Module 4: Pharmacology-Pharmacokinetics

2. Which of the following are the reason/s for formulating prodrugs?

I. Improve bioavailability of the drug

II. Decrease cost of the drug

III. Promotes site-specific delivery of the drug

a. I & II

b. I, II & III

c. I & III

d. I

3. The intensity of the pharmacological action of the drug is most dependent on ____________.

a. Concentration of the drug at the receptor site

b. Onset of action

c. Protein binding

d. Volume of distribution

4. Drugs with “wide” therapeutic window means that the drug is ____________.

a. Less potent

b. More potent

c. Less safe

d. More safe

5. Four identical animals were treated with mg doses of the following toxins. (refer to the choices below with their corresponding

LD50), Which would most likely cause death to the animals?

a. Toxin AB (LD50 = 5mg/kg)

b. Toxin CD (LD50 = 1,500mg/kg)

c. Toxin EF (LD50 = 8,000mg/kg)

d. Toxin GH (LD50 = 0.00001 mg/kg)

6. Two drugs that act on the same tissue or organ through independent receptors resulting in effects of opposite directions is

known as ____________.

a. Physiologic antagonism

b. Irreversible antagonism

c. Competitive antagonism
 d. Chemical antagonism

7. A drug was shown to reverse the action of a particular neurotransmitter. It appears to interact directly with the neurotransmitter

and not at all with the neurotransmitter’s receptors. Which of the following BEST describes the drug?

a. Chemical antagonist

b. Physiologic antagonist

c. Pharmacologic antagonist

d. Partial agonist

8. Which of the following describes the action of Protamine against Heparin?

a. Physiologic antagonism

b. Competitive antagonism

c. Irreversible antagonism

d. Chemical antagonism

9. Drug of choice for cholera:

a. Gentamicin

b. Erythromycin

c. Doxycycline

d. Mebendazole

10. Decreased oral absorption of drug due to high stomach pH would result to:

a. Decreased gastric toxicity of the drug

b. Decreased bioavailability of the drug

c. Increased bioavailability of the drug

d. Increased clearance of the drug

11. Human milk is more acidic than the plasma. Which of the following statements are true given this condition?

I. Weak acid may diffuse into the breast milk and ionize.

II. Weak acid may diffuse into the breast milk and remain unionized.

III. Weak base may diffuse into the breast milk and ionize.

IV. Weak base may diffuse into the breast milk and remain unionized

a. II & III

b. II & IV

c. I & III

d. I & IV

12. Which of the following are factors affecting the systemic availability of a drug?

I. Intestinal motility

II. Hepatic first pass effect

III. Absorption after oral dosing

 a. I & II

b. I & III

c. I, II & III

d. I & III

13. Which of the following is TRUE if there is a significant difference between the oral and parenteral doses of the same drug; for

example, oral dose (tablet) is 40 mg vs. IV dose of 4 mg?

a. Drug preparation has fast rate of dissolution.

b. Drug has very good absorption at the GI tract.

c. Drugs undergoes significant first-pass effect.

d. Drug preparation has fast disintegration rate.

14. Drugs with VERY HIGH volumes of distribution are those that have ____________.

a. Higher concentrations in the extravascular tissue than in the vascular compartments.

b. Higher concentrations in the vascular compartments than in the extravascular tissue.

c. Lower concentrations that will be absorbed after oral administration.

d. Higher concentrations that will be absorbed after oral administration.

15. Pharmaceutical equivalent drug products must have the same ____________.

I. Therapeutically active drug ingredients

II. Salts or ester

III. Dosage form and strength

a. I, II & III

b. I

c. II

d. III

16. In neonates, where there is a relative decrease in serum proteins, which of the following will be true if a highly protein bound

drug is administered to this type of patients?

a. Decreased protein binding, resulting in a greater free fraction of the drug

b. Increased protein binding, resulting in a reduced free fraction of the drug

c. Increased protein binding, resulting in a greater free fraction of the drug

d. Decreased protein binding, resulting in a reduced free fraction of the drug

17. Drug metabolism happens in most cases, to convert the drug to a compound that is ____________.

I. More polar

II. More non-polar

III. More lipid-soluble

IV. More water-soluble

a. II & III
 b. I & IV

c. I & III

d. II & IV

18. Phenylephrine and amphetamine are: ____________

a. adrenergic antagonists

b. adrenergic agonists

c. cholinergic antagonists

d. cholinergic agonists

19. Isoniazid undergoes what type of conjugation reaction?

a. Glycine Conjugation

b. Acetylation

c. Glucuronidation

d. Methylation

20. Pharmacokinetic variations in drug metabolizing enzymes (DME’s) are considered significant if ____________.

I. Active metabolites are formed.

II. The drug has a very wide margin of safety.

III. The parent drug is a prodrug that requires activation by DMEs’.

a. I & III

b. I, II & III

c. III

d. II

21. The enzyme capacity in newborns and infants is reduced. What possible effects would this have on clearance and

elimination half-life of drugs?

a. Increase in clearance and decrease in elimination half-life

b. Increase in clearance and increase in elimination half life

c. Decrease in clearance and decrease in elimination half-life

d. Decrease in clearance and increase in elimination half-life

22. Which of the following is/are true regarding 1st order kinetics?

I. The drug is distributed to only a compartment outside the vascular system.

II. Half-life is the same regardless of plasma concentration.

III. Rate of elimination is proportional to the rate of administration only at steady state.

a. II & III

b. II

c. I

d. III
23. What is the order of the reaction if the concentration of the drug is decreasing at a rate that is proportional to the

concentration of the drug remaining?

a. Zero

b. Third

c. First

d. Second

24. Which of the following refers to the process that distinguishes ethanol from the elimination of most other drugs?

a. First Order Elimination

b. Biliary Excretion

c. First Pass Effect

d. Zero Order Elimination

25. The following are true regarding patients with renal impairment EXCEPT:

a. They have reduced requirement for drugs that are directly excreted by the kidneys.

b. The elimination of renally cleared drugs is increased.

c. Adjustments can be done by prolonging dose-intervals.

d. The serum creatinine levels are higher than the reference value.

26. Which of the following are true for half-life?

I. Increases as volume of distribution increases.

II. Decreases as volume of distribution increases.

III. Increases as clearance increases.

IV. Decreases as clearance increases.

a. II & III

b. I & IV

c. II & IV

d. I & III

27. What percent of the drug is removed per hour if the elimination rate constant is 0.25/hr?

a. 25

b. 0.25

c. 75

d. 0.75

28. What is the mechanism of action of sympathomimetic drugs?

a. Metabolic transformation by the same pathway as the precursor of the neurotransmitter.

b. Mimicry of the neurotransmitter at the post-synaptic receptor.

c. Prevention of the release of the neurotransmitter.

d. Interference with the synthesis of the neurotransmitter.

29. Adrenergic peripheral responses are mediated by what type of receptors?

I. Alpha

II. Beta

III. Muscarinic

a. I & II

b. I, II & III

c. II & III

d. I & III

30. Which of the following is TRUE regarding the effects of adrenergic agonists on peristalsis?

a. No effect

b. Decrease in peristalsis

c. Either increase or decrease in peristalsis

d. Increase in peristalsis

31. Which of the following is/are TRUE regarding Botulinum toxin?

I. It is a toxin produced by a fungus.

II. It is a neurotoxic agent.

III. It is commercially used as a medicine.

a. II

b. I, II & III

c. II & III

d. I

32. Most of the drugs used in the treatment of Alzheimer’s disease are designed to produce ____________ effects.

a. Serotoninergic

b. Sympathetic

c. Cholinergic

d. Dopaminergic

33. Tamsulosin acts selectively on what type of receptor?

a. Beta-2

b. Alpha-1

c. Beta-1

d. Alpha-2

34. Which of the following drugs should a patient avoid if he has previously experienced an allergic type of reaction to aspirin?

I. Naproxen

II. Paracetamol

III. Ketoprofen
 a. I & III

b. I & II

c. I, II & III

d. II & III

35. Which of the following can reverse the action of lead and other heavy metals?

a. Succimer

b. Atropine

c. Flumazenil

d. Naloxone

36. Which of the following agents used in the treatment of diarrhea is/are opioid derivative/s?

I. Loperamide

II. Attapulgite

III. Diphenoxylate

a. I

b. I & II

c. I & III

d. I, II & III

37. The following are signs and symptoms of Organophosphate poisoning EXCEPT:

a. Diarrhea

b. Tachycardia

c. Miosis

d. Salivation

38. The following are effects of Atropine EXCEPT:

a. Dryness of mouth

b. Dilation of pupils

c. Decrease in heart rate

d. Inhibition of sweating

39. Which of the following is the action of Dantrolene?

a. Agonizes dopamine-2 receptors

b. Causes sustained depolarization of neuromuscular end plates leading to spastic paralysis

c. Inhibits calcium release from sarcoplasmic reticulum from skeletal muscles

d. Antagonizes nicotinic receptors of skeletal muscles

40. Which of the following can increase the risk of bleeding due to Warfarin in relation to its PK profile?

I. Displacement from its protein carriers.

II. Prolongation of binding to its protein carriers.

 III. Inhibition of its hepatic metabolism.

IV. Induction of its hepatic metabolism.

a. I & IV

b. II & IV

c. I & III

d. II & III

41. Which of the following drugs can INCREASE the risk of bleeding when combined with Warfarin?

I. Anti-thyroid agents

II. Anti-platelets

III. Anti-thrombotics

a. I, II & III

b. I & III

c. I & II

d. II & III

42. The following would require the need to review the dose, or stop administration of Warfarin EXCEPT:

a. Elevated baseline INR

b. Increased Paracetamol dose

c. Increased Vitamin K intake

d. Low hemoglobin/hematocrit level

43. Adenosine is classified as a/an ____________.

a. Diuretic

b. Tocolytic

c. Anti-diabetic

d. Anti-arrhythmic

44. Which of the following is also known as the growth hormone-inhibiting hormone? It’s therapeutic use is targeted on blocking

hormone release in endocrine secreting tumors.

a. Simvastatin

b. Somatostatin

c. Gonadotropin

d. Somatropin

45. Which of the following are inhaled corticosteroids?

a. Dexamethasone and Fluticasone

b. Prednisone and Budesonide

c. Formoterol and Dexamethasone

d. Fluticasone and Budesonide

46. The following are asthma inflammation controllers EXCEPT:

a. Leukotriene modifiers

b. Inhaled corticosteroids

c. Beta agonists

d. Mast cell stabilizers

47. Which of the following anti-hypertensives does not act at autonomic receptors?

a. Terazosin

b. Carvedilol

c. Clonidine

d. Hydralazine

48. Sulfonylureas are the primary mode of therapy in the treatment of ____________.

a. Diabetic pregnant women

b. Non-insulin dependent diabetes mellitus patients

c. Insulin-dependent diabetes mellitus patients

d. Patients with diabetic ketoacidosis

49. Which of the following is the main adverse effect of insulin?

a. Hypoglycemia

b. Hyperglycemia

c. Bone marrow suppression

d. Hepatotoxicity

50. Which of the following is a synthetic analogue of the human amylin that reduces post-prandial glucagon secretion?

a. Metformin

b. Sitagliptin

c. Pramlintide

d. Exenatide

51. Which of the following preparations is a peakless insulin?

a. Insulin Lispro

b. Insulin Glargine

c. Insulin Glulisine

d. NPH Insulin

52. Which of the following ingredients of a cough and cold preparation is classified as a decongestant?

a. Guaifenesin

b. Phenylpropanolamine

c. Chlorpheniramine

d. Dextromethorphan
53. Drugs commonly known as Setrons are used as:

a. Muscle relaxants

b. Anti-emetics

c. Ant-parkinsonism

d. Anti-neutropenics

54. Which of the following drugs is/are antimicrobial agents?

I. Anti-viral

II. Anti-bacterial

III. Anti-helminthic

a. II

b. III

c. I & II

d. I, II & III

55. Which of the following is not a beta-lactamase inhibitor?

a. Aztreonam

b. Clavulanic Acid

c. Sulbactam

d. Tazobactam

A patient is treated at the Emergency Room for an infection. She has an allergy to Penicillin that was documented in her medical

chart.

56. If an antimicrobial is being considered for this patient, which of the following may cause cross-sensitivity?

a. Azithromycin

b. Clindamycin

c. Levofloxacin

d. Piperacillin-Tazobactam

57. If the patient was inadvertently given Penicillin inspite of the documented allergy, which of the following BEST describes the

incident?

a. Medication Error – Omission Error

b. Adverse Drug Reaction - Type A

c. Medication Error – Commission Error

d. Adverse Drug Reaction – Type B

58. Ceftazidime belongs to what group of cephalosporins?

a. 1st

b. 4th

c. 2nd
 d. 3rd

59. Which of the following is a known adverse effect associated with the use of Chloramphenicol?

a. Staining of the teeth

b. Alopecia

c. Phototoxicity

d. Aplastic anemia

60. Which of the following is the adverse effect associated with Streptomycin?

a. Peripheral neuritis

b. Ototoxicity

c. Optic neuritis

d. Hepatitis

61. Which of the following drugs is primarily used for the treatment of severe infections caused by gram negative bacteria?

a. Gentamicin

b. Vancomycin

c. Doxycycline

d. Cefalexin

62. Arrange the following route of toxin delivery in order, from MOST effective to LEAST effective:

I. Oral

II. Intravenous

III. Subcutaneous

IV. Inhalation

V. Dermal

a. II, III, IV, I, V

b. II, IV, III, I, V

c. IV, II, III, V, I

d. IV, III, II, V, I

63. Poisons may enter human body through the following routes of exposure:

I. Orally by ingestion

II. By inhalation

III. From mother to infant via transplacental route

a. I & II

b. II & III

c. I & III

d. I, II & III

64. Which of the following is depleted when there is Paracetamol overdose consequently causing its toxicity?
 a. S-adenosylmethionine

b. N-acetyl-p-benzoquinoneimine

c. Glutathione

d. Acetyl CoA

65. Which of the following can be administered to the patient for Acetaminophen poisoning?

a. N-acetylcysteine

b. Dimercaprol

c. Succimer

d. Pralidoxime

66. What vitamin can be used to treat cyanide poisoning?

a. Vitamin K

b. Vitamin C

c. Vitamin B12

d. Vitamin B6

67. Which of the following is the main physical hazard when administering drugs with vesicant properties?

a. Hypothermia

b. Air embolism

c. Extravasation

d. Thrombosis

68. Which of the following IV solutions given to the patient is a colloid?

a. 5% Dextrose in Lactated Ringer’s Solution

b. 5% Human Albumin Solution

c. 0.9% NaCl Solution

d. Dobutamine Hydrochloride in 5% Dextrose Injection Solution

69. Which of the following statements are TRUE regarding the similarities of Phenytoin and Phenobarbital?

I. They have anti-epileptic effects.

II. They are enzyme inhibitors.

III. They both have low therapeutic indices.

a. I & II

b. II & III

c. I & III

d. I, II & III

70. Which of the following would be the expected interaction between vasopressors and the beta blockers relative to a patient’s

blood pressure?

a. Synergism
 b. Potentiation

c. Antagonism

d. Additive

71. Compute for the Volume of Distribution of the drug in L if the patient received a single intravenous dose of 200mg of a drug

substance that produced an immediate blood concentration of 10mcg/mL.

a. 20L

b. 0.5L

c. 500L

d. 0.2L

72. Which of the following is a vasopressor?

a. Lidocaine

b. Amiodarone

c. Norepinephrine

d. Desmopressin

73. Which of the following neurotransmitters will be increased by Rivastigmine in the central nervous system synapses?

a. Dopamine

b. Acetylcholine

c. Epinephrine

d. Serotonin

74. Gabapentin is used for what indication?

a. Antidote for Lead poisoning

b. Anti-arrhythmia

c. Anti-convulsant

d. Anti-cancer

75. Which of the following is a synthetic analogue of human glucagon-like polypeptide-1 that increases insulin secretion and

reduces glucagon secretion?

a. Sitagliptin

b. Empagliflozin

c. Exenatide

d. Pramlintide

76. Which of the following is known to cause chemotherapy-induced cardiotoxicity?

a. Bleomycin

b. Amifostine

c. Doxorubicin

d. Cisplatin
77. All of the following statements regarding drug transport are true EXCEPT:

a. High molecular weight drugs diffuse across cell membrane more easily than low molecular weight drugs.

b. Drugs bound to proteins do not easily cross cell membranes.

c. Lipophilic drugs cross cell membranes more easily than hydrophilic drugs.

d. Drugs maybe transported by passive diffusion, carrier-mediated, paracellular or vesicular transports.

78. Which of the following pairings of an unwanted effect and the causative drug are TRUE?

I. Headache with Nitrates

II. Cough with Irbesartan

III. Lupus-like syndrome with Hydralazine

a. I & III

b. II & III

c. I

d. I, II & III

79. Which of the following NSAIDs have the shortest half-life?

a. Ibuprofen

b. Piroxicam

c. Naproxen

d. Sulindac

80. Which of the following will enhance the excretion of an alkaline poison in the urine?

a. Probenecid

b. Urinary Acidifier

c. Urinary Alkalinizer

d. Inulin

81. Which of the following drugs is an example of a mixed adrenergic antagonist?

a. Terazosin

b. Carvedilol

c. Clonidine

d. Hydralazine

82. Which of the following statements is CORRECT?

a. The greater the efficacy, the more potent the drug.

b. If 1 mg of drug A produces the same response as 10mg of Drug B, Drug A is more effective than Drug B.

c. In selecting a drug, potency is usually more important than efficacy.

d. If 1 mg of Drug A produces the same response as 10mg of Drug B, Drug A is more potent than Drug B.

83. Which of the following are TRUE regarding Dextromethorphan?

I. Highly effective anti-emetic

 II. No appreciable analgesic activity

III. Effective antitussive

IV. Causes less constipation than codeine

a. I & IV

b. II, III, IV

c. II & III

d. I, II, III & IV

84. Which of the following equations is used to compute for the patient’s creatinine clearance?

a. Michaelis-Menten Equation

b. Cockroft and Gault Equation

c. Harris-Benedict Equation

d. Henderson-Hasselbalch Equation

85. What is the main difference between 2nd generation and 1st generation H1 receptor antagonists?

a. 2nd generation agents are non-sedating at therapeutic doses

b. 2nd generation agents do not cause GIT irritation

c. 2nd generation agents are cheaper

d. 2nd generation agents are useful in preventing motion-sickness

86. According to the Singh-Vaughan-Williams Classification, Verapamil is:

a. Class I

b. Class II

c. Class III

d. Class IV

87. Based on the figure below, which of the following new drugs would be the most potent?

a. B

b. C

c. D

d. A
88. Which of the following statements are TRUE regarding eicosanoids?

I. Arachidonic acid is the most abundant eicosanoid precursor.

II. Lipoxygenase catalyzes the formation of leukotrienes.

III. Cyclooxygenase produces both prostaglandins and thromboxane.

a. I & II

b. II & III

c. I & II

d. I, II & III

89. Which of the following is an ergot derivative used for the treatment of idiopathic parkinsonism?

a. Bromocriptine

b. Morphine

c. Aspirin

d. Ipratropium

90. Which of the following is useful in treating ascites and pulmonary edema? The principal site of action is on the thick

ascending limb of the loop of Henle.

a. Hydrochlorothiazide

b. Acetazolamide

c. Spirinolactone

d. Furosemide

91. Which of the following is NOT an antiviral drug?

a. Nevirapine

b. Terbinafine

c. Lamivudine

d. Tenofovir

92. In the management of a poisoned patient, what is the rationale for administering activated charcoal?

a. Chelates the poison to form more water-soluble complexes for faster excretion

b. Directly prevents the formation of toxic metabolites from the poison

c. Counteracts the toxic effects of the poison by producing an opposing pharmacological effect

d. Prevents further absorption of the poison

93. Vitamin B12 is indicated for:

a. Pernicious Anemia

b. Megaloblastic Anemia

c. Hypochromic Microcytic Anemia

d. Aplastic Anemia

94. Which of the following monoclonal antibody is a tumor necrosis factor-alpha blocker?
 a. Omalizumab

b. Infliximab

c. Vedolizumab

d. Reslizumab

95. Which of the following drugs are uric acid synthesis inhibitors?

I. Lesinurad

II. Allopurinol

III. Febuxostat

IV. Rasburicase

a. I & IV

b. II

c. II & IV

d. II & III

96. Ivabradine is properly classified as a/an

a. spasmolytic

b. cardiac drug

c. anti-sialogogue

d. anti-microbial

97. According to the Singh-Vaughan-Williams classification, Amiodarone is:

a. Class IV

b. Class III

c. Class II

d. Class I

98. Aside from seizures, Pregabalin is used for:

a. Hyperglycemia

b. Diarrhea

c. Asthma

d. Neuropathy

99. Which of the following agents has an active metabolite that is capable of neprilysin inhibition?

a. Sacubitril

b. Aliskiren

c. Ticagrelor

d. Nesiritide

100. The following anticoagulants are factor X inhibitors EXCEPT:

a. Enoxaparin
 b. Rivaroxaban

c. Vorapaxar

d. Fondaparinux

101. Selegiline is a drug used for:

a. Parkinson’s Disease

b. Alzheimer’s Disease

c. Myasthenia Gravis

d. Depression