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WorksheetsPharmacology Quiz
Total questions: 41
Worksheet time: 21mins
Which receptor mechanism best explains tachyphylaxis to repeated doses of nasal decongestants (e.g., oxymetazoline)?
Receptor down-regulation
Receptor up-regulation
Receptor desensitization/internalization
Increased second-messenger generation
Which antiarrhythmic exhibits reverse-use dependence (greater APD prolongation at slower heart rates) increasing torsades risk?
Amiodarone
Sotalol
Lidocaine
Verapamil
A neonate develops apnea after maternal administration of an analgesic during labour. Which drug is most likely responsible?
Meperidine (pethidine)
Ibuprofen
Paracetamol
Amoxicillin
Which protein mutation is classically associated with multi-drug resistance (MDR) via efflux of chemotherapeutics?
BCR-ABL
P-glycoprotein (ABCB1) overexpression
EGFR mutation
BRAF V600E
In pharmacokinetics, clearance (CL) equals:
Vd × elimination rate constant (k)
Half-life × Vd
Bioavailability × dose
Area under curve / dose
Which anticonvulsant is most associated with aplastic anemia and therefore used cautiously?
Carbamazepine
Ethosuximide
Valproate
Lamotrigine
Which enzyme inhibition would most reduce formation of the active metabolite of clopidogrel?
CYP3A4 inhibition
CYP2C19 inhibition
CYP1A2 induction
Glucuronidation inhibition
A patient on chronic statin therapy is started on diltiazem. Which adverse reaction should be anticipated?
Increased risk of statin-induced myopathy
Increased LDL cholesterol
Statin withdrawal syndrome
Hypoglycaemia
Which anti-cancer drug’s cardiotoxicity is mediated by free radical generation and is dose-limited?
Cisplatin
Doxorubicin
Vincristine
Methotrexate
Which antibiotic’s absorption is markedly reduced by concurrent oral iron therapy?
Ciprofloxacin
Azithromycin
Cefixime
Doxycycline
For an elderly patient with CKD (eGFR 25 mL/min/1.73m²), which analgesic is least preferable long-term?
Paracetamol
Naproxen (NSAID)
Low-dose buprenorphine patch
Topical diclofenac
Which glucose-lowering agent reduces cardiovascular mortality in patients with established atherosclerotic CVD?
Glimepiride
Pioglitazone
Empagliflozin
Acarbose
Which antimicrobial combination is antagonistic in vitro when bactericidal activity is required?
Penicillin + gentamicin
Chloramphenicol + penicillin
TMP-SMX
Piperacillin + tazobactam
Which drug is a mechanism-based (suicide) inhibitor of CYP450 and can cause long-lasting interactions?
Fluoxetine
Ketoconazole
Clopidogrel
Omeprazole
Which drug pair poses the highest risk of serotonin syndrome?
Sertraline + tramadol
Amitriptyline + warfarin
Fluoxetine + metoprolol
Citalopram + calcium channel blocker
A patient with autoimmune disease needs immunosuppression but wishes to father a child soon. Which agent is least preferred due to gonadal toxicity?
Azathioprine
Methotrexate
Hydroxychloroquine
Low-dose prednisone
Which inhaled anesthetic is associated with the highest risk of postoperative nausea and vomiting (PONV)?
Sevoflurane
Propofol (IV)
Nitrous oxide
Thiopental
Which antibiotic’s toxicity is potentiated by concurrent loop diuretics leading to ototoxicity?
Amoxicillin
Gentamicin
Vancomycin (less ototoxic)
Azithromycin
Which drug is most likely to cause drug-induced lupus?
Isoniazid
Hydralazine
Doxycycline
Omeprazole
Which receptor polymorphism is most relevant for warfarin dosing variability?
VKORC1 and CYP2C9 genetic variants
CYP3A4 only
P-gp only
UGT1A1 only
In elderly patients, which pharmacokinetic change commonly increases drug sensitivity?
Increased renal clearance
Increased Vd for hydrophilic drugs
Decreased hepatic metabolism and reduced clearance
Faster gastric emptying
Which antiplatelet agent irreversibly inhibits the P2Y12 receptor?
Ticagrelor
Clopidogrel
Cangrelor (reversible)
Dipyridamole
Which neuroleptic has the lowest risk of extrapyramidal side effects but higher metabolic adverse effects?
Haloperidol
Clozapine
Olanzapine
Fluphenazine
What is the principal mechanism of action of sulfonylureas?
Activate GLP-1 receptor
Block ATP-sensitive Kn channels on pancreatic β-cells → insulin release
Increase insulin sensitivity in peripheral tissues exclusively
Inhibit α-glucosidase in intestine
Which drug requires therapeutic drug monitoring due to narrow therapeutic index and non-linear kinetics?
Phenytoin
Gabapentin
Levetiracetam
Pregabalin
Which antibiotic is associated with QT prolongation and torsades de pointes?
Levofloxacin (fluoroquinolones)
Ceftriaxone
Doxycycline
Amoxicillin
Which antiviral requires dose adjustment in renal impairment due to renal excretion?
Acyclovir
Zidovudine (hepatic metabolism)
Nevirapine
Efavirenz
Which targeted cancer therapy is a BCR-ABL tyrosine kinase inhibitor?
Imatinib
Erlotinib
Trastuzumab
Bevacizumab
Which analgesic is safest for a breastfeeding mother with pain?
Codeine
Ibuprofen (short half-life NSAID)
Tramadol
High-dose aspirin
Which mechanism explains ACE inhibitor–induced angioedema?
Bradykinin accumulation increasing vascular permeability
IgE-mediated allergic reaction exclusively
Direct mast cell degranulation only
Complement activation only
Which drug is a direct oral anticoagulant that inhibits factor Xa?
Dabigatran
Rivaroxaban
Heparin
Warfarin
Which vaccine type is contraindicated in severe immunosuppression?
Live-attenuated vaccines (e.g., MMR)
Inactivated vaccines
Conjugate vaccines
Recombinant subunit vaccines
Which anti-TB drug causes optic neuritis requiring visual acuity monitoring?
Isoniazid
Ethambutol
Pyrazinamide
Rifampicin
Which drug interaction causes decreased efficacy of hormonal contraceptives leading to failure?
St. John’s Wort (CYP3A4 inducer)
Cimetidine (CYP inhibitor)
Ketoconazole (inhibitor)
Erythromycin (inhibitor)
Which opioid is a partial agonist at μ receptor and has ceiling effect for respiratory depression?
Morphine
Buprenorphine
Fentanyl
Methadone
Which drug class is associated with pancreatitis as an adverse effect?
ACE inhibitors only
GLP-1 receptor agonists and DPP-4 inhibitors (reported)
Benzodiazepines
Statins exclusively
Which antiarrhythmic is safest in patients with structural heart disease (reduced proarrhythmia risk)?
Flecainide (contraindicated in structural disease)
Amiodarone
Quinidine
Dofetilide (careful monitoring required)
Which antifungal interacts seriously with statins causing rhabdomyolysis?
Fluconazole (less)
Itraconazole/ketoconazole (strong CYP3A4 inhibitors)
Nystatin (no systemic absorption)
Terbinafine (less interaction)
Which drug is recommended as the first-line agent for acute gout flare?
Allopurinol
Colchicine or NSAIDs (e.g., indomethacin) or corticosteroids depending on patient profile
Febuxostat only
Probenecid
Which cytokine blockade is targeted by tocilizumab?
TNF-α
IL-6 receptor
IL-1 receptor
CD20
Which pharmacological property is most important for CNS penetration?
High molecular weight
Lipophilicity and low P-gp efflux
High plasma protein binding only
High ionization at physiological pH
