PHARMACOLOGY Superexam TOPNOTCH

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1. 1. Which of the following medications is NOT contraindicated in a patient 81 A. Medscape expect questions on never before
taking RANOLAZINE? a. Losartan b. Itraconazole c. clarithromycin d. heard drugs.
metronidazole e. prednisone
2. 2. Phoebe Marie, G2 P1 (1001), recently traveled to Palawan and is taking 82 A. Halofantrine is not used for chemoprohylaxis
Quinine for malaria. Which of the following medications can she take? a. because of its potential for quinidine like
clindamycin b. doxycycline c. primaquine d. Halofantrine e. all of the cardiotoxicity (QT prolongation) and embryotoxicity.
above Likewise, doxycycline and primaquine are
contraindicated during pregnancy. Katzung
Pharmacology Examination and Board Review 10th
edition p.453
3. 3. Future clinicians may screen every patient for a variety of individual 683 C. Answer: C. PharmaCogenetiCs (pp. 3 and 82
differences in drug response. Differences in the rate of acetylation of [.pdf file] Katzung Pharmacology, 9th edition)
isoniazid among groups of individuals exemplifies A. Pharmacodynamics
B. Posology C. Pharmacogenetics D. Biochemorphology
4. A 3/M was brought to the hospital for decreased sensorium. On further 366 B. Antidotes for ethylene glycol or methanol
history, the child accidentally ingested a mouthful of antifreeze. You then poisoning include ethanol and fomepizole. Although
proceed to give the child which antidote? A. Disulfiram B. Fomepizole C. ethanol is effective, it is difficult to achieve safe and
Famotidine D. Methanol E. There is no antidote effective blood levels that is why fomepizole is
preferred. Katzung 12th ed pg 1037
5. 3. Which of the following drugs is a reversible acetylcholinesterase 83 C. Memantine - low to moderate affinity
inhibitor that causes an increase in concentrations of acetylcholine and is uncompetitive NMDA receptor antagonist blocking
metabolized by cholinesterase and excreted mainly by the kidneys and receptor only under conditions of excessive
used in Alzheimer's disease? a. Memantine b. Galantamine c. Rivastigmine stimulation without effect of normal
d. Donepezil e. none of the above neurotransmission Donepezil - acetylcholinesterase
inhibitor but metabolized by hepatic P - 450
enzymes Galantamine - increases acetylcholine from
surviving presynaptic nerve terminals by modulating
nicotinic Ach receptor Medscape
6. 4. Which of the following is the mechanism why Cefuroxime is not used for 84 C.
meningitis? a. poor penetration to CSF b. levels achieved in CSF not http://pedsinreview.aappublications.org/content/2
adequate to sterilize it c. potential for delayed sterilization and 9/8/264.full
therapeutic failures d. presence of efflux pumps e. none of the above
7. A 4 year old child, febrile at 38deg. C was given Paracetamol at 15mkd. 476 C. Paracetamol or acetaminophen selectively
What is the mechanism of action of this drug? A. COX-2 selective inhibitor inhibits COX-3. COX-2 selective inhibitors are coxib
B. IL-1 and IL-6 inhibitors C. COX-3 selective inhibitor D. Irreversible COX-1 such as celecoxib. Irreversible COX-1 and 2 inhibitor
and COX-2 inhibitor E. TNF - α inhibitor is aspirin. TNF - α inhibitors are infliximab,
adalimumab and etanercept.
8. 5. Which of the following is the drug topically used for acne? a. allylamine 85 B. Goodman Gilman 12th edition. Dermatology
b. clindamycin c. mupirocin d. bacitracin e. none of the above section
9. A 5 year old boy with Trisomy 21 was diagnosed to have acute 638 D. Asparaginase, depletes serum asparagine. It is
lymphoblastic leukemia. What is the most important drug in the the main and the most impt drug in the management
therapeutic regimen of this disease entity? A. Rituximab B. Cytarabine C. od ALL.
Idarubucin D. Asparaginase E. Prednisone
10. A 5 year old known case of seizure disorder maintained on phenytoin was 583 C. Phenytoin is an inducer, which will lower
rushed to the ER due to an asthma attack. IV theophylline was given to theophylline levels. Asthma may not be adequately
control the asthma using usual dose computations. What are the treated with this monotherapy.
consequences of the drug-drug interactions? A. The patient will be more
prone to the toxic side-effects of theophylline. B. The patient may be at
risk for a seizure attack. C. The patient is not being treated adequately for
his asthma. D. There will be an increased in plasma levels of phenytoin. E.
No drug interactions exist beween theophylline and phenytoin
11. A 6/F is brought to the clinic due to frequent episodes of sudden activity 550 B. Ethosuzimide and valproic acid are the
arrest with staring and minimal eyelid flutter occurring for 10 - 20 preferred drugs for absence seizures because they
seconds, 5 - 10 times per day. During such episodes, patient is cause minimal sedation.
unresponsive to voice or tactile stimulation. She is diagnosed with
absence seizure. Which of the following antiseizure drugs is most
appropriate? A. Carbamazepine B. Valproic acid C. Phenytoin D.
Phenobarbital E. Levetiracetam
12. 6. Which of the following anti folate drugs is a blood schizonticide? a. 86E Katzung Pharmacology Examination and Board
Atovaquone b. Artesunate c. Halofantrine d. Doxycycline e. Review 10th edition p.453
Pyrimethamine
13. A 6-year-old patient was recently diagnosed with Cat I PTB. DOTS 1 B. Know the doses of anti-TB drugs for BOTH
Treatment is initiated for this patient. The dosing should be: A. INH children and adults. Adults: INH 5mg/kg + Rif 10mg/kg
5mg/kg + Rif 10mg/kg + Pyz 25mg/kg + Eth 15mg/kg B. INH 10mg/kg + Rif + Pyz 25mg/kg + Eth 15mg/kg Generally just make
15mg/kg + Pyz 35mg/kg + Eth 20mg/kg C. INH 15mg/kg + Rif 10mg/kg + sure you are familiar with TB! It can come out over
Pyz 35mg/kg + Eth 15mg/kg D. INH 25mg/kg + Rif 10mg/kg + Pyz and over in different subjects from pharma, micro,
25mg/kg + Eth 11mg/kg E. INH 5mg/kg + Rif 20mg/kg + Pyz 15mg/kg + pedia, im, patho, even gyne. Source: National TB
Eth 10mg/kg Control Program Manual of Procedures
14. 7. Which of the following is a long acting insulin? a. Lantus b. Lente c. 87 C. D and E - short acting A and B - intermediate
Glargine d. Detemir e. Glulisine acting Katzung Pharmacology Examination and Board
Review 10th edition p.363
15. A 7 year-old male child with nephritic syndrome on steroid therapy was 696 B. Answer: B After susceptible person is exposed
exposed to a sister with measles. You would administer: A. Measles to measles, either measles vaccine given within 72 hrs
vaccine B. Human immunoglobulin C. Antisera D. Vitamin A or immune globulin given within 6 days can prevent
or modify disease. However, px has nephritic
syndrome & is immunocompromised so an active
measles vaccine may even be harmful.
16. 7 year old male was noted to have difficulty sustaining attention in tasks 198 B. Methylphenidate is the drug of choice for
or play activities in school and at home. He often leaves his seat inside ADHD in children 6 years old and above. Mechanism
the classroom and runs about and climbs excessively. What is the of action is unknown but it mainly acts as a CNS
treatment of choice for this case? A. sibutramine B. methylphenidate C. stimulant similar to amphetamines.
diazepam D. behavioral therapy E. magnesium pemoline
17. A 7 yo male was brought to ER secondary to symptoms suggestive of 222 D. Botulinum toxin inhibits the release of vesicular
botulinum toxin ingestion, which of the following are likely included in the contents from all types of cholinergic nerve endings.
symptoms of the patient? A. Muscle fasciculation B. Bronchoconstriction Since both ganglionic/autonomic and peripheral
C. Increased bowel movement D. blurred near vision E. hypertension motor synapse are affected. Patient will present with
hypotension and lack of muscular contraction.
Blurred near vision is a result of paralysis of ciliary
muscle aka cycloplegia
18. 8. Which of the following is NOT true of Gentamicin? a. killing action 88 B. has greater efficacy when administered as a
continues when plasma levels decline below measurable levels b. lesser single large dose than when given as multiple smaller
efficacy when administered as a single large dose c. in vivo efficacy not doses Katzung Pharmacology Examination and Board
directly related to time above MIC d. as plasma level is increased above Review 10th edition p.399
MIC, it kills an increasing proportion of bacteria at a more rapid rate e.
toxicity depends on both critical plasma concentration and the time that
such level is exceeded
19. An 8-year-old being treated with a combination of chemotherapeutic 492 A. Major toxicities of methotrexate include
agents had difficulty eating and drinking due to red, inflamed sores in gastrointestinal mucositis, bone marrow suppression,
her mouth and esophagus. Which of the following antineoplastic agents is skin erythema and hepatic dysfunction. SIMILAR TO
the most likely etiology? A. Methotrexate B. Vinblastine C. Doxorubicin D. PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
Prednisone
20. 9. Which of the following chemotherapeutic drugs is used for bladder 89 B. Medscape expect questions on never before
cancer (intravesical administration) and control of malignant pericardial/ heard drugs.
pleural/ peritoneal effusions (intracavitary)? a. cyclophosphamide b.
thiotepa c. carmustine d. lomustine e. none of the above
21. A 9-year old Filipino child was brought to you in the clinics by her 413 A. Valproate is the DOC for Absence Seizures, most
mother due to an observed blank-stare episodes noted by her especially in our setting here in the Philippines, Ethosuximide
mother which lasts from a few seconds to a few minutes. Which of is NOT commercially available.
the following medications is the most suitable for this patient? A.
Valproate B. Phenytoin C. Phenobarbital D. Carbamazepine E.
Lorazepam
22. A 10/F, diagnosed case of HSV encephalitis, was given IV 559 A. Acyclovir, foscarnet and ganciclovir are DNA
acyclovir. Acyclovir is an efffective antiviral because it inhibits: A. polymerase inhibitors.
DNA polymerase B. RNA polymerase C. Aspartate protease D.
Neuraminidase E. Hemagluttinin
23. 10. Which of the following is a mixed FSH and LH agonist and is 90 A. B - FSH only C - LH only D - GH agonist E - GnRH
used to stimulate gonadal function including spermatogenesis and agonist Katzung Pharmacology Examination and Board
ovulation? a. menotropin b. urofollitropin c. Lutropin d. Review 10th edition p.327
Somatropin e. Gonadorelin
24. A 10 year old child, known asthmatic had episodes of nocturnal 475 E Salbutamol is the druig of choice for acute asthma
asthma attacks approximately 2-3x/week. In order to prevent attack, while aminophylline is used for prophylaxis against
subsequent attack, what drug is used for prophylaxis against nocturnal attacks.
nocturnal attack? A. Salbutamol + Ipratropium B. Salbutamol C.
salmeterol D. cromolyn E. Aminophylline
25. A 10 year-old child with asthma was prescribed with a drug which 460 C. Montelukast blocks leukotriene receptor for
inhibits binding of leukotriene D4 to its receptor on target tissues. leukotrienes C4, D4, E4 preventing airway inflammation and
The drug prescribed is: A. Zileuton B. Ipratropium C. Montelukast bronchoconstriction in asthmatic patients.
D. Omalizumab E. Theophylline
26. 11. Which of the following is not likely used for treatment of 91 D. D is used for CMV Katzung Pharmacology Examination
Herpes Simplex virus? a. Acyclovir b. Penciclovir c. Famciclovir d. and Board Review 10th edition p.429
Ganciclovir e. none of the above
27. 12. A neonate in the NICU was observed by the Neonatologist 92 D.
fellow to have epicanthal folds, low nasal bridge, short palpebral
fissures, flat midface, and indistinct philtrum. Which of the
following medications did the mother likely take during
pregnancy? a. phenytoin b. carbamazepine c. valproic acid d.
ethyl alcohol e. warfarin
28. A 12-year-old boy presents with a rash on the palms and soles of 39 D. Doxycycline, a tetracycline, is the antibiotic of choice
his feet as well as fever and headache. He was camping last to treat Rocky Mountain spotted fever, a rickettsial disease.
weekend and admits to being bitten by a tick. His Weil-Felix test Streptomycin can be used to treat plague and brucellosis.
result is positive, suggesting Rocky Mountain spotted fever. What Bacitracin is only used topically. Ciprofloxacin can be used
antibiotic should be given? A. Streptomycin B. Bacitracin C. to treat anthrax, and erythromycin is the most effective drug
Ciprofloxacin D. Doxycycline E. Erythromycin for the treatment of Legionnaires disease.
29. 13. which of the following is the chemoprophylactic drug of choice 93 B. http://www.who.int/ith/ITH_chapter_7.pdf
for pregnant patients visiting falciparum malaria endemic places?
a. chloroquine b. mefloquine c. doxycycline d. atovaquone -
proguanil e. artemether - lumefantrine
30. 14. Which of the following is NOT true of phenytoin? a. metabolism 94 D. metabolism is enhanced by presence of inducers of
is nonlinear b. drug binds extensively to proteins in plasma c. liver metabolism (phenobarbital, rifampin) and inhibited by
fosphenytoin in the water soluble prodrug for parenteral other drugs (cimetidine, isoniazid) Katzung Pharmacology
administration d. metabolism is induced by isoniazid e. drug of Examination and Board Review 10th edition p.217
choice for grand mal seizures
31. A 14 year old child was diagnosed with Schizophrenia, which of the 408 B.
following is the only antipsychotic approved for pediatric
patients? A. Clozapine B. Risperidone C. Quetiapine D. Olanzapine
E. Thioridazine
32. 15. A 54 year old male presents to the clinic with a circular lesion on 95 B. acedapsone is the repository form that provides
the arm and anesthesia on pin prick of the center of the lesion. Patient inhibitory plasma concentrations for several months. It is
was then brought to Cebu Skin Clinic for further evaluation. Dr. AM the most active drug for leprosy. Mechanism of action is
impression was leprosy tuberculoid type and decides to start the inhibition of folic acid synthesis. It is contraindicated to
patient with antimycobacterials. Which of the following is true of G6PD patients. Katzung Pharmacology Examination and
Dapsone? a. fluorodapsone is the respository form b. it is used as an Board Review 10th edition p.415
alternative drug for treatment of PCP pneumonia c. it is not the most
active drug for Leprosy d. mechanism of action is to inhibit arabinosyl
transferase e. can be given to G6PD patients
33. 15 units of Drug X was given to a patient. If this drug undergoes first- 104 C. Page 4 of Topnotch Handout. In a drug
order elimination how many half-lifes will it take for the drug undergoing first-order elimination concentration
concentration to reach 1.88 units: A. 1 B. 2 C. 3 D. 4 E. 5 decreases by 50% for every half-life. SO if the drug was
15 units at the start, 1st half life- 7.5, 2nd half life 3.75, third
half life 1.875.
34. A 15 year old post partum girl in Fabella hospital was bleeding 74 B. SIMILAR TO PREVIOUS BOARD EXAM
profusely after giving birth despite oxytocin administration, what CONCEPT/PRINCIPLE. Methylergonovine can be given
class of drug can you give as second line treatment? A. 5-HT1 agonist which is a 5-HT2 receptor antagonist selective to the
B. 5-HT2 antagonist C. 5-HT3 antagonist D. 5-HT4 antagonist E. Alpha uterus.
1 agonist
35. 16. DC, a 69 year old female, presented with resting tremors and 96 B. Katzung Pharmacology Examination and Board
shuffling gait. Upon cleaning her bathroom, she accidentally damaged Review 10th edition p.249
the bathroom sink thus prompting consult. Having a good
understanding of the pathophysiology of Parkinson’s disease, Dr.
MC starts the patient with dopamine agonists. Which of the following
can be given as monotherapy for mild parkinsonism and has high
affinity for D3 receptor? a. bromocriptine b. pramipexole c. ropinirole
d. apomorphine e. cabergoline
36. 17. Which of the following is the regimen for a 29 year old male with a 97 E A - hodgkin’s lymphoma B - ovarian C -
testicular mass? a. ABVD regimen b. paclitaxel + carboplatin c. pancreatic D - colorectal Katzung Pharmacology
gemcitabine + erlotinib d. fluorouracil and leucovorin + oxaliplatin e. Examination and Board Review 10th edition p.468
PEB regimen
37. A 17-year-old boy is brought to the emergency department by his 526 D.
parents because of bizarre behavior for 6 hours. Last night he was out
with friends, and since returning, he has been confused and has
"trashed" his room. His blood pressure is 165/95 mm Hg. He is
hypervigilant, has little spontaneous speech, and is disoriented to
place and time. He appears catatonic but abruptly becomes
assaultive two times and needs to be restrained. Which of the
following is the most likely substance taken? A) Cocaine B) Ecstasy C)
LSD D) PCP
38. A 17-year-old girl sees her physician for swollen lymph nodes in the 34 E ABVD is a treatment regimen used for Hodgkin
supraclavicular region. A core biopsy demonstrates disease and includes adriamycin, bleomycin, vinblastine,
Reedâ€"Sternberg cells and fibrotic bands, a finding characteristic of and dacarbazine. R-CHOP is used for treating non-
nodular sclerosis Hodgkin disease. Which of the following combined Hodgkin’s disease. CMF, or cyclophosphamide,
regimens might be used in this patient? A. R-CHOP B. CMF C. FOLFOX methotrexate, and fluorouracil, is used for breast cancer.
D. BEP E. ABVD FOLFOX, a regimen that uses 5-fluorouracil, oxaliplatin,
and leucovorin, is used in the treatment of colon cancer.
BEP (bleomycin, etoposide, and platinum [cisplatin]) is
used in the management of metastatic testicular
neoplasms.
39. A 18/M previously diagnosed with epilepsy and maintained on 372 B. Memorize inducers & inhibitors VERY HIGH YIELD
phenobarbital seizure free for the past 2 years, presented to you
with a 3 month history of cough, recurrent fever and weight loss. AFB
was positive on two occasions and CXR show cavitations on the
upper lung fields. You conclude that he has PTB and you start him of
HRZE. After a few days, you were informed that you patient was in
the ER and their working impression is status epilepticus. Which of
the following drugs could have caused the breakthrough seizures?
A. Isoniazid B. Rifampicin C. Pyrazinamide D. Ethambutol E. None of
the above
40. 18. NT a 39 year old male with adult polycystic kidney disease 98 A. Cyclosporine binds to cyclophilin and tacrolimus
underwent kidney transplant. Which of the following immunophilin binds to FKBP. Both complexes inhibit calcineurin, a
inhibitors bind to FK - binding protein 12 and inhibit the mTOR cytoplasmic phosphatase. Calcineurin regulates the ability
pathway which inhibits the T - cell proliferation response to IL - 2? a. of the nuclear factor of activated T cells to translocate to
sirolimus b. tacrolimus c. cyclosporin d. cyclophiline e. none of the the nucleus and increase the production of key cytokines
above such as IL 2, 3, and IFN gamma. Cyclophilin and tacrolimus
prevent the increased production of cytokines that
normally occurs in response to T cell receptor activation.
Katzung Pharmacology Examination and Board Review
10th edition p.482
41. 19. A 23 year old female came in for unilateral throbbing headache 99 C. Ergot alkaloids can produce marked and prolonged
associated with nausea and photophobia. Which of the following alpha receptor mediated vasoconstriction. Ergotamine is
ergot alkaloids has no effects on the dopamine receptor D2 but the prototype and has been a mainstay of treatment of
stimulates the uterine smooth muscle? a. bromocriptine b. acute attacks of migraine. Katzung Pharmacology
ergonovine c. ergotamine d. LSD e. methylergometrine Examination and Board Review 10th edition p.160
42. 20. Which of the following prostaglandin derivatives increases 100 E Latanoprost increases outflow of aqueous humor
outflow of aqueous humor? a. misoprostol b. alprostadil c. and reduces intraocular pressure in glaucoma. Katzung
dinoprostone d. epoprostenol e. none of the above Pharmacology Examination and Board Review 10th edition
p.176
43. A 20 year old male develops tachycardia, hypotension, muscle 347 C. This is a case of malignant hyperthermia, which is
rigidity, and spiking fever immediately after start of surgery. Which associated with the combination of inhaled anaesthetics
of the following are commonly associated with this anaesthetic and succinylcholine.
complication? A. IV anesthetic and succinylcholine B. IV anesthetic
and midazolam C. Inhalational anesthetic and succinylcholine D.
Inhalational anesthetic and midazolam
44. A 21/M presented with recurrent fever, night sweats, enlarged 375 A. ABVD (doxorubicin, bleomycin, vinblastine, and
abdomen and generalized lymphadenopathy. Biopsy of a lymph dacarbazine) and MOPP (mechlorethamine, vincristine,
node showed Reed-Sternberg cells. Which of the following procarbazine, and prednisone) have been used to treat
chemotherapeutic regimen/s can be given to the patient? A. ABVD B. Hodgkin's lymphoma. ABVD has supplanted MOPP as the
CHOP C. MOPP D. Rituximab E. A and C regimen of choice since it is more effective and less toxic.
CHOP and Rituximab are used for NHL Katzung 12th ed
pg 970
45. A 23-year-old presents with abdominal pain, tenesmus, and mucoid 485 A. Ciprofloxacin is the recommended empiric
diarrhea with frank blood. Which is the best empiric treatment? A. treatment for patients with acute dysenteriae. SIMILAR TO
Ciprofloxacin B. Metronidazole C. Amoxicillin D. Cotrimoxazole PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
46. A 23 y/o female previous RHD patient s/p valve replacement is 118 A. Page 39 of Topnotch Handout. CYP 450 inhibitors
being maintained on warfarin. 3 days prior she had symptoms of PUD prolong/increase warfarin's anticoagulant effectsince they
for which she self medicated. She now presented at the ER due to inhibit drug clearance. Cimetidine is a CYP450 inhibitor.
black tarry stools, epigastric pain, coffee ground emesis, gum
bleeding and dizziness. Laboratory showed prolonged PT. Which of
the following drugs caused a drug interaction with warfarin
prolonging its anticoagulant effect? A. Cimetidine B. Omeprazole C.
Bismuth D. Sucralfate E. Maalox
47. A 24/G3P2(2002) who came in with a BP of 200/140 was given Hydralazine. What is the 545 C. A describes the MOA of
mechanism of action of hydralazine? A. Reduction of Ca influx via L-type channels B. verapamil; D describes minoxidil; E
Antagonism of alpha-adrenergic receptors in blood vessels C. Release of NO D. describes fenoldopam. All are direct
Hyperpolarization of smooth muscles due to opening of K channels E. Activation of vasodilators.
dopamine D1 receptors
48. A 24 year old female G1P0, 12 weeks AOG, sought consult due to purulent vaginal 293 E Cephalosporins should be
discharge and dyspareunia. Gram stain of the vaginal discharge showed intracellular avoided in patients with history of
gram negative diplococci. The patient disclosed that she had a severe allergic reaction severe allergic reaction to penicillin.
to amoxicillin a year ago. Which of the following is the safest antibiotic for this case ? A. FQ and doxycycline are avoided in
Doxycyline B. Ciprofloxacin C. Ceftriaxone D. Gentamicin E. Azithromycin pregnancy since it can cause cartilage
and bone damage. Azithromycin, a
macrolide antibiotic is the safest drug
for this case.
49. A 24 year old female is taking oral contraceptives as family planning method. Which of 256 C. SIMILAR TO PREVIOUS BOARD
the following drugs is considered a CYP450 enzyme inducer which can cause rapid EXAM CONCEPT/PRINCIPLE, what
metabolism of other drugs such as oral contraceptives which can potentially decrease came out as an enzyme inducer in ours
their effectiveness? A. isoniazid B. trimethoprim sulfamethoxazole C. griseofulvin D. was phenobarbital, griseofulvin is an
Amiodarone E. ketoconazole inducer all the others are inhibitors,
memorize at least the most common of
them inducers and inhibitors, topnotch
handouts are good reference
50. A 24-year-old student has been taking over-the-counter diphenhydramine for her 22 A. Diphenhydramine blocks H1-
allergy symptoms most of her life. Lately, however, she has had more frequent receptors in the brain, thereby
symptoms, so he increased the dose of the medication. She now asks her friend, who is a producing sedation. The release of
medical student, to explain to her how exactly this agent makes her more sleepy lately. dopamine and serotonin is modulated
What is the most likely answer regarding diphenhydramine? A. It blocks H1-receptors in via H3- receptors. Diphenhydramine
the brain B. It modulates the release of dopamine and serotonin C. It acts peripherally, readily crosses the bloodâ€"brain
since it does not cross the bloodâ€"brain barrier D. It exerts its effects via muscarinic- barrier. This agent has
cholinergic agonist activity E. It contains tryptophan, which produces sedation muscariniccholinergic agonist
properties. It is not known to contain
tryptophan.
51. A 25 year-old farmer was brought to the emergency room after having allegedly drank 445 E Pralidoxime is a cholinesterase
a poison. PE revealed that he had constricted pupils, excessive salivation and sweating, regenerator, an antidote for
wheezing and had several bouts of vomiting and diarrhea. He was given antidotes organophosphate poisoning.
Atropine and Pralidoxime. Pralidoxime exert its effects by: A. Destruction of the enzyme Pralidoxime is an example of chemical
B. Competitive antagonism C. Noncompetitive antagonism D. Physiologic antagonism E. antagonism. Chemical antagonism is
Chemical antagonism when an antagonist directly interacts
with the drug being antagonized to
remove it or prevent it from reaching
its target.
52. 25 year old female came in with chief complaint of cough of 3 weeks duration, this was 241 B. SIMILAR TO PREVIOUS BOARD
accompanied by night sweats, weight loss, body malaise. PE revealed slightly pale EXAM
palpebral conjunctiva, multiple bilateral posterior cervical lymphadenopathies but with CONCEPT/PRINCIPLE.,Considered as
no adventitious breath sounds on bilateral lung fields. The rest of the physical the most active anti-TB drug, in fact the
examination was unremarkable, which of the following drugs is considered to be the only drug given to treat latent
most active for her condition? A. Rifampicin B. Isoniazid C. Pyrazinamide D. Ethambutol tuberculosis
E. streptomycin
53. A 25-year-old woman with AIDS comes to the physician because of a 10-day 539 D.
history of fever, shortness of breath, night sweats, fatigue, and a non-
productive cough. She had been treated with antiretroviral agents for 2
years but stopped taking her medications 6 weeks ago. She has no known
allergies. Her temperature is 38.6 C, pulse is 110/min, respiration are 20/min,
and blood pressure is 110/60 mm Hg. Examination shows no cyanosis. Diffuse
fine crackles are heard bilaterally. An x-ray of the chest shows bilateral
interstitial infiltrates. A silver stain of sputum is positive for cysts and
organisms. Which of the following is the most appropriate pharmacotherapy?
A) Ceftriaxone B) Erythromycin C) Cotrimazole D) Co-trimoxazole
54. A 26/M presented with RUQ pain and fever. Imaging showed an abscess and 361 E For cases of amebic hepatic abscess you
aspiration biopsy was done. The aspirate resembled anchovy paste in color can give either Metronidazole, 750 mg 3 times
and in consistency. What is/are the possible drug/s that you can give for this daily (or 500 mg IV every 6 hours) for 10 days or
patient? A. Metronidazole B. Tinidazole C. Chloroquine D. A and B E. All of Tinidazole, 2 g daily for 5 days PLUS a luminal
the above agent. Alternatively you can give
Dehydroemetine2 or emetine,2 1 mg/kg SC or IM
for 8â€"10 days, followed by (liver abscess only)
chloroquine, 500 mg twice daily for 2 days, then
500 mg daily for 21 days PLUS a luminal agent
Luminal agent (Diloxanide, iodoquinol,
paramomycin) Katzung 12th ed pg 928
55. 27-year old female presents to the ER approximately one hour after 62 C. The physiological antagonism is related to
swallowing 70 propranolol tablets with suicidal intent. At the time of the fact that glucagon activates cAMP through
assessment she is drowsy (GCS 13) with a heart rate of 46 bpm and BP non- adrenergic pathways. Because the
100/60. What drug/class can be given by virtue of physiologic antagonism? adrenergic pathways are blocked by propanol,
A. Beta agonists B. Alpha agonists C. Glucagon D. Diazepam E. Atropine glucagon essentially uses a back door to enhance
myocardial activity.
56. A 27-year-old nulligravid woman comes to the physician for 540 C.
preconceptional counseling. She has a mechanical mitral heart valve and
chronic rheumatoid arthritis. Her cardiac status is New York Heart
Association Class II. She feels well. Current daily medications include
warfarin, prednisone, and acetaminophen with codeine. Examination shows
no abnormalities except for audible clicking from the heart valve. Which of
the following is the most appropriate advice for this patient? A) Chemical
dependency counseling before pregnancy B) Discontinuation of
anticoagulant therapy during pregnancy C) Discontinuation of prednisone
during pregnancy D) Switching from warfarin to heparin before pregnancy
57. A 28/M car mechanic was brought to the emergency room after ingesting 548 E Ethylene glycol and methanol poisoning
automobile antifreeze. ABG reveals high anion gap metabolic acidosis; while may be treated with fomepizole, an alcohol
urinalysis reveals calcium oxalate crystals. You suspect ethylene glycol dehydrogenase inhibitor, which prvents
poisoning. Which of the following drugs is recommended? A. Naltrexone B. conversion of methanol/ehtylene glycol to toxic
Diazepam C. Disulfiram D. Acamprosate E. Fomepizole metabolites.
58. A 28 year-old woman wanted to get pregnant. A substance that enhances 452 C. Clomiphene citrate enhances probability of
probability of ovulation by blocking the inhibitory effect of estrogen and ovulation by blocking the inhibitory effect of
thus stimulating the release of gonadotrophin from the pituitary is: A. estrogen and thus stimulating the release of
Tamoxifen B. Danazol C. Clomiphene D. Progesterone E. Oxytocin gonadotrophin from the pituitary.
59. A 29 year old woman presented with amenorrhea, galactorrhea and loss of 282 A. Bromocriptine is an effective dopamine
sexual libido. On evaluation her serum prolactin was noted to be markedly agonist in the CNS with the advantage of oral
elevated. Which of the following medications is most useful in the treatment activity. The drug inhibits prolactin secretion by
of her condition? A. Bromocriptine B. Cimetidine C. Sumatriptan D. activating pituitary dopamine receptors
Ergotamine E. Ondansetron
60. A 30 year old female with bipolar disorder delivered a baby with Ebstein 345 B.
anomaly. The drug that the mother was taking during her pregnancy that
caused this congenital anomaly is: A. Olanzapine B. Lithium C.
Carbamazepine D. Risperidone
61. A 30-year-old woman has suffered from cyclical migraines for many years. 38 B. Sumatriptan is a 5-HT1D agonist. An
She now presents to her physician asking for a medication designated example of an agent known as a 5-HT1A agonist
specifically for migraines, not just a general pain reliever. Her physician would be buspirone, an antianxiety agent.
decided to prescribe sumatriptan as a trial medication. The patient, who is a Fluoxetine is an example of a serotonin-reuptake
biochemist, would like to know how this medication works. A. It is a 5-HT1A inhibitor. Ondansetron, an antinausea medication,
agonist B. It is a 5-HT1D agonist C. It blocks reuptake of serotonin D. It is a 5- is a 5-HT3 antagonist. The antipsychotic
HT3 antagonist E. It is a 5-HT2A antagonist medication Risperdal is an example of a 5-HT2A
antagonist.
62. A 30 y/o male patient developed methemoglobinemia after receiving 119 B. Page 52 of Topnotch Handout. For
prilocaine during a minor surgery. What should be administered to this methemoglobinemia the antidote is methylene
patient? A. NAC B. Methylene blue C. EDTA D. Dimercaprol E. Deferoxamine blue.
63. A 32 year old G2P1 mother delivered a live term baby Boy with an upturned 478 A. The physical description of the neonate is
nose, mild midfacial hypoplasia, long upper lip, and lower distal digital consistent with fetal hydantoin syndrome which is
hypoplasia. Upon review of maternal history, the mother was taking an anti- the side effect of phenytoin
epileptic drug. The drug that is most likely used was: A. phenytoin B. valproic
acid C. diazepam D. carbamazepine E. lamotrigine
64. A 32-year-old woman comes to the physician because of a 3-month history of 530 C.
increasing pain and stiffness in her wrists, hands, and ankles. During this
period, she also has had progressive fatigue and morning stiffness lasting 2
hours. She has a 1-year history of rheumatoid arthritis treated with naproxen.
Examination shows redness, swelling, and warmth over the wrist, hand, and
ankle joints bilaterally. There are nontender subcutaneous nodules over the
extensor surfaces of both elbows. X-ray films of the hands show diffuse
osteopenia and erosions over several of the distal metacarpal bones. Which
of the following is the most appropriate pharmacotherapy? A) Add oral
cyclophosphamide B) Add oral gold C.) Add oral Methotrexate D.) Add Oral
Penicillamine
65. A 33-year old farmer, after 1 hour of spraying insecticides, started to note 614 A. The patient had an insecticide poisoning.
generalized body weakness, drowsiness, shortness of breath, numbness and Insecticides usually contain organophosphates or
severe epigastric pain. After 10 hours, he was brought to the ER due to loss of carbamates. Before 6 hours, pralidoxime and
consciousness. He was soaking in sweat, drooling with saliva and diarrheic. atropine should be both administered. In this
What should be administered to this patient? A. Atropine B. Pralidoxime C. patient, 10 hours has already elapsed, hence
Neostigmine D. A and B E. B and C pralidoxime can no longer be effective.
66. A 34/F asthmatic, scheduled to undergo cholelithiasis, was being induced by 369 C. The patient is most likely experiencing
the anesthesiologist. After starting the volatile anesthetic, the bronchospasm and although all volatile
anesthesiologist noted increased peak air pressure, prolonged expiration with anesthetics possess varying degrees of
the classic "shark fin" capnograph. Which of the following most likely have bronchodilating properties airway irritation
caused the above findings? A. Halothane B. Sevoflurane C. Desflurane D. induced by the pungency of isoflurane and
Nitrous oxide E. None of the above desflurane may induce bronchospasm. These
rarely occur with halothane, sevoflurane and
nitrous oxide since they are non pungent.
Katzung 12th ed pg 436
67. A 34/F came in to the ER complaining of severe eye pain. On PE you notice 379 C. All of the choices can decrease IOP and
that the cornea is steamy with accompanying conjunctival injection. You are used in the treatment of glaucoma. Beta
proceed to administer a drug that will cause an increase in the outflow of blockers, osmotic agents, alpha-2 agonists and
aqueous humor through the canal of Schlemm resulting in a decrease in IOP. carbonic anhydrase inhibitors decrease secretion
Which drug was administered? A. Timolol B. Apraclonidine C. Latanoprost D. of aqueous humor from the ciliary epithelium.
Pilocarpine E. Epinephrine Cholinomimetics cause contraction of the ciliary
muscle causing the trabecular meshwork to
open, increasing outflow. Prostaglandins increase
outflow through the canal of Schlemm.
Nonselective alpha agonists increase outflow via
the uveoscleral veins. Topnotch
68. A 34/F was diagnosed to have lepromatous leprosy. She was given the 364 C. Clofazimine is a phenazine dye which causes
appropriate drugs which she took religiously. One day she came back to red- brown to nearly black skin discoloration. SE of
you complaining that her skin changed to a red-brownish color. Which of dapsone: methemoglobinemia; Rifampicin: red orange
the following drug/s most likely have caused her predicament? A. discoloration of body fluid Katzung 12th ed pg 846
Dapsone B. Rifampicin C. Clofazimine D. Rifabutin E. Cycloserine
69. A 34-year-old carpenter presents to the ER after an accident in which he 37 D. Epinephrine is contraindicated as an anesthetic
inadvertently chopped off the tip of his index finger. He is taken to the adjuvant for surgeries involving most facial structures,
OR for reattachment of the digit, and after sedation, a local anesthetic is digits, and the penis, because of the risk of vascular
administered around the site of the injury. The local anesthetic used in compromise. This agent causes decreased blood loss
the procedure did not contain any epinephrine, as it usually does for for most other surgeries because of vasoconstriction.
most surgical procedures. The reason for this is: A. Epinephrine causes Although local anesthetic agents such as lidocaine or
increased blood loss during delicate surgery B. Epinephrine causes xylocaine can cause mild local tissue swelling,
swelling of the tissues, making surgery more challenging C. Epinephrine epinephrine does not; either way, it is not a
is contraindicated in emergency surgery D. Epinephrine causes contraindication for hand surgery. Epinephrine causes
vasoconstriction, which can lead to vascular ischemia in digits E. elevated blood pressure when administered
Epinephrine can cause hypotension when administered with sedative systemically; however, it has no systemic side effects
agents when administered locally.
70. A 35 year old female underwent treatment for endometriosis for 12 603 B. Danazol is a derivative of the synthetic steroid
months. She then developed male-pattern hair growth, deepening of the ethisterone, a modified testosterone, also known as 17-
voice and acne. The drug given is most likely: A. GnRH agonist B. alpha-ethinyl testosterone. Danazol inhibits ovarian
Danazol C. Combined oral contraceptive pills D. Medroxyprogesterone steroidogenesis resulting in decreased secretion of
acetate E. GnRH antagonist estradiol and may increase androgens. This drug
causes androgenic side effects, such as hirsutism,
deepening of the voice, acne and oily skin.
71. A 35 year old woman came to your clinic because of dysuria. She has 518 D. Quinolones act by blocking bacterial DNA
been experiencing burning on urination with increased frequency and synthesis by inhibitting bacterial topoisomerase II and
urgency to urinate for 5 days now. Urinalysis revealed WBC of 20- IV. Moxifloxacin is the only non-renally cleared
30/hpf, bacteria=moderate, nitrite=positive. You may prescribe the fluoroqionolone and thus achieves low urinary level
following drugs to her except for: A. Ciprofloxacin B. Levofloxacin C. making it ineffective for cases of UTI. Katzung 10th
Ofloxacin D. Moxifloxacin E. None of the above ed., 768.
72. A 37 year old female diagnosed with chronic schizophrenia maintained 291 C. Clozapine can cause agranulocytosis in a small
on an antipsychotic medication was brought to the clinic due to a 3 day but significant number of patients (1-2%). This serious,
history of fever. PE showed presence of tonsillar exudates. A CBC was potentially fatal effect can develop rapidly usually
requested which showed a markedly decreased WBC count. The between the 6th to 18th week of treatment. It appears
medication was immediately discontinued by the patient's physician. to be reversible upon discontinuation of treatment.
What is the anti-psychotic medication that could have caused this Because of this risk, patient on clozapine must have
problem? A. Haloperidol B. Quetiapine C. Clozapine D. Risperidone E. weekly blood counts for the first 6 months of
Olanzapine treatment and every 3 weeks thereafter
73. A 37 year old man comes to the physician because of a 1 week history of 521 C.
pain with swallowing. He received the diagnosis of AIDS 4 years ago, but
has not been able to tolerate highly active antiretroviral therapy. He
currently takes TMP-SMX. Vital signs are within normal limits.
Examination shows a few white plaques over the pharynx. CD4+ count is
50/mm3 and plasma HIV viral load is 50000 copies/mL. Which of the
following is the most appropriate pharmacotherapy? A) Acyclovir B)
Amphotericin B C) Fluconazole D) Foscarnet
74. A 37 year old man comes to the physician for a follow-up examination. He was diagnosed 535 C. Start HAART with CD4
with HIV infection 3 weeks ago. He is asymptomatic and takes no edications. His below 350 and Pneumocystis
temperature is 37.2 C, pulse is 100 bpm, and blood presure is 100/60 mmHg. Examination prophylaxis with CD4 below 200
shows no abnormalities except for erythematous scaling at the hairline and nasolabial
folds. His CD4+ T-lymphocyte count is 160/mm3 and plasma HIV viral load is 25,000
copies/mL. Which of the following is the most appropriate pharmacotherapy? A)
Pneumocystis jiroveci prophylaxis only B) Three-drug antiretroviral therapy only C) Three-
drug antiretroviral therapy and P. jiroveci prophylaxis D.) Two Drug Antiretroviral therapy
and P. iroveci Prophylaxis
75. A 39 year old female, known case of Graves' disease but poorly compliant with 298 A. beta blockers are the most
medications, presented to the ER due to palpitations and shortness of breath. She was effective agents in acute thyrotixc
hooked to a cardiac monitor which showed supraventricular tachycardia. Which of the arrythmias . Esmolo is a rapid
following drugs would be most suitable for this case ? A. Esmolol B. Quinidine C. Flecainide parenteral beta blocker
D. Disopyramide E. Lidocaine
76. A 39 y/o male went for follow up consult secondary to open angle glaucoma. He was 309 C. dermanent discoloration of
compliant with all the topical medications given to him. Indirect ophthalmoscopy revealed the iris and eyelashes is a well
brownish discoloration in his iris. What is the mechanism of action of the drug that causes known side effect of latanoprost.
such change?. A. decrease aqueous secretion due to lack of HCO3 B. increase outflow via Its mechanism of action is to
uveoscleral veins C. increase aqueous outflow D. decrease aqueous secretion from the increase aqueous outflow. A-
ciliary epithelium E. none of the above brinzolamide, dorsolamide, B-
epinephrine. D- timolol. Katzung
review p 87.
77. A 41/M, presenting with high fever and chills, is admitted at the hospital. He reports having 557 D. Aztreonam is active only
had serious allergic reactions to amoxicillin one year ago. Blood GS/CS reveals growth of against Gram-(-) organisms and has
Gram negative bacteremia. Which of the following antibiotics is MOST appropriatE? A. NO cross-reactivity with penicillins.
Cefazolin B. Ampicillin-sulbactam C. Piperacillin-tazobactam D. Aztreonam E. Vancomycin
78. A 42-year-old MDS patient presents to the emergency room with mental status changes 28 C. Toxoplasmosis is treated with
and a headache. A computed tomography scan is ordered and demonstrates a ring- a combination of pyrimethamine
enhancing lesion. You decide to treat him empirically due to the possibility of and sulfadiazine. Ivermectin is used
Toxoplasmosis gondii abscess. Which agent should be included in his treatment? A. to treat filariasis, whereas
Ivermectin B. Praziquantel C. Sulfadiazine D. Niclosamide E. Pyrantel pamoate praziquantel is used to treat
schistosomiasis. Niclosamide can be
used to treat tapeworm infections,
and pyrantel pamoate is used to
treat many helminth infections.
79. A 42-year-old woman, gravida 2, para 2, comes to the physician because of a 3-month 533 A.
history of swelling of her legs and mild abdominal pain and bloating. Abdominal
examination shows no abnormalities. Rectovaginal examination shows fullness in the right
adnexa. Transvaginal ultrasonography shows an irregular mass in the right ovary with some
solid components to a predominantly cystic lesion. Her serum CA 125 level is 120 U/mL
(N<35). Treatment with which of the following is most likely to have prevented this patient's
symptoms? A) Antiestrogens B) Antiprogestationals C) Medroxyprogesterone D) Oral
contraceptives
80. A 43 year-old male was diagnosed with Pulmonary Tuberculosis. He was given Anti-TB 451 D. Pyrazinamide provoke avute
medications. However, he developed hyperuricemia. Which among these drugs inhibits the gouty arthritis by inhibiting urate
excretion of urate causing the above findings: A. Ethionamide B. Streptomycin C. excretion.
Ethambutol D. Pyrazinamide E. Rifampicin
81. A 45 year old male complained of chest pain upon exertion but relieved by rest. The 464 B. drugs used in angina
doctor prescribed him a beta blocker. What is the effect of beta blocker? A. Increase pectoris are the following: those
oxygen supply B. Decrease oxygen demand C. Increase oxygen demand D. decrease that increase the oxygen supply
oxygen supply E. A and B are: nitrates and calcium blockers;
those that decrease the oxygen
demand are: beta blockers and still
calcium blockers
82. A 45 year old male presented to the ER due to sudden onset of right 295 D. Atropine is a mydriatic and cyloplegic and can
eye pain accompanied by blurring of vision. On examination there was further increase IOP hence worsen angle closure
note of ciliary injection over the right eye, IOP pressure was noted to glaucoma.
be elevated. A diagnosis of acute angle closure glaucoma was made.
Which of the following ophthalmic medications should be avoided ? A.
Brinzolamide B. Timolol C. Apraclonidine D. Atropine E. All of the above
83. A 45 year old male with history of polyuria, polyphagia and weight loss 10 D. The first and second generation sulfonylureas are
was recently started on antidiabetic medications after workup associated with weight gain. Source: Katzung Basic and
confirmed DM type II. 2 months later, he notes increasing weight. Which Clinical Pharmacology 11th ed p748
of the following antidiabetic medications is associated with this? A.
Chlorpropramide B. Glimepiride C. Exenetide D. A and B E. All of the
above
84. A 45 year old man who has received long treatment for schizophrenia 623 B. this is TARDIVE DYSKINESIA, which is a
has recently been noted to display involuntary movements that include complication of long term antipsychotic therapy with
lateral deviations of the jaw and "fly catching" motions in his tongue. the older agents like, FLUPHENAZINE.
Which of the following agents is the most likely cause of his involuntary
movements? A. Clozapine B. Fluphenazine C. Lithium D. Risperidone E.
selegiline
85. A 45-year-old man with a history of medication-controlled 21 D. Hydrochlorothiazide, a thiazide diuretic, can
hypertension presents to your office with complaints of a painful, precipitate a gouty attack in predisposed individuals.
swollen big toe on the left foot. You suspect gout and check his uric This is because these agents increase serum uric acid as
acid levels, which are elevated. From looking at the list of the a result of competition for the organic acid carrier.
medications the patient is taking, you realize that one of the Loop diuretics can have this effect too. Acetazolamide
medications may be the cause of his current symptoms. Which is a carbonic anhydrase inhibitor; this agent does not
medication might that be? A. Acetazolamide B. Amiloride C. have a significant impact on the levels of uric acid.
Spironolactone D. Hydrochlorothiazide E. Mannitol Amiloride and spironolactone are potassium-sparing
diuretics, and they do not have a significant impact on
the levels of uric acid either. The same is true for
mannitol, an osmotic diuretic.
86. A 45 year old soldier has been maintaining on fluoxetine for his major 520 E This is a case of serotonin syndrome which is a
depressive disorder. Which of the following drugs can precipitate a condition precipitated when MAO inhibitors are given
potentially fatal syndrome of hypertension, hyperreflexia, tremor, with serotonin agaonists, especially antidepressants of
clonus, hyperhtermia, diarrhea, mydriasis and agitation within hours the SSRI class. Amytriptyline and Imipramine are TCAs.
when taken consurrently with fluoxetine? A. Amytriptyline B. Fluoxetine, Sertraline and Citalopram are SSRIs.
Imipramine C. Sertraline D. Citalopram E. Phenelzine Phenelzine is a MAO inhibitor. Katzung 10th ed., 267.
87. A 47-year-old man is admitted to the hospital after threatening to harm 528 C.
a radio announcer he believed was broadcasting his thoughts. Over the
past 20 years, he has had multiple psychiatric hospitalizations for
threatening people who he believed were plotting against him, trying to
control his mind, or causing him to hear voices by implanting devices in
his head. Past symptoms improved with neuroleptic therapy; after
discharge, he discontinued the medication and his symptoms worsened.
Which of the following is the most appropriate pharmacotherapy to
decrease this patient's risk for future hospitalization? A) Clozapine B)
Fluphenazine hydrochloride C) Haloperidol decanoate D) Risperidone
88. A 47-year-old man is admitted to the hospital after threatening to harm 529 C.
a radio announcer he believed was broadcasting his thoughts. Over the
past 20 years, he has had multiple psychiatric hospitalizations for
threatening people who he believed were plotting against him, trying to
control his mind, or causing him to hear voices by implanting devices in
his head. Past symptoms improved with neuroleptic therapy; after
discharge, he discontinued the medication and his symptoms worsened.
Which of the following is the most appropriate pharmacotherapy to
decrease this patient's risk for future hospitalization? A) Clozapine B)
Fluphenazine hydrochloride C) Haloperidol decanoate D) Risperidone
89. A 47 year old obese male, who is a heavy alcoholic beverage drinker, was 283 D. Metformin is associated with lactic acidosis.
recently diagnosed with diabetes mellitus. He was started on Metformin 500 It should be avoided or used with extreme caution
mg/tab TID. This patient is at risk of developing which of the following in patients who are heavy alcoholics since acute
complications? A. Hypoglycemia B. Disulfiram like reaction C. Congestive ethanol ingestion increaes the risk of lactic acidosis
heart failure D. Lactic acidosis E. Diarrhea
90. A 47 year old woman comes to the physician for a routine health 523 D.
maintenance examination. She has a 2 year history of venous insufficiency
and noted daily swelling of her ankles that worsens in the evening. She takes
no medications. Her pulse is 80 bpm, and blood pressure is 160/100 mmHg.
Cardiopulmonary examination shows no abnormalities. Examination of the
lower extremities shows 2+ edema and increased pigmentation .Which of the
following antihypertensive medications would most likely exacerbate this
patient’s swelling? A) Atenolol B) Lisinopril C) Losartan D) Nifedipine
91. A 48/M farmer with a history of alcohol abuse, is rushed to the emergency 542 E A chemical antagonist interacts directly with
room after the patient has deliberately ingested 300 mL of an unknown the drug being antagonized to remove it or
pesticide while drunk. On examination, you note that the patient has prevent it from binding to its target. Pralidoxime
pinpoint pupils and frothy secretions at the mouth. After you determine that which combines avidly with the phosphorus in
the patient has ingested malathion; you then immediately start treatment organosphosphate cholinesterase inhibitors is an
with pralidoxime. Pralidoxime and malathion are examples of: A. example. (KBR9e, p. 14)
Competitive pharmacologic antagonists B. Irreversible pharmacologic
antagonists C. Physiologic antagonists D. Structural antagonists E. Chemical
antagonists
92. A 48-year old Caucasian male is referred to you for chronic cough, night 543 A. 50% of white and African american persons
sweats and weight loss. Sputum AFB was positive on three occasions; are slow acetylators of INH, hydralazine and
findings of chest X ray done was also consistent with pulmonary procainamide. KBR9e, p33
tuberculosis. Before you start drug therapy, you remember that a much
larger percentage of Caucasians are slow acetylators of one of the anti-TB
drugs. The dosage of which of the following may need to be modified. A.
Isoniazid B. Rifampicin C. Streptomycin D. Pyrazinamide E. Ethambutol
93. A 48 year old female, a known case of Acute Myelogenous Leukemia (AML), 287 A. Valaciclovir is a prodrug, an esterified
who is on reinduction chemotherapy was started on anti viral prophylaxis version of aciclovir that has greater oral
with Valacyclovir 500 mg/tab TID. What is the mechanism of action of this bioavailability (about 55%) than aciclovir
anti viral medication? A. Inhibition of Viral DNA polymerase B. Blockage of (10â€"20%). It is phophorylated three times and this
M2 proton channel C. Inhibition of neuraminidase D. Inhibition of viral form acts as a competitive substrate for DNA
reverse transcriptase E. Prevents fusion of virus with the host cellular polymerase and it leads to chain termination
membrane
94. A 49 year old made came to the ER with a 3 hour history of anginal chest 3 C. Other than Aspirin, NSAIDs are absolutely
pain. Past medical history is significant only for uncontrolled hypertension. contraindicated to patients with acute MI. Drugs
Cardiac markers and ECG both confirm the diagnosis of acute myocardial which are administered post MI include beta-
infarction probably of the anterior wall. Currently the patient has stable vital blockers (unless with contraindications), ACE
signs within normal range with persistence of angina. The following should inhibitors (beneficial in preventing cardiac
be given except: A. Lisinopril B. Simvastatin C. Ibuprofen D. Metoprolol E. remodeling), Statins (stabilizes the atheromatous
None of the above. All should be administered. plaque), antiplatelet therapy like aspirin or
clopidogrel, aldosterone antagonist (epleronone
only), nitrates (increase O2 supply).
95. A 50/M is about to be given 6-mercaptopurine for his ulcerative colitis as 371 D. Because allopurinol inhibits xanthine
an off-label use. The patient has multiple comorbidities which include oxidase, simultaneous therapy with allopurinol and
hypertension, diabetes, asthma and gout and takes losartan, metformin, 6-MP would result in increased levels of 6-MP,
salmeterol, allopurinol and diclofenac for these conditions. Which of the thereby leading to excessive toxicity. In this
above drugs would prompt you to rethink the dose of 6-MP that you are setting, the dose of mercaptopurine must be
about to administer? A. Losartan B. Metformin C. Salmeterol D. Allopurinol reduced by 50â€"75%. Katzung 12th ed pg 961-962
E. Diclofenac
96. A 50/M previously diagnosed with BPH develops mild fever, 373 B. Sympathomimetic agents may cause or worsen urinary
cough and rhinorrhea. Thinking that he just has the common difficulty in patients with prostate enlargement due to smooth
cold, he self medicates with over the counter medication. muscle contraction in the bladder neck via stimulation of alpha-1
After 12 hours he rushes to the ER and complains of inability adrenergic receptors. Katzung 12th ed pg 139
to void. Which of the following OTCs may have caused his
condition? A. Chlorphenamine B. Phenylephrine C.
Acetaminophen D. Ibuprofen E. None of the above
97. A 50-year man with mild hypertension complains of 24 B. SIMILAR TO PREVIOUS BOARD EXAM
discomfort in his chest. He has slightly enlarged fat deposits CONCEPT/PRINCIPLE. Spironolactone antagonizes the action of
in his breasts with prominent nipples. Which of the following the mineralocorticoid, progesterone, and androgen receptors.
medications might be causing this adverse effect? A. Inhibition of androgen receptors can lead to gynecomastia and
Amiloride B. Spironolactone C. Metolazone D. breast tenderness, most often in men.
Hydrochlorothiazide E. Acetazolamide
98. A 50 year old female consulted due to palpitations. This was 651 D. RAI may induce production of cancer cells but ALL patients
accompanied by frequent bowel movements and heat administered with RAI will suffer from permanent hypothyroidism
intolerance. You gave her Radioactive iodine and you know and will require exogenous thyroxine as supplement
that its most common side effect is? A. Papillary Thyroid CA
B. Medullary Thyroid CA C. Rebound hyperthyroidism D.
Permanent hypothyroidism E. Rebound tachycardia
99. A 50-year old male with DM type II had been on metformin 128 C. This is a case of hypomagnesemia, which can be
for nine years and presented with diarrhea, paresthesia, and exacerbated by administration of a loop diuretic Furosemide is a
muscular weakness. On examination, he has hyperactive loop diuretic that acts on the thick ascending limb of the loop of
DTRs. Blood electrolytes showed serum Na 138 mEq/L, henle. This tubular segment is responsible for a significant sodium
Serum K= 3.4 mEq/L, serum Ca=8.2 mg/dL and Mg 0.8 mEq/L. chloride reabsorption, as well as the site for calcium and
Which of the following medications should you avoid to magnesium reabsorption. Side effects of Furosemide :
prevent exacerbation of his symptoms? A. Spironolactone B. Hypokalemia, hypocalcemia, hypomagnesemia, hyperuricemia,
Magnesium sulfate C. Furosemide D. Indomethacin E. dehydration, metabolic alkalosis, ototoxicity, sulfa allergy, nephritis
Acetazolamide
100. A 50 year old obese patient was diagnosed to have DM type 479 C. Metformin is the first line treatment for type 2 DM and is
2. There were no other comorbidities. What hypoglycemic the drug of choice for obese patients. It is contraindicated in
drug should you prescribed with this patient? A. Insulin B. patients with renal disease, hepatic disease, and alcoholism
Gliclazide C. Metformin D. Pioglitazone E. Sitagliptin
101. A 50 year old smoker, hypertensive patient complained of 2 462 A.
month cough and dyspnea. He was on Carvedilol for his
hypertension. What is the side effect of this drug that
aggravates the condition. A. bronchospasm B.
bronchoconstriction C. tachycardia D. tremor E. all of the
choices
102. A 53/M, admitted at the Medical ICU, after having a 552 D. Lidocaine and other Class IB drugs act primarily in ischemic
myocardial infarction, develops ventricular tachycardia. tissues and are best for arrhythmias following MI.
Which of the following anti-arrhythmics is most appropriate?
A. Quinidine B. Mexiletine C. Adenosine D. Lidocaine E.
Flecainide
103. A 53-year-old woman with breast cancer undergoes a 27 E Paclitaxel is often used in the treatment of breast as well as
breast-conserving lumpectomy and lymph node biopsy. The ovarian and lung cancer. Its main toxicities are myelosuppression
pathology report returns with mention of cancer cells in two and peripheral neuropathy that usually manifest as numbness and
of eight lymph nodes removed. Following radiation therapy, tingling in the distal extremities. Blood in the urine can indicate
chemotherapy is started that includes the use of paclitaxel. hemorrhagic cystitis, a complication of cyclophosphamide use.
Which side effect is the patient likely to complain of? A. Easy bruising can result from mechlorethamine use. Hot flashes
Blood in the urine B. Easy bruising C. Hot flashes D. are a common complaint in patients using tamoxifen. Shortness of
Shortness of breath E. Numbness and tingling breath can result from pulmonary fibrosis secondary to busulfan
or bleomycin use.
104. A 53 year old woman with newly diagnosed type 2 diabetes presents to 621 E This is a disulfiram like reaction after drinking
mergency department complaining of vomiting, severe headache, alcohol at a cocktail party. TOLBUTAMIDE is
dizziness, blurry vision, and DOB. She says that she had been at a cocktail associated with this kind of reaction
party when the symptoms began. her skin is notably flushed on physical
examination. Which of the following medications is responsible for this
reaction? A. Acarbose B. Glipizide C. Glyburide D. Metformin E.
Tolbutamide
105. A 55/M comes in due to sudden headache described as the "worst 560 A. Nimodipine given for 21 days should be
headache of his life." He is a diagnosed hypertensive, with poor compliance started on admission for vasospasm prophylaxis.
to medications. PE reveals nuchal tenderness (positive Kernig's sign), and a
left cranial nerve palsy. Brain CT reveals diffuse subarachnoid hemorrhage
in the basal cisterns. Which of the following drugs has a proven role in the
management of his condition? A. Nimodipine B. Propanolol C. Captopril D.
Nifedipine E. Aspirin
106. A 55-year-old man has had crushing substernal chest pain on exertion over 524 B.
the past 6 weeks. He had a myocardial infarction 2 months ago. He takes
nitroglycerin as needed and one aspirin daily. He has smoked two packs of
cigarettes daily for 30 years. Examination shows normal heart sounds and
no carotid or femoral bruits. Treatment with a β-adrenergic blocking agent
is most likely to improve his symptoms due to which of the following
mechanisms? A) Decreasing diastolic relaxation B) Decreasing myocardial
contractility C) Dilating the coronary arteries D) Peripheral vasodilation
107. A 55-year-old woman is admitted to the surgical intensive care unit after 40 B. Milrinone reduces left ventricular filling
having a coronary artery bypass grafting of four of her coronary vessels. pressure and thus enhances cardiac output. It is
Overnight she develops hypotension, and her cardiac output, as measured related to the anticholinergic agent biperiden.
by the Swan-Ganz catheter, is significantly lower than it had been Milrinone inhibits cardiac phosphodiesterase type
postsurgery. You decide to give her a dose of milrinone. This results in an 3. It increases cAMP, and therefore intracellular
increase in her cardiac output. How does milrinone work? A. It is a calcium.
cholinergic agonist B. It reduces left ventricular filling pressure C. It
potentiates cardiac phosphodiesterase type 3 D. It decreases cyclic AMP E.
It decreases intracellular calcium
108. A 55-year-old woman was recently diagnosed with an adrenal mass due to 536 B. Phenoxybenzamine >> nonselective,
symptoms of sweating, elevated blood pressure, and severe headaches. IRREVERSIBLE alpha blocker..Phentolamine>>
Which of the following nonselective, irreversible alpha blocker is the drug reversible alpha blocker.
of choice as a preoperative agent used in this disease? A) Phentolamine B)
Phenoxybenzamine C) Prazosin D) Yohimbine
109. A 55 y/o male presented at the ER with complaints of 3 day diarrhea, 109 D. Page 12 of hand out. The patient is
frequent urination, increased salivation and sweating. You noted his pupils experiencing symptoms of organophosphate
to be constricted. He works in a factory manufacturing pesticides for farms. poisoning. Remember the DUMBBELSS mnemonic!
Which of the following drugs will you give this patient? A. Pyridostigmine B. Diarrhea, Urination, Miosis, Bronchospasm,
Edrophonium C. Pilocarpine D. Atropine E. Varenicline Bradycardia, Excitation (skeletal muscle and CNS),
Lacrimation, Sweating and Salivation. The antidote
to be given in organophosphate poisoning is
Atropine (Cholinergic antagonist, muscarinic) and
Pralidoxime (Cholinesterase regenerator)
110. A 56 year old patient diagnosed with rheumatic heart disease underwent 242 A. SIMILAR TO PREVIOUS BOARD EXAM
mitral valve replacement and is placed on oral anticoagulant Warfarin, she CONCEPT/PRINCIPLE, which asked us directly
comes to your clinic for a follow up check up and complaints of heartburn which of the following is a CYP inhibitor:
and epigastric pain, which of the following medications will you avoid cimetidine, Warfarin is majorly metabolized by CYP
prescribing? A. Cimetidine B. Aluminum Magnesium Hydroxide C. 2C9, cimetidine inhibits this enzyme among others
lansoprazole D. ranitidine E. sucralfate which inhibits warfarin metabolism which increases
its toxicity
111. A 57-year-old man has been hospitalized for 2 days for treatment of unstable angina 532 D. Heparin-induced
pectoris. He is currently receiving intravenous heparin and undergoing evaluation for thrombocytopenia >>> the Heparin-
coronary artery bypass grafting. His blood pressure is 160/90 mm Hg, pulse is 88/min, Platelet4 complex are attacked by IgG
and respirations are 16/min. Laboratory studies show: Platelet count 90,000/mm3 in the human bodies that essentially
Prothrombin time 12 sec (INR=1.1) Partial thromboplastin time 35 sec Which of the activate the platelet and thus form
following is the most likely cause of these findings? A) Excessive platelet destruction clots. These clots are the reason free
B) Factor VIII deficiency C) Inadequate platelet production D) Uncontrolled activation platelets are low.
of coagulation and fibrinolytic cascades
112. A 58 year old male hypertensive was diagnosed with benign prostatic hyperplasia. 471 B. Alpha1 blockers are
What is the antihypertensive drug that is the most selective for prostatic smooth antihypertensive that is also used for
muscle? A. prazosin B. tamsulosin C. losartan D. metoprolol E. Terazosin BPH. Prazosin, tamsulosin, and
terazosin are alpha1 blockers, but the
most selective for prostatic smooth
muscle is tamsulosin.
113. A 58-year-old woman with newly diagnosed type 2 diabetes mellitus presents to the 538 A. tolbutamide >> disulfuram
emergency department complaining of vomiting, severe headache, dizziness, blurry reaction
vision, and dyspnea. She says that she had been at a party when the symptoms began.
Her skin is notably flushed on physical examination. Which of the following medications
is responsible for this reaction? A) Tolbutamide B) Glipizide C) Glyburide D) Metformin
114. A 59-year-old female nurse who has been diagnosed with type 2 diabetes is admitted 26 C. Any of the sulfonylureas can
to the emergency room. She is tachycardic, tachypneic, and appears very disoriented; cause hypoglycemia which can
she does not remember the day of the week or her address or any emergency contact produce shock-like symptoms.
numbers. She vaguely remembers taking her “sugar medicine†earlier in the day. Metformin and the α-glycosidase
Which of the following drugs is most likely responsible for her condition? A. Metformin inhibitors such as acarbose rarely
B. Acarbose C. Glipizide D. Glucagon E. Pioglitazone cause ypoglycemia. Glucagon would
raise plasma glucose.
115. 59 year old male, hypertensive for 22 years, came in the ER due to difficulty of 182 A. my mnemonics: improves
breathing. PE revealed crackles on bilateral lower lobes of the lungs and bipedal QUANTITY of life in CHF- ABS
edema. Which of the drugs used in CHF can prolong survival of patients? A. carvedilol (ACEI/ARBS, Beta-Blockers,
B. atenolol C. digitalis D. furosemide E. A and B Spironolactone). Improves QUALITY of
life- Digital Film (Digitalis, Furosemide).
Only 3 beta blockers are found to be
useful in CHF: Carvedilol, metoprolol
and bisopolol.
116. A 60/M was diagnosed to have refractory follicular B-cell lymphoma. He was 368 A. Cetuximab targets EGFR;
prescribed with an agent which binds CD20 on both normal and malignant B Bevacizumab targets VEGF;
lymphocytes. Which of the following is this drug? A. Rituximab B. Cetuximab C. Omalizumab is an anti-IgE useful in
Bevacizumab D. Omalizumab E. Natalizumab asthma therapy; Natalizumab binds to
α4-subunit of α4β1 and α4β7 integrins
expressed on the surfaces of all
leukocytes except neutrophils. Used in
MS and Crohn's disease. Katzung 12th
ed pg 991-993
117. A 60 year-old female patient was diagnosed with breast cancer. She was given an 457 B. Acrolein is the metabolite of
alkylating agent, Cyclophosphamide. Later in the treatment, she developed Cyclophosphamide that causes
hemorrhagic cystitis due to this toxic metabolite: A. Amifostine B. Acrolein C. hemorrhagic cystitis.
Mercaptopurine D. Lomustine E. Mesna
118. A 63 year old male patient presenting with intermittent complaints of chest pain upon 269 A. Nitroglcerin decreases
walking several blocks or climbing several flights of stairs is prescribed with afterload, thus, decreasing end systolic
nitroglycerin to used on an as needed basis. What will be the expected physiologic volume. Compensatory sympathetic
changes as a result of this drug? A. Increased HR and and decreased left ventricular activity increases heart rate.
end-systolic volume B. Decreased HR and decreased left ventricular end-systolic
volume C. Decreased HR and increased left ventricular end-systolic volume D.
Increased HR and increased left ventricular end-systolic volume E. None of the above
119. A 65/M hypertensive, diabetic, smoker presents to you with fever, 363 D. Vancomycin and meropenem need to be
productive cough with an infected non healing wound in the foot. Labs adjusted Katzung 12th ed pg 798 Metoprolol is
showed anemia and very elevated creatinine.You schedule the patient metabolized in the liver and requires no adjustment pg
for dialysis. As the prescribing physician, which of the following drug/s 179
dose/s would you have to modify? A. Vancomycin B. Meropenem C.
Metoprolol D. A and B E. All of the above
120. A 65/M was diagnosed to have CAP-HR. You plan to start Piperacillin- 377 B. Clearance is involved in determining the
Tazobactam with a loading dose of 4.5g IV. Which among the following maintenance dose Topnotch
variables is not involved in the calculation of the loading dose? A.
Volume of distribution B. Clearance C. Bioavailability D. Desired
concentration E. All are needed to calculate the LD
121. A 65 year old female presented to the ER due to progressive dyspnea. 284 C. This is a case of an acute decompensated heart
She is a known hypertesive but is poorly compliant with medications. failure. Due to the marked systolic dysfunction as
On history, patient claims to experience orthopnea, paroxysmal evident by a depressed ejection fraction, beta blockers
nocturnal dyspnea and easy fatigability. On PE, her BP is 80/50. There are contraindicated at this time as it may further lower
is prominent neck vein distention. S3 gallop, bibasal crackle and a the cardiac output.
grade 3 bipedal edema were also appreciated. A 2d echo was done
which showed a depressed ejection fraction of 32%. Which of the
following medications should not be given at this time for this patient ?
A. Furosemide B. Digoxin C. Metoprolol D. Dobutamine E. None of the
above
122. A 65 year old man comes to the physician because he awakens to 622 A. BPH. Finasteride is a 5 alpha reductase inhibitor
urintae several times per night and has developed problems starting that inhibits conversion of testosterone to DHT.
and stopping his stream of urine. A biopsy of the prostate shows
enlargement and dilation of the prostate glands but no dysplasia.
Which of the following is the most appropriate pharmacological
treatment for this patient? A. Finasteride B. Flutamide C. Ketoconazole
D. Spirinolactone E. Yohimbine
123. A 65 y/o male on Clonidine for a few months for his hypertension 112 A. Page 17 of Topnotch Handout. For rebound
abruptly discontinued his medication because he felt he was feeling hypertension due to clonidine withdrawal the DOC is
better. After 2 days, during which he had strong headaches. Three days Phentolamine. Clonidine is an alpha 2 agonist,
after withdrawal, the patient had home blood pressure levels of sympathetic outflow blocker. Phentolamine Its primary
140â€"150/95â€"105 mmHg. Ten days after, the patient went to the action is vasodilation due to α1 blockade, but can also
emergency room with a symptomatic hypertensive crisis at 220/130 lead to reflex tachycardia because of hypotension and
mmHg. What is the drug of choice to treat the rebound hypertension? α2 inhibition, which increases sympathetic tone. The
A. Phentolamine B. Hydrochlorthiazide C. Propanolol D. Hydralazine E. primary application for phentolamine is for the control
Nicardipine of hypertensive emergencies.
124. A 67-year old male, on warfarin maintenance after undergoing valve 611 A. Cimetidine inhibits metabolism of warfarin,
replacement surgery, was brought to the ER due to unresolving thereby prolonging its effect.
epistaxis and easy bruising noted for the past week. In asking the
history, the following substances are also being taken by the patient.
Which of them contributed to the patient's condition? A. Cimetidine B.
Digoxin C. Griseofulvin D. Procainamide
125. A 67-year-old male with ischemic heart disease, compliant with his 17 E This is a case of acute renal failure secondary to
medications is admitted for acute renal failure. Labs reveal statin induced rhabdomyolysis. Statins inhibit
hyperkalemia, a rapidly elevating creatinine, and markely increased CK cholesterol synthesis. One of the intermediates of
and myoglobin levels. Which of the following medications he was taking cholesterol synthesis is farnesyl. Farnesyl is needed for
could have precipitated the condition? A. Aspirin B. Carvedilol C. the synthesis of Coenzyme Q, which is important for
Losartan D. Captopril E. Rosuvastatin ATP production in metabolically active cells like the
muscles. Depletion of this can result to
rhabdomyolysis. To prevent this, one can administer
Coenzyme Q10 with statins. Source: Katzung Basic and
Clinical Pharmacology 11th ed p 1122
126. A 67-year-old male with ischemic heart disease, compliant with his 16 E This is a case of acute renal failure secondary to
medications is admitted for acute renal failure. Labs reveal hyperkalemia, statin induced rhabdomyolysis. Statins inhibit
a rapidly elevating creatinine, and markely increased CK and myoglobin cholesterol synthesis. One of the intermediates of
levels. Which of the following medications he was taking could have cholesterol synthesis is farnesyl. Farnesyl is needed
precipitated the condition? A. Aspirin B. Carvedilol C. Losartan D. for the synthesis of Coenzyme Q, which is important
Captopril E. Rosuvastatin for ATP production in metabolically active cells like
the muscles. Depletion of this can result to
rhabdomyolysis. To prevent this, one can administer
Coenzyme Q10 with statins. Source: Katzung Basic
and Clinical Pharmacology 11th ed p 1122
127. A 67-year-old man is hospitalized for treatment of renal insufficiency. 534 C. insulin and glucose >> fastest way to lower
Three days after admission, his pulse is 40/min. An ECG shows tall, tented down serum K
T waves. Serum studies show a sodium level of 134 mEq/L, potassium level
of 6.9 mEq/L, and glucose level of 85 mg/dL. The most appropriate next
step in management is intravenous administration of which of the
following? A) Calcium, furosemide, and 3% saline B) Calcium, insulin, and
digitalis C) Calcium, insulin, and glucose D) Glucose, furosemide, and
phosphate
128. A 67 year old woman, known diabetic for 20 years and maintained on 299 B. Metoclopramide is DOC for diabetic
Gliclazide, complained of severe bloating and post prandial fullness. gastropathy
Evaluation was done and she was assessed to have diabetic gastropathy.
Which of the following medications would be most appropriate for this
case? A. Cimetidine B. Metoclopramide C. Alosetron D. Loperamide E.
Bismuth subsalicylate
129. A 70 year old male who is diagnosed with Colon Cancer Stage IV with 289 D. Imatinib is a tyosine kinase inhibitor used in
metastasis to the liver who is currently on FOLFOX regimen was started on CML. Sorafenib inhibit multiple tyrosne kinase
a monoclonal antibody which binds to the vascular endothelial growth receptors and are primarily used in HCC.
factor (VEGF) receptor. What is the medication that was given to the Trastuzumab inhibits cells that overexpress the Her-
patient? A. Imatinib B. Sorafenib C. Trastuzumab D. Bevacizumab E. 2/neu recepto in Breast CA. Erlotinib inhibits
Erlotinib epidermal growth factor receptor and is used for
non small cell lung CA and pancreatic cancer
130. A 72-year-old man comes for a routine follow-up examination. He has 525 C. COPD and Peripheral arterial disease >>
chronic obstructive pulmonary disease treated with β-adrenergic agonists contraindications for Beta-Blockers
and ipratropium by metered-dose inhaler and mild arterial insufficiency of
the lower extremities treated with aspirin. His blood pressure is 160/60 mm
Hg, pulse is 70/min, and respirations are 12/min. Funduscopic examination
shows arteriovenous nicking. Pedal pulses are decreased bilaterally.
Which of the following antihypertensive drugs is most likely to cause
adverse effects in this patient? A) α2-Adrenergic agonist B) α-Adrenergic
blocking agent C) β-Adrenergic blocking agent D) Angiotensin-converting
enzyme (ACE) inhibitor
131. A 72-year-old man comes to the physician because of a 2-month history of urination 527D.
twice nightly and occasional urinary frequency and urgency. He has a 15-year history of
type 2 diabetes mellitus now moderately well controlled with glyburide. His father was
diagnosed with prostate cancer at the age of 70 years, and his sister died of complications
from systemic lupus erythematosus. His blood pressure is 135/86 mm Hg.
Cardiopulmonary examination shows no abnormalities. Abdominal examination shows no
suprapubic fullness or tenderness. There is mild enlargement of the prostate with no
palpable nodules. His postvoid residual volume is 10 mL. Serum studies show a urea
nitrogen (BUN) level of 45 mg/dL and creatinine level of 3.8 mg/dL. Urine dipstick shows
3+ protein. Which of the following is most likely to have prevented progression of this
patient's renal disease? A) Oral finasteride therapy B) Oral terazosin therapy C) Oral
cyclophosphamide and prednisone therapy D) Oral enalapril therapy
132. A 72 year old man is brought to the physician by his daughter because of a 7 month 522 B.
history of difficulty with memory. He frequently loses his keys and misses appointments
and regular family dinners. He lives alone, but recently family members had to drive him
on errands and help him with daily tasks at home. He has not had difficulty sleeping and
does not use illicit drugs. Mental status examination shows an irritable mood and labile
affect. There is no evidence of depressed mood, anxiety, or hallucinations. Which of the
following is the most appropriate pharmacotherapy for this patient? A) Alprazolam B)
Donepezil C) Dextroamphetamine D) imipramine
133. A 72-year-old man was diagnosed to have glaucoma. Which of the following drugs 537 D. Pilocarpine >> ciliary muscle
induces ciliary muscle contraction thereby opening the trabecular meshwork and contraction >> opening trabecular
increasing the outflow? A) Timolol B) Mannitol C) Epinephrine D) Pilocarpine meshwork and increasing the
outflow
134. A 74-year-old man with a 100-pack/year history of smoking is evaluated for hemoptysis. 29 A. Etoposide is used in the
A computed tomography (CT) scan of the chest shows numerous pulmonary nodules. A treatment of small-cell lung
nodule on the pleural surface is selected for CT-guided biopsy by the interventional carcinomas as well as testicular
radiologist. The biopsy report is small-cell carcinoma of the lung, and chemotherapy tumors. Its mechanism of action is
containing etoposide is started. This drug works by A. Inhibiting topoisomerase II B. related to its ability to inhibit
Inhibiting dihydrofolate reductase C. Alkylating double-stranded DNA D. Stabilizing topoisomerase II. Methotrexate
microtubules, with resultant mitotic arrest E. Causing DNA chain scission and inhibits dihydrofolate reductase.
fragmentation Alkylating agents include
mechlorethamine,
cyclophosphamide, and ifosfamide.
Paclitaxel and docetaxel stabilize
microtubules and thereby disrupt
mitosis. Bleomycin causes DNA chain
scission and fragmentation.
135. A 74-year-old woman who is undergoing chemotherapy for advanced lung cancer 36 B. Oprelvekin has been shown to
presents to the infusion center for her next treatment. Before each treatment her white reduce the need for platelet
count, emoglobin, and platelet counts are checked to make sure she is not experiencing transfusions following
chemotherapy-related cytotoxicity. Her blood sample is run in the analyzer, and her myelosuppressive chemotherapy.
platelet count is reported to be at a dangerously low level. Which medication is her Erythropoietin is used for anemia.
oncologist likely to prescribe in this situation, along with a platelet transfusion? A. Filgrastim and sargramostim are
Erythropoietin B. Oprelvekin C. Filgrastim D. Sargramostim E. Leucovorin used for neutropenia. Leucovorin is
used in patients undergoing
treatment with methotrexate, to
prevent some of its side effects.
136. A 75 year old male diabetic, hypertensive and a diagnosed case of CHF came in due to 472 E Spironolactone, triamterene,
edema and dyspnea. If the patient had hypokalemia, a potassium sparing diuretic is and amiloride are all potassium
indicated. This potassium sparing diuretic inhibits ENaC - epithelial sodium channel in sparing diuretic. Triamterene and
collecting duct. A. Amiloride B. triamterene C. spironolactone D. all of the above E. A and amiloride inhibit the ENaC of
B only collecting duct, while
spironolactone inhibits aldosterone
receptor in collecting ducts.
137. A 75 year old male was brought to the ER due to sudden onset of right sided 285 D. Mannitol is used to decrease the ICP
weakness accompanied by a progressive deterioration in sensorium. On PE, BP in patient's with hemorrhagic stroke. It acts
was elevated at 220/100. Neurologic exam showed a GCS of 11, an MMT of 2/5 on as an osmotic diuretic thus removes water
the both right upper and lower extremities and a positive babinski on the right. A from the intracellular compartment. This
CT scan showed a massive intracerebral hemorrhage involving the left basal rapid fluid shifting may cause hyponatremia
ganglia. A diuretic was started to decrease the patient's intracranial pressure. and pulmonary edema and as the water is
Which of the following is an associated adverse effect of this medication ? A. excreted, hypernatremia may follow.
Ototoxicity B. Hyperlipidemia C. Gynecomastia D. Pulmonary Edema E.
Thrombocytosis
138. A 100kg male patient had elevated LDL and VLDL. What vitamin is also used as 473 C.
antihyperlipidemic drug? A. Vitamin A B. pyridoxine C. niacin D. resin E.
Cholestyramine
139. The absorption of most orally administered drug, which occur in the small 699 A. Answer: A Increasing gastric
intestine, may be enhanced by A. Taking agents that accelerate gastric emptying emptying time allow drugs to reach the
time B. The presence of food C. Stimulation of hepatic microsomal CYP3A4 small intestine sooner, hence increasing the
enzymes D. Increasing intestinal motility rate of drug absorption.
140. Administration of most inhaled anesthetics cause a decrease in the following 551 E
except: A. Arterial blood pressure B. Brain metabolic rate C. Myocardial function
D. Tidal volume E. None of the above
141. Adrenoreceptor blockers such as acebutolol and pindolol are unique for having 266 B.
intrinsic sympathetic activity. What is meant by this characteristic? A. has a
membrane-stabilizing activity B. has partial agonist activity C. has receptor
selectivity D. A and B E. All of the above
142. Adverse events associated with the use of quinolones include all of the following 700 E Answer: E Quinolones inhibit
except: A. Tendinitis and possible tendon rupture B. Seizures C. Arthropathy in topoisomerase II (DNA gyrase) & IV
children D. Clostridium difficile colitis E. Narrowing of QT interval impairing DNA synthesis. Adverse effects
include GI intolerance, antibiotic-
asso.colitis, cutaneous rxns, hepatotoxicity,
prolongation of QT interval and Achilles
tendon rupture.
143. After the oath-taking, you decided to establish a clinic on your province. A 63 655 C. The antidote for organophosphate
year-old farmer was brought to you, soaked in sweat and salivating. When you poisoning is Pralidoxime. BUT the golden
asked his son about the history, you were told that he was found in that condition period of 6 hours had already passed. And
at the middle of the field, which is an 8-hour travel from your clinic, with a bottle of the best medication to give in this case is
Malathion on his side. Assuming you have all the following medications in hand, ATROPINE.
what is the most appropriate to give? A. Pralidoxime B. Physostigmine C. Atropine
D. Scopolamine E. Atracurium
144. . A good drug combination along with thiazides by virtue of its effect on potassium 575 A. Urinary K+ loss can be a problem
retention: a. losartan b. amlodipine c. verapamil d. metoprolol with thiazides. Angiotensin converting
enzyme (ACE) inhibitors and angiotensin
receptor antagonists will attenuate diuretic-
induced loss of potassium to some degree,
and this is a consideration if a second drug
is required to achieve further blood
pressure reduction beyond that attained
with the diuretic alone.
145. Allen Dimo, is a 38 y/o G8P8(6208), known hypertensive and diabetic, turned out 641 B. Captopril is an ACE inhibitor and its
to be pregnant for 5 weeks already. What anti-hypertensive medication should use during gestation may result in IUGR,
you AVOID to give to the patient? A. Propranolol B. Captopril C. Hydralazine D. acute fetal renal failure, PDA, and even fetal
Methyldopa E. None of the above death.
146. All fo the ff are side effects of lithium therapy EXCEPT? A. Tremors B. 68 B. Lithium decreases thyroid function in
Hyperthyroidism C. Nephrogenic diabetic insipidus D. Edema E. Sinus node most patients exposed to the drug and
depression some show symptoms of hypothyroidism.
Tremors is the most common adverse effect
and occurs even on therapeutic doses.
147. All of the following are mechanism of action of propylthiouracil EXCEPT: A. 166 D. SIMILAR TO PREVIOUS BOARD EXAM
inhibits thyroid peroxidase-catalyzed reactions B. Blocks iodine organification CONCEPT/PRINCIPLE. Katzung 11th edition
C. Blocks coupling of the iodotyrosinase D. Block uptake of iodide by the gland page 672. All of the choices are mechanisms of
E. inhibits peripheral deiodination action of PTU except for the blocking of
uptake of iodide by the gland. Inhibition of
thyroid peroxidase-catalyzed reaction and the
blocking of iodine organification.
148. All of the following drugs are considered disease-modifying antirheumatic 169 E ketoprofen is a non selective COX
drugs (DMARDs) except: A. Abatacept B. Azathioprine C. Chloroquine D. inhibitor
Methotrexate E. Ketoprofen
149. All of the following reactions are considered Phase 2 reactions in drug 175 B. other choices are phase 1 reaction
metabolism except: A. glucoronidation B. hydoxylation C. Glutathione
conjugation D. sulfation E. Methylation
150. Allopurinol exerts its theraputic effect by: A. Inhibiting excretion of uric acid at 150 D. Allopurinol inhibits the enzyme xanthine
the PCT B. Increasing purine catabolism C. Competes with uric acid for oxidase which metabolizes purines to form uric
excretion in the kidney D. Inhibiting formation of uric acid E. None of the above acid. Therefore its activity inhibits the formation
of uric acid
151. Among insulin secretagogues, the risk of hypoglycemia is least in? A. 321 A. Biguanides are not insulin
Meglitinides B. 1st generation sulfonylureas C. 2nd generation sulfonylureas D. secretagogues.
Biguanides
152. Among the beta adrenergic blockers, which of the following will less likely to 305 C. pindolol, acebutolol, carteolol,
cause bradycardia and increased VLDL concentration? A. metoprolol B. bopindolol, penbutolol,celiprolol are the beta
nebivolol C. carteolol D. labetalol E. None of the above blockers having also partial b agonist activity (
intrinsic sympathomimetic activity). The
advantage of this property is that it is less likely
to cause elevation of plasma lipids without
affecting its antihypertensive effect. Katzung
11th ed p 159.
153. Among the following Anti-arrhythmics, which of the following has a highest 410 C. K channel blockers like Sotalol can
potential for Torsade de pointes? A. Lidocaine B. Propranolol C. Sotalol D. increase the QT interval thereby increasing the
Procainamide E. Verapamil propensity to develop Torsade de Pointes.
154. Among the inhaled anesthetics, nitrous oxide has the _______ MAC and the ______ 215 C. The MAC is a measure of an inhaled
potency. A. Lowest, lowest B. Lowest, highest C. Highest, lowest D. Highest, anesthetic's potency. The relationship is inverse.
highest E. Intermediate, intermediate
155. Among the thioamide antithyroid drugs, which of the following is the one 165 E SIMILAR TO PREVIOUS BOARD EXAM
preferred for pregnant women because it crosses the placental barrier less CONCEPT/PRINCIPLE. Katzung 11th edition
readily giving lesser effect to the fetus A. potassium iodide B. Ipodate C. page 672. PTU is preferable because it is more
carbimazole D. methimazole E. PTU strongly protein-bound and therefore crosses
the placcenta less readily.
156. Ampicillin is eliminated by first-order kinetics. Which of the following 53 B. "First-order" means that the elimination
statements best describes the process by which the plasma concentration of rate is proportional to the concentration
this drug declines? A. There is only 1 metabolic path for drug elimination B. The perfusing the organ of elimination. The half-life
half-life is the same regardless of the plasma concentration C. The drug is is a constant. The rate of elimination is
largely metabolized in the liver after oral administration and has low proportional to the rate of administration only
bioavailability D. The rate of elimination is proportional to the rate of at steady state. The order of elimination is
administration at all times E. The drug is distributed to only 1 compartment independent of the number of compartments
outside the vascular system into which a drug distributes.
157. Antibiotic which inhibits transpeptidation by binding to 50s subunit, used in the 678 A. Chloramphenicol is a bacteriostatic drug
treatment of meningitis secondary to strep, H.inf, Neisseria neningitidis, causes that stops bacterial growth by inhibiting protein
aplastic anemia as its most common idiosyncratic effect? A. Chloramphenicol synthesis. Chloramphenicol prevents protein
B. Erythromycin C. Linezolid D. Clindamycin E. None of the above chain elongation by inhibiting the peptidyl
transferase activity of the bacterial ribosome.
158. An anticancer agent that is prescribed for melanoma: A. Carmustine B. 455 A. Carmustine is an alkylating agent, cell
Cytarabine C. Vincristine D. Vinblastine E. Cisplatin cycle non- specific that is given for melanoma.
159. An anticoagulant which has a more selective effect on factor 671 C. It is an anticoagulant used to prevent and treat deep vein
Xa? A. hepanin B. Lepirodin C. enoxaparin D. warfarin E. thrombosis or pulmonary embolism, and is given as a
None of the above subcutaneous injection (by a health care provider or the patient).
160. Antifolates sulfamethoxazole and trimethoprim are 436 D.
bactericidal by virtue of their synergistic actions.
Nonetheless, resistence can develop via plasmid-mediated:
A. Decrease in sensitivity of dihydropteroate synthase to
sulfonamides B. Increase in PABA synthesis by the organism
C. Poor intracellular accumulation of the drugs D. All of the
above E. None of the above
161. An antihelminthic agent for strongyloidiasis: A. Nifurtimox B. 456 C. Ivermectin is the drug of choice for strongyloidiasis. It
Praziquantel C. Ivermectin D. Diethylcarbamazine E. intensifies GABA-mediated neurotransmission in nematodes and
Niclosamide immobilizes parasites.
162. Antihyperlipidemic agent which is contraindicated in patients 672 A. Fibrates and cholestipol increases risk of forming
prone to GB stone formation? A. Genifibrozil B. Niacin C. gallstones.
Ezetimibe D. Simvastatin E. None of the above
163. These anti-neoplastic agents are cell-cycle specific, except: 353 B.
A. 5-fluorouracil B. Cyclophosphamide C. Bleomycin D.
Vincristine
164. These are agents or drugs that bind to a different receptor, 121 D. Competitive/Reversible antagonist - bind to receptors in a
producing an effect opposite to that produced by the drug it reversible way without activating the effector system; Non-
is antagonizing: A. Competitive antagonists B. Irreversible competitive/Irreversible antagonist - cause downward shift of the
antagonists C. Chemical antagonists D. Physiologic DRC; Chemical antagonist - interact directly with the drug being
antagonists E. Partial agonists antagonized; PHYSIOLOGIC ANTAGONIST is the answer.
Examples are histamine and epinephrine, propanolol and thyroid
hormone. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT.
165. Aside from its lipid-lowering action, statins are used in 428 B.
coronary artery disease because it can also: A. Vasodilate
stenotic segments of the coronary B. Stabilize
atherosclerotic plaques C. Inhibits platelet aggregation D.
Decrease myocardial oxygen demand
166. Aspirin toxicity results in increased respiratory drive that 431 C. Aspirin is not an inhibitor of electron-transport chain (ETC),
leads to hyperventilation and respiratory alkalosis. Which of but an uncoupler. Uncouplers of oxidative phosphorylation in
these statements is not true about aspirin intoxication? A. It mitochondria inhibit the coupling between the electron transport
is achieved when given at a dose of 150 mg/kg. B. It can and phosphorylation reactions and thus inhibit ATP synthesis
manifest as a pure high anion gap metabolic acidosis in without affecting the respiratory chain and ATP synthase (H(+)-
children. C. It is a known inhibitor of the electron transport ATPase), thus heat is just produced without producing the needed
chain. D. All of the abbove E. None of the above ATPs.
167. Assuming that the patient above is NOT pregnant. What is 642 B. ACE inhibitors block the formation of Angiotensin II which is
the best medication for her? A. Propranolol B. Captopril C. a potent vasoconstrictor of the afferent and efferent Renal blood
Hydralazine D. Methyldopa E. None of the above vessels. When administered to the patient, it prevents diabetic
nephropathy by increasing blood flow to the kidneys.
168. An asthmatic patient whose symptoms occur less than once a 698 B. Answer: B Px’s asthma is classified as intermittent.
week, lasts a few hours to a few days and has nighttime *Review GINA guidelines
symptoms twice a month is best managed with an: A. Inhaled
long-acting B2 agonist at H.S. B. Inlahed short-acting B2
agonist PRN C. Inhaled steroid OD D. Oral B2 agonist TID
169. At the E.R., you saw a 24-yr old woman complaining of 697 C. Answer: C Lab picture: N.meningitides. Tx = Pen G 4 million
severe, acute, generalized headache. PE revealed T 400C units IV q4h
with (+) nuchal rigidity. Her CSF showed gram-neg diplococci
& 200 leukocytes/mm3 (98% PMNs). Administration of which
of these is the next important management: A. IV
sulphonamides B. Intrathecal penicillin C. IV penicillin D.
Intratechal chloramphenicol
170. Baby B. Ulate, suffers from infestation of the “unholy 688 B. Answer: B. SeleCtively inhibits miCrotubule synthesis and
trinity†of roundworms, namely Ascaris lumbricoides, gluCose uptake in nematodes is the meChanism of aCtion of
Trichuris trichiura and Ancylostoma duodenale. What is the Mebendazole, the drug of ChoiCe for AsCariasis (pp. 40 of part2,
mechanism of action of the drug suitable for the Pharmacology, Topnotch Handouts). Notes: • Increases
patient’s condition? A. Increases permeability to permeability to calcium causing muscle paralysis, vacuolization and
calcium causing muscle paralysis, vacuolization and death. death â€" Praziquantel (DOC for Trematodes and Cestodes) •
B. Selectively inhibits microtubule synthesis and glucose Immobilizes the parasite and alters their surface structure displacing
uptake in nematodes. C. Immobilizes the parasite and them and making them more susceptible to destruction by host
alters their surface structure displacing them from the defense mechanisms â€" Diethylcarbamazine (DOC for Filariasis)
tissues and making them more susceptible to destruction • Intensifies GABA-mediated neurotransmission in nematodes
by host defense mechanisms. D. Intensifies GABA- immobilizing the parasite â€" Ivermectin (DOC for Strongyloidiasis)
mediated neurotransmission in nematodes immobilizing • “Unholy trinity†of roundworms â€" Ascaris, Whipworm
the parasite. and Hookworms
171. B - Blocker with intrinsic sympathomimetic activity? A. 668 A. Acebutolol and Pindolo has ISA.
Acebutolol B. Atenolol C. esmolol D. metroprolol E. None
of the above
172. Before intubation, prior to surgery, a 66 year-old male 646 E Succinylcholine is being metabolized by the enzyme
Asthmatic was injected with Succinylcholine. He was noted pseudocholinesterase, hence deficiency or lack of this enzyme will
to remain apneic and paralyzed for an extended period of lead to extended drug effect of Succinyhlcholine.
time. The patient most likely A. Received an excessive
dose of the drug B. has been recieving aminoglycosides C.
has impaired renal function D. had an allergic reaction E.
has pseudocholinesterase deficiency
173. Being an IM resident, you are assigned to watch over a 660 C. Ondansetron is a 5TH-3 anatagonist and is the drug of
patient who is undergoing chemotherapy. Which drug is choice for post-chemo vomiting.
best to be given to prevent post-chemo vomiting? A.
Metoclopramide B. Hyoscine N-Butyl-bromide C.
Ondansteron D. Methylergonovine E. Methyrgine
174. The best treatment option for an obese patient with Type 2 459 B. Metformin is a biguanide which is the first-line treatment for
Diabetes Mellitus is: A. Glibenclamide B. Metformin C. Type 2 DM, also a drug of choice for obese diabetics.
Repaglinide D. Acarbose E. Insulin
175. Beta-lactamase inhibitors are usually given with beta- 610 B. Synergism is giving two active drugs and the combined effect
lactam containing antibiotics, such as penicillins. This is is greater than the sum of their effects (1+1=3). Potentiation is the
done to produce a favorable drug interaction, specifically: addition of an inactive drug to an active drug, leading to increased
A. Synergism B. Potentiation C. Additive D. Antagonism E. effect of the active drug (1+0=3).
None of the above
176. Blocks the final common pathway of platelet aggregation 60 B. ASA - inhibits COX; Abciximab - GPIIBIIIA inhibitor;
A. ASA B. Abciximab C. Clopidogrel D. Both A and B E. Clopidogrel - ADP receptor inhibitor
AOTA
177. The Board of Medicine decided to change the program of 685 C. Answer: C. Loperamide (pp. 713 [.pdf file], Katzung
examination for the August 2013 Physician Licensure Pharmacology, 9th edition) â€" must know, MPL 1.0
Examination (PLE) changing the first subject to
Pharmacology. Because of this, a non-prepared Non-
Topnotch examinee suddenly got an attack of diarrhea
while on his way to the testing site. If he will stop at a
nearby drugstore to buy an over-the-counter opioid with
an antidiarrheal action, he will be asking for A. Codeine B.
Dextromethorphan C. Loperamide D. Diphenoxylate
178. By which mechanism does 113 B. Page 19 of Topnotch Handout.ACE inhibitors produce vasodilation by inhibiting the
Angiotensin converting enzyme formation of angiotensin II. ACE also breaks down bradykinin (a vasodilator substance).
inhibitors cause cough? A. By Therefore, ACE inhibitors, by blocking the breakdown of bradykinin, increase bradykinin
inhibiting ACE and formation of levels, which can contribute to the vasodilator action of ACE inhibitors. The increase in
angiotensin II B. By blocking the bradykinin is also believed to be responsible for a troublesome side effect of ACE inhibitors,
breakdown of bradykinin C. By namely, a dry cough. Angiotensin II also facilitates the release of norepinephrine from
facilitating the release of sympathetic adrenergic nerves and inhibits norepinephrine reuptake by these nerves. This
norepinephrine from sympathetic effect of angiotensin II augments sympathetic activity on the heart and blood vessels. ACE
adrenergic nerves D. By inhibiting inhibitors promote renal excretion of sodium and water (natriuretic and diuretic effects) by
norepinephrine reuptake E. By blocking the effects of angiotensin II in the kidney and by blocking angiotensin II stimulation
blocking angiotensin II stimulation of aldosterone secretion. This reduces blood volume, venous pressure and arterial pressure.
of aldosterone secretion
179. A cancer patient is scheduled for 178 C. dexrazoxane is a rescue therapy for doxorubicin; mesna is for cyclophosphamide;
methotrexate chemotherapy. amifostine is for cisplatin
Which of the following rescue
agent/s is used to alleviate the
toxic effect of the drug? A.
Dexrazoxane B. Mesna C.
Leucovorin D. Amifostine E. None
of the above
180. Causes analgesia, amnesia and 676 B. Dissociative anesthesia
catatonia with retained
conciousness? A. Midazolam B.
Ketamine C. Thiopental D. Fentanyl
E. None of the above
181. Ceftriaxone is commonly given as 558 C. Organisms NOT covered by cephalosporins are L.A.M.E.: Listeria monocytogenes,
an empiric antibiotic in the Atypicals (chlamydia, mycoplasma), MRSA, and Enterococci.
treatment of bacterial meningitis.
However, it must be noted that this
antibiotic will NOT cover the
following etiologic agent in
meningitis: A. Neisseria
meningitidis B. Streptococcus
pneumoniae C. Listeria
monocytogenes D. Group B
streptococcus E. C and D
182. A child was brought to you with 73 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Among the choices only
severe itching due to multiple fexofenadine is a 2nd generation antihistamine. Montelukast is a leukotriene receptor
insect bites. The mother requested antagonist. All the others arer 1st gen antihistamines
for a non sedating anti histaminic
agent. What drug can you give? A.
Chlorpheniramine B. Montelukast
C. Meclizine D. Fexofenadine E.
Hydroxyzine
183. Chlorpromazine may be used not 458 A. Chlorpromazine may be used not only in treating schzophrenia but is also effective in
only in treating schzophrenia but reducing nausea and vomiting.
is also effective in: A. Reducing
nausea and vomiting B. Allergies C.
Hypertension D. Treating bipolar
disorders E. Sleep disorders
184. Chronic administration of phenobarbital causes metabolic tolerance via 152 C. Stimulation of the microsomal ethanol oxidizing
which mechanism? A. Stimulation of aldehyde dehydrogenase B. system is implicated in the development of tolerance
Stimulation of alcohol dehydrogenase C. Stimulation of MEOS D. to phenobarbital aside from playing a minor role in
Stimulation of Monoamine oxidase E. None of the above individuals with chronic alcoholism. The rest have no
role in the development of tolerance to phenobarbital
185. Cimetidine is used as anti-PUD drug and it acts as a/an? A. 653 E Cimetidine is a H2 blocker
mucuprotectant B. H1 blocker C. pH neutralizer D. A and B E. None
186. A Class I-B anti-arrhythmic drug which has a high degree of 510 D. Katzung 10th ed., 225 Quinidine- Class IA,
effectiveness in arrhythmias associated with acute myocardial associated with cinchonism; Flecainide- Class IC, very
infarction. A. Quinidine B. Flecainide C. Propranolol D. Lidocaine E. effective in suppressing premature vebtricular
Amiodarone contractions; Propranolol-Class 2, Amiodarone-broad
spectrum of actions
187. Clomiphene acts to induce ovulation by: A. Diminishing estrogen 356 A.
mediated negative feedback at the pituitary B. Increasing the action of
estrogen in the hypothalamus C. Increasing the action of estrogen in the
ovary D. Increasing the amount of estrogen receptors
188. Clomiphene is a selective estrogen-receptor modulator commonly used 392 B. C refers to leuprolide when administered in
to induce ovulation in patients undergoing assisted reproduction pulsatile fashion.
therapy. Which of the following best describes its mechanism of action?
A. It potentiates the action of FSH and LH on the ovaries. B. It acts as a
partial agonist in the pituitary to block negative feedback from
estradiol. C. It acts as a GnRH analogue that increases the release of
FSH and LH from the pituitary. D. It inhibits the release of inhibin from
ovarian follicles, thus facilitating FSH and LH secretion. E. It is an LH
analogue and mimics the physiologic LH surge when given just before
ovulation.
189. Clopidogrel exerts its antithrombotic effect through which of the 612 A. Clopidogrel works by irreversibly inhibiting a
following mechanisms: A. Irreversible inhibition of ADP receptor B. receptor called P2Y12, an adenosine diphosphate
Inhibition of thromboxane synthesis C. Reversible blockade of (ADP) chemoreceptor on platelet cell membranes.
glycoprotein IIb/IIIa D. Conversion of plasminogen to plasmin E.
Posttranslational modification of vitamin K-dependent clotting factors
190. Cocaine has which of the following mechanism of action? A. Promotes 420 E
Adrenergic Synthesis B. Inhibits Adrenergic Storage C. Promotes
Adrenergice Release D. Inhibits Adrenergic Metabolism/Degradation E.
Inhibits Adrenergic Reuptake
191. Colchicine is a widely used drug in the treatment of gout. Which among 170 A. B. are uricosuric agents like probenecid and
the following describes the mechanism of action of the drug? A. Binding sulfinpyrazone… C. allopurinol….D. Febuxostat
to intracellular tubulin to excert anti inflammatory effect B. It increases SIMILAR TO PREVIOUS BOARD EXAM
the excretion of uric acid through urine C. inhibits xanthine oxidase CONCEPT/PRINCIPLE
catalized reactions D. non purine xanthine oxidase inhibitor E. none of
the above
192. A college friend consults you regarding the suitability of the medication 684 A. Answer: A. A drug whiCh inhibits the release of
given by his doctor for severe hypertension. He complains of postural norepinephrine from sympathetiC nerve endings. The
and exercise hypotension (“dizzinessâ€), some diarrhea, and adverse effects described pertains to Guanethidine
problems with ejaculation during sexual activity. Given those adverse (pp. 237, 241, 244 and 251 [.pdf file], Katzung
effects stated, which of the following mechanisms of action is most Pharmacology, 9th edition). Notes: • A drug which
likely related to the drug described by your friend? A. A drug which decreases blood pressure as a result of a decrease in
inhibits the release of norepinephrine from sympathetic nerve endings. cardiac output due to its nonselective β-blockade â€"
B. A drug which decreases blood pressure as a result of a decrease in Propranolol • An oral vasodilator which relaxes
cardiac output due to its nonselective β-blockade. C. An oral smooth muscles of arterioles, thereby decreasing the
vasodilator which relaxes smooth muscles of arterioles, thereby systemic vascular resistance â€" Hydralazine • A
decreasing the systemic vascular resistance. D. A drug which inhibits the drug which inhibits the converting enzyme peptidyl
converting enzyme peptidyl dipeptidase that hydrolyzes angiotensin I dipeptidase that hydrolyzes angiotensin I to
to angiotensin II and also inactivates bradykinin. angiotensin II and also inactivates bradykinin â€"
Captopril

193. The combination of metronidazole and alcohol will most 131 D. Metronidazole has a disulfiram-effect, so that nausea and
likely cause? A. Ataxia B. Blurring of vision C. Dizziness D. vomiting can occur if alcohol is ingested during therapy.
Nausea and vomiting E. Pancreatitis (Katzung) SIMILAR TO PREVIOUS BOARD EXAM CONCEPT.
194. A commercial product for colds contain the following: 218 C. Phenylephrine constricts blood vessels through stimulation
Phenylephrine, chlorpheniramine, and paracetamol. Which of adrenergic receptors. This acts as a decongestant.
acts as the decongestant? A. Paracetamol B.
Chlorpheniramine C. Phenylephrine D. Both
chlorpheniramine and phenylephrine E. This product does
not contain a decongestant.
195. A condition characterized by the acute onset of 573 A. Due to the association with Reye's syndrome, aspirin and
encephalopathy, liver dysfunction, and fatty infiltration of other salicylates are contraindicated in children and young adults
the liver and other viscera known as Reye's syndrome is less than 20 years old with fever associated with viral illness.
associated with what drug? a. Aminosalicylate b. Long chain Reye's syndrome is characterized by the acute onset of
fatty acids c. Indomethacin d. nitric oxide encephalopathy, liver dysfunction, and fatty infiltration of the liver
and other viscera
196. A condition where there is depletion of needed substrates as 421 C. Idiosyncratic means unusual drug reponse, infrequently
a result of continuous activation by a drug and hence observed in most patients; tolerance on the other hand, refers to
decrease in responsiveness, such as in chronic nitroglycerin decrease in the intensity of response to drug as a consequence
use, is known as: A. Tachyphylaxis B. Idiosyncratic response of continued administration.
C. Tolerance D. Resistance
197. Constipation is one of the major side effects of this drug: A. 495 B. Aluminum hydroxide causes constipation (ALang tae).
Magnesium hydroxide B. Aluminum hydroxide C. Omeprazole Magnesium hydroxide causes diarrhea (MaGtatae). Colchicine
D. Colchicine also causes diarrhea if taken in excess.
198. A COPD patient with severe concomitant heart condition is 274 E Ipratoropium is an anticholinergic used in COPD because of
being prescribed a drug that will relieve his dyspnea and less cardiac effects
shortness of breath. Which of the following bronchodilators
will be the primary choice? A. Salmeterol B. Salbutamol C.
Terbutaline D. Atropine E. Ipratropium
199. The danger of long term use of propylthiouracil is: A. 139 D. The most dangerous complication of thioamides is
Cholestatic jaundice B. Exfoliative dermatitis C. Liver failure agranulocytosis, (granulocyte <500) an infrequent but potentially
D. Agranulocytosis E. Arthralgia fatal adverse reaction. Hepatitis can also be fatal. The most
common adverse effect of PTU is maculopapular rash. (Katzung).
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT.
200. Dantrolene is the drug of choice to treat malignant 625 A.
hyperthermia caused by succinylcholine because? A. It
blocks Ca release from sarcoplasmic reticulum B. It induces
contraction of skeletal muscle C. It increases the rate of
succinylcholine metabolism D. Succinylcholine binding to
nicotinic receptors is antagonized by dantrolene E.
Dantrolene acts centrally to reduce fever.
201. Dicycloverine is used for: A. Paralytic ileus B. Biliary colic C. 129 C. Dicycloverine is an antispasmodic, prescribed for
Intestinal spasm D. Constipation E. Urinary retention gastrointestinal tract spasm and irritable bowel syndrome. It
blocks the activity of acetylcholine on muscarinic receptors. It
should not be used in patients with PARALYTIC ILEUS,
myasthenia gravis, narrow angle glaucoma, enlarged prostate, or
pyloric stenosis. Constipation is a side-effect of this drug. SIMILAR
TO PREVIOUS BOARD EXAM CONCEPT.
202. Disruption of cell membrane is not seen with A. Amphotericin 48 B. Fluconazole inhibits ergosterol syntehsis
B B. Fluconazole C. Nystatin D. Polymxin B E. Griseofulvin
203. Disseminated intravascular coagulation (DIC) is a condition 620 E DIC clinical findings: â†" Fibrinogen, â†' fibrin split products,
characterized by widespread stimulation of thrombosis. â†" platelets, â†' PT, â†' PTT, fragmented red blood cells on
Which of the following is NOT consistent with the clinical peripheral smear
findings in DIC? A. Increased PTT B. Increased PT C.
Decreased fibrinogen D. Increased fibrin split products E.
None of the above
204. Dissociative anesthesia is effectively achieved by the 214 B.
combination of: A. Thiopental, diazepam, ketamine B.
Ketamine, nitrous oxide, fentanyl C. Succinylcholine,
thiopental, diazepam D. Nitrous oxide, halothane,
fentanyl E. Succinylcholine, halothane, thiopental
205. Disulfiram causes extreme discomfort in patients who 512 B. Katzung 10th ed., 371. this was SIMILAR TO PREVIOUS BOARD
drink alcoholic beverages by inhibitting which enzyme EXAM CONCEPT/PRINCIPLE
resulting to accumulation of acetaldehyde causing
flushing, throbbing headache, nausea, vomiting,
sweating, hypotension and confusion within few hours
of drinking alcohol: A. alcohol dehydrogenase B.
aldehyde dehydrogenase C. alcohol decarboxylase D.
aldehyde decarboxylase E. none of the above
206. Doxylamine is an ethanolamine H1 antagonist drug 681 C. Answer: C. Vitamin B6 (pp. 389 [.pdf file], Katzung Pharmacology,
previously utilized as a possible treatment of nausea 9th edition) Notes: Several H1 antagonist drugs have been studied for
and vomiting of pregnancy. Now, this drug is still possible use in treating "morning sickness." The piperazine derivatives
available over-the-counter as sleep aid. What B- were withdrawn from such use when it was demonstrated that they have
vitamin is a component of Doxylamine? A. Vitamin B2 teratogenic effects in rodents. Doxylamine, an ethanolamine H1
B. Vitamin B3 C. Vitamin B6 D. Vitamin B12 antagonist, was promoted for this application as a component of
Bendectin, a prescription medication that also contained pyridoxine. *
SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
207. a dreadful side effect, although not common, of this 571 B. Clozapine is notorious for its side effect of agranulocytosis,
atypical antipsychotic is agranulocytosis. a. Quetiapine although uncommon
b. Clozapine c. Risperidone d. Aripiprazole
208. A drug is 90% cleared by the liver and 10% by the 106 D. Page 7 of Topnotch Handout. Normal creatinine clearance for
kidney. The normal dosage of the drug is 500mg/d. If healthy men is 97-137 mL/min. Normal creatinine clearance for healthy
this drug is to be given for a patient with a creatinine women is 88-128 mL/min. In this patient his crea clearance is only
clearance of 30ml/min, what should be the corrected 30ml/min. Hence to compute for the corrected dose the formula is
dose: A. 15 B. 50 C. 450 D. 465 E. 500 Corrected dose= Average dose (aaplied only to the part of the dose
cleared by the kidney) x patient's crea clearance/ 100ml/min. In this
case 500 x 0.10= 50; 30/100= 0.3; ).3 x 50= 15. Corrected dose is 500 x
0.90=450+ 15=465.
209. the drug of choice for Chagas disease acts through 318 B. the drug of choice for Chagas disease or american
what mechanism of action? A. Inhibit mitochondrial trypanosomiasis is nifurtimox. Its anitprotozoan action is due to inhibition
electron transport B. Trypanothione reductase of trypanothiane reductase. A- atovaquone MOA ( use for PCP and
inhibition C. Suicide substrate of ornithine chloroquine resistant malaria) C- eflornithine ( use in cerebral stage of
decarboxylase D. Inhibits enzyyme sulfhydryl groups african trypanosomiasis). D- melarsoprol ( african sleeping sickness).
E. none of the above SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE Katzung
review p 438-439.
210. The drug of choice for clostridium tetani infection 561 B. The use of penicillin (10â€"12 million units IV, given daily for 10
because of the drug's excellent antimicrobial activity days) has been recommended, but metronidazole (500 mg every 6 h or
and the absence of the GABA-antagonistic activity a. 1 g every 12 h) is preferred by some experts on the basis of this drug's
Penicillin G b. Metrobidazole c. Vancomycin d. excellent antimicrobial activity and the absence of the GABA-
Chloramphenicol antagonistic activity seen with penicillin.
211. Drug of choice for hydatid disease? A. Niclosamide B. 186 C. Albendazole is the drug of choice for hydatid disease and
Praziquantel C. Albendazole D. Mebendazole E. cysticercosis.
Pyrantel pamoate
212. The drug of choice for leptospirosis is: A. Doxycycline 484 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
B. Penicillin C. Ceftriaxone D. Erythromycin The rest of the choices are alternate drug choices for leptospirosis.
213. The drug of choice for paroxysmal Supraventricular 124 E SIMILAR TO PREVIOUS BOARD EXAM CONCEPT.
tachycardia is: A. Procainamide B. Verapamil C.
Amiodarone D. Lidocaine E. Adenosine
214. Drug of choice for partial seizures? A. Diazepam B. 675 D. Diazepam - s. epilepticus Phenobarbital - s. epilepticus Valproic
Phenobarbital C. Valproic Acid D. Carbamazepine E. Acid - absence, myoclonic Carbamazepine - partial seizures
None of the above
215. Drug of choice for prostatic carcinoma? A. gemcitabine B. Paditaxel C. 680 D. Leuprolide acts as an agonist at pituitary GnRH
Cisplatin D. Leuprolide E. None of the above receptors. By interrupting the normal pulsatile
stimulation of, and thus desensitizing, the GnRH
receptors, it indirectly down regulates the secretion
of gonadotropins luteinizing hormone (LH) and
follicle-stimulating hormone (FSH), leading to
hypogonadism and thus a dramatic reduction in
estradiol and testosterone levels in both sexes.
216. The drug of choice for the treatment of bladder and bowel atony is: A. 609 D. Bethanechol is a muscarinic agonist that is
Neostigmine B. Metoclopramide C. Pilocarpine D. Bethanecol E. None of administered orally to promote GI and bladder
the above motility, usually used in post-op ileus and diabetic
neurogenic bladder.
217. Drug of choice for uncomplicated essential hypertension? A. 667 C. Thiazide diuretics are first line of treatment for
Furosemide B. Metoprolol C. HCTZ D. Captopril E. None of the above uncomplicated hypertension.
218. These drugs act by preventing the binding of the agonist molecule to 501 A. Katzung 10th ed, p. 11 - Pharmacologic
the receptor but do not activate generation of a signal: A. anatgonists bind to the receptor preventing agonist
Pharmacologic antagonists B. Inverse agonists C. Competitive agonists binding thereby blocking the agonist's biologic
D. Partial agonists E. Orphan drug actions.
219. These drugs increase the outflow of aqueous humor used in glaucoma 193 A. Drugs that increase outflow of aqueous humor:
except? A. timolol B. latanoprost C. epinephrine D. pilocarpine E. pilocarpine, physostigmine, latanoprost, epinephrine.
physostigmine Drugs that decrease aqueous humor secretion;
mnemonics- TAMAD: Timolol, Acetazolamide,
Mannitol, Apraclonidine, Dorzolamide.
220. Drugs like quinidine, procainamide and disopyramide are very useful in 449 E Drugs like quinidine, procainamide and
treatment of: A. Congestive heart failure B. Hypertension C. disopyramide are very useful in treatment of
Thyrotoxicosis D. Status asthmaticus E. Arrhythmia arrhythmia.
221. Drugs which undergo zero order kinetics, except? A. Warfarin B. Heparin 663 C. WHATPET - Warfarin, Heparin, ASA,
C. Hydralazine D. Aspirin E. None of the above Tolbutamide, Phenytoin, Ethanol, Theophylline
222. The drug that is used for cardiogenic shock as a last resort. A. 470 D.
epinephrine B. dopamine C. dobutamine D. norepinephrine E.
Vasopressin
223. A drug used for treatment of advanced prostatic carcinoma by 358 C. Leuprolide combined with an androgen
producing continuous gonadal suppression: A. Ketoconazole B. receptor antagonist such as flutamide is the primary
Testosterone undecanoate C. Leuprolide D. Cyproterone acetate medical therapy for advanced prostate cancer and is
as effective as surgical castration. Reference:
Katzung. Basic and Clinical Pharmacology, 11th ed. p.
654
224. A drug with diuretic activity is being studied based on its effects on 271 D. Thiazide increases Na and K excretion and
electrolyte levels in the urine. It was found to moderately increase urine causes metabolic alkalosis. It increases Ca
NaCl and urine K while decreasing urine Ca with associated slight reabsorption
increase in body pH and minimal change in urine HCO3-. This drug has
characteristics similar to that of? A. Loop diuretic B. Carbonic anhydrase
inhibitor C. K-sparing diuretic D. Thiazide diuretic E. Osmotic diuretic
225. Drug X has greater affinity for albumin than Drug Y. Considering all 213 D. Only the free, unbound drug can interact with
other parameters are the same, what significant drug-drug interaction is receptors, exert biologic activity, and be excreted by
expected to take place when both drugs are administered the kidneys.
simultaneously? A. Drug X will have a higher plasma concentration than
Drug Y. B. Drug Y will not be filtered by the renal glomerulus. C. Drug Y
will not be available to interact with its receptors in the tissues. D. The
free plasma drug concentration of Drug Y will increase. E. Drug X can
exert its full biologic activity.
226. Drug X is currently undergoing clinical 376 A. Phase 1- tested on small number of healthy volunteers in order to find the
trials with it being tested on a small maximum tolerated dose and prevent severe toxicity; Phase 2- studied on a modest
number of volunteers with the goal number of patients with the target disease to test efficacy; Phase 3- evaluated on a
being to find the maximum tolerated large number of patients to further establish efficacy and safety, usually a RCT with
dose. It is now on what phase of clinical blinding and crossover; Phase 4- post marketing surveillance Katzung 12th ed pg 75
testing? A. Phase 1 B. Phase 2 C. Phase 3
D. Phase 4 E. Phase 5
227. During anaphylaxis, administration of 301 B. physiologic antagonist binds to a different receptor molecules producing an
IM epinephrine is essential because of effect opposite to that produced by the drug it antagoniszes. It differs from a
its bronchodilatory effect in the lungs. pharmacologic antagonist, which interacts with the same receptors as the drug it is
How does epinephrine acts to produce inhibiting. the antagonism of bronchoconstrictor effect of histamine ( through histamine
such an effect in this particular receptors) by epinephrine bronchodilator action ( beta receptors). chemical antagonist
condition? A. Chemical antagonist B. - reacts directly with the drug being antagonized to remove it or to prevent it from
physiologic antagonist C. partial reaching its target. Katzung review 8th ed p 13.
agonist D. noncompetitive antagonist E.
none of the above
228. Early morning hyperglycemia 677 C. Waning of insulin dose - low dose insulin Dawn Phenomenon - wrong type of
characterized by development of insulin Somogyi Effect - high dose of insulin
hypoglycemia around 3AM and pre-
breakfast hyperglycemia:? A. Waning
of insulin dose B. Dawn Phenomenon C.
Somogyi Effect D. Combined Waning +
Dawn E. None of the above
229. Early morning hypoglycemia is a 415 A.
challenge among physicians in treating
diabetic patients. When a diabetic
patient monitors his Glucose at 3 AM
revealing Hypoglycemia with a
Hyperglycemic 7 AM CBG, This effect is
termed as: A. Somogyi B. Waning C.
Dawn D. Dawn and Waning E. Somogyi
and Waning
230. Ephedrine can cause increased blood 31 C. Ephedrine acts indirectly to release norepinephrine from nerve terminals, causing
pressure by A. Indirect action on effects similar to those of catecholamines, including elevated blood pressure. This
cholinergic receptors B. Blockade of potentially dangerous agent has been removed from the OTC market because of an
adrenergic receptors C. Stimulation of increasing number of deaths being reported as caused by this agent. An example of an
release of epinephrine D. Inhibition of indirect- acting cholinergic agonist is edrophonium, which is used for diagnosis of
reuptake of catecholamines E. Direct myasthenia gravis. Some adrenoceptor blockers, such as atenolol, are used for the
action on dopamine receptors treatment of hypertension. Catecholamine reuptake inhibition is a property of some
antidepressant medications. Dopamine receptor agonists are used in the treatment of
Parkinson disease.
231. Escitalopram is an antidepressant agent 197 A. Drugs that belong to SSRI: fluoxetine, sertraline, paroxetine, fluvoxamine,
that belongs to which drug class? A. citalopram, escitalopram
SSRI B. SNRI C. TCA D. MAOI E. 5HT2
antagonist
232. Excessive use of Nitroprusside may 643 A. Methylene blue
result in Methemoglobinemia. The
antidote for this condition is? A.
Methylene blue B. Silver Nitrate C. 100%
oxygen D. Dialysis E. Blood transfusion
233. Factor/s that influence/s passage of 441 E All are faCtors that influenCe passage of drugs through Cell membranes. Lipid
drugs through cell membranes: A. solubility is the most important limiting factor for permeation of drugs because cells are
Presence of pores in the membrane B. covered by lipid membranes.
Amount of protein binding C. Lipid
solubility D. pH E. All of the above
234. A few substances that are almost completely inert in the 682 B. Answer: B. Antiflatulent (pp. 1520 [.pdf file], Katzung
chemical sense nevertheless have significant pharmacologic Pharmacology, 9th edition) Notes: Some antacid preparations
effects. An example of these substances is Simethicone, which is include simethicone, an antiflatulent to relieve symptoms of
included in many antacid preparations in order to act as A. bloating and pressure. *SIMILAR TO PREVIOUS BOARD EXAM
Antispasmodic B. Antiflatulent C. Antiemetic D. Antiminth CONCEPT/PRINCIPLE
235. Fifith Generation cephalosporin with activity against 59 B. Both A and B are fifth generation but only B has activity
Pseudomonas aeruginosa A. Ceftraline B. Ceftabiprole C. against Pseudomonas.
Ceftazidime D. Cefepime E. Cefixime
236. Flumazenil may be effective in patients who overdosed on the 553 C. Most S-H drugs facilitate the actions of GABA, a major
following sedative-hypnotics except: A. Alprazolam B. Zolpidem inhibitory transmitter. Benzodiazepines potentiate GABA by
C. Thiopental D. Midazolam E. Lorazepam increasing frequency of Cl ion channel opening; its action is
blocked by flumazenil, a BZ receptor antagonist. Flumazenil,
on the other hand, does NOT block the effects of barbiturates.
237. Fluoxetine (prozac) is one of the most commonly use 167 A. SIMILAR TO PREVIOUS BOARD EXAM
antidepressants worldwide. Which of the following is the CONCEPT/PRINCIPLE. Katzung 11th edition page 513. SSRIs
mechanism of action of the drug? A. Selectively inhibits like Fluoxetine are agents that have their primary action the
serotonin reuptake B. Inhibits serotonin and norepinephrine inhibition of serotonin transporter.
reuptake C. selectively inhibits reuptake of norepinephrine D.
directly antagonize serotonin E. directly antagonize epinephrine
238. Flushing is a unique side effect of Nicotinamide used in 569 B. The cutaneous effects include flushing and pruritus of
hyperlipidemia. The drug that may be used to counter this effect the face and upper trunk, skin rashes, and acanthosis nigricans.
is: a. Acetaminophen b. Aspirin c. Chlorphenamine d. Arginine Flushing and associated pruritus are prostaglandin-mediated.
Taking an aspirin each day alleviates the flushing in many
patients.
239. The following antibiotics eliminate intestinal flora thus causing 146 D. Erythromycin is not associated with
pseudomembranous colitis except A. 3rd gen cephalosporins B. pseudomembranous colitis
Aminoglycosides C. Clindamycin D. Erythromycin E. None of the
above
240. The following anti-convulsant is not sedating A. Phenobarbital 51 B. Phenytoin is the oldest non-sedating anti-seizure drug
B. Phenytoin C. Clonazepam D. Gabapentin E. NOTA
241. The following anti-tuberculosis drugs are correctly paired with 328 B. Rifampicin inhibits DNA dependent RNA polymerase
their mechanisms of action, except: A. INH - inhibits mycolic acid
synthesis B. Rifampin - inhibits RNA dependent DNA polymerase
C. Ethambutol - inhibits arabinosyl transferase D. none of the
above
242. The following are adverse effects of amiodarone except? A. 189 E Adverse effects of amiodarone: bradycardia, heart
hyperthyroidism B. hypothyroidism C. photodermatitis D. block, pulmonary fibrosis, elevated liver enzymes,
pulmonary fibrosis E. None of the above photodermatitis, corneal microdeposit, halos in peripheral
visual field, optic neuritis, hypothyroidism (blocks the
peripheral conversion of T4 to T3) and hyperthyroidism
(because it is also a potential source of large amounts of
inorganic iodine)
243. The following are bactericidal, except: A. TMP-SXZ B. 327 E All drugs stated are bactericidal. TMP and SXZ alone
Vancomycin C. Metronidazole D. Cefalexin E. none of the above are bacteriostatic but are bactericidal when in combination.
244. The following are true of sulfonamides except: A. Sulfonamides are structural 519 B. It is interesting that rickettsiae are not
analogs of p-aminobenzoic acid and act by inhibitting dihydropteroate synthase inhibitted by sulfonamides but are actually
and folate production. B. Sulfonamides are very effective against rickettsiae. C. stimulated in their growth. Katzung 10th ed.,
Combination of a sulfonamide with an inhibitor of dihydrofolate reductase 763.
provides synergistic activity because of sequential inhibition of folate synthesis.
D. trimethoprim-sulfamethoxazole is the drug of choice for infections such as
Pneumocystis jiroveci pneumonia. E. Sulfadiazine with pyrimethamine is first-line
therapy for treatment of acute toxoplasmosis.
245. The following drugs accelerate substrate metabolism causing a decrease in the 690 D. Answer: D. Cimetidine (pp. 8 [part 1],
pharmacologic action of the co-administered drug, except; A. Griseofulvin B. Pharmacology, Topnotch Handouts; pp. 77
Rifampicin C. Ethanol D. Cimetidine [.pdf file], Katzung Pharmacology, 9th
edition). The question defines a CYP450
Inducer. The only CYP450 inhibitor among
the choices is Cimetidine.
246. The following drugs are included in the ABVD regimen for Hodgkin’s 689 A. Answer: A. Vinblastine (pp 41 [part 1],
Lymphoma, except: A. Vinblastine B. Doxorubicin C. Dacarbazine D. Oncovin E. Pharmacology, Topnotch Handouts). Notes:
Bleomycin A â€" Adriamycin (Doxorubicin) B â€"
Bleomycin V â€" Vincristine (Oncovin) D â€"
Dacarbazine
247. The following drugs' efficacy is directly related to time above the minimal 326 D. What is described is the time-
inhibitory concentration and becomes independent of concentration once the dependent killing property for which
MIC has been reached, except? A. Penicillins B. Cephalosporins C. A & B D. none penicillins and cephalosporins are known.
of the above Aminoglycosides are known for their
concentration-dependent killing.
248. The following drugs have concentration dependent killing, except A. 43 C. Concentration dependent or dose-
Aminoglycosides B. Fluoroquinolones C. Penicillin D. Metronidazole E. NOTA dependent killing means that the higher the
concentration, the greater the bactericidal
effect. Examples are aminoglycosides,
fluoroquinolines, daptomycin,
metronidazole, streptogramins. Penicillin
employs time-dependent killing
249. The following drug/s is/are used to augment labor: A. Oxytocin B. Misoprostol C. 359 A.
Methyl ergonovine D. All of the above
250. The following drugs promote induction of liver CYP enzymes except ? A. 303 D. CYP inducers enhances drug
Rifampin B. Carbamazepine C. Phenylbutazone D. Disulfiram E. Glutethimide metabolism. Ex. Benzopyrene,
carbamazepine, chlorcyclizine, glutethimide,
griseofulvin, phenobarbital, phenylbutazone,
phenytoim, rifampin, ritonavir ( chronic
administration, acute -acts as inhibitor), st
johns wort. Katzung 11th ed p 64-65.
251. The following has increased bioavailabity when taken with food, except A. 42 E All of the choices has increased
Cefuroxime B. Fusic acid C. Nitrofuratoin D. Griseofulvin E. NOTA bioavailability when taken with food.
252. The following helminths are matched with their respective drug of choice except: 513 C. The drug of choice in strongylodiasis
A. Fasciola hepatica - Bithionol B. Echinococcus granulosus - Albendazole C. and onchocerciasis that acts by intensifying
Stongyloides stercoralis - Thiabendazole D. Schistosoma mansoni - Praziquantel GABA- mediated transmission of signals in
E. Dracunculus medinensis - Metronidazole peripheral nerves resulting to paralysis of
the worms is IvermeCtin. Thiabendazole is an
alternative drug only. Katzung 10th ed., 870;
See also p.868 for the table of drug of
choice for other helminthic infections
253. The following laxative mechanisms are correctly paired with its representative 337 D. Polyethylene glycol is an osmotic
laxative drug, except: A. bulk forming - psyllium B. stool softening - docusate C. laxative. Examples of stimulant laxatives
osmotic - lactulose D. stimulant - polyethylene glycol include senna, bisacodyl, castor oil.
254. The following statements are true of Aminoglycosides, 409 A.
EXCEPT: A. Act by Time-Dependent Killing Action B. As the
plasma level is increased above the MIC an increasing
proportion of bacteria are killed and at a more rapid rate C.
Has a post-antibiotic effect D. Requires Oxygen for uptake E.
Amikacin has the widest coverage
255. Formation of methyltransferases that alter drug binding sites 556 D. Question could be rephrased into: which acts on the 50s
on the 50S ribosomal subunit is the primary mechanism of subunit? Macrolides such as azithromycin do.
resistance to which antibiotic: A. Streptomycin B. Tetracycline
C. Amikacin D. Azithromycin E. Levofloxacin
256. For the treatment of brain tumors, it is important for a drug 19 B. Procarbazine, Dacarbazine, Nitrosureas (Lomustine,
to be able to penetrate the blood brain barrier. Which of the Carmustine, Streptozocin) are chemotherapeutic agents which are
following antineoplastic agents cannot cross the blood brain able to penetrate the blood brain barrier. Source: Topnotch
barrier? A. Procarbazine B. Dacarbazine C. Streptozocin D. Handout on Pharmacology
Carmustine E. 5-FU
257. Furosemide is a loop diuretic that is known for its ototoxicity. 658 D. Kanamycin is an aminoglycoside is very ototoxic
Which among the following drugs should you AVOID
administering it simultaneously? A. Penicillin B. Ceftriaxone
C. Clindamycin D. Kanamycin E. Erythromycin
258. A fusion inhibitor used in the treatment of HIV infection a. 578 C.
Efavirenz b. Lamivudine c. Enfuvirtide d. Atazanavir
259. A G7P7 (6107) came in for consult. She asks you that she 173 E Rifampicin is a CYP450 inducer which hastens the excretion
wants to take oral contraceptive pills as family planning. If of OCP
given in conjunction with OCP, which among the following
will decrease the effectivity of OCP? A. Isoniazid B.
Cimetidine C. ketoconazole D. erythromycin E. Rifampicin
260. Given a hypothetical species of bacteria that is resistant to 608 A. Chloramphenicol inhibits peptidyl transferase. Clindamycin
antibacterial agents that prevent translocation during and erythromycin inhibits translocation.
translation, which of the following can be used effectively for
this bacterial infection? A. Chloramphenicol B. Clindamycin
C. Erythromycin D. A and B E. B and C
261. High dose statins are given during ACS, the MOA of which in 45 B.
these cases is: A. Inhibit HMG-CoA reductase B. Stabilize
plaque C. Reduce TAG synthesis D. Increase HDL E. AOTA
262. Highly leukogenic anti-neoplastic drugs A. Topoisomerase II 49 D. Toposiomerase II inhibitors and alkylating agents are the
inhibitor B. Alkylating agents C. Anthrcycline antibiotics D. most leukogenic anti-neoplastic agents.
Both A and B E. AOTA
263. a highly lipophilic derivative of obiquinone that has activity 576 A. Atorvaquone is promising synthetic derivative with potent
against plasmodium species and Pneumocystis pneumonia activity against Plasmodium species and the opportunistic
among patients intolerant to Co-trimoxazole: a. pathogens Pneumocystis carinii and Toxoplasma gondii. After
Atorvaquone b. Quinine c. Proguanil d. artemisinin limited clinical trials, the FDA approved this compound in 1992 for
treatment of mild-to-moderate P. carinii pneumonia in patients
intolerant to trimethoprim-sulfamethoxazol
264. Hoffman elimination is exhibited by: A. Succinylcholine B. 205 E Hoofman elimination aka exhaustive methylation
Diazepam C. Phenobarbital D. Phenytoin E. Atracurium
265. Hydralazine lowers BP by causing arteriolar smooth muscle 425 D.
relaxation. This effect is achieved by its ability to alter
metabolism of which ion? A. Sodium B. Potassium C.
Magnesium D. Calcium
266. A hypertensive patient was found to have elevated 616 D.Fibrates are indicated for hypertriglyceridemia. Fibrates
triglycerides, normal LDL and decreased HDL levels. Which typically lower triglycerides by 20% to 50%. Level of the good
of the following is most efficacious for this patient? A. cholesterol HDL is also increased. Fibrates may decrease LDL,
Simvastatin B. Ezetimibe C. Colestipol D. Fenofibrate E. though generally to a lesser degree than statins.
Orlistat

267. If a patient has COPD, which of the following beta-blockers would be more 491 D. Atenolol, metoprolol, esmolol,
preferrable to use, theoretically? A. propranolol B. carvedilol C. labetalol D. atenolol betaxolol, and acebutolol (A-BEAM)
are more beta1-selective hence are
advantageous in patients with comorbid
pulmonary disease.
268. If a single dose of a known drug with first order elimination is given intravenously, 261 D. Review first-order elimination.
how long will it take for 75% of the drug to be eliminated if the half-life is 1.5 hours? A. 50% is one half-life, 75% is 2 X half-life
1.5 hours B. 2 hours C. 2.5 hours D. 3 hours E. 6 hours and so on..
269. If the plasma concentration of a drug declines with “first order kinetics,†this 602 A. First Order Kinetics : elimination
means that: A. The halflife is constant regardless of plasma concentration B. The drug of the Drug is directly proportional to
is largely metabolized in the liver after oral administration and has low bioavailability its plasma concerntration. its dependent
C. The rate of elimination is proportionate to the rate of administration at all times D. on its half life, which remains constant.
The drug has a high volume of distribution E. The drug is eliminated with a constant First order implies that no matter how
concentration regardlesss of the plasma concentration much concerntration of the Drug u give
it will be eliminated 50% by its first half-
life
270. If you need to give a skeletal muscle relaxant to a burn patient, you will AVOID 277 E Succinylcholine is contraindicated
prescribing which of the following drugs? A. Pancuronium B. Baclofen C. Dantrolene D. in patient with rhabdomyolysis,
Vecuronium E. Succinylcholine hyperkalemia, burn patients, malignant
hyperthermia
271. In a Diabetic patient with impaired renal function which of the following drugs is 417 B. Before prescribing 2nd
contraindicated? A. Nateglinide B. Glipizide C. Metformin D. Pioglitazone E. Acarbose generation Sulfonylureases liver and
hepatic function must be checked first
because they are contraindicated.
272. In anticoagulation, warfarin therapy is usually overlapped with heparin for the first 1-2 217 D. Warfarin acts by vitamin K
days. Why is this so? A. To achieve supraoptimal anticoagulation during critical anatagonism. The initial prothrombotic
periods of illness as warfarin and heparin have synergistic effects. B. To prevent effect of warfarin is because the
bleeding as heparin partially counteracts warfarin's hemorrhagic property. C. synthesis of protein S, an anticoagulant,
Warfarin is metabolized slowly thus leading to a delay in anticoagulation if heparin is also depends on vitamin K. Thus,
not also given. D. To compensate for warfarin's initial prothrombotic property. E. protein S levels decline initially and the
Heparin decreases the clearance of warfarin thus achieving greater plasma drug effect of protein C (for which it serves
concentration of warfarin. as a co-factor) is also diminshed.
273. In a patient suffering from organophosphate poisoning with a cardiac rate of 45, what 206 B. Because of its antimuscarinic
drug should be given? A. Neostigmine B. Atropine C. Epinephrine D. Pancuronium E. effect on the heart, atropine (the
Edrophonium antidote for organophosphate
poisoning) has a positive chronotropic
effect.
274. In a patient with Grave's Disease this drug is given to decrease peripheral conversion 416 A.
of T4 to T3: A. Propranolol B. I 131 C. Methimazole D. PTU E. Lugol's Iodine
275. In calculating the loading dose of a drug, which of the following parameters are not 405 D. LD = (Vd x DPC) / Bioavailability
necessary? A. Volume of distribution B. Desired Plasma Concentration C.
Bioavailability D. Clearance E. None of the Above
276. incidence of Reye syndrome among patients less than 20 who took Aspirin concurrent 574 A. Less than 0.1% of children who
with influenza A/B infection: a. 0.1% b. 1% c. 5% d. 10% took aspirin developed Reye syndrome,
but more than 80% of patients
diagnosed with Reye syndrome had
taken aspirin in the past 3 weeks
277. In dermatologic pharmacology, approximately how many grams of topical 579 C. An amount of topical medication
preparation is needed to cover the body surface? a. 10g b. 20g c. 30g d. 40g sufficient to cover affected body
surfaces in repeated applications must
be dispensed to the patient. A general
rule is that approximately 30 g is
required to cover the body surface.

278. Injection of a small dose of Ach will cause what? A. 158 D. Ach causes depression of the SA and AV nodes thus slowing the
Reflex bradycardia B. Hypotension C. Splanchnic heart rate, hypotension through the relaxation of arterioles, splanchnic
stimulation D. All of the above E. None of the above stimulation through the stimulation of the muscarinic receptors
279. Intake of potassium supplements is contraindicated in 157 B. Amiloride is a potassium sparing diuretic which therefore spares
patients taking which of the following? A. Ethacrynic renal excretion of potassium raising the potassium levels and therefore is
acid B. Amiloride C. Hydrochlorothiazide D. contraindicated in patients taking potassium supplements.
Acetazolamide E. None of the above
280. In the acute settings the following drugs are useful 594 D. Propylthiouracil, iodides and propanolol are the first line drugs
for the emergent management of thyroid storm for thyroid storm. Hydrocortisone may be added for realtive adrenal
EXCEPT? A. Propanolol B. KI C. Propylthiouracil D. insufficiency in the acute attack. Methimazole may be used, but is not
Methimazole E. Hydrocortisone usually given in the acute therapy of thyroid storm and PTU is preferred.
281. In the case above, which of the following patient's 604 C. All the other side effects of danazol is reversible, except for
manifestations may be IRREVERSIBLE? A. Acne B. deepening of the voice.
Male-pattern hair growth C. Deepening of the voice
D. All of the above E. B and C
282. In the CHOP regimen for non-Hodgkin's lymphoma, 202 C. Oncovin is vincristine.
which chemotherapeutic drug acts by inhibiting the
mitotic spindle? A. Cyclophosphamide B.
Hydroxyurea C. Oncovin D. Prednisone E.
Doxorubicin
283. In the kidney, which one of the following is inhibited 626 A. Thiazide diuretics inhibit sodium chloride reabsorption in DCT.
by thiazide diuretics? A. Sodium chloride
reabsorption in the early part of the distal convuluted
tubule B. Water removal from intracellular space by
osmosis C. Reabsorption of Calcium D. Aldosterone
action on the nephron E. Excretion of chloride
284. In the stomach, aspirin will exist predominantly as the 201 B. Review the Henderson-Hasselbach equation. Aspirin
______________ form. A. Hydrophilic, ionized, polar B. (acetylsalicyclic acid) is acidic in nature. In an acidic environment like the
Lipophilic, unionized, non-polar C. Hydrophilic, stomach, it will exist predominantly as the lipid-soluble, unionized, non-
unionized, non-polar D. Lipophilic, ionized, polar E. polar form.
Hydrophilic, unionized, polar
285. In the treatment of CHF, this drug is characterized as 695 B. Answer: B Dobutamine is a relatively b-1 selective adrenoreceptor
having a selective beta-1 antagonistic activity and agonist that causes peripheral vasodilation in some vascular beds useful
devoid of dopaminergic activity: A. Fenoldopam B. for many cases of acute heart failure.
Dobutamine C. Dopamine D. Isoproterenol
286. In the treatment of Parkinson's disease, what drug is 210 C. Carbidopa peripherally inhibits the enzyme DOPA decarboxylase,
given with levodopa to increase the drug's the enzyme that converts DOPA to dopamine. Dopamine itself is unable
bioavailability? A. Entacapone B. Selegiline C. to cross the blood-brain barrier but DOPA can. Inhibition of the enzyme
Carbidopa D. Fluoxetine E. Pyridoxine results in more DOPA available to enter the CNS. Within the CNS, DOPA
is converted to dopamine by the same enzyme. However, it is not
inhibited by carbidopa at this location.
287. In this clinical phase of drug development, the drug is 442 C. Phase 1 trial involves evaluation of dose-response relationship and
studied in patients with the target disease to pharmacokinetics in normal volunteer patients with target disease. Phase
determine its efficacy: A. Phase 0 B. Phase 1 C. Phase 2 trial involves determination whether the agent has the desired efficacy
2 D. Phase 3 E. Phase 4 at doses that are tolerated by sick patients. Phase 3 trial is a large design
including placebo and positive controls in a double-blind crossover
design. Phase 4 trial is a postmarketing surveillance.
288. In this phase of clinical trials, the drig is evaluated in a 664 B. I - normal volunteers, pharmacokinteics and dose sensitive acute
moderate number of target patients to test dose effects II - moderate number of PATIENTS, dose efficacy III - large # of
efficacy of the drug? A. I B. II C. III D. IV E. None of the patients, toxicities IV - post - marketing, idiosyncratic reactions
above
289. In what phase of the cell cycle does vinca alkaloid 239 E Vinca alkaloids ( vinblastine, vincristine, vinorelbine) blocks the
exerts its effect? A. G0 B. G1 C. S D. G2 E. M formation of mitotic spindle by preventing the assembly of tubin dimers
into microtubules. Therefore it acts on the M phase.

290. In which of the following drugs used for the 388 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.
treatment of gout is cataract an important side
effect? A. Colchicine B. Probenicid C.
Allopurinol D. Febuxostate E. Indomethacin
291. In which of the following penicillins is 398 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.
interstitial nephritis a known adverse effect,
partly leading to a decline in its popularity? A.
Nafcillin B. Methicillin C. Carbenicillin D.
Bacitracin E. Metampicillin
292. IOP can be decreased by increasing aqueous 52 B. PG analogues decrease IOP by increasing aqueous outflow. CA inhibitors
outflow with the following drugs A. Timolol B. and Beta-blocker decrease aqeuous production. Alpha2 agonist inreases
Latanoprost C. Mannitol D. Dorzolamide E. outflow and decreases production.
NOTA
293. Isoniazid is the most important drug used in 437 B.
TB. It inhibits mycolic acid synthesis and is
therefore bactericidal. Possible adverse
effects include neuritis, insomnia and seizures.
To prevent neurotoxicities, patient should be
supplemented with: A. Folic acid B. Pyridoxine
C. Vitamin A D. Riboflavin
294. It is a drug that is used almost solely as an 448 B. Spectinomycin is an aminoglycoside that inhibits protein synthesis by
alternative treatment for gonorrhea in binding to 30s subunit. It is the drug of choice of drug-resistant gonorrhea and
patients whose gonococci are resistant to for gonorrhea in penicillin-allergic patients.
other drugs is: A. Docycycline B.
Spectinomycin C. Ofloxacin D. Azithromycin E.
Tetracycline
295. It is a monoclonal anti-IgE antibody used in the 499 D. Trastuzumab aka herceptin is a monoclonal antibody that interferes with
treatment of asthma resistant to inhaled the HER2/neu receptor, rituximab is against the protein CD20 on B cells, and
steroids and long-acting B2-agonists: A. infliximab is against TNF-alpha.
trastuzumab B. rituximab C. infliximab D.
omalizumab
296. It is an anticonvulsant that is effective for 450 B. Gabapentin is an anticonvulsant drug, a GABA derivative which blocks
neuropathic pain: A. Valproic acid B. calcium channels, increases GABA release, very useful in neuropathic pain also in
Gabapentin C. Phenytoin D. Duloxetine E. postherpetic neuralgia.
Levetiracetam
297. It is a very efficacious orally active arteriolar 509 A. Katzung 10th ed, 173.
vasodilator that is also available in topical
preparations used to stimulate hair growth for
correction of baldness. A. Minoxidil B. Sodium
Nitroprusside C. Hydralazine D. Diazoxide E.
Fenoldopam
298. It is during this phase of drug development 504 A. Phase 1 trials determine the probable limits of the safe clinical dosage
and testing that the effects of the drug as a range in a small number of healthy volunteers. In Phase 2, the drug is studied in
function of dosage are established in a small patients with the target disease to determine its efficacy. In phase 3, the drug is
number of healthy volunteers. A. Phase 1 B. evaluated in larger numbers of patients with the target disease to further
Phase 2 C. Phase 3 D. Phase 4 E. Phase 5 establish safety and efficacy. Phase 4 constitutes monitoring the safety of the
new drug under actual conditions of use in large number of patients. Katzung
10th ed., 70-71.
299. It is the antiarrythmic of choice for termination 162 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Katzung
of ventricular tachycardia and prevention of 11th edition page 239. "Lidocaine is the agent of choice for termination of
ventricular fibrillation after cardioversion in ventricular tachycardia and prevention of ventricular fibrillation after
the setting of acute ischemia. A. adenosine B. cardioversion the setting of acute ischemia. However, routine prophylactic use
esmolol C. lidocainne D. procainamide E. of lidocaine in this setting may actually increase total mortality, possibly by
Amiodarone increasing incidence of asystole, and is not the standard of care. Most physicians
administer IV lidocaine only to patients with arrythmia"

300. It is the flow or transfer of a drug to the bloodstream. A. 467 C. Absorption is the transfer of a drug to the
distribution B. bioequivalence C. absorption D. bioavailability E. bloodstream. Distribution is the entry of a drug to the target
Elimination organ. Elimination is the termination of drug action.
Bioavailability is the fraction of a drug that reaches the
systemic circulation. Bioequivalence is the comparability of 2
related drugsnto achieve peak blood concetration.
301. It is the major second messenger of beta receptor activation that 446 B. cAMP is the major second messenger of beta
participates in signal transduction: A. Inositol triphosphate B. receptor activation that participates in signal transduction.
cAMP C. cGMP D. Calcium E. Adenylyl cyclase
302. It is the only licensed chemotherapy drug for advanced 487 D. SIMILAR TO PREVIOUS BOARD EXAM
melanoma: A. adriamycin B. bleomycin C. cisplatin D. Dacarbazine CONCEPT/PRINCIPLE There was quite a number of
questions on oncology drugs.
303. Jan Deo is a newly diagnosed with essential hypertension. He has 163 B. Enalapril is an ACE inhibitor. One of the many
no other co morbidities. Aside from lifestyle modification, he was alternative names for ACE is peptidyl dipeptidase. SIMILAR
prescribed with Enalapril as his maintainance. Which of the TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
following BEST describes the mechanism of action of the drug. A.
blocks Angiotensin receptor which will prevent rise in BP B.
inhibits peptidyl dipeptidase C. direct vasodilator D. reduces
calcium uptake of smooth muscles E. none of the above
304. Ketamine exerts its anaesthetic effect by its inhibitory action on 346 A.
these receptors: A. NMDA B. GABA-A C. Glycine D. Neuronal
nictonic acetylcholine receptors
305. Knowledge of potency and solubility is important in general 280 A. Low MAC - high potency; High MAC - low potency;
anesthetic medications. Which of the following characteristics Low blood:gas coefficient - low solubility; High blood:gas
refers to high potency? A. Low minimum alveolar concentration B. coeeficient - high solubility
High minimum alveolar concentration C. Low blood:gas partition
coefficient D. High blood:gas partition coefficient E. None of the
above
306. KVM, a 29 year old female was brought to the ER due to ingestion 160 D. Pralidoxime regenerates acetylcholinesterase and is
of insecticide, you ordered pralidoxime to be given, what does it only effective when the bond between the organophosphate
do? A. Induces the enzyme Acetylcholinesterase B. Regenerates and acetylcholinesterase hasn't matured which takes 6-8
acetylcholinesterase if given within 6-8 hours after ingestion C. hours, afterwhich, pralidoxime even if given is no longer
Breaks the bond between organophosphate and effective.
acetylcholinesterase D. B and C only E. All of the above
307. Lactulose is the most frequently administered laxative in post-MI 615 B. Lactulose is an osmotic agent. Bulk forming agents
patients. It is classified as: A. Bulk-forming laxative B. Osmotic include insoluble fibers (psyllium). Stool softeners include
laxative C. Stool softener D. Emollient E. None of the above docusate Na. Emollients include mineral oil.
308. The least nephrotoxic among the aminoglycosides is: a. 577 D. The nephrotoxic potential varies among individual
Tobramycin b. Kanamycin c. Amikacin d. Streptomycin aminoglycosides. The relative toxicity correlates with the
concentration of drug found in the renal cortex in
experimental animals. Neomycin, which concentrates to the
greatest degree, is highly nephrotoxic in human beings and
should not be administered systemically. Streptomycin does
not concentrate in the renal cortex and is the least
nephrotoxic
309. Leukotrienes are among the most potent bronchoconstrictors 547 B. Zileuton is a lipooxygenase inhibitor.
implicated in the pathogenesis of bronchial asthma. Which of the
following is a leukotriene receptor inhibitor that has found
clinical application in asthma prophylaxis? A. Zileuton B.
Zafirlukast C. Ipratropium D. Budesonide E. Bosentan
310. Loca is a 23 year old G4P4 (4004) who has been on oral contraceptives for 8 503 E Rifampin revs up the cytochrome
months now. What is the expected drug-drug interaction If she was to start on an P450 enzyme system thereby enhancing the
anti-tuberculosis drug that acts by inhibitting RNA synthesis and which imparts metabolism and hence the elimination of the
orange color to urine and sweat? A. Enhanced efficacy of the oral contraceptive oral contraceptive the patient is taking
she is taking B. Enhanced potency of the oral contraceptive she is taking C. resulting to its significantly lower serum
reduced activity of the cytochrome P450 isoforms D. Increased elimination of the level. Katzung 10th ed, p.774.
anti-tuberculosis drug E. Significantly lower serum level of the oral contraceptive
311. Local anesthetics are not effective in inflamed infected tissues because? A. The 188 E Local anesthetics are weak bases,
cationic form is increased B. Protonated form predominates C. The drug is more therefore, in an acidic environment like in
water soluble D. A and B E. All of the above infected tissues, the protonated or cationic
form of the drug predominates. This is water
soluble so the drug undergoes rapid
clearance rather than being able to cross
biological membranes.
312. Local anesthetics block nerve conduction through inhibition of what electrolyte? 570 B. Local anesthetics block conduction
a. Potassium b. Sodium c. Calcium d. All of the above by decreasing or preventing the large
transient increase in the permeability of
excitable membranes to Na+ that normally is
produced by a slight depolarization of the
membrane
313. The main indication of this agent is hypertension in pregnancy: A. Reserpine B. 349 C.
Prazosin C. Methyldopa D. Clonidine
314. majority of phase2 reactions involving Glucoronic acid conjugation are found in 567 A. conjugating enzymes, notably the
what cell compartment? a. ER b. cytosol c. Mitochondrial matrix d. Golgi bodies UGTs, are all located in the endoplasmic
reticulum of the cell
315. the major systemic side effects of systemic corticosteroids are much more likely 230 A. Katzung Review of pharmacology
to occur if at least the duration of treatment is more than_____? A. 14 days B. 4 8th ed pp 171. .
weeks C. 3 weeks D. 20 days E. 2 months
316. A man is being treated for intestinal strongyloidiasis, you know that the drug of 155 B. Ivermectin is the DOC in the
choice is: A. Praziquantel B. Ivermectin C. Melarsoprol D. Pyrimethamine-sulfa E. treatment of strongyloidiasis
Trimethoprim-sulfamethoxazole
317. Marc, an asthmatic, is on theophylline. He has a number of other medical 481 A. Theophylline has a narrow
conditions. Which of the following medications may be safely administered with therapeutic window and drug interactions
theophylline? A. Penicillin B. Erythromycin C. Phenytoin D. Rifampicin can lead to severe morbidity. Erythromycin
decreases the clearance of theophylline
and increases its serum levels. Phenytoin
and rifampicin have the oppositve effect.
Advice: Memorize the inducers and
inhibitors of the CYP450 system!
318. The mechanism of action of Allopurinol : A. Inhibits microtubule assembly B. 133 D. Option A and B - MOA of Colchicine;
Decreases macrophage migration and phagocytosis C. Compete with uric acid for Option C and E - MOA of Probenecid; MOA
reabsorption in the proximal tubules D. Irreversibly inhibits xanthine oxidase E. of Allopurinol: its active metabolite
Increases uric acid excretion irreversibly inhibits xanthine oxidase and
lowers production of uric acid. SIMILAR TO
PREVIOUS BOARD EXAM CONCEPT.
319. Mechanism of action of chloroquine except:? A. Suppression of B-Lymphocyte 673 A. Chloroquine suppress T -
response to mitogens B. Free-Radical Trapping C. Lysosomal enzyme stabilization lymphocyte response
D. Decreased leukocyte chemotaxis E. None of the above
320. Mechanism of action of cyanide poisoning? A. Inhibits complex III of ETC B. 670 D. Complex I - amytal, rotenone;
Uncoupler C. Inhibits oxidative bursts D. Inhibits complex IV of ETC E. None of the Complex II - malonate; Complex III -
above antimycin A, Dimercaprol; Complex IV - CN,
CO, Na azide; Complex V - Oligomycin
Uncoupler - ASA, 2,4 - DNP

321. Mechanism of action of diazepam? A. Increases 674 B. Increases frequency of channel opening
duration of Cl- channel opening B. Increases
frequency of Cl- channel opening C. Agonist at
5HT1a and D2 receptors D. Blocks voltage gated
Na+ channels E. None of the above
322. Mechanism of action of mebendazole? A. Inhibits 679 A. Mebendazole causes degenerative alterations in the tegument and
microtubule assembly B. Inhibits glucose uptake in intestinal cells of the worm by binding to the colchicine-sensitive site of
rematudes C. Causes dipolarization induced tubulin, thus inhibiting its polymerization or assembly into microtubules. The
paralysis D. Increase permeability of membrane to loss of the cytoplasmic microtubules leads to impaired uptake of glucose
Ca2+ causing muscle paralysis E. None of the by the larval and adult stages of the susceptible parasites, and depletes
above their glycogen stores.
323. The mechanism of action of Nedocromil: A. 132 B. Option A - Beta 2 agonist (Salbutamol, Terbutaline); Option C-
Activates beta-2 receptors in bronchial smooth leukotriene synthesis inhibitor (Zileuton); Option D - Muscarinic receptor
muscle B. Prevents calcium influx and stabilizes antagonist (Ipratropium); Option E - Leukotriene antagonist (Zafirlukast).
mast cells preventing release of histamine C. Cromolyn, Nedocromil, and Lodoxamide are mast cell stabilizers, which
Inhibits 5-lipoxygenase D. Prevents vagal- acts by preventing calcium influx and stabilizes mast cells, preventing
stimulated bronchoconstriction E. Blocks cysteinyl degranulation and release of histamine, leukotrienes, and other mediators.
leukotriene-1 receptor SIMILAR TO PREVIOUS BOARD EXAM CONCEPT.
324. The metabolism of which drug is inhibited by 333 D. Allopurinol inhibits the enzymatic inactivation of 6- MP and its
allopurinol and febuxostat? A. Cytarabine B. derivative, Azathioprine, by xanthine oxidase. Thus, when allopurinol is used
Methotrexate C. Fluorouracil D. Mercaptopurine concurrently with oral 6-MP/azathioprine, dosage of the antineoplastic
agent must be reduced to 1/2 to 1/3 of usual dose.
325. Methyldopa is a drug of choice in treating pre- 424 C. Activation of alpha-2 adrenergic receptors by methyldopa
eclampsia. Its ability to lower blood pressure is metabolites in the brainstem appears to inhibit sympathetic nervous system
based on its action of: A. Activating alpha-1 output and lower blood pressure. This is also the mechanism of action of
adrenergic receptors B. Inhibiting alpha-1 clonidine. Activation of alpha-1 adrenergic receptors meanwhile, stimulates
adrenergic receptors C. Activating alpha-2 vasoconstriction and hence increase in BP.
adrenergic receptors D. Inhibiting alpha-2
adrenergic receptors
326. Minoxidil causes vasodilation through: A. 380 A. Choice B - calcium channel blockers; Choice C - Nitroprusside,
Hyperpolarization of smooth muscle membrane nitrates; Choice D - fenoldepam
through opening of potassium channels B.
Blockade of voltage gated calcium channels
causing a reduction in calcium influx C. Release of
nitric oxide from the drug itself D. Activation of
dopamine receptors E. Blockade of beta receptors
327. Monday disease is caused by occupational 465 D.
exposure to: A. lead B. dust C. arsenic D. nitrates E.
Gun powder
328. The most common anti-arrythmic drug used for 125 A. Lidocaine is the drug of choice for ventricular arrythmias post-MI,
cardiac arrest is: A. Lidocaine B. Adenosine C. and digoxin-induced arrythmias. It is the least cardiotoxic among
Flecainide D. Sotalol E. Amiodarone conventional anti-arrythmic. SIMILAR TO PREVIOUS BOARD EXAM
CONCEPT..
329. Most common side effect of clomiphene citrate A. 153 A. Hot flushes are the most common side effect of use of clomiphene
Hot flushes B. Constipation C. Headache D. Allergic citrate, the rest are occasional side effects
skin reactions E. None of the above
330. The most dangerous hallucinogenic agent. A. LSD 461 B.
B. phencyclidine C. MDMA D. cocaine E. Marijuana
331. The most important pharmacologic action of 443 E The most important pharmacologic action of digitalis in the treatment
digitalis in the treatment of heart failure is its ability of heart failure is its ability to increase myocardial contractile force by
to: A. Increase heart rate B. Reduce venous inhibiting Na/K ATPase and increaseing intracellular calcium.
pressure C. Reduce arterial pressure D. Produce
diuresis in edematous patients E. Increase
myocardial contractile force

332. The most powerful hallucinogen known to man is: A. LSD B. marijuana C. 486 A. SIMILAR TO PREVIOUS BOARD EXAM
methamphetamine D. phencyclidine CONCEPT/PRINCIPLE
333. Mr. A. Lipin, a farmer from a distant hacienda was brought to the ED and 691 B. Answer: B. Atropine (pp. 141, 149 and 162,
admitted due to unconsciousness, profuse salivation and shallow Katzung Pharmacology, 9th edition) Notes: Atropine
breathing. It took 7 hours of travel time from the hacienda to the nearest is the prototype antimuscarinic drug to be given
Provincial Hospital. BP 140/90 mmHg, PR 52 bpm, temp 30OC and with initially in this patient suffering from
constricted pupils. As an ED physician, what medication will you initially organophosphate poisoning. It is best to give both
give that will most likely benefit the patient? A. Pralidoxime B. Atropine C. Atropine and Pralidoxime if the golden period of 6
Pralidoxime + Atropine D. Physostigmine hours was not violated. The likelihood of aging of
the phosphate enzyme complex occurs after 6
hours; however, recent reports suggest that
administration of multiple doses of pralidoxime over
several days may be useful in severe poisoning.
334. MRSA, a multi drug resistant organism is kept at bay through 78 C. Structural change in target PBP is mechanism
administration of vancomycin. Currently, reports of MRSA resistant to of resistance of MRSA not VRSA. Resistance to
vancomycin (VRSA) are being reported. What is the mechanism of vancomycin in vancomycin-resistant S aureus strains
resistance to vancomycin? A. Structural change in target PBP B. is due to modification of the D-Ala-D-Ala binding
Formation of extended spectrum beta lactamases C. D ala-ala is modified site of the peptidoglycan building block in which the
to D ala-lactate D. Changes in porin structure of outer cell wall E. terminal D-Ala is replaced by D-lactate. This results
Extrusion of the drug through P-glycoprotein efflux pump in the loss of a critical hydrogen bond that facilitates
high- affinity binding of vancomycin to its target and
loss of activity.
335. Mrs. T. Anga, 25 yo, G1P1 was misdiagnosed to have preeclampsia 687 A. Answer: A. Methyldopa (pp. 235 [.pdf file],
because of the inaccuracy of her history and was given an anti- Katzung Pharmacology, 9th edition). Notes: The
hypertensive to control her blood pressure. Fortunately, patient had no symptoms experienced by the patient are consistent
postpartum complications and BP was controlled. She continued taking with Autoimmune Hemolytic Anemia which is a rare
the previously given antihypertensive but was lost to follow-up. After adverse effect of methyldopa. Methyldopa is a drug
maintaining the drug for more than 12 months, patient developed which lowers blood pressure chiefly by reducing the
intermittent episodes of headache, myalgias, jaundice and passage of peripheral vascular resistance and variably reduces
dark brown urine. She finally went back to her physician for consult and heart rate and cardiac output. Ten to twenty percent
laboratory testing revealed a positive Antiglobulin Test. If the condition of patients undergoing therapy for longer than 12
was drug-induced, what is the most likely offending agent? A. months from methyldopa will have positive
Methyldopa B. Hydralazine C. Clonidine D. Magnesium Sulfate Coomb’s Test (or Antiglobulin Test).
336. Mr. X was maintaining an unrecalled drug for the past few months. He is 463 C.
now complaining of visual changes or "yellow halo vision". What is the
drug that is known to cause such effect? A. amiodarone B. ethambutol C.
digoxin D. furosemide E. Procainamide
337. Muscarinic antagonists used for the treatment of parkinsonism, except? A. 666 B. Triamterene - potassium sparing diuretic
Trinexyphenidyl B. Triamterene C. Benztropine D. Biperiden E. None of
the above
338. A neonate was given IV antibiotics for 3 days. However, the baby 447 C. Chloramphenicol is the drug that was given
developed hypothermia associated with diarrhea and grayish color of the to neonate causing gray baby syndrome. It inhibits
skin. What is the mechanism of action of the drug that was given to the transpeptidation at 50s subunit and it is
baby? A. Inhibits transpeptidation in bacterial cell walls B. Inhibits protein bacteriostatic. Penicillin inhibits transpeptidation in
synthesis by binding to 30s subunit C. Inhibits transpeptidation at 50s bacterial cell walls. Aminoglycoside inhibits protein
subunit D. Inhibits dihydropteroate synthase E. Inhibits DNA replication by synthesis by binding to 30s subunit. Co-trimoxazole
binding to DNA gyrase inhibits dihydropteroate synthase. Fluoroquinolone
inhibits DNA replication by binding to DNA gyrase.
339. A newly formulated drug with a half life of 6 hours is eliminated via 1st 404 D. 100% elimination will be reached in 4 half
order kinetics, how many hours will the drug be 100% eliminated from the lives. (6 x 4=24)
body of a normal person? A. 6 hours B. 12 hours C. 18 hours D. 24 hours E.
36 hours
340. Nitrates relieve angina by: A. Decreasing venous return to the heart B. 348 A.
Increasing intracardiac volume C. Increasing end diastolic left ventricular
volume D. All of the above

341. Notable to these drugs are its capability of inducing CP450 enzyme system 568 B. All except Cimetidine induce CYP450
in the liver except: a. Phenytoin b. Cimetidine c. Carbamazepine d. enzyme complex
Griseofulvin
342. NOT True of Phase 2 enzymes in Xenobiotic metabolism: a. they facilitate 566 D. Because of conjugation of these
the elimination of drugs b. inactivation of electrophilic and potentially toxic substances, they have a higher molecular weight
metabolites produced by oxidation. c. phase 2 reactions produce a
metabolite with improved water solubility d. products have decreased
molecular weight
343. On a patient with signs of shock, At a dose of 5 mcg/kg/min, dopamine will 66 C. Dopamine has different dose dependent
predominanty have what effect? A. Increased peripheral vascular actions. At 1-2 mcg/kg/min, it preferentially
resistance B. Activation of the RAAS C. Inotropic effect D. Renal activates D1 receptor. At 2-10 mcg, it activates B1
vasodilation E. Arrythmias receptor and at >10 mcg, it activates A1 receptors
344. Ondansetron, highly effective in preventing chemotherapy-induced nausea 338 C.
and vomiting, is an antagonist at which receptor? A. muscarinic B. B2 C. 5-
HT3 D. D2
345. Ondansetron is an antagonist of which serotonin receptor? A. 5HT1D B. 391 D. 5HT3 receptor is also the only ligand-gated
5HT1B C. 5HT2 D. 5HT3 E. 5HT4 ion channel among the serotonin receptors.
346. One of the choices does not belong to the third generation cephalosporins. 477 D. All of the choices except cefoxitin are all
A. cefotaxime B. ceftazidime C. ceftriaxone D. cefoxitin E. Ceftizoxime third generation cephalosporin. Cefoxitin is a
second generation.
347. One of the following drugs causes an increase in metabolism of other drugs 645 B. Rifampicin is an inducer. All other choices
when administered simultaneously. A. Valproic Acid B. Rifampicin C. are inhibitors.
Venlafaxine D. Ritonavir E. Ketoconazole
348. One of the following drugs is effective in reducing the risk of ulcers in 279 D.
chronic NSAID users. Diarrhea is a frequent side effect. Which is it? A.
Sucralfate B. Ranitidine C. Omeprazole D. Misoprostol E. Cimetidine
349. The only beta-lactam antibiotcs that does not cross react with penicillins A. 57 B. The monobactams have activity against
Ceftriaxone B. Aztreonam C. Meropenem D. Aminoglycosides E. aerobic Gram negative bacilli and dose not cross
Vancomycin react with penicillin.
350. On your clinic, an 18 month old infant was brought for consult due to "blank 656 C. This is absence seizure and DOC is
stares" with a duration of 5-10 seconds. The best medication to be given for Ethosuximide
this case is A. Phenobarbital B. Valproic acid C. Ethosuximide D.
Levepiracetam E. Carbamazepine
351. oral administration of this antibiotic will yield greater blood levels 316 A. the pharmacokinetics of chlorampenicol is
compared when it is administered intravenously? A. chlorampenicol B. unusual since blood levels are higher when the
Quinipristin -dalfopristin C. Azithromycin D. Telithromycin E. None of the drug is given at oral form rather than intravenous
above form. Katzung 11th ed page 802
352. Oral chelation treatment in hemochromatosis can be done by giving: A. 430 B. Therapeutic phlebotomy is the main line of
Deferoxamine B. Deferasirox C. EDTA D. Penicillamine treatment of hemochromatosis, especially the
primary type. Should chelation becomes
warranted, it can be done via IV (deferoxamine)
or oral (Deferasirox).
353. Organophosphate toxicity is based on its ability to: A. Compete with brain 357 B.
pyridoxal phosphate B. Inhibit acetylcholinesterase C. Interrupt heme
synthesis D. React with sulfhydryl groups binding to protein and other
enzymes

354. Organs involved in xenobiotic metabolism are as follows, EXCEPT: 606 E Xenobiotic metabolizing enzymes are found in most
A. Liver B. Small intestines C. Lung D. Nasal mucosa E. None of the tissues in the body with the highest levels located in the
above tissues of the gastrointestinal tract (liver, small and large
intestines). Other organs that contain significant
xenobiotic-metabolizing enzymes include the tissues of
the nasal mucosa and lung, which play important roles in
the first-pass metabolism of drugs that are administered
through aerosol sprays.
355. An otherwise healthy 19-year-old woman comes to the physician 531 A. Oral isotretinoin is never the first option for acne,
because of a 3-year history of intermittent facial blemishes. She only used when topical treatments have failed
drinks wine occasionally on weekends. She takes no medications.
Examination shows multiple 1- to 2-mm red and white papules and
on the forehead and cheeks. Which of the following is the most
appropriate initial pharmacotherapy? A) Topical benzoyl peroxide
B) Systemic corticosteroids C) Oral isotretinoin D) Topical
corticosteroids
356. A patient came in at the ER having severe headache and heat 171 C. Take note, the patient has asthma… Katzung 11th
intolerance. Examination revealed enlarged thyroid, high blood edition chapter 38 page 677. “If propanolol is
pressure and severe tachycardia. On history, his relative told you contraindicated by the presence of severe heart failure or
that he also has frequent attacks of asthma. In your findings, you asthma, hypertension and tachycardia may be controlled
are suspecting that he is having thyroid storm. Which of the with diltiazem, 90-120mg orally three or four times daily or
following drugs can be given immediately to relieve hypertension 5-10 mg/h by IV infusion.†SIMILAR TO PREVIOUS
and tachycardia? A. propanolol B. esmolol C. diltiazem D. nifedipine BOARD EXAM CONCEPT/PRINCIPLE. Katzung 11th edition
E. clonidine page 677
357. A patient came in for consult due to infertility. It was found out that 161 A. SIMILAR TO PREVIOUS BOARD EXAM
the patient is having ovulation disorder so you decided to give here CONCEPT/PRINCIPLE. Katzung 11th edition page 719.. "the
clomiphene. It is important to tell to the patient that the most most common adverse effects in patients treated with this
common adverse effect of clomiphene is: A. hot flushes B. bleeding drug are hot flushes, which resemle those experienced by
C. constipation D. headache E. nausea and vomiting menopausal patients."
358. Patient came in the clinic complaining of amenorrhea and 194 C. Risperidone causes hyperprolactinemia.
galactorrhea. History revealed intake of an anti-psychotic drug.
What could have caused the symptoms of the patient? A. Clozapine
B. Olanzapine C. Risperidone D. Haloperidol E. Chlorpromazine
359. A patient came to the ER with diarrhea, tremors and excessive 65 D. The patinet is exhibting symptoms of
sweating. HR is 50, BP is 120/70, RR is 22. Pupils are 1-2 mm. What organophosphate poisoning with increased secretion of all
drug can be given to the patient? A. Naloxone B. Neostigmine C. body fluids plus bradycardia, miosis and skeletal muscle
Diazepam D. Atropine E. EDTA exictation. Antidote is Atropine and Pralidoxime
360. A patient in PACU is in no apparent distress. The V/S are stable 692 D. Answer: D Patient has atrial fibrillation w/ rapid
except for HR of 128 bpm that is irregular with no p wave. Which of ventricular response. B-blocker, Ca Channel blocker or
the following treatment option would not be appropriate as initial Digoxin may be used. Supraventricular tachycardia, not
therapy? A. Metoprolol B. Diltiazem C. Digoxin D. Adenosine a.fib responds to adenosine.
361. The patient is being maintained on oral anticoagulant. Which of the 122 A. Phenobarbital, a barbiturate, is a Cytochrome P450
following if taken by the patient will decrease the effect of the drug inducer which will increase clearance of other drugs, thus,
he is presently taking? A. Phenobarbital B. Sulfamethoxazole C. decreasing their effects. SIMILAR TO PREVIOUS BOARD
Valproic acid D. Ketoconazole E. Vancomycin EXAM CONCEPT.
362. Patient is diagnosed with Lennox-Gaustat Syndrome and is taking 196 A. Topiramate is used as an adjunct in Lennox-Gaustat
maintenance drug. He later on developed urolithiasis. The patient is Syndrome. Its adverse effects are unusual/weird for anti-
probably taking what drug? A. topiramate B. lamotrigine C. seizure drugs (ex. Urolithiasis, myopia, glaucoma)
ethosuximide D. carbamazepine E. levetiracetam
363. A patient is taking fenofibrate for elevated trigylceride levels, 253 C. SIMILAR TO PREVIOUS BOARD EXAM
which of the following laboratory examinations should the doctor CONCEPT/PRINCIPLE, fibrates can potentially increase
request to monitor for potential side effects upon follow up after 3 liver enzymes
to 6 months? A. CBC with differential count B. urinalysis C. AST, ALT
D. fasting blood glucose levels E. serum total cholesterol and
triglycerides

364. A patient presented to your clinic with complaints of 276 B. Methotrexate is known to cause pulmonary fibrosis
dyspnea and chronic cough. He states that he frequently
gets short of breath and is unable to take a deep breath.
History is significant for prolonged treatment of rheumatoid
arthritis. Chest X-ray revealed fine reticulonodular densities.
Which drug is most likely responsible? A. Glucocorticoids B.
Methotrexate C. Infliximab D. Cyclosporine E. Anakinra
365. A patient presents with petit mal seizures. The drug of choice 496 C. Petit mal seizures, also known as absence seizures,
for this type of seizure is: A. phenytoin B. topiramate C. involves a brief, sudden lapse of consciousness. The DOC is
ethosuximide D. lamotrigine ethosuximide.
366. Patients receiving cyclophosphamide should also be given: 207 A. Leucovorin for methotrexate. Pyridoxine for isoniazid.
A. Mesna B. Leucovorin C. Vitamin B6 D. Thiamine E. Thiamine for alcoholics.
Amifostine
367. A patient was diagnosed with familial combined 115 C. Page 29 of Topnotch Handout. A synergistic combination
hypercholesterolemia, which of the following synergistic for patients with familial combined hypercholesterolemia
drug combination will be most suitable for this patient: A. (overproduction of VLDL) are niacin+resin and statin+fibrate.
Niacin + Statin B. Statin + Ezetimibe C. Niacin + Resin D. Statin Fibrate nd resin combinations are disadvantageous because they
+ Resin E. Fibrate + Resin confer an increased risk of cholelithiasis. while Statin and resin
combinations cause impaired statin absorption. Niacin and statin
combinations are more for familial hypercholesterolemiawhere
the defect is in the LDL receptors hence increased LDL.
368. A patient was given Nedocromil for asthma. Which of the 164 D. SIMILAR TO PREVIOUS BOARD EXAM
following is the mechanism of action of the drug? A. Inhibits CONCEPT/PRINCIPLE. Katzung 11th edition page 349
the release of histamine B. Direct relaxation of smooth
muscle C. Inhibits leukotriene pathway D. mast cell stabilizer
E. none of the above
369. A patient was put on standrard dose of warfarin therapy, 63 A., D. INH is also an inhibitor. Rifampicin is an inducer.. The
aftter 1 week he suddenly experienced hematochezia. Which patient probably is taking a CYP450 inbibitor such as valproic
of the ff drugs he is also currently taking could have caused acid that decreased the metabolism of warafarin leading to its
this? A. Valproic acid B. Ethanol C. Carbamazepine D. toxic side effectds. All the rest of the drugs are inducers
Isoniazid E. Griseofulvin
370. A patient will be undergoing neurosurgery, the 407 A. Ketamine is capable of Dissociative Anesthesia (
neurosurgeon would like to maintain the patient's Analgesia, Amnesia and Catatonia with retained consciousness)
consciousness while the procedure is on going. What would
be the preferred anesthetic of choice? A. Ketamine B.
Etomidate C. Midazolam D. Fentanyl E. Propofol
371. A patient with CHF was rushed to the ED where you are on- 411 D. Spironolactone and Acetazolamide can aggravate the
duty, ABG was done revealing Metabolic Acidosis. His wife ongoing acidosis of the patient, the only ones left are loop
told you that he had a history of severe allergic reaction to diuretics, but then Furosemide and Torsemide are both Sulfa
Sulfa drugs, but you need to give the patient a powerful containing hence cannot be given to the patient. Ethacrynic acid
diuretic, Unfortunately the following drugs are the only ones is most suitable to this patient.
available in your Pharmacy, Among which of the following
will you give? A. Furosemide B. Spironolactone C. Torsemide
D. Ethacrynic Acid E. Acetazolamide
372. A patient with leprosy is taking a drug that casts a red color 203 C. Rifampin causes red discoloration of body fluids but not
to the skin. He is probably taking: A. Dapsone B. Rifampin C. the skin.
Clofazimine D. Ethambutol E. Phenylbutazone
373. A patient with neuropathic pain was prescribed gabapentin. 549 B. Although gabapentin is a structural analog of GABA, it
What is the primary mechanism of action of gabapentin? A. does NOT activate GABA receptors directly.
Direct activation of GABA reeptors B. Inhibition of T type
Ca2+ channels C. Blockade of voltage-gated Na channels D.
Inhibition of GABA transporter (GAT-1) prolonging the action
of the neurotransmitter E. Enhancement of K+ channel
permeability causing neuronal hyperpolarization

374. A patient with warfarin as a maintenance medication is treated 273 D. Erythromycin inhibits metabolism of warfarin causing an
for pneumonia. Prothrombin time monitoring during treatment increase In INR
of the respiratory infection reveals elevated INR but it
decrease back to baseline levels after treatment with the
antibiotic is completed. Which of the following is most likely
given? A. Amoxicillin B. Ceftriaxone C. Clindamycin D.
Erythromycin E. TMP-SMX
375. Penicillin is the drug of choice for syphilis. It acts through: A. 480 A. Penicillin inhibits transpeptidase enzyme needed for the
Inhibition of transpeptidase B. Inhibition of topoisomerase II C. bacterial cell wall synthesis. Vancomycin inhibits D-ala D ala
Inhibition of glucan synthase D. Inhibition of D-ala-D-ala synthase. Caspofungin inhibits glucan synthase.
terminus E. None of the choices Flouroquinolone inhibits topoisomerase II and IV.
376. A physician prescribes a diabetic patient with an antidiabetic 275 C. Thiozolidinediones - activates PPAR, a nuclear receptor
agent that activates a nuclear receptor that increases to improve sensitivity to insulin
transcription of GLUT-4 transporters in adipose tissue. The
drug prescribed is most likely: A. Methotrexate B. Insulin C.
Pioglitazone D. Glyburide E. Sitagliptin
377. Plasma magnesium levels should be maintained at this 488 B.
therapeutic range to prevent eclamptic convulsions: A. 2-4
meq/L B. 4-7 meq/L C. 8-10 meq/L D. 10-12 meq/L
378. A post stroke patient is taking in warfarin. Which among the 172 D. Isoniazid in a P450 inhibitor which will delay the
following drugs will most likely increase the possibility of excretion of warfarin when given. Other choices are P450
having warfarin toxicity when added in his management? A. inducers
Smoking B. Barbiturates C. Carbamazepine D. Isoniazid E.
Ethanol
379. A potent antiandrogen that is usually coadministered with 511 E Katzung 10th ed., 679. this is SIMILAR TO PREVIOUS
leuprolide that has been used in the treatment of prostatic BOARD EXAM CONCEPT/PRINCIPLE
carcinoma that frequently causes gynecomastia and
occassionally mild reversible hepatic toxicity: A. Goserelin B.
Spironolactone C. Cyproterone D. Ketoconazole E. Flutamide
380. Pralidoxime is an antidote to organophosphate poisoning. 423 E
Which of the following is not true about this drug? A. It is a
cholinesterase regenerator. B. It requires to be given 6-8 hours
before organophosphate-cholinesterase binding occurs. C. It
binds with the phosphorus of organophosphates. D. All of the
above E. None of the above
381. The preferred antiseizure drug for pregnant women: A. 134 B. Phenobarbital is the preferred antiseizure drug in
Valproic acid B. Phenobarbital C. Phenytoin D. Carbamazepine children and pregnant women. SIMILAR TO PREVIOUS BOARD
E. Topiramate EXAM CONCEPT.
382. The preferred anti-thyroid drug for thyroid storm: A. 354 C.
Methimazole B. Carbimazole C. Propylthiouracil D. Propranolol
383. A pregnant patient complains of multiple external genital 483 C. The most common treatments for genital warts in
warts. Which of the following agents can be used in this pregnancy are cryotherapy, laser removal, and trichloroacetic
patient? A. Podofilox solution B. Imiquimod cream C. acid. The rest of the choices are under Pregnancy Category C.
Trichloroacetic acid D. Sinecatechins ointment
384. The primary indication of Epoprostenol? A. Open angle 228 B. SIMILAR TO PREVIOUS BOARD EXAM
glaucoma - increase outflow of aqueous humor B. Severe CONCEPT/PRINCIPLE last aug 2014. Epoprostenol is a
pulmonary hypertension C. Postpartum bleeding D. All of the Prostacyclin analog use for dialysis to prevent platelet
above E. None of the above aggregation and also for pulmonary hypertension. Latanoprost
or PGF2a analog is the one use for glaucoma. Misoprostol or
RU 486 (PGE1 analog) has an off label indication for induction
of labor. it primarily acts as an abortifacient.

385. The prime target of addictive drugs in the brain: A. Thalamocortical 344 C. Reference: Katzung. Basic and Clinical
system B. Nigrostriatal dopamine system C. Mesolimbic dopamine Pharmacology, 11th ed. p. 554
system D. Mesocortical dopamine system
386. The prokinetic MOA of metoclopramide A. Inhibition of dopamine 50 A. Metoclopramide inhibits the D2 receptors in the
receptors in the gut B. Inhibition of motilin receptors in the gut C. gut; erythromycin stimulates the molitin receptors in
Inhibition of serotonin receptors in the gut D. AOTA E. Both A and B the gut.
387. Prolonged treatment with a PPAR alpha ligand in the treatment of 234 D. PPAR alpha ligands is the MOA of fibric acid
hyperlipidemia will increase the risk for the following condition? A. derivatives ( Gemfibrozil and fenofibrate). It increases
Cutaneous flushing B. Hyperuricemia leading to Gout C. Intestinal the supersaturation of bile leading cholelithiasis. Risk
malabsorption D. Gallstones E. hepatotoxicity for hepatotoxicity only significantly increase if
gemfibrozil is combined with HMG CoA inhibitor.
Cutaneous flushing and hyperuricemia are toxicity
profile of Niacin. Intestinal malabsorption is a primary
side effect of resins ( cholestyramine, colestipol,
colsevelam)
388. Prolonged treatment with a PPAR alpha ligand in the treatment of 315 D. PPAR alpha ligands is the MOA of fibric acid
hyperlipidemia will increase the risk for the following condition? A. derivatives ( Gemfibrozil and fenofibrate). It increases
Cutaneous flushing B. Hyperuricemia leading to Gout C. Intestinal the supersaturation of bile leading cholelithiasis. Risk
malabsorption D. Gallstones E. hepatotoxicity for hepatotoxicity only significantly increase if
gemfibrozil is combined with HMG CoA inhibitor.
Cutaneous flushing and hyperuricemia are toxicity
profile of Niacin. Intestinal malabsorption is a primary
side effect of resins ( cholestyramine, colestipol,
colsevelam)
389. Propylthiouracil and Methimazole are both used in the treatment of 6 B. The halflife of PTU is 1.5hrs and methimazole is 6-
hyperthyroidism. They are thioamides which inhibits the enzyme 8hrs. PTU is generally given every 6-8hrs while
thyroid peroxidase necessary for the synthesis of thyroid hormone. methimazole is given once a day. Thus methimazole is
Which of the following is false about propylthiouracil? A. PTU is more more convenient for patients. Methimazole is also 10
highly protein bound than methimazole B. PTU has a longer halflife and times more potent than PTU. Source: Katzung Basic and
requires less frequent dosing than methimazole C. PTU is less potent Clinical Pharmacology 11th ed p671
than methimazole. D. PTU has the added activity of preventing
peripheral conversion of T4 to T3 E. None of the Above
390. A psychotic patient on haloperidol presents with rigidity, hyperpyrexia 497 B. Tardive dyskinesia is also one of the toxicities of
and autonomic instability. This condition is known as: A. Serotonin antipsychotics aside from NMS. It is a condition where
syndrome B. Neuroleptic malignant syndrome C. Tardive dyskinesia D. the patient presents with stereotypic oral- facial
Malignant hyperthermia movements.
391. the pungency of this inhaled anesthetics leading breath-holding limits 313 D. (SIMILAR TO PREVIOUS BOARD EXAM
it use in anesthesia induction? A. desflurane B. Isoflurane C. CONCEPT/PRINCIPLE) Katzung review 8th ed p 211
Sevoflurane D. enflurane E. Halothane
392. Pupillary construction is a characteristic effet of all opioids, except: A. 323 B.
Oxycodone B. Meperidine C. Morphine D. Fentanyl
393. A pure opioid antagonist with a greater affinity for μ receptors and 607 B. Naloxone is a pure opioid anatagonist and is
used for acute opioid overdose: A. Morphine B. Naloxone C. Codeine D. used to counter the effects of opiate overdose, for
Dextrometorphan E. Diphenoxylate example heroin or morphine overdose. The other
drugs are opioid agonists.
394. A recently-diagnosed hypertensive was started on a BP lowering 544 D.
agent. Due to financial constraints, the patient abruptly stopped taking
the prescribed medications after stocks were consumed. A day later,
the patient was brought to the clinic for light-headedness; on
admission, patient's BP was 180/100. Which of the following anti-
hypertensives, known for rebound hypertension, was most likely taken
by the patient? A. Enalapril B. Furosemide C. Methyldopa D. Clonidine
E. Metoprolol

395. The rectal route is said to have partial avoidance of the first pass 103 A. Page 3 of Topnotch Handout. The superior rectal
effect. Thru which of the following venous drainage of the rectum vein will drain to the Inferior mesenteric vein then to the
will not bypass the first pass effect : A. Superior rectal vein B. Middle portal vein, hence having a first pass effect. The middle
rectal vein C. Inferior rectal vein D. Both B and C E. All of the above rectal vein will drain thru the internal iliac vein then to the
inferior vena cava, while the inferior rectal vein will drain
via the internal pudendal vein then thru the internal iliac
vein then thru the inferior vena cava.
396. Remarkable to these drugs is their ability to inhibit cytochrome P450 434 D.
causing significant interactions with other drugs, except: A. Isoniazid
B. Cimetidine C. Erythromycin D. Barbiturates
397. Reserpine blocks this step of adrenergic transmission: A. Synthesis 444 B. Reserpine blocks vesicular transport in adrenergic
of the neurotransmitter B. Transport of neurotransmitter to vesicles transmission.
C. Release of the neurotransmitter D. Reuptake into the presynaptic
neuron E. Diffusion in the synaptic cleft
398. RH, a 50 year old bank executive was brought to the ER due to loss 148 A. The patient has been poisoned with arsenic and the
of consciousness, upon PE you noted his breath smelling like sweet drug of choice is dimercaprol
with garlicky odor, what is the appropriate drug for this case A.
Dimercaprol B. EDTA C. Hydration D. Deferoxamine E. Flumazenil
399. Rivastigmine is used for: A. Motion sickness B. Myasthenia gravis C. 469 E Rivastigmine is a cholinomimetic drug used for
Schizophrenia D. Parkinson's disease E. Alzheimer's disease Alzheimer's disease.
400. RJLC, a 30 year old female was treated for extraintestinal amebiasis, 149 C. Metronidazole eliminates the trophozoite forms of
what is the drug of choice to eliminate the extraintestinal parasites? the parasite in the intestine or in the tissues.
A. Paromomycin B. Diloxanide furoate C. Metronidazole D. Pyrantel
pamoate E. Praziquantel
401. Route of administration with instantaneous absorption, bypasses 662 A. Compared with other routes of administration, the
first pass effect with I00% bioavailabilty? A. IV B. SL C. Oral D. Rectal intravenous route is the fastest way to deliver fluids and
E. None of the above medications throughout the body.
402. Salmeterol has a slower onset of action as compared with 601 A. The quickier onset of action of formoterol can be
formoterol in terms of producing bronchodilation. This is because of: explained by diffusion microkinetic model. This model
A. Increased lipophilicity of salmeterol B. Faster degradation of suggests that formoterol and salmeterol are both retained
salmeterol C. More efficient absorption of formoterol D. Higher in the lipid bilayer adjacent to the beta2-adrenergic
affinity of formoterol to beta adrenergic receptors E. A and D receptor. Because of salmeterol's lipophilicity, it
associates more with the lipid bilayer than with the
receptor, accounting for its slower onset of action.
403. a second generation Cephalosporin with intrinsic activity against 562 A. Cefoxitin has anaerobe coverage apart from its
anaerobes: a. cefoxitin b. cefipime c. cefaclor d. ceftriaxone 0 activity against gram positive and some gram neg
infections
404. Serum concentration of lithium in mEq/L favored for acutely manic 340 A. The serum concentration favored for long-term
patients is: A. 0.9-1.1 B. 0.6-0.75 C. 0.5-0.85 D. 0.1-0.5 use in the prevention of reccurent manic-depressive
illness, on the other hand, is 0.6-0.75 mEq/L.
405. Single dose drug used in eradication of meningococcal carrer state 46 B. Drugs used to eradicate meningococcal carrier
A. RIfampicin B. Ciprofloxacin C. TMP/SMX D. Chloramphenicol E. state: 1. rifampin 2. ciprofloxacin (single dose) 3.
NOTA ceftriaxone (single dose)
406. Single dose oral antibacterial agent used to eradicate 47 D. Ceftriaxone - single dose IM s
uncomplicated gonorrhoea A. Ceftriaxone B. Cefixime C.
Azithromycin D. Both B and C E. AOTA
407. Sisa, 28/F, recently-diagnosed schizophrenic was admited to the 555 D. Neuroleptic malignant syndrome is characterized
Psychiatry ward and started on Risperidone. Three days later, the by FEVER, RIGIDITY, and AUTONOMIC INSTABILITY.
patient developed fever (39.9C) and rigidity. Patient was notably NMS is linked to intake with several atypical
confused. Vital signs were as follows: BP 170/120, HR 118, RR 22. antipsychotics.
What could explain Sisa's symptoms? A. Extrapyramidal symptoms
B. Tardive dyskinesia C. Serotonin syndrome D. Neuroleptic
malignant syndrome E. Malignant hyperthermia

408. SMA, a 68 year old female with hypertension is taking 156 D. Peptidyl dipeptidase is otherwise known as ACE which is the
captopril, you know that it is effective in hypertension enzyme inhibited by ACE inhibitors like captopril.
because it inhibits: A. Cathepsin C B. Dipeptidyl
dipeptidase-2 C. Dipeptidyl dipeptidase-4 D. Peptidyl
dipeptidase E. Procarboxypeptidase
409. Somatostatin interacts with a A. Gq- 23 B. Somatostatin (growth-inhibiting factor) binds to Gi- coupled protein
proteinâ€"coupled receptor B. Gi-proteinâ€"coupled receptor, initiating exchange of GTP for GDP, which inhibits AC and
receptor C. Ligand-activated ion channel D. Receptor- leads to reduced cAMP production.
activated tyrosine kinase E. Intracellular nuclear
receptor
410. Some drugs like magnesium sulfate needs a loading 582 A. Loadign dose = (Vd) (desired plasma
dose in order to reach steady state at a reduced concentration)/(bioavailabitlity) the minimum effective dose is usually the
amount of time. The following are used to compute desired plasma concentration. Clearance is used to calculate the
for loading dose EXCEPT? A. Clearance B. Volume of maintenance dose
Distribution C. Minimum effective dose D.
Bioavailabiloity E. No exception
411. Sources of drugs can either be natural or synthetic. 686 D. Answer: D. AmphoteriCin B (pp. 1104 [.pdf file], Katzung
These might be derived from plant sources, animal or Pharmacology, 9th edition.) Notes: incomplete list Streptomycin à Strept.
marine products, minerals, microorganisms and others griseus Neomycin à Strept. fradiae Paromomycin à Strept. rimosus
from laboratory sources. Many antibiotics were Kanamycin (der. Amikacin) à Strept.kanamyceticus Tobramycin à Strept.
derived from Genus Streptomyces, Penicillium, tenebrarius Ivermectin à Strept. avermitilis Mitomycin à Strept.
Micromonospora, etc. Which of the following drugs is caespitosus Erythromycin à Strept. erythreus Lincomycin (der.
a polyene antibiotic derived from Streptomyces Clindamycin) Ã Strept. lincolnensis Rifamycin (der. Rifampicin) Ã Strept.
nodosus? A. Netilmicin B. Amikacin C. Streptomycin D. mediterranei Gentamicin à Micromonospora purpurea Sisomicin (der.
Amphotericin B Netilmicin) Ã Micromonospora inyoensis
412. Strongest inhibitor of CYP3A4 amongst the protease 44 A. Ritonavir - Strongest
inhibitor A. Ritonavir B. Saquinavir C. Lopinavir D.
Amprenavir E. Atazanavir
413. Succor Mendiola was diagnosed to have glaucoma. 631 E Pilocarpine induces ciliary muscle contraction thereby opening the
Which of the following drugs induces ciliary muscle trabecular meshwork and increasing the outflow
contraction thereby opening the trabecular meshwork
and increasing the outflow? A. Timolol B. Mannitol C.
Epinephrine D. Latanoprost E. Pilocarpine
414. Sulfone in the management of leprosy causes? A. 136 A. Drugs used in leprosy: Dapsone, Rifampicin, and Clofazimine.
Inhibition of folic acid synthesis B. Inhibition of PABA Dapsone, a sulfone, is the most active drug used against M. leprae. It is
C. Inhibition of DNA synthesis D. Inhibition of protein bacteriostatic and inhibits folic acid synthesis. Clofazimine acts by
synthesis E. Inhibition of arabinosyl transferase binding to guanine bases in bacterial DNA.
415. Sympathomimetic drug that causes mydriasis without 613 C. Atropine and tropicamide cause mydriasis and cycloplegia.
cycloplegia: A. Atropine B. Tropicamide C. Timolol has no mydriatic effect.
Phenyephrine D. Pilocarpine E. Timolol
416. Teratogenesis is one of the dreaded complications of 422 A.
improper use of drugs during pregnancy. Of note,
lithium, a drug primarily used to treat bipolar
disorders, can cause: A. Ebstein's anomaly B. Vaginal
clear cell adenocarcinoma C. Phocomelia D. Mobius
sequence
417. Theophylline has a pKa of 8.7, what is the 581 D. Above pKa, the unprotonated and uncharged form of a weak
predominant form at pH 11.3? A. Ionized and base predominates.
protonated B. Non-ionized and protonated C.
Charged and unprotonated D. Uncharged and
unprotonated E. None of the above
418. This 3rd generation cephalosporin can cross the 192 A. All 3rd generation cephalosporins can cross the blood brain
blood brain barrier A. ceftizoxime B. cefpodoxime C. barrier except: ceftibuten, cefpodoxime, cefixime, cefoperazone.
ceftibuten D. cefaclor E. cefuroxime

419. This antidiabetic drug because of its unique mechanism of 79 B. Acarbose and miglitol are competitive inhibitors of the
action should be taken just before ingesting the first portion intestinal α-glucosidases and reduce postmeal glucose
of each meal? A. Exenatide B. Miglitol C. Pramlintide D. excursions by delaying the digestion and absorption of starch
Pioglitazone E. Metformin and disaccharide. Both acarbose and miglitol are taken in doses
of 25â€"100 mg just before ingesting the first portion of each
meal
420. This antihistamine causes depolarization-induced paralysis in 330 C. Mebendazole selectively inhibits microtubule synthesis
nematodes: A. Mebendazole B. Ivermectin C. Pyrantel and glucose uptake. Ivermectin interferes with GABA mediated
pamoate D. Piperazine neurotransmission. Piperazine is an agonist at GABA receptors.
421. This antihypertensive drug is absolutely contraindicated in 350 D.
pregnancy because it can cause renal damage in the fetus: A.
Reserpine B. Hydralazine C. Propranolol D. Captopril
422. This antiplatelet inhibits aggregation by interfering with 324 D. Aspirin is a nonselective irreversible COX inhibitor.
GpIIb/IIIa binding to fibrinogen and other ligands: A. Aspirin B. Clopidogrel irreversibly inhibits platelet ADP receptor.
Clopidogrel C. Dipyridamole D. Tirofiban Dipyridamole inhibits adenosine uptake and inhibits
phosphodiesterase enzymes that degrade cyclic nucleotides.
423. This antiviral agent against Influenza A acts by blocking the 516 A. katzung 10th ed., 815.
M2 proton ion channel of the virus particle and by inhibitting
uncoating of the viral RNA within infected host cells, thus
preventing its replication. A. Amantadine B. Ribavirin C.
Oseltamivir D. Entecavir E. None of the abpve
424. This autonomic drug should be given with caution in patients 490 D. Reserpine which crosses the blood brain barrier is
with depressive disorders: A. guanethidine B. metyrosine C. notorious for causing depression and increasing suicidal
vesamicol D. Reserpine tendencies.
425. This beta blocker has a unique mechanism of action owing to 69 E Nebivolol is a β1 receptor blocker with nitric oxide-
its it has a nitric oxide (NO)-potentiating vasodilatory effect in potentiating vasodilatory effect used in treatment of
addition to beta blockade. A. Carvedilol B. Pindolol C. Nadolol hypertension
D. Esmolol E. Nebivolol
426. This cell-cycle specific drug is commonly used for testicular 140 D.
cancer. It does not cause myelosuppression, however, dose
modification is recommended in the setting of renal
dysfunction. What is this chemotherapeutic drug? A.
Cyclophosphamide B. Cisplatin C. Busulfan D. Bleomycin E.
Etoposide
427. This chemotherapeutic agent is known for its association with 336 D.
heart toxicity in cumulative doses: A. 5-FU B. 6-MP C.
Methotrexate D. Doxorubicin
428. This direct acting cholinomimetic is used in the treatment of 341 B.
postoperative ileum and neurogenic bladder: A. Neostigmine
B. Bethanechol C. Pilocarpine D. Physostigmine
429. This diuretic can also be used in the treatment of glaucoma: A. 498 A. Technically, mannitol can also be used but
acetazolamide B. hydrochlorothiazide C. mannitol D. amiloride acetazolamide is a better answer. SIMILAR TO PREVIOUS
BOARD EXAM CONCEPT/PRINCIPLE
430. This drug activates peroxisome proliferator-activated 494 A. Do not confuse with the mechanism of action of fibrates
receptors, a group of nuclear receptors, with greatest which is activation of the nuclear transcription factor PPAR-α.
specificity to PPAR-γ receptors: A. pioglitazone B. gemfibrozil
C. sitagliptin D. Exenatide
431. This drug belongs to a class of antiarrhythmic drugs which 114 A. Page 24 of Topnotch Handout. Under the Singh- Vaughn
prolongs AP duration, PR interval, QRS duration and QT Williams classification. The class being described are Class 1A
interval: A. Procainamide B. Lidocaine C. Flecainide D. Antiarrhythmics. Classified underwhich is Procainamide
Propanolol E. Dofetilide Quinidine and Disopyramide.

432. This drug class used in asthma exerts its 75 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Corticosteroids do
effect by contraction of engorged not relax airway smooth muscle directly but reduce bronchial reactivity and reduce the
vessels in the bronchial mucosa and frequency of asthma exacerbations if taken regularly. Their effect on airway
reduces bronchial hyperreactivity? A. obstruction may be due in part to their contraction of engorged vessels in the
Beta 2 agonists B. Inhaled bronchial mucosa and their potentiation of the effects of β- receptor agonists, but their
corticosteroids C. Methylxanthines D. most important action is inhibition of the infiltration of asthmatic airways by
Mast cell stabilizers E. Antimuscarinic lymphocytes, eosinophils, and mast cells.
agent
433. This drug inhibits intestinal absorption 174 B.
of phytosterol and cholesterol which
will eventually decrease the level of
LDL. A. rosuvastatin B. ezetimibe C.
Niacin D. Gemfibrozil E. Simvastatin
434. This drug inhibits platelet aggregation 500 D. Cilostazol is a phosphodiesterase III inhibitor, tirofiban binds to GP IIb/IIIa
by irreversibly blocking ADP receptors: receptor, and alteplase is a thrombolytic (not an anti-platelet) which converts
A. cilostazol B. tirofiban C. alteplase D. plasminogen to plasmin.
Ticagrelor
435. This drug inhibits the transport of 108 E Page 11 of Topnotch Handout. Storage of Ach into vesicles is inhibited by
Acetylcholine into vesicles for storage vesamicol.
by VAT: A. Hemicholinium B. Botulinum
C. Neostigmine D. Betanechol E.
Vesamicol
436. This drug is a derivative of rifamycin 517 B. Katzung 10th ed., 777. Rifabutin is a less potent inducer of the cytochrome P450
which is indicated in place of rifampin enzyme (compared to Rifampin) resulting to slower elimination and longer halflife of
for treatment of tuberculosis in HIV- protease inhibitors used in treating HIV patients is cases of HIV with concurrent
infected patients who are receiving tuberculosis. Rifapentine like Rifampin is a potent inducer of cytochrome p450
concurrent protease inhibitors: A. enzymes and should not be used to treat HIV-infected patients because of an
Rifapentine B. Rifabutin C. Ritonavir D. unaccepptably high relapse rate with rifampin- resistant organisms. Rtonavir is a
Rifadin E. Rimactane protease inhibitor. Rifadin and Rimactane are brand names of Rifampin.
437. This drug is a monoclonal antibody that 335 A. Rituximab is a monoclonal antibody that binds to surface protein in NHL
binds to VEGF and prevents it from inducing lysis, cytotoxicity and apoptosis. Trastuzumab is a monoclonal antibody that
interacting with VEGF receptors: A. recognizes protein in breast CA cells overexpressing HER-2neu receptor for EGF.
Bevacuzimab B. Rituximab C. Imatinib inhibits tyrosine kinase activity of the product of bcr-abl oncogene expressed
Trastuzumab D. Imatinib in CML.
438. This drug reduces the relapse rates for 151 E Primaquine eradicates hypnozoites in the liver responsible for causing relapse
malaria A. Quinine B. Arthemeter-
lumefantrine C. Mefloquine D.
Doxycycline E. Primaquine
439. This drug requires phosphorylation by 329 D. Efavirenz, delaverdine, and nevirapine are non nucleoside reverse transcriptase
host cell kinases to be active: A. inhibitors which do not require host cell kinase for activation, unlike tenofovir, a
Efavirenz B. Delavirdine C. Nevirapine nucleoside reverse transcriptase inhibitor which does.
D. Tenofovir
440. This drug stimulates platelet production 339 A. Filgrastim stimulates the function and production of neutrophils.
and decreases the number of platelet
transfusions required by patients
undergoing bone marrow suppression in
treatment for CA: A. Oprevelkin B.
Filgrastim C. Erythropoietin D. Folic acid
441. This drug that produces a permanent 55 A. Radioactive iodine is the only medical therapy that produces a permanent
reduction in thyroid activity is A. 131I B. reduction of thyroid activity.
Amiodarone C. Propranolol D.
Propylthiouracil E. Triiodothyronine

442. This drug when given IV and 225 B. Verapamil can also decrease AV node conduction however via blocking L
supraphysiologic dose will cause type Ca channels and not K channels. Fleicanide is a class IC drug that affects
conduction block on AV node via increasing primarily Na channels present in both atria and ventricles. Amiodarone is the most
K efflux? A. Verapamil IV B. Adenosine C. efficacious of all antiarrhythmic drug since it blocks Na, Ca, K and Beta receptors.
Fleicanide D. Amiodarone E. None of the the question is specific on its action in reference to AV node. the best answer is
above adenosine.
443. This factor indicates the spread of local 693 B. Answer: B Density of local anesthetic in relation to density of CSF at normal
anesthetic in CSF? A. Addition of narcotic to body temp.is termed as baricity. Degree of spread is determnined primarily by
local anesthetic. B. Density of local density of anesthetic & patient’s position.
anesthetic C. Patient’s body surface
area D. Dose administered
444. This halogen in a 1:20,000 solution is 515 D. Katzung 10th ed., 822. Phenolic disinfectants are the oldest of the surgical
bactericidal in 1 minute and kills spores in 15 antiseptics. They are used for hard surface decontamination in hospitals and labs.
minutes. It is the most active antiseptic for They are no longer used as a disinfectant because of its corrosive effect on tissues,
intact skin: A. Phenol B. Hypochlorus acid C. its toxicity when absorbed (hyperbilirubinemia in newborns) and its carcinogenic
Sodium hypochlorite D. Iodine E. effect. Sodium hypochlorite (household bleach) in 1:10 dilution which provides 5000
Hexachlorophene ppm of available chlorine is recommended by CDC for disinfection of blood spills
and to kill spores.
445. This is a mucosal protective drug used as an 440 D.
adjunct treatment of PUD. It binds to injured
tissues and forms a protective covering
over ulcer beds, resulting in accelerated
healing: A. Misoprostol B. Bismuth salicylate
C. Calcium carbonate D. Sucralfate
446. This is not a characteristic of phase I clinical 343 B. Determination of drug efficacy is done during phase II of clinical trials.
trials in drug development: A.
Pharmacokinetic measurements are done B.
Determination of drug’s efficacy C.
Determination of maximum tolerated dose
D. Subjects are healthy volunteers
447. This is the anti-Asthma drug which is only of 644 D.
worth if given as prophylaxis. A. Salbutamol
B. Budesonide C. Salmeterol D. Cromolyn E.
Hydrocortisone
448. This is the only ligand-gated serotonin 489 C.
receptor: A. 5HT1 B. 5HT2 C. 5HT3 D. 5HT4
449. This is time of drug solubility and absorption 661 C. polar, ionized - less soluble in lipids, excreted; non - polar, unionized - more
and clearance? A. Ionized drugs are better soluble, absorbed
absorbed in the GIT B. Polar drugs have
decreased clearance C. Non-ionized drugs
are better absorbed in the GIT D. Non-polar
drugs have increased clearance E. None of
the above
450. This opioid antagonist is used in opioid and 190 B. Naltrexone reduces craving in alcohol dependence. Note: there are
alcohol dependence A. Nalmefene B. probably 4 questions about opiates in our boards.
Naltrexone C. Naloxone D. Nalbuphine E. A
and C

451. this oral iron compound has the 563 C. Ferrous sulfate (FEOSOL, others) is the hydrated salt, FeSO4×7H2O, which contains
highest elemental iron content: a. 20% iron. Dried ferrous sulfate (32% elemental iron) is also available. Ferrous fumarate
ferrous sulfate b. ferrous (FEOSTAT, others) contains 33% iron and is moderately soluble in water, stable, and almost
gluconate c. ferrous fumarate d. tasteless. Ferrous gluconate (FERGON, others) also has been successfully used in the
iron dextran therapy of iron-deficiency anemia. The gluconate contains 12% iron. Polysaccharide-iron
complex (NIFEREX, others), a compound of ferrihydrite and carbohydrate, is another
preparation with comparable absorption. The effective dose of all of these preparations is
based on iron content.
452. This prostaglandin F2 alpha 116 D. Page 32 of Topnotch Handout. Latanoprost is commonly used off label for eyelash
analog is commonly used off label lengthening. It is a prostaglandin F2alpha analog that activates FP receptors, increases
for its side effect which is outflow of aquaeous humor and reduces intraocular pressure. Its other side effects are
lengthening of eyelashes: A. Blurred vision, eye irritation, or tearing darkening of eyelid skin color, increase in brown
Beraprost B. Dinoprostone C. color in colored part of eye.
Alprostail D. Latanoprost E.
Gemeprost
453. This regimen is utilized in the 334 B. ABVD - adriamycin, bleomycin, vincristine, dacarbazine, prednisone. PEB (cisplatin,
treatment of Hodgkin lyphoma: A. etoposide, bleomycin) regimen is used in testicular CA. CHOP (cyclophosphamide,
PEB regimen B. ABVD regimen C. doxorubicin, vincristine, prednisone) regimen in non-Hodgkin lymphoma, and GnRH agonist
CHOP regimen D. GnRH agonist and androgen receptor antagonist in prostate CA treatment.
and androgen receptor antagonist
454. This route of drug administration is 502 C. Katzung 10th ed, p. 41
the most convenient, however
bioavailability may be less than
100% because of incomplete
absorption and first-pass
elimination. A. Intramuscular B.
Subcutaneous C. Oral D.
Transdermal E. All of the above
455. Though 1% is systemically 159 B. Bronchodilation is still the net effect of ipratropium, the systemic effect is negligent as
absorbed when Ipratropium the drug is administered to its site of action which is the lungs.
Bromide is given via nebulization,
what is its net effect? A. Reflex
tachycardia B. Bronchodilation C.
Bronchoconstriction D. Laryngeal
spasm E. None of the above
456. Throbbing headaches in patients 426 B.
taking nitrates are mainly
attributed to: A. Chemical toxicity
B. Meningeal artery vasodilation C.
Reflex tachycardia D. Abrupt
lowering of BP
457. Thru what route is the usual portal 101 C. Page 94 of Topnotch Handout. The usual setting of either acute or chronic inorganic
of entry in Inorganic Mercury mercury poisoning is thru Inhalation of inorganic mercury vapor.
poisoning? A. Ingestion B. Topical
application C. Inhalation D. Rectal
E. None of the above
458. Tocainide is an antiarrhythmic 390 B.
agent classified under which
group? A. Class IA B. Class IB C.
Class IC D. Class II E. Class III

459. To improve the quality of life of patients with on-going 412 C. Flutamide an Androgen Antagonist is given in adjunct to
treatment for Prostate Adenocarcinoma with Leuprolide to lessen the side effects of Leuprolide like Gynecomastia,
Leuprolide, which of the following medications should decreased libido, Apoplexy and hot flushes.(SIMILAR TO PREVIOUS
be added? A. Anastrazole B. Examestane C. Flutamide BOARD EXAM CONCEPT/PRINCIPLE)
D. Prednisone E. Morphine
460. Tolerance is seen in which of the following drugs: A. 56 A. Tolerance develop with nitrates when used for more than 8
Nitrates B. Dopamine C. Epinephine D. Aspirin E. AOTA hours without interruption
461. A topical preparation that are concentric spherical 580 A. Newer vehicles include liposomes and microgel formulations.
shells of phospholipids in an aqueous medium that may Liposomes are concentric spherical shells of phospholipids in an
enhance percutaneous absorption. a. Liposome b. aqueous medium that may enhance percutaneous absorption.
Microgrel c. Transfersome d. Micelle Variations in size, charge, and lipid content can influence liposome
function substantially. Liposomes penetrate compromised epidermal
barriers more efficiently (Korting et al., 1991). Microgels are polymers
that may enhance solubilization of certain drugs, thereby enhancing
penetration and diminishing irritancy.
462. Tranexamic acid is used to prevent and treat acute 432 A. Plasminogen are converted to plasmin whose function is to lyse
bleeding episodes in patients who are at high risk, the formed fibrin. When it is inhibited, hemostasis is promoted.
especially those who have hemophilia and intracranial
aneurysms. The mechanism of action of this drug
involves: A. Inhibition of plasminogen activators B.
Inhibition of plasmin-degrading factors C. Potentiation
of factor VIII activity D. Delivery of Vitamin K to the
clotting factor-synthesizing cells
463. Treatment for inflammatory bowel disease: A. 433 B. Sulfasalazine is poorly absorbed in the GIT and therefore it is
Sulfadiazine B. Sulfasalazine C. Sulfamethoxazole D. believed that it has its main action in lumen. It is used to treat IBDs by
Sulfatide reducing the synthesis of inflammatory mediators known as
eicosanoids and inflammatory cytokines. However, unlike
glucocorticoids, sulfasalazine is also a mild immunosuppressant.
464. A tricyclic antidepresssant drug long used to reduce 506 B. Katzung 115: Ipratropium-is an anti-muscarinic drug used as an
incontinence in institutionalized elderly patients and in inhalational drug for asthma. Scopolamine- is an antimuscarinic drug
children with bedwetting problems because of its strong used to remedy seasickness. Oxybutinin- is an antimuscarinic selective
anti-muscarinic actions: A. Ipratropium B. Imipramine C. for M3 receptors used to relieve bladder spasm after urologic surgery
Scopolamine D. Oxybutinin E. Fluoxetine and is also valuable in reducing involuntary voiding in patients with
neurologic disease. Fluoxetine is an SSRI.
465. True of Acetaminophen: a. It covalently binds to COX 572 B. Observational studies suggest that acetaminophen, which is a ,
inhibiting prostaglandin synthesis b. very weak very weak antiinflammatory agent at the typical daily dose of 1000 mg
antiinflammatory agent at the typical daily dose of 1000 is associated with a reduced incidence of gastrointestinal adverse
mg c. incidence of Gastrointestinal adverse effects effects compared to tNSAIDs
comparable to Ibuprofen d. its inhibition of
thromboxane A2 synthesis discourages its use in
dengue cases
466. Type II DM with insulin resistance will be best treated 360 D.
with which of the following: A. Sulfonylureas B. Gliptins
C. Insulin glargine D. TZDs
467. Upon taking Penicillin, a 20 year-old male suddenly 453 D. Epinehrine is a sympathomimetic, nonselective and direct-
experienced respiratory distress. A drug would be most acting. It is helpful in patients with anaphylactic shock. Respiratory
helpful to treat the respiratory symptoms was given in distress is treated by Epinephrine's action on beta 2 receptors resulting
this patient. In comparison to norepinephrine, to bronchodilation.
epinephrine has more effects on: A. alpha 1 receptors B.
alpha 2 receptors C. beta 1 receptors D. beta 2
receptors E. dopamine receptors
468. Use of aspirin as an anti-platelet inhibits primarily which 342 B.
prostanoid? A. Prostacyclin B. Thromboxane C.
Prostaglandin D. Epoprosterenol

469. Using drugs to block which of the following chemical mediators 252 D. SIMILAR TO PREVIOUS BOARD EXAM
could potentially decrease leukocyte chemotaxis? A. CONCEPT/PRINCIPLE, but leukotrienes could also serve as
prostaglandin H B. cyclooxygenase C. bradykinin D. chemotactic factors
leukotrienes E. serotonin
470. Using the Henderson-Hasselbach equation, in a pH above the 102 D. Page 2 of Topnotch Handout. According to the
dissociation constant, a weak acid is present in the _____________ Henderson-Hasselbach equation Weak acid above the pKa is
form. A. unprotonated, uncharged B. protonated, charged C. unprotonated and charged.
protonated, uncharged D. unprotonated, charged E.
unpredictable
471. Vancomycin is administered orally for this condition: A. Sepsis B. 352 C.
Endocarditis C. Antibiotic-associated enterocolitis D. Meningitis
472. A vinca alkaloid acting primarily in the M phase of cancer cell 439 B.
cycle that is useful in the treatment of acute leukemias,
lymphomas and neuroblastoma: A. Paclitaxel B. Vincristine C.
Doxorubicin D. Cytarabine
473. Warfarin is prescribed to a 40 year-old male. The excessive 454 E Bleeding with warfarin can be reversed by
anticoagulant effect results to bleeding in this patient can be administration of Vitamin K, FFP and by discontinuance of the
reversed by: A. Administration of vitamin K B. Administration of drug.
fresh frozen plasma C. Discontinuance of the drug D. A and C E.
All of the above
474. What anti-retroviral agent causes peripheral neuropathy and 184 C. SIMILAR TO PREVIOUS BOARD EXAM
pancreatitis? A. Zidovudine B. Zalcitabine C. Didanosine D. CONCEPT/PRINCIPLE.. Zidovudine causes bone marrow
Abacavir E. Foscarnet suppression. Abacavir causes hypersensitivity. Didanosine
causesperipheral neuropathy and pancreatitis. Stavudine and
Zalcitabine causes peripheral neuropathy.
475. What anti-TB medication readily penetrates into phagocytic 80 B. As stated verbatim in Katzung, rifampicin readily
cells and can kill organisms that are poorly accessible to many penetrates most tissues and penetrates into phagocytic cells.
other drugs, such as intracellular organisms and those It can kill organisms that are poorly accessible to many other
sequestered in abscesses and lung cavities? A. Isoniazid B. drugs, such as intracellular organisms and those sequestered
Rifampicin C. Ethambutol D. Pyrazinamide E. Streptomycin in abscesses and lung cavities.
476. What class of anti-hypertensive drugs are also used in BPH? A. 419 C. Alpha 1-A receptor is specifically seen in the Urinary
Alpha 1A Agonists B. Alpha 1B Agonists C. Alpha 1A Antagonists tract most especially the Prostate.Alpha 1A
D. Alpha 1B Antagonists E. Alpha 2 Agonists antagonists/Quinazolines include Prazosin Terazosin, and
Tamsulosin
477. What drug acts on epithelial sodium channels in cortical 199 D. Triamterene and Amiloride are potassium sparing
collecting ducts and is used to reduce potassium excretion in diuretics that act on epithelial sodium channels (ENaC) in
cases of hypokalemia? A. furosemide B. acetazolamide C. cortical collecting duct, causing decreased Na reabsorption
spironolactone D. triamterene E. hydrochlorothiazide and K excretion. Spironolactone and eplerenone are also
potassium sparing diuretics but they act on aldosterone
receptors.
478. What drug should be given to an immunocompromised patient 220 D. Ganciclovir is the drug of choice for CMV. Foscarnet is
with CMV retinitis? A. Acyclovir B. Vidarabine C. Indinavir D. an alternative.
Ganciclovir E. AZT
479. What enzyme do statins inhibit? A. HMG-CoA synthase B. HMG- 15 B. Statins inhibit the rate-limiting step of cholesterol
CoA reductase C. HMG-CoA lyase D. HMG-CoA transferase A. synthesis. Don’t get confused with HMG CoA synthase
All of the above which is the rate limiting step of ketogenesis. Source: Katzung
Basic and Clinical Pharmacology 11th ed p 612
480. What hypertensive drug commonly used for the outpatient 587 C. Methyldopa is a selective alpha 2 agonist.
treatment of preeclampsia is prominent for its side-effect of
hemolytic anemia with a positive Coomb's test? A. α1 adrenergic
agonist B. α2 adrenergic antagonist C. α1 adrenergic agonist D.
α2 adrenergic antagonist E. non-selective α antagonist

481. What is the anti-hypertensive drug of choice for patients with 70 C. ACE inhibitors are renal efferent arteriole dilators
diabetic nephropathy? A. Nifedipine B. Clonidine C. Enalapril D. decreasing albumin excretion and slowing progression of
Atenolol E. Thiazides CKD.
482. what is the dose limiting toxicity of vincristine ? A. areflexia B. 320 A. vincristine does not cause serious myelosuppresive
Bone marrow suppression C. Acute tubular necrosis D. effect however it induces neurotoxicity such as areflexia,
Hepatocyte degeneration E. None of the above ileus and peripheral neuritis. Katzung review 8th ed p 455.
483. What is the drug of choice for all forms of schistosomiasis and 238 B. DEC is the drug of choice for loa loa infection, it is
paragonimiasis? A. Diethylcarbamazine B. Praziquantel C. also an alternative drug for elephantiasis. Ivermectin - DOC
Ivermectin D. Albendazole E. Piperazine for onchocerciasis, cutaneous larva migransm and
strongyloides. Albendazole- ascariasis, hookworm, pinworm,
whipworm, cysticercosis and hydatid disease. Piperazine is an
alternative drug for ascariasis.
484. What is the drug of choice for paroxysmal supraventricular 474 B. Esmolol, sotalol, verapamil are all used for the
tachycardia? A. Esmolol B. adenosine C. verapamil D. Sotalol E. treatment of supraventricular tachycardia. For paroxysmal
Any of the choices supraventricular tachycardia, the drug of choice is adenosine.
485. what is the drug of choice for restless leg syndrome? A. 314 D. the pathologic basis for restless leg syndrome is
haloperidol B. aripriprazole C. Citalopram D. Ropinirole E. dopamine blockade. Agonist to dopamine receptors such as
Propanolol pramipexole or ropinirole is very effective in treating this
condition. Katzung review 8th ed p 235
486. What is the drug of choice for the cyst carrier state of Entamoeba 438 A.Diloxanide furoate is a luminal amoebicide which is
histolytica? A. Diloxanide furoate B. Metronidazole C. Tinidazole hydrolysed in the gut, thus releasing the free diloxanide
D. Paramomycin which acts as an amoebicide. It is given alone in
asymptomatic cyst passers. For patients with active amoebic
infections, it can be administered along with metronidazole.
487. What is the drug of choice for the eradication of dormant liver 514 B. Primaquine is the only available agent active against
forms of Plasmodium vivax and Plasmodium ovale? A. Quinidine the dormant hypnozoite stages of p. vivax and p. ovale.
B. Primaquine C. Mefloqione D. Chloroquine E. Lumefantrine (radical cure) Katzung 10th ed., 852
488. What is the drug of choice for the rapid termination of 72 A. Adenosine is the drug of choice for paroxysmal SVT.
paroxysmal supraventricular tachycardia? A. Adenosine B. Magnesium is the drug of choice for Torsades de pointes.
Magnesium C. Lidocaine D. Amiodarone E. Verapamil Lidocaine is the drug of choice for post MI arrythmias and
digoxin induced arrythmias.
489. What is the drug of choice for trigeminal neuralgia? A. 647 D. SIMILAR TO PREVIOUS BOARD EXAM
Lamotrigine B. Gabapentin C. Pregabalin D. Carbamazepine E. B CONCEPT/PRINCIPLE
or C
490. What is the drug of choice in acute arrhythmias A. Metoprolol B. 144 B.
Lidocaine C. Quinine D. Bisoprolol E. None of the above
491. What is the drug of choice in preventing the recurrence of 145 A.
arryhthmia A. Adenosine B. Procainamide C. Lidocaine D.
Carvedilol E. None of the above
492. What is the half-life of alcohol? A. 2 hours B. 4 hours C. 8 hours D. 541 E Ethanol, over most of its plasma concentration range,
12 hours E. None of the above exhibits zero-order elimination. Thus, there is no constant
half life of elimination as in drugs exhibiting first order
elimination. (Katzung Board Review 9e, p.6)
493. What is the major advantage of Etomidate over other intravenous 292 B. Etomidate has no analgesic effects. Distribution is
anesthetics? A. Has greater analgesic effects B. Causes minimal rapid from the brain to highly perfused tissue hence a
cardiovascular and respiratory depression C. Relatively longer relatively short duration of its anesthetic effect. It has a high
duration of effect D. Has a lower incidence of postoperative incidence of postoperative nausea and vomiting, pain and
nausea and vomiting E. Has a rapid onset of recovery when myoclonic activity. Initial recovery is less rapid compared
compared with Propofol with propofol
494. What is the maximum dose of Vincristine? A. 100 micrograms B. 482 D. SIMILAR TO PREVIOUS BOARD EXAM
200 micrograms C. 1 milligram D. 2 milligrams CONCEPT/PRINCIPLE

495. What is the mechanism of action of 181 B. A- fluoroquinolones. C- nitrofurantoin.

metronidazole? A. Inhibits DNA replication by
binding to DNA gyrase B. Reactive reduction by
ferredoxin forming free radicals C. Forms multiple
reactive intermediates when acted upon by
bacterial enzyme D. Unknown E. None of the
above
496. what is the mechanism of action of nystatin? A. 317 A. nystatin and ampothericin B are both polyene antifungal antibiotics. It
Formation of artificial pore in the fungal binds to ergosterol and creates an artificial pores in the fungal membrane
membrane B. Inhibit ergosterol synthesis C. Inhibit leading to increase membrane permeability. Katzung review 8th ed p 401
microtubular formation D. Inhibits squalene
epoxidase E. Inhibit the synthesis of B(1-2) glycan
497. What is the mechanism of action of PTU? A. 191 D. There are 5 steps in thyroid hormone synthesis. 1. iodide trapping; 2.
Blocks iodination and organification B. Inhibits iodination/organification; 3. coupling; 4. secretion; 5. peripheral conversion.
iodide trapping C. Blocks coupling reaction D. Steps 2 to 5 are actually blocked by PTU but the main effect among these is
Blocks peripheral conversion of T4 to T3 E. the inhibition of peripheral conversion.
Inhibits secretion
498. What is the most important drug in pulmonary 322 A.
tuberculosis? A. INH B. Pyrazinamide C. Rifampin
D. Ethambutol
499. What is the most serious side effect of Methanol 231 A. Methanol or wood alcohol is metabolized by alcohol dehydrogenase
ingestion? A. Retinal damage B. Hepatotoxicity C. to produce a product called Formaldehyde and formic acid. This metabolite
Blood dyscrasia D. Nephrotoxicity E. causes severe acidosis and prominent retinal damage. Nephrotoxicity is a
Neurotoxicity- status epilepticus major side effect of ethylene glycol poisoning via its oxalic acid metabolite.
treatment for both alcohol is by administration of Fomepizole ( inhibitor
alcohol dehydrogenase) and ethanol ( competitive substrate for alcohol
dehydrogenase).
500. What is the MOST-SLECTIVE alpha 1 selective 669 B. However, all of the mentioned drugs are alpha-1 selective antagonists
antagonist used in the treatment of BPH? A. used in the treatment of BPH (Prazosin, Tamsulosin, Terazosin, Doxazosin).
Prazosin B. tamsulosin C. Terazosin D. Doxazosin Tamsulosin is the most selective alpha-1 selective antagonist. . Tamsulosin is a
E. all of the above selective α1 receptor antagonist that has preferential selectivity for the α1A
receptor in the prostate versus the α1B receptor in the blood vessels. When
alpha 1 receptors in the bladder neck and the prostate are blocked, this
causes a relaxation in smooth muscle and therefore less resistance to urinary
flow. Due to this the pain associated with BPH can be reduced.
501. What is the pharmacologic basis of using Timolol 221 C. MOA: letter A- alpha agonist and epinephrine; B- Cholinomimetics (
in open angle glaucoma? A. Increaed outflow via physostigmine, pilocarpine) D- there is no such thing cAMP dependent
dilatation of uveoscleral veins B. It leads to decrease in bicarbonate; however inhibition of Carbonic anhydrase leads to
opening of trabecular meshwork C. It suppresses decrease humor production via decreased bicarbonate levels.
the ciliary epithelium from producing aqueous
humor D. lt decrease production of aqueous
humor by decreasing levels of bicarbonate
through cAMP mediated pathway. E. none of the
above
502. What is the predominant form of a weakly acidic 466 A. The physiologic pH is at 7.35-7.45 which is above the pKa of this drug
drug with pKa of 5 at physiologic pH? A. 5. At pH above pKa, weakly acidic drug is predominantly unprotonated
Unprotonated charged B. Protonated charged C. charged, if it is below pKa, the predominant form is protonated uncharged.
Unprotonated uncharged D. Protonated
uncharged E. None of the choices

503. What is the predominant reason why 248 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, high
nitroglycerin is generally preferred not to be first pass effect is the best answer, low bioavailability through the oral route
given via the oral route? A. could potentially due to liver metabolism
cause dangerous systemic hypotension B. is
considerably less effective when given through
this route C. is immediately inactivated by
exposure to low gastric pH D. there is high first
pass effect E. food in the stomach significantly
retards absorption
504. what is the primary drug of treatment for 319 A. B,C,D has no clinical effectivity in hydatid disease.
ascariasis, pinworm, whipworm and hydatid
disease? A. albendazole B. Mebendazole C.
Pyrantel pamoate D. Diethylcarbamazine E. All of
the above
505. what is the recommended treatment for a 29 y/o 312 B. single dose administration of spectinomycin is effective in treating
G1PO female diagnosed with Gonnorrhea Gonnorhea in a patient who has severe beta lactam hypersensitivity. It has
infection who has severe hypersensitivity to lesser risk of teratogenicity compared to conventional aminglycosides.
pennicilin? A. erythromycin B. Spectinomycin C. Clindamycin is active only on gram positive and anaerobic organisms.
Cetriaxone D. Doxycycline E. Clindamycin ceftriaxone is a 3rd generation cephalosporin effective against Gonorrhea
infection however it should be avoided since the patient has beta lactam
hypersensitivity. Doxycycline should never be given for pregnant patients.
erythromycin is not effective treatment for gonorrhea infection. Katzung 11th
ed p 813.
506. What is the second messenger system for the 209 A. Beta-2 receptors are coupled to the cAMP second messenger system.
receptors blocked by metoprolol? A. cAMP B.
IP3 C. DAG D. cGMP E. PLC
507. What is the site of action of corticosteroids in 229 C. Corticosteroids exerts its anti inflammatory effect by inhibiting the
terms of its antiinflammatory effect? A. Phospholipase A2 enzyme which is responsible for generation of arachidonic
Cyclooxygenase 1 and 2 B. Phospholipase C C. acid from membrane lipids. Phospholipase C is not connected with
Phospholipase A2 D. Thromboxane synthase E. corticosteroids and its function is to generate IP3 and DAG. Cyclooxygenase
All of the above and thromboxane synthase is primarily inhibit by Coxibs and NSAIDS.
508. What is the treatment for malignant 12 A. Source: Topnotch handout on Pharmacology
hyperthermia? A. Dantrolene B. Nitroglycerin C.
Paracetamol D. Halothane E. All of the above
509. What part of the pharmacokinetics of penicillin is 204 C. Probenecid raises plasma concentration of penicillin by inhibiting its
affected by the drug probenecid? A. Glomerular tubular secretion in the renal tubules.
filtration B. Tubular reabsorption C. Tubular
secretion D. Hepatic uptake E. Protein-binding
with albumin
510. What type of muscarinic receptors is used by the 468 B. M1 - nerve endings, M2-heart, M3 - smooth muscle, glands,
heart? A. M1 B. M2 C. M3 D. N1 E. N2 endothelium
511. When a pregnant 18 year old female delivered 247 C. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, know
her child, her baby was noted to have the common syndromes and teratogen, answer here is fetal alcohol syndrome
characteristic small palpebral fissures, smooth
philtrum and thin upper lip, which of the following
substances when ingested by the mother during
pregnancy could potentially be the cause of such
changes? A. phenytoin B. warfarin C. ethanol D.
captopril E. isotretinoin
512. Which aminoglycoside has the narrowest 435 C.
therapeutic window but with the widest
coverage? A. Gentamicin B. Streptomycin C.
Amikacin D. Kanamycin

513. Which among the 258 E know the mechanism understand them, know and master normal physiology, digoxin is a negative
following cardiac drugs chronotropic but positive inotropic inc contractility, captopril inhibits ACE, acts on the RAAS decreases
can decrease preload, preload by decreasing aldosterone and sodium water retention hence decrease blood volume dec
afterload and venous return, amlodipine calcium antagonist predominantly on the vessels decrease afterload by
contractility? A. digoxin dilating resistance vessels, hydrochlorthiazide decreases preload by increasing secretion of both
B. captopril C. sodium water, propranolol, non selective beta blocker, decreases renin secretion hence RAAS through
amlodipine D. B1 blockage this includes angiotensin 2 so decreased both preload afterload, decreases contractilitty
hydrochlorthiazide E. through B1 blockade,
propranolol
514. Which among the 652 A. Carbonic anhydrase inhibitors
following diuretics can
also be used for
mountain sickness? A.
Acetazolamide B.
Furosemide C. Thiazide
D. Mannitol E. None
515. Which among the 168 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. Katzung 11th edition page 514.
following drugs deliver Fluoxetine is a SSRI. Venlafaxine is a SNRI. Imipramine is a TCA. Selegiline is MAOi. Trazadone is a
its action through serotonin antagonist.
selectively inhibiting
reuptake of serotonin?
A. venlafaxine B.
imipramine C. selegiline
D. fluoxetine E.
trazodone
516. Which among the 659 A.
following drugs is
commonly used in
controlling the manic
phase of a bipolar
patient? A. Lithium B.
Selegiline C. Reserpine
D. Haloperidol E.
Biperiden
517. Which among the 654 C. Loperamide is an opioid that acts on Kappa receptors to increase gastric emptying time.
following is/are opioid
agonist? A. Hyoscine B.
Metoclopramide C.
Loperamide D.
Attapulgite E. AlMg(OH)
518. Which among the 143 A. The opioid ohmefentanyl is the most potent opioid
following is the most
potent opioid A.
Ohmefentanyl B.
Morphine C. Fentanyl D.
Pethidine E.
Remifentanil
519. Which among the lipid- 648 B.
lowering medicatins
causes flushing? A.
Statins B. Niacin C.
Cholestyramine D. A
and B E. B and C

520. which anong the following drugs 564 B. Phenobarbitals should be avoided in patients diagbosed with porphyria
should be avoided in patients with
porphyria? a. phenytoin b.
secobarbital c. midazolam d.
sodium valproate
521. Which antifungal drug inhibits β- 362 E Terbinafine - inhibits squalene oxidase; Ketoconazole - inhibits synthesis of
glucan synthase causing a ergosterol; Fluconazole - inhibits thymidylate synthase; Ampho B - polyene causes
disruption in cell wall synthesis? A. disruption of fungal cell walls Katzung 12th ed pg 857
Terbinafine B. Ketoconazole C.
Amphotericin B D. Fluconazole E.
Caspofungin
522. Which antihelminthic drugs rapidly 367 B. MOA of mebendazole: Mebendazole probably acts by inhibiting microtubule
kills adult worms presumably synthesis; Praziquantel: increase the permeability of trematode and cestode cell membranes
through inhibition of oxidative to calcium, resulting in paralysis, dislodgement, and death; Pyrantel pamoate:
phosphorylation or stimulation of neuromuscular blocking agent that causes release of acetylcholine and inhibition of
ATPase activity? A. Mebendazole B. cholinesterase which results in paralysis of worms followed by expulsion; Ivermectin:
Niclosamide C. Praziquantel D. paralyze nematodes and arthropods by intensifying γ-aminobutyric acid
Pyrantel pamoate E. Ivermectin (GABA)â€"mediated transmission of signals in peripheral nerves. Katzung 12th ed pg 941-
945
523. Which antimalarial drug should not 219 E
be given to a patient with glucose-
6-phosphate dehydrogenase
deficiency? A. Chloroquine B.
Quinine C. Atovaquone-proquanil
D. Mefloquine E. Primaquine
524. Which anti-parasitic drug exerts its 649 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
actions on the microtubules of
helminths? A. Mebendazole B.
Stibogluconate C. Ivermectin D.
Diloxanide Furoate E.
Metronidazole
525. Which antiretroviral drug acts 212 D. Amantadine is also effective for influenza.
through the M2 ion channel? A.
Efavirenz B. Nevirapine C. AZT D.
Amantadine E. Indinavir
526. Which class of antibiotics can be 351 D.
safely given during pregnancy? A.
Tetracycline B. Aminoglycoside C.
Fluoroquinolones D. Beta-lactams
527. Which diuretic is found to have 427 C.
long-term benefits and can reduce
mortality in chronic heart failure?
A. Thiazide B. Furosemide C.
Spironolactone D. Ethacrynic acid
528. Which drug is most effective in 332 A.
raising HDL? A. Niacin B. Fibrates C.
Statins D. Bile acid sequestrants
529. Which drugs reduces the risk of 593 A. Clozapine is the anit-psychotic that reduces the risk of suicide.
suicide? A. Clozapine B. Clonidine
C. Clonazepam D. Clofazimine E.
Clofibrate

530. Which drug used in the treatment of depression 211 A. Imipramine is a tricyclic antidepressant.
possess a tricyclic ring? A. Imipramine B.
Fluoxetine C. Trazodone D. Venlafaxine E.
Bupropion
531. Which drug when taken together with 300 C. Azathioprine is converted to mercaptopurine which is responsible for
Azathioprine has resulted in severe its immunosuppressant and hematotoxicity. Allopurinol inhibits xanthine
myelosupression by inhibiting the enzyme oxidase, the enzyme that metabolizes mercaptopurine.
responsible for its metabolism ? A. Theophylline
B. Celecoxib C. Allopurinol D. Digoxin E.
Rifampicin
532. Which has the highest partition coefficient 195 A. Methoxyflurane has the highest partition coefficient which means that it
among the inhalation anesthetics? A. has the slowest onset and recovery.
methoxyflurane B. Nitrous oxide C. isoflurane D.
sevoflurane E. desflurane
533. Which helminthic infection does not respond to 54 A. In hydatid disease, praziquantel has marginal efficacy because it does
treatment with praziquantel? A. Hydatid disease not affect the inner germinal membrane of Echinococcus granulosus present
B. Opisthorchiasis C. Paragonimiasis D. Pork in hydatid cysts.
tapeworm infection E. Schistosomiasis
534. which in the following antipsychotic medications 310 D. Olanzapine -weight gain, clozapine - agranulocytosis, haloperidol-
has the greatest risk of inducing Torsades de extrapyramidal symptoms. Thioridazine - retinal deposits. Among the atypical
pointes arryhthmia? A. Fluphenazine B. antipsychotics, ziprasidone has the greatest risk of inducing QT prolongation
Clozapine C. Thioridazine D. Ziprasidone E. leading to ventricular arrhythmias. Kazung review p 242.
Haloperidol
535. Which in the following choices can be primarily 237 D. Sodium stibogluconate - treatment of all forms of leishmaniasis
use for the treatment of hemolymphatic stage of infection; Metronidazole is not effective in the said infection, it is use for
trypanosomiasis and for Pneumocystis jiroveci giardia and trichomonas infection. Nifurtimox is for chagas diseae ( T cruzi
infection A. Sodium Stibogluconate B. infection). Cotrimoxazole is used for P jiroveci but not effective in
Metronidazole C. Nifurtimox D. Pentamidine E. Trypanosomiasis infection.
Cotrimoxazole
536. Which in the following drugs is classified as 227 D. Naratriptan and its prototype Sumatriptan are 5HT 1D agonist use for
5HT1D agonist? A. Tegaserod B. Ketanserin C. the treatment of acute migraine and cluster headache. Tegaserod indicated
Ondansetron D. Naratriptan E. None of the for constipation is a 5HT4 partial agonist.Ondansetron is a 5-HT3 antagonist
above ise for antiemesis in post operative and postchemotherapy patients.
Ketanserin is a 5HT2 antagonist use for controlling the systemic effects of
carcinoid syndrome.
537. Which nondepolarizing neuromuscular blocker 120 C. Page 53 of Topnotch Handout. Atracurium is broken down to inactive
undergoes rapid breakdown by Hoffman metabolites by (minor) ester hydrolysis and spontaneous Hoffman elimination
elimination? A. Vecuronium B. Mivacurium C. (major pathway) to Laudanosine.
Atracurium D. Tubcurarine E. Rocuronium
538. Which novel and innovative drug is used to treat 599 B. Abciximab - Glycoprotein Iib/IIIa (anti-platelet) Omalizumab - IgE
rheumatoid arthritis through its action as an (asthma) Infliximab - TNF (inflammatory bowel disease) Trastuzumba -
antibody against the protein CD20, found in the Her2neu (Breast cancer)
surface of B-cells? A. Abciximab B. Rituximab C.
Omalizumab D. Infliximab E. Trastuzumab
539. Which of the ff anticonvulsant agents do not 76 E Ethosuxime blocks the T type Calcium current in the thalamus and is the
exerts its effect through Na channel blocakade? drug of choice for absence seizures. All the other drugs block Na channels.
A. Phenytoin B. Carbamazepine C. Topiramate D.
Valproic acid E. Ethosuximide
540. Which of the ff drugs acts to improve aqueous 67 A. Pilocarpine is a cholinomimeti agent that contracts the ciliary muscle
humor outflow in patients with glaucoma? A. opening the trabecular meshwork. All of the other drugs decreases secretion
Pilocarpine B. Mannitol C. Apraclonidine D. of aqueous humor
Timolol E. Acetazlamide

541. Which of the ff electrolyte abnormality will increase digitalis 71 B. Digitalis toxicity is increased in patients with
toxicity? A. Hyponatremia B. Hypokalemia C. Hypocalcemia D. hypokalemia, hypomagnesemia and hypercalcemia.
Hypermagnesemia E. Hyperphosphatemia Potassium and digitalis interact by inhibiting each
other’s binding to Na+/K+-ATPase; therefore,
hyperkalemia reduces the enzyme-inhibiting actions of
cardiac glycosides, whereas hypokalemia facilitates these
actions.
542. Which of the ff statements regarding drug elimination is correct? A. 61 B. Elimination of parent molecules does not terminate
Elimination of parent molecules terminats the drug's action for drugs the drug's action for drugs with active metabolites. First
with active metabolites B. First order eliminination occurs when the order kinetics exhibits the characteristic half life of most
concentration of the drug decreases exponentially over time C. Zero drugs. Zero order kinetics occurs when drugs have
order kinetics exhibits the characteristic half life of most drugs D. saturated their elimination mechanisms. Phenobarbital
First order kinetics occurs when drugs have saturated their does not display zero roder kinetics
elimination mechanisms E. Phobarbital is an example of a drug that
exhibit zero order kinetics
543. Which of the ff teratogenic drugs causes atrialization of the right 64 B. Ebstein's anomaly from lithium is a congenital heart
ventricle? A. Misoprostol B. Lithium C. Ethanol D. Penicillamine E. defect in which the septal and posterior leaflets of the
Phenytoin tricuspid valve are displaced towards the apex of the
right ventricle of the heart. There is subsequent
'atrialization' of a portion of the morphologic right
ventricle
544. Which of the following adrenergic receptors in the ciliary body of 389 B. Activation of alpha-2 receptors decreases
the eye causes a decrease in aqueous humor production when aqueous humor production, while activation of either
activated? A. alpha-1 B. alpha-2 C. beta-1 D. beta-2 E. beta-3 beta-1 or beta-2 receptors increases aqeous humor
production. Alpha-1 and beta-3 receptors have no known
function in relation to aqueous humor production.
545. Which of the following agents will increase myocardial contractility 627 D. Dobutamine increases myocardial contractility, but
with the LEAST effect on total peripheral resistance? A. Epinephrine it has little effect on TPR. Beta 1 selective.
B. Phenylephrine C. Terbutaline D. Dobutamine E. Carbachol
546. Which of the following analgesics would you avoid in a patient with 387 C.
history of epilepsy as it is known to lower the seizure threshold? A.
Ketorolac B. Aspirin C. Tramadol D. Celecoxib E. Indomethacin
547. Which of the following anesthetic agent has analgesic property and 127 E Nitrous oxide , not nitric oxide, is used as an
used as an adjunct to other anesthetics? A. Halothane B. Nitric oxide anesthetic agent with analgesic property. Fentanyl is
C. Etomidate D. Desflurane E. Fentanyl often used for anesthesia and analgesia. SIMILAR TO
PREVIOUS BOARD EXAM CONCEPT.
548. Which of the following antiarrhythmics primarily exerts its action on 588 C. Class 2 anti arrhythmics or B blockers exert its
phase 4 of the cardiac action potential, prolonging PR interval? A. effort on phase 4 and prolongs the PR interval
Procainamide B. Lidocaine C. Propanolol D. Amiodarone E. Verapamil
549. Which of the following antibiotic agents is bacteriostatic? A. 4 D. Generally, cell wall inhibitors are â€"cidal, drugs
Piperacillin B. Vancomycin C. Gentamycin D. Doxycycline E. Co- which interfere with DNA are â€"cidal except
trimoxazole sulfonamides which are only static unless they are given
with trimethoprim/pyrimethamine (in this case synergism
results to cidal activity) Protein synthesis inhibitors are
â€"static except aminoglycosides because they cause
frameshift mutations by misreading of the genetic code.
Source: Topnotch handout on Pharmacology
550. Which of the following antibiotics are highly protein bound which can 259 C. SIMILAR TO PREVIOUS BOARD EXAM
act to displace other substances from albumin binding and increase CONCEPT/PRINCIPLE, sulfa drugs are usually highly
free drug levels A. chloramphenicol B. ciprofloxacin C. protein bound drugs which can displace other drugs
cotrimoxazole D. tetracycline E. gentamicin making the free drug available to easily permeate cell
membranes or bind to receptors, it can also displace
bilirubin from albumin raising bilirubin levels in neonates

551. Which of the following antibiotics does NOT 596 C. The broad class of Beta lactams including the class of monobactams
follow time-dependent killing action? A. and aztreonams exhibit time- dependent killing action. Bacitracin and
Amoxicillin B. Aztreonam C. Metronidazole D. vancomycin that also act on the cell wall exhibit time dependent killing.
Bacitracin E. Vancomycin Metronidazole, FQ and AG are concentration- dependent.
552. Which of the following antibiotics is a protein 179 E Ciprofloxacin is a fluoroquinolone which inhibits topoisomerase. The
synthesis inhibitor at 30S sub unit? A. other choices inhibits at 50s subunit.
Ciprofloxacin B. azithromycin C. clindamycin D.
linezolid E. Doxycycline
553. Which of the following antibiotics work by 399 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE.
binding to the D-Ala-D-Ala terminus of bacterial Piperacillin: inhibits transpeptidase and binds to penicillin-binding proteins in
cell wall precursors, thus preventing the cell membrane. Cycloserine: blocks incorporation of D-Ala into the
peptidoglycan polymerization? A. Imipenem B. pentapeptide side chain of peptidoglycan. Bacitracin: interferes with a late
Cycloserine C. Bacitracin D. Vancomycin E. stage in cell wall synthesis.
Piperacillin
554. Which of the following anti fungals will enhance 142 C. Ketoconazole is a potent cytochrome P450 inhibitor and therefore
the activity of cyclosporine? A. Itraconazole B. inhibits the metabolism of other drugs and increases their effects, griseofulvin
Fluconazole C. Ketoconazole D. Griseofulvin E. is a cytochrome inducer and thus facilitates the metabolism of other drugs
Terbinafine thus decreasing their effect.
555. Which of the following anti hypertensive 281 C. Intake of ACE inhibitors can produce teratogenic effect in the fetus
medications when taken during pregnancy can which includes renal dysgenesis and hypoplastic skulls (hypocalvaria) thus it is
cause hypocalvaria in the fetus? A. Carvedilol B. contraindicated during pregnancy
Amlodipine C. Captopril D. HCTZ E. Hydralazine
556. Which of the following anti-hypertensives has 605 C. Reserpine is an indole alkaloid antipsychotic and antihypertensive drug
been recalled from the market due to its side that has been used for the control of high blood pressure and for the relief of
effect of producing rebound suicide? A. psychotic symptoms. Reserpine mediated depletion of monoamine
Guanethidine B. Phenoxybenzamine C. neurotransmitters in the synapses is often cited as evidence to the theory that
Reserpine D. Trimetaphan depletion of the neurotransmitters causes subsequent depression in humans
557. Which of the following antihypertive agents 628 D. Hydralazine is CI in ptients with myocardial ischemia.
commonly used in hypertension in pregnancy is
contraindicated to patients having myocardial
ischemia? A. Methyldopa B. Methergine C.
Clonidine D. Hydralazine E. Magnesium sulfate
558. Which of the following anti-lipid drugs would 393 C.
you avoid giving to a diabetic patient due to its
adverse effect of inducing hyperglycemia? A.
Cholestyramine B. Egetimibe C. Niacin D.
Gemfibrozil E. Colestipol
559. Which of the following antimalarial drugs may 154 D. Quinine is precipitates hemolytic crisis in patients with malaria with
precipitate a hemolytic crisis in a patient with G6PD deficiency.
G6PD A. Lumefantrine B. Doxycycline C.
Artemether D. Quinine E. None of the above
560. Which of the following anti-malarial is 597 D. The fetus is G6PD deficient, so primaquine cannot be used. To achieve
contraindicated for pregnant women? A. radical cure for pregnant women, primaquine is given after delivery of the
Chloroquine B. Quinine C. Quinidine D. baby.
Primaquine E. Mefloquine
561. Which of the following antimicrobial agent acts 397 A.
as a dihydrofolate reductase inhibitor? A.
Trimethoprim B. Sulfamethoxazole C.
Metronidazole D. Nitrofurantoin E. Rifampicin
562. Which of the following anti-microbial agent is 185 E Bacteriostatic agents: All protein synthesis inhibitors except
bacteriostatic? A. Co-trimoxazole B. aminoglycoside; ethambutol, nitrofurantoin; those with anti-metabolite
Pyrazinamide C. Metronidazole D. mechanism of action- sulfonamide and trimethoprim (but they become
Aminoglycoside E. Tetracycline bactericidal when combined).

563. Which of the following anti-neoplastic drug is highly lipophilic, 598 C. Carmustine and Lomustine are highly lipophilic, used to
use for the treatment of cancers that are not readily permeable treat brain cancer.
through vascular channels? A. Bleomycin B. Busulfan C.
Carmustine D. Cyclophosphamide E. Carboplatin
564. Which of the following antineoplastic drugs can cause 177 A. cisplatin are nephrotoxic and ototoxic. Vincristine causes
hemorrhagic cystitis? A. cyclophosphamide B. cisplatin C. peripheral neuropathy. Methotrexate usually causes
vincristine D. methotrexate E. Bleomycin myelosuppression. Bleomycin is usually associated with
pulmonary fibrosis
565. Which of the following antiparkinsonian drugs can cause 233 B. Katzung Review of pharmacology 8th ed pp 233. Both
exacerbation of psychosis and produce ergot related effects Levodopa and bromocriptine can cause exacerbation of
such as pulmonary fibrosis and erythromelalgia A. Amantadine schizophrenia by increasing brain dopamine levels. However,
B. Bromocriptine C. Entacapone D. Haloperidol E. None of the only bromocriptine can cause ergot related side effects.
above
566. Which of the following antiretroviral would cause 137 B. Indinavir (Protease Inhibitor) - all Pis/'navirs' may cause
hyperlipidemia and hyperglycemia? A. Enfuvitide B. Indinavir C. hyperlipidemia, hyperglycemia, and insulin resistance as
Zidovudine D. Delavirdine E. Didanosine potential adverse events; Efuvirtide is a fusion inhibitor, SE:
Hypersensitivity, increased incidence of bacterial pneumonia,
injection site reaction; Zidovudine and Didanosine (NRTI) - all
NRTI carry the risk of lactic acidosis with hepatic steatosis
567. which of the following antiseizure drugs can inhibit cytochrome 232 D. Oxcarbazepine, carbamazepine, Barbiturates, Phenytoin
isoenzymes leading to increase plasma concentration of other are all drug metabolizing inducers. Only Valproic acid in the
drugs? A. Phenobarbital B. Lorazepam C. Oxcarbazepine D. choice is an inhibitor. Benzodiazepines do not affect the
Valproic acid E. None of the above function of the cytochromes.
568. Which of the following anti-TB drug is matched incorrectly with 2 D. Anti-TB drug most associated with skin rashes is
its adverse effects? A. Most hepatotoxic â€" Pyrazinamide B. streptomycin. Source: National TB Control Program Manual of
Psychosis â€" Isoniazid C. Most ototoxic â€" Streptomycin D. Procedures
Most associated with skin rashes due to hypersensitivity â€"
Rifampicin E. Most associated with visual impairment -
Ethambutol
569. Which of the following anti TB drugs is known to cause 637 C.
hyperuricemia and is noted to be the most hepatotoxic? A.
Rifampicin B. Ethambutol C. Pyrazinamide D. Streptomycin E.
Isoniazid
570. Which of the following antitumor antibiotics is cell-cycle 396 C. Bleomycin is specific for G2 phase of the cell cycle. The
specific? A. Mitomycin B. Doxorubicin C. Bleomycin D. rest of the choices are non-cell-cycle specific.
Actinomycin E. None of the above
571. Which of the following antivirals is a reverse transcriptase 618 C. Lamivudine is used in hepatitis B as well as in HIV
inhibitor that is used in the treatment of Hepatitis B infection? A. infection.
Amantadine B. Ganciclovir C. Lamivudine D. Interferon alpha E.
Acyclovir
572. Which of the following beta blocker drugs has/have intrinsic 629 E Pindolol and Acebutolol have intrinsic sympathomimetic
sympathomimetic activity? A. Timolol B. Acebutolol C. Pindolol activity.
D. Betaxolol E. B and C
573. Which of the following beta-blockers are less likely to cause 111 C. Page 16 of Topnotch Handout. The two beta blockers
bronchospasm in patients with asthma due to its partial agonist with intrinsic sympathomimetic activity are Pindolol and
activity? A. Carvedilol B. Labetalol C. Pindolol D. Propanolol E. Acebutolol.
Nadolol
574. Which of the following beta-blockers demonstrates the relative 586 D. Because of its relatively β1 selectivity, betaxolol has
selectivity in the manner described? A. Betaxolol: relatively fewer side effects. Timolol and levobunolol are non- selective
selective for β2-receptors B. Timolol: relatively selective for β-blockers
β1-receptors C. Levobunolol: relatively selective for β2-
receptors D. Betaxolol: relatively selective for β1-receptors E.
Levobunolol: relatively selective for β1-receptors

575. Which of the following Beta Blockers has an 414 B. Pindolol has ISA, which makes it a B blocker with a partial Alpha agonist
Intrinsic Sympathomimetic Activity? A. action.
Carvedilol B. Pindolol C. Nadolol D. Metoprolol
E. Timolol
576. Which of the following beta-blockers have local 200 C. Beta-blockers with partial agonist effect on adrenergic receptors have
anesthetic effect? A. Nadolol B. Penbutolol C. intrinsic sympathetic activity: LAPPCC (Labetalol, Acebutolol, Penbutolol,
Pindolol D. Carteolol E. Atenolol Pindolol, Carteolol, Celiprolol). Beta-blockers with membrane stabilizing
activity have local anesthetic effect: LAMPP (Labetalol, Acebutolol,
Metoprolol, Pindolol, Propranolol)
577. Which of the following beta blockers possess 296 E Acebutolol and Pindolol have partial agonist activity (ISA)
intrinsic sympathomimetic activity? A.
Metoprolol B. Esmolol C. Pindolol D. Acebutolol
E. Both C and D
578. Which of the following can't be used topically? 58 C. Topical clindamycin and erythromycin are used topically againts acne.
A. Clindamycin B. Erythromycin C. Amoxicllin D. Topical fusidic acid and mupirocin are used topically againts other superficial
Fusidic acid E. Mupirocin bacterial infection.
579. Which of the following cephalosporins can be 180 D. antipseudomonal cephalosporins are ceftazidime, cefepime, and
used to patients with Pseudomonas infection? A. cefoperazone
cefuroxime B. cefazolin C. cefoxitin D.
Ceftazidime E. Ceftriaxone
580. Which of the following cephalosporins is highly 617 C. Ceftazidime, 3rd gen cephalosporin, is considered to be most
effective against pseudomonas? A. Cefazolin B. efficacious agaianst pseudo monas among cephalosporins.
Cefuroxime C. Ceftazidime D. Cefaclor E.
Ceftriaxone
581. Which of the following Cephalosporins is 418 C. 3rd gen Cephalosporins have syndergistic effects with Aminoglycosides,
synergistic with Aminoglycosides? A. Cefazolin 1st and 2nd gen cephalosporines can increase nephrotoxic effects of
B. Cefaclor C. Cefixime D. Cefipime E. aminoflycosides.
Loracarbef
582. which of the following changes will promote 306 C. any condition that can predisposed to hyperkalemia, hypermagnesemia
digitalis induced cardiototoxicity? A. Acute and hypocalcemia will inhibit the binding of digitalis to Na K ATPase resulting
tubular necrosis B. hypermagnesemia C. to decrease toxicity. Triamterene and ATN can induce hyperkalemia. Katzung
hyperparathyroidism D. Triamterene 11th ed p 216.
administration E. All of the above
583. Which of the following chemotherapeutic 257 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, know the
agents can produce pulmonary fibrosis as characteristic adverse effects and toxicities, the peculiar ones, the ones that
toxicity? A. bleomycin B. doxorubicin C. make the drugs famous, pulmo fibrosis = bleomycin
irinotecan D. etoposide E. carmustine
584. Which of the following chemotherapeutic drugs 401 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
may be used for Lentigo Maligna? A.
Actinomycin B. Bleomycin C. Doxorubicin D.
Vinblastine E. Cisplatin
585. Which of the following chemotherapeutic drugs 402 D. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
may be used for Lung Cancer? A. Procarbazine
B. Cytarabine C. Topotecan D. Cisplatin E.
Cyclophosphamide
586. Which of the following chemotherapeutic 245 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE - MOPP
regimens could be used for the treatment of nitrogen mustard, oncovin, procarbazine, prednisone, take time to know the
advanced hodgkin's disease? A. FOLFOX B. common regimens for other cancers as well, ex: folfox colorectal, CHOP
MOPP C. CHOP D. 7+3 E. BEP nonhodgkins, BEP testicular, 7+3 AML
587. Which of the following Cholinomimetic drugs 264 E Donepezil, Rivastigmine, Tacrine used exclusively in Alzheimer's
are used exclusively in the treatment of
Alzheimer's disease? A. Donepezil B.
Physostigmine C. Rivastigmine D. A and B E. A
and C

588. Which of the following correctly describes FDA Drug category B? A. 176 D. A: category C------ B. Category A-------- C.
Either animal studies revealed adverse effects on the fetus and Category D
there are no controlled studies in women or studies in women and
animals are not available B. Control studies in women fail to
demonstrate a risk to the fetus in the first trimester and the
possibility of fetal harm is remote C. there is positive evidence of
human fetal risk but the benefits from use in pregnant women may
be acceptable despite the risk D. Animal reproduction studies have
shown an adverse effect that was not confirmed in controlled
studies in women in the first trimester E. None of the above
589. Which of the following diuretics do not act on the luminal side of the 383 C. SIMILAR TO PREVIOUS BOARD EXAM
renal tubules? A. Mannitol B. Furosemide C. Spironolactone D. CONCEPT/PRINCIPLE. Spironolactone is an aldosterone
Acetazolamide E. Hydrochlorothiazide antagonist that blocks its binding to mineralocorticoid
receptors in the basolateral membrane of the cortical
collecting tubules. The rest of the choices act on the
luminal side. Mannitol is an osmotic diuretic. Furosemide
inhibits Na/K/Cl transporters in the luminal side of the
loop of Henle. Acetazolamide inhibits carbonic anhydrase
activity at the luminal side of the PCT.
Hydrochlorothiazide inhibits Na/Cl transporters in the
luminal side of the DCT.
590. Which of the following diuretics is incorrectly paired with its 546 A. Thiazides increase reabsorption of Ca and prevent
associated toxicity? A. Thiazide - renal stone B. Acetazolamide - Ca stone formation. Hepatic encephalopathy can ensue
hepatic encephalopathy C. Bumetanide - hypokalemic metabolic with acetazolamide because it causes alkalinization of
alkalosis D. Eplerenone - hyperkalemic metabolic acidosis E. urine due to decreased bicarbonate reabsorption. This
Mannitol - pulmonary edema prevents ammonia from turning to ammonium. Ammonia is
more easily reabsorbed.
591. Which of the following diuretics may cause hyperkalemia? A. 126 A. Amiloride (also Triamterene, Eplerenone,
Amiloride B. Ethacrynic acid C. Indapamide D. Mannitol E. Spironolactone) is a potassium sparing diuretics. All other
Acetozalamide options are potassium-wasting. SIMILAR TO PREVIOUS
BOARD EXAM CONCEPT.
592. Which of the following drug acts by selectively inhibitting 508 B. Katzung 10th ed., 169. Metoprolol, Esmolol,
stimulation of B1 adrenoceptor and may be advantageous in treating Atenolol, Acebutolol, Betaxolol, Bisoprolol are selective
hypertensive patients who also suffer from asthma, diabetes, or B1-blockers. Propranolol and Nadolol are non-selective
peripheral vascular disease? A. Nadolol B. Metoprolol C. B-blockers. Labetalol and Carvedilol have combined
Propranolol D. Labetalol E. Carvedilol alpha and b-blocking activity.
593. Which of the following drugs are beneficial in delaying organ 18 E SIMILAR TO PREVIOUS BOARD EXAM
remodeling such as in cardiac remodeling in heart failure and CONCEPT/PRINCIPLE. Source: Topnotch Handout on
reduces progression of DM nephropathy? A. Captopril B. Losartan C. Pharmacology
Eplerenone D. A and B only E. All of the above
594. Which of the following drug/s can be used for eliminating 365 E Minocycline, 200 mg orally daily for 5 days, can
meningococcal carriage states? A. Minocycline B. Pen G C. Rifampin eradicate the meningococcal carrier state, but because of
D. Demeclocycline E. A and C side effects and resis- tance of many meningococcal
strains, rifampin is preferred. Katzung 12th ed pg 812
595. Which of the following drugs can be used to reduce intraocular 624 E
pressure in the treatment of glaucoma? A. Pilocarpine B.
Acetazolamide C. Neostigmine D. Timolol E. All of the above
596. Which of the following drugs can cause cataract formation? A. 244 A. SIMILAR TO PREVIOUS BOARD EXAM
allopurinol B. pyrazinamide C. propanolol D. omeprazole E. CONCEPT/PRINCIPLE, one of the hardes pharma
ciprofloxacin questions we encountered, we did not know at that time
that allopurinol was associated with cataracts :)

597. Which of the following drugs can cause prolonged QT interval 226 C. antiarrhytmic drugs that affects the K channel at
leading to Torsade de Pointes arrhytmia? A. Esmolol B. phase 3 causes prolongation of Action Potential leading
Propafenone C. Procainamide D. Verapamil E. None of the above prolonged QT interval. These drugs are of the Class IA and
III. Class IA drugs - procainamide, quinidine, disopyramide.
Class III- Ibutilide, sotalol, dofetilide
598. Which of the following drugs/drug regimen is primarily used for 240 A. B- testicular cancer, C- pancreatic cancer, D-
Hodgkin's Lymphoma A. ABVD- adriamycin, bleomycin, vincristine, choriocarcinoma. Aug 2014 SIMILAR TO PREVIOUS
dacarbazine, prednisone B. PEB - cisplatin, etoposide, bleomycin C. BOARD EXAM CONCEPT/PRINCIPLE.
Gemcitabine + 5 FU + radiation D. EMACO- etoposide,
methotrexate, actinomycin D, cyclophosphamide, vincristine E. all
of the above
599. which of the following drugs exhibit zero order kinetics ? A. Ethanol 302 E zero order kinetics refers to a contant rate of
B. tolbutamide C. warfarin D. heparin E. All of the above elimination of a drug regardless of its concentration. The
following drugs exhibit zero order kinetics: aspirin, ethanol,
warfarin,heparin, penytoin, tolbutamide, theophyline
phenylbutazone, and salicylates.
600. Which of the following drugs for glaucoma increased aqueous 585 B. Beta blockers, CAIs and osmotic agents (mannitol)
humor outflow through the non-conventional pathway without decreases aqueous humor production. Alpha adrenergic
decreaing the secretion of aqueous humor by the ciliary body? A. agonist increases outflow and also decreases the secretion
β-blockers B. Prostaglandin analogues C. α-adrenergic agonist D. of the ciliary body. Prostaglandins increased outflow but
Carbonic anhydrase inhibitors E. Mannitol has no effect on production.
601. Which of the following drugs given contains an effect which 250 D. SIMILAR TO PREVIOUS BOARD EXAM
suppresses nausea and vomiting ? A. propanolol B. procarbazine C. CONCEPT/PRINCIPLE, difficult because chlorpromazine
chlorambucil D. chlorpromazine E. chloramphenicol usually is used as a antipsychotic but has antiemetic effects
belonging to the phenothiazine class along with other
drugs used to control nausea vomiting like promethazine
602. Which of the following drugs is a direct acting cholinoninetic used 665 B. Bethanecol for bowel and bladder atony
for treatment of glaucoma, sjoqren and sicca syndrome? A.
Betanechol B. Pilocarpine C. Physostigmine D. Neostigmine E. None
of the above
603. Which of the following drugs is an effective prophylactic drug 403 E SIMILAR TO PREVIOUS BOARD EXAM
against migraine headache attacks? A. Ondansetron B. Sumatriptan CONCEPT/PRINCIPLE
C. Ergotamine D. Methylergonovine E. Propranolol
604. Which of the following drug/s is/are notorius in causing gingival 633 E
hyperplasia? A. Nifedipine B. Cyclosporine C. Phenytoin D.
Verapamil E. All of the above
605. Which of the following drugs is classified as Category X during 381 B. The rest of the choices are category D drugs.
pregnancy? A. Valproate B. Statins C. Aspirin D. Captopril E.
Phenytoin
606. which of the following drugs is highly selective to ischemic or 307 A. phenytoin, lidocaine and mexiletine are classified as
prolonged depolarized purkinje fibers? A. Mexiletine B. class IB antiarrhythmics. This group affects primarily
Procainamide C. Propafenone D. ibutilide E. None of the above ischemic or depolarized ventricular tissue and does not
have any use in atrial arrhytmia. B- procainamide is a class
IA drug, C- propafenone is a Class IB agent, D- ibutilide is
class III drugs.
607. Which of the following drugs is used to induce ovulation in 297 B. SIMILAR TO PREVIOUS BOARD EXAM
anovulatory women by selectively blocking estrogen receptors in CONCEPT/PRINCIPLE
the pituitary, thus increasing FSH and LH output? A. Raloxifene B.
Clomiphene C. Fulvestrant D. Anastrozole E. Progestins

608. Which of the following drugs lower blood 505 E Metyrosine inhibits tyrosine hydroxylase which is responsible for the
pressure by preventing normal physiologic conversion of Tyrosine to Dopa, the rate-limiting step in catecholamine
release of norepinephrine from postganglionic synthesis. Cocaine blocks re-uptake of NE from the synaptic cleft thereby
sympathetic neurons? A. Metyrosine B. Cocaine prolonging its effect. Reserpine blocks dopamine transport into the vesicle.
C. Reserpine D. Botulinum toxin E. Guanethidine Botulinum blocks Acetylcholine release from the nerve terminal into the
junctional cleft. Study figures 6-3 and 6-4 of Katzung 10th ed, p. 79 and 81.
609. Which of the following drugs of abuse is non 288 D. Some drugs of abuse do not lead to addiction. This is the case for
addictive? A. Amphetamine B. Cocaine C. substances that alter perception without causing sensation of reward and
Morphine D. LSD E. Heroin euphoria. These include LSD, Phencyclidine and ketamine
610. Which of the following drugs that used in gout 267 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE
has been associated with cataract formation? A.
Colchicine B. Allopurinol C. Probenecid D.
Indomethacin E. Acetaminophen
611. Which of the following drugs used in the 386 B.
treatment of peptic ulcer disease works by
forming a protective coating over ulcer beds
and has known adverse effects of melena and
darkening of the tongue? A. Sucralfate B.
Bismuth salicylate C. Psyllium D. Senna E. Kaolin
612. Which of the following drugs with mechanism of 260 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE, please
action that inhibits protein synthesis by know the mechanism of action of each drug class
inhibiting binding of the tRNA to the mRNA
ribosome complex A. tetracycline B.
clindamycin C. gentamycin D. erythromycin E.
chloramphenicol
613. which of the following effects in parathion 304 C. pralidoxime is a chemical antagonist acting as cholinesterase
poisoning will not be antagonized by timely regenerator. It cannot enter the BBB because of its positively charged group
administration of pralidoxime? A. cyclospasm B. and poor lipid solubility. Katzung review pp 69.
Urinary incontinence C. convulsion D. Negative
dromotrophy E. None of the above
614. which of the following effects of acetazolamide 308 B. the major effect of acetazolamide is bicarbonate diuresis resulting to
is self limiting? A. Sodium reabsorption B. metabolic acidosis. As increased sodium is presented to the cortical collecting
Tubular bicarbonate excretion C. CSF acidosis tubule, some of the excess sodium is reabsorbed and potassium is secreted
D. Aqueous humor production E. None of the resulting to significant potassium wasting. as a result of bicarbonate depletion,
above sodium bicarbonate excretion slows even with continued administration.
Katzung review 8th ed p 135
615. Which of the following ergot alkaloids is known 639 A.
to cause retroperitoneal fibrosis? A.
Methylsergide B. Dihydroergotamine C.
Methylergonovine D. Sumatriptan E. None of
the above
616. Which of the following has the lowest incidence 635 A. Clozapine is a new drug with least extrapyramidal effect but is known to
of extrapyramidal symptoms but is known to cause agranulocytosis.
cause agranulocytosis? A. Clozapine B.
Fluphanazine C. Chlorpromazine D. Pimozide E.
Haloperidol
617. Which of the following has the most potent 7 D. Contraindication to thrombolysis - History of CVS hemorrhage at ANY
mineralocorticosteroid activity? A. time - History of CVS infarct within the past year - Marked hypertension
Hydrocortisone B. Triamcinolone C. (>180/110) - Suspicion of aortic dissection - Active internal bleeding (excluding
Betamethasone D. Fludrocortisone E. menstruation) Source: Topnotch handout on Pharmacology
Dexamethasone
618. Which of the following have been proven to 374 E Topnotch
cause pulmonary fibrosis? A. Methothrexate B.
Bleomycin C. Busulfan D. Amiodarone E. All of
the above

619. Which of the following inhibit/s cortisol 378 D. Aminoglutethimide blocks the conversion of cholesterol to pregnenolone
synthesis? A. Aminoglutethimide B. and causes a reduction in the synthesis of all hormonally active steroids.
Ketoconazole C. Mifepristone D. A and B E. Ketoconazole is a potent nonselective inhibitor of adrenal and gonadal steroid
All of the above synthesis through inhibiton of P450 enzymes. Mifepristone is a glucocorticoid
receptor antagonist with strong antiprogesterone activity. Katzung 12th ed pg
709- 711
620. Which of the following insulin preparations 595 E The long acting insulin mimics the normal secretion of the pancreas in the
mimics the secretion pattern of insulin by the non-fed state.
normal pancreas in the fasting state? A.
Lispro B. Regular C. NPH D. Glulisine E.
Detemir
621. Which of the following is a balanced 382 B. Balanced vasodilators include ACEIs, ARBs, alpha- adrenergic blockers,
vasodilator--meaning, both an arterial and a alpha-central agonists, nitroprusside and nesiritide.
venous vasodilator--used to treat both
congestive heart failure and coronary artery
vasospasm? A. Verapamil B. Captopril C.
Nifedipine D. Propranolol E. Hydralazine
622. Which of the following is a contraindication 355 B. Reference: Katzung. Basic and Clinical Pharmacology, 11th ed. p. 743
to the use of thiazolidinediones? A. Alcohol
ingestion B. Heart failure C. Cholelithiasis D.
Renal insufficiency
623. Which of the following is a drug of choice for 236 E AIDS patient with a CD4 count of less than 50/UL are prone to have
daily dose prophylaxis in AIDS patient with a Mycobacterium Avum Intracellulare infection. The only approved prophylactic
CD4 count of 50/UL? A. Cotrimoxazole B. treatment are daily dose of clarithromycin with or without rifabutin and once
Kanamycin C. Azithromycin D. Erythromycin weekly dose of azithromycin.
E. Clarithromycin
624. Which of the following is a good choice to 33 C. Buspirone is a partial serotonin 5-HT1A-receptor agonist that has efficacy
treat newly diagnosed generalized anxiety comparable to that of benzodiazepines for the treatment of anxiety, but is
disorder in a truck driver? A. Alprazolam B. significantly less sedating. Alprazolam is an intermediate-acting benzodiazepine
Triazolam C. Buspirone D. Trazodone E. used in the treatment of generalized anxiety disorder (GAD) but still has some
Thiopental sedation, which would be undesirable in this situation. Triazolam is a short-acting
benzodiazepine, and trazodone is a heterocyclic antidepressant, both used to
induce sleep. Thiopental is a barbiturate sometimes used to induce anesthesia.
625. Which of the following is a major adverse 294 B. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. A major
effect associated with use of fenofibrates? A. toxicity of fenofibrates is increased risk of gallstone which may be due to
Constipation B. Gallstones C. Hyperuricemia enhanced biliary excretion
D. Cardiac arrythmia E. Liver damage
626. Which of the following is a major toxicity 590 B. Gemfibrozil is associated with cholelithiasis. Myopathy is only expected in
associalted with gemfibrozil therapy? A. combination with statins.
Bloating and constipation B. Cholelithiasis C.
Hyperuricemia D. Myopathy E. Severe
cardiac arryhtmia
627. Which of the following is a mechanism of 123 A. Hydralazine binds to and activates potassium channels on vascular smooth
action of Hydralazine? A. Alters intracellular muscle resulting to efflux of potassium and subsequent hyperpolarization of the
calcium B. Opens potassium channel causing cell. This prevents calcium- mediated activation and constriction of smooth
arteriolar and venular dilatation C. Blocks muscle, resulting in vasodilation. It dilates arterioles, but not veins. SIMILAR TO
alpha-1 adrenergic receptor D. PREVIOUS BOARD EXAM CONCEPT.
Competitively bloocks Nn nicotinic receptor
E. Blocks voltage-gated L-type calcium
channels
628. Which of the following is an extraluminal 135 A. Tissue amebicides act in the bowel wall and liver: Metronidazole, emetine,
amoebicide? A. Metronidazole B. Diloxanide chloroquine, tinidazole; Luminal amebicide: Diloxanide furoate, Iodoquinol,
furoate C. Lumefrantrine D. Pentamidine E. Paromomycin. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT
Nifurtimox

629. Which of the following is an inhalational anesthetic of 249 A. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE,
choice for asthmatic patient because it causes the least halothane generally is the inhaled agent of choice, sevoflurane is
bronchospasm? A. halothane B. desflurane C. debatable, desflurane is pungent, the others are IV anesthetics
sevoflurane D. thiopental E. propofol
630. Which of the following is an orally active direct 286 E Apixaban and Rivaroxaban are both oral Factor Xa inhibitors.
thrombin inhibitor? A. Apixaban B. Rivaroxaban C. Enoxaparin and Fondaparinux are both SC factor Xa inhibior.
Enoxaparin D. Fondaparinux E. Dabigatran
631. Which of the following is a potential side effect of 32 C. Agranulocytosis occurs more frequently with clozapine than with
clozapine? A. Cholestatic jaundice B. QT prolongation other agents, requiring routine blood tests. It is the only agent that
C. Agranulocytosis D. Photosensitivity E. Galactorrhea improves the negative symptoms of schizophrenia. Cholestatic jaundice
and photosensitivity are common with chlorpromazine. Galactorrhea is
a side effect of older high-potency agents that block dopamine. QT
prolongation is a complication of agents such as thioridazine and
ziprasidone.
632. Which of the following is a reversible inhibitor of 406 C. Allopurinol is an IRREVERSIBLE Xanthine Oxidase inhibitor,
Xanthine Oxidase used in Chronic Gout? A. Allopurinol Febuxostat is a REVERSIBLE Xanthine Oxidase inhibitor,
B. Colchicine C. Febuxostat D. Mycophenolate Mofetil
E. Probenecid
633. Which of the following is considered as a reliever of 429 D. Terbutaline is a beta-2 receptor agonist used as a fast-acting
asthma rather than a controller? A. Montelukast B. bronchodilator for asthma and is also used in preventing premature
Cromolyn C. Omalizumab D. Terbutaline labor (tocolysis).
634. Which of the following is correct regarding isosorbide 224 C. ISMN is the oral form of nitroglycerin. Its mechanism is by
mononitrate? A. Can be use along with PDE inhibitors activating guanylyl cyclase causing an increase in cGMP eventually
compared to other forms of nitroglycerin B. It has a leading dephosphorylation of MLC. Its antihypertensive effect is
similar mechanism of action with Nitroprusside by primarily via venodilation. It has no direct inotropic or chronotropic
phosphorylation of myosin light chain phosphate C. It effect to the heart. all forms of nitroglycerin should not concomitantly
has no direct effect on cardiac muscle D. the primary use with anyform of PDEI ( sildenafil) since it will cause profound
mechanism for decrease in BP is due to decrease in hypotension and hypoperfusion of critical organs
afterload E. B and C are correct
635. Which of the following is incorrectly matched? A. 9. Bonus. No correct answ.Menotropin â€" FSH and LH analog
Menotropin â€" FSH and LH analog B. Ocreotide â€" Ocreotide â€" Somatostatin analog Desmopressin â€" ADH analog
Somatostatin analog C. Desmopressin â€" ADH analog Ganirelix â€" GnRH antagonist Levothyroxine â€" T4 Source: Topnotch
D. Ganirelix â€" GnRH analog E. Levothyroxine â€" T4 handout on Pharmacology
636. Which of the following is not a 3rd generation 13 E 1st gen â€" Cefazolin, Cephalotin, Cephalexin, Cephradine,
cephalosporin? A. Ceftazidime B. Ceftriaxone C. Cephapirin 2nd gen â€" Cefaclor, Cefuroxime, Cefoxitin, Cefotetan,
Ceftizoxime D. Cefixime E. Cefepime Cefamandole, Cefonicid, Cefprozil, Cefometazole 3rd gen â€"
Ceftriaxone, Cefoperazone, Cefotaxime, Cefixime, Ceftazidime,
Ceftizoxime, Cefpodoxime proxetil, Cefdinir, Cefditoren, Ceftibuten 4th
gen â€" Cefepime Source: Katzung Basic and Clinical Pharmacology
11th ed
637. Which of the following is NOT an effect of Naloxone? 130 A. Naloxone is an opioid antagonist used for opioid overdose. It
A. It will cause respiratory depression B. It may cause competitively blocks opioid receptors and rapidly reverses effects of
nausea and vomiting C. It induces abstinence syndrome opioid agonists. In individuals who are acutely depressed by an
D. It decreases constipation E. None of the above overdose of an opioid, the antagonist effectively normalizes respiration,
LOC, pupil size, bowel activity, and awareness of pain. In dependent
subjects who appear normal while taking opioids, naloxone or
naltrexone almost instantaneously precipitates an abstinence
syndrome. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT
638. Which of the following is not an indication for SSRIs? A. 5 E SIMILAR TO PREVIOUS BOARD EXAM CONCEPT/PRINCIPLE. SSRIs
Major depressive disorder B. OCD C. Anxiety and panic are the first line drugs for MDD. OCD â€" SSRI! Source: Topnotch
attacks D. Phobias E. None of the above handout on Pharmacology
639. Which of the following is not associated with 11 E All of the following are associated with pulmonary fibrosis. Source:
pulmonary fibrosis? A. Bleomycin B. Busulfan C. Topnotch handout on Pharmacology
Amiodarone D. Methotrexate E. None of the above

640. Which of the following is not considered a controller drug 20 B. Terbutaline is a bronchodilator used for acute relief of
for asthma? A. Budesonide B. Terbutaline C. Montelukast D. asthma exacerbations. Source: Topnotch handout on
Nedocromil E. Omalizumab Pharmacology
641. Which of the following is NOT true about insulin action? A. 619 D. The insulin receptor is a transmembrane receptor that is
It stimulates glycogen synthesis in muscle fiber B. It inhibits activated by insulin, IGF-I, IGF-II and belongs to the large class of
lipolysis in the adipocyte C. It stimulates fatty acid synthesis tyrosine kinase receptors.
in the hepatocytes D. It binds to G receptor to increase
intracelluar cAMP
642. Which of the following is not true in the pharmacologic 235 E Aminoglycoside exerts concentration dependent killing and
profile of Aminoglycosides? A. The primary mechanism of post antibiotic effect. It also has curare like action at high dose
resistance is due to plasmid mediated group transferases B. leading to respiratory paralysis. Aminoglycosides needs Oxygen
Bactericidal action continuous even if the plasma drug dependent transport to exerts inhibitory effect 30s ribosome.
concentration is below measuring levels C. It does not have therefore, it has no activity to anaerobes. acetylation by plasmid
an activity against anaerobic organisms D. high dose can mediated group transferase is the major mode of resistance.
cause respiratory paralysis E. none of the above
643. Which of the following is not true regarding Noncompetitive 8 A. Competitive antagonism: ED50 increases, potency decreases,
antagonism? A. No effect on Emax B. No effect on ED50 C. No effect of maximum efficacy Noncompetitive antagonism: No
No effect on potency D. A and B E. All of the above effect ED50, No effect on potency, decreased Emax Source:
Topnotch handout on Pharmacology
644. Which of the following is not used for the treatment of 395 A. Chlordiazepoxide is used for the treatment of alcohol
alcohol dependence? A. Chlordiazepoxide B. Disulfiram C. withdrawal, not dependence. Diazepam may also be used for
Naltrexone D. Acamprosate E. None of the above alcohol withdrawal.
645. Which of the following is the drug of choice for partial 592 C. Carbamazepine, phenytoin and lamotrigine are drug of
seizures? A. Valproic acid B. Phenobarbital C. Lamotrigine choices for partial seizures
D. Ethosuximide E. Topiramate
646. Which of the following is the drug of choice for tic 385 A. Carbamazepine is also the drug of choice for trigeminal
disorders? A. Carbamazepine B. Lamotrigine C. Valproic neuralgia.
acid D. Topiramate E. Phenytoin
647. Which of the following is true? A. Azithromycin has lesser 41 E Choramphenicol is one of the few antibiotics with higher oral
bioavailability when taken with food B. Metronidazole has bioavailability than parenteral form.
the same oral and parenteral bioavailability. C. The oral
bioavailabity of chloramphenicol is higher than parenteral
form. D. Both B and C E. AOTA
648. Which of the following is true about Buspirone? A. 311 C. Buspirone is a selective anxiolytic medication that does not
Anxiolytic effect is secondary to direct stimulation of cause, sedative, hypnotic, euphoric, and acute withdrawal or
GABAergic neurons B. It is highly effect in acute panic rebound effect. It has no effect in psychomotor skills (driving
attacks C. Less psychomotor retardation D. Abrupt skills). The mechanism of anxiolysis is secondary to partial
discontinuation can lead acute withdrawal syndrome E. all antagonism to 5HT1A receptors in the brain. it has no direct
of the above GABAergic activity. weeks are needed before buspirone takes
effect, therefore, it is not effect in treating acute panic attacks.
Katzung 11ed p374.
649. Which of the following is uricosuric? A. Allopurinol B. 331 C. Allopurinol is a xanthine oxidase inhibitor. Colchicine inhibits
Colchicine C. Sulfinpyrazone D. Celecoxib microtubule assembly. Celecoxib is a COX-2 inhibitor.
650. Which of the following IV anesthetics is the only one that 554 D.
causes CV stimulation? Its use in neurosurgical operations
is limited due to its propensity to increase ICP. A.
Midazolam B. Propofol C. Fentanyl D. Ketamine E.
Thiopental
651. Which of the following loop diuretics is not prone to induce 589 E Ethacrynic acid does not contain a sulfa group.
an allergic response? A. Furosemide B. Bumetanide C.
Brinzolamide D. Torsemide E. Ethacrynic acid

652. Which of the following mechanism indicates high-level 270 E E is INH high level resistance; A is INH low level
resistance in a TB patient being treated with Isoniazid? A. resistance; B is rifampicin resistance
deletions in inhA gene that encodes target enzyme B. changes
in drug sensitivity to RNA polymerase C. expression of drug
efflux system D. expression of inactivating enzymes E. deletion
in katG gene involved in the bioactivation of the drug
653. Which of the following medication-rescue therapy pair is 640 E
INCORRECT? A. Methotrexate : Leucovorin B.
Cyclophosphamide : MESNA C. Doxorubicin : Dexrazoxane D.
Cisplatin : Amifostine E. None of the above
654. Which of the following medications can be given once a week 290 A. because of its long elimination half life (3-4 days),
for prophylaxis against bactermia caused by M. avium complex weekly administration of azithromycin has proved to be
(MAC) in AIDS patients? A. Azithromycin B. Kanamycin C. equivalent to daily administration of clarithromycin when used
Ethambutol D. Rifampicin E. Cycloserine for prophylaxis against MAC in AIDS
655. Which of the following medications can be used as part of a 254 D. SIMILAR TO PREVIOUS BOARD EXAM
regimen for migraine prophylaxis? A. ibuprofen B. CONCEPT/PRINCIPLE, prophylaxis: pizotifen, TCA,
acetaminophen C. sumatriptan D. propranolol E. anticonvulsants and beta blockers, methysergide, flunarizine
dihydroergotamine
656. Which of the following medications can decrease conduction 255 B. SIMILAR TO PREVIOUS BOARD EXAM
through the AV node? A. nifedipine B. verapamil C. lithium D. CONCEPT/PRINCIPLE, verapamil is a non dihydropyridine
prazosin E. dypyridamole calcium channel blocker which exerts its actions more on the
heart decreasing AV nodal conduction
657. Which of the following medications causes mydriasis but 246 D. SIMILAR TO PREVIOUS BOARD EXAM
without cycloplegia? A. tropicamide B. homatropine C. CONCEPT/PRINCIPLE also a difficult one, only phenylephrine
cylopentolate D. phenylephrine E. atropine among the choices causes mydriasis without affecting
accomodation
658. Which of the following medications could be given to high risk 251 E SIMILAR TO PREVIOUS BOARD EXAM
or immunocompromised patients with RSV infections? A. CONCEPT/PRINCIPLE, acyclovir and ganciclovir for herpes
Acyclovir B. Fosamprenavir C. Indinavir D. Ganciclovir E. group, indinavir and fosamprenavir for hiv
Ribavirin
659. Which of the following medications exert its anticoagulant 278 B. Fondaparinux and LMW heparin combines with
effect through the inactivation of thrombin? A. Fondaparinux B. antithrombin and selectively inhibits factor X but NOT thrombin.
Unfractionated heparin C. Low molecular weight heparin D. Apixaban is a direct Xa inhibitor
Apixaban E. All of the above
660. Which of the following medications is considered as an 243 D. SIMILAR TO PREVIOUS BOARD EXAM
inhibitor of glucocorticoid synthesis which could be used in the CONCEPT/PRINCIPLE, I couldn’t believe this was actually
treatment of cushing's syndrome and some types of cancers? asked, aminoglutethimide inhibits desmolase blocking
A. Methylprednisolone B. anastrozole C. Danazol D. conversion of cholesterol to pregnenolone reduces synthesis
Aminogluthetimide E. Flutamide of all hormonally active steroids, anastrozole inhibits only
estrogen synthesis, danazol is an androgen, flutamide is
androgen antagonist
661. Which of the following nonselective , irreversible alpha 630 B. DOC for pheochromocytoma is Phenoxybenzamine, it is
blocker is the drug of choice as a preoperative agent used in a nonselective, IRREVERSIBLE alpha blocker.. Phentolamine is a
Pheochromocytoma? A. Phentolamine B. Phenoxybenzamine C. reversible alpha blocker.
Prazosin D. Yohimbine E. Clonidine
662. Which of the following ophthalmic agents decreases 400 B. Bimatoprost is a prostaglandin analogue that increase
intraocular pressure by increasing outflow of aqueous humor outflow via the uveoscleral pathway. Apraclonidine is a alpha-2
through the uveoscleral or unconventional pathway? A. receptor agonist that decreases aqueous humor production.
Homatropine B. Bimatoprost C. Apraclonidine D. Mannitol E. Mannitol works via osmosis. Timolol is a beta-receptor
Timolol antagonist that also decreases aqueous humor production.
Homatropine has no effect on IOP.

663. Which of the following regarding anticholesterol drugs is/are TRUE? A. 370 D. Fibrates stimulate PPAR alpha, most effective
Simvastatin, a reversible inhibitor of HMG-CoA reductase, is most for decreasing elevated triglyceride levels. Katzung
effective in reducing LDL levels B. Niacin stimulates PPAR-α causing an 12th ed pg 626, 628, 631
increase in HDL and a decrese in triglycerides C. There is increased risk
of gallstone formation when fibrates are combined with bile acid binding
resins D. A and C E. All of the above
664. Which of the following statements about the mechanism of action of 636 B.
ipratropium? A. It acts cebtrally to decrease vagal Ach release B. It
inhibits pulmonary Ach receptors C. It decreases mast cell release of
histamine D. It blocks the action of histamine at H1 receptors E. None of
the above
665. Which of the following statements concerning barbiturates is true? A. 634 B.
Barbiturates can increase bleeding time when administered to patients
taking anticoagulants B. Barbiturates are contraindicated in patients with
acute intermittent porphyria C. Patients tolerant to the therapeutic
actions of barbiturates are also tolerant to analgesic effect of morphine
D. Barbiturates are used to prevent withdrawal symptoms associated with
heroin dependence E. All of the above
666. Which of the following statements is/are true regarding the binding 105 E Page 4 of Topnotch Handout. Binding affinity
affinity of a drug: A. Kd is the concentration required to bind 100% of the refers to the fraction of receptors bound by a drug
drug receptors B. The smaller the Kd the lesser the affinity of the drug plotted against the log of the drug concentration. Kd
for its receptor C. A smaller Kd means that the drug is less potent D. is the concentration required to bind 50% of the
Binding affinity refers to the fraction of receptors bound by a drug receptors. The smaller the Kd, the greater the affinity
plotted against the log of the drug effect E. None of the above of a drug for its receptor, the more potent it is.
667. Which of the following statements is true for cromolyn: A. It reduces 117 B. SIMILAR TO PREVIOUS BOARD EXAM
synthesis of leukotrienes B. It has no bronchodilator action C. It binds IgE CONCEPT/PRINCIPLE. Page 33 of Topnotch
antibodies on mast cells D. It reduces the expression of cyclooxygenase Handout. Cromolyn is a mast cell stabilizer by the
E. It prevents vagal-stimulated bronchoconstriction prevention of calcium influx, therefore preventing
degranulation and release of histamine, leukotrienes
and other mediators. A is moa of zileuton, C is for
omalizumab, D is for corticosteroids while E is for
Ipratropium 9muscarinic receptor antagonist.
668. Which of the following statements regarding diuretics is not true? A. 507 D. The collecting tubule and not the distal tubule
Diuretics lower blood pressure primarily by depleting body sodium is the final site NaCl reabsorption. It is responsible for
stores. B. The most common adverse effect of thiazide diuretics is tight regulation of body fluid volume and for
potassium depletion. C. The intercalated cells in the collecting tubule are determining the final sodium concentration of the
+the primary sites of H secretion. D. The distal convoluted tubule is the urine. Katzung 10th ed., 239.
final site of NaCl reabsorption and is responsible for the final sodium
concentration of the urine. E. The thick ascending limb of the loop of
Henle is the "diluting segment".
669. Which of the following statements regarding the pharmacokinetics of 35 B. The metabolism of theophylline depends on
theophylline is correct? A. It is primarily metabolized by the kidney B. Its age; the half-life of the drug in children is much
metabolism depends on age C. It is poorly absorbed after oral shorter than in adults. The methylxanthines are all
administration D. It has a wide therapeutic index E. It stimulates well absorbed and are metabolized in the liver. The
phosphodiesterase PHARMACODYNAMIC porperties of theophylline
include its adenosine-receptor antagonist activity and
the inhibition of phosphodiesterase.
670. Which of the following steroid antagonists inhibits cytochrome P450 272 A. Ketoconazole is a potent cytochrome p450
enxymes necessary for all steroids? A. Ketoconazole B. inhibitor. Aminoglutethimide inhibits conversion of
Aminogluthetimide C. Metyrapone D. Spinorolactone E. Mifepristone cholesterol to pregnenolone. Metyrapone inhibits
cortisol synthesis. Spinorolactone inhibits
aldosterone. Mifepristone inhibits progesterone

671. Which of the following substances 600 A. Remember that activated charcoal is effective only to organic substances, so if it is
can be adsorbed by activated inorganic like ions or acids/bases, it is not effective. Alcohol, though organic does not
charcoal, effectively enhance its elimination with activated charcoal.
decontaminating the
gastrointestinal tract? A.
Barbiturates B. HCl C. Lithium D.
Cyanide E. Lye
672. Which of the following substances 584 C. Cocaine and TCA prevents reuptake of norepinephrine. Review the inhibitors for
will increase the available each step in the process of neurotransmitter release for both the sympathetic and
adrenergic neurotransmitter in the parasympathetic system.
synaptic cleft by inibiting
reuptake? A. Botulinum B. MAOIs
C. Cocaine D. Guanethidine E.
Reserpine
673. Which of the following 138 B. Because of its short half-life, Tolbutamide is the safest sulfonylurea for elderly
sulfonylurea is safest drug for diabetics. SIMILAR TO PREVIOUS BOARD EXAM CONCEPT.
elderly diabetics? A.
Chlorpropramide B. Tolbutamide
C. Tolazamide D. Glyburide E.
Glimepiride
674. Which of the following teratogenic 107 B. Page 9 of Topnotch Handout. Sulfonamides:kernicterus; Misoprostol: Mobius
drug and effect is correctly sequence; Phenytoin: Fetal hydantoin syndrome; Lithium: Ebstein's anomaly.
paired? A. Sulfonamides:
ototoxicity B. Penicillamine: cutis
laxa C. Misoprostol: Ebstein's
anomaly D. Phenytoin: Mobius
sequence E. Lithium: kernicterus
675. Which of the following teratogenic 262 B.A is carbamazepine; C is Lithium, D is phenytoin
effects is associated with valproic
acid use in pregnancy? A.
Craniofacial anomalies B. Neural
tube defects C. Ebstein anomaly
D. Fetal hydantoin syndome E.
Microcephaly
676. Which of the following traditional 394 A. Promethazine is histamine H1-antagonist. Haloperidol and chlorpromazine are typical
antipsychotic agents has now antipsychotics mainly used for psychotic disorders, not so much as antiemesis.
been more widely used for Metoclopramide is a D2- antagonist used as GI prokinetic agent.
antiemetic treatment of nausea
and vertigo? A. Prochlorperazine
B. Promethazine C. Haloperidol D.
Chlorpromazine E.
Metoclopramide
677. Which of the following 14 B. The mechanism of action of diazoxide is by opening K channels causing
vasodilators can worsen Diabetes hyperpolarization and relaxation of vascular smooth muscles. However, recall the
Mellitus? A. Hydralazine B. mechanism of release of insulin in the pancreatic beta cells. Glucose enters cells resulting to
Diazoxide C. Verapamil D. increased ATP production. This closes ATP dependent K channels resulting to
Nifedipine E. Nitroprusside depolarization, entry of Calcium and release of insulin. Diazoxide causes opening of K
channels resulting to hyperpolarization and inhibition of insulin release. Diazoxide is actually
used in treatment of insulinomas. Source: Katzung Basic and Clinical Pharmacology 11th ed p
180

678. Which of the following vasodilators has also been used for the treatment of male pattern 384 D.
baldness due to its side effect of inducing hair growth A. Verapamil B. Fenoldopam C.
Nitroprusside D. Minoxidil E. Hydralazine
679. Which of the following vasodilators has the common side effect of headache, hypotension and 632 B. Nitroprusside is a
CYANIDE toxicity? A. Fenoldopam B. Nitroprusside C. Nifedipine D. Dopamine E. Minoxidil parenteral vasodilator known
to cause CYANIDE toxicity.
680. Which of the following will increase the arrythmogenic side effect of digoxin? A. Decrease 223 D. hypokalemia,
sympathetic discharge B. Increase serum Potassium C. Decrease serum Calcium D. Increase hypomagnesemia,
Parasympathetic discharge E. None of the above hypercalcemia, and increase
vagal tone increases the risk for
digoxin induced arrhytmia
681. Which of the inhaled anesthetics forms a toxic metabolite, Compound A, that is nephrotoxic at 77 D. Well known side effects:
high doses? A. Halothane B. Isoflurane C. Enflurane D. Sevoflurane E. Desflurane Halothane-- Hepatitis.
Isoflurane- Coronary steal
syndrome. Enflurane- Seizures.
Sevoflurane- Renal
insufficiency. Desflurane-
Pulmonary irritant
682. Which of these anesthetics is known to cause acute porphyria? A. Nitrous oxide B. Halothane 591 D. Barbiturates such as
C. Ketamine D. Thiopental E. Propofol thiopental can cause acute
porphyria.
683. Which of these drugs will be the fastest to be eliminated from the body? A. 100mg drug with 187 C.
zero order kinetics; elimination rate is 25mg/2hrs B. 100mg drug with first order kinetics;
elimination t 1/2 is 2 hours C. 150mg drug with zero order kinetics; elimination rate is 25mg/hr
D. 150mg drug with first order kinetics; elimination t 1/2 is 2 hours E. All of these will be
eliminated at the same time
684. Which properties of digoxin make it an effective treatment in cases of heart failure? A. 216 B. Digoxin also slows AV
Positive inotrope, positive chronotrope B. Positive inotrope, negative chronotrope C. Negative conduction (negative
inotrope, negative chronotrope D. Negative inotrope, positive chronotrope E. None of the dromotrope)
above
685. Which statement is correct regarding the aminoglycosides? A. They work in anaerobic 208 B. Aminoglycosides only
conditions. B. They exhibit concentration-dependent killing. C. Most drugs of this class are work in arebic conditions. They
myelosuppresive. D. They cannot be given to patients allergic to penicillins. E. They are acidic do not have cross-reactivity
in nature. with the penicillins. Most drugs
are nephrotoxic and ototoxic.
686. Which tetracycline has the broadest spectrum of microbial coverage? A. Tetracyline B. 325 D.
Doxycyline C. Minocycline D. Tigecycline
687. Why is nitroglycerin preferred given sublingually? A. Giving it orally will require a higher 147 D. Sublingual route is
dose B. Giving it orally will produce a greater effect C. It D. Protect it from first-pass preferred as there is less dose
metabolism E. None of the above needed and it is protected from
hepatic first-pass metabolism
688. Xenobiotic metabolizing enzymes have historically been grouped into the phase 1 reactions 565 D. Phase 1 reaction does
and the phase 2 reactions. Which is NOT TRUE regarding the former? a. enzymes carry out little to the water solubility of a
oxidation, reduction, or hydrolytic reactions b. enzymes lead to the introduction of what are drug metabolized
called functional groups resulting in a modification of the drug c. the reaction process adds an
-OH, -COOH, -SH, -O- or NH2 group. d. the addition of functional groups significantly increase
the water solubility of the drug
689. You are assigned to go on duty as an intern of the toxicology department of the hospital. You 263 A. Iron, lithium, cyanide,
recall that activated charcoal will NOT be effective adsorbing which of the following? A. Iron alcohol are poorly adsorbed
B. Theophylline C. Phenobarbital D. Amitryptiline E. Digoxin by activated charcoal

690. You are treating a patient HIV-patient for an opportunistic viral infection 268 C. Cidofovir is phosphorylated by host kinases
affecting the eyes. If you suspect viral strains that are thymidine-kinase while Foscarnet doesn’t reqauire
deficient, you decide to choose an antiviral drug that is exclusively phosphorylation. Both are used in thymidine-
phosphorylated by host cell kinases but which doesn't require viral kinase deficient resistant strains of CMV
phosphorylation. Which of the following will you choose? A. Acyclovir B.
Ganciclovir C. Cidofovir D. Foscarnet E. Lamivudine
691. You are treating a patient with hyperthyroidism and you prescribed 141 B. Thioamides like methimazole and PTU inhibit
methimazole, you know that this drug inhibits which enzyme? A. Sodium- the organification of iodine to tyrosine via the
Iodide co-transporter B. Thyroid peroxidase C. Proteases in the thyroid enzyme thyroid peroxidase.
gland D. All of the above E. None of the above
692. You encountered a 2 year old patient suffering from an acute asthmatic 657 C. Salbutamol is a short-acting beta agonist
attack. You immediately nebulized him with Salbutamol. Knowing its mode and may stimulate beta 1 receptors of the heart,
of action, you would expect that the patient may have A. Seizures B. Dry leading to transient tachycardia.
mouth C. Tachycardia D. Somnolence E. Excessive salivation
693. A young boy with G6PD deficiency would note tea-colored urine after the 493 D.
intake of which drug/s: A. primaquine B. cotrimoxazole C. nitrofurantoin D.
All of the above
694. A young couple present to their primary care physician stating that they 30 D. Pregnancy and lactation are the states of
are trying to conceive. They would like to know if the future mom-to-be increased iron demands. While increased bleeding
needs to be on any supplements. Along with recommending a multivitamin tendency, dietary deficiency, and malabsorption
with folic acid, the doctor also suggests an iron supplement. Pregnant are all true causes of iron deficiency anemia, they
women develop iron deficiency anemia because of A. Increased bleeding are not the culprits during pregnancy. Iron storage
tendency B. Increased dietary deficiency C. Malabsorption D. Increased is regulated at the level of absorption, and very
iron demands E. Increased excretion little of it is lost from the body.
695. A young, male patient presents with mental deterioration and tremors. He 694 B. Answer: B Wilson’s disease: excess
has brown pigmentation in a ring surrounding the periphery of his cornea copper deposition (cornea = Kayser-Fleischer ring)
and altered liver function tests. Which treatment modality should he
receive? A. Dimercaprol B. Penicillamine C. EDTA D. Deferoxamine
696. You prescribe a cancer patient who is undergoing chemotherapy with 265 A. Azathioprine/Mercaptopurine metabolism is
allopurinol to address hyperuricemia. Upon reviewing his chart, you realize inhibited by allopurinol.
caution is needed because of risk of toxicity. Which of the following
chemotherapeutic drus is most likely being given to the patient? A.
Azathioprine B. Methotrexate C. Fluorouracil D. Cytarabine E. All of the
above
697. Your patient is in cardiogenic shock. Which of the following is the drug of 110 E Page 15 of Topnotch Handout. In cardiogenic
choice to increase cardiac contractility without the vasoconstricting shock the DOC is Dobutamine. It is a selective Beta
effects? A. Norepinephrine B. Dopamine C. Epinephrine D. Phenylephrine E. 1 Agonist hence it has no Alpha 1 vasoconstricting
Dobutamine effects.
698. Your patient requires a local anesthetic with long duration of action. What 183 D. SIMILAR TO PREVIOUS BOARD EXAM
will you give? A. procaine B. lidocaine C. cocaine D. bupivacaine E. None of CONCEPT/PRINCIPLE.. my mnemonics for this:
the above BeT-long. Local anesthetics with long duration of
action are Bupivacaine and Tetracaine. The longest
acting is Ropivacaine ("at the end of a long ROPe")
699. Zidovudine is a very remarkable drug for HIV. Howeve,r precaution for its 650 C. SIMILAR TO PREVIOUS BOARD EXAM
use should be observed because of this side effect. A. pancreatitis B. CONCEPT/PRINCIPLE
diarrhea C. myelosuppression D. Pulmonary fibrosis E. Optic neuritis
700. Zileuton is useful in the treatment of asthma because it A. Inhibits 25 B. By inhibiting 5-lipoxygenase, zileuton reduces
prostaglandin biosynthesis B. Inhibits leukotriene synthesis C. Inhibits leukotriene biosynthesis; it does not inhibit (and in
leukotriene receptors D. Inhibits 12-lipoxygenase E. None of the above. fact it might increase) prostaglandin synthesis.