Pharmacology

Pharmacology
The following antibiotics are usually effective against pseudomonas aeruginosa: 1
F Cephradine. A
F Amoxicillin. B
T Carbenicillin. C
T Gentamicin. D
F Trimethoprim. E

√ The following antibiotics act on bacterial cell walls: 2
T Penicillin A
T Ceftazidime B
F Metronidazole C
F Clindamycin D
F Gentamicin E
Comment:
Metranidazole inhibit nucleic acid synthesis.
Clindamycin and gentamycin inhibit protein synthesis.

listeria monocytogenes: 3
T Can grow at 6c. A
F Is gut commensal B
F Is a gram-negative bacillus C
F Infection is best treated with benzylpenicillin D
T Is a cause of septicaemia in neonates E

Metronidazole: 4
T Is effective against giardia lamblia A
T Is effective when administered per rectum B
F Should not be administered intravenously C
T Is usually effective against entamoeba histolytica D
T Interferes with ethanol metabolism E

Metronidazole: 5
F Is a folic acid antagonist A
F Is ineffective when given per rectum B
F Should not be administered intravenously C
T Is effective against Entamoeba histolytica D
T Interferes with ethanol metabolism E

Gentamicin: 6
T Is ineffective systemically when given by mouth A
F Is metabolized prior to excretion by the kidney B
T May cause damage to the eighth cranial nerve C
T Is a bacteriostatic drug D
T Toxicity is potentiated by frusemide E

Co-trimoxazole: 7
T Contains two different drugs. A
T Inhibits folic acid synthesis. B
T Potentiates the action of warfarin. C
F Is bacteriostatic D
T Displaces methotrexate from protein binding sites. E
Comments 2:
Combination of sulphonamide and trimethorpim, with synergistic bactericidal effect through inhibition of folic acid synthesis. It potentiates the effects of warfarin (like erythromycin, isoniazid) and the sulphonamide component can displace methotrexate from its plasma protein binding site.+
The following substances are sympathomimetic amines: 8
T Amphetamines A
T Ephedrine B
F Histamine C
T Isoprenaline D
F Chlorpromazine E


Sympathomimetic drugs in therapeuticc doses: 9
T Cause tachycardia A
F Cause hypotension B
F Cause a decrease in cardiac output C
T Cause arrhythmias in association with hydrocarbon anaesthetics D
F Are contraindicated in thyrotoxicosis E
Comments 2:
Beta-sympathomimetic drugs in therapeutic doses causes a direct inotropic and chronotropic effect on the heart. There is little or no effect on the mean blood pressure because the increase in blood pressure resulting from increased heart rate and contractility is counteracted by the decrease in total peripheral resistance due to vasodilation in blood vessels perfusing skeletal muscle. Arrhythmias can occur in large doses – tachycardia is commonly associated with their use. Beta-sympathomimetic drugs are not contraindicated in thyrotoxicosis but may produce an increase in heart rate eg you can use beta agonists to treat asthma in a patient with thyrotoxicosis.
The following drugs are beta-sympathomimetic agonists: 10
T Adrenaline A
T Noradrenaline B
F Phenylephrine C
T Ritodrine hydrochloride D
F Oxprenolol hydrochloride E
Comment:
Phenylephrine is α– agonist
Beta sympathomimetic drugs may: 11
F Cause bronchospasm A
T Reduce the frequency of uterine contractions B
F Cause heart block C
T Reduce diastolic blood pressure D
T Increase blood glucose concentration E
Comments 2:
These drugs have the following effects vasodilation, bronchial relaxation, intestinal and genitourinary wall relaxation, cardiac stimulation, renin release, glycogenolysis, gluconeogenesis, lipolysis.
The following are beta-mimetic effects 12
F Constriction of bronchioles A
T Increased heart rate B
F A decrease in the force of cardiac contraction C
F Constriction of arterioles in the skin D
T Increased glycogenolysis in skeletal muscle E


The following agents are bronchodilators: 13
T Salbutamol A
F Atenolol B
F Prostaglandin F2α C
F Morphine D
T Prednisolone E

The following drugs can cause bronchoconstriction: 14
T Propranolol A
F Atropine B
T Morphine C
F Ritordine D
T Aspirin E
Comments 2:
These bronchoconstrictors act in the following manner - Porpanolol by being a beta blocker and Morphine causes histamine release. Aspirin induced bronchoconstriction is thought to be due to shunting of arachidonic acid into the lipooxygenase pathway or removal of cyclooxygenase product which prevent bronchospasm. Ritodrine is a beta symphatomimetic and atropine is an anticholinergic agent that causes broncodilation.
Ventilation is increased due to stimulation of central receptors by 15
T Nikethamide A
T Hypoxia B
T Doxapram C
F Phenobarbitone D
F Salbutamol E

The following drugs stimulate myometrial contractility: 16
T Vasopressin A
F Nifedipine B
F Hydralazine hydrochloride C
F Salbutamol D
F Indomethacin E

The following statements describe the action of drugs on the myometrium: 17
T Ergometrine stimulates sympathetic alpha receptors. A
F Indomethacin inhibits contractions by blocking prostaglandin receptors. B
F Prostaglandin E1 is a stimulant of isolated uterine tissue in vitro. C
T Oxytocin requires ionised calcium as a co-factor. D
F Magnesium sulphate is a myometrial stimulant. E

The following are features of Ergometrine maleate: 18
F It is inactive when administered orally A
F The onset of action after intravenous injection occurs in approximately 5 minutes. B
T Transient hypertension may occur after its administration C
T Parenteral administration may result in vomiting D
F Its use is contraindicated in patients with migraine E

The following agents inhibit uterine activity: 19
T Magnesium sulphate A
T Ritodrine hydrochloride B
F Oxprenolol hydrochloride C
Fenoterol hydrobromide D
T Indomethacin E

Recognised unwanted effects of prostaglandin E include 20
F Water retention A
F Increased uterine contractility B
T Increased small bowel peristalsis C
T Flushing of the skin D
T Vomiting E

Concerning heparins: 21
T Heparin is synthesized in the lungs A
T Antithrombin III is necessary for standard heparins to exert their anticoagulant effect B
T Factor X is inhibited by low-molecular-weight heparins C
T Low-molecular-weight heparins have a longer half-life than standard heparins D
T Penicillins potentiate the action of low-molecular-weight heparins E


The following statements about drug interactions are correct: 22
T Antacids decrease intestinal absorption of tetracycline. A
F The effects of warfarin are potentiated by combined oral contraceptives. B
F The action of heparin is opposed by vitamin K C
T Alcohol metabolism is impaired by metronidazole D
F The effects of bromocriptine are potentiated by chlorpromazine. E


The following statements about anticoagulants are correct: 23
T Heparin inhibits the action of thrombin A
F The action of heparin is antagonized by vitamin k B
T Heparin increases antithrrombin III activity C
F The effects of coumarin anticoagulants are decreased by metronidazole D
T Warfarin is greater than 80%protein-bound in plasma E

Aspirin: 24
T Inhibits cyclooxegenase. A
F Is the treatment of choice in childhood fever. B
T Is contraindicated in gout. C
T Should be avoided by women in anticoagulant therapy. D
T Has little anti –platelet activity when given in low dosage. E

Propanolol: 25
F Is a selective beta adrenergic blocking agent A
F Is not secreted in breast milk B
T Given in pregnancy slows the maternal heart rate C
T Causes bad dreams D
T Antagonises the tocolytic effect of salbutamol E

The following anti-hypertensive agents are correctly paired with their mode of action: 26
T Captopril : angiotensin –converting enzyme inhibition A
T Phentolamine : alpha adrenoceptor blockade B
F Methyldopa : ganglion blockade C
F Hydralazine hydrochloride : angiotensin II inhibition D
T Sodium nitroprusside: vasodilatation E

The following drugs are potassium sparing diuretics: 27
T Amiloride hydrochloride A
T Triameterene B
T Spironolactone C
F Chlorothiazide D
F Frusemide E

Hypokalaemia may be caused by: 28
T Bendrofluazide A
F Digoxin B
F Spironolactone C
T Carbenoxolone D
F amiloride E
Comments 2:
Carbenoxolone may cause hypokalaemic hypertension like liquorice through inhibition of 11beta hydroxysteroid dehydrogenase (11bHSD). Bendroflumethiazide is a thiazide diuretic and promotes potassium excretion. Amiloride, like spironolactone is a potassium sparing diuretic and causes hyperkalaemia. Digoxin toxicity is exacerbated by hypokalaemia but it does not cause hypokalaemia.
The following substances exert their diuretic actions upon the distal convoluted tubule: 29
T Bendrofluaside A
F Fusemide B
F Bumetanide C
F Mannitol D
F Alcohol E

Fluid retention may be caused by the administration of: 30
F Spironolactone A
F Chlorothiazide B
T Diethylstilboestrol C
T Carbenoxolone D
T Prednisolone E

Parenteral administration of atropine in therapeutic doses to a normal person causes: 31
T Impaired visual accommodation. A
F Diarrhoea. B
F Constriction of the bronchi. C
T An increase in heart rate. D
T A reduction in bronchial secretions. E

Subcutaneous atropine injection characteristically produces 32
T An increase in heart rate A
F An increase in salivation B
F Constriction of the pupil C
F A hypnotic effect D
T Decreased bronchiolar secretion. E

The following drugs have anti-cholinergic effects: 33
T Propantheline bromide. A
F Carbachol. B
F Distigmine bromide. C
T Benzhexol. D
T Atropine. E
Comment:
Carbachol- Nicotinic Agonists.
Benzhexol - used in Parkinson’s disease and is MUSCARINIC ANTAGONISTS.
Atropine is MUSCARINIC ANTAGONISTS.
Propantheline bromide is ANTI-MUSCARINIC DRUGS FOR URINARY FREQUENCY, ENURESIS AND URGE INCONTINENCE.
The following have an antiemetic action: 34
T Hyoscine hydrobromide A
F Morphine sulphate B
T Chlorpropamide C
T Promethazine hydrochloride D
T Perphenazine E
Comments 2:
Hyoscine is an alkaloid, Promethazine is an antihistamine, Perphenazine is an antipsychotic and all 3 have antiemetic properties. The sulphonyl urea chloropropramide may have antiemetic properties and has thus been marked as true. Morphine has an emetic action.
The following statements are true: 35
F Suxamethonium is non-depolarising muscle relaxant. A
F Huxamethonium is a ganglion blocker. B
T Tubocurarine is reversed by neostigmine C
F Streptomycin is absorbed from the gastrointestinal tract D
F Thiopentone can be given intramuscularly. E

The following stimulate peristalsis in the large bowel: 36
F Opiates A
T Liquid paraffin B
F Suxamethonium chloride C
T Neostigmine D
T Senna glycoside E

Treatment with morphine: 37
T Causes respiratory depression A
F Increases gastric motility B
T Causes side effects which may be reversed by naloxone C
T Increases the secretion of antidiuretic hormone D
F Causes papillary dilatation E

Treatment with morphine: 38
T Causes respiratory depression A
F Increases gastric motility B
T Causes side effects, all of which may be reversed C
T Increases the secretion of anti-diuretic hormone D
F Causes papillary dilatation E

The following statements about morphine are true: 39
T All of its pharmacological actions are reversed by naloxone A
T It is transferred into breast milk B
F It does not cross the placenta in significant quantites C
F Its analgesic effects last about 1 hour D
F It causes papillary dilatation E

Neostigmine in therapeutic doses: 40
F Acts for several days A
T Inhibits hydrolysis of acetylcholine B
F Causes paralytic ileus C
F Reverses the action of carbachol D
T Relieves the effects of myasthenia E

Lignocaine used as a local anaesthetic: 41
T Cause tachycardia if given as systemic injection A
F Has a longer lasting action than bupivicaine B
F Is used in combination with adrenaline for ring block C
F Causes vasoconstriction D
T Is a week base E
Comments 2:
Lidocaine may cause tachycardia and rise in blood pressure on IV administration. Bupivicaine has a longer lasting action than lidocaine. Adenaline is a vasoconstrictor and cannot be used in organs with end-arteries. Local anaesthetics cause vasodilataion. All local anaesthetics are weak bases.
Halothane produces: 42
T Cardiac arrhythmias A
F Explosive mixtures with air B
T Liver damage if given repeatedly C
T Myometrial relaxation D
F Bronchial irritation E

Thiopentone sodium administered intravenously: 43
F Is a potent muscle relaxant A
F Is predominantly excreted by the kidney B
T Binds to protein C
T Is fat soluble D
T Crosses the placenta E

Oestrogen therapy raises the plasma concentrations of: 44
T Thyroxine binding globulin. A
F Free cortisol. B
T Transferring. C
F Albumin. D
F Folate. E

The following compounds are predominantly progestogens: 45
F Buserelin A
T Dydrogesterone B
T Norethisterone C
T 17 α -hydroxyprogesterone D
F Androstenedione E

The effectiveness of a combined oral contraceptive may be reduced by: 46
F Bromocriptine A
T Phenytoin B
T Rifampicin C
T Ampicillin D
F Sodium valproate E

Clomifene citrate: 47
F Is an anti-androgen A
T Does not stimulate ovulation directly B
T Can produce visual disturbances C
T Is generally prescribed throughout the proliferative phase of the menstrual cycle D
T In the treatment of an ovulation, increases the risk of multiple pregnancy E

Cyproterone acetate 48
F Is an oestrogen A
F Is used for the treatment of amenorrhea B
T Bind to androgen receptors C
F Increases libido D
T Inhibits spermatogensis E

The following are cytotoxic alkylating agents 49
T Cyclophosphamide A
F Mercaptopuracil B
T Chloroambucil C
F Fluorouracil D
F Methotrexate E

The following drugs may cause enlargement of the fetal thyroid gland: 50
F Methyldopa A
F Thyroxine B
T Carbimazole C
F Propranolol D
T Propylthiouracil E

The following substances lower the blood glucose concentration: 51
F Adrenaline A
T Chlorpropamide B
F Chlorothiazide C
T Metformin D
F Thyroxine E

The following drugs and side effects are associated: 52
T Carbenoxolone : sodium retention A
F Chlorothiazide: hypoglycaemia B
F Salbutamol: bronchospasm C
T Clonidine: rebound hypertension D
T Phenytoin: folate deficiency E

The following drugs and side effects are associated: 53
T Methyldopa:depression A
F Paracetamol: thromboembolism B
T Indomethacin:peptic ulcer C
T Prednisolone :osteoporosis D
F Ritodrine:hypoglycaemia E

The following substances increase the serum uric acid concentration: 54
F Colchicine A
T Cholorothiazide B
F Allopurinol C
F Probenecid D
F Phenylbutazone E

The therapeutic effect of the first drug is enhanced by the second drug: 55
F Phenytoin: ethinyloestradiol A
F Bromocriptine: metoclopramide B
T Penicillin: probenecid C
T Ritodrine: dexamethasone D
F Warfarin: phenobarbitone E

The following factors enhance the transplacental passage of drugs: 56
T Lipid solubility A
F A high degree of ionic dissociation B
F High molecular weight C
F Protein binding D
F Uterine contractions E

The following drugs diminish detrusor contractions: 57
T Atropine. A
F Carbachol. B
T Propantheline. C
T Nifedipine. D
F Distigmine. E
Comments 2:
Atropine has anticholinergic effects. Carbachol causes the detrusor muscle to contract. Propantheline has antimuscarinic and ganglionic-blocking effects Nifedipine – calcium antagonist - Influx of extracellular calcium is important for detrusor muscle contractions and this can be blocked by calcium antagonists. Distigmine does not have any effect on detrusor contractility.
The following drug combinations have been shown to interact to produce the stated effects: 58
T Ampicillin enhances the anticoagulant action of warfarin. A
T Aciclovir diminishes the effect of oral contraceptives. B
F Cimetidine inhibits the metabolism of phenytoin. C
T Aspirin diminishes the action of ritodrine. D
F Tamoxifen increases the anticoagulant effect of warfarin. E
Comment:
Oestrogens (including tamoxifen) are pro-thrombotic and antagonise warfarin effects *.
Anti-viral agents - nevirapine, nelfinavir, ritonavir - induce hepatic enzymes *.
The following cytotoxic drugs are correctly classified: 59
F Methotrexate: alkylating agent A
T Cyclophosphomide: alkylating agent B
F Vinblastine: antimetabolite C
T Mercaptopurine: antimetabolite D
F Fluoruracil: antibiotic E

The following drugs should be avoided in renal impairment: 60
T Cephalothin A
T Cisplatin B
F Norethisterone C
F Dopamine D
T Gentamycin E