Pharmacology Exam One

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

B. transdermal

1. 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

1. 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

1. 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

1. 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

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

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+.

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 stimulating the Nm receptors

1. 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

1. 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

1. 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

1. 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

1. 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

1. 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

1. 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

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

In emergency situations what happens to GI tract activity?

Decrease in activity by EPI and NE stimulating alpha 1 to decrease intestinal peristalsis

Reserpine

Depletes the nerve ending vesicles of NE which is then metabolized by MAO

1. 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

1. 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

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

D. epinephrine

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

1. 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

1. 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

1. 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

1. 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

1. 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

1. 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

Alpha 2 adrenergic receptor

Located on adrenergic nerve endings; they are activated by NE and EPI to activate a negative feedback mechanism that reduces and regulates the release of additional NE

Selective Beta-1 Blockers Effect and examples:

Metoprolol Atenolol Esmolol Decrease heart rate and force of contraction

Cholinergic Crisis

Overstimulation at a neuromuscular junction due to an excess of acetylcholine 1. Overdose with a cholinesterase inhibitor 2. Exposure to nerve agents known as organophosphates 3. Chemical warfare agents 4. Victims of crimes

Selective Beta-2 Drugs Effect and examples:

Tertbutaline Albuterol Fenoterol Beta 2 - Relaxation of smooth muscle in tissues possessing beta-2 receptors, bronchioles, uterus

Guanethidine

Acts on the nerve endings to deplete the nerve vesicles of NE. The Guanethidine becomes concentrated in the vesicle and replaces the NE in the vesicle resulting in a depletion of NE storage in the nerve endings

1. 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

Alpha Drugs Effect and Examples

Norepinephrine Epinephrine Phenylephrine Contraction of smooth muscle in tissues possessing alpha-1 receptors ex. vasoconstriction

Alpha-Blocking Drugs Effect and Examples

Prazoin Terazoin Doxazoin Relaxation of smooth muscle in tissues possessing alpha-1 receptors ex. vasodilation

Beta 2 adrenergic receptor

Predominant beta receptor in the smooth muscle of coronary and skeletal muscle blood vessels and bronchiolar smooth muscle; vasodilation and bronchodilation

Beta 1 adrenergic receptor

Predominant receptors in the heart and when stimulated by NE or EPI, they increase heart rate and force of contraction

Affinity

Refers to the chemical forces that cause a substance to bind its receptor. Refers to how much attraction is between a drug and a receptor

In emergency situations what happens to respiratory bronchioles activity?

Relaxation of smooth muscle (bronchodilation) by EPI stimulation beta 2

Competitive antagonist

binds specifically to the same site of the receptors as the natural ligand and competes with each other for the same receptor site (effects the potency of the natural ligand)

1. 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

1. 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

1. 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

26. 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.

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.

Noncompetitive antagonist

does not bind the same site as the natural ligand and it allosterically affects the efficacy of the natural ligand

Nicotinic Nn receptor

in autonomic ganglia, adrenal medulla, and CNS

Alpha methyldopa

inhibits the enzyme that converts dopa into dopamine and therefore it is converted into a false transmitter instead of NE

Inverse agonist

molecule that binds to the same receptor as an agonist but induces a pharmacological response opposite to that of an agonist

What are the adverse effects of the anticholinergic drugs?

-dry mouth -visual disturbances -urinary retention -constipation -flushing and dryness of the skin -fever -tachycardia * similar to the effects of EPI and NE during fight or flight -symptoms of CNS stimulation and depression

What are the adverse effects of the cholinergic drugs?

-nausea -vomiting -diarrhea -blurred vision -excessive sweating -muscular tremors -bronchoconstriction -bradycardia -hypotension

GABA

Famous inhibitory neurotransmitter

Muscarinic M5 receptor

In the CNS (excitatory)

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

. pharmacokinetics

What sites are involved in the production of skeletal muscle relaxation?

1. Depression of the CNS 2. Blocking receptors within the neuromuscular junctions 3. Interfering with components of muscle fiber

What are the three types of cholinergic receptors in the peripheral nervous system?

1. Muscarinic (M1-M5) receptors are located at the parasympathetic postganglionic nerve endings 2. Nicotinic-neural receptors are located at the ganglionic sites of both sympathetic and parasympathetic nerves 3. Nicotinic-muscle receptors are located at the skeletal neuromuscular junctions

Nicotinic Nm receptor

In skeletal muscle at neuromuscular junction (NMJ)

1. 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

1. 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

The pharmacologic effects of ziconotide is A. to treat severe pain B. increase calcium entry in the pre synapse C. decrease serotonin release only D. increase neuronal activity E. Increase NE, serotonin, and acetylcholine release

A. to treat severe pain

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

Answer: D

Partial agonist

a molecule that binds to a receptor at its active site but produces only a partial response even when all the receptors are occupied (bound) by the agonist

. 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. 150 mg

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.

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.

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

1. 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

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.

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

B. tolterodine

1. 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

Nonselective Beta Drugs Effect and examples:

Epinephrine Isoproterenol Dopamine Dobutamine Beta 1 - cardiac stimulation Beta 2 - Relaxation of smooth muscle ex. bronchodilation

Alpha 1 adrenergic receptor

Found predominantly on smooth muscle membranes of arteries, veins, and sphincters of the urinary and GI tract. When stimulated by NE or EPI, they produce contraction; for example, vasoconstriction of most blood vessels

In emergency situations what happens to heart activity?

Heart activity is increased by NE and EPI stimulate beta-1 receptors

Muscarinic M4 receptor

In the CNS (inhibitory)

Muscarinic M1 receptor

In the autonomic ganglia / CNS (excitatory)

Muscarinic M2 receptor

In the heart (inhibitory)

Muscarinic M3 receptor

In the smooth muscle (excitatory)

Nonselective Beta Blockers Effect and examples:

Propranolol Nadolol Pindolol Beta 1 - Decreased heart rate, force of contraction Beta 2 - Blockade of beta-2 receptors not clinically useful

What two neurotransmitter substances are associated with the sympathetic nervous system? Describe the effects of each

The two neurotransmitter substances are norepinephrine and epinephrine. norepinephrine- primarily stimulates alpha receptors resulting in vasoconstriction and also stimulates beta 1 receptors in the heart epinephrine- Stimulates all adrenergic receptors. Epinephrine additionally causes bronchodilation and vasodilation of skeletal muscle blood vessels

In emergency situations what happens to arteries to GI and urinary tract activity?

Vasoconstriction to divert blood to skeletal muscle by NE stimulating alpha 1 receptors

In emergency situations what happens to arteries to skeletal muscle activity?

Vasodilation to increase blood flow by EPI stimulating beta 2

Efficacy

refers to the drugs ability to activate or inhibit the receptor once it has bound the receptor regardless of the dosage

Uncompetitive antagonist

requires the prior activation of receptor and affects both the potency and efficacy of the natural ligand. Typically blocks channels

Potency

the amount of a drug thats necessary to produce a desired effect (how powerful or strong a drug is) -mainly determined by the drugs affinity for the receptors