Question 1

Which of the following cholinomimetics is commonly used in the treatment of glaucoma?

Accepted Answer

Answer reason: Pilocarpine is a muscarinic agonist used topically to increase aqueous humor outflow and lower intraocular pressure in glaucoma. Lobeline is a nicotinic agonist, acetylcholine has very short action clinically, and neostigmine is an AChE inhibitor used for myasthenia gravis—not glaucoma.

Question 2

Chronic long-term therapy of myasthenia is usually accomplished with?

Accepted Answer

Answer reason: Long-term symptomatic management of myasthenia gravis uses reversible acetylcholinesterase inhibitors; neostigmine (and pyridostigmine) are used chronically. Edrophonium is short-acting for diagnosis, echothiophate is an irreversible agent used in glaucoma, and carbachol is a direct cholinergic agonist with excessive systemic effects.

Question 3

Which of the following agents is a ganglion-blocking drug?

Accepted Answer

Answer reason: Hexamethonium is the classic nicotinic Nn ganglionic blocker. Homatropine is an antimuscarinic, rapacuronium is a neuromuscular blocker, and edrophonium is an acetylcholinesterase inhibitor.

Question 4

Which of the following antimuscarinic drugs is a selective M1 blocker?

Accepted Answer

Answer reason: Pirenzepine is an M1-selective muscarinic antagonist; the others are nonselective antimuscarinics.

Question 5

Atropine may cause a rise in body temperature (atropine fever)?

Accepted Answer

Answer reason: Atropine’s antimuscarinic action inhibits sweating, predisposing to hyperthermia; this risk is greatest in infants and children due to immature thermoregulation.

Question 6

The pharmacologic actions of scopolamine most closely resemble those of?

Accepted Answer

Answer reason: Scopolamine is a belladonna alkaloid and competitive muscarinic antagonist, sharing pharmacologic effects with atropine. Hexamethonium blocks ganglia, succinylcholine is a depolarizing neuromuscular blocker, and pilocarpine is a muscarinic agonist.

Question 7

Indicate an antimuscarinic drug, which is effective in the treatment of mushroom poisoning?

Accepted Answer

Answer reason: Muscarinic mushroom (muscarine) poisoning is treated with the antimuscarinic atropine. Pralidoxime is for organophosphate poisoning, pilocarpine is a muscarinic agonist, and homatropine is mainly ophthalmic.

Question 8

The treatment of the antimuscarinic effects can be carried out with?

Accepted Answer

Answer reason: Antimuscarinic toxicity is treated by increasing synaptic acetylcholine with a cholinesterase inhibitor; neostigmine fits, whereas hexamethonium is a ganglionic blocker, homatropine is antimuscarinic, and acetylcholine is not used therapeutically.

Question 9

Which of the following drugs has "double-acetylcholine" structure?

Accepted Answer

Answer reason: Succinylcholine is a dicholine ester of succinic acid—essentially two acetylcholine molecules linked together—hence a "double-acetylcholine" structure.

Question 10

Indicate the nondepolarizing agent, which has the fastest onset of effect?

Accepted Answer

Answer reason: Among nondepolarizing neuromuscular blockers, rapacuronium has the most rapid onset of action; succinylcholine is rapid but is depolarizing, while pancuronium and tubocurarine have slower onsets.

Question 11

Indicate the nondepolarizing agent, which has short duration of action?

Accepted Answer

Answer reason: Mivacurium is a short-acting nondepolarizing neuromuscular blocker (rapidly hydrolyzed by plasma cholinesterase). Succinylcholine is depolarizing, while tubocurarine and pancuronium are long-acting nondepolarizers.

Question 12

Which of the following sympathomimetics acts indirectly?

Accepted Answer

Answer reason: Indirect-acting sympathomimetics increase norepinephrine release from nerve terminals. Ephedrine has mixed action with a significant indirect component, while epinephrine, norepinephrine, and methoxamine act directly on adrenergic receptors.

Question 13

Catecholamine includes following EXCEPT?

Accepted Answer

Answer reason: Ephedrine is a noncatecholamine sympathomimetic (lacks the catechol ring). Epinephrine, norepinephrine, and isoprenaline are catecholamines.

Question 14

All of the following agents are beta receptor agonists EXCEPT?

Accepted Answer

Answer reason: Methoxamine is a selective alpha-1 adrenergic agonist, not a beta agonist. Epinephrine (mixed alpha/beta), isoproterenol (nonselective beta), and dobutamine (beta-1 predominant) all have beta-agonist activity.

Question 15

Which of the following agents is an alfa1 alfa2 beta1 beta2 receptor agonist?

Accepted Answer

Answer reason: Epinephrine is a nonselective adrenergic agonist that stimulates α1, α2, β1, and β2 receptors. Methoxamine is mainly α1, albuterol is β2-selective, and norepinephrine has little β2 activity.

Question 16

Norepinephrine produces?

Accepted Answer

Answer reason: Norepinephrine primarily stimulates alpha-1 adrenergic receptors causing peripheral vasoconstriction; it has minimal beta-2 activity, so it does not cause bronchodilation or hypokalemia.

Question 17

Indicate the sympathomimetic drug, which is used in a hypotensive emergency?

Accepted Answer

Answer reason: Phenylephrine is a selective alpha-1 agonist used IV as a vasopressor to raise blood pressure in acute hypotension. Xylometazoline is a topical decongestant, Terbutaline is a beta-2 agonist, and Ephedrine is less preferred due to weaker, indirect action and tachyphylaxis.

Question 18

Indicate the agent of choice in the emergency therapy of anaphylactic shock?

Accepted Answer

Answer reason: Epinephrine is the first-line drug for anaphylaxis; its alpha- and beta-adrenergic effects reverse hypotension, bronchospasm, and edema. The others are not first-line for anaphylactic shock.

Question 19

Which of the following sympathomimetics is an effective mydriatic?

Accepted Answer

Answer reason: Phenylephrine is an alpha-1 agonist used topically to produce mydriasis without cycloplegia. Salmeterol (beta-2), dobutamine (beta-1), and norepinephrine are not used as ocular mydriatics.

Question 20

Which of the following drugs is a nonselective alfa receptor antagonist?

Accepted Answer

Answer reason: Phentolamine blocks both alpha-1 and alpha-2 receptors (nonselective alpha antagonist). Prazosin is selective for alpha-1, metoprolol is a beta-1 blocker, and reserpine depletes catecholamines.

Question 21

Indicate the alfa1-selective antagonist?

Accepted Answer

Answer reason: Prazosin is a selective alpha1-adrenergic receptor antagonist; phentolamine is nonselective alpha, dihydroergotamine is an ergot partial agonist, and labetalol blocks both beta and alpha1 receptors.

Question 22

Which of the following drugs is useful in the treatment of pheochromocytoma?

Accepted Answer

Answer reason: Phentolamine is a nonselective alpha-adrenergic blocker used to control hypertensive crises in pheochromocytoma. Phenylephrine and epinephrine are adrenergic agonists that would worsen hypertension, and using a beta-blocker alone (propranolol) is contraindicated before alpha blockade.

Question 23

Indicate a beta receptor antagonist, which has very long duration of action?

Accepted Answer

Answer reason: Nadolol has a very long half-life (about 20–24 hours), allowing once-daily dosing, longer than metoprolol, propranolol, or pindolol.

Question 24

Indicate a beta1-selective receptor antagonist, which has very long duration of action?

Accepted Answer

Answer reason: Betaxolol is a cardioselective (β1-selective) beta-blocker with a long half-life, giving a very long duration of action. Sotalol and nadolol are nonselective, and metoprolol has a shorter duration.

Question 25

Indicate a beta receptor antagonist with intrinsic sympathomimetic activity?

Accepted Answer

Answer reason: Oxprenolol is a nonselective beta-blocker with intrinsic sympathomimetic activity; propranolol, metoprolol, and carvedilol lack ISA.

Question 26

Indicate the adrenoreceptor antagonist drug, which is a rauwolfia alkaloid?

Accepted Answer

Answer reason: Reserpine is an alkaloid derived from Rauwolfia serpentina; the others are synthetic alpha or beta blockers. Thus the rauwolfia-derived antiadrenergic agent is reserpine.

Question 27

Select a hypnotic drug, which is an imidazopyridine derivative?

Accepted Answer

Answer reason: Zolpidem is a non‑benzodiazepine hypnotic of the imidazopyridine class; pentobarbital is a barbiturate, temazepam is a benzodiazepine, and chloral hydrate is an older sedative-hypnotic.

Question 28

Which of the following hypnotic agents is absorbed slowly?

Accepted Answer

Answer reason: Temazepam is a benzodiazepine hypnotic that is absorbed slowly with a delayed onset; flurazepam and triazolam are absorbed rapidly.

Question 29

Which of the following barbiturates is an ultra-short-acting drug?

Accepted Answer

Answer reason: Thiopental is an ultra-short-acting barbiturate used for induction of anesthesia; secobarbital is short-acting, amobarbital is intermediate-acting, and phenobarbital is long-acting.

Question 30

Indicate the hypnotic benzodiazepine, which has the shortest elimination half-life?

Accepted Answer

Answer reason: Triazolam is an ultra–short-acting benzodiazepine hypnotic with a very short elimination half-life (~2–5 hours), shorter than temazepam (intermediate) and flurazepam or diazepam (long with active metabolites).

Question 31

Barbiturates increase the rate of metabolism of?

Accepted Answer

Answer reason: Barbiturates induce hepatic microsomal enzymes, accelerating metabolism of many drugs including warfarin-type anticoagulants, certain digitalis (e.g., digitoxin), and glucocorticoids—hence all listed options.

Question 32

Which of the following hypnotics is preferred for elderly patients?

Accepted Answer

Answer reason: Temazepam lacks active metabolites and has intermediate duration, minimizing accumulation and next-day sedation in older adults. Flurozepam has long-acting metabolites, and barbiturates (phenobarbital, secobarbital) are inappropriate due to higher adverse effects in the elderly.

Question 33

Which of the following benzodiazepines is used mainly for hypnosis?

Accepted Answer

Answer reason: Flurazepam is a long-acting benzodiazepine used primarily as a hypnotic for insomnia; clonazepam and lorazepam are mainly anxiolytic/anticonvulsant, and midazolam is used for procedural sedation/anesthesia.

Question 34

Phenytoin is used in the treatment of?

Accepted Answer

Answer reason: Phenytoin is effective for generalized tonic–clonic (grand mal) and focal seizures but is not used for absence (petit mal) or myoclonic seizures; therefore, the correct option is grand mal epilepsy.

Question 35

The mechanism of action of carbamazepine appears to be similar to that of?

Accepted Answer

Answer reason: Carbamazepine, like phenytoin, primarily blocks voltage-gated sodium channels to reduce high-frequency neuronal firing.

Question 36

Indicate an irreversible inhibitor of GABA aminotransferase (GABA-T)?

Accepted Answer

Answer reason: Vigabatrin irreversibly inhibits GABA transaminase, increasing CNS GABA. Diazepam and phenobarbital are GABA-A modulators; felbamate mainly blocks NMDA receptors.

Question 37

Indicate the antiseizure drug – a benzodiazepine receptor agonist?

Accepted Answer

Answer reason: Lorazepam is a benzodiazepine that acts as a GABA-A receptor benzodiazepine-site agonist and is used for seizures (e.g., status epilepticus). The others are not benzodiazepines.

Question 38

Which of the following antiseizure drugs may produce teratogenicity?

Accepted Answer

Answer reason: Phenytoin (fetal hydantoin syndrome), valproate (neural tube defects), and topiramate (oral clefts) are all associated with teratogenic risk; therefore, all listed drugs may produce teratogenicity.

Question 39

Select the narcotic analgesic, which is an antagonist or partial mu receptor agonist?

Accepted Answer

Answer reason: Pentazocine is a mixed opioid: κ-agonist with antagonist/partial agonist activity at μ receptors. Fentanyl, codeine, and methadone are μ-agonists.

Question 40

Which of the following opioid analgesics is used in obstetric labor?

Accepted Answer

Answer reason: Meperidine (pethidine) is the classic systemic opioid used for analgesia during labor; alternatives like pentazocine and buprenorphine are not standard for labor, and fentanyl is more commonly used neuraxially.

Question 41

Which of the following opioid agents is used in the treatment of acute opioid overdose?

Accepted Answer

Answer reason: Naloxone is a short-acting competitive opioid receptor antagonist used to rapidly reverse acute opioid toxicity. Pentazocine is a mixed agonist–antagonist analgesic, methadone is used for maintenance/withdrawal, and remifentanyl is an opioid agonist anesthetic.

Question 42

Indicate the pure opioid antagonist, which has a half-life of 10 hours?

Accepted Answer

Answer reason: Naltrexone is a pure opioid antagonist with a long duration of action (approx. 10 hours), whereas naloxone has a short half-life and tramadol and pentazocine are not pure antagonists.

Question 43

Select the antiseizure drug with an analgesic component of effect?

Accepted Answer

Answer reason: Carbamazepine has analgesic properties and is used for neuropathic pain (e.g., trigeminal neuralgia) in addition to its antiseizure effects.

Question 44

Which of the following antipsychotic drugs is typical?

Accepted Answer

Answer reason: Haloperidol is a first-generation (typical) antipsychotic; clozapine, quetiapine, and olanzapine are atypical.

Question 45

Indicate the antipsychotic drug, which is a butyrophenone derivative?

Accepted Answer

Answer reason: Butyrophenone antipsychotics include haloperidol and droperidol. Thioridazine and fluphenazine are phenothiazines, and sertindole is an atypical indole derivative.

Question 46

Indicate the antipsychotic drug, which is a thioxanthene derivative?

Accepted Answer

Answer reason: Thiothixene is a typical antipsychotic of the thioxanthene class; haloperidol is a butyrophenone, chlorpromazine is a phenothiazine, and clozapine is an atypical dibenzodiazepine.

Question 47

Indicate the antipsychotic drug having H1-antihistaminic activity?

Accepted Answer

Answer reason: Clozapine, chlorpromazine, and olanzapine all antagonize H1 receptors, causing sedation and weight gain; therefore all are correct.

Question 48

Which of the following antidepressants is a selective serotonin reuptake inhibitor?

Accepted Answer

Answer reason: Fluoxetine is an SSRI. Phenelzine is an MAOI, desipramine is a TCA, and maprotiline is a tetracyclic NRI.

Question 49

Indicate the irreversible MAO inhibitor, which is a hydrazide derivative?

Accepted Answer

Answer reason: Phenelzine is an irreversible MAOI of the hydrazine class. Moclobemide is a reversible MAO-A inhibitor; selegiline is an irreversible MAO-B propargylamine; tranylcypromine is a non-hydrazine cyclopropylamine.

Question 50

Indicate the antidepressant agent, which is a phenyltoylpropylamine derivative?

Accepted Answer

Answer reason: Fluoxetine is an SSRI of the phenylpropylamine (aryloxyphenylpropylamine) class. Paroxetine is a piperidine derivative, maprotiline is a tetracyclic antidepressant, and amitriptyline is a tricyclic.

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