ITEM QUESTION CHOICES ANSWER RATIONALE SOURCE

1 Select the antibiotic regimen NOT A. Clindamycin plus C. Co-amoxiclav plus Cefotetan 2 g IV every 12 hours PLUS Center for
approved by the Center for Disease gentamycin doxycycline Doxycycline 100 mg orally or IV every 12 hours Disease
Control in the management of pelvic B. Ceftriaxone with OR Control and
inflammatory disease. doxycycline Cefoxitin 2 g IV every 6 hours PLUS Prevention
C. Co-amoxiclav plus Doxycycline 100 mg orally or IV every 12 hours 2015
doxycycline OR Treatment
D. Cefoxitin plus Clindamycin 900 mg IV every 8 hours PLUS Guidelines for
doxycycline Gentamicin loading dose IV or IM (2 mg/kg), followed by a Pelvic
maintenance dose (1.5 mg/kg) every 8 hours. Inflammatory
Diseases
Alternative Parenteral Regimen
Ampicillin/Sulbactam 3 g IV every 6 hours PLUS
Doxycycline 100 mg orally or IV every 12 hours

Recommended Intramuscular/Oral Regimens

Ceftriaxone 250 mg IM in a single dose PLUS
Doxycycline 100 mg orally twice a day for 14 days
WITH* or WITHOUT
Metronidazole 500 mg orally twice a day for 14 days
OR
Cefoxitin 2 g IM in a single dose and Probenecid, 1 g orally
administered concurrently in a single dose PLUS
Doxycycline 100 mg orally twice a day for 14 days
WITH or WITHOUT
Metronidazole 500 mg orally twice a day for 14 days
OR
Other parenteral third-generation cephalosporin (e.g.,
ceftizoxime or cefotaxime) PLUS
Doxycycline 100 mg orally twice a day for 14 days
WITH* or WITHOUT
 Metronidazole 500 mg orally twice a day for 14 days

2 Which of the following autonomic nervous A. muscarinic receptor B. beta-2 receptor β-Adrenoceptors, located mostly in postjunctional effector BRS
system receptor should be targeted and B. beta-2 receptor cells, are classified into two major receptor subtypes, Pharmacology
stimulated to control the preterm labor of a C. beta-1 receptor β1-receptors (primarily excitatory) and β2-receptors 6th edition pp.
pregnant woman? D. nicotinic receptor (primarily inhibitory). 30-32

β1-Receptors mediate increased contractility and conduction

velocity, and renin secretion in the kidney (β3-receptors
mediate activation of fat cell lipolysis).

β2-Receptors mediate vasodilation and intestinal, bronchial,

and uterine smooth muscle relaxation.

Nicotinic receptors are localized at myoneural junctions of

somatic nerves and skeletal muscle (NM), autonomic ganglia
(NG), including the adrenal medulla, and certain areas in
the brain. They are components of postjunctional
transmembrane polypeptide that forms a ligand-gated (i.e.,
regulated) cation-selective ion channel. Binding of ACh to the
receptor site causes opening of the ion channel and an
influx of positively charged ions (sodium and potassium)
and across the cellular membrane. This influx of positive
charge depolarizes the postsynaptic membrane.

Muscarinic receptors are localized on numerous autonomic

effector cells, including cardiac atrial muscle and cells of
the sinoatrial (SA) and atrioventricular (AV) nodes,
smooth muscle, exocrine glands, and vascular endothelium
(mostly arterioles), although the latter does not receive
parasympathetic innervation, as well as certain areas in
the brain.
3 Junjun is diagnosed with multiple sexually A. Trimetoprim/Sulfameth B. Ceftriaxone Causative agents for syphillis (​Treponema pallidum)​ , Center for
transmitted diseases namely: syphillis, oxasole chlamydia (​Chlamydia trachomatis)​ and gonorrhea Disease
gonorrhea and chlamydia. Select the B. Ceftriaxone (​Neisseria gonorrheae​) are gram negative bacteria which are Control and
antibiotic that can cure all three infections. C. Streptomycin covered by ceftriaxone. Prevention
D. Doxycycline 2015
From the 2015 Sexually Transmitted Disease (STD) Treatment
guidelines, the CDC recommends treatment for a Guidelines for
gonorrhea-chlamydia coinfection with azithromycin Sexually
(Zithromax) 1 gram given orally in a single dose, plus Transmitted
ceftriaxone (Rocephin) 250 mg given intramuscularly as Diseases.
first-line therapy.

Tetracycline, erythromycin, and ceftriaxone have shown

antitreponemal activity in clinical trials; however, they
currently are recommended only as alternative treatment
regimens in patients allergic to penicillin. A 10- to 14-day trial
of ceftriaxone is effective for treating early syphilis, although
the optimal dose and duration have not been established.

4 Identify the penicillinase-resistant A. Carbenicillin C. Methicillin Penicillinase-resistant penicillins: CONDOM Katzung Basic
antibiotic. B. Bacampicillin Cloxacillin and Clinical
C. Methicillin Oxacillin Pharmacology
D. Piperacillin Nafcillin 13th edition p.
Dicloxacillin 775
Oxcacillin
Methicillin https://www.dr
ugs.com/drug-
class/penicillin
Penicillinase resistant penicillins are antibiotics, which are ase-resistant-p
not inactivated by the penicillinase enzyme. Some bacteria enicillins.html
produce the enzyme penicillinase that destroys the
beta-lactam ring of the antibiotic, making the penicillin
 ineffective. Penicillinase resistant penicillins are used to treat
resistant strains of staphylococci and other infections.

Extended-Spectrum Penicillins (Aminopenicillins,

Carboxypenicillins, and Ureidopenicillins) These drugs have
greater activity than penicillin against gram negative bacteria
because of their enhanced ability to penetrate the
gram-negative outer membrane. Like penicillin G, they are
inactivated by many β lactamases. Carbenicillin, the first
antipseudomonal carboxypenicillin.

5 Select among the following drugs used in A. Ranitidine D. Misoprostol Pregnancy risk categories reflect a drug's potential to cause Springhouse
gastritis is categorised as pregnancy B. Omeprazole birth defects. Nurse's Drug
category X. C. Sucralfate Guide 2006
D. Misoprostol A: Adequate studies in pregnant women haven't shown a risk
to fetus.
B: Animal reproduction studies have failed to demonstrate a
risk to the fetus and there are no adequate and
well-controlled studies in pregnant women.
C: Animal reproduction studies have shown an adverse
effect on the fetus and there are no adequate and
well-controlled studies in humans, but potential benefits may
warrant use of the drug in pregnant women despite potential
risks.
D: There is positive evidence of human fetal risk based on
adverse reaction data from investigational or marketing
experience or studies in humans, but potential benefits may
warrant use of the drug in pregnant women despite potential
risks.
X: Studies in animals or humans have demonstrated fetal
abnormalities and/or there is positive evidence of human
fetal risk based on adverse reaction data from investigational
 or marketing experience, and the risks involved in use of the
drug in pregnant women clearly outweigh potential benefits.

Misoprostol: Prostaglandin E1 analogue; Gastric mucosal

protectant, category X. Risk of uterine rupture and fetal
death.

Ranitidine: H2-receptor antagonist; Antiulcerative, category

B.

Omeprazole: Substituted benzimidazole; Proton pump

inhibitor, category C.

Sucralfate: Pepsin inhibitor; Antiulcerative, category B.

6 Joel, 23 years old, developed blisters that A. decrease severity of D. reduce pain felt by Acyclovir is a purine analog that needs to be converted to BRS
transformed into open genital sores. The recurrent infection the patient nucleoside triphosphate for activity. Acyclovir does not Pharmacology
following results can be achieved by giving B. no effect on number of eradicate latent virus; it has good CSF penetration. It 6th edition pp.
Joel oral acyclovir lesions of initial can be administered orally and intravenously. 287
infection
C. decrease frequency of These agents are active against herpes simplex virus (HSV) Katzung Basic
recurrent infection types I and II, and to a lesser extent against Epstein–Barr and Clinical
D. reduce pain felt by the virus, varicella-zoster virus, and cytomegalovirus (CMV). Pharmacology
patient 13th edition p.
Acyclovir is an antiviral drug. However, it is not a cure for 837
these infections. The viruses that cause these infections
continue to live in the body even between outbreaks.
Acyclovir decreases the severity and length of these
outbreaks. It helps the sores heal faster, keeps new sores
from forming, and ​decreases pain/itching​.

Oral acyclovir has multiple uses. In first episodes of genital

herpes, oral acyclovir shortens the duration of symptoms by
 approximately 2 days, the time to lesion healing by 4 days,
and the duration of viral shedding by 7 days. In recurrent
anogenital herpes, the time course is shortened by 1–2 days.
Treatment of first episode genital herpes ​does not alter
the frequency or severity of recurrent outbreaks​.

7 Jojo is suffering from acute urinary A. Tamsulosin C. Ipatropium Acute urinary retention in men is a medical emergency Springhouse
retention. The doctor can prescribe the B. Betanechol characterised by the sudden and often painful inability to Nurse's Drug
following medications EXCEPT: C. Ipatropium pass urine. There are many known causes including prostate Guide 20
D. Dutasteride obstruction (because of enlargement of the prostate or
cancer), urethral strictures (a narrowing of the urethra due to https://jamanet
scar tissue), urine infection, constipation and neurological work.com/journ
conditions. als/jamainterna
lmedicine/fullar
Tamsulosin: Alpha-1 antagonist, smooth muscle relaxant. ticle/227387
Improves urine flow.

Bethanecol: Cholinergic agonist, urinary tract stimulant.

Relieves urinary retention.

Dutasteride: 5-alpha-reductase enzyme inhibitor, BPH drug.

Use of short- and long-acting Inhaled Anticholinergics

(Ipratropium) is associated with an increased risk of acute
urinary retention in men with COPD. Men receiving
concurrent treatment with both short- and long-acting IACs
and those with evidence of benign prostatic hyperplasia are
at highest risk.

8 Aling Julia has been taking prednisone for A. Hyperglycemia B. Increased bone Systemic glucocorticoids cause a dose-dependent https://www.nc
her allergy for the last 2 years without B. Increased bone density increase in fasting glucose levels and a more significant bi.nlm.nih.gov/
consulting a doctor. As a doctor you density increase in postprandial values in patients without preexisting books/NBK531
should warn her regarding the following ill C. Decreased secretion diabetes mellitus. 462/
effects of chronic use of this drug except: of endogenous ACTH
 D. Increased Glucocorticoids induced osteoporosis is one of the
susceptibility to well-known and devastating adverse effects of long-term
infection use of glucocorticoids. Up to 40% of patients on long-term
glucocorticoids develop bone loss leading to
fractures.Several mechanisms play a role, including
osteoclast activation by promoting RANK-ligand as well as a
decrease in function and number of osteoblasts and
osteocytes.

Administration of ​glucocorticoids can suppress the

hypothalamic-pituitary-adrenal (HPA) axis decreasing
corticotropin-releasing hormone (CRH) from the
hypothalamus, adrenocorticotropic hormone (ACTH)
from the anterior pituitary gland and endogenous
cortisol​. Prolonged ACTH suppression cause atrophy of
adrenal glands, and abrupt cessation or rapid withdrawal of
Glucocorticoids in such patients may cause symptoms of
adrenal insufficiency.

Moderate to high dose use of ​glucocorticoids poses a

significant risk of infections, including common mild
infections as well as serious life-threatening infections​.
There is a linear increase in the risk with dose and duration
of therapy, especially with common bacterial, viral, and
fungal pathogens.

9 Julius has been taking Captopril for the A. Headache D. Dry cough Adverse effects common to all ACE inhibitors include a ​dry BRS
last year for hypertension. As an adverse B. Vomiting cough and, rarely, angioedema, especially of the face Pharmacology,
effect of this drug, he has been C. Non-healing wound (both due to increased bradykinin levels), hypotension, 6th Edition,
complaining of: D. Dry cough and hyperkalemia. page 75

10 Sulfamethoxazole may cause precipitation A. Co-administration of B. Acidic urine Sulfa crystals can be seen with both sulfamethoxazole and Shrishrimal, K.,
of crystals in the collecting tubules of the trimethoprim sulfadiazine. Sulfadiazine crystalluria appears in a and Wesson,
B. Acidic urine volume-depleted state during administration of higher doses J. 2011.
 kidneys. This crystallization predisposed C. Low urinary of both oral and intravenous formulations. The major Sulfamethoxaz
in: concentration of the metabolite of sulfamethoxazole in urine is ​N​-acetyl ole
drug sulfamethoxazole. ​The crystals generally are pleomorphic Crystalluria,
D. High urinary solubility and form in acidic urine. ​Treatment involves stopping the https://www.ajk
of the drug drug treatment and alkalinizing the urine with intravenous d.org/article/S0
fluids. 272-6386(11)0
1039-0/fulltext

11 Fast acting drug used in the management A. Montelukast D. Salbutamol ​ ​2-adrenoceptor agonists
Short-acting a BRS
of bronchial asthma is: B. Cromolyn sodium ● Albuterol, terbutaline, pirbuterol, and metaproterenol Pharmacology,
C. Methylprednisolone ○ These agents have enhanced β2-receptor 6th Edition,
D. Salbutamol selectivity. page 213
○ These agents are generally administered by
inhalation and their ​onset of action is
1–5 minutes. Some preparations are
available for oral administration.
○ Long-term use of these agents for the
treatment of chronic asthma is associated
with diminished control, perhaps due to
β-receptor down-regulation.

12 Rofecoxib has been removed from the A. Increased C. Increased risk of The rationale for the use of selective COX-2 inhibitors https://www.us
market due to increased risk of myocardial atherosclerosis thrombosis stemmed from the negative gastrointestinal (GI) effects of pharmacist.co
infarction. This can be a result of: B. Increased risk of GI nonselective NSAIDs and aspirin. Selectivity for the COX-2 m/article/cardio
bleeding enzyme proves to be gastroprotective, which is a major vascular-risk-a
C. Increased risk of benefit for pain management in patients with GI ssociated-with-
thrombosis complications such as peptic ulcer disease (PUD), nsaids-and-cox
D. Hyponatremia gastroesophageal reflux disease (GERD), and GI bleeding. 2-inhibitors
However, the COX-2 selective inhibition exhibited by certain
NSAIDs can increase the risk of cardiovascular events in
patients with preexisting cardiovascular disease. This
prothrombotic risk results from thromboxane
A2–mediated vasoconstriction and platelet aggregation​,
which will remain unbalanced and unopposed when
prostacyclin activity is suppressed via COX-2 inhibition.
13 Select the drug that can inhibit the A. Pargyline A. Pargyline Pargyline causes noncompetitive antagonism of
metabolism of acetylcholine. B. Selegeline maximal outputs of norepinephrine, acetylcholine,
C. Tolcapone potassium.
D. Neostigmine
Selegiline results in​: (a) MAO-B inhibition and/or free
radical protection on tyrosine hydroxylase by the drug may
increase brain catecholamine concentrations resulting
possibly in (Na(+),K(+))-ATPase stimulation; (b) ​AChE and
(Na(+),K(+))-ATPase activation by the drug could modulate
brain cholinergic, catecholaminergic and serotoninergic
systems as well as the neural excitability and metabolic
energy production.

Tolcapone is a COMT inhibitor that acts similarly to MAO

inhibitors such as selegeline.

AChe inhibitors (neostigmine) block the degradation of

ACh​, prolong its action at the muscle end plate, and increase
the size of the EPP.

14 Botolinum (BoTox) is being used in A. Epinephrine and C. Acetylcholine and Botulinum toxin (Botox) BRS
dermatology to reduce wrinkles. This is alpha-1 receptors nicotinic receptors Pharmacology,
achieved by blocking the interaction B. Epinephrine and ● Botulinum toxin acts by inhibiting the release of ACh 6th Edition,
between: beta-1 receptors from motor nerve terminals. page 43
C. Acetylcholine and ● Botulinum toxin is used to treat local muscle spasms,
nicotinic receptors spastic disorders like cerebral palsy, and BRS
D. Acetylcholine and blepharospasm and strabismus-associated dystonia. Physiology, 6th
muscarinic receptors It is also used for cosmetic reduction of facial Edition, page
wrinkles. 35

Nicotinic receptors are located in the autonomic ganglia of

the sympathetic and parasympathetic nervous systems, at
 the NMJ, and in the adrenal medulla. Muscarinic receptors
are located in the heart, smooth muscle, and glands.

15 Select the anti-platelet drug that works by A. Aspirin B. Abciximab Glycoprotein IIb/IIIa receptor antagonists include abciximab,
inhibiting glycoprotein IIb/IIIa. B. Abciximab eptifibatide, and tirofiban. Glycoprotein IIb/IIIa antagonists
C. Cilostazol prevent the binding of fibrinogen, thereby blocking platelet
D. Dipiridamole aggregation.

16 The patient was complaining of extreme A. Streptomycin C. Vancomycin Third and fourth generation cephalosporins (D) have reduced BRS
knee pain associated with erythema, B. Azithromycin gram (+) activity. Pharmacology,
swelling of the knee. Your diagnosis is C. Vancomycin 6th Edition,
septic arthritis. Gram stain of the synovial D. Ceftriaxone Aminoglycosides (A, B) inhibit bacterial protein synthesis and page 269-270
fluid secured through arthrocentesis are bactericidal against most gram (-) organisms.
revealed gram positive cocci. The empiric
treatment should be: Vancomycin is active against gram-positive organisms​;
resistant strains have been reported. Vancomycin is used in
serious MRSA infections, in patients allergic to penicillins and
cephalosporins, and to treat antibiotic-associated
enterocolitis (​C. difficile ​colitis).

17 Which electrolyte disturbance is seen in A. Hypomagnesemia A. Hypomagne Adverse Effects. Because of the low therapeutic index of Goodman and
prolonged digoxin therapy or digoxin B. Hyperkalemia semia cardiac Gilman, The
overdose? C. Hypocalcemia glycosides, their toxicity is a common clinical problem. Pharmacologic
D. Hypernatremia Basis of
Arrhythmias, nausea, disturbances of cognitive function, and Therapeutics,
blurred or yellow vision are the usual manifestations. 11 Edition,
page 838
Elevated serum concentrations of digitalis, hypoxia (e.g.,
owing to chronic
lung disease), and electrolyte abnormalities (e.g.,
hypokalemia,
 hypomagnesemia, hypercalcemia​) predispose patients to
digitalis-induced
arrhythmias.

18 A patient was given a high dose of A. Acetylcholine ​B. Pralidoxime In moderate or severe intoxication with an organophosphorus Goodman and
Physostigmine and is manifesting toxicity. B. Pralidoxime anti- ChE agent (e.g. physostigmine), the recommended Gilman, The
Identify the antidote. C. Flumazenil adult dose of ​pralidoxime is 1-2 g​, infused intravenously Pharmacologic
D. Ipatropium Bromide over not < 5 minutes. If weakness is not relieved or if it recurs Basis of
after 20-60 minutes, the dose should be Therapeutics,
repeated. 11 Edition,
page 248
Early treatment is very important to assure that the oxime
reaches the phosphorylated AChE while the latter still can be
reactivated.

19 Which of the following conditions is A. Escherichia coli C. Mycobacterium Many pathogens are typically ​resistant to TMP-SMX​. These https://www.up
resistant to Sulfamethoxazole/Trimetoprim B. Pneumocystis carinii tuberculosis include Pseudomonas aeruginosa, Bacteroides fragilis (and todate.com/co
combination? C. Mycobacterium most other anaerobes), ​Mycobacterium tuberculosis​, ntents/trimetho
tuberculosis Treponema pallidum, Campylobacter, penicillin-resistant prim-sulfameth
D. Shigella spp. Streptococcus pneumoniae, and Rickettsiae. oxazole-an-ov
erview#H3

20 Juan has been diagnosed with rheumatic A. Increase conductivity D. Increase the The main mechanism of action of digitalis is on the Digitalis
heart disease. ECG of Juan revealed atrial of the AV node effective refractory sodium-potassium ATPase of the myocyte. It reversibly toxicity.
fibrillation. The consultant started Juan on B. Increase automaticity period of the AV inhibits the ATPase resulting in increased intracellular https://www.nc
Digoxin. Select the rationale for such of the heart node sodium levels. The build-up of intracellular sodium leads to a bi.nlm.nih.gov/
medication. C. Increase in excitability shift of sodium extracellularly through another channel in books/NBK459
of the aria and exchange for calcium ions. This influx of intracellular calcium 165/
ventricles assists with myocyte contractility.
D. Increase the effective
refractory period of Digoxin also has direct effects on conduction through
the AV node increased vagal tone. Digoxin stimulates the vagus nerve
leading to prolonged conduction through the sinuatrial (SA)
and atrioventricular (AV) nodes. Overall, digoxin ​slows the
 conduction ​and increases the refractory period in
cardiac tissue by enhancing vagal tone​.

21 First line drug of treatment of typhoid fever A. Co-trimoxazole D. The initial choice of antibiotics Harrison’s
is ____________. B. Chloramphenicol Fluoroquinolones depends on the susceptibility of the S. Typhi and S. Internal
C. Ampicillin Paratyphi strains Medicine, 20th
D. Fluoroquinolone in the area of residence or travel. F​or treatment of Edition, page
drug-susceptible typhoid fever, fluoroquinolones are the 1176
most effective class of agents​, with cure rates of ~98%
and relapse and fecal carriage rates of <2%. Experience is
most extensive with ciprofloxacin.

22 Emong, 72 year old has been receiving A. Galactorrhea ​B. Osteoporosis Leuprolide was the first of a set of synthetic peptides with Katzung and
Leuprolide for 1 year for prostate cancer. B. Osteoporosis long-acting GnRH agonist activity. Trevor
Which is the most common complication C. Hypothyroidism Examination
associated with long term use of D. Pain In men treated continuously with a GnRH agonist, adverse Review of
Leuprolide? effects include hot flushes, sweats, gynecomastia, reduced Pharmacology,
libido, decreased hematocrit, and ​reduced bone density​. In 11th Edition,
men with prostate cancer and children with central page 271
precocious puberty, the first few weeks of therapy can
temporarily exacerbate the condition.

23 Transmission of Trichomoniasis can be A. Treat partner B. Vaginal ● Douching is not recommended ​because it might https://www.cd
prevented by the following methods B. Vaginal douching douching increase the risk for vaginal infections, including c.gov/std/tg201
EXCEPT: C. Sex avoidance trichomoniasis 5/trichomoniasi
D. Use of condom ● The most reliable way to avoid transmission of STDs s.htm
is to ​abstain from oral, vaginal, and anal sex ​or to
be in a long-term, mutually monogamous relationship
with a partner known to be uninfected. For persons
who are being treated for an STD other than HIV (or
whose partners are undergoing treatment),
counseling that encourages abstinence from
sexual intercourse until completion of the entire
course of medication is crucial​.
 ● Studies demonstrate that ​consistent condom use
reduces the risk for other STDs, including
chlamydia, gonorrhea, and trichomoniasis
● Concurrent treatment of all sex partners is
critical for symptomatic relief, microbiologic
cure, and prevention of transmission and
reinfections. ​Current partners should be referred for
presumptive therapy to avoid reinfection.

24 Select the benzodiazepine that is short A. Diazepam D. Midazolam BRS Review of

acting with half life of 1-12 hours. B. Clonazepam Pharmacology,
C. Alprazolam 6th Edition,
D. Midazolam page 102

25 A patient was rushed to the ER for A. Pralidoxime D. ​Flumazenil Flumazenil BRS

overdose of Diazepam. Identify the B. Atropine 1. Flumazenil is a competitive antagonist at benzodiazepine Pharmacology
antidote. C. Acetylcysteine receptors. 6E. p104
D. Flumazenil 2. Flumazenil is used to prevent or reverse the CNS effects
from benzodiazepine overdose or to speed recovery from the
effects of benzodiazepines used in anesthetic and diagnostic
procedures; it may precipitate withdrawal. Its short duration
of action often necessitates multiple dosing.
26 Culture studies showed Klebsiella spp. A. Ceftazidime C. ​Clindamycin Third-generation cephalosporins ● BRS
Select the drug that will NOT be effective B. Aztreonam (a) Third-generation cephalosporins include cefdinir Pharmacolo
for the patient. C. Clindamycin (Omnicef), cefixime (Suprax), cefotaxime (Clarofan), gy 6E. p268
D. Imipinem ceftizoxime (Cefizox), ceftazidime ​(Fortaz,Tazicef), and ● BRS
ceftriaxone (Rocephin). Pharmacolo
(b) These agents have enhanced activity against gy 6E.
gram-negative organisms. They demonstrate high potency p268-269
against H. influenzae, N. gonorrhoeae, N. meningitides, ● BRS
Enterobacter, Salmonella, indole-positive Proteus, and Pharmacolo
Serratia spp., and E. coli; and moderate activity against gy 6E. p273
anaerobes. Cefoperazone and ceftazidime have excellent ● BRS
activity against P. aeruginosa. Ceftriaxone is used for Pharmacolo
sexually transmitted infections caused by gonorrhea, as well gy 6E. p269
as in empiric therapy for community- acquired meningitis.
(c) With the exception of cefoperazone, third-generation
cephalosporins penetrate the CSF.
(d) These agents are excreted by the kidney, except
cefoperazone and ceftriaxone, which are excreted through
the biliary tract, thus enabling the use of these agents for
infections of the biliary tree.
(e) Third-generation cephalosporins are used to treat
gonorrhea, Lyme disease, meningitis, and serious
hospital-acquired gram-negative infections, alone or in
combination with an aminoglycoside.

Aztreonam (Azactam)
(1) Aztreonam is a naturally occurring monobactam lacking
the thiazolidine ring that is highly resistant to a-lactamases.
(2) Aztreonam has good activity against gram-negative
organisms, but it lacks activity against anaerobes and
gram-positive organisms.
(3) This agent demonstrates no cross-reactivity with
penicillins or cephalosporins for hypersensitivity reactions.
(4) Aztreonam is administered parenterally.
(5) Aztreonam is useful for various types of infections caused
by E. coli, Klebsiella pneumoniae, H. influenzae, P.
aeruginosa, Enterobacter spp., Citrobacter spp., and P.
mirabilis.

Clindamycin (Cleocin)
a. Clindamycin acts similar to erythromycin.
b. Clindamycin can be administered orally and is well
distributed throughout body fluids, except for the CNS.
c. Use of clindamycin is limited to alternative therapy for
abscesses associated with infections caused by anaerobes,
such as B. fragilis. It is used in dental patients with valvular
heart disease for prophylaxis of endocarditis. Topical
preparations of the drug are used for the treatment of acne.
d. Clindamycin produces diarrhea, which is observed in up to
20% of individuals. Potential severe pseudomembranous
colitis occurs as a result of superinfection by resistant
clostridia

Carbapenems (imipenem-cilastatin [Primaxin],

ertapenem [Invanz], meropenem [Merrem IV], doripenem
[Doribax])
(1) Carbapenems are relatively resistant to a-lactamases.
(2) Carbapenems demonstrate no cross-resistance with
other antibiotics.
(3) Imipenem is marketed in the combination product
imipenem/cilastatin (Primaxin); cilastatin is an inhibitor of
renal dehydropeptidase I (which inactivates imipenem).
(4) These agents are useful for infections caused by
penicillinase-producing S. aureus, E. coli, Klebsiella spp.,
Enterobacter spp., and H. influenzae, among others. They
are powerful agents used for Pseudomonas infections.
 (5) Nausea, vomiting, diarrhea, and skin rashes, and at
higher doses, seizures, are their most common adverse
effects, particularly for imipenem.

27 Which of the following is an effect notable A. Increase ventilator D. ​Negative ​ . Cardiovascular Effects
B Basic and
with the use of general anesthesia? response to hypoxia inotropic effect Halothane, enflurane, isoflurane, desflurane, and sevoflurane Pharmacology
B. CNS excitation all depress normal cardiac contractility (halothane and 14E. p447
C. Increase glomerular enflurane more so than isoflurane, desflurane, and
filtration rate sevoflurane). As a result, all volatile agents tend to decrease
D. Negative inotropic mean arterial pressure in direct proportion to their alveolar
effect concentration. With halothane and enflurane, the reduced
arterial pressure is caused primarily by myocardial
depression (reduced cardiac output) and there is little change
in systemic vascular resistance. In contrast, isoflurane,
desflurane, and sevoflurane produce greater vasodilation
with minimal effect on cardiac output. These differences may
have important implications for patients with heart failure.
Because isoflurane, desflurane, and sevoflurane better
preserve cardiac output as well as reduce preload
(ventricular filling) and afterload (systemic vascular
resistance), these agents may be better choices for patients
with impaired myocardial function.
Nitrous oxide also depresses myocardial function in a
concentration-dependent manner. This depression may be
significantly offset by a concomitant activation of the
sympathetic nervous system resulting in preservation of
cardiac output. Therefore, administration of nitrous oxide in
combination with the more potent volatile anesthetics can
minimize circulatory depressant effects by both
anesthetic-sparing and sympathetic-activating actions.

28 Structure activity relationship is important A. Substitution on the oral D. ​Removal of the ​Substitution on the Benzene Ring Basic and
in the physical and drug effect of beta carbon of the side hydroxyl group Maximal α and β activity is found with catecholamines, ie, Clinical
sympathetic drugs. Catecholamines are chain from the phenyl-ring drugs having –OH groups at the 3 and 4 positions on the
 usually degraded by enzymes B. Substitution on the benzene ring. The absence of one or the other of these Pharmacology
Catechol-O-methyl transferase (COMT) alpha carbon of the groups dramatically reduces the potency of these drugs. For 14E. p142-143
and Monoamine oxidase inhibitors side chain example, phenylephrine is much less potent than
(MAO-I) making them orally C. Substitution on the epinephrine; its affinity to α receptors is decreased
non-bioavailable. Which modification can amino group side approximately 100-fold, but because its β activity is almost
improve oral bioavailability? chain negligible except at very high concentrations, it is a selective
D. Removal of the α agonist.
hydroxyl group from On the other hand, the presence of –OH groups make
the phenyl-ring catecholamines subject to inactivation by
catechol-O-methyltransferase (COMT), and because this
enzyme is found in the gut and liver, catecholamines are not
active orally. ​Absence of one or both –OH groups on the
phenyl ring increases the bioavailability after oral
administration and prolongs the duration of action​.
Furthermore, absence of ring –OH groups tends to increase
the distribution of the molecule to the central nervous system
(CNS). For example, ephedrine and amphetamine are orally
active, have a prolonged duration of action, and produce
central nervous system effects not typically observed with the
catecholamines. Methamphetamine (“crystal meth,” a
common drug of abuse) can be synthesized by simple
dehydroxylation of ephedrine, which led to the restriction of
over-the-counter distribution of its isomer pseudoephedrine.

29 Which of the following drugs or conditions A. Quinidine C. ​Cholestyramine The bile acid-binding resin cholestyramine was administered Use of
does NOT result in increased toxicity when B. Hypokalemia in a dose of 4 g every six hours to a patient with digoxin cholestyramine
occurring with -or concomitantly given C. Cholestyramine intoxication. The serum digoxin concentration declined in the
during digoxin administration? D. Renal Failure rapidly, and the digoxin half-life decreased from 75.5 hours to treatment of
19.9 hours while cholestyramine was administered. All signs digoxin
and symptoms of toxic reaction subsided during the period of intoxication.
cholestyramine therapy, which correlated with the decline in https://www.nc
digoxin concentrations. Cholestyramine and a related agent, bi.nlm.nih.gov/
colestipol, presumably interrupt the enterohepatic recycling
 of digoxin to enhance elimination. These agents represent pubmed/33418
potentially useful adjunctive measures in the management of 74
non-life-threatening digitalis intoxication.

30 In addition to the effect of tramadol on A. Serotonin (increase B. Acetylcholine Tramadol is a centrally acting analgesic whose mechanism Basic and
pain by affecting opioid receptors, it also release) (receptor of action is complex and dependent on the ability of the Clinical
affects the following neurotransmitters B. Acetylcholine (receptor antagonist)- Not parent drug and its metabolites to ​block serotonin and Pharmacology
EXCEPT___ antagonist) sure norepinephrine reuptake​. Because its analgesic effect is 14E. p569-570
C. Norepinephrine (inhibit only partially antagonized by naloxone, it is thought to
re-uptake) depend less on its low-affinity binding to the μ receptor for
D. Dopamine (increase therapeutic activity. The recommended dosage is 50–100 mg
release) orally four times daily; however, its systemic concentration
and analgesic effect are dependent on the enzymatic activity
of CYP2D6 polymorphisms. Toxicity includes association
with seizures; the drug is relatively contraindicated in patients
with a history of epilepsy and for use with other drugs that
lower the seizure threshold. Another serious risk is the
development of serotonin syndrome, especially if selective
serotonin reuptake inhibitor antidepressants are being
administered. Other adverse effects include nausea and
dizziness, but these symptoms typically abate after several
days of therapy. No clinically significant effects on respiration
or the cardiovascular system have thus far been reported
when used as monotherapy. Given the fact that the analgesic
action of tramadol is largely independent of μ-receptor action,
tramadol may serve as an adjunct with pure opioid agonists
in the treatment of chronic neuropathic pain.

31 Side effect associated with thiazide A. Hyperlipidemia B. ​Hyperkalemia Adverse effects and contraindications​. Thiazide diuretics ● BRS
diuretics are the following EXCEPT B. Hyperkalemia should be used cautiously in the presence of renal or hepatic Pharmacolo
C. Hyperglycemia diseases such as cirrhosis, and they should be used only as gy 6E.
D. Hypercalcemia an ancillary treatment in nephrotic syndrome. p62-63
a. Thiazide diuretics produce electrolyte imbalances such as
hypokalemia, hyponatremia, and hypochloremic alkalosis.
 These imbalances are often accompanied by central nervous
system (CNS) disturbances, including dizziness, confusion,
and irritability; muscle weakness; cardiac arrhythmias; and
by decreasing plasma K1, increased sensitivity to digitalis.
Diets low in Na1 and high in K1 are recommended; K1
supplementation may be required.
b. These agents often elevate serum urate, presumably as a
result of competition for the organic anion carriers (which
also eliminates uric acid). Gout-like symptoms may appear.
c. Thiazide diuretics can cause hyperglycemia (especially in
patients with diabetes), hypertriglyceridemia,
hypercholesterolemia, and hypersensitivity reactions (sulfa
groups).

32 Gigi, 30 years old, with acute A. Carbapenem C. Fosfomycin Fosfomycin inhibits the enzyme enolpyruvate transferase BRS
pyelonephritis. Which of the following B. Amikacin and thereby interferes downstream with the formation of Pharmacology,
intravenous drugs is inappropriate? C. Fosfomycin bacterial wall specific N-acetylmuramic acid. This oral agent Sixth Edition
D. Fluoroquinolone is active against both gram-positive and gram-negative
organisms. It is used to treat simple lower urinary tract
infection.

33 The following drugs can increase the A. Amiodarone C. Antacid Antacids reduce digoxin absorption. Other drugs that Various
serum level of Digoxin when given B. Azithromycin decrease digoxin concentration include rifampicin. Macrolide researches
concomitantly EXCEPT C. Antacid (i.e. azithromycin) antibiotics increase digoxin concentration.
D. Quinine Antiarrhythmics increase digoxin concentration as well, such
as amiodaron and quinine.

34 As a N-methyl D aspartate (NMDA) A. Donezepil D. Memantine Memantine is a noncompetitive inhibitor of N-methyl-d BRS
receptor blocker, which of the following B. Sertraline aspartate (NMDA) receptors that has a few side effect, is Pharmacology,
drugs is used in the treatment of C. Carbegoline used to treat Alzheimer's Disease. Donezepil is an Sixth Edition
dementia? D. Memantine acetylcholinesterase inhibitor used to treat Alzheimer's
disease. Sertraline is an SSRI antidepressant which is a
selective inhibitor of serotonin uptake. Carbegoline is a
 potent dopamine receptor agonist on D2 receptors used in
the treatment of hyperprolactinemia.

35 Which drug facilitates the body's A. Butamirate B. Bromhexine Bromhexine is a derivative of the Adhatoda vasica plant, and BRS
mechanism for clearing mucus from the B. Bromhexine is a mucolytic drug which enhances the secretion of various Pharmacology,
respiratory tract. It increases the C. Dextromethorphan mucus components by modifying the physicochemical Sixth Edition;
production of serous mucus in the D. Phenylephrine characteristics of mucus. These changes, in turn, increase Various
respiratory tract making phlegm thinner mucociliary clearance and reduce cough. Butamirate and Researches
and less viscous. Dextromethorpan are antitussives and act to supress the
coughing reflex. Phenylephrine acts by direct a1-receptor
stimulation resulting to vasoconstriction, increased total
peripheral resistance, and increased systolic and diastolic
pressure.

36 Tramadol exerts its effect on pain by A. Steroid receptors C. Mu-opioid Tramadol has a weak opioid mu-receptor agonist activity and BRS
reacting with B. Serotonin receptors receptors weakly blocks reuptake of serotonin and norepinephrine. Pharmacology,
C. Mu-opioid receptors Tramadol may also have special use for neuropathic pain. Sixth Edition
D. The enzyme The action of tramadol is partially reversed by naloxone. In
cyclooxygenase the presence of MAOIs, Tramadol may precipitate the
serotonin syndrome. Tramadol use is associated with an
increased risk of seizures and is contraindicated in patients
with epilepsy.

37 Cefpirome is superior to Ceftazidine A. Pseudomonas aeruginosa C. Enterobacter Cefpirome is a 4th class generation cephalosporin known to Various
because it has activity against B. Streptococcus pneumonia lactamase have strong antimicrobial activity against beta-lactamases Researches
C. Enterobacter lactamase and is highly stable to hydrolysis by various P-lactamases.
D. Haemophilus influenzae Both cefpirome and ceftazidime have in vitro activity against
P. aeruginosa with the same efficacy, yet Ceftazidime is
superior when it comes to said in vitro activity as compared
to Cefpirome.

38 Select the drug of choice for Cholera. A. Streptomycin B. Doxycycline Oral or intravenous hydration is the mainstay of cholera CDC on
B. Doxycycline treatment. Doxycyline is the recommended first-line Cholera -
C. Penicillin G
 D. Imipenem treatment for adults, while Azithromycin is recommended as Vibrio cholerae
first-line treatment for children and pregnant women. infection

39 Mario was rushed to the emergency room A. Clopidogrel ​C. Mefenamic acid Patients who routinely took nonsteroidal anti-inflammatory
for severe crushing chest pain. ECG drugs (except for aspirin) before STEMI should discontinue https://www.aa
showed ST wave elevation. The ff B. Atorvastatin these agents because of increased risks of mortality, fp.org/afp/2009
medications should be given to Mario reinfarction, hypertension, heart failure, and myocardial /0615/p1080.ht
EXCEPT C. Mefenamic acid rupture. ml

D. Nitroglycerin

40 Select the drug for the treatment of A. Denosumab ​B. Teriparatide Teriparatide (Forteo). This powerful drug is similar to
osteoporosis that is chemically similar to parathyroid hormone and stimulates new bone growth. It's https://www.m
parathyroid hormone. B. Teriparatide given by daily injection under the skin. After two years of ayoclinic.org/di
treatment with teriparatide, another osteoporosis drug is seases-conditi
C. Raloxifene taken to maintain the new bone growth. ons/osteoporo
sis/diagnosis-tr
D. Strontium eatment/drc-20
351974

41 Select the correct statement regarding A. It is poorly absorbed from C. It acts as a Sucralfate is a locally acting substance that in an acidic
Sucralfate. the GI tract. protective barrier In environment (pH < 4), ​reacts with hydrochloric acid in the
the stomach against stomach to form a cross-linking, viscous, paste-like
B. It inhibits proton pump that the action of acid material capable of acting as an acid buffe​r for as long as
secretes Hcl acid in the and pepsin. 6 to 8 hours after a single dose. It also attaches to proteins
stomach on the surface of ulcers -- such as albumin and fibrinogen --
D. It reacts with Hcl to form stable, insoluble complexes. These complexes serve
C. It acts as a protective acid to form a as ​protective barriers at the ulcer surface, preventing
barrier In the stomach viscous, paste like further damage from acid, pepsin​, and bile. In addition, it
against the action of acid substance that acts prevents back diffusion of hydrogen ions, and adsorbs both
and pepsin. as acid buffer. pepsin and bile acids. Recently, it has been indicated that
sucralfate also stimulates the increase of prostaglandin E2,
epidermal growth factors (EGF), bFGF), and gastric mucus
 D. It reacts with Hcl acid to
form a viscous, paste like
substance that acts as acid
buffer.

42 Maricel is suffering from pelvic A. Fosfomycin D. Minocycline

inflammatory disease complicated by
Chlamydia trachomatis. Which of the ff B. Ciprofloxacin
drugs is effective for this organism?
C. Amoxicillin

D. Minocycline
43 Which of the following vaccine products A. Conjugate vaccine B. Attenuated Live attenuated: The immune response to a live attenuated https://www.cd
when given to human is the closest to a vaccine vaccine is virtually identical to that produced by a natural c.gov/vaccines
natural infection? B. Attenuated vaccine infection. The immune system does not differentiate between /pubs/pinkbook
an infection with a weakened vaccine virus and an infection /downloads/pri
C. Subunit vaccine with a wild virus. nvac.pdf
Inactivated vaccine: Inactivated vaccines are not alive and
D. Inactivated vaccine cannot replicate. The entire dose of antigen is administered
in the injection. These vaccines cannot cause disease from
infection, even in an immunodeficient person. Inactivated
antigens are less affected by circulating antibody than are
live agents, so they may be given when antibody is present
in the blood (e.g., in infancy or following receipt of
antibody-containing blood products).
Subunit, recombinant, polysaccharide, and conjugate
vaccines use specific pieces of the germ — like its protein,
sugar, or capsid (a casing around the germ).

44 The nephrotoxicity associated with the use A. Hypovolemia D. Hypernatremia Several factors related to the nephrotoxicity of
of aminoglycosides is increased in the aminoglycosides have been reported: multiple doses, https://doi.org/
presence of the following conditions B. Reduced liver function male animals, infection, acidosis, volume depletion, 10.1590/S0102
EXCEPT sodium depletion, hyperkalemia, hypomagnesemia, -76382006000
C. Reduced renal function hepatic disease and concomitant use of other drugs 400015
 D. Hypernatremia including vancomycin, teicoplamin, cyclosporin and
cisplatin. Brazilian
Journal of
Cardiovascul
ar Surgery

45 Which of the following is NOT an effect A. Positive inotropic action B. Vasoconstriction Milrinone, a phosphodiesterase 3 inhibitor, inhibits the
associated with Milrinone? B. Vasoconstriction breakdown of cyclic AMP in both cardiac and vascular
C. Fall in peripheral vascular smooth muscle cells and acts as a powerful inotrope and
resistance pulmonary vasodilator agent with little effect on systemic
D. Inhibits phophodiesterase III arterial blood pressure.

46 Select the biologic agent used in the A. Azathioprine C. Infliximab Biologic therapy is now commonly given as an initial therapy Harrisons
treatment of ulcerative colitis. B. Sulfasalazine for patients with moderate to severe CD and UC. The first Internal
C. Infliximab biologic therapy approved for moderate to severely active CD Medicine
D. Dexamethasone and also UC was infliximab, a chimeric IgG1 antibody against
TNF-α.

Azathioprine - purine analogue

Sulfasalazine - 5-ASA agent
Dexamethasone - corticosteroid

47 In the final maturation induction during A. Clomiphene D. Gonadotropin GnRH analogs have two main uses BRS Pharma
fertility treatment and in the presence of B. Human chorionic releasing hormone a. Chemical castration, requiring chronic administration, is 6th ed Chapter
mature ovarian follicles, ovulation can be gonadotropin agonist useful in the treatment of hormone-dependent cancers and 10
triggered by the administration of ____ C. Follicular stimulating hyperplasias such as prostate cancer, breast cancer,
hormone endometriosis, and fibroids
D. Gonadotropin b. Treatment of infertility requires pulsatile administration to
releasing hormone stimulate FSH and LH.
agonist
 Clomiphene is used to treat infertility in cases of anovulation
in women with an intact hypothalamic-pituitary axis and
sufficient production of estrogen.
FSH and LH of pituitary origin are not used
pharmacologically.
hCG is produced by the placenta

48 Identify the drug that can antagonize A. Dobutamine B. Phentolamine α-Adrenoceptors are distinguished from β-adrenoceptors by BRS Pharma
epinephrine at alpha adrenergic receptors B. Phentolamine their interaction, with the adrenergic agonists epinephrine, 6th ed Chapter
C. Dopamine norepinephrine > isoproterenol, and by their interaction with 2
D. Isoproterenol relatively selective
antagonists such as phentolamine.

Dopamine activates peripheral a1-adrenoceptors to increase

heart rate and contractility.
 Dobutamine is a synthetic catecholamine that is related to
dopamine but whose
activities are related to actions at beta-receptors and
alpha-receptors with no effect on dopamine receptors.

Isoproterenol - ​non-selective β adrenoreceptor agonist

49 Select the INCORRECT statement A. Adjustment in patients D is correct

regarding beta lactamase inhibitors. with CRF is based on
the penicillin
component
B. The new anti-bacterial
spectrum of the
combination is
determined by the
beta-lactamase
inhibitor
C. They have similar
appearance to
penicillin but with
limited antibacterial
activity
D. Beta-lactamase
inhibitors are
compounds that
irreversibly inactivate
bacterial
beta-lactamase

50 Controlled ovarian hyperstimulation is A. Human menopausal D. Clomiphene ​ onadotropins are the most commonly used medication for
G BRS Pharma
achieved using the ff drugs EXCEPT gonadotropin controlled ovarian stimulation in in vitro fertilization (IVF). 6th ed Chapter
B. Human chorionic 10
gonadotropin
C. Follitropin
 D. Clomiphene Human menopausal gonadotropins (menotropins) are
isolated from the urine of postmenopausal women and
contain a
mixture of LH and FSH. Menotropins are used in concert with
hCG to stimulate ovulation in women with functioning
ovaries.

Recombinant human FSH (follitropin-α and follitropin-β)

Clomiphene is used to treat infertility in cases of anovulation

in women with an intact hypothalamic-pituitary axis and
sufficient production of estrogen.

51 The psychomimetic effect of morphine is A. Sigma opioid receptor C. K-opioid receptor Interaction with μ-receptors contributes to supraspinal and BRS Pharma
associated with reaction of morphine with B. Delta opioid receptor spinal analgesia, respiratory depression, sedation, euphoria, 6th ed Chapter
C. K-opioid receptor decreased GI transit, and physical dependence. 2
D. Mu opioid receptor
Interaction with δ-receptors also contributes to supraspinal
and spinal analgesia.

The significance of interaction with κ-receptors is unclear, but

it may contribute to analgesia and also psychomimetic
effects of some opioids.

52 The overdose of morphine and other A. Nalbuphine C. Naloxone Naloxone and naltrexone (also nalmefene) are competitive BRS Pharma
opioid can be reversed by giving __ B. Heroin inhibitors of the actions of opioids. These drugs will 6th ed Chapter
C. Naloxone precipitate opioid withdrawal. It is used to diagnose opioid 2
D. Hydrocodone dependence and to treat acute opioid overdose.

Nalbuphine - opioid κ-receptor agonists

Heroin and Hydrocodone are opioid agonist
53 Adjunct treatment for prostate cancer is A. Danazol C. Leuprolide The treatment of choice for patients with advanced prostate Katzung 12th
____? B. Testosterone cancer is elimination of testosterone production by the testes ed pg. 972
C. Leuprolide through either surgical or chemical castration.
D. Dopamine Presently, the use of luteinizing hormone-releasing hormone
(LHRH) agonists— including leuprolide and goserelin
agonists, alone or in combination with an antiandrogen (eg,
flutamide, bicalutamide, or nilutamide)—is the preferred
approach

54 The nurse referred the patient for poor A. Epinephrine

urine output secondary to relative B. Digoxin
hypotension. The best management is to C. Dobutamine
start ____. D. Dopamine

55 Which of the following diuretics does not A. Acetalozamide C. Furosemide Furosemide stimulates urinary acidification in normal
alkalinify the urine? B. Hydrochlorothiazide humans probably by increasing distal Na delivery and https://www.nc
C. Furosemide transport, thus creating a favorable electric gradient for H+ bi.nlm.nih.gov/
D. Spirinolactone and K secretion pubmed/67474
43

56 Juan is suffering from acromegaly A. Leuprolide

resistant to radiation. You would like to B. Mecasermin
start the patient on an antagonist of growth C. Pegvisomant
hormone receptor. Select the appropriate D. Decapeptyl
drug.

57 Which of the following statements is A. It is a result of release C. Repeated A. Katzung 12th

INCORRECT regarding tachyphylaxis of vasoconstrictors administration of B. The clinical efficacy of slow-release forms of nitroglycerin ed pg. 199
seen in chronic nitrate use? angiotensin II nitrates results in in maintenance therapy of angina is thus limited by the
B. Tachyphylaxis can be increase in effect development of significant tolerance. Therefore, a nitrate-free
avoided by having a period of at least 8 hours between doses should be observed
6-8 hour nitrate free to reduce or prevent tolerance.
dose
 C. Repeated C. Systemic compensation also plays a role in tolerance in
administration of the intact human. Initially, significant sympathetic discharge
nitrates results in occurs, and after one or more days of therapy with
increase in effect long-acting nitrates, retention of salt and water may reverse
D. It is explained by the the favorable hemodynamic changes normally caused by
“oxidative stress nitroglycerin.
theory”
D.

58 Among the following drugs that can A. Leuprolide

induce medical menopause, identify the B. Abarelix
drug that will NOT cause the “flare effect” C. Triptorelin
D. Goserelin

59 After taking her medications for A. Isoniazid B. Streptomycin Streptomycin is ototoxic and nephrotoxic. Vertigo and Katzung 12th
pulmonary TB, Shiela is now complaining B. Steptomycin hearing loss are the most common adverse effects and may ed pg. 843
of vertigo and inability to perceive C. Ethambutol be permanent. Toxicity is dose-related, and the risk is
termination of movement and difficulty D. Pyrazinamide increased in the elderly. As with all aminoglycosides, the
sitting and standing without visual clues. dose must be adjusted according to renal function (see
This can be explained as a side effect of Chapter 45 ). Toxicity can be reduced by limiting therapy to
___? no more than 6 months whenever possible.

60 Reserpine is used in the management of a. Agonist at muscarinic C.Inhibiting Reserpine blocks the ability of aminergic transmitter vesicles Katzung’s
hypertension by __. receptors adrenergic re-uptake to take up and store biogenic amines, probably by interfering Basic and
at synapses with the vesicular membrane-associated transporter. This Clinical
b. Agonist effect at effect occurs throughout the body, resulting in depletion of Pharmacology
sympathetic beta receptors norepinephrine, dopamine, and serotonin in both central and 13​th edition.
peripheral neurons. Chromaffin granules of the adrenal Page 280
c. Inhibiting adrenergic medulla are also depleted of catecholamines, although to a
re-uptake at synapses lesser extent than are the vesicles of neurons. Reserpine’s
effects on adrenergic vesicles appear irreversible; trace
d. blocking the effect of amounts of the drug remain bound to vesicular membranes
epinephrine at adrenergic for many days
receptors
61 Dutasteride is given to Manuel for his a. As estrogen receptor c. By inhibiting Dutasteride inhibits both type I and II 5-reductase and is BRS
prostate hyperplasia. It works __. antagonist 5-alpha reductase more potent than finasteride. Pharmacology
6​th Edition.
b. By inhibiting aromatase Serum dihydrotachysterol (DHT) levels can be reduced by Page 240
enzyme more than 90% in 2 weeks.

c. By inhibiting 5-alpha Dutasteride is used to treat BPH and baldness.

reductase

d. As testosterone receptor
antagonist

62 Among the phosphodiesterase inhibitors, a. Papaverine d. Milrinone Parenteral formulations of Inamrinone (previously named Goodman and
identify the drug that inhibits selectively amrinone) and milrinone are approved for shortterm Gilman’s The
PDE3 used in patients with cardiac b. Tadalafil circulation support in advanced CHF. Both drugs are Pharmacologic
pathology. bipyridine derivatives and are selective PDE3 inhibitors, the al Basis of
c. Theophylline cyclic GMP–inhibited cyclic AMP–PDE. These drugs directly Therapeutics.
stimulate myocardial contractility and accelerate myocardial 12​th Edition.
d. Milrinone relaxation. In addition, they cause balanced arterial and Page 1525
venous dilation with a consequent fall in systemic and
pulmonary vascular resistances and left and right- heart
filling pressure. As a result of its effect on LV contractility,the
increase in cardiac output from milrinone is superior to that
from nitroprusside, despite comparable reductions in
systemic vascular resistance. Conversely, the arterial and
venodilatory effects of milrinone are greater than those of
dobutamine at concentrations that produce similar increases
in cardiac output.

63 Lymphogranuloma venereum or Climatic a. Azithromycin c. Doxycycline Doxycycline (100 mg twice daily for 21 days) is first-line Goodman and
bubo is treated with the following drugs therapy for treatment of lymphogranuloma venereum. The Gilman’s The
EXCEPT __. b. Co-trimoxazole size of buboes decreases within 4 days, and inclusion and Pharmacologic
elementary bodies entirely disappear from the lymph nodes al Basis of
within 1 week. Therapeutics.
 c. Doxycycline 12​th Edition.
Page 1525
d. Tetracycline

64 Spontaneous bacterial peritonitis is a. Ampicillin b.Aminoglycosides Patients who develop peritonitis as a result of peritoneal Goodman and
treated empirically by giving __. dialysis may be treated with aminoglycoside diluted into the Gilman’s The
b. Aminoglycosides dialysis fluid to a concentration of 4-8 mg/L for gentamicin, Pharmacologic
netilmicin, or tobramycin or 6-12 mg/L for amikacin. al Basis of
c. Third generation Intravenous or intramuscular administration of drug is Therapeutics.
cephalosphorine unnecessary because serum and peritoneal fluid will 12​th Edition.
equilibrate rapidly. Page 1515
d. Tetracycline

65 . Flatulence is a common side effect of a. Pioglitazone b. Acarbose a-Glucosidase inhibitors reduce intestinal absorption of Goodman and
which of the following anti-diabetic drugs? starch, dextrin, and disaccharides Gilman’s The
b. Acarbose by inhibiting the action of a-glucosidase in the intestinal Pharmacologic
brush border. Inhibition of this enzyme slows the absorption al Basis of
c. Metformin of carbohydrates from the GI tract and blunts the rate of rise Therapeutics.
of postprandial plasma glucose. The drugs in this class are 12​th Edition.
d. Glibenclamide acarbose (PRECOSE, others), miglitol (GLYSET), and Page 1264
voglibose. The most prominent adverse effects related to
a-glucosidase inhibitors are malabsorption, flatulence,
diarrhea, and abdominal bloating

66 Consuela accidentally took an overdose a. Ethinyl estradiol d. Phytomenadione If the INR is above the therapeutic range but <5 and the Goodman and
amount of warfarin. Lab test showed INR patient is not bleeding or in need of a surgical procedure, Gilman’s The
is 10, no active bleeding reported. The b. pRBC transfusion warfarin can be discontinued temporarily and restarted at a Pharmacologic
antidote for warfarin toxicity is __. lower dose once the INR is within the therapeutic range al Basis of
c. Dexamethasone (Hirsh et al., 2003). If the Therapeutics.
12​th Edition.
d. Phytomenadione INR is ≥5, vitamin K1 (phytonadione​, ​ EPHYTON,
M Page 864
AQUAMEPHYTON)
 can be given orally at a dose of 1-2.5 mg (for 5≤ INR ≤9) or
3-5 mg

(for INR >9). These doses of oral vitamin K1 generally cause

the

INR to fall substantially within 24-48 hours without rendering

the patient resistant to further warfarin therapy.

67 Empagliflozin is used in the treatment of a. Increasing the insulin D. Decreasing the Empagliflozin works by ​inhibiting the sodium-glucose ​Heise T, et al.
diabetes mellitus, it works by ___ effect on peripheral amount of sugar co-transporter-2 (SGLT-2) ​found in the ​proximal tubules Acute
tissues (insulin reabsorbed from the in the kidneys​. Through SGLT2 inhibition, empagliflozin Pharmacodyna
sensitizer) proximal tubules of reduces renal reabsorption of glucose and increases mic Effects of
b. Increasing the release the kidneys urinary excretion of glucose​. Empagliflozin
of insulin from With and
pancreatic beta cells Without
(insulin secretagogue) Diuretic Agents
c. Decreasing the in Patients
amount of sugar With Type 2
absorbed from food Diabetes
d. Decreasing the Mellitus. Clin
amount of sugar Ther. 2016
reabsorbed from the Oct;38(10):224
proximal tubules of 8-2264.e5.
the kidneys

68 Loperamide slows down gastrointestinal a. Serotonin receptor D. Opioid receptors Loperamide is an ​opioid-receptor ​agonist and ​acts on the Katzung, B. G.
contraction by ___ effect activation μ-opioid receptors in the ​myenteric plexus of the large (2004). ​Basic
b. Stimulation of intestine​. It works like ​morphine​, decreasing the activity of and Clinical
sympathetic system the myenteric plexus, which decreases the tone of the Pharmacology
c. Anticholinergic effect longitudinal and circular ​smooth muscles of the intestinal (9th ed.).
wall.This increases the time material stays in the intestine,
 d. Opioid receptors allowing more water to be absorbed from the fecal matter. It National
activation also decreases colonic mass movements and suppresses Center for
the gastrocolic reflex. Biotechnology
Information.
PubChem
Database.
Loperamide,
CID=3955,
https://pubche
m.ncbi.nlm.nih.
gov/compound
/Loperamide

69 Ceftaroline is reserved for the following a. Infection with D. Atypical bacteria Ceftaroline fosamil (Teflaro) is a prodrug that is ​active BRS
infections EXCEPT ___ Enterobacter spp. against methicillin resistant staphylococci used to ​treat Pharmacology
b. MRSA infection skin infections and community-acquired pneumonia​. 6th ed p268
c. Complicated skin
infection The activity of ceftaroline is ​limited against ​Enterococcus Chen HH, et
d. Atypical bacteria sp., beta-lactamase–producing ​Enterobacteriacea and al. Ceftaroline
Pseudomonas aeruginosa​. Ceftaroline has also exhibited –an anti-MRSA
activity against a variety of gram-positive and gram-negative cephalosporin
anaerobes; however, activity was limited against ​Bacteroides and its
species, ​Clostridium difficile and beta-lactamase–producing implications for
Prevotella​ isolates. Singapore.
Ann Acad Med
The drug has ​no activity against atypical organisms and Singapore.
mycobacteria. In summary, ceftaroline demonstrates potent 2014;43(3):177
activity against Gram-positive organisms but only moderate –186.
activity against Gram-negative organisms in vitro.

70 Identify the component that blocks a. Paracetamol C. Antihistamines are histamine ​(H1)-receptor antagonists​; BRS
histamine-1 receptors in this cough and b. Phenylephrine Brompheniramine they include first generation diphenhydramine, Pharamacolog
cold preparation c. Brompheniramine brompheniramine​, chlorpheniramine, and y 6th ed p174,
d. Carbocisteine p219
 second-generation loratadine, which are useful in allergic
rhinitis but have little effect on rhinitis associated with colds.

71 Select the correct statement regarding a. It has activity against ​A and C MOA: ​Bind to 50S ribosomal subunit and ​inhibit protein BRS
clindamycin. both gram positive synthesis by blocking the polypeptide exit tunnel, which Pharmacology
and gram negative prevents peptide chain prolongation 6th ed p273
organism
b. It has no activity Use of clindamycin is limited to alternative therapy for Gold HS,
against anaerobic abscesses associated with infections caused by ​anaerobes​, Moellering RC,
organism Jr. 1999.
 c. It can be given to such as B. fragilis. It is used in dental patients with valvular Macrolides and
penicillin-allergic heart disease for prophylaxis of endocarditis. clindamycin, p
patient 291−297. In
d. It inhibits bacteria by Clindamycin is a lincosamide antibiotic that is ​active against Root RK,
inhibiting cell wall many aerobic Gram-positive cocci and a range of Waldvogel F,
synthesis anaerobic Gram-positive and Gram-negative​ bacteria Corey L,
Stamm WE
In penicillin-allergic patients, clindamycin has historically (ed), Clinical
been the recommended optional drug because it is believed infectious
to have little or no cross-allergenicity with penicillin. diseases: a
practical
approach.
Oxford
University
Press, New
York, NY​.

72 The development of tolerance to a. Naltrexone D. ​Ketamine Naloxone and naltrexone (also nalmefene) are BRS
morphine can be inhibited by b. Naloxone competitive inhibitors of the actions of opioids​. These Pharmacology
c. Phenobarbital drugs will ​precipitate opioid withdrawal​. 6th ed
d. Ketamine
Mechanism of morphine tolerance and physical dependence: Trujillo KA.
Although unclear, persistent morphine activation of Inhibition of
μ-receptors has been shown to result in decreased receptor morphine
recycling and also receptor uncoupling with its intracellular tolerance and
targets. dependence
by the NMDA
The development of tolerance complicates the use of receptor
morphine to manage persistent pain. ​N-methyl-D-aspartate antagonist
receptor antagonists can attenuate or reverse morphine MK-801.
tolerance​. Systemically administered ketamine attenuates Science, 251
and reverses systemically induced morphine tolerance in (1991)
 mice, and intraspinal ketamine attenuates tolerance
produced by intraspinal morphine in rats Shimoyama N,
wt al.
Ketamine
attenuates and
reverses
morphine
tolerance in
rodents.
Anesthesiology
. 1996
Dec;85(6):135
7-1366.

73 Select the INCORRECT statement a. Oral antibiotic can A. Oral antibiotic The primary mechanisms by which ​antibiotic medications ​ aillargeon J,
B
regarding warfarin potentiate the effect can potentiate the interact with warfarin to increase the risk of major bleeding et al.
of warfarin by effect of warfarin by is through ​disruption of intestinal flora that synthesize Concurrent
reducing normal reducing normal vitamin K,​2 and inhibition of cytochrome p450 isozymes use of warfarin
bacterial flora bacterial flora which metabolize warfarin​. and antibiotics
b. Hypothyroidism makes and the risk of
the patient less Correct statements: bleeding in
responsive to the In hypothyroid states, ​decreased catabolism of vitamin older adults.
effect of warfarin K–dependent clotting factors is believed to cause the Am J Med.​
c. Patients on warfarin decreased response to oral anticoagulants 2012;125(2):18
should have regular 3–189.
aPTT determination Patients on warfarin should have regular INR, aPTT doi:10.1016/j.a
d. Broccoli can determination mjmed.2011.0
counteract the effects 8.014
of warfarin The effectiveness of warfarin hinges on its effects on vitamin
K levels. ​Increasing the amount of vitamin K in your diet Walling, A.
by eating more broccoli can make the warfarin less Concurrent
effective
Disease Alters
 Warfarin
Effectiveness
Am Fam
Physician.
2000 Nov
15;62(10):2318
-2321.

74 Oxybutinin is a drug used for the a. Salivation D. Constipation Oxybutynin,which is somewhat selective for M3 receptors, is
treatment of overactive bowel. Which of b. Hyperacidity used to relieve
the following side effects is seen with its c. Uterine relaxation bladder spasm after urologic surgery, eg, prostatectomy. It is
use? d. Constipation also valuable in reducing involuntary voiding in patients with
neurologic disease, eg, children with meningomyelocele.
Oral oxybutynin or instillation of the drug by catheter into the
bladder in such patients appears to improve bladder capacity
and continence
and to reduce infection and renal damage.

75 Taking phenylephrine can worsen the a. Peripheral artery C. Orthostatic Phenylephrine is a direct-acting sympathomimetic amine
following co-morbid disease EXCEPT? disease hypotension chemically related to ​adrenaline and ​ephedrine with potent
b. Anxiety disorder vasoconstrictor property. It is a post-synaptic
c. Orthostatic alpha-adrenergic receptor agonist that causes
hypotension vasoconstriction, increases systolic/diastolic pressures, reflex
d. Benign prostatic bradycardia, and stroke output.
hyperplasia THERAPEUTIC USES OF SYMPATHOMIMETIC DRUGS
 ● Treatment of Acute Hypotension
● Chronic Orthostatic Hypotension
● Cardiac Applications : Epinephrine is used during
resuscitation from cardiac arrest. Current evidence
indicates that it improves the chance of returning to
spontaneous circulation.
● Inducing Local Vasoconstriction
● One of the most important uses of sympathomimetic
drugs is in the therapy of asthma and chronic
obstructive pulmonary disease
● Anaphylactic shock and related immediate (type I)
IgE-mediated reactions affect both the respiratory
and the cardiovascular systems. to the parenteral
administration of epinephrine, 0.3–0.5 mg (0.3–0.5
mL of a 1:1000 epinephrine solution).
● Phenylephrine is an effective mydriatic agent
frequently used to facilitate examination of the retina.
● It is also a useful decongestant for minor allergic
hyperemia and itching of the conjunctival
membranes.
● β2-selective agents (eg, terbutaline) relax the
pregnant uterus. In the past, these agents were used
to suppress premature labor.

76 For the treatment of advanced prostate a. Anastrozole C. Leuprolide Leuprolide​ - The treatment of choice for patients with
cancer, select the drug that is given to b. Cyproterone metastatic prostate cancer is elimination of testosterone
control this condition. c. Leuprolide production by the testes through either surgical or chemical
d. Dutasteride castration. The use of luteinizing hormone releasing hormone
(LHRH) agonists—including
leuprolide and goserelin agonists, alone or in combination
with an antiandrogen (eg, flutamide, bicalutamide, or
nilutamide)— is the preferred approach
 Dutasteride - is a similar orally active steroid derivative with
a slow onset of action and a much longer half-life than
finasteride. It is approved for treatment of benign prostatic
hyperplasia at a dosage of 0.5 mg daily. These drugs are not
approved for use in women
or children, although finasteride has been used successfully
in the treatment of hirsutism in women and is approved for
treatment of early male pattern baldness in men (1 mg/d)
Cyproterone and cyproterone acetate ​- are effective
antiandrogens that inhibit the action of androgens at the
target
organ. The acetate form has a marked progestational effect
that
suppresses the feedback enhancement of LH and FSH,
leading
to a more effective antiandrogen effect. These compounds
have
been used in women to treat hirsutism and in men to
decrease
excessive sexual drive and are being studied in other
conditions
in which the reduction of androgenic effects would be useful.
Cyproterone acetate in a dosage of 2 mg/d administered
Anastrozole - a selective nonsteroidal inhibitor of aromatase
(the
enzyme required for estrogen synthesis,is effective in some
women whose breast tumors have become resistant to
tamoxifen

77 Shiela was given the antibiotic A. Reducing the renal B. Reducing Clavulanic acid is a beta-lactamase inhibitor that is frequently https://www.dr
combination Amoxiclav 625mg 2x a day by elimination degradation combined with ​Amoxicillin or ​Ticarcillin to fight antibiotic ugbank.ca/dru
her doctor. Clavulinic acid is added to B. Reducing degradation resistance by preventing their degradation by beta-lactamase gs/DB00766
 improve the activity of Amoxicillin by C. Improving intestinal enzymes, broadening their spectrum of susceptible bacterial
______. absorption infections.​8 Clavulanic acid is derived from the organism
D. Displacing amoxicillin Streptomyces clavuligerus.​1​When it is combined with
from its protein binding amoxicillin, clavulanic acid is frequently known as
site Augmentin, Co-Amoxiclav, or Clavulin.

78 A patient is taking acarbose and is now a. Glucose tablet a. Glucose The ​a​-glucosidase inhibitors (Acarbose, Miglitol, Voglibose ) Basic &
suffering from hypoglycemia. What will you b. Intravenous glucose tablet competitively inhibit the intestinal α-glucosidase enzymes Clinical
give? c. Ampalaya capsule and reduce post-meal glucose excursions by delaying the Pharmacology,
d. Prednisone digestion and absorption of starch and disaccharides. Fourteenth
Acarbose treatment is initiated at a dosage of 50 mg twice Edition
daily with gradual increase to 100 mg three times a day. It (LANGE)
lowers postprandial glucose levels by 30–50%. Miglitol By Katzung
therapy is initiated at a dosage of 25 mg three times a day.
The usual maintenance dosage is 50 mg three times a day, https://www.he
but some patients may need 100 mg three times a day. The althline.com/he
drug is not metabolized and is cleared by the kidney. It alth/acarbose-
should not be used in renal failure. Prominent adverse oral-tablet#inte
effects of α-glucosidase inhibitors include flatulence, ractions
diarrhea, and abdominal pain and result from the appearance
of undigested carbohydrate in the colon that is then
fermented into short-chain fatty acids, releasing gas.
All the manifestations of hypoglycemia are relieved by
glucose administration. To expedite absorption, simple
sugar or
glucose should be given, preferably in liquid form. To
treat mild
hypoglycemia in a patient who is conscious and able to
swallow, dextrose tablets, glucose gel, or any
sugar-containing beverage or food may be given. If more
severe hypoglycemia has producedunconsciousness or
stupor, the treatment of choice is 1 mg of glucagon injected
either subcutaneously or intramuscularly. This may restore
 consciousness within 15 minutes to permit ingestion of
sugar.

79 The suggested treatment for a. Micronazole B. Omeprazole Laryngopharyngeal reflux (LPR) is the retrograde movement
laryngopharyngeal reflux is ____ b. Omeprazole of gastric contents (acid and enzymes such as pepsin) into
c. Cefuroxime the laryngopharynx, leading to symptoms referable to the
d. Phenylephrine larynx/hypopharynx. Typical LPR symptoms include
dysphonia/hoarseness, globus pharyngeus, mild dysphagia,
chronic cough, and nonproductive throat clearing. Drug
therapy for LPR typically involves acid suppression with
proton pump inhibitors (PPIs). H2 blockers and antacids may
provide additional benefits. For patients with symptoms that
are not relieved by acid suppression, neuromodulators may
be an option.

PPIs inhibit both fasting and meal-stimulated secretion

because they block the final common pathway of acid
secretion, the proton pump. In standard doses, PPIs inhibit
90–98% of 24-hour acid secretion. Six PPIs are available for
clinical use: omeprazole, esomeprazole, lansoprazole,
dexlansoprazole, rabeprazole, and pantoprazole.

80 Julia is diagnosed with diabetes type 2. a. Metformin C. Glipizide Several categories of glucose-lowering agents are available
She is prescribed with Glibenclamide but b. Acarbose for
still with uncontrolled sugar. The doctor c. Glipizide patients with type 2 diabetes:
would like to add a second drug. The d. Pioglitazon (1) agents that bind to the sulfonylurea receptor and
doctor can choose any drug from the stimulate insulin secretion (sulfonylureas, meglitinides,
following EXCEPT______ d-phenylalanine derivatives);
(2) agents that lower glucose levels by their actions on liver,
muscle, and adipose tissue (biguanides, thiazolidinediones);
 (3) agents that principally slow the intestinal absorption of
glucose (α-glucosidase inhibitors);
(4) agents that mimic incretin effect or prolong incretin action
(GLP-1 receptor agonists, dipeptidyl peptidase 4 [DPP-4]
inhibitors), (5) agents that inhibit the reabsorption of glucose
in the kidney (sodium-glucose co-transporter inhibitors
[SGLTs]), and
(6) agents that act by other or ill-defined mechanisms
(pramlintide, bromocriptine, colesevelam)
In patients suffering from inadequate glycemic control,
sulfonylureas can rapidly achieve significant improvement
when added to metformin . According to recent guidelines,
they can also be associated with glitazones , GPL-1
analogues, DPP-4 inhibitors or long acting insulin when the
association with metformin alone fails to achieve the
glycemic target. Considering adverse events, sulfonylureas,
especially the older ones, are linked to a greater prevalence
of hypoglycemia, and cardiovascular risk; in this respect,
newer prolonged-release preparations of sulfonylureas are
undoubtedly safer, mainly due to reducing hypoglycemia,
and for this reason should be preferred.

81 Cough inhibition of Dextromethorphan is A. Lungs C. brain Dextromethorphan is a centrally active antitussive. It is the Goodman &
achieved through action on cough center B. throat D-isomer of the codeine analogue methorphan; however, gilman 13th ed
located in the ______. C. Brain unlike the L-isomer, it has no analgesic or addictive
D. carotid properties and does not act through opioid receptors.
Rather, the drug acts centrally to elevate the threshold for
coughing.

82 Cielo is suffering from nosocomial A. Cefpirome C. Cefuroxime A. Cefpirome – 4​th generation Cephalosporin, parenteral
pneumonia caused by Pseudomonas B. Ceftazidime antipseudomonal cephalosporins same as Cefepime
aeruginosa. You can use any of the C. Cefuroxime
following antibiotics EXCEPT _____. D. ceftobiprole
B. Ceftazidime – Antipseudomonal Cephalosporin, 3​rd
generation Cephalosporin

C. Cefuroxime – 2​nd​ generation Cephalosporin

D. Ceftobiprole – Anti-MRSA Cephalosporin, has similar

activity to ceftaroline against gram-positive organisms. Its
gram negative spectrum includes activity similar to cefepime
against Pseudomonas spp. And other gram negative bacilli.
83 Identify the drug that inhibits the A. BromcripTine C. Carbidopa A. Bromcriptine – acts as a partial agonist at dopamine D2
conversion of levodopa to dopamine B. Tolcaopne receptors in the brain. The drug increases the functional
outside the brain thereby decreasing the C. Carbidopa activity of dopamine neurotransmitter pathways, including
side effect and increasing the available D. selegiline those involved in extrapyramidal functions.
levodopa for transport inside the brain.
B. Tolcapone – inhibitors of COMT, the enzyme in both the
CNS and peripheral tissues that converts levodopa to
3-O-methyldopa (3OMD)

C. Carbidopa – a peripheral inhibitor of dopamine

metabolism. It does not cross the blood-brain barrier but
inhibits dopa decarboxylase in peripheral tissues.

D. Selegiline – selective inhibitors of monoamine oxidase

Type B, the form of enzyme that metabolizes dopamine

84 Identify the drug that causes nasal A. Paracetamol B. Phenylephrine A. Paracetamol – analgesic and antipyretic effects but only
decongestion in this preparation B. Phenylephrine weak anti-inflammatory effects
C. Dextromethorphan
D. Chlorpheniramine B. Phenylephrine is an a1-selective agonist; it activates B
receptors only at much higher concentrations. It is used as a
nasal decongestant and as mydriatic in various nasal and
ophthalmic formulations.

C. Dextromethorphan is a centrally active antitussive.

D. Chlorpheniramine – H1 receptor antagonists are used for

treatment of various immediate hypersensitivity reactions.

85 Shiela is sufferiNG from acute bacterial A. Cefaclor C. Azithromycin B-lactam antibiotics – penicillins, cephalosporins,
tonsilopharyngitis. She is allergic to food B. Cefuroxime carbepenems, and monobactams – share a common
 and penicillin. Select the appropriate drug C. Azithromycin structure (B-lactam ring) and mechanism of action (i.e.,
for Shiela. D. ampicillin inhibition of the synthesis of the bacterial peptidoglycan cell
wall)

A. cefaclor – 2​nd​ generation cephalosporin

B. Cefuroxime – 2​nd​ generation cephalosporin

C. Azithromycin - Macrolide

D. Ampicillin – aminopenicillin

86 Once the diagnosis of cervicitis is made, A. Chlamydia D. Candida Chlamydia - Azithromycin, 1g PO, single dose or
drugs should be administered against the B. Gonorrhea Doxycycline, 100mg PO bid for 7 days
following causative agents, if present, C. Herpes Gonorrhea - Ceftriaxone, 250mg IM, single dose
EXCEPT _____. D. candida Acyclovir, 400mg PO TID x 7-10 days

87 Which drug is given to patients with A. Anastrozole A. Anastrozole A. Anastrozole – an oral nonsteroidal aromatase inhibitor,
breast cancer to prevent conversion of B. Tamoxifen the enzyme required for the last step in estrogen synthesis,
androstenedione to estrogen? C. Dutasteride Androstenedione (an androgenic precursor) to estrone (an
D. buserelin estrogenic hormone)
B. Tamoxifen – selective estrogen receptor modulator, is a
frequently prescribed hormonal agent for breast carcinoma. It
acts as an antagonist to prevent receptor activation by
endogenous estrogen
C. Dutasteride – is a newer 5a-reductase inhibitor that
inhibits
the conversion of testosterone to DHT.
D. Buserelin – is a GnRH analog, it inhibits gonadotropin
release by downregulating GnRH receptors in the pituitary
cells that normally
release gonadotropins.
88 The muscarinic side effects of a. Epinephrine C. atropine Atropine can be used to control excessive muscarinic BRS
acetylcholinesterase inhibitors in the b. Betanechol stimulation by AChE inhibitors. Pharmacology
treatment of myasthenia gravis can be c. Atropine pg. 36
alleviated by giving d. nicotine

89 Joan, 27/female, complained of curd-like a. Ciprofloxacin C. fluconazole For treatment of vulvovaginal candidiasis, the CDC
white vaginal discharge, non-foul smelling b. Metronidazole recommends placing the woman into an uncomplicated or Comprehensiv
and accompanied by itchy sensation. c. Fluconazole complicated category to guide treatment. A number of azole e gynecology
Which of the following medications is d. Azithromycin vaginal preparations and single oral agent, fluconazole, are 7e
effective? approved for treatment.

90 Cora has been complaining of a. Cimetidine B. simethicone For the alleviation, an antifoaming agent such as
gastrointestinal distress. She describes b. Simethicone simethicone may be taken orally. This agent will coalesce the snst.hu.lzu.edu
the pain as “gassy”. Identify the drug that c. Omeprazole smaller gas bubbles into larger bubbles, thereby easing the .cn
can coalesce smaller gas bubbles into d. aluminum-magnesium release of gas within the gastrointestinal tract via burping or
larger bubbles thereby easing the release flatulence.
of gas via burping or flatulence
91 The management of mild leptospirosis is a. Chloramphenicol D. doxycycline Harrison’s
the administration of 500mg every 8 hours 100mg 12hourly principle of
b. Ciprofloxacin 500mg internal
BID medicine
c. Imipenem 1g IV every
12 hours
d. Doxycycline 100mg
12-hourly

92 Contraindications to the use of NSAID are a. Third trimester D. people taking

the following except pregnant woman misoprostol
b. Person with
uncontrolled
hypertension
c. Person who
experienced transient
ischemic attack
d. People taking
misoprostol

93 Gonadorelin is an agonist of the GnRH a. In a pulsatile Sustained nonpulsatile administration of GnRH or GnRH Katzung
receptor. It can stimulate the secretion of subcutaneous analogs inhibits the release of FSH and LH by the pituitary in Pharmacology
follicular stimulating hormone (FSH) and administration both women and men.
 luteinizing hormone (LH). it can inhibit the b. Topically from a patch This suppression is most commonly achieved by daily
release of both FSH and LH if given c. Intrathecal subcutaneous injections leuprolide, GnRH analog.
d. In a continuous
manner through
intramuscular injection

94 Select the drug used in the treatment of a. Digibind D. neostigmine Neostigmine is an indirect acting cholinergic agonist used for BRS
myasthenia gravis in a 24 year old patient b. Duloxetine the treatment of myasthenia gravis and reversal of Pharmacology
presenting with difficulty of breathing and c. Bretylium neuromuscular blockade.
weakness d. Neostigmine

95

96

97

98

99

100