Pharmacology Exam 1

Drug X has a half-life of 6 hours. How much drug is left in the body 18 hours after an IV injection of 1200 milligrams (mg)? A. 75 mg B. 150 mg C. 300 mg D. 600 mg E. 900 mg

B. 150mg

Which of the following major routes remove etomidate and midazolam from the body? A. hepatic metabolism and renal excretion B. excretion through the lungs and sweating C. accumulation in fat tissue and redistribution D. increased salivation and bile production E. gastrointestinal reabsorption

A. hepatic metabolism and renal excretion

Eszopiclone A. is classified as a benzodiazepine B. has a half-life of 1-2 hours C. increases total sleep time D. is used as an antianxiety agent E. is also used as an anticonvulsant

C. increases total sleep time

Why is propofol a drug of choice for induction and maintenance of anesthesia? A. it is a potent analgesic at all doses B. it slowly brings the patient to the stage of surgical anesthesia C. it is a complete anesthetic with a quick onset of action and recovery period uncomplicated by nausea and vomiting D. it is administered by special vaporizer to avoid mask delivery E. its preparation does not require special handling technique

C. it is a complete anesthetic with a quick onset of action and recovery period uncomplicated by nausea and vomiting

Disadvantages to the use of barbiturate hypnotics include A. development of drug tolerance B. risk of drug dependency C. disruption of normal stages of sleep D. suppression of REM sleep E. all of these statements are true

E. all of these statements are true

A medication that does not require a physician's service to obtain is referred to as A. trade B. nonproprietary C. nonprescription D. brand E. generic

C. nonprescription

Succinylcholine is associated with which of the following actions? A. stimulation of the actin and myosin muscle fibrils directly B. liver damage because the drug is metabolized only by the liver C. peripheral neuromuscular receptor blockade after stimulating the Nm receptors D. longer duration of action than vecuronium E. stimulation of presynaptic ACH release

C. peripheral neuromuscular receptor blockade after simulating the Nm receptors

The study of drug absorption, distribution, metabolism, and excretion is known as A. pharmacotherapeutics B. pharmacodynamics C. pharmacokinetics D. pharmacy E. posology

C. pharmacokinetics

Which of the following drugs has a recognized medical therapy and does not interact with opioid receptors? A. heroin B. codeine C. methadone D. acetaminophen

D. acetaminophen

At therapeutic doses, albuterol stimulates A. alpha-1 receptors B. alpha-2 receptors C. beta-1 receptors D. beta-2 receptors E. all of these

D. beta-2 receptors

The drug of choice to treat acute allergic reactions is A. norepinephrine B. phenylephrine C. pseudoephedrine D. epinephrine E. propranolol

D. epinephrine

The mechanism of action of methyldopa is A. increased release of NE from adrenergic nerve ending B. alpha-1 receptor blocker C. beta-1 receptor blocker D. formation of a false transmitter in adrenergic nerve ending E. none of these

D. formation of a false transmitter in adrenergic nerve ending

Oxycodone in therapeutic doses can stimulate mu receptors to cause A. hyperventilation and deep breathing B. bronchospasms C. spasmogenic activity in the ureters and sphincter muscle D. relaxation of the skeletal muscles controlling posture (spasmolytic) E. suppression of coughing

D. relaxation of the skeletal muscles controlling posture (spasmolytic)

The actions of epinephrine (EPI) include which of the following? A. bronchodilation B. vasoconstriction C. relaxation of uterus D. increased heart rate E. all of these

E. all of these

Which drugs would be used as adjunct therapy to anesthesia? A. analgesics B. antiarrhythmics C. antianxiety, short-acting CNS depressants like midazolam D. anticholinergics E. all of these

E. all of these

Which of the following are actions of nonselective beta-adrenergic blocking drugs? A. decreasing heart rate B. decreasing force of myocardial contraction C. vasoconstriction of skeletal muscle blood vessels D. lowering of blood pressure E. all of these

E. all of these

Which of the following could be categorized as an adverse reaction? A. idiosyncrasy B. drug allergy C. teratogenicity D. carcinogenicity E. all of these

E. all of these

Flurazepam A. is classified as long-acting B. forms active metabolites C. may cause next-day residual effects D. increases chloride ion influx E. all of these statements are true

E. all of these statements are true

Barbiturate and benzodiazepine hypnotics both A. increase NREM stage 2 sleep B. increase REM sleep C. increase NREM stage 4 sleep D. cause REM rebound E. all of these statements are true

A. increase NREM stage 2 sleep

Physostigmine (Eserine ) is classified as a(n) A. direct-acting cholinergic drug B. reversible acetylcholinesterase inhibitor C. irreversible acetylcholinesterase inhibitor D. anticholinergic drug E. ganglionic blocker

B. reversible acetylcholinesterase inhibitor

Which of the following would be a preferred treatment for overactive bladder? A. neostigmine B. tolterodine C. physostigmine D. bethanechol E. donepezil

B. tolterodine

The drug administration route demonstrating the slowest onset of action is A. inhalation B. transdermal C. intramuscular D. sublingual E. intravenous

B. transdermal

The pharmacologic effect of IV metaraminol (an alpha-1 drug) is A. vasodilation B. vasoconstriction C. cardiac stimulation D. cardiac depression E. bronchodilation

B. vasoconstriction

Metoprolol is classified as a(n) A. alpha-blocker B. nonselective beta-blocker C. selective beta-1 blocker D. adrenergic neuronal blocker E. selective beta-2 blocker

C. selective beta-1 blocker

The proprietary drug name supplied by a pharmaceutical company is also referred to as the A. generic name B. over-the-counter name C. trade name D. chemical name E. none of these

C. trade name

The main pharmacologic effect of norepinephrine on alpha-1 receptors is A. increased heart rate B. bronchodilation C. vasoconstriction D. contraction of urinary bladder E. increased force of myocardial contraction

C. vasoconstriction

Which of the following is a correct statement? A. opioid analgesics produce little or no respiration depression with long-term use of analgesic doses B. opioid antagonists include endorphins C. all drugs in the opioid analgesic group are controlled substances, Schedule III D. in low doses, opioids produce nausea and vomiting E. fentanyl is a partial opioid antagonist

D. in low doses, opioids produce nausea and vomiting

The medical situation when a particular drug should not be administered is referred to as A. side effect B. adverse effect C. drug allergy D. contraindication E. antagonism

D. contraindication

A drug that has the potential for abuse and is regulated by the Drug Enforcement Agency is classified as a A. poison B. OTC drug C. prescription drug D. controlled substance E. nonproprietary drug

D. controlled substance

Prolonged receptor stimulation during chronic drug therapy may induce cells to endocytose and sequester drug receptors in endocytic vesicles. This molecular mechanism is called A) tachyphylaxis. B) inactivation. C) desensitization. D) downregulation. E) refractoriness.

D. downregulation

In order for drugs to cross the blood-brain barrier, they must be A. ionized B. positively charged C. water soluble D. lipid soluble E. negatively charged

D. lipid soluble

Parasympathetic receptors located on the membranes of the internal organs are classified as A. alpha-1 B. nicotinic-neural (Nn) C. nicotinic-muscle (Nm) D. muscarinic E. ganglionic

D. muscarinic

The antidote for atropine poisoning is A. scopolamine B. bethanechol C. neostigmine D. physostigmine E. dicyclomine

D. physostigmine

Which factor of individual variation is dependent upon the patient's attitude toward treatment? A. weight B. age C. genetic variation D. placebo effect E. gender

D. placebo effect

Alcohol has pharmacological effects on which body systems? A. central nervous system B. gastrointestinal system C. renal system D. vascular system E. all of these

E. all of these

Epinephrine stimulates A. alpha-1 receptors B. alpha-2 receptors C. beta-1 receptors D. beta-2 receptors E. all of these

E. all of these

Opioid drugs are derived from which of the following? A. poppy B. opium C. chemical synthesis D. alkaloids E. all of these

E. all of these

Symptoms of cholinergic drug overdosage include A. slow pulse rate B. increased urination C. diarrhea D. sweating E. all of these

E. all of these

The time a drug continues to produce its effect is its A. ED50 B. maximal response C. ceiling effect D. onset of action E. duration of action

E. duration of action

The rate of drug absorption would be increased by which of the following? A. drug ionization B. water solubility C. positively charged drug D. negatively charged drug E. lipid solubility

E. lipid solubility

A 16-year-old female with a history of goiter is admitted with fever, profuse sweating, tachyarrhythmia, hypertension, abdominal pain, and anxiety. Based on a working diagnosis of thyrotoxicosis, she is started on a beta-adrenoceptor antagonist that has a very short half-life. Refer to the case above. Regarding the mechanism by which the drug ameliorates the toxic effects of excessive thyroxine levels, the drug acts as A)a physiologic antagonist. B)a competitive receptor antagonist. C)a noncompetitive receptor antagonist. D)a partial agonist. E)an inverse agonist.

A. a physiologic antagonist

Zolpidem A. binds to the alpha-1 subunit of the GABA A receptor B. is useful as a muscle relaxant C. has a slow onset of action D. is useful as an anticonvulsant E. is chemically classified as a benzodiazepine

A. binds to the alpha-1 subunit of the GABA A receptor

Fentanyl is an opioid analgesic that A. can be used for relief of cancer pain B. has many formulations (lozenge, film) because it is used routinely in dental surgery C. induces neuropathic pain D. primarily works on peripheral nerve endings rather than higher centers E. does not have a black box warning because of its low addiction potential

A. can be used for relief of cancer pain

Select the adverse effects of opioid analgesics. A. constipation B. polyuria C. convulsions D. mydriasis E. excessive tearing

A. constipation

During tolerance to opioid analgesics, the following is happening. A. fewer receptors are available to produce a response B. increased pain by the patient requires greater doses of medication C. the body reacts to removal of the opioid analgesic D. histamine release causes hypotension E. signals from nocieocptors are reduced

A. fewer receptors are available to produce a response

Which FDA pregnancy category would appear to be the safest for a developing fetus? A. Category A B. Category B C. Category C D. Category D E. Category X

A. Category A

The graph shows the dose-response relationship for three different drugs. Which of the following correctly describes properties of drug X in comparison to drugs A and B? (DIAGRAM ON RECITATION 1-3 QUESTION 28) A)X is less potent than A and less efficacious than B. B)X is equally potent with A and more efficacious than B. C)X is less potent than B and equally efficacious with A. D)X is equally potent with B and less potent than A. E)X is more efficacious than A and less efficacious than B.

A. X is less potent than A and less efficacious than B

What is the best reason for using a balanced anesthesia strategy? A. producing complementary effects using a few drugs avoids unnecessary intense (deep) CNS depression with one anesthetic to achieve the same effect B. the concentration of volatile anesthetic in the alveoli is balanced against the amount of anesthetic in the blood C. less monitoring of anesthesia is required D. fewer patients experience emergence delirium E. there is less chance of aspirating saliva

A. producing complementary effects using a few drugs avoids unnecessary intense (deep) CNS depression with one anesthetic to achieve the same effect

A 45-year-old female shop assistant is treated for heartburn with omeprazole. She notes that the effect of a dose of omeprazole lasts much longer than that of a dose of the antacid drug calcium carbonate she had previously taken. The active metabolite of omeprazole binds covalently and irreversibly to a molecular structure involved in releasing protons into the gastric juice. Drugs that modify their target structures through this mechanism are called A) suicide substrates. B) orphan drugs. C) protein drugs. D) competitive antagonists. E) enantiomers.

A. suicide substrates

A 17-year-old girl with suspected intrinsic asthma but nearly normal results on spirometry and flow volume testing takes a methacholine provocative test. The mechanism of action of methacholine most closely resembles that of: A. hemicholinium. B. acetylcholine. C. edrophonium. D. succinylcholine. E. neostigmine.

B. acetylcholine

The correct statement concerning the use of hypnotic drugs is A. zolpidem binds to the GABA receptor B. benzodiazepines increase chloride channel opening C. barbiturates block the GABA receptor D. ramelteon is a melatonin antagonist E. flumazenil is a benzodiazepine receptor agonist

B. benzodiazepines increase chloride channel opening

When a drug increases the rate of drug metabolism of other drugs, the process is termed A. first-pass metabolism B. enzyme induction C. enzyme inhibition D. enterohepatic cycling E. microsomal inhibition

B. enzyme induction

Select the pharmacologic effect produced by cholinergic drugs. A. increased heart rate B. increased gastrointestinal motility C. decreased urination D. pupillary dilation E. bronchodilation

B. increased gastrointestinal motility

A 36-year-old male has been diagnosed with chronic myeloid leukemia. His oncologist discusses treatment options with him. The patient is glad to hear that novel anticancer drugs used to treat chronic myeloid leukemia have a much better risk-benefit ratio than older ones, due to their improved selectivity. A major determinant for the selectivity of a given drug is A) its target receptor ligand affinity. B) its target receptor cell-type distribution. C) its ionic interactions. D) its hydrogen bonding. E) its intrinsic activity.

B. its target receptor cell-type distribution

The muscarinic receptor that couples to G proteins responsible for adenylyl cyclase inhibition and plays a key role in cholinergic input to the heart is classified as A) muscarinic-M1 receptor. B) muscarinic-M2 receptor. C) muscarinic-M3 receptor. D) muscarinic-M4 receptor. E) muscarinic-M5 receptor.

B. muscarinic-M2 receptor

Sharp pain is transmitted through which type of nerve fibers? A. unmyelinated B. myelinated A-delta C. CTZ D. C fibers E. mu fibers in the intestine

B. myelinated A-delta

The time from drug administration to the first observable drug effect is known as the A. duration of action B. onset of action C. ceiling effect D. maximal response E. ceiling effect

B. onset of action

In the delivery room, a 24-year-old patient who is pregnant and in gestational week 40 with twins, receives an intravenous infusion of oxytocin to promote the onset of regular uterine contractions. The goal is a constant state of medication delivery. Which of the graphs in the figure is the best approximation of the patient's oxytocin plasma curve? (DIAGRAM ON RECITATION 1-3 QUESTION 30) A) Graph A B) Graph B C) Graph C D) Graph D E) Graph E

C. Graph C

In the presynaptic terminal of neuronal cells, the immediate trigger to release a neurotransmitter from synaptic vesicles into the synaptic cleft is A. a drop in cytosolic Ca2+. B. a drop in cytosolic K+. C. a rise in cytosolic Ca2+. D. a drop in cytosolic Mg2+. E. a rise in cytosolic K+. F. a rise in cytosolic Mg2+.

C. a rise in cytosolic Ca2+

Which of the following is a correct statement? A. endorphin is an abbreviation from the terms meaning inside the organ B. endogenous opioid receptors include mu, alpha-2 adrenergic, and delta receptors C. agonism means the drug occupies the receptor and causes a response D. opioid agonism means the drug occupies the receptor and stimulates the release of endorphins E. tolerance is a characteristic of chronic opioid antagonism

C. agonism means the drug occupies the receptor and causes a response

An unusual or unexpected drug reaction by an individual is known as A. toxic effect B. antagonism C. idiosyncrasy D. side effect E. drug allergy

C. idiosyncrasy

Anticholinergic effects include all of the following except A. bronchodilation B. increased heart rate C. increased gastrointestinal activity D. decreased respiratory secretions E. dry mouth

C. increased gastrointestinal activity

13. First-pass metabolism refers to the metabolism of drugs in the A. kidney B. blood vessels C. liver D. heart E. adipose tissue

C. liver

17. Drugs that have demonstrated teratogenic effects in women are classified as Pregnancy Category A. B B. C C. D D. X E. NR

D. X

Which of the following is correct about the nicotinic-muscle (Nm) receptor blocking drugs? A. the mechanism of action is the same as represented by dantrolene B. all of these drugs depolarize the muscle fiber before blockade occurs C. calcium ions are released from the storage sites D. there are two groups in this class: either depolarizing agents or nondepolarizing agents E. botulinumtoxinA rapidly attaches to these receptors

D. there are two groups in this class: either depolarizing agents or nondepolarizing agents

All opioid analgesics are associated with which of the following? A. reversal of respiratory depression from barbiturates B. use only for the relief of acute pain C. cough suppression alone or in combination with other analgesics over-the-counter D. tolerance develops to the analgesic response E. drug of choice in treating biliary obstruction

D. tolerance develops to the analgesic response

A 25-year old female presents with delirium, hyperthermia, and symptoms of central anticholinergic intoxication. She has attended a ìwitches' conventî and ingested some herbal extracts including fruits of the species ìAtropa belladonna.î As one component of her treatment, she receives a dose of physostigmine. Refer to the case above. Indicate the site of physostigmine action in the schematic drawing of a cholinergic neuron. (DIAGRAM ON RECITATION 4-6 QUESTION 25) A) Metabolism at Site A B) Uptake at Site B C) Metabolism at Site C D) Vesicle fusion with the synaptic membrane at Site D E) Metabolism at Site E

E. metabolism at site E

The following diagram shows the antagonist effect on the agonist dose-response relationship. This is an example of a (DIAGRAM ON RECITATION 1-3 QUESTION 27) A) competitive antagonist. B) partial agonist. C) inverse agonist. D) spare receptor. E) noncompetitive antagonist.

E. noncompetitive antagonist

Pick the correct pharmacological effect(s) of direct-acting cholinergic drugs. A. respiratory paralysis B. urinary retention C. increased heart rate D. bronchodilation E. none of these

E. none of these

Opioid analgesics are used in which of the following settings? A. induction of Monitored Anesthesia Care and treatment of chronic severe pain B. routine treatment of migraine C. unmonitored treatment of chronic severe pain D. analgesia for patients with paralytic ileus E. chronic osteoarthritis

A. induction of monitored anesthesia care and treatment of chronic severe pain

Choose the correct class of general anesthetics. A. intravenous B. dissociative anesthesia C. oral D. topical E. epidural

A. intravenous

Refer to the case above. Physostigmine is preferred over neostigmine because A) it is a nonpolar compound that penetrates the CNS more easily than neostigmine. B) it has a shorter half-life than neostigmine, making it more useful for emergency treatment. C) it has a longer half-life than neostigmine, better matching the half-life of atropine. D) it is eliminated via the kidneys, and dosage is not critical with compromised liver function. E) it is eliminated via the liver, and dosage is not critical with compromised renal function.

A. its is a nonpolar compound that penetrates the CNS more easily than neostigmine

Which of the following is NOT correct? A. ketamine causes chloride ions to flow out of the nerve cell by binding to GABA B. propofol binds to the GABA A receptor and enhances hyperpolarization of the neuron C. barbiturates and propofol act on the receptor and directly on the chloride channel D. potent anesthetics enhance GABA A receptor function E. general anesthetics interact with neurotransmitter-gated ion channels

A. ketamine causes chloride ions to flow out of the nerve cell by binding to GABA

Select the types of anesthesia in which there is no loss of consciousness. A. local anesthesia B. Monitored Anesthesia Care C. general anesthesia D. balanced anesthesia E. maintenance anesthesia

A. local anesthesia

Select the term below that relates to the amount of drug administered to produce a therapeutic effect. A. posology B. toxicology C. pharmacodynamics D. pharmacotherapeutics E. pharmacy

A. posology

A 56-year-old man with chest pain is diagnosed with stable angina and treated with several drugs including nitroglycerin. Every day he has to discontinue nitroglycerin for some hours to re-establish reactivity of his body to the drug. The clinical observation of a rapidly decreasing response to nitroglycerin after administration of just a few doses is called A) idiosyncrasy. B) tachyphylaxis. C) heterologous desensitization. D) refractoriness. E) receptor downregulation.

B. tachyphylaxis