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. ToleranceD. Potency

  1. This is the fraction of unchanged drug reaching the systemic circulation following administration by any route:(p. 41)

A. AbsorptionB. First Pass Effect C. Bioavailability***D. Bioequivalence

  1. 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 1B. phase 2***C. phase 3 D. phase 4

  1. 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 1B. phase 2***C. phase 3 D. phase 4

  1. 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. tiagabineD. gabapentin

  1. Action of Insulin in the liver: (p. 717)

A, increase storage of glucose as glycogen**

B. increase glycogenolysis

C.Increase ketogenesis

D.increase gluconeogenesis

  1. Most common adverse effect of insulin: (p. 721)

A. hypoglycemiaC. lipodystrophy

B. allergyD. bleeding

  1. Effect of digitalis in the AV node during arrythmias: (p. 207)

A. prolonged PR interval B. AV blockadeC. bradycardia D. prolonged QT interval

  1. Immediate metabolic precursor of dopamine that penetrates the blood-brain barrier: (p.464)

A. carbidopaB. levodopaC. selegilineD. ropinorole

  1. 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.stimulates histamine (H1) acetylcholine and serotonin receptors

  1. Antiarrhythmic drugs that prolong effective refractory period by prolonging action potential duration: (p. 239)

A. Bepridil B. BretyliumC. EsmololD. Lidocaine

  1. Antiarrhytmic of choice for suppression of recurrences of ventricular tachycardia & fibrillation after termination of the arrhythmia by cardioversion: (p. 240)

A. AdenosineB. EsmololC. Lidocaine

D. Procainamide

  1. The most serious toxic reaction to local anesthetics is: (p. 441)

A.circumoral numbnessC. nystagmus

B. metabolic acidosisD. tonic-clonic convulsions

  1. Lithium’s 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

  1. Most important unwanted effect of anti-psychotics secondary to relative choline deficiency.(p. 488)

A. AkathisiaC. Tardive dyskinesia****

B. Parkinsonian syndromeD. Perioral rabbit syndrome

  1. Blocks norepinephrine & serotonin reuptake pumps-the “the off switches” of amine transmission (p. 503)

A. MAO inhibitorsB. tricyclics***C. SSRID. heterocyclics

  1. Drug interaction of older MAO inhibitor with tyramine ingested in food:(p. 505)

A. depressionB. Hypertensive reactions***C. hypotension D. mania

  1. The following are sites of the major classes of anti-hypertensive drugs, except:(p.158 )

A.Sympathetic nerve terminals

B.ß-receptors of juxtaglomerular cells that release rennin

C.Hypothalamus

D.Vasomotor center

  1. 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 ß-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

  1. 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

  1. The following are the pharmacodynamics of nitroglycerine, except: (p. 184-185)

A.Smooth muscle relaxation

B.Decreased ventricular preload

C.Responsible for a decrease in platelet aggregation

D.Increased cardiac output

  1. The following are the pharmacodynamics of NSAIDs, except: (p. 598-599)

A.Mediated chiefly through inhibition of biosynthesis of prostaglandins

B.All NSAIDs inhibit platelet aggregation

C.All NSAIDs are anagesic, anti-inflammatory and antipyretic

D.They are all gastric irritants as well

  1. The following are disease-modifying antirheumatic drugs, except: (p. 608)
  2. Methotrexate
  3. Cyclosporins
  4. Corticosteroids
  5. Azathioprine
  1. 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. CycloserineB. VancomycinC. Teicoplanin

D. Bacitracin

  1. 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. ChloramphenicolB. ChlortetracyclineC. AmikacinD. Penicillins

  1. 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. AzithromycinB. LinezolidC. Tetracyclines

D. Aminoglycosides

  1. 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. SulfadoxineB. SulfamethoxazoleC. Sulfasalazine

D. Sulfadiazine

  1. 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

  1. 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

  1. The most widely used mineralocorticoid, with both mineralocorticoid and glucocorticoid activity: (page 672)

A. aldosterone B. deoxycortisone C. fludrocortisone D. cortisone

  1. Act as a partial agonist at estrogen receptors in the pituitary, to treat infertility inwomen by stimulating ovulation: (page 699)

A. tamoxifen B. clomiphene C. danazol D. mifepristone

  1. An antiandrogen that prevents synthesis of dihydrotestosterone by inhibiting the activity of 5-α reductase: (page 705)

A. spirinolactone B. cyproterone C. finasteride D. flutamide

  1. Effects of progesterone: (page 690)

A. increase basal insulin levels C. promotes breast development

B. promotes blood coaguability D. affects protein metabolism

  1. 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

  1. 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

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

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

  1. 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

  1. 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

  1. 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

  1. Which beta blocker is most widely used to control the symptom of hyperthyroidism? (p. 653)

A.Propranolol – ans

B.Metoprolol

C.Labetalol

D.Guanithidine

  1. Drugs that competitively inhibit CYP enzymes cause
  2. Decrease in concentration of the object drug
  3. Increase in concentration of object drug
  4. Decrease efficacy of object drug
  5. Irreversible inactivation of the enzyme
  1. The mechanism of action of benzodiazepines is explained by:
  2. Substitution for GABA
  3. Direct activation of GABA receptors
  4. Increase duration of GABA – gated chloride channel opening
  5. Increase frequency of GABA – gated chloride channel opening
  1. The use of benzodiazepines in the chronic treatment of seizures is limited because of their
  2. high toxicity effectsc. tolerance
  3. slow absorptiond. low therapeutic index
  1. Which should be observed to minimize adverse effects of sedative hypnotics?
  2. Always give a very low dose.
  3. Doses should be given at daytime.
  4. Combine two drugs with different toxicities
  5. Efficacy of therapy is based on patient’s subjective response
  1. 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?
  1. Bupropionc. citalopram

b. Sertraline d venlafaxine

  1. A fly catching movement of the tongue commonly observed as a drawback of all typical antipsychotics is called
  2. “lead pipe” rigidity c. tardive dyskinesia
  3. “rabbit “ syndrome d. akathisia
  1. The most hepatotoxic general inhalational anesthetic
  2. Nitrous oxidec. isoflurane
  3. Sevofluraned. halothane
  1. A 55 – year old female has post-menopausal osteoporosis. Which is not a recommended drug?
  2. Estrogenc. Biphosphonate
  3. Calciumd. Calcitonin
  1. Corticosteroid with most potent anti-inflammatory activity:
  1. Prednisonec. Betamethasone
  2. Dexamethasoned. Cortisone
  1. Drug of choice (DOC) for endometriosis in young women
  2. danazolc. mifepristone
  3. leuprolided. misoprostol
  1. The effect of diethylstilbestrol intake taken during pregnancy on female infants:
  2. vaginal adenocarcinomac. cervical polyp
  3. endometrial carcinomad. breast fibroadenoma
  1. The most common adverse effect of clomiphene is
  2. hot flushesc. constipation
  3. hair lossd. headache
  1. 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?
  2. Spironolactonec. Ketoconazole
  3. Finasterided. Flutamide
  1. Testosterone therapy may be indicated for the treatment of erectile dysfunction in which of the following situation?
  2. Aged patientc. Alcoholism
  3. Hypogonadismd. Depression
  1. Major mechanism of action of aspirin as NSAID is
  2. Reversible COX inhibitorc. Irreversible PG biosynthesis inhibition
  3. Chemotaxis inhibitiond. Down – regulation of IL-1
  1. Which of the following is the drug of choice for inducing labor
  2. Oxytocinc. Methyl ergonovine
  3. Misoprostold. Dinoprostone
  1. The primary consideration in all clinical trials is to
  2. Determine the safety of the drug
  3. Determine the efficacy of the drug
  4. Ensure that there is no risk to the subject
  5. Provide for the welfare of the subject
  1. According to the Philippine National Drug Formulary (PNDF), complementary drugs are:

A. those drugs italicized in the guide

B. drugs that satisfy the health care needs of majority of population

C. drugs with special pharmacological properties

D. not to be used as an alternative to core drugs

Ans. C.

Philippine National Drug Formulary, 2000 edition, p. 109.

Essential Drugs Concept

  1. Which of the following is considered a regulated drug?

A. pseudoephedrineC. lysergic acid diethylamide (LSD)

B. meperidineD. cocaine

Ans. A.

Dangerous Drug Board Info – Republic Act 6425

Dangerous Drugs

  1. Differences in the rate of acetylation of isoniazid among groups of individuals exemplifies.

A. pharmacodynamicsC. pharmacogenetics

B. posologyD. biochemorphology

Ans. C.

Katzung, 9th edition, pp. 2 and 5.

Pharmacogenetics

  1. Absorption of most orally administered drugs occurs in the small intestine. This may be enhanced by:

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

  1. The nicotinic acetylcholine receptors are categorized as to which type?

A. G protein coupledC. kinase-linked

B. ion channel-linkedD. nuclear

Ans. B

Katzung, 9th edition pp. 18-23

Pharmacodynamics

  1. 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

  1. What is the major second messenger of beta receptor activation that participates in signal transduction?

A. inositol triphosphatesC. calcium

B. cAMPD. adenylyl cyclase

Ans. B.

Katzung, 9th edition, p. 25-27.

Pharmacodynamics

  1. In what condition are the drugs phenoxybenzamine and phentolamine useful?

A. pheochromocytomaC. essential hypertension

B. migraine attacksD. benign prostatic hyperplasia

Ans. A.

Katzung, 9th edition, pp. 144-146.

Adrenergic Receptor Blockers

  1. 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

  1. Which of the following antihypertensive agents has the best documented evidence for prophylaxis against migraine attacks?

A. pindololC. clonidine

B. propranololD. prazosin

Ans. B.

Katzung, 9th edition, pp. 148 and 156

Adrenoceptor Antagonists

  1. Which is a direct effect of nitrates when given in the usual doses for the management of angina?

A. increased preloadC. increased cardiac contractility

B. increased afterloadD. smooth muscle relaxation

Ans. D.

Katzung, 9th edition, p. 190.

Vasodilators / CVS Drugs

  1. 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. propranololC. hydralazine

B. guanethidineD. captopril

Ans. B.

Katzung, 9th edition, p. 166.

Antihypertensive / CVS Drugs

  1. 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

  1. Side effects of oxytocin use in a woman in labor includes the following, EXCEPT:

A. increase in BPC. fetal death

B. uterine ruptureD. diuresis

Ans. D.

Katzung 9th edition, p. 621

Hormones and Pituitary glands / Drugs used for Endocrine Disorders

  1. An antithyroid drug which may be given to reduce the vascularity of the thyroid gland prior to thyroidectomy:

A. RAIC. methimazole

B. PTUD. Lugol's iodine

Ans. D.

Katzung, 9th edition, p. 633

Thyroid & Antithyroid Drugs / Drugs used for Endocrine Disorders

  1. Drugs that decrease bone resorption include the following, EXCEPT:

A. calcitoninC. alendronate

B. estrogenD. fluoride

Ans. D.

Katzung, 9th edition, p. 719

Agents that affects bone mineral homeostasis

  1. Which drug is used as an antiretroviral agent?

A. oseltamivirC. indinavir

B. famciclovirD. ribavirin

Ans. C.

Katzung, 9th edition, p. 820

Anti-viral Agents

  1. Which of the following enzymes is inhibited by the binding of a beta lactam antimicrobial with penicillin-binding proteins (PBPs)?

A. beta-lactamaseC. peptidyl tranferase

B. transpeptidaseD. acetylase

Ans. B.

Katzung, 9th edition, pp. 734-735 and 764.

Beta-lactams / Antimicrobials

  1. A poor farm helper from Palawan was diagnosed to have falciparum malaria by blood smear. The safe, cost-effective, and readily available agent to prescribe if this farmer has an allergy to sulfonamides is:

A. FansidarC. chloroquine

B. quinineD. mefloquine

Ans. B.

Katzung, 9th edition, p. 869

Anti-malarial Drugs / Antiprotozoals

  1. Radical cure for malaria is achieved by giving:

A. chloroquine C. mefloquine

B. quinineD. primaquine

Ans. D.

Katzung, 9th edition, p.871

Anti-malarial Drug

  1. There is a sudden increase of atypical pneumonia secondary to Mycoplasma, Chlamydia, and Rickettsia in the Pneumonia Ward of a tertiary hospital. Majority ofpatients were treated with doxycycline. All of the following ADRs are to be watched out for in these patients EXCEPT:

A. photosensitivityC. superinfection

B. fetal bone defectsD. renal failure

Ans. D.

Katzung, 9th edition, pp. 758

Tetracyclines / Antimicrobials

  1. Which of the following agents may predispose to the development of pseudomembranous colitis?

A. erythromycinC. vancomycin

B. metronidazoleD. clidamycin

Ans. D.

Katzung, 9th edition, p. 761

Antimicrobials

  1. 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

  1. 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

  1. Activated charcoal may be used to treat poisoning due to the following EXCEPT:

A. primaquineC. propoxyphene

B. aspirinD. iron overdose

Ans. D.

Katzung, 9th edition, p. 989

Management of Poisoned Patient

  1. This herbal plant endorsed by the DOH is useful for the relief of muscle pain:

A. Yerba BuenaC. Tsaang gubat

B. AkapulkoD. Sambong

Ans. A.

DOH Manuals.

Herbal Medicines

  1. 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

  1. 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

  1. 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

  1. Which of the following is a common mechanism of action shared by all NSAIDs?
  1. inhibition of arachidonate release from the plasma membrane by ihibiting

phospholipase

  1. Inhibition of histamine release by inhibiting mast cell degranulation
  2. Inhibition of the production of prostaglandin and thromboxane from arachidonic acid through inhibition of prostaglandin H synthesis
  3. 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

  1. 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 Reye’s syndrome

C. lack of liquid preparation and high toxicity effect

D. need for frequent administration and association with Reye’s syndrome

Answer D.

Katzung, 9th edition, p. 579-581. Goodman and Gilman, 10th edition, p. 698.

Agents which control prostaglandin effect / CNS Drugs

  1. The intravenous anesthetic producing the so-called "dissociative anesthesia" is:

A. fentanyl C. ketamine

B. thiopental D. propofol

Answer: C.

Katzung, 9th edition, pp. 413-414. Goodman and Gilman, 10th edition,

pp. 346-347.

General Anesthetic / CNS Drugs

  1. 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.