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pharmacyTopic wise MCQs

Pharmacology MCQs (Part:- 17)

Pharmacology MCQs

1 The following are true for adrenaline EXCEPT:
a) it acts via G-proteins
b) alpha receptor stimulation results in decreased cAMP production
c) it may be administered via inhalation, orally and parentally
d) it has no active metabolites
e) in cardiac arrest it facilitates CPR via peripheral varioconstruction

2 Heparin:
a) inhibits clotting by decreasing anti-thrombin III effects
b) oral bioavailability is 20-30%
c) is low plasma protein bound
d) molecular weight ranges from 3,000 – 60,000
e) binds to anti-thrombin III causing a conformational change

3 Volume of distribution:
a) is always a real volume
b) amount of drug in plasma
    concentration in body
c) concentration of drug in plasma
     amount of drug in blood
d) amount of drug in body
    concentration of drug in plasma
e) AUC

4 Aspirin:
a) is hydrolysed to acetone and salicylate
b) exhibits first order kinetics with elimination in low doses
c) is mostly conjugated by the liver and excreted in the bile
d) reversibly blocks the cyclooxygenase enzyme
e) causes an immediate doubling of bleeding time

5 Amiodarone:
a) effects Na+, K+ channels but not Ca2+ channels
b) has antianginal effects
c) has a short half life
d) increases peripheral resistance
e) has little effect on the lung

6 Tricyclic antidepressants:
a) have a low volume of distribution
b) are useful in urinary retention and chronic pain
c) can prolong QT interval
d) block the enzyme which degrades amine neurotransmitters
e) is useful in severe depression with strong suicidal ideation

7 Regarding diazepam:
a) it has no active metabolites
b) activated charcoal is useful in overdose
c) it undergoes extensive enterohepatic recirculation
d) it is a GABA antagonist via the benzodiazepine receptors
e) It has no spinal inhibitory action

8 Atropine:
a) can cause bronchodilation
b) produces miosis
c) is not lipid-soluble
d) blocks reuptake of ACH
e) causes an increase in salivary gland secretions

9 All are true about penicillins EXCEPT:
a) most penicillins only cross blood-brain barrier when the meninges are inflamed
b) penicillins don’t require adjustment in renal failure
c) penicillins inhibit cross linkage of peptidoglycans in cell wall
d) piperacillin is a penicillin active against pseudomonas
e) only about 5-10% of people with a past history of penicillin allergy have a reaction on re-exposure

10 Which of the following receptor-ligand pathway is TRUE:
a) insulin and G-protein receptor
b) mineralocorticoid and tyrosine kinase receptor
c) vitamin D and intracellular receptor
d) adrenaline and ligand gated channel receptor
e) platelet derived growth factor and cytokine receptor

11 GTN has its major effect on effort angina by:
a) reducing coronary vasospasm
b) reduction in renin-ang II system effect
c) reducing afterload and preload
d) coronary vasodilation
e) systemic vasoconstriction

12 Warfarin:
a) is 90% bioavailable
b) inactivates Vit K
c) can cause venous thrombosis
d) loading should be initiated with 0.5mg / day
e) effect is ameliorated by metronidazole via a bactercidal affect

13 Most  blockers:
a) have half lives of 3-10 hours
b) have a small volume of distribution
c) have poor oral bioavailability
d) are highly lipid soluble and hence cross the blood-brain barrier
e) are rarely excreted unchanged

14 Age associated changes in pharmacokinetics include:
a) a reduction in creatinine clearance in two thirds of the population
b) a decrease in body fat
c) an increase in body water
d) a greater reduction in conjugation compared with oxidation
e) a decreased absorption related to age alone

15 The following drug may be used safely in pregnancy:
a) carbamazepine
b) digoxin
c) streptomycin
d) methotrexate
e) propylthiouracil

16 Regarding NSAIDS:
a) at high doses aspirin demonstrates first order kinetics
b) aspirin is a reversible inhibitor of cyclooxygenase
c) aspirin at a does of  2g/day reduces uric acid levels
d) all NSAIDS can be found in synovial fluid after repeated dosing
e) use of ibuprofen and aspirin together increases the anti-inflammatory effect

17 Regarding biotransformation, which of the following is true:
a) ethanol enhances methanol metabolism
b) grapefruit juice inhibits cyclosporin metabolism
c) phenytoin inhibits theophylline metabolism
d) rifampicin inhibits oral contraceptives metabolism
e) griseofulvin inhibits warfarin metabolism

18 Bioavailability is:
a) less than 100% by any route
b) is the percentage of a drug formulation that is absorbed
c) is not affected by first pass metabolism
d) is close to 80% for orally administered verapamil
e) is equivalent to absorption minus the extraction rate for an orally administered drug

19 Dobutamine:
a) has no arrhythmogenic effect
b) decreases myocardial oxygen consumption
c) is a non selective  agonist
d) predominantly affects D2 receptors in the central nervous system
e) may be used in heart failure

20 Which of the following antihypertensives act on the vasomotor centre:
a) prazosin
b) methyldopa
c) hydralazine
d) reserpine
e) iosartan

21 Haloperidol:
a) is particularly prone to producing hypotensive side-effects
b) is particularly prone to producing extrapyramidal side-effects
c) is particularly prone to producing arrhythmias
d) is particularly prone to producing anti-muscarinic side-effects
e) is particularly prone to producing a toxic confusional state

22 Effects of  blockers include:
a) stimulation of aqueous humour production
b) inhibition of bronchial smooth muscle spasm
c) stimulation of lipolysis via the sympathetic nervous system
d) stimulation of the release of renin
e) inhibition of glycogenolysis in the liver

23 Regarding phenytoin, all the following are true EXCEPT:
a) oral bioavailability is variable
b) binds poorly with plasma proteins
c) metabolism is enhanced in presence of inducers of liver metabolism
d) elimination kinetics shift from first order to zero order at moderate to high dose
e) half life varies from 12-36 hours

24 Regarding inhaled anaesthetics:
a) nitrous oxide has a relatively low minimum alveolar concentration
b) halogenated agents have a lower brain : blood partition coefficient
c) they reduce mean arterial pressure in direct proportion to their alveolar concentration
d) nitrous oxide causes a decrease in tidal volume and an increase in respiratory rate
e) they decrease the metabolic rate in the brain by decreasing cerebral blood flow

25 Regarding glucocorticoids:
a) The major glucocorticoid in humans is cortisol
b) A normal adult male secretes 100mg of cortisol each day
c) Feedback suppression of pituitary ACTH occurs within hours
d) Absence of cortisol increases the response of vascular and smooth muscle tone to catecholamines
e) Inhibition of leucocyte and tissue macrophages is not an action of glucocorticoids

26 Of the secondary messengers:
a) compared to cAMP, cGMP is a more versatile and ubiquitous carrier of diverse messages
b) phosphoinositides act independently of phospholipase -C
c) upregulation of cAMP degradation is one way theophylline produces its effects
d) cAMP’s effector enzyme is adenylyl cyclase
e) all of the above

27 Which of the following are antagonist and agonist pairs for the same receptor:
a) butoxamine, terbutaline
b) phenyoxybenzamine, cyclopentolate
c) pilocarpine, bethanechol
d) oxymetazoline, dobutamine
e) bromocriptine, pranipexole

28 Regarding calcium channel blockers:
a) not all are active when given orally
b) most have half lives of 8-12 hours
c) mechanism of action is the blockage of voltage dependent L-type calcium channels
d) they do not affect bronchiolar smooth muscle
e) dihydropyridines typically cause bradycardia

29 Cephalosporins are:
a) excreted in the bile
b) excreted via the kidneys in the tubules
c) drugs that can undergo hepatic metabolism
d) are classified on the basis of antibacterial activity
e) all of the above

30 With regard to non-depolarising neuromuscular blocking drugs:
a) pancuronium is eliminated via the kidney
b) rocuronium is an isoquinolone derivative
c) rocuronium undergoes Hoffman elimination
d) vecuronium is eliminated predominantly via the kdney
e) atracurium is eliminated via plasma pseudocholinesterases

31 Regarding opioids:
a) neonates have a blood – brain barrier for opioids
b) at the spinal level, only the receptors contribute to analgesia
c) the most reliable indicator of respiratory depression is a depressed response to CO2 challenge
d) tolerance develops with miosis
e) people with Addison’s disease have normal response to opioids

32 Which statement is false:
a) drug A with a higher potency can have a lower efficacy than drug B
b) drug A with a higher affinity for its drug receptors have a higher potency
c) drug A with a lower potency must have a lower efficacy than drug B
d) drug A with a higher potency than drug B, can still have the same efficacy
e) none of the above

33 Local anaesthetic agents:
a) are primarily potassium channel blockers
b) prevent repolarisation of the membrane
c) can be used with a vasodilator to prolong local action
d) activity is enhanced by high extracellular K+ concentration
e) activity is enhanced by high extracellular (Ca++)

34 Drugs with no significant effect on anticoagulant therapy include:
a) amiodarone
b) disulfiram
c) flucanazole
d) benzodiazepines
e) metronidazole

35 Regarding first pass metabolism:
a) its effect on bioavailability is expressed as the extraction ratio where
       ER = CL (liver)
          Q (liver)
b) it affects volume of distribution
c) it reduces the bioavailability of oral morphine to 15%
d) the extraction ratio of phenytoin is higher
e) it makes it impossible to attain therapeutic levels of lignocaine using oral dosage

36 With regard to oral anti-asthmatic agents:
a) prednisone is a long acting glucocorticoid
b) methotrexate has been shown to be beneficial in prednisone-dependent asthmatics in all studies
c) cyclosporin’s toxicity limits its use as an oral anti-asthmatic agent
d) oral nifedipine significantly inhibits exercise-induced bronhoconstriction
e) macrolide antibiotics show no benefit in managing asthmatics

37 Trimethoprim:
a) activates dihydrofolic acid reductase
b) is a weak base
c) has limited activity in the prostate gland
d) does not distribute into the CSF
e) is harmless in pregnancy

38 Regarding antibiotic resistance:
a) betalactamase production is responsible for penicillin resistance in pneumococci
b) penicillin’s inability to penetrate the organism is more common with gram –ve bacteria
c) penicillin resistance is mainly because of alteration in the target PBPs
d) methicillin resistance in staphylococcus is due to betalactamase production
e) beta lactamase are identical but produced by different bacteria

39 Clearance:
a) is the amount of drug eliminated divided by the concentration of the drug
b) is constant for most drugs in clinical settings at therapeutic levels
c) is very high for lithium
d) is independent of concentration for phenytoin
e) is inversely proportional to volume of distribution

40 Toxicity of nicotine containing products:
a) may result in neuromuscular blockade best treated with atropine
b) usually causes hypotension
c) will have no effects on the foetus
d) can be symptomatically controlled with benzodiazepines
e) will result in several days of nausea and vomiting

41 The following are side effects of SSRI’s EXCEPT:
a) rash
b) weight gain
c) sexual dysfunction
d) anxiety
e) gastrointestinal symptoms

42 Regarding drugs used in the treatment of status epilepsy:
a) phenytoin is useful in status for its sedating as well as anticonvulsant activity
b) phenytoin may be diluted in both saline and dextrose
c) the effect of diazepam is long lasting
d) respiratory depression is a common complication of phenobarbitone
e) administration of phenytoin should be at a minimum rate of 50mg/min

43 ACE inhibitors:
a) decrease levels of bradykinin
b) cause hyperkalaemia less often in patients with diabetes
c) are contraindicated in patients on NSAIDS
d) decrease glomerular efferent arteriolar resistance
e) lead to decreased prostaglandin synthesis

44 Regarding active immunisation:
a) the measles vaccine is an inactivated virus
b) the hepatitis B vaccine is preferably given by subcutaneous injection
c) booster doses for yellow fever are not required
d) primary immunisation for haemophilis influenzae type B involves two doses given one month apart
e) the meningococcal vaccine should be given to asplenic individuals