Pharmacology Exam for Grade 2005Pakistan Students
(Exam 1) — Nov 15th,2007
Part Ⅰ Choice Questions （60 points, 1/item）
Type A (only one answer is correct)
1. The study of the time course of absorption, distribution, metabolism and excretion of drugs in the body is called
A. pharmacology
B. pharmacokinetics
C. pharmacodynamics
D. pharmacy
E. pharmaceutics
2. Which of the following is true for a drug whose elimination from plasma shows first-order kinetics?
- the half-life of the drug is proportional to the drug concentration in plasma
- the amount eliminated per unit time is constant
- the rate of elimination is proportional to the plasma concentration
- elimination involves a rate-limiting enzymic reaction operating at its maximal velocity(Vm)
- a plot of drug concentration versus time is a straight line
3. All of the following statements are true except
A. aspirin(pKa=3.5) is 90% in its lipid-soluble, protonated form at pH=2.5
B. the basic drug promethazine (pKa=9.1) is more ionized at pH=7.4 than at pH=2.
C. absorption of a weakly basic drug is likely to occur faster from the intestine than from the stomach
D. acidification of the urine accelerates the secretion of a weak base, pKa = 8
E. unchanged molecules more readily cross cell membranes than charged molecules
4. Among the following drugs, which will be excreted most quickly in acidic urine？
A. a weak acid drug with pKa of 5.5
B. a weak base drug with pKa of 7.5
C .a weak base drug with pKa of 4.5
D. a weak acid drug with pKa of 3.5
E. a weak base drug with pKa of 6.5
5. Which of the following drugs has the largest therapeutic index ?
A. Drug A LD50=150mg, ED50=100mg
B. Drug B LD50=100mg, ED50=50mg
C. Drug C LD50=250mg, ED50=100mg
D. Drug D LD50=300mg, ED50=50mg
E. Drug E LD50=300mg, ED50=150mg
6. A drug eliminated with first-order kinetics, the concentration of the drug in plasma is 100mg/L at 9 am after administration of a single dose, and at 6 pm the drug plasma concentration is 12.5 mg/L. So, its t1/2 is
A. 4h
B. 5h
C. 6h
D. 3h
E. 12h
7. The pharmacological mechanism of side effect is
A. overdose
B. low in selectivity
C. hypersensitivity
D. administration of drug for a long time
E. the sensitivity of the body
8. After repeated administration of phenobarbital sodium, the patients complain the drug is less useful, this phenomenon is called
A. tolerance
B. resistance
C. dependence
D. side reaction
E. residual effect
9. The bioavailability is
A. the quantity of drug absorbed after oral administration
B. the rate of drug absorbed after oral administration
C. the ratio of AUC(oral)/AUC(intravenous)
D. the area under curve of oral administration
E. the area under curve of intravenous administration
10. Which of the following statements is correct
- if 10mg of drug A produces the same response as 100mg of drug B, drug A is more efficacious than drug B.
- the greater the efficacy, the greater the potency of a drug
- n selecting a drug, potency is usually more important than efficacy
- a competitive antagonist increases ED50
- variation in response to a drug among different individuals is most likelyto occur with a drug showing a large therapeutic index
11. The maximal effect of a drug is called
A. potency
B. efficacy
C. affinity
D. toxic effect
E. margin of safety
12. Property of a partial agonist is
A. high affinity and high intrinsic activity
B. low affinity and low intrinsic activity
C. high affinity and low intrinsic activity
D. low affinity and high intrinsic activity
E. high affinity and no intrinsic activity
13. The drugs that can pass across the blood brain barrier are
A. small in molecular weight and ionized drugs
B. small in molecular weight and nonionized drugs
C. large in molecular weight and ionized drugs
D. large in molecular weight and nonionized drugs
E. all of above are not true
14.The half-life is
A. the time that the concentration of the drug in plasma declines by 50%
B. the time that the amount of the drug in the body declines by 50%
C. the time that half amount of the drug in the body are metabolized
D. the time that the effects of the drug decline in a half
E. all of above are wrong
15..A drug with t1/2=3h is given intravenously, the steady state of plasma concentration can be expected within
A .3 hrs
B. 8 hrs
C. 10 hrs
D. 15 hrs
E. 20 hrs
16. The first-pass effect occurs most often after which route of drug administration
A. sublingual
B. subcutaneous
C. intravenous
D. intramuscular
E. oral
17. When presynaptic α-receptor is activated
A. the release of NE is not influenced
B. the release of NE is increased
C. the synthesis of NE is increased
D. the release of NE is decreased
E. none of above
18. The main mechanism of atropine in the treatment of shock is
A. antivagal nerve to stimulate heart
B. vasodilation and microcirculation improvement
C. bronchodilation
D. CNS stimulation and improve respiratory
E. dilate coronary artery and renal vessel
19. Atropine can not be used to treat patients with
A. bradycardia
B. glaucoma
C. infectious shock
D. neostigmine overdose
E. intoxication of organophosphate
20. The main route of inactivation of ACh is
A. it is destroyed by MAO
B. it is destroyed by COMT
C. it is retaken into the cytoplasm
D. it is hydrolyzed by cholinesterase
E. A+D
21. Atropine has the following effects except
A. mydriasis
B. spasm of accommodation
C. increasing intraocular pressure
D. decrease salivary secretion
E. stimulating CNS in larger dose
22. Which is correct description about the β-adrenoceptor effect?
A．both vascular dilation and bronchial dilation belong to β2 effect
B．both cardiac excitation and bronchial dilation belong to β2 effect
C．both cardiac excitation and vascular dilation belong to β1 effect
D．both cardiac excitation and vascular dilation belong to β2 effect
E．both cardiac excitation and bronchial dilation belong to β1 effect
23. Epinephrine may be mixed with certain anesthetics, such as procaine, in order to
A. stimulate local wound repair
B. promote hemostasis
C.enhance their interaction with neural membranes and their ability to depress nerve conduction
D. retard their systemic absorption
E. facilitate their distribution along nerves
24. Which is NOT the indication of phentolamine?
A．shock
B．diagnosis of pheochromacytoma
C．male sexual dysfunction
D．primary hypertension
E．peripheral vascular occlusive disorders
25. The dilation of bronchial smooth muscle can be caused by
- α1 -receptor activation
- α2 -receptor activation
- β2-receptor activation
- β1-receptor activation
E. M-receptor activation
26. The released norepinephrine is disposed mainly by
A．the metabolism in the liver
B．enzymatic inactivation
C．re-uptake by the neuronal terminal
D．hydrolysis
E. MAO and COMT in the circulation
27. A predictably dangerous side effect of nadolol that constitutes a contraindication to its clinical use in susceptible patients is the induction of
A. hypertension
B. cardiac arrhythmia
C. asthmatic attacks
D. respiratory depression
E. hypersensitivity
28.The effect of pilocarpine on eye is
A. miosis, increase intraocular pressure, paralysis of accommodation
B. miosis, decrease intraocular pressure, spasm of accommodation
C. mydriasis, decrease intraocular pressure, paralysis of accommodation
D. mydriasis, increase intraocular pressure, spasm of accommodation
E. mydriasis, increase intraocular pressure, paralysis of accommodation
29. The intoxication of tubocurarine can be antagonized by
A. atropine
B. adrenaline
C. neostigmine
D. dopamine
E. ephedrine
30.Which of the following drugs can be used in the treatment of glaucoma?
A. neostigmine
B. pilocarpine
C. phentolamine
D. norepinephrine
E. atropine
31.A male patient is brought to the emergency department following ingestion of an unknown substance. He is found to have an elevated temperature, hot and flushed skin, dilated pupils, and tachycardia. Of the following, which would most likely cause these findings?
A. propranolol
B. tolazoline
C. prazosin
D. donepezil
E. atropine
32. Which of the following therapeutic projects would be used in the treatment of patient with serious organophosphate intoxication?
A．atropine + norepinephrine
B．atropine+ neostigmine
C．atropine + pralidoxime iodide
D．atropine + epinephrine
E．atropine + morphine
33. Which of the following can inhibit the acetylcholinesterase
A. Pilocarpine
B. Organophosphate
C. Epinephrine
D. Timolol
E. Atropine
34. Atropine can be used as a preanesthetic agent because it can
A. relax the gastrointestinal smooth muscle
B. stimulate the heart
C. reduce the bronchial secretion
D. dilate the blood vessels
E. excite the CNS
35.The elevated blood pressure caused by epinephrine may be reversed by
A．propranolol
B．phentolamine
C．norepinephrine
D．nicotine
E．atropine
36. Which of the following drugs would reverse myocardial remodeling and reduce overall mortality in patients with heart failure?
A. Cardiac glucosides
B. ACE inhibitors
C. Diuretics
D.Phosphodiesterase inhibitor
E. Calcium channel blockers
37. All of the following measures can be used in the treatment of digoxin-induced arrhythmia EXCEPT
A. stopping digoxin administration
B. diuretic agents such as furosemide are used to promote the excretion of digoxin
C. phenytoin administration
D. atropine administration
E. lidocaine administration
38. Which one of the following drugs decreases de novo cholesterol biosynthesis by inhibiting the enzyme HMG CoA reductase?
A. Niacin
B. Gemfibrozil
C. Lovastatin
D. Cholestyramine
E. Probucol
39. The mechanism of Positive myodynamial action of cardiac glycoside is due to
A. exciting vagal nerve.
B. exciting sympathetic nerve
C. activating Na+-K+-ATPase
D. inhibiting Na+-K+-ATPase
E. inhibiting Na+-Ca2+ exchange
40. Which of the following agents is the drug of choice for ventricular arrhythmia caused by cardiac glycoside ?
- lidocaine
- amiodarone
- propranolol
- phenytoin sodium
E. quinidine
41. The mechanism of anti-hypertensive effect of losartan is
A. decrement of renin activity
B. inhibition of angiotensin converting enzyme
C. blockade of the angiotensin Ⅱ type 1 receptors
D. increment of kinin synthesis
E. causing vasodilation directly
42. The therapeutic action of β-adrenergic receptor blockers such as propranolol in angina pectoris is believed to be primarily the result of
A. Reduced production of catecholamines
B. Dilation of the coronary vasculature
C. Decreased requirement for myocardial oxygen
D. Increased peripheral resistance
E. Increased sensitivity to catecholamines
43.Captopril can do all of the following EXCEPT
A. inhibit ACE
B. damage heart
C. decrease angiotensin Ⅱ concentration in the blood
D. increase sodium in the urine
E. increase bradykinin concentration in the blood
44.Which of the following antianginal drugs is not useful in variant angina?
A. verapamil
B. nitroglycerin
C. propranolol
D. nifedipine
E.diltiazem
45. The reason that digoxin can reduce the ventricular rate of atrial fibrillation patient is answer:
A.Decreasing automaticity of ventricles
B. Decreasing automaticity of atria
C. Reducing the conduction of A-V node
D. improving cardiac ischemia
E. shortening the effective refractory period atria
46. A 65-year-old male has a blood pressure of 170/105mmHg. Which of the following would be effective in lowering this patient’s blood pressure?
A. terbutaline
B. dobutamine
C. pancuronium
D. prazosin
E. scopolamine
47. Which of the followings does not belong to the first-line drugs therapy for mild congestive heart failure currently?
A. A vasodilator such as hydralazine
B. A cardiac Glycoside such as digoxin
C. A β-adrenergic agonist such as norepinephrine
D. A diuretic such as hydrochlorothiazide
E. An ACE inhibitor, such as captopril
48. Which one of the following is the most serious main side effect of statins and this effect would be increased if a statin is taken with gemfibrozil, ciclosporin or nicotinic acid.
A. Gastrointestinal problems
B. Rhabdomyolysis
C. Elevated blood pressure
D. Migraine headaches
E. palpitations
49.The best choice for the hypertensivepatient with heart failure is
A. lidocaine
B. captopril
C. hydralazine
D. minoxidil
E. nifedipine
50.Which of the following drugs is the best choice for variant angina?
A. propranolol
B. nitroglycerin
C. nifedipine
D. hydralazine
E. procainamide
51.Which of the following drugs acts at central imidazoline (I1) recptors?
A. verapamil
B. enalapril
C. hydralazine
D. moxonidine
E. nifedipine
52.The mechanism of vasodilation of sodium nitroprusside is
A. vasodilating directly
B. blocking α receptor
C. producing NO
D. stimulating β2 receptor and causing vasodilation
E.stimulating adenyl cyclase to increase intracellular cAMP concentration
53.Among the following antihypertensive drugs, which can cause dry cough easily？
A. verapamil
B. captopril
C. losartan
D. propranolol
E. nifedipine
54.The antihypertensive mechanism of diuretics for long-term treatment is:
A. increasing water and sodium excretion from the kidneys.
B. decreasing sodium concentration in vascular smooth muscle cell
C. increasing the activity of rennin
D. decreasing the activity of rennin
E. decreasing the secretion of aldosterone
55.In which of the following drugs postrual hypotension occurs most frequently in first use:
A. clonidine
B. nifedipine
C. propranolol
D. enalapril
E. prazosin
56.Which of the following statements about the treatment of chronic heart failure is wrong?
A. Patients with evidence of fluid retention should receive a diuretic.
B. Treatment with an ACE inhibitor and a β-R blocker should be initiated and maintained unless specifically contraindicated.
C. Digoxin may be added if needed to reduce symptoms or to slow the ventricular repsonse in patients with rapid atrial fibrillation.
D. Patients with severe heart failure should also receive a β-R blocker
E. Spironolactone may reduce mortality in patients with severe heart failure
57.A 58-year-old patient with a history of hypertension and congestive heart failure administrating some drugs, now he complains of nausea, blurred vision and bradycardia, intoxication of glycoside is suspected, then digoxin is stopped, which of the following drugs also must be stopped?
A. nifedipine
B. diazoxide
C. hydrochlorothiazide
D. prazosin
E. clonidine
58.Which of the following antiatheroscleroticdrugs has antioxidant effect?
A. Acipimox
B. Gemfibrozil
C. Lovastatin
D. Cholestyramine
E. Probucol
59.All of the following produce a significant decrease in peripheral resistance EXCEPT:
A. chronic administration of diuretics
B. hydralazine
C. ACE inhibitors
D. β-R blockers
E. Calcium channel blockers
60.Which of the following hypertensive patients is not suited for primary therapy with propranolol?
A. patients withbronchial asthma
B. patients withangina pectoris
C. young hypertensive patients with rapid resting heart rate
D. patients with previous myocardial infarction
E. patients with Supraventricular tachycardia
PART Ⅱ Assay Questions （40 points）
1.Please describe the pharmacological action of atropine. ( 15 points)
2.Please describe the mechanism of ACEI in the treatment of hypertension( 10 points).
3. please describe the antianginal action of nitroglycerin and its mechanism.( 15 points)