Question 1

Which one of the following drugs is most likely to cause symptoms of severe depressive disorder when used in the treatment of hypertensive patients?

Accepted Answer

The drug that is most likely to cause symptoms of severe depressive disorder when used in the treatment of hypertensive patients is resperpine. Although other drugs used in the management of HTN may cause CNS effects, reserpine is the most known drug to cause severe depression.

Question 2

The most common manifestation of lidocaine toxicity is?

Accepted Answer

The most common manifestation of lidocaine toxicity is CNS dysfunction. This can range from drowsiness to excitation, culminating in seizures and is caused by a buildup of metabolites of lidocaine in the blood.

Question 3

Which one of the following drugs is most likely to be effective against all strains of H. influenza, M. catarrhalis, and N. gonorrhea?

Accepted Answer

The drug that is most likely to be effective against all strains of H. influenzae, M. catarrhalis, and N. gonorrhoeae is ceftriaxone. It is a 3rd generation cephlasporin with good gram positive and gram negative activity. It is a drug of choice in the sexually transmitted disease N. gonorrhea and is also highly effective in otitis media, infections in which beta-lactamase-producing strains of H. influenzae and M. catarrhalis are commonly implicated.

Question 4

Which one of the following drugs inhibits bacterial protein synthesis, preventing the translocation step via its intersection with the 50s ribosomal subunit?

Accepted Answer

The drug that inhibits bacterial protein synthesis, preventing the translocation step via its interaction with the 50s ribosomal subunit, is clindamycin. Clindamycin has a mechanism of action similar to, if not identical with, erythromycin and related macrolides. They bind to rRNA bases on the 50s subunit to prevent translocation of peptidyl-mRNA from the acceptor to the donor site.

Question 5

Which one of the following anti-inflammatory drugs used in rheumatoid arthritis has a mechanism of action that leads to a decrease in tumor necrosis factor?

Accepted Answer

An anti-inflammatory drug that is used in rheumatoid arthritis and has a mechanism of action that leads to a decrease in tumor necrosis factor (TNF) is etanercept. Etanercept binds to TNF, resulting in the inactivation of this powerful cytokine, which plays a major role in a number of inflammatory disorders including Crohn's disease and rheumatoid arthritis.

Question 6

When used in the management of inflammatory disorders, glucocorticoids are likely to cause:

Accepted Answer

When used in the management of inflammatory disorders, glucocorticoids are likely to cause increase in intraocular pressure (IOP). Ocular side effects of glucocorticoids include the development of cataracts and glaucoma through increases in IOP.

Question 7

All of the following agents are among recommended lines of treatment for chronic obstructive pulmonary disease except:

Accepted Answer

All of the listed agents are among recommended lines of treatment for chronic obstructive pulmonary disease (COPD) except beta blockers. Smoking cessation, pneumococcal and flu vaccines, systemic or inhaled corticosteroids, oxygen, inhaled beta-agonists, and anticholinergics are all among common treatment modalities recommended in the management of COPD. Beta blockers are usually contraindicated in the condition because of the beta adrenergic receptors on cell surfaces that line the pulmonary airway; thus, blocking them would increase the difficulty in breathing and not decrease.

Question 8

Which of the following drug classes remains the mainstay of therapy for CHF to date?

Accepted Answer

The drug class that remains the mainstay of therapy for CHF to date is ACEIs. While all of the above-mentioned drugs are frequently used, to date, Angiotensin converting enzyme inhibitors (ACEIs) remain the recommended first line treatment in patients who have CHF because of their ability to improve symptoms, decrease mortality, and reduce ventricular hypertrophy.

Question 9

Which of the following clinical features is a sign of digitalis toxicity?

Accepted Answer

A clinical feature that is a sign of digitalis toxicity is nausea. Other signs include dizziness, confusion, weakness, and arrhythmias. Digitalis toxicity is considered when a high level of digitalis is in the body or from a decreased tolerance to the drug.

Question 10

Which of the following diseases is Acyclovir the drug of choice for?

Accepted Answer

Acyclovir is the drug of choice for is HSV 1 and 2. Acyclovir (Zovirax) is specifically for herpes virus infections. It is an antiviral that attacks the DNA replication mechanism of the virus. It is excreted unchanged in the urine and therefore, must be used cautiously in the presence of renal impairment.

Question 11

Which of the following classes of drugs is the first-line therapy in the management of an acute asthma attack?

Accepted Answer

The class of drugs that is the first-line therapy in the management of an acute asthma attack is ?2-agonists. Nebulizer ?2-agonists can be given every 5 min in emergency situations until the attack has subsided or the patient develops any side effects. Short acting ?2-agonists allow for an opening of the constricting airways, but are not a long term solution.

Question 12

Which one of the following features is a major common side effect of TCAs (Tricyclics Antidepressants)?

Accepted Answer

A feature that is a major side effect of TCAs (Tricyclics Antidepressants) is fainting. Fainting and hypotension are considered as one of the most common side effects associated with the use of TCAs. The dangerous side effect of TCAs is overdose that can be fatal.

Question 13

Which of the following is one of the main indications of lidocaine?

Accepted Answer

One of the main indications of lidocaine is to control premature ventricular contractions. Lidocaine helps suppress ectopic ventricular rhythms by depressing automaticity, which decreases the slope of phase IV depolarization.

Question 14

All of the following are important in quickly mediating and correcting states of hypoglycemia except:

Accepted Answer

All of the listed options are important in quickly mediating and correcting states of hypoglycemia except glucocorticoid. The counterregulatory hormones glucagon and epinephrine are released in response to hypoglycemia. Within minutes, glycogenolysis is activated and glucose is released into the bloodstream.

Question 15

Which of the following drugs is associated with discoloration of the skin, photosensitivity, thyroid dysfunction, and pulmonary complications?

Accepted Answer

The drug that is associated with discoloration of the skin, photosensitivity, thyroid dysfunction, and pulmonary complications is amiodarone. Amiodarone, an anti-arrhythmic, is a large, insoluble molecule that deposits in the skin (and the cornea) and causes photosensitivity. It contains two iodine atoms, which may be responsible for binding to thyroid receptors.

Question 16

The appropriate antibiotic to prescribe for cellulitis while awaiting specific culture verification is:

Accepted Answer

The appropriate antibiotic to prescribe for cellulitis while awaiting specific culture verification is penicillin. Penicillin remains the mainstay of therapy against presumed streptococcal infections. Most streptococcal cellulitis is adequately treated by penicillin, elevation of the infected extremity, and attention to the local wound to ascertain adequate local drainage and absence of any persisting foreign body.

Question 17

Absolute contraindications to prescribing beta blockers include all of the following except:

Accepted Answer

Absolute contraindications to prescribing beta blockers include all of the above except first-degree AV block. Administration of beta blockers to patients with first degree AV-block can be effective, but must be administered with caution.

Question 18

Nitrates have all of the following properties except:

Accepted Answer

Nitrates have all of the listed effects except improving clinical outcomes when used orally during an acute myocardial infarction. Nitrates are vasodilators that reduce cardiac preload and to a lesser extent, afterload. The result is a lower cardiac volume, reduced wall stress, and decreased myocardial oxygen consumption.

Question 19

Sodium nitroprusside has all of the following actions except:

Accepted Answer

Sodium nitroprusside has all of the following actions except duration of action of 1 to 2 hours. Nitroprusside has a rapid onset and short duration of action (plasma half-life of 3 to 4 minutes). It causes both arterial and venous smooth muscles to dilate and decreases preload and afterload, resulting in decreased myocardial oxygen demand.

Question 20

Which of the following effects is the most important adverse reaction of spironolactone therapy?

Accepted Answer

The effect that is the most important adverse reaction of spironolactone therapy is anti-androgen. Spironolactone acts as an anti-androgen by decreasing the production of testosterone by the adrenal gland and by preventing DHT (dihydrotestosterone) from binding to its androgen receptor.

Quiz 1: Pharmacology and Protein Structures