Pharma credit 2 1st take '22

A 46-year-old man was in the dentist's office for a dental extraction. A local anesthetic was injected near the mandibular nerve. Which of the following physiological functions was most likely the last to be blocked in that patient? a. Motor function b. Pain sensation c. Muscle tone d. Touch sensation e. Vasomotor function

a. Motor function

A 58-year-old woman with metastasized breast cancer received an intramuscular injection of morphine for pain, but she suffered nausea and vomiting soon after the injection. Which of the following brain areas was most likely the main site of these adverse effects of morphine? a. Locus ceruleus b. Area postrema c. Median hypothalamic eminence d. Nucleus accumbens e. Putamen f. Rostral ventrolateral medulla

b. Area postrema

An 11-year-old girl recently diagnosed with attention deficit hyperactivity disorder (ADHD) started treatment with methylphenidate. Which of the following molecular actions on central adrenergic neurons most likely mediated the therapeutic effect of the drug in the patient's disease? a. Blockade of dopamine reuptake b. Stimulation of norepinephrine metabolism c. Blockade of serotonergic receptors d. Activation of glutamate receptors e. Blockade of gamma-aminobutyric acid (GABA) receptors

a. Blockade of dopamine reuptake

A 4-year-old girl who had been suffering from severe asthma for 6 months was scheduled for a short suture procedure that was anticipated to take approximately 10 minutes. She was brought to the operating room by her parents and was in distress over parting from them and afraid of the doctors. Which of the following drugs would be appropriate for providing sedation and analgesia for this girl? a. Ketamine b. Thiopental c. Fentanyl d. Halothane e. Sevoflurane

a. Ketamine

A 57-year-old woman was admitted semiconscious to the emergency department after an accident at home. Artificial ventilation was needed, and a drug was given to facilitate intubation. This drug has the shortest duration of action among skeletal muscle relaxants. Which of the following drugs was most likely administered? a. Succinylcholine b. Cisatracurium c. Dantrolene d. Vecuronium e. Tubocurarine f. Tizanidine

a. Succinylcholine

A 2.1-kg (4.6-lb) baby boy was born at 34 weeks gestation by vaginal delivery. One hour after birth, the baby appeared hypothermic and lethargic. Apgar scores were low, and blood pressure was 55/35 mm Hg. Lab tests revealed that the newborn had a genetic dopamine β-hydroxylase deficiency. Lab tests would have also shown which of the following results? a. Very low plasma levels of norepinephrine b. Very low plasma levels of dopamine c. High plasma levels of epinephrine d. High urinary levels of normetanephrine e. Low urinary levels of homovanillic acid

a. Very low plasma levels of norepinephrine

The bronchial effects of a new alpha-beta agonist that does not cross the blood−brain barrier was studied in laboratory animals. It was found that the drug caused relaxation of bronchiolar smooth muscle. The activation of which of the following pairs of adrenoceptors most likely mediated the effect of the drug? a. β2 postsynaptic and α2 presynaptic b. β1 presynaptic and α1 postsynaptic c. α2 postsynaptic and β3 postsynaptic d. α1 presynaptic and β2 presynaptic e. β1 postsynaptic and α2 presynaptic

a. β2 postsynaptic and α2 presynaptic

A 32-year-old man suffering from hemophilia had been recently diagnosed with tension headache. The headaches occurred two to four times weekly, usually toward the end of his workday. The pain was constant, dull in character, and usually lasted the rest of the day with variable intensity. Which of the following analgesic drugs would be appropriate for this patient? a. Indomethacin b. Acetaminophen c. Aspirin d. Ketorolac e. Piroxicam f. Naproxen

b. Acetaminophen

A 12-year-old girl started smoking her first cigarette. A few minutes later, she had two episodes of nausea and vomiting. Activation of receptors located in which of the following sites most likely mediated this adverse effect of nicotine? a. Sympathetic ganglia b. Chemoreceptor trigger zone c. Locus ceruleus d. Adrenal medulla e. Vestibular nuclei

b. Chemoreceptor trigger zone

An 18-year-old girl who had never used recreational drugs joined in smoking multiple marijuana cigarettes at a party. Which of the following signs and symptoms did the girl most likely experience just after smoking? a. Hypertension b. Increased heart rate c. Depressive mood d. Hyperalgesia e. Improved memory f. Pale skin

b. Increased heart rate

A 62-year-old man complained to his physician of facial grimacing, lip-smacking and rocking of the trunk that occurred 1 to 2 hours after taking his prescribed medication. The man who suffered from Parkinson disease, had been receiving an antiparkinson drug for 3 years. Which of the following drugs most likely caused the adverse effects reported by the patient? a. Selegiline b. Levodopa c. Entacapone d. Amantadine e. Benztropine

b. Levodopa

A 62-year-old woman had no bowel movements 4 days after surgery to remove a colon cancer. A diagnosis of adynamic ileus was made, and an intramuscular injection of neostigmine was given. The activation of which of the following pairs of receptors most likely mediated the therapeutic effect of the drug in the patient's disorder? a. Nm and M2 cholinergic b. Nn and M3 cholinergic c. β2 adrenergic and M3 cholinergic d. β2 adrenergic and Nn cholinergic e. Nn cholinergic and α1 adrenergic f. Nm cholinergic and α1 adrenergic

b. Nn and M3 cholinergic

An intravenous injection of drug X was given to a laboratory animal before and after the administration of atropine and the heart rate was recorded. The results are depicted below: Which of the following drugs was most likely drug X? (HR was 70 and dropped to 60 after drug X administration. It rose back to 70 after atropine. It rose to 80 after drug X second administration.) a. Epinephrine b. Norepinephrine c. Prazosin d. Albuterol e. Isoproterenol f. Dobutamine

b. Norepinephrine

A 45-year-old woman complained of dizziness to the point of fainting upon standing. She also felt drowsy for most of the day. The patient had been admitted to a hospital psychiatric unit 2 weeks earlier because of her third episode of major de- pressive disorder. She had been receiving an antidepressant therapy for the past 10 days. Which of the following drugs most likely caused the patient's symptoms? a. Bupropion b. Mirtazapine c. Amitriptyline d. Paroxetine e. Venlafaxine f. Lithium

c. Amitriptyline

A 63-year-old man underwent surgery to remove a laryngeal carcinoma. Before surgery, the anesthesiologist administered a drug intramuscularly to decrease bronchial secretions and to prevent bradycardia due to manipulation of the vagus nerve. Which of the following drugs would be most appropriate in this situation? a. Ipratropium b. Dopamine c. Atropine d. Isoproterenol e. Epinephrine

c. Atropine

A 58-year-old man complained to his physician of morning stiffness in the hip and knee and some joint stiffness after inactivity. Past medical history of the patient was significant for a myocardial infarction 6 months earlier. Further exams led to the diagnosis of osteoarthritis, and an analgesic pharmacotherapy was prescribed. Which of the following analgesic drugs would be contraindicated for this patient? a. Ibuprofen b. Piroxicam c. Celecoxib d. Acetaminophen e. Diclofenac

c. Celecoxib

A 29-year-old man complained to his psychiatrist of abnormal growth of his breast. The man had been receiving a psychotropic drug for 6 months to treat paranoid schizophrenia. He was medication-compliant, and his illness was well con- trolled. Which of the following drugs most likely caused the adverse effect reported by the patient? a. Clozapine b. Amitriptyline c. Haloperidol d. Venlafaxine e. Diazepam f. Fluoxetine

c. Haloperidol

A 28-year-old pregnant woman who was near term decided to have the delivery under spinal anesthesia. The patient's past history included an anaphylactic reaction 3 years earlier, ap- parently due to a sun screen containing para-aminobenzoic acid (PABA). Which of the following local anesthetics would be appropriate for this patient? a. Procaine b. Tetracaine c. Lidocaine d. Benzocaine e. Cocaine

c. Lidocaine

A 45-year-old man had been suffering from a central nervous system disorder for many years. Recently, a barbiturate was added to his pharmacotherapy. Which of the following central nervous system effects was most likely elicited by that drug? a. Antidepressant b. Antiparkinson c. Antipsychotic d. Anticonvulsant e. Analgesic

d. Anticonvulsant

A 54 - year old woman suffering from initial insomnia was prescribed a hypnotic drug that increases the activity of a major neurotransmitter system in the brain. Which of the following neurotransmitter systems was most likely involved in the therapeutic action of the drug? a. Cholinergic b. Noradrenergic c. Glutamatergic d. GABAergic e. Dopaminergic f. Endorphinergic

d. GABAergic

A 40-year-old female alcoholic was admitted to an alcohol rehabilitation center because she was determined to quit the habit. A drug was given to facilitate avoidance from ethanol dependence, based on research suggesting that compulsive alcohol drinking is influenced by opiate receptor activity. Which of the following drugs was most likely administered? a. Diazepam b. Clonidine c. Disulfiram d. Naltrexone e. Methadone f. Buprenorphine

d. Naltrexone

A 34-year-old man was admitted to a psychiatric hospital during an acute manic attack. The man had his first manic attack at the age of 27 and had had three other manic attacks since then. A diagnosis of acute mania was made, and a therapy was prescribed that included a drug that acts by blocking D2 and 5-HT2 receptors in the brain. Which of the following drugs was most likely prescribed? a. Lamotrigine b. Clomipramine c. Valproic acid d. Olanzapine e. Lithium f. Trazodone

d. Olanzapine

A 34-year-old woman recently diagnosed with undifferentiated schizophrenia started treatment with haloperidol. Which of the patient's presenting symptoms was most likely best controlled after 1 week of therapy? a. Social withdrawal b. Lack of emotion c. Low energy d. Persecutory delusions e. Affective flattening

d. Persecutory delusions

A 45-year-old woman complained of blurred vision, dry mouth, palpitations, and constipation. The patient was diagnosed with Parkinson disease 4 months earlier and had been receiving a levodopa/carbidopa combination since then. Recently, her neurologist added a drug to the therapeutic regimen because of an increase in the patient's resting tremor. Which of the following drugs most likely caused the patient's symptoms? a. Pramipexole b. Selegiline c. Levodopa d. Amantadine e. Benztropine f. Carbidopa

e. Benztropine

A 25-year-old male volunteer received an intravenous infusion of a new drug in a phase 1 clinical trial. It was found that the drug causes an increase in cardiac contractility, a slight increase in heart rate and no major changes or a decrease in systemic vascular resistance. Which of the following drugs does the new agent most resemble? a. Phenylephrine b. Norepinephrine c. Isoproterenol d. Epinephrine e. Dobutamine

e. Dobutamine

A 28-year-old man was brought to the emergency department because of a generalized tonic-clonic seizure. History showed that the man had been suffering from epilepsy since childhood, but the seizures were only partially controlled by medication. Which of the following pairs of neurotransmitters are thought to be mainly involved in seizure disorders? a. Gamma-aminobutyric acid (GABA) and serotonin b. Serotonin and acetylcholine c. GABA and acetylcholine d. Serotonin and glutamate e. GABA and glutamate f. Acetylcholine and glutamate

e. GABA and glutamate

A 60-year-old man complained to his physician of obstinate constipation. The man, recently diagnosed with a schizo-affective disorder, had started treatment with olanzapine. Blockade of which of the following pairs of receptors most likely mediated the adverse effect of the drug? a. Nicotinic and dopaminergic b. GABAergic and muscarinic c. Nicotinic and α1 d. Dopaminergic and α1 e. Muscarinic and serotonergic

e. Muscarinic and serotonergic

A 35-year-old man admitted to the hospital because of a second-degree burn on his left forearm complained of increasing pain. An oral combination of acetaminophen/ codeine was administered for pain control. Which of the following statements best explain the reason for using this drug combination? a. Codeine counteracts acetaminophen-induced hepato- toxicity. b. Acetaminophen counteracts codeine-induced constipation. c. The combination does not cause tolerance or dependence. d. Acetaminophen speeds up the biotransformation of codeine into morphine. e. The two drugs enhance each other's analgesic effects.

e. The two drugs enhance each other's analgesic effects.

A 25-year-old man complained to his physician of painfulerection and impaired ejaculation during intercourse. Three weeks earlier, he had been diagnosed with Raynaud disease and had started an appropriate therapy. A drug with which of the following mechanisms of actions most likely caused the patient's symptoms? a. β2-receptor blockadeb. b. M3-receptor activation c. β1-receptor blockade d. α2-receptor activation e. α1-receptor blockade f. Nm-receptor activation

e. α1-receptor blockade

A 46-year-old woman complained to her physician of daytime sleepiness. One day earlier, she had started taking an antihistamine for allergic rhinitis. The physician explained that drowsiness was most likely due to inhibition of the action of histaminergic neurons in the brain. Which of the following brain regions was most likely involved in the adverse effect of this drug? a. Nucleus tractus solitarius b. Caudatum c. Hippocampus d. Nucleus basalis of Meynert e. Amygdala f. Ventral posterior hypothalamus

f. Ventral posterior hypothalamus