Question 1

Indicate the agents of choice in the treatment of most anxiety states?

Accepted Answer

Answer reason: Benzodiazepines are first-line agents for most anxiety disorders due to rapid anxiolytic effects; barbiturates are obsolete for anxiety, lithium treats bipolar disorder, and phenothiazines are antipsychotics.

Question 2

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

Accepted Answer

Answer reason: Triazolam is an ultra–short-acting benzodiazepine with the shortest elimination half-life (about 2–5 hours), whereas quazepam, diazepam, and clorazepate are long-acting.

Question 3

Which of the following benzodiazepines is preferred for elderly patients?

Accepted Answer

Answer reason: In older adults, short-acting benzodiazepines without long-acting active metabolites are preferred to reduce accumulation and sedation. Triazolam is short-acting, whereas clorazepate, chlordiazepoxide, and prazepam are long-acting prodrugs with active metabolites.

Question 4

Which of the following anxiolytics has minimal abuse liability?

Accepted Answer

Answer reason: Buspirone is a 5-HT1A partial agonist with little sedative effect and minimal risk of tolerance or dependence, unlike benzodiazepines such as oxazepam and alprazolam. Flumazenil is a benzodiazepine antagonist, not an anxiolytic.

Question 5

Indicate the anesthetic, which is an inhibitor of NMDA glutamate receptors?

Accepted Answer

Answer reason: Ketamine is a dissociative anesthetic that acts as an NMDA glutamate receptor antagonist; the others primarily enhance GABAergic activity.

Question 6

Which of the following inhaled anesthetics has rapid onset and recovery?

Accepted Answer

Answer reason: Nitrous oxide, desflurane, and sevoflurane all have low blood:gas partition coefficients, producing rapid induction and recovery.

Question 7

Indicated the inhaled anesthetic, which decreases the ventilatory response to hypoxia?

Accepted Answer

Answer reason: Halogenated volatile anesthetics blunt the carotid-body hypoxic ventilatory drive; halothane produces a particularly marked depression compared with agents like nitrous oxide.

Question 8

Which of the following inhaled anesthetics can produce hepatic necrosis?

Accepted Answer

Answer reason: Halothane is associated with idiosyncratic hepatotoxicity (halothane hepatitis) that can progress to massive hepatic necrosis; the others are not typically linked to this complication.

Question 9

Following drugs directly activate the respiratory center EXCEPT?

Accepted Answer

Answer reason: Cytiton acts mainly via peripheral carotid body chemoreceptor stimulation (reflex), not by directly activating the medullary respiratory center. Bemegride, caffeine, and aethymizole directly stimulate central respiratory centers.

Question 10

Choose the drug belonging to membranestabilizing agents?

Accepted Answer

Answer reason: Sodium cromoglycate is a mast cell membrane-stabilizing agent. Zileutin inhibits 5-lipoxygenase, while zafirlucast and montelucast are leukotriene receptor antagonists.

Question 11

Choose the drug which is a H2-receptor antagonist?

Accepted Answer

Answer reason: Ranitidine is an H2-receptor antagonist; omeprazole is a proton pump inhibitor, pirenzepine is an M1 antimuscarinic, and carbenoxolone is a cytoprotective agent.

Question 12

All of the following drugs are proton pump inhibitors EXCEPT?

Accepted Answer

Answer reason: Famotidine is an H2-receptor antagonist, not a proton pump inhibitor. Omeprazole, pantoprazole (spelled Pantoprozole here), and rabeprazole are PPIs.

Question 13

Indicate the drug that cause metabolic alkalosis?

Accepted Answer

Answer reason: Systemically absorbed antacid; bicarbonate load raises serum HCO3− leading to metabolic alkalosis. The others are not typical causes.

Question 14

Select the emetic agent having a reflex action?

Accepted Answer

Answer reason: Ipecac derivatives induce vomiting by irritating the gastric mucosa, triggering a vagal reflex; apomorphine acts centrally at the CTZ, and chlorpromazine/metoclopramide are antiemetics.

Question 15

Choose the drug irritating the gut and causing increased peristalsis?

Accepted Answer

Answer reason: Phenolphthalein is a stimulant (irritant) laxative that increases intestinal peristalsis by irritating the mucosa. Methyl cellulose is bulk-forming, mineral oil is a lubricant, and proserine increases motility via cholinergic action but is not an irritant laxative.

Question 16

All of the following drugs are indirect acting anticoagulants EXCEPT?

Accepted Answer

Answer reason: Dicumarol, warfarin, and phenindione are oral vitamin K antagonists (indirect anticoagulants). Dalteparin is a low–molecular-weight heparin, a parenteral anticoagulant, not an indirect oral agent.

Question 17

This drug is a Class II antiarrhythmic drug?

Accepted Answer

Answer reason: Class II antiarrhythmic agents are beta-blockers; propranolol is a beta-blocker. Flecainide is Class IC, lidocaine is Class IB, and verapamil is Class IV.

Question 18

This drug has a little or no direct effect on chronotropy and dromotropy at normal doses?

Accepted Answer

Answer reason: Nifedipine (a dihydropyridine CCB) primarily causes peripheral vasodilation and has minimal direct effects on SA/AV node activity at normal doses, unlike diltiazem and verapamil which decrease chronotropy and dromotropy.

Question 19

Which of the following antianginal agents is a calcium channel blocker?

Accepted Answer

Answer reason: Nifedipine is a dihydropyridine calcium channel blocker used as an antianginal. The others are not CCBs: nitroglycerin is a nitrate, dipyridamole is an antiplatelet vasodilator, and minoxidil is a potassium channel opener antihypertensive.

Question 20

Which of the following antianginal agents is a myotropic coronary dilator?

Accepted Answer

Answer reason: Dipyridamole directly relaxes vascular smooth muscle (myotropic action) and acts as a coronary vasodilator. Atenolol is a beta-blocker (cardiotropic), Validol is mainly a reflex agent, and Alimidine is a bradycardic agent, not a coronary dilator.

Question 21

Which of the following antianginal agents is the specific bradycardic drug?

Accepted Answer

Answer reason: Alinidine is a selective sinus node inhibitor (specific bradycardic agent) that reduces heart rate; the others are not specific bradycardic drugs.

Question 22

Which of the following antianginal agents is a potassium channel opener?

Accepted Answer

Answer reason: Minoxidil is a potassium channel opener; the others are not K+ channel openers (atenolol is a beta-blocker, dipyridamole is a vasodilator/antiplatelet, and Validol is not a KCO).

Question 23

Which of the following is true for tripe therapy?

Accepted Answer

Answer reason: Standard H. pylori triple therapy is a PPI plus clarithromycin with either amoxicillin or metronidazole; the PPI can be omeprazole or esomeprazole. Therefore all listed combinations are correct.

Question 24

The students are going to kalam for a visit one of them is suffered from chronic diarrhea what should be the drug of choice?

Accepted Answer

Answer reason: Chronic diarrhea is commonly due to protozoal infections such as giardiasis or amoebiasis; metronidazole is the drug of choice for these. The other options target primarily bacterial causes of acute traveler’s diarrhea.

Question 25

A child having 8 years age is suffered from phyrinistics so what should be the choice of drug?

Accepted Answer

Answer reason: First-line therapy for streptococcal pharyngitis in school-aged children is oral penicillin V for 10 days; benzathine penicillin G IM is an alternative when adherence is a concern.

Question 26

A patient is having gonorrhea but he is also suffering from UTI’s then what should be the choice of drug in cephalosporin?

Accepted Answer

Answer reason: Ceftriaxone is the cephalosporin of choice for Neisseria gonorrhoeae and also provides effective gram-negative coverage for UTIs.

Question 27

Which of the following belongs to quinolones and floroguinolones?

Accepted Answer

Answer reason: Norfloxacin and levofloxacin are fluoroquinolones, and nalidixic acid is a quinolone; thus all listed drugs belong to the quinolone/fluoroquinolone group.

Question 28

Which of the following statement about fluconazole is most accurate?

Accepted Answer

Answer reason: Fluconazole (an azole) inhibits 14-α-demethylase, blocking demethylation of lanosterol to ergosterol. It penetrates the BBB well and is not highly effective against Aspergillus.

Question 29

Which of the following drug is most likely to cause anemia due to reduced erythropiotien?

Accepted Answer

Answer reason: Amphotericin B can cause nephrotoxicity that decreases renal erythropoietin production, leading to anemia; the azoles listed are not associated with this effect.

Question 30

To target the micrometastasis we use chemotherapy followed by surgery and radiation treatment which is called ____________ chemotherapy?

Accepted Answer

Answer reason: Adjuvant chemotherapy is given after local therapy (surgery/radiation) to eradicate micrometastases. The clue is targeting micrometastasis, which defines adjuvant therapy.

Question 31

Sulfonamides increase the risk of neonatal kernicterous because?

Accepted Answer

Answer reason: Sulfonamides displace bilirubin from albumin binding sites, increasing free unconjugated bilirubin that can cross the immature blood–brain barrier and cause kernicterus.

Question 32

Which one of the following antibiotic is the most effective in the treatment of infection due to enterococci if used with penicillin G?

Accepted Answer

Answer reason: Enterococcal infections are treated with a cell wall–active agent (penicillin G/ampicillin) plus an aminoglycoside for synergy. Gentamicin is the standard and most effective choice; amikacin and tobramycin have poor activity against enterococci, and streptomycin is less favored due to resistance and toxicity.

Question 33

Pick out the appropriate alimentary route of administration when passage of drugs through liver is minimized?

Accepted Answer

Answer reason: The rectal route partly bypasses portal circulation (lower rectum drains to systemic veins), minimizing first-pass hepatic metabolism. Oral and intraduodenal undergo first-pass; transdermal is not an alimentary route.

Question 34

If an agonist can produce maximal effects and has high efficacy it's called?

Accepted Answer

Answer reason: A drug that elicits the maximal possible response at a receptor has high efficacy and is defined as a full agonist; partial agonists produce submaximal effects and antagonists have no efficacy.

Question 35

If an agonist can produce submaximal effects and has moderate efficacy it’s called?

Accepted Answer

Answer reason: A partial agonist has lower intrinsic efficacy and produces a submaximal response even at full receptor occupancy.

Question 36

Drug resistance is a term used to describe the loss of effectiveness of antimicrobial or antitumour drugs. This consideration is?

Accepted Answer

Answer reason: Drug resistance denotes reduced or lost effectiveness of drugs against microbes or tumor cells due to adaptive or acquired mechanisms, so the statement is correct.

Question 37

Ionizable group is responsible for?

Accepted Answer

Answer reason: In drug structure–activity (e.g., local anesthetics), the ionizable amine group determines the degree of ionization (pKa), which governs membrane permeability and thus diffusion to the site of action. Potency relates more to lipid solubility and duration to protein binding/metabolism, not primarily to the ionizable group.

Question 38

Indicate a cholinomimetic agent, which is related to direct-acting drugs?

Accepted Answer

Answer reason: Carbachol is a direct-acting cholinomimetic (muscarinic/nicotinic agonist). Edrophonium, Physostigmine, and Isoflurophate are acetylcholinesterase inhibitors, i.e., indirect-acting agents.

Question 39

Which of the following direct-acting cholinomimetics has the shortest duration of action?

Accepted Answer

Answer reason: Acetylcholine is very rapidly hydrolyzed by acetylcholinesterase, giving it the shortest duration; carbamate analogs (carbachol, bethanechol) are resistant and last longer, and methacholine lasts longer than ACh.

Question 40

Isofluorophate increases all of the following effects except?

Accepted Answer

Answer reason: Isofluorophate is an irreversible acetylcholinesterase inhibitor that increases acetylcholine, leading to parasympathetic muscarinic and nicotinic effects such as lacrimation, salivation, and muscle fasciculations. It causes bronchoconstriction, not bronchodilation; therefore bronchodilation is the exception.

Question 41

Which of the following cholinomimetics is used in the treatment of atropine intoxication?

Accepted Answer

Answer reason: Physostigmine, a tertiary amine reversible acetylcholinesterase inhibitor, crosses the blood–brain barrier and reverses central and peripheral anticholinergic effects of atropine. Neostigmine does not cross the BBB, carbachol is blocked by atropine at muscarinic receptors, and lobeline is nicotinic.

Question 42

Which of the following drugs is both a muscarinic and nicotinic blocker?

Accepted Answer

Answer reason: Benztropine is an anticholinergic with central actions that can antagonize both muscarinic and nicotinic cholinergic activity. Atropine is purely muscarinic, hexamethonium is nicotinic ganglionic only, and succinylcholine is a nicotinic agonist.

Question 43

Indicate the skeletal muscle relaxant, which is a depolarizing agent?

Accepted Answer

Answer reason: Succinylcholine is the classic depolarizing neuromuscular blocker; vecuronium is nondepolarizing, scopolamine is an antimuscarinic, and hexamethonium is a ganglionic blocker.

Question 44

Which of the following drugs is a nondepolarizing muscle relaxant?

Accepted Answer

Answer reason: Pancuronium is a competitive (nondepolarizing) neuromuscular blocker. Succinylcholine is depolarizing; hexamethonium is a ganglionic blocker; scopolamine is antimuscarinic.

Question 45

The effect of the drug on parasympathetic function declines rapidly in all organs EXCEPT?

Accepted Answer

Answer reason: Antimuscarinic effects (e.g., atropine) wane quickly in most organs such as heart, glands, and smooth muscle, but ocular effects (mydriasis, cycloplegia) persist much longer; therefore the eye is the exception.

Question 46

Atropine is frequently used prior to administration of inhalant anesthetics to reduce?

Accepted Answer

Answer reason: Atropine is an antimuscarinic used preoperatively to decrease salivary and bronchial secretions; it is not used to reduce muscle tone or postoperative nausea and vomiting.

Question 47

Atropine causes?

Accepted Answer

Answer reason: Atropine is an antimuscarinic that decreases GI smooth muscle tone and secretions, producing an antispasmodic (spasmolytic) effect; it does not increase motility, contractions, or secretory activity.

Question 48

Which of the following agents is used as an inhalation drug in asthma?

Accepted Answer

Answer reason: Ipratropium is an inhaled antimuscarinic bronchodilator commonly used for asthma and COPD; the others are not used as inhaled agents for asthma.

Question 49

Which of the following agents is a short-acting ganglion blocker?

Accepted Answer

Answer reason: Trimetaphan camsylate is a short-acting ganglionic blocker used historically for controlled hypotension. Homatropine is a muscarinic antagonist, hexamethonium is a longer-acting ganglion blocker, and pancuronium is a neuromuscular blocker.

Question 50

Which competitive neuromuscular blocking agent could be used in patients with renal failure?

Accepted Answer

Answer reason: Atracurium is a nondepolarizing (competitive) neuromuscular blocker eliminated by Hofmann degradation and ester hydrolysis, independent of renal function; pipecuronium and doxacurium are renally excreted, and succinylcholine is depolarizing.

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