1) How are metabolites NOT excreted?

a) Into the feces

b) Through shedding of epithelial cells
c) Into the urine
d) Through breathing
2) Which reaction is NOT part of phase I
biotransformation?
a) Oxidation
b) Reduction
c) Hydrolysis
d) Sulfation
3) Which drug is a CYP450 inhibitor?
a) Ritonavir
b) Phenytoin
c) PHB
d) Carbamazepine
4) Which drug is a CYP450 inducer?
a) Carbamazepine
b) Erythromycin
c) Ritonavir
d) Omeprazole
5) Which reaction is NOT part of phase I
biotransformation?
a) Methylation
b) Glutathionylation
c) Phosphorylation
d) Glucuronidation
6) Excretion of drugs is MOST affected in
which
condition?
a) Gastritis
b) Inflammatory Bowel Disease
c) Chronic Kidney Disease
d) Pneumonia
7) What is the effect on excretion of a drug,
if it has
increased binding to albumin?
a) Increased
b) Decreased
c) Remains the same
d) First increases, then decreases
8) A patient has been prescribed Warfarin
(99% plasma
protein bound) and Aspirin (80% plasma
protein
bound). What side effect could MOST LIKELY
be
seen in this patient?
a) Bleeding tendency
b) Clotting tendency
c) Both a & b
d) None of the above
9) A patient with previous history of
Myocardial
Infarction was prescribed with prophylaxis
of Aspirin
(80% plasma protein bound). During a
recent checkup,
he was diagnosed with Diabetes Mellitus,
and
was prescribed with an oral hypoglycemic
drug,
Tolbutamide, which acts by increasing
insulin
secretion (60% plasma protein bound).
Which side
effect could this patient MOST LIKELY
present with?
a) Bleeding tendency
b) Hypoglycemia
c) Hyperglycemia
d) Both a & b
10) Which combination of characteristics of
a drug will
help in promoting its excretion?
a) Water soluble, unionized
b) Lipid soluble, unionized
c) Water soluble, ionized
d) Lipid soluble, ionized
11) Which combination of characteristics of
a drug will
help in promoting its reabsorption from
DCT?
a) Water soluble, non-polar
b) Lipid soluble, non-polar
c) Water soluble, polar
d) Lipid soluble, polar
12) A patient diagnosed with depression
was prescribed
with amitriptyline. He doesn’t take his
medication
regularly. He got fired from his job as he
refused to
meet deadlines and due to lack of focus.
This
triggered him into taking 20 of his tablets.
His wife
noticed this and immediately drove him to
the
hospital. After ensuring his vitals are stable,
what is
the MAIN component that should be given in
his
fluids?
a) Bicarbonate
b) Phosphate
c) Sulphate
d) Chloride
13) Alkalization of urine by giving
bicarbonate is used to
treat patients presenting with
phenobarbital (weak
acid) overdose. Which of the following best
describes the rationale for alkalization of
urine in this
setting?
a) To reduce tubular reabsorption of
phenobarbital
b) To decrease ionization of phenobarbital
c) To increase glomerular filtration of
phenobarbital
d) To decrease proximal tubular secretion
e) To increase tubular reabsorption of
phenobarbital
14) NN610 is an investigational
cholesterol-lowering
agent. Has a high molecular weight and
is
extensively bound to albumin. NN will
have a _____
apparent volume of distribution (Vd)
a) High
b) Low
c) Extremely high
d) Normal
15) A 40-year-old male patient (70 kg)
was recently
diagnosed with infection involving
methicillinresistant
S. aureus. He received 2000 mg of
Vancomycin dose. The peak plasma
concentration of
Vancomycin was 28.5 mg/L.
The apparent volume of distribution is:
a) 1 L/kg
b) 7 L/kg
c) 10 L/kg
d) 14 L/kg
e) 70 L/kg
16) Levodopa is a drug very commonly
used to treat
Parkinson’s disease that acts by being
converted to
dopamine in the brain. Which property
should it have
in order to being able to cross the BBB?
a) Large and polar
b) Large and nonpolar
c) Hydrophobic
d) Bound to proteins
17) What is the formula to determine Vd
of a drug?
a) Vd = F x dose / C
b)Vd = F / dose x C
c)Vd = C x F / C
d)Vd = F + dose / C
18) Which of the following organs is crucial
in the
elimination of drugs?
a) Kidney
b) Lungs
c) Salivary glands
d) Lacrimal glands
19) The fraction of the drug that is
eliminated per unit
time is constant, this principle is related to
which
type of elimination kinetics?
a) Zero-order kinetics
b) First-order kinetics
c) Second-order kinetics
d) None of the above
20) What is the correct sentence with
respect to firstorder
kinetics?
a) The amount of drug given to a patient is
directly
proportional to the rate of elimination
b) The amount of drug given to a patient is
inversely
proportional to the rate of elimination
c) The rate of elimination for these drugs is
independent of concentration of the drug given
d) Both a & c
21) What is the portion of the drug where it
is considered
that the drug has reached steady state?
a) 75%
b) 85%
c) 95%
d) 100%
22) Which of the following drugs do not
follow zeroorder
kinetics?
a) Phenytoin
b) Ethanol
c) Salicylates
d) Paracetamol
23) 18-year-old female brought to ED due to
drug
overdose. Which route is most desirable for
administering the antidote?
a) IM
b) IV
c) Oral
d) SC
24) Drug A is a weakly basic drug with a pKA
of 7.8. If
administered orally, at which of the
following sites of
absorption will the drug be able to readily
pass
through the membrane?
a) Mouth (pH 7.0)
b) Stomach (pH 2.5)
c) Duodenum (pH 6.1)
d) Jejunum (pH 8.0)
e) Ileum (pH 7.0)
25) Which mechanism of transport requires
ATP to move
the molecule across the cell membrane?
a) Passive diffusion
b) Facilitated diffusion
c) Active transport
d) Endocytosis
26) Which of the following drugs would have
the highest
bioavailability based on its administration
route?
a) Penicillin G taken orally
b) Nitroglycerin taken orally
c) Insulin taken intravenously
d) Vitamin B12 taken orally
27) Which of the following routes has a
100%
bioavailability?
a) Intramuscular
b) Subcutaneous
c) Oral
d) Intravenous
e) Sublingual
28) Which is the best place for the
absorption of weak
acid drugs?
a) Stomach
b) Proximal duodenum
c) Distal Duodenum
d) Distal ileum
29) How can weak bases be absorbed in the
GI tract?
e) ↓ protons to ↑ B
f) ↓ protons to ↑ BH+
g) ↑ protons to ↑ B
h) ↑ protons ↓ BH+
30) Why does absorption of drugs decrease
in shock states?
i) There is a reduced surface area of the GIT
j) There is reduced blood perfusion to the organs
that
absorb the drugs
k) Contact time of the drug to the GIT cells is
reduced
l) Shock patients have P-glycoproteins in the cell
membrane which inhibit absorption of drugs.
31) What is the result of P-Glycoprotein
action in the GI
system?
m) Multidrug resistance
n) Inflammatory Bowel Disease
o) Decreased Total Surface Area
p) Decrease contact time
32) What is the formula to determine
bioavailability of a
drug?
q) F = AUC IV / AUC oral
r) F = AUC IV x AUC oral
s) F = AUC oral / AUC IV
t) F = [Oral Dose] / AUC IV
33) Which of the following is TRUE about
pharmacodynamics?
a) What drug does to the body
b) What body does to the drug
c) Involves ADME
d) Concerned in first pass effect
34) GABA-A receptors are examples of
a) Ligand-gated ion channel receptors
b) Intracellular receptors
c) GPCR
d) None of the above
35) Which G-protein is responsible for the
breaking down
of PIP2 when activated?
a) Gq
b) Gi
c) Gs
d) Gd
36) Ligand-gated ion channel receptors are
classified as
extracellular receptors that are related to
influx and
efflux of ions
a) True
b) False
37) G-stimulatory proteins work by
activating adenylate
cyclase in order to activate protein kinase A
a) True
b) False
38) Which of the following ligands will not
be able to utilize
the extracellular receptor pathway
a) Large
b) Polar
c) Hydrophilic
d) Uncharged
39) Which of the following is TRUE about
tolerance?
a) Due to chronic exposure to a drug
b) Due to successive stimulation of the receptors
c) Employs the same mechanisms as
tachyphylaxis
except that it does not involve inactivation by
arrestin
d) All the choices are correct
40) Which of the following is NOT true about
tyrosine
kinase receptors
a) Its cytosolic domain has tyrosine kinase
activity
b) Its extracellular domain is for ligand-binding
c) Tyrosines cross-phosphorylate each other
d) Tyrosine kinase receptors start out as inactive
dimers.
41) Which of the following is TRUE about
drug potency?
a) The stronger the interaction, the higher the
affinity,
the less potent the drug is
b) Higher potency usually produces higher
efficacy
c) Potency can be measured with EC50 and this is
inversely proportional to each other
d) All of the above
42) Which of the following is FALSE about
drug
efficacy?
a) Efficacy can be measured through Emax
b) A higher efficacious drug shifts the curve to the
right
c) Efficacy is dependent upon the drug-receptor
interaction and intrinsic activity of the drug
d) All of the above
43) Which of these drugs should be
monitored
CLOSELY?
a) Amoxicillin
b) Bumetanide
c) Digoxin
d) All of the above
44) Partial agonists may act as antagonist
a) True
b) False
45) Competitive agonist decreases Emax
a) True
b) False
46) Which type of drugs that may cause the
receptor
activity to be lower than basal activity?
a) Full agonist
b) Partial agonist
c) Inverse agonist
d) Competitive antagonist
e) Uncompetitive antagonist
47) Sarin is a nerve gas that is an
organophosphate
cholinesterase inhibitor. Which agent could
be used
as an antidote to sarin poisoning?
a. Pilocarpine
b. Carbachol
c. Atropine
d. Physostigmine.
48) A patient with asthma was prescribed a
β2 agonist
for acute relief of bronchospasm, but did
not respond
to treatment. Which drug is the most likely
next
option for this patient?
a. Benztropine
b. Ipratropium
c. Oxybutynin
d. Physostigmine
49) A 50-year-old male who is noncompliant
with
medications was recently diagnosed with
COPD. His
physician would like to prescribed an
inhaled
anticholinergic that is dosed once or twice
daily.
Which drug is most appropriate for this
patient?
a. Atropine
b. Ipratropium
c. Tiotropium
d. Trospium
50) Which is the most effective drug for
motion sickness
for a person planning to go on a cruise?
a. Atropine
b. Fesoterodine
c. Scopolamine
d. Tropicamide
51) Which drug is useful in treating sinus
bradycardia?
a. Atropine
b. Cisatracurium
c. Neostigmine
d. Succinylcholine
52) CN III, CN VII, CN IX, CN X are the cranial
nerves that
have sympathetic fibers
a) True
b) False
53) Bethanechol, methacholine, and
pilocarpine works
on both muscarinic receptors and nicotinic
receptors
a) True
b) False
54) When acetylcholine binds to muscarinic
receptor
(M3) in the smooth muscle, it will cause
relaxation of
the muscle
a) True
b) False
55) Indirect cholinergic agonists’
mechanism of action is
the inhibition of acetylcholinesterase
a) True
b) False
56) Which drugs below are classified as
indirect
cholinergic agonists? (May choose more
than one)
a) Bethanechol
b) Carbachol
c) Edrophonium
d) Neostigmine
e) Pilocarpine
f) Pyridostigmine
g) Rivastigmine
57) Which of the following is NOT a part of
the cholinergic
crisis?
a) Miosis
b) Constipation
c) Lacrimation
d) Bradycardia
58) What is the is used for Tensilon Test?
a) Neostigmine
b) Edrophonium
c) Rivastigmine
d) Atropine
59) What is the drug of choice for
glaucoma?
a) Pilocarpine
b) Carbachol
c) Physostigmine
d) Any of the above
60) Which drug is used to treat a patient
who has
hypertension and BPH?
a) Tamsulosin
b) Prazosin
c) Phenoxybenzamine
d) Propranolol
61) What is the adverse effect of
prazosin?
a) Blurring of vison
b) Precipitation of angle closure glaucoma
c) Hypertension
d) Orthostatic hypotension
62) A 60-year old patient started a new
antihypertensive
medication. His blood pressure is well
controlled, but
he complains of fatigue, drowsiness,
and fainting
when he gets up from the bed
(orthostatic
hypertension). Which of the following
drugs is he
most likely taking?
a. Metoprolol
b. Propranolol
c. Prazosin
d. Alfusozin
63) A 30-year-old male patient was
brought to the ER
with amphetamine overdose. He
presented with high
BP and arrhythmias. Which drug is the
most
appropriate to treat the cardiovascular
symptoms of
amphetamine overdose in this patient?
a. Metoprolol
b. Prazosin
c. Labetalol
d. Nebivolol
64) A β-blocker was prescribed for
hypertension in a
patient with asthma. After a week of
treatment, the
asthma attacks got worse, and the
patient was asked
to stop taking the β-blocker. Which β-
blocker would
you suggest as an alternative that is less
likely to
worsen the asthma?
a. Propranolol
b. Metoprolol
c. Labetalol
d. Carvedilol
65) A 70-year-old male is treated with
doxazosin for
overflow incontinence due to his
enlarged prostate.
He complains of dizzy spells while
getting up from
bed at night. Which drug would you
suggest as an
alternative that may not cause
dizziness?
a. Propranolol
b. Phentolamine
c. Tamsulosin
d. Terazosin

Answer key
1b 2d 3a 4a 5c 6c 7b 8a
9b 10c 11b 12d 13a 14b 15a 16c
17d 18a 19b 20a 21c 22.d 23b 24e
25c 26c 27d 28a 29a 30b 31a 32c
33a 34a 35a 36a 37a 38b 39d 40d
41c 42b 43c 44a 45b 46c 47c 48b
49c 50c 51a 52b 53b 54b 55a 56
 skip
57b 58b 59a 60c 61d 62c 63c 64b
65c