Pharmacology Exam 1 - Multiple Choice Part 2

A 17-year-old girl with suspected intrinsic asthma but nearly normal results on spirometry and flow volume testing takes a methacholine provocative test. The mechanism of action of methacholine most closely resembles that of

A. hemicholinium.

B. acetylcholine.

C. edrophonium.

D. succinylcholine.

E. neostigmine.

The muscarinic receptor that couples to G proteins responsible for adenylyl cyclase inhibition and plays a key role in cholinergic input to the heart is classified as

A. muscarinic-M1 receptor.

B. muscarinic-M2 receptor.

C. muscarinic-M3 receptor.

D. muscarinic-M4 receptor.

E. muscarinic-M5 receptor.

A 25-year old female presents with delirium, hyperthermia, and symptoms of central anticholinergic intoxication. She has attended a ìwitches' conventî and ingested some herbal extracts including fruits of the species ìAtropa belladonna.î As one component of her treatment, she receives a dose of physostigmine.

Refer to the case above. Physostigmine is preferred over neostigmine because

A) it is a nonpolar compound that penetrates the CNS more easily than neostigmine.

B) it has a shorter half-life than neostigmine, making it more useful for emergency treatment.

C) it has a longer half-life than neostigmine, better matching the half-life of atropine.

D) it is eliminated via the kidneys, and dosage is not critical with compromised liver function.

E) it is eliminated via the liver, and dosage is not critical with compromised renal function.

Which of the following is a correct statement?

A. opioid analgesics produce little or no respiration depression with long-term use of analgesic doses

B. opioid antagonists include endorphins

C. all drugs in the opioid analgesic group are controlled substances, Schedule III

D. in low doses, opioids produce nausea and vomiting

E. fentanyl is a partial opioid antagonist

Oxycodone in therapeutic doses can stimulate mu receptors to cause

A. hyperventilation and deep breathing

B. bronchospasms

C. spasmogenic activity in the ureters and sphincter muscle

D. relaxation of the skeletal muscles controlling posture (spasmolytic)

E. suppression of coughing

Opioid analgesics are used in which of the following settings?

A. induction of Monitored Anesthesia Care and treatment of chronic severe pain

B. routine treatment of migraine

C. unmonitored treatment of chronic severe pain

D. analgesia for patients with paralytic ileus

E. chronic osteoarthritis

Which of the following is a correct statement?

A. endorphin is an abbreviation from the terms meaning inside the organ

B. endogenous opioid receptors include mu, alpha-2 adrenergic, and delta receptors

C. agonism means the drug occupies the receptor and causes a response

D. opioid agonism means the drug occupies the receptor and stimulates the release of endorphins

E. tolerance is a characteristic of chronic opioid antagonism

Which of the following drugs has a recognized medical therapy and does not interact with opioid receptors?

A. heroin

B. codeine

C. methadone

D. acetaminophen

All opioid analgesics are associated with which of the following?

A. reversal of respiratory depression from barbiturates

B. use only for the relief of acute pain

C. cough suppression alone or in combination with other analgesics over-the-counter

D. tolerance develops to the analgesic response

E. drug of choice in treating biliary obstruction

Fentanyl is an opioid analgesic that

A. can be used for relief of cancer pain

B. has many formulations (lozenge, film) because it is used routinely in dental surgery

C. induces neuropathic pain

D. primarily works on peripheral nerve endings rather than higher centers

E. does not have a black box warning because of its low addiction potential

Sharp pain is transmitted through which type of nerve fibers?

A. unmyelinated

B. myelinated A-delta

C. CTZ

D. C fibers

E. mu fibers in the intestine

Opioid drugs are derived from which of the following?

A. poppy

B. opium

C. chemical synthesis

D. alkaloids

E. all of these

Select the adverse effects of opioid analgesics.

A. constipation

B. polyuria

C. convulsions

D. mydriasis

E. excessive tearing

During tolerance to opioid analgesics, the following is happening.

A. fewer receptors are available to produce a response

B. increased pain by the patient requires greater doses of medication

C. the body reacts to removal of the opioid analgesic

D. histamine release causes hypotension

E. signals from nocieocptors are reduced

What is the best reason for using a balanced anesthesia strategy? (LO 18.1)

A. producing complementary effects using a few drugs avoids unnecessary intense (deep) CNS depression with one anesthetic to achieve the same effect

B. the concentration of volatile anesthetic in the alveoli is balanced against the amount of anesthetic in the blood

C. less monitoring of anesthesia is required

D. fewer patients experience emergence delirium

E. there is less chance of aspirating saliva

Why is propofol a drug of choice for induction and maintenance of anesthesia?

A. it is a potent analgesic at all doses

B. it slowly brings the patient to the stage of surgical anesthesia

C. it is a complete anesthetic with a quick onset of action and recovery period uncomplicated by nausea and vomiting

D. it is administered by special vaporizer to avoid mask delivery

E. its preparation does not require special handling technique

Which of the following is NOT correct?

A. ketamine causes chloride ions to flow out of the nerve cell by binding to GABA

B. propofol binds to the GABA A receptor and enhances hyperpolarization of the neuron

C. barbiturates and propofol act on the receptor and directly on the chloride channel

D. potent anesthetics enhance GABA A receptor function

E. general anesthetics interact with neurotransmitter-gated ion channels

Which of the following major routes remove etomidate and midazolam from the body?

A. hepatic metabolism and renal excretion

B. excretion through the lungs and sweating

C. accumulation in fat tissue and redistribution

D. increased salivation and bile production

E. gastrointestinal reabsorption

Select the types of anesthesia in which there is no loss of consciousness.

A. local anesthesia

B. Monitored Anesthesia Care

C. general anesthesia

D. balanced anesthesia

E. maintenance anesthesia

Choose the correct class of general anesthetics.

A. intravenous

B. dissociative anesthesia

C. oral

D. topical

E. epidural

Which drugs would be used as adjunct therapy to anesthesia?

A. analgesics

B. antiarrhythmics

C. antianxiety, short-acting CNS depressants like midazolam

D. anticholinergics

E. all of these

Barbiturate and benzodiazepine hypnotics both

A. increase NREM stage 2 sleep

B. increase REM sleep

C. increase NREM stage 4 sleep

D. cause REM rebound

E. all of these statements are true

Disadvantages to the use of barbiturate hypnotics include

A. development of drug tolerance

B. risk of drug dependency

C. disruption of normal stages of sleep

D. suppression of REM sleep

E. all of these statements are true

The correct statement concerning the use of hypnotic drugs is

A. zolpidem binds to the GABAB receptor

B. benzodiazepines increase chloride channel opening

C. barbiturates block the GABA receptor

D. ramelteon is a melatonin antagonist

E. flumazenil is a benzodiazepine receptor agonist

Flurazepam

A. is classified as long-acting

B. forms active metabolites

C. may cause next-day residual effects

D. increases chloride ion influx

E. all of these statements are true

Eszopiclone

A. is classified as a benzodiazepine

B. has a half-life of 1-2 hours

C. increases total sleep time

D. is used as an antianxiety agent

E. is also used as an anticonvulsant

Zolpidem

A. binds to the benzodiazepine-1 (BZD1) receptor

B. is useful as a muscle relaxant

C. has a slow onset of action

D. is useful as an anticonvulsant

E. is chemically classified as a benzodiazepine

real answer is

Alcohol has pharmacological effects on which body systems?

A. central nervous system

B. gastrointestinal system

C. renal system

D. vascular system

E. all of these

The main pharmacologic effect of the SSRIs is

A. increase levels of norepinephrine

B. increase levels of serotonin

C. decrease levels of norepinephrine

D. decrease levels of serotonin

E. decrease levels of dopamine

The pharmacologic effects of TCAs include

A. alpha-adrenergic blockade

B. antihistaminic

C. anticholinergic

D. sedation

E. all of the above

The serotonin syndrome is mainly associated with overdosage of

A. tricyclic antidepressants

B. monoamine oxidase inhibitors

C. selective serotonin reuptake inhibitors

D. psychomotor stimulants

E. lithium

The main pharmacologic effects of TCAs on neurotransmitter activity is

A. increase norepinephrine

B. increase acetylcholine

C. increase serotonin

D. increase norepinephrine and serotonin only

E. increase norepinephrine, acetylcholine, and serotonin

Venlafaxine (Effexor) is classified as

A. MAOI

B. TCA

C. SSRI

D. SNRI

E. psychomotor stimulant

Adverse effects of TCAs include

A. liver toxicity

B. cardiac arrhythmias

C. convulsions

D. postural hypotension

E. all of these

Which of these represents the drug that is not correctly matched with its drug classification?

A. paroxetine—SSRI

B. amitriptyline—TCA

C. methylphenidate—MAOI this is targets dop transporter

D. duloxetine—SNRI

E. phenelzine—MAOI

Which drug requires a dietary restriction for foods containing tyramine?

A. nortriptyline (TCA)

B. tranylcypromine (MAOI)

C. venlafaxine (SNRI)

D. fluoxetine (SSRI)

E. methamphetamine

The site of action of diazepam (Valium) to relieve anxiety is the

A. spinal cord

B. limbic system

C. reticular formation

D. basal ganglia

E. cerebellum

The antianxiety effect of buspirone (BuSpar) is associated with

A. stimulation of DA receptors

B. stimulation of serotonin receptors

C. blockage of serotonin receptors

D. blockade of dopamine receptors

E. blockage of GABA receptors

Flumazenil (Romazicon) is used to reverse the depressant effects of

A. clozapine

B. alprazolam (benzodiazepine)

C. haloperidol

D. chlorpromazine

E. thiothixene

What are the main areas at which benzodiazepines exert their effects?

A. limbic system

B. cerebral cortex

C. reticular formation

D. spinal cord

E. all of these

Symptoms of Parkinsonism would be increased by

A. excess levels of acetylcholine

B. treatment with some antipsychotic drugs

C. decreased levels of dopamine

D. drug administration after a high-protein meal

E. all of these

The drug classified as a dopamine receptor agonist is

A. amantadine

B. benztropine

C. ropinirole

D. entacapone (COMT)

E. carbidopa

Select the drugs that increase the duration of action of DA and/or the amount of levodopa that enters the brain.

A. carbidopa

B. tolcapone

C. selegiline

D. rasagiline

E. all of these

In Parkinson's disease, slowed movements are defined as

A. rigidity

B. bradykinesia

C. tremor

D. dystonia

E. postural instability

Sinemet is the trade name of a drug combination that contains levodopa and

A. carbidopa and entacapone

B. entacapone

C. carbidopa

D. selegiline

E. amantadine

The COMT inhibitor that has been associated with causing liver toxicity is

A. ropinirole

B. entacapone

C. pramipexole

D. tolcapone

E. benztropine

Select the symptoms of Parkinson's disease

A. muscular rigidity

B. increased sweating

C. salivary drooling

D. movement disturbances

E. all of these

Which of the following drugs would be used to decrease the actions of ACH?

A. amantadine

B. levodopa

C. bromocriptine

D. procyclidine

E. carbidopa

Select the mechanisms by which levodopa works.

A. crosses blood-brain barrier by an amino acid transporter

B. converted to dopamine in the substantia nigra neurons

C. increases level of dopamine in the brain

D. peripheral metabolism to DA inhibited by carbidopa

E. all of these

Apomorphine is classified as

A. MAO-B inhibitor

B. dopamine receptor agonist

C. COMT inhibitor

D. anticholinergic drug

E. DOPA decarboxylase inhibitor