The main routes of enteral administration of drugs are:
oral
by injection
rectal
per mucosa
Advantages of the oral route of drug administration are:
easily self-administered
toxicity and overdose may be overcome with antidotes
drugs avoid first-pass metabolism
drugs go directly into the systemic circulation
Advantages of the rectal route of drug administration are:
suitable for vomiting patients
suitable for children
suitable for unconscious patients
a way to avoid first-pass metabolism
Disadvantages of intravenous drug administration are:
a trained staff is required
risk of bacterial contamination at the site of injection
it is painful and stressful for the patient
drugs undergo first-pass metabolism in the liver
Point out the correct statements for intravenous drug administration:
aqueous solutions can be administered i.v.
oil solutions can be administered i.v.
has the highest bioavailability
used for treatment of life-threatening conditions
The subject of pharmacokinetics is:
drug absorption and distribution
drug biotransformation
drug elimination
drug biological activity
Point out the correct statements for passive diffusion:
does not require energy
requires energy
involves a carrier
drugs move from high to lower concentration
A drug-weak acid will be absorbed
in a medium with low pH
in a medium with high pH
in the stomach
in the intestine
The diffusion of Iipid soluble drugs
depends on the charge of the drug molecule
does not depend on the charge of the drug molecule
is penetration through aqueous channels or pores
is penetration through the biological membranes
A drug-weak base will be absorbed
Point out the correct statements for active drug transport
it is energy - dependent
it is not energy - dependent
requires carriers
does not require carriers
Point out the correct statement for drugs bound to plasma proteins
bound drugs are pharmacologically active
only the unbound drugs can act on target sites in the tissues
only the bound drugs are available to the process of elimination
drugs may displace each other from the binding proteins
Drug metabolism may
increase a drug’s pharmacological activity
decrease a drug’s pharmacological activity
change the pharmacological effects of a drug
change the toxicity of a drug
First phase liver metabolism reactions include
acetylation
conjugation
reduction
oxidation
Second phase liver metabolism reactions include
Phase 1 of drug metabolism
may or may not involve cytochrome P450 system
phase 1 reactions convert Iipophilic molecules to more polar molecules
includes alcohol dehydrogenation, amine oxidation, hydrolysis
consists of conjugation reactions
Renal excretion of a drug will be reduced if
the drug is a weak acid and the urine is alkaline
the drug is a weak acid and the urine is acidic
the drug is a weak base and the urine is alkaline
the drug is a barbiturate and the urine is alkaline
Drug pharmacodynamics includes
drug effects
mechanisms of drug action
how the organism changes drugs
The changes that occur due to the interaction between drug molecules and organism structures are called
drug effect
drug action
adverse drug reaction
placebo effect
The organism response as a result of the changes that have occurred due to its interaction with the drug is called
What is characteristic for a drug receptor
induces (generates) a change in organism functions
has selectivity
has sensitivity
has specificity
Agonists are ligands which
have affinity
block receptors
have intrinsic activity
bind to the receptor
Antagonists are ligands which
have strong affinity
block the receptor
do not have intrinsic activity
Therapeutic margin is the
difference between minimal toxic and minimal therapeutic doses
ratio between minimal toxic and minimal therapeutic doses
difference between mean lethal and mean effective doses
ratio between lethal and mean effective doses
Drugs’ therapeutic index is the:
ratio between mean lethal and mean effective doses
Types of drug interaction are:
synergy
antagonism
synergy/antagonism
chemical antagonism (formation of complexes)
Potentiation can be observed during the concomitant use of:
Fentanyl and Droperidol
Heparin and Protamine
Amoxicillin and Clavulanic acid
Diazepam and Flumazenil
Full competitive antagonist of opioid receptors, administered in acute opioid intoxication is:
Allylnormorphine
Methadone
Naloxone
Flumazenil
Chemical antagonism or complex formation can be observed in:
Morphine and Naloxone
Epinephrine and Histamine
Iron preparation and Deferroxamine
Which of the following are enzyme inducers:
Phenytoin
Phenobarbital
Metamizol
Metronidazole
Multiple drug administration could lead to:
drug tolerance
drug dependence
drug accumulation
allergic reactions
Drug addiction/dependence involves:
physical dependence
psychological dependence
allergy
Antiseptics are used for:
decontamination of laundry and sanitary facilities
decontamination of skin and mucous membranes
internal administration
treatment of fever
Disinfectants are used for decontamination of:
urine, faeces and other
mouth
instruments
clothing and underwear
Antiseptics and disinfectants are:
detergents
barbiturates
oxidizing agents and halogen derivatives
phenols
Mechanism of action of sulfonamide is:
they are synthetic analogues of p-aminobenzoic acid (PABA) and complete with it for the enzyme dihydropteroate synthetase
they increase the permeability of the bacterial cell membrane
they inhibit bacterial wall synthesis
they inhibit the synthesis of bacterial dihydrofolic acid
For non-combined sulfanamides is true:
have broad antibacteriai spectrum
have narrow antibacterial spectrum
they are bactericidal
they are bacteriostatic
Combined sulfonamides are:
bacteriostatic drugs
bactericidal drugs
antiviral drugs
narrow spectrum antimicrobial drugs
Fluoroquinoiones are:
Gentamycin
Moxifloxacin
Ciprofloxacin
Levofloxacin
Mechanism of action of quinolones is:
inhibition of protein synthesis
inhibition of cell wall synthesis
inhibition of topoisomerase II and IV
inhibition of DNA transcription and replication
Fluoroquinolones have:
broad antibacterial spectrum
narrow antibacterial spectrum
bacteriostatic effect
bactericidal effect
Adverse drug reactions of fluoroquinolones are:
articular cartilage erosion (arthropathy)
hypertension
seizures in patients with epilepsy
prolongation of QT interval
Antimicrobials that inhibit bacterial cell wall synthesis are:
penicillins
cephalosporins
monobactams
tetracyclines
Tetracyclines
are bactericidal
are bacterostatic
accumulate in tissues- in bones and teeth
are effective against rickettsiae, mycoplasma, chlamydia
Macrolide antibiotics are:
Azithromycin (Azatril)
Roxithromycin (Rulid)
Clarithroomycin (Klacid)
Macrolides are:
bactericidal
bacteriostatic
inhibitors of methylxanthines’ metabolism
effective against mycoplasmas, Legionella, Chlamydia
Adverse drug reactions of macrolides include:
gastrointestinal disturbances
hepatotoxicity
nephrotoxicity
Beta-lactam antibiotics are
carbapenems
Adverse drug reactions of penicillins are:
anaphylactic shock
disbactenosrs (for orally administered broad-spectrum penicillins)
Cephalosporins 1st generation are:
More effective against Gram (+) microorganisms
Cefalexin and Cefazolin
Bacteriostatic
Some agents are nephrotoxic
Cephalosporins 3rd generation are:
Cefetamet and Ceftriaxon
Cefaclor and Cefamandol
More effective against Gram (-) microorganisms
Used for treatment of life-threatening infections
Aminoglycoside antibiotics are:
Amoxiclav
Amikacin
Tobramycin
The correct statements of aminoglycoside antibiotics are:
they block protein synthesis and are bactericidal
they accumulate in soft tissues and bones
they are administrated orally for treatment of urinary infections
they are effective against Gram (-) microorganisms
Adverse drug reactions of aminoglycosides are:
ototoxicity
myelotoxlcity
hepatotoxiclty
Azoles
are fungistatic
inhibit cell wall synthesis
inhibit ergosterol synthesis
inhibit hepatic CYP450 enzymes
ADRs of azole antifungals are:
endocrine disorders
nausea, vomiting
Point the correct statements for Nystatin
has fungistatic activity
causes gastrointestinal disturbances
is effective against Trichomonas vaginalis
is effective against Candida species
Point out the correct statements for Aciclovir
it inhibits viral DNA polymerase
it is used for treatment of herpes virus infections
it inhibits neuraminidase enzyme
can be applied topically, orally or intravenously
Mechanism of action of Oseltamivir (Tamiflu) is
interference with the function of the viral M2 protein
inhibition of specific neuraminidase enzyme
inhibition of reverse transcriptases
inhibition of proteases
Mechanism of action of Rifampicin (Rifampin) is
inhibition of 50 S ribosomal subunit
inhibition of DNA-dependent RNA polymerase
increased cell membrane permeability
ADRs of Rifampicin (Rifampin) are:
heart failure
orange-red color of urine and other secretions
hypoglycaemia
What are the effects of benzodiazepines?
hypnotic effect
anxiolytic effect
muscle-relaxing effect
anticonvulsant effect
How do benzodiazepines exert their effects?
they enhance the effectiveness of GABA
they inhibit the phosphodiesterase
they are positive allosteric modulators of the GABA-mediation
they block D2 receptors in the CNS
Nonbenzodiazepines hypnotics that act at GABA-recptor are
Melatonin
Zolpidem (Stilnox)
Zopiclone (Imovan)
Adverse drug reaction of Zopiclone (Imovan) are
bitter or metallic taste in the mouth
behavioral changes
hypoglycemia
Magnesium sulfate has sedative effects when administered
orally
parenterally
subcutaneously
by inhalation
Mechanism of action of antiepileptic drugs includes
enhancing GABA synaptic transmission
blocking D2 receptors
reducing cell membrane permeability to calcium T-channels
reducing cell membrane permeability to sodium channels
Drugs reducing cell membrane permeability to voltage-dependent sodium channels are
Carbamazepine
Benzodiazepines
Lamotrigine
Valproate
Cell membrane permeability to calcium T-channels is reduced by
Ethosuximide
Levetiracetam
What are the clinical indications for prescribing Carbamazepine?
It is a drug of first choice or focal and secondary generalized epilepsy
It is appropriate for treatment of absence seizures
It is used in the treatment of insomnia
It is useful for treatment of trigeminal neuralgia
What is characteristic of Phenytoin?
It reduces cell membrane permeability to voltage-dependent sodium channels
It increases GABA synaptic transmission
It is a potent enzyme inducer
It is also used as an antiarrhythmic drug
Adverse drug reactions of Valproates are
constipation
weight gain
hair loss
Which antiepileptic drugs can be used for treating status epilepticus?
Carboxamides
Valproates
Barbiturates
Muscarinic cholinergic receptors are located in:
skeletal muscles
bronchial smooth muscles
heart
smooth muscles of GIT
Nicotinic cholinergic receptors are located in:
autonomic ganglia
adrenal gland medulla
heart muscle
Pharmacological effects of Acetylcholine are:
bradycardia
tachycardia
increased digestive (abundant saliva), bronchial, cutaneous, (sweat) and lacrimal secretions
increased tone and peristaltic contractions of GIT
M-receptor agonist used for treatment of glaucoma is:
Atropini sulfas
Pilocarpini hydrochloridum
Neostigmini methylsulfas
Galantamini bromidum
What are the effects of Pilocarpine after eye application?
mydriasis
miosis
increases the intraocular pressure
decreases the intraocular pressure
Acetylcholine esterase inhibitors (anticholinesterases) are:
lpratropii bromidum
Galantamine bromidum
Neostigmine methylsulfas
Pyridostigmine bromidum
Anticholinesterases are contraindicated in:
bronchial asthma
paralytic ileus
epilepsy
Antimuscarinic receptor antagonists are:
Butylscopolamine
Atracurium besilas
Ipratropium bromidum
Pharmacological effects of antimuscarinic drugs are:
intestinal smooth muscle relaxation
decrease the secretion of exocrine glands
Clinical indications for prescribing antimuscarinic drugs are
spasm of the smooth muscles of GlT
to elicit papillary dilation
glaucoma
Adverse drug reactions of Atropine are:
dry mouth
difficulties in seeing close objects
disorientation and hallucinations
Adverse drug reactions of non-depolarizing muscle relaxants are:
histamine release
hypotension
allergic reaction
Which of the following drugs will antagonise the effect of the non-depolarizing neuromuscular blockers?
Anticholinesterases
MAO inhibitors
Antimuscarinic agents
Aminoglycoside antibiotics
What are the main features of Suxamethonium chioridum:
short-lasting effect
has no antagonist
anticholinesterases prolong its effect
oral administration
α1-adrenoceptors are located on:
presynaptic neuronal endings
postsynaptic neuronal endings
blood vessels
iris dilator muscle
β1-adrenoceptors are located on:
myocardial cells
juxtaglomerular apparatus in the kidney
β2-adrenoceptors are located on:
liver
uterus (womb)
Indications for the clinical use of Epinephrine are:
arrhythmia
glaucoma with wide iridocorneal angle
Pharmacological effects of the selective β2-agonists are:
pupillary dilation
bronchial dilation
blood pressure elevation
relaxation of uterine muscle
Which of the following drugs are selective β2-agonists?
lsoprenalini sulfas
Orciprenalini sulfas
Salbutamol
Salmeterol
β2-agonists are indicated in:
digitalis intoxication
arterial hypertension
threatening abortion
Adverse drug reactions of β2-agonists are:
finger tremor
bronchial dilatation
hyperglycemia
tolerance
Which of the following drugs act as agonists of the presynaptic α2-adrenoceptors?
Clonidini hydrochloridum
α-Methyldopum (Dopegyt)
Sotalol
Adverse drug reactions of Clonidin are:
Dry mouth
Drowsiness and depression
Hypertensive attacks following abrupt cessation of treatment
CNS stimulation
For Methyldopa is true:
has antihypertensive effect
it is safe in pregnancy
could cause drug-induced parkinsonism
used to treat threatening abortion
Which of the following drugs are selective β1-blockers?
Atenolol
Pindolol
Propranolol
Metoprolol
β-blockers are indicated in case of:
ischaemic heart disease
β-blocker approved for topical use in treatment of glaucoma is:
Bisoprolol
Timolol
Potential adverse drug reactions of β-blockers are
bronchoconstriction
hyperglycaemia
nightmares
Effects of methylxanthines on the cardio-vascular system are:
positive inotropic effect
negative inotropic effect
increased cardiac output
cranial vessels constriction
Adverse drug reactions of methylxanthines are:
seizures - in higher doses
increased oxygen demand of the heart
bronchial constriction
Therapeutic uses of Methylehenidaie are:
attention deficit hyperactivity disorder (ADHD) in children
narcolepsy
concentration and attention deficit in adults
Antidepressants, selective serotonin reuptake inhibitors are:
Fluoxetine
Clomipramine
Paroxetine
Amitriptyiine
Mode of action of antidepressants involves:
Inhibition of serotonin reuptake
Inhibition of norepinephrin reuptake
Stimulation of serotonin reuptake
MAO inhibition
In treatment with MAOIs should be avoided the intake of:
tyramine containing nutrition
cyclic antidepressants
adrenomimetics
cholinolytics