Pharmacology

Multiple Choice Questions 42 Pages

University of Mumbai

Bachelor of Dental Surgery

OMB

Contributed by

Omar Mitesh Bobal

Pharmacology – Part 1 Quiz
Version: 16Oct2008 Page 1 of 42
1 – Introduction to Pharmacology: Basic Principles
1) Which of the following is NOT part of the etymology of the word pharmacology?
a) Medicine
b) Drug
c) Herb
d) Poison
e) Study
2.1) Which of the following describes an agonist?
a) Any substance that brings about a change in biologic function through its
chemical action
b) A specific regulatory molecule in the biologic system where a drug interacts
c) A drug that binds to a receptor and stimulates cellular activity
d) A drug that binds to a receptor and inhibits or opposes cellular activity
e) A drug directed at parasites infecting the patient
2.2) Xenobiotics are considered:
a) Endogenous
b) Exogenous
c) Inorganic poisons
d) Toxins
e) Ligands
2.3) Which of the following would be a toxin (poison of biological origin)?
a) Pb
b) As
c) Hg
d) Atropine
2.4) The vast majority of drugs have molecular weights (MW) between 100 and 1,000.
Large drugs, such as alteplase (t-PA), must be administered:
a) Into the compartment where they have their effect
b) Orally so they do not absorb too quickly
c) Rectally to prevent irritation to the stomach lining and vessels
d) Via the intraosseous (IO) route
e) Titrated with buffering agents to prevents cell lysis
2.5) Which of the following occurs with drugs that are extremely small, such as Lithium?
a) Receptor mediated endocytosis
b) Minor drug movement within the body
c) Vasodilation when injected intravenously (IV)
d) Specific receptor binding
e) Nonspecific binding
2.6) Drugs fit receptors using the lock and key model. Covalent bonds are the ____ and
the ____ specific.
a) Strongest; Most
b) Strongest; Least
c) Weakest; Most
d) Weakest; Least
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2.7) Warfarin (Coumadin) is given as a racemic mixture with the S enantiomer being four
times more active than the R enantiomer. If the mixture of Warfarin given is 50% S and
50% R, what is the potency compared with a 100% R enantiomer solution?
a) 4 * R + 1 * S = 1
b) 4 * R + 1 * S = 1.5
c) 4 * R + 1 * S = 2
d) 4 * R + 1 * S = 2.5
e) 4 * R + 1 * S = 4
2.8) What determines the degree of movement of a drug between body compartments?
a) Partition constant
b) Degree of ionization
c) pH
d) Size
e) All of the above
3.1) Which of the following is NOT a protein target for drug binding?
a) Side of action (transport)
b) Enzymes
c) Carrier molecules
d) Receptors
e) Ion channels
3.2) Which of the following is an example of a drug acting directly through receptors?
a) Protamine binds stoichiometrically to heparin anticoagulants
b) Adrenergic beta blockers for thyroid hormone-induced tachycardia
c) Epinephrine for increasing heart rate and blood pressure
d) Cancer chemotherapeutic agents
e) Mannitol for subarachnoid hemmorhage
4.1) What is added with drug subclassification, such as an antitubercular drug versus an
antibacterial drug?
a) Cost
b) Size
c) Ionization
d) Precision
e) Speed
4.2) What type of drug is propranolol (Inderal)?
a) Anticonvulsive
b) Antihypertensive
c) Antinauseant
d) Antihistamine
e) Antipyretic
5.1) Which of the following is considered the brand name?
a) Propranolol
b) Inderal
c) Adrenergic ß-blocker
d) “off label” use
e) Blocks ß-receptors in heart myocardium
5.2) Which of the following is considered the class?
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a) Propranolol
b) Inderal
c) Adrenergic ß-blocker
d) “off label” use
e) Blocks ß-receptors in heart myocardium
5.3) Which of the following cases would be contraindicated for propranolol (Inderal)?
a) Hypertension
b) Essential tremor
c) Angina
d) Tachycardia
e) Asthma
5.4) Which of the following adverse effects (side-effects) is NOT commonly seen with
cholinergic antagonists?
a) Blurred vision
b) Confusion
c) Miosis
d) Constipation
e) Urinary retention
6.1) The drug chloramphenicol (Chloromycetin) is risky for which of the following?
a) Neonates
b) Geriatric patients
c) Adult males
d) Obese patients
e) Congestive heart failure patients
6.2) How does the glomerular filtration rate (GFR) change after the age of 40?
a) Increase 1% each year
b) Increases 2% each year
c) Decreases 1% each year
d) Decreases 2% each year
e) Does not depend on age
6.3) A decrease in renal and liver function, as seen in the elderly, would prolong drug
half-life, ____ plasma protein binding, and ____ volume of distribution.
a) Increase; Increase
b) Decrease; Decrease
c) Increase; Decrease
d) Decrease; Increase
6.4) When prescribing isoniazid (Rimifon), pharmacogenetics must be considered as
>90% of Asians and certain other groups are ____ acetylators, and thus have a ____
blood concentration of a given dose and a decreased risk of toxicity.
a) Slow; Increased
b) Slow; Decreased
c) Fast; Increased
d) Fast; Decrease
6.5) Which of the following are the two modifying factors that contribute to why women
have higher blood peak concentrations of alcohol than men when consuming equivalent
amounts?
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a) Lower blood volume & increased hormones
b) Lower fat content & more gastric alcohol dehydrogenase (ADH)
c) Higher fat content & more gastric alcohol dehydrogenase (ADH)
d) Lower fat content & less gastric alcohol dehydrogenase (ADH)
e) Higher fat content & less gastric alcohol dehydrogenase (ADH)

2 – Pharmacokinetic Principles: Drug Movement
1) Pharmacokinetics is the effect of the ____ and pharmacodynamics is the effect of the
____.
a) Drug on a drug; Body on the drug
b) Body on the drug; Drug on a drug
c) Drug on the body; Body on the drug
d) Body on the drug; Drug on the body
e) Drug on a drug; Drug on a drug
2.1) Which of the following is NOT an action of the body on a drug?
a) Absorption
b) Distribution
c) Metabolism
d) Excretion
e) Side effects
3) If a drug is 80% bound to blood elements or plasma proteins, what part is considered
the free form?
a) 20%
b) 40%
c) 50%
d) 80%
e) 100%
4.1) Which of the following describes minimal effective concentration (MEC)?
a) The minimal drug plasma concentration that can be detected
b) The minimal drug plasma concentration to enter tissues
c) The minimal drug plasma concentration to interact with receptors
d) The minimal drug plasma concentration to produce effect
e) The minimal drug plasma concentration to reach therapeutic levels
4.2) If a patient misses three doses of their daily drug, which of the following (in general)
is the best solution?
a) Take a 4x dose at the next dose time
b) Wait 3 more days (week total) then return to normal regimen
c) Do nothing and continue normal regimen
d) Setup an appointment to have the patient evaluated
e) Prescribe a higher dosage pill so missed doses will have less effect
4.3) Blood levels of a drug correlate to the effectiveness of that drug, such as with
pentazocine (Talwin) or phenobarbitol (Luminal).
a) True
b) False
5.1) Which of the following drug permeation mechanisms involves polar substances too
large to enter cells by other means, such as iron or vitamin B12?
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a) Aqueous diffusion
b) Lipid diffusion
c) Carrier molecules
d) Endocytosis and exocytosis
5.2) Which of the following drug permeation mechanisms occurs across epithelial tight
junctions and is driven by a concentration gradient?
a) Aqueous diffusion
b) Lipid diffusion
c) Carrier molecules
d) Endocytosis and exocytosis
5.3) Which of the following drug permeation mechanisms uses the Henderson-
Hasselbalch equation for the ratio of solubility for the weak acid or weak base?
a) Aqueous diffusion
b) Lipid diffusion
c) Carrier molecules
d) Endocytosis and exocytosis
5.4) Which of the following drug permeation mechanisms is used for peptides, amino
acids, glucose, and other large or insoluble molecules?
a) Aqueous diffusion
b) Lipid diffusion
c) Carrier molecules
d) Endocytosis and exocytosis
5.5) Which of the following drug permeation mechanisms uses caveolae?
a) Aqueous diffusion
b) Lipid diffusion
c) Carrier molecules
d) Endocytosis and exocytosis
6.1) Using the Fick Law of Diffusion, how will flux change if membrane thickness is
doubled?
a) It will double
b) It will quadruple
c) It will halve
d) It will quarter
e) It will not change
6.2) Using the Fick Law of Diffusion, how will flux change if the permeability
coefficient is quadrupled?
a) It will double
b) It will quadruple
c) It will halve
d) It will quarter
e) It will not change
7.1) Which of the following is the amount of a drug absorbed per the amount
administered?
a) Bioavailability
b) Bioequivalence
c) Drug absorption
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d) Bioinequivalence
e) Dosage
7.2) Which of the following is NOT needed for drug bioequivalence?
a) Same active ingredients
b) Same strength or concentration
c) Same dosage form
d) Same route of administration
e) Same side effects
7.3) For intravenous (IV) dosages, what is the bioavailability assumed to be?
a) 0%
b) 25%
c) 50%
d) 75%
e) 100%
7.4) Although morphine (Avinza, Oramorph SR, MS Contin) is well-absorbed when
administered orally (PO), how much of the drug is metabolized on its first pass through
the liver?
a) 90%
b) 70%
c) 50%
d) 30%
e) 10%
7.5) For a generic drug to be bioequivalent to an innovator drug (per FDA), it must be
measured in ____ of subjects to fall within ____ of the mean of the test population
bioavailability.
a) 50; 50
b) 80; 20
c) 20; 80
d) 95; 5
e) 5; 95
7.6) Using the FDA bioequivalence rule, how much variation could a generic drug
potentially have from an innovator and still be considered equivalent?
a) 100%
b) 20%
c) 40%
d) 60%
e) 80%
8.1) Which of the following is NOT a pharmacokinetic process?
a) Alteration of the drug by liver enzymes
b) Drug metabolites are removed in the urine
c) Movement of drug from the gut into general circulation
d) The drug causes dilation of coronary vessels
e) The drug is readily deposited in fat tissue
8.2) Which of the following can produce a therapeutic response? A drug that is:
a) Bound to plasma albumin
b) Concentrated in the bile
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c) Concentrated in the urine
d) Not absorbed from the GI tract
e) Unbound to plasma proteins
8.3) Which of the following most correctly describes steroid hormones with respect to
their ability to gain access to intracellular binding sites?
a) They cross the cell membrane via aqueous pores
b) They have a high permeability coefficient
c) They are passively transported via membrane carriers
d) They require vesicular transport
e) Their transport requires the hydrolysis of ATP

3 – Pharmacokinetic Principles: pH and Drug Movement
1) Most drugs are either ____ acids or ____ bases.
a) Strong; Strong
b) Strong; Weak
c) Weak; Weak
d) Weak; Strong
2.1) Aspirin readily donates a proton in aqueous solutions and pyrimethamine readily
accepts a proton in aqueous solution. Thus, aspirin is a(b) ____ and pyrimethamine is
a(n) ____.
a) Acid; Base
b) Base; Acid
c) Acid; Acid
d) Base; Base
2.2) Given the equilibrium HA <=> A- + H+ (acid) and BH+ <=> B + H+ (base), in an
acid environment (low pH) the acid reaction will move to the ____ and the base reaction
will move to the ____.
a) Right; Left
b) Right; Right
c) Left; Right
d) Left; Left
3.1) What form of a drug is more lipid-soluble, and thus would remain trapped within a
compartment where the pH does not favor the lipid-soluble form?
a) Strong acid (A-)
b) Weak acid (A-)
c) Neutral (AH and B)
d) Weak base (BH+)
e) Strong base (BH+)
3.2) The lipid-soluble form of a base is ____ and the lipid-soluble form of an acid is
____.
a) Protonated; Protonated
b) Protonated; Unprotonated
c) Unprotonated; Unprotonated
d) Unprotonated; Protonated
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4.1) If the pKa of Aspirin (acetylsalicylic acid) is 3.5 and the pH of the stomach is 2.5,
how much Aspirin is in the protonated species in the stomach and is this the amount
available for absorption?
a) ≈ 91%; Yes
b) ≈ 91%; No
c) ≈ 9%; Yes
d) ≈ 9%; No
4.2) What percentage of Aspirin would be ionized in the blood compartment (pH = 7.4)
assuming pH is 7.5 and Aspirin pKa is 3.5?
a) (10,000 - 1) / 1 = 99.99%
b) (100 - 1) / 1 = 99%
c) None
d) 1 / (100 - 1) = 0.9%
e) 1 / (10,000 - 1) = 0.009%
4.3) If the pH - pKa = -1, what percentage of weak base is nonionized?
a) 99
b) 90
c) 50
d) 10
e) 1
4.4) If the pH - pka = 2, what percentage of weak acid is nonionized?
a) 99
b) 90
c) 50
d) 10
e) 1
4.5) If pH > pKa, the drug is ____ and if pH < pKa, the drug is ____. An unprotonated
acid is ____ and a protonated base is ____.
a) Protonated; Unprotonated; Charged; Charged
b) Protonated; Unprotonated; Neutral; Neutral
c) Unprotonated; Protonated; Charged; Charged
d) Unprotonated; Protonated; Neutral; Charged
e) Unprotonated; Protonated; Charged; Neutral
5.1) Weak acids are excreted faster in ____ urine and weak bases are excreted faster in
____ urine.
a) Acidic; Alkaline
b) Alkaline; Acidic
c) Acidic; Neutral
d) Neutral; Alkaline
e) Alkaline; Neutral
5.2) A patient presents with an overdose of acidic Aspirin. The drug ____ can be given to
____ the pH of the urine and trap the Aspirin, preventing further metabolism.
a) NaHCO3; Increase
b) NaHCO3; Decrease
c) NH4Cl; Increase
d) NH4Cl; Decrease
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5.3) A patient presents with an overdose of alkaline Codeine. The drug ____ can be given
to ____ the pH of the urine and trap the Codeine, preventing further metabolism.
a) NaHCO3; Increase
b) NaHCO3; Decrease
c) NH4Cl; Increase
d) NH4Cl; Decrease
6.1) The principle of drug manipulation for excretion of a drug out of the renal tubule can
be accomplished by:
a) Acidifying the urinary pH
b) Adjusting the urinary pH to protonate weakly acidic drugs
c) Adjusting the urinary pH to unprotonate weakly basic drugs
d) Adjusting the urinary pH to ionize the drug
e) By neutralizing the urinary pH
6.2) Aspirin is a weak organic acid with a pKa of 3.5. What percentage of a given dose
will be in the lipid-soluble form at a stomach pH of 1.5?
a) About 1%
b) About 10%
c) About 50%
d) About 90%
e) About 99%
6.3) For which of the following drugs is excretion most significantly accelerated by
acidification of the urine?
a) Weak acid with pKa of 5.5
b) Weak acid with pKa of 3.5
c) Weak base with pKa of 7.5
d) Weak base with pKa of 7.1
6.4) A patient diagnosed with type 2 diabetes is administered an oral dose of 0.1 mg
chloropropamide, an insulin secretagogue and weak acid with a pKa of 5.0. What is the
amount of this drug that could be absorbed from the stomach at pH 2.0?
a) 99.9 µg
b) 90 µg
c) 50 µg
d) 0.05 mg
e) 0.01 mg

4 – Pharmacokinetic Principles: Absorption
1) Bioavailability (F) is the fraction or percentage of administered drug that reaches the
systemic circulation via a given route as compared to what route?
a) Oral
b) IV (intravenous)
c) IO (intraosseous)
d) CSF (cerebrospinal fluid)
e) Whatever route attains the target drug concentration in plasma (CT)
2) What organ is responsible for metabolism in the “first pass effect”?
a) Brain
b) Heart
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c) Kidney
d) Liver
e) Spleen
3.1) A patient is in the hospital and is stable on digoxin 0.175 mg IV qd (daily). How
much digoxin in mg. would you need to give your patient orally, given that the
bioavailability for oral digoxin tablets is 0.7?
a) (0.175 * 0.7) / (1.0) = 0.1225 mg
b) (0.175 * 1) / (0.7) = 0.25 mg
c) (0.175 + 0.7) / (1.0) = 0.875 mg
d) (0.175 + 1) / (0.7) = 1.67 mg
e) No change is necessary
3.2) Given a graph of plasma drug concentration versus time, what part of the graph
would be used to calculate bioavailability for a PO (oral) drug administration?
a) Maximum concentration
b) Steady concentration
c) Derivative of the curve (slope)
d) Integral of the curve (area underneath)
e) The curve is not used to calculate bioavailability
4.1) Which of the following routes of administration has a bioavailability of about 80-
100%, is usually very slow absorbing, and has prolonged duration of action?
a) IV (intravenous)
b) IM (intramuscular)
c) SQ (subcutaneous)
d) Rectal
e) Transdermal
4.2) Which of the following routers of administration is the most convenient, although
may have a bioavailability anywhere from 5-100%?
a) PO (oral)
b) IV (intravenous)
c) IM (intramuscular)
d) SQ (subcutaneous)
e) Transdermal
4.3) Which of the following enteral administration routes has the largest first-pass effect?
a) SL (sublingual)
b) Buccal
c) Rectal
d) Oral
4.4) Epithelial cells are connected by ____, which are tough to cross and materials often
must pass through the cells. Endothelial cells of blood vessels are connected by ____,
which proteins cannot cross but smaller drugs (MW 200-500) can.
a) Macular gap junctions; Tight junctions
b) Tight junctions; Macular gap junctions
c) Adherens junctions; Tight junctions
d) Tight junctions; Adherens junctions
e) Macular gap junctions; Adherens junctions
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Pharmacology

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