Sample Questions on psPharmacology-2

By Dr Esraa

Choose one correct answer:

1. A 14-year-old boy with a childhood history of asthma was delivered to the
emergency room complaining of severe symptoms of cough, dyspnea, and wheezing
after his tennis exercise. Which of the following is the most appropriate drug to
rapidly reverse his bronchoconstriction?

A. Inhaled fluticasone.

B. Inhaled beclomethasone.

C. Inhaled albuterol.

D. Intravenous propranolol.

E. Oral theophylline.

Correct answer = C. Inhalation of a rapid-acting β2 agonist, such as albuterol, usually

provides immediate bronchodilation. An acute asthmatic crisis often requires
intravenous corticosteroids, such as methylprednisolone. Inhaled beclomethasone
and fluticasone treat chronic airway inflammation but will not provide any
immediate effect. Propranolol is a nonselective β-blocker and would aggravate the
patient’s bronchoconstriction. Theophylline has been largely replaced with β2
agonists and is no longer recommended for acute bronchospasm.

2. A 63-year-old female with a COPD exacerbation has recently been discharged

from the hospital, as the third time in the past year. The patient is currently on the
same drug regimen prior to her admission of salmeterol inhalation twice daily and
tiotropium inhalation once daily. Which of the following would be an
appropriate change in her medication regimen?

A. Chronic systemic corticosteroids.

B. Discontinue the tiotropium.

C. Discontinue the salmeterol.

Dr. Esraa zakaria Page 1

D. Change the salmeterol to a combination product that includes both a LABA and
an inhaled corticosteroid (for example, salmeterol/fluticasone DPI).

E. Theophylline.

Correct answer = D. The addition of an inhaled corticosteroid may provide

additional benefit since the patient has significant airway obstruction and frequent
exacerbations requiring hospitalization. Systemic corticosteroids are used on a
short-term basis to treat exacerbations in patients with COPD but are not
recommended for chronic use. It is not routinely recommended to discontinue a
long-acting bronchodilator unless the patient experiences an adverse effect or
experiences no therapeutic benefit. In this case, the patient reports only mild
symptoms in between exacerbations, suggesting she may be benefiting from both
bronchodilators. Theophylline is an oral bronchodilator that is beneficial to some
patients with stable COPD. However, because of its toxic potential, its use is not
routinely recommended.

3. Due to its anti-inflammatory mechanism of action, which of the following

medications requires regular administration for the treatment of asthma?

A. Tiotropium MDI (metered-dose inhaler).

B. Salmeterol.

C. Mometasone.

D. Albuterol MDI.

4. All of the following are preferred antihistamines for the management of

allergic rhinitis except:

A. Chlorpheniramine.

B. Fexofenadine.

C. Loratadine.

D. Cetirizine.

5. Which of the following medications inhibits the action of 5-lipoxygenase

and consequently the action of leukotriene B4?

A. Cromolyn.

B. Zafirlukast.

Dr. Esraa zakaria Page 2

C. Zileuton.

D. Montelukast.

E. Theophylline

6. Which of the following medications has the least potential to significantly

impair the ability to drive a vehicle?

A. Diphenhydramine.

B. Levocetirizine.

C. Chlorpheniramine.

D. cyclizine.

7. Angiotensin converting enzyme inhibitors cause cough by the following

mechanism:

A. Prevent conversion of Angiotensin I to angiotensin II

B. Prevent bradykinin degradation
C. Increase bradykinin degradation
D. Blocking B2 receptors in bronchial muscles

8. Which of the following may precipitate acute asthma attacks?

A. Smoking
B. Exercise
C. Aspirin
D. A & C
E. A, B,& C

9. Anti-asthma agent that acts by activating pulmonary B2 receptors is:

A. Ipratropium
B. Terbutaline
C. Cromolyn
D. Fluticasone

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10. An asthmatic patient was prescribed an adrenergic agent. After administration,
the drug makes the patient tachycardiac and nervous. This drug was probably:

A. Albuterol
B. Isoprenaline
C. Salmuterol
D. A & B

1. A 21-year-old college student is curious about the effects of LSD. She

asks what type of risks may be involved with using the drug for the first
time. Which of the following is a correct response to her question?

A. Exaggerated hallucinations.

B. Cardiomyopathy.

C. Hyperphagia.

D. Bronchitis.

Correct answer = A. Exaggerated hallucinations, sometimes known as

“bad trips,” may occur, even in first-time users. These hallucinations can
lead to extreme panic, which has caused individuals to react in a manner
very uncharacteristic of their typical behavior. Other symptoms are not
characteristic to LSD.

2. A 35-year-old man has been abusing cocaine and is agitated,

tachycardic, hypertensive, and hyperthermic. Which of the following is
correct regarding treatment in this situation?

A. This patient should undergo gastric lavage; that is, he should have his
stomach pumped immediately.

B. Cocaine toxicity commonly involves CNS depression that can be

reversed with IV atropine.

C. Benzodiazepines would be a good choice, as they should help calm the

patient down, decrease heart rate, decrease blood pressure, and
decrease body temperature.

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D. Phenobarbital should be the first choice as an anticonvulsant.

Correct answer = C. Benzodiazepines such as lorazepam have anxiolytic

properties and can calm a cocaine toxic patient down, thereby decreasing
heart rate and blood pressure. As the patient becomes less agitated,
he/she decreases movement and his or her body temperature drops. In
addition, the use of benzodiazepines decreases the chance of the patient
experiencing a convulsion and would be the first choice to treat cocaine-
induced convulsions.

3. JM is a 10-year-old male who is sent to a pediatric neurologist for an

evaluation due to receiving poor grades in class. JM’s parents have
recently received complaints from his teacher that he is performing
poorly in school and he is repeatedly caught not paying attention in
class. Several times a day during class, JM is noted to be getting out of
his chair and socializing with other students. JM is given a diagnosis of
ADHD with impulsivity and irritability. Which of the following is the
most appropriate recommendation for management of the ADHD?

A. Clonidine.

B. Desipramine.

C. Dextroamphetamine.

D. Atomoxetine.

E. Methylphenidate

Correct answer = E. Methylphenidate is the first line medication in the list

for ADHD. The other agents may assist in the management of ADHD, but
methylphenidate is superior in treating ADHD.

4. All of the following drugs are controlled substances with a risk for
drug addiction or dependence except:

A. Oxycodone.

B. Lisdexamfetamine.

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C. Dexmethylphenidate.

D. Atomoxetine.

E. Methamphetamine.

5. Amphetamines are contraindicated in patients with all of the

following conditions, Except:

A. Cardiovascular disease.

B. Glaucoma.

C. Hypertension.

D. Hyperthyroidism.

E. Obesity

Correct answer= E. The use of amphetamines in the management of

obesity should be closely monitored. However, this is an older use of these
agents, and there are amphetamine analogs that are FDA approved for
obesity. The other conditions are contraindications when considering the
use of amphetamines, because amphetamines may exacerbate these
medical conditions.

6. Which of the following drugs stimulates the release of

norepinephrine & dopamine?

A. Cocaine
B. Methylphenidate
C. LSD
D. Phencyclidine
E. None of the above

Cocaine & Methylphenidate act by inhibiting reuptake of

neurotransmitters by nerve endings. LSD is 5-HT1 & 5-HT2 receptor
agonist. Phencyclidine act by inhibiting NMDA receptors.

7. One of the following is a behavioral feature of ADHD:

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 A. Inattentiveness
B. Inability to concentrate
C. Hypoactivity
D. Impulsivity

Other symptoms are mental rather than behavioral

8. WK. was prescribed Adderall for his narcolepsy attacks. He is

more likely to encounter all of the following symptoms, EXCEPT?

A. Arrhythmias
B. Cataplexy
C. Insomnia
D. Weight loss

Cataplexy is treated with Adderall not a side effect of it.

9. Which of the following has the highest addiction potential?

A. Methylphenidate
B. Phencyclidine
C. Dextroamphetamine
D. Ecstasy
E. Cocaine

Best Regards

Sample Questions on Respiratory Pharmacology

Choose one correct answer:

1. A 14-year-old boy with a childhood history of asthma was delivered to the

emergency room complaining of severe symptoms of cough, dyspnea, and wheezing
after his tennis exercise. Which of the following is the most appropriate drug to
rapidly reverse his bronchoconstriction?

A. Inhaled fluticasone.

B. Inhaled beclomethasone.

C. Inhaled albuterol.

Dr. Esraa zakaria Page 7

D. Intravenous propranolol.

E. Oral theophylline.

2. A 63-year-old female with a COPD exacerbation has recently been discharged

from the hospital, as the third time in the past year. The patient is currently on the
same drug regimen prior to her admission of salmeterol inhalation twice daily and
tiotropium inhalation once daily. Which of the following would be an
appropriate change in her medication regimen?

A. Chronic systemic corticosteroids.

B. Discontinue the tiotropium.

C. Discontinue the salmeterol.

D. Change the salmeterol to a combination product that includes both a LABA and
an inhaled corticosteroid (for example, salmeterol/fluticasone DPI).

E. Theophylline.

3. Due to its anti-inflammatory mechanism of action, which of the following

medications requires regular administration for the treatment of asthma?

A. Tiotropium MDI (metered-dose inhaler).

B. Salmeterol.

C. Mometasone.

D. Albuterol MDI.

4. All of the following are preferred antihistamines for the management of

allergic rhinitis except:

A. Chlorpheniramine.

B. Fexofenadine.

C. Loratadine.

D. Cetirizine.

5. Which of the following medications inhibits the action of 5-lipoxygenase

and consequently the action of leukotriene B4?

A. Cromolyn.

Dr. Esraa zakaria Page 8

B. Zafirlukast.

C. Zileuton.

D. Montelukast.

E. Theophylline

6. Which of the following medications has the least potential to significantly

impair the ability to drive a vehicle?

A. Diphenhydramine.

B. Levocetirizine.

C. Chlorpheniramine.

D. cyclizine.

7. Angiotensin converting enzyme inhibitors cause cough by the following

mechanism:

E. Prevent conversion of Angiotensin I to angiotensin II

F. Prevent bradykinin degradation
G. Increase bradykinin degradation
H. Blocking B2 receptors in bronchial muscles

8. Which of the following may precipitate acute asthma attacks?

F. Smoking
G. Exercise
H. Aspirin
I.A & C
J.A, B,& C

9. Anti-asthma agent that acts in part by activating pulmonary B2 receptors is:

E. Ipratropium
F. Terbutaline
G. Cromolyn
H. Fluticasone

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10. An asthmatic patient was prescribed an adrenergic agent. After administration,
the drug makes the patient tachycardiac and nervous. This drug was probably:

E. Albuterol
F. Isoprenaline
G. Salmuterol
H. A & B

1. A 52-year-old patient is diagnosed with ovarian cancer. She begins using cisplatin
but becomes nauseous and suffers from severe vomiting. Which of the following
medications would be the most effective to counteract the emesis in this
patient?

A. Nabilone.
B. Dolasetron.
C. Prochlorperazine.
D. Dexamethasone.

2. A couple celebrating their 40th wedding anniversary are given a trip to Peru to
visit Machu Picchu. Due to past experiences while traveling, they ask their doctor to
prescribe an agent for diarrhea. Which of the following would be effective?

A. Omeprazole.
B. Loperamide.
C. Famotidine.
D. Lorazepam.

3. Which of the following drugs has been known to cause discoloration of the
tongue?

A. Amoxicillin.
B. Omeprazole.
C. Bismuth compounds.
D. Lubiprostone.

4. Which of the following drugs is the least tolerated for the treatment of
constipation:

A. Castor oil.
B. Methylcellulose.

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 C. Lactulose.
D. Docusate.

5. Mesoprostol is contraindicated in pregnancy because:

A. It is teratogenic.
B. it stimulates uterine contractions.
C. It worsens pregnancy-associated heart burn
D. None of the above.

6. A 45-year-old woman complains of persistent heartburn and an unpleasant, acid-

like taste in her mouth. The clinician suspects that she has gastroesophageal reflux
disease and advises her to raise the head of her bed 20 cm, not to eat for several
hours before sleeping, and to eat smaller meals. Two weeks later, she returns and
says the symptoms have subsided slightly but still are a concern. The clinician will
likely prescribe which one of the following drugs?

A. Aluminum hydroxide.
B. Dicyclomine.
C. Alprazolam.
D. Lansoprazole

7. Which class of these antiulcer drugs can eradicate Helicobacter pylori and
cure associated gastritis:

A. Sucralfate
B. Colloidal bismuth
C. H2 blockers
D. Anticholinergic drugs

8. Antacid: effective, but associated with systemic alkalosis:

A. Calcium carbonate
B. Sodium bicarbonate
C. Magnesium hydroxide

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 D. Aluminium hydroxide

9. All of the following are examples of H2 antagonists, EXCEPT:

A. Cimetidine
B. Citrizine
C. Ranitidine
D. Nizatidine
E. Famotidine

10. Phenothiazine prevents nausea and vomiting by inhibiting one of the

following receptors:

A. H1 receptor
B. Serotonine 3
C. Serotonine 5
D. Dopamine 2
E. Acetylcholine

Best Regards

Dr. Esraa zakaria Page 12