NURS 531 Rang & Dale’s Pharmacology, 7th Edition TestBank

Document Content and Description Below

NURS 531 Rang & Dale’s Pharmacology, 7th Edition TestBankRang: Rang & Dale’s Pharmacology, 7th Edition Test Bank Chapter 1: What is pharmacology? MULTIPLE CHOICE 1. The modern era of antimicrobial... chemotherapy originated with the discovery of 1. penicillin 2. arsenical compounds 3. quinine 4. sulfonamides 5. calomel Answer b: arsenical compounds 1. Morphine was isolated from opium by 1. Paul Ehrlich 2. Gerhard Domagk 3. Friedrich Sertürner 4. Rudolf Buchheim 5. Henry Dale Answer c: Friedrich Sertürner 1. The use of genetic information to guide the choice of drug therapy is called 1. pharmacoepidemiology 2. pharmacogenetics 3. biotechnology 4. pharmacogenomics 5. pharmacoeconomics Answer d: pharmacogenomics Chapter 2: How drugs act: general principles MULTIPLE CHOICE 1. The concentration of a drug required to occupy 50 percent of its receptor sites is 1. the concentration required to produce the maximum physiological effect 2. directly proportional to the drug’s affinity for its receptor 3. inversely proportional to the drug’s affinity for its receptor 4. directly proportional to the drug’s intrinsic efficacy 5. usually determined with the Schild equation Answer c: inversely proportional to the drug’s affinity for its receptor 1. In the presence of a competitive antagonist, the agonist log-concentration effect curve is 1. shifted to the right without a change in slope or maximum effect 2. shifted to the left without a change in slope or maximum effect 3. shifted to the right with a decreased slope and maximum effect 4. shifted to the left with a decreased slope and maximum effect 5. not shifted right or left but shows a decreased maximum effect Answer a: shifted to the right without a change in slope or maximum effect 1. The magnitude of the response to a drug is related to the 1. total number of receptors for the drug 2. number of receptors occupied by the drug 3. number of vacant receptors in the tissue 4. number of spare receptors in the tissue 5. number of phosphorylated receptors in the tissue Answer b: number of receptors occupied by the drug 1. The Schild equation shows that the concentration ratio of an agonist required to occupy the same number of receptors in the absence and presence of a competitive antagonist is determined by the 1. equilibrium constant of the agonist 2. affinity of the agonist for its receptor 3. equilibrium constant of the antagonist 4. total number of available receptors 5. number of spare receptors in the tissue Answer c: equilibrium constant of the antagonist 1. A partial agonist is typically a drug that 1. has low affinity for its receptor 2. can only occupy a small fraction of its receptors 3. can only produce a submaximal response 4. requires high doses to produce a maximal response 5. increases the number of spare receptors Answer c: can only produce a submaximal response 1. A type of drug that reduces the slope and maximum response of an agonist is 1. a non-competitive antagonist 2. a competitive antagonist 3. a physiologic antagonist 4. an inverse agonist 5. a partial agonist Answer a: a non-competitive antagonist 1. Drugs that form covalent bonds with their receptors are usually 1. reversible competitive antagonists 2. irreversible competitive antagonists 3. partial agonists 4. inverse agonists 5. inverse antagonists Answer b: irreversible competitive antagonists 1. A gradual decrease in the number of drug receptors is most likely to result from exposure to 1. a competitive antagonist 2. a non-competitive antagonist 3. an agonist 4. an inverse agonist 5. an antimetabolite Answer c: an agonist 1. The total number of receptor binding sites in a preparation and the binding equilibrium constant can be determined from a 1. total binding versus drug concentration curve 2. dose-response curve 3. Hill-Langmuir equation 4. Scatchard plot 5. Schild plot Answer d: Scatchard plot 1. Receptor desensitization typically results from 1. endocytosis of receptors 2. exposure to an inverse agonist 3. irreversible agonist binding 4. spare receptors 5. phosphorylation of receptor protein Answer e: phosphorylation of receptor protein Chapter 3: How drugs act: molecular aspects MULTIPLE CHOICE 1. The Jak/Stat pathway of signal transduction responds to activation by 1. acetylcholine 2. steroid hormones 3. human growth hormone 4. cytokines 5. epinephrine Answer d: cytokines 1. In the growth factor kinase cascade, Map (mitogen-activated protein) kinase acts to phosphorylate 1. DNA 2. transcription factors 3. cyclic AMP 4. ion channels 5. transport proteins Answer b: transcription factors 1. Which second messenger in a G-protein coupled receptor signal transduction cascade typically increases intracellular calcium? 1. cyclic GMP 2. cyclic AMP 3. diacylglycerol 4. arachidonic acid 5. inositol triphosphate Answer e: inositol triphosphate 1. Which signal transduction pathway is most important in cell division, growth, and differentiation? 1. beta-adrenoceptor signal pathways 2. phospholipase C pathways 3. Ras/Raf/Map kinase 4. eicosanoid signal pathways 5. guanylate cyclic signal pathways Answer c: Ras/Raf/Map kinase 1. Coupling of a G-protein alpha subunit to an agonist-occupied receptor initially leads to 1. activation of the beta-gamma complex 2. hydrolysis of GTP 3. activation of adenylate cyclase 4. exchange of bound GDP with GTP 5. dissociation of the alpha-subunit from the receptor Answer d: exchange of bound GDP with GTP 1. The nicotinic receptor is an example of a 1. G-protein coupled receptor 2. ligand-gated ion channel 3. tyrosine-kinase linked receptor 4. cytokine receptor 5. transport protein Answer b: ligand-gated ion channel 1. In G-protein coupled receptor signal transduction, protein kinase A is typically activated by 1. inositol triphosphate 2. ATP 3. cyclic AMP 4. cyclic GMP 5. diacylglycerol Answer c: cyclic AMP 1. An agonist for a ligand-gated ion channel typically 1. increases channel conductance 2. increases the number of open channels 3. increases the rate of channel closing 4. alters channel ion selectivity 5. alters the open channel conformation Answer b: increases the number of open channels 1. Diacylglycerol produces its intracellular effects by 1. activating protein kinase C 2. activating protein kinase A 3. releasing intracellular calcium 4. activating adenylate cyclase 5. activating guanylate cyclase Answer a: activating protein kinase C 1. Class I nuclear receptors that control gene transcription 1. contain cysteine residues bound to iron 2. interact with nucleolar RNA 3. bind to hormone response elements of DNA 4. only act to inhibit DNA transcription 5. only act to stimulate DNA transcription Answer c: bind to hormone response elements of DNA 1. Myasthenia gravis is a disease in which 1. receptors have an abnormal amino acid sequence 2. G proteins have mutated 3. signal transmission pathways are defective 4. autoantibodies are directed against receptor proteins 5. nuclear receptors are down-regulated Answer d: autoantibodies are directed against receptor proteins 1. Receptors for insulin 1. contain tyrosine kinase in their intracellular domain 2. bind and activate intracellular kinases 3. exhibit phosphatase activity 4. phosphorylate DNA transcription factors 5. are linked to guanylate cyclase Answer a: contain tyrosine kinase in their intracellular domain 1. Which ion inhibits an enzyme (inositol-1-phosphatase) in the phosphoinositol cycle? 1. calcium 2. ferrous 3. sodium 4. potassium 5. lithium Answer e: lithium 1. The opening of chloride ion channels by gamma-amino butyric acid is facilitated by 1. tricyclic antidepressant drugs 2. benzodiazepine drugs 3. local anesthetics 4. opioid analgesics 5. central nervous system stimulants Answer b: benzodiazepine drugs 1. The most rapid response is produced by activation of 1. kinase-linked receptors 2. G-protein coupled receptors 3. receptors activating gene transcription 4. ionotropic receptors 5. insulin receptors Answer d: ionotropic receptors 1. Which type of receptors contains seven transmembrane helices? 1. nicotinic acetylcholine receptors 2. sodium channels 3. steroid hormone receptors 4. insulin receptors 5. G-protein-coupled receptors Answer e: G-protein-coupled receptors 1. The treatment of chronic myeloid leukemia with imatinib results from the ability of the drug to inhibit a specific 1. ligand-gated ion channel 2. G-protein-coupled receptor 3. tyrosine kinase 4. Map (mitogen-activated protein) kinase 5. nuclear receptor Answer c: tyrosine kinase 1. Which receptors are activated by proteolytic cleavage and inactivated by phosphorylation? 1. neurotransmitter receptors 2. cytokine receptors 3. growth factor receptors 4. thrombin receptors 5. insulin receptors Answer d: thrombin receptors 1. Which receptors are entirely located intracellularly? 1. G-protein-coupled receptors 2. nicotinic receptors 3. thyroid hormone receptors 4. cytokine and growth factor receptors 5. muscarinic receptors Answer c: thyroid hormone receptors Chapter 4: How drugs act: cellular aspects—excitation, contraction and secretion MULTIPLE CHOICE 1. L(long-lasting)-type calcium channels are correctly described as having 1. low activation threshold and slow inactivation 2. high activation threshold and slow inactivation 3. low activation threshold and fast inactivation 4. high activation threshold and fast inactivation 5. none of the above as correct Answer b: high activation threshold and slow inactivation 1. The extrusion of calcium from the cell cytoplasm primarily depends on 1. ligand-gated calcium channels 2. voltage-gated calcium channels 3. the sodium-calcium exchange transporter 4. the ATP-driven calcium pump 5. nuclear sequestration Answer d: the ATP-driven calcium pump 1. The mechanism by which monamine neurotransmitters are released from nerve terminals is 1. calcium-mediated exocytosis 2. carrier-mediated release 3. ATP-dependent active transport 4. diffusion through aqueous pores 5. diffusion through membrane lipid Answer a: calcium-mediated exocytosis 1. Batrachotoxin binds sodium channels and thereby 1. opens channels 2. prevents channel opening 3. prevents channel inactivation 4. closes channels 5. causes channels to remain closed Answer c: prevents channel inactivation 1. Closure of potassium channels in excitable membranes causes membrane 1. repolarization 2. depolarization 3. hyperpolarization 4. disintegration 5. inactivation Answer b: depolarization 1. In smooth muscle, inositol triphosphate releases calcium from the 1. Golgi body 2. mitochondria 3. cell nucleus 4. T-tubule 5. sarcoplasmic reticulum Answer e: sarcoplasmic reticulum 1. Calcium facilitates the release of nitric oxide by 1. causing exocytosis 2. causing membrane depolarization 3. activating nitric oxide synthase 4. activating transport carriers 5. activating G-protein-coupled receptors Answer c: activating nitric oxide synthase 1. Amiloride affects epithelial ion transport by blocking 1. the Na+/K+ exchange pump 2. the Na+/K+ co-transporter 3. sodium channels 4. potassium channels 5. calcium channels Answer c: sodium channels 1. In the colon, chloride transport is important in 1. potassium secretion 2. potassium reabsorption 3. fluid secretion 4. fluid reabsorption 5. sodium bicarbonate reabsorption Answer d: fluid reabsorption 1. A key step in causing smooth muscle contraction is the phosphorylation of 1. actin 2. myosin light chain 3. myosin heavy chain 4. guanylate cyclase 5. myosin phosphatase Answer b: myosin light chain 1. Adrenergic beta-receptor agonists cause smooth muscle relaxation by 1. increasing cyclic AMP formation 2. decreasing cyclic AMP formation 3. increasing cyclic GMP formation 4. decreasing cyclic GMP formation 5. inhibiting protein kinase A Answer a: increasing cyclic AMP formation Chapter 5: Cell proliferation, apoptosis, repair and regeneration MULTIPLE CHOICE 1. In the death receptor pathway, activation of tumor necrosis factor receptors causes the receptors to trimerize and complex an adapter protein, thereby leading to activation of 1. mitochondrial pathways 2. caspase-8 3. pro-apoptotic factor Bcl-2 4. a p53 protein 5. DNA transcription factors Answer b: caspase-8 1. The activation of primitive stem cells so as to replace a damaged tissue is called 1. healing 2. repair 3. restoration 4. regeneration 5. rejuvenation Answer d: regeneration 1. Defective apoptosis may contribute to the development of 1. cancer 2. Alzheimer’s disease 3. myocardial infarction 4. aplastic anemia 5. stroke Answer a: cancer 1. The activation of caspase-3 leads to 1. activation of transcription factors 2. inhibition of transcription factors 3. activation of the anti-apoptotic pathway 4. fragmentation of genomic DNA 5. stabilization of cell membranes Answer d: fragmentation of genomic DNA 1. Bortemozib causes accumulation of an apoptotic-promoter protein by inhibiting 1. mitochondrial DNA 2. suvivin 3. matrix metalolproteinases 4. pro-apoptotic Bcl-2 5. the proteasome Answer e: the proteasome 1. Matrix metalloproteinases are responsible for 1. inhibition of neoplastic cell growth 2. adjusting the cell cytoskeleton 3. degradation of extracellular matrix 4. initiating angiogenesis 5. activation of the cell cycle Answer c: degradation of extracellular matrix 1. Antisense compounds active against antiapoptotic factors are potentially useful for treating 1. myocardial infarction 2. leukemia 3. Parkinson’s disease 4. multiple sclerosis 5. impaired wound healing Answer b: leukemia 1. Bevacizumab is a monoclonal antibody that targets 1. caspase-3 2. metalollproteinase 3. cyclin 4. vascular endothelial growth factor 5. promoters of apoptosis Answer d: vascular endothelial growth factor 1. Mitochondria participate in apoptosis by releasing 1. apoptotic protease activating factor 2. caspase-9 3. cytochrome c 4. p53 protein 5. inhibitors of apoptosis Answer c: cytochrome c 1. Progress through the cell cycle is stimulated by 1. cyclin-dependent kinases 2. phosphorylated Rb protein 3. check point factors 4. p53 protein 5. inhibitors of kinases Answer a: cyclin-dependent kinases NO Chapter 6??????????????? Chapter 7: Method and measurement in pharmacology MULTIPLE CHOICE 1. A statistical technique used to pool data from several independent but related studies is called 1. double-blind technique 2. randomization 3. sequential studies 4. meta-analysis 5. high-powered trial Answer d: meta-analysis 1. The main problem with all types of bioassay is 1. human error 2. inadequate instrumentation 3. biological variation 4. high cost compared to other techniques 5. inability to determine potency Answer c: biological variation 1. If the dose-response curves of two drugs are parallel in a bioassay, it usually indicates that the two drugs 1. have the same potency 2. act on the same type of receptors 3. are identical 4. are clinically effective 5. produce a quantal response Answer b: act on the same type of receptors 1. Quantal dose-response curves are obtained when studying 1. all-or-nothing responses 2. submaximal responses 3. bimodal responses 4. partial agonists 5. pain intensity Answer a: all-or-nothing responses 1. The double-blind technique is employed in clinical trials to 1. facilitate meta-analysis 2. confuse regulatory agencies 3. avoid bias in assigning subjects to treatment groups 4. avoid bias of patients and investigators 5. obviate the need for a control group Answer d: avoid bias of patients and investigators 1. Transgenic mice that overexpress mutated forms of amyloid precursor protein provide a useful model for studying 1. Alzheimer’s disease 2. Parkinson’s disease 3. Huntington’s disease 4. amyotrophic lateral sclerosis 5. multiple sclerosis Answer a: Alzheimer’s disease 1. Transgenic animal models referred to as “knock-outs” 1. result from insertion of new genes 2. result from substitution of one gene for another 3. result from inactivation of an existing gene 4. result from mutation of an existing gene 5. typically cause overexpression of proteins Answer c: result from inactivation of an existing gene Chapter 8: Drug absorption and distribution MULTIPLE CHOICE 1. Concerning the effect of pH on the urinary excretion of drugs, it can be correctly stated that 1. urinary acidification accelerates excretion of weak acids and bases 2. urinary alkalinization accelerates excretion of weak acids and bases 3. urinary acidification accelerates excretion of weak acids 4. urinary alkalinization accelerates excretion of weak acids 5. urinary alkalinization has no effect on excretion of weak bases Answer d: urinary alkalinization accelerates excretion of weak acids 1. Bioavailability is defined as the proportion of ingested drug that 1. is absorbed from the gastrointestinal tract 2. reaches the systemic circulation in an active form 3. crosses the blood-brain barrier 4. is unbound to plasma proteins 5. is distributed to the target tissue Answer b: reaches the systemic circulation in an active form 1. The rectal route of administration 1. provides nearly 100 percent bioavailability 2. is only used for localized effects 3. is suitable for persons with nausea and vomiting 4. is subject to a high degree of first-pass metabolism 5. is used for administration of nitroglycerin Answer c: is suitable for persons with nausea and vomiting 1. The passage of drugs across the blood-brain barrier 1. is facilitated by a high degree of drug ionization 2. is most rapid for drugs with low lipid solubility 3. occurs more readily in the chemoreceptor trigger zone 4. is reduced by inflammation of the meninges 5. is rapid with aminoglycoside antibiotics Answer c: occurs more readily in the chemoreceptor trigger zone 1. A calculated volume of distribution greater than total body water is most likely to occur with drugs that are 1. highly ionized 2. highly lipid soluble 3. subject to a high degree of first-pass inactivation 4. highly bound to plasma proteins 5. very large molecules Answer b: highly lipid soluble 1. Drugs are most readily absorbed across cells of the 1. gastrointestinal tract 2. renal tubules 3. vascular endothelium 4. lung parenchyma 5. liver Answer c: vascular endothelium 1. The binding of drugs to plasma albumin 1. is usually irreversible 2. is saturable 3. is most important for basic drugs 4. accelerates drug metabolism 5. accelerates drug excretion Answer b: is saturable 1. Most drugs are absorbed across cell membranes of the gut by the process of 1. diffusing through lipid 2. pinocytosis 3. diffusing through aqueous pores 4. carrier-mediated transport 5. ion trapping Answer c: diffusing through lipid 1. Which drug is absorbed by a membrane carrier that transports phenylalanine? 1. insulin 2. propranolol 3. levodopa 4. aspirin 5. penicillin Answer c: levodopa 1. Transdermal drug administration 1. is most suitable for highly polar drugs 2. is not subject to first-pass hepatic metabolism 3. provides rapid and complete absorption 4. is only used for localized effects 5. is most suitable for unconscious persons Answer b: is not subject to first-pass hepatic metabolism Chapter 9: Drug metabolism and elimination MULTIPLE CHOICE 1. Hepatic cytochrome P450 drug-metabolizing enzymes are primarily found in 1. cell nuclei 2. plasma membranes 3. the cytoplasm 4. the smooth endoplasmic reticulum 5. mitochondria Answer d: the smooth endoplasmic reticulum 1. Phase II drug metabolism 1. includes hydrolytic reactions 2. produces low molecular weight products 3. usually forms inactive metabolites 4. takes place mainly in the kidneys 5. requires NADPH as a cofactor Answer c: usually forms inactive metabolites 1. Ketoconazole produces non-competitive inhibition of cytochrome P450 by 1. binding to the ferric form of heme iron 2. binding to the active site of the enzyme 3. causing enzyme autolysis 4. oxidizing NADPH 5. binding covalently to the P450 protein Answer a: binding to the ferric form of heme iron 1. In first-order drug elimination 1. drug half-life is directly proportional to drug concentration 2. the rate of elimination is directly proportional to drug concentration 3. drug clearance is directly proportional to plasma drug concentration 4. the rate of elimination is constant 5. the rate of elimination is unpredictable Answer b: the rate of elimination is directly proportional to drug concentration 1. If a drug is administered repeatedly at the same dose and dosage interval, the time required to reach the steady-state plasma drug concentration is proportional to the 1. dose 2. route of administration 3. dosage interval 4. bioavailability 5. elimination half-life Answer e: elimination half-life 1. If a drug exhibits saturation (zero-order) kinetics, then 1. the rate of drug elimination is constant 2. drug half-life is constant 3. drug clearance is constant 4. plasma drug concentration is constant 5. plasma drug concentration falls exponentially Answer a: the rate of drug elimination is constant 1. In the two-compartment pharmacokinetic model, orally administered drugs are 1. absorbed into the peripheral compartment 2. distributed from the central to the peripheral compartment 3. metabolized in the central compartment 4. excreted in the peripheral compartment 5. none of the above Answer b: distributed from the central to the peripheral compartment 1. Which of the following will be increased if the rate of drug absorption from the gut is reduced? 1. oral bioavailability 2. volume of distribution 3. peak plasma drug concentration 4. elimination half-life 5. duration of action Answer e: duration of action 1. The volume of plasma from which a drug is eliminated in a unit of time is known as the 1. volume of elimination 2. volume of distribution 3. clearance 4. elimination rate constant 5. kinetic volume Answer c: clearance 1. Inactive prodrugs have been developed to 1. reduce drug toxicity 2. increase drug half-life 3. decrease hepatic drug metabolism 4. increase drug absorption 5. slow drug excretion Answer d: increase drug absorption Chapter 10: Pharmacokinetics MULTIPLE CHOICE 1. Hepatic cytochrome P450 drug-metabolizing enzymes are primarily found in 1. cell nuclei 2. plasma membranes 3. the cytoplasm 4. the smooth endoplasmic reticulum 5. mitochondria Answer d: the smooth endoplasmic reticulum 1. Phase II drug metabolism 1. includes hydrolytic reactions 2. produces low molecular weight products 3. usually forms inactive metabolites 4. takes place mainly in the kidneys 5. requires NADPH as a cofactor Answer c: usually forms inactive metabolites 1. Ketoconazole produces non-competitive inhibition of cytochrome P450 by 1. binding to the ferric form of heme iron 2. binding to the active site of the enzyme 3. causing enzyme autolysis 4. oxidizing NADPH 5. binding covalently to the P450 protein Answer a: binding to the ferric form of heme iron 1. In first-order drug elimination 1. drug half-life is directly proportional to drug concentration 2. the rate of elimination is directly proportional to drug concentration 3. drug clearance is directly proportional to plasma drug concentration 4. the rate of elimination is constant 5. the rate of elimination is unpredictable Answer b: the rate of elimination is directly proportional to drug concentration 1. If a drug is administered repeatedly at the same dose and dosage interval, the time required to reach the steady-state plasma drug concentration is proportional to the 1. dose 2. route of administration 3. dosage interval 4. bioavailability 5. elimination half-life Answer e: elimination half-life 1. If a drug exhibits saturation (zero-order) kinetics, then 1. the rate of drug elimination is constant 2. drug half-life is constant 3. drug clearance is constant 4. plasma drug concentration is constant 5. plasma drug concentration falls exponentially Answer a: the rate of drug elimination is constant 1. In the two-compartment pharmacokinetic model, orally administered drugs are 1. absorbed into the peripheral compartment 2. distributed from the central to the peripheral compartment 3. metabolized in the central compartment 4. excreted in the peripheral compartment 5. none of the above Answer b: distributed from the central to the peripheral compartment 1. Which of the following will be increased if the rate of drug absorption from the gut is reduced? 1. oral bioavailability 2. volume of distribution 3. peak plasma drug concentration 4. elimination half-life 5. duration of action Answer e: duration of action 1. The volume of plasma from which a drug is eliminated in a unit of time is known as the 1. volume of elimination 2. volume of distribution 3. clearance 4. elimination rate constant 5. kinetic volume Answer c: clearance 1. Inactive prodrugs have been developed to 1. reduce drug toxicity 2. increase drug half-life 3. decrease hepatic drug metabolism 4. increase drug absorption 5. slow drug excretion Answer d: increase drug absorption Chapter 11: Individual variation and drug interaction MULTIPLE CHOICE 1. In babies born at term, the ability to conjugate drugs with glucuronate reaches adult levels in about 1. one week 2. one month 3. 8 weeks 4. 6 months 5. 1 year Answer c: 8 weeks 1. The bimodal distribution of plasma isoniazid concentrations in a typical human population is the result of a genetically determined variation in 1. acetyltransferase activity 2. glucuronyl transferase activity 3. cytochrome P450 enzymes 4. plasma cholinesterase activity 5. plasma protein binding Answer a: acetyltransferase activity 1. Carbamazepine may cause acute porphyria in susceptible persons because the drug 1. inhibits porphyrin excretion 2. increases porphyrin excretion 3. induces d-amino levulinic acid synthase 4. inhibits d-amino levulinic acid synthase 5. induces cytochrome P450 enzymes Answer c: induces d-amino levulinic acid synthase 1. Mercaptopurine doses should be reduced in persons receiving allopurinol because 1. mercaptopurine induces metabolism of allopurinol 2. mercaptopurine inhibits metabolism of allopurinol 3. allopurinol induces metabolism of mercaptopurine 4. allopurinol inhibits metabolism of mercaptopurine 5. allopurinol has the same toxicity as mercaptopurine Answer d: allopurinol inhibits metabolism of mercaptopurine 1. Idiosyncratic reactions are defined as drug effects that occur in 1. all persons 2. most persons 3. a few persons 4. persons taking a toxic overdose 5. persons abusing a drug Answer c: a few persons 1. Drugs that inhibit the metabolism of other drugs by cytochrome P450 enzymes include 1. disulfiram 2. allopurinol 3. phenobarbital 4. rifampicin 5. ketoconazole Answer e: ketoconazole 1. Atropine slows the absorption of other drugs from the gut primarily by 1. forming an insoluble complex with other drugs 2. causing vasoconstriction 3. inhibiting gastric acid secretion 4. inhibiting gastric emptying 5. increasing intestinal motility Answer d: inhibiting gastric emptying 1. Plasma concentrations of digoxin are increased by amiodarone as a result of 1. decreased renal tubular secretion of digoxin 2. increased reabsorption of digoxin in the nephron 3. decreased hepatic metabolism of digoxin 4. increased hepatic metabolism of digoxin 5. increased absorption of digoxin from the gut Answer a: decreased renal tubular secretion of digoxin Chapter 12: Chemical mediators and the autonomic nervous system MULTIPLE CHOICE 1. The release of acetylcholine from cholinergic nerve terminals is stimulated by 1. nitric oxide 2. norepinephrine 3. acetylcholine 4. prostaglandins 5. endothelin Answer a: nitric oxide 2. Co-transmitters released from postganglionic sympathetic neurons include 1. acetylcholine 2. vasoactive intestinal peptide 3. nitric oxide 4. adenosine triphosphate 5. gamma-aminobutyric acid Answer d: adenosine triphosphate 3. Constriction of bronchi is typically produced by activation of 1. adrenergic beta-1 receptors 2. adrenergic beta-2 receptors 3. muscarinic M1 receptors 4. muscarinic M2 receptors 5. muscarinic M3 receptors Answer e: muscarinic M3 receptors 4. Activation of adrenergic beta-2 receptors produces 1. contraction of the iris sphincter muscle 2. relaxation of the iris sphincter muscle 3. relaxation of the ciliary muscle 4. contraction of the ciliary muscle 5. lacrimal gland secretion Answer c: relaxation of the ciliary muscle 5. The enteric nervous system is primarily concerned with the regulation of 1. the urinary tract 2. gastrointestinal motility 3. male sex organs 4. respiration 5. vascular smooth muscle Answer b: gastrointestinal motility 6. The co-transmitter known as neuropeptide Y enhances the 1. vasodilative effect of acetylcholine 2. vasodilative effect of nitric oxide 3. vasodilative effect of dopamine 4. vasoconstrictive effect of norepinephrine 5. vasoconstrictive effect of endothelin Answer d: vasoconstrictive effect of norepinephrine 7. The final step in the release of norepinephrine from sympathetic neurons is 1. docking 2. loading 3. diffusion 4. synthesis 5. exocytosis Answer e: exocytosis 8. In the parasympathetic nervous system, neurotransmitter action is terminated by 1. diffusion from the synapse 2. active reuptake into presynaptic nerves 3. inactivation by inhibitors 4. enzymatic degradation 5. endocytosis Answer d: enzymatic degradation 9. The enteric nervous system 1. receives input only from the sympathetic nervous system 2. receives input only from the parasympathetic nervous system 3. releases several peptide neurotransmitters and nitric oxide 4. cannot function without the central nervous system 5. has cell bodies lying in plexuses outside the intestinal wall Answer c: releases several peptide neurotransmitters and nitric oxide Chapter 13: Cholinergic transmission MULTIPLE CHOICE 1. Activation of muscarinic M2 receptors 1. increases calcium conductance 2. increases potassium conductance 3. increases cardiac rate and force 4. causes central nervous system excitation 5. produces vascular smooth muscle relaxation Answer b: increases potassium conductance 1. Succinylcholine is characteristically an agonist at 1. muscarinic M1 receptors 2. muscarinic M2 receptors 3. muscarinic M3 receptors 4. nicotinic receptors in skeletal muscle 5. nicotinic receptors in autonomic ganglia Answer d: nicotinic receptors in skeletal muscle 1. The second messengers formed by activation of muscarinic acetylcholine receptors include 1. inositol triphosphate 2. cyclic AMP 3. cyclic GMP 4. eicosanoids 5. guanosine triphosphate Answer a: inositol triphosphate 1. Pilocarpine lowers intraocular pressure by 1. decreasing aqueous humor formation 2. contracting the iris sphincter muscle 3. contracting the ciliary muscle 4. relaxing the iris sphincter muscle 5. relaxing the ciliary muscle Answer c: contracting the ciliary muscle 1. The increased release of potassium from denervated muscles by succinylcholine is due to 1. inhibition of cholinesterase 2. desensitization of nicotinic receptors 3. nicotinic receptor up-regulation 4. denervation supersensitivity 5. destruction of the motor end plate Answer d: denervation supersensitivity 1. Edrophonium produces reversible inhibition of cholinesterase by 1. binding the anionic site 2. binding the esteratic site 3. binding both anionic and esteratic sites 4. reversibly binding an allosteric site 5. forming a complex with acetylcholine Answer a: binding the anionic site 1. Pyridostigmine enhances neuromuscular transmission in myasthenia gravis patients by 1. increasing release of acetylcholine 2. inhibiting degradation of acetylcholine 3. causing up-regulation of nicotinic receptors 4. reactivating cholinesterase 5. blocking autoantibodies Answer b: inhibiting degradation of acetylcholine 1. Activation of muscarinic M3 receptors leads to 1. smooth muscle relaxation 2. cardiac slowing 3. central nervous system stimulation 4. vasoconstriction 5. exocrine gland secretion Answer e: exocrine gland secretion 1. The effects produced by topical ocular administration of atropine include 1. miosis 2. mydriasis 3. lacrimation 4. decreased intraocular pressure 5. conjunctivitis Answer b: mydriasis 1. If a test dose of edrophonium increases muscle weakness in a myasthenia gravis patient being treated with pyridostigmine, it means that 1. the patient does not actually have myasthenia gravis 2. the dose of pyridostigmine is too low 3. the dose of pyridostigmine is too high 4. atropine should be administered 5. none of the above is correct Answer c: the dose of pyridostigmine is too high 1. Atropine poisoning in children typically causes 1. respiratory depression 2. muscle paralysis 3. sweating 4. hyperthermia 5. sedation Answer d: hyperthermia 1. Persons with a genetic variant conferring abnormal plasma cholinesterase activity may exhibit prolonged muscle paralysis following administration of 1. tubocurarine 2. pilocarpine 3. pancuronium 4. atracurium 5. succinylcholine Answer e: succinylcholine 1. The release of acetylcholine from cholinergic nerve terminals is blocked by 1. atropine 2. bungarotoxin 3. botulinum toxin 4. batrachotoxin 5. tetrodotoxin Answer c: botulinum toxin 1. Scopolamine is employed clinically in the prevention or treatment of 1. motion sickness 2. asthma 3. peptic ulcer 4. glaucoma 5. constipation Answer a: motion sickness 1. The neuromuscular blockade produced by atracurium can be reversed by administration of 1. atropine 2. neostigmine 3. succinylcholine 4. pilocarpine 5. nicotine Answer b: neostigmine 1. Transient muscle fasciculations followed by paralysis typically occur after administration of 1. succinylcholine 2. tubocurarine 3. vecuronium 4. gallamine 5. atropine Answer a: succinylcholine Chapter 14: Noradrenergic transmission MULTIPLE CHOICE 1. An intravenous infusion of norepinephrine typically 1. increases peripheral resistance and heart rate 2. decreases peripheral resistance and heart rate 3. increases peripheral resistance and decreases heart rate 4. decreases peripheral resistance and increases heart rate 5. has no consistent effect on peripheral resistance and heart rate Answer c: increases peripheral resistance and decreases heart rate 1. In the liver, epinephrine acts via adrenergic beta-2 receptors to 1. stimulate both phosphorylase and glycogen synthase 2. inhibit both phosphorylase and glycogen synthase 3. inhibit phosphorylase and stimulate glycogen synthase 4. stimulate phosphorylase and inhibit glycogen synthase 5. stimulate phosphorylase, glycogen synthase, and lipase Answer d: stimulate phosphorylase and inhibit glycogen synthase 1. Which drug inhibits the transport of norepinephrine into synaptic vesicles, thereby leading to neurotransmitter depletion? 1. reserpine 2. methyldopa 3. bretylium 4. 6-hydroxydopamine 5. guanethidine Answer a: reserpine 1. Doxazosin is an example of a 1. nonselective alpha-adrenoceptor antagonist 2. selective alpha-1 adrenoceptor antagonist 3. selective alpha-2 adrenoceptor antagonist 4. selective alpha-1 adrenoceptor agonist 5. selective alpha-2 adrenoceptor agonist Answer b: selective alpha-1 adrenoceptor antagonist 1. Irreversible blockade of alpha-adrenoceptors results from covalent binding of these receptors by 1. phentolamine 2. phenylephrine 3. prazosin 4. phenoxybenzamine 5. pseudoephedrine Answer d: phenoxybenzamine 1. The reuptake of norepinephrine by presynaptic nerve terminals (uptake 1) is inhibited by 1. guanethidine 2. reserpine 3. methyldopa 4. methyltyrosine 5. cocaine Answer e: cocaine 1. The first-line treatment for acute severe type I hypersensitivity reactions is 1. dopamine 2. epinephrine 3. isoproterenol 4. norepinephrine 5. phenylephrine Answer b: epinephrine 1. Which adrenergic receptor antagonist increases heart rate at rest but reduces it during exercise? 1. pindolol 2. propranolol 3. prazosin 4. timolol 5. phentolamine Answer a: pindolol 1. In the peripheral tissues, the primary end product of norepinephrine metabolism is 1. 3-methoxy, 4-hydroxyphenylglycol 2. normetanephrine 3. vanillylmandelic acid 4. 3,4-dihydroxymandelic acid 5. 3,4-dihydroxyphenylglycol Answer c: vanillylmandelic acid 1. The adverse effects of beta-adrenoceptor antagonists include 1. hyperglycemia 2. cardiac arrhythmias 3. myocardial ischemia 4. anxiety 5. bronchoconstriction Answer e: bronchoconstriction 1. Selective beta-3 adrenoceptor agonists are potentially useful in treating obesity because of their ability to 1. suppress appetite 2. inhibit digestion of fats 3. uncouple oxidative phosphorylation 4. increase thermogenesis 5. increase thyroid function Answer d: increase thermogenesis 1. Symptoms of urinary retention due to benign prostatic hyperplasia may be improved by 1. alpha-1 adrenoceptor antagonists 2. alpha-2 adrenoceptor antagonists 3. alpha-1 adrenoceptor agonists 4. alpha-2 adrenoceptor agonists 5. nonselective adrenoceptor agonists Answer a: alpha-1 adrenoceptor antagonists 1. Persons with acute thyrotoxicosis are often treated with propranolol because it 1. reduces peripheral vascular resistance 2. increases cardiac output 3. decreases cardiac stimulation 4. decreases blood glucose levels 5. inhibits thyroid hormone secretion Answer c: decreases cardiac stimulation 1. Persons with pheochromocytoma may benefit from administration of methyltyrosine because of its ability to 1. block alpha-1 adrenoceptors 2. block beta-1 adrenoceptors 3. inhibit norepinephrine release 4. inhibit norepinephrine synthesis 5. inhibit norepinephrine storage Answer d: inhibit norepinephrine synthesis Chapter 15: 5-Hydroxytryptamine and the pharmacology of migraine MULTIPLE CHOICE 1. Urinary levels of 5-hydroxyindole acetic acid provide an indication of the body’s production of 1. adenosine 2. serotonin 3. adenosine triphosphate 4. histamine 5. endothelin Answer b: serotonin 1. Some of the effects of theophylline are attributed to antagonism of 1. glutamate 2. 5-hydroxytrypamine 3. adenosine 4. norepinephrine 5. histamine Answer c: adenosine 1. The effects of chemical mediators on platelets include 1. stimulation of platelet aggregation by adenosine diphosphate 2. stimulation of platelet aggregation by adenosine 3. inhibition of platelet aggregation by adenosine diphosphate 4. inhibition of platelet aggregation by histamine 5. inhibition of platelet aggregation by serotonin Answer a: stimulation of platelet aggregation by adenosine diphosphate 1. Cyproheptadine is useful in treating carcinoid syndrome because of its ability to 1. activate 5-HT1 receptors 2. block 5-HT1 receptors 3. activate 5-HT2 receptors 4. block 5-HT2 receptors 5. activate 5-HT4 receptors Answer d: block 5-HT2 receptors 1. In persons with irritable bowel syndrome whose predominant symptom is constipation, intestinal peristaltic activity may be increased by drugs that 1. activate 5-HT1 receptors 2. block 5-HT1 receptors 3. activate 5-HT2 receptors 4. block 5-HT2 receptors 5. activate 5-HT4 receptors Answer e: activate 5-HT4 receptors 1. Activation of 5-HT1D receptors is usually beneficial in persons suffering from 1. carcinoid syndrome 2. nausea and vomiting 3. migraine headache 4. constipation 5. anxiety Answer c: migraine headache 1. Retroperitoneal and mediastinal fibrosis is a characteristic adverse effect of 1. methysergide 2. ergotamine 3. bromocriptine 4. sumatriptan 5. tegaserod Answer a: methysergide 1. Blockade of 5-HT3 receptors in vagal afferent neurons is useful in preventing 1. migraine headache 2. serotonin syndrome 3. platelet aggregation 4. nausea and vomiting 5. constipation Answer d: nausea and vomiting ******Chapter 15 & 16 are the same??????!! Chapter 17: Local hormones: cytokines, biologically active lipids, amines and peptides MULTIPLE CHOICE 1. The conversion of fibrinogen to fibrin is accelerated by 1. plasmin 2. plasminogen 3. kallikrein 4. complement 5. thrombin Answer e: thrombin 1. The release of histamine from mast cells is activated by 1. complement component C3a 2. complement component C4b 3. opsonin 4. chemotaxin 5. plasmin Answer a: complement component C3a 1. Type I hypersensitivity reactions results from the production of 1. natural killer cells 2. interleukin-2 3. immunoglobulin E 4. leukotriene D4 5. thromboxane Answer c: immunoglobulin E 1. Prostanoids and leukotrienes are both formed from 1. cyclic endoperoxides 2. arachidonic acid 3. linolenic acid 4. lipoxins 5. 5-hydroperoxyeicosatetraenoic acid Answer b: arachidonic acid 1. Vasodilation and inhibition of platelet aggregation are the primary effects of 1. prostacyclin 2. prostaglandin E2 3. thromboxane 4. prostaglandin F1a 5. prostaglandin F2a Answer a: prostacyclin 1. The formation of 5-hydroperoxyeicosatetraenoic acid is inhibited by 1. montelukast 2. nonsteroidal anti-inflammatory drugs 3. prostaglandins 4. zileuton 5. platelet-activating factor Answer d: zileuton 1. Leukotriene B4 causes 1. coronary vasoconstriction 2. vasodilation in most vascular bed 3. bronchoconstriction 4. bronchodilation 5. chemotaxis and activation of leukocytes Answer e: chemotaxis and activation of leukocytes 1. The structure of bradykinin is that of 1. a prostanoid 2. a nonapeptide 3. a leukotriene 4. a monoamine 5. a glycopeptide Answer b: a nonapeptide 1. It is postulated that bradykinin plays a role in 1. peptic ulcer 2. gastroesophageal reflux disease 3. diarrhea 4. inflammatory bowel disease 5. gallstones Answer c: diarrhea 1. Substance P, neurokinin A, and calcitonin gene-related peptide are partly responsible for 1. neurogenic inflammation 2. acute anaphylactic reactions 3. septic shock 4. rheumatoid arthritis 5. coronary vasoconstriction Answer a: neurogenic inflammation 1. Latanoprost is used clinically to 1. dilate the pupil 2. constrict the pupil 3. correct strabismus 4. lower intraocular pressure 5. treat uveitis Answer d: lower intraocular pressure 1. The treatment of primary pulmonary hypertension may include administration of 1. prostaglandin F2a 2. prostaglandin I2 3. thromboxane 4. misoprostol 5. dinoprostone Answer b: prostaglandin I2 1. The release of arachidonate from cell membrane phospholipids is inhibited by 1. non-steroidal anti-inflammatory drugs 2. zileuton 3. glucocorticoids 4. histamine H1 receptor antagonists 5. zafirlukast Answer c: glucocorticoids 1. Activation of prostaglandin EP3 receptors leads to 1. contraction of bronchial smooth muscle 2. inhibition of platelet aggregation 3. relaxation of gastrointestinal smooth muscle 4. increased gastric mucus secretion 5. contraction of uterine smooth muscle Answer d: increased gastric mucus secretion 1. Intradermal injection of histamine produces a “triple response” in which the wheal is caused by 1. dilation of small arterioles and precapillary sphincters 2. increased permeability of postcapillary venules 3. increased capillary permeability 4. an axon reflex 5. release of calcitonin gene-related peptide Answer b: increased permeability of postcapillary venules 1. A bradykinin antagonist would be expected to 1. cause vasodilation 2. increase vascular permeability 3. increase gastrointestinal fluid secretion 4. contract intestinal smooth muscle 5. decrease stimulation of nociceptive neurons Answer e: decrease stimulation of nociceptive neurons 1. During the induction of lymphocytes by antigen, the proliferation of T-helper-1 cells is increased by 1. interleukin-2 2. interleukin-4 3. interferon-gamma 4. tumor necrosis factor-beta 5. glucocorticoids Answer a: interleukin-2 Chapter 18: Peptides and proteins as mediators MULTIPLE CHOICE 1. Peptide and protein mediators typically 1. function as fast neurotransmitters 2. contain intramolecular diphosphate bonds 3. are easily crystallized 4. have highly rigid structures 5. activate cell surface receptors Answer e: activate cell surface receptors 1. As pharmacologic agents, most peptides are 1. easily absorbed from the gastrointestinal tract 2. rapidly distributed to the brain 3. usually administered by the transdermal route 4. rapidly degraded by plasma and tissue enzymes 5. inexpensive to manufacture Answer d: rapidly degraded by plasma and tissue enzymes 1. Bosentan is an antagonist of 1. opioid receptors 2. angiotensin AT1 receptors 3. endothelin receptors 4. bradykinin receptors 5. platelet fibrinogen receptors Answer c: endothelin receptors 1. Most neural and endocrine peptide mediators 1. act on G-protein-coupled receptors 2. activate ligand-gated ion channels 3. exhibit protein kinase activity 4. cause receptor up-regulation 5. bind to membrane transport proteins Answer a: act on G-protein-coupled receptors 1. Cyclosporine is a fungal polypeptide used clinically to 1. diagnose endocrine disease 2. cause immunosuppression 3. treat cystic fibrosis 4. treat thromboembolism 5. induce labor Answer b: cause immunosuppression 1. Which agent blocks substance P (neurokinin NK1) receptors and thereby prevents nausea and vomiting? 1. granisetron 2. promethazine 3. diphenhydramine 4. aprepitant 5. scopolamine Answer d: aprepitant Chapter 19: Cannabinoids MULTIPLE CHOICE 1. Activation of the cannabinoid CB1 receptor in nerve endings leads to 1. activation of neurotransmitter release 2. inhibition of potassium channels 3. inhibition of calcium channels 4. activation of adenylate cyclase 5. inhibition of Map (mitogen-activated protein) kinase Answer c: inhibition of calcium channels 1. Cannabinoids have been used therapeutically for the purpose of 1. increasing appetite 2. treating obesity 3. improving memory 4. treating drug dependence 5. treating anxiety Answer a: increasing appetite 1. Anandamide is correctly described as a substance that 1. is synthesized from amino acid precursors 2. is stored in synaptic vesicles 3. is a cannabinoid receptor antagonist 4. inhibits retrograde neuronal transmission 5. exerts endocannabinoid activity Answer e: exerts endocannabinoid activity 1. The effects produced by cannabinoid administration include 1. increased intraocular pressure 2. decreased intraocular pressure 3. vasoconstriction 4. bronchoconstriction 5. emesis Answer b: decreased intraocular pressure 1. Rimonabant is a new drug for the treatment of 1. obesity 2. nausea and vomiting 3. asthma 4. neuropathic pain 5. Parkinson’s disease Answer a: obesity Chapter 20: Nitric oxide & related mediators MULTIPLE CHOICE 1. The effects exerted by nitric oxide include 1. stimulation of platelet aggregation 2. vasoconstriction 3. inhibition of smooth muscle proliferation 4. increased atherogenesis 5. inhibition of host defenses Answer c: inhibition of smooth muscle proliferation 1. The primary action of inhaled nitric oxide is 1. vasoconstriction 2. pulmonary vasodilation 3. bronchoconstriction 4. cardiac stimulation 5. respiratory distress Answer b: pulmonary vasodilation 1. Nitric oxide causes vasodilation by 1. decreasing formation of cyclic GMP 2. increasing formation of cyclic GMP 3. decreasing formation of cyclic AMP 4. increasing formation of cyclic AMP 5. increasing calcium influx Answer b: increasing formation of cyclic GMP 1. In the gastrointestinal tract, nitric oxide serves to 1. inhibit gastric emptying 2. stimulate gastric emptying 3. inhibit peristalsis 4. inhibit gastric acid formation 5. cause constipation Answer b: stimulate gastric emptying 1. Nitroprusside produces its effects by acting as 1. a nitric oxide donor 2. a substrate for nitric oxide synthase 3. an inducer of nitric oxide synthase 4. an inhibitor of nitric oxide degradation 5. an agonist at nitric oxide receptors Answer a: a nitric oxide donor 1. Glucocorticoids may be beneficial in treating sepsis in part due to their ability to 1. inhibit constitutive nitric oxide synthase 2. stimulate constitutive nitric oxide synthase 3. stimulate inducible nitric oxide synthase 4. inhibit inducible nitric oxide synthase 5. inhibit both constitutive and inducible nitric oxide synthase Answer d: inhibit inducible nitric oxide synthase Chapter 21: The heart MULTIPLE CHOICE 1. Delayed after-depolarizations in cardiac tissue typically result from an increased influx of 1. sodium 2. potassium 3. calcium 4. chloride 5. sodium and potassium Answer c: calcium 1. The re-excitation of cardiac tissue prior to the next cardiac impulse occurs in the process known as 1. re-entry 2. ectopic automaticity 3. atrioventricular block 4. atrial fibrillation 5. bradycardia Answer a: re-entry 1. In persons with atrial fibrillation, digoxin may slow the ventricular rate by 1. decreasing sinoatrial node automaticity 2. increasing ventricular contractility 3. inhibiting the Na+/K+ pump 4. reducing the calcium transient 5. slowing atrioventricular conduction Answer e: slowing atrioventricular conduction 1. Sotalol exerts an antiarrhythmic effect primarily by 1. slowing ventricular conduction 2. blocking sodium channels 3. slowing atrioventricular conduction 4. increasing the effective refractory period 5. decreasing action potential duration Answer d: increasing the effective refractory period 1. Drugs that increase serum digoxin levels include 1. furosemide 2. cholestyramine 3. amiodarone 4. enalapril 5. hydrochlorothiazide Answer c: amiodarone 1. Verapamil is indicated for the treatment of 1. supraventricular tachycardia 2. ventricular tachycardia 3. atrial fibrillation 4. ventricular fibrillation 5. cardiac asystole Answer a: supraventricular tachycardia 1. In persons who have had a myocardial infarction, flecainide has been shown to 1. decrease the incidence of ventricular fibrillation 2. decrease the incidence of atrial fibrillation 3. decrease the incidence of sudden death 4. increase the frequency of ventricular ectopic beats 5. increase the incidence of sudden death Answer e: increase the incidence of sudden death 1. The pharmacokinetic attributes of amiodarone include 1. rapidly metabolized and excreted 2. a very short elimination half-life 3. a very long elimination half-life 4. distributed only to extracellular fluid 5. limited binding to plasma proteins Answer c: a very long elimination half-life 1. Dobutamine is useful in treating acute heart failure because of its ability to 1. increase heart rate more than contractile force 2. increase contractile force more than heart rate 3. produce a negative dromotropic effect 4. cause cardiac stimulation and vasoconstriction 5. inhibit phosphodiesterase Answer b: increase contractile force more than heart rate 1. Digoxin slows AV conduction and decreases heart rate by 1. activating cardiac muscarinic receptors 2. blocking cardiac adrenergic beta-1 receptors 3. antagonizing cardiac calcium channels 4. increasing vagal outflow from the CNS 5. increasing cardiac contractile force Answer d: increasing vagal outflow from the CNS 1. The half-life of digoxin is considerably longer in persons with 1. renal insufficiency 2. pulmonary edema 3. atrial fibrillation 4. hypertension 5. endocarditis Answer a: renal insufficiency 1. Which drug has been shown to reduce mortality in persons who have had a myocardial infarction? 1. amiodarone 2. lidocaine 3. propranolol 4. amiodarone 5. verapamil Answer c: propranolol 1. Hypothyroidism is most likely to occur in persons who are taking 1. sotalol 2. flecainide 3. timolol 4. amiodarone 5. adenosine Answer d: amiodarone 1. Nitroglycerin relieves typical angina pectoris in part by 1. increasing cardiac stroke volume 2. dilating coronary arterioles 3. decreasing cardiac oxygen consumption 4. constricting collateral vessels in the heart 5. increasing blood pressure Answer c: decreasing cardiac oxygen consumption 1. Nitroglycerin and other organic nitrates produce their vasodilator effect by 1. increasing formation of cyclic AMP 2. increasing formation of cyclic GMP 3. blocking calcium channels 4. blocking adrenergic alpha receptors 5. activating potassium channels Answer b: increasing formation of cyclic GMP Chapter 22: The vascular system MULTIPLE CHOICE 1. Which vasoconstrictor substance is produced by vascular endothelial cells? 1. nitric oxide 2. bradykinin 3. prostacyclin 4. natriuretic peptide 5. endothelin Answer e: endothelin 1. The opening of membrane potassium channels by minoxidil leads to 1. increased potassium influx 2. increased calcium influx 3. inactivation of calcium channels 4. membrane depolarization 5. formation of cyclic GMP Answer c: inactivation of calcium channels 1. Both valsartan and enalapril 1. increase serum potassium levels 2. often cause a dry cough 3. block angiotensin AT1 receptors 4. inhibit formation of angiotensin II 5. increase bradykinin levels Answer a: increase serum potassium levels 1. Bosentan is an antagonist of 1. endothelin ETA and ETB receptors 2. angiotensin AT1 receptors 3. angiotensin AT2 receptors 4. nitric oxide receptors 5. prostaglandin FP receptors Answer a: endothelin ETA and ETB receptors 1. In persons with heart failure, enalapril typically increases 1. cardiac afterload 2. cardiac preload 3. vascular resistance 4. cardiac output 5. aldosterone secretion Answer d: cardiac output 1. Which drug reduces sympathetic outflow from the central nervous system? 1. fosinopril 2. clonidine 3. terazosin 4. felodipine 5. hydralazine Answer b: clonidine 1. Captopril is a structural analog of the terminal dipeptide of 1. renin 2. nitric oxide synthase 3. endothelin 4. angiotensin converting enzyme 5. angiotensin I Answer e: angiotensin I 1. Effects similar to those of angiotensin converting enzyme inhibitors may be obtained in heart failure patients by administering 1. furosemide 2. digoxin 3. hydralazine and isosorbide dinitrate 4. dobutamine 5. nitroglycerin Answer c: hydralazine and isosorbide dinitrate 1. The adverse effects of terazosin and related drugs typically include 1. hypokalemia 2. drowsiness and dry mouth 3. urinary retention in older men 4. postural hypotension and edema 5. bradycardia and syncope Answer d: postural hypotension and edema 1. In persons with decompensated heart failure, nesiritide activates 1. adrenergic alpha receptors 2. adrenergic beta receptors 3. adenylate cyclase 4. guanylate cyclase 5. myosin phosphatase Answer d: guanylate cyclase 1. The preferred drugs for the initial treatment of most patients with mild hypertension include 1. hydralazine 2. minoxidil 3. hydrochlorothiazide 4. methyldopa 5. prazosin Answer c: hydrochlorothiazide 1. Fenoldopam is useful in treating hypertensive emergencies because of its ability to 1. block adrenergic beta receptors 2. block adrenergic alpha receptors 3. block calcium channels 4. open potassium channels 5. activate dopamine D1 receptors Answer e: activate dopamine D1 receptors 1. Beginning therapy with low doses that are gradually increased over several months is appropriate when treating heart failure with 1. digoxin 2. furosemide 3. dobutamine 4. carvedilol 5. nitroglycerin Answer d: carvedilol 1. The progression of diabetic nephropathy may be slowed by 1. propranolol 2. enalapril 3. hydrochlorothiazide 4. amlodipine 5. doxazosin Answer b: enalapril 1. The use of eplerenone in the treatment of heart failure is based on its ability to 1. cause vasodilation 2. inhibit sympathetic nervous system activity 3. antagonize aldosterone 4. inhibit angiotensin II formation 5. increase cardiac contractile force Answer c: antagonize aldosterone Chapter 23: Atherosclerosis and lipoprotein metabolism MULTIPLE CHOICE 1. Activation of the peroxisome proliferator-activated receptor-alpha is produced by administration of 1. ezetimibe 2. fenofibrate 3. simvastatin 4. niacin 5. colesevelam Answer b: fenofibrate 1. Ezetimibe reduces serum LDL-cholesterol levels by 1. inhibiting cholesterol synthesis 2. increasing HDL-cholesterol levels 3. inhibiting cholesterol absorption 4. inhibiting bile acid reabsorption 5. stimulate lipoprotein lipase Answer c: inhibiting cholesterol absorption 1. Myositis leading to rhabdomyolysis is a potentially severe adverse effect of 1. atorvastatin 2. niacin 3. colestipol 4. ezetimibe 5. cholestyramine Answer a: atorvastatin 1. Increased expression of apoproteins A-I and A-II occurs in persons receiving 1. colestipol 2. niacin 3. simvastatin 4. ezetimibe 5. gemfibrozil Answer e: gemfibrozil 1. Simvastatin and related drugs have been shown to reduce mortality in persons with 1. hypertriglyceridemia 2. low HDL-cholesterol levels 3. an inability to make LDL receptors 4. symptomatic coronary artery disease 5. myositis Answer d: symptomatic coronary artery disease 1. Which drug inhibits hepatic triglyceride synthesis and VLDL secretion? 1. fenofibrate 2. colestipol 3. niacin 4. ezetimibe 5. atorvastatin Answer c: niacin Chapter 24: Haemostasis and thrombosis MULTIPLE CHOICE 1. Warfarin inhibits coagulation by 1. inactivating prothrombin 2. inhibiting active factor Xa 3. inhibiting vitamin K oxidase 4. inhibiting vitamin K reductase 5. activating antithrombin III Answer d: inhibiting vitamin K reductase 1. Which drug competes with ADP (adenosine diphosphate) for its platelet receptor? 1. clopidogrel 2. epoprostenol 3. hirudin 4. aspirin 5. tirofiban Answer a: clopidogrel 1. Abciximab is a monoclonal antibody to receptors for 1. thrombin 2. thromboxane 3. glycoprotein IIb/IIIa 4. adenosine diphosphate 5. von Willebrand factor Answer c: glycoprotein IIb/IIIa 1. Dipyridamole and aspirin are used together primarily for the prevention of 1. pulmonary embolism 2. ischemic stroke 3. myocardial infarction 4. deep vein thrombosis 5. unstable coronary syndromes Answer b: ischemic stroke 1. Acute thrombotic stroke may be effectively treated within 3 hours of onset with 1. warfarin 2. tranexamic acid 3. eptifibatide 4. aspirin 5. tenecteplase Answer e: tenecteplase 1. Clinical trials of adding clopidogrel to aspirin for preventing thromboembolic disease found that combined therapy is 1. less effective than aspirin alone 2. less effective than clopidogrel alone 3. equally effective as clopidogrel alone 4. equally effective as aspirin alone 5. more effective than aspirin alone Answer e: more effective than aspirin alone 1. Enoxaparin increases the activity of antithrombin III against 1. primarily thrombin 2. primarily factor Xa 3. thrombin and factor Xa equally 4. neither thrombin nor factor Xa 5. fibrin stabilizing factor Answer b: primarily factor Xa 1. One of the adverse effects of high-dose or long-term therapy with heparin is 1. hyponatremia 2. hypernatremia 3. hypokalemia 4. hyperkalemia 5. hypophosphatemia Answer d: hyperkalemia 1. Eptifibatide is used to prevent thrombosis in persons undergoing 1. coronary angioplasty 2. fibrinolysis 3. blood transfusion 4. abdominal surgery 5. hip-replacement surgery Answer a: coronary angioplasty 1. Fondaparinux is correctly described as a 1. hirudin derivative 2. cyclic peptide from snake venom 3. low-molecular-weight heparin 4. warfarin analogue 5. synthetic pentasaccharide Answer e: synthetic pentasaccharide Chapter 25: Haemopoietic system and treatment of anaemia MULTIPLE CHOICE 1. Ascorbic acid influences iron absorption from the gastrointestinal tract by 1. forming an insoluble iron-chelate 2. oxidizing iron to the ferric state 3. reducing iron to the ferrous state 4. stimulating the iron transport protein 5. activating haem oxidase Answer c: reducing iron to the ferrous state 1. Neural tube birth defects can be prevented by the administration to pregnant women of 1. folic acid 2. cyanocobalamin 3. ferrous gluconate 4. epoetin 5. filgrastim Answer a: folic acid 1. Desferrioxamine is administered for the purpose of treating 1. iron deficiency anemia 2. megaloblastic anemia 3. pernicious anemia 4. iron toxicity 5. hemosiderosis Answer d: iron toxicity 1. Persons with an elevated blood level of methylmalonyl-Coenzyme A may have a deficiency of 1. erythropoietin 2. iron 3. formyl-tetrahydrofolic acid 4. colony-stimulating factors 5. vitamin B12 Answer e: vitamin B12 1. Filgrastim is conjugated with polyethylene glycol to 1. increase its absorption from the gut 2. increase its elimination half-life 3. reduce its duration of action 4. decrease its adverse effects 5. increase its potency Answer b: increase its elimination half-life 1. Epoetin is indicated for the treatment of 1. pernicious anemia 2. anemia of renal failure 3. megaloblastic anemia 4. neutropenia 5. platelet deficiency Answer b: anemia of renal failure Test Bank Chapter 26: Anti-inflammatory and immunosuppressant drugs MULTIPLE CHOICE 1. N-acetyl-p-benzoquinone is the hepatotoxic metabolite of 1. aspirin 2. indomethacin 3. ketorolac 4. acetaminophen 5. ibuprofen Answer d: acetaminophen 1. The cyclooxygenase-2 isozyme forms products that cause 1. inflammation 2. platelet aggregation 3. fever 4. gastric acid secretion 5. vasoconstriction Answer a: inflammation 1. The most common adverse effect of most non-steroidal anti-inflammatory drugs is 1. thrombosis 2. skin rash 3. gastrointestinal distress 4. renal impairment 5. hepatitis Answer c: gastrointestinal distress 1. High therapeutic doses of aspirin are most likely to cause 1. metabolic acidosis 2. metabolic alkalosis 3. respiratory acidosis 4. respiratory alkalosis 5. hypothermia Answer d: respiratory alkalosis 1. Which drug forms a complex that inhibits activation of transcription factors for interleukin-2 by calcineurin? 1. tacrolimus 2. sirolimus 3. azathioprine 4. muromonab-CD3 5. mycophenolate Answer a: tacrolimus 1. Which antihistamine lacks significant sedative and muscarinic receptor antagonist actions? 1. meclizine 2. fexofenadine 3. chlorpheniramine 4. diphenhydramine 5. promethazine Answer b: fexofenadine 1. Allopurinol is used in treating gout because of its ability to 1. increase uric acid formation 2. decrease uric acid formation 3. increase uric acid excretion 4. increase uric acid degradation 5. inhibit leukocyte migration Answer b: decrease uric acid formation 1. Which disease-modifying anti-rheumatoid drug typically has the greatest efficacy and fewest adverse effects? 1. gold sodium thiomalate 2. auranofin 3. penicillamine 4. hydroxychloroquine 5. methotrexate Answer e: methotrexate 1. The most common serious adverse effect of cyclosporine is 1. peripheral neuropathy 2. congestive heart failure 3. nephrotoxicity 4. hypotension 5. alopecia Answer c: nephrotoxicity 1. Which drug is a monoclonal antibody to tumor necrosis factor-alpha? 1. leflunomide 2. etanercept 3. muromonab-CD3 4. infliximab 5. methotrexate Answer d: infliximab 1. Which drug inhibits a regulatory kinase involved in cytokine-driven T-cell proliferation? 1. prednisone 2. cyclosporine 3. tacrolimus 4. mycophenolate 5. sirolimus Answer e: sirolimus 1. Selective cyclooxygenase-2 inhibitors have been associated with an increased risk of 1. congestive heart failure 2. thromboembolic disorders 3. hypertension 4. atherosclerosis 5. diabetes mellitus Answer b: thromboembolic disorders 1. In the treatment of rheumatoid arthritis, anakinra acts as an antagonist of 1. interleukin-1 2. interleuk [Show More]

Last updated: 1 year ago

Preview 1 out of 97 pages