Pharmacology Test #2

Front 1

All of the following are clinical symptoms and physical manifestations of congestive heart failure EXCEPT

A.edema such as ankle swelling.
B.distended neck veins.
C.increased urinary output.
D.hepatomegaly.
E.atrial tachycardia.

Back 1

Increased Urinary Output

Front 2

Diuretics such as furosemide are used to treat congestive heart failure because they

A.increase pulmonary congestion.
B.decrease plasma volume.
C.create a negative nitrogen balance.
D.increase oxygen demand.
E.cause increased urinary calcium retention.

Back 2

Decrease Plasma Volume

Front 3

Which effect would BEST describe the mechanism of action of digoxin, a digitalis glycoside used in treatment of congestive heart failure?

A.Decreases systolic force of contraction
B.Activates Na+-K+ exchange in cardiac muscle
C.Decreases the influx of Ca2+ into cardiomyocytes
D.Increases cardiac output
E.Decreases systolic blood pressure

Back 3

Increases Cardiac Output

Front 4

Angiotensin converting enzyme (ACE) inhibitors such as Captopril are effective in the treatment of congestive heart failure because they are

A.afterload reducing agents.
B.preload reducing agents.
C.direct vasoconstrictors.
D.direct vasodilators.
E.effective in increasing sodium and water retention.

Back 4

Afterload reducing agents

Front 5

Which of the following is a -adrenergic antagonist (-blocker) used in the treatment of congestive heart failure?

A.Hydrochlorthiazide
B.Propranolol
C.Verapamil
D.Enalapril
E.Digoxin

Back 5

Propranolol

Front 6

Which of the following statements regarding class III anti-arrhythmia drugs such as Amiodarone is CORRECT?

A.May display toxicity to thyroid and lungs
B.Can behave as a partial beta-adrenergic antagonist (beta-blocker)
C.Attenuate the action potential (phase 0 depolarization)
D.Block Na+ channels to increase repolarization currents

Back 6

Block Na+ channels to increase repolarization currents

Front 7

Which effect would be observed if binding of angiotensin II to the AT1 receptor were inhibited?

A.Decreased vasoconstriction
B.Increased blood pressure
C.Increased Na+ and H2O retention
D.Increased afterload

Back 7

Decreased vasoconstriction

Front 8

All of the following statements regarding isoproterenol are correct EXCEPT isoproterenol

A.binds with high affinity to alpha-adrenergic receptors.
B.produces peripheral vasodilation.
C.is a good bronchodilator.
D.increases cardiac output
E.is a good antiarrhythmic.

Back 8

Binds with high affinity alpha-adrenergic receptors

Front 9

The Ca2+-channel antagonist nifedipine reduces myocardial ischemia/angina by which of the following mechanisms?

A.Reducing activation of alpha1-adrenergic receptors
B.Decreasing blood pressure and dilating coronary arteries
C.Dilating coronary arteries and increasing myocardial wall tension
D.Enhancing growth of collateral coronary arteries
E.Dissolving atherosclerotic plaques

Back 9

Decreasing blood pressure and dilating coronary arteries

Front 10

Losartan or Irbesartan administration reduces blood pressure by blocking/inhibiting

A.angiotensin II receptors.
B.angiotensin-converting enzyme.
C.Ca2+-channels in the vasculature.
D.alpha-adrenergic receptors in the vasculature.
E.beta-adrenergic receptors in the heart.

Back 10

Angiotensin II receptors

Front 11

Which of the following physiological effects is associated with the proper administration of verapamil?

A.Reduced triglyceride levels
B.Shortening of cardiac action potential
C.Suppression of phase 4 depolarization
D.Reduction in phase 0 depolarization
E.Reduces ventricular fibrillation

Back 11

Shortening of cardiac action potential

Front 12

Statins such as MevacorTM and LipitorTM are antihyperlipidemic agents because they

A.inhibit HMG-CoA reductase.
B.inhibit transcription of proteins involved in fatty acid metabolism.
C.inhibit lipolysis in adipose tissue.
D.remove bile acids from the gastrointestinal tract.
E.inhibit cholesterol uptake by the liver.

Back 12

Inhibit HMG-CoA reductase

Front 13

CholestipolTM is used as an antihyperlipidemic agent because it

A.inhibits HMG-CoA reductase.
B.inhibits transcription of proteins involved in fatty acid metabolism.
C.inhibits lipolysis in adipose tissue.
D.inhibits cholesterol uptake by the intestine.
E.inhibits cholesterol uptake by the liver.

Back 13

inhibits cholesterol uptake by the intestine

Front 14

Which of the following drugs would likely be used to treat sinus tachycardia?

A.Dopamine
B.Dobutamine
C.Propranolol
D.Captopril
E.Verapamil

Back 14

Propranolol

Front 15

All of the following cations are important in generating currents during each cardiac cycle EXCEPT

A. Ca2+.
B. K+.
C. Cl-.
D. Na+.

Back 15

Cl-

Front 16

Which of the following receptors is important for sensing short term changes in blood pressure?

A.alpha1-Adrenergic receptors
B.Baroreceptors
C.Chemoreceptors
D.Angiotensin II receptors
E.Muscarinic cholinergic receptors

Back 16

Baroreceptors

Front 17

Which tissue is responsible for the pacemaker potentials that control contraction of the heart?

A.Atrioventricular node
B.Bundle of His
C.Purkine fibers
D.Sinoatrial node
E.Ventricular myocardium

Back 17

Sinoatrial node

Front 18

Which of the following sequences correctly describes the order of the conduction pathway for the cardiac action potential?

A.AV node – SA node – internodal pathways – Purkinje fibers – ventricular myocardium
B.AV node – SA node – Purkinje fibers – internodal pathways – ventricular myocardium
C.SA node – AV node – Internodal pathways – Purkinje fibers – ventricular myocardium
D.SA node – internodal pathways – AV node – Purkinje fibers – ventricular myocardium
E.Ventricular myocardium – SA node – internodal pathways – AV node – Purkinje fibers

Back 18

SA node – AV node – Internodal pathways – Purkinje fibers – ventricular myocardium

Front 19

All of the following are common precipitants of arrhythmias EXCEPT

A.hypoxia.
B.excessive sympathetic discharge.
C.excessive parasympathetic discharge.
D.genetic defects in potassium channels.
E.genetic defects in sodium channels

Back 19

Excessive parasympathetic discharge

Front 20

All of the following agents have significant physiological roles in directly regulating one or more components of the cardiovascular system EXCEPT

A. acetylcholine.
B. atrial natriuretic peptide.
C. dopamine.
D. epinephrine.
E. norepinephrine

Back 20

Dopamine

Front 21

Which of the following drugs is contraindicated in women of child-bearing age?

A.Aspirin
B.Prednisone
C.Ibuprofen
D.Misoprostol
E.Naproxen

Back 21

Misoprostol

Front 22

All of the following drugs are antiinflammatory EXCEPT

A.ibuprofen.
B.naproxen.
C.acetaminophen.
D.aspirin.
E.cortisol.

Back 22

Acetaminophen

Front 23

Which of the following conditions or effects does NOT result from prolonged treatment with corticosteroids?

A.Gastric ulcer
B.Osteoporosis
C.Hyperglycemia
D.Skeletal muscle atrophy
E.Redistribution of body fat

Back 23

Gastric Ulcer

Front 24

All of the following agents useful for treatment of rheumatoid arthritis can be used simultaneously with anakinra EXCEPT

A.aspirin.
B.celecoxib.
C.infliximab.
D.methotrexate.
E.prednisone.

Back 24

Infliximab

Front 25

Which of the following agents may predispose patients to activation of a latent tubercular infection or acquisition of tuberculosis?

A.Prednisone
B.Methotrexate
C.Etanercept
D.Celecoxib
E.Leflunomide

Back 25

Etanercept

Front 26

Of the following agents, gastric acid secretion has been shown to be most effectively reduced by administration of

A.cortisol.
B.muscarinic cholinergic antagonists.
C.sucralfate.
D.H1-histamine receptor antagonists.
E.omeprazole.

Back 26

Omeprazole

Front 27

Which of the following agents is an opiod antitussive with minimal problems of dependence or addiction?

A. Codeine
B. Dextromethorphan
C. Guaifenesin
D. Hydrocodone
E. Oxycodone

Back 27

Dextromethorphan

Front 28

Which of the following classes of drugs has been used with moderate success for neuropathic pain?

A.Antiarrhythmic drugs
B.Dopamine agonists
C.Opioid antagonists
D.Corticosteroids
E.Serotonin receptor antagonists

Back 28

Serotonin receptor antagonists

Front 29

All of the following terms have a distinct medical meaning or definition EXCEPT

A.opioid.
B.opiate.
C.dependence.
D.addiction.
E.narcotic.

Back 29

Narcotic

Front 30

All of the following effects can be produced by administration of an opioid EXCEPT

A.suppression of cough reflex.
B.elevation of mood.
C.constriction of pupils.
D. inhibition of vomiting.
E.stimulation of release of histamine from mast cells.

Back 30

Inhibition of vomiting

Front 31

Which of the following agents is LEAST likely to produce either physical dependence or addiction?

A.Codeine
B.Morphine
C.Oxycodone
D.Hydrocodone
E.Tramadol

Back 31

Tramadol

Front 32

A 57 year old person receiving propranolol (beta-blocker) for hypertension presents with an acute allergic asthma attack. Which of the following treatments will not work?

A.Ipratropium bromide (Atrovent)
B.Loratadine (Claritin)
C.Dudenoside (Pulmicort)
D.Albuterol (Proventil)

Back 32

Albuterol (Proventil)

Front 33

Bronchoconstriction in chronic obstructive pulmonary disease (COPD) due to epithelial damage occurs by what mechanism?

A.Loss of endogenous beta-agonist release leading to increased smooth muscle contraction
B.Activation of exposed sensory nerve fibers leading to acetyl choline release and cholinergic bronchoconstriction
C.Increased inflammatory mediator release leading to smooth muscle oxidative damage
D.Loss of epithelial derived acetyl choline release leading to increased bronchoconstriction

Back 33

Activation of exposed sensory nerve fibers leading to acetyl choline release and cholinergic bronchoconstriction

Front 34

Which statement accurately describes the mechanisms of action of corticosteroids?

A.Fast-acting anti-inflammatory due to increased calcium release stimulated in inflammatory cells, especially mast cells.
B.Bind selectively to epithelial cells leading to endogenous -agonist release
C.Slow-acting agents that influence protein expression by forming complexes with nuclear receptors and binding directly to specific DNA sequences
D.Fast-acting agents that increase chloride secretion across epithelial cells leading to improved airway clearance
E.Slow-acting agents that bind to membrane receptors and elevate Ca2+

Back 34

Slow acting agents that influence protein expression by forming complexes with nuclear receotors and binding directly to specific DNA sequences

Front 35

All of the following statements describe a known effect of corticosteroid treatment EXCEPT

A.decreased recruitment of eosinophils.
B.increased expression of Beta-receptors on smooth muscle cells.
C.decreased cytokine expression from T-lymphocytes and macrophages.
D.reduced mucous secretion from glands.
E.increased mast cell recruitment and histamine release.

Back 35

Increased Mast cell recruitment and histamine release

Front 36

Anti-leukotrienes and antihistamines are both used as treatments for allergen-induced asthma. These compounds are best used
A.prophylactically to prevent allergen-mediated responses.
B.in response to an acute asthmatic attack due to their fast action.
C.in combination with anti-cholinergic agents.
D.in combination with NSAIDs.

Back 36

prophylactically to prevent allergen-mediated responses

Front 37

Which of the following is a concern for prolonged, repeated use of Beta-receptor agonists for the treatment of acute asthmatic exacerbations?
A.negative regulation of corticosteroid receptor function resulting in reduced steroid effectiveness.
B.secondary release of acetyl choline leading to cholinergic airway contraction.
C.increased mast cell recruitment leading to more severe allergic responses.
D.desensitization of Beta-receptors due to Beta-adrenergic receptor kinase (BetaARK) activation.

Back 37

desensitization of Beta-receptors due to Beta-adrenergic receptor kinase (BetaARK) activation

Front 38

Dobutamine is contraindicated for which of the following conditions?

A. Congestive heart failure
B. Hypotension
C. Angina
D. Arrhythmia

Back 38

Hypotension

Front 39

Local anesthetics produce anesthesia primarily through phasic (or frequency-dependent) blockade of

A.Mg2+ channels.
B.Na+ channels.
C.K+ channels.
D.Ca2+ channels.
E.Cl- channels.

Back 39

Na+ Channels

Front 40

All of the following agents can bind to and inactivate Na+ channels EXCEPT
A.local anesthetics.
B.general anesthetics.
C.dihydropyridine class Ca2+ channel antagonists.
D.frog toxins.
E.Beta-adrenergic antagonists.

Back 40

Beta-adrenergic Antagonists

Front 41

All of the following agents or conditions can affect local anesthetic potency and/or efficacy EXCEPT
A.vasoconstrictors.
B.alkalinization of blood or tissue.
C.pregnancy.
D.site of injection.
E.protein binding.

Back 41

Protein Binding

Front 42

All of the following are signs of CNS toxicity from local anesthetics EXCEPT

A.vertigo.
B.flushing (of the skin).
C.tinnitus.
D.circum-oral numbness.
E.garrulousness.

Back 42

Flushing of the skin

Front 43

Compared to local anesthesia, general anesthesia has all of the following advantages EXCEPT

A.patient cooperation is not completely essential.
B.the patient is unconscious.
C.amnesia regarding the surgery/trauma.
D.titration of the level of anesthesia is easier.
E.cardiovascular toxicity is more easily avoided.

Back 43

Cardiovascular toxicity is more easily avoided

Front 44

For volatile anesthetics, the rapidity of onset of anesthesia is determined primarily by

A.lipid solubility.
B.the rate of liver metabolism.
C.the blood:gas partition coefficient.
D.solubility in muscle.
E.metabolism by blood pseudocholinesterases.

Back 44

The blood:gas partition coefficient

Front 45

All of the following are potential adverse effects of general anesthetics EXCEPT

A.pneumothorax with nitrous oxide.
B.malignant hyperthermia.
C.fulminant hepatic necrosiswith halothane.
D.coma.
E.peripheral pain sensitization with volatile anesthetics.

Back 45

Peripheral pain sensitization with volatile anesthetics

Front 46

Compared to most other parenteral anesthetics, midazolam has the desirable property of producing

A.loss of consciousness.
B.analgesia.
C.decreased salivation.
D.amnesia.
E.lack of hallucination upon recovery.

Back 46

Amnesia

Front 47

Pseudoephedrine and oxymetazoline are marketed as nasal decongestants. They are alpha-adrenergic agonists. Which of the following effects is likely from oral administration of pseudoephedrine but not after intranasal administration of oxymetazoline?

A.Bradycardia
B.Increased blood pressure
C.Decreased blood pressure
D.Tachycardia
E.Bronchoconstriction

Back 47

Increased Blood Pressure

Front 48

Which of the following drugs is highly likely to cause skin rash and allergic reactions when applied topically?

A.Antibiotic ointments
B.Benzocaine
C.Lubriderm
D.Selenium sulfide
E.Hydrocortisone

Back 48

Benzocaine

Front 49

Which of the following drugs or groups of drugs are responsible for the most accidental overdoses?

A.Heroin and similar “narcotics”
B.Alcohol
C.OTC drugs such as analgesics and antihistamines
D.OTC vitamins

Back 49

OTC drugs such as analgesics and antihistamines

Front 50

Minoxidil is used to treat

A.excess hair growth.
B.congestive heart failure.
C.hypertension.
D.atrial fibrillation.
E.hypotension.

Back 50

Hypertension

Minoxidil is a vasodilator used to treat hair loss. The original use was for treatment of hypertension. (ROGA
INE)

Front 51

Niacin at high doses can be used as an antihyperlipidemic agent because it

A.inhibits HMG-CoA reductase.
B.inhibits lipolysis in adipose tissue.
C.removes bile acids from the gastrointestinal tract.
D.inhibits cholesterol uptake by the intestine.
E.inhibits cholesterol uptake by the liver.

Back 51

Inhibits lypolisis in adipose tissue

Front 52

All of the following pairs of agents and actions or agents and receptors occur and/or interact physiologically in normal individuals EXCEPT

A.acetylcholine – muscarinic receptors.
B.acetylcholine – nicotinic receptors.
C.epinephrine – dopamine receptors.
D.epinephrine – vasodilation.
E.norepinephrine – bronchodilation.

Back 52

Epinephrine - Dopamine receptors

Front 53

A patient who has been taking large quantities of aspirin might show increased postoperative bleeding because aspirin inhibits

A.synthesis of thromboxane and thus prevents platelet aggregation.
B.synthesis of prostacyclin and thus prevents platelet disaggregation.
C.synthesis of prostaglandin and thus prevents production of blood platelets.
D.thrombin and thus prevents formation of the fibrin network.
E.intestinal absorption of vitamin K and thus prevents synthesis of blood clotting factors.

Back 53

synthesis of thromboxane and thus prevents platelet aggregation.

Front 54

All of the following bind to opioid receptors EXCEPT

A.endorphins.
B.enkephalins.
C.naloxone.
D.triptans.
E.dynorphins

Back 54

Triptans