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General pharmacology Retake 26/07/2023

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General pharmacology Retake 26/07/2023
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Quiz by ab cd, updated more than 1 year ago
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Question 1

Question
Sugammadex is a new drug that reverses the action of rocuronium and certain other skeletal musclerelaxing 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?
Answer
  • Chemical antagonist
  • Noncompetitive antagonist
  • Partial agonist
  • Physiologic antagonist
  • Pharmacologic antagonist

Question 2

Question
You are the only physician in a clinic that is cut off from the outside world by violent storms, flooding, and landslides. A 15-year-old girl is brought to the clinic with severe asthmatic wheezing. Because of the lack of other drugs, you decide to use intravenous theophylline for treatment. The pharmaco- kinetics of theophylline include the following average param- eters: Vd 35 L; CL 48 mL/min; half-life 8 h. If an intravenous infusion of theophylline is started at a rate of 0.48 mg/min, how long would it take to reach 93.75% of the final steady- state concentration?
Answer
  • Approximately 48 min
  • Approximately 24 h
  • Approximately 32 h

Question 3

Question
Which drug used in the maintenance treatment of patients with tonic- clonic or partial seizure states increasef many drugs including both phenytoin and warfarin?
Answer
  • Clonazepam
  • Eszopiclone
  • Triazolam
  • Phenobarbital
  • Buspirone

Question 4

Question
A 20-year-old male patient scheduled for hernia surgery was anesthetized with halothane and nitrous oxide; tubocurarine was provided for skeletal muscle relaxation. The patient rapidly developed tachycardia and became hypertensive. Generalized skeletal muscle rigidity was accompanied by marked hyperthermia. Laboratory values revealed hyperkalemia and acidosis. This unusual complication of anesthesia is most likely to be caused by
Answer
  • Acetylcholine release from somatic nerve endings at skeletal muscle
  • Activation of brain dopamine receptors by halothane
  • Antagonism of autonomic ganglia by tubocurarine
  • Toxic metabolites of nitrous oxide
  • Calcium released within skeletal muscle

Question 5

Question
A significant number of patients started on ACE inhibitor therapy for hypertension are intolerant and must be switched to a different class of drug. What is the most common manifestation of this intolerance?
Answer
  • Angioedema
  • Glaucoma
  • Headache
  • Incessant cough
  • Ventricular arrhythmias

Question 6

Question
Actions and clinical uses of muscarinic cholinoceptor agonists include which one of the following?
Answer
  • Bronchodilation (treatment of asthma)
  • Miosis (treatment of narrow angle glaucoma)
  • Decreased gastrointestinal motility (treatment of diarrhea)
  • Decreased neuromuscular transmission and relaxation of skeletal muscle (during surgical anesthesia)
  • Increased sweating (treatment of fever)

Question 7

Question
A child requires multiple minor surgical procedures involving the nasopharynx. Which drug has high surface local anesthetic activity and intrinsic vasoconstrictor actions that reduce bleeding in mucous membranes?
Answer
  • Bupivacaine
  • Cocaine
  • Lidocaine
  • Mepivacaine
  • Tetracaine

Question 8

Question
Oral medications are popular for the treatment of asthma in children because young children may have difficulty with the proper use of aerosol inhalers. Which of the following is an orally active inhibitor of leukotriene receptors?
Answer
  • Albuterol
  • Aminophylline
  • Ipratropium
  • Zafirlukast
  • Zileuton

Question 9

Question
On her release from the hospital, the patient is advised not to rely solely on oral contraceptives to prevent pregnancy because they may be less effective while she is being maintained on antimycobacterial drugs. The agent most likely to interfere with the action of oral contraceptives is
Answer
  • Amikacin
  • Ethambutol
  • Pyrazinamide
  • Isoniazid
  • Rifampin

Question 10

Question
A 19-year-old college student has well-controlled asthma but on reporting to the college health clinic, complains of a sore throat. On examination, he has typical signs of thrush, a fungal infection with Candida albicans. The asthma controller medication most likely to be associated with Candida infection is:
Answer
  • Albuterol by aeroso
  • Ipratropium by inhaler
  • Beclomethasone by aerosol
  • Prednisone by mouth
  • Theophylline in long-acting oral form

Question 11

Question
Which of the following drugs is the most effective in the emergency management of malignant hyperthermia?
Answer
  • Atropine
  • Dantrolene
  • Haloperidol
  • Succinylcholine
  • Vecuronium

Question 12

Question
A 17-year-old patient complains that he develops wheezing and severe shortness of breath whenever he takes aspirin for headache. Increased levels of which of the following may be responsible, in part, for some cases of aspirin hypersensitivity?
Answer
  • Alprostadil
  • Leukotriene LTC4
  • PGE2
  • Prostacyclin
  • Thromboxane

Question 13

Question
The primary mechanism of resistance of Gram-positive organisms to macrolide antibiotics including erythromycin is
Answer
  • Changes in the 30S ribosomal subunit
  • Methylation of binding sites on the 50S ribosomal subunit
  • Formation of esterases that hydrolyze the lactone ring
  • Formation of drug-inactivating acetyltransferases
  • Decreased drug permeability of the cytoplasmic membrane

Question 14

Question
Tolcapone may be of value in patients being treated with levodopa- carbidopa because it
Answer
  • Activates COMT
  • Decreases the formation of 3-O-methyldopa
  • Inhibits monoamine oxidase type A
  • Inhibits neuronal reuptake of dopamine
  • Releases dopamine from nerve endings

Question 15

Question
A 46-year-old male patient has Cushing’s syndrome due to an adrenal tumor. Which of the following drugs would be expected to reduce the signs and symptoms of this man’s disease?
Answer
  • Betamethasone
  • Cortisol
  • Fludrocortisone
  • Ketoconazole
  • Triamcinolone

Question 16

Question
Which of the following is an antagonist at NK1 receptors and is used to prevent or reduce chemotherapy-induced nausea and vomiting?
Answer
  • Angiotensin I
  • Aprepitant
  • Bradykinin
  • Brain natriuretic peptide
  • Enalapril

Question 17

Question
If ampicillin and piperacillin are used in combination in the treatment of infections resulting from Pseudomonas aeruginosa, antagonism may occur. The most likely explanation is that
Answer
  • Ampicillin is bacteriostatic
  • Ampicillin induces beta-lactamase production
  • Autolytic enzymes are inhibited by piperacillin
  • Piperacillin blocks the attachment of ampicillin to penicillin-binding proteins
  • The 2 drugs form an insoluble complex

Question 18

Question
Certain drugs can cause severe hypotension when combined with nitrates. Which of the following interacts with nitroglycerin by inhibiting the metabolism of cGMP?
Answer
  • Atenolol
  • Hydralazine
  • Nifedipine
  • Sildenafil
  • Terbutaline

Question 19

Question
A 28-year-old office worker suffers from intense migraine headaches. Which of the following is a serotonin 5-HT1D/1B agonist useful for aborting an acute migraine headache?
Answer
  • Bromocriptine
  • Cimetidine
  • Ketanserin
  • Ephedrine
  • Sumatriptan

Question 20

Question
Which of the following agents, when used in combination with other anti- HIV drugs, permits dose reductions?
Answer
  • Efavirenz
  • Procainamide
  • Verapamil
  • Ritonavir

Question 21

Question
A 4-year-old child is brought to the hospital after ingesting pills that a parent had used for bacterial dysentery when traveling outside the United States. The child has been vomiting for more than 24 h and has had diarrhea with green stools. She is now lethargic with an ashen color. Other signs and symptoms include hypothermia, hypotension, and abdominal distention. The drug most likely to be the cause of this problem is
Answer
  • Ampicillin
  • Azithromycin
  • Chloramphenicol
  • Doxycycline

Question 22

Question
Flumazenil will counteract the action of each of the following drugs :except
Answer
  • Alprazolam
  • Buspirone
  • Diazepam
  • Eszopiclone
  • Zaleplon

Question 23

Question
A 20-year-old woman is taking over-the-counter diphenhydramine for severe hay fever. Which of the following adverse effects is she most likely to report?
Answer
  • Muscarinic increase in bladder tone
  • Nausea
  • Nervousness, anxiety
  • Sedation
  • Vertigo

Question 24

Question
A 73-year-old man with a history of a recent change in his treatment for moderately severe hypertension is brought to the emergency department because of a fall at home. Which of the following drug groups is most likely to cause postural hypotension and thus an increased risk of falls?
Answer
  • ACE inhibitors
  • Alpha1-selective receptor blockers
  • Arteriolar dilators
  • Beta1-selective receptor blockers
  • Calcium channel blockers

Question 25

Question
A 23-year-old woman is admitted to the emergency department with difficulty breathing. Examination reveals significant laryngeal edema. Past medical history indicates that she suffers from recurrent episodes of angioneurotic edema with release of histamine and other mediators. Which of the following drugs is the most effective physiologic antagonist of histamine in smooth muscle?
Answer
  • Epinephrine
  • Loratadine
  • Ondansetron
  • Ranitidine
  • Sumatriptan

Question 26

Question
A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations and shortness of breath. These episodes occasionally terminate spontaneously but often require a visit to the emergency department of the local hospital. Her ECG during these episodes reveals an AV nodal tachycardia. Which of the following drugs would be most suitable for prophylaxis of future episodes of acute AV nodal tachycardia? #Foucous:- prophylaxis !!!!!
Answer
  • Adenosine
  • Flecainide
  • Amiodarone
  • Propranolol
  • Verapamil

Question 27

Question
A 60-year-old woman comes to the emergency department with atypical chest pain. Her ECG reveals ventricular tachycardia with rare normal sinus beats, and ST-segment elevation. Troponin C levels are markedly increased, suggesting myocardial damage. A diagnosis of myocardial infarction is made, and the woman is admitted to the cardiac intensive care unit. Her arrhythmia will probably be treated initially with:
Answer
  • Adenosine
  • Digoxin
  • Lidocaine
  • Quinidine
  • Verapamil

Question 28

Question
All of the following factors influence the action of local anesthetics :except
Answer
  • Acetylcholinesterase activity in the region of the injection site
  • Blood flow through the tissue in which the injection is made
  • Dose of local anesthetic injected
  • The use of vasoconstrictors
  • Tissue pH

Question 29

Question
A 56-year-old man has hypertension and an enlarged prostate, which biopsy shows to be benign prostatic hyperplasia. He complains of urinary retention. Which of the following drugs would be the most appropriate initial therapy?
Answer
  • Albuterol
  • Atenolol
  • Metoprolol
  • Prazosin
  • Timolol

Question 30

Question
Which of the following is a direct-acting cholinomimetic that is lipid- soluble and is used to facilitate smoking cessation?
Answer
  • Varenicline
  • Physostigmine
  • Neostigmine
  • Bethanechol
  • Acetylcholine

Question 31

Question
Which of the following is the best-documented mechanism of beneficial action of cardiac glycosides?
Answer
  • A decrease in calcium uptake by the sarcoplasmic reticulum
  • An increase in systolic cytoplasmic calcium levels
  • A modification of the actin molecule
  • An increase in a late transmembrane sodium current
  • A block of cardiac β adrenoceptors

Question 32

Question
Which of the following has been shown to prolong life in patients with chronic congestive failure in spite of having a negative inotropic effect on cardiac contractility?
Answer
  • Carvedilol
  • Digoxin
  • Dobutamine
  • Enalapril
  • Furosemide

Question 33

Question
A 60-year-old patient complains of paresthesias and occasional nausea associated with one of the drugs she is taking. She is found to have hyperchloremic metabolic acidosis. She is probably taking
Answer
  • Acetazolamide for glaucoma
  • Amiloride for edema associated with aldosteronism
  • Furosemide for severe hypertension and heart failure
  • Hydrochlorothiazide for hypertension
  • Mannitol for cerebral edema

Question 34

Question
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
Answer
  • Distribution
  • Excretion
  • First-pass effect
  • Zero-order elimination

Question 35

Question
A 65-year-old woman with impaired renal function and a necrotic ulcer in the sole of her right foot is admitted to the ward from the emergency department. She has longstanding type 2 diabetes mellitus and you wish to examine her retinas for possible vascular changes. Which of the following drugs is a good choice when pupillary dilation—but not cycloplegia—is desired?
Answer
  • Isoproterenol
  • Norepinephrine
  • Phenylephrine
  • Pilocarpine
  • Tropicamide

Question 36

Question
A patient with parkinsonism is being treated with levodopa. He suffers from irregular, involuntary muscle jerks that affect the proximal muscles of the limbs. Which of the following statements about these symptoms is most accurate?
Answer
  • Coadministration of muscarinic blockers prevents the occurrence of dyskinesias during treatment with levodopa
  • Drugs that activate dopamine receptors can exacerbate dyskinesias in a patient taking levodopa
  • Dyskinesias are less likely to occur if levodopa is administered with carbidopa
  • Symptoms are likely to be alleviated by continued treatment with levodopa
  • The symptoms are usually reduced if the dose of levodopa is increased

Question 37

Question
A 38-year-old man is being treated for HIV-induced acquired immunodeficiency syndrome (AIDS). When abacavir therapy is begun, he develops a severe skin rash. Which of the following pharmacogenomic diagnoses might explain this skin rash?
Answer
  • CYP2D6*3 (PM)
  • CYP3A5*3 (PM)
  • HLA-B*57:01 (EM)
  • SLCO1B1*5 (PM)

Question 38

Question
A 65-year-old woman has been admitted to the coronary care unit with a left ventricular myocardial infarction. She develops acute severe heart failure with marked pulmonary edema, but no evidence of peripheral edema. Which one of the following drugs would be most useful?
Answer
  • Digoxin
  • Minoxidil
  • Furosemide
  • Propranolol
  • Spironolactone

Question 39

Question
A 9-year-old child is having learning difficulties at school. He has brief lapses of awareness with eyelid fluttering that occur every 5–10 min. Electroencephalogram (EEG) studies reveal brief 3-Hz spike and wave discharges appearing synchronously in all leads. Which drug would be effective in this child without the disadvantages of excessive sedation or tolerance development?
Answer
  • Clonazepam
  • Diazepam
  • Gabapentin
  • Phenobarbita
  • Ethosuximide

Question 40

Question
With chronic use in seizure states, the adverse effects of this drug include coarsening of facial features, hirsutism, and gingival hyperplasia.
Answer
  • Carbamazepine
  • Ethosuximide
  • Phenytoin
  • Tiagabine
  • Zonisamide

Question 41

Question
Which of the following is an accepted therapeutic indication for the use of antimuscarinic drugs?
Answer
  • Chronic obstructive pulmonary disease (COPD)
  • Botulinum poisoning
  • Glaucoma
  • Postoperative urinary retention
  • Atrial fibrillation

Question 42

Question
An NO-containing molecule that releases nitric oxide in the blood is:
Answer
  • Citrulline
  • Histamine
  • Isoproterenol
  • Nitroprusside
  • Nitroglycerin

Question 43

Question
Certain drugs can cause severe hypotension when combined with nitrates. Which of the following interacts with nitroglycerin by inhibiting the metabolism of cGMP?
Answer
  • Atenolol
  • Hydralazine
  • Isosorbide mononitrate
  • Nifedipine
  • Sildenafil
  • Ranolazine

Question 44

Question
A 32-year-old woman with hypertension wishes to become pregnant. Her physician informs her that she will have to switch to another antihypertensive drug. Which of the following drugs is absolutely contraindicated in pregnancy?
Answer
  • Atenolol
  • Losartan
  • Methyldopa
  • Nifedipine
  • Propranolol

Question 45

Question
A 54-year-old man comes to the emergency department with acute chest pain, nausea, sweating, and shortness of breath. The patient has a history of recreational drug use and reports using cocaine, heroin, and alcohol earlier in the day. Temperature is 36.1°C (97°F), pulse is 101/min, respirations are 22/min, and blood pressure is 150/100 mm Hg. The medication typically used to treat this acute condition is currently contraindicated for this patient. Which of the following physiologic responses would occur if the contraindicated Beta blocker) medication were given?
Answer
  • Unopposed vascular smooth muscle relaxation
  • Unopposed vascular smooth muscle contraction
  • Unopposed cardiac muscle contraction
  • Unopposed cardiac muscle relaxation

Question 46

Question
Which one of the following is characteristic of nifedipine treatment in patients with essential hypertension?
Answer
  • Competitively blocks angiotensin II at its receptor
  • Decreases calcium efflux from skeletal muscle
  • Decreases renin concentration in the blood
  • Decreases calcium influx into smooth muscle
  • Decreases calcium flux into the urine

Question 47

Question
Which of the following is a leukotriene receptor blocker?
Answer
  • Alprostadil
  • Aspirin
  • Ibuprofen
  • Leukotriene LTC4
  • Montelukast
  • Zileuton

Question 48

Question
After several cycles of chemotherapy, the patient was found to have a high resting pulse rate. A noninvasive radionuclide scan revealed evidence of cardiomyopathy. The drug that is most likely responsible for the cardiac toxicity is:
Answer
  • Cyclophosphamide
  • Doxorubicin
  • Flurouracil
  • Methotrexate
  • Tamoxifen

Question 49

Question
A 16-year-old girl has paroxysmal attacks of rapid heart rate with palpitations and shortness of breath. These episodes occasionally terminate spontaneously but often require a visit to the emergency department of the local hospital. Her ECG during these episodes reveals an AV nodal tachycardia. The antiarrhythmic of choice in most cases of acute AV nodal tachycardia is
Answer
  • Adenosine
  • Amiodarone
  • Flecainide
  • Propranolol
  • Verapamil

Question 50

Question
A 38-year-old man who is obese complains of an extremely painful, swollen metatarsophalangeal joint of his left big toe. He has had two similar attacks in the past 4 years. The physician prescribes febuxostat. Which of the following describes febuxostat's mecha-nism of action?
Answer
  • Anti-inflammatory
  • Inhibition of leukocyte migration
  • Inhibition of urate reabsorption
  • Inhibition of xanthine oxidase
  • Upregulation of urate metabolism

Question 51

Question
A 36-year-old man with multiple medical problems including diabetes, hypertension, and morbid obesity is hospitalized for treatment of a vancomycin-resistant Enterobacter infection. Recent blood cultures are positive. He is given quinupristin/dalfopristin intrave-nously through the antecubital vein. Which of the following sequelae is most likely?
Answer
  • Arthritis
  • Hepatic dysfunction
  • Muscle fatigue
  • Renal failure
  • Venous irritation

Question 52

Question
Ampicillin and amoxicillin are in thesame group of penicillins.However, there are important differences.Which of the following beststates how amoxicillin differs fromampicillin?
Answer
  • Has better oral bioavailability, particularlywhen taken with meals
  • Is effective against penicillinase-producing organisms
  • Is a broad-spectrum penicillin
  • Does not cause hypersensitivity reactions
  • Has great antipseudomonal activity

Question 53

Question
A 69-year-old man is admitted to the hospital for management of a pulmonary embolus for which he receives heparin. Five days later, he reports bilateral leg swelling and pain. Ultrasonography reveals bilateral occlusive thrombi in the popliteal veins.Platelet count is 27,000/mm3, prothrombin time is 12 sec, and activated partial thromboplastin time is 65 sec. His heparin is discontinued. Administration of which of the following medications is the best next step in treatment (for the patient without monitoring) ?
Answer
  • Vitamin K
  • Aspirin
  • Protamine sulfate
  • Direct thrombin inhibitor
  • Warfarin

Question 54

Question
A 29-year-old woman is undergoing an elective laparoscopic cholecystectomy. After being sedated, she is given a muscle relaxant intravenously. Just after administration of this drug, the patient's arms and legs twitch briefly. Which of the following drugs was most likely administered?
Answer
  • Dantrolene
  • Rocuronium
  • Lidocaine
  • Succinylcholine
  • Fentanyl

Question 55

Question
A 36-year-old man with multiple medical problems including diabetes, hypertension, and morbid obesity is hospitalized for treatment of a vancomycin-resistant Enterobacter infection. Recent blood cultures are positive. He is given quinupristin/dalfopristin intravenously through the antecubital vein. Which of the following sequelae is most likely?
Answer
  • Arthritis
  • Hepatic dysfunction
  • Muscle fatigue
  • Renal failure
  • Venous irritation

Question 56

Question
A 44-year-old man comes to the clinic using crutches due to the abrupt onset of an exquisitely painful, swollen, erythematous, and warm right metatarsophalangeal. Two months ago, he developed mild peripheral edema and was started on a new medication that may cause decreased urine calcium excretion. On physical examination, his right toe is tender, erythematous, and warm to the touch. Which of the following antihypertensive medications was most likely responsible for this patient’s findings?
Answer
  • Furosemide
  • Hydrochlorothiazide
  • Nifedipine
  • Lisinopril
  • Prazosin

Question 57

Question
A 50-year-old man has a history of frequent episodes of renal colic with calcium-containing renal stones. A careful workup indicates that he has a defect in proximal tubular calcium reabsorption, which results in high concentrations of calcium salts in the tubular urine. The most useful diuretic agent in the treatment of recurrent calcium stones is
Answer
  • Chlorthalidone
  • Diazoxide
  • Ethacrynic acid
  • Mannitol
  • Spironolactone

Question 58

Question
Patient with hypertension he has symptoms like inflammation and pain in the pig tone what is the drug that he used: افهم
Answer
  • inhibiting of sodium in the distal convoluted tubule (thiazide)
  • !

Question 59

Question
patient with pulmonary disease and have high blood pressure and high pulse which drug is contraindicated? افهم
Answer
  • Alfa agonist
  • beta antagonist
  • non selective B blocker

Question 60

Question
Patient have high blood pressure and Renal failure which drug should not be given. افهم
Answer
  • angiotensin covering enzyme inhibitor
  • !

Question 61

Question
Drug prophylaxis for av tachycardia:
Answer
  • verapamil
  • phenytoin
  • Carbamazepine
  • Luoprolide
  • Adenocine

Question 62

Question
Patient is having epilepsy and take drug for seizures also work in voltage-gated calcium:
Answer
  • clozapine and carbamazepine and another drug was suggested
  • !!

Question 63

Question
Patient is take anti epileptic drug (valporic acid) put symptoms are not relief which drug can be used for partial seizures:
Answer
  • Carbamazepine
  • phenytoin
  • Phenoberbital

Question 64

Question
Mechanism of digoxin : increase in ejection fraction
Answer
  • decreases HR
  • !

Question 65

Question
Patient have epilepsy and take over dose of diazepam the symptoms relief with flumazenil explained this on a curve:
Answer
  • capitative antagonist
  • !!

Question 66

Question
Antipsychotic drugs (ALZHEIMER )that in supine position increase blood pressure in siting positive decrease BP:
Answer
  • in the answer need the mechanism of the drug (risperidone)
  • !!

Question 67

Question
Inticancer drug that inhibits myosis:
Answer
  • - paclitaxel, docetaxel, vinblastineمنهن و
  • !!

Question 68

Question
Pregnant Woman experience hemorrhage she has given petamethasone which is mechanism of this drug :
Answer
  • this drug for lung reduce respiratory distress syndrome in fetus
  • !!

Question 69

Question
Patients is taking drug for arrhythmias he developed pulmonary disease:
Answer
  • ب بخلص طويل الجوابvia potassium channel blockers ( amiodarone )
  • !!

Question 70

Question
Patient which hypertension taking diuretic he experiences fatigue pills (vertigo) which substances is increased in this patient:
Answer
  • bicarbonate HCO3 BUT THR other OPTIONS WAS SODIUM, potassium, chloride I think he toke furosemide
  • furosemide

Question 71

Question
Patient how is taking antipsychotic drug - and his mother have history of anxiety disorder developed muscle rigidity what drug he used that caused this symptoms?
Answer
  • Haloperidol
  • !!

Question 72

Question
Grapes fruit Which drug should not take with which anticoagulants drug :
Answer
  • factor 1 / factor | factor 11 / factor 5
  • !!
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