Pharmacology Practice Questions PDF

**Fill gaps** **Antibacterials** **1.** The clinical efficacy of cefepime is based on the percentage of time that the drug concentration remains.......... **Answer:** above the MIC **2.** Chloramphenicol can cause toxic effects in newborns due to poorly developed................\ **Answer:** ren...

**Fill gaps** **Antibacterials** **1.** The clinical efficacy of cefepime is based on the percentage of time that the drug concentration remains.......... **Answer:** above the MIC **2.** Chloramphenicol can cause toxic effects in newborns due to poorly developed................\ **Answer:** renal and hepatic elimination processes **3.** Penicillin G, tobramycin, and vancomycin are primarily eliminated by....... **Answer:** the kidneys **4.** Aspirin is a direct, irreversible inhibitor of.... **Answer:** cyclooxygenase **5.** Drug interactions have occurred with clarithromycin through its ability to inhibit... **Answer:** cytochrome P450. **6.** Azithromycin has a half-life of more than 70 h, which allows for... -... dosing. **Answer:** once-daily **7.** Fluoroquinolones are not recommended for use in pregnancy or for children younger than 10 years because they may damage... \.... **Answer:** growing cartilage **8.** Monitoring plasma drug levels is important when... antibiotics are used. **Answer:** aminoglycosides **Angina** **9.** Transdermal nitroglycerin can sustain blood levels for as long as \... **Answer:** 24 hours. **10.** Nitroglycerin can cause a reflex tachycardia because of its... properties. **Answer:** vasodilating **11.** Nitroglycerin (glyceryl trinitrate) is rapidly denitrated in the... and in......---first to the 2 dinitrates (glyceryl dinitrate), which retain a significant... effect; and more slowly to the mononitrates, which are much less active. **Answer:** liver, smooth muscle, vasodilating **12.** Nitrates release...... within smooth muscle cells, probably through the action of the mitochondrial enzyme aldehyde dehydrogenase-2 (ALDH2). **Answer:** nitric oxide **13.** Preload is filling pressure of the heart, dependent on...... and......; determines enddiastolic fiber length and tension **Answer:** venous tone; blood volume **14.** The most common toxic effects of nitrates are the responses evoked by vasodilation and include... (from the baroreceptor reflex),...... (a direct extension of the venodilator effect), and throbbing... from meningeal artery vasodilation **Answer:** tachycardia, orthostatic hypotension, headache **15.** The combination of nitrates (through increased production of cGMP) and a PDE5 inhibitor (through decreased breakdown of cGMP) causes a synergistic relaxation of......... with potentially dangerous hypotension and inadequate perfusion of critical organs. **Answer:** vascular smooth muscle **16.** Several types of calcium channel blockers are approved for use in angina:..., a dihydropyridine (and several other dihydropyridines), and the nondihydropyridines... and.... **Answer:** nifedipine; diltiazem, verapamil **17.** Secretory cells use L-type channels, but these channels are...... to the calcium blockers than are cardiac and smooth muscle L-type channels. **Answer:** less sensitive. **18.** Calcium blockers are effective as... therapy in both effort and vasospastic angina. **Answer:** prophylactic **Hypertenzion** **19.** ACE inhibitors and ARBs are contraindicated in pregnant women , because they have been shown to be.... **Answer:** teratogenic **20.** Postural (orthostatic) hypotension is usually due to venous pooling, which normally can be by... receptor inhibition. **Answer:** α-adrenoreceptor **21.** Chronic, intolerable cough is an important adverse effect of \....... **Answer:** ACE inhibitors **22.** Beta blockers do not cause... hypotension. **Answer:** orthostatic **23**. Diltiazem, as well as nifedipine and verapamil, act as vasodilators by reducing calcium influx via \... -....... **Answer:** L-type channels **24.** African American patients with hypertension respond poorly to...... and \.... **Answer:** valsartan, atenolol and enalapril. **25.** Sympathoplegic drugs interfere with of...... of cardiovascular function. The result is a reduction of one or more of the following: venous tone,..., contractile force of the heart,..., and total peripheral resistance **Answer:** sympathetic control; heart rate, cardiac output **26.** Because it can cause hirsutism, minoxidil is also available as a topical agent for the treatment of.... **Answer:** baldness **27.** The strategies for treating idiopathic hypertension are based on the determinants of arterial pressure. These strategies include reductions of...... (eg.diuretics), sympathetic effects (eg. beta and alfa blockers), vascular smooth muscle tension (eg. calcium channel blockers) and...... (...... ). **Answer:** blood volume, angiotensin effects (eg. Angiotensin antagonists) **28.** The nonselective α blockers (phentolamine, phenoxybenzamine) are of no value in chronic hypertension because of....... **Answer:** excessive tachycardia **Coagulation** **29.** Like other anticoagulants, the direct thrombin inhibitors can cause.... **Answer:** bleeding **30**. The most common serious adverse effect of the fibrinolytics is... , especially in the cerebral circulation. **Answer:** bleeding **31.** Antiplatelat drugs... and...have similar mechanisms of action and therapeutic efficacy. **Answer:** Aspirin clopidogrel **32.** Low-molecular-weight heparin (LMWH) does not...... and shows no teratogenic effects. **Answer:** cross the placenta **33.** Aspirin exerts its antiplatelet effect through irreversible inhibition of... and \.... **Answer: COX-1 COX-2** **34.** Oral Xa inhibitors, including the small molecules rivaroxaban, apixaban, and edoxaban, have a...... of action and... half-lives than warfarin. **Answer:** rapid onset, shorter **35.** In the presence of heparin, ATIII proteolyzes... and...... approximately 1000-fold faster than in its absence. **Answer:** thrombin, factor Xa **36.** Direct oral factor Xa inhibitors undergo cytochrome P450-... and cytochrome P450-... elimination. **Answer:** dependent, independent **37....** thrombin Inhibitor argatroban is a small molecule with a... half-life.; **Answer:** Direct, short **Antiarrhitmics** **39.** Quinidine reduces the clearance of... and may increase the serum concentration of the... significantly. **Answer:** digoxin, glycoside **40.** *Propranolol* and *esmolol* are prototypic antiarrhythmic β blockers. Their mechanism in arrhythmias is primarily......-... blockade and reduction in..., which results in a modest reduction of both... and... currents and the suppression of abnormal pacemakers. **Answer:** cardiac β-adrenoceptor, cAMP, sodium, calcium **41.** An anticonvulsant drug phenytoin is classified with the group 1B antiarrhythmic agents because it can be used to reverse...-....... It lacks significant effects on the normal ECG. **Answer:** digitalis-induced arrhythmias. **42.** Normal pacemaking and conduction require normal...... (dependent on sodium, calcium, and potassium channel activity) under appropriate... control. **Answer:** action potentials, autonomic. **43.** Group 1A antiarrhythmic drugs affect both... and... arrhythmias. **Answer:** atrial, ventricular. **44.** *Torsades de pointes* is a ventricular arrhythmia of great pharmacologic importance because it is often induced by *antiarrhythmic* and *other drugs* that change the shape of the action potential and.......... **Answer:** prolong the QT interval **45.** Mexiletine is an... active 1B agent. It selectively affect ischemic or depolarized... and... tissue and have little effect on atrial tissue. **Answer:** orally , Purkinje, ventricular **46.** Propranolol, metoprolol, and timolol are commonly used as...... in patients who have had a myocardial infarction. **Answer:** prophylactic drugs. **47.** Disopyramide has marked... effects and may precipitate....... **Answer:** antimuscarinic, heart failure. **48.** Amiodarone is usually classified as a group 3 drug because it blocks the... channels and markedly prolongs...... as well as blocking other channels and... adrenoreceptors. **Answer:** K**^+^**, AP duration, β **Diuretics** **49.** The major renal effect of acetazolamide is... diuresis (ie, sodium bicarbonate is excreted); body... is depleted, and metabolic acidosis results. **Answer:** bicarbonate, bicarbonate **50.** The loop diuretics are relatively... -... and diuresis usually occurs over a... hour period following a dose. **Answer:** short-acting, four (4). **51.... and... are topical analogs of acetazolamide used for chronic treatment of primary open-angle glaucoma or ocular hypertension.** **Answer:** **Dorzolamide, brinzolamide** **52. Reabsorption of sodium, potassium, and chloride in the th**ick ascending limb of the... of... **are all accomplished by a Na+ /K+ /2Cl-- carrier.** **It is also a major site of... and... reabsorption.** **Answer:** loop of Henle **calcium, magnesium.** **53.** Carbonic anhydrase inhibitors reduce secretion of... into aqueous humor by the ciliary epithelium in the eye and into the cerebrospinal fluid by the choroid plexus. In the eye, a useful reduction in...... can be achieved. In the central nervous system (CNS), acidosis of the cerebrospinal fluid results in... , which can protect against high-altitude sickness. **Answer:** bicarbonate, intraocular pressure, hyperventilation **54.** Patients with hepatic impairment often excrete large amounts of ammonia in the urine in the form of ammonium ion. If they are given acetazolamide,... of the urine prevents conversion of ammonia to ammonium ion. As a result, they may develop...... because of increased ammonia reabsorption and hyperammonemia. **Answer:** alkalinization, hepatic encephalopathy. **55.** Loop diuretics reduce the diluting ability of the nephron because the loop of Henle is the site of significant... of.... **Answer:** dilution of urine **56.** Aldosteronism is a feature of heart failure, and... and... have been shown to have significant long-term benefits in this condition **Answer:** spironolactone, eplerenone. **57.** Inhibition of renal prostaglandin synthesis reduces the efficacy of the.... **Answer:** thiazides. **58.** The major location for the action of osmotic diuretics is the... convoluted tubule. **Answer:** proximal **59.** Because thiazides act in a diluting segment of the nephron, they may reduce the......... and are also used in the treatment of nephrogenic....... **Answer:** excretion of water, diabetes insipidus.