Pharmacology Mastery Quiz

A-50-year-old man has a history of frequent episodes of renal colic with high calcium renal stones. The most useful agent in the treatment of recurrent calcium stones is

A newborn was diagnosed as having a congenital abnormality that resulted in transposition of her great arteries. While preparing the infant for surgery, the medical team needed to keep the ductus arteriosus open. They did this by infusing

A drug that binds to a receptor and produces a biological response that mimics the response to the endogenous ligand is known as

A 55-year-old patient with severe posthepatitis cirrhosis is started on a diuretic for another condition. Two days later he is found in a coma. The drug most likely to cause coma in a patient with cirrhosis is

Pick out the answer which is the most appropriate to the term "receptor"

A friend has very severe hypertension and asks about a drug her doctor wishes to prescribe. Her physician has explained that this drug is associated with tachycardia and fluid retention (which may be marked) and increased hair growth. Which of the following is most likely to produce the effects that your friend has described?

Alpha-glucosidase inhibitors act by:

A 10-year-old female with allergy-induced asthma is treated with cromolyn. What is the mechanism of action of cromolyn?

Enhancement of the effects of bradykinin is most likely to occur with drugs like

A 31-year-old female is brought to the emergency department by friends who said she has been "taking drugs." They did not know specifically what she had taken. She presents with respiratory depression and dysphoria. Stimulation of which receptor is likely causing her dysphoria?

A 60-year-old male with chronic obstructive lung disease is given ipratropium as part of his therapeutic regimen. What is the mechanism of action of ipratropium?

In a patient suffering from angina of effort, nitroglycerin may be given sublingually because this mode of administration

Which of the following is a leukotriene receptor blocker?

Actions of mifepristone (RU-486) include:

A 16-year-old girl plans to become sexually active. She does not want a pregnancy, so she requests an oral contraceptive pill from her primary care physician. The physician prescribes a pill that contains both an estrogen analog and a progesterone analog. What is an effect of the progesterone analog?

Pick out the right statement

A 53-year-old woman with seizure disorder, bipolar disorder, and trigeminal neuralgia presents to her primary care physician for follow-up and treatment She has no new complaints. Which of the following medications may serve to treat all of her earlier mentioned problems?

A 44-year-old man with Type-2 diabetes presents to the ambulatory care clinic for follow-up. He was diagnosed with diabetes 6 months ago and was started on oral medication then. His blood sugar has been under good control with a hemoglobin A1c of 6.7%. He has not had any hypoglycemic episodes. His only complaint is that despite daily exercise and eating healthier, he has gained 12 lb in the last 6 months. What medication is most likely to cause his weight gain?

This compound decrease the functional activities of several CNS neurotransmitters, including dopamine, norepinephrine, and serotonin. At high doses it may cause parkinsonism-like extrapyramidal system dysfunction.

A 66-yew-old woman with a history of Cushing's disease treated with oral glucocorticoids presents to her primary care physician for follow-up. She was recently hospitalized for a hip fracture following a fall. What is the most likely mechanism for hip fracture in this patient?

A 73-yew-old man with a history of coronary disease and angina pectoris is taking aspirin and dipyridamole. The most likely mechanism of action of this agent involves which of the following?

A 37-year-old man is preparing to undergo functional endoscopic sinus surgery. In the operating room, he is given intravenous succinylcholine. This agent will initially produce which of the following responses?

A 34-year -old woman with long-standing hypertension is taking an ACE inhibitor. She is now newly married. Which of the following potential adverse effects is most applicable to her at this time?

A 27-year-old hospital worker has access to the pharmacy when no other workers are around. He is able to find morphine and inject himself with supratherapeutic dose of morphine. He then collapses and is found dead by coworkers 24 h later. What is the most likely explanation for his death?

A 45-year-old male who is obese presents to his primary care physician complaining of postprandial epigastric pain. The pain does not appear after every meal. He has noticed the pain especially after eating spicy foods and oatmeal. He is not currently taking any medications. Which of the following drugs prevents acid secretion by antagonizing a receptor?

Which one of the following drugs, when used chronically, is associated with the development of bone pain and mineralization defects such as osteomalacia?

What drug is useful to distinguish neurogenic from nephrogenic diabetes insipidus?

A 37-year-old man complains of chest pain after meals. He says this pain has gone on for a few months and gets only minimal relief from antacid tablets. The physician prescribes a drug that will decrease the amount of acid secreted by binding to and inhibiting an ATPase on the lumenal surface of parietal cells. Which of the following drugs works by this mechanism?

Which of the following drugs may be effective in the treatment of gouty arthritis by acting by two separate and distinct mechanisms?

A 28-year-old woman complains of fatigue that increases throughout the day. At the end of her workday, she says her eyes feel “heavy” and “droopy,” although she does not feel particularly tired. Pyridostigmine is prescribed to treat her myasthenia gravis. Which of the following is a potential side effect of this therapy?

A patient takes an oral sympathomimetic agent for regulation of heart rate. This agent is taken orally. Which of the following systemic effects is likely a result of this medication?

A 28-year-old man is hospitalized after a fall from a cliff. His current medical problems include cardiogenic shock, heart failure, renal disease, and cirrhosis from chronic alcoholism. Because of weight loss, he is felt to be somewhat hypermetabolic. Which of the following factors will have the most significant effect to decrease drug half-life of medications administered to him?

Indications of bromocriptine are following, EXCEPT

A 52-year-old woman presents to the primary care clinic with progressive weakness and muscle aches for the past month. She can still do her daily tasks but can notice a difference in her strength. When she lies down at night, her legs always ache. Her electrolytes are significant for a K1 of 2.9 mEq/L. She was recently started on a diuretic for peripheral edema. She is pleased that she has not had peripheral edema since starting the diuretic. What is the most appropriate diuretic to treat this patient?

A 64-year-old man is brought to the emergency department complaining of crushing chest pain radiating to his left arm. He is admitted, stabilized, and treated for an acute myocardial infarction. Later, he developed ventricular tachycardia and is treated with an antiarrhythmic. After a week of antiarrhythmic treatment, he began having difficulty breathing. A chest X-ray reveals pulmonary fibrosis. Which antiarrhythmic was he taking?

Which of the following has been shown to prolong life in patient with chronic congestive failure but has a negative inotropic effect on cardiac contractility?

A 42-year-old man with HIV disease is hospitalized for refractory fungemia. He has begun on a course of caspofungin. After administration of the first intravenous dose, the patient develops flushing and sweats. What is the most likely mechanism of action for this finding?

Which of the following statements regarding warfarin is true?

Several children at a summer camp were hospitalized with symptoms thought to be due to ingestion of food containing botulinum toxins. The effects of botulinum toxin are likely to include

The rationale behind the use of dopamine as a treatment of shock in a 38-year-old man who was a driver in a motor vehicle accident who was thrown from the vehicle is

A 7-years-old boy has a significant bedwetting problem. A long-acting indirect sympathomimetic agent sometimes used by the oral route for this and other indications is

Accidental poisonings are common with both aspirin and ibuprofen, two OC drugs available in tasty chewable tablets. In cases of overdose, aspirin is more likely than ibuprofen to cause

A one-year-old male develops decreased breath sounds, and wheezing during a febrile episode, which is relieved by albuterol. What is the mechanism of action of albuterol?

When used in the management of asthma, glucocorticoids are likely to cause

A 27-year-old woman presents to the emergency department complaining of right flank pain and hematuria. She has passed calcium oxalate stones in the past and likely has another stone. After treating her for the stone, which of the following diuretics could be started to prevent future calcium oxalate stones?

A 33-year-old woman presents to her primary care physician with tachycardia, heat intolerance, tremor, and unintentional weight loss. A thyroid scan shows multiple regions of thyroid taking up excess iodine. She is prescribed with a drug that will decrease synthesis of thyroid hormones and decrease the peripheral conversion of T4 to T3. Which drug is this?

One effect that theophylline, nitroglycerin, isoproterenol, and histamine have in common is

What Is the rationale for combining levodopa with carbidopa?

A 29-year-old man with a family history of heart disease presents to his primary care physician for a routine checkup. A lipid profile on a blood draw reveals high LDL and low HDL, One way to decrease amount of LDL in the blood is to hinder the livers ability for de novo cholesterol synthesis. Which of the following drugs blocks de novo cholesterol synthesis in hepatocytes?

Commonalities of the sympathetic parasympathetic, and somatic nervous systems involve which of the following neuroeffector transmitters?

A reasonable explanation for the therapeutic effects of ibuprofen or naproxen in primary dysmenorrhea is that these drugs

A 45-year-old surgeon has developed symmetric early morning stiffness in her hands. She wishes to take a nonsteroidal anti-inflammatory drug to relieve these symptoms and wants to avoid gastrointestinal side effects. Which of the following drugs is most appropriate?

A young female patient who suffers from bipolar affective disorder (BAD) has been managed with lithium. If she becomes pregnant, which one of the following drugs is likely to be effective in bipolar affective disorder with minimal risk of teratogenicity?

A patient has been taking digoxin for several years for chronic heart failure is about to receive atropine for another condition. A common effect of digoxin ( at therapeutic blood levels ) that can be almost entirely blocked by atropine is

A direct-acting cholinomimetic that is lipid-soluble and often used in the treatment of glaucoma is

A 58-year-old man with diabetes presents to the ambulatory care clinic for follow up. He has tried to eat better and exercise over the Past 6 months.He has lost 10 lb with his new lifestyle. However, his urinalysis shows microalbuminuria. The physician decides to start the patient on captopril. What is a common side effect of captopril?

Which one of the following statements best describes the mechanism of action of benzodiazepines ?

An 83-year-old woman with Parkinson's disease is currently being treated with carbidopa/levodopa, but her Parkinson's symptoms are worsening. She has normal liver physician adds tolcapone to her regimen on tolcapone. How does tolcapone help in Parkinson's disease?

A 52 -year-old overweight woman presents to the clinic for a diabetes management. She had not been doing well controlling her blood sugars with metformin. Her last hemoglobin A1c Was 13.4%, despite her taking her Medication every day. The physician decides to start her on a long-acting insulin that is injected only once a day for better glucose control. Also, he wants the insulin to have a minimal risk of hypoglycemia. What is the most likely medication given to this patient?

A 62-year -old man with congestive heart failure and hypertension on digoxin takes an extra few pills because he is angry about his daughter being pregnant out of wedlock He is found unconscious and brought to the emergency department for evaluation. If electrocardiogram is performed, which of the following would be most likely?

A researcher is studying the bioavailability of commonly used antimuscarinics to treat irritable bowel syndrome. Medication A is administered in a 1C from the gastrointestinal tract unchanged. Thus, the bioavailability of Medication A is

A visitor from another city comes to your office complaining of incessant cough. He has diabetes and hypertension and has recently started taking a different antihypertensive meditation. The most likely cause of his cough is

All of the following statements concerning cholestyramine (Questran) are true, EXCEPT

Chronic use of ethanol is reported to increase

Sulphonylureas act by :

A 61 -year-old female is hospitalized for COPD exacerbation. She is obese and not able to ambulate very far on her own . Upon discharge, the physician wants to send her home on heparin to reduce the risk of deep vein thrombosis. Why would the physician choose a low-molecular-weight heparin (LMWH) instead of unfractionated heparin (UFH)?

A 72-year-old woman with Parkinson’s disease is taking a medication that increases release of dopamine, blockade of cholinergic receptors, and inhibiting the N-methyl-d-aspartate receptor. This describes which of the following agents?

Oseltamivir and zanamivir are available for treatment of infections due to influenza A and B. The mechanism of their antiviral action is inhibition of which of the following ?

In review of the benzodiazepine class, which of the following agents has the longest duration of action and may be useful in the treatment of a 39 – year – old patient with spinal cord injury and with skeletal muscle spasticity ?

A 43-year-old woman with recurrent urinary tract infections who is usually sensitive to ciprofloxacin now has three consecutive UTIs in a 4-month period. Each time, the culture and sensitivity reveal resistance to ciprofloxacin. What is the most likely source of resistance?

Fosfomycin is given as a large single dose to treat which infection?

Muscle rigidity can be a side effect of which intravenous anesthetic?

The molecular mechanism underlying the antiepileptic effects of carbamazepine and phenytoin is best described by which one of the following statements?

A 34-year-old man is prescribed labetalol for hypertension. The effect on the cardiovascular system is a result of its action as an antagonist at which of the following?

Which of the following drugs has the following effects: nausea and vamiting, blurred and abnormally colored vision, and palpitations?

Which effect is caused by both atenolol and diltiazem?

Which of the following describes the major difference between a first- and second-generation antihistamine?

Treatment of hyperthyroidism by propylthiouracil (PTU) shows clinical effects due ta:

A 65-year-old retired military man with hypertension and type Il diabetes comes in for a follow-up visit. Along with making appropriate diet and lifestyle changes, he is taking an ACE inhibitor-thiazide diuretic combination for his hypertension and metformin for his diabetes. His blood pressure and diabetes are under acceptable control. Routine blood work revealed normal electrolytes, renal function, and liver enzymes, He is noted to have elevated total cholesteral and low-density lipoprotein (LDL) levels, which have remained high in spite of his lifestyle changes. In an effort ta reduce his risk of developing coronary artery disease, you start him on a 3-hydraxy-3- methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitor. Mechanism of action of HMG-CoA reductase inhibitors

A man with chronic heartburn caused by gastric acid reflux is prescribed metoclopramide. Which mechanism is responsible for its pharmacologic effect?

Which of the following drugs may cause tinnitus, vertigo, and hearing loss in case of large intravenous doses?

This orally administered inhibitor of active factor X (Stuart factor) is used to prevent and treat deep vein thrombosis. Select the correct drug from the following choices:

Which drug used for the treatment of asthma inhibits 5-lipoxygenase?

Which drug inhibits RNA polymerase in Mycobacteria?

Following his third episode of gouty arthritis, a 50-year-old man sees you in the clinic. Each case was successfully treated acutely; however, your patient is interested in trying to prevent future episodes. He is not on regular medications and has a normal physical examination today. Blood work reveals an elevated serum uric acid level and otherwise normal renal function and electrolytes. A 24-hour urine collection for uric acid reveals that he is under-excreting urie acid. Suspecting that this is the cause of his recurrent gout, you place him on probenecid. What is the mechanism of action of probenecid?

G protein-coupled receptors that activate an inhibitory Ga subunit alter the activity of adenylate cyclase to

The fact that the degree of reinforcement for morphine is less than that of heroin is best explained by which one of the following statements?

Which drug is recommended for treatment of most persons with latent TB?

Which of the following drugs is the same as PGI2 (prostacyclin) and is used for the treatment of pulmonary hypertension?

A patient with essential hypertension requires a drug that reduces both cardiac output and peripheral resistance. Select the most appropriate drug therapy

After receiving a low dose of dexamethasone, a patient is found to have a plasma cortisol level of 20 meg/dL the next morning. Which disorder is most lixely in this patient?

Which of the following statements best explains the observation that morphine is more likely to cause nausea and vomiting in ambulatory patients?

Please choose the most correct description of flumazenil.

A man is given a drug that inhibits the synthesis of norepinephrine. Which response would result from this treatment?

If a drug exhibits first-order elimination, then

A type 2 diabetic patient is prescribed metformin. Which adverse effect often occurs when

A man with obstructive pulmonary disease requires therapy to prevent anginal attacks. Which drug should be avoided in this patient?

In case of ONLY hyperbaric conditions, which one of the following anesthetics provide anesthetic effectiveness?

A boy experiences a moderately severe reaction to a wasp sting. Which method of corticosteroid administration is approoriate for this patient?

A woman is placed on fluconazole to treat renal candidiasis. Which pharmacologic property is associated with this drug?

Administration of this drug to persons with renal insufficiency can cause hyperkalemia. Select the correct drug from the following choices:

A71-year-old man is noted to have dilated cardiomyopathy with atrial fibrillation and a rapid ventricular rate. An agent is used to control the ventricular rate, but the cardiac contractility is also affected, placing him in pulmonary edema. Which of the following agents was most likely used?

Which drug should be avoided in persons with asthma?

Selegiline, an antidepressant also used for the treatment of Parkinson disease, has which one of the following mechanisms of action?

A man being treated for chlamydial urethritis presents with severe erythema over his upper body after sun exposure. Which antibiotic is most likely responsible for this adverse effect?

Which antimicrobial drugs disrupt the bacterial cell membrane?

Which drug has been demonstrated to increase survival in persons with heart failure?

A 70-year-old man is seen in follow-up at your office after he has been hospitalized for a myocardial infarction (MI), He underwent successful angioplasty and is currently asymptomatic. Prior to his MI, he was not on medications. He is not a smoker and is not diabetic. During his hospitalization, he was noted to have persistently elevated blood pressure readings. He had asthma as a child, but has not had any recent wheezing episodes. While in the hospital, he was started on oral metoprolol. What effects do agents such as metoprolol have on the cardiovascular system?

Which of the following represents the most common side effect of the treatment targeted to inhibit the release of acetylcholine in case of facial muscle spasms?

Which drug combination usually provides the most rapid and effective treatment for duodenal ulcer caused by H. Pylori infection?

Which nonnucleoside drug is used to treat systemic acyclovir and ganciclovir-resistant herpesvirus infections, such as CMV esophagitis?

A 64-year-old woman with a history of two previous myocardial infarctions (Mls) comes to the emergency room with shortness of breath. In the previous 2 weeks, she has developed dyspnea with exertion and swelling of her legs. She sleeps on three pillows because she coughs and gets short of breath if she tries to lie flat. In the emergency department. She is sitting upright, appears to be in moderate respiratory distress, and is tachycardic and hypertensive. She has jugular venous distension to the angle of her jaw. On auscultation of her lungs, wet rales are heard bilaterally. She has pitting edema of both lower legs up to her knees. A chest x-ray confirms the diagnesis of pulmonary edema. She is placed on oxygen and immediately given an IV injection of furosemide. What is the mechanism of action of

Toxic doses of scopolamine would be expected to cause all of the following effects EXCEPT

A progestin is included in regimens for HRT to prevent which of the following adverse effects?

A71-year-old man is noted to have dilated cardiomyopathy with atrial fibrillation and a rapid ventricular rate. An agent is used to control the ventricular rate, but the cardiac contractility is also affected, placing him in pulmonary edema. Which of the following agents was most likely used?

Which of the following agents is contraindicated in a patient with epilepsy?

Aspirin is often used in low doses to prevent platelet aggregation by inhibiting the synthesis of which substance?

A type 2 diabetic patient is prescribed metformin. Which adverse effect often occurs when taking this drug?

Clinical antipsychotic potency for "typical" antipsychotics correlates with actions at which receptor?

A woman is placed on an antidysrhythmic drug that dissociates very slowly from ventricular sodium channels. Which electrocardiographic finding results from this property?

Which of the following phrases correctly describes insulin glargine?

Which hormone receptors are blocked by drospirenone?

All of the following are the classes of antidepressant medications, except:

A 62-year-old man is being managed in the intensive care unit following a large anterior wall MI. He has been appropriately managed with oxygen, aspirin, nitrates, and B-adrenergic receptor blockers but has developed recurrent episodes of ventricular tachycardia. During these episodes he remains conscious but feels dizzy, and he becomes diaphoretic and hypotensive. He is given an IV bolus of lidocaine and started on an IV lidocaine infusion, To what class of antiarrhythmic does lidocaine belong and What is lidacaine’s mechanism of action?

Which of the following is the most accurate statement regarding digoxin?

A patient takes nateglinide before each meal. Which mechanism is responsible for the therapeutic effect of this drug?

A man with chronic heartburn caused by gastric acid reflux is prescribed metoclopramide. Which mechanism is responsible for its pharmacologic effect?

A man with episodic severe hypertension is found to have markedly elevated levels of epinephrine and norepinephrine metabolites in his urine and needs a long-acting drug to lower blood pressure before surgery. Select the most appropriate drug therapy from the following

A 16-year-old female comes to the physician’s office because of menstrual cramps. She had menarche at age 13. Her menses lasts for 4-5 days, and she has 28-day cycles. For the first 2-3 days of her menses she states that she has very bad cramping. The cramps have occurred since menarche and seem to have worsened in the past year. They have been so bad at times that she has missed school and has not been able to participate in her afterschool sports. She has been taking acetaminophen and over-the-counter “menstrual cramp” pills without adequate relief. She has no significant medical history, takes na medications regularly, and is not sexually active. Her examination is normal. You assess the problem as primary dysmenorrhea and prescribe diclofenac to be used on an as-needed basis, What are the therapeutic effects of nonstercidal anti-inflammatory drugs (NSAIDs)?

Which one of the following agents is considered the drug of choice for initial treatment of generalized absence seizure (petit mal) in children?

Which of the following most likely describes the cardiac arrhythmias as the effect of the initial doses of levodopa (I-dopa)?

A man with HIV infection is taking darunavir, a protease inhibitor, Which adverse effect is associated with this class of drugs?

A 72-year-old man presents to the office for routine follow-up. He is under treatment for hypertension and congestive heart failure with enalapril and a diuretic. His blood pressure is under acceptable control and he has no symptoms of heart failure at present. He does complain that he has been coughing frequently in the past few months. History and examination reveal no other cause of a chronic cough, so you decide to discontinue his enalapril and start him on losartan. Mechanism of action of enalapril:

Which of the following is the most common adverse effect of methimazale?

Octreotide is correctly described by which of the following statements?

Which of the following is the most accurate statement?

A 19-year-old man is brought to the physician's office by his very concerned mother. He has been kicked out of the dormitory at college for his “bizarre” behavior. He has accused several fellow students and professors of spying on him for the CIA. He stopped attending his classes and spends all of his time watching TV because the announcers are sending him secret messages on how to save the world. He has stopped bathing and will only change his clothes once a week. In your office you find him to be disheveled, quiet, and unemational. The only spontaneous statement he makes is when he asks why his mother brought him to the office of “another government spy.” His physical examination and blood tests are normal. A drug screen is negative. You diagnose him with acute psychosis secondary to schizophrenia, admit him to the psychiatric unit of the hospital, and start him on haloperidol. Describe mechanism of therapeutic action of haloperidol

Which of the following is not a mechanism of action for antiparkinsonism agents?

Acetaminophen is a potent analgesic and antipyretic NSAID but differs from other agents in that it has no antiinflammatory action. Which of the following reasons explains this unique aspect of acetaminophen?

Which property is characteristic of the sympathetic nervous system?

Which of the following best describes the mechanism of disulfiram as the effective treatment of alcohol (ethanol) dependence?

A man is given a drug to reduce thyroid gland size and vascularity before surgical thyroidectomy. Which mechanism is responsible for its use in this setting?

Which drug produces transient muscle fasciculations followed by muscle paralysis that is not reversed by neostigmine?

Which of the following molecular processes best describes the mechanism of action of benzodiazepines?