The following affects drug absorption through passive diffusion,

EXCEPT:
I. Concentration gradient along compartments
II. Specific carrier proteins
III. Saturability of the receptors
IV. Selectivity of receptors

a.
I

b.
I, II, III

c.
II, III, IV

d.
III, IV

e.
I, II, III, IV
Feedback
Carrier-mediated transport requires specific carrier proteins. These
carrier proteins are selective and is subjected to saturation.
Two types of carrier mediated transport:
a.     Facilitated Diffusion: along the gradient, does not require energy.
b.     Active Transport: against the gradient, requires energy

The correct answer is: II, III, IV

Question 2
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Process by which drugs find their way to the urine:
I. Passive glomerular filtration
II. Active tubular secretion
III. Passive tubular secretion
IV. Passive tubular reabsorption

a.
I, II, III, IV

b.
I, III, IV

c.
I, II, IV

d.
I, II, III

e.
II, III, IV

Feedback
Filtration and secretion = drugs to the urine
Reabsorption = drugs are reabsorbed from the urine back to the system.
 
Filtration is purely a passive process.
Tubular secretion is passive and active throughout the tubules.
Tubular reabsorption too is done through passive diffusion and active
transport in the tubules.

The correct answer is: I, II, III

Question 3
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Which of the following regarding receptors are true?
 I. Drug receptors are of proteinaceous material
 II. Drug receptors are the biological site of action of a drug
 III. All drugs have corresponding receptors
 IV. All receptors are found in the cell membranes

a.
I

b.
I, II

c.
II, III

d.
I, II, IV

e.
I, II, III, IV

Feedback
Drug receptors are mostly protein. The active sites of such receptors are
mostly amino acid residues primarily Arginine, Histidine, Lysine. They
act as the biological site of action of drugs Upon binding of a specific
drug molecule to a receptor, it causes such activity.
 
But not all drugs require receptors to elicit such effect. For example,
orlistat/cholestyramine does not bind to a specific receptor in the body
hence they elicit their activity locally, binding to fats/bile in the intestines.
Some receptors are found in the cytosol and in the nucleus of the cell.

The correct answer is: I, II

Which of the following is true regarding the different transport

processes?
 I. Convective transport is movement by solvent drag.
 II. Convective transport movement is opposite the movement of water
 III. Ion-Pair transport is used for high-MW charged compounds
 IV. Convective transport utilizes the use of aquaporins

a.
I, II, III

b.
I, III, IV

c.
I, II, III, IV

d.
I, II, IV

e.
II, IV
Feedback
Convective transport movement is by solvent drag which is along the
movement of water.
It is important in the transport of high MW solutes. It utilizes aquaporins
as stated.

The correct answer is: I, III, IV

A general rule of thumb is that a drug should be allowed to undergo 5

half-lives before considering that it is eliminated from the body.
The correct answer is: 5

The following drugs follow first order kinetics, EXCEPT:

 I. Aspirin
 II. Ethanol
 III. Phenytoin
 IV. Heparin

a.
I, II

b.
I, II, III

c.
II, III

d.
II, III, IV

e.
I, II, III, IV

Feedback
Other drugs that follow the zero-order kinetics of elimination:
a.     Ethanol
b.     Warfarin
c.      Phenytoin
d.     ASA and salicylates
e.     Tolbutamide
f.       Theophylline
g.     Omeprazole
h.     Phenylbutazone
i.       Heparin
j.      Cisplatin

The correct answer is: I, II, III, IV

Let Drug C be the combination of agonist drugs, Drugs A and B, what
could be said about the properties of Drug B?

a.
Partial agonist
b.
Competitive antagonist
c.
Non-competitive antagonist
d.
Inverse agonist

e.
2 of the above
Feedback
Your answer is incorrect.
Partial agonists act as competitive antagonists in the presence of a full
agonist. Drug B is a partial agonist but in relation with Drug A, it
functions as a competitive antagonist.
The correct answer is:
2 of the above

Patient DEF also requires another drug, Drug Y (F=0.43). Drug Y should
be administered orally BID (9AM, 9PM). It is cleared at a rate of 2.7L/hr.
Calculate the maintenance dose if the desired steady state concentration
is 25mg/L.
a.
150mg

b.
1.9g

c.
3.5g

d.
810mg

e.
1.6g
Feedback
Maintenance dose = (Cl x Css x interval)/F
Using the formula,
(2.7 x 25 x 12)/0.43
= 1883.7mg
=1.9g

The correct answer is: 1.9g

Methylation Methyltransferase SAM

Sulfation Sulfotransferase PAPS
Acetylation N-acetyltransferase Acetyl-CoA
Glucuronidation UDP- UDP-
glucuronosyltransferase glucuronic
acid
GSH conjugation Glutathione-S-transferase GSH
Glycine Glycine N-acyltransferase Glycine
conjugation
Ibuprofen is of what BCS classification?

a.
BCS I

b.
BCS II

c.
BCS III

d.
BCS IV
Feedback
BCS I High Solubility High
Permeability
II Low Solubility High
Permeability
III High Solubility Low
Permeability
IV Low Solubility Low
Permeability

The correct answer is: BCS II

Sample size recommended for Bioequivalence studies

a.
3

b.
6

c.
12

d.
20

e.
50
Feedback
BA = 6
BE = 12

The correct answer is: 12

Cardioselective Beta-blockers: “BANBEAMC” or NvBEAMC

Non selective: NSTPPCart
NON SELECTIVE CARDIO SELECTIVE
Nadolol Bisoprolol
Sotalol Atenolol
Timolol Nebivolol
Pindolol Betaxolol
Propranolol Esmolol
Carteolol Acebutolol
Metoprolol
Celiprolol
 
Others:
CLAP (Carteolol, Labetalol, Acebutolol, Pindolol) – ISA
PALM (Pindolol and Propranolol, Acebutolol, Labetalol, Metoprolol) –
MSA
Mixed alpha and beta: LabetAlol and CarvedIlol
BCM – vs SCHF
PEA – vs Arrhythmia

The correct answer is: Nadolol

The following are not true regarding drugs for glaucoma, EXCEPT:
I. Ecothiopate increases drainage via the trabecular meshwork
II. Latanoprost increases drainage via the canal of Schlemm
III. Diuretics increases drainage through the uveoscleral pathway.
IV. Decreased drainage increases aqueous humor thereby increasing
the intraocular pressure.

a.
I, II, III

b.
I, II, IV

c.
I, III, IV

d.
II, III, IV

e.
I, II, III, IV
Feedback
Epinephrine increases drainage through the uveoscleral pathway
 
Drugs that lower production:
·       Apraclonidine
·       Betablockers
·       Diuretics

The correct answer is: I, II, IV

H2-blocker that has the most adverse effects.

a.
Pepcid

b.
H2-bloc

c.
Tagamet

d.
Zantac

e.
Axid
Feedback
H2bloc and Pepcid (Famotidine) – most potent
Tagamet (Cimetidine) – least potent, most AE
Zantac (Ranitidine)
Axid (Nizatidine) – least AE

The correct answer is: Tagamet

Question text
Which of the following prostaglandin analogues acts at prostacyclin IP
receptors?
a.
Misoprostol

b.
Alprostadil

c.
Dinoprostone

d.
Epoprostenol

e.
Latanoprost
Feedback
PGI2 analog
 
M PGE
A PGE
D PGE
E PGI2
L PGF

The correct answer is: Epoprostenol

The following is true regarding paracetamol overdose:

 I. Paracetamol poisoning is characterized by the depletion of GSH
reserves.
 II. Paracetamol is converted to the toxic metabolite NAPQI
 III. The antidote for this type of poisoning is N-acetylcysteine.

a.
I, II

b.
I, III

c.
II, III

d.
I, II, III

Feedback
The correct answer is: I, II, III
Question 62
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The following are direct thrombin inhibitors, EXCEPT

a.
Hirudin

b.
Argatroban

c.
Rivaroxaban

d.
Dabigatran

e.
Bivalirudin
Feedback
Rivaroxaban is a CF Xa direct inhibitor.
The correct answer is: Rivaroxaban
Question 63
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The following is true regarding heparin:

a.
Heparin affects the intrinsic pathway of the coagulation cascade.

b.
IV Heparin is not needed to be monitored.

c.
HMWH is administered IV.

d.
2 of the above

e.
All of the above
Feedback
SQ Heparin is not needed to be monitored.
HMWH is administered SQ
Heparin can cause hematoma when injected SQ

The correct answer is: Heparin affects the intrinsic pathway of the
coagulation cascade.
Question 64
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Patient KL is taking warfarin. He will experience hemorrhage or bleeding
in the following situations, EXCEPT:

a.
Patient KL is consuming more than enough green leafy vegetables.
b.
Patient KL has a liver disease.

c.
Patient KL is taking ASA for his fever.

d.
Patient KL drinks grapefruit juice.

e.
None of the above

Feedback
Green leafy vegetables contain high amounts of Vitamin K which acts as
an antagonist of warfarin.
 
Liver disease affects warfarin’s binding to proteins and its metabolism
resulting in an increase amount of warfarin in the body.
 
Aspirin is an antiplatelet agent.
Grapefruit juice inhibits the enzyme to metabolize warfarin.

The correct answer is: Patient KL is consuming more than enough green
leafy vegetables.
Question 65
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The following are antiplatelet agents except:

a.
Aspirin

b.
Ticlopidine
c.
Ticagrelor

d.
Abciximab

e.
Apixaban

Feedback
Apixaban is an anticoagulant.
Acts on factor Xa

The correct answer is: Apixaban

Question 66
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This is a recombinant tissue plasminogen activator that is used to treat
myocardial infarctions and other severe conditions caused by blood
clotting.

a.
Alteplase

b.
Reteplase

c.
Streptokinase

d.
Tirofiban
e.
Dipyridamole
Feedback
Alteplase – human t-Pa
Reteplase – Recombinant t-Pa

The correct answer is: Reteplase

Question 67
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The following statements are true regarding streptokinase, EXCEPT:

a.
Streptokinase is a protein derived from Streptococcus pyogenes.

b.
The gold standard of treatment for ischemic stroke.

c.
It acts by dissolving fibrin.

d.
Major adverse effect of the drug is hypersensitivity.

e.
There should be no previous dose of streptokinase within the last 2
years.

Feedback
t-Pa is the gold standard for ischemic stroke
Some literature cited that streptokinase increases the mortality rate of
ischemic stroke patients.
The correct answer is: The gold standard of treatment for ischemic
stroke.
Question 68
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A synthetic analog of the amino acid lysine that serves as an
antifibrinolytic by reversibly binding to five lysine receptor sites at the
plasminogen.

a.
Eptifibatide

b.
Clopidogrel

c.
Tranexamic Acid

d.
Urokinase

e.
Diazoxide
Feedback
Epsilon-aminocaproic acid analog
 
Eptifibatide – binds to glycoprotein IIb-IIIa
Clopidogrel – inhibits ADP
Urokinase – thrombolytic agent from urothelium of mammals
Diazoxide – Potassium channel activator that is a hypoglycemic drug.

The correct answer is: Tranexamic Acid

Question 69
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Which of the following is/are pure arteriolar vasodilators?

a.
Minoxidil

b.
Hydralazine

c.
Sodium Nitroprusside

d.
2 of the above

e.
All of the above
Feedback
Pure arteriolar vasodilators include: Minoxidil, Hydralazine, Diazoxide.
The correct answer is: 2 of the above

High ceiling – loop diuretics

Low ceiling – Thiazide (increasing the dose above normal therapeutic
doses will not promote further diuresis)

Selective Estrogen Receptor Modulators (SERM) useful for treating

osteoporosis.

a.
Clomifene

b.
Raloxifene
c.
Toremifene

d.
Anastazole

e.
Exemestane
Feedback
Clomifene – fertility booster
Tamoxifen – use for breast CA responsive to hormones
Anastazole and Exemestane – Aromatase inhibitors (lower estrogen
levels)

The correct answer is: Raloxifene

Biphasic contraceptive oral pills have varying amounts of ____ and

constant amount of ____.

a.
Estrogen; Progesterone

b.
Estrogen; Progestin

c.
Progesterone; Estrogen

d.
Progestin; Estrogen

e.
None of the above
Feedback
Monophasic – both constant
Triphasic – both varying

The correct answer is: Progestin; Estrogen

OHAs have been a major factor in controlling diabetes mellitus in

humans. These drugs lower glucose levels in the blood. Which of the
following is not an action of OHAs?

a.
Sulfonylureas induces secretion of insulin

b.
Acarbose inhibits alpha glucosidase

c.
Sensitization of the cells to insulin

d.
Provide peptide analogs and stimulating the GLP1 receptors
Feedback
GLP 1 analogs are not OHAs. They are administered SQ not PO.
The correct answer is: Provide peptide analogs and stimulating the

Administration of Iodine solution can cause an adverse effect called

Iodism. The following are hallmark signs of iodism, EXCEPT:

a.
Conjunctivitis

b.
Rhinitis

c.
Sialadenitis

d.
All of the above

e.
None of the above

Feedback
“CRS” - Iodism
The correct answer is: None of the above

The following are post-prandial insulins, EXCEPT:

a.
Humalog®

b.
NovoLog®

c.
Apidra®

d.
Lantus®

e.
None of the above
Feedback
Post prandial insulins are short acting and rapid acting insulins.
Basal insulins include intermediate and long acting insulin.
 

The correct answer is:

Lantus®
Question 90
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Which of the following does not belong to the group?

a.
Cyproheptadine

b.
Clozapine

c.
Haloperidol

d.
Quetiapine

e.
Ondansetron

Feedback
Haloperidol has no effect on Serotonin receptors
 
Cyproheptadine is an antihistamine with antiserotogenic effect
Clozapine, Quetiapine are 2nd generation antipsychotics, hence they
also block serotonin receptors.
Ondansetron – 5HT3 antagonist
The correct answer is: Haloperidol

Olanzapine – increased risk of DM