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Pharmacology Teaching and Research


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Pharmacology 3 - Examination Preparation:

                                                                            MBChB 3 and BDS 3

                                                      MCQ, Match Questions and Descriptive Questions:


Pharmacokinetics and Pharmacodynamics:

The following route and method of administering a drug is correct.

1.    Enteral – oral, sublingual, intravenous

2.    Enteral – oral, subcutaneous, rectum

3.    Parenteral – intravenous, subcutaneous, intramuscular

4.    Parenteral – intranasal, inhalation, intramuscular

5.    Other – intranasal, inhalation, sublingual

 

A = 1              B = 2                  C = 3                   D = 4           E = 5

 

Which of the following is not classified as a “pathway of movement and modification”

for a drug administered to the body?

1.    Absorption into the body

2.    Binding to proteins in the body

3.    Distribution through the body

4.    Metabolized by the body

5.    Eliminated from the body

 

A = 1               B = 2                C = 3           D = 4           E = 5

 

Eight (8) milligram of a drug is dissolved in the body fluids resulting in a drug

concentration of 0,16 mg.dm-3. The apparent volume of distribution of the drug in dm 3, is?

1.    0,75

2.    4,8

3.    50

4.    20

5.    100

 

A = 1              B = 2                  #C = 3                  D = 4                    E = 5

 

True statements:

1.    Rapidly metabolized drugs (by the liver) will reach the systemic circulation at a low concentration

2.    Coating and binders have no effect on the dissolution of drugs

3.    The albumin-drug complex could sustain the plasma drug concentration during an extended time

4.    The chemical nature of a drug has no effect on the bio-availability of a drug

5.    Non-polar drugs migrate freely through cell membranes

 

A = 1,3,5        B = 2,4,5    C = 1,3,4,5       D = 2,3,5      E = 2,3,4,5


 The following statements regarding the pK a-value of a drug are true.

1.    Reflects a pH-value at which the concentration of the ionized and unionized forms of the drug are equal

2.    A low value indicates a more acidic drug

3.    A high value indicates a more basic drug

4.    A low value indicates a more potent drug

5.    A high value indicates a drug with less adverse effects

 

A = 2,3,4  B = 1,2,3         C = 2,4,5      D = 1,3,4,5   E 1,3,5

 

Correct “concept – description combination” includes:

1.    Passive diffusion : a protein carrier is required to transport a drug

2.    Non-polar : drugs can migrate easily through a cell membrane

3.    Rapid absorption : advantage of the sublingual route of administering a drug

4.    Potency : indication of the amount of drug needed to produce an effect of given magnitude

5.    Pharmacodynamics : what a drug does to the body and how drugs bind to receptors

 

A = 3,4,5         B = 1,4,5   C = 2,3,5      D = 2,3,4,5  E = 1,2,3,4,5

 

 

“Glucoronidation is a common deconjugation reaction rendering drug metabolites lipid soluble”.

 

The above statement is wrong. Which of the following could correctly replace this incorrect statement?

1.    Glucoronidation is a common conjugation reaction rendering drug metabolites lipid soluble

2.    Glucoronidation is a common deconjugation reaction rendering drug metabolites lipid insoluble

3.    Glucoronidation is a common conjugation reaction rendering drug metabolites water soluble

4.    Glucoronidation is a common deconjugation reaction rendering drug metabolites lipid soluble

5.    Glucoronidation is a common conjugation reaction rendering drug metabolites lipid as well as water soluble

 

A = 1                   B = 2               C = 3                     D = 4                    E = 5

 

 

The following is true regarding the pharmacokinetics of phenobarbital.

1.    The half-life in adults is up to 100 hours

2.    25 % of unchanged drug is excreted in the urine

3.    The therapeutic range is 10 – 40 ug.ml-1

4.    Time taken to reach steady state condition is 10 – 60 days

5.    Bioavailability after oral administration is 70 – 90 %

 

A = 1,2     B = 1,2,4          C = 1,2,3,4             D = 1,2,5    E = 1,2,3,4,5


ANS:

Cocaine:

1.       Inhibits monoamine oxidase enzyme

2.       Is a mixed-acting adrenergic agonist

3.       Is an indirect-acting adrenergic agonist

4.       Inhibits the re-uptake of noradrenaline

5.       Is an adrenergic antagonist

A = 4,5        B = 1,3        C = 1,4        D = 3,5        E = 3,4

 

 The pharmacokinetic parameters of pilocarpine include:

1.       Stability to hydrolysis by acetylcholinesterase

2.       Excreted by the kidneys

3.       Highly hydrophilicity

4.       Inability to cross the blood brain barrier

5.       Acidification of clearance by acidified urine

 

A = 1,2,4        B = 1,2,5        C = 2,4,5          D = 1,2,3       E = 1,3,4

 

 

Atropine is contraindicated in the following conditions:

1.       Urinary obstruction

2.       Organophosphate poisoning

3.       Asthma

4.       Glaucoma

5.       Excessive salivation

 

A = 4,5                      B = 1,3           C = 1,4          D = 3,5          E = 3,4

Succinylcholine:

1.       Its effect can be counteracted with neostigmine

2.       It is a competitive antagonist at the nicotinic receptor

3.       Malignant hyperthermia is one its adverse effect

4.       Has a rapid onset of action?

5.       Has a short duration of action

 

A = 3,4,5       B = 2,4,5       C = 2,3,4      D = 1,3,5     E = 1,2,5

 

 

Edrophonium is used:

1.       In the treatment of myasthenia gravis

2.       To reverse non-depolarising neuromuscular block

3.       In the treatment of diarrhoea

4.       As an antidote to organophosphates

5.       In the diagnosis of myasthenia gravis

 

A = 1,3,4     B = 1,2,5      C = 2,4,5    D= 1,2,4      E = 2,3,5

 

The following are alpha blockers:

1.       Phenoxybenzamine

2.       Phentolamine

3.       Tamsulosin

4.       Ephedrine

5.       Phenylephrine

 

A = 1,3,4     B = 1,2,5      C = 3,4,5   D= 1,2,3   E = 2,4,5

 

Phenoxybenzamine:

1.       A reversible, indirect-acting cholinergic agonist

2.       An irreversible, indirect-acting cholinergic agonist

3.       An irreversible, non-selective α-adrenergic antagonist

4.       Selective α1-adrenergic antagonist

5.       A reversible, non-selective α-adrenergic antagonist

 

A = 1            B = 2          C = 3         D = 4      E = 5

 

Selective β1-blockers include:

1.       Atenolol

2.       Carvedilol

3.       Labetalol

4.       Propranolol

5.       Nadolol

 

A = 1          B = 2          C = 3           D = 4          E = 5

 

Which of the following drugs are long-acting bronchodilators:

1.       Salbutamol

2.       Salmeterol

3.       Terbutaline

4.       Fenoterol

5.       Formoterol

 

A = 1,4                  B = 2,3        C=3,4          D = 1,5        E = 2,5

 

Pyridostigmine inhibits:

1.       Plasma pseudocholinestrase

2.       Catechol-O-methyl transferase

3.       Acetylcholinesterase

4.       Liver butyrylcholinesterase

5.       Monoamine oxidase

 

A = 1          B = 2           C = 3        D = 4           E = 5

 

The non-depolarising muscle relaxants include:

1.       Suxamethonium

2.       Mivacurium

3.       Ipratropium

4.       Cisatracurium

5.       Pancuronium

 

A = 1,3,4        B = 1,2,5        C = 2,4,5      D = 1,2,4       E = 2,3,5

 

The pharmacokinetic parameters of the neuromuscular junction blockers include:

1.       Parenteral administration

2.       Highly hydrophilic

3.       Lipid soluble

4.       CNS activities

5.       Inability to cross the blood brain barrier

 

A = 1,2,4        B = 1,2,5        C = 2,4,5          D = 1,2,3       E = 1,3,4

 

Cardiovascular:

Which drug may cause reflex tachycardia and/or postural hypotension on initial administration?

1.       Atenolol

2.       Hydrochlorothiazide

3.       Metoprolol

4.       Prazosin

5.       Verapamil

 

A = 1          B = 2          C = 3           D = 4           E = 5

Which is an appropriate choice for hypertension treatment during pregnancy?

1.      Methyldopa

2.      Fosinopril

3.      Enalapril

4.      Valsartan

5.      Reserpine

 

A = 1,2         B = 2,3                  C = 3,4                   D = 4                   E = 5

 

The following statement is true about ACE inhibitors:

1.      Can be safely used in pregnant hypertensive women

2.      Can cause hyperkalaemia

3.      Perindopril may induce an angioedema

4.       Must be taken concomitantly with a potassium sparing diuretic and potassium  supplement to prevent hypokalaemia

5.     Reversible renal failure can occur in patients with renal artery stenosis

 

A = 1,4        B = 2,3        C = 3,4         D = 4         E = 5

 

Warfarin:

1.      Is a platelet antagonist

2.      It is oral anticoagulant drug

3.      Phenytoin will potentiate the effect of warfarin

4.      The effect of warfarin is monitored using the activated partial thromboplastin time

5.      Warfarin is safe during pregnancy

 

A = 1           B = 2          C = 3   D = 4          E = 5

 

The following statement about digoxin is true:

1.       It has a high therapeutic index

2.       Furosemide may increase digoxin levels

3.       Furosemide may decrease digoxin levels

4.       It is a positive chronotrope

5.       Drugs causing hyperkalaemia predispose to digoxin toxicity

 

A = 1           B = 2         C = 3            D = 4          E = 5

 

Verapamil:

1.      Causes vasoconstriction

2.      Is a positive inotrope

3.      Increases AV conduction

4.      Is an alpha-2 antagonist

5.      Decreases AV conduction

 

A = 1           B = 2           C = 3            D = 4               E = 5

 

Atenolol:

1.      Is the drug of choice for treating anaphylactic shock

2.      Is useful for treating urinary retention

3.      Can be used to stop labour

4.      Increases gastric motility

5.       Is a cardioselective beta-blocker

 

A = 1           B = 2           C = 3            D = 4       E = 5

 

  Which of the following has been shown to prolong life in the above patients but has

    a negative inotropic effect on cardiac contractility?

1.      Carvedilol

2.      Digoxin

3.      Dobutamine

4.     Enalapril

5.      Furosemide

 

A = 1          B = 2          C = 3           D = 4           E = 5

 

The following drugs are oral anticoagulants:

1.       Aspirin

2.       Rivaroxaban

3.       Dabigatran

4.       Heparin

5.       Warfarin

 

A = 1,2,3      B = 2,3,5             C = 2,3,4       D = 3,4,5     E = All of the above

 

Angiotensin Converting Enzyme Inhibitors (ACEI’s) should be used in the treatment of the following diseases except:

1.      Left ventricular hypertrophy

2.      Diabetic nephropathy

3.      Hypertension in pregnancy

4.      Hypertension

5.      Congestive heart failure

 

A = 4             B = 1,2        C = 1                  D = 2           E = 3

 

A drug that prevents conduction of impulses in the AV node is:

1.      Perindopril

2.      Flecainide

3.      Lidocaine

4.      Quinidine

5.      Verapamil

 

A = 1           B = 2          C = 3           D = 4           E = 5

 

In the treatment of hypertension:

1.      β-blockers are indicated in anxious patients

2.      Angiotensin converting enzyme inhibitors will not be effective

3.      Methyldopa is the drug of choice during pregnancy

4.      L-Dopa is the drug of choice in patients who also have diabetes mellitus

5.      a-Blockers are contra-indicated

 

A = 1,2        B = 1,3       C = 2,4                   D = 4,5        E = 3,5


Match:

Match the description in column B with the corresponding term or concept in column A.

 

Column A:                                                                            Column B:

 

37.      Bile                                        a. Time taken to change the concentration of a drug by 50%

38.      First order kinetics                 b. Constant fraction of a drug is metabolized per time unit

39.      Cell membrane                      c. Minor route of eliminating a drug from the body

40.      Half-life of a drug                   d. Rate of drug administration = rate of drug elimination

41.      Transdermal                           e. Non-polar in nature

42.      Steady-state concentration     f. Absorption of a drug through the skin 


ANS

Match the following pharmacological uses with the appropriate drugs:

Class

A.      Benign prostatic hyperplasia

B.      Sjogren syndrome

C.      Overactive bladder

D.      Pheochromocytoma

E.      Malignant hyperthermia

F.       Bronchospasm due to asthma or bronchitis

 

Drugs

1.       Dantrolene             

2.        Salbutamol            

3.       Doxazocin              

4.        Phentolamine        

5.        Flavoxate                

6.        Pilocarpine              

 

Cardiovascular:

Match the side effects most likely to be caused by the following drugs:

Each drug may be used more than once or not at all:

 

A.      Gigoxin

B.      Hydrochlorothiazide

C.      Nitroglycerine

D.      Enalapril

E.       Amiodarone

F.       Propranolol

 

1.     Hypokalaemia                 

2.     Flushing                           

3.     Ventricular arrhytmia        

4.     Hypothyroidism               

5.     Bronchospasm                 

6.     Hyperkalaemia 



Descriptive Questions:    


1.   List the pharmacokinetic parameters of mebendazole.

Mention the adverse effects of β-blockers                                                                                                        (4)

2. Why do β-blockers not induce postural hypotension                                                                                    (1)

3. Give four reasons why formoterol is used for acute and long term treatment of

asthma                                                                                                                                                              (4)

4. Mention the pharmacokinetic parameters of salbutamol                                                                              (3)

5. Explain why NSAID’s should be used with extreme caution together with ACEI’s and diuretics.                                                                                                                                                                                                                                                                (4)

6.  Name two (2) therapeutic uses of atenolol.                                                   (2)

7. Give the mechanism of action of the following:

                 a.        Amiodarone                                                                                                                           (2)

         b.        Ticagrelor                                                                                                                                 (2)

                c.         Simvastatin                                                                                                                            (2)