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An administration of one drug leads to a shift in the log dose-response curve of another drug to the left a range in the maximal efficacy, this is called: a. Agonism b. Partial agonism c. Non-competitive antagonism d. Competitive antagonism e. Potentiation - anse. Potentiation Voltage-gated ion channels serve as site of actions for drugs such as I. Diltiazem and Nifedipine II. Lidocaine and Procaine III. Captopril and Losartan a. I only b. I and II c. III only d. I and III e. I, II, and III - ansb. I and II Whiich of the following drug groups have mechanisms of aaction that involve binding to enzymes as target protiens a. Benzodiazepines b. Barbiturates c. Calcium channel blockers d. Non-steroidal anti-inflammatory agents e. Phenothiazine antipsychotics - ansd. Non-steroidal anti-inflammatory agents The action of this drug is dependent on a colligative property a. Mannitol b. Cocaine c. Reserpine d. Furosemide e. Losartan - ansa. Mannitol Drugs with mechanism of action that involves Tubulin-binding leading to loss of function of the structural protien include a. Cyclosporine b. Neostigmine c. Colchicine d. Glibenclamide e. Metformin - ansc. Colchicine What type of protien is primarily targeted by Digitalis glycosides when they exert their effect on the heart? a. Receptors
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b. Ion channels c. Enzymes d. Transporters e. Structural protiens - ansd. Transporters Which of the following features cahracterize nicotinic, GABA-A, and Glutamate receptors? a. Thay control the movements of ions and out of the cell b. Their action is mediated bysecondary messengers c. They all have excitatory effect on the cell membrane d. They are located on the cytoplasm - ansa. Thay control the movements of ions and out of the cell Which of the following drugs bind to receptors located at the cell membrane? a. Thyroid hormone b. Prednisone c. Estrogen d. Insulin e. Vitamin D - ansd. Insulin Cyclic Adenosine Monophophate (cAMP) is generated as a secondary messenger by the action of the enzyme Adenylyl Cyclase. The substrate for the synthesis of cAMP is a. AMD b. ADP c. ATP d. GTP e. Adenosine - ansc. ATP Stimulation of Beta-adrenoceptor, a G-protien-linked receptor involves a generation of a secondary messenger known as a. IP b. cGTP c. DAG d. cAMP e. Calcium ions - ansd. cAMP What is the mechanism of action of Sildenafil, a drug popularly known as viagra? a. Inhibits phosphodiesterase (PDE) leading to increase cAMP b. Inhibits PDE leading to increase cGMP c. Stimulates adenylyl cyclase leading to increase cAMP d. Stimulates guanylyl cyclase leading to increase cGMP e. Inhibits phosphodiesterase leading to increase cGMP - ansb. Inhibits PDE leading to increase cGMP
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Competitive antagonist of the receptors of Dopamine and Benzodiazepine are expected to produced which effect? a. Reversal of the intrinsic activity of the receptors b. Maintain the consitutive activity of the receptors c. Stimulate the constitutive activity of the receptors d. Stimulate the constitutive activity of the recptorsin the absence of any ligand e. Produce a negative efficacy - ansb. Maintain the consitutive activity of the receptors The PT-INR of a patient with Warfarin has been maintained at 2.5 for the last 3 months. 1 week earlier, the patient was given Phenobarbital. What can be expected with the PT-INR of the patient? a. Increased PT-INR b. Decreased PT-INR c. Maintained PT-INR - ansb. Decreased PT-INR Phenobarbital when given to a patient on chronic warfarin is classified as a. Pharmacodynamic antagonist b. Pharmacokinetic antagonist c. Physiologic antagonist d. Synergistic agonist e. Additive agonist - ansb. Pharmacokinetic antagonist Digibind which effetively terminates the action of Digitalis glycosides is classified as what type of antagonist? a. Pharmacodynamic antagonist b. Pharmacokinetic antagonist c. Physiologic antagonist d. Chemical antagonist e. Non-competitive antagonist - ansd. Chemical antagonist Omeprazole can inhibiy gastric acid secretion induced by Histamine and Acetylcholine. It is thus classified as what type of antagonist? a. Pharmacodynamic antagonist b. Pharmacokinetic antagonist c. Physiologic antagonist d. Chemivall antagonist e. Non-competitive antagonist - ansc. Physiologic antagonist Which of the following mechanism may explain the development of tolerance to drugs? a. Increase in the quantity of mediators b. Decreased metabolic degradation of the active drug
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c. Decreased excretion or extrusion of drugs from cells d. Downregulation of receptors e. Inactivation of counterregulatory physiologic response - ansb. Decreased metabolic degradation of the active drug The prerequisite that drugs must be present in aqueous solution for them to be absorbed is true if the drugs are absorbed by which mechanism? I. Passive transport II. Carrier-mediated transport III. Pinocytosis a. I only b. I and II c. III only d. I and III e. I, II, and III - ansb. I and II According to the Fick's Diffusion Equation, the rate of transport of a drug by passive diffusion is a. Independent of the concentration gradient b. Inversely proportional to the membrane surface area c. Inversele proportional to the membrane thickness d. Inversely proportional to the partition coefficient e. Independent of the diffusion constant of drug - ansc. Inversele proportional to the membrane thickness Which of the following feature common to all carrier-mediated transport processes? a. Movement is along a concentration gradient b. Involves non-specific binding to carriers c. Can be characterized by allosteric inhibition d. Displays a Michaelis-Menten Kinetics e. Non-energy requiring - ansd. Displays a Michaelis-Menten Kinetics Which of the following substances may be absorbed significantly by pinocytosis a. Vitamin K b. Cyanocobalamin c. Cardiac glycosides d. Quarternary ammonium compounds e. Inorganic and organic electrolytes - ansa. Vitamin K 100ml of aqueous solutionof a given drug has a concentration of 25%.50ml of Octanol was added and after equlibration, the concentration of the drug in the aqueous layer was 5%. What is the apparent lipid-water partition coefficient of the drug?>
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A given drug with a half life of 8 hours is being administered at 100mg every 8 hours. What is the amount remaining in the body after 32nd hour, just before administering the next dose? a. 50mg b. 75mg c. 87.5mg d. 93.75mg e. 100mg - ansd. 93.75mg What is the con centration at steady state of Phenobarbital if the drug is given to a 60kg patient as a 65mg tablet once daily with a bioavailability of 90%? The drug has volume distribution of 0.5liters/KBW and t1/2 of 100hrs a. 0.10mg/L b. 1.50mg/L c. 11.70mg/L d. 22.20mg/L e. 48.20mg/L - ansc. 11.70mg/L A 47 year old female diabetic is maintained on Tolbutamide for control of her hyperglycemia. Her fasting blood sugar is maintained at 102mg%. Three days prior to admission, she self-medicated with Indomethacin due to a joint pain. She was admitted at the emergency room unconscious and difficult to arouse. What laboratory finding may be consistent with the history of the patient? a. Capillary blood glucose of 20mg/dL b. Capillary blood glucose of 400mg/dL c. ALT level that is 3x elevated d. ALT level that is 6x elevated e. Platelet level of 100,000/ul - ansa. Capillary blood glucose of 20mg/dL A drug molecule does not possess biologic activity by itself but it converted in the body to an active metabolite is called a/an a. Orphan drug b. Prodrug c. Prototype drug d. Parent drug e. Metabolic drug - ansb. Prodrug Astemizole and Terfenadine have been withdrawn from the market because of their intrinsic cardiotoxicity. Tha risk of cardiotoxicity is increased with concominant intake of Grapefruit juiceor Erythromycin. The explanation for this interaction is a. Displacemnet from the protien binding of Astemizole or Terfenadine by Grapefruit juice of Erythromycin
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b. Decreased urinary excretion of Astemizole and Terfenadine c. Inhibtion of the CYP3A4 enzyme by Grapejuice or Erythromycin d. Increased absorption of Astemizole or Terfenadine e. Induction of metabolism of Astemizole and terfenadineby Grapefruit juice or Erythromycin
- ansc. Inhibtion of the CYP3A4 enzyme by Grapejuice or Erythromycin Paients who are poor Debrisoquin metabolizers have decreased activity of which enzyme system a. CYP 1A b. CYP 2C c. CYP 2D d. CYP 2C e. CYP 3A4 - ansc. CYP 2D A patient has been assessed to have poor Debrisoquin metabolizing capability. Which of the following drugs will have an increased likelihood of causing toxicity in this patient? a. Thioridazine b. Amiodarone c. Acetaminophen d. Warfarin e. Theophylline - ansa. Thioridazine What is considered as dominant phase I metaabolic reaction? a. Oxidation b. Reduction c. Hydrolysis d. Glucuronidation e. Acetylation - ansa. Oxidation Chloramphenicol when given to a nenonate or premature baby causes cardiovascular collapse manifestin as the so-called "Gray Baby Syndrome" This toxicity in such subsets of the patients is due to what age-related biologic feature? a. Decreased protien binding b. Decreased urinary excretion of the metabolite c. Deficiency of Glucuronosyl acyl transferase d. Increased metabolism by nitro-reduction e. Increased volume of distribution - ansc. Deficiency of Glucuronosyl acyl transferase Cimetidine, Ketoconazole, and Allopurinol share a common pharmacokinetic property that predisposes patients taking other drugs concominantly with any of these agents to toxicity. What is this property? a. Inhibition of tubular secretion
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What neurotransmitter is released by preganglionic fibers as a response to sympathetic stimulation? a. Acetylcholine b. Norepinephrine c. Epinephrine d. Serotonin e. Dopamine - ansa. Acetylcholine What is the dominant ganglionic receptor found in most sympathetic fibers? a. Alpha- 1 b. Alpha- 1 c. Beta- 1 d. Nicotinic e. Muscarinic - ansd. Nicotinic What is the neurotransmitter mainly released by postganglionic parasympathetic fibers? a. Acetylcholine b. Norepinephrine c. Epinephrine d. 5-Hydroxyryptamine e. Dopamine - ansa. Acetylcholine Which of the following non-adrenergic, non-cholinergic neurotransmitters is involved in the action of the enteric nervous system? a. ATP b. Dopamine c. GABA d. Glutamate e. Glycine - ansa. ATP In synaptic neurotransmission, which of the following ions plays a significant role in neurotransmitter release a. Sodium b. Potassium c. Magnesium d. Calcium e. Chloride - ansd. Calcium The primary mechanism of neuro transmitter release is accomplished by what process? a. Diffusion b. Carrier-mediated
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c. Active transport d. Facilitated transport e. Exocytosis - anse. Exocytosis What is the amino acid precursor in the synthesis of catecholamines? a. Phenylalanine b. Glycine c. Tyrosine d. Tryptamine e. Glutamic acid - ansc. Tyrosine In the biosynthesis of Norepinephrine, what step is considered rate-limiting? a. Active uptake of Tyrosine b. Conversion of tyrosine to dihydroxyphenylalanine c. Conversion of DOPA to dopamine d. Uptake of Dopamine in presynaptic storage vesicles e. Conversion of Norepinephrine to Epinephrine - ansb. Conversion of tyrosine to dihydroxyphenylalanine Which of the following substances exert a negative feedback control on Tyrosine Hydroxylase which serves as the mechanis for moment-to-moment regulation of the rate catecholamine synthesis? a. Dopamine b. Acetylcholine c. DOPA d. Epinephrine e. Norepinephrine - anse. Norepinephrine Reserpine, an alkaloid from Rauwolfia, can lower the blood pressure and depress the CNS. What enzyme or part of the biosynthetic pathway is inhibited by Reserpine to bring about these effects? a. DOPA decarboxylase b. Storage of catecholamines in the presynaptic vesicles c. Release of Norepinephrine from presynaptic terminals d. MAO enzymes e. Uptake-1 mechanism - ansb. Storage of catecholamines in the presynaptic vesicles What is the most important mechansim of termination of effects of released Norepinephrine which is the target of action of tricyclic antidepressants and Cocaine a. Degradation of COMT b. Degradation of MAO c. Sequestration into cells
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III. Sympomatic bradycardia a. I only b. I and II c. III only d. I and III e. I, II, and III - ansb. I and II Which of the following effects can be attributed to alpha-2 receptor stimulation? I. Vasodilation II. Inhibition of catecholamine release III. Vasoconstriction a. I only b. I and II c. III only d. I and III e. I, II, and III - anse. I, II, and III A given adrenergic agent induces uterine relaxation and bronchial smooth muscle relaxation. These effects can be attributed to: a. Alpha-1 stimulation b. Alpha-2 stimulation c. Beta-1 inhibition d. Beta-1 stimulation e. Beta-2 stimulation - anse. Beta-2 stimulation What is the dominant adrenergic receptor in the heart? a. Dopamine- 1 b. Alpha- 1 c. Alpha- 2 d. Beta- 1 e. Beta- 2 - ansd. Beta- 1 Which of the following effects is/are consistent with the systemic use of the drug Clonidine? I. Initial transient increase in blood pressure II. "First-dose" phenomenon III. Lowering of the blood pressure a. I only b. I and II c. III only d. I and III e. I. II, and III - ansd. I and III
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In terms of mechanism of action, which of the following drugs most closely resembles that of Clonidine? a. Phenylphrine b. Reserpine c. Guanethidine d. Methyldopa e. Amlodipine - ansd. Methyldopa Epinephrine is considered as the first line for the management of anaphylaxis and anaphylactic shock. Which of the following explain/s the mechanism of action of Epinephrine in anaphylaxis and anaphylactic shock? I. Inhibition of Histamine release by beta-2 receptor activation II. Alpha-1 activation leading to vasoconstriction III. Beta-2 activation leading to bronchodilation a. I only b. I and II c. III only d. I and III e. I, II, and III - anse. I, II, and III The activity of this drug is attributed to its metabolite which is a false neurotransmitter at the central nervous system a. Guanethidine b. Methyldopa c. Propanolol d. Labetalol e. Phenylpropanolamine - ansb. Methyldopa Which of the following inotropic agents is most useful for paatient with acute heart failure complicated by acute reduction in creatinine clearance? a. Epinephrine b. Norepinephrine c. Dopamine d. Dobutamine e. Digitalis - ansc. Dopamine In the adrenal medulla, norepinephrine is converted to epinephrine by the action of which enzyme? a. DOPA decarboxylase b. Tyrosine hydroxylase c. Cathecol- 0 - nethyl transferase
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Which of the following is an accepted indication for Epinephrine? a. Bronchodilator for intermittent bronchial asthma b. Local vasoconstrictor c. Anti-arrythmic for supraventricular tachycardia d. Tocolytic agent for premature labor e. Inotropic for cardiogenic shock - ansb. Local vasoconstrictor A dominant alpha-1 agonist effect is expected when Epinephrine is given as an IV infusion at what doses? a. <10ng/kg/min b. 10-50ng/kg/min c. 10- 80 ng/kg/min d. At least 120ng/kg/min - ansd. At least 120ng/kg/min What is the clinical use of the Dopamine-1 agonist Fenoldopan? a. Chronic treatment of Congestive Heart Failure b. Acute treatment of Pheochromocytoma c. Acute treatment of Hypertension d. Chronis treatment of Supraventricular Tachycardia e. Acute treatment of Congestive Heart failure - ansc. Acute treatment of Hypertension Which of the following adrenergic agents is/are most useful for hypodynamic septic shock with hypotension I. Dopamine II. Dobutamine III. Norepinephrine a. I only b. I and II c. III only d. I and III e. I, II, and III - ansd. I and III At what dose should Dopamine be given as IV infusion to produce a predominantly dopaminergic effect? a. 0.5 ug/kg/min b. 5-10ug/kg/min c. 10-20ug/kg/min d. 20-50ug/kg/min e. >50ug/kg/min - ansa. 0.5 ug/kg/min Guanfacine and Guanabenz are primarily agonists at what receeptors?
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a. Muscarinic- 1 b. Nicotinic-N c. Presynaptic alpha- 2 d. Postsynaptic alpha- 2 e. Alpha- 1 - ansc. Presynaptic alpha- 2 Which of the following is/are correct clinical indication for the drug Terbutaline I. Subcutaneously given as management of recalcitrant acute exacerbations of bronchial asthma II. To increase heart rate in symptomatic bradycardia III. Adjunct treatment of malignant hypertension a. I only b. I and II c. III only d. I and III e. I, II, and III - ansb. I andII Which of the following drugs primarily stimulates beta-1 receptors? a. Dobutammine b. Ritodrine c. Yohimbine d. Phenoxybenzamine e. Oxymetazoline - ansa. Dobutammine A new drug is currently being developed whose mechanism of action is stimulation of the beta-3 receptors. In which condition will this drug have most likely usefulness? a. Obesity b. Bronchial asthma c. Hypertension d. Shock e. Acute renal failure - ansa. Obesity A patient complains of muscle weakness after several doses of Salbutamol nebulization. This condition can be attributed to _______________? a. Hypokalemia induced by Salbutamol therapy b. Hypocalcemia induced by Salbutamol therapy c. Metabolic alkalosis due to bronchial asthma d. Decreased firing of neuromuscular junction fibers as a direct effect of Salbutamol e. Respiratory alkalosis due to bronchial asthma - ansa. Hypokalemia induced by Salbutamol therapy Which of the following beta-blockers also has peripheral vasodilating effect similar to Prasozin?
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b. I and II c. III only d. I and III e. I, II, and III - ansa. I only Among diabetic patients using insulin or oral hypoglycemic agents (OHAs) why are beta- blockers are used with special caution if not totally avoided? a. Beta-blockers can induce hyperglycemia b. Beta-blockers can mask hypoglemic symptoms c. Beta-blockers can attenuate effect of insulin and OHAs d. Beta-blockers can induce insulin or OHA failure e. Beta-blockers can increase the risk of renal failure - ansb. Beta-blockers can mask hypoglemic symptoms In which subset/s of patients are beta-blockers used with caution if not avoided? I. Patients with bronchospastic disease like COPD and bronchial asthma II. Patients with peripheral vascular disease especially vasospastic type III. Patients with recent myocardial infarction a. I only b. I and II c. III only d. I and III e. I, II, and III - ansb. I and II A 44-year old patient is started a week ago on the following medications: Metoprolol 100mg BIB, Diltiazem 30mb tablet BID and Indapamide 1.5 mg OD for poorly controlled hypertension and chronic stable angina pectoris. She is now admitted at the ICU for dizziness and two episodes of syncope. Her heart rate was 45 beats/min. What course of action would you suggest? a. Continue her medication and suggest for a 12-lead ECG b. Stop Metoprolol and request for a 12-lead ECG c. Stop Diltiazem and request for a 12-lead ECG d. Stop indapamide and Diltiazem and request for a 12-lead ECG as well as serum potassium measurement e. Stop Metoprolol and Diltiazem and request for a 12-lead ECG - anse. Stop Metoprolol and Diltiazem and request for a 12-lead ECG Methylphenidate and Dextroamphetamine are centrally acting sympathomimetics which have found use in which of the following conditions? a. Manic-depression b. Alcohol withdrawal c. Attention deficit hyperactivity disorder
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d. Generalized anxiety disorder e. Hypotensive epidoses - ansc. Attention deficit hyperactivity disorder Which of the following effects is are consistent with direct stimulationof the muscarinic receptors? I. Peripheral vasodilation II. Relaxation of the ciliary muscles III. Negative dromotropic effect a. I only b. I and II c. III only d. I and III e. I, II, and III - ansd. I and III The effect of muscarinic receptor activation in tissues like the exocrine glands and the extravascular smooth muscles have been linked with the generation of which second messenger molecule? a. IP b. cAMP c. cGMP d. ATP e. Adenosine - ansa. IP What is thw physiologic event that follows stimulation of the NM type cholinergic receptors? a. Opening of inward chloride channels b. Opening of outward potassium channels c. Opening of inward sodium channels d. Opening of the outward calcium channels e. Opening of the outward sodium channels - ansc. Opening of inward sodium channels Bethanecol is clinically used for which of the following conditions? a. Urinary retention in neurogenic bladder b. Intestinal obstruction c. Chronic glaucoma d. Supraventicular tachycardia e. Congestive heart failure - ansa. Urinary retention in neurogenic bladder What is/are the clinical use/s of Edorphonium (Tensilon)? I. Reverse the effect of neuromuscular blockers after surgery II. Treatment of overdose of atropine III. Management of organophosphate poisoning a. I only b. I and II
