalosis: a) Sodium bicarbonate b) Cimetidine c) Pepto-Bismol d) Carbenoxolone e) Famotidine Which drug is an analog of prostaglandin E1? a) Misoprostole b) De-nol c) Sucralfate d) Omeprazole e) Lansoprasole Name antacid that causes constipation: a) Sodium bicarbonate b) Aluminium hydroxide c) Calcium carbonate d) Magnesium oxide e) Almagel The effect of omeprazole on a parietal cellular level manifests itself through: a) competitive inhibition of gastrinic effect b) competitive inhibition of histamines on a H2-receptor level c) irreversible inhibition of H+/K+ ATPase d) irreversible inhibition of adenylate cyclase e) blocking of prostaglandin receptors Name the drug forming a physical barrier to HCL and Pepsin: a) Ranitidine b) Sucralfate c) Omeprazole d) Pirenzepine e) Sodium bicarbonate 58 Name drug used in gastric ulcer complex treatment: a) chloroquine phosphate b) metronidazole c) chiniophone d) pyrimethamine e) solusurmine Alkaloid of opium with potent smooth muscle relaxant properties: a) phenytoin b) papaverine c) digitalis d) reserpine e) propranolol Name the drug, which inhibits peristalsis: a) Castor oil b) Bisacodyl c) Loperamide d) Sorbitol e) Metoclopramide Namer an emetic drug of central action: a) Ipecacuanha derivatives b) Promethazine c) Metoclopramide d) Apomorphine hydrochloride e) Zinc sulphate Name the metoclopramide’s mechanism of antiemetic action: a) H1and H2-receptor blocking effect b) M-cholinoreceptor stimulating effect c) D2 -dopamine and 5-HT3-serotonin receptor blocking effect d) M-cholinoblocking effect e) stimulation of D2 -dopamine and 5-HT3-serotonin receptor Name the emetic agent having a reflex action: a) Ipecacuanha derivatives b) Apomorphine hydroclorid c) Chlorpromazine d) Metoclopramide e) Cytostatics Name an antiemetic agent which is related to neuroleptics: a) Apomorphine hydroclorid b) Nabilone c) Domperidone d) Chlorpromazine e) Metoclopramide Name the laxative drug belonging to osmotic laxatives: a) Docusate sodium b) Bisacodyl 59 c) Phenolphthalein d) Sodium phosphate e) Bulk laxatives Which of the laxative and purgative preparation listed below acts exclusively on the small intestine level? a) purgative antrachinone b) castor oil c) phenolphthalein d) magnesium sulfate e) paraffin oil Laxatives and purgatives can act through whichever mechanism listed below but one: a) stimulates motility through an irrigative mechanism. b) stimulates direct cholinergic receptors c) difussion growth plus active water and electrolytes secretion d) water retention in the intestines through hydrophilic and osmotic force. e) direct softening of defecation The mechanism of stimulant purgatives is: a) Increasing the volume of non-absorbable solid residue b) Increasing motility and secretion c) Altering the consistency of the feces d) Increasing the water content e) Makes feces softer and more easily passed Arginine is part of a substance group listed below: a) Cholecystokinetic b) Choleretic c) Astringent d) Hepatoprotective e) Antiflatulent Choose hepatoprotective preparations: a) papaverine b) olive oil c) silymarin d) calcium salt e) apomorphine Name a hepatoprotector: a) papaverine b) essentiale c) apomorphine d) lipase e) atropine Name the drug used in chronic pancreatitis: a) apomorphine b) bisacodyl c) pancreatine d) cimetidine 60 e) All of the above Select the medication that ameliorate digestion. a) tripsine, chimotripsine, chimopsine b) fibrinolizine, alteplase, streptokinase c) pepsine, digestal, abomine d) hialuronidase, ronidase, lecozim e) cholinesterase, monoaminoxidase Phenylbutazone belongs to following derivatives: a) pyrazolone b) salicylates c) oxicam d) anthranilic acid e) indoleacetic acid Anti-Inflammatory effect of glucocorticoids is caused by: a) inhibition of phospholipase A2 with reduced synthesis of prostaglandins and leukotriene b) reducing the migration of macrophages in the inflammatory foci c) reduce capillary permeability d) the influence of macrophages by blocking the formation of free radicals e) all of the listed Name specific effects for NSAIDs: a) antihistaminic, antipyretic, analgesic b) immunosuppressive, anti-inflammatory, analgesic c) antipyretic, analgesic, anti-inflammatory d) anti-inflammatory, immunosuppressive, antihistaminic e) analgesic, antihistamine, immunosuppressive Name drug from indole acetic derivatives? a) ibuprofen b) indomethacin c) mefenamic acid d) diclofenac e) piroxicam The selective non steroid anti-inflammatory drug is: a) ibuprofen b) naproxen c) nimesulid d) paracetamol e) diclofenac Name drug from oxicam: a) piroxicam b) indomethacin c) mefenamic acid d) diclofenac e) paracetamol Which NSAIDs is a COX-2 selective NSAIDs? a) piroxicam 61 b) indomethacin c) celecoxib d) diclofenac e) ibuprofen Which NSAIDs is a non-selective NSAIDs? a) piroxicam b) rofecoxib c) celecoxib d) meloxicam e) parecoxib What is the contraindication for NSAIDs? a) rheumatism, inclusive and nonarticulary b) the development of gastric ulcer c) deforming osteoarthrosis d) lumbago e) osteoarthritis Which of the following NSAIDs is a selective COX-2 inhibitor? a) Piroxicam b) Indomethacin c) Celecoxib d) Diclofenac e) Acetylsalicylic acid Choose a steroidal anti-inflammatory drug: a) Phenylbutazone b) Ketoprofen c) Ketorolac d) Triamcinolone e) Hydroxychloroquine Corticoids are indicated in: a) colagenoses b) viral diseases c) AIDS d) immunodeficiency e) herpetic diseases The primary objective for designing drugs that selectively inhibit COX-2 is to a) Decrease the risk of nephrotoxicity b) Improve anti-inlammatory effectiveness c) Lower the risk of gastrointestinal toxicity d) Reduce the cost of treatment of rheumatoid arthritis e) Selectively decrease thromboxane A2 without effects on other eicosanoids. Mechanism of action of non steroid anti-inflammatory preparations: a) Antiemetic effect b) Increasing prostaglandin's synthesis c) Cyclooxigenase inhibition d) Activation of lysosomic enzymes 62 e) Decreasing of neutrophils migration Antiinflammatory steroids often induce: a) hypoglycemia b) hypotension c) hyponatriemia d) buffalo hump e) abdominal colics Name indication for Diclofenac sodium: a) Extraarticular rheumatism b) Gastroduodenal ulcer c) Hemmorrhagic diathesis d) nonspecific ulcerous colitis e) Bronchial asthma Mechanism of action of anti inflammatory steroids consists of: a) Stimulation of Phospholipase A2 b) Inhibition of Phospholipase A2 c) Producing of prostaglandins rises d) Stimulates phosphodiesterase e) blocks beta- adrenergic receptors Mechanism of action of steroidal anti-inflammatory consists in: a) Inhibition of phosphodiesterase b) Stimulation of adenylate cyclise c) Inhibition of phospholipase A2, which is necessary for arachidonic acid. d) Rising in mast cells degranulation. e) Depressing heart activity Inhibits the synthesis of prostaglandins: a) Sodium salicylate b) Bromhexine c) Colchicine d) Aminophylline e) Carsil The analgesic action of salicylates is the result of: a) the irritability of the reticular pathways b) hypothalamic effect c) cortical effect d) peripheral effect e) opioid receptors stimulation The toxicity spectrum of acetylsalicylic acid does not include: a) Respiratory alkalosis b) Metabolic acidosis c) Hyperprothrombinemia d) Increased risk of peptic ulcer e) Increased risk of encephalopathy in children with viral infection Select nonselective non-steroid anti-inflammatory drug: 63 a) phenytion b) ascorbic acid c) indomethacin d) morphine e) phenobarbital Oral doses may cause gastric irritation and may even cause gastrointestinal bleeding: a) Levomepromazine b) Ampicillin c) Acetylsalicylic acid d) Diphenhydramine d) Loratadine Which of the following statements concerning the anti-inflammatory effect of NSAIDs are TRUE? a) Anti-inflammatory effect of NSAIDs results from inhibition of cyclooxygenase b) Anti-inflammatory effect of NSAIDs results from inhibition of phospholipase A2 c) Anti-inflammatory effect of NSAIDs results from induction of cyclooxygenase II d) Anti-inflammatory effect of NSAIDs results from inhibition of leucotriens e) All of the answers Which group of histamine H1 antagonists is noted for the alpha-adrenoreceptor-blocking effect? a) Alkylamines b) Ethanolamines c) Ethylenediamines d) Phenothiazines e) Piperidines Effects of antihistamines are, EXCEPT: a) Euphoria and /or disphorya b) Anticholinergic peripheral effect c) Low blood pressure d) Antiemetic e) Sedation Name H1 antihistamine from II generation: a) loratadine b) diphenhydramine c) suprastine d) promethazine e) chlorpheniramine Antihistamines H1 aren’t used in: a) the vertigo and Meniere's disease b) psychotic disorders c) allergic symptoms (rhinitis, urticaria) d) nausea and vomiting in pregnancy e) sleep disorders These categories of histamine H1 antagonists are noted for the anticholinergic effect, EXCEPT: 64 a) Alkylamines (propylamines) b) Piperazines c) Ethylenediamines d) Phenothiazines e) Imidasols These categories of histamine H1 antagonists are noted for sedative effects, EXCEPT: a) Piperidines; i.e. Loratadine b) Ethanolamines (aminoalkyl ethers); i.e. Diphenhydramine c) Ethylenediamines; i.e. Chlorophiramine d) Phenothiazines; i.e. Promethazine e) Imidasols: i.e. Antasoline Which category of histamine H1 antagonists is noted for the best antiemetic action? a) Alkylamines b) Ethanolamines c) Piperazines; d) Ethylenediamines; e) Imidasols: i.e. Which category of histamine H1 antagonists is noted for the highest local anesthetic effect? a) Alkylamines (propylamines); i.e. Brompheniramine b) Piperidines; i.e. Loratadine, Fexofenadine c) Ethylenediamines; i.e. Chlorophiramine d) Phenothiazines; i.e. Promethazine e) Imidasols: i.e. Antasoline Side effect of first-generation histamine H1 antagonists is: a) Aplastic anemia b) Vomiting, tinnitus, decreased hearing c) Sedation d) Gastric ulcers and upper gastrointestinal bleeding e) Ventricular arrhtythmias Which category of histamine H1 antagonists is recognized for as second-generation antihistamines? a) Alkylamines ; i.e. Chlorphenamine b) Piperidines; i.e. Loratadine, Fexofenadine c) Ethylenediamines; i.e. Chlorophiramine d) Phenothiazines; i.e. Promethazine e) Imidasols: i.e. Antasoline Which of histamine H1 antagonists is noted for the serotonin-blocking effect? a) Diphenhydramine b) Cyproheptadine c) Chlorophiramine d) Antasoline e) Promethasine Many antihistamines have additional nonhistamine-related: these are likely to include all of the following EXCEP: 65 a) Antimuscarinic reduction in bladder tone b) Local anesthetic effects if the drug is injected c) Anti-motion sickness effects d) Increase in total peripheral resistance e) Sedation Which of the below listed preparation doesn’t inhibit the synthesis of prostaglandins? a) Indomethacin b) Diclofenac c) Piroxicam d) Dyphenhydramine e) Ibuprofen Mechanism of action of diphenhydramin: a) inhibit α- adrenoreceptors b) inhibit dopaminoreceptors c) inhibit H1- receptors d) inhibit Purinergic receptors e) inhibit Serotoninergic receptors. Which receptors block diphenhydramine chloride to cause anti-allergic action? a) H1-histaminoreceptors b) H2-histaminoreceptors c) alpha1-adrenoreceptors d) alpha2-adrenoreceptors e) alpha, beta-adrenoreceptors Gold-salts drugs are: a) methotrexate, azathioprine, cyclosporine b) auranofin, gold sodium thiomalate, aurothioprol c) hydrocortisone, prednesolone, dexamethasone d) nimesulid, meloxicam, celecoxib e) diclofenac, ibuprofen, naproxen Class of cyclosporine A is: a) Interferons b) Immunosuppressive agents c) Monoclonal antibodies d) Immunoglobulins e) H1 antihistamines The most important side effect of interferon gamma is: a) Hypertension b) Pulmonary edema c) Nephrotoxicity d) Fatigue e) Hepatotoixicity Immunomodulating agent is: a) Sirolimus b) Levamisole c) Tacrolimus 66 d) Promethasine e) Cyproheptadine Indication for interferon alpha administration is: a) Autoimmune diseases b) Rheumatoid arthritis c) Organ transplantation d) Hepatitis C virus infection e) Gastric ulcers and upper gastrointestinal bleeding Name immunomodulatory preparations from cytokines:recombined interleukins: a) Chipferon, Reaferon b) Amyxin, Arbidol c) Timogen, Imunofan d) Pyrogenic, Prodighiozan e) Roncoleuchin, Betaleuchin. Which one of the following compounds enhances immune function in vitro and in clinical trials decreases the symptoms of the common cold? a) Echinacea b) Feverfew c) Garlic d) Milk Thistle e) Melatonin Name the main indication for administration of interferon alpha: a) autoimmune diseases b) rheumatoid arthritis c) organ transplantation d) hepatitis C e) atopic asthma Name minor immunosuppressive preparations: a) cyclophosphamide, chlorambucil b) chloroquine, hydroxychloroquine c) mercaptopurine, azathioprine d) cyclosporine, tacrolimus e) tacrolimus, actinomycin Glycosidic anthracyclene antibiotoc effective in treatment of acute leukemias, malignant lymphomas, and a number of solid tumors: a) Doxorubicin b) Vinblastine c) Penicillin d) Emetine e) Vincristine Choose a slow-acting anti-inflammatory drug: a) Phenylbutazone b) Ketoprofen c) Ketorolac d) Triamcinolone 67 e) Hydroxychloroquine Which one of the following drugs reduces the activity of phospholipase A2: a) Aspirin b) Ibuprofen c) Misoprostol d) Prednisolone e) Zafirlukast Choose a non-steroidal anti-inflammatory drug from pyrazolone derivatives: a) Phenylbutazone b) Ketoprofen c) Ketorolac d) Triamcinolone e) Hydroxychloroquine Name an endocrine drug, which is an amino acid derivative: a) Insulin b) Hydrocortisone c) Calcitonin d) Thyroxin e) Prednesolone Name an endocrine drug, which is a peptide derivative: a) Insulin b) Prednisolone c) Nandrolone d) Progesterone e) Thyroxin Which one of the following compounds is not a hormone? a) Thyroxine b) Somatotropin c) Vasopressin d) Bromocriptine e) Oxytocin Indicate the use of parathyroid hormone: a) spasmophilia b) pregnancy c) acute renal insufficiency d) hyperglycemia e) Addison disease Indications of vasopressin is following: a) Diabetes mellitus b) Hypertension c) Pituitary diabetes insipidus d) Incompleted abortion e) Acromegaly Which of the following organs is a target for prolactin? 68 a) Liver b) Adrenal cortex c) Thyroid d) Mammary gland e) Pancreas What kind of drug is contraindicated in pregnancy because of high uterine stimulation? a) oxytocin b) salbutamol c) fenoterol d) drotaverine e) acetylsalicylic acid Which of the following hormones is produced by the thyroid gland? a) Thyroid-stimulating hormone b) Thyrotropin-releasing hormone c) Triiodothyronine d) Adrenaline e) Parathormone Corticosteroids are contraindicated in: a) crisis of bronchial asthma b) status asthmaticus c) allergic rhinitis d) colagenosis e) hypertention Which of the following compounds is not a hormone? a) Tamoxifen b) Somatomedin c) Somatotropin d) Thyroxine e) Vasopressin Name the estrogen inhibitor: a) Leuprolide b) Tamoxifen c) Flutamide d) Anastrozole e) Testosterone Name the antiandrogen drug: a) Flutamide b) Aminoglutethimide c) Tamoxifen d) Testosterone e) Carbapenem Toxic effects of the corticosteroids do not include: a) Growth inhibition b) Hypertention c) Hypoglicemia 69 d) Psychosis e) Salt retention. Potentiates the hypokalemia associated with cortisol therapy: a) Glucagon b) Calcium c) Furosemide d) Pyridoxine e) Imipramine Name an antiestrogen drug: a) Aldosterone b) Bromocriptine c) Carbimazole d) Tamoxifen e) Hydrocortisone Triphasic contraceptive is: a) nonoxynol b) tricvilar c) regulon d) divina e) marvelone Which of the following is most useful in the treatment of hyperprolactemia? a) Bromocriptine b) Cimetidine c) Ergotamine d) Ondansetron e) Sumatriptan A hormone that acts to stimulate absorption of calcium and phosphate from the intestine: a) Calcium b) Calcitonin c) Sodium etidronate d) Vitamin D e) Fluoride Name the drug that has the strongest action in water retention in the body: a) aldosteron b) progesterone c) estradyol d) cortocosteron e) testosteron Glucocorticoids are contraindicated in: a) Bronchial asthma b) Status astmaticus c) Allergic rhinitis d) Collagenoses e) Diabetus mellitus 70 Prednisone is contraindicated in: a) crisis of the bronchial asthma b) status asthmaticus c) allergic rhinitis d) collagenosis e) duodenal ulcer Name the indication for estrogens in oncological practice: a) Leukemia b) Cancer of prostate c) Endometrial cancer d) Brain tumors e) Cancer of thyroid gland Hormone androgen preparations have following indications but one: a) Insufficient renal anemia treatment b) inoperable breast cancer in woman during postmenopause c) hypogonadism d) lactic suppression e) breast cancer in men The rate of secretion of thyrotropin is controlled by: a) The amount of iodine in the thyroid gland b) The amount of thyroid hormones in the thyroid gland c) The concentration of thyroid hormones in blood d) The concentration of catecholamines in blood e) The concentration of cortisol in blood Which of the following drugs may be used in diabetes insipidus? a) Ergometrine b) Oxytocin c) Vasopressin d) Methylergometrine e) Quinine What drug might be useful for triggering and obtaining labor term? a) Ergometrine b) Oxytocine c) Dinoprost d) Methylergometrine e) Quinine Indicate the mechanism of contraception being based on preparations, which contains estrogen and gestagen: a) Spermatocidal action b) Annihilation of spermatozoic activities. c) Development inhibition of the follicle and implantation disturbances of the fertilized ovary. d) Cervical liquefaction e) Contribution to the proliferation of uterine mucosa Hormones are: a) Products of endocrine gland secretion b) Mediators of inflammatory process 71 c) By-products of tissue metabolism d) Products of exocrine gland secretion e) Products of arachydonic acid cascade Give the definition of hormone analogues: a) Naturally occurring substances but slightly different from hormones b) Naturally occurring substances but less efficacious than hormones c) Naturally occurring substances having the same structure but different pharmacological properties than hormones d) Synthetic compounds, which resemble the naturally occurring hormones e) Naturally occurring substances Name hormones produced by the hypothalamic gland: a) Growth hormone-releasing hormone (GHRH) b) Follicle-stimulating hormone (FSH) c) Aldosterone d) Estradiol e) Prednesolone Name the hormonal preparation of hypothalamus: a) Thyreotoxin b) Somatostatine c) Hydrocortisone d) Glucagon e) Insulin Which of the following hormone is not synthesized in the hypothalamus? a) Vasopressin b) Thyrotropin-realizing hormone c) Oxytocin d) Luteinizing hormone e) Corticotropin- releasing hormone Name hormones produced by the anterior lobe of the pituitary gland: a) Thyrotropin-releasing hormone (TRH) b) Corticotropin-releasing hormone (CRH) c) Growth hormone (somatotropin, GH) d) Growth hormone-releasing hormone (GHRH) e) Aldosterone How does oxytocin change the sensitivity of the myometrium during the period of pregnancy? a) decreasing b) nonessential decreasing c) no changes d) nonessential increasing e) increasing Choose the indication for anabolic steroids: a) Obesity b) Formation of bony callus c) Myxedema 72 d) Arterial hypertension e) Hyperglycemia Vasopressin possesses the following: a) Antidiuretic property b) Vasodilatation property c) Release of a thyroid hormone into the plasma d) Diuretic property e) Release of a adrenal hormone into the plasma Which of the following drugs may be used in diabetes insipidus? a) Ergometrine b) Oxytocin c) Vasopressin d) Methylergometrine e) quinine Excessive doses of thyroid hormone may cause each of the following EXCEPT: a) angina pectoris b) cardiac decompensation c) adrenal insufficiency d) psychotic behavior e) constipation Concerning testosterone, all of the following are true EXCEPT: a) it is a major male hormone b) it is highly effective by the oral route c) it is reduced to dihydrotestosterone in the body d) it is produced by the testes, ovaries, and adrenal cortices e) about 99% of testosterone in plasma is bound to protein Thyrotropin stimulates the following processes: a) Concentration of iodine by thyroid follicles b) Iodination of thyroglobulin c) Release of thyroxine and triidothyronine d) De-iodination of thyroid hormones e) Release of calcitonine Thyroid hormones produce various pharmacological effects. Indicate the wrong statement: a) Decrease of the basal metabolic rate in the body b) Increase in the rate and force of contraction of the heart c) Increase in the blood level of cholestrol d) Increase in the heat production e) Decrease body mass Insulin is a polypeptide hence: a) It is resistant to destruction by gastric juice b) It is destroyed by gastric juice c) It is not a polypeptide d) It is metabolized immediately by cellular enzymes e) It is used in diabetes mellitus 73 Witch drug is indicated in diabetes insipitus? a) oxytocin b) vasopresin c) angiotensin d) ephedrine e) prazosin Which drug is preferentially indicated in diabetes mellitus, type II? a) tolbutamine b) vasopresin c) glucagon d) insulin e) gonadotropine Which of the following is true for glucagon? a) Stimulates gluconeogenesis in the liver b) Stimulates the secretion of insulin by beta cells c) Inhibits glucose utilization by skeletal muscle d) Inhibits uptake of aminoacids by cells e) Stimulates the secretion of calcitonine by beta cells Alpha-glucosidase inhibitors act by: a) Diminishing insulin resistance by increasing glucose uptake and metabolism in muscle and adipose tissues b) Competitive inhibiting of intestinal alpha-glucosidases and modulating the postprandial digestion and absorption of starch and disaccharides c) Reducing the absorption of carbohydrate from the gut d) Stimulating the beta islet cells of pancreas to produce insulin e) Replacement therapy Insulin cannot be administered by: a) Oral route b) Intravenous route c) Subcutaneous route d) Intramuscular route e) Artificially pancreas Choose the pair of hormones that have agonistic effects on blood sugar levels: a) Calcitonin and PTH b) Adrenalin and Glucagon c) Glucagon and Glucose d) ADH and Aldosterone e) Insulin and Glucagon Glucocorticosteroids are contraindicated in which of the below listed diseases? a) herpetic keratitis b) status asthmaticus c) lymphoma maligna d) rheumatoid arthritis e) chronic hepatitis 74 Effects of the glucocorticoids do not include: a) Reduction in circulating lymphocytes b) Inhibition of leukotriene synthesis c) Increased skin protein synthesis d) Increased blood glucose e) Altered fat deposition Choose following indications for antithyroid preparations: a) cretinism b) diabetes mellitus c) impotence d) thyrotoxicosis e) myxedema Mineralocorticoid drug cause: a) Increased catabolism b) Increased Na+ retension and К+ excretion c) Increased gluconeogenesis d) Deposition of fat on shoulders, face and abdomen e) Increased К+retension and Na+ excretion Prednisone can determine every side effect listed below but one: a) Arterial Hypertension b) Gastroduodenal ulcer c) Retention of sodium and water d) Hyperpotassemia e) Central nervous excitation Immunosupressive effect of glucocorticoids is caused by: a) Reducing concentration of lymphocytes (T and B cells) b) Suppression of cyclooxygenase II expression c) Activation of phospholipase A2 d) Activation of cyclooxygenase II expression e) All of the answers Which of the following glucocorticoids is a long-acting drug? a) Prednisolon b) Dexamethasone c) Triamcinolone d) Cortisone e) All of the answers Serious side effects of glucocorticoids include the following, EXCEPT: a) Acute peptic ulcers b) Iatrogenic Cushing's syndrome (rounding, puffiness, fat deposition, moon faces) c) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo) d) Hypomania or acute psychosis e) High arterial pressure Serious side effects of glucocorticoids include the following: a) Adrenal suppression b) Insomnia, behavioral changes (primarily hypomania) c) Rounding, puffiness, fat deposition and plethora alter the appearance of the face - moon 75 faces d) Diabetus mellitus type II e) All of the answers Indicate the mechanism of contraception based on preparations, which contains estrogen and gestagen: a) Spermicide action b) Annihilation of spermatozoic activities c) Development inhibition of the follicle and implantation disturbances of the fertilized ovary. d) Cervical liquefaction e) Contribution to the proliferation of uterine mucosa Glucocorticosteroids are contraindicated in which of the below listed diseases? a) Rheumatoid arthritis b) Status asthmaticus c) Lymphoma maligna d) Herpetic keratits e) Chronic hepatits Glucocorticoids are hormonal steroids: a) Having an important effect on intermediary metabolism, cardiovascular function, growth, and immunity b) Having principally salt-retaining activity c) Having androgenic or estrogenic activity d) Having thyroid stimulating activity e) All of the answers Which of the following glucocorticoids is an intermediate-acting drug? a) Cortisone b) Triamcinolone c) Betamethasone d) Dexamethasone e) All of the answers Which of the following glucocorticoids is a short- to medium-acting drug? a) Prednisolon b) Dexamethasone c) Hydrocortisone d) Cortisone e) All of the answers Which of the following substances has the most intense salt and water retention? a) estradiol b) progesterone c) aldosterone d) corticosterone e) testosterone Note the mechanism of antiplatelet action of acetylsalicylic acid: a) inhibs irreversibly platelet cyclooxygenase b) stimulates platelet biosynthesis of TxA2 c) inhibits prostacycline PgI2 biosynthesis d) inhibits PgI1 biosynthesis 76 e) inhibits PgE2 biosynthesis Indicate the effect of protamine sulphate: a) antifybrinolytic b) antidot of heparine c) thrombolytic d) local hemostatic e) nonspecific hemostatic Note the mechanism of action of cumarins: a) are active in vivo and in vitro b) blocks synthesis of factors II, VII, IX, X by inhibition of epoxi-reductase c) are vitamine C antimetabolits d) often cause thromboses e) administered only intramusculary Which stage of arterial thrombosis is inhibited by acetylsalicylic acid: a) adderation of platelets to colagen b) arahydonic acid release c) formation of thromboxan A2 d) activation of thromboxan A2 receptors e) inhibition of adenilatcyclase-AMPc system Indicate the antithrombotic drug with fibrinolytic action: a) alteplaze b) sulphinpirazon c) warfarin d) heparin e) dypiridamole Which antitrombotic drug activates AT III: a) streptokinaze b) sulphinpirazone c) warfarin d) heparin e) acetylsalicylic acid Indicate the antidote of oral anticoagulants: a) etamsilat b) carbazocrome c) aprotinine d) vitamine K iv and blood transfuzion e) fibrinogen Name the reason of acetylsalicylic acid long duration: a) high half-life b) concentration in thombocytes c) inactivates ireversibilly platelet cyclooxigenase d) lysis of fibrin e) slow absorption Which drug is better for long-term prophylaxis of venous thrombosis? 77 a) acenocumarol b) heparin intravenuosly c) streptokinase d) acetylsalycilic acid e) dypiridamole Which drug is from Coumarin derivates? a) sulphinpirazone b) acenocumarol c) acetylsalycilic acid in low dose d) carbazocrom e) dypiridamole Name the drug which can't be used as local hemostatic: a) epinephrine b) tromboplastin c) trombin d) fibrin e) fitomenadione Indicate heparine antagonist: a) trombin b) acenocumarol c) menadion d) protamine sulphate e) fibrinogen All preparations listed below might be used for local homeostasis but one exception: a) fibrin b) phytomenadion c) thrombin d) epinephrine e) thromboplastin Indicate the mechanism of action of indirect anticoagulants: a) inhibits thromboplastine activity b) fixes calcium ions in blood c) inhibts gama-carboxilation of protrombin and proconvertin in liver d) activates antithrombin III e) activates factors IX,X,XI,XII and calicrein What is specific for iron drugs, prescribed intravenously: a) can increase sideremia les then oral drugs b) iron from this drugs is fixt initially by reticulo-endotelial system c) restore landfills weaker than oral preparations d) they require an acid medium e) side effects more rare and less pronounced then oral drugs Indicate the topical drug used to stop hemorrhage from little vessels: a) fitomenadion b) calcium chloride c) acetylsalycilic acid 78 d) trombin e) fibrinogen Indicate the pharmacologic feature of iron drugs: a) it is absorbed mostly in the stomach b) daily recquest in healthy - 1 mg and 1,4 mg in women c) food and stomach antacids increase bioavailability for absorption d) absorption is not higher in patients with iron deficiency anemia than in healthy people, because it's transported stably by specific proteins e) after iron absorption is carried by the plasma erythrocytes Indicate the antagonist of indirect anticoagulants: a) fitomenadion b) calcium chloride c) protamine sulphate d) aprotinin e) epinephrine Tick the mechanism of action of sodium citrate: a) fixes calcium ions b) inhibits trombin activation c) decreases tromboplastine synthesis d) inhibs protrombine and proconvertin synthesis in liver e) increases platelet aggregation Aminocapronic acid is a drug of choice for treatment of: a) Acute myocardial infarction b) Bleeding after fibrinolytic therapy c) Heart failure d) Multiple pulmonary emboli e) Myocardial infarction Indicate the pharmacologic feature of heparin: a) heparin is obtained from human tissue b) heparin is badlly absorbed from digestive tub c) speed of elimination of heparin is not dose-dependent d) effect of heparin can be antagonized by nadroparin e) heparin does not pass into the breast milk Indicate heparin antagonist: a) naloxone b) naltrexon c) flumazenil d) protamine sulphate e) disulfiram Choose the mechanism of action of heparin: a) activates prothrombin and other factors of coagulation. b) binds to and activates endogenous antithrombin III. (ATIII). c) activates physiologic fibrinolytic system,that degradate fibrin into fragments d) inhibits COX and decreases synthesis of tromboxan, that has aggregant effect. e) interferes with the normal posttranslational modification of clotting factors in the liver, a 79 process that depends on vitamin K. Which of the following antiaggregans inhibits prostaglandin synthesis? a) dextran 40 b) dypiridamole c) prostacyclin d) acetylsalycilic acid e) ticlopidin Indicate low-molecular-weight heparin: a) acenocumarol b) heparin c) sodium citrate d) nadroparine e) warfarin Indicate the drug that stop bleeding by vassoconstrictive action: a) epinephrine b) menadion c) menadiol d) fibrinogen e) fitomenadion Note the mechanism of antiplatelet action of acetylsalicylic acid: a) inhibits the activity of tromboplastine and impairs the passage of prothrombin in thrombin b) fixes calcium ions in blood c) inhibits thromboxan synthesis d) activates antithrombin III e) activates factors IX, X, XI, XII and calicrein A 26-year-old woman comes to the outpatient clinic with a complain of rapid heart rate and easy fatigability. Laboratory work up reveals low hemoglobin and microcytic red cell size. The most suitable therapy will be: a) ferrous sulfate b) folic acid c) iron d) pyridoxine e) cyanocobalamin What is the onset of furosemide at intravenous administration: a) after 25 minutes and lasts for 4 ore b) after 3-4 minutes and lasts for 1-2 ore c) after 10 minutes and lasts for 6 ore d) after 60 minutes and lasts for 24 ore e) after 25 minutes and lasts for 4-8 ore Which kind of action will be in furosemide administration in pulmonary edema? a) dehydration b) antidiuretic action c) anti-foam action d) antihypertensive action e) sedative action 80 Name diuretic drug with antiepileptic properties: a) Furosemide b) Acetazolamide c) Etacrinic acid d) Spironolactone e) Triamterene The drug inhibits the carbonic anhydrase enzyme: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Amiloride Which one of the following statements about spironolactone is TRUE? a) Spironolactone reverses many of the manifestations of aldosteronism b) Spironolactone is also an androgen antagonist and as such is used in the treatment of hirsutism in women c) Spironolactone is useful as a diuretic d) All the answers e) No one answer All of the following statements regarding diuretics are true, EXCEPT: a) Carbonic anhydrase inhibition leads to increased reabsorption of NaHCO3 b) Loop diuretics decrease Na+ reabsorption at the loop of Henle by competing for the Cl- site on the Na+/K+/2Clcotransporter c) In general, the potency of a diuretic is determined by where it acts in the renal tubule d) Hydrochlorothiazide decreases urinary calcium excretion e) Diuretics decrease edema in the body The drug acts by competitively blocking NaCl cotransporters in the distal tubule: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Triamteren The drug acts by competing with aldosterone for its cytosolic receptors: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Ethacrinic acid The drug is a potassium-sparing diuretic that blocks Na+ channels in the collecting tubules: a) Acetazolamide b) Amiloride c) Furosemide d) Hydrochlorothiazide e) Indapamid 81 The drug inhibits the enzyme carbonic anhydrase: a) Sulthiame b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Triamteren Name carboanhydrase inhibitor diuretics: a) hydrochlorothiazide b) spironolactone c) furosemide d) triamterene e) acetazolamine Which kind of diuretic is more active in treatment of glaucoma? a) acetazolamide b) hydrochlorthiazide c) ethacrinic acid d) furosemide e) triamteren Sustained use of this drug results in increased plasma urate concentrations: a) Furosemide b) Acetazolamide c) Both of the above d) Neither of the above e) Their associated administration Chronic use of this drug can lead to metabolic acidosis: a) Acetazolamide b) Amiloride c) Furosemide d) Hydrochlorothiazide e) Triamteren The drug acts at the proximal tubule: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Triamteren The drug can be used to treat glaucoma: a) Furosemide b) Acetazolamide c) Both of the above d) Neither of the above e) Their association The drug has a steroid-like structure which is responsible for its anti-androgenic effect: a) Amiloride 82 b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Indapamid The drug decreases calcium excretion in urine: a) Hydrochlorothiazide b) Amiloride c) Furosemide d) Acetazolamide e) Manitol The drug can cause ototoxicity: a) Furosemide b) Acetazolamide c) Both of the above d) Neither of the above e) just their associated administration Which of the following diuretics may cause deafness (ototoxicity) in case of an overdose? a) hydrochlorothiazide b) furosemide c) acetazolamide d) spironolactone e) triamterene Diuretics with action in thick ascending limb of the loop of Henle (TAL): a) chlortalidon + clopamide b) mannitol, urea c) spironolactone + amiloride + triamterene d) furosemide + ethacrine acid + bumetamide e) cyclopentazide + polythiazide The drug is sometimes part of fixed-dose combinations used to treat essential hypertension: a) Hydrochlorothiazide b) Amiloride c) Both of the above d) Neither of the above e) Their associated administration Choose short-acting drug: a) Furosemide b) Acetazolamide c) Spironolactone d) Acetazolamide e) Polythiaside The drug needs aldosterone present in order to be effective: a) Hydrochlorothiazide b) Amiloride c) Both of the above 83 d) Neither of the above e) Their associated administration The drug acts only in loop Henle, ascending part: a) Furosemide b) Acetazolamide c) Both of the above d) Neither of the above e) Their associated administration Which of the following diuretic groups act above the collecting tube? a) thiazides b) loop diuretics c) carbonic anhydrase inhibitor d) antialdosteronics e) osmotic diuretics The drug can be used to treat nephrogenic diabetes insipidus: a) Hydrochlorothiazide b) Acetazolamide c) Spironolactone d) Mannitol e) Amilorid The drug should never be administered to patients taking potassium supplements: a) Hydrochlorothiazide b) Amilorid c) Furosemide (Lasix) d) Neither of the above e) Their associated administration The drug acts by competitively blocking the Na+/K+/2Cl- cotransporter: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Osmotic diuretics The drug acts at the proximal tubule: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Osmotic diuretics The drug acts in the distal convoluted tubule: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Osmotic diuretics 84 The drug is the most potent diuretic: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Cardiac glycosides Which kind of diuretic is more active in acute renal failure ? a) triamteren b) furosemide c) indapamide d) hydrochlorthiazide e) acetazolamide Name agent - aldosterone antagonist: a) Furosemide b) Spironolactone c) Dichlothiazide d) Captopril e) Bumetamide The drug acts by competitively blocking the NaCl cotransporter: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Osmotic diuretics The drug is one of the most potent diuretics: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Amiloride e) Indapamid The drug inhibits sodium and chloride transport in the early distal tubule: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Amiloride e) Manitol The drug acts in the collecting tubules: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Osmotic diuretics The drug blocks the sodium/potassium/chloride cotransporter in the thick ascending loop of Henle: 85 a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Amiloride e) Manitol Choose antagonist of aldosterone: a) aminoglutethimide b) mitotan c) spironolactone d) ketoconazole e) miphepristone The drug can cause ototoxicity: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Amiloride e) Manitol Drug used in night enuresis: a) Osmotic diuretics b) Loop diuretics c) Thiazide diuretics d) Potassium-sparing diuretics e) Carbonic anhydrase inhibitors These agents must be given parenterally because they are not absorbed when given orally: a) Osmotic diuretics b) Loop diuretics c) Thiazide diuretics d) Potassium-sparing diuretics e) Thiazide like diuretics Amiloride acts at this nephron site: a) Proximal convoluted tubule b) Ascending thick limb of the loop of Henle c) Distal convoluted tubule d) Collecting duct e) All nephron These drug may be used in the treatment of recurrent calcium nephrolithiasis: a) Mannitol b) Ethacrinic acid c) Hydrochlorthiazide d) Spironolactone e) Acetazolamide Furosemide acts at this nephron site: a) Proximal convoluted tubule 86 b) Ascending thick limb of the loop of Henle c) Distal convoluted tubule d) Collecting duct e) Glomerules The drug is the least (less) potent diuretic: a) Mannitol b) Furosemide c) Indapamid d) Spironolactone e) Hydrochorthiazide Acetazolamide acts at this nephron site: a) Proximal convoluted tubule b) Ascending thick limb of the loop of Henle c) Distal convoluted tubule d) Collecting duct e) All nephron Amiloride acts at this nephron site: a) Proximal convoluted tubule b) Ascending thick limb of the loop of Henle c) Distal convoluted tubule d) Collecting duct e) All nephron The drug inhibiting the cotransport of sodium, potassium, and chloride in Loop Henle: a) Torasemid b) Acetazolamide c) Triamterene d) Manitol e) Indapamid Carbonic anhydrase inhibitor is: a) Furosemide b) Acetazolamide c) Triamterene d) Manitol e) Indapamid Mechanism of action of osmotic diuretics includes: a) They inhibit sodium chloride transport in the early segment of the distal convoluted tubule b) This drugs inhibit the cotransport of sodium, potassium, and chloride c) They increase osmotic pressure of plasma, increase minute-volume of blood and increase also the renal circulation and filtration d) Inhibition of carbonic anhydrase in the brush border and intracellular carbonic anhydrase in the PCT cell e) They are antagonist (competitive or noncompetitive) of aldosterone in the collecting tubules The drug acts by competitively blocking NaCl cotransporters in the distal tubule: a) Ethacrinic acid 87 b) Furosemide c) Polythiazide d) Spironolactone e) Triamterene The drug acts by competing with aldosterone for its cytosolic receptors: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Triamterene Choose non-competitive antagonist of spironolactone: a) Acetazolamide b) Amiloride c) Furosemide d) Hydrochlorothiazide e) Spironolactone The drug that inhibit carbonic anhydrase: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Mannitol The drug has a steroid-like structure which is responsible for its anti-androgenic effect: a) Amiloride b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Triamterene The drug decreases calcium excretion in urine: a) Hydrochlorothiazide b) Amiloride c) Furosemide d) Acetazolamide e) Spironolactone The drug can promote sodium loss in patients with low (e.g., 40 ml/min) glomerular filtration rates: a) Furosemide b) Acetazolamide c) Hydrochlorothiazide d) Spironolactone e) Amiloride The drug needs aldosterone present in order to be effective: a) Furosemide b) Acetazolamide c) Hydrochlorothiazide 88 d) Spironolactone e) Amiloride The drug can be used to treat nephrogenic diabetes insipidus: a) Hydrochlorothiazide b) Amiloride c) Acetazolamide d) Hydrochlorothiazide e) Spironolactone The drug is the most potent diuretic: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Aldosteron's antagonists The drug acts by competitively blocking the NaCl cotransporter: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Aldosteron's antagonists The drug is one of the most potent diuretics: a) Acetazolamide b) Ethacrinic acid c) Hydrochlorothiazide d) Amiloride e) Spironolactone The drug inhibits sodium and chloride transport in the early distal tubule: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Amiloride e) Spironolactone The drug acts in the collecting tubules: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Osmotic diuretics The drug blocks the sodium/potassium/chloride cotransporter in the thick ascending loop of Henle: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Amiloride e) Spironolactone 89 The drug is usually given in combination with a thiazide diuretic: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Amiloride e) Bumetanide What diuretic is contraindicated in cardiac insufficiency? a) furosemide b) hydroclorothiazide c) acetazolamide d) spironolactone e) mannitol Diuretic that acts in loop Henle is: a) Indapamide b) Furosemide c) Mannitol d) Spironolactone e) Acetazolamide An important therapeutic effect of loop diuretics is: a) Decreased blood volume b) Decreased heart rate c) Increased serum sodium d) Increased total body potassium e) Metabolic acidosis Spironolactone acts at this nephron site: a) Proximal convoluted tubule b) Ascending thick limb of the loop of Henle c) Distal convoluted tubule d) Collecting duct e) Glomerulus These drugs may be used in the treatment of recurrent calcium nephrolithiasis: a) Osmotic diuretics b) Loop diuretics c) Thiazide diuretics d) Potassium-sparing diuretics e) Furosemide Furosemide acts at this nephron site: a) Proximal convoluted tubule b) Ascending thick limb of the loop of Henle c) Distal convoluted tubule d) Collecting duct e) Glomerulus The drug is the least potent diuretic: a) Osmotic diuretics 90 b) Loop diuretics c) Thiazide diuretics d) Potassium-sparing diuretics e) Thiazide-like diuretics Acetazolamide acts at this nephron site: a) Collecting duct b) Ascending thick limb of the loop of Henle c) Distal convoluted tubule d) Proximal convoluted tubule e) Glomerulus Amiloride acts at this nephron site: a) Proximal convoluted tubule b) Ascending thick limb of the loop of Henle c) Distal convoluted tubule d) Collecting duct e) Glomerulus The drug competitively blocks chloride channels and prevents movement of sodium, potassium, and chloride into the renal tubular cells: a) Furosemide b) Acetazolamide c) Triamterene d) Mannitol e) Spironolactone Choose anti gout drug: a) salbutamol b) propranolol c) allopurinol d) carvedilol e) atenolol Has been used in the treatment of gout: a) Loperamide b) Probenecid c) Both d) Neither Effective in the treatment of gout by inhibition of the movement of leukocytes into the inflamed joint: a) Sodium salicylate b) Acetylcysteine c) Colchicine d) Acetaminophen e) Sulfinpyrazone Electrolytes are responsible for: a) Acid-base balance b) Blood sugar levels c) Hemoglobin levels 91 d) Hormone levels e) Enzymes level What vitamin is inactivated by pyrazinamide? a) Vitamin B6 b) Vitamin B1 c) Vitamin A d) Vitamin C e) Vitaimin K List typical characteristics of acid folic: a) Inhibits central nervous system b) acts on coagulation of blood. c) occurs as a formation of purine and pyrimidine nucleotides. d) Stimulates central nervous system. e) act directly on plasminogen. Which vitaminic preparation is being used in scurvy? a) thiamine b) cyanocobalamin c) pyridoxine d) ascorbic acid e) biotin Name the indications for Vitamin K preparations: a) Keratits b) Rheumatoid arthritis c) Angina Pectoris d) Parenchymal hemorrhage e) Muscle pain Vitamins are: a) Inorganic nutrients needed in small quantities in the body b) Organic substances needed in very large quantities in the body c) An organic compound and a vital nutrient that an organism requires in limited amounts. d) Products of endocrine gland secretion e) Any of numerous proteins or conjugated proteins produced by living organisms and functioning as specialized Antienzymes are: a) a substance that inhibits or counteracts the action of an enzyme b) substances that prevent vitamins from exerting their typical metabolic effects c) any of numerous proteins or conjugated proteins produced by living organisms and functioning as specialized atalysts for biochemical reactions d) nonprotein organic substances that usually contain a vitamin or mineral e) products of endocrine gland secretion Select the fat-soluble vitamin: a) Ascorbic acid b) Tocopherol c) Thiamine 92 d) Riboflavin e) Piridoxin Beri-beri is caused by the deficiency of: a) Riboflavin b) Ascorbic acid c) Nicotinic acid d) Thiamine e) Riboflavin Select a water-soluble vitamin: a) Vitamin A b) Vitamin E c) Vitamin D d) Vitamin B1 e) Vitamin K Which of the following vitamins is responsible for increasing intestinal absorption of calcium,: a) Vitamin К b) Vitamin A c) Vitamin D d) Vitamin E e) Vitamin B1 Which of the following vitamins can be also synthesized from a dietary precursor? a) Vitamin С b) Vitamin A c) Vitamin B1 d) Vitamin B6 e) Vitamin P Vitamin C is required for the production and maintenance of: a) Collagen b) Hormone c) Ascorbic Acid d) Red Blood Cells e) Vitamin P Vitamin C deficiency is called: a) Rickets b) Scurvy c) Cancer d) Cold e) Beri-beri Which of the following statements concerning pyridoxine (vitamin B6) functions is true: a) Active functional form is pyridoxal phosphate, which is an essential coenzyme for transamination and decarboxylation of amino acids b) Active group of the coenzymes nicotinamide-adenine dinucleotide (NAD) and nicotinamide-adenine phosphate (NADP) c) Essential constituent of flavoproteins, flavin mononucleotide (FMN) and flavin adenine 93 dinucleotide (FAD) d) An extremely important antioxidant, which protects cell membrane lipids from peroxidation by breaking the chain reaction of free radical formation to which polyunsaturated fatty acids are particularly vulnerable e) Active functional form is dihydroergocalciferol Name the main function of Vitamin A in the body: a) Immune defenses, maintenance of body linings and skin b) Vision, c) Normal cell development and reproduction d) Bone and body growth e) All of the above Vitamin B12 deficiency caused by lack of intrinsic factor is called: a) Rickets b) Pernicious anemia c) Scurvy d) Poor circulation of the red blood cells e) Beri-beri The vitamin Folate works together with ______________to produce new red blood cells a) Vitamin D b) Vitamin B12 c) Vitamin A d) Vitamin B6 e) None of the above Which of the following vitamins is also known as an antisterility factor? a) Vitamin E b) Vitamin B6 c) Vitamin B1 d) Vitamin C e) Vitamin D Characterictic of Vitamin B12: a) Is present in large amounts in green, leafy vegetables b) Prevents goiter c) Prevents scurvy d) Requires intrinsic factor secreted in the stomach to aid its absorption e) Prevents Beri-beri disease .Whch of the following is a function of Vitamin B12 a) Red blood cell formation b) Normal cell development and reproduction c) Immune defenses, maintenance of body linings and skin d) Just anti-oxidant action e) Vision, bone and body growth Indicate the influence of ergocalciferol upon metabolic processes: a) stimulates nucleic acid synthesis b) depresses nucleic acid synthesis c) increases the permeability of the intestinal epithelium for calcium and phosphor. d) stimulates alpha-keto acid decarboxylation 94 e) inhibits alpha-keto acid decarboxylation Which of the following vitamins is also known as an anti-sterility factor? a) tocopherol b) piridoxine c) thiamine d) fitomenadione e) ascorbic acid Which of the following vitamins is also known as a haemostatic agents? a) tocopherol b) piridoxine c) thiamine d) fitomenadione e) ascorbic acid Dermatitis, diarrhea and dementia are characteristics of: a) Dry beri-beri b) Pyridoxine deficiency c) Scurvy d) Pellagra e) Cholesterol deficiency Scurvy is: a) A disease caused by deficiency of vitamin C and characterized by spongy bleeding gums, bleeding under the skin, and weakness b) Extreme dryness of the conjunctiva resulting from a disease localized in the eye or from systemic deficiency of vitamin A c) A disease caused by deficiency of niacin in the diet d) All of the answers e) A disease caused by deficiency of vitamin K Pellagra is: a) A disease caused by a deficiency of niacin (vit. PP) in the diet and characterized by skin eruptions, digestive and nervous system disturbances, and eventual mental deterioration b) Inflammation of several nerves at one time caused by a deficiency of thiamin, marked by paralysis, pain, and muscle wasting. c) A severe form of anemia most often affecting elderly adults caused by a failure of the stomach to absorb vitamin B12 d) All of the answers e) A severe form of anemia most often affecting children Characterize vitamins: a) are all synthesized in the body b) provide energy c) are necessary for proper growth and development d) all are hormons e) needed in large amounts Which of the following vitamins is given along with isoniazide in treatment of tuberculosis? 95 a) Nicotinic acid b) Riboflavin c) Pyridoxine d) Ascorbic acid e) Vitamin A Which of the following vitamins is used in megaloblast anemia? a) Vitamin B12 b) Vitamin BC c) Vitamin PP d) Vitamin D e) Vitamin A Which of the following enzymes is used in cancer therapy? a) Pepsin b) Urokinase c) L-asparaginase d) Lydaze e) Aprotinine Loosening of teeth, gingivitis and hemorrhage occur in the deficiency of: a) Vitamin К b) Vitamin В1 c) Vitamin B6 d) Vitamin C e) Vitamin A A 30-year-old woman who was suffering from untreatable gastric carcinoma underwent a gastrectomy. A deficiency of which one of the following vitamins will develop as a result of this procedure and must be treated with? a) Vitamin B6 b) Vitamin B12 c) Vitamin C d) Vitamin D e) Vitamin E Name vitamin obtained from sunlight: a) Vitamin A b) Vitamin D c) Vitamin K d) Vitamin E e) Vitamin C Name vitamin synthesized from bacteria in the intestines: a) Vitamin A b) Vitamin D c) Vitamin K d) Vitamin E e) Vitamin C Name easily destroyed vitamin: a) Vitamin A 96 b) Vitamin D c) Vitamin K d) Vitamin E e) Vitamin C Clinical uses of vitamin D do not include: a) Osteoporosis b) Nutritional rickets c) Intestinal osteodystrophy d) Hyperparathyroidism e) Chronic renal failure Vitamin A deficiency causes: a) Beri-beri b) Night blindness c) Scurvy d) Megaloblastic anemia e) Pellagra Name ion that helps muscles to contract and relax, thereby helping to regulate heartbeat: a) Iron b) Calcium c) Cobalt d) Iodide e) Sulfur Along with potassium, plays a role in fluid balance: a) Iron b) Sodium c) Cobalt d) Iodide e) Sulfur Charactericitc of fat-soluble vitamins: a) Are more stable than water-soluble vitamins b) Are found in all foods c) Must be supplied daily d)Cannot be stored in the body e) Non of the above If a person has vitamin K deficiency, which of the following is likely to occur? a) Acne b) Formation of blood clots A c) Excessive bleeding d) Acidosis e) Non of the above Which of the following antienzymes is a trypsin inhibitor? a) Aprotinine b) Sulbactam c) Aminocaproic acid d) Disulfiram 97 e) Cylastatine Which of the following antienzymes is a carbonic anhydrase inhibitor: a) Physostigmine b) Selegiline c) Aminocaproic acid d) Acetazolamide e) Disulfiram Which of the following antienzymes is a fibrinolysis inhibitor? a) Clavulanic acid b) Sulbactam c) Aminocaproic acid d) Disulfiram e) Selegiline Which of the following antienzymes is a cholinesterase inhibitor? a) Physostigmine b) Selegiline c) Aminocaproic acid d) Disulfiram e) Sulbactam Which of the following enzymes improves GIT functions (replacement therapy): a) Pepsin b) Urokinase c) L-asparaginase d) Lydaze e) 5-LOX Which of the following antienzymes is a monoamine oxidase (MAO) inhibitor: a) Physostigmine b) Selegiline c) Acetazolamide d) Disulfiram e) Sulbactam Which of the following antienzymes is an aldehyde dehydrogenase inhibitor? a) Tazobactam b) Sulbactam c) Aminocaproic acid d) Disulfiram e) Physostigmine Which of the following antienzymes is a xantine oxidase inhibitor? a) Physostigmine b) Allopurinol c) Aminocaproic acid d) Acetazolamide e) Disulfiram Which of the following enzymes has fibrinolytic activity? 98 a) Pepsin b) Urokinase c) L-asparaginase d) Lydaze e) COX-1 Which of the following antienzymes is an aromatase inhibitor used in cancer therapy? a) Physostigmine b) Allopurinol c) Aminocaproic acid d) Aminoglutethimide e) Acetazolamide Name enzymes with antimicrobial properties: a) hyaluronidase b) asparaginase c) bactisubtil d) panzynorm e) urokinase What's the definition of "antibiotics"? a) non-organic or synthetic substances that selectively inhibit growth of other microorganisms b) substance produced by some microorganisms or their synthetic analogs that selectively kills or inhibits the growth of other microorganisms c) substances produced by certain microorganisms or their synthetic analogs inhibit the growth of body cells d) synthetic analogues of natural substances that kill protozoa and helminthes e) non of the above What is the minimum duration of antibacterial treatment?: a) not less than one day b) not less than 5 days c) not less than 10-14 days d) not less than three weeks e) not less than 1 month The mechanism of bacterial resistance to penicilins can be described as: a) Inactivation of drug by beta-lactamases b) Overproduction of PBPs c) Overproduction of peptidoglycans d) Breakdown of penicillins by the immune system e) Rapid biotransformation Antibiotics are chemicals produced by? a) Cancer cells b) Viruses c) Bacteria d) Protozoa e) Microorganisms What antibiotic should be used for the treatment of fever with unknown origin? a) Antibiotics should not be used 99 b) Cephalosporins c) Macrolides d) Aminoglycosides e) Penicillins Bactericidal effect is: a) Inhibition of bacterial cell division b) Inhibition of young bacterial cell growth c) Destroying of bacterial cells d) Formation of bacterial L-form e) Stimulation of bacterial cell division Bacteristatic effect is: a) Inhibition of bacterial cell division b) Bacteria killing c) Destroying of bacterial cells d) Formation of bacterial L-form e) Stimulation of bacterial cell division Name bactericidal drug? a) Cephalosporins b) Trimethoprim c) Macrolides d) Lincosamides e) Choramphenicol A(n) ____ drug will halt bacterial growth but not deplete it, while a(n) ____ drug will kill bacteria: a) Bactericidal; Antibiotic b) Antibiotic; Bacteriostatic c) Bactericidal; Bacteriostatic d) Bacteriostatic; Bactericidal e) Antibiotic; Bactericidal When treating meningitis, one of the steps to achieve the MIC (minimum inhibitory concentration) is by injecting antibiotic where? a) Epidural space b) Subdural space c) Subarachnoid space d) Subpial space e) Corneal space Penicillin is a ____ drug and tetracycline is a ____ drug: a) Bactericidal; Bacteriostatic b) Bacteriostatic; Bactericidal c) Bactericidal; Bactericidal d) Bacteriostatic; Bacteriostatic e) Fungicidal; Bactericidal Penicillin was first discovered when colonies of staphylococci lysed when contaminated with what? a) Penicillium bacteria 100 b) Penicillium virus c) Penicillium fungi d) Penicillium parasite e) Penicillium protozoa Penicillin G is ____ to penicillinase and methicillin is ____ to penicillinase. Both are considered ____ spectrum antibiotics: a) Resistant; Sensitive; Narrow b) Resistant; Sensitive; Broad c) Sensitive; Resistant; Narrow d) Sensitive; Resistant; Broad e) Resistant; Resistant; Broad What enzyme is the main target for penicillin? a) Transglucosylases b) Transpeptidases c) D-alanine carboxykinases d) Glucoronuyltransferase e) Dihidropteroat synthetase Which antibiotic is considered extended-spectrum as it can fight pseudomonal aeroginosa, enterobacter species, proteus, bacteroids fragilis, and many klebsiella? a) Oxacillin b) Ampicillin c) Amoxicillin d) Penicillin G e) Carbencillin Which next antibiotic would be used to treat Neisseria gonorrhoeae if the patient was allergic to penicillins? a) Ticarcillin b) Carbencillin c) Ceftriaxone d) Penicillin G (Benzylpenicillin) e) Penicillin V Clavulanate is added to amoxicillin (Augmentin) to protect the drug molecule. This results in a ____ bioavailability and a change from dosage three times a day to ____ times a day. However, this produces a high incidence of diarrhea: a) Increase; Four b) Increase; Two c) Decrease; Four d) Decrease; Two Clavulanic acid and sulbactam ____ antibiotics, and are added to give better ____ properties and effects: a) Are; Antibacterial b) Are; Pharmacokinetic c) Are not; Antibacterial d) Are not; Pharmacokinetic Name antibiotic considered the least toxic? 101 a) Ticarcillin b) Oxacillin c) Ampicillin d) Penicillin G (Benzylpenicillin) e) Chloramphenicol Imipenem/Cilastatin is an example of a: a) Antibiotic + inhibitor of penicillinase b) Combination from 2 antibiotics to increase spectrum of action c) Antibiotic + inhibitor of renal enzyme dehydropeptidase d) Antibiotic + inhibitor of beta lactamase e) 2 antibiotics to decrease side effects Several families of drugs such as penicillins and cephalosporins act to ____ the bacterial ____ and thereby promoting lysis. The mechanism is through prevention of murein (peptidoglycan) synthesis: a) Weaken; Cell membrane b) Weaken; Cell wall c) Strengthen; Cell membrane d) Strengthen; Cell wall a) Inhibit protein synthesis What is the most frequent side effect, which occurs after administrating of benzyl penicillin? a) Agranulocytosis b) Anemia c) Renal insufficiency d) Allergy e) Dysbacteriosis Severe allergic reactions are more common with what family of drugs? a) Tetracyclines b) Macrolides c) Cephalosporins d) Penicillins e) Sulfonamides Tick the drug belonging to antibiotics-monobactams: a) Ampicillin b) Bicillin-5 c) Aztreonam d) Imipinem e) Tienam Antibiotic inhibiting bacterial RNA synthesis is: a) Erythromycin b) Rifampicine c) Chloramphenicol d) Imipinem e) Cycloserine Which antimicrobial remedy is excreted in bile in active concentrations?: 102 a) ampicillin b) kanamycin c) griseofulvin d) sulfizoxazolul e) nalidixic acid Mechanism of penicillins' antibacterial effect is: a) Inhibition of transpeptidation in the bacterial cell wall b) Inhibition of beta-lactamase in the bacterial cell c) Activation of endogenous proteases, that destroy bacterial cell wall d) Activation of endogenous phospholipases, which leads to alteration of cell membrane permeability e) Activation of beta-lactamase in the bacterial cell Name the main indication for benzylpenicillin: a) salmonelosis b) typhoid fever c) subacute endocarditis d) syphilis e) tuberculosis Which from penicillins is an aminopenicillin? a) Methicillin b) Ampicillin c) Penicillin G d) Penicillin V e) Carbencillin Which of the penicillins produces a higher incidence of diarrhea? a) Cloxacillin b) Ampicillin c) Amoxicillin d) Augmentin e) Penicilin G IV rd Generation Cephalosporins have a ____ spectrum of antimicrobial activity and are considered ____: a) Broad; Bactericidal b) Broad; Bacteristatic c) Narrow; Bactericidal d) Narrow; Bacteristatic e) Narrow; Fungistatic Cephalosporin from I-st generation for parenteral administration is: a) cefazolin b) cefamandole c) cephachlor d) cefipime e) cefadroxil Which of the bacteria would not be affected by a second-generation cephalosporin, but would be affected by ceftazidime? a) Staphylococcus 103 b) Streptococcus c) Listeria d) Enterococcus e) Pseudomonas Which of cephalosporin generation should be given for gram-negative bacterial meningitis? a) First-generation cephalosporin b) Second-generation cephalosporin c) Third-generation cephalosporin d) First-generation cephalosporin, just parenteral drug e) Cephalosporin should not be given Describes ceftazidime and cefepime: a) First-generation cephalosporins b) Second-generation with Haemophilus influenzae activity c) Second-generation with Bacteroids fragilis activity d) Third-generation cephalosporins e) Third-generaion with Pseudomonas aeruginosa activity Describes cefazolin and cephalexin: a) First-generation cephalosporins b) Second-generation with Haemophilus influenzae activity c) Second-generation with Bacteroids fragilis activity d) Third-generation cephalosporins e) Third-generaion with Pseudomonas aeruginosa activity Describes cefmetazole, cefotetan, and cefoxitin: a) First-generation cephalosporins b) Second-generation with Haemophilus influenzae activity c) Second-generation with Bacteroids fragilis activity d) Third-generation cephalosporins e) Third-generaion with Pseudomonas aeruginosa activity Describes cefaclor and cefuroxime: a) First-generation cephalosporins b) Second-generation with Haemophilus influenzae activity c) Second-generation with Bacteroids fragilis activity d) Third-generation cephalosporins e) Third-generaion with Pseudomonas aeruginosa activity Describes cefoperazone and ceftriaxon: a) First-generation cephalosporins b) Second-generation with Haemophilus influenzae activity c) Second-generation with Bacteroids fragilis activity d) Third-generation cephalosporins e) Third-generaion with Pseudomonas aeruginosa activity Which of the microorganisms would be treated with a first-generation cephalosporin? a) E. Coli b) Klebsiella c) Proteus d) Staphylococcus 104 e) Enterobacter A 2-mo-old male neonate presents with a thick eye discharge. The mother admits to having sexual partners and complains of a vaginal discharge. Exams of both eyes of infant reveals a thick purulent discharge and conjunctival congestion and edema. Corneal ulcerations was also noted. Conjunctival swabs on gram staining revealed presence of gram-negative diplococci and many polymorphonuclear cells. What organism, which can be treated with penicillin G or a third-generation cephalosporin, is the most likely cause? a) C. trachomatis b) T. pallidum c) N. gonorrhea d) H. ducreyi e) H. influenza Macrolids are ____ ribosomal subunit inhibitors that are ____ at low concentrations and ____ at high concentrations: a) 30s; Bactericidal; Bacteriostatic b) 30s; Bacteriostatic; Bactericidal c) 50s; Bactericidal; Bacteriostatic d) 50s; Bacteriostatic; Bactericidal Although erythromycin is not normally effective with gram-negative bacteria, cell wall deficient forms of E. coli and Proteus mirabilis (L-forms) are exceptions. These are seen in recurrent: a) Pneumonia b) Upper respiratory tract infections c) Urinary tract infections d) Gastroenteritis e) Endocarditis Name bactericidal antibiotic - the drug of choice for pneumonia caused by H. influenzae? a) Erythromycin b) Clarithromycin c) Azithromycin d) Dirithromycin e) Telithromycin A patient presents with mild symptoms of fever, chills, headache, and coughing. However, they show little sign of bacterial infection. Lab blood results show infection is present and the physician chooses to use a macrolide antibiotic. What agent was most likely the cause of the patient's symptoms? a) Streptococcus pyogenes b) Streptococcus agalactiae c) Mycoplasma pneumoniae d) Listeria monocytogenes e) Streptococcus pneumoniae Which of the organs is the main organ for biotransformation of macrolides such as erythromycin (90%) and clarithromycin? a) Spleen b) Kidneys 105 c) Brain d) GI tract e) Liver An 8-yr-old child presents with pharyngitis and fever of 3 days duration. Microbiology lab confirms translucent beta-hemolytic colonies. Past history includes a severe allergic reaction to amoxicillin when used for ear infection. Which one of the аntimicrobial agents as an oral drug is most likely appropriate in terms of both effectiveness and safety? a) Penicillin G (Benzylpenicillin) b) Cefaclor c) Doxycycline d) Vancomycin e) Azithromycin Aminoglycosides are effective only against which of the microbs and are a good choice for septicemia (a serious toxicity)? a) Gram-positive aerobic bacteria b) Gram-positive anaerobic bacteria c) Gram-negative aerobic bacteria d) Gram-negative anaerobic bacteria e) Just Streptococcus pneumoniae Aminoglycosides inhibit bacterial protein synthesis through binding to ____ bacterial ribosome subunits. They cause leakage of intracellular contents and thus are ____: a) 30s; Bactericidal b) 30s; Bacteriostatic c) 50s; Bactericidal d) 50s; Bacteriostatic Describes the mechanism of aminoglycosides at low dosages: a) Partial inhibition of protein causing ribosome to translate incorrectly b) Amino acid deletions during protein synthesis leading to nonfunctional proteins c) Misreading of mRNA during elongation leading to synthesis of proteins containing incorrect amino acids. d) Nonsense insertion in mRNA during elongation leading to a stop codon e) No effect on protein synthesis Describes the mechanism of aminoglycosides at high dosages: a) Misreading of mRNA during elongation leading to synthesis of proteins containing incorrect amino acids. b) Nonsense insertion in mRNA during elongation leading to a stop codon c) Complete inhibition of protein causing ribosomes to become trapped at the AUG strand condons of mRNA d) Partial inhibition of protein causing ribosome to translate incorrectly e) Amino acid deletions during protein synthesis leading to nonfunctional proteins Following administration of aminoglycosides, where would concentrations be the lowest? a) Prostate b) Brain c) Vitreous fluid d) CSF e) Intracellular 106 Accumulation of aminoglycosides is most common in what location? a) Liver capsule b) Renal medulla c) Nephrons d) Renal cortex e) Spleen Which of the following drugs can be mixed with aminoglycosides, such as for use against Staphylococcus aureus? a) Diuretics b) NSAIDs c) Cisplatin d) Amphotericin B e) Penicillin G (Benzylpenicillin) Which of the antimicrobial drugs is combined with isoniazid to treat tuberculosis? a) Neomycin b) Streptomycin c) Amikacin d) Kanamycin e) Gentamicin AE is a 75-yr-old man with sepsis resulting from a urinary tract infection. He has allergies to beta-lactam antibiotics and erythromycim. The result of blood cultures are positive for P. aeroginosa; the urine culture is positive for P. aeroginosa and E. coli. From aminoglycoside class, which one would you choose? a) Neomycin b) Streptomycin c) Netilmicin d) Kanamycin e) Gentamicin The most active aminoglycoside against Mycobacterium tuberculosis is: a) Kanamycin b) Tobramycin c) Streptomycin d) Amikacin e) Neomycin Cephalosporines are drugs of choice for treatment of: a) Gram-negative microorganism infections b) Gram-positive microorganism infections c) Gram-negative and gram-positive microorganism infections, if penicillins have no effect d) Only bacteroide infections e) Gram-negative and gram-positive microorganism infections, if vancomicin have no effect Carbapenems are effective against: a) Only Gram-positive microorganisms b) Only Gram-negative microorganisms c) Only bacteroide infections d) Broad-spectum 107 e) Very Narrow spectrum Benzylpenicillin acts on the level of: a) cytoplasmatic membrane b) Bacterial wall c) Cytoplasm of a bacterial cell d) Proteine synthesis e) Ribosome of a bacterial cel Which of the antimicrobial drugs would be used to treat methicillin-resistant Staphylococcus aureus (MRSA)? a) Nafcillin b) Vancomycin c) Gentamycin d) Erythromycin e) Clindamycin Penicillin is used in combination with what drug to enhance antibacterial action in the treatment of enterococcal endocarditis? a) Sulfonamides b) Cephalosporins c) Macrolides d) Aminoglycosides e) Fluoroquinolones Prophylactic penicillin is indicated in patients with rheumatic carditis. If the patient is allergic to penicillin, which drug should be used? a) Sulfonamides b) Cephalosporins c) Macrolides d) Aminoglycosides e) Fluoroquinolones At what level penicillin work? a) cytoplasmic membrane b) cellular wall c) cell bacterial ribosome d) bacterial cell nucleus e) bacterial cell cytoplasm Specify the antibacterial mechanism of action of benzyl penicillin: a) disturbance of synthesis of the components of microbial walls b) change of the permeability of cytoplasmatic membranes of microorganisms c) Competitive antagonism with folic acid in bacterial cell d) inhibits coenzyme A activity e) membrane permeability distarbances Specify the action spectrum for biosynthetic penicillins: a) Gram-positive and Gram-negative cocci, Corynebacterium diphtheria, spirokets, Clostridium b) Corynebacterium diphtheria, mycobacteria c) Gram positive cocci, viruses 108 d) gram-negative cocci, Rickettsia, fungal e) mycobacteria, viruses, Corynebacterium diphtheria Antibacterial mechanism of penicillin is: a) inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. b) inhibition of bacterial beta-lactamases c) activation of endogenous protease that destroys the cell wall d) phospholypase endogenous activation, with subsequent alteration of membrane permeability e) inhibition of nucleic acids Cephalosporins are the first choice in treatment: a) Gram-positive b) Gram-negative c) Gram-negative and gram-positive, if penicillins are not effective d) only infections with bacteroides e) only for infections caused by protozoa Classified generally as a ˝third generation˝ cephalosporin: a) Cefazolin b) Cefachlor c) Cephalexin d) Cefotaxime sodium e) Cefamandol Available as tables for oral administration: a) thienam b) cephalexin c) benzatin-benzylpenicillin d) procaine benzyl penicillin e) cefazolin Action spectrum for carbapenems is: a) just gram-positive b) just gram-negative c) only infections with bacteroides d) broad-spectrum e) only for infections caused by mycobacteria. Name aminoglycoside antibiotic: a) erythromycin b) gentamicin c) vancomycin d) polymyxin e) lincomycin Drug from imipenems: a) methicillin b) isoniazid c) tazocine d) atropine e) tienam 109 Name side effect characteristic for aminoglycosides: a) hepatotoxicity b) SNC toxicity c) ototoxicity d) cardiotoxicity e) mielotoxicity The main side efects of aminoglycosides are EXCEPT: a) Ototoxicity b) Nephrotoxicity c) Extrapyramidal disorders d) Neuromuscular blockade e) Nause and vomiting Aminoglycosides have the following spectrum of action: a) gram positive microorganisms, anaerobic, spirochete b) The broad spectrum, exception - Pseudomonas aeruginosa c) gram-negative microorganisms, anaerobic d) The broad spectrum, exception - anaerobes and viruses e) gram-negative cocci, Rickettsia, fungal Which one of the following drugs is most likely to cause loss of equilibrium and ototoxicity? a) Canamycin b) Ethambutol c) Isoniazid d) Para-aminosalicylic acid e) Rifabutin Has the capacity to cause ototoxicity, nephrotoxicity, and neuromuscular blockade: a) vancomycine b) augmenthine c) cefachlor d) erythromycin e) gentamicin Named one of the major indications of aminoglycosides: a) typhus b) streptococcal angina c) meningitis d) typhoid e) coli bacillary pyelonephritis Name the adverse effects of aminoglycosides: a) pancytopenia b) hepatotoxicity c) ototoxicity, nephrotoxicity d) mucosal gastroinitestinale irritation e) agranulocytosis Macrolides include of from the following drugs EXCEPT: a) clarithromycin b) olethetrin 110 c) kanamycin d) roxythromycin e) oleandomycin What are the characteristics for lincosamides? a) broad-spectrum; bactericidal effect. b) influence predominantly anaerobes, gram negative cocci. c) broad-spectru; bacteriostatic effect d) influence predominantly anaerobes, gram positive cocci e) gram-negative cocci, gram-positive cocci and gram-negative bacilli. What is the adverse reaction for lincosamides? a) nephrotoxicity b) carcinogenic effect c) pseudomembranous colitis d) respiratory irritation e) ototoxicity and neurotoxicitae. Chloramphenicol mechanism of action is: a) Changes the shape of 30 rRNA to cause mRNA to be read incorrectly b) Binds to 50s rRNA and inhibits formation of peptide bond c) Binds to 50s rRNA and prevents movement along mRNA d) Interferes with the tRNA anticodon reading of mRNA codon e) Inhibits folic acid metabolism Which antibiotic most easily penetrate into the CNS: a) benzylpenicillin b) streptomycin c) chloramphenicol d) tetracycline e) erythromycin A bacteremic patient is being treated with an antibiotic. Following one week of therapy, this patients develops severe bone marrow depression resulting in pancytopenia. Which antibiotic is the most likely cause of this patient's toxic reaction? a) Doxycycline b) Chloramphenicol c) Azithromycin d) Gentamycin e) Ciprofloxacin A one-yr-old baby who has been diagnosed with brain abscess is undergoing an antibiotic treatment. The baby develops abdominal distention, emesis, and irregular respiration. Name antibiotic that is the most likely cause of this baby's toxic reaction? a) Oxytetracycline b) Amikacin c) Clarithromycin d) Sparfloxacin e) Chloramphenicol Tetracyclines, such as doxycycline, are effective against rare infections. Which of the epidemic infections that can be treated with doxycycline is associated with voluminous 111 rice-water diarrhea and may be seen as an epidemic in third world countries? a) Chancroid (Haemophilus ducreyi) b) Rabid fever (Francisella tularensis) c) Black plague (Yersinia pestis) d) Brucellosis (Brucella species) e) Cholera (Vibrio choler) Among the side effects of tetracycline that may be seen in children taking the drug for long or short periods is: a) depression of bone growth b) ototoxicity c) nefrotoxicity d) gastrointestinal irritation e) allergy Which drug from tetracyclines should be used for spirochetes Borellia burgdorferi.? a) Demeclocycline b) Doxycycline c) Tetracycline d) Oxytetracycline e) Minocycline What kind of side effect is more frequent in tetracycline administration? a) Agranulocytoses b) Anemia c) Renal disturbances d) Allergic reaction e) Bones destruction and teeth coloration Which of the types of drugs binds to teeth and can cause discoloration? a) Tetracyclines b) Macrolides c) Cephalosporins d) Penicillins e) Sulfonamides What is the most common adverse reaction for tetracyclines? a) Prolonged bleeding b) Aplastic anemia c) Bloody diarrhea d) Seizures e) Tooth enamel dysplasia Patients on tetracycline should due which of the following to prevent toxicity? a) Brush their teeth b) Exercise regularly c) Limit exposure to sunlight d) Rest at least six hours each night e) Eat a complete diet including meat and dairy A patient presents with pain in their right side. After physical exam and testing, a fatty liver is found. History is negative for excessive alcohol use. Name classe of antibiotics that 112 could have caused this: a) Tetracyclines b) Aminoglycosides c) Cephalosporins d) Fluoroquinolones e) Sulfonamides Name drug associated with gray baby syndrome? a) Demeclocycline b) Doxycycline c) Tetracycline d) Oxytetracycline e) Chloramphenicol Which drug would be given to a patient with rickettsia who is allergic to doxycycline? a) Demeclocycline b) Tetracycline c) Chloramphenicol d) Minocycline e) Oxytetracycline What antibiotic has strong bactericidal effect? a) tetracycline b) macrolide c) penicillins d) chloramphenicol e) aminoglycoside What remedy is from macrolides group? a) neomycin b) doxycycline c) erythromycin d) cefotaxime e) imipenem What kind of side effect is more frequent in penicillin's administration? a) agranulocytoses b) anemia c) renal disturbances d) allergic reaction e) disbacteriosis Erythromycin works by which of the mechanisms? a) Disruption of protein synthesis via ribosomes b) Inhibition of DNA gyrase c) Inhibition of reverse transcriptase d) Inhibition of fungal membrane e) Inhibition of cell wall synthesis What are the specific adverse effects of erythromycin: a) agranulocytosis b) acoustic-vestibular disorders 113 c) nausea , vomiting and gastrointestinal irritation d) apnea with neuromuscular e) polyneuritis What remedy is from carbapenem group? a) aztreonam b) amoxicillin c) imipinem d) clarithromycin e) doxycycline What remedy-is from tetracycline group? a) doxycycline b) streptomycin c) clarithromycin d) amoxicillin e) penicillin Name antibiotic from lincosamides: a) gentamicin b) streptomycin c) clindamycin d) neomycin e) kanamycin Name antibiotic that inhibits RNA synthesis: a) erythromycin b) rifampicin c) chloramphenicol d) imipinem e) azithromycin Aminoglycosides are effective against: a) Gram positive microorganisms, anaerobic microorganisms, spirochetes b) Broad-spectum, except Pseudomonas aeruginosa c) Gram negative microorganisms, anaerobic microorganisms d) Broad-spectum, except anaerobic microorganisms and viruses e) Only anaerobic microorganisms Which of the antimicrobial drug would affect gram-negative aerobes (versus grampositive cocci/bacilli)? a) Nafcillin b) Vancomycin c) Gentamycin d) Erythromycin e) Clindamycin Choose the characteristics of chloramphenicol: a) Broad-spectum. not active against chlamydia. b) Influences only the Gram-positive microorganisms. c) Influences only the Gram-negative microorganisms. d) Broad-spectum. Active also against chlamydia. 114 e) Narrow-spectrum. Demonstrates a bactericidal effect. May be fatal to neonates owing to an inability to conjugate the drug with glucuronic acid: a) Chloramphenicol b) Polymyxin B c) Erythromycin d) Kanamycin e) Neomycin Which of the following antibiotics penetrate the easiest in cephalorachidian liquid? a) benzathine benzyl penicillin b) streptomycin c) chloramphenicol d) tetracycline e) erythromycin The drug chloramphenicol is risky for which categories of patients? a) Neonates b) Congestive heart failure patients c) Obese patients d) Adult males e) Geriatric patients Name drug that can cause irreversible bone marrow depression, leading to aplastic anemia: a) Oxytetracyclinу b) Minocycline c) Chloramphenicol d) Tetracycline e) Demeclocycline Chloramphenicol has the following unwanted effects: a) Nephrotoxicity b) Pancytopenia c) Hepatotoxicity d) Ototoxicity e) Hypertension Erythromycin may produce following side effects: a) Agranulocytosis b) Vestibular disorders c) Hepatoxic effects d) Apnea caused by neuromuscular blocker e) Polineuritis Name following antibiotic, which is used for abdominal typhus treatment: a) benzathine benzylpenicillin b) benzylpenicillin potassium c) tetracycline d) cloramphenicol e) kanamycin 115 Pick out substance that inhibits the human enzyme dehydropeptidase: a) Cilastatin b) Sulbactam c) Sultiam d) Aztreonam e) Tazobactam Cilastatin can therefore be combined intravenously with ______________ in order to protect it from renal dehydropeptidase: a) imipenem b) meropenem c) carbepenem d) aztreonam e) Tazobactam Choose the characteristics of lincozamides: a) Broad-spectum. Demonstrates a bactericidal effect. b) Influence mainly the anaerobic organisms, Gram negative cocci. c) Broad-spectum. Demonstrates a bacteristatic effect. d) Influence mainly the anaerobic organisms, Gram positive cocci e) Influence mainly the aerobic organisms, Gram positive cocci What kind of remedy will color tears in red-orange color? a) cloramphenicol b) rifampicine c) metronidazol d) carbenicilline e) neomycine Lincozamides have the following unwanted effect: a) Nephrotoxicity b) Cancerogenity c) Pseudomembranous collitis d) Irritation of respiratory organs e) Nonspecific ulcerative colitis Which of the following drugs is used for systemic and deep mycotic infections treatment: a) Co-trimoxazol b) Griseofulvin c) Amphotericin B d) Nitrofungin e) Vancomicin Mechanism of Amphotericin B action is: a) Inhibition of cell wall synthesis b) Inhibition of fungal protein synthesis c) Inhibition of DNA synthesis d) Alteration of cell membrane permeability e) Inhibition of RNA synthesis Witch drug is from quinolones? a) nitroxoline 116 b) nalidixic acid c) furazolidon d) co-trimoxazole e) furasolidone Mechanism of sulfonamides' antibacterial effect is: a) Inhibition of dihydropteroate reductase b) Inhibition of dihydropteroate synthase c) Inhibition of cyclooxygenase d) Activation of DNA gyrase e) Inhibition of dihydropteroate oxydase Mechanism of action of sulphonamides is: a) To inhibit alaninaminotransferase. b) To inhibit dihydropteroatsynthetase c) To inhibit H K ATPase d) To inhibit the enzyme transpeptidase e) To inhibit monoaminoxidase Name sulfonamides, which act only in the intestinal area: a) Sulfocarbamides b) Ftalilsulfatiazol c) Sulfacetamide d) Sulfa Ethiodol e) Sulfadimidine Sulphonamides with gastrointestinal action: a) streptocide, sulphacarbamide, sulphadimidine b) lidaprim, sulphaton, co-trimoxazole c) sulphacethamide, sulphadiazine d) sulphaguanide, sulphasalazine, salazodine. What kind of side effects may Sulfonamides produce? a) Colestasis b) Chrystalluria c) Pseudomembranous Colitis d) Neuromuscular Block e) Balance Disturbances Sulfonamides and nalidixic acid can cause hemolysis in patients that are deficient in what enzyme? a) Phosphoenolpyruvate carboxykinase b) Fructose 1,6-bisphosphatase c) Glucose 6-phosphate d) Glucokinase e) Fructokinase The enzyme that sulfonamides inhibit (para-aminobenzoic acid, PABis needed for bacterial production of which of the substrat which is required for synthesis of DNA, RNA, and protein? a) Murein b) Niacin 117 c) Folic acid d) Arachidonic acid e) Phosphodiesterase Bactrim is an effective and cheap medication containing a sulphonamide and trimethoprim. Which enzyme is targeted by trimethoprim? a) Monohydropteroate synthase b) Monohydrofolate reductase c) Dihydropteroate synthase d) Dihydrofolate reductase e) Phosphodiesterase Combination of sulfonamides with trimethoprim: a) Decreases the unwanted effects of sulfonamides b) Increases the antimicrobial activity c) Decreases the antimicrobial activity d) Increases the elimination ofsulfonamides e) Decreases the elimination ofsulfonamides Name sulphonamide drug: a) streptomycin b) penicillin c) co-trimoxazole d) chloramphenicol e) clarithromycin e Mechanism of action of sulfonamides? a) Changes the shape of 30 rRNA to cause mRNA to be read incorrectly b) Binds to 50s rRNA and inhibits formation of peptide bond c) Binds to 50s rRNA and prevents movement along mRNA d) Interferes with the tRNA anticodon reading of mRNA codon e) Inhibits folic acid metabolism Show mechanism of action of sulphonamides: a) Inhibition of RNA-polymerase b) Have the competitive antagonism with paraaminobenzoic acid c) Inhibition of acetylcholinesterase d) Activation of dihydropholatreductase e) Inhibition of cell wall Sulfonamides have been considered the agents of choice in the treatment of : a) pneumonia b) allergy c) cellulites d) inflammation e) acute pain Which enzyme is targeted by sulfonamide? a) Monohydropteroate synthase b) Monohydrofolate reductase c) Dihydropteroate synthase d) Dihydrofolate reductase 118 e) Tetrahydrofolate reductase Name sulfonamide would be used to treat ulcerative colitis? a) Sulfacetamide b) Trimethoprim c) Co-trimazole d) Sulfamethoxazole e) Sulfasalazine Co-trimazole is used in patient who develop P. carinii pneumonia. This type of pneumonia is seen in what type of patient? a) Neonates b) Elderly c) Immune compromised d) Patients taking warfarin e) Patients with glucose-6-phosphate deficiency Name sulfonamide used topically for ocular infections? a) Sulfacetamide b) Trimethoprim c) Co-trimazole d) Sulfamethoxazole e) Sulfasalazine Which drug is used in bacterial infections of the eyes? a) sulphaguanide b) sulphadimethoxine c) sulfacetamide d) sulphadiazine e) sulphaton Mechanism of Trimethoprim' action is: a) Inhibition of cyclooxygenase b) Inhibition of dihydrofolate reductase c) Inhibition of dihydropteroate synthase d) Inhibition of DNA gyrase e) Inhibition of aldoreductase Which of the effetcs was accomplished with second-generation fluoroquinolones? a) Decreased potency (toxicity) b) Increased potency (effectiveness) c) Decreased protein binding (less drug-drug interaction) d) Added activity against anaerobes e) Improved gram-positive antibiotic activity Fluoroquinolones inhibit which topoisomerase in gram-positive bacteria? a) I b) II c) III d) IV e) non of the above 119 Which group of drugs can cause CNS symptoms and have a tendancy to damage cartiledge, thus should never be given to children under the age of 18? a) Penicillins b) Cephalosporins c) Macrolides d) Aminoglycosides e) Fluoroquinolones Name the antibacterial drug - a nitrofurane derivative: a) Nitrofurantoin b) Trimethoprim c) Ciprofloxacin d) Nystatin e) Metronidazole Name the antibacterial drug - a nitroimidazole derivative: a) Clavulanic acid b) Metronidazole c) Nitrofurantoin d) Doxycycline e) Nystatin Witch drug is from 8-oxyquinolinics? a) nitroxoline b) nalidixic acid c) furazolidon d) co-trimoxazole e) tetracycline Name the antibacterial drug - a quinolone derivative: a) Nitrofurantoin b) Nalidixic acid c) Streptomycin d) Metronidazole e) Nystatin Name the antibacterial drug - a fluoroquinolone derivative: a) Chloramphenicol b) Nitrofurantoin c) Nalidixic acid d) Ciprofloxacin e) Metronidazole Name the main indications for nitrofuranes: a) Infections of respiratory tract b) Infections of urinary and gastro-intestinal tracts c) Syphilis d) Tuberculosis e) As a disinfectant Name the indications for metronidazole: a) Intra-abdominal infections, vaginitis, enterocolitis 120 b) Pneumonia c) As a disinfectant d) Influenza e) Tuberculosis Mechanism of action of metronidazol: a) Inhibits protein synthesis by blocking ribosomal movement along messenger RNA b) The drug undergoes a reductive bioactivation of its nitro group by ferredoxin (prezent in anacrobie parasites) to form reactive cytotoxic products c) The drug blocks glucose uptakc, which leads to decreased formation of ATP d) It may act by uncoupling oxidative phosphorylation or by activating ATP-ases e) Inhibits synthesis of cell wall of microbes The mechanism of fluoroquinolones' action is: a) Inhibition of phospholipase C b) Inhibition of DNA gyrase c) Inhibition of bacterial cell synthesis d) Alteration of cell membrane permeability e) Inhibition of pyridoxalphosphate synthesis Fluoroquinolones are active against: a) Gram negative microorganisms only b) Mycoplasmas and Chlamidiae only c) Gram positive microorganisms only d) Variety of Gram-negative and positive microorganisms, including Mycoplasma and Chlamidiae e) Only protozoa and anaerobes Fluoroquinolones works by which mechanisms? a) Disruption of protein synthesis via ribosomes b) Inhibition of DNA gyrase c) Inhibition of reverse transcriptase d) Inhibition of fungal membrane e) Inhibition of cell wall synthesis The drug of choice for syphilis treatment is: a) Gentamycin b) Penicillin c) Chloramphenicol d) Doxycycline e) Tetracycline The main drugs used in lues? a) tetracycline b) benzylpenicillins c) erythromycin d) co-trimoxazole e) Chloramphenicol Mechanism of Cycloserine's action is: a) Inhibition of mycolic acids synthesis b) Inhibition of RNA synthesis 121 c) Inhibition of cell wall synthesis d) Inhibition of pyridoxalphosphate synthesis e) Inhibition of DNA synthesis Mechanism of Streptomycin action is: a) Inhibition of cell wall synthesis b) Inhibition of protein synthesis c) Inhibition of DNA synthesis d) Inhibition of cell membranes permeability e) Inhibition of RNA synthesis Which chemotherapies may produce reactions from the disulfiram type? a) cloramfenicol b) gentamicin c) metronidazol d) clotrimazol e) ofloxacin Antifungal polyene macrolide that preferentially binds to fungal ergosterol which alters cellular permeability: a) ketoconazole b) amphotericin B c) flucytosine d) grisefulvin e) clotrimazole Amphotericin and nystatin are what type of antifungal drugs? a) Polyenes b) Azoles c) Pyrimidines d) Imidasole’s e) Bis- quaternary ammoniac salts An azole most commonly used for topical treatment of candidiasis: a) amphotericin B b) clotrimazole c) griseofulvin d) flucytosine e) none of the answers Antifungal agent useful in treatment of candidiasis: a) Amphotericin B b) Nystatin c) Both d) Neither Polyene used topically; active against most Candida species--most commonly used for suppression of local candidal infection: a) miconazole b) terbinafine c) nystatin 122 d) fluconazole e) flucytosine Inhibition of fungal squalene epoxidase is this antifungal drug's mechanism of action: a) ketoconazole b) fluconazole c) terbinafine d) nystatin e) flucytosine Given by i.v. administration, the drug of choice for nearly all life-threatening mycotic infections--usually used as the initial induction regiment: a) ketoconazole b) itraconazole c) flucytosine d) amphotericin B e) nystatin First available reverse transcriptase drug for treatment of HIV-1; a deoxythymidine analogue: a) foscarnet b) zidovudine c) amantidine d) indinavir e) remantadine Saquinavir and ritonavir are what type of drugs? a) Fusion inhibitors b) Ion channel blockers c) Polymerase inhibitors d) Protease inhibitors e) Neuraminidase inhibitors Amantadine and rimantadine are what type of drugs? a) Fusion inhibitors b) Ion channel blockers c) Polymerase inhibitors d) Protease inhibitors e) Neuraminidase inhibitors Zanamivir and oseltamivir are what type of drugs? a) Fusion inhibitors b) Ion channel blockers c) Polymerase inhibitors d) Protease inhibitors e) Neuraminidase inhibitors HIV protease inhibitor: a) rimantadine b) ribavirin c) saquinavir d) stavudine e) remantadine 123 These drug is prophylactic against influenza A virus infection with 80% efficacy: a) zidovudine b) saquinavir c) ribavarine d) acyclovir e) amantadine Effective antiviral agent, which is also approved for use in the treatment of Parkinson disease: a) Idoxuridine b) Amantadine c) Vidarabine d) Cytarabine e) Trifluridine Name standard therapy for CMV infections? a) Idoxuridine b) Cytarabine c) Ganciclovir d) Vidarabine e) Zidovudine Therapy for viral infections is aimed at which of the following? a) Enhancing CD4 counts b) Enveloping viral infected cells c) Lysing viral infected cells d) Destroying viruses directly e) Preventing or delaying viral replication Protease inhibitors (PIs) block which of the following steps in the viral life cycle? a) Binding b) Reverse transcription c) Integration d) Transcription e) Assembly AZT (Retrovir), also called zidovudine, is used in the treatment of HIV by inhibiting which step in the viral life cycle? a) Binding b) Reverse transcription c) Integration d) Transcription e) Translation Acyclovir is phosphorylated by viral kinsases at which step? a) First (mono-phosphate) b) Second (di-phosphate) c) Third (tri-phosphate) d) Transcription e) Translation 124 AZT (Zidovudinhas) what mechanism of action? a) Blocks viral absorption b) Blocks uncoating stage c) Blocks early protein synthesis d) Blocks reverse transcriptase e) Blocks packaging and assembly Mechanism of action of zidovudine: a) It induce the formation of enzymes, that phosphorylates a factor witch blocks peptide chain initiation, a phosphodiesterase that degrades terminal nucleotides of t RNA and enzymes that activate kinase b) They inhibit the first steps in replication of the influenza A and rubella viruses c) inhibits reverse transcriptase of HIV-1 and HIV-2 and causes chain termination in viral DNA d) it is active against herpes simplex virus and varicella- zoster virus, by inhibition of DNApolymerase e) inhibit protein formation in viruses Name the drug used for HIV infection treatment, a derivative of nucleosides: a) Acyclovir b) Zidovudine c) Gancyclovir d) Trifluridine e) Amantadine Name the drug from antivirale group with wide spectrum of action: a) Saquinavir b) Interferon alfa c) Didanozine d) Acyclovir e) 3 Zidovudine Most likely to cause additive myelosuppresion in an HIV patient also receiving ganciclovir for CMV retinitis: a) didanosine b) zidovudine c) zalcitabine d) saquinavir e) amantadine Used to treat HSV (herpes): a) zidovudine b) acyclovir c) interferon d) ribavirin e) amantadine Monophosphorylation of this antiviral drug is catalyzed by virus-specified protein kinase phosphotransferase in CMV-infected cells and by viral thymidine kinase in HSV-infected (herpes) cells: 125 a) ganciclovir b) foscarnet c) cidofovir d) valacyclovir e) amantadine Mechanism of paraaminosalicylic acid action is: a) Inhibition of mycolic acids synthesis b) Inhibition of folate synthesis c) Inhibition of DNA dependent RNA polymerase d) Inhibition of DNA gyrase e) Inhibition of cell wall synthesis Indication for isoniazid: a) Meningococcal meningitis b) Typhoid fever c) Subacute endocarditis d) Lues e) Tuberculosis Which of the following pairs of substances is matched? a) Ceruloplasmin - copper b) Deferoxamine - iron c) Isoniazid - pyridoxine d) Vitamin B12 - zinc. The most important drug for treatment of all types of tuberculosis is: a) Augmentine b) Isoniazid c) Aminosalicylic acid d) Ampicylline e) Clarithromycin Which one of the following side effects is more characteristic for ethambutol: a) proteinuria b) decreased visual acuity c) nongouty polyarthralgia d) hemolysis e) methemoglobinemia The important drugs for treatment of tuberculosis are: a) penicillin, cloramphenicol, gentamicin b) isoniazid, riphampicin, ethambutol c) aminosalicylic acid, nitroxoline, furazidine d) norepinephrine, ephedrine, epineprine e) atropine, neostigmine, aceclidine The most common reaction to isoniazid therapy, if pyridoxine is not given concurrently, is: a) peripheral neuritis b) hypersensitivity 126 c) optic neuritis d) dryness of mouth e) convulsions Name drug used specifically only in M. leprae: a) Dapsone b) Isoniazid c) Rifampin d) Pyrazinamide e) Streptomycin Name drug that can cause reversible optic neuritis: a) Ethambutol b) Isoniazid c) Rifampin d) Pyrazinamide e) Streptomycin A 34-year-old man under treatment for pulmonary TB has acute-onset right big toe pains, swelling, and low-grade fever. His physical exam is consistent with gouty arthritis, and he is found to have high serum uric acid levels. Name anti-TB drug that is the most likely cause of this patient's UA levels? a) Isoniazid b) Pyrazinamide c) Cycloserine d) Rifampin e) Ethionamide Isoniazid inhibits mycolid acid synthesis, disrupting bacterial walls and is associated with hepatotoxicity, peripheral and central neuropathy, and optic neuritis. What vitamin should be given as a supplement with isoniazid to help prevents these effects? a) Vitamin A b) Vitamin K c) Vitamin B6 d) Vitamin B12 e) Vitamin E Name aminoglycoside only used for tuberculosis: a) Ethambutol b) Isoniazid c) Rifampin d) Pyrazinamide e) Streptomycin A patient returns complaining of a reddish-orange color in their urine, saliva, sweat, and tears. Which drug from anti TBC drugs was the patient likely taking? a) Dapsone b) Isoniazid c) Rifampicin d) Pyrazinamide e) Streptomycin 127 Name a pro-drug that is activated by tuberculosis and can cause hyperuricemia? a) Ethambutol b) Isoniazid c) Rifampin d) Pyrazinamide e) Streptomycin Which of the following is considered a second-line antitubercular agent? a) Para-aminosalicyclic acid b) Isoniazid c) Rifampin d) Pyrazinamide e) Streptomycin Name the antimycobacterial drug belonging to first-line (I group) agents: a) para-aminosalicylic acid b) Isoniazid c) Kanamycin d) Pyrazinamide e) Prothyonamide Name the antimycobacterial drug, belonging to antibiotics: a) Isoniazid b) PAS c) Ethambutol d) Rifampin e) Pyrazinamide Mechanism of Izoniazid action is: a) Inhibition of protein synthesis b) Inhibition of mycolic acids synthesis c) Inhibition of RNA synthesis d) Inhibition of ADP synthesis e) Inhibition of DNA dependent RNA polymerase Mechanism of Rifampin action is: a) Inhibition of mycolic acids synthesis b) Inhibition of DNA dependent RNA polymerase c) Inhibition of topoisomerase II d) Inhibition of cAMP synthesis e) Inhibition of protein synthesis Mechanism of Streptomycin action is: a) Inhibition of cell wall synthesis b) Inhibition of protein synthesis c) Inhibition of RNA and DNA synthesis d) Inhibition of cell membranes permeability e) Inhibition of pyridoxalphosphate synthesis Name unwanted effect of ethambutol: a) Cardiotoxicity b) Immunotoxicity 128 c) Retrobulbar neuritis with red-green color blindness d) Hepatotoxicity e) Ototoxicity, nephrotoxicity Name unwanted effect of streptomycin: a) Cardiotoxicity b) Hepatotoxicity c) Retrobulbar neuritis with red-green color blindness d) Ototoxicity, nephrotoxicity, neuromuscular blockage e) Immunotoxicity Name the antimalarial drug having a gametocidal effect: a) Mefloquine b) Primaquine c) Doxycycline d) Sulfonamides e) Quinidine Name the drug used for malaria chemoprophylaxis and treatment: a) Chloroquine b) Quinidine c) Quinine d) Sulfonamides e) Metronidazole Name the group of antibiotics having an antimalarial effect: a) Aminoglycosides b) Tetracyclins c) Sulfonamides d) Penicillins e) Carbapenems What antimalarial preparation has an anti inflammmatory action? a) Chloroquine b) Quinine c) Primetamin d) Primaquine e) Emetine Name the drug used for trichomoniasis treatment: a) Metronidazole b) Suramin c) Pyrimethamine d) Tetracycline e) Quinidine Name the drug used for balantidiasis treatment: a) Azitromycin b) Tetracycline c) Quinine d) Trimethoprim e) Quinidine 129 Name the drug, blocking acetylcholine transmission at the myoneural junction of helminthes: a) Levamisole b) Mebendazole c) Piperazine d) Niclosamide e) Suramin Describe niclosamide mechanism of action: a) Increasing cell membrane permeability for calcium, resulting in paralysis, and death of helminthes b) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes c) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake d) Inhibiting oxidative phosphorylation in some species of helminthes e) Inhibiting microtubule synthesis in helminthes Describe praziquantel mechanism of action: a) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes b) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake c) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and death of helminthes d) Inhibiting oxidative phosphorylation in some species of helminthes e) Increasing cell membrane permeability for calcium Describe piperazine mechanism of action: a) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake b) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes c) Inhibiting oxidative phosphorylation in some species of helminthes d) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and death of helminthes e) Inhibiting microtubule synthesis in helminthes Describe mebendazole mechanism of action: a) Inhibiting oxidative phosphorylation in some species of helminthes b) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement and death of helminthes c) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose uptake d) Blocking acetylcholine transmission at the myoneural junction and paralysis of helminthes e) Increasing cell membrane permeability for sodium Name the drug, inhibiting oxidative phosphorylation in some species of helminthes: a) Niclosamide b) Piperazine c) Praziquantel d) Metronidazole e) Mebendazole 130 Name the drug for nematodosis (roundworm invasion) treatment: a) Niclosamide b) Praziquantel c) Pyrantel d) Metronidazole e) Bithionol Name the drug for cestodosis (tapeworm invasion) treatment: a) Piperazine b) Praziquantel c) Pyrantel d) Ivermectin e) Metronidazole Name the drug for echinococcosis treatment: a) Suramin b) Mebendazole or Albendazole c) Piperazine d) Iodoquinol e) Metronidazole Adverse drug interactions may occur due to alteration of: a) pharmacodynamics b) distribution c) excretion d) absorption e) all of them Universal antagonist is: a) unitiol b) protamine sulfate c) naloxone d) atropine e) flumazenil Antagonist of heparin: a) unitiol b) protamine sulfate c) naloxone d) atropine e) flumazenil Antagonis of pilocarpine: a) unitiol b) protamine sulfate c) naloxone d) atropine e) flumazenil Antagonis of diazepam: a) unitiol b) protamine sulfate 131 c) naloxone d) atropine e) flumazenil Antagonis of opioids: a) unitiol b) protamine sulfate c) naloxone d) atropine e) flumazenil MUTLIPLE CHOICE Specify the areas of study of pharmacokinetics? a) absorption of medicinal substances b) types of action of drugs c) distribution of drug substances in the body d) drug biotransformation e) pharmacological effects of drug substances What is an action of the body on a drug? a) Absorption b) Distribution c) Mechanism of action d) Excretion e) Side effects Specify the correct statements about the definition of pharmacology: a) studying methods of preparing, standardization and quality assessment of medicines b) studying methods of storage and distribution of drugs in the pharmaceutical market c) study drug substances interaction with cells of living organisms d) study the effectiveness and safety aspects of drug substances e) studying methods of medical treatment of pathologies of living organisms Specify the correct statements about the definition of the drugs: a) any substance or mixture of substances used for prophylaxis b) any substance or mixture of substances intended for diagnosis c) any substance or mixture of substances used with curative purpose d) any substance or mixture of substances intended for deratization e) any substance or mixture of substances intended for use as an insecticide Describe etymology of the word pharmacology? a) tissue b) drug c) herb d) poison e) science List solid drugs pharmaceutical formulation: a) dragées b) pomade c) plaster d) species 132 e) film List semisolid (soft) pharmaceutical formulation: a) suppositories b) pomade c) plaster d) species e) film List the liquid pharmaceutical formulation: a) decoction b) pomade c) balsam d) species e) emulsion What kinds of reactions occurring in stage II of drugs biotransformation: a) hydrolysis b) sulfo conjugation c) oxidation d) glucuroconjugation e) acetylation What kinds of reactions occurring in stage I of drugs biotransformation: a) oxidation b) glucuroconjugation c) reduction d) hydrolysis e) sulfation Name parts of a phase II substrate? a) Glucuronic acid b) Sulfuric acid c) Acetic acid d) Amino acids e) Cytochrome P450 Name parts of a phase I: a) Oxidations b) Reductions c) Conjugations d) Excretion e) Hydrolyses Drug biotransformation: a) biotransformation products can be toxic b) takes place just for orally administered drugs c) mainly, but not exclusively in the liver d) biotransformation is not influenced by the drugs e) biotransformation products are never toxic Major receptor role(s): a) mediates agonist effects of drugs 133 b) mediates antagonist effects of drugs c) mediates volume of distribution d) mediates clearance e) important for drug action selectivity List properties that can favor absorption by passive diffusion: a) the macromolecular structure b) high proportion of unionized form in case of electrolytes c) peptidic structure in oral administration d) high lipophilicity e) low lipophilicity Which statements are correct for the filtration as one of the ways of penetration of membranes? a) occurs only for small water-soluble molecules b) energy needs c) requires the presence of specialized carrier system d) occurs only for electrolytes e) involves a flow of water Passive diffusion is dependent on: a) small degree of ionization b) pKa of the substance c) pH of the medium d) the presence of a specialized carrier system e) the use of energy Specialized transport systems: a) passive diffusion b) filtration c) pinocytosis d) active transport e) facilitated diffusion Choose right statements for active transport as one of the ways of penetration of membranes: a) energy needs b) is done against the concentration gradient c) requires a specialized carrier system d) occurs only for small molecules and water soluble e) occurs only soluble molecules List routes of administration avoiding the liver: a) peroral b) duodenal c) sublingual d) rectal e) by intragastric sonde Concerning oral administration -- disadvantages: a) least economical b) drug taken orally may cause emesis c) drug taken orally may be destroyed by gastric acidity 134 d) drug taken orally may be metabolized by gastrointestinal flora e) drug taken orally may be in consistently absorbed due to the presence of food What drugs can cause rebound phenomenon at the suddenly stopping of a long treatment? a) clonidine b) captopril c) furosemide d) prazosin e) xpropranolol Characteristic of Cytochrome P450: a) is found in the endoplasmic reticulum of hepatocytes b) is involved in phase II metabolism c) is induced by phenytoin d) is inhibited by cimetidine e) induction of P450 reduces the effect of warfarin Name parameters of pharmacokinetics: a) bioavailability b) half life c) volume of distribution d) the therapeutic window e) clearance Concerning oral administration advantages: a) convenient - portable, no pain, easy to take. b) drug taken orally may cause emesis c) drug taken orally may be destroyed by gastric acidity d) no need to sterilize drug e) drug taken orally may be inconsistently absorbed due to the presence of food Roots of administration that avoid "first-pass" hepatic effects: a) sublingual b) oral c) transdermal d) lower rectal suppositories e) inhalation Concerning renal drug excretion: a) almost all drugs are filtered by the glomerulus b) a lipid-soluble, filtered drug will likely be reabsorbed by passive diffusion c) water soluble drugs are less excreted than lipid soluble drugs d) weak acids are excreted faster in alkaline urinary pH e) weak acids are excreted slowly in alkaline urinary pH What is required for drug bioequivalence? a) Same active ingredients b) Same strength or concentration c) Same dosage form 135 d) Same route of administration e) Same side effects Which is an advantage of prolonged release medications? a) Less frequent administration b) Therapeutic effect overnight c) Sustained blood levels d) Patient compliance e) More fluctuation in plasma concentration Concerning influence of age on drug responses: variation in response usually due to: a) reduced cardiac output b) reduced hepatic perfusion c) decreased body fat d) increased protein binding e) decreased renal function These agents must be given parenterally because they are not absorbed when given orally: a) Osmotic diuretics b) Loop diuretics c) Penicillins d) Macrolides e) Aminoglycosydes antibiotics Name contraindications to morphine: a) bronchial asthma b) acute abdomen c) intense postoperative pain d) respiratory depression e) children under 2 years Specify the adverse effects of metamizol: a) leukopenia and agranulocytosis b) gastric cancer c) allergic reactions d) methemoglobinemia e) cardiotoxicity Indicate how morphine affects the CNS: a) inhibits the cough center b) excites the vagus nerve center c) stimulating the respiratory center d) stimulates the thermoregulatory center e) causes light sleep What is the mechanism of constipation caused by morphine? a) excitation of opioid receptors in the gut b) direct excitation of neurons from vomiting center c) chemoreceptors excitement of the "trigger zone" of vomiting center d) increase sphincter tone e) increasing the secretion 136 What is the mechanism of action of morphine: a) opioid receptor blockade b) inhibits nociceptors c) stimulate opioid receptors d) stimulates the release of mediators e) blocking the release of mediators Effects of morphine on the digestive system: a) increasing of the bile elimination b) diarrhea c) intestine segmentation d) relaxation of the sphincters e) contraction of the sphincters The blood brain barrier is highly permeable to: a) diclofenac b) paracetamol c) indometacine d) morphine e) acetylsalicylic acid List CNS centers that are stimulated by morphine: a) cough b) respiratory c) vagus nerve d) thermoregulation e) optic nerve Choose neuroendocrine effects of morphine: a) increase in cortisol levels b) decrease in cortisol levels c) decrease in gonadotropin-releasing factor d) decrease in corticotropin releasing factor e) increase in gonadotropin-releasing factor Name characteristics of the opioid analgesics: a) depression of the respiratory center b) adequate absorption when given orally c) miosis d) depression of the cough center e) bronchospasm Choose physiological effects of morphine: a) constipation b) miosis c) respiratory depression d) mydriasis e) chronic diahrrea Choose physiological effect typically associated with opioids: 137 a) mydriasis b) miosis c) bradycardia d) tachycardia e) constipation Name mechanism of action of opioid analgesics: a) Bind to opioid receptors on inhibitory fibers, stimulating them b) Inhibit neurotransmitter release c) Inhibit opioid receptors d) Prevent pain impulse transmission to the brain e) Do not work centrally Contraindications/caution for opioid use are: a) patients with lungs oedema b) patients with bones fractures c) patients with cerebral edema d) abdominally unclear pain e) children under 3 years Name effects of morphine: a) myosis b) constipation c) bradycardia d) hypothermia e) hyperthermia Name antagonist of opioids? a) naltrexone b) naloxone c) flumazenil d) pentazocine e) tramadol Name mechanism concerning the nausea resulting from morphine administration: a) results from stimulation of the chemoreceptor trigger zone for emesis b) results from stimulation of H1 histaminoreceptors from vestibular apparatus c) is overcome by morphine antagonist d) is due because of tachycardia and hypertention e) results from stimulation of cough center Name characteristic of opioid poisoning: a) Coma b) Myosis c) Depressed respiration d) Mydriases e) Elevated body temperature Name the main effects of non-opioid analgesics: a) antimicrobial b) antiagregant c) antipyretic 138 d) somnolence e) analgesic Choose the effects of paracetamol: a) Anti-diuretic b) Analgesic c) Antipyretic d) Antiaggregant e) Anticoagulant With regard to salicylate: a) it is rapidly exreted by the kidney if the urine is rendered acidic b) the same group as aspirin c) it causes hypeglycemia d) it potentiates the activity of warfarin e) it has powerful antipyretic properties Choose correct affirmations concerning antiaggregant effect of acetylsalicylic acid: a) Low doses (81-325 mg/day) are sufficient for antiagregant effect b) Acetylsalicylic acid inhibits platelet cyclooxygenase c) Acetylsalicylic acid inhibits Phospholipase A2 d) Acetylsalicylic acid has also analgesic, and anti-inflammatory effects e) Acetylsalicylic acid stimulates lipocortin 1 Specify the correct pharmacological characteristics on phenobarbital: a) cause somnolence upon awakening and marked residual sedation b) cause seizures at higher doses c) does not generate interactions with other drugs d) is indicated in epilepsy e) powerful enzyme inducer Anticonvulsant drugs are: a) selegiline b) pimozide c) carbamazepine d) valproic acid e) phenytoin What drugs are anticholinergic antiparkinsonian drugs: a) trihexyphenidyl b) amantadine c) levodopa d) selegiline e) benactyzine Benzodiazepines indications: a) epilepsy b) parkinsonism c) neurosis d) depression e) seizure by unknown genesis 139 What is characteristic of zolpidem? a) It is a benzodiazepine derivative. b) Stimulates benzodiazepine receptors. c) Enhances GABAergic processes in the CNS. d) Less influence on sleep structure compared to barbiturates. e) Much less addictive than benzodiazepines and barbiturates Choose drugs with anxiolytic effects: a) flumazenil b) propranolol c) amphepramon d) alprazolam e) diazepam Choose zolpidem characteristics: a) short duration of action b) long duration of action c) from barbiturates group d) used for the treatment of obesity e) used for the treatment of insomnia Side effects of benzodiazepines are: a) reducing symptoms of anxiety b) psychologic dependencies c) insomnia d) Rebound effect e) decrease mental concentration What substances belonging to the group of benzodiazepines? a) nitrazepam b) barbital c) diazepam d) chlorpromazine e) meprobamate Name sedative preparations: a) natrium bromide b) valerian drugs c) amphetamine d) caffeine e) barbital What effects are caused by phenytoin? a) antianginal b) antihypertensive c) antiarrhythmic d) antiepileptic e) antipsychotic Which drugs can be used as antiepileptic? a) paracetamol 140 b) chlorpromazine c) morphine d) carbamazepine e) phenytoin Name the possible side effects in therapy with tranquilizers: a) increased skeletal muscle tone b) disturbance of coordination of movements c) somnolence d) drug addiction e) extrapyramidal disorders Tranquilizers indications: a) psychotic disorders accompanied by hallucinations b) neurotic states c) psychotic disorders accompanied by delirium d) insomnia e) depression, somnolence Mention effects characteristic for benzodiazepines tranquilizers group: a) anxiolytic b) hypnotic c) anticonvulsant d) antipsychotic e) antagonizes the action of anesthetics, hypnotics and narcotic analgesics Name benzodiazepines: a) fenazepam b) haloperidol c) diazepam d) chlorpromazine e) droperidol Name drugs without major influence on paradoxical sleep: a) Zolpidem b) Pentobarbital c) Barbital d) Pentobarbital e) Zopiclon Name the pharmacological properties of nitrazepam? a) Inhibits GABA ergic processes in the CNS b) Enhances GABA ergic processes in the CNS. c) It possesses anxiolytic properties. d) Causes sedative effect. e) Enhances the central effects of alcohol. Mechanism of action for benzodiazepines: a) benzodiazepines interact with benzodiazepinic receptors on the GABA receptor b) block sodium channels in neuronal membranes c) the frequency of chloride ion channel opening is increased d) inhibits Ca 2+ currents, especially in thalamic neurons 141 e) enhancing K+ channel permeability Choose correct statement about buspirone: a) causes sedative effect b) causes strong excitement effect c) causes muscle-relaxing action d) causes muscle contracted action e) has a low tendency to induce drug dependence Anxiolytics are mainly used in the treatment of: a) Neuroses b) Psychosis c) Insomnia d) Status epilepticus e) Acute hypotension Bromism is manifested by: a) Apathy b) Memory disorder c) Acne bromica d) Rhinitis e) Extrapyramidal disorders What are the advantages of benzodiazepine hypnotics compared with barbiturates? a) Possesse greater therapeutic range. b) Don’t cause tolerance and Rebound c) Less influence on sleep structure. d) Don’t have essential influence on hepatic microsomal enzymes e) Don’’t potentiate other substances influencing the CNS. Flumazenil is used as an antidote in: a) Zopiclone overdose b) Zolpidem overdose c) Pentobarbital overdose d) Chloral hydrate overdose e) Nitrazepam overdose Name the pharmacological properties of flumazenil: a) Benzodiazepine receptor agonist. b) Benzodiazepine receptor antagonist. c) Used as an antagonist of benzodiazepine receptor stimulated by hypnotics. d) Opioid receptor agonist. e) Antagonist of the opioid receptor. List symptoms of barbiturates poisoning: a) Inhibition of the CNS b) Inhibition of reflex activity c) Hypertensive crisis d) Tahypnoe e) Extreme sleepiness or even coma Determine the main signs of acute intoxication with barbiturates: 142 a) excitation. b) comatose state. c) inhibition of respiration. d) decrease of reflex excitability. e) decrease in blood pressure. Name the phenomena that may occur in prolonged use of barbiturates: a) Tolerance b) Dependence c) Extrapyramidal disorders d) The induction of liver enzymes e) Inhibition of hepatic enzymes The main task of the treatment of acute barbiturate poisoning: a) To establish adequate breathing b) Analeptics in mild forms of poisoning c) Benzodiazepins as antagonist d) Flumazenil injection e) Hemodialysis in renal failure Name psychostimulants: a) Phenylethylamine b) Paraaminophenol's derivates c) Piperidines d) Sydnonimines e) Methylxanthines Neuroleptics indications: a) psychosis b) parkinsonism c) neuroleptanalgesia d) central origin vomiting e) epilepsy Name characteristic effects of antipsychotics: a) antipsychotic b) xanti-vomiting c) sedative d) motor hyperactivity e) antagonizes the action of anesthetics, hypnotics and narcotic analgesics Indicate the adverse effects of neuroleptics: a) extrapyramidal disorder b) euphoria c) potentiating the action of alcoholic drinks d) sexual disorders e) dependence Name neuroleptic preparations: a) chlorpromazine b) phenelzine c) haloperidol 143 d) trifluoperazine e) imipramine Choose phenothiazine derivatives: a) Chlorprothixene b) Chlorpromazine c) Haloperidol d) Trifluoperazine e) Sulpiride Choose "atypical" antipsychotic drugs: a) Sulpiride b) Clozapine c) Chlorprothixene d) Chlorpromazine e) Haloperidol List side effects of chlorpromazine: a) Extrapiramidal disorders b) Decreased blood pressure with dizziness c) The patient salivates excessively d) May deposit in ocular tissues with visual disturbances e) Hypertension How to manage extrapyramidal toxicity of neuroleptics? a) By decreasing the dose b) By increasing the dose c) By concomitant use of cholinoblockers d) By concomitant use of cholinomimetics e) By concomitant use of adrenomimetics List adverse neurologic effects of lithium: a) Tremor b) Sedation c) Weight gain d) Excitability e) Psychosis Choose antimanic drugs: a) Lithium carbonate b) Carbamazepine c) Sodium valproate d) Phenazepam e) Diazepam Which one of the following statements concerning the treatment of bipolar affective disorders is accurate? a) Excessive intake of sodium chloride enhances the toxicity of lithium b) Lithium does not cross the placental barrier c) Lithium will alleviate the manic symptoms within 24 hours d) Above 1,5 mmol/l lithium produces a variety of toxic effects 144 e) Drug therapy with neuroleptics may be required at the initiation of lithium therapy Sedation is more likely with: a) Sulpiride b) Risperidone c) Chlorprothixene d) Chlorpromazine e) Clozapine Choose advantages of clozapine compared with haloperidol: a) It causes less extrapyramidal disorders b) It does not affect prolactin production c) It affects prolactin production d) It does not cause agranulocytosis e) It does not cause seizures List indication of phenothiazine derivatives: a) Schizoaffective disorder b) Vomiting c) Psychosis d) Extrapyramidal disorders e) The amenorrhea-galactorrhea syndrome Haloperidol is used in: a) Schizoaffective disorder b) Vomiting c) Psychosis d) Extrapyramidal disorders e) The amenorrhea-galactorrhea syndrome Indicate the adverse effects of chlorpromazine: a) sexual disorders b) hyperthermia c) extrapyramidal disorder d) hypotension e) psychostimulant Site(s) of chlorpromazine receptor blockade: a) serotonin - 5-HT2 receptor b) beta adrenergic receptor c) H1 histaminic receptor d) muscarinic cholinergic receptor e) alpha adrenergic receptor Antipsychotic endocrine effect(s) are: a) amenorrhea-galactorrhea b) decreased libido in men c) hypoprolactinemia d) increased testosteron e) hyperprolactinemia Indicate pharmacodynamic effects of tranquilizing drugs: 145 a) anxiolytic b) myorelaxant c) anticonvulsant d) psychostimulants e) antipsychotic Name benzodiazepines indications: a) neurotic syndrome b) psychotic episode c) striated muscle contracture states d) status epilepticus e) induction of general anesthesia Name levomepromazine indications: a) acute psychosis with psychomotor agitation b) schizophrenia c) manic phases of bipolar disorder d) acute depression e) hypotension Name cortical psychostimulant drugs : a) caffeine b) amphetamine c) amfepramone d) trifluoperazine e) lobeline Name the bulb stimulants: a) camphor b) bemegrid c) niketamide d) droperidol e) mezocarb Named antidepressants: a) imipramine b) amitriptyline c) phenelzine d) haloperidol e) chlorprothixene Choose antidepresants -nerve terminal reuptake inhibitor: a) fluoxetine b) desipramine c) timolol d) reserpine e) methoxamine How to start antidepressants? a) Start with low doses b) Start with the big doses to achieve the best effect c) Increase dosage rapidly as tolerated 146 d) Maintain typical dose for at least 7 months e) Maintain typical dose for at least 4 to 8 weeks Choose antidepressant with psychostimulant effect: a) Amitriptyline b) Pipofezine c) Nialamide d) Fluoxetine e) Moclobemide Choose correct statement about imipramine: a) The therapeutic effect sets in after 2-3 weeks b) The therapeutic effect sets in after 2-3 years c) Is contraindicated in glaucoma d) It is not indicated to be combined with non-selective MAO inhibitors e) is used in the treatment of Schizoaffective disorder Choose correct statement about fluoxetine: a) is selective serotonin reuptake inhibitor (SSRI) class b) blocks intensively M-cholinoreceptors c) is frequently used to treat major depressive disorder d) is a phenothiazine with actions similar to chlorpromazine e) The therapeutic antidepressant effect develops rapidly in 2-3 days Indicate the pharmacological effects of nootropics: a) antipsychotic b) antidepressant c) enhance metabolic processes d) acts on the specific receptors e) improves associative CNS functions The following are true about the drugs used in general anaesthetic: a) ether is a volatile liquid b) ciclopropan is a gas c) ketamine is used intravenously d) propofol is from opioid derivatives e) enflurane is used intravenously Name intravenous anesthetics: a) Propanidid b) Nitrous oxide c) Thiopental d) Ketamine e) Halothane List requirements for general anesthetics: a) Must start quickly b) Must be without excitatory stage c) To have good control over the depth of anesthesia d) Recovery should be long e) Must start slowly 147 What is characteristic for neuroleptanalgezia? a) development of a general analgesic effect b) combination of fentanyl and droperidol as talamonal c) psychic indifference d) loss of consciousness in therapeutic dose e) without total loss of consciousness. What is Neuroleptanalgesia? a) It is characterized by general quiescence, psychic indifference and intense analgesia without total loss of consciousness b) a state of unconsciousness, analgesia and amnesia, with skeletal muscle relaxation and loss of reflexes c) Combination of Fentanyl and Droperidol as Talamonal d) Is the condition that results when sensory transmission from local area of the body to the CNS is blocked e) Used for endoscopies, angiography and minor operations For neuroleptanalgesia are used: a) fentanyl b) morphine c) ketamine d) droperidol e) propofol Choose rationale for adding epinephrine to local anesthetic solutions: a) cardiovascular stimulation b) increased systemic absorption c) higher anesthetic concentration near nerve fibers d) prolongation of conduction blockade e) reduced systemic absorption Ethanol properties: a) causes protein coagulation in high concentration b) of 70% concentration can be used as an antiseptic c) can be used to disinfect the skin before injections are given, d) used as anti-foaming in pulmonary edema e) used to treat gastrointestinal erosions Name disulfiram mechanism of action: a) Inhibits ethyl alcohol absorption in stomach b) Inhibits ethyl alcohol absorption in small intestine c) Inhibits ethyl alcohol elimination through kidney d) Delay alcohol oxidation e) Leads to acetaldehyde accumulation Describe characteristics of ethanol: a) after ingestion, ethanol is rapidly and completely absorbed b) it is distributed to the most body tissues c) it is not distributed into the body d) mechanism of action: is not fully understood e) bind with ethanol receptors 148 Name drugs used in treatment for alchololism: a) disulfiram b) protamine sulphate c) naltrexone d) fluoxetine e) flumazenil Which drugs are used to build up negative reaction to ethyl alcohol: a) Disulfiram b) Apomorphine c) Morphine d) Diazepam e) Clonidine Antiepileptic drugs decrease pathologically enhanced excitability of brain neurons by: a) Inhibition of GABAergic processes b) Intensifying GABAergic processes. c) Inhibition of neuronal sodium channels. d) Inhibition of neuronal calcium channels. e) The antagonism with M cholinoreceptors effects . What is characteristic of sodium valproate? a) Inhibits the GABA-ergic processes in the brain b) Enhances GABA-ergic processes in the brain. c) It is used to prevent various manifestations of epilepsy (grand mal, petit mal, focal epilepsy (partial seizures)). d) It is used only to prevent petit mal. e) It is used only to prevent grand mal. What is characteristic of carbamazepine: a) Inhibits membrane sodium channels in neurons. b) It is effective only for petit mal prevention. c) It is effective in all types of epilepsy. d) It inhibits the GABA-ergic processes in the brain. e) Enhances GABA-ergic processes in the brain. What is characteristics of phenobarbital? a) Inhibits the GABA-ergic processes in the brain. b) Enhances GABA-ergic processes in the brain c) Sedative effect. d) It is used to prevent grand mal. e) It is used to prevent petit mal. What is characteristic of diazepam? a) Is a benzodiazepine derivative. b) Is a benzodiazepine receptor agonist. c) EnhanceGABAergic processes in the CNS. d) It inhibits the GABA-ergic processes in the brain. e) In the status epilepticus is administered intravenously. Name the remedies used to prevent major crises: 149 a) Phenytoin. b) Ethosuximide. c) Carbamazepine d) Phenobarbital. e) Sodium valproate. Name the remedies used for minor crisis prevention: a) Phenytoin. b) Ethosuximide. c) Carbamazepine. d) Phenobarbital. e) Sodium valproate. Name the remedies used to prevent partial seizures: a) Ethosuximide. b) Carbamazepine. c) Lamotrigine. d) Phenytoin. e) Sodium valproate. Name the remedies used to prevent myoclonic seizures: a) Phenytoin. b) Ethosuximide. c) Phenobarbital. d) Sodium valproate. e) Clonazepam. Name the remedies used for status epilepticus: a) Ethosuximide. b) Carbamazepine. c) Diazepam. d) Thiopental Sodiu. e) Nitrous Oxide. As antiparkinson remedies are used: a) The dopamine receptor blockers b) Dopaminomimetics c) Non-selective MAO inhibitors. d) MAO-B inhibitors. e) Cholinoblockers Name the adverse effects of levodopa: a) Nausea. b) Vomiting. c) Excitation. d) Drowsiness. e) Hallucinations. Name the adverse effects of levodopa: a) Arrhythmias. b) Orthostatic hypotension. c) Dyskinesia. 150 d) Dependence. e) Skeletal muscles hypertonus Name the measures that can be used to decrease cardiovascular and digestive side effects of levodopa: a) The inhibition of acetylcholinesterase b) Inhibition of peripheral dopa-decarboxylase. c) DOPA decarboxylase inhibition in the CNS. d) To block peripheral dopamine receptors. e) The administration of haloperidol. Name the preparations that stimulate dopamine receptors in the CNS: a) Selegiline. b) Amantadine. c) Trihexyphenidyl. d) Bromocriptine. e) Apomorphine. What is characteristic of selegiline? a) Inhibits MAO-A and MAO-B. b) It selectively inhibits MAO-B. c) More effective than levodopa. d) It is used usually in combination with levodopa. e) Typically administered in monotherapy. What adverse effects of trihexyphenidyl are determined by the influence of peripheral cholinoreceptors? a) Dry mouth. b) Increased intraocular pressure. c) Tachycardia. d) Motor excitation e) Bradycardia. Choose correct statement about trihexyphenidyl: a) Should be administered with caution in glaucoma b) Most effectively decreases tremor c) Most effectively decreases rigidity d) Most effectively decreases hypokinesia e) Causes bradycardia Indicate the pharmacological effects of M-cholinomimetics: a) NO-mediated vasodilatation b) constipation c) increased intraocular pressure d) spasm of accommodation e) tachycardia Indicate the pharmacological effects of M-cholinomimetics: a) urinary retention b) lowering intraocular pressure c) miosis d) increasing myocardial oxygen consumption 151 e) increase in blood pressure Indicate the pharmacological effects of M-cholinomimetics: a) diarrhea b) hypersalivation c) mydriasis d) diaphoresis e) bradycardia The effects of direct-acting cholinergic agonists include: a) mydriasis b) myosis c) spasm of accomodation d) decrease intraoculary pressure e) increased lacrimation Name indications of M-cholinomimetics: a) glaucoma b) bronchial asthma c) atony of the urinary bladder d) cardiac arrest e) intestinal atony Name indications of M-cholinomimetics: a) xerostomia b) bronchoobstructive syndrome c) intestinal colics d) gastric ulcer e) atony of the urinary bladder Name M-cholinomimetics: a) aceclidine b) galanthamine c) pilocarpine d) atropine e) suxamethonium Name anticholinesterases remedies: a) carbacholine b) neostigmine c) pilocarpine d) physostigmine e) acetylcholine The following are true about physostigmine: a) it is a reversible cholinesterase inhibitor b) it is a nonreversible cholinesterase inhibitor c) it acts only on the muscarinic receptors d) it acts only on the nicotinic receptors e) it causes miosis Pharmacologic characteristic of physostigmine: 152 a) causes accommodative spasm b) causes conjunctival vasoconstriction c) increases the intraocular pressure d) causes smooth muscle contraction e) can be used in hypotonia of gastrointestinal system Describe effects of pilocarpine: a) is an alkaloid derived from plant b) is a direct acting muscarinic agonist c) causes contraction of the longitudinal muscles of the ciliary body d) causes myriasis e) causes miosis Mydriasis occurs with: a) atropine b) scopolamine c) carbachol d) neostigmine e) acetylcholine Muscarinic agonists are: a) pilocarpine b) atropine c) aceclidine d) scopolamine e) platyphylline The effects of muscarinic agonists include: a) reduced intraocular pressure b) increased intraocular pressure c) spasm of accomodation d) increased lacrimation e) contraction of the pupillary sphincter muscle Acetylcholinesterase inhibitors include: a) physostigmine b) atropine c) edrophonium d) pyridostigmine e) scopolamine The systemic side effects of pilocarpine include: a) constipation b) excessive sweating c) spasm of accommodation d) bronchial spasm e) dry mouth The side effects of pilocarpine include: a) dry eye b) increased sweating c) bronchiolar spasm 153 d) increased salivation e) constipation The following are true about pilocarpine: a) used in bronchal asthma b) used for glaucoma c) causes mydriasis d) causes miosis e) stimulates the secretion of large amounts of saliva and sweat Choose anticolynestarase drugs: a) Clonidine b) Guanethidine c) Neostigmine d) Atropine e) Physostigmine The following are cholinomimetics with irreversible action: a) Pilocarpine b) Tabex c) Armine d) Soman e) Pirophos Choose drugs that can produce miosis: a) ipratropium bromide b) tropicamide c) armine d) atropine e) pilocarpine What are the pharmacological characteristics related to neostigmine? a) is an anticholinesterase drug b) works by directly stimulating the cholinergic receptors c) is indicated in postoperative hypotonia or atony of gastrointestinal and bladder d) is contraindicated in bronchial asthma, Parkinson's disease, heart failure e) has a good bioavailability after oral administration Indicate anticholinesterases properties: a) stimulates the synthesis of acetylcholine b) directly stimulates cholinergic receptors c) increases the tone of smooth muscles of the gastrointestinal tract d) inhibits the hydrolysis of acetylcholine e) inhibits the synthesis of acetylcholine Name effects of anti-cholinesterase preparations: a) miosis and lowering intraocular pressure b) increased smooth muscle tone of internal organs c) intensified secretion of bronchial and digestive glands d) tachycardia, and increased blood pressure e) mydriasis 154 Characteristics of neostigmine: a) inhibits the action of cholinesterase b) inhibits M cholinoreceptors c) causes miosis d) is used in the X-ray diagnosis of intestine disease e) causes bradycardia Cholinomimetics used in glaucoma: a) pilocarpine b) atropine c) scopolamine d) aceclidine e) scopolamine The following eye drops causes cycloplegia: a) tropicamide b) phenylephrine c) atropine d) pilocarpine e) aceclidine Side effects of depolarizing muscle relaxants: a) muscle pain b) miosis c) potassium release d) diarrhea e) muscle fasciculations Indicate muscle relaxants a) suxamethonium b) isoprenaline c) ephedrine d) norepinephrine e) tubocurarine What are the effects M cholinoblockers on the digestive tract? a) smooth muscle relaxation b) smooth muscle spasm c) the relaxation of the sphincter d) sphincter spasm e) gland hypersecretion Named drugs used in organophosphate derivatives poisoning: a) neostigmine b) atropine c) physostigmine d) obidoxim e) pilocarpine Treatment of intoxication with organophosphates: a) II phase 2-4ml Atropine i/m, or i/v after 1-2 ml every 10 min. b) I phase -attack doze 1-2 ml Atropine s/c or i/m after, 0,5 ml s/c or i/m every 30 min. 155 c) II phase 4-8 ml Atropine i/v or i/m after 2-3ml every 3-8 min. d) I phase 2-4ml Atropine i/m, or i/v after 1-2 ml every 10 min. e) III phase 4-8 ml Atropine i/v or i/m after 2-3ml every 3-8 min. In organophosphate poisoning, this agent(s) may be capable of re-activating inhibited acetylcholinesterase: a) isonitrosyne b) mecamylamine c) pilocarpine d) trimedoxim e) atropine Name M cholinoblockers indications: a) bronchial asthma b) gastrointestinal spasms and colics c) tachycardia d) hypertention e) sinus bradycardia Name M cholinoblockers effects in the eye: a) mydriasis b) increase intraocular pressure c) cycloplegia d) miosis e) decrease intraocular pressure Indicate adverse effects of atropine: a) dry mouth and dysphagia b) bronchospasm with dyspnea c) atonic constipation d) urinary retention e) miosis The pairing of the following drugs and their side-effects are correct: a) atropine - dry mouth b) scopolamine - pernicious anaemia c) neostygmine - bone marrow suppression d) cititon -hepatic fibrosis e) aceclidine – miosis Characteristis of atropine: a) inhibits the sweat glands b) mydriasis c) causes hyperpyrexia in overdose d) bronchospasm e) is more sedative than scopolamine Characteristic of atropine: a) blocks nicotinic acethylcholine receptors b) dries bronchial and salivary secretion c) diminishes the risk of vagal cardiac arrest d) is used to avoid unwanted side effects of neostigmine 156 e) causes loss of accommodation With regard to the effect of atropine: a) mydriasis is the result of paralysis of the constrictor muscle of the pupil b) causes cycloplegia c) miosis d) bronchospasm e) diarrhea Indicate adverse effects of M cholinomimetics: a) dyspnoea and bronchial asthma attacks in asthmatics b) constipation c) urinary retention d) bradycardia e) colics Name effects of cholinomimetics: a) bradycardia b) bronchospasm c) xerosthomia d) lacrimation e) miosis The effects of muscarinic agonists include: a) spasm of accommodation b) bradycardia c) mydriasis d) tachycardia e) miosis Name primary effects of stimulating muscarinic M receptors? a) Release of nitric oxide (vasodilation) b) Iris contraction (miosis) c) Ciliary muscle contraction and accommodation of the lens (near vision) d) Bronchi dilation and decreased bronchiole secretions e) Hyposalivation Name effects of stimulating muscarinic M receptors? a) Tachycardia, increased conduction velocity b) Increased GI tract tone and secretions c) Vasoconstrcition d) Penile erection e) Contraction of urinary detrusor muscle and relaxation of urinary sphincter Indicate anticholinesterases: a) neostigmine b) edrophonium c) physostigmine d) pilocarpine e) carbachol Indicate the pharmacological effects of atropine in the digestive system: 157 a) increase tone and peristalsis b) salivary hyposecretion c) antispasmodic effect d) reduction of gastric secretion e) diarrhea Note nondepolarizing neuromuscular blocking drugs: a) tubocurarine b) atropine c) pilocarpine d) pancuronium e) suxamethonium Name drugs that cause non-depolarising blockade of the neuromuscular junction during anaesthesia: a) scopolamine b) physostigmine c) pancuronium d) tubocurarine e) suxamethonium Cholinomimetics have following effects: a) bronchospasm b) tachycardia c) bradycardia d) midriasis e) bronchodilation Characteristics of pilocarpine are: a) It is a tertiary amine alkaloid b) It causes miosis c) Causes a decrease in secretory and motor activity of gut d) It is useful in the treatment of glaucoma e) Causes increased intraocular pressure Which of the following cholinomimetics are indirect-acting? a) Lobeline b) Neostigmine c) Pilocarpine d) Galantamine e) Atropine Indicate the location of N-cholinoreceptors: a) Parasimpathetic autonomic ganglia b) Simpathetic autonomic ganglia c) Skeletal muscle neuromuscular junctions d) Autonomic effector cells e) Sensory carotid sinus baroreceptor zone Indicate the location of M3 cholinoreceptor type: a) Heart b) Glands 158 c) Smooth muscle d) Skeletal muscle neuromuscular junctions e) Eye smooth muscle Cholinoblocking drugs cause: a) Bronchodilation b) Mydriasis c) Bradycardia d) Tachycardia e) Xerostomia The following are true about physostigmine: a) it is a reversible cholinesterase inhibitor b) it causes bronchodilation c) it causes intestinal spasm d) it exites N cholinoreceeptors e) it causes miosis Characteristics of physostigmine: a) causes accommodative spasm b) causes conjunctival vasoconstriction c) increases the intraocular pressure d) causes smooth muscle contraction e) can be used in hypotonia of gastrointestinal system Characteristics of pilocarpine: a) is an alkaloid derived from plant b) is a direct acting muscarinic agonist c) causes contraction of the cilliary muscles d) causes mydriasis e) has a greater effect on patients with blue iris than brown iris. Name the results of excessive cholinergic stimulation, as would be seen with a nerve agent or organophosphate poisoning: a) Diarrhea b) Miosis c) Mydriasis d) Bronchodilation e) Hypersalivation The effects of direct-acting cholinergic agonists include: a) mydriasis b) miosis c) spasm of accomodation d) decrease intraocular pressure e) xerostomia Contraindications to the use of muscarinic agonists: a) diarrhea b) bronchial asthma c) treatment of diminished salvation, secondary to radiation d) peptic ulcer 159 e) myasthenia gravis Cardiovascular effects of cholinomimetics: a) negative chronotropic b) vasoconstriction c) decreased AV nodal conduction velocity d) negative inotropism e) positive inotropism Anticholinesterases used moslty to treat myasthenia gravis: a) neostigmine b) pyridostigmine c) acetylcholine d) pylocarine e) armine The effects of muscarinic agonists include: a) reduced intraocular pressure b) reduced aqueous production c) accommodative myopia d) increased lacrimation e) contraction of the pupillary sphincter muscle Associated with parasympathetic activation (direct effects): a) increased GI motility b) urinary retention c) decrease cardiac contractility d) decreased GI motility e) increase heart rate Localization of muscarinic cholinergic receptors: a) sweating glands b) heart c) postsynaptic membrane of the vegetative ganglia d) neuro-musular junction e) eyes Indirect-acting cholinomimetic: a) neostigmine b) acetylcholine c) carbachol d) edrophonium e) atropine Mechanism(s) of vasodilation mediated by the cholinergic system: a) acetylcholine stimulates M3 cholinoreceptors on endothelial cells b) acetylcholine stimulates beta-2-adrenoreceptors c) acetylcholine inhibits alpha-1-adrenoreceptors d) acetylcholine inhibit alpha-2- adrenoreceptors e) cholinergic activation promotes nitric oxide release from endothelial cells Associated with excessive vagal tone: 160 a) total heart block b) mydriasis c) bradyarrhythmias d) tachyarrhythmias e) smouth muscle contraction Effect(s) of muscarinic agonists on the gastrointestinal and urinary tracts: a) increased glands secretion b) decrease ureteral peristalsis c) increased contraction amplitude d) relax sphincters e) decreased intestinal peristalsis Clinical uses of neostigmine: a) treatment of reduced salivation secondary to radiation therapy b) stimulation of postoperative urinary bladder c) in people with myasthenia gravis d) treatment of gastric ulcer e) intoxication with atropine Opthalmological uses of cholinomimetics: a) for the visualization of the retina b) treatment of glaucoma c) used along with mydriatic agent in breaking iris-lens adhesions d) acetylcholine may be used as a miotic e) acetylcholine may be used as a midriatic Choose major contraindications for muscarinic agonists: a) atony af the intestine b) peptic ulcer c) intestinal spasm d) glaucoma e) bronchial asthma Anticholinesterases: used in treating glaucoma: a) tropicamid b) phyzostigmine c) aceclidine d) atropine e) armine General clinical uses of anticholinesterases: a) treatment of paralytic ileus and urinary bladder atony b) glaucoma treatment c) myasthenia gravis management d) antagonist-assisted reversal of neuromuscular blockade produced by depolarizing neuromuscular-blocking drugs e) antagonist-assisted reversal of neuromuscular blockade produced by nondepolarizing neuromuscular-blocking drugs Acetylcholinesterase inhibitors include: a) physostigmine 161 b) atropine c) edrophonium d) pyridostigmine e) scopolamine Cholinomimetics used in glaucoma: a) pilocarpine b) atropine c) scopolamine d) aceclidine e) tropicamide The following muscarinic agonists work directly on both M, and N cholinoreceptors : a) pilocarpine b) carbachol c) acetylcholine d) atropine e) aceclidine The side effects of pilocarpine include: a) dry eye b) increased sweating c) bronchospasm d) increased salivation e) constipation The following are true about pilocarpine: a) it increases the concentration of acetylcholine in the synaptic cleft b) it decreases intraocular presure c) it causes diarrhea d) it increases intraocular presure e) it causes constipation Atropine causes: a) Miosis, a reduction in intraocular pressure and cyclospasm b) Mydriasis, a rise in intraocular pressure and cycloplegia c) Miosis, a rise in intraocular pressure and cycloplegia d) Xerostomia, constipation e) Tachycardia Contraindications to the use of antimuscarinic drugs are all of the following: a) Glaucoma b) Gastric ulcer c) Bronchial asthma d) Paralytic ileus e) Atony of the urinary bladder Antimuscarinics are used in the treatment of: a) Motion sickness b) Glaucoma c) Urinary retention d) Bronchial asthma 162 e) Gastric hypersecretion The atropine poisoning includes all of the following symptoms: a) Mydriasis, cycloplegia b) Hyperthermia, dry mouth, hot and flushed skin c) Agitation and delirium d) Bradicardia, orthostatic hypotension e) Miosis Choose the antimuscarinic drug, which is used as a mydriatic: a) Pilocarpine b) Neostigmine c) Homatropine d) Ipratropium e) Tropicamide Which of the following agents is used by inhalation in asthma? a) Atropine b) Ipratropium c) Lobeline d) Homatropine e) Oxitropium Choose a M-cholinoreceptor-blocking drugs: a) Scopolamine b) Pipecuronium c) Trimethaphan d) Pilocarpine e) Atropine Mydriasis occurs with: a) atropine b) tropicamide c) carbachol d) neostigmine e) pilocarpine Characteristic of atropine: a) blocks nicotinic acethylcholine receptors b) inhibits bronchial and salivary secretion c) causes bronchospasm d) is used to avoid unwanted side effects of neostigmine e) causes loss of accommodation With regard to the effects of atropine: a) mydriasis is the result of paralysis of the constrictor muscle of the pupil b) miosis is the result of constriction of the constrictor muscle of the pupil c) increases lacrimation d) it causes cycloplegia e) it causes spasm of accommodation Name adverse effects (side-effects) commonly seen with cholinergic antagonists? 163 a) Blurred vision b) Confusion c) Miosis d) Diarrhea e) Urinary retention The following eye drops causes cycloplegia: a) tropicamide b) atropine c) epinephrine d) pilocarpine e) aceclidine Atropine causes: a) Bradycardia, hypotension and bronchoconstriction b) Tachycardia, no effect on blood pressure and bronchodilation c) Decrease in contractile strength, conduction velocity through the AV node d) Tachycardia, hypertensive crisis and bronchodilation e) Tachycardia and increasing of conduction velocity through the AV node Atropine effects: a) dry mouth b) pupillary dilation c) miosis d) increased heart rate e) decresed heart rate Atropine block: a) M1 receptor subtype b) M2 receptor subtype c) M3 receptor subtype d) N receptor subtype e) All of the above Atropine is used for premedication to reduce or prevent: a) Bradycardia b) Hypersecretions c) AV block d) Hiposecretion e) Tachycardia Which of the following antimuscarinic drugs is a selective M1 blocker? a) Atropine b) Scopolamine c) Pirenzepine d) Homatropine e) Telenzepine Atropine causes: a) Spasmolitic activity b) Intestinal hypermotility c) Stimulation of contraction in the gut 164 d) Stimulation of secretory activity e) Tachycardia Name effects of atropine: a) dry moth b) mydriasis c) hypersalivation d) tachycardia e) bradycardia Name characteristics about scopolamine? a) It causes psychostimulant effect b) The same group as atropine is c) Doesn’t across blood-brain barrier d) It may prevent motion sickness and vertigo e) Used in brochal asthma by inhalation Which of the following agents is a ganglion-blocking drug? a) Suxamethonium b) Hexamethonium c) Pancuronium d) Trepirium iodide e) Azamethonium Which of the following agents is a neuro-muscular blocking drug? a) Suxamethonium b) Hexamethonium c) Pancuronium d) Trepirium iodide e) Azamethonium Adverse effect(s) associated with autonomic ganglionic blockade: a) Bladder dysfunction b) Xerostromia c) Blurred vision d) Paralytic ileus e) Diarrhea Name the main effects of ganglion-blocking drugs: a) vasodilatation and hypotension b) hyposecretion c) increase of intraoculary pression d) bronchospasm e) bradycardia Name effects of autonomic ganglion blocking: a) Anhidrosis and xerostomia b) Mydriasis c) Tachycardia d) Hypertension e) Cycloplegia 165 Name the nicotinic receptor-blockers: a) Azamethonium b) Atropine c) Tubocurarine d) Neostigmine e) Scopolamine Ganglion-blocking drug is used for: a) Pulmonary edema b) Hypertensive crisis c) Controlled hypotension during surgery d) Acute hypotension e) Xerostomia Choose ganglionic blockers: a) trimetaphan b) nicardipine c) azamethonium d) hydralazine e) prazosin Adverse effect(s) associated with autonomic ganglionic blockade: a) paralytic ileus b) blurred vision c) xerostomia d) bradycardia e) bladder dysfunction Ganglionic blockers: a) Prazosin b) Hydralazine c) Hexamethonium d) Nicardipine e) Azamethonium List therapeutic use of cytisine: a) To stimulate respiration b) To decrease blood pressure c) To aid „quitting" smoking d) In pulmonary edema e) For xerostomia The following cause non-depolarising blockade of the neuromuscular junction during anaesthesia: a) succinylcholine b) physostigmine c) pancuronium d) tubocurarine e) atropine Side effects of depolarizing muscle relaxants: a) miosis 166 b) potassium release c) muscle pain d) muscle fibrilation e) diarrhea The systemic effects of hexamethonium include all of the following: a) Reduction of both peripheral vascular resistance and venous return b) Partial mydriasis and loss of accommodation c) Constipation d) Stimulation of sweating e) urinary retention Skeletal muscle relaxation and paralysis can occur from interruption of functions at several sites, including all of the following: a) Nicotinic receptors b) Muscarinic receptors c) The motor end plate d) Nicotinic receptors in autonomic ganglia e) Muscarinic receptors in smooth muscle Indicate the long-acting neuromuscular blocking agent: a) Pipecuronium b) Atracurium c) Tubocurarine d) Pancuronium e) Suxamethonium Which of the following neuromuscular blocking drugs is an intermediate-duration muscle relaxant? a) Vecuronium b) Tubocurarine c) Pancuronium d) Suxamethonium e) Atracurium Effects seen only with depolarizing blockade include all of the following: a) Hyperpotassemia b) Decrease in intraocular pressure c) Bronchospasm d) Muscle pain e) Cardiac arithmias Describe endogenous adrenoreceptor agonists: a) are catecholamines and are rapidly metabolized by COMT and MAO. b) are ofen used enteral c) are inactive when given by the oral route d) work ultra long into the body e) have a short duration of action Which of the adrenergic receptors is most commonly found pre-synaptic? a) α1 b) α2 167 c) β1 d) β2 e) β3 Location for beta1-postsynaptic receptors: a) Heart b) Juxtaglomerular apparatus c) Pancreas d) CNS e) Vessels Name location of beta2 adrenoreceptors: a) vessels b) ciliary muscle c) liver d) bronchi e) juxtaglomerular cells Location for beta3 receptors: a) adipose tissue b) CNS c) vessels d) skeletal muscle e) salivary glands Clinical use(s) of alpha-1-receptor agonists: a) nasal decongestant b) management hypotensive states c) hypertensive states d) angina pectoris e) bronchial asthma Activates alpha receptors: a) metharaminol b) terbutaline c) phenylephrine d) propranolol e) isoproterenol Phenylephrine causes: a) Constriction of vessels in the nasal mucosa b) Increased gastric secretion and motility c) Increased skin temperature d) Mydriasis e) Increased blood pressure Which substance can be used in acute rhinitis? a) clonidine b) naphasoline c) salbutamol d) izoprenaline e) xylometazoline 168 Catecholamine includes following: a) Ephedrine b) xEpinephrine c) Norepinephrine d) Dopamine e) Fenilephrine Epinephrine increases level of: a) blood lactic acid b) blood insulin c) skeletal muscle glycogen d) blood glucose e) blood free fatty acids Direct cardiac responses to epinephrine: a) increase contractility b) increased rate of isometric muscle tension development c) increased heart rate d) decreased automaticity e) decreased heart rate Epinephrine: therapeutic uses: a) rapid relief of respiratory distress due to bronchospasm b) topical hemostasis c) supraventricular tachycardia d) reversal of hypersensitivity reactions e) to decrease blod pressure Principal receptors activated by norepinephrine: a) alpha-adrenergic b) beta1 adrenergic c) beta2 adrenergic d) H1 histamine reseptors e) M cholynoreceptors Distribution of alfa adrenoreceptor subtypes is associated with all of the following tissues: a) Mast cell b) Blood vessels c) Prostate d) Pupillary dilator muscle e) Juxtaglomerular apparatus Epinephrine characteristics: a) stimulates both α and β receptors b) causes miosis c) used in anaphylactic shock d) can be used to prolong the action of local anaesthetic e) used in hypertension 169 A nonselective beta receptor agonist causes all of the following effects: a) Increase cardiac output b) uterus contraction c) uterus relaxation d) Causes bronchoconstriction e) Causes bronchodilation Name indirect mechanism of action of adrenomimetics: a) these drugs inhibit reuptake of catecholamines by nerve terminals b) directly activate their adrenoreceptors c) blockade of metabolism (block of catechol-O-methyltransferase (COMT) and monoamine oxidase (MAO) and increase the quantity of catecholamines d) activate the effects of endogenous catecholamines e) activate directly the main centers from CNS Definition for indirect sympathomimetics: a) are agents that elevate the concentration of NE at neuroeffector junctions, b) they either inhibit re-uptake, facilitate release, or slow breakdown by MAO, c) side chain "-hydroxyl group confers affinity for α - and β -receptors d) the ability of a substance to release norepinephrine from its neuronal stores without exerting an agonist action at the adrenoceptor e) can penetrate the blood-brain barrier and evoke such CNS effects as a feeling of well-being, enhanced physical activity and mood (euphoria), and decreased sense of hunger or fatigue. Adverse effects associated with guanethidine: a) Hypotension (symptomatic) b) Male sexual dysfunction c) Diarrhea d) Constipations e) Hypertension The effects of clonidine include: a) sedation b) bradycardia c) dry mouth d) tachycardia e) hypotention Which of the following effects is related to direct beta1-adrenoreceptor stimulation? a) Bronchodilation b) Vasodilatation c) Tachycardia d) Renine release e) Bradycardia Beta2 receptor stimulation includes all of the following effects: a) Stimulation of renin secretion b) Hyperglicemia c) Relaxation of bladder, uterus d) Tachycardia e) Bronchodilation 170 Beta-2 selective agonist: a) fenoterol b) epinephrine c) salbutamol d) phenylephrine e) labetalol Hyperglycemia induced by epinephrine is due to: a) Gluconeogenesis b) Inhibition of insulin secretion (alfa) c) Stimulation of glycogenolysis (beta2) d) Inhibition of insulin synthesis e) Increasing in glucose absorbtion from the gut Action of drugs acting adrenergic system on the eyes: a) Αlfa agonists cause miosis b) Αlfa agonists cause mydriasis c) Beta antagonists decrease the production of aqueous humor d) Αlfa agonists increase the outflow of aqueous humor from the eye e) Αlfa agonists increase intraocular pressure in narrow-angle glaucoma Αlfa-receptor stimulation includes all of the following effects: a) Relaxation of gastrointestinal smooth muscle b) Contraction of gastrointestinal smooth muscle c) Stimulation of insulin secretion d) Vasodilation e) Stimulation of platelet aggregation Choose cardiovascular effects of dobutamine: a) decreases peripheral resistance b) negative inotropism c) positive inotropism d) negative dromotropism e) positive dromotropism Toxicities/adverse reactions associated with sympathomimetics: a) anxiety reactions b) cardiac tachyarrhythmias c) hypertension; cerebral hemorrhage d) syncope e) angina pectori Adverse effects associated with dopamine administration: a) bradycardia b) arrhythmias c) hypertension d) tachycardia e) palpitations Epinephrine effects on the heart: a) reduces oxygen consumption b) reduces conduction 171 c) increased contraction d) decreased contractility e) increased rate Cardiac effects associated with epinephrine: a) increased oxygen consumption b) increased cardiac output c) positive inotropic effect d) decreased cardiac output e) positive chronotropic effect Ventricular effects associated with epinephrine administration: a) decreased contractility b) increased contractility c) decreased conduction d) increased conduction e) decreased automaticity Alpha agonist: vasoconstriction and elevated blood pressure: a) ethylephrine b) clonidine c) terbutaline d) methoxamine e) prazosine Alpha adrenergic receptor blockers are: a) atenolol b) terazosine c) terbutaline d) phenoxybenzamine e) phentolamine Alpha-adrenergic receptor blocker(s) - blockade of alpha1 adrenergic receptors: a) proroxan b) doxazosin c) phentolamine d) terazosin e) prazosin Adverse effects associated with prazosin: a) tachycardia b) hypertension c) dizziness d) bradycardia e) initial-dose marked orthostatic hypotension Characteristic of labetalol: a) is a mixed alpha/beta adrenergic antagonist b) xused in hypertension management c) is selective alpha adrenergic antagonist d) is selective beta adrenergic antagonist e) can causes orthostatic hypotension 172 Blocks both alpha and beta receptors: a) carvedilol b) diazoxide c) propranolol d) labetalol e) timolol Block both alpha and beta receptors: a) Atenolol b) Labetalol c) Metoprolol d) Salbutamol e) Carvedilol Name contraindication for Beta-non selective adrenoblockers: a) Bronchial asthma b) Atrial- ventricular block c) Tachyarrhythmias d) Angina Pectoris e) Raynoud disease Beta- receptor activation is produced by: a) pentetrasol b) terphenadine c) isoprenaline d) phenoterenol e) terbutaline Which drugs are beta-agonists: a) Digoxin b) Dobutamine c) Amrinone d) Salbutamol e) Isoprenaline Adverse effects associated with beta adrenergic receptor agonists: a) over usage of these drugs may predisposed to mortality in asthmatics b) skeletal muscle tremor c) excessive cardiovascular stimulation d) bronchospasm e) anxiety Name adverse affect of the β1 blockade: a) Bradycardia b) Decreased cardiac output c) Tachycardia d) Hypertention e) Low contractility Clinical uses of for propranolol: a) treatment of essential hypertension 173 b) management of angina c) management of certain arrhythmias d) prophylactic against asthma attacks e) AV block Alpha2 selective adrenergic agonists: a) phentolamine b) clonidine c) epinephrine d) phenoxybenzamine e) methyldopa Beta1 selective adrenergic receptor antagonist: a) propranolol b) timolol c) nadolol d) metoprolol e) atenolol Selective beta1 blockers: a) Atenolol b) Propranolol c) Acebutolol d) Labetolol e) Timolol Beta1 receptor stimulation includes all of the following effects: a) Increase in heart contractility b) Bronchodilation c) Miometrium relaxation d) Tachycardia e) Increase in conduction velocity in the atrioventricular node Bronchodilation is caused by: a) atenolol b) fenoterol c) salbutamol d) timolol e) metoprolol List beta blockers: a) atenolol b) fenoterol c) salbutamol d) timolol e) metoprolol Which of the following drugs causes bronchodilation without significant cardiac stimulation? a) Isoprenaline b) Fenoterol c) Xylometazoline 174 d) Methoxamine e) Salbutamol Propanolol causes: a) can cause bronchospasm b) can cause bronchodilation c) increases blodd pressure d) decreases blodd pressure e) can mask hypoglycaemia induced by insulin The main adverse effects of phentolamine include all of the following: a) Hypertenssion b) Bradycardia c) Tachycardia d) Colaps e) Hypotention Characteristics of phentolamine include all of the following: a) Reduction in peripheral resistance b) Bradicardia c) Tachycardia d) Stimulation of muscarinic and histamine receptors e) Block alfa-adrenoreceptors Beta-blocking drugs-induced hypotension may be associated with their effects on: a) The heart b) The blood vessels c) The renin-angiotensin system d) Inhibition of norepinephrine release e) Inhibition of norepinephrine reuptake Clinical applications of beta-adrenergic antagonists: a) treatment of hypertension b) treatment of arrhythmias c) Raynaud disease d) bronchial asthma e) management of angina pectori Non-selective beta-adrenergic receptor blocker(s): a) nadolol b) esmolol c) timolol d) atenolol e) metoprolol Beta-adrenergic receptor blockers: effects on the heart: a) increased automatism b) decreased contractility c) increased contractility d) decrease automatism e) increase heart rate 175 Most likely to cause dangerous bronchiolar constriction in asthmatic patients: a) timolol b) atenolol c) nebivolol d) propranolol e) metoprolol Characteristics of beta-blocking agents include all of the following: a) They occupy beta receptors and competitively reduce receptor occupancy by catecholamines or other beta agonists b) They causes hypotention c) They induce hypertention d) They cause tachycardia e) They can cause blockade in the atrioventricular node Principal mechanisms by which beta adrenergic receptor blockade decreases blood pressure: a) blockade of angiotensin II receptors b) reduced myocardial contractility c) reduced heart rate d) renin release suppression e) they induce hypertention Adverse effect(s) associated with beta-adrenergic blockers: a) bradycardia b) bronchospasm c) tachycardia d) impotence e) hypertention Beta-blocker with some intrinsic sympathomimetic properties: a) practolol b) sotalol c) pindolol d) metoprolol e) propranolol Selective beta1 blocker(s): a) alprenolol b) propranolol c) acebutolol d) pindolol e) atenolol Beta-receptor antagonists have all of the following cardiovascular effects: a) The negative inotropic and chronotropic effects b) Acute hypertention c) Vasoconstriction d) Vasodilation e) Reduction of the release of renin Compared with phentolamine, prazosine has all of the following features: 176 a) Irreversible blockade of alfa 2 receptors b) More often causes bradicardia c) Highly selective for alfa1 receptors d) Highly selective for alfa2 receptors e) Persistent block of alfa1 receptors Characteristics of alfa-receptor antagonists include all of the following: a) They cause a fall in peripheral resistance and blood pressure b) They cause epinephrine reversal (convert a pressor response to a depressor response) c) Bronchospasm d) Hypertension e) They may cause postural hypotension and reflex tachycardia Which of the following drugs is a competitive antagonist at both alfa1 and alfa2 receptors? a) Prazosin b) Doxazosin c) Labetalol d) Phenoxybenzamine e) Phentolamine List sympatholytic drugs: a) clonidine b) methyldopa c) diazoxide d) propranolol e) reserpine Characteristics of reserpine include all of the following: a) It inhibits the uptake of norepinephrine into vesicles b) It decreases cardiac output, peripheral resistance and inhibits pressor reflexes c) It may cause a transient sympathomimetic effect d) Can be used as neuroleptic e) It depletes stores of catecholamines in the brain Determine Beta1-adrenoceptor location: a) myocardium b) bronchi c) juxtaglomerular apparatus d) the syno-carotid zone e) CNS Determine the preponderant location of the beta2-adrenoceptors: a) bronchial muscles b) skeletal muscle c) uterus d) myocardium e) juxtaglomerular apparatus Indicate the effects caused by the excitation of postsynaptic alpha 1-adrenergic receptor: a) mydriasis b) miosis 177 c) contraction of the spleen capsule d) vassoconstriction e) bronchodilation Specify the effects caused by the excitation of beta1-adrenergic receptors: a) intensification of contractility and cardiac automaticity b) negative inotropic action c) negative chronotropic action d) miosis e) to increase renin secretion Specify the effects caused by the excitation of beta2-adrenoceptors: a) relaxation of the myometrium b) bronchodilation c) bronchoconstriction d) vasoconstriction e) contraction of the spleen capsule Specify peripheral alpha2-adrenomimetics: a) methyldopa b) clonidine c) xylometazoline d) naphazoline e) orciprenaline Specify central alpha2-adrenomimetics: a) xmethyldopa b) clonidine c) xylometazoline d) naphasoline e) orciprenaline Indicate nonselective Beta1,2-adrenomimetics: a) isoprenaline b) salbutamol c) fenoterol d) orciprenaline e) epinephrine Characteristic of epinephrine: a) stimulates α and β receptors b) block α β receptors c) used in anaphylactic shock d) can be used to prolong the action of local anaesthetic e) used in hyperglycemia Indicate selective Beta2-adrenomimetics: a) terfenadine b) salbutamol c) isoprenaline d) hexoprenaline e) terbutaline 178 Indicate adrenergic drugs with bronchodilator effect: a) salmeterol b) dopamine c) norepinephrine d) epinephrine e) isoprenaline Name indications of epinephrine: a) anaphylactic shock b) cardiogenic shock c) hypoglycemic coma d) hyperosmolar diabetic coma e) conjunctivitis Indicate drugs used to treat anaphylactic shock: a) epinephrine b) diphenhydramine c) propranolol d) salbutamol e) phentolamine Indicate drugs used to treat hypoglycemic coma: a) epinephrine b) norepinephrine c) glucagon d) glucose e) insulin Indicate the adverse effects of epinephrine: a) bradycardia b) tachycardia c) hypoxia and tissue necrosis d) anxiety, tremor e) bronchospasm Name the beta-2-adrenomimetics indications: a) imminence of spontaneous abortion b) paroxysmal supraventricular tachycardia c) ventricular extrasystole d) pectoral angina e) bronchial asthma Name the effects of beta1- adrenomimetics: a) intensification of heart contractions b) tachycardia c) increased heart automaticity d) bronchial muscle relaxation e) bronchial spasm Name Beta2 adrenomimetics: a) salbutamol 179 b) epinephrine c) ephedrine d) isoprenaline e) fenoterol Indicate pharmacological characteristic of clonidine: a) stimulates beta2-adrenergic receptors b) stimulates alpha2 receptors c) causes bradycardia d) can cause sedation and somnolence e) causes tachycardia The effects of clonidine include: a) sedation b) bradicardia c) dry mouth d) tachycardia e) hypotention Indicate the specific pharmacological effects of drugs that stimulate alfa1-adrenergic receptors: a) vasoconstriction b) improvement of microcirculation c) vasodilatation d) decrease in microcirculation e) decrease of blood pressure Indicate the effects of beta-blockers: a) antihypertensive b) antiarrhythmic c) antiangina d) antipsychotic e) anxiolytic The following side-effects are seen in beta-antagonists: a) bradycardia b) hypotention c) hypertention d) impotence e) tachycardia Name beta-adrenoblockers: a) Propranolol b) Validol c) Metoprolol d) Alopurinol e) Oxprenolol The following are selective beta blockers: a) pindolol b) propanolol c) nadolol 180 d) atenolol e) acebutol The following are non-selective beta-blocker: a) metoprolol b) propranolol c) oxprenolol d) nadolol e) sotalol Characteristic of propanolol: a) block alfa adrenoreceptors b) block beta adrenoreceptors c) decreases cardiac contractility d) block alfa beta adrenoreceptors e) can mask hypoglycaemia induced by insulin Indicate beta-blocker drugs indications: a) angina pectoris b) acute heart failure c) schizophrenia d) tachyarrhythmia e) sinus bradycardia Name indications of beta-blockers: a) bronchial asthma b) myocardial infarction c) migraine d) atrioventricular block e) hypertension List the adverse effects of selective beta-blockers: a) atrioventricular block b) worsening angina pectoris c) worsening of heart failure d) exacerbation of bronchial asthma e) spasm of peripheral vessels Indicate pharmacological peculiarities characteristic for alpha-blockers? a) produce vasodilatation b) bradycardia c) reduce microcirculation d) tachycardia e) improves microcirculation Name contraindications of propranolol: a) supraventricular tachycardia b) atrioventricular block c) bronchial asthma d) angina pectores e) Raynaud's disease 181 Simpatholitics are used in: a) treatment of the hypertension b) myocardial infarction c) severe forms oh hypertension d) Raynaud disease e) ventricular arrhythmias Witch statements about sympatholytics is adequate? a) affect noradrenaline synthesis b) affect noradrenaline release c) affect noradrenalne uptake d) bind covalently to the alpha receptor an produce an irreversible effect e) inhibit the flux of Ca 2+ through presynaptic membrane and inhibit in this way mediators release Name adverse effects of reserpine: a) tachycardia b) bradycardia c) the excitation of the CNS d) depression e) the decrease intestinal motility Name alpha-adrenoblockers indications: a) pheochromocytoma b) hypertension c) hypotension d) ventricular arrhythmias e) Raynoud disease Name beta-blockers indications: a) hypertension b) angina pectoris c) migraine d) bradyarrythmie e) imminence of premature birth Indicate pharmacological peculiarities characteristic for propranolol: a) is indicated to treat hypertension b) is indicated in the treatment of migraine c) possessing psycho-sedative action d) possessing psychostimulant action e) is administered to treat angina pectores Indicate the adverse effects of beta-adrenoblockers: a) Rebound phenomena b) increased intraocular pressure c) anxiety d) atherogenic action e) increase the need in oxygen of myocardium Name astringent indications: a) Poisoning with heavy metals salts 182 b) Inflammatory processes of the digestive tract c) Inflammation of the skin d) To antagonize with morphine e) For local anesthesia Choose coating drugs: a) Zinc oxide b) Silver nitrate c) Starch mucilage d) Mucilage from flax seeds e) Activated charcoal Choose adsorbants indications: a) Meteorism b) Diarrhea c) To decrease chloralhydrate irritant properties d) Inflammatory processes of the urinary tract e) Acute poisoning Choose irritants: a) Zinc oxide b) Silver nitrate c) Menthol d) Ammonia solution e) Starch mucilage Are effective antitussives: a) ambroxol b) dimemorfan c) acetylcysteine d) ethylmorphine e) codeine Name drugs used in bronchial asthma treatment: a) salbutamol b) propranolol c) fenoterol d) sotalol e) pindolol Name drugs avoided in bronchial asthma: a) salbutamol b) propranolol c) fenoterol d) sotalol e) pindolol Name respiratory analeptics: a) aminophilline b) bemegrid c) nikethamide. d) camphor 183 e) prenoxdiazine Name the reasons of morphine used for pulmonary edema: a) cause bronchodilation b) relief of anxiety c) diuretic effect d) - increases peripheral vasodilatation e) causes vasoconstriction Name antitussive drugs: a) aminophilline b) glaucine c) xcodeine d) mucaltin e) bromhexine Name expectorant drugs: a) ambroxol b) glaucine c) codeine d) mucaltin e) bromhexine Name opioids antitussives: a) codeine phosphate b) glaucina c) prenoxdiazine d) pronilid e) ethylmorphine Indicate drugs used to treat bronchial asthma: a) isoprenaline b) orciprenaline c) pentoxiverine d) pronilid e) prenoxdiazine Name side effects of aminophylline: a) Arrythmia b) Sudden death c) Depression d) Insomnia e) Gastric irritation Indicate antiallergic drugs used to treat asthma: a) terfenadine b) loratadine c) astemizole d) platifilină e) fenoterol Indicate effective drugs in bronchial asthma: 184 a) ipratropium b) aminophylline c) salbutamol d) propranolol e) strophantin Following drugs directly activate the respiratory center: a) Bemegride b) Caffeine c) Aethymizole d) Cytiton e) Salbutamol Which of these groups of drugs is used for asthma treatment? a) Methylxanthines b) M-cholinoblocking agents c) Beta2 -stimulants d) Alfa1-stimulants e) M-cholinomimetic agents Choose anti-asthma agents that act in part by activating pulmonary beta-receptors thus increasing cAMP: a) salbutamol b) methoxamine c) cromolyn d) terbutaline e) ipratropium Choose methylxantines used in bronchial asthma therapy: a) theophylline b) cyclosporine c) metaproterenol d) aminophylline e) ipratropium bromide Pick out the bronchodilator drug related to xanthine: a) Atropine b) Orciprenaline c) Adrenaline d) Theophylline e) Aminophylline Name drugs that decrease the release of mediators ( histamine, other ABS) from mast cell. (Stabilization of mast cells): a) glucocorticoids b) salbutamol c) sodium cromoglicate d) epinephrine e) cyclosporine The mechanisms of methylxanthines action are: a) Inhibition of the enzyme phosphodiesterase (high doses) 185 b) Beta2 -adrenoreceptor stimulation c) Inhibition of the production of inflammatory cytokines d) Inhibition of M-cholinoreceptors e) Inhibition of adenosine receptors All of the following drugs are inhaled glucocorticoids: a) Triamcinolone b) Beclometazone c) Sodium cromoglycate d) Budesonide e) Ketotifen Choose the drug belonging to membranestabilizing agents: a) Zileuton b) Sodium cromoglycate c) Zafirlucast d) Montelucast e) Ketotifen Indicate the drug which is a leucotriene receptor antagonist: a) Sodium cromoglycate b) Zafirlucast c) Zileuton d) Triamcinolone e) Montelucast Which of the following drugs are inhibitors of leukotrienes' receptors? a) Montelukast b) Zileuton c) Ibuprofen d) Diclofenac e) Zafirlukast Indicate pharmacological characteristic for isoprenaline: a) stimulates beta1 and beta2 adrenergic receptors b) stimulates just beta1 adrenoreceptors c) produces tachycardia, palpitations, and tremor d) is contraindicated in bronchial asthma e) can be used in aerosols in bronchial asthma crisis Indicate pharmacological characteristic for theophylline: a) is from methylxanthines b) is an ergot alkaloid derivative c) has bronchodilator action, stimulates the heart and CNS d) is contraindicated in bronchial asthma e) is a synthetic catecholamine stimulates beta1 and beta2 adrenergic receptors Explain the pharmacological effects of glucocorticoids used in bronchial asthma treatment: a) have marked anti-inflammatory effect b) decrease bronchi edema and bronchial secretion 186 c) inhibits the respiratory system d) promotes the synthesis of lipocortin e) increase bronchial edema and bronchial secretion Indicate pharmacological peculiarities for codeine: a) is an opiate drug b) inhibits the cough center of the bulb c) inhibit the vagus nerve center d) possesses analgesic effect e) possesses antipyretic action Indication for antitussive drugs: a) cough in rib fractures b) bronchitis with wet cough c) cough in open pneumothorax d) cough in pulmonary tumor e) pneumonia with wet cough What drugs excites sino carotid reflexogenic zone? a) caffeine b) niketamidă c) cititon d) lobeline e) bemegride Indicate expectorant drugs: a) mucaltin b) sodium hydrocarbonate c) potassium iodide d) codeine e) morphine Indicate pharmacological characteristics for prenoxidiazine: a) inhibits the cough center b) depresses the reflex of cough by acting peripherally c) antitussive effect is equivalent to codeine’s d) antitussive effect is less than codeine’s e) causes tolerance and drug addiction Name preparations effective in status asthmaticus: a) disodium cromoglycate b) aminophylline c) diazepam d) dexamethasonum e) ketotifenum Which of the following drugs are not 5-lipoxygenase (5-LOG) inhibitors? a) Diclofenac b) Metamizole c) Zileuton d) Ibuprofen e) Zafirlukast 187 Which of the following drugs are leucotreine D4 receptor (LTD) blockers? a) Diclofenac b) Zafirleukast c) Zileuton d) Ibuprofen e) Montelukast Which of these groups of drugs are used for asthma treatment? a) Methylxanthines b) M-cholinoblocking agents c) Beta2 -stimulants d) Beta blockers e) M cholinomimetics Which of the following drugs are used in treatment of bronchial asthma? a) Zafirlukast b) Diclofenac c) Zileuton d) Salbutamol e) Propranolol Indicate disodium chromoglycate pharmacodynamic properties: a) inhibits mast cell degranulation b) blocks M- cholinoreceptors c) inhibits the influx of calcium into the cell d) decreases release histamine and other mediators of allergic reactions e) stimulates beta-2-adrenoceptors Choose indications for disodium chromoglycate a) prevention of acute bronchospasm b) status astmaticus c) prevention and relief of nasal allergies d) hyperaldosteronism type 1 e) to prevent the acute transplant rejection What are the mechanisms of bronchodilator action of aminophylline? a) the stimulation of beta-2-adrenergic receptors b) blocking adenosine receptors c) antagonizing the factor of platelet aggregation d) toxic doses inhibit phosphodiesterase e) stimulation adenilaciclazei What is the mechanism of action of disodium cromoglycate to treat asthma? a) prevents calcium influx into cells b) causes adrenergic stimulation c) is a musculotropic bronchodilator d) antagonizes the action of histamine on bronchi e) prevent mast cell degranulation What preparations are preferred for mild bronchial asthma accesses? 188 a) disodium cromoglycate b) indomethacine c) ketotifen d) salbutamol e) terbutaline Indicate the pharmacological effects of aminophylline: a) antiarrhythmic b) cardiostimulator c) hypertensive d) diuretic e) bronchodilator Name inhaled glucocorticoids: a) Triamcinolone b) Beclometazone c) Sodium cromoglycate d) Budesonide e) Prednesolone Inhibitors of cyclic nucleotide phosphodiesterases (enzymes that degrade cyclic AMP): a) theophylline b) caffeine c) carbachol d) aspartate e) aminophylline Name mecanisms of antihypertenisve effects: a) Sympatic vegetative ganglia paralises b) beta 1 adrenoblocking action c) alfa 1 adrenostimulating action d) beta 2 adrenoblocking action e) alfa adrenoblocking action In hypertensive emergencies are used: a) Diltiazem b) Prazozine c) Reserpine d) Phenylephrine e) Captopril Total peripheral resistance (TPR) is a determining factor for mean arterial pressure. What are correct relationships between norepinephrine, minoxidil, and lisinopril and TPR? a) Minoxidil : TPR increases b) Fosinopril : TPR increases c) Norepinephrine : TPR increases d) Phenoxybenzamine : TPR increases e) Minoxidil : TPR decreases Name antihypertensive mechanisms: a) paralyzation of the vegetative sympathetic ganglions 189 b) elective stimulation of alpha 1-adrenergic receptors c) paralyzation of the sympathetic-peripheric terminals d) elective blocking of alpha-adrenergic receptors e) blocking of beta-adrenergic receptors Name antihypertensive drugs: a) alpha- adrenoblockers b) alpha- adrenomimetics c) beta- adrenoblockers d) alpha-2-central adrenomimetics e) sympathomimetics Name sympapholitics: a) rezerpine b) capropril c) phentolamine d) guanethidine e) prazosine Name Angiotensin-converting enzyme inhibitors: a) lisionopril b) capropril c) phentolamine d) enalapril e) enalkiren Concerning the use of ACE (angiotensin-converting-enzyme ) inhibitors in heart disease: a) reduces efficacy of diuretic treatment requiring higher diuretic dosages b) contraindicated in hypertensive patients with hypertrophic left ventricles c) reduces aldosteron level d) contraindicated in diabetic patients e) benefits due to reduction in circulating angiotensin II levels Name rennin inhibitors: a) lisionopril b) remikiren c) phentolamine d) enalapril e) enalkiren Name angiotensin II receptor blockers: a) losartan b) remikiren c) phentolamine d) valsartan e) enalkiren Angiotensin II receptor antagonist: a) saralasyne b) phenoxybenzamine c) methyldopa d) losartan 190 e) captopril Orthostatic (postural) hypotension is produced by: a) ganglionic blocker b) dopamine receptor activation c) alpha receptor blocker d) alpha receptor activation e) beta receptor activation Most likely to increase blood pressure: a) norepinephrine b) timolol c) phenylephrine d) propranolol e) captopril Decreases blood pressure a) prazosine b) phentolamine c) phenylephrine d) trimetaphan e) propranolol Calcium channel blockers with predominantly vascular effects: a) diltiazem b) nicardipine c) verapamil d) nifedipine e) amlodipine Centrally-acting antihypertensive drug: a) moxonidine b) captopril c) methoxamine d) clonidine e) sodium nitroprusside Name izothyoureic derivates: a) izoturon b) dopamine c) izoprenaline d) profetur e) difetur Name vasoconstrictors with central action: a) niketamide b) camphor c) sulfocamphocaine d) epinephrine e) izoturon Name alkaloids from Ergot: 191 a) b) c) d) e) ergotal angiotensinamide ergotamine tartrate epinephrine dihydroergotamine Name effects of clonidine: a) antihypertention b) antihypotention c) analgesic d) psychostimulant e) sedation Antihypertensive: action based on inhibition of norepinephrine release from adrenergic nerve endings: a) brethilium b) phentolamine c) hexamethonium d) reserpine e) propranolol Choose antihypertensive agents: a) methyldopa b) guanethidine c) carbidopa d) epinephrine e) reserpine Usual adverse effects of vasodilating, antihypertensive drugs: a) headache b) bradycardia c) angina pectori d) reflex tachycardia e) syncope Adverse effects associated with ACE (angiotensin-converting-enzyme) inhibitor use: a) hypokaliemia b) dry cough c) angioedema d) proteinuria e) hyperkalaemia Indications for Angiotensin-converting enzyme inhibitors: a) treatment of hypertention b) treatment of hypotention c) treatment of bronchial asthma d) treatment of familiar hyperkalemia e) treatment of cardiac failure ACE (angiotensin-converting-enzyme) inhibitors: a) trandolapril 192 b) methyldopa c) timolol d) captopril e) nifedipine Vasoconstriction, aldosterone secretion, and renin release suppression occur upon activation of the renin-angiotensin-aldosterone system. How would captopril affect these responses? a) block ACE (angiotensin-converting-enzyme) b) blocks all except vasoconstriction c) blocks only vasoconstriction d) decrease angiotensine II synthesis e) blocks only aldosterone secretion Calcium channel blocker: vasodilation, less likely to have direct cardiac effects: a) nimodipine b) amlodipine c) verapamil d) diltiazem e) nifedipine Choose antihypertensive drugs belonging to the same class: a) lisinopril b) clonidine c) verapamil d) nifedipine e) doxazosin Name advers effects of nifedipine: a) hypertention b) reflex tachycardia c) hypotension d) bradycardia e) constipation Name adverse effects of verapamil: a) AV-block b) reflex tachycardia c) low blood pressure d) bradycardia e) dry cough Why should be avoided association between beta-blockers and verapamil? a) promote bronchoconstriction b) both acting negative inotropically c) produce angina pectoris d) depress A-V node conductivity e) promote peripheral vascular spasms Name drugs causing bradycardia having both antianginal and antiarrhythmic effects: a) propranolol b) isosorbide dinitrate 193 c) nitroglycerine d) nifedipine e) verapamil Indicate antiarrhythmics acting on the innervation of the heart: a) procainamide b) propranolol c) quinidine d) phenytoin e) atenolol Name class I A antiarrhythmic drugs: a) verapamil b) procainamide c) lidocaine d) metoprolol e) quinidine Name class I B antiarrhythmic drugs: a) verapamil b) procainamide c) lidocaine d) metoprolol e) phenytoine Name groups af drugs with antiarrhythmic propierties: a) alpha-blockers b) beta-blockers c) potassium channel blockers d) calcium channel blockers e) sodium channel blockers Antiarrhythmic drugs classified as sodium channel blockers: a) amiodarone b) verapamil c) lidocaine d) procainamide e) quinidine gluconate Quinidine: mechanism(s)/properties of antiarrhythmic activity: a) slow rate of rise of phase 0 b) prolong repolarization c) activates beta-receptors d) activates K channels e) block sodium channel Prominent quinidine-mediated actions at receptors: a) nicotinic agonist b) H1 antagonist c) alpha adrenergic antagonist d) muscarinic, cholinergic antagonist 194 e) beta adrenergic agonist Correct match(es) between antiarrhythmic drugs and side effects: a) verapamil: tachycardia b) propranolol: bronchospasm c) lidocaine: CNS-related side effects including paresthesias d) quinidine: diarrhea, cinchonism e) metoprolol: tachycardia Agent(s) may be effective in terminating paroxysmal supraventricular tachycardia (PSVT)? a) propranolol b) dobutamine c) verapamil d) atropine e) epinephrine Useful in treating third-degree (complete) heart block: a) digoxine b) isoprenaline c) lidocaine d) edrophonium e) atropine Common drugs that induce AV block include: a) digoxin b) beta-blockers c) atropine d) isoprenaline e) calcium channel blockers (verapamil) Procainamide side effects: a) tachycardia b) hypertension c) drug-induced lupus d) hypotension e) bradycardia Choose class I antiarrhythmic drugs: a) Quinidine gluconate b) Lidocaine c) Flecainide d) Verapamil e) Adenosine Procainamide side effects: a) Nausea b) Hypotension c) Drug-induced lupus d) Tachycardia e) Hypertension 195 Antiarrhythmic drugs classified as sodium channel blockers: a) Quinidine gluconate b) Procainamide c) Phenytoin d) Verapamil e) Adenosine Quinidine gluconate : mechanism(s)/properties of antiarrhythmic activity: a) Inhibition of sodium channel b) Depression of conduction velocity c) Reduced excitability d) Activation of sodium channel e) Activated calcim channel blockade Quinidine gluconate : major clinical use: a) Atrial fibrillation b) Atrial flutter c) Ventricular tachycardia d) AV block e) Cardiac arrest Name arrhythmics: a) verapamil b) enalapril c) metoprolol d) mexiletine e) amiodarone Indicate pharmacological peculiarities characteristic for lidocaine: a) has tropism to certain tissues b) calcium channel blocker c) sodium channel blocker d) can cause neuropsychiatric adverse reactions (in high doses) e) peros bioavailability is reduced, and as a result is administered parenteraly The following are true with regard to lidocaine: a) is local anesthetic b) x is antiarrhythmic drug c) is diuretic drug d) it slows the heart by producing beta-adrenoceptor blockade e) it is effective in the treatment of ventricular arrhythmias The following are true about lidocaine: a) it has a local anaesthetic action lasting for about 2 days b) is more active if injected into an inflameted area c) inhibits the rapid influx of sodium ions into excitable cells d) its action is prolonged by the concurrent use of epinephrine e) has antiarhythmic effetc Characteristics of lidocaine: a) used to treat ventricular arythmia b) is opiod analgesic 196 c) common side effects include sleepiness, muscle twitching, confusion d) is an antiarrhythmic medication e) used in infectous diseases Indicate pharmacological peculiarities characteristic for lidocaine: a) is the choice in ventricular arrhythmias b) sodium channel blocker c) potassium chanel blocker d) calcium channel blocker e) shorten the repolarization Indicate pharmacological characteristics for verapamil: a) is calcium channel blocker b) has a depressing action on the myocardium c) increased therapeutic efficacy in heart failure d) works by blocking the potassium channels e) causes bradycardia The action of calcium blockers (verapamil) on the heart: a) bradycardia; b) automatism diminishing c) contractility diminishing; d) contractility increasing; e) automatism increasing; Calcium channel blocker(s) most likely to affect myocardial contractility and AV conduction: a) nimodipine b) nicardipine c) verapamil d) nifedipine e) diltiazem Agents which decreased ventricular performance: a) theophylline b) metoprolol c) cardiac glycosides d) caffeine e) diltiazem Indicate pharmacological characteristics of amiodarone: a) block membrane sodium channels b) membrane potassium channel blocker c) antiarrhythmic and antianginal effects d) disrupts thyroid function e) is commonly associated with beta-blockers and verapamil Indicate pharmacological peculiarities characteristic for phenytoin: a) Class 1 antiarrhythmic b) is used in digitalis overdose-induced arrhythmias c) is useful in the combination with acetylsalicylic acid d) is used in the treatment of epilepsy 197 e) is calcium channel blocker Name reserpine indications: a) mild to moderate hypertension b) depression c) peptic ulcer d) diarrheic syndrome e) alcoholic psychosis Indicate pharmacological characteristic for raviten: a) is an isothiourea derivative b) hypertensive effect through direct action on the vascular wall c) decreases and body temperature, and oxygen consumption by the organism d) excites alpha1-adrenoceptors e) non-peptide selective inhibitor interacting with the active center of the rennin Name centrally acting antihypertensive drugs: a) clonidine b) sodium nitroprusside c) capropril d) prazosine e) methyldopa Common adverse effects of clonidine are: a) Orthostatic hypotension b) Somnolence c) Diarrhea d) Reflex tachycardia e) Xerostomia Adverse effects associated with clonidine: a) euphoria b) tachycardia c) sedation d) dry mouth e) anxiety Clonidine mechanism of action: a) stimulating presynaptic α2 receptors in the brain b) inhibiting presynaptic α2 receptors in the brain c) inhibiting the release of norepinephrine (NE) d) stimulating the release of norepinephrine (NE) e) inhibiting presynaptic beta 2 receptors Name systemic vasoconstrictor drugs groups: a) alpha-adrenomimetics b) beta-adrenomimetics c) alpha, beta-adrenoblockers d) isothiourea derivatives e) alpha, beta-adrenomimetics 198 Name antihypertensive preparations which acts presynaptically: a) clonidine b) reserpine c) propranolol d) guanethidine e) hydralazine Indicate pharmacological characteristic for captopril: a) increases blood pressure b) acting on the angiotensin receptors c) lower blood pressure d) decreases the angiotensin II level e) inhibit converting enzyme Indicate hypotensives from alpha1-adrenoblockers: a) clonidine b) terazosin c) prazosin d) propranolol e) hydralazine Name drugs with nitrovasodilatator mechanism: a) nitroglycerine b) molsidomine c) sodium nitroprusside d) nitrazepam e) nitrofurantoin Name antianginal drugs which may cause tachycardia: a) propranolol b) nifedipine c) isosorbide dinitrate d) nitroglycerine e) verapamil Indicate the mechanisms of action of antianginal drugs: a) reducing the work of the heart b) reduction of cardiac pre and afterload c) decrease in cytoplasmic calcium d) increased sympathetic tone e) coronary dilatation Name mechanisms of action of antianginal drugs: a) coronary dilatation b) decrease sympathetic tone c) reducing the work of the heart d) increased cardiac afterload and preload e) increase in cytoplasmic calcium Drugs clinically used for management of angina: a) metoprolol 199 b) nadolol c) glycerol d) propranolol e) salbutamol Drug effects that may prevent/terminate angina: a) negative chronotropic drugs b) peripheral vasodilators c) negative inotropic drugs d) positive chronotropic drugs e) coronary vasodilators Toxicities associated with nitrates: a) hypotensive reactions b) drug rash c) dizziness d) hypertension e) headaches caused by meningeal vascular dilatation Antianginal action of calcium channel blockers: a) decreased myocardial wall tension b) coronary artery dilatation c) reduced afterload d) increased preload e) negative inotropism Mechanism basis/bases for antianginal effects of beta-blockers: a) increased preload b) decreased contractility c) increased automatism d) increased blood pressure e) decreased heart rate Calcium channel blocker(s) that cause tachycardia and are most likely to worsen myocardial ischemia: a) nimodipine b) diltiazem c) nicardipine d) verapamil e) amlodipine Main clinical uses of calcium channel blockers are: a) Angina pectoris b) Hypertension c) Supraventricular tachyarrhythmias d) A-V block e) Hypotension Ca channels blocker are: a) Diltiazem b) Verapamil 200 c) Propranolol d) Ivabradine e) Labetolol Characteristis of nitric oxide: a) increases cardiac contractility b) decreases blood pressure c) causes coronarodilation d) causes pulmonary vasoconstriction e) is also known as endothelium relaxing factor Symptoms associated with nitrates: a) hypertension b) tachycardia c) headache d) hypotension e) bradycardia Indicate the mechanisms of antianginal action of organic nitrites and nitrates: a) arterioconstriction and venous constriction b) decrease heart preload and afterload c) decrease in cardiac oxygen consumption d) coronary dilatation e) increase the supply of oxygenated blood Side effects associated with nitrates: a) Bradycardia b) Hypotension c) Headache d) Hypertension e) Diarrhea Pharmacologic features of nitroprusside sodium: a) lead to vasoconstriction b) nitric oxide activates guanylyl cyclase c) forms nitric oxide d) forms methemoglobin e) lead to vasodilation Cardiovascular effects of nitroglycerin: a) increased systemic vascular resistance b) reduced systemic vascular resistance c) ameliorates circulation in the ischemic areas d) negative inotropic and chronotropic effects e) significant reflex tachycardia Indicate side effects of organic nitrites: a) hypertension b) headache c) hypotension d) reflex tachycardia e) tolerance 201 Indicate pharmacological peculiarities characteristic for nitroglycerin: a) is an organic nitrate b) is a volatile explosive liquid c) used in angina pectoris accesses d) is used just sublingually e) to avoid the sublingual use Indicate the effects of organic nitrates: a) coronary dilatation b) arterio dilation c) afterload reduction d) venous constriction e) preload reduction Name antianginal molecular mechanisms of action of nitrites and nitrates: a) stimulates guanylate cyclase b) reduce the level of cGMP c) increase the concentration of cGMP d) blocks the receptors for nitrous oxide e) inhibit adenosine deaminase Name antianginal preparations which may cause tachycardia: a) propranolol b) nifedipine c) isosorbide dinitrate d) nitroglycerine e) verapamil Drugs clinically used for management of angina: a) Atenolol b) Propranolol c) Salbutalol d) Metoprolol e) Cholecalcipherol All these drug groups useful in angina both decrease myocardial oxygen requirement and increase myocardial oxygen delivery: a) Nitroglycerin b) Isosorbide dinitrate c) Atenolol d) Metoprolol e) Alinidine Which of the following statements concerning nitrate mechanism of action is true? a) Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in to vascular smooth muscle target tissues b) Nitric oxide (NO) is an effective activator of soluble guanylyl cyclase and probably acts mainly through this mechanism c) Nitrates useful in angina decrease myocardial oxygen requirementand increase myocardial oxygen delivery d) Nitrates useful in angina only decrease myocardial oxygen requirement 202 e) Nitrates useful in angina only increase myocardial oxygen delivery The following statements concerning mechanism of nitrate beneficial clinical effect are true: a) Decreased myocardial oxygen requirement b) Relief of coronary artery spasm c) Improved perfusion to ischemic myocardium d) Increased myocardial oxygen consumption e) Decreased myocardial oxygen delivery Side effect of nitrates and nitrite drugs are: a) Orthostatic hypotension, tachycardia b) Bradycardia c) Throbbing headache d) Tolerance e) Orthostatic hypertension The following statements concerning antianginal mechanism of calcium channel blockers' action are true: a) are capable of releasing nitric oxide (NO) in vascular smooth muscle target tissues b) bind to L-type calcium channel sites c) decrease myocardial oxygen requirement and increase myocardial oxygen delivery d) decrease transmembrane calcium current associated in smooth muscle with long-lasting relaxation and in a cardiac muscle with a reduction in contractility e) bind to T-type calcium channel sites Which of the following antianginal agents are calcium channel blockers? a) Nitroglycerin b) Dipyridamole c) Minoxidil d) Amlodipine e) Verapamil Which of the following antianginal agents is a beta-adrenoreceptor-blocking drug: a) Dipyridamole b) Validol c) Atenolol d) Alinidine e) Propranolol The following agents are cardioselective beta1-adrenoreceptor-blocking drugs labeled for use in angina: a) Metoprolol b) Talinolol c) Atenolol d) Propranolol e) Nadolol Which of the following antianginal agents is the specific bradycardic drug: a) Dipyridamole b) Validol c) Pentoxiphylline 203 d) Alinidine e) Falipamil Name organic nitrates: a) nifedipine b) nitroglycerin c) sustac mite d) trinitrolong e) minoxidil Name classes of drugs used to treat angina pectoris: a) alfa-adrenomimetics b) beta-adrenomimetics c) beta adrenoblockers d) organic nitrates e) Ca channel blocking drugs Effects of Ca channel-blocking drugs (nifedipine): a) decrease calcium influx into smooth muscle b) increase calcium influx into smooth muscle c) cause vascular relaxation d) cause vascular contraction e) cause reflex tachycardia What are the adverse effects of nitrates? a) flushing (do to vasodilation) b) tachycardia c) hypotention d) hypertention e) headache What are the adverse effects of nitrates? a) met-hemoglobinaemia b) tolerance c) reflex tachycardia d) bradycardia e) hypertention What are the therapeutic uses for beta blockers? a) angina pectoris b) hypertension c) tachyarrhythmias d) bradyarrhythmia e) atrioventricular block What type of cardiovascular side effects do beta blockers have? a) hypotension b) hypertension c) tachycardia d) bradycardia e) atrioventricular block 204 List drugs that are beta blockers: a) metoprolol b) validol c) propranolol d) trinitrolong e) salbutamol List contraindication for beta blockers: a) angina pectori b) hypertension c) tachyarrhythmias d) atrioventricular block e) decompensated cardiac failure List effects of nitrates: a) increase heart rate b) increase the supply off blood flow c) decrease preload and afterload d) increase blood pressure e) decrease heart rate List effects of beta blockers: a) increase heart rate b) increase diastole duration c) decrease cardiac contractility d) increase blood pressure e) decrease heart rate List Beta blockers contraindications: a) hypertention b) systolic heart failure c) peripheral vascular disease d) angina pectoris e) diabetes mellitus Name chemical classes of calcium channel blockers: a) benzodiazepines b) phenylalkylamines c) benzothiazepines d) dihydropyridines e) methylxanthines List adverse effects of calcium channel blockers: a) hypertention b) peripheral edema c) hypotension d) tachycardia or bradycardia e) bronchospasm Drugs used to treat migraine: a) nitrates b) triptans 205 c) d) e) ergot alkaloids nonsteroidal anti-inflammatory drugs beta blockers Name cerebral vasodilators: a) nicergoline b) nitroglycerine c) cinnarizine d) vinpocetine e) niketamide Indicate the group of drugs from cerebral vasodilators: a) Ca-channel blockers b) Antispastic drugs c) Loop diuretics d) Organic nitrates e) Derivatives of Vinca minor plant The following Ergot derivative is used for treatment of acute migraine attack: a) Paracetamol b) Sumatriptan c) Ergotamine d) Metoclopramide e) Methylergometrine The following indol derivatives are used for treatment of acute migraine attack: a) Paracetamol b) Sumatriptan c) Ergotamine d) Metoclopramide e) Zolmitriptan Indicate groups of drugs classified as influencing the cerebral flow: a) Ca2+-channel blockers b) Derivatives of GABA c) Derivatives of Vinca minor plant d) K+-channel blockers e) Benzidiazepines Indicate the drugs which are Ca2+-channel blockers influencing the cerebral blood flow: a) Aminalon (Gama aminobutiric acid) b) Nimodipine c) Cinnarizine d) Heparin e) Vinpocetine Indicate the drugs influencing the blood flow in the brain - derivatives of GABA: a) Aminalon (Gama aminobutiric acid) b) Picamilon c) Nimodipine d) Heparin e) Vinpocetine 206 Indicate the drugs - Vinca minor alcaloids: a) Nicergoline b) Warfarin c) Cinnarizine d) Vinpocetine e) Vincamine The following indol derivatives are used for treatment of acute migraine attack: a) Paracetamol b) Sumatriptan c) Ergotamine d) Metoclopramide e) Zolmitriptan What are the therapeutic benefits of tonicardiacs in heart failure? a) reduce tachycardia b) positive inotropic action c) increase in cardiac output d) vasoconstrictor action e) batmotropic positive action Indicate drugs that can be used in heart failure: a) drugs which lower the contractile force of the myocardium b) vasodilating drugs c) diuretics d) beta-2 adrenomimetics e) converting enzyme inhibitors Indicate adverse effects characteristic for digitalis: a) bradycardia b) anorexia, nausea, vomiting c) headache, confusion d) mydriasis and hyposalivation e) visual disturbances ECG finding(s) consistent with digitalis intoxication include: a) PQ decrese b) third degree heart block c) sinus bradycardia d) ectopic A-V junctional beats e) PQ increase Symptoms of digitalis toxicity include the following: a) tachycardia b) yellow halos around lights (xanthopsia) c) bradycardia d) no vision affection e) hallucinations Positive inotropic agent - phosphodiesterase inhibitor: a) milrinone 207 b) dopamine c) amrinone d) digoxin e) dobutamine The non-glycoside positive inotropic drugs are: a) Digoxin b) Strophantin K c) Dobutamine d) Digitoxin e) Amrinone Primary chemical components of digoxine: a) fat residues b) sugar residues c) steroid nucleus d) lactic acid residues e) lactone ring Cardiac glycosides: principal mechanism of action: a) increases vagal nerve activity b) inhibits calcium transport c) inhibits Na/K ATPase d) activates myocardial leukotrienes e) blocks beta-adrenergic receptors Which of the following agents belong to cardiac glycosides? a) Digoxin b) Strophantin K c) Amrinone d) Digitoxin e) Adoniside Choose derivatives of the plant Foxglove (Digitalis): a) Digoxin b) Strophantin K c) Dobutamine d) Amrinone e) Digitoxin All of the following statements regarding cardiac glycosides are true: a) They inhibit the Na+/K+-ATPase and thereby increase intracellular Ca2+ in myocardial cells b) They inhibit the H+/K+-ATPase from parietal cell c) They inhibit the Na+ K+ Cl- from loop Henle d) The most frequent cause of digitalis intoxication in concomitant administration with diuretics that deplete K+ e) They activate the Na+/K+-ATPase All of the following statements regarding cardiac glycosides are true: a) They inhibit the activity of the Na+/K+-ATPase b) They decrease intracellular concentrations of calcium in myocytes c) They increase vagal tone 208 d) They have a very low therapeutic index e) They increase the tone of sympathetic system All of the following statements regarding cardiac glycosides are true: a) Digoxin is a cardiac glycoside of medium duration of action b) Digoxin increases vagal tone c) Digoxin has a longer half-life than digitoxin d) Digoxin acts by inhibiting the Na+/K+ ATPase e) Amrinone acts by inhibiting the Na+/K+ ATPase The manifestations of glycosides intoxication are: a) Visual changes b) AV block c) Gastrointestinal disturbances d) Pseudomembranous colitis e) Atrial tachyarrhythmias For treatment of digitalis-induced arrhythmias are used the following drugs: a) Quinidine b) Phenytoin c) Lidocaine d) Propanolol e) Procainamide Symptoms of digitalis toxicity: a) disturbed color vision b) nausea c) poliuria d) hypertension e) first-degree A-V block Useful in managing serious ventricular arrhythmias due to digitalis overdosage: a) metoprolol b) phenytoin c) phenylephrine d) adenosine e) potassium administration Indicate effects characteristic for cardiac glycosides: a) negative inotropic b) negative dromotropic c) negative chronotropic d) positive dromotropic e) positive inotropic Indicate effects at the therapeutic doses of digoxin in the heart: a) intensification of the force of contractions of the heart b) bradycardia c) slowing of impulse transmission through the conducting system of the heart d) tachycardia e) decrease heart automaticity 209 Specify mechanism of action of the cardotonic glycosides: a) inhibits phosphodiesterase b) inhibits adenylate cyclase c) inhibits Na + K-ATPase d) increases calcium concentration in cells e) decreases calcium concentration in cells How is modified the concentration of free ions in cardiomyocytes under the influence of cardiac glycosides? a) increases the content of potassium ions b) is reduced potassium ion content c) increases the content of magnesium ions d) increases the content of calcium ions e) is reduced content of calcium ions Name cardiac glycosides indications: a) acute heart failure b) supraventricular tachyarrhythmias c) bradycardia d) angina e) chronic heart failure Name cardiac glycosides indications: a) ventricular tachycardia b) supraventricular tachyarrhythmias c) acute and chronic heart failure d) acute myocarditis e) Wolf-Parkinson-White syndrome The remedies used in intoxication with cardiac glycosides: a) potassium chloride b) unitiol c) phenytoin d) digoxine e) strophantine The symptoms of cardiac glycosides intoxication: a) bradycardia b) tachycardia c) altered color vision (xanthopsia) d) broncospasm e) hyperpotasiemia Drug classes used in management of heart failure: a) diuretics b) NSAIDs c) glycozides d) alpha1 adrenergic agonists e) bipyridines Effect(s) of circulating catecholamines on cardiac function: 210 a) negative dromotropism b) reduced contractility c) negative chronotropism d) increased cardiac output e) positive chronotropism Example(s) of drugs that improve ventricular performance: a) procainamide b) amrinone c) xmilrinone d) propranolol e) levosimendan Cardiac glycosides are still in use today to treat: a) bronchial asthma b) cardiac failure c) atrial fibrillation or flutter d) angyna pectori e) acute hypertention Name the modifications on ECG produced by cardiac glycosides in therapeutical doses: a) no essential modifications b) decrease of R-R c) low amplitude of R d) high amplitude of R e) increasing of R-R Name non glycosides cardiotonics: a) amrinone b) corglycon c) milrinone d) digoxine e) strophantine Choose the positive inotropic drug of glycoside structure: a) Dopamine b) Digoxin c) Dobutamine d) Adrenalin e) Strophantine Choose the positive inotropic drug of non-glycoside structure: a) Digitoxin b) Digoxin c) Dobutamine d) Strophanthin e) Milrinone Name steroid glycosides: a) amrinone b) corglycon c) milrinone 211 d) e) digoxine strophantine List nonsteroidal anti-inflammatory drugs: a) dihydroergotamine mesylate b) sumatriptan c) ibuprofen d) diclofenac e) caffeine List triptans mechanism of action: a) 5HT1b/1d agonist in vasculature b) antagonist of D2 receptors c) vasoconstriction of intracranial blood vessels. d) vasodilatation of intracranial blood vessels. e) block calcium channels Name cardiac glycosides indications: a) ventricular tachycardia b) supraventricular tachyarrhythmias c) acute and chronic heart failure d) acute myocarditis e) Wolf-Parkinson-White syndrome Name selective inhibitors of myocardial phosphodiesterase III: a) theophylline b) dobutamine c) aminophylline d) amrinone e) milrinone Note the mechanisms of action of cardiotonic digitalis: a) the inhibition of Na + / K + ATPase b) the stimulation of Na + / K + ATPase c) increase in cytoplasmic Ca2 + in cardiac fiber d) inhibiting the release from the sarcoplasmic reticulum Ca2 + e) pacemaker stimulation Name orexygenic drugs: a) Vitamins b) Bitters c) Amfepramone d) Insulin e) Carnitine Name drugs that stimulate appetite: a) Insulin b) Bitters c) Sibutramine d) Vitamins e) Amphetamine 212 List remedies with orexigenic effect: а) cyproheptadine б) amphetamine в) phenfluramine г)insulin д) amitryptiline Indicate pharmacodynamic properties of cyproheptadine: a) possesses anticholinergic action b) possesses H1-antihistamine action c) possesses antiserotonin action d) excite the receptors of mouth e) decreases blood glucose Indicate the mechanisms of action of bitter staff: a) reflex stimulate hunger center b) increase appetite as a result of direct action on hunger center c) stimulates the pancreas function d) decreases the elimination of bile e) affect reflectory the central nervous system, which signals the gut to release digestive hormones that stimulate appetite Name the preparations that increase the appetite: a) amfepranone b) insulin c) sibutramine d) bitter stuffs e) mazindol Name cyproheptadine indications: a) gastric ulcer b) allergic rhinitis c) gastritis d) obesity e) anorexia Name the antacid preparations: a) Magnesium trisilicate b) Atropine c) Magnesium oxide d) Sodium bicarbonate e) Sucralfate What drugs are contraindicated in active peptic ulcer? a) phenylbutazone b) pentazocine c) omeprazol d) diazepam e) acetylsalicylic acid Name drugs that intensify gastrointestinal motility: 213 a) Papaverine b) Metoclopramide c) Domperidone d) Cisapride e) Neostygmine Name the mechanism of antiemetic action of metoclopramide: a) H1 and H2-receptor blocking effect b) M-cholinoreceptor stimulating effect c) D2-dopamine receptor blocking effect d) 5-HT3-serotonin receptor blocking effect e) M-cholinoblocking effect Name emetic drugs with reflex action: a) Ipecacuanha derivatives b) Apomorphine hydroclorid c) Chlorpromazine d) Metoclopramide e) Cuprum sulphate Indicate emetics: a) Copper sulfate b) Chlorpromazine c) Pepsin d) Diphenhydramine e) Apomorphine Name antiemetics: a) Metoclopramide b) Ondansetron c) Chlorpromazine d) Apomorphine hydrochloride e) Cuprum sulphate Name drugs with antiemetic effect: a) Scopolamine b) Diphenhidramine c) Chlorpromazine d) Cyproheptadine e) Amphetamine Choose centrally-acting anti-emetics: a) thiethylperazine b) cholestyramine c) bismuth subsalicylate d) chlorpromazine e) lidocaine Indicate antivomiting preparations: a) apomorphine b) metoclopramide 214 c) thiethylperazine d) Paraffin oil e) diphenhydramine Name antacids: a) Misoprostol b) Magnesii oxydum c) Famotidine d) Almagel e) Omeprasole Antacids are: a) sodium bicarbonate b) omeprazole c) almagel A d) cimetidine e) atropine Drug(s) used iin eradication of Helicobacter pylori infection: a) metronidazole b) clarithromycin c) amoxicillin d) remantadine e) tetracycline Choose antacids that may cause constipation: a) aluminium hydroxidum b) aluminium carbonas c) almagel d) magnesii subcarbonas e) magnesii oxydum Choose antacids that may cause diarrhea : a) aluminium hydroxidum b) aluminium carbonas c) almagel d) magnesii subcarbonas e) magnesii oxydum Side Effects of antiacids are: a) Constipation (for Aluminum compounds) b) Diarrhea (for Magnesium compounds) c) Decreases absorption of other drugs d) Constipation (for Magnesium compounds) e) Diarrhea (for Aluminum compounds) Indicate gastric preparations with antisecretory effect: a) omeprazole b) sucralfate c) cimetidine d) pirenzepine e) carbenoxolone 215 List H2 histaminoblockers: a) famotidine b) omeprazol c) lansoprazol d) ranitidine e) cimetidine List proton pump inhibitors: a) famotidine b) omeprazol c) lansoprazol d) ranitidine e) cimetidine Indicate the main effects of atropine in duodenal ulcer: a) stimulates the secretion of gastric glands b) increases the activity of pepsin c) contracts pyloric sphincter d) relaxeses pylorus e) decreases gastric secretion Gastric acid secretion is under the control of the following agents: a) Histamine b) Acetylcholine c) Serotonin d) Gastrin e) Somatostatine Remedies used in hyposecretion of digestive glands are: a) neostigmine b) atropine c) galantamine d) scopolamine e) cimetidine Indicate the drug belonging to proton pump inhibitors: a) Pirenzepine b) Ranitidine c) Omeprazole d) Trimethaphan e) Pantoprazole Pharmaological pecularities of omeprazole are: a) is a prodrug that needs a low pH to be active b) irreversible inhibits proton pump c) is a competitive H2 receptor Antagonist; d) blocks all types of muscarinic receptors e) Chemically neutralizes stomach acid Which of the following drugs is an agent of substitution (replacement) therapy? a) Gastrin 216 b) Diluted hydrochloric acid c) Pepsin d) Carbonate mineral waters e) Omeprazole For substitution of gastric glands secretion are used: a) artificial gastric juice b) natural gastric juice c) pepsin d) omeprazole e) caffeine Choose the drug which is a H2-receptor antagonist: a) Omeprazole b) Pirenzepine c) Carbenoxolone d) Ranitidine e) Famotidine Indicate pharmacodynamic properties of cimetidine: a) block H2 receptors b) blocks M- receptors c) increases the secretion of gastric juice d) H1-receptor blocking e) decreases the secretion of pepsin and HC All of the following drugs are proton pump inhibitors: a) Pantoprozole b) Omeprazole c) Ketoconazole d) Rabeprazole e) Fluconazol Indicate the drug belonging to M1-cholinoblockers: a) Cimetidine b) Ranitidine c) Pirenzepine d) Omeprazole e) Telenzepine Selective M1 receptor antagonists are: a) pirenzepine b) atropine c) telenzepine d) scopolamine e) neostigmine Choose the drug that causes constipation: a) Sodium bicarbonate b) Aluminium hydroxide c) Calcium carbonate d) Magnesium oxide 217 e) Atropine Are H2 receptor antagonist: a) mizoprostol b) nizatidine c) omeprazole d) ranitidine e) famotidine Indicate adverse effects of cimetidine: a) inhibition of liver enzymes b) hypertention c) hyperacidity d) tachycardia e) gynecomastia Choose anti-ulcer agents that block proton generations by parietal cells: a) lansoprazole b) bismuth compounds c) ranitidine d) omeprazole e) sucralfate Acting at prostaglandin EP3 receptors on parietal cells & on epithelial cells prostaglandin agonists inhibits: a) acid secretion b) gastrin release c) pepsin secretion d) mucus secretion e) mucosal blood flow Acting at prostaglandin EP3 receptors on parietal cells & on epithelial cells prostaglandin agonists stimulates: a) acid secretion b) gastrin release c) pepsin secretion d) mucus secretion e) mucosal blood flow Mechanism of Action of Proton Pump Inhibitors: a) bloc H2 histaminoreceptors b) Irreversibly bind to proton pump (H+/K+ ATPase enzyme) c) Preventing the movement of hydrogen ions from the parietal cell into the stomach d) bloc M3 cholinoreceptors e) contain alkaline ions that chemically neutralize stomach gastric acid List indications of Proton Pump Inhibitors: a) aErosive esophagitis b) bZollinger-Ellison syndrome c) cTreatment of H. pylori-induced ulcers; given with an antibiotic d) dGastric carcinoma 218 e) eViral hepatitis Name the groups of substances that reduce the secretion of gastric juice: a) M-cholinoblockers b) antacid remedies c) antigastrinices d) H2- histaminoreceptors blockers e) H1- histaminoreceptors blockers Name gastroprotective drugs: a) famotidine b) omeprazole c) sucralfate d) pirenzepine e) bismuth chelate Name gastroprotectors: a) cimetidine b) bismuth salts c) atropine d) propantheline e) sucralfate Indicate pharmacological characteristic of sucralfate: a) weakly interacts with intact mucosa b) extensively covers the ulcer c) is not absorbed and does not exert systemic effects d) inhibits gastric acid secretion e) possesses purgative effect Name mechanism of action and effects of sucralfate a) protects the gastric and duodenal mucosa from acid/pepsin attack b) does not decrease the concentration or total amount of acid in the stomach c) It works by forming a protective layer on the ulcer to serve as a barrier against acid d) is weak base that neutralize HCl in the stomach e) is synthetic Analog of Prostaglandin E1 Name gatroprotectors drugs that forms a paste-like membrane on the surface of ulcer: a) carbenoxolone b) mizoprosol c) omeprazole d) bismuth subcitrate e) sucralfate Severe obesity may be treated by: a) cyproheptadine b) amphetamine c) phenfluramine d) insulin e) amitryptiline 219 List remedies used in pancreatic hypersecretion: a) x aprotinine b) atropine c) pancreatin d) abomine e) festal Drugs indicated in acute pancreatitis: a) aprotinine b) atropine c) neostigmine d) tramadol e) natural gastric juice List remedies used in inadequate pancreatic secretion: a) aprotinine b) atropine c) pancreatin d) abomine e) festal Name preparations used in pancreas hyposecretion as substitution: a) aprotinin b) digestal c) misoprostol d) pancreatin e) triferment What are the mechanisms of action of aprotinin in acute pancreatitis? a) suppress the secretion of pancreatic juice b) facilitates the excretion of pancreatic juice in the duodenum c) stimulates the activity of proteolytic enzymes in the blood d) inhibits the proteolytic enzymes in the blood e) inhibits the proteolytic enzymes of pancreas Name the drugs used in the treatment of chronic pancreatitis: a) panzinorm b) triferment c) bisacodyl d) pancreatin e) cimetidine Indicate preparations for replacement therapy in hypoacidity of gastric juice: a) pepsin b) natural gastric juice c) artificial gastric juice d) atropine e) drotaverine Indicate characteristic of pharmacological effects of magnesium oxide: a) in large doses have purgative action 220 b) causes constipation c) works longer then sodium bicarbonate d) neutralizes the gastric juice e) acts momentanly Are used in treatment of diarrhea: a) apomorphine b) loperamide c) diphenoxylate d) senadexin e) bisacodil Indicate pharmacological characteristic of castor oil: a) irritate the stomach b) irritate the bowel c) act in the small intestine d) is activated by intestinal juice e) soften the feces by increasing its volume Laxatives and purgatives can act through follow mechanisms: a) stimulates motility through an irritative mechanism b) stimulates direct cholinergic receptors c) difussion growth plus active water and electrolytes secretion d) water retention in the intestines through hydrophilic and osmotic force e) direct softening of defecation Name the drugs with antidiarrheal properties: a) lopiramide b) abomine c) atropine d) morphine e) castor oil Name 3 types of drugs with antidiarrheal properties: a) adsorbents, mucilaginous, opioids b) opiates, absorbents, anticholinergics c) osmotic laxative, anticholinergics, stool softners d) osmotic laxative, stimulants and contact laxatives, stool softners e) cholinomimetics, stool softners, opiates Indicate neurotropic spasmolytics: a) papaverine b) atropine c) butylscopolamine d) neostigmine e) drotaverine Indicate the pharmacodynamics of myotropic spasmolitics: a) H2-receptors stimulates b) inhibits phosphodiesterase c) inhibits H2 receptors d) increases the concentration of cAMP 221 e) stimulates adenylate cyclase Name hepatoprotective preparations: a) carbenoxolone b) silymarin c) sucralfate d) ademethionine e) liv-52 Name hepatoprotective preparations: a) silymarin b) abomine c) LIV-52 d) Essential e) Almagel Name the preparations from cholelitholytics group: a) cholosas b) ursodeoxycholic acid c) alochol d) chenodeoxycholic acid e) colenzim List tensio-active drugs used for fighting flatulence: a) Dimethicone b) Pancreatin c) Almagel d) Simethicone e) atropine Indicate the mechanisms of action of loop diuretics: a) block thiol (SH) groups of the epithelial cells enzymes of ascending part of the loop of Henle b) inhibit energetic processes, diminishing the active absorption of Na, Cl and partially K ions. c) inhibits carbonic anhydrase as a secondary mechanism d) increases osmotic pressure in the blood vessel by attracting fluid bed e) inhibit aldosterone receptors and prevent mineralocorticoid effects. What are the main side effects of furosemide: a) retain uric acid in the body b) retain potassium in the body c) increases excretion of calcium ions d) can cause hyperglycemia e) retain magnesium in the body Indicate adverse effects of furosemide: a) ototoxicity b) hypercalcaemia c) dehydration d) hipernatriemie e) hypokalaemia 222 Adverse effect(s) associated with loop diuretics: a) hyperglycemia b) hyperuricemia c) hypercalcemia d) ototoxicity e) potassium depletion Adverse effect(s) associated with thiazide diuretic use: a) hypercalcemia b) hyperglycemia c) ototoxicity d) potassium depletion e) hyperuricemia Characteristic of mannitol: a) is antagonist of aldosterone b) is indicated just in patient with cardiac failure c) is used just orally d) decreases the vitreous volume e) can be given in acute glaucoma List diuretics used to treat acute intoxication: a) spironolactone b) mannitol c) triamterene d) urea e) amiloride Which of the following diuretics agents would be the LEAST apt to cause hypokalemic alkalosis? a) Furosemide b) Acetazolamide c) Triamterene d) Manitol e) Spironolactone Which of the following diuretics agents would be apt to cause hypervolemia and hypertention at the beginning of the treatment? a) Furosemide b) Urea c) Triamterene d) Manitol e) Spironolactone Indications for thiazides: a) Diabetes mellitus b) Diabetus insipitus c) Hypertension d) Acute glaucoma e) Conn's syndrome Diuretics used to treat hypopotasemia: 223 a) Furosemide b) Acetazolamide c) Triamterene d) Manitol e) Spironolactone The following are true with regard to acetazolamide: a) is a medication used to treat glaucoma b) is a medication used to treat epilepsy c) is a medication used to treat altitude sickness d) is a medication used to treat pulmonary edema e) is a medication used to treat acute intoxications Choose properties of acetazolamide: a) decreases potassium secretion b) increases HCO-3 elimination c) may produce metabolic acidosis d) may produce metabolic alkalosis e) inhibits carbonic anhydrase Choose diuretics least likely to produce hypokalemia: a) chlortalidon b) amilorid c) furosemide d) triamterene e) ethacrynic acid Characteristics of mannitol: a) is a loop Henle diuretic b) is poorly absorbed from the gut c) is used in the treatment of cerebral oedema d) is completely filtered at the renal glomeruli and not reabsorbed from the renal tubule e) is carbonic anhydrase inhibitor Which of the following statements about spironolactone is TRUE? a) Spironolactone reverses many of the manifestations of aldosteronism b) Spironolactone is also an androgen antagonist c) Spironolactone is useful as a diuretic d) Spironolactone is useful as an anti diabetic agent e) Spironolactone is useful as an anti gout drug Potassium sparing diuretic: a) acetazolamide b) triamteren c) chlorothiazide d) bumetanide e) amiloride All of the following statements regarding diuretics are true: a) Carbonic anhydrase inhibition leads to increased reabsorption of NaHCO3 b) Loop diuretics increase Na+ reabsorption at the loop of Henle by competing for the Cl- site 224 on the Na+/K+/2Cl- co-transporter c) Loop diuretics decrease Na+ reabsorption at the loop of Henle by competing for the Cl- site on the Na+/K+/2Cl- cotransporter d) In general, the potency of a diuretic is determined by where it acts in the renal tubule e) Hydrochlorothiazide decreases urinary calcium excretion These drugs should never be administered to patients taking potassium supplements: a) Hydrochlorothiazide b) Amilorid c) Furosemide (Lasix) d) Spironolactone e) Triamterene The drug acts by competitively blocking the Na+/K+/2Cl- cotransporter: a) Furosemide b) Indapamid c) Spironolactone d) Sulthiam e) Torasemide The drug acts in the distal convoluted tubule: a) Loop diuretics b) Thiazide diuretics c) Potassium-sparing diuretics d) Carbonic anhydrase inhibitors e) Thiazide like diuretics List Loop diuretics: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Amiloride e) Torasemide These drugs act by affecting the tubular fluid composition by increasing of osmotic pressure: a) Furosemide b) Acetazolamide c) Triamterene d) Mannitol e) Urea List drugs used in gout treatment: a) xallopurinol b) furosemide c) sulphinpyrazone d) aspirin e) acetazolamide List drugs used in gout crises: a) prednisolone b) aspirin 225 c) dexamethasone d) penicillin e) acetazolamide Potassium sparing diuretics: a) Bumetanide b) Chlorothiazide c) Amiloride d) Spironolactone e) Mannitol The drug inhibits the enzyme carbonic anhydrase: a) Furosemide b) Spironolactone c) Sultiam d) Acetazolamide e) Torasemide The drug acts by competitively blocking NaCl cotransporters in the distal tubule: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Indapamide The drug acts by competing with aldosterone for its cytosolic receptors, EXCEPT: a) Acetazolamide b) Furosemide c) Hydrochlorothiazide d) Spironolactone e) Triamteren The drug is a potassium-sparing diuretic that blocks Na+ channels in the collecting tubules: a) Furosemide b) Amiloride c) Spironolactone d) Triamteren e) Hydrochlorothiazide The drug has a steroid-like structure which is responsible for its anti-androgenic effect, EXCEPT: a) Spironolactone b) Hydrochlorothiazide c) Furosemide d) Amiloride e) Triamteren The drug acts by competitively blocking the Na+/K+/2Cl- cotransporter: a) Ehacrinic acid b) Indapamid c) Spironolactone 226 d) Furosemide e) Acetazolamide Name of heparin therapeutic indications: a) thrombophlebitis b) thromboses and thrombembolisms c) to prevent osteoporosis d) cardiac and vascular surgery e) anemias Name heparin therapeutic indications: a) Thrombophlebitis b) Deep-vein thrombosis and pulmonary embolism c) Thrombocytopenia d) Brain aneurysm e) Myocardial Infarction Characteristics of warfarin: a) inhibits the vitamin K-dependent synthesis of clotting factors b) inhibit tromboxane activity c) is indirect anticuagulant d) is well absorbed from the gastrointestinal system e) the common side effect is bleeding. Characteristic of warfarin: a) has a higher molecular weight than heparin b) is metabolized chiefly by liver c) works directly binding with AT III d) interferes with the production of factor II, VII, IX and X e) its control is based on the prothrombin time Characteristic of Heparin: a) is found in the human mast cells b) is not active if given orally c) lowers the plasma triglyceride level d) binds to anti-thrombin III and increases its inactivation of thrombin e) is reversed by administration of vitamin K Indicate pharmacological characteristics for nadroparin: a) prophylaxis of thromboembolic disease b) equal anticoagulant and antifybrinolitic actions c) low molecular weight heparin d) high molecular weight heparin e) oral and injectable administration Indicate pharmacological effects of heparin: 227 a) binds to the enzyme antithrombin III b) inactivates thrombin, factor Xa and other proteases c) has additional anti-inflammatory action d) favors platelets agglutination e) atherosclerotic action Nume indications of heparin: a) thrombophlebitis b) arterial thrombosis and embolia c) myocardial infarction d) cardiac and vascular surgery e) anemia Name pharmacodinamic effects of cumarinic anticoagulants: a) decrease hepatic synthesis of factors: II, VII, IX, X b) antifibrinolytic action c) are antimetabolites of vitamin K d) decrease platelet aggregation e) are used parenterally Note the mechanism of antiplatelet action of dipyridamole: a) inhibits TXA2 synthesis through acetilation of cyclooxygenase b) blocks uptake and metabolism of adenosine c) serotonin antagonist effect d) inhibits phosphodiesterase and increases the AMPc e) inhibits synthesis of TXA2 by blocking thromboxane synthase All of the following groups of drugs are for thrombosis treatment: a) Anticoagulant drugs b) Antifibrinolitic drugs c) Fibrinolitic drugs d) Antiplatelet drugs e) Coagulant drugs Choose the drug belonging to anticoagulants of direct action: a) Acetylsalicylic acid b) Heparin c) Acenocumarol d) Phenandione e) Nandroparin Choose drugs used as oral anticoagulants: a) Enoxaparin b) Acenocumarol c) Daltreparin d) Heparin e) Warfarin Choose antiplatelet agents: a) Dipyridamole b) Ticlopidine c) Heparin 228 d) Dazoxiben e) Lamifiban Which of the following drugs is an inhibitor of platelet glycoprotein IIb/IIIa receptors? a) Acetylsalicylic acid b) Clopidogrel c) Ticlopidine d) Abciximab e) Eptifibatide Which of the following drugs are fibrinolytics? a) Ticlopidine b) Streptokinase c) Acetylsalicylic acid d) Warfarin e) Alteplase Fibrinolytic drugs are used for following: a) Acute myocardial infarction b) Heart failure c) Multiple pulmonary emboli d) Central deep venous thrombosis e) GI bleedings Indicate the drug belonging to fibrinoliytic inhibitors: a) Aminocapronic acid b) Ticlopidine c) Streptokinase d) Vitamin K e) Tranexanic acid Indicate the drugs used in deep venouse thrombosis: a) phytomenadione b) alteplase c) aminocapronic acid d) heparin e) aprotinine Name phytomenadione contraindications: a) tromboembolia b) thrombophlebitis c) blood hypercoagulability d) overdose of coumarins e) hipovitaminosis K Pharmacological characteristics of phytomenadione are: a) promotes hepatic synthesis of clotting factors b) the effect increases in case of liver cells damege c) used to treat haemorrhages related to vitamin K deficiency d) antidote is protamine sulfate e) binds to the enzyme inhibitor antithrombin III (AT) 229 Indicate antifibrinolytic drugs: a) carbazocrom b) aminocaproic acid c) batroxobin d) aprotinine e) etamsilat Pinpoint causes of acetylsalicylic acid should be avoided in patients under treatment with heparin: a) inhibits the synthesis of vitamin K b) interfers with metabolism of heparin c) is fibrinolytic d) inhibit the aggregation of platelets e) causes hemorrage because of tromboxane inhibition Indicate pharmacological characteristics of warfarin: a) inhibits the synthesis of factors II, VII, IX, X b) is avoided in pregnancy c) used just intravenously d) indicated in the treatment of thrombosis e) is oral anticoagulant Name indications of heparine: a) thrombophlebitis b) arterial thromboses and embolia c) hemophilia d) brain aneurysm e) myocardial infarction Indicate the heparin drugs with low molecular weight: a) clopidogrel b) enoxaparin c) dalteprarin d) hirudin e) nadroparin Indicate pharmacological characteristics of clopidogrel: a) is drug of heparin b) stimulates antithrombin II, and blocks thrombin and X factor c) selectively and irreversibly inhibits platelets receptors of ADP and decrease aggregation d) used for the prevention of thrombosis e) may cause thrombotic thrombocytopenic purpura and hemorrhage Indicate the antiaggregant drugs: a) abciximab b) tirofibad c) heparin d) eptifibatide e) acenocumarol Indicate pharmacological characteristics of streptokinase: 230 a) fibrinolytic action b) is indicated in thrombophlebitis c) antiaggregant effect d) inhibits the synthesis of prothrombin in the liver e) is contraindicated in the postoperative period What are the differences between heparins with low molecular weight(LMWH) versus standard heparin: a) oral administration for LMWH b) marked inhibition of Factor Xa for LMWH c) marked human thrombin inhibition for LMWH d) x longer duration of action of for LMWH e) for LMWH does not cause osteoporosis Indicate the pharmacological characteristic for coumarin anticoagulants (oral): a) fast action and short-duration b) inactivates the enzymes and complex factors Xa, IXa, XIIa, XIa c) are active both in vitro and in vivo d) in case of hemorrhagic accidents specific antidote is phytomenadione e) pass through the placental barrier, and in breast milk Indicate pharmacological characteristics of streptokinase: a) is extracted from Streptomices venezuelae cultures filtrate b) activates convertion of plasminogen in plasmin (fibrinolyitic enzyme) c) long half-life allows oral administration d) can be useful in acute myocardial infarction, pulmonary embolism, deep vein thrombosis, peripheral artery occlusion e) has not been described serious adverse reactions Indicate the pharmacological peculiarities of acetylsalicylic acid as platelet antiaggregatory agent: a) used 1 time per week b) is useful (among other information) in patients with unstable angina, suspects of myocardial infarction c) its given in high doses d) is given by inhibiting cyclooxygenase e) main contraindications are allergy, gastrointestinal bleeding, peptic ulcer Indicate anti-haemorrhagics with systemic action: a) heparin b) nandroparine c) phytomenadione d) fibrinogen e) blood clotting factors Name preparations used for local hemostasis: a) epinephrine b) thromboplastin c) thrombin d) fibrin e) phytomenadion 231 Indicate hemostatics with antifibrinolytic mechanism of acting: a) tromboplastin b) aprotinin c) aminocaproic acid d) etamsilate e) carbazochrome Indicate drugs used in leucopenia: a) heparin b) methyluracil c) cyanocobalamine d) pentoxil e) phenindione Indicate the coagulant drugs: a) menadione b) cyanocobalamine c) thrombin d) acenocumarol e) heparin Indicate hemostatics: a) acenocumarol b) aminocaproic acid c) warfarine d) fibrinogen e) heparin Indicate hemostatics with topic action: a) heparin b) trombin c) menadion d) human fibrine e) gelatine Indicate direct anticoagulants: a) heparin b) acenocumarol c) fibrinolysin d) nadroparin e) sodium hydrocytrate Indicate the indirect anticoagulants: a) acenocumarol b) heparin c) phenindione d) warfarin e) sodium cytrate Name antifibrinolytics indications: a) hyperfibrinolysis b) thrombophlebitis 232 c) acute pancreatitis d) traumatic, hemorrhagic and septic shock e) myocardial infarction Name fibrinolytics indications: a) pulmonary thrombembolia b) acute myocardic infarction c) arterial and venoase thrombosis d) thrombocytopenia e) hyperfibrinolysis Name indications of indirect coagulants: a) gastric hemorrhage b) thrombophlebitis c) parenchymal and capillary hemorrhages d) indirect anticoagulants overdose e) arterial and venous thrombosis Indicate the mechanism of anticoagulant action of heparin: a) activates antihtrombin III b) decrease activity of factors IX,X,XI,XII and calicrein c) inhibits tromboplastin activitaty and blocks convertion of protrombin in trombin d) inhibits protrombine synthesis in the liver e) activates natural fibrinolysis Name antiaggregants indications: a) arterial thrombosis prophylaxis b) myocardial infarction c) ischemic cardiopathy d) cerebral circulatory disorders e) parenchymal and capillary hemorrhage Name antifibrinolytics indications: a) haemorrhages caused by hyperfibrinolysis b) predisposition to thrombosis c) hepatic cirrhosis d) streptokinase overdose e) arterial thrombosis Indicate the mechanism of antifibrinolytic effect of aminocapronic acid: a) decrease plasmin activity b) inhibits synthesis of clothing factors c) increase plasmin activity d) use in the treatment of thrombosis e) use in the treatment of acute bleeding due to elevated fibrinolytic activity Indicate pharmacologic characteristics of indirect anticoagulants: a) absorbed orally b) inhibit epoxi-reductase that convert vit. K to active form of vit. K c) they cross the placental barrier d) used in hemorrhagic syndrome e) are safe drugs and can be used in pregnancy 233 Name the drugs which stimulates leucopoesis: a) cyanocobalamine b) pentoxil c) iron sulphate d) sodium nucleinat e) coamide Name main characteristics of heparin: a) active both in vivo and in vitro b) the effect appears after 18-24 hours and last for some hours c) activates antithrombin III d) the effect appears almost immediately, and lasts for 3-6 hours e) inbibits blood clotting only in vitro Which drugs decrease platelets aggregation? a) dazoxiben b) acetylsalycylic acid c) ridogrel d) streptokinase e) heparin Inhibition of which enzymes are the base of antiaggregants actions: a) monoaminoxidase b) phosphodiesterase c) lipooxygenase d) cholinesterase e) cyclooxygenase Name direct anticoagulants: a) acenocumarol b) heparin c) sodium cytrate d) nadroparine e) streptokinase With regard to iron drug in the human body: a) it is stored chiefly in the bone marrow b) 70% of iron in the body is found in the haemoglobin c) it is transported in the body as transferrin d) it is absorbed mainly in the ferric form e) the liver excretes excess iron Pernicious anemia is: a) A severe form of anemia most often affecting elderly adults, caused by a failure of the stomach to absorb vitamin B12 b) A form of anemia in which the capacity of the bone marrow to generate red blood cells is defective, caused by a bone marrow disease or exposure to toxic agents, such as radiation, chemicals, or drugs c) Anemia characterized by a decrease in the concentration of corpuscular hemoglobin d) Is characterized by abnormally large red blood cells, gastrointestinal disturbances, and 234 lesions of the spinal cord e) Anemia characterized by an increase in the concentration of corpuscular hemoglobin The administration of histamine in man can produce: a) bronchodilatation b) increased gastric acid secretion c) vasodilation and edemas d) negative chronotropic action e) reduced secretion of intrinsic factors Indicate effects characteristic for the NSAIDs remedies: a) xanti-inflammatory b) antihistamine c) adrenergic d) ganglioblocant e) analgesic Common Uses of non-steroidal anti-inflammatory drugs (NSAIDS): a) used to increase intraocular pressure b) used to relieve pain c) used in bronchal asthma d) used to treat arthritis e) used to reduce signs of inflammation Name correctly the mechanism of action for acetylsalicylic acid: a) inhibits phospholipase A2 b) inhibit cyclooxygenase c) decreased prostaglandin production d) increases thromboxane A2 production e) decreases leukotrienes Name effects of piroxicam: a) analgesic b) antispasmodic c) anti-inflammatory d) anxiolitic e) anticoagulant What effects are caused by inhibition of COX synthesis? a) antiplatelet b) immunosuppressive c) antiallergic d) antipyretic e) analgesic What are the mechanisms of action of antiplatelet action of acetylsalicylic acid? a) inhibits platelet aggregation by stimulating adenylate cyclase b) intensifies the synthesis of thromboxane A2 c) inhibits the synthesis of thromboxane A2 d) irreversibly inhibits cyclooxygenase e) inhibits phosphodiesterase 235 Name typical effects of steroidal anti-inflammatory remedies: a) xanti-inflammatory b) immunostimulatory c) desensitizing d) immunosuppressive e) cholinomimetic Choose non-steroidal anti-inflammatory drugs: a) Phenylbutazone b) Ketoprofen c) Ketorolac d) Triamcinolone e) Hydroxychloroquine Choose nonsteroidal anti-inflammatory drugs from propionic (arilpropionic) acid derivatives: a) phenylbutazone b) ketorolac c) ibuprofen d) diclofenac e) naproxen Choose nonsteroidal anti-inflammatory drugs from indole derivatives: a) Indomethacin b) Sulindac c) Diclofenac d) Ketoprofen e) Naproxen Choose non-steroidal anti-inflammatory drugs from oxicams: a) Indomethacin b) Sulindac c) Piroxicam d) Tenoxicam e) Lornoxicam Choose non-selective non-steroidal anti-inflammatory drugs: a) Meloxicam b) Celecoxib c) Piroxicam d) Tenoxicam e) Lornoxicam Choose selective nonsteroidal anti-inflammatory drugs: a) Meloxicam b) Celecoxib c) Piroxicam d) Tenoxicam e) Lornoxicam Choose steroidal anti-inflammatory drugs: a) Meloxicam 236 b) Celecoxib c) Prednisone d) Prednisolone e) Methylprednisolone Choose steroidal anti-inflammatory drugs with moderate anti-inflammatory and mineralocorticoid effects: a) Cortisone b) Hydrocortisone c) Prednisone d) Prednisolone e) Methylprednisolone Choose steroidal anti-inflammatory drugs with marked anti-inflammatory effect and practically free from effects of salt and water retention: a) Cortisone b) Betamethasone c) Dexamethasone d) Prednisolone e) Methylprednisolone Choose slow-acting anti-inflammatory drugs from gold compounds: a) Sodium aurothiomalate b) Aurothioprol c) Auranofin d) Phenylbutazone e) Hydroxychloroquine Choose slow-acting anti-inflammatory drugs from 4-aminoquinoline derivatives: a) Sodium aurothiomalate b) Aurothioprol c) Chloroquine d) Phenylbutazone e) Hydroxychloroquine Choose slow-acting anti-inflammatory drugs from cytotoxics: a) Cyclophosphamide b) Azathioprine c) Methotrexate d) Chloroquine e) Hydroxychloroquine Choose characteristics of COX-2: a) It is a constitutive enzyme expressed in most tissues b) It has a "housekeeping" role in the body c) It is induced in inflammatory cells when they are injured d) It is induced in inflammatory cells when they are activated by the inflammatory cytokine IL-1 e) It is induced in inflammatory cells when they are activated by the inflammatory cytokine TNF-alpha Mechanisms of action of nonsteroidal anti-inflammatory drugs: 237 a) Block COX b) Block phospholipase A2 c) Block 5 lipooxigenase d) block synthesis of leucotriens e) Decrease synthesis of prostaglandins Mechanisms of action of steroidal anti-inflammatory drugs: a) Block Cholinestarase b) Block phospholipase A2 c) Activate directly COX2 d) Activate 5 lipooxigenase e) Decrease synthesis of prostaglandins Mechanisms of action of steroidal anti-inflammatory drugs: a) Decrease expression of COX-2 b) Increase synthesis of lipocortine c) Decrease synthesis of lipocortine d) Increase synthesis of prostaglandins e) Decrease synthesis of leukotriens Choose the effects of nonsteroidal anti-inflammatory drugs: a) Anti-inflammatory b) Analgesic c) Antipyretic d) Bronchodilator e) Decrease blood pressure Choose the effects of nonsteroidal anti-inflammatory drugs: a) Antiagregant b) Moderate desensitizing c) Tocolytic d) Orexigenic e) Anorexigenic Choose peculiarities of analgesic effect of the nonsteroidal anti-inflammatory drugs: a) They are effective against mild or moderate pain b) They are effective against pain arising from inflammation c) Their ability to relieve headache may be related to the reduction in vasodilator prostaglandins acting on the cerebral vasculature d) Their analgesic effect develops only when used in combination with opiod analgesics e) Higher analgesic effect than opioids Choose indications for nonsteroidal anti-inflammatory drugs: a) Ankylosing spondylitis b) Dysmenorrhoea c) Acute gout d) Arterial hypertension e) Bleedings from varicose veins of the esophagus Choose indications for nonsteroidal anti-inflammatory drugs: a) Headache and migraine b) Musculoskeletal injuries and pain 238 c) Osteoarthritis d) Gastric ulcer e) Duodenal ulcer Choose indications for nonsteroidal anti-inflammatory drugs: a) Postoperative pain b) Rheumatoid arthritis c) Secondary prevention of vascular events among patients with a history of vascular events d) Bronchial asthma e) Hemorrhagic cerebro-vascular accidents Choose indications for nonsteroidal anti-inflammatory drugs: a) Hyperpyrexia (fever) b) Migaine c) Osteoarthritis d) Neuroleptic malignant syndrome e) Hyperprolactinemia Choose specific side effects of nonsteroidal anti-inflammatory drugs: a) Hemathopoetic deregulations b) Gastrointestinal bleeding c) Interstitial nephritis d) Arterial hypotension e) Bradycardia Choose side effects of nonsteroidal anti-inflammatory drugs: a) Bronchospasm b) Renal papillary necrosis c) Gastric ulcers d) Bronchodilation e) Osteoporosis Choose side effects of nonsteroidal anti-inflammatory drugs: a) Gastrointestinal bleedings b) Thrombocytopenia c) Aspirin - Reye's syndrome d) Tachycardia e) Hyperglycemia Choose side effects of nonsteroidal anti-inflammatory drugs: a) Suppression of gastroprotective prostaglandins in the gastric mucosa b) Neutropenia c) Abnormal liver function tests and rare liver failure d) Moon face e) Buffalo hump Choose side effects of nonsteroidal anti-inflammatory drugs: a) Aplastic anemia b) Cutanous rashes c) Reversible renal insufficiency d) Obesity e) Rebound syndrome 239 Which of the following property combinations is peculiar to the majority of NSAIDs? a) Anti-inflammatory, immunodepressive, antihistaminic b) Antipyretic, analgesic, anti-inflammatory c) Immunodepressive, anti-inflammatory, analgesic d) Antipyretic, analgesic, anti-aggregant effect e) Immunodepressive, anti-inflammatory, antipyretic Which of the following are NSAIDs? a) Indomethacin b) Clarithromycin c) Metamizole d) Diclofenac e) Ketorolac Which of the following NSAIDs are not indol derivatives? a) Diclofenac b) Meclofenamic acid c) Indomethacin d) Ibuprofen e) Ketorolac Which of the following NSAIDs are selective COX-2 inhibitors? a) Diclofenac b) Celecoxib c) Indomethacin d) Piroxicam e) Nimesulid The following statements concerning acetylsalicylic acid are true: a) Acetylsalicylic acid inhibits tromboxane A2 formation b) Acetylsalicylic acid inhibits phospholipase A2 c) Acetylsalicylic acid causes Reye syndrome d) Acetylsalicylic acid irreversibly inhibits COX e) Acetylsalicylic acid stimulates tromboxane A2 formation Indication for acetylsalicylic acid administration are the following: a) Reducing elevated body temperature b) Relieving severe visceral pain in acute abdomenum c) Decreasing the incidence of transient ischemic attack d) Treatment of gastric ulcer e) Inflammatory conditions Anti-inflammatory effect of steroidal anti-inflammatory drugs develops due to: a) Decreased recruitment of WBC (White blood cells) and monocyte-macrophage into affected areas b) Decreased elaboration of chemotactic substances c) Increased lipocortin synthesis d) Decreased lipocortin synthesis e) Increased recruitment of WBC and monocyte-macrophage into affected areas Anti-inflammatory effect of steroidal anti-inflammatory drugs develops due to: 240 a) Decreased synthesis of IL1 by monocyte-macrophage b) Decreased formation of plasminogen activator c) Decreased synthesis of arachidonic acid d) Increased synthesis of IL1 by monocyte-macrophage e) Increased formation of plasminogen activator Anti-inflammatory effect of steroidal anti-inflammatory drugs develops due to: a) Decreased fibroblastic activity b) Decreased expression of COX-2 c) Increased synthesis of arachidonic acid d) Increased expression of COX-2 e) Decreased expression of lipocortin Choose contraindications for steroidal anti-inflammatory drugs: a) Vaginal yeast infections b) Patients who are in high risk for infection c) Peptic ulcer d) Systemic lupus erythematosus e) Wegener's granulomatosis Choose contraindications for steroidal anti-inflammatory drugs: a) Fungal infections b) Diabetes mellitus c) Hypertension d) Rheumatoid arthritis e) Psoriatic arthritis Choose synonyms of slow-acting anti-inflammatory drugs: a) Anti-rheumatoid drugs b) Disease modifying anti-rheumatic drugs (DMARDs) c) Non-steroidal anti-inflammatory drugs (NSAIDs) d) Steroidal anti-inflammatory drugs (SAIDs) e) Selective COX-2 inhibitors Name slow-acting , anti-inflammatory drugs: a) chloroquine b) prednisone c) diclofenac d) D-penicillamine e) cortisol What side effects can be caused by glucocorticoids? a) increased blood pressure b) increased intraocular pressure c) central nervous system stimulation d) hyperkalemia e) gynecomastia Chronic administration of glucocorticoids results in: a) hypertension b) hyperkalaemia c) hypercalcemia 241 d) hyperglicemia e) ocular hypertension Corticosteroid inhibits: a) inflammatory proceses b) allergic reactions c) immunity d) gluconeogenesis e) lipocortin production The following are true about corticosteroids: a) they are synthesized in the adrenal medulla b) are produced in the adrenal cortex c) chronic use may predispose to cataract and retinopathy. d) they suppress immune reactions e) cause a movement of body fat to the face and torso Choose pharmacological properties of gold compounds: a) Alter morphology and function of macrophages b) Are used in early stages of adult and juvenile rheumatoid arthritis c) Side effects are cutaneous reactions such as erythema and exfoliative dermatitis d) Side effects are blood dyscrasias and renal toxicity e) Block COX (cyclooxigenase) and LOX-5 (lipoxygenase -5) Choose correct affirmations concerning mechanisms of action of 4-aminoquinoline derivatives: a) Suppress T-lymphocyte responses to mitogens b) Decrease leukocyte chemotaxis c) Stabilize lysosomal enzymes d) Block COX-1 (cyclooxigenase 1) e) Block COX-2 (cyclooxigenase 2) Choose correct affirmations concerning mechanisms of action of 4-aminoquinoline derivatives: a) Inhibit DNA and RNA synthesis b) Trapping of free radicals c) Block PL-A2 (phospholipase A2) d) Increase expression of lipocortin e) Decrease expression of lipocortin Name anti-inflammatory effects of 4-aminochinolinic derivatives? a) do not change radiological manifestations of the disease b) develop slowly, not earlier than 4-8 weeks, up to 6-12 months, with reduction of inflammation, and rheumatoid factor titre c) are associated with the analgesics d) appear rapidly, and are used in the acute period e) are used to reduce platelet aggregation Choose pharmacological properties of hydroxychloroquine: a) Is used in the treatment of rheumatoid arthritis b) Is used in the treatment of juvenile chronic arthritis c) Can cause retinal degeneration 242 d) Block PL-A2 (phospholipase A2) e) Increase expression of lipocortin Choose pharmacological properties of hydroxychloroquine: a) Is used for short-term treatment of acute malaria b) Is used in the treatment of Systemic lupus erythematosus c) Can affect the eyes d) Can cause rheumatoid arthritis e) Can cause Systemic lupus erythematosus Choose pharmacological properties of penicillamine: a) works by binding heavy metals b) should not be used in combination with gold compounds c) it is used in the treatment of Sclerodermia d) side effect is aplastic anemia e) It is used in the treatment of postoperative pain Choose pharmacological properties of penicillamine: a) Penicillamine works by binding heavy metals b) It is used in the treatment of resistant cases of rheumatoid arthritis c) Side effect is membranous glomerulonephritis d) It is used in the treatment of aplastic anemia e) It has antipyretic action Name drugs used in immediate-allergy : a) dexamethasone b) clemastine c) epinephrine d) metotrexat e) chloroquine Indicate the pharmacological effects of H1-antihistamines: a) antivomiting effect b) hypnotic effect c) antiallergic effects d) gastric antisecretory effect e) immunostimulatory Name additional nonhistamine-related effects of antihitamines: a) Antimuscarinic reduction in bladder tone b) Local anesthetic effects if the drug is injected c) Anti-motion sickness effects d) Increase in total peripheral resistance e) Sedation Name effects of antihistamines : a) Euphoria and /or disphorya b) Anticholinergic peripheral effect c) Vomiting d) Antiemetic e) Sedation 243 Which of the H1 antihistamines are used to prevent vomiting? a) astemisol b) promethazine c) terfenadine d) diphenhydramine e) loratadine These categories of histamine H1 antagonists are noted for sedative effects: a) Phenothiazines; b) Ethylenediamines; c) Ethanolamines d) Piperidines; e) Piperazines These histamine H1 antagonists are recognized for as second-generation antihistamines: a) Phenothiazines; b) Ethylenediamines; c) Ethanolamines d) Piperidines; e) Piperazines Indications for administration of 1st generation histamine H1 antagonists are the following: a) Treatment of sleep disorders b) Nausea and vomiting in pregnancy ("morning sickness") c) Management of seizure states d) Alcoholism e) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria) Side effects of first-generation histamine H1 antagonists are: a) Gastric ulcers and upper gastrointestinal bleeding b) Sedation c) Dry mouth d) Vomiting, tinnitus, decreased hearing e) Aplastic anemia The following are true about anti-histamines 1st generation: a) they inhibit the release of histamines from mast cells b) they have anticholinergic effects c) they can be used as anti-emetic agents d) they increase blood pressure e) they reduce gastric secretion Name drugs from the I-generation antihistamines: a) - chloropyramine b) - clemastine c) - loratadine d) - cetirizine e) - diphenhydramine Name contraindications for H1 antihistamines: 244 a) drivers b) hepatic and renal insufficiency c) depressive states d) rhinitis e) hight fever Pharmacodynamic actions of H1 antihistamines, to antagonize the effects of histamine are: a) prevent bronchial spasm b) prevents uterine spasm c) total antagonize the effects of anaphylactic shock d) prevents intestinal spasm e) decrease gastric secretion Ketotifen has the following properties: a) antiserotoninic b) blocks H1 receptors c) inhibit degranulation of mast cell d) anticholinergic e) inhibits histamine release Name antiallergic without sedative effects: a) astemizole b) diphenhydramine c) loratadine d) promethazine e) clemastine Name effects of H1-antihistamines (I generation) : a) antiallergic b) emetic c) sedative d) hypothermic e) orexigen Contraindications and precautions for H1-antihistamines 1st generation : a) prostate hypertrophy b) Menier disease c) hypotension d) liver and kidney disease e) polynosis Name mechanism of action of H1 antihistamins: a) contain a groupe ethanolamino as histamine has, works competitively b) works by preventing the release of natural chemicals from cells in the body (mast cells) involved in an allergic reaction c) inhibit competitively H1 receptors and the corresponding effects i. e. vasodilation and capillary permeability increase d) are envisaged to enhance body's resistance against infections e) do not inhibit antigen/antibodies reactions, nor histamine release, they inhibit H1 effects Name I generation antihistamines: 245 a) cloropiramine b) clemastine c) loratadine d) cetirizine e) x, diphenhydramine The following are mast cell stabilizers: a) disodium cromoglycate b) loratadine c) ketotifen d) clemastine e) nedocromil The effects of anti-histamines of I generation: a) sedation b) arrhythmogenic effect c) atropine like effects d) anti-vomiting effect e) local anesthetic effect Name pharmacological effects of H1-antihistamines (I generation): a) antiallergic b) emetic c) antiparkinsonian d) hypothermic e) anorectic Indication for administration of histamine H1 antagonists is: a) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria) b) Motion sickness and vestibular disturbances c) Nausea and vomiting in pregnancy ("morning sickness") d) Gastric and duodenal ulcer e) Acute pancreatitis These histamine H1 antagonists are recognized for as second-generation antihistamines: a) Astemizole b) Loratadine c) Cetirizine d) Clemastine e) Chlorophiramine Indications for administration of histamine H1 antagonists are the following: a) Prevention or treatment of the symptoms of allergic reactions (rhinitis, urticaria) b) Management of seizure states c) Nausea and vomiting in pregnancy ("morning sickness") d) Treatment of sleep disorders e) Acute psychosis Choose examples of second-generation antihistamine: a) loratadine b) cyproheptadine c) astemizole 246 d) diphenhydramine e) cetirizine Choose antihistaminics most likely to exhibit anticholinergic activity: a) clemastine b) terfenadine c) cetirizine d) astemizole e) diphenhydramine Name therapeutic indications of cyproheptadine: a) vomiting b) allergic rhinitis c) gastric ulcer d) viral hepatitis e) anorexia nervosa Indicate glucocorticoids effects: a) antiallergic b) immunostimulant c) anti-shock d) xanti-inflammatory e) anabolic What is entomology immunomodulatory preparations? a) extracted from insect tissues b) alkaloids c) containing essential and nonessential amino acids d) preparations of the thymus e) are polypeptides acquired by genetic engineering involving E. coli. What are the indications for immunomodulatory entomological preparations? a) conditions with decreasing resistance body b) bronchial asthma c) gastrointestinal bleeding d) infectious and inflammatory diseases with immunodeficiency e) duodenal ulcers Select an endocrine drug which is an amino acid derivative: a) Insulin b) Hydrocortisone c) Calcitonin d) Levothyroxine e) Liothyronine Select endocrine drugs which are peptide derivatives a) Progesterone b) Nandrolone c) Prednisolone d) Oxitocin e) Calcitonin 247 Select endocrine drugs which are steroidal derivatives: a) Gonadorelin b) Insulin c) Levothyroxine d) Hydrocortisone e) Levonorgestrel Which of the following hormones are produced by the hypothalamus? a) Estradiol b) Aldosterone c) Follicle-stimulating hormone (FSH) d) Growth hormone-releasing hormone (GHRH) e) Somatostatin Which of the following hormones are produced by the anterior lobe of the pituitary? a) Thyrotropin-releasing hormone (TRH) b) Corticotropin-releasing hormone (CRH) c) Growth hormone (somatotropin, GH) d) Growth hormone-releasing hormone (GHRH) e) Follicule-stimulating hormone (FSH) All of the following statements about growth hormone are true: a) Stimulates growth, cell reproduction, and cell regeneration b) Hypersecretion can result in acromegaly c) Hyposecretion can result in acromegaly d) It is contraindicated in subjects with closed epiphyses e) It is secreted by suprarenal glands Correct statements about adrenocorticotropic hormone (ACTH) include all of the following: a) The oral route is the preferred rout of administration b) ACTH is most useful clinically as a diagnostic tool in adrenal insufficiency c) ACTH stimulates the synthesis of corticosteroids d) Endogenous ACTH is also called corticotropin e) ACTH inhibits the synthesis of corticosteroids Indications of bromocriptine are following: a) Prolactin deficiency b) Acromegaly caused by hyperprolactinaemia c) Amenorrhea-Galactorrhea d) Prolactin-secreting adenomas e) Parkinson's disease Indications of oxitocin are following: a) For control of pospartum uterine hemorrhage b) Incompleted abortion c) Labor and augment dysfunctional labor for conditions requiring early vaginal delivery d) Heart failure e) Diabetes insipidus Indications of vasopressin is following, EXCEPT: a) Incompleted abortion 248 b) Pituitary diabetes insipidus c) Hypertension d) Diabetes mellitus e) Сontrol of postpartum uterine hemorrhage Vasopressin causes a pressor effect by: a) All of the mechanisms b) A direct action on smooth muscles of the blood vessels c) Releasing and activating renin-angiotensin system d) Releasing noradrenaline from the nerve terminals e) Activating specific receptors on smooth muscles of the blood vessels Which of the following hormones is produced by the thyroid gland? a) Thyroxine b) Thyroid-stimulating hormone c) Thyrotropin-releasing hormone d) Thyroglobulin e) Сalcitonine Thyrotrophin stimulates the following processes: a) De-iodination of thyroid hormones b) Release of triidothyronine c) Iodination of thyroglobulin d) Concentration of iodine by thyroid follicles e) Release of thyroxine Indications of thyroid hormones are following: a) For treatment of simple obesity b) Hashimoto's disease c) Myxedema d) Cretinism e) Basedov-Graves disease Name hormone drugs: a) Thyroxine b) Somatotropin c) Vasopressin d) Bromocriptine e) Oxytocin The posterior pitutary secrets: a) Vasopressin b) Oxytocin c) Growth hormone d) Methylergometrine e) Insulin Oxytocin produces the following effects: a) It causes contraction of the uterus b) It assists the progress of spermatozoa into the uterine cavity c) It brings about milk ejection from the lactating mammary gland d) It causes relaxation of the uterus 249 e) It has no effect on the milk ejection The adrenal cortex produces: a) aldosterone b) angiotensin II c) deoxycorticosterone d) noradrenaline e) adrenaline Mineralocorticoid effects cause: a) Deposition of fat on shoulders, face and abdomen b) Increased gluconeogenesis c) Increased Na retention d) Increased К excretion e) Increased catabolism The major mineralocorticoids are the following: a) Cortisone b) Budesonid c) Hydrocortisone d) Deoxycorticosterone e) Fludrocortisone Name naturale corticosteroids: a) betamethasone b) cortisone c) prednisolone d) triamcinolone e) hydrocortisone Side effects for prednisone: a) Arterial hypertension b) Gastroduodenal ulcer c) Retention of sodium and water d) Hyperpotassemia e) Central nervous excitation Name effects of chronic treatment with big doses of prednisolon: a) decrease of endogenous corticotropin secretion b) rise of susceptibility to infections disorders c) Hypoglycemia d) Hydroelectrolitic disturbances e) Osteoporosis Glucocorticoid hormones alter bone mineral homeostasis because of : a) are potent osteopenic agents b) direct inhibition of matrix synthesis by the osteoblast c) directly stimulate the secretion of parathormone d) inhibiting renal calcium excretion e) decreasing parathyroid hormone stimulated bone resorption Name toxic effects of the corticosteroids: 250 a) Growth inhibition b) Hypertention c) Hypoglicemia d) Psychosis e) Salt retention Indications of glucocorticoids are following: a) Skin diseases (atopic dermatitis, dermatoses, localized neurodermatitis) b) Inflammatory conditions of bones and joints (arthritis, bursitis, tenosynovitis) c) Postmenopausal hormonal therapy d) Gastrointestinal diseases (inflammatory bowel disease) e) Addison disease Serious side effects of glucocorticoids include the following: a) Hypomania or acute psychosis b) Salicylism (vomiting, tinnitus, decreased hearing, and vertigo) c) Iatrogenic Cushing's syndrome (rounding, puffiness, fat deposition and plethora alter the appearance of the face - moon faces) d) Acute peptic ulcers e) Diabetes insipidus The major mineralocorticoids are the following: a) Aldosterone b) Deoxycorticosterone c) Fludrocortisone d) Hydrocortisone e) Cortisone Name side effects caused by steroids: a) high blood pressure b) increased intraocular pressure c) CNS stimulation d) hyperkalaemia e) gynecomastia With regard to thyroxine: a) synthesized by adrenal cortex b) used in bronchial asthma c) it is important for skeletal growth d) it increases the sensitivity of receptors to catecholamines e) it increases oxygen consumption Excessive doses of thyroid hormone may cause: a) angina pectoris b) cardiac decompensation c) adrenal insufficiency d) psychotic behavior e) constipation Indicate the effects of thyroid hormone drugs: a) increased basal metabolism b) decreased basal metabolism 251 c) tachycardia d) bradycardia e) xtremor Synthesis and release of thyroid hormones are controlled by: a) Anterior pituitary b) Hypothalamus c) Blood levels of thyroid hormones d) Posterior pituitary e) Blood levels of cortisole level Currently used antithyroid drugs include the following: a) Propylthiouracil b) Iodine in high dosage c) Thiamazole d) Thyrotropin-releasing hormone e) Thyroglobulin Indications of thyroid hormones are following: a) Cretinism b) Myxoedema c) Hashimoto's disease d) For treatment of simple obesity e) Diabetus insipidus Characteristics of thiamazole: a) Decreases thyroid hormone synthesis b) Inhibits peripheral conversion of T4 in T3 c) Causes neutropenia d) Should be stopped if causes rashes e) Decreases TSH production The following statements about the parathyroid hormone are true: a) The parathyroid hormone (PTH) is a hormone secreted by the parathyroid glands b) The parathyroid hormone increases calcium and phosphate absorption in intestine c) The parathyroid hormone increases serum calcium and decreases serum phosphate d) The parathyroid hormone increases calcium excretion and decreases phosphate excretion in kidneys e) The parathyroid hormone decreases calcium and phosphate absorption in intestine Indications for calcitonin administration are the following: a) Hypercalcemia b) Paget's disease c) Osteoporosis d) Hypophosphatemia e) Wegener's granulomathosis Which of the following statements about calcitonin is true: a) Calcitonin is secreted by parafollicular cells of the thyroid b) lower blood calcium and phosphate by acting on bones and kidneys c) Calcitonin inhibits osteoclastic bone resorption 252 d) Effects of calcitonin are to increase blood calcium and phosphate by acting on bones and kidneys e) Calcitonin stimulates osteoclastic bone resorption Indicate drugs used to treat diabetes mellitus: a) insulin b) insulin-zinc-protamine c) glibenclamide d) vasopressin e) adiurecrine Indicate preparations used in type II diabetes mellitus? a) glibutid b) metfornin c) glucagon d) prednisolone e) glibenclamide Insulin causes reduction in blood sugar level by the following mechanisms: a) Increased glucose uptake in the peripheral tissue b) Decreased glucose absorption from the gut c) Diminished gluconeogenesis d) Reduction of breakdown of glycogen e) Increased glucose absorption from the gut Insulin can be administered by: ) Intramuscular route b) Subcutaneous route c) Intravenous route d) Oral route e) Intrarectal route Antidiabetic sulphonylureas act by: a) Reducing the absorption of carbohydrate from the gut b) Increasing the uptake of glucose in peripheral tissues c) Reducing the hepatic gluconeogenesis d) Stimulating the beta islet cells of pancreas e) Stimulating production of insulin by the beta islet cells of pancreas Thiazolidinediones act by: a) Diminishing insulin resistance b) Reducing the absorption of carbohydrate from the gut c) Stimulating the beta islet cells of pancreas to produce insulin d) Increase glucose uptake and its metabolism in muscle and adipose tissues e) All of the answers Alpha-glucosidase inhibitors act by: a) Stimulating the beta islet cells of pancreas to produce insulin b) Reducing the absorption of carbohydrate from the gut c) Competitive inhibiting of intestinal alpha-ghucosidases d) Modulating the postprandial digestion and absorption of starch and disaccharides 253 e) Diminishing insulin resistance by increasing glucose uptake and metabolism in muscle and adipose tissues Biguanides are used in the following conditions: a) In case of hyperglycemic shock b) In case of hypoglycemic shock c) To reduce insulin requirements d) In over weight diabetics e) As a supplement to sulphonylurea, where it is insufficient to give good results Biguanides are used in the following conditions: a) As a supplement to sulphonylurea, where it is insufficient to give good results b) In diabetes mellitus type I c) To reduce insulin requirements d) In case of hyperglycemic shock e) In over weight diabetics Metformin characteristics are: a) It's a biguanide drug b) Used in diabetes mellitus type II c) Causes anorexia and weight loss d) It's a sulphonylurea drug e) Used in diabetes mellitus type I Characteristics of metformin: a) is a biguanide b) used in Diabetus Mellitus type II c) causes anorexia and weight loss d) causes hyperglycemia e) is contraindicated in Diabetus Mellitus Type I Characteristics of Thiamazol: a) decreases thyroid hormone synthesis b) inhibits peripheral conversion of T4 to T3 c) causes neutropenia d) used in cretinism e) decreases directly TSH production Name androgens drugs: a) testosterone b) estradiol c) methyltestosterone d) cortisone e) ethinylestradiol The major natural estrogens produced by women are following: a) Estriol b) Ethinyl estradiol c) Diethylstilbestrol d) Estron e) Estradiol 254 The major synthetic estrogens are following: a) Estradiol b) Estron c) Benzestrol d) Diethylstilbestrol e) Dienestrol Indications of synthetic estrogens are following: a) For treatment of simple obesity b) Diabetes mellitus c) Hormonal contraception d) Postmenopausal hormonal therapy e) Primary hypogonadism Tamoxifen is, EXCEPT: a) Androgen b) Antiestrogen c) Antiandrogen d) Antiprogestin e) Estrogen Mifepristone is: a) Androgen b) Antiestrogen c) Antiandrogen d) Antiprogestin e) Antiglucocorticoid Name Testosterone effects: a) growth of genitals in a boy b) muscular development c) erythropoietin secretion decreased d) behavioral changes in men e) growth of facial, pubic & axillary hairs Name indication for hormone androgen preparations: a) Insufficient renal anemia treatment b) inoperable breast cancer in woman during postmenopause c) hypogonadism d) amenorhea e) breast cancer in men Name characteristic of testosterone: a) it is a major male hormone b) it is highly effective by the oral route c) it is reduced to dihydrotestosterone in the body d) it is produced by the testes, ovaries, and adrenal cortices e) it is a major female hormone Name Testosterone effects: a) Growth of genitals in men 255 b) Muscular development c) Decrease of erythropoietin secretion d) Behavioral changes in men e) Growth of facial, pubic & axillary hairs Mechanism of action of oral contraceptives: a) Inhibition of follicular development & ovulation b) Thicken of cervical mucus c) Inhibition of implantation of blastocyst in endometrium d) Indirect inhibition of spermatogenesis e) Activation of follicular development & ovulation All of the following statements about oral contraceptives are true: a) The "combination pill" contains both estrogen and progestin b) Ethinyl estradiol and mestranol are commonly used in oral contraceptives c) The "minipill" contains progestin alone d) The "triphasic pill" contains estrogen, progestin, and luteinizing hormine (LH) e) The "triphasic pill" contains progestin, and luteinizing hormine (LH General principles of anti-infective therapy are: a) Clinical judgment of microbiological factors b) Definitive identification of a bacterial infection and the microorganism's susceptibility c) Optimal route of administration, dose, dosing frequency and duration of treatment d) Identification of a bacterial infection and the microorganism's susceptibility is not important e) Optimal route of administration is always internally Which of the following antienzymes are beta-lactamase inhibitors? a) Clavulanic acid b) Neostigmine c) Tazobactam d) Aminocaproic acid e) Disulfiram Name inhibitors of betalactamase? a) clavulanic acid b) tazobactam c) sulbactam d) ticarcillin e) piperacillin Name antibiotics from beta lactamines: a) ampicillin b) rifampicin c) tetracycline d) benzylpenicillin e) gentamicin Describe pharmacokinetic properties of benzylpenicillin? a) resistance on gastric juice action b) used just orally c) in case of a healthy meninx weak penetration in cephalo rachidine liquid 256 d) most of the dose - predominantly renal elimination e) sensitivity at beta-lactamase The following medication can cause ototoxicity: a) cephalexin b) kanamycin c) penicillin d) gentamicin e) vancomycin Name characteristics for aminoglycosides: a) are absorbed well after oral administration b) prevent the synthesis of protein bacterias c) all generations are used in tuberculosis d) excretes through glomerular filtration without significant tubular resorbtion e) are used in anaerobic infections Aminoglycosides can be associated (acting synergistically) with antibiotics group: a) tetracycline b) glycopeptide c) macrolide d) beta-lactamins e) polimixines The following medications can cause neuromuscular block: a) gentamycin b) cefuroxim c) streptomycin d) pilocarpine e) kanamycin With regard to gentamicin: a) it is used just orally b) it is well absorbed by the small intestine c) it can produce permanent vestibular nerve damage d) it can cause neuromuscular block e) it can produce nephrotoxicity The main side efects of aminoglycosides are : a) Ototoxicity b) Nephrotoxicity c) Extrapyramidal disorders d) Neuromuscular blockade e) Hepatotoxicity Characteristics of cefuroxime: a) inhibits cell wall synthesis b) has cross-sensitivity with penicillin c) is an enteral second-generation cephalosporin antibiotic. d) is a third generation cephalosporin e) is less toxic to the renal function than gentamicin 257 Macrolides are naturally resistant to: a) Bacillus fragilis b) Pseudomonas c) Chlamydia d) Acinetobacter e) Mycoplasma pneumoniae The following antibiotics are bacteriostatic: a) penicillins b) erythromycin c) isoniazid d) chloramphenicol e) cephalosporins The following are true about tetracycline: a) treat Chlamydia b) should be avoided in children c) are used in viral infections d) broad-spectrum antibiotics e) inhibit the cell wall synthesis Characteristics of gentamycin: a) is poorly soluble in lipid and therefore needs to be given parenterally b) is excreted exclusively by the kidneys c) inhibits presynaptic acetylcholine release with neuro-muscular block d) causes ototoxicity e) inhibits cell wall synthesis of bacteria Characteristics of vancomycin: a) inhibits bacteria DNA synthesis b) is effective against Gram negative aerobic organisms c) is well absorbed from the gut d) is a type of glycopeptide antibiotic e) stimulates the release of histamine Drugs that are bacteriostatic include: a) cephalexin b) gentamicin c) chloramphenicol d) tetracyclines e) penicillin Charactristics of aminoglycosides: a) are effective against anaerobic infection b) cause nephrotoxicity c) Very active against Gr- aerobic bacillus d) are not effectively against systemic infection if given orally e) cause ototoxicity With regard to vancomycin: a) is a glycopeptide 258 b) can cause ototoxicity c) is bacteriostatic in action d) is bactericidal in action e) causes “Red man” syndrome Describe vancomycin: a) is an aminoglycoside. b) ototoxicity and nephrotocicity common sides effects c) targets the RNA of bacteria. d) is used in parenterally way e) is used against Gram positive bacteria. Describe vancomycin: a) active on gram-positive cocci b) is a type of glycopeptide antibiotic c) causing ototoxicity and nephrotoxicity d) active on gram-negative flora e) bacteriostatic Name unwanted effects of vancomycin: a) Gray baby syndrom b) Ototoxicity c) "Red neck" syndrome, phlebitis d) Cristaluria e) Pneumonitis Vancomicin has the following unwanted effects: a) Pseudomembranous colitis b) Hepatotoxicity c) "Red men" syndrome d) All of the above e) Phlebitis All of the following drugs are antibiotics: a) Streptomycin b) Penicillin c) Co-trimoxazole d) Chloramphenicol e) Ciprofloxacine Which of the following groups of antibiotics demonstrates a bactericidal effect? a) Tetracyclines b) Macrolides c) Penicillins d) Aminiglycosides e) Cephalosporins Which of the following groups of antibiotics demonstrates a bacteristatic effect: a) Carbapenems b) Macrolides c) Aminoglycosides d) Cephalosporins 259 e) Tetracyclines Which of the following antibiotics contains a beta-lactam ring in their chemical structure: a) Penicillins b) Cephalosporins c) Carbapenems d) Monobactams e) Tetracyclines Tick the drug belonging to antibiotics-macrolides and azalides: a) Neomycin b) Doxycycline c) Erythromycin d) Cefotaxime e) Azithromycin Tick the drug belonging to antibiotics-carbapenems: a) Aztreonam b) Amoxacillin c) Imipinem d) Clarithromycin e) Meropenem Tick the drug belongs to antibiotics-cephalosporins: a) Streptomycin b) Cefaclor c) Phenoxymethylpenicillin d) Erythromycin e) Cefalexin Tick the drug belonging to lincosamides: a) Erythromycin b) Lincomycin c) Clindamycin d) Azithromycin e) Aztreonam Tick the drug belonging to antibiotics-tetracyclines: a) Doxycycline b) Minocycline c) Streptomycin d) Clarithromycin e) Amoxacillin Tick the drug belonging to antibiotics-aminoglycosides: a) Gentamycin b) Streptomycin c) Clindamycin d) Neomycin e) Amoxacillin Tick the drug belonging to glycopeptides: 260 a) Vancomycin b) Lincomycin c) Neomycin d) Carbenicillin e) Teicoplanin Antibiotics inhibiting the bacterial cell wall synthesis are: a) Beta-lactam antibiotics b) Tetracyclines c) Aminoglycosides d) Macrolides e) Glycopeptides All of the following antibiotics inhibit the protein synthesis in bacterial cells: a) Macrolides b) Aminoglycosides c) Glycopeptides d) Tetracyclines e) Cycloserine Choose antibiotics from carbapenems: a) Thienam b) Amoxacillin c) Bicillin-5 d) Penicillin e) Imipenem Pick out the beta-lactamase inhibitor for co-administration with penicillins: a) Cilastatin b) Sulbactam c) Sultiam d) Aztreonam e) Tazobactam All of the following antibiotics are macrolides: a) Erythromycin b) Clarithromycin c) Lincomycin d) Roxythromycin e) Aztreonam Tetracyclins have following unwanted effects: a) Irritation of gastrointestinal mucosa, phototoxicity b) Hepatotoxicity, anti-anabolic effect c) Dental hypoplasia, bone deformities d) Myocardial infarction e) Addison syndrome Tick the drug belonging to antibiotics-aminoglycosides: a) Erythromycin b) Gentamycin c) Vancomycin 261 d) Polymyxin e) Kanamycin Aminoglycosides have the following unwanted effects a) Pancytopenia b) Hepatotoxicity c) Ototoxicity d) Irritation of gastrointestinal mucosa e) Nephrotoxicity Name antibiotics used parenterally: a) streptomycin b) erythromycin c) gentamicin d) ampicillin e) imipinem Choose antibiotics most likely to produce increased neuromuscular-blockade in the presence of nondepolarizing blockers: a) vancomycin b) kanamycin c) amikacin d) gentamicin e) ampicillin Name characteristic for Aztreonam? a) is a monobactam antibiotic b) is active against gram-negative bacteria c) is active against Pseudomonas aeroginosa d) is active against protozoa e) is active against helmints With regard to tetracycline: a) directly inhibits DNA synthesis in bacteria b) crosses the placenta and accumulates in foetal skeleton c) side effects include poor tooth development d) have a narrow spectrum of antibiotic action e) used just intravenously Name semisynthetic tetracyclines: a) tetracicline b) doxycycline c) metacycline d) demeclocycline e) minocycline Name spectrum of action for tetracyclines: a) chlamydia b) mycoplasma c) brucella d) helmints 262 e) rickettsiae What antimicrobial inhibits bacterial protein synthesis following attachment of 30 S subunits of ribosomes? a) clindamycin b) tetracycline c) chloramphenicol d) imipenem e) doxycycline Charactristics of chloramphenicol: a) inhibits cell wall synthesis b) is active against Haemophilus and Neisseria c) causes ototoxicity d) causes aplastic anaemia e) should not be given to newborns What remedies inhibit bacterial protein synthesis, following attachment of 50S ribosomes subunits: a) chloramphenicol b) clarithromycin c) clindamycin d) tetracycline e) doxycycline Name pharmacological properties of chloramphenicol: a) choice for systemic salmonellosis b) not acting in anaerobic infections c) induces gray syndrome d) induced aplastic anemia e) does not penetrate the blood-brain barrier Name the chloramphenicol causes of gray syndrome in neonates and premature: a) excessive doses b) baby diseases c) liver enzyme deficiency of glucuronyltransferase d) genetic predisposition e) association with penicillins Concerning sulfonamides: a) act as competitive inhibitors of the enzyme dihydropteroate synthase b) are big group from antibiotics c) certain sulfonamides are sometimes mixed with the drug trimethoprim d) contraindicated in pregnancy and newborn e) minimal side effects Charactristics of sulphonamides: a) inhibit the conversion of para-aminobenzoic acid to folate b) are bactericidal c) can be combined with trimethroprim d) are used just intravenously e) are a known cause of Steven-Johnson's syndrome 263 Sulfonamides are effective against: a) Bacteria and Chlamidia b) Grame negative aerobes c) Gonococcus d) Echinococcus e) Cytomegalovirus Sulfonamides have the following unwanted effects: a) tendinitis and tendons ruptures b) crystalluria c) peripheral neuropathy d) neuro-muscular block e) gray baby syndrome Tick the antibacterial drug - a quinolone derivative: a) Nitrofurantoin b) Nalidixic acid c) Streptomycin d) Pipemidic acis e) Nystatine The following are true about fluoroquinolone: a) it acts by inhibiting DNA gyrase b) ciprofloxacin is poorly absorbed by the gastrointestinal system c) corneal deposition is a complication of topical ofloxacin d) it is active against gram negative bacilli e) have been shown to contribute to tendinopathies Name indications for fluoroquinolones: a) Urinary tract infections b) Gonorrhea c) Urethritis d) Treatment of pneumonia e) Listeriosis Antimicrobials that inhibit folic acid synthesis include: a) ciprofloxacine b) sulfonamides c) pyrimethamine d) clindamycin e) tetracycline Mechanisms of bacterial resistance to anti-microbial agents are the following: a) Active transport out of a microorganism b) Enlarged uptake of the drug by a microorganism c) Modification of a drug's target d) Reduced uptake by a microorganism e) Hydrolysis of an agent via enzymes produced by a microorganism Antimalarial drug classification: a) penicillin 264 b) metronidazol c) quinine d) tetracyclines e) chloroquine Characteristics of quinine: a) is a medication to treat malaria b) highly effective schizonticide against P vivax, P ovale, P falciparum, P. malariae c) is a medication to treat viruses infection d) is antibiotic used just in anaerobes infections e) is used just intravenously Name metronidazole indications: a) amebiasis b) malaria c) syphilis d) duodenal ulcer e) anaerobic infections True statements about metronidazole include: a) it is bacteristatic b) it inhibits bacterial protein synthesis c) it is most effective against Gram positive bacteria d) it is most effective against Gram negative bacteria e) alcohol should be avoided while taking metronidazole Name effective preparations in echinococcosis: a) mebendazole b) albendazole c) piperazine d) befeniu e) pirviniu Name metronidazole indications: a) tuberculosis b) lambliozis c) amebiasis d) malaria e) trichomoniasis Show drugs used to treat giardiasis: a) levamisole b) metronidazole c) furazolidone d) pyrantel e) mebendazole Specify pharmacological peculiarities typical for interferons: a) antiviral b) immunomodulatory c) antiproliferative d) induce biochemical changes that create an antiviral state in infected cells 265 e) antioxidant Name antivirals effective against flaviviruses (hepatitis C virus): a) Interferon alfa-2b b) PEG-interferon alpha-2b c) PEG interferon alpha-2a d) foscarnet e) Interferon alfa-2a Ganclovir characteristics: a) is effective against cytomegalovirus infection b) causes bone marrow failure c) is effective against HIV infection d) is effective against influenza e) inhibits DNA polymerase Drugs effective against cytomegalovirus include: a) acyclovir b) gancyclovir c) foscarnet sodium d) zidovudine e) amantadine Name drugs that inhibit viral enzymes? a) acyclovir b) zidovudine c) ethambutol d) saquinavir e) indinavir Group of endogenous proteins that exhibit antiviral activities: a) ribavirin b) interferon beta c) ganciclovir d) vidarabine e) interferon alpha The indication for interferon alpha administration is: a) Hepatitis C virus infection b) Treatment of sleep disorders c) Kaposi's sarcoma d) Can be used to treat multiple sclerosis e) All of the answers Name poliene antibiotics: a) grizeofulvine b) ristomicine c) kanamycin d) amphotericin B e) natamycin Which of the following drugs is used for candidiasis treatment: 266 a) Nystatine b) Ampicillin c) Myconazol d) Streptomycin e) Gentamicin Name drugs that demonstrate a fungicidal effect: a) Cloramphenicol b) Amfotericin B c) Ketoconazole d) Myconazole e) Imipinem Choose antifungal remedies: a) nystatine b) tropicamide c) rifampicin d) fluconazole e) cocaine Name antifungal drugs from imidazole derivatives group: a) econazole b) flucytosine c) amphotericin B d) ketoconazole e) miconazole Specify the first choice drugs in superficial candidiasis: a) clotrimazole b) flucytosine c) nystatin d) amphotericin B e) ketoconazole Characteristic of fluconazole: a) used systemically b) is an antifungal medication c) is an antibiotic d) prevents the conversion of lanosterol to ergosterol from fungal membrane e) inhibits cell wall Name therapeutic indications of miconazole: a) iv infusion in severe fungal infections with coccidioides b) per os in oral and intestinal candidiasis c) topic in pityriasis d) intravaginal in candidiasis e) per os in trichomoniasis Specify polyene antifungal antibiotic: a) nystatin b) griseofulvin c) amphotericin B 267 d) flucytosine e) capreomycin Specify anti leprous drugs: a) nalidixic acid b) co-trimoxazole c) solasulfon d) dapsone e) nitroxoline Tick the antibiotics that have antituberculous action: a) Ampicillin b) Penicillin c) Kanamycin d) Gentamicin e) Rifampicine Mechanism of Izoniazid action is: a) Inhibition of protein synthesis b) Inhibition of mycolic acids synthesis c) Inhibition of ADP synthesis d) Inhibition of cAMP synthesis e) Inhibition of cell-wall synthesis Mechanism of Rifampicin's action is: a) Inhibition of mycolic acids synthesis b) Inhibition of DNA dependent RNA polymerase c) Inhibition of topoisomerase II d) Inhibition of cAMP synthesis e) Inhibition of RNA synthesis Isoniazid has following unwanted effect: a) Cardiotoxicity b) Hepatotoxicity c) Loss of hair d) Immunotoxicity e) Peripheral neuropathy Specify pharmacological typical peculiarities of Ethambutol: a) is an antilepros drug b) is an antituberculosis drug c) mechanism of antituberculous action is bacteriostatic d) mechanism of antileprous action is bactericidal e) can cause optic neuritis Specify pharmacological peculiarities characteristic for the hormonal drugs from antitumor grups: a) estrogen is used in prostate cancer b) androgens are used in breast cancer c) antiandrogens are used in prostate cancer d) antiestrogens are used in breast cancer e) aminoglutethimide inhibit aromatase 268 Specify group of monoclonal antibodies from antitumor preparations: a) transtuzumab b) rituximab c) bevacizumab d) vincristine e) colchicine Specify antitumor preparations made by vegetal origin: a) vinblastine b) vincristine c) vinorelbine d) bevacizumab e) bruneomicine Cyclosporin A: a) can only be given orally as it is too toxic to be given intravenously b) it may be given prophylactically to reduce organ rejection before transplantation c) causes little bone marrow suppression d) causes renal impairment e) acts specifially on cytotoxic T lymphocytes The following cytotoxic drugs are immunosuppressive drugs: a) chlorambucil b) cyclophosphamide c) vinblastine d) mielopid e) timogen Name immunosuppressive drugs: a) imupurine b) thiamazole c) interferon d) cyclophosphamide e) chlorambucil The Immunosuppressive agents are: a) Corticosteroids b) Imunofan c) Cyclosporine d) Tacrolimus e) Interferon Cytotoxic agents are the following: a) Azathioprine b) Imupurin c) Ampicillin d) Cyclophosphamide e) Clemastine Name cytostatics: a) azathioprine 269 b) diphenhydramine c) cyclosporine d) ipratropium e) mercaptopurine Name the indications for immunosuppressive preparations: a) rheumatoid arthritis b) allergic rhinitis c) lack of glucose-6-fosfatdehidrogenase d) organ transplantation e) collagen diseases Immunosupressive effect of glucocorticoids is caused by: a) Reducing concentration of lymphocytes (T and B cells) b) Inhibiting function of tissue macrophages and other antigen-presenting cells c) Activation of Cyclooxygenase I&II expression that results in reducing amount of an enzyme available to produce prostaglandins d) Activation of phospholipase A2 and reducing prostaglandin and leukotriene synthesis e) Activation of cyclooxygenase II expression that results in reducing amount of an enzyme available to produce prostoglandins Cyclosporine A is from the group, EXCEPT: a) Immunoglobulins b) Monoclonal antibodies c) Immunosuppressive agents d) Interferons e) Immunostimulating agents Indication for interferon alpha administration is, EXCEPT: a) Hepatitis C virus infection b) Organ transplantation c) Rheumatoid arthritis d) Autoimmune diseases e) Hepatitis A virus infection Indications for interferon alpha administration are: a) Chronic granulomatous disease b) Hepatitis C virus infection c) Kaposi's sarcoma d) Rheumatoid arthritis e) Prophylaxis of sensitization by Rh antigen Optic neuropathy occurs in deficiency of the following vitamins: a) vitamin A b) phytomenadione c) riboflavine d) retinyl acetate e) cyanocobolamine The following are true about vitamin A: a) it is fat soluble b) it is water soluble 270 c) deficiency can lead to scurvy d) deficency causes pellagra. e) deficiency can lead to night blindness Fat-Soluble Vitamins are: a) Vitamin A b) Vitamin D c) Vitamin K d) Vitamin E e) Vitamin C The following are true about vitamin A deficiency: a) causes night blindness b) causes scurvy c) causes pellagra d) causes Beri-beri. e) the immune system is impaired by vitamin A deficiency Name clinical uses of vitamin D: a) Osteoporosis b) Nutritional rickets c) Scurvy d) Pellagra e) Beriberi Optic neuropathy occurs in deficiency of the following vitamin B: a) Vitamin B1 b) Vitamin B2 c) Vitamin B3 d) Vitamin B6 e) Vitamin B12 Symptom of vitamin A deficiency are: a) Night blindness - lessened ability to see in dim light b) Xerophthalmia and keratomalacia c) Various epithelial tissue defects d) Osteoporosis e) induced Parkinson disease Choose the correct statements relating to adverse allergic reactions: a) appear due to pharmacokinetic features b) does not depend on the dose c) are characteristic of drugs with a high intrinsic toxicity and narrow therapeutic window d) are crossed for structurally related compounds e) high incidence when drugs are given orally Choose drug complications caused by the suspension of medication: a) idiosyncrasy b) the liver enzyme induction c) suppression of hepatic enzymes d) Rebound syndrome e) absence syndrome 271 Name drug complications caused by the patients hypersensitivity: a) immediate immunoallergic type reactions b) delayed immunoallergic type reactions c) tachyphylaxis d) tolerance e) dysbacteriosis Indicate antidotes definitions: a) drug possessing action to neutralize and / or elimination of toxic substances b) drug preventing action to develop symptoms of intoxication with a certain toxic c) drug which possess antagonistic action against a specific toxic d) drug possessing agonistic action to a particular toxic e) drug potentiating action of a particular toxic Specify how to divide antidotes according to the mechanism of action: a) Physical b) Chemical c) Physiological d) Inhibitory e) Stimulatory Name antidotes used in morphine and other opioid analgesics intoxication: a) naloxone b) nalorphine hydrochloride c) izonitrozin d) dipiroxim e) aloxim Name antidotes used in organophosphorus compounds poisoning: a) naloxone b) nalorphine hydrochloride c) izonitrozin d) dipiroxim e) aloxim Indicate groups of drugs causing depression more frequently as adverse effects: a) centrally acting hypotensive drugs b) tranquilizers c) beta-adrenoblockers d) adrenomimetics e) MAO inhibitors Specify groups or drugs frequently cause side effects such as mixed liver injury: a) NSAIDs b) anti-tuberculous drugs c) contraceptives d) beta-adrenoblockers e) converting enzyme inhibitors Specify drugs that cause more frequently as adverse effect bronchospasm: a) acetylsalicylic acid 272 b) propranolol c) neostigmine d) ipratropium bromide e) salbutamol Specify preparations that cause more frequently as adverse effect orthostatic hypotension and collapse: a) trimetaphan b) nifedipine c) clonidine d) izoturon e) dopamine Specify drugs would frequently cause anaphylaxis as a side effect: a) penicillins b) procaine c) famotidine d) omeprazole e) diphenhydramine Specify drugs would cause more frequently as adverse effect duodenal and gastric ulcer: a) prednisolone b) acetylsalicylic acid c) diclofenac d) sucralfate e) misoprostol Specify groups of drugs that would cause more frequently as adverse effect dysbacteriosis: a) antibiotics b) nitrofurans c) glucocorticoids d) NSAIDs e) converting enzyme inhibitors Specify drugs possessing a major potential to develop drug addiction: a) trimeperidine b) diazepam c) amfepramone d) diclofenac e) piracetam Which drugs can cause ototoxicity? a) Furosemide b) Gentamycine c) Kanamycin d) Acetazolamide e) Scopolamine Which drugs can cause neuro-muscular blocking effect? a) Streptomycine b) Gentamycine 273 c) Kanamycin d) Acetazolamide e) Scopolamine Which drugs can cause xerosthomia? a) Atropine b) Diphenhydramine c) Scopolamine d) Neostigmine e) Pilocarpine Which drugs can cause ventricular arhythmias? a) Loratadine b) Diphenhydramine c) Cetirizine d) Clemastine e) Cyproheptadine Which drugs can cause somnolence? a) Loratadine b) Diphenhydramine c) Cetirizine d) Clemastine e) Cyproheptadine Which drugs can cause constipation? a) Atropine b) Neostigmine c) Pilocarpine d) Scopolamine e) Platyphylline Which drugs can cause specific side effect- dry cough? a) Captopril b) Clonidine c) Salbutamol d) Enalapril e) Lisinopril 274