Pharmacology Final Exam

The drug used in asthma to block IgE antibodies is A. cromolyn B. omalizumab C. ipratropium D. guaifenesin E. nedocromil

B. omalizumab

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

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

The primary therapeutic goal in treatment of peptic ulcer is to A. increase mucosal production B. suppress acid production and relieve symptoms C. prevent erosion of ileum D. maintain levels of magnesium and calcium with antacids E. get patient on prostaglandins

B. suppress acid production and relieve symptoms

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

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

B. vasoconstriction

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+.

C) a rise in cytosolic Ca2+.

Cyclooxygenase (COX) is a family of enzymes that A. increase uric acid production and deposition B. degrade various prostaglandins C. inhibited by NSAIDs D. are inhibited by allopurinol and febuxostat E. are the final products causing platelet adhesion and clot formation

C. inhibited by NSAIDs

An acute allergic response A. can be blocked only by histamine B. cannot be prophylactically treated C. is characterized by itching, sneezing, and edema D. is only characterized by wheals and urticaria E. is the same as a type IV delayed allergic response

C. is characterized by itching, sneezing, and edema

1. 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

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

Metoclopramide (Reglan) is used to treat which ailments of the GI tract? A. GI hypermotility B. irritable bowel syndrome C. newly diagnosed peptic ulcers D. neurogenic colon E. GERD and chemotherapy induced vomiting

C. newly diagnosed peptic ulcers

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 stimulating 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

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

C. pharmacokinetics

The drug that possesses anesthetic properties and that acts by blocking glutamate receptors is A. cocaine B. methamphetamine C. phencyclidine D. MDMA E. marijuana

C. phencyclidine

Which of the following drugs blocks the release of HCl from parietal cells? A. antacids B. H2 -receptor antagonists C. proton pump inhibitors D. sucralfate E. misoprostil

C. proton pump inhibitors

Select the mechanisms of action for terbutaline (a beta-2 agonist). A. inhibit release of mediators from mast cells B. block beta-2 receptors C. relax smooth muscle D. only inhibit release of mediators from mast cells and relax smooth muscle E. all of these

C. relax smooth muscle

he bronchodilator drug that would provide the longest duration of action is A. epinephrine (Adrenaline) B. ipratropium (Atrovent) C. salmeterol (Serevent) D. theophylline (Elixophylline) E. terbutaline (Brethine)

C. salmeterol (Serevent)

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

Select the neurotransmitter receptor interaction that explains the mechanism of action of LSD and other hallucinogens. A. norepinephrine B. dopamine C. serotonin D. acetylcholine E. GABA

C. serotonin

Mast cell stabilizers work by blocking A. histamine after it is released B. H1 -receptors from binding histamine C. the release of histamine and other active substances from cells D. the effect of histamine after it binds E. only histamine in the treatment of eczematoid dermatitis

C. the release of histamine and other active substances from cells

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 treatments for simple diarrhea works by forming a complex with the irritant? A. antibiotics B. opioid derivatives C. anticholinergics D. adsorbents E. lactulose

D. adsorbents

Multidrug Resistance Protein 1 (MDR1) A. is only expressed in the liver B. only does bad things C. is an ion channel D. an efflux transporter and can reduce drug bioavailability E. pumps various exogenous agents into the cell or the body

D. an efflux transporter and can reduce drug bioavailability

Cromolyn and pemirolast A. are effective oral antihistamines B. work best after the mast cells have degranulated C. are effective in reducing the symptoms of conjunctivitis D. are applied intranasally E. increase ocular hyperemia

D. are applied intranasally

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 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

Acetaminophen A. is an aspirin substitute for the management of severe pain B. is an opioid substitute for analgesia and antipyresis in women C. has no associated liver toxicity with chronic use of large doses D. does not have an anticoagulation effect.

D. does not have an anticoagulation effect.

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

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

Which of the following drugs has been approved for treatment of patients with constipation caused by opioid analgesics? A. emollients B. lubiprostone C. stimulants D. methylnaltrexone E. magnesium citrate

D. methylnaltrexone

The drug used in the treatment of asthma that blocks the leukotriene receptor is A. fluticasone (Flovent) B. cromolyn (Intal) C. albuterol (Proventil) D. montelukast (Singulair) E. tiotropium (Spiriva)

D. montelukast (Singulair)

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 sympathetic and behavioral actions of cocaine in the brain are due to increases in A. norepinephrine B. serotonin C. dopamine D. norepinephrine and dopamine E. all of these

D. norepinephrine and dopamine

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

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

Which tissue can serve as the reservoir for most drugs A. kidney B. blood vessels C. liver D. heart E. adipose tissue

E. adipose tissue

Epinephrine stimulates A. alpha-1 receptors B. cholinergic receptors C. beta-1 receptors D. beta-2 receptors E. all except B

E. all except B

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

Intravenous administration and abuse of psychomotor stimulants, such as methamphetamine, are associated with the following: A. increased sympathomimetic actions B. development of drug tolerance C. behavioral and psychotomimetic effects D. activation of mesolimbic dopamine 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 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

The chemical mediators involved in asthma include A. prostaglandins B. ECF-A C. leukotrienes D. only prostaglandins and leukotrienes E. all of these

E. all of these

The pharmacologic actions of theophylline in the treatment of COPD include A. bronchodilation B. increased contractility of respiratory muscles C. increased mucociliary activity D. only bronchodilation and increased mucociliary activity E. all of these

E. all of these

What are the signs of PCP intoxication? A. muscular rigidity B. catatonia C. convulsions D. nystagmus E. all of these

E. all of these

Which is an indication for aspirin? A. analgesia B. antipyresis C. painful menstruation D. anticoagulation and dysmenorrhea 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

Select the statement(s) that are true concerning the use of marijuana. A. active ingredient referred to as THC B. believed to bind to a specific receptor in the brain C. frequent use associated with development of drug tolerance D. psychic effects involve release of dopamine E. all statements are true

E. all statements are true

Coxib A. is a potent activator of cyclooxygenase B. is used for its effectiveness in relieving severe and sharp pain C. inhibits xanthine oxidase to relieve pain and inflammation D. is not an anti-inflammatory drug E. does not significantly cause stomach upset, intestine bleeding and ulcers, as they selectively inhibit Cox-2

E. does not significantly cause stomach upset, intestine bleeding and ulcers, as they selectively inhibit Cox-2

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 into the brain 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

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

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.

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) it is a nonpolar compound that penetrates the CNS more easily than neostigmine.

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.

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

Fexofenadine and cetirizine A. are more selective for peripheral H 1 -receptors B. bind the H 1 -receptors in the brain to produce fewer side effects C. are more sedating and drying than diphenhydramine D. are mast cell stabilizers E. shorten the cardiac QTc interval

A. are more selective for peripheral H 1 -receptors

Morphine is an opioid analgesic that A. can be used for relief of severe visceral pain B. has many formulations (lozenge, film) because it is used routinely in dental surgery C. induces chronic 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 severe visceral pain

Methylnaltrexone A. cannot go to the brain due to a positive charge in the chemical structure B. is used to treat opioid-induced diarrhea C. stimulate activity of opioid receptor D. cause addiction E. a sedative

A. cannot go to the brain due to a positive charge in the chemical structure

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

A. direct-acting anticholinergic drug

The causes of peptic ulcers include A. not enough mucosal lining in the stomach B. suppressed acid production C. regurgitation of bile acids into the esophagus D. being genetically predisposed E. hypersecretion of mucus in the stomach

A. not enough mucosal lining in the stomach

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

Select the first-generation antihistaminic drug. A. promethazine B. cetirizine C. loratadine D. levocetirizine E. bepotastine

A. promethazine

LSD is associated with the following pharmacologic effect when taken repeatedly: A. rapid development of drug tolerance B. drug dependency C. no cross-tolerance with other hallucinogens D. intense withdrawal symptoms E. all of these

A. rapid development of drug tolerance

A patient presents with severe diarrhea. Upon questioning, the patient mentions that he returned from Thailand a week ago. The patient is diagnosed with "traveler's diarrhea." The drug of choice for this patient would include A. rifaximin (an antibiotic) B. bulk laxatives C. lubiprostone (a ClC 2 chloride channel activator) D. methylnaltrexone E. polyethylene glycol-electrolyte solution (PEG-ES)

A. rifaximin (an antibiotic)

The site of action of centrally acting skeleton muscle relaxant is the A. spinal cord B. limbic system C. reticular formation D. basal ganglia E. cerebellum

A. spinal cord

The pharmacologic effects of ziconotide (a N-type voltage-gated calcium channel blocker isolated from the cone snail venom) 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 norepinephrine, acetylcholine, and serotonin release

A. to treat severe pain

The mechanism of action of cromolyn sodium (Intal) is to A. produce bronchodilation B. increase expectoration of mucus C. inhibit release of mast cell mediators D. liquefy bronchial secretions E. block leukotrienes

C. inhibit release of mast cell mediators

After being picked up in a police raid at an illegal beach party, a 21-year-old female is admitted to the emergency department with delirium, hallucinations, and amnesia. The drug screen is positive for phencyclidine ("angel dust"). Flumazenil (which antagonizes GABAA receptors) will not be effective as an antidote because phencyclidine predominantly blocks A) GABAA receptors. B) NMDA receptors. C) GABAB receptors. D) Dopamine receptors .E) Acetylcholine receptors.

B) NMDA receptors.

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.

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.

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.

Histamine A. is classified as a mast cell release inhibitor B. is one of the substances released during an allergic response C. is found in white blood cells known as neutrophils D. does not cause skin reactions E. is clinically limited to interacting with H1-receptors

B. is one of the substances released during an allergic response

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

Mast cells A. are only found in the bloodstream B. are coated with immunoglobulins that recognize antigens C. have no other role than antiallergy in the body D. degranulate when the H 1 -receptor is stimulated E. degranulation results in hypertension

B. are coated with immunoglobulins that recognize antigens

Antihistamines like chlorpheniramine A. are the newest, third-generation drugs B. are effective and can cause drowsiness C. are not found in OTC products D. do not have anticholinergic properties E. are less effective than diphenhydramine

B. are effective and can cause drowsiness

Naloxone is used to A. activate opioid receptors B. competitively antagonize opioid receptors and treat opioid overdose C. relieve server pain D. cannot go to the brain E. selectively target opioid receptor in the gut

B. competitively antagonize opioid receptors and treat opioid overdose

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

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 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. agonist means the drug occupies the receptor and causes a response D. opioid agonist means the drug occupies the receptor and stimulates the release of endorphins E. tolerance is a characteristic of chronic opioid antagonism

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

The antidote for organophosphate poisoning includes A. scopolamine B. bethanechol C. atropine D. physostigmine E. dicyclomine

C. atropine

2. PIP2 is A. an analgesic agent B. locates in the nucleus C. can be broken down into arachidonic acid by phospholipase A D. an amino acid E. a lipid in inner membrane of the plasma membrane and its break down can generate second messengers such as cAMP and DAG

C. can be broken down into arachidonic acid by phospholipase A

Corticosteroids are used in the treatment of asthma in which of the following ways? A. decrease activation of arachidonic acid B. increase the release of inflammatory mediators C. decrease the production of allergic antibodies D. only decrease activation of arachidonic acid and decrease the production of allergic antibodies E. all of these

C. decrease the production of allergic antibodies

Which of the three phases of gastric acid secretion is stimulated by the distention of the stomach? A. cephalic B. colonic C. gastric D. intestinal E. activation of the CTZ

C. gastric

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 mucus secretions E. increase blood pressure

C. increased gastrointestinal activity

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

Parasympathetic activation of the respiratory tract causes which of the following? A. bronchodilation B. increased cyclic AMP C. increased mucus secretion D. stimulation of the beta-2 receptors E. increased mucociliary action

C. increased mucus secretion

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.

What is the most common etiology of peptic ulcer disease? A. alcohol B. GERD (gastroesophageal reflux disease) C. NSAIDs (nonsteroidal antiinflammatory drugs) D. Helicobacter pylori E. hypersecretory conditions

D. Helicobacter pylori