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EXAM 1 SAMPLE QUESTIONS (answers to questions are at the end) Pharmacology Introductory/Drug Development 1.

Which statement concerning a drugs generic (nonproprietary) name is correct? A. each drug can have multiple generic names B. the generic name may be related to the chemical or pharmacological class of the compound C. the company developing the drug has the final decision on the generic name D. drugs are usually marketed using the generic name E. none of the above statements are true. Drug Absorption, Distribution and Elimination 2. A major advantage of the rectal route of administration is that the drug is A. subjected to a full (100%) first-pass effect. B. subjected to about half of the first-pass effect. C. not subjected to any (0%) first-pass effect. D. absorbed as rapidly as when applied intravenously. E. always absorbed extremely slowly. 3. A. B. C. D. E. 4. A. B. C. D. E. 5. A. B. C. D. E. 6. A. B. C. D. E. The apparent volume of distribution of a drug will be increased by active transport of the drug out of blood cells. tight binding to plasma proteins. exclusion from the intracellular space. increasing the plasma half-life. tight binding to peripheral tissues. The loading dose of a drug can be calculated knowing the desired plasma concentration and rate of excretion. rate of metabolism. apparent volume of distribution. rate of elimination. its fractional binding to plasma proteins. Sulfation is an example of Phase I drug metabolism. Phase 2 drug metabolism. drug oxidation. drug reduction. biliary recycling. A weakly acidic drug at a pH above its pKa: Will be more lipophilic than at low pH (below the pKa) Its unionized form will be more abundant than its ionized form Its rate of passive diffusion across a biological membrane would be less than at low pH Its ability to enter a lipid phase will be increased relative to at low pH Its protonated form will be most abundant relative to low pH

Pharmacokinetics 7. Which of the following statements most accurately describes a zero-order elimination? A. The half-life is independent of dose B. The drug concentration decreases exponentially with time C. A constant amount of drug is lost per hour D. Acetaminophen is eliminated by zero-order processes at therapeutic doses E. Enzymatic degradation is zero-order when the drug concentration is small compared with the Michaelis constant of the metabolizing enzyme 8. A. B. C. D. E. What is the clearance of a drug in a 70 kg patient in which the elimination is first-order with a half time of 3 hours and a volume of distribution of 0.43 liter/kg? 0.5 liter/hour 1 liter/hour 2 liter/hour 5 liter/hour 7 liter/hour

E. Half-life for elimination D. Clearance C. indicates the variability of a drug response in a group of individuals. A quantal (all-or-none) dose-response relationship A. Curve D E. Curve C D. Double the dose interval and keep the size of the dose the same C. Which of the following actions would decrease the fluctuations (peaks and troughs) without altering the average steady state drug level for a person on an intermittent dose regimen? A. None of the above Dose-Response Relationships 12. D. Which of the following pharmacokinetic parameters for vancomycin change as a result of this new dose schedule? A. In comparison to curve X. A. B. Curve X . which curve represents the concentration-response of this agonist in the presence of a non-competitive antagonist? A. nausea with occasional vomiting.9. How long should you withhold digoxin in order to reach a safer yet propably therapuetic level of one ng/mL? 12 hours one day two days four days six days 10. D. The plasma digoxin level in this patient is 4 ng/mL. Both B and D are correct 13. In the graph. E. is useful to estimate a drug dose that produces 50% of a biological systems maximal response. Decrease the dose interval by one half and decrease the size of the dose by one half 11. B. curve X represents a concentration-response of a full agonist. Curve A B. The mode of elimination changes from first-order to zero-order E. Double the dose interval and the decrease the size of the dose by one-half D. defines the maximal response a biological system can produce. C. Curve B C. relates the dose of a drug that produces a pre-defined response in a number of individuals. The half-life for elimination of digoxin is 2 days. A patient taking vancomycin by intravenous infusion is changed to intermittent dosing with a bolus intravenous injection given at a dose interval of every 6 hours. A patient on digoxin therapy reports signs of toxicity. C. Volume of distribution B. Double the size of the dose and keep dose interval the same B.

and the metabolites diffuse into mother for renal elimination. E. A. D. C. C. Drug X is a partial agonist. D. If one administers sulfonamides to a jaundiced newborn. Change in potency Both B and C are correct. C. 21. E. E. B. B. E. C. The fetal lung metabolizes most drugs quite rapidly in large part because of the fetal circulation. Most drugs accumulate in the fetus (relative to maternal concentrations) because fetal drug metabolism is very slow. 15. Individuality and Drugs 17. D. D. C. E. B. Autonomic Pharmacology 19. 18. a decreased efficacy of the sulfonamide in comparison to its efficacy in a non-jaundiced infant. A. B. A. Channel-linked receptors G-protein coupled receptors. reduced salivary gland secretion C. a decrease in the rate glomerular filtration of non-conjugated bilirubin. E. C. the most likely explanation involves: Desensitization of the receptor system presence of a competitive antagonist. B. D. The fetus actively metabolizes most drugs. D. B. a decreased brain concentration of non-conjugated bilirubin. A. 16. If maximum efficacy of a drug X diminishes over time. The elimination of most drugs from the fetus depends on maternal liver and/or kidney.14. E. D. dilation of the pupil B. both A and C are correct 20. C. enhanced urination E. A. Sulfonamides can displace non-conjugated bilirubin from plasma albumen. an increased risk for kernicterus associated with any given plasma concentration of total (bound and free) non-conjugated bilirubin. Which of the following would result from sympathetic stimulation? A. an increased plasma concentration of total (bound and free) non-conjugated bilirubin. B. Which of the following statements about the 2nd trimester maternal-fetal relationship is most valid? A healthy placenta is not permeable to most drugs. Which of the following nerves and paired neurotransmitter release is INCORRECT? Preganglionic parasympathetic nerve to ganglia: acetylcholine Postganglionic parasympathetic nerve to heart: acetylcholine Preganglionic sympathetic nerve to ganglia: acetylcholine Preganglionic sympathetic nerve to adrenal gland: norepinephrine Postganglionic sympathetic nerve to vascular smooth muscle: norepinephrine Stimulation of muscarinic receptors can mediate all of the following responses EXCEPT: slowing of heart rate slowing of atrio-ventricular conduction stimulation of eccrine sweating pupil contraction increase in ventricular contractility . one can expect A. Therapeutic index: Indicates amount of drug absorbed to maintain concentration within therapeutic window Is an indication of a drug’s half-life Is a measure of a drug’s efficacy compared to partial agonist Defines the therapeutic window of a drug Is a ratio of the TD50 to ED50 and provides information on safety Which receptor system has the fastest response encompassing receptor activation to cellular effect: Steroid (nuclear) receptors Kinase-linked receptors Cytokine receptors. A. constriction of vascular smooth muscle D.

26. A. have cell bodies with perikarya in the thoracic region. E. A. D. B. Postganglionic sympathetic nerves are tonically active. D. C. E. 27. B. D. B. C. reduced neuromuscular transmission C. C. D. Alpha-1 adrenergic selective agonist Phentolamine Phenylephrine Propranolol Metoprolol Isoproterenol All of the following drugs cause vasodilation in skeletal muscle EXCEPT: Isoproterenol Norepinephrine Epinephrine (low dose) Albuterol There are no exceptions. E. D. increased neuromuscular transmission B. B. E. Which of the following drugs will NOT significantly change mean arterial blood pressure? Phentolamine Norepinephrine Prazosin Isoproterenol Phenoxybenzamine . together? increased GI motility arteriole constriction improved memory increased lacrimal gland secretions bradycardia Sympathetic activation is most likely to increase lipolysis and improve eye accommodation. E. cause miosis and increase hepatic gluconeogenesis. cause miosis and reduce hepatic glycogenolysis. have all of the above characteristics. never use acetylcholine as a transmitter. C. C. 23. C.22. D. 28. A. A. 29. C. A. Which of the following would you MOST LIKELY expect after IV administration of acetylcholine and atropine. have the same nicotinic receptors on their cell bodies as are found on striated muscle cells. E. B. slow heart rate and increase stomach motility and tone. Which of the following potential effects of di-isopropylfluorophosphate (DFP) would you MOST LIKELY expect to be blocked by high dose atropine? A. A. B. D. reduced blood pressure 25. Which of the following would you most likely observe after administering a low dose of bethanechol IV? reduced GI motility mydriasis increased blood pressure increased lacrimal gland secretions increased glycogenolysis in skeletal muscle 24. A. B. all cause vasodilation in skeletal muscle. E. miosis E. increase lipolysis and reduce insulin secretion. increased blood pressure D.

E. alpha-methyldopa D. D. For which of the following conditions would you most likely avoid giving a nonselective beta-blocker hyperlipidema chronic obstructive pulmonary disease diabetes peripheral vascular disease with ischemia Both B and D are correct Compensatory mechanisms to maintain cardiac output during heart failure include all of the following EXCEPT: ventricular dilation vasoconstriction venoconstriction increased parasympathetic nervous system activity enhanced renin release from the kidney Digoxin increases cardiac contractility by stimulating norepinephrine release. C. D. C. C. A. D. B. stimulating calcium channels. A. A. 34. C. E. E. Enalapril Prazosin Propranolol alpha-methyl dopa Common characteristics of verapamil and propranolol include all of the following except: Lowers blood pressure Decrease cardiac contractility Constriction of airways with pre-existing asthma Decreases A-V conduction . 36. D. Losartan E. 31. little or mild tachycardia and hypotension usually on initial dosing. B. A. C. E. blocking muscarinic receptors. 35. B. A. D. Prazosin B.30. B. D. Produces a decrease in peripheral vascular resistance. Which of the following drugs does NOT cause a reflex change in heart rate? Propranolol Norepinephrine Phenylephrine Phentolamine All of the drugs produce reflex changes in heart rate Which of the following drugs has the LEAST effect on peripheral vascular resistance after acute administration? Norepinephrine Propranolol Metoprolol Epinephrine (low dose) Phentolamine Anithypertensives and Heart Failure 32. C. C. and dobutamine include all of the following EXCEPT: beta-adrenergic receptor agonists pro-arrhythmic tachycardia tolerance dilates renal arterioles Decreases cardiac output and lowers plasma angiotensin II levels. E. an atropine like effect. B. Propranolol 33. C. B. A. Common characteristics of dopamine. 38. A. B. A. 37. inhibiting phosphodiesterase activity. D. B. Clonidine C. E. inhibiting Na-K-ATPase activity leading to an increase in intracellular calcium. A. D.

Losartan 44. Vasodilator that directly blocks calcium channels and can cause reflex tachycardia. D. Nifedupine D. C.J. Verapamil B. A. 41. digoxin B. Digoxin can be useful in slowing a rapid ventricular response during atrial fibrillation because: usually suppresses the atrial arrhythmia decreases firing rate of the S-A node increases cardiac contractility reduces A-V conduction 45. D. C. A.39. Metoprolol D. is a 60-year-old male with hypertension that is currently controlled with enalapril. normal vascular resistance. propranolol B. a 71-year-old female with a blood pressure of 168/96 on 2 clinic visits also has a history of mild asthma and recurrent atrial fibrillation. and hemodynamic parameters reveal that he has a low cardiac output. She takes digoxin to control the ventricular beating rate and albuterol to manage the asthma. A. C. B. hydralazine E. C. captopril D.L. Prazosin C. Positive inotropic agent that can also lower heart rate and increase the atrio-ventricular node refractory period. dobutamine . D. atropine C. He has recently experienced frequent nocutia and has been diagnosed with bladder outlet obstruction due to benign prostatic hypertrophy (BPH). Propranolol Alpha-methyl dopa Hydralazine Enalapril 43. Which would you choose? A. D. What therapeutic approach should be considered for the high blood pressure? A. hydralazine 46. B.. Clonidine 47. Dopamine Nitroglycerin Digoxin Milrinone Selectively decreases afterload with a reflex increase in heart rate and atrio-ventricular conduction. Propranolol Enalapril Dobutamine Hydralazine Anti-hypertensive drug that lowers heart rate and cardiac contractility. 42. A.P. D. The following change to which drug might be benefit J. Prazosin C. A. B. nifedipine C. isoproterenol D. C. and adequate filling pressures.L. You wish to administer a drug that will rapidly improve the contractility of the heart without having a marked effect on heart rate. C. His blood pressure is barely adequate at 90/60 mmHg. A. B. Hydrochlorothiazide B. A. 40. is in the coronary care unit recovering from am acute myocardial infarction. J. A. Hydralazine Losartan Prazosin Clonidine Dilates veins and arterioles. B. he is tachycardiac (150b/m). with no increase in blood volume.

B. B 29. B 28. 51. E. D 10. They can decrease potassium secretion resulting in hyperkalemia. Furosemide D. D 25. A. C. C 8. D 30. D. B. A 23. E 12. D 21. D. C 5. E. C. D 17. Are less efficacious than loop diuretics in producing diuresis. E 3. B 27. Triamterene C. A. Acetazolamide 49. ANSWERS 1. B 26. Which one of the following drugs activates lipoprotein lipase and promotes delivery of triglycerides to adipose tissues? Lovastatin Colestipol Gemfibrozil Nicotinic acid Vitamin E Which one of the following drugs is an aldosterone antagonist? Hydrochlorothiazide Furosemide Spironolactone Amiloride Acetazolamide Which one of the following statements about thiazide diuretics is incorrect? They inhibit sodium reabsorption by acting on the Na+/Cl. E 20. A 31. A. D. C 18. C 7. E. C . D 19.cotransporter in the distal convoluted tubule. D 11. A. B. Which one of the following diuretics increases urine pH? A. Mannitol E. D 24. They can cause hyperglycemia. A 15. C. C 14. 50. E 4. B 2. E 16. B 6. They are ineffective in renal disease when the GFR is low. E 22. E 9. Hydrochlorothiazide B.Diuretics 48. E 13.

35. 41. 51. 46. 50. 34. 36. 33. 47. 48. 44. 43. 37. 42. 45. 49. 39. 40. 38.32. A E D E E C C C D D D C D C B E E C C B .