PHARMACOLOGY Basic & Clinical Pharmacology by Katzung 8th Edition)

1.

This measure relates the dose of the drug required to produce a desired effect to that which produces an undesired effect. (p. 8) A. therapeutic index*** B. Idiosyncratic effect C. Tolerance D. Potency

2. 3. 4. 5.

This is the fraction of unchanged drug reaching the systemic circulation following administration by any route:(p. 41) A. Absorption B. First Pass Effect C. Bioavailability*** D. Bioequivalence

In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy. (p. 72) A. Phase 1 B. phase 2*** C. phase 3 D. phase 4 In this clinical phase of drug development, the drug is studied in patients with the target disease to determine its efficacy. (p. 72) A. Phase 1 B. phase 2*** C. phase 3 D. phase 4 This is an irreversible inhibitor of GABA aminotransferase and is useful in the treatment of partial seizures and WEST syndrome: (p. 404) A. vigabatrin **** C. lamotrigine B. tiagabine D. gabapentin

6.

Action of Insulin in the liver: (p. 717) A, increase storage of glucose as glycogen** B. increase glycogenolysis C.Increase ketogenesis D.increase gluconeogenesis

7. 8. 9. 10.

Most common adverse effect of insulin: (p. 721) A. hypoglycemia*** C. lipodystrophy B. allergy D. bleeding Effect of digitalis in the AV node during arrythmias: (p. 207) A. prolonged PR interval B. AV blockade C. bradycardia

D. prolonged QT interval

Immediate metabolic precursor of dopamine that penetrates the blood-brain barrier: (p.464) A. carbidopa B. levodopa C. selegiline The following are true of phenoxybenzamine: (p. 141) A. causes reversible blockade of alpha receptors B. blocks catecholamine-induced vasoconstriction C. significantly reduces blood pressure in supine individuals

D. ropinorole

D.

stimulates histamine (H1) acetylcholine and serotonin receptors

11. Antiarrhythmic drugs that prolong effective refractory period by prolonging action potential duration: (p. 239)
A. Bepridil B. Bretylium C. Esmolol D. Lidocaine

12. Antiarrhytmic of choice for suppression of recurrences of ventricular tachycardia & fibrillation after termination of the
arrhythmia by cardioversion: (p. 240) A. Adenosine B. Esmolol D. Procainamide C. Lidocaine

13.

The most serious toxic reaction to local anesthetics is: (p. 441) A. circumoral numbness C. nystagmus B. metabolic acidosis D. tonic-clonic convulsions

14. Lithiums most common side effect/s (p. 491)

A.polyuria and subclinical hypothyrodism*** C.polyuria and polydipsia B.polydipsia and subclinical hypothyroidism D. Polyuria and polyphagia

15. Most important unwanted effect of anti-psychotics secondary to relative choline deficiency.(p. 488)
A. Akathisia B. Parkinsonian syndrome C. Tardive dyskinesia**** D. Perioral rabbit syndrome

16. Blocks norepinephrine & serotonin reuptake pumps-the the off switches of amine transmission (p. 503)
A. MAO inhibitors B. tricyclics*** C. SSRI D. heterocyclics

17. Drug interaction of older MAO inhibitor

A. depression

with tyramine ingested in food:(p. 505) B. Hypertensive reactions*** C. hypotension D. mania

18. The following are sites of the major classes of anti-hypertensive drugs, except:(p.158 )
A. B. C. D. Sympathetic nerve terminals -receptors of juxtaglomerular cells that release rennin Hypothalamus Vasomotor center

19. The following statements regarding selection of anti-hypertensive drugs are correct, except: (p. 179)
A. ACE inhibitors are particularly useful in diabetic patients with evidence of renal disease. B. White race responds better to diuretics and calcium channel blockers than to -blockers and ACE inhibitors. C. Beta-blockers or calcium channel blockers are useful in patients who have angina. D. Diuretics or ACE inhibitors are useful who also have CHF

20. The following are the determinants of vascular tone, except:(p. 182)
a.Increasing cGMP b.Increasing cAMP in the vascular cells c.Decreasing intracellular calcium d.Stabilizing or preventing depolarization of the vascular smooth muscle cell membrane

21. The following are the pharmacodynamics of nitroglycerine, except: (p. 184-185)
A. B. C. Smooth muscle relaxation Decreased ventricular preload Responsible for a decrease in platelet aggregation Increased cardiac output

D.
A. B. C. D.

22. The following are the pharmacodynamics of NSAIDs, except: (p. 598-599)
Mediated chiefly through inhibition of biosynthesis of prostaglandins All NSAIDs inhibit platelet aggregation All NSAIDs are anagesic, anti-inflammatory and antipyretic They are all gastric irritants as well

23. The following are disease-modifying antirheumatic drugs, except: (p. 608)
a. b. c. d. Methotrexate Cyclosporins Corticosteroids Azathioprine

24. This agent inhibits cell wall synthesis by binding firmly to the D-Ala-D-Ala terminus of nascent peptidoglycan pentapeptide.
It inhibits the transglycosylase, preventing further elongation of peptidoglycan and cross-linking. ( p. 768 ) A. Cycloserine B. Vancomycin C. Teicoplanin D. Bacitracin

25. This agent is a potent inhibitor of microbial protein synthesis. It binds reversibly to the 50 S subunit of the bacterial ribosome
and inhibits peptidyl transferase step of protein synthesis. This agent is active against rickettsiae but not chlamydiae: ( p. 774) A. Chloramphenicol B. Chlortetracycline C. Amikacin D. Penicillins

26. These agents readily bound to calcium deposited in newly formed bone or teeth in young children. When drug is given
during pregnancy, it can be deposited in the fetal teeth, leading to fluorescence, discoloration, and enamel dysplasia: ( p. 778 ) A. Azithromycin B. Linezolid C. Tetracyclines D. Aminoglycosides

27. This drug is split by intestinal microflora to yiels sulfapyridine and 5 aminosalicylate and is widely used in ulcerative colitis,
enteritis and other inflammatory bowel diseases. (p. 794-795) A. Sulfadoxine B. Sulfamethoxazole C. Sulfasalazine D. Sulfadiazine

28. Blocks the conversion of cholesterol to pregnanolone and causes reduction in the synthesis of all hormonally active steroids;
used in pts. with breast Ca (page 674) A. metyrapone B. trilostane C. aminoglutethimide D. spirinolactone

29. A glucocoorticoid antagonist that is an antifungal imidazole derivative, that is potent and rather nonselective inhibitor of
adrenal and gonadal steroid synthesis: (page 674) A. aminogluthetimide B. ketoconazole C. trilostane D. mitotane

30. The most widely used mineralocorticoid, with both mineralocorticoid and glucocorticoid activity: (page 672)
A. aldosterone B. deoxycortisone C. fludrocortisone D. cortisone

31. Act as a partial agonist at estrogen receptors in the pituitary, to treat infertility in women by stimulating ovulation: (page 699)
A. tamoxifen B. clomiphene C. danazol D. mifepristone

32. An antiandrogen that prevents synthesis of dihydrotestosterone by inhibiting the activity of 5- reductase: (page 705)
A. spirinolactone B. cyproterone C. finasteride D. flutamide

33. Effects of progesterone: (page 690)

A. increase basal insulin levels B. promotes blood coaguability C. promotes breast development D. affects protein metabolism

34. Mazzoti reaction, as an adverse effect is seen with the use of this agent, characterized as eosinophilia, rashes due to the
release of foreign particles from the dying microfilariae: : (page 908) A. niclosamide B. diethylcarbamazine C. piperazine D. chloroquine

35. A

depolarizing muscular blocking agent used as an alternative to mebendazole in the treatment of ascariasis and enterobiasis: (page 917) A. piperazine citrate B. pyrantel pamoate C. praziquantel D. primaquine

36. Kills dormant liver forms in malaria: (page 889)

A. piperazine citrate B. pyrantel pamoate C. praziquantel D. primaquine

37. The drug that could accelerate antithrombin activity resulting to blockade of the coagulation cascade at the at the thrombin
level, thus preventing the formation of a clot is: (p. 567) A. Warfarin B. Heparin ans C. Coumarin D. Plasmin

38. This is an antiplatelet drug whose mechanism of action involves inhibition of thromboxane synthesis, thus consequently,
prevention of platelet aggregation & thrombus formation: (p. 574) A. Clopidogel B. Ticlopidine C. Aspirin ans D. Dipyridamole

39. Among the thioamide antithyroid drug, which one is preferred for pregnant women because it crosses the placental barrier
less readily thus will not affect the fetus?( p. 651) A. Methimazole B. Carbimazole C. Propylthiouracil ans D. Ipodate

40. Which beta blocker is most widely used to control the symptom of hyperthyroidism? (p. 653)
A. B. C. D. Propranolol ans Metoprolol Labetalol Guanithidine

41. Drugs that competitively inhibit CYP enzymes cause a. Decrease in concentration of the object drug b. Increase in concentration of object drug c. Decrease efficacy of object drug d. Irreversible inactivation of the enzyme 42. The mechanism of action of benzodiazepines is explained by: a. Substitution for GABA b. Direct activation of GABA receptors c. Increase duration of GABA gated chloride channel opening d. Increase frequency of GABA gated chloride channel opening 43. The use of benzodiazepines in the chronic treatment of seizures is limited because of their

a.
b.

high toxicity effects slow absorption

c. tolerance d. low therapeutic index

44. Which should be observed to minimize adverse effects of sedative hypnotics? a. Always give a very low dose. b. Doses should be given at daytime. c. Combine two drugs with different toxicities d. Efficacy of therapy is based on patients subjective response 45. A 50 y/o male coca cola executive was using fluoxetine for depression but decided to stop taking the drug for it affects his sexual performance and even said he is getting older. He is also a tobacco user. What is the next best drug to use?

a.

Bupropion b. Sertraline

c. citalopram d venlafaxine

46. A fly catching movement of the tongue commonly observed as a drawback of all typical antipsychotics is called

a.
b.

lead pipe rigidity rabbit syndrome

c. tardive dyskinesia d. akathisia c. isoflurane d. halothane Which is not a recommended drug?

47. The most hepatotoxic general inhalational anesthetic a. Nitrous oxide

b.

Sevoflurane

48. A 55 year old female has post-menopausal osteoporosis. a. Estrogen c.

b. Calcium 49. Corticosteroid with most potent anti-inflammatory activity:

Biphosphonate d. Calcitonin

a.
b.

Prednisone Dexamethasone

c. Betamethasone d. Cortisone

50. Drug of choice (DOC) for endometriosis in young women

a. b. a.
b.

danazol leuprolide

c. mifepristone d. misoprostol

51. The effect of diethylstilbestrol intake taken during pregnancy on female infants: vaginal adenocarcinoma endometrial carcinoma c. cervical polyp d. breast fibroadenoma

52. The most common adverse effect of clomiphene is

a.
b.

hot flushes hair loss

c. constipation d. headache

53. A 65 year old married man was found to have greatly enlarged prostate. Which one of the following drug is MOST likely to suppress prostatic growth without affecting libido? a. Spironolactone c. Ketoconazole

b. b. a.
b.

Finasteride

d. Flutamide

54. Testosterone therapy may be indicated for the treatment of erectile dysfunction in which of the following situation? a. Aged patient c. Alcoholism Hypogonadism d. Depression

55. Major mechanism of action of aspirin as NSAID is Reversible COX inhibitor Chemotaxis inhibition c. Irreversible PG biosynthesis inhibition d. Down regulation of IL-1

56. Which of the following is the drug of choice for inducing labor

a.
b.

Oxytocin Misoprostol

c. Methyl ergonovine d. Dinoprostone

57. The primary consideration in all clinical trials is to a. Determine the safety of the drug b. Determine the efficacy of the drug c. Ensure that there is no risk to the subject d. Provide for the welfare of the subject

58. According to the Philippine National Drug Formulary (PNDF), complementary drugs are:
A. B. C. D. those drugs italicized in the guide drugs that satisfy the health care needs of majority of population drugs with special pharmacological properties not to be used as an alternative to core drugs

Ans. C. Philippine National Drug Formulary, 2000 edition, p. 109. Essential Drugs Concept 59. Which of the following is considered a regulated drug? A. pseudoephedrine C. lysergic acid diethylamide (LSD) B. meperidine D. cocaine Ans. A. Dangerous Drug Board Info Republic Act 6425 Dangerous Drugs 60. Differences in the rate of acetylation of isoniazid among groups of individuals exemplifies. A. pharmacodynamics C. pharmacogenetics B. posology D. biochemorphology Ans. C. Katzung, 9th edition, pp. 2 and 5. Pharmacogenetics

61. Absorption of most orally administered drugs occurs in the small intestine.
A. taking agents that accelerate gastric emptying time B. the presence of food C. stimulation of hepatic microsomal CYP3A4 enzymes D. increasing intestinal motility Ans. A. Katzung, 9th edition, pp. 41, 42, 53, and 56. Pharmacokinetics 62. The nicotinic acetylcholine receptors are categorized as to which type? A. G protein coupled C. kinase-linked B. ion channel-linked D. nuclear Ans. B Katzung, 9th edition pp. 18-23 Pharmacodynamics 63. If a drug has a high distribution volume, it indicates: A. it is highly bound to plasma proteins B. the drug is highly retained in the vascular compartment C. the plasma drug concentration will increase D. there is extensive tissue uptake Ans. D. Katzung, pp. 35 and 47. Pharmacokinetics 64. The index of safety of a drug decreases as the median toxic dose : A. decreases and the median effective dose increases B. increases and the median effective dose decreases C. and the median effective dose decrease D. and the median effective dose increase Ans. A. Katzung, 9th edition, p. 30. Pharmacodynamics

This may be enhanced by:

65. What is the major second messenger of beta receptor activation that participates in signal transduction? A. inositol triphosphates C. calcium B. cAMP D. adenylyl cyclase Ans. B. Katzung, 9th edition, p. 25-27. Pharmacodynamics 66. In what condition are the drugs phenoxybenzamine and phentolamine useful?

A. pheochromocytoma B. migraine attacks Ans. A. Katzung, 9th edition, pp. 144-146. Adrenergic Receptor Blockers 67. Acetylcholine acts by: A. increasing adenylyl cyclase activity B. decreasing cGMP concentrations C. activating the IP3, diacylglycerol pathway D. all of the above Ans. C Katzung, 9th edition, p.97 Cholinergic Agonists

C. essential hypertension D. benign prostatic hyperplasia

68. Which of the following antihypertensive agents has the best documented evidence for prophylaxis against migraine attacks?
A. pindolol B. propranolol Ans. B. Katzung, 9th edition, pp. 148 and 156 Adrenoceptor Antagonists C. clonidine D. prazosin

69. Which is a direct effect of nitrates when given in the usual doses for the management of angina?
A. increased preload B. increased afterload Ans. D. Katzung, 9th edition, p. 190. Vasodilators / CVS Drugs 70. A college friend consults you regarding the suitability of the therapy his doctor has prescribed for severe hypertension. He complains of postural and exercise hypotension ("dizziness"), some diarrhea, and problems with ejaculation during sex. Which of the following is most likely to produce the effects that your friend has described? A. propranolol C. hydralazine B. guanethidine D. captopril Ans. B. Katzung, 9th edition, p. 166. Antihypertensive / CVS Drugs 71. The most important pharmacologic action of digitalis in the treatment of heart failure is its ability to: A. reduce venous pressure C. produce diuresis in edematous patients B. increase heart rate D. increase myocardial contractile force Ans. D. Katzung, 9th edition, p. 205. Cardiac Glycosides / CVS Drugs C. increased cardiac contractility D. smooth muscle relaxation

72. Side effects of oxytocin use in a woman in labor includes the following, EXCEPT:
A. increase in BP B. uterine rupture C. fetal death D. diuresis Ans. D. Katzung 9th edition, p. 621 Hormones and Pituitary glands / Drugs used for Endocrine Disorders 73. An antithyroid drug which may be given to reduce the vascularity of the thyroid gland prior to thyroidectomy: A. RAI C. methimazole B. PTU D. Lugol's iodine Ans. D. Katzung, 9th edition, p. 633 Thyroid & Antithyroid Drugs / Drugs used for Endocrine Disorders

74. Drugs that decrease bone resorption include the following, EXCEPT:
A. calcitonin B. estrogen C. alendronate D. fluoride

Ans. D. Katzung, 9th edition, p. 719 Agents that affects bone mineral homeostasis 75. Which drug is used as an antiretroviral agent? A. oseltamivir C. indinavir B. famciclovir D. ribavirin Ans. C. Katzung, 9th edition, p. 820 Anti-viral Agents 76. Which of the following enzymes is inhibited by the binding of a beta lactam antimicrobial with penicillin-binding proteins (PBPs)? A. beta-lactamase C. peptidyl tranferase B. transpeptidase D. acetylase Ans. B. Katzung, 9th edition, pp. 734-735 and 764. Beta-lactams / Antimicrobials

77. A poor farm helper from Palawan was diagnosed to have falciparum malaria by blood smear.
readily available agent to prescribe if this farmer has an allergy to sulfonamides is: A. Fansidar C. chloroquine B. quinine D. mefloquine Ans. B. Katzung, 9th edition, p. 869 Anti-malarial Drugs / Antiprotozoals 78. Radical cure for malaria is achieved by giving: A. chloroquine C. mefloquine B. quinine D. primaquine Ans. D. Katzung, 9th edition, p.871 Anti-malarial Drug

The safe, cost-effective, and

79. There is a sudden increase of atypical pneumonia secondary to Mycoplasma, Chlamydia, and Rickettsia in the Pneumonia
Ward of a tertiary hospital. Majority of patients were treated with doxycycline. All of the following ADRs are to be watched out for in these patients EXCEPT: A. photosensitivity C. superinfection B. fetal bone defects D. renal failure Ans. D. Katzung, 9th edition, pp. 758 Tetracyclines / Antimicrobials 80. Which of the following agents may predispose to the development of A. erythromycin C. vancomycin B. metronidazole D. clidamycin Ans. D. Katzung, 9th edition, p. 761 Antimicrobials 81. A patient with persistent chronic cough and fever had no response to adequate doses of oral penicillin. The PE showed normal chest findings. Further PE showed bullous myringitis. A chest Xray showed infiltrates in the right lower lobe. Which of the following antimicrobials would be effective? A. parenteral penicillin G C. vancomycin B. chlarithromycin D. gentamicin Ans. B. Katzung, 9th edition, pp. 760 Macrolides / Antimicrobials pseudomembranous colitis?

82. A 4 year old boy that has diarrhea and malnutrition was noted to have a mixed parasitic infection of Ascaris, Capillaria
philippinensis, and Trichiuris trichiura. The single agent that could be effective for this patient is: A. pyrantel pamoate C. diethylcarbamazine B. mebendazole D. niclosamide Ans. B.

Katzung, 9th edition, pp. 889-895. Harrison, 15th edtition, p. 1249. Anti-helmintic Drugs

83. Activated charcoal may be used to treat poisoning due to the following EXCEPT:
A. primaquine B. aspirin Ans. D. Katzung, 9th edition, p. 989 Management of Poisoned Patient 84. This herbal plant endorsed by the DOH is useful for the relief of muscle pain: A. Yerba Buena C. Tsaang gubat B. Akapulko D. Sambong Ans. A. DOH Manuals. Herbal Medicines 85. On regular follow-up for tuberculosis, you noticed that the visual acuity of Vilma worsened from 20/20 to 20/50 in both eyes after only three weeks of HRPE. Your approach in management would be to discontinue: A. all of the 4 drugs and reintroduce one drug at a time B. ethambutol and refer to an ophthalmologist C. pyrazinamide and refer to an ophthalmologist D. ethambutol, reintroduce it after 1 week, and refer to an ophthalmologist Ans. . Katzung, 9th edition, p. 786. Anti-tuberculosis Drugs 86. Phenytoin is administered intravenously for acute management of seizure, but when given at a rapid rated can cause A. generalized seizure C. cardiac arrhythmia B. gingival hyperplasia D. gastrointestinal disturbances Answer C. Goodman and Gilman, 10th edition, p. 530. Anti-epileptic drugs / CNS Drugs 87. Which anticonvulsant is safe in pregnancy? A. hydantoin C. valproic acid B. trimethadione D. none of the above Answer D. Katzung, 9th edition, pp. 398. Anti-epileptic drugs / CNS Drugs C. propoxyphene D. iron overdose

88. Which of the following is a common mechanism of action shared by all NSAIDs?
A. inhibition of arachidonate release from the plasma membrane by ihibiting phospholipase B. Inhibition of histamine release by inhibiting mast cell degranulation C. Inhibition of the production of prostaglandin and thromboxane from arachidonic acid through inhibition of prostaglandin H synthesis D. Inhibition of the the formation of leukotrienes by inhibiting lipoxygenase Answer: C. Katzung, 9th edition, pp. 263, 306, 577, and 581 Agents which controls prostaglandin effect / CNS Drugs 89. The primary reason why aspirin has been displaced by NSAIDs as first choice drug of pediatric rheumatologists is because: A. poor inflammatory effect and gastric irritation B. poor inflammatory effect and Reyes syndrome C. lack of liquid preparation and high toxicity effect D. need for frequent administration and association with Reyes syndrome Answer D. Katzung, 9th edition, p. 579-581. Goodman and Gilman, 10th edition, p. 698. Agents which control prostaglandin effect / CNS Drugs

90. The intravenous anesthetic producing the so-called "dissociative anesthesia" is:
A. fentanyl B. thiopental C. ketamine D. propofol

Answer: C. Katzung, 9th edition, pp. 413-414. Goodman and Gilman, 10th edition, pp. 346-347. General Anesthetic / CNS Drugs

91. Your patient requests you to give her a sedative-hypnotic that not will not only calm her down or put her to sleep but will
make her forget the whole operating room experience as well. To facilitate this request your drug regimen should include: A. midazolam C. phenobarbital B. succinylcholine D. etomidate Answer: A. Katzung, 9th edition, p. 413-415. General Anesthetic / CNS Drugs B 92. The process by which the amount of drug in the body is reduced after administration but before entering the systemic circulation is called A. Excretion B. First-pass Effect C. Metabolism D. First-order elimination MPL: 0.33 Page 43 with the antagonist and not

C 93. Which of the following terms best describes an antagonist that interacts directly at all, or only incidentally, with the receptor? A. Pharmacologic antagonist B. Partial agonist C. Chemical antagonist D. Physiologic antagonist MPL: 0.33 Page 16 B 94. A child has swallowed the contents of 2 bottles of a nasal decongestant whose primary ingredient is a potent, selective adrenoceptor agonist drug. The signs of alpha activation that may occur in this patient include A. Bronchodilation B. Cardioacceleration (tachycardia) C. Vasodilation D. Pupillary dilation (mydriasis) MPL: 0.33 Page 127 A 95. Ms. Green has severe hypertension and is to receive minoxidil. Minoxidil is a vasodilator that does not act on autonomic receptors. When used in severe hypertension, its effects would probably include A. Tachycardia and increased cardiac contractility B. Tachycardia and decreased cardiac output C. Decreased mean arterial pressure and decreased cardiac contractility D. Decreased mean arterial pressure and increased salt and water excretion by the kidney MPL: 0.25 Page 170 B 96. Several children at a summer camp were hospitalized with symptoms thought to ingestion of food containing botulinum toxin. The effects of botulinum toxin are likely to include A. Bronchospasm B. Cycloplegia C. Diarrhea D. Skeletal muscle spasms MPL: 1.0 Page 89 D 97. Parathion has which one of the following characteristics? A. It is less toxic to humans than malathion B. It is more persistent in the environment than DDT C. It is poorly absorbed through skin and lungs D. Its toxicity, if treated early, may be partly reversed by pralidoxime MPL: 0.5 Page 1029 B 98. Ms. Brown has had myasthenia gravis for several years. She reports to the department complaining of rapid onset of weakness of her hands,

powerful arteriolar

be due to

emergency

diplopia, and difficulty swallowing. She may be suffering from a change in response to her myasthenia therapy, ie, a cholinergic or a myasthenic crisis. The best drug for distinguishing between myasthenic crisis (insufficient therapy) and cholinergic crisis (excessive therapy) is A. Atropine B. Edrophonium C. Physostigmine D. Pralidoxime MPL: 0.25 Page 103 D 99. A 30-year-old man has been treated with several autonomic drugs for 4 weeks. He is now admitted to the emergency department showing signs of drug toxicity. Which of the following signs would distinguish between an overdose of a ganglion blocker versus a muscarinic blocker? A. Blurred vision B. Dry mouth, constipation C. Physostigmine D. Postural hypotension MPL: 0.33 Page 116 B 100. Dilation of vessels in muscle, constriction of cutaneous vessels, and positive and chronotropic effects on the heart are all actions of A. Acetylcholine B. Epinephrine C. Isoproterenol D. Metaproterenol MPL: 0.5 Page 130 A 101. Adverse effects that limit the use of adrenoceptor blockers include failure exacerbation from -blockers inotropic

Heart

A. B. C.

Impaired blood sugar response with -blockers Increased intraocular pressure with -blockers

Sleep disturbances from -blocking drugs MPL: 0.5 Page 145 C 102. Which of the following binds covalently to the site specified? Atenolol - receptor A.

B. C. D.

Carvedilol cardiac receptors Phenoxybenzamine- receptor

Pindolol - receptors MPL: 1.0 Page 141 B 103 Which one of the following is characteristics of enalapril treatment in patients essential hypertension? A. Competitively blocks angiotensin II at its receptor B. Decreases angiotensin II concentration in the blood C. Decreases renin concentration in the blood D. Increases sodium and decreases potassium in the blood MPL: 0.5 Page 173 A 104 A visitor from another city comes to your office complaining of incessant cough. diabetes and hypertension and has recently started taking a different antihypertensive medication. The most likely cause of his cough is A. Captopril B. Losartan C. Propranolol D. Verapamil MPL: 0.5 Page 172 B 105. Verapamil is associated with all of the following, EXCEPT: A. Bradycardia B. Hyperglycemia with

He has

C. Increased PR interval D. Pretibial edema MPL: 0.2 Page 172 A 106. The antianginal effect of propranolol may be attributed to which one of the A. Block of exercise-induced tachycardia B. Decreased end-diastolic ventricular volume C. Dilation of constricted coronary vessels D. Increased cardiac force MPL: 0.5 Page 195 following?

B 107. A patient is admitted to the emergency department following a drug overdose. He is noted to have a severe tachycardia. He has been receiving therapy for hypertension and angina. A drug that often causes tachycardia is A. Diltiazem B. Isosorbide dinitrate C. Propranolol D. Verapamil MPL: 0.33 Page 185 B 108. Drugs that have been found to be useful in one or more types of heart failure all of the following, EXCEPT include

A.

Na+/K+ ATPase inhibitors B. Alpha-adrenoceptors agonist C. Beta-adrenoceptors antagonists D. ACE inhibitors MPL: 1.0 Page 127 D 109. The mechanism of action of digitalis is associated with A. A decrease in calcium uptake by the sarcoplasmic reticulum B. An increase in ATP synthesis C. A modification of the acting molecule D. An increase in systolic intracellular calcium levels MPL: 0.33 Page 205 recent-onset heart

B 110. A patient with long-standing diabetic renal disease and hyperkalemia and failure requires a diuretic. Which of the following agents would be LEAST harmful in a patient with severe hyperkalemia? (pp.256) A. Amiloride B. Hydrochlorothiazide C. Spironolactone D. Triamterene MPL: 1.0 Page 256 B

111. Inflammation is a complex tissue reaction that includes the release of cytokines, leukotrienes, prostaglandins, and peptides. Prostaglandins involved in inflammatory processes are produced from arachidonic acid by A. Cyclooxygenase -1 B. Cyclooxygenase-2

C. D.
B 112.

Lipoxygenase

Phospholipase A2 MPL: 0.5 Page 312 Which of the following situations constitutes an added risk of digoxin toxicity? A. Administration of captopril B. Adminstration of quinidine C. Hypermagnesemia D. Hyperkalemia MPL: 0.33 Page 230 Successful therapy of heart failure with digoxin will result in which one of A. B. C. D. Decreased heart rate Increased afterload Increased aldosterone Increased renin secretion the

A 113. following?

MPL: 1.0 Page 206 D 114. When used as an antiarrhythmic drug, lidocaine typically A. increases action potential duration B. Increases contractility C. Increases PR interval D. Reduces abnormal automaticity MPL: 0.25 Page 235 Which of the following is a recognized effect of nitric oxide (NO)? A. Arrhythmia B. Bronchoconstriction C. Constipation D. Pulmonary vasodilation MPL: 1.0 Page 329 One effect that theophylline, nitroglycerin, isoproterenol, and histamine have A. Increased gastric acid secretion B. Direct stimulation of cardiac contractile force C. Tachycardia D. Postural hypotension MPL: 0.25 Page 1023 B 117. Nedocromil has as its major action A. Block of calcium channels in lymphocytes B. Block of mediator release from mast cells C. Block of phosphodiesterase in mast cells and basophils D. Smooth muscle relaxation in the bronchi MPL: 0.5 Page 337 diarrhea. in

D 115.

C 116. common is

C 118 You are on your way to take an examination and you suddenly get an attack of If you stop at a nearby drugstore for an over-the-counter opioid with antidiarrheal action, you will be asking for A. Codeine B. Dextromethorphan C. Loperamide D. Diphenoxylate MPL: 1.0 Page 527 C 119. Conversion of plasminogen to plasmin is brought about by A. Aminocaproic acid B. Heparin C. Reteplase D. Warfarin MPL: 0.2 Page 572 Which of the following pairs of a drug effect and mechanism of action is A. B. Allopurinol action in gout: inhibits reuptake of uric acid from renal tubular fluid Etanercept antirheumatic action: inhibits dihydroorotate dehydrogenase, the enzyme in lymphocytes that is required for pyrimidine synthesis C. Hydroxychloroquine antirheumatic action: a cytotoxic drug that kills rapidly dividing lymphocytes D. Indomethacin closure of patent ductus arteriosus: blocks prostaglandin E production in the ductus arteriosis of the newborn MPL: 0.4 Page 605 B 121. A 52-year-old woman presented with intense pain, warmth, and redness in the on her left foot. Examination of fluid withdrawn from the inflamed joint revealed crystals of uric acid. In the treatment of this womans acute attack of gout, the advantage of using indomethacin instead of colchicines is that indomethacin is A. Less likely to cause acute renal failure B. Less likely to cause severe diarrhea C. Less likely to precipitate sudden gastrointestinal bleeding

120.

accurate?

first toe

D. More likely to prevent another acute attack MPL: 0.6 Page 605 A 122. A 27-year-old woman with amenorrhea, infertility, and galactorrhea was with a drug that successfully restored ovulation and menstruation. Before being given the drug, the woman was carefully questioned about previous mental health problems, which she did not have. She was advised to take the drug orally. The drug used to treat this patient was probably A. Bromocriptine B. Desmopressin C. Leuprolide D. Human gonadotropin hormone MPL: 0.5 Page 468 D 123. Methimazole reduces serum concentration of T3 primarily by treated

A.

Accelerating the peripheral metabolism of T3 B. Inhibiting the proteolysis of thyroid-binding globulin C. Inhibiting the secretion of TSH D. Preventing the addition of iodine to tyrosine residues on thyroglobulin MPL: 0.6 Page 651 C 124. Pharmacologic effects of exogenous glucocorticoids include A. Increased muscle mass B. Hypoglycemia C. Inhibition of leukotriene synthesis D. Improved wound healing MPL: 0.33 Page 665 Toxic effects of long-term administration of a glucocorticoid include A. A lupus-like syndrome B. Adrenal gland neoplasm C. Hepatotoxicity D. Osteoporosis MPL: 0.33 Page 670 who now wish to

D 125.

D 126. For patients who have been on long-term therapy with a glucocorticoid and discontinue the drug, gradual tapering of the glucocorticoid is needed to allow recovery of A. Depressed release of insulin from pancreatic B cells B. Hematopoiesis in the bone marrow C. Normal osteoblast function D. The hypothalamic-pituitary-adrenal system MPL: 0.6 Page 671 B 127. The estrogen that is used in most combined hormonal contraceptives is A. Clomiphene B. Ethinyl estradiol C. DES D. Norgestrel MPL: 1.0 Page 682 The most likely complication of insulin therapy in this patient is A. Dilutional hyponatremia B. Hypoglycemia C. Pancreatitis D. Severe hypertension MPL: 1.0 Page 721

B 128.

C 129. A 54-year-old obese patient with type 2 diabetes and a history of alcoholism should not receive metformin because it can increase the risk of A. A disulfiram-like reaction B. Excessive weight gain C. Lactic acidosis D. Hypoglycemia MPL: 0.5

probably

Page 728 B 130. Which of the following drugs is MOST likely to cause hypoglycemia when used monotherapy in the treatment of type 2 diabetes? A. Acarbose B. Glyburide C. Miglitol D. Rosiglitazone MPL: 0.4 Page 726 D 131. A patient needs antibiotic treatement for native valve, culture-positive infective entericoccal endocarditis. His medical history includes a severe anaphylactic reaction to penicillin G during the past year. The best approach would be treatment with A. Amoxicillin-clavulanate B. Aztreonam C. Meropenem D. Vancomycin MPL: 0.4 Page 768 C 132. The mechanism of antibacterial action of tetracyclines involves A. Binding to a component of the 50S ribosomal subunit B. Inhibition of translocase activity C. Blockade of binding of aminoacyl-tRNA to bacterial ribosomes D. Selective inhibition of ribosomal peptidyl transferases MPL: 0.33 Page 776 respond to as

D 133. In patient with culture-positive enterococcal endocarditis who has failed to vancomycin because of resistance, the treatment most likely to be effective is A. Clarithromycin B. Erythromycin C. Minocycline D. Linezolid MPL: 1.0 Page 782 D 134. Which of the following adverse effects is most likely to occur with sulfonamides? A. Neurologic effects, including headache, dizziness, and lethargy B. Hematuria C. Fanconis aminoaciduria syndrome D. Skin reactions MPL: 0.2 Page 793

135. On her release from hospital, the patient is advised not to rely solely on oral avoid pregnancy because they may be less effective while she is being maintained on antimycobacterial drugs. The agent most likely to interfere with the action of oral contraceptives is A. Ethambutol B. Isoniazid C. Rifampin D. Pyrazinamide MPL: 1.0 Page 806

contraceptives to

C 136. Chemical interactions between this drug and cell membrane components formation of pores lined by hydrophilic groups present in the drug molecule A. Caspofungin B. Griseofulvin C. Nystatin D. Fluconazole MPL: 0.25 Page 1049 D 137. Which of the following statements about fluconazole is most accurate? A. it is highly effective in treatment of aspergillosis B. It does not penetrate the blood-brain barrier C. Its oral bioavailability is less than that of ketoconazole

can result in the

D. It inhibits demethylation of lanosterol MP[L: 0.25 Page 819 D 138. Which of the following drugs binds to a viral envelope protein preventing conformational changes required for the fusion of viral and cellular membranes? A. Abacavir B. Adenavir C. Oseltamivir D. Enfuvirtide MPL: 0.33 Page 820 No Question Ans 139. Which of the following is NOT an expected effect of muscarinic agonists C instilled into the conjunctival sac? a. Contraction of the smooth muscle of the iris sphincter b. Contraction of the ciliary muscle c. Mydriasis d. Improves aqueous humor outflow in the canal of Schlemm. 140. Nausea, vomiting, diarrhea, urinary urgency, salivation, sweating, cutaneous D vasodilation and bronchial constriction are caused by an overdose of: a. Ipratropium b. Pirenzepine c. Benztropine d. Pilocarpine 141. In normal individuals and more so in patients with airway disease, the A administration of this agent causes cause some bronchodilation and reduction in secretion. a. Atropine b. Metacholine c. Carbachol d. Bethanechol 142. This agent relieves motion sickness and is as effective as any more recently introduced agent but causes significant sedation and dry mouth. a. Oxybutinin b. Scopolamine c. Tolterodine d. Darifenacin AL, 25y.o. male patient is brought to the emergency room suffering from bronchospasm, mucous membrane congestion, angioedema, and severe hypotension. The appropriate drug is: a. Phenylephrine b. Ephedrine c. Amphetamine d. Epinephrine BM, 50 yo female is asthmatic and hypertensive. The following class of drugs should be avoided as maintenance treatment for her hypertension. a. ACE inhibitors b. Calcium channel blockers c. Beta-blockers d. Diuretics Which of the following CNS neurotransmitters has only an inhibitory mechanism of action? a. GABA b. Acetylcholine c. Glutamate d. 5-Hydroxttryptamine Which among the following sedative-hypnotic drugs has the longest elimination half-life and is ingested as a prodrug that is hydrolyzed to its active form in the stomach? a. Alprazolam b. Lorazepam c. Oxazepam d. Clorazepate This drug is a novel hypnotic drug prescribed for patients who have difficulty in falling asleep. In polysomnography studies of patients with chronic insomnia, this drug reportedly reduced the latency to persistent sleep with no rebound insomnia or withdrawal symptoms. a. Remelteon b. Buspirone B the

Ref page4 97

105

113

114

143.

137

144.

156

145.

341

146.

352

147.

350

147.

c. Diazempam d. Triazolam EJ, 35 yo executive often awakens early in the sleep cycle and could hardly go to sleep again. He may probably benefit from which of the following drugs? a. Flurazepam b. Clorazepate c. Zolpidem d. None of the above

358

148.

149.

150.

151.

152.

153.

GM, 30 yo female experiences visual scotomas followed after around 30 minutes by a severe throbbing right-sided headache that would last 4 8 hours if untreated. Which group of drugs isalmost exclusively used for this condition? a. Triptans b. Propranolol c. Topiramate d. Valproate This drug is effective in reducing pain of mild to moderate intensity through its effects on inflammation and because it probably inhibits pain stimuli at a subcortical site. a. Paracetamol b. Tramadol c. Aspirin d. All of the above IT, 60 yo male suffers from excruciatingly painful inflammation of the big toe after binge eating. The following agents may be helpful except? a. Indomethacin b. Colchicine c. Tolmetin d. None of the above YH, 62 yo female is suffering from rheumatoid arthritis. Her physician strongly believes that this condition causes significant systemic effects which shorten life in addition to the joint disease that reduces mobility and quality of life. He decides to give her metothrexate, the disease-modifying antirheumatic drug (DMARD) of choice for her condition. The most common adverse effects of this drug is: a. hepatotoxicity b. hypersensitivity lung reaction c. nausea and mucosal ulcers d. pseudolymphomatous reactions This antihypertensive drug is approximately equipotent to propranolol in inhibition stimulation of 1-adrenoceptors but 50- to 100-fold less potent than propranolol in blocking 2-adrenoceptors. a. Nadolol, b. Carteolol c. Pindolol d. Metoprolol This antihypertensive agent illustrates how one persons toxicity may be another persons therapy in that it causes hirsutism, which is bothersome in women but a topical formulation is used to stimulate hair growth, which is beneficial for many men. a. Diltiazem b. Hydralazine c. Minoxidil d. Methyldopa

268

577

583

583 584

169

173

154.

This antihypertensive drug may cause severe hypotension in hypovolemic patients, acute renal failure. Hyperkalemia, dry cough sometime accompanied by wheezing, and angioedema. a. Captopril b. Methyldopa

177

155.

156.

c. Reserpine d. Sodium nitroprusside MF, 45 yo female with evidence of chronic kidney disease was also diagnosed with hypertension. Which of the following drugs may be helpful for both of her conditions> a. Metoprolol b. Hydrochlorothiazide c. Captopril d. Nifedipine GG, 68 yo female teacher has chronic heart failure with left ventricular dysfunction but no edema. The first drug to be used for her are - blockers b. Diuretics c. Calcium blockers d. ACE inhibitors Chloroquine is effective in the treatment of nonfalciparum and sensitive falciparum malaria but it causes which of the following common side effects? a. pruritus b. hemolysis c. alopecia d. hypotension The common adverse effects of Quinine in treating falciparum malaria include the following, except a. tinnitus b. hemoglobinuria c. flushing d. visual disturbances TT, 7yo male public elementary school student develops mixed soiltransmitted helminthic infections. Which of the following drugs is appropriate? a. Pyrantel pamoate b. Praziquantel c. Mebendazole d. Metronidazole This group of antimicrobials kills bacterial cells interfering with the transpeptidation reaction of bacterial cell wall synthesis a. Tetracyclines

178

206

a.

157.

849

158.

851

159.

868

160.

726

b.
c. d. 161.

-lactam antibiotics Macrolides All of the above B 732

162.

The following penicillins are resistant to Staphylococcal beta lactamases, except a. Methicicillin b. Amoxicillin c. Nafcillin d. Cloxacillin Which of the following drugs is more stable to bacterial -lactamases? a. Penicillin G b. Amoxicillin c. Cephalexin d. None of the above The class of cephalosporins with expanded gram-negative coverage with some agents being able to cross the blood-brain barrier, but with 2 agents effective vs. P aeruginosa. a. First generation b. Second generation c. Third generation d. Fourth generation ME, 33 yo male develops pneumonia and was given penicillin but develops allergy. He was given an alternative drug which had to be discontinued because of gastrointestinal intolerance due to direct stimulation of gut motility. This drug is most probably. a. Cefalexin b. Amoxicillin-clavulanic acid c. Minocycline d. Erythromycin This agent participates in conversion of diatary folate to tetrahydrofolate and isomerization of methylmalonyl-CoA to succinyl CoA and is effective in the

733 734

163.

737

164.

749

165.

532

treatment of megaloblastic anemia. Vitamin B12 b. Iron c. Erythropoietin d. None of these BV, 45 year old female suffers from chronic kidney disease due to diabetic nephropathy leading to recurring anemia. Which of the following agents is most useful for this patient? a. Iron b. Folate c. Erythropoietin d. Interleukin TU, 3 yo male has manifest slowing down of bodily functions leading to striking retaration of growth and development leading to very slow growth and some degree of mental retardation. The most satisfactory preparation for replacement therapy in this case is. a. Liothyronine b. Levothyroxine c. Methimazole d. Propylthiouracil

a.

166.

537

167.

628

168.

GF, 25 yo female manifests with warm moist skin, sweating, heat intolerance, periorbital edema, retraction of upper lid with wide stare, exopthalmos an diplopia. The management of this condition involves the following, except: a. Methimazole b. Thyroidectomy Iodine d. None of the above This agent is a prohormone that serves as a precursor to a number of biologically active metabolites, including calcitriol. a. Calcimimetics b. Vitamin D c. Calcitonin d. None of these Which of the following is an inscription and translation of a violative prescription based on the Generics Act of 1988? a. Paracetamol 500mg tabs ----------------#20 b. Amoxil 500 mg caps ---------------------#21 c. Ponstan (Mefenamic Acid) 500 mg ---#12 d. B an C are violative prescriptions

630

c.

131

169.

710

170.

Generics Act of 1988

Basic and Clinical Pharmacology by: Bertram G. Katzung, 10th edition, 2007 _____ 171. All of the following factors can affect the rate and extent of drug absorption EXCEPT A. lipophilicity C. protein binding B. intestinal motility D. presence of P glycoprotein transporter ANS C p.41 _____ 172. Which of the following factors is TRUE regarding drug distribution? A. All drugs distribute to the same degree in all tissues. B. The binding of drugs to tissues has no relationship to the distribution of drug in the body. C. In general, a drug with a higher degree of plasma protein binding will have a lower Vd. D. In general, lipophilic drugs distribute to a lesser extent than hydrophilic drugs ANS C p. 34 _____ 173. The amount of a drug dose that reaches the systemic circulation in the unchanged form is: A. Bioavailability C. Cmax B. Clearance D. half-life ANS A p. 40

_____

174. A laboratory experiment is being conducted in which an animal is injected with a non-competitive antagonist to the histamine receptor. Which of the following best describes this drug? A. The drug binds to the histamine receptor and partially activates it. B. The drug binds to the histamine receptor but does not activate it. C. The drug binds to the receptor, but not where histamine binds and prevents the receptor from being activated. D. The drug irreversibly binds to the histamine receptor and renders it ineffective. ANS C p. 16

_____

175. The rate and extent of absorption of a drug is decreased by: A. inhibition of P-glycoprotein transporter B. addition of carbon-nitrogen bond ( quaternary amine ) C. inhibition of gut wall metabolism D. low ionization constant ANS B p. 41

_____

176. At low doses, dobutamine receptor selectivity and activity will primarily result to: A. bronchodilation C. uterine contraction B. dilatation of renal bladder vessels D. increase in cardiac contractility ANS D p.133 177. Antiarrythmic with the most marked K-blocking effect A. lidocaine C. quinidine B. amiodarone D. verapamil ANS B pp 228

_____

_____

178. Blocks the final common pathway of platelet aggregation: A. ticlopidine C. abciximab B. clopidogrel D. ASA 179. Drug interaction seen with concomitant spironolactone and ACE inhibitor use A. ACE inhibitors may decrease renal perfusion decreasing the action of spironolactone in the collecting tubules B. Additive afterloader effect C. Enhanced hyperkalemia* D. Enhanced vasodilating effect of ACE inhibitors because of inhibition of metabolism by spironolactone ANS C p. 177

_____

_____

180. The following anti-hypertensive drug should be used with caution in patients on potassium-sparing diuretics A. losartan* C. hydrochlorthiazide B. verapamil D. methyldopa ANS A p. 177

_____

181. Accumulation of bradykinin due to ACE inhibition is responsible for these adverse effects EXCEPT one: A. cough C. angioedema B. hypotension D. hyperkalemia ANS D p. 177

_____

182. The absence of reflex tachycardia with the use of ACE inhibitors is due to A. downward resetting of the baroreceptor B. mild decrease in peripheral vascular resistance C. enhanced sympathetic activity D. inhibition of RAA system ANS A p. 176

_____

183. This adverse effect of nitrates can be prevented by providing nitrate-free interval between administration A. dependence C. tolerance B. hypotension D. tachycardia ANS D p. 186

_____

184. Which of the following drug combinations will give the best hemodynamic effects of decreasing filling pressure and increasing cardiac output in CHF patients? A. furosemide and dopamine C. captopril and digoxin B. digoxin and verapamil D. furosemide and digoxin

ANS A p. 208 _____ 185. The drug of choice for converting paroxysmal atrial tachycardia to normal sinus rhythm A. propranolol C. quinidine B. adenosine D. flecainide ANS B p. 231 _____ 186. This class I antiarrhythmic drug has marked negative inotropic action and therefore should not be used in patient with heart failure A. quinidine C. disopyramide B. procainamide D. lidocaine ANS D p.225 _____ 187. The risk of Torsades des pointes is highest with the use of A. sotalol C. bretylium B. flecainide D. amiodarone ANS D p. 223 _____ 188. Drug-induced lupus is an adverse effect of

A.
B. _____

procainamide amiodarone

C. disopyramide D. amiloride

189. A 60 year old male has dilated cardiomyopathy and is on digoxin. He complains of nausea and vomiting and you think he has digitalis toxicity. Which of the following drugs he is taking most likely enhanced this? A. Furosemide* C. spironolactone B. Carvedilol D. captopril ANS A p. 204

_____

190. The positive inotropic action of cardiac glycosides is associated with A. an increase in ATP synthesis B. a modification in actin molecule C. decreased outward flow of calcium* D. a decrease in calcium uptake by the sarcoplasmic reticulum ANS C p. 199-202

_____

191. A patient in CHF has developed oliguria because of low cardiac output. To improve renal perfusion, dopamine must be given at this dose in ug/kg/min A. 2* C. 15 B. 10 D. 20 ANS A p. 133

_____

192. A.M. a 55 year old known hypertensive was found to have heart block on ECG. Which of the drugs below should not be given? A. Spironolactone C. captopril B. Verapamil* D. prazosin ANS A p. 175; 230

_____

193. Rapid intravenous administration of this drug may cause respiratory depression: A. phenytoin C. phenobarbital B. lamotrigine D. carbamazepine ANS C p.359

_____

194. This drug increases free phenytoin levels due to protein binding displacement. A. Cimetidine C. chloramphenicol B. salicylates D. isoniazid ANS B p.377

_____

195. Which of the following antidepressants will produce a life-threatening syndrome of hyperthermia, muscle rigidity and myoclonus when administered with MAO? A. Fluoxetine C. imipramine B. trazodone D. clomipramine

ANS A p. 486 _____ 196. Ideally, baseline liver function tests are done prior to giving this anticonvulsant A. topiramate C. valproic acid B. levetiracetam D. gabapentin ANS C p. 387 _____ 197. Elimination of this anticonvulsant is enhanced significantly by alkalinization of the urine A. Phenobarbital C. valproic acid B. Carbamazepine D. phenytoin ANS A p.380 _____ 198. Orthostatic hypotension is most common with which of the following antipsychotic agents: A. Perphenazine C. chlorpromazine B. Haloperidol D. olanzapine ANS C p.461

_____

199. Carbamazepine exerts its antiepileptic effect through A. inhibition of low threshold transient Ca++ current B. inhibition of neurotransmission by NMDA and non-NMDA receptors C. reduction of Na+ current D. enhancement of post-synaptic GABA receptor current ANS C p. 378 200. Based on the mechanism of action, the following antimicrobial is NOT selectively toxic: A. piperacillin C. amphotericin B B. cotrimoxazole D. gentamicin ANS B p. 763

_____

_____

201. Which of the following antibiotics is effective against both aerobes and anaerobes? A. metronidazole C. aztreonam B. gentamicin D. chloramphenicol ANS D p. 752

_____

202. This antibiotic is frequently associated with 8th nerve damage in the offspring if given to pregnant women, thus classified under pregnancy risk category D A. Clarithromycin C. ciprofloxacin B. Tetracycline D. streptomycin ANS D p. 759 203. Maculopapular rash with this antibiotic is non-immunologic in nature and does not preclude the use of chemically related antibiotics in the future A. Erythromycin C. amoxicillin B. Cefalexin D. cotrimoxazole ANS C p. 733 204. A 15 year old college student came in because of headache, fever, chills and photophobia. Thick and thin smears showed P. vivax. The oral drug of choice to rid the blood of plasmodia is A. Quinine C. mefloquine B. Primaquine D. chloroquine ANS D p.846 205. Mebendazole is effective against the following parasites EXCEPT A. capillaria philippinensis C. necator americanus B. ascaris lumbricoides D. trichuris trichiuria ANS A p. 872

_____

_____

_____

_____

206. The following antiviral agents DOES NOT require activation by phosphorylation and it directly inhibits DNA and RNA polymerases as well as HIV reverse transcriptase A. penciclovir C. cidofovir B. acyclovir D. foscarnet ANS D p. 797

_____

207. The following adverse reaction to isoniazid is age-related A. SLE like syndrome C. neuropathy B. Hemolysis D. hepatitis ANS D p. 773

_____

208. A 50 year old male receiving anti-TB treatment develops mono-articular arthritis. Which of the following could have caused it? A. pyrazinamide and ethambutol C. ethambutol + streptomycin B. rifampicin + pyrazinamide D. ethambutol + INH ANS A pp. 774-775

_____

209. Of the following, the mechanism of actions of this antifungal does not involve inhibition of cell membrane synthesis A. Terbinafine C. flucytosine B. Fluconazole D. griseofulvin ANS C p. 784

_____

210. Aromatase inhibitor used in the treatment of breast cancer A. Tamoxifen C. anastrazole B. Danazol D. leuprolide ANS C p. 673

_____

211. Which of the following statements is TRUE regarding the direct genomic pharmacodynamic action of glucocorticoids (GC)? A. GCs diffuse into cell cytoplasm and into nucleus where it binds to glucocorticoid response element (GRE) and act as transcription factor, upregulating gene transcription B. GCs diffuse into cell cytoplasm and bind to steroid receptors leading to release of heat shock proteins and dimerization of steroid receptor complexes which translocate into nucleus and bind to GRE, inducing or inhibiting gene transcription C. GCs diffuse into cell cytoplasm, binding to steroid receptors, the steroid-receptor complexes then bind to transcription factor inhibiting synthesis of pro-inflammatory cytokines

D.
_____

GCs activate cell membrane enzymes leading to formation 2nd messenger ANS B p. 639 212. The main mechanism of action is to lower post meal glycemic excursion: A. metformin C. acarbose B. glipizide D. nateglinide ANS C p. 700 _____ 213. This drug is an estrogen agonist in the bone but an estrogen antagonist in breast tissue: A. raloxifene C. tamoxifen B. alendronate D. calcitonin ANS A p. 672 214. This is essential for the antithyroid activity of thioamides: A. phenyl group C. thiocarbamide group B. methyl group at 3 D. iodide substituent at 3 ANS C p.625 215. The main mechanism for its effectiveness in diabetics is the release of endogenous insulin A. sulfonylurea C. biguanide B. thiazolidinedione D. alpha glucosidase inhibitor ANS A p. 694 216. The main action as anti-diabetic agent is to stimulate the nuclear receptors that regulate the transcription of genes encoding proteins involved in protein and carbohydrate metabolism A. insulin C. sulfonylurea B. thiazolidinedione D. biguanide ANS A p. 686 _____ 217. Which of the following glucocorticoids has the least mineralocorticoid effect and is best for decreasing cerebral edema associated with increased intracranial pressure? A. Prednisone C. dexamethasone B. Hydrocortisone D. prednisolone ANS C p. 641-644

_____

_____

_____

_____

218. Organophosphate toxicity results from its ability to A. interrupt heme synthesis B. inhibit acetycholinesterase C. compete with brain pyridoxal phosphate D. react with sulfhydryl groups binding to protein and other enzymes ANS B p 968 219. A class of proteins that functions as drug receptors that mediate the actions of endogenous chemical signals such as neurotransmitters and hormones: A. enzymes B. regulatory proteins C. structural proteins D. transport proteins Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 11 220. Receptor/s coupled to G protein that modulate the production of intracellular second messengers include/s A. muscarinic receptor B. alpha adrenergic receptor C. leukotriene receptor D. all of the above Application Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 22 221. The neuromuscular blocker succinylcholine acts by: A. Depolarizing muscle endplate receptors B. Repolarizing muscle endplate receptors C. Inhibiting the release of acetylcholine from the nerve ending D. Blocking the access of acetylcholine at the myoneural junction Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 437

222.

Therapeutic benefit/s of 2 receptor agonists include: A. antihypertensive B. antiglaucoma C. antidiarrheal D. all of the above Application Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, pp. 130 - 131

223.

Non-benzodiazepine that has affinity for the Benzodiazepine receptors: A. Zolpidem B. Midazolam C. Alprazolam D. All of the above Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 360

224.

Sedative-Hypnotic with low solubility and penetrate the brain slowly includes: A. Phenobarbital B. Flumazenil C. Trimethadione D. Valproic acid Application Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 354

225.

The following drugs/substance of abuse are CNS stimulants, EXCEPT:

A. Gamma-hydroxybutyric acid (GHB) B. Cocaine C. Amphetamine D. Methylenedioxy-Methamphetamine (MDMA, Ecstasy) Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 520 226. Characteristic physiologic sign of Cannabis intoxication includes: A. increased pulse rate B. pale conjunctivae C. miotic pupil D. high blood pressure Application Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 526

227. Which among these intravenous general anesthetics produces a dissociative type of anesthesia? A. Propofol B. Ketamine C. Thiopental D. Midazolam Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 415 228. A. B. C. D. Painless digital vasospasm is a dose-related complication of long term treatment with: Levodopa Bromocriptine Selegiline Tolcapone Recall Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 453 229. A. B. C. D. The peripheral metabolism to Levodopa can be prevented if it is given concomitantly with: Carbidopa Amantadine Biperiden Bromocriptine Application Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 449, p. 454 230. An overdose of this opioid causes mydriasis instead of the characteristic miosis of opioid toxicity: A. Hydromorphone B. Meperidine C. Methadone D. Morphine Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 511 231. Which of these group of tissues would be the first to take up appreciable amounts of inhalational anesthetics? A. Fat B. Muscle C. Vessel-rich D. Vessel-poor Recall Answer: C

Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 405 232. A narcotic-addicted patient is given this drug as a substitute to be able to control the withdrawal symptoms: A. Hydromorphone B. Meperidine C. Methadone D. Disulfiram Recall Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p.510, p. 520 233. The duration of action of the intravenous barbiturate anesthetic thiopental is largely determined by: A. Spontaneous degradation B. Hepatic extraction C. Renal clearance D. Redistribution Application Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 412

234.

This drug inhibits binding of leukotriene D4 to its receptor on target tissues A. Montelukast B. Zilenton C. Ipratropium bromide D. Omalizumab

Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 330 235. The mechanism of action of corticosteroids in the treatment of bronchial asthma includes A. directly relax airway smooth muscle B. enhance bronchial reactivity C. inhibit airway mucosal inflammation D. prevent release of chemotactic agents Application Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 328 236. A non-steroidal anti-inflammatory drug that irreversibly acetylates and blocks platelet cycloocygenase is A. Naproxen B. Mefenamic acid C. Aspirin D. Ibuprofen Recall Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 577 237. Corticosteroids must be used with great caution in patients with A. osteoporosis B. varicella C. peptic ulcer D. all of the above Application Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 652 238. The most common adverse effect of Aspirin is A. gastric upset and ulcers B. renal toxicity C. asthma D. hepatotoxicity Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 581

239. A uricosuric drug that decreases body pool of urate in patients with tophaceous gout is A. Allopurinol B. Colchicine C. Probenecid D. Meloxicam Recall Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 598 240. Sinoatrial and atrioventricular nodal tissue are affected markedly by A. Diltiazem B. Verapamil C. Nifedipine D. Amlodipine Recall Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 196 241. The beneficial effect of Captopril in patients with heart failure is attributed to: A. reduction in afterload B. increased preload C. increased myocardial contractility D. all of the above Application Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 209

242. A. B. C. D.

Beta blockers with membrane-stabilizing action, useful as anti-arrhythmics include: Metoprolol Propranolol Acebutolol All of the above Recall Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 151 243. Which of the following antiarrhythmic drugs act by blocking sodium channel? A. Lidocaine B. Verapamil C. Sotalol D. Adenosine Application Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 226 244. Antibiotic/s shown to be effective when applied topically in the treatment of acne vulgaris include/s: A. Clindamycin B. Erythromycin C. Metronidazole D. All of the above Application Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 1017 245. This organophosphate compound is thought to have a cholinesterase inhibitory action which temporarily paralyzes the adult Schistosoma haematobium worms.

A. B. C.
D.

Metrifonate Niclosamide Mebendazole Pyrantel pamoate

Recall Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 891

246. Which of these drugs selectively inhibits microtubule synthesis and glucose uptake in nematodes? A. Piperazine B. Mebendazole C. Pyrantel pamoate D. Diethylcarbamazine citrate Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 891 247. For onchocerciasis and strongyloidiasis, this drug is the first choice because it causes fewer systemic and ocular reactions: A. Diethylcarbamazine citrate B. Metrifonate C. Ivermectin D. Bithionol Application Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 890 248. Most of the serious adverse effects of Penicllins are due to: A. Blood dyscrasias B. Hypersensitivity reactions C. CNS reactions D. Hepatic impariment Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 741 249. The following anti-TB drugs are potentially hepatotoxic, EXCEPT: A. RIfampin B. Isoniazid C. Pyrazinamide D. Streptomycin Recall Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 784-786 250. This Anti-TB is relatively contraindicated in young children whose visual acuity and red-green color assessment can not be adequately assessed: A. Isoniazid B. Rifampin C. Ethmabutol D. Pyrazinamide Recall Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 785 251. This antibacterial is available as a nasal ointment useful in the elimination of nasal carriage of Staphylococcus aureus: A. Neomycin B. Muprocin C. Polymycin B sulfate D. Bacitracin Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 1016 252. A drug that is used almost solely as an alternative treatment for gonorrhea in patients whose gonococci are resistant to other drugs is: A. Ofloxacin B. Tetracycline C. Doxycycline D. Spectinomycin Recall Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 771

253. Excessive anticoagulant effect results in bleeding from Warfarin can be reversed by: A. discontinuance of the drug B. administration of Vitamin K C. administration of fresh frozen plasma D. all of the above Application Answer: D Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 552 254. The amount of elemental iron per 325 mg tablet of hydrated ferrous sulfate is ___ mg: A. 36 B. 65 C. 80 D. 106 Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 531 255. The preparation of choice for thyroid replacement and suppression therapy is: A. Liothyronine B. Levothyroxine C. Dessicated thyroid D. Thyrogloculin Recall Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 630 256. The combination of estrogens and progestins exert their contraceptive effect largely through A. inhibition of pituitary function B. production of a mucoid cervical secretion C. alteration in the motility of the uterine tubes D. enhancement of the rupture of the ovarian follicle Application Answer: A Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 673 257. The most dangerous complication of Thioamides is: A. lupus-like reaction B. hepatitis C. agranulocytosis D. exfoliative dermatitis Recall Answer: C Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 633 258. The major use of this drug is in the treatment of endometriosis A. Nifepristone B. Danazol C. Tamoxifen D. Clomiphine Recall Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 680 259. The best treatment option for an obese patient with NIDDM with associated insulin resistance syndrome is: A. Glibenclamide B. Metformin C. Repaglimide D. Acarbose Application Answer: B Reference: KATZUNG, Basic and Clinical Pharmacology, ninth edition, p. 708 260. Treatment Regimen III as indicated in the National Tuberculosis Control Program consists of: A. 2 HRZES B. 2HRZ / 4HR

C. 2HRZE / 4HR D. 2HRZES / 1 HREZ / 5HRE Application Answer: B Reference: National TB Control Program, Treatment Regimens 261.The study of the absorption, distribution, metabolism and excretion of drug is known as: A. Pharmacodynamics B. Pharmacokinetics C. Phamacotherapeutics D. Pharmacology Ans. B p. 5

262. First pass effect is more likely to occur with this route of administration : A.Oral B.Buccal C.Sublingual D.Rectal Ans. A p. 43 263. Inert binding sites bind a drug without initiating events leading to a drug effect. They are located in: A.True receptors B.Spare receptors C.Plasma proteins D.Ttissue proteins Ans. C p. 5 264. Drug A at a dose of 100 mg. produces the same effect as drug B at a dose of 1000 mg. One of the following statements is correct regarding the two drugs: A. Drug A has a greater efficacy than Drug B B. Drug B has a greater efficacy than Drug A C. Drug A is more potent than Drug B D. Drug B is more potent than Drug A Ans. C p.28 265. Drugs with very high volume of distribution: A. are completely retained within the vascular compartment B. have higher concentrations in extravascular tissue C. are homogeneously distributed in blood D. have minimum possible volume of distribution Ans.B p.34 266. Bioavailability of a drug is 100% following this route of administration: A. subcutaneous B. intramuscular C. transdermal D. intravenous 267. Drug biotransformation may result in formation of: A. inactive metabolites B. reactive intermediates that are toxic to various organs C. an active substance from a prodrug D. all of the above Ans. D p. 55-56 268. Selective COX-2 inhibitors differ from nonselective COX inhibitors in that selective COX-2 inhibitors have no: A. analgesic-antipyretic and anti-inflammatory effects B. gastrointestinal side effects C. effects on platelet aggregation D. renal toxicities Ans. B p. 582 269. Pharmacologic effects of alcohol include stimulation of the: A. central nervous system B. heart C. smooth muscles of the blood vessels D. secretion of gastric acid

Ans. D p.41

Ans. D p. 368

270. One of the following general anesthetics with their respective blood:gas partition coefficients is most soluble in blood: A.Nitrous oxide 0.47 B. Enflurane 1.40 C. Halothane 2.30 D. Methoxyflurane 12.0 Ans. D p. 403 271. Reserpine blocks this step in adrenergic transmission: A. synthesis of the transmitter B. incorporation of norepinephrine into the vesicle

C. release of the neurotransmitter D. reuptake into presynaptic neuron

Ans. B p. 169

272. A 24 year old male was brought to the emergency room after having allegedly drank poison. He had constricted pupils, was noted to have salivation and sweating, wheezing, vomiting and diarrhea: The poison must have been: A. atropine B. organophosphate C. opiate D. ephedrine Ans. B p. 101 273. Therapeutic applications of atropine include/s: A. peptic ulcer B. bradycardia caused by myocardial infarction C. urinary retention D. constipation 274. Mechanism of action of pralidoxime: A. competitive antagonism B. noncompetitive antagonism C. physiologic antagonism D. regeneration of the enzyme 275. Compared to norepinephrine, epinephrine has more effects on: A. alpha 1 receptors B. alpha 2 receptors C. beta 1 receptors D. beta 2 receptors

Ans. B p. 115

Ans. D p. 117

Ans. D p. 133

A. B. C. D.

276. Drugs like quinidine, procainamide and disopyramide are useful in the treatment of: A. congestive heart failure C. status asthmaticus B. thyrotoxicosis D. arrhythmia Ans. D. pp. 227-229 277. A 65-year old male was admitted at the intensive care unit disoriented with a blood pressure of 220/120. Which of the following drugs will be most appropriate: A. Sodium nitroprusside C. Methyldopa B. Clonidine D. Aldactone Ans. A p. 175 278. Propranolol and other beta-adrenergic receptor antagonist have the following effect/s on the heart that makes them useful as antiarryhthmic agents: A. Depress automaticity C. Reduce heart rate B. Prolong A-V conduction D. All of the above Ans. D. p. 232 279. All of the following are true of sodium nitroprusside EXCEPT: The gold standard for use in hypertensive crisis Mechanism of vasodilating effects similar to nitrates Sensitive to light Metabolite is pharmacologically inert Ans. D. p.175 280. In patients with congestive heart failure, the use of angiotensin converting enzyme inhibitors will increase A. peripheral resistance C. salt and water excretion B. preload D. sympathetic activity Ans. C p. 209 281. One of the following antianginal agents is contraindicated in patients with vasospastic angina: A. Propranolol C. Diltiazem B. Verapamil D. Isosorbide dinitrate Ans. A. p. 198 282. Methyldopa as antihyperatensive agent exerts its effect by conversion to alpha-methylnorepinephrine which stimulates centrally this receptor: A. alpha-1 C. alpha-2 B. Beta-1 D. Beta-2 Ans. C. p. 166 283. Aminopenicillins, Carboxypenicillins and Ureidopenicillins compared to Penicillin G: A. Are not effective for oral adminsitration B. Have lesser tendency to cause hypersensitivity reaction C. Have greater activity against gram-negative bacteria D. Are resistant to B-lactamse Ans. C. p. 741 284. Clavulanic acid is added to Ampicillin in order to: A. Prevent occurrence of diarrhea B. Protect the beta-lactam ring from destruction C. Increase the bioavailability by increasing absorption

D. Increase the pH of gastrointestinal tract Ans. B. p. 741 285. The most common side effect of erythromycin is: A. Gastroinetstinal upset B. red neck syndrome C. Pseudomembranous colitis D. Nephrotoxicity Ans. A p. 759 286. Bacterial synergism is produced by the following drug combination: A. Tetracycline and penicillin G B. Cephalexin and gentamycin C. Tetracycline and chloramphenicol D. Tetracycline and streptomycin Ans. B p. 846 287. This antimicrobial drug may provoke acute gouty arthritis: A. Pyrazinamide B. Ethambutol C. INH D. PAS 288. This agent is proven effects for influenza A: A. Riboxinin B. Acyclovir C. Zidoxcedine D. Amantadine

Ans. A p. 786

Ans. D p. 824

289. This agent apparently acts as a GABA agonist at the neuromuscular junction and causes flaccid paralysis of the nematode: A. Mebendazole B. Piperazine C. Bephenrium D. Pyrantel Ans. B p. 861 290. This antimicrobial agent is also effective for amebic abscesses that fail initial therapy with metronoidazole: A. Chloroquine B. Amodiaquine C. Mefloquine D. Primaquine Ans. A p. 867 291. Adverse effects A. B. C. D. of aminoglycosides include all, EXCEPT: Nephrotoxicity Cardiotoxicity Neuromuscular blockade Ototoxicity

Ans. B p. 767

292. The most common use of estrogen in therpeutics is: A. Dysfunctional uterine bleeding B. Chemotherapy in prostatic malignancy C. Replacement therapy in menopause D. Component of contraceptice pills

Ans. D

293. This is a partial agonist inhibitor of estradiol at the estrogen receptor and used in the palliative treatment of advanced breast cancer: A. Donazol B. Diathylstilbesterol C. Tamoxifen D. Mefepristone Ans. C p. 679 294. Clomiphone enhanced pregnancy by: A. Preparing the uterus for implantation B. Inhibiting estradiols negative feedback C. Increasing sperm motility D. Inhibiting ovulation 295. The most common side effect of insulin is: A. Lipid deposition B. Renal dystrophy C. Insulin allergy D. Hypoglycemia

Ans. B p. 681

Ans. D p. 703

296. Actions of Vit. D include: A. Antagonism oof parathyroid hormone B. Promote absorption of calcium and phosphate from the intestine C. Hasten calcium excretion in the kidney

D.

Promotes water excretion

Ans. B p. 718