1. All of the following are general mechanisms of drug permeation Except (a) Aqueous diffusion (b) Aqueous hydrolysis (c) Lipid diffusion (d) Pinocytosis or endocytosis (e) Special carrier transport
2. If the plasma concentration of a drug declines with “first-order kinetics”, this means that (a) There is only one metabolic path for drug disposition (b) The half-life is the same regardless of the plasma concentration (c) The drug is largely metabolized in the liver after oral administration and has low bioavailability elimination (d) The rate of climination is proportionate to the rate of administration at all times (e) The drug is not distributed outside the vascular system
3. Regarding termination of drug action (a) Drug must be exerted from the body to terminate their action (b) Metabolism of drugs always increases their water solubility (c) Metabolism of drugs always abolishes their pharmacologic activity (d) Hepatic metabolism and renal excretion are the two most important mechanisms involved (e) Distribution of a drug out of the bloodstream terminates the drug’s effect
4. Distribution of drugs to specific tissues (a) Is independent of blood flow to the organ (b) Is independent of the solubility of the drug in that tissue (c) Depends on the unbound drug concentration gradient between blood and tissue (d) Is increased for drugs that are strongly bound to plasma proteins (e) Has no effect on the half-life of the drug
5. A physical process by which a weak acid becomes less water-soluble and more lipid-soluble at low pH is (a) Distribution (b) Elimination (c) First-pass effect (d) Permeation (e) Protonation
6. Dose-response curves are used for drug evaluation in the animal laboratory and in the clinic, Quantal dose-response curves are often (a) Used for determining the therapeutic index of a drug (b) Used for determining the maximal efficacy of a drug (c) Invalid in the presence of inhibitors of the drug being studied (d) Obtained from the study of intact subject but not from isolated tissue preparations (e) Used to determine the statistical variation (standard deviation) of the maximal response to the drug.
7. The following are excreted faster in basic urine (a) Weak acids (b) Strong acids (c) Weak Bases (d) None of the above
8. Which of the following statements about spare receptors is most correct ? (a) Spare receptors, in the absence of drug, are sequestered in the cytoplasm (b) Spare receptors will be detected if the intracellular effect of drug-receptor interaction lasts longer than the drug-receptor interaction itself (c) Spare receptors influence the maximal efficacy of the drug-receptor system (d) Spare receptors activate the effector machinery of the cell without the need for a drug (e) Spare receptors may be detected by the finding that the EC50 is greater than the Kd for the agonist
9. Which of the following terms best describes an antagonist that interacts directly with the agonist and not at all or only incidentally, with the receptor ? (a) Pharmacological antagonist (b) Partial agonist (c) Physiological antagonist (d) Chemical antagonist (e) Noncompetitive antagonist
10. Which of the following terms best describes a drug that blocks the action of epinephrine at its receptors by occupying those receptors without activating them ? (a) Pharmacological antagonist (b) Partial agonist (c) Physiological antagonist (d) Chemical antagonist (e) Noncompetitive antagonist
11. Which of the following provides information about the variation in sensitivity of the drug within the population studied ? (a) Maximal efficacy (b) Therapeutic index (c) Drug potency (d) Grade dose-response curve (e) Quantal dose-response curve
12. Which of the following most accurately describes the transmembrane signaling process involved in steroid hormone action ? (a) Action on a membrane spanning tyrosine kinase (b) Activation of a G protein which activates or inhibits adenyl cyclase (c) Diffusion into the cytoplasm and binding to an intracellular receptor (d) Diffusion of “STAT” molecules across the membrane (e) Opening of transmembrane ion channels
13. Which of the following is a phase II drugmetabolizing reaction ? (a) Acetylation (b) Deamination (c) Hydrolysis (d) Oxidation (e) Reduction
14. Which of the following drugs may inhibit the hepatic microsomal P450 responsible for warfarin metabolism (a) Cimetidine (b) Ethanol (c) Phenobarbital (d) Procainamide (e) Rifampin
15. With regard to clinical trials of new drugs, which of the following is most correct ? (a) Phase I involves the study of a small number of normal volunteers by highly trained clinical pharmacologists (b) Phase II involves the use of the new drug in a large number of patients (100-5000) who have the disease to be treated (c) Phase III involves the determination of the drug’s therapeutic index by the cautious induction of toxicity (d) Chemical antagonist (e) Phase II requires the use of a positive control (a known effective drug) and a placebo
16. Animal testing of potential new therapeutic agents (a) Extends over a time period of at least 3 years in order to discover late toxicities (b) Requires the use of at least two primate species, eg. Monkey and baboon (c) Requires the submission of histopathologic slides and specimens to the FDA for government evaluation (d) Has good predictability for drug allergy-type reactions (e) May be abbreviated in the case of some very toxic agents used in cancer
17. The “dominant lethal” test involves the treatment of a male adult animal with a chemical before mating; the pregnant female is later examined for fetal death and abnormalities. The dominant lethal test therefore is a test of (a) Teratogenicity (b) Mutagenicity (c) Carcinogenicity (d) All of the above (e) None of the above
18. The Ames test is a method for detecting (a) Carcinogenesis in rodents (b) Carcinogenesis in primates (c) Teratogenesis in any mammalian species (d) Teratogenesis in primates (e) Mutagenesis in bacteria
19. “Nicotinic” sites include all of the following except (a) Bronchial smooth muscle (b) Adrenal medullary cells (c) Parasympathetic ganglia (d) Skeletal muscle (e) Sympathetic ganglia
20. A good example of chemical antagonism (a) Heparin & Protamine (b) Protamine & Zinc (c) Heparin & Prothrombin (d) All the above
21. Which of the following agents is a prodrug that is much less toxic in mammals than in insects ? (a) Acetylcholine (b) Bethanechol (c) Physostigmine (d) Pilocarpine (e) Neostigmine
22. Phenylephrine causes (a) Constriction of vessels in the nasal mucosa (b) Increased gastric secretion and motility (c) Increased skin temperature (d) Miosis (e) All of the above
23. Pretreatment with propranolol will block which one of the following ? (a) Methacholine-induced tachycardia (b) Nicotine-induced hypertension (c) Norepinephrine-induced bradycardia (d) Phenylephrine-induced mydriasis
24. Most drug receptors are (a) Small molecules with a molecular weight between 100 and 1000 (b) Lipids arranged in a bilayer configuration (c) Proteins located on cell membranes or in the cytosol (d) DNA molecules (e) RNA molecules
25. With regard to distribution of a drug from the blood into tissues (a) Blood flow to the tissue is an important determinant (b) Solubility of the drug in the tissue is an important determinant (c) Concentration of the drug in the blood is an important determinant (d) Size (volume) of the tissue is an important determinant (e) All of the above are important determinants
26. The pH value is calculated mathematically as the (a) Log of the hydroxyl ion (OH–) concentration (b) Negative log of the OH– concentration (c) Log of the hydrogen ion (H+) concentration (d) Negative log of the H+ concentration (e) Ratio of H+/OH– concentration
27. Which property is classified as colligative? (a) Solubility of a solute (b) Osmotic pressure (c) Hydrogen ion (H+) concentration (d) Dissociation of a solute (e) Miscibility of the liquids
28. The colligative properties of a solution are related to the (a) pH of the solution (b) Number of ions in the solution (c) Total number of solute particles in the solution (d) Number of unionized molecules in the solution (e) pKa of the solution
29. The pH of a buffer system can be calculated with the (a) Noyes – Whitney equation (b) Henderson – Hasselbalch equation (c) Michaelis – Menten equation (d) Yong equation (e) Stokes equation
30. Which mechanism is most often responsible for chemical degradation? (a) Racemization (b) Photolysis (c) Hydrolysis (d) Decarboxylation (e) Oxidation
31. Which equation is used to predict the stability of a drug product at room temperature from experiments at accelerated temperature? (a) The stokes equation (b) The Yong equation (c) The Arrhenius equation (d) The Michaelis – Menten equation (e) The Hixson – Crowell equation
32. Based on the relation between the degree of ionization and the solubility of a weak acid, the drug aspirin (pKa 3.49) will be most soluble at (a) pH 1.0 (b) pH 2.0 (c) pH 3.0 (d) pH 4.0 (e) pH 6.0
33. The particle size of the dispersed solid in a suspension is usually greater than (a) 0.5 µm (b) 0.4 µm (c) 0.3 µm (d) 0.2 µm (e) 0.1 µm
34. In the extemporaneous preparation of a suspension, levigation is used to (a) Reduce the zeta potential (b) Avoid bacterial growth (c) Reduce particle size (d) Enhance viscosity (e) Reduce viscosity
35. Active transport differs from facilitated transport in following ways, except (a) Carrier is involved (b) It is against concentration gradient (c) Energy is required (d) All of the above
36. Vanishing cream is an ointment that may be classified as (a) A water –soluble base (b) An oleaginous base (c) An absorption base (d) An emulsion base (e) An oleic base
37. Rectal suppositories intended for adult use usually weigh approximately (a) 1g (b) 2g (c) 3g (d) 4g (e) 5g
38. In the fusion method of making cocoa butter suppositories,which substance is most likely to be used to lubricate the mold? (a) Mineral oil (b) Propylene glycol (c) Cetyl alcohol (d) Stearic acid (e) Magnesium silicate
39. A very fine powdered chemical is defined as one that (a) Completely passes through a # 80 sieve (b) Completely passes through a # 120 sieve (c) Completely passes through a # 20 sieve (d) Passes through a # 60 sieve and not more than 40% through a # 100 sieve (e) Passes through a # 40 sieve and not more than 60% through a # 60 sieve
40. Which technique is typically used to mill camphor? (a) Trituration (b) Levigation (c) Pulverization and intervention (d) Geometric dilution (e) Attrition
41. Which type of paper best protects a divided hygroscopic powder? (a) Waxed paper (b) Glassine (c) White bond (d) Blue bond (e) Vegetable parchment
42. Which capsule size has the smallest capacity? (a) 5 (b) 4 (c) 1 (d) 0 (e) 000
43. The shells of soft gelatin capsules may be made elastic or plastic–like by the addition of (a) Sorbitol (b) Povidone (c) Polyethylene glycol (d) Lactose (e) pKa of the solution
44. Nonionic surface-active agents used as synthetic emulsifiers include (a) Tragacanth (b) Sodium lauryl sulphate (c) Sorbitan esters(spans)
45. A ceramic mortar may be preferable to a glass mortar when (a) A volatile oil is added to a powder mixture (b) Colored substances (dyes) are mixed into a powder (c) Comminution is desired in addition to mixing (d) None of these
46. Divided powders may be dispensed in (a) Individual-dose packets (b) A bulk container (c) A perforated, sifter –type container
47. Agents that may be used to coat enteric coated tablets include (a) Hydroxypropyl methyl cellulose (b) Carboxymethyl cellulose (c) Cellulose acetate phthalate
51. The route of drug administration that gives the most rapid onset of the pharmacological effect is (a) Intramuscular injection (b) Intravenous injection (c) Intradermal injection (d) Peroral administration (e) Subcutaneous injection
52. Acidic drugs mainly bind to plasma (a) Albumin (b) á1 – acid glycoprotein (c) Both (a) and (b) (d) None of the above
53. After peroral administration, drugs generally are absorbed best from the (a) Buccal cavity (b) Stomach (c) Duodenum (d) Ileum (e) Rectum
54. The passage of drug molecules from a region of high drug concentration to a region of low drug concentration is known as (a) Active transport (b) Bioavailability (c) Biopharmaceutics (d) Simple diffusion (e) Pinocytosis
55. What equation describes the rate of drug dissolution from a tablet? (a) Fick’s law (b) Henderson – Hasselbach equation (c) Law of mass action (d) Michaelis – Menten equation (e) Noyes Whitney equation
56. Dose dumping is a problem in the formulation of (a) Compressed tablets (b) Modified- release drug products (c) Hard gelatin capsules (d) Soft gelatin capsules (e) Suppositories
57. The rate of drug bioavailability is most rapid when the drug is formulated as a (a) Controlled – release product (b) Hard gelatin capsule (c) Compressed tablet (d) Solution (e) Suspension
58. Creatinine clearance is used as a measurement of (a) Renal excretion rate (b) Glomerular filtration rate (GFR) (c) Active renal secretion (d) Passive renal absorption (e) Drug metabolism rate
59. The earliest evidence that a drug is stored in tissue is (a) An increase in plasma protein binding (b) A large apparent volume of distribution (VD) (c) A decrease in the rate of formation of metabolites by the liver (d) An increase in the number of side effects produced by the drug (e) A decrease in the amount of free drug excreted in the urine
60. The intensity of the pharmacologic action of a drug is most dependent on the (a) Concentration of the drug at the receptor site (b) Elimination half-life (t½ ) of the drug (c) Onset time of the drug after oral administration (d) Minimum toxic concentration (MTC) of the drug in plasma (e) Minimum effective concentration (MEC) of the drug in the body
61. Drug that show nonlinear pharmacokinetics have which property? (a) A constant ratio of drug metabolites is formed as the administered dose increases (b) The elimination half-life (t½) increases as the administered dose increases (c) The area under the plasma drug concentration versus time curve (AUC) increases in direct proportion to an increase in the administered dose (d) Both low and high doses follow first-order elimination kinetics (e) The steady-state drug concentration increases in direct proportion to the dosing rate
62. The loading dose (DL) of a drug is usually based on the (a) Total body clearance (ClT) of the drug (b) Percentage of drug bound to plasma proteins GENERAL PHARMACOLOGY 7 (c) Fraction of drug excreted unchanged in the urine (d) Apparent volume of distribution (VD) and desired drug concentration in plasma (e) Area under the plasma drug concentration versus time curve (AUC)
63. The renal clearance of insulin is used as a measurement of (a) Effective renal blood flow (b) Rate of renal drug excretion (c) Intrinsic enzyme activity (d) Active renal secretion (e) Glomerular filtration rate (GFR)
64. All of the following statements about plasma protein binding of a drug are true except (a) Displacement of a drug from plasma protein binding sites results in a transient increased volume of distribution (VD) (b) Displacement of a drug from plasma protein binding sites makes more free drug available for glomerular filtration (c) Displacement of a potent drug that is normally more than 95% bound may cause toxicity (d) Albumin is the major protein involved in protein binding of drugs (e) Drugs that are highly bound to plasma proteins generally have a greater VD compared with drugs that are highly bound to tissue proteins
65. _______ is expressed in both the intestinal epithelium and the kidney. (a) CYP2D6 (b) CYP1A1/2 (c) CYP3A4 (d) CYP2E1
66. The initial distribution of a drug into tissue is determined chiefly by the (a) Rate of blood flow to tissue (b) Glomerular filtration rate (GFR) (c) Stomach emptying time (d) Affinity of the drug for tissue (e) Plasma protein binding of the drug
67. Which tissue has the greatest capacity to bio-transform drugs? (a) Brain (b) Kidney (c) Liver (d) Lung (e) Skin
68. The principle of superposition in designing multiple-dose regimens assumes that (a) Each dose affects the next subsequent dose causing nonlinear elimination (b) Each dose of drug is eliminated by zero-order elimination (c) Steady-state plasma drug concentration are reached at approximately 10 half-lives (d) Early doses of drug do not affect subsequent doses (e) The fraction of drug absorbed is equal to the fraction of drug eliminated
69. Which equation is true for a zero-order reaction rate of drug ? (a) dA/dt = - k (b) t½ = 0.693/k (c) A = A0e -kt
70. Which of the following functional groups is most susceptible to hydrolysis ? (a) R – CO – R (b) R – COOR (c) R – O - R (d) R – NH- CH3 (e) R – COOH
71. Monomer units of proteins are known as (a) Monosaccharides (b) Prosthetic groups (c) Amino acids (d) Purines (e) Nucleosides
72. Glucose is a carbohydrate that cannot be hydrolyzed into a simpler substance. It is best described as (a) A sugar (b) A monosaccharide (c) A disaccharide (d) A polysaccharide (e) An oligosaccharide
73. All of the following carbohydrates are considered to be polysaccharides except (a) Heparin (b) Starch (c) Glycogen (d) Maltose (e) Cellulose
74. Which of the following compounds are considered the building blocks of nucleic acids ? (a) Nucleotides (b) Nucleosides (c) Monosaccharides (d) Purines (e) Amino acids
75. Which of the following terms best describes a co-factor that is firmly bound to an apoenzyme? (a) Holoenzyme (b) Prosthetic group (c) Coenzyme (d) Transferase (e) Heteropolysaccharide
76. Enzymes that uncouple peptide linkages are best classified as (a) Hydrolases (b) Ligases (c) Oxidoreductases (d) Transferases (e) Isomaerases
77. The sugar that is inherent in the nucleic acids RNA and DNA is (a) Glucose (b) Sucrose (c) Ribose (d) Digitoxose (e) Maltose
78. N-oxidation will be involved with the metabolism of following drugs, except (a) Dapsone (b) Meperidine (c) Phenytoin (d) Chlorpheniramine
79. Which of the following statements describes plasmids? They (a) Are single – stranded DNA molecules (b) Carry optional gene(s) (c) Carry genes essential for growth (d) Are always found in linear form
80. Bacteria that grow at temperatures as high as 550C are known as (a) Psychrophiles (b) Thermophiles (c) Mesophiles (d) Auxotrophs
81. Which of the following organisms can use only molecular oxygen as the final acceptor? (a) Obligate anaerobes (b) Facultative anaerobes (c) Obligate aerobes (d) Strict anaerobes
82. A declining growth rate occurs during which of the following phases of bacterial cell growth? (a) Lag phase (b) Exponential phase (c) Stationary phase (d) Death phase
83. Which class of antibody has the longest serum half-life and opsonizes antigens for phagocytosis through two different pathways? (a) Immunoglobulin G (IgG) (b) Immunoglobulin M(IgM) (c) Immunoglobulin A (IgA) (d) Immunoglobulin E (IgE)
84. Urticaria that appears rapidly after the ingestion of food usually indicates which type of hypersensitivity reaction? (a) Type I (b) Type II (c) Type III (d) Type IV
85. A patient receives long-term, high-dose therapy with a sulfonamide. After approximately 3 weeks of therapy, the patient has a low-grade fever, rash, and muscle and joint pain. Which type of hypersensitivity accounts for these symptoms? (a) Type I (b) Type II (c) Type III (d) Type IV
86. CD4+T cells specifically recognize antigens in which form? (a) Bound to major histocompatibility (MHC) class I molecules on the surface of any body cell (b) In free, soluble form in extracellular fluids (c) Bound to MHC class II molecules on the surface of special antigen-presenting cells(APCs)
87. Which of the following statements concerning a drug receptor is true? (a) It mediates the nonspecific action of volatile anesthetics (b) Its expression is induced only by exogenously added drugs (c) It can bind endogenous ligand to produce physiological activity (d) It mediates the cathartic activity of magnesium citrate (e) Down-regulation of receptor level can lead to sensitization of the target cell to the receptor agonist.
88. Which of the following acids has the highest degree of ionization in an aqueous solution? (a) Aspirin pKa = 3.5 (b) Indomethacin pKa = 4.5 (c) Warfarin pKa = 5.1 (d) Ibuprofen pKa = 5.2 (e) Phenobarbital pKa = 7.4
89. Which of the following salts forms an aqueous solution that is alkaline to litmus? (a) Sodium chloride (b) Benzalkonium chloride (c) Meperidine hydrochloride (d) Cefazolin sodium (e) Chlordiazepoxide hydrochloride
90. Hydrolysis reaction are involved with the metabolism of following drugs, except (a) Procaine (b) Diazepam (c) Aspirin (d) Lidocaine
91. Flurazepam has pKa of 8.2. What percentage of flurazepam will be ionized at a urine pH of 5.2? (a) 0.1% (b) 1% (c) 50% (d) 99% (e) 99.9%
92. Precipitation may occur when mixing aqueous solutions of meperidine hydrochloride with which of the following solutions? (a) Sodium bicarbonate injection (b) Atropine sulfate injection (c) Sodium chloride injection
93. The excretion of a weakly acidic drug generally is more rapid in alkaline urine than in acidic urine. This process occurs because (a) A weak acid in alkaline media will exist primarily in its ionized form, which cannot be reabsorbed easily (b) A weak acid in alkaline media will exist in its lipophilic form, which cannot be reabsorbed easily. (c) All drugs are excreted more rapidly in an alkaline urine.
94. Which of the following drugs is considered to be the agent of choice for anaphylactic reactions? (a) Edrophonium (b) Ipratropium (c) Ambenonium (d) Propantheline (e) Homatropine
95. Which of the following drugs is considred to be the agent of choice for anaphylactic reactions? (a) Clonidine (b) Isoproterenol (c) Epinephrine (d) Phenylephrine (e) Terbutaline
96. Which of the following emissions from the decay of radionuclides is most commonly used in nuclear medicine imaging? (a) X-ray (b) Beta (c) Alpha (d) Gamma (e) Positron
97. Which of the following radionuclides is mot commonly used in nuclear pharmacy practice? (a) 67GA (b) 201TI (c) 99mTC (d) 123I (e) 133Xe
98. Which of the following radionuclides is generator produced? (a) 99mTC (b) 201TI (c) 67GA (d) 133Xe (e) 123I
99. Abrasives, ingredients in dentifrices, are noted for which of the following actions? (a) Providing flavor (b) Cleansing via a foaming detergent action (c) Removing plaque and debris (d) Preventing dental caries (e) Adding thickness to the product
100. The appropriate pH range for ophthalmic products is (a) 2.0 – 3.0 (b) 4.0 – 6.0 (c) 6.0 – 8.0 (d) 8.0 – 10.0
101. Which type of contact lens can most easily be ruined by the absorption of chemicals? (a) Hard lenses (b) Soft lenses (c) Gas-permeable lenses
102. All of the following desensitizing agents are recommended for sensitive teeth except (a) 10% carbamide peroxide (b) 5% potassium nitrate (c) Dibasic sodium citrate (d) 10% strontium chloride hexahydrate
103. Carbamide peroxide appears to soften earwax by (a) Causing oxygen to be released, which loosens the wax (b) Stimulating fluid secretion in the ear canal (c) Actually dissolving the ear wax (d) Decreasing lipid content of the wax (e) None of the above
104. A common oral problem caused by herpes simplex type I virus (HSV-1) is (a) Aphthous ulcers (b) Canker sores (c) Aphthous stomatitis (d) Fever blisters (e) Thrush
105. The definition of a surfactant (an ingredient in toothpaste) can best be described by which of the following statements? Surfactant (a) Prevents drying of the preparation (b) Removes debris by its detergent action and causes foaming, which is usually desired by the patient (c) Physically removes plaque and debris (d) Determines the texture, dispersiveness, and appearance of the product (e) Adds flavor to the preparation which makes it more appealing to the patient
106. Which is not a risk factor for hyperphosphatemia and death from sodium phosphate enemas when used in children? (a) Renal insufficiency (b) Hirschsprung’s disease (c) Anorectal malformations (d) Children between the ages of 6 and 12 years
107. Which of the following factors is associated with an increased risk of noncompliance in the elderly? (a) Polypharmacy (b) Hypertension (c) Male gender (d) Living with a spouse in an isolated environment (e) Expensive medications
108. The principal difference between competitive and non-competitive inhibition is (a) Extent of receptor site blocking (b) Whether inhibition occurs (c) Extent of enzyme inhibition (d) Degree of agonism (e) None of the above
109. Drug administrated through which of the following routes is mot likely to be subjected to first-pass metabolism: (a) Oral (b) Sublingual (c) Subcutaneous (d) Rectal
110. Many receptors use distinct hetero _________ GTPä-binding regulatory proteins (a) Tetrameric (b) Trimeric (c) Dimeric (d) Monomeric
111. Alkalinization of urine hastens the excretion of (a) Weakly basic drugs (b) Weakly acidic drugs (c) Strong electrolytes (d) Nonpolar drugs
113. The most important factor which governs diffusion of drugs across capillaries other than those in the brain is (a) Blood flow through the capillary (b) Lipid solubility of the drug (c) pKa value of the drug (d) pH of the medium
114. Active transport of a substance across biological membrane has the following characteristics except (a) It is specific (b) It is pH dependent (c) It is saturable (d) It requires metabolic energy
115. Bioavailability differences among oral formulations of a drug are most likely to occur if the drug (a) Is freely water soluble (b) Is completely absorbed (c) Is incompletely absorbed (d) Undergoes little first-pass metabolism
116. Bioavailability of drug refers to (a) Perecentage of administered dose that reaches systemic circulation in the unchanged form (b) Rario of oral to parental dose (c) Ratio of orally administered drug to that excreted in the faeces (d) Ratio of drug excreted unchanged in urine to that excreted as metabolites
117. The most important factor governing absorption of a drug from intact skin is (a) Molecular weight of the drug (b) Site of application (c) Lipid solubility of the drug (d) Nature of the base used in the formulation
118. Redistribution is a feature of (a) Highly plasma protein bound drugs (b) Depot preparations (c) Poorly lipid soluble drugs (d) Highly lipid soluble drugs
119. Weakly acidic drugs (a) Are bound primarily to a1 acid glycoprotein in plasma (b) Are excreted faster in alkaline urine (c) Are highly ionized in the gastric juice (d) Do not cross blood—brain barrier
120. High plasma protein binding (a) Increases the volume of distribution of the drug (b) Facilitates glomerular filtrtion of the drug (c) Minimizes drug interactions (d) Generally makes the drug long acting
121. Biotransformation of drugs is primarily directed to (a) Activate the drug (b) Inactivate the drug (c) Convert lipid soluble drugs into nonlipid soluble metabolites (d) Convert nonlipid soluble drugs into lipid soluble metabolites
122. A prodrg is (a) The prototype member of a class of drugs (b) The oldest member of a class of drugs (c) An inactive drug that is transformed in the body to an active metabolite (d) A drug that is stored in body tissues and is then gradually released in the circulation
123. Which of the following cytochrome P450 isoenzymes is involved in the metabolism of a large number of drugs in human beings and has been implicated in some dangerous drug interactions: (a) CYP 3A4 (b) CYP 2C9 (c) CYP 2E1 (d) CYP 1A2
124. The most commonly occurring conjugation reaction for drugs and their metabolites is (a) Glucuronidation (b) Acetylation (c) Methylation (d) Glutathione conjugation
125. G-protein coupled receptors span the plasma membrane as a bundle of _____ alpha helices (a) One (b) Three (c) Seven (d) Ten
126. Which of the following drug metabolizing reactions is entirely nonmicrosomal (a) Glucuronide conjugation (b) Acetylation (c) Oxidation (d) Reduction
127. Induction of drug metabolizing enzymes involves (a) A conformational change in the enzyme protein to favor binding of substrate molecules (b) Expression of enzyme molecules on the surface of hepatocytes (c) Enhanced transport of substrate molecules into hepatocytes (d) Increased synthesis of enzyme protein
128. Drugs which undergo high degree of firstpass metabolism in liver (a) Have oral bioavailability (b) Are excreted primarily in bile (c) Are contraindicated in liver disease (d) Exhibit zero order kinetics of elimination
129. Glomerular filtration of a drug is affected by its (a) Lipid solubility (b) Plasma protein binding (c) Degree of ionization (d) Rate of tubular secretion
130. If a drug undergoes net tubular secretion, its renal clearance will be (a) More than the glomerular filtration rate (b) Equal to the glomerular filtration rate (c) Less than the glomerular filtration rate (d) Equal to the rate of urine formation
131. Which of the following is not a primary fundamental, but a derived pharmacokinetic parameter (a) Bio-availability (b) Volume of distribution (c) Clearance (d) Plasma half life
132. If a drug is eliminated by first order kinetics (a) A constant amount of the drug will be eliminated per unit time (b) Its clearance value will remain constant (c) Its elimination half-life will increase with dose (d) It will be completely eliminated from the body in 2 x half-life period
133. If a drug has a constant bio-availability and first order elimination, its maintainance dose rate will be directly proportional to its (a) Volume of distribution (b) Plasma protein binding (c) Lipid solubility (d) Total body clearance
134. The following dose of a drug is governed by its (a) Aqueous diffusion (b) Aqueous hydrolysis (c) Lipid diffusion (d) Pinocytosis or endocytosis
135. Monitoring plasma drug concentration is useful while using (a) Antihypertensive drugs (b) Levodopa (c) Lithium carbonate (d) MAO inhibitors
136. Microsomal enzyme induction has one of the following features (a) Takes about one week to develop (b) Results in increased affinity of the enzyme for the substrate (c) It is irreversible (d) Can be used to treat acute drug poisonings
137. Which of the following is a competitive type of enzyme inhibitor (a) Acetazolamide (b) Disulfiram (c) Physostigmine (d) Theophyline
138. What is true in relation to drug receptors (a) All drugs act through specific receptors (b) All drug receptors are located on the surface of the target cells (c) Agonists induce a conformational change in the receptor (d) Partial agonists have low affinity for the receptor
139. A partial agonist can antagonize the effects of a full agonist because it has (a) High affinity but low intrinsic activity (b) Low affinity but high intrinsic activity (c) No affinity and low intrinsic activity (d) High affinity but no intrinsic activity
140. Receptor agonists possess (a) Result in increased smooth endoplasmic reticulum (b) Result in increased rough endoplasmic reticulum (c) Result in decreased enzymes in the soluble cytoplasmic fraction (d) Require 3–4 months to reach completion
141. Agonists affect the receptor molecule in the following manner (a) Alter its amino acid sequence (b) Denature the receptor protein (c) Alter its folding or alignment of subunits (d) Induce covalent bond formation
142. Receptors perform the following function/functions (a) Ligand recognition (b) Signal transduction (c) Both ligand recognition and signal transduction (d) Disposal of agonists and antagonists
143. Which of the following receptor types has 7 helical membrane, spanning amino acid segments with 3 extracellular and 3 intracellular loops (a) Tyrosine protein kinase receptor (b) Gene expression regulating receptor (c) Intrinsic ion channel containing receptor (d) G protein coupled receptor
144. Which of the following is a G protein coupled receptor (a) Muscarinic cholinergic receptor (b) Nicotinic cholinergic receptor (c) Glucocorticoid receptor (d) Insulin receptor
145. Placebo effects result presumably from the (a) Physician-patient relationship (b) Mental set up imparted by the therapeutic settings (c) Mental set up imparted by the physician (d) All of the above
146. All of the following subserve as intracellular second messengers in receptor mediated signal transduction except (a) Cyclic AMP (b) Inositol trisphosphate (c) Diacyl glycerols (d) G protein
147. A receptor which itself has enzymatic property is (a) Insulin receptor (b) Progesterone receptor (c) Thyroxine receptor (d) Glucagon receptor
148. Down regulation of receptors can occur as a consequence of (a) Continuous use of agonists (b) Continuous use of antagonists (c) Chronic use of CNS depressants (d) Denervation
149. When therapeutic effects decline both below and above a narrow range of doses, a drug is said to exhibit (a) Ceiling effect (b) Desensitization (c) Therapeutic window phenomenon (d) Nonreceptor mediated action
150. ‘Drug efficacy’ refers to (a) The range of diseases in which the drug is beneficial (b) The maximal intensity of response that can be produced by the drug (c) The therapeutic dose range of the drug (d) The therapeutic index of the drug
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