WorksheetsPharmacology
Total questions: 50
Worksheet time: 25mins
Pharmacokinetics studies:
What the drug does to the body only
What the body does to the drug- metabolism, excretion (ADME) absorption, distribution,
Only drug pricing
Only side effects
Bioavailability (F) refers to:
Fraction of administered dose reaching systemic circulation unchanged
Drug potency only
Chemical composition
Half-life
Volume of distribution (Vd) indicates:
Drug concentration in plasma only
Apparent space in body available to contain the drug helps estimate loading dose
Elimination lag time only
Toxicity exclusively
A drug with high protein binding will:
Have more free fraction available
Have less free (active) fraction in plasma leading to potential drug interactions if displaced
Be water insoluble only
Not be metabolized
Half-life (1/2) is the time taken for:
Drug concentration to double
Plasma concentration to reduce by half during elimination phase
Drug to act
Drug to be excreted wholly
Which enzyme system is major for hepatic drug metabolism?
Renal enzymes only
Cytochrome P450 (CYP) enzymes
Digestive enzymes only
Mitochondrial DNA only
A cytochrome P450 inhibitor will:
Increase metabolism of other drugs
Decrease metabolism of substrate drugs, potentially increasing their plasma levels and toxicity
Always be therapeutic
Decrease drug absorption
First-pass metabolism reduces oral bioavailability by:
Metabolism in the gut wall and liver before reaching systemic circulation
Eliminating drugs in kidney only
Enhancing absorption
Converting to active metabolites always
Which route bypasses first-pass metabolism?
Oral
Intravenous and sublingual (to some extent)
Enteral only
Rectal always
Agonist produces:
No effect at receptor
Activation of receptor producing a physiological effect
Only antagonist effects
Inverse agonism always
Competitive antagonist effect can be overcome by:
Increasing agonist concentration (dose)
Decreasing agonist concentration only
Not possible to overcome
Changing route of administration only
A partial agonist:
Produces maximal response always
Produces submaximal response even when occupying all receptors (has intrinsic activity less than full agonist)
Is same as antagonist
Is toxic only
Pharmacodynamics involves:
ADME only
Drug-receptor interactions and physiological effect (what the drugdoes to body)
Drug manufacturing only
Price determination only
Therapeutic index (TI) is:
Ratio between toxic dose and therapeutic dose (TD50/ED50) - higher TI = safer drug
Percentage of drug absorbed
Half-life ratio
Cost-effectiveness ratio
An example of an aminoglycoside antibiotic is:
Ciprofloxacin
Gentamicin (aminoglycoside)
Amoxicillin
Erythromycin
Beta-lactam antibiotics act by:
Inhibiting protein synthesis only
Inhibiting bacterial cell wall synthesis via penicillin-binding proteins
Inactivating DNA directly
Altering human cell membranes
Which antibiotic is bacteriostatic rather than bactericidal typically?
Penicillin
Chloramphenicol or tetracyclines. many protein synthesis inhibitors are bacteriostatic
Vancomycin always bactericidal
Aminoglycosides always bacteriostatic
Resistance to antibiotics can be mediated by:
Efflux pumps, drug-modifying enzymes, target alteration, decreased permeability
Only increased drug dosing
Only patient noncompliance
Weather changes
Which medication is first-line for Type 2 diabetes initial management along with lifestyle?
Insulin only initially
Metformin (biguanide) commonly first-line unless contraindicated
Aspirin
Sulfonylurea always
ACE inhibitors may cause which common side effect?
Hyperkalemia and cough (due to bradykinin)
Hypoglycemia always
Constipation only
Ringing in ears always
Which class of drugs is contraindicated in pregnancy?
Paracetamol
ACE inhibitors (teratogenic, especially in 2nd/3rd trimester)
Prenatal vitamins
Certain penicillins (safe generally)
NSAIDs primarily work by inhibition of:
Monoamine oxidase
Cyclooxygenase (COX) enzymes decreasing prostaglandin synthesis
Acetylcholinesterase
DNA synthesis
Which antiplatelet drug irreversibly inhibits platelet function via COX-1 inhibition?
Clopidogrel
Aspirin (acetylsalicylic acid)
Heparin
Warfarin
Heparin acts by potentiating:
Protein C only
Antithrombin III (inhibits thrombin and factor Xa)
Vitamin K activity
Platelet aggregation
Warfarin's effect is antagonized by:
Vitamin C only
Vitamin K (phytonadione)
Heparin directly
Aspirin
Proton pump inhibitors decrease gastric acidity by inhibiting:
H2 receptors only
H+/K+ ATPase (proton pump) in parietal cells
Muscarinic receptors
Mucus production
Which antiemetic acts as a dopamine (D2) receptor antagonist?
Ondansetron (5-HT3 antagonist)
Metoclopramide (D2 antagonist)
Loperamide
Ranitidine
Insulin lispro is an example of:
Long-acting insulin
Rapid-acting insulin analog used for postprandial glucose control
Oral antidiabetic
Sulfonylurea
Statins lower cholesterol primarily by inhibiting:
Lipase enzyme only
HMG-CoA reductase (rate-limiting enzyme in cholesterol synthesis)
LDL receptors
Bile acid absorption only
Which analgesic is also antipyretic and not an NSAID (minimal anti-inflammatory)?
Ibuprofen
Paracetamol (acetaminophen)
Aspirin
Naproxen
Which drug class is commonly associated with ototoxicity and nephrotoxicity?
Beta-lactams only
Aminoglycosides (e.g., gentamicin)
Macrolides only
Statins
Beta-blockers decrease heart rate and contractility primarily by blocking:
Alpha-1 receptors
Beta-1 adrenergic receptors in heart
Dopamine receptors
Muscarinic receptors
Which local anesthetic has the longest duration among the commonly used agents?
Lidocaine
Bupivacaine (longer duration)
Procaine
Cocaine
A drug with narrow therapeutic index requires:
No monitoring
Therapeutic drug monitoring and careful dosing (e.g., digoxin, lithium)
High dosing always
No prescription
Antiplatelet drug clopidogrel requires activation by:
Gastric acid only
Hepatic CYP enzymes (prodrug requiring activation)
Kidney only
Light exposure
The mechanism of action of proton pump inhibitors is:
Competitive antagonism at H2 receptor
Irreversible inhibition of H+/K+ ATPase on parietal cell luminal membrane
Neutralization of acid in stomach lumen only
Coating the mucosa
A major side effect of prolonged corticosteroid use is:
Hypotension only
Immunosuppression, hyperglycemia, osteoporosis, adrenal suppression
Better hair quality only
Rapid weight loss always beneficial
Which drug is a broad-spectrum macrolide antibiotic?
Erythromycin or azithromycin (macrolides)
Trimethoprim only
Vancomycin only
Metronidazole
A medication causing QT prolongation on ECG should be used carefully with:
Other QT-prolonging drugs and electrolyte disturbances (hypokalemia, hypomagnesemia)
Beta-blockers only
Aspirin only
Opiates only
Which drug is used as an antidote for acetaminophen (paracetamol) poisoning?
N-acetylcysteine (replenishes glutathione)
Naloxone
Atropine
Diazepam
Which antihistamine is sedating due to central penetration?
Cetirizine (less sedating)
First-generation antihistamines like diphenhydramine (sedating)
Loratadine always sedating
Fexofenadine always sedating
In renal impairment, dose adjustments are usually required for drugs that are:
Hepatically metabolized only
Substantially renally excreted or have active renally-excreted metabolites
Totally inert
Protein pills only
Which antiplatelet agent is a glycoprotein IIb/IIIa inhibitor used intravenously?
Aspirin
Abciximab (GP IIb/IIIa inhibitor)
Clopidogrel oral only
Warfarin
Which antimicrobial is the drug of choice for MRSA serious infections (IV)?
Penicillin G
Vancomycin (or alternatives like linezolid depending on context)
Amoxicillin
Erythromycin
The "loading dose" calculation uses which parameter primarily?
Half-life only
Desired plasma concentration and volume of distribution (Loading dose = Vdx target concentration)
Bioavailability only
Cost of drug only
The main route of metabolism for morphine is:
CYP450 oxidative demethylation only
Glucuronidation in liver (morphine-3-glucuronide and morphine-6-glucuronide)
Renal excretion unchanged only
Hydrolysis in gut only
Which antibiotic works by inhibiting DNA gyrase/topoisomerase?
Penicillins
Fluoroquinolones (e.g., ciprofloxacin)
Macrolides
Aminoglycosides
Which pharmacokinetic parameter determines the steady-state concentration during continuous infusion?
Volume of distribution only
Clearance (Css = infusion rate / clearance) and half-life affects time to reach steady state
Protein binding only
Drug color only
Adverse drug reaction Type A (augmented) is:
Unpredictable, idiosyncratic
Dose-related and predictable from pharmacology (e.g., bleeding with warfarin)
Allergic only
Psychosomatic only
Which drug is a prokinetic and antiemetic acting partly as a dopamine receptor antagonist and 5-HT4 agonist?
Ondansetron only
Metoclopramide (prokinetic and antiemetic)
Loperamide only
Ranitidine only
