Pharmacology Exam 1 - Multiple Choice

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1. 1.Barbiturate and benzodiazepine hypnotics both A. increase NREM stage 2 sleep

A. increase NREM stage 2 sleep

B. increase REM sleep
C. increase NREM stage 4 sleep
D. cause REM rebound
E. all of these statements are true
2. 1. Symptoms of Parkinsonism would be increased by I had ABC highlighted I think this was a mistake
A. excess levels of acetylcholine please edit
B. treatment with some antipsychotic drugs
C. decreased levels of dopamine
D. drug administration after a high-protein meal
E. all of these
3. 1.The main pharmacologic effect of the SSRIs is B. increase levels of serotonin

A. increase levels of norepinephrine

B. increase levels of serotonin
C. decrease levels of norepinephrine
D. decrease levels of serotonin
E. decrease levels of dopamine
4. 1. The study of drug absorption, distribution, metabolism, and excretion is C
known as
A. pharmacotherapeutics
B. pharmacodynamics
C. pharmacokinetics
D. pharmacy
E. posology
5. 2.Disadvantages to the use of barbiturate hypnotics include E. all of these statements are true

A. development of drug tolerance

B. risk of drug dependency
C. disruption of normal stages of sleep
D. suppression of REM sleep
E. all of these statements are true
6. 2. The drug classified as a dopamine receptor agonist is C. ropinirole
A. amantadine
B. benztropine
C. ropinirole
D. entacapone (COMT)
E. carbidopa
7. 2. The medical situation when a particular drug should not be administered is D
referred to as
A. side effect
B. adverse effect
C. drug allergy
D. contraindication
E. antagonism
8. 3. An unusual or unexpected drug reaction by an individual is known as C
A. toxic effect
B. antagonism
C. idiosyncrasy
D. side effect
E. drug allergy
9. 3. Select the drugs that increase the duration of action of DA and/or the amount of E. all of these
levodopa that enters the brain.
A. carbidopa
B. tolcapone
C. selegiline
D. rasagiline
E. all of these
10. 3. The correct statement concerning the use of hypnotic drugs is B. benzodiazepines increase chloride
channel opening
A. zolpidem binds to the GABAB receptor
B. benzodiazepines increase chloride channel opening
C. barbiturates block the GABA receptor
D. ramelteon is a melatonin antagonist
E. flumazenil is a benzodiazepine receptor agonist
11. 3. The serotonin syndrome is mainly associated with overdosage of E. lithium

A. tricyclic antidepressants
B. monoamine oxidase inhibitors
C. selective serotonin reuptake inhibitors
D. psychomotor stimulants
E. lithium
12. 4. Flurazepam E. all of these statements are true

A. is classified as long-acting
B. forms active metabolites
C. may cause next-day residual effects
D. increases chloride ion influx
E. all of these statements are true
13. 4. In Parkinson's disease, slowed movements are defined as B. bradykinesia
A. rigidity
B. bradykinesia
C. tremor
D. dystonia
E. postural instability
14. 4.The main pharmacologic effects of TCAs on neurotransmitter activity is D. increase norepinephrine and serotonin
A. increase norepinephrine only
B. increase acetylcholine
C. increase serotonin
D. increase norepinephrine and serotonin only
E. increase norepinephrine, acetylcholine, and serotonin
15. 4. The proprietary drug name supplied by a pharmaceutical company is also referred to as the C
A. generic name
B. over-the-counter name
C. trade name
D. chemical name
E. none of these
16. 5. Eszopiclone C. increases total sleep
time
A. is classified as a benzodiazepine
B. has a half-life of 1-2 hours
C. increases total sleep time
D. is used as an antianxiety agent
E. is also used as an anticonvulsant
17. 5. Sinemet is the trade name of a drug combination that contains levodopa and C. carbidopa
A. carbidopa and entacapone
B. entacapone
C. carbidopa
D. selegiline
E. amantadine
18. 5. The time from drug administration to the first observable drug effect is known as the B
A. duration of action
B. onset of action
C. ceiling effect
D. maximal response
E. ceiling effect
19. 5. Venlafaxine (Effexor) is classified as D. SNRI
A. MAOI
B. TCA
C. SSRI
D. SNRI
E. psychomotor stimulant
20. 6. A drug that has the potential for abuse and is regulated by the Drug Enforcement Agency is D
classified as a
A. poison
B. OTC drug
C. prescription drug
D. controlled substance
E. nonproprietary drug
21. 6. Adverse effects of TCAs include E. all of these
A. liver toxicity
B. cardiac arrhythmias
C. convulsions
D. postural hypotension
E. all of these
22. 6. The COMT inhibitor that has been associated with causing liver toxicity is D. tolcapone
A. ropinirole
B. entacapone
C. pramipexole
D. tolcapone
E. benztropine
23. 6. Zolpidem real answer is

A. binds to the benzodiazepine-1 (BZD1) receptor Bound to the alpha subunit receptor
B. is useful as a muscle relaxant
C. has a slow onset of action
D. is useful as an anticonvulsant
E. is chemically classified as a benzodiazepine
24. 7. Alcohol has pharmacological effects on which body systems? E. all of these

A. central nervous system

B. gastrointestinal system
C. renal system
D. vascular system
E. all of these
25. 7. Select the symptoms of Parkinson's disease A and D
A. muscular rigidity
B. increased sweating
C. salivary drooling
D. movement disturbances
E. all of these
26. 7. Select the term below that relates to the amount of drug administered to A
produce a therapeutic effect.
A. posology
B. toxicology
C. pharmacodynamics
D. pharmacotherapeutics
E. pharmacy
27. 7. Which of these represents the drug that is not correctly matched with its drug C. methylphenidate—MAOI this is targets
classification? dop transporter
A. paroxetine—SSRI
B. amitriptyline—TCA
C. methylphenidate—MAOI this is targets dop transporter
D. duloxetine—SNRI
E. phenelzine—MAOI
28. 8. A medication that does not require a physician's service to obtain is referred to C
as
A. trade
B. nonproprietary
C. nonprescription
D. brand
E. generic
29. 8. Which drug requires a dietary restriction for foods containing tyramine? B. tranylcypromine (MAOI)
A. nortriptyline (TCA)
B. tranylcypromine (MAOI)
C. venlafaxine (SNRI)
D. fluoxetine (SSRI)
E. methamphetamine
30. 8. Which of the following drugs would be used to decrease the actions of ACH? D. procyclidine
A. amantadine
B. levodopa
C. bromocriptine
D. procyclidine
E. carbidopa
31. 9. Select the mechanisms by which levodopa works. E. all of these
A. crosses blood-brain barrier by an amino acid transporter
B. converted to dopamine in the substantia nigra neurons
C. increases level of dopamine in the brain
D. peripheral metabolism to DA inhibited by carbidopa
E. all of these
32. 9. The site of action of diazepam (Valium) to relieve anxiety is the B. limbic system
A. spinal cord
B. limbic system
C. reticular formation
D. basal ganglia
E. cerebellum
33. 9. Which of the following could be categorized as an adverse reaction? E
A. idiosyncrasy
B. drug allergy
C. teratogenicity
D. carcinogenicity
E. all of these
34. 10. Apomorphine is classified as B. dopamine receptor agonist
A. MAO-B inhibitor
B. dopamine receptor agonist
C. COMT inhibitor
D. anticholinergic drug
E. DOPA decarboxylase inhibitor
35. 10. The antianxiety effect of buspirone (BuSpar) is associated with C. blockage of serotonin receptors
A. stimulation of DA receptors
B. stimulation of serotonin receptors
C. blockage of serotonin receptors
D. blockade of dopamine receptors
E. blockage of GABA receptors
36. 10. The time a drug continues to produce its effect is its E
A. ED50
B. maximal response
C. ceiling effect
D. onset of action
E. duration of action
37. 11. Flumazenil (Romazicon) is used to reverse the depressant effects of alprazolam (benzodiazepine)
A. clozapine
B. alprazolam (benzodiazepine)
C. haloperidol
D. chlorpromazine
E. thiothixene
38. 12. What are the main areas at which benzodiazepines exert their effects? E. all
A. limbic system of
B. cerebral cortex these
C. reticular formation
D. spinal cord
E. all of these
39. 13. First-pass metabolism refers to the metabolism of drugs in the C
A. kidney
B. blood vessels
C. liver
D. heart
E. adipose tissue
40. 14. Drug X has a half-life of 6 hours. How much drug is left in the body 18 hours after an IV injection of 1200 milligrams B
(mg)?
41. 15. Drugs that have demonstrated teratogenic effects in women are classified as Pregnancy Category D= x
A. B
B. C
C. D
D. X
E. NR
42. 16. When a drug increases the rate of drug metabolism of other drugs, the process is termed B
A. first-pass metabolism
B. enzyme induction
C. enzyme inhibition
D. enterohepatic cycling
E. microsomal inhibition
43. A 16-year-old female with a history of goiter is admitted with fever, profuse sweating, tachyarrhythmia, hypertension, A
abdominal pain, and anxiety. Based on a working diagnosis of thyrotoxicosis, she is started on a beta-adrenoceptor
antagonist that has a very short half-life.

24. Refer to the case above. Regarding the mechanism by which the drug ameliorates the toxic effects of excessive
thyroxine levels, the drug acts as
A) a physiologic antagonist.
B) a competitive receptor antagonist.
C) a noncompetitive receptor antagonist.
D) a partial agonist.
E) an inverse agonist.
44. 17. The rate of drug absorption would be increased by which of the following? E
A. drug ionization
B. water solubility
C. positively charged drug
D. negatively charged drug
E. lipid solubility
45. 18. Which factor of individual variation is dependent upon the patient's attitude toward treatment? D
A. weight
B. age
C. genetic variation
D. placebo effect
E. gender
46. 19. Which FDA pregnancy category would appear to be the safest for a developing fetus? A
A. Category A
B. Category B
C. Category C
D. Category D
E. Category X
47. 20. A 45-year-old female shop assistant is treated for heartburn with omeprazole. She notes that the effect of a dose of A
omeprazole lasts much longer than that of a dose of the antacid drug calcium carbonate she had previously taken. The
active metabolite of omeprazole binds covalently and irreversibly to a molecular structure involved in releasing protons
into the gastric juice. Drugs that modify their target structures through this mechanism are called
suicide substrates.
orphan drugs.
protein drugs.
competitive antagonists.
enantiomers.
48. 21. A 36-year-old male has been diagnosed with chronic myeloid leukemia. His oncologist discusses treatment options with B
him. The patient is glad to hear that novel anticancer drugs used to treat chronic myeloid leukemia have a much better risk-
benefit ratio than older ones, due to their improved selectivity. A major determinant for the selectivity of a given drug is
A) its target receptor ligand affinity.
B) its target receptor cell-type distribution.
C) its ionic interactions.
D) its hydrogen bonding.
E) its intrinsic activity.
49. 22. A 56-year-old man with chest pain is diagnosed with stable angina and treated with several drugs including B
nitroglycerin. Every day he has to discontinue nitroglycerin for some hours to re-establish reactivity of his body to the
drug. The clinical observation of a rapidly decreasing response to nitroglycerin after administration of just a few doses is
called
idiosyncrasy.
tachyphylaxis.
heterologous desensitization.
refractoriness.
receptor downregulation.
50. 23. Prolonged receptor stimulation during chronic drug therapy may induce cells to endocytose and sequester drug D
receptors in endocytic vesicles. This molecular mechanism is called
A) tachyphylaxis.
B) inactivation.
C) desensitization.
D) downregulation.
E) refractoriness.
51. 25. The main pharmacologic effect of norepinephrine on alpha-1 receptors is C
A. increased heart rate
B. bronchodilation
C. vasoconstriction
D. contraction of urinary bladder
E. increased force of myocardial contraction
52. 26. The pharmacologic effect of IV metaraminol (an alpha-1 drug) is B
A. vasodilation
B. vasoconstriction
C. cardiac stimulation
D. cardiac depression
E. bronchodilation
53. 27. Epinephrine stimulates E
A. alpha-1 receptors
B. alpha-2 receptors
C. beta-1 receptors
D. beta-2 receptors
E. all of these
54. 28. At therapeutic doses, albuterol stimulates D
A. alpha-1 receptors
B. alpha-2 receptors
C. beta-1 receptors
D. beta-2 receptors
E. all of these
55. 29. Metoprolol is classified as a(n) C
A. alpha-blocker
B. nonselective beta-blocker
C. selective beta-1 blocker
D. adrenergic neuronal blocker
E. selective beta-2 blocker
56. 30. The mechanism of action of methyldopa is D
A. increased release of NE from adrenergic nerve ending
B. alpha-1 receptor blocker
C. beta-1 receptor blocker
D. formation of a false transmitter in adrenergic nerve ending
E. none of these
57. 31. The drug of choice to treat acute allergic reactions is D
A. norepinephrine
B. phenylephrine
C. pseudoephedrine
D. epinephrine
E. propranolol
58. 32. Which of the following are actions of nonselective beta-adrenergic blocking drugs? E
A. decreasing heart rate
B. decreasing force of myocardial contraction
C. vasoconstriction of skeletal muscle blood vessels
D. lowering of blood pressure
E. all of these
59. 33. The actions of epinephrine (EPI) include which of the following? E
A. bronchodilation
B. vasoconstriction
C. relaxation of uterus
D. increased heart rate
E. all of these
60. 34. Parasympathetic receptors located on the membranes of the internal organs are classified as D
A. alpha-1
B. nicotinic-neural (Nn)
C. nicotinic-muscle (Nm)
D. muscarinic
E. ganglionic
61. 35. Select the pharmacologic effect produced by cholinergic drugs. B
A. increased heart rate
B. increased gastrointestinal motility
C. decreased urination
D. pupillary dilation
E. bronchodilation
62. 36. Physostigmine (Eserine ) is classified as a(n) B
A. direct-acting cholinergic drug
B. reversible acetylcholinesterase inhibitor
C. irreversible acetylcholinesterase inhibitor
D. anticholinergic drug
E. ganglionic blocker
63. 37. Symptoms of cholinergic drug overdosage include E
A. slow pulse rate
B. increased urination
C. diarrhea
D. sweating
E. all of these
64. 38. Anticholinergic effects include all of the following except C
A. bronchodilation
B. increased heart rate
C. increased gastrointestinal activity
D. decreased respiratory secretions
E. dry mouth
65. 39. The antidote for atropine poisoning is D
A. scopolamine
B. bethanechol
C. neostigmine
D. physostigmine
E. dicyclomine
66. 40. Pick the correct pharmacological effect(s) of direct-acting cholinergic drugs. E
A. respiratory paralysis
B. urinary retention
C. increased heart rate
D. bronchodilation
E. none of these
67. 41. Which of the following would be a preferred treatment for overactive bladder? B

A. neostigmine
B. tolterodine
C. physostigmine
D. bethanechol
E. donepezil
68. 42. Which of the following is correct about the nicotinic-muscle (Nm) receptor blocking drugs? D
A. the mechanism of action is the same as represented by dantrolene
B. all of these drugs depolarize the muscle fiber before blockade occurs
C. calcium ions are released from the storage sites
D. there are two groups in this class: either depolarizing agents or nondepolarizing agents
E. botulinumtoxinA rapidly attaches to these receptors
69. 43. Succinylcholine is associated with which of the following actions? C
A. stimulation of the actin and myosin muscle fibrils directly
B. liver damage because the drug is metabolized only by the liver
C. peripheral neuromuscular receptor blockade after stimulating the Nm receptors
D. longer duration of action than vecuronium
E. stimulation of presynaptic ACH release
70. 44. Centrally acting skeletal muscle relaxants B
A. include dantrolene and cisatracurium
B. inhibit or reduce activity within the spinal cord (intraneuronal), interrupting the central stimulus to muscle contraction
C. can only be given parenterally
D. cause systemic release of histamine, leading to hypotension
E. counteract the effect of botulinumtoxin B
71. 45. Skeletal muscle relaxants may alter control of respiration because A
A. the diaphragm is a skeletal muscle
B. succinylcholine stimulates the respiratory centers in the brain
C. like dantrolene, all muscle relaxants inhibit the action of norepinephrine at the neuromuscular junction
D. relaxation of the muscles in the lower extremities pulls blood away from the lungs
E. all skeletal muscle relaxants interfere with calcium ion storage in the muscle
72. 46. Select the drug or condition(s) that decrease the effects of neuromuscular blockers. B
A. neomycin
B. corticosteroids
C. general anesthetics like isoflurane
D. alcohol
E. myasthenia gravis and spinal cord lesions
73. 47. Which of the following is a way in which skeletal muscles are relaxed? E
A. blockage of conduction in the spinal cord
B. inhibiting nerve transmission
C. blockage of the Nm receptors
D. decreasing ACH in the neuromuscular junction
E. all of these
74. 48. Select reasons for using muscle relaxants during surgical or diagnostic procedures. A
A. reduce muscle tear
B. decrease body temperature
C. potentiate vasodilators
D. increase muscle tone
E. depress respiration
75. 49. Which of the following is NOT a potential adverse effect of peripherally acting skeletal muscle relaxants? C
A. difficulty swallowing (dysphagia)
B. skeletal muscle weakness
C. decreased respiration
D. bronchospasm
E. muscle fasciculations
76. 50. In the presynaptic terminal of neuronal cells, the immediate trigger to release a neurotransmitter from synaptic vesicles C
into the synaptic cleft is
A) a drop in cytosolic Ca2+.
B) a drop in cytosolic K+.
C) a rise in cytosolic Ca2+.
D) a drop in cytosolic Mg2+.
E) a rise in cytosolic K+.
F) a rise in cytosolic Mg2+.
77. 51. A 17-year-old girl with suspected intrinsic asthma but nearly normal results on spirometry and flow volume testing takes B
a methacholine provocative test. The mechanism of action of methacholine most closely resembles that of
hemicholinium.
acetylcholine.
edrophonium.
succinylcholine.
neostigmine.
78. 52. The muscarinic receptor that couples to G proteins responsible for adenylyl cyclase inhibition and plays a key role in B
cholinergic input to the heart is classified as
muscarinic-M1 receptor.
muscarinic-M2 receptor.
muscarinic-M3 receptor.
muscarinic-M4 receptor.
muscarinic-M5 receptor.
79. 53. A 25-year old female presents with delirium, hyperthermia, and symptoms of central anticholinergic intoxication. She A
has attended a ìwitches' conventî and ingested some herbal extracts including fruits of the species ìAtropa belladonna.î As
one component of her treatment, she receives a dose of physostigmine.
Refer to the case above. Physostigmine is preferred over neostigmine because
A) it is a nonpolar compound that penetrates the CNS more easily than neostigmine.
B) it has a shorter half-life than neostigmine, making it more useful for emergency treatment.
C) it has a longer half-life than neostigmine, better matching the half-life of atropine.
D) it is eliminated via the kidneys, and dosage is not critical with compromised liver function.
E) it is eliminated via the liver, and dosage is not critical with compromised renal function.
80. 54. Which of the following is a correct statement? D
A. opioid analgesics produce little or no respiration depression with long-term use of analgesic doses
B. opioid antagonists include endorphins
C. all drugs in the opioid analgesic group are controlled substances, Schedule III
D. in low doses, opioids produce nausea and vomiting
E. fentanyl is a partial opioid antagonist
81. 55. Oxycodone in therapeutic doses can stimulate mu receptors to cause D
A. hyperventilation and deep breathing
B. bronchospasms
C. spasmogenic activity in the ureters and sphincter muscle
D. relaxation of the skeletal muscles controlling posture (spasmolytic)
E. suppression of coughing
82. 56. Opioid analgesics are used in which of the following settings? A
A. induction of Monitored Anesthesia Care and treatment of chronic severe pain
B. routine treatment of migraine
C. unmonitored treatment of chronic severe pain
D. analgesia for patients with paralytic ileus
E. chronic osteoarthritis
83. 57. Which of the following is a correct statement? C
A. endorphin is an abbreviation from the terms meaning inside the organ
B. endogenous opioid receptors include mu, alpha-2 adrenergic, and delta receptors
C. agonism means the drug occupies the receptor and causes a response
D. opioid agonism means the drug occupies the receptor and stimulates the release of endorphins
E. tolerance is a characteristic of chronic opioid antagonism
84. 58. Which of the following drugs has a recognized medical therapy and does not interact with opioid receptors? D
A. heroin
B. codeine
C. methadone
D. acetaminophen
85. 59. All opioid analgesics are associated with which of the following? D
A. reversal of respiratory depression from barbiturates
B. use only for the relief of acute pain
C. cough suppression alone or in combination with other analgesics over-the-counter
D. tolerance develops to the analgesic response
E. drug of choice in treating biliary obstruction
86. 60. Fentanyl is an opioid analgesic that A
A. can be used for relief of cancer pain
B. has many formulations (lozenge, film) because it is used routinely in dental surgery
C. induces neuropathic pain
D. primarily works on peripheral nerve endings rather than higher centers
E. does not have a black box warning because of its low addiction potential
87. 61. Sharp pain is transmitted through which type of nerve fibers? B
A. unmyelinated
B. myelinated A-delta
C. CTZ
D. C fibers
E. mu fibers in the intestine
88. 62. Opioid drugs are derived from which of the following? E
A. poppy
B. opium
C. chemical synthesis
D. alkaloids
E. all of these
89. 63. Select the adverse effects of opioid analgesics. A
A. constipation
B. polyuria
C. convulsions
D. mydriasis
E. excessive tearing
90. 64. During tolerance to opioid analgesics, the following is happening. A
A. fewer receptors are available to produce a response
B. increased pain by the patient requires greater doses of medication
C. the body reacts to removal of the opioid analgesic
D. histamine release causes hypotension
E. signals from nocieocptors are reduced
91. 65. What is the best reason for using a balanced anesthesia strategy? (LO 18.1) A
A. producing complementary effects using a few drugs avoids unnecessary intense (deep) CNS depression with one
anesthetic to achieve the same effect
B. the concentration of volatile anesthetic in the alveoli is balanced against the amount of anesthetic in the blood
C. less monitoring of anesthesia is required
D. fewer patients experience emergence delirium
E. there is less chance of aspirating saliva
92. 66. Why is propofol a drug of choice for induction and maintenance of anesthesia? C
A. it is a potent analgesic at all doses
B. it slowly brings the patient to the stage of surgical anesthesia
C. it is a complete anesthetic with a quick onset of action and recovery period uncomplicated by nausea and vomiting
D. it is administered by special vaporizer to avoid mask delivery
E. its preparation does not require special handling technique
93. 67. Which of the following is NOT correct? A
A. ketamine causes chloride ions to flow out of the nerve cell by binding to GABA
B. propofol binds to the GABA A receptor and enhances hyperpolarization of the neuron
C. barbiturates and propofol act on the receptor and directly on the chloride channel
D. potent anesthetics enhance GABA A receptor function
E. general anesthetics interact with neurotransmitter-gated ion channels
94. 68. Which of the following major routes remove etomidate and midazolam from the body? A
A. hepatic metabolism and renal excretion
B. excretion through the lungs and sweating
C. accumulation in fat tissue and redistribution
D. increased salivation and bile production
E. gastrointestinal reabsorption
95. 69. Select the types of anesthesia in which there is no loss of consciousness. A
A. local anesthesia
B. Monitored Anesthesia Care
C. general anesthesia
D. balanced anesthesia
E. maintenance anesthesia
96. 70. Choose the correct class of general anesthetics. A
A. intravenous
B. dissociative anesthesia
C. oral
D. topical
E. epidural
97. 71. Which drugs would be used as adjunct therapy to anesthesia? E
A. analgesics
B. antiarrhythmics
C. antianxiety, short-acting CNS depressants like midazolam
D. anticholinergics
E. all of these
98. In order for drugs to cross the blood-brain barrier, they must be D
A. ionized
B. positively charged
C. water soluble
D. lipid soluble
E. negatively charged
99. The pharmacologic effects of TCAs include E. all of the above
A. alpha-adrenergic blockade
B. antihistaminic
C. anticholinergic
D. sedation
E. all of the above
100. . The drug administration route demonstrating the slowest onset of action is B
A. inhalation
B. transdermal
C. intramuscular
D. sublingual
E. intravenous