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Pharmacology Exam 1

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Pharmacology Exam 1

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1) The study of drug absorption, distribution, metabolism, and excretion is known as
  1. pharmacotherapeutics
  2. pharmacodynamics
  3. pharmacokinetics
  4. pharmacy
2) The medical situation when a particular drug should not be administered is referred to as
  1. side effect
  2. adverse effect
  3. drug allergy
  4. contraindication
3) An unusual or unexpected drug reaction by an individual is known as
  1. toxic effect
  2. antagonism
  3. idiosyncrasy
  4. side effect
4) The proprietary drug name supplied by a pharmaceutical company is also referred to as the
  1. generic name
  2. over-the-counter name
  3. trade name
  4. chemical name
5) The time from drug administration to the first observable drug effect is known as the
  1. duration of action
  2. onset of action
  3. ceiling effect
  4. maximal response
6) A drug that has the potential for abuse and is regulated by the Drug Enforcement Agency is classified as a
  1. poison
  2. OTC drug
  3. prescription drug
  4. controlled substance
7) Which term relates to the amount of drug administered to produce a therapeutic effect?
  1. posology
  2. toxicology
  3. pharmacodynamics
  4. pharmacotherapeutics
8) A medication that does not require a physician's service to obtain is referred to as
  1. trade
  2. nonproprietary
  3. nonprescription
  4. brand
9) Which of the following could be categorized as an adverse reaction?
  1. idiosyncrasy
  2. drug allergy
  3. teratogenicity
  4. carcinogenicity
10) The time a drug continues to produce its effect is its
  1. ED50
  2. maximal response
  3. ceiling effect
  4. onset of action
11) . The drug administration route demonstrating the slowest onset of action is
  1. inhalation
  2. transdermal
  3. intramuscular
  4. sublingual
12) In order for drugs to cross the blood-brain barrier, they must be
  1. ionized
  2. positively charged
  3. water soluble
  4. lipid soluble
13) First-pass metabolism refers to the metabolism of drugs in the
  1. kidney
  2. blood vessels
  3. liver
  4. heart
14) Drugs that have demonstrated teratogenic effects in women are classified as Pregnancy Category
  1. B
  2. C
  3. D
  4. X
15) When a drug increases the rate of drug metabolism of other drugs, the process is termed
  1. first-pass metabolism
  2. enzyme induction
  3. enzyme inhibition
  4. enterohepatic cycling
16) The rate of drug absorption would be increased by which of the following?
  1. drug ionization
  2. water solubility
  3. positively charged drug
  4. negatively charged drug
17) Which factor of individual variation is dependent upon the patient's attitude toward treatment?
  1. weight
  2. age
  3. genetic variation
  4. placebo effect
18) Which FDA pregnancy category would appear to be the safest for a developing fetus?
  1. Category A
  2. Category B
  3. Category C
  4. Category D
19) A 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
  1. suicide substrates.
  2. orphan drugs.
  3. protein drugs.
  4. competitive antagonists.
20) 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
  1. idiosyncrasy.
  2. tachyphylaxis.
  3. heterologous desensitization.
  4. refractoriness.
21) Prolonged receptor stimulation during chronic drug therapy may induce cells to endocytose and sequester drug receptors in endocytic vesicles. This molecular mechanism is called
  1. tachyphylaxis.
  2. inactivation.
  3. desensitization.
  4. downregulation.
22) 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. Regarding the mechanism by which the drug ameliorates the toxic effects of excessive thyroxine levels, the drug acts as:
  1. a physiologic antagonist.
  2. a competitive receptor antagonist.
  3. a noncompetitive receptor antagonist.
  4. a partial agonist.
23) The main pharmacologic effect of norepinephrine on alpha-1 receptors is
  1. increased heart rate
  2. bronchodilation
  3. vasoconstriction
  4. contraction of urinary bladder
24) The pharmacologic effect of IV metaraminol (an alpha-1 drug) is
  1. vasodilation
  2. vasoconstriction
  3. cardiac stimulation
  4. cardiac depression
25) Epinephrine stimulates
  1. alpha-1 receptors
  2. alpha-2 receptors
  3. beta-1 receptors
  4. beta-2 receptors
26) At therapeutic doses, albuterol stimulates
  1. alpha-1 receptors
  2. alpha-2 receptors
  3. beta-1 receptors
  4. beta-2 receptors
27) Metoprolol is classified as a(n)
  1. alpha-blocker
  2. nonselective beta-blocker
  3. selective beta-1 blocker
  4. adrenergic neuronal blocker
28) The mechanism of action of methyldopa is
  1. increased release of NE from adrenergic nerve ending
  2. alpha-1 receptor blocker
  3. beta-1 receptor blocker
  4. formation of a false transmitter in adrenergic nerve ending
29) The drug of choice to treat acute allergic reactions is
  1. norepinephrine
  2. phenylephrine
  3. pseudoephedrine
  4. epinephrine
30) Which of the following are actions of nonselective beta-adrenergic blocking drugs?
  1. decreasing heart rate
  2. decreasing force of myocardial contraction
  3. vasoconstriction of skeletal muscle blood vessels
  4. lowering of blood pressure
31) The actions of epinephrine (EPI) include which of the following?
  1. bronchodilation
  2. vasoconstriction
  3. relaxation of uterus
  4. increased heart rate
32) Parasympathetic receptors located on the membranes of the internal organs are classified as
  1. alpha-1
  2. nicotinic-neural (Nn)
  3. nicotinic-muscle (Nm)
  4. muscarinic
33) What is the pharmacologic effect produced by cholinergic drugs?
  1. increased heart rate
  2. increased gastrointestinal motility
  3. decreased urination
  4. pupillary dilation
34) Physostigmine (Eserine ) is classified as a(n)
  1. direct-acting cholinergic drug
  2. reversible acetylcholinesterase inhibitor
  3. irreversible acetylcholinesterase inhibitor
  4. anticholinergic drug
35) Symptoms of cholinergic drug overdosage include
  1. slow pulse rate
  2. increased urination
  3. diarrhea
  4. sweating
36) Anticholinergic effects include all of the following except
  1. bronchodilation
  2. increased heart rate
  3. increased gastrointestinal activity
  4. decreased respiratory secretions
37) The antidote for atropine poisoning is
  1. scopolamine
  2. bethanechol
  3. neostigmine
  4. physostigmine
38) Pick the correct pharmacological effect(s) of direct-acting cholinergic drugs.
  1. respiratory paralysis
  2. urinary retention
  3. increased heart rate
  4. bronchodilation
39) Which of the following would be a preferred treatment for overactive bladder?
  1. neostigmine
  2. tolterodine
  3. physostigmine
  4. bethanechol
40) Which of the following is correct about the nicotinic-muscle (Nm) receptor blocking drugs?
  1. the mechanism of action is the same as represented by dantrolene
  2. all of these drugs depolarize the muscle fiber before blockade occurs
  3. calcium ions are released from the storage sites
  4. there are two groups in this class: either depolarizing agents or nondepolarizing agents
41) Succinylcholine is associated with which of the following actions?
  1. stimulation of the actin and myosin muscle fibrils directly
  2. liver damage because the drug is metabolized only by the liver
  3. peripheral neuromuscular receptor blockade after stimulating the Nm receptors
  4. longer duration of action than vecuronium
42) Centrally acting skeletal muscle relaxants
  1. include dantrolene and cisatracurium
  2. inhibit or reduce activity within the spinal cord (intraneuronal), interrupting the central stimulus to muscle contraction
  3. can only be given parenterally
  4. cause systemic release of histamine, leading to hypotension
43) Skeletal muscle relaxants may alter control of respiration because
  1. the diaphragm is a skeletal muscle
  2. succinylcholine stimulates the respiratory centers in the brain
  3. like dantrolene, all muscle relaxants inhibit the action of norepinephrine at the neuromuscular junction
  4. relaxation of the muscles in the lower extremities pulls blood away from the lungs
44) Which drug or condition(s) decrease the effects of neuromuscular blockers?
  1. neomycin
  2. corticosteroids
  3. general anesthetics like isoflurane
  4. alcohol
45) Which of the following is a way in which skeletal muscles are relaxed?
  1. blockage of conduction in the spinal cord
  2. inhibiting nerve transmission
  3. blockage of the Nm receptors
  4. decreasing ACH in the neuromuscular junction
46) For which reason would you use muscle relaxants during surgical or diagnostic procedures?
  1. reduce muscle tear
  2. decrease body temperature
  3. potentiate vasodilators
  4. increase muscle tone
47) Which of the following is NOT a potential adverse effect of peripherally acting skeletal muscle relaxants?
  1. difficulty swallowing (dysphagia)
  2. skeletal muscle weakness
  3. decreased respiration
  4. bronchospasm
48) In the presynaptic terminal of neuronal cells, the immediate trigger to release a neurotransmitter from synaptic vesicles into the synaptic cleft is
  1. a drop in cytosolic Ca2+.
  2. a drop in cytosolic K+.
  3. a rise in cytosolic Ca2+.
  4. a drop in cytosolic Mg2+.
49) 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
  1. hemicholinium.
  2. acetylcholine.
  3. edrophonium.
  4. succinylcholine.
50) A 25-year old female presents with delirium, hyperthermia, and symptoms of central anticholinergic intoxication. She has attended a ìwitches' conventî and ingested some herbal extracts including fruits of the species ìAtropa belladonna.î As one component of her treatment, she receives a dose of physostigmine. Physostigmine is preferred over neostigmine because:
  1. it is a nonpolar compound that penetrates the CNS more easily than neostigmine.
  2. it has a shorter half-life than neostigmine, making it more useful for emergency treatment.
  3. it has a longer half-life than neostigmine, better matching the half-life of atropine.
  4. it is eliminated via the kidneys, and dosage is not critical with compromised liver function.
51) Which of the following is a correct statement?
  1. opioid analgesics produce little or no respiration depression with long-term use of analgesic doses
  2. opioid antagonists include endorphins
  3. all drugs in the opioid analgesic group are controlled substances, Schedule III
  4. in low doses, opioids produce nausea and vomiting
52) Oxycodone in therapeutic doses can stimulate mu receptors to cause
  1. hyperventilation and deep breathing
  2. bronchospasms
  3. spasmogenic activity in the ureters and sphincter muscle
  4. relaxation of the skeletal muscles controlling posture (spasmolytic)
53) Opioid analgesics are used in which of the following settings?
  1. induction of Monitored Anesthesia Care and treatment of chronic severe pain
  2. routine treatment of migraine
  3. unmonitored treatment of chronic severe pain
  4. analgesia for patients with paralytic ileus
54) Which of the following is a correct statement?
  1. endorphin is an abbreviation from the terms meaning inside the organ
  2. endogenous opioid receptors include mu, alpha-2 adrenergic, and delta receptors
  3. agonism means the drug occupies the receptor and causes a response
  4. opioid agonism means the drug occupies the receptor and stimulates the release of endorphins
55) Which of the following drugs has a recognized medical therapy and does not interact with opioid receptors?
  1. heroin
  2. codeine
  3. methadone
  4. acetaminophen
56) All opioid analgesics are associated with which of the following?
  1. reversal of respiratory depression from barbiturates
  2. use only for the relief of acute pain
  3. cough suppression alone or in combination with other analgesics over-the-counter
  4. tolerance develops to the analgesic response
57) Fentanyl is an opioid analgesic that
  1. can be used for relief of cancer pain
  2. has many formulations (lozenge, film) because it is used routinely in dental surgery
  3. induces neuropathic pain
  4. primarily works on peripheral nerve endings rather than higher centers
58) Sharp pain is transmitted through which type of nerve fibers?
  1. unmyelinated
  2. myelinated A-delta
  3. CTZ
  4. C fibers
59) Opioid drugs are derived from which of the following?
  1. poppy
  2. opium
  3. chemical synthesis
  4. alkaloids
60) What is the adverse effect of opioid analgesics?
  1. constipation
  2. polyuria
  3. convulsions
  4. mydriasis
61) During tolerance to opioid analgesics, the following is happening.
  1. fewer receptors are available to produce a response
  2. increased pain by the patient requires greater doses of medication
  3. the body reacts to removal of the opioid analgesic
  4. histamine release causes hypotension
62) What is the best reason for using a balanced anesthesia strategy? (LO 18.1)
  1. producing complementary effects using a few drugs avoids unnecessary intense (deep) CNS depression with one anesthetic to achieve the same effect
  2. the concentration of volatile anesthetic in the alveoli is balanced against the amount of anesthetic in the blood
  3. less monitoring of anesthesia is required
  4. fewer patients experience emergence delirium
63) Why is propofol a drug of choice for induction and maintenance of anesthesia?
  1. it is a potent analgesic at all doses
  2. it slowly brings the patient to the stage of surgical anesthesia
  3. it is a complete anesthetic with a quick onset of action and recovery period uncomplicated by nausea and vomiting
  4. it is administered by special vaporizer to avoid mask delivery
64) Which of the following is NOT correct?
  1. ketamine causes chloride ions to flow out of the nerve cell by binding to GABA
  2. propofol binds to the GABA A receptor and enhances hyperpolarization of the neuron
  3. barbiturates and propofol act on the receptor and directly on the chloride channel
  4. potent anesthetics enhance GABA A receptor function
65) Which of the following major routes remove etomidate and midazolam from the body?
  1. hepatic metabolism and renal excretion
  2. excretion through the lungs and sweating
  3. accumulation in fat tissue and redistribution
  4. increased salivation and bile production
66) Which type of anesthesia does not cause the patient to lose consciousness?
  1. local anesthesia
  2. Monitored Anesthesia Care
  3. general anesthesia
  4. balanced anesthesia
67) Choose the correct class of general anesthetics.
  1. intravenous
  2. dissociative anesthesia
  3. oral
  4. topical
68) Which drugs would be used as adjunct therapy to anesthesia?
  1. analgesics
  2. antiarrhythmics
  3. antianxiety, short-acting CNS depressants like midazolam
  4. anticholinergics
69) 1.Barbiturate and benzodiazepine hypnotics both
  1. increase NREM stage 2 sleep
  2. increase REM sleep
  3. increase NREM stage 4 sleep
  4. cause REM rebound
70) 2.Disadvantages to the use of barbiturate hypnotics include
  1. risk of drug dependency
  2. disruption of normal stages of sleep
  3. suppression of REM sleep
  4. all of these statements are true
71) The correct statement concerning the use of hypnotic drugs is
  1. zolpidem binds to the GABAB receptor
  2. benzodiazepines increase chloride channel opening
  3. barbiturates block the GABA receptor
  4. ramelteon is a melatonin antagonist
72) Flurazepam
  1. forms active metabolites
  2. may cause next-day residual effects
  3. increases chloride ion influx
  4. all of these statements are true
73) Eszopiclone
  1. is classified as a benzodiazepine
  2. has a half-life of 1-2 hours
  3. increases total sleep time
  4. is used as an antianxiety agent
74) 1.The main pharmacologic effect of the SSRIs is
  1. increase levels of norepinephrine
  2. increase levels of serotonin
  3. decrease levels of norepinephrine
  4. decrease levels of serotonin
75) The pharmacologic effects of TCAs include
  1. antihistaminic
  2. anticholinergic
  3. sedation
  4. all of the above
76) The serotonin syndrome is mainly associated with overdosage of
  1. monoamine oxidase inhibitors
  2. selective serotonin reuptake inhibitors
  3. psychomotor stimulants
  4. lithium
77) 4.The main pharmacologic effects of TCAs on neurotransmitter activity is
  1. increase norepinephrine
  2. increase acetylcholine
  3. increase serotonin
  4. increase norepinephrine and serotonin only
78) Venlafaxine (Effexor) is classified as
  1. MAOI
  2. TCA
  3. SSRI
  4. SNRI
79) Adverse effects of TCAs include
  1. cardiac arrhythmias
  2. convulsions
  3. postural hypotension
  4. all of these
80) Which of these represents the drug that is not correctly matched with its drug classification?
  1. paroxetine—SSRI
  2. amitriptyline—TCA
  3. methylphenidate—MAOI this is targets dop transporter
  4. duloxetine—SNRI
81) Which drug requires a dietary restriction for foods containing tyramine?
  1. nortriptyline (TCA)
  2. tranylcypromine (MAOI)
  3. venlafaxine (SNRI)
  4. fluoxetine (SSRI)
82) The site of action of diazepam (Valium) to relieve anxiety is the
  1. spinal cord
  2. limbic system
  3. reticular formation
  4. basal ganglia
83) The antianxiety effect of buspirone (BuSpar) is associated with
  1. stimulation of DA receptors
  2. stimulation of serotonin receptors
  3. blockage of serotonin receptors
  4. blockade of dopamine receptors
84) Flumazenil (Romazicon) is used to reverse the depressant effects of
  1. clozapine
  2. alprazolam (benzodiazepine)
  3. haloperidol
  4. chlorpromazine
85) What are the main areas at which benzodiazepines exert their effects?
  1. cerebral cortex
  2. reticular formation
  3. spinal cord
  4. all of these
86) Symptoms of Parkinsonism would be increased by
  1. excess levels of acetylcholine
  2. treatment with some antipsychotic drugs
  3. decreased levels of dopamine
  4. drug administration after a high-protein meal
87) The drug classified as a dopamine receptor agonist is
  1. amantadine
  2. benztropine
  3. ropinirole
  4. entacapone (COMT)
88) Which the drug increases the duration of action of DA and/or the amount of levodopa that enters the brain?
  1. tolcapone
  2. selegiline
  3. rasagiline
  4. all of these
89) In Parkinson's disease, slowed movements are defined as
  1. rigidity
  2. bradykinesia
  3. tremor
  4. dystonia
90) Sinemet is the trade name of a drug combination that contains levodopa and
  1. carbidopa and entacapone
  2. entacapone
  3. carbidopa
  4. selegiline
91) The COMT inhibitor that has been associated with causing liver toxicity is
  1. ropinirole
  2. entacapone
  3. pramipexole
  4. tolcapone
92) Which of the following is a symptom of Parkinson's disease?
  1. muscular rigidity
  2. increased sweating
  3. salivary drooling
  4. movement disturbances
93) Which of the following drugs would be used to decrease the actions of ACH?
  1. amantadine
  2. levodopa
  3. bromocriptine
  4. procyclidine
94) How does levodopa work?
  1. converted to dopamine in the substantia nigra neurons
  2. increases level of dopamine in the brain
  3. peripheral metabolism to DA inhibited by carbidopa
  4. all of these
95) Apomorphine is classified as
  1. MAO-B inhibitor
  2. dopamine receptor agonist
  3. COMT inhibitor
  4. anticholinergic drug
96) 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
  1. muscarinic-M1 receptor.
  2. muscarinic-M2 receptor.
  3. muscarinic-M3 receptor.
  4. muscarinic-M4 receptor.

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