Pharmacology Toughest Exam Quiz!
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- 1.Pindolol and some other β adrenergic receptor antagonists have an additional property that is referred to as intrinsic sympathomimetic activity (ISA). This additional property indicates these agents are:
- A.
Full agonists
- B.
Inverse agonist
- C.
Neutral antagonists
- D.
Noncompetitive antagonists
- E.
Partial agonists
- 2.A 28-year-old woman is brought to the emergency department after overdosing on oxycodone, an opiate analgesic. She is unconscious and barely breathing when she arrives at the hospital, but revives and is breathing normally within 2 minutes after receiving an injection of naloxone. After about an hour, she requires another dose of naloxone as the symptoms of opiate overdose begin to redevelop. Naloxone is likely acting as a:
- A.
Strong stimulant that counteracts the CNS-depressant effects of the opiate.
- B.
Diuretic that increases renal excretion of the opiate.
- C.
Drug that stimulates respiratory centers in the brain.
- D.
Competitive antagonist of opioid receptors.
- E.
Noncompetitive antagonist of opioid receptors.
- 3.The therapeutic window is an indication of the:
- A.
Length of time a drug should be administered to achieve optimal effects
- B.
Time of day when a drug should be administered or optimal effects
- C.
Range of concentrations over which a drug is maximally effective for all patients
- D.
Range of concentrations over which a drug is safe and efficacious for most patients
- E.
Age range of patients that is optimal for a given drug
- 4.Preclinical characterization of a new drug indicates that it is an inverse agonist for adenosine receptors. It interacts syntopically with adenosine. In the presence of adenosine, this drug will behave like a(n):
- A.
Full agonist with additive effects to adenosine at high concentrations
- B.
Partial agonist with additive effects to adenosine at high concentrations
- C.
Partial agonist with inhibitory effects to adenosine at high concentrations
- D.
Inert compound with no additive or inhibitory effects to adenosine at high concentrations
- E.
Competitive antagonist with inhibitory effects on receptor activation
- 5.The term “first-pass effect” refers to the
- A.
Effect a new drug has on the body after its first administration.
- B.
Time it takes for a drug to be detected in the urine or feces after oral administration.
- C.
Ability of the intestines and liver to reduce the bioavailability of a drug.
- D.
Time it takes for a drug to reach therapeutic concentrations in the target tissue.
- E.
Initial effect a drug has on target tissues.
- 6.The term “blood-brain barrier” (BBB) refers to a:
- A.
Noncellular barrier that prevents drugs from entering the CNS unless transported by specific carriers.
- B.
Cellular barrier that includes brain capillary endothelial cells that limits drug entry into the brain.
- C.
Virtual or conceptual barrier that can explain the behavior of some drug effects on the CNS.
- D.
Physical barrier that prevents blood from entering the brain.
- E.
Device that is used to prevent blood-borne drugs from entering the brain
- 7.Phase 1 drug metabolism differs from phase 2 metabolism in that:
- A.
Phase 1 metabolism always occurs prior to phase 2 metabolism.
- B.
Phase 1 metabolism occurs in the intestine where orally administered drugs can first be metabolized, whereas phase 2 metabolism occurs in the blood.
- C.
Phase 1 metabolism occurs in the liver soon after a drug is absorbed, whereas phase 2 metabolism occurs after a drug is excreted into the urine.
- D.
Phase 1 metabolic enzymes activate prodrugs, whereas phase 2 metabolic enzymes inactivate drugs.
- E.
Phase 1 metabolic reactions functionalize drugs, whereas phase 2 metabolic reactions conjugate drugs.
- 8.The most important pharmacokinetic concept to consider when designing a rational long-term pharmacotherapy is
- A.
Bioavailability.
- B.
Route of administration.
- C.
Volume of distribution.
- D.
Clearance.
- E.
Elimination t1/2
- 9.A drug that is a weak acid (pKa = 5) is largely excreted unchanged by the kidneys. To increase its rate of excretion
- A.
The pH of the urine should be increased.
- B.
The pH of the urine should be decreased.
- C.
The pH of the urine should be left unchanged.
- D.
CYP liver enzymes should be induced to increase metabolism of the drug.
- E.
The patient should drink more water to increase urine output.
- 10.A 3-year-old is brought to the emergency department having just ingested a large overdose of tolbutamide, an oral antidiabetic drug. Tolbutamide is a weak acid with a pKa of 5.3. It is capable of entering most tissues, including the brain. On physical examination, the heart rate is 100/min, blood pressure 90/50 mm Hg, and respiratory rate 20/min. Which of the following statements about this case of tolbutamide overdose is most correct?
- A.
Urinary excretion would be accelerated by administration of NH4Cl, an acidifying agent
- B.
Urinary excretion would be accelerated by giving NaHCO3, an alkalinizing agent
- C.
Less of the drug would be ionized at blood pH than at stomach pH
- D.
Absorption of the drug would be slower from the stomach than from the small intestine
- E.
Hemodialysis is the only effective therapy
- 11.Botulinum toxin is a large protein molecule. Its action on cholinergic transmission depends on an intracellular action within nerve endings. Which one of the following processes is best suited for permeation of very large protein molecules into cells?
- A.
Aqueous diffusion
- B.
Endocytosis
- C.
First-pass effect
- D.
Lipid diffusion
- E.
Special carrier transport
- 12.A 12-year-old child has bacterial pharyngitis and is to receive an oral antibiotic. She complains of a sore throat and pain on swallowing. The tympanic membranes are slightly reddened bilaterally, but she does not complain of earache. Blood pressure is 105/70 mm Hg, heart rate 100/mm, temperature 37.8 °C (100.1 °F). Ampicillin is a weak organic acid with a pKa of 2.5. What percentage of a given dose will be in the lipid-soluble form in the duodenum at a pH of 4.5?
- A.
About 1%
- B.
About 10%
- C.
About 50%
- D.
About 90%
- E.
About 99%
- 13.Ampicillin is eliminated by first-order kinetics. Which of the following statements best describes the process by which the plasma concentration of this drug declines?
- A.
There is only 1 metabolic path for drug elimination
- B.
The half-life is the same regardless of the plasma concentration
- C.
The drug is largely metabolized in the liver after oral administration and has low bioavailability
- D.
The rate of elimination is proportional to the rate of administration at all times
- E.
The drug is distributed to only 1 compartment outside the vascular system.
- 14.The pharmacokinetic process or property that distinguishes the elimination of ethanol and high doses of phenytoin and aspirin from the elimination of most other drugs is called
- A.
Distribution
- B.
Excretion
- C.
First-pass effect
- D.
First-order elimination
- E.
Zero-order elimination
- 15.
A new drug was administered intravenously, and its plasma levels were measured for several hours. A graph was prepared as shown below, with the plasma levels plotted on a logarithmic ordinate and time on a linear abscissa. It was concluded that the drug has first-order kinetics. From this graph, what is the best estimate of the half-life?- A.
0.5h
- B.
1h
- C.
3h
- D.
4h
- E.
7h
- 16.A large pharmaceutical company has conducted extensive animal testing of a new drug for the treatment of advanced prostate cancer. The chief of research and development recommends that the company now submit an IND application in order to start clinical trials. Which of the following statements is most correct regarding clinical trials of new drugs?
- A.
Phase 1 involves the study of a small number of normal volunteers by highly trained clinical pharmacologists
- B.
Phase 2 involves the use of the new drug in a large number of patients (1000–5000) who have the disease to be treated under conditions of proposed use (eg, outpatients)
- C.
Chronic animal toxicity studies must be complete and reported in the IND
- D.
Phase 4 involves the detailed study of toxic effects that have been discovered in phase 3
- E.
Phase 2 requires the use of a positive control (a known effective drug) and a placebo.
- 17.Which of the following statements about the testing of new compounds for potential therapeutic use in the treatment of hypertension is most correct?
- A.
Animal tests cannot be used to predict the types of clinical toxicities that may occur because there is no correlation with human toxicity
- B.
Human studies in normal individuals will be done before the drug is used in individuals with hypertension
- C.
The degree of risk must be assessed in at least 3 species of animals, including 1 primate species
- D.
The animal therapeutic index must be known before trial of the agents in humans
- 18.Which of the following statements about new drug development is most correct?
- A.
Drugs that test positive for teratogenicity, mutagenicity, or carcinogenicity can be tested in humans
- B.
Food supplements and herbal (botanical) remedies are subject to the same FDA regulation as ordinary drugs
- C.
All new drugs must be studied in at least 1 primate species before NDA submission
- D.
Orphan drugs are drugs that are no longer produced by the original manufacturer
- E.
Phase 4 (surveillance) is the most rigidly regulated phase of clinical drug trials
- 19.A 55-year-old woman with hypertension is to be treated with a thiazide diuretic. Thiazide A in a dose of 5 mg produces the same decrease in blood pressure as 500 mg of thiazide B. Which of the following statements best describes these results?
- A.
Thiazide A is more efficacious than thiazide B
- B.
Thiazide A is about 100 times more potent than thiazide B
- C.
Toxicity of thiazide A is less than that of thiazide B
- D.
Thiazide A has a wider therapeutic window than thiazide B
- E.
Thiazide A has a longer half-life than thiazide B
- 20.
Prior to clinical trials in patients with heart failure, an animal study was carried out to compare two new positive inotropic drugs (A and B) to a current standard agent (C). The results of cardiac output measurements are shown in the graph below. Which of the following statements is correct?
- A.
Drug A is most effective
- B.
Drug B is least potent
- C.
Drug C is most potent
- D.
Drug B is more potent than drug C and more effective than drug A
- E.
Drug A is more potent than drug B and more effective than drug C
- 21.A study was carried out in isolated intestinal smooth muscle preparations to determine the action of a new drug “novamine,” which in separate studies bound to the same receptors as acetylcholine. In the absence of other drugs, acetylcholine caused contraction of the muscle. Novamine alone caused relaxation of the preparation. In the presence of a low concentration of novamine, the EC50 of acetylcholine was unchanged, but the Emax was reduced. In the presence of a high concentration of novamine, extremely high concentrations of acetylcholine had no effect. Which of the following expressions best describes novamine?
- A.
A chemical antagonist
- B.
An irreversible antagonist
- C.
A partial agonist
- D.
A physiologic antagonist
- E.
A spare receptor agonist
- 22.Sugammadex is a new drug that reverses the action of rocuronium and certain other skeletal muscle-relaxing agents (nondepolarizing neuromuscular blocking agents). It appears to interact directly with the rocuronium molecule and not at all with the rocuronium receptor. Which of the following terms best describes sugammadex?
- A.
Chemical antagonist
- B.
Noncompetitive antagonist
- C.
Partial agonist
- D.
Pharmacologic antagonist
- E.
Physiologic antagonist
- 23.A 42-year-old man has just been prescribed a new drug. After several doses he notices dry mouth, dry eyes, and a rapid heart rate. This is most likely due to an inhibition of which of the following neurotransmitter:
- A.
Norepinephrine
- B.
Serotonin
- C.
Glutamate
- D.
Acetylcholine
- E.
Epinephrine
- 24.A 23-year-old man is accosted by 3 men late at night. Immediately his heart rate increases due to an increase in epinephrine in his circulation. This release of epinephrine from the adrenal medulla is the result of the action of acetylcholine on
- A.
Muscarinic receptors.
- B.
α adrenergic receptors.
- C.
Nicotinic receptors.
- D.
β adrenergic receptors.
- E.
Glutamate receptors.
- 25.A 56-year-old woman goes to an ophthalmologist for an eye examination. The ophthalmologist administers an eye drop to dilate her pupils prior to the eye examination. The medication in the eye drop is most likely acting on
- A.
Serotonin receptors.
- B.
α1 adrenergic receptors.
- C.
β2 adrenergic receptors.
- D.
Nicotinic receptors.
- E.
Acetylcholinesterase.
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