Page 3 :
This page, intentionally left, blank

Page 5 :
Copyright © 2008, New Age International (P) Ltd., Publishers, Published by New Age International (P) Ltd., Publishers, All rights reserved., No part of this ebook may be reproduced in any form, by photostat, microfilm,, xerography, or any other means, or incorporated into any information retrieval, system, electronic or mechanical, without the written permission of the publisher., All inquiries should be emailed to rights@newagepublishers.com, , ISBN (13) : 978-81-224-2926-8, , PUBLISHING FOR ONE WORLD, , NEW AGE INTERNATIONAL (P) LIMITED, PUBLISHERS, 4835/24, Ansari Road, Daryaganj, New Delhi - 110002, Visit us at www.newagepublishers.com

Page 7 :
This page, intentionally left, blank

Page 8 :
SNIPPETS, , Very useful book for students preparing for GATE & USMLE. Recommended reading., Dr. Sanjay Pai, Al-Ameen college of Pharmacy, Bangalore., I found the book absorbing, questions are well framed., Dr. Gabhe, C.U Shah College of Pharmacy,, Mumbai., Good Reference for PG medical entrance. Recommended reading., Dr. Kaushik Shah, M.S.(Gen. Surgery), Rana Hospital, Mandvi, This book will be of good use for students appearing for Competitive exams., Presentation of the matter is good., Prof. Y. Madhusudhan Rao, Univ. College of Pharmaceutical Sciences, Kakatiya University, Warangal.

Page 9 :
FOREWORD, , Medical & Pharmacy are fast growing professions with a wide range of opportunities open to the students after a basic, degree. These professions play a vital role in health care management., This book will be of immense value for students to develop themselves as the meritorious & motivated candidates for, admission to post graduate courses like M.D., M.S. & M.Pharm., I compliment the author for his pains-taking efforts in mobilizing a very large number of good MCQs from a vast, subject like Pharmacology. Adequate coverage of all topics is done., I feel that this book will be a very useful companion for professional PG entrance examinations. I strongly recommend this book to college library collection, PROF. DR. KANTIBHAI GOR, Vice Chancellor, K. S. K. V. Kachchh University, Bhuj - Kutch.

Page 11 :
This page, intentionally left, blank

Page 13 :
This page, intentionally left, blank

Page 14 :
CONTENTS, , Preface, CHAPTER 1, , (xi), 1, , General Pharmacology, CHAPTER 2, , 29, , Drugs Acting on Central Nervous System, CHAPTER 3, , 85, , Drugs Acting on Autonomous Nervous System, CHAPTER 4, , 103, , Vitamins & Minerals, CHAPTER 5, , 107, , Analgesics & Antipyretics, CHAPTER 6, , 121, , Cardiovascular Drugs, CHAPTER 7, , 135, , Drugs Used in Respiratory Disorders, CHAPTER 8, , 143, , Antibiotics, CHAPTER 9, , 157, , Drugs Used in Gastrointestinal Tract Disorders, CHAPTER 10, , 165, , Oxytocics & Uterine Muscle Relaxants, CHAPTER 11, , Chemotherapy, , 167

Page 15 :
xiv, CHAPTER 12, , 193, , Drugs used in Endocrine disorders (Hormones), CHAPTER 13, , 207, , ANTIDIABETICS, CHAPTER 14, , 211, , Anticoagulants, CHAPTER 15, , 215, , Antihyperlipedemic agents, CHAPTER 16, , 217, , Antacids, CHAPTER 17, , 221, , Antiemetics, CHAPTER 18, , Match the Following, , 223

Page 16 :
CHAPTER 1, GENERAL PHARMACOLOGY, , 1. All of the following are general, mechanisms of drug permeation Except, (a), (b), (c), (d), (e), , Aqueous diffusion, Aqueous hydrolysis, Lipid diffusion, Pinocytosis or endocytosis, Special carrier transport, , 2. If the plasma concentration of a drug, declines with “first-order kinetics”, this, means that, (a) There is only one metabolic path for drug, disposition, (b) The half-life is the same regardless of the, plasma concentration, (c) The drug is largely metabolized in the liver, after oral administration and has low, bioavailability elimination, (d) The rate of climination is proportionate to, the rate of administration at all times, (e) The drug is not distributed outside the, vascular system, 3. Regarding termination of drug action, (a) Drug must be exerted from the body to, terminate their action, (b) Metabolism of drugs always increases their, water solubility, (c) Metabolism of drugs always abolishes their, pharmacologic activity, (d) Hepatic metabolism and renal excretion are, the two most important mechanisms involved, , (e) Distribution of a drug out of the bloodstream, terminates the drug’s effect, 4. Distribution of drugs to specific tissues, (a) Is independent of blood flow to the organ, (b) Is independent of the solubility of the drug in, that tissue, (c) Depends on the unbound drug concentration, gradient between blood and tissue, (d) Is increased for drugs that are strongly bound, to plasma proteins, (e) Has no effect on the half-life of the drug, 5. A physical process by which a weak acid, becomes less water-soluble and more, lipid-soluble at low pH is, (a) Distribution, (c) First-pass effect, (e) Protonation, , (b) Elimination, (d) Permeation, , 6. Dose-response curves are used for drug, evaluation in the animal laboratory and, in the clinic, Quantal dose-response, curves are often, (a) Used for determining the therapeutic index, of a drug, (b) Used for determining the maximal efficacy, of a drug, (c) Invalid in the presence of inhibitors of the, drug being studied, (d) Obtained from the study of intact subject but, not from isolated tissue preparations

Page 17 :
MCQs IN PHARMACOLOGY, , 2, (e) Used to determine the statistical variation, (standard deviation) of the maximal response, to the drug., 7. The following are excreted faster in basic, urine, (a) Weak acids, (c) Weak Bases, , (b) Strong acids, (d) None of the above, , 8. Which of the following statements about, spare receptors is most correct ?, (a) Spare receptors, in the absence of drug, are, sequestered in the cytoplasm, (b) Spare receptors will be detected if the, intracellular effect of drug-receptor interaction, lasts longer than the drug-receptor interaction, itself, (c) Spare receptors influence the maximal, efficacy of the drug-receptor system, (d) Spare receptors activate the effector, machinery of the cell without the need for a, drug, (e) Spare receptors may be detected by the, finding that the EC50 is greater than the Kd, for the agonist, 9. Which of the following terms best, describes an antagonist that interacts, directly with the agonist and not at all or, only incidentally, with the receptor ?, (a), (b), (c), (d), (e), , Pharmacological antagonist, Partial agonist, Physiological antagonist, Chemical antagonist, Noncompetitive antagonist, , 10. Which of the following terms best, describes a drug that blocks the action of, epinephrine at its receptors by occupying, those receptors without activating them ?, (a), (b), (c), (d), (e), , Pharmacological antagonist, Partial agonist, Physiological antagonist, Chemical antagonist, Noncompetitive antagonist, , 11. Which of the following provides information, about the variation in sensitivity of the drug, within the population studied ?, , (a), (b), (c), (d), (e), , Maximal efficacy, Therapeutic index, Drug potency, Grade dose-response curve, Quantal dose-response curve, , 12. Which of the following most accurately, describes the transmembrane signaling, process involved in steroid hormone, action ?, (a) Action on a membrane spanning tyrosine, kinase, (b) Activation of a G protein which activates or, inhibits adenyl cyclase, (c) Diffusion into the cytoplasm and binding to, an intracellular receptor, (d) Diffusion of “STAT” molecules across the, membrane, (e) Opening of transmembrane ion channels, 13. Which of the following is a phase II drugmetabolizing reaction ?, (a) Acetylation, (c) Hydrolysis, (e) Reduction, , (b) Deamination, (d) Oxidation, , 14. Which of the following drugs may inhibit, the hepatic microsomal P450 responsible, for warfarin metabolism, (a) Cimetidine, (c) Phenobarbital, (e) Rifampin, , (b) Ethanol, (d) Procainamide, , 15. With regard to clinical trials of new drugs,, which of the following is most correct ?, (a) Phase I involves the study of a small number, of normal volunteers by highly trained clinical, pharmacologists, (b) Phase II involves the use of the new drug in a, large number of patients (100-5000) who, have the disease to be treated, (c) Phase III involves the determination of the, drug’s therapeutic index by the cautious, induction of toxicity, (d) Chemical antagonist, (e) Phase II requires the use of a positive control, (a known effective drug) and a placebo, 16. Animal testing of potential new, therapeutic agents

Page 18 :
GENERAL PHARMACOLOGY, , 3, , (a) Extends over a time period of at least 3 years, in order to discover late toxicities, (b) Requires the use of at least two primate, species, eg. Monkey and baboon, (c) Requires the submission of histopathologic, slides and specimens to the FDA for, government evaluation, (d) Has good predictability for drug allergy-type, reactions, (e) May be abbreviated in the case of some very, toxic agents used in cancer, 17. The “dominant lethal” test involves the, treatment of a male adult animal with a, chemical before mating; the pregnant, female is later examined for fetal death, and abnormalities. The dominant lethal, test therefore is a test of, (a), (b), (c), (d), (e), , Teratogenicity, Mutagenicity, Carcinogenicity, All of the above, None of the above, , 18. The Ames test is a method for detecting, (a), (b), (c), (d), (e), , Carcinogenesis in rodents, Carcinogenesis in primates, Teratogenesis in any mammalian species, Teratogenesis in primates, Mutagenesis in bacteria, , 19. “Nicotinic” sites include all of the, following except, (a), (b), (c), (d), (e), , Bronchial smooth muscle, Adrenal medullary cells, Parasympathetic ganglia, Skeletal muscle, Sympathetic ganglia, , 20. A good example of chemical antagonism, (a), (b), (c), (d), , Heparin & Protamine, Protamine & Zinc, Heparin & Prothrombin, All the above, , 21. Which of the following agents is a prodrug that is much less toxic in mammals, than in insects ?, (a) Acetylcholine, , (b) Bethanechol, , (c) Physostigmine, (e) Neostigmine, , (d) Pilocarpine, , 22. Phenylephrine causes, (a), (b), (c), (d), (e), , Constriction of vessels in the nasal mucosa, Increased gastric secretion and motility, Increased skin temperature, Miosis, All of the above, , 23. Pretreatment with propranolol will block, which one of the following ?, (a), (b), (c), (d), , Methacholine-induced tachycardia, Nicotine-induced hypertension, Norepinephrine-induced bradycardia, Phenylephrine-induced mydriasis, , 24. Most drug receptors are, (a) Small molecules with a molecular weight, between 100 and 1000, (b) Lipids arranged in a bilayer configuration, (c) Proteins located on cell membranes or in the, cytosol, (d) DNA molecules, (e) RNA molecules, 25. With regard to distribution of a drug from, the blood into tissues, (a) Blood flow to the tissue is an important, determinant, (b) Solubility of the drug in the tissue is an, important determinant, (c) Concentration of the drug in the blood is an, important determinant, (d) Size (volume) of the tissue is an important, determinant, (e) All of the above are important determinants, 26. The pH value is calculated mathematically, as the, (a), (b), (c), (d), (e), , –, , Log of the hydroxyl ion (OH ) concentration, –, Negative log of the OH concentration, +, Log of the hydrogen ion (H ) concentration, +, Negative log of the H concentration, +, –, Ratio of H /OH concentration, , 27. Which property is classified as colligative?, (a) Solubility of a solute, (b) Osmotic pressure

Page 19 :
MCQs IN PHARMACOLOGY, , 4, (c) Hydrogen ion (H+) concentration, (d) Dissociation of a solute, (e) Miscibility of the liquids, 28. The colligative properties of a solution are, related to the, (a), (b), (c), (d), , pH of the solution, Number of ions in the solution, Total number of solute particles in the solution, Number of unionized molecules in the, solution, (e) pKa of the solution, , 29. The pH of a buffer system can be, calculated with the, (a), (b), (c), (d), (e), , Noyes – Whitney equation, Henderson – Hasselbalch equation, Michaelis – Menten equation, Yong equation, Stokes equation, , 30. Which mechanism is most often, responsible for chemical degradation?, (a) Racemization, (c) Hydrolysis, (e) Oxidation, , (b) Photolysis, (d) Decarboxylation, , 31. Which equation is used to predict the, stability of a drug product at room, temperature from experiments at, accelerated temperature?, (a), (b), (c), (d), (e), , The stokes equation, The Yong equation, The Arrhenius equation, The Michaelis – Menten equation, The Hixson – Crowell equation, , 32. Based on the relation between the degree, of ionization and the solubility of a weak, acid, the drug aspirin (pKa 3.49) will be, most soluble at, (a) pH 1.0, (c) pH 3.0, (e) pH 6.0, , (b) pH 2.0, (d) pH 4.0, , 33. The particle size of the dispersed solid in, a suspension is usually greater than, (a) 0.5 µm, , (b) 0.4 µm, , (c) 0.3 µm, (e) 0.1 µm, , (d) 0.2 µm, , 34. In the extemporaneous preparation of a, suspension, levigation is used to, (a), (b), (c), (d), (e), , Reduce the zeta potential, Avoid bacterial growth, Reduce particle size, Enhance viscosity, Reduce viscosity, , 35. Active transport differs from facilitated, transport in following ways, except, (a), (b), (c), (d), , Carrier is involved, It is against concentration gradient, Energy is required, All of the above, , 36. Vanishing cream is an ointment that may, be classified as, (a), (b), (c), (d), (e), , A water –soluble base, An oleaginous base, An absorption base, An emulsion base, An oleic base, , 37. Rectal suppositories intended for adult, use usually weigh approximately, (a) 1g, (c) 3g, (e) 5g, , (b) 2g, (d) 4g, , 38. In the fusion method of making cocoa, butter suppositories,which substance is, most likely to be used to lubricate the mold?, (a) Mineral oil, (b) Propylene glycol, (c) Cetyl alcohol, (d) Stearic acid, (e) Magnesium silicate, 39. A very fine powdered chemical is defined, as one that, (a), (b), (c), (d), , Completely passes through a # 80 sieve, Completely passes through a # 120 sieve, Completely passes through a # 20 sieve, Passes through a # 60 sieve and not more, than 40% through a # 100 sieve, (e) Passes through a # 40 sieve and not more, than 60% through a # 60 sieve

Page 20 :
GENERAL PHARMACOLOGY, , 5, , 40. Which technique is typically used to mill, camphor?, (a), (b), (c), (d), (e), , Trituration, Levigation, Pulverization and intervention, Geometric dilution, Attrition, , 41. Which type of paper best protects a, divided hygroscopic powder?, (a) Waxed paper, (b) Glassine, (c) White bond, (d) Blue bond, (e) Vegetable parchment, 42. Which capsule size has the smallest, capacity?, (a) 5, (c) 1, (e) 000, , (b) 4, (d) 0, , 43. The shells of soft gelatin capsules may, be made elastic or plastic–like by the, addition of, (a), (b), (c), (d), (e), , Sorbitol, Povidone, Polyethylene glycol, Lactose, pKa of the solution, , 44. Nonionic surface-active agents used as, synthetic emulsifiers include, (a) Tragacanth, (b) Sodium lauryl sulphate, (c) Sorbitan esters(spans), 45. A ceramic mortar may be preferable to a, glass mortar when, (a) A volatile oil is added to a powder mixture, (b) Colored substances (dyes) are mixed into a, powder, (c) Comminution is desired in addition to mixing, 46. Divided powders may be dispensed in, (a) Individual-dose packets, (b) A bulk container, (c) A perforated, sifter –type container, 47. Agents that may be used to coat enteric, coated tablets include, (a) Hydroxypropyl methyl cellulose, , (b) Carboxymethyl cellulose, (c) Cellulose acetate phthalate, 48. For each tablet processing problem listed, below, select the most likely reason for, the condition, (a) Excessive moisture, in the granulation, (b) Entrapment of air, (c) Tablet friability, (d) Degraded drug, , (1) Picking, (2) Mottling, (3) Capping, (4) Sticking, , (e) Tablet hardness, 49. For each description of a comminution, procedure below, select the process that, it best describes, (a) Trituration, (b) Spatulation, (c) Levigation, (d) Pulverization by intervention, (e) Tumbling, (1) Rubbing or grinding a substance in a, mortar that has a rough inner surface, (2) Reducing and subdividing a substance, by adding an easily removable solvent, (3) adding a suitable agent to form a paste, and then rubbing or grinding the paste, in mortar, 50. Match the drug product below with the, type of controlled-release dosage form, that it represents, (a) Matrix device, (b) Ion-exchange, resin complex, (c) Hydrocolloid, system, (d) Osmotic system, , (1) Biphenamine, Capsules, (2) Thorazine, Spansule Capsules, (3) Valrelease, (4) Slow - K, , (e) Coated granules, 51. The route of drug administration that, gives the most rapid onset of the pharmacological effect is, (a) Intramuscular injection, (b) Intravenous injection, (c) Intradermal injection

Page 21 :
MCQs IN PHARMACOLOGY, , 6, (d) Peroral administration, (e) Subcutaneous injection, 52. Acidic drugs mainly bind to plasma, (a), (b), (c), (d), , Albumin, á1 – acid glycoprotein, Both (a) and (b), None of the above, , 53. After peroral administration, drugs, generally are absorbed best from the, (a) Buccal cavity, (c) Duodenum, (e) Rectum, , (b) Stomach, (d) Ileum, , 54. The passage of drug molecules from a, region of high drug concentration to a, region of low drug concentration is, known as, (a) Active transport (b) Bioavailability, (c) Biopharmaceutics (d) Simple diffusion, (e) Pinocytosis, 55. What equation describes the rate of drug, dissolution from a tablet?, (a), (b), (c), (d), (e), , Fick’s law, Henderson – Hasselbach equation, Law of mass action, Michaelis – Menten equation, Noyes Whitney equation, , 56. Dose dumping is a problem in the, formulation of, (a), (b), (c), (d), (e), , Compressed tablets, Modified- release drug products, Hard gelatin capsules, Soft gelatin capsules, Suppositories, , 57. The rate of drug bioavailability is most, rapid when the drug is formulated as a, (a), (b), (c), (e), , Controlled – release product, Hard gelatin capsule, Compressed tablet (d) Solution, Suspension, , 58. Creatinine clearance is used as a measurement of, (a) Renal excretion rate, , (b) Glomerular filtration rate (GFR), (c) Active renal secretion, (d) Passive renal absorption, (e) Drug metabolism rate, 59. The earliest evidence that a drug is stored, in tissue is, (a) An increase in plasma protein binding, (b) A large apparent volume of distribution (VD), (c) A decrease in the rate of formation of, metabolites by the liver, (d) An increase in the number of side effects, produced by the drug, (e) A decrease in the amount of free drug, excreted in the urine, 60. The intensity of the pharmacologic action, of a drug is most dependent on the, (a) Concentration of the drug at the receptor site, (b) Elimination half-life (t½) of the drug, (c) Onset time of the drug after oral, administration, (d) Minimum toxic concentration (MTC) of the, drug in plasma, (e) Minimum effective concentration (MEC), of the drug in the body, 61. Drug that show nonlinear pharmacokinetics have which property?, (a) A constant ratio of drug metabolites is formed, as the administered dose increases, (b) The elimination half-life (t½) increases as the, administered dose increases, (c) The area under the plasma drug, concentration versus time curve (AUC), increases in direct proportion to an increase, in the administered dose, (d) Both low and high doses follow first-order, elimination kinetics, (e) The steady-state drug concentration increases, in direct proportion to the dosing rate, 62. The loading dose (DL) of a drug is usually, based on the, (a) Total body clearance (ClT) of the drug, (b) Percentage of drug bound to plasma proteins

Page 22 :
GENERAL PHARMACOLOGY, , 7, , (c) Fraction of drug excreted unchanged in the urine, (d) Apparent volume of distribution (VD) and, desired drug concentration in plasma, (e) Area under the plasma drug concentration, versus time curve (AUC), 63. The renal clearance of insulin is used as, a measurement of, (a), (b), (c), (d), (e), , Effective renal blood flow, Rate of renal drug excretion, Intrinsic enzyme activity, Active renal secretion, Glomerular filtration rate (GFR), , 64. All of the following statements about, plasma protein binding of a drug are true, except, (a) Displacement of a drug from plasma protein, binding sites results in a transient increased, volume of distribution (VD), (b) Displacement of a drug from plasma protein, binding sites makes more free drug available, for glomerular filtration, (c) Displacement of a potent drug that is normally, more than 95% bound may cause toxicity, (d) Albumin is the major protein involved in, protein binding of drugs, (e) Drugs that are highly bound to plasma, proteins generally have a greater V D, compared with drugs that are highly bound, to tissue proteins, 65. _______ is expressed in both the intestinal, epithelium and the kidney., (a) CYP2D6, (c) CYP3A4, , (b) CYP1A1/2, (d) CYP2E1, , 66. The initial distribution of a drug into tissue, is determined chiefly by the, (a), (b), (c), (d), (e), , Rate of blood flow to tissue, Glomerular filtration rate (GFR), Stomach emptying time, Affinity of the drug for tissue, Plasma protein binding of the drug, , 67. Which tissue has the greatest capacity to, bio-transform drugs?, (a) Brain, (c) Liver, (e) Skin, , (b) Kidney, (d) Lung, , 68. The principle of superposition in designing, multiple-dose regimens assumes that, (a) Each dose affects the next subsequent dose, causing nonlinear elimination, (b) Each dose of drug is eliminated by zero-order, elimination, (c) Steady-state plasma drug concentration are, reached at approximately 10 half-lives, (d) Early doses of drug do not affect subsequent, doses, (e) The fraction of drug absorbed is equal to, the fraction of drug eliminated, 69. Which equation is true for a zero-order, reaction rate of drug ?, (a) dA/dt = - k, (c) A = A0e -kt, , (b) t½= 0.693/k, , 70. Which of the following functional groups, is most susceptible to hydrolysis ?, (a) R – CO – R, (c) R – O - R, (e) R – COOH, , (b) R – COOR, (d) R – NH- CH3, , 71. Monomer units of proteins are known as, (a) Monosaccharides (b) Prosthetic groups, (c) Amino acids, (d) Purines, (e) Nucleosides, 72. Glucose is a carbohydrate that cannot be, hydrolyzed into a simpler substance. It is, best described as, (a) A sugar, (b) A monosaccharide, (c) A disaccharide (d) A polysaccharide, (e) An oligosaccharide, 73. All of the following carbohydrates are, considered to be polysaccharides except, (a) Heparin, (c) Glycogen, (e) Cellulose, , (b) Starch, (d) Maltose, , 74. Which of the following compounds are, considered the building blocks of nucleic, acids ?, (a) Nucleotides, (b) Nucleosides, (c) Monosaccharides (d) Purines, (e) Amino acids

Page 23 :
MCQs IN PHARMACOLOGY, , 8, 75. Which of the following terms best, describes a co-factor that is firmly bound, to an apoenzyme?, (a) Holoenzyme, (b) Prosthetic group, (c) Coenzyme, (d) Transferase, (e) Heteropolysaccharide, 76. Enzymes that uncouple peptide linkages, are best classified as, (a) Hydrolases, (b) Ligases, (c) Oxidoreductases (d) Transferases, (e) Isomaerases, 77. The sugar that is inherent in the nucleic, acids RNA and DNA is, (a) Glucose, (c) Ribose, (e) Maltose, , (b) Sucrose, (d) Digitoxose, , 78. N-oxidation will be involved with the, metabolism of following drugs, except, (a) Dapsone, (c) Phenytoin, , (b) Meperidine, (d) Chlorpheniramine, , 79. Which of the following statements, describes plasmids? They, (a), (b), (c), (d), , Are single – stranded DNA molecules, Carry optional gene(s), Carry genes essential for growth, Are always found in linear form, , 80. Bacteria that grow at temperatures as, high as 550C are known as, (a) Psychrophiles, (c) Mesophiles, , (b) Thermophiles, (d) Auxotrophs, , 81. Which of the following organisms can use, only molecular oxygen as the final, acceptor?, (a), (b), (c), (d), , Obligate anaerobes, Facultative anaerobes, Obligate aerobes, Strict anaerobes, , 82. A declining growth rate occurs during, which of the following phases of bacterial, cell growth?, (a) Lag phase, (b) Exponential phase, (c) Stationary phase (d) Death phase, , 83. Which class of antibody has the longest, serum half-life and opsonizes antigens for, phagocytosis through two different, pathways?, (a) Immunoglobulin G (IgG), (b) Immunoglobulin M(IgM), (c) Immunoglobulin A (IgA), (d) Immunoglobulin E (IgE), 84. Urticaria that appears rapidly after the, ingestion of food usually indicates which, type of hypersensitivity reaction?, (a) Type I, (c) Type III, , (b) Type II, (d) Type IV, , 85. A patient receives long-term, high-dose, therapy with a sulfonamide. After, approximately 3 weeks of therapy, the, patient has a low-grade fever, rash, and, muscle and joint pain. Which type of, hypersensitivity accounts for these, symptoms?, (a) Type I, (c) Type III, , (b) Type II, (d) Type IV, , 86. CD4+T cells specifically recognize antigens, in which form?, (a) Bound to major histocompatibility (MHC), class I molecules on the surface of any body, cell, (b) In free, soluble form in extracellular fluids, (c) Bound to MHC class II molecules on the, surface of special antigen-presenting cells, (APCs), 87. Which of the following statements, concerning a drug receptor is true?, (a) It mediates the nonspecific action of volatile, anesthetics, (b) Its expression is induced only by exogenously, added drugs, (c) It can bind endogenous ligand to produce, physiological activity, (d) It mediates the cathartic activity of, magnesium citrate, (e) Down-regulation of receptor level can lead, to sensitization of the target cell to the, receptor agonist.

Page 24 :
GENERAL PHARMACOLOGY, , 9, , 88. Which of the following acids has the, highest degree of ionization in an, aqueous solution?, (a), (b), (c), (d), (e), , Aspirin pKa = 3.5, Indomethacin pKa = 4.5, Warfarin pKa = 5.1, Ibuprofen pKa = 5.2, Phenobarbital pKa = 7.4, , 89. Which of the following salts forms an, aqueous solution that is alkaline to, litmus?, (a), (b), (c), (d), (e), , Sodium chloride, Benzalkonium chloride, Meperidine hydrochloride, Cefazolin sodium, Chlordiazepoxide hydrochloride, , 90. Hydrolysis reaction are involved with the, metabolism of following drugs, except, (a) Procaine, (c) Aspirin, , (b) Diazepam, (d) Lidocaine, , 91. Flurazepam has pKa of 8.2. What, percentage of flurazepam will be ionized, at a urine pH of 5.2?, (a) 0.1%, (c) 50%, (e) 99.9%, , (b) 1%, (d) 99%, , 92. Precipitation may occur when mixing, aqueous solutions of meperidine hydrochloride with which of the following, solutions?, (a) Sodium bicarbonate injection, (b) Atropine sulfate injection, (c) Sodium chloride injection, 93. The excretion of a weakly acidic drug, generally is more rapid in alkaline urine, than in acidic urine. This process occurs, because, (a) A weak acid in alkaline media will exist, primarily in its ionized form, which cannot, be reabsorbed easily, (b) A weak acid in alkaline media will exist in, its lipophilic form, which cannot be, reabsorbed easily., , (c) All drugs are excreted more rapidly in an, alkaline urine., 94. Which of the following drugs is, considered to be the agent of choice for, anaphylactic reactions?, (a) Edrophonium, (c) Ambenonium, (e) Homatropine, , (b) Ipratropium, (d) Propantheline, , 95. Which of the following drugs is considred, to be the agent of choice for anaphylactic, reactions?, (a) Clonidine, (c) Epinephrine, (e) Terbutaline, , (b) Isoproterenol, (d) Phenylephrine, , 96. Which of the following emissions from the, decay of radionuclides is most commonly, used in nuclear medicine imaging?, (a) X-ray, (c) Alpha, (e) Positron, , (b) Beta, (d) Gamma, , 97. Which of the following radionuclides is, mot commonly used in nuclear pharmacy, practice?, (a), (c), (e), , GA, 99m, TC, 133, Xe, 67, , (b), (d), , 201, 123, , TI, I, , 98. Which of the following radionuclides is, generator produced?, (a), (c), (e), , TC, GA, 123, I, 99m, 67, , (b), (d), , 201, 133, , TI, Xe, , 99. Abrasives, ingredients in dentifrices, are, noted for which of the following actions?, (a), (b), (c), (d), (e), , Providing flavor, Cleansing via a foaming detergent action, Removing plaque and debris, Preventing dental caries, Adding thickness to the product, , 100. The appropriate pH range for ophthalmic, products is, (a) 2.0 – 3.0, (c) 6.0 – 8.0, , (b) 4.0 – 6.0, (d) 8.0 – 10.0

Page 25 :
MCQs IN PHARMACOLOGY, , 10, 101. Which type of contact lens can most easily, be ruined by the absorption of chemicals?, (a) Hard lenses, (b) Soft lenses, (c) Gas-permeable lenses, 102. All of the following desensitizing agents, are recommended for sensitive teeth, except, (a), (b), (c), (d), , 10% carbamide peroxide, 5% potassium nitrate, Dibasic sodium citrate, 10% strontium chloride hexahydrate, , 103. Carbamide peroxide appears to soften, earwax by, (a) Causing oxygen to be released, which, loosens the wax, (b) Stimulating fluid secretion in the ear canal, (c) Actually dissolving the ear wax, (d) Decreasing lipid content of the wax, (e) None of the above, 104. A common oral problem caused by, herpes simplex type I virus (HSV-1) is, (a), (b), (c), (d), (e), , Aphthous ulcers, Canker sores, Aphthous stomatitis, Fever blisters, Thrush, , 105. The definition of a sur factant (an, ingredient in toothpaste) can best be, described by which of the following, statements? Surfactant, (a) Prevents drying of the preparation, (b) Removes debris by its detergent action and, causes foaming, which is usually desired by, the patient, (c) Physically removes plaque and debris, (d) Determines the texture, dispersiveness, and, appearance of the product, (e) Adds flavor to the preparation which makes, it more appealing to the patient, 106. Which is not a risk factor for hyperphosphatemia and death from sodium, phosphate enemas when used in, children?, , (a), (b), (c), (d), , Renal insufficiency, Hirschsprung’s disease, Anorectal malformations, Children between the ages of 6 and 12 years, , 107. Which of the following factors is associated with an increased risk of noncompliance in the elderly?, (a), (b), (c), (d), (e), , Polypharmacy, Hypertension, Male gender, Living with a spouse in an isolated environment, Expensive medications, , 108. The principal difference between competitive and non-competitive inhibition is, (a), (b), (c), (d), (e), , Extent of receptor site blocking, Whether inhibition occurs, Extent of enzyme inhibition, Degree of agonism, None of the above, , 109. Drug administrated through which of the, following routes is mot likely to be, subjected to first-pass metabolism:, (a) Oral, (c) Subcutaneous, , (b) Sublingual, (d) Rectal, , 110. Many receptors use distinct hetero, _________ GTPä-binding regulatory, proteins, (a) Tetrameric, (c) Dimeric, , (b) Trimeric, (d) Monomeric, , 111. Alkalinization of urine hastens the, excretion of, (a), (b), (c), (d), , Weakly basic drugs, Weakly acidic drugs, Strong electrolytes, Nonpolar drugs, , 112. Majority of drugs cross biological, membranes primarily by, (a), (b), (c), (d), , Weakly basic drugs, Weakly acidic drugs, Strong electrolytes, Nonpolar drugs

Page 26 :
GENERAL PHARMACOLOGY, 113. The most important factor which governs, diffusion of drugs across capillaries other, than those in the brain is, (a), (b), (c), (d), , Blood flow through the capillary, Lipid solubility of the drug, pKa value of the drug, pH of the medium, , 114. Active transport of a substance across, biological membrane has the following, characteristics except, (a), (b), (c), (d), , It is specific, It is pH dependent, It is saturable, It requires metabolic energy, , 115. Bioavailability differences among oral, formulations of a drug are most likely to, occur if the drug, (a), (b), (c), (d), , Is freely water soluble, Is completely absorbed, Is incompletely absorbed, Undergoes little first-pass metabolism, , 116. Bioavailability of drug refers to, (a) Perecentage of administered dose that, reaches systemic circulation in the, unchanged form, (b) Rario of oral to parental dose, (c) Ratio of orally administered drug to that, excreted in the faeces, (d) Ratio of drug excreted unchanged in urine, to that excreted as metabolites, 117. The most important factor governing, absorption of a drug from intact skin is, (a), (b), (c), (d), , Molecular weight of the drug, Site of application, Lipid solubility of the drug, Nature of the base used in the formulation, , 118. Redistribution is a feature of, (a), (b), (c), (d), , Highly plasma protein bound drugs, Depot preparations, Poorly lipid soluble drugs, Highly lipid soluble drugs, , 119. Weakly acidic drugs, , 11, (a) Are bound primarily to a1 acid glycoprotein, in plasma, (b) Are excreted faster in alkaline urine, (c) Are highly ionized in the gastric juice, (d) Do not cross blood—brain barrier, 120. High plasma protein binding, (a) Increases the volume of distribution of the, drug, (b) Facilitates glomerular filtrtion of the drug, (c) Minimizes drug interactions, (d) Generally makes the drug long acting, 121. Biotransformation of drugs is primarily, directed to, (a) Activate the drug, (b) Inactivate the drug, (c) Convert lipid soluble drugs into nonlipid, soluble metabolites, (d) Convert nonlipid soluble drugs into lipid, soluble metabolites, 122. A prodrg is, (a) The prototype member of a class of drugs, (b) The oldest member of a class of drugs, (c) An inactive drug that is transformed in the, body to an active metabolite, (d) A drug that is stored in body tissues and is, then gradually released in the circulation, 123. Which of the following cytochrome P450, isoenzymes is involved in the metabolism, of a large number of drugs in human, beings and has been implicated in some, dangerous drug interactions:, (a) CYP 3A4, (c) CYP 2E1, , (b) CYP 2C9, (d) CYP 1A2, , 124. The most commonly occurring conjugation, reaction for drugs and their metabolites is, (a), (b), (c), (d), , Glucuronidation, Acetylation, Methylation, Glutathione conjugation, , 125. G-protein coupled receptors span the, plasma membrane as a bundle of _____, alpha helices, (a) One, (c) Seven, , (b) Three, (d) Ten

Page 27 :
MCQs IN PHARMACOLOGY, , 12, 126. Which of the following drug metabolizing, reactions is entirely nonmicrosomal, (a), (b), (c), (d), , Glucuronide conjugation, Acetylation, Oxidation, Reduction, , 127. Induction of drug metabolizing enzymes, involves, (a) A conformational change in the enzyme, protein to favor binding of substrate, molecules, (b) Expression of enzyme molecules on the, surface of hepatocytes, (c) Enhanced transport of substrate molecules, into hepatocytes, (d) Increased synthesis of enzyme protein, 128. Drugs which undergo high degree of firstpass metabolism in liver, (a), (b), (c), (d), , Have oral bioavailability, Are excreted primarily in bile, Are contraindicated in liver disease, Exhibit zero order kinetics of elimination, , 129. Glomerular filtration of a drug is affected, by its, (a), (b), (c), (d), , Lipid solubility, Plasma protein binding, Degree of ionization, Rate of tubular secretion, , 130. If a drug undergoes net tubular secretion,, its renal clearance will be, (a), (b), (c), (d), , More than the glomerular filtration rate, Equal to the glomerular filtration rate, Less than the glomerular filtration rate, Equal to the rate of urine formation, , 131. Which of the following is not a primary/, fundamental, but a derived pharmacokinetic parameter, (a), (b), (c), (d), , Bio-availability, Volume of distribution, Clearance, Plasma half life, , 132. If a drug is eliminated by first order, kinetics, , (a) A constant amount of the drug will be, eliminated per unit time, (b) Its clearance value will remain constant, (c) Its elimination half-life will increase with dose, (d) It will be completely eliminated from the body, in 2 x half-life period, 133. If a drug has a constant bio-availability, and first order elimination, its maintainance dose rate will be directly, proportional to its, (a), (b), (c), (d), , Volume of distribution, Plasma protein binding, Lipid solubility, Total body clearance, , 134. The following dose of a drug is governed, by its, (a), (b), (c), (d), , Aqueous diffusion, Aqueous hydrolysis, Lipid diffusion, Pinocytosis or endocytosis, , 135. Monitoring plasma drug concentration is, useful while using, (a), (b), (c), (d), , Antihypertensive drugs, Levodopa, Lithium carbonate, MAO inhibitors, , 136. Microsomal enzyme induction has one of, the following features, (a) Takes about one week to develop, (b) Results in increased affinity of the enzyme, for the substrate, (c) It is irreversible, (d) Can be used to treat acute drug poisonings, 137. Which of the following is a competitive, type of enzyme inhibitor, (a) Acetazolamide, (c) Physostigmine, , (b) Disulfiram, (d) Theophyline, , 138. What is true in relation to drug receptors, (a) All drugs act through specific receptors, (b) All drug receptors are located on the surface, of the target cells, (c) Agonists induce a conformational change in, the receptor

Page 28 :
GENERAL PHARMACOLOGY, (d) Partial agonists have low affinity for the, receptor, 139. A partial agonist can antagonize the, effects of a full agonist because it has, (a), (b), (c), (d), , High affinity but low intrinsic activity, Low affinity but high intrinsic activity, No affinity and low intrinsic activity, High affinity but no intrinsic activity, , 140. Receptor agonists possess, (a) Result in increased smooth endoplasmic, reticulum, (b) Result in increased rough endoplasmic reticulum, (c) Result in decreased enzymes in the soluble, cytoplasmic fraction, (d) Require 3–4 months to reach completion, 141. Agonists affect the receptor molecule in, the following manner, (a), (b), (c), (d), , Alter its amino acid sequence, Denature the receptor protein, Alter its folding or alignment of subunits, Induce covalent bond formation, , 142. Receptors perform the following function/, functions, (a) Ligand recognition, (b) Signal transduction, (c) Both ligand recognition and signal, transduction, (d) Disposal of agonists and antagonists, 143. Which of the following receptor types has, 7 helical membrane, spanning amino acid, segments with 3 extracellular and 3, intracellular loops, (a), (b), (c), (d), , Tyrosine protein kinase receptor, Gene expression regulating receptor, Intrinsic ion channel containing receptor, G protein coupled receptor, , 144. Which of the following is a G protein, coupled receptor, (a), (b), (c), (d), , Muscarinic cholinergic receptor, Nicotinic cholinergic receptor, Glucocorticoid receptor, Insulin receptor, , 13, 145. Placebo effects result presumably from, the, (a) Physician-patient relationship, (b) Mental set up imparted by the therapeutic, settings, (c) Mental set up imparted by the physician, (d) All of the above, 146. All of the following subserve as, intracellular second messengers in, receptor mediated signal transduction, except, (a) Cyclic AMP, (b) Inositol trisphosphate, (c) Diacyl glycerols, (d) G protein, 147. A receptor which itself has enzymatic, property is, (a) Insulin receptor, (b) Progesterone receptor, (c) Thyroxine receptor, (d) Glucagon receptor, 148. Down regulation of receptors can occur, as a consequence of, (a) Continuous use of agonists, (b) Continuous use of antagonists, (c) Chronic use of CNS depressants, (d) Denervation, 149. When therapeutic effects decline both, below and above a narrow range of, doses, a drug is said to exhibit, (a) Ceiling effect, (b) Desensitization, (c) Therapeutic window phenomenon, (d) Nonreceptor mediated action, 150. ‘Drug efficacy’ refers to, (a) The range of diseases in which the drug is, beneficial, (b) The maximal intensity of response that can, be produced by the drug, (c) The therapeutic dose range of the drug, (d) The therapeutic index of the drug

Page 29 :
MCQs IN PHARMACOLOGY, , 14, 151. If the dose-response curves of a drug for, producing different actions are widely, separated on the dose axis, the drug is, (a) Highly potent, (c) Highly toxic, , (b) Highly efficacious, (d) Highly selective, , 152. The therapeutic index of a drug is a, measure of its, (a) Safety, (c) Efficacy, , (b) Potency, (d) Dose variability, , 153. If the effect of combination of two drugs, is equal to the sum of their individual, effects, the two drugs are exhibiting, (a) Potentiation, (c) Cross tolerance, , (b) Synergism, (d) Antagonism, , 154. The antagonism between adrenaline and, histamine is called ‘Physiological antagonism’ because, (a), (b), (c), (d), , Both are physiologically present in the body, They act on physiological receptors, Both affect many physiological processes, They have opposite physiological effects, , 155. A drug ‘R’ producing no response by itself, causes the log dose-response curve of, another drug ‘S’ to shift to the right in a, parallel manner without decreasing the, maximal response : Drug ‘R’ is a, (a), (b), (c), (d), , Partial agonist, Inverse agonist, Competitive antagonist, Noncompetitive antagonist, , 156. A drug which does not produce any, action by itself but decreases the slope, of the log dose-response curve and, suppresses the maximal response to, another drug is a, (a), (b), (c), (d), , Physiological antagonist, Competitive antagonist, Noncompetitive antagonist, Partial agonist, , 157. A drug which is generally administered, in standard doses without the need for, dose individualization is, (a) Insulin, (c) Prednisolone, , (b) Mebendazole, (d) Digoxin, , 158. A fixed dose combination preparation, meant for internal use must not contain, the following class of drug, (a), (b), (c), (d), , Thiazide diuretic, Fluoroquinolone antimicrobial, Corticosteroid, H2 blocker, , 159. Interindividual variations in equieffective, doses of a drug are most marked if it is, disposed by, (a), (b), (c), (d), , glomerular filtration, Tubular secretion, Both (a) and (b), Hepatic metabolism, , 160. The pharmacokinetics of drugs in the, neonate differs from that in adults,, because their, (a) Intestinal transit is fast, (b) Glomerular filtration rate is high, (c) Tubular transport mechanisms are not well, developed, (d) Drug metabolizing enzymes are overactive, 161. Pharmacodynamic tolerance may involve, changes in _____of drug receptors, (a) Number, (c) Function, , (b) Affinity, (d) All the above, , 162. Drug metabolism can be induced by the, following factors except, (a), (b), (c), (d), , Cigarette smoking, Acute alcohol ingestion, Exposure to insecticides, Consumption of characoal boiled meat, , 163. Which of the following is true of placebos, (a) Placebo is a dummy medication, (b) Placebo is the inert material added to the, drug for making tablets, (c) Placebos do not produce any effect, (d) All patients respond to placebos, 164. In patients of hepatic cirrhosis, (a) The extent of change in pharmacokinetics of, drugs can be predicted from the values of, liver function tests

Page 30 :
GENERAL PHARMACOLOGY, (b) High doses of furosemide can be safely used, (c) Metformin is the preferred oral hypoglycaemic, (d) Disposition of atenolol is not significantly, affected, 165. An undersireable effect of a drug that, occurs at therapeutic doses and can be, predicted from its pharmacological, actions is called, (a) Side effect, (b) Toxic effect, (c) Allergic reaction (d) Idiosyncrasy, 166. Which of the following is a type II, (unpredictable) adverse drug reaction, (a), (b), (c), (d), , Side effect, Toxic effect, Idiosyncrasy, Physical dependence, , 167. A ‘toxic effect’ differs from a ‘side effect’, in that, (a) It is not a pharmacological effect of the drug, (b) It is a more intense pharmacological effect, that occurs at high dose or after prolonged, medication, (c) It must involve drug induced cellular injury, (d) It involves host defence mechanisms, 168. Which of the following statements is true, in relation to ‘drug toxicity’ and ‘poisoning’, (a) The two terms are synonymous, (b) When a toxic effect requires specific, treatment, it is called poisoning, (c) A toxic effect which endangers life by, markedly affecting vital functions is called, poisoning, (d) Toxicity is caused by drugs while poisoning, is caused by other harmful chemicals, 169. The most vulnerable period of pregnancy, for the causation of foetal malformations, due to drugs is, (a), (b), (c), (d), , 18–55 days of gestation, 56–84 days of gestation, Second trimester, 36 weeks onwards, , 170. Which of the following is a proven human, teratogen, , 15, (a) Chloroquine, (c) Dicyclomine, , (b) Warfarin sodium, (d) Methyldopa, , 171. Select the drug which has been found to, be a strong human teratogen, (a) Isoniazid, (c) Hydralazine, , (b) Isotretinoin, (d) Propylthiouracil, , 172. Oral route, (a) Yields better absorption than parenteral, administration for majority of drugs, (b) Should be avoided in the recumbent position, (c) Has no demerit, (d) Produces quick onset of action, 173. Intramuscular route, (a) Always produces faster absorption than oral, route, (b) Can be used to inject mild irritants, (c) In a child is made into the gluteus maximus, muscle, (d) Can be used to inject a volume of 15 ml, 174. Advantage of sublingual route include the, following except, (a), (b), (c), (d), , It has a rapid onset of action, Spitting out the tablet can terminate its action, Its usefulness is limited to treat local conditions, It avoids first pass hepatic metabolism, , 175. First pass metabolism, (a) Can increase the oral bio-availability of the, drug, (b) Occurs only in the liver, (c) Is higher on intravenous administration, (d) Necessitates high oral dose for certain drugs, 176. Bio-transformation, (a), (b), (c), (d), , Renders the drug more lipid soluble, Can be altered by drugs, Is necessary for all drugs for their elimination, Takes place only in the liver, , 177. Entry of a drug in the central nervous, system is enhanced if the drug is, (a), (b), (c), (d), , Ionized, More lipid soluble, Given intravenously, Highly plasma protein bound

Page 31 :
MCQs IN PHARMACOLOGY, , 16, 178. Kinetic processes of elimination for a, large number of drugs is, (a), (b), (c), (d), , First order, First order followed by zero order, Zero order followed by first order, Zero order, , 179. A drug is said to be potent when, (a) It produces maximal response, (b) The amount needed to produce a certain, response is less, (c) It produces minimal/no side effects, (d) It has a rapid onset of action, 180. Spare receptors are often found among, drugs that elicit, (a), (b), (c), (d), , Smooth muscle contraction, Smooth muscle relaxation, Secretion, Cardiac stimulation, , 181. What is the best criterian for judging the, therapeutic superiority of a drug over its, congeners?, (a), (b), (c), (d), , Potency, Wide range of activity, Efficacy, Variability, , 182. pKa of a compound, (a) Is the pH of solution at which the compound, is 50% ionized, (b) Is the pH of compound at which it is 50%, ionized, (c) Is the time in which the compound is ionized, (d) Is the time in which total compound is ionized, 183. Pharmacokinetics is, (a) The study of absorption, distribution,, metabolism and excretion of drugs, (b) The study of biological and therapeutic effects, of the drugs, (c) The method of development of new, pharmacological agent, (d) The study of carcinogenic activity of a new, drug, 184. In which form the drug is absorbed more, rapidly?, , (a), (b), (c), (d), , In aqueous solution, In suspension, In oily solution, In solid form, , 185. Alcohol is rapidly absorbed from the, intestine because, (a), (b), (c), (d), , It is lipid soluble and non-electrolyte, It is lipid soluble and highly ionised, It is absorbed by active transport, It is not absorbed quickly, , 186. After intramuscular injection, the drugs, (a) In oily solution are more rapidly absorbed, (b) In aqueous solution are more rapidly, absorbed, (c) Suspended in various repository vehicles are, more rapidly absorbed, (d) All solutions are rapidly absorbed, 187. Bio-availability of a drug is, (a) The percentage of drug released from a, formulation that becomes available for, biological effect, (b) The percentage of drug that is ionized from, a formulation, (c) The net amount of actual therapeutic agent, present in the formulation, (d) The dose of a drug by which 50% animals, show signs of toxicity, 188. The absorption time of a drug can be, reduced by, (a), (b), (c), (d), , Making a more soluble salt – for oral, By using hyaluronidase – for injection, By using vesoconstrictor substances, By giving combination of drugs, , 189. Reduction of heavy metal toxicity by, dimercaprol is an exmple of, (a), (b), (c), (d), , Chemical antagonist, Physiological antagonist, Pharmacokinetic antagonist, Antagonism by receptor block, , 190. Which of the following drugs is primarily, stored in the natural fat of the body, (a) Primaquine, (c) Thiopentone, , (b) Acetyl salicylic acid, (d) Vitamin C

Page 32 :
GENERAL PHARMACOLOGY, , 17, , 191. Bio-transformation of the drugs is to, render them, (a), (b), (c), (d), , Less lipid soluble, More protein bound, Less ionized, Less protein bound, , 192. Drug metabolism occurs chiefly in, (a) Liver, (c) Spleen, , (b) Brain, (d) Kidneys, , 193. For renal excretion the factors important, are, (a), (b), (c), (d), , Extent of plasma protein binding of drugs, Glomerular filtration rate, Active renal tubular reabsorption, All of the above, , 194. If tubular urine is made more acid, (a), (b), (c), (d), , Excretion of weak acid is reduced, Excretion of weak acid is increased, Excretion of weak base is increased, Excretion of weak base is reduced, , 195. Simultaneous administration of two, drugs may – (select the false statement), (a), (b), (c), (d), , Show an additive effect, Produce synergism, Result in antagonism, Produce any of above phenomena, , 196. The advantages of bio-assay over, chemical assay include – (select false, statement), (a) It is cheaper, (b) The active principal does not have to be, known, (c) The active principal does not have to be in a, pure state, (d) The sensitivity may be greater, 197. In presence of competitive antagonist, (a) The maximum response of agonist can never, be achieved, (b) The maximum can be achieved by increasing, the concentration activity, (c) Maximum can be achieved only if the, antagonist is having intrinsic activity, (d) None of the above, , 198. The receptor concept was first introduced, by, (a), (b), (c), (d), , J.N. Langley in 1878, Paul Ehrlich in 1926, Somonis in 1964, Wakesman in 1826, , 199. True tolerance develops because of, (a), (b), (c), (d), , Diminition in absorption, Rapid excretion of the drug, Both of the above, None of the above, , 200. Two drugs binding to the same receptors, is, (a), (b), (c), (d), , Chemical antagonism, Pharmacokinetic antagonism, Competitive antagonism, Non-competitive antagonism, , 201. Tachyphylaxis is, (a) A drug interaction between two similar types, of drugs, (b) Rapidly developing tolerance, (c) A synergism between two types of drugs, (d) None of the above, 202. Drug A in a dose of 10 mg produces same, response as with 100 mg of drug B, (a) Drug A is 10 times more potent than drug B, (b) Drug B is 10 times more potent than drug A, (c) Drug A is 10 times more efficacious than, drug B, (d) Both are equally potent, (e) Both are equally efficacious, 203. Teratogenicity is, (a), (b), (c), (d), , The acute reaction to drugs, Intolerance to drugs, Tumour forming action of the drugs, Malformation of the foetus, , 204. The chances of foetal malformation with, a teratogenic drug is maximum, (a), (b), (c), (d), , During first trimester of pregnancy, During second trimester of pregnancy, During third trimester of pregnancy, When given just prior to the labor

Page 33 :
MCQs IN PHARMACOLOGY, , 18, 205. Phocomelia is a known teratogenic effect, of, (a), (b), (c), (d), , Anticancer drugs, Antiviral drugs, Antiepileptic drugs, Thalidomide, , 206. Which of the following drugs are known, to cause toxic cataract?, (a) Chloroquine, (c) Phenothiazine, (e) All of the above, , (b) Ergot, (d) Naphthalene, , 207. The passage of drugs into the foetus from, placenta, (a), (b), (c), (d), , Is by active transport, Is by passive diffusion, Is by carrier mediated transport, By any of the above methods, , 208. Idiosyncrasy reaction of a drug is, (a) A type of hypersensitivity reaction, (b) A type of drug antagonism, (c) Unpredictable, inherent, qualitatively, abnormal reaction of a drug, (d) Quantitatively exaggerated response, 209. Two drugs having similar effects are, termed as, (a), (b), (c), (d), , 210. If the combined effect of two drugs acting, by the same mechanism is equal to the, allegebric sum of their individual effect,, it is called as, (b) Additive effect, (d) None of the above, , 211. Antagonism between barbiturate and, amphetamine is termed as, (a), (b), (c), (d), , (a) Warfarin plus salicylates–prolongation of, anticoagulant effect and bleeding tendency, (b) Methotrexate plus sulfonamides–pancytopenia, (c) Heparin plus protamine–reversal of heparin, effect, (d) Sulfonamides plus salicylate–sulfa toxicity, 213. First order kinetics of the drugs is called, when, (a) A constant fraction of the drug is removed in, per unit time, (b) A constant amount of the drug is removed in, per unit time, (c) Total amount of the drug is removed in one, hour, (d) Total amount of the drug is removed in first, passage through the kidneys, 214. For the drugs which follow first order, kinetics, after 4 half life the elimination, will be approximately, (a) 40%, (c) 25%, , Non-competitive antagonism, Physiological antagonism, Competitive antagonism, Synergism, , (b) 94%, (d) 4%, , 215. Passive diffusion of a drug across cell, membrane is low when its molecular, mass is greater than, (a) 50–100 Da, (c) 200–300 Da, , Heterergic drugs, Isomer drugs, Homergic drugs, Antagonistic drugs, , (a) Antagonism, (c) Potentiation, , 212. Which one of the following is an example, of physical or chemical interaction?, , (b) 100–200 Da, (d) 300–400 Da, , 216. Passage of drug across most capillary, endothelial membranes is dependent, upon, (a) Lipid solubility, (c) Blood flow, , (b) pH gradient, (d) All of the above, , 217. Following receptors are membrane, proteins, except, (a) Receptors for fast neurotransmitters, coupled, directly to an ion channel, (b) Receptors for many hormones and slow, transmitters, coupled to effector system, (c) Receptor for insulin and various growth, factors, which are directly linked linked to, tyrosine kinase, (d) Receptors for steroid hormone

Page 34 :
GENERAL PHARMACOLOGY, , 19, , 218. pH difference between extracellular and, intracellular fluid is, (a) Nil, (c) 0.4, , (b) 0.2, (d) 0.8, , 219. Which type of drugs penetrate CNS better, (a) Lipid soluble, (c) Weak bases, , (b) Weak acids, (d) All equally, , 220. Acidic drugs mostly bind to plasma, (a) Albumin, (c) Glycoprotein, , (b) Globulin, (d) None of the above, , 221. The number of P 450 gene families, identified in human being is, (a) 4, (c) 12, , (b) 8, (d) 16, , 222. The majority of drug biotransformation, occurs by which cytochrome family, (a) CYP1, (c) CYP3, , (b) CYP2, (d) None of the above, , 223. Nonlinearity in pharmacokinetics of a, drug is due to saturation of, (a), (b), (c), (d), , Protein binding, Hepatic metabolism, Active renal transport, All of the above, , 224. Which of the following disease is due to, G protein receptor malfunction, (a), (b), (c), (d), , Precocious puberty, Retinitis pigmentosa, Malignant hyperthyroidism, All of the above, , 225. The pharmacokinetic alternations in, elderly are due to, (a) Reduction in lean body mass and total body, water, (b) Increase in percentage of body fat, (c) Reduced cytochrome P450 enzymes, (d) All of the above, 226. The effect of enzyme induction is greatest, when the drug is given, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 227. The hepatic enzyme inducer naringenin, is present in, (a) Tobacco smoke, (c) Alcohol, , (b) Grape juice, (d) Apple Juice, , 228. In gene tranfer which metal particle is, often used, (a) Iron, (c) Platinum, , (b) Gold, (d) Mobybdenum, , 229. Slow reacting substance of anaphylaxis, refers to, (a) LTC4, (b) LTD4, (c) Both of the above (d) None of the above, 230. Drugs producing allergic reaction, generally act as, (a), (b), (c), (d), , Complete antigens, Haptens, Antibodies, Mediators, , 231. An addicting drug which produces little, or no physical dependence is, (a) Amphetamine, (c) Phenobarbitone, , (b) Methadone, (d) Diazepam, , 232. Which of the following statements, regarding therapeutic window is correct ?, (a) The ratio of LD50 to the ED50, (b) The Dosage range between the minimum, effective therapeutic concentration and the, minimum toxic concentration, (c) Both the above, (d) None of the above, 233. Which of the following statements, regarding acid –base balance is not, correct ?, (a) it is an essential balance between the amount, of carbonic acid and biocarbonate in blood., (b) It must be kept constant so that the hydrogen, in concentration in the blood plasma is in, turn kept constant, (c) Any deviation in the balance can have a, profound effect on physiological function, (d) All the above, (e) None of the above

Page 35 :
MCQs IN PHARMACOLOGY, , 20, 234. During liver disease the metabolism and, elimination of which of the following, drugs is decreased, (a), (b), (c), (d), (e), , Morphine, Pentobarbitone, Propanolol, All the above, None of the above, , 235. In celiac disease oral absorption of which, of the following drugs is decreased, (a), (b), (c), (d), , Amoxycillin, Cephalexin, Cotrimoxazole, All the above, , 236. Which people are said to be slowest, acetylators because they metabolize, isoniazid by the process of acetylation, very slowly, (a), (b), (c), (d), (e), (f), , Canadian Eskimos, Indians, Asiatic Jews, Chinese, Europeans, all the above, , 237. Which people are said to be fastest, acetylators because they metabolize, isoniazid by the process of acetylation, very quickly, (a), (b), (c), (d), (e), (f), , Canadian Eskimos, Indians, Asiatic Jews, Chinese, Europeans, all the above, , 238. Clearance of which of the following drugs, is reduced parallel to decrease in the, creatine clearance, (a) Aminoglycosides (b) Digoxin, (c) Phenobarbitone (d) All the above, (e) None of the above, 239. Pharmaceutical factors which can modify, the effect of drug are, (a) Formulation type, , (b) Bioavailabiligy, (c) Bioequivalence, (d) Fixed Dose combination, (e) All the above, (f) None of the above, 240. Following statement is true about, receptors linked directly to ion channels, (a) These receptors are involved mainly in fast, synaptic transmission, (b) These are monomeric proteins containing, one transmembrane segment, (c) Ligand binding and channel opening occur, on a minute time-scale, (d) All of the above, 241. Route of administration suitable for, emergency and permits titration of the, dosage as well is, (a) Oral, , (b) Intravenous, , (c) Intramuscular, , (d) Subcutaneous, , (e) All the above, , (f) None of the above, , 242. The disadvantage of oral route is, (a) Vomiting as a result of gastrointestinal, irritation, (b) Destruction of some drugs by the digestive, enzyme and non-favorable gastric pH, (c) Irregularities in the absorption in the presence, of the food and other drugs, (d) Patient non-compliance, (e) All the above, (f) None of the above, 243. Drugs which have a tendency to accumulate in the body fat mostly have, (a) Extremely high lipid-water partition coefficient, (b) Extremely low lipid-water partition co-efficient, (c) None of the above, 244. Once the drug enters the blood, the rate, at which it subsequently penetrates the, tissues and other body fluids depends on, (a) Capillary permeability, (b) Extent of plasma protein and tissue binding, (c) Transport mechanism

Page 36 :
GENERAL PHARMACOLOGY, , 21, (a) Oxidation, (c) Acetylation, , (d) All the above, (e) None of the above, 245. Factor which can effect the absorption of, drug is, , 252., , (a) Dissolution rate (b) Particle Size, (c) Lipid Solubility, (d) All the above, (e) None of the above, 246. The movement of drug molecules across, the cell membrane is by, (a) Diffusion through the lipid, (b) Diffusing through aqueous pores that traverse, the lipid, (c) Combination with a carrier molecule which, acts as a catalyst, (d) Pinocytosis, (e) All the above, , 254., , 247. Which of the following responses develops, to drugs due to antigen-antibody reaction ?, Toxic response, Idiosyncratic response, Allergic response, None of the above, , 255., , (a) Oxidation, (c) Hydrolysis, , 256., , 250. Which one of the statements regarding, microsomal enzymes is not correct, , 251. Which one of the following is a Phase II –, Drug metabolizing reaction, , (b) Reduction, (d) All the above, , Excipients are, , Bio-assay is used to, (a) Determine the relationship between the dose, administered and the magnitude of response, (b) Determine the potency of a new agent, compared with that of an established drug, (c) Determine the relationship between the doses, producing a desired effect and those eliciting, undesirable or toxic effect, (d) All the above, (e) None of the above, , (b) Reduction, (d) None of the above, , (a) They lack specificity, (b) Capable of metabolizing substances of, different structure, (c) Only catalyze reaction of compounds which, are lipid insoluble, (d) All the above, , The removal of oxygen or an alteration, in a drug which leads to a decrease in, the proportion of oxygen in the drug, compound is known as, , (a) Pharmacologically inert substances, (b) Used to mask an unpleasant taste, (c) Used to increase solubility or stability to the, agent, (d) Employed to add bulk to the active agent, used in small quantities, (e) All the aboves, , (b) Kidney, (d) small intestine, , 249. The mechanism of Biotransformation of, Aspirin to Salicylic acid and Acetic acid is, , Prodrug, , (a) Oxidation, (c) Hydrolysis, , 248. The microsomal oxidation of drugs is, carried out through a larger or smaller, extent in, (a) Liver, (c) Lung, (e) all of the above, , (b) Oxidation, (d) All the above, , (a) Facilitates absorption and distribution of, drugs with poor lipid solubility, (b) Increases the duration of action of drugs that, are rapidly eliminated, (c) Promotes Site specific delivery of drugs, (d) All the above, , (f) None of the above, , (a), (b), (c), (d), , The metabolic reaction which makes the, metabolite of codeine more Pharmacologically potent analgesic is, (a) Dealkylation, (c) Deamination, , 253., , (b) Reduction, (d) All the above, , 257., , Which of the following endogenous, compounds undergo methylation ?, (a) Histamine, (b) Estradiol, (c) Thyroxine, (d) All the above, (e) None of the above

Page 37 :
MCQs IN PHARMACOLOGY, , 22, 258. Which one of the following statements, regarding glucuronide conjugation is not, correct, (a) The most frequently occurring reactions, (b) The conjugating agent is glucuronic acid,, C6H10O6, (c) The glucuronide are rapidly eliminated in the, urine, (d) The glucuronides are also secreted in the bile,, but this does not always lead to their, elimination in the feces, (e) All the above, (f) None of the above, 259. Which of the following therapeutic systems provides continuous, unattended,, controlled drug input for a long period, without gastrointestinal or hepatic drug, inactivation prior to systemic circulation ?, (a) Parenteral, (b) Oral, (c) Transdermal, (d) All the above, (c) None of the above, 260. The translocation of a solute from one, side of a biologic barrier to the other side, and the transferred solute appearing in, the same form on both side of the, biological barrier is known as, (a) Bioavailability, (c) Bioequivalence, , (b) Biotransport, (d) None of the, , 261. Guanine nucleotides bind to the ______, subunit of G-proteins, (a) α, (c) γ, , (b) β, (d) All the above, , 262. Pharmacodynamics include, (a) The biological effects produced by chemicals, (b) The site/s and mechanism by which the, biological effects are produced, (c) The factors that effect the safety and, effectiveness of the agent, (d) All the above, (e) None of the above, 263. The person who set forth the principles, that drugs are effective only after, reaching a responsive tissue and that, there is a relationship between the, , structure of drugs and the effects that, they produce, (a) Paracelsus, (b) William Harvey, (c) James Blake, (d) Rudolf Buccheim, (e) None of the above, 264. The great scientist who explained the, circulation of the blood to the world which, signaled of the beginning of the scientific, study of the medical sciences was, (a) Paracelsus, (b) William Harvey, (c) James Blake, (d) Rudolf Buccheim, (e) None of the above, 265. All the below mentioned drugs cause, enzyme inhibition in man except one, (a) Acetazolamide, (c) Meprobamate, (e) Selegiline, , (b) Allopurinol, (d) Disulfiram, , 266. All the below mentioned drugs cause, enzyme induction in man except one, (a) Phenytoin, (c) Griseofulvine, (e) Rifampicin, , (b) Phenobarbitone, (d) Enalapril, , 267. Cimetidine potentiates the action of, propranol, theophylline, warfarin and, phenytoin because, (a), (b), (c), (d), , It causes deficiency of G - 6–PD, It blocks the H2 – histaminergic receptors, It is an inhibitor of microsomal P–450, None of the above, , 268. The incidence of adverse drug reaction, rises with age in the adult, especially after, 65 years because of, (a) The increasing number of drugs they need, to take because they tend to have multiple, diseases, (b) Poor compliance with dosing regimens, (c) Bodily changes of aging that require, modification of dosage regimens, (d) All the above, (e) None of the above, 269. Agranulocytosis is, (a) Virtual absence from the blood of white cells, known as neutrophils

Page 38 :
GENERAL PHARMACOLOGY, (b) It is a life-threatening conditions that results, from toxic damage to the bone-marrow by, some drugs, (c) Can be treated with antibiotics and, sometimes transfusion of white blood cells, (d) All the above, 270. Characteristically following oral administration to a man, drugs, (a) Are absorbed readily when in the unionized, rather than in the ionized form, (b) Are absorbed primarily in the intestine, (c) Cross membranes mainly by simple diffusion, (d) With high lipid solubility readily penetrate, into CNS, (e) All the above, 271. Competitive antagonists, (a) Dissociate from receptors faster than their, respective agonists, (b) Alter the shape of the log dose response, curve of an agonist, (c) According to the rate theory have low, dissociation rate constants, (d) Initiate the opposite cellular response to, receptor occupancy to that obtained by the, agonist, (e) All the above, 272. A non-competitive antagonist, (a) Alters the mechanism of action of an agonist, (b) Alters the potency of an agonist, (c) Shifts the dose-response curve of an agonist, to the right, (d) Decreases the maximum response to an, agonist, (e) None of the above, 273. Repeated administration of a drug may, (a) Increase its own metabolism, (b) Increase the metabolism of other drugs, (c) Increase the metabolism of endogenous, compounds, (d) All the above, (e) None of the above, 274. Plasma concentration is useful for, (a) Drugs with high safety margin, , 23, (b) Drugs with low safety margin, (c) Drugs activated in the body, (d) Hit and run drugs, 275. During competitive equilibrium type of, antagonism, (a) Equilibrium constant (Km) is unchanged, but, total number of binding sites (Vmax) is reduced, (b) Equilibrium constant (Km) is increased and, total number of binding sites (Vmax) is reduced, (c) Equilibrium constant (Km) is increased and, total number of binding sited (Vmax) remain, unchanged, (d) None of the above, 276. Addition of oxygen or negatively charged, radical and removal of hydrogen or, positively charged radical is known as, (a) Reduction, (b) Oxidation, (c) Acetylation, (d) Hydrolysis, (e) None of the above, 277. Pharmacopoeia includes list of established drugs and medicinal preparation, with the description of their, (a), (b), (c), (d), (e), , Physical properties, Identification test, Purification test, Potency test, All the above, , 278. Claude Bernard is known as, (a), (b), (c), (d), (e), , Father of Medicine, Father of Pharmacognosy, Father of Polypharmacy, Father of Pharmacology, Father of Experimental Medicine, , 279. Oswald Schmiedeberg is known as, (a), (b), (c), (d), (e), , Father of Medicine, Father of Pharmacognosy, Father of Polypharmacy, Father of Pharmacology, Father of Experimental Medicine, , 280. Catalytic conversion of GTP to GDP is, carried out by _____ subunit of G-proteins, (a) α, (c) γ, , (b) β, (d) All the above

Page 39 :
MCQs IN PHARMACOLOGY, , 24, 281. Theophrastus is known as, (a), (b), (c), (d), (e), , Father of Medicine, Father of Pharmacognosy, Father of Polypharmacy, Father of Pharmacology, Father of Experimental Medicine, , 282. Hippocrates is known as, (a), (b), (c), (d), (e), , Father of Medicine, Father of Pharmacognosy, Father of Polypharmacy, Father of Pharmacology, Father of Experimental Medicine, , 283. When a drug lacking effect of its own, increases the effects of the second active, drug [0 +1= >1]; such an effect is called, (a) Additive effect, (c) Potentiation, , (b) Synergism, , 284. When two drugs with the same effect, produce an effect greater than the sum, of the effects of individual drugs [1 + 1>2];, such an effect is called, (a) Additive effect, (c) Potentiation, , (b) Synergism, , 285. Weak acids ionize more in, (a) Alkaline pH, (b) Acidic pH, (c) Not dependent of pH, 286. Theophylline has shorter half life in, infants and children because, (a) Renal tubular secretor y mechanism is, deficient, (b) Immaturity of the nephron, (c) Immaturity of the blood-brain barrier, (d) Reduced plasma - protein binding, (e) Liver size larger on a body weight basis, 287. An antagonist has, (a), (b), (c), (d), , Intrinsic activity and no affinity, Only intrinsic activity and no affinity, No intrinsic activity and no affinity, Affinity same as agonist and devoid of, intrinsic activity, (e) None of the above, , 288. Acetylcholine and atropine action on the, muscarinic receptors is a classical example of, (a), (b), (c), (d), (e), , Competitive antagonism, Non-competitive antagonism, Non-equilibrium antagonism, Physiological antagonism, Chemical antagonism, , 289. Biological half-life of is calculated as, (a), (b), (c), (d), (e), , t ½ = 0.693 x CL/Vd, t ½ = 0.693 x K/ln2, t ½ = 0.693 x Vd/CL, t ½ = 0.693 x ln2/K, None of the above, , 290. Following statement is true regarding, therapeutic index, (a) It is based on animal toxicity data, (b) It reflects forms of toxicity that are important, clinically, (c) It takes into account idiosyncratic toxic reaction, (d) All the above, 291. Ocuserts are, (a), (b), (c), (d), , Placed under the eyelid, Intrauterine contraceptives, Monoclonal antibodies, None of the aboves, , 292. Nitroglycerin is given in angina pectoris, by sublingual route because:, (a), (b), (c), (d), (e), , Liver is by-passed, Can be spat after desired effect, Rapid absorption, Non irritant and lipid soluble drug, All the above, , 293. Volatile drug may be best administered, by:, (a) Oral route, (c) Sublingual route, (e) Rectal route, , (b) Inhalation, (d) Intrathecal route, , 294. A desired clinical response may be, delayed altered or blocked by:, (a) A drug that does not go into solution, (b) A drug that does not get to its site of action

Page 40 :
GENERAL PHARMACOLOGY, , 25, , (c) Abnormal pharmacogenetics, (d) Lack of absorption from site of administration, (e) All the above, 295. Following compartment constitutes the, largest percentage, (a) Plasma, (b) Intestinal fluid, (c) Intracellular fluid (d) Fat, 296. The duration of action of a drug is dependent of its, (a), (b), (c), (d), , Plasma and tissue binding, Metabolism, Tubular filtration and secretion, All the above, , 297. When a drug has a low therapeutic, index, that drug should be, (a), (b), (c), (d), , Used mostly orally, Used mostly intravenously, Considered a potentially toxic substance, Given only in submilligram doses, , 298. A drug is being metabolized by zeroorder kinetics. This indicates that, (a) A constant amount of drug is being, catabolised each hour, (b) A constant fraction of drug is being, catabolised each hour, (c) A drug is water soluble substance, (d) The time required to catabolise half of the, drug is independent of the initial concentration of the drug, 299. Drugs interact with their receptors sites, by forming, (a), (b), (c), (d), , Ionic bonds, Hydrogen bonds, Van der Waals bond, All the above, , 300. The main route of administration of a, drug to produce a local effect is, (a) Topical, (c) Parenteral, , (b) Oral, , 301. The main routes of administration of a, drug is to provide a systemic effect., Identify the wrong answer, , (a) Topical, (c) Parenteral, , (b) Oral, , 302. Parenteral administration of a drug refers, to the giving of a preparation, except, (a) Orally, (b) Intradermally, (c) Intramuscularly, (d) Intravenously, 303. Pharmacokinetics consIders, (a) The way in which the body affects a drug by, the process of absorption, distribution,, metabolism and excretion, (b) The effects of the drug on the body and the, mode of drug action., (c) The proportion of administered drug that is, available to have an effect., (d) The removal of the drug by the liver before it, has become available, 304. If gut motility is increased then, (a) Drug absorption is decreased, (b) Drug absorption is increased, (c) Drug absorption is not effected, 305. The rate of drug absorption is greatest in, (a) The small intestine, (b) The large intestine, (c) The stomach, 306. Drug distribution may depend on tissue, perfusion, (a) Highly vascular organs rapidly acquire a, drug, (b) Highly vascular organs acquire a drug slowly, (c) Levels of a drug in bone may rise quickly, due to its high vascularity, (d) Levels of a drug in bone may rise slowly due, to its reduced, 307. Most drugs and metabolites are excreted, by, (a) The kidneys, (b) The bile, (c) The lungs, (d) Perspiration, saliva and tears

Page 41 :
MCQs IN PHARMACOLOGY, , 26, 308. Pharmacodynamics considers:, (a) The way in which the body affects the drug, (b) The effects of the drug on the body and the, mode of drug action, (c) Drug metabolism, , (a) Steroids, (c) Retinoids, , (b) Vitamin D, (d) all the above, , 311. Factors affecting a client’s response to a, drug include all the following except:, (a) A body weight i.e. the larger the individual,, the larger the area for drug distribution, (b) Body fat –A loss of body fat stores means, less drug available for activity, (c) Body fat–An increase in body fat means, greater sequestering in body fat and less drug, activity, (d) The presence of certain foods, , 309. A drug that binds to a cell receptor and, causes a response is called an:, (a) Agonist, (b) Antagonist, (c) Receptor blocker, 310. Receptors for _________ are DNA-binding, proteins, , ANSWERS, 1. b, , 2. b, , 3. d, , 4. c, , 5. e, , 6. a, , 7. a, , 8. b, , 9. d, , 10. a, , 11. e, , 12. c, , 13. a, , 14. a, , 15. a, , 16. a, , 17. b, , 18. e, , 19. a, , 20. a, , 21. a, , 22. a, , 23. a, , 24. c, , 25. e, , 26. d, , 27. b, , 28. c, , 29. b, , 30. c, , 31. c, , 32. e, , 33. a, , 34. c, , 35. a, , 36. d, , 37. b, , 38. a, , 39. b, , 40. c, , 41. a, , 42. a, , 43. a, , 44. a, , 45. c, , 46. a, , 47. c, , 48. 1. a, 2. d, 3. b, 4. a, , 49. 1. a, 2. d, 3. c, , 50. 1. b, 2. e, 3. c, 4. a, , 51. b, , 52. b, , 53. c, , 54. d, , 55. d, , 56. b, , 57. d, , 58. b, , 59. b, , 60. a, , 61. b, , 62. d, , 63. e, , 64. e, , 65. c, , 66. a, , 67. c, , 68. d, , 69. a, , 70. b, , 71. c, , 72. b, , 73. d, , 74. a, , 75. b, , 76. a, , 77. c, , 78. c, , 79. b, , 80. b, , 81. c, , 82. d, , 83. a, , 84. a, , 85. c, , 86. c, , 87. c, , 88. a, , 89. d, , 90. b, , 91. e, , 92. a, , 93. a, , 94. b, , 95. c, , 96. d, , 97. c, , 98. a, , 99. c, , 100. c, , 101. b, , 102. a, , 103. a, , 104. d, , 105. b, , 106. d, , 107. a, , 108. c, , 109. a, , 110. b, , 111. b, , 112. a, , 113. a, , 114. b, , 115. c, , 116. a, , 117. c, , 118. d, , 119. b, , 120. d, , 121. c, , 122. c, , 123. a, , 124. a, , 125. c, , 126. b, , 127. d, , 128. a

Page 42 :
GENERAL PHARMACOLOGY, , 27, , 129. b, , 130. a, , 131. d, , 132. b, , 133. d, , 134. c, , 135. c, , 136. b, , 137. c, , 138. c, , 139. a, , 140. c, , 141. c, , 142. c, , 143. d, , 144. a, , 145. d, , 146. d, , 147. a, , 148. a, , 149. c, , 150. b, , 151. d, , 152. a, , 153. b, , 154. d, , 155. c, , 156. c, , 157. b, , 158. c, , 159. d, , 160. c, , 161. d, , 162. b, , 163. a, , 164. d, , 165. a, , 166. c, , 167. b, , 168. c, , 169. a, , 170. b, , 171. b, , 172. b, , 173. b, , 174. c, , 175. d, , 176. b, , 177. b, , 178. a, , 179. b, , 180. a, , 181. b, , 182. a, , 183. a, , 184. a, , 185. a, , 186. b, , 187. a, , 188. a, , 189. a, , 190. b, , 191. a, , 192. a, , 193. d, , 194. a, , 195. d, , 196. a, , 197. b, , 198. a, , 199. d, , 200. c, , 201. b, , 202. a, , 203. d, , 204. a, , 205. d, , 206. d, , 207. b, , 208. c, , 209. b, , 210. b, , 211. b, , 212. c, , 213. a, , 214. b, , 215. b, , 216. c, , 217. d, , 218. c, , 219. a, , 220. a, , 221. c, , 222. c, , 223. d, , 224. d, , 225. d, , 226. a, , 227. b, , 228. b, , 229. c, , 230. b, , 231. a, , 232. b, , 233. e, , 234. d, , 235. a, , 236. e, , 237. a, , 238. d, , 239. e, , 240. a, , 241. b, , 242. d, , 243. a, , 244. d, , 245. d, , 246. 5, , 247. c, , 248. e, , 249. c, , 250. c, , 251. c, , 252. a, , 253. d, , 254. b, , 255. d, , 256. b, , 257. d, , 258. f, , 259. c, , 260. b, , 261. a, , 262. d, , 263. c, , 264. b, , 265. c, , 266. d, , 267. c, , 268. d, , 269. d, , 270. e, , 271. c, , 272. d, , 273. d, , 274. b, , 275. c, , 276. b, , 277. e, , 278. e, , 279. d, , 280. a, , 281. b, , 282. a, , 283. c, , 284. b, , 285. a, , 286. e, , 287. d, , 288. a, , 289. c, , 290. a, , 291. a, , 292. e, , 293. b, , 294. e, , 295. c, , 296. d, , 297. c, , 298. a, , 299. d, , 300. a, , 301. a, , 302. a, , 303. a, , 304. a, , 305. a, , 306. a & d, , 307. a, , 308. b, , 309. a, , 310. d, , 311. a & d

Page 43 :
MCQs IN PHARMACOLOGY, , 28, , EXPLANATIONS FOR ANSWERS, 7. a, 20. a, , 35. a, , 52. a, , 65. c, , 78. c, , 110. b, , 125. c, , 145. d, , 161. d, , because of enhanced disassociation weak acids, are excreted faster in basic (not acidic) urine., Chemical antagonism does not involve any, receptors. Protamine is a positively charged, protein at physiological pH and thus, antagonizes the effects of Heparin which is, negatively charged at physiological pH., Facilitated diffusion differs from active transport, in that it does not require energy source and it, carries the transport in the direction of, electrochemical gradient., Glycoprotein binds to basic drugs and albumin, binds to many acidic drugs and a small number, of basic drugs., CYP3A4 is involved in the metabolism of, majority of drugs and is also expressed, extrahepatically. In fact, poor bioavailability of, many drugs is attributed to the drug metabolism, by CYP3A4 in gastrointestinal tract., N-oxidation is involved in the metabolism of, dapsone, meperidine and chloramphenicol., Metabolism of phenytoin involves oxidative Ndealkylation., Many receptors use heterotrimeric GTP-binding, regulatory proteins. The subunits are designated, as β, α and α and their classification is based, on á subunits., G-protein coupled receptors are hydrophobic, proteins and span the plasma membrane in, seven á-helical segments., Placebo effect is a desired response to a therapy, without drug. Placebo effect is mainly because, of various psychological reasons e.g. physicianpatient relationship, mental set up affected by, surroundings and positive mental set up because, of known and trusted physician., Pharmacodynamic tolerance involves multiple, mechanism such as number, affinity and function, of receptors., , 180. a, , 189. a, , 200. c, , 217. d, , 240. a, , 261. a, , 280. a, , 290. a, , 295. c, , 310. d, , Spare receptors are generally found whenever, a receptor acts catalytically and not, stoichiometrically. Hence, they are generally, found among drugs, which elicit smooth muscle, contraction., Dimercaprol interacts directly with heavy metals, in blood and tissue fluids and prevents binding, of heavy metals to cellular constituents., Dimercaprol forms an inactive complex with, heavy metals., Two drugs binding to the same receptor is an, example of competitive antagonism and effect, of one drug can be decreased by increasing, the concentration of other drug., Receptors for steroid hormones are intracellular, DNA – binding proteins, which regulate gene, transcription., Receptors linked directly to ion channels are, involved in the fast synaptic transmission e.g., nicotinic acetylcholine receptor. This receptor is, a pentamer i.e. it is made up of five poly-peptide, subunits., In G-protein coupled receptors, agonist-receptor, complex enhances GTP binding to the α subunit,, mainly by dissociating already bound GDP., The termination of agonist-receptor coupling in, a G-protein-coupled receptor is because of, conversion of GTP to GDP by a GTPase that is, intrinsic to α subunit., Therapeutic index is the range between minimal, and maximal concentration required to elicit, desired response., intracellular fluid comprises 35%, whereas, contribution of other compartments is far less, e.g. plasma – 5%; interstitial fluid – 16%; fat –, 20% and transcellular fluid – 2%., Receptors for steroids, vitamin D, retinoids and, also thyroid hormones are DNA-binding, proteins, which regulate transcription of genes.

Page 44 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, , 29, , CHAPTER 2, DRUGS ACTING ON CENTRAL, NERVOUS SYSTEM, 1. A-50-year-old man has a history of, frequent episodes of renal colic with highcalcium renal stones. The most useful, agent in the treatment of recurrent, calcium stones is, (a) Mannitol, (c) Spironolactone, (e) Acetazolamide, , (b) Furosemide, (d) Hydrochlorothiazide, , 2. Which of the following drugs is correctly, associated with its site of action and, maximal diuretic efficacy?, (a) Thiazides–distal convoluted tubute–10% of, filtered Na+, (b) Spironolactone–proximal convoluted tubule, –40%, (c) Bumetanide–thick ascending limb–15%, (d) Metolazone–collecting tubule–2%, (e) All of the above, 3. Substance secreted into the blood by a, neuron is, (a) Neurohormone, (c) Neuromediator, , (b) Neuromodulator, (d) Neurotransmitter, , 4. Which of the following is a leukotriene, receptor blocker?, (a) Alprostadil, (c) Ibuprofen, (e) Zafirlukast, , (b) Aspirin, (d) LTC4, , 5. A molecule that stimulates nitric oxide, synthase, especially the eNOS isoform, is, , (a) Acetylcholine, , (b) Citruline, , (c) Isoproterenol, , (d) Nitroglycerin, , (e) Nitroprusside, 6. The primary endogenous substrate for, nitric oxide synthase is, (a) Acetylcholine, , (b) Angiotensinogen, , (c) Arginine, , (d) Citruline, , (e) Heme, 7. Which of the following is a recognized, effect of nitric oxide?, (a) Arrhythmia, (b) Bronchoconstriction, (c) Constipation, (d) Inhibition of acute graft rejection, (e) Pulmonary vasodilation, 8. cAMP is an example of, (a) Neurohormone, , (b) Neuromodulator, , (c) Neuromediator, , (d) Neurotransmitter, , 9. One effect that theophylline, nitroglycerin,, isoproterenol, and histamine have in, common is, (a) Direct stimulation of cardiac contractile force, (b) Tachycardia, (c) Increased gastric acid secretion, (d) Postural hypotension, (e) Throbbing headache

Page 45 :
MCQs IN PHARMACOLOGY, , 30, 10. Which one of the following chemicals, does not satisfy the criteria for a, neurotransmitter role in the CNS?, (a) Acetylcholine, (c) Glycine, (e) Substance P, , (b) Dopamine, (d) Nitric Oxide, , 11. Neurotransmitters may, (a) Increase chloride conductance to cause, inhibition, (b) Increase potassium conductance to cause, excitation, (c) Increse sodium conductance to cause, inhibition, (d) Increase calcium conductance to cause, inhibition, (e) Exert all of the above actions, 12. Which of the following chemicals is most, likely to function as a neurotransmitter, in hierarchical systems?, (a) Dopamine, (c) Metenkephalin, (e) Serotonin, , (b) Glutamate, (d) Norepinephrine, , 13. Activation of metabotropic receptors, located presynaptically causes inhibition, by decreasing the inward flux of, (a) Calcium, (b) Chloride, (c) Potassium, (d) Sodium, (e) None of the above, 14. This compound decrease the functional, activities of several CNS neurotransmitters, including dopamine, norepinephrine, and serotonin. At high doses it may, cause parkinsonism-like extrapyramidal, system dysfunction., (a) Amphetamine, (c) Diazepam, (e) Reserpine, , (b) Baclofen, (d) Ketamine, , 15. This amine neurotransmitter is found in, high concentration in cell bodies in the, pons and brain stem; at some sites,, release of transmitter is autoregulated via, presynaptic inhibition., (a) Acetylcholine, (c) Glutamate, (e) Substance P, , (b) Dopamine, (d) Norepinephrine, , 16. Suramin is an antagonists of ________, receptors, (a) Purine, (c) Neuropeptide Y, , (b) Somatostanin, (d) Neurotensin, , 17. Which one of the following statements, best describes the mechanism of action, of benzodiazepines?, (a) Benzodiazepines activate GABAB receptors, in the spinal cord, (b) Their inhibition of GABA transminase leads, to increased levels of GABA, (c) Benzodiazepines block glutamate receptors, in hierarchical neuronal pathways in the, brain, (d) They increase the frequency of opening of, chloride ion channels that are coupled to, GABAA receptors, (e) They are direct-acting GABA receptor, agonists in the CNS, 18. Which one of the following statements, about the use of triazolam in this elderly, patient is accurate?, (a) Ambulatory dysfunction does not occur in, elderly patients taking one-half of the, conventional adult dose, (b) Hypertension is a common adverse effects, of benzodiazepines in patients over 70 years, of age, (c) Over-the-counter cold medications may, antagonize the hypnotic effects of the drug, (d) She may experience amnesia, especially if, she also drinks alcoholic beverages, (e) Triazolam is distinctive in that it does not, cause rebound insomnia on abrupt, discontinuance, 19. The most likely explanation for the, increased sensitivity of elderly patients, to a single dose of triazolam and other, sedative-hypnotic drugs is, (a) Changes in brain function that accompany, the aging process, (b) Decreased renal function, (c) Increased cerebral blood flow, (d) Decreased hepatic metabolism of lipidsoluble drugs, (e) Changes in plasma protein binding

Page 46 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 20. Induction of various forms of synaptic, plasticity is more closely associated with, ______ receptors, (a) AMPA, (c) NMDA, , (b) Kainate, (d) All of the above, , 21. Which one of the following drugs may, increase anticoagulant effects by, displacement of warfarin from plasma, protein binding sites and is inactive until, converted in the body to an active, metabolite?, (a) Buspirone, (c) Clorazepate, (e) Zaleplon, , (b) Chloral hydrate, (d) Secobarbital, , 22. Which one of the following drugs has, been used in the management of alcohol, withdrawal states and in maintenance, treatment of patient with tonic-clonic or, partial seizure states? Its chronic use may, lead to an increased metabolism of, warfarin and phenytoin., (a) Chlordiazepoxide (b) Meprobamate, (c) Phenobarbital, (d) Triazolam, (e) Zolpidem, 23. A 40-year-old patient with liver, dysfunction is scheduled for a surgical, procedure. Lorazepam can be used for, preanesthetic sedation in this patient, without concern for excessive CNS, depression because the drug is, (a), (b), (c), (d), (e), , A selective anxiolytic like buspirone, Actively secreted in the renal proximal tubule, Conjugated extrahepatically, Eliminated via the lungs, Reversible by administration of naloxone, , 24. This hypnotic drug facilitates the, inhibitory actions of GABA, but it lacks, anticonvulsant or muscle relaxing, properties and has minimal effect on, sleep architecture., (a) Buspirone, (c) Flurazepam, (e) Zaleplon, , (b) Diazepam, (d) Phenobarbital, , 25. The most frequent type of drug interaction, that occurs in patients using drugs of the, sedative hypnotic class is, , 31, (a), (b), (c), (d), (e), , Additive CNS depression, Antagonism of sedative or hypnotic actions, Competition for plasma protein binding, Induction of liver drug-metabolizing enzymes, Inhibition of liver drug-metabolizing enzymes, , 26. A 42-year-old man with a history of, alcoholism is brought to the emergency, room in a confused and delirious state. He, has truncal ataxia and ophthalmoplegia., The most appropriate immediate course of, action is to administer., (a) Chlordiazepoxide (b) Disulfiram, (c) Folic acid, (d) Lorazepam, (e) Thiamine, 27. Which one of the following statements, about the bio-disposition of ethanol is, accurate?, (a) Ethanol is absorbed at all levels of the, gastrointestinal tract, (b) Acetic acid is the initial product of ethanol, metabolism, (c) After an intravenous dose, plasma levels of, ethanol are lower in women than in men, (d) The elimination of ethanol follows first-order, kinetics, (e) Alcohol dehydrogenase exhibits genetic, variability, 28. Following is GABAA agonist, (a) Muscimol, (c) Bicuculline, , (b) Baclofen, (d) None of the above, , 29. Chronic use of ethanol is reported to, increase, (a), (b), (c), (d), (e), , Alcohol dehydrogenase, Aldehyde dehydrogenase, Microsomal ethanol-oxidizing system activity, Monoamine oxidase, NADH dehydrogenase, , 30. The chronic abuse of alcohol predisposes, to hepatic damage following overdose of, acetaminophen because ethanol, (a) Blocks acetaminophen metabolism, (b) Causes thiamine deficiency, (c) Displaces acetaminophen from plasma, proteins

Page 47 :
MCQs IN PHARMACOLOGY, , 32, (d) Induces liver drug-metabolizing enzymes, (e) Inhibits renal clearance of acetaminophen, 31. The activity of this enzyme is specifically, decreased in the Wernicke-Korsakoff, syndrome, (a), (b), (c), (d), (e), , Alcohol dehydrogenase, Cytochrome P450, L-Aromatic amino acid decarboxylase, NADH dehydrogenase, Pyruvate dehydrogenase, , 32. Following is glycine antagonists, (a) Quisqualate, (c) Strychnine, , (b) Taurine, (d) â-alanine, , 33. Which one of the following statements, concerning the pharmacokinetics of, antiseizure drugs is accurate?, (a) At high doses, phenytoin elimination follows, first-order kinetics, (b) Valporic acid may increase the activity of, hepatic ALA synthase and the synthesis of, porphyrins, (c) The administration of phenytoin to patients, in methadone maintenance programs has led, to symptoms of opioid overdose, including, respiratory depression, (d) Although ethosuximide has a half-life of, approximately 40 hours, the drug is usually, taken twice a day, (e) Treatment with vigabatrin may reduce the, effectiveness of oral contraceptives, 34. With chronic use in seizure states, the, adverse effects of this drug include, coarsening of facial features, hirsutism,, gingival hyperplasia, and osteomalacia., (a) Carbamazepine, (c) Gabapentin, (e) Valproic acid, , (b) Ethosuximide, (d) Phenytoin, , 35. Which one of the following statements, about vigabatrin is accurate?, (a), (b), (c), (d), (e), , Blocks neuronal reuptake of GABA, Drug of choice in absence seizures, Is established to be teratogenic in humans, Life-threatening skin disorders may occur, Visual field defects occur in up to one-third, of patients, , 36. Withdrawal of antiseizure drugs can, cause increased seizure frequency and, severity. Withdrawal is least likely to be, a problem with, (a) Clonazepam, (c) Ethosuximide, (e) Phenytoin, , (b) Diazepam, (d) Phenobarbital, , 37. A young femal patient who suffers from, bipolar affective disorder (BAD) has been, managed with lithium. If she becomes, pregnant, which one of the following, drugs is likely to be effective in bipolar, affective disorder with minimal risk of, teratogenicity?, (a) Carbamazepine (b) Clonazepam, (c) Phenytoin, (d) Valproic acid, (e) None of the above, 38. The most likely mechanism involved in, the antiseizure activity of carbamazepine, is, (a) Block of sodium ion channels, (b) Block of calcium ion channels, (c) Facilitation of GABA actions on chloride ion, channels, (d) Glutamate receptor antagonism, (e) Inhibition of GABA transaminase, 39. Which one of the following statements, about phenytoin is accurate?, (a) Displaces sulfonamides from plasma proteins, (b) Drug of choice in myoclonic seizures, (c) Half-life is increased if used with phenobarbital, (d) Isoniazid (INH) decreases steady state blood, levels of phenytoin, (e) Toxicity may occur with only small increments, in dose, 40. Which one of the following statements, concerning nitrous oxide is accurate?, (a) It continues to be a useful component of, anesthesia protocols because of its lack of, cardiovascular depression, (b) Megaloblastic anemia is a common adverse, effect in patients exposed to nitrous oxide, for periods longer than 2 hours, (c) It is the most potent of the inhaled

Page 48 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, anaesthetics, (d) There is a direct association between the use, of nitrous oxide and malignant hyperthermia, (e) More than 30% of nitrous oxide is eliminated, via hepatic metabolism, 41. Following is GABAB agonist, (a) Muscimol, (c) Picrotoxin, , (b) Baclofen, (d) Bicuculline, , 42. Following is GABAA antagonist, (a) Muscimol, (c) Strychnine, , (b) Bicuculline, (d) Baclofen, , 43. The inhalation anesthetic with the fastest, onset of action is, (a) Enflurane, (c) Nitric oxide, (e) Nitrous oxide, , (b) Isoflurane, (d) Nitrogen dioxide, , 44. An intravenous bolus dose of thiopental, usually leads to loss of onsciousness, within 10–15 seconds. If no further drugs, are administered, the patient will regain, consciousness in just a few minutes. The, reason for this, that thiopental is, (a), (b), (c), (d), (e), , A good substrate for renal tubular secretion, Exhaled rapidly, Rapidly metabolized by hepatic enzymes, Redistributed from brain to other body tissues, Secreted in the bile, , 45. Respiratory depression following use of, this agent may be reversed by administration of flumazenil, (a) Desflurane, (c) Ketamine, (e) Propofol, , (b) Fentanyl, (d) Midazolam, , 46. Use of this agent is associated with a high, incidence of disorientation, sensory and, perceptual illusions, and vivid dreams, during recovery from anesthesia, (a) Diazepam, (c) Ketamine, (e) Thiopental, , (b) Fentanyl, (d) Midazolam, , 47. Postoperative vomiting is uncommon, with this intravenous agent; patients are, able to ambulate sooner than those who, , 33, receive other anaesthetics, (a) Enflurane, (c) Morphine, (e) Remifentanil, , (b) Ketamine, (d) Propofol, , 48. The pKa of lidocaine is 7.9. In infected, tissue at pH 6.9, the fraction in the ionized, form will be, (a) 1%, (c) 50%, (e) 99%, , (b) 10%, (d) 90%, , 49. Which of the following statements about, nerve blockade with local anaesthetics, is most correct?, (a), (b), (c), (d), (e), , Block is faster in onset in infected tissues, Block is faster in onset in unmyelinated fibers, Block is slower in onset in hypocalcemia, Block is faster in onset in hyperkalemia, Block is slower in onset in the periphery of a, nerve bundle than in the center of a bundle, , 50. Which of the following was the first compound to be identified Pharmacologically, as a transmitter in the CNS ?, (a) Glycine, (c) Acetulcholine, , (b) Glutamate, (d) Norepinephrine, , 51. You have a vial containing 4 mL of a 2%, solution of lidocaine. How much lidocaine, is present in 1 mL?, (a) 2 mg, (c) 20 mg, (e) 200 mg, , (b) 8 mg, (d) 80 mg, , 52. Which one of the following statements, about the toxicity of local anaesthetics is, most correct?, (a) Serious cardiovascular reactions are more likely, to occur with tetracaine than with bupivacaine, (b) Cyanosis may occur following injection of, large doses of lidocaine, especially in, patients with pulmonary disease, (c) Intravenous injection of local anaesthetics may, stimulate ectopic cardiac pacemaker activity, (d) In overdosage, hyper ventilation (with, oxygen) is helpful to correct acidosis and, lower extracellular potassium, (e) Most local anaesthetics cause vasoconstriction

Page 49 :
MCQs IN PHARMACOLOGY, , 34, 53. Epinephrine added to a solution of, lidocaine for a peripheral nerve block will, (a) Increase the risk of convulsions, (b) Increase the duration of anesthetic action of, the local anesthetic, (c) Both (A) and (B), (d) Neither (A) nor (B), (e) None of the above, 54. A child requires multiple minor surgical, procedures in the nasopharynx. Which, of the following drugs has high surface, activity and vasoconstrictor actions that, reduce bleeding in mucous membrane?, (a) Benzocaine, (c) Cocaine, (e) Procaine, , (b) Bupivacaine, (d) Lidocaine, , 55. Characteristics of nondepolarizing, neuromuscular blockade include which, one of the following?, (a) Block of posttetanic potentiation, (b) Histamine blocking action, (c) Poorly sustained titanic tension, (d) Significant muscle fasciculations during onset, of block, (e) Stimulation of autonomic ganglia, 56. Which of the following does not cause, skeletal muscle contactions or twitching?, (a) Acetylcholine, (c) Strychnine, (e) Vecuronium, , (b) Nicotine, (d) Succinylcholine, , 57. Which one of the following is most, effective in the management of malignant, hyperthermia?, (a) Baclofen, (c) Haloperidol, (e) Vecuronium, , (b) Dantrolene, (d) Succinylcholine, , 58. Following is a G-protein coupled receptor, (a) AMPA, (c) NMDA, , (b) Kainate, (d) Metabotropic, , 59. Which one of the following drugs is most, often associated with hypotension caused, by histamine release?, , (a) Diazepam, (c) Tizanidine, (e) Vecuronium, , (b) Pancuronium, (d) Tubocurarine, , 60. Which one of the following drugs has, caused hyperkalemia leading to cardiac, arrest in patients with neurologic, disorders?, (a) Baclofen, (c) Succinylcholine, (e) Vecuronium, , (b) Dantrolene, (d) Tubocurarine, , 61. Following is an excitatory amino acid, receptor antagonist?, (a) Phencyclidine, (c) Homocysteate, , (b) Quisqualate, (d) Kainate, , 62. Which one of the following drugs has, spasmolytic activity and could also be, used in the management of seizures, caused by overdose of a local anesthetic?, (a) Baclofen, (c) Dantrolene, (e) Tizanidine, , (b) Cyclobenzaprine, (d) Diazepam, , 63. Which one of the following drugs given, preoperatively will prevent postoperative, pain caused by succinylcholine?, (a) Baclofen, (c) Diazepam, (e) Tubocurarine, , (b) Dantrolene, (d) Lidocaine, , 64. As the physician, you could tell the patient, (and close family members) all of the, following things about levodopa except?, (a) Taking the drug in divided doses will, decrease nausea and vomiting, (b) He should be careful when he stands up, because he may get dizzy, (c) Uncontrollable muscle jerks may occur, (d) A net-like reddish to blue discoloration of, the skin is a likely side effect of the medication, (e) The drug will probably improve his symptoms, for a period of time but not indefinitely, 65. As the physician who is prescribing, levodopa, you will note that the drug, (a) Causes less severe behavioral side effects if, given with carbidopa

Page 50 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (b) Fluctuates in its effectiveness with increasing, frequency as treatment continues, (c) Prevents extrapyramidal adverse effects of, antipsychotic drugs, (d) Protects against cancer in patients with, melanoma, (e) Has toxic effects that include pulmonary, infiltrates, 66. The major reason why carbidopa is of, value in parkinsonism is that the, compound, (a), (b), (c), (d), , Crosses the blood-brain barrier, Inhibits monoamine oxidase type A, Inhibits aromatic L-amino acid decarboxylase, Is converted to the false neurotransmitter, carbidopamine, (e) Inhibits monoamine oxidase type B, , 67. Which one of the following statements, about bromocriptine is accurate?, (a) It should not be administered to patients, taking antimuscarinic drugs, (b) Effectiveness in Parkinson’s disease requires, its metabolic conversion to an active, metabolite, (c) The drug is contraindicated in patients with, a history of psychosis, (d) The drug should not be administered to, patients already taking levodopa, (e) Mental disturbances occur more commonly, with levodopa than with bromocriptine, 68. A 72-year-old patient with parkinsonism, presents with swollen feet. They are red,, tender, and very painful. You could clear, up these symptoms within a few days if, you told the patient to stop taking, (a) Amantadine, (c) Bromocriptine, (e) Selegiline, , (b) Benztropine, (d) Levodopa, , 69. Concerning the drugs used in, parkinsonism, which of the following, statements is accurate?, (a) Levodopa causes mydriasis and can, precipitate an attack of acute glaucoma, (b) Useful therapeutic effects of amantadine, continue for several years, , 35, (c) The primar y therapeutic benefit of, antimuscarinic drugs in parkinsonism is their, ability to reliever bradykinesia, (d) Dopamine receptor against should not be, used in Parkinson’s disease prior to a trial of, levodopa, (e) The concomitant use of selegiline may, increase the peripheral adverse effects of, levodopa, 70. A previously healthy 50-year-old woman, begins to suffer from slowed mentation, and develops writhing movement of her, tongue and hands. In addition, she has, delusions of being persecuted. The, woman has no past history of psychiatric, or neurologic disorders. The most, appropriate drug for treatment is, (a) Amantadine, (c) Haloperidol, (e) Trihexyphenidyl, , (b) Bromocriptine, (d) Levodopa, , 71. Great caution must be exercised in the, use of this drug (or drugs from the same, class) in parkinsonian patients who have, prostatic hypertrophy or obstructive, gastrointestinal disease, (a) Benztropine, (c) Levodopa, (e) Selegiline, , (b) Carbidopa, (d) Ropinirole, , 72. Which of the following statements about, pramipexole is accurate?, (a) Activates dopamine D2 receptors, (b) Commonly a first-line therapy for Parkinson’s, disease, (c) May cause postural hypotension, (d) Not an ergot derivative, (e) All of the above, 73. Tolcapone may be of value in patient, being treated with levodopa–carbidopa, because it, (a), (b), (c), (d), (e), , Activates catechol – O – methyltransferease, Decreases formation of 3 – O – methyldopa, Inhibits monoamine oxidase type B, Inhibits dopamine reuptake, Releases dopamine from nerve endings

Page 51 :
MCQs IN PHARMACOLOGY, , 36, 74. Concerning hypotheses for the pathophysiologic basis of schizophrenia, which, one of the following statements is accurate?, (a) Positron emission tomography has shown, decreased dopamine receptors in the brains, of both untreated and drug-treated, schizophrenics, (b) Drugs that block dopamine receptors are, useful for alleviating psychotic symptoms in, parkinsoniam patients, (c) The clinical potency of many antipsychotic, drugs correlates well with their beta, adrenoceptor-blocking actions, (d) Drug-induced psychosis can occur without, activation of brain dopamine receptors, (e) All effective antipsychotic drugs have high, affinity for dopamine D2 receptors, 75. Choose the correct statement from the, following?, (a) Muscimol is GABAB selective, (b) Bicuculline is GABAA agonist, (c) Picrotoxin blocks chloride channels, associated with GABAA receptors, (d) Baclofen is GABAA agonist, 76. A 30-year-old male patient is on drug, therapy for a psychiatric problem. He, complains that he feels “flat” and that, he gets confused at times. He has been, gaining weight and has lost his sex drive., As he moves his had, you notice a slight, tremor. He tells you that since he has been, on medication he is always thirsty and, frequently has to urinate. The drug he is, most likely to be taking is, (a) Clonazepam, (c) Haloperidol, (e) Trifluoperazine, , (b) Clozapine, (d) Lithium, , 77. A young male patient diagnosed as, schizophrenic develops severe muscle, cramps with torticollis a short time after, drug therapy is intiated with haloperidol., The best course of action would be to, (a) Add clozapine to the drug regimen, (b) Discontinue haloperidol and observe the, patient, , (c) Give oral diphenydramine, (d) Switch the patient to fluphenazine, (e) Inject benztropine, 78. Which one of the following statements, about the action of phenothiazines is, accurate?, (a) They activate muscarinic receptors, (b) They are antiemetic, (c) They decrease serum prolactin levels, (d) They elevate the seizure threshold, (e) They raise blood pressure, 79. Within days of starting haloperidol treatment for a psychatric disorder, a young, male patient developed severe generalized muscle rigidity and a high fever. In, the emergency room he was incoherent,, with increased heart rate, hypotension,, and diaphoresis, Laboratory studies indicated acidosis, leukocytosis, and increased creatine kinase. The most likely, reason for these symptoms is that the patient was suffering from, (a), (b), (c), (d), , Agranulocytosis, A severe bacterial infection, Neuroleptic malignant syndrome, Spastic retrocollis, , (e) Tardive dyskinesia, 80. Following is the main inhibitor y, transmitter in the brain, (a) Dopamine, (c) Glycine, , (b) Norepinephrine, (d) GABA, , 81. Concerning the proposed mechanisms of, action of antidepressant drugs, which one, of the following statements is accurate?, (a) Bupropion is an effective inhibitor of NE and, 5-HT transporters, (b) Chronic treatment with an antidepressant often, leads to the up-regulation of adrenoceptors, (c) Elevation in amine metabolites in cerebrospinal fluid is characteristic of most, depressed patients prior to drug therapy, (d) MAO inhibitors used as antidepressants, selectively decrease the metabolism of, norepinephrine

Page 52 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (e) The acute effect of most tricyclics is to block, the neuronal reuptake of both norepinephrine, and serotonin in the CNS, 82. Which one of the following effects is, unlikely to occur during treatment with, amitriptyline?, (a), (b), (c), (d), (e), , Alpha adrenoceptor blockade, Elevation of the seizure threshold, Mydriasis, Sedation, Urinary retention, , 83. A 54-year-old male patient was using, fluoxetine for depression but decided to, stop taking the drug. When questioned,, he said that it affected his sexual, performance and that “he wasn’t getting, any younger.” You notice that he is a used, of tobacco products. If you decide to, reinstitute drug therapy in this patient,, the best choice would be, (a) Amoxapine, (c) Imipramine, (e) Venlafaxine, , (b) Bupropion, (d) Sertraline, , 84. Regarding maprotiline, which one of the, following statements is accurate?, (a), (b), (c), (d), (e), , Blocks serotonin reuptake selectively, Cause hypertension, Raises the seizure threshold, Sedation occurs commonly, Has a tricyclic structure, , 85. Which one of the following drugs is most, likely to be of value in obsessive, compulsive disorders (OCD)?, (a) Amitriptyline, (c) Clomipramine, (e) Mirtazapine, , (b) Bupropion, (d) Desipramine, , 86. Compared with other antidepressant, drugs, mirtazapine has the distinctive, ability to act as an antagonist of, (a), (b), (c), (d), (e), , Alpha2 adrenoceptors, Beta adrenoceptors, D2 receptors, NE transporters, 5-HT transporters, , 37, 87. Established clinical uses of this drug, include enuresis and chronic pain, (a) Bupropion, (c) Imipramine, (e) Selegiline, , (b) Fluvoxamine, (d) Phenelzine, , 88. Which one of the following drugs is most, likely to increase plasma levels of, alprazolam, the ophyline, and warfarin, (a) Desipramine, (c) Imipramine, (e) Venlafaxine, , (b) Fluvoxamine, (d) Nefazodone, , 89. Which one of the following actions of, opioid analgesics is mediated via, activation of kappa receptors?, (a), (b), (c), (d), (e), , Cerebral Vascular dilation, Decreased uterine tone, Euphoria, Sedation, Psychologic dependence, , 90. ______ antagonists are known to, attenuate some of the actions of alcohol., (a) GABAA, (c) NMDA, , (b) GABAB, (d) Glycine, , 91. Which one of the following statements, about propoxyphene is accurate?, (a), (b), (c), (d), (e), , Analgesia equivalent to oxycodone, Antagonist at mu receptors, Causes dose-limiting diarrhea, Highly effective cough suppressant, Seizures have occurred in overdose, , 92. A young male patient is brought to the, emergency room of a hospital suffering, from an overdose of cocaine following, intravenous administration. His symptoms are unlikely to include, (a) Agitation, (c) Hyperthermia, (e) Seizures, , (b) Bradycardia, (d) Myocardial infarct, , 93. Which one of the following statements, about hallucinogens is accurate?, (a) Mescaline and related hallucinogens are, thought to exert their CNS actions through, dopaminergic systems in the brain

Page 53 :
MCQs IN PHARMACOLOGY, , 38, (b) Teratogenic effects are known to occur with, the use of LSD during pregnancy, (c) Scopolamine is unique among hallucinogens, in that animals will self-administer it, (d) Dilated pupils, tachycardia, tremor and, increased alertness are characteristic effects, of psilocybin, (e) Phencyclidine can be anticipated to cause, dry mouth and urinary retention, 94. Which one of the following signs or symptoms is likely to occur with marijuana?, (a), (b), (c), (d), (e), , Bradycardia, Conjunctival reddening, Hypertension, Increased psychomotor performance, Mydriasis, , 95. This agent has sedative and amnestic, properties. Small doses added to, alcoholic beverages are not readily, detected by taste and have been used in, “date rape” attacks. The drug is, chemically related to a brain inhibitory, neurotransmitter. Which one of the, following most closely resembles the, description given?, (a), (b), (c), (d), (e), , Amyl nitrite, Flunitrazepam, Gamma-hydroxybutyrate, Hashish, Metcathinone, , 96. The patient is started on gemfibrozil. The, major mechanism of action of gemfibrozil, is, (a) Increased excretion of bile acid salts, (b) Increased expression of high-affinity LDL, receptors, (c) Increased lipid hydrolysis by lipoprotein, lipase, (d) Inhibition of secretion of VLDL by the liver, (e) Reduction of secretion of HDL by the liver, 97. When used as monotherapy, a major, toxicity of gemfibrozil is increased risk of, (a) Bloating and constipation, (b) Cholelithiasis, , (c) Hyperuricemia, (d) Liver damage, (e) Severe cardiac arrhythmia, 98. Alcohol drinking is associated with which, of the following changes in serum lipid, concentrations?, (a), (b), (c), (d), (e), , Decreased HDL cholesterol, Decreased IDL cholesterol, Decreased VLDL cholesterol, Increased LDL cholesterol, Increased triglyceride, , 99. A patient suffering from a depressive, disorder is being treted with imipramine., If he uses diphenhydramine for allergic, rhinitis, a drug interaction is likely to, occur because, (a) Diphehydramine inhibits imipramine, metabolism, (b) Both drugs block reuptake of norepinephrine, released from sympathetic nerve endings, (c) Imipramine inhibits the metabolism of, diphenydramine, (d) Both drugs block muscarinic receptors, (e) The drugs compete with each other for renal, elimination, 100. If phenelzine is administered to a patient, taking fluoxetine, the most likely result, is, (a) Antagonism of the antidepressant action of, fluoxetine, (b) A decrease in the plasma levels of fluoxetine, (c) Hypertensive crisis, (d) Priapism, (e) Agitation, muscle rigidity, hyperthermia,, seizures, 101. The antihypertensive effects of captopril, can be antagonized (reduced) by, (a), (b), (c), (d), (e), , Angiotensin II receptor blockers, Loop diureties, NSAIDS, Sulfonylurea hypoglycemics, Thiazides, , 102. Which one of the following drugs most, resembles the psychoactive constituent(s)

Page 54 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, of St. John’s wort in terms of proposed, mechanism of action?, (a) Alprazolam, , (b) Fluoxetine, , (c) Levodopa, (e) Selegine, , (d) Methylphenidate, , 103. The primary site of action of tyramine is, (a) Ganglionic receptors, (b) Gut and liver catechol–O–methyltransferase, (c) Postganglionic sympathetic nerve terminals, (d) Preganglionic sympathetic nerve terminals, (e) Vascular smooth muscle cell receptors, 104. Which one of the following drugs has, been used in ophthalmology, but causes, mydriasis and cycloplegia lasting more, than 24 hours?, (a) Atropine, (c) Edrophonium, , (b) Echothiophate, (d) Ephedrine, , (e) Tropicamide, 105. The antihypertensive drug most likely to, aggravate angina pectoris is, (a) Clonidine, (c) Hydralazine, (e) Propranolol, , (b) Guanethidine, (d) Methyldopa, , 106. After an intravenous bolus injection of, lidocaine, the major factors determining, the initial plasma concentration are, (a) Dose and clearance, (b) Dose and apparent volume of distribution, (c) Apparent volume of distribution and, clearance, (d) Clearance and half-life, (e) Half-life and dose, 107. Diuretics that increase the delivery of, poorly absorbed solute to the thick, ascending limb of the nephron include, (a) Furosemide, , (b) Indapamide, , (c) Mannitol, , (d) Spironolactone, , (e) All of the above, 108. Following is used in methanol poisoning, (a) Disulfiram, , (b) Naltrexone, , (c) Ethanol, , (d) None of the above, , 39, 109. Recreational use of drugs sometimes, leads to dependence. Which of the, following is least likely to cause physical, dependence?, (a) Alcohol is excitatory in nature, (b) Alcohol has a direct stimulatory effect on, sexual responsiveness, (c) Alcohol is teratogenic, (d) Alcohol increases ADA production, 110. This agent is currently a first-choice drug, in the management of absence seizures, as well as partial, primary generalized,, and tonic-clonic seizures., (a) Carbamazepine, (c) Ethosuximide, (e) Valproic acid, , (b) Clonazepam, (d) Phenytoin, , 111. If one patient is taking amitriptyline and, another patient is taking chlorpromazine,, they are both likely to experience, (a), (b), (c), (d), (e), , Excessive salivation, Extrapyramidal dysfunction, Gynecomastia, Increased gastrointestinal motility, Postural hypotension, , 112. The phenothiazines have a variety of, actions at different receptor types., However, they do not appear to interact, with receptors for, (a) Dopammine, (c) Nicotine, (e) Muscarine, , (b) Histamine, (d) Norepinephrine, , 113. A psychiatric patient taking medications, develops a tremor, thyroid enlargement,, and leukocytosis. The drug he is taking, is most likely to be, (a) Clomipramine, (c) Imipramine, (e) Sertraline, , (b) Haloperidol, (d) Lithium, , 114. The mechanism of action of benzodiazepines is, (a) Activation of GABAB receptors, (b) Antagonism of glycine receptors in the spinal, cord

Page 55 :
MCQs IN PHARMACOLOGY, , 40, (c) Blockade of the action of glutamic acid, (d) Increased GABA mediated chloride ion, conductance, (e) Inhibition of GABA aminotranferase, 115. A drug that is used in the treatment of, parkinsonism and will also attenuate, reversible extrapyramidal side effects of, neuroleptics is, (a) Amantadine, (c) Pergolide, (e) Trihexyphenidyl, , (b) Levodopa, (d) Selegiline, , 116. The characteristics of one-daily dosing, with aminoglycosides compared with, conventional dosing protocols (every 6-12, hours) include, (a), (b), (c), (d), (e), , Decreased drug uptake into the renal cortex, Higher peak serum drug levels to MIC ratios, Postantibiotic actions, All of the above, None of the above, , 117. A young mother is breast-feeding her 2month-old infant. Which one of the, following drug situations involving the, mother is most likely to be safe for the, nursing infant?, (a), (b), (c), (d), (e), , Doxycycline, for Lyme disease, Metronidazole, for trichomoniasis, Nystatin, for a yeast infection, Phentermine, used for weight reduction, Triazolam, used as a sleeping pill, , 118. Cocaine intoxication has become a, common problem in hospital emergency, rooms. Which one of the following drugs, is not likely to be of any value in the, management of cocaine overdose?, (a) Dantrolene, (c) Lidocaine, (e) Nitroprusside, , (b) Diazepam, (d) Naltrexone, , 119. Which one of the following agents used, in hypertension is a prodrug that is, converted to its active form in the brain?, (a) Clonidine, (c) Methyldopa, (e) Verapamil, , (b) Doxazosin, (d) Nitroprusside, , 120. the consumption of shellfish harvested, during a “red tide” (due to a large, population of a dinoflagellate species) is, not recommended. This is because the, shellfish are likely to contain, (a) Arsenic, (c) Cyanide, (e) Tetrodotoxin, , (b) Botulinum toxins, (d) Saxitoxin, , 121. A 35-year-old female who has never, been pregnant suffers each month from, pain, discomfort, and mood depression, at the time of menses. She may benefit, from the use of this selective inhibitor of, the reuptake of serotonin., (a) Amitriptyline, (c) Mirtazapine, (e) Trazodone, , (b) Bupropion, (d) Paroxetine, , 122. Which of the following is a common effect, of muscarinic stimulant drugs?, (a), (b), (c), (d), (e), , Decreased peristalsis, Decreased secretion by salivary glands, Hypertension, Inhibition of sweat glands, Miosis, , 123. Four stages of general anesthesia are, distinctly seen with the use of, (a) Halothane, (c) Nitrous oxide, , (b) Diethyl ether, (d) Enflurane, , 124 Infusion of phenotolamine into the, cerebrospinal fluid of an experimental, animal will prevent the bood pressure –, lowering action of, (a) Clonidine, (c) Guanethidine, (e) Trimethaphan, , (b) Enalapril, (d) Reserpine, , 125. A drug suitable for producing a brief (5, to 15 minute) increase in cardiac vagal, tone is, (a) Digoxin, (c) Ergotamine, (e) Pyridostigmine, , (b) Edrophonium, (d) Pralidoxime, , 126. Propranolol and hydralazine have which, of the following effects in common?

Page 56 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (a), (b), (c), (d), (e), , Decreased cardiac force, Decreased cardiac output, Decreased mean arterial blood pressure, Increased systemic vascular resistance, Tachycardia, , 127. Toxicities of local anaesthetics do not, include, (a) Cardiovascular arrhythmias and collapse, (bupivacaine), (b) Convulsions (lidocaine), (c) Dizziness, sedation (lidocaine), (d) Hypertensive emergencies, strokes (procaine), (e) Methemoglobinemia, 128. Benzodiazepines are least effective in, (a) Alcohol withdrawal syndromes, (b) Balanced anesthesia regimens, (c) Initial management of phencyclidine, overdose, (d) Obsessive – compulsive disorders, (e) Social phobias, 129. Which one of the following drugs exerts, its anticonvulsant effects by blocking, sodium channels in neuronal membranes?, (a) Acetazolamide, (c) Diazepam, (e) Vigabatrin, , (b) Carbamazepine, (d) Gabapentin, , 130. Regarding the pharmacodynamic actions, of local anaesthetics, which one of the, following statements is most accurate?, (a) All local anaesthetics with ester bonds are, vasodilators, (b) Amides cause a high incidence of, hypersensitivity reactions, (c) Protonated forms of such drugs readily, penetrate bio-membranes, (d) The ionized forms of local anaesthetics cause, a use-dependent blockade of sodium ion, channels, (e) Type A alpha nerve fibers are highly sensitive, to blockade, 131. A patient is brought to the emergency, room suffering from an overdose of an, illicit drug. She is agitated, has disordered, , 41, thought processes, suffers from paranoia,, and “hears voices”. The drug most likely, to be responsible for her condition is, (a), (b), (c), (d), (e), , Gamma-hydroxybutyrate (GHB), Hashish, Heroin, Marijuana, Methamphetamine, , 132. Mental retardation, microcephaly, and, underdevelopment of the mid face region, in an infant is associated with chronic, maternal abuse of, (a) Amphetamine, (c) Ethanol, (e) Phencyclidine, , (b) Cocaine, (d) Mescaline, , 133. After ingestion of a meal that included, sardines, cheese, and red wine, a patient, taking an antidepressant drug experiences a hypertensive crisis. The drug most, likely to be responsible is, (a) Bupropion, (c) Imipramine, (e) Trazodone, , (b) Fluoxetine, (d) Phenelzine, , 134. A woman taking haloperidol develops a, spectrum of adverse effects that include, the amenorrheagalactorrhea syndrome, and extrapyramidal dysfunction,, including bradykinesia, muscle rigidity,, and tremor at rest. Her psychiatrist, prescribes a newer antipsychotic drug, that improves both positive and negative, symptoms of schizopherenia with few of, the side effects that result from dopamine, receptor blockade. Since weekly blood, tests are not deemed necessary the drug, prescribed by the psychiatrist is probably, (a) Bupropion, (c) Nefazodone, (e) Sertraline, , (b) Clozapine, (d) Olanzapine, , 135. A 24-year-old man with a history of, partial seizures has been treated with, standard anticonvulsants for several, years. He is currently taking valproic acid,, which is not fully effective and his neurologist prescribes a new drug approved

Page 57 :
MCQs IN PHARMACOLOGY, , 42, for adjunctive use in partial seizures., Unfortunately, the patient develops toxic, epidermal necrolysis. The new drug prescribed was, (a) Felbamate, (c) Lamotrigine, (e) Vigabatrin, , (b) Gabapentin, (d) Tiagabine, , 136. The introduction of this drug may, represent a novel approach to the, treatment of major depressive disorders, since it appears to act as an antagonist, at alpha2 adrenoceptors in the CNS, (a) Amoxapine, (c) Citalopram, (e) Paroxetine, , (b) Bupropion, (d) Mirtazapine, , 137. Which one of the following pairs of drug:, indication is accurate?, (a), (b), (c), (d), (e), , Amphetamine:Alzheimer’s dementia, Bupropion:Acute anxiety, Fluoxetine:Insomnia, Ropinirole:Parkinson’s disease, Trazodone:Attention deficit disorder, , 138. The dose of this immunosuppressive, prodrug must be significantly reduced in, patients who are also taking the xanthine, oxidase inhibitor allopurinol., (a), (b), (c), (d), (e), , Azathioprine, Cyclosporine, Hydroxychloroquine, Methotrexate, Tacrolimum, , 139. Which one of the following drugs is most, likely to cause hypoglycemia when used, as monotherapy in the treatment of type, 2 diabetes?, (a) Acarbose, (c) Metformin, (e) Rosiglitazone, , (b) Glipizide, (d) Miglitol, , 140. Anticoagulation is needed immediately in, a patient with pulmonary embolism., Since there is some concern about a, possible drug-induced thrombocytopenia,, the most appropriate drug for parenteral, administration in this patient is, , (a) Clopidogrel, (c) Heparin, (e) Warfarin, , (b) Enoxaparin, (d) Ticlopidine, , 141. Following general anesthetic is not, metabolized, (a) Halothane, (c) Isoflurane, , (b) Ether, (d) Nitrous oxide, , 142. Which of the following statements, concerning morphine and hydromorphone, is true?, (a) Hydromorphone is a more effective analgesic, because it has a smaller ED50 than morphine., (b) Morphine and hydromorphone are equally, potent because they have the same Emax, (c) Morphine has a greater ED50 and is thus a, less effective analgesic than hydromorphone, (d) Hydromorphone is a more potent analgesic, because it has a greater Emax than morphine, (e) Hydromorphone has a smaller ED50 and is, thus a more potent analgesic than morphine, 143. Meperidine is classified as a, (a) Weak acid, (c) Weak base, , (b) Salt, , 144. Assuming that meperidine is absorbed, after oral administration and that a large, percentage of the dose is excreted, unchanged, the effect of alkalinization of, the urine will increase its, (a) Duration of action, (b) Rate of excretion, (c) Ionization in the glomerular filtrate for growth, 145. The appropriate chemical classification, for meperidine is, (a) Phenylpropylamines, (b) Piperazines, (c) 4-phenylpiperidines, 146. Which of the following neuromuscular, blocking agents can cause muscarinic, responses such as bradycardia and, increased glandular secretions?, (a) Tubocurarine, (c) Pancuronium, (e) Gallamine, , (b) Succinycholine, (d) Decamethonium

Page 58 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 147. Which of the following drugs is a volatile, substance that is administered by, inhalation?, (a) Thiopental, (c) Alprazolam, (e) Phenytoin, , (b) Halothane, (d) Buspirone, , 148. The brief duration of action of an ultrashort acting barbiturate is due to a, (a) Slow rate of metabolism in the liver, (b) Low lipid solubility, resulting in a minimal, concentration in the brain, (c) High degree of binding to plasma proteins, (d) Rapid rate of redistribution from the brain, due to its high liposolubility, (e) Slow rate of excretion by the kidneys, 149. Which of the following mechanisms of, action most likely contributes to the, treatment of parkinsonism?, (a) The direct-acting dopaminergic agonist, amantadine mimics the activity of striatal, dopamine, (b) The antimuscarinic activity of dophenhydramine contributes to the restoration of, striatal dopaminergic-cholinergic neurotransmitter balance, (c) Striatal H1 – receptors are blocked by the, antihistaminic trihexyphenidyl, (d) The ergoline bromocriptine stimulates the, release of striatal dopamine from intact, terminals., (e) One of the above, 150. All of the following adverse effects are, associated with the use of levodopa, except, (a), (b), (c), (d), (e), , Sialorrhea, Orthostatic hypotension, Delusions, confusion, and depression, Dyskinesia and dystonia, Livedo reticularis, , 151. The activity of which of the following, drugs is dependent on a p-phenyl – N –, alkylpiperidine moiety?, (a) Phenobarbital, (c) Diazepam, (e) Meperidine, , (b) Chlorpromazine, (d) Imipramine, , 43, 152. Which of the following agents would not, be an alternative to Phenobarbital in the, treatment of partial seizures?, (a) Trimethadione, (b) Gabapentin, (c) Felbamate, (d) Lamotrigine, (e) None of the above, 153. A 32-year-old forklift operator with a, past history of cardiac arrhythmias is, suffering from seasonal rhinitis. Which of, the following choices is the best recommendation for this patient?, (a) Diphenhydramine (b) Meclizine, (c) Astemizole, (d) Fexofenadine, (e) Famotidine, 154. Which of the following diuretics is most, similar in chemical structure to the, antihypertensive agent diazoxide?, (a) Furosemide, (c) Mannitol, (e) Chlorothiazide, , (b) Spironolactone, (d) Acetazolamide, , 155. Following is an example of ideal anesthetic, (a) Ether, (c) Thiopental, , (b) Halothane, (d) None of the above, , 156. An action common to most general, anesthetic, (a) Increase in the cellular threshold of firing, (b) Potentiation of spontaneous and evoked, activity of neurons, (c) Inhibition of effects of glutamate, (d) None of the abvoe, 157. An unconscious patient is brought to the, emergency department with a history of, an unknown drug overdose. Which of the, following actions should the physician, perform?, (a) Administer 50ml of 50% dextrose, thiamine, 100 mg IV push, and naloxone 0.8 mg IV, push, and naloxone 0.8 mg IV push, (b) Protect the patient’s airway and ensure that, vital signs are stable, (c) Perform gastric lavage, (d) Order the following laboratory tests: CBC,, electrolytes, and a toxicology screen, (e) All of the above

Page 59 :
MCQs IN PHARMACOLOGY, , 44, 158. Ethyl alcohol (EtOH) is administered to, patients who have ingested either, ethylene glycol or methanol because, EtOH, (a) To call EMS and have the child taken to the, hospital emergency department, (b) Administer 1 g/kg of activated charcoal with, sorbitol, (c) Administer syrup of ipecac 15 ml by mouth, to induce vomiting, (d) Suggest that the child receive emergency, hemodialysis, (e) Suggest that the child receive acid diuresis, with ammonium chloride, 159. Parenteral calcium is used as an antidote, for which of the following situations?, (a), (b), (c), (d), , Verapamil overdoses, Hyperkalemia, Cocaine intoxication, Verapamil overdoses and hyperkalemia, , 160. An overdose victim presents to the, emergency department with an elevated, heart rate, decreased blood pressure,, dilated pupils, and lethargy, upon arrival, to the ICU, she has a generalized tonicclonic seizure that is treated with IV, diazepam and forsphenytoin. Which of, the following is the most likely intoxicant?, (a) Ethyl alcohol, (c) Acetaminophen, (e) Amitriptyline, , (b) Methanol, (d) Oxycodone, , 161. Opthalmic agents contriaindicated in, glaucoma patients include which of the, following substances?, (a) Antioxidants, (c) Decongestants, , (b) Antipuritics, (d) Emollients, , 162. Which of the following drugs is excepted, to cause anticholinergic adverse effects, in the elderly?, (a) Propoxyphene, (c) Amitriptyline, (e) Cimetidine, , (b) Ciprofloxacin, (d) Propranolol, , 163. Which of the following antihypertensive, agents should be avoided in elderly, patients?, , (a), (b), (c), (d), (e), , Amlodipine 5 mg every day, Atenolol 25 mg every day, Benazepril 10 mg every day, Hydrochlorothiazide 25 mg every day, Methyldopa 250 mg three times a day, , 164. Which of the following benzodiazepines, is expected to cause the least amount of, adverse effects in the elderly?, (a) Chlordiazepoxide (b) Diazepam, (c) Fluazepam, (d) Oxazepam, (e) Temazepam, 165. The use of morphine in the patient who, has had a myocardial infarction (MI) centers around three distinct pharmacologic, properties. Which of the following choices, includes these properties?, (a) Relief of pain, relief of anxiety, and increased, oxygen supply, (b) Relief of anxiety, after load reduction,, increased preload, (c) Relief of anxiety, preload reduction, and relief, of pain, (d) Vagomimetic effect, relief of anxiety,, respiratory depression, (e) Bradycardia, preload reduction, and, increased after load, 166. Which of the following agents represents, a relatively new class of drugs used in, treating hypertension?, (a) Trandolapril, (c) Lorsartan, (e) Nitrendipine, , (b) Carvedilol, (d) Moexipril, , 167. Reflex tachycardia, headache, and, postural hypotension are adverse effects, that limit the use of which of the following, antihypertensive agents?, (a) Prazosin, (c) Methyldopa, (e) Hydralazine, , (b) Captopril, (d) Guanethidine, , 168. Following is inverse agonist, benzodiazepine receptors, (a) Flumazenil, (b) β-Carbolines, (c) Chlordiazepoxide (d) Glutethimide, , of

Page 60 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 169. Match the adverse effects with the, antihypertensive agent that is most likely, to cause them., (a) Trandolapril, (b) Methyldopa, (c) Nitroprusside, (d) Terazosin, (e) Propranolol, (1) Thiocyanate intoxication, hypotension,, and convulsions, (2) Bradycardia, bronchospasm, and, cardiac decompensation, (3) Postural, hypotension, fever, and a, positive Coombs’ test, (4) First–dose syncope, postural hypotension, and palpitations, 170. Match each description of a β -blocker, with the most appropriate β -adrenergicblocking agent., (a) Esmolol, (b) Labetalol, (c) Bisoprolol, (d) Nadolol, (e) Pindolol, (1) A β-blocker with intrinsic sympathomimetic activity, (2) A β-blocker that also blocks a-adrenergic, receptors, (3) A β-blocker with an ultrashort duration, of action, (4) A β-blocker with a long duration of, action and nonselective blocking activity, (5) A b-blokcer with relative cardioselective, blocking activity, 171. Phenytoin is effective for the treatment, of all of the following types of seizures, except, (a), (b), (c), (d), (e), , Generalized tonic-clonic, Simple partial, Complex partial, Absence, Grand mal, , 172. Which of the following anticonvulsants, is contraindicated in patients with a, history of hypersensitivity to tricyclic, antidepressants?, (a) Phenytoin, (c) Acetazolamide, (e) Phenobarbital, , (b) Ethosuximide, (d) Carbamazepine, , 45, 173. Which anticonvulsant drug requires, therapeutic monitoring of Phenobarbital, serum levels as well as it’s own serum, levels?, (a) Phenytoin, (c) Clonazepam, (e) Carbamazepine, , (b) Primidone, (d) Ethotoin, , 174. Zolpidem belongs to following class of, drugs, (a), (b), (c), (d), , Benzodiazepines, Carbamates, Imidazopyridines, None of the above, , 175. What are the most common adverse, effects of anticonvulsive drugs?, (a), (b), (c), (d), (e), , headache and dizziness, Gastrointestinal symptoms, Alternation of cognition and mentation, Adverse effects on appetite and body weight, All of the above, , 176. What are the important elements in, considering treatment strategies for, Parkinson’s patients?, (a), (b), (c), (d), (e), , Age, Clinical presentation of disease, Sex, Etiology of the disease, All of the above, , 177. Which of the following have liver failure in, their side effect profile and how often the, liver function tests should be monitored?, (a), (b), (c), (d), (e), , Ropinirole, Pramipexole, Levodopa/carbidopa, Tolcapone, Both (a) and (b), , 178. Which of the following agents should not, be used concurrently with levodopa?, (a), (b), (c), (d), (e), , Diphenhydramine, Benztropine, Amantadine, Monoamine oxidase (MAO) inhibitors, Carbidopa

Page 61 :
MCQs IN PHARMACOLOGY, , 46, 179. Amantadine has which of the following, advantages over levodopa?, (a) More rapid relief of symptoms, (b) Higher success rate, (c) Better long-term effects, 180. A patient that has been treated with, haloperidol for 3 weeks presents with, muscle stiffness, tremor, and shuffling, gait. This is most likely which type of, extrapyramidal side effect?, (a), (b), (c), (d), , Akathisia, Tardive dyskinesia, Pseudoparkinsonism, Acute dystonia, , 181. The atypical antipsychotics differ from the, typical agents in various ways that define, them as atypical. Which of the following, is not a defining property of the atypical, antipsychotics?, (a) Sustained hyperprolactinemia, (b) Improved efficacy in treating the negative, symptoms, (c) Lower risk for extrapyramidal symptoms (EPS), (d) Greater serotonin receptor blockade than, dopamine blockade, 182. Which of the following atypical, antipsychotics would be the least, sedating?, (a) Quetiapine, (c) Olanzapine, , (b) Risperidone, (d) Clozapine, , 183. The typical antipsychotic agents are, classified into high and low potency, agents. Which of the following statements, best defines high and low potency?, (a) High potency = more weight gain; low, potency = weight loss, (b) High potency = less extrapyramidal, symptoms (EPS); low potency = high EPS, (c) High potency = high EPS; low potency = low, EPS, (d) High potency = high dose; low potency =, low dose, 184. Which of the following agents is not used, to treat extrapyramidal symptoms?, , (a), (b), (c), (d), , Donepezil (Aricept), Trihexyphenidyl (Artane), Diphenhydramin (Benadryl), Benztropine (Cogentin), , 185. Which of the following statements about, depression is true?, (a) The incidence of depression is greater in men, than in women, (b) Approximately 5% of institutionalized elders, develop depression, (c) Depression has no genetic link, (d) Depression is diagnosed using the DSM-IV, criteria, 186. A patient with major depression should, receive antidepressant therapy for at, least, (a) 2 weeks, (c) 2 months, , (b) 6 weeks, (d) 6 months, , 187. Which of the following patients is mot, likely to require maintenance antidepressant therapy?, (a) A 22-year–old woman depressed about the, loss of a parent, (b) A 33-year-old man presenting with his second, episode of depression, (c) A67-year-old man experiencing his first, episode of depression, (d) A34-year-old woman experiencing, postpartum depression, 188. Which of the following medications would, most likely exacerbate a preexisting, seizure disorder?, (a) Venlafaxine, (c) Bupropion, , (b) Trazodone, (d) Paroxetine, , 189. A patient receiving astemizole for, seasonal allergies is diagnosed with, major depression. Which of the following, antidepressants would most likely, interact with the current regiment?, (a) Nefazodone, (c) Sertraline, , (b) Amitriptyline, (d) Venlafaxine, , 190. Which of the following medications would, be considered first-line monotherapy for, the treatment of bipolar disorder?

Page 62 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (a) Gabapentin, (c) Risperidone, , (b) Lithium, (d) Lamotrigine, , 191. Which of the following is the appropriate, therapeutic range for lithium in the, treatment of acute mania?, (a) 0.6–1.0 mEq/L, (c) 0.6–0.8 mEq/L, , (b) 0.6–1.5 mEq/L, (d) 0.8–1.2 mEq/L, , 192. Which of the following mood stabilizers, would be most appropriate in a patient, with liver disease?, (a) Lithium, (c) Carbamazepine, , (b) Valproic acid, (d) None of the above, , 193. Ethinamate is _________ derivative, (a) Phenothiazine, (c) Piperidine, , (b) Urethane, (d) Tertiary alcohol, , 194. Which of the following factos may reduce, lithium concentrations?, (a), (b), (c), (d), , Dehydration, Pregnancy, Reduced sodium intake, Nonsteroidal anti – inflammatory drugs, , 195. Match the description with the appropriate agent., (a) Cimetidine, , (1), , (b) Albuterol, , (2), , (c) Impratropium, , (3), , Decrease theophylline, clearance, Has anticholinergic, activity with few side, effects, Has high β2 – adrenergic, selectivity bromide, , (d) Epinephrine, (e) Atropine, 196. The diuretic of choice for the initial, treatment of a patient with either acute or, chronic renal failure (ARF, CRF) whose, creatinine clearance is below 25 ml/min is, (a), (b), (c), (d), , Hydrochlorothiazide, Bumetanide, Furosemide, Ethacrynic acid, , 197. Erythropoietin is used commonly to treat, the anemia associated with chronic renal, failure (CRF). Which of the following, , 47, conditions limits the effectiveness of, erythropoietin?, (a) A patient’s allergy to erythropoietin, (b) Depletion of iron stores, requiring oral or, parenteral supplementation, (c) The ineffectiveness of erythropoietin, as 30%, of patients do not respond, (d) The anemia of chronic renal failure is not, due to a lack of er ythropoietin, so, erythropoietin will not ameliorate, 198. Morphine stimulates, (a) Billary and pancreatic secretions, (b) Nonpropulsive rhythmic contractions of small, intestine of man, (c) Propulsive contractions in small intestine of, man, (d) Propulsive peristaltic waves in colon, (e) Human uterus at full term, 199. The brain-stem centers affected most, strongly by barbiturates are the, (a), (b), (c), (d), (e), , Respiratory centers, Vasomotor centers, Cardioinhibitory centers, Cardioacceleratory centers, None of the above, , 200. Following statement is correct about, criteria for neurotransmitter, (a) Must be shown to be present in the, presynaptic terminals, (b) Must be released from the presynaptic, terminal concomitanly with presynaptic, activity, (c) When applied experimentally, effects must, be identical to the effects of stimulating the, presynaptic pathway, (d) All of the above, 201. A drug that produces increased, contraction of the sphincter iridis by local, application is a, (a), (b), (c), (d), (e), , Parasympathimimetic drug, Parasympatholytic drug, Sympathomimetic drug, Sympatholytic drug, None of the above

Page 63 :
MCQs IN PHARMACOLOGY, , 48, 202. BAL (British Anti-Lewiside is used to, counter the toxic effects of, (a) Atropine, (c) Morphine, (e) Digitalis, , (b) Mercury, (d) Barbiturates, , 203. Which of the following should not be administered to a patient with myasthenia, gravis?, (a) Prostigmine, (c) Atropine, (e) Insulin, , (b) Digitalis, (d) Curare, , 204. The toxicity of methanol is due to its, conversion in the body to, (a), (b), (c), (d), (e), , Acetaldehyde, Formic acid and formaldehyde, Ethyl alcohol, Carbonic acid, Methane, , 205. One of epinephrine’s actions on the heart is, (a), (b), (c), (d), , Acceleration due to depression of the vagus, Increase in refractory period, Depression of the SA node, Increase in the concentration of the enzyme, phosphorylase A, (e) None of the above, , 206. Epinephrine HCl has little or no effect on, (a), (b), (c), (d), (e), , Unbroken skin, Conjunctiva, Precapillary sphincter, Nasal mucosa, Pupil, , 207. Epinephrine is often included in the adminstration of local anaesthetics, because it, (a) Enhances analgesic effect, (b) Neutralizes irritant action, (c) Delays diffusion of the anesthetic from the, site of injection, (d) Increases diffusion of the anesthetic, (e) Increases blood levels of the anesthetic, 208. Paxipam (halazepam) is used primarily, to treat, , (a) Edema, (b) Congestive heart failure, (c) Symptoms of anxiety, (d) Epilepsy, (e) Muscle spasms, 209. Isoetharine is a drug which stimulated, primarily which of the following, receptors?, (a) Alpha, (c) Beta 1, , (b) Histamine, (d) Beta 2, , (e) None of the above, 210. The mechanism explaining the clinical, picture observed in carbon monoxide, poisoning is, (a) Hemolysis of red blood cells, (b) A chemical union of the carbon monoxide, with the hemoglobin of the red blood cells, (c) Transformation of the carbon monoxide to, carbon dioxide in the blood, (d) Arrest of oxidation in the tissues by enzyme, interference, (e) None of the above, 211. Acetylcholine has both muscarinic and, nicotinic actions. The muscarinic action, can be blocked by, (a) Epinephrine, , (b) Atropine, , (c) Nicotine, (d) Curare, (e) Nicotine and curare, 212. Which of the following is the fastest acting, anticoagulant?, (a) Warfarin (Coumadin), (b) Heparin, (c) Ouabain, (d) Protamine sulfate, (e) Vitamin K, 213. Phencyclidine is a non-competitive antagonist of, (a) Kainate, (c) NMDA, , (b) AMPA, (d) All of the above, , 214. Which of the following would be the drug, oc choice for treatment of hypertensive, crisis?

Page 64 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, , 49, , Diazoxide (Hyperstat), Clonidine (Catapres), Propranolol (Inderal), Guanethidine (Ismelin), Proserpine (Serpasil), , 222. Which of the following may increase, seizure activity in epileptic patients?, , 215. Parkingsonism is probably due to, , 223. Trazodone (Desyrel) is used primarily as, a (an), , (a), (b), (c), (d), (e), , (a), (b), (c), (d), (e), , Too, Too, Too, Too, Too, , little dopamine in the brain, little levodopa in the brain, little acetylcholine in the brain, much levodopa in the brain, much dopamine in the brain, , 216. A prominent toxic effect of local anaesthetics is, (a) CNS stimulation (b) CNS depression, (c) Tachycardia, (d) Local ischemia, (e) None of the above, 217. Which of the following could be used as, an antidote for curare poisoning?, (a) Neostigmine, (b) Atropine, (c) Homatropine, (d) Hexamethonium, (e) None of the above, 218. Cigarette smoking increases the side, effects of, (a), (b), (c), (d), (e), , Narcotic analgesics, Analeptics, Antidepressants, Oral contraceptives, Cardiac glycosides, , 219. Fluoxetine is a________ transport blocker, (a) Serotonin, (c) Dopamine, , (b) Norepinephrine, (d) GABA, , 220. Vivactil (protriptyline) is used mainly as, a (an), (a) Analgesic, (c) Cardiotonic, (e) Antispasmodic, , (b) Muscle relaxant, (d) Antidepressant, , 221. Which is the drug of choice for trigeminal, neuralgia?, (a) Carbamazepine, (c) Flurazepam, (e) Trimethadione, , (b) Phenytoin, (d) Diazepam, , (a) Ethotoin, (c) Trihexyphenidyl, (e) L - Dopa, , (b) Phenobarbital, (d) Amantadine, , (a) Analgesic, (b) Cardiotonic, (c) Tranquilizer, (d) Antidepressant, (e) Antihypertensive, 224. In addition to their marked potency, the, loop diuretics Lasix and Edecrin have an, added advantage of, (a), (b), (c), (d), (e), , Being completely free of side effects, Causing hypokalemia, Not causing any electrolyte imbalance, Requiring only once weekly dosing, Being effective when given orally, , 225. Neuronal death in response to high, glutamate concentration is mediated by, (a) Kainate, (c) NMDA, , (b) AMPA, (d) All of the above, , 226. A common side effect of ephedrine is, (a) Rashes, (c) Blood dyscrasia, (e) Ulcers, , (b) Nervousness, (d) Drowsiness, , 227. Thiazide diuretics may produce an, increase in blood levels of uric acid and, (a) Potassium, (c) Urea, (e) Glucose, , (b) BUN, (d) Lithium, , 228. A group of drugs used widely to treat, mild hypertension is, (a), (b), (c), (d), (e), , Synaptic blockers, Diuretics, Ganglionic blockers, MAO inhibitors, None of the above, , 229. What is the advantage of levodopa over, dopamine in treating parkinsonism?, (a) It is more stable, (b) It is less toxic, (c) It is more readily available

Page 65 :
MCQs IN PHARMACOLOGY, , 50, (d) It is considerably less expensive, (e) It is more effective, 230. In an anaesthetized dog, repeated, intravenous injection of ephedrine shows, the phenomenon of, (a) Anaphylaxis, (c) Idiosyncrasy, , (b) Tachyphylaxis, (d) Drug resistance, , 231. The cotransmitter may ser ve the, following function/functions, , (c) It has additional direct agonistic action on, nicotinc receptors at the muscle end plate, (d) It penetrates blood-brain barrier, 237. The mechanism by which neostigmine, improves contraction of myasthenic, muscle involves, (a) Repetitive binding of the acetylcholine, molecules to the same receptors at the muscle, end plate, , (a) Regulate the release of the primary transmitter, from the nerve ending, (b) Alter postjunctional action of the primary, transmitter, (c) Itself act as an alternative transmitter, (d) All of the above, , (b) Diffusion of acetylcholine released from, motor ner ve endings to a wider area, activating neighbouring receptors, , 232. Pseudocholinesterase differs from the, cholinesterase in that, , 238. Symptoms of schizophrenia are produced, by following agents, except, , (a) It does not hydrolyse acetylcholine, (b) It hydrolyses acetylcholine at a slower rate, (c) It is more susceptible to inhibition by, physostigmine, (d) It is the only form of circulating cholinesterase, 233. Acetylcholine has no therapeutic application because, (a) None of its actions are beneficial in any, condition, (b) Its effects are transient, (c) It produces wide spread actions affecting, many organs, (d) Both ‘B’ and ‘C’ are correct, 234. Pilocarpine is used in, (a) Glaucoma, (b) Paralytic ileus, (c) Urinary retention (d) All of the above, 235. Which of the following inhibitors binds, only to the anionic site of the cholinesterase enzyme ?, (a) Neostigmine, (c) Edrophonium, , (b) Physostigmine, (d) Dyflos, , 236. Neostigmine is preferred over physostigmine for treating myasthenia gravis because, (a) It is better absorbed orally, (b) It has longer duration of action, , (c) Activation of motor end-plate receptors by, neostigmine molecules themselves, (d) All of the above, , (a) Amphetamine, , (b) Apomorphine, , (c) Bromocriptine, , (d) Reserpine, , 239. Select the anticholinesterase drug that is, being used to afford symptomatic, improvement in Alzheimer’s disease, (a) Echothiophate, , (b) Tacrine, , (c) Demecarium, , (d) Ambenonium, , 240. Pilocarpine reduces intraocular tension in, open angle glaucoma by, (a) Contracting sphincter pupillae, (b) Increasing tone of ciliary muscle, (c) Reducing aqueous formation, (d) Enhancing u/veo-scleral outflow, 241. Timolol eye drops are preferred over, pilocarpine eye drops by many glaucoma, patients because, (a) Timolol is more effective than pilocarpine, (b) Timolol acts by enhancing uveo-scleral, outflow, (c) Timolol produces less ocular side effects, (d) There are no contraindications to timolol, 242. Select the longer acting ocular beta, blocker, (a) Timolol, , (b) Betaxolol, , (c) Cartilol, , (d) Levobunolol

Page 66 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 243. Which of the following is a prodrug of, adrenaline used topically in glaucoma ?, (a), (b), (c), (d), , Phenylephrine, Dipivefrine, Phenylpropanolamine, Dorzolamide, , 244. Which of the following diuretics is most, effective in acute congestive glaucoma ?, (a) Indapamide, (c) Mannitol, , (b) Amiloride, (d) Furosemide, , 245. Neostigmine is beneficial in cobra envenomation because, , 51, 250. Local anaesthetics block nerve conduction, by, (a) Blocking all cation channels in the neuronal, membrane, (b) Hyperpolarizing the neuronal membrane, (c) Interfering with depolarization of the, neuronal membrane, (d) Both (b) and (c), 251. Sensitivity of a nerve fibre to blockade, by lidocaine depends on, (a) Whether the fibre is sensory or motor, (b) Whether the fibre is myelinated or, nonmyelinated, (c) Internodal distances in the fibre, (d) Both (b) and (c), , (a) It binds to and inactivates cobra toxin, (b) It reverses coma due to cobra toxin, (c) It counteracts the cardio-depressant action, of cobra toxin, (d) It antagonizes the paralyzing action of cobra, toxin, , 252. Which sensation is blocked first by low, concentrations of a local anaesthetic ?, , 246. Which is the most important drug in the, treatment of organophosphate poisoning ?, , 253. Following are the MAO-inhibitors, except, , (a) Atropine sulfate, (c) Diazepam, , (b) Pralidoxime, (d) Adrenaline, , 247. Which of the following diseases is worsened by propranolol ?, (a), (b), (c), (d), , Glaucoma, Raynaud’s disease, Benign prostatic hypertrophy, Parkinsonism, , 248. Diazepam is used as a muscle relaxant for, (a), (b), (c), (d), , Deep intra-abdominal operation, Trachial intubation, Tetanus, Diagonosis of myasthenia gravis, , 249. The local anaesthetics having amide, linkage differ from those having ester, linkage in that the amide linked local, anaesthetics, (a), (b), (c), (d), , Are not surface anaesthetics, Have a shorter duration of action, Are degraded in the plasma, Do not show cross-sensitivity with ester linked, local anaesthetics, , (a) Temperature, (c) Touch, , (b) Pain, (d) Deep pressure, , (a) Tranylcypromine (b) Nomifensine, (c) Moclobemide, (d) Isocarboxid, 254. The local anaethetic with the longest, duration of action is, (a) Procaine, (c) Lidocaine, , (b) Chloroproacine, (d) Dibucaine, , 255. Which of the following is a poor surface, anaesthetic ?, (a) Procaine, (c) Tetracaine, , (b) Lidocaine, (d) Benoxinate, , 256. The local anaesthetic having high cardiotoxic and arrhythmogenic potential is, (a) Lidocaine, (c) Bupivacine, , (b) Procaine, (d) Chloroprocaine, , 257. Low concentration of bupivacaine is, preferred for spinal/epidural obstetric, analgesia because, (a) It has a longer duration of action, (b) It can produce sensory blockade without, paralyzing abdominal muscles, (c) It distributes more in maternal tissues so that, less reaches the foetus, (d) All of the above are correct

Page 67 :
MCQs IN PHARMACOLOGY, , 52, 258. Which of the following local anaesthetics, is poorly water soluble PABA derivative, and primarily used for anorectal lesions,, wounds and ulcers ?, (a) Benzocaine, (c) Procaine, , (b) Dibucaine, (d) Benoxinate, , 259. Oxethazaine is used for anaesthetizing, gastric mucosa because, (a) It is not absorbed from the gastrointestinal, tract, (b) It remains largely unionized in acidic medium, (c) It is highly ionized in acidic medium, (d) It produces no systemic effects even at high, doses, 260. In which of the following techiniques the, concentration of the local anaesthetic, required is the lowest ?, (a), (b), (c), (d), , Infiltration anaesthesia, Field block anaesthesia, Nerve block anaesthesia, Spinal anaesthesia, , 261. The segmental level of spinal anaesthesia, depends on, (a) Volume of the local anaesthetic injected, (b) Specific gravity of the local anaesthetic, solution, (c) Posture of the patient, (d) All of the above, 262. Spinal anaesthesia is not suitable for, (a), (b), (c), (d), , Vaginal delivery, Lower segment caesarian section, Prostatectomy, Operations on mentally ill patients, , 263. Epidural anaesthesia differs from spinal, anaesthesia in that, (a) Epidural anaesthesia produces less, cardiovascular complications, (b) Headache is more common after epidural, anaesthesia, (c) Blood concentrations of the local anaesthetic, are lower after epidural anaesthesia, (d) Greater separation between sensory and, motor blockade can be obtained with, epidural anaesthesia, , 264. The calcium channel blocker used for, prophylaxis of migraine but not for, angina pectoris is, (a) Verapamil, (c) Flunarizine, , (b) Diltiazem, (d) Amlodipine, , 265. Select the nonapeptide which can be, generated from plasma globulin by, snake venom enzymes and causes fall in, BP and intense pain when applied to, blister base, (a) Kallidin, (c) Angiotensin II, , (b) Bradykinin, (d) Angiotensin III, , 266. Captopril produces greater fall in blood, pressure in, (a), (b), (c), (d), , Diuretic treated patients, Patients having low plasma rennin activity, Sodium replete normotensive individuals, Untreated CHF patients, , 267. Enalapril differs from captopril in that, (a) It blocks angiotensin II receptors, (b) It does not produce cough as a side effect, (c) It is less liable to cause abrupt first dose, hypotension, (d) It has a shorter duration of action, 268. Which of the following drugs increases, cardiac output in congestive heart failure, without having any direct myocardial, action ?, (a) Digoxin, (c) Amrinone, , (b) Captopril, (d) Dobutamine, , 269. Which of the following statements most, closely describes the current status of, angiotensin converting enzyme inhibitors, in congestive heart failure ?, (a) They are the first choice drugs unless, contraindicated, (b) They are used when diuretics alone fail, (c) They are a substitute for digitalis, (d) They are to be used as adjuncts only in, resistant cases, 270. Following is a MAO-inhibitor and also has, anit-tubercular activity, (a) Iproniazid, (c) Moclobemide, , (b) Phenelzine, (d) Isocarboxid

Page 68 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 271. Losartan is a, (a), (b), (c), (d), , Selective AT1 receptor antagonist, Selective AT2 receptor antagonist, Nonselective AT1 + AT2 receptor antagonist, AT1 receptor partial agonist, , 272. Losartan differs from analapril in the, following respect, (a), (b), (c), (d), , It does not potentiate bradykinin, If depresses cardiovascular reflexes, It impairs carbohydrate tolerance, It does not have fetopathic potentisl, , 273. Bisphosphonates are indicated in the, following condition, (a), (b), (c), (d), , Organophosphate poisoning, Dementia, Steven’s Johnson syndrome, Postmenopausal osteoporosis, , 274. The most likely mechanism by which, general anaesthetics produce their action, is, (a) Affecting receptor operated ion channels in, cerebral neurones, (b) Blocking voltage sensitive Na+ channels in, neuronal membrane, (c) Depressing metabolic activity of cerebral, neurons, (d) Blocking production of high energy, phosphates in the brain, 275. Which of the following is a sign of deep, anaesthesia ?, (a), (b), (c), (d), , Appearance of tears in eyes, Resistane to passive inflation of lungs, Fall in blood pressure, Patient makes swallowing movements, , 276. Which inhalational general anaesthetic is, metabolized in the body to a significant, extent, (a) Sevoflurane, (c) Ether, , (b) Isoflurane, (d) Halothane, , 277. Which of the following general anaesthetics has poor muscle relaxant action ?, (a) Ether, (c) Halothane, , (b) Nitrous oxide, (d) Isoflurane, , 53, 278. Which of the following is true of nitrous, oxide ?, (a) It irritates the respiratory mucosa, (b) It has poor analgesic action, (c) It is primarily used as a carrier and adjuvant, to other anaesthetics, (d) It frequently induces post anaesthetic nausea, and retching, 279. Ether is widely used as a general anaesthetic in India, specially in peripheral, hospitals because, (a), (b), (c), (d), , It is nonexplosive, It is pleasant smelling and nonirritating, It induces anaesthesia rapidly, It is cheap and can be administered without, anaesthetic machine, , 280. The factor that effects rate of elimination, of general anaesthetics is, (a), (b), (c), (d), , Pulmonary ventilation, Blood flow, Solubility in blood and tissue, All of the above, , 281. Which of the following general anaesthetics has the most marked uterine relaxant action ?, (a) Propofol, (c) Nitrous oxide, , (b) Halothane, (d) Ether, , 282. The distinguishing feature of enflurane, compared to halothane is its, (a), (b), (c), (d), , Pleasant and nonirritating nature, Propensity to precipitate seizures, Propensity to cause hypotension, Bronchodilator action, , 283. The drug/drugs used mainly for induction, of general anaesthesia is/are, (a), (b), (c), (d), , Thiopentone sodium, Fentanyl + droperidol, Ketamine, All of the above, , 284. The anaesthetic action of thiopentone, sodium is characterized by, (a) Good muscle relaxation, (b) Poor analgesia

Page 69 :
MCQs IN PHARMACOLOGY, , 54, (c) Sensitization of heart to adrenaline, (d) No postoperative residual CNS depression, 285. Dissociative anaesthesia is produced by, (a), (b), (c), (d), , Ketamine, Fentanyl + droperidol, Propofol, Both (a) and (b), , 286. Use of morphine in preanaesthetic, medication, (a) Is routine except in the presence of, contraindications, (b) Is restricted to patients being anaesthetized, with ether, (c) Should be made only in combination with, atropine, (d) Is restricted mostly to patients in pain, preoperatively, 287. Which of the following drugs is routinely, used in preanaesthetic medication for, prolonged operations, (a) Atropine, (c) Promethazine, , (b) Morphine, (d) Ranitidine, , 288. Patients treated with the following drugs, should be cautioned not to consume, alcoholic beverages, (a) Mebendazole, (c) Methimazole, , (b) Metronidazole, (d) Metamizol, , 289. Consumption of alcoholic beverages,, even in moderate amounts, is contraindicated for the following category of, subjects except, (a), (b), (c), (d), , Epileptics, Patients with history of myocardial infarction, Gastroesophageal reflux patients, Pregnant women, , 290. What is considered to be the safe limit of, daily alcohol consumption by an adult, man in the absence of contraindications, and interacting drugs, (a), (b), (c), (d), , 20 – 40 ml of whisky, 50 – 100 ml of whisky, 120 – 180 ml of whisky, 200 – 300 ml of whisky, , 291. Which of the following drugs has been, found to reduce alcohol craving and, chances of resumed heavy drinking by, alcoholics after they have undergone a, detoxification programme, (a) Chlordiazepoxide (b) Chlorpromazine, (c) Methadone, (d) Naltrexone, 292. Following agent potentiates actions of, GABA, (a), (b), (c), (d), , Volatile anaesthetics, Barbiturates, Propofol, All of the above, , 293. Ethanol is used in methanol poisoning, because it, (a) Antagonises the actions of methanol, (b) Stimulates the metabolism of methanol and, reduces its blood level, (c) Inhibits the metabolism of methanol and, generation of toxic metabolite, (d) Replenishes the folate stores depleted by, methanol, 294. The mechanism of action of barbiturates, differs from that of benzodiazepines in, that they, (a) Do not affect the GABA–benzodiazepine, receptor–chloride channel complex, (b) Act as inverse agonists at the benzodiazepine receptor, (c) Increase the frequency of chloride channel, opening without affecting its life time, (d) Have both GABA–facilitatory as well as, GABA–mimetic actions, 295. Which one of the following processes, plays the major role in terminating the, action of phenobarbitone, (a), (b), (c), (d), , Billary excretion, Renal excretion, Hepatic metabolism, Redistribution, , 296. Currently barbiturates are primarily used, as, (a) Hypnotic, (b) Sedative

Page 70 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (c) Antiepileptic, (d) Preanaesthetic medicant, 297. Hypnotic benzodiazepines increase the, period of time spent in the following stage, of sleep, (a) Stage II, (c) Stage IV, , (b) Stage III, (d) REM stage, , 298. The primary mechanism of action of, benzodiazepines is, (a), (b), (c), (d), , Dopamine antagonism, Adenosine antagonism, Opening of neuronal chloride channels, Facilitation of GABA–mediated chloride, influx, , 299. At a single hypnotic dose, the pharmacokinetics of diazepam is characterized, by, (a), (b), (c), (d), , Slow elimination and little redistribution, Slow elimination with marked redistribution, Rapid elimination and marked redistribution, Ultra rapid elimination, , 300. The following drug is used to reverse the, CNS depression produced by diazepam, (a) Nikethamide, (c) Physostigmine, , (b) Doxapram, (d) Flumazenil, , 301. Which of the following is not a CNS, depressant but increases the tendency to, fall asleep at night ?, (a) Pyridoxine, (c) Melatonin, , (b) Methaqualone, (d) Ethanol, , 302. The barbiturate having higher anticonvulsant sedative activity ratio is, (a) Pentobarbitone, (c) Bultabarbitone, , (b) Phenobarbitone, (d) Thiopentone, , 303. The most probable mechanism of, anticonvulsant action of phenytoin is, (a) Facilitation of GABA ergic inhibitory, transmission, (b) Hyperpolarization of neurones, (c) Interaction with Ca2+ channels to rpmote Ca2+, influx, (d) Prolongation of voltage sensitive neuronal, Na+ channel inactivation, , 55, 304. Phenytoin appears to derive its anticonvulsant action from, (a) Selective inhibition of high frequency, neuronal discharges, (b) Selective inhibition of epileptic focus, (c) Selective inhibition T-type Ca2+ current in, brain cells, (d) Selective enhancement of inhibitor y, transmission in the brain, 305. The characterstics feature of phenytoin, pharmacokinetics is, (a) High first pass metabolism, (b) Nonsaturation kinetics of metabolism, (c) Capacity limited metabolism saturating at, higher therapeutic concentration range, (d) Extrahepatic metabolism, 306. Which of the following drugs displaces, plasma protein bound phenytion as well, as decreases its metabolism, (a) Carbamazepine, (c) Cimetidine, , (b) Sodium valproate, (d) Chloramphenicol, , 307. The following antiepileptic drug is also, effective in manic-depressive illness, (a) Ethosuccimide, (c) Phenobarbitone, , (b) Primidone, (d) Carbamazepine, , 308. The drug of choice for trigeminal neuralgia, is, (a) Aspirin, (c) Carbamazepine, , (b) Imipramine, (d) Valproic acid, , 309. Which of the following is a narrow, spectrum antiepileptic drug effective only, in absence seizures, (a) Phenacemide, (b) Ethosuccimide, (c) Sodium valproate (d) Primidone, 310. Sodium valproate has been shown to, (a) Prolong neuronal Na+ channel inactivation, (b) Attenuate ‘T’ type Ca2+ current in neurones, (c) Inhibit degradation of GABA by GABA –, transaminase, (d) All of the above, 311. Sodium valproate should be used with, caution in young children because they

Page 71 :
MCQs IN PHARMACOLOGY, , 56, are particularly at risk of developing the, following adverse effect, (a) Hepatitis, (c) Anorexia, , (b) Loss of hair, (d) Tremor, , 312. 2-bromo-2-chloro-1,1,1 trifluroethane is, (a) Halothane, (c) Isoflurane, , (b) Enflurane, (d) Desflurane, , 313. Clobazam is a benzodiazepine used as, (a) Hypnotic, (c) Anxiolytic, , (b) Muscle relaxant, (d) Antiepileptic, , 314. Which of the following is a recently, developed antiepileptic drug used mainly, as add-on therapy of refractory partial, seizures ?, (a) Viloxazine, (c) Bupropion, , (b) Lamotrigine, (d) Clozapine, , 315. Gabapentin acts, (a), (b), (c), (d), , As GABAA agonist, As precursor of GABA, By enhancing GABA release, By GABA independent mechanism, , 316. Which of the following is a GABA –, transaminase inhibitor ?, (a) Gabapentin, (c) Lamotrigine, , (b) Vigabatrin, (d) Clobazam, , 317. Which of the following factors indicates, that withdrawal of the successfully used, antiepileptic medication is likely to result, in recurrence of seizures ?, (a), (b), (c), (d), , Childhood epilepsy, Partial seizures, Treatment started soon aftrer seizure onset, Absence of EEG abnormality, , 318. An epileptic woman controlled by phenytoin therapy conceives. Which of the following measures is most appropriate ?, (a) Mecal termination of pregnancy, (b) Withdraw phenytoin therapy, (c) Gradually reduce phenytoin dose to the, lowest effective level, (d) Stubstitute phenytoin with a combination of, carbamazepine and sodium valproate, , 319. Which of the following is the most suitable, drug for a 6-year-old girl suffering from, absence seizures with occasional, generalized tonic-clonic seizures ?, (a) Ethosuccimide, (c) Carbamazepine, , (b) Sodium valproate, (d) Phenytoin, , 320. The preferred drug for status spilepticus, is, (a), (b), (c), (d), , Intravenous diazepam, Intravenous phenytoin sodium, Intramuscular phenobarbitone, Rectal paraldehyde, , 321. The most effective single drug in parkinsonism is, (a) Bromocriptine, (c) Levodopa, , (b) Selegiline, (d) Biperiden, , 322. The dopamine D2 receptor has the following feature., (a), (b), (c), (d), , It, It, It, It, , is excitatory in nature, is negatively coupled to adenlyl cyclase, is selectively blocked by chlorpromazine, is not blocked by metoclopramide, , 323. The usual cardiovascular effect of, levodopa is, (a) Bradycardia due to increased vagal tone, (b) Rise in blood pressure due to increased, noradrenaline content of adrenergic nerve, endings, (c) Fall in blood pressure due to decrease in, sympathetic tone, (d) Both (a) and (b), 324. Which of the following adverse effects of, levodopa has a delayed onset and, increases in severity with continued, therapy ?, (a), (b), (c), (d), , Nausea and vomiting, Postural hypotension, Cardiac arrhythmia, Abnormal movements, , 325. The drug which abolishes the therapeutic effect of levodopa in parkinsonism, but, not that of levodopacarbidopa combination is

Page 72 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (a) Metoclopramide (b) Pyridoxine, (c) Chlorpromazine (d) Isoniazid, 326. Use of carbidopa along with levodopa in, the treatment of parkinsonism, (a) Inhibits development of involuntar y, movements, (b) Minimises ‘on–off’ effect, (c) Inhibits occurrence of behavioral abnormal, ities, (d) Accentuates nausea and vomiting, 327. Which of the following adverse effects of, levodopa is not minimized by combining, it with carbidopa, (a), (b), (c), (d), , Involuntary movements, Nausea and vomiting, Cardiac arrhythmia, ‘On–off ‘ effect, , 328. Though bromocriptine acts directly on, dopamine receptors, it is used in, parkinsonism only as a supplement to, levodopa because, (a) It has low efficacy, (b) It produces ‘first dose hypotension’, (c) Used alone, its effective doses produce, intolerable side effects, (d) Its therapeutic effect takes long time to develop, 329. Nitrous oxide is, (a), (b), (c), (d), , Non-flammable, Non-irritant, Potent analgesis, All of the above, , (b) Amantadine, (d) Bromocriptine, , 331. Tolerance to the antiparkinsonian action, develops most rapidly in the case of, (a), (b), (c), (d), , 332. Which of the following drugs is added to, levodopa therapy of parkinsonism to, attenuate wearing off effect ?, (a) Selegiline, (c) Amantadine, , Levodopa, Levodopa + carbidopa, Amantadine, Bromocriptine, , (b) Trihexiphenidyl, (d) Any of the above, , 333. The following drug is effective in, chlorpromazine induced parkinsonism., (a), (b), (c), (d), , Trihexyphenidyl, Selegiline, Bromocriptine, Levodopa + carbidopa, , 334. For majority of patients of parkinsonism, the standard drug therapy is, (a), (b), (c), (d), , Levodopa, Levodopa + carbidopa, Levodopa + trihexiphenidyl, Bromocriptine, , 335. Compared to other antipsychotic drugs,, the distinctive feature of penfluridol is, (a), (b), (c), (d), , Very long duration of action, Weak dopamine D2 blocking activity, Lack of extrapyramidal side effects, Additional 5–HT2 receptor blocking activity, , 336. Which of the following adverse effects of, neuroleptic drugs is positively correlated, to the antipsychotic potency of the, different compounds ?, (a), (b), (c), (d), , 330. The antiparkinsonian drug which acts by, inhibiting the degradation of dopamine, in the brain is, (a) Carbidopa, (c) Selegiline, , 57, , Sedation, Extrapyramidal motor distubances, Postural hypotension, Lowering of seizure threshold, , 337. Chlorpromazine therapy increases the, secretion of the following hormone., (a) Prolactin, (c) Corticotropin, , (b) Gonadotropin, (d) Antidiuretic hormone, , 338. What is true of risperidone ?, (a) It is an atypical neuroleptic which produces, few extrapyramidal side effects, (b) It has combined dopamine D2 and 5-HT2, receptor blocking activity, (c) It is highly sedative, (d) Both (a) and (b)

Page 73 :
MCQs IN PHARMACOLOGY, , 58, 339. Which of the following is a high potency, antipsychotic drug having minimal, sedative and autonomic effects and no, propensity to cause weight gain ?, (a) Chlorpromazine, (c) Haloperidol, , (b) Triflupromazine, (d) Reserpine, , 340. The psychotic symptoms most benefited, by neuroleptic drugs are, (a), (b), (c), (d), , Judgement and memory impairment, Loss of insight and voltion, Hallucinations, delusions and aggressive, Apathy and social withdrawl, , 341. A manic patient has been brought to the, hospital with nonstop talking, singing,, uncontrollable behavior and apparent, loss of contact with reality. Which of the, following is the most appropriate drug, for rapid control of his symptoms ?, (a) Lithium carbonate (b) Diazepam, (c) Haloperidol, (d) Chloral hydrate, 342. The drug which should not be used to, treat neurotic anxiety and tension, syndromes despite having antianxiety, action is, (a) Buspirone, (c) Diazepam, , (b) Chlorpromazine, (d) Alprazolam, , 343. Which of the following is a nonsedative, anxiolytic ?, (a) Meprobamate, (c) Hydroxyzine, , (b) Buspirone, (d) Alprazolam, , 344. Which of the following statements in, correct about buspirone ?, (a) It interacts with benzodiazepine receptor as, an inverse agonist, (b) It is a rapidly acting anxiolytic, good for, panic states, (c) It produces physical dependence and, suppresses barbiturate withdrawl syndrome, (d) It has anxiolytic but no anticonvulsant or, muscle relaxant propery, 345. Which of the following selective MAO–B, inhibitor ?, (a) Selegiline, (c) Moclobemide, , (b) Chlorgiline, (d) Tranylcypromine, , 346. The most important reason for the, unpopularity of nonselective MAO, inhibitors as antidepressants is their, (a) Low antidepressant efficacy, (b) Organ toxicity, (c) Potential to interact with many foods and, drugs, (d) Propensity to precipitate hypomania in, depressed patients, 347. The antidepressant which selectively, blocks 5-hydroxytryptamine uptake is, (a) Desipramine, (c) Fluoxetine, , (b) Amoxapine, (d) Dothiepin, , 348. Adaptive changes in brain monoamine, turnover due to blockade of noradrenaline/5-HT reuptake is credited with the, following effect., (a) Antipsychotic, (b) Antianxiety, (c) Antiparkinsonian (d) Antidepressant, 349. A 65-year-old man was brought to the, hospital with complaints of pain in lower, abdomen and not having passed urine, for 16 hours. The bladder was found to, be full. His son informed that he was, depressed for the last 2 years and only, the day before a doctor had given him, some medicine. Which of the following, drugs is he most likely to have received ?, (a) Alprazolam, (c) Imipramine, , (b) Haloperidol, (d) Trazodone, , 350. Following analgesics are frequently, employed as supplemental drugs during, general anesthesia., (a) Meperidine, (c) Alfentanil, , (b) Fentanyl, (d) All of the above, , 351. Prolonged painful erection of penis has, been noted particularly as a side effect, of, (a) Doxepin, (c) Mianserin, , (b) Trimipramine, (d) Trazodone, , 352. A 30-year old woman suffering from, endogenous depression improved after, one month of treatment with amitriptyline. How long the drug should be, continued

Page 74 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (a) Selegiline, (c) Moclobemide, , (b) Chlorgiline, (d) Tranylcypromine, , 353. Which of the following statements about, lithum is not correct, (a) It has a sedative action in normal individuals, (b) It controls mania, but takes 1–2 weeks to, produce the effect, (c) It has prophylactic effect in recurrent unipolar, depression, (d) It can be combined with tricyclic antidepressants for refractory cases of major depression, 354. For therapeutic effect in manic depressive, illness, stady-state serum lithium concentration should be maintained between, (a) 0.2–0.4 mEq/L, (c) 1.0–1.3 mEq/L, , (b) 0.5–0.8 mEq/L, (d) 1.5–2.5 mEq/L, , 355. Renal excretion of lithium is enhanced by, (a) Furosemide, (c) Indomethacin, , (b) Mannitol, (d) Both (a) and (b), , 356. Which of the following drugs can be used, as an alternative to lithium in mania and, bipolar illness, (a), (b), (c), (d), , Diethyl carbamazine, Haloperidol, Clomipramine, Carbamazepine, , 357. The constellation of side effects consisting of thirst, polyuria, looseness of stools, and fine tremors is characteristically associated with the following psychotropic, drug, (a) Amitriptyline, (c) Lorazepam, , (b) Buspirone, (d) Lithium carbonate, , 358. Prolonged lithium therapy can cause, (a) Diabetes mellitus (b) Goiter, (c) Parkinsonism, (d) Gout, 359. Strychnine produces convulsions by, (a), (b), (c), (d), , Stimulating NMDA receptors, Facilitating the excitatory transmitter glutamate, Blocking the inhibitory transmitter GABA, Blocking the inhibitory transmitter glycine, , 59, 360. The drug of choice for hyperkinetic children, is, (a) Methylphenidate (b) Nikethamide, (c) Caffeine, (d) Clonazepam, 361. The neurotransmitter system in the brain, most affected in Alzheimer’s disease is, (a) Glutaminergic, (c) Dopaminergic, , (b) Gabaergic, (d) Cholinergic, , 362. Which of the following drugs is claimed, to have a therapeutic effect in senile, dementia and has adrenergic blocking, activity, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 363. Which of the following drugs improves, some symptoms in Alzheimer’s dementia, by increasing brain acelylcholine levels, (a) Pemoline, (c) Nicergoline, , (b) Tacrine, (d) Piribedil, , 364. Pyritinol (pyrithioxine) is used as, (a) Analeptic drug, (b) Cerebroactive drug, (c) Antiepileptic drug (d) Antidepressant drug, 365. Extract of the following plant has platelet, activating factor antagonistic activity and, is claimed to benefit congnitive disorders, due to cerebral ischaemia, (a) Ginkgo biloba, (b) Claviceps purpurea, (c) Amanita muscaria (d) Artemisia annua, 366. Digitalis increases the force of contraction, of ventricles by, (a) Increasing the duration of systole, (b) Increasing the rate of contraction without, affecting the duration of systole, (c) Increasing the rate of contraction, but, reducing the duration of systole, (d) Increasing both the rate of contraction as, well as the duration of systole, 367. Digitalis induced increase in refractory, period of myocardial fibres is most, consistent and pronounced in the, (a) Atria, (c) A-V node, , (b) Ventricles, (d) Purkinje fibres

Page 75 :
MCQs IN PHARMACOLOGY, , 60, 368. Following general anaesthetic is oil at, room temperature, (a) Propofol, (c) Droperidol, , (b) Ketamine, (d) Diazepam, , 369. The most important channel of elimination of digoxin is, (a), (b), (c), (d), , Glomerular filtration, Tubular secretion, Hepatic metabolism, Excretion in bile, , 370. Digitalis is most suitable for treatment of, CHF when it is due to, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 371. The dose of digoxin in congestive heart, failure is adjusted by monitoring, (a), (b), (c), (d), , Electrocardiogram, Heart rate and symptoms of CHF, Blood pressure, Plasma digoxin levels, , 372. Digoxin affords the following benefit/, benefits in CHF, (a) Restores cardiac compensation and relieves, symptoms, (b) Reverses the pathological changes of CHF, (c) Prolongs survival of CHF patients, (d) Both (a) and (b), 373. A patient of CHF was treated with, furosemide and digoxin. He became, symptom-free and is stable for the last 3, months with resting heart rate 68/min, in sinus rhythm but left ventricular, ejection fraction is low. Which of the, following lines of action is warranted., (a) Stop above medication and start an ACE, inhibitor, (b) Continue all medication as before, (c) Continue the diuretic but stop digoxin, (d) Continue digoxin but stop the diuretic, 374. Which of the following actions of digoxin, is responsible for beneficial effect in, auricular fibrillation ?, (a) Increased myocardial contractility, (b) Suppression of SA node, , (c) Depression of A-V conduction, (d) Enhanced Purkinje fibre automaticity, 375. What is the usual response to digoxin in, a patient of atrial fibrillation ?, (a) Restoration of normal sinus rhythm, (b) Conversion of atrial fibrillation to atrial flutter, (c) Increase in atrial fibrillation frequency, but, decrease in ventricular rate, (d) Decrease in atrial fibrillation frequency, but, increase in ventricular rate, 376. The preferred diuretic for mobilizing, edema fluid in CHF is, (a) Polythiazide, , (b) Furosemide, , (c) Metolazone, , (d) Amiloride, , 377. Infusion of potassium chloride is indicated, in digitalis toxicity when the manifestation(s), is/are, (a) Vomiting, hyperapnoea and visual disturbance, (b) Pulsus bigeminus with heart rate 110/min, in a patient on maintenance digoxin therapy, (c) Ventricular tachycardia in a child who has, accidentally ingested 10 digoxin tablets, (d) 2:1 A-V block with occasional ventricular, extrasystoles, 378. Which of the following is the most suitable, antiarrhythmic drug for counteracting, ventricular extrasystoles due to digoxin, toxicity ?, (a) Lidocaine, , (b) Quinidine, , (c) Verapamil, , (d) Amiodarone, , 379. The apparent stimulation of CNS by local, anesthetic is due to, (a) Direct excitatory action, (b) Depression of inhibitory neurons, (c) Non specific action, (d) All of the above, 380. The following drug is used for short-term, control of emergency heart failure but not, for long-term treatment of congestive, heart failure, (a) Digoxin, (c) Dobutamine, , (b) Enalapril, (d) Theophylline

Page 76 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 381. Select the drug which is an ‘inodilator’, beneficial in refractory congestive heart, failure, (a) Astemizole, , (b) Amiodarone, , (c) Amrinone, , (d) Amiloride, , 382. The principal action common to all class I, antiarrhythmic drugs is, (a) Na+ channel blockade, (b) K+ channel openine, (c) Depression of impulse conduction, (d) Prolongation of effective refractory period, 383. Following is an amide linked local anaesthetic, (a) Bupivacaine, , (b) Procaine, , (c) Tetracaine, , (d) Proparacaine, , 384. Persistent dry cough may occur as a side, effect of the following antihypertensive, drug, , 61, (a) It has selective antihypertensive action at, doses which cause little diuresis, (b) It is a more efficacious antihypertensive, (c) Its antihypertensive action develops more, rapidly, (d) All of the above, 389. In the treatment of hypertension the beta, adrenergic blockers have the following, advantage, (a) They have minimal effect on work capacity,, sleep quality and libido, (b) They do not cause postural hypotension, (c) Used alone, they have high ceiling, antihypertensive efficacy, (d) They can be used in combination with any, other antihypertensive drug, 390. The following antihypertensive drug has, a favourable effect on plasma lipid profile, , (a) Enalapril, , (b) Atenolol, , (a) Prazosin, , (c) Diltiazem, , (d) Methyldopa, , (b) Propranolol, (c) Hydrochlorothiazide, (d) Furosemide, , 385. Loss of taste sensation can be a side effect, of the following antihypertensive drug, (a) Clonidine, , (b) Captopril, , (c) Verapamil, , (d) Prazosin, , 386. Furosemide is to be preferred over, hydrochlorothiazide when hypertension, is accompanied by, (a) Asthma, (b) Hyperuricaemia, (c) Diabetes, (d) Congestive heart failure, 387. Thiazide diuretics are the preferred first, line antihypertensives from the following, category of patients, (a) Young hypertensives, (b) Physically and sexually active male, hypertensives, (c) Elderly obese hypertensives, (d) Diabetic hypertensives, 388. Indapamide differs from other diuretics, in that, , 391. The following drug has been found to, improve urine flow in elderly males with, benign prostatic hypertrophy, (a) Nifedipine, (c) Disopyramide, , (b) Prazosin, (d) Imipramine, , 392. Following is an ester linked local anaesthetic, (a) Mepivacaine, (c) Benzocaine, , (b) Ropivacaine, (d) Prilocaine, , 393. The following antihypertensive is used, topically to treat alopacia areata, (a) Hydralazine, (c) Minoxidil, , (b) Prazosin, (d) Guanethidine, , 394. Diazoxide is an effective hypotensive, but, it is not used in the long-term treatment, of hypertension because, (a) It impairs glucose tolerance by inhibiting, insulin release, (b) It inhibits uric acid excretion, (c) It causes marked Na+ and water reterntion, (d) All of the above

Page 77 :
MCQs IN PHARMACOLOGY, , 62, 395. The following antihypertensive drug, tends to lower plasma rennin activity, (a) Clonidine, (c) Nifedipine, , (b) Hydralazine, (d) Captopril, , 396. Methyldopa lowers BP by, (a) Inhibiting dopa decarboxylase in adrenergic, nerve endings, (b) Generating α-methyl noradrenaline in brain, which reduces sympathetic tone, (c) Generating α-methyl noradrenaline which, acts as a false transmitter in peripheral, adrenergic nerve endings, (d) Activating vascular dopamine receptors, 397. Injection of local anaesthetic directly into, tissue without taking into consideration, the course of cutaneous nerves is, (a), (b), (c), (d), , Infiltration anesthesia, Field block anesthesia, Nerve block anesthesia, All of the above, , 398. Select the correct statement about, combining antihypertensive drugs, (a) Antihypertensive combinations should, always be preferred over single drugs, (b) Combinations of antihypertensives with, similar pattern of haemodynamic action are, superior to those with dissimilar pattern, (c) Only those antihypertensives which act on, different regulatory systems maintaining, blood pressure should be combined, (d) A diuretic must be included whenever, antihypertensives are combined, 399. Angiotensin converting enzyme inhibitors, are contraindicated in, (a), (b), (c), (d), , High rennin hypertensives, Diabetics, Congestive heart failure patients, Pregnant women, , 400. A woman in the 28th week of pregnancy, has been found to have pregnancy induced hypertension with a blood pressure reading of 150/95 mm Hg. Select, the most appropriate antihypertensive, drug for her, , (a) Furosemide, (c) Propranolol, , (b) Methyldopa, (d) Captopril, , 401. Secretion of K+ in the late distal tubule, and collecting ducts of kidney depends, on, (a) Intracellular K+ content, (b) Unabsorbed Na+ load presented to the distal, segment, (c) Aldosterone, (d) All of the above, 402. Which of the following diuretics is orally, active, efficacious in acidosis as well as, alkalosis, causes diuresis even in moderately, severe renal failure and has additional, carbonic anhydrase inhibitory action, (a), (b), (c), (d), , Mannitol, Bendroflumethiazide, Mersalyl, Furosemide, , 403. The following diuretic abolishes the, corticomedullary osmotic gradient in, the kidney, (a) Acetazolamide, (c) Benzthiazide, , (b) Furosemide, (d) Spironolactone, , 404. Intravenous furosemide promptly mitigates dyspnoea in acute left ventricular, failure by, (a) Producing bronchodilatation, (b) Causing rapid diuresis and reducing, circulating blood volume, (c) Increasing venous capacitance and reducing, cardiac preload, (d) Stimulating left ventricular contractility, 405. Parenteral furosemide is an alternative, diuretic to mannitol in the following, condition, (a) Pulmonary edema (b) Cirrhotic edema, (c) Cerebral edema (d) Cardiac edema, 406. Though ethacrynic acid is also a high, ceiling diuretic, it is rarely used compared, to furosemide because, (a) It is more ototoxic, (b) It causes diarrhoea and gut bleeding

Page 78 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (c) Its response increases steeply over a narrow, dose range, (d) All of the above, +, , 407. Thiazide diuretics enhance K elimination, in urine primarily by, +, , (a) Inhibiting proximal tubular K reabsorption, –, (b) Inhibiting Na+ K+–2C1 cotransport in the, ascending limb of of loop of Henle, (c) Increasing the availability of Na+ in the distal, tubular fluid to exchange with interstitial K+, (d) Potentiating the action of aldosterone, 408. The primary site of action of thiazide, diuretics is, (a), (b), (c), (d), , Proximal tubule, Ascending limb of loop of Henle, Cortical diluting segment, Collecting ducts, , 409. The most important reason for the, thiazides being only moderately efficacious diuretics is, (a) FSH + LH obtained from urine of menstruating, women, (b) LH obtained from urine of pregnant women, (c) FSH + LH obtained from urine of menopausal, women, (d) LH obtained from serum of pregnant mare, 410. Combined tablets of thiazide or high, ceiling duretics with potassium chloride, are not recommended because, (a) Potassium absorbed while diuresis is, occurring is largely excreted out, (b) Potassium administered concurrently, diminishes the diuretic action, (c) Potassium chloride in tablet formulation is, likely to cause gut ulceration, (d) Both (a) and (c), 411. _______ technique relies on using the, vasculature to bring the local anesthetic, solution to the nerve trunks and endings, (a), (b), (c), (d), , Spinal anesthesia, Nerve block anesthesia, Intravenous regional anesthesia, All of the above, , 63, 412. A patient of congestive heart failure was, being treated with furosemide and, digoxin. He developed urinary tract, infection. Which of the following, antimicrobials should not be prescribed, (a) Ampicillin, (c) Norfloxacin, , (b) Gentamicin, (d) Cotrimoxazole, , 413. Which of the following has a ‘self limiting, diuretic’ (action of the drug itself causing, changes which limit further diuresis), action ?, (a) Indapamide, (c) Theophylline, , (b) Spironolactone, (d) Acetazolamide, , 414. The most important therapeutic indication, of acetazolamide is, (a), (b), (c), (d), , Congestive heart failure, Renal insufficiency, Cirrhosis of liver, Glaucoma, , 415. Aldosterone increases Na+ reabsorption, and K+ excretion in the renal collecting, duct cells by, (a) Inducing synthesis of Na+ K+ ATP ase, (b) Inducing synthesis of amiloride sensitive Na+, channels, (c) Translocating Na+ channels from cytosolic, site to luminal membrane, (d) All of the above, 416. Select the diuretic that can cause gynaecomastia, hirsutism and menstrual disturbance as a side effect on long-term use., (a) Amiloride, (c) Metolazone, , (b) Spironolactone, (d) Acetazolamide, , 417. Which of the following is a potassium, retaining diuretic ?, (a) Trimethoprim, (c) Trimethaphan, , (b) Triamterene, (d) Trimethadione, , 418. Triam, (a) It has greater natriuretic action, (b) Its K+ retaining action is not dependent on, presence of aldosterone, (c) It acts from the luminal membrane side of, the distal tubular cells, (d) Both (b) and (c)

Page 79 :
MCQs IN PHARMACOLOGY, , 64, 419. Potassium sparing diuretics should not be, coadministered with, (a), (b), (c), (d), , Furosemide, Hydrochlorothiazide, Captopril, Verapamil, , 420. The primar y mechanism by which, antidiuretic hormone reduces urine, volume is, (a) Decrease in glomerular filtration rate, (b) Decreased renal blood flow, (c) Decreased water permeability of descending, limb of loop of Henle, (d) Increased water permeability of collecting, duct cells, 421. Which of the following tissues is most, sensitive to vasopressin ?, (a), (b), (c), (d), , Vascular smooth muscle, Intestinal smooth muscle, Renal collecting ducts, Uterus, , 422. Which of the following drugs reduces, urine volume in both pituitary origin as, well as renal diabetes insipidus and is, orally active ?, (a), (b), (c), (d), , Vasopressin, Hydrochlorothiazide, Chlorpropamide, Carbmazepine, , 423. Alpha methyldopa, (a) Is ineffective when given orally, (b) Decreases serum prolactin levels, (c) Is valuable in patients with compromised, renal function, (d) Causes troublesome postural hypotension, 424. Fetal alcohol syndrome is characterized by, (a), (b), (c), (d), , Normal CNS function, Characteristic cluster of facial abnormalities, Normal growth, All of the above, , 425. Prazosin, (a) Is relatively ineffective in blocking presynaptic, alpha2 receptors, , (b) Produces reflex tachycardia, (c) Is contraindicated in patients with renal, insufficiency, (d) Decreases plasma renin activity, 426. Diazoxide, (a), (b), (c), (d), , Causes marked sodium and water retention, Can be used in hypertensive emergencies, Can produce alopecia, Lowers blood sugar levels, , 427. Hydroxyethyl starches, (a), (b), (c), (d), , Are allergenic, Do not cause coagulation disturbances, Can precipitate renal failure, Are hydrolysed by amylase, , 428. Normal saline, (a) Has a long duration of action, (b) Is commonly used as a vehicle for, noradrenaline drip, (c) Is 5% sodium chloride, (d) Is a commonly used agent to raise effective, blood volume in emergencies, 429. The sympathomimetic amine preferred in, shock due to myocardial infarction is, (a) Dopamine, (c) Epinephrine, , (b) Isoprenaline, (d) Norepinephrine, , 430. Phenytoin sodium, (a), (b), (c), (d), , Depresses ventricular automaticity, Decreases AV nodal conduction, Is given by constant intravenous infusion, Decreases the conduction velocity in the, ventricular fibers, , 431. Dale’s vasomotor reversal phenomenon, is exhibited by, (a) Adrenaline, (c) Isoprenaline, , (b) Noradrenaline, (d) Both (a) and (b), , 432. Phenylephrine instilled in the eye can, produce, (a), (b), (c), (d), , Mydriasis but no cycloplegia, Mydriasis and cycloplegia, Miosis and cycloplegia, Miosis without cycloplegia

Page 80 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 433. Synthesis of norepinephrine occurs from, (a) Tyramine, (c) Tyrosine, , (b) Tyrptophan, (d) Tetracaine, , 434. The drug of choice in anaphylactic shock, is, (a) Isoprenaline, (c) Dobutamine, , (b) Adrenaline, (d) Noradrenaline, , 435. Phenoxybenzamine is less commonly used, to treat chronic essential hypertension,, because it, (a) Has a transient action of 2 hours, (b) Has to be given parenterally, (c) Also blocks the vasodilatory beta2 adrenergic, receptors, (d) Causes tachycardia and postural hypotension, 436. The anti-cholinesterase with the shortest, duration of action is, (a) Neostigmine, (c) Edrophonium, , (b) Physostigmine, (d) Ambenonium, , 437. The agent that produces cycloplegia for, a short time is, (a) Cyclopentolate, (c) Tropicamide, , (b) Homatropine, (d) Atropine, , 438. The drug of choice in the treatment of, organophosphorus poisoning is, (a) Neostigmine, (c) Pralidoxime, , (b) Atropine, (d) Acetylcholine, , 439. The average rate of ethanol metabolism, in one hour in normal adults is between, (a) 1 to 2 ml, (c) 30 to 50 ml, , (b) 8 to 12 ml, (d) 100 to 150 ml, , 440. Following barbiturate is significantly, excreted as unchanged drug, (a) Phenobarbital, (c) Secobarbital, , (b) Pentobarbital, (d) All of the above, , 441. Acute opium poisoning is treated by, intravenous administration of, (a) Naloxone, , (b) Pethidine, , (c) Nalbuphine, , (d) Noscapine, , 442. Ultrashort duration of effct of thiopentone, sodium given intravenously is due to, , 65, (a) Rapid hepatic metabolism, (b) Rapid renal clearance, (c) Extensive binding to plasma proteins, (d) Redistribution to body tissues outside the CNS, 443. The drug of choice for myoclonic epilepsy, (a) Carbamazepine (b) Phenobarbitone, (c) Phenytoin sodium (d) Valproic acid, 444. Peripheral conversion of levodopa to, dopamine is facilitated by, (a) Thiamine, , (b) Riboflavin, , (c) Pyridoxine, , (d) Cyanocobalamin, , 445. Which of the following does not produce, hypertensive crisis when coadministered, with levodopa?, (a) Phenelzine, (c) Isocarboxazid, , (b) Selegiline, (d) Pargyline, , 446. Nitrous oxide, (a) Provides slow induction, (b) Produces adequate muscle relaxation, (c) By itself is not a potent anaesthetic, (d) Is a poor analogesic, 447. Propofol, (a) Enhances the neuromuscular blockade of dtubocurarine, (b) Causes marked postoperative confusion, (c) Can produce involuntary movements during, its use, (d) Has a delayed recovery after induction, 448. Neurolept analgesia, (a), (b), (c), (d), , Is used in patients with Parkinson’s disease, Precludes the use of succinylcholine, Induces unconsciousness, Is useful for minor surgical procedures, , 449. The local anaesthetic with a short duration of action is, (a) Lignocaine, (c) Tetracaine, , (b) Procaine, (d) Mepivacaine, , 450. The local anaesthetic with significant, vasoconstriction effect is, (a) Cocaine, (c) Bupivacaine, , (b) Procaine, (d) Tetracaine

Page 81 :
MCQs IN PHARMACOLOGY, , 66, 451. The local anaesthetic recommended as an, antiarrhythmic is, (a) Lignocaine, (c) Medivacuene, , (b) Procaine, (d) Tetracaine, , 452. A H 1 receptor antagonist has limited, beneficial effect in, (a), (b), (c), (d), , Combating motion sickness, Systemic anaphylaxis, Allergic conjunctivitis, Reversing extrapyramidal side effects caused, by phenothazines, , 453. The H1 receptor antagonist with high, anticholinergic activity is, (a) Diphenhydramine (b) Terfenadine, (c) Mepyramine, (d) Clemastine, 454. Magnesium sulfate, (a) Is used to control eclamptic seizures during, pregnancy, (b) Is not given in patients in whom b2 adrenergic, receptor, (c) Is used to arrest post partum hemorrhage, (d) Can arrest labor even when cervix is 7 cm, dilated, 455. Colchicine, (a) Is used for treatment and prevention of acute, gouty arthritis, (b) Causes cellular proliferation, (c) Is an effective analgesic in osteoarthritis, (d) Enhances uric acid excretion, 456. Probenecid, (a) Increases excretion of uric acid by blocking, its tubular reabsorption, (b) Is used in combination with salicylates, (c) Is useful in gouty patients with nephrolithiasis, (d) Reduces the plasma concentrations of, rifampicin, 457. Salicylates and barbiturates are more, readily absorbed from the stomach, because, (a) They are weak bases and are ionized at, gastric pH, (b) They are weak acids and predominantly nonionized in gastric pH, , (c) They are strong bases and are highly ionized, at gastric pH, (d) They are weak acids and are ionized at, gastric pH, 458. Zolpidem interacts with, (a) BZ1 receptors, (b) BZ2 receptors, (c) Both (a) and, (d) None of the above, 459. Phenobarbitone reduces the incidence of, severe hyperbilirubinaemia in the, neonates because, (a) It prevents the synthesis of bilirubin, (b) It conjugates with the bilirubin, (c) It stimulates hepatic glucuronyl tranferase, (d) None of the above mechanism, 460. The methanol is toxic to optic nerve, it is, because of, (a) Methanol itself, (b) Oxidative metabolites of methanol, (c) Conjugated product of methanol, (d) Idiosyncratic reaction, 461. A patient has resulted in acute, hypertensive episode after ingestion of, certain cheeses or wine. This interaction, is because he is on, (a) Tetracyclines, , (b) Tranyleypromine, , (c) Aspirin, , (d) Digitalis, , 462. Which of the following drugs increases, the metabolism of bishydroxycoumarin, by induction of hepatic microsomal, enzymes?, (a) Digoxin, , (b) Furosemide, , (c) Enalapril, , (d) Amrinone, , 463. Antihistamines, phenothiazines, tricyclic, antidepressants and antiparkinsonian, agents have a common property that, (a) All produces CNS stimulation, (b) All have adrenergic action, (c) All have some atropine like action, (d) All have long plasma half-life

Page 82 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 464. Regarding the eardiac and therapeutic, effect of phenytoin, which of the following, is true?, (a) It increases the action potential duration in, purkinje fibres, (b) It has a brief duration of action because, of t½ of 2 hours, (c) It is probably the drug of choice in the, treatmet of arrhythmias caused by digitalis, intoxication, (d) The drug markedly depresses conduction, velocity in the A-v node and intraventricular, conduction system, 465. Phenytoin, (a) Is useful only in the treatment of epilepsy, (b) Has an antiarrhythmic action that is quite, different from that of quinidine, (c) Has antiarrhythmic action against many types, of arrhythmias, (d) Increases excitability of atrial or ventricular, muscle, 466. The drug of choice in the treatment of, hypertensive emergency is, (a) Guanethidine, (c) Diazoxide, , (b) Reserpine, (d) Furosemide, , 467. Which of the following statements, concerning hypertension is true?, (a) It is easier to obtain salt depletion in, hypertensive patients with thiazide diuretics, than by limitation of salt intake, (b) I.V. guanethidine is very useful in controlling, hypertensive emergencies, (c) In essential hypertension the excretion of, catecholamine in the urine is abnormally high, (d) Aldosterone stimulates the secretion of, angiotensin leading to certain types of, hypertension, 468. The duration of action of methacholine is, longer than that of acetylcholine because, (a) Acetylcholine is inactivated by active, transport into schwan cell, (b) Acetylcholine is inactivated by active, transport into nerve cell, (c) Acetylcholine is metabolized more rapidly, (d) Acetylcholine is excreted more rapidly, , 67, 469. Hemicholinium modifies Ach metabolism, by, (a), (b), (c), (d), , Interfering with destruction of Ach, Interfering with relese of Ach, Interfering with synthesis of Ach, Promoting release of Ach, , 470. Action of acetylcholine is terminated by, (a), (b), (c), (d), , Diffusion away from the site of action, Deamination, Hydrolysis, Temporary adsorption on plasma proteins, , 471. Norepinephrine in the synaptic cleft can, activate presynaptic alpha 2 receptors, which results in, (a) Increased release of exocytotic norepinephrine, (b) Displacement of norepinephrine from the, storage site, (c) Further inhibition of exocytotic release of, norepinephrine, (d) Increased synthesis of norephinephrine, 472. Which of the following barbiturates is, preferred as sedative agent in a patient, having liver disease ?, (a) Allobarbitone, (c) Phenobarbitone, , (b) Cyclobarbitone, (d) Pentobarbitone, , 473. One of the way to classify regions of the, cortex is, (a) By the modality of information processed, (b) By the physiological position, (c) By the chemical relationship between cell, types in the major cortical layers, (d) All of the above, 474. Peak serum level of orally administered, lithium is usually achieved in, (a) 5 to 10 min, (c) 2 to 4 hours, , (b) 1 to 2 days, (d) 8 to 12 hours, , 475. For induction of anaesthesia nitrous oxide, is superior to ether because, (a) Nitrous oxide is not explosive, while ether, vapours are flammable in air, (b) Iuduction with nitrous oxide is very rapid, while with ether it is slow and unplea sant to, patient

Page 83 :
MCQs IN PHARMACOLOGY, , 68, (c) Ether is irritant to respiratory tract and may, lead to coughing, laryngeal spasm and, increased mucus secretion while nitrous oxide, does not, (d) All of the above, , 482. Which of the following neuromuscular, blocking agent has short duration of, action, , 476. Succinylcholine is preferred over dtubocurarine for endotrachial intubation,, because of the following reasons except, , 483. Botulinium toxin causes muscle palsy by, blocking, , (a) With succinylcholine total paralysis lasts upto, 4 min. with 50% recovery at about 10 min, (b) Allergic reactions due to release of histamine, are not seen with succinylcholine, (c) In addition to neuromuscular blocking effect, succinylcholine blocks autonomic ganglia, (d) Bronchospasm is less common with, succinylcholine, 477. The difference between autonomic and, somatic nerves are all except, (a) Somatic nerves do not contain peripheral, ganglia unlike autonomic nerves, (b) Motor nerves to skeletal muscles are, myelinated while postganglionic autonomic, nerves are unmyelinated, (c) The presynaptic transmitted in both the cases, is different, (d) None of the above, 478. In endothelium nitric oxide is synthezised, from, (a) Arginine, (c) Tyrosine, , (b) Valine, (d) All of the above, , 479. Ipratropium bromide is principally, effective in, (a) Asthma, (c) COPD, , (b) Bronchitis, (d) All of the above, , 480. What are obidoxine and pralidoxime, (a), (b), (c), (d), , Acetylcholine reactivators, Choline esterase reactivators, Choline esterase inhibitors, Cellular poisons, , 481. Which of the following cholinergic drugs, is used in Alzheimer’s disese, (a) Neostigmine, (c) Tacrine, , (b) Pyridostigmine, (d) None of the above, , (a) Atracurium, (c) Pancuronium, , (a), (b), (c), (d), , (b) Mivacurium, (d) Doxacurium, , Nerve action potential, Acetylcholine release, Permeability to sodium and potassium, Muscle action potential, , 484. Dopamine is preferred over norepinephrine in cardiogenic and hypovolemic shock because, (a), (b), (c), (d), , Better cardiac stimulation, Potent renal vasodilator, Potent cerebral vasodilation, All of the above, , 485. What is the mechanism of action of, clonidine, (a) α1 antagonist, (c) α1 agonist, , (b) α2 agonist, (d) β1 agonist, , 486. What is true of methylphenidate, (a) Mild CNS stimulant, (b) Abuse potential as of amphetamine, (c) Effective in narcolepsy and attention deficitdisorder, (d) All of the above, 487. The longest half-life is of which of the, following betablockers, (a) Esmolol, (c) Pindolol, , (b) Nadolol, (d) Acebutolol, , 488. Which of the following is both alpha and, beta blocker, (a) Propranolol, (c) Esmolol, , (b) Labetalol, (d) Metoprolol, , 489. The rate limiting enzyme in synthesis of, melatonin and serotonin is, (a), (b), (c), (d), , Tryptophan hydroxylase, 5 HT N-acetylase, Aldehyde dehydrogenase, Aldehyde reductase

Page 84 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 490. Which of the following is a function of, melatonin, (a), (b), (c), (d), , Darkening of skin colour, Suppression of ovarian function, Regulation of biorhythm, All of the above, , 491. Which neurotransmitter has maximum, number of receptor subtypes, (a) GABA, (c) Serotonin, , (b) Glutamate, (d) Substance P, , 492. The cell bodies of 5HT neurons in CNS are, principally located in, (a) Hypothalamus, (c) Raphenuclei, , (b) Frontal lobe, (d) Caudate nucleus, , 493. In GI tract enterochromaffin cells, maximum in, (a) Stomach, (c) Jejunum, , (b) Duodenum, (d) Colol, , 494. Tryptophan is essential for synthesis of, (a) Niacin, (c) Melatonin, , (b) Serotonin, (d) All of the above, , 495. Which of the following is 5HT antagonists, except, (a) Sumatriptan, (c) Ketanserin, , (b) Ondansetron, (d) None of the above, , 496. The rate at which inhalational anaesthetic, passes into tissues depends on, (a) Tissue: Blood partition coefficient, (b) The rate at which gas is delivered to the, tissues, (c) The partial pressure of the gas in the arterial, blood, (d) All of the above, 497. General anaesthesis for surgery requires, (a), (b), (c), (d), (e), , Unconsciousness, Analgesia, Suppression of visceral reflexes, Muscle relaxation, All of the above, , 498. The most ideal inhalation anaesthetic is, (a) Halothane, , (b) Enflurane, , 69, (c) Isoflurane, , (d) Desflurane, , 499. The barbiturate of choice for induction of, anaesthesis is, (a) Pentothal, (c) Methohexital, , (b) Thiamylal, (d) Etomidate, , 500. Ketamine injection produces, (a) Amnesia, (c) Sedation, (e) All of the above, , (b) Analgesia, (d) Immobility, , 501. Local anaesthetics prevent or relieve pain, by, (a), (b), (c), (d), , Inhibit substance P, Interrupt nerve conduction, Modify neuronal metabolism, All of the above, , 502. What is true about sensitivity of nerve, fibres to local anaesthetics ?, (a) Small fibres are more sensitive, (b) Large fibres are more sensitive, (c) Both small and large fibres are equally, senstive, (d) Small fibres are resistant, 503. Which function is lost last after local, anaesthetic injection, (a) Pain, (c) Muscle tone, , (b) Touch, (d) Deep pressure, , 504. A vasoconstrictor is added to local, anaesthetic for, (a), (b), (c), (d), , Prolongation of anaesthetic action, Tackling anaphylaxis, To prevent bleeding, All of the above, , 505. The local anaesthetic of choice during, labor is, (a) Procaine, (c) Cocaine, , (b) Bupivacaine, (d) Lignocaine, , 506. Bier’s block refers to, (a), (b), (c), (d), , Field block anaesthesia, Nerve block anaesthesia, Intravenous regional anaesthesia, Infiltration anaesthesia

Page 85 :
MCQs IN PHARMACOLOGY, , 70, 507. Which of the following is the most trouble, shooter in spinal anaesthesia, (a), (b), (c), (d), , Sympathetic block, Parasympathetic block, Contracted intestines, Paralysed intercostals muscles, , 508. A local anaesthetic in its lowest concentration will block, (a), (b), (c), (d), , Somatic motor, Somatic sensory, Preganglionic sympathetic, All of the above, , 509. Benzodiazepines act on which receptors, (b) GABAB, (a) GABAA, (c) Both of the above (d) None of the above, 510. Which of the following benzodiazepines, has shortest half-life, (a) Alprazolam, (c) Clonazepam, , (b) Oxazepam, (d) Midazolam, , 511. Which of the following barbiturate has, shortest half-life, (a) Secobarbital, (c) Methohexital, , (b) Pentobarbital, (d) Amobarbital, , 512. Barbiturate induced enzyme induction, facilitates metabolism of, (a) Steroid, (c) Vit K and D, , (b) Ethanol, (d) All of the above, , 513. Most barbiturates loose biological action, after oxidation of radicals at position, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 514. The metabolism of ethanol is directly, proportional to, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 515. Disulfiram–ethanol interaction often, produces hypertension due to, (a), (b), (c), (d), , Increased concentration of ethanol, Inhibition of sympathetic tone, Inhibition of dopamine hydroxylase, None of the above, , 516. Chemically the phenothiazines have, (a) One ring, (c) Three rings, , (b) Two rings, (d) Five rings, , 517. Following are examples of generalized, seizures, except, (a), (b), (c), (d), , Tonic-clonic seizures, Infantile spasms, Simple partial seizures, Atonic seizures, , 518. The D3 receptors are preferentially, present in, (a), (b), (c), (d), (e), , Negative inotropy, QT prolongation, P-R prolongation, ST depression, All of the above, , 519. What is rabit syndrome, (a), (b), (c), (d), , Tardive dyskinesia, Akathisia, Perioral tremor, None of the above, , 520. The maximum daily dose of Alprazolam is, (a) Anxiolytic, (c) Antidepressant, , (b) Sedative, (d) All of the above, , 521. Atypical antidepressant is, (a) Selegiline, (c) Desipramine, , (b) Trazodone, (d) Doxeptan, , 522. Setraline belongs to which class of compounds, (a), (b), (c), (d), , MAO inhibitor, Serotonin reuptake inhibitor, Nor epinephrine reuptake inhibitor, None of the above, , 523. Following is an irreversible inhibitor of, GABA amino transferase, (a) Pyrimidine, (c) Lamotrigine, , (b) Vigabatrin, (d) Gabapentin, , 524. Lithium has also been used for which of, the following, (a) Gout, (c) Anticonvulsant, , (b) Salt substitute, (d) All of the above

Page 86 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 525. Which lithium salt is used for manicdepressive disorders, (a) Carbonate, (c) Bromide, , (b) Chloride, (d) All of the above, , 526. MAO inhibitors in general raise the brain, level of, (a) Dopamine, (c) Nor adrenaline, , (b) Serotonin, (d) All of the above, , 527. Which of the following is not MAO-A, inhibitor, (a) Selegiline, (c) Clorgyline, , (b) Brofaromine, (d) Moclobemide, , 528. Which of the recently introduced, antiepileptics is useful in absence seizure, (a), (b), (c), (d), , Absence attack, Partial seizure (simple), Clonic tonic seizure, Complex partial seizure, , 529. Gabapentin acts by, (a), (b), (c), (d), (e), , Binds to GABAA receptors, Binds to GABAB receptors, Inhibits GABA destruction, Promotes GABA release, All of the above, , 530. IV administration of phenytoin in status, epilepticus carries the danger of, (a) Arrhythmia, (c) Renal failure, (e) All of the above, , (b) Cerebellar atrophy, (d) Jaundice, , 531. For seizure control, therapeutic plasma, phenobarbitone should be, (a) 2 –5 µg/ml, (c) 50 – 60 µg/ml, , (b) 10 – 20 µg/ml, (d) 80 – 90 µg/ml, , 532. The drug of choice for status epilepticus, is, (a) Clonazepam, (c) Lorazepam, , (b) Diazepam, (d) Alprazolam, , 533. The maximum dose of ergotamine per, week in treatment of migraine is, (a) 5 mg, (c) 20 mg, , (b) 10 mg, (d) 40 mg, , 71, 534. Which of the following is 5 HT receptor, antagonist, (a) Methysergide, , (b) Plzotifen, , (c) Minaserin, , (d) All of the above, , 535. Fenton reaction refers to the formation of, (a) Free radical, (c) Nitric oxide, , (b) Hydrogen peroxide, (d) None of the above, , 536. How many types of dopamine receptors, are present in brain, (a) 3, , (b) 5, , (c) 7, , (d) 9, , 537. The term endorphin refers to which of the, following, (a) Encephalins, (c) b endrophin, , (b) Dynorphins, (d) All of the above, , 538. How many types of opioid receptor are, present in brain, (a) 3, (c) 5, , (b) 4, (d) 6, , 539. The agent that has strong affinity for µ, δ, and kappa receptor is, (a) Morphine, (c) Fentanyl, , (b) Etorphine, (d) Sufentanil, , 540. Anti-epileptic, chemically derived from, the tricyclic antidepressant is, (a) Carbamazepine, (c) Phenytoin, , (b) Ethosuximide, (d) None of the above, , 541. The triad of coma, pinpoint pupil and, decreased respiration points toward, poisoning with, (a) Organophosphorus, (b) Morphine, (c) Mushroom, (d) Belladona, 542. Which of the following is not a feature of, alcohol withdrawal syndrome, (a) Seizure, (b) Hypertension, (c) Constricted pupils, (d) Delirium tremens

Page 87 :
MCQs IN PHARMACOLOGY, , 72, , 552. Quinidine is contraindicated in, , 543. Angel dust refers to, (a) LSD, (c) Phencyclidine, , (b) MDMA, (d) MDA, , 544. Acetazolamide inhibits which form of, carbonic anhydrase, (a) Membrane bound (b) Cytosolic, (c) Both of the above (d) None of the above, 545. The site of action of loop diuretics is, (a), (b), (c), (d), , Proximal convoluted tubule, Proximal straight tubule, Thick ascending limb, Distal convoluted tubule, , 546. Which loop diuretic is more likely to have, toto toxicity Ethacryhia, (a) Furosemide, (c) Ethacrynic acid, , (b) Bumetamide, (d) Torsemide, , 547. Among thiazide diuretics the relative, potency is highest for, (a), (b), (c), (d), , Hydrochlorthiazide, Benzthiazide, Polythiazide, Indapamide, , 548. The anti diuretic action of vasopressin is, mediated via, (b) V2 receptor, (a) V1 receptor, (c) Both of the above (d) None of the above, 549. Hyoscine differs from atropine in that, (a), (b), (c), (d), , Its duration of action is longer, Anticholinergic action is more on heart, Has depressant action on CNS in low doses, Slowly absorbed from GI tract, , 550. All are side effects of bromocriptine, except, (a), (b), (c), (d), , Hallucination, Tremor, Suppression of lactation, Postural hypotension, , 551. ETDA is useful in poisoning due to all except, (a) Lead, (c) Iron, , (b) Zinc, (d) Mercury, , (a) Atrial flutter, (c) PSVT, , (b) Atrial fibrillation, (d) Digoxin toxicity, , 553. Nalorphine is not used as antidote for, (a) Morphine, (c) Pentazocine, , (b) Pethidine, (d) Heroin, , 554. Carbonic anhydrase inhibitor is often, useful in, (a) Thyrotoxicosis, (b) Petit mal epilepsy, (c) Myasthenia gravis (d) Bronchial asthma, 555. Which of the following drug is, contraindicated in myasthenia gravis ?, (a) Neostigmine, (c) Quinine, , (b) Pyridostigmine, (d) Ephedrine, , 556. Petit mal epilepsy is treated by, (a) Phenobarbitone, (c) Diazepam, , (b) Ethosuximide, (d) Phenytoin, , 557. Lithium toxicity may manifest as, (a) Polyuria, (c) Renal calculi, , (b) Nephrotic syndrome, (d) Acute renal failure, , 558. In Parkinsonism levodopa exer ts, following effects except, (a), (b), (c), (d), , Improves tremor, Improves akinesia, Improves muscle power, Improves dystonia, , 559. The primary mechanism of action of, benzodiazepine is, (a), (b), (c), (d), , Dopamine antagonism, Adenosine antagonism, Opening up of chloride channel, Facilitation of GABA mediated chloride influx, , 560. Which of the following general anaesthetic has poor muscle relaxation ?, (a) Ether, (c) Halothane, , (b) Nitrous oxide, (d) Enflurane, , 561. Which of the following secretions is not, stimulated by acetylcholine ?, (a) Tear, (c) Sweat, , (b) Bile, (d) Pancreatic juice

Page 88 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 562. Which of the following drugs is not, effective in acute congestive glaucoma, (a) Acetazolamide, (c) Timolol, , (b) Pilocarpine, (d) Mannitol, , 563. The anticholinergic used only as preanaesthetic medication is, (a) Atropine, (c) Isopropamide, , (b) Glycopyrrolate, (d) Dicyclomine, , 564. Ephedrine is similar to adrenaline in, respect to, (a), (b), (c), (d), , Duration of action, Potency, Penetration of blood brain barrier, Both α and β adrenergic effects2106., , 565. The neurotransmitter released at the end, of the sympathetic nerve fibre is, (a) Epinephrine, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 566. Valproic acid is shown to be effective, against, (a), (b), (c), (d), , Absence seizures, Partial seizures, Generalized seizures, All of the above, , 567. In which of the following conditions, centrally acting anticholinergic drugs, cannot be used for treatment, (a), (b), (c), (d), (e), , Parkinsonian disease, Akathisia, Tardive dyskinesia, All the above, None of the above, , 568. Levodopa and carbidopa combination is, used to treat parkinsonian disease, because carbidopa, (a) Selectively stimulates dopa decarboxylase, (b) Enters the CNS and increases the dopamine, in the nigro-striatum, (c) Reduces levodopa – induced dyskinesias, (d) Reduces levodopa induced vomiting and, nausea, (e) All of the above, (f) None of the above, , 73, 569. Huntington’s chorea is hereditary, disorder where there is, (a) Loss of GABA neurons in corpus striatum, (b) An over-activity in dopaminergic nigro-striatal, pathway, (c) Loss of some cholinergic neurons in the, corpus striatum, (d) All the above, (e) None of the above, 570. Which of the following MAO inhibitors, prevents the 1-methyl 4-Phenyl 1,2,3,6, tetrahydropyridine’s (MPTP) selective, action in destroying the dopaminergic, nigro-striatal neurons, (a), (b), (c), (d), (e), , Tranylcypromine, Phenelzine, Selegiline, All of the above, None of the above, , 571. Concurrent use ow which of the following, drugs may reverse the antiparkinsonian, effect of levodopa, (a) Carbidopa, (c) Bromocriptine, (e) All of the above, , (b) Selegiline, (d) Pyridoxine, (f) None of the above, , 572. Selegiline is a, (a), (b), (c), (d), (e), , MAO – A inhibitor, MAO – B inhibitor, Drug that releases dopamine, All of the above, None of the above, , 573. Schizophrenia has following clinical, feature, (a), (b), (c), (d), , Delusions, Hallucinations, Thought disorders, All of the above, , 574. Which of the following is an ergot, derivative used in Parkinson’s disease as, a dopamine agonist, (a), (c), (e), (g), , Levodopa, (b) Carbidopa, Bromocriptine, (d) Selegiline, Amantadine, (f) All of the above, None of the abvoe

Page 89 :
MCQs IN PHARMACOLOGY, , 74, 575. Which of the following drugs used in, Parkinson’s disease is a peripherally, acting dopa decarboxylase inhibitor ?, (a), (c), (e), (g), , Levodopa, (b) Carbidopa, Bromocriptine, (d) Selegiline, Amantadine, (f) All of the above, None of the above, , 576. Which of the following opioid antagonists, is used as an adjunct to prevent relapse, in addicts following detoxification, because of its long half-life ?, (a) Nalorphine, (b) Naloxone, (c) Naltrexone, (d) All of the above, (e) None of the above, 577. Which of the following opioid antagonists, is not a derivative of oxymorphone ?, (a) Nalorphine, (b) Naloxone, (c) Naltrexone, (d) All of the above, (e) None of the above, 578. Which of the following opioid antagonists, is a competitive antagonist of all the, effects of morphine at opioid receptor in, a low dose and in higher dose mimics, effects of morphine (such as analgesic, effect) ?, (a) Nalorphine, (b) Naloxone, (c) Naltrexone, (d) All of the above, (e) None of the above, 579. Morphine administration leads to, (a), (b), (c), (d), , Physical dependence, Psychological dependence, Physical as well as Psychological dependence, None of the above, , 580. Naloxone and naltrexone are, (a), (b), (c), (d), , Opioid agonists, Opioid agonists/antagonists, Opioid antagonists, None of the above, , 581. Opioid analgesics inhibit the release of, which of the following hormones., (a), (b), (c), (d), , Anti-diuretic hormone, Luteinizing hormone, Prolactin, Somatotropin, , 582. Droperidol, a neuroleptic, belongs to, following class of drugs., (a), (b), (c), (d), , Phenothiazines, Thioxanthines, Butyrophenone, Benzamides, , 583. Which of the following opioid analgesics, is used as a preferred and rational, antitussive agent ?, (a) Morphine, (c) Meperidine, , (b) Codeine, (d) Methadone, , 584. Which of the following opioid analgesics, has very low protein binding ?, (a), (c), (e), (g), , Morphine, (b) Codeine, Meperidine, (d) Methadone, Propoxyphene, (f) All of the above, None of the above, , 585. Which of the following group of analgesic, drugs act on the CNS ?, (a), (b), (c), (d), (e), , Morphine – like drugs, NSAIDS (Aspirin and related drugs), Local Anaesthetic, All of the above, None of the above, , 586. Which of the following statements, regarding lithium is not correct ?, (a) It is a monovalent cation, (b) Salts of lithium share some chemical, characteristics with salts or sodium and, potassium, (c) The half life of lithium is more in adult and, adolescent patient of bipolar as compared, to an elderly patient of bipolar disorder, (d) Chances of neonatal goiter and congenital, cardiovascular malformation if administered, to a pregnant women, (e) All of the above, (f) None of the above, 587. Which of the following anticonvulsant, drugs is used for prophylactic treatment, of mood swings (i.e. manic-depression, illness) in patients unresponsive to lithium, carbonate ?, (a) Phenobarbitone, , (b) Phenytoin

Page 90 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, (c) Ethosuximide, (e) All of the above, , (d) Carbamazepine, (f) None of the above, , 588. Which of the following thioxanthene, derivatives may be used as an antiemetic and sedative ?, (a) Chlorprothixene (b) Flupenthixol, (c) Thiothixene, (d) All of the above, (e) None of the above, 589. Haloperidol is used in Huntington’s chorea, as a, (a), (b), (c), (d), , Anti-psychotic drug, Anti-dyskinetic drug, Anti-emetic, None of the above, , 590. Chlorpromazine is a phenothiazine derivative having a, (a) Aliphatic side chain, (b) Piperazine side chain, (c) Peperazine side chain, 591. Which of the following extra-pyramidal, effects seen with antipsychotic agents is, not due to dopamine receptor blockade,, but due to super-sensitivity of dopamine, receptors ?, (a), (b), (c), (d), (e), (f), , Acute dystonia reaction, Parkinsonian syndrome, Tardive dyskinesia, Akathisia, All the above, None of the above, , 592. Which of the following extra-pyramidal, effects seen with antipsychotic agents is, also known as “rabbit syndrome” ?, (a), (b), (c), (d), (e), , Acute dystonia reaction, Parkinsonian syndrome, Tardive dyskinesia, Perioral tremon, Akathisia(f) None of the above, , 593. MAO is localized in, (a) Cell membrane, (b) Plasma, , 75, (c) Mitochondrial membrane, (d) All of the above, 594. Which of the following drugs is used in, the childhood enuresis ?, (a), (b), (c), (d), , Imipramine hydrochloride, Imipramine pamoate, Both the above, None of the above, , 595. Which of the following tricyclic antidepressant drugs has the least anticholinergic effect and sedation ?, (a) Amitriptyline, (c) Clomipramine, (e) All the above, , (b) Amoxapine, (d) Desipramine, (f) None of the above, , 596. The tricyclic antidepresent drugs produce, their effect by, (a) Increasing the synaptic concentration of, noradrenaline in the CNS, (b) Increasing the synaptic concentration of 5HT in the CNS, (c) By causing inhibition of noradrenaline and, 5-HT re-uptake by the pre-synaptic neuronal, membrane, (d) All the above, 597. Which of the following tricyclic antidepressant drugs is a preferred drug in the, treatment of obsessive – compulsive, dirorder ?, (a) Amitriptyline, (c) Clomipramine, (e) All the above, , (b) Amoxapine, (d) Doxepin, (f) None of the above, , 598. MAO – A enzyme has no substrate, preference for, (a) Noradrenaline, (c) 5–HT, (e) All the above, , (b) Dopamine, (d) Phenylethylamine, (f) None of the above, , 599. Risk with acute overdose is less with which, of the following class of antidepressants, (a), (b), (c), (d), , Tricyclic antidepressants, MAO inhibitors, 5-HT uptake inhibitors, Atypical antidepressand drugs

Page 91 :
MCQs IN PHARMACOLOGY, , 76, 600. Pergolide is., (a), (b), (c), (d), , Dopamine precursor, Dopamine agonist, Dopamine releasing agent, Dopamine antagonist, , 601. Phenelzine and tranylcypromine belong, to which one of the following group, (class) of antidepressants, (a), (b), (c), (d), (e), , Tricyclic antidepressants, MAO inhibitors, 5-HT uptake inhibitors, Atypical antidepressant drugs, None of the above, , 602. Which one of the following drugs is not, 5-HT uptake inhibitor but used as an, antidepressant ?, (a) Fluoxetine, (c) Paroxetine, (e) All of the above, , (b) Maprotiline, (d) Sertraline, (f) None of the above, , 603. Following endogenous opioid peptide is, a pentapeptide, (a) Enkephalin, (c) Endorphin, , (b) Dynorphin A, (d) Dynorphin B, , 604. Concurrent use of which of the following, may lead to similar effects seen in, patients who are administered disulfiram, after the ingestion of alcohol, (a), (b), (c), (d), (e), , Oral hypoglycemic drug, Coumarin type antigoagulants, Salicylates, All of the above, None of the abvoe, , 605. Wernicke’s encephalopathy and Korsakoff’s psychosis occur often in alcoholic’s, due to, (a), (b), (c), (d), (e), , Malnutrition, Vitamin deficiencies, Faulty gastrointestinal deficiencies, All of the above, None of the above, , 606. Phenobarbitone is beneficial in the, treatment of which of the following, generalized seizures, , (a), (b), (c), (d), (e), , Tonic – clonic seizures, Absence seizures, Atonic seizures, All of the above, None of the above, , 607. Which of the following barbiturates is a, long acting barbiturate (i.e. has a longer, onset and duration of action), (a) Phenobarbital, (b) Amobarbital, (c) Secobarbital, (d) All the above, (e) None of the above, 608. The half life of ethosuximide in adult is, (a) 10–20 hours, (b) 30–40 hours, (c) 50–60 hours, (d) 60–70 hours, (e) None of the above, 609. Concurrent use of carbamazepine and, phenyton will lead to, (a) Increased metabolism of phenyton, (b) Decreased metabolism of phenytoin, (c) No change in the metabolism of phenytoin, 610. Zolpidem is used as, (a), (b), (c), (d), (e), (f), , Anticonvulsant drug, Anti-anxiety drug, Sedative and hypnotic drug, myorelaxant drug, All the above, None of the above, , 611. Which of the benzodiazepines is used, only as a sedative and hypnotic, (a) Chlordiazepoxide (b) Clorazepam, (c) Diazepam, (d) Flurazepam, (e) All of the above (f) None of the above, 612. Which of the following benzodiazepines, is not in active form and behaves as a, prodrug or drug prercursor, (a) Chlordiazepoxide (b) Diazepam, (c) Parzepam, (d) Clorazepate, (e) All of the above (f) None of the above, 613. The dynorphins are endogenous ligands, for, (a) µ, (c) κ, , (b) δ, (d) σ

Page 92 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 614. A drug that produces a mild degree of, nonselective depression of the central, nervous system by decreasing the, response of an individual to all sensory, modalities is known as, (a) Sedative, (b) Hypnotic, (c) None of the above, 615. Lidocaine is used as, (a) Mucosal local anaesthetic, (b) Parenteral local anaesthetic agent, (c) Mucosal as well as parenteral local anaesthetic, agent, (d) None of the above, 616. Prilocaine, a local anaesthetic is used as, (a) Dental anaesthesia, (b) Low spinal anaesthesia for vaginal delivery, (c) Abdominal surgical anaesthesia, (d) Caudal anaesthesia, (e) All the above, (f) None of the above, 617. Which of the following statements, regarding procaine, a local anaesthetic, agent is not correct., (a) It has a very low lipid solubility at pH 7.4, (b) It is least protein bound, (c) it has a short duration of action, (d) It is an amide – type local anaesthetic, (e) All of the above, 618. Which of the following parenteral local, anaesthetics has a very high protein, binding and may produce analgesia for, more than 10 hours via its nerve block, action, (a) Chloroprocaine, (c) Lidocaine, , (b) Bupivacaine, (d) Prilocaine, , (e) All of the above, , (f) None of the above, , 619. Which of the following parenteral local, anaesthetics has a short duration of, action (i.e. between 30 to 60 minutes), (a) Chloroprocaine, , (b) Bupivacaine, , (c) Lidocaine, , (d) Prilocaine, , 77, (e) All of the above, , (f) None of the above, , 620. In small intestine, morphine particularly, affects, (a), (b), (c), (d), , Duodenum, Ileum, Both (a) and (b), Does not affect small intestine, , 621. Local anaesthetics affect membrane, excitability by inhibiting, (a), (b), (c), (d), (e), , Sodium (Na+) Channel inactivation, Increased (Na+) conductance, Increased potassium (K+) conductance, All of the above, None of the above, , 622. The order of loss of sensory function, when a local anaesthetic is used is, (a), (b), (c), (d), , Temperature, pain, touch and deep pressure, Pain, touch, deep pressure and termperture, Pain, temperature, touch and deep pressure, None of the above, , 623. Ester type local anaesthetics are hydrolyzed, by, (a), (b), (c), (d), (e), , True cholinesterase, Pseudo cholinesterase, Liver microsomal enzymes, All of the above, None of the above, , 624. When an amide is acted upon by an, amidase, (a), (b), (c), (d), , Alcohol and acid is formed, Amine and acid is formed, Alcohol and amine is formed, None of the above, , 625. Which one of the following is not an ester, local anaesthetic ?, (a) Cocaine, (c) Lidocaine, (e) All of the above, , (b) Procaine, (d) Benzocaine, (f) None of the above, , 626. Which of the following local anaesthetics, cause arteriolar vasoconstriction ?, (a) Lidocaine, (c) Cocaine, , (b) Procaine, (d) Prilocaine

Page 93 :
MCQs IN PHARMACOLOGY, , 78, (e) All of the above, 627. Local anaesthetics are drugs that produce, (a) Irreversible loss of sensitivity to pain in the, restricted area to which they are applied, (b) Reversible loss of sensitivity to pain in the, restricted area to which they are applied., (c) No loss of sensitivity to pain in the area to, which they are applied, (d) None of the above, 628. Local anaesthetic molecule consists of, (a) Lipophilic group linked by an ester or amide, chain, (b) Lipophilic group linked by an ester or amide, chain to an amine substitute, (c) Lipophilic group linked to an amine substitute, (d) None of the above, 629. Ketamine, a general anaesthetic agent, can be administered by, (a), (b), (c), (d), , Intravenous route, Intramuscular route, Intravenous or Intramuscular route, None of the above, , 630. In the following benzodiazepines used as, intravenous general anaesthetic which, one has a more rapid onset and shorter, half life, (a) Diazepam, (c) Midazolam, , (b) Lorazepam, , 631. Which of the following is a intravenous, anaesthetic, (a) Thiopental, (c) Propofol, (e) All of the above, , (b) Ethomidate, (d) Ketamine, (f) None of the above, , 632. Which of the following intravenous, anaesthetic agents is useful to produce, sedation prior to anaesthesia and is also, helpful in reducing the amount of, inhalation anaesthetic, (a), (b), (c), (d), (e), (f), , Ultra–short acting barbiturates, Benzodiazepines, Opioid analgesic anaesthesia, Propofol, All of the above, None of the above, , 633. Post – anaesthesia emergency delirium, is most frequent side effect of, (a), (c), (e), (g), , Enflurane, (b) Halothane, Isoflurane, (d) Methoxyflurane, Nitrous oxide, (f) All the above, None of the above, , 634. Which of the following anaesthetic agents, is not indicated in low doses to provide, analgesia for procedures not requiring, loss of consciousness, (a), (c), (e), (g), , Enflurane, (b) Halothane, Isoflurane, (d) Methoxyflurane, Nitrous oxide, (f) All the above, None of the above, , 635. Blood pressure is thought to generally, remain unchanged with which one of the, following anaesthetic agent, (a) Enflurane, (c) Isoflurane, (e) All the above, , (b) Halothane, (d) Nitrous oxide, (f) None of the above, , 636. Which of the following anaesthetic agents, has the best (most) analgesic effect in low, concentration, (a) Enflurane, (c) Isoflurane, (e) All the above, , (b) Halothane, (d) Nitrous oxide, (f) None of the above, , 637. Opioid angalgesics provide symptomatic, relief of, (a) Pain, (c) Diarrhea, , (b) Cough, (d) All of the above, , 638. Opioid receptors act via, (a), (b), (c), (d), , Opening of potassium channels, Inhibition of calcium channels, Both (a) and (b), Opening of sodium channels, , 639. The main factor that determines the speed, and recovery from inhalation of anaesthetics is, (a), (b), (c), (d), (e), , Blood : Gas partition coefficient, Oil : Gas partition coefficient, Minimum alveolar concentration, All of the above, None of the above

Page 94 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, , 79, , 640. Which of the following inhalation general, anaesthetic is not a volatile liquid, (a), (c), (e), (g), , Enflurane, (b) Methoxyflurane, Ether, (d) Isoflurane, Nitrous oxide, (f) All of the above, None of the above, , 641. Which of the following general anaesthetics, is not administered intravenously, (a) Thiopental, (c) Ketamine, (e) All of the above, , (b) Diazepam, (d) Halothane, , 642. The use of nitrous oxide to relieve the, pain of surgery, (a) Horace Wells, (c) William Morton, , (b) Humphry Davy, (d) None of the above, , 643. Which of the following is designated as, “The Vital Node”, (a), (b), (c), (d), (e), , Mid brain, Pons, Medulla oblongata, All of the above, None of the above, , 646. Which of the following CNS Neurotransmitters is excitatory on the individual, neurons and causes decrease in potassium conductance, (a) Dopamine, (c) GABA, (d) All of the above, , (b) Acetylcholine, (d) Glycine, (e) None of the above, , 647. Which of the following amino acids is an, inhibitory transmitter and increases the, membrane permeability to chloride ions,, and thus causing inhibitory post synaptic, potential (IPSP) in the CNS, (a) Glycine, (b) Glutamate, (c) Aspartate, (d) All of the above, (e) None of the above, 648. Which of the following is a neurotransmitter in the central nervous system (CNS), , 644. CNS stimulant agents belong to, (a), (b), (c), (d), , (a) Excitatory causing decrease in potassium, conductance, (b) Inhibitory causing decrease in potassium, conductance, (c) Excitor y causing increase in cation, conductance, (d) All of the above, (e) None of the above, , Respiratory stimulants, Psychomotor stimulants, Psychomimetic agents, All of the above, , (a) Acetylcholine, (b) Noradrenaline, (c) Dopamine, , 645. Acetylcholine action at the nicotinic, receptor in the motoneuron – Renshaw, cell synapse is, , (d) 5–Hydroxytryptamine, (e) All of the above, , ANSWERS, 1., 7., 13., 19., 25., 31., 37., 43., , d, e, a, a, a, e, b, e, , 2., 8., 14., 20., 26., 32., 38., 44., , a, b, e, c, e, c, a, d, , 3., 9., 15., 21., 27., 33., 39., 45., , a, b, d, b, a, d, e, d, , 4., 10., 16., 22., 28., 34., 40., 46., , e, d, a, c, a, d, a, c, , 5., 11., 17., 23., 29., 35., 41., 47., , a, a, d, c, c, e, b, d, , 6., 12., 18., 24., 30., 36., 42., 48., , c, b, d, e, d, c, b, d

Page 95 :
MCQs IN PHARMACOLOGY, , 80, 49., 55., 61., 67., 73., 79., 85., 91., 97., 103., 109., 115., 121., 127., 133., 139., 145., 151., 157., 163., , d, c, a, c, b, c, c, e, b, c, c, e, d, d, d, c, c, e, e, e, , 50., 56., 62., 68., 74., 80., 86., 92., 98., 104., 110., 116., 122., 128., 134., 140., 146., 152., 158., 164., , c, e, d, c, d, d, a, b, e, a, e, d, e, d, d, b, d, a, c, d, , 169. 1. c, 2. e3. a, 4. b, 173., 179., 185., 191., 196., 202., 208., 214., 220., 226., 232., 238., 244., 250., 256., 262., 268., 274., 280., 286., 292., 298., , b, a, d, d, c, b, c, a, d, b, b, d, c, c, c, d, b, a, d, d, b, d, , 174., 180., 186., 192., 197., 203., 209., 215., 221., 227., 233., 239., 245., 251., 257., 263., 269., 275., 281., 287., 293., 299., , c, c, d, a, b, d, d, a, a, e, d, b, d, d, d, d, a, c, b, d, c, b, , 51., 57., 63., 69., 75., 81., 87., 93., 99., 105., 111., 117., 123., 129., 135., 141., 147., 153., 159., 165., , c, b, e, a, c, e, c, d, d, c, e, c, b, b, c, d, b, d, d, c, , 52., 58., 64., 70., 76., 82., 88., 94., 100., 106., 112., 118., 124., 130., 136., 142., 148., 154., 160., 166., , d, d, d, c, d, b, b, b, e, b, c, d, a, d, d, e, e, e, e, c, , 170. 1. e, 2. b3. a, 4. d5. c, 175., 181., 187., 193., 198., 204., 210., 216., 222., 228., 234., 240., 246., 252., 258., 264., 270., 276., 282., 288., 294., 300., , e, a, c, b, b, b, b, a, d, b, a, b, a, b, a, c, a, d, b, c, d, d, , 176. d, 182. b, 188. c, 194. b, 199. a, 205. d, 211. b, 217. a, 223. d, 229. e, 235. c, 241. c, 247. b, 253. b, 259. b, 265. b, 271. a, 277. b, 283. a, 289. b, 295. b, 301. c, , 53., 59., 65., 71., 77., 83., 89., 95., 101., 107., 113., 119., 125., 131., 137., 143., 149., 155., 161., 167., , b, d, b, a, e, b, d, c, c, c, d, c, b, e, d, c, b, d, c, e, , 171. d, 177., 183., 189., 195., 200., 206., 212., 218., 224., 230., 236., 242., 248., 254., 260., 266., 272., 278., 284., 290., 296., 302., , 54., 60., 66., 72., 78., 84., 90., 96., 102., 108., 114., 120., 126., 132., 138., 144., 150., 156., 162., 168., , c, c, c, e, b, d, a, c, b, c, d, d, c, c, a, a, e, a, c, b, , 172. d, , d, 178., c, 184., a, 190., 1. a, 2. c3. b, d, 201., d, 207., b, 213., d, 219., e, 225., b, 231., c, 237., d, 243., c, 249., d, 255., a, 261., a, 267., a, 273., c, 279., b, 285., b, 291., c, 297., b, 303., , d, a, b, a, c, c, a, c, d, d, b, d, a, d, c, d, d, a, d, a, d

Page 96 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 304., 310., 316., 322., 328., 334., 340., 346., 352., 358., 364., 370., 376., 382., 388., 394., 400., 406., 412., 418., 424., 430., 436., 442., 448., 454., 460., 466., 472., 478., 484., 490., 496., 502., 508., 514., 520., 526., 532., 538., 544., 550., 556., 562., , a, d, b, b, c, b, c, c, b, b, b, d, b, a, a, d, b, d, b, d, b, a, c, d, d, a, b, c, b, a, b, d, d, a, c, c, b, d, b, a, c, b, b, c, , 305., 311., 317., 323., 329., 335., 341., 347., 353., 359., 365., 371., 377., 383., 389., 395., 401., 407., 413., 419., 425., 431., 437., 443., 449., 455., 461., 467., 473., 479., 485., 491., 497., 503., 509., 515., 521., 527., 533., 539., 545., 551., 557., 563., , c, a, b, c, d, a, c, c, a, d, a, b, b, a, b, a, d, c, d, c, a, a, c, d, b, a, b, a, a, c, a, c, e, c, a, c, b, a, b, b, c, d, a, b, , 306., 312., 318., 324., 330., 336., 342., 348., 354., 360., 366., 372., 378., 384., 390., 396., 402., 408., 414., 420., 426., 432., 438., 444., 450., 456., 462., 468., 474., 480., 486., 492., 498., 504., 510., 516., 522., 528., 534., 540., 546., 552., 558., 564., , 81, b, a, c, d, c, b, b, d, b, a, c, a, a, a, a, b, d, c, d, d, b, a, b, c, a, a, a, c, c, b, d, c, c, a, d, c, b, b, d, a, c, d, c, b, , 307., 313., 319., 325., 331., 337., 343., 249., 355., 361., 367., 373., 379., 385., 391., 397., 403., 409., 415., 421., 427., 433., 439., 445., 451., 457., 463., 469., 475., 481., 487., 493., 499., 505., 511., 517., 523., 529., 535., 541., 547., 553., 559., 565., , d, d, b, b, c, a, b, c, b, d, c, a, b, b, b, a, b, a, d, c, b, c, b, b, a, b, b, c, d, c, b, b, b, b, c, c, b, d, a, b, c, c, d, a, , 308., 314., 320., 326., 332., 338., 344., 350., 356., 362., 368., 374., 380., 386., 392., 398., 404., 410., 416., 422., 428., 434., 440., 446., 452., 458., 464., 470., 476., 482., 488., 494., 500., 506., 512., 518., 524., 530., 536., 542., 548., 554., 560., 566., , c, b, a, b, a, d, d, d, d, c, a, c, c, d, c, c, c, d, b, b, d, b, a, c, b, a, c, c, c, b, b, d, e, c, d, c, d, e, b, c, b, b, b, d, , 309. b, 315. c, 321. c, 327. a, 333. a, 339. c, 345. a, 351. d, 357. d, 363. b, 369. a, 375. c, 381. c, 387. c, 393. c, 399. d, 405. c, 411. c, 417. b, 423. c, 429. a, 435. d, 441. a, 447. c, 453. a, 459. c, 465. b, 471. c, 477. c, 483. b, 489. a, 495. b, 501. b, 507. a, 513. b, 519. c, 525. a, 531. b, 537. d, 543. c, 549. d, 555. c, 561. b, 567. c

Page 97 :
MCQs IN PHARMACOLOGY, , 82, 568., 574., 580., 586., 592., 598., 604., 610., 616., 622., 628., 634., 640., 646., , d, c, c, c, d, d, a, c, a, d, b, b, e, b, , 569., 575., 581., 587., 593., 599., 605., 611., 617., 623., 629., 635., 641., 647., , d, b, b, d, c, d, d, d, d, b, c, d, d, a, , 570., 576., 582., 588., 594., 600., 606., 612., 618., 624., 630., 636., 642., 648., , c, c, c, a, a, b, a, d, b, b, c, d, b, e, , 571., 577., 583., 589., 595., 601., 607., 613., 619., 625., 631., 637., 643., , d, a, b, b, d, b, a, c, a, c, d, d, c, , 572., 578., 584., 590., 596., 602., 608., 614., 620., 626., 632., 638., 644., , b, a, b, a, d, b, c, a, a, c, b, c, d, , 573., 579., 585., 591., 597., 603., 609., 615., 621., 627., 633., 639., 645., , d, c, a, c, c, a, a, c, a, b, b, a, c, , EXPLANATIONS FOR ANSWERS, 3.a, , 8. b, 16. a, 20. c, , 28. a, , 32. c, , 41. b, , Neurotransmitter is a substance present in, neuron and is secreted by neurons to transmit, signals to its postsynaptic targets., An example of neuromodulator is cAMP. It acts, as a second messenger of synaptic transmission., Suramin is an antagonist of purinergic receptors,, specifically P2x and P2y, NMDA receptors are closely associated with, the induction of synaptic plasticity. AMPA and, kainite receptors are involved in mediation of, fast depolarization., Muscimol is GABAA agonist., Baclofen is a GABAB agonist., Bicuculline is a GABAA antagonist., Strychnine is an antagonist of glycine receptors., Taurine and â-analine are agonists of glycine, receptors. Quisqualate is an agonist of AMPA, receptors., Baclofen is an agonist of GABAB receptor., Muscimol is an agonist of GABAA receptor., Picrotoxin and bicuculline are antagonists of, GABAA receptors., , 50. c, , 58. d, , 61. a, , 75. c, , 80. d, , 90. a, , In CNS, acetylcholine was the first neurotransmitter to be identified pharmacologically. In, 1950s Eccles showed that excitation of Renshaw, cells by motor axon collaterals was blocked by, nicotinic antagonists., Metabotropic receptors of glutamate are, coupled with G-proteins. AMPA, kinate and, NMDA receptors are coupled with ion channels., Phencyclidine blocks NMDA receptors and thus, antagonizes effects of glutamate, an excitatory, amino acid neurotransmitter., Picrotoxin is an antagonist of GABAB receptors, and blocks chloride channels associated with, it. Muscimol is GABAA selective agonist., Bicuculline is GABAA antagonist. Baclofen is, GABAB agonist., In the brain, GABA is the main inhibitory, neurotransmitter, whereas glycine plays an, important inhibitory role in brain stem and spinal, cord., A direct interaction is believed to exist between, GABAA receptors and various drugs e.g. alcohol,, volatile anaesthetics etc. Hence, GABA A, antagonists attenuate some of the action of alcohol.

Page 98 :
DRUGS ACTING ON CENTRAL NERVOUS SYSTEM, 108. c, , 109. c, 123. b, , 141. d, , 155. d, , 156. a, , 168. b, 174. c, , 193. b, , 200. d, , 213. c, , 219. a, 225. c, , 238. d, , 253. b, , As ethanol competes for alcohol dehydrogenase, a 10% ethanol solution is generally used, in methanol poisoning., Alcohol is teratogenic and is associated with, fetal alcohol syndrome., Diethyl ether has high solubility in blood and, has slow onset of central action and hence all, the four stages of general anesthesia can be, observed with this drug., Metabolism is not an important route of, elimination of inhalational anaesthetics. However,, except nitrous oxide, other anaesthetics such as, halothane, ether and isoflurane do undergo some, degree of metabolism., An ideal anesthetic should possess wide margin, of safety with no adverse effect. But no single, anaesthetic can achieve all the desirable effects, of general anaesthetics without some adverse, effects., An action common to most general anaesthetics, is to increase the cellular threshold of firing and, thus decreasing neuronal activity., β-Carbolines are inverse agonists of, benzodiazepines., Zolpidem is a nonbenzodiazepine sedativehypnotic agent and belongs to imidazopyridine, class of drugs., Ethinamate is a sedative-hypnotic agent and is, a urethane derivative. Ethinamate has rapid, onset and short duration of action., For substance to be classified as neuro-transmitter,, it has to fulfill all the criteria as stated in A, B and, C., Phencyclidine, also called as angel-dust, is a, non-competitive antagonist of NMDA receptors, and it produces various psychotic symptoms e.g., hallucinations, thought disorders etc., Fluoxetine is a serotonin transport blocker and, it is an antidepressant agent., Neuronal death in response to high glutamate, concentration is mediated by excessive, activation of NMDA receptors and is associated, with influx of calcium., Drugs that increases dopaminergic activity in, CNS can produce or aggravate symptoms of, schizophrenia, Tranylcypromine, moclobemide and isocarboxid, are MAO inhibitors. Nomifensine is a dopamine, transport blocker., , 83, 270. a, 280. d, , 292. b, , 312. a, 329. d, , 350. d, , 368. a, , 379. b, , 383. a, , 392. c, , 397. a, , 411. c, , 424. b, , 440. a, , 458. a, , Iproniazid is an antitubercular agent, an, inhibitor of MAO and has antidepressant effect., The major factors, which affect elimination of a, general anesthetic are, pulmonary ventilation,, blood flow and solubility in blood and tissues., Barbiturates bind to GABA receptors (GABAA), but on a different site than benzodiazepines and, enhance the action of GABA., Chemical name of halothane is 2-bromo-2chloro-1,1,1-trifluoroethane., Nitric oxide is a colorless gas without significant, odor or taste and is non-flammable, non-irritant, and potent analgesic., Surgical pain is often severe and hence opioid, analgesics such as meperidine, fentanyl,, alfentanil, sufentanil and morphine are generally, used as supplemental agents during general, anaesthesia., Propofol is an intravenous anesthetic agent. It, is an oil at room temperature and is supplied as, 1% emulsion., Local anaesthetics produce stimulation of CNS,, restlessness and tremors, which may proceed, to convulsions. Selective depression of inhibitory, neurons is responsible for the CNS excitation., Bupivacaine is an amide-linked local anaesthetic., Procaine, tetracaine and proparacaine have ester, linkage in their structure., Benzocaine has ester linkage in its structure., Mepivacaine, ropivacaine and priocaine have, amide linkage in their structure., In infiltration anesthesia, local anaesthetic is, directly injected into tissue without taking into, consideration the course of cutaneous nerves., Intravenous regional anesthesia or Bier’s block, relies on using the vasculature to bring the local, anaesthetic to the nerve trunks and endings., Fetal alcohol syndrome is characterized by, cluster of facial abnormalities viz. short nose,, hypoplastic upper lip and short palpebral, fissures. In addition, it is associated with CNS, dysfunction and slow growth., Except Phenobarbital, only insignificant, quantities of the barbiturates are excreted, unchanged., Zolpidem is a nonbenzodiazepine sedativehypnotic that interacts with benzodiazepine BZ1, receptors to produce its effects.

Page 99 :
MCQs IN PHARMACOLOGY, , 84, 473. a, (i), (ii), , (iii), 496. d, , 517. c, , 523. b, , 540. a, , 566. d, , 573. d, , Regions of the cortex can be classified in three, different ways:, By the modality of the information processed., By the cytoarchitectonic classification i.e. the, geometrical relationship between cell types in, the major cortical layers., By the anatomical position., The rate at which inhalational anaesthetics, passes into tissues depends on various factors;, tissue-blood partition coefficient i.e. solubility, of anaesthetics in tissues and blood, the rate of, delivery of anesthetic to the tissue., Generalized seizure can be of various types –, tonic- clonic seizures, absence seizures, tonic, seizures, atonic seizures, clonic and myoclonic, seizures and infantile spasms., Vigabatrin is an irreversible inhibitor of GABA, aminotransferase, the enzyme responsible for, the degradation of GABA and thus increases, GABA at synaptic sites., Carbamazepine is a derivative of iminostilbene, and is chemically related to tricyclic, antidepressants., Although valproic acid has been widely used, for the treatment of absence seizures, it is also, effective against wide variety of partial and, generalized seizures., Schizophrenia is an idiopathic psychoses, , 582. c, 593. c, , 600. b, , 603. a, 613. c, , 620. a, , 637. d, , 638. c, , 644. d, , characterized by disordered thinking, delusions,, auditory hallucinations and emotional, withdrawal., Droperidol like haloperidol belongs to, butyrophenone neuroleptic class of drug., MAO is a flavin-containing enzyme, which is, localized in mitochondrial membranes in nerve, terminals, liver and other organs., Pergolide, an ergot derivative, is a dopamine, agonist and it interacts with both D1 and D2, receptors., Enkephalin is a pentapeptide i.e. it has 5 amino, acids in its structure., Dynorphin, specifically dynorphin A, is the, endogenous ligand for ê1 receptors that are, responsible for spinal analgesia., In small intestine, morphine particularly affects, upper part of small intestine, especially the, duodenum compared to ileum., Opioid analgesics provide symptomatic relief, of pain, cough and diarrhea but the disease, remains unaffected., All the opioid receptors are coupled to pertussis, toxin-sensitive GTP binding proteins. These, receptors produce opening of potassium, channels and inactivation of calcium channels., CNS stimulants belong to all three categories.

Page 100 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, , 85, , CHAPTER 3, DRUGS ACTING ON, AUTONOMOUS NERVOUS SYSTEM, 1. In the autonomic regulation of blood, pressure, (a) Cardiac output is maintained constant at the, expense of other hemodynamic variables, (b) Elevation of blood pressure results in elevated, aldosterone secretion, (c) Baroreceptor nerve fibers docrease firing rate, when arterial pressure increases, (d) Stroke volume and mean arterial blood, pressure are the primary direct determinants, of cardiac output, (e) A condition that reduces the sensitivity of the, sensory baroreceptor nerve endings might, cause an increase in sympathetic discharge, 2. The autonomic nervous system is also, known as, (a), (b), (c), (d), , Visceral, Vegetative, Involuntary nervous system, All of the above, , 3. Full activation of the sympathetic nervous, system, as in maximal exercise, can, produce all of the following responses, except, (a), (b), (c), (d), (e), , Bronchial relaxation, Decreases intestinal motility, Increased renal blood flow, Mydriasis, Increased heart rate (tachycardia), , 4. Several children at a summer camp were, hospitalized with symptoms thought to, be due to ingestion of food containing, botulinum toxins. The effects of botulinum, toxin are likely to include, (a), (b), (c), (d), (e), , Bronchospasm, Cycloplegia, Diarrhea, Skeletal muscle spasms, Hyperventilation, , 5. The neurotransmitter agent that is, normally released in the sinoatrial node, of the heart in response to a blood, pressure increase is, (a) Acetylcholine, (c) Epinephrine, (e) Norepinephrine, , (b) Dopamine, (d) Glutamate, , 6. A direct-acting cholinomimetic that is, lipid-soluble and often used in the, treatment of glaucoma is, (a) Acetylcholine, (c) Physostigmine, (e) Neostigmine, , (b) Bethanechol, (d) Pilocarpine, , 7. Which of the following agents is a prodrug that is much less toxic in mammals, than in insects ?, (a) Acetylcholine, (c) Physostigmine, (e) Neostigmine, , (b) Bethanechol, (d) Pilocarpine

Page 101 :
MCQs IN PHARMACOLOGY, , 86, 8. Atropine overdose may cause which one, of the following, (a), (b), (c), (d), (e), , Gastrointestinal smooth muscle crampine, Increased cardiac rate, Increased gastric secretion, Pupillary constriction, Urinary frequency, , 9. The synaptic pre-ganglionic neurons have, their cell bodies in the lateral horn of the, grey matter of the, (a), (b), (c), (d), , Thoracic segment only, Lumbar segment only, Both (a) and (b), None of the above, , 10. Which one of the following can be, blocked by atropine?, (a) Decreased blood pressure caused by, hexamethonium, (b) Increased blood pressure caused by nicotine, (c) Increased skeleton muscle strength caused, by neostigmine, (d) Tachycardia caused by exercise, (e) Tachycardia caused by infusion of acetylcholine, 11. Which of the following best describes the, mechanism of action of scopolamine ?, (a) Irreversible antagonist at nicotinic receptors, (b) Irreversible antagonist at muscarinic, receptors, (c) Physiologic antagonist at muscarinic receptors, (d) Reversible antagonist at muscarinic receptors, (e) Reversible antagonist at nicotinic receptors, 12. Accepted therapeutic indications for the, use of antimuscarinic drugs include all of, the following except, (a), (b), (c), (d), (e), , Hypertension, Motion sickness, Parkinson’s disease, Postoperative bladder spasm, Traveler’s diarrhea, , 13. In male sex organs _______ system is, responsible for erection., (a) Sympathetic, (c) Norepinephrine, , (b) Parasympathetic, (d) None of the above, , 14. A 7-years-old boy has a significant bedwetting problem. A long-acting indirect, sympathomimetic agent sometimes used, by the oral route for this and other, indications is, (a) Dobutamine, , (b) Ephedrine, , (c) Epinephrine, , (d) Isoproterenol, , (e) Phenylephrine, 15. When pupillary dilation-but not cycloplegia-is desired, a good choice is, (a) Homatropine, , (b) Isoproterenol, , (c) Phenylephrine, , (d) Pilocarpine, , (e) Tropicamide, 16. ‘Fight or flight’ state can be described as, (a) Sympathetic active; para-sympathetic, quiescent, (b) Sympathetic active; para-sympathetic active, (c) Sympathetic quiescent; para-sympathetic, active, 17. Your patient is to receive a selective β2, stimulant drug β2 selective stimulant are, often effective in, (a) Angina due to coronary insufficiency, (b) Asthma, (c) Chronic heart failure, (d) Delayed or insufficiently strong labor, (e) All of the above, 18. Which of the following drugs is the drug, of choice in anaphylaxis associated with, bronchospasm and hypotension ?, (a) Cortisone, , (b) Epinephrine, , (c) Isoproterenol, , (d) Norepinephrine, , (e) Phenylephrine, 19. Which of the following effects of epinephrine would be blocked by phentolamine, but not by metoprolol ?, (a) Cardiac stimulation, (b) Contractionof radial smooth muscle in the iris, (c) Increase of camp in fat, (d) Relaxation of bronchial smooth muscle, (e) Relaxation of the uterus

Page 102 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, 20. Propranolol is useful in all of the following, except, (a) Angina, (b) Familial tremor, (c) Hypertension, (d) Idiopathic hypertrophic subaortic cardiomyopathy, (e) Partial atrioverntricular heart block, 21. ‘Rest and digest’ state can be described, as, (a) Sympathetic active; para-sympathetic, quiescent, (b) Sympathetic active; para-sympathetic active, (c) Sympathetic quiescent; para-sympathetic, active, 22. A friend has very severe hypertension and, asks about a drug her doctor wishes to, prescribe. Her physician has explained that, this drug is associated with tachycardia, and fluid retention (which may be marked), and increased hair growth. Which of the, following is most likely to produce the, effects that your friend has described?, (a) Captopril, , (b) Guanethidine, , (c) Minoxidil, , (d) Prazosin, , (e) Propranolol, , 87, (d) β1 – selective receptor blockers, (e) Nonselective β - blockers, 25. A visitor from another city comes to your, office complaining of incessant cough. He, has diabetes and hypertension and has, recently started taking a different, antihypertensive medication. The most, likely cause of his cough is, (a) Enalapril, (c) Minoxidil, , (b) Losartan, (d) Propranolol, , (e) Verapamil, 26. Reserprine, an alkaloid derived from the, root of Rauwolfia serpentina, (a) Can be used to control hyperglycemia, (b) Can cause severe depression of mood, (c) Can decrease gastrointestinal secretion and, motility, (d) Has no cardiac effects, (e) A spare receptor agonist, 27. Nitroglycerin, either directly or through, reflexes, results in which one of the, following effects, (a) Decreased heart rate, (b) Decreased venous capacitance, (c) Increased afterload, (d) Increased cardiac force, , 23. Which one of the following is characteristic of captopril and enalapril ?, , (e) Increased diastolic intramyocardial fiber, tension, , (a) Competitively blocks angiotensim II at its, receptor, , 28. The antianginal effect of propranolol may, be attributed to which one of the following, , (b) Decreases angiotensin II concentration in the, blood, (c) Decreases rennin concentration in the blood, (d) Increases sodium and decreases potassium, in the blood, (e) Decreases sodium and increases potassium, in the urine, 24. Postural hypotension is a common adverse effect of which one of the following types of drugs ?, (a) ACE inhibitors, (b) Alpha-receptor blockers, (c) Arteriolar dilators, , (a) Block of exercise – induced tachycardia, (b) Decreased end – diastolic ventricular volume, (c) Dilation of consticted coronary vessels, (d) Increased cardiac force, (e) Increased resting heart rate, 29. The major common determinant of myocardial oxygen consumption is, (a) Blood volume, (b) Cardiac output, (c) Diastolic blood pressure, (d) Heart rate, (e) Myocardial fiber tension

Page 103 :
MCQs IN PHARMACOLOGY, , 88, 30. Choose the incorrect statement from the, following, (a) Sympathetic system increases rate of SA node, (b) Sympathetic system causes constriction of, coronary arteries, (c) Sympathetic system causes increased motility, of GIT smooth muscles, (d) Sympathetic system causes constriction of, sphincter in GIT, 31. Denervation super-sensitivity includes, (a), (b), (c), (d), , Proliferation of receptors, Loss of mechanism for transmitter removal, Increased post-junctional responsiveness, All of the above, , 32. Which of the following is approved for, the treatment of hemorrhagic stroke ?, (a), (b), (c), (d), (e), , Amyl nitrite, Hydralazine, Isosorbide moninitrate, Nifedipine, Nimodipine, , 33. Which of the following drugs used for the, treatment of angina by inhalation has a, very rapid onset and a brief duration of, effect ?, (a), (b), (c), (d), (e), , Amyl nitrite, Hydralazine, Isosorbide mononitrate, Nifedipine, Nimodipine, , 34. Which of the following is a vasodilator, drug used for hypertension that lacks a, direct effect on autonomic receptors but, may provoke anginal attacks?, (a), (b), (c), (d), (e), , Amyl nitrite, Hydralazine, Isosorbide mononitrate, Nifedipine, Nimodipine, , 35. The biochemical 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 actin molecule, (d) An increase in systolic intracellular calcium, levels, (e) A block of sodium/calcium exchange, 36. A patient has been taking digoxin for, several years for chronic heart failure is, about to receive atropine for another, condition. A common effect of digoxin (at, therapeutic blood levels) that can be, almost entirely blocked by atropine is, (a), (b), (c), (d), (e), , Decreased appetite, Increased atrial contractility, Increased PR interval on the ECG, Headaches, Tachycardia, , 37. In a patient given a cardiac glycoside,, important effects of the drug on the heart, include which of the following?, (a) Decreased atrioventricular conduction, velocity, (b) Decreased ejection time, (c) Increased ectopic automaticity, (d) Increased ectopic automaticity, (e) All of the above, 38. Which of the following situations constitutes an added risk of digoxin toxicity ?, (a), (b), (c), (d), (e), , Starting administration of captopril, Starting administration of quinidine, Hyperkalemia, Hypermagnesemia, Hypocalcemia, , 39. At rest, the interior of the typical, mammalian neuronal axon potential is, approximately ________ mV, (a) 0, (c) –100, , (b) –70, (d) –20, , 40. Following enzyme is involved in the, synthesis of actylcholine, (a), (b), (c), (d), , Choline acetyl transferase, Acetyl cholinesterase, Both (a) and (b), None of the above

Page 104 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, 41. Which of the following has been shown, to prolong life in patient with chronic, congestive failure but has a negative, inotropic effect on cardiac contractility?, (a) Carvedilol, (c) Digoxin, (e) Enalapril, , (b) Digitoxin, (d) Dobutamine, , 42. Which of the following is the drug of, choice in treating suicidal overdose of, digitoxin ?, (a), (b), (c), (d), (e), , Digoxin antibodies, Lidocaine, Magnesium, Potassium, Quinidine, , 43. When used as an antiarrhythmic drug,, Lidocaine typically, (a), (b), (c), (d), (e), , Increases action potential duration, Increases contractility, Increses PR interval, Reduces abnormal automaticity, Reduces resting potential, , 44. A 16-year-old-girl is found to have, paroxysmal attacks of rapid heart rate., The antiarrhythmic of choice in most cases, of acute AV nodal tachycardia is, (a) Adenosine, (c) Flecainide, (e) Quinidine, , (b) Amiodarone, (d) Propranolol, , 45. Recognized adverse effects of quinidine, include which one of the following?, (a), (b), (c), (d), (e), , Cinchonism, Constipation, Lupus erythematosus, Increase in digoxin clearance, Precipitation of hyperthyroidism, , 46. Following is an antagonist of ganglion, type nicotinic receptors, (a) Tubercurarine, (c) Trimethaphan, , (b) α-bungarotoxin, (d) All of the above, , 47. Which of the following is an orally active, drug that blocks sodium channels and, decreases action potential duration?, , 89, (a) Adenosine, (c) Disopyramide, (e) Mexiletine, , (b) Amiodarone, (d) Esmolol, , 48. Which of the following has the longest, half-life of all antiarrhythmic drugs?, (a) Adenosine, (c) Disopyramide, (e) Flecainide, , (b) Amiodarone, (d) Esmolol, , 49. Which of the following diuretics would, be most useful in a patient with cerebral, edema?, (a) Acetazolamide, (c) Ethacrynic acid, (e) Mannitol, , (b) Amiloride, (d) Furosemide, , 50. Which of the following therapies would, be most useful in the management of, severe hypercalcemia?, (a), (b), (c), (d), (e), , Amiloride plus saline infusion, Furosemide plus saline infusion, Hydrochlorothiazide plus saline infusion, Mannitol plus saline infusion, Spironolactone plus saline infusion, , 51. A 55-year-old patient with severe posthepatitis cirrhosis is started on a diuretic, for another condition. Two days later, he is found in a coma. The drug most, likely to cause coma in a patient with, cirrhosis is, (a), (b), (c), (d), (e), , Acetazolamide, Amiloride, Furosemide, Hydrochlorothiazide, Spironolactone, , 52. Oxytremorine is a selective agonist of, muscarinic _______ receptors, (a) M1, (c) M3, , (b) M2, (d) M4, , 53. A drug that is useful in glaucoma and, high-altitude sickness is, (a) Acetazolamide, (c) Demeclocycline, (e) Ethacrynic acid, , (b) Amiloride, (d) Desmopressin

Page 105 :
MCQs IN PHARMACOLOGY, , 90, 54. Cromolyn 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, (e) Stimulation of cortisol release by the adrenals, 55. Following events occur in the cytoplasm, and not inside storage vesicles, except, (a), (b), (c), (d), , Conversion of tyrosine to dopa, Conversion of dopa to dopamine, Conversion of dopamine to norepinephrine, Conversion of dopamine to 3,4 dihydroxy, phenyl acetic acid, , 56. Which one of the following is lest likely, to be useful in the therapy of hypercalcemia?, (a), (b), (c), (d), (e), , Calcitonin, Glucocorticoids, Plicamycin, Parenteral infusion of phosphate, Thiazide diuretics, , 57. Characteristics of Vitamin D and its, metabolites include which one of the, following?, (a) Act to decrease serum levels of calcium, (b) Activation of their Vitamin D receptors, increases cellular CAMP, (c) Calcitriol is the major derivative responsible, for increasing intestinal absorption of, phosphate, (d) Metabolites of Vitamin D increase renal, excretion of calcium, (e) Vitamin D deficiency results in Pager’s, disease, 58. Which of the following conditions is an, indication for the use of calcitonin?, (a), (b), (c), (d), (e), , Chronic renal failure, Hypoparathyroidism, Intestinal osteodystrophy, Pager’s disease, Rickets, , 59. Clinical uses of Vitamin D do not include, , (a), (b), (c), (d), (e), , Chronic renal failure, Hyperparathyroidism, Intestinal osteodystrophy, Nutritional rickets, Osteoporosis, , 60. Which one of the following drugs, when, used chronically, is associated with the, development of bone pain and mineralization defects such as osteomalacia?, (a), (b), (c), (d), (e), , Calcitonin, Dihydrotachysterol, Ergocalciferol, Etidronate, Norgestrel, , 61. A 70-year-old man has severe urinary, hesitancy associated with benign, prostatic hyperplasia. He has tried alpha, blockers with little relief. His physician, α recommends a drug that blocks 5α, reductase in the prostate and writes a, prescription for, (a) Atropine, (c) Hydralazine, (e) Propranolol, , (b) Clonidine, (d) Neostigmine, , 62. Action of norepinephrine and epinephrine, are terminated by, (a) Reuptake into nerve terminal, (b) Dilution by diffusion and uptake at extraneuronal site, (c) Metabolic transformation, (d) All of the above, 63. Typical results of beta-receptor activation, include which one of the following?, (a), (b), (c), (d), (e), , Hypoglycemia, Lipolysis, Glycogen synthesis, Decreased skeletal muscle tremor, Decreased rennin secretion, , 64. A patient is admitted to the emergency, room with orthostatic hypotension and, evidence of marked GI bleeding. Which, of the following most accurately describes, the probable autonomic response to this, bleeding?

Page 106 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, (a) Slow heart rate, dilated pupils, damp skin, (b) Rapid heart rate, dilated pupils, damp skin, (c) Slow heart rate, dry skin, increased bowel, sounds, (d) Rapid heart rate, constricted pupils,, increased bowel sounds, (e) Rapid heart rate, constricted pupils, warm, skin, 65. Drugs that block the α receptor on effector, cells at adrenergic nerve endings, (a) Antagonize the effects of isoproterenol on, the heart rate, (b) Antagonize some of the effects of, epinephrine on the blood pressure, (c) Antagonize the effects of epinephrine on, adenylyl cyclase, (d) Cause mydriasis, (e) Decreases blood glucose levels, 66. Yohimbine is an antagonist of ______, receptors., (a) α1, (c) both (a) and (b), , (b) α2, (d) None of the above, , 67. Which of the following organs is, innervated only by parasympathetic, nerves ?, (a) Iris muscles, (c) Sweat glands, , (b) Ciliary muscle, (d) Splenic capsule, , 68. Muscarinic cholinergic receptors, (a) Are located only on parasympathetically, innervated effector cells, (b) Mediate responses by opening an instrinsic, Na+ ion channel, (c) Are present on vascular endothelium which, has no cholinergic nerve supply, (d) Predominate in the autonomic ganglia, 69. The cardiac muscarinic receptors, (a), (b), (c), (d), , Are of the M1 subtype, Are of the M2 subtype, Are selectively blocked by pirenzepine, Function through the PIP 2 → IP 3/DAG, pathway, , 70. Atropine does not exert relaxant/ antispasmodic effect on the following muscle, , 91, (a) Intestinal, (c) Bronchial, , (b) Ureteric, (d) Layngeal, , 71. α 1 – receptors are coupled with _______, G protein., (a) Gs, (c) Gq, , (b) Gi, (d) Go, , 72. Hyoscine differs from atropine in that it, (a) Exerts depressant effects on the CNS at, relatively low doses, (b) Exerts more potent effects on the heart than, on the eye, (c) Is longer acting, (d) Has weaker antimotion sickness activity, 73. Which of the following anticholinergic, drugs is primarily used in preanaesthetic, medication and during surgery, (a), (b), (c), (d), , Glycopyrrolate, Pipenzolate methyl bromide, Isopropamide, Dicyclomine, , 74. Glycopyrrolate is the preferred antimuscannic drug for use before and during, surgery because, (a), (b), (c), (d), , It is potent and fast acting, It has no central action, It has antisecretory and vagolytic actions, All of the above, , 75. Which of the following mydriatics has the, fastest and briefest action ?, (a) Atropine, (c) Tropicamide, , (b) Homatropine, (d) Cyclopentolate, , 76. The most suitable mydratic for a patient, of corneal ulcer is, (a) Atropine sulfate, (c) Cyclopentolate, , (b) Homatropine, (d) Tropicamide, , 77. The most effective antidote for belladonna poisoning is, (a) Neostigmine, (c) Pilocarpine, , (b) Physostigmine, (d) Methacholine, , 78. Atropine is contraindicated in, (a) Cyclic AMP, (c) Diacyl glycerols, , (b) Inositol trisphosphate, (d) G protein

Page 107 :
MCQs IN PHARMACOLOGY, , 92, 79. Select the correct statement from the, following about α1 – adrenergic receptor, agonists, (a), (b), (c), (d), , Isoproterenol > epinephrine ≥ norepinephrine, Epinephrine > isoproterenol > norepinephrine, Isoproterenol = epinephrine ≥ norepinephrine, Epinephrine ≥ norepinephrine > isoproterenol, , 80. The most efficacious inhibitor of catecholamine synthesis in the body is, (a) α - methyl – p - tyrosine, (b) α - methyldopa, (c) α - methyl - norepinephrine, (d) Pyrogallol, 81. Tyramine induces release of noradrenaline, from adrenergic nerve endings, (a) By depolarizing the axonal membrane, (b) By mobilizing Ca2+, (c) By a nonexocytotic process, (d) Only in the presence of MAO inhibitors, 82. Choose the correct statement from the, following about α1 – adrenergic receptor, agonists, (a) Norepinephrine > isoproterenol > epinephrine, (b) Norepinephrine < epinephrine > isoproterenol, (c) Epinephrine ≥ norepinephrine >> isoproterenol, (d) Epinephrine > isoproterenol > norepinephrine, 83. A sympathomimetic amine that acts almost, exclusively by releasing noradrenaline, from the nerve endings is, (a) Ephedrine, , (b) Dopamine, , (c) Isoprenaline, , (d) Tyramine, , 84. Low doses of adrenaline dilate the, following vascular bed, (a) Cutaneous, (c) Renal, , (b) Mucosal, (d) Skeletal muscle, , 85. α 2–adrenergic receptors are associated, with following except, (a) Increase in phospholipase C activity, (b) Increase in potassium channel conductance, (c) Decrease in calcium channel conductance, (d) Increase in adenylyl cyclase activity, , 86. Adrenaline raises blood glucose level by, the following actions except, (a) Inducing hepatic glycogenolysis, (b) Inhibiting insulin secretion from pancreatic, β cells, (c) Augmenting glucagons secretion from, pancreatic α cells, (d) Inhibiting peripheral glucose utilization, 87. Noradrenaline is administered by, (a), (b), (c), (d), , Subcutaneous injection, Intramuscular injection, Slow intravenous infusion, All of the above routes, , 88. Dobutamine differs from dopamine in that, (a) It does not activate peripheral dopaminergic, receptors, (b) It does not activate adrenergic β receptors, (c) It causes pronounced tachycardia, (d) It has good blood-brain barrier penetrability, 89. Ephedrine is similar to adrenaline in the, following feature, (a), (b), (c), (d), , Potency, Inability to penetrate blood-brain barrier, Duration of action, Producing both α and β adrenergic effects, , 90. Continuous exposure of ctecholaminesensitive cells and tissues to adrenergic, agonists causes a progressive diminition, in their capacity to respond, this, phenomenon is called as, (a) Refractoriness, (c) Tachyphylaxis, , (b) Desensitization, (d) All of the above, , 91. While undergoing a surgical procedure, a patient develops hypotension. Which, of the following drugs can be injected, intramuscularly to raise his BP, (a) Noradrenaline, (c) Mephentermine, , (b) Isoprenaline, (d) Isoxsuprine, , 92. Vasoconstrictors should not be used in, (a), (b), (c), (d), , Neurogenic shock, Haemorrhagic shock, Secondary shock, Hypotension due to spinal anaesthesia

Page 108 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, 93. Guanethidine inhibits, (a), (b), (c), (d), , 93, 100. Phenylephrine, , Synthesis of transmitter, Metabolism of transmitter, Release of transmitter, Displacement of transmitter from axonal, terminal, , (a) Mimics the transmitter at post-synaptic, receptors, (b) Displaces transmitter from axonal terminal, (c) Inhibits synthesis of transmitter, (d) None of the above, , 94. The drug which produces vasoconstriction, despite being an α adrenergic blocker is, , 101. A β adrenergic blocker that is primarily, eliminated unchaged by renal excretion is, , (a), (b), (c), (d), , Phenoxybenzamine, Ergotamine, Dihydroergotoxine, Tolazoline, , 95. Prazosin is an effective antihypertensive, while nonselective α adrenergic blockers, are not because, (a) It is the only orally active α blocker, (b) It improves plasma lipid profile, (c) It does not concurrently enhance noradrenaline release, (d) It improves urine flow in males with prostatic, hypertrophy, 96. Which of the following is true of sildenafil, (a) It enhances sexul enjoyment in normal men, (b) It delays ejaculation, (c) It is indicated only for treatment of erectile, dysfunction in men, (d) It blocks cavernosal α2 adrenoceptors, 97. The β-adrenergic blocker which possesses, both β 1 selectivity as well as intrinsic, sympathomimetic activity is, (a) Alprenolol, (c) Acebutolol, , (b) Atenolol, (d) Metoprolol, , 98. Propanolol can be used to allay anxiety, associated with, (a), (b), (c), (d), , Chronic neurotic disorer, Schizopherenia, Short-term stressful situation, Endogenous depression, , 99. Propranolol does not block the following, action of adrenaline, (a) Bronchodilation, (c) Muscle tremor, , (b) Lipolysis, (d) Mydriasis, , (a), (b), (c), (d), , Propranolol, Metoprolol, Alprenolol, Atenolol, , 102. In a patient of myocardial infarction, β, adrenergic blockers are used with the, following aim/aims:, (a), (b), (c), (d), , To reduce the incidence of reinfarction, To prevent cardiac arrhythmias, Myocardial salvage, All of the above, , 103. Congential dopamine-β, β -hydroxylase, deficiency is characterized by, (a), (b), (c), (d), , Absence of norepinephrine and epinephrine, Increased concentration of dopamine, Intact cholinergic innervation, All of the above, , 104. The site of action of d-tubocurarine is, (a), (b), (c), (d), , Spinal internuncial neurone, Motor nerve ending, Muscle end-plate, Sodium channels in the muscle fiber, , 105. The fall in blood pressure caused by dtubocuranine is due to, (a), (b), (c), (d), , Reduced venous return., Ganglionic blockade, Histamine release, All of the above, , 106. The neuromuscular blocker having, prominent antivagal action is, (a), (b), (c), (d), , Pancuronium, Vecuronium, Atracurium, Gallamine triethiodide

Page 109 :
MCQs IN PHARMACOLOGY, , 94, 107. Neuromuscular blocking drugs do not, produce central actions because, (a) Nicotinic receptors are not present in the, brain, (b) They do not cross the blood-brain barrier, (c) They are sequestrated in the periphery by, tight binding to the skeletal muscles, (d) They do not ionize at the brain pH, 108. Pancuronium differs from tubocurarine in, that, (a), (b), (c), (d), , It is a depolarizing blocker, Its action is not reversed by neostigmine, It can cause rise in BP on rapid I.V. injection, It causes marked histamine release, , 109. Muscarinic receptors are G-protein, coupled receptors, causing, (a) Inactivation of phospholipase C, (b) Activation of adenylyl cyclase, (c) Activation of potassium or inhibition of, calcium channels, (d) All of the above, 110. Postoperative muscle soreness may be, side effect of the following neuromuscular, blocker, (a) d-tubocurarine, (c) Pancuronium, , (b) Succinylcholine, (d) Atracurium, , 111. Following drug enhances the evoked, release of acetylcholine, (a) 4-aminopyridine (b) Vesamicol, (c) Magnesium ion (d) None of the above, 112. Which of the following muscle relaxants, can be used to control spasticity associated, with upper motor neurone paralysis ?, (a) d-tubocurarine, (c) Mephenesin, , (b) Succinylcholine, (d) Baclofen, , 113. Following muscarinic agonist is susceptible to hydrolysis by cholinesterase, (a) Carbachol, (c) Bethanechol, , (b) Methacholine, (d) Muscarine, , 114. Dihydroergotamine differs from ergotamine in the following respect, , (a) It is a more potent oxytocic, (b) It has antiemetic property, (c) It is a less potent a adrenergic blocker but, more potent vasoconstrictor, (d) It is a more potent a adrenergic blocker and, less potent vasoconstrictor, 115. Select the ergot compound which is, primarily used for dementia, (a) Bromocriptine, (c) Codergocrine, , (b) Ergotamine, (d) Methysergide, , 116. The ‘amine’ ergot alkaloid differs from, ‘amino acid’ ergot alkaloids in that it has, (a), (b), (c), (d), , High oral bioavailability, Better CNS penetrability, Weaker oxytocic action, Strong anti – 5 – HT action, , 117. Select the correct statement in relation to, drug therapy of migraine, (a) Simple analgesics like paracetamol are, ineffective in migraine, (b) Ergot alkaloids are used for the prophylaxis, as well as treatment of migraine attacks, (c) Use of ergot alkaloids is restricted to severe, or resistant cases, (d) Ergot alkaloids should be given till 24 hours, after an attack has subsided, 118. Ergotamine relieves migraine by, (a), (b), (c), (d), , Blocking vascular a adrenergic receptors, Blocking vascular 5-HT2 receptors, Dilating cranial arterio-venous shunt channels, Constricting cranial vessels and reducing, perivascular neurogenic inflammation, , 119. Which of the following drugs is most commonly used for prophylaxis of migraine ?, (a) Ergotamine, (c) Methysergide, , (b) Propranolol, (d) Sumatripitan, , 120. Stimulation of exocrine glands by, muscarinic agonist leads to, (a), (b), (c), (d), , Sweating, Salivation, Bronchial secretions, All of the abvoe

Page 110 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, 121. Datura stramonium (thorn apple), mainly contains following muscarinic, antagonist, (a) Atropine, (c) Homatropine, , (b) Hyoscine, (d) Dicyclomine, , 122. β-blockers are contraindicated in, (a), (b), (c), (d), , Prophylaxis of anxiety states, Hyperthyroidism, Hypertrophic obstructive cardiomyopathy, Peripheral vascular disease, , 123. β-blockers are better avoided in, (a), (b), (c), (d), , Bronchial astham, Pheochromocytoma, Myocardial infarction, Migraine, , 124. Preferential beta1 adrenergic blocking, agent is, (a) Propranolol, (c) Penbutolol, , (b) Atenolol, (d) Oxprenolol, , 125. Prazosin, (a) Produces preferential alpha1 adrenergic, receptor blockade, (b) Has a half-life of 24 hours, (c) Can worsen lipid profile in hypertensive, patients, (d) Does not depress the baroreceptor function, 126. The organ extremely sensitive to the, action of atropine is, (a), (b), (c), (d), , Gastric glands, Salivary glands, Urinary bladder muscle, Heart, , 127. The antimuscarinic agent preferred in the, management of motion sickness is, (a), (b), (c), (d), , Atropine methonitrate, Scopolamine, Homatropine methyl bromide, Ipratropium bromide, , 128. Belladonna poisoning is best treated with, (a) Neostigmine, (c) Acetylcholine, , (b) Physostigmine, (d) Adrenaline, , 95, 129. The drug that produces neuromuscular, blockade by persistent depolarization is, (a) D-tubocurarine, (c) Pancuronium, , (b) Gallamine, (d) Decamethonium, , 130. Agents that block neuromuscular, transmission of acetyl choline acts via, (a) Inhibiting acetyl choline synthesis, (b) Inhibiting acetyl choline release, (c) Inhibiting post-synaptic action of acetyl, choline, (d) All of the above, 131. The skeletal muscle relaxant causing, significant release of histamine is, (a) Pancuronium, (c) Gallamine, , (b) Atracurium, (d) D-tubocurarine, , 132. The antibiotic that may accentuate the, neuromuscular blockade produced by dtubocurarine is, (a) Pencillin G, (c) Streptomycin, , (b) Erythromycin, (d) Chloramphenicol, , 133. Centrally acting skeletal muscle relaxant, is, (a) Carisoprodol, (c) Gallamine, , (b) Dantrolene, (d) Succinylcholine, , 134. β-blockers, (a), (b), (c), (d), , Relieve symptoms of thyrotoxicosis, Should not be used along with carbimiazole, Reduce the synthesis of hormones in the gland, Should not be given before thyroid surgery, , 135. Which of the following alpha adrenoceptor blockers is powerful and also has, longer duration of action ?, (a) Tolazoline, (c) Phentolamine, , (b) Phenoxybenzamine, (d) Chlorpromazine, , 136. Heart has beta as sympathetic and vagus as parasympathetic drive. If simultaneously both are blocked by beta, blocker and stropine, the heart will, (a), (b), (c), (d), , Stop, Beat with very slow rate, Beat with very fast rate, Beat at its intrinsic rate, about 100/min

Page 111 :
MCQs IN PHARMACOLOGY, , 96, 137. Side effect which is observed only with, the use of β blockers and not with other, sympathetic blocking agents, (a), (b), (c), (d), , Sedation and drowsiness, Congestive heart failure, Bronochoconstriction, Reflex tachycardia, , 138. Following agent inhibits the release of, acetyl choline, (a) Magnesium ion, , (b) Triethylcholine, , (c) Vesamicol, , (d) All of the above, , 139. What is composition of vagus nerve ?, (a) Entirely sensory, (b) Purely motor, (c) ¾ sensory ¼ motor, (d) ¼ sensory ¾ motor, 140. The ciliary muscle of iris has predominant, , (c) α1, (e) All of the above, , (d) α1, , 146. Which of the following drugs has highest, alfa agonist activity ?, (a) Epinephrine, (c) Ephedrine, , (b) Norepinephrine, (d) Amphetamine, , 147. Atropine is antagonist to which type of, muscarinic, (a) M1, (c) M3, , (b) M2, (d) M4, , 148. Following are irreversible anti-cholinesterases, except, (a) Parathion, , (b) Pyridostigmine, , (c) Dyflos, , (d) Ecothiopate, , 149. The order of paralysis with d-tubocuraine, is, (a) Fingers, Neck, Eyes, Limbs, Trunk Respiratory, , (a) Sympathetic inervation, (b) Parasympathetic inervation, (c) Somatic inervation, , (b) Neck, Limbs, Face, Eyes, Pharynx, Trunk, Respiratory, (c) Fingers, Eyes, Limbs, Neck, Trunk Respiratory, , (d) Mixture of all the above, , (d) Face, Eyes, Fingers, Neck, Limbs, Trunk, Respiratory, (e) None of the above, , 141. Following is a short-acting anti-cholinesterase, (a) Neostigmine, , (b) Pyridostigmine, , (c) Edrophonium, , (d) Physostigmine, , 142. Catecholamine D methyl tranferase is, found in all except, (a) Adrenergic neurone, (b) Brain, (c) Kidney, (d) None of the above, 143. β3 receptor is present in, (a) Adipose tissue, (c) Heart, , (b) Smooth muscle, (d) All of the above, , 144. b1 receptors are present in, (a) Liver, (c) Brain, , (b) Kidney, (d) None of the above, , 145. Activity of which adrenergic receptor is, linked to activation of G proteins, (a) β1, , (b) β, , 150. Following is a naturally occurring tertiary, amine anti-cholinesterase, (a) Edrophonium, (c) Pyridostigmine, , (b) Neostigmine, (d) Physostigmine, , 151. Which of the following sympathomimetic, drugs is a non –catecholamine ?, (a) Adrenaline, , (b) Noradrenaline, , (c) Isoprenaline, (e) All of the above, , (d) Ephedrine, (f) None of the above, , 152. Which of the following β – adrenoceptor, blocker is the least lipid soluble ?, (a) Propanolol, (c) Oxprenolol, (e) All of the above, , (b) Atenolol, (d) Metoprolol, (f) None of the above, , 153. Propanolol is contraindicated / not, beneficial in, (a) Parkinsonism tremors

Page 112 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, (b) Bronchial asthma, (c) Insulin – treated diabetes, (d) All of the above, (e) None of the above, 154. Which of the following adrenoreceptor, antagonists has partial agonist activity, and also membrane stabilizing activity, (a) Propanolol, (c) Oxprenolol, (e) All of the above, , (b) Atenolol, (d) Metoprolol, (f) None of the above, , 155. Which of the following indirectly acting, sympathomimetics is an uptake-1, inhibitor ?, (a) Tyramine, (b) Amphetamine, (c) Ephedrine, (d) All of the above, (e) None of the above, 156. Which of the following drugs is used in, cardiogenic shock ?, (a) Noradrenaline, (c) Isoprealine, , (b) Adrenaline, (d) Dobutamine, , (e) Salbutamol, 157. Pseudo-cholinesterase is present in, (a) Membrane, (c) Synaptic cleft, , 97, (e) All of the above, , 161. Following agent reduces the transmitter, release by blocking nerve terminal, calcium channels, (a) Botulinum toxin, (c) ω-conotoxin, , (b) β-bungarotoxin, (d) All of the above, , 162. Atropine in doses of 2.0mg to 5.0mg may, cause, (a) Increased heart rate, (b) dryness of mouth, (c) Dilated pupils, (d) Difficulty in micturition, (e) Reduced intestinal peristalsis, (f) All of the above, (g) None of the above, 163. Chemically following anti-cholinesterase, is an alcohol, (a) Ambenonium, (c) Ecothiophate, , (b) Edrophonium, (d) None of the above, , 164. Which of the following â-adrenoceptor, blockers has the minimal hepatic, biotransformation ?, , (b) Vesicles, , (a) Atenolol, , (b) Labetalol, , (d) Plasma and tissue, , (c) Metoprolol, (e) Sotalol, , (d) Propranolol, , 158. Which of the following drugs is used as, inhalation as a bronchodilator and may, be used when cough is a pronounced, symptom in asthmatic patient ?, , 165. Which of the following β –adrenoceptor, blockers is the drug of choice for, treatment of essential tremors ?, , (a) Atropine, (c) Ipratropium, , (b) Homtropine, (d) Tropicamide, , (a) Propranolol, (c) Timolol, , (e) All of the above, , (f) None of the above, , (e) All of the above, , 159. Activation of sympathetic system leads, to _________ except, (a), (b), (c), (d), , (f) None of the above, , Contraction of bronchial smooth muscles, Gluconeogenesis, Glycogenolysis, Contraction of radial smooth muscle of iris, , 160. Which of the following antimuscarinic, drugs is short acting mydriatic ?, , (b) Nadolol, (d) Atenolol, (f) None of the above, , 166. Which of the following â-adrenoceptor, blockers is used as anti-glaucoma agent, (a) Propranolol, (c) Timolol, (e) All of the above, , (b) Nadolol, (d) Atenolol, (f) None of the above, , 167. Concurrent use of atropine will interfere, with the anti-glaucoma action of, , (a) Atropine, , (b) Homatropine, , (a) Pilocarpine, (c) Carbachol, , (b) Physostigmine, (d) All of the above, , (c) Ipratropium, , (d) Tropicamide, , (e) None of the above

Page 113 :
MCQs IN PHARMACOLOGY, , 98, 168. To reduce the muscarinic side effects of, oral forms of cholinesterase inhibitors, they should be administered, (a), (b), (c), (d), , On empty stomach, With food, With milk, One hour after food, , (e) With food or milk, 169. Which of the following cholinesterase, inhibitors is said to produce more severe, muscarinic side effects, (a) Pyridostigmine, (c) Ambenonium, , (b) Neostigmine, (d) All of the above, , (e) None of the above, 170. Which of the following cholinesterase, inhibitors is preferred in patients, hypersensitive to the bromide ion ?, (a) Pyridostigmine, (b) Neostigmine, (c) Ambenonium, (d) All of the above, (e) None of the above, 171. Following is a synthetic analogue of, atropine, used as an inhalational drug in, asthma, (a) Benztropine, (c) Ipratropium, , (b) Pirenzepine, (d) All of the above, , 172. All the cholinomimetic alkaloids except, one which is a choline ester, (a) Pilocarpine, (c) Muscarine, , (b) Carbachol, (d) Arecoline, , 173. Which one of the following β – blockers, has reduced risk of bronchospasm ?, (a) Propranolol, (c) Pindolol, , (b) Atenolol, (d) None of the above, , 174. Metoprolol is a cardioselective beta blocker (relatively selective beta1 – blocker), (a) With membrane stabilizing effect and with, partial agonist effect, (b) Without membrane stabilizing effect and with, partial agonist effect, , (c) Without membrane stabilizing effect and, without partial agonist effect, (d) With membrane stabilizing effect, partial, agonist effect and direct vasodilator activity, 175. Phenylephrine is useful as, (a) Mydriatic to facilitate examination of retina, (b) Decongestant for minor allergic hyperemia, of conjunctival membranes, (c) A drug in localizing the lesion in Horner’s, Syndrome, (d) All of the above, (e) None of the above, 176. d-Amphetamine is not used in, (a) Narcolepsy, (b) Hyperkinetic child (specilly attention deficit, disorder), (c) Migraine, (d) Child appetite suppressant, 177. Following is a tertiary amine anti-muscarinic drug used for Parkinson’s disease, (a) Benztropine, (c) Pirenzepine, , (b) Dicyclomine, (d) Tropicamide, , 178. d-Amphetamine has most prominent, (a), (b), (c), (d), (d), , Beta1 effects, Beta2 effects, Metabolic effects, CNS excitatory effects, None of the above, , 179. Phenylephrine has most prominent, (a), (b), (c), (d), (e), , Alpha1 effects, Beta1 effects, Beta2 effects, Metabolic effects, CNS excitatory effects, , 180. Following is a tertiary amine anti-muscarinic drug mainly used for mydriatic or, cycloplegic action, (a) Benztropine, (c) Pirenzepine, , (b) Dicyclomine, (d) Trpicamide

Page 114 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, , 99, , ANSWERS, 1. d, , 2. c, , 3. c, , 4. b, , 5. a, , 6. d, , 7. c, , 8. b, , 9. c, , 10. e, , 11. d, , 12. a, , 13. b, , 14. b, , 15. c, , 16. a, , 17. b, , 18. b, , 19. b, , 20. e, , 21. c, , 22. c, , 23. b, , 24. b, , 25. a, , 26. b, , 27. d, , 28. a, , 29. e, , 30. c, , 31. d, , 32. e, , 33. a, , 34. b, , 35. d, , 36. c, , 37. e, , 38. b, , 39. b, , 40. a, , 41. a, , 42. a, , 43. d, , 44. a, , 45. a, , 46. c, , 47. e, , 48. b, , 49. e, , 50. b, , 51. a, , 52. a, , 53. a, , 54. b, , 55. c, , 56. e, , 57. c, , 58. d, , 59. b, , 60. d, , 61. b, , 62. d, , 63. b, , 64. b, , 65. b, , 66. b, , 67. b, , 68. c, , 69. b, , 70. d, , 71. c, , 72. a, , 73. a, , 74. d, , 75. c, , 76. a, , 77. b, , 78. d, , 79. a, , 80. a, , 81. c, , 82. c, , 83. d, , 84. d, , 85. d, , 86. d, , 87. c, , 88. a, , 89. d, , 90. d, , 91. c, , 92. c, , 93. c, , 94. b, , 95. c, , 96. c, , 97. c, , 98. c, , 99. d, , 100. a, , 101. d, , 102. d, , 103. d, , 104. c, , 105. d, , 106. d, , 107. b, , 108. c, , 109. c, , 110. b, , 111. a, , 112. d, , 113. b, , 114. d, , 115. c, , 116. a, , 117. c, , 118. d, , 119. b, , 120. d, , 121. b, , 122. d, , 123. a, , 124. b, , 125. a, , 126. b, , 127. b, , 128. b, , 129. d, , 130. d, , 131. d, , 132. c, , 133. a, , 134. a, , 135. b, , 136. d, , 137. a, , 138. a, , 139. c, , 140. b, , 141. c, , 142. a, , 143. a, , 144. b, , 145. e, , 146. a, , 147. a, , 148. b, , 149. c, , 150. d, , 151. d, , 152. b, , 153. d, , 154. c, , 155. b, , 156. d, , 157. d, , 158. c, , 159. a, , 160. d, , 161. c, , 162. f, , 163. b, , 164. a, , 165. a, , 166. c, , 167. d, , 168. e, , 169. b, , 170. c, , 171. c, , 172. b, , 173. b, , 174. c, , 175. d, , 176. c, , 177. a, , 178. d, , 179. a, , 180. d

Page 115 :
MCQs IN PHARMACOLOGY, , 100, , EXPLANATIONS FOR THE ANSWERS, 2. d, , 9. c, , 13. b, , 16. a, , 21. c, 30. c, , 31. d, , 39. b, , 40. a, , The autonomic nervous system consists of, sympathetic, parasympathetic and enteric, nervous systems. Hence, the ANS is also called, as visceral, vegetative or involuntary nervous, system., The sympathetic preganglionic neurons have, their cell bodies in the lateral horn of the grey, matter of thoracic and lumbar segments of the, spinal cord. The fibers leave the spinal cord in, the spinal nerve as thoracolumbar sympathetic, outflow., In male reproductive system, the sympathetic, nervous system is responsible for ejaculation, (α-receptors), and parasympathetic nervous, system is responsible for erection via. Muscarinic, receptors., Sympathetic system is active and parasympathetic, system is quiescent in ‘fight or flight’ response, i.e. stress., Parasympathetic system predominates during, satiation and repose i.e. ‘rest and digest’, response., See explanation of Q. 16, Sympathetic system increases rate of SA node,, cause contraction of coronary arteries and, constriction of sphincters in GIT., Sympathetic system relaxes the smooth muscles, of GIT, thus decreases the motility., If a nerve is cut and its terminal are allowed to, degenerate, the organ or tissue supplied by it, becomes supersensitive to the neurotransmitter, released by the nerve terminal. This is called as, denervation super-sensitivity and it involves, various mechanisms such as proliferation of, receptors, loss of mechanism of transmitter, removal and increased post-junctional, responsiveness., At rest, the interior of the typical mammalian, neuronal axon potential is approximately – 70, mV. It is essentially a diffusion potential based, on high potassium inside and high sodium and, chloride outside the axon. Axonal membrane is, relatively more permeable to potassium than, sodium and chloride ions., Acetylcholine is synthesized from acetyl-CoA, and choline through the catalytic action of, , 46. c, , 52. a, , 55. c, , 62. d, •, •, •, 66. b, , 71. c, , 79. a, , 82. c, , cholineacetyltransferase., Acetylcholinesterase splites the acetylcholine into, choline and acetate., There are three types of nicotinic receptors –, muscle type, ganglion type and CNS type., Trimethaphan is an antagonist of ganglion type, nicotinic receptors., Tubocurarine is an antagonist of muscle type, and α-bungarotoxin is an antagonist of CNS, type nicotinic receptor., Oxytremorine is a selective agonist of M1, muscarinic receptors present in autonomic, ganglia., Pirenzepine is an antagonist of these receptors., Coversion of tyrosine to dopa, dopa to dopamine, and dopamine to 3, 4 dihydorxyphenyl acetic, acid occurs in the cytoplasm., Dopamine α hydorxylase, which converts, dopamine to norepinephrine, is present in, storage vesicles. Hence conversion of dopamine, to norepinephrine occurs in storage vesicles and, not cytoplasm., Actions of norepinephrine and epinephrine are, terminated by:, Reuptake into nerve terminals., Dilution by diffusion out of the junctional cleft, and uptake by extraneuronal sites., Metabolic transformation by monoamine oxide, and catechol –O-methyltransferase., Yohimbine is an antagonist of α2-receptors, present in nerve terminals, platelets and, pancreatic β-cells. Clonidine is an agonist of, these receptors., α1 – Receptors are coupled with Gq G- proteins, and the biochemical affect is increased in either, phospholipase C, D or A2 activity and/or, opening of calcium channels., The affinity of β1 – adrenergic receptors can be, shown as :, Isoproterenol > Epinephrine = Norepinephrine, The specific agonist of this receptor is, dobutamine and specific antagonist is, metoprolol., The affinity of α1 – adrenergic receptors can be, shown as:

Page 116 :
DRUGS ACTING ON AUTONOMOUS NERVOUS SYSTEM, , 85. d, •, •, •, •, 90. d, , 93. c, , 100. a, , 103. d, , 109. c, •, •, •, 111. a, , 113. b, , Epinephrine ≥ Norepinephrine >> Isoproterenol, Phenylephrine is a specific agonist and prazocin, is a specific antagonist of this receptor., Activation of α 2 – adrenergic receptors is, associated with:, Increase in phospholipase activity., Increase in potassium channel conductance., Decrease in calcium channel conductance, Decrease (and not increase in adenylyl cyclase, activity., Refractoriness, desensitization or tachchyphylaxis, describes the same phenomenon. Because of this,, the duration of action and therapeutic efficacy, of catecholamines and other agents is, significantly limited., Guanethidine inhibits the release of transmitter., Another agent, which also inhibits the release, of transmitter, is bretylium., Synthesis of transmitter is inhibited by α-methyl, tyrosine., Metabolism of transmitter is inhibited by, pargyline and tranylcypromine. Amphetamine, and tyramine cause displacement of transmitter, from axon terminals., Phenylephrine is an agonist of α1-adrenergic, receptor and it mimics the transmitter at postsynaptic receptors, producing sympathomimetic, effect., Congenital dopamine β hydroxylase deficiency, is characterized by absence of norepinephrine, and epinephrine, increased concentration of, dopamine and intact cholinergic innervation., These patients suffer from severe postural, hypotension and other symptoms., Muscarinic receptors are G protein coupled, receptors, causing:, Activation of potassium or inhibition of calcium, channels., Activation of phospholipase C, Inhibition of adenylyl cyclase, 4-Aminopyridine enhances the evoked release, of acetylcholine., Vesamicol blocks the transport of acetylcholine, into storage vesicles., Magnesium ions block the calcium entry and, thus inhibit the release of acetylcholine., Methacholine, although three times more, , 101, , 120. d, , 121. b, , 130. d, •, •, •, 138. a, , 141. c, , 148. b, , 150. d, , 157. d, , 159. a, •, , resistant than acetylcholine, is susceptible to, hydrolysis by cholinesterase., Carbachol and bethanechol are completely, resistant to hydrolysis by cholinesterase., Muscarine is not metabolized by cholinesterase., Muscarinic agonists stimulate the secretory, activity of sweat, lacrimal, salivary and, nasopharyngeal glands and hence lead to, increased sweating, salivation and bronchial, secretions., Datura stramonium mainly contains atropine., Hyoscine (scopolamine)is mainly found in, Hyoscymus niger., Homatropine is a semisynthetuic derivative., Dicyclomine is a synthetic derivative., Blockers of neuromuscular transmission of, acetylcholineact via various mechanisms:, Inhibition of acetylcholine synthesis., Inhibition of acetylcholine release., Inhibition of postsynaptic action of acetylcholine., Magnesium inhibits the entry of calcium into, the nerve terminal and thus inhibits the, exocytosis and hence release of acetylcholine., Triethylcholine inhibits the transport of choline, into the nerve terminal., Vesamicol inhibits the transport of acetylcholine, into synaptic vesicles., Edrophonium is a short-acting anticholinesterase. It is mainly used in the diagnosis of myasthenia gravis., Neostigmine, pyridostigmine and physostigmine, are medium duration anticholinesterase., Pyridostigmine is a medium duration anticholinesterase. Parathion, dyflos and ecothiopate, are irreversible anticholinesterase., Physiostigmine is a naturally occurring tertiary, amine anticholinesterase., Edrophonium, neostigmine and pyridostigmine, are quaternary ammonium compounds., Pseudocholinesterase (or butyrylcholinesterase), is widely distributed in tissues e.g. liver, skin, brain, and gastrointestinal smooth muscles. It is also, present in soluble form in plasma. However, it is, not present in synaptic cleft, vesicles or membrane., Activation of sympathetic system lead to;, Relaxation (and not contraction) of bronchial, smooth muscles.

Page 117 :
MCQs in Pharmacology, , 102, •, •, •, 161. c, , 163. b, , 171. c, , Gluconeogenesis., Glycogenolysis, Contraction of radial smooth muscle of iris., ω-Conotoxin is an inhibitor of nerve terminal, calcium channels and thus reduces the, transmitter release., Botulinum toxin and β-bungarotoxin reduce, transmitter release by cleaving specific proteins, involved in the exocytosis., Edrophonium is an anticholinesterase and is, chemically an alcohol. It has - OH group, attached to a benzene ring. Ambenonium is a, bis-quaternary compound and ecothiophate is, an organophosphate anti-cholinesterase., Ipratropium is a synthetic analogue of atropine, , 177. a, , 180. d, , and is used as an inhalational drug in the, treatment of asthma., Benzotropine is efficacious in preventing, dystonia or parkinsonian symptoms., Pirenzepine is used as an anticular agent., Benzotropine is the only antimuscarinic drug, with profound CNS effects and hence it is used, for the treatment of the Parkinson’s disease., Tropicamide is mainly used for mydriatic or, cycloplegic action., Dicyclomine is antispasmodic., Pirenzepine is anticular agent., Benzetropine is used in the treatment of, Parkinson’s disease.

Page 118 :
VITAMINS & MINERALS, , 103, , CHAPTER 4, VITAMINS & MINERALS, , 1. Thiamine is vitamin, (a) B1, (c) B6, , (b) B2, (d) B12, , 2. The iron stored in intestinal mucosal cells, is complexed to, (a) Ferritin, (c) Oprelvekin, (e) Transferrin, , (b) Intrinsic factor, (d) Transcobalamin II, , 3. Which of the following is most likely to, be required by a 5-year-old boy with, chronic renal in sufficiency?, (a) Erythropoietin, (c) Interleukin - 11, (e) Thrombopoietin, , (b) G-CSF, (d) Stem cell factor, , 4. in adults, approximately ______ mg of, thiamine per day is completely degraded, by the tissue, (a) 0.01, (c) 1, , (b) 0.1, (d) 10, , 5. The drug of choice for the management, of osteoporosis caused by high-dose use, of glucocorticoids is, (a) Alendronate, (c) Mestranol, (e) Vitamin D, , (b) Calcitonin, (d) Oxandrolone, , 6. Which of the following drugs is correctly, associated with its clinical application?, , (a) Erythropoietin : Macrocytic anemia, (b) Filgrastim : Thrombocytopenia due to, myelocytic leukemia, (c) Iron dextran : Severe macrocytic anemia, (d) Ferrous sulfate : Microcytic anemia of, pregnancy, (e) Folic acid : Hemochromatosis, 7. Conversion of methionine to cysteine, depends on vitamin, (a) B1, (c) B6, , (b) B2, (d) B12, , 8. Avidin, a protein found in egg white is, an antagonist of, (a) Biotin, (c) Choline, , (b) Pantothenic acid, (d) Pyridoxal, , 9. All of the following are important, functions of magnesium (Mg), except, (a), (b), (c), (d), , Nerve conduction, Phospholipid synthesis, Muscle contractility, Carbohydrate, fat, and electrolyte metabolism, , 10. Factors likely to cause an increase in the, blood urea nitrogen (BUN) level include, (a) Intramuscular (IM)injection of diazepam, (Valium), (b) Severe liver disease, (c) Chronic kidney disease

Page 119 :
MCQs IN PHARMACOLOGY, , 104, 11. Physiologically carnitine plays following, role, , 18. The gut controls the entry of ingested iron, in the body of, , (a) Important for oxidation of fatty acids, (b) Decreases aerobic metabolism of carbohydrates, (c) Decreases rate of oxidative phosphorylation, (d) All of the above, , (a) Regulating the availability of apoferritin, which acts as the carrier of iron across the, mucosal cell, (b) Regulating the turnover of apoferritin-ferritin, interconversion in the mucosal cell, (c) Complexing excess iron to form ferritin which, remains stored in the mucosal cell and is shed, off, (d) Regulating the number of transferring, receptors on the mucosal cell, , 12. Patients receiving iron therapy should be, warned about, (a), (b), (c), (d), (e), , Dizziness, Ringing in the ears, Danger of sunlight, Blackening of the stool, Paresthesia, , 13. Therapeutically vitamin B1 has been, employed most successfully in the, treatment of, (a), (b), (c), (d), (e), , Microcytic anemia, Pellagra, Scurvy, Beriberi, Macrocytic anemia, , 14. Magnesium ion is necessary in, (a), (b), (c), (d), (e), , Stimulating enzyme systems, Muscular contraction, Nerve conduction, All of the above, None of the above, , 15. The following derivatives of retinal shows, the greatest biological potency than, others, (a) 9-Cis-retinoic acid (b) All-trans-retinoic acid, (c) All-trans-retinol, (d) 11-Cis-retinal, 16. The drug used for controlling tetany is, (a), (b), (c), (d), , Intravenous diazepam, Intramuscular vitamin D, Intravenous calcium gluconate, Intravenous calcitonin, , 17. Absorption of oral iron preparations can, be facilitated by coadministering, (a) Antacids, (c) Phosphates, , (b) Tetracyclines, (d) Ascorbic acid, , 19. The percentage of elemental iron, hydrated ferrous sulfate is, (a) 5%, (c) 20%, , (b) 10%, (d) 33%, , 20. In isolated fibroblast or epithelial cells,, retinoids enhance the synthesis of, following protein, (a), (b), (c), (d), , Fibronectin, Collagenase, Certain species of keratin, All of the above, , 21. The side effect which primarily limits, acceptability of oral iron therapy is, (a), (b), (c), (d), , Epigastric pain and bowel upset, Black stools, Staining of teeth, Metallic taste, , 22. Iron sorbitol-citric acid differs from iron, dextran in that, (a), (b), (c), (d), , It cannot be injected i.v., It is not excreted in urine, It is not bound to transferritin in plasma, It produces fewer side effects, , 23. Which of the following is true about iron, therapy ?, (a) Haemoglobin response to intramuscular iron, is faster than with oral iron therapy, (b) Iron must be given orally except in pernicious, anaemia, (c) Prophylactic iron therapy must be given, during pregnancy

Page 120 :
VITAMINS & MINERALS, , 105, , (d) Infants on breast feeding do not require, medicinal iron, 24. Concentrations of retinal in plasma in, excess of _____ µ g/dl usually are, diagnostic of hypervitaminosis A, (a) 10, (c) 100, , (b) 50, (d) 200, , 25. Megaloblastic anaemia occurs in, (a), (b), (c), (d), , Vitamin B12 but not folic acid deficiency, Folic acid but not Vitamin B12 deficiency, Either Vitamin B12 or folic acid deficiency, Only combined Vitamin B12 + folic acid, deficiency, , 26. The daily dietary requirement of Vitamin, B12 by an adult is, (a) 1–3 µg, (c) 0.1–0.5 µg, , (b) 50–100 µg, (d) 1–3 µg, , 27. Which of the following factor(s) is/are, required for the absorption of Vitamin B12, ingested in physiological amounts ?, (a), (b), (c), (d), , Gastric acid, Gastric intrinsic factor, Transcobalamine, Both (a) and (b), , 28. Hydroxocobalamine differs from cyanocobalamine in that, (a) It is more protein bound and better retained, (b) It is beneficial in tobacco amblyopia, (c) It benefits haematological but not neurological, manifestations of Vit B12 deficiencey, (d) Both (a) and (b), 29. Megaloblastic anemia is caused by, deficiency of, (a) Iron, (c) Vitamin C, , (b) Vitamin B12, (d) All of the above, , 30. Vitamin B12 is a required co-factor for, the following reaction, (a) Conversion of methylmalonyl-CoA to succinylCoA, (b) Conversion of 5-CH3-H4-folate to H4-folate, , (c) Conversion of homocysteine to methionine, (d) All of the above, 31. Vitamin K is indicated for the treatment, of bleeding occurring in patients, (a) Being treated with heparin, (b) Being treated with streptokinase, (c) Of obstructive jaundice, (d) Of peptic ulcer, 32. Menadione (Vitamin K3), (a) Can cause hemolysis in patients with G-6-PD, deficiency, (b) Is given in large doses in patients with severe, liver disease, (c) Is useful to prevent haemorrhagic disease of, the newborn, (d) Is the preparation of choice to antagonize, the effect of warfarin overdose, 33. Vitamin K promotes the hepatic biosynthesis, of following blood clotting factor, (a) Factor I, , (b) Factor II, , (c) Factor VIII, , (d) All of the above, , 34. folinic acid is principally used, (a) In pernicious anaemia, (b) In megaloblastic anaemia secondary to, Vitamin B12, (c) Along with methotrexate therapy, (d) In treatment of folic acid deficiency, 35. Penicillamine, (a) Is effective orally, (b) Can cause anaphylactic reactions in patients, allergic to penicillin, (c) Is safe in pregnancy, (d) Is not effective in lead poisoning, 36. Succimer, (a) Can significantly mobilize essential metals, (b) Produces less toxicity than Dimercaprol, (c) Is ineffective orally, (d) Is contraindicated in children

Page 121 :
MCQs IN PHARMACOLOGY, , 106, Answer, 1. c, 7. c, 13. d, 19. c, 25. c, 31. c, , 2. a, 8. a, 14. d, 20. a, 26. a, 32. a, , 3. a, 9. b, 15. c, 21. a, 27. d, 33. b, , 4. c, 10. c, 16. c, 22. a, 28. d, 34. c, , 5. a, 11. a, 17. d, 23. c, 29. b, 35. a, , 6. d, 12. d, 18. c, 24. c, 30. d, 36. b, , EXPLANATIONS FOR THE ANSWERS, 1. a, , 4. c, , 7. c, , 8. a, , 11. a, •, •, •, •, 15. c, , 20. a, , Thiamine is vitamin B1 and was the first member, of vitamin B complex to be identified. Vitamin B6, – Pyridoxine, pyridoxal and pyridoxamine. Medically used vitamin B12 is hydroxycobalamine., Vitamin B2 is riboflavin, In adults, approximately 1 mg of thiamine per, dayis completely degraded by the tissues and, 1mg is roughly the minimal daily requirement, of thiamine., Conversion of methionine to cysteine depends, on vitamin B6. Vitamin B1, B2 and B12 do not, play any role in this conversion. Vitamin B6 is, also involved in various metabolic transformations of amino acids e.g. decarboxylation, transamination and racemization., Avidin, a protein found in egg white, is an, antagonist of biotin. Avidin is a glycoprotein, and it binds with biotin with great affinity and, thus prevents its absorption., Carnitine has several physiological roles:, It is important for oxidation of fatty acids., It increases aerobic metabolism of carbohydrates., It increases rate of oxidative phosphorylation., It enhances the excretion of certain organic, acids., Of all known derivatives of retinal, all-transretinol (and its aldehyde, retinal) has the greatest, biological potency., In isolated fibroblasts and epithelial cells,, retinoids enhance the synthesis of fibronectin, , 24. c, , 29. b, , 30. d, •, , •, , 33. b, , and reduce the synthesis of collagen and certain, species of keratin. These effects are mediated, by change in the nuclear transcription., Retinoic acid is more potent than retinal in, mediating these effects., Concentrations of retinal in plasma in excess of, 100µg/dl. usually are diagnostic of hypervitminosis, A. Such hypervitaminosis is generally seen during, the therapeutic use of retinoids in the treatment of, skin disorders., Megaloblastic anemia is caused by deficiency, of vitamin B12. It is characterized by macocytic, anemia, mild to moderate leukopenia and/or, thrombocytopenia, hypercellular bone marrow, with megaloblastic maturation or erythroid and, other precursor cells., Vitamin B12 is a cofactor for various biochemical, reactions:, Conversion of methylmalonyl CoA to succinyl CoA., This reaction requires deoxyadenosylcobolamin, as a cofactor., Conversion of 5-methyl tetrahydrofolate to, tetrahydro-olate and conversion of homocysteine, to methionine. These two reactions use, methylcobolamine as a cofactor., Vitamin K promotes the hepatic biosynthesis of, factor II (prothrombin)and also factors VII, IX, and X., Vitamin K does not play important role in the, biosynthesis of factors I and VIII.

Page 122 :
ANALGESICS & ANTIPYRETICS, , 107, , CHAPTER 5, ANALGESICS & ANTIPYRETICS, , 1. â-Aminoethylimidazole is?, (a), (b), (c), (d), , 2-methyl histamine, Histamine, 2-pyridyl ethylamine, 4-methyl histamine, , 2. Agents that often cause vasoconstriction, include all of the following except, (a) Angiotensin II, (c) PGF2α, (e) Thromboxane, , (b) Methysergide, (d) Prostacyclin, , 3. 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), (b), (c), (d), (e), , Cyclooxygenase 1, Cyclooxygenase 2, Glutathione – S – transferase, Lipoxygenase, Phospholipase A2, , 4. A 60-year-old woman has glaucoma, following cataract surgery. Which of the, following can be used to reduce, intraocular pressure?, (a) Leukotriene LTD4 or its analogs, (b) Prostaglandin E2 or its analogs, (c) Prostaglandin F2α or its analogs, , (d) Slow-reacting substance of anaplylaxis, (SRS-A), (e) Thromboxane A2 or its analogs, 5. Which of the following is a reversible, inhibitor of platelet cyclooxygenase?, (a) Alprostadil, (c) Ibuprofen, (e) Misoprostol, , (b) Aspirin, (d) LTC4, , 6. Vasodilation by prostaglandins involves, (a), (b), (c), (d), , Arterioles, Precapillary sphincters, Postcapillary venules, All of the above, , 7. Fentanyl transdermal patches have been, used postoperatively to provide transdermal analgesia. The most dangerous, adverse effect of this mode of administration is, (a), (b), (c), (d), (e), , Cutaneous reactions, Diarrhea, Hypertension, Relaxation of skeletal muscle, Respiratory depression, , 8. Opioid analgesics are either contraindicated, or must be used with extreme caution in, several clinical situations. For morphine,, such situations do not include, (a) Aqueous diffusion

Page 123 :
MCQs IN PHARMACOLOGY, , 108, (b), (c), (d), (e), , Aqueous hydrolysis, Lipid diffusion, Pinocytosis or endocytosis, Special carrier transport, , 9. Following is an example of paraaminophenol NSAID, (a) Diclofenac, (c) Piroxicam, , (b) Acetaminophen, (d) Celecoxib, , 10. This drug, which does not activate opioid, receptors, has been proposed as a, maintenance drug in treatment programs, for opioid addicts; a singly oral dose will, block the effects of injected heroin for up, to 48 hours, (a) Amphetamine, (c) Naloxone, (e) Propoxyphene, , (b) Buprenorphine, (d) Naltrexone, , 11. Which one of the following statements, about dextromethorphan is accurate?, (a), (b), (c), (d), (e), , Activates kappa receptors, Analgesia equivalent to pentazocine, Highly effective antiemetic, Less constipation than codeine, Use requires a prescription, , 12. Which one of the following effects does, not occur in salicylate intoxication ?, (a), (b), (c), (d), (e), , Hyperventilation, Hypothemia, Metabolic acidosis, Respiratory alkalosis, Tinnitus, , 13. Which one of the following drugs is not, useful in dysmenorrhea?, (a) Aspirin, (c) Ibuprofen, (e) Naproxen, , (b) Colchicine, (d) Rofecoxib, , 14. Following gold compound is generally, administered orally, (a), (b), (c), (d), , Aurothioglucose, Auronafin, Gold sodium thiomalate, All of the above, , 15. The main advantage of ketorolac over, aspirin is that ketorolac, (a) Can be combined more safely with an opioid, such as codeine, (b) Can be obtained as an over-the-counter agent, (c) Does not prolong the bleeding time, (d) Is available in a parenteral formulation, that can be injected intramuscularly or, intravenously, (e) Is less likely to cause acute renal failure in, patients with some preexisting degree of, renal impairment, 16. A 45-year-old surgeon has developed, symmetric early morning stiffness in her, hands. She wishes to take a nonsteroidal, anti-inflammatory drug to relieve these, symptoms and wants to avoid gastrointestinal side effects. Which one of the following drugs is most appropriate?, (a) Aspirin, (c) Ibuprofen, (e) Piroxicam, , (b) Celecoxib, (d) Indomethacin, , 17. Following is an example of preformed, and not lipid derived mast cell mediator, of inflammatory process, (a) LTC4, (c) PAF, , (b) PGD2, (d) Histamine, , 18. The toxicity spectrum of aspirin does not, include, (a) Increased risk of encephalopathy in children, with viral infections, (b) Increased risk of peptic ulcers, (c) Hyperprothrombinemia, (d) Metabolic acidosis, (e) Respiratory alkalosis, 19. Accidental poisonings are common with, both aspirin and ibuprofen, two OC drugs, available in tasty chewable tablets. In, cases of overdose, aspirin is more likely, than ibuprofen to cause, (a), (b), (c), (d), (e), , Autonomic Instability, Hepatic necrosis, Metabolic acidosis, Thrombocytopenia, Ventricular arrhythmias

Page 124 :
ANALGESICS & ANTIPYRETICS, , 109, , 20. A drug that decreases blood pressure and, has analgesic and spasmolytic effects, when given intrathecally is, (a) Atenolol, (c) Morphine, (e) Prazosin, , (b) Clonidine, (d) Nitroprusside, , 21. Cyclooxygenase-1 and –2 are responsible, for, (a) The synthesis of prostaglandins from, arachidonate, (b) The synthesis of leukotrienes from arachidonate, (c) The conversion of ATP to cAMP, (d) The metabolic degradation of cAMP, (e) The conversion of GTP to cGMP, 22. Following agent is generally used in, allergic rhinitis, (a) Beclomethasone, , (b) Fluticasone, , (c) Triamcinolone, , (d) All of the above, , 23. The primary objective for designing drugs, that selectively inhibit COX – 2 is to, (a) Decrease the risk of nephrotoxicity, (b) Improve anti-inflammatory effectiveness, (c) Lower the risk of gastrointestinal toxicity, (d) Reduce the cost of treatment of rheumatoid, arthritis, (e) Selectively decrease thromboxane A2 without, effects on other eicosanoids, 24. A newborn was diagnosed as having a, congenital abnormality that resulted in, transposition of her great arteries. While, preparing the infant for surgery, the, medical team needed to keep the ductus, arteriosus open. They did this by infusing, (a) Cortisol, (c) Ketorolac, (e) Tacrolimus, , (b) Indomethacin, (d) Misoprostol, , 25. Acetyl salicylic acid is soluble in, (a) An aqueous base (b) Water, (c) An aqueous acid, 26. Decomposition of the acetyl salicylic acid, at room temperature most likely would, occur by, , (a) Oxidation of the ester, (b) Reduction of the carboxylic acid, (c) Hydrolysis of the ester, 27. Diamprit is an agonist of ______ receptors,, except, (a) H1, (c) H3, , (b) H2, (d) All of the above, , 28. Which of the following enzymes is, ultimately responsible for the production, of prostaglandins associated with, inflammatory reactions?, (a), (b), (c), (d), (e), , Phospholipase, Lipoxygenase, Cyclooxygenase-I, Cyclooxygenase II, Xanthine oxidase, , 29. Which of the following prostaglandin, analogs is used specifically for the, treatment, of, NSAID, induced, gastrointestinal ulcertation?, (a) Alprostadil, (c) Carboprost, (e) Epoprostenol, , (b) Misoprostol, (d) Dinoprostone, , 30. Which of the following compounds is, most likely to lower circulating levels of, leukotrienes?, (a) Zileuton, (c) Carprofen, (e) Allopurinol, , (b) Montelukast, (d) Aspirin, , 31. The action of aspirin that results in its, greater efficacy as an antithrombotic, (anti-platelet) drug is its ability to, (a), (b), (c), (d), (e), , Inhibit lipoxygenase as well as cyclooxygenase, Selectively inhibit cyclooxygenase I, Inhibit leukocyte migration, Promote uric acid excretion, Acetylate cyclooxygenase, , 32. Which of the following drugs may be, effective in the treatment of gouty, arthritis by acting by two separate and, distinct mechanisms?, (a) Allopurinol, (c) Colchicine, (e) Sulfinpyrazone, , (b) Probenecid, (d) Indomethacin

Page 125 :
MCQs IN PHARMACOLOGY, , 110, 33. Acute or chronic colchicine toxicity may, be identified by which of the following, signs/symptoms?, (a), (b), (c), (d), (e), , Alopecia, Blood dyscrasias, Severe gastrointestinal upset, All of the above, None of the above, , 34. Patients taking chronic doses of nonselective nonsteroidal anti-inflammatory, drugs (NSAIDs) should periodically be, screened for which of the following, toxicities?, (a), (b), (c), (d), (e), , Nephrotoxicity, Peripheral neuropathy, Cardiotoxicity, All of the above, None of the above, , 35. Which of the following medications would, represent arthritis therapy that is least, likely to cause gastric ulceration?, (a) Aspirin, (c) Piroxicam, (e) Rofecoxib, , (b) Acetaminophen, (d) Meclofenamate, , 36. In addition to their ability to decrease, inflammatory prostaglandin synthesis,, some non-steroidal anti-inflammatory, drugs (NSAIDs) may owe part of their, effects to their ability to, (a), (b), (c), (d), (e), , Inhibit leukocyte migration, Inhibit leukotriene synthesis, Stabilize lysosmal membranes, All of the above, None of the above, , 37. The termination of heparin activity by, protamine sulfate is due to, (a) A chelating action, (b) The inhibition of gastrointestinal absorption, of heparin, (c) The displacement of heparin-plasma protein, binding, (d) An acid-base interaction, (e) The prothrombin-like activity of protamine, 38. In gastrointestinal tract, serotonin causes, , (a), (b), (c), (d), , Contraction of gastrointestinal muscles, Decreased muscle tone, Decreased peristalsis, All of the above, , 39. A FDA – approved ingr edient for, protection against painful sensitivity of, the teeth due to cold, heat, acids, sweets, or contact is, (a), (b), (c), (d), (e), , Dicalcium phosphate, Sodium lauryl sulfate, 5% potassium nitrate, Zinc chloride, Calcium carbonate, , 40. Which local anesthetic should be used to, treat symptoms of pain, itching, burning,, and disconfort in patients with an, established lidocaine allergy?, (a) Tetracaine, (c) Pramoxine, , (b) Dibucaine, (d) Benzocaine, , 41. What is the most commom sign/symptom, of hemorrhoids?, (a) Bleeding, (c) Seepage, , (b) Pain, (d) Pruritus, , 42. Which of the following agents is, designated as a safe and effective, analgesic, anesthetic and antipruritic by, the Food and Drug Administration?, (a) Witch hazel, (c) Hydrocortisone, , (b) Juniper tar, (d) Phenylephrine, , 43. A 65-year-old is interested in taking ginkgo. Which of the following statements is, correct regarding ginkgo?, (a) Ginkgo is contraindicated in diabetes and, pregnancy, (b) There is a drug-herb interaction between, ginkgo and aspirin, (c) Toxic effects include hypertension and, cardiac arrest, (d) There is a drug-herb interaction between, ginkgo and phenelzine, (e) Ginkgo is contraindicated in patients with, gallstone pain, 44. All of the following medications should, not be used routinely in pregnant patients, during the third trimester except

Page 126 :
ANALGESICS & ANTIPYRETICS, (a), (b), (c), (d), (e), , 111, , Acetaminophen, Nonsteroidal anti-inflammatory drugs, Warfarin, Lithium, Aspirin, , 45. Which of the following statements best, describes the usual course of rheumatoid, arthritis?, (a) It is an acute exacerbation of joint pain treated, with short-term anti-inflammatory therapy, (b) It is a chronic disease characterized by acute, changes within nonsynovial joints, (c) It is an acute disease that is characterized by, rapid synovial changes due to inflammation, (d) It is a chronic disease characterized by acute, exacerbations followed by remissions with, consequences associated with chronic, inflammatory changes, (e) It is a joint disease characterized by a, marked loss of calcium from the bones and, a resultant thinning of the bones, 46. Match the drug characteristic with the, appropriate agent., (a) Corticosteroids, (b) Lbuprofen, (c) Aspirin, (d) Aurancfin, (e) Penicillamine, , (1) Persistent platelet, function effect, (2) Oral form of gold, (3) Given on an empty, stomach, (4) May be used intraarticularly, (5) May cause drowsiness, , 47. Match the phrase below with the appropriate agent used to treat rheumatoid, arthritis., (a), (b), (c), (d), (e), , Indomethacin, Aspirin, Hydroxychloroquine, Methotrexate, Cyclophosphamide, (1) May cause hemorrhagic cystitis, (2) May cause more severe central nervous, system (CNS)adverse effects than other, nonsteroidal anti-inflammatory drugs, (NSAIDS), (3) Enteric – coated form may be useful in, treating some patients, , (4) Aspirin may slow this drug’s rate of excretion, (5) Vision should be monitored every 3–6, months, 48. All of the following statements concerning, an acute gouty arthritis attack are correct, except, (a) The diagonosis of gout is assured by a good, therapeutic response to colchicines because, no other form of arthritis responds to this drug, (b) To be assured of the diagnosis, monosodium, urate crystals must be identified in the, synovial fluid of the affected joint, (c) Attacks frequently occur in the middle of the, night, (d) An untreated attack may last up to 2 weeks, (e) The first attack usually involves only one joint,, most frequently the big toe (first metatarsophalangeal joint), 49. TNF-α, αis an example of eicosanoids, (a), (b), (c), (d), , Interleukins, Cytotoxic factors, Interferons, Colony stimulating factors, , 50. Potential adverse effects associated with, aspirin include all of the following except, (a), (b), (c), (d), (e), , Gastrointestinal ulceration, Renal dysfunction, Enhanced methotrexate toxicity, Cardiac arrhythmias, Hypersensitivity asthma, , 51. All of the following facts are true about, non-steroidal anti-inflammatory drugs, (NSAIDs) except, (a), (b), (c), (d), (e), , They are antipyretic, There is a celling effect to their analgesia, They can cause tolerance, They do not cause dependence, They are anti-inflammatory, , 52. Which of the following narcotics has the, longest duration of effect?, (a), (b), (c), (d), (e), , Methadone, Controlled-release morphine, Levorphanol, Transdermal fentanyl, Dihydromorphone

Page 127 :
MCQs IN PHARMACOLOGY, , 112, 53. Cylcoocygenase-II specific inhibitors block, the following, (a) Production of cytoprotective prostaglandins, (b) Tumor necrosis factor - α, (c) Production of prostaglandins responsible for, pain and inflammation, 54. The emetic action of morphine is due to, (a), (b), (c), (d), , Irritation of gastrointestinal tract, Stimulation of cerebral cortex, Stimulation of medullary vomiting center, Stimulation of emetic chemoreceptor trigger, zone, (e) None of the above, , 55. Colchicine is used mainly to treat, (a) Gout, (b) Arthiritis, (c) Diabetes, (d) Carcinomas, (e) High blood pressure, 56. Which type of patient is most likely to, hypersensitive to aspirin?, (a), (b), (c), (d), (e), , Intrinsic asthamatic, Extrinsic asthamatic, Chronic bronchitic, Patient with viral injection, Both (c) and (d), , 57. Codeine acts as a cough sedative by, (a), (b), (c), (d), (e), , Producing mild nausea, Depressing bronchiolar secretions, Depressing pulmonary action, Depressing cough center, Paralyzing sensory nerves of bronchi, , 58. The greatest threat from morphine, poisoning is, (a), (b), (c), (d), (e), , Renal shutdown, Paralysis of spinal cord, Respiratory depression, Cardiovascular collapse, None of the above, , 59. A very common side effect of morphine, is, (a) Allergic response (b) Blood dyscrasias, (c) Constipation, (d) Liver damage, (e) Visceral pain, , 60. Eicosanoids are a group of _____ carbon, unsaturated fatty acids, (a) 20, (c) 25, , (b) 10, (d) 35, , 61. Which of the following durgs is a, monamine oxidase inhibitor, but is used, to treat hypertension?, (a), (b), (c), (d), (e), , Tranylcypromine (Parnate), Reserpine, Propranolol (Inderal), Pargyline (Eutonyl), Imipramine (Tofranil), , 62. Autacoids differ from hormones in that, (a) Autacoids are involved only in the causation, of pathological states, (b) Autacoids do not have a specific cell/ tissue, of origin, (c) Autacoids generally act locally at the site of, generation and release, (d) Both (b) and (c), 63. Which of the following eicosanoids is, generated through the lipozygenase, pathway ?, (a) Prostaglandin E2 (b) Thromboxane A2, (c) Prostacyclin, (d) Leukotriene C4, 64. The cyclooxygenase isoenzymes COX-1, and COX-2 differ from each other in that, (a) They catalyse different pathways in prostanoid, biosynthesis, (b) COX–1 is inhibited by aspirin but not COX–2, (c) COX–2 is inhibited by ibuprofen but not, COX–1, (d) COX–1 is constitutive while COX–2 is, inducible, 65. Which of the following is an irreversible, inhibitor of cyclooxygenase ?, (a) Aspirin, (c) Indomethacin, , (b) Phenylbutazone, (d) Piroxicam, , 66. The prostanoid that consistently constricts, blood vessels is, (a) Prostaglandin E2 (b) Prostaglandin F2a, (c) Thromboxane A2 (d) Prostacyclin

Page 128 :
ANALGESICS & ANTIPYRETICS, 67. The following prostanoid is a potent, inducer of platelet aggregation, (a) Prostacyclin, (b) Prostaglandin E2, (c) Prostaglandin D2 (d) Thromboxane A2, 68. Aspirin in low doses produces longlasting, inhibition, (a) Platelets contain low quantity of COX, (b) Platelets cannot synthesize fresh COX, molecules, (c) Platelets bind aspirin with high affinity, (d) Platelet COX is inducible, 69. The early pregnancy uterus is sensitive, to the following oxytocic, (a), (b), (c), (d), , Oxytocin, Methylergometrine, Prostaglandin F2α, Both (a) and (b), , 70. Cervical priming with prostaglandin, results in, (a) Facilitation of sperm movement through, cervical canal, (b) Increased cervical tone, (c) Softening of cervix, (d) Increased cervical secretions, 71. Corticosteroids exert anti-inflammatory, action by inhibiting the following enzyme, (a), (b), (c), (d), , Cycloxygenase, Lipozygenase, Phospholipase - A, Phosphodiesterase, , 72. Main effect of sulphinpyrazone in, hyperuricaemia is, (a), (b), (c), (d), , Suppress the symptoms, Promote the elimination of urate, prevent urate synthesis, All of the above, , 73. Which of the following glucocorticoids has, significant mineralocorticoid activity also ?, (a), (b), (c), (d), , Hydrocortisone, Triamcinolone, Dexamethasone, Betamethasone, , 113, 74. Corticosteroid therapy is practically, mandatory in the following condition., (a), (b), (c), (d), , Septic shock, Renal transplant, Rheumatoid arthritis, Ulcerative colitis, , 75. For limiting cerebral edema due to brain, tumour, the preferred corticosteroids are, betamenthasone/dexamethasone, because, (a), (b), (c), (d), , They do not cause Na+ and water retention, They are more potent, They can be administered intravenously, They inhibit brain tumours, , 76. Systemic corticosteroid therapy is not, used routinely and is reserved only for, severe cases of, (a), (b), (c), (d), , Exfoliative dermatitis, Posterior uveitis, Acute rheumatic fever, Hodgkin’s disease, , 77. The following adverse effect of corticosteroids is due to their mineralocorticoid, action, (a), (b), (c), (d), , Osteoporosis, Rise in blood pressure, Moon face, Increased susceptibility to infection, , 78. Which of the following bones is affected, more by glucocorticoid induced osteoporosis ?, (a) Femur, (c) Radius, , (b) Humerus, (d) Lumber vertebra, , 79. Morphine produces analgesia by acting at, (a), (b), (c), (d), , Peripheral pain receptors, A spinal site, Suspraspinal sites, Both (b) and (c), , 80. In man sedation caused by morphine is, characterized by, (a), (b), (c), (d), , Initial excitement, Little or no motor incoordination, Rise in seizure threshold, All of the above

Page 129 :
MCQs IN PHARMACOLOGY, , 114, 81. Instead of depressing, morphine stimulates, (a), (b), (c), (d), , Vasomotor centre, Edinger westphal nucleus, Temperature regulating centre, Cough centre, , 82. In a comatose patient suspected of, poisoning, which of the following findings, would be against the drug being morphine, (a) Selegiline, (c) Moclobemide, , (b) Chlorgiline, (d) Tranylcypromine, , 83. Instead of being effective in hyperuricaemia following drug is contradictred in the, treatment of gout, (a) Indomethacin, (c) Piroxicam, , (b) Diclofenac, (d) Aspirin, , 84. Morphine dependence is characterized by, (a) Marked drug seeking behavior, (b) Physical dependence without psychic, dependence, (c) Physical as well as psychic dependence, (d) Both (a) and (c), 85. Morphine is contraindicated in head, injury because, (a), (b), (c), (d), , It, It, It, It, , does not relieve the pain of head injury, can raise intracranial tension, can cause constipation, is liable to cause addiction, , 86. Which of the following opioids is more, potent than morphine ?, (a), (b), (c), (d), , Pethidine, Fentanyl, Dextropropoxyphene, Tramadol, , 87. Which of the following opioid analgesics, is similar to codeine in pharmacological, profile but is less constipating ?, (a), (b), (c), (d), , Methadone, Buprenorphine, Butorphanol, Dextropropoxyphene, , 88. Select the analgesic which acts through, opioids as well as additional spinal, monoaminergic mechanisms., , (a), (b), (c), (d), , Tramadol, Ethoheptazine, Dextropropoxyphene, Alfentanil, , 89. An opioid analgesic is preferred over, aspirin like analgesic in the following, condition., (a) Acute gout, (c) Toothache, , (b) Burn, (d) Neuralgia, , 90. Morphine has high affinity for the, following opioid receptor(s)., (a) µ (Mu), (c) d (Delta), , (b) k (Kappa), (d) All of the above, , 91. Which of the following is an agonistantagonist type of opioid analgesic, (a) Pethidine, (c) Fentanyl, , (b) Pentazocine, (d) Buprenorphine, , 92. Pentazocine differs from morphine in that, (a), (b), (c), (d), , It is inactive by the oral route, It does not produce physical dependence, It has a lower ceiling of analgesic effect, Its action is not blocked by naloxone, , 93. Which action of morphine is incompletely, reversed by naloxone ?, (a), (b), (c), (d), , Analgesia, Respiratory depression, Sedation, Miosis, , 94. Lower dose of naloxone is required to, (a) Antagonise the actions of nalorphine, (b) Antagonise the actions of pentazocine, (c) Precipitate withdrawal in mildly morphine, dependent subjects, (d) Precipitate withdrawal in highly morphine, dependent subjects, 95. Following mediators are involved in acute, inflammation except, (a) Histamine, (c) Interferons, , (b) Leukotrienes, (d) Bradykinin, , 96. The distinctive feature of the isoenzyme, cyclooxygenase-2 is, (a) It is not inhibited by indomethacin

Page 130 :
ANALGESICS & ANTIPYRETICS, (b) It is inducible, (c) It generates cytoprotective prostagladins in, gastric mucosa, (d) It is found only in foetal tissues, 97. Aspirin produces analgesia by, (a) Preventing sensitization of peripheral pain, receptors, (b) Affecting gating of pain impulses at spinal, level, (c) Raising pain threshold at subcortical level, (d) Both (a) and (b), 98. Aspirin reduces fever by, (a), (b), (c), (d), , Decreasing heat production in the body, Enhancing cutaneous blood flow, Inducing sweating, Both (b) and (c), , 99. In the treatment of chronic inflammatory, diseases, the most important limitation, of aspirin is, (a), (b), (c), (d), , Acid – base and electrolytc disturbances, Hypersensitivity and idiosyncratic reactions, Gastric mucosal damage, Salicylism, , 100. Generally the earliest manifestation of, salicylism is, (a) Visual disturbance (b) Excitement, (c) Hyperventillation (d) Tinnitus, 101. Aspirin is contraindicated in children, suffering from influenza or similar viral, infection because of increased risk of, (a), (b), (c), (d), , Gastric bleeding, Thrombocytopenia, Fancony syndrome, Reye’s syndrome, , 102. Aspirin is contraindicated in pregnant, women near term because, (a) Labour may be delayed and prolonged, (b) Blood loss during delivery may be more, (c) Foetus may suffer premature closure of ductus, arteriosus, (d) All of the above risks, 103. Phenylbutazone should be used only in, patients not responding to other nonste-, , 115, roidal anti-inflammatory drugs (NSAIDs), because, (a) It has lower anti-inflammatory efficacy than, other NSAIDs, (b) It has potential to cause agranulocytosis, (c) It has weak analgesic action, (d) It alters the protein binding and metabolism, of many drugs, 104. The non-steroidal anti-inflammatory drug, which is contraindicated in drivers and, machine operators is, (a) Phenylbutazone, , (b) Indomethacin, , (c) Naproxen, , (d) Diclofenac sodium, , 105. In overall assessment, which non-steroidal anti-inflammatory drug has been considered to be the safest, (a) Aspirin, , (b) Naproxen, , (c) Ibuprofen, , (d) Piroxicam, , 106. The constellation of adverse effects, associated with non-steroidal anti-inflammatory drugs does not include the following, (a) Sedation, , (b) Gastric irritation, , (c) Fluid retention, , (d) Rashes, , 107. Histamine induced edema results from, the action on _____ receptors, (a) H3, , (b) H2, , (c) H1, , (d) All of the above, , 108. The following nonsteroidal anti-inflammatory drug is a relatively selective cycloodygenase-2 inhibitor, (a) Tenoxicam, , (b) Meloxicam, , (c) Diclofenac sod, , (d) Ketoprofen, , 109. What is the true of nimesulide, (a) It exerts anti-inflammatory action by several, mechanisms in addition to cyclooxygenase, inhibition, (b) It is preferred for long-term use in rheumatoid, arthritis, (c) It is contraindicated in aspirin intolerant, asthma patients, (d) All of the above

Page 131 :
MCQs IN PHARMACOLOGY, , 116, 110. The distinctive feature of nimesulide is, (a) It does not inhibit prostaglandin synthesis, (b) It does not cause gastric irritation, (c) It is well tolerated by aspirin intolerant, asthama patients, (d) It is not bound to plasma proteins, 111. 5-HT produces contraction of smooth, muscle and platelet aggregation via, _______ receptors, (a) 5-HT1, , (b) 5-HT2, , (c) 5-HT3, , (d) 5-HT4, , 112. N-acetyl cysteine is beneficial in acute, paracetamol poisoning because, (a) It reacts with paracetamol to form a nontoxic, complex, (b) It inhibits the generation of the toxic, metabosite of paracetamol, (c) It is a free readical scavenger, (d) It replenishes hepatic glutathione which in turn, binds the toxic metabolite of paracetamol, 113. For a patient of peptic ulcer, the safest, nonopioid analgesic is, (a) Ketorolac, , (b) Diclofenac sodium, , (c) Paracetamol, , (d) Ibuprofen, , 114. Which of the following anti-inflammatory, analgesics has been cleared for pediatric, use, (a) Indomethacin, (c) Ketorolac, , (b) Ibuprofen, (d) Piroxicam, , 115. Which of the following statements is, correct about gold therapy of rheumatoid, arthiritis, (a) It is indicated only in rapidly progressing, disease, not controlled by nonsteroidal antiinflammatory drugs, (b) It is indicated only in severe cases after both, nonsteroidal anti-inflammatory drugs and, corticosteroids have failed, (c) When gold therapy is started, nonsteroidal, anti-inflammator y drugs should be, discontinued, (d) Intramuscular gold is the most rapidly acting, drug in severe rheumatoid arthritis, , 116. Sulfasalazine is used in the following, disease(s), (a), (b), (c), (d), , Bacillary dysentery, Ulcerative colitis, Rheumatoid arthritis, Both (b) and (c), , 117. Which component of sulfasalazine is, responsible for the therapeutic effect in, rheumatoid arthritis ?, (a), (b), (c), (d), , Sulfapyridine, 5–aminosalicylic acid, Both (a) and (b), Intact sulfasalazine molecule, , 118. Among the rheumatoid arthritis disease, modifying drugs, fastest symptom relief, is obtained with, (a) Auranofin, (c) Sulfasalazine, , (b) Penicillamine, (d) Methotrexate, , 119. Strong nonsteroidal anti-inflammatory, drugs are more commonly used than, colchicines in acute gout because, (a), (b), (c), (d), , They are more effective, They act more rapidly, They have additional uricosutic action, They are better tolerated, , 120. Select the drug which is neither analgesic,, nor antiinflammatroy nor uricosuric, but, is highly efficacious in acute gout, (a) Prednisolone, (c) Naproxen, , (b) Colchicine, (d) Sulfinpyrazone, , 121. The most important dose-limiting adverse, effect of colchicines is, (a) Sedation, (c) Diarrhoea, , (b) Kidney damage, (d) Muscle paralysis, , 122. Probenecid has the following action(s), (a) Uricosuric, (b) Analgesic, (c) Antiinflammatory (d) Both (a) and (c), 123. Vasodilation mediated by 5-HT1 receptors involve following mechanism, (a), (b), (c), (d), , Direct relaxant effect on smooth muscle, Inhibition of norepinephrine, Nitric oxide release from endothelial cells, All of the above

Page 132 :
ANALGESICS & ANTIPYRETICS, , 117, , 124. Allopurinol decreases the plasma concentration of, (a) Hypoxanthine, (c) Uric acid, , (b) Xanthine, (d) All of the above, , 125. Allopurinol is indicated in the following, category of chronic gout patients, (a), (b), (c), (d), , Over producers of uric acid, Under excretors of uric acid, Those with tophi and/or renal urate stones, All of the above, , 126. Nonsteroidal anti-inflammatory drugs, reduce the diuretic action of furosemide, by, (a) Preventing prostaglandin mediated intrarenal, haemodynamic actions, (b) Blocking the action in ascending limb of loop, of Henle, (c) Enhancing salt and water reabsorption in, distal tubule, (d) Increasing aldosterone secretion, 127. The glucocorticoid described as highly, potent anti-inflammatory agent is, (a), (b), (c), (d), , Methyl prednisolone, Cortisone, Triamcinolone, Dexamethasone, , 128. The corticosteroid with a longer duration, of action is, (a) Cortisone, (c) Betamethasone, , (b) Prednisone, (d) Fludrocortisone, , 129. Gold in rheumatoid arthritis, (a) Can cause regression of degenerative lesions, of this disease, (b) Can reduce the concentrations of rheumatoid, factor, (c) Does not halt the progress of the disease, (d) Is employed as first line therapy, 130. Use of gold compounds in rheumatoid, arthritis is beneficial in, (a) Early active disease not responding to, NSAIDs, (b) Mild disease, , (c) Advanced disease, (d) As first line therapy, 131. Following 5-HT receptors is a ligand gated, ion channel, (a) 5-HT1A, (c) 5-HT3, , (b) 5-HT2A, (d) 5-HT4, , 132. In a person suffering from hepatic disease,, the dose of pethidine should be, (a) Reduced because it shows idiosyncratic, reaction, (b) Reduced because the clearance is reduced, (c) Increased because the clearance is increased, (d) Increased because patient becomes resistant, to pethidine, 133. Kinins play a role in which of the following, (a) Pain, (c) Asthma, (e) All of the above, , (b) Inflammation, (d) Vasodilatation, , 134. The term eicosanoid refers to which of, the following compounds, (a) Prostaglandins, (c) Interleukins, , (b) Leukotrienes, (d) A + B, , 135. Which of the following is a side effect of, NSAID ?, (a), (b), (c), (d), (e), , GI ulceration, Blockade of platelet agregation, Inhibition of uterine motility, Renal vasoconstriction, All of the above, , 136. Which of the following has minimal antiinflammatory action ?, (a) Piroxicam, (c) Enalapril, , (b) Oxaprozin, (d) Amrinone, , 137. Probenecid increases excretion of, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 138. Which of the following is involved in, pathobiology of inflammatory process ?, (a), (b), (c), (d), , Cytokines, Cell adhension molecules, Phospholipoase A2, All of the above

Page 133 :
MCQs IN PHARMACOLOGY, , 118, 139. Following is the effect of histamine on, small vessels, (a) Outward passage of plasma protein and fluid, into the extracellular spaces, (b) Increase in the flow of lymph and its protein, content, (c) Formation of edema, , (d) All of the above, 140. Earliest sign of aspirin toxicity is, (a), (b), (c), (d), , Tinnitus, Metabolic acidosis, Reye syndrome, Respiratory depression, , ANSWERS, 1. b, 7. e, 13. b, 19. c, 25. a, 31. e, 37. d, 43. b, , 2. d, 8. e, 14. b, 20. b, 26. c, 32. d, 38. a, 44. a, , 46. 1.c, 2.d, 3.c, 4.a, 5.b, 50. e, 51. c, 56. a, 57. d, 62. d, 63. d, 68. b, 69. c, 74. b, 75. a, 80. b, 81. b, 86. b, 87. d, 92. c, 93. c, 98. d, 99. c, 104. b, 105. c, 110. c, 111. b, 116. d, 117. a, 122. a, 123. d, 128. c, 129. b, 134. d, 135. e, 140. a, , 3. b, 9. b, 15. d, 21. a, 27. a, 33. d, 39. c, 45. d, , 4. c, 10. d, 16. b, 22. d, 28. d, 34. a, 40. c, , 47.1.e, 2.a, 3.b, 4.d, 5.c, 52. d, 53. c, 58. c, 59. c, 64. d, 65. a, 70. c, 71. c, 76. c, 77. b, 82. a, 83. d, 88. a, 89. b, 94. d, 95. c, 100. d, 101. d, 106. a, 107. c, 112. d, 113. c, 118. d, 119. d, 124. c, 125. d, 130. a, 131. c, 136. c, 137. c, , 5. c, 11. d, 17. d, 23. c, 29. b, 35. e, 41. a, , 6. d, 12. b, 18. c, 24. d, 30. a, 36. d, 42. b, , 48. a, 54. d, 60. a, 66. c, 72. b, 78. d, 84. d, 90. a, 96. b, 102. d, 108. b, 114. d, 120. b, 126. a, 132. b, 138. d, , 49. b, 55. a, 61. d, 67. d, 73. a, 79. b, 85. b, 91. b, 97. d, 103. b, 109. a, 115. a, 121. c, 127. d, 133. e, 139. d

Page 134 :
ANALGESICS & ANTIPYRETICS, , 119, , EXPLANATIONS FOR THE ANSWERS, 1. b, 6. d, , 9. b, , 9. b, , 17. d, , 22. d, , 27. a, 38. a, •, •, •, 49. b, 60. a, , 72. b, , β-Aminoethylimidazole is a chemical name of, histamine, Prostaglandins are potent vasodilators and this, action involves arterioles, precapillary sphincters, and postcapillary venules. Prostaglandins have, no effect on large veins., Acetaminophen or paracetamol is a paraaminophenol derivative., Diclofenac is a phenylacetic acid derivative., Piroxicam is an oxicam derivative., Celecoxib is a benzenesulphonamide derivative., Auronofin is more hydrophilic gold compound, than aurothioglucose and gold sodium thiomalate, and hence is administered orally., Aurothioglucose and gold sodium thiomalate, show erratic absorption when administered orally, and are generally administered intramuscularly., Histamine is an example of preformed mast cell, mediator of inflammatory process. It produces, vasodilation, vasopermeability, itch, cough and, bronchoconstriction. PAF, LTC4 and PGD2 are, lipid – derived mediators., Topical glucocorticoids e.g. beclomethasone,, fluticasone, triamcinolone, budesonide,, flunisolide or cromolyn are quite effective in, allergic rhinitis., Dimaprit is a selective agonist of H2 and H3, receptors but not H1 receptors., In gastrointestinal tract, serotonin causes:, , 83. d, , 95. c, , 107. c, , 111. b, , 123. d, •, •, •, 131. c, , Contraction of GI smooth muscles., Increase in muscle tone., Increase in peristalsis., TNF-α is a cytotoxicfactor and plays important, role in the inflammatory response., Eicosa means twenty and hence the genral name, eicosanoids for prostaglandins, thromboxanes, and leukotrienes which contains 18, 20 and, 22 carbon skeleton., Sulphinpyrazone inhibits the renal tubular, , 139. d, , reabsorption of uric acid and thus promotes the, elimination of urate., Aspirin (in general salicylates) are contraindicated in the treatement of gout as they elevate, uric acid levels and they also antagonize the, actions of probenecid and sulfinpyrazone., Indomethacin, diclofenac and piroxicam have no, such effects and hence are not contraindicated., Histamine, leukotrienes and bradykinin are, mediators of acute inflammation., Interferons are involved in chronic inflammatory, conditions., Histamine induced edema results from the action, of H1 receptors. This H1 receptor effect results in, outward passage of plasma protein and fluid from, capillaries into extracellular spaces and increase, in the flow of lymph and its protein content., H2 and H3 receptors are not involved in these, effects., 5-HT2 receptors are involved in the 5-HT, mediated smooth muscle contraction and platelet, aggregation., Vasodilation mediated by 5-HT 1 receptors, involve various mechanisms:, Direct relaxant effect on smooth muscles, Release of NO from endothelial cells., Inhibition of norepinephrine from sympathetic, nerve terminals., 5-HT3 receptors are ligand gated ion channels., 5-HT1A, 5-HT2A and 5-HT4 receptors are coupled, to second messenger system as follows:, 5-HT1A : Decrease in cAMP, 5-HT2A : Increase in IP3/DAG, 5-HT4 : Increase in cAMP., In general, histamine dilates blood vessels in, humans. It produces variety of effects on small, blood vessels such as outward passage of, plasma protein and fluid into the extracellular, spaces, increase in the flow of lymph and its, protein content and finally formation of edema.

Page 135 :
This page, intentionally left, blank

Page 136 :
CHAPTER 6, CARDIOVASCULAR DRUGS, , 1. Relationship between arterial blood, pressure (BP), cardiac outpur (CO) and, peripheral vascular resistance (PVR), can be described as, (a) BP = COxPVR, (c) BP = PVR/CO, , (b) BP = CO/PVR, (d) None of the above, , 2. If a fibrinolytic drug is used for treatment, of acute myocardial infarction, the, adverse drug effect that is most likely to, occur is, (a), (b), (c), (d), (e), , Acute renal failure, Development of antiplatelet antibodies, Encephalitis secondary to liver dysfunction, Hemorrhagic stroke, Neutropenia, , 3. Increased serum levels of which of the, following may be associated with a, decreased risk of atherosclerosis?, (a), (b), (c), (d), (e), , Very low-density lipoproteins (VLDL), Low-density lipoproteins (LDL), Intermediate – density lipoproteins (IDL), High-density lipoproteins (HDL), Cholesterol, , 4. If the patient has a history of gout, which, of the following drugs is most likely to, exacerbate this condition?, (a) Colestipol, (b) Gemfibrozil, , (c) Lovastatin, (d) Niacin, (e) Simvastatin, 5. After being counseled about lifestyle and, dietary changes, the patient was started, on atorvastatin. During his treatment with, atorvastatin, it is important to routinely, monitor serum concentrations of, (a), (b), (c), (d), (e), , Blood urea nitrogen (BUN), Alanine and aspartate aminotransferase, Platelets, Red blood cells, Uric acid, , 6. Six months after beginning atorvastatin,, the patient’s total and LDL cholesterol, concentrations remained above normal, and he continued to have anginal attacks, despite good adherence to his antianginal, medications. His physician decided for, niacin. The major recognized mechanism, of action of niacin is, (a) Decreased lipid synthesis in adipose tissue, (b) Decreased oxidation of lipids in endothelial, cells, (c) Decreased secretion of VLDL by the liver, (d) Increased endocytosis of HDL by the liver, (e) Increased lipid hydrolysis by lipoprotein, lipase

Page 137 :
MCQs IN PHARMACOLOGY, , 122, 7. Following drugs act on imidazoline, receptor, (a) Moxonidine, , (b) Dexmedetomidine, , (c) Tizanidine, , (d) All of the above, , 8. Which one of the following drugs increase, digoxin plasma concentration by a, pharmacokinetic mechanism?, (a) Captopril, (c) Lidocaine, (e) Sulfasalazine, , (b) Hydrochorothiazide, (d) Quinidine, , (b) Fluoxetine, , (c) Mifepristone, , (d) Sildenafil, , (e) Zafirlukast, 14. A treatment of angina that consistently, decreases the heart rate and can prevent, vasospastic angina attacks is, (a) Isosorbide dinitrate, (b) NIFedipine, (c) Nitroglycerin, (d) Propranolol, , 9. A 55-year-old patient currently receiving, other drugs for another condition is to, be started on diuretic therapy for mild, heart failure. Thiazides are known to, reduce the excretion of, (a) Diazepam, , (b) Fluoxetine, , (c) Imipramine, (e) Potassium, , (d) Lithium, , 10. A hypertensive patient has been using, nifedipine for some time without untoward effects. If he experiences a rapidly, developing enhancement of the antihypertensive effect of the drug, it is probably, due to, (a) Concomitant use of antacids, (b) Fods containing tyramine, (c) Grapefruit juice, (d) Induction of drug metabolism, (e) Over – the – counter decongestants, 11. A drug lacking vasodilator properties that, is useful in angina is, (a) Isosorbide dinitrate, (b) Metoprolol, , (e) Verapamil, 15. In a patient receiving digoxin for congestive, heart failure, condition that may facilitate, the appearance of toxicity include, (a) Hyperkalemia, , (b) Hypernatremia, , (c) Hypocalcemia, , (d) Hypomagnesemia, , (e) All of the above, 16. Activation of endothelin receptor ETA,, leads to, (a) Vasoconstriction, (b) Bronchoconstriction, (c) Aldosterone release, (d) All of the above, 17. Methylxanthine drugs such as aminophylline cause which one of the following?, (a) Vasoconstriction in many vascular beds, (b) Decrease in the amount of cAMP in mast, cells, (c) Bronchodilation, (d) Activation of the enzyme phosphodiesterase, (e) Sedation, 18. Drugs used in asthma that often cause, tachycardia and tremor include, , (c) NIfedipine, (d) Nitroglycerin, (e) Verapamil, 12. Aldosterone release is stimulated by, (a) Angiotensin I, (c) Angiotensin III, , (a) Alprostadil, , (b) Angiotensin, (d) Both (b) and (c), , 13. Which one of the following drugs is used, in the treatment of male impotence and, activates prostaglandin E1 receptors?, , (a) Beclomethasone, , (b) Cromolyn sodium, , (c) Ipratropium, , (d) Metaproterenol, , (e) All of the above, 19. Following potassium sparing diuretic, inhibits action of aldosterone, (a) Amiloride, , (b) Triamterene, , (c) Spironolactone, , (d) All of the above

Page 138 :
CARDIO–VASCULAR DRUGS, , 123, , 20. In patients with chronic granulomatous, disease which of the following agents, increases the synthesis of tumor necrosis, factor, leading to activation of phagocytosis?, (a) Aldesleukin, (b) Cyclosporine, (c) Filgrastim, (d) Infliximab, (e) Interferon gamma, 21. The mechanism of action of cyclosporine, involves, (a) Activation of calcineurin, (b) Binding to cyclophilin to cause inhibition of, a cytoplasmic phosphatase, (c) Blockade of interleukin – 2- receptors, (d) Inhibition of phospholipase A2, (e) Suppression of bone marrow progenitors, 22. Which one of the following drugs predictably, prolongs the PR interval and increases, cardiac contractility?, (a) Digoxin, (c) Propranolol, (e) Verapamil, , (b) Lidocaine, (d) Quinidine, , 23. Which of the following is the drug of, choice for management of cardiac, arrhythmias that occur in digitalis, toxicity?, (a) Amiodarone, (c) Propranolol, (e) Prazosin, , (b) Lidocaine, (d) Sotalol, , 24. A 54-year-old woman with severe, hypercholesterolemia is to be treated, with a combination of niacin and, atorvastatin. With this drug combination,, it is important that the patient be, monitored closely for signs of, (a) Agranulocytosis, (c) Lactic acidosis, (e) Thyrotoxicosis, , (b) Gallstones, (d) Myopathy, , 25. Regarding verapamil, which one of the, following statements is false?, (a) Angina pectoris is an important indication, for the use of verapamil, (b) Contraindicated in the asthmatic patient, (c) Relaxes vascular smooth muscle, , (d) Slows the depolarization phase of the action, potential in AV nodal cells, (e) Used in management of supraventricular, tachycardias, 26. What drug is used to prevent embolism in, the lung and during myocardial infarction?, (a) Alteplase, (b) Human growth hormone, (c) Granulocyte–macrophage colony – stimulating, factor (GM–CSF), (d) EPOGEN (EPO), (e) None of the above, 27. Which of the following cardiovascular, agents is classified chemically as a glycoside?, (a) Nifedipine, (c) Flecainide, (e) Warfarin, , (b) Digoxin, (d) Cholestyramine, , 28. Inhibition of carbonic anhydrase results in, (a) Abolition of NaHCO 3 reabsorption in, proximal tubule, (b) Enhanced of NaHCO3 reabsorption in, proximal tubule, (c) Enhanced NAHCO3 secretion in distal tubule, (d) None of the above, 29. Which of the following cyclotron produced, radiopharmaceuticals is used for assessing, regional myocardial perfusion as part of, an exercise stress test?, (a), (b), (c), (d), (e), , Thallous chloride 201TI USP, Sodium iodide 123I, Gallium citrate 67Ga USP, Indium 111In pentetate, Cobalt 57Co cyanocobalamin, , 30. Mary has a family history of heart disease, and wonders if garlic would be beneficial, to her. Which of the following statements, is correct about garlic?, (a) Enteric-coated tablets release their contents, in the stomach, (b) Side effects include heartburn, flatulence, and, sweating, (c) The safety of garlic in pregnancy is unknown, (d) Garlic does not interact with warfarin

Page 139 :
MCQs IN PHARMACOLOGY, , 124, 31. Exertion–induced angina, which is, relieved by rest, nitroglycerin, or both, is, referred to as, (a), (b), (c), (d), (e), , Prinzmetal’s angina, Unstable angina, Classic angina, Variant angina, Preinfarction angina, , 32. Myocardial oxygen demand is increased, by all of the following factors except, (a), (b), (c), (d), (e), , Exercise, Smoking, Cold temperatures, Isoproterenol, Propranolol, , Nitroglycerin, Nifedipine, Timolol, Isosorbide mononitrate, Propranolol, , 34. The oral absorption of following osmotic, diuretic is negligible, (a) Glycerin, (c) Isosorbide, , (b) Mannitol, (d) All of the above, , 35. Maximal medical therapy for treating, angina pectoris is represented by which, of the following choices?, (a), (b), (c), (d), (e), , Diltiazem, verapamil, nitroglycerin, Atenolol, isoproterenol, diltiazem, Verapamil, nifedipine, propranolol, Isosorbide, atenolol, diltiazem, Nitroglycerin, isosorbide, atenolol, , 36. The term ischemic heart disease (IHD), is used to designate all of the following, conditions except, (a), (b), (c), (d), , (a) Anisoylated plasminogen streptokinase, activator complex (APSAC), (b) Streptokinase (SK), (c) Recombinant tissue-type plasminogen, activator (t-PA), 38. Strong anticholinergic effects limit the, antiarrhythmic use of, (a) Quinidine, (c) Tocainide, (e) Disopyramide, , (b) Procainamide, (d) Flecainide, , 39. Following loop diuretic is a phynoxy, acetic acid derivative, , 33. Which of the following agents used in, prinzmetal’s angina has spasmolytic, actions, which increase coronary blood, supply?, (a), (b), (c), (d), (e), , 37. Which of the following thrombolytic, agents would be appropriate at this time?, , Angina pectoris, Sudden cardiac death, Congestive heart failur (CHF), Arrhythmias, , (a) Furosemide, (c) Ethacrynic acid, , (b) Bumetanide, (d) All of the above, , 40. Following potassium sparing diuretic is, a mineralocorticoid receptor antagonist, (a) Amiloride, (c) Spironolactone, , (b) Triamterene, (d) All of the above, , 41. A patient receiving a class I antiarrhythmic agent on a chronic basis complains, of fatigue, low-grade fever, and joint, pain suggestive of systemic lupus erythematosus (SLE). The patient is most likely, receiving, (a) Lidocaine, (c) Quinidine, (e) Propranolol, , (b) Procainamide, (d) Flecainide, , 42. Which of the following drugs is a class IV, antiarrhythmic that is primarily indicated, for the treatment of supraventricular, tachyarrhythmias?, (a) Lbutilide, (c) Diltiazem, (e) Propranolol, , (b) Mexiletine, (d) Quinidine, , 43. Which of the following agents has a direct, effect on the AV mode, delaying calciumchannel depolarization?, (a) Lidocaine, (c) Bretylium, (e) Lbutilide, , (b) Diltiazem, (d) Quinidine, , 44. Which of the following drugs is a class III

Page 140 :
CARDIO–VASCULAR DRUGS, , 125, , antiarrhythmic agent that is effective in, the acute management of atrial fibrillation or atrial flutter of recent onset ?, (a) Bretylium, , (b) Lbutilide, , (c) Metoprolol, , (d) Disopyramide, , 45. Which of the following groups of, symptoms is most often associated with, a patient who has right-sided heart, failure?, (a) Nocturia, rales, paroxysmal nocturnal dyspnea, (b) Paroxysmal nocturnal dyspnea, pedal edema,, jugular venous distention, hepatojugular reflux, (c) Jugular venous distention, hepatojugular, reflux, pedal edema, shortness of breath, (d) Hepatojugular reflux, jugular venous, distension, pedal edema, abdominal, distention, (e) Paroxysmal nocturnal dyspnea, jugular, venous distention, abdominal distention,, shortness of breath, 46. Which of the following combinations of, drugs, when used together, reduce both, preload and afterload?, (a) Nitroglycerin and isosorbide dinitrate, (b) Hydralazine and isosorbide dinitrate, (c) Captopril and methyldopa, (d) Prazosin and angiotension II, (e) Hydralazine and methyldopa, 47. When digoxin is used in a patient with, congestive heart failure (CHF), it works, by exerting a positive effect on, (a) Stroke volume, (b) Total peripheral resistance, (c) Heart rate, (d) Blood pressure, (e) Venous return, 48. Because of proven beneficial effects on, “cardiac remodeling”, these agents are, now indicated as first line therapy in CHF, patients. Which of the following is, representative of this group of drugs?, (a) Hydrochlorothiazide, (b) Enalapril, , (c) Furosemide, (d) Carvedilol, (e) Bumetanide, 49. For treating the patient with congestive, heart failure (CHF), which of the following, dosages of dopamine is selected for its, positive inotropic effects?, (a), (b), (c), (d), (e), , 2.0 mg/kg/min, 5–10 mg/kg/min, 10–20 mg/kg/min, 40 mg/kg/min, 40 mg/kg/min, , 50. Milrinone is an example of, (a), (b), (c), (d), , Phosphodiesterase I inhibitor, Phosphodiesterase II inhibitor, Phosphodiesterase III inhibitor, Phosphodiesterase IV inhibitor, , 51. Situations that predispose a digitalistreated patient to toxicity include, (a) Hypercalcemia, (b) Hyperkalemia, (c) Hypermagnesemia, 52. Unfractionated heparin binds to antithrombin III and inactivates clotting, factor(s), (a) Xa, (b) Ixa, (c) Iia, (d) All of the above, (e) None of the above, 53. A patient to be commenced on oral anticoagulant therapy for DVT would be, treated with, (a) Oral anticoagulant therapy with warfarin for, a goal intenational normalized ration (INR), of 2–3, (b) Oral anticoagulant therapy with warfarin for, a goal INR of 2.5–3.5, (c) Oral anticoagulant therapy with aspirin for, a goal INR of 2–3, 54. A patient on oral anticoagulant therapy, is commenced on sulfamethoxazoletrimethoprim, double-strength twice daily., One may expect to see the international, normalized ratio

Page 141 :
MCQs IN PHARMACOLOGY, , 126, (a) Increase, (b) Decrease, (c) Remain unchanged, 55. When compared to unfractionated, heparin, low molecular weight heparins, have, (a) Preferential binding affinity to factor Xa, relative to Iia (thrombin), (b) Shorter half-lives, (c) Dose – dependent renal clearance, 56. Acute renal failure (ARF) may be caused, by all of the following except, (a) Acute tubular necrosis (ATN) due to drug, therapy (e.g., aminoglycosides, contrast, media), (b) Severe hypotension or circulatolry collapse, (c) Decreased cardiac output, as from, congestive heart failure, (d) Hemolysis, myoglobinuria, (e) Hyperkalemia, 57. During Phase 2 of action potential in, cardiac cell, depolarizing current through, calcium channels is balanced by, (a), (b), (c), (d), , Delayed rectifier potassium current, outward chloride channel, Both (a) and (b), None of the above, , 58. The action of quinidine differs from that, of digitalis in, (a) Decreasing irritability of cardiac muscle, (b) Preventing passage of impulses to the, ventricle, (c) Increasing irritability of heart muscle, (d) Reducing conductivity, (e) None of the above, 59. Overuse of digitalis may result in, (a) Habituation, (b) Tolerance, (c) Addiction, (d) Physical dependence, (e) Cummulative poisoning, 60. The action of digitalis is enhanced by, (a) Sodium, (c) Magnesium, (e) Chloride, , (b) Calcium, (d) Potassium, , 61. In case of acute pain of angina pectoris, the most effective treatment would be to, administer, (a), (b), (c), (d), (e), , Mannitol hexanitrate, Erythrityl tetranitrate, Sodium nitrate, Pentaerythritol tetranitrate, Nitroglycerin, , 62. Which of the following is used to lower, blood lipid levels?, (a) Trimethadione, (c) Flucytosine, (e) Propranolol, , (b) Clofibrate, (d) Coumarin, , 63. The chief use of levoarterenol is to treat, (a) Shock, (c) Hypertension, (e) Iron deficiencies, , (b) Diabetes, (d) Cardiac arrhythmias, , 64. Tolerance to nitroglycerin may be, overcome by, (a) Initially using the largest safe dose of the drug, (b) Using other nitrites, (c) Temporarily discontinuing the drug for one, or two weeks, (d) Use of higher doses, (e) None of the above, 65. Quinidine can cause paradoxical tachycardia in a patient of, (a), (b), (c), (d), , Stick sinus syndrome, Auricular extrasystoles, Auricular fibrillation, Ventricular extrasystoles, , 66. Quinidine is now used primarily for, (a) Conversion of auricular fibrillation to sinus, rhythm, (b) Control of ventricular rate in atrial flutter, (c) Termination of ventricular tachycardia, (d) Prevention of recurrences of atrial and, ventricular extrasystoles/tachycardias, 67. Procainamide differs from quinidine in the, following respect, (a), (b), (c), (d), , It does not cause paradoxical tachycardia, It has no alfa adrenergic blocking activity, It has little antivagal action, Both (b) and (c)

Page 142 :
CARDIO–VASCULAR DRUGS, , 127, , 68. In heart, potassium channels determine, (a), (b), (c), (d), , Pacemaker function, Resting potential, Action potential duration, All of the above, , 69. Lidocaine is the preferred antiarrhythmic, for emergency control of cardiac arrhythmias following acute myocardial infarction, because, (a) It has a rapidly developing and titratable, antiarrhythmic action, (b) It casues little myocardial depression and, hypotension, (c) It has broad spectrum antiarrhythmic efficacy, in atrial as well as ventricular arrhythmias, (d) Both (a) and (b), 70. Hypothyroidism is a possible consequence, of prolonged therapy with, (a) Procainamide, (c) Sotalol, , (b) Mexiletine, (d) Amiodarone, , 71. Which of the following drugs is preferred, for termination of paroxysmal supraventricular tachycardia, (a) Digoxin, (c) Propranolol, , (b) Quinidine, (d) Verapamil, , 72. The following drug is used to reduce the, frequency of angina pectoris as well as, to terminate an acute attack, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 73. Antianginal drugs afford the following, benefit/benefits, (a) Terminate anginal attacks, (b) Decrease the frequency of anginal attacks, (c) Retard the progression of coronary artery, disease, (d) Both (a) and (b), 74. Choose the correct statement about the, action of nitrates on coronary vessels, (a) They mitigate angina pectoris by increasing, total coronary flow, (b) They preferentially dilate conducting arteries, without affecting resistance arterioles, , (c) They preferentially dilate autoregulatory, arterioles without affecting the larger arteries, (d) They increase subepicardial blood flow, without affecting subendocardial blood flow, 75. Organic nitrates relax vascular smooth, muscle by, (a), (b), (c), (d), , Increasing intracellular cyclic AMP, Increasing intracellular cyclic GMP, Decreasing intracellular cyclic AMP, Both (b) and (c), , 76. Select the organic nitrate which undergoes, minimal first-pass metabolism in the liver, (a), (b), (c), (d), , Glyceryl trinitrate, Isosorbide dinitrate, Isosorbide mononitrate, Erythrityl tetranitrate, , 77. The primary mechanism of beneficial, effect of glyceryl trinitrate in classical, angina pectoris is, (a), (b), (c), (d), , Increase in total coronary blood flow, Redistribution of coronary blood flow, Reduction of cardiac preload, Reduction of cardiac after load, , 78. Enhanced automaticity in cardiac cells, may occur because of, (a), (b), (c), (d), , β-adrenergic stimulation, Hypokalemia, Mechanical stretch of cardiac muscles, All of the above, , 79. Glyceryl trinitrate is administratered by, all of the following routes except, (a) Oral, (c) Intramuscular, , (b) Sublingual, (d) Intravenous, , 80. A patient of acute myocardial infarction, being treated in intensive care unit, developed left ventricular failure with raised, central venous pressure. It was decided to, use glyceryl trinitrate. Which route/method, of administration would be most suitable., (a), (b), (c), (d), , Sublingual, Oral, Intravenous bolus injection, Slow intravenous infusion

Page 143 :
MCQs IN PHARMACOLOGY, , 128, 81. A patient suffers from spisodic pain, diffusely localized over the chest and upper, abdomen, which is relieved by sublingual, glyceryl trinitrate. He could be suffering, from, (a), (b), (c), (d), , Angina pectoris, Biliary colic, Esophageal spasm, All of the above, , 82. The dihydropyridines block the following, type of calcium channels., (a), (b), (c), (d), , L-type voltage sensitive channels, T-type voltage sensitive channels, N-type voltage sensitive channels, Receptor operated calcium channels, , 83. Which of the following drugs is most, likely to accentuate varient (Prinzmetal), angina ?, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 84. In cardiac cells, adenosine, (a), (b), (c), (d), , Causes shortening of action potential duration, Depolarization, Increase in normal automaticity, All of the above, , 85. Which of the following antianginal drugs, is most likely to produce tachycardia as, a side effect ?, (a) Amlodipine, (c) Diltiazem, , (b) Nifedipine, (d) Verapamil, , 86. Which of the following is not an attribute, of amlodipine ?, (a), (b), (c), (d), , High and consistent oral bioavailability, Large volume of distribution, Generation of an active metabolite, Long elimination half-life, , 87. Propranolol should not be prescribed for, a patient of angina pectoris who is already, receiving, (a), (b), (c), (d), , Nifedipine, Felodipine, Verapamil, Isosorbide mononitrate, , 88. Which of the following drugs is a potassium, channel opener ?, (a) Pinacidil, (c) Glibenclamide, , (b) Hydralazine, (d) Amiloride, , 89. Though nitrates and calcium channel, blockers are both vasodilators, they are, used concurrently in angina pectoris, because, (a) They antagonize each other’s side effects, (b) Nitrates primarily reduce preload while, calcium channel blockers primarily reduce, after load, (c) Nitrates increase coronary flow while, calcium, (d) Both (b) and (c), 90. ‘Coronary steal phenomenon’ has been, noted most frequently with, (a) Glyceryl trinitrate (b) Dipyridamole, (c) Propranolol, (d) Diltiazem, 91. Which of the following drugs is believed, to improve microcirculation in peripheral, vascular diseases by promoting RBC, flexibility ?, (a) Cyclandelate, (c) Pentoxiphyline, , (b) Theophyline, (d) Nicotinic acid, , 92. Higher incidence of myocardial infarction and increased mortality has been, noted with the use of the following antihypertensive drug, (a) Nifedipine, (c) Diltiazem, , (b) Verapamil, (d) Lisinopril, , 93. Cardiac glycosides are obtained from, following plant source., (a), (b), (c), (d), , Rauwolfia serpentina, Strophanthus gratus, Ricinus commounts., Atropa belladonna, , 94. Therapeutic dose of digoxin in a normal, individual has the following effects, except, (a), (b), (c), (d), , Increase in the speed of myocardial contractility, No significant change in cardiac output, Relaxation of peripheral vascular bed, Increase in the force of myocardial, contractility

Page 144 :
CARDIO–VASCULAR DRUGS, , 129, , 95. Digoxin given for cardiac failure is, extremely valuable in patients of, (a) Thyrotoxicosis, (c) Cor pulmonale, , (b) Beriberi, (d) Atrial fibrillation, , 96. The agent given sublingually in an acute, attack of angina pectoris is, (a), (b), (c), (d), , Glyceryl trinitrate, Amyl nitrite, Erythrital tetranitrate, Pentaerythritol tetranitrate, , 97. Following statement is true about lidocaine, (a), (b), (c), (d), , Reduce the slope of Phase 4, Threshold excitability is not altered, Action potential is not affected, All of the above, , 98. Aspirin in small doses (50 to 150 mg per, day), (a) Is of benefit in patients of unstable angina, (b) Has thrombolytic action, (c) PREFerentially inhibits prostacyclin synthetase, enzyme, (d) MAY Alleviate need for Verapamil in variant, angina, 99. Major beneficial effect of nitrates in, classical angina is due to, (a) Dilation of veins more than arteries, (b) Increase in total coronary blood flow, (c) An increase in the end diastolic size of the, heart, (d) An increase in the heart rate, 100. Major lipid class present in chylomicrons, is, (a), (b), (c), (d), , Endogenous triglycerides, Cholesterol esters, Dietary triglycerides, All of the above, , 101. Polymorphic ventricular tachycardia can, occur when terfenadine, (a), (b), (c), (d), , Is coadministered with azithromycin, Is coadministered with fluconazole, Is given in higher doses, Reduces QT interval, , 102. Digitalis was discovered by, (a), (b), (c), (d), , William Withering, Ottolewi, Walksman, Dale, , 103. The cardiac slowing by digitalis in atrial, fibrillation and congestive failure, (a) Is due partly to increased vagal activity, (b) Is due partly to decreased sympathetic, activity, (c) Is due partly to depression of S.A. Node, (d) May be partly related to a vagal mediated, increse in atrial frequency, 104. After oral administration peak concentration of digoxin is reached in, (a) 1 to 2 mins, (c) 5 to 10 mins, , (b) 30 to 60 mins, (d) 4 to 6 hours, , 105. The normal therapeutic plasma concentration of digitalis is, (a) 0.5 to 1.5 ng/ml and toxicity appears above, 3 mg/ml, (b) 1 to 5 ng/µl and toxicity appears above 50, mg/ml, (c) 0.1 to 0.5 αg mg/ml and toxicity appears, above 5, (d) 0.5 to 1.5 αg mg/ml and toxicity appears, above 5 αg mg/ml, 106. Drug of choice for digitalis induced, arrhythmia is, (a) Propranolol, (c) Xylocaine, , (b) Phenytoin, (d) Phenylephrine, , 107. In which of the following conditions,, digitalis is most likely to be beneficial?, (a), (b), (c), (d), , Heart failure from valvular lesions, Furosemide, Heart disease with anaemia, Heart failure from thyrotoxicosis, , 108. Nicotinic acid, (a), (b), (c), (d), , Decreases production of VLDL, Decreases LDL levels, Increases HDL levels, All of the above

Page 145 :
MCQs IN PHARMACOLOGY, , 130, 109. Which of the following would least likely, benefit a patient in acute pulmonary, edema due to congestive heart failure?, (a), (b), (c), (d), , Intravenous morphine, Digoxin, Oxygen, Rotating tourniquets, , (c) Probably be the result of drug-induced heart, block, 115. Digoxin differs from digitoxin in that, digoxin, (a) Has a longer half life, , (a) Do not cause postural hypotension, (b) Are known to reduce blood pressure by, depleting catecholamines, (c) Have a prompt hypotensive action, (d) Generally do not cause tachycardia, 111. Digitalis is given before quinidine in the, treatment of atrial fibrillation, because, digitalis increase A-V conduction and, counteracts, and, and, and, and, , 112. The earliest toxic symptom of chronic, digitalis administration is, (a), (b), (c), (d), , (b) Be the desired response of the drug, , (d) Be an indication for increasing the drug dose., , 110. Monoamine oxidase inhibitors, , (a) The “Vagotonic” effect of quinidine, prevents “paradoxic” tachycardia, (b) The “Vagolytic” effect of quinidine, prevents “paradoxic” bradycardia, (c) The “Vagotonic” effect of quinidine, prevents paradoxic bradycardia, (d) The “Vagolytic” effect of quinidine, prevents paradoxic tachycardia, , (a) Probably be unrelated to drug administration, , Altered color vision, Psychic symptoms, Anorexia, nausea, vomiting, Retrosternal pain, , 113. In normal condition sequence of conduction of cardiac action potential is, (a) SA node to AV node to bundle of His to atrium, (b) SA node to atrium to AV node to bundle of, His, (c) SA node to atrium to bundle of His to AV, node, (d) SA node to AV node to atrium to bundle of, His, 114. While treating a CHF patient with cardiac, glycoside, one notices that the patient’s, resting heart rate, which previously had, been 86/min is now 40/min. This would, , (b) Is completely absorbed from the GI tract, (c) Is bound extensively to plasma proteins, (d) Its half-life is more dependent on the, adequacy of renal function, 116. Diazoxide is administered by slow IVinjection in emergency treatment of, hypertension because, (a) The drug is rapidly biotransformed by hepatic, microsomal enzymes, (b) The drug is highly lipid-soluble and quickly, deposited in natural fat, (c) This measure is necessary to prevent severe, hyperglycemia, (d) The drug is quickly inactivated by serum, protein binding, 117. Glyceryl trinitrate is generally taken by, (a) Oral route, , (b) Intravenous route, , (c) Sublingual route, , (d) Subcutaneous route, , 118. Which of the following is longest acting, nitrate?, (a) Glyceryl trinitrate, (b) Ethyt tetranitrate, (c) Octyl nitrite, (d) Pentaerythritol tetranitrate, 119. Methaemoglobinaemia can occur with, high doses of, (a) Digitalis, , (b) Nitrites, , (c) Propranolol, , (d) All of the above, , 120. Cardiac glycoside consists of, (a) Aminoacids and sugar, (b) A steroid combined with sugar residue, (c) A polypeptide and sugar, (d) None of the above

Page 146 :
CARDIO–VASCULAR DRUGS, 121. Vascoconstriction is produced by following, agent, (a), (b), (c), (d), , Sympathomimetic amines, Eicosanoids, Endothelin, All of the above, , 122. Perhexillene meleate is a, (a), (b), (c), (d), , Vasodilator drug, Cardiotonic drug, Antihyperlipidaemic drug, Urinary antiseptic, , 123. The dose of verapamil is, (a), (b), (c), (d), , 4 to 6 gms per day, 40 to 80 gms thrice daily, 1 to 10 mg thrice daily, 250 mg once daily, , 124. Chronic use of nitrites may lead to, (a), (b), (c), (d), , Allergic response, Addietion, Atherosclerotic changes, Tolerance, , 125. While treating auricular fibrillation, digitalization is necessary prior to quinidine, because, (a) It prevents paradoxical increase in ventricular, rate, (b) Quinidine is only effective in the presence, of digitalis, (c) It reduces the dose and side effects of, quinidine, (d) It antagonizes the extracardiac effects of, quinidine, 126. Which of the following pharmacological, properties of quinidine is not useful, clinically?, (a) Shorterning of A-V nodal refractory period, due to vagolytic action, (b) Depression of cardiac contractility, (c) Decrease in the automaticity of the normal, pacemaker, (d) Reduction in the slope of slow diastolic, depolarization, , 131, 127. Resperine is used in hypertension, only, in low doses because, (a) It is a very strong antihypertensive, (b) Side effects become disproportionately, marked, (c) High doses on chronic use cause addiction, (d) It has a very long duration of action, 128. There is no rationale of giving digitoxin, parenterally because, (a) It is very painful if given parenterally, (b) Its total initial oral and parenteral digitalization, dose is same, (c) It is quickly metabolized if given I.V. or I.M., (d) It is always preferred by I.V. route, 129. For a longer duration of action nitroglycerine, can be administered by which of the, following routes, (a), (b), (c), (d), , Sublingual, Inhalation, Intravenous, Cutaneous application, , 130. Activation of prothrombin to thrombin is, carried out by, (a) Factor VIII, (c) Factor IX, , (b) Factor V, (d) All of the above, , 131. Which of the following is not a calcium, channel blocker?, (a) Verapamil, (c) Prenylamine, , (b) Diltiazam, (d) Propranolol, , 132. In the treatment of cardiac shock, the, drug of choice is, (a), (b), (c), (d), , Dopamine, Propranolol, Phenoxybenzamine, Metaraminol, , 133. Polymorphic ventricular tachycardia can, be a complication of, (a) Loratadine, (c) Astemizole, , (b) Cetirizine, (d) C + D, , 134. In hypertension which drug besides, lowering blood pressure arrests and even, reverses cardiac hypertrophy

Page 147 :
MCQs IN PHARMACOLOGY, , 132, (a), (b), (c), (d), , ACE inhibitors, Betablockers, Calcium channel blockers, Diuretics, , 138. Which of the following is directly acting, vascular smooth muscle relaxant ?, , 135. The ACE inhibitor useful in hypertensive, emergencies is, (a) Enalaprilat, (c) Fosinoprilat, , (b) Benzalaprilat, (d) Quinoprilat, , 136. Effect of decreased vitamin K on action, of warfarin is, (a), (b), (c), (d), , Enhanced anticoagulatory effect, Decreased anticoagulatory, No effect, Unpredictable effect, , (b) Minoxidil, , (c) Clonidine, , (d) Diazoxide, , 139. The most potent stimulant for heart is, (a) Adrenaline, , (b) Noradrenaline, , (c) Dopamine, , (d) Ephedrine, , 140. Fibrinolysis is mainly carried out by, (a) Tissue – type plasminogen activator, (b) Urokinase – type plasminogen activator, (c) Both (a) and (b), (d) None of the above, , 137. Nitroglycerin ointment in clinical use is, (a) 1%, (c) 5%, , (a) Verapamil, , (b) 2%, (d) 10%, , 141. Following is a phenothiazine analog with, sodium channel blocking properties, (a) Moricizine, , (b) Mexiletine, , (c) Tocainide, , (d) Propafenone, , ANSWERS, 1. a, 7. a, 13. a, 19. c, 25. b, 31. c, 37. c, 43. b, 49. b, 55. a, 61. e, 67. d, 73. d, 79. c, 85. b, 91. c, 97. a, 103. a, 109. d, 115. d, 121. d, 127. b, 133. d, 139. a, , 2. d, 8. d, 14. e, 20. e, 26. a, 32. e, 38. e, 44. b, 50. c, 56. e, 62. b, 68. d, 74. b, 80. d, 86. c, 92. a, 98. a, 104. d, 110. d, 116. d, 122. a, 128. b, 134. a, 140. c, , 3. d, 9. d, 15. d, 21. b, 27. b, 33. b, 39. c, 45. d, 51. a, 57. a, 63. a, 69. d, 75. b, 81. d, 87. c, 93. b, 99. a, 105. a, 111. d, 117. c, 123. b, 129. d, 135. a, 141. a, , 4. d, 10. c, 16. d, 22. a, 28. a, 34. b, 40. c, 46.b, 52. d, 58. a, 64. c, 70. d, 76. c, 82. a, 88. a, 94. c, 100. c, 106. b, 112. c, 118. d, 124. d, 130. b, 136. b, , 5. d, 11. b, 17. c, 23. b, 29. a, 35. d, 41. b, 47.a, 53. a, 59. e, 65. c, 71. d, 77. c, 83. a, 89. b, 95. d, 101. c, 107. a, 113. b, 119. b, 125. a, 131. d, 137. b, , 6. c, 12. d, 18. d, 24. d, 30. b, 36. c, 42. c, 48. b, 54. a, 60. b, 66. d, 72. a, 78. d, 84. a, 90. b, 96. a, 102. a, 108. b, 114. c, 120. b, 126. a, 132. a, 138. a

Page 148 :
CARDIO–VASCULAR DRUGS, , 133, , EXPLANATIONS FOR THE ANSWERS, 1. a, , 7. d, , Arterial blood pressure is directly proportional, to the blood flow, i.e., cardiac output and, peripheral vascular resistance. This relationship, is correctly represented by equation in ‘A’, Moxonidine acts mainly on imidazline I 1, receptors and produces antihypertensive effect., , other phosphodiesterase isoforms are as follows:, Phosphodiesterase I : Vinopocetine, Phosphodiesterase II : Not available, Phosphodiesterase IV : Rolipram, 57. a, , Phase 2 of action potential, also known as, ‘plateau phase’ involves inward calcium current,, which has a slower inactivation. This inward, calcium current is balanced by outward delayed, rectifier potassium current., , 68. d, , Potassium channels play an important role in, various aspects of action potential in the heart, viz. pacemaker function, resting potential and, action potential duration., , 78. d, , β-Adrenergic stimulation, hypokalemia and, mechanical stretch produce increase in phase, 4 slope, leading to acceleration of pacemaker, rate, which results in enhanced automaticity., , 84. a, , In cardiac cells, adenosine acts on its specific, membrane receptors and activates acetylcholinesensitive potassium current, specifically in atrium,, sinus and AV node. This results in shortening of, action potential duration. Activation of potassium, current also results in hyperpolarization and, slowing of automaticity., , 97. a, , Lidocaine blocks both open and inactivated, cardiac sodium channels. It decreases, automaticity mainly by reducing the slope of, phase 4 and alters the threshold for cardiac, excitability., , Dexmedetomidine is a α2-adrenergic receptor, agonist., Tizanidine is a spasmolytic agent., 12. d, , Both angiotensin II and III promote aldosterone, release. Aldosterone promotes the reabsorption, of sodium by distal renal tubules and this may, increase the plasma volume and hypertension., Angiotensin I is inactive., , 16. d, , Activation of ETA receptors leads to vasoconstriction, bronchoconstriction and stimulation of, aldosterone release., Affinity of various endothelins for ETA receptor, is ET1 = ET2 > ET3., , 19. c, , Spironolactone binds with cytoplasmic, mineralocorticoid receptors. It also decreases, the interacellular formation of active metabolites, of aldosterone., Triamterene and amiloride directly interfere with, sodium entry., , 28. a, , 34. b, , Carbonic anhydrase inhibitors inhibit both the, membrane and cytoplasmic forms of carbonic, anhydrase and thus completely inhibit, reabsorption of sodium bicarbonate in the, proximal tuble., Both glycerin and isosorbide are orally active, osmotic diuretics and hence show good oral, absorption., Mannitol shows negligible absorption., , 39. c, , 40. c, , 50. c, , Lidocaine may shorten the duration of action, potential because of blockade of sodium, channels, which get inactivated late during, action potential,, 100. c, , Ethacrynic acid is a phenoxy acetic acid, derivative. Furosemide and bumetanide contain, sulfonamide moiety in their structure., Spironolactone is an aldosterone antagonist., Aldosterone is a mineralocorticoid and mineralcorticoid receptors are present in epithelial, cells of late distal tubule and collecting duct., Milrinone is an inhibitor of phosphodiesterase, III and it produces positive inotropism via, inhibition of cGMP. Examples of inhibitors of, , Chylomicrons contain dietary triglycerides as, the major lipid class., VLDL contains endogenous triglycerides and IDL,, LDL and HDL contain cholesterol esters as major, lipid class., , 108. d, , Nicotinic acid produces decrease in LDL levels, because of decreased VLDL production and, enhanced clearance of LDL precursors in liver., VLDL levels are decreased because of decreased, delivery of free fatty acids to liver, decrease in, triglyceride synthesis and decrease in VLDL-

Page 149 :
MCQs IN PHARMACOLOGY, , 134, , 113. b, , 221. d, , 130. b, , 136. a, , triglyceride transport. Mechnism of increased, levels of HDL by nicotinamide is not known but, decreased clearance of apo A-I and decreased, synthesis of apoA-II may play important role., The entire sequence of conduction of action, potential under normal condition is as follows:, SA node → Atria → AV node → Bundle of His,, Purkinje fibers → Ventricles., Sympathomimetic amines, eicosanoids and, endothelins act on their respective receptors and, increase the calcium influx thereby production, contraction of smooth muscles and hence, vasoconstriction., Prothrombin, which is bound to phospholipid, surface of platelets, is activated by factor Xa in, the presence of actor V to thrombin., Warfarin acts as an anticoagulant by inhibiting, , 140. c, , 141. a, , enzymatic reduction of vitamin K to its active, hydroquinone form and the inhibition is, competitive. Thus, if there are decreased levels, of vitamin K obviously there will be less, competition for inhibition resulting in enhanced, anticoagulatory effect of warfarin., Fibrinolysis (thrombolysis) is carried out by, various endogenous plasminogen activators e.g., tissue-type plasminogen activator, urokinase-type, plasminogen activator and also kallikrein and, neutrophil elastase., Moricizine is a phenothiazine analogue with, sodium channel blocking activity and is used in, the treatment of ventricular arrhythmias., Mexiletine and tocainide are analogous of, lidocaine., Propafenone has some structural similarities to, propranolol.

Page 150 :
DRUGS USED IN RESPIRATORY DISORDERS, , 135, , CHAPTER 7, DRUGS USED IN RESPIRATORY, DISORDERS, 1. Which of the following terms best, describes the antagonism of leukotriene’s, bronchoconstrictor effect (mediated at, leukotriene receptors) by terbutaline, (acting α adrenoceptors) in a patient with, asthma?, (a), (b), (c), (d), (e), , Pharmacologic antagonist, Partial agonist, Physiologic antagonist, Chemical antagonist, Noncompetitive antagonist, , 2. If therapy with multiple drugs causes, induction of drug metabolism in your, asthma patient, it will, (a) Result in increased smooth endoplasmic, reticulum, (b) Result in increased rough endoplasmic, reticulum, (c) Result in decreased enzymes in the soluble, cytoplasmic fraction, (d) Require 3-4 months to reach completion, (e) Be irreversible, 3. The Symptoms of allergen-mediated, asthma result from which of the, following?, (a) Increased release of mediators from mast, cells, (b) Increased adrenergic responsiveness of the, airways, (c) Increased vascular permeability of bronchial, tissue, , (d) Decreased calcium influx into the mast cells, (e) Decreased prostaglandin production, 4. Which of the following will result from, blockade of H2 receptors?, (a), (b), (c), (d), (e), , Decreased camp in cardiac muscle, Increased camp in cardiac muscle, Decreased IP3 in gastric mucosa, Increased IP3 in gastric mucosa, Increased IP3 in smooth muscle, , 5. Toxicities of H2 antihistamines include, which one of the following?, (a), (b), (c), (d), (e), , Blurred vision, Diarrhea, Orthostatic hypotension, P450 inhibition, Sleepiness, , 6. A patient undergoing cancer chemotherapy is vomiting frequently. A drug that, might help in this situation is, (a) Bromocriptine, (c) Ketanserin, (e) Ondansetron, , (b) Cimetidine, (d) Loratadine, , 7. Which of the following is most useful in, the treatment of hyperprolactinemia ?, (a) Bromocriptine, (c) Ergotamine, (e) LSD, , (b) Cimetidine, (d) Ketanserin

Page 151 :
MCQs IN PHARMACOLOGY, , 136, 8. Drugs that can dilate bronchi during an, acute asthmatic attack include all of the, following except, (a) Epinephrine, (c) Nedocromil, (e) Ipratropium, , (b) Terbutaline, (d) Theophyline, , 9. Which of the following is a nonselective but, very potent and efficacious bonchodilator, that is not active by the oral route?, (a) Aminophyline, (c) Epinephrine, (e) Metaproterenol, , (b) Cromolyn, (d) Ipratropium, , 10. Which of the following is a prophylactic, agent that appears to stabilize mast cells?, (a) Aminophyline, (c) Epinephrine, (e) Metaproterenol, , (b) Cromolyn, (d) Ipratropium, , 11. Which of the following is a direct bronchodilator that is most often used in, asthma by the oral route?, (a) Aminophyline, (c) Epinephrine, (e) Metaproterenol, , (b) Cromolyn, (d) Ipratropium, , 12. Acute exacerbations of asthma can be, triggered by all of the following except, (a), (b), (c), (d), (e), , Bacterial of viral pneumonia, Hypertsensitivity reaction to penicillin, Discontinuation of asthma medication, Hot, dry weather, Stressful emotional events, , 13. Which of the following has overdose, toxicity that includes insomnia, arrhythmias, and convulsions?, (a) Aminophyline, (c) Epinephrine, (e) Metaproterenol, , (b) Cromolyn, (d) Ipratropium, , 14. Which of the following is a very longacting β2 – selective agonist that is used, for asthma prophylaxis?, (a) Aminophyline, (c) Epinephrine, (e) Salmeterol, , (b) Cromolyn, (d) Ipratropium, , 15. Which one of the following drugs is most, suitable for management of essential, tremor in a patient who has pulmonary, disease?, (a) Diazepam, (c) Metoprolol, (e) Terbutaline, , (b) Levodopa, (d) Propranolol, , 16. A drug useful in the treatment of asthma, but lacking bronchodilator action, is, (a) Cromolyn, (c) Isoproterenol, (e) Metoprolol, , (b) Ephedrine, (d) Metaproterenol, , 17. Relative to fexofenadine, diphenhydramine is more likely to, (a) Be used for treatment of asthma, (b) Be used for treatment of gastroesophageal, reflux disease, (c) Cause cardiac arrhythmias in overdose, (d) Have efficacy in the prevention of motion, sickness, (e) Increase the serum concentration of warfarin, 18. Bacteria that make either a fementative, or respiratory set of enzymes are known, as, (a), (b), (c), (d), , Obligate anacerobes, Obligate aerobes, Microacerophiles, Facultative organisms, , 19. The symptoms of allergen-mediated asthma, result from which of the following?, (a) Increased release of mediators from mast, cells, (b) Increased adrenergic responsiveness of the, airways, (c) Inceased vascular permeability of bronchial, tissue, (d) Decreased calcium influx into the mast cell, (e) Decreased prostaglandin production, 20. Acute exacerbations of asthma can be, triggered by all of the following except, (a) Bacterial or viral pneumonia, (b) Hypersensitivity reaction to penicillin, (c) Discontinuation of asthma medication

Page 152 :
DRUGS USED IN RESPIRATORY DISORDERS, (d) Hot, dry weather, (e) Stressful emotional events, 21. In the emergency department, the preferred, first-line therapy for asthma exacerbation, is, (a) Theophyline, , (b) A β-agonist, , (c) A corticosteroid, , (d) Cromolyn sodium, , (e) An antihistamine, 22. Which of the following tests is used at home, to assess therapy and determine if a patient, with asthma should seek emergency care?, (a) Forced expiratory volume in one second, (FEV1), (b) Forced vital capacity (FVC), (c) Total lung capacity (TLC), (d) Peak expiratory flow rate (PEFR), (e) Residual volume (RV), 23. Which of the following agents and, dosage regimens is the best choice of, treatment for an asthma patient with, rheumatoid arthritis who is considered, sensitive to aspirin (experiences bronchospasm with use)?, (a) Lbuprofen, 800 mg three times daily, (b) Acetaminophen, 650 mg every 4 hours, (c) Gold injections, 25 mg intramuscularly once, a week, (d) Azathioprine, 75 mg daily, (e) Cyclophosphamide, 100 mg daily, 24. A drug administered by inhalation of, powder as a prophylactic for asthma is, (a) Ephedrine, , (b) Disodium cromolyn, , (c) Isoproterenol, , (d) Ocytriphylline, , (e) Epinephrine, 25. Which of the following may precipitate, an asthma attack?, (a) Respiratory acidosis, (b) Viran and bacterial infections, (c) Respiratory alkalosis, (d) Cranberry jiuce, (e) Chocolate or Coca Cola, , 137, 26. Terbutaline has a preference for stimulation, of which of the following receptors?, (a) Alpha, , (b) Gamma, , (c) Beta 1, , (d) Beta 2, , (e) Dopaminergic, 27. The National Institutes of Health (NIH), guidelines for the treatment of asthma, recommended institution of routine, inhaled corticosteroids when patients are, classified as having greater than or equal, to which type of asthma?, (a) Mild intermittent, (b) Mild persistent, (c) Moderate persistent, (d) Severe persistent, 28. Isoxuprine is used to treat, (a) Asthma, , (b) Severe hypotension, , (c) Nasal congestion (d) Premature labor, (e) Hypertension, 29. The most likely complication of prolonged, use of nasal decongestant drops is, (a) Atrophic rhinitis, (b) Hypertrophy of nasal mucosa, (c) Naso-pharyngeal moniliasis, (d) Blockage of Eustachian tubes, 30. Which of the following is a selective H1, receptor agoinist ?, (a) 4-methyl histamine, (b) Impromidine, (c) 2-Thiazolyl ethylamine, (d) Mepyramine, 31. Fall in blood pressure caused by larger, doses of histamine is blocked by, (a) H1 antihistaminics alone, (b) H2 ANTAgonists alone, (c) Combination of H1 and H2 antagonists, (d) None of the above, 32. Histamine is involved as a mediator in, the following pathological conditon, (a) Cocaine, , (b) Dibucaine, , (c) Lidocaine, , (d) Procaine

Page 153 :
MCQs IN PHARMACOLOGY, , 138, 33. In the emergency department, the, preferred first-line therapy for asthma, exacerbation is, (a) Theophylline, (b) A β-agonist, (c) A corticosteroid (d) Cromolyn sodium, (e) An antihistamine, 34. The capacity of an antihistaminic to produce, sedation depends on the following except, , 40. The action of 5-Hydroxy tryptamine, mediated by the 5-HT3 receptor is, (a) Vasoconstriction, (c) EDRF release, , (b) Bradycardia, (d) Platelet aggregation, , 41. Tachyphylaxis to many actions on, repeated injection is a feature of the, following autocoid, (a) Histamine, (c) Bradykinin, , (b) 5-Hydroxytryptamine, (d) Angiotensin, , (a) Relative affinity for central versus peripheral, H1 receptors, (b) Ability to penetrate blood-brain barrier, (c) Individual susceptibility, (d) Ratio of H1 : H2 blockade produced by the drug, , 42. The smooth muscle stimulating action of, 5-HT is most marked in the, , 35. While prescribing the conventional H1, antihistaminics the patient should be, advised to avoid, , 43. The 5-HT antagonist that has antihypertensive property is, , (a), (b), (c), (d), , Driving motor vehicles, Consuming processed cheese, Strenuous physical exertion, All of the above, , 36. The antihistaminc which has calcium, channel blocking and labyrinthine, suppressant property is, (a) Cyproheptadine, (c) Clemastine, , (b) Cinnarizine, (d) Cetirizine, , 37. Erythromycin should not be given to patient, being treated with terfenadine because, (a) Erythromycin induces the metabolism of, terfenadine, (b) Dangerous ventricular arrhythmias can occur, (c) Terfenadine inhibits metabolism of erythromycin, (d) Terfenadine antagonizes the antimicrobal, action of erythromycin, 38. Select the H1 antihistaminic which is used, topically in the nose for allergic rhinitis, (a), (b), (c), (d), , Deep intra-abdominal operation, Trachial intubation, Tetanus, Diagonosis of myasthenia gravis, , 39. H1 antihistaminics are beneficial in, (a) All types of allergic disorders, (b) Certain type I allergic reactions only, (c) Anaphylactic shock(d) Bronchial asthma, , (a) Bronchi, (c) Ureter, , (a) Methysergide, (c) Ketanserin, , (b) Intestines, (d) Billary tract, , (b) Cyproheptadine, (d) Ondansetron, , 44. The most important receptor involved in, cytotoxic drug induced vomiting is, (a), (b), (c), (d), , Histamine H1 receptor, Serotonin 5-HT3 receptor, Dopamine D2 receptor, Opioid µ receptor, , 45. Which of the following expectorants acts, both directly on the airway mucosa as, well as reflexly ?, (a) Potassium iodide (b) Guaiphenesin, (c) Terpin hydrate, (d) Bromhexine, 46. Bromhexine acts by, (a) Inhibiting cough center, (b) Irritating gastric mucosa and reflexly, increasing bronchial secretion, (c) Depolymerizing mucopolysaccharides present, (d) Desensitizing stretch receptors in the lungs, 47. The primary goals of asthma therapy, include all of the following except, (a), (b), (c), (d), , maintain normal activity levels, maintain control of symptoms, avoid adverse effects of asthma medications, prevent acute exacerbations and chronic, symptoms, (e) prevent destruction of lung tissue

Page 154 :
DRUGS USED IN RESPIRATORY DISORDERS, 48. Antitussives act by, (a) Liquifying bronchial secretions, (b) Raising the threshold of cough centre, (c) Reducing cough inducing impulses from the, lungs, (d) Both (b) and (c), 49. Which of the following antitussive is, present in opium but has no analgesic or, addicting properties ?, (a) Noscapine, (c) Pholcodeine, , (b) Codeine, (d) Ethylmorphine, , 50. Bronchodilators are useful in cough, (a) Only when cough is non-productive, (b) Only when cough is associated with thick, sticky secretions, (c) Only when reflex bronchoconstriction is, associated, (d) Irrespective of nature of cough or associated, features, 51 The common and dose related side effect, of salbutamol is, (a), (b), (c), (d), , Rise in blood pressure, Muscle tremor, Hyperglycaemia, Central nervous system stimulation, , 52. Which of the following tests is used at home, to assess therapy and determine if a patient, with asthma should seek emergency care?, (a), (b), (c), (d), (e), , Forced expiratory volume in one second (FEV1), Forced vital capacity (FVC), Total lung capacity (TLC), Peak expiratory flow rate (PEFR), Residual volume (RV), , 53. In a patient of bronchial asthma, inhaled, salbutamol produces the following, effect(s)., (a), (b), (c), (d), , Inhibits antigen-antibody reaction in the lungs, Causes bronchodilatation, Reduces bronchial hyperreactivity, Both (b) and (c), , 54. Select the correct statement about salmeterol., (a) It is a long acting selective β2 agonist bronchodilator, , 139, (b) It is a bronchodilator with anti-inflammatory, property, (c) It is a β blocker that can be safely given to, asthmatics, (d) It is an antihistaminic with mast cells stabilizing, property, 55. Caffeine is more powerful than theophylline, in exerting the following action, (a), (b), (c), (d), , Bronchodilatation, Cardiac stimulation, Diuresis, Augmentation of skeletal muscle contractility, , 56. Methylxanthines exert the following, action (s) at cellular/molecular level, (a), (b), (c), (d), , Intracellular release of Ca2+, Antagonism of adenosine, Inhibition of phosphodiesterase, All of the above, , 57. Relatively higher dose of theophylline is, required to attain therapeutics plasma, concentration in, (a), (b), (c), (d), , Smokers, Congestive heart failure patients, Those receiving erythromycin, Those receiving cimetidine, , 58. The antiasthma drug which cannot be, administered by inhalation is, (a) Theophylline, (c) Budesonide, , (b) Ipratropium bromide, (d) Terbutaline, , 59. A 10 year old child suffers from exercise, induced asthma: Which is the most suitable first line drug for regular prophylactic therapy ?, (a), (b), (c), (d), , Oral salbutamol, Oral theophylline, Inhaled sodium cromoglycate, Inhaled beclomethasone dipropionate, , 60. Which of the following drugs is neither, bronchodilator nor anti-inflammatory,, but has antihistaminic and mast cell, stabilizing activity ?, (a) Sodium cromoglycate, (b) Ketotifen

Page 155 :
MCQs IN PHARMACOLOGY, , 140, (c) Beclomethasone dipropionate, (d) Mepyramine maleate, 61. The most consistent, pronounced and, sustained relief of symptoms in chronic, bronchial asthma is afforded by, (a), (b), (c), (d), , β2 sympathomimetics, Anticholinergics, Sodium cromoglycate, Corticosteroids, , 62. Intransasal spray of budesonide is, indicated in, (a), (b), (c), (d), , Common cold, Acute vasomotor rhinitis, Perennial vasomotor rhinitis, Epistaxis, , 63. In patients of bronchial asthma inhaled, corticosteroids achieve the following, except, (a) Reduce the need for bronchodilator, medication, (b) Control an attack of refractory asthma, (c) Reduce bronchial hyperreactivity, (d) Reverse diminished responsiveness to, sympathomimetic bronchodilators, 64. Budesonide is a, (a), (b), (c), (d), , Nonsteroidal anti-inflammatory drug, High ceiling diuretic, Inhaled corticosteroid for asthma, Contraceptive, , 65. In an asthma patient treated with, systemic corticosteroids, bronchodilator, drugs, (a), (b), (c), (d), , Are not needed, Are contraindicated, May be used on ‘as and when required’ basis, Are ineffective, , 66. To be a useful inhaled glucocorticoid the, drug should have, (a), (b), (c), (d), , High oral bioavailability, Low oral bioavailability, Additional bronchodilator activity, Prodrug character, , 67. Histamine, (a) May be released from mast cells by a number, of therapeutic agents, (b) Causes sedation, (c) Decreases the force of contraction of, ventricular muscle, (d) Can cause strong contractions of the gravid, human uterus, 68. Chronic Bronchitis is characterized by, I. the distruction of central and peripheral, portions of the acinus, II. an increased number of mucous glands and, goblet cells, III. edema and inflammation of the bronchioles, (a) only I is correct, (b) only III is correct, (c) I and II are correct, (d) II and III are correct, (e) I, II and III are correct, 69. Smooth muscle relaxation is due to, stimulation of which type of histamine, receptors, (a) H1, (c) H3, , (b) H2, (d) All of the above, , 70. All the following are employed in, inhalation therapy of asthma except, (a) Beclomethasone, (c) Dexamethasone, , (b) Budesonide, (d) Triamcinolone, , 71. Which xanthine derivative has no function, in asthma ?, (a) Theophylline, (c) Enprofylin, , (b) Pentoxyphyllin, (d) None of the above, , 72. What is symport ?, (a), (b), (c), (d), , Counter transport, Contransport, Carrier mediated diffusion, Solvent drug, , 73. Pyridostigmine differs from neostigmine, in that, (a), (b), (c), (d), , More potent orally, Longer acting, Less muscarinic side effects, All of the above

Page 156 :
DRUGS USED IN RESPIRATORY DISORDERS, , 141, , ANSWERS, 1. c, 7. a, 13. a, 19. a, 25. b, 31. c, 37. b, 43. c, 49. a, 55. d, 61. d, 67. d, 73. b, , 2. a, 8. c, 14. e, 20. d, 26. d, 32. b, 38. d, 44. b, 50. c, 56. d, 62. c, 68. c, , 3. a, 9. c, 15. c, 21. b, 27. b, 33. b, 39. b, 45. a, 51. b, 57. a, 63. b, 69. b, , 4. a, 10. b, 16. a, 22. d, 28. d, 34. d, 40. b, 46. c, 52. d, 58. a, 64. c, 70. c, , 5. d, 11. a, 17. d, 23. c, 29. a, 35. a, 41. b, 47. e, 53. b, 59. c, 65. c, 71. b, , 6. e, 12. d, 18. d, 24. b, 30. c, 36. b, 42. b, 48. d, 54. a, 60. b, 66. b, 72. b, , EXPLANATIONS FOR THE ANSWERS, 3. a, , 12. d, , 27. b, , 33. b, , 47. e, , In asthma, airborne antigen binds to the mast, cell, activating the immunoglobulin E (IgE)mediated process. Mediators (e.g., histamine,, leukotrienes, prostaglandins) are then released,, causing bornchoconstriction and tissue edema., Exacerbations of asthma can be triggered by, allergens, respiratory infections, occupational, stimuli (e. g., fumes from gasoline or paint),, emotions, and environmental factors. Studies, have shown that cold air can cause release of, mast cells mediators by an undetermined, mechanism. Hot, dry air does not cause this, release., The National Institutes of Health (NIH), guidelines recommend routine use of inhaled, corticosteroids in patients who have mild, persistent asthma. Short-acting β-agonist, administered in a nebulizer or administered as, a subcutaneous agent is the most appropriate, first line therapy., In an emergency situation, the most rapidly, acting agent is used first. Selection of the route, of administration depends on the severity of the, attack. An inhaled β-agonist administered in a, nebulizer or administered as a subcutaneous, agent is the most appropriate first-line therapy., Asthma is characterized by reversible airway, obstruction in response to specific stimuli. Mast, cells release mediators, which trigger bronchoc-, , 52. d, , 68. d, , onstriction. After an acute attack, in most cases, symptoms are minimal, and pathological changes are not permanent. Unlike asthma, chronic, obstructive pulmonary disease does cause progressive airway destruction, chronic bronchitis, by excessive mucus production and other changes, and emphysema by destruction of the acinus., In monitoring of asthma therapy at home, peak, expiratory flow rate (PEFR) is the best test for, assessment of therapy, trigger identification, and, the need for referral to emergency care. It is, recommended for patients who have had severe, exacerbations of asthma, who are poor, perceivers of asthma symptoms, and those with, moderate to severe disease., Chronic bronchitis is characterized by an, increase in the number of mucous and goblet, cells due to bronchial irritation. This results, in increased mucus production. Other, changes include edema and inflammation of, the bronchioles and changes in smooth, muscle and cartilage. Emphysema is a, permanent destruction of the central and, peripheral portions of the acinus distal to the, bronchioles. In this disease, adequate, oxygen reaches the alveolar duct, due to, increased rate of breathing, but perfusion is, abnormal.

Page 157 :
This page, intentionally left, blank

Page 158 :
CHAPTER 8, ANTIBIOTICS, , 1. Isoniazid is a primary antitubercular, agent that, , (a) It is active against MRSA strains, , (b) May discolor the tears, saliva, urine or feces, orange-red, , (b) It is the drug of choice in community-acquired, pneumonia, (c) It is a fourth-generation cephalosporin, (d) It decreases prothrombin time, , (c) Causes ocular complications that are, reversible if the drug is discontinued, , (e) Its antibacterial spectrum include Bacteroides, fragilis, , (a) Requires pyridoxine supplementation, , (d) May be ototoxic and nephrotoxic, (e) Should never be used due to hepatotoxic, potential, 2. A 36-year-old woman recently treated for, leukemia is admitted to hospital with, malaise, chills and high fever. Gram stain, of blood reveals the presence of gramnegative bacilli. The initial diagnosis is, bacteremia and parenteral antibiotics are, indicated. The records of the patient, reveal that she had a severe uriticarial, risk, hypotension, and respirator y, difficulty following oral penicillin V about, 6 months ago. The most appropriate drug, regimen for empiric treatment is, (a) Ampicillin plus sulbactam, (b) Aztreonam, (c) Cefazolin, (d) Imipenem plus cilastatin, (e) Ticarcillin plus clavulanic acid, 3. Which one of the following statements, about cefotetan is accurate?, , 4. A patient needs antibiotic treatment for, native valve, culture-positive infective, enterococcal 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), (c), (d), (e), , Aztreonam, Cefazolin plus genatamicin, Meropenem, Vancomycin, , 5. This drug has activity against many strains, of Pseudomomas aeruginosa. However,, when it is used alone, resistance has, emerged during the course of treatment., The drug should not be used in penicillinallergic patients. Its activity against gramnegative rods is enhanced if it is given in, combination with tazobactam, (a) Amoxicillin, , (b) Aztreonam, , (c) Imipenem, (e) Vancomycin, , (d) Piperacillin

Page 159 :
MCQs IN PHARMACOLOGY, , 144, 6. Which of the following statements about, vancomycin is accurate?, (a), (b), (c), (d), (e), , It is bacteriostatic, It binds to PBPs, It is not susceptible to penicillinase, It has the advantage of oral bioavailability, Staphylococcal enterocolitis occurs, commonly with its use, , 7. Which one of the following statements, about ampicillin is false?, (a) Its activity is enhanced by sulbactam, (b) It causes maculopapular rashes, (c) It is the drug of choice for Listeria monocytogenes infection, (d) It eradicates most strains of MRSA, (e) Pseudomembranous colitis may occur with, its use, 8. The mechanism of antibacterial action of, tetracycline 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, (e) Inhibition of DNA–dependent RNA, polymerase, 9. Clarithromycin and erythromycin have very, similar spectrums of antimicrobial activity., The major advantage of clarithromytcin is, that it, (a) Eradicates mycoplasmal infections in a single, dose, (b) Is active against strains of streptococci that, are resistant to erythromycin, (c) Is more active against Mycobacterium avium, complex, (d) Does not inhibit live drug-metabolizing enzymes, (e) Acts on methicillin-resistant strains of, staphylococci, 10. The primary mechanism underlying the, resistance of gram-positive organisms to, macrolide antibiotics is, , (a) Methylation of binding sites on the 50S, ribosomal subunit, (b) Formation of esterases that hydrolyze the, lactone ring, (c) Increased activity of efflux mechanisms, (d) Formation of drug-inactivating acetyltranferases, (e) Decreased drug permeability of the, cytoplasmic membrane, 11. The appearance of markedly vacuolated,, nucleated red cells in the marrow, anemia,, and reticulocytopenia are characteristic, dose-dependent side effects of, (a) Azithromycin, (c) Clindamycin, (e) Linezolid, , (b) Chloramphenicol, (d) Doxycycline, , 12. In a patient with culture-positive enterococcal endocarditis who has failed to, respond to vancomycin because of, resistance, the treatment most likely to, be effective is, (a) Clarithromycin, (c) Linezolid, (e) Ticarcillin, , (b) Erythromycin, (d) Minocycline, , 13. All of the following factors may increase, the risk of nephrotoxicity from gentamicin, therapy except, (a), (b), (c), (d), (e), , age over 70 years, prolonged courses of gentamicin therapy, concurrent amphotericin B therapy, trough gentamicin levels below 2 mg/ml, concurrent cisplatin therapy, , 14. Which one of the following antibiotics is, likely to be most effective agent in the, treatment of an infection due to enterococci, if used in conjuction with penicillin G?, (a) Amikacin, (c) Netilmicin, (e) Tobramycin, , (b) Gentamicin, (d) Streptomycin, , 15. Regarding the antibacterial action of, gentamicin, which one of the following, statements is most accurate?, (a) Efficacy is directly proportionate to the time, that the plasma level of the drug is greater, than the minimal inhibitory concentration

Page 160 :
ANTIBIOTICS, , 145, , (b) The antibacterial action of gentamicin is not, concentration - dependent, (c) Gentamicin continues to exert antibacterial, effects even after plasma levels decrease, below detectable levels, (d) Antibacterial activity is often reduced by the, presence of an inhibitor of cell wall synthesis, (e) The antibacterial action of gentamicin is time, – dependent, 16. Which one of the following drugs is most, likely to be effective against multidrug –, resistant strains of M tuberculosis,, including those resistant to streptomycin?, (a) Amikacin, (c) Gentamicin, (e) Spectinomycin, , (b) Clarithromycin, (d) Meropenem, , 17. Sterptomycin has no useful activity in the, treatment of, (a) Bubonic plague, (c) Lyme disease, (e) Tularemia, , (b) Brucellosis, (d) Tuberculosis, , 18. Your 23-year-old female patient is, pregnant and has gonorrhea. The past, medical history includes anaphylaxis, following exposure to amoxicillin., Worried about compliance, you would like, to treat this patient with a singly dose, so, you chose, (a) Cefixime, (c) Ciprofloxacin, (e) Tetracycline, , (b) Ceftriaxone, (d) Spectinomycin, , 19. In the empiric treatment of severe bacterial, infections of unidentified entiology, this, drug, often used in combination with an, aminoglycoside, provides coverage against, many staphylococci, (a) Amoxicillin, (c) Erythromycin, (e) Tetracycline, , (b) Clavulanic acid, (d) Nafcillin, , 20. Which one of the following statements, about “one daily” dosing with aminoglycosides is false ?, (a) It is convenient for outpatient therapy, (b) Adjustment of dosage is less important in, renal insufficiency, (c) Less nursing time is required, , (d) It is often less toxic than conventional, (multiple)dosing regimens, (e) Under-dosing is less of a problem, 21. Regarding the recently introduced lipid, formulation of amphotericin B, which one, of the following statements is accurate?, (a) Affinity of amphotericin B for these lipids is, greater than affinity for ergosterol, (b) They are less expensive to use than conventional, amphotericin B, (c) They are more effective in fungal infections, because they increase tissue uptake of, amphotericin B, (d) They may decrease nephrotoxicity of, amphotericin B, (e) They have wider spectrums of antifungal, activity than conventional formulations of, amphotericin B, 22. Which one of the following antimicrobial, drugs does not require supplementation, of dosage following hemodialysis?, (a) Ampicillin, (c) Ganciclovir, (e) Vancomycin, , (b) Cefazolin, (d) Tobramycin, , 23. The persistent suppression of bacterial, growth that may occur following limited, exposure to some antimicrobial drugs is, called, (a), (b), (c), (d), (e), , Time-dependent killing, The post antibiotic effect, Clinical synergy, Concentration – dependent killing, Sequential blockade, , 24. In which of the following groups do all four, drugs warrant careful monitoring for drugrelated seizures in high-risk patients?, (a) Penicillin G, imipenem, amphotericin B,, metronidazol, (b) Penicillin G, chlormphenicol, tetracycline,, vancomycin, (c) Imipenem, tetracycline, vancomycin,, sulfadiazine, (d) Cycloserine, metronidazole, vancomycin,, sulfadiazine, (e) Metronidazole, imipenem, doxycycline,, erythromycin

Page 161 :
MCQs IN PHARMACOLOGY, , 146, 25. Which one of the following antibiotics is a, potent inducer of hepatic drug-metabolizing, enzymes?, (a) Ciprofloxacin, , (b) Cyclosporine, , (c) Erythromycin, , (d) Rifampin, , (e) Tetracycline, 26. Beta – lactamase production by strains, of Haemophilus influenzae, Moraxella, catarrhalis, and Neissera gonorrhoeae, confers resistance against penicillin G., which one of the following antibiotics is, most likely to be effective against all, strains of each of the above organisms?, (a) Ampicillin, , (b) Ceftriaxone, , (c) Clindamycin, , (d) Gentamicin, , (e) Piperacillin, 27. A 19-year-old woman with recurrent, sinusitis has been treated with different, antibiotics on several occasions. During, the course of one such treatment she, developed a severe diarrhea and was, hospitalized. Sigmoidoscopy revealed, colitis, and pseudomembranes, were, confirmed histologically. Which of the, following drugs, administered orally, is, most likely to be effective in the treatment, of colitis due to C difficile?, (a) Ampicillin, , (b) Cefazolin, , (c) Clindamycin, , (d) Metonidazole, , (e) Tetracycline, 28. Bleomycin is used in most effective drug, combination regiment for the chemotherapy of testicular carcinoma. Which one, of the following statements about the, drug is accurate?, (a) Acts mainly in the M phase of the cell cycle, (b) Derived from the bark of yew trees, (c) Myelosuppression is dose-limiting, (d) Peripheral neuropathy occurs in more than, 50% of patients, (e) Pulmonary infiltrates and fibrosis may occur, 29. A high school student presents with headache, fever, and cough of 2 day’s duration. Sputum is scant and nonpurulent, , and a Gram stain reveals many white, cells but no organisms. Since this patient, appears to have atypical pneumonia. You, should initiate treatment with, (a) Cefazolin, (c) Erythromycin, (e) Trovafloxacin, , (b) Clindamycin, (d) Gentamicin, , 30. Chloramphenicol is particularly effective, in the treatment of, (a) Diphtheria, (b) Tuberculosis, (c) Emphysema, (d) Rickettsial diseases, (e) Streptomyces pyogenes infections, 31. An advantage of bleomycin over most, antineoplastic drugs is its, (a), (b), (c), (d), (e), , Rapid onset of action, Lack of toxicity to all normal cells, Relative lack of bone marrow toxicity, Very broad spectrum of activity, Both (a) and (b), , 32. The drug of choice for scarlet fever is, (a) Tetracycline, (c) Penicillin, (e) Novobiocin, , (b) Sulfonamides, (d) Chloromycetin, , 33. An advantge of betamethasone acetate, over betamethasone sodium phosphate, is, (a), (b), (c), (d), (e), , Fewer allergic reactions, Prompter action, More sustained action, Greater solubility, There is no advantage, , 34. Cyclosporine is used for, (a), (b), (c), (d), (e), , Allergies, Angina, Prevention of transplant rejection, Steroid deficiency, Treating led poisoning, , 35. The plasma half life of pencillin-G is, longer in the new born because their, (a) Plasma protein level is low, (b) Drug metabolizing enzymes are immature

Page 162 :
ANTIBIOTICS, , 147, , (c) Glomerular filtration rate is low, (d) Tubular transport mechanisms are not well, developed, 36. Choose the correct statement about the, role of opioid antimotility drugs in the, management of diarrhoeas, (a) They are used to control diarrhoea irrespective, of its etiology, (b) They should be used only as a short-term, measure after ensuring that enteroinvasive, organisms are not involved, (c) They are used as adjuvants to antimicrobial, therapy of diarrhoea, (d) They are the drugs of choice in irritable bowel, syndrome diarrhoea, 37. Spectinomycin is an aminoglycoside-like, antibiotic indicated for the treatment of, (a), (b), (c), (d), (e), , Gram-negative bacillary septicemia, Tuberculosis, Penicillin-resistant gonococcal infections, Syphilis, Gram-negative meningitis due to susceptible, organisms, , 38. Select the antibiotic with a high therapeutic, index, (a) Streptomycin, (c) Cephalexin, , (b) Doxy, (d) Polymyxin B, , 39. Which of the following organisms is, notorious for developing antimicrobial, resistance rapidly ?, (a), (b), (c), (d), , Streptococcus pyogenes, Meningococcus, Treponema pallidum, Escherichia coli, , 40. Widespread and prolonged used of an, antibiotic leads to emergence of drug, resistant strains because antibiotics, (a), (b), (c), (d), , Induce mutation in the bacteria, Promote conjugation among bacteria, Allow resistant strains to propagate preferentially, All of the above, , 41. Of the following which is the most, important mechanism of concurrent, , acquisition of multidrug resistance among, bacteria ?, (a) Mutation, (c) Transduction, , (b) Conjugation, (d) Transformation, , 42. Methicillin resistant staphylococci do not, respond to β-lactam antibiotics because, (a) They produce a β-lactamase which destroys, methicillin and related drugs, (b) They elaborate an amidase which destroys, methicillin and related drugs, (c) They have acquired a penicillin binding, protein which has low affinity for β-lactam, antibiotics, (d) They are less permeable to β-lactam antibiotics, 43. A man has an Escherichia coli bacteremia, with a low-grade fever (101.6°F)., Appropriate management of his fever, would be, (a) Give acetaminophen 650 mg orally every 4, hours, (b) Give aspirin 650 mg orally every 4 hours, (c) Give alternating doses of aspirin and, acetaminophen every 4 hours, (d) Withhold antipyretics, and use the fever curve, to monitor his response to antibiotic therapy, (e) Use tepid water baths to reduce the fever, 44. Superinfections are more common with, (a) Use of narrow spectrum antibiotics, (b) Short courses of antibiotics, (c) Use of antibiotics that are completely absorbed, from the small intestines, (d) Use of antibiotic combinations covering both, gram positive and gram negative bacteria, 45. Select the antibiotic whose dose must be, reduced in patients with renal insufficiency, (a) Ampicillin, (c) Tobramycin, , (b) Chloramphenicol, (d) Erythromycin, , 46. Which antimicrobial should be avoided, in patients of liver disease ?, (a), (b), (c), (d), , Chlortetracycline, Cotrimoxazole, Cephalexin, Ethambutol

Page 163 :
MCQs IN PHARMACOLOGY, , 148, 47. What is break point concentration of an, antibiotic ?, (a) Concentration at which the antibiotic lyses the, bacteria, (b) Concentration of the antibiotic which demarks, between sensitive and resistant bacteria, (c) Concentration of the antibiotic which, overcomes bacterial resistance, (d) Concentration at which a bacteriostatic antibiotic, becomes bactericidal, 48. Which type of antimicrobial drug, combination is most likely to exhibit, antagonism ?, (a) Bactericidal + Bactericidal, (b) Bactericidal + Bacteriostatic for a highly, sensitive organism, (c) Bactericidal + Bacteriostatic for a marginally, sensitive organism, (d) Bacteriostatic + Bacteriostatic, 49. Indicate the sulfonamide whose sodium, salt yields a nearly neutral solution which, is suitable for topical use in the eye, (a) Sulfadiazine, , (b) Sulfacetamide, , (c) Sulfamerazine, , (d) Sulfamethizole, , 50. Sulfamethoxypyridazine and other, related long acting sulfonamides have, now gone into disuse because, (a) They have produced serious cutaneous, reactions, (b) They have produced high incidence of, crystalluria, (c) They interact with many drugs, (d) They do not penetrate blood-brain barrier, 51. Which of the following is not true of, sulfonamides ?, , 52. Adverse effects of ciprofloxacin are, referable primarily to the following except, (a), (b), (c), (d), , Gastrointestinal tract, Kidney, Skin, Nervous system, , 53. A single oral dose of the following drug, can cure most cases of uncomplicated, gonorrhoea, (a) Ciprofloxacin, (c) Spectinomycin, , (b) Cotrimoxazole, (d) Doxycycline, , 54. Which fluoroquinolone has markedly, enhanced activity against gram positive, bacteria and anaerobes ?, (a) Pefloxacin, (c) Sparfloxacin, , (b) Ciprofloxacin, (d) Norfloxacin, , 55. A woman has an upper respiratory infection. Six years ago, she experienced, an episode of bronchospasm follwing, penicillin V therapy. The cultures now, reveal a strain of streptococcus pneumoniae that is sensitive to all of the following drugs. Which of these drugs would, be the best choice for this patient?, (a), (b), (c), (d), (e), , Amoxicillin/clavulanate, Erythromycin, Ampicillin, cefaclor, Cyclacillin, , 56. Important microbiological features of, ciprofloxacin include the following except, (a), (b), (c), (d), , Long postantibiotic effect, Marked suppression of intestinal anaerobes, MBC values close to MIC values, Slow development of resistance, , (a) They are primarily metabolized by acetylation, , 57. Currently the drug of choice for emperic, treatment of typhoid fever is, , (b) They are more likely to produce crystalluria, in alkaline urine in which they are less soluble, , (a) Chloramphenicol (b) Cotrimoxaxole, (c) Ciprofloxacin, (d) Ampicillin, , (c) They may exert bactericidal action in the, urinary tract, , 58. In the treatment of typhoid fever, ciprofloxacin has the following advantage(s), , (d) Used alone, they have become therapeutically, unreliable for serious infections, , (a) It is effective in nearly all cases, (b) Early abetment of fever and other symptoms

Page 164 :
ANTIBIOTICS, (c) Development of carrier state is less likely, (d) All of the above, 59. Penicillins interfere with bacterial cell wall, synthesis by, (a) Inhibiting synthesis of N-acetyl muramic acid, pentapeptide, (b) Inhibiting conjugation between N-acetyl, muramic acid and N-acetyl glucosamine, (c) Inhibiting transpeptidases and carboxy, peptidases which cross link the peptidoglycan, residues, (d) Counterfeiting for D-alanine in the bacterial, cell wall, 60. All of the following drugs are suitable oral, therapy for a lower urinary tract infection, due to Pseudomonas aeruginosa except, (a), (b), (c), (d), (e), , Norfloxacin, Trimethoprim-sulfamethxazole, Ciprofloxacin, Carbenicillin, Methenamine mandelate, , 61. Gram negative organisms are largely, insensitive to benzyl penicillin because, (a) They produce large quantities of penicillinase, (b) They do not utilize D-alanine whose, incorporation in the cell wall is inhibited by, benzyl penicillin, (c) Benzyl penicillin is not able to penetrate, deeper into the lipoprotein-peptidoglycan, multiplayer cell wall of gram-negative, bacteria, (d) Both (a) and (b), 62. The penicillin G preparation with the, longest duration of action is, (a), (b), (c), (d), , Benzathine penicillin, Sodium penicillin, Potassium penicillin, Procaine penicillin, , 149, (d) All natural and semisynthetic penicillins are, contraindicated for him, 64. The most important reason for highly, restricted use of penicillin G injections in, present day therapeutics is its, (a), (b), (c), (d), , Narrow spectrum of activity, Potential to cause hypersensitivity reaction, Short duration of action, Neurotoxicity, , 65. Benzathine penicillin injected once every, 4 weeks for 5 years or more is the drug, of choice for, (a) Agranulocytosis patients, (b) Prophylaxis of bacterial endocarditis in, patients with valvular defects, (c) Prophylaxis of rheumatic fever, (d) Treatment of anthrax, 66. Which of the following is not a semisynthetic penicillin ?, (a) Procaine penicillin(b) Ampicillin, (c) Cloxacillin, (d) Carbenicillin, 67. Cloxacillin is indicated in infections, caused by the following organism(s), (a) Staphylococci, (c) Gonococci, , (b) Streptococci, (d) All of the above, , 68. The most frequent side effect of oral, ampicillin is, (a), (b), (c), (d), , Nausea and vomiting, Loose motions, Constipation, Urticaria, , 69. Amoxicillin is inferior to ampicillin for the, treatment of the following infection, (a), (b), (c), (d), , Typhoid, Shigella enteritis, Subacute bacterial endocarditis, Gonorrhoea, , 63. If a patient gives history of urticaria, itching, and swelling of lips following injection of, penicillin G, then, , 70. Piperacillin differs from carbenicillin in the, following respect(s), , (a) He will develop similar reaction whenever, penicillin is injected, (b) He can be given ampicillin safely, (c) He can be given oral phenoxymethyl, penicillin safely, , (a) It is more active against pseudomonas, aeruginosa, (b) It is active against Klebsiella also, (c) It is acid resistant, (d) Both (a) and (b)

Page 165 :
MCQs IN PHARMACOLOGY, , 150, 71. Clavulanic acid is combined with, amoxicillin because, (a) It kills bacteria that are not killed by-moxicillin, (b) It reduces renal clearance of amoxicillin, (c) It counteracts the adverse effects of, amoxicillin, (d) It inhibits beta lactamases that destroy, amoxicillin, 72. Amoxicillin + Clavulanic acid is active, against the following organism except, (a), (b), (c), (d), , Methicillin resistant Staph. aureus, Penicillinase producing Staph. aureus, Penicillinase producing n. gonorrhoeae, β-lactamase producing E. coli, , 73. A woman’s neglected hangnail has, developed into a mild staphylococcal, cellulites. Which of the following regimens, would be appropriate oral therapy?, (a), (b), (c), (d), (e), , Dicloxacillin 125 mg q6h, Vancomycin 250 mg q6h, Methicillin 500 mg q6h, Cefazolin 1 g q8h, Penicillin V 500 mg q6h, , 74. Cefotaxime has the following properties, except, (a) It is highly active against aerobic gram, negative bacteria, (b) It is the most active cephalosporin against, Pseudomonas aeruginosa, (c) It produces an active metabolite, (d) It has achieved high cure rates in serious, hospital acquired infections, 75. Select the fourth generation cephalosporin among the following, (a) Cefpirome, (c) Ceftazidime, , (b) Ceftizoxime, (d) Cefuroxime, , 76. The most important mechanism by which, tetracycline antibiotics exert antiimicrobial, action is, (a) They chelate Ca2+ ions and alter permeability, of bacterial cell membrane, (b) They bind to 30S ribosomes and inhibit, bacterial protein synthesis, , (c) They bind to 50S ribosomes and interfere, with translocation of the growing peptide, chain in the bacteria, (d) They interfere with DNA mediated RNA, synthesis in bacteria, 77. Select the most potent tetracycline, antibiotic, (a) Demeclocycline, (c) Minocycline, , (b) Methacycline, (d) Doxycycline, , 78. An 8-year-old child presented with, brownish discoloured and deformed, anterior teeth. History of having received, an antibiotic about 4 years earlier was, obtained. Which antibiotic could be, responsible for the condition ?, (a) Chloramphenicol (b) Tetracycline, (c) Erythromycin, (d) Genetamicin, 79. The most suitable tetracycline for use in, a patient with impaired renal function is, (a) Chlortetracycline (b) Demeclocycline, (c) oxytetracycine, (d) Doxycycline, 80. Compared to older tetracyclines, doxycycline, produces a lower incidence of superinfection, diarrhoea because, (a) It is completely absorbed in the small, intestines so that drug concentration in the, colonic contents is low, (b) It is inactivated by the gut microflora, (c) It is not active against the microbes of the, normal gut flora, (d) It is a potent tetracycline and inhibits the, superinfection causing microbes as well, 81. Tetracyclines are still the first choice drugs, for the following disease., (a), (b), (c), (d), , Granuloma linguinale, Chancroid, Syphilis, Gonorrhoea in patients allergic to penicillin, , 82. Chloramphenicol is more active than, tetracyclines against, (a), (b), (c), (d), , Bateroides fragilis, Treponema pallidum, Streptococci, Staphylococci

Page 166 :
ANTIBIOTICS, , 151, , 83. Which out of the following antibiotics, penetrates blood-CSF barrier the best, (a) Erythromycin, (c) Tetracycline, , (b) Gentamicin, (d) Chloramphenicol, , 84. The most important mechanism by which, gram negative bacilli acquire chloramphenicol resistance is, (a) Decreased permeability into the bacterial cell, (b) Acquisition of a plasmid encoded for, chloramphenicol acetyl transferase, (c) Lowered affinity of the bacterial ribosome, for chloramphenicol, (d) Switching over from ribosomal to, mitochondrial protein synthesis, 85. What is the most important reason for, restricted clinical use of chloramphenicol ?, (a), (b), (c), (d), , Its narrow spectrum of activity, Emergence of chloramphenicol resistance, Its potential to cause bone marrow depression, Its potential to cause superinfections, , 86. Aminoglycoside antibiotics have the, following common property, (a) They are primarily active against gramnegative bacilli, (b) They are more active in acidic medium, (c) They readily enter cells and are distributed, in total body water, (d) They are nearly completely metabolized in, liver, 87. Which aminoglycoside antibiotic causes, more hearing loss than vestibular, disturabance as toxic effect ?, (a) Streptomycin, (c) Kanamycin, , (b) Gentamicin, (d) Sisomicin, , 88. Which of the following drugs has, demonstrated in vitro activity against, Mycobacterium avium-intracellular, (MAI)?, (a), (b), (c), (d), (e), , Vancomycin, Clarithromycin, Erythromycin base, Troleandomycin, Erythromycin estolate, , 89. The most important mechanism of bacterial, resistance to an aminoglycoside antibiotic, is, (a) Plasmid mediated acquisition of aminoglycoside conjugating enzyme, (b) Mutational acquisition of aminoglycoside, hydrolyzing enzyme, (c) Mutation reducing affinity of ribosomal, protein for the antibiotic, (d) Mutational loss of porin channels, 90. Which toxic effect of aminoglycoside, antibiotics is most irreversible in nature ?, (a) Vestibular damage, (b) Hearing loss, (c) Neuromuscular blockade, (d) Kidney damage, 91. Streptomycin sulfate is not absorbed, orally because it is, (a) Degraded by gastrointestinal enzymes, (b) Destroyed by gastric acid, (c) Highly ionized at a wide range of pH values, (d) Insoluble in water, 92. The aminoglycoside antibiotic which is, distinguished by its resistance to bacterial, aminoglycoside inactivating enzymes is, (a) Kanamycin, , (b) Sisomicin, , (c) Amikacin, , (d) Tobramycin, , 93. An aminoglycoside antibiotic should not, be used concurrently with the following, drug, (a) Ampicillin, , (b) Vancomycin, , (c) Ciprofloxacin, , (d) Rifampin, , 94. All of the following statements regarding, pentamidine isethionate are true except, (a) it is indicated for treatment or prophylaxis of, infection due to Pneumocystis carinii, (b) it may be administered intramuscularly,, intravenously or by inhalation, (c) it has no clinically significant effect on serum, glucose, (d) it is effective in the treatment of leishmaniasis

Page 167 :
MCQs IN PHARMACOLOGY, , 152, 95. Prolonged oral therapy with the following, antibiotic can damage intestinal villi, resulting in statorrhoea and loose motions, (a) Ampicillin, , (b) Tetracycline, , (c) Neomycin, , (d) Nystatin, , 96. Hepatitits with cholestatic jaundice occurs, most frequently as an adverse reaction to, the following preparation of erythromycin, (a) Erythromycin base, (b) Erythromycin stearate, (c) Erythromycin estolate, (d) Erythromycin ethylsuccinate, 97. The following antibiotic is a first line drug, for treatment of Mycobacterium avium, complex infection in AIDS patients, (a) Clindamycin, , (b) Clarithromycin, , (c) Roxithromycin, , (d) Erythromycin, , 98. Roxithromycin has the following, advantages over erythromycin except, (a) It is more effective in whooping cough, (b) It causes less gastric irritation, (c) It has longer plasma half-life, (d) It is unlikely to precipitate theophylline toxicity, 99. Highest incidence of antibiotic associated, pseudo membranous enterocolitis has, been noted with the use of, (a) Ampicillin, , (b) Chloramphenicol, , (c) Vancomycin, , (d) Clindamycin, , 100. The drug of choice for treatment of, methicillin resistant Staphylococcus, aureus infection is, (a) Cloxacillin, , (b) Vancomycin, , (c) Erythromycin, , (d) Amikacin, , 101. ‘Red man syndrome’ has been associated, with rapid intravenous injection of the, following antibiotic, (a) Vancomycin, , (b) Clindamycin, , (c) Cefoperazone, , (d) Piperacillin, , 102. Clarithromycin is used for the following, (a) Multidrug resistant M.tuberculosis infection, , (b) M.avium complex infection in AIDS patient, (c) M.tuberculosis infection in a patient who, develops jaundice due to first line, antitubercular drugs, (d) Both (a) and (b), 103. A 23-year-old male with a history of, influenza A infection. An outbreak of, influenza A has just been reported in, his community and he is exhibiting, initial symptoms of influenza A. Which, agent would be the most useful to treat, him?, (a) Cidofovir, (c) Rimantidine, (e) Ribavirin, , (b) Famciclovir, (d) Foscarnet, , 104. Addition of clavulanic acid to amoxicillin, is to, (a) Decrease the renal excretion of amoxicillin, (b) Enhance the anti-bacterial activity of, amoxicillin, (c) Decrease the biotransformation of amoxicillin, (d) To increase oral absorption of amoxicillin, 105. The aminoglycoside that can be used in, amoebiasis is, (a) Paromomycin, (c) Amikacin, , (b) Framycetin, (d) Netilmicin, , 106. Tetracyclines are avoided in pregnancy, because they can, (a), (b), (c), (d), , Cause abortions, Cause excessive postpartum hemorrhage, Affect the bones and teeth of the fetus, Cause excessive vomiting in the mother, , 107. Ciprofloxacin inhibits the bacterial enzyme, (a), (b), (c), (d), , Transpeptidase, DNA gyrase, DNA dependent RNA polymerase, Dihydrofolate reductase, , 108. Erythromycin is the drug of choice in, (a), (b), (c), (d), , Pertussis, Gonococcal urethritis, Prophylaxis of bacterial endocarditis, Chlamydial infections

Page 168 :
ANTIBIOTICS, , 153, , 109. Cyclosporine, (a) Is derived from a bacterium, (b) Has a selective inhibitory effect on Tlymphocytes, (c) Is not absorbed orally, (d) Is excreted unchanged from the body, 110. Tetracycline is stored in the body in, (a), (b), (c), (d), , Protein bound form, In hairs, nails and skin, In muscular tissues, In bones, , 111. Drug which interfere with the bacterial, cell wall synthesis is, (a), (b), (c), (d), , Chloramphenicol, Tetracyclines, Colistin, Penicillins and cephalosporins, , 112. Antibiotic(s) which inhibit the protein, synthesis in cells is/are, (a), (b), (c), (d), , Sulphonamides and PAS, Isonized and PAS, Tetracyclines and chloramphenicol, Penicillin and cephalosporins, , 113. Penicillins are not effective against, (a), (b), (c), (d), , Gram-positive cocci, Gram-positive bacilli, Gram-negative bacilli, Gram-negative cocci, , 114. Pseudomonas aeruginosa organism is, always sensitive to, (a) Streptomycin, (c) Penicillin, , (b) Colistin, (d) Tetracyclines, , 115. Drug of choice for Brucella infection is, (a), (b), (c), (d), , Tetracycline, Gentamycin, Ampicillin, Sulfonamides, , 116. Streptomycin is more active at, (a), (b), (c), (d), , pH 5.5 than pH 8.5 of urine, pH 8.5 than pH 5.5 of urine, Equally active at all pH of urine, All of the above, , 117. Dr. Jones requests your help in prescribing a protease inhibitor for his patient., He has heard that not all agents are the, same and asks for your recommendation, as to which agent would penetrate the, blood-brain barrier. Which agent would, you recomment?, (a) Saquinavir, (c) Indinavir, (e) Amprenavir, , (b) Ritonavir, (d) Nelfinavir, , 118. Which of the following agents is not a, broad spectrum antibiotic, (a), (b), (c), (d), , Ampicillin, Tetracycline, Chloremphenicol, Gentamycin, , 119. Probenacid increases the plasma concentration of penicillin because, (a) It blocks the renal tubular excretion of, penicillin, (b) It prevents the metabolism of penicillin, (c) It displaces penicillin from protein binding, sites and thus increases free drug concentration, (d) It acts by all above mechanisms, 120. Benzylpenicillin is not used orally because, (a) It is destroyed by acid in stomach and, absorption is also incomplete, (b) It is well absorbed from intestine but is, unpredictable, (c) It produces severe diarrhoea on oral, administration, (d) All of the above, 121. Penicillins should not be given by, (a), (b), (c), (d), , Intramuscular route, Intravenous route, Intrathecal route, Intra – articular route, , 122. Anaphylactic shock to penicillin occurs, (a), (b), (c), (d), , Almost at once after administration, Between 6 to 12 hrs of administration, Between 4 to 6 hrs of administration, After 12 hrs of administration

Page 169 :
MCQs IN PHARMACOLOGY, , 154, 123. Drugs usually active against penicillinase, producing Staphylococcus aureus include, which of the following?, I. Timentin (ticarcillin-clavulanate), II. Augmentin (amoxicillin-clavulanate), III. Oxacillin, (a) Only I is correct, (b) Only III is correct, (c) I and II are correct, (d) II and III are correct, (e) I, II and III are correct, 124. Cephalosporins, (a) Are more vulnerable to beta–lactamase, enzyme, (b) Are less vulnerable to beta–lactamase, enzyme, (c) Do not possess beta lactam ring, (d) Have multiple beta lactam rings, 125. Which of the following antibiotics possess, neuromuscular blocking action, (a) Ampicillin, (b) Streptomycin, (c) Chloramphenicol (d) Sulphonamides, 126. Oral neomycin and streptomycin are used, for sterlization of bowel and for dysentery because, (a) They are least absorbed from oral route, (b) The peak concentration in blood is achieved, quickly, (c) They are least toxic to G.I.T, (d) None of the above, 127. Chloramphenicol is the drug of choice in, (a), (b), (c), (d), , Staphylococcal infection, Salmonella infection, Viral infection, Amoebic dysentry, , 128. Drug of choice for ringworm infection is, (a) Griseofulvin, (c) Nystatin, , (b) Amphotericin B, (d) Neomycin, , 129. In renal failure safest tetracycline is, (a), (b), (c), (d), , Oxytetracycline, Chlortetracycline, Doxycycline, Demethyl chlortetracycline, , 130. Penicillin was first used clinically for, systemic infections in the year, (a) 1926, (c) 1941, , (b) 1935, (d) 1957, , 131. Antiviral agents that are active against, cytomegalovirus (CMV) include which of, the following?, I. Ganciclovir, II. Foscarnet, III. Acyclovir, (a) Only I is correct, (b) Only III is correct, (c) I and II are correct, (d) II and III are correct, (e) I, II and III are correct, 132. Which of the following is a steroidal, antibiotic, (a) Nalidixic acid, (c) Spectinomycin, , (b) Fusidic acid, (d) Nitrofurantoin, , 133. The antibiotic that enters brain freely is, (a) Tetracycline, (b) Erythromycin, (c) Chloramphenicol (d) Gentamicin, 134. The tetracycline safe in renal failure is, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 135. The semisynthetic penicillin which is, destroyed by acid is, (a), (b), (c), (d), , Phenoxymethyl penicillin, Ampicillin, Carbenicillin, Coxacillin, , 136. Why benzyl penicillin is ineffective in, gram negative infections ?, (a) Is destroyed by penicillinase of gram negative, organisms, (b) Gram negative organisms donot utilize Dalanine whose incorporation is inhibited by, benzyl penicillin, (c) The lipoprotein – peptidoglycan cell wall of, gram negative organisms prevents entry of, penicillin, (d) All of the above

Page 170 :
ANTIBIOTICS, , 155, , ANSWERS, 1. a, 7. d, 13. d, 19. d, 25. d, 31. c, 37. c, 43. d, 49. b, 55. b, 61. c, 67. a, 73. a, 79. d, 85. c, 91. c, 97. b, 103. c, 109. b, 115. d, 121. b, 127. b, 133. c, , 2. b, 8. c, 14. d, 20. b, 26. b, 32. c, 38. c, 44. d, 50. a, 56. b, 62. a, 68. b, 74. b, 80. a, 86. a, 92. c, 98. a, 104. b, 110. d, 116. b, 122. a, 128. a, 134. b, , 3. e, 9. c, 15. c, 21. d, 27. d, 33. c, 39. d, 45. c, 51. b, 57. c, 63. d, 69. b, 75. a, 81. a, 87. c, 93. b, 99. d, 105. a, 111. d, 117. d, 123. e, 129. c, 135. c, , 4. e, 10. a, 16. a, 22. e, 28. e, 34. c, 40. c, 46. a, 52. b, 58. d, 64. b, 70. d, 76. b, 82. a, 88. b, 94. c, 100. b, 106. c, 112. c, 118. d, 124. b, 130. c, 136. c, , 5. d, 11. b, 17. c, 23. b, 29. c, 35. d, 41. b, 47. b, 53. a, 59. c, 65. c, 71. d, 77. c, 83. d, 89. a, 95. c, 101. a, 107. b, 113. c, 119. a, 125. b, 131. c, , 6. c, 12. c, 18. d, 24. a, 30. d, 36. b, 42. c, 48. b, 54. c, 60. b, 66. a, 72. a, 78. b, 84. b, 90. b, 96. c, 102. b, 108. a, 114. c, 120. a, 126. a, 132. b, , EXPLANATIONS FOR THE ANSWERS, 1. a, , 13. d, , 24. a, , Isoniazid increases the excretion or pyridoxine,, which can lead to peripheral neuritis,, particularly in poorly nourished patients., Pyridoxine (a form of vitamin B6), deficiency may cause convulsions as well as, the neuritis, involving synovial tenderness and, swelling. Treatment with the vitamin can reverse, the neuritis and prevent or cure the seizures., Trough serum levels below 2 mg/ml are, considered appropriate for gentamicin and are, recommended to minimize the risk of toxicity from, this aminoglycoside. Because aminoglycosides, accumulate in the proximal tubule of the kidney,, nephrotoxicity can occur., Seizures have been attributed to the use of, penicillin G, imipenem, amphotericin B and, metronidazole. Seizures are especially likely, with high doses in patients with a history of, , 37. c, , 43. d, , 55. b, , seizures and in patients with impaired drug, elimination., Although active against various gram-negative, organisms, spectinomycin is approved only for, the treatment of gonorrhea and is particularly, recommended for treatment of uncomplicated, forms of the disease., The fever curve is very useful for monitoring a, patient’s response to antimicrobial therapy., Antipyretics can be used to reduce high fever in, patients at risk for complications (e. g., seizures), or in some cases to make the patient more, comfortable., Amoxicillin, ampicillin and cyclacillin are all, penicillins and should be avoided in patients, with histories of hypersensitivity to other, penicillin compounds. Although the risk of crossreactivity with cephalosporins (e. g., cefaclor)

Page 171 :
MCQs IN PHARMACOLOGY, , 156, , 60. b, , 73. a, , 88. b, , is now considered very low, most clinicians, avoid the use of these agents in patients with, histories of type I hypersensitivity reactions (e.g.,, anaphylaxis, bronchospasm, giant hives), Norfloxacin, ciprofloxacin, carbenicillin and, methenamine mandelate achieve urine, concentrations high enough to treat urinary tract, infections due to Pseudomonas aeruginosa., Trimethoprim-sulfamethoxazole is not useful for, treating infections due to this organism, although, the combination is useful for treating certain, other urinary tract infections., Although vancomycin, methicillin and cefazolin, have excellent activity against staphylococci,, they are not effective orally for systemic, infections. Vancomycin is prescribed orally for, infections limited to the gastrointestinal tract, but, because it is poorly absorbed orally, it is not, effective for systemic infections. Most hospital, and community acquired staphylococci are, currently resistant to penicillinV. Thus, of the, drugs listed in the question, the most appropriate, drug for oral therapy of staphylococcai cellulites, is dicloxacillin., Clarithromycin, an alternative to erythromycin,, has demonstrated in vitro activity against, Mycobacterium avium-intracellulare (MAI)., Clarithromycin is also used against Toxoplasma, gondii and Cryptosporidium species, and it is, more active than erythromycin against, staphylococci and streptococci. Vancomycin is, used to treat staphylococci and streptococci, but, has no demonstrated activity versus MAI., Troleandomycin is similar to erythromycin but, is generally less active against these organisms., , 94. c, , 103. c, , 117. d, , 123. e, , 131. c, , Pentamidine isethionate is indicated for both, treatment and prophylaxis of infection due to, Pneumocystis carinii. It can be administered, intramuscularly, intravenously or by inhalation., Inhalation may produce bronchospasm. Blood, glucose should be carefully monitored because, pentamidine may produce either hyperglycemia, or hypoglycemia., Cidofovir, famciclovir and foscarnet have little, or no in vivo activity agains influenza A., Ribavirin has some activity but is a second line, agent for influenza A and is mainly indicated, for treatment of RSV. Rimantidine is a derivative, of amantidine with excellent activity against, influenza A. it is indicated for the prophylaxis, and treatment of influenza A viral infections., All are protease inhibitors, but only nelfinavir, has been shown to cross the blood-brain barrier,, a known reservoid for HIV viruses., Timentin and augmentin each include a βlactamase inhibitor, combined with ticarcillin, and amoxicillin respectively. These combinations, offer activity against Staphylococcus aureus, similar to that of the penicillinase-resistant, penicillins, such as oxacillin., Only ganciclovir and foscarnet are active, against cytomegalovirus (CMV) infections. These, agents are virustatic and arrest DNA synthesis, by inhibiting viral DNA polymerase. Although, ganciclovir in the treatment of CMV infections, in the CNs has not been successful. Foscarnet, is a broad-spectrum antiviral agent and is used, in patients with ganciclovir resistance. Acyclovir, is not clinically useful for the treatment of CMV, infections because CMV is relatively resistant to, acyclovir in vitro.

Page 172 :
DRUGS USED IN GASTRO INTESTINAL TRACT DISORDERS, , 157, , CHAPTER 9, DRUGS USED IN GASTROINTESTINAL, TRACT DISORDERS, 1. Which of the following is most effective, in the treatment of peptic ulcer disease?, (a) Bromocriptine, (c) Ergotamine, (e) LSD, , (b) Cimetidine, (d) Ketanserin, , 2. Which laxative should not be used to, treat acute constipation because of its, slow onset of action?, (a), (b), (c), (d), , Glycerin, Bisacodyl suppository, Psyllium, Milk of magnesia, , 3. Which of the following–if given, intravenously–will cause increased, gastrointestinal motility and diarrhea?, (a) Angiotensin II, (c) Bradykinin, (e) All of the above, , (b) Bethanechol, (d) Renin, , 4. A peptide that causes increased capillary, permeability and edema is, (a) Angiotensin II, (c) Captopril, (e) Losartan, , (b) Bradykinin, (d) Histamine, , 5. A vasodilator that can be inactivated by, proteolytic enzymes is, (a) Angiotensin I, (c) Histamine, , (b) Isoproterenol, (d) Neuropeptide Y, , (e) Vasoactive intestinal peptide, 6. Which of the following is released in, traumatized tissue, causes pain and, edema, and is inactivated by angiotensin, converting enzyme?, (a), (b), (c), (d), (e), , Angiotensin I, Angiotensin II, Atrial natriuretic peptide, Bradykinin, Calcitonin gene-related peptide, , 7. Which of the following is a decapeptide, precursor of a vasoconstictor substance?, (a), (b), (c), (d), (e), , Angiotensin I, Angiotensin II, Atrial natriuretic peptide, Bradykinin, Calcitonin gene-related peptide, , 8. Which is not a risk factor for hyperphosphatemia and death from sodium phosphate enemas when used in children?, (a), (b), (c), (d), , Renal insufficiency, Hirschsprung’s disease, Anorectal malformations, Children 6 to 12 years of age, , 9. Which of the following is the most potent, vasodilator discovered to date and is, found in high concentration in the, thyroid?

Page 173 :
MCQs IN PHARMACOLOGY, , 158, (a), (b), (c), (d), (e), , Angiotensin I, Angiotensin II, Atrial natriuretic peptide, Bradykinin, Calcitonin gene-related peptide, , 10. Which of the following statements, adequately describes bulk-forming, laxaties?, (a) Can cause diarrhea if not taken with water, (b) Are derived from polysaccharides and, rersemble fiber (bran) in mechanism of, action, (c) Onset of action is in 4–8 hours, (d) Produce much more complete evacuation of, constipation than stimulant products, 11. Cardiac arrhythmias have occurred when, this drug was used by patients taking the, gastrointestinal promotility agent cisapride, (a) Amphotericin B, (c) Griseofulvin, (e) Voriconazole, , (b) Clotrimazole, (d) Ketoconazole, , 12. Metronidazole is least likely to be effective, in the treatment of, (a) Amebiasis, (c) Pneumocystosis, colitis, (e) Trichomoniasis, , (b) Giardiasis, (d) Psudomembranous, , 13. Which of the following statements about, non-drug therapies for acute diarrhea is, not correct?, (a) Breast feeding should be continued as normal, (b) Even if the patient is not vomiting, food should, be withheld for 6–12 hours, (c) Fluids can be given to patients who, experience vomiting, but small amounts of, fluid should be used., (d) Replacement fluids mainly consist of water,, sugar, potassium, sodium and bicarbonates, 14. A 2-year-old child was brought to the, emergency room 1 hour after ingestion of, tablets he had managed to obtain from a, bottle on top of the refrigerator. His, symptoms included marked gastrointestinal distress, vomiting (with hemate-, , mesis), and epigastric pain. Metabolic, acidosis and leukocytosis were also, present. This patient is most likely to have, ingested tablets containing, (a), (b), (c), (d), (e), , Acetaminophen, Aspirin, Diphenhydramine, Iron, Vitamin C, , 15. A patient is broght to the emergency room, suffering from nausea, vomiting, and, abdominal pain. He has muscle, weakness, which seems to be progressing, downward from the head and neck. The, patient has difficulty talking clearly and, has ptosis and ophthalmoplegia. The most, likely cause of these symptoms is, (a), (b), (c), (d), (e), , Accidental ingestion of paraquat, An overdose of phenobarbital, Excessive consumption of ethanol, Food poisoning, Organophosphate poisoning, , 16. A 55-year-old woman with insulindependent diabetes of 40 years’ duration, complains of severe bloating and abdominal, distress, especially after meals. Evaluation, is consistent with diabetic gastroparesis. The, drug you would be most likely to, recommend is, (a) Docusate, (c) Loperamide, (e) Sucralfate, , (b) Dopamine, (d) Metoclopramide, , 17. A patient who must take verapamil for, hypertension and angina has become, severely constipated. Which of the, following drugs would be most suitable, as a cathartic?, (a), (b), (c), (d), (e), , Aluminum hydroxide, Diphenoxylate, Magnesium hydroxide, Metoclopramide, Mineral oil, , 18. Your cousin is planning a three-week trip, overseas and asks your advice regarding, medications for traveler’s diarrhea. A drug, suitable for noninfectious diarrhea is

Page 174 :
DRUGS USED IN GASTRO INTESTINAL TRACT DISORDERS, (a), (b), (c), (d), (e), , Aluminum hydroxide, Diphenoxylate, Magnesium hydroxide, Metoclopramide, Mineral oil, , 19. Which of the following products should, not be used to replenish lost fluids from, acute diarrhea?, (a), (b), (c), (d), , Pedialyte solution, Kool-Aid, Gatorade (half-strength diluted with water), The world Health Organization (WHO), solution, , 20. A drug associated with the long QT, syndrome and cardiac arrhythmias is, (a), (b), (c), (d), (e), , Aluminum hydroxide, Cisapride, Granisetron, Loperamide, Metromidazole, , 21. On your way to an examination you, experience that vulnerable feeling that, an attack of diarrhea is imminent. If you, stopped at a drugstore, you could buy, this antidiarrheal drug without a, prescription even though it is related, chemically to the strong opioid – analgesic, meperidine, (a), (b), (c), (d), (e), , Aluminum hydroxide, Diphenoxylate, Loperamide, Magnesium hydroxide, Metoclopramide, , 22. This antibiotic is not appropriate for use, as an oral agent in the treatment of, recurrent peptic ulcer associated with, Helicobacter pylori, (a) Amoxicillin, (c) Metronidazole, (e) Vancomycin, , (b) Clarithromycin, (d) Tetracycline, , 23. Which of the following statements about, adsorbant drugs used for diarrhea is, true?, , 159, (a) Useful for treatment of severe diarrhea, (b) Very unsafe because not absorbed systemically, (c) In general, small doses are needed to relieve, diarrhea, (d) Kaolin is now generally recognized as a safe, and effective OTC antidiarrheal agent., 24. Which one of the following drugs has no, effect on prothrombin but increases the, likelihood of bleeding in patients who are, also taking warfarin?, (a) Carbamazepine, , (b) Cholestyramine, , (c) Naproxen, , (d) Rifampin, , (e) Vitamin K, 25. Which one of the following drugs has, resulted in severe hematotoxicity when, administered to a patient being treated, with azathioprine?, (a) Allopurinol, , (b) Cholestyramine, , (c) Digoxin, , (d) Lithium, , (e) Theophyline, 26. Which one of the following antibodies has, the longest half-life?, (a) Black widow spider antivenin, (b) Botulinum antitoxin, (c) Diphtheria antitoxin, (d) Hepatitits B immune globulin, (e) Snake bite antivenin, 27. Hepatitis B vaccine is least likely to be, recommended for prophylactic use in, (a) Dialysis patients, (b) Intravenous drug abusers, (c) Newborns, (d) Raw oyster eaters, (e) Surgeons, 28. Which of the following statements, concerning traveler’s diarrhea (TD) is, true?, (a) TD can usually be avoided by not eating raw, vegetables, seafood or eggs when traveling, to third-world countries, (b) TD can be prevented by taking one dose of, antibiotic 1 day before a trip

Page 175 :
MCQs IN PHARMACOLOGY, , 160, (c) A specific of Helicobacter pylori is the, primary pathogen responsible for TD, (d) Phillip’s milk of magnesia is used to prevent/, treat TD, 29. Dietary supplementation with DHEA is, best documented to have therapeutic, value in the treatment of, (a), (b), (c), (d), (e), , Acne, Diabetes insipidus, Hirsutism in female patient, Postmenopausal osteoporosis, Systemic lupus erythematosus, , 30. Which one of the following compounds has, been shown to have value in managing, symptoms of jet lag?, (a) DHEA, (c) Ginseng, (e) Sassfras, , (b) Garlic, (d) Melatonin, , 31. A patient with Zollinger–Ellison syndrome, has been receiving high doses of, cimetidine for 7 weeks. A frequent, adverse effect of cimetidine is, (a) Agranulocytosis, (b) Systemic lupus erythematosus, (c) Inhibition of hepatic metabolism of other, drugs, (d) Antiestrogenic effects, (e) Hypertension, 32. Most weak acid drugs as well as weak, base drugs are absorbed primarily from, the small intestine after oral administration, because, (a) Both types are more ionized in the small, intestine, (b) Bothe types are less ionized in the small, intestine, (c) The blood flow is greater in the small intestine, than that of other parts of the gut, (d) The surface area of the small intestine is, greater than other parts of the gut, (e) The small intestine has nonspecific carriers, for most drugs, 33. A patient with a 30-year history of type, 1 diabetes comes to you with a complaint, , of bloating and sour bleaching after, meals. On several occasions, vomiting, has occurred after a meal. Evaluation, reveals delayed emptying of the stomach,, and you diagnose diabetic gastro paresis., Which of the following drugs would be, most useful in this patient?, (a) Famotidine, (c) Misoprostol, (e) Ondansetron, , (b) Metoclopramide, (d) Omeprazole, , 34. Which one of the following agents is least, likely to protect the upper gastrointestinal, tract from ulcer formation?, (a) Antacids, (c) Cimetidine, (e) Sucralfate, , (b) Celecoxib, (d) Misoprostol, , 35. This agent is the drug of choice in severe, amebic disease and for hepatic abscess., It is activated to toxic intermediates by, the pyruvate – ferredoxin oxidoreductase, enzyme system present in the parasite., (a), (b), (c), (d), (e), , Diloxanide furoate, Emetine, Iodoquinol, Metronidazole, Paromomycin, , 36. All of the following agents are considered, close to ideal laxatives except, (a), (b), (c), (d), , emollient laxatives, bulk-forming laxatives, fiber, stimulant laxatives, , 37. Which solution is used as an astringent?, (a), (b), (c), (d), (e), , Strong iodine solution USP, Aluminum acetate topical solution USP, Acetic acid NE, Aromatic ammonia spirit USP, Benzalkonium chloride, , 38. Mechanistically, which of the following, drugs will decrease stomach acid secretion, by blockade of H2 histaminic receptors?, (a) Pyrilamine, (c) Cisapride, (e) Ranitidine, , (b) Hydroxyzine, (d) Omeprazole

Page 176 :
DRUGS USED IN GASTRO INTESTINAL TRACT DISORDERS, 39. Lansoprazole would be effective in the, treatment of, (a), (b), (c), (d), (e), , Gastroesophageal reflux disease, Peptic ulcer disease, Zollinger-Ellison syndrome, All of the above, None of the above, , 40. All of the following statements about, stool softners are true except, (a) There is minimal systemic absorption, (b) the onset of action is usually 1–2 days, (c) they are useful in patients with constipation, who have experienced an acute myocardial, infractioon, (d) they can be taken with little or no water, 41. All of the following statements adequately, describe bulk-forming laxatives except, (a) they produce a much more complete, evacuation of constipation than stimulant, products, (b) they can cause constipation if not taken with, water, (c) they are derived from polysaccharides and, resemble fiber (bran)in the mechanism of, action, (d) the onset of action is 24–72 hours, 42. Which of the following statements, adequately describes bulk-forming, laxatives?, (a) Can cause diarrhea if not taken with water, (b) Are derived from polysaccharides and, resemble fiber (bran)in mechanism of action, (c) Onset of action is in 4–8 hours, (d) Produce much more complete evacuation of, constipation than stimulant products, 43. Which of the following statements about, adsorbent drugs used for diarrhea is, true?, (a) Useful for treatment of severe diarrhea, (b) Very safe because not absorbed systemically, (c) In general, small doses are needed to relieve, diarrhea, (d) Kaolin and pectin are considered to be very, effective (category I)adsorbents, , 161, 44. Which of the following statements, concerning traveler’s diarrhea (TD) is, true?, (a) TD can usually be avoided by not eating raw, vegetables, seafood, or eggs when traveling, to third-world countries., (b) TD can be prevented by taking one dose of, antibiotic one day before a trip, (c) A specie of Helicobacter pylori is the primary, pathogen responsible for TD, (d) Phillip’s Milk of Magnesia is used to prevent, / treat TD, 45. All of the following statements about, stool softeners are true except, (a) There is minimal systemic absorption, (b) The onset of action is usually 1–2 days, (c) They are useful in patients with constipation, who have experienced an acute myocardial, infarction, (d) They can be taken with little or no water, 46. Which of the following is an appropriate, non-pharmacologic recommendation for, patients with gastroesophageal reflux, disease (GERD)?, (a) Eat larger but fewer meals, (b) Avoid meals high in protein, (c) Eat evening meals at least 3 hours before, bed, (d) Prop a patient’s head up with 2 pillows at, night, 47. Which of the following organisms has, been implicated as a possible cause of, chronic gastritis and peptic ulcer disease?, (a), (b), (c), (d), (e), , Campylobacter jejuni, Escherichia coli, Helicobacter pylori, Calymmatobacterium granulomatis, Giardia lamblia, , 48. A patient suffering from acute infectious, diarrhea caused by Shigella can be, managed in all of the following ways, except, (a) no treatement because signs and symptoms, usually resolve in 48 hours

Page 177 :
MCQs IN PHARMACOLOGY, , 162, (b) use of glucose solutions (e.g., soda, apple, juice)to settle the stomach and decrease the, number of stools, (c) avoiding food for at least 6 hours, then slowly, increasing fluid intake., (d) using antibiotics (e.g. Bactrim, doxycycline), for 7 days, 49. As part of a comprehensive management, strategy to treat peptic ulcer disease,, patients should be encouraged to do all, of the following except, (a), (b), (c), (d), (e), , Decrease caffeine ingestion, Eat only bland foods, Stop smoking, Avoid alcohol, Avoid the use of milk as a treatment modality, , 50. A gastric ulcer patient requires close, follow-up to document complete ulcer, healing because, (a) Perforation into the intestine is common, (b) Spontaneous healing of the ulcer may occur, in 30% – 50% of cases, (c) There is the risk of the ulcer being cancerous, (d) Symptoms tend to be chronic and recur, (e) Weight loss may be severe in gastric ulcer, patients, 51. For each effect, select the agent that is, most likely associated with it, (a), (b), (c), (d), (e), , Sodium bicarbonate, Aluminum hydroxide, Calcium carbonate, Magnesium hydroxide, Propantheline, (1) May cause diarrhea, (2) Cannot be used by patients with heart, failure, (3) Use with milk and an alkaline substance, can cause milk-alkali syndrome, , (4) May cause dry mouth, (5) Can be alternated with an antacid, mixture to control diarrhea, 52. Aluminum hydroxide is used to treat, hyperphosphatemia associated with, renal failure. Chronic use of aluminum, hydroxide may cause all of the following, conditions except, (a), (b), (c), (d), , Phosphate depletion, Calcium resorption and bone demineralization, Anorexia and constipation, Fluid retention, , 53. Which local anesthetic should be used to, treat symptoms of pain, itching, burning, and discomfort in patients with an, established lidocaine allergy?, (a) Tetracaine, (c) Pramoxine, , (b) Dibucaine, (d) Benzocaine, , 54. Which of the following agents in most, useful for carcinoma of the liver?, (a) Vinblastine, (c) Vincristine, (e) Mercaptopurine, , (b) Floxuridine (FUDR), (d) Cytarabine (Cytosar), , 55. All of the following vasoconstrictors are, deemed safe and effective for the temporary, relief of itching and swelling except, (a), (b), (c), (d), , ephedrine 0.1% – 1.25%, epinephrine 0.005% – 0.01%, phenylpropanolamine 1% – 10%, phenylephrine 0.25%, , 56. Bisacodyl frequently can cause, (a), (b), (c), (d), (e), , Abdominal cramps, Constipation, Skin rashes, Dizziness, Nauseas

Page 178 :
DRUGS USED IN GASTRO INTESTINAL TRACT DISORDERS, , 163, , ANSWERS, 1. c, 7. a, 13. b, 19. b, 25. a, 31. c, 37. b, 43. b, 49. b, 54. b, , 2. c, 8. d, 14. d, 20. b, 26. d, 32. d, 38. e, 44. a, 50. c, 55. c, , 3. b, 4. b, 9. e, 10. b, 15. d, 16. d, 21. c, 22. e, 27. d, 28. a, 33. b, 34. b, 39. d, 40. d, 45. d, 46. c, 51. 1.d, 2.a, 3.c, 4.e, 5.b, 56. a, , 5. e, 11. d, 17. c, 23. d, 29. e, 35. d, 41. a, 47. c, 52. d, , 6. d, 12. c, 18. b, 24. c, 30. d, 36. d, 42. b, 48. b, 53. c, , EXPLANATIONS FOR THE ANSWERS, 1. c, , 8. d, , 10. b, , 13. b, , Glycerin and the bisacodyl suppository all, produce stools in one-half hour to a few hours,, whereas psyllium, a bulk-forming laxative,, produces stool in 24–72 hours in the same, manner as a normal bolus of food or fiber., The populr sodium phosphate enemas (e.g.,, fleet)are very effective but have resulted in, hyperphosphatemia, hypocalcemia (tetany),, hypokaemia, metabolic acidosis and cardia, death usually due to conduction abnormalities, in very small children. This has mainly occurred, in children younger than 2 years of age or, between 2 and 5 years of age with predisposing, factors. These factors include chronic renal, disease, anorectal disease, anorectal, malformations, and/or Hirschsrprung’s disease,, which allow phosphate blood concentrations to, become abnormally, Stimulant products result in a quicker, more, complete and often more violent evacuation of, the bowel than do the bulk-forming agents. Bulk, forming agents are developed from complex, sugars, similar to fiber, that provide bulk to, increase gastrointestinal motility and water, absorption into the bowel. However, patients, must drink plenty of water to facilitate the, absorption of water into the bowel, or they may, become more constipated., Treating acute diarrhea is the replacement of, lost fluids. If severe vomiting persists, then, patients may need intra-venous rehydration., , 19. b, , 23. d, , 28. a, , Earlier Parents were told that children should, not receive food, milk-products or breast milk, for 6–68 hours after the onset of diarrhea, but, recent information shows that children should, remain on their normal dier or breast feeding, during episodes of diarrhea because these do, not make the diarrhea worse and may actually, improve the diarrhea., Replacement fluids for diarrhea should contain, the appropriate amount of electrolytes (K+, Na+,, Cl -, citrate)and glucose per specified amount, of water as found in commercially available oralrehydration. The World Health Organization, (WHO)solution can provide necessar y, ingredients. In addition, one-half-strength, Gatorade will provide necessary electrolytes, and glucose. Kool-Aid does not contain, potassium. Carbonated beverages are low in, potassium, and some are too high in glucose., Adsorbents are not effective for severe diarrhea, because they simply cannot adsorb enough, water and do not reverse the cause of the, diarrhea. Large doses may decrease symptoms., Of all the adsorbents, kaolin is the most effective, and is now recognized by the FDA as safe and, effective. All adsorbents are safe because they, are not adsorbed systemically., Traveler’s diarrhea (TD)primarily is caused by, bacteria. Prophylaxis and treatment regimens, include oral antibiotics and bismuth subsalicylate., Helicobacter pylori is the organisms shown to, contribute to refractory pepetic ulcer disease.

Page 179 :
MCQs IN PHARMACOLOGY, , 164, 36. d, , 40. d, , 41. a, , The ideal laxative is natural and produces stool, on a regular basis. The product produces stool, quickly without adverse effects such as, abdominal cramping or the formation of a hard, stool, which may be difficult to pass. Products, such as fiber or bulk-forming agents produce a, stool similar to a bolus of food, without adverse, effects. Emollient laxatives produce soft stools, without difficult defecation. Stimulants produce, a stool quickly, but patients often experience, severe abdominal cramping and hard stools., Stool softeners are safe and do not produce, any adverse systemic effects. Because stool, softners work as surfactants, they allow, absorption of water into the stool, which makes, stool softer and easier to pass. These products, are useful in patients who should avoid., Stimulant products result in a quicker, more, complete and often more violent evacuation of, the bowel than do the bulk-forming agents are, developed from complex sugars, similar to fiber,, that provide bulk to increase gastrointestinal, , 48. b, , 53. c, , 55. c, , motility and increase water absorption into the, bowel. However, patients must drink plenty of, water to facilitate the absorption of water into, the bowel, or they may become more constipated., Giving highly osmotic solutions of glucose can, result in more water absorbed into the intestinal, tract and, thus further diarrhea. Many cases of, diarrhea resolve within 48 hours without treatment., People with diarrhea can avoid food for atleast 6, hours, then increase their fluid intake slowly. Severe, cases of infectious diarrhea can be treated with, antibiotic or antiprotozoals, depending on the, organism that caused the episode., Due to its chemically distinct structure, promoxine, exhibits less cross-sensitivity when compared to, the other anesthetics and should be used in, patients with a lidocaine allergy., Vasoconstrictors deemed safe and effective by, the FDA are ephedrine HCl 0.1% – 1.25%,, epinephrine HCl 0.005% – 0.01% and, phenylephrine HCl 0.25%.

Page 180 :
OXYTOCICS & UTERINE MUSCLE RELAXANTS, , 165, , CHAPTER 10, OXYTOCICS & UTERINE MUSCLE, RELAXANTS, 1. A 29-year-old woman who was in her, 41st week of gestation had been in labor, for 12 hours. Although her uterine, contractions had been strong and regular, initially, they had diminished in force, during the past hour. Which of the, following drugs would be administered, to facilitate this woman’s labor and, delivery?, (a) Dopamine, (c) Oxytocin, (e) Vasopressin, , (b) Leuprolide, (d) Prolactin, , 2. Which one of the following agents is not, used in oral or implantable contraceptives?, (a), (b), (c), (d), (e), , Clomiphene, Ethinyl estradiol, Mestranol, Norethindrone, Norgestrel, , 3. All of the following are recognized effects, of combined oral contraceptives except, (a), (b), (c), (d), (e), , Breakthrough bleeding, Decreased risk of endometrial cancer, Increased risk of ischemic stroke, Increased risk of ovarian cancer, Nausea, , 4. A 50-year-old woman with a positive, mammogram undergoes lumpectomy, and a small carcinoma is removed. Bio-, , chemical analysis of the cancer reveals, the presence of estrogen and progesterone receptors. After this procedure, she, will probably receive, (a) Danazol, (c) Leuprolide, (e) Tamoxifen, , (b) Flutamide, (d) Mifepristone, , 5. A young woman complains of severe, abdominal pain at the time of menstruation., Careful evaluation indicates the presence, of significant endometrial deposits on the, pelvic peritoneum. The most appropriate, therapy for this patient would be, (a) Fultamide, orally, (b) Medroxyprogesterone acetate by intramuscular, injection, (c) Norgestreal as an implant, (d) Oxandrolone by intramuscular injection, (e) Raloxifene orally, 6. Diethylstilbestrol should never be used in, pregnant women because it is associated, with, (a) Development of deep vein thrombosis in the, pregnant woman, (b) Feminization of the external genitalia of male, offspring, (c) Infertility and development of vaginal cancer, in female offspring, (d) Miscarriage, (e) Virilization of the external genitalia of female, offspring

Page 181 :
MCQs IN PHARMACOLOGY, , 166, 7. Finasteride has efficacy in the prevention, of male-pattern baldness by virtue of its, ability to, (a), (b), (c), (d), (e), , Competitively antagonize androgen receptors, Decrease the release of gonadotropins, Increase the serum concentration of SHBG, Inhibit the synthesis of testosferone, Reduce the production of dihydrotestosterone, , 8. A 52-year-old postmenopausal patient, has evidence of low bone mineral, denisity. She and her physician are considering therapy with raloxifene or a, combination of conjugated estrogens, and medroxyprogesterone acetate., Which of the following patient characteristics is most likely to lead them to, select raloxifene?, (a), (b), (c), (d), (e), , Previous hysterectomy, Recurrent vaginitis, Rheumatoid arthritis, Strong family history of breast cancer, Troublesome hot flushes, , 9. Following delivery of a healthy baby, a, young woman begins to bleed extensively, because her uterus has failed to contract., Which one of the following drugs should, be administered to this woman?, , (a) Desmopressin, (c) Oxytocin, (e) Triamcinolone, , (b) Octreotide, (d) Prolactin, , 10. Raloxifene is a selective estrogen receptor, modulator (SERM). Its characteristic, properties make the drug most suitable, for treatment of a female patient who, (a) Decides to start using an oral contraceptive, (b) Has postmenopausal osteoporosis and is at, risk for breast cancer, (c) Needs postcoital contraception, (d) Suffers from hirsutism, (e) Wants a therapeutic abortion, 11. Select the drug which can improve, urinary flow rate in benign prostatic, hypertrophy without affecting prostate, size, (a) Amphetamine, (c) Finasteride, , (b) Prazosin, (d) Goserelin, , 12. The drug used for cervical priming to, facilitate labour is, (a), (b), (c), (d), , Oxytocin, Stilboestrol, Progesterone, Prostaglanding E2, , ANSWERS, 1. c, 7. e, , 2. a, 8. d, , 3. d, 9. c, , 4. e, 10. b, , 5. b, 11. b, , 6. c, 12. d

Page 182 :
OXYTOCICS & UTERINE MUSCLE RELAXANTS, , 167, , CHAPTER 11, CHEMOTHERAPY, , 1. Twenty months after finishing her chemotherapy, the woman had a relapse of breast, cancer. The cancer was now unresponsive, to standard doses of chemotherapy. The, decision was made to treat the patient with, high-dose chemotherapy followed by autologous stem cell transplantation. Which, of the following drugs is most likely to be, used to mobilize the peripheral blood stem, cells for the patient’s autologous stem cell, transplantation?, (a) Erythropoietin, (c) Interleukin - 11, (e) Thrombopoietin, , (b) G – CSF, (d) Intrinsic factor, , 2. The combination of trimethoprim and, sulfamethoxazole is effective against, which one of the following opportunistic, infections in the AIDS patient?, (a) Disseminated herpes simplex, (b) Cryptococcal meningitis, (c) Toxoplasmosis, (d) Oral cnadidiasis, (e) Tuberculosis, 3. The top four most commonly diagnosed, cancers include all of the following except, (a) Lung, (b) Prostate, (c) Colon and rectum (d) Thyroid, (e) Breast, , 4. A 31-year-old man has gonorrhea. He has, no drug allergies, but he recalls that a few, years ago while in Africa he had acute, hemolysis following use of an antimalarial, drug. The physician is concerned that the, patient has an accompanying urethritis, due to C trachomatis, though no cultures, or enzyme tests have been performed., Which of the following drugs is most likely, to be effective against gonococci and to, eradicate C trachomatis in this patient?, (a) Cefixime, (b) Ciprofloxacin, (c) Ofloxacin, (d) Spectinomycin, (e) Sulfamethoxazole, 5. The mechanism by which sulfasalazine, exerts its primary action in ulcerative, colitis is inhibition of, (a), (b), (c), (d), (e), , Folic acid synthesis, The formation of leukotrienes and prostaglandins, Phospholipase C, Proton pump activity, The formation of interleukind, , 6. Which one of the following adverse effects, is most likely to occur with sulfonamides?, (a) Neurologic effects, including headache,, dizziness, and lethargy, (b) Hematuria, (c) Fanconi’s aminoaciduria syndrome, (d) Kernicterus in the newborn, (e) Skin reaction

Page 183 :
MCQs IN PHARMACOLOGY, , 168, 7. This drug is the preferred agent for teatment of nocardiosis and, in combination, with pyrimethamine, is prophylactic, against preumocystis carinii infections in, AIDS patiens., (a) Ampicillin, (c) Norfloxacin, (e) Trimethoprim, , (b) Clindamycin, (d) Sulfadiazine, , 8. Supplementary folinic acid may prevent, anemia in folate-deficient persons who, use this drug; it is a weak base, and, achieves tissue levels similar to those in, plasma, (a) Ciprofloxacin, (c) Sulfacetamide, (e) Trovafloxacin, , (b) Norfloxacin, (d) Trimethoprim, , 9. It is now recommended that trovafloxacin, be reserved for treatment of life-threatening, infections because, (a), (b), (c), (d), (e), , Bacterial resistance to the drug is very common, Complete liver failure has occured, It is very expensive, Its use is associated with torsade de pointes, Nephrotoxicity is dose-limiting, , 10. The primary reason for the use of drug, combinations in the treatment of tuberculosis, is to, (a) Ensure patient compliance with the drug, regimen, (b) Reduce the incidence of adverse effects, (c) Enhance activity against metabolically, inactive mycobacteria, (d) Delay or prevent the emergence of resistance, (e) Provide prophylaxis against other bacterial, infections, 11. The mechanism of high – level INH, resistance of M tuberculosis is, (a) Formation of drug-inactivating N-acetyltransferase, (b) Reduced expression of the katG gene, (c) Decreased intracellular accumulation of INH, (d) Mutation in the inhA gene, (e) Change in the pathway of mucolic acid, synthesis, , 12. A patient with AIDS and a CD4 cell count, µL has persistent fever and weight, of 100/µ, loss associated with invasive pulmonary, disease that is due to M avium complex., Optimal management of this patient is, to, (a) Treat with rifabutin, since it prevents the, development of MAC bacteremia, (b) Select an antibiotic regimen based on drug, susceptibility of the cultured organism, (c) Start treatment with INH and pyrazinamide, (d) Treat the patient with clarithromycin,, ethambutol, and rifabutin, (e) Treat with trimethoprim – sulfamethoxazole, 13. This drug has been used prophylactically, in contacts of children with infection due to, Haemophilus influenzae type B. It is also, prophylactic in meningococcal and, staphylococcal carrier states. While the, drug eliminates a majority of meningococci, from carriers, highly resistant strains may, be selected out during treatment, (a) Ciprofloxacin, (c) Dapsone, (e) Streptomycin, , (b) Clofazimine, (d) Rifampin, , 14. Once–weekly administration of this, antibiotic has prophylactic activity against, bacteremia due to M avium complex in, AIDS patients., (a) Azithromycin, (c) Isoniazid, (e) Rifabutin, , (b) Clarithromycin, (d) Kanamycin, , 15. Which one of the following drugs is most, likely to cause loss of equilibrium and, auditory damage?, (a), (b), (c), (d), (e), , Amikacin, Ethambutol, Isonazid, Para-aminosalicylic acid, Rifabutin, , 16. Chemical interactions between this drug, and cell membrane components can, result in the formation of pores lined by, hydrophilic groups present in the drug, molecule.

Page 184 :
CHEMOTHERAPY, (a) Dactinomycin, (c) Fluconazole, (e) Terbinafine, , 169, (b) Griseofluvin, (d) Nystatin, , 17. Which one 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, (d) It inhibits demethylation of lanosterol, (e) It is potent inhibitor of hepatic drug–, metabolizing enzymes, 18. Which one of the following drugs is least, likely to be effective in the treatment of, esophageal candidiasis, it is used by the, oral route?, (a) Amphotericin B, (c) Fluconazole, (e) Ketoconazole, , (b) Clotrimazole, (d) Griseofulvin, , 19. Which one of the following statements, about flucytosine is accurate?, (a), (b), (c), (d), (e), , It is bioactivated by fungal cytosine deaminase, It does not cross the blood–brain barrier, It inhibits cytochrome P450, It is useful in esophageal candidiasis, It has a wide spectrum of antifungal activity, , 20. Which one of the following drugs is most, appropriate for oral use in vaginal, candidiasis?, (a) Clotrimazole, (c) Fluconazole, (e) Nystatin, , (b) Griseofluvin, (d) Flucytosine, , 21. Which one of the following statements, about the mechanisms of action of, antiviral drugs is least accurate?, (a) The initial step in activation of famciclovir in, HSV-infected cells is its phosphorylation by, viral thymidine kinase, (b) The reverse transcriptase of HIV is 30–50, times more sensitive to inhibition by indinavir, than host cell DNA polymerases, (c) Gancicolvir inhibits viral DNA polymerase, but does not cause chain termination, , (d) Increased activity of host cell phosphodiesterases that degrade tRNA is one of the, antiviral actions of interferons, (e) Foscarnet has no requirement for activation, by phosphorylation, 22. Which of the following drugs is most likely to cause additive anemia and neutropenia if administered to an AIDS patient, taking zidovudine?, (a) Acyclovir, (c) Ganciclovir, (e) Stavudine, , (b) Amantadine, (d) Pentamidine, , 23. The antiviral actions of this drug include, inhibition of both RNA and DNA synthesis. The drug is used for the treatment of, severe respiratory syncytial virus infections in neonates., (a) Amantadine, (c) Foscarnet, (e) Ritonavir, , (b) Amprenavir, (d) Ribavirin, , 24. Regarding interferon alpha, which one, of the following statements is least, accurate?, (a) At the start of treatment, most patients, experience flu-like symptoms, (b) Indications include treatment of genital warts, (c) It is used in the management of hepatitis C, (d) Lamivudine interferes with its activity against, hepatitis B, (e) Toxicity includes bone marrow suppression, 25. Over 90% of this drug is excreted in the, urine in intact form. Because its urinary, solubility is low, patients should be well, hydrated to prevent nephrotoxicity, (a) Acyclovir, (c) Indinavir, (e) Zidovudine, , (b) Amantadine, (d) Zanamivir, , 26. Used in the prophylaxis and treatment of, infection due to influenza viruses, this drug, facilitates clumping of mature virions and, their adhesion to infected cells., (a) Amantadine, (c) Oseltamivir, (e) Saquinavir, , (b) Efavirenz, (d) Rimantadine

Page 185 :
MCQs IN PHARMACOLOGY, , 170, 27. Which statement regarding phase-specific, chemotherapic agents is correct ? They, (a) Are most effective in one phase of the cell, cycle, (b) Effective in all phases of the cell cycle, (c) Are only effective in G0 phase, (d) Include the alkylating agents, (e) Include the antituber antibiotics, 28. Infections due to gram–negative bacilli, have occurred when this agent has been, used as a skin antiseptic, (a), (b), (c), (d), (e), , Acetic acid, Benzalkonium chloride, Hexachlorophene, Merbromin, Thimerosal, , 29. Which one of the following compounds, is used topically to treat scabies and, pediculosis?, (a), (b), (c), (d), (e), , Lindane, Mupirocin, Nitrofurazone, Polymyxin B, Silver sulfadiazine, , 30. Methenamine salts are used as urinary, antiseptics. The reason why they lack, systemic antibacterial action is that they, are, (a) Not absorbed into the systemic circulation, following oral ingestion, (b) Rapidly metabolized by liver drug– metabolizing, enzymes, (c) Converted to formaldehyde only at low urinary, pH, (d) Substrates for active tubular secretion, (e) Over 90% bound to plasma proteins, 31. Which one of the following antiseptics, promotes wound healing?, (a), (b), (c), (d), (e), , Cetylpyridium, Chlorhexidine, Hexachlorophene, Iodine, None of the above, , 32. A patient with AIDS has an extremely, high viral RNA titer. While blood is being, drawn from this patient, the syringe is, accidentally dropped, contaminating the, floor, which is made of porous material., The best way to deal with this is to, (a) Completely replace the contaminated part, of the floor, (b) Clean the floor with soap and water, (c) Seal the room and decontaminate with, ethylene oxide, (d) Clean the floor with a 10% solution of, household bleach, (e) Neutralize the spill with a solution of, potassium permanganate, 33. Certain anaerobic protozoan parasites, lack mitochondria and generate energy–, rich compounds, such as acetyl–CoA, by, means of enzymes present in organelles, called hydrogenosomes. An important, enzyme involved in this process is, (a) Cytochrome P450, (b) Glycerol – 3 – phosphate oxidase, (c) Hypoxanthine – guanine phosphoribosyltranferase, (d) Pyruvate – ferredoxin oxidoreductase, (e) Thymidylate synthase, 34. Which of the following compounds is a, good substrate for hypoxanthine–, guanine phosphoribosyltransferase in, trypanosomes (but not mammals) and is, eventually converted into metabolites that, are incorporated into RNA?, (a), (b), (c), (d), (e), , Allopurinol, Alpha - difluoromethylornithine, Glycerol, Mebendazole, Salicylhydroxamic acid, , 35. One chemotherapeutic strategy used to, eradicate the blood-stream form of, African trypanosomes is based on the, absolute dependence of the organism on, (a) Cytochrome – dependent electron transfer, (b) Dihydropteroate synthesis, (c) Glycolysis

Page 186 :
CHEMOTHERAPY, , 171, , (d) Lactate dehydrogenase, (e) Mitochondrial respiration, 36. Which of the following drugs enhances, GABA actions on the neuromuscular, junctions of nematodes and arthropods?, (a) Glutamic acid, (c) Picrotoxin, (e) Pyrimethamine, , (b) Ivermectin, (d) Pyrantel pamoate, , 37. Which of the following drugs is an antimetabolite that inhibits a trypanosomal, enzyme involved in putrescine synthesis?, (a), (b), (c), (d), (e), , Alpha - difluoromethylornithine, Alpha - fluorodeoxyuridine, Metronidazole, Polymyxin, Thiopurinol riboside, , 38. Which one of the following enzymes is, not unique to parasites?, (a) Dihydropteridine pyrophosphokinase, (b) Hypoxanthine–guanine phosphoribosyltransferase, (c) Lanosterol demethylase, (d) Purine nucleoside phosphotransferase, (e) Trypanothione reductase, 39. Which of the following antimalarial drugs, causes a dose–dependent toxic state that, includes flushed and sweaty skin,, dizziness, nausea, diarrhea, tinnitus,, blurred vision, and impaired hearing?, (a) Amodiaquine, (c) Pyrimethamine, (e) Sulfadoxine, , (b) Primaquine, (d) Quinine, , 40. Plasmodial resistance to chloroquine is, due to, (a) Change in receptor structure, (b) Decreased carrier–mediated drug transport, (c) Increase in the activity of DNA repair, mechanisms, (d) Induction of inactivating enzymes, (e) Inhibition of dihydrofolate reductase, 41. This drug is the antimalarial agent most, commonly associated with causing an, acute hemolytic reaction in patients with, , glucose – 6 – phosphate dehydrogenase, deficiency., (a) Chloroquine, (c) Mefloquine, (e) Quining, , (b) Clindamycin, (d) Primaquine, , 42. This drug can clear trypanosomes from, the blood and lymph nodes and is active, in the late CNS stages of African sleeping, sickness., (a) Emetine, (c) NIfurtimox, , (b) Melarsoprol, (d) Pentamidine, , 43. Which one of the following drugs is, recommended as a single agent for oral, treatment of uncomplicated malaria due, to chloroquine–resistant P falciparum, strains?, (a) Doxycycline, (c) Primaquine, (e) Quinine, , (b) Iodoquinol, (d) Proguanil, , 44. A missionary from Chicago is sent to work, in a geographic region of a Cental American country wher onchocerca volvulus is, endemic. Infections due to this tissue, nematode (onchocerciasis) are a major, cause of “river blindness”, since microfilariae migrate through subcutaneous tissues and concentrate in the eyes. Which, one of the following durgs can be used, prophylactically to prevent onchocerciasis?, (a) Bithionol, (c) Niclosamide, (e) Suramin, , (b) Ivermectin, (d) Oxamniquine, , 45. In a patient with diffuse lymphoma, the, oncologist suggests a treatment strategy, that involves the initial administration of, doxorubicin to obtain a significant log–, kill, followed by the cell cycle–specific, drugs cytarabine and vincristine. This, therapeutic strategy is called, (a), (b), (c), (d), (e), , Pulse therapy, Recruitment, Rescue therapy, Sequential blockade, Synchrony

Page 187 :
MCQs IN PHARMACOLOGY, , 172, 46. Which one of the following statements, about the mechanisms of action of drugs, used in cancer chemotherapy is least, accurate?, (a) Alkylatine agents commonly attack the, nucleophilic N-7 position in guanine, (b) Anthracyclines intercalate with base pairs to, block nucleic acid synthesis, (c) In steady doses, leuprolide inhibits the release, of pituitary gonadotropins, (d) Mercaptopurine is an irreversible inhibitor, of HGPRT ase, (e) Paclitaxel acts mainly in the M phase of the, cell cycle, 47. Which of the following agents used in, drug combination regimens to treat, testicular carcinoma is mot likely to cause, nephrotoxicity?, (a) Bleomycin, (c) Etoposide, (e) Vinblastine, , (b) Cisplatin, (d) Leuprolide, , 48. Which one of the following is least likely, to be a mechanism of cancer cell resistance, to antineoplastic drugs?, (a) Change in properties of a target enzyme, (b) Decreased activity of activating enzymes, (c) Increase in drug–metabolizing cytochrome, P450, (d) Increase in DNA repair, (e) Increase in production of drug–trapping, molecules, 49. All of the following agents have been, used in drug regimens for the treatment, of breast carcinoma. Which one has, specific activity in a subset of female, breast cancers?, (a) Anastrozole, (b) Doxorubicin, (c) Fluoxymesterone (d) Methotrexate, (e) Trastuzumab, 50. Which cell involved in immune function, recognizes foreign peptides bound of, MHC class II molecules on the surface of, APC cells, secretes interleukin-2, and, initiates the cell-mediated immunity, reaction responsible for host-versus-graft, reactions?, , (a), (b), (c), (d), (e), , B lymphocyte, Cytotoxic T lymphocyte, Dendritic cell, Macrophage, TH lymphocyte, , 51. Cyclosporine is effective in organ transplantation. The immunosuppressant, action of the drug appears to be due to, (a) Activation of natural killer (NK) cells, (b) Blockade of tissue responses to inflammatory, mediators, (c) Increased catabolism of IgG antibodies, (d) Inhibition of the gene transcription of, interleukins, (e) Interference with antigen recognition, 52. Azathiprone, (a), (b), (c), (d), , Binds avidly to a cytoplasmic immunophillin, Blocks formation of tetrahydrofolic acid, Is a precursor of cytarabine, Is markedly hematotoxic and has caused, neoplasms, (e) Is a metabolite of mercaptopurine, , 53. Body Surface Area (BSA) is used in, calculating chemotherapy doses because, (a) BSA is an indicator of tumor cell mass, (b) BSA correlates with cardiac output, (c) BSA correlates with gastrointestinal transit, time, (d) the National Cancer Institute requires that, BSA be used, (e) the Food and Drug Administration requires, that BSA be used, 54. Which one of the following agents acts, at the step of antigen recognition?, (a), (b), (c), (d), (e), , Cyclosporine, Cyclophosphamide, Methotrexate, Rho(D)immune globulin, Tacrolimus, , 55. Tumor necrosis factor - α - appears to play, an important role in autoimmunity and, inflammatory diseases. Which of the, following is a humanized monoclonal

Page 188 :
CHEMOTHERAPY, , 173, , antibody that binds to TNF - a and inhibits, its action?, (a) Etanercept, (b), (c), (d), (e), , Infliximab, Muromonab – CD3, Sirolimus, Thalidomide, , 56. Which one of the following agents is able, to suppress both B and T lymphocytes via, its inhibition of de novo synthesis of, purines?, (a) Cyclophosphamide, (b) Methotrexate, (c) Mycophenolate mofetil, (d) Prednisone, (e) Tacrolimus, 57. Which one of the following agents increases, phagocytosis by macrophages in patients, with chronic granulomatous disease?, (a) Aldesleukin, (b) Interferon - γ, (c) Lymphocyte immune globulin, (d) Prednisone, (e) Trastuzumab, 58. A young woman employed as a dental, laboratory technician complains of, conjunctivitis, skin irritation, and hair loss., On examination, she has perforation of, the nasal septum and a “milk and roses”, complexion. These signs and symptoms, are most likely to be due to, (a) Acute mercury poisoning, (b) Chronic inorganic arsenic poisoning, (c) Chronic mercury poisoning, (d) Excessive use of supplementary iron tablets, (e) Lead poisoning, 59. In the treatment of acute inorganic arsenic poisoning, the most likely drug to, be used is, (a) Deferoxamine, (c) EDTA, (e) Succimer, , (b) Dimercaprol, (d) Penicillamine, , 60. Which of the following drugs or drug, groups is not useful in the prevention of, nausea and vomiting included by cancer, chemotherapy ?, (a) Dexamethasone, (c) Ketaserin, (e) Phenothiazines, , (b) Dronabinol, (d) Ondansetron, , 61. Passive immunization involves, (a), (b), (c), (d), (e), , Live immunogens, Polysaccharide vaccines, Stimulation of antibody formation, Use of antigens, Use of preformed antibodies, , 62. A businessman intends to travel abroad, in a geographical region where several, diseases are endemic. He would not be, able to be vaccinated against, (a), (b), (c), (d), (e), , Cholera, Malaria, Meningococcal infection, Typhoid fever, Yellow fever, , 63. Which of the following is used in active, immunization of children and combines, bacterial toxoids with a bacterial, antigen?, (a) BCG, (c) DTP, (e) Rho(D), , (b) BSA, (d) ISG, , 64. Which of the following is a polysaccharide, used for active immunization in patients, with chronic cardiorespiratory ailments?, (a), (b), (c), (d), (e), , Antilymphocyte immune serum, BCG vaccine, Mumps virus vaccine, Pertussis immune globulin, Pneumococcal vaccine, , 65. A needlestick injury is sustained by a, health care worker, and the blood is, known to contain HBV surface antigens., The health care worker should be given, (a) Nothing, (b) Immune globulin, (c) Hepatitis B immune globulin

Page 189 :
MCQs IN PHARMACOLOGY, , 174, (d) Hepatitis B vaccine, (e) Hepatitis B vaccine and hepatitis B immune, globulin, 66. Which one of the following compounds, enhances immune function in vitro and, in clinical trials decreases the symptoms, of the common cold?, (a), (b), (c), (d), (e), , Decreased blood volume, Decreased heart rate, Increased serum sodium, Increased total body potassium, Metabolic acidosis, , 68. The most appropriate drug for reversing, myasthenic crisis in a patient who is, experiencing diplopia, dysarthria, and, difficulty swallowing is, (a) Neostigmine, (c) Pralidoxime, (e) Tubocurarine, , (b) Pilocarpine, (d) Succinylcholine, , 69. In the management of patients with AIDS,, the sulfonamides are often used in, combination with inhibitors of folate, reductase. However, such combinations, have minimal activity against, (a), (b), (c), (d), (e), , Escherichia coli, Nocardia species, Pneumocystis carinii, Toxoplasma gondi, Treponema pallidum, , 70. Chemoprophylaxis for travelers to, geographic regions where chloroquine–, resistant P falciparum is endemic is best, provided by, (a), (b), (c), (d), (e), , (a) Dacarbazine, (c) Prednisone, (e) Vinblastine, , (b) Doxorubicin, (d) Procarbazine, , 72. A 54-year-old farmer has a 5-year, history of frequent, recurrent, and very, painful kidney stones. Appropriate, chronic therapy for this man is, , Echinacea, Feverfew, Garlic, Melatonin, Milk Thistle, , 67. An important therapeutic or toxic effect, of loop diuretics is, (a), (b), (c), (d), (e), , 71. This agent, which is used in the chemotherapy of Hodgkin’s lymphoma, is potentially leukemogenic, , Atovaquone, Mefloquine, Primaquine, Pyrimethamine plus sulfadoxine, Quinine, , (a) Furosemide, (b) Hydrochlorothiazide, (c) Morphine, (d) Spironolactone, (e) Triamterene, 73. A 55-year-old executive has cardiomyopathy and congestive heart failure. He, is being treated with diuretics. The mechanism of action of furosemide is best described as, (a) Interference with H+/HCO3 exchange, (b) Blockade of a Na+/K+/2Cl- transporter, (c) Blockade of a Na+/Cl- cotransporter, (d) Blockade of carbonic anhydrase, (e) Inhibition of genetic expression of DNA in, the kidney, 74. Which one of the following peptides is, not a vasodilator?, (a) Atrial natriuretic factor (ANF), (b) Calcitonin gene-related peptide, (c) Endothelin, (d) Substance P, (e) Vasoactive intestinal peptide, 75. A young female patient using an oral, contraceptive is to be treated for pulmonary tuberculosis. She is advised to use, an additional method of contraception, since the efficacy of the oral agents is, commonly decreased if her drug regimen, includes, (a) Amikacin, (c) Isoniazid, (e) Rifampin, , (b) Ethambutol, (d) Pyrazinamide

Page 190 :
CHEMOTHERAPY, , 175, , 76. Which one of the following drugs is most, likely to be effective in the treatment of, gonorrhea in this patient and safe to use?, (a), (b), (c), (d), (e), , Amoxicillin - clavulanate, Ceftriaxone, Clarithromycin, Ofloxacin, Tetracycline, , 77. The rationale for combination chemotherapy includes all of the following except, (a), (b), (c), (d), (e), , Biochemical enhancement of effect, rescue of normal cells, overcoming or preventing resistance, biochemical nullification of effect, cytotoxic to both resting and dividing cells, , 78. This compound reduces the need for, platelet transfusions in patients undergoing, cancer chemotherapy, (a), (b), (c), (d), (e), , 79. Which one of the following anticancer, drugs acts in the M-phase of the cell cycle, to prevent disassembly of the mitotic, spindle?, (b) Etoposide, (d) Procarbazine, , 80. While colchicines has been used in acute, gout, the drug often causes severe, gastrointestinal distress. Consequently,, many authorities now consider that the, drug of choice for acute gout is, (a) Acetaminophen, (c) Indomethacin, (e) Sulfinpyrazone, , 82. In antiviral immunity, what directly, recognized and kills viral-infected cells?, (a) Cytotoxic T cells (CTLs), (b) Antiviral antibodies, (c) Interferons, 83. An organ donor who is human leukocyte, antigen (HLA)- matched with the recipient, of a graft is sought. Which individual is, at least somewhat likely to provide a total, HLA match?, (a) A sibling of the graft recipient, (b) A parent of the graft recipient, (c) A cadaver, 84. Graft–versus–host (GVH) disease is, associated primarily with which type of, transplantation?, , Cyanocobalamin, Erythropoietin, Interleukin - II, Iron dextran, Tranexamic acid, , (a) Dactinomycin, (c) Paclitaxel, (e) Vinblastine, , (c) Increased likelihood of causing exophthalmo, during the first week of treatment, (d) Increased risk of fetal toxicity, (e) More sustained antithyroid activity when used, continuously for several months, , (b) Aspirin, (d) methotrexate, , 81. Relative to Lugol’s solution propylthouracil has, (a) A faster onset of antithyroid action, (b) A greater inhibitory effect on the proteolytic, release of hormones from the thyroid gland, , (a) Kidney, (b) Heart, (c) Bone marrow, 85. Which is a valid comparison of live, attenuated and killed, inactivated active, vaccines?, (a) Replication of the organisms in a live,, attenuated vaccine increases the stimulation, of the immune system, and a lower dose is, often required, (b) Attenuated vaccines often require multiple, doses, (c) A killed, inactivated vaccine probably, produces life-long immunity in one or two, doses, 86. Which type of cell does not contain double, standard deoxyribonucleic acid (DNA)?, (a) Human cells, (b) Bacteria cells, (c) Human immunodeficiency virus (HIV), cells, 87. Which enzyme is used by the Human, Immunodeficiency Virus (HIV) to form

Page 191 :
MCQs IN PHARMACOLOGY, , 176, deoxyribonucleic acid (DNA) in the host, cell?, (a), (b), (c), (d), (e), , Restrictive endonuclease, DNA-directed polymerase, Reverse transcriptase, Both (a) and (b), None of the above, , 88. Gamma immunoglobulin is considered, (a), (b), (c), (d), , Deoxyribonucleic acid (DNA), Ribonucleic acid (RNA), Protein, None of the above, , 89. Glycoprotein is considered a protein linked, to, , (b) Adenine, (d) Thymine, , (c) Guanine, (e) All of the above, , 94. Which of the following statements, regarding signal transduction is incorrect?, (a) Thyroxine-bound receptors act on DNA and, regulate specific transcription of genes., (b) Cyclic adenosine monophosphate can act, as second messenger., (c) The level of drug receptors at the cell surface, increases with chronic stimulation by receptor, agonists, (d) Binding of ligand to cell-surface receptors, can lead to synthesis of proteins, (e) Antacids act by interacting with small ions, normally found in the gastrointestinal tract., , A carbohydrate, A hormone, A lipid, A deoxyribonucleic acid (DNA), None of the above, , 95. All of the following chemotherapy agents, can be administered intrathecally except, , 90. An enzyme that cleaves deoxyribonucleic, acid (DNA) at a specific site is called, , 96. The efficacy rates for nonprescription, antifungal agents for vaginal yeast, infections is, , (a), (b), (c), (d), (e), , (a), (b), (c), (d), , Restrictive endonuclease, Restrictive ribonuclease, Trypsin, None of the above, , 91. An example of a cytokine is, (a), (b), (c), (d), (e), , Interleukin, Insulin, Gonadotropin, Thyroxine, None of the above, , 92. A common storage condition for most, biotechnology products after reconstitution, is, (a), (b), (c), (d), (e), , Room temperature, Cool place, Warm place, No excessive heat, Freezer, , 93. What base is found in deoxyribonucleic, acid (DNA)?, (a) Cytosine, , (a) Methotrexate, (c) Hydrocortisone, (e) Vincristine, , (a) 50%, (c) 70%, , (b) Cytrabine, (d) Thiotepa, , (b) 60%, (d) 80%, , 97. The best product to treat vulvar pruritus, in a woman with a vaginal yeast infection, is, (a) External miconazole (Monistat), (b) External miconazole and intravaginal, miconazole (Monistat-7 combination pack), (c) Intravaginal tioconazole (Vagistat 1), (d) Intravaginal butoconazole (Femstat 3), 98. Which of the following patients complaining of vaginal yeast infection symptoms, should be referred to a physician?, (a) If there is a history of recurrent vaginal yeast, infection, (b) If she is pregnant, (c) If she is less than age 12, (d) All of the above, 99. Which of the following herbs is known, to cause cancer?

Page 192 :
CHEMOTHERAPY, (a) Chaparral, (c) Ma huang, (e) St. John’s wort, , 177, (b) Comfrey, (d) Licorice, , 100. Which of the following herbs should be, used with caution while driving or, performing other tasks that require, alertness and coordination?, (a) Valerian, (c) Dong quai, (e) Saw palmetto, , (b) Echinacea, (d) Feverfew, , 101. Tom would like to try Echinacea to, prevent colds and flus during the winter, months. Which of the following, statements is true about Echinacea?, , 104. Cisapride should not be used in combination, with either fluconazole or indinavir because, of increased potential for, (a) Atrial fibrillation, (b) Atrial flutter, (c) Ventricular fibrillation, (d) Torsades de pointes, (e) Angina pectoris, 105. Which statement reageding phasespecific chemotherapeutic agents is, correct? They, (a) Are most effective in one phase of the cell, cycle, (b) Are effective in all phases of the cell cycle, , (a) It is contraindicated in patients allergic to, parsley, (b) It should only be taken continuously for three, months, (c) It is contraindicated in patients with lupus, and leucosis, (d) Prolonged use of Echinacea will upregulate, the immune system, (e) Side effects include headache, rash, and, dizziness, , 106. Body surface area (BSA) is used in calculating chemotherapy doses because, , 102. Hematological testing of a patient with, acquired immune deficiency syndrome, (AIDS) is most likely to show which of the, following abnormalities?, , (d) The National Cancer Institute requires that, BSA be used, , (a) Basophilia, (c) Lymphopenia, (e) Agranulocytosis, , (b) Eosinophilia, (d) Reticulocytosis, , 103. Hematological studies are most likely to, show a low reticulocyte count in a patient, who has which one of the following, abnormalities ?, (a) Aplastic anemia secondary to cance, chemotherapy, (b) Acute hemolytic anemia secondary to, quinidine treatment, (c) Severe bleeding secondary to an automobile, accident, (d) Iron deficiency anemia 1 week after, treatment with ferrous sulfate, (e) Megaloblastic anemia due to folate, deficiency 1 week after treatment with folic, acid, , (c) Are only effective in G0 phase, (d) Include the alkylating agents, (e) Include the antitumor antibiotics, , (a) BSA is an indicator of tumor cell mass, (b) BSA correlates with cardiac output, (c) BSA correlates with gastrointestinal transit, time, , (e) The Food and Drug Administration (FDA), requires that BSA be used, 107. The rationale for combination chemotherapy includes all of the following except, (a) Biochemical enhancement of effect, (b) Rescue of normal cells, (c) Overcoming or preventing resistance, (d) Biochemical nullification of effect, (e) Cytotoxic to both resting and dividing cells, 108. Which of the following chemotherapeutic, agents is classified as an alkylating agent?, (a) Cyclophosphamide, (b) Etoposide, (c) Mechlorethamine, (d) Paclitaxel, (e) Cyclophosphamide and mechlorethamine

Page 193 :
MCQs IN PHARMACOLOGY, , 178, 109. Which of the following chemotherapy, agents acts by intercalation?, (a), (b), (c), (d), (e), , Vincristine, Paclitaxel, Doxorubicin, Vincristine and paclitaxel, Topotecan, , 110. How do antimetabolites exert their, cytotoxic effect?, (a) Inhibiting DNA synthesis by sliding between, DNA base pairs, (b) Inhibiting RNA synthesis by sliding between, RNA base pairs, (c) Acting as false metabolites in the, microtubules, (d) Acting as false substitutions in the production, of nucleic acids, (e) Promoting microtubule assembly and, stabilization, 111. Which of the following chemotherapy, agents are correctly paired according to, their mechanism of action?, (a), (b), (c), (d), (e), , Vincristine and paclitaxel, Etoposide and paclitaxel, Docetaxel and paclitaxel, Docetaxel and etoposide, Vincristine and etoposide, , 112. When does not neutrophil nadir associated, with chemotherapy agents generally, occur?, (a), (b), (c), (d), (e), , During administration of the chemotherapy, 1–2 days after therapy, 10–14 days after therapy, 1 month after therapy, When the platelet count begins to rise, , 113. N-acetylcysteine is classified as a (an), (a), (b), (c), (d), (e), , Analgesic, Antitussive, Mucolytic agent, Antitubercular agent, Protein hydrolysate, , 114. Procarbazine (Matulane) is used primarily, to treat, , (a), (b), (c), (d), (e), , Ovarian carcinoma, Psoriasis, Breast carcinoma, Melanoma, Hodgkin’s disease, , 115. The principal active alkaloid of ipecac is, (a) Yohimbine, (c) Apomorphine, (e) Emetine, , (b) Caffeine, (d) Lobeline, , 116. Emetine is used in the treatment of, (a) Malalria, (b) Schistosomiasis, (c) Tuberculosis, (d) Amebiasis, (e) None of the above, 117. The therapeutic use of neostigmine, bromide is as a, (a), (b), (c), (d), (e), , Miotic, CNS depressant, Treatment of curare poisoning, Neuromuscular blocker, Muscle relaxant, , 118. Ethylenediamine-tetracetic acid is an, antidote for which of the following?, (a), (b), (c), (d), (e), , Sodium secobarbital, Aspirin, Paris green, Phosphorus, Lead, , 119. Which of the following chemotherapeutic, agents is classified as an alkylating, agent?, (a), (b), (c), (d), (e), , Cyclophosphamide, Etoposide, Mechlorethamine, Paclitaxel, Cyclophosphamide and mechlorethamine, , 120. Which of the following is a gametocidal, agent in malaria?, (a) Atabrine, (c) Paludrine, (e) Aralen, , (b) Quinine, (d) Primaquine, , 121. Which of the following is contraindicated, in the presence of active tuberculosis?

Page 194 :
CHEMOTHERAPY, (a) Hydrocortisone, (c) INH, (e) PABA, , 179, (b) Streptomycin, (d) PAS, , 122. A drug that is very effective in the, treatment of tinea versicolor is, (a), (b), (c), (d), (e), , Undecylenic acid, Clotrimazole (Lotrimin), Acrisorcin (Akrinol), Penicillin G, Prednisolone, , 123. Which of the following is a first-line drug, to treat tuberculosis?, (a) PAS, (c) Ethionamide, (e) Ethambutol, , (b) Rifampin, (d) Cycloserine, , 124. Yellow pigmentation of the skin is most, common with, (a) Chloraquine, (c) Quinacrine, (e) Atabrine, , (b) Pamaquin, (d) Quinine, , 125. The most effective single chemotherapeutic, agent of those indicated, in the treatement, of tuberculosis is, (a) Neomycin, (c) Streptomycin, (e) Terramycin, , (b) Sulfones, (d) Penicillin, , 126. Which is an antidote for malathion, poisoning?, (a), (b), (c), (d), (e), , Vitamin K, Protamine sulfate, Nalorphine (Nalline), Pralidoxine (Protopam), Edrophonium (Tensilon), , 127. Antimicrobial treatment does not alter the, course of the following diarrhoeas except, (a), (b), (c), (d), , Mild enterotoxigenic E.coli diarrhoea, Campylobacter diarrhoea, Coeliac disease diarrhoea, Food poisoning diarrhoea, , 128. Which of the following diarrhoeas is, consistently benefited by antimicrobial, therapy, , (a), (b), (c), (d), , Irritable bowel syndrome, Cholera, Salmonella diarrhoeas, Traveller’s diarrhoea, , 129. The therapeutic effect of sulfasalazine in, ulcerative colitis is exerted by, (a) Inhibitory action of the unabsorbed drug on, the abnormal colonic flora, (b) Breakdown of the drug in colon to release, 5-aminosalicylic acid which suppresses, inflammation locally, (c) Release of sulfapyridine having antibacterial, property, (d) Systemic immunomodulatory action of the, drug, 130. The preferred drug for controlling an, acute exacerbation of ulcerative colitis is, (a) Prednisolone, (c) Mesalazine, , (b) Sulfasalazine, (d) Vancomycin, , 131. To be effective in ulcerative colitis, 5aminosalicylic acid has to be given as, (a) Acrylic polymer coated tablet which releases, the drug only in the lower bowel, (b) A complex of two molecules joined together, by azo bond, (c) A retention enema, (d) All of the above, 132. A small amount of atropine is added to, the diphenoxylate tablet/syrup to, (a) Suppress associated vomiting of gastroenteritis, (b) Augment the antimotility action of diphenoxylate, (c) Block side effects of diphenoxylate, (d) Discourage overdose and abuse of, diphenoxylate, 133. Select the sulfonamide drug which is, active against pseudomonas and is used, by topical application for prophylaxis of, infection in burn cases, (a), (b), (c), (d), , Sulfadiazine, Silver sulfadiazine, Sulfadoxine, Sulfamethoxazole

Page 195 :
MCQs IN PHARMACOLOGY, , 180, 134. The drug of choice for prophylaxis of, meningococcal meningitis during an, epidemic is, (a), (b), (c), (d), , Phenoxymethyl penicillin, Tetracycline, Rifampin, Ciprofloxacin, , 135. Trimethoprim inhibits bacteria without, affecting mammalian cells because, (a) It does not penetrate mammalian cells, (b) It has high affinity for bacterial but low affinity, for mammalian dihydrofolate reductase, enzyme, (c) It inhibits bacterial folate synthetase as well, as dihydrofolate reductase enzymes, (d) All of the above, 136. Trimethoprim is combined with sulfamethoxazole in a ration of 1:5 to yield, a steady state plasma concentration ratio, of, (a), (b), (c), (d), , Trimethoprin 1:Sulfamethoxazole 5, Trimethoprin 1:Sulfamethoxazole 10, Trimethoprin 1:Sulfamethoxazole 20, Trimethoprin 1:Sulfamethoxazole 1, , 137. Indicate the condition in which neither, trimethoprim nor sulfamethoxazole alone, are effective, but their combination, cotrimoxazole is, (a), (b), (c), (d), , Prostatitis, Lymphogranuloma venereum, Pneumocystis carinii pneumonia, Bacillary dysentery, , 138. Select the antimicrobial drug which is, used orally only for urinary tract infection, for bacterial diarrhoeas, (a), (b), (c), (d), , Pefloxacin, Azithromycin, Bacampicillin, Nalidixic acid, , 139. Nalidixic acid is primarily active against, (a), (b), (c), (d), , Cocci, Bacilli, Gram-positive bacteria, Gram-negative bacteria, , 140. Indicate the drug which attain therapeutic, antibacterial concentration in the urinary, tract but not in other tissues, (a) Sulfasomidine, (c) Nitrofurantoin, , (b) Piperacillin, (d) Both (b) and (c), , 141. Acidic urine augments the antibacterial, action of the following drug, (a) Sulfadiazine, (c) Gentamicin, , (b) Cotrimoxazole, (d) Nitrofurantoin, , 142. Which of the following is not a first line, antitubercular drug ?, (a) Ciprofloxacin, (c) Pyrazinamide, , (b) Streptomycin, (d) Ethambutol, , 143. The intermittently multiplying (spurter), tubercle bacilli present within caseous, material having low oxygen tension are, most susceptible to, (a) Ethambutol, (c) Streptomycin, , (b) Rifampin, (d) Pyrazinamide, , 144. Occurrence of the following adverse, reaction absolutely contraindicates, further use of rifampin in the treatment, of tuberculosis, (a), (b), (c), (d), , Respiratory syndrome, Cutaneous syndrome, Flu syndrome, Abdominal syndrome, , 145. Which of the following chemotherapy, agents acts by intercalation?, (a), (b), (c), (d), (e), , Vincristine, Paclitaxel, Doxorubicin, Vincristine and paclitaxel, Topotecan, , 146. Ethambutol is not used in children below, 6 years of age because, (a) Young children are intolerant to ethambutol, (b) Ethambutol causes growth retardation in, young children, (c) It is difficult to detect ethambutol induced, visual impairment in young children, (d) In young children visual toxicity of ethambutol, is irreversible

Page 196 :
CHEMOTHERAPY, 147. In a patient of pulmonary tuberculosis,, pyrazinamide is most active on the, following subpopulation of tubercle bacilli, (a) Rapidly multiplying bacilli located on cavity, walls, (b) Slow growing bacilli within macrophages, and at sites showing inflammatory response, (c) Intermittently multiplying bacilli within, caseous material, (d) Dormant bacilli, 148. The most important reason for using a, combination of chemotherapeutic agents, in the treatment of tuberculosis is, (a) To obtain bactericidl effect, (b) To prevent developmet of resistance to the, drugs, (c) To broaden the spectrum of activity, (d) To reduce adverse effects of the drugs, 149. Addition of pyrazinamide and ethambutol, for the first two months to the isoniazid +, rifampin therapy of tuberculosis serves the, following purpose(s), (a) Reduces the total duration of therapy to 6, months, (b) Produces more rapid sputum conversion, (c) Permits reduction of rifampin dose, (d) Both (a) and (b), 150. What is true of short course DOTS(WHO), stategy for treatment of tuberculosis ?, (a) It consists of an initial intensive phase and a, later continuation phase, (b) The dose of antitubercular drugs is reduced, after clinical response occurs, (c) The patient himself is made responsible for, administering antitubercular drugs, (d) All of the above, 151. According to the currect WHO guidelines, new (untreated) sputum smear positive, cases of pulmonary tuberculosis are to, be treated with the following regimen, (a) Isoniazid + Rifampin + Pyrazinamide for 6, months, (b) Isoniazid + Thiacetazone + Rifampin for 2, months followed by isoniazid + thiacetazone, for 6 months, (c) Isoniazid + Rifampin for 6 months with, additional Pyrazinamide + Ethambutol/, Streptomycin during the initial 2 months, , 181, (d) Isoniazid + Rifampin for 6 months with, additional Pyrazinamide during the initial 2, months, 152. Corticosteroids are absolutely contraindicated in which of the following types, of tuberculosis, (a) Miliary, (c) Intestinal, , (b) Meningeal, (d) Renal, , 153. Multi Drug Resistant (MDR) tuberculosis, is defined as resistance to, (a) Any two or more antitubercular drugs, (b) Isoniazid + any other antitubercular drug, (c) Isoniazid + Rifampin ± any one or more, antitubercular drugs, (d) All five first line antitubercular drugs, 154. Mycobat tuberculosis infection in a HI V, infected patient is treated with, (a) The same antitubercular regimen as HIV, negative patient, (b) Four first line antitubercular drugs for 2, months followed by a longer continuation, phase of 7 months with rifampin + isoniazid, (c) All five first line antitubercular drugs for nine, months, (d) Clarithromycin + Ciprofloxacin + Rifabutin, for 12 months, 155. The most important dose dependent, toxicity of dapsone is, (a), (b), (c), (d), , Methemoglobinemia, Haemolysis, Hepatitis, Dermatitis, , 156. The tetracycline with highest antileprotic, activity is, (a) Minocylcine, (c) Methacycline, , (b) Docycycline, (d) Oxytetracycline, , 157. Multidrug therapy with dapsone,, rifampin and clofazimine is the treatment, of choice of, (a), (b), (c), (d), , Multibacillary leprosy, Paucibacillary leprosy, Dapsone resistant leprosy, All forms of leprosy

Page 197 :
MCQs IN PHARMACOLOGY, , 182, 158. The newer lipid formulations of amphotericin B differ from the conventional formulation in the following respects except, (a), (b), (c), (d), , They, They, They, They, , are more efficacious, produce milder acute reaction, are less nephrotoxic, produce milder anaemia, , 159. The drug of choice for monilial diarrhoea, is, (a) Flucytosine, (c) Natamycin, , (b) Nystatin, (d) Ketoconazole, , 160. Griseofulvin is indicated in., (a), (b), (c), (d), , All types of tinea infection, Onychomycosis, Pityriasis versicolor, Both (b) and (c), , 161. Choose the azole antifungal drug which, is used only topically, (a) Ketoconazole, (c) Itraconazole, , (b) Fluconazole, (d) Econazole, , 162. Fluconazole differs from ketoconazole in, that, (a), (b), (c), (d), , It is not active by the oral route, It is a more potent inhibitor of drug metabolizm, It is not effective in cryptococcal meningitis, It is unlikely to produce anti-androgenic side, effects, , 163. The only antifungal drug which has some, activity against moulds like Mucor and, Aspergillus is, (a) Itraconazole, (c) Miconazole, , (b) Fluconazole, (d) Ketoconazole, , 164. Iodoxuridine is indicated in, (a), (b), (c), (d), , Herpes simplex keratitis, Herpes zoster, Chicken pox, All of the above, , 165. Which of the following viruses is most, susceptible to acyclovir ?, (a) Herpes simplex type I virus, (b) Herpes simplex type II virus, , (c) Varicella-zoster virus, (d) Epstein–Barr virus, 166. Which of the following is true of acyclovir, treatment of genital herpes simplex ?, (a) Topical treatment affords symptomatic relief, in primary as well as recurrent disease, (b) Oral therapy for 10 days affords symptomatic, relief as well as prevents recurrences, (c) Oral therapy for 10 days affords symptomatic, relief but does not prevent recurrences, (d) Continuous long-term topical therapy is, recommended to prevent recurrences, 167. The virus directed reverse transcriptase, enzyme is inhibited by, (a) Amantadine, (c) Vidarabine, , (b) Zidovudine, (d) Acyclovir, , 168. How do antimetabolites exert their cytotoxic, effect?, (a) Inhibiting DNA synthesis by sliding between, DNA base pairs, (b) Inhibiting RNA synthesis by sliding between, RNA base pairs, (c) Acting as false metabolites in the microtubules, (d) Acting as false substitutions in the production, of nucleic acids, (e) Promoting microtubule assembly and, stabilization, 169. Antiretroviral therapy is not recommended in asymptomatic HIV infected subjects, because of the following reason(s)., (a) All antiretroviral drugs lose efficacy after, some time, (b) Adverse effects of antiretroviral drugs, compromise the quality of life of, asymptomatic subjects, (c) The treated subjects may produce and, transmit drug resistant virus, (d) All of the above, 170. Choose the correct statement about amantadine, (a) It is an antimetabolite used for viral infections, (b) It prevents penetration of the virus into the, host cell

Page 198 :
CHEMOTHERAPY, , 183, , (c) Concurrent administration of amantadine, prevents antibody response to influenzavaccine, , (b) Residents of endemic areas, , (d) It is used to protect high risk subjects during, an influenza A2 epidemic, , (d) Travellers from endemic to nonendemic areas, , 171. The antiviral action of amantadine is, exerted through, , (c) Travellers from nonendemic to endemic areas, 177. Radical cure of vivax malaria should be, attempted in, (a) Areas where only sporadic cases occur, , (a) Interaction with a virus directed thymidine, kinase, , (b) Endemic areas with effective vector control, measures, , (b) Interaction with a viral M2 protein, , (c) Endemic areas not covered by vector control, , (c) Inhibition of a viral protease enzyme, (d) Inhibition of viral RNA mediated DNA, synthesis, 172. Erythrocytic schizontocide antimalarial, drugs are used as, (a) Suppressive prophylactic, (b) Clinical curative, (c) Radical curative for P. Vivax, (d) Both (a) and (b), 173. Which of the following drugs is a causal, prophylactic for falciparum malaria and, suppressive prophylactic for vivax malaria, (a) Chloroquine, , (b) Mepacrine, , (c) Quinine, , (d) Chloroguanide, , 174. Recrudescence of malaria refers to, recurrence of malarial fever due to, (a) Reinfection of the patient by mosquito bite, (b) Reinfection of blood by exoerythrocytic, hyponozoites, (c) Incomplete clearance of schizonts from blood, (d) Reinfection of blood by sporozoites, 175. If a drug is active against the preerythrocytic stage of the malarial parasite it, will be useful as a, (a) Suppressive prophylactic, (b) Causal prophylactic, (c) Clinical curative, (d) Radical curative, 176. Chemoprophylaxis of malaria is recommended for the following category of, subjects, (a) Residents of nonedemic areas, , (d) Both (a) and (b), 178. Chloroquine acts as, (a) Preerythrocytic schizontocide for both P., falciparum and P. vivax, `, , (b) Erythrocytic schizontocide for both P., falciparum and P. vivax, (c) Exoerythrocytic schizontocide for P. vivax, (d) Gametocidal for P. falciparum, , 179. Which of the following drugs is suitable, for treatment of malaria during pregnancy, (a) Quinine, (b) Chloroquine, (c) Pyrimethamine, (d) Primaquine, 180. Amodiaquine differs from chloroquine in, the following respect(s), (a) It is currently not recommended for treatment, of clinical attacks of malaria, (b) Its used as a suppressive prophylactic is, prohibited, (c) It is less bitter and causes less itching, (d) Both (b) and (c), 181. Choose the correct statement about mefloquine, (a) In a single dose it affords clinical cure in all, types of malaria, (b) It is selectively active against chloroquine, resistant P. falciparum but not the chloroquine, sensitive Strains, (c) It is recommended only in areas where, chloroquine resistant P.falciparum is prevalent, (d) Both (a) and (c)

Page 199 :
MCQs IN PHARMACOLOGY, , 184, 182. The drug of choice for cerebral malaria, due to P. falciparum is, (a), (b), (c), (d), , Quinine, Mefloquine, Chloroguanide, Pyrimethamine + Sulfadoxine, , 183. Intravenous injection of quinine produces, (a), (b), (c), (d), , Rise in blood pressure, Neuromuscular block, Hyperglycaemia, Hypoglycaemia, , 184. The following is true of quinine, (a) It has a longer elimination half-life than, chloroquine, (b) It is not to be used for prophylaxis of malaria, (c) It is not active against P. vivax, (d) It should not be used along with sulfapyrimethamine, 185. The fastest acting schizontocidal drug, among the following is, (a), (b), (c), (d), , Artemether, Melfoquine, Chloroquine, Pyrimethamine, , (b) Artemisinin, , (c) Primaquine, , (d) Mefloquine, , 189. All of the following chemotherapy agents, work through affecting microtubule, function except, (a) Docotaxel, , (b) Vinblastine, , (c) Mitoxantrone, , (d) Vincristine, , (e) Vinorelbine, 190. Choose the correct statement(s) about, metronidazole, (a) It is a drug of choice for amoebic dysentery, as well as amoebic liver abscess, (b) It affords the most rapid symptom relief in, amoebi dysentery, (c) It is the most effective drug in eradicating, amoebic cysts from the colon, (d) All of the above, 191. Metronidazole is used for, (a) Round worm infestation, (b) Hook worm infestation, (c) Kala-azar, (d) Giardiasis, 192. In addition to having antiamoebic activity,, tinidazole inhibits, , 186. Pyrimethamine + sulfadoxine should be, used as a, (a) Clinical curative in areas with chloroquine, resistance, (b) Clinical curative in areas without chloroquine, resistance, (c) Prophylactic in areas with or without, chloroquine resistance, (d) All of the above, 187. Which of the following antimalarial drugs, is more active against pre-and exoerythrocytic stages of the malarial parasite, than against the erythrocytic stage ?, (a) Chloroguanide, (c) Pyrimethamine, , (a) Pyrimethamine, , (b) Primaquine, (d) Quinine, , 188. Use of the following antimalarial drug, carrys high risk of adverse effect in, subjects with G-6-PD deficiency., , (a) Anaerobic bacillin, (b) Aerobic bacilli, (c) Gram-positive cocci, (d) Gram-negative cocci, 193. Tinidazole differs from metronidazole in, that, (a) It is not active against anaerobic bacteria, (b) It has a broader spectrum of activity, (c) It has a longer elimination half life, (d) It has better oral absorption, 194. Emetine is now used only as a reserve, drug for amoebiasis because, (a) It is less effective than metronidazole, (b) It produces a slower response than, metronidazole, (c) It has cardiotoxic potential, (d) It does not clear stools of amoebic cysts

Page 201 :
MCQs IN PHARMACOLOGY, , 186, (c) Levamisole, (d) Piperazine citrate, 209. Diethyl carbamazine citrate has the, following action in filariasis, (a) Rapidly kills adult filarial worms and stops, production of microfilariae, (b) Kills circulating microfilariae, (c) Kills microfilariae present in nodules and, serous fluids, (d) Promotes phagocytosis of circulating, microfilariae, 210. Hormonal agents that are useful in the, treatment of cancer include, (a), (b), (c), (d), (e), , Tamoxifen, Prednisone, Flutamide, Tamoxifen and flutamide, Tamoxifen, prednisone and flutamide, , 211. Praziquantel is preferred over niclosamide, for Taenia solium infestation because, (a) It achieves higher cure rates, (b) It produces fewer side effects, (c) It does not lead to digestion of worm and, kills encysted larvae, so that chances of, cysticercosis are minimized, (d) Both (a) and (b), 212. For the treatment of Hymenolepis nana, infestation, praziquantel has the following, advantage(s) over niclosamide, (a) It is better tolerated, (b) It requires single dose treatment against 5, days treatment with niclosamide, (c) A purgative is required after niclosamide but, not after praziquantel, (d) All of the above, 213. Praziquantel is effective against the, following helminth(s), (a), (b), (c), (d), , Taenia saginata, Diphyllobothrium latum, Schistosomes, All of the above, , 214. The following anticancer drug has high, emetogenic potential, , (a), (b), (c), (d), , Vincristine, Chlorambucil, 6-Mercaptopurine, Cisplatin, , 215. The most important target of action of, chlorambucil is, (a) Myeloid tissue, (c) Neural tissue, , (b) Lymphoid tissue, (d) Skin, , 216. Which of the following antineoplastic, drugs is a mitotic inhibitor and causes, metaphase arrest ?, (a) Busulfan, (c) Cytarabine, , (b) Vincristine, (d) Procarbazine, , 217. Vinca alkaloids exert antitumor activity, by, (a) Activating topoisomerase II to cause breaks, in DNA strands, (b) Crosslinking DNA strands, (c) Inhibiting DNA mediated RNA synthesis, (d) Inhibiting polymerization of tubulin to form, intracellular microtubules, 218. Vincristine differs from vinblastine in the, following respect(s), (a), (b), (c), (d), , Its prominent adverse effect is neuropathy, It frequently produces alopecia, It does not significantly depress bone marrow, All of the above, , 219. Patients treated with the following, anticancer drug are likely to develop a, disulfiram like reaction on taking alcohol., (a) Dacarbazine, (c) Melphalan, , (b) Procarbazine, (d) Hydroxyurea, , 220. Select the cell cycle nonspecific antineoplastic drug., (a) Vincristine, (c) Methotrexate, , (b) Bleomycin, (d) 5-Fluorouracil, , 221. Biological response modifiers like GM-CSF, are used in conjunction with anticancer, drugs for the following purpose(s)., (a) To enhance antitumour activity of the drug, (b) To prevent hypersensitivity reactions to the, drug

Page 203 :
MCQs IN PHARMACOLOGY, , 188, 237. Methotrexate, (a), (b), (c), (d), , Is useful in choriocarcinoma, Is safe in patients with renal dysfunction, Induced neurotoxicity is reversed by leucovorin, Is not used in children, , 238. Prolactin, (a) Has somatotropic activity, (b) If low can cause infertility in women, (c) Can suppress menstrual cycle in lacting, women, (d) Levels are increase by dopamine, 239. Thioamide drugs, (a), (b), (c), (d), , Aggravate endocrine exophthalmos, Are safe in children, Produce irreversible hypothyroidism, Do not produce relapse, , 240. Liothyronine is the drug of choice in, treatment of, (a), (b), (c), (d), , Myxoedema coma, Cretinism, Iodine deficiency goiter, Non-resectable cases of papillary thyroid, carcinoma, , 241. When does the neutrophil nadir, associated with chemotherapy agents, generally occur?, (a), (b), (c), (d), (e), , During administration of the chemotherapy, 1–2 days after therapy, 10–14 days after therapy, 1 month after therapy, When the platelet count begins to rise, , 242. Which of the following are the principal, organisms in superinfection?, (a), (b), (c), (d), , Salmonella, shigella, Candida, albicans, proteus and staphylococci, E. Coli, Mycobacterium tuberculosis, None of the above, , 243. In tuberculosis combination of antimicrobials is used, (a) To delay the development of drug resistance, (b) To reduce severity of adverse reactions, , (c) To broaden the spectrum of antimicrobial, activity, (d) All of the above, 244. The bactericidal drugs act most effectively, on, (a), (b), (c), (d), , The toxin liberated by organisms, Preventing liberation of toxins from organisms, Slowly dividing organisms, Rapidly dividing organisms, , 245. Most of the laboratory sensitivity tests for, antimicrobials are conducted at pH, (a) 4.6–4.8, (c) 3.2–3.6, , (b) 8.4–8.6, (d) 7.2–7.4, , 246. Sulphonamides prevent the synthesis of, folic acid in bacterial cells because, (a) They compete with PABA which is a precursor, of folic acid, (b) They potentiate action of PABA which is, natural antagonist of folic acid, (c) They bind to PABA and form a complex, (d) None of the above, 247. Sulphonamide-trimethoprim combination, becomes bactericidal because, (a) Sulphonamide inhibits conversion of folic, acid to folinic acid, and trimethoprim from, PABA to folic acid, (b) Sulphonamide inhibits conversion of PABA, to folic acid and trimethoprim from folic acid, to folinic acid, (c) Trimethoprim increases the free drug, concentration of sulphonamide, (d) Sulphonamide increases the free drug, concentration of trimethoprim, 248. Sulphonamide given in late pregnancy or, to new born can result in kernicterous, because, (a) It stimulates synthesis of bilirubin, (b) It displaces bilirubin from plasma protein and, and results in high free bilirubin concentration, (c) It prevents the metabolism of bilirubin, (d) It is metabolized in bilirubin, 249. Concentration of sulphonamides in C.S.F., is about 40 to 80% of that in blood, because

Page 204 :
CHEMOTHERAPY, , 189, , (a) In C.S.F. there is no protein to bind the drug, (b) C.S.F. has higher protein content than the, blood, (c) C.S.F has low protein content than the blood, (d) In C.S.F sulphonamides are quickely, destroyed, 250. Sulphonamides are primarily metabolized, by, (a), (b), (c), (d), , Acetylation, Glucuronidation, Etheral sulphate formation, None of the above, , 251. In an alkaline urine sulphonamides are, (a), (b), (c), (d), , Less soluble, More soluble, Not at all soluble, No effect of pH on stability of sulphonamides, , 252. The risk of crystallurea by suylphonamides, can be reduced by, (a) Giving more soluble sulphonamides, (b) Making urine alkaline, (c) Ensuring urinary volume at least 2 liters a, day, (d) All of the above, 253. Sulphamethizole is principally used for, (a), (b), (c), (d), , Topical application, Systemic infection, Occular infection, Urinary infection, , 254. Stomatitis is characterized by all of the, following signs and symptoms except, (a) headache, (b) erythema, (c) bleeding, (d) ulcerations, (e) dryness of mouth, 255 In co-trimoxazole, sulphamethoxazole, and trimethoprim are in ratio of, (a) 2 : 1, (c) 1 : 1, , (b) 1 : 5, (d) 5 : 1, , 256. Pyrimethamine and progunil act by, (a) Interfering with parasite’s ability to digest Hb, (b) Inhibiting dihydrofolate reductase which, converts folic acid to folinic acid, , (c) Interfering with plasmodium mitochondria, (d) By all of the above mechanisms, 257. Drug resistance develops, (a), (b), (c), (d), , More readily to pyrimethamine than chloroquin, More readily to chloroquin than pyrimethamine, In both cases resistance does not develop, In both cases resistance develops readily, , 258. For suppressive prophylaxis of malaria, the drug used is, (a), (b), (c), (d), , Pyrimethamine 25 mg. once a week, Pyrimethamine 250 mg. once a week, Primaquine 15 mg daily for 2 days, All of the above drug can be used, , 259. For radical cure of malaria the drug of, choice is, (a), (b), (c), (d), , Primaquine 25 mg bd. × 7 days, Primaquine 15 mg once daily × 14 days, Chloroquine 400 mg. once is a month, None of the above, , 260. Which of the following statements, describe hemorrhagic cystitis? It, (a) Is caused by excretion of tumor cell, breakdown products, (b) Is associated with iforfamide or cyclophosphamide administration, (c) Is caused by the administration of mesna, (d) Can be prevented or treated with acrolein, (e) Can be treated with G-CSF, 261. The less common causative organism in, urinary tract infection is, (a) E. Coli, (b) Pseudomonas, (c) Tubercular bacilli (d) Proteus, 262. In an acute U.T.I. with alkaline urine and, unidentified organism, the treatment, should begin with, (a) Co-trimoxazole, (c) Nitrofurantoin, , (b) Sulphonamide, (d) Mendallic acid, , 263. Nitrofurantion is useful only in urinary, tract infection because, (a) It is rapidly excreted and concentrated in, urine, (b) It is rapidly metabolized in liver which, prevents effective plasma concentration

Page 205 :
MCQs IN PHARMACOLOGY, , 190, (c) It’s concentration in renal tissue is high, because of renal tubular reabsorption, (d) It is effective against common organisms of, U.T.I e.g. proteins, and E. Coli, (e) All above reasons, 264. Hexamine mandelate is only effective in, U.T.I. and not in systemic infection, because, (a) It is only concentrated in urine, (b) In urine at pH less than 5.5, it liberates active, antibacterials, (c) For systemic infection dose required is too, high which is toxic, (d) Organisms in systemic infection are not, sensitive to it, 265. All of the following chemotherapy agents, are vesicants except, (a) Doxorubicin, (c) Vincristine, (e) Idarubicin, , (b) Mechlorethamine, (d) Methotrexate, , (b) Thioactazone, (d) Pyrazinamide, , 267. Which of the following drugs is effective, against intracellular organism of tuberculosis?, (a) INH, (c) PAS, , 270. In cell targeted suicide mode of gene, therapy for cancer the prodrug used is, (a) Gancyclovir, (c) Ara c/m, , (b) Acyclovir, (d) All of the above, , 271. Drug of choice for guinea worm infestation, is, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 272. Which of the following can not be treated, with danzol ?, (a), (b), (c), (d), , Endometriosis, Menorrhagia, Fibrocystic disease, Hirsutism, , 273. Melphalan is the drug of choice in, , 266. Which of the following is most effective, antitubercular drug?, (a) INH, (c) PAS, , (c) It potentiates the antitubercular effect of other, drugs, (d) It has reduced the duration of antitubercular, therapy, , (b) Streptomycin, (d) Ethambutol, , 268. Isoniazid may cause peripheral, neuropathy and anaemia as its side, effects because, (a) It is toxic to nerves and to R.B.C, (b) It interferes with pyridoxin metabolism and, induces its defeciency, (c) It prevents absorption of iron and ascorbic acid, (d) It is a type of hypersensitivity reaction, 269. Rifampicin has gained significance in, antitubercular therapy because, (a) It is the cheapest and effective drug, (b) It is least toxic, so suitable for chronic use, , (a), (b), (c), (d), , Leukemia, Multiple myeloma, Hodgkin’s disease, Osteosarcoma, , 274. Prolonged chlorpromazine therapy, results in, (a), (b), (c), (d), , Osteomalacta, Photosensitivity, Yellowish discolouration, Altered renal function, , 275. Drug of choice for actionomycosis is, (a) Penicillin, (c) Sulfonamide, , (b) Tetracycline, (d) Dapsone, , 276. Match each of the following toxicities to, the agent most likely to cause the toxicity, (a), (b), (c), (d), (e), , Cardiotixicity, Hypersensitivity, Diarrhea, Pulmonary toxicity, Constipation, , (1), (2), (3), (4), (5), , Vincristine, Irinotecan, Doxorubicin, Paclitaxel, Bleomycin

Page 206 :
CHEMOTHERAPY, , 191, , ANSWERS, 1. d, 7. d, 13. d, 19. a, 25. a, 31. e, 37. a, 43. e, 49. e, 55. b, 61. e, 67. a, 73. b, 79. c, 85. a, 91. a, 97. b, 103. a, 109. c, 115. e, 121. a, 127. b, 133. b, 139. d, 145. c, 151. c, 157. d, 163. a, 169. d, 175. b, 181. d, 187. b, 193. c, 199. c, 205. b, 211. c, 217. d, 223. d, 229. a, 235. c, 241. c, , 2. c, 8. d, 14. a, 20. c, 26. c, 32. d, 38. b, 44. b, 50. e, 56. c, 62. b, 68. a, 74. c, 80. c, 86. c, 92. b, 98. d, 104. d, 110. d, 116. d, 122. c, 128. c, 134. c, 140. c, 146. c, 152. c, 158. a, 164. a, 170. d, 176. c, 182. a, 188. c, 194. c, 200. b, 206. d, 212. b, 218. d, 224. a, 230. c, 236. a, 242. b, , 3. b, 9. b, 15. a, 21. b, 27. a, 33. d, 39. d, 45. b, 51. d, 57. b, 63. c, 69. e, 75. e, 81. e, 87. c, 93. e, 99. b, 105. a, 111. c, 117. c, 123. b, 129. b, 135. b, 141. d, 147. b, 153. c, 159. b, 165. a, 171. b, 177. d, 183. d, 189. c, 195. b, 201. d, 207. d, 213. d, 219. b, 225. d, 231. d, 237. a, 243. a, , 4. c, 10. d, 16. d, 22. c, 28. b, 34. a, 40. b, 46. d, 52. d, 58. b, 64. e, 70. b, 76. d, 82. a, 88. c, 94. c, 100. a, 106. b, 112. c, 118. e, 124. e, 130. a, 136. c, 142. a, 148. b, 154. b, 160. b, 166. c, 172. d, 178. b, 184. b, 190. a, 196. a, 202. b, 208. a, 214. d, 220. d, 226. d, 232. b, 238. c, 244. d, , 5. b, 11. b, 17. d, 23. d, 29. a, 35. c, 41. d, 47. b, 53. b, 59. b, 65. e, 71. d, 77. d, 83. a, 89. a, 95. e, 101. b, 107. d, 113. c, 119. e, 125. c, 131. d, 137. c, 143. b, 149. d, 155. b, 161. d, 167. b, 173. d, 179. b, 185. a, 191. d, 197. c, 203. d, 209. d, 215. b, 221. c, 227. d, 233. c, 239. b, 245. d, , 6. e, 12. d, 18. d, 24. d, 30. c, 36. b, 42. b, 48. c, 54. d, 60. c, 66. a, 72. b, 78. c, 84. c, 90. a, 96. d, 102. c, 108. e, 114. e, 120. d, 126. d, 132. d, 138. d, 144. a, 150. a, 156. a, 162. d, 168. d, 174. c, 180. d, 186. a, 192. a, 198. b, 204. a, 210. e, 216. b, 222. b, 228. a, 234. b, 240. a, 246. a

Page 207 :
MCQs IN PHARMACOLOGY, , 192, 247. b, 248. b, 253. d, 254. b, 259. b, 260. b, 265. d, 266. a, 271. a, 272. d, 276. a.3, b.4, c.2, d.5, e.1, , 249. c, 255. d, 261. c, 267. a, 273. b, , 250. a, 256. b, 262. a, 268. b, 274. a, , 251. b, 257. a, 263. e, 269. d, 275. a, , 252. a, 258. a, 264. b, 270. d, , EXPLANATIONS FOR THE ANSWERS, 1. d, , 27. a, , 53. b, , 77. d, , 95 e, , 119. e, , 145. c, , 168. d, , 189. c, , Prostate cancer is the most common cancer in, men, breast cancer is the most common cancer, in women, followed by lung, then colon and, rectum for both men and women., Phase-specific agents are most active in one, specific phase of the cell cycle. These agents, have no activity against cell in G0, the resting, phase. Examples of phase-specific agents, include the mitotic inhibitors, asparaginase, the, antimetabolites and etoposides., BSA correlates with cardiac output, which, determines renal and hepatic blood flow and, thus affects drug elimination., Combination chemotherapy has been, developed to have maximum cytotoxicity to, tumor cells and minimal toxicity to normal cells., The drugs are dosed and scheduled such that, maximal cell kill and occurs, while sparing, normal cells as much as possible. Combination, regimens often contain agents with different, spectrums of toxicity., Intrathecally administered vincristine is fatal. All, syringes of vincristine must be labeled “Fatal if, given intrathecally. For intravenous use only.”, Cyclophosphamide and mechlorethamine are, nitrogen mustards, a subgroup of the alkylating, agents. Etoposide is a topoisomerase II inhibitor, and paclitaxel is a mitotic inhibitor., Doxorubicin is an antitumor antibiotic that, inhibits DNA synthesis by intercalation., Vincristine and paclitaxel are mitotic inhibitors, that act on microtubule assembly. Topotecan, inhibits topoisomerase I., Antimetabolites are structural analogues of, naturally occurring substrates for biochemical, reactions. They inhibit DNA synthesis by acting, as false substitutions in the production of DNA., Docetaxel is a taxane, which works by promoting, microtubule assembly and stabilization, resulting, , in inhibition of cell division. Vincristine, vinblastine, and vinorelbine are vinca alkaloids, which work, by preventing microtubule formation., Mitoxantrone is an antitumor antibiotic that works, by DNA intercalation., 210. e Tamoxifen is an antiestrogen used in the, treatment of breast cancer. Prednisone is used, for its antilymphocytic. Properties in the treatment, of non-Hodgkin’s lymphoma. Flutamide is an, antiandrogen used in the treatment of prostate, cancer., 241. c Bone marrow suppression, particularly of the, neutrophils, ususlly is the most profound 10–, 14 days after chemotherapy., 252. a Stomatitis, or mucositis, is an inflammation of, the mucous membranes, particularly the oral, mucosa. Although the symptoms generally are, limited to the mouth and throat, stomatitis may, effect any part of the gastrointestinal tract,, potentially causing diarrhea and anal fissures., 260. b Hemorrhagic cystitis results from irritation of the, lining of the bladder by acrolein, a metabolite, of ifosfamide and cyclophosphamide. Mesna, may be used to inactivate the acrolein, thus, preventing hemorrhagic cystitis., 265. d Vesicant chemotherapy agents may cause local, necrosis if extravasated outside the vein., Doxorubicin, idarubicin, mechlorethamine and, vincristine are all classified as vesicants., 276.a. 3, b. 4, c. 2, d. 5, e.1: Cardiotoxicity is associated, with cumulative doses of doxorubicin and other, antitumor antibiotics. Hypersensitivity from, paclitaxel may be due to its cremophor diluent., Severe diarrhea, requiring treatment with atropine,, is associated with irrinotecan. Pulmonary toxicity, is associated with cumulative doses of bleomycin., Severe constipation and paralytic ileus is, associated with the use of vincristine.

Page 208 :
DRUGS USED IN ENDOCRINE DISORDERS (HORMONES), , 193, , Chapter 12, DRUGS USED IN ENDOCRINE, DISORDERS (HORMONES), 1. Which one of the following compounds, is not a hormone?, (a) Bromocriptine, (c) Somatotropin, (e) Vasopressin, , (b) Somatomedin, (d) Thyroxine, , 2. Which one of the following hormones not, synthesized in the hypothalamus?, (a), (b), (c), (d), (e), , Corticotropin–releasing hormone, Luteinizing hormone, Oxytocin, Thyrotropin–releasing hormone, Vasopressin, , 3. An important difference between leuprolide, and the new drug ganirelix is that ganirelix, (a) Can be administered as an oral formulation, (b) Can be used alone to restore fertility to, hypogonadal men and women, (c) Immediately reduces gonadotropin secretion, (d) Initially stimulates pituitary production of LH, and FSH, (e) Must be administered in a pulsatile fashion, 4. A 27-year-old woman with amenorrhea,, infertility, and galactorrhea was treated, with a drug that successful 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), (b), (c), (d), (e), , Bromocriptine, Desmopressin, Human gonadotropin hormone, Leuprolide, Octreotide, , 5. Who is least likely to be treated with, somatropin?, (a) A 3-year-old cow on a diary farm, (b) A 4-year-old girl with an XO genetic, genotype, (c) A 4-year-old boy with chronic renal failure, and growth deficiency, (d) A 10-year-old boy with polydipsia and, polyuria, (e) A 37-year-old AIDS patient who is 180 cm, tall and weights 52 Kg, 6. Hormones that are useful in the diagnosis, of endocrine insufficiency include, (a), (b), (c), (d), (e), , Corticotropin-releasing hormone, Cosyntropin, Gonadotropin–releasing hormone, Thyrotropin–releasing hormone, All of the above, , 7. All of the following substances are, endogenous topic hormones secreted by, the pituitary gland except, (a) Somatotropin, (b) Human chorionic gonadotropin (HCG)

Page 209 :
MCQs IN PHARMACOLOGY, , 194, (c) Follicle-stimulating hormone (FSH), (d) Thyroid-stimulating hormone (TSH), (e) Adrenocorticotropic hormone (ACTH), 8. Which of the following drugs is least likely, to be used as part of a controlled ovarian, hyperstimulation protocol?, (a), (b), (c), (d), (e), , Human chorionic gonadotropin, Leuprolide, Menotropins, Pergolide, Urofollitropin, , 9. Actions of thyroxine do not include, (a), (b), (c), (d), (e), , Acceleration of cardiac rate, Decreased glomerular filtration rate, Fine tremor of skeletal muscles, Increased appetite, Stimulation of oxygen consumption, , 10. Effects of iodide salts given in large doses, do not include, (a), (b), (c), (d), (e), , Decreased size of the thyroid gland, Decreased vascularity of the thyroid gland, Decreased hormone release, Decreased iodination of tyrosine, Increased 131I uptake, , 11. Synptoms of hypothyroidism (myxedema), do not include, (a), (b), (c), (d), (e), , Dry, puffy skin, Increased appetite, Large tongue and drooping of the eyelids, Lethargy, sleepiness, Slow heart rate, , 12. When initiating thyroxine therapy for an, elderly patient with long-standing, hypothyroidism, it is important to begin, with small doses to avoid, (a), (b), (c), (d), (e), , A flare of exophthalmos, Acute renal failure, Hemolysis, Overstimulation of the heart, Seizures, , 13. A 46-year-old male patient has Cushing’s, syndrome that is due to the presence of, , an adrenal tumor. Which of the following, drugs would be expected to reduce the, signs and symptoms of this man’s, disease?, (a) Betamethasone, (c) Fludrocortisone, (e) Triamcinolone, , (b) Cortisol, (d) Ketoconazole, , 14. In the treatment of congenital adrenal, hyperplasis in which there is excess, production of cortisol precursors due to, β-hydroxylase activity, the, a lack of 21β, purpose of administration of a synthetic, glucocorticoid is, (a), (b), (c), (d), (e), , Inhibition of aldosterone synthesis, Normalization of renal function, Prevention of hypoglycemia, Recovery of normal immune function, Suppression of ACTH secretion, , 15. Glucocorticoids have not been proved to, be effective in the treatment of, (a), (b), (c), (d), (e), , Acute lymphocytic leukemia, Addison’s disease, Asthma, Chemotherapy-inhduced vomiting, Osteoporosis, , 16. For patients who have been on long-term, therapy with a glucocorticoid and who, now wish to 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 control by vasopressin of water excretion, (e) The hypothalamic-pituitary-adrenal system, 17. A 24-year-old woman with type 1 diabetes, wishes to try tight control of her diabetes to, improve her long-term prognosis. Which of, the following regimens is most appropriate?, (a) Morning injections of mixed lente and, ultralente insulins, (b) Evening injections of mixed regular and lente, insulin

Page 210 :
DRUGS USED IN ENDOCRINE DISORDERS (HORMONES), (c) Morning and evening injections of regular, insulin, supplemented by small amounts of, insulin at mealtimes, (d) Morning injections of ultralente insulin,, supplemented by small amounts of insulin, lispro at mealtimes, (e) Morning injection of semilente insulin and, evening injection of lente insulin, 18. Which of the following substances when, present in urine is the most likely positive, sign of pregnancy?, (a), (b), (c), (d), (e), , Thyroid-stimulating hormone (TSH), Corticotropin, Human chronic gonadotropin (HCG), Interstitial cell-stimulating hormone (ICSH), Protamine zinc insulin (PZI), , 19. A 54-year-old obese patient with type 2, diabetes and a history of alcoholism, probably should not receive metformin, because it can increase his risk of, (a), (b), (c), (d), (e), , A disulfiram-like reaction, Excessive weight gain, Hypoglycemia, Lactic acidosis, Serious hepatotoxicity, , 20. Which of the following drugs is taken, during the first part of a meal for the, purpose of delaying the absorption of, dietary carbohydrates?, (a) Acarbose, (c) Glipizide, (e) Repaglinide, , (b) Colestipol, (d) Pioglitazone, , 21. Which of the following drugs is most, likely to cause hypoglycemia when used, as monotherapy in the treatment of type, 2 diabetes?, (a) Acarbose, (c) Metformin, (e) Rosiglitazone, , (b) Glyburide, (d) Miglitol, , 22. In the treatment of hypothyroidism,, thyroxine is preferred over liothyronine, because thyroxine, (a) Can be made more easily by recombinant, DNA technology, , 195, (b) Has a longer half-life, (c) Has higher affinity for thyroid hormone, receptors, (d) Is faster acting, (e) Is more likely to improve a patient’s mood, 23. A young woman seeks advice because she, had unprotected sexual intercourse 12, hours earlier. Based on her menstrual cycle,, she believes that conception is possible., Which of the following drugs should she, use as a postcoital contraceptive?, (a), (b), (c), (d), (e), , Clompihene, Diethylstilbestrol plus raloxifene, Ethinyl estradiol combined with norethindrone, Flutamide, Letrozole plus finasteride, , 24. All of the following hormonal drugs, possess a steroidal nucleus except, (a), (b), (c), (d), (e), , Ethinyl estradiol, Nonethindrone, Liothyronine, Prednisolone, Fluoxymesterone, , 25. Which one of the following statements, about hormone replacement therapy (HRT), regimens in menopause is accurate?, (a) It commonly includes a progestin to reduce, the risk of endometrial cancer, (b) It has been shown in clinical trials to reduce, migraine attacks, (c) It includes steroids that induce cytochrome, P450, (d) It should be avoided in women with a history, of diabetes, (e) It uses the same effective doses of steroids, as those combined oral contraceptives, 26. Hypercoagulability and dermal vascular, necrosis due to protein C deficiency is known, to be an early–appearing adverse effect of, treatment with, (a) Aspirin, (c) Heparin, (e) Warfarin, , (b) Clopidogrel, (d) Streptokinase

Page 213 :
MCQs IN PHARMACOLOGY, , 198, 50. Which of the values represents the lower, level of detection for the fourth generation, sensitive TSH assay as established by the, Thyroid Association?, (a), (b), (c), (d), (e), , 0.5–5 mlU/L, 1–2 mlU/L, 0.01–0.02 mlU/L, 0.0001–0.002 mlU/L, 0.0001–0.0002 mlU/L, , 51. In which of the following clinical, presentations should the sensitive TSH, assay be used?, (a) Population screening for thyroid disease, (b) Screening hospitalized patients, (c) Patients receiving thyroid replacement after, 6 to 8 weeks of therapy, (d) Patients who are human immunodeficiency, virus (HIV) positive, (e) Screening patients with psychiatric illness, 52. Which of the following classes of compounds stimulates the release of insulin, from pancreatic β-cells?, (a), (b), (c), (d), (e), , Progestins, Biguanides, α-Glucosides inhibitors, Thiourylenes, Sulfonylureas, , 53. Which of the following is not an estrogenic, substance?, (a), (b), (c), (d), (e), , Estradiol, Premarin, Theelin, Follicle-stimulating hormone, Stilbesterol, , 54. Propylthiouracil is useful in the treatment, of, (a), (b), (c), (d), (e), , Derangement toxicosis, Hypothyroidism, Hypoparathyroidism, Hyperthyroidism, Thyroidits, , 55. Which of the following is an idiosyncratic, adverse drug reaction ?, , (a), (b), (c), (d), , Muscle dystonia caused by triflupromazine, Insomnia after taking pentobarbitone, Precipitation of asthma by morphine, Gum hyperplasia caused by phenytoin, , 56. An immunologically mediated reaction to, a drug producing stereotyped symptoms, unrelated to its pharmacodynamic actions, is, (a) Hypersensitivity, (c) Intolerance, , (b) Supersensitivity, (d) Idiosyncrasy, , 57. Drugs producing allergic reactions, generally act as, (a), (b), (c), (d), , Complete antigens, Haptenes, Antibodies, Mediators, , 58. Which of the following allergic drug reaction, is caused by circulating antibodies ?, (a), (b), (c), (d), , Serum sickness, Anaphylactic shock, Systemic lupus erythematosus, Angioedema, , 59. The essential feature in drug addiction is, (a), (b), (c), (d), , Physical dependence, Psychological dependence, Both (a) and (b), Psychiatric abnormality, , 60. Adaptive neurophysiological changes, produced by repeated administration of, a drug, which result in the appearance, of characteristic withdrawal syndrome on, discontinuation of the drug is called, (a), (b), (c), (d), , Drug addiction, Drug abuse, Psychological dependence, Physical dependence, , 61. What constitutes ‘drug abuse’?, (a) Physician prescribed use of penicillin G for, the cure of viral fever, (b) Self administration of aspirin to relieve headache, (c) Repeated self administration of morphine to, derive euphoria, (d) All of the above

Page 214 :
DRUGS USED IN ENDOCRINE DISORDERS (HORMONES), 62. Under physiological conditions the rate, limiting enzyme in the generation of, angiotensin II is, (a), (b), (c), (d), , Renin, Angiotensin converting enzyme, Aminopeptidase, Angiotensinase, , 63. Angiotensin II causes rise in blood pressure, by, (a), (b), (c), (d), , Direct vasoconstriction, Releasing adrenaline from adrenal medulla, Increasing central sympathetic tone, All of the above, , 64. Which of the following is a pressor peptide, that can be generated both in circulation, as well as locally in certain tissues ?, (a) Bradykinin, (c) Kallidin, , (b) Angiotensin, (d) Plasmin, , 65. Angiotensin II palys a key role in the, following risk factor for ischaemic heart, disease, (a), (b), (c), (d), , Hypercholesterolemia, Ventricular hypertrophy, Carbohydrate intolerance, Cardiac arrhythmia, , 66. Several actions of growth hormone are, exerted through the elaboration of, (a), (b), (c), (d), , Cyclic AMP, Cyclic GMP, Somatostatin, Insulin like growth factor – 1, , 67. Somatostatin inhibits the release of, (a) Growth hormone (b) Insulin, (c) Thyrotropin, (d) All of the above, 68. For therapeutic use, growth hormone is, obtained from, (a), (b), (c), (d), , Recombinant DNA technique, Human cadaver pituitaries, Porcine pituitaries, Chemical synthesis, , 69. Which of the following compounds is, incorrectly matched with its mechanism, of action?, , 199, (a) Flutamide: Competitively blocks the binding, of androgens to their receptor, (b) Finasteride: Inhibits 5α-reductase, (c) Miglitol: Inhibits α-glucosidase, (d) Pioglitazone: Competitively blocks the, binding of estrogens to their receptor, (e) Anastrazole: Inhibits aromatase, 70. The most prominent action of bromocriptine, is, (a), (b), (c), (d), , Dopamine D2 agonism, Dopamine D2 antagonism, Dopamine D1 antagonism, α adrenergic antagonism, , 71. Gynaecomastia can be treated with, (a), (b), (c), (d), , Chlorpromazine, Cimetidine, Bromocriptine, Metoclopramide, , 72. Menotropins is a preparation of, (a) FSH + LH obtained from urine of menstruating, women, (b) LH obtained from urine of pregnant women, (c) FSH + LH obtained from urine of menopausal, women, (d) LH obtained from serum of pregnant mare, 73. Serum TSH levels are high in most cases, of, (a), (b), (c), (d), , Myxoedema, Grave’s disease, Carcinoma thyroid, Toxic nodular goiter, , 74. Adrenocorticotropic hormone is primarily, used for, (a), (b), (c), (d), , Treatment of Addison’s disease, Treatment of congenital adrenal hyperplasia, Treatment of autoimmune disease, Diagnosis of pituitary-adrenal axis disorders, , 75. Which of the following compounds is, incorrectly matched with one of its, therapeutic uses?, (a) Raloxifene: Advanced breast cancer, (b) Metformin: Non-insulin dependent diabetes, mellitus (NIDDM)

Page 215 :
MCQs IN PHARMACOLOGY, , 200, (c) Finasteride : Benign prostatic hyperplasia, (d) Propylthiouracil: Hyperthyroidism, (e) Tamoxifen : Estrogen-dependent breast, cancer, , I – resume carbimazole after 1 week for 2 –, 3 months, (d) Propranolol + Lugol’s iodine for 2 weeks –, 131, I – continue Lugol’s iodine for 2 – 3 months, , 76. Metabolic rate of the following organ is, not significantly affected by thyroxine, , 82. The thyroid inhibitor which produces the, fastest response is, , (a) Brain, (c) Liver, , (b) Heart, (d) Skeletal muscle, , 77. Actions of thyroxine include the following, except, (a), (b), (c), (d), , Rise in blood sugar level, Reduction in plasma cholesterol level, Fall in plasma free fatty acid level, Induction of negative nitrogen balance, , 78. Triiodothyronine is preferred over, thyroxine in the treatment of, (a), (b), (c), (d), , Endemic goiter, Cretinism, Papillary carcinoma of thyroid, Myxoedema coma, , 79. Carbimazole acts by inhibiting, (a), (b), (c), (d), , Iodide trapping, Oxidation of iodide, Proteolysis of thyroglobulin, Synthesis of thyroglobulin protein, , 80. Antithyroid drugs exert the following, action., (a) Block the action of thyroxine on peripheral, tissues, (b) Block the action of thyroxine on pituitary, (c) Block the action of TSH on thyroid, (d) Inhibit thyroxine synthesis, 81. A 60-year-old male presents with severe, hyperthyroidism and multinodular goiter., It was decided to treat him with 131I. The, most appropriate course of treatment, would be, (a) Immediate 131 I dosing with no other drug, before or after, (b) Propranolol for 1 week followed by 131 I, (c) Propranolol + carbimazole till severe, thyrotoxicosis controlled – 1 week gap – 131, , (a), (b), (c), (d), , Radioactive iodine, Lugol’s iodine, Propylthiouracil, Lithium carbonate, , 83. In the treatment of hyperthyroidism,, carbimazole has the following advantage, over radioactive iodine., (a), (b), (c), (d), , cost of treatment is lower, It is preferable in uncooperative patient, It is better tolerated by the patients, Hypothyrodism when in luced is reversible, , 84. Glucose entry into the cells of the following, organ/ tissue is highly dependent on the, presence of insulin., (a) Brain, (c) Adipose tissue, , (b) Liver, (d) Kidney tubules, , 85. Prolonged testosterone therapy can cause, (a), (b), (c), (d), , Hypertrophy of seminiferous tubules of testes, Hypertrophy of interstitial cells of testes, Atrophy of interstitial cells of testes, Both (a) and (b), , 86. Testosterone therapy started in a boy of, 8 years and continued till puberty is likely, to, (a), (b), (c), (d), , Increase adult stature, Reduce adult stature, Have no effect on adult stature, Cause hypertrophy of penis, , 87. Which of the following is true of anabolic, steroids ?, (a) They are testosterone congeners having, anabolic but no androgenic activity, (b) They are androgens with relatively selective, anabolic activity, (c) They are suitable for long-term therapy in, children, (d) Both (b) and (c)

Page 216 :
DRUGS USED IN ENDOCRINE DISORDERS (HORMONES), 88. Which of the following drugs has potent, antiandrogenic and weak progestational, activity ?, (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 89. Which of the following is a non-steroidal, antiandrogen that has been found to be, palliative in advanced carcinoma prostate ?, (a), (b), (c), (d), , Cyproterone acetate, Danazol, Finasteride, Flutamide, , 90. Hormones that form lipophilic esters, without prior structural modifications, include, I. Hydrocortisone, II. Testosterone, III. Progesterone, (a) I only is correct, (b) III only is correct, (c) I and II are correct, (d) II and III are correct, (e) I, II and III are correct, 91. Finasteride acts by, (a) Blocking testosterone receptors in the prostate, gland, (b) Reducing testosterone secretion from testes, (c) Reducing LH secretion from pituitary, (d) Reducing circulating as well as prostatic, dihydrotestosterone concentration, 92. Transdermal estradiol differs from oral, estrogen therapy in that it, (a) FSH + LH obtained from urine of menstruating, women, (b) LH obtained from urine of pregnant women, (c) FSH + LH obtained from urine of menopausal, women, (d) LH obtained from serum of pregnant mare, 93. In which of the following conditions, estrogen is not the primary drug but is, added to progestin as adjuvant ?, (a) Dysfunctional uterine bleeding, (b) Menopausal syndrome, , 201, (c) Osteoporosis, (d) Atrophic vaginitis, 94. Addition of a progestin for 10-12 days, each month to estrogen replacement, therapy in menopausal women is, recommended because the progestin, (a) Blocks the increased risk of myocardial, infarction due to estrogen, (b) Blocks the increased risk of endometrial, carcinoma due to estrogen, (c) Reverses vulval atrophy occurring in, postmenopausal women, (d) Enhances the metabolic benefits of estrogen, treatment, 95. The preferred estrogen for hormone replacement therapy in menopausal women is, (a), (b), (c), (d), , Ethinylestradiol, Estradiol benzoate, Diethylstilbestrol, Conjugated estrogens, , 96. Select the compound which used for, hormone replacement therapy in, postmenopausal women serves the, purpose of both estrogen and progestin, with weak androgenic activity., (a) Digoxin, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 97. Estrogen replacement therapy fro postmenopausal women is contraindicated in, subjects with, (a), (b), (c), (d), , Leg vein thrombosis, Undiagnosed vaginal bleeding, Migraine, All of the above, , 98. Clomiphene citrate is indicated for the, following condition/conditions, (a), (b), (c), (d), , Female infertility due to anovular cycles, Male infertility due to oligozoospermia, Endometriosis, Both (a) and (b), , 99. Which of the following is an orally active, ovulation inducing agent ?, (a) Menotropin, (c) Danazol, , (b) Mifepristone, (d) Clomiphene citrate

Page 217 :
MCQs IN PHARMACOLOGY, , 202, 100. Insulin preparations that contain a modifying protein include, I. Lente insulin, II. Regular insulin, III. Isophane insulin (NPH), (a) I only is correct, (b) III only is correct, (c) I and II are correct, (d) II and III are correct, (e) I, II and III are correct, 101. Progesterone administration, (a), (b), (c), (d), , Suppresses onset of menstruation, Induces watery cervical secretion, Sensitizes the uterus to oxygocin, Cornifies vaginal epithelium, , 102. Select the indication for which a progestin, is used alone without combining with an, estrogen., (a), (b), (c), (d), , Threatened abortion, Dysfunctional uterine bleeding, Hormone replacement therapy, Premenstrual tension, , 103. Mifepristone possesses the following, activities, (a), (b), (c), (d), , Potent antiprogestin + weak androgenic, Potent antiprogestin + weak antiglucocorticoid, Potent antiestrogenic + weak antiprogestin, Potent antiestrogenic + weak glucocorticoid, , 104. Which of the following drugs is an antiprogestin, (a) Gemeprost, (c) Mifepristone, , (b) Megestrol, (d) Tamoxifen, , 105. The most important indication of mifepristone is, (a), (b), (c), (d), , Endometriosis, Cushings syndrome, First term abortion, Second term abortion, , 106. Which of the following can act as a single, dose postcoital contraceptive ?, (a) Clomiphene citrate, (b) Mifepristone, , (c) Danazol, (d) Medroxyprogesterone acetate, 107. Which hormone is secreted by pancreatic, β cells to facilitate glucose and amino acid, transport for normal cellular metabolic, processes ?, (a) Testosterone, (c) Corticotropin, (e) Vasopressin, , (b) Insulin, (d) Estradiol, , 108. The purpose/purposes served by the, progestin component of the combined, estrogen + progestin contraceptive pill is/, are, (a) Suppression of ovulation, (b) Prompt bleeding at the end of the course, (c) Blockade of increased risk of endometrial, carcinoma, (d) All of the above, 109. In which of the following forms of oral, contraception, pills are taken continuously, without interruption ?, (a) Combined pill, (c) Minipill, , (b) Sequential pill, (d) Phased pill, , 110. A progestin and an estrogen are combined, in oral contraceptive pill because, (a) The estrogen blocks the side effects of the, progestin, (b) The progestin blocks the side effects of the, estrogen, (c) Both synergise to suppress ovulation, (d) Both synergise to produce hostile cervical, mucus, 111. The most common and important undersirable effect of injectable contraceptive, depot medroxyprogesterone acetate is, (a), (b), (c), (d), , Nausea and vomiting, Disruption of cyclic menstraual bleeding, Venous thrombosis, Hypertension, , 112. The primary mechanism of action of the, combined estrogen-progestin oral contraceptive pill is

Page 218 :
DRUGS USED IN ENDOCRINE DISORDERS (HORMONES), (a) Production of cervical mucus hostile to sperm, penetration, (b) Suppression of FSH and LH release, (c) Making endometrium unsuitable for, implantation, (d) Enhancing uterine contractions to dislodge, the fertilized ovum, 113. Which of the following is advised when, a woman on combined oral contraceptive, pill misses a dose, (a) Continue with the course without regard to, the missed dose, (b) Take 2 pills the next day and continue with, the course, (c) Take 2 pills every day for the remaining part, of the course, (d) Discontinue the course and use alternative, method of contraception, 114. Which side effect effect of the oral, contraceptive subsides after 3-4 cycles of, continued use, (a), (b), (c), (d), , Glucose intolerance, Rise in blood pressure, Headache, Fluid retention, , 115. Concurrent use of the following drug is, likely to cause failure of oral contraception, (a) Isoniazid, (c) Cimetidine, , (b) Rifampicin, (d) Propranolol, , 116. On stoppage of the combined estrogenprogestin contraceptive pill, fertility, returns after, (a) 1–2 months, (c) 6–12 months, , (b) 4–6 months, (d) Uncertain period, , 117. Which hormone promotes the resorption, of water at the renal distal convoluted, tubule, (a) Testosterone, (c) Corticotropin, (e) Vasopressin, , (b) Insulin, (d) Estradiol, , 118. Which of the following has been found, to act as a male contraceptive without, affecting libido or potency, , 203, (a), (b), (c), (d), , Cyproterone acetate, Goserelin, Centchroman, Gossypol, , 119. Which of the following tissues is most sensitive to oxytocin., (a), (b), (c), (d), , Myometrium, Myoepithelium of mammary alvioli, Vascular smooth muscle, Renal collecting ducts, , 120. Which class of drug closely relates to :, “Peptic ulceration and gastrointestinal, hemorrhage; hyperglycemia, hypertension, and edema; “buffalo hump” and, “moon face”; psychological disturbances; and increased susceptibility to infection ?, (a), (b), (c), (d), (e), , Antithyroid agents, Sulfonylurea oral hypoglyccemics, Adrenocorticosteroids, Progestins, Androgens, , 121. Oxytocin is preferred over ergometrine, for augmenting labour because, (a), (b), (c), (d), , It has brief and titratable action, It is less likely to cause foetal anoxia, It is less likely to impede foetal descent, All of the above, , 122. The drug of choice for controlling postpartum haemorrhage is, (a), (b), (c), (d), , Oxytocin, Methylergometrine, Dihydroergotamine, Prostaglandin E2, , 123. Ergometrine stops post partum haemorrhage by, (a), (b), (c), (d), , Causing vasoconstriction of uterine arteries, Increasing tone of uterine muscle, Promoting coagulation, Inducing platelet aggregation, , 124. Bone resorption is accelerated by, (a) Estrogens, (b) Parathormone, (c) Bisphosphonates (d) Calcitonin

Page 219 :
MCQs IN PHARMACOLOGY, , 204, 125. The primary action of parathormone is, (a) To increase intestinal calcium absorption, (b) To increase calcium reabsorption in kidney, tubules, (c) To promote calcium deposition in extraosseus, tissues, (d) To increase resorption of calcium from bone, 126. The drug of choice for hypoparathyroidism is, (a) Parathormone, (c) Vitamin D, , (b) Calcium lactate, (d) Pamidronate, , 127. The most suitable Vitamin D preparation, for vitamin D dependent rickets is, (a) Calciferol, (c) Calcifediol, , (b) Cholecalciferol, (d) Calcitriol, , 128. The vitamin that is regarded to be a hormone is, (a) Vitamin D, (c) Vitamin B12, , (b) Vitamin C, (d) Vitamin A, , 129. Which of the following drugs can cause, rickets in children by interfering with, Vitamin D action ?, (a) Tetracycline, (c) Phenytoin, , (b) Phenylbutazone, (d) Ciprofloxacin, , 130. Estrogens, (a), (b), (c), (d), , Block bone resorption, Maintain negative calcium balance, Decrease HDL levels, Increase bile acid secretion, , 131. Which class of drug closely relates to:, “Agranulocytosis and other blood, dyscrasias, cholestatic jaundice, nausea, and vomiting, hypoglycemia and photosensitivity” ?, (a), (b), (c), (d), (e), , Antithyroid agents, Sulfonylurea oral hypoglyccemics, Adrenocorticosteroids, Progestins, Androgens, , 132. The principle source of circulating, estrogen in menstructing women is, (a) Granulosa cells, , (b) Breast cells, (c) Placenta, (d) Gonadotropes, 133. Progesterone, (a) Increases muscular contractility of fallopian, tubes, (b) Decreases the frequency of LH pulses, (c) Increases the myometrial contractions, (d) Increases the thickness of the endometrium, 134. Feminization is not a side effect of, (a), (b), (c), (d), , Mesterolone, Testosterone cypionate, Testosterone, Testosterone propionate, , 135. Anabolic steroids are contraindicated in, (a), (b), (c), (d), , Prostatic carcinoma, Carcinoma of the breast in females, Promoting growth in hypogonadal children, Refractory anaemias associated with, hypoplastic bone marrow, , 136. Potassium iodide, (a) Increases bronchial secretions, (b) On prolonged use may result in hyperthyroidism, (c) Is useful in inflammation of the bronchi, (d) Is contraindicated in thyroid storm, 137. Which of the following is physiological, role of vasopressin ?, (a), (b), (c), (d), , Smooth muscle vasoconstriction, Neurotransmission/neuromodulation, Increased factor VIII concentration, All of the above, , 138. Angiotensin increases peripheral resistance, by, (a) Direct vasoconstriction, (b) Catecholamine release from adrenal medulla, (c) Noradrenaline release from sympathetic, nerve terminals, (d) All of the above, 139. The drug of choice for hypoparathyroidism is

Page 220 :
DRUGS USED IN ENDOCRINE DISORDERS (HORMONES), (a) Parathormone, (c) Calcium, , 205, , (b) Pamidronate, (d) Vitamin D, , (a), (b), (c), (d), (e), , 140. Which class of drug closely relates to:, “Hepatotoxicity and jaundice, urinary, retention and azoospermia, prostatic, hypertrophy and priapism and paradoxical gynecomastia.”, , Antithyroid agents, Sulfonylurea oral hypoglyccemics, Adrenocorticosteroids, Progestins, Androgens, , ANSWERS, 1. a, 7. b, 13. d, 19. d, 25. a, 31. d, 37. a, 43. c, 49. b, 55. b, 61. c, 67. d, 73. a, 79. b, 85. c, 91. d, 97. d, 103. b, 109. c, 115. b, 121. d, 127. d, 133. b, 139. d, , 2. b, 8. d, 14. e, 20. a, 26. e, 32. a, 38. b, 44. a, 50. d, 56. a, 62. a, 68. a, 74. d, 80. d, 86. b, 92. a, 98. d, 104. c, 110. c, 116. a, 122. b, 128. a, 134. a, 140. e, , 3. c, 9. b, 15. e, 21. b, 27. d, 33. e, 39. d, 45. b, 51. c, 57. b, 63. d, 69. d, 75. a, 81. c, 87. b, 93. a, 99. d, 105. c, 111. b, 117. a, 123. b, 129. c, 135. a, , 4. a, 10. e, 16. e, 22. b, 28. b, 34. c, 40. e, 46. d, 52. e, 58. a, 64. b, 70. a, 76. a, 82. b, 88. c, 94. b, 100. b, 106. b, 112. b, 118. d, 124. b, 130. a, 136. a, , 5. d, 11. b, 17. d, 23. c, 29. c, 35. a, 41. e, 47. e, 53. d, 59. b, 65. b, 71. c, 77. c, 83. d, 89.d, 95. d, 101. a, 107. b, 113. b, 119. b, 125. d, 131. b, 137. d, , 6. e, 12. d, 18. c, 24. c, 30. d, 36. a, 42. a, 48. c, 54. d, 60. d, 66. d, 72. c, 78. d, 84. c, 90. c, 96. a, 102. a, 108. d, 114. c, 120. c, 126. c, 132. a, 138. d, , EXPLANATIONS FOR THE ANSWERS, 7. b, , Human chorinic gonadotropin (hCG) is, produced by placental tissue and serves to, stimulate the secretion of progesterone during, pregnancy. Growth hormone (somatotropin),, follicle-stimulating hormone (FSH), thyroidstimulating hormone (TSH) and corticotropin, (ACTH) are all secreted by the anteriour pituitary, gland., , 18. c, , 24. c, , Human chorinic gonadotropin (hCG) is a, proteinaceous tropic hormone that is secreted, by chorinic (e. g., placental) tissue. Thus, hCG, is present in the urine only after conception, has occurred., Liothyronine is a thyroid hormone. Thyroid, hormones consist of iodinated aromatic amino, acids and are not steroidal in nature. Ethinyl

Page 221 :
MCQs IN PHARMACOLOGY, , 206, , 30. d, , 37. a, , 49. b, , 52. e, , 69. d, , estradiol is a steroidal estrogen, norethindrone, is a steroidal 19-norprogestin, prednisolone is, an adrenocorticosteroid and fluoxymesterone, is a steroidal adrogen., Glucocorticoids have varying degrees of, mineralocorticoid activity. This mineralocorticoid, activity, which can result in sodium and fluid, retention, can be blocked by the introduction of a, methyl or hydroxyl group in position 16 of the, steroidal nucleus. Dexamethasone has a 16 β-methyl, substituent., Most insulin preparation are suspensions; thus,, they contain particulate matter. Only clear, solutions may be administered intravenously., Regular insulin, which consists of water-soluble, crystalline zinc insulin is therefore suitable for, intravenous administration. Insulin preparations, are normally injected subcutaneously., The thyroid gland produces both levothyroxine (T4), and liothyronine (T3). The natural ratio of these, compounds is 4 to 1 in favor of levothyroxine;, therefore, liothyronine is normally present at a lower, concentration thatn levothyroxine. Liothyronine is, more potent than levothyroxine, but has a shorter, duration of action. Peripheral conversion involves, deiodination, thus levothyroxine is converted to, liothyronine. The reverse process is not possible., Of the five classes of compounds listed, only, biguanides, α-glucosidase inhibitors, and, sulfonylureas are used in the treatment of non-insulindependent mellitus (NIDDM). These classes provide, their beneficial effects through different mechanism, of action. Biguanides enhance the peripheral use, of insulin, suppress gluconeogenesis, and are often, referred to as antiheperglycemic agents. αGlucosidase inhibitors decrease the absorption of, glucose . sulfonylureas and the structurally unrelated, compounds, repaglinide and nateglinide, stimulate, the secretion of insulin from pancreatic β-cells., Pioglitazone does not interact with estrogen, receptors. It is an oral hypoglycemic agent that, produces its effects by binding to nuclear, peroxisome proliferator-activated receptors (PPARs), involved in transcription of insulin–responsive, genes and in regulation of adipocyte differentiation, and lipid metabolism. The other four agents are, correctly matched to their mechanisms., , 75. a, , Raloxifene is a selective estrogen receptor, modulator (SERM) and is not used to treat breast, cancer. Instead, because of its ability to reduce, bone resorption and decrease bone turnover, it, is used for the prevention of osteoporosis. All of, the other four compounds are correctly matched, to their therapeutic use. Finasteride is also used, to treat androgenic alopecia., 90. c Hydrocortisone has a 21-hydroxyl group, and, testosterone has a 17-hydroxyl group; therefore,, both of these agents can form esters (e.g.,, hydrocor ticosone acetate, testosterone, propionate). Progesterone does not have any, alcohol groups in its molecule; therefore, it, cannot directly form any esters., 100. b Regular insulin, which is a rapid-acting insulin, preparation, contains only zinc insulin crystals., All lente insulins are free of modifying proteins,, which contributes to their hypoallergenic, properties. Isophane insulin is NPH insulin,, which contains protamina, a strongly basic, protein. The protamine reduces the water, solubility of zinc insulin and lengthens its, duration of action. Isophane insulin is classified, as an intermediate-acting insulin preparation,, having a duration of action of about 24 hours., Common explanation for 107. b, 117. a:, Insulin is required for the proper utilization of, glucose and the transport of glucose and amino, acids across cell membranes. Testosterone,, which is produced principally from the Leydig, cells of the testes, is responsible for male sexual, characteristics. Vasopressin is secreted from the, posterior pituitary and is sometimes referred to, as an antidiuratic hormone., Common explanation for 120. c, 131. b and 118. e:, Exogenously administered adrenocorticosteroids, are effective anti-inflammatory agents but give rise, to a wide range of metabolic and, immunosuppressive effects that result in severe, adverse effects. Oral antidiabetic agents of the, sulfonylurea type can cause blood dyscrasias,, impaired liver function, and photosensitivity., Exogenously administered adrogens suppress, sperm formation and cause paradoxical, gynecomastia. Most significant is the hepatotoxicity, produced by alkyl-substituted adrogen compounds.

Page 222 :
ANTIDIABETICS, , 207, , CHAPTER 13, ANTIDIABETICS, , 1. Current criteria used in the diagnosis of, diabetes mellitus (DM) include all of the, following symptoms except, (a), (b), (c), (d), (e), , Fasting hyperglycemia, Polyuria, Polydipsia, Tinnitus, Weight loss, , 2. The most useful glucose test used in monitoring diabetes mellitus (DM) therapy is, (a), (b), (c), (d), (e), , Urine monitoring, Blood monitoring, Renal function monitoring, Cardiovascular monitoring, Vascular monitoring, , 3. Which of the following statements, concerning insulin replacement therapy, is most accurate?, (a) Most commercial insulin products vary little, with respect to time, course, and duration of, hypoglycemic activity, (b) Regular insulins cannot be mixed with NPH, (isophane insulin suspension), (c) Regular insulin cannot be given intravenously, (d) Counting or regulating carbohydrate consumption is a necessity for all diabetic patients, (e) Insulin therapy does not have to be monitored, closely, 4. A mass of adipose tissue that develops, at the injection site is usually due to the, , patients neglect in rotating the insulin, injection site. This is known as, (a), (b), (c), (d), (e), , Lipoatrophy, Hypertrophic degenerative adiposity, Lipohypertrophy, Atrophic skin lesion, Dermatitis, , 5. Sulfonylureas are a primary mode of, therapy in the treatment of, (a) Insulin–dependent (type 1) diabetes mellitus, (DDM) patients, (b) Diabetic patients experiencing severe hepatic, or renal dysfunction, (c) Diabetic pregnant women, (d) Patient with diabetic ketoacidosis, (e) Non-insulin-dependent (type 2) DM patients, 6. Patients taking chlorpropamide should, avoid products containing, (a) Acetaminophen, (c) Vitamin A, (e) Milk products, , (b) Ethanol, (d) Penicillins, , 7. The standard recommended dose of glyburide is, (a), (b), (c), (d), (e), , 0.5–2 mg/day, 1.25–20mg/day, 50–100 mg/day, 200 mg/day, 200–1000 mg/day

Page 223 :
MCQs IN PHARMACOLOGY, , 208, 8. Which of the following may increase the, insulin need of diabetics?, (a), (b), (c), (d), (e), , Isoniazid, Penicillin, Glyceryl guaiacolate, Aspirin, Prednisone, , 9. Excessive use of tolbutamide will lead to, (a), (b), (c), (d), (e), , Diarrhea, Prolonged hypoglycemia, Tolerance to alcohol, Acidosis, Glycosuria, , 10. The insulin receptor is a, (a), (b), (c), (d), , Ion channel regulating receptor, Tyrosine protein kinase receptor, G-protein coupled receptor, None of these, , 11. The duration of action of insulin–zinc, suspension (lente insulin) is, (a) 2–4 hours, (c) 20–24 hours, , (b) 8–10 hours, (d) 30–36 hours, , 12. The most common adverse reaction to, insulin is, (a) Hypoglycaemia, (c) Urticaria, , (b) Lipodystrophy, (d) Angioedema, , 13. Which of the following is a neuroglucopenic, symptom of hypoglycaemia ?, (a) Sweating, (c) Tremor, , (b) Palpitation, (d) Abnormal behavior, , 14. There is no alternative to insulin therapy, for, (a) All insulin dependent diabetes mellitus, (IDDM) patients, (b) All noninsulin dependent diabetes mellitus, (NIDDM) patients, (c) NIDDM patients not controlled by a, sulfonylurea drug, (d) NIDDM patients not controlled by a, biguanide drug, 15. In a patient of diabetes mellitus maintained, on insulin therapy, administration of the, following drug can vitiate glycaemia, control., (a) Prednisolone, (c) Paracetamol, , (b) Prazosin, (d) Phenytoin, , 16. The insulin preparation of choice in, diabetic ketoacidosis is, (a), (b), (c), (d), , Regular insulin, Lente insulin, Isophane insulin, Monocomponent insulin, , 17. Insulin resistance can be overcome by the, use of, (a), (b), (c), (d), , Corticosteroids, Tolbutamide, Protamine, Monocomponent insulin preparations, , 18. Human insulins are obtained by the, following sources/methods except, (a), (b), (c), (d), , Cadaver pancreas, Proinsulin recombinant bacterial, Precursor yeast recombinant, Enzyme modification of prok insulin, , 19. Compared to pork/beef insulins, the, human insulins, (a) Are more potent, (b) Have a faster kinetics of absorption and, elimation, (c) Have longer biological action half-life, (d) Penetrated blood-brain barrier more, efficiently, 20. The second generation sulfonylurea, hypoglycaemics differ from the first, generation one in that they, (a) Are more potent, (b) Are longer acting, (c) Do not lower blood sugar in nondiabetics, subject, (d) Are less prone to cause hypoglycaemic, reaction, 21. Metformin is preferred over phenformin, because, (a) It is more potent, (b) It is less liable to cause lactic acidosis, (c) It does not interfere with vitamin B 12, absorption, (d) It is not contraindicated in patients with, kidney disease, 22. Sulfonylureas do not lower blood sugar, level in, (a) Nondiabetics, (b) Noninsulin dependent diabetics

Page 224 :
ANTIDIABETICS, (c) Insulin dependent diabetics, (d) None of these, 23. Sulfonylurea hypoglycaemics act by, (a) Reducing intestinal absorption of glucose, (b) Increasing insulin secretion from pancreas, (c) Reversing down-regulation of insulin, receptors, (d) Both (b) and (c), 24. The hypoglycaemic action of sulfonylureas, is likely to be attenuated by the concurrent, use of, (a), (b), (c), (d), , Hydrochlorothiazid, Propranolol, Chloramphenicol, Aspirin, , 25. Sulfonylureas are more commonly used, than biguanides as oral hypoglycaemics, because, (a) Biguanides are less efficacious, (b) Sulfonylureas lower blood sugar in both, IDDM and NIDDM patients, (c) Sulfonylureas also aid weight reduction in, obese diabetics, (d) Biguanides are prone to precipitate, ketoacidosis, 26. The present status of oral hypoglycaemics, in diabetes mellitus is, , 209, (d) It raises circulating insulin levels, 29. Guargum limits post-prandial glycaemia, by, (a) Inhibiting intestinal brush border αglucosidases, (b) Slowing carbohydrate absorption from, intestine, (c) Releasing incretins from the intestine, (d) Promoting uptake of glucose into skeletal, muscles, 30. Select the drug which tends to reverse, insulin resistance by increasing cellular, glucose transporters., (a) Glibenclamide, (c) Acarbose, , (b) Troglitazone, (d) Prednisolone, , 31. Glucagon release from pancreas is, stimulated by, (a), (b), (c), (d), , High blood glucose level, Insulin, Somatostatin, Adrenaline, , 32. Aldosterone enhances Na+ reabsorption, in renal tubules by, (a), (b), (c), (d), , Stimulating carbonic anhydrase, Inhibitng Na+ K+ ATP ase, Inducing the synthesis of Na+ K+ ATP ase, Promoting K+ secretion, , (a) They are the first choice drugs in all cases, (b) They should be prescribed only if the patient, refuses insulin injections, (c) They are used only in type I diabetes mellitus, (d) They are used first in most uncomplicated, mild to moderate type II diabetics, , 33. Nephrogenic diabetes insipidus is seen, with, , 27. Which of the following features disfavors, use of oral hypoglycaemics in diabetes, mellitus ?, , 34. The antidiabetic agent most likely to, cause lactic acidosis is, , (a) Age at onset of disease over 40 years, (b) Insulin requirement more than 40 U/day, (c) Fasting blood sugar level between 100–200, mg/dl, (d) Associated obesity, , 35. The treatment of gestational diabetes, would comprise of, , 28. Which of the following is ture of acarbose ?, (a) It reduces absorption of glucose from, intestines, (b) It produces hypoglycaemia in normal as well, as diabetic subjects, (c) It limits postprandial hyperglycaemia in, diabetis, , (a) Demeclocycline, (c) Minocycline, , (b) Doxycycline, (d) Oxytetracycline, , (a) Chlorpropamide (b) Phenformin, (c) Glipizide, (d) Metformin, , (a) Glibenclamide, (c) Glipizide, , (b) Chlorpropamide, (d) Insulin, , 36. Diabetic ketoacidosis is best managed by, (a), (b), (c), (d), , Crystalline insulin given intravenously, Human insulin given intramusculary, Lente insulin given subcutaneously, Isophane insulin given intradermally

Page 225 :
MCQs IN PHARMACOLOGY, , 210, 37. The sulfonylurea with a relatively longer, duration of action is, (a) Chlorpropamide (b) Tolbutamide, (c) Glibenclamide, (d) Glipizide, 38. Insulin, (a) Release is enhance by somatostatin, (b) Has an identical chemical structure in all the, species, (c) Release from the pancreas occurs only in the, postprandial state, (d) Promotes synthesis of triglycerides, (a) Does not cause hypoglycemia even in large, doses, (b) Should not be combined with glipizide, (c) Is contraindicated in obese NIDDM patients, (d) Causes release of insulin from the pancreas, 40. The agent with neglible mineralocorticold, effect is, (a) Prednisone, (c) Fludrocortisone, , (b) Betamethasone, (d) Cortisol, , 41. Preferred route of insulin is, (b) Subcutaneous, (d) Enteric coated tabs, , 42. Incorporation of vasoconstrictor substance, in a solution of a drug to be injected, subcutaneously retards absorption. This, principal is utilized in combination of, (a), (b), (c), (d), , (a) Chloramphenicol itself has mild hypoglycaemic, effect, (b) Chloramphenicol increases the absorption, of chlorpropamide, (c) Chloramphenicol causes release of insulin, (d) Chloramphenicol inhibits the metabolism of, chlorpropamide, 44. For increasing the excretion of weakly, acidic drugs, urine should be made, , 39. Metformin, , (a) Oral, (c) Sublingual, , 43. A diabetic on oral hypoglycaemic drug, chlorpropamide, suffered from enteric, fever and was prescribed chloramphenicol., He developed severe hypoglycaemia. This, is because, , Epinephrine with local anaesthetics, Epinephrine with I.V. glucose, With vaccines, With insulin, , (a), (b), (c), (d), , Alkaline, At neutral pH, Acidic, pH does not effect the urinary excretion of, acidic drugs, , 45. Longest acting insulin is, (a), (b), (c), (d), , Insulin zinc suspension, Isophane insulin, Globin zinc insulin, protamine zinc insulin, , 46. Diuretic effective in diabetes insipidus is, (a), (b), (c), (d), , Thiazides, Loop diuretic, Mercurial diuretic, Carbonic anhydrase inhibitor, , 47. The insulin receptor is, (a), (b), (c), (d), , Tyrosine protein kinase receptor, G protein coupled receptor, Ion channel regulating receptor, None of these, , 4. c, 10. b, 16. a, 22. c, 28. c, 34. b, 40. b, 46. a, , 5. e, 11. c, 17. d, 23. d, 29. b, 35. d, 41. b, 47. a, , ANSWERS, 1. d, 7. b, 13. d, 19. b, 25. a, 31. d, 37. a, 43. d, , 2. b, 8. e, 14. a, 20. a, 26. d, 32. c, 38. d, 44. a, , 3. d, 9. b, 15. a, 21. b, 27. b, 33. a, 39. a, 45. d, , 6. b, 12. a, 18. a, 24. a, 30. b, 36. a, 42. a

Page 226 :
ANTICOAGULANTS, , 211, , CHAPTER 14, ANTICOAGULANTS, , 1. Which preparation of Vitamin K should, not be injected in the new born ?, (a), (b), (c), (d), , Phytonadione, Menadione, Menadione sod.diphosphate, Both (b) and (c), , 2. Unfractionated heparin binds to antithrombin III and inactivates clotting, factor(s)., (a) Xa, (c) Iia, (e) None of these, , (b) Ixa, (d) All of the above, , 3. Low concentrations of heparin selectively, interfere with the following coagulation, patheay(s), (a), (b), (c), (d), , Intrinsic pathway, Extrinsic pathway, Common pathway, Both (a) and (c), , 4. Low doses of heparin prolong, (a), (b), (c), (d), , Bleeding time, Activated partial thromboplastin time, Prothrombin time, Both (b) and (c), , 5. Low molecular weight heparins differ, from conventional heparin in that, (a) They selectively inhibit factor Xa, (b) They do not significantly prolong clotting time, , (c) They are metabolized slowly and have longer, duration of action, (d) All of the above, 6. Initiation of unfractionated heparin, therapy for the patient in question 1, would best be achieved with, (a) 5000-unit, units/hr, (b) 5000-unit, units/hr, (c) 8000-unit, units/hr, (d) 8000-unit, units/hr, , loading dose followed by 1000, loading dose followed by 1800, loading dose followed by 1800, loading dose followed by 1000, , 7. Which of the following can be used to, antagonize the action of heparin in case, of overdose ?, (a) Heparin sulfate, (b) Dextran sulfate, (c) Protamine sulfate (d) Ancrod, 8. Blood level of which clotting factor, declines most rapidly after the initation, of warfarin therapy, (a) Factor VII, (c) Factor X, , (b) Factor IX, (d) Prothrombin, , 9. The following drug reduces the effect of, oral anticoagulants, (a) Broad spectrum antibiotic, (b) Cimetidine

Page 227 :
MCQs IN PHARMACOLOGY, , 212, (c) Aspirin, (d) Oral contraceptive, , (a), (b), (c), (d), (e), , 10. The most definite beneficial results are, obtained in the use of anticoagulants for, the following purpose, (a) Prevention of recurrences of myocardial, infarction, (b) Prevention of venous thrombosis and, pulmonary embolism, (c) Cerebrovascular accident, (d) Retinal artery thrombosis, 11. Anticoagulants are indicated in, (a), (b), (c), (d), , Immobilized elederly patients, Buerger’s disease, Stroke due to cerebral thrombosis, All of these, , 12. Which of the following tests are used to, monitor antithrombotic therapy?, I. International normalized ratio (INR), II. Activated partial thromboplastin time (APTT), III. Heparin assay, (a) If I only is correct, (b) If III only is correct, (c) If I and II are correct, (d) If II and III are correct, (e) If I, II, and III are correct, 13. Which fibrioolytic drug(s) is/are antigenic, (a) Streptokinase, (c) Alteplase, , (b) Urokinase, (d) Both (a) and (b), , 14. The most important complication of, streptokinase therapy is, (a) Hypotension, (c) Fever, , (b) Bleeding, (d) Anaphylaxis, , 15. A patient to be commenced on oral, anticoagulant therapy for DVT would be, treated with:, I. Oral anticoagulant therapy with warfarin for, a goal international normalized ratio (INR), of 2–3, II. Oral anticoagulant therapy with warfarin for, a goal INR of 2.5–3.5, III. Oral anticoagulant therapy with aspirin for, a goal INR of 2–3, , If, If, If, If, If, , I only is correct, III only is correct, I and II are correct, II and III are correct, I, II, and III are correct, , 16. Thrombolytic therapy instituted within 36 hours of onset of acute myocardial, infarction affords the following benefit(s), (a), (b), (c), (d), , Reduces mortality, Reduces area of myocardial necrosis, Preserves ventricular function, All of these, , 17. The preferred route of administration of, streptokinase in acute myocardial infarction, is, (a) Intravenous, (c) Intracoronary, , (b) Subcutaneous, (d) Intracardiac, , 18. A patient on oral anticoagulant therapy, is commenced on sulfamethoxazoletrimethoprim, double-strength twice, daily. One may expect to see the INR, I. Increase, II. Decrease, III. Remain unchanged, (a) If I only is correct, (b) If III only is correct, (c) If I and II are correct, (d) If II and III are correct, (e) If I, II, and III are correct, 19. Aspirin prolongs bleeding time by inhibiting, the synthesis of, (a), (b), (c), (d), , Clotting factors in liver, Prostacyclin in vascular endothelium, Cyclic AMP in platelets, Thromboxane A2 in platelets, , 20. Route of heparin administration is, (a) Oral, (c) Intramuscular, , (b) Subcutaneous, (d) Sublingual, , 21. The anticoagulant effects of heparin can, be promptly arrested by administration of, (a) Epsilon amino caproic acid, (b) Protamine sulfate

Page 228 :
ANTICOAGULANTS, , 213, , (c) Adrenaline, (d) Vitamin K, , I. Hold the drug therapy, II. Administer vitamin K, III. Administer fresh frozen plasma, (a) If I only is correct, (b) If III only is correct, (c) If I and II are correct, (d) If II and III are correct, (e) If I, II, and III are correct, , 22. Severe cases of bleeding due to, fibrinolytic agents are treated with, (a), (b), (c), (d), , Aspirin, Heparin, EACA (Epsilon Amino Caproic Acid), Vitamin K, , 23. If a patient has an INR greater than 20, and active bleeding that is clinically, significant (i.e., hematuria), the pharmacist, should, , ANSWERS, 1. d, 7. c, 13. a, 19. d, , 2. b, 8. a, 14. b, 20. b, , 3. a, 9. d, 15. b, 21. b, , 4. b, 10. b, 16. d, 22. c, , 5. d, 11. a, 17. a, 23. b, , 6. a, 12. c, 18. a, , EXPLANATIONS FOR THE ANSWERS, 2. d, , 6. c, , 12. d, , Unifractionated heparin acts heparin acts as, an anticoagulant by catalyzing the, inactivation of thrombin (factor Iia), activated, factor X (factor Xa), and activated factor IX, (factor Ixa)by antithrombin III., Varying nomograms for dosing continuousinfusion unfractionated heparin exist in the, medical and pharmaceutical literature. The, loading dose is typically 70–100 units/kg., In this case the loading dose is 80 units/kg., Maintenance doses of 15–25 units/kg/hr are, typically used. In this case , the maintenance, dose is 18 units/kg/hr., Unfractionated heparin may be appropriately, monitored by either the activated partial, thromboplastin time (aPTT) or heparin assay., Because different laboratories use APTT, reagents with varying sensitivities, the APTT, range and its corresponding ratio must be, correlated to a heparin level of 0.2–0.4 units/, ml; or 0.3–0.7 units/ml by plasma-amidolytic, assay. The safety and efficacy of lowmolecular-weight heparin (LMWH), cannot be reliably evaluated by APTT, determinations. LMWH safety and efficacy, , 15. a, , 18. a, , can be evaluated by heparin assay. Because of, the reliability of dose responsiveness seen with, LMWH therapy, the need to perform heparin, assays is controversial., Oral anticoagulant therapy is monitored by, measuring the prothrombin time (PT). The PT is, responsive to depression of three of the four, vitamin K-dependent procoagulant clotting, factors, these respective clotting factors take, approximately 96 hours to be depleted, at which, time the PT should be sufficient to arrive at an, international normalized ratio (INR) of 2.0–3.0, for patients with deep venous thrombosis. Patients, with mechanical prosthetic heart valves have INRs, targeted in the 2.5–3.5 range. Aspirin therapy, is not monitored by INR determinations., Oral anticoagulant therapy with warfarin may be, complicated by a myriad of drug-drug interactions, owing to the highly protein-bound state of warfarin., Such drug interactions may potentiate the, prothrombin time/international normalized ration, (PT/INR), inhibit the anticoagulant effect of warfarin,, or have no effect on the actions of warfarin., Sulfamethoxazole-trimethoprim and other antibiotics, have the potential to augment the anticoagulant

Page 229 :
MCQs IN PHARMACOLOGY, , 214, , 23. e, , effect of warfarin by eliminating bacterial flora and, thereby, producing vitamin – K deficiency., Pharmacists may be called on to offer advice, regarding reversal of warfarin therapy or may, be empowered using Pharmacy and, Therapeutics Committee or Medical Board, approved protocols to reverse warfarin’s effect., In all instances, the pharmacist must critically, and clinically evaluate the situations and, communicate with the physician regarding, management issue. A need for immediate, , surgery or invasive procedures will always, hasten the urgency of warfarin reversal. In the, setting of active bleeding, its clinical significance, must be demonstrated by consultation with the, patient’s physician. If the international, normalized ration is >20 and the patient has, active bleeding that is clinically significant, the, pharmacist must hold drug therapy, consider the, most appropriate dose and route of vitamin-K, delivery and administer fresh frozen plasma to, replete the vitamin-Kdependent clotting factors.

Page 230 :
ANTIHYPERLIPEDEMIC AGENTS, , 215, , Chapter 15, ANTIHYPERLIPEDEMIC AGENTS, , 1. Inhibition of thromboxane synthesis by, aspirin in platelets lasts for 5–7 days, because, (a) Aspirin persists in the body for 5–7 days, (b) Aspirin induced depletion of arachidonic, acid lasts 5–7 days, (c) Regeneration of aspirin inhibited cyclooxygenase takes 5–7 days, (d) Platelets cannot generate fresh thromboxane, synthetase and their turnover time is 5-7 days, 2. Choose the drug which has a direct effect on, platelet membrane to inhibit aggregation,, release reaction and to improve platelet, survival in extra-corporeal circulation, (a) Dipyridamole, , (b) Ticlopidine, , (c) Aspirin, , (d) Sulfinpyrazone, , 3. Combined therapy with dipyridamole, and warfarin is recommended in subjects, with the following, (a) Risk factors for coronary artery disease, (b) prosthetic heart valves, (c) Chronic arteriovenous shunts for repeated, haemodialysis, (d) Both (b) and (c), 4. Select the hypocholesterolemic drug which, interferes with intestinal absorption of bile, salts and cholesterol, and secondarily, increases cholesterol turnover in the liver, , (a) Clofibrate, (c) Lovastatin, , (b) Cholestyramine, (d) Bezafibrate, , 5. Select the most appropriate hypolipidemic, drug for a patient with raised LDLcholesterol level but normal triglyceride, level, (a), (b), (c), (d), , A HMG – CoA reductase inhibitor, A fibric acid derivative, Probucol, Nicotinic acid, , 6. A patient with coronary artery disease, has raised serum triglyceride (600 mg/, dl) but normal total cholesterol level (150, mg/dl). Which hypolipidemic drug should, be prescribed, (a) Probulol, (c) Cholestyramine, , (b) Gemfibrozil, (d) Lovastatin, , 7. Choose the correct statement about, lovastatin, (a) It markedly lowers plasma triglyceride with, little effect on cholesterol level, (b) It is used as an adjuvant to gemfibrozil for, type III hyperlipoproteinemia, (c) It is not effective in diabetes associated, hypercholesterolemia, (d) It is a competitive inhibitor of the rate limiting, step in cholesterol synthesis, 8. Select the drug which reduces cholesterol, synthesis in liver, increases expression of

Page 231 :
MCQs IN PHARMACOLOGY, , 216, LDL receptors on hepatocytes and has, been found to reduce mortality due to, coronary artery disease, (a) Simvastatin, (c) Probucol, , (b) Nicotinic acid, (d) Colestipol, , 9. What is true of nicotinic acid as well as, nicotinamide ?, (a) Both possess vitamin B3 activity, (b) Both cause cutaneous vasodilatation, (c) Both lower plasma triglyceride and VLDL, levels, (d) Both cause hyperglycaemia after prolonged, medication, 10. Which hypolipidemic drug has been used, to control and prevent pancreatitis in, familial hypertriglyceridemia ?, (a) Lovastatin, (c) Cholestyramine, , (b) Clofibrate, (d) Nicotinic acid, , 11. The rare but characteristic adverse effect, of HMGCoA reductase inhibitors is, (a), (b), (c), (d), , Onycolysis, Myopathy, Alopecia, Oculomucocutaneous syndrome, , (b) 160 mg/dl, (d) 240 mg/dl, , Plasma expander, Haemostatic, Heparin substitute, Bile acid sequestrant, , 15. Cholestyramine resin, (a) Significantly lowers plasma triglyceride levels, (b) Can enhance the oral absorption of digoxin, (c) May enhance the absorption of fat-soluble, vitamins, (d) Is the drug of choice in type II hyperlipoproteinemia, 16. Clofibrate, (a), (b), (c), (d), , May reduce the action of warfarin, Can decrease gall stone formation, Can elevate plasma HDL cholesterol levels\, Increases platelet aggregation, , 17. Probucol, (a), (b), (c), (d), , Can lower HDL cholesterol levels, Reduces clearance of plasma LDL by the liver, Can produce constipation, Is benefician in patients with recent myocardial, infarction, , (a) Reduces production of VLDL, (b) Should not be used in combination with, cholestyramine resin, (c) Can lower HDL levels, (d) Can increase serum triglyceride levels, 19. Which of the following statements is true, regarding cholestyramine?, , 13. High molecular weight, pharmacodynamically inert, nonantigenic substances, which form colloidal solution are used as, (a), (b), (c), (d), , (a), (b), (c), (d), , 18. Nicotinic acid, , 12. In a 50-year-old male without any other, coronary artery disease risk factor,, hypocholesterolemic drugs are recommended only when the serum LDL, cholesterol level is higher than, (a) 130 mg/dl, (c) 190 mg/dl, , 14. Hydroxyethyl starch is a, , Osmotic purgatives, Osmotic diuretics, Plasma expanders, All of the above, , (a) It inhibits free fatty acid release from adipose, tissue, (b) It releases lipoprotein lipase, (c) It blocks the final step in the synthesis of cholestrol, in the body, (d) When used in large doses, it decreases serum, cholesterol, , ANSWERS, 1. d, 7. d, 13. c, 19. d, , 2. b, 8. a, 14. a, , 3. d, 9. a, 15. d, , 4. b, 10. c, 16. c, , 5. a, 11. b, 17. a, , 6. b, 12. c, 18. a

Page 232 :
ANTACIDS, , 217, , Chapter 16, ANTACIDS, , 1. For healing duodenal ulcer the usual, duration of H2 blocker therapy is, (a), (b), (c), (d), , 4 weeks, 6 weeks, 8 weeks, 12 weeks, , 2. What is true of acid control therapy with, H2 blockers ?, , 5. Antacid combinations of magnesium and, aluminium salts are superior to single, component preparations because, (a) They have rapid as well as sustained acid, neutralizing action, (b) They are less likely to affect gastric emptying, (c) They are less likely to alter bowel movement, (d) All of the above, , (a) It generally heals duodenal ulcers faster than, gastric ulcers, (b) It checks bleeding in case of bleeding peptic, ulcer, (c) It prevents gastroesophageal reflux, (d) Both (a) and (b), , 6. In peptic ulcer, antacids are now primarily, used for, , 3. The ‘acid neutralizing capacity’ of an, antacid is governed by, , 7. The following is a noncompetitive antagonist at the gastric jparietal cell H2, receptor., , (a), (b), (c), (d), , The equivalent weight of the antacid, The pH of 1N solution of the antacid, The rate at which the antacid reacts with HCl, Both (a) and (c), , 4. An antacid with the following property, would be desirable in the treatment of, peptic ulcer., (a) Which raises gastric pH to 4.0, (b) Which raises gastric pH to 7.0, (c) Which increases gastric motility and hastens, gastic emptying, (d) Both (b) and (c), , (a), (b), (c), (d), , Prompt pain relief, Ulcer healing, Preventing ulcer relapse, Control of bleeding from the ulcer, , (a) Cimetidine, (c) Roxatidine, , (b) Loxatidine, (d) Rantidine, , 8. Gynaecomastia can occur as a side effect, of, (a) Bromocriptine, (c) Famotidine, , (b) Levodopa, (d) Cimetidine, , 9. Which histamine H2 blocker has maximum, inhibitory effect on microsomal cytochrome, P-450 enzyme ?, (a) Cimetidine, (c) Roxatidine, , (b) Ranitidine, (d) Famotidine

Page 233 :
MCQs IN PHARMACOLOGY, , 218, 10. Choose the correct statement about H2, receptor blockers., (a) They are the most efficacious drugs in, inhibiting gastric acid secretion, (b) They cause fastest healing of duodenal ulcers, (c) They are the most commonly used drugs for, inhibiting gastric acid secretion, (d) They afford most prompt relief of ulcer pain, , (a), (b), (c), (d), , Carbenoxolone sodium, Sucralfate, Famotidine, Lansoprazole, , 17. Omeprazole exerts practically no other, action except inhibition of gastric acid, secretion because, , (a) Rapid relief of gastric ulcer pain, (b) Prophylaxis of gastric erosion in patients with, extensive burns, (c) Zollinger Ellison syndrome, (d) Reflux oesophagitis, , (a) In transforms into the active cationic forms, only in the acidic pH of the gastric juice, (b) Its active forms have selective affinity for the, H+K+ ATP ase located in the apical canaliculi, of gastric parietal cells, (c) Its cationic forms are unable to diffuse out, from the gastric parietal cell canaliculi, (d) All of the above, , 12. Ranitidine differs from cimetidine in the, following manner., , 18. The most efficacious drug for inhibiting, round the clock gastric acid output is, , 11. Ranitidine is mostly given by intravenous, infusion for the following indication., , (a), (b), (c), (d), , It, It, It, It, , is less potent, is shorter acting, does not have antiandrogenic action, produces more CNS side effects, , 13. Eradication of H pylori along with gastric, antisecretory drugs affords the following, benefit(s)., (a), (b), (c), (d), , Faster relief of ulcer pain, Faster ulcer healing, Reduced chance of ulcer relapse, Both (b) and (c), , 14. The drugs employed for anti H pylori, therapy include the following except, (a) Ciprofloxacin, (c) Tinidazole, , (b) Clarithromycin, (d) Amoxicillin, , 15. The following class of gastric antisecretory, drug have primary effect on juice volume,, with less marked effects on acid and, pepsin content, and also reduce gastric, motility, (a), (b), (c), (d), , Histamine H2 blockers, Anticholinergics, Proton pump inhibitors, Prostaglandins, , 16. The following drug is an inhibitor of, gastric mucosal proton pump., , (a) Omeprazole, (c) Pirenzepine, , (b) Cimetidine, (d) Misoprostol, , 19. The primar y mechanism by which, prostaglandins promote ulcer healing is, (a) Inhibition of gastric secretion, (b) Augmentation of bicarbonate buffered mucus, layer covering gastroduodenal mucosa, (c) Increased bicarbonate secretion in gastric, juice, (d) Increased turnover of gastric mucosal cell, 20. Which of the following statements is true, about misoprostol ?, (a) It relieves peptic ulcer pain, but does not, promote ulcer healing, (b) It heals nonsteroidal anti-inflammatory drug, induced gastric ulcer not responding to H2, blockers, (c) It produces fewer side effects than H2 blockers, (d) It is the most effective drug for preventing, ulcer relapse, 21. Sucralfate promotes healing of duodenal, ulcer by, (a) Enhancing gastric mucus and bicarbonate, secretion, (b) Coating the ulcer and preventing the action, of acid-pepsin on ulcer base

Page 234 :
ANTACIDS, , 219, , (c) Promoting regeneration of mucosa, (d) Both (a) and (b), , (c) Senna, , (d) Magnesium sulfate, , 29. Saline osmotic purgatives are used for, , 22. Antacids administered concurrently, reduce efficacy of the following antipeptic, ulcer drug., (a) Cimetidine, , (b) Omeprazole, , (c) Sucralfate, , (d) Pirenzepine, , 23. The most important drawback of sucralfate, in the treatment of duodenal ulcer is, (a) Low ulcer healing efficacy, (b) Poor relief of ulcer pain, , (a) Reatment of constipation, (b) Prevention of constipation in patients of piles, (c) Avoidance of straining at stools in patients, of hernia, (d) Tapeworm infestation: Following niclosamide, administration, 30. The most suitable laxative for a patient, of irritable bowel syndrome with spastic, constipation is, , (c) Highincidence of side effects, , (a) Dietary fibre, , (b) Liquid paraffin, , (d) Need for taking a big tablet four times a day, , (c) Bisacodyl, , (d) Senna, , 24. The preferred regimen for preventing, duodenal ulcer relapse is, (a) Maintenance antacid regimen, (b) Maintenance H2 blocker regimen, (c) On demand intermittent H2 blocker regimen, (d) Mintenance sucralfate regimen, 25. Used as a laxative, liquid paraffin has, the following drawbacks except, (a) It interferes with absorption of fat soluble, vitamins, (b) It is unpleasant to swallow, (c) It causes gripping, (d) It may produce foreignbody granulomas, 26. Which of the following purgatives, undergoes enterohepatic circulation to, produce prolonged action ?, , 31. The success of oral rehydration therapy, of diarrhoea depends upon the following, process in the intestinal mucosa., (a) Sodium pump mediated Na+ absorption, (b) Glucose coupled Na+ absorption, (c) Bicarbonate coupled Na+ absorption, (d) Passive Na+ diffusion secondary to nutrient, absorption, 32. Saline laxatives containing magnesium, (a) Reduce the secretion of cholecystokinin, (b) Are more effective when administered on an, empty stomach, (c) Are commonly used in the treatment in, functional constipation, (d) Are safe in patients with impaired renal function, 33. Antimotility drugs are contraindicated in, , (a) Docusates, , (b) Phenolphthalein, , (a) Mild traveler’s diarrhoea, , (c) Castor oil, , (d) Lactulose, , (b) Acute infective diarrhoeas, , 27. The following laxative lowers blood, ammonia level in hepatic encephalopathy., (a) Bisacodyl, , (b) Liquid paraffin, , (c) Lactulose, , (d) Magnesium sulfate, , 28. Select the purgative that should not be, taken at bed time., (a) Ispaghula, , (b) Bisacodyl, , (c) Ileostomy patients, (d) Patients after anal surgery, 34. Octreotide, (a) Has a short half-life of 2 minutes, (b) Is given orally three times in a day, (c) Is useful in carcinoid syndrome, (d) Increases intestinal smooth muscle, contractility

Page 235 :
MCQs IN PHARMACOLOGY, , 220, 35. Therapy of choice in Zollinger Ellison, syndrome is, (a), (b), (c), (d), , Omeprazole, Ranitidine, Sucralfate, Carbenoxolone sodium, , 38. Omeprazole is most useful in, (a), (b), (c), (d), , Gastric ulcer, Duodenal ulcer, Reflux esophagitis, Gastritis, , 39. Antacids should not be prescribed concurrently with, , 36. Misoprostol, (a) Is helpful in preventing ulcers induced by, NSAIDs, (b) Can cause constipation, (c) Does not inhibit acid secretion, (d) Can delay labor in a pregnant woman, 37. Ranitidine is a new histamine receptor, blocker. It is, (a) Less potent, non competitive but selective, antagonist of histamine at gastric site than, cimetidine, (b) More potent, non selective and most toxic, histamine antagonist of histamine at gastric, site, (c) More potent, competitive and selective, antagonist of histamine at gastric site, (d) None of the above, , (a) Ranitidine, (c) Sucralfate, , (b) Pirenzipine, (d) Omeprazole, , 40. The antiulcer drug ver y helpful in, preventing NSAID induced gastric ulcer, is, (a) Roxatidine, (c) Enalapril, , (b) Furosemide, (d) Amrinone, , 41. In peptic ulcer, antacids do have a, primary role in, (a), (b), (c), (d), , Prompt relief of pain, Ulcer healing, Control of bleeding, Prevention of ulcer relapse, , ANSWERS, 1. c, 7. b, 13. d, 19. b, 25. c, 31. b, 37. c, , 2. a, 8. d, 14. a, 20. b, 26. b, 32. b, 38. b, , 3. d, 9. a, 15. b, 21. b, 27. c, 33. b, 39. c, , 4. a, 10. c, 16. d, 22. c, 28. d, 34. c, 40. c, , 5. d, 11. b, 17. d, 23. d, 29. d, 35. a, 41. a, , 6. a, 12. c, 18. a, 24. b, 30. a, 36. a

Page 237 :
MCQs IN PHARMACOLOGY, , 222, (c) Blocking serotonin 5-HT3 receptor, (d) Blocking dopamine D2 receptor, , (d) Three times the molar concentration of Na+, , 10. The most effective antiemetic for, controlling cisplatin induced vomiting is, (a) Prochlorperazine (b) Ondansetron, (c) Metoclopramide (d) Promethazine, 11. Ondansetron is a, (a), (b), (c), (d), , Second generation antihistaminic, Drug for peptic ulcer, New antiarrhythmic, Antiemetic for cancer chemotherapy, , 12. Ondansetron blocks emetogenic impulses, at the following site(s)., (a), (b), (c), (d), , Vagal afferents in intestines, Nucleus tractus solitarius, Chemoreceptor trigger zone, All of the above, , 13. Cancer chemotherapy induced vomiting, that is not controlled by metoclopramide, alone can be suppressed by combining it, with, (a) Amphetamine, (c) Hyoscine, , (b) Dexamethasone, (d) Cyclizine, , 14. Irrespective of the type, all laxatives exert, the following action., (a), (b), (c), (d), , Increase the content of solids in the faeces, Increase the water content of faeces, Reduce absorption of nutrients, Increase intestinal motility, , 15. For optimum rehydration, the molar, concentration of glucose in ORS should be, (a) Equal to the molar concentration of Na+, (b) Somewhat lower than molar concentration, of Na+, (c) Somewhat higher than the molar, concentration of Na+, , 16. The concentration of sodium ions in WHO, oral rehydration solution is, (a) 40 m moles/L, (c) 90 m moles/L, , (b) 60 m moles/L, (d) 110 m moles/L, , 17. The electrolyte composition of WHO oral, rehydration solution is based upon that of, (a), (b), (c), (d), , Enterotoxigenic E. coli diarrhea stools, Cholera stools in adults, Cholera stools in children, Rotavirus diarrhea stools, , 18. A case of acute diarrhea presents with, abdominal pain, fever, mucus and blood, in stools and is suspected to be suffering, from Shigella enteritis. What antimicrobial, treatment would be most appropriate., (a), (b), (c), (d), , No antimicrobial treatment, Metronidazole, Norfloxacin, Chloramphenicol, , 19. Ordansetron, (a), (b), (c), (d), , Can cause extrapyramidal side effects, Is not effective in control of acute emesis, Can prevent emesis due to radiation, Is not absorbed orally, , 20. The prokinetic effects of metoclopramide, can be abolished by, (a) Vagotomy, (c) Bethanechol, , (b) Atropine, (d) Acetylcholine, , 21. The most potent drug for prevention of, motion sickness is, (a) Dimenhydrinate, (c) Scopolamine, , (b) Tripelenamine, (d) Hydroxygene, , ANSWERS, 1. c, 7. c, 13. b, 19. c, , 2. d, 8. c, 14. b, 20. b, , 3. b, 9. a, 15. c, 21. c, , 4. d, 10. b, 16. c, , 5. a, 11. d, 17. c, , 6. c, 12. d, 18. c

Page 238 :
MATCH THE FOLLOWING, , 223, , CHAPTER 18, MATCH THE FOLLOWING, , 1. Match the correct mechanism of action for, the diuretic agents mentioned below:, (1), (2), , Acetazolamide, Chlorthiazide, , (3), , Spiranolactone, , (4), , Triamterene, , (a) Increases serum K+ level, (b) Competitively antagonizes, aldodsterone, (c) Inhibits active Na+ secretion,, decreasing K+ excretion in the, distal nephron, (d) Inhibits carbonic anhydrase, (e) Inhibits electrolyte reabsorption in the distal portion of the, ascending limb of the loop of, Henle, , 2. Listed are some of the commonly used, drugs. Their pharmacological actions are, listed in A to E, match them., (1), (2), , Aspirin, Acetaminophen, , (3), , Phenylbutazone, , (4), , Probenacid, , (a) Rises body temperature, (b) Non–analgesic anti-inflammatory, (c) Non–anti-inflammator y analgesic, (d) Increases of depth of respiration, (e) Increases fluid retention, , 3. The following are the test animals or, substances used for the biological assay, of preparations listed in A to E. Match, them correctly., (1), (2), (3), , Mice, Albino rats, Guinea pigs, , (a) Vasopressin, (b) Diphtheria antitoxin, (c) Insulin, , (4) Sheep plasma, , (d) Human antihaemophyllic, fraction, , 4. The drug A to E are used as diuretics., Match them to their classes., (1) Osmotic diuretic, (2) Loop diuretic, (3) Potassium sparing, diuretic, (4) Organomercurial, diuretic, , (a), (b), (c), (d), (e), , Spiranolactone, Isosorbide, Merasalyl theophylline, Furosemide, Probenecid, , 5. Pharmacologicla activity of certain well, known plant drugs are listed A to E., Match them., (1), (2), (3), (4), , Papaverin, Camphor, Veratrum alkaloids, Vincristine, , (a), (b), (c), (d), (e), , Weak analeptic, Vasodilator, Antineoplastic, Central vasoconstrictor, Anxiolytic, , 6. Listed are drugs 1 to 4. Their appropriate, antihypertensive mechanisms are given, in A to F match them., (1) Pindalol, (2) Minoxidil, (3) Captopril, (4) Amiloride, , (a) Vadoilator, (b) Angiotiensin coverting enzyme inhibitor, (c) Diuretic, (d) Beta–blocker, (e) Centrally acting alpha, adrenoceptor agonist, f) Potassium induction

Page 239 :
MCQs IN PHARMACOLOGY, , 224, 7. Symptoms for the following diseases are, indicated from A to E . Match them., (1), (2), (3), (4), , Cushing’s syndrome (a), Addison’s disease (b), Grave’s disease, (c), Crohn’s disease, (d), (e), , Hyperthyroidism, Inflammatory bowel, Decreased production of cortisol, Decreased production of cortisol, Increased production of cortisol, , 8. The undersirable effects of the antibiotics, are listed in A to E. Match them., (1), (2), (3), (4), , Tetracycline, Streptomycin, Chloramphenicol, Rifampicin, , (a), (b), (c), (d), , Gray–baby syndrome, Discolouration of teeth, Jaundice, Obesity, , 9. Match the following terms with their, respective definitions A to E:, (1) Achyliagestrica, (2) Acidosis, (3) Actinomycosis, , (a) Decrease in alkali contents, (b) Absence of hydrochloric acid, (c) A deficient disorder of adrenal, contex with anaemia, weakness,, dyspepsia, hypotension, (4) Addision’s disease (d) A fungal disease caused by, Actinomyces, (e) A state of psychic and physical, drug dependence, , 10. Match the following categories of, Adrenocorticosteroids with their, respective examples A to E:, (1), (2), (3), (4), , Glucocorticoids, Mineral corticoids, Receptor, Synthetic Inhibitors, , (a), (b), (c), (d), (e), , Aldosterone, Fludrocortisone, Ketokonazole, Metyapone, Cholesterol, β-Sitosterol, Cortisol, Triamcinolone, Mifepristone, Spironolactone, , 11. Match the following anaesthetics with, their respective nature A to E:, (1) Coacine, (2) Lignocaine, (3) Propanediol, (4) Chlorpromazine, , (a) Other anaesthetic, (b) Synthetic non-nitrogenous, compound, (c) Inhaled anaesthetic, (d) Synthetic nitrogenous compound, (e) Natural alkaloid, , 12. Match the following antiemetic drugs with, their respective categories A to E:, (1) Weak agonist, (2) Strong agonist, (3) Antidiarrhea, , (a) Pentazocine, (b) Propoxyphene, (c) Heroin, , (4) Antitussive, , (d) Diphenoxylate, (e) Codeine, , 13. Match the following antiarrhythmic drugs, to the respective categories A to E:, (1), (2), (3), (4), , Acebutalol, Verapamil, Kromakalem, Phenytoin, , (a), (b), (c), (d), (e), , Calcium channel blocker, Potassium channel blocker, Sodium channel blocker, Beta adrenoceptor blocker, Chloride channel blocker, , 14. Match the following categories of, antibiotics with their respective examples, A to E:, (1) Narrow spectrum, (2) Broad - spectrum, (3) Acting on cell, membrane, (4) Inhibiting protein, synthesis, , (a) Neomycin, (b) Cephalsporins, (c) Streptomycin, (d) Cycloserine, , 15. Match the following penicillins with their, respective categories A to E:, (1), (2), (3), (4), , Penicillin G, Penicillin V, Methicillin, Ampicillin, , (a), (b), (c), (d), (e), , Broad spectrum, Penicillinase resistant, Natural, Semi–synthetic, Anti–pseudomonas, , 16. Match the following categories of, anticancer hormones with their respective, examples A to E:, (1) Androgens, (2) Gonadotropinreleasing, (3) Estrogens, (4) Adrenocortrocoids, , (a) Methoxyestradiol, (b) Prednisolone, (c) Testosterone, (d) Goserelin, (e) Diethylstilbestrol, , 17. Match the following antidepressant drugs, with their respective categories A to E:, (1), (2), (3), (4), , Amitriptyline, Nizoxetin, Caffeine, Isoniazid, , (a), (b), (c), (d), , Non-specific, Tricyclic first generation, Tricyclic second generation, Psychomotor stimulant, , (e) Heterocyclic, , 18. Match the following antidiabetic drugs, with their respective categories A to E, (1) Phenformin, (2) Tolbutamide, , (a) Long acting, (b) Rapid acting

Page 240 :
MATCH THE FOLLOWING, (3) NPH Insulin, (4) Protamine zinc, insulin, , 225, , (c) Intermediate acting, (d) Beguanide suspension, (e) Sulphonylurea, , 19. Match the following categories of, antifungal drugs with their respective, examples A to E:, (1) For superficial, infection, (2) Topical, (3) For systemic, mycoses, (4) For vaginal, candidiasis, , (a) Amphotericin B, (b) Nystatin, (c) Undercylenic acid, (d) Grisefulvin, meanings, (e) Nystatin, , 20. Match the following antihyperlipidemic, drugs with their respective categories A, to E:, (1), (2), (3), (4), , Cholesteryl amine, Clofibrate, Lovastation, Niacin, , (a), (b), (c), (d), (e), , Fibric acid derivative, Bile acid sesquestrant, VLDL secreting inhibitor, Antioxidant, HMGCO – A reductase, , 21. Match the following categories of, antimalarial drugs with their respective, examples A to E:, (1), (2), (3), (4), , Acridine dyes, Cinchona alkaloid, Aminoquinoline, Diaminopyrimidine, , (a), (b), (c), (d), (e), , Biguanide, Primaquine, Quinacrine, Quinine, Mepacrine, , 22. Match the following antiseptic drugs with, their respective categories A to E:, (1), (2), (3), (4), , Halazone, Thimerosol, Delqualinium, Proflavin, , (a), (b), (c), (d), (e), , Dye, Anionic surfactant, Halogen containing, Heavy metals, Cationic surfactant, , 23. Match the following terms with their, respective meaning A to E:, (1) Aphrodisiac, (2) Arrhythmia, (3) Arthralgia, (4) Ataxia, , (a) Pain in joint, (b) Loss of power of governing, (c) Absence of spermatozoa in the, sperm, (d) Exciting sexual desire, (e) Variation from the normal, regular rhythm of the heart, beat, , 24. Match the following antiasthamtic drugs, with their respective categories A to E:, (1) Ephedrine, , (a) Purine base bronchodilator, , (2), , (b), , Theophyline, , Symathomimetic bronchodilator, , (3) Ipratropium bromide (c) Polypetide, (4) Disodium, cromoglycate, , (d) Anticholinergics bronchodilator, (e) Anti - inflammatory, , 25. Match the following terms with their, respective meaning A to E:, (1) Bradicardia, , (a) Irritation of the mucous, membrane, , (2) Bronchitis, , (b) Feeble state produced by a, serious disease, , (3) Chachexia, , (c), , (4) Catarrh, , (d) Glowness of the heart beat, , Inflammation of mucous, membrane, , (e) Narrowing of the bronchi, , 26. Match the following drugs with therir, respective mechanisms A to E:, (1) Methotrexate, , (a) Nucleic acid derivative, binding to viral enzymes, , (2) PAS, , (b) Inhibitor of dihydrofolate, reductase, , (3) Acyclovir, , (c), , (4) Rifumpicin, , (d) Reversible inhibition of protein, synthesis, , Competitive inhibition of PABA, uptake, , (e) Inhibition of DNA dependent, RNA polymerase, , 27. Match the following cholinoceptor acting, drugs their categories A to E:, (1) Pilocarpine, , (a) Nicotinic blockers, , (2) Physostigmine, , (b) Cholinesterase regenerator, , (3) Pirenzepine, , (c), , (4) Pralidoxine, , (d) Indirect acting carbamate, , Direct acting agonist, , (e) Muscarinic blocker, , 28. Match the following diseases with their, respective diagnostic tests A to E:, (1) Leprosy, , (a) Shick test, , (2) Scarlet Fever, , (b) Lepromin Test, , (3) Syphilis, , (c), , (4) Typhoid, , (d) VDRL and Widal test, , Dick test, , (e) Widal test

Page 241 :
MCQs IN PHARMACOLOGY, , 226, 29. Match the following drugs with their, respective mechanisms of action from, A to E:, (1) Local anaesthetics, , (a) Blocks calcium channels, , (2) Minoxidil, , (b), , Prevents synthesis of prothrombin, , (3) Proserpine, , (c), , Blocks neuronal sodium, channels, , (4) Warfarin, , (d) Vasodilation by blocking, potassium channels, (e) Depletes the catecholamine, store in neurons, , 30. Match the following drugs of abuse with, their respective categories A to E:, (1) Scopolamine, (2) Nitrous oxide, , (a) Inhalant, (b) Marijuana, , (3) Hashish, , (c), , (4) Cocaine, , (d) Sedative hyponotic, , Hallucinogen, , (e) Stimulant, , 31. Match the following enzymes inhibited by, the corresponding agents A to E:, (1) Acetylcholine, esterase, , (a) Acetazolamide, , (2) Carbonic anhydrase, , (b) Methotrexate, , (3) Dihydrofoleate, reducatase in human, , (c) Trimethoprim, , (4) Dihydrofoleate, (d) Physostigmine, reducatase in microbes, , (1) Astemizole, , (a) 500 mg, , (2) Captopril, (3) Ascorbic acid, (4) Cephalothin, , (b), (c), (d), (e), , 200 mg, 2g, 10 mg, 100 mg, , 35. Match the following psychoactive drugs, with their respective categories A to E:, (1), (2), (3), (4), , Haloperidol, Meprobamate, Imipramine, LSD, , (a), (b), (c), (d), (e), , Leukotriene, Antipsychotic, Anti - anxiety, Anti - depressant, Psychotogenic, , 36. Match the following sympathomimetic, drugs with their respective categories A, to E:, (1), (2), (3), (4), , Amphetamine, Phenylephrine, Dobutamine, Albuterol, , (a), (b), (c), (d), (e), , Dopamine, Indirect releaser, Alpha–1 selective, Beta–1 selective, Beta–2 selective, , 37. Given below are the ailments and the, drugs used. Match them correctly., (1), (2), (3), (4), , (e) Primethamine, , Parkinson’s disease (a) Probenecid, Glaucoma, (b) Ampicillin, Gout, (c) Nitroglycerin, Angina, (d) Pilocarpine, (e) Levo dopa, , 32. Match the following neurotransmitters with, their respective localizations A to E:, , 38. Given below are the drugs and their, antagonists. Match them correctly., , (1) GABA, , (a) Neuromuscular junction, , (2) L - Glutamate, , (b) Hypothalamus, , (3) Neuropeptide, , (c), , (4) Dopamine, , (d) Cerebral cortex, , (1), (2), (3), (4), , Substantia nigra and striatum, , 5–HT, Codeine, Phenobarbitone, Muscarine, , (e) Cerebral nerve, , 33. Match the following drugs used in, Parkinsonism with their respective, categories A to E:, (1) Levodopa, (2) Carbidopa, , (a) Dopa decarboxylase inhibitor, (b) MAU inhibitor, , (3) Biperiden, , (c), , (4) Penicillamine, , (d) Dopamine prodrug, , Used in Wilson’s disease, , (e) Used in Tremor, , 34. Match the following drugs with their, respective usual doses A to E:, , (a), (b), (c), (d), (e), , Bemegride, Atropine, Cyproheptadine, Naloxone, Pyridoxine, , 39. Choose the most appropriate from the, group below to match drugs:, (1), (2), (3), (4), , Cocaine, Codeine, Physostigmine, Atropine, , (a), (b), (c), (d), (e), , Central stimulant, Acetylcholine estrase inhibitor, Cardiotonic, Relief of mild pain, Mydriatic, , 40. Given below are some of the drugs and, their mode of action in A to E. Match them, correctly.

Page 242 :
MATCH THE FOLLOWING, (1) Hydralazine, (2) Phenothiazine, (3) Methysergide, (4) Tolazamide, , 227, , (a) Vasodilator by direct action, (b) Inhibits the vasconstrictor and, pressor effects of 5-HT, (c) Antagonist to HT receptor of, Histamine, (d) Stimulate the islet tissue to, secrete insulin, (e) Inhibiting the enzyme carbonic, anhydrase, , (2) Streptomycin, , (b) An antibiotic cotaining nitro, group which binds to 50 S, ribosomal subunit, , (3) Chloramphenicol, , (c), , A dimeric indole alkaloid which, binds avidily to tubulin, a class, of protein that forms the miotic, spindle, , (4) Rifampicin, , (d), , A quinoline alkalid which inhibits, the growth of Plasmodium vivax, , (e), , A naphthalene antibiotic which, inhibits cell wall synthesis, , 41. Givern below are the hypotensive agents., Match their modes of action:, (1) Minoxidil, , (a) Alpha adereno receptor, antagonist, (2) Parazosin, (b) Beta adereno receptor, antagonist, (3) Alpha – methyl dopa (c) From alpha methyl norepinepherine, (4) Clonidine, (d) Direct action on blood vessel, (e) Decreases sympathetic activity, through brain, , 46. For the following drugs, specific mechanism, of action is given in A to D. Match them:, (1) Spironolactone, , (a) Non-competitively inhibit the, enzyme carbonic anhydrase, , (2) Acetazolamide, , (b) Inhibit the cotransport of Na+, and Cl- in loop of Henle, (c), , 42. Given below are the drugs and their, enzymes inhibited by them. Match them, correctly., (1), (2), (3), (4), , Physostigmine, Imipramine, Pyrogallol, Disulfiram, , (a), (b), (c), (d), (e), , COMT, Acetaldehyde dehydrogenase, Carbonic anhydrase, Cholinesterase, MAO, , 43. Choose the most appropriate drug for the, following:, (1) Potassium sparing, diuretic, (2) Loop diuretic, (3) Osmotic diuretic, (4) Carbonic anhydrase, , (a) Spironolactone, (b), (c), (d), (e), , Mannitol, Furosemide, Acetazolamide inhibitor, Aldosterone, , Competitive inhibitor of, aldosterone at the receptors in, the distal tubule, , (d) Direct inhibition of Na+ and Clreabsorption, , 47. Match the following terms with their, respective definitions A to E:, (1) Drug allergy, , (a) Excessive pharmacological, action of the drug due to, overdosage or prolonged use, , (2) Toxic effect, , (b) Characteristic toxic effects of, a drug in an individual at, therapeutic doses, , (3) Idiosyncrasy, , (c), , (4) Intolerance, , (d) Abnormal reactivity to a, chemical, (e), , An immunologically mediated, reaction producing sterotype, symptoms, , Alteration of mood and feelings, , 44. Match the following regions in GIT with, the pH levels indicated from A to E:, , 48. Match the following terms with their, respective meanings A to E:, , (1), (2), (3), (4), , (1) Carcinogenicity, , (a) Drugs causing genetic defects, , (2) Mutagenicity, , (b), , Drugs causing foetal absormalities, , (3) Teratogenicity, , (c), , Drugs capable of altering, mood and feelings, , (4) Drug dependence, , (d) Drugs causing functional, disturbances which persist,, even after the offending drug, , Mouth, Stomach, Deodenum, Large intestine, , (a), (b), (c), (d), (e), , = 5.0–6.0, = 6.8–7.5, = 6.8–7.0, = 3.0–5.0, = 1.5–3.0, , 45. For the drugs listed 1 to 4, mechanism of, action is indicated from A to E. Match them:, (1) Vincristine, , (a) Macrolide antibiotic which, inhibits DNA dependent RNA, polymerase, , (e) Drug causing cancer

Page 244 :
MATCH THE FOLLOWING, , 229, , ANSWERS, 1., 4., 7., 10., 13., 16., 19., 22., 25., 28., 31., 34., 37., 40., 43., 46., 49., 52., 55., 58., , 1-d, 2-e, 3-b, 4-c, 1-b, 2-d, 3-a, 4-c, 1- e, 2-c, 3-a, 4-b, 1-d, 2-a, 3-e, 4-b, 1-d, 2-c, 3-e, 4-a, 1-c, 2-d, 3-e, 4-b, 1-d, 2-e, 3-a, 4-b, 1-c, 2-d, 3-e, 4-a, 1-d, 2-c, 3- b, 4- a, 1-b, 2-c, 3-d, 4-e, 1-d, 2-a, 3-b, 4-c, 1-d, 2-e, 3-a, 4-c, 1-e, 2-d, 3-a, 4-c, 1-a, 2-a, 3-a, 4-a, 1-a, 2-c, 3-b, 4-d, 1-X, 2-X, 3-X, 4-X, 1-c, 2-a, 3-b, 4-a, 1-c, 2-a, 3-d, 4-e, 1-e, 2-d, 3-c, 4-a, 1-e, 2-d, 3-c, 4-b, , 2., 5., 8., 11., 14., 17., 20., 23., 26., 29., 32., 35., 38., 41., 44., 47., 50., 53., 56., , 1-d, 2-c, 3-b, 4-e, 1- b, 2-a, 3-b, 4-c, 1-b, 2-e, 3-a, 4-c, 1-c, 2-e, 3-d, 4-b, 1-d, 2-a, 3-b, 4-c, 1-b, 2-c, 3-d, 4-a, 1-b, 2-a, 3-e, 4-c, 1-d, 2-e, 3-a, 4-b, 1-b, 2-c, 3-a, 4-e, 1-c, 2-d, 3-e, 4-b, 1-e, 2-d, 3-b, 4-c, 1-b, 2-c, 3-d, 4-e, 1-c, 2-d, 3-a, 4-b, 1-b, 2-a, 3-a, 4-e, 1-b, 2-e, 3-d, 4-c, 1-c, 2-a, 3-d, 4-b, 1-b, 2-c, 3-a, 4-e, 1-d, 2-c, 3-a, 4-b, 1-d, 2-a, 3-b, 4-a, , 3., 6., 9., 12., 15., 18., 21., 24., 27., 30., 33., 36., 39., 42., 45., 48., 51., 54., 57., , 1-c, 2-d, 3-a, 4-c, 1-d, 2-a, 3-b, 4c, 1-b, 2-a, 3-d, 4-c, 1-b, 2-c, 3-d, 4-e, 1-c, 2-d, 3-b, 4-a, 1-d, 2-e, 3-c, 4-a, 1-e, 2-d, 3-b, 4-c, 1-b, 2-a, 3-d, 4-e, 1-c, 2-d, 3-e, 4-b, 1-c, 2-a, 3-b, 4-e, 1-d, 2-a, 3-b, 4-c, 1-b, 2-c, 3-d, 4-e, 1-a, 2-d, 3-b, 4-e, 1-e, 2-d, 3-b, 4-c, 1-c, 2-d, 3-b, 4-a, 1-e, 2-a, 3-b, 4-c, 1-e, 2-c, 3-b, 4-a, 1-b, 2-c, 3-a, 4-e, 1-b, 2-c, 3-e, 4-d