Department of Pharmacology and Therapeutics                                                                                                             Sefako Makgatho Health Sciences University                                                                                                                               South Africa             




MBChB III and BDS III - Test 2 Questions

Test Composition

 

Questions: CNS and Respiratory System

www.pharmacology-medicine.africa

Which of the following drugs are used to treat acute gout?

1.       Aspirin

2.       Colchicine

3.       Probenecid

4.       Allopurinol

5.       Ibuprofen

 

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

Which of the following are adverse effects of morphine?

1.       Bronchodilation

2.       Increased intracranial pressure

3.       Constipation

4.       Urinary retention

5.       Hypertension

 

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

The following are true regarding ipratropium:

1.    Action is classified as short-acting anticholinergic

2.    Indicated for allergic rhinitis and COPD

3.    Onset is fast, starting after 3 minutes

4.    Duration of action is about 30 minutes

5.    A small amount is absorbed from the lungs

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

The following are true regarding common encountered respiratory diseases and the treatment of these conditions:

1.    Asthma, chronic obstructive pulmonary disease (COPD) and allergic rhinitis are commonly       encountered respiratory diseases

2.    Asthma is a chronic disease characterized by hyper-responsive airways

3.    Allergic rhinitis is characterized by itchy, watery eyes and a running nose

4.    Drugs used to treat respiratory conditions can be delivered topically to the nasal mucosa or inhaled into the lungs

5.    Nasal spray or inhalers are preferred local drug delivery methods to target affected tissues while minimizing systemic side effects

 

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

Correctly associate the mechanism of action of the following drugs:

1.       Risperidone  - stabilization of neuronal sodium channels

2.       Haloperidol  - dopamine 2 receptor antagonist

3.       Diazepam     - serotonin receptor modifier

4.       Venlafaxine   - selective serotonin and noradrenaline re-uptake inhibitor

5.       Amitriptyline - stabilization of triptyline receptors

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

Correctly associate the mechanism of action of the following drugs:

1.       Risperidone  - stabilization of neuronal sodium channels

2.       Haloperidol  - dopamine 2 receptor antagonist

3.       Diazepam     - serotonin receptor modifier

4.       Venlafaxine   - selective serotonin and noradrenaline re-uptake inhibitor

5.       Amitriptyline - stabilization of triptyline receptors

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

Leukotriene modifiers:

  1.    Fluticasone

  2.    Budesonide

  3.    Montelukast

  4.    Zafirlukast

  5.    Beclometasone

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

Short-acting anticholinergic:

1.    Ipratropium bromide

2.    Codein phosphate

3.    Cetirizine

4.    Fexofenadine

5.    Oxymetazoline

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


The following are true regarding salbutamol:

1.    Short-acting B 2-adrenergic agonist

2.    Indicated for asthma treatment

3.    Metabolized in the liver

4.    Bronchodilation occurs 30 minutes after inhalation

5.    Effect lasts for 3 – 4 hours

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

 

Name five (5) common side effects of morphine except nausea and vomiting.

List five (5) effects following the use of benzodiazepines.


The following are classified as intravenous induction agents except

1.              Thiopentone

2.              Propofol

3.              Ketamine

4.              Etomidate

5.              Indomethacin

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


The following drug is correctly associated with its effects:

1.       Benzodiazepines – analgesia

2.       Moclobemide-depression

3.       Lithium-epilepsy

4.       Ethosuximide – “floppy baby syndrome”

5.       Zolpidem – narcolepsy

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

Which of the following can be used in the management of neuropathic pain:

1.       Carbamazepine

2.       Phenytoin

3.       Pregablin

4.       Amitriptyline

5.       Valproic acid

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

The following statements regarding leukotriene modifiers are true:

1.    Zafirlukast should not be used when bronchodilation is immediately required

2.    Montelukast – blocks the effects of cysteinyl leutotrienes

3.    Zarfirlukast – absorption is impaired by food

4.    The metabolites of zarfirlukast and montelukast undergo biliary excretion

5.    Cholinergic antagonists – xerostomia is an adverse effect

 

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


Inhaled corticosteroids (ICS) therapy is positively related to the following actions on the lungs:

1.    Reverse mucosal oedema

2.    Decrease permeability of capillaries

3.    Stimulate the release of leukotrienes

4.    Regular use for months will increase hyper responsiveness of airway smooth muscle

5.    Increase the inflammatory cascade – eosinophils, macrophage and T-lymphocytes

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


Leukotriene modifiers include:

1.    Zafirlukast

2.    Montelukast

3.    Tiotropium bromide

4.    Fluticasone

5.    Beclomethasone

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

Correct pharmacokinetics of various asthma medications:

1.    Montelukast – 99 % protein binding

2.    Zafirlukast – activate the action of CYP3A4 and CYP2CP

3.    Cetirizine – mainly secreted in urine and 60 % as an unchanged drug

4.    Oxymetazoline – maximum effect lasts for 12 hours and decline over the following 12 hours

5.    Codeine phosphate – half-life of 8 hours

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


The following are true regarding salbutamol:

1.    Short-acting B 2-adrenergic agonist

2.    Indicated for asthma treatment

3.    Metabolized in the liver

4.    Bronchodilation occurs 30 minutes after inhalation

5.    Effect lasts for 3 – 4 hours

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


The following drugs may be used as additives to local anaesthetic agents:

1.       Etomidate

2.       Fentanyl

3.       Adrenaline

4.       Scoline

5.       Pancuronium

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


The following are classified as medium acting opioids:

1.       Fentanyl

2.       Sufentanil

3.       Tramadol

4.       Remifentanil

5.       Paracetamol

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


The following are true regarding salbutamol:

1.    Short-acting B 2-adrenergic agonist

2.    Indicated for asthma treatment

3.    Metabolized in the liver

4.    Bronchodilation occurs 30 minutes after inhalation

5.    Effect lasts for 3 – 4 hours

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


Correct pharmacokinetics of various asthma medications:

1.    Montelukast – 99 % protein binding

2.    Zafirlukast – activate the action of CYP3A4 and CYP2CP

3.    Cetirizine – mainly secreted in urine and 60 % as an unchanged drug

4.    Oxymetazoline – maximum effect lasts for 12 hours and decline over the following 12 hours

5.    Codeine phosphate – half-life of 8 hours

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


Which of the following drugs belong to the amide group of local anaesthetics:

1.       Lignocaine

2.       Dexamethasone

3.       Bupivacaine

4.       Fentanyl

5.       Methotrexate

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


Adverse effects of propofol includes the following:

1.       Weight gain

2.       Insomnia

3.       Gynaecomastia

4.       Apnoea following induction of anaesthesia

5.       Pain on injection

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

Regarding codeine phosphate:

1.    Indicated for cough suppression

2.    Half-life is 4-6 hours

3.    Analgesic effect may be expected with 15 – 30 minutes and last for 4 – 6 hours

4.    Metabolized in the liver with 10% converted to morphine

5.    Excreted renally, with 1 – 25 % unchanged

 

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

The following medicines are examples of inhaled corticosteroids indicated for asthma, COPD and allergic rhinitis:

1.   Budesonide

2.    Beclometasone

3.    Ciclesonide

4.    Salmeterol

5.    Fluticasone

 

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

The following are true regarding the pharmacokinetics of salbutamol:

1.    Metabolized in the gastro-intestinal wall only and not in the liver

2.    No unchanged drug (salbutamol) and metabolites are excreted in the urine

3.    Bronchodilation occurs 5 – 15 minutes after inhalation

4.    Bronchodilation occurs within 30 minutes after oral dosing

5.    Effect lasts for 24 h

 

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


Which of the following can be used in the management of neuropathic pain:

1.       Carbamazepine

2.       Phenytoin

3.       Pregablin

4.       Amitriptyline

5.       Valproic acid

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

Long-acting anticholinergic(s):

1.    Loratadine

2.    Phenylephrine

3.    Tiotropium bromide

4.    Ipratropium bromide

5.    Codeine phosphate

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

 Inhaled corticosteroid(s):

1.    Budesonide

2.    Ciclesonide

3.    Ipratropium bromide

4.    Fluticasone

5.    Montelukast

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


Long-acting β2-adrenergic agonists:

1.    Ciclesonide

2.    Salmeterol

3.    Beclometasone

4.    Flutacosone

5.    Formoterol

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


 

List any 5 side effects of opioids.       



Short-acting β2-adrenergic agonists:

1.    Salbutamol

2.    Montelukast

3.    Tiotropium bromide

4.    Zafirlukast

5.    Azelastine

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


Which of the following local anaesthetics are classified as esters:

 1.      Sufentanil

 2.      Cocaine

 3.      Procaine

 4.      Morphine

 5.      Pancuronium

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

The following are side effects of tricyclic antidepressants:

1.       Decreased appetite

2.       Dry mouth

3.       Confusion

4.       Bulimia nervosa

5.       Tachycardia

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

The following are true regarding Metered Dose Inhalers (MDIs):

1.    Propellants eject the active medication from the canister

2.    A large fraction (80 – 90 %) of inhaled glucocorticoids is deposited in airways

3.    A small fraction (10 – 20 %) of inhaled glucocorticoids is deposited in the mouth and pharynx or is swallowed

4.    When inappropriately inhaled the adverse effects of ICS is more likely due to systemic absorption

5.    Dry powder inhalers (DPT) requires patients to inhale quickly and deeply that would result in optimizing of drug delivery to the lungs

 

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

The following are true regarding leukotrienes:

1.    Adsorbed by mast cells during an asthma attack

2.    Primarily responsible for bronchodilatation

3.    Attract eosinophils into the bronchioles

4.    Derived from arachidonic acid

5.    Release by mast cells during an asthma attack

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

 The following are true regarding codeine phosphate:

1.    Used as an agent for cough

2.    Half-life is 2,5 – 4 hours

3.    Analgesic effects last 15 – 30 minutes

4.    Metabolized in the kidneys where 10 % is converted into morphine

5.    Excreted renally, 5 – 15% as unchanged drugs

 

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

The following are true regarding drugs used for disorders in the respiratory system:

1.    Budesonide – inhaled corticosteroid

2.    Ipratropium bromide – short acting anticholinergic agent

3.    Tiotropium bromide – long acting anticholinergic agent

4.    Montelukast – leukotriene modifier

5.    Levocabastine – H 1-receptor blocker

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


Tilidine/valoron drops may be used in the following conditions:

1.       Postoperative pain

2.       Postmenopausal bleeding

3.       Thyroid storm

4.       Severe pain

5.       Anaphylactic shock

 

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

Which of the following are adverse effects of morphine:

1.       Cardiotoxic

2.       Histamine release→reaction at injection site (urticaria), itching,  flushing,sweating

3.       CNS→sedation, euphoria, miosis

4.       Haematuria (blood in urine)

5.       Nervousness

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


Which of the following are intravenous induction agents:

1.       Thiopentone

2.       Propofol

3.       Lithium

4.       Paracetamol

5.       Indomethacin

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


The following are true regarding drugs used for disorders in the respiratory system:

1.    Budesonide – inhaled corticosteroid

2.    Ipratropium bromide – short acting anticholinergic agent

3.    Tiotropium bromide – long acting anticholinergic agent

4.    Montelukast – leukotriene modifier

5.    Levocabastine – H 1-receptor blocker

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


Leukotriene modifiers include:

1.    Zafirlukast

2.    Montelukast

3.    Tiotropium bromide

4.    Fluticasone

5.    Beclomethasone

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


Which of the following is known to produce DISSOCIATIVE ANAESTHESIA:

1.       Propofol

2.       Ketamine

3.       Etomidate

4.       Midazolam

5.       Mivacurium

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


Which of the following are inhalational agents:

1.       Sevoflurane

2.       Metoclopramide

3.       Oxytocin

4.       Pethidine

5.       Isoflurane

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