Module 4 New PACOP D.

I, II and III
BIOPHARMACEUTICS AND E. None of these
PHARMACOKINETICS
5. Which of the following is not true regarding
1. It is the ability of a drug to exist in two or more the purpose of tablet coating?
crystalline form: A. Improves palatability
A. Chirality B. Improve aesthetic value of tablet
B. Polymorphism C. Improve stability
C. Stereoisomerism D. Improve in-vivo degradation
D. A and C E. None of these
E. None of these
6. A surface active agent that facilitates the
2. Arrange the following dosage forms from absorption of lipophilic drug or water insoluble
highest to lowest dissolution rate: drugs.
I. Solution A. Bile
II. Capsule B. Albumin
III. Suspension C. Rennin
IV. Tablet D. Gastric acid
E. None of these
A. I, II, III, IV
B. I, III, II, IV 7. Phase 2 metabolism that protects the body
C. IV, III, II, I against chemically reactive metabolites
D. IV, II, III, I A. Sulfate conjugation
E. None of these B. Glutathione conjugation
C. Methylation
3. All of the following statements are true D. Acetylation
regarding particle size of a drug, EXCEPT: E. Glycine conjugation
A. Reducing the particle size can decrease the
surface are of the molecule exposed to the 8. All of the following listed below are
solvent procecesses of drug excretion, EXCEPT
B. Reduction of particle size can be achieved by A. Glomerular filtration
micronisation using jet mill, spray drying and air B. Active secretion
attrition methods C. Tubular secretion
C. The dissolution of some drugs available in the D. Tubular reabsorption
market has been improved by reducing the E. None of these
particle size
D. Reducing the particle size of a drug may 9. It is the functional unit of the kidney
increase drug absorption A. Glomerulus
E. None of these B. Loop of henle
C. Nephron
4. Which of the following may increase drug D. Collecting tubule
dissolution rate? E. None of these
I. Too much binder
II. Insoluble diluents 10. Creatinine clearance of a patient with kidney
III. High amount of lubricants failure
A.60-89 mL
A. I only B. 30-59 mL
B. I and II C.15-29 mL
C. II and III D. <15 mL
E. None of these 15. Volume of serum or blood completely
cleared of the drug per unit time.
11. Which of the following drugs listed below will A. Volume of distribution
increase its clearance at alkaline urine? B. Clearance
I. Amphetamine C. Elimination
II. Imipramine D. Plasma concentration
III. Barbiturates E. None of these
IV. Salicylic acid
16. Hypothetical volume that relates drug serum
A. I and II concentrations to the amount of drug in the
B. II and III body.
C. III and IV A. Volume of distribution
D. All of these B. Clearance
E. None of these C. Drug elimination
D. Plasma concentration
12. Which of the following correctly describes E. None of these
ion trapping?
A. Changing the pH of urine used to facilitate the 17. All of the following factors affects the volume
elimination of drug that proved to be toxic to a of distribution of drug, EXCEPT:
patient or has been taken in overdosed amount A. Volume of blood
B. Administration of acidic drug to neutralize an B. Size of venous organs and tissues in the
alkaline poison in the stomach body
C. Alkalanizing the urine to facilitate excretion of C. Protein binding
weakly basic drugs D. Physicochemical properties of drug
D. A and C E. None of these
E. None of these
18. The fraction of the administered dose that is
13. Discipline that applies pharmacokinetic delivered to the systemic circulation is known as
concepts and principles in humans in order to the:
design individualized dosage, regimens that A. Loading dose
optimize the therapeutic response of a B.Maintenance dose
medication while minimizing the chance of an C. Bioavailability
adverse drug reaction. D. Active dose
A. Clinical toxicology E. None of these
B. Clinical pharmacy
C. Clinical pharmacokinetics 19. Below is an example of:
D. Pharmacotherapeutics
E. None of these

14. Chemical coversion of the drug molecule,

usually by an enzymatically mediated reaction,
into another chemical entity referred to as a
metabolite.
A. Absorption A. Dose-response curve
B. Distribution B. Plasma-level time curve
C. Metabolism C. Quantal-dose response curve
D. Excretion D. A and B
E. None of these E. None of these
20. After the first dose of gentamicin is given to allows the transfer of the free drug molecule but
a patient with renal failure, the following serum not the drug bound to protein.
concentrations are obtained: A. Ultrafiltration
B. Equilibrium dialysis
C. Hemodialysis
Time after drug Concentration D. A and B
administration (h) (mcg/mL) E. None of these
1 7.7
e 5.6
24. Which of the following statements are true
48 4.0
regarding volume of distribution (Vd)?
A. Relates the amount of absorbed drug with the
A. 30 hours and 0.0123/hr amount of eliminated drug
B. 45 hours and 0.0146/hr B. Total volume of drug absorbed
C. 55 hours and 0.0129/hr C. Drugs that are highly distributed into the
D. 50 hours and 0.0139/hr tissues have low Vd
E. None of these D. Drugs that are highly bound to plasma
proteins have low Vd
21. All of the following are true regarding the E. All of these
rate of drug distribution, EXCEPT:
A. The rate of drug distribution wil be faster in 25. For nos. 25-29:
highly prefuse tissues A single IV bolus of drug was administered to a
B. The blood brain barrier (BBB) prevents the patient and the amount of drug in the body was
distribution of many polar compounds in the determined at different time points after drug
blood to the brain tissues administration:
C. Only the lipophilic compounds can distribute
across BBB by passive diffusion
D. The equilibrium between the drug in highly Time (h) Amount (mg)
perfused tissues is achieved slower than the 0.5 396
equilibrium between the drug in blood and the 1 315
poorly perfused tissues 2 198
E. None of these 4 79
8 12.4
12 1.96
22. Which of the following factors affect drug
distribution?
What is the order of the elimination process of
I. Blood perfusion
this drug?
II. Tissue composition
A. Zero order kinetics
III. Plasma protein binding
B. First order kinetics
IV. Physicochemical properties of drug
C. Second order kinetics
D. A or B
A. I only
E. None of these
B. I and II
C. II and III
26. What is the rate constant for elimination
D. I, II, III and IV
process?
E. None of these
A. 0.5712/hr
B. 0.3789/hr
23. Technique in the determination of drug
C. 0.6234/hr
plasma protein binding that utilize a special
D. 0.4617/hr
dialysis chamber that is separated into two
E. 0.2341/hr
halves by a semipermeable membrane that
 C. Quinidine
27. What is the dose of drug administered to this D. A and B
patient? E. B and C
A. 500 mg
B. 300 mg 32. Elimination of a drug refers to:
C. 200 mg I. Excretion of uncharged drug in the urine
D. 100 mg II. Renal excretion of drug
E. 700 mg III. Uptake of drug from the blood into the liver
IV. Metabolism of drug in the liver
28. Calculate the amount of drug in the body V. Distribution of drug into fat
10h after administraton
A. 5.32 mg A. I and II
B. 3.45 mg B. II and III
C. 4.94 mg C. II and IV
D. 3.22 mg D. III and V
E. 6.55 mg E. None of these

29. What is the half-life of the drug immediately 33. The loading dose of a drug is determined by:
after drug administration? I. Drug clearance
A. 3 hrs II. Elimination rate
B. 5 hrs III. Target plasma drug concentration
C. 2.5 hrs IV. Volume of distribution
D. 1.5 hrs V. Duration of drug effect
E. 3.5 hrs
A. I and II
30. For nos. 30-31 B. II and III
C. III and IV
The following are the pharmacokinetic D. IV and V
parameters for a group of drugs E. All of the above

34. Half-life:
Drug Vd (L/Kg) Elimination I. Increases as the clearance increases
rate constant II. Decreases as the volume of distribution
(h-1)
increases
Theophylline 0.45 0.11
Ampicillin 0.3 0.6 III. Decreases as clearance increases
Quinidine 3 0.08 IV. Increases as volume of distribution increases
Gentamicin 2 0.08 V. Increases as the elimination rate increases
Digoxin 20 0.01
A. I and II
Which drug has the highest ClT? B. II and III
A. Theophylline C. III and IV
B. Ampicillin D. IV and V
C. Quinidine E. None of these
D. Gentamicin
E. Digoxin 35. After a single dose of a drug which has a
half-life of 12 hours, what percentage of the
31. Which drug has the lowest ClT? dose is still in body after 1 day?
A. Theophylline A. 87.5%
B. Ampicillin B. 75%
C. 50% excretion is called:
D. 25% A. Pharmacodynamics
E. 12.5% B. Drug concentration
C. Pharmacokinetics
36. Which of the following routes of D. Kinetics Homogeneity
administration completely avoid first pass E. Biopharmaceutics
clearance?
I. Buccal 40. The Application of pharmacokinetic
II. Sublingual principles to the safe and effective therapeutic
III. Rectal management of drugs in and individual patient is
IV. Oral known as:
V. Transdermal A. Pharmacodynamics
B. Pharmacokinetics
A. I and II C. Clinical pharmacokinetics
B. I, II and III D. Biopharmaceutics
C. I, II and IV E. None of these
D. I, II and V
E. III and V 41. Pharmacodynamics refers to the relationship
of drug:
37. The term linear pharmacokinetic means: A. Dose to drug concentration in plasma
I. A plot of drug concentration vs. time is linear B. Dose to drug concentration at the receptor
II. Half-life increases proportionally with dose site
III. A constant amount of drug is eliminated per C. Concentration to drug effect
unit time D. Dose to drug effect
IV. Clearance is proportional to the dose E. None of these
V. Steady state drug concentration is
proportional to the dose 42. The EC50 refers to the drug concentration at
which:
A. I only A. One-half the maximum response is achieved.
B. I and II B. The maximal effect is achieved.
C. III only C. Tolerance likely to be observed
D. II and IV D. Minimum effective concentration
E. V only E. Minimum toxic concentration

38, Which of the following process are saturable 43. An example of a situation that would not
and can result in non-linear pharmacokinetics? support therapeutic drug concentration
I. Drug metabolism monitoring with plasma drug concentrations
II. Glomerular filtration would be one in which:
III. Protein binding A. A wide variation in plasma concentrations is
IV. Renal tubular secretion achieved in different patients given a standard
drug dose.
A. I only B. The toxic plasma concentration is many times
B. II, III and IV the therapeutic concentration range.
C. I, II and IV C. Correlation between drug’s plasma
D. I, III and IV concentration and therapeutic response is good.
E. None of these D. A and B
E. B and C
39. The study of the time course of drug
absorption, distribution, metabolism, and 44. The most commonly used model in clinical
pharmacokinetic situations is the:
A. One-compartment model A. I only
B. Two-compartment model B. II only
C. Multicompartment model C. II and III
D. A and C D. III only
E. All of these E. None of these

45. Instantaneous distribution to most body 49. With a drug that follows first-order
tissues and fluids is assumed in which of the elimination, the amount of drug elimination per
following models? time:
A. One-compartment model A. Remains constant while the fraction of drug
B. Two-compartment model eliminated decreases.
C. Multicompartment model B. Decreases while the fraction of drug
D. A and C eliminated remains constant
E. All of these C. Increases while the fraction of drug
eliminated remains constant
46. For a drug that has first-order elimination D. B or C
and follows a one- compartment model, which of E. None of these
the following plots would result in curved line?
A. Plasma concentration versus time 50. Which of the following is a proper unit for 1st
B. Natural log of plasma concentration versus order elimination constant?
time A. Minutes
C. Common log of plasma concenctration versus B. mg/minute
time C. hr1
D. A and B D. mg/L
E. B and C E. Cl

47. For the body fluid compartments below, rank 51. Trapezoidal rule method is used in the
them from the lowest volume to the highest, in a composition of:
typical 70-kg person. A. K
A. Plasma < extracellular fluid < intracellular fluid B. T ½
< total body water C. AUC
B. Extracellular fluid < intracellular fluid < plasma D. Vd
< total body water E. Cl
C. Intracellular fluid < extracellular fluid < plasma
< total body water 52. Which of the following are true regarding
D. Total body water < plasma < intracellular fluid AUC?
< extracellular fluid I. Can be used to determine drug clearance
E. None of these II. Reflects the amount of drug absorbed
III. Dose administered divided by drug’s
48. All of the following are true regarding clearance
clearance, EXCEPT:
I. The unit for clearance is volume/time A. I only
II. Total body clearance is the sum of clearance B. I and II
by the kidneys, liver, and other routes of C. II and III
elimination D. All of these
III. To determine drug clearance, we must first E. None of these
determine whether a drug best fits one or two
compartment model.
53. Gentamicin has a t1/2 of: A. I and II
A. 39 hours B. II and III
B. 22 hours C. III and IV
C. 7 hours D. All of these
D. 20 hours E. None of these
E. 2-3 hours
58. This method of giving multiple doses by
54. The time between administration of doses is infusion at specified intervals is called:
the: A. IV Bolus
A. Onset time B. Intermittent IV Infusion
B. Dosing range C. Multiple Infusion
C. Dosing interval D. A and B
D. tmax E. None of these
E. None of these
59. For a drug regimen, if the elimination rate (K)
55. The point at which the amount of drug of a drug is reduced while volume distribution,
administered over a dosing interval equals the drug dose, and dosing interval remain constant,
amount of drug being eliminated over that same the peak and trough concentration will:
period and is totally dependent on the A. Increase
elimination rate constant B. Decrease
A. Rate Constant C. Remains the same
B. Steady state D. A or B
C. Elimination E. None of these
D. Absorption phase
E. None of these 60. Method used in toxicokinetics and for the
extrapolation of therapeutic drug doses in
56. Steady-state concentration can be increase humans from nonclinical animal drug studies.
by adjusting which of the following parameters? A. Interspecies Scaling
B. Toxicological Extrapolation
I. t 12 C. Linear Analysis
II. Dose Administered D. A and C
III. Dosing Interval E. None of these

A. I only 61. A condition in which glomerular filtration is

B. II only impaired or reduced, leading to accumulation of
C. II and III excessive fluid and blood nitrogenous products
D. All of these in the body.
E. None of these A. Cystitis
B. Uremia
57. To predict the plasma concentration of a C. Pancreatitis
drug at any time t after n number of doses, we D. Hypovolemia
therefore need to know which among the E. None of these
following values?
62. Common cause of Kidney failure EXCEPT:
I. Drug Dose
I. Pyelonephritis
II. Volume of distribution
II. Hypotension
III. Elimination rate constant
III. Diabetes Mellitus
IV. Dosing Interval
IV. Nephroallergens
A. I only 67. Stage of kidney disease with Creatinine
B. I and II clearance of 30-59 mL/min
C. II only A. Stage I
D. III and IV B. Stage 2
E. IV only C. Stage 3
D. Stage 4
63. A fructose polysaccharide used as a E. Stage 5
standard reference for the measurement of
GFR: 68. Patient with mild decrease in glomerular
A. Chitosan filtration rate has a Creatinine clearance of
B. Inulin A. > 90 mL/min
C. Cellulose B. 60-89 mL/min
D. Chitin C. 30-59 mL/min
E. A and B D. 15-29 mL/min
E. < 15 mL/min
64. Commonly used clinical diagnostic
laboratory test for renal disease: 69. An artificial process in which the
A. Creatinine Clearance accumulation of drugs or waste metabolites is
B. Measurement of blood urea nitrogen removed by diffusion from the body into the
C. Detection of kidney stones specialized fluid
D. Detection of uric acid in urine A. Dialysis
E. None of these B. Hemodiffusion
C. Ultra filtration
65. The normal blood urea nitrogen for a patient D. A and C
is: E. None of these
A. 1-10 mg/dl
B. 10-20 mg/dl 70. Used a dialysis machine and filters blood
C. 20-30 mg/dl through an artificial membrane. It requires
D. 30-40 mg/dl access to the blood vessel to allow the blood to
E. 40-50 mg/dl flow to the dialysis machine back to the body.
A. Hemodialysis
66. Which of the following are true regarding B. Peritoneal Dialysis
Creatinine clearance? C. Continuous Ambulatory Peritoneal Dialysis
I. Volume of plasma cleared of Creatinine per D. Hemoperfusion
unit time E. Hemofiltration
II. Calculated directly by dividing the rate of
urinary excretion of Creatinine by the patient’s 71. The process of removing drug by passing
serum Creatinine concentration. the blood from the patient through an adsorbent
III. Creatinine clearance is expressed in mL/min material and back to the patient:
and serum Creatinine concentration in mg/dl or A. Hemodialysis
mg% B. Peritoneal Dialysis
C. Continuous Ambulatory Peritoneal Dialysis
A. I only D. Hemoperfusion
B. I and II E. Hemofiltration
C. II and III
D. All of these
E. None of these
72. A process by which fluids, electrolytes, and 76. Patients having liver disease have the
small molecular weight substances are removed following pharmacokinetic characteristics
from the blood by means of Low Pressure flow except:
through hollow artificial fibers or flat plate A. increase drug protein binding
membranes B. Decreased drug metabolism
A. Hemodialysis C. Increase drug half-life
B. Peritoneal Dialysis D. Increased Vd for hydrophilic drugs
C. Continuous Ambulatory Peritoneal Dialysis E. None of these
D. Hemoperfusion
E. Hemofiltration 77. Pregnancy category wherein there is a
positive evidence of risk in taking the drug but
73. Which of the following are true regarding the benefit in taking the drug outweighs the risk.
dosing consideration on patients with hepatic A. Category A
impairments? B. Category B
I. All liver diseases affect the pharmacokinetics C. Category C
of the drugs to the same extent. D. Category D
II. Drug-protein binding may be altered due to E. Category X
alteration in hepatic synthesis of albumin.
III. Metabolism of drugs with high intrinsic 78. Pharmacokinetic behavior of geriatric
clearance may be impaired. patients:
IV. Drugs with a wide therapeutic range will be I. Impaired absorption
less affected by moderate hepatic impairment. II. Slow metabolism
III. Prolonged drug-life
A. I, II, and III
B. II, III, and IV A. I only
C. I, II, and IV B. I and II
D. All of these C. II and III
E. None of these D. All of these
E. None of these
74. Hepatic metabolic marker found in liver and
many other tissues, including cardiac and 79. All of the following are true regarding
skeletal muscles: capacity limited excretion EXCEPT
A. ALT A. Passive secretion and passive reabsorption
B. ALP are saturable processes
C. AST B. Saturated tubular secretion decreases Clr
D. SGPT C. Saturated tubular reabsorption increase Clr
E. A and D D. A and B
E. None of these
75. Hepatic metabolic marker that is only
specific on liver: 80. Example of drug tha exhibits saturable
A. ALT protein binding:
B. ALP I. Nicardipine
C. AST II Propanolol
D. SGPT III . Amoxicillin
E. A and D
A. I only
B. I and II
C. II and III
D. All of these
E. None of these 86. Which of the following enzyme(s) is/are
utilized in Phase I Metabolism?
81. The following parameters listed below can I. CYP3A4
be adjusted when designing a multiple dosage II. UDP glucuronosyl acyltransferase
regimen except: III. N- acyltransferase
A. Size of dose administered
B. Drug protein binding A. I only
C. Dosing interval B. I and II
D. All of these C. II and III
E. None of these D. I and III
E. all of these
82. The initial step in the elimination process via
kidney occurs in the: 87. Which of the following enzyme(s) is/are
A. Glomerulus utilized in Phase II Metabolism?
B. Nephron I. CYP3A4
C. Distal Tubule II. UDP glucuronosyl acyltransferase
D. Proximal Tubule III. N- acyltransferase
E. None of these
A. I only
83. The capacity of the body to eliminate the B. I and II
drug after it has reached the general circulation C. II and III
is reflected by the: D. I and III
A. Total clearance E. None of these
B. Volume of distribution
C. Biliary recycling 88. A lipophilic medicinal agent hasthe following
D. AUC property:
E. None of these A. Low ability to penetrate through the cell
membrane lipids
84. The process of drug metabolism and B. Penetrate through membranes by means of
excretion constitute: endocytosis
A. Deposition C. Low permeation through the blood-brain
B. Elimination barrier
C. Accumulation D. High reabsorption in renal tubules
D. Biotransformation E. None of these
E. Clearance
89. The plasma level time curve below follows
85. True about enzyme induction: what compartment model?
I. Low Therapeutic levels of active drug
(decrease drug efficacy)
II. Prodrug (decrease in efficacy)
III. Toxic metabolite (decrease in toxicity)

A. I only
B. I and II
C. II and III A. One compartment
D. II and IV B. Two compartment
E. None of these C. Three compartment
D. A or B
E. None of these
90. Two compartment model: B. I and II
I. Resolves the body into central and peripheral C. II and III
compartment D. I and III
II. Peripheral compartment is composed of less E. All of these
perfused organs muscle, fat, and lungs.
III. The difference from one compartment model 94. Determine the half-life of an antihypertensive
is that the drug does achieve instantaneous drug if it appears to be eliminated from the body
distribution. at a rate constant of 0.07/hour. Assume first-
order kinetics occurs.
A. I only A. 12 hours
B. I and II B. 9.9 hours
C. II and III C. 7 hours
D. I and III D. 4 hours
E. All of these E. 1.5 hours

91. The drug achieves instantaneous distribution 95. The amount of drug A is decreasing at a rate
throughout the body and the drug equilibrates that is proportional to the amount of drug A
instantaneously between tissues: remaining
A. Non-linear pharmacokinetics A. Non-linear pharmacokinetics
B. One-compartment model B. 1st Order
C. Two-compartment model C. Zero Order
D. A or C D. Enzyme Kinetics
E. None of these E. B or C

92. Drug Clearance: 96. Procedures employing test apparatus and

I. A measure of drug elimination from the body equipment without involving laboratory animals
II. Drug clearance refers to the volume of or humans.
plasma fluid that is cleared of drug per unit time. A. In-vivo
III. Clearance may also be considered as the B. In-silico
fraction of drug removed per unit time multipled C. In-vitro
by the rate D. Ex-vivo
constant E. All of these

A. I only 97. Release of the drug substance from the

B. I and II drug product either for local drug action or for
C. II and III drug absorption into the plasma for systemic
D. I and III therapeutic activity
E. None of these A. Drug product performance
B. Pharmacokinetics
93. Volume Distribution: C. Biopharmaceutics
I. The theoretical volume that would be D. Pharmacodynamics
necessary to contain the total amount of an E. A and B
administered drug at the same concentration
that it is observed in the plasma 98. Biopharmaceutics examines the
II. Indicator of the extent of drug distribution into interrelationship of the following EXCEPT:
body fluids and tissues I. Physical/Chemical properties of the drug
III. Important in circulation of drug dose II. The dosage form (drug product) in which the
drug is given
A. I only III. Route of administration
IV. Rate and extent of systemic drug absorption 103. The noncellular liquid fraction of whole
blood and contains all the proteins including
A. I only albumin
B. II only A. Platelet
C. II and III B. Serum
D. IV only C. Plasma
E. None of these D. Fibrin
E. None of these
99. Oral, topical, parenteral, transdermal,
inhalations are examples of: 104. Liquid obtained from whole blood after the
A. Dosage form blood is allowed to clot and the clot is removed.
B. Route of administration Does not contain the cellular elements,
C. Therapeutic effect fibrinogen, or othe clotting factors from the
D. A and B blood.
E. None of these A. Platelet
B. Serum
100. Application of pharmacokinetic principles to C. Plasma
the design, conduct, and interpretation of drug D. Fibrin
safety evaluation studies and in validating dose E. None of these
related exposure in animals.
A. Toxicokinetics 105. Indicate the part of a plasma level-time
B. Biopharmaceutics curve
C. Pharmacodynamics
D. Pharmacokinetics
E. A and B

101. Include sampling blood, spinal fluid,

synovial fluid, tissue biopsy, or any biologic
material that requires parenteral or surgical
intervention in the patient.
A. In-vitro methods
B. Invasive methods A. tmax
C. Non-invasive methods B. Therapeutic range
D. Ex-vivo methods C. Cmax
E. None of these D. MEC
E. MTC
102. Include sampling ofurine, saliva, feces,
expired air, or any biologic material that can be
obtained without parenteral or surgical
intervention.
A. In-vitro methods
B. Invasive methods
C. Non-invasive methods
D. Ex-vivo methods
E. None of these
106. Indicate the part of a plasma level-time 109. Indicate the part of a plasma level-time
curve curve

A. Cmax
A. Cmax
B. tmax
B. tmax
C. Onset time
C. MEC
D. AUC
D. MTC
E. Therapeutic range
E. AUC
107. Indicate the part of a plasma level-time
110. Indicate the part of a plasma level-time
curve
curve

A. Duration of action
B. Onset time A. tmax
C. MEC B. Cmax
D. MTC C. Onset time
E. Therapeutic range D. Duration of action
E. MEC
108. Indicate the part of a plasma level-time
curve 111. Indicate the part of a plasma level-time
curve

A. Duration of action
B. Onset of time
A. tmax
C. MEC
B. Cmax
D. MTC
C. Onset time
E. tmax
D. MTC
E. MEC
 116. Which of the following functions of
112. Difference between the onset time and the pharmacokinetic models?
time for the drug to decline back to the MEC. I. Predict plasma, tissue and urine drug levels
A. Duration of action with any dosage regimen
B. Onset time II. Calculate the optimum dosage regimen for
C. AUC each patient individually
D. C max III. Evaluate the differences in the rate or extent
E. MTC of availability between formulations
(bioequivalence)
113. Corresponds to the time required for the
drug to reach the MEC A. I only
A. Duration of action B. I and II
B. Onset time C. II and III
C. AUC D. All of these
D. C max E. None of these
E. MTC
117. Unit for zero order rate constant:
114. The plasma level time curve below portrays A. Concentration / time
a drug that is administered in what route of B. Drug / volume
administration? C. Volume / time
D. Concentration x time
E. 1 / time

118. Unit for clearance:

A. Concentration / time
B. Drug / volume
C. Volume / time
D. Concentration x time
E. 1 / time
A. IV Bolus
B. Oral 119. Unit for plasma drug concentration
C. IV infusion A. Concentration / time
D. Intramuscular B. Drug / volume
E. None of these C. Volume / time
D. Concentration x time
E. 1 / time
115. Presence of drug in this sample may reflect
drug that has not been absorbed after an oral 120. Unit for area under the curve
dose or may reflect drug that has been expelled A. Concentration / time
by biliary secretion after systemic absorption. B. Drug / volume
A. Feces C. Volume / time
B. Urine D. Concentration x time
C. Saliva E. 1 / time
D. Milk
E. Sweat 121. Unit for 1st order rate constant:
A. Concentration / time
B. Drug / volume
C. Volume / time
D. Concentration x time
E. 1 / time D. Both statement is correct
E. Cannot determine the validity of both
122. All of the following are included in the statements
peripheral compartment / tissue compartment,
EXCEPT: 126. Drug elimination is usually divided into two
I. Fat major components: excretion and
II. Muscle biotransformation. Drug excretion is the removal
III. Cerebrospinal fluid of intact drug.
IV. Plasma A. Only the 1st statement is correct
B. Only the 2nd statement is correct
A. I and II C. Both statement is incorrect
B. II only D. Both statement is correct
C. III and IV E. Cannot determine the validity of both
D. IV only statements
E. None of these
127. Nonvolatile and polar drugs are excreted
123. The curve that represents the initial, more mainly by renal excretion. Volatile drugs, such
rapid decline of drug from the central as gaseous anesthetics, alcohol, or drugs with
compartment into the tissue compartment as high volatility, are excreted via the lungs into
seen in the plasma level time curve below is: expired air.
A. Only the 1st statement is correct
B. Only the 2nd statement is correct
C. Both statement is incorrect
D. Both statement is correct
E. Cannot determine the validity of both
statements

128. Biotransformation is the process by which

A. Absorption phase
the drug is chemically converted in the body to a
B. Distribution phase
metabolite. Other name for drug
C. Excretion phase
biotransformation is drug elimination.
D. Metabolism phase
A. Only the 1st statement is correct
E. Elimination phase
B. Only the 2nd statement is correct
C. Both statement is incorrect
124. The pharmacokinetics of a drug given by
D. Both statement is correct
constant IV-infusion follows what input process?
E. Cannot determine the validity of both
A. Zero order
statements
B. 1st order
C. 2nd order
129. The two major drug eliminating organs in
D. A or B
the body:
E. None of these
I. Heart
II. Lungs
125. Constant IV drug infusions are considered
III. Liver
to have zero order drug absorption because of
IV. Kidney
direct input. Once the drug is infused, most of
the drug is eliminated by first order elimination.
A. I and II
A. Only the 1st statement is correct
B. II and III
B. Only the 2nd statement is correct
C. III and IV
C. Both statement is incorrect
D. I and IV
E. I and III D. Enterohepatic recycling
E. None of these
130. Major route of elimination for many drugs:
A. Renal excretion 135. All of the following listed below are
B. Biliary excretion characteristics of active tubular secretion
C. Fecal excretion process, EXCEPT:
D. B and C I. Carrier mediated system that requires energy
E. None of these input
II. Drugs with similar structure may compete for
the same carrier system
131. The processes by which a drug is excreted III. It can be a passive process
via the kidneys may include any combination of
the following listed below, EXCEPT: A. I only
I. Glomerular filtration B. I and II
II. Active tubular secretion C. II and III
III. Passive secretion D. III only
IV. Tubular reabsorption E. None of these

A. I only 136. Active tubular secretion happens in this

B. I and II part of kidney:
C. II only A. Glomerulus
D. II and III B. Proximal tubule
E. III only C. Distal tubule
D. Collecting duct
132. Unidirectional drug excretion process that E. None of this
occurs for most small molecules (MW < 500),
including dissociated (nonionized) drugs. 137. Tubular reabsorption happens in this part of
A. Glomerular filtration kidney:
B. Active tubular secretion A. Glomerulus
C. Tubular reabsorption B. Proximal tubule
D. Enterohepatic recycling C. Distal tubule
E. None of these D. Collecting duct
E. None of this
133. A carrier mediated system that requires
energy input, because the drug is transported 138. Which renal elimination processes are
against a concentration gradient. influenced by protein binding?
A. Glomerular filtration A. Glomerular filtration
B. Active tubular secretion B. Active tubular secretion
C. Tubular reabsorption C. Tubular reabsorption
D. Enterohepatic recycling D. Enterohepatic recycling
E. None of these E. None of these

134. Occurs after the drug is filtered through the 139. Which renal elimination processes are
glomerulus and can be an active or a passive influenced by urinary pH?
involving transporting back of the drug into the A. Glomerular filtration
plasma: B. Active tubular secretion
A. Glomerular filtration C. Tubular reabsorption
B. Active tubular secretion D. Enterohepatic recycling
C. Tubular reabsorption E. None of these
140. Which renal elimination processes are
influenced by competitive inhibitors?
A. Glomerular filtration
B. Active tubular secretion
C. Tubular reabsorption
D. Enterohepatic recycling
E. None of these
For nos. 141-145
JPT is a 35-year-old male weighing 80 kg.
The patient is to be given multiple IV bolus
injections of an antibiotic every 6 hours. The
effective concentration of this drug is 16
mg/mL. After the patient is given a single IV
dose. The elimination half-life for the drug is
determined to be 3.0 hr and the apparent VD
is 196 mL/kg.
141. Determine a multiple IV dose regimen for
this drug (assume drug is given every 6 hours)
A. 255 mg every 6 hours
B. 350 mg every 6 hours
C. 362 mg every 6 hours
D. 348 mg every 6 hours
E. 445 mg every 6 hours
142. Assume that the antibiotic is 90%
bioavailable and that the physician would like to
continue oral medication every 6 hours.
Determine the multiple oral dose regimen:
A. 386 mg every 6 hours
B. 252 mg every 6 hours
C. 198 ml every 6 hours
D. 333 mg every 6 hours
E. 401 mg every 6 hours
143. Assume that the antibiotic is available in
125-, 250-, and 500-mg tablets. The pharmacist
decide to dispense 125 mg tablet and 250-mg
tablet. What is the new plasma drug
concentration if the patient is given 375 mg
every 6 hours? (Bioavailability of drug in tablet
form is - 90%)
A. 16.12 mcg/mL
B. 14.4 mcg/mL
C. 25.49 mcg/mL
D. 15.53 mcg/mL
E.15.98 mcg/mL
144. What is the new drug plasma concentration
if the patient takes a 500-mg dose (eg. Two 250-
mg tablets) every 6 hours? (Bioavailability of
drug in tablet form - 90%)
A. 20.71 mcg/mL
B. 19.2 mcg/mL
C. 25.39 mcg/mL
D. 15.53 mcg/mL
E. 15.98 mcg/mL
145. What is the drug plasma concentration if
the patient follows a dosage regimen of 500mg
tablet every 8 hours?
A.16.12 mcg/mL
B. 14.4 mcg/mL
C. 25.39 mcg/mL
D. 15.53 mcg/mL
E. 18.11 mcg/mL
146. The purpose of giving a loading dose is to
achieve desired (therapeutic) plasma
concentrations as quickly as possible. For a
drug with long elimination half-life, it may take a
long time (several half-lives) to achieve steady
state levels.
A. Only the 1st statement is correct
B. Only the 2nd statement is correct
C. Both statement is incorrect
D. Both statement is correct
E. Cannot determine the validity of both
statements
147. When several doses are administered for a
drug with linear kinetics, drug accumulation may
occur according to the principle of superposition.
The principle of superposition is used to
examine the effect of an early, late, or missing
dose on steady state drug concentratioon.
A. Only the 1st statement is correct
B. Only the 2nd statement is correct
C. Both statement is incorrect
D. Both statement is correct
E. Cannot determine the validity of both
statements
For nos. 148-149:
A physician wants to give theophylline to
Joshua E., a young male asthmatic patient
(age 29 years, 75kg) According to the IV. Riboflavin
literature, the elimination half-life for
theophylline is 5 hours and the apparent VD A. I only
is equal to 50% of the body weight. The B. I and II
plasma level of theophylline required to C. II and III
provide adequate airway ventilation is D. III and IV
approximately 11mcg/mL. E. IV only
The physician wants the patient to take
medication every 6 hours around the clock. 152. Drugs that demonstrate saturation kinetics
What dose of theophylline would you usually show which of the following
recommend (assume theophylline is 100% characteristics?
bioavailable) I. Elimination of drug does not follow simple first
order kinetics
148. II. Elimination kinetics are linear
A. 289 mg III. The area under the curve (AUC) is not
B. 343 mg proportional to the amount of bioavailable drug.
C. 315 mg IV. The elimination half-life does not change as
D. 256 mg dose is increased
E. 450 mg
A. I only
149. If you were to find that theophylline is B. I and III
available in 225 mg capsule only, what dosage C. II and III
regimen would you recommend? D. II and III
A. 225 mg every 3 hours E. I and IV
B. 225 mg every 4 hours
C. 225 mg every 5 hours 153. Refers to a noncyclical change in the drug
D. 225 mg every 6 hours absorption or drug elimination rate process over
E. 225 mg every 7 hours a period of time.
A. Chronopharmacokinetics
150. Example of a drug/s that undergo non- B. Time-dependent pharmacokinetics
linear pharmacokinetics thru saturable plasma C. Product inhibition
protein binding: D. Linear pharmacokinetics
I. Phenylbutazone E. A or B
II. Warfarin
III. Levodopa 154. For a 70 kg male patient, the approximate
IV. Riboflavin volume of extracellular water is:
A. 27 L
A. I only B. 15 L
B. I and II C. 12 L
C. II and III D. 5 L
D. III and IV E. 1 L
E. IV only
155. For a 70 kg male patient, the approximate
151. Example of a drug/s that undergo non- volume of intracellular water is:
linear pharmacokinetics thru saturable transport A. 27 L
in GUT wall: B. 15 L
I. Phenylbutazone C. 12 L
II. Warfarin D. 5 L
III. Levodopa E. 1 L
 B. 10 mL/min/kg
C. 5 mL/min/kg
156. Represents the pressure gradient between D. 3 mL/min/kg
the arterial end of capillaries entering the tissue E. 1 mL/min/kg
and the venous cappilaries leaving the tissue.
A. Osmotic pressure 162. Acetaminophen is converted to a reactive
B. Concentration gradient metabolite which causes hepatic necrosis thru
C. Hydrostatic pressure what biotransformation reaction?
D. Arterial pressure A. Demethylation
E. Venous pressure B. Acetylation
C. Aromatic hydroxylation
157. Which of the following human tissues D. Deamination
receives the highest blood flow? E. Conjugation
A. Kidney
B. Heart 163. Codeine is converted to morphine thru what
C. Brain biotransformation reaction?
D. Fat A. Demethylation
E. Muscle B. Acetylation
C. Aromatic hydroxylation
158. Which of the following human tissues D. Deamination
receives the least blood flow? E. Conjugation
A. Kidney
B. Heart 164. These drugs are inactive and must be
C. Brain biotransformed in the body to metabolites that
D. Fat have pharmacologic activity:
E. Muscle A. Enteric coated drugs
B. Prodrugs
159. Physical property that measures the ratio of C. Orphan drugs
the solubility of the drug in the oil phase to D. Xenobiotics
solubility in aqueous phase E. Lead drug
A. Osmotic gradient
B. Partition coefficient 165. Which of the following listed below is under
C. Solubility gradient phase I biotransformation reaction?
D. Absorption coefficient I. Aromatic hydroxylation
E. Diffusion coefficient II. Deamination
III. Nitroreduction
160. The volume of blood that perfuses the liver IV. Glycine conjugation
which is cleared of drug per unit of time V. Methylation
A. Cardiac output
B. Regional blood flow A. I, II and III
C. Hepatic clearance B. I, II and IV
D. Renal clearance C. II, III and IV
E. Body clearance D. III and IV
E. IV and V
161. The total body clearance for a drug is 15
mL/min/kg. Renal clearance accounts for 10 166. Which of the following listed below is under
mL/min/kg. What is the hepatic clearance for the phase II biotransformation reaction?
drug? I. Aromatic hydroxylation
A. 15 mL/min/kg II. Deamination
III. Nitroreduction 5% of marketed drugs including fluvoxamine,
IV. Glycine conjugation clozapine, olanzapine, and theophylline:
V. Methylation A. CYP2C9
B. CYP2D6
A. I, II and III C. CYP2C19
B. I, II and IV D. CYP3A4
C. II, III and IV E. CYP1A2
D. III and IV
E. IV and V 172. Polymorphisms of this phase 1 enzyme
result in a loss of enzymatic activity leading to
167. CYP450 enzyme responsible for the the accumulation of the chemotherapeutic agent
metabolism of warfarin, phenytoin and losartan: 5-flourouracil (5FU), which leads to significant
A. CYP2C9 toxicity including leukopenia, thrombocytopenia,
B. CYP2D6 and stomatitis
C. CYP2C19 A. CYP450
D. CYP3A4 B. Plasma pseudocholinesterase
E. CYP1A2 C. Dihydropyrimidine dehydrogenase
D. Glutathione transferase
168. Which of the following CYP450 enzyme is E. N-acetyl transferase
prone to genetic polymorphism?
I. CYP2C9 173. The metabolism of procainamide,
II. CYP2D6 hydralazine, and isoniazid is dependent on this
III. CYP2C19 phase II enzyme:
IV. CYP3A4 A. Uridine Diphosphate (UDP)
glucuronosyltransferase
A. I only B. Thiopurine S-methyltransferase
B. I and II C. Glutathione transferase
C. II and III D. N-acetyltransferase
D. I, II and III E. CYP450 enzyme
E. IV only
174. An assay intended to determine
169. The most highly polymorphic CYP with interindividual variations in DNA sequence
more than 70 allelic variants reported: related to drug absorption and disposition
A. CYP2C9 (pharmacokinetics) or drug action
B. CYP2D6 (pharmacodynamics), including polymorphic
C. CYP2C19 variation in the genes that encode the functions
D. CYP3A4 of transporters, metabolizing enzymes,
E. CYP1A2 receptors, and other proteins:
A. Pharmacogenomic test
170. The most abundant CYP450 in the liver B. Genome determination
and metabolizes over 50% of the clinically used C. Polymorphism test
drugs: D. Pharmacogenetics
A. CYP2C9 E. Pharmacogenetic test
B. CYP2D6
C. CYP2C19 175. An assay intended to study interindividual
D. CYP3A4 variations in whole genome or candidate gene,
E. CYP1A2 single nucleotide polymorphism (SNP) maps,
haplotype markers, or alterations in gene
171. Responsible for the metabolism of about expression or inactivation that may be
completed with pharmacological function and IV. Complete drug absorption
therapeutic response. In some cases, the
pattern or profile of change is the relevant A. I and II
biomaker, rather than changes in individual B. II and III
markers. C. III and IV
A. Pharmacogenomic test D. I and III
B. Genome determination E. IV only
C. Polymorphism test
D. Pharmacogenetics 180. This age group is the most medicated
E. Pharmacogenetic test group of patients receive the highest proportion
of medications:
176. Genome wide analysis of the genetic A. 15-24 yrs
determinants of drug efficacy and toxicity: B. 25-35 yrs
A. Pharmacogenomic test C. 35-45 yrs
B. Pharmacogenomics D. 46-65 yrs
C. Polymorphism test E. >/= 65 yrs
D. Pharmacogenetics
E. Pharmacogenetic test 181. All of the following is/are drug absorption
characteristics for older adults, EXCEPT:
177. The systemic absorption of drug is I. Increased gastric pH
dependent on the following factors, EXCEPT: II. Delayed gastric emptying
A. The physicochemical properties of the drug III. Decreased absorption surface
B. The nature of the drug product IV. Increased gastrointestinal motility
C. The anatomy and physiology of the drug
absorption site. A. I only
D. Drug liberation from the dosage form B. I and II
E. Distribution of drugs to target tissues or organ C. II and III
D. III and IV
178. Which of the following is not an advantage E. IV only
of parenteral route of administration?
I. Drug is given for immediate effect 182. Which of the following is/are true regarding
II. Plasma drug level more precisely controlled transdermal drug absorption?
III. Decrease chance for adverse drug reaction I. Not advisable for older patients
IV. Prevents tissue damage at the site of II. There is a significant difference in absorption
injection of drugs between young and old individuals
III. Applicable for highly lipophilic chemicals
A. I and II IV. Fentanyl is an example of drug administered
B. II and III thru transdermal route
C. III and IV
D. I and III A. I only
E. IV only B. I and II
C. II and III
179. Which of the following is not an advantage D. III and IV
of enteral route of administration? E. IV only
I. No 1st pass effect for buccal or sublingual
route 183. Which of the following is/are true regarding
II. Safeast and easiest route of administration subcutaneous drug absorption?
III. Rectal route is useful for patient who cannot I. Drug absorption is through the vescular
swallow cappilaries and lymphatic channels.
II. Molecular size of the drug primarily
determines the passage across the capillary
endothelium.
III. Subcutaneous absorption of drugs is not
affected by aging
IV. Most common route of administration for
therapeutic peptides and proteins
A. I only
B. I, II and III
C. I, II and IV
D. II, III and IV
E. IV only
184. All of the following are true regarding
pulmonary drug absorption characteristics,
EXCEPT:
A. Age is an important parameter that affects the
pharmacokinetics of inhaled drugs
B. Lung anatomy and physiology change with
age which can affect pulmonary drug absorption
C. Young adults show a decrease of the alveolar
surface, a variation of lung elasticity, and a
decrease of the alveolar capillary volume.
D. There has been very little research for the
pharmacokinetic and pharmacodynamics
characteristics of new inhaled drugs in older
patients.
E. Decrements in cognition, praxis, and
executive function that are highly prevalent in
frail order individuals have a profoundly
detrimental effect on inhaler technique
185. Which of the following are two major factors
of aging on drug distribution?
A. Route of administration and GI motility
B. 1st pass metabolism and drug clearance
C. Tissue fluid pH and urine pH
D. Gastric emptying and intestinal metabolism
E. Plasma protein concentration and body
composition
186. Which of the following are two major drug
binding proteins in the plasma?
A. Albumin and α1-acid glycoprotein
B. Nucleoprotein and albumin
C. Glycoprotein and lipoproteins
D. Enzymes and bile
E. Albumin and lipoprotein
187. Combination of clarithromycin and warfarin
may result to:
A. Decreased warfarin exposure and decreased
anticoagulant effect.
B. Decrease clarithromycin exposure and
decreased antibacterial effect.
C. Risk of increased warfarin exposure and
increased anticoagulant effect.
D. Increased clarithromycin exposure and
increased antibacterial effect.
E. Increased toxicity of clarithromycin and
warfarin
188. Which of the following is the most
appropriate choice related to aging?
A. Increased extracellular fluid volume
B. Increased hepatic blood flow
C. Increased amount of sleep required
D. Increased subcutaneous fat as a percentage
of total body mass
E. Increased size of alveolar ducts in the lung
189. Which of the following is the most
appropriate choice to describe age associated
changes that can affect pharmacokinetics in
older patients?
A. Changes in gastrointestinal function that lead
to reduced drug absorption
B. Increas in total body water
C. Decrease in body fat
D. Decrease in the serum albumin
concentrations with advancing age
E. Decrease in creatinine clearance with
advancing age
190. Which of the following statement regarding
renal function and pharmacokinetics in older
patients is most accurate?
A. Decreased muscle mass in the reason for
normal or low serum creatinine concentration in
older patients even in the presence of
decreased renal function.
B. Renal tubular secretion is not changed with
aging.
C. Serum creatinine concentration of 1.5 mg/dL
reflects normal renal function in older men.
D. Glomerular function always declines with
aging.
E. Gentamicin can be used safely in older
patients with older patients with serum creatinine
concentrations of 1.7 mg/dL
191. Which of the following statements
concerning the safety of medications used by
older patients is wrong?
A. Chlorpropamide can cause hypoglycemia.
B. Benzodiazepines have large volume of
distribution and are thus relatively safe for use in
older people.
C. Amantadine’s excretion depends on renal
function and may cause confusion and falls if the
dose is not adjusted for renal impairment.
D. Diphenhyramine may exacerbate urinariry
retention of older men.
E. Meperidine is not an effective oral analgesic
in dosages commonly used and may cause
neurotoxicity
192. BMI(kg/m2) of an obese patient:
A. <18.5
B. 18.5 - 24.9
C. 25 - 29.9
D. 30 - 39.9
E. 240
193. BMI(kg/m2) of an individual with a normal
body weightt:
A. <18.5
B. 18.5 - 24.9
C. 25 - 29.9
D. 30 - 39.9
E. 240
194. All of the following statements are true
regarding obesity, EXCEPT:
A. Defined as body mass index (BMI) of 30 or
higher and already has been recognized as
“disease”.
B. Obesity related chronic conditions, includes
diabetes, hypertension, high cholesterol, stroke,
heart disease, certain cancers, and arthritis.
C. Obesity was associated with significantly
increased mortality from cardiovascular
diseases and obesity related cancers
D. Clinically, a patient may be considered obese
when the total body (TBW) is equeal to or
greater than 20% of ideal body weight.
E. Individuals with obesity also have significantly
higher health related quality of life scores than
those individuals with normal weight.
195. Which of the following factors listed below
influence drug distribution in the body?
I. 1st pass metabolism
II. Tissue perfusion
III. Tissue membrane permeability
IV. Physicochemical property of drug
A. I, II and III
B. II, III and IV
C. I, II and IV
D. I, III and IV
E. I and IV
196. All of the following are drug distribution
characteristic for obese patient, EXCEPT:
A. The obese individuals have an increased total
tissue mass and adipose tissue mass thereby
increasing volume of distribution
B. Lipophilicity plays a major role in the drug
distribution in obese individuals
C. In the obese patients, lipophilic medications
show a high increased volume of distribution
D. The concentrations of plasma binding
proteins, albumin, α1acid glycoprotein, and
lipoproteins--may be unchanged (albumin),
increased or decreased (α1acid glycoprotein)
with obesity
E. Hydrophillic medications showed a high
increased in volume of distribution in obese
individuals
197. Which of the following is true regarding
pharmacokinetic characteristics of obese
individuals?
I. For Phase 1 metabolism, CYP3A4 activity was
consistently higher in the obese group.
II. Renal clearance is increased in the obese
patients due to increased glomerular filtration
and tubular secretion.
III. Enzyme activities of CYP2E1 and xanthine
oxidase were consistently higher in the obese
group.
A. I only
B. I and II
C. II and III
D. I and III the obese patients.
E. III only E. The size of the kidney is usually smaller in the
obese patients.
For nos. 198-199:
Anjelle, a 45-year old female, was admitted to 202. Which of the following statements most
the hospital with chief complaints of accurately reflects an appropriate drug dosing
shortness of breath, wheezing, chills, and strategy for the obese patients?
fever. Past medical history included A. The TBW should always be used to calculate
hypertension, arthritis, and asthma. The the loading dose for the obese patients.
patient’s weight and height were 300 lb and B. The IBW should always be used to calculate
5’4”, respectively: the loading dose for the obese patients.
C. The TBW should always be used to calculate
198. Which of the following is correct for the the maintenance dose for the obese patients.
patient’s body mass index (BMI)? D. The IBW should always be used to calculate
A. 35 the maintenance dose for the obese patients.
B. 39.3 E. Applying the pharmacokinetic principles and
C. 60.9 using modified weight strategies, combining with
D. 54.2 therapeutic drug monitoring.
E. 51.6
203. Which of the following age range is
199. If this patient has a serum creatinine of 1.0 classified a infant:
mg/dL, calculate her estimated creatinine A. Born at gestational age < 38 weeks
clearance in mL/min using adjusted body weight B. 0-4 weeks postnatal age
(Adj. BW) in the Cockcroft-Gault equation: C. 1 month to 2 years of age (1 month to <12
A. 115.3 months old)
B. 96 D. 2-12 years of age (1-2 years old)
C. 61.3 E. 12-21 years of age (13-16, 18, or 19 years
D. 152.9 old)
E. 120
204. Which of the following age range is
200. Which of the following CYP450 isoenzymes classified as child:
showed a reduced activity in obese patients? A. Born at gestational age < 38 weeks
A. CYP3A4 B. 0-4 weeks postnatal age
B. CYP2E1 C. 1 month to 2 years of age (1 month to <12
C. CYP2C9 months old)
D. CYP2D6 D. 2-12 years of age (1-2 years old)
E. Xanthine oxidase E. 12-21 years of age (13-16, 18, or 19 years
old)
201 Which of the following statements most
accurately reflects the physiological changes 205. Calculation of child dose using Young’s rule
commonly occured with obesity? is based on:
A. Glomerular filtration is usually increased in A. Age
the obese patients. B. Weight
B. Tubular reabsorption is usually increased in C. BSA
the obese patients. D. BMI
C. Tubular secretion is usually decreased in the E. Dosage
obese patients.
D. The activity of uridine diphosphate 206. Calculation of child dose using Young’s rule
glucuronosyltransferase is usually decreased in is based on:
A. Age B. Narrow therapeutic index (NTI) drugs
B. Weight C. Prohibited and restricted drugs
C. BSA D. A or B
D. BMI E. A or C
E. Dosage
210. Which of the following are functions of
207. All of the following are drug absorption Therapeutic drug monitoring services?
characteristics of pediatric patients, EXCEPT: I. Design dosage regimen
A. In neonates, the gastric pH is >4, and gastric II. Perform pharmacokinetic evaluation of drug
empyting and intestinal transit are faster. concentrations
B. In infants, the pH is 2-4 with increasing III. Montior serum drug concentrations
emptying and transit time, but biliary function is IV. Compounding of intravenously administered
near the adult pattern. drug
C. Low gastric pH in neonates and infants result
higher bioavailability (F) of acid labile drugs, A. I and II
such as penicillin G, ampicillin and nafcillin. B. II and III
D. The fast GI transit reduces the rate and C. I, II and III
extent of absorption in neonates, infants, and D. II, III and IV
young children. E. I, II and IV
E. The neonates are difficult to absorb fat
soluble vitamins compared to infants and 211. The dosage of reproducibility ofthe test
children due to the immature biliary function. results obtained by the analysis of the same
samples by different analytical laboratories or by
208. All of the following are drug distribution different instruments.
characteristics of pediatric patients, EXCEPT: A. Precision
A. Changes in plasma protein concentration, B. Sensitivity
total body fat, as well as total body water and C. Accuracy
extracellular water are the three major factors D. Ruggedness
exerting significant effects on drug distribution in E. Specificity
pediatric population.
B. The total body water is low in pediatric 212. The minimum detectable level or
patients resulting to increase volume of concentration of drug in serum that may be
distribution of hydrophilic drugs. approximated as the lowest drug concentration
C. The protein concentrations are low in the that is two or three times in the background
neonates and infants up to one year old noise.
resulting to a high concentration of unbound A. Dynamic range
drug. B. Sensitivity
D. In neonates and young infants, phenytoin has C. Accuracy
a higher unbound fraction of the drug in D. Ruggedness
circulation to exert activity. E. Linearity
E. The age dependent Vd of lipophilic drugs is
less apparent on pediatric population. 213. Measurement of the variability or
reproducibility of the data. Measurement are
209. Defined as those drugs where obtained by replication of various drug
comparetively small differences in dose or concentrations and by replication of standard
concentration lead to dose and concentration concentration curves prepared separately on
dependent, serious therapeutic failures, and/or different days:
serious adverse drug reactions: A. Precision
A. Critical drug dose B. Sensitivity
C. Accuracy D. Sublingual
D. Ruggedness E. Rectal
E. Specificity
219. A dosage form that allowst at least a
214. Refers to the difference between the twofold reduction in dosage frequency as
average assay values and the true or known compared to drug presented as an immediate
drug concentrations: release (conventional) dosage form:
A. Precision A. Extended release drug products
B.Linearity B. Delayed release drug products
C. Accuracy C. Targeted release drug products
D. Ruggedness D. Orally disintegrating tablets
E. Specificity E. Enteric coated tablets

215. Pharmaceutical proudct that delivers a
recombinant gene to somatic cells in vivo
A. Monoclonal antibody
B. Gene therapy
C. Antisense drugs
D. RNAi
D. Bioharmaceutical
216. Drugs that seek to block DNA transcription
or RNA translation in order to moderate many
disease processes.
A. Monoclonal antibody
B. Gene therapy
C. Antisense drugs
D. RNAi
D. Bioharmaceutical
217. Which of the following is not a requirement
for effective oral drug delivery of protein and
peptide drug?
A. Protection of the drug from degradation while
in the harsh environment of the digestive tract.
B. Consistent absorption of the drug in a manner
that meets bioavailability requirements
C. Consistent release of the drug so that it
enters the bloodstream in a reproducible
manner. D. Delivery of the drug through the GI
tract or other organ and maintenance of
pharmacologic effect similar to IV injection.
E. None of these.
220. Developed to disintegrate rapidly in the
saliva after oral administration. The drug is
dispersed in saliva and swallowed with little or
no water.
A. Extended release drug products
B. Delayed release drug products
C. Targeted release drug products
D. Orally disintegrating tablets
E. Enteric coated tablets
221. Dosage form that releases the drug at or
near the intended physiologic site of action:
A. Extended release drug products
B. Delayed release drug products
C. Targeted release drug products
D. Orally disintegrating tablets
E. Enteric coated tablets
222. Designed to release a drug at a
predetermined rate for the constant drug
concentration maintaining during a specific
period of time. The drug may release its
medication properties over a controlled mode
within a certain period where the drug is
released bit by bit in the body.
A. Enteric coated tablet
B. Repeat action tablet
C. Prolonged action drug tablet
D. Sustained release drug product
E. Extended release drug product

218. What is the most frequent route of 223. Drug product designed to produce an
administration of biologic compounds? instant effect where once administered, the
A. Parenteral effects took place immediately and its extended
B. Oral effect would be often happened at an hourly
C. Buccal basis. When the drug concentration goes down,
this drug product may have the capability to B. Minipress XL
maintain the effectiveness by the formulation C. Procardia XL
itself. D. Adalat CR
A. Enteric coated tablet E. Volmax
B. Repeat action tablet
C. Prolonged action drug tablet 228. Extended release tablets for the relief of
D. Sustained release drug product bronchospasm in pateints with reversible
E. Extended release drug product obstructive airway disease
A. DynaCirc CR
224. Type of modified release drug product that B. Minipress XL
is designed to release one dose of drug initially, C. Procardia XL
followed by a second or more doses of drug at a D. Adalat CR
later time: E. Volmax
A. Enteric coated tablet
B. Repeat action tablet 229. Extended release tablets indicated as an
C. Prolonged action drug tablet adjunct to diet for the control of hyperglycemia in
D. Sustained release drug product patients with non-insulin dependent diabetes:
E. Extended release drug product A. Glucotrol XL
B. Covera HS
225. All of the following are advantage of C. Procardia XL
extended release drug product, EXCEPT: D. Adalat CR
I. Sustained therapeutic blood levels of the drug E. Efidac 24
II. Improved patient compliance
III. Reduction in adverse side effects and 230. Systematic, scientific, risk based, holistic,
improvement in tolerability and proactive approach to pharmaceutical
IV. Dose dumping development that begins with predefined
V. Less possibility for high dosage objectives and emphasizes the understanding of
product and processes and process control:
A. I and II A. Quality by design (QbD)
B. II and III B. Process analytical technology (PAT)
C. III and IV C. Process development
D. IV and V D. Design space
E. I and V E. Risk based regulation

226. Defined either as the release of more than 231. The geometrical region suitable for quality
the intended fraction of drug or as the release of manufacturing when two or more
drug at a greater rate than the customary process/material variables are plotted in a two
amount of drug per dosage interval, such that dimensional space to show the combined effects
potentially adverse plasma levels may be of the relevant processing variables during
reached. manufacturing:
A. Drug accumulation A. Quality by design (QbD)
B. Dose dumping B. Process analytical technology (PAT)
C. Prolonged drug release C. Process development
D. Over-extended release D. Design space
E. A or B E. BioRAM

227. Extended release tablets for treatment of 232. Optimizes drug product development and
angina and hypertension: performance by using therapy driven target drug
A. Acutrim delivery profiles as a framework to achieve the
desired therapeutic outcome: E. II, IV and V
A. Quality by design (QbD)
B. Process analytical technology (PAT) 236. The most common way to estimate the
C. Process development ability of the liver to metabolize drug is to
D. Design space determine the Child-Pugh score for a patient. All
E. BioRAM of the following are laboratory tests/clinical
symptoms included in this test, EXCEPT:
233. A system for designing, analysing, and A. Serum albumin
controlling manufacturing through timely B. Total albumin
measurements (ie, during processing) of critical C. Prothrombin time
quality and performance attributes of raw and in D. Kidney encephalopathy
process materials and processes with the goal E. Ascites
of ensuring final product quality:
A. Quality by design (QbD) 237. Which of the following is not true for
B. Process analytical technology (PAT) patients with heart failure?
C. Process development A. There is a decline of hepatic clearance for
D. Design space drugs with moderate-high hepatic extraction
E. Risk based regulation ratio.
B. Increase bioavailability of drugs.
234. Therapeutic equivalence of a generic C. The volume of distribution for some drugs
product with an innovator drug is assumed when decreases in patients with heart failure.
the following conditions are met: D. There is a charge in drug pharmacokinetic
I. They are approved as safe and effective. due to change in renal blood flow.
II. They are pharmaceutical equivalents and E. Hal-life of drug is difficult to predict in patients
bioequivalent. with renal failure
III. They are adequately labeled.
IV. They are manufactured in compliance with 238. The fluid portion of a sample of whole blood
Current Good Manufacturing Practice allowed to clot for 30 minutes before
regulations. centrifugation is:
V. They have the same price. A. Serum
B. Plasma
A. I, II and III C. Serous fluid
B. II, III and IV D. Citrate blood
C. III, IV and V E. Platelet
D. I, II, III and IV
E. I, II, III, IV and V 239. The fluid portion of whole blood centrifuged
before clot formation is called:
235. Pharmaceutical equivalent products may A. Serum
differ in which of the following aspects? B. Plasma
I. Active ingredients C. Serous fluid
II. Excipients D. Citrate blood
III. Impurities E. Platelet
IV. Release mechanism
V. Dosage form 240. Which of the following drugs listed below
has the least percentage of protein binding?
A. I, II and III A. Ampicillin
B. II, III and IV B. Chloramphenicol
C. III, IV and V C. Lidocaine
D. I, II and V D. Phenytoin
E. Vancomycin
246. Which of the following drugs listed below is
241. Which of the following drugs listed below a substrate of CYP2D6 isoenzyme?
has the highest percentage of protein binding? A. Caffeine
A. Ampicillin B. Paclitaxel
B. Chloramphenicol C. Phenytoin
C. Lidocaine D. Alcohol
D. Phenytoin E. Codeine
E. Vancomycin
247. Which of the following is not a prodrug?
242. Which of the following statements best A. Azathioprine
describes F? B. Prednisone
A. Rate of absorption of the administered drug C. Zidovudine
into the systemic circulation. D. Morphine
B. Amount of administered drug that reaches the E. Enalapril
systemic circulation.
C. Speed at which the administered drug 248. All of the following are true regarding drug
reaches the systemic circulation. elimination by the kidney, EXCEPT:
D. Fraction of the administered drug that A. Most drugs, unless highly bound to plasma
reaches the systemic circulation. protein, cross the glomerular filter freely.
E. Amount of drug absorbed after drug B. Many drugs, especially weak acids and weak
dissolution. bases, are actively secreted into the renal tubule
and thus more rapidly excreted.
243. If 500 mg of a drug is given orally and 250 C. Water soluble drugs are passively
mg is absorbed into the systemic circulation, reabsorbed by diffusion across the tubule, so
What is F? are not efficiently excreted in the urine.
A. 0.2 D. Because of pH partition, weak acids are more
B. 0.3 rapidly excreted in alkaline urine, and vice versa.
C. 0.4 E. Several important drugs are removed
D. 0.5 predominantly by renal excretion, and are liable
E. 0.6 to cause toxicity in elderly persons and patients
with renal disease.
244. Antifungal drug used to treat systemic
mycoses which is available in a liposomal 249. A requirement imposed by the Food and
formulation that is less nephrotoxic and better Drug Administration for in vitro and/or in vivo
tolerated than the conventional form: testing for specified drug products, which must
A. Heparin be satisfied as a condition of marketing.
B. Levodopa A. Bioavailability requirement
C. Amphotericin B. Bioequivalence requirement
D. Nystatin C. Blowaiver
E. Griseofulvin D. Regulatory requirement
E. Bioassay
245. Which of the following drug is present in the
extracellular fluid compartment of the body? 250. Drug products that contain the identical
A. Phenytoin therapeutic moiety, or its precursor, but not
B. Ethanol necessarily in the same amount of dosage form
C. Morphine as the same salt or ester:
D. Gentamicin A. Pharmaceutical equivalents
E. Haloperidol B. Bioequivalent
C. Pharmaceutical alternative
D. Therapeutic equivalence 255. The systemic exposure of a drug in a
E. Therapeutic equivalent designated formulation (generally referred to as
treatment A or reference formulation) is
251. Multisource drug product that has been compared with that of the same drug
approved by the FDA as a therapeutic administered in a reference formulation
equivalent to the reference listed drug product (generally referred to as treatment B or test
(usually the brand or innovator drug product) formulation):
and has proven equivalent drug product A. Bioavailability
performance: B. Bioequivalence
A. Innovator drug product C. Relate bioavailability
B. Orphan drug D. Biowaiver
C. Experimental drug E. Absolute bioavailability
D. Generic drug product
E. Pharmaceutical equivalent product For nos. 256-257
The bioavailability of a new investigational
252. Defined as the rate and extent to which the drug was studied in 12 volunteers. Each
active ingredient or active moiety is absorbed volunteer received either a single oral tablet
from a drug product and becomes available at containing 200 mg of the drug. 5 mL of a
the site of action: pure aqueous solution containing 200 mg of
A. Bioavailability the drug, or a simple IV bolus injection
B. Bioequivalence containing 50 mg of the drug. Plasma
C. Drug absorption samples were obtained periodically up to 48
D. Biowaiver hours after the dose and assayed for drug
E. Drug liberation concentration. The average AUC values (0-48
hours) are given in the table below:
253. Defined as the absence of a significant
difference in the rate and extent to which the Drug Dose AUC (µg · Standard
active ingredient or active moiety becomes product h/mL) Deviation
available at the site of drug action when
Oral 200 59.5 19.7
administered at the same molar dose under
tablet
similar conditions in an appropriately designed
study.
Oral 200 86.1 18.1
A. Bioavailability
solution
B. Bioequivalence
C. Relate bioavailability IV bolus 50 37.5 5.7
D. Biowaiver injection
E. Absolute bioavailability

254. Compares the bioavailability of the active 256. From these data, calculate the relative
drug in the systemic circulation following bioavailability of the drug from the tablet
extracellular administration which the compared to the oral solution:
bioavailability of the same drug following A. 100%
intravenous administration. B. 101%
A. Bioavailability C. 102%
B. Bioequivalence D. 103%
C. Relate bioavailability E. 104%
D. Biowaiver
E. Absolute bioavailability 257. The absolute drug bioavailability from the
tablet is calculated: B. II and III
A. 35.9% C. III and IV
B. 45.5% D. I, II and III
C. 59.2% E. II, III and IV
D. 61.9%
E. 70.1% 262. Defined by the USP-NF ( National
Formulary) as “that state in which any residues
258. Which of the following is not a drug of the table except fragments of insoluble
absorption rate limiting step for solid oral, coating, remaining on the screen of the test
immediate release drug products? apparatus in the soft mass have no palpably fil
A. Disintegration of the drug product core:
B. Subsequent release of the drug A. Complete dissolution
C. Dissolution of the drug in an aqueous B. Complete absorption
environment C. Complete drug liberation
D. Absorption across cell membranes into the D. Complete disintegration
systemic circulation E. A or B
E. Drug protein binding
263. The process by which a solid drug
259. Which of the following is the slowest step substance become dissolved in a solvent over
and therefore exerts a rate limiting effect on time:
drugs that have very poor aqueous solubility? A. Dissolution
A. Disintegration of the drug product B. Disintegration
B. Subsequent release of the drug C. Absorption
C. Dissolution of the drug in an aqueous D. Liberation
environment E. Solubilization
D. Absorption across cell membranes into the
systemic circulation 264. The physicochemical property gives some
E. Drug protein binding indication of the relative affinity of the drug for oil
and water. A drug that has high affinity for oil
260. For an orally administered drug that has a may have poor release and dissolution from the
high aqueous solubility, which is the rate limiting drug product:
step for drug absorption? A. Hygroscopicity
A. Disintegration of the drug product B. Polymorphism
B. Subsequent release of the drug C. pKa and pH
C. Dissolution of the drug in an aqueous D. Particle size
environment E. Partition coefficient
D. Absorption across cell membranes into the
systemic circulation 265. Which of the following is true regarding
E. Drug protein binding solubility-pH profile of a drug?
I. An acidic drug is more soluble in an acidic
261. Solid drug products exempted from medium, forming a soluble salt.
disintegration tests includes which of the II. A basic drug is more soluble in the intestine,
following? forming a soluble salt.
I. Troches III. The solubility-pH profile gives a rough
II. Tablets that are intended to be chewed estimation the completeness of dissolution for a
III. Drug products intended for sustained release dose of a drug in the stomach or in the small
IV. Sugar coated tablet intestine.

A. I and II A. I only
B. I and II I. Paddle over disk
C. II and III II. Cylinder
D. I and III III. Diffusion cell
E. III only IV. Reciprocating
V. Reciprocating disk
266. Which of the following is true regarding
particle size and drug absorption? A. I and II
I. Dissolution rate is proportional to the surface B. II and III
area of the drug. C. I, II and III
II. The effective surface area of a drug is D. II, III and IV
decreased enormously by a reduction in the E. V only
particle size.
III. Reduction of particle size increases the 271. Static diffusion system that is used for
absorption of the drug characterizing drug permeation through a skin
model. They are commercially available to
A. I only characterize in vitro drug release and drug
B. I and II permeation kinetics from topically applied
C. II and III dosage form (eg. Ointment, cream) or
D. I and III transdermal drug product:
E. III only A. Paddle over disk
B. Reciprocating disk
267. Which of the following drug excipients C. Intrinsic Dissolution method
increases the absorption rate constant of a D. Rotating Bottle Method
durg? E. Franz diffusion cell
A. Lubricants
B. Disintigrants 272. A scientific framework for classifying drug
C. Enteric coating substances based on their aqueous solubility
D. Sustained release agents and intestinal permeability:
E. Coating agent A. Biopharmaceutics classification system (BCS)
B. Pharmacokinetics classification system (PCS)
268. USP=NF dissolution apparatus for C. Absorption classification system (ACS)
extended release drug products: D. Permeation classification system (PCS)
A. Apparatus 1 E. Solubility classification system (SCS)
B. Apparatus 2
C. Apparatus 3 273. Biopharmaceutics classification system
D. Apparatus 4 (BCS) class for drug substances with high
E. Apparatus 5 solubility and low permeability:
A. Class 1
269. USP-NF dissolution apparatus for drug B. Class 2
products containing low water soluble drugs: C. Class 3
A. Rotating basket D. Class 4
B. Paddle E. Class 5
C. Reciprocating cylinder
D. Flow cell 274. Biopharmaceutics classification system
E. Paddle over disk (BCS) class for drug substances with low
solubility and low permeability:
270. Which of the following dissolution A. Class 1
apparatus is/are used for transdermal drug B. Class 2
products? C. Class 3
D. Class 4 279. These excipients are incorporated into the
E. Class 5 drug product to promote systemic drug
absorption from the application site:
275. All of the following are true regarding A. Absorption enhancers
colonic drug delivery, EXCEPT: B. Permeation enhancers
A. Drugs that are destroyed following oral C. Systemic enhancers
administration by the acidic environment of the D. A or B
stomach or metabolized by enzymes may only E. A or C
be slightly affected in the colon.
B. Crohn’s disease may be more effectively 280. Part of the skin that is the major barrier to
treated by direct drug delivery to the colon. systemic drug absorption of transdermal
C. Drug delivery to the colon is highly influenced products:
by several factors including high bacterial level. A. Stratum granulosum
D. Drugs such as metropolol, nonsteroidal anti- B. Stratum corneum
inflammatory drugs (NSAIDs), steroids, C. Stratum lucidum
peptides, and vaccines are well absorbed in the D. Stratum spinosum
colon. E. Stratum basale
E. Not recommended for the delivery of proteins
and therapeutic peptides 281. Estraderm®, an estradiol transdermal
contains ethanol which serves as which of the
276. Which of the following is true for rectal following?
route of administration? A. Provide a soothing effect to the skin
A. Many drugs are poorly or erratically absorbed B. Promotes drug delivery to the stratum
across the rectal mucosa. corneum
B. Release of drug from a suppository does not C. Increases stability of the patch
depend on the composition of the suppository D. Prevents microbial growth on the patch
base. E. Potentiate the effect of the patch
C. Not applicable for synthetic drug delivery.
D. Slow absorption of low molecular weight 282. A technique using a small electric charge to
drugs. deliver drug containing an ionic charge through
E. Prone to 1st pass metabolism. the stratum corneum:
A. Charge induction
277. The component of transdermal patch is B. Ionic charge delivery
important for maintaining uninterrupted skin C. Sonophoresis
contact for drug diffusion through the skin: D. Electrophoresis
A. Backing or support layer E. Iontophoresis
B. Drug layer
C. Release-controlling layer 283. This parenteral route of administration is
D. Pressure-sensitive adhesive often used for allergy and other diagnostic tests,
E. Protective strip such as tuberculosis:
A. Intradermal injection
278. Ethylvinyl copolymer is a component of B. Intra-arerial injection
which of the following part of transdermal patch? C. Intrathecal injection
A. Backing or support layer D. Subcutaneous injection
B. Drug layer E. Intravenous infusion
C. Release-controlling layer
D. Pressure-sensitive adhesive 284. Parenteral route of administration generally
E. Protective strip used for insulin injection:
A. Subcutaneous injection
B. Intravenous injection
C. Intramuscular injection
D. Intravenous infusion
E. Intradermal injection
285. Which of the following is the safest and
easiest route of drug administration?
A. Intravenous
B. Rectal (PR)
C. Oral (PO)
D. Inhalation
E. Intranasal
286. In drug absorption, some polar molecules
may not be able to traverse the cell membrane
but, instead, go through gaps or tight junctions
betwell cells, this process is known as:
A. Transcellular absorption
B. Lipid diffusion
C. Facilitated diffusion
D. Paracellular drug diffusion
E. Active transport
287. Cell membrance structure theory that
states that the plasma membrane is composed
of two layers of phospholipid between two
surface layers of proteins, with hydrophilic
“head” groups of the phospholipids facing the
protein layers and the hydrophobic “tail” groups
of the phospholipids aligned in the interior
A. Unit membrane theory
B. Fluid mosaic model
C. Drug absorption theory
D. Hydrophilic-lipophilic balance theory
E. Phospholipid theory
288. According to this, the cell membrane
consists of globular proteins embedded in a
dynamic fluid, lipid bilayer matrix. These proteins
provide a pathway for the selective transfer of
certain polar molecules and charged ions
through the lipid barrier:
A. Unit membrane theory
B. Fluid mosaic model
C. Drug absorption theory
D. Hydrophilic-lipophilic balance theory
E. Phospholipid theory
289. According to the pH partition hypothesis, if
the pH on one side of a cell membrane differs
from the pH on the other side of the membrane,
then,
A. The drug (weak acid or base) will ionize to
different degrees on respective sides of the
membrane.
B. The total drug concentrations (ionized plus
non-ionized drug) on either side of the
membrane will be equal.
C. Compartment in which the drug is more
highly ionized will contain the greater drug
concentration
D. A and B
E. A and C
290. A carrier-mediated transport system,
differing from active transport in that the drug
moves along a concentration gradient:
A. Endocytosis
B. Passive diffusion
C. Pinocytosis
D. Facilitated diffusion
E. Convective transport
291. Defined as a series of structurally related
chemical compounds that have shown
interesting pharmacological activity and from
which drug candidates may be selected:
A. Leads
B. Drug candidates
C. Drug substances
D. Active pharmaceutical Ingredient
E. Drug product
292. Defined as pharmacologically active
compounds undergoing evaluation of their
potential as future drug substances:
A. Leads
B. Drug candidates
C. Drug substances
D. Active pharmaceutical Ingredient
E. Drug product
293. The most important class of hydrolysis
reactions influencing the stability of prod-drug
and drug candidates:
A. Hydrolysis of esters
B. Hydrolysis of amides
C. Hydrolysis of carboxyl functional groups
D. Hydrolysis of alcohols stomach at fasting state?
E. Hydrolysis of imides A. 2.1-3.4
B. 4.2-5.1
294. Which of the following hydrolysable C. 1.1-2.0
carboxyl compound is present on acetyl salicylic D. 4.1-5.2
acid (ASA)? E. 1.5-2.9
A. Imide
B. Amide 299. The most common dissolution theory. This
C. Alcohol theory assumes that the dissolution rate is
D. Ester transport-rate controlled, and in fact mos
E. Lactam dissolution processes are controlled by this
diffusion-convection-controlled step.
295. Lipinski’s rule of five is based on an A. Reaction rate theory
analysis of keyl physicochemical properties of B. Film theory
drug substances in the World Drug Index. The C. Noyes whitney
rule is based on four physicochemical D. Fick’s theory
parameters that are globally associated with E. Transport rate theory
solubility and permeability, and it states that
drug substances are most likely to have good 300. Cell lines used for hepatic drug uptake and
bioavailability when the following four metabolism that have also been developed to
parameters listed below are fulfilled, EXCEPT: serve as a tool for biotransformation studies in
A. Number of hydrogen bond (H-bond) donors conjuction with drug transport:
<5 A. Caco-2 cells
B. Number of H-bond acceptors <10 B. MDCK cell line
C. Molecular weight (MW) is <500 C. HepG2
D. Logarithm of the calculated octanol/water D. MDCK-MDR1
partition coefficient, logP<5 E. HT-29
E. Number of functional groups present <5

296. Carriers that have two or more substrates

moving in one direction during the transport
process are called:
A. Antiports
B. Symports
C. Active transporters
D. Enzyme
E. Bioports

297. Cell culture which serves as an easy

screen of drug permeation and for prediction of
human intestinal permeability and fraction of the
oral dose absorbed in man:
A. Caco-2 cells
B. MDCK cell line
C. HepG2
D. MDCK-MDR1
E. HT-29

298. Which of the following is the pH of the


Module 4 New PACOP
PHARMACOLOGY
1. Mechanism of action of local anesthetics
A. Block sodium channel thereby
stopping axonal conduction
B. Block alpha and beta receptor
C. Block neuronal firing by decreasing
Ach in the neuromuscular junction
D. Inhibition of acetyl cholinesterase
enzyme
E. Inhibition of enzyme responsible for
pain response
2. The following are factors that affect the
absorption of drug from the
gastrointestinal (GI) tract except:
A. Surface area absorption
B. Blood flow to the site of absorption
C. Physical state of the drug
concentration of the drug at the site
of absorption
D. Concentration of the drug at the site
of absorption
E. Protein binding
3. Continues stimulation of cells with
agonist generally results in which of the
following?
A. Desensitization
B. Up-regulation
C. Down-regulation
D. A and B
E. A and C
4. Drug that lacks intrinsic efficacy but
retains affinity and competes with
agonist for the binding site on the
receptor
A. Competitive antagonist
B. Full agonist
C. Non-competitive antagonist
D. Partial antagonist
E. Partial agonist
5. This type of drug produces its effect by
binding a site on the receptor
distinctfrom that on the primary agonist
and thereby changing the affinity of the
receptor for the agonist
A. Competitive antagonist
B. Full agonist
C. Non-competitive antagonist
D. Partial antagonist
E. Partial agonist
6. In this type of study, participants are
blinded to treatment assignment, but
investigators are not.
A. Double blind study
B. Single blind study
C. Masking
D. Open-label
E. Un-blinded study
7. The neurotransmitter of preganglionic
autonomic fibers, and all postganglionic
parasympathetic fibers:
A. Norepinephrine
B. Noradrenaline
C. Acetylcholine
D. A and B
E. A and C
8. The release of ach and other
neurotransmitter by exocytosis is
inhibited by:
A. Acetylcholinesterase
B. Botulinum toxin
C. Reserpine
D. Metyrosine
E. Guanethodine
9. All of the following are enzymes
involved in the biosynthesis of
epinephrine from tyrosine except:
A. Tyrosine hydroxylase
B. Aromatic L-amino acid
decarboxylase
C. Dopamine beta-hydroxylase
D. Phenylethanolamine-N-Methyl
transferase
E. Monoamine oxidase
10. Rate limiting enzyme in the synthesis of
catecholamines:
A. Tyrosine hydroxylase
B. Aromatic L-amino acid
decarboxylase
 C. Dopamine beta-hydroxylase 16. Major contraindications to the use of the
D. Phenylethanolamine-N-Methyl muscarinic agonist are the following,
transferase EXCEPT:
E. COMT A. Asthma
11. All of the following are effects of B. Hyperthyroidism
activating beta 2 receptor, EXCEPT: C. Coronary insufficiency
A. Bronchoconstriction D. Acid-peptic disease
B. Uterine relaxation E. Hypertension
C. Glyconeolysis 17. Use in the treatment of glaucoma where
D. Gluconeogenesis it is instilled into the eye usually at 0.5-
E. Bronchodilation 4% solution?
12. All of the following are effects of A. Epinephrine
activating alpha 1 receptor, EXCEPT: B. Eye-Mo®
A. Vascular smooth muscle relaxation C. Pilocarpine
B. Intestinal smooth muscle relaxation D. Bethanecol
C. Increase contractile force of the E. Atropine
heart 18. Most effective prophylactic agent for
D. Glyconeolysis in the liver short (4-6hours) exposures to severe
E. Vascular smooth muscle motion, also available as transdermal
constriction patch
13. Which of the following is a A. Atropine
pharmacological effect of muscarinic B. Scopolamine
stimulation in the cardiovascular C. Ipratropium
system? D. Tiotropium
A. Vasoconstriction E. Varenicline
B. Decrease in cardiac rate 19. Which of the following drug/s is/are
C. Positive chronotropic rate classified as acetylcholinesterase
D. Positive dromotropic rate inhibitor?
E. Positive inotropic rate I. Pilocarpine
14. All of the following are naturally II. Edrophonium
occurring cholinomimetic alkaloid, III. Tacrine
EXCEPT: IV. Atropine
A. pilocarpine A. I only
B. Muscarine B. I and II
C. Acetylcholine C. II and III
D. Arecoline D. I,II, and III
E. NOTA E. IV only
15. Which of the following is/are effects of 20. Whichof the following is not an effect of
cholinomimetic drugs? anti-cholinesterase agents?
I. Stimulation of GI smooth muscle A. Stimulation of muscarinic receptor
II. Stimulation of secretion of responses at autonomic effector
exocrine glands organs
III. Bronchoconstriction B. Stimulation followed by depression
IV. Tachycardia or paralysis of all autonomic ganglia
A. I and II and skeletal muscle
B. II and III C. Stimulation with occasional
C. I, II, and III subsequent depression of
D. I and IV cholinergic receptor sites in the CNS
E. All of the above D. AOTA
 E. NOTA obstruction) or chronic obstructive
21. Intoxication with an organophosphorous pulmonary disease(COPD)
anti-cholinesterase agent can be treated A. Beta 1 adrenergic agonist
with B. Beta 2 adrenergic agonist
A. Atropine C. Beta 1 adrenergic antagonist
B. Pralidoxime D. Beta 2 adrenergic antagonist
C. Malathion E. Non selective beta agonist
D. A and B 27. Potent, non-selective beta receptor
E. B and C agonist with every low affinity for alpha
22. This agent is used in the diagnosis of receptors
myasthenia gravis A. Ipratropium
A. Edrophonium B. Terbutaline
B. Atropine C. Isoproterenol
C. Neostigmine D. Prazosin
D. Pralidoxime E. Phenylephrine
E. Acetylcholine 28. This sympathomimetic drug is indicated
23. All are standards anti-cholinesterase for the short term treatment of cardiac
drugs used in the symptomatic decompensation post cardiac surgery or
treatment of myasthenia gravis, in patients with congestive heart failure
EXCEPT: or acute myocardial infarction
A. Pyridostigmine A. Dobutamine
B. Neostigmine B. Isoproterenol
C. Atropine C. Metaproterenol
D. Ambenonium D. Albuterol
E. Edrophonium E. Isoetharine
24. MOA of indirect acting sympathomimetic 29. Selective beta 2 agonist originally
drugs developed as uterine relaxant
A. Agents act directly on one or more A. Terbutaline
of the adrenergic receptors thereby B. Ritodrine
producing an effect C. Oxytocin
B. Increase the availability of D. Prazosin
norepinephrine (NE) or epinephrine E. Salmeterol
(Epi) to stimulate adrenergic 30. Life-threatening condition characterized
receptors by inadequate perfusion of tissues,
C. Releasing or displacing NE from hypotension, and, ultimately, failure of
sympathetic nerve varicosities organ system
D. A and B A. Coma
E. B and C B. Shock
25. Me3tabloic precursor of NE and EPI is C. Arrhythmia
also a neurotransmitter particularly D. Heart failure
important in the regulation of movement E. Kidney failure
A. Dopamine 31. Structurally related to amphetamine, this
B. Serotonin drug is a mild CNS stimulant with more
C. Oxytocin prominent effect on mental than motor
D. Norepinephrine activities. This drug is also effective in
E. Noradrenaline the treatment of narcolepsy and ADHD.
26. These drugs play a major role only in A. Methamphetamine
the treatment of bronchoconstriction in B. Ephedrine
patients with asthma (reversible airway C. Clonidine
 D. Methylphenidate E. Pilomotor smooth muscle
E. Phenobarbital contraction
32. Classified as alpha 2 selective 38. Which of the following hypnotic is a
antagonist benzodiazepine derivative?
A. Phenoxybenzamine A. Zolpidem
B. Prazosin B. Flurazepam
C. Yohimbinhe C. Secobarbital
D. Nadolol D. Ramelteon
E. Metoprolol E. Buspirone
33. Classified as beta 1 selective antagonist 39. Which of the following hypnotic drug
A. Phenoxybenzamine increases the activity of hepatic drug-
B. Prazosin metabolizing enzyme systems?
C. Yohimbinhe A. Phenobarbital
D. Nadolol B. Zolpidem
E. Metoprolol C. Flurazepam
34. Used in the treatment of D. Secobarbital
pheocromocytoma, tumors of the E. Ramelteon
adrenal medulla and sympathetic 40. Which of the following is the mechanism
neurons that secretes enormous of barbiturate action?
quantities of catecholamines A. Increasing the duration of the
A. Phenoxybenzamine GABA-gated Cl- channel openings
B. Epinephrine B. Directly activating the chloride
C. Metoprolol channels
D. Dopamine C. Increasing the frequency of Cl-
E. Isoxuprine channel opening events
35. Which of the following is not correct? D. Antagonist of benzodiazepine
A. Alpha agonist cause miosis binding site on the GABAA receptor
B. Alpha agonist cause E. Partial agonist at 5-HT receptors but
vasoconstriction also affinity for D2 receptor
C. Beta antagonist decrease the 41. The usual case of adverse effect/death
formation of aqueous humor due to overdose of hypnotic drug is due
D. Beta 2 agonist cause to
bronchodilation A. Depression of the CNS
E. Beta 3 agonist cause lipolysis B. Heart attack
36. Beta 2 receptor stimulation includes all C. Hypothermia
of the following effects EXCEPT D. Cerebral edema
A. Stimulation of renin secretion E. Status epilepticus
B. Fall of potassium concentration in 42. Which of the following anti-seizure drugs
plasma produces a voltage dependent
C. Relaxation of bladder, uterus inactivation of sodium channels?
D. Uterine muscle contraction I. Phenytoin
E. Skeletal muscle contraction II. Carbamazepine
37. Which of the following effects is III. Vigabatrin
associated with beta 3-receptor IV. Gabapentin
stimulation A. I only
A. Lipolysis B. I and II
B. Decrease in platelet C. II and III
C. Bronchodilation D. IIandIV
D. Tachycardia E. IV only
43. Mechanism of action of phenytoin D. MAO-A metabolizes dopamine,
A. Block high-frequency firing of MAO-B metabolizes norepinephrine
neurons through action of voltage- and serotonin
gated (VG) Na+ Channels E. D. MAO-A metabolizes dopamine,
B. It binds to an allosteric regulatory MAO-B metabolizes norepinephrine
site on the GABA-BZ receptor and 48. A catechol-O-methyltransferase
prolongs of the Cl- Channels inhibitor, which prolongs the action of
C. It effects on Ca2+ currents, reducing levodopa by diminishing its peripheral
the low threshold (T-type) current metabolism
D. It inhibits GABA-transaminase, A. Carbidopa
which catalyzes the breakdown of B. Clozapine
GABA C. Tolcapone
E. Decreases excitatory transmission D. Resagiline
by acting on VG Ca2+ channels E. Selegiline
presynaptically 49. Mu receptor are associated with
44. The pathophysiologic basis for anti- A. Supraspinal and spinal analgesia,
parkinsonism therapy is sedation, respiratory depression,
A. The loss of dopaminergic neurons and slowed GI transit
B. The loss of some cholinergic B. Spinal analgesia, mydriasis,
neurons sedation, physical dependence
C. The loss of GABAnergic cells C. Dysphoria, hallucinations,
D. The loss of glutamatergic neurons respiratory and vasomotor
E. Abnormal firing of neurons from the stimulation
CNS D. Analgesia, euphoria, respiratory
45. Which of the following drugs is used in stimulation, physical dependence
the treatment of parkinsonian disorder? E. CNS stimulation and respiratory
A. Phenytoin stimulation
B. Selegeline 50. Which of the following opioid analgesic
C. Haloperidol is a strong mu receptor agonist?
D. Fluoxetine A. Morphine
E. Aspirin B. Pentazocine
46. The mechanism of action of carbidopa is C. Buprenorphine
A. Stimulating the synthesis, release, D. Naloxone
or reuptake of dopamine E. Prrpoxyphene
B. Inhibition of dopa decarboxylase 51. Which of the following agents is a full
enzyme antagonist of opioid receptors?
C. Stimulating dopamine receptors A. Meperidine
D. Inhibition of COMT B. Buprenorphine
E. Monoamine oxidase inhibitor C. Naloxone
47. Which of the following statement is D. Butorphanol
correct E. Morphine
A. MAO-A metabolizes dopamine, 52. The diagnostic triad of opioid
MAO-B metabolizes serotonin overdosage is
B. MAO-A metabolizes norepinephrine A. Mydriasis, coma and
and dopamine, MAO-B metabolizes hyperventilation
serotonin B. Coma, depressed respiration and
C. MAO-A metabolizes norepinephrine miosis
and serotonin, MAO-B metabolizes C. Mydriasis, chills, and abdominal
dopamine cramps
 D. Miosis, tremor and vomiting 58. Recommendations on dietary
E. Mydriasis, diarrhea increase approaches to stop hypertension
urination (DASH)
53. Which of the following non-narcotic A. High intake of fruits
agents is salicylic derivative? B. Low fat dairy product along with a
A. Phenylbutazone reduced content of dietary
B. Ketamine cholesterol, saturated fat and total
C. Aspirin fat
D. Tramadol C. The diet is rich in potassium and
E. Diclofenac calcium, and low sodium
54. Correct a statement concerning aspirin D. High intake of vegetables
include the following, EXCEPT E. AOTA
A. Irreversibly inhibit platelet COX 59. Recommended blood pressure targets
B. Main adverse effect at for patients with heart failure
antithrombotic doses are gastric A. <150/<90
upset (intolerance) and gastric and B. <140/<90
duodenal ulcer C. <140/<80
C. It inhibits platelet aggregation D. <160/<90
D. Safe to use in patient with E. <130/<80
hemophilia 60. Increase the secretion of NA+, Cl+, and
E. Epidemiologic studies suggest that H2O by inhibiting NA+/Cl- ion exchange
long term use of aspirin at low in the early part of the distal tubule
dosage is associated of colon A. Thiazide diuretics
cancer B. Loop diuretics
55. A drug that inhibits HMG-CoA C. Potassium sparring diuretics
reductase, it also reduces cholesterol D. Aldosterone antagonist
synthesis and up-regulate low-density E. Osmotic pressure
lipoprotein(LDL) receptors of hepatocyte 61. Drug that antagonize angiotensin II at
A. Fenofibrates the AT1 receptor subtype, which
B. Colestipol decreases systemic vascular resistance
C. Ezetimibe A. Furosemide
D. Atorvastatin B. Amiloride
E. Niacin C. Metoprolol
56. A vasodilator that also inhibits platelet D. Captopril
function by inhibiting adenosine uptake E. Losartan
and CGMP phosphodiesterase activity 62. Reduce both resting and exercise heart
A. Dypiridamole rate, cardiac output, and both systolic
B. Abciximab and diastolic blood pressure
C. Cilostazol A. Furosemide
D. Anistreplase B. Amiloride
E. Streptokinase C. Metoprolol
57. The mathematical product of peripheral D. Captopril
vascular resistance (PVR) and Cardiac E. Losartan
output (CO) 63. Block the conversion of angiotensin I to
A. Hypertension angiotensin II by interfering with
B. Blood pressure angiotensin converting Enzyme (ACE)
C. Hypotension activity
D. Vascular pressure A. Furosemide
E. Afterload B. Amiloride
 C. Metoprolol E. Pernicious anemia
D. Captopril 69. Required for biosynthesis of heme and
E. Losartan heme-containing proteins, including
64. A condition of chronic excess total body hemoglobin and myoglobin
iron caused either by an inherited A. Deferoxamine
abnormality of iron absorption or by B. Vitamin B12
frequent transfusion to treat certain C. Folic acid
types of hemolytic disorder D. Ferrous sulfate
A. Hemochromatosis E. Filgastrim
B. Megaloblastic anemia 70. Stimulates G-CSF receptors expressed
C. Microcytic anemia on mature neutrophils and their
D. Neutropenia progenitors for the treatment of
E. Pernicious anemia neutropenia:
65. A deficiency in serum hemoglobin and A. Deferoxamine
erythrocytes in which the erythrocytes B. Vitamin B12
are abnormally large. Results from C. Folic acid
either folate or vitamin B12 deficiency D. Ferrous sulfate
A. Hemochromatosis E. Filgastrim
B. Megaloblastic anemia 71. An endogenous anticlotting protein that
C. Microcytic anemia irreversibly inactivates thrombin and
D. Neutropenia factor Xa. Its enzymatic action is
E. Pernicious anemia markedly accelerated by the heparins
66. A deficiency in serum hemoglobin and A. Antithrombin III
erythrocytes in which the erythrocytes B. GIycoprotein Ilb/Illa
are abnormally small. Often caused by C. Clottin cascade
iron deficiency. D. Prothrombin
A. Hemochromatosis E. A and B
B. Megaloblastic anemia 72. A protein complex on the surface of
C. Microcytic anemia platelets. When activated, it aggregates
D. Neutropenia platelets primarily by binding to fibrin.
E. Pernicious anemia A. Antithrombin Ill
67. An abnormally low number of B. GIycoprotein Ilb/Illa
neutrophils in the blood; patients with C. Clottin cascade
this condition are susceptible to serious D. Prothrombin
infection E. A and C
A. Hemochromatosis 73. Laboratory test used to monitor the
B. Megaloblastic anemia anticoagulant effect of unfractionated
C. Microcytic anemia heparin and direct Thrombin inhibitors;
D. Neutropenia prolonged when drug effect is adequate
E. Pernicious anemia A. Activated partial Thromboplastin
68. A form of megaloblastic anemia time (aptt) test
resulting from deficiency of intrinsic B. Clotting cascade
factor, a protein produced by gastric C. Prothrombin time (PT) test
mucosal cells and required for intestinal D. Platelet test
absorption of vitamin B12 E. Coagulase test
A. Hemochromatosis 74. Laboratory test used to monitor the
B. Thrombocytopenia anticoagulant effect of warfarin;
C. Microcytic anemia prolonged when drug effect is adequate
D. Neutropenia
 A. Activated partial Thromboplastin 80. The following has an excellent efficacy
time (aptt) test on infection caused by Pneumocystic
B. Clotting cascade jiroveci pneumonia, except
C. Prothrombin time (PT) test A. Penicillin
D. Platelet test B. Dapsone
E. Coagulase test C. Atrovaquone
75. Which of the following are classified as D. Trimetoprim-sulfamethoxazole
thrombolytic agents? E. NOTA
I. Streptokinase 81. First line drug in treating early stage of
II. Warfarin infection caused by West African
III. T-PA Derivatives trypanosomiasis
IV. Heparins A. Pentamidine
A. I and II B. Melarsoprol
B. II and III C. Metronidazole
C. I and III D. Iodoquinol
D. II and IV E. Tetracycline
E. IV only 82. It inhibits topoisomerase II and has a
76. . What is the bactericidal concentration side effect of alopecia and
of ethanol and isopropanol by volume in myelosuppression
water? A. Irinotecan
A. 60 — 90% B. Etoposide
B. 30 — 50% C. Paclitaxel
C. 70 — 99% D. Vinblastine
D. 80 — 100% E. Vincristine
E. 10 - 20 % 83. The FDA approved a novel, oral and
77. It is a destruction or marked reduction in highly selective small molecule inhibitor
number of activity of microorganisms of BRAFV600E last August 2011 and
A. Antisepsis has a highly promising activity in
B. Decontamination metastatic melanoma. What drug is
C. Disinfection this?
D. Sterilization A. Lomustine
E. Sterilization B. Camustine
78. it contains 2% Iodine and 2.4% Nal in C. Cyclophosphamide
alcohol and is the most active antiseptic D. Vemurafenib
for intact skiN E. Etoposide
A. lodophors 84. It is an immunosuppressant macrolide
B. Povidone iodine antibiotic produced by Steptomyces
C. Tincture of Iodine USP tsukabaensis
D. Iodine solution A. Cyclosporine
E. Both A and B B. Tacrolimus
79. A phenolic disinfectant that causes C. Temsirolimus
cerebral edema and convulsions in D. Cycloserine
premature infants. E. Sirolimus
A. O-Phenylphenol 85. What class of Gastrointestinal drugs are
B. P-amylphenol most effective agents for the treatment
C. 0-benzyl-P-Chlorophenol of non-erosive and erosive reflux
D. Heptachlorophene disease and extra-esophageal
E. Hexachlorophene manifestations of reflux disease?
A. NSAID
 B. H2 receptor antagonist E. 5HT4
C. Proton pump inhibitor
D. Prostaglandin analogs 90. These are examples of amides:
E. H1 receptor antagonist
I. Lidocaine
86. The ff. are common preparations of
natural plant products which are bulk II. Bupivacaine
forming laxatives except
A. Psyllium III. Cocaine
B. Methylcellulose
C. Polycarbophil IV. Prilocaine
D. A and B
A. I & II
E. None of these
87. It is the most commonly used osmotic B. I,II, & III
laxative and should not be used for
prdlonged periods for patient with renal C. I,II,& IV
insufficiency due to the risk of
hypermagnesemia D. II, III, &IV

A. Magnesium hydroxide E. AOTA

B. Milk of Magnesia 91. High plasma concentrations of local

anesthetics result from rapid absorption,
C. Furosemide thus causing;

D. A and B I. Sedation

E. Mannitol II. Light headedness

88. It is effective in reducing nocturnal acid III. Auditory disturbances

but is less effective against stimulated
secretion IV. Restlessness

A. H2 receptor antagonist A. I & II

B. PPI B. I,II, & III

C. Sucralfate C. I,II,& IV

D. Laxative D. I & IV

E. Diuretic E. AOTA

89. Condansetron and Granisetron block 92. Selective Serotonin-Norepinephrine

which receptor site? Reuptake inhibitor include;

A. 5HT3 I. Venlafaxine

B. 5HT1A II. Sertraline

C. 5HT1B III. Duloxetine

D. 5HT1C IV. Citalopram

 A. I only II. Factor XIII — Fibrin-
stabilizing factor
B. I, II and III III. Factor XII — Prothrombin
IV. Factor X — Stuart power
C. I, II and IV
factor
D. I and III A. III only
B. IV only
E. II and III C. I and II
D. II, Ill and IV
93. Which pair is a mismatch? E. I, II, Ill and IV
96. The deficiency of factor IX can cause
I. Butyrophenone —
hemophilia B and Christmas Disease.
Haioperidol
Hemophilia A is also known as
II. Atypical antipsychotics — Christmas Disease.
Clozapine A. Only the 1st statement is correct
B. Only the 2nd statement is
III. Thioxanthene — correct
Thiothixene C. Both statements are correct
D. Both statements are wrong
IV. Phenothiazine — 97. The following are non-selective COX
Chlorpromazine inhibitor, EXCEPT: I.
I. Diclofenac
A. I only
II. Celecoxib
B. II only III. Meloxicam
IV. Ibuprofen
C. III only A. I and II
B. II and III
D. II only C. Ill and IV
D. l and IV
E. NOTA
E. IV only
94. Which of the following is NOT true about 98. It is a peptide antibiotic and is
opioids? considered as a non-biologic DMARD
I. Opioid analgesics may A. Cycloserine
prolong labor B. Cyclosporine
II. Opioids contract biliary C. Chloroquine
smooth muscle. D. Abatacept
III. Opioid analgesics E. Azathioprine
stimulates release of ADH, 99. It is the active metabolite of phenacetin
Prolactin and Somatropin. I. Acetaminophen
IV. Opioid causes mydriasis II. N-acetyl-p-aminophenol
A. I,II,III, IV III. N-acetylcysteine
B. IV only IV. ASA
C. III only A. IV ONLY
D. I only B. I ONLY
E. II only C. I AND II
95. Which of the following is a mismatch? D. III ONLY
I. Factor I — Fibrinogen E. AOTA
100. It is the most common form of
hyperthyroidism
 A. Myxedema coma I. Antibiotic
B. Subacute thyroiditis II. PPI
C. Ophthalmopathy III. H2 receptor blocker
D. Grave's disease IV. Prostaglandin analogs
E. NOTA A. Antibiotic and PPI
101. This is the sudden acute B. PPI and H2 receptor
exacerbation of all of the symptoms of blocker
thyrotoxicosis presenting as a life- C. H2 receptor blocker and
threatening syndrome Prostaglandin analogs
I. Myxedema coma D. Antibiotic and H2
II. Grave's Disease receptor blocker
III. Thyroid Storm E. Antibiotic and
IV. Thyrotoxic crisis prostaglandin analog
A. I ONLY 106. This is the main form of
B. II ONLY leukemia in childhood, and it is the most
C. III ONLY common form of cancer in children
D. I AND II A. Acute Lymphoblastic
E. III AND IV Leukemia
102. A syndrome of thyroid B. Acute Myelogenous
enlargement without excessive thyroid Leukemia
hormone production C. Hodgkin's Leukemia
A. Nontoxic goiter D. Non-Hodgkin's Leukemia
B. Thyroid neoplasm E. None of these
C. Neonatal grave’s disease 107. It is the most common leukemia
D. Myxedema coma in adults
E. Thyroiditis A. Acute Lymphoblastic Leukemia
103. What is the route of B. Acute Myelogenous Leukemia
administration of methyltestosterone? C. Hodgkin's Leukemia
I. IM D. Non-Hodgkin's Leukemia
II. IV E. None of these
III. Oral 108. The hallmark of this type of
IV. Transdermal diabetes is selective beta cell
A. I and II destruction and severe or absolute
B. II AND IV insulin deficiency
C. I ONLY A. TYPE 1
D. III ONLY B. TYPE 2
E. NOTA C. TYPE 3
104. It is a chemotherapeutic drug D. TYPE 4
which is a folic acid analog that binds E. AOTA
with high affinity to the active catalytic 109. What type of organ transplant
site of dihydrofolate reductase rejection occurs within hours and cannot
A. Cisplatin be stopped with immunosuppressive
B. Dacarbazine drugs and occurs due to preformed
C. Methotrexate antibodies against the donor organ?
D. Vincristine A. Acute
E. Gemcitabine B. Accelerated
105. The combination of these are C. Hyperacute
the most effective regimen for H. pylori D. Chronic
associated ulcers: E. Superficial
110. Its generic name is lmiquimod C. I,II, AND III
and it is used in the treatment of D. II, III, AND IV
external genital and perianal warts in E. I, II, III, AND IV
adults. Available as 5% cream. 116. This is also known as manic-
A. Protopic depressive illness
B. Aldara A. Anxiety
C. Elidel B. Bipolar disorder
D. Zovirax C. Obstructive-Compulsive disorder
E. Denavir D. ADHD
111. Podophyllum resin, an alcoholic E. NOTA
extract of mandrake root or May apple is 117. PGE1 analog used as treatment
used in the treatment of and prophylaxis of NSAID-induced
A. Condyloma acuminatum gastric ulcer and is also an abortifacient
B. Psoriasis drug.
C. Photophobia A. Alprostadil
D. Lichen simplex chronicus B. Misoprostol
E. Cushing's syndrome C. Dinoprostone
112. This vitamin enhances the D. Epoprestenol
extracerebral metabolism of levodopa E. Prostine E2
A. Vitamin A 118. PGE1 analog used to treat
B. Vitamin B9 erectile dysfunction:
C. Vitamin B6 A. Alprostadil
D. Vitamin E B. Misoprostol
E. Vitamin D C. Dinoprostone
113. A combination of levodopa and D. Epoprestenol
MAO-A inhibitors could lead to this E. Prostine E2
condition: 119. Drug for the treatment of gout
A. Hypertensive crisis which blocks xanthine oxidase thereby
B. Alopecia decreasing the production of uric acid:
C. Memory loss A. Indomethacin
D. Hyperactivity B. Colchicine
E. GI bleeding C. Allopurinol
114. A catechol-o-methyltransferase D. Febuxosat
inhibitor E. C and D
A. Selegiline 120. Drug for gout which increases
B. Entacapone urinary excretion of uric acid (inhibits
C. Pergolide reabsorption of uric acid in the proximal
D. Ropinirole tubule):
E. Rotigotine A. Indomethacin
115. Which of the following is an B. Colchicine
example of piperidine type of C. Allopurinol
phenothiazines? D. Febuxosat
I. Thioridazine E. Probencid
II. Piperacetazine 121. Drug for the treatment of gout
III. Mesoridazine that disrupts the inflammatory cycle,
IV. Carphenazine which inhibits leukocyte migration and
A. I AND II phagocytosis of uric acid crystals:
B. III AND IV A. Indomethacin
 B. Colchicine II. Cyclosporine
C. Allopurinol III. Aldesleukin
D. Febuxosat IV. Interferon alfacon-1
E. Probencid V. Prednisone
122. NSAID that inhibits COX A. I, II, AND III
enzyme thereby reducing the production B. I, III, AND IV
of prostaglandins. May cause C. II, III, AND IV
cholestatic hepatitis. thrombocytopenia D. II AND V
and leukopenia. E. II AND III
A. Indomethacin 127. Immunosuppressant drug that
B. Colchicine binds to FK-binding protein and forms a
C. Allopurinol complex that inhibits calcineurin.
D. Febuxosat A. Tacrolimus
E. Probencid B. Methotrexate
123. Medium to large vessel C. Thalidomide
vasculitis seen in children: symptoms D. Azathioprine
include conjunctivitis, rash, erythema of E. Cyclophosphamide
the palms and soles, coronary 128. Chemotherapeutic drug that
aneurysms, and strawberry tongue: inhibits dihydrofolate reductase,
A. Aplastic anemia blocking synthesis of nucleoside
B. Erythema nodosum leprosum phosphates inhibiting DNA synthesis:
C. Kawasaki disease A. Tacrolimus
D. Hirsutism B. Methotrexate
E. Malignant osteoporosis C. Thalidomide
124. Painful erythematous D. Azathioprine
subcutaneous nodules seen in patients E. Cyclophosphamide
with a high level of mycobacterial 129. Drug that inhibits DNA and RNA
antigens. synthesis via cross-linking of these
A. Aplastic anemia molecules. Used as chemotherapy for
B. Erythema nodosum leprosum solid tumor malignancies
C. Kawasaki disease A. Tacrolimus
D. Hirsutism B. Methotrexate
E. Malignant osteoporosis C. Thalidomide
125. Which of the following drugs D. Azathioprine
listed below are classified as E. Cyclophosphamide
immunostimulants? 130. A syndrome characterized by
I. Filgastrim polyuria, polydipsia, and hypernatremia
II. Cyclosporine and is caused by inadequate production
III. Aldesleukin of vasopressin
IV. Interferon alfacon-1 A. Acromegaly
V. Predinisone B. Central diabetes insipidus
A. I, II, AND III C. Gigantism
B. I, III, AND IV D. Prolactinoma
C. II, III, AND IV E. Aplastic anemia
D. II AND V 131. A rare syndrome of growth
E. II AND III hormone (GH) excess in adults
126. Which of the following drugs characterized by abnormal growth of
listed below are classified as tissues (particularly connective tissue),
immunosuppresants? I. I.Filgastrim
 metabolic abnormalities, and cardiac D. Leuprolide
dysfunction E. Bromocriptine
A. Acromegaly 137. Antagonist of vasopressin: Vla
B. Central diabetes insipidus and V2 receptors used as a treatment of
C. Gigantism hyponatremia in hospitalized patients
D. Prolactinoma A. Desmopressin
E. Aplastic anemia B. Conivaptan
132. A syndrome of GH excess in C. Atosiban
children and adolescents with open long D. Oxytocin
bone epiphyses that results in excessive E. Ganirelix
height 138. Agonist of vasopressin V2
A. Acromegaly receptors for the treatment of pituitary
B. Central diabetes insipidus diabetes insipidus:
C. Gigantism A. Desmopressin
D. Prolactinoma B. Conivaptan
E. Aplastic anemia C. Atosiban
133. Pituitary tumor that secretes D. Oxytocin
excessive amounts of prolactin and is E. Ganirelix
associated with a syndrome of infertility 139. Antagonist of oxytocin receptor:
and galactorrhea A. Desmopressin
A. Acromegaly B. Conivaptan
B. Central diabetes insipidus C. Atosiban
C. Gigantism D. Oxytocin
D. Prolactinoma E. Ganirelix
E. Aplastic anemia 140. Protein synthesized in the liver
134. Somatostatin receptor agonist that transports thyroid hormone in the
used in the treatment of acromegaly and blood
several other hormone-secreting A. Thyroxine binding globulin
tumors. (TBG)
A. Ocreotide B. Thyroglobulin
B. Pegsivomant C. Thyroid stimulating hormone
C. Somatropin (TSH)
D. Leuprolide D. Thyroid hormone
E. Bromocriptine E. Thyroxine
135. Dopamine D2 receptor agonist 141. A protein synthesized in the
used in the treatment of thyroid gland; its tyrosine residues are
Hyperprolactinemia and Parkinson's used to synthesized thyroid hormones
disease A. Thyroxine binding globulin
A. Ocreotide (TBG)
B. Pegsivomant B. Thyroglobulin
C. Somatropin C. Thyroid stimulating hormone
D. Leuprolide (TSH)
E. Bromocriptine D. Thyroid hormone
136. Gonadotropin-releasing E. Thyroxine
hormone (GnRH) analogs for ovarian 142. The anterior pituitary hormone
suppression that regulate thyroid gland growth,
A. Ocreotide uptake of iodine and synthesis of thyroid
B. Pegsivomant hormone:
C. Somatropin
 A. Thyroxine binding globulin C. Cushing’s syndrome
(TBG) D. Potassium iodide
B. Thyroglobulin E. Levothyroxine
C. Thyroid stimulating hormone 147. Partial or complete loss of
(TSH) adrenocortical function, including loss of
D. Thyroid hormone glucocorticoid and mineralocorticoid
E. Thyroxine function:
143. Which of the following listed A. Addison’s disease
below are key features of B. Adrenal suppression
hypothyroidism C. Cushing’s syndrome
I. Sensation of being cold D. Pheocromocytoma
II. Reduced appetite E. Adrenocorticoids
III. Weight loss 148. A metabolic disorder caused by
IV. Tachycardia excess secretion of adrenocorticoid
V.Dropping of eyelids steroids, which is most commonly due to
A. I, II, AND III increased amounts of ACTH
B. I, II, AND IV A. Addison’s disease
C. I, II, AND V B. Adrenal suppression
D. II AND III C. Cushing’s syndrome
E. III AND IV D. Pheocromocytoma
144. Which of the following listed E. Adrenocorticoids
below are key features of 149. Strong agonist at
thyrotoxicosis? mineralocorticoid receptors and
I. Sensation of being cold moderate activation of glucocorticoid
II. Reduced appetite receptors. Use to manage adrenal
III. Weight loss insufficiency in Addison's disease.
IV. Tachycardia A. Prednisone
V.Dropping of eyelids B. Fludrocortisone
C. Mifepristone
A. I, II, AND III D. Spironolactone
B. I, II, AND IV E. Ketoconazole
C. I, II, AND V 150. Pharmacologic antagonist of
D. II AND III mineralocorticoid receptor and weak
E. III AND IV antagonist of androgen receptors. May
145. Drug that inhibit thyroid cause gynecomastia.
peroxidase reactions, iodine A. Prednisone
organification, and peripheral B. Fludrocortisone
conversion of T4 to T3 C. Mifepristone
A. Methimazole D. Spironolactone
B. Propranolol E. Ketoconazole
C. Lugol’s solution 151. All of the following are true
D. Potassium iodide about CNS drugs, EXCEPT:
E. Levothyroxine I. Water solubility is an important
146. Inhibition of f3 receptors and characteristic of most of CNS drugs
inhibition of conversion of 14 to T3. II. CNS drugs readily cross the placental
Used in the management of thyroid barrier and enter the fetal circulation
storm III. Almost all CNS drugs require
A. Methimazole metabolism to more water soluble form
B. Propranolol for their elimination
 A. I ONLY D. Flumazenil
B. II ONLY E. Phenytoin
C. III ONLY 157. Activates MT1 and MT2
D. I AND II receptors in suprachiasmatic nucleus
E. II AND III used for the treatment of sleep disorder
152. Which of the following drugs are A. Ramelteon
classified as benzodiazepine? B. Buspirone
I. Alprazolam C. Secobarbital
II. Clonazepam Diazepam D. Flumazenil
IV. Thiopental E. Phenytoin
V. Phenobarbital 158. Partial agonist at 5-HT receptors
A. I, II, AND III and possibly D2 receptors used for
B. I, III, AND IV generalized anxiety states:
C. IV AND V A. Ramelteon
D. I AND II B. Buspirone
E. II AND V C. Secobarbital
153. Which of the following drugs are D. Flumazenil
classified as barbiturates? E. Phenytoin
I. Alprazolam 159. NAD±-dependent enzymes,
II. Clonazepam Diazepam found mainly in the liver and gut which
IV. Thiopental accounts for the metabolism of low to
V. Phenobarbital moderate doses of ethanol.
A. I, II, AND III A. Alcohol dehydrogenase
B. II, III, AND IV B. Microsomal ethanol-oxidizing
C. IV AND V system
D. I AND II C. Monoamine oxidase
E. II AND V D. Aldehyde dehydrogenase
154. Binds to GABAA receptor E. Catechol-o-methyl transferase
subunits to facilitate chloride channel 160. Severe form of alcohol
opening and increase frequency withdrawal whose main symptoms are
A. Benzodiazepine sweating, tremor, confusion, and
B. Barbiturates hallucinations:
C. Tricyclic antidepressant A. Alcohol withdrawal syndrome
D. Antipsychotics B. Delirium tremens (dts)
E. Ant seizure C. Fetal alcohol syndrome
155. Binds to GABAA receptor sites D. Wernicke-korsakoff syndrome
(distinct from benzodiazepines), E. Acute alcohol toxicity
facilitate chloride channel opening and 161. A syndrome of craniofacial
increase duration dysmorphia, heart defects, and mental
A. Benzodiazepine retardation caused by the teratogenic
B. Barbiturates effects of ethanol consumption during
C. Tricyclic antidepressant pregnancy:
D. Antipsychotics A. Alcohol withdrawal syndrome
E. Ant seizure B. Delirium tremens (dts)
156. Antagonist at benzodiazepine C. Fetal alcohol syndrome
sites on GABAA receptor D. Wernicke-korsakoff syndrome
A. Ramelteon E. Acute alcohol toxicity
B. Buspirone 162. The characteristic syndrome of
C. Secobarbital insomnia, tremor, agitation, seizures,
 and autonomic instability by deprivation plus coma, seizures, acidosis, and
in an individual who is physically death due to respiratory failure
dependent on ethanol: A. Ethanol
A. Alcohol withdrawal syndrome B. Methanol
B. Delirium tremens (dts) C. Ethylene glycol
C. Fetal alcohol syndrome D. Diazepam
D. Wernicke-korsakoff syndrome E. Thiamine
E. Acute alcohol toxicity 168. BDZ receptor agonist that
163. A syndrome of ataxia, facilitates GABA-mediated activation of
confusion, and paralysis of the GABAA receptors used in the
extraocular muscles that is associated prevention and treatment of acute
with chronic alcoholism and thiamine ethanol withdrawal syndrome:
deficiency: A. Ethanol
A. Alcohol withdrawal syndrome B. Methanol
B. Delirium tremens (dts) C. Ethylene glycol
C. Fetal alcohol syndrome D. Diazepam
D. Wernicke-korsakoff syndrome E. Thiamine
E. Acute alcohol toxicity 169. Vitamin administered to patients
164. The most common medical suspected of alcohol dependence to
complication of chronic alcohol abuse: prevent the Wernicke-Korsakoff
A. Hypertension syndrome:
B. Diabetes A. Ascorbic acid
C. Lung disease B. Riboflavin
D. Liver disease C. Thiamine
E. Cancer D. Folic acid
165. NMDA glutamate receptor E. Niacin
antagonist that is also US-FDA 170. Nonselective competitive
approved for treatment of alcoholism: antagonist of opioid receptors used to
A. Naltrexone reduced risk of relapse in individuals
B. Acamprosate with alcohol-use disorders:
C. Disulfiram A. Acamprosate
D. Methanol B. Disulfiram
E. Ethylene glycol C. Fomepizole
166. Aldehyde dehydrogenase D. Ethanol
inhibitor used adjunctively in some E. Naltrexone
treatment program for alcoholics. If 171. Inhibits alcohol dehydrogenase
ethanol is consumed by a patient who and prevents conversion of methanol
has taken this drug, acetaldehyde and ethylene glycol to toxic metabolites.
accumulation leads to nausea, Used as an antidote for methanol and
headache, flushing, and hypotension: ethylene glycol poisoning:
A. Naltrexone A. Acamprosate
B. Acamprosate B. Disulfiram
C. Disulfiram C. Fomepizole
D. Methanol D. Ethanol
E. Ethylene glycol E. Naltrexone
167. Poisoning of this substance 172. Tonic phase (less than 1 min)
result in toxic levels of formate, which involves abrupt loss of consciousness,
causes characteristic visual disturbance muscle rigidity, and respiration arrest;
clonic phase (2-3 min) involves jerking
 of body muscles, with lip or tongue
biting, and fecal and urinary
incontinence; formerly called grand mal:
A. Partial seizure simple
B. Tonic-clonic seizure generalized
C. Absence seizure generalized
D. Myoclonic seizure
E. Status epilipticus
173. Impaired consciousness (often
abrupt onset and brief), sometimes with
automatisms, loss of postural tone, or
enuresis; begin in childhood (formerly,
petit mal) and usually cease by age 20
yrs:
A. Partial seizure simple
B. Tonic-clonic seizure generalized
C. Absence seizure generalized
D. Myoclonic seizure
E. Status epilipticus
174. A series of seizures (usually
tonic-clonic) without recovery of
consciousness between attacks; it is a
life-threatening emergency:
A. Partial seizure simple
B. Tonic-clonic seizure generalized
C. Absence seizure generalized
D. Myoclonic seizure
E. Status epilipticus
175. Which of the following is not a
mechanism of action of an antiseizure
drug?
I. Sodium channel blockade
II. GABA-related mechanism
Calcium channel blockade
IV. Alpha receptor blockade
A. I ONLY
B. II ONLY
C. III ONLY
D. IV ONLY
E. III AND IV
176. Which of the following is a
preferred drug for the treatment of
absence seizures?
A. Phenytoin
B. Carbamazepine
C. Ethosuximide
D. Diazepam
E. Clonazepam
177. Stage of anesthesia where the
patient has decreased awareness of
pain, sometimes with amnesia,
Consciousness may be impaired but is
not lost.
A. Stage 1: Analgesia
B. Stage 2: Disinhibition
C. Stage 3: Surgical anesthesia
D. Stage 4: Medullary depression
E. Stage 5: Delirium
178. Stage of anesthesia where the
patient develops severe respiratory and
cardiovascular depression that requires
mechanical and pharmacologic support.
A. Stage 1: Analgesia
B. Stage 2: Disinhibition
C. Stage 3: Surgical anesthesia
D. Stage 4: Medullary depression
E. Stage 5: Delirium
179. Stage of anesthesia where the
patient appears to be delirious and
excited. Amnesia occurs, reflexes are
enhanced, and respiration is typically
irregular; retching and incontinence may
occur:
A. Stage 1: Analgesia
B. Stage 2: Disinhibition
C. Stage 3: Surgical anesthesia
D. Stage 4: Medullary depression
E. Stage 5: Delirium
180. Anesthesia produced by a
mixture of drugs, often including both
inhaled and intravenous agents
A. Maximum anesthesia
B. Balanced anesthesia
C. General anesthesia
D. Inhalation anesthesia
E. Optimal anesthesia
181. The alveolar concentration of an
inhaled anesthetic that is required to
prevent a response to a standardized
painful stimulus in 50% of patients
A. Maximum alveolar concentration
B. Optimal anesthetic dose
C. Minimum alveolar concentration
D. Standard alveolar concentration
E. Anesthetic alveolar
concentration
182. Which of the following drugs D. Midazolam
listed below is classified as inhaled E. Ketamine
anesthetic? 187. Long acting ester local
I. Halothane anesthetic:
II. Thiopental A. Tetracaine
Ill. Ketamine B. Procaine
IV. Enflurane C. Benzocaine
A. I AND II D. Bupivacaine
B. II AND III E. Lidocaine
C. I AND IV 188. All of the following are clinical
D. III AND IV use of local anesthetic, EXCEPT
E. I AND V A. Used for minor surgical
183. Which of the following drugs procedures often in combination
listed below is classified as intravenous with vasoconstrictors such as
anesthetic? epinephrine
I. Halothane B. Used in spinal anesthesia and
II. Thiopental to produce autonomic blockade
Ill. Ketamine in ischemic conditions
IV. Enflurane C. Slow epidural infusion at low
A. I AND II concentrations has been used
B. II AND III successfully for postoperative
C. I AND IV analgesia
D. III AND IV D. Oral and parenteral forms of
E. I AND V local anesthetics are sometimes
184. This drug produces a state of used adjunctively in neuropathic
"dissociative anesthesia" in which the pain states.
patient remains conscious but has E. Used as a component of
marked catatonia, analgesia, and balance anesthesia
amnesia 189. Neuromuscular paralysis that
A. Midazolam results from pharmacologic antagonism
B. Thiopental at the acetylcholine receptor of the end
C. Ketamine plate:
D. Morphine A. Depolarizing blockade
E. Etomidate B. Nondepolarizing blockade
185. Centrally acting a2-adrenergic C. Stabilizing blockade
agonist that has analgesic and hypnotic D. A or C
actions when used intravenously: E. B or C
A. Phenylephrine 190. Neuromuscular paralysis that
B. Dexmedetomidine results from persistent depolarization of
C. Prazosin the end plate:
D. Clonidine A. Depolarizing blockade
E. Minoxidil B. Nondepolarizing blockade
186. Barbiturate that is used for C. Stabilizing blockade
induction of anesthesia and for short D. A or C
surgical procedure: E. B or C
A. Nitrous oxide 191. Which of the following drug can
B. Thiopental reverse the blockade brought about by
C. Halothane non-depolarizing neuromuscular
blockers
 A. Neostigmine A. Parkinsonism
B. Succinylcholine B. Huntington disease
C. Tubocurarine C. Tourette’s syndrome
D. Atropine D. Wilon’s disease
E. Acetylcholine E. Athetosis
192. Which of the following drugs can 197. An inherited (autosomal
be used in the treatment of malignant recessive) disorder of copper
hyperthermia? accumulation in liver, brain, kidneys,
A. Tubocurarine and eyes: symptoms include jaundice,
B. Bavlofen vomiting, tremors, muscle weakness,
C. Cyclobenzaprine stiff movements, liver failure, and
D. Dantrolene dementia
E. Diazepam A. Parkinsonism
193. Which of the following listed B. Huntington disease
bellows are signs of Parkinsonism? C. Tourette’s syndrome
I. Rigidity of skeletal muscle D. Wilon’s disease
II. Akinesia E. Athetosis
Ill. Flat facies 198. Strategies of drug treatment of
IV. Tremor at rest parkinsonism involve which of the
A. I AND II following?
B. II AND III I. increasing dopamine activity in the
C. III AND IV brain
D. I, II, AND III II. Decreasing muscarinic cholinergic
E. AOTA activity
194. A progressive neurologic III. Neuromoscular blockade
disease characterized by shuffling gait, IV. Increasing acetylcholine activity
stooped posture, resting tremor, speech A. I ONLY
impediments, movement difficulties, and B. I AND II
an eventual slowing of mental C. II AND III
processes and dementia: D. III ONLY
A. Parkinsonism E. III AND IV
B. Huntington disease 199. . Drug that does not cross the
C. Tourette’s syndrome blood-brain barrier but inhibits dope
D. Wilon’s disease decarboxylase in peripheral tissues
E. Athetosis used in combination with levodopa for
195. An inherited adult-onset the treatment of parkinsonism
neurologic disease characterized by A. Reserpine
dementia and bizarre involuntary B. Selegeline
movements: C. Carbidopa
A. Parkinsonism D. Pramipexole
B. Huntington disease E. Ropinirole
C. Tourette’s syndrome 200. Non ergot which has high
D. Wilon’s disease affinity for Dopamine D3 receptor which
E. Athetosis is effective as monotherapy in mild
196. A neurologic disease of parkinsonism and can be used together
unknown cause that presents with with levodopa in more advanced
multiple tics associated with snorting, disease:
sniffing, and involuntary vocalizations A. Reserpine
(often obscene): B. Selegeline
 C. Carbidopa 205. Refers to an eclectic group of
D. Pramipexole drugs that are used for non-medical
E. Ropinirole purposes. It includes drugs of abuse,
201. Dummy medicine containing no drugs used to enhance athletic or other
active ingredient (or alternatively, a performance, as well as those taken for
dummy surgical procedure, diet or other cosmetic purposes or for purely social
kind of therapeutic intervention), which reasons
the patient believes is (or could be, in A. Recreational drugs
the context of a controlled trial) the real B. Non-medical drugs
thing. C. Prescription drugs
A. Prodrug D. Lifestyle drugs
B. Orphan drug E. Performance drugs
C. Lead drug 206. Which of the following belongs
D. Placebo to medicines approved for specific
E. Experimental drug indications but can also be used for
202. To avoid bias, clinical trials are other 'lifestyle' purposes:
performed using the following study A. Orlistat
design, EXCEPT: B. Minoxidil
A. Un-blinded studies C. Alcohol
B. Controlled D. Caffeine
C. Randomized E. Cannabis
D. Double blind 207. Which of the following belongs
E. B ans C to medicines approved for specific
203. Lethal dose for 50% of the indications that can also be used to
population divided by effective dose for satisfy 'lifestyle choices' or to treat
50% of population is called: 'lifestyle diseases'
A. Meta-analysis A. Orlistat
B. Therapeutic range B. Minoxidil
C. Therapeutic index C. Alcohol
D. Potency D. Caffeine
E. Efficacy E. Cannabis
204. All of the following are true 208. Used mainly to achieve rapid
regarding drug therapeutic index, weight loss before weighing in and also
EXCEPT: to mask presence of other agents in
A. Unsatisfactory as a measure of urine by dilution:
drug safety A. Anabolic agents
B. Based on animal toxicity data, B. Hormones and related agents
which may not reflect forms of C. Diuretics
toxicity or adverse reactions that D. Stimulants
are important clinically E. Narcotic analgesic
C. It takes no account of 209. Anthelminthic drug that acts by
idiosyncratic toxic reactions inhibiting the polymerization of helminth
D. Provide a measure of the B-tubulin, thus interfering with
margin of safety of a drug, by microtubule-dependent functions such
drawing attention to the as glucose uptake:
relationship between the A. Diethylcarbamazine
effective and toxic doses B. Ivermectin
E. NOTA C. Niclosamide
D. Praziquantel
 E. Benzimidazoles 214. Potential and actual clinical
210. Anthelmintic drug act by uses/indications of cannabinoids
changing the parasite such that it agonists include which of the following?
becomes susceptible to the host's I. Neuropathic pain
normal immune responses. It may also II. Glaucoma
interfere with helminth arachidonate III. Drug addiction
metabolism IV. Alcoholism
A. Diethylcarbamazine V. Head injury
B. Ivermectin A. I, II, AND IV
C. Niclosamide B. I, II, AND V
D. Praziquantel C. II, III, AND IV
E. Benzimidazoles D. II, IV, AND V
211. These class of antifungal agents E. V ONLY
inhibit the fungal cytochrome P450 3A 215. Primary autonomic mechanism
enzyme, lanosine 14a-demethylase, for blood pressure homeostasis;
which is responsible for converting involves sensory input from carotid
lanosterol to ergosterol, the main sterol sinus and aorta to the vasomotor center
in the fungal cell membrane: and output via the parasympathetic and
A. Echinocandins sympathetic motor nerves:
B. Amphotericin A. Stepped care
C. Flucytosine B. Baroreceptor reflex
D. Azoles C. Positive feedback
E. Griseofulvin D. Negative feedback
212. These class of antifungal agents E. RAAS
inhibit the synthesis of 1,3-p-glucan, a 216. Hypertension caused by a
glucose polymer that is necessary for diagnosable abnormality, e.g, aortic
maintaining the structure of fungal cell coarctation, renal artery stenosis,
walls. In the absence of this polymer, adrenal tumor, etc.
fungal cells lose integrity and lyse. A. Primary hypertension
A. Echinocandins B. Essential hypertension
B. Amphotericin C. Secondary hypertension
C. Flucytosine D. A or B
D. Azoles E. A or C
E. Griseofulvin 217. An accelerated form of severe
213. Potential and actual clinical hypertension associated with rising
uses/indications of cannabinoids blood pressure and rapidly progressing
antagonists include which of the damage to vessels and end organs.
following? Often signaled by renal damage,
I. obesity encephalopathy, and retinal
II. Tobacco independence hemorrhages or by angina, stroke, or
III. Drug Addition myocardial infarction. Also called
IV. Alcoholism malignant hypertension
V. Parkinson’s disease A. Hypertensive emergency
A. I AND II B. Essential hypertension
B. I, II, AN III C. Orthostatic hypertension
C. II, III, AND IV D. Rebound hypertension
D. I, II, III, AND IV E. Secondary hypertension
E. IV AND V 218. Elevated blood pressure
(usually above pretreatment levels)
 resulting from loss o antihypertensive
drug effect:
A. Hypertensive emergency
B. Essential hypertension
C. Orthostatic hypertension
D. Rebound hypertension
E. Secondary hypertension
219. Important diuretic usually used
in severe hypertension and hypertensive
emergencies:
A. Loop diuretics
B. Thiazide diuretics
C. Osmotic diuretics
D. Carbonic anhydrase
inhibitor
E. ACE inhibitors
220. Blockade of calcium channels,
release of nitric oxide, opening of
potassium channels (which leads to
hyperpolarization), and activation of D,
dopamine receptors are the major
mechanisms of action of what class of
antihypertensive drugs?
A. Diuretics
B. Angiotensin antagonists
C. Vasodilators
D. Sympathoplegics
E. ACE inhibitors
221. . Newer drug in the
antihypertensive group and inhibits
renin's action on its substrate,
angiotensinogen. It reduces the
formation of angiotensin I and, in
consequence, angiotensin II.
A. Captopril
B. Losartan
C. Aliskiren
D. Enalapril
E. Minoxidil
222. Industrial disease caused by
chronic exposure to vasodilating
concentrations of organic nitrates in the
workplace; characterized by headache,
dizziness, and tachycardia on return to
work after 2 days absence:
A. Sunday disease
B. Monday disease
C. Angina
D. Nitrate disease
E. Worker’s disease
223. Rapidly progressing increase in
frequency and severity of anginal
attacks; an acute coronary syndrome
that often heralds imminent myocardial
infarction.
A. Classic angina
B. Prinzmetal angina
C. Angina of effort
D. Atherosclerotic angina
E. Unstable angina
224. Angina precipitated by
reversible spasm of coronary vessels,
often at rest:
A. Classic angina
B. Prinzmetal angina
C. Angina of effort
D. Atherosclerotic angina
E. Unstable angina
225. Filling pressure of the heart,
dependent on venous tone and blood
volume; determines end-diastolic fiber
length and tension:
A. Preload
B. Afterload
C. Intramyocardial fiber tension
D. Myocardial revascularization
E. Coronary pressure
226. Force exerted by myocardial
fibers, especially ventricular fibers at
any given time which also serves as a
primary determinant of myocardial 02
requirement:
A. Preload
B. Afterload
C. Intramyocardial fiber tension
D. Myocardial revascularization
E. Coronary pressure
227. Which of the following is the
fundamental physiologic defect seen on
patients with heart failure?
A. Irregular heartbeat
B. Increase in cardiac output
C. Decrease in cardiac output
D. Tachycardia
E. Bradycardia
228. Cardiac glycosides were
formerly considered as 1St line drug in
the treatment of heart failure. What is
 the mechanism of action of cardiac C. Theobromine
glycosides? D. Cromolyn
A. Inhibition of angiotensin E. Theophylline
converting enzyme 234. An acute or chronic
B. Inhibition of phosphodiesterase inflammatory skin condition
C. Inhibition of renal sodium characterized by the presence of 1 or
transporter more areas of pruritus (severe itching),
D. Inhibition of Na+/K+ ATPase erythema (redness), scaling (dry
E. Proton pump inhibition exfoliative shedding), macules
229. Which of the following class of (discoloration), papules (pimples), or
drug is not use in the treatment of heart vesicles (blister-like sacs):
failure? A. Alopecia
A. ACE inhibitors B. Eczema
B. Phosphodiesterase inhibitors C. Psoriasis
C. Beta blockers D. Scabies
D. Vasodilators E. Urticaria
E. Calcium channel blocker 235. This drug/s can worsen
230. Which of the following drug psoriasis and should be avoided by the
belongs to phosphodiesterase patients:
inhibitors? I. Beta blockers
A. Nitroglycerin II. Topical steroids
B. Milrinone III. Systemic steroids
C. Furosemide IV. Vitamin D analogs
D. Losartan A. I and II
E. Captopril B. I and III
231. Hormone that stimulates insulin C. II and IV
secretion and inhibit gastric secretion D. III and IV
and motility: E. I and IV
A. Gastrin 236. The mainstay of pharmacologic
B. Secretin therapy for scabies is the use of topical
C. Cholecystokinin scabicides. Example of topical
D. GIP scabicides includes which of the
E. Motilin following?
232. Hormone that stimulates A. Ivemectin
pancreatic ductal cell H2O and HCO3 B. Tacrolimus
secretion: C. Dapsone
A. Gastrin D. Permethrin
B. Secretin E. Sulfasalazine
C. Cholecystokinin 237. Deficiency of water-soluble
D. GIP niacin (nicotinic acid) or its amide
E. Motilin (nicotinamide) will results in which of the
233. This drug block mast cell following?
degranulation by suppressing release of A. Ophthalmoplegia
mediators of immediate B. Cyanosis
bronchoconstriction (early response) C. Swollen, congested and
and reducing eosinophil recruitment bleeding gums
causing airway inflammation: D. Dietary deficiency or impaired
A. Albuterol Absorption
B. IgE antibody
 E. Multiple perifollicular
Hemorrhages
238. Absorption of this vitamin is
impaired by mineral oil, neomycin, and
cholestyramine:
A. Vitamin A
B. Vitamin B
C. Vitamin C
D. Vitamin D
E. Vitamin E
239. Carbenicillin, piperacillin, and
ticarcillin display improved activity
against gram-negative organisms and
are usually used in combination with
aminoglycosides in patients with febrile
neutropenia and in those with hard to
treat nosocomial infections caused by
strains of Enterobacter, Klebsiella,
Citrobacter, Serratia, Bacteroides
fragilis, and Pseudomonas aeruginosa.
These drugs belong to which class of
antibiotics?
A. Aminopenicillins
B. Antipseudomonal penicillins
C. Beta lactamase inhibitors
D. Beta lactamase resistant
penicillins
E. Cephalosporins
240. Clavulanate, sulbactam, and
tazobactam are 13-lactamase inhibitors
and are used only in combination with
13-lactam antibiotics, which creates a
product that has extended activity
against (3 lactamase—producing
strains. Which of these 13-lactamase
inhibitors is usually used in combination
with the antibacterial drug Piperacillin?
A. Sulbactam
B. Clavulanate
C. Tazobactam
D. A or B
E. B or C
241. Common adverse effect
experienced in taking 13-lactamase
resistant penicillins:
A. Hepatotoxicity
B. Maculopapular rash
C. Acute interstitial nephritis
D. Jarisch-Herxheimer reaction
E. Bleeding, hyperkalemia,
hypernatremia
242. Common adverse effect
experienced in taking extended-
spectrum penicillins (high doses):
A. Hepatotoxicity
B. Maculopapular rash
C. Acute interstitial nephritis
D. Jarisch-Herxheimer reaction
E. Bleeding, hyperkalemia,
hypernatremia
243. Which of the following are the
broadest spectrum B-lactam antibiotics?
A. Penicillins
B. Cephalosporins
C. Carbapenems
D. Aminoglycosides
E. Monobactam
244. A monobactam antibiotic that
inhibits bacterial cell wall synthesis and
is resistant to most B-lactamases
A. Gentamicin
B. Tetracycline
C. Clindamycin
D. Aztreonam
E. Vancomycin
245. A glycopeptide antibiotic that
inhibits bacterial cell wall synthesis by
binding to cell wall phospholipids and
inhibiting polymerise and
transpeptidation, which leads to cell wall
lysis:
A. Gentamicin
B. Tetracycline
C. Clindamycin
D. Aztreonam
E. Vancomycin
246. Broad-spectrum bactericidal
antibiotics that inhibit DNA gyrase or
topoisomerase IV (essential for
Duplication, transcription, and repair of
bacterial DNA), target various aerobic
gram-positive (eg, methicillin-resistant
and 13 lactamase—producing
Staphylococcus species, S.
Pneumoniae) and gram-negative (eg, H.
lnfluenzae, M. Catarrhalis, P.
Aeruginosa, Legionella, Chlamydia)
organisms:
 A. Tetracycline
B. Quinolones
C. Aminoglycosides
D. Sulfonamides
E. Cephalosporins
247. An oxazolidinone derivatve that
binds to ribosomal subunits and
interferes with bacterial protein
synthesis. The drug is intended for
treatment of multidrug-resistant gram-
positive cocci, particularly as an
alternative in infections caused by
vancomycin-resistant Enterococcus,
multidrug-resistant S. Pneumonia
(including vancomycin-ceftriaxone
resistant). and MRSA or methicillin-
resistant S. Epidermidis
A. Doxycycline
B. Linezolid
C. Dalfopristin
D. Ciprofloxacin
E. Sulfasalazine
248. A polyene antifungal agent that
binds to ergosterol in fungal plasma
membranes, interferes with membrane
function, and causes cell death:
A. Amphotericin B
B. Flucytosine
C. Griseofulvin
D. Caspofungin
E. Ketoconazole
249. All of the following are true
regarding combination chemotherapy,
EXCEPT
A. Provides higher and more
durable response rates
B. Only agents with demonstrated
activity as monotherapy against
the specific type of tumor should
be selected
C. All agents within the regimen
should have same mechanisms
of action (which often has
additive or synergistic effects).
D. To minimize unacceptable
toxicity, agents should not have
overlapping adverse effects
E. To optimize efficacy and
minimize resistance, the optimal
dose and schedule of the drugs
should be used.
250. One of the oldest and most
studied antineoplastic drug related to
folic acid that acts by inhibiting
dihydrofolate reductase:
A. Mercaptopurine
B. 5-Fluorouracil
C. Methotrexate
D. Cytarabine
E. Gemcitabine
251. Combination oral contraceptives
contain both estrogen and progestin and
prevent pregnancy through the following
mechanisms, EXCEPT:
A. They inhibit ovulation via a
negative feedback mechanism
on the hypothalamus, which
alters the normal pattern of FSH
and LH secretion by the anterior
pituitary
B. Alteration of the tubal transport
of the sperm, egg, and fertilized
ovum through the fallopian
tubes.
C. Inducing an environment in the
endometrium that is unfavorable
for implantation
D. Changing the cervical mucus
and rendering it unfavourable
for sperm penetration even if
ovulation occurs
E. Inhibition of binding to estrogen
receptor that leads to a
disruption in the negative
feedback of estrogens on the
hypothalamus and pituitary, a
subsequent increase in
secretion of GnRH and
gonadotropins
252. Drug for parkinsonism that acts
by binding to dopamine receptors and
mimic the action of dopamine
A. Amantadine
B. Selegiline
C. Biperiden
D. Bromocriptine
E. Levodopa
253. Drug for parkinsonism that acts II. Radioactive iodine
by increasing the dopamine release and III. Surgery
reduces dopamine reuptake into IV. Adrenergic antagonist
dopaminergic nerve terminals of V. Iodines
substantia nigra neurons: A. I ONLY
A. Amantadine B. I AND II
B. Selegiline C. I, II, AND III
C. Biperiden D. II, III, AND IV
D. Bromocriptine E. IV AND V
E. Levodopa 258. Preferred treatment option for
254. A neurodegenerative disorder children, pregnant women, and young
characterized by progressive adults with uncomplicated Graves'
impairment of short-term memory and disease
other memory, language, and thought A. Thioamides
processes: B. Radioactive iodine
A. Parkinsonism C. Surgery
B. Huntington disease D. Adregenergic antagonists
C. Tourette syndrome E. Iodides
D. Alzheimer's disease 259. This drug is used to treat
E. Stroke Cushing syndrome when dose limiting
255. Which of the following class of side effects occur with ketoconazole,
drugs listed below is/are included in and it can be used in combination with
pharmacologic management options in other agents. It reduces cortisol
AlzheiMer disease? production by inhibiting 11-(3-
I. Cholinesterase inhibitors hydroxylation, the final step in
II. Muscarinic agonists glucocorticoid synthesis.
III.Beta blockers A. Metyrapone
IV. Dopamine agonist B. Aminoglutethimide
A. I only C. Progesterone
B. I and III D. Aldosterone
C. II and III E. Estradiol
D. I and III 260. Oral antihyperlipidemic agents
E. II and IV which is contraindicated with Type 1
256. Primary treatment options for DM, pregnancy or breast feeding,
patients with hyperthyroidism include severe hepatic or renal dysfunctions,
which of the following? and severe acute comorbidities or
I. Thioamides surgery:
II. Radioactive iodine A. 1st gen sulfonylureas
III. Surgery B. 2nd gen sulfonylureas
IV. Adregenergic antagonists C. Alpha glucosidase inhibitors
V. iodides D. Biguanide
A. I only E. Meglitinides
B. I and II 261. Which of the following drugs is a
C. I, II, and III meglitinide?
D. II, III, and IV I. Glimepiride
257. Adjunct to primary treatment II. Repaglinide
options for patients with hyperthyroidism III. Acarbose
include which of the following? IV. Nateglinide
I. Thioamides A. I ONLY
 B. I AND II D. Hemicholinium
C. II AND III E. Nifedipine
D. I AND III 266. This group of drug elicit
E. II AND IV vasoconstriction and mydriasis and is
262. The historical mainstay of also used as nasal decongestants and
therapy in type 2 DM, used as in eye examinations:
monotherapy or with insulin or other oral A. B1-Adrenoceptor antagonists
agents, act mainly by stimulating insulin B. B2-Adrenoceptor agonists
secretion from pancreatic 3 cells, C. A1-Adrenoceptor antagonists
enhancing (3-cell sensitivity to glucose, D. A1-Adrenoceptor agonists
and reducing glucagon release. They E. Mixed alpha and Beta agonist
work only if B-cells are functioning. 267. These drugs stimulate
A. Thiazolidinediones bronchodilation and are used to treat
B. Meglitinides asthma:
C. Alpha glucosidase inhibitors A. B1-Adrenoceptor antagonists
D. Sulfonylureas B. B2-Adrenoceptor agonists
E. Biguanide C. A1-Adrenoceptor antagonists
263. 2nd gen sulfonylureas have D. A1-Adrenoceptor agonists
greater potency, fewer drug interactions, E. Mixed alpha and Beta agonist
and have better pharmacokinetic 268. Alpha-antagonist (non-selective,
profiles compared to older class 1S1 irreversible) drug used in the treatment
gen sulfonylureas. Which of the of pheochromocytoma:
following drugs listed below belongs to A. Prazosin
2' gen sulfonylureas? B. Propranolol
I. Glimipiride C. Labetalol
II. Tolbutamide D. Phenoxybenzamine
III. Glipizide E. Yohimbine
IV. Acetohexamide 269. Mixed alpha/beta antagonists
A. I ONLY drug used in hypertension during
B. I AND II pregnancy:
C. II AND III A. Prazosin
D. I AND III B. Propranolol
E. II AND IV C. Labetalol
264. This drug binds to Ach receptors D. Phenoxybenzamine
and block Ach from binding to open E. Yohimbine
cation channels, thus preventing 270. Beta-non selective antagonist
depolarization: drug indicated in the treatment of
A. Physostigmine angina, hypertension, cardiac
B. Curare dysrhythmias, anxiety, tremor and
C. Succinylcholine glaucoma:
D. Hemicholinium A. Prazosin
E. Nifedipine B. Propranolol
265. This drug blocks acetyl C. Labetalol
cholinesterase from degrading D. Phenoxybenzamine
acetylcholine to choline and acetate, E. Yohimbine
thus prolonging action of acetylcholine: 271. Which adrenoreceptor mediates
A. Physostigmine relaxation of smooth muscle, increase
B. Curare glycogenolysis and increase heart rate
C. Succinylcholine and force?
 A. Alpha1 276. Inhibitors of the gastric 1-1',K*-
B. Alpha2 ATPase and considered as the most
C. Beta1 potent suppressors of gastric acid
D. Beta2 secretion:
E. Dopamine1 A. H2-receptor antagonists
272. Which of the following B. Proton pump inhibitors
steps/processes in autonomic C. Antacids
transmission is affected by the drug D. Cytoprotectants
tranylcypromine? E. Bismuth compounds
A. Action potential propagation 277. Long-term use of this H2-
B. Transmitter synthesis receptor antagonist at high doses
C. Enzymatic inactivation of decreases testosterone binding to the
transmitter androgen receptor and inhibits a CYP
D. Transmitter storage that hydroxylates estradiol. These
E. Receptor activation or blockade effects can cause galactorrhea in
273. Which of the following women and gynecomastia, reduced
steps/processes in autonomic sperm count, and impotence in men:
transmission is affected by the drug A. Famotidine
Vesamicol and Reserpine? B. Nizatidine
A. Action potential propagation C. Histamine
B. Transmitter synthesis D. Ranitidine
C. Enzymatic inactivation of E. Cimetidine
transmitter 278. This drug inhibits the pepsin-
D. Transmitter storage mediated hydrolysis of mucosal proteins
E. Receptor activation or blockade that contributes to mucosal erosion and
274. Which of the following ulcerations
statements is correct regarding the A. Misoprostol
effects of cholinomimetic drug on major B. Sucralfate
organ systems? C. Rebamipide
I. Sphincter muscle of iris — constriction D. Carbenoxolone
(mydriasis) E. Lansoprazole
II. Sinoatrial node - Decrease in rate 279. An octapeptide analog of
(negative chronotropy) somatostatin that is effective in inhibiting
III. Blood vessels - Dilation via release the severe secretory diarrhea brought
of EDRF from endothelium about by hormone-secreting tumors of
IV. Skeletal muscle - Activation of the pancreas and the GI tract. Its
neuromuscm end plates, contraction mechanism of action appears to involve
A. I ONLY inhibition of hormone secretion,
B. I, II, AND III including serotonin and various other GI
C. II, III, AND IV peptides:
D. I, III, IV ONLY A. Ondansetron
E. IV ONLY B. Dronabinol
275. A partial agonist at N receptors C. Hyoscine
which is used for smoking cessation: D. Ocreotide
A. Bethanecol E. Promethazine
B. Muscarine 280. Prototypical 5HT3-receptor
C. Varenicline antagonist used for chemotherapy-
D. Neostigmine induced emesis:
E. Physostigmine A. Metoclopramide
 B. Ondasentron D. Decreased activation of
C. Tropisetron prodrugs
D. DronabinoL E. Decreased drug accumulation
E. Granisteron 285. 5-Fluorouracil, methotrexate,
281. A naturally occurring gemcitabine and 6-mercaptopurine
cannabinoid that can be synthesized belong to which group of anticancer
chemically or extracted from the drugs?
marijuana plant, Cannabis sativa. It is a A. Alkylating agents
useful prophylactic agent in patients B. Antimetabolites
receiving cancer chemotherapy when C. Natural products
other antiemetic medications are not D. Antitumor antibiotics
effective: E. Hormonal
A. Dexamethasone 286. A highly basic, positively
B. Ondasentron charged peptide that antagonize the
C. Scoploamine effect of warfarin:
D. DronabinoL A. Argatroban
E. Granisteron B. Hirudin
282. The drug of choice for drug- C. Vitamin K
resistant P. falciparum malaria. This D. Protamine sulfate
drug is associated with toxicities E. Dabigatran etexilate mesylate
including cinchonism, hypoglycaemia, 287. Advantages of oral direct
and hypotension when it is given at full thrombin inhibitors include predictable
therapeutic or excessive doses: pharmacokinetics and bioavailability,
A. Primaquine which allow for fixed dosing and
B. Choloroquine predictable anticoagulant response, and
C. Quinine make routine coagulation monitoring
D. Proguanil unnecessary. Which of the following is
E. Pyrimethamine the first oral direct thrombin inhibitor
283. It is used primarily for the approved by the US-FDA?
terminal prophylaxis and radical cure of A. Dabigatran
P. vivax and P. ovale (relapsing) B. Streptokinase
malarias because of its high activity C. Aminocaproic acid
against their latent tissue forms. In D. Heparin
contrast with other antimalarials, it acts E. Hirudin
on tissue stages (exoerythrocytic) of 288. A specific, irreversible thrombin
plasmodia in the liver to prevent and inhibitor from leech saliva that is now
cure relapsing malaria. available in recombinant form as
A. Primaquine lepirudin:
B. Choloroquine A. Argatroban
C. Quinine B. Bivalirudin
D. Proguanil C. Hirudin
E. Pyrimethamine D. Rivaroxaban
284. Mechanism of resistance in E. Warfarin
cancer chemotherapy include all of the 289. A diuretic agent which is also
following, EXCEPT: used as a treatment for glaucoma:
A. Decreased DNA repair A. Furosemide
B. Formation of trapping agents B. Hydrochlorothiazide
C. Change in enzyme targets C. Amiloride
D. Acetazolamide
 E. Tolvaptan
290. Natrixam, a drug used in the
treatment of hypertension is marketed
with a generic name of:
A. Amlodipine and HCTZ
B. Amlodipine and Indapamide
C. Amlodipine and Rosuvastatin
D. Amlodipine and Erythromycin
E. Amlodipine and Erythromycin
291. A newly developed drug in the
management of diabetes which is used
as adjunct to diet and exercise to
improve glycemic control in adults with
type 2 DM. It is marketed under the
brand name, invokana:
A. Canaglifozin
B. Atorvastatin
C. Perampanel
D. Agmatine sulfate
E. Anastrozole
292. The generic name of
Rapamune, a drug which serves as a
prophylaxis of organ rejection in patients
receiving renal transplant:
A. Tacrolimus
B. Sirolimus
C. Tamsulosin
D. Ramipril
E. Renapril
293. This drug inhibits the Na/Cl
transporter in the distal convoluted
tubule resulting to modest increase in
NaCI excretion, some K wasting,
hypokalemic metabolic alkalosis, and
decreased urine Ca:
A. Mannitol
B. Connivaptan
C. Acetazolamide
D. Hydrochlorothiazide
E. Furosemide
294. Trump plus, a newly developed
drug which is indicated to treat
moderate to severe pain is a
combination of:
A. Paracetamol and Caffeine
B. Paracetamol and Tramadol
C. Paracetamol and Mefenamic
acid
D. Paracetamol and
Chlorphenamine maleate
E. Paracetamol and Codeine
295. Which of the following describes
2 generation H1-antihistamines?
A. Example of 2nd generation
antihistamines include
Chlorpheniramine and Cyclizine
B. Common effect of first-
generation H1 antagonists is
sedation
C. Some 2nd generation H1
antihistamines possess
serotonin-blocking and
adrenoreceptor blocking action
D. Second-generation H1
antihistamines are used mainly
for the treatment of allergic
rhinitis and chronic urticaria
E. 2nd generation Fil
antihistamines are less
expensive compared to 1st gen
H1 antihistamines
296. It is the newly marketed Live
attenuated Dengue tetravalent vaccine
developed by Sanofi-pasteur:
A. Pneumovax 23
B. Biothrax
C. Dengvaxia
D. Denguevaxx
E. Tetravax
297. H1-antagonist that possess an
alpha-receptor blocking action:
A. Diphenydramine
B. Promethazine
C. Chlorpheniramine
D. Fexofenadine
E. Cyproheptadine
298. A gaseous signaling molecule
that readily diffuses across cell
membranes and regulates a wide range
of physiologic and pathophysiologic
processes including cardiovascular,
inflammatory, and neuronal functions:
A. NO
B. N2O
C. NO2
D. NO3
 E. N2O3
299. Leukotriene-receptor inhibitor
used in the treatment of asthma:
A. Albuterol
B. Zileuton
C. Cromolyn
D. Alprostadil
E. Monteleukast
300. All of the following are correct
statements regarding COX-1 and COX-
2 enzyme ecxpet:
A. COX-2 is an immediate early
response gene product that is
markedly up-regulated by shear
stress, growth factors, tumour
promoters, and cytokines
B. COX-2 is the major source of
prostanoids in inflammation and
cancer
C. Traditional NSAIDs are selective
for COX-2
D. COX-1 generates prostanoids
for ‘housekeeping’ such as
gastric epithelial cytoprotection
E. Indomethacin and sulindac are
slightly selective COX-1
Module 4 New PACOP
CLINICAL TOXICOLOGY
1. The first priority step in the treatment of
poisoned patient is:
A. Clinical evaluation
B. Prevention of further toxin
absorption
C. Administration of Antidote
D. Supportive care and clinical follow-
up
E. Stabilization of the patient
2. Characteristic odor of garlic detected on
the poisoned patient’s breath or clothing
may point toward exposure or poisoning
of which of the following?
A.Cyanide
B.Hydrogen sulfide
C.Organophosphates
D. Naphthalene
E.Methyl salicylate
3. This term denotes the disposition of
poison in the body:
A.Toxicodynamics
B.Pharmacokinetics
C.Toxicokinetics
D.Toxidrome
E.Clinical toxicology
4. The following are the four primary
methods to prevent continued
absorption of an oral poison. EXCEPT:
A.Induction of emesis with syrup of
ipecac
B.Oral administration of MgO
C.Gastric lavage
D.Oral administration of activated
charcoal
E.Whole bowel irrigation
5. The difference between the serum
concentration of the major cations
(Na+/K+) and anions –(HCO3-/Cl-); an
increase of this value indicates the
presence of extra anions and is most
commonly caused by metabolic
acidosis.
A. Osmolar gap
B.Anion gap
C.Cation gap
D.Osmosis gap
E.Metabolic gap
6. Hepatic lipid accumulation can occur as
the result of one or more of the
following. EXCEPT:
A.Increased fatty acid supply to the liver
B.Increased fatty acid transporter
expression
C.Increased de novo fatty acid and
triglyceride synthesis
D.Increased fatty acid oxidation
E.Decreased synthesis and/or secretion
of VLDL
7. Characteristic odor of bitter almond
detected on the poisoned patient’s
breath or clothing may point exposure or
poisoning of which of the following?
A.Cyanide
B.Hydrogen sulfide
C.Organophosphates
D. Naphthalene
E.Methyl salicylate
8. Denotes the injurious effect of toxins
and very important in the diagnosis and
management of poisoning:
A.Toxicodynamics
B.Pharmacokinetics
C.Toxicokinetics
D.Toxidrome
E.Clinical toxicology
9. Which of the following plant may cause
nausea, emesis, hypotension, and
bradycardia on ingestion?
A. Veratrum califomicum
B.Convallaria majalis
C.Digitalis purpurea
D.Ricinus communis
E.Podophyllum peltatum
10. For many years, orally administered
activated charcoal has been routinely
incorporated into the initial treatment of
a patient poisoned by the oral route. The
term “activated” means:
A.Inorganic impurities removed on the
charcoal to prevent intoxication
B.The charcoal has been specially
processed to be more efficient at
adsorbing toxins.
C.The charcoal is sterilized to increase
affectiveness
D.The charcoal comes from a synthetic
source
E.The charcoal is converted to its active
form when exposed into acidic pH of the
stomach.
11. The most frequently result of overdose
of drugs with antimuscarinic actions, the
salicylates, or symathomimetics:
A.Hypotension
B.Hyperthermia
C. Mydriasis
D.Respiratory depression
E.Coma
12. Ingestion of this fungus causes
vasoconstriction. In extreme cases, the
vasoconstriction was severe enough
that gangrene would develop in the
extremities. Abortion in pregnant women
is also common after ingestion of this
grains contaminated with this fungus:
A.Veratrum album
B.Claviceps purpurea
C.Histoplasma capsulatum
D.Candida albicans
E.Amanita phalloides
13. All of the following are primary methods
to enhance the elimination of specific
poisons or drugs, EXCEPT:
A.Alkallination of the urine
B.Hemodialysis
C.Chelation
D.Hemofiltration
E.Plasma exchange or exchange
transfusion
14. The most commonly endangered or
impaired vital function in a poisoned
patient is:
A.Heart rate
B.Respiration
C.Temperature
D.Blood Circulation
E.Blood Pressure
15. Which of the following substance is the
most frequently involve in human
poisoning exposure?
A.Personal cre products
B.Analgesics
C.Cleaning substances
D.Sedatives, hypnotics, antipsychotics
E.Cough and cold medications
16. The difference between the measured
serum osmolality that is calculated from
serum concentration of sodium, glucose,
and BUN; an increase of this value is
associated with poisoning due to
ethanol and other alcohols.
A.Glucose gap
B.Serum gap
C.BUN gap
D.Osmolar gap
E.Anion gap
17. The CNS depression produced by
barbiturates is largely predictable in a
dose-dependent fashion and the
progression of clinical effect goes from
anxiolysis to sedation to somnolence to
coma. This therapeutic drug toxicity is
best classified as:
A.Pathological toxicity
B.Genotoxic effects
C.Allergic Reactions
D.Pharmacological toxicity
E.Idiosyncratic reactions
18. Administered to prevent Wernicke’s
syndrome in patient with suspected
alcoholism or malnourishment:
A. Methanol
B.Fomepizole
C.Activated charcoal
D.Thiamine
E.Pyridoxime
19. Ionizing radiation and many
environment chemicals are known to
injure DNA, and may lead to mutagenic
or carcinogenic toxicities. This
therapeutic drug toxicity is best
classified as:
A.Pathological toxicity
B.Genotoxic effects
C.Allergic Reactions
 D.Pharmacological toxicity 25. Manihot esculenta(Euphorbiaceae) raw
E.Idiosyncratic reactions root contains this cyanogenic glucoside
20. In patient with signs of respiratory or that must be removed during processing
CNS depression, intravenous of the root for human consumption.
administration of the drug offsets A. Argemone
possible toxic effects of opioid analgesic B. Cicutoxin
overdose: C. Xanthium
A.Thiamine D. Linamarin
B.Flumazenil E. Fumonisin
C.Naloxone 26. Delirium, ileus, flushing and increase in
D.Phenobarbital heart rate, blood pressure, temperature,
E.Morphine and pupil size are best associated with
21. Initial treatment approach for acute what drug poisoning?
poisoning includes all of the A. Anticholinergics
following.EXCEPT: B. Sympathomimetics
I. Airway: Maintain potency C. Opioid
II. Breathing: Maintain adequate D. Salicylate
oxygenation and ventilation E. Sedative-hypnotics
III. Circulation: Maintain perfusion of 27. Fleshy tubers of this plant material
vital organs contains a neurotoxin that upon
IV. Disability: Assess for central nervous consumption can result in fatal
system dysfunction poisoning, characterized by tonic-clonic
V. Exposure: Assess toxidrome convulsions, owing to the neurotoxin
binding to GABAgated chloride
A. I only channels:
B. I and II A. Cicuta maculate
C. II and III B. Manihot esculenta
D. III and IV C. Amanita muscarita
E. NONE OF THESE D. Nicotiana tobacum
E. Strychnos nux vomica
28. Drugs associated with hypokalemia
22. Agitation and increase in heart rate, include all of the following. EXCEPT:
blood pressure, temperature, and pupil A. Barium
size are best associated with what drug B. Methylxanthines
poisoning? C. Loop diuretics
A. Anticholinergics D. Lithium
B. Sympathomimetics E. Toluene
C. Opioid 29. The recommended dose for activated
D. Salicylate charcoal is:
E. Sedative-hypnotics A. 0.5-2 g/kg of body weight
23. Somnolence/coma and decrease in B. 1-3 g/kg of body weight
heart rate, respiratory rate and pupil size C. 5-6 g/kg of body weight
best associated with what poisoning? D.10-12g/kg of body weight
A. Anticholinergics E. 20-25g/kg of body weight
B. Sympathomimetics 30. Poisons that can be removed by
C. Opioid multiple treatments with activated
D. Salicylate charcoal includes all of the following.
E. Sedative-hypnotics EXCEPT:
24. Drugs that cause hyperkalemia includes I. Amitryptylline
all of the following except: II. Barbiturates
A. β-adrenoreceptor agonist III. Digitalis glycosides
B. Digitalis IV. Iron
C. Fluoride V. Lithium
D. Lithium
E. Potassium-sparing diuretics A. I and II
B. II and III
 C. III and IV D. Octreotide acetate
D. IV and V E. Pralidoxime chloride
E. I and V 37. An extracorporeal circulation procedure
31. Decontamination method of poisoned in which a patient’s blood is pumped
patient that involves the enteral through a column containing a
administration of large amount of a high semipermeable membrane that allows
molecular weight, iso-osmotic the removal of many toxic compounds.
polyethylene glycol electrolyte solution A. Ion trapping
with the goal of passing poison by the B. Hemodialysis
rectum before it can be absorbed: C. Peritoneal dialysis
A. Gastric lavage D. Whole bowel irrigation
B. Ion trapping E. Gastric lavage
C. Extracorporeal drug removal 38. Used as an antidote for caffeine,
D. Administration of cathartic theophylline, and sympathomimetics
E. Whole bowel irrigation overdose:
32. Confusion, lethargy, coma, seizure, A. Flumazenil
hyperventilation, hyperthermia, B. Fomepizole
dehydration, hypokalemia, anion gap C. Naloxone
metabolic acidosis are clinical features D. Ethanol
of toxicity with what agent? E. Esmolol
A. Opioids 39. Antidote used for sulfonylurea-induced
B. Salicylates hypoglycemia:
C. Tricyclic antidepressant A. Sodium thiosulfate
D. Antimuscarinic drugs B. Penicillamine
E. Sedative-hypnotics C. Octreotide acetae
33. Antidote used for beta-adrenergic D. Vitamin K
antagonist poisoning: E. Leucovorin calcium
A. Fomepizole 40. Useful in treating hyperthermia and
B. Glucagon hydrochloride rhabdomyolysis caused by drug-induced
C. Leucovorin calcium muscular hyperactivity that is not
D. Octreotide acetate controlled by usual cooling measures or
E. Pralidoxime chloride neuromuscular paralysis. Primary
34. Hallucinations, dilated pupils and indicated for the treatment of malignant
hypertension are toxic features of which hyperthermia:
agent? A. Bromocryptine
A. Acetaminophen B. Dantrolene
B. Carbon monoxide C. Esmolol
C. Lead D. Fomepizole
D. Lysergic acid (LSD) E. Glucagon
E. Mercury 41. Used for rapid reversal of
35. Abdominal pain, hypertension, seizure, benzodiazepine overdose-induced coma
muscle weakness, metallic taste, and respiratory depression:
anorexia, encephalopathy, delayed A. Epinephrine
motor neuropathy, and changes in renal B. Isoproterenol
and reproductive function are toxic C. Leucovorin calcium
features of which agent? D. Potassium iodide
A. Mercury E. Flumazenil
B. Methanol 42. Ingestion of this plant material may
C. Cyanide result into tachycardia, dry mouth,
D. Phencyclidine (PCP) dilated pupils, and decreased
E. Lead gastrointestinal motility of an individual:
36. Antidote used for organophosphorus A. Atropa belladonna
pesticides poisoning: B. Thermopsis Montana
A. Fomepizole C. Solanum malacoxylon
B. Glucagon hydrochloride D. Leucaena leucocephala
C. Peritoneal dialysis E. Cassia obtusifolia
43. Antidote used for methotrexate
poisoning:
A. Sodium thiosulfate
B. Penicillamine
C. Octreotide acetate
D. Vitamin K
E. Leucovorin calcium
44. Indicated for the treatment of
hypotention, bradycardia, or condition
impairment caused by beta adrenergic
blocker intoxication:
A. Glucagon
B. Activated charcoal
C. Labetalol
D. Magnesium
E. Fomepizole
45. A widely-used solvent for metal
degreasing associate with a number of
non-cancer toxicities including
autoimmune disorders, immune system
dysfunction, and is also potentially a
male reproductive toxicant.
A. Tetrachloroethylene
B. Trichloroethylene
C. Methylene chloride
D. Carbon tetrachloride
E. Chloroform
46. Indicated for acute management of
seizure caused by intoxication with
isoniazid, hydralzine, Gyromitra
mushroom or possibly cycloserine:
A. Pyridoxine
B. Thiamine
C. Vasopressin
D. Nitroprusside
E. Metoclopramide
47. The most studied protein from
Latrodectus mactans (female black
widow spider) that is toxic only to
vertebrates and not to insects or
crustaceans:
A. Hyaluronidase
B. Protoxin I
C. Apyrase
D. α-Latrotoxin
E. Formic acid
48. Indicated for patient with carbon
monoxide poisoning, to increase the
conversion of carboxyhemoglobin and
carboxymyoglobin to hemoglobin and
myoglobin.
A. Helium
B. Ferrous sulfate
C. 100% oxygen
D. Nitrogen
E. Carbon dioxide
49. Used for the reversal of the
anticoagulant effect of heparin when an
excessively large dose has been
administered inadvertently:
A. Warfarin
B. Hirudin
C. Vitamin K
D. Protamine
E. Octreotide
50. Used primarily in the production of the
refrigerant which is also a hepatotoxic
and nephrotoxic agent. It can invoke
CNS symptoms at sub-anesthetic
concentrations similar to those of
alcohol intoxication and can sensitize
the myocardium to cathecholamines,
possibly resulting in cardiac
arrhythmias.
A. Tetrachloroethylene
B. Trichloroethylene
C. Methylene chloride
D. Carbon tetrachloride
E. Chloroform
51. Indicated for severe pain associated
with black widow spider envenomation,
rattlesnake envenomation, or other bites
or stings:
A. Acetaminophen
B. Morphine
C. Propofol
D. Dantrolene
E. Cyproheptadine
52. Indicated for internal contamination with
plutonium, americium, and curium, it has
also been used for treatment of internal
contamination with californium and
berkelium:
A. EDTA
B.DTPA
C. BAL
D. KI
E. Unithiol
53. The hematopoietic toxicity of chronic
exposure to this agent may manifest
initially as anemia, leucopenia,
thrombocytopenia, or a combination of
these:
A. Xylenes
B. Benzene
C. Toluene
D. Ethylbenzene
E. Ethanol
54. This drug is to treat intractable nausea
and vomiting, particularly when the
ability to administer activated charcoal
 or antidotal therapy (e.g. N- D. Cyproheptadine
acetylcysteine) is compromised: E. Ipecac
A. Penicillamine 60. The major target organ in chronic
B. Protamine inoraganic arsenic exposure:
C. Prussian blue A. Liver
D. Ipecac B. Skin
E. Ondansetron C. Bone
55. A copper containing glycoprotein D. Lungs
oxidase in plasma that converts ferrous E. Brain
iron to ferric iron, which then bind to 61. Indicated for excessive anticoagulation
transferrin. This protein also stimulates caused by coumarin and indanedione
iron uptake by transferrin independent derivatives, as evidenced by elevated
mechanism: prothrombin time:
A. Ceruloplasmin A. Protamine
B. Transferrin B. Phytonadione
C. Ferritin C. Heparin
D. Metallothioneins D. Hirudin
E. Albumin E. Lepirudin
56. Component of food supplements that is 62. Oral chelator used in removing arsenic
possibly effective as adjuvant therapy in from a poisoned patient:
case of acute hepatic injury caused by A. Succimer
Amanita phalloides mushroom B. Methylene blue
ingestion, acetaminophen toxicity, and C. Sodium Thiosulfate
potentially other chemical and drug- D. Magnesium oxide
induce liver disease: E. Activated charcoal
A. Silymarin 63. Agent used to treat
B. Botulinum methemoglobinemia, in which the
C. Octreotide patient has symptoms or signs of
D. Orlistat hypoxemia (e.g. dyspnea, confusion, or
chest pain) or has a
57. The most typical strategy used to treat methemoglobinemia level greater than
metal poisoning is thru the 30%:
administration of: A. Succimer
A. Antacids B. Dantrolene
B. Neutralizers C. Sodium thiosulfate
C. Chelators D. Methylene blue
D. Pharmacologic antagonist E. Nitroprusside
E. Emetic 64. Classic manifestation of lead toxicity in
58. Which of the following is a characteristic adults:
of arsenic poisoning: A. Encephalopathy
A. Arsenate’s illness B. Peripheral neuropathy
B. Neutralizers C. Ataxia
C. Chronic neuropathy D. Footdrop and wristdrop
D. Footdrop and wristdrop E. Mental retardation
E. Mee’s illness 65. Caused by ingestion of botulinum
59. An alkaloid salt derived morphine that is spores (not preformed toxin) followed by
a dopaminergic agonist with minimal in vivo production of toxin (typically type
analgesic properties but market emetic A or B) in the immature infant out. Risk
efficacy. Previously used for induction of factor include age less than 1 year,
emesis in the acute management of oral breast-feeding, and ingestion of honey
poisoning, but it has been abandoned (which commonly contains botulinum
because of its potential for respiratory spores):
depression: A. Food-borne botulism
A. Ondasentron B. Infant botulism
B. Metoclopramide C. Wound botulism
C. Apomorphine
 D. Adult intestinal colonization (adult- nausea, vomiting, abdominal pain, and
infant) botulism diarrhea, often bloody:
E. Water botulism A. Gossypol
66. Which of the following is true regarding B. Ricin
mercury poisoning? C. Quinine
I. Mercury vapor is less hazardous D. Castorin
II. Consumption of fish is the major route E. Mycotoxin
of exposure to methylmercury 71. Chromic excessive use and large IV
III. The kidney is the major target organ doses of this vitamins can produce
for inorganic mercury increase levels of the metabolite oxalic
IV. The major human health effect from acid. Urinary acidification promotes
exposure to methylmercury is calcium oxalate crystal formation, which
neurotoxicity can result in neuropathy or acute rebal
failure:
A. I only A. Vitamin A
B. I and II B. Vitamin B
C. II and III C. Vitamin C
D. I, II and III D Vitamin D
E. II, III and IV F.Vitamin E
67. Which of the following is the mechanism 72. An autosomal recessive genetic
of toxicity of mercury? disorder of copper metabolism
A. High affinity binding to sulfhydryl characterized by the excessive
groups of proteins in the cells accumulation of copper in the liver,
B. Inhibition of enzymes brain, kidneys, and cornea:
C. Destruction of hepatocytes A. Plumbism
D. Uncoupling of mitochondrial oxidative B. Menke’s Disease
phosphorylation C. Asthenic-vegetative syndrome
E. Prevention of acetylcholine release D. Wilson’s disease
68. Occurs after ingestion of preformed E. Cuprism
toxin in contaminated food. Initial 73. Chronic ingestion of excessive amount
symptoms are nonspecific and may of this vitamins enhances calcium
include nausea, vomiting, sore throat, absorption and produces
and abdominal discomport: hypercalcemia:
A. Food-borne botulism A. Vitamin A
B. Infant botulism B. Vitamin B
C. Wound botulism C. Vitamin C
D. Adult intestinal colonization (adult- D. Vitamin D
infant) botulism F.Vitamin E
E. Water botulism 74. Toxicity of this vitamin is characterized
69. Excess dietary intake of this essential by dry, peeling skin, alopecia, and signs
metal is associated with damage to of increased intracranial pressure.
exocrine pancreas. Deficiency on the Bulging fontanelles have been
other hand may alter an antioxidant described in infants. Liver injury may
enzyme resulting in excessive free cause jaundice and ascites.
radicals that are damaging to cell A. Vitamin A
membranes: B. Vitamin B
A. Zinc C. Vitamin C
B.Lead D. Vitamin D
C. Platinum F.Vitamin E
D. Chromium 75. The most common initial complaint of
E. Aluminum patient having this disease is pain and
70. Derived from castor bean and may be stiffness of the jaw, progressing to
delivered as a powder or dissolved in trismus, risus sardonicus, and
water and may be inhaled, ingested, or opisthotosnus over several days:
injected. Clinical effects of toxin include A. Metal fume fever
B. Methemoglobinemia
 C. Hymenoptera
D. Tetanus
E. Botulism
76. Chronic overdose of this vitamin may
alter neuronal conduction, resulting in
paresthesias and muscular
incoordination:
A. Thiamine
B. Riboflavin
C. Niacin
D. Pyridoxine
E. Folic acid
77. The major toxic side effect of this
arrhythmic drug is hypotension caused
by inhibition of catecholamine release.
Orthostatic hypotension may persist for
several hours:
A. Tocainide
B. Mexiletine
C. Flecainide
D. Bretylium
E. Amiodarone
78. Bradykinin-mediated effects in patient
taking therapeutic doses of these
antihypertensive drugs include dry
cough (generally, mild often persistent
and annoying) and acute angioderma,
usually involving the tongue, lips, and
face, which may lead to life-threatening
airway obstruction:
A. ACE inhibitor
B. Angiotensin II receptor blocker
C, Beta blockes
D. Calcium channel blocker
E. Vasodilators
79. Toxicity of these antibacterial agents
includes ototoxicity to vestibular and
cochlear cells, nephrotoxicity causing
proximal tubular damage and acute
tubular necrosis and competitive
neuromuscular blockade if given rapidly
intravenously with other neuromuscular
blockade if given rapidly intravenously
with other neuromuscular blocking
drugs.
A. Cephalosporins
B. Penicillins
C. Macrolides
D. Glycopeptide antibiotics
E. Aminoglycosides
80. Symptoms of alcohol withdrawal include
which of the following?
I. Decrease in blood pressure
II. Decrease in heart rate
III. Flushing and temperature elevation
IV. Anxiety
V. Tremor
A. I and II
B. II and III
C. III and IV
D. I, II and III
E. III, IV and V
81. Symptoms opioid withdrawal include
which of the following?
I. Sweating
II. Dilated pupils
III. Diarrhea
IV. Decrease blood
V. Decrease heart rate
A. I and II
B. II and III
C. III and IV
D. I, II and III
E. III, IV and V
82. This antibiotic can cause abdominal
pain, idiosyncratic hepatotoxicity with
estolate salt and administration of more
than 4g/day may cause tinnitus and
ototoxicity:
A. Azithromycin
B. Nalidixic acid
C. Metronidazole
D. Erythromycin
E. Ampicillin
83. Permits mechanistic toxicologist to
identify and protect genetically
susceptible individuals from harmful
environmental exposure, and to
customize drug therapies based on their
individual genetic makeup:
A. Mechanistic toxicology
B. Descriptive toxicology
C. Regulatory toxicology
D. Toxicogenomics
E. Toxidrome
84. Concerned directly with toxicity testing,
which provides information for safety
evaluation and regulatory requirement:
A. Clinical toxicologist
B. Mechanical Toxicologist
C. Descriptive toxicologist
D. Regulatory toxicologist
E. Forensic toxicology
85. A hybrid of analytic chemistry and
fundamental toxicologic principles that
focuses primarily on the medicolegal
aspect of the harmful effects of
chemicals on humans and animals:
A. Forensic toxicology
 B. Clinical toxicology 93. Environmental and therapeutic agents
C. Environmental toxicology associated with methemoglobinemia
D. Developmental toxicology include which of the following?
E. Reproductive toxicology I. Benzocaine
86. LD50 of ethyl alcohol: II. Dapsone
A. 150mg/kg III. Nitrates
B. 900mg/kg IV. Chloramphenicol
C. 1,500mg/kg V. Allopurinol
D. 4,000mg/kg
E. 10,000mg/kg A. I and II
87. LD50 of Phenobarbital sodium: B. I, II and III
A. 150mg/kg C. II, III and IV
B. 900mg/kg D. III, IV and IV
C. 1,500mg/kg E. IV and V
D. 4,000mg/kg 94. Drugs associated with the development
E. 10,000mg/kg of aplastic anemia includes which of the
88. Toxic substance that are produced by or following?
are a by-product of human activities. I. Benzocaine
A. Toxins II. Dapsone
B. Toxicant III. Nitrates
C. Toxic IV. Chloramphenicol
D. Poisons V. Allopurinol
E. Antidote
89. The study of the adverse effect of A. I and II
exogenous chemicals on blood and B. I, II and III
blood-forming tissues: C. II, III and IV
A. Mutagenecity D. III, IV and IV
B. Hematotoxicology E. IV and V
C. Genetoxicology
D. Carcinogenecity
E. Developmental toxicology 95. An immunological mediated adverse
90. This life threatening disorder is reaction to a chemical resulting from
characterized by peripheral blood previous sensitization to that chemical
pancytopenia, reticulocytopenia and or to a structurally similar one:
bone marrow hypoplasia: A. Deleterious reaction
A. Megaloblastic anemia B. Chemical allergy
B. Aplastic anemia C. Chemical idiosyncrasy
C. Pure red cell aplasia D. Hypoxia
D. Sideroblastic anemia E. Anaphylactic shock
E. Iron deficiency anemia 96. Xenobiotics associated with oxidative
91. Deficiency of folate and/or vitamin B12 injury include which of the following?
results in this condition: I. Acetaminophen
A. Megaloblastic anemia II. Ascorbic acid
B. Aplastic anemia III. Mefenamic acid
C. Pure red cell aplasia IV. Phenol
D. Sideroblastic anemia V. Nitrobenzene
E. Iron deficiency anemia
92. Generally refers to toxic substances that A. I and II
are produced by biological systems B. I, II and III
such as plants, animals, fungi, or C. II, III and IV
bacteria: D. III, IV and IV
A. Toxins E. IV and V
B. Toxicants 97. Proliferative disorder of hematopoietic
C. Venom tissue that are monoclonal and originate
D. Poisons from individual bone marrow cells:
E. Antidote A. Anemia
 B. Leukemia C. Guanadrel
C. Agranulocytosis D. Catapres
D. Neutropenia E. Losartan
E. Methemoglobinemia 103. Hydralazine, isoniazid, and
98. A state of decreased responsiveness to procainamide produce autoimmunity,
a toxic effect of a chemical resulting which is manifested as which of the
from prior exposure to that chemical or following?
to a structurally related chemical: A. Systemic lupus erythematosus-like
A. Potentiation syndrome
B. Tolerance B. Hypersensitivity
C. Antagonism C. Leukemia
D. Immediate toxicity D. Gray baby syndrome
E. Delayed toxicity E. Aplastic anemia
99. Metals capable of immunosuppression 104. Defined as exposure to a
include which of the following? chemical for less than 24 hours.
I. Magnesium A. Acute exposue
II. Calcium B. Subacute exposure
III. Arsenic C. Subchronic exposure
III. Cobalt D. Chronic exposure
IV. Gold E. Repeated exposure
105. Who determined the onset of
A. I, II and III action, potency, specificity, site of action
B. II, III and IV and effects of toxic agent by testing
C. III, IV and V them on the poor and the sick?
D. I and V A. Paracelsus
E. IV and V B. Orfila
C. Catherine de Medicl
D. Mithridates
E. Bernardo Ramazinni

100. Defined as exposure to a 106. He correlated exposure to

chemical for more than 3 months: polyaromatic hydrocarbons and the
A. Acute exposue prevalence of scrotal cancer among
B. Subacute exposure chimney sweeps:
C. Subchronic exposure A. Bernardo Ramazinni
D. Chronic exposure B. Louis Lewin
E. Repeated exposure C. Orfila
101. Structurally diverse secondary D. Percival Pott
metabolites of fingi which comprise E. Ostwald Schiedeberg
toxins such as aflatoxin, ochratoxin, and 107. It is branch of toxicology which
the trichothecenes. is a analytical chemistry and
A. Mycotoxin fundamental toxicological principles that
B. Neurotoxin focuses primarily on the medico legal
C. Cytotoxin aspect of the harmful effects of
D. Necrotoxin chemicals.
E. Cyanotoxin A. Environmental toxicology
102. Centrally acting sympatholytic B. Reproductive toxicology
drug that has been widely used for the C. Developmental toxicology
treatment of essential hypertension, but D. Clinical toxicology
with the advent of newer E. Forensic toxicology
antihypertensive drugs, the use of this 108. A decrease in the therapeutic
drug has declined due to incidence of index of a drug _________________.
thrombocytopenia and hemolytic A. Increases the potential of a drug to
anemia. become toxic
A. Captopril B. Increases the efficacy of a drug
B. Methyldopa C. Decreases the lethality of a drug
 D. Increases the volume of distribution
of a drug
E. All of these
109. It is concerned with identifying
and understanding the cellular,
biochemical, and molecular
mechanisms by which chemicals exert
effects on living organisms.
A. Mechanistic toxicology
B. Descriptive toxicology
C. Regulatory toxicology
D. Environmental toxicology
E. Food toxicology
110. Which statement refers to a
toxicant?
I. Toxic substances that are produced
by biological system as such plants,
animal, fungi or bacteria
II. Toxic substances that are produced
by or are a by-product of anthropogenic
activites
III.Toxic substances that are produced
by or are a by-product of human-made
activities
A. I only
B. I and II only
C. II and III only
D. III only
E. I, II and III
111. Capable of eliciting antibodies,
and usually at least 1-2 weeks is
required for the synthesis of antibodies.
I. antigen
II. hapten
III. hapten – protein complex
A. I only
B. I and II
C. I and III
D. II and III
E. III only
112. Analyze the given statements:
I. Tissues such as liver, which has a
high ability to regenerate, most injuries
are reversible.
II. Injury to the CNS is largely
irreversible because differentiated cells
of the CNS cannot divide and be
replaced.
III. Carcinogenic and teratogenic effects
of chemicals, once they occur, are
usually considered irreversible toxic
effects.
A. Statement I is correct
B. Statement II is correct
C. Statement I and II are correct
D. Statement I and III are correct
E. All statements are correct
113. Which statement is true
regarding synergic effects?
I. Carbon tetrachloride and ethanol are
hepatotoxic compounds, but together
they produce much more liver injury
than the mathematical sum of their
individual effects on liver at a given dose
would suggest
II. Isopropranol, is not hepatotoxic, but
when it is administered in addition to
carbon tetrachloride, the hepatoxicity of
carbon tetrachloride is much greater
than when it is given alone
III. Promethazine, an antihistamine,
when given with a painkilling narcotic
such as Demerol intensifies its effect,
thereby cutting down the amount of
narcotic needed
A. I only
B. II only
C. I and II only
D. I and III only
E. II and III only
114. All of the following statements
describe functional antagonism
EXCEPT:
I. Occurs when two chemicals counter
balance each other by producing
opposite effect on the same physiologic
function
II. Use of strongly basic low-molecular-
weight protein protamine sulfate to form
a stable complex with heparin, which
abolishes its anticoagulant activity
III. Chemical reaction between two
compounds that produces less toxic
product
IV. Blood pressure can marketedly fall
during severe barbiturates intoxication,
which can be effectively antagonized by
the intravenous administration of a
vasopressor agent such as
norepinephrine or metaraminol
A. I only
B. I and II only
C. II and III only
D. III and IV only
E. IV only
115. Dimercaprol chelates metal ion
such as arsenic, mercury, and lead and
 decreases their toxicity. What kind of I. Failure of DNA repair
antagonism the example describes? II. Failure of apoptosis
A. Functional antagonism III. Failure to terminate call proliferation
B. Chemical antagonism
C. Receptor Antagonism A. I only
D. Dispositional Antagonism B. I and II
E. Physiological Antagonism C. II and III
116. Distribution to toxicants to D. I and III
specific sites may be hindered by E. I, II and III
several processes. These includethe 120. Adaptation to toxicity may result
following, EXCEPT: from biological changes causing which
I. Binding to plasma protein of the following?
II. Non-specialized barrier I. Diminished delivery of the toxicant to
III. Distribution to stirage sites the target
IV. Association with intracellular binding II. Increased size or susceptibility of the
proteins target
III. Increased capacity of the organism
A. I only to repair itself
B. II only IV. Strengthened mechanisms to
C. I and II only compensate the toxicant-inflicted
D. II and IV dysfunction
E. III and IV
A. I and II
B. II and III
C. III and IV
D. I, II and III
E. I, II and IV
121. The discovery of sulfanilamide
was heralded as a major event in
117. Choose the correct statement/s combating bacterial diseases. However,
which describe Margin of Safety: it was soon discovered that the drug
I. LD1/ED99 was more soluble in diethylene glycol.
II.LD50/ED50 The drug was sold in the diethylene
III. Ratio of the dose required to produce glycol solution but was labeled as an
a toxic effect and the dose needed to elixir, and several patients died of acute
elicit the desired therapeutic response. renal failure resulting from the
IV. Chemical produces injury to one kind metabolism of the glycol. What is the
of living matter without harming another ultimate toxicant of glycol?
form of life A. Oxalic acid
B. Formic acid
A. I only C. Ethanol
B. I and II only D. Arsenate
C. II and III only E. Acetone
D. I and III only 122. What is the topical treatment for
E. II and IV only skin contamination of white
118. It is defined as the removal of phosphorus?
xenobiotics from blood their return to the A. Calcium soak
external environment. B. Mineral oil
A. Clearance C. Ethyl alcohol
B. Excretion D. 1% copper sulfate
C. Metabolism E. None of these
D. Disintegration 123. All of the following precautionary
E. Liberation measures regarding skin
119. Chemical carcinogenesis decontamination, EXCEPT:
involves insufficient function of various A. Wear protective gears such as
repair mechanisms. These include: gloves, gown and goggles
 B. Remove contaminated clothing D. Contaminant
C. Flush with hot water E. Toxicant
D. All of these 129. The following are treatment in
E. None of these case of acute intoxication of Carbon
124. All of the following precautionary monoxide, except:
measures regarding eye I. Removal of the individual from the
decontamination, EXCEPT: exposure source
A. Flush exposed eyes with copious II. Administration of carbon dioxide
quantities of saline III. Use of hyberbaric oxygen chamber
B. Instill local anesthetic drops to
facilitate irrigation A. I only
C. Instill neutralization solution B. II only
D. Remove contact lenses C. III only
E. None of these D. I and II
125. All of the following can be given E. II and III
and/or done as gastrointestinal 130. These are examples of
decontamination, EXCEPT: organophosphates pesticides, except:
A. Ipecac syrup I. Malathion
B. activated charcoal II. Parathion
C. Gastric lavage III. Dimethoate
D. Cathartics IV. Isolan
E. None of these
126. If activated charcoal and A. I and II
cathartic was used as GI B. II and III
decontamination and there is no C. I, II and III
charcoal in the stool after 6-8 hrs. What D. III only
action will you employ? E. IV only
131. A water-soluble analog of
A. Repeat administration of cathartic dimercaprol
same of the original dose I. Succimer
B. Repeat administration of cathartic II.DMSA
twice of the original dose III. BAL
C. Repeat administration of cathartic IV. EDTA
one half of the original dose
D. No need to administer another dose A. I and II
of cathartics B. II and III
E. None of these C. III and IV
127. It is concerned with the toxic D. II only
effect of chemical and physical agents E. III only
on populations and communities of 132. Used in the treatment of
living organism within defined Wilson’s disease?
ecosystem: A. Deferoxamine
A. Environmental toxicology B. BAL
B. Ecotoxicology C. EDTA
C. Occupational toxicology D. Penicillamine
D. Forensic toxicology E. Methylene blue
E. Descriptive toxicology 133. Regarding Deferoxamine:
128. If the intake of a long-lasting I. Deferoxamine is isolated from
contaminant by an organism exceeds Sreptomyces pilosus.
the latter’s ability to metabolize or II. It is the parenteral chelator of choice
excrete the substance, the chemical for iron poisoning
accumulates within the tissues of the III. Deferoxamine plus Hemodialysis
organism. This called: may also be useful in the treatment of
A. Bioaccumulation Aluminum toxicity in renal failure
B. Biomagnification
C. Biosystem A. Only statement I is correct
 B. Only statement II is correct D. Prussian blue
C. Only statement III is correct E. Methyl orange
D. Only statement I and II are correct 140. Which is true regarding EDTA?
E. All statement are correct I. Ethylenediaminetetracetic acid
134. This is the antidote used in II. A dimercapto chelating agent
treating of poison caused by III. D-dimethylcysteine
theophylline, caffeine and IV. Ferric Hexacyanderrate
metaproterenol
A. Ethanol A. I only
B. Esmolol B. II only
C. Naloxone C.III only
D. Pralidoxime D. IV only
E. Deferoxamine E. I and II only
135. Flumazenil is the antidote used 141. It is a gas that has similar
in treating poisoning caused by: mechanism of toxicity with cyanide and
A. Benzodiazepines has a smell of rotten eggs:
B. Ethylene glycol A. Carbon monoxide
C. Acetaminophen B. Hydrogen sulfide
D. Digoxin C. Nitrogen oxide
E. Cyanide D. Sulfur dioxide
136. Suggested treatment for E. Ammonia
delirium caused by anticholinergic 142. Which of the following is a
agents: mismatch?
I. Methamphetamine – Crystal
II. MDMA – ecstasy
III. Cocaine – crack

A. Sodium Bicarbonate A. I only

B. Atropine B. II only
C. Physostigmine C. III only
D. Hydroxocobalamine D. I and II
E. Pralidoxime E. II and III
137. Large doses of this drug 143. This is typical among opioids,
opposes the muscarinic effect of clonidine, phenothiazines, and
extremely potent agents like parathion cholinesterase inhibitors:
and chemical warfare nerve gases. A. Dry mouth
A. Glucagon B. Sneezing
B. Atropine C. Bradycardia
C. Physostigmine D. Mydriasis
D. Naloxone E. Miosis
E. Oxygen 144. In poisoning with atropine and
138. It prevents and reduces the other antimuscarinic agents, skin often
arsenic-induced inhibition of sulfhydryl- appears:
containing enzymes: I. Flushed
A. Demercaprol II. Hot
B. Penicillamine III. Dry
C. Unithiol IV. Wet
D. Deferasirox
E. Prussian blue A. I and II
139. In 2003, the FDA approved this B. II and III
for the treatment of contamination with C. I, II, III
radioactive Cesium (133Cs) and D. I, II, IV
intoxication with Thallium salt: E. I and IV
A. Methylene blue 145. Antidote for acetaminophen
B. Malachite green poisoning:
C. Crystal violet A. Ambolar
 B. Acetylsalicylic acid E. Fibrosis
C. Flumazenil 152. CNS excitation, seizure,
D. Mucomyst tachycardia, hypotension and mydriasis
E. Flunisolide are associated with which of the
146. Antidote for organophosphate following?
cholinesterase inhibitor: I. Cocaine
A. Atropine II. Caffeine
B. 2-PAM III. Acetylcholine
C. Ma Huang IV. Codeine
D. Desipramine V. SSRI
E. Doxepin
147. An opioid antagonist that A. I and II
reverse the effects of a dose of B. II and III
morphine or heroin within minutes. C. III and IV
A. Naloxone D. IV and V
B. Nalbuphine E. I and V
C. Manfine 153. The systematic scientific
D. Meperidine characterization of potential adverse
E. Nabilone health effect resulting from human
148. Biotransformation thet exposure to hazardous agents or
eliminates the ultimate toxicant or situations:
prevent its formation is called : A. Risk
A. Metabolic activation B. Risk assessment
B. Toxication C. Risk management
C. Metabolic transformation D. Risk systematic
D. Detoxification E. Risk communication
E. Xenobiotic elimination 154. 4-methypyrazole is used as an
149. Chemicals can oxidize Fe(II) in antidote for ____________ toxicity.
hemoglobin to Fe(III), producing A. Cholinesterase inhibitor
methemoglobinemia. The type of B. Digitalis
reaction involve is: C. Fluoride
A. Hydrogen abstraction D. Isoniazid
B. Electron transfer E. Methanol
C. Enzymatic reaction 155. One of the most widely studied
D. Non covalent binding drugs inducing autoimmunity. It is an
E. Covalent binding inhalation anesthetic that can induce
150. Clinical manifestation such as autoimmune hepatitis.
altered mental status, increased muscle A. Propofol
tone, hyperreflexia, hyperthermia and B. Sevoflurane
tremor is associated with what toxic C. Halothane
syndrome? D. Isoflurane
A. Sympathomimetic E. Ketamine
B. Anticholinergic 156. Defined as the probability of an
C. Opiate adverse outcome under specified
D. Cholinergic condition.
E. Serotonin A. Risk
151. A pathologic condition B. Risk assessment
characterized by excessive deposition of C. Risk management
an extracellular matrix of abnormal D. Hazard
composition and is a specific E. Risk potential
manifestation of dyspair of the 157. Hepatobillary injury caused by
chronically injured tissue: amiodarone. CCl4, ethanol, tamoxifen
A. Tissue necrosis and valproic acid:
B. Carcinogenesis A. Fatty liver
C. Tumor B. Hepatocellular death
D. Apoptosis C. Canalicular cholestatsis
 D. Bile duct damage
E. Fibrosis and cirrhosis A. I and II
158. Hepatobillary injury caused by B. II and III
acetaminophen, allyl alcohol, Cu, C. III and IV
dimethylformamide and ethanol: D. I, II and III
A. Hepatocyte death E. II, III and IV
B. Tumors 164. Substances that exist
C. Sinusoidal disorder predominantly in the gas phase at body
D. Canalicular cholestasis temperature and volatile liquids are
E. Bile duct damage eliminated mainly by which organ?
159. Refers to the process by which A. Skin
policy actions are chosen to control B. lungs
hazards: C. Kidney
A. Risk D. Liver
B. Hazard E. Stomach
C. Risk management 165. The most common site of
D. Risk systematic toxicant induced renal injury:
E. Risk communication A. Glomerular injury
160. Mechanisms of toxicant induced B. Proximal tubular injury
injury to liver include which of the C. Loop of Henle injury
following? D. Papiliary injury
I. Lipid peroxidation E. Collecting duct injury
II. Metochondrial damage 166. Defined as a heritably altered,
III. Disruption of the cytoskeleton relatively autonomous growth of tissue
IV. Massive potassium influx with abdominal regulation of gene
expression:
A. I and II A. Cancer
B. II and III B. Neoplasm
C. III and IV C. Metastases
D. I, II and III D. Carcinogen
E. IV only E. Fibroma
161. Consumption of high amounts of 167. This group consists of two or
_____ will result to orange coloration of more amino sugars joined ina glycosidic
skin. linkage to a central hexose nucleus.
A. Carotene Although they are drugs of choice for
B. Vitamin B many gram negative infections, their use
C. Lycopene is primarily limited by their
D. Citric acid nephrotoxicity:
E. Carica papaya A. Penicillins
162. Factors that influence the B. Aminoglycosides
absorption of toxicants through the skin C. Macrolides
include all of the following. EXCEPT: D. Cephalosporin
A. Integrity of the stratum corneum E. Radiocontrast agents
B. Hydration state of the stratum 168. An agent whose administration
corneum to previously untreated animals leads to
C. Solvents as carriers a statistically significant increased
D. Molecular size incidence of neoplasm of one or more
E. Volume of distribution of toxicant histogenetic types as compared with the
163. Drug that impairs glomerular incidence in appropriate untreated
filtration without significant loss of animals:
structural integrity and decrease GFR A. Teratogen
includes which of the following? B. Neoplasm
I. Cyclosporine C. Metastases
II. Amphotericin B D. Carcinogen
III. Gentamicin E. Fibroma
IV. Cefalexin
169. This toxicant may cause shaver V. May function at tumor promotion
disease, corundum smelter’s lung and stage
bauxite lung:
A. Acrolein A. I and II
B. Aluminum abrasive B. II and III
C. Ammonia C. I, II and III
D. Arsenic D. II, III and IV
E. Asbestos E. IV and V
170. A disease of cellular mutation, 176. Byssinosis which is
proliferation, and aberrant cell growth. characterized by chest tightness,
A. Cancer wheezing and dyspnea is caused by:
B. Neoplasm A. Coal dust
C. Metastases B. Cotton dust
D. Carcinogen C. Hydrogen fluoride
E. Fibroma D. Iron oxide
171. This toxicant may cause framer E. Isocyanates
lung, compost lung, malt worker’s lung: 177. The second stage of the
A. Aspergillus carcinogenesis process that involves the
B. Beryllium selective clonal expansion of initiated
C. Ammonia cells to produce a peraneoplastic lesion:
D. Arsenic A. Promotion
E. Asbestos B. Initiation
172. Carcinogens that interact with C. Mutation
DNA resulting in mutation: D. Cloning
E. Progression

A. Malignant
B. Neoplasia 178. Genes that stimulate the
C. Genotoxic transformation of normal cell into cancer
D. Nongenotoxic cells:
E. Metastases A. Tumor
173. Lesions characterized by B. Oncogenes
expansive growth, frequencyexhibiting C. Hapten
slow rates of proliferation that do not D. Fibroblasis
invade surrounding tissues: E. Somatic cells
A. Benign 179. Silo-filler’s diseases which can
B. Malignant induce immediate or delayed pulmonary
C. Tumor edema is caused by which toxicant?
D. Neoplasia A. Phosgene
E. Neoplasm B. Perchloroethylene
174. Lesions demonstrating invasive C. Manganese
growth, capable of metastases to the D. Fibroblasis
tissues and organs: E. Somatic cells
A. Adenoma 180. Encompasses the study of
B. Carcinoma pharmacokinetics mechanisms,
C. Benign pathogenesis, and outcomes following
D. Malignant exposure to agents or condition leading
E. Sarcoma to abnormal development.
175. Features of a genotoxic agent A. Developmental toxicology
include which of the following? B. Environmental toxicology
I. Mutagenic C. Regulatory toxicology
II. Can be complete carcinogen D. Clinical toxicology
III. Tumorigenicity is dose responsive E. Forensic toxicology
IV. No direct DNA damage
181. Chronic effect of this toxicant
include fibrosis, pleural calcification,
lung cancer, and mesotheloma.
A. Aspegillus
B. Ammonia
C. Asbestos
D. Chlorine
E. Isocyanates
182. In 1960 a large increase in
newborns with rare limb malformations
of amelia (absence of the limbs) of
various degrees of phocomelia
(reduction of the long bones of the
limbs) was recorded in West Germany.
The identified causative agent is:
A. Nuclear radiation
B. Thalidomide
C. Acetaminophen
D. Isotretinoin
E. Tacrolimus
183. Toxicant induced irreversible
loss of neurons, including its
cytoplasmic extensions, dendrites, and
axons, and the myelin ensheathing the
axon:
A. Axonopathy
B. Neuropathy
C. Wallerian degeneration
D. Myelinopathy
E. Encephalopathy
184. A systemic nonsteroidal
estrogen widely used from the 1940s to
the 1970s in the United States to
prevent threatened miscarriage that was
soon linkage to clear cell
adenocracinoma of the vagina.
A. Estradiol
B. Progesterone
C. Diethylstilbestrol
D. Estrogen
E. Progestin
185. Neurotoxicant that may cause
optic neuritis and peripheral neuropathy:
A. Chloramphenicol
B. Carbon tetrachloride
C. Cyanide
D. Doxurubicin
E. Manganese
186. High exposure to this vitamin
during pregnancy can cause
malformations of the face, limbs, heart,
central nervous system, and skeleton of
the infant. Spontaneous abortion, live-
born infants having at least one major
malformation, and numerous exposed
children having full-scale IQ scores
below 85 at age 5 years have been
documented:
A. Vitamin A (Retinol)
B. Vitamin B1 (Thiamine)
C. Vitamin B2 (Riboflavin)
D. Vitamin B3 (Niacin)
E. Vitamin C (Ascorbic acid)
187. Nystagmus, ataxia and
dizziness are caused by which agent?
A. Phenytoin
B. Quinine
C. Streptomycin
D. Manganese
E. Doxorubicin
188. A quinine containing
anthracycline antibiotic which is one of
the most effective antibiotics in cancer
chemotherapy. Clinical application of the
drug is greatly limired due to incidence
of acute and chronic cardiotoxicity:
A. Methotrexate
B. Vincristine
C. Doxorubicin
D. Chlorambucil
E. Cyclophosphamide
189. 4-aminoquinoline derivatives
used as antimalarial and anti-
inflammatory drugs that can cause
irreversible loss of retinal function:
A. Artemissin
B. Chloroquine
C. Primaquine
D. Digoxin
E. Naphthalene
190. This drug is used in the
treatment of congestive heart disease
and in certain cardiac arrhythmias. It
may cause visual system abnormalities
which include decreased vision and
altered color vision:
A. Nifedipine
B. Digoxin
C. Dobutamine
D. Minoxidil
E. Nitroglycerine
191. A nonsteroidal anti-inflammatory
drug with analgesic and antipyretic
properties that is frequently used for
management of arthritis, gout, and
musculoskeletal discomfort. Chronic
administration of 50 to 200 mg/day of
this agent for 1 to 2 years has been
reported to produce corneal opacities,
paramacular depigmentation decrease
in visual acuity, altered visual fields,
 increase in the threshold for dark 196. Common mechanisms of
adaptation and blue-yallow color vascular toxicity include which of the
deficits: following?
A. Aspirin I. Alterations in membrane structure and
B. Piroxicam function
C. Indomethacin II. Redox stress
D. Mefenamic acid III. Vessel specific bioactivation of
E. Acetaminophen protoxicans
192. Acute poisoning of this agent IV. Preferential accumulation of the
may result in profound and permanent acute toxin in vascular cells
structural alterations in the retina and
visual impairment, ranging from blurred A. I and II
vision to decreased visual acuity and B. II and III
light sensitivity to blindness: C. III and IV
A. Lead D. I and IV
B. Methanol E. I, II and IV
C. Vigabatrin 197. The ultimate response of the
D. Tamoxifen heart to toxic exposure, which can be
E. Aspirin measured by both morphologic and
193. An antimycobacterial drug for functional degenerative phenotypes:
the treatment of tuberculosis that is A. Myocardial adaptation
known to produce dose related B. Myocardial degeneration
alterations. In the visual system, such as C. Sudden cardiac death
blue-yellow and red-green D. Cardiomyopathy
dyschromatopsias, decrease contrast E. Myocardial ischemic injury
sensitivity, reduced visual acuity, and 198. Biomarkers for cardiac toxicity
visual field loss: include which of the following?
A. Rifampicin I. Myoglobin
B. Isoniazid II. BNP
C. Vigabatrin III. CRP
D. Ethambutol IV. ALT
E. Cycloserine
194. An increased size of cardiac A.I and II
myocytes in which new contractile B. II and III
protein units are assembled in series, C. III and IV
resulting in a relatively greater increase D. I, II and III
in the length than in the width of E. II, III and IV
individual myocytes: 199. Cardiotoxic manifestation of this
A. Cardiomyopathy class of antiarrhythmic drugs include
B. Concentric cardiac hypertrophy bradycardia and heart block:
C. Eccentric cardiac hypertrophy A. Class I
D. Heart failure B. Class II
E. Chronic cardiac toxicity C. Class III
195. The inability of the heart to D. Class IV
maintain cardiac output sufficient to E. Class V
meet the metabolic and oxygen 200. A vasoconstrictor released from
demands of peripheral tissues, including the posterior pituitary gland in response
changes in systolic and diastolic to volume depleting conditions, such as
function that reflect specific alterations hemorrhage:
in ventricular function and abnormalities A. Atrial natriuretic peptide
in a variety of subcellular processes. B. Antidiuretic hormone
A. Cardiomyopathy C. Renin
B. Concentric cardiac hypertrophy D. Angiotensin
C. Eccentric cardiac hypertrophy E. Aldosterone
D. Heart failure 201. Used to relief symptoms caused by
E. Chronic cardiac toxicity excessive histamine effect (e.g. ingestion of
scombroid-contaminated fish or niacin and rapid copper:
intravenous administration of acetylcysteine): A. Penicillamine
A. Bromocriptine B. BAL
B. Diphenhydramine C. Dimercaprol
C. Dantrolene D. Succimer
D. Benztropine E. Unithiol
E. Glucagon 208. Condition that arises from the direct contact
202. A first- generation, histamine-1 receptor of agents on the skin and accounts for nearly
blocker that is beneficial in alleviating mild to 80% of contact dermatitis cases:
moderate symptoms in cases of suspectid A. Allergic Contact Dermatitis
serotonin syndrome: B. Granulomatous reaction
A. Phenylephrine C. Irritant dermatitis
B. Fexofenadine D. Urticaria
C. Loratidine E. Anaphylactic reaction
D. Cimetidine 209. All of the following conditions are
E. Cyproheptadine associated with abnormal synthesis of vitamin K-
203. Used to increase blood pressure, cardiac dependent coagulation factors, except:
output, and urine flow in patients with shock who A. Warfarin and analogs
have not responded to intravenous fluid B. Rodenticides
challenge, correction of hypothermia, or reversal C. Intravenous αtocopherol
of acidosis D. Ascorbic acid
A. Epinephrine E. Dietary deficiency
B. Dopamine 210. The major complication associated with
C. Metoprolol heparin therapy is:
D. Isosorbide dinitrate A. Thrombosis
E. Digitoxin B. Bleeding
204. It is an endogenous catecholamine with C. Nausea
alpha- and beta-adrenergic agonist properties D. Abdominal cramps
that is used primarily in emergency situiations to E. Migraine
treat anaphylaxis or cardiac arrest: 211. Which of the following is not a function of
A. Flumazenil the liver?
B. Activated charcoal A. Protein synthesis
C. Dimercaprol B. Xenobiotic absorption
D. Epinephrine C. Bioactivation and detoxification
E. Esmolol D. Formation of bile
205. A B-complex vitamin that is essential for E. Biliary secretion
protein synthesis and erythropoiesis. Also used 212. Aflatoxin, androgens, arsenic, thorium
as adjunctive treatment for methanol poisoning: dioxide and vinyl chloride cause this type of liver
A. Thiamine injury:
B. Pyridoxine A. Fatty liver
C. Riboflavin B. Hepatocyte death
D. Folic acid C. Bile duct damage
E. Niacin D. Tumors
206. Synthetic form of vitamin B12 that is also E. Canalicular cholestasis
used for the treatment of pemicious anemia. 213. Characterized by cell swelling, leakage,
This agent is also indicated for the treatment of nuclear disintegration (karyolysis), and an influx
acute cyanide poisoning or patients suspected of inflammatory cells in the liver:
to be at high risk for cyanide poisoning: A. Necrosis
A. Retinol B. Apoptosis
B. Folic acid C. Cholestasis
C. Hydroxycobalamin D. Fatty liver
D. Ascorbic acid E. Tumor
E. Thiamine 214. Defined physiologically as a decrease in
207. A derivative of penicillin that has no the volume of the bile formed or an impared
antimicrobial activity but effectively chelates secretion specific solutes into bile, characterized
some heavy metals, such as lead, mercury, and biochemically by elevated serum levels of
compounds normally concentrated in bile, A. Cyanide
particularly bile salts and bilirubin. B. Cisplatin
A. Steatosis C. Methotrexate
B. Apoptosis D. Clonidine
C. Cholestasis E. Epinephrine
D. Fatty liver 222. Prussian blue (Radiogardase) is given for
E. Sinusoidal damage the management of which poisoning?
215. An antifungal agent that causes A. Thalium
nephrotoxicity characterized by ADH-resistant B. Insulin
polyuria, renal tubular acidosis, hypokalemia, C. Cyanide
and either acute or chronic renal-failure: D. Warfarin
A. Nystatin E. Ethylene glycol
B. Amphoterin B 223. Given as a treatment for Amatoxin
C. Amoxicillin mushroom poisoning:
D. Cylosporine A. Protamine
E. Ketoconazole B. Pyridoxine
216. A valuable drug in the treatment of solid C. Folinic acid
tumors, with nephrotoxicity limiting its clinical D. Silibinin
use: E. Succimer
A. Cylosporine 224. Analog of somatostatin that inhibits
B. Cisplatin pancreatic insulin secretion. It currently is the
C. Methotrexate essential complement to dextrose for the
D. Tetracycline treatment of refractory hypoglycemia by
E. Doxycycline overdoses of insulin secretagogues:
217. Casein, β-lactoglobulin and α-lactalbumin A. Leucovorin
are allergic proteins found in: B. Ocreotide
A. Egg whites C. Physostigmine
B. Egg yolks D. Deferoxamine
C. Soybeans E. Activated charcoal
D. Codfish 225. Indicated for the reversal of an elevated
E. Cow’s milk prothrombin time (PT) or an international
218. Hypertension, cardiac enlargement and normalized ration (NR) in patients with
sodium retention may be observed in individuals xenobiotic induced vitamin K deficiency.
after intake of this food: A. Phytonadione
A. Licorice B. Beta carotene
B. Cassava roots C. Alpha tocopherol
C. Soybeans D. Ascorbic acid
D. Peanut E. Calcitriol
E. Chicken liver 226. A rapidly acting antidote that is used
219. Given as antidote/treatment for flouride, primarily to reverse the anticoagulant effects of
hydrofluoric, ethylene glycol, CCBs, and β- unfractionated heparin (UFH)
adrenergic antagonists overdose/poisoning: A. Leprirudin
A. Atropine B. Vitamin K1
B. Benzodiazepine C. EDTA
C. Calcium gluconate D. Warfarin
D.Cyproheptadine E. Protamine
E. Dantrolene 227. A safe and effective pyridoxine regimen of
220. Treatment for poisoning caused by INH overdoses in adults is:
cardioactive steroids: A. 5 g of pyridoxine for each gram of INH
A. Digitoxin-specific antibody fragments ingested
B. Dimercaprol B. 4 g of pyridoxine for each gram of INH
C. Diphenhydramine ingested
D. Insulin C. 3 g of pyridoxine for each gram of INH
E. Iodide ingested
221. Glucarpidase is given as a treatment for D. 2 g of pyridoxine for each gram of INH
overdose of which of the following? ingested
E. 1 g of pyridoxine for each gram of INH D. I and III
ingested E. III only
228. Glucagon is indicated for which of the 233. For prevention of Wernicke
following? encephalopathy, initial therapy usually consists
I. Management of overdoses of antipsychotics of the immediate parenteral administration of
II. Management of overdoses of Beta adrenergic how many mg of thimaine hydrochloride?
antagonists A. 50 mg
III. Management of calcium channel blocker B. 100 mg
overdose C. 200 mg
IV. Reversal of hypoglycemia D. 250 mg
E. 300 mg
A. I and II 234. Calcium preparation is used in the
B. II and III management of following conditions, except:
C. II and IV I. Calcium channel blocker toxicity
D. I, II and III II. β-Adrenergic antagonist toxicity
E. II, III and IV III. Hypocalcemia due to hydrofluoric acid
229. What is the initial dose of dantrolene for the exposure
treatment of acute malignant hyperthermia? IV. Hypomagnesemia
A. IV bolus 2-3 mg/kg
B. IV bolus 5-6 mg/kg A. I and II
C. IV bolus 0.3-0.5 mg/kg B. II and III
D. IV bolus 0.5-1 mg/kg C. III and IV
E. IV bolus 8-10 mg/kg D. III only
230. An antidote most extensively studied for the E. IV only
treatment of local anesthetic systemic toxicity. 235. Problems encountered with the
This agent is also being investigated for the administration of ethanol include which of the
treatment of overdose from lipophilic xenobiotics following?
such as calcium channel blockers, cyclic I. Risk of central nervous system (CNS)
antidepressants, and β-adrenergic antagonists, depression
among others: II. Behavioral disturbances
A. Dantrolene III. Hepatitis and pancreatitis
B. Intravenous fat emulsion IV. Hyperglycemia
C. Leucovorin
D. Folic acid A. I and II
E. Pralidoxime B. II and III
231. Flumazenil is used in the management of C. III and IV
the following, EXCEPT: D. I, II and III
I. Benzodiazepine overdose E. II, III and IV
II. Hepatic encephalopathy 236. In a patient with presumed cyanide
III. Paradoxical reactons poisoning, the adult dose of sodium thiosulfate
IV. Nephrotoxicity is:
A. 5 g
A. I and II B. 10 g
B. II and III C. 12.5 g
C. III and IV D. 15 g
D. III only E. 20 g
E. IV only 237. The initial dose of hydroxocobalamin for
232. Indication for thiamine hydrochloride cyanide poisoning in adults is:
includes which of the following? A. 5 g
I. Wernicke encephalopathy B. 10 g
II. Ethylene glycol poisoning C. 12.5 g
III. Malignant hyperthermia D. 15 g
E. 20 g
A. I only 238. Antidote to radioactive iodine that may be
B. I and II released into the atmosphere following a nuclear
C. II and III incident:
A. Activated charcoal B. II and III
B. Methylene blue C. I, II and III
C. Deferoxamine D. II, III and IV
D. Potassium iodide E. II and IV
E. BAL 245. A yellow to yellow-orange macular
239. Xenobiotics commonly implicated in discoloration of the skin. It can be caused by
gastritis and peptic ulcer disease includes which xenobiotics such as carotenoids, which deposit
of the following? in the stratum corneum, and cause
I. Corticosterioids carotenoderma.
II. Ethanol A. Cyanosis
III. Acetaminophen B. Xanthoderma
IV. NSAIDs C. Pruritus
D. Flushing
A. I and II E. Sweating
B. II and III 246. Poorly localized, unpleasant sensation that
C. I, II and IV elicits a desire to scratch. It is a common
D. I, II and IV manifestation of urticarial reactions, but it may
E. II, III and IV also be of non-immunologic origin:
240. Xenobiotics implicated with esophagitis and A. Cyanosis
esophageal ulcerations include all of the B. Xanthoderma
following, EXCEPT: C. Pruritus
A. Antipsychotics D. Flushing
B. Potassium chloride E. Sweating
C. Tetracycline 247. It is an acute self-limited disease
D. NSAIDs characterized by target-shaped, erythematous
E. Antacids macules and patches on the palms and soles,
241. Chlorhexidine oral rinse can cause what as well as the trunk and extremities:
color of stain in the teeth? A. Urticaria
A. Yellow B. Erythema Multiforme
B. Brown C. Stevens-Johnson Syndrome
C. Green D. Stevens-Johnson Syndrome
D. Doxycycline E. Bullous Reactions
E. Blue 248. Xenobiotics commonly associated with
242. Xenobiotics causing discoloration of teeth Erythema multiforme include all of the following,
and gums includes all of the following, EXCEPT: EXCEPT:
A. Cadmium A. Allopurinol
B. Ciprofloxacin B. Cimetidine
C. Doxycycline C. Furosemide
D. Lead D. NSAIDs
E. Aspirin E. Arsenic
243. Refers to a concentration formed anywhere 249. Xenobiotics commonly associated with
in the alimentary system and may be a alopecia include all of the following, EXCEPT:
complication of overdose. A. Anticoagulants
A. Pancreatitis B. Phenytoin
B. Enteritis C. Antineoplastics
C. Bezoar D. Retinoids
D. Esophagitis E. Sulfonamides
E. Dysphagia 250. Drug causing bradycardia include which of
244. Xenobiotics commonly associated with the following?
pancreatitis include which of the following? I. α1-Adrenergic agonists
I. Ethanol II. α2-Adrenergic agonists
II. Isoniazid III. β-Adrenergic antagonists
III. Carbamazepine IV. Cholinergics
IV. Amoxicillin V. Phosphodiesterase inhibitors

A. I and II A. I and II
B. I, II and III 257. Defined as a rapid onset of liver injury
C. I, II, III and IV progressing over 2 to 3 weeks that results in
D. II, III and IV altered mental status, vasodilation, kidney and
E. II, III, IV and V pulmonary failure, frequent infection, and a poor
251. Agents causing sinus tachycardia and outcome without transplantation.
tachydysrhytmias include which of the following? A. Acute liver failure
I. Anticholinergics B. Hepatic encephalopathy
II. Hydrocarbons and solvents C. Chronic hepatitis
III. Sympathomimetics D. Venocclusive Disease
IV. Opiods E. Steatosis
V. Sedative hypnotics 258. All of the following agent may cause acute
hepatocellular necrosis, EXCEPT:
A. I and II A. APAP
B. I, II and III B. Carbon tetrachloride
C. I, II, III and IV C. Methotrexate
D. II, III and IV D. Phenytoin
E. II, III, IV and V E. Sallicylates
252. Drugs causing hypertension include all of 259. Type of hepatic injury caused by
the following, EXCEPT: phosphorus:
A. Epinephrine A. Angiosarcoma
B. Metoprolol B. Acute necrosis
C. Amphetamine C. Acute cholestasis
D. Dopamine D. Steatohepatitis
E. Cocaine E. Granulomatous hepatitis
253. Agents associated with aplastic anemia 260. The following agents listed below may
inclue all of the following, EXCEPT: induce parkinsonis, EXCEPT:
A. Diclofenac A. Antipsychotics
B. Chloramphenicol B. CCB
C. Carbamazepine C. Dopaminergic agonist withdrawal
D. Cimetidine D. NSAIDs
E. Famotidine E. Cyclosporine
254. Uncommon condition in which erythrocyte 261. Olfactory fatigue which is manifested by
precursors are absent from an otherwise normal failure to detect odor is caused by which agent?
bone marrow. It results in a normocytic anemia A. Hydrogen sulphide
with inappropriately low reticulocyte count. B. Amiodarone
A. Erythrocytosis C. Botulinum toxin
B. Megaloblastic anemia D. Strycnine
C. Pernicious anemia E. Ethylene glycol
D. Pure Red Cell Aplasia 262. Patients taking ethambutol is known to
E. Aplastic anemia experience this type of ocular abnormality:
255. The abnormal accumulation of fat in A. Alteration of color vision
hepatocytes. B. Cataracts
A. Acute Hepatocellular Necrosis C. Corneal deposits
B. Steatosis D. Cortical blindness
C. Venocclusive Disease E. Macular edema
D. Chronic Hepatitis 263. Cortical blindess is associated with the
E. Cirrhosis following xenobiotics listed below, EXCEPT:
256. Disease is cause by xenobiotics that injure A. Cisplatin
the endothelium of terminal hepatic venules, B. Busulfan
resulting in intimal thickening, edema, and C. Cyclosporine
nonthrombotic obstruction: D. Glycine
A. Chronic hepatitis E. Tacrolimus
B. Cirrhosis 264. Xenobiotics reported to cause visual loss
C. Steatosis after acute exposures include which of the
D. Acute Hepatocellular Necrosis following?
E. Venocclusive Disease I. Caustics
II. Methanol D. Salicylates
III. Quinine E. Anticholinergics
IV. Lead 271. Pregnancy category for drugs with positive
A. I and II risk on fetus, but benefit from the drug may
B. II and III outweigh the risk:
C. III and IV A. Category A
D. I, II and III B. Category B
E. I, II, III and IV C. Category C
265. It is the inability to perceive odor or a lack D. Category D
of functioning olfaction--the loss of the sense of E. Category X
smell. 272. Studies in animals or humans or
A. Anosmia investigational or post marketing reports have
B. Hyposmia shown fetal risk that clearly outweighs any
C. Dysosmia possible benefit to the patient. It is
D. Cacosmia contraindicated in pregnancy.
E. Phantosmia A. Category A
266. Defined as distorted perception of smell: B. Category B
A. Anosmia C. Category C
B. Hyposmia D. Category D
C. Dysosmia E. Category X
D. Cacosmia 273. Acetaminophen and penicillin is under what
E. Phantosmia pregnancy category?
267. This antihypertensive drug commonly A. Category A
cause gustatory impairment, usually hypogeusia B. Category B
and dysgeusia: C. Category C
A. ARB D. Category D
B. ACEi E. Category X
C. Beta blockers 274. Isotretinoin is under what pregnancy
D. Vasodilators category?
E. Alpha blockers A. Category A
268. This drug causes cacogeusia (perceived B. Category B
foul, perverted, or metallic taste) when C. Category C
carbonated beverages are consumed: D. Category D
A. Spirinolactone E. Category X
B. Acetazolamide 275. Tetracycline is under what pregnancy
C. Ethambutol category?
D. Penicillamine A. Category A
E. Phenytoin B. Category B
269. Irreversible xenobiotic-induced hearing loss C. Category C
is commonly associated with which of the D. Category D
following? E. Category X
I. Aminoglycosides 276. A synthetic nonsteroidal estrogen that
II. Chemotherapeutics (bleomycin, cisplatin) stimulates estrogen receptor-containing tissue
III. Bromates and may cause misplaced genital tissue with a
IV. NSAIDs propensity to develop cancer.
A. Diethylstilbestrol (DES)
A. I and II B. Progesterone
B. II and III C. Estrogen
C. I, II and III D. Clomiphene
D. III only E. Tamoxifen
E. IV only 277. Drug responsible for fetal hydantoin
270. Drugs associated with tinnitus include all of syndrome. This is characterize by microcephaly,
the following, EXCEPT: intelectual disability, cleft lip or palate,
A. β-Adrenergic antagonists hypoplastic nails or phalanges, characteristic
B. Antifungals: amphotericin B facies--low nasal bridge, inner epicanthal folds,
C. Cinchona alkaloids: quinine, quinidine ptosis, strabismus, hypertalorism, low-set ears
and wide mouth: C. Wrong dose
A. Quinine D. Wrong route
B. Phenytoin E. Wrong dose
C. Methimazole 283. A 17 month-old girl with a central venous
D. Fluconazole line (CVL) and a gastrostomy tube required an
E. Ethanol upper gastrointestinal series. Barium sulfate was
278. This agent is known to cause limb inadvertently injected into the CVL instead of the
phocomelia, amelia, hypoplasia, congenital gastrostomy tube. The patient had several
heart defects, renal malformations, episodes of vomiting and developed fever and
cryptorchidism, abducens paralysis, deafness, rigors but ultimately recovered. This is an
microtia, and anotia: example of what type of medication error?
A. Tetracycline A. Wrong drug
B. Trimethoprim B. Wrong drug information
C. Valproic acid C. Wrong dose
D. Thalidomide D. Wrong route
E. Vitamin D E. Wrong dose
279. A preservative added to liquid 284. It is the study of the identification,
pharmaceutical preparations that is known to distribution, and quantification of xenobiotics
cause gasping syndrome on children: after death:
A. Benzoic acid A. Forensic toxicology
B. Benzyl alcohol B. Environmental toxicology
C. Ethanol C. Postmortem toxicology
D. Propranol D. Clinical toxicology
E. Parabens E. Regulatory toxicology
280. Poisoning by this agent in children is 285. Gastric emptying may usually be indicated
associated with hypoglycemia because of using the following conditions, EXCEPT:
reduced hepatic glycogen stores: A. There is reason to believe that given the time
A. Chloramphenicol of ingestion, a significant amount of the ingested
B. Ethanol xenobiotic is still present in the stomach
C. Benzyl alcohol B. The ingested xenobiotic is not adsorbed by
D. Clonidine activated charcoal or activated charcoal is
E. Oxymetazoline unavailable
281. A 1 kg premature infant required sedation C. The xenobiotic has limited toxicity at almost
for a diagnostic study. A high dose of chloral any dose
hydrate, 100 mg/kg, was miscalculated to be 1 g D. The patient has not had spontaneous emesis
(1000 mg) instead of 100 mg. The child had a E. No highly effective specific antiodte exists or
cadiopulmonary arrest and died. When drugs atlernative therapies (eg, hemodialysis) pose a
require miligram per kilogram dosing, it is easy significant risk to the patient
to make decimal mistakes in the calculation or in 286. Gastric emptying is usually not indicated if:
the transcription. This is an example of what I. Although the xenobiotic ingested is potentially
type of medication error? toxic, the dose ingested is likely less than that
A. Wrong drug expected to produce significant illness.
B. Wrong drug information II. The ingested xenobiotic is well adsorbed by
C. Wrong dose activated charcoal, and the amount ingested is
D. Wrong route not expected to exceed the adsorptive capacity
E. Wrong dose of activated charcoal.
282. In one nursery, an epidemic mimicking III. The patient presents many hours post
neonatal sepsis was caused when racemic ingestion and has minimal signs or symptoms of
epinephrine was inadvertently administered poisoning.
instead of vitamin E because both drugs were IV. No highly effective specific antidote exists ir
manufactured by the same company, distributed alternative therapies (e.g. hemodialysis) pose a
in nearly identical bottles, stored near each other significant risk to the patient.
inside the nursery refrigerator. This is an
example of what type of medication error? A. I and II
A. Wrong drug B. II and III
B. Wrong drug information C. III and IV
D. I, II and III B. II and III
E. II, III and IV C. III and IV
287. Contraindications for orogastric lavage D. I, II and III
include which of the following? E. II, III and IV
I. The patient hast lost or will likely lose his or 290. Enhanced elimination of xenobiotics may
her airway protective reflexes and has not been be indicated for several types of patients which
intubated. include:
II. Ingestion of a xenobiotic with a high aspiration I. Patients who fail to respond adequately to
potential comprehensive supportive care
III. Ingestion of a xenobiotic in a form known to II. Patients in whom the normal route of
be too large to fit into the lumen of the lavage elimination of the xenobiotic is impaired.
tube III. Patients in whom the normal route of
IV. The patient meets criteria for gastric elimination of the xenobiotic is impaired.
emptying IV. Adult patients associated with low risk of
morbidity or mortality from drug overdose
A. I and II
B. II and III A. I and II
C. III and IV B. II and III
D. I, II and III C. III and IV
E. II, III and IV D. I, II and III
288. Indications of single-dose activated E. II, III and IV
charcoal therapy without gastric emptying 291. It is an ion exchanger resin that is used
include which of the following? regularly for hyperkalemia in patients with
I. Activated charcoal is know not to adsorb a chronic kidney disease.
clinically meaningful amount of the ingested A. Sodium polystyrene sulfonate
xenobiotic B. Cholestyramine
II. Gastric emptying is likely to be harmful C. Sodium Chloride
III. The ingestion has occured within a time D. Sodium bicarbonate
frame amenable to adsorption by activated E. Ammonium chloride
charcoal or clinical factors are present that 292. Characteristics of xenobiotics that allow
suggest that not all of the xenobiotic has already clearance by hemodialysis includes:
been systemically absorbed. I. MW >500 da
IV. Gastrointestinal perforation is likely as in II. Water soluble
cases of caustic ingestions. III. Not bound to plasma proteins

A. I and II A. I and II
B. II and III B. II and III
C. III and IV C. II and III
D. I, II and III D. I and III
E. II, III and IV E. III only
289. Contraindications of whole-bowel irrigation 293. This is defined by a rectal temperature
include which of the following? greater than 106F (41.1°c) in the setting of
I. Airway protective reflexes are absent or neurologic disturbance manifested by mental
expected to become so in a patient who has not status changes.
been intubated A. Heatstroke
II. GI tract is not intact. There are signs of ileus, - B. Hypothermia
obstruction, significant GI hemorrhage, or - C. Frostbite
hemodynamic instability that might compromise D. Rewarming
GI motility. E. Afterdrop
III. Persistent vomiting 294. Clearance of xenobiotics is affected by the
IV. Ingestion of a toxic amount of a xenobiotic following, except:
that is not adsorbed to activated charcoal when A. Organ perfusion
other methods of GI decontamination are not B. Enzyme activity
possible or not efficacious C. Protein binding
D. PKa
A. I and II E. None of these
295. The deficiency of this vitamin adversely listed below may cause ATN, EXCEPT:
affects the hypothalamus and leads to A. Aluminum phosphide
hypothermia because of inefficient glucose B. Deferoxamine
metabolism: C. Arsenic
A. Cyanocobalamin D. Ibuprofen
B. Ascorbic Acid E. APAP
C. Thiamine
D. Biotin
E. Vitamin P
296. The primary function of lungs is to
exchange gases. Specifically, this involves the
transport of ___ into the blood and the
elimination of ___.
A. Carbon dioxide - Oxygen
B. Oxygen - Carbon dioxide
C. Oxygen - Nitrogen
D. Oxygen - Hydroxide
E. Carbon monoxide - Oxygen
297. A severe extra pyramidal syndrome
associated with muscle rigidity, autonomic
dysfunction, and altered mental status. This
disorder develops during the administration of
antipsychotics or the withdrawal of dopaminergic
xenobiotics:
A. Serotonin Toxicity
B. Malignant Hyperthermia
C. Neuroleptic Malignant Syndrome
D. Hypothermia
E. Nueropsychiatric impairment
298. Drugs that cause hypoventilation include
which of the following?
I. Ethanol
II. Strychnine
III. Clonidine
IV. Methylxanthines

A. I and II
B. II and III
C. I, II and III
D. I, II and IV
E. II, III and IV
299. An inhaled solution of 2% of this agent may
provide symptomatic relief for patiens with
pulmonary exposure to hydrogen chloride to
chlorine:
A. Sodium carbonate
B. Sodium chloride
C. Supplemental oxygen
D. Neostigmine
E. Pralidoxime
300. Acute tubular necrosis (ATN) is the most
common cause of acute kidney injury in
hospitalized patients. ATN is manifested
pathologically by patchy necrosis of the tubular
epithelium and occlusion of the lumen by casts
and cellular debris. All of the following agents
DISPENSING, INCOMPATBILITIES AND ADRs III. Are available in different colors to give
them prominence once attached to the
1. Which of the following factors are associated medication container
with a patient’s non-adherence to the prescribed a. I only
therapeutic regimen? b. III only
a. How often the medication is taken c. I and II
b. The cost of the medication d. II and III
c. The duration of therapy e. I, II and III
d. All of these
e. None of these 8. An example of an auxillary label
I. Shake well
2. The part of the prescription that is understood to II. Take with food
mean “thou take” or “you take” III. May cause drowsiness
a. Medications prescribed a. I only
b. Signatura b. III only
c. Rx symbol c. I and II
d. Superscription d. II and III
e. Subscription e. I, II and III

3. The part of the prescription that is also known as 9. A sample of a dispensing error
the inscription I. Providing the incorrect medication to the
a. Medications prescribed right patient
b. Signatura II. Providing the incorrect dosage strength
c. Rx symbol and dosage form
d. Superscription III. Undetected interactions with other
e. Subscription medications
a. I only
4. The part of the prescription that refers to the b. III only
dispensing directions to the pharmacist c. I and II
a. Medications prescribed d. II and III
b. Signatura e. I, II and III
c. Rx symbol
d. Superscription 10. A risk factor for adverse drug reactions
e. Subscription I. Patient age
II. Concurrent medications taken
5. Which of the following is a dispensing direction III. Ethnicity and genetics
for the pharmacist? a. I only
a. Gtt i-ii ou BID b. III only
b. M ft caps dtd #50 c. I and II
c. Inh 2 puffs PO q 4 to 6 h prn difficulty d. II and III
breathing e. I, II and III
d. Ii tabs PO q 4 h 11. Factor contributing to the occurrence of a drug
e. 50 units SC q AM interaction
I. Multiple pharmacological effects
6. The packaging suitable for dispensing bulk II. Multiple prescribers
powders III. Use of over the counter products
a. Round vials a. I only
b. Wide-mouth bottles b. III only
c. Dropper bottles c. I and II
d. Ointment jars d. II and III
e. Collapsible tubes e. I, II and III

7. Which is TRUE regarding auxillary labels?
I. Emphasizes important aspects of the
dispensed medication
II. Provides cautionary statements from the
pharmacist regarding the dispensed
medication
12. Which of the following statements is TRUE
regarding patient variables affecting drug
response?
I. Taking sedatives and alcoholic
beverages together could result to an
excessive depressive response.
 II. Food may often affect the rate and b. Alteration of ph
extent of absorption of a drug from the c. Complexation and adsorption
GIT d. Alteration of distribution
III. Renal and hepatic function do not affect e. Alteration of metabolism in the GIT
the patient’s response to a medication
a. I only 17. The mechanism of drug interaction between
b. III only phenytoin and valproic acid
c. I and II a. Displacement form protein binding site
d. II and III b. Drug-food interaction
e. I, II and III c. Alteration of GI flora
d. Stimulation of metabolism
13. How would you counsel a patient who is e. Alteration of active transport
prescribed a ketoconazole and an antacid,
knowing that the ketoconazole requires an acidic 18. Phenobarbital causes enzyme induction hence,
environment to achieve dissolution after oral increases the rate of metabolism of warfarin
administration? when taken together. As pharmacist, what would
be your recommendation to the prescriber?
a. Advice the patient that both drugs could be I. Increase the dose of warfarin while on
taken together. phenobarbital then lower it down once
b. Advice the patient to go back to the doctor phenobarbital is discontinued
and have the ketoconazole replaced with II. Consider an alternative to phenobarbital
another drug such as benzodiazepines which are not
c. Advice the patient to take the antacid two likely to interact with warfarin
hours after taking the ketoconazole. III. There is no need to make any
d. Advice the patient to go to the doctor and recommendation to the prescriber
have both drugs changed. a. I only
e. Advice the patient to stop taking both b. III only
medications. c. I and II
d. II and III
14. A patient is prescribed ciprofloxacin to treat a e. I, II and III
respiratory tract infection. What would advise the 19. The following are examples of a drug with a
patients? narrow therapeutic index, EXCEPT
I. Do not take with milk and or dairy a. Theophylline
products b. Warfarin
II. Take aluminum or magnesium c. Digoxin
containing antacids when stomach d. Penicillin
upset occurs e. Lithium
III. The patient may continue taking iron
supplements even while on the 20. An example of a type A adverse drug reaction
medication a. Carcinogenesis
a. I only b. Anaphylaxis from penicillins
b. III only c. Tachycardia from salbutamol
c. I and II d. Teratogenesis
d. II and III e. None of these
e. I, II and III
21. As a pharmacist, what would you advice your
15. The mechanism of drug interaction between oral patient when dispensing ophthalmic solutions:
contraceptives and antibiotics I. Never allow the tip of the dropper to
touch any surface
a. Alteration of gastric emptying rate II. Never rinse the dropper
b. Complexation III. Never use eyedrops that have changed
c. Alteration of pH color
d. Alteration of GI absorption
e. Alteration of distribution a. I only
b. III only
16. The mechanism of drug interaction between oral c. I and II
contraceptives and antibiotics d. II and III
a. Alteration of GI flora e. I, II and III
22. During medication review the patient reveals medication is causing this symptoms. Which
that he is an avid fan of grapefruit juice and drug is this?
takes his medications, including verapamil with
grapefruit juice. Which is TRUE regarding a. Enalapril
verapamil and grapefruit juice? b. Losartan
c. Metoprolol
I. Avoid taking medications with grapefruit d. Hydrochlorothiazide
juice e. Furosemide
II. The combination may inhibit the metabolism
of the (verapamil) resulting to increased 27. Which of the following drugs may cause postural
pharmacologic effects and increased risk for hypertension and reflex tachycardia once the
adrs drug is initiated and when increasing doses?
III. The combination may increase the
metabolism of the drug (verapamil) resulting a. Prasozin
to decreased pharmacological activity b. Amlodipine
c. Labetalol
a. Only I d. Propranolol
b. Only II e. Furosemide
c. I and II
d. II and III 28. A patient’s blood pressure has been well
e. I, II and III controlled for years using a thiazide diuretics but
lately there has been an increase in his diastolic
23. A patient complains of extreme muscle blood pressure warranting an additional blood
weakness and myopathy. Which of his pressure medication. However, he noticed that
medications may have caused this? lately he has been experiencing erectile
dysfunction. Which of the following medication
a. Metformin 500 mg BID classes may have caused this?
b. Atorvastatin 80 mg hs
c. Losartan 50 mg qam a. Thiazide diuretics
d. Multivitamins b. Beta blockers
e. Paracetamol 500 mg Q 4 to 6 h prn c. ACE inhibitors
d. ARBs
24. A patient with hypertension complains of e. Loop diuretics
swelling in her feet and mentions that this
started when she was given her new 29. A common side effect of minoxidil
antihypertensive drug. Which of the following
medication may have caused this? a. Persistent dry cough
b. Peripheral edema
a. Metoprolol c. Reflex tachycardia
b. Hydrochlorothiazide d. Drowsiness
c. Valsartan e. Hypertrichosis
d. Furosemide
e. Amlodipine besylate 30. A patient’s routine lab results showed an
increase in her serum potassium level. Her
25. A patient with infection was given levofloxacin physician informed her that he hypertensive
500 mg once daily for 10 days. The patient medication which was initiated three months ago
noticed no improvement of symptoms on the 7th may have cause this increase. Which of the
day of therapy. A review of the patient’s following is her medication?
medication profile reveals that he is taking which
of the following drugs that may have interacted a. Furosemide
with the antibiotic? b. Hychlorothiazide
c. Losartan
a. FeSO4 d. Nifedipine
b. Vit C e. Chlorthalidone
c. Guaifenesin
d. Ibuprofen 31. A patient who is hypertensive and has a history
e. Paracetamol of gout was placed by his physician on a
diuretic. He develops an attack of gout a few
26. A patient comes to the pharmacy asking for a weeks after starting therapy. Which of the
recommendation for a cough medicine because following diuretics was he taking?
of persistent cough. A review of the patient’s
medication profile revealed that one of his a. Spironolactone
 b. Hydrochlorothiazide 38. A patient comes into the pharmacy and hands you,
c. Triamterene the pharmacist, a prescription for sildenafil. You recall
d. Urea that you just counselled this same patient two weeks ago
e. Chlorthalidone regarding the use of sublingual nitroglycerin. What would
be the result of the interaction between the two
32. This antihypertensive drug is associated with medications?
drug induced lupus that resolves upon cessation
of the drug.
I. Potentiate the effects of sildenafil
a. Digoxin II. Dangerous hypertension
b. Hydralazine III. Dangerous Hypotension
c. Minoxidil
d. Labetalol a. I only
e. Valsartan b. III only
c. I and II
33. A patient on an antiarrhythmic medication d. II and III
complains of dry mouth, blurred vison, and
e. I, II and III
urinary hesitancy. Which of the following
medication is the patient taking?
39. The interaction between aspirin and ketorolac would
a. Disopyramide result to which of the following;
b. Flecainide a. Increased bleeding
c. Lidocaine b. Dry mouth
d. Amiodarone c. Blurred vision
e. Sotalol d. All of these
e. None of these
34. This antiarrhythmic may induce the symptoms of
cinchonism 40. A patient who is on probenecid for his gout reports
that he has been experiencing attacks of his gout when
a. Quinidine
he was on daily aspirin therapy. This is due to which of
b. Flecainide
c. Procainamide the following;
d. Mexiletine I. Increased metabolism of aspirin
e. Sotalol II. Increased vasodilation
III. Patients on clopidogrel should avoid omeprazole
35. A common adverse effect of mexiletine a. I only
b. III only
a. Bleeding c. I and II
b. Anorexia d. II and III
c. Dyspepsia
e. I, II and III
d. Somnolence
e. Shortness of breath 41. A patient is on clopidogrel for her arrhythmia and she
came to you to bring in a prescription for omeprazole
36. An antiarrhythmic that should be avoided by from her doctor. What can you say about this
patient’s with asthma combination?
I. The two drugs could be given together
a. Propafenone II. The combination is not recommended
b. Flecainide III. Patients on clopidogrel should avoid omeprazole
c. Quinidine a. I only
d. Sotalol b. III only
e. Mexiletine
c. I and II
37. The following are adverse effects of amiodarone d. II and III
EXCEPT e. I, II and III
42. A treatment for excessive bleeding due to heparin
a. Pulmonary fibrosis therapy
b. Neuropathy I. Vitamin K
c. Blue-gray skin discoloration II. Discontinue heparin
d. Hype or hyperthyroidism III. Protamine Sulfate
e. Bleeding a. I only
b. III only
 c. I and II a. I only
d. II and III b. III only
e. I, II and III c. I and II
d. II and III
43. A consequence of long term heparin therapy e. I, II and III
a. Osteoporosis
b. Persistent cough 48. Which of the following statements is TRUE regarding
c. Obesity bile acid sequestrants?
d. Weight gain
e. Hair loss I. Most common side effects include constipation,
nausea, and flatulence
44. A patient brought in a new prescription for II. They may impair thge absorption
fluconazole. A review of her medicine profile revealed of vitamins A, D, E, K
that she is on warfarin therapy. Which of the following III. They impair the absorption of many drugs, such as
statements is TRUE regarding the combination of these warfarin, digoxin, etc.
two drugs?
I. The two drugs are safe to be taken together a. I only
II. Fluconazole inhibits the metabolism of warfarin b. III only
III. The combination of these two medications could lead c. I and II
to serious bleeding d. II and III
a. I only
e. I, II and III
b. III only
c. I and II
49. A counselling point when dispensing colesevelam to
d. II and III a patient on warfarin therapy.
e. I, II and III
a. Stop taking warfarin for this interacts with colesevelam
45. A patient complains of weakness and muscle b. Take warfarin 1 to 2 hours before or 4 to 6 hours
achiness that will not resolve. He said that his symptoms after the bile acid-binding resin
are interfering with his daily activities for he feels too c. Switch colesevelam to cholestyramine
weak even to get out of bed. You reviewed his d. Take both drugs at the same time with food
medication profile and found out that one of his e. Take both drugs at the same time on empty stomach
medications may be the cause of his condition. Which of
the following medications may have caused these 50. Which of the following patient groups would be more
symptoms? likely to experience the adverse effect of HMG coa
reductase inhibitors (myopathy and rhabdomyolysis)?
a. Losartan 50mg daily
b. Lipitor 80mg daily a. Patients with on blood thinners
c. Ibuprofen 200mg q 4 to 6 h prn pain b. Patients with hyperurinemia
d. Multivitamins 1 cap daily c. Patients with hypertension
e. Metformin 500mg daily d. Patients with renal insufficiency
e. Patients with hypertriglyceridemia
46. The following are adverse effects of niacin, EXCEPT
51. The most serious and common adverse reaction to
a. Intense cutaneous flush insulin.
b. Pruritus
c. Hepatotoxicity a. Hypotension
d. Anorexia b. Hypoglycemia
e. Abdominal pain c. Hypertension
d. Hyperglycemia
47. Which of the following statements is TRUE regarding e. Hypercholesterolemia
simvastatin and gemfibrozil?
52. How can lipodystrophy, an adverse effect of insulin
I. The use of gemfibrozil is contraindicated with use, be minimized?
simvastatin
II. The combination increases the risk for myopathy and a. Switch to an oral medication
rhabdomyolysis b. Rotate injection sites
III. There is no interaction between the two medications c. Inject insulin into the muscle
d. Inject once daily only e. A and B
e. Use insulin pens
59. The following are common side effects
53. Major adverse effects of sulfonylureas encountered when using ophthalmic
preparations EXCEPT.
I. Weight gain
II. Hypoglycemia
a. Persistent burning sensation
III.Hyperinsulinemia b. Tearing
c. Decrease vision
a. I only d. Foreign body sensation
b. III only e. Margin Crusting
c. I and II
d. II and III 60. A patient brought in a prescription for finasteride.
e. I, II and III Your pharmacy technician assigned at the filling
station is in her 1st trimester of pregnancy. What
precaution should be observed?
54. A rare but serious side effect of metformin
I. Let her fill the prescription
a. Candidiasis II. Tell her not to fill the prescription and
b. Lactic acidosis have somebody else to fill it
c. Pancreatitis III. Remind her not to touch the medication
d. Urinary tract infection
e. Heart failure a. I only
b. III only
55. Adverse effect associated with estrogen therapy. c. I and II
d. II and III
a. Breast tenderness e. I, II and III
b. Nausea
c. Thromboembolism 61. Drug interaction includes the following.
d. Breast cancer
e. All of these a. Drug-drug interaction
b. Drug-lab test interaction
c. Drug-food interaction
56. Which of the following antidiabetic drugs is d. Drug-herb interaction
associated with a risk of pancreatitis? e. All of these

a. Metformin 62. The type of interaction that occurs when the

b. Liraglutide pharmacokinetic disposition of the drug is
c. Glimepiride altered by genetic polymorphism in affecting
d. Insulin processes..
e. Nateglinide
a. Pharmacokinetic
57. A patient on warfarin therapy brought in prescription b. Pharmacogenetic
for naproxen. Upon consult, you were informed that he c. Biopharmaceuticals
did not tell his prescriber that he is taking warfarin. You d. Pharmacodynamic
recall that warfarin is 97% protein bound and naproxen e. Pharmaceutical
is 99% protein bound. What would happen if this patient
takes naproxen? 63. A contraindication for the use of ergotamine and
dihyroergotamine
a. The patiet will benefit from this combination
b. The pain and inflammation will be treated
I .Angina
c. There is no interaction between the two drugs
II. Peripheral vascular disease
d. The patient will experience bleeding
III. Diabetes
e. The patient would have blot clots.

58. This should be checked by the pharmacist when a. I only

dispensing suppositories b. III only
c. I and II
a. Excessive softening d. II and III
b. Oil stain in packaging e. I,II and III
c. Present of precipitate
d. A and B 64. An antimicrobial agent that have potential to
cause interstitial nephritis:
 d. Do not cross into the cerebrospinal fluid
a. Methicillin e. Can cause blood disorders
b. Ceftriaxone
c. Naproxen 70. A drug that colors body fluids
d. Cephalexin
e. Sertraline a. Tetracycline
b. Lexofloxacin
65. Red man syndrome is an adverse event c. Bacitracin
associated with which medication. d. Rifampin
e. Neomycin
a. Erythromycin
b. Vancomycin 71. Rifampin and oral contraceptives
c. Ciprofloxacin
d. Moxifloxacin I. Reduced effect of oral contraceptives
e. Daptomycin II. Increase metabolism of oral
contraceptives
66. An adverse effect associated with the use of III Need for back-up contraception while
daptomycin. rifampicin
a. I only
a. Redman syndrome b. III only
b. Rhabdomyosis c. I and II
c. Bleeding d. II and III
d. Flushing e. I,II, and III
e. ototoxicity
72. A drug that causes optic neuritis with blurred
67. Phototoxicity is associated with the use of which vision, and also red-green color blindness.
antibiotic.
a. Pyrazinamide
a. Tetracycline b. Streptomycin
b. Gentamycin c. Dapsone
c. Erytromycin d. Ethambutol
d. Amoxicillin e. Capreomycin
e. Neomycin .
73. The interaction between simvastatin and
68. A patient maintained on warfarin was given a intraconazole would result to:
prescription for clarithromycin for an upper
respiratory tract infection. Which of the following I. Traetment failure of intraconazole
statements is true? II. Increase exposure to simvastatin
III. Increase risk of rhabdomyolysis
I. The prescriber needs to be informed
that the patient is on warfarin a. I only
therapy b. III only
II. Clarithromycin inhibits the c. I and II
metabolism of warfarin which could d. II and III
lead to bleeding. e. I,II,and III
III. There is no need to cintact the
prescribers. It is safe to take both 74. The co-administration of triazolam and any
medication together. protease inhibitor (ritonavir,
saquinavir,indinavir,etc.) is contraindicated
a. I only because
b. III only
c. I and II a. This could result to excessive
d. II and III sedation
e. I.II and III b. This could lead to treatment failure of
the protease inhibitor
69. A contraindication for the use of tetracycline is c. There is no ingteraction between the
children below 8 years old because two drugs
tetracyclines. d. Both drugs are expensive
e. None of these
a. Crosses the blood brain berrier
b. Do not cross into the cerebrospinal fluid 75. Paclitaxel is associated with serious
c. Deposits into the bones and teeth hypersensitivity reactions. Premedications
 necessary for a patient who would be a. Failure to therapy of calcium channel
administered paclitaxel include. blockers
b. Failure of therapy of St. John’s wort
I Dexamethaxone c. There is no interaction between the St.
II. Ranitidine John’s wort and calcium channel blocker
III.Diphenhydramine d. Elevated levels of St. John’s wort
e. Elevated levels of calcium channel
a. I only blockers
b. III only
c. I and II 82. “A patient asks you for recommendation for an
d. II and III over the counter product for hot flashes due to
e. I,II and III menopause. Black cohosh is a common herbal
supplement indicated for hot flashes. However
76. The toxicity associated with this agent is further interview revealed that she has
interstitial nephritis. maintenance medication for hypertension. What
would happen is she takes black cohosh
a. Bleomycin together with her anti-hypertensive?
b. Cyclophosphamide
c. Cytarabine a. Hypertension
d. Cisplatin b. No interaction
e. Doxorubicin c. Treatment failure of black cohosh
d. Hypotension
77. The drug chemical or food element causing the e. None of these
interaction.
83. Factors that increase the chances of a drug
a. Object drug interaction to occur
b. Precipitant drug I. Multiple prescriber
c. Target drug II. Multiple drug therapy
d. Precipitated drug III. Geriatric patients
e. None of these
a. I only
78. Mechanism of interaction between an antacid b. III only
and an enteric-coated tablet. c. I and II
d. II and III
a. Alteration of gastric pH e. I,II and III
b. Increase GI motility
c. Alteration of Intestinal Flora 84. The interaction between probenecid and
d. Complexation penicillin
e. Decrease GI motility I. Is beneficial
II. Inhibits renal tubular secretion of
79. Mechanism of interaction between digoxin and penicillin
antibiotics resulting an increase in digoxin levels III. Decreases the plasma half-life of
penicillin
a. Alteration of gastric pH
b. Increase GI motility a. I only
c. Alteration of Intestinal Flora b. III only
d. Complexation c. I and II
e. Decrease GI motility d. II and III
e. I,II and III
80. Which of the following herbal preparations
increase bleeding in patients on warfarin 85. A type of chemical incompatibility
therapy?
a. Complexation
a. Garlic b. Reduction
b. Ginger c. Photolysis
c. Feverfew d. Oxidation
d. A and B e. all of these
e. A, B, and C
86. factors affecting IV compatibility
81. Interaction between St. John’s wort and calcium
channel blockers result to: a. pH
b. Order of mixing
 c. Length of time b. III only
d. Temperature c. I and II
e. All of these d. II and III
e. I, II and III
87. Therapeutic hazards for IV preparations
93. Taking which of the following drugs could result
a. Drug instability to false positive Coombs test
b. Labelling errors
c. Preservative and solubilizing agent a. Levodopa
toxicity b. Amantadine
d. incompatibility c. Bromocriptine
e. All of these d. Selegiline
e. Phenothiazine
88. The interaction between gingko biloba and
warfarin could result to 94. The combination of levodopa and phenelzine is
I. Increase risk of bleeding avoided because it could result to
II. Decrease risk of bleeding
III. Antagonism a. Hypertensive crisis
b. Urinary incontinence
a. I only c. Nausea and vomiting
b. III only d. Hypotension
c. I and II e. Profuse sweating
d. II and III
e. I,II and III 95. Pyridoxime should be taken with caution in
Parkinson’s patients on levodopa because
89. The mechanism for the interaction between
ethanol and phenobarbital a. Pyridoxime inceases the peripheral
metabolism if levodopa
a. Increase metabolism of b. The effect of levodopa will be dcrease
phenobarbital c. The effect of levodopa will be increases
b. Decrease metabolism of phenobarbital d. A and B
c. Decrease absorption of phenobarbital e. B and C
d. Decrease metabolism of ethanol
e. None of these 96. A patient was prescribed amantadine. A review
of his medication profile revealed that he has
90. False positive urine ketone tests may result in hydrochlorothiazide triamterene tablets for the
patients taking valproic acid. This significant for managements of his hypertension. What could
this type of patients when using urine tests be the result if these are given together?

a. Hypertensive patients a. There would be an increase in the

b. Diabetic patients plasma concentration of amantadine
c. Seizure patients b. There will be decrease in the urinary
d. Asthma patients excretion of amantadine
e. All of these c. There will be no interaction between the
two medications
91. The following are adverse effect of d. A and B
anticholinergic EXCEPT e. B and C

a. Dry mouth 97. An extrapyramidal side effect that describes

b. Increased urination sudden muscle spasms that primarily occur in
c. Constipation the eye, neck,face,and throat muscles
d. Urinary retention
e. Decreased sweating a. Acute distonia
b. Tardive dyskinesia
92. These agents potentiate the side effects of c. Akathisia
anticholinergics d. Pseudoparkinsonism
e. None of these
I. Antihistamines
II. Antidepressants 98. An extrapyramidal side effect that is defined as
III. Phenothiazines the inability to sit still and as being functionally
motor restless.
a. I only
 a. Acute dystonia
b. Tardive dyskinesia a. There is no reason for concern, the
c. Akathisia patient could take coenzyme Q10
d. Pseudoparkinsonism b. Coenzyme q10 may antagonize the
e. None of these activity of warfarin use of which
warrants a consult with the doctor.
99. Which of the following is considered most c. Warfarin antagonizes the effect of
sedating angtipsychotics? coenzyme Q10, do not take warfarin
d. Tell the patient to tell the doctor to
a. Chorpromazine remove his warfarin so he could take
b. Clozapine Coenzyme Q10
c. Olanzapine e. It is not safe to take both medications
d. Thioridazine together, so stop taking warfarin before
e. All of these taking Coenzyme Q10

100. An uncommon but potentially fatal 104. A patient comes in complaining that the
adverse effect of antipsychotics, characterized diazepam that was not working. Upon reviewing
by fever, severe rigidity,altered mental status, the patient profile and further interview, it was
unstable blood pressure , tachycardia , revealed that the patient still has not stopped
incontinence , elevated creatinine kinase,and smoking despite the doctor’s and your
increase WBC count. recommendation to do so. What could be the
cause for the patient’s complain?
a. Steven-johnson syndrome
b. Tardive dyskinesia a. Smoking does not affect the activity of
c. Serotonin syndrome diazepam. There might be another
d. Neuroleptic malignant syndrome reason.
None of these b. Smoking decreases the activity of
diazepam by inducing its metabolism
101. Cholestyramine can bind with digoxin. c. Smoking decreases the activity of
Which of the following is TRUE regarding thids diazepam by inhibiting its metabolism
drug interaction? d. Smoking increases the activity of
diazepam, by inducing its metabolism.
I. Cholestyramine is the object drug e. Alcohol decreases the activity of
II. Digoxin is the precipitant drug diazepam by inhibiting its metabolism.
III. Digoxin is the object drug
105. A safety technique observed in
a. I only community pharmacies to minimize medication
b. III only errors.
c. I and II I. Organized and simplified work
d. II and III procedures
e. I,II and III II. Working on one prescription at a
time, instead of handling several
102. Which of the following is paired prescription at once.
correctly? III. Using a magnifying lens when
necessary
a. Tetracycline-object drug
Antacid – precipitant a. I only
b. Ciprofloxacin- precipitan b. III only
Milk- object drug c. I and II
c. Cimetidine- object drug d. II and III
Atorvastatin- precipitant drug e. I,II and III
d. Tetracycline- precipitant
Antacid – object drug 106. Purpose of auxiliary tablets EXCEPT:
e. Penicillin – precipitant
Probenecid-object drug a. Ensure proper use of the medication
b. Reinforce information given during
103. A patient asks you about using counseling
Coenzyme Q10 since he has read about its c. To minimize verbal patient
benefits in a madazine. further interview of the counseling
patient revealed that he is maintained on 2mg d. Ensure proper storage of the medication
daily dose of warfarin. What would be the e. Warn against taking with food or other
recommendation for this patient? drugs.
107. An alcoholic taking Paracetamol 500mg 113. TRUE about thrombolytic agents
every 6 hours pm back pain, is exposed to ;
a. Hemorrhage is amajor adverse effect
a. Increased risk of renal toxicity b. Contraindicated in pregnancy
b. Increased risk of hapatotoxicity c. Cannot be given to patients with a
c. Increased risk of photosensitivity history of cerebrovascular accident
d. Decresed effect of paracetamol d. Head trauma and intracranial bleeding
e. All of these are also contraindications
e. All of these
108. A patient refills prescription for oral
contraceptives. you recall seeing this patient in 114. Which of the following effects is
the parking lot smoking cigarettes with a couple associated to physostigmine?
of friends a few minutes before she came into
the pharmacy. This patient is an increased risk a. Miosis
for developing b. Bradycardia
c. Hypotension
a. Cardiovascular disease d. Contraction of visceral smooth muscles
b. Hepatic disease e. All of these
c. Lung disease
d. Renal disease 115. The following cholinergic agonist are
e. There is no reason for concern matched correctly with the effects EXCEPT:
regarding this patient
a. Bethanecol – treat urinary retention
109. A monitoring parameter for a patient on b. Neostigmine- treat myasthenia gravis
warfarin therapy c. Pilocarpine- reduces intraocular
pressure
a. ANC d. Carbachol- produce miosis during ocular
b. CBC surgery
c. ECG e. Acetylcholine- produce mydriasis in
d. INR eye surgery
e. Platelet count
116. Which of the following effects is
110. A patient comes to you complaining of associated with atropine?
sleepiness, feeling lethargic, and seems like not
in the mood to do anything, which of the a. Mydriasis
following medications that the patient is currently b. antispasmodic
on could cause the patient’s complaints? c. Xerostomia
d. Cyclopegia
a. Gabapentin e. All of these
b. Lorazepam
c. Hydrocodone acetaminophen 117. Scopolamine as an anti-motion sickness
d. All of these drug is available in what dosage form?
e. None of these
a. Oral tablet
111. An antiseizure drug associated with b. Chewable tablet
gingival hyperplasia c. Transdermal patch
d. Effervescent tablet
a. Carbamazepine e. Suppository
b. Phenytoin
c. Divalproex 118. Antimuscarinic agents approved as
d. Lamotigrine bronchodilators
e. Topiramate
a. Ipratropium
112. Inhibitors of platelet aggregation b. Tiotropium
EXCEPT: c. Cyclopentolate
d. A and B
a. Heparin e. B and C
b. Dipyridamole
c. Absiximab 119. Which of the following antimuscarinic
d. Clopidogrel agents is correctly matched with its therapeutic
e. Ticlopidine use?
 b. Clonidine
a. Oxybutin- treatment of overactive c. Albuterol
bladder d. Isoproterenol
b. Bentropine- treatment of Alzheimer’s e. Dobutamine
c. Nicotine- smoking cessation
d. Scopolamine – treatment of COPD 125. Counseling points regarding the use of
e. Atropine – to produce miosis OTC nasal decongestant sprays
I. Topical nasal decongestant should
120. An antidiarrheal agent contains not be shared to others
diphenoxylate and atropine. what is the effect of II. Used should be limited for 3 to 5
atropine in the preparation? days only
III. This could be used as long as the
a. Increased GI motility patient is still congested
b. Decrease GI motility
c. Increases urination a. I only
d. Increases salivation b. III only
e. Increases acid secretion c. I and II
d. II and III
121. A patient who is going on a cruise e. I,II and III
comes to the pharmacy to pick up her
prescription for scopolamine patches. She 126. An important counseling point when
informed you that she knows the patch is dispensing first generation antihistamines.
applied behind the ear, but wonder why only I. This may cause drowsiness
three patches were dispensed when she would II. Do not drink,drive or operate
be on the cruise for 7 days . what should you tell machinery while on this medication
her? III. Avoid activities that would require
your full attention while on this
a. There was an error on filling her medication.
prescription.
b. The doctor only prescribed three a. I only
patches and that is what she’s getting b. III only
c. The patch is designed for the drug to c. I and II
be delivered over a period of three d. II and III
days and the patch should be e. I,II,and III
replaced every three days.
d. The wrong quantity was dispensed. 127. The following are adverse effects
e. You will call the doctor to check for the commonly observed in patients treated with
correctness of the prescription. propranolol,EXCEPT.

122. Which of the following adverse effect is a. Bronchodilation

observed with adrenergic agonists? b. Sexual impairment
c. Arrhythmia (with abrupt withdrawal)
a. Arrhythmia d. Fatigue
b. Insomnia e. Bronchoconstriction
c. Nausea
d. Hyperactivity 128. These substances may liquefy or form
e. All of these eutectic mixtures when in close, prolonged
contact with one another
123. An adrenergic agonist used in the
management of anaphylactic shock a. Aspirin
b. Phenol
a. Phenylephrine c. Camphor
b. Oxymetazoline d. Menthol
c. Epinephrine e. All of these
d. Pseudoephedrine
e. Clonidine 129. All of the following are drugs with narrow
therapeutic indices EXCEPT
124. An adrenergic agonist commonly used
in over the counter nasal sprays for nasal a. Amoxicillin
congestion b. Levothyroxine
c. Warfarin
a. Oxymethazoline d. Heparin
 e. Quinidine 135. A patient who was recently on
allopurinol therapy comes to the pharmacy
130. Adverse effects of cimetidine associated complaining that his medication is not working
with its action as a nonsteroidal antiandrogen for he has had more gouty attacks than before.
I. Gynecomastia What should you tell this patient?
II. Galactorrhea
III. Hirsutism I. Acute gouty attacks do occur more frequently
during the first few months of therapy
a. I only II. Ensure patient is prescribed colchicine,
b. III only NSAIDS or corticosteroids to minimize
c. I and II symptoms
d. II and III III. Agree with the patient that there was indeed
e. I,II, and III an error in filling the prescription

131. Isotretinoin, a vitamin A derivative, is a. I only

used in the treatment of severe acne. How b. III only
would you counsel a patient on this medication? c. I and II
I. This is potent teratogen and shoud d. II and III
be avoided in pregnancy e. I, II and III
II. If the patient plants to get pregnant
she should talk with her doctor and 136. A patient who was given
plan to stop the use of the diphenhydramine capsules for the management
medication. of an allergic reaction continues to drink alcohol.
III. Isotretinoin is perfectly safe for her What could be the result of taking both together?
even if she becomes pregnant.
a. Increased alertness
a. I only b. Increased craving of alcohol
b. III only c. Increased sedation
c. I and II d. Deceased effect of diphenhydramine
d. II and III e. There would be no effect to the patient
e. I,II and III
137. The concurrent administration of
132. A patient on theophylline is also taking antihistamines with MAO inhibitors could result
cimetidine prescribed by another doctor. What to
would be the result of the interaction between
these two medications? a. Increased anticholinergic effect
b. Decreased anticholinergic effect
a. Increased clearance of theophylline c. Hypertensive crisis
b. Decreased clearance of theophylline d. Arrhythmia
c. Decreased clearance of cimetidine e. None of these
d. Increased clearance of cimetidine
e. No change in clearance profiles of both 138. A patient with Alzheimer’s disease is on
drugs donepezil. Concurrent administration with
diphenhydramine could result to which of the
133. Sudden cessation of beta blockers could following
result in
a. Increased effect of diphenhydramine
a. Cardiac arrhythmia b. Decreased effect of diphenhydramine
b. Hypotension c. Increased effect of donepezil
c. Angina d. Decreased effect of donepezil
d. Bronchodilation e. None of these
e. None of these
139. A patient on phenelzine had smoked
134. Common side effect of colchicine fish and red wine for dinner , what could happen
to this patient?
a. Nausea
b. Alopecia I. This patient would not be able to
c. Aplastic anemia metabolize tyramine from diet
d. Diarrhea II. This patient would experience a
e. All of these hypertensive crisis
 III. This patient shoul be on a restricted d. Take vitamin C and minerals with his B
diet free of tyramine –containing complex
foods. e. There is no interaction between the two
drugs.
a. I only
b. III only 144. Celecoxib a COX-2 inhibitor , has a
c. I and II black box warning because it is linked with
d. II and III which of the following
e. I,II and III
a. Increased risk of peptic ulcer
140. The co-administration of MAO inhibitors b. Increased risk of cardiovascular
with SSRI’s is contaminated because events
c. Contraindicated in patients with sulfa
a. The combination will decreased the allergy
effect of MAO inhibitors d. Is associated with alopecia
b. The combination will deceased the e. None of these
effect of SSRI’s
c. The patient will more depressed 145. Aspirin should not be used in patients
d. The combination could cause being treated with methotrexate because
serotonin syndrome
e. None of these a. The combination increases the
toxicity of methotrexate
141. Which of the following statements is/are b. The combination decreases the toxicity
TRUE regarding the use of MAO inhibitors and of methotrexate
SSRI’s? c. The combination increases the effect of
I. These could be given together aspirin
safety d. The combination decreases the effect of
II. A wash out period of at least 2 aspirin
weeks is necessary before the other e. None of these
type is administered
III. Fluoxetine should be discontinued 146. Common adverse effect associated with
at least 6 weeks before a MAOI is narcotic pain relievers
initiated.
a. Constipation
a. I only b. Nausea
b. III Only c. Vomiting
c. I andII d. Sedation
d. II and III e. All of these
e. I,II and III
147. The most serious adverse effect
142. The drug interaction between levodopa accompanying narcotic overdose?
and pheneizine could result to which of the
following a. Respiratory depression
b. Renal toxicity
a. Serotonin syndrome c. Hemorrhage
b. Hypertensive crisis d. Hepatotoxicity
c. Hyperthyroidism e. Neuralgia
d. Hyperthermia
e. None of these 148. Narcotic analgesics when used together
with benzodiazepines could result to
143. A patient takes levodopa together with
his vitamin B complex preparation contains a. Sedation
vitamins B1, B6,and B12. What should you tell the b. Cardiovascular event
patient about this? c. Bleeding
d. GI upset
a. Levodopa should not be co- e. None of these
administered with vitamin B6
b. The b complex vitamins enhance the 149. Adverse effects commonly seen in
effects of levodopa patients on opioid therapy
c. There is a risk of developing
hypervitaminosis a. Constipation
b. Nausea
 c. Hypotension
d. Sedation
e. All of these evening. You went ahead and reviewed the patient’s
medication profile and found out that one of her
150. Which of the following is a clinical use of medication is causing dry cough. Which medication is
opioids? this?

a. Analgesia a. Metformin
b. Relief of cough b. Captopril
c. Anesthesia c. Multivitamins
d. Treatment of diarrhea d. Paracetamol
e. All of these e. Furosemide

151. Major adverse effect associated with the 157. ACE inhibitors should be used with caution in which
use of triptants of the following patients

a. Cardiovascular events a. Patients who are on potassium sparring diuretics

b. Renal toxicity b. Patients with renal disease
c. CNS depression c. Pregnant hypertensive women
d. Hepatotoxicity d. a and b
e. None of these e. b and c

152. An incompatibility where there is 158. A commonly encountered side effect of calcium
migration of the packaging material into the drug channel blockers
product
a. Peripheral edema
a. Permeation
b. Leaching b. Dry mouth
c. Lamination c. Pruritus
d. Sorption d. Hypertension
e. None of these e. All of these

153. An example of loop diuretic 159. Which of the following agents is used in the
management of gestational hypertension?
a. Triematerene
b. Hydrochlorothiazide a. Propranolol
c. Furosemide b. Benazepril
d. Chlorthalidone
c. Labetalol
e. Spironolactone
d. Losartan
154. Thiazide diuretic use increases the risk e. Terazosin
for
160. This group of diuretics may cause oxotoxicity
a. Hyperkalemia
b. Hypokalemia I. Loop diuretics
c. Hypernatremia II. Thiazide diuretics
d. Haypocalcemia III. Potassium-sparing diuretics
e. None of thes a. I only
b. II only
155. All are broad spectrum antibiotics
c. I and II
EXCEPT
d. II and III
a. Ceftriaxone e. I, II and III
b. Ciprofloxacin
c. Imipenem 161. This drug is contraindicated in a patient with a
d. Isoniazid history of severe allergic reaction in a sulfa drug
e. Tetracycline
a. Spironolactone
156. A patient come to you asking for a b. Hydrochlorothiazide
recommendation for an over the counter cough c. Amiloride
preparation. You were informed that it is a dry
d. Mannitol
cough that is bothersome especially in the
e. Furosemide
 168. Cimetidine when co-administered with metoprolol
162. A condition that predisposes a patient to digoxin would result to
toxicity
a. Hypotension
a. Hypokalemia b. Sedation
b. Hyperkalemia c. Anorexia
c. Anorexia d. Hypertension
d. Hypotension e. None of these
e. All of these
169. Protease inhibitors taken together with St. John’s
163. The type of interaction when two drugs taken wort could result in
concurrently producing additive effects
a. Lower levels of protease inhibitors
a. Pharmacokinetic b. Induced metabolism of protease inhibitors
b. Pharmacogenetic c. Inhibit metabolism of protease inhibitors
c. Pharmacodynamic d. a and b
d. Pharmaceutical e. b and c
e. All of these
170. Evening primrose oil when taken by patients on
164. Drugs that are highly protein bound to a carrier antiplatelet therapy would lead to
protein can be displaced if the second drug introduced
has a higher binding affinity to the carrier protein. This is a. Increased antiplatelet effect
what type of drug interaction? b. Bleeding
c. Failure of antiplatelet therapy
a. Pharmacokinetic d. a and b
b. Pharmacogenetic e. b and c
c. Pharmacodynamic
d. Pharmaceutical 171. When dispensing amoxicillin 500mg capsules, it is
e. None of these important to tell the patient to take this on an empty
stomach because
165. Promethazine taken together with OTC
antihistamines could result to a. Food delays the absorption of amoxicillin
b. Food would minimize stomach upset
a. Excessive dryness of the mouth c. Food would alter the taste of amoxicillin
b. Blurred vision d. Food enhances the absorption of amoxicillin
c. Urinary retention e. All of these
d. All of these
e. None of these 172. Which of the following statements is TRUE
regarding chemical-drug interaction
166. Atypical antipsychotics taken together with
amiodarone may result to I. Smoking induces the metabolism of theophylline
II. Chronic alcoholism increases the rate of metabolism
a. Prolongation of QT interval of warfarin
b. Increased anticholinergic effect III. Acute alcohol intoxication can inhibit hepatic
c. Decreased antipsychotic effect enxymes in nonalcoholics
d. a and b a. I only
e. b and c b. III only
c. I and II
167. Rifampin when co-administered with d. II and III
carbamazepine would result to e. I, II and III

a. Increased rifampin effects 173. Disulfiram and alcohol (ethanol) when taken
b. Decreased rifampin effects together results in
c. Increased carbamazepine effects
d. Decreased carbamazepine effects I. Severe alcohol intolerance
e. None of these II. Disulfiram inhibits aldehyde dehydrogenase
III. The metabolism of ethanol is limited in the presence I. Decrease
of disulfiram II. Increase
a. I only III. No effect
b. III only a. I only
c. I and II b. III only
d. II and III c. I and II
e. I, II and III d. II and III
e. I, II and III
174. Which of the following when given in large doses
produce symproms of cinchonism 180. Thiazide diuretics should be used with caution in
which of the following patient groups
a. Colchicine
b. Procainamide a. Those with sulfa allergy
c. Sotalol b. Those with gout
d. Quinidine c. Those with diabetes
e. Amiodarone d. All of these
e. None of these
175. The following are adverse effects of amiodarone,
EXCEPT 181. A patient on warfarin therapy is started on
erythromycin, the patient’s INR would be
a. Pulmonary fibrosis
b. Hepatotoxicity I. Increased
c. Blue-gray skin discoloration II. Decreased
d. Neuropathy III. No effect
e. Cinchonism a. I only
b. III only
176. Concomitant administration of quinidine and c. I and II
nitroglycerin could result to d. II and III
e. I, II and III
a. Hypertension
b. Hemorrhage 182. Bradycardia, hypotension, increased airway
c. Myalgia resistance, and cingestive heart failure are adverse
d. Severe orthostatic hypotension events associated with which class of drugs
e. Arthralgia
a. Nitrites and nitrates
177. Which of the following drugs antagonize quinidine b. Cardiac glycosides
activity and may reduce the therapeutic activity of c. Angiotensin converting enzyme inhibitors
quinidine d. Calcium channel blockers
e. Beta adrenergic antagonists
a. Phenytoin
b. Antacid 183. Possible hyperkalemia, acute renal failure,
c. Sodium bicarbonate angioedema, persistent dry cough and birth defects
d. All of these when taken during early pregnancy are adverse events
e. None of these associated with which drug class

178. Amiodarone may increase the pharmacological a. Nitrites and nitrates

effects of which of the following b. Cardiac glycosides
c. Angiotensin converting enzyme inhibitors
a. Beta blockers d. Calcium channel blockers
b. Calcium channel blockers e. Beta adrenergic antagonists
c. Warfarin
d. All of these 184. Anorexia, nausea and vomiting, halos,
e. None of these photophobia, visual disturbances(yellow, green vision),
confusion, AV block, ventricular tachycardia are adverse
179. NSAIDs ____ the effect of loop and thiazide events associated with which drug class.
diuretics
a. Nitrites and nitrates
b. Cardiac glycosides 190. A contraindication for the use of tetracyclines
c. Angiotensin converting enzyme inhibitors
d. Calcium channel blockers I. Neonate
e. beta adrenergic blockers II. Breast-feeding women
III. Women on their 2nd trimester of pregnancy
185. Patients on furosemide and digoxin should be a. I only
monitored for which of the following. b. III only
c. I and II
a. Liver enzymes d. II and III
b. Creatinine clearance e. I, II and III
c. Pulmonary function
d. INR 191. The process of calling the prescriber to discuss
e. Electrolyte levels concerns identified during a drug utilization review

186. Aburpt cessation of which of the following drugs a. Pharmaceutical intervention

could lead to rebound hypertension? b. Therapeutic intervention
c. Comprehensive medication review
a. Clonidine d. Therapeutic substitution
b. Gaunfacine e. Medication therapy management
c. Guanabenz
d. Methyldopa 192. The information that should be provided when
e. All of these conducting a therapeutic intervention

187. Long-term adverse effects of proton pump a. A brief description of the problem
inhibitors. b. A reference source that documents the problem
c. A description of the clinical significance of the problem
a. Hypomagnesimia d. A suggestion of a solution to the problem
b. Bone Fractures e. All of these
c. Vitamin B12 deficiency
d. All of these
e. None of these 193. An example of drug therapy problem

188. The most common side effect of sulfonylureas a. A prescribed drug with no indication
b. There is a more effective drug for the condition
a. Hyperglycemia indicated
b. Hypoglycemia c. Incorrect dosing frequency resulting to insufficient
c. Hyperthermia dose to the patient
d. Hypertension d. The patient is only taking half tablet instead of whole
e. Hypotension tablet because of cost
e. All of these
189. Trimethoprim is known to increase repaglinide (a
short-acting insulin secretagogue) levels by 60%. Which 194. A patient brought in new prescription for his
of the following statements is true? medication for peptic ulcer. While counseling this patient,
you mentioned that if he smokes he needs to try to quit
I. The dosage of repaglinide needs to be adjusted while smoking. Why?
the patients is on trimethoprim
II. Increased repaglinide levels may result to prolonged I. Cigarette smoking impairs ulcer healing
hypoglycemic reactions. II. Cigarette smoking increases ulcer recurrence
III. Increased repaglinide levels may result to inefficient III. Cigarette smoking increases ulcer risk
hypoglycemic control a. I only
b. III only
a. I only
c. I and II
b. III only
d. II and III
c. I and II
e. I, II and III
d. II and III
e. I, II and III 195. A patient’s drug regimen for the management of his
peptic ulcer includes the following:
 Proton pump inhibitor bid 200. Which of the following is used as an over the
Clarithromycin 500mg bid counter sleep aid?
Amoxicillin 1g bid
All medications to be taken for 14 days a. Melatonin
b. Valerian root
The patient wanted to know why there is an antibiotic c. Doxylamine
included in the medications that were prescribed to him. d. Diphenhydramine
The antibiotic would e. All of these

a. Decrease acid secretion 201. An over the counter cough preparation that is
b. Eradicate H. pylori which is the bacteria recommended for (non-reproductive cough)
present in PUD
c. Eradicate all intestinal flora that may cause PUD a. Dextromethorphan
d. Increase the effect of the other drugs b. Codeine
e. None of these c. Guaifenesin
d. A and B
196. Which of the following statement is TRUE regarding e. B and C
drug distribution?
I. Drug distribute rapidly to tissues with limited blood flow 202. The combination of bisacodyl and antacids could
II. Drug distribute rapidly to tissues with high blood flow result to
III. The liver is an example of a highly perfused organ
where drugs could distribute rapidly a. Decreased effect of bisacodyl
a. I only b. Increased effect of bisacodyl
c. Decreased effect of antacid
b. III only
d. Increased effect of antacid
c. I and II
e. There is no interaction
d. II and III
e. I, II and III 203. What would you advice a patient on bisacodyl and
antacids?
197. Aside from tissue perfusion (blood flow in tissues),
what are other factors affecting drug distribution? a. Take both drugs with a full glass of water
b. Take both drugs with food
I. Protein binding c. Take bisacodyl at least an hour before the antacid
II. Drug permeability across membranes d. There is no need to space the two drugs
III. Presence or absence of disease e. Do not take antacids
a. I only
b. III only 204. As part of colon prep for a colonoscopy procedure,
c. I and II the patient purchases a bottle of magnesium citrate.
d. II and III What should you tell the patient regarding the use of
e. I, II and III magnesium citrate?

198. Which of the following is matched correctly? I. The whole bottle should be consumed
II. Refrigeration of the product helps improve palatability
a. Cyanocobalamin – B12 III. Keep the product at room temperature only.
b. Pyridoxine – B1 a. I only
c. Thiamine – B5 b. III only
d. Nicotinic acid – B3 c. I and II
e. Biotin – B6 d. II and III
e. I, II and III
199. The following are adverse effects of nicotine
lozenges, EXCEPT 205. Counselling points for patients on oral
bisphosphonates such as alendronate (Fosamax)
a. Skin irritation on application site
b. Nausea I. Take this on an empty stomach first thing in the
c. Insomia morning
d. Dyspepsia II. Take with a full glass of water
e. Coughing
III. Remain in an upright position for at least 30 minutes 211. The most serious problem that may occur during
after taking the drug infusion of antineoplastics
a. I only
b. III only I. Too long infusion time
c. I and II II. Inflammation of a vein
d. II and III III. Extravasations
e. I, II and III a. I only
b. III only
206. Food – alendronate interaction results in c. I and II
d. II and III
a. Decreased absorption of alendronate e. I, II and III
b. Increased absorption of alendronate
c. Decreased elimination of alendronate 212. These are large volume admixtures that are used
d. Increased metabolism of alendronate when enteral nutrition cannot be tolerated.
e. None of these
a. NGT feeding
207. A prostaglandin analog used in the treatment of b. Total parenteral nutrition
open angle glaucoma that increases eyelash c. Direct GI feeding
prominence, lenghth and darkness d. Parenteral admixtures
e. None of these
a. Latanoprost
b. Bimatoprost 213. Visible color change or darkening of color is a type
c. Travoprost of
d. Tafluprost
e. Epoprostenol I. Physical incompatibility
II. Chemical incompatibility
208. Sildenafil is contraindicated in patients maintained III. Therapeutic incompatibility
on nitrates because of a. I only
b. III only
a. Severe hypotension c. I and II
b. Sexual dysfunction d. II and III
c. Priapism e. I, II and III
d. Severe hypertension
e. Therapeutic failure of nitroglycerin 214. The manifestation of the incompatibility when
phosphate and calcium are combined in solution
209. Which of the following drugs is matched correctly
with its therapeutic use? a. Evolution of gas
a. Oxybutynin – overactive bladder b. Dark discoloration of solution
b. Tamsulosin – BPH c. Precipitate formation
c. Tadalafil – erectile dysfunction d. Visible color change
d. Androgel – testosterone replacement therapy e. Formation of separate layers
e. All of these
215. When penicillin G is given after tetracycline when
210. A precaution when using D5W in parenteral treating a patient with infection, a reduction in the
preparations. bactericidal activity of the former is observed.

I. Instability when used with acid-sensitive drugs I. Physical incompatibility

II. Must be used cautiously in diabetic patients II. Chemical incompatibility
III. Instability when used with acidic drugs III. Therapeutic incompatibility
a. I only
a. I only b. III only
b. III only c. I and II
c. I and II d. II and III
d. II and III e. I, II and III
e. I, II and III
216. The following drug classes may cause tinnitus, a. Decresed antibiotic effect
EXCEPT b. Increased antibiotic effect
c. Increased phenytoin effect
a. Salicylates d. Decresed phenytoin effect
b. Aminoglycosides e. None of these
c. Loop diuretics
d. Penicillins 223. An antibiotic drug class that may cause QT
e. Chemotherapeutic agents prolongation

217. A patient was given cefdinir but continued to take a. Fluoroquinolones

iron supplements. What could be the result of this drug b. Tetracyclines
interaction? c. Penicillins
d. Macrolides
a. Failure of antibiotic therapy e. None of these
b. Patients develop iron-deficiency anemia
c. Cefdinir toxicity 224. Concurrent use of fluoroquinolones with
d. Decreased effect of iron antiarrhythmics could result in
e. None of these
a. QT prolongation
218. The interaction between theophylline and b. Increased CNS stimulation
erythromycin could result in c. Decreased fluoroquinolone absorption
d. Failure of antibiotic therapy
a. Inhibition of metabolism e. None of these
b. Toxic accumulation of theophylline
c. Induction of metabolism of theophylline 225. Norfloxacin when taken together with antacids
d. a and b results in
e. b and c
a. Increased antibiotic effect
219. Patients treated for 1 week or longer with b. Decreased antibiotic effect
erythromycin estolate may develop c. There is no interaction between the two
d. Increased CNS effect
a. Cholestatic hepatitis e. None of these
b. Hypertension
c. Ototoxicity 226. The antibiotic associated with gray-baby syndrome
d. Renal failure in neonates
e. None of these
a. Ciprofloxacin
220. Clarithromycin co-administered with cisapride could b. Sulfamethoxazole
result in c. Clindamycin
d. Chloramphenicol
a. Serious cardiac arrhythmias e. Trimethoprim
b. Difficulty breathing
c. Enzyme depletion 227. Fluconazole is prescribed to a patient taking
d. Bradycardia sulfonylureas, this could lead to
e. None of these
a. Decreased antibiotic effect
221. Clarithromycin and oral anticoagulants when given b. Increased antibiotic effect
together c. Decreased hypoglycemic effect
d. Increased hypoglycemic effect
a. Potentiate anticoagulant effect e. None of these
b. Prothrombin time needs to be monitored
c. Diminish anticoagulant effect 228. Co-administration of ketoconazole with terfenadine
d. a and b will cause
e. b and c
I. Increased terfenadine levels
222. Tetracycline when given together with phenytoin II. Life-threatening dysrhythmias and death
would result to III. Increased ketoconazole levels
I. Physical incompatibility
II. Chemical incompatibility 234. A concern in elderly patients on aminoglycoside
III. Therapeutic incompatibility antibiotics
a. I only
b. III only a. Nephrotoxicity
c. I and II b. Ototoxicity
d. II and III c. Diabetes
e. I, II and III d. a and b
e. b and c
229. Chloroquine and hydrochloroquine are known to
concentrate in the liver. These should be used with 235. An adverse effect of aminoglycoside antibiotics
caution in this patient group. associated with a rapid increase in concentrations or
concurrent administration with neuromuscular blockers
a. Those with hepatic disease
b. Those with pulmonary disease a. Bone resorption
c. Those with cardiac disease b. Neuromuscular paralysis
d. Those with renal disease c. Aplastic anemia
e. Those with diabetes d. CNS depression
e. None of these
230. Quinine is contraindicated in patients with
236. The safest antibiotic to give a pregnant patient with
I. G6PD deficiency MRSA
II. Tinnitus
III. Optic neuritis a. Tetracycline
a. I only b. Clindamycin
b. III only c. Methicillin
d. Doxycycline
c. I and II
e. Tigecycline
d. II and III
e. I, II and III
237. An auxillary label when dispensing nystatin to treat
oral candidiasis
231. Quinine should be used with caution in patients with
a. Shake well
a. Hepatic disease b. Dispense 30ml
b. Atrial fibrillation c. Drink with full glass of water
c. Diabetes d. Do not drive
d. Bone disease e. No refills
e. Respiratory tract infection
238. A contraindication for sulfa drugs because of the
232. A patient prescribed with metronidazole still danger of kernicterus
continues to drink alcohol, what could this patient
experience? a. Adult patients with renal disease
b. Adult patients with hepatic disease
a. Alcohol intolerance c. Neonates and infants less than 2 months of age
b. Anorexia d. Patients with diabetes
c. Diarrhea e. Children above 6 years of age
d. Euphoria
e. Sedation 239. Which of the following drugs is correctly matched
with its adverse effect?
233. An adverse effect associated with the use of
daptomycin a. Nitrofurantoin – pulmonary fibrosis
b. Tetracycline – phototoxicity
a. QT prolongation c. Fluoroquinolone – tendonitis
b. Hypertension d. Sulfa drugs – SJS
c. Hot flashes e. All of these
d. Rhabdomyolysis
e. Wheezing
240. The most serious side effect of isoniazid 246. Intraconazole has a negative inotropic effect and
should be avoided by which patients
a. Hepatitis
b. Hypoglycemia a. Diabetic patients
c. Hypotension b. Asthmatic patients
d. Optic neuritis c. Those with heart failure
e. None of these d. Those with hypertension
e. None of these
241. Which of the following anti-TB drugs causes
peripheral neuropathy? 247. Common adverse effects of zidovudine (AZT)
a. Rifampicin
b. Isoniazid a. Anemia
c. Pyrazinamide b. Neutropenia
d. Ethambutamol c. Headaches
e. Streptomycin d. All of these
e. None of these
242. A patient came back to the pharmacy to refill his
prescription for anti-tubercular drugs. He informs you 248. A major adverse effect of didanosine (ddl)
that he is doing well, except that he seems to be having
difficulty reading books and has actually set an a. Pancreatitis
appointment with an ophthalmologist and plans to get b. Renal failure
glasses. Which of his medications may be causing his c. Headache
decline in vision? d. Hepatitis
e. Diarrhea
a. Rifampicin
b. Isoniazid 249. These agents work by dissolving or breaking down
c. Pyrazinamide the outermost layer of the skin, causing peeling of the
d. Ethambutamol stratum corneum.
e. Streptomycin
a. Cytostatic agents
243. What should be determined prior to initiation of anti- b. Keratolytic agents
TB therapy because the drugs may cause hepatitis c. Tocolytic agents
d. Astringents
a. Renal function test e. Antimetabolites
b. Baseline hepatic enzyme measurement
c. ECG 250. An example of a keratolytic agent
d. CBC
e. Lung function test a. Coal tar
b. Salicylic acid
244. IV administration of amphotericin B may cause c. Hydrocortisone OTC
thrombophlebitis, this could be prevented by adding ___ d. Selenium sulphide
to the infusion e. Burow’s solution

a. Heparin 251. These are mild protein precipitants that result in

b. Aspirin contraction of tissue which in turn decreases the local
c. Diphenhydramine edema and inflammation.
d. Warfarin
e. Paracetamol a. Cytostatic agents
b. Keratolytic agents
245. A contraindication for azole antifungals c. Tocolytic agents
a. Pregnancy d. Astringents
b. Hypertension e. Antimetabolites
c. Asthma
d. Pneumonia
252. an example of an astringent
e. Diabetes
a. Coal tar
b. Salicylic acid
c. Hydrocortisone OTC
 d. Selenium sulphide a. Potassium chloride and sodium chloride
e. Burrow’s solution b. Potassium phosphate and calcium gluconate
c. Potassium phosphate and magnesium chloride
253. The major plasma protein involved in drug protein d. Zinc chloride and sodium chloride
binding e. None of these
a. Alpha 1-glycoprotein 260. Strategy to manage drug metabolism
b. Transcortin
c. Lipoprotein a. Use of different dosage forms
d. Albumin b. Modification of key functional groups
e. None of these c. Concurrent use of enzyme inhibitors
d. All of these
254. The process by which drugs are eliminated through e. None of these
the kidneys into the urine
261. A patient who is a slow acetylator of isoniazid will
I. Glomerular filtration experience _____
II. Tubular reabsorption
III. Active tubular secretion a. Hypertension
b. Peripheral neuropathy
a. I only c. Hypotension
b. III only d. Hypertrophy
c. I and II e. Arthritis
d. II and III
e. I, II and III 262. These are morphine related toxicities
255. The effect of the administration of sodium a. Diarrhea
bicarbonate to weakly acidic drugs such as salicylates b. Constipation
c. Respiratory depression
a. No effect d. A and B
b. Decrease excretion e. B and C
c. Increase excretion
d. All of these 263. A therapeutic advantage of using prodrugs
e. None of these
a. Increased water solubility
256. Most biologic products are sensitive to which of the b. Increased oral absorption
following c. Increased duration of action
d. Decreased GI irritation
a. Extreme heat e. All of these
b. Light
c. Freezing 264. The process by which a drug reversibly leaves the
d. Shaking bloodstream and enters the extracellular fluid and the
e. All of these tissues is known as
257. Adalimumab (Humira) a monoclonal antibody used a. Absorption
for treating autoimmune disorders has a black box b. Distribution
warning of? c. Metabolism
d. Excretion
a. Increased risk of lactic acidosis e. Elimination
b. Increased infection
c. Increased cardiovascular events 265. When drawing cisplatin from vials, a stainless steel
d. All of these needle should be used instead of aluminum because
e. None of these aluminum displaces the platinum in cisplatin. What type
of incompatibility is described?
258. The type of incompatibility between oxidizing
agents and reducing agents a. Chemical incompatibility
b. Therapeutic incompatibility
a. Physical incompatibility c. Physical incompatibility
b. Chemical incompatibility d. All of these
c. Therapeutic incompatibility e. None of these
d. A and B
e. B and C 266. An auxiliary label that ensures proper preparation
storage and disposal of medicines
259. In TPN preparations a potential problem that may
occur is between a. Keep refrigerated. Do not freeze
b. Shake well
 c. Protect from light 272. These powders contain water of hydrating that may
d. Keep out reach of children be released when the powders are triturated or when
e. All of these stored in an environment of low relative humidity
resulting to powders that are damp or pasty
267. An auxiliary label that is also a warning label about
potential adverse drug reactions EXCEPT a. Hygroscopic powders
b. Deliquescent powders
a. Avoid sun exposure c. Efflorescent powders
b. May cause drowsiness. Do not drink, drive or d. Amorphous powders
operate machinery e. None of these
c. External use only
d. May cause discoloration of urine or feces 273. An agent that softens the skin or soothes irritation
e. All of these in skin mucous membranes

268. An auxiliary label that ensures appropriate dosing a. Humectant

considerations b. Occlusive
c. Protective
a. Take with food d. Emollient
b. Take with a full glass of water e. None of these
c. Finish all this medication
d. Take on an empty stomach 274. Primary adverse effects associated with the use of
e. All of these lithium

269. A patient comes to the pharmacy telling you that a. Tremors

her salbutamol inhaler is not working properly. You recall b. Edema
that this is a new medication for the patient and this c. Loss of sensitivity to antidiuretic hormone
patient should denied to be counseled regarding the use d. Decreased thyroid function
of this new medication. What is the best thing to do? e. All of these

I. Ask the patient to demonstrate how the inhaler is used 275. You have a patient on tramadol who was also
II. Tell the patient that the device may be defective prescribed lactulose to be taken prn. Lactulose is for the
III. Remind the patient that she refused counseling management of which side effect of tramadol?
regarding this medication
a. Sedation
b. Vomiting
a. I only c. Constipation
b. III only d. Nausea
c. I and II e. Diarrhea
d. II and III
e. I, II and III 276. An SNRI is also used for the management of bone
and muscle pain
270. Patients on which of the following medications
should be strongly reminded that they should always a. Venlafaxine (Effexor)
have these with them for emergency use b. Mirtazapine (Remeron)
c. Paroxetine (Paxil)
d. Duloxetine (Cymbalta)
e. Fluoxetine (Prozac)

277. When counseling patients with depression who are

a. Nitroglycerin sublingual tablets
on antidepressant medication they should be informed of
b. Salbutamol inhaler
which of the following
c. Injectable epinephrine
d. All of these I. Adherence to the treatment plan is essential to achieve
e. None of these a successful outcome
II. The adverse effects of the drugs may occur
271. Information that is included during patient immediately while the resolution of symptoms may take
counseling 2 to 4 weeks or longer
a. Route of administration III. The resolution of symptoms is immediate while the
b. Missed dose instruction adverse effects may take a while to occur
c. Direction for use
d. Frequency of taking the drug a. I only
e. All of these b. III only
c. I and II
d. II and III
 e. I, II, and III reduction in the clearance of lamotrigine. What type of
interaction is involved in the drug combination?
278. The following medications should be used with
caution in patients in MAO inhibitors because of a risk of a. Pharmacokinetic interaction
hypertensive crisis b. Pharmacodynamic interaction
c. Pharmaceutical interaction
a. Topical and systemic decongestants d. A and B
b. Epinephrine e. B and C
c. Other MAOIs
d. All of these 285. A patient an alprazolam continues to take alcohol
e. None of these which results in additive CNS depressant effects. The
type of interaction is
279. The interaction between fluoxetine and other
MAOIs could result in a. Pharmacokinetic interaction
b. Pharmacodynamic interaction
a. Hypertensive crisis c. Pharmaceutical interaction
b. Serotonin syndrome d. A and B
c. Hypotension e. B and C
d. A and B
e. B and C 286. Concurrent use of benzodiazepines with St. John’s
Wort results in reduction of benzodiazepine levels. The
280. Which of the following may be experienced when combination could result in
bupropion is given to a patient who are on medication
that lower the seizure threshold? a. Toxicity of benzodiazepine
b. Increased CNS depression
a. Increased incidence of seizures c. Decreased benzodiazepine effect
b. Decreases incidence of seizures d. A and B
c. No effect on seizure activity e. B and C
d. All of these
e. None of these 287. You are called to counsel a patient regarding
sildenafil. However, this is a female patient. What could
281. A serious ADR that is common to all she be using this drug for?
antidepressants
a. Erectile dysfunction
a. Hypotension b. Pulmonary hypertension
b. Suicidality c. Hormone replacement therapy
c. QT interval prolongation d. Hypotension
d. Serotonin syndrome e. Androgen therapy
e. All of these
288. The following drugs are known to sorb to glass or
282. When carbamazepine is administered together with plastics
valproate, valproate displaces carbamazepine from
protein binding sites. What type of drug interaction was I. Insulin
described?
II. Nitroglycerin
a. Pharmacokinetic interaction III. Diazepam
b. Pharmacodynamic interaction
c. Pharmaceutical interaction
a. I only
d. All of these
b. III only
e. None of these
c. I and II
283. The combination of clozapine and carbamazepine d. II and III
is not recommended because of the possibility of bone e. I, II and III
marrow suppression with both agents. What is the type
289. This chemotherapeutic drug in a co-solvent system
of interaction described?
requires the use of non-PVC containers and
a. Pharmacokinetic interaction administration set because of the problem of leaching
b. Pharmacodynamic interaction
a. Paclitaxel
c. Pharmaceutical interaction
b. Cyclosporine
d. All of these
c. Propofol
e. None of these
d. Vitamin A
284. Valproate is often prescribed together with e. All of these
lamotrigine resulting in an augmentation of mood
stabilizing and antidepressant properties as well as a
290. The most concerning adverse effect of amiodarone III. If there is a need to administer both at the same time,
used in the management of arrhythmia administer salbutamol first
a. Hypertension
b. Pulmonary fibrosis a. I only
c. Bronchospasm b. III only
d. Hypoglycemia c. I and II
e. Renal toxicity d. II and III
e. I, II and III
291. A patient counseling point for asthmatic patients
maintained on inhaled corticosteroids 296. Carbamazepine is both a substrate and an inducer
of the CYP3A4 isoenzyme. Which of the following
I. Rinse mouth after using the inhaler statement is TRUE?
II. Using a spacer may help minimize fungal infections
III. Inhaled corticosteroids are not for acute asthma I. Carbamazepine induces its own metabolism
attacks II. It may take 3 to 4 weeks to achieve stable blood
levels of carbamazepine
III. Carbamazepine induces the metabolism of other
a. I only drugs metabolized via the same pathway.
b. III only
c. I and II
d. II and III a. I only
e. I, II and III b. III only
c. I and II
292. Drug absorption in the gastrointestinal tract is d. II and III
affected by the following EXCEPT e. I, II and III
a. Changes in gastric pH 297. A patient who is taking methadone to manage pain
b. Increased or decreased GI motility from a sports injury continues to drink grapefruit juice.
c. Enzyme induction or inhibition What could happen to this patient?
d. Complexation and chelation
e. Alteration of GI flora I. No effect on the patient
II. Failure of therapy of the pain medication
293. The effect of laxatives and cathartics on drug III. May experience toxicity due to methadone
absorption
a. Increased absorption a. I only
b. Decreased absorption b. III only
c. No effect on drug absorption c. I and II
d. All of these d. II and III
e. None of these e. I, II and III

294. The interaction between epinephrine and lidocaine 298. A common side effect of nitrates
a local anesthetic is
I. A desired drug interaction
II. Allows local anesthesia with minimal bleeding and a. Hypertension
without systemic absorption while repairing a skin wound b. Headache
III. Epinephrine and lidocaine should not be administered c. Dry cough
together d. Bronchospasm
e. Vasoconstriction
a. I only
b. III only 299. A manifestation of a chemical incompatibility
c. I and II EXCEPT
d. II and III
e. I, II and III a. Evolution of gas
b. Get formation
295. A patient on salbutamol (Ventolin) and salmeterol c. Immiscibility
and fluticasone (Advair) should be informed of the d. Photolysis
following e. None of these

I. Salbutamol inhaler should be used during acute

asthma attacks
II. Salmeterol and fluticasone is the maintenance inhaler
to be used daily to minimize asthma attacks
300. Oral antidiabetic drugs that are structurally different
with sulfonylureas however exert the blood glucose
lowering action by the same mechanism.
a. Metformin
b. Insulin
c. Meglitinides
d. Tolazamide
e. None of these