4-To treat overdose toxicity of acidic drug,you may perform gastric lavage with: a-sodium bicarbonate. b-ascorbic acid c-saline

Transcription

1 Compare between type I and type II adverse drug reaction as regards dose dependency and mechanism.give 2 examples of each type. Define the following terms and mention 3 factors affecting them: Volume of distribution. Hepatic clearance. -Define the following terms and give an example of each: Non competitive antagonist Idiosyncrasy. Cumulative drug. Mention the clinical significance of the following(2 points): Drugs that inhibit microsomal enzymes. Drugs that pass blood brain barrier -Mention Idiosyncrasy reaction after administration of INH. 3 drugs whose GIT absorption is decreased by food. 3 examples of drugs administrated in prenatal period.. One inducer of cytochrome p450piiic19. One example of active drug metabolized to another active metabolite. Explain the following statements on pharamacological basis: Barbaiturates are used in treatment of neonatal jaundice. Adrenaline is used in combination with local anesthetics. Choose the correct answer: 1-A drug undergoing glomerular filtration: a- Highly bound to plasma proteins. b free and not bound to plasma protein. c-has positively charged quaternary ammonium ion. d-has low volume of distribution. 2- Which of the following drug absorption mechanisms involves polar substances too large to enter cells by other means, such as vitamin B12? a) Aqueous diffusion b) Lipid diffusion c) Carrier molecules d) Endocytosis and exocytosis 3-Using the Fick Law of Diffusion, how will flux change if membrane thickness is doubled? a) It will double b) It will quadruple c) It will halve d) It will quarter e) It will not change 4-To treat overdose toxicity of acidic drug,you may perform gastric lavage with: a-sodium bicarbonate. b-ascorbic acid c-saline

2 d-non of above. 5-Drug disposition is : a-absorption and distribution b-distribution and metabolism c-metabolsim and excretion d-distribution + metabolism + excretion 6- A decrease in renal and liver function, as seen in the elderly, would prolong drug half-life, plasma protein binding, and volume of distribution. a) Increase; Increase b) Decrease; Decrease c) Increase; Decrease d) Decrease; Increase 7-All of the following drugs are highly excreted in milk except: a-acidic drugs b-basic drugs c-lipid soluble drugs d-unionized drugs. 8-The lipid-soluble form of a base is and the lipid-soluble form of an acid is. a) Protonated; Protonated b) Protonated; Unprotonated c) Unprotonated; Unprotonated d) Unprotonated; Protonated 9- What determines the degree of movement of a drug between body compartments? a) Partition constant b) Degree of ionization c) ph d) Size e) All of the above 10-The non ionized lipid soluble drug with low molecular weight is usually absorbed by: a-pinocytosis. b-passive diffusion. c-acitive transport d-filtration Compare between Test 2

3 Microsomal and non-microsomal enzymes as regards their location,drug specificity,liability for induction and their level in neonates. Define the following terms and mention 3 factors affecting them: Oral bioavailability Renal clearance. Define the following terms and give an example of each: Drug hypersensitivity. Enterohepatic circulation Mention the clinical significance of the following: Drugs that induce microsomal enzymes. Drugs wih high plasma protein binding Mention 3 drug gtoups excreted in breast milk. 3 examples of prenatal drugs. 3 drugs whose GIT absorption is decreased by food.. One inducer of cytochrome p450iiic19. Idiosyncrasy reaction after administration of paracetamol Explain the following statements on pharamacological basis: Penicillin G is used in treatment and not prophylaxis of bacterial meningitis. Adrenaline reverses the vasodilator effect of histamine. Choose the correct answer: 1- Which of the following is NOT a pharmacokinetic process? a) Alteration of the drug by liver enzymes b) Drug metabolites are removed in the urine c) Movement of drug from the gut into general circulation d) The drug causes dilation of coronary vessels e) The drug is readily deposited in fat tissue 2-Which of the following drugs have low dissociation rate from receptor sites: a-agonist. b-antaagonist c-partial agonist d-irreversible antagonist. 3-Succenylcholine apnea is due to a-drug hypersensitivity. b-drug idiosyncrasy. c-overdose toxicity d-non of above 4-Which one of the following drugs induces cytochrome p450ia1 a-aromatic hydrocarbons. b-barbiturates c-corticosteroids d-phenytoin 5-For intravenous (IV) dosages, what is the bioavailability assumed to be? a) 0%

4 b) 25% c) 50% d) 75% e) 100% 6-Effective concentration 50 is: a-the concentration of the drug that produce half maximal efficacy. b-the concentration of the drug that produce half maximal receptor occupancy. c-the concentration of the drug that produce half of steady state concentration d-the concentration of the drug that produce the required effect in half number of patients. 7-Tubular reabsorption of drugs is mediated by: a-filtration b-diffusion. c-active transport d-non of above 8-Salicylates are mainly conjugated in the liver with: a-acetic acid b-glucuronic acid. c-glycine d-methyl group 9-Which of the following locations would most trap a lipid soluble drug? a) Blood b) Intestines c) Brain d) Stomach 10-Which of the following administration routes has the largest first-pass effect? a) sublingual b) Subcutaneous c) Rectal d) Oral Test 3 Compare between placental and blood brain barrier as regards to structure, location and clinical significance. Define the following terms and mention 3 factors affecting them Therapeutic dose. Drug metabolism

5 Define the following terms and give an example of each: Teratogenicity. Irreversible drug antagonism Mention the clinical significance(2 points) of the following: Drugs that pass placental barrier Enterohepatic circulation. -Mention 3 advantages of intravenous root of administration. 2 methods to prolong the action of penicillin. One method that prolong the action of local anesthetics. An example of partial agonist 3 disadvantages of oral drug administration. Explain the following statements on pharamacological basis: Males need relatively higher dose of drugs than females in the same age and weight. Mitoclopramide augments the effect of paracetamol (acetaminophen). Choose the correct answer: 1- Which of the following describes an agonist? a) Any substance that brings about a change in biologic function through its chemical action b) A specific regulatory molecule in the biologic system where a drug interacts c) A drug that binds to a receptor and stimulates cellular activity d) A drug that binds to a receptor and inhibits or opposes cellular activity e) A drug directed at parasites infecting the patient 2-Half life of distribution is: a-the time required for the drug to increase its concentration to 50% of steady state concentrartion. b-time required for the drug to decrease its concentration to 50% of steady state conenctration. c-time required for the drug to decrease its biological effect by 50%. d-non of above 3-Subacute toxicity study is performed over: a-1-4 weeks. b-1-6 months. c-6-12 months d-1-2 years 4-All of the following enzymes are inducible except: a-cytohrome p4501a1oxidase b- Cytohrome p4501iic19oxidase c- Cytohrome p4501d6oxidase.

6 d- Cytohrome p4501a2oxidase 5-Which of the following brain areas is outside blood brain barrier a-choroid plexus. b-vomiting center. c-limbic system. c-supraoptic nucleus of the hypothalamus. 6-What percentage of the steady-state drug concentration is achieved at 3.3 * t(1/2)? a) 10% b) 25% c) 50% d) 75% e) 90% 7-Damage at which of the following locations would most affect the goals of phase II biotransformation? a) Skin b) Kidneys c) Lungs d) Liver e) GI Tract 8-Acidic drugs, such bind primarily to which of the following plasma proteins? a) 1-fetoprotein. b) gamma Globulin c) Albumin d) 1-acid glycoprotein. 9-What organ is responsible for metabolism in the first pass effect? a) Brain b) Heart c) Kidney d) Liver

7 10-Weak acids are excreted faster in urine and weak bases are excreted faster in urine. a) Acidic; Alkaline b) Alkaline; Acidic c) Acidic; Neutral d) Neutral; Alkaline e) Alkaline; Neutral Test 4 Compare between oral and sublingual root of drug administration as regards rate of absorption, bioavailability and amount of absorbed drugs. Define the following terms and mention 3 factors affecting them Effective dose 50. Therapeutic index Define the following terms and give example of each: Idiosyncrasy. Teratogenicity Mention the clinical significance(2 points) of the following: Cumulative drugs. Drugs with zero order kinetics. Mention Idiosyncrasy reaction after administration of succenylcholine mention the mechanism. 2 factors that decrease oral bioavailability of drugs. 3 drugs whose GIT absorption is increased by food.. One example of active drug metabolized to another active metabolite. 3sites of drug storage and give example for each one. Explain the following statements on pharamacological basis: The therapeutic effect of barbiturates may be lost after prolonged administration. Old patients need relatively lower doses of drugs than middle aged ones. Explain the following statements on pharamacological basis: 1-All of the following processes are related to phase I drug metabolism except: a-oxidation. b-reduction c-conjugation d-hydrolysis 2-Refampicin induce which of the following subtypes of cytochrome oxidase a-cytohrome p4501a1oxidase

8 b- Cytohrome p4501iic19oxidase c- Cytohrome p4501d6oxidase. d- Cytohrome p4501a2oxidase 3-Low molecular weight hydrophilic drugs are absorbed by: a-filtration b-diffusion c-active transport d-pinocytosis 4-To maintain a drug concentration at steady state, the dosing rate should equal the elimination rate. Which of the following is true? (CL = Drug Clearance) a) Dosing rate = CL + target concentration b) Dosing rate = CL - target concentration c) Dosing rate = CL * target concentration d) Dosing rate = CL / target concentration 5-Which of the following metabolically active tissues is the principle organ for drug metabolism? a) Skin b) Kidneys c) Lungs d) Liver e) GI Tract 6-What type of drugs can cross the blood-brain barrier (BBB)? a) Large and lipid-soluble b) Large and lipid-insoluble c) Small and lipid-soluble d) Small and lipid-insoluble 7-Bioavailability is the fraction or percentage of administered drug that reaches the systemic circulation via a given route as compared to what route? a) Oral b) IV (intravenous) c) IO (intraosseous) d) CSF (cerebrospinal fluid) 8-Drugs interact with their receptor sites by forming : a-coordinate covalent bond. b-covalent bonds.

9 c-ionic bonds. d-vander walls bonds. 9-Which of the following can produce a therapeutic response? A drug that is: a) Bound to plasma albumin b) Concentrated in the bile c) Concentrated in the urine d) Not absorbed from the GI tract e) Unbound to plasma proteins 10-Which one of the following drugs is highly bound to plasma proteins a-sulfonamide b-heparine c-salicylates d-warfarine Mid term examination Of the following drugs which one is passive mydriatic with longest duration a-_atropine b-homatropine. c-cocaine d-eucatropine Of the following drugs which one is used intravenously to treat acute narrow angle glaucoma a-timolol. b-pilocarpine c-physostigmine d-mannitol Which one of the following drugs causes mydriasis with loss of corneal reflex and preservation of accommodation reflex a-atropine b-cocaine c-adrenaline d-phenylephrine Which of the following is the most severe adverse effect that has been associated with sudden termination of 1-blockers? a) Heart block b) Reflex bradycardia c) Syncope (fainting) d) Angina

10 Which of the following drugs causes rebound hypertension after sudden withdrawal a-prazocine b-clonidine c-turbutaline. d-isoprenaline Which of the following is the most likely to occur with parenteral administration of a 1-agonist drug? a) Hypotension b) Hypertension c) Tissue necrosis d) Vasodilation e) Lipolysis Which of the following adrenergic receptor activation mechanisms is involved with ephedrine and amphetamine,? a) Direct binding to the receptor b) Promoting release of norepinephrine c) Inhibiting reuptake of norepinephrine d) Inhibiting inactivation of norepinephrine Which drug act by activation of phospholipase C (PLC)? a) 1agonists b) 2 agonists c) agonists d) 1 selective blockers Which one of the following catecholamine is only inactivated by Catechol ortho methyl transferase a-adrenaline b-noradreanline c-dopamine d-isoprenaline Intragranular uptake of norepinephrine is blocked by a-guanthedine b-reserpine c-phenoxybenzamine d-corticosteroids At the adrenergic synapse, what does clonidine do? a) Stimulates NE release b) Inhibits NE release c) Stimulates ACh release d) Inhibits ACh release

11 Which of the following β 1 selective blocker blockers with membrane stabilizing action and no intrinsic sympathomimetic activity a-propranolol b-acebutalol c-metoprolol d-esmolol An advantage of enteric coated tablet is: ait is meant for chewing or sucking. b-can be used topically. c-it is resistant to gastric acid. d-it allows for slow and sustained release of the drug. Liquid containing drug + propeller gas under pressure inside a container is: a-spin inhaler. b-aerosol c-pessary d-lintus Which one of the following drugs is microsomal enzyme inhibitor a-pheytoin. b-refamicin c-allopurinol. d-carbamazipine. Competitive antagonist has the following properties except: a-has affinity b-binds reversibly with the receptor. c-does not have intrinsic activity. d-can inhibit the effect of an agonist which binds with the same receptor e-its effect can not be overcome by increasing concentration of the agonist. Which one is a measure of the safety of the drug a-effective dose 50. b-lethal dose 50. c-potency d-efficacy e-therapeutic index. All of the following statements are true about α receptor blockers except: a-tamulosin is the preferable aent in treatment of urinary retention. b-selective α 1 blockers produce more reflex tachycardia than the non selective agents c-they should be given before B blockersin the management of pheochromocytoma. d-ergotamine is effective in treatment of acute attack of migraine e-they cause nasal congestion All of the following statements are true regarding sympathmimetics except: a-clonidine increases noradrenaline release by activating pre-synaptic α2 adrenoceptors b-dopamine at low dosesis useful in treatement of cardiogenic shock.

12 c-amphetamine is indirectly acting sympathomimetic. d-ritordine is used to suppress premature labor. The pressor effect of adrenaline is converted to depressor action by administration of: a-prazocin b-clonidne c-isoprenaline d-dopamine The following are factors affecting bioavailability except: a-surface of absorbing area. b-first pass metabolism. c-rate of drug elimination. d-ph of the media