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Pharmacology Quiz

Total questions: 41

Worksheet time: 21mins

Name
Class
Date
1.

Which receptor mechanism best explains tachyphylaxis to repeated doses of nasal decongestants (e.g., oxymetazoline)?

a)

Receptor down-regulation

b)

Receptor up-regulation

c)

Receptor desensitization/internalization

d)

Increased second-messenger generation

2.

Which antiarrhythmic exhibits reverse-use dependence (greater APD prolongation at slower heart rates) increasing torsades risk?

a)

Amiodarone

b)

Sotalol

c)

Lidocaine

d)

Verapamil

3.

A neonate develops apnea after maternal administration of an analgesic during labour. Which drug is most likely responsible?

a)

Meperidine (pethidine)

b)

Ibuprofen

c)

Paracetamol

d)

Amoxicillin

4.

Which protein mutation is classically associated with multi-drug resistance (MDR) via efflux of chemotherapeutics?

a)

BCR-ABL

b)

P-glycoprotein (ABCB1) overexpression

c)

EGFR mutation

d)

BRAF V600E

5.

In pharmacokinetics, clearance (CL) equals:

a)

Vd × elimination rate constant (k)

b)

Half-life × Vd

c)

Bioavailability × dose

d)

Area under curve / dose

6.

Which anticonvulsant is most associated with aplastic anemia and therefore used cautiously?

a)

Carbamazepine

b)

Ethosuximide

c)

Valproate

d)

Lamotrigine

7.

Which enzyme inhibition would most reduce formation of the active metabolite of clopidogrel?

a)

CYP3A4 inhibition

b)

CYP2C19 inhibition

c)

CYP1A2 induction

d)

Glucuronidation inhibition

8.

A patient on chronic statin therapy is started on diltiazem. Which adverse reaction should be anticipated?

a)

Increased risk of statin-induced myopathy

b)

Increased LDL cholesterol

c)

Statin withdrawal syndrome

d)

Hypoglycaemia

9.

Which anti-cancer drug’s cardiotoxicity is mediated by free radical generation and is dose-limited?

a)

Cisplatin

b)

Doxorubicin

c)

Vincristine

d)

Methotrexate

10.

Which antibiotic’s absorption is markedly reduced by concurrent oral iron therapy?

a)

Ciprofloxacin

b)

Azithromycin

c)

Cefixime

d)

Doxycycline

11.

For an elderly patient with CKD (eGFR 25 mL/min/1.73m²), which analgesic is least preferable long-term?

a)

Paracetamol

b)

Naproxen (NSAID)

c)

Low-dose buprenorphine patch

d)

Topical diclofenac

12.

Which glucose-lowering agent reduces cardiovascular mortality in patients with established atherosclerotic CVD?

a)

Glimepiride

b)

Pioglitazone

c)

Empagliflozin

d)

Acarbose

13.

Which antimicrobial combination is antagonistic in vitro when bactericidal activity is required?

a)

Penicillin + gentamicin

b)

Chloramphenicol + penicillin

c)

TMP-SMX

d)

Piperacillin + tazobactam

14.

Which drug is a mechanism-based (suicide) inhibitor of CYP450 and can cause long-lasting interactions?

a)

Fluoxetine

b)

Ketoconazole

c)

Clopidogrel

d)

Omeprazole

15.

Which drug pair poses the highest risk of serotonin syndrome?

a)

Sertraline + tramadol

b)

Amitriptyline + warfarin

c)

Fluoxetine + metoprolol

d)

Citalopram + calcium channel blocker

16.

A patient with autoimmune disease needs immunosuppression but wishes to father a child soon. Which agent is least preferred due to gonadal toxicity?

a)

Azathioprine

b)

Methotrexate

c)

Hydroxychloroquine

d)

Low-dose prednisone

17.

Which inhaled anesthetic is associated with the highest risk of postoperative nausea and vomiting (PONV)?

a)

Sevoflurane

b)

Propofol (IV)

c)

Nitrous oxide

d)

Thiopental

18.

Which antibiotic’s toxicity is potentiated by concurrent loop diuretics leading to ototoxicity?

a)

Amoxicillin

b)

Gentamicin

c)

Vancomycin (less ototoxic)

d)

Azithromycin

19.

Which drug is most likely to cause drug-induced lupus?

a)

Isoniazid

b)

Hydralazine

c)

Doxycycline

d)

Omeprazole

20.

Which receptor polymorphism is most relevant for warfarin dosing variability?

a)

VKORC1 and CYP2C9 genetic variants

b)

CYP3A4 only

c)

P-gp only

d)

UGT1A1 only

21.

In elderly patients, which pharmacokinetic change commonly increases drug sensitivity?

a)

Increased renal clearance

b)

Increased Vd for hydrophilic drugs

c)

Decreased hepatic metabolism and reduced clearance

d)

Faster gastric emptying

22.

Which antiplatelet agent irreversibly inhibits the P2Y12 receptor?

a)

Ticagrelor

b)

Clopidogrel

c)

Cangrelor (reversible)

d)

Dipyridamole

23.

Which neuroleptic has the lowest risk of extrapyramidal side effects but higher metabolic adverse effects?

a)

Haloperidol

b)

Clozapine

c)

Olanzapine

d)

Fluphenazine

24.

What is the principal mechanism of action of sulfonylureas?

a)

Activate GLP-1 receptor

b)

Block ATP-sensitive Kn channels on pancreatic β-cells → insulin release

c)

Increase insulin sensitivity in peripheral tissues exclusively

d)

Inhibit α-glucosidase in intestine

25.

Which drug requires therapeutic drug monitoring due to narrow therapeutic index and non-linear kinetics?

a)

Phenytoin

b)

Gabapentin

c)

Levetiracetam

d)

Pregabalin

26.

Which antibiotic is associated with QT prolongation and torsades de pointes?

a)

Levofloxacin (fluoroquinolones)

b)

Ceftriaxone

c)

Doxycycline

d)

Amoxicillin

27.

Which antiviral requires dose adjustment in renal impairment due to renal excretion?

a)

Acyclovir

b)

Zidovudine (hepatic metabolism)

c)

Nevirapine

d)

Efavirenz

28.

Which targeted cancer therapy is a BCR-ABL tyrosine kinase inhibitor?

a)

Imatinib

b)

Erlotinib

c)

Trastuzumab

d)

Bevacizumab

29.

Which analgesic is safest for a breastfeeding mother with pain?

a)

Codeine

b)

Ibuprofen (short half-life NSAID)

c)

Tramadol

d)

High-dose aspirin

30.

Which mechanism explains ACE inhibitor–induced angioedema?

a)

Bradykinin accumulation increasing vascular permeability

b)

IgE-mediated allergic reaction exclusively

c)

Direct mast cell degranulation only

d)

Complement activation only

31.

Which drug is a direct oral anticoagulant that inhibits factor Xa?

a)

Dabigatran

b)

Rivaroxaban

c)

Heparin

d)

Warfarin

32.

Which vaccine type is contraindicated in severe immunosuppression?

a)

Live-attenuated vaccines (e.g., MMR)

b)

Inactivated vaccines

c)

Conjugate vaccines

d)

Recombinant subunit vaccines

33.

Which anti-TB drug causes optic neuritis requiring visual acuity monitoring?

a)

Isoniazid

b)

Ethambutol

c)

Pyrazinamide

d)

Rifampicin

34.

Which drug interaction causes decreased efficacy of hormonal contraceptives leading to failure?

a)

St. John’s Wort (CYP3A4 inducer)

b)

Cimetidine (CYP inhibitor)

c)

Ketoconazole (inhibitor)

d)

Erythromycin (inhibitor)

35.

Which opioid is a partial agonist at μ receptor and has ceiling effect for respiratory depression?

a)

Morphine

b)

Buprenorphine

c)

Fentanyl

d)

Methadone

36.

Which drug class is associated with pancreatitis as an adverse effect?

a)

ACE inhibitors only

b)

GLP-1 receptor agonists and DPP-4 inhibitors (reported)

c)

Benzodiazepines

d)

Statins exclusively

37.

Which antiarrhythmic is safest in patients with structural heart disease (reduced proarrhythmia risk)?

a)

Flecainide (contraindicated in structural disease)

b)

Amiodarone

c)

Quinidine

d)

Dofetilide (careful monitoring required)

38.

Which antifungal interacts seriously with statins causing rhabdomyolysis?

a)

Fluconazole (less)

b)

Itraconazole/ketoconazole (strong CYP3A4 inhibitors)

c)

Nystatin (no systemic absorption)

d)

Terbinafine (less interaction)

39.

Which drug is recommended as the first-line agent for acute gout flare?

a)

Allopurinol

b)

Colchicine or NSAIDs (e.g., indomethacin) or corticosteroids depending on patient profile

c)

Febuxostat only

d)

Probenecid

40.

Which cytokine blockade is targeted by tocilizumab?

a)

TNF-α

b)

IL-6 receptor

c)

IL-1 receptor

d)

CD20

41.

Which pharmacological property is most important for CNS penetration?

a)

High molecular weight

b)

Lipophilicity and low P-gp efflux

c)

High plasma protein binding only

d)

High ionization at physiological pH