Pharmacological Principles Multiple Choice Questions
Chapters
- Pharmacokinetics – Pharmacodynamics
- Pharmacodynamics & Pharmacokinetics
1. Which of the following is >90% bound to plasma proteins?
A. Atenolol
B. Diazepam
C. Gentamycin
D. Lithium
E. Theophylline
Answer: B.Diazepam
2. Which of the following has the largest volume of distribution?
A. Digoxin
B. Imipramine
C. Lithium
D. Chloroquine
E. Trimethoprim
Answer: D.Chloroquine
3. Which of the following has the shortest half life?
A. Theophylline
B. Diazepam
C. Aspirin
D. Lithium
E. Digoxin
Answer: C.Aspirin
4. Which of the following is a phase one reaction?
A. Reduction
B. Acetylation
C. Glucuronidation
D. Methylation
E. Sulphate conjugation
Answer: A.Reduction
5. Clearance of which drug involves capacity limited elimination?
A. Theophylline
B. Gentamycin
C. Digoxin
D. Lithium
E. Phenytoin
Answer: E.Phenytoin
6. An example of drugs that undergo chemical antagonism is
A. Insulin – glucagon
B. Protamine – heparin
C. Prednisone – glipizide
D. Morphine – naloxone
E. Phenoxybenzamine – prazosin
Answer: B.Protamine – heparin
7. Regarding first order kinetics – all of the following are true EXCEPT
A. First order kinetics means rate of reaction is proportional to concentration
B. First order kinetics is more common than zero order kinetics
C. First order kinetics apply to exponential processes
D. First order kinetics generally apply to high plasma concentrations (>20 mg / 100 ml) of ethanol
E. First order kinetics result in steady state concentrations after multiple dosing.
Answer: D.First order kinetics generally apply to high plasma concentrations (>20 mg / 100 ml) of ethanol
8. Bioavailability is
A. The difference between the amount of drug absorbed and the amount excreted
B. The proportion of the drug in a formulation that is found in the systemic circulation
C. The AUC relating plasma concentration of drug to time after administration
D. Always identical with different formulations of the same drug
E. A measure of the rate of absorption of a drug
Answer: B.The proportion of the drug in a formulation that is found in the systemic circulation
9. Which of the following drugs has a high extraction ratio?
A. Diazepam
B. Theophylline
C. Phenytoin
D. Warfarin
E. Propranolol
Answer: E.Propranolol
10. What is the half life of a drug with a volume of distribution of 700l/70kg and clearance of 49l/hour/70kg?
A. 5 hours
B. 7 hours
C. 10 hours
D. 12.5 hours
E. 15 hours
Answer: C.10 hours
11. Regarding biotransformation
A. Phase one reactions always precede phase two reactions
B. Skin is an organ involved in drug biotransformation
C. Water conjugation is a phase one reaction
D. CYP2D6 accounts for the majority of P450 activity
E. Epoxidation is phase two biotransformation
Answer: B.Skin is an organ involved in drug biotransformation
12. Which of the following receptor – ligand pathway is correct?
A. Insulin – G protein receptor
B. Mineralocorticoid – tyrosine kinase receptor
C. Vitamin D – intracellular receptor
D. Adrenaline – ligand gated channel receptor
E. Platelet derived growth factor – cytokine receptor
Answer: C.Vitamin D – intracellular receptor
13. Age associated changes in pharmacokinetics include
A. Reduction in creatinine clearance in 2/3 population
B. Decreased body fat
C. Increase body water
D. A greater reduction in conjugation compared with oxidation
E. A decreased absorption related to age alone
Answer: A.Reduction in creatinine clearance in 2/3 population
14. The metabolic pathway of detoxification that become increasingly important in paracetamol toxicity is
A. Conjugation with glucuronide
B. Oxidation
C. Reduction
D. Methylation
E. Cytochrome p450 dependent glutathione conjugation
Answer: E.Cytochrome p450 dependent glutathione conjugation
15. You are given a vial with 15 ml of 0.5% prilocaine to do an arm block. How many mg of prilocaine are you injecting?
A. 7.5 mg
B. 15 mg
C. 30 mg
D. 50 mg
E. 75 mg
Answer: E.75 mg
16. Drugs that enhance other drug metabolism include all of the following EXCEPT
A. Rifampicin
B. Ketoconazole
C. Phenobarbital
D. Griseofulvin
E. Phenytoin
Answer: B.Ketoconazole
17. Which is the safest to give in pregnancy?
A. Lithium
B. Phenytoin
C. Gentamycin
D. Heparin
E. ACE inhibitors
Answer: D.Heparin
18. Regarding pharmacology principles
A. Diffusion is directly proportional to thickness and inversely proportional to surface area
B. LD50 – 50% of the dose that kills most people
C. Efficacy is the maximum response produced by a drug
D. A partial agonist is always less potent than a full agonist
E. EC50 = concentration of agonist that results in maximal response in 50% of patients
Answer: C.Efficacy is the maximum response produced by a drug
19. Reports of cardiac arrhythmias caused by unusually high blood levels of 2 antihistamines (terfenadine and astemizole) are best explained by
A. Concomitant treatment with phenobarbital
B. Use of these drugs by smokers
C. Use of antihistamines by persons of Asian background
D. A genetic predisposition to metabolise succinylcholine slowly
E. Treatment of these patients with ketoconazole
Answer: E.Treatment of these patients with ketoconazole
20. Which of the following statements is correct?
A. The half life is the time taken for a parameter to fall to 1/4 its original value
B. Partial agonists act at receptor sites to cause maximal pharmacological effect at high doses
C. Diazepam has a high extraction ratio and is thus subject to flow dependent elimination
D. Morphine and pethidine have the same potency
E. A patient with oedema will have an increased volume of distribution of tobramycin
Answer: E.A patient with oedema will have an increased volume of distribution of tobramycin
chapter:
Pharmacodynamics & Pharmacokinetics
21. Which of the following drugs has an average half life of 50 hours?
A. Nortriptylline
B. Digoxin
C. Trimethoprim
D. Valproic acid
E. Lithium
Answer: B.Digoxin
22. All of the following have 100% oral bioavailability EXCEPT
A. Valproic acid
B. Trimethoprim
C. Digoxin
D. Diazepam
E. Lithium
Answer: C.Digoxin
23. All of the following drugs are >90% plasma protein bound EXCEPT
A. Diazepam
B. Frusemide
C. Fluoxetine
D. Gentamicin
E. Warfarin
Answer: D.Gentamicin
24. Which of the following drugs has a volume of distribution >2000 ℓ/70kg?
A. Aspirin
B. Imipramine
C. Digoxin
D. Propranolol
E. Chloroquine
Answer: E.Chloroquine
25. What is the half life of a drug with a volume of distribution of 100ℓ/70kg and a clearance of 7ℓ/hr/70kg
A. 5 hours
B. 10 hours
C. 12.5 hours
D. 15 hours
E. 20 hours
Answer: B.10 hours
26. All of the following drugs exhibit flow dependent elimination EXCEPT
A. Atenolol
B. Isoniazid
C. Propoxyphene
D. Amitriptylline
E. Lignocaine
Answer: A.Atenolol
27. Which of the following undergoes a phase I hydrolysis reaction?(biotransformation)
A. Ethanol
B. Naloxone
C. Morphine
D. Lignocaine
E. Diazepam
Answer: D.Lignocaine
28. Which of the following undergoes acetylation in the liver? (Phase 2 biotransformation)
A. Isoniazid
B. Acetaminophen
C. Salicylic acid
D. Epinephrine
E. Diazepam
Answer: A.Isoniazid
29. A D Response B C Concentration Which of these drugs is the most efficacious?
A. Drugs A and B
B. Drug C
C. Drugs A and D
D. Drugs D and C
E. Drug A
Answer: C.Drugs A and D
30. Referring to the graph in question 9 – which of the drugs is most potent?
A. A
B. B
C. C
D. D
E. A and B
Answer: A.A
31. EC50 is
A. Measured with a radioactive receptor
B. Always equal to Kd
C. Drug concentration with 50% receptors bound
D. Representation of the receptors affinity for drug binding
E. Drug concentration with 50% of maximal drug effect
Answer: E.Drug concentration with 50% of maximal drug effect
32. Which of the following will NOT alter the volume of distribution of a drug?
A. Cardiac failure
B. Clearance
C. Age
D. Burns
E. Pleural effusion
Answer: B.Clearance
33. Volume of distribution equals
A. Dose given/plasma concentration
B. Total amount of drug in the body/plasma concentration
C. Urine drug concentration/plasma concentration
D. Dose given/urine concentration
E. Urine drug concentration/plasma concentration
Answer: B.Total amount of drug in the body/plasma concentration
34. Which of the following drugs undergoes rate limited elimination?
A. Lignocaine
B. Morphine
C. Warfarin
D. Propanolol
E. Aspirin
Answer: E.Aspirin
35. Ligand gated channel receptors include all of the following EXCEPT
A. GABA
B. Aspartate
C. Glycine
D. Glutamate
E. Ach-muscarinic
Answer: E.Ach-muscarinic
36. Regarding receptor regulation
A. Receptor down regulation occurs over hours – days
B. Receptor responses to drugs often “desensitise” with time – this desensitisation is usually irreversible
C. The mechanism of agonist induced desensitisation of the nicotinic Ach receptor has been worked out in detail
D. All “internalised” receptors are degraded by lysosomes
E. None of the above are correct
Answer: A.Receptor down regulation occurs over hours – days
37. Which of the following acts on intracellular receptors
A. Serotonin
B. Glucagon
C. Corticosteroids
D. GABA
E. Insulin
Answer: C.Corticosteroids
38. Which of the following has ↑ bioavailability in the neonate whencompared with older children/adults?
A. Penicillin
B. Digoxin
C. Acetaminophen
D. Diazepam
E. Phenobarbital
Answer: A.Penicillin
39. First order kinetics
A. Means rate of reaction is proportional to concentration
B. Are more common than zero order kinetics
C. Apply to exponential processes
D. Generally apply to high plasma concentrations (>20mg/100ml) of ethanol
E. Result in steady state concentrations after multiple dosing
Answer: D.Generally apply to high plasma concentrations (>20mg/100ml) of ethanol
40. A single compartment model means that
A. One exponential term describes the decreasing plasma concentration of the drug
B. A single exponential term describes the rise in plasma concentration following oral administration
C. The drug does not penetrate tissues
D. The drug is restricted to the ECF
E. The drug is highly ionised
Answer: A.One exponential term describes the decreasing plasma concentration of the drug