1) The study of drug absorption, distribution, metabolism, and excretion is known as
pharmacotherapeutics
pharmacodynamics
pharmacokinetics
pharmacy
2) The medical situation when a particular drug should not be administered is referred to as
side effect
adverse effect
drug allergy
contraindication
3) An unusual or unexpected drug reaction by an individual is known as
toxic effect
antagonism
idiosyncrasy
side effect
4) The proprietary drug name supplied by a pharmaceutical company is also referred to as the
generic name
over-the-counter name
trade name
chemical name
5) The time from drug administration to the first observable drug effect is known as the
duration of action
onset of action
ceiling effect
maximal response
6) A drug that has the potential for abuse and is regulated by the Drug Enforcement Agency is classified as a
poison
OTC drug
prescription drug
controlled substance
7) Which term relates to the amount of drug administered to produce a therapeutic effect?
posology
toxicology
pharmacodynamics
pharmacotherapeutics
8) A medication that does not require a physician's service to obtain is referred to as
trade
nonproprietary
nonprescription
brand
9) Which of the following could be categorized as an adverse reaction?
idiosyncrasy
drug allergy
teratogenicity
carcinogenicity
10) The time a drug continues to produce its effect is its
ED50
maximal response
ceiling effect
onset of action
11) . The drug administration route demonstrating the slowest onset of action is
inhalation
transdermal
intramuscular
sublingual
12) In order for drugs to cross the blood-brain barrier, they must be
ionized
positively charged
water soluble
lipid soluble
13) First-pass metabolism refers to the metabolism of drugs in the
kidney
blood vessels
liver
heart
14) Drugs that have demonstrated teratogenic effects in women are classified as Pregnancy Category
B
C
D
X
15) When a drug increases the rate of drug metabolism of other drugs, the process is termed
first-pass metabolism
enzyme induction
enzyme inhibition
enterohepatic cycling
16) The rate of drug absorption would be increased by which of the following?
drug ionization
water solubility
positively charged drug
negatively charged drug
17) Which factor of individual variation is dependent upon the patient's attitude toward treatment?
weight
age
genetic variation
placebo effect
18) Which FDA pregnancy category would appear to be the safest for a developing fetus?
Category A
Category B
Category C
Category D
19) A 45-year-old female shop assistant is treated for heartburn with omeprazole. She notes that the effect of a dose of omeprazole lasts much longer than that of a dose of the antacid drug calcium carbonate she had previously taken. The active metabolite of omeprazole binds covalently and irreversibly to a molecular structure involved in releasing protons into the gastric juice. Drugs that modify their target structures through this mechanism are called
suicide substrates.
orphan drugs.
protein drugs.
competitive antagonists.
20) A 56-year-old man with chest pain is diagnosed with stable angina and treated with several drugs including nitroglycerin. Every day he has to discontinue nitroglycerin for some hours to re-establish reactivity of his body to the drug. The clinical observation of a rapidly decreasing response to nitroglycerin after administration of just a few doses is called
idiosyncrasy.
tachyphylaxis.
heterologous desensitization.
refractoriness.
21) Prolonged receptor stimulation during chronic drug therapy may induce cells to endocytose and sequester drug receptors in endocytic vesicles. This molecular mechanism is called
tachyphylaxis.
inactivation.
desensitization.
downregulation.
22) A 16-year-old female with a history of goiter is admitted with fever, profuse sweating, tachyarrhythmia, hypertension, abdominal pain, and anxiety. Based on a working diagnosis of thyrotoxicosis, she is started on a beta-adrenoceptor antagonist that has a very short half-life. Regarding the mechanism by which the drug ameliorates the toxic effects of excessive thyroxine levels, the drug acts as:
a physiologic antagonist.
a competitive receptor antagonist.
a noncompetitive receptor antagonist.
a partial agonist.
23) The main pharmacologic effect of norepinephrine on alpha-1 receptors is
increased heart rate
bronchodilation
vasoconstriction
contraction of urinary bladder
24) The pharmacologic effect of IV metaraminol (an alpha-1 drug) is
vasodilation
vasoconstriction
cardiac stimulation
cardiac depression
25) Epinephrine stimulates
alpha-1 receptors
alpha-2 receptors
beta-1 receptors
beta-2 receptors
26) At therapeutic doses, albuterol stimulates
alpha-1 receptors
alpha-2 receptors
beta-1 receptors
beta-2 receptors
27) Metoprolol is classified as a(n)
alpha-blocker
nonselective beta-blocker
selective beta-1 blocker
adrenergic neuronal blocker
28) The mechanism of action of methyldopa is
increased release of NE from adrenergic nerve ending
alpha-1 receptor blocker
beta-1 receptor blocker
formation of a false transmitter in adrenergic nerve ending
29) The drug of choice to treat acute allergic reactions is
norepinephrine
phenylephrine
pseudoephedrine
epinephrine
30) Which of the following are actions of nonselective beta-adrenergic blocking drugs?
decreasing heart rate
decreasing force of myocardial contraction
vasoconstriction of skeletal muscle blood vessels
lowering of blood pressure
31) The actions of epinephrine (EPI) include which of the following?
bronchodilation
vasoconstriction
relaxation of uterus
increased heart rate
32) Parasympathetic receptors located on the membranes of the internal organs are classified as
alpha-1
nicotinic-neural (Nn)
nicotinic-muscle (Nm)
muscarinic
33) What is the pharmacologic effect produced by cholinergic drugs?
increased heart rate
increased gastrointestinal motility
decreased urination
pupillary dilation
34) Physostigmine (Eserine ) is classified as a(n)
direct-acting cholinergic drug
reversible acetylcholinesterase inhibitor
irreversible acetylcholinesterase inhibitor
anticholinergic drug
35) Symptoms of cholinergic drug overdosage include
slow pulse rate
increased urination
diarrhea
sweating
36) Anticholinergic effects include all of the following except
bronchodilation
increased heart rate
increased gastrointestinal activity
decreased respiratory secretions
37) The antidote for atropine poisoning is
scopolamine
bethanechol
neostigmine
physostigmine
38) Pick the correct pharmacological effect(s) of direct-acting cholinergic drugs.
respiratory paralysis
urinary retention
increased heart rate
bronchodilation
39) Which of the following would be a preferred treatment for overactive bladder?
neostigmine
tolterodine
physostigmine
bethanechol
40) Which of the following is correct about the nicotinic-muscle (Nm) receptor blocking drugs?
the mechanism of action is the same as represented by dantrolene
all of these drugs depolarize the muscle fiber before blockade occurs
calcium ions are released from the storage sites
there are two groups in this class: either depolarizing agents or nondepolarizing agents
41) Succinylcholine is associated with which of the following actions?
stimulation of the actin and myosin muscle fibrils directly
liver damage because the drug is metabolized only by the liver
peripheral neuromuscular receptor blockade after stimulating the Nm receptors
longer duration of action than vecuronium
42) Centrally acting skeletal muscle relaxants
include dantrolene and cisatracurium
inhibit or reduce activity within the spinal cord (intraneuronal), interrupting the central stimulus to muscle contraction
can only be given parenterally
cause systemic release of histamine, leading to hypotension
43) Skeletal muscle relaxants may alter control of respiration because
the diaphragm is a skeletal muscle
succinylcholine stimulates the respiratory centers in the brain
like dantrolene, all muscle relaxants inhibit the action of norepinephrine at the neuromuscular junction
relaxation of the muscles in the lower extremities pulls blood away from the lungs
44) Which drug or condition(s) decrease the effects of neuromuscular blockers?
neomycin
corticosteroids
general anesthetics like isoflurane
alcohol
45) Which of the following is a way in which skeletal muscles are relaxed?
blockage of conduction in the spinal cord
inhibiting nerve transmission
blockage of the Nm receptors
decreasing ACH in the neuromuscular junction
46) For which reason would you use muscle relaxants during surgical or diagnostic procedures?
reduce muscle tear
decrease body temperature
potentiate vasodilators
increase muscle tone
47) Which of the following is NOT a potential adverse effect of peripherally acting skeletal muscle relaxants?
difficulty swallowing (dysphagia)
skeletal muscle weakness
decreased respiration
bronchospasm
48) In the presynaptic terminal of neuronal cells, the immediate trigger to release a neurotransmitter from synaptic vesicles into the synaptic cleft is
a drop in cytosolic Ca2+.
a drop in cytosolic K+.
a rise in cytosolic Ca2+.
a drop in cytosolic Mg2+.
49) A 17-year-old girl with suspected intrinsic asthma but nearly normal results on spirometry and flow volume testing takes a methacholine provocative test. The mechanism of action of methacholine most closely resembles that of
hemicholinium.
acetylcholine.
edrophonium.
succinylcholine.
50) A 25-year old female presents with delirium, hyperthermia, and symptoms of central anticholinergic intoxication. She has attended a ìwitches' conventî and ingested some herbal extracts including fruits of the species ìAtropa belladonna.î As one component of her treatment, she receives a dose of physostigmine. Physostigmine is preferred over neostigmine because:
it is a nonpolar compound that penetrates the CNS more easily than neostigmine.
it has a shorter half-life than neostigmine, making it more useful for emergency treatment.
it has a longer half-life than neostigmine, better matching the half-life of atropine.
it is eliminated via the kidneys, and dosage is not critical with compromised liver function.
51) Which of the following is a correct statement?
opioid analgesics produce little or no respiration depression with long-term use of analgesic doses
opioid antagonists include endorphins
all drugs in the opioid analgesic group are controlled substances, Schedule III
in low doses, opioids produce nausea and vomiting
52) Oxycodone in therapeutic doses can stimulate mu receptors to cause
hyperventilation and deep breathing
bronchospasms
spasmogenic activity in the ureters and sphincter muscle
relaxation of the skeletal muscles controlling posture (spasmolytic)
53) Opioid analgesics are used in which of the following settings?
induction of Monitored Anesthesia Care and treatment of chronic severe pain
routine treatment of migraine
unmonitored treatment of chronic severe pain
analgesia for patients with paralytic ileus
54) Which of the following is a correct statement?
endorphin is an abbreviation from the terms meaning inside the organ
endogenous opioid receptors include mu, alpha-2 adrenergic, and delta receptors
agonism means the drug occupies the receptor and causes a response
opioid agonism means the drug occupies the receptor and stimulates the release of endorphins
55) Which of the following drugs has a recognized medical therapy and does not interact with opioid receptors?
heroin
codeine
methadone
acetaminophen
56) All opioid analgesics are associated with which of the following?
reversal of respiratory depression from barbiturates
use only for the relief of acute pain
cough suppression alone or in combination with other analgesics over-the-counter
tolerance develops to the analgesic response
57) Fentanyl is an opioid analgesic that
can be used for relief of cancer pain
has many formulations (lozenge, film) because it is used routinely in dental surgery
induces neuropathic pain
primarily works on peripheral nerve endings rather than higher centers
58) Sharp pain is transmitted through which type of nerve fibers?
unmyelinated
myelinated A-delta
CTZ
C fibers
59) Opioid drugs are derived from which of the following?
poppy
opium
chemical synthesis
alkaloids
60) What is the adverse effect of opioid analgesics?
constipation
polyuria
convulsions
mydriasis
61) During tolerance to opioid analgesics, the following is happening.
fewer receptors are available to produce a response
increased pain by the patient requires greater doses of medication
the body reacts to removal of the opioid analgesic
histamine release causes hypotension
62) What is the best reason for using a balanced anesthesia strategy? (LO 18.1)
producing complementary effects using a few drugs avoids unnecessary intense (deep) CNS depression with one anesthetic to achieve the same effect
the concentration of volatile anesthetic in the alveoli is balanced against the amount of anesthetic in the blood
less monitoring of anesthesia is required
fewer patients experience emergence delirium
63) Why is propofol a drug of choice for induction and maintenance of anesthesia?
it is a potent analgesic at all doses
it slowly brings the patient to the stage of surgical anesthesia
it is a complete anesthetic with a quick onset of action and recovery period uncomplicated by nausea and vomiting
it is administered by special vaporizer to avoid mask delivery
64) Which of the following is NOT correct?
ketamine causes chloride ions to flow out of the nerve cell by binding to GABA
propofol binds to the GABA A receptor and enhances hyperpolarization of the neuron
barbiturates and propofol act on the receptor and directly on the chloride channel
potent anesthetics enhance GABA A receptor function
65) Which of the following major routes remove etomidate and midazolam from the body?
hepatic metabolism and renal excretion
excretion through the lungs and sweating
accumulation in fat tissue and redistribution
increased salivation and bile production
66) Which type of anesthesia does not cause the patient to lose consciousness?
local anesthesia
Monitored Anesthesia Care
general anesthesia
balanced anesthesia
67) Choose the correct class of general anesthetics.
intravenous
dissociative anesthesia
oral
topical
68) Which drugs would be used as adjunct therapy to anesthesia?
analgesics
antiarrhythmics
antianxiety, short-acting CNS depressants like midazolam
anticholinergics
69) 1.Barbiturate and benzodiazepine hypnotics both
increase NREM stage 2 sleep
increase REM sleep
increase NREM stage 4 sleep
cause REM rebound
70) 2.Disadvantages to the use of barbiturate hypnotics include
risk of drug dependency
disruption of normal stages of sleep
suppression of REM sleep
all of these statements are true
71) The correct statement concerning the use of hypnotic drugs is
zolpidem binds to the GABAB receptor
benzodiazepines increase chloride channel opening
barbiturates block the GABA receptor
ramelteon is a melatonin antagonist
72) Flurazepam
forms active metabolites
may cause next-day residual effects
increases chloride ion influx
all of these statements are true
73) Eszopiclone
is classified as a benzodiazepine
has a half-life of 1-2 hours
increases total sleep time
is used as an antianxiety agent
74) 1.The main pharmacologic effect of the SSRIs is
increase levels of norepinephrine
increase levels of serotonin
decrease levels of norepinephrine
decrease levels of serotonin
75) The pharmacologic effects of TCAs include
antihistaminic
anticholinergic
sedation
all of the above
76) The serotonin syndrome is mainly associated with overdosage of
monoamine oxidase inhibitors
selective serotonin reuptake inhibitors
psychomotor stimulants
lithium
77) 4.The main pharmacologic effects of TCAs on neurotransmitter activity is
increase norepinephrine
increase acetylcholine
increase serotonin
increase norepinephrine and serotonin only
78) Venlafaxine (Effexor) is classified as
MAOI
TCA
SSRI
SNRI
79) Adverse effects of TCAs include
cardiac arrhythmias
convulsions
postural hypotension
all of these
80) Which of these represents the drug that is not correctly matched with its drug classification?
paroxetine—SSRI
amitriptyline—TCA
methylphenidate—MAOI this is targets dop transporter
duloxetine—SNRI
81) Which drug requires a dietary restriction for foods containing tyramine?
nortriptyline (TCA)
tranylcypromine (MAOI)
venlafaxine (SNRI)
fluoxetine (SSRI)
82) The site of action of diazepam (Valium) to relieve anxiety is the
spinal cord
limbic system
reticular formation
basal ganglia
83) The antianxiety effect of buspirone (BuSpar) is associated with
stimulation of DA receptors
stimulation of serotonin receptors
blockage of serotonin receptors
blockade of dopamine receptors
84) Flumazenil (Romazicon) is used to reverse the depressant effects of
clozapine
alprazolam (benzodiazepine)
haloperidol
chlorpromazine
85) What are the main areas at which benzodiazepines exert their effects?
cerebral cortex
reticular formation
spinal cord
all of these
86) Symptoms of Parkinsonism would be increased by
excess levels of acetylcholine
treatment with some antipsychotic drugs
decreased levels of dopamine
drug administration after a high-protein meal
87) The drug classified as a dopamine receptor agonist is
amantadine
benztropine
ropinirole
entacapone (COMT)
88) Which the drug increases the duration of action of DA and/or the amount of levodopa that enters the brain?
tolcapone
selegiline
rasagiline
all of these
89) In Parkinson's disease, slowed movements are defined as
rigidity
bradykinesia
tremor
dystonia
90) Sinemet is the trade name of a drug combination that contains levodopa and
carbidopa and entacapone
entacapone
carbidopa
selegiline
91) The COMT inhibitor that has been associated with causing liver toxicity is
ropinirole
entacapone
pramipexole
tolcapone
92) Which of the following is a symptom of Parkinson's disease?
muscular rigidity
increased sweating
salivary drooling
movement disturbances
93) Which of the following drugs would be used to decrease the actions of ACH?
amantadine
levodopa
bromocriptine
procyclidine
94) How does levodopa work?
converted to dopamine in the substantia nigra neurons
increases level of dopamine in the brain
peripheral metabolism to DA inhibited by carbidopa
all of these
95) Apomorphine is classified as
MAO-B inhibitor
dopamine receptor agonist
COMT inhibitor
anticholinergic drug
96) The muscarinic receptor that couples to G proteins responsible for adenylyl cyclase inhibition and plays a key role in cholinergic input to the heart is classified as
muscarinic-M1 receptor.
muscarinic-M2 receptor.
muscarinic-M3 receptor.
muscarinic-M4 receptor.
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