1.

The ANS subserves the following functions except

a. Neuromuscular contraction of skeletal muscles
b. Neuromuscular contraction of smooth muscles
c. Exocrine gland secretion
d. Homeostasis
e. Energy metabolism
2. Which of the following tissues possesses parasympathetic innervation?
a. Sweat gland
b. Coronary arteries
c. Atrioventricular node
d. Myocardium
e. Epidermis
3. Which of these is not cholinergic in nature?
a. Preganglionic parasympathetic neurone
b. Postganglionic sweat gland fibres
c. Postganglionic sympathetic neurone
d. Postganglionic parasympathetic neurone
e. Preganglionic sympathetic neurone
4. Which is not a response to alpha 1 agonist administration?
a. Salivation
b. Mydriasis
c. Increased vascular resistance
d. Widened palpebral fissure
e. Piloerection
5. Which of the following is a type of simple diagnostic techniques in pharmacology?
a. Dipstick technique
b. Immunoassay
c. Thin Layer Chromatography
d. Mass Spectrometry
e. Gas chromatography
6. Which of the following is not type of immunoassay?
a. Radioimmunoassay
b. Enzyme immunoassay
c. Fluoroimmunoassay
d. Chemiluminescence immunoassay
e. Luminescent oxygen channeling immunoassay
7. Thin Layer Chromatography can be used to screen for the following except
a. Drug overdose
b. Aminoaciduria
c. Galactosuria
d. Determination of L/S ratios
e. Hydrogen sulphide quantification
8. Concerning Phase 1 clinical trials, which is untrue?
a. Single ascending dose regime may be employed
b. Multiple ascending dose regime may be the study model
c. Food effect may be tested
d. Large number of healthy volunteers used
e. Maximum tolerated dose is reached
9. Concerning Phase 3 clinical trials, which is untrue?
a. Are randomized, controlled, multicenter trials
b. Meant to provide long term safety data
c. Study thousands of volunteers who have the condition
d. Study period usually less than a year
e. Determine efficacy and monitor adverse reactions in ill volunteers
10. Concerning the following statements, which is untrue?
a. Drug is any substance or product that is used or is intended to be used to modify or
explore physiological systems or pathological states for the benefit of the recipient
b. Drug dependence is a compulsion to take a drug to experience its psychic effect and
sometimes to avoid the discomfort of withdrawal symptoms.
c. Drug addiction is a chronic relapsing brain disease that is characterized by compulsive
drug seeking and use, despite harmful consequences.
d. Tolerance describes the decrease in pharmacological effect on repeated administration
of a drug.
e. Psychoactive drugs are generally unaddictive.
11. Concerning the following statements on drug addiction, which is untrue?
a. Feeling of having to use drug regularly as prescribed by the physician.
b. Having intense urges for the drug that block out any other thought.
c. Over time, needing more of the drug to get the same effect.
d. Taking large amount of the drug over a longer period of time than you intended.
e. Experiencing withdrawal syndromes when one attempts to stop taking the drug.
12. Roots of administration that avoid "first-pass" hepatic effects
a. Sublingual
b. Oral
c. Transdermal
d. Lower rectal suppositories
e. Inhalation
13. Sources of drugs include the following except
a. Natural sources
b. Semisynthetic sources
c. Synthetic sources
d. Research laboratories
e. Biosynthetic sources
14. A rectal suppository is used to treat a fever. This would represent what type of drug delivery?
a. Parenteral and local
b. Parenteral and systemic
 c. Enteral and local
d. Enteral and systemic
e. Subcutaneous and systemic
15. The following statements about synthetic drugs are correct except
a. Are made by alterations to the naturally found structure of the drug to improve its
effect
b. Easy production of more effective drug by modification of the chemical structure of the
prototype
c. Chemically pure
d. Few of the drugs used in clinical practice
e. Ease of production with reduced cost
16. Are the following statements true or false?
a. In pharmacology, the word ‘agonist’ describes a drug that binds or interacts with its
biological receptor but produces no effect. F
b. An antagonist may be described as competitive or non- competitive. T
c. The pharmacological action of a drug varies significantly among individuals. T
d. A pro- drug describes a drug that is pharmacologically inactive until it reaches the
liver and is metabolized. T
e. Drugs administered intravenously (IV) are considered to have 100% absorption into
the systemic circulation. T
17. Materia medica, which is the science of drug preparation and the medical used of the
drugs. Which began to develop as precursor refers to
a. Pharmacology
b. Environmental pharmacology
c. Pharmacokinetics
d. Toxicology
e. Pharmacology history
18. The study of substances (drugs) that interacts with living systems through chemical processes
refers to
a. Pharmacodynamics
b. Environmental pharmacology
c. Pharmacokinetics
d. Pharmacology
e. Clearance
19. Which of the following statement is not correct?
a. Adverse drug reaction is a noxious and unintended response to a medicine that occurs
at normal therapeutic doses used in humans.
b. Side effect is any intended effect of a pharmaceutical product occurring at normal
therapeutic doses and is related to its pharmacological properties.
c. Serious adverse effect is any untoward medical occurrence that occurs at any dose and
results in death, requires hospital admission or prolonged hospital stay, results in
persistent or significant disability, or is life threatening
d. Adverse drug event is any untoward medical occurrence that may be present during
treatment with a medicine but does not necessarily have a causal relationship with this
treatment. Adverse drug events include medication errors and overdoses
 e. Medication error is the administration of a medicine or dose that differs from the
written order
20. The following are mechanisms of adverse drug events occurrence except
a. Direct toxicity of parent drug
b. Hypersensitivity reactions always occur in line with the pharmacological mechanism of
the inciting drug
c. Due to the pharmacokinetic and pharmacodynamic alterations of the drug products
d. Toxicity reactions attributed to the toxic effects of a drug metabolites
e. An exaggerated response to a drug or its metabolites
21. Concerning Type A adverse drug reaction, which is incorrect?
a. Can be predicted on the base of pharmacodynamic properties of drug
b. Depend on drug dose, they appear at higher doses
c. Frequency of occurrence is low
d. Mortality is low
e. Therapy consists in dose adjustment
22. Concerning Type B adverse drug reaction, which is incorrect?
a. Immunologic and idiosyncratic reactions
b. Can be hardly predicted
c. Mortality is low
d. Treatment consists in stopping drug administration
e. Haemolytic anaemia after methyldopa is an example
23. Which of the following is untrue concerning immunologic type adverse drug reactions?
a. Type 1 is IgE mediated
b. Haemolytic anaemia from penicillin administration is a Type 2 reaction
c. Type 3 reaction is cytotoxic immunologic reaction
d. Type 4 is a delayed immunologic response adverse drug reaction
e. Drug induced lupus-like reaction is immunologically mediated
24. The following are drug related risk factors associated with the occurrence of adverse drug
reaction except
a. Drugs that are nonselective and nonspecific
b. Drugs with narrow therapeutics range
c. Lipophilic drugs
d. Nonprescription drugs
e. Controlled medicines
25. The following are patient related risk factors associated with the occurrence of adverse drug
reaction except
a. Polymorbidity
b. Diseases of organs of elimination
c. Extremes of age
d. Pharmacokinetic variability
e. Being male
26. The following are prescription related risk factors associated with the occurrence of adverse
drug reaction except
a. Wrong selection of drug
b. Wrong drug combination
c. Underdosage is most commonly associated
d. Wrong route of administration
e. Therapy length
27. Which of the following statements concerning the development of adverse drug reaction is
untrue?
a. Many drugs can be passed from mother to infant via breast milk leading to adverse
reactions in the newborn
b. Genetic polymorphisms may play a role
c. Quinolones is characterized with higher risk of hemolysis in some populations, such as
African, middle eastern, and southeast Asian races
d. Metabolism of prodrugs may be impaired with hepatic disease leading to severe
adverse reactions
e. Renal insufficiency can result in too high drug levels which may become toxic
28. The following drugs are hepatic enzymes inducers except
a. Phenytoin
b. Carbamazepine
c. Omeprazole
d. Rifampicin
e. Alcohol
29. The following drugs are hepatic enzymes inhibitors except
a. Valproate
b. Disulfiram
c. Erythromycin
d. Isoniazid
e. Barbiturates
30. The following are factors contributing to drug interactions except
a. Multiple drug therapy.
b. Multiple prescribers.
c. Multiple pharmacological effects of drug.
d. Multiple diseases or predisposing illness.
e. Patient compliance.
31. Most clinically significant absorption drug interaction occurs due to the following factors except
a. Changes in gastrointestinal pH
b. Changes induced by chelation and adsorption
c. Changes in gastrointestinal motility
d. Transporter based interactions
e. Changes in normal microflora components of the site of drug absorption
32. Which of the following statement is correct?
 a. Inhibition of a cytochrome P450 enzyme decreases the concentration of some drugs by
decreasing their metabolism.
b. Clarithromycin is a strong inducer of CYP3A-catalysed simvastatin metabolism.
c. Drug inhibition of cytochrome P450 enzymes is also used therapeutically.
d. Inhibition of a cytochrome P450 enzyme decreases the concentration of some drugs by
decreasing their metabolism.
e. Carbamazepine is a strong inhibitor of CYP3A that decreases the metabolism of the
combined oral contraceptive.
33. Concerning pharmacodynamic drug–drug interactions which of the following statements is not
correct.
a. They are often intentional.
b. Unintentional harmful interactions are particularly common with multiple drugs acting
on the central nervous system.
c. These interactions occur between drugs with additive or opposing effects.
d. The brain is the organ least compromised by pharmacodynamic interactions because
of the protective effect of blood brain barrier.
e. Pharmacodynamic interactions are relatively common in practice and occur when a
precipitant drug alters the clinical effects of the object drug at its site of action.
34. Concerning influence of food on drug interactions, which is not correct.
a. Food affects the rate and extent of absorption of drugs from the GI tract.
b. Many antibiotics should be given at least 1hr before or 2hr after meals to achieve
optimal absorption.
c. The type of food may be important regarding the absorption of concurrently
administered drugs.
d. Dietary items such as milk and other dairy products that contain calcium may
enhances the absorption of tetracycline and fluoroquinolone derivatives.
e. The mean % of the time patients were responding satisfactorily to levodopa was 51% for
high-protein diet, 67% for low-protein diet over 3 meals, 77% for low-protein diet
restricted to evening meal.
35. Which of the following statement is incorrect?
a. Drugs with a narrow therapeutic index are particularly susceptible to pharmacokinetic
drug–drug interactions.
b. Any interactions between existing drugs in each patient might have already occurred.
c. Pharmacogenetics may identify subsets of patients who will have a remarkably high or
an incredibly low likelihood of responding to an agent.
d. Chemogenomic is the systematic screening of targeted chemical libraries of small
molecules against individual drug target families with the goal of identification of novel
drugs and drug targets.
e. Pharmacogenetics is widely utilized in clinical practice.
36. The following substances are metabolise by CYP1A2 except
a. Clozapine
b. Olanzapine
 c. Fluvoxamine
d. Nicotine
e. John’s wort
37. Phenytoin induces the following enzymes except
a. CYP2E1
b. CYP1A2
c. CYP2C9
d. CYP2C19
e. CYP3A4
38. The following drugs predispose to impotence except
a. Methyldopa
b. Thiazide diuretics
c. Beta blockers
d. Vardenafil
e. Risperidone
39. Which of the following are causes related to medication errors?
a. Medicine prescribed but not given T
b. Administration of a medicine not prescribed T
c. Medicine given to the wrong patient T
d. Wrong medicine or IV fluid administered T
e. Wrong dosage form given T
40. The following are factors associated with medication errors
a. Heavy staff workload and fatigue T
b. Inexperience, lack of training, poor handwriting, and oral orders T
c. Poor lighting, noise, interruptions, excessive workload T
d. Confusing medicine nomenclature, packaging, or labeling T
e. Increased number or quantity of medicines per patient T
41. The following are types of pain except
a. Psychological pain
b. Neurogenic pain
c. Nociceptive pain
d. Idiopathic pain
e. Reciprocal pain
42. Which of the following give objective pain indication?
a. Patient’s rating
b. Guardian’s rating
c. Physician’s rating
d. Nurse’s rating
e. Electrical pain studies
43. The following are appropriate therapy for pain except
a. Transcutaneous electrical nerve stimulation
b. Psychotropic drugs
 c. Opiate analgesia
d. Nonsteroidal anti-inflammatory agents
e. Parasympatholytic therapy
44. The following statements are true about half-life (T1/2) except
a. T1/2 will depend on both the volume of distribution and the clearance T
b. If a drug has intermediate t1/2, it’s may be given 2 to 4 times daily T
c. It requires about 5 t1/2s to removes a drug completely from the body T
d. T1/2 will depend only on the volume of distribution F
e. It requires about 4 to 5 t1/2s to removes a drug completely from the body. T
45. Which are correct concerning receptors for neurotransmitters or hormones?
a. Are always located in the surface membrane of the cell. F
b. Are proteins. T
c. Play no role in ion channel.
d. have zero affinity for antagonist F
e. Can by activated only by an endogenous compound. F
46. Consider the following statement, which is untrue?
a. There is a dose-response relationship for therapeutic response but not adverse effects
b. Most drugs exert effects on several organs or tissues T
c. Pharmacodynamics describes the relationship of drug concentration and the biologic
effect T
d. Pharmacokinetics describes the time course of drug absorption, distribution,
metabolism and excretion T
e. A drug is any substance used for the diagnosis, prevention, treatment or palliation of
disease and maintenance of optimal health T
47. Which is untrue of the following statements?
a. Chemical structures of drugs can provide information about mechanism of action,
pharmacokinetics, stability, and metabolic fate F
b. A modification of the chemical structure of a drug may accentuate or diminish its
pharmacological effects F
c. Drugs are metabolized by body systems, which may convert the parent drug to a more
active or a less active form F
d. The drug structure can be modified to enhance or diminish the rate of metabolic
conversion F
e. Macromolecules, only present on cell membranes, with which drugs interact to exert
their effects are called receptors T
48. The bioavailability of a drug can be affected by the following factors except
a. first pass effect F
b. blood flow to the area F
c. chemical composition of the drug F
d. the macromolecules of receptor T
e. route of drug administration F
49. Factors which affect a drug volume of distribution does not include
a. patient sex T
b. Pregnancy T
 c. presence of diseases T
d. extent of drug-plasma binding T
e. Food
50. Two most important sites of elimination of drugs are:
a. Pulmonary and liver F
b. Skin and liver F
c. Kidney and liver T
d. Liver and gastrointestinal tract
e. Pulmonary and kidney
51. Drugs can bind to a receptor via different types of chemical bonds. Which of the following is the
least common drug-receptor bond?
a. Hydrophobic
b. Hydrogen
c. Ionic
d. Covalent T
e. van der Waals
52. Which of the following term best defined a drug with intrinsic activity higher than 0% and lower
than 100%
a. Full agonist
b. Pharmacological antagonist
c. Partial agonist T
d. Chemical antagonist
e. Functional antagonist
53. Which of the following statements is true of the elimination process?
a. unchanged molecules may be excreted T
b. cardiac failure leads to increased excretion
c. the distal tubule is the main site of active secretion
d. alkalinisation of the urine may promote excretion of basic drug
e. ultrafiltration contribute minimally
54. Inactive prodrugs have been developed to:
a. delay drug excretion
b. increase drug absorption T
c. decrease hepatic drug metabolism
d. increase drug half-life
e. reduce drug toxicity
55. The unchanged drug in the urine represents
a. Absorption
b. clearance T
c. biotransformation
d. metabolism
e. volume of distribution
56. The dose of a drug that provides the desired plasma concentration instantaneously:
a. maintenance dose
b. steady dose
 c. loading dose T
d. standard
e. infusion dose
57. The correct sequence of pharmacokinetic phases a drug may pass through is:
a. absorption, administration, elimination and excretion
b. disintegration, absorption, elimination and expiration
c. absorption, distribution, metabolism and excretion T
d. formulation, absorption, metabolism and excretion
e. administration, inhalation, absorption and excretion
58. Concerning Vitamin B12, which of the following statement is true?
a. Excreted in bile, urine and sweat
b. Heat labile
c. PO and intranasal route indicated until haematological remission and resolution
of sign of nervous system involvement
d. Injectables predispose to aluminium toxicity in patients with renal dysfunction,
taking high doses or on prolonged use
e. Arthralgia is unknown adverse effect in administration
59. Haematinics include the following drugs except
a. Vitamin B12
b. Ferrous
c. Vitamin C
d. Folate
e. Vitamin B complex
60. Consider the following statements, which is untrue.
a. Sources of folic acid in the diet include yeast, liver, kidney, and green vegetables,
although it can also be formed by microbes.
b. Folic acid acts as oxidising agent for the formation of coenzymes in metabolic
system in purine and pyrimidine metabolism
c. Folic acid is essentially absorbed in proximal while Vitamin B12 is absorbed in
distal small intestine
d. The main form of iron storage in the tissue is ferritin and haemosiderin
e. Recommended daily requirement for iron is dependent on health status; in
healthy individuals’ requirement is highest in pregnant women
61. The following are Haemostatics except
a. 5% Phenol in almond oil
b. Ethanolamine oleate
c. Oxidized cellulose
d. Tannic acid
e. Aspirin
62. Which of the following is the wrong combination of the following antiplatelets and
mechanism of action?
a. Aspirin: selective COX inhibitor
b. Clopidogrel: ADP inhibitor
c. Dipyridamole: PHOSPHODIESTERASE INHIBITOR
d. Abciximab: GP IIb-IIIa receptors INHIBITORS
e. Ticlopidine: ADP inhibitor
63. Which of the following is not an oral anticoagulant?
a. Rivaroxaban
b. Dabigatran
c. Lepirudin
d. Phenindione
e. Acenocoumarol
64. Concerning warfarin, which of the following is correct
a. Racemic mixture of R and S isomers with R isomer being more active
b. 10% of circulating warfarin is bound to albumin
c. High cost but highly effective
d. Plasma t1/2 is 36-42 hours
e. Slowly and incompletely absorbed from GI tract
65. Which is not a characteristic of an ideal anticoagulant
a. Oral administration
b. Rapid onset of action or rapid offset of action
c. Low therapeutic range
d. Predictable therapeutic effect with fixed or weight-based dosing
e. No food or drug-drug interactions
66. Which of the following is a rivaroxaban inhibitor?
a. Ketoconazole
b. Ritonavir
c. Clarithromycin
d. Erythromycin
e. St. John’s wart
67. The following characteristics of fondaparinux are true except
a. Selective inhibition of Xa
b. No scaffolding actions
c. Lesser incidence of haemorrhage
d. Better bioavailability
e. Short half-life
68. The following are fibrinolytic agent except
 a. Streptokinase
b. Urokinase
c. Tissue plasminogen activator
d. Tranexaemic acid
e. Alteplase
69. A significant number of patients started on ACE inhibitor therapy for hypertension are
intolerant and must be switched to a different class of drug. What is the most
common manifestation of this intolerance?
a) Angioedema
b) Ventricular arrhythmias
c) Incessant cough
d) Headache
e) Glaucoma
70. Which of the following is very short-acting and acts by releasing nitric oxide?
a) Atenolol
b) Hydrochlorothiazide
c) Captopril
d) Nitroprusside
e) Diltiazem
71. Which one of the following is characteristic of nifedipine treatment in patients with
essential hypertension?
a) Competitively blocks angiotensin II at its receptor
b) Decreases calcium flux into the urine
c) Decreases renin concentration in the blood
d) Decreases calcium efflux from skeletal muscle
e) Decreases calcium influx into smooth muscle
72. 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
e) Verapamil
73. Myocardial oxygen demand is increased by all the following factors except:
a) Exercise
b) Cold temperatures
c) Smoking
d) Isoproterenol
e) Propranolol
74. Milrinone is an example of
a) Phosphodiesterase I inhibitor
b) Phosphodiesterase II inhibitor
c) Phosphodiesterase III inhibitor
 d) Phosphodiesterase IV inhibitor
e) Phosphodiesterase inducer
75. Overuse of digitalis may result in
a) Habituation
b) Tolerance
c) Addiction
d) Physical dependence
e) Cumulative poisoning
76. The dihydropyridines block the following type of calcium channels.
a) L-type voltage sensitive channels
b) T-type voltage sensitive channels
c) N-type voltage sensitive channels
d) Receptor operated calcium channels
e) a and b are correct
77. 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)
e) Both (a) and (b)
78. Which of the following drugs is a potassium channel opener?
a) Pinacidil
b) Hydralazine
c) Glibenclamide
d) Amiloride
e) Flecainide
79. A 72-year-old woman has long-standing heart failure. Which one of the following
drugs has been shown to reduce mortality in chronic heart failure?
a) Atenolol
b) Digoxin
c) Dobutamine
d) Furosemide
e) Spironolactone
80. 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
b) Procainamide
c) Quinidine
d) Flecainide
e) Propranolol
81. Which of the following classes of diuretics is not correctly matched with the site of
action in the nephron?
a) Loop diuretics: thin ascending limb
b) Aldosterone antagonist: distal convoluted tubule
c) Thiazide diuretics: distal convoluted tubule
d) Carbonic anhydrase inhibitor: proximal convoluted tubule
e) Osmotic diuretics: intraluminal in the nephron
82. A drug lacking vasodilator properties that is useful in angina is
a. Isosorbide dinitrate
b. Metoprolol
c. Nifedipine
d. Nitroglycerin
e. Verapamil
83. Which one of the following is characteristic of nifedipine treatment in patients with
essential hypertension?
a. Competitively blocks angiotensin II at its receptor
b. Decreases calcium efflux from skeletal muscle
c. Decreases renin concentration in the blood
d. Decreases calcium influx into smooth muscle
e. Decreases calcium flux into the urine
84. Strong anticholinergic effects limit the antiarrhythmic use of
a. Quinidine
b. Procainamide
c. Tocainide
d. Flecainide
e. Disopyramide
85. In case of acute pain of angina pectoris the most effective treatment would be to
administer
a. Mannitol hexanitrate
b. Erythrityl tetranitrate
c. Sodium nitrate
d. Pentaerythritol tetranitrate
e. Nitroglycerin
86. Certain drugs can cause severe hypotension when combined with nitrates. Which of the
following interacts with nitroglycerin by inhibiting the metabolism of cGMP?
a. Atenolol
b. Hydralazine
c. Isosorbide mononitrate
d. Nifedipine
e. Sildenafil
87. Which one of the following drugs is associated with clinically useful or physiologically
important positive inotropic effect?
a. Captopril
b. Dobutamine
c. Enalapril
d. Losartan
e. Nesiritide
88. A 72-year-old woman has long-standing heart failure. Which one of the following drugs
has been shown to reduce mortality in chronic heart failure?
a. Atenolol
b. Digoxin
c. Dobutamine
d. Furosemide
e. Spironolactone
89. 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
b. Procainamide
c. Quinidine
d. Flecainide
e. Propranolol
90. 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)
e. All the options are correct
91. Which of the following statements is incorrect?
a. Smooth muscle contraction results in constriction of airway
b. Parasympathetic Nervous system releases acetylcholine which causes bronchodilation
c. Sympathetic Nervous system releases epinephrine which stimulates beta-2 receptors in
bronchial smooth muscle resulting in bronchodilation
d. Bronchiolar smooth muscle is relaxed by beta-2 adrenergic receptor stimulation
e. Bronchiolar smooth muscle is contracted by muscarinic receptor stimulation
92. Which of the following statements is incorrect?
a. Respiratory secretions are increased by cholinergic stimulation
b. Drugs that increase intracellular levels of cyclic AMP produce bronchodilation
c. Bronchoconstriction result from release ACH, histamine and inflammatory mediators
d. Vagus nerve releases ACH which triggers release of pulmonary secretion
e. Treated with sympathomimetics is unreliable
93. The following statements are true of antihistamines except
a. Block action of histamine at the receptor sites
b. Compete with histamine for binding at unoccupied receptors.
c. Displaces histamine off the receptor if already bound.
 d. The binding of H1 blockers to the histamine receptors prevents the adverse
consequences of histamine stimulation
e. More effective in preventing the actions of histamine rather than reversing them
94. The following are effects of antihistamines except
a. Prevent dilation of blood vessels
b. Enhances increased capillary permeability
c. Prevent salivary, gastric, lacrimal, and bronchial secretions
d. Block wheal-and-flare formation, itching
e. Drying effect that reduces nasal, salivary, and lacrimal gland secretions
95. Therapeutic indications of antihistamines include the following disorders except
a. Nasal allergies
b. Hay fever
c. Allergic reactions
d. Motion sickness
e. Stroke
96. Which of these is not a side effect of antihistamines?
a. Dry mouth
b. Diuresis
c. Constipation
d. Changes in vision
e. Drowsiness
97. The following are antihistamines except
a. Diphenhydramine
b. Chlorpheniramine
c. Fexofenadine
d. Loratadine
e. Ephedrine
98. Which of these is not a contraindication to antihistamine therapy?
a. Allergies to antihistamines
b. Acute asthma attacks
c. Lower respiratory diseases
d. Peptic ulcer disease
e. Operating heavy machinery when using first generation antihistamines
99. The mechanisms of action of nasal decongestants include the following except
a. Constrict small blood vessels that supply URT structures
b. Enhances drainage of nasal secretions in the swollen mucous membranes
c. Relieve nasal stuffiness
d. Enhances pro-inflammatory effect
e. Turn off the immune system cells involved in the inflammatory response
100. The following are side effects of nasal decongestants except
a. Local mucosal oedema
b. Nervousness
c. Insomnia
d. Palpitations
 e. Tremors
101. The following are adrenergic decongestants except
a. Flunisolide
b. Ephedrine
c. Naphazoline
d. Oxymetazoline
e. Phenylephrine
102. Identify opioid antitussives
a. benzonatate F
b. dextromethorphan F
c. Codeine T
d. Benzonatate F
e. Hydrocodeine T
103. The following statements are true about expectorants
a. Drugs that aid in the removal of mucus T
b. Reduce the viscosity of secretions T
c. Disintegrate and thin secretions T
d. The secretory glands are stimulated directly to increase their production of respiratory
tract fluids. T
e. Mechanisms of Action involves direct stimulation and or reflex stimulation T
104. The following are indications for expectorant administration
a. Common cold T
b. Pertussis T
c. Bronchitis T
d. Influenza T
e. Laryngitis T
105. Which of the following is not a bronchodilator?
a. Caffeine
b. Theobromine
c. Theophylline
d. Dyphilline
e. Guanidine
106. Which of the following is not a response of xanthine derivative administration?
a. Bronchospasm
b. Increased cAMP levels
c. Smooth muscle relaxation
d. Bronchodilation
e. Increased airflow
107. The following are organ system effect of xanthine derivatives except
a. Increased force of contraction
b. Increased Heart Rate
c. Increased cardiac output
d. Increased blood flow to the kidneys
e. Reduced urine flow
108. This is an example of selective beta agonist.
a. Epinephrine
b. Norepinephrine
c. Isoproterenol
d. Albuterol
e. Ipratropium
109. The following are indications for administration of beta agonist.
a. Relief of bronchospasm T
b. Used in the treatment of hypotension and shock T
c. Used to produce uterine relaxation to prevent premature labor T
d. Hyperkalemia T
e. Acidosis F
110. The following are side effect of beta agonist.
a. Insomnia T
b. Restlessness T
c. Tremor T
d. Headache T
e. Angina pain T
111. The following are effects of mast cell stabilizers.
a. Prevent IgG-mediated mast cell degranulation F
b. Prevent the release of histamine and slow-reacting substance of anaphylaxis (SRS-A) -
mediators of type I allergic reactions T
c. Prevent the release of the various substances that cause bronchospasm T
d. Stabilize the cell membranes of inflammatory cells (mast cells, monocytes,
macrophages), thus preventing release of harmful cellular contents T
e. Their beneficial effects in the treatment of asthma are largely curative F
112. A young couple (25-year-old male, 23-year-old female) wants to start a family.
They have not conceived after 1 yr of unprotected intercourse. Infertility evaluation
revealed no abnormalities in the female partner and low sperm count in the male.
Which of the following is a drug that is purified from the urine of postmenopausal
women and is used to promote spermatogenesis in infertile men?
a. Desmopressin
b. Gonadorelin
c. Goserelin
d. Somatropin
e. Urofollitropin
113. A 29-year-old woman in her 41st wk of gestation had been in labor for 12 h.
Although her uterine contractions had been strong and regular initially, they had
diminished in force during the past hour. Which of the following agents would be used
to facilitate this woman’s labor and delivery?
a. Dopamine
b. Leuprolide
c. Oxytocin
d. Prolactin
 e. Vasopressin
114. A 3-year-old boy with failure to thrive and metabolic disturbances was found to
have an inactivating mutation in the gene that encodes the growth hormone receptor.
Which of the following drugs is most likely to improve his metabolic function and
promote his growth?
a. Atosiban
b. Bromocriptine
c. Mecasermin
d. Octreotide
e. Somatropin
115. A 47-year-old man exhibited signs and symptoms of acromegaly. Radiologic
studies indicated the presence of a large pituitary tumor. Surgical treatment of the
tumor was only partially effective in controlling his disease. At this point, which of the
following drugs is most likely to be used as pharmacologic therapy?
a. Cosyntropin
b. Desmopressin
c. Leuprolide
d. Octreotide
e. Somatropin
116. Consider the following sentences
 60% of endogenous insulin is cleared by the liver while 40% is cleared by the
kidneys
 60% of exogenous insulin is cleared by the liver while 40% is cleared by the
kidneys
 Insulin clearance is dhared equally by the liver and the kidneys
 Insulin inhibits beta cell release of insulin but promotes glucose entry to
peripheral cells
 Beta cell depolarisation is triggered by elevated blood glucose only
a) Sentences 1 - 5 are correct F
b) Sentences 2, 3 and 5 are correct F
c) Sentences 1, 4 and 5 are correct T
d) Only sentences 1 and 4 are correct F
e) None of the sentences is correct F
117. Concerning insulin formulations
a) Rapid-acting insulin preparations – lispro T
b) Short-acting insulin preparations – aspart F
c) Intermediate-acting insulin - humulin R F
d) Long-acting insulin preparations – lantus T
e) Insulin combinations (premixed) - Humulin 30/70 T
118. The following are indications for insulin administration except:
a) Treatment of diabetes mellitus
b) Treatment of hyperkalaemia
 c) Treatment of severe ketoacidosis or diabetic coma
d) Treatment of obesity
e) Control of carbohydrates metabolism
119. Which of the following classes of hypoglycaemic agents produce its effect via
insulin receptors?
a) Alpha glucosidase inhibitors
b) Meglinitinides
c) SGLT2 inhibitors
d) Cycloset
e) Thiazolidinediones
120. Which is incorrect concerning oral hypoglycaemic agents?
a) Sulfonylureas – Glimepiride
b) Meglitinides – repaglinide
c) Biguanides – metformin
d) Thiazolidinediones – Sitagliptin
e) α-Glucosidase inhibitors - acarbose
121. Which of the following do not derive from pancreatic beta cells?
a) Insulin
b) Proinsulin
c) Amylin
d) C-peptide
e) Ghrelin
122. Which of the following does not stimulate insulin release?
a) beta adrenergic activity
b) Insulin
c) CCK
d) Glucagon
e) High concentration of fatty acids
123. Concerning levothyroxine
a) T3
b) Preparation of choice for thyroid replacement and suppression therapy
c) Has a very short half-life
d) Available only as parenteral preparation
e) More potent than Liothyronine
124. Concerning liothyronine
a) T3 T
b) More potent than Levothyroxine T
c) Has short half-life of 24hrs T
d) Requires once daily dosing F
 e) Recommended for patients with cardiac malfunctioning F
125. Which of the following is the indication for propylthiouracil administration?
a) Grave”s disease
b) Addison”s disease
c) Hashimoto”s disease
d) Gigantism
e) Cushing”s disease
126. A consequence of abruptly stopping prednisone is
a) Anxiety
b) Fever
c) Hypoglycaemia
d) Weight loss
e) Constipation
127. Which of the following could counteract growth-promoting effects of
somatropin?
a) Aminoglycosides
b) Glucocorticoids
c) NSAIDs
d) Anticoagulants
e) Beta blockers
128. All the following should be monitored in a patient taking
fludrocortisones except:
a) Serum potassium
b) Serum sodium
c) Weight
d) Blood sugar
e) Calcium
129. Which of the following agents may be used to treat hypercalcaemia?
a) Furosemide
b) Thiazides
c) Vitamin D
d) Parathyroid hormone
e) Growth hormone
130. All the following methods of the administration of Octreotide are
correct except:
a) Subcutaneous
b) Injection site should be rotated
c) Administration of octreotide should be slow
d) IV push in emergency situation
e) IV slowly over 3 minutes in emergency situation
131. Cimetidine interacts with more drugs than ranitidine because
a) It is subjected to greater first pass metabolism
b) It is a more potent enzyme inducer
 c) It is a more potent enzyme inhibitor
d) It has better oral absorption
e) It forms covalent bond with coadministered drugs
132. Which of the following drug is implicated in the causation of osteomalacia?
a) Steroid
b) Estrogen
c) Heparin
d) Phenytoin
e) Warfarin
133. Principles of management of peptic ulcer disease include
a. Neutralize acid in the lumen T
b. Antagonise gastric stimulants T
c. Protect the mucosa from acid destruction T
d. Eradication of Helicobacter pylori T
e. Use of milk F
134. The following are indications for Histamine Type 2 (H2) Antagonists
administrationGERD T
a. PUD T
b. Erosive esophagitis T
c. Adjunct therapy in control of upper GI bleeding T
d. Pathologic gastric hypersecretory conditions T
135. Which of the following statements about mechanism of action of drugs administered in
the treatment of peptic ulcer disease is not correct
a. Antacids directly neutralize stomach acid
b. Prostaglandins promote gastric mucosal defense mechanisms
c. Histamine Type 2 (H2) Antagonists block histamine (H2) receptors of acid-producing
parietal cells resulting in decreased production of HCl
d. Proton Pump Inhibitors irreversibly inhibiting H+/K+ ATPase, which blocks final step in
acid secretion
e. Antibiotics inhibits the growth of Salmonella typhi responsible for the development of
peptic ulcer disease (A)
136. Which of the following statements about antidiarrhoeas is untrue
a. Aim to decrease fecal water content by increasing solute absorption
b. Loperamide is an opioid (A)
c. Aim to decrease fecal water content by decreasing intestinal secretion and motility
d. Administration is reserved for patients with significant & persistent symptoms of
diarrhea
e. Agents used include opioid derivatives and adsorbents
137. The following are antidiarrhoea agents except
a. Dicyclomine (A)
b. Codeine
c. Loperamide
d. Diphenoxylate
 e. Activated charcoal
138. Consider the following statements on the mechanism of action of laxative drugs
a. Bulk-forming laxatives increase luminal mass which stimulates peristalsis T
b. Salt-containing osmotic laxatives retain water in lumen by osmosis and cause a reflex
increase in peristalsis T
c. Salt-free osmotic laxatives retain ammonia in colon, producing osmotic effect that
stimulates bowel evacuation T
d. Irritant laxatives causes bowel inflammation resulting in increased luminal contents
which stimulate reflex peristalsis T
e. Stool softeners produce a detergent action that facilitates mixing of water and fatty
substances to increase luminal mass T
139. The side effects of laxatives include the following except
a. Electrolyte imbalance F
b. Abdominal cramps F
c. Diarrhoea F
d. Increased thirst F
e. Nutrients malabsorption F
140. Consider the following classes of antiemetics and their examples
a. First generation H1 antagonists – diphenhydramine T
b. Second generation H1 antagonists – chlorpheniramine F
c. Dopamine antagonists – metoclopramide T
d. Benzodiazepines – lorazepam T
e. Muscarinic receptor antagonists – scopolamine T
141. Consider the following side effects of classes of antiemetics
a. Benzodiazepines – respiratory depression when taking together with alcohol T
b. First generation H1 antagonists – drowsiness and loss of coordination T
c. Second generation H1 antagonists – drowsiness T
d. Muscarinic receptor antagonists – mydriasis and blurred vision T
e. Dopamine antagonists – dystonic reactions T
142. Which of the following classes of diuretics is not correctly matched with the
site of action in the nephron?
a. Loop diuretics: thin ascending limb
b. Aldosterone antagonist: distal convoluted tubule
c. Thiazide diuretics: distal convoluted tubule
d. Carbonic anhydrase inhibitor: proximal convoluted tubule
e. Osmotic diuretics: intraluminal in the nephron
143. A 10-year-old boy has uncomplicated pulmonary tuberculosis. After initial
hospitalization, he is now being treated at home with isoniazid, rifampin, and
ethambutol. Which statement about this case is accurate?
a. A baseline test of auditory function test is essential before drug treatment is
initiated
b. His mother, who takes care of him, does not need INH prophylaxis
c. His 3-year-old sibling should receive INH prophylaxis
d. Polyarthralgia is a potential adverse effect of the drugs the boy is taking
 e. The potential nephrotoxicity of the prescribed drugs warrants periodic
assessment of renal function
144. Which statement about antitubercular drugs is accurate?
a. Antimycobacterial actions of streptomycin involve inhibition of
arabinosyltransferases
b. Cross-resistance of M tuberculosis to isoniazid and pyrazinamide is common
c. Ocular toxicity of ethambutol is prevented by thiamine
d. Pyrazinamide treatment should be discontinued immediately if hyperuricemia
occurs
Resistance to ethambutol involves mutations in the emb gene
145. A patient with AIDS and a CD4 cell count of 100/μL has persistent fever and
weight loss associated with invasive pulmonary disease due to M. avium complex
(MAC). Optima management of this patient is to
a. Choose an antibiotic based on drug susceptibility of the cultured organism
b. Initiate a two-drug regimen of INH and pyrazinamide
c. Prescribe rifabutin because it prevents the development of MAC bacteremia
d. Start treatment with the combination of azithromycin, ethambutol, and
rifabutin
e. Treat with trimethoprim-sulfamethoxazole
146. Which helminthic infection does not respond to treatment with praziquantel?
a. Hydatid disease
b. Opisthorchiasis
c. Paragonimiasis
d. Pork tapeworm infection
e. Schistosomiasis
147. Which parasite is susceptible to niclosamide?
a. Ascaris lumbricoides (roundworm)
b. Echinococcus granulosus (hydatid disease)
c. Fasciola hepatica (sheep liver fluke)
d. Necator americanus (hookworm)
e. Taenia solium (pork tapeworm)
148. Which drug should be used for oral treatment of the acute attack of P vivax
malaria but does not eradicate exoerythrocytic forms of the parasite?
a. Chloroquine
b. Mefloquine
c. Primaquine
d. Pyrimethamine-sulfadoxine
e. Quinidine
149. Which drug should be given later to eradicate schizonts and latent hypnozoites
in the patient’s liver?
a. Artesunate
b. Dapsone
c. Halofantrine
d. Primaquine
 e. Quinine
150. Which statement about the actions of antimicrobial agents is false?
a. Metronidazole has activity against C difficile.
b. Neonatal gonococcal ophthalmia can be prevented by silver nitrate
c. Polymyxins act as cationic detergents to disrupt bacterial cell membranes
d. Resistance to nitrofurans emerges rapidly, and there is cross-resistance with
sulphonamides
e. Salicylic acid has useful antidermatophytic activity when applied locally
151. Which antiseptic promotes wound healing?
a. Cetylpyridinium chloride F
b. Chlorhexidine F
c. Hexachlorophene F
d. Phenol F
e. None of the options is correct T
152. Which statement about the mechanisms of action of antiviral drugs is accurate?
a. Acyclovir has no requirement for activation by phosphorylation
b. Ganciclovir inhibits viral DNA polymerase but does not cause chain termination
c. Increased activity of host cell ribonucleases that degrade viral mRNA is one of
the actions of interferon alpha
d. The initial step in activation of foscarnet in HSV infected cells is its
phosphorylation by thymidine kinase
e. The reverse transcriptase of HIV is 30–50 times more sensitive to inhibition by
fosamprenavir than host cell DNA polymerases
153. A 27-year-old nursing mother is diagnosed as suffering from genital herpes. She
has a history of this viral infection. Previously, she responded to a drug used topically.
Apart from her current problem, she is in good health. Which drug to be used orally is
most likely to be prescribed at this time?
a. Amantadine
b. Foscarnet
c. Ritonavir
d. Trifluridine
e. Valacyclovir
154. Oral formulations of this drug should not be used in a pregnant AIDS patient
because they contain propylene glycol. One of the characteristic adverse effects of the
drug is hyperpigmentation on the palms of the hands and soles of the feet, especially in
African American patients
a. Amprenavir
b. Emtricitabine
c. Efavirenz
d. Fosamprenavir
e. Zalcitabine
155. Which of the following statements about interferon is false?
a. At the start of treatment, most patients experience flulike symptoms
b. Indications include treatment of genital warts
 c. It is used in the management of hepatitis B and C
d. Lamivudine interferes with its activity against hepatitis B
e. Toxicity includes bone marrow suppression
156. Which statement about fluconazole is accurate?
a. Does not penetrate the blood-brain barrier
b. Drug of choice in treatment of aspergillosis
c. Induces hepatic drug-metabolizing enzymes
d. Has the least effect of all azoles on drug metabolism
e. Oral bioavailability is less than that of ketoconazole
157. Which drug is least likely to be effective in the treatment of esophageal
candidiasis if it is used by the oral route?
a. Clotrimazole
b. Griseofulvin
c. Ketoconazole
d. Itraconazole
e. Nystatin
158. A Ideal local anesthetic agent shouldn’t cause:
a. Local irritation and tissue damage T
b. Systemic toxicity T
c. Fast onset and long duration of action F
d. Vasodilatation T
e. Blockade of pain stimulus F
159. Which of the following is an analgesic and antipyretic drug that lacks an anti-
inflammatory action?
a. Acetaminophen
b. Celecoxib
c. Colchicine
d. Indomethacin
e. Probenecid
160. A 16-year-old girl comes to the emergency department suffering from the effects
of an aspirin overdose. Which of the following syndromes is this patient most likely to
exhibit because of this drug overdose?
a. Bone marrow suppression and possibly aplastic anemia
b. Fever, hepatic dysfunction, and encephalopathy
c. Hyperthermia, metabolic acidosis, and coma
d. Rapid, fulminant hepatic failure
e. Rash, interstitial nephritis, and acute renal failure
161. Hypnotic drugs should:
a. Reduce anxiety and exert a calming effect F
b. Induce absence of sensation F
c. Produce drowsiness, encourage the onset and maintenance of sleep T
d. Prevent mood swings in patients with bipolar affective disorders F
e. Initiate sleep T
162. Anxiolytics are also useful for:
 a. Treatment of epilepsy and seizures T
b. Insomnia T
c. Muscle relaxation in specific neuromuscular disorders T
d. a and c only F
e. All the options are correct F
163. Indicate the agents of choice in the treatment of most anxiety states:
a. Barbiturates F
b. Benzodiazepines T
c. Lithium salts F
d. Phenothiazines F
e. SSRIs T
164. A woman, 68 years of age, presents with blunted affect; she seems indifferent to
her surroundings and says that she has no sense of pleasure in life. She complains that
she hears voices and fears that she is about to be killed. She is admitted to the acute
psychiatric ward where she is given an antipsychotic –Drug A. After treatment, her
hallucinations and paranoia resolve, but she complains that she has a tremor and cannot
move about quickly. After a change in her medication to Drug B, all of her symptoms
improved. She does not need to have weekly blood tests. Which one of the following
pairs most likely corresponds to Drug A and Drug B?
a. Fluphenazine Clozapine
b. Haloperidol Olanzapine
c. Risperidone Sertraline
d. Thioridazine Clozapine
e. Quetiapine Paroxetine
165. A 33 year old female was brought to hospital for acute mental status change by
her husband. He reports that she has been taking the same medication to treat
symptoms of anxiety and paranoia for the past year. On examination the woman is
diaphoretic, with some rigidity of her extremities. Her blood pressure is 198/109,
Temperature 101oF. Blood analyses show grossly elevated creatine kinase. Which of the
following medications could have caused her serious condition?
a. Clozapine
b. Dantrolene
c. Asenapine
d. Quetiapine
e. Fluphenazine
166. A 35-year-old man with abnormal behavior has been diagnosed with
schizophrenia. In schizophrenia, Clozapine is more effective than haloperidol against:
a. Hallucinations
b. Bizarre delusions
c. Delusions
d. Social withdrawal
e. Lack of insight
167. Benzodiazepines are use therapeutically for all the following indications
except:
a) Pain disorder
b) Schizophrenia
c) Status epilepticus
d) Insomnia
e) Ethanol withdrawal
168. Which of the following adverse effects is caused by thioridazine?
a) Constipation
b) Sedation
c) Tardive dyskinesia
d) Orthostatic hypotension
e) All the options are correct
169. Identify the first-generation antipsychotics.
a) Chlorpromazine T
b) Haloperidol T
c) Olanzapine F
d) Clozapine F
e) Fluphenazine T
170. The following are mechanisms of action of antineoplastic drugs except:
a) Influence hormone homeostasis F
b) Interfere protein synthesis and function F
c) Interfere transcription and block RNA synthesis F
d) Direct influence the structure and function of DNA F
e) Block nucleic acid biosynthesis F
171. Mode of antineoplastic therapy include the following except
a. Combination therapy
b. Adjuvant therapy
c. Neoadjuvant therapy
d. Physiotherapy
e. Monotherapy
172. The following are cell cycle specific antineoplastic drugs except
a. Vinblastine
b. Methotrexate
c. Bleomycin
d. Actinomycin-D
e. Vincristine
173. The following are cell cycle nonspecific antineoplastic drugs except
a. Cyclophosphamide
b. Chlorambucil
c. Cisplatin
 d. Daunorubicin
e. L-asparaginase
174. Which of the following is not a class of directly acting cytotoxic antineoplastic
drug?
a. 5 alpha reductase inhibitors
b. Alkylating agents
c. Antimetabolites
d. Antibiotics
e. Vinca alkaloids
175. Which of the following is not a class of indirectly acting cytotoxic antineoplastic
drug?
a. Corticosteroids
b. Estrogens & ERMs
c. Epipodophyllotoxins
d. GnRH agonists
e. Progestins
176. Which of the following is not an alkylating antineoplastic agent?
a. Oxaliplatin
b. Mechlorethamine
c. Cyclophosphamide
d. Chlorambucil
e. Mephalan
177. Which of the following is not an antibiotic antineoplastic agent?
a. Bleomycin
b. Mitomycin C
c. Procarbazine
d. Actinomycin D
e. Doxorubicin
178. Which of the following is not an antimetabolite antineoplastic agent?
a. Methotrexate
b. 6-Thioguanine
c. 5-Fluorouracil
d. Cytarabine
e. Dacarbazine
179. Which of the following is not an antitubulin antineoplastic agent?
a. Vincristine
b. Vinblastine
c. Paclitaxel
 d. Estramustine
e. Etoposide
180. Which of the following antineoplastic agent is not correctly paired?
a. Tyrosine protein kinase inhibitor: Imatinib
b. EGF receptor inhibitors: Geftinib
c. Angiogenesis inhibitors: Bevacizumab
d. Progesterone inhibitors: Cetuximab
e. Monoclonal antibody: Rituximab