Module-4

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1. Full activation of the sympathetic nervous system, as in
the fight-or-flight reaction, may occur during maximal
exercise. Which of the following effects is likely to occur?
A. Bronchoconstriction C
B. Increased intestinal motility
C. Decreased renal blood flow
D. Miosis
2. Which of the following is a direct-acting cholinomimetic
that is lipid-soluble and is used to facilitate smoking
cessation?
A. Bethanechol D
B. Neostigmine
C. Physostigmine
D. Varenicline
3. A crop duster pilot has been accidentally exposed to a
high concentration of a highly toxic agricultural
organophosphate insecticide. If untreated, the cause of
death from such expo- sure would probably be
D
A. Cardiac arrhythmia
B. Gastrointestinal bleeding
C. Heart failure
D. Respiratory failure
4. A 7-year-old boy with a previous history of bee sting
allergy is brought to the emergency department after
being stung by 3 bees. If this child has signs of
anaphylaxis, what is the treatment of choice?
C
A. Diphenhydramine
B. Ephedrine
C. Epinephrine
D. Methylprednisolone
5. A 60-year-old man has hypertension and an enlarged
prostate, which biopsy shows to be benign prostatic
hyperplasia. He complains of urinary retention. Which of the fol-
lowing drugs would be the most appropriate initial
therapy? D
A. Albuterol
B. Atenolol
C. Metoprolol
D. Prazosin
6. A 32-year-old woman with hypertension wishes to
become pregnant. Her physician informs her that she will
have to switch to another antihypertensive drug. Which of
the following drugs is absolutely contraindicated in
pregnancy? B
A. Atenolol
B. Captopril
C. Methyldopa
D. Prazosin
7. A significant number of patients started on ACE
inhibitor therapy for hypertension are intolerant and must
be switched to a different class of drug. What is the most
common manifestation of this intolerance?
C
A. Diarrhea
B. Glaucoma
C. Incessant cough
D. Lupus-like syndrome
8. A patient with hypertension is to receive a calcium
channel blocker. Verapamil is associated with which one
C
of the following?
A. Diarrhea
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B. Hypoglycemia
C. Bradycardia
D. Tachycardia
9. A 45-year-old woman with hyperlipidemia and frequent
migraine headaches develops angina of effort. Which of
the following is relatively contraindicated because of her
migraines?
D
A. Amlodipine
B. Diltiazem
C. Metoprolol
D. Nitroglycerin
10. A 5-year-old child is brought to the emergency
department with sinus arrest and a ventricular rate of 35
bpm. An empty bottle of his uncle's digoxin was found
where he was playing. Which of the following is the drug
of choice in treating a severe overdose of digoxin? A
A. Digoxin antibodies
B. Lidocaine infusion
C. Magnesium infusion
D. Phenytoin by mouth
11. A 16-year-old girl has paroxysmal attacks of rapid heart
rate with palpitations and shortness of breath. These
episodes occasionally terminate spontaneously but often
require a visit to the emergency department of the local
hospital. Her ECG during these episodes reveals an AV
nodal tachycardia. The antiarrhythmic of choice in most A
cases of acute AV nodal tachycardia is
A. Adenosine
B. Amiodarone
C. Flecainide
D. Propranolo
12. A 62-year-old man with advanced prostate cancer is
admit- ted to the emergency department with mental
obtundation. An electrolyte panel shows a serum calcium
of 16.5 (normal <8.5-10.5 mg/dL). Which of the following
therapies would be most useful in the management of
B
severe hypercalcemia?
A. Acetazolamide plus saline infusion
B. Furosemide plus saline infusion
C. Hydrochlorothiazide plus saline infusion
D. Mannitol plus saline infusion
13. A graduate student is planning to make a high-altitude
climb in South America while on vacation. He will not
have time to acclimate slowly to altitude. A drug that is
useful in preventing high-altitude sickness is
A
A. Acetazolamide
B. Amiloride
C. Demeclocycline
D. Desmopressin
14. Which one of the following drugs promotes the release
of endogenous insulin?
A. Acarbose
B
B. Glipizide
C. Metformin
D. Miglitol
15. A 54-year-old obese patient with type 2 diabetes has a
history of alcoholism. In this patient, metformin should
either be avoided or used with extreme caution because D
the combination of metformin and ethanol increases the
risk of which of the following?
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A. A disulfiram-like reaction
B. Excessive weight gain
C. Hypoglycemia
D. Lactic acidosis
16. This drug used in the management of insomnia
facilitates the inhibitory actions of GABA, but it lacks
anticonvulsant or muscle-relaxing properties and has
minimal effect on sleep architecture. Its actions are
antagonized by flumazenil. C
A. Buspirone
B. Chlordiazepoxide
C. Eszopiclone
D. Ramelteon
17. With chronic use in seizure states, the adverse effects
of this drug include coarsening of facial features,
hirsutism, and gingival hyperplasia
A. Carbamazepine C
B. Felbamate
C. Phenytoin
D. Phenobarbital
18. Which of the following drugs is the most effective in
the emergency management of malignant hyperthermia?
A. Baclofen
B
B. Dantrolene
C. Gabapentin
D. Secobarbital
19. Which drug has spasmolytic activity and could also be
used in the management of seizures caused by overdose
of a local anesthetic?
A. Baclofen C
B. Cyclobenzaprine
C. Diazepam
D. Tizanidine
20. Which of the following drugs is most suitable for
management of tremor in a patient who has pulmonary
disease?
A. Diazepam C
B. Levodopa
C. Metoprolol
D. Propranolol
21. A young male patient recently diagnosed as
schizophrenic develops severe muscle cramps with
torticollis a short time after drug therapy is initiated with
haloperidol. The best course of action would be to
D
A. Add risperidone to the drug regimen
B. Discontinue haloperidol and observe the patient
C. Give oral diphenhydramine
D. Inject benztropine
22. Which of the following drugs is established to be both
effective and safe to use in a pregnant patient suffering
from bipolar disorder?
A. Carbamazepine D
B. Chlorpromazine
C. Lithium
D. Quetiapine

23. Which of the following group of drugs are known to

cause extrapyramidal symptoms (EPS)?
C
A. Narcotics
B. Anti-neoplastics

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C. Anti-psychotics
D. Anti-arrythmias
24. Neuromuscular blockers act mainly on what type of
receptors?
A. Beta receptors
B
B. Nicotinic receptors
C. Alpha receptors
D. Muscarinic receptors
25. 5-HT3 antagonist are used as an ________.
A. Antidiabetic
B. Anticancer C
C. Antiemetic
D. Antiasthma
26. Which of the following is the drug of choice for
absence seizure?
A. Carbamazepine
C
B. Gabapentin
C. Ethosuximide
D. Phenytoin
27. Which is the mechanism of action of aspirin in exerting
its analgesic and anti-inflammatory effect?
A. Irreversibly inhibits cyclooxygenase-2 enzymes
B. Irreversibly inhibits cyclooxygenase-1 enzymes D
C. Binds with mu receptors in the brain
D. Irreversibly inhibits cyclooxygenase-1 and 2
enzymes
28. Which of the following are inhaled corticosteroids?
A. Formoterol and dexamethasone
B. Prednisone and budesonide C
C. Fluticasone and budesonide
D. Dexamethasone and fluticasone
29. Which of the following drugs is an antitussive?
A. Carbocisteine
B. Acetylcysteine C
C. Dextromethorphan
D. Bromhexine
30. Which of the following is a stimulant laxative?
A. Bisacodyl
B. Lactulose A
C. Docusate
D. Psyllium
31. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are
drugs that are used to treat______.
A. Hypertension
D
B. Psychosis
C. Hyperthyroidism
D. Type 2 diabetes
32. In the essay of antibiotics, which of the following is
TRUE if Drug A results to a significantly larger zone of
inhibition vs. Drug B at equivalent doses against the same
organism?
D
A. Drug A is safer than Drug B
B. Drug B is more effective than Drug A
C. Drug B is safer than Drug A
D. Drug A is more effective than Drug B
33. Which of the following elements is used in the
treatment of Rheumatoid Arthritis?
A
A. Gold
B. Magnesium
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C. Iron
D. Selenium
34. What is the order of reaction in which the
concentration of a drug is decreasing at a rate that is
proportional to the concentration of the drug remaining?
A. First A
B. Zero
C. Third
D. Second
35. The higher the Therapeutic Index of the drug means
that the drug is ______.
A. More safe
A
B. Less effective
C. More effective
D. Less safe
36. Which of the following is the adverse effect associated
with Streptomycin?
A. Optic neuritis
C
B. Hepatitis
C. Ototoxicity
D. Peripheral neuropathy
37. Which of the following is the antidote for
benzodiazepine overdose?
A. Atropine
D
B. Deferoxamine
C. Naloxone
D. Flumazenil
38. Ethanol may be used to manage poisoning due
to_____.
A. Methanol
A
B. Antidepressants
C. Narcotics
D. Carbon monoxide
39. Which of the following is an anticholinergic drug?
A. Pilocarpine
B. Rivastigmine D
C. Edrophonium
D. Homatropine
40. Two drugs that act on the same tissue or organ
through independent receptors resulting in effects in
opposite directions known as ______
A. Physiologic antagonism A
B. Irreversible antagonism
C. Competitive antagonism
D. Chemical antagonism
41. Which of the following equations is used to compute
for the patient's creatinine clearance?
A. Michaelis-Menten equation
B
B. Cockcroft and Gault equation
C. Harris-Benedict equation
D. Henderson-Hasselbalch equation
42. Which of the following is also known as the "growth
hormone-inhibiting hormone"? Its therapeutic use is
targeted on blocking hormone release in endocrinesecreting
tumors.
B
A. Simvastatin
B. Somatostatin
C. Gonadotropin
D. Somatropin

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43. Decreased oral absorption of a drug due to high
stomach pH would result to _____
A. Decreased gastric toxicity of the drug
B
B. Decreased bioavailability of the drug
C. Increased bioavailability of the drug
D. Increased clearance of the drug
44. Which of the following neurotransmitter will be
increased by Rivastigmine in the Central Nervous System
synapses?
A. Dopamine B
B. Acetylcholine
C. Epinephrine
D. Serotonin
45. What vitamin can be used to treat cyanide poisoning?
A. Vitamin K
B. Vitamin C C
C. Vitamin B12
D. Vitamin B6
46. Which of the following refers to the process that
distinguishes the elimination of ethanol from the
elimination of most other drugs?
A. First-order elimination D
B. Biliary excretion
C. First-pass effect
D. Zero-order elimination
47. Which of the following dosage forms would be
absorbed the FASTEST in the gastrointestinal tract?
A. Capsule
C
B. Tablet
C. Solution
D. Suspension
48. Which of the following drugs can cause
"serotoninergic syndrome" in patients already with an
overdose of tricyclic antidepressants?
A. Morphine B
B. MAO antidepressants
C. Phenytoin
D. Benzodiazepine
49. Isoniazid undergoes what type of conjugation
reaction?
A. Glycine conjugation
B
B. Acetylation
C. Glucuronidation
D. Methylation
50. Which of the following is the main adverse effect of
Insulin?
A. Hypoglycemia
A
B. Hyperglycemia
C. Bone marrow depression
D. Hepatotoxicity
51. Which of the following is the main physical hazards
when administering parenteral drugs with vesicant
properties?
A. Hypothermia C
B. Air embolism
C. Extravasation
D. Thrombosis
52. Which of the following is TRUE regarding the effect of
adrenergic agonist on peristalsis?
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A. No effect
B. Decrease in peristalsis
C. Effect is either an increase or decreases in peristalsis B
depending on the agonist
D. Increase in peristalsis
53. The following are effects of Atropine
EXCEPT____________
A. Dryness of the mouth
C
B. Dilation of pupils
C. Decrease in heart rate
D. Inhibition of sweating
54. The intensity of the pharmacologic action of the drug
is MOST dependent on ______
A. Concentration of the drug at the receptor site
A
B. Onset of action
C. Protein binding
D. Volume of distribution
55. What is the mechanism of action of sympathomimetic
drugs?
A. Metabolic transformation by the same pathway as
the precursor of the neurotransmitter
B
B. Mimicry of the neurotransmitter at the
postsynaptic receptor
C. Prevention of the release of the neurotransmitter
D. Interference with synthesis of the neurotransmitter
56. Which of the following is a known adverse effect
associated with the use of chloramphenicol?
A. Staining of the teeth
D
B. Alopecia
C. Phototoxicity
D. Aplastic anemia
57. Which of the following will enhance the excretion of
an alkaline poison in the urine?
A. Probenecid
B
B. Urinary acidifier
C. Urinary alkalinizer
D. Inulin
58. Which of the following drugs is an example of a mixed
adrenergic antagonist?
A. Terazosin
B
B. Carvedilol
C. Clonidine
D. Hydralazine
59. Drugs with very HIGH Volume of Distribution are those
that have __________
A. Higher concentration in the extravascular tissue
than in the vascular compartments
B. Higher concentrations in the vascular compartments A
than in the extravascular tissue
C. Higher concentrations that will be absorbed after oral
administration
D. Shorter elimination half-life

60. Which of the following statements is CORRECT?

A. The greater the efficacy, the potent the drug
B. If 1 mg drug A produces the same response as 10 mg
D
of Drug B, Drug A is more effective than Drug B
C. In selecting a drug, potency is usually more
important than efficacy

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D. If 1 mg Drug A produces the same response as 10
mg of Drug B, Drug A is more potent than drug B
61. Which of the following drugs has both antiviral and
anti-parkinsonian activity?
A. Oseltamivir
B
B. Amantadine
C. Ganciclovir
D. Acyclovir
62. A drug was shown to reverse the action of a particular
neurotransmitter. It appears to interact directly with the
neurotransmitter and not at all with the
neurotransmitter's receptors. Which of the following BEST
describes the drug? A
A. Chemical antagonist
B. Physiologic antagonist
C. Pharmacologic antagonist
D. Partial agonist
63. Four identical experimental animals were treated with
1 mg of the following toxins. (Refer to the below with their
corresponding LD50). Which toxin would most likely
cause death to the animals?
D
A. Toxin EF (LD50= 5 mg/kg)
B. Toxin GH (LD50= 15000 mg/kg)
C. Toxin AB (LD50 = 8000 mg/ kg)
D. Toxin CD (LD50 = 0.00001 mg/kg)
64. Which of the following poisons would be indicated for
treatment by Physostigmine?
A. Muscarinic antagonists
A
B. Muscarinic agonists
C. Benzodiazepines
D. Carbamates
65. What type(s) of receptors are associated with
phospholipase C (PLC)?
A. Alpha-1
A
B. Alpha-2
C. Beta and alpha-1
D. Beta and alpha 2
66. Which of the following correctly describes the formula
for an intravenous loading
A. Loading dose = (desired plasma concentration of
drug) X (clearance)
B. Loading dose= (desired plasma concentration of
B
the drug) X (volume of distribution)
C. Loading dose= (amount of drug administered) /
(initial plasma concentration)
D. Loading dose= (clearance) X (plasma drug
concentration)
67. Which one of the following acts commonly both on
parasympathetic and sympathetic division?
A. Atropine
C
B. Pilocarpine
C. Acetylcholine
D. Adrenaline
68. Which of the following agonists would be used for
asthma patients or to delay premature labor?
A. alpha2-agonist
C
B. alpha1-agonist
C. beta2-agonist
D. beta1-agonist

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69. Which of these drugs is used to treat Neuroleptic
Malignant Syndrome
A. Bethanechol
B
B. Dantrolene
C. Dexamethasone
D. Simvastatin
70. A nonstimulant agent that can be used to treat
attention-deficit/hyperactivity disorder (ADHD) is
A. Methylphenidate
D
B. Caffeine
C. Dextroamphetamine
D. Atomoxetine
71. Which of the following alpha-blocker drug is used in
the treatment of benign hypertrophy of prostate without
producing significant hypotension?
A. Doxazosin C
B. Phentolamine
C. Tamsulosin
D. Terazosin
72. Enalapril + Indapamide
A. ACE Inhibitor+ Calcium Channel Blocker
B. ARB+ Diuretic C
C. ACE Inhibitor+ Diuretic
D. ARB + Calcium Channel Blocker
73. Which of the following inhibit HMG-CoA reductase?
A. Nicotinic acid
B. Rosuvastatin B
C. Ezetimibe
D. Cholestyramine
74. Which of these drugs has the highest salt retaining
property?
A. Aldosterone
A
B. Dexamethasone
C. Hydrocortisone
D. Morphine
75. Which of the following drug is a SERM useful for the
treatment of osteoporosis?
A. Alendronate
B
B. Raloxifene
C. Flutamide
D. Estradiol
76. Where does the tumor from Zollinger- Ellison Disease
occur?
A. stomach
B
B. pancreas
C. intestines
D. liver
77. Which drug accumulates in parietal cell canaliculi and
undergoes conversion to a derivative that irreversibly
inhibits H+/K+ ATPase?
A. Cimetidine C
B. Diphenoxylate
C. Esomeprazole
D. Metoclopramide

78. Which of the given is considered the DMARD of 1st

choice to treat rheumatoid arthritis?
B
A. Cyclophosphamide
B. Methotrexate

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C. Azathioprine
D. Mycophenolate mofetil
79. The cause of Rofecoxib withdrawal from the market
A. cardiotoxicity
B. hepatotoxicity A
C. nephrotoxicity
D. neurotoxicity
80. Febuxostat was used in the treatment regimen of a
patient. What was its use?
A. Decrease uric acid
B. Decrease cholesterol in the blood
C. increase urine output
D. decrease heart activity
81. A neonate is identified as having atrial septal defect of
congenital origin that will require surgical repair.
Adequate systemic perfusion requires that the patency of
the ductus arteriosus be maintained. Which of the
following agents would best accomplish this goal? b
A. Indomethacin
B. PGE1
C. PGI2
D. Celecoxib
82. A 37-year-old woman recently had a large soft tissue
sarcoma surgically resected from her retroperitoneum.
She is to receive both radiation and chemotherapy, with
cyclophosphamide as part of her chemotherapy. Which
agent should be given in conjunction with this drug? A
A. Mesna
B. Leucovorin
C. Cilastatin
D. MOPP
83. A world-class cyclist was diagnosed with metastatic
testicular cancer with lesions in both his lung and brain.
He forgoes the standard treatment for his condition
because he learns one of the drugs typically used for his
condition could ultimately compromise his pulmonary
function. Which of the following is included in the
C
standard regimen and is associated with his feared
complication?
A. Cisplatin
B. Busulfan
C. Bleomycin
D. Cyclophosphamide
84. An 18-month-old boy presented in a semiconscious
state with profound hypotension and bradycardia after
ingesting a number of his grandmother's metoprolol
tablets. In this case, the most appropriate antidote is
A
A. Glucagon
B. Naloxone
C. Neostigmine
D. Atropine
85. The healthcare provider administered Naloxone for a
patient at the Emergency room. Which of the following
physical assessment data would be the most important to
indicate that the drug has been effective?
C
A. Absence of fever
B. Seizure activity has stopped
C. Respiratory rate has normalized
D. Chest pain is better

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86. Which of the following can occur in an adult patient
treated with chloramphenicol?
A. Gray baby syndrome
B
B. Bone marrow suppression
C. Nephrotoxicity
D. Disulfiram-like reaction
87. Which of this is an example of a Chelating agent?
A. Dextromethorphan
B. Calcium disodium edetate B
C. Betamethasone
D. Neostigmine
87. Which of this is an example of a Chelating agent?
A. Dextromethorphan
B. Calcium disodium edetate C
C. Betamethasone
D. Neostigmine
89. Which of the following drug is not advertised on the
television?
A. paracetamol 500 mg
C
B. ibuprofen 500 mg
C. mefenamic 500 mg
D. biogesic 500mg
90. Which one of the following pairs of drug and
indication is accurate?
A. Amphetamine: Alzheimer's dementia
B. Bupropion: acute anxiety C
C. Pramipexole: Parkinson's disease
D. Fluoxetine: insomnia
E. Ramelteon: attention deficit disorder
91. An alternative medicine that is commonly used to treat
the urinary symptoms associated with benign prostatic
hyperplasia (BPH) is
A. Echinacea C
B. Ephedra
C. Saw palmetto
D. Milk thistle
92. A type of ligand that acts as a full antagonist in the
presence of a full agonist
A. Inverse agonist
B
B. Partial agonist
C. Full antagonist
D. Partial antagonist
93. Causes excessive sneezing
A. lacrimator
B. asthenic D
C. asphyxiant
D. sternutator
94. Which of the following is most useful for stage fright?
A. Vasodilators
B. alpha blockers C
C. Beta blockers
D. Sedative
95. Process by which toxicants cross body membranes
and enter the bloodstream
A. Distribution
C
B. First pass effect
C. Absorption
D. Biotransformation

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96. Peakless insulin
A. Isophane insulin
B. Lispro D
C. Aspart
D. Glargine
97. What does "affinity" mean?
A. A measure of how tightly a drug binds to plasma
proteins
B
B. A measure of how tightly a drug binds to a receptor
C. A measure of inhibiting potency of a drug
D. A measure of bioavailability of a drug
98. The main mechanism of most drugs absorption in GI
tract is:
A. Active transport (carrier-mediated diffusion)
D
B. Filtration (aqueous diffusion)
C. Endocytosis and exocytosis
D. Passive diffusion (lipid diffusion)
99. Biotransformation of the drugs is to render them:
A. Less ionized
B. More pharmacologically active D
C. More lipid soluble
D. Less lipid soluble
100. The total amount of a drug present in the body at a
given time is 2.0 g and its plasma concentration is 25
mcg/mL, calculate its volume of distribution
A. 100 L B
B. 80 L
C. 60 L
D. 50 L

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