General Pharmacology:

2nd Midterm
Date: 17.01.2017
Total Score 20 (number of questions 40)

1.
A.
B.
C.
D.

All of the following are normally involved in the pathogenesis of heart failure EXCEPT:
A cardiac lesion that impairs cardiac output
An increase in peripheral vascular resistance
A decrease in preload
An increase in sodium and water retention

2.
A.
B.
C.
D.
3.
A.
B.
C.
D.
4.
A.
B.
C.
D.

The non-glycoside positive inotropic drug is:

Digoxin
Strophantin K
Dobutamine
Digitoxin
Choose the derivative of the plant Foxglove (Digitalis):
Digoxin
Strophantin K
Dobutamine
Amrinone
All of the following agents belong to cardiac glycosides EXCEPT:
Digoxin
Strophantin K
Amrinone
Digitoxin

5.
A.
B.
C.
D.

All of the following statements regarding cardiac glycosides are true EXCEPT:
They inhibit the activity of the Na+/K+-ATPase
They decrease intracellular concentrations of calcium in myocytes
They increase vagal tone
They have a very low therapeutic index

6. Compare the half-life of digoxin and the half-life of digitoxin:

A. Digoxin is greater than digitoxin
B. Digitoxin is greater than digoxin
7.
A.
B.
C.
D.

The manifestations of glycosides intoxication are:

Visual changes
Ventricular tachyarrhythmias
Gastrointestinal disturbances
All the above

8. Drugs most commonly used in chronic heart failure are:

A. Cardiac glycosides
B. Diuretics
C. Angiotensin-converting enzyme inhibitors
D. All the above

9. This drug is a Class II antiarrhythmic drug:

A. Flecainide
B. Propranolol
C. Lidocaine
D. Verapamil
10. This drug is associated with Torsades de pointes.
A. Flecainide
B. Sotalol
C. Lidocaine
D. Verapamil
11. This is a drug of choice for acute treatment of ventricular tachycardias:
A. Flecainide
B. Sotalol
C. Lidocaine
D. Verapamil
12. The calcium channel blockers have direct negative inotropic effects because they reduce the
inward movement of
calcium during the action potential. Thic consideration is:
A. True
B. False
13. All of the following statements regarding verapamil are true EXCEPT:
A. It blocks L-type calcium channels
B. It increases heart rate
C. It relaxes coronary artery smooth muscle
D. It depresses cardiac contractility
14. Angina pectoris is:
A. Severe constricting chest pain, often radiating from the precordium to the left shoulder and
down the arm, due to insufficient blood supply to the heart that is usually caused by
coronary disease
B. An often fatal form of arrhythmia characterized by rapid, irregular fibrillar twitching of the
ventricles of the heart instead of normal contractions, resulting in a loss of pulse
C. The cardiovascular condition in which the heart ability to pump blood weakens
D. All of the above
15. This drug group useful in angina decreases myocardial oxygen requirement (by decreasing the
determinations of oxygen demand) and does not increase myocardial oxygen delivery (by
reversing coronary arterial spasm):
A. Nitrates and nitrite drugs (Nitroglycerin, Isosorbide dinitrate)
B. Myotropic coronary dilators (Dipyridamole)
C. Potassium channel openers (Minoxidil)
D. Beta-adrenoceptor-blocking drugs (Atenolol, Mtoprolol)
16. Which of the following statements concerning nitrate mechanism of action is True?
A. Therapeutically active agents in this group are capable of releasing nitric oxide (NO) in to
vascular smooth muscle target tissues
B. Nitric oxide (NO) is an effective activator of soluble guanylyl cyclase and probably acts mainly

through this mechanism

C. Nitrates useful in angina decrease myocardial oxygen requirement (by decreasing the
determinations of oxygen demand) and increase myocardial oxygen delivery (by reversing
coronary arterial spasm)
D. All of the above
17.
A.
B.
C.
D.

Duration of nitroglycerin action (sublingual) is:

10-30 minutes
6-8 hours
3-5 minutes
1.5-2 hours

18. Side effect of nitrates and nitrite drugs are, EXCEPT:

A. Orthostatic hypotension, tachycardia
B. GI disturbance
C. Throbbing headache
D. Tolerance
19. Main clinical use of calcium channel blockers is:
A. Angina pectoris
B. Hypertension
C. Supraventricular tachyarrhythmias
D. All of the above
20. Which of the following statements concerning beta-adrenoceptor-blocking drugs are true:
A. These agents decrease transmembrane calcium current associated in a smooth muscle
with long-lasting relaxation and in a cardiac muscle with a reduction in contractility
B. These agents has a moderate reflex and vascular dilative action caused by the stimulation
of sensitive nerve endings
C. Beneficial effects of these agents are related primarily to their hemodynamic effects
decreased heart rate, blood pressure, and contractility which decrease
myocardial oxygen requirements at rest and during exercise
D. These agents increase the permeability of K channels, probably ATP-dependent K
channels, that results in stabilizing the membrane potential of excitable cells near the
resting potential
21. All of the following are central acting antihypertensive drugs EXCEPT:
A. Methyldopa
B. Clonidine
C. Moxonidine
D. Minoxidil
22. This drug inhibits the angiotensin-converting enzyme:
A. Captopril
B. Enalapril
C. Ramipril
D. All of the above
23. Pick out the diuretic agent for hypertension treatment:
A. Losartan
B. Dichlothiazide

C. Captopril
D. Prazosin
24. This drug activates alpha-2 adrenergic receptors:
A. Labetalol
B. Phentolamine
C. Clonidine
D. Enalapril
25. All of the following statements regarding angiotensin II are true EXCEPT:
A. It is a peptide hormone
B. It stimulates the secretion of aldosterone
C. Angiotensin I is almost as potent as angiotensin II
D. It is a potent vasoconstrictor
26. For increasing blood pressure in case of low cardiac output the following agents must be used:
A. Ganglioblockers
B. Vasoconstrictors
C. Positive inotropic drugs
D. Diuretics
27. A 65-year-old woman has been admitted to the coronary care unit with a left ventricular
myocardial infarction. She develops acute severe heart failure with marked pulmonary edema, but
no evidence of peripheral edema or weight gain.
Which one of the following drugs would be most useful?
A.
B.
C.
D.
E.

Digoxin
Furosemide
Minoxidil
Propranolol
Spironolactone

28. A 60-year-old man presents to his primary care physician with a complaint of severe chest pain
when he walks uphill to his home in cold weather. The pain disappears when he rests. After
evaluation and discussion of treatment options, a decision is made to treat him with nitroglycerin.
In advising the patient about the adverse effects he may notice, you point out that nitroglycerin in
moderate doses often produces certain symptoms. Which of the following effects might occur due
to the mechanism listed?
A. Apnea due to cranial vasodilation
B. Dizziness due to reduced cardiac force of contraction
C. Diuresis due to sympathetic discharge
D. Headache due to meningeal vasodilation
E. Hypertension due to reflex tachycardia
29. A 45-year-old woman with hyperlipidemia and frequent migraine headaches develops angina of
effort. Which of the following is relatively contraindicated because of her migraines?
A. Amlodipine
B. Diltiazem
C. Metoprolol
D. Nitroglycerin

E. Verapamil
30. A 5-year-old child is brought to the emergency department with sinus arrest and a ventricular rate
of 35 bpm. An empty bottle of his uncles digoxin was found where he was playing.
Which of the following is the drug of choice in treating a severe overdose of digoxin?
A.
B.
C.
D.
E.

Digoxin antibodies
Lidocaine infusion
Magnesium infusion
Phenytoin by mouth
Potassium by mouth

31. A 73-year-old man with a history of falling at home is found to have moderately severe
hypertension. Which of the following drug groups is most likely to cause postural hypotension
and thus an increased risk of falls?
A. ACE inhibitors
B. Alpha-receptor blockers
C. Arteriolar dilators
D. Beta1-selective receptor blockers
E. Nonselective blockers
32. All of the following statements regarding verapamil are true EXCEPT:
A. It blocks L-type calcium channels
B. It increases heart rate
C. It relaxes coronary artery smooth muscle
D. It depresses cardiac contractility
33. All of the following statements regarding cardiac glycosides are true EXCEPT:
A. They inhibit the Na+/K+-ATPase and thereby increase intracellular Ca++ in myocardial
cells
B. They cause a decrease in vagal tone
C. Children tolerate higher doses of digitalis than do adults
D. The most frequent cause of digitalis intoxication is concurrent administration of diuretics
that deplete K+
34. This drug is a selective beta-1 agonist:
A. Digoxin
B. Dobutamine
C. Amrinone
D. Dopamine
35. All of the following drugs are used in the treatment of severe congestive heart failure EXCEPT:
A. Verapamil
B. Digoxin
C. Dobutamine
D. Dopamine
36. This drug is a Class IA antiarrhythmic drug:
A. Sotalol
B. Propranolol

C. Verapamil
D. Quinidine
37. This drug is an effective bronchodilator:
A. Nifedipine
B. Verapamil
C. Both of the above.
D. None of the above
38. All of the following are common adverse effects of calcium channel blockers EXCEPT:
A. Skeletal muscle weakness
B. Dizziness
C. Headache
D. Flushing
39. This drug group useful in angina increase myocardial oxygen delivery (by reversing coronary
arterial spasm) and does not decrease myocardial oxygen requirement (by decreasing the
determinations of oxygen demand):
A. Beta-adrenoceptor-blocking drugs (Atenolol, Metoprolol):
B. Myotropic coronary dilators (Dipyridamole)
C. Calcium channel blockers (Nifedipine, Nimodipine)
D. Potassium channel openers (Minoxidil)
40. The following statements concerning mechanism of nitrate beneficial clinical effect are true,
EXCEPT?
A. Decreased myocardial oxygen requirement
B. Relief of coronary artery spasm
C. Improved perfusion to ischemic myocardium
D. Increased myocardial oxygen consumption
41. Which of the following antianginal agents is a myotropic coronary dilator:
A. Dipyridamole
B. Validol
C. Atenolol
D. Alinidine
This drug blocks alpha-1 adrenergic receptors:
A. Prazosin
B. Clonidine
C. Enalapril
D. Nifedipine
42. This drug is a non-peptide angiotensin II receptor antagonist:
A. Clonidine
B. Captopril
C. Losartan
D. Diazoxide