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MODULE 4: Pharmacology

Total questions: 125

Worksheet time: 2hrs 17mins

Name
Class
Date
1.

In scientific and medical usage, drugs should be referred to by their

a)

Chemical name

b)

Generic name

c)

Color

d)

Botanic origin

e)

Brand name

2.

Drugs have been classified on the basis of all the following EXCEPT

a)

Pharmacotherapeutic

b)

Source

c)

Chemical Nature

d)

Color

e)

Molecular mechanism of action

3.

W/c of the ff statements describe a receptor?

a)

may be the surface of a cell or w/in the cell

b)

a macromolecular protein substance

c)

actual site of drug action

d)

a molecule w/c interacts w/ a ligand (drug) to mediate a pharmacologic effect

e)

ALL

4.

Stimulation of β-adrenoreceptor, a G-protein-linked receptor involves generation of a secondary messenger known as

a)

IP3

b)

cGTP

c)

DAG

d)

cAMP

e)

Ca ions

5.

A full agonist is

a)

a β-receptor antagonist

b)

a drug w/ no intrinsic activity

c)

a drug that blocks ion channels

d)

a drug w/ intrinsic activity of 1

e)

an inverse agonist

6.

The median dose, or the dose of the drug that produces half of the maximum achievable response is called

a)

ED50/EC50

b)

LD50

c)

Ceiling dose

d)

TD50

e)

none of the above

7.

The maximum effect (Emax) achieved by a drug is a measure of

a)

Potency

b)

Efficacy

c)

quantal response

d)

Antagonist magnitude

e)

The therapeutic index

8.

Potency is determined by

a)

affinity alone

b)

efficacy alone

c)

affinity and efficacy

d)

affinity and intrinsic activity

e)

efficacy and intrinsic activity

9.

All of the following statements about efficacy and potency are true except that

a)

Efficacy is usually a more important clinical consideration than potency

b)

Efficacy is indicated by the height of the log-dose response

c)

The ED50 is a measure of a drug’s efficacy

d)

Drugs that produce a similar pharmacologic effect can have very different levels of efficacy

e)

On a log-dose response curve, two drugs with the same action but with different potencies usually have parallel curves

10.

______ trials are generally focused on drug safety, usually conducted in healthy

volunteers.

a)

Phase I

b)

Phase II

c)

The ED50 is a measure of a drug’s efficacy

d)

Phase III

11.

The primary mechanism of neurotransmitter release is accomplished by what process?

a)

diffusion

b)

storage

c)

uptake process

d)

exocytosis

e)

synthesis

12.

A 12-yo boy develops uncontrollable panic while camping with his parents in the Mojave Desert. Which of

the following drugs is most appropriate for the following situation?

a)

Midazolam

b)

Diazepam

c)

Alprazolam

d)

Clonazepam

e)

flurazepam

13.

A 54-yo man is scheduled for an elective colonoscopy that will take approximately 20 minutes. Which of

the following drugs would be most likely to produce the desired anesthesia and anterograde amnesia?

a)

buspirone

b)

zephalon

c)

midazolam

d)

chlordiazepoxide

e)

hydroxyzine

14.

After ingesting several tablets of a prescription drug, a 5 year-old child exhibits slurred speech, ataxia, drowsiness, and labored breathing. These effects are rapidly reversed by IV of flumazenil. Which of the following drug has been ingested by the child?

a)

loperamide

b)

triazolam

c)

haloperidol

d)

naltrexone

15.

Which of the following agents may not be expected to produce potentiating CNS depressant effect with

alcohol when taken simultaneously?

a)

diazepam

b)

phenobarbital

c)

hydroxyzine

d)

buspirone

e)

chloral hydrate

16.

Which of the following benzodiazepines has the shortest half-life and a rapid onset of action?

a)

lorazepam

b)

triazolam

c)

oxazepam

d)

diazepam

e)

prazepam

17.

Which of the following agents is absolutely contraindicated in patients with disorders associated with porphyrin such as acute intermittent porphyria, variegate porphyria, and symptomatic porphyria?

a)

chlordiazepoxide

b)

diazepam

c)

zolpidem

d)

Phenobarbital

e)

buspirone

18.

What is responsible for the very short duration and very rapid onset of effect of the so-called “ultra short acting

barbiturates?

a)

presence of sulfur

b)

presence of methoxy group

c)

presence of substituted barbital structure

d)

high lipid solubility of these agents

e)

increase in number of polar substituents

19.

The neurotransmitter mediating synaptic transmission between preganglionic and postganglionic neuron

include

a)

MAO

b)

NE

c)

EPI

d)

ACh

e)

ChAT

20.

Which of the following effects is/are consistent with direct stimulation of the muscarinic receptors?

a)

peripheral vasodilation

b)

relaxation of the ciliary muscles

c)

negative dromotropic effect

21.

What is the amino acid precursor in the synthesis of catecholamines?

a)

phenylalanine

b)

glycine

c)

tyrosine

d)

trytamine

22.

Serotonin is biosynthesized from

a)

arachidonic acid

b)

glutamic acid

c)

tryptophan

d)

histidine

23.

Which of the following is an expected response to alpha-1 adrenoceptor stimulation?

a)

uterine smooth muscle relaxation

b)

Vasoconstriction

c)

ciliary muscle relaxation

d)

GI wall smooth muscle contraction

e)

platelet aggregation

24.

Which of the following effects can be attributed to alpha-2 receptor stimulation?

a)

vasodilation

b)

inhibition of catecholamine release

c)

vasoconstriction

25.

What is the dominant adrenergic receptor in the heart?

a)

dopamine-1

b)

alpha-1

c)

alpha-2

d)

beta-1

e)

beta-2

26.

A given adrenergic agent induces uterine relaxation and bronchial smooth muscle relaxation. These effects

can be attributed to

a)

alpha-1 stimulation

b)

alpha-2 stimulation

c)

beta-1 stimulation

d)

beta-2 stimulation

27.

In which of the following clinical conditions are the agonists of the alpha-1 adrenoceptors found to be

clinically useful?

a)

nasal congestion

b)

hypotension

c)

symptomatic bradycardia

28.

An injection of a nonselective adrenergic agonist may cause all the following effects except

a)

constriction of cutaneous vascular beds

b)

increase in cardiac rate

c)

bronchiolar constriction

d)

an increase blood sugar level

e)

dilation of the pupil of the eye

29.

Which of the following is an accepted indication for EPI?

a)

bronchodilator for intermittent bronchial asthma

b)

local vasoconstrictor

c)

anti-arrhythmic for SVT

d)

tocolytic agent for premature labor

e)

inotropic for cardiogenic shock

30.

Which of the following drugs is the DOC in anaphylaxis associated with bronchospasm and hypotension?

a)

Cortisone

b)

EPI

c)

isoproterenol

d)

NE

e)

90% oxygen, 10% CO2

31.

As an inotropic agent, NE (levophed) has been shown in some small clinical trials to be most useful in which of the following conditions?

a)

cardiogenic shock

b)

septic shock

c)

acute renal failure

d)

acute myocarditis

e)

dilated cardiomyopathy

32.

Which of the following adrenergic agents is/are most useful for hypodynamic septic shock with hypotension?

a)

dopamine

b)

dobutamine

c)

NE

33.

Which of the following sympathomimetic drugs has nonselective beta-receptor agonist action with no affinity for alpha receptors?

a)

Dopamine

b)

Isoproterenol

c)

Amphetamine

d)

Mephentermine

34.

Which nonselective beta-adrenergic agonist is best suited for treatment of cardiogenic shock?

a)

digoxin

b)

digitoxin

c)

amrinone

d)

isoproterenol

e)

dopamine

35.

Which of the following inotropic agents is most useful for patients with acute heart failure complicated by

acute reduction in creatinine clearance?

a)

EPI

b)

NE

c)

dopamine

d)

dobutamine

e)

digitalis

36.

Which of the following drugs primarily stimulates beta-1 receptors sometimes used in acute heart failure?

a)

dobutamine

b)

ritodrine

c)

yohimbine

d)

phenoxybenzamine

e)

oxymetazoline

37.

Drugs associated with physiologically important positive inotropic and positive chronotropic effects include

a)

propranolol

b)

milrinone

c)

dobutamine

d)

digoxin

38.

What are known clinical uses of beta-2 agonists?

a)

in the management of premature labor

b)

as part of the interventions employed for hyperkalemia

c)

management of bronchial asthma

d)

all

39.

A patient complains of muscle weakness after several doses of salbutamol nebulization. This weakness can

be attributed to _______.

a)

induced hypokalemia

b)

induced hypocalcemia

c)

metabolic alkalosis due to bronchial asthma

d)

decreased firing of neuromuscular junction fibers as its direct effect

e)

respiratory alkalosis due to bronchial asthma

40.

A new drug is currently being developed whose MOA is stimulation of the beta-3 receptors. In which

condition will this drug have most likely usefulness?

a)

obesity

b)

bronchial asthma

c)

HTN

d)

shock

e)

acute renal failure

41.

Which of the following is a selective alpha1-blocker?

a)

Phentolamine

b)

Prazosin

c)

Dopamine

d)

phenoxybenzamine

42.

Orthostatic hypotension and syncope are manifestations of a phenomenon associated with the first dose of

which agent?

a)

labetalol

b)

methyldopa

c)

fenoldopam

d)

doxazosin

43.

A nonselective alpha-adrenergic blocker used for confirming the presence of pheochromocytoma in a patient who is severely hypertensive that blocks both presynaptic and postsynaptic alpha receptors include

a)

prazosin

b)

isoproterenol

c)

phenoxybenzamine

d)

amphetamine

e)

pindolol

44.

In the management of paroxysmal HTN in pheochromocytoma, which of the following drugs is the most appropriate initial therapy?

a)

phentolamine

b)

metoprolol

c)

guanfacine

d)

reserpine

e)

clonidine

45.

A non-selective beta-blocker, antihypertensive agent that possesses atherogenetic (increase LDL) properties

a)

propranolol

b)

hydralazine

c)

prazosin

d)

mononidine

46.

Which of the ff antihypertensive agent must be avoided in COPD?

a)

beta-blockers

b)

diuretics

c)

ACE inhibitors

d)

calcium channel blockers

47.

Which of the ff agents would bring a rapid heart rate back to normal?

a)

isoproterenol

b)

Edrophonium

c)

phentolamine

d)

Dobutamine

e)

propranolol

48.

A selective β1-adrenergic blocking agent include which of the following

a)

timolol

b)

metoprolol

c)

propranolol

d)

carvedilol

e)

labetalol

49.

Which of the following beta-blockers is considered as cardioselective?

a)

labetalol

b)

propranolol

c)

pindolol

d)

esmolol

e)

timolol

50.

Which of the following beta-adrenergic blocking agents has an intrinsic sympathetic activity?

a)

pindolol

b)

atenolol

c)

timolol

d)

propranolol

51.

Rebound tachycardia and HTN are expected complications of abrupt withdrawal of beta-blocker therapy.

Which of the following agents has the least likelihood of causing rebound effects when withdrawn?

a)

acebutolol

b)

propranolol

c)

bisoprolol

d)

metoprolol

e)

atenolol

52.

A predictable dangerous side effect that constitutes a contraindication to the clinical use in susceptible

patients due to beta-receptor blockade is the induction of

a)

hypertension

b)

respiratory depression

c)

cardiac arrhythmias

d)

angina pectoris

e)

asthmatic attacks

53.

Among diabetic patients using insulin or oral hypoglycemic agents (OHAs), why are beta-blockers used

with special caution if not totally avoided? Beta-blockers

a)

can induce hyperglycemia

b)

can mask hypoglycemia symptoms

c)

can attenuate effect of insulin and OHAs

d)

can induce insulin or OHA failure

e)

can increase the risk of renal failure

54.

In which subset/s of patients are beta-blockers used with caution if not avoided? Patients with

a)

bronchospastic diseases like COPD and bronchial asthma

b)

peripheral vascular disease especially vasospastic type

c)

recent MI

55.

What is the most frequent side effect of methyldopa which can be seen particularly at the onset of treatment?

a)

sedation

b)

depression

c)

extrapyramidal signs

d)

(+) Coomb’s test

e)

galactorrhea

56.

Guanfacine and Guanabenz are primarily agonists at what receptors?

a)

muscarinic-1

b)

nicotinic-N

c)

presynaptic alpha-2

d)

postsynaptic alpha-2

e)

alpha-1

57.

What enzyme or part of the biosynthetic pathway is inhibited by reserpine to bring about lowering of BP and depression of the CNS?

a)

dopa decarboxylase

b)

storage of catecholamines in the presynaptic vesicles

c)

release of NE from presynaptic terminals

d)

MAO enzyme

e)

uptake-1-mechanism

58.

Which of the following effects is/are consistent with the systemic use of the drug Clonidine?

a)

initial transient increase in BP

b)

“first-dose” phenomenon

c)

lowering of BP

59.

In terms of MOA, which of the following drugs most closely resembles that of Clonidine?

a)

phenylephrine

b)

reserpine

c)

guanethidine

d)

methyldopa

e)

amlodipine

60.

A peripherally acting antihyperstensive agent that produces sedation and a state of indifference to environmental stimuli by competition with NE on secretory vesicles causing depletion of NE granules thus inhibiting NE release.

a)

atenolol

b)

methyldopa

c)

reserpine

d)

clonidine

61.

Diuretics that function primarily in the ascending limb of the loop of Henle include

a)

acetazolamide

b)

Spironolactone

c)

lithium

d)

furosemide

62.

Which diuretic increases the renal excretion of sodium, potassium and calcium?

a)

acetazolamide

b)

amiloride

c)

furosemide

d)

hydrochlorothiazide

63.

Furosemide increases the excretion of all the following except

a)

Na+

b)

K+

c)

Ca2+

d)

uric acid

64.

Of the following which adverse reaction is not associated with furosemide?

a)

hyperlipidemia

b)

fluid & electrolyte imbalance

c)

hypotension

d)

hypocalcemia

65.

Which of the following agents may be associated with ototoxicity which may have increased risk of occurring when patients also receive aminoglycoside antibiotic?

a)

furosemide

b)

chlorthalidone

c)

amiloride

d)

spironolactone

e)

dorzolamide

66.

What is the primary MOA of the drug indapamide?

a)

inhibition of the 2Cl-Na-K cotransporters

b)

inhibition of the Na-Cl cotransporter at the DCT

c)

inhibition of the Na-Cl cotransport at the collecting duct

d)

competitive inhibition of aldosterone binding to its receptor

e)

competitive inhibition of vasopressin binding to V2 receptors

67.

Hydrochlorothiazide is known to produce all the following effects except

a)

hyperuricemia

b)

hypocalcemia

c)

hyperkalemia

d)

hyponatremia

e)

hyperglycemia

68.

A reduction in insulin release from the pancreas may be caused by which of the following diuretics?

a)

chlorothiazide

b)

aminophylline

c)

acetazolamide

d)

propranolol

69.

Which of the following agents would be least harmful in a patient with severe hyperkalemia?

a)

amiloride

b)

hydrochlorothiazide

c)

losartan

d)

triamterene

70.

Which of the following is a synthetic steroid that acts as a competitive antagonist aldosterone?

a)

furosemide

b)

amiloride

c)

spironolactone

d)

ethacrynic acid

71.

Which of the following effects can be attributed to angiotensin II?

a)

stimulation of release of NO

b)

stimulation of release of NE

c)

stimulation of synthesis and release of aldosterone

72.

Which of the following is used in severe hypertensive emergencies; is very short-acting; and must be given

by intravenous infusion?

a)

atenolol

b)

captopril

c)

Nitroprusside

d)

prazosin

73.

Hypertrichosis is an adverse effect most likely to be associated with the use of which of the following drugs?

a)

propranolol

b)

hydrochlorothiazide

c)

minoxidil

d)

furosemide

74.

The following are important effects of digitalis on the heart EXCEPT

a)

positive inotropic

b)

decreased AV velocity

c)

decrease myocardial hypertrophy

d)

positive chronotropic

75.

Which of the following agents is/are considered useful as single agent in the acute treatment of vasospastic angina pectoris?

a)

isosorbide dinitrate

b)

propranolol

c)

verapamil

d)

all

76.

A class IV antiarrhythmic drug

a)

lidocaine

b)

sotalol

c)

phenytoin

d)

diltiazem

e)

quinidine

77.

Which of the following antiarrhythmic drug is used as a local anesthetic and preferred for the management of sustained ventricular arrhythmia associated with acute MI and digitalis intoxication?

a)

procainamide

b)

lidocaine

c)

amiodarone

d)

verapamil

e)

adenosine

78.

A man treated with this drug complains of lethargy, cold intolerance, weight gain, and constipation. Blood test reveal an elevated level of TSH, select the most likely causative agent

a)

amiodarone

b)

lidocaine

c)

procainamide

d)

quinidine

e)

verapamil

79.

What is the clinical use/s of edrophonium (tensilon)?

a)

reverses the effect of NMBs after surgery

b)

treatment of overdose of atropine

c)

management of organophosphate poisoning

80.

Which of the following agents may be used for the management of glaucoma?

a)

pilocarpine-physostigmine combination therapy

b)

ecothiophate

c)

demecarium

d)

all

81.

Atropine is useful in treating poisoning by organophosphate insecticides because it

a)

stimulates receptor directly

b)

reactivates inhibited ACHase

c)

blocks the action of ACh at both central and peripheral sites

d)

inhibits normal ganglionic transmission

82.

The drug of choice for the treatment of hyperkinetic children include

a)

diazepam

b)

methylphenidate

c)

secobarbital

d)

imipramine

e)

pyridostigmine

83.

In terms of potency, which of the following phenothiazine drugs listed below is expected to be most potent?

a)

trifluoperazine

b)

thioridazine

c)

piperacetazine

d)

trifloupromazine

e)

chlorpromazine

84.

Which of the following is an atypical neuroleptic that has the highest likelihood of producing alterations in peripheral white cell count though blockade of dopamine4-receptor?

a)

Imipramine

b)

thioridazine

c)

Droperidol

d)

clozapine

e)

promethazine

85.

Weight gain is an expected complication of therapy with all the clinically useful antipsychotics. One of the drugs listed below, however, does not produce this side effect. What is this drug?

a)

thioridazine

b)

chlorpromazine

c)

loxapine

d)

trifluphenazine

e)

molindone

86.

After receiving a large, parenterally administered dose of a psychotherapeutic drug, a patient exhibits thoracic muscle rigidity, hyperthermia, diaphoresis, rapid pulse and respiration, and urinary incontinence. Which 2 drugs are best given to antagonize this effect?

a)

dantrolene

b)

nikethamide

c)

bromocriptine

d)

phenelzine

e)

deprenyl

87.

Which of the following is/are advantage/s of the SSRIs compared to the rest of the drugs used for depression?

a)

lesser lethality with overdose

b)

generally, no dose titration is required

c)

minimal anticholinergic effects

d)

All

88.

What is the most common side effect associated with the use of TCA is similar to that of neuroleptics?

a)

sedation

b)

tachycardia

c)

weight gain

d)

hypertensive crisis

e)

None

89.

Which of the following antidepressant agents exhibits an amphetamine-like CNS stimulation?

a)

Doxepin

b)

tranylcypromine

c)

trazodone

d)

fluoxetine

90.

Which of the following side effects of lithium can be seen even in usual doses thus by itself is not considered a sign of lithium toxicity?

a)

coarse hand tremors

b)

hyperreflexia

c)

confusion

d)

ataxia

e)

polyuria

91.

Which of the following correctly describes the clinical use of carbidopa in the therapy of parkinsonism?

a)

increase the CNS bioavailability

b)

improves symptoms of bradykinesia

c)

minimize nausea and vomiting associated with levodopa

92.

Amantadine exerts its antiparkinsonism effect by

a)

preventing entry of virus into the cell

b)

inhibiting metabolism of levodopa

c)

inhibit re-uptake of dopamine

d)

blocking the cholinergic pathway in the neostriatum

93.

Which of the following is a selective inhibitor of MAO B useful in the treatment of parkinsonism?

a)

bromocriptine

b)

carbidopa

c)

selegiline

d)

phenelzine

94.

A 50-year old male with generalized tonic-clonic seizures was initially given carbamazepine as maintenance therapy. He however developed adverse response to the drug in the form of Stevens-Johnson syndrome. Which of the following agents may be safe to use as an alternative treatment of seizures?

a)

valproic acid

b)

phenytoin

c)

Phenobarbital

95.

Phenobarbital and phenylethylmalonamide are metabolites of

a)

diazepam

b)

mephobarbital

c)

trimethadione

d)

primidone

96.

A GABAmimetic drug useful in the management of muscle spasticity

a)

baclofen

b)

neostigmine

c)

chlorpromazine

d)

thiopental

97.

45-year old male admitted for severe chest pain was diagnosed with acute MI. he was being given morphine 2 mg IV for relief of of the chest pain. Which of the following is/are important findings that must be observed as expected consequence/s of the use of morphine?

a)

tachycardia

b)

hypotension

c)

vasospasm

98.

This opioid agonist is used as maintenance drug for addicts in treatment programs or to wean off patients addicted to heroin or morphine

a)

naloxone

b)

naltrexone

c)

nalbuphine

d)

methadone

99.

This drug is an opioid receptor agonist that also inhibits neuronal reuptake of serotonin

a)

codeine

b)

fentanyl

c)

tramadol

d)

methadone

100.

Morphine is useful in the clinical treatment of

a)

insomnia

b)

terminal cancer pain

c)

narcolepsy

d)

meningitis

101.

Which of the following eicosanoids is a product of the metabolism of arachidonic acid by the COX enzyme?

a)

leukotrienes

b)

isoprostanes

c)

epoxides

d)

lipoxins

e)

prostaglandins

102.

Eicosanoids derived from unsaturated fatty acids that increase the sensitivity of pain receptors include

a)

cytokines

b)

substance P

c)

prostaglandins

d)

serotonin

103.

What is the principal mechanism which can explain the antipyretic effect of aspirin?

a)

peripheral reduction in the levels of prostaglandins

b)

peripheral vasodilation

c)

inhibition of prostaglandin synthesis at subcortical

d)

inhibition of CNS response to interleukin-1

e)

activation of the thermoregulatory sweat glands

104.

Which of the following NSAIDs have minimal anti inflammatory activity and is/are primarily indicated as analgesic especially in the management of post-operative pain?

a)

Diclofenac

b)

Ketorolac

c)

Etodolac

105.

A toxic metabolite of acetaminophen binds with macromolecules of liver and results in cell death. When this drug is in overdosage this will bring about depletion in:

a)

stores of glutathione

b)

stores of tyramine

c)

stores of acetycholine

d)

none

106.

What is the primary advantage of drugs like celecoxib and etericoxib?

a)

less incidence of gastric irritation or ulceration

b)

less incidence of nephrotoxicity

c)

less incidence of hematologic toxicities

d)

minimal risk of causing worsening of HTN

e)

less likelihood of inhibiting platelet aggregation

107.

Which of the following agents is currently used as the first-line DMARDs in the management of rheumatoid arthritis?

a)

hydroxychloroquine

b)

auranofin

c)

penicillamine

d)

azathioprine

e)

methotrexate

108.

Which of the following is an H1-receptor antagonist?

a)

cimetidine

b)

ranitidine

c)

promethazine

d)

aluminum hydroxide

109.

In the management of bronchial asthma, which of the following medications is/are considered as controller medications?

a)

low-dose inhaled glucocorticosteroids

b)

short-acting beta-2 agonists

c)

long-acting inhaled beta-2 agonists

110.

Malignant hyperthermia which may develop in susceptible individuals exposed to inhalational anesthetics is appropriately treated with which of the following agents?

a)

diazepam

b)

baclofen

c)

dantrolene

d)

thiamylal

e)

haloperidol

111.

An enzyme produced by the kidney, used as a fibrinolytic agent that converts endogenous plasminogen to the enzyme plasmin that helps prevent or reduce arterial thrombi include

a)

sulfinpyrazone

b)

urokinase

c)

heparin

d)

aminocaproic acid

e)

arachidonic acid

112.

Which of the following is a drug that blocks the ADP receptor on the antiplatelet membrane?

a)

aspirin

b)

abciximab

c)

heparin

d)

clopidogrel

e)

Eptifibatide

113.

Which of the following agents is associated with formation of antibodies that can cause development of allergic reactions with subsequent exposure to the drug?

a)

urokinase

b)

streptokinase

c)

alteplase

d)

tPA

e)

tenecteplase

114.

Which of the ff hypolipidemic drugs will likely produced cholelithiasis?

a)

probucol

b)

gemfibrozil

c)

colestipol

d)

lovastatin

115.

An inhibitor of potent androgen, dihydrotestosterone include

a)

Testosterone

b)

Finasteride

c)

Clomiphene

d)

tamoxifen

116.

Which of the following is a biguanide?

a)

acetohexamide

b)

rosiglitazone

c)

Nateglinide

d)

Metformin

e)

acarbose

117.

A 55 year old patient with mild type II diabetes lives half of the time in hotels because his job involves traveling. He has trouble maintaining a suitable diet with restaurant meals, and cannot take insulin easily because of sterilization problem. All the following drugs could be tried EXCEPT

a)

acetohexamide

b)

chlorpropamide

c)

sulfanilamide

d)

tolbutamide

118.

If the patient was treated with cerivastatin, what adverse effect would be of greatest potential concern?

a)

constipation

b)

intense cutaneous rash

c)

hepatic dysfunction

d)

rhabdomyolysis

e)

hyperglycemia

119.

Which of the ff drugs is correctly matched with their mechanism of action?

a)

cholestyramine : inhibits lipolysis

b)

clofibrate : CoA reductase inhibitor

c)

gemfibrozil : increases the activity of lipoprotein lipase

d)

niacin : bile acid sequestrant

120.

What is the MOA of tranexamic acid?

a)

ADP inhibition

b)

serine protease inhibition

c)

inhibits plasminogen activation

d)

inhibits reductive hydrolysis of vitamin K epoxide

e)

increase factor VIII activity

121.

Which of the following mechanism of aspirin correctly describes its effect as an inhibitor of platelet aggregation?

a)

irreversible inhibition of endothelial cell COX

b)

irreversible inhibition of platelet COX

c)

reversible inhibition of platelet COX

d)

reversible inhibition of endothelial cell COX

e)

all

122.

Which of the following correctly describes the MOA of fibrinolytic agents?

a)

directly catalyze the proteolysis of fibrin and fibrinogen

b)

inhibit the action of thrombin by preventing its binding to fibrin and

fibrinogen

c)

activate plasminogen to plasmin, a serine protease that catalyzes breakdown of fibrin and fibrinogen

d)

inhibit activation of fibrinogen by proteolysis of thrombin

e)

activate the endogenous anticoagulants protein C and protein S

123.

Warfarin exerts its effect primarily by inhibiting the gamma-carboxylation of the glutamate residues of which of the following clotting factors?

a)

IXa, Xa, XIa, XIIIa

b)

IIa, VIIa, IXa, Xa

c)

II, VII, IX, X

d)

IX, X, XI, XIII

e)

I, II, V, VII

124.

Hirsutism or hypertrichosis, gingival hyperplasia and Steven’s Johnson syndrome is a complication of long term treatment which occurs with

a)

phenytoin therapy

b)

digoxin therapy

c)

amiodarone therapy

d)

propranolol therapy

125.

During the maintenance therapy with levodopa, patients are advised to take the drug on an empty stomach. Why is this advice given?

a)

to minimize the risk of aspiration in as much as the drug can cause

nausea and vomiting

b)

oral bioavailability of the drug is reduced as levodopa can be found to food particles in the GIT

c)

bile acids released in response to food can interfere with the absorption of the drug

d)

large neutral amino acids in food interfere with the drug’s transport across the blood brain barrier

e)

food can induce expression of DOPA

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