General Pharmacology Questions' book for 1st year

PHARMACOLOGY Questions

For 1st year

Previous exams & Formative:

1- One of the following is an example of ionotropic receptor:

a. α-adrenergic receptors

b. β-adrenergic receptors.

c. Cholinergic nicotinic receptors

d. Cholinergic muscarinic receptors.

2- Pharmacodynamics is defined as:

a. The effect our body has on drugs

b. The action of the liver on drug molecules.

c. The movement of a drug around the body

d. The effect a drug has on our bodies.

3- The intrinsic activity or efficacy of a drug is:

a. Related to its maximal effect.

b. A measure of its potency.

c. The amount of drug in relation to its effect.

d. Related to its affinity to a receptor site.

4- Which of the following signaling mechanisms can involve heat-shock protein (hsp90)?

a. G-protein coupled receptors.

b. Intracellular receptors for lipid-soluble ligands

c. Transmembrane receptors.

d. Ligand-gated ion channels

5- Which one of the following statements describes an agonist?

a. A drug that binds to a receptor and stimulates cellular activity.

b. A drug that binds to a receptor but not produce intrinsic activity

c. A specific regulatory molecule in the biologic system where a drug interacts.

d. A drug that increases concentration of another drug at receptor sites

6- With reference to drug receptors Select one:

a. Pure pharmacologic antagonists bind to receptors and directly alter the receptors’ function.

b. They include regulatory proteins, enzymes, transport proteins and structural proteins.

c. The total number of receptors is unrelated to the maximal effect of a drug

d. Receptor-mediated responses to drugs usually remain constant over time, even in the continued presence of the agonist

7- A 67-year-old hospitalized patient with a deep venous thrombosis of the left calf and pulmonary embolism is currently on intravenous heparin on an hourly

drip. Unfortunately, because of a calculation error, the heparin drip is running at 100 times the rate it should be running at. Protamine sulfate is immediately given intravenously. This agent works by which of the following mechanisms of action?

a. Inverse agonist.

b. Partial antagonist

c. Chemical antagonist.

d. Partial agonist

8- A study was carried out in isolated intestinal smooth muscle preparations to determine the action of a new drug “novamine,” which in separate studies bound to the same receptors as acetylcholine. In the absence of other drugs, acetylcholine caused contraction of the muscle. Novamine alone caused relaxation of the preparation. In the presence of a low concentration of novamine, the EC50 of acetylcholine was unchanged, but the Emax was reduced. In the presence of a high concentration of novamine, extremely high concentrations of acetylcholine had no effect. Which of the following expressions best describes novamine?

a. An irreversible antagonist

b. A physiologic antagonist.

c. A spare receptor agonist

d. Physiologic antagonist.

e. A chemical antagonist

9- A competitive antagonist affects the agonist --------and a noncompetitive antagonist affect the agonist _ _ _ _.

a. Duration; Speed

b. Speed; Duration.

c. Potency; Efficacy

d. Efficacy; Potency.

10- Intrinsic activity is a drug’s ability to elicit:

a. Response

b. Weak receptor binding.

c. Strong receptor binding

d. Excretion.

11- Regarding competitive antagonist, all the following statements are false except:

a. Phenoxybenzamine and atropine act as competitive antagonists.

b. It has high affinity and intrinsic activity.

c. It forms strong covalent bonds with the receptors.

d. It produces shift of the dose response curve of the agonist to the right.

12- Regarding receptor up regulation, one of the following statements is true:

a. It usually occurs after chronic administration of an agonist.

b. It usually involves a decrease in the number of receptors

c. It occurs after chronic administration of an antagonist.

d. It may involve decrease in the effectiveness of receptors.

13- Sugammadex is a new drug that reverses the action of rocuronium and certain other skeletal muscle-relaxing agents (nondepolarizing neuromuscular blocking agents). It appears to interact directly with the rocuronium molecule and not at all with the rocuronium receptor. Which of the following terms best describes sugammadex?

a. Pharmacologic antagonist.

b. Noncompetitive antagonist

c. Chemical antagonist.

d. Physiologic antagonist

14- Pharmacodynamic tolerance means:

a. Alteration of the pharmacokinetics of drugs.

b. Induction of liver microsomal enzymes

c. Adaptation of the body cells to the presence of the drug.

d. Great susceptibility to drug

15- Agent which activates a receptor to produce an effect similar to that of the physiologic signal molecule is:

a. Agonists

b. Antagonists.

c. Partial agonists

d. Inverse agonists.

16- Which of the following acts on intracellular receptors?

a. Serotonin

b. Glucagon.

c. Corticosteroids

d. GABA.

17- Continued stimulation of cells with agonist leads to a state of desensitization, referred as

a. Down regulation.

b. Up regulation.

c. Change in the number of receptors by other substances

d. Change in the number of receptors by a disease state.

18- Intrinsic activity of the partial agonist is:

a. Between 0 and -1

b. Equal to 1

c. Equal to 0

d. between 0 and 1

Extra

1- Drugs can induce their effects by all the following mechanisms EXCEPT:

a. Inhibition of target enzymes.

b. Binding to target receptors.

c. Binding to plasma proteins.

d. Blockade of ion channels.

2- Pharmacokinetics is the study of the kinetics of the drug which includes the following EXCEPT:

a. Absorption

b. Excretion

c. Uses

d. Metabolism

3- Reversal of histamine-induced bronchoconstriction by adrenaline is regarded as:

a. Competitive antagonism.

b. Noncompetitive antagonism

c. Chemical antagonism.

d. Physiological antagonism

4- The phrase "ability to bind to a receptor" fits the definition of:

a. Affinity.

b. Agonist.

c. Antagonist

d. Efficacy.

5- A none-competitive antagonist can produce:

a. Parallel shift of the dose response curve of agonist to right.

b. Decrease in the maximal response of the agonist.

c. Change in the mechanism of action of the agonist.

d. Its effect can be overcome by higher concentration of the agonist.

e. All of the above.

6- Regarding a noncompetitive antagonist, which statement is correct?

a.Binds irreversibly to the recognition site of the receptor.

b. Causes parallel shift to the right in the dose-response curve.

c. Causes a decrease in £„,„

d. Causes an increase in ED50

e. A and C

7- Regarding a partial agonist, which of the following is/are incorrect?

a. In absence of the agonist, it activates the empty receptor.

b. In the presence of the agonist, it acts as an antagonist.

c. Efficacy is less than that of a full agonist.

d. Affinity is less than that of a full agonist.

e. C and D

8- All of the following interact with ligand-gated ion channels EXCEPT:

a. Glutamate.

b. Insulin.

c. Benzodiazepines.

d. Aspartate

9- Insulin at insulin receptor interacts with

a. Ligand-activated ion channel

b. Intracellular nuclear receptor

c. Receptor-activated tyrosine kinase

d. G-protein–coupled receptor

1. 2 Pharmacodynamics

Previous exams & Formative:

1- All of the following are Characteristics of a Dose-Response Curve EXCEPT?

a. Clearance

b. Maximal

c. Efficacy Slope

d. Biological Variability

2- Regarding receptor down regulation all of the following are true EXCEPT?

a. Results from continued stimulation of cells with agonist

b. Results from long-term exposure of cells to antagonists

c. Causes a decrease in the response to the drug

d. Repeated use of β-adrenergic stimulant drugs for treatment of bronchial

3- One of the following is correct Regarding Therapeutic Index (TI)?

a. The ratio of the LD50 to the ED50

b. It's an indication of the safety of the drug

c. The greater the value of the therapeutic index the safer the drug is

d. all of the above

4- Regarding Receptor up-regulation, ONE of the following statements is TRUE:

a. Results from continued stimulation of cells with agonist.

b. Results from long-term exposure of cells to antagonists.

c. Causes a decrease in the response to the drug.

d. Repeated use of B-adrenergic stimulant drugs for treatment of bronchial asthma is an example

5- Therapeutic index of the drug is:

a. The lethal doses (LDs) divided by the toxic dose5o (TD50)

b. The effective doses (ED5) divided by the (TD50)

c. The TD50 divided by the LD50

d. The ED50 divided by the LD50

6- Continued stimulation of cells with agonist leads to a state of desensitization, referred as:

a. Down regulation

b. Up regulation

c. Change in the number of receptors by other substances

d. Change in the number of receptors by a disease state

7- Therapeutic Index (TI) is:

a. The ratio of the ED50 to the LD50

b. An indication of the safety of the drug.

c. The smaller the value of the therapeutic index, the safer the drug

d. Drug with therapeutic index of 1 can be used therapeutically

8- Toxic reactions are:

a. Usually dose-related.

b. These effects are usually irreversible and cannot be treated.

c. Hepatic injury produced by acetaminophen is an example of the pharmacological toxic reaction.

d. Muscle and bone are the most frequently involved in systemic

Extra:

1- The following is /are incorrect concerning therapeutic index of drugs:

a. It is calculated by dividing ED50 by LD50

b. Can be obtained from the All/None curve

c. It gives an idea about the safety of the drug

d. Can be obtained from the graded dose-response curve

e. a and d

2- The following is /are incorrect concerning ED50 of drugs:

a. It is the dose that produces 50% of the maximal response in the all/none curve.

b. It is the dose that cures 50% of cases in graded dose-response curve

c. It gives an idea about the potency of the drug

d. The lower the ED so the more potent the drug.

e. a and b

3- Tolerance is:

a. Decreased response to the usual dose of a drug

b. Increased response to the usual dose of a drug

c. Abnormal reaction to a drug due to genetic or enzyme defect

d. Inactivation of a drug be the kidney

4- Give the definition for a therapeutical dose:

a. The amount o fa substance to produce the minimal biological effect

b. The amount of a substance to produce effects hazardous for an organism

c. The amount of a substance to produce the required effect in most patients

d. The amount of a substance to accelerate an increase of concentration of medicine in an organism

5- Pick out the correct definition of a toxic dose:

a. The amount of substance to produce the minimal biological effect

b. The amount of substance to produce effects hazardous for an organism

c. The amount of substance to produce the necessary effect in most of patients

d. The amount of substance to fast creation of high concentration of medicine in an organism

6- Which effect may lead to toxic reactions when a drug is taken continuously or repeatedly?

a. Refractoriness

b. Cumulative effect

c. Tolerance

d. Tachyphylaxis

7- What term is used to describe a more gradual decrease in responsiveness to a drug, taking days or weeks to develop?

a. Refractoriness

b. Cumulative effect

c. Tolerance

d. Tachyphylaxis

8- What term is used to describe a decrease in responsiveness to a drug which develops in a few minutes?

a. Refractoriness

b. Cumulative effect

c. Tolerance

d. Tachyphylaxis

9- Tachyphylaxis is:

a. A drug interaction between two similar types of drugs

b. Very rapidly developing tolerance

c. A decrease in responsiveness to a drug, taking days or weeks to develop

d. None of the above

10- Tolerance and drug resistance can be a consequence of:

a. Drug dependence

b. Increased metabolic degradation

c. Depressed renal drug excretion

d. Activation of a drug after hepatic first-pass

11- Tolerance and drug resistance can be a consequence of:

a. Change in receptors, loss of them or exhaustion of mediators

b. Increased receptor sensitivity

c. Decreased metabolic degradation

d. Decreased renal tubular secretion

12- Tolerance develops because of:

a. Diminished absorption

b. Rapid excretion of a drug

c. Both of the above

d. None of the above

13- Therapeutic index (TI) is:

a. A ratio used to evaluate the safety and usefulness of a drug for indication

b. A ratio used to evaluate the effectiveness of a drug

c. A ratio used to evaluate the bioavailability of a drug

d. A ratio used to evaluate the elimination of a drug

Previous exams & Formative:

1- All the following are factors affecting drug absorption except:

a. Surface area of absorption

b. Blood flow to the site of absorption

c. Age of the patient

d. Route of administration

2- Regarding plasma protein binding all the following are false except:

a. Albumin for basic drugs

b. α 1 acid glycoprotein for acidic drugs

c. The bound fraction is considered as drug reservoir

3- The false statement about oral administration is:

a. Not suitable for emergency

b. More rapid onset than parenteral route

c. Its absorption is irregular

d. Not suitable with vomiting

4- Binding of a drug to plasma proteins will tend to:

a. Decrease half-life.

b. Decrease its rate of glomerular filtration.

c. Increase its rate of biotransformation.

d. Increase its concentration in the plasma

5- Regarding binding of drugs to plasma albumin:

a. All drugs are strongly bound to albumin

b. Binding of drugs enhances their therapeutic effects.

c. Binding of drugs to albumin enhances their elimination.

d. Albumin binds reversibly certain acidic drugs.

6- What kind of substances can’t permeate membranes by passive diffusion:

a. Lipid soluble substances

b. Non-ionized substances

c. Hydrophobic substances

d. Hydrophilic substances

7- What is meant by “active transport”?

a. Transport of drugs through a membrane by means of diffusion

b. Transport without energy consumption

c. Engulf of a drug by a cell membrane with a new vesicle formation

d. Transport against concentration gradient

8- The appropriate alimentary route of administration when passage of drugs through the liver is minimized is:

a. Oral

b. Sublingual

c. Rectal

d. Intraduodenal

9- The route of drug administration is most likely to lead to the first-pass effect:

a. Sublingual

b. Oral

c. Intravenous

d. Intramuscular

10- The reason that complicated penetration of some drugs through the brainblood barrier is:

a. High lipid solubility of a drug

b. Meningitis

c. Absence of pores in the brain capillary endothelium

d. High endocytosis degree in a brain capillary

11- What is characteristic of the intramuscular route of drug administration?

a. Only water solutions can be injected

b. Oily solutions can be injected

c. Opportunity of hypertonic solution injections

d. The action develops slower, than at oral administration

12- Which of the following drug permeation mechanisms is used for peptides, Amino acids, and other large or insoluble molecules?

a. Aqueous diffusion

b. Lipid diffusion

c. Carrier molecules

d. Endocytosis

13- The initial distribution of a drug into tissue is determined by the:

a. Rate of blood flow to tissue

b. Glomerular filtration rate (GFR)

c. Stomach emptying time

d. Affinity of the drug for tissue

14- A hydrophilic medicinal agent has the following property:

a. Low ability to penetrate through the cell membrane lipids

b. Penetrate through membranes by means of endocytosis

c. Easy permeation through the blood-brain barrier

d. High reabsorption in renal tubules

15- The feature of the sublingual route is:

a. Pretty fast absorption

b. A drug is exposed to gastric secretion

c. A drug is exposed to more prominent liver metabolism

d. A drug can be administrated in a variety of doses

16- Regarding passive diffusion of the drug across membrane:

a. The drug moves against concentration gradient

b. The process needs energy

c. The process may be competitive as drugs with similar structures may compete for the same carrier

d. The drug moves from an area of high concentration to an area of lower concentration

17- Active transport includes all the following except:

a. Drug moves with concentration gradient

b. Process needs energy

c. The carrier may be saturated at high concentrations

d. The process may be competitive

18- what is meant by “pinocytosis”?

a. Transport of drugs through a membrane by means of diffusion

b. Transport without energy consumption

c. Engulf of a drug by a cell membrane with a new vesicle formation

d. Transport against concentration gradient

19- Acidic drugs bind primarily to which of the following plasma proteins:

a. A1-fetoprotein

b. Gamma globulin

c. Albumin

d. A1- acid glycoprotein

20- regarding plasma protein binding all the following are true except:

a. Variable proportion of drug present in the blood is bound to plasma protein

b. Chiefly albumin for acidic drug and a1-glycoprotein for basic drug

c. Fraction of drug that bound to plasma protein is pharmacologically active

d. The bound fraction is considered as drug reservoir

21- Diffusion of drugs across cell membrane:

a. Is dependent upon metabolic activity of the cell

b. Is competitively inhibited by chemically related drugs

c. Is affected by extent of ionization of drug molecules

d. Exhibit saturation kinetics

22- Factors affecting distribution including all the following except:

a. Regional blood flow.

b. Lipid solubility.

c. Capillary permeability.

d. Route of drug administration

23- All the following factors affecting drug absorption except:

a. Surface area of absorption.

b. Blood flow to site of absorption.

c. Physical state of the drug.

d. Content of the drug

24- All the following routes are parenteral except:

a. Intrathecal.

b. Subcutaneous.

c. Sublingual.

d. Intravenous.

25- One of the following routes of medication administration would provide the lowest serum drug concentration?

a. Intramuscular

b. Intravenous

c. Oral

d. Intrathecal

26- Distribution is affected by all the following factors EXCEPT:

a. Ionization of the drug

b. First-pass metabolism

c. Lipid solubility of the drug

d. Plasma protein binding of the drug

27-lipid soluble drugs are absorbed mainly by:

a. Passive diffusion

b. Filtration

c. Active transport

d. Pinocytosis

28- Iodide has selective accumulation to:

a. Bone

b. Liver

c. Brain

d. Thyroid gland

28-d

Extra questions:

1- Important factor/s which may govern diffusion of drugs across cell membranes:

a. pKa value of the drug

b. pH of the medium

c. Lipid solubility of the drug

d. Molecular weight of the drug

e. All of the above

2- Advantages of the oral route of drug administration include the following except:

a. Most convenient

b. Best route in emergency

c. Safest

d. Most economic

3- the sublingual route of drug administration is suitable for:

a. Drug rapidly destroyed by liver

b. Drug rapidly excreted by kidney

c. Drug used in large dose

d. Drug destroyed by salivary secretion

4- Advantages of intravenous route of drug administration include the following except:

a. Rapid onset

b. Best in shock

c. Best for highly irritant

d. Least in toxic reactions

5- Enteric coated tablets are used in:

a. Drugs irritant to stomach

b. Drugs destroyed by intestinal enzymes

c. Antacids drugs

d. Drugs destroyed by saliva

6- Drug absorption is often irregular with:

a. Intravenous administration

b. Intramuscular administration

c. Rectal suppository administration

d. Sublingual administration

7- Concerning the placental barrier, which of the following is correct?

a. Allow passage of hydrophilic drugs to the fetus

b. Drugs crossing the placenta can be teratogenic

c. Steroid can pass while aspirin can’t

d. None of the above

Previous exams & Formative:

1- Weak acidic drugs:

a. Excreted slowly in acidic urine.

b. Bound primarily to alpha 1 acid glycoprotein in plasma.

c. Highly ionized in the gastric juice.

d. Do not cross blood brain barrier.

2- Biotransformation of the drug is to render them:

a. Less ionized

b. More pharmacologically active

c. More lipid soluble

d. Less lipid soluble

3- Biotransformation(phase1) is:

a. Acetylation and methylation of substances.

b. Transformation of substances due go oxidation, reduction, or hydrolysis.

c. Glucuronide formation.

d. Binding to plasma proteins.

4- Biotransformation of a medicinal substance results in:

a. Faster urinary excretion.

b. Slower urinary excretion.

c. Easier distribution in organism.

d. Higher binding to membranes.

5- The factor/s determine bioavailability is/are:

a. Extent of absorption and hepatic first pass effect.

b. Amount of a substance obtained orally and quantity of intakes.

c. Half time of the drug.

d. Glomerular filtration rate.

6- Enzyme inhibitors such as cimetidine and valproic acid are likely to produce:

a. Increase rate of breakdown oof some drugs.

b. Decrease free level of some drugs.

c. Inhibition of certain enzymes which break down some drugs.

d. Reduction the toxicity of some drugs.

7- Half-life is the time required to:

a. Change the amount of a drug in plasma by half during elimination.

b. Absorb half of an introduced drug.

c. Bind a half of an introduced drug to plasma proteins.

d. Obtained the half of its biological response.

8- One of the following is enzyme inducer:

a. Tolbutamide

b. Malnutrition

c. Cimetidine

d. Valproic acid

9- In the first order kinetics, one false:

a. The rate of elimination is directly proportional to the concentration of drug in plasma.

b. Fixed % of drug is eliminated per time.

c. Linear relationship.

d. It is saturable elimination.

10- Volume of distribution increases with all of the following except:

a. The drug is greatly unionized.

b. High lipid solubility.

c. Reduce binding to plasma protein.

d. Reduce binding to tissue protein.

11- Weak bases are excreted faster in:

a. Acidic urine

b. Alkaline urine

c. Neutral urine

d. Concentrated urine

12- The main site of excretion of drugs is:

a. Kidney

b. Salivary glands

c. Skin

d. Lung

13- All the following are sites of drug biotransformation except:

a. Liver

b. Gut mucosa

c. Kidney

d. Bone

14- One of the following is enzyme inhibitor:

a. Rifampicin

b. Tolbutamide

c. Phenytoin

d. Valproic acid

15- Phase1 reaction includes all the following except:

a. Oxidation

b. Sulfation

c. Acetylation

d. b & c

16- All the following factors influencing the volume of distribution except:

a. Extent of ionization

b. 1st pass metabolism

c. Degree of lipid solubility

d. Degree of binding to plasma proteins

17- Which of the following promote excretion of acidic drugs?

a. Sodium bicarbonate

b. Ammonium chloride

c. Methionine

d. Ascorbic acid

18- Binding of a drug to plasma proteins tends to:

a. Decrease half-life.

b. Decrease its rate of glomerular filtration.

c. Increase its rate of biotransformation.

d. Increase its concentration in the plasma.

19- In general, biotransformation usually results in a product which is more:

a. Likely to produce side effects.

b. Water soluble than the original drug.

c. Lipid soluble than the original drug.

d. Likely to be reabsorbed by kidney tubules.

20- Which tissue has the greatest capacity to bio transform drugs?

a. Brain

b. Kidney

c. Liver

d. Lung

21- Stimulation of liver microsomal enzymes can:

a. Require dose increase of some drugs.

b. Require dose decrease of some drugs.

c. Prolong the duration of action of a drug.

d. Intensify the unwanted action of a drug.

22- The reason that complicated penetration of some drugs through brain blood barriers:

a. High lipid solubility of the drug.

b. Meningitis

c. Absence of pores in brain capillary endothelium.

d. High endocytosis degree in a brain capillary.

23- In a study, it is found that the dose if drug A to decrease the blood pressure is 0.1 mg/kg and for drug B is 0.3 mg/k. From this we can conclude:

a. Drug A has a greater maximal effect.

b. Drug B has a greater maximal effect.

c. Drug B has shorter half-life.

d. None of the above.

24- Systemic clearance (CLs) is related to:

a. Only the concentration of substances in plasma.

b. Only the elimination rate constant.

c. Volume of distribution, half-life and elimination rate constant .

d. Bioavailability and half-life.

23-d 24-c

Extra:

1- Which of the following steps is most critical to achieve a therapeutic drug concentration in plasma:

a. Metabolism

b. Absorption

c. Distribution

d. Elimination

2- Enterohepatic circulation occurs with:

a. Drugs excreted in bile.

b. Drugs excreted in urine.

c. Water soluble drugs.

d. All of the above.

3- Liver enzyme induces increase the effect of:

a. Water soluble drugs.

b. All drugs.

c. Prodrugs.

d. Lipid soluble drugs.

4- One is true regarding drug excretion:

a. Ammonium chloride increase ionization of morphine, so increases its excretion.

b. Vitamin C increases ionization of aspirin, so increases its excretion.

c. NaHCO3 decreases ionization of aspirin, so increases its excretion.

d. NaHCO3 decreases ionization of atropine, so increases its excretion

5- Drugs with small volume of distribution are characterized by:

a. Limited tissue uptake.

b. Dialysis is useful in toxicity.

c. Their Vd cannot be less than 5 liters.

d. All of the above.

e. None of the above.

Previous exams & Formative:

1- Parasympathetic receptor in eye is:

a. Muscarinic M1

b. Muscarinic M3

c. Nicotinic Nn

d. Nicotinic Nm

2- Which of the following adrenergic receptor is most commonly found presynaptic?

a. α1

b. α2

c. β1

d. β3

3- Which receptor associated with the sympathetic response increased lipid breakdown?

a. α1

b. β 2

c. β1

d. β3

4- Transmitter that carries excitatory signal from the preganglionic to the postganglionic neuron in autonomic nervous system is:

a. Acetylcholine

b. Epinephrine

c. Dopamine

d. Norepinephrine

5- Preganglionic sympathetic and parasympathetic fibers release......., postganglionic parasympathetic fibers release..........(for muscarinic cholinergic receptors), and postganglionic sympathetic fibers release..........(for adrenergic receptors).

a. Ach; Ach; NE

b. Ach; NE; Ach

c. NE; Ach; NE

d. NE; NE; Ach

6- Which of the following adrenergic receptor is most found pre – synaptic?

a. α1

b. α2

c. β1

d. β2

Extra:

1- Influx of what ion causes ACh release into the synaptic cleft, prior to ACh being terminated by acetylcholinesterase (AChE)? Select one:

a. Cl

b. Na+

c. Ca2+

d. K+

2- The correct statement about acetylcholine: Select one:

a. Is synthesized from an amino acid precursor

b. Has a half-life of 8 to10 hours in plasma

c. It’s released from nerve terminals is stimulated by botulinum toxin

d. It acts on both muscarinic and nicotinic receptors

3- Which of the following statements concerning the parasympathetic nervous system is Correct? Select one:

a. The preganglionic fibers of the parasympathetic division are short, compared to those of the sympathetic system.

b. The postganglionic fibers of the parasympathetic division are long, compared to those of the sympathetic system.

c. Is considered cranio-sacral

d. The parasympathetic nervous system uses epinephrine as a neurotransmitter.

4- Which of the following statements is correct regarding the sympathetic and parasympathetic systems? Select one:

a. Activation of the sympathetic system causes a drop in blood pressure.

b. Acetylcholine activates adrenergic receptors.

c. Norepinephrine activates muscarinic receptors.

d. Acetylcholine activates muscarinic receptors

5- Which of the following statements concerning the parasympathetic nervous system is correct? Select one:

a. The parasympathetic system often discharges as a single, functional system.

b. The parasympathetic division is involved in accommodation of near vision, movement of food, and urination.

c. The postganglionic fibers of the parasympathetic division are long compared to those of the sympathetic nervous system.

d. The parasympathetic system uses norepinephrine as a neurotransmitter.

6- Which of the following is correct regarding neurotransmitters and neurotransmission? Select one:

a. Serotonin and dopamine are the primary neurotransmitters in the ANS.

b. Neurotransmitter release is triggered by the arrival of action potentials in the postsynaptic cell.

c. Neurotransmitters are released from the presynaptic nerve terminals

d. Intracellular calcium levels drop in the neuron before the neurotransmitter is released.

7- Indicate the location of M2 cholinoreceptor type: Select one:

a. Smooth muscle

b. Glands

c. Endothelium

d. Heart

8- Which of the following is correct regarding the autonomic nervous system Select one:

a. Sympathetic neurons release in the effector organs

b. The neurotransmitter at the parasympathetic ganglion is norepinephrine

c. The neurotransmitter at the sympathetic ganglion is acetylcholine

d. Parasympathetic neurons release NE in the effector organs

Cholinergic agents 4

Previous exams & Formative:

1- What is bethanechol most commonly used for?

a. For decreasing heart rate

b. To decrease blood pressure (vasodilation)

c. For urinary retention

d. Decreasing intraocular pressure

2- Pilocarpine exhibits all the following characters EXCEPT:

a. It is a natural alkaloid

b. It is a tertiary amine accordingly it penetrates the BBB.

c. It is orally absorbed

d. It is mainly metabolized by monoamine oxidase enzyme

3- Regarding the cardiovascular effects of acetylcholine and parasympathomimetic, all the following are correct EXCEPT:

a. Negative chronotropic effect (decrease the heart rate)

b. Positive Inotropic effect (increases the force of contraction)

c. Negative dromotropic (reduces A-V conduction)

d. the cardiac effects are antagonized by atropine

4- Used in diagnosis of bronchial airway hyperreactivity in patients

a. Carbachol

b. Methacholine

c. Edrophonium

d. Neostigmine

5- One of the following is incorrect regarding the side effects of choline esters

a. Tightness of urinary bladder

b. Transient complete heart block and hypertension

c. Nausea, vomiting and abdominal cramps

d. Visual disturbance, headache and dyspnea.

6- One of the following is incorrect regarding pilocarpine

a. It is a direct muscarinic agonist with very weak nicotinic effect

b. It is a potent stimulator of secretions: sweat, tears, and saliva

c. It is local application on the eye leads to rapid miosis and spasm of accommodation

d. It is used in treatment of parkinsonism and terminated by true choline estrases

Extra:

1- Pilocarpine is most commonly used for:

a. Decreasing intraocular pressure

b. To decrease blood pressure

c. For decreasing heart rate

d. For urinary retention

2- Which of the following is the effect of stimulating muscarinic receptors:

a. xerostomia

b. Vasoconstriction

c. Mydriasis

d. Spasm of accommodation

3- Parasympathomimetic drugs cause:

a. Mydriasis

b. Bradycardia

c. Constipation

d. Bronchodilation

4- Following gastrointestinal surgery, your patient remains severely constipated. Bowel sounds are absent. The drug you are most likely to prescribe to treat this problem is:

a. Acetylcholine

b. Pilocarpine

c. Bethanechol

d. Atropine

5- Characteristics of carbachol include all of the following Except

a. It causes a decrease in intraocular pressure

b. It exerts both nicotinic and muscarinic effects

c. It causes mydriasis

d. It is a parasympathetic agent

6- The following is not an adverse effect of cholinomimetics

a. Bronchospasm

b. Tachycardia

c. Diarrhea

d. Aggravate peptic ulcer

Cholinesterase inhibitors

Previous exams & Formative:

1- Diagnosis of myasthenia gravis is done by:

a. Edrophonium

b. Methacholine

c. Neostigmine

d. Pyridostigmine

2- Which of the following reversible cholinesterase inhibitors is used for atropine intoxication?

a. Edrophonium

b. Neostigmine

c. Physostigmine

d. Pyridostigmine

3- Organophosphorus compounds produce toxic effects in humans by:

a. Inhibition of acetylcholine release

b. Inhibition of acetylcholine reuptake

c. Inhibition of acetylcholinesterase

d. Inhibition of nicotinic receptors

4- Many drugs, such as phenothiazines, antihistamines, and tricyclic antidepressants, have central and peripheral anticholinergic activity. Which of the following is useful in reversing the central anticholinergic syndrome produced by overdosage

a. Physostigmine

b. Neostigmine

c. Methacholine

b. Carbachol

Extra:

1- Which of the following is NOT a result of excessive cholinergic stimulation, as? Would be seen with a nerve agent or organophosphate poisoning? Select one:

a. Urinary urgency

b. Nausea

c. Diaphoresis

d. Mydriasis

e. Diarrhea

2- What type of drug is rivastigmine? Select one:

a. Adrenergic agonists

b. Reversible acetylcholinesterase inhibitors

c. Muscarinic antagonists

d. Irreversible acetylcholinesterase inhibitors

3- Which of the following reversible cholinesterase inhibitors is used for Alzheimer disease? Select one:

a. Neostigmine

b. Rivastigmine

c. Edrophonium

d. Pyridostigmine

4- In case of organophosphate insecticide poisoning, which of the following:

a. Atropine and propranolol

b. Physostigmine and propranolol

c. Atropine and pralidoxime

d. Physostigmine and pralidoxime

5- Which of the following drugs is irreversible cholinesterase inhibitor? Select one:

a. Physostigmine

b. Echothiophate

c. Neostigmine

d. Pilocarpine

6- A 29-year-old woman says that her eyes will not stay open despite the fact that She is not tired. Which of the following drugs would be most useful in helping to? Make a diagnosis in this patient? Select one:

a. Physostigmine.

b. Edrophonium.

c. Pyridostigmine.

d. Neostigmine.

7- Head and neck irradiation in cancer patients can decrease salivary secretion and cause dry mouth. All of the following drugs or classes of drugs are theoretically useful in improving secretion of saliva in these patients except: Select one:

a. Muscarinic agonists.

b. Muscarinic antagonists

c. Pilocarpine.

d. Anticholinesterase agents.

e. Neostigmine.

8- Sarin is a volatile nerve agent that inhibits cholinesterase enzymes. Which of the following symptoms would you expect to see in a patient exposed to sarin? Select one:

a. Urinary retention.

b. Dry mouth.

c. Tachycardia.

b. Miosis.

9- An elderly female who lives in a farm house was brought to the emergency room in serious condition after ingesting a liquid from an unlabeled bottle found near her bed, apparently in a suicide attempt. She presented with diarrhea, frequent urination, convulsions, breathing difficulties, constricted pupils (miosis), and excessive salivation. Which of the following is correct regarding this patient? Select one:

a. Her symptoms can be treated using a cholinergic agonist.

b. She most likely consumed an organophosphate pesticide.

c. The symptoms are consistent with sympathetic activation.

d. Her symptoms can be treated using an anticholinesterase agent.

10-In Alzheimer’s disease, there is a deficiency of cholinergic neuronal function in the brain. Theoretically, which of the following strategies will be useful in treating the symptoms of Alzheimer’s disease? Select one:

a. Inhibiting the acetylcholinesterase enzyme in the brain

b. Activating the acetylcholinesterase enzyme in the brain.

c. Inhibiting the release of acetylcholine in the brain.

b. Inhibiting cholinergic receptors in the brain

Anticholinergic agents 6

Previous exams & Formative:

1- Muscarinic action of acetylcholine can be blocked by:

a. Epinephrine

b. Atropine

c. Nicotine

d. Phenylephrine

2- Which of the following antimuscarinic drugs is short acting mydriatic?

a. Atropine

b. Homatropine

c. Ipratropium

d. Tropicamide

3- Following is a synthetic analogue of atropine, used as an inhalational drug in Asthma:

a. Benztropine

b. Pirenzepine

c. Ipratropium

d. All of the above

4- Which of the following used for motion sickness?

a. Atropine

b. Scopolamine

c. Homatropine

d. Tropicamide

5- What two clinical results of atropine facilitate ophthalmoscopic examination?

a. Mydriasis (iris dilation) and increased lacrimation

b. Cycloplegia (ciliary paralysis) and miosis (iris constriction)

c. Miosis and increased lacrimation

d. Mydriasis and cycloplegia

e. Xerophthalmia (dry eyes) and mydriasis

6- Atropine substitute used in urinary incontinence and nocturnal enuresis

a. Telenzepine

b. Benztropine

c. Oxybutynin

d. Ipratropium

7- Atropine is not used in treatment of:

a. A-V block

b. Senile hypertrophy of prostate

c. Parkinsonism

d. Urinary incontinence

8- Acetylcholine reversal is due to the action of Ach on :

a. Nicotinic receptor in non atropinized animal

b. Muscarinic receptors in atropinized animal

c. Nicotinic receptors in atropinized animal

d. Muscarinic receptor in non atropinized animal

9- One of the following is incorrect regarding the effect of atropine on GIT:

a. It reduces the tone and motility of GIT

b. It reduces GIT secretion

c. It exhibits a mild anti-spasmodic effect in biliary tract

d. It increases the salivary secretion leading to difficulty in swallowing and talking

10- One of the following is lifesaving drug in treatment of organophosphorus toxicity:

a. Atropine

b. Choline esters (oximes)

c. Diazepam

d. Anti-convulsive drugs as ethyl alcohol

Extra:

1- Which of the following is an adverse effect of atropine?

a. Blurred vision

b. Increased salivation

c. Decreased intraocular pressure

d. Bradycardia

2- What type of drugs is scopolamine?

a. Nicotinic agonists

b. Nicotinic antagonists

c. Muscarinic agonists

d. Muscarinic antagonists

3- Adverse effects which frequently occur during treatment with high doses of atropine include all of the following EXCEPT:

a. Dry mouth

b. Sandy eyes

c. Diarrhea

d. Urinary retention

4- Muscarinic antagonists are useful for all of the following EXCEPT:

a. Eye examinations

b. Treatment of narrow angle glaucoma

c. Antidote for cholinergic agonists

d. Prevention of motion sickness

5- The only cholinomimetic that can antagonize atropine after fundus examination is:

a. Pilocarpine

b. Physostigmine

c. Ecothiophate

d. Edrophonium

6- The following are therapeutic uses of atropine rather than atropine substitutes Except:

a. Organophosphate poisoning

b. Asthma & COPD

c. Hyperactive carotid sinus - heart block

d. Travelers diarrhea

7- Atropine is used as pre-anesthetic medication due to all the following EXCEPT:

a. It blocks the cardiac muscarinic receptors

b. It decreases blood pressure

c. It decreases vomiting

d. It induces bronchodilatation and stimulates respiration

8- Which of the following is NOT an adverse effect of atropine?

a. Confusion

b. Bradycardia

c. Dry mouth

d. Blurred vision

e. Urine retention

9- Treatment of atropine poisoning does not include:

a. Gastric lavage

b. Neostigmine

c. Diazepam

d. Cooling blankets

10- Which of the following adverse effects would NOT be expected with Scopolamine?

a. Blurred vision

b. Diaphoresis (increased sweating)

c. Constipation

d. Confusion

e. Xerostomia (dry mouth)

10-b

Previous exams & Formative:

1- Full activation of the sympathetic nervous system, can produce all of the following responses except:

a. Bronchial relaxation.

b. Decreases intestinal motility

c. Increased renal blood flow.

d. Mydriasis

2- The sympathetic and parasympathetic systems exert functionally opposite influences on the following parameters except:

a. Pupil diameter.

b. Atrial refractory period

c. Intestinal motility.

d. Heart rate.

3- The following sympathomimetic amine has agonistic action on alpha1 + alpha2 +beta1 adrenoceptors, but not on beta2 receptors:

a. Adrenaline

b. Phenylephrine.

c. Isoprenaline

d. Noradrenaline.

4- Adrenaline injected with a local anesthetic:

a. Reduces systemic toxicity of the local anesthetic

b. Makes the injection less painful.

c. Reduces local toxicity of the local anesthetic

d. Shortens duration of local anesthesia.

5- If a child has signs of anaphylaxis, what is the treatment of choice?

a. Diphenhydramine (an antihistamine).

b. Epinephrine.

c. Ephedrine

d. Isoproterenol.

6- Concerning the cardiovascular effects of epinephrine, all the following statements are true except:

a. Epinephrine has negative inotropic effect.

b. Epinephrine has positive inotropic effect.

c. Biphasic action of epinephrine is due to more prominent α effect leading to increase in blood pressure, followed by more persistent β2 effect leading to decrease in blood pressure.

d. Epinephrine reversal effect is due its action on β2 receptor only.

7- All the following are therapeutic uses of epinephrine Except:

a. Hypertension.

b. Glaucoma.

c. To prolong the action of local anesthetics.

d. Cardiac arrest.

8- All the following drugs are endogenous catecholamine except:

a. Epinephrine.

b. Isoprenaline.

c. Norepinephrine.

d. Dopamine.

9- Epinephrine is not effective after one of the following routes of administration:

a. Oral administration

b. Subcutaneous administration.

c. Intramuscular administration

d. Intravenous administration.

10- The following drug produces biphasic effect:

a. Dopamine

b. Isoproterenol.

c. Epinephrine

d. Norepinephrine.

11- Fight or flight’ state can be described as:

a. Sympathetic active; para-sympathetic inactive.

b. Sympathetic active; para-sympathetic active.

c. Sympathetic inactive; para-sympathetic active

d. Sympathetic inactive; para-sympathetic inactive.

12- Pharmacological antagonist of histamine is:

a. Diphenhydramine

b. Epinephrine.

c. Cromolyn sodium

13- What is the mechanism of action of clonidine?

a. a 1 antagonist

b. a 1 agonist.

c. a2 agonist.

d. B1 agonist

14- When the epinephrine is combined with local anesthetic it is added because:

a. It is Beta 1 agonist

b. It is Beta 2 agonist.

c. It is Alpha 1 agonist

d. It is Alpha 2 agonist.

15- Which of the following is the drug of choice in anaphylaxis associated with bronchospasm and hypotension:

a. Histamine

b. Epinephrine.

c. Isoproterenol

d. Phenylephrine.

16- The following indication/s of epinephrine is/ are entirely due to its a effect:

a. Anaphylactic shock.

b. Cardiac Arrest.

c. Prolong action of local Anesthetics

d. Epistaxis.

e. c and d.

15-b 16-e

Previous exams & Formative:

1- The drug used in treatment of shock due to myocardial infarction is:

a. Norepinephrine

b. Epinephrine

c. Dopamine

d. Isoproterenol

2- What is the mechanism of action of clonidine?

a. Alpha 1 antagonist

b. Alpha 2 agonist

c. Alpha 1 agonist

d. Beta 1 agonist

3- The following drug is indirect acting:

a. Epinephrine

b. Ephedrine

c. Dopamine

d. Amphetamine

4- Amphetamine has most prominent:

a. Beta 1 effects

b. Beta 2 effects

c. Metabolic effects

d. CNS excitatory effects

e. None of the above

5- A drug that decreases blood pressure and has analgesic and effects is:

a. Atenolol

b. Clonidine

c. phentolamine

d. reserpine

e. Prazosin

Extra

1- The drug of choice which used in treatment of hypertension with pregnancy is:

a. Dopamine

b. Clonidine

c. Alpha methyl dopa

d. Isoproterenol

2- The following drugs produce biphasic effect:

a. Epinephrine

b. Isoproterenol

c. Norepinephrine

d. Dopamine

3- Hypertensive crisis occurs with sudden withdrawal of:

a. Verapamil

b. Clonidine

c. Guanethidine

d. Thiazides

4- The following sympathomimetic amine has agonist action on alpha1 + alpha2 +beta1 adrenoceptors, but not on beta2 receptors:

a. Adrenaline

b. Phenylephrine

c. Isoprenaline

d. Noradrenaline

5- Select the side-effect characteristic for selective beta2-adrenomimics: Select one:

a. Tachycardia

b. Depression of the breathing center

c. Peripheral vasoconstriction

d. Dry mouth

6- Dopaminergic D1 and D2 as well as adrenergic a and beta1, but not beta2 receptors are activated by:

a. Phenylephrine

b. Dobutamine

c. Methoxamine

d. Dopamine

7- All the following are therapeutic uses of epinephrine Except:

a. Hypertension.

b. Glaucoma.

c. To prolong the action of local anesthetics.

d. Cardiac arrest

8- Which of the following sympathomimetics acts indirectly?

a. Epinephrine

b. Norepinephrine

c. Ephedrine

d. Methoxamine

9- Catecholamine includes following EXCEPT:

a. Ephedrine

b. Epinephrine

c. Isoprenaline

d. Norepinephrine

10- A nonselective beta receptor agonist causes all of the following effects EXCEPT:

a. Increase cardiac output

b. Increase peripheral arterial resistance

c. Decrease peripheral arterial resistance

d. Decrease the mean pressure

11- All of the following agents are beta receptor agonists EXCEPT:

a. Epinephrine

b. Isoproterenol

c. Methoxamine

d. Dobutamine

12-Which of the following agents is an alfa1 alfa2 beta1 beta2 receptor agonist?

a. Methoxamine

b. Albuterol

c. Epinephrine

d. Norepinephrine

13- Indicate the direct-acting sympathomimetic, which is an alfa1 alfa2 beta1 receptor agonist:

a. Isoproterenol

b. Ephedrine

c. Dobutamine

d. Norepinephrine

14-Which of the following agents is a nonselective beta receptor agonist?

a. Norepinephrine

b. Terbutaline

c. Isoproterenol

d. Dobutamine

15-Indicate the beta1-selective agonist:

a. Isoproterenol

b. Dobutamine

c. Metaproterenol

d. Epinephrine

Part One

Previous exams & Formative:

1- Postural hypotension is a common adverse effect of which one of the following types of drugs?

a. ACE inhibitors

b. Alpha-receptor blockers

c. Angiotensin receptor blockers

d. Beta-receptor blockers

2- The drug that causes extrapyramidal effect?

a. Reserpine

b. Amphetamine

c. Atropine

d. Adrenalin

3- Indicate which of the following statements concerning reserpine are correct:

a. It is one of the drugs which used in treatment of congestive heart failure

b. It inhibits the uptake of dopamine into catecholamine synaptic vesicles

c. It lowers catecholamine levels in the brain

d. a and b

e. b and c

4- Which of the following effects of epinephrine would be blocked phentolamine not by metoprolol:

a. Cardiac stimulation

b. Contraction of radial smooth muscle of the iris

c. Relaxation of bronchial smooth muscles

d. Relaxation of the uterus

5- The B blocker agent used in treatment of hypertensive emergency in pregnancy is:

a. Propranolol

b. Labetalol

c. Carvedilol

d. Timolol

6- Which of the following drugs has both α1 selective and β blocking effects:

a. Labetalol

b. Phentolamine

c. Metoprolol

d. Propranolol

Extra:

1- Regarding prazosin, the following is not true?

a. It is used in benign prostatic hyperplasia.

b. Doxazocin is preferred to it as it is longer acting with less 1st dose hypotension

c. Tamsulosin is preferred to it in benign prostatic hyperplasia as it induces minimal change in BP as it acts on alpha 1A not alpha 1B receptors.

d. It causes mydriasis.

2- The following is not an adverse effect of alpha blockers?

a. 1st dose postural hypotension.

b. Tachycardia, marked with non-selective agents

c. Fluid retention.

d. Hypertriglyceridemia

e. Impaired ejaculation and sexual dysfunction

1- d 2- d

Previous exams & Formative:

1- Best drug in treatment of heart failure because of its antioxidant effect:

a. Carvedilol

b. Labetalol

c. Propranolol

d. Nebivolol

2- Selective B1 blocker with additional alpha effects:

a. Propranolol

b. Nebivolol

c. Timolol

d. Pindolol

3- Terbutaline has the following side effects except:

a. Palpitation

b. Skeletal muscle tremors

c. Headache

d. Myocardial ischemia

4- Which of the following B receptor antagonists is preferable in patients with asthma, diabetes or peripheral vascular diseases?

a. Propranolol

b. Metoprolol

c. Nadolol

d. Timolol

5- ẞ blockers can cause all the following except:

a. Bronchospasm

b. Sedation, sleep disturbances and depression

c. Hyperglycemia in diabetic person

d. Bradycardia

6- B-carbolines is an example of:

a. Agonists

b. Antagonists

c. Partial agonists

d. inverse agonists

7- Propranolol is useful in all of the following except:

a. Angina

b. Familial tremor

c. Hypertension

d. Partial heart block

8- The mechanisms of antihypertensive effect of propranolol are all the following except:

a. By its effect on the heart

b. By antagonize the release of renin

c. By Effects on central nervous system

d. By vasodilation of blood vessels

9- Which one of the following B-blockers has reduced risk of bronchospasm?

a. Propranolol

b. Atenolol

c. Pindolol

d. None of the above

10- Which one of the following B-blockers has reduced risk of bronchospasm?

a. Propranolol

b. Atenolol

c. Pindolol

d. None of the above

11- Propranolol is contraindicated in:

a. Prophylaxis of anxiety states

b. Hyperthyroidism

c. Hypertrophic obstructive cardiomyopathy

d. Hypotension

12- Which of the following drugs is a non-selective ẞ receptor antagonist:

a. Metoprolol

b. Atenolol

c. Propranolol

d. Acebutolol

13- Which of the following drugs has both alpha 1 selective and ẞ blocking effects:

a. labetalol

b. Phentolamine

c. Metoprolol

d. Propranolol

14- All of the following are therapeutic uses of B blockers except

a. Hypertension

b. Thyrotoxicosis

c. Prinzmetal's angina

d. Prophylaxis of migraine headache

Extra:

1- All of the following contributes to the antihypertensive action of propranolol except:

a. Reduced cardiac output

b. Less noradrenaline release from sympathetic nerve endings

c. Decreased renin release from kidney

d. Direct vasodilatation

2- Propranolol does not block the following action of adrenaline:

a. Bronchodilatation

b. Lipolysis

c. Muscle tremor

d. Mydriasis

3- Beto-adrenergic blockers are indicated in the following conditions except:

a. Hypertrophic cardiomyopathy

b. Congestive heart failure

c. Vasospastic angina pectons

d. Dissecting aortic aneurysm

4- Select the B-adrenergic blocker that has additional ~1 blocking, vasodilator and antioxidant properties:

a. Celiprolol

b. Metoprolol

c. Acebutolol

d. Carvedilol

5- The following adverse effect of ẞ blockers is not due to ẞ-1 blockade:

a. Bradycardia.

b. Heart failure.

c. Hypotension.

d. Prolongation of insulin-induced hypoglycemia.

6- The following adverse effect of ẞ blockers is not due to ẞ2 blockade:

a. Bronchospasm.

b. Prolong insulin-induced hypoglycemia.

c. Cold extremities.

d. Hypotension

7- Non-selective B Blocker with vasodilator effect secondary to ~(alpha) blockade

a. Labetalol

b. Carvedilol

c. Nebivolol

d. Celiprolol

e. a and b

8- A patient with severe hypotension is given norepinephrine. Which of the following drugs antagonizes both its vascular and cardiac actions?

a. Atenolol

b. Esmolol

c. Carvedilol

d. Celiprolol

e. Prazosin

9- B-mediated antihypertensive effects of bisoprolol do not include:

a. Decrease renin release

b. Resetting of baroreceptors

c. Negative inotropic & chronotropic effects

d. Vasodilatation of skeletal blood vessels

10- The following is/are not true concerning anti-anginal effects of B-blockers:

a. Blockade of renin release.

b. Reduction in heart rate & myocardial contractility.

c. Reduction in blood pressure

d. Coronary vasodilation in vasospastic angina

e. Inhibition of lipolysis resulting in decreased fatty acid utilization.

11- The following is/are true concerning anti-arrhythmic effects of B-blockers:

a. Decrease SAN rate & AVN conduction

b. Slow automaticity of sympathetically-induced ectopic focus.

c. Both of the above

d. None of the above

12- In prophylaxis of esophageal varices, B2 blocking effect (s) of non-selective B blockers reduce (s) portal blood flow secondary to:

a. Splanchnic vasoconstriction

b. Reduction of cardiac output.

c. Both of the above

d. None of the above

Previous exams & Formative:

1. A Second generation H1 antagonist:

a. Diphenhydramine

b. Chlorpheniramine

c. Hydroxyzine

d. Fexofenadine

2. Most common adverse effect of first generation H1 antagonists:

a. Sedation

b. Bronchospasm

c. Cardiac Failure

3. Sumatriptan is:

a. 5HT4 agonist

b. H1 antagonist

c. 5HT1B agonist

d. 5HT2A antagonist

4. Pharmacological antagonist of histamine is:

a. Diphenhydramine

b. Epinephrine

c. Cromolyn sodium

5. Antagonizing the action of histamine by epinephrin is an example of:

a. Chemical antagonism

b. Pharmacological antagonism

c. Functional antagonism

d. Dispositional antagonism

6. Therapeutic use of fexofenadine

a. Hypertension

b. Heart failure

c. Peptic ulcer

d. Urticaria

7. Common side effect of first generation H1 antagonists

a. Tachycardia

b. Pulmonary hypertension

c. Cholecystitis

d. Sedation

8. Ondansetron interacts with its serotonin receptor subtype

a. 5HT1A

b. 5HT1D

c. 5HT3

d. 5HT4

9. Greater than 90% of serotonin is located in

a. Platelets

b. Raphe nucleus

c. Enterochromaffin cells of Gl tract

d. Lungs

Extra:

1. Fall in blood pressure caused by larger doses of histamine is blocked by: Select one:

a. None of the above.

b. Combination of H1 and H2 antagonists

c. H2 antagonists alone

d. H1 antihistaminic alone

2. The drug that can directly release histamine from mast cells without involving antigen antibody reaction is: Select one:

a. Sulfadiazine

b. Morphine

c. Aspirin

d. Procaine

3. The following is not a feature of second generation antihistaminics: Select one:

a. High antimotion sickness activity

b. No impairment of psychomotor performance

c. Longer duration of antiallergic action

d. Absence of anticholinergic/anti 5-HT actions

4. The second generation H1 antihistaminic have the following advantages except: Select one:

a. Lack of anticholinergic side effects

b. Good antipruritic action.

c. Recipient can drive motor vehicles

d. Lack of alcohol potentiating potential

5. The typical response to intravenous injection of 5-HT in an anaesthetised animal is: Select one:

a. Rise followed by brief fall in BP

b. Fall in BP

c. Transient fall, followed by brief rise, followed by prolonged fall in BP

d. Rise in BP

6. The following 5-HT receptor is not a G protein coupled receptor: Select one:

a. 5 ht1

b. 5 ht4

c. 5 ht3