Pharmacokinetics

1. Pharmacokinetics is:

a) The study of biological and therapeutic effects of drugs

b) The study of absorption, distribution, metabolism and excretion of drugs
c) The study of mechanisms of drug action
d) The study of methods of new drug development

2. What does “pharmacokinetics” include?

a) Complications of drug therapy

b) Drug biotransformation in the organism
c) Influence of drugs on metabolism processes
d) Influence of drugs on genes

3. What does “pharmacokinetics” include?

a) Pharmacological effects of drugs

b) Unwanted effects of drugs
c) Chemical structure of a medicinal agent
d) Distribution of drugs in the organism

4. What does “pharmacokinetics” include?

a) Localization of drug action

b) Mechanisms of drug action
c) Excretion of substances
d) Interaction of substances

5. The main mechanism of most drugs absorption in GI tract is:

a) Active transport (carrier-mediated diffusion)

b) Filtration (aqueous diffusion)
c) Endocytosis and exocytosis
d) Passive diffusion (lipid diffusion)

6. A hydrophilic medicinal agent has the following property:

a) Low ability to penetrate through the cell membrane lipids

b) Penetrate through membranes by means of endocytosis
c) Easy permeation through the blood-brain barrier
d) High reabsorption in renal tubules

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7. What is implied by «active transport»?

a) Transport of drugs trough a membrane by means of diffusion

b) Transport without energy consumption
c) Engulf of drug by a cell membrane with a new vesicle formation
d) Transport against concentration gradient

8. What does the term “bioavailability” mean?

a) Plasma protein binding degree of substance

b) Permeability through the brain-blood barrier
c) Fraction of an uncharged drug reaching the systemic circulation following any route
administration
d) Amount of a substance in urine relative to the initial doze

9. The reasons determing bioavailability are:

a) Rheological parameters of blood

b) Amount of a substance obtained orally and quantity of intakes
c) Extent of absorption and hepatic first-pass effect
d) Glomerular filtration rate

10. Pick out the appropriate alimentary route of administration when passage of drugs through
liver is minimized:

a) Oral
b) Transdermal
c) Rectal
d) Intraduodenal

11. Which route of drug administration is most likely to lead to the first-pass effect?

a) Sublingual
b) Oral
c) Intravenous
d) Intramuscular

12. What is characteristic of the oral route?

a) Fast onset of effect

b) Absorption depends on GI tract secretion and motor function
c) A drug reaches the blood passing the liver
d) The sterilization of medicinal forms is obligatory

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13. Tick the feature of the sublingual route:

a) Pretty fast absorption

b) A drug is exposed to gastric secretion
c) A drug is exposed more prominent liver metabolism
d) A drug can be administrated in a variety of doses

14. Pick out the parenteral route of medicinal agent administration:

a) Rectal
b) Oral
c) Sublingual
d) Inhalation

15. Parenteral administration:

a) Cannot be used with unconsciousness patients

b) Generally results in a less accurate dosage than oral administration
c) Usually produces a more rapid response than oral administration
d) Is too slow for emergency use

16. What is characteristic of the intramuscular route of drug administration?

a) Only water solutions can be injected

b) Oily solutions can be injected
c) Opportunity of hypertonic solution injections
d) The action develops slower, than at oral administration

17. Intravenous injections are more suitable for oily solutions:

a) True
b) False

18. Correct statements listing characteristics of a particular route of drug administration include
all of the following EXCEPT:

a) Intravenous administration provides a rapid response

b) Intramuscular administration requires a sterile technique
c) Inhalation provides slow access to the general circulation
d) Subcutaneous administration may cause local irritation

19. Most of drugs are distributed homogeneously:

a) True
b) False

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20. Biological barriers include all EXCEPT:

a) Renal tubules
b) Cell membranes
c) Capillary walls
d) Placenta

21. What is the reason of complicated penetration of some drugs through brain-blood barrier?

a) High lipid solubility of a drug

b) Meningitis
c) Absence of pores in the brain capillary endothelium
d) High endocytosis degree in a brain capillary

22. The volume of distribution (Vd) relates:

a) Single to a daily dose of an administrated drug

b) An administrated dose to a body weight
c) An uncharged drug reaching the systemic circulation
d) The amount of a drug in the body to the concentration of a drug in plasma

23. For the calculation of the volume of distribution (Vd) one must take into account:

a) Concentration of a substance in plasma

b) Concentration of substance in urine
c) Therapeutical width of drug action
d) A daily dose of drug

24. A small amount of the volume of distribution is common for lipophylic substances easy
penetrating through barriers and widely distributing in plasma, interstitial and cell fluids:

a) True
b) False

25. The term “biotransformation” includes the following:

a) Accumulation of substances in a fat tissue

b) Binding of substances with plasma proteins
c) Accumulation of substances in a tissue
d) Process of physicochemical and biochemical alteration of a drug in the body

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26. Biotransformation of the drugs is to render them:

a) Less ionized
b) More pharmacologically active
c) More lipid soluble
d) Less lipid soluble

27. Tick the drug type for which microsomal oxidation is the most prominent:

a) Lipid soluble
b) Water soluble
c) Low molecular weight
d) High molecular weight

28. Pick out the right statement:

a) Microsomal oxidation always results in inactivation of a compound

b) Microsomal oxidation results in a decrease of compound toxicity
c) Microsomal oxidation results in an increase of ionization and water solubility of a drug
d) Microsomal oxidation results in an increase of lipid solubility of a drug thus its excretion
from the organism is facilitated

29. Stimulation of liver microsomal enzymes can:

a) Require the dose increase of some drugs

b) Require the dose decrease of some drugs
c) Prolong the duration of the action of a drug
d) Intensify the unwanted reaction of a drug

30. Metabolic transformation (phase 1) is:

a) Acetylation and methylation of substances

b) Transformation of substances due to oxidation, reduction or hydrolysis
c) Glucuronide formation
d) Binding to plasma proteins

31. Biotransformation of a medicinal substance results in:

a) Faster urinary excretion

b) Slower urinary excretion
c) Easier distribution in organism
d) Higher binding to membranes

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32. Conjugation is:

a) Process of drug reduction by special enzymes

b) Process of drug oxidation by special oxidases
c) Coupling of a drug with an endogenous substrate
d) Solubilization in lipids

33. Which of the following processes proceeds in the second phase of biotransformation?

a) Acetylation
b) Reduction
c) Oxidation
d) Hydrolysis

34. Conjugation of a drug includes the following EXCEPT:

a) Glucoronidation
b) Sulfate formation
c) Hydrolysis
d) Methylation

35. Metabolic transformation and conjugation usually results in an increase of a substance

biological activity:

a) True
b) False

36. In case of liver disorders accompanied by a decline in microsomal enzyme activity the
duration of action of some drugs is:

a) Decreased
b) Enlarged
c) Remained unchanged
d) Changed insignificantly

37. Half life (t ½) is the time required to:

a) Change the amount of a drug in plasma by half during elimination

b) Metabolize a half of an introduced drug into the active metabolite
c) Absorb a half of an introduced drug
d) Bind a half of an introduced drug to plasma proteins

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38. Half life (t ½) doesn’t depend on:

a) Biotransformation
b) Time of drug absorption
c) Concentration of a drug in plasma
d) Rate of drug elimination

39. Elimination is expressed as follows:

a) Rate of renal tubular reabsorption

b) Clearance speed of some volume of blood from substance
c) Time required to decrease the amount of drug in plasma by one-half
d) Clearance of an organism from a xenobiotic

40. Elimination rate constant (Kelim) is defined by the following parameter:

a) Rate of absorption
b) Maximal concentration of a substance in plasma
c) Highest single dose
d) Half life (t ½)

41. The most rapid eliminated drugs are those with high glomerular filtration rate and actively
secreted but aren’t passively reabsorbed:

a) True
b) False

42. Systemic clearance (CLs) is related with:

a) Only the concentration of substances in plasma

b) Only the elimination rate constant
c) Volume of distribution, half life and elimination rate constant
d) Bioavailability and half life

43. What kind of substances can’t permeate membranes by passive diffusion?

a) Lipid-soluble
b) Non-ionized substances
c) Hydrophobic substances
d) Hydrophilic substances

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 Pharmacodynamics

1. Pharmacodynamics involves the study of following EXCEPT:

a) Biological and therapeutic effects of drugs

b) Absorption and distribution of drugs
c) Mechanisms of drug action
d) Drug interactions

2. Pharmacodynamics involves the study of following?

a) Mechanisms of drug action

b) Biotransformation of drugs in the organism
c) Distribution of drugs in the organism
d) Excretion of drug from the organism

3. Pharmacodynamics involves the following?

a) Information about main mechanisms of drug absorption

b) Information about unwanted effects
c) Information about biological barriers
d) Information about excretion of a drug from the organism

4. Pick out the answer which is the most appropriate to the term “receptor”

a) All types of ion channels modulated by a drug

b) Enzymes of oxidizing-reducing reactions activated by a drug
c) Active macromolecular components of a cell or an organism which a drug molecule has
to combine with in order to elicit its specific effect
d) Carriers activated by a drug

5. What does “affinity” mean?

a) A measure of how tightly a drug binds to plasma proteins

b) A measure of how tightly a drug binds to a receptor
c) A measure of inhibiting potency of a drug
d) A measure of bioavailability of a drug

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6. Target proteins which a drug molecule binds are:

a) Only receptors
b) Only ion channels
c) Only carriers
d) All of the above

7. An agonist is a substance that:

a) Interacts with the receptor without producing any effect

b) Interacts with the receptor and initiates changes in cell function, producing various
effects
c) Increases concentration of another substance to produce effect
d) Interacts with plasma proteins and doesn’t produce any effect

8. If an agonist can produce maximal effects and has high efficacy it’s called:

a) Partial agonist
b) Antagonist
c) Agonist-antagonist
d) Full agonist

9. If an agonist can produce submaximal effects and has moderate efficacy it’s called:

a) Partial agonist
b) Antagonist
c) Agonist-antagonist
d) Full agonist

10. An antagonist is a substance that:

a) Binds to the receptors and initiates changes in cell function, producing maximal effect
b) Binds to the receptors and initiates changes in cell function, producing submaximal effect
c) Interacts with plasma proteins and doesn’t produce any effect
d) Binds to the receptors without directly altering their functions

11. A competitive antagonist is a substance that:

a) Interacts with receptors and produces submaximal effect

b) Binds to the same receptor site and progressively inhibits the agonist response
c) Binds to the nonspecific sites of tissue
d) Binds to one receptor subtype as an agonist and to another as an antagonist

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12. The substance binding to one receptor subtype as an agonist and to another as an antagonist
is called :

a) Competitive antagonist
b) Irreversible antagonist
c) Agonist-antagonist
d) Partial agonist

13. Irreversible interaction of an antagonist with a receptor is due to:

a) Ionic bonds
b) Hydrogen bonds
c) Covalent bonds
d) All of the above

14. Mechanisms of transmembrane signaling are the following EXCEPT:

a) Transmembrane receptors that bind and stimulate a protein tyrosine kinase

b) Gene replacement by the introduction of a therapeutic gene to correct a genetic effect
c) Ligand-gated ion channels that can be induced to open or close by binding a ligand
d) Transmembrane receptor protein that stimulates a GTP-binding signal transducer protein
(Gprotein) which in turn generates an intracellular second messenger

15. Tick the second messenger of G-protein-coupled (metabotropic) receptor:

a) Adenylyl cyclase
b) Sodium ions
c) Phospholipase C
d) cAMP

16. Tick the substance which changes the activity of an effector element but doesn’t belong to
second messengers:

a) cAMP
b) cGMP
c) G–protein
d) Calcium ions

17. The increase of second messengers’ (cAMP, cGMP, Ca2+ etc.) concentration leads to:

a) Inhibition of intracellular protein kinases and protein phosphorylation

b) Proteinkinases activation and protein phosphorylation
c) Blocking of interaction between a receptor and an effector
d) Antagonism with endogenous ligands

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18. Tick the substances whose mechanisms are based on interaction with ion channels

a) Sodium channel blockers

b) Calcium channel blockers
c) Potassium channels activators
d) All of the above

19. All of the following statements about efficacy and potency are true EXCEPT:

a) Efficacy is usually a more important clinical consideration than potency

b) Efficacy is the maximum effect of a drug
c) Potency is a comparative measure, refers to the different doses of two drugs that are
needed to produce the same effect
d) The ED50 is a measure of drug’s efficacy

20. Give the definition for a therapeutical dose:

a) The amount of a substance to produce the minimal biological effect

b) The amount of a substance to produce effects hazardous for an organism
c) The amount of a substance to produce the required effect in most patients
d) The amount of a substance to accelerate an increase of concentration of medicine in an
organism

21. Pick out the correct definition of a toxic dose:

a) The amount of substance to produce the minimal biological effect

b) The amount of substance to produce effects hazardous for an organism
c) The amount of substance to produce the necessary effect in most of patients
d) The amount of substance to fast creation of high concentration of medicine in an
organism

22. Which effect may lead to toxic reactions when a drug is taken continuously or repeatedly?

a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis

23. What term is used to describe a more gradual decrease in responsiveness to a drug, taking
days or weeks to develop?

a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis
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24. What term is used to describe a decrease in responsiveness to a drug which develops in a few
minutes?

a) Refractoriness
b) Cumulative effect
c) Tolerance
d) Tachyphylaxis

25. Tachyphylaxis is:

a) A drug interaction between two similar types of drugs

b) Very rapidly developing tolerance
c) A decrease in responsiveness to a drug, taking days or weeks to develop
d) None of the above

26. Drug resistance is a term used to describe the loss of effectiveness of antimicrobial or
antitumour drugs. This consideration is:

a) True
b) False

27. Tolerance and drug resistance can be a consequence of:

a) Drug dependence
b) Increased metabolic degradation
c) Depressed renal drug excretion
d) Activation of a drug after hepatic first-pass

28. Tolerance and drug resistance can be a consequence of:

a) Change in receptors, loss of them or exhaustion of mediators

b) Increased receptor sensitivity
c) Decreased metabolic degradation
d) Decreased renal tubular secretion

29. Tolerance develops because of:

a) Diminished absorption
b) Rapid excretion of a drug
c) Both of the above
d) None of the above

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30. Dependence is often associated with tolerance to a drug, a physical abstinence syndrome, and
psychological dependence (craving). This consideration is:

a) True
b) False

31. The situation when failure to continue administering the drug results in serious psychological
and somatic disturbances is called?

a) Tachyphylaxis
b) Sensibilization
c) Abstinence syndrome
d) Idiosyncrasy

32. What is the type of drug-to-drug interaction which is connected with processes of absorption,
biotransformation, distribution and excretion?

a) Pharmacodynamic interaction
b) Physical and chemical interaction
c) Pharmaceutical interaction
d) Pharmacokinetic interaction

33. What is the type of drug-to-drug interaction which is the result of interaction at receptor, cell,
enzyme or organ level?

a) Pharmacodynamic interaction
b) Physical and chemical interaction
c) Pharmaceutical interaction
d) Pharmacokinetic interaction

34. What phenomenon can occur in case of using a combination of drugs?

a) Tolerance
b) Tachyphylaxis
c) Accumulation
d) Synergism

35. If two drugs with the same effect, taken together, produce an effect that is equal in magnitude
to the sum of the effects of the drugs given individually, it is called as:

a) Antagonism
b) Potentiation
c) Additive effect
d) None of the above

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36. What does the term “potentiation” mean?

a) Cumulative ability of a drug

b) Hypersensitivity to a drug
c) Fast tolerance developing
d) Intensive increase of drug effects due to their combination

37. The types of antagonism are:

a) Summarized
b) Potentiated
c) Additive
d) Competitive

38. The term “chemical antagonism” means that:

a) two drugs combine with one another to form an inactive compound

b) two drugs combine with one another to form a more active compound
c) two drugs combine with one another to form a more water soluble compound
d) two drugs combine with one another to form a more fat soluble compound

39. A teratogenic action is:

a) Toxic action on the liver

b) Negative action on the fetus causing fetal malformation
c) Toxic action on blood system
d) Toxic action on kidneys

40. Characteristic unwanted reaction which isn’t related to a dose or to a pharmacodynamic

property of a drug is called:

a) Idiosyncrasy
b) Hypersensitivity
c) Tolerance
d) Teratogenic action

41. Idiosyncratic reaction of a drug is:

a) A type of hypersensitivity reaction

b) A type of drug antagonism
c) Unpredictable, inherent, qualitatively abnormal reaction to a drug
d) Quantitatively exaggerated response

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42. Therapeutic index (TI) is:

a) A ratio used to evaluate the safety and usefulness of a drug for indication
b) A ratio used to evaluate the effectiveness of a drug
c) A ratio used to evaluate the bioavailability of a drug
d) A ratio used to evaluate the elimination of a drug

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 Cholinomimetic drugs

1. Acetylcholine is not a specific neurotransmitter at:

a) Sympathetic ganglia
b) Sympathetic postganglionic nerve endings
c) Parasympathetic ganglia
d) Parasympathetic postganglionic nerve endings

2. Muscarinic receptors are located in:

a) Autonomic ganglia
b) Skeletal muscle neuromuscular junctions
c) Autonomic effector cells
d) Sensory carotid sinus baroreceptor zone

3. Indicate the location of M2 cholinoreceptor type:

a) Heart
b) Glands
c) Smooth muscle
d) Endothelium

4. The symptoms of mushroom poisoning include all of the following EXCEPT:

a) Salivation, lacrimation, nausea, vomiting

b) Dryness of mouth, hyperpyrexia, hallucination
c) Headache, abdominal colic
d) Bradycardia, hypotension and shock

5. Which of the following cholinomimetics activates both muscarinic and nicotinic receptors?

a) Lobeline
b) Pilocarpine
c) Nicotine
d) Bethanechol

6. Indicate a cholinomimetic agent, which is related to direct-acting drugs:

a) Edrophonium
b) Physostigmine
c) Carbachol
d) Isoflurophate

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7. Characteristics of carbachol include all of the following EXCEPT:

a) It decreases intraocular pressure

b) It causes mydriasis
c) It exerts both nicotinic and muscarinic effects
d) It is resistant to acethylcholiesterase

8. Acetylcholine is not used in clinical practice because:

a) It is very toxic
b) The doses required are very high
c) It is very rapidly hydrolyzed
d) It is very costly

9. Parasympathomimetic drugs cause:

a) Bronchodilation
b) Mydriasis
c) Bradycardia
d) Constipation

10. Which of the following direct-acting cholinomimetics is mainly muscarinic in action?

a) Bethanechol
b) Carbachol
c) Acetylcholine
d) None of the above

11. Which of the following direct-acting cholinomimetics has the shortest duration of action?

a) Acetylcholine
b) Methacholine
c) Carbachol
d) Bethanechol

12. Bethanechol has all of the following properties EXCEPT:

a) It is extremely resistant to hydrolysis

b) Purely muscarinic in its action
c) It is used for abdominal urinary bladder distention
d) It exerts both nicotinic and muscarinic effects

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13. A M-cholinimimetic agent is:

a) Carbachol
b) Pilocarpine
c) Acetylcholine
d) Bethanechol

14. Characteristics of pilocarpine include all of the following EXCEPT:

a) It is a tertiary amine alkaloid

b) It causes miosis and a decrease in intraocular pressure
c) Causes a decrease in secretory and motor activity of gut
d) It is useful in the treatment of glaucoma

15. Which of the following cholinomimetics is a plant derivative with lower potency than
nicotine but with a similar spectrum of action?

a) Lobeline
b) Pilocarpine
c) Carbochol
d) Acetylcholine

16. Which of the following cholinomimetics is indirect-acting?

a) Lobeline
b) Edrophonium
c) Pilocarpine
d) Carbachol

17. The mechanism of action of indirect-acting cholinomimetic agents is:

a) Binding to and activation of muscarinic or nicotinic receptors

b) Inhibition of the hydrolysis of endogenous acetylcholine
c) Stimulation of the action of acetylcholinesterase
d) Releasing acetylcholine from storage sites

18. Indicate a reversible cholinesterase inhibitor:

a) Isoflurophate
b) Carbochol
c) Physostigmine
d) Parathion

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19. Which of the following cholinesterase inhibitors is irreversible?

a) Physostigmine
b) Edrophonium
c) Neostigmine
d) Isoflurophate

20. Indicate cholinesterase activator:

a) Pralidoxime
b) Edrophonium
c) Pilocarpine
d) Isoflurophate

21. Isofluorophate increases all of the following effects EXCEPT:

a) Lacrimation
b) Bronchodilation
c) Muscle twitching
d) Salivation

22. Indicate a cholinesterase inhibitor, which has an additional direct nicotinic agonist effect:

a) Edrophonium
b) Carbochol
c) Neostigmine
d) Lobeline

23. Сholinesterase inhibitors do not produce:

a) Bradycardia, no change or modest fall in blood pressure

b) Increased strength of muscle contraction, especially in muscles weakened by myasthenia
gravis
c) Miosis and reduction of intraocular pressure
d) Dramatic hypertension and tachycardia

24. Which of the following cholinomimetics is commonly used in the treatment of glaucoma?

a) Pilocarpine
b) Lobeline
c) Acethylcholine
d) Neostigmine

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25. Indicate the organophosphate cholinesterase inhibitor, which can be made up in an aqueous
solution for ophthalmic use and retains its activity within a week:

a) Physoctigmine
b) Edrophonium
c) Echothiophate
d) Neostigmine

26. Which of the following cholinomimetics is most widely used for paralytic ileus and atony of
the urinary bladder?

a) Lobeline
b) Neostigmine
c) Pilocarpine
d) Echothiophate

27. Chronic long-term therapy of myasthenia is usually accomplished with:

a) Edrophonium
b) Neostigmine
c) Echothiophate
d) Carbachol

28. Which of the following cholinomimetics is a drug of choice for reversing the effects of
nondepolarizing neuromuscular relaxants?

a) Echothiophate
b) Physostigmine
c) Edrophonium
d) Pilocarpine

29. Indicate the reversible cholinesterase inhibitor, which penetrates the blood-brain barrier:

a) Physostigmine
b) Edrophonium
c) Neostigmine
d) Piridostigmine

30. Which of the following cholinomimetics is used in the treatment of atropine intoxication?

a) Neostigmine
b) Carbochol
c) Physostigmine
d) Lobeline

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31. The symptoms of excessive stimulation of muscarinic receptors include all of the following
EXCEPT:

a) Abdominal cramps, diarrhea

b) Increased salivation, excessive bronchial secretion
c) Miosis, bradycardia
d) Weakness of all skeletal muscles

32. The excessive stimulation of muscarinic receptors by pilocarpine and choline esters is
blocked competitively by:

a) Edrophonium
b) Atropine
c) Pralidoxime
d) Echothiophate

33. The toxic effects of a large dose of nicotine include all of the following EXCEPT:

a) Hypotension and bradycardia

b) Convulsions, coma and respiratory arrest
c) Skeletal muscle depolarization blockade and respiratory paralysis
d) Hypertension and cardiac arrhythmias

34. The dominant initial sights of acute cholinesterase inhibitors intoxication include all of the
following EXCEPT:

a) Salivation, sweating
b) Mydriasis
c) Bronchial constriction
d) Vomiting and diarrhea

35. Which of the following drugs is used for acute toxic effects of organophosphate
cholinesterase inhibitors?

a) Atropine
b) Pilocarpine
c) Pralidoxime
d) Edrophonium

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 Cholinoreceptor blocking drugs

1. The group of nicotinic receptor-blocking drugs consists of:

a) Ganglion-blockers
b) Atropine-similar drugs
c) Neuromuscular junction blockers
d) Both a and c

2. M3 receptor subtype is located:

a) In the myocardium
b) In sympathetic postganglionic neurons
c) On effector cell membranes of glandular and smooth muscle cells
d) On the motor end plates

3. Which of the following drugs is both a muscarinic and nicotinic blocker?

a) Atropine
b) Benztropine
c) Hexamethonium
d) Succinylcholine

4. Indicate a muscarinic receptor-blocking drug:

a) Scopolamine
b) Pipecuronium
c) Trimethaphan
d) Pilocarpine

5. Which of the following agents is a ganglion-blocking drug?

a) Homatropine
b) Hexamethonium
c) Rapacuronium
d) Edrophonium

6. Indicate the skeletal muscle relaxant, which is a depolarizing agent:

a) Vencuronium
b) Scopolamine
c) Succinylcholine
d) Hexamethonium

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7. Which of the following drugs is a nondepolarizing muscle relaxant?

a) Pancuronium
b) Succinylcholine
c) Hexamethonium
d) Scopolamine

8. Indicate the drug, which is rapidly and fully distributed into CNS and has a greater effect than
most other antimuscarinic agents?

a) Atropine
b) Scopolamine
c) Homatropine
d) Ipratropium

9. The effect of the drug on parasympathetic function declines rapidly in all organs EXCEPT:

a) Eye
b) Heart
c) Smooth muscle organs
d) Glands

10. The mechanism of atropine action is:

a) Competitive ganglion blockade

b) Competitive muscarinic blockade
c) Competitive neuromuscular blockade
d) Noncompetitive neuromuscular blockade

11. The tissues most sensitive to atropine are:

a) The salivary, bronchial and sweat glands

b) The gastric parietal cells
c) Smooth muscle and autonomic effectors
d) The heart

12. Atropine is highly selective for:

a) M1 receptor subtype
b) M2 receptor subtype
c) M3 receptor subtype
d) All of the above

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13. Which of the following antimuscarinic drugs is often effective in preventing or reversing
vestibular disturbances, especially motion sickness?

a) Atropine
b) Ipratropium
c) Scopolamine
d) Homatropine

14. Atropine causes:

a) Miosis, a reduction in intraocular pressure and cyclospasm

b) Mydriasis, a rise in intraocular pressure and cycloplegia
c) Miosis, a rise in intraocular pressure and cycloplegia
d) Mydriasis, a rise in intraocular pressure and cyclospasm

15. Patients complain of dry or “sandy” eyes when receiving large doses of:

a) Atropine
b) Hexamethonium
c) Pilocarpine
d) Carbachol

16.All of the following parts of the heart are very sensitive to muscarinic receptor blockade
EXCEPT:

a) Atria
b) Sinoatrial node
c) Atrioventricular node
d) Ventricle

17. Atropine causes:

a) Bradycardia, hypotension and bronchoconstriction

b) Tachycardia, little effect on blood pressure and bronchodilation
c) Decrease in contractile strength, conduction velocity through the AV node
d) Tachycardia, hypertensive crisis and bronchodilation

18. Atropine is frequently used prior to administration of inhalant anesthetics to reduce:

a) Muscle tone
b) Secretions
c) Nausea and vomiting
d) All of the above

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19. Atropine is now rarely used for the treatment of peptic ulcer because of:

a) Slow gastric empting and prolongation of the exposure of the ulcer bed to acid
b) Low efficiency and necessity of large doses
c) Adverse effects
d) All of the above

20. Which of the following antimuscarinic drugs is a selective M1 blocker?

a) Atropine
b) Scopolamine
c) Pirenzepine
d) Homatropine

21. Atropine causes:

a) Spasmolitic activity
b) Intestinal hypermotility
c) Stimulation of contraction in the gut
d) Stimulation of secretory activity

22. Which of the following drugs is useful in the treatment of uterine spasms?

a) Carbachol
b) Vecuronium
c) Atropine
d) Edrophonium

23. Atropine may cause a rise in body temperature (atropine fever):

a) In adults
b) In pregnant women
c) In infants and children
d) All of the above

24. The pharmacologic actions of scopolamine most closely resemble those of:

a) Hexamethonium
b) Atropine
c) Succinylcholine
d) Pilocarpine

25
25. Compared with atropine, scopolamine has all of the following properties EXCEPT:

a) More marked central effect

b) Less potent in decreasing bronchial, salivary and sweat gland secretion
c) More potent in producing mydriasis and cycloplegia
d) Lower effects on the heart, bronchial muscle and intestines

26. Which of the following drugs is useful in the treatment of Parkinson′s disease?

a) Benztropine
b) Edrophonium
c) Succinylcholine
d) Hexamethonium

27. Indicate the antimuscarinic drug, which is used as a mydriatic:

a) Pilocarpine
b) Neostigmine
c) Homatropine
d) Ipratropium

28. Which of the following agents is used as an inhalation drug in asthma?

a) Atropine
b) Ipratropium
c) Lobeline
d) Homatropine

29. Which of the following agents is most effective in regenerating cholinesterase associated
with skeletal muscle neuromuscular junctions?

a) Suscinilcholine
b) Pralidoxime
c) Pirenzepine
d) Propiverine

30. Indicate an antimuscarinic drug, which is effective in the treatment of mushroom poising:

a) Pralidoxime
b) Pilocarpine
c) Homatropine
d) Atropine

26
31. Antimuscarinics are used in the treatment of the following disorders EXCEPT:

a) Motion sickness
b) Glaucoma
c) Hyperhidrosis
d) Asthma

32. The atropine poisoning includes all of the following symptoms EXCEPT:

a) Mydriasis, cycloplegia
b) Hyperthermia, dry mouth, hot and flushed skin
c) Agitation and delirium
d) Bradicardia, orthostatic hypotension

33. The treatment of the antimuscarinic effects can be carried out with:

a) Neostigmine
b) Hexametonium
c) Homatropine
d) Acetylcholine

34. Contraindications to the use of antimuscarinic drugs are all of the following EXCEPT:

a) Glaucoma
b) Myasthenia
c) Bronchial asthma
d) Paralytic ileus and atony of the urinary bladder

35. Hexamethonium blocks the action of acethylcholine and similar agonists at:

a) Muscarinic receptor site

b) Neuromuscular junction
c) Autonomic ganglia
d) Axonal transmission

36. The applications of the ganglion blockers have disappeared because of all of the following
reasons EXCEPT:

a) Orthostatic hypotension
b) Lack of selectivity
c) Homeostatic reflexes block
d) Respiratory depression

27
37. Which of the following agents is a short-acting ganglion blocker?

a) Homatropine
b) Trimethaphane
c) Hexamethonium
d) Pancuronium

38. Indicate the ganglion-blocking drug, which can be taken orally for the treatment of
hypertension?

a) Mecamylamine
b) Scopolamine
c) Trimethaphane
d) Vecocuronium

39. The systemic effects of hexamethonium include all of the following EXCEPT:

a) Reduction of both peripheral vascular resistance and venous return

b) Partial mydriasis and loss of accommodation
c) Constipation and urinary retention
d) Stimulation of thermoregulatory sweating

40. Ganglion blocking drugs are used for the following emergencies EXCEPT:

a) Hypertensive crises
b) Controlled hypotension
c) Cardiovascular collapse
d) Pulmonary edema

41. Agents that produce neuromuscular blockade act by inhibiting:

a) Interaction of acetylcholine with cholinergic receptors

b) Release of acetylcholine from prejunctional membrane
c) Packaging of acetylcholine into synaptic vesicles
d) Reuptake of acetylcholine into the nerve ending

42. Skeletal muscle relaxation and paralysis can occur from interruption of functions at several
sites, including all of the following EXCEPT:

a) Nicotinic acethylcholine receptors

b) Muscarinic acethylcholine receptors
c) The motor end plate
d) Contractile apparatus

28
43. Nondepolarisation neuromuscular blocking agents:

a) Block acetylcholine reuptake

b) Prevent access of the transmitter to its receptor and depolarization
c) Block transmission by an excess of a depolarizing agonist
d) All of the above

44. Which of the following drugs has “double-acetylcholine” structure?

a) Rocuronium
b) Carbachol
c) Atracurium
d) Succylcholine

45. Indicate the long-acting neuromuscular blocking agent:

a) Rapacuronium
b) Mivacurium
c) Tubocurarine
d) Rocuronium

46. Which of the following neuromuscular blocking drugs is an intermediate-duration muscle

relaxant?

a) Vecuronium
b) Tubocurarine
c) Pancuronium
d) Rapacuronium

47. Indicate the nondepolarizing agent, which has the fastest onset of effect?

a) Succinylcholine
b) Rapacuronium
c) Pancuronium
d) Tubocurarine

48. Indicate the neuromuscular blocker, whose breakdown product readily crosses the blood-
brain barrier and may cause seizures:

a) Pancuronium
b) Succinylcholine
c) Tubocurarine
d) Atracurium

29
49. Which competitive neuromuscular blocking agent could be used in patients with renal
failure?

a) Atracurium
b) Succinylcholine
c) Pipecuronium
d) Doxacurium

50. Indicate the nondepolarizing agent, which has short duration of action:

a) Succinylcholine
b) Tubocurarine
c) Mivacurium
d) Pancuronium

51. Which depolarizing agent has the extremely brief duration of action?

a) Mivacurium
b) Rapacuronium
c) Rocuronium
d) Succinylcholine

52. Neuromuscular blockade by both succinylcholine and mivacurium may be prolonged in

patients with:

a) Renal failure
b) An abnormal variant of plasma cholinesterase
c) Hepatic disease
d) Both b and c

53. Depolarizing agents include all of the following properties EXCEPT:

a) Interact with nicotinic receptor to compete with acetylcholine without receptor activation
b) React with the nicotinic receptor to open the channel and cause depolarisation of the end
plate
c) Cause desensitization, noncompetive block manifested by flaccid paralysis
d) Cholinesterase inhibitors do not have the ability to reverse the blockade

54. Which of the following neuromuscular blockers causes transient muscle fasciculations?

a) Mivacurium
b) Pancuronium
c) Succinylcholine
d) Tubocurarine

30
55. Indicate muscles, which are more resistant to block and recover more rapidly:

a) Hand
b) Leg
c) Neck
d) Diaphragm

56. Which neuromuscular blocking agent has the potential to cause the greatest release of
histamine?

a) Succylcholine
b) Tubocurarine
c) Pancuronium
d) Rocuronium

57. Which of the following muscular relaxants causes hypotension and bronchospasm?

a) Vecuronium
b) Succinylcholine
c) Tubocurarine
d) Rapacuronium

58. Indicate the neuromuscular blocker, which causes tachycardia:

a) Tubocurarine
b) Atracurium
c) Pancuronium
d) Succinylcholine

59. Which of the following neuromuscular blocking agents cause cardiac arrhythmias?

a) Vecuronium
b) Tubocurarine
c) Rapacuronium
d) Succinylcholine

60. Effects seen only with depolarizing blockade include all of the following EXCEPT:

a) Hypercaliemia
b) A decrease in intraocular pressure
c) Emesis
d) Muscle pain

31
61. Which neuromuscular blocking agent is contraindicated in patients with glaucoma?

a) Tubocurarine
b) Succinylcholine
c) Pancuronium
d) Gallamine

62. Indicate the following neuromuscular blocker, which would be contraindicated in patients
with renal failure:

a) Pipecuronium
b) Succinylcholine
c) Atracurium
d) Rapacuronium

63. All of the following drugs increase the effects of depolarizing neuromuscular blocking agents
EXCEPT:

a) Aminoglycosides
b) Antiarrhythmic drugs
c) Nondepolarizing blockers
d) Local anesthetics

64. Which of the following diseases can augment the neuromuscular blockade produced by
nondepolarizing muscle relaxants?

a) Myasthenia gravis
b) Burns
c) Asthma
d) Parkinsonism

65. Indicate the agent, which effectively antagonizes the neuromuscular blockade caused by
nondepolarizing drugs:

a) Atropine
b) Neostigmine
c) Acetylcholine
d) Pralidoxime

32
 Adrenergic Acting agents

1. Sympathetic stimulation is mediated by:

a) Release of norepinephrine from nerve terminals

b) Activation of adrenoreceptors on postsynaptic sites
c) Release of epinephrine from the adrenal medulla
d) All of the above

2. Characteristics of epinephrine include all of the following EXCEPT:

a) It is synthesized into the adrenal medulla

b) It is synthesized into the nerve ending
c) It is transported in the blood to target tissues
d) It directly interacts with and activates adrenoreceptors

3. Which of the following sympathomimetics acts indirectly?

a) Epinephrine
b) Norepinephrine
c) Ephedrine
d) Methoxamine

4. Indirect action includes all of the following properties EXCEPT:

a) Displacement of stored catecholamines from the adrenergic nerve ending

b) Inhibition of reuptake of catecholamines already released
c) Interaction with adrenoreceptors
d) Inhibition of the release of endogenous catecholamines from peripheral adrenergic
neurons

5. Catecholamine includes following EXCEPT:

a) Ephedrine
b) Epinephrine
c) Isoprenaline
d) Norepinephrine

6. Epinephrine decreases intracellular camp levels by acting on:

a) α1 receptor
b) α2 receptor
c) beta1 receptor

33
 d) beta2 receptor

7. Which of the following statements is not correct?

a) ALFA receptors increase arterial resistence, whereas beta2 receptor promote smooth
muscle relaxation
b) The skin and splanchic vessels have predominantly alfa receptors
c) Vessels in a skeletal muscle may constrict or dilate depending on whether alfa or beta2
receptors are activated
d) Skeletal muscle vessels have predominantly alfa receptors and constrict in the presence of
epinephrine and norepinephrine

8. Direct effects on the heart are determined largely by:

a) Alfa1 receptor
b) Alfa2 receptor
c) Beta1 receptor
d) Beta2 receptor

9. Which of the following effects is related to direct beta1-adrenoreceptor stimulation?

a) Bronchodilation
b) Vasodilatation
c) Tachycardia
d) Bradycardia

10. Distribution of alfa adrenoreceptor subtypes is associated with all of the following tissues
except those of:

a) Heart
b) Blood vessels
c) Prostate
d) Pupillary dilator muscle

11. Beta adrenoreceptor subtypes is contained in all of the following tissues EXCEPT:

a) Bronchial muscles
b) Heart
c) Pupillary dilator muscle
d) Fat cells

34
12. In which of the following tissues both alfa and beta1 adrenergic stimulation produces the
same effect?

a) Blood vessels
b) Intestine
c) Uterus
d) Bronchial muscles

13. The effects of sympathomimetics on blood pressure are associated with their effects on:

a) The heart
b) The peripheral resistance
c) The venous return
d) All of the above

14. A relatively pure alfa agonist causes all of the following effects EXCEPT:

a) Increase peripheral arterial resistance

b) Increase venous return
c) Has no effect on blood vessels
d) Reflex bradycardia

15. A nonselective beta receptor agonist causes all of the following effects EXCEPT:

a) Increase cardiac output

b) Increase peripheral arterial resistance
c) Decrease peripheral arterial resistance
d) Decrease the mean pressure

16. Which of the following statement is not correct?

a) Αlfa agonists cause miosis

b) Αlfa agonists cause mydriasis
c) Beta antagonists decrease the production of aqueous humor
d) Αlfa agonists increase the outflow of aqueous humor from the eye

17. A bronchial smooth muscle contains:

a) Αlfa1 receptor
b) Αlfa2 receptor
c) Beta 1 receptor
d) Beta 2 receptor

35
18. All of the following agents are beta receptor agonists EXCEPT:

a) Epinephrine
b) Isoproterenol
c) Methoxamine
d) Dobutamine

19. Which of the following drugs causes bronchodilation without significant cardiac stimulation?

a) Isoprenaline
b) Terbutaline
c) Xylometazoline
d) Methoxamine

20. Αlfa-receptor stimulation includes all of the following effects EXCEPT:

a) Relaxation of gastrointestinal smooth muscle

b) Contraction of bladder base, uterus and prostate
c) Stimulation of insulin secretion
d) Stimulation of platelet aggregation

21. Beta1 receptor stimulation includes all of the following effects EXCEPT:

a) Increase in contractility
b) Bronchodilation
c) Tachycardia
d) Increase in conduction velocity in the atrioventricular node

22. Beta2 receptor stimulation includes all of the following effects EXCEPT:

a) Stimulation of renin secretion

b) Fall of potassium concentration in plasma
c) Relaxation of bladder, uterus
d) Tachycardia

23. Hyperglycemia induced by epinephrine is due to:

a) Gluconeogenesis (beta2)
b) Inhibition of insulin secretion (alfa)
c) Stimulation of glycogenolysis (beta2)
d) All of the above

36
24. Which of the following effects is associated with beta3-receptor stimulation?

a) Lipolysis
b) Decrease in platelet aggregation
c) Bronchodilation
d) Tachycardia

25. Which of the following statements is not correct?

a) Epinephrine acts on both alfa- and beta-receptors

b) Norepinephrine has a predominantly beta action
c) Methoxamine has a predominantly alfa action
d) Isoprenaline has a predominantly beta action

26. Indicate the drug, which is a direct-acting both alfa- and beta-receptor agonist:

a) Norepinephrine
b) Methoxamine
c) Isoproterenol
d) Ephedrine

27. Which of the following agents is an alfa1 alfa2 beta1 beta2 receptor agonist?

a) Methoxamine
b) Albuterol
c) Epinephrine
d) Norepinephrine

28. Indicate the direct-acting sympathomimetic, which is an alfa1 alfa2 beta1 receptor agonist:

a) Isoproterenol
b) Ephedrine
c) Dobutamine
d) Norepinephrine

29. Which of the following agents is an alfa1-selective agonist?

a) Norepinephrine
b) Methoxamine
c) Ritodrine
d) Ephedrine

37
30. Indicate the alfa2-selective agonist:

a) Xylometazoline
b) Epinephrine
c) Dobutamine
d) Methoxamine

31. Which of the following agents is a nonselective beta receptor agonist?

a) Norepinephrine
b) Terbutaline
c) Isoproterenol
d) Dobutamine

32. Indicate the beta1-selective agonist:

a) Isoproterenol
b) Dobutamine
c) Metaproterenol
d) Epinephrine

33. Which of the following sympathomimetics is a beta2-selective agonist?

a) Terbutaline
b) Xylometazoline
c) Isoproterenol
d) Dobutamine

34. Indicate the indirect-acting sympathomimetic agent:

a) Epinephrine
b) Phenylephrine
c) Ephedrine
d) Isoproterenol

35. Epinephrine produces all of the following effects EXCEPT:

a) Positive inotropic and chronotropic actions on the heart (beta1 receptor)

b) Increase peripheral resistance (alfa receptor)
c) Predominance of alfa effects at low concentration
d) Skeletal muscle blood vessel dilatation (beta2 receptor)

38
36. Epinephrine produces all of the following effects EXCEPT:

a) Decrease in oxygen consumption

b) Bronchodilation
c) Hyperglycemia
d) Mydriasis

37. Epinephrine is used in the treatment of all of the following disorders EXCEPT:

a) Bronchospasm
b) Anaphylactic shock
c) Cardiac arrhythmias
d) Open-angle glaucoma

38. Compared with epinephrine, norepinephrine produces all of the following effects EXCEPT:

a) Similar effects on beta1 receptors in the heart and similar potency at an alfa receptor
b) Decrease the mean pressure below normal before returning to the control value
c) Significant tissue necrosis if injected subcutaneously
d) Increase both diastolic and systolic blood pressure

39. Norepinephrine produces:

a) Vasoconstriction
b) Vasodilatation
c) Bronchodilation
d) Decresed potassium concentration in the plasma

40. Which of the following direct-acting drugs is a relatively pure alfa agonist, an effective
mydriatic and decongestant and can be used to raise blood pressure?

a) Epinephrine
b) Norepinephrine
c) Phenylephrine
d) Ephedrine

41. Characteristics of methoxamine include all of the following EXCEPT:

a) It is a direct-acting alfa1-receptor agonist

b) It increases heart rate, contractility and cardiac output
c) It causes reflex bradycardia
d) It increases total peripheral resistance

39
42. Which of the following agents is an alfa2-selective agonist with ability to promote
constriction of the nasal mucosa?

a) Xylometazoline
b) Phenylephrine
c) Methoxamine
d) Epinephrine

43. Indicate the sympathomimetic, which may cause hypotension, presumably because of a
clonidine-like effect:

a) Methoxamine
b) Phenylephrine
c) Xylometazoline
d) Isoproterenol

44. Isoproterenol is:

a) Both an alfa- and beta-receptor agonist

b) beta1-selective agonist
c) beta2-selective agonist
d) Nonselective beta receptor agonist

45. Isoproterenol produces all of the following effects EXCEPT:

a) Increase in cardiac output

b) Fall in diastolic and mean arterial pressure
c) Bronchoconstriction
d) Tachycardia

46. Characteristics of dobutamine include all of the following EXCEPT:

a) It is a relatively beta1-selective synthetic catecholamine

b) It is used to treat bronchospasm
c) It increases atrioventricular conduction
d) It causes minimal changes in heart rate and systolic pressure

47. Characteristics of salmeterol include all of the following EXCEPT:

a) It is a potent selective beta2 agonist

b) It causes uterine relaxation
c) It stimulates heart rate, contractility and cardiac output
d) It is used in the therapy of asthma

40
48. Characteristics of ephedrine include all of the following EXCEPT:

a) It acts primarily through the release of stored cathecholamines

b) It is a mild CNS stimulant
c) It causes tachyphylaxis with repeated administration
d) It decreases arterial pressure

49. Ephedrine causes:

a) Miosis
b) Bronchodilation
c) Hypotension
d) Bradycardia

50. Compared with epinephrine, ephedrine produces all of the following features EXCEPT:

a) It is a direct-acting sympathomimetic
b) It has oral activity
c) It is resistant to MAO and has much longer duration of action
d) Its effects are similar, but it is less potent

51. Which of the following sympathomimetics is preferable for the treatment of chronic
orthostatic hypotension?

a) Epinephrine
b) Norepinephrine
c) Ephedrine
d) Salmeterol

52. Indicate the sympathomimetic drug, which is used in a hypotensive emergency:

a) Xylometazoline
b) Ephedrine
c) Terbutaline
d) Phenylephrine

53. Which of the following sympathomimetics is preferable for the emergency therapy of
cardiogenic shock?

a) Epinephrine
b) Dobutamine
c) Isoproterenol
d) Methoxamine

41
54. Indicate the sympathomimetic agent, which is combined with a local anesthetic to prolong
the duration of infiltration nerve block:

a) Epinephrine
b) Xylometazoline
c) Isoproterenol
d) Dobutamine

55. Which of the following sympathomimetics is related to short-acting topical decongestant

agents?

a) Xylometazoline
b) Terbutaline
c) Phenylephrine
d) Norepinephrine

56. Indicate the long-acting topical decongestant agents:

a) Epinephrine
b) Norepinephrine
c) Phenylephrine
d) Xylometazoline

57. Which of the following topical decongestant agents is an alfa2-selective agonist?

a) Phenylephrine
b) Xylometazoline
c) Ephedrine
d) Epinephrine

58. Indicate the sympathomimetic, which may be useful in the emergency management of
cardiac arrest:

a) Methoxamine
b) Phenylephrine
c) Epinephrine
d) Xylometazoline

42
59. Which of the following sympathomimetics is used in the therapy of bronchial asthma?

a) Formoterol
b) Norepinephrine
c) Methoxamine
d) Dobutamine

60. Indicate the agent of choice in the emergency therapy of anaphylactic shock:

a) Methoxamine
b) Terbutaline
c) Norepinephrine
d) Epinephrine

61. Which of the following sympathomimetics is an effective mydriatic?

a) Salmeterol
b) Phenylephrine
c) Dobutamine
d) Norepinephrine

62. The adverse effects of sympathomimetics include all of the following EXCEPT:

a) Drug-induced parkinsonism
b) Cerebral hemorrhage or pulmonary edema
c) Myocardial infarction
d) Ventricular arrhythmias

43
 Adrenergic Antagents

1. Which of the following drugs is a nonselective alfa receptor antagonist?

a) Prazosin
b) Phentolamine
c) Metoprolol
d) Reserpine

2. Indicate the alfa1-selective antagonist:

a) Phentolamine
b) Dihydroergotamine
c) Prazosin
d) Labetalol

3. Which of the following agents is an alfa2–selective antagonist?

a) Yohimbine
b) Tamsulosin
c) Tolazoline
d) Prazosin

4. Indicate the irreversible alfa receptor antagonist:

a) Tolazoline
b) Labetalol
c) Prazosin
d) Phenoxybenzamine

5. Which of the following drugs is an nonselective beta receptor antagonist?

a) Metoprolol
b) Atenolol
c) Propranolol
d) Acebutolol

6. Indicate the beta1-selective antagonist:

a) Propranolol
b) Metoprolol
c) Carvedilol
d) Sotalol

44
7. Which of the following agents is a beta2–selective antagonist?

a) Tolazolin
b) Pindolol
c) Ergotamin
d) Butoxamine

8. Indicate the beta adrenoreceptor antagonist, which has partial beta–agonist activity:

a) Propranolol
b) Metoprolol
c) Pindolol
d) Betaxolol

9. Which of the following drugs is a reversible nonselective alfa, beta antagonist?

a) Labetalol
b) Phentolamine
c) Metoprolol
d) Propranolol

10. Indicate the indirect-acting adrenoreceptor blocking drug:

a) Tolazoline
b) Reserpine
c) Carvedilol
d) Prazosin

11. The principal mechanism of action of adrenoreceptor antagonists is:

a) Reversible or irreversible interaction with adrenoreceptors

b) Depletion of the storage of catecholamines
c) Blockade of the amine reuptake pumps
d) Nonselective MAO inhibition

12. Characteristics of alfa-receptor antagonists include all of the following EXCEPT:

a) They cause a fall in peripheral resistance and blood pressure

b) They cause epinephrine reversal (convert a pressor response to a depressor response)
c) Bronchospasm
d) They may cause postural hypotension and reflex tachycardia

45
13. Which of the following drugs is an imidazoline derivative and a potent competitive
antagonist at both alfa1 and alfa2 receptors?

a) Prazosin
b) Labetalol
c) Phenoxybenzamine
d) Phentolamine

14. Characteristics of phentolamine include all of the following EXCEPT:

a) Reduction in peripheral resistance

b) Stimulation of responses to serotonin
c) Tachycardia
d) Stimulation of muscarinic, H1 and H2 histamine receptors

15. The principal mechanism of phentolamine-induced tachycardia is:

a) Antagonism of presynaptic alfa2 receptors enhances norepinephrine release, which

causes cardiac stimulation via unblocked beta receptors
b) Baroreflex mechanism
c) Direct effect on the heart by stimulation of beta1 receptors
d) Inhibition of transmitter reuptake at noradrenergic synapses

16. Nonselective alfa-receptor antagonists are most useful in the treatment of:

a) Asthma
b) Cardiac arrhythmias
c) Pheochromocytoma
d) Chronic hypertension

17. The main reason for using alfa-receptor antagonists in the management of
pheochromocytoma is:

a) Inhibition of the release of epinephrine from the adrenal medulla

b) Blockade of alfa2 receptors on vascular smooth muscle results in epinephrine stimulation
of unblocked alfa2 receptors
c) Direct interaction with and inhibition of beta2 adrenoreceptors
d) Antagonism to the release of renin

18. Which of the following drugs is useful in the treatment of pheochromocytoma?

a) Phenylephrine
b) Propranolol
c) Phentolamine
d) Epinephrine
46
19. Indicate adrenoreceptor antagonist agents, which are used for the management of
pheochromocytoma:

a) Selective beta2-receptor antagonists

b) Nonselective beta-receptor antagonists
c) Indirect-acting adrenoreceptor antagonist drugs
d) Αlfa-receptor antagonists

20. The principal adverse effects of phentolamine include all of the following EXCEPT:

a) Diarrhea
b) Bradycardia
c) Arrhythmias
d) Myocardial ischemia

21. Indicate the reversible nonselective alfa-receptor antagonist, which is an ergot derivative:

a) Ergotamine
b) Prazosin
c) Phenoxybenzamine
d) Carvedilol

22. Indicate an alfa-receptor antagonist, which binds covalently to alfa receptors, causing
irreversible blockade of long duration (14-48 hours or longer):

a) Phentolamine
b) Phenoxybenzamine
c) Ergotamine
d) Prazosin

23. Compared with phentolamine, prazosin has all of the following features EXCEPT:

a) Irreversible blockade of alfa receptors

b) Highly selective for alfa1 receptors
c) The relative absence of tachycardia
d) Persistent block of alfa1 receptors

24. Which of the following statements is not correct?

a) There are at least three subtypes of alfa1 receptors, designated alfa1a, alfa1b and alfa1d
b) ALFA1a subtype mediates prostate smooth muscle contraction
c) ALFA1b subtype mediates vascular smooth muscle contraction
d) ALFA1a subtype mediates both vascular and prostate smooth muscle contraction

47
25. Indicate an alfa1 adrenoreceptor antagonist, which has great selectivity for alfa1a subtype:

a) Prazosin
b) Tamsulosin
c) Phenoxybenzamine
d) Phentolamine

26. Subtype-selective alfa1 receptor antagonists such as tamsulosin, terazosin, alfusosin are
efficacious in:

a) Hyperthyroidism
b) Cardiac arrhythmias
c) Benign prostatic hyperplasia (BPH)
d) Asthma

27. Indicate an alfa receptor antagonist, which is an efficacious drug in the treatment of mild to
moderate systemic hypertension:

a) Phentolamine
b) Tolazoline
c) Ergotamine
d) Prazosin

28. Which of the following alfa receptor antagonists is useful in reversing the intense local
vasoconstriction caused by inadvertent infiltration of norepinephrine into subcutaneous tissue
during intravenous administration?

a) Propranolol
b) Phentolamine
c) Tamsulosin
d) Ergotamine

29. Beta-blocking drugs-induced chronically lower blood pressure may be associated with theirs
effects on:

a) The heart
b) The blood vessels
c) The renin-angiotensin system
d) All of the above

48
30. Characteristics of beta-blocking agents include all of the following EXCEPT:

a) They occupy beta receptors and competitively reduce receptor occupancy by

catecholamines or other beta agonists
b) They do not cause hypotension in individuals with normal blood pressure
c) They induce depression and depleted stores of catecholamines
d) They can cause blockade in the atrioventricular node

31. Beta-receptor antagonists have all of the following cardiovascular effects EXCEPT:

a) The negative inotropic and chronotropic effects

b) Acute effects of these drugs include a fall in peripheral resistance
c) Vasoconstriction
d) Reduction of the release of renin

32. Beta-blocking agents have all of the following effects EXCEPT:

a) Increase plasma concentrations of HDL and decrease of VLDL

b) Bronchoconstriction
c) Decrease of aqueous humor prodaction
d) “membrane-stabilizing” action

33. Beta-receptor antagonists cause:

a) Stimulation of lipolysis
b) Stimulation of gluconeogenesis
c) Inhibition of glycogenolysis
d) Stimulation of insulin secretion

34. Propranolol has all of the following cardiovascular effects EXCEPT:

a) It decreases cardiac work and oxygen demand

b) It reduces blood flow to the brain
c) It inhibits the renin secretion
d) It increases the atrioventricular nodal refractory period

35. Propranolol-induced adverse effects include all of the following EXCEPT:

a) Bronchoconstriction
b) “supersensitivity” of beta-adrenergic receptors (rapid withdrawal)
c) Hyperglycemia
d) Sedation, sleep disturbances, depression and sexual dysfunction

49
36. Propranolol is used in the treatment all of the following diseases EXCEPT:

a) Cardiovascular diseases
b) Hyperthyroidism
c) Migraine headache
d) Bronchial asthma

37. Metoprolol and atenolol:

a) Are members of the beta1-selective group

b) Are nonselective beta antagonists
c) Have intrinsic sympathomimetic activity
d) Have an anesthetic action

38. Which of the following beta receptor antagonists is preferable in patients with asthma,
diabetes or peripheral vascular diseases?

a) Propranolol
b) Metoprolol
c) Nadolol
d) Timolol

39. Indicate a beta receptor antagonist, which has very long duration of action:

a) Metoprolol
b) Propranolol
c) Nadolol
d) Pindolol

40. Indicate a beta1-selective receptor antagonist, which has very long duration of action:

a) Betaxolol
b) Sotalol
c) Nadolol
d) Metoprolol

41. Which of the following drugs is a nonselective beta-blocker without intrinsic

sympathomimetic or local anesthetic activity and used for the treatment of life-threatening
ventricular arrhythmias?

a) Propranolol
b) Oxprenolol
c) Sotalol
d) Atenolol

50
42. Indicate a beta receptor antagonist with intrinsic sympathomimetic activity:

a) Propranolol
b) Oxprenolol
c) Metoprolol
d) Carvedilol

43. Pindolol, oxprenolol have all of the following properties EXCEPT:

a) They are nonselective beta antagonists

b) They have no partial agonist activity
c) They are less likely to cause bradycardia and abnormalities in plasma lipids
d) They are effective in hypertension and angina

44. Which of the following drugs has both alfa1-selective and beta-blocking effects?

a) Labetalol
b) Betaxolol
c) Propranolol
d) Timolol

45. Characteristics of carvedilol include all of the following EXCEPT:

a) It is a beta1-selective antagonist
b) It has both alfa1-selective and beta-blocking effects
c) It attenuates oxygen free radical-initiated lipid peroxidation
d) It inhibits vascular smooth muscle mitogenesis

46. Indicate the adrenoreceptor antagonist drug, which is a rauwolfia alkaloid:

a) Prazosin
b) Propranolol
c) Reserpine
d) Phentolamine

47. Characteristics of reserpine include all of the following EXCEPT:

a) It inhibits the uptake of norepinephrine into vesicles and MAO

b) It decreases cardiac output, peripheral resistance and inhibits pressor reflexes
c) It may cause a transient sympathomimetic effect
d) It depletes stores of catecholamines and serotonin in the brain

51
48. Indicate a beta-blocker, which is particularly efficacious in thyroid storm:

a) Pindolol
b) Sotalol
c) Phentolamine
d) Propranolol

49. Beta-receptor blocking drugs are used in the treatment all of the following diseases
EXCEPT:

a) Hypertension, ischemic heart disease, cardiac arrhythmias

b) Glaucoma
c) Pheochromocytoma
d) Hyperthyroidism

50. Beta-blocker-induced adverse effects include all of the following EXCEPT:

a) Bronchoconstriction
b) Depression of myocardial contractility and excitability
c) “supersensitivity” of beta-receptors associated with rapid withdrawal of drugs
d) Hyperglycemia

52
 ANTIBIOTICS

1. What does the term “antibiotics” mean:

a) Non-organic or synthetic substances that selectively kill or inhibit the growth of other
microorganisms
b) Substances produced by some microorganisms and their synthetic analogues that
selectively kill or inhibitthe growth of another microorganisms
c) Substances produced by some microorganisms and their synthetic analogues that inhibit
the growth of organism cells
d) Synthetic analogues of natural substances that kill protozoa and helminthes

2. General principles of anti-infective therapy are:

a) Clinical judgment of microbiological factors

b) Definitive identification of a bacterial infection and the microorganism’s susceptibility
c) Optimal route of administration, dose, dosing frequency and duration of treatment
d) All of the above

3. Minimal duration of antibacterial treatment usually is:

a) Not less than 1 day

b) Not less than 5 days
c) Not less than 10-14 days
d) Not less than 3 weeks

4. Rational anti-microbial combination is used to:

a) Provide synergism when microorganisms are not effectively eradicated with a single
agent alone
b) Provide broad coverage
c) Prevent the emergence of resistance
d) All of the above

5. Mechanisms of bacterial resistance to anti-microbial agents are the following, EXCEPT:

a) Active transport out of a microorganism or/and hydrolysis of an agent via enzymes

produced by a microorganism
b) Enlarged uptake of the drug by a microorganism
c) Modification of a drug’s target
d) Reduced uptake by a microorganism

53
6. The statement, that some microorganisms can develop alternative metabolic pathways for
rendering reactions inhibited by the drug, is:

a) True
b) False

7. All of the following drugs are antibiotics, EXCEPT:

a) Streptomycin
b) Penicillin
c) Co-trimoxazole
d) Chloramphenicol

8. Bactericidal effect is:

a) Inhibition of bacterial cell division

b) Inhibition of young bacterial cell growth
c) Destroying of bacterial cells
d) Formation of bacterial L-form

9. Which of the following groups of antibiotics demonstrates a bactericidal effect?

a) Tetracyclines
b) Macrolides
c) Penicillins
d) All of the above

10. Bacteristatic effect is:

a) Inhibition of bacterial cell division

b) Inhibition of young bacterial cells growth
c) Destroying of bacterial cells
d) Formation of bacterial L-form

11. Which of the following groups of antibiotics demonstrates a bacteristatic effect:

a) Carbapenems
b) Macrolides
c) Aminoglycosides
d) Cephalosporins

54
12. Which of the following antibiotics contains a beta-lactam ring in their chemical structure :

a) Penicillins
b) Cephalosporins
c) Carbapenems and monobactams
d) All groups

13. Tick the drug belonging to antibiotics-macrolides:

a) Neomycin
b) Doxycycline
c) Erythromycin
d) Cefotaxime

14. Tick the drug belonging to antibiotics-carbapenems:

a) Aztreonam
b) Amoxacillin
c) Imipinem
d) Clarithromycin

15. Tick the drug belonging to antibiotics-monobactams:

a) Ampicillin
b) Bicillin-5
c) Aztreonam
d) Imipinem

16. Tick the drug belongs to antibiotics-cephalosporins:

a) Streptomycin
b) Cefaclor
c) Phenoxymethilpenicillin
d) Erythromycin

17. Tick the drug belonging to lincozamides:

a) Erythromycin
b) Lincomycin
c) Azithromycin
d) Aztreonam

55
18. Tick the drug belonging to antibiotics-tetracyclines:

a) Doxycycline
b) Streptomycin
c) Clarithromycin
d) Amoxacillin

19. All of antibiotics are aminoglycosides, EXCEPT:

a) Gentamycin
b) Streptomycin
c) Clindamycin
d) Neomycin

20. Tick the drug belonging to nitrobenzene derivative:

a) Clindamycin
b) Streptomycin
c) Azithromycin
d) Chloramphenicol

21. Tick the drug belonging to glycopeptides:

a) Vancomycin
b) Lincomycin
c) Neomycin
d) Carbenicillin

22. Antibiotics inhibiting the bacterial cell wall synthesis are:

a) Beta-lactam antibiotics
b) Tetracyclines
c) Aminoglycosides
d) Macrolides

23. Antibiotic inhibiting bacterial RNA synthesis is:

a) Erythromycin
b) Rifampin
c) Chloramphenicol
d) Imipinem

56
24. Antibiotics altering permeability of cell membranes are:

a) Glycopeptides
b) Polymyxins
c) Tetracyclines
d) Cephalosporins

25. All of the following antibiotics inhibit the protein synthesis in bacterial cells, EXCEPT:

a) Macrolides
b) Aminoglycosides
c) Glycopeptides
d) Tetracyclines

26. Biosynthetic penicillins are effective against:

a) Gram-positive and gram-negative cocci, Corynebacterium diphtheria, spirochetes,

Clostridium gangrene
b) Corynebacterium diphtheria, mycobacteries
c) Gram positive cocci, viruses
d) Gram negative cocci, Rickettsia, mycotic infections

27. Which of the following drugs is a gastric acid resistant:

a) Penicillin G
b) Penicillin V
c) Carbenicillin
d) Procain penicillin

28. Which of the following drugs is penicillinase resistant:

a) Oxacillin
b) Amoxacillin
c) Bicillin-5
d) Penicillin G

29. All of the following drugs demonstrate a prolonged effect, EXCEPT:

a) Penicillin G
b) Procain penicillin
c) Bicillin-1
d) Bicillin-5

57
30. Mechanism of penicillins’ antibacterial effect is:

a) Inhibition of transpeptidation in the bacterial cell wall

b) Inhibition of beta-lactamase in the bacterial cell
c) Activation of endogenous proteases, that destroy bacterial cell wall
d) Activation of endogenous phospholipases, which leads to alteration of cell membrane
permeability

31. Pick out the beta-lactamase inhibitor for co-administration with penicillins:

a) Clavulanic acid
b) Sulbactam
c) Tazobactam
d) All of the above

32. Cephalosporines are drugs of choice for treatment of:

a) Gram-positive microorganism infections

b) Gram-negative microorganism infections
c) Gram-negative and gram-positive microorganism infections, if penicillins have no effect
d) Only bacteroide infections

33. Carbapenems are effective against:

a) Gram-positive microorganisms
b) Gram-negative microorganisms
c) Only bacteroide infections
d) Broad-spectum

34. All of the following antibiotics are macrolides, EXCEPT:

a) Erythromycin
b) Clarithromycin
c) Lincomycin
d) Roxythromycin

35. Tetracyclins have following unwanted effects:

a) Irritation of gastrointestinal mucosa, phototoxicity

b) Hepatotoxicity, anti-anabolic effect
c) Dental hypoplasia, bone deformities
d) All of the above

58
36. Tick the drug belonging to antibiotics-aminoglycosides:

a) Erythromycin
b) Gentamycin
c) Vancomycin
d) Polymyxin

37. Aminoglycosides are effective against:

a) Gram positive microorganisms, anaerobic microorganisms, spirochetes

b) Broad-spectum, except Pseudomonas aeruginosa
c) Gram negative microorganisms, anaerobic microorganisms
d) Broad-spectum, except anaerobic microorganisms and viruses

38. Aminoglycosides have the following unwanted effects:

a) Pancytopenia
b) Hepatotoxicity
c) Ototoxicity, nephrotoxicity
d) Irritation of gastrointestinal mucosa

39. Choose the characteristics of chloramphenicol:

a) Broad-spectum. Demonstrates a bactericidal effect.

b) Influences the Gram-positive microorganisms. Demonstrates a bactericidal effect.
c) Influences the Gram-negative microorganisms. Demonstrates a bactericidal effect.
d) Broad-spectum. Demonstrates a bacteristatic effect.

40. Chloramphenicol has the following unwanted effects:

a) Nephrotoxicity
b) Pancytopenia
c) Hepatotoxicity
d) Ototoxicity

41. Choose the characteristics of lincozamides:

a) Broad-spectum. Demonstrates a bactericidal effect.

b) Influence mainly the anaerobic organisms, Gram negative cocci.
c) Broad-spectum. Demonstrates a bacteristatic effect.
d) Influence mainly the anaerobic organisms, Gram positive cocci.

59
42. Lincozamides have the following unwanted effect:

a) Nephrotoxicity
b) Cancerogenity
c) Pseudomembranous colitis
d) Irritation of respiratory organs

43. Choose the characteristics of vancomicin:

a) It is a glycopeptide, inhibits cell wall synthesis active only against Gram-negative

bacteria
b) It is a glycopeptide, that alters permeability of cell membrane and is active against
anaerobic bacteria
c) It is a beta-lactam antibiotic, inhibits cell wall synthesis active only against Pseudomonas
aeruginosa
d) It is a glycopeptide, inhibits cell wall synthesis and is active only against Gram-positive
bacteria.

44. Vancomicin has the following unwanted effects:

a) Pseudomembranous colitis
b) Hepatotoxicity
c) “Red neck” syndrome, phlebitis
d) All of the above

45. Which of the following drugs is used for systemic and deep mycotic infections treatment:

a) Co-trimoxazol
b) Griseofulvin
c) Amphotericin B
d) Nitrofungin

46. Which of the following drugs is used for dermatomycosis treatment:

a) Nystatin
b) Griseofulvin
c) Amphotericin B
d) Vancomycin

47. Which of the following drugs is used for candidiasis treatment:

a) Griseofulvin
b) Nitrofungin
c) Myconazol
d) Streptomycin
60
48. All of the following antifungal drugs are antibiotics, EXCEPT:

a) Amphotericin B
b) Nystatin
c) Myconazol
d) Griseofulvin

49. Mechanism of Amphotericin B action is:

a) Inhibition of cell wall synthesis

b) Inhibition of fungal protein synthesis
c) Inhibition of DNA synthesis
d) Alteration of cell membrane permeability

50. Azoles have an antifungal effect because of:

a) Inhibition of cell wall synthesis

b) Inhibition of fungal protein synthesis
c) Reduction of ergosterol synthesis
d) Inhibition of DNA synthesis

51. Which of the following drugs alters permeability of Candida cell membranes:

a) Amphotericin B
b) Ketoconazole
c) Nystatin
d) Terbinafine

52. Amfotericin B has the following unwanted effects:

a) Psychosis
b) Renal impairment, anemia
c) Hypertension, cardiac arrhythmia
d) Bone marrow toxicity

53. Tick the drug belonging to antibiotics having a polyene structure:

a) Nystatin
b) Ketoconazole
c) Griseofulvin
d) All of the above

61
54. All of the following drugs demonstrate a fungicidal effect, EXCEPT:

a) Terbinafin
b) Amfotericin B
c) Ketoconazole
d) Myconazol

55. Characteristics of polyenes are following, except:

a) Alter the structure and functions of cell membranes

b) Broad-spectrum
c) Fungicidal effect
d) Nephrotoxicity, hepatotoxicity

56. Characteristics of Amfotericin B are following, EXCEPT:

a) Used for systemic mycosis treatment

b) Poor absorption from the gastro-intestinal tract
c) Does not demonstrate nephrotoxicity
d) Influences the permeability of fungus cell membrane

62
 SYNTHETIC ANTIBACTERIAL DRUGS

1. Sulfonamides are effective against:

a) Bacteria and Chlamidia

b) Actinomyces
c) Protozoa
d) All of the above

2. Mechanism of sulfonamides’ antibacterial effect is:

a) Inhibition of dihydropteroate reductase

b) Inhibition of dihydropteroate synthase
c) Inhibition of cyclooxygenase
d) Activation of DNA gyrase

3. Combination of sulfonamides with trimethoprim:

a) Decreases the unwanted effects of sulfonamides

b) Increases the antimicrobial activity
c) Decreases the antimicrobial activity
d) Increases the elimination of sulfonamides

4. Sulfonamide potency is decreased in case of co-administration with:

a) Oral hypoglycemic agents

b) Local anesthetics – derivatives of paraaminobenzoic acid
c) Local anesthetics – derivatives of benzoic acid
d) Non-narcotic analgesics

5. The following measures are necessary for prevention of sulfonamide precipitation and
crystalluria:

a) Taking of drinks with acid pH

b) Taking of drinks with alkaline pH
c) Taking of saline drinks
d) Restriction of drinking

63
6. Resorptive sulfonamides have the following unwanted effects on blood system:

a) Hemolytic anemia
b) Thrombocytopenia
c) Granulocytopenia
d) All of the above

7. Mechanism of Trimethoprim’ action is:

a) Inhibition of cyclooxygenase
b) Inhibition of dihydropteroate reductase
c) Inhibition of dihydropteroate synthase
d) Inhibition of DNA gyrase

8. Sulfonamides have the following unwanted effects:

a) Hematopoietic disturbances
b) Crystalluria
c) Nausea, vomiting and diarrhea
d) All of the above

9. Tick the drug, which is effective against mycobacteria only:

a) Isoniazid
b) Streptomycin
c) Rifampin
d) Kanamycin

10. Tick the antimycobacterial drug belonging to first-line agents:

a) PAS
b) Isoniazid
c) Kanamycin
d) Pyrazinamide

11. Tick the antimycobacterial drug, belonging to second-line agents:

a) Isoniazid
b) PAS
c) Rifampin
d) Streptomycin

64
12. Tick the antimycobacterial drug, belonging to antibiotics:

a) Isoniazid
b) PAS
c) Ethambutol
d) Rifampin

13. Tick the antimycobacterial drug – hydrazide of isonicotinic acid:

a) Rifampin
b) Isoniazid
c) Ethambutol
d) Pyrazinamide

14. Mechanism of Izoniazid action is:

a) Inhibition of protein synthesis

b) Inhibition of mycolic acids synthesis
c) Inhibition of RNA synthesis
d) Inhibition of ADP synthesis

15. Mechanism of Rifampin action is:

a) Inhibition of mycolic acids synthesis

b) Inhibition of DNA dependent RNA polymerase
c) Inhibition of topoisomerase II
d) Inhibition of cAMP synthesis

16. Mechanism of Cycloserine action is:

a) Inhibition of mycolic acids synthesis

b) Inhibition of RNA synthesis
c) Inhibition of cell wall synthesis
d) Inhibition of pyridoxalphosphate synthesis

17. Mechanism of Streptomycin action is:

a) Inhibition of cell wall synthesis

b) Inhibition of protein synthesis
c) Inhibition of RNA and DNA synthesis
d) Inhibition of cell membranes permeability

65
18. Rifampin has the following unwanted effect:

a) Dizziness, headache
b) Loss of hair
c) Flu-like syndrome, tubular necrosis
d) Hepatotoxicity

19. Isoniazid has following unwanted effect:

a) Cardiotoxicity
b) Hepatotoxicity, peripheral neuropathy
c) Loss of hair
d) Immunotoxicity

20. Ethambutol has the following unwanted effect:

a) Cardiotoxicity
b) Immunetoxicity
c) Retrobulbar neuritis with red-green color blindness
d) Hepatotoxicity

21. Streptomycin has the following unwanted effect:

a) Cardiotoxicity
b) Hepatotoxicity
c) Retrobulbar neuritis with red-green color blindness
d) Ototoxicity, nephrotoxicity

22. Mechanism of aminosalicylic acid action is:

a) Inhibition of mycolic acids synthesis

b) Inhibition of folate synthesis
c) Inhibition of DNA dependent RNA polymerase
d) Inhibition of DNA gyrase

23. All of the following agents are the first-line antimycobacterial drugs, EXCEPT:

a) Rifampin
b) Pyrazinamide
c) Isoniazid
d) Streptomycin

66
24. All of the following antimycobacterial drugs have a bactericidal effect, EXCEPT:

a) Pyrazinamide
b) Streptomycin
c) Rifampin
d) Isoniazid

25. Combined chemotherapy of tuberculosis is used to:

a) Decrease mycobacterium drug-resistance

b) Increase mycobacterium drug-resistance
c) Decrease the antimicrobal activity
d) Decrease the onset of antimycobacterial drugs biotransformation:

26. Tick the antibacterial drug – a nitrofurane derivative:

a) Nitrofurantoin
b) Trimethoprim
c) Ciprofloxacin
d) Nystatin

27. Tick the antibacterial drug – a nitroimidazole derivative:

a) Clavulanic acid
b) Metronidazole
c) Nitrofurantoin
d) Doxycycline

28. Tick the antibacterial drug – a quinolone derivative:

a) Nitrofurantoin
b) Nalidixic acid
c) Streptomycin
d) Metronidazole

29. Tick the antibacterial drug – a fluoroquinolone derivative:

a) Chloramphenicol
b) Nitrofurantoin
c) Nalidixic acid
d) Ciprofloxacin

67
30. Tick the indications for nitrofuranes:

a) Infections of respiratory tract

b) Infections of urinary and gastro-intestinal tracts
c) Syphilis
d) Tuberculosis

31. Tick the unwanted effects of nitrofuranes:

a) Nausea, vomiting
b) Allergic reactions
c) Hemolytic anemia
d) All of the above

32. Tick the indications for Metronidazole:

a) Intra-abdominal infections, vaginitis, enterocolitis

b) Pneumonia
c) As a disinfectant
d) Influenza

33. Tick the unwanted effects of Metronidazole:

a) Nausea, vomiting, diarrhea, stomatitis

b) Hypertension
c) Disturbances of peripheral blood circulation
d) All of the above

34. Themechanism of fluoroquinolones’ action is:

a) Inhibition of phospholipase C
b) Inhibition of DNA gyrase
c) Inhibition of bacterial cell synthesis
d) Alteration of cell membrane permeability

35. Fluoroquinolones are active against:

a) Gram negative microorganisms only

b) Mycoplasmas and Chlamidiae only
c) Gram positive microorganisms only
d) Variety of Gram-negative and positive microorganisms, including Mycoplasmas and
Chlamidiae

68
36. Tick the unwanted effects of fluoroquinolones:

a) Hallucinations
b) Headache, dizziness, insomnia
c) Hypertension
d) Immunetoxicity

37. Tick the indications for fluoroquinolones:

a) Infections of the urinary tract

b) Bacterial diarrhea
c) Infections of the urinary and respiratory tract, bacterial diarrhea
d) Respiratory tract infections

38. The drug of choice for syphilis treatment is:

a) Gentamycin
b) Penicillin
c) Chloramphenicol
d) Doxycycline

69
 ANTIPROTOZOAL AND ANTHELMINTIC DRUGS

1. Tick the drug used for malaria chemoprophylaxis and treatment:

a) Chloroquine
b) Quinidine
c) Quinine
d) Sulfonamides

2. Tick the drug used for amoebiasis treatment:

a) Nitrofurantoin
b) Iodoquinol
c) Pyrazinamide
d) Mefloquine

3. Tick the drug used for trichomoniasis treatment:

a) Metronidazole
b) Suramin
c) Pyrimethamine
d) Tetracycline

4. Tick the drug used for toxoplasmosis treatment:

a) Chloroquine
b) Tetracyclin
c) Suramin
d) Pyrimethamine

5. Tick the drug used for balantidiasis treatment:

a) Azitromycin
b) Tetracycline
c) Quinine
d) Trimethoprim

6. Tick the drug used for leishmaniasis treatment:

a) Pyrimethamine
b) Albendazole
c) Sodium stibogluconate
d) Tinidazole

70
7. Tick the antimalarial drug belonging to 8-aminoquinoline derivatives:

a) Doxycycline
b) Quinidine
c) Primaquine
d) Chloroquine

8. All of the following antimalarial drugs are 4-quinoline derivatives, EXCEPT:

a) Chloroquine
b) Mefloquine
c) Primaquine
d) Amodiaquine

9. Tick the antimalarial drug belonging to pyrimidine derivatives:

a) Mefloquine
b) Pyrimethamine
c) Quinidine
d) Chloroquine

10. Tick the drug used for trypanosomosis treatment:

a) Melarsoprol
b) Metronidazole
c) Tetracyclin
d) Quinidine

11. Tick the antimalarial drug having a gametocidal effect:

a) Mefloquine
b) Primaquine
c) Doxycycline
d) Sulfonamides

12. All of the following antimalarial drugs influence blood schizonts, EXCEPT:

a) Mefloquine
b) Chloroquine
c) Primaquine
d) Quinidine

71
13. Tick the antimalarial drug influencing tissue schisonts:

a) Mefloquine
b) Chloroquine
c) Quinidine
d) Primaquine

14. Tick the group of antibiotics having an antimalarial effect:

a) Aminoglycosides
b) Tetracyclins
c) Carbapenems
d) Penicillins

15. Tick the amebecide drug for the treatment of an asymptomatic intestinal form of amebiasis:

a) Chloroquine
b) Diloxanide
c) Emetine
d) Doxycycline

16. Tick the drugs for the treatment of an intestinal form of amebiasis:

a) Metronidazole and diloxanide

b) Diloxanide and streptomycin
c) Diloxanide and Iodoquinol
d) Emetine and metronidazole

17. Tick the drug for the treatment of a hepatic form of amebiasis:

a) Diloxanide or iodoquinol
b) Tetracycline or doxycycline
c) Metronidazole or emetine
d) Erythromycin or azitromycin

18. Tick the luminal amebecide drug:

a) Metronidazole
b) Emetine
c) Doxycycline
d) Diloxanide

72
19. Tick the drug of choice for the treatment of extraluminal amebiasis:

a) Iodoquinol
b) Metronidazole
c) Diloxanide
d) Tetracycline

20. Tick the drug, blocking acetylcholine transmission at the myoneural junction of helminthes:

a) Levamisole
b) Mebendazole
c) Piperazine
d) Niclosamide

21. Tick niclosamide mechanism of action:

a) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement

and death of helminthes
b) Blocking acetylcholine transmission at the myoneural junction and paralysis of
helminthes
c) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose
uptake
d) Inhibiting oxidative phosphorylation in some species of helminthes

22. Tick praziquantel mechanism of action:

a) Blocking acetylcholine transmission at the myoneural junction and paralysis of

helminthes
b) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose
uptake
c) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement
and death of helminthes
d) Inhibiting oxidative phosphorylation in some species of helminthes

23. Tick piperazine mechanism of action:

a) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose

uptake
b) Blocking acetylcholine transmission at the myoneural junction and paralysis of
helminthes
c) Inhibiting oxidative phosphorylation in some species of helminthes
d) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement
and death of helminthes

73
24. Tick the drug, a salicylamide derivative:

a) Praziquantel
b) Piperazine
c) Mebendazole
d) Niclosamide

25. Tick mebendazole mechanism of action:

a) Inhibiting oxidative phosphorylation in some species of helminthes

b) Increasing cell membrane permeability for calcium, resulting in paralysis, dislodgement
and death of helminthes
c) Inhibiting microtubule synthesis in helminthes and irreversible impairment of glucose
uptake
d) Blocking acetylcholine transmission at the myoneural junction and paralysis of
helminthes

26. Tick the drug, inhibiting oxidative phosphorylation in some species of helminthes:

a) Niclosamide
b) Piperazine
c) Praziquantel
d) Mebendazole

27. Tick the drug for neurocysticercosis treatment:

a) Praziquantel
b) Pyrantel
c) Piperazine
d) Bithionol

28. Tick the drug for nematodosis (roundworm invasion) treatment:

a) Niclosamide
b) Praziquantel
c) Bithionol
d) Pyrantel

29. Tick the drug for cestodosis (tapeworm invasion) treatment:

a) Piperazine
b) Praziquantel
c) Pyrantel
d) Ivermectin

74
30. Tick the drug for trematodosis (fluke invasion) treatment:

a) Bithionol
b) Ivermectin
c) Pyrantel
d) Metronidazole

31. Tick the drug, a benzimidazole derivative:

a) Praziquantel
b) Mebendazole
c) Suramin
d) Pyrantel

32. Tick the broad spectrum drug for cestodosis, trematodosis and cycticercosis treatment:

a) Piperazine
b) Ivermectine
c) Praziquantel
d) Pyrantel

33. Tick the drug for ascaridosis and enterobiosis treatment:

a) Bithionol
b) Pyrantel
c) Praziquantel
d) Suramin

34. Tick the drug for strongiloidosis treatment:

a) Niclosamide
b) Praziquantel
c) Bithionol
d) Ivermectin

35. Tick the drug for echinococcosis treatment:

a) Suramin
b) Mebendazole or Albendazole
c) Piperazine
d) Iodoquinol

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 ANTIVIRAL AGENTS. AGENTS FOR CHEMOTHERAPY OF CANCER

1. All of the following antiviral drugs are the analogs of nucleosides, EXCEPT:

a) Acyclovir
b) Zidovudine
c) Saquinavir
d) Didanozine

2. Tick the drug, a derivative of adamantane:

a) Didanozine
b) Rimantadine
c) Gancyclovir
d) Foscarnet

3. Tick the drug, a derivative of pyrophosphate:

a) Foscarnet
b) Zidovudine
c) Vidarabine
d) Acyclovir

4. Tick the drug, inhibiting viral DNA synthesis:

a) Interferon
b) Saquinavir
c) Amantadine
d) Acyclovir

5. Tick the drug, inhibiting uncoating of the viral RNA:

a) Vidarabine
b) Rimantadine
c) Acyclovir
d) Didanozine

6. Tick the drug, inhibiting viral reverse transcriptase:

a) Zidovudine
b) Vidarabine
c) Rimantadine
d) Gancyclovir

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7. Tick the drug, inhibiting viral proteases:

a) Rimantadine
b) Acyclovir
c) Saquinavir
d) Zalcitabine

8. Tick the drug of choice for herpes and cytomegalovirus infection treatment:

a) Saquinavir
b) Interferon alfa
c) Didanozine
d) Acyclovir

9. Tick the drug which belongs to nonnucleoside reverse transcriptase inhibitors:

a) Zidovudine
b) Vidarabine
c) Nevirapine
d) Gancyclovir

10. All of the following antiviral drugs are antiretroviral agents, EXCEPT:

a) Acyclovir
b) Zidovudine
c) Zalcitabine
d) Didanozine

11. Tick the drug used for influenza A prevention:

a) Acyclovir
b) Rimantadine
c) Saquinavir
d) Foscarnet

12. Tick the drug used for HIV infection treatment, a derivative of nucleosides:

a) Acyclovir
b) Zidovudine
c) Gancyclovir
d) Trifluridine

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13. Tick the antiviral drug which belongs to endogenous proteins:

a) Amantadine
b) Saquinavir
c) Interferon alfa
d) Pencyclovir

14. Tick the drug which belongs to nucleoside reverse transcriptase inhibitors:

a) Didanosine
b) Gancyclovir
c) Nevirapine
d) Vidarabine

15. All of the following antiviral drugs are anti-influenza agents, EXCEPT:

a) Acyclovir
b) Amantadine
c) Interferons
d) Rimantadine

16. Tick the unwanted effects of zidovudine:

a) Hallucinations, dizziness
b) Anemia, neutropenia, nausea, insomnia
c) Hypertension, vomiting
d) Peripheral neuropathy

17. Tick the unwanted effects of intravenous acyclovir infusion:

a) Renal insufficiency, tremors, delerium

b) Rash, diarrhea, nausea
c) Neuropathy, abdominal pain
d) Anemia, neutropenia, nausea, insomnia

18. Tick the drug that can induce peripheral neuropathy and oral ulceration:

a) Acyclovire
b) Zalcitabine
c) Zidovudine
d) Saquinavir

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19. Tick the unwanted effects of didanozine:

a) Hallucinations, dizziness, insomnia

b) Anemia, neutropenia, nausea
c) Hypertension, vomiting, diarrhea
d) Peripheral neuropathy, pancreatitis, diarrhea, hyperuricemia

20. Tick the unwanted effects of indinavir:

a) Hypotension, vomiting, dizziness

b) Nephrolithiasis, nausea, hepatotoxicity
c) Peripheral neuropathy, pancreatitis, hyperuricemia
d) Anemia, neutropenia, nausea

21. Tick the drug that can induce nausea, diarrhea, abdominal pain and rhinitis:

a) Acyclovire
b) Zalcitabine
c) Zidovudine
d) Saquinavir

22. All of the following effects are disadvantages of anticancer drugs, EXCEPT:

a) Low selectivity to cancer cells

b) Depression of bone marrow
c) Depression of angiogenesis
d) Depression of immune system

23. Rational combination of anticancer drugs is used to:

a) Provide synergism resulting from the use of anticancer drugs with different mechanisms
combination
b) Provide synergism resulting from the use of anticancer drugs with the same mechanisms
combination
c) Provide stimulation of immune system
d) Provide stimulation of cell proliferation

24. Tick the anticancer alkylating drug, a derivative of chloroethylamine:

a) Methotrexate
b) Cisplatin
c) Cyclophosphamide
d) Carmustine

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25. Tick the anticancer alkylating drug, a derivative of ethylenimine:

a) Mercaptopurine
b) Thiotepa
c) Chlorambucil
d) Procarbazine

26. Tick the group of hormonal drugs used for cancer treatment:

a) Mineralocorticoids and glucocorticoids

b) Glucocorticoids and gonadal hormones
c) Gonadal hormones and somatotropin
d) Insulin

27. Tick the anticancer alkylating drug, a derivative of alkylsulfonate:

a) Fluorouracil
b) Carboplatin
c) Vinblastine
d) Busulfan

28. Tick the anticancer drug of plant origin:

a) Dactinomycin
b) Vincristine
c) Methotrexate
d) Procarbazine

29. Action mechanism of alkylating agents is:

a) Producing carbonium ions altering protein structure

b) Producing carbonium ions altering DNA structure
c) Structural antagonism against purine and pyrimidine
d) Inhibition of DNA-dependent RNA synthesis

30. Tick the anticancer drug, a pyrimidine antagonist:

a) Fluorouracil
b) Mercaptopurine
c) Thioguanine
d) Methotrexate

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31. Methotrexate is:

a) A purine antagonist
b) A folic acid antagonist
c) An antibiotic
d) An alkylating agent

32. Tick the antibiotic for cancer chemotherapy:

a) Cytarabine
b) Doxorubicin
c) Gentamycin
d) Etoposide

33. Fluorouracil belongs to:

a) Antibiotics
b) Antimetabolites
c) Plant alkaloids
d) Bone marrow growth factor

34. Tick the action mechanism of anticancer drugs belonging to plant alkaloids:

a) Inhibition of DNA-dependent RNA synthesis

b) Cross-linking of DNA
c) Mitotic arrest at a metaphase
d) Nonselective inhibition of aromatases

35. General contraindications for anticancer drugs are:

a) Depression of bone marrow

b) Acute infections
c) Severe hepatic and/or renal insufficiency
d) All of the above

36. Action mechanism of methotrexate is:

a) Inhibition of dihydrofolate reductase

b) Activation of cell differentiation
c) Catabolic depletion of serum asparagine
d) All of the above

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37. Tick the anticancer drug belonging to inorganic metal complexes:

a) Dacarbazine
b) Cisplatin
c) Methotrexate
d) Vincristine

38. Tick the indication for estrogens in oncological practice:

a) Leukemia
b) Cancer of prostate
c) Endometrial cancer
d) Brain tumors

39. Enzyme drug used for acute leukemia treatment:

a) Dihydrofolate reductase
b) Asparaginase
c) Aromatase
d) DNA gyrase

40. All of the following drugs are derivatives of nitrosoureas, EXCEPT:

a) Carmustine
b) Vincristine
c) Lomustine
d) Semustine

41. Tick the group of drugs used as subsidiary medicines in cancer treatment:

a) Cytoprotectors
b) Bone marrow growth factors
c) Antimetastatic agents
d) All of the above

42. Tick the estrogen inhibitor:

a) Leuprolide
b) Tamoxifen
c) Flutamide
d) Anastrozole

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43. Tick the antiandrogen drug:

a) Flutamide
b) Aminoglutethimide
c) Tamoxifen
d) Testosterone

44. Tick the drug belonging to aromatase inhibitors:

a) Octreotide
b) Anastrozole
c) Flutamide
d) Tamoxifen

45. Tick the drug belonging to gonadotropin-releasing hormone agonists:

a) Leuprolide
b) Tamoxifen
c) Flutamide
d) Anastrozole

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