Pharmacology Test 3
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Endocrine, Reproduction and Central Nervous System
- 1.Which drug used in management of seizure disorders is most likely to elevate the plasma concentration of other drugs administered concomitantly?
- A.
Carbamazepine
- B.
Clonazepine
- C.
Gabapentin
- D.
Valproic Acid
- E.
Vigabatrin
- 2.A 16-year-old boy suffering from type I diabetes is seen in the emergency room with the chief complaint of severe right-sided chest pain. Two hours earlier he felt feverish and experienced a teeth-chattering chill. The diabetes of the patient is presently well controlled on 2 daily doses of insulin. The patient also is very compliant with his prescribed diet. After physical examination and laboratory tests a diagnosis of atypical pneumonia is made. Which of the following should be included in an appropriate treatment plan for this patient?
- A.
Increase the daily insulin dosage
- B.
Start a course of ampicillin therapy
- C.
Start a course of vancomycin therapy
- D.
Add a daily administration of metformin
- 3.Which of the following best describes the mechanism of action of benzodiazepines?
- A.
Activate GABAb receptors in the spinal cord
- B.
Block glutamate receptors in hierarchical neuronal pathways in the brain
- C.
Increase frequency of opening of chloride ion channels coupled to GABAa receptors
- D.
Inhibit GABA transaminase to increase brain levels of GABA
- E.
That if he stops taking the drug abruptly, he will experience withdrawal signs
- F.
Stimulate release of GABA from nerve endings in the brain
- 4.A 18-year-old girl was admitted to the emergency room following a motor vehicle accident. She was obtunded and responded only to pain. Medical history obtained from her mother was unremarkable. Physical examination showed contusions on face and arms but no sings of cranial trauma. Vital signs: T 97°F, RR 22/min, pulse 124 bpm, BP 90/70 mm Hg. Blood values: HCO3- 6 mEq/L, glucose 847 mg/dL, creatinine 1.1 mg/dL. Urinalysis: specific gravity 1.036, glucose 4+, ketones 4+. Which of the following statements correctly pairs the most likely disorder of the patient with the appropriate emergency treatment?
- A.
Acute renal failure-IV furosemide
- B.
Diabetic ketoacidosis- IV insulin
- C.
Respiratory acidosis- IV bicarbonate
- D.
Diabetic ketoacidosis- SC NPH insulin
- 5.Which of the following contributes to the therapeutic effects of benzodiazepines?
- A.
Increase GABA release
- B.
Activation of GABAb receptors
- C.
Blockade of glutamate receptors
- D.
Inhibition of GABA transaminase
- E.
Increased frequency of chloride channel opening
- 6.A 21-year-old obese man with a 2-year history of type 2 diabetes mellitus is found to have a fasting blood glucose level of 220 mg/dL and a blood pressure of 165/105. His diabetes has been reasonably well controlled in the past with diet and glipizide. The physician decides to switch to insulin treatment and to start an antihypertensive therapy. Which of the following antihypertensive drugs would be relatively contraindicated in this patient?
- A.
Captopril
- B.
Propanolol
- C.
Clonidine
- D.
Hydralazine
- E.
Diltiazem
- 7.Which of the following antiseizure drugs is most likely to decrease the plasma levels of other drugs administered concomitantly?
- A.
Valproic Acid
- B.
Topiramate
- C.
Lamotrigine
- D.
Gabapentin
- E.
Phenobarbital
- 8.Benzodiazepines can worsen the condition in a patient with which of the following?
- A.
Myasthenia gravis
- B.
Panic disorders
- C.
Tonic-clonic seizures
- D.
Febrils convulsions in children
- 9.A 23-year-old woman suddenly lost consciousness in the dining room, became rigid and fell to the floor. Her respiration temporarily ceased. About 1 minute later, jerking of all four limbs supervened for about 3 minutes, then the woman was unconscious for about 4 minutes. She was brought to the emergency room by the ambulance. On examination the patient was drowsy, but the neurologic examination was otherwise unremarkable and vital signs were normal. A CT scan turned out to be negative. Which of the following drugs represent therapeutic options for this patient? (Check all that apply)
- A.
Carbamepine
- B.
Ethosuximide
- C.
Lorazepam
- D.
Lamotrigine
- 10.Which drug used in the maintenance treatment of patients with tonic-clonic or partial seizure states increases the hepatic metabolism of many drugs including both warfarin and phenytoin?
- A.
Buspirone
- B.
Chlordiazepoxide
- C.
Eszopiclone
- D.
Phenobarbital
- E.
Triazolam
- 11.A 24-year-old man with a history of partial seizures has been treated with standard anticonvulsants for several years. He is currently taking valproic acid, which is not fully effective, and his neurologist prescribes another drug approved for adjunctive use in partial seizures. Unfortunately, the patient develops a toxic epidermal necrolysis. The second drug prescribed was
- A.
Diazepam
- B.
Ethosuximide
- C.
Lamotrigine
- D.
Phenobarbital
- 12.Which of the following adverse effects represents potential problems when flurazepam is used as a hypnotic? (Check all that apply)
- A.
Daytime sedation
- B.
Early awakening
- C.
Irritability
- D.
Apnea
- 13.A 45 year old chain smoker male visits his doctor for an annual check-up. Upon examination, his blood pressure was 158/98 mmHg. Which one of the following health complications is he likely to experience if he keeps his smoking habit, and his high blood pressure is untreated?
- A.
Arousal dysfunction
- B.
Depression
- C.
Impaired erection
- D.
Penile stiffness
- E.
Unlimited sexual arousal
- 14.Which of the following conditions will prompt a reduction in the dose of sildenafil in a patient with erectile dysfunction?
- A.
Ashtma
- B.
Hyperthyroidism
- C.
Liver cirrhosis
- D.
Renal failure
- E.
Pulmonary hypertension
- 15.Regarding the clinical use of antidepressant drugs, which statement is accurate?
- A.
Chronic use of antidepressants increases the activity of hepatic drug metabolizing enzymes
- B.
In the treatment of major depressive disorders, sertaline is usually more effective that fluoxetine
- C.
Tricyclics are highly effective in depressions with attendant anxiety, phobic features, and hypochondriasis
- D.
Weight gain often occurs during the first few months in patients taking SSRIs
- E.
When selecting an appropriate drug for treatment of depression, the history of patient response to specific drugs is a valuable guide
- 16.A 45-year-old woman with a 3-year history of type 2 diabetes has been reasonably well controlled with diet and glyburide. Recently her fasting blood glucose started rising and the physician decided to add a second antidiabetic drug that acts on a nuclear receptor and decreases insulin resistance in target cells. Which of the following drugs was most likely prescribed?
- A.
Glyburide
- B.
Metformin
- C.
Miglitol
- D.
Pioglitazone
- E.
Repaglinide
- 17.Which of the following drugs is most likely to cause hypoglycemia when used as monotherapy in the treatment of a patient with type 2 diabetes?
- A.
Acarbose
- B.
Glipizide
- C.
Metformin
- D.
Miglitol
- E.
Rosiglitazone
- 18.A 22-year-old man with type I diabetes mellitus noticed symptoms of tachycardia, sweating, nausea, headache and dizziness following his participation in a game of football. The man has been maintained with twice daily injections of regular insulin and NPH insulin. Which of the following would be the most appropriate treatment for this patient?
- A.
SC regular insulin
- B.
Oral propanolol
- C.
IM glucagon
- D.
Oral glucose
- 19.The mechanism of action of antiseizure drugs includes which of the following?
- A.
Activation of glutamate receptors
- B.
Enhancement of GABA-mediated synaptic inhibition
- C.
Blockade of resting Na+ channels
- D.
Enhancement of Ca2+ current through T -type Ca2+ channels
- E.
Blockade of K+ channels
- 20.A 10-year-old boy was brought to the hospital after his parents had observed repeated episodes in which he stopped speaking in midsentence, dropped what was in his hands, and stared into space for a few moments. An EEG showed 3 second spike wave activity. Which of the following drugs would be appropriate for this patient?
- A.
Phenobarbital
- B.
Carbamazepine
- C.
Ethosuximide
- D.
Gabapentin
- E.
Tiagabine
- 21.Which of the following drugs is most likely to cause hypoglycemia when used as monotherapy in the treatment of type 2 diabetes?
- A.
Acarbose
- B.
Glyburide
- C.
Metformin
- D.
Miglitol
- E.
Rosiglitazone
- 22.A 16 year old female suffers from depression. Which of the following neurotransmitters is most likely deficient in this patient?
- A.
Acetylcholine
- B.
Dopamine
- C.
Epinephrine
- D.
Serotonin and Norepinephrine
- 23.Which of the following drugs inhibits dipeptidyl peptidase IV?
- A.
Exenatide
- B.
Glyburide
- C.
NPH Insulin
- D.
Lispro Insulin
- E.
Metformin
- F.
Pioglitazone
- G.
Regular Insulin
- H.
Repaglinide
- I.
Sitagliptin
- 24.A 24-year-old woman with type I diabetes was brought unconscious to the emergency room. Her blood glucose level was 395 mg/dL. An intravenous infusion of insulin was started and the patient’s blood glucose decreased to a normal level after 6 hours. Which of the following molecular actions most likely contributed to the therapeutic effect of the drug in this patient?
- A.
Inhibition of glucose transporters in pancreas cell membranes
- B.
Phosphorylation of tyrosine kinase receptors
- C.
Activation of ATP-sensitive K+ channels in target cells
- D.
Stimulation of hormone sensitive lipase
- E.
Inhibition of liver glucokinase
- 25.Which of the following drugs is taken during the first part of a meal for the purpose of delaying the absorption of dietary carbohydrates?
- A.
Acarbose
- B.
Exenatide
- C.
Glipizide
- D.
Pioglitazone
- E.
Repaglinide
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