Question 1

Which depolarizing agent has the extremely brief duration of action?

Accepted Answer

Answer reason: Succinylcholine is the only depolarizing neuromuscular blocker listed and is rapidly hydrolyzed by plasma cholinesterase, giving it an ultra-short duration of action.

Question 2

Which of the following neuromuscular blockers causes transient muscle fasciculations?

Accepted Answer

Answer reason: Succinylcholine is a depolarizing neuromuscular blocker that produces an initial depolarization of the motor end plate, leading to transient muscle fasciculations before paralysis.

Question 3

Which of the following muscular relaxants causes hypotension and bronchospasm?

Accepted Answer

Answer reason: Tubocurarine releases histamine and can cause ganglionic blockade, leading to hypotension and bronchospasm.

Question 4

Which of the following neuromuscular blocking agents cause cardiac arrhythmias?

Accepted Answer

Answer reason: Succinylcholine can trigger bradycardia and other dysrhythmias, especially with repeat dosing or via hyperkalemia, whereas agents like vecuronium are cardiovascularly stable.

Question 5

Which neuromuscular blocking agent is contraindicated in patients with glaucoma?

Accepted Answer

Answer reason: Succinylcholine transiently increases intraocular pressure; therefore it is avoided in glaucoma and penetrating eye injuries.

Question 6

Which of the following effects is related to direct beta1-adrenoceptor stimulation?

Accepted Answer

Answer reason: Beta1 receptors are primarily in the heart; their stimulation increases heart rate and contractility, producing tachycardia. Bronchodilation and vasodilation are beta2 effects; bradycardia is the opposite.

Question 7

Indicate the drug, which is a direct-acting both alfa- and beta-receptor agonist?

Accepted Answer

Answer reason: Norepinephrine is a direct-acting adrenergic agonist that stimulates alpha receptors and beta-1 receptors. Methoxamine is primarily alpha-1 selective, isoproterenol acts only on beta receptors, and ephedrine is mixed-acting (direct and indirect).

Question 8

Indicate the direct-acting sympathomimetic, which is an alfa1 alfa2 beta1 receptor agonist?

Accepted Answer

Answer reason: Norepinephrine is a direct-acting agonist with strong activity at alpha1, alpha2, and beta1 receptors. Isoproterenol is beta1/beta2 only, ephedrine is mixed direct/indirect, and dobutamine is primarily beta1.

Question 9

Which of the following sympathomimetics is a beta2-selective agonist?

Accepted Answer

Answer reason: Terbutaline is a selective beta2-adrenergic agonist used as a bronchodilator. Xylometazoline is an alpha agonist, isoproterenol is a nonselective beta agonist, and dobutamine is primarily beta1-selective.

Question 10

Indicate the long-acting topical decongestant agents?

Accepted Answer

Answer reason: Xylometazoline is an imidazoline nasal decongestant with long duration of action (about 8–10 hours). Epinephrine, norepinephrine, and phenylephrine are short-acting.

Question 11

Which of the following topical decongestant agents is an alfa2-selective agonist?

Accepted Answer

Answer reason: Among topical nasal decongestants, xylometazoline (an imidazoline derivative) has alpha-2 adrenergic agonist activity, whereas phenylephrine is alpha-1 selective and ephedrine/epinephrine are nonselective.

Question 12

Which of the following sympathomimetics is used in the therapy of bronchial asthma?

Accepted Answer

Answer reason: Formoterol is a long-acting selective beta-2 agonist used as a bronchodilator in asthma therapy; the other agents are not used for asthma management.

Question 13

Which of the following drugs is a reversible nonselective alfa, beta antagonist?

Accepted Answer

Answer reason: Labetalol blocks both alpha and beta adrenergic receptors and is a reversible, nonselective antagonist. The other options lack combined alpha and beta blockade.

Question 14

Nonselective alfa-receptor antagonists are most useful in the treatment of?

Accepted Answer

Answer reason: Nonselective alpha-receptor blockers (e.g., phenoxybenzamine, phentolamine) are used to control catecholamine-induced hypertension in pheochromocytoma; they are not treatments for asthma, arrhythmias, or routine chronic hypertension.

Question 15

Indicate the reversible nonselective alfa-receptor antagonist, which is an ergot derivative?

Accepted Answer

Answer reason: Ergotamine is an ergot alkaloid that can act as a reversible, nonselective alpha-adrenergic antagonist. Prazosin is a selective alpha-1 blocker; phenoxybenzamine is an irreversible nonselective alpha blocker; carvedilol is primarily a beta blocker with alpha-1 blockade.

Question 16

Indicate an alfa1 adrenoreceptor antagonist, which has great selectivity for alfa1a subtype?

Accepted Answer

Answer reason: Tamsulosin is highly selective for the alpha1A subtype, providing prostate-selective alpha blockade.

Question 17

Which of the following chemical agents are used in the treatment of insomnia?

Accepted Answer

Answer reason: Benzodiazepines and barbiturates are sedative-hypnotics, and imidazopyridines (e.g., zolpidem) are non-benzodiazepine hypnotics; all are used for insomnia.

Question 18

Indicate the barbituric acid derivative, which has 4-5 days elimination half-life?

Accepted Answer

Answer reason: Phenobarbital is a long-acting barbiturate with an elimination half-life around 80–120 hours (approximately 4–5 days). Secobarbital and amobarbital are shorter-acting, and thiopental is ultra–short acting.

Question 19

Which of the following agents is preferred in the treatment of insomnia?

Accepted Answer

Answer reason: Benzodiazepine hypnotics (e.g., temazepam) are preferred for insomnia due to better safety and lower toxicity than barbiturates; ethanol and phenothiazides are inappropriate.

Question 20

Which of the following hypnotic drugs causes least suppression of REM sleep?

Accepted Answer

Answer reason: Benzodiazepine hypnotics suppress REM sleep less than barbiturates. Flurazepam is a benzodiazepine; phenobarbital and secobarbital are barbiturates, and flumazenil is not a hypnotic.

Question 21

Indicate an antiseizure drug, inhibiting central effects of excitatory amino acids?

Accepted Answer

Answer reason: Lamotrigine reduces release of excitatory amino acids (e.g., glutamate) primarily by blocking voltage-gated sodium channels, whereas ethosuximide blocks T-type Ca2+ channels, diazepam enhances GABA-A activity, and tiagabine inhibits GABA reuptake.

Question 22

Which of the following antiseizure drugs is also effective in treating trigeminal neuralgia?

Accepted Answer

Answer reason: Carbamazepine is first-line therapy for trigeminal neuralgia; the other listed antiseizure drugs are not standard first-line treatments for this condition.

Question 23

Indicate the drug of choice for status epilepticus in infants and children?

Accepted Answer

Answer reason: Phenobarbital is the preferred anticonvulsant for status epilepticus in infants and young children; clonazepam is not first-line for acute status, ethosuximide treats absence seizures, and phenytoin is an alternative but not the pediatric drug of choice.

Question 24

Adverse effect caused by phenobarbital is?

Accepted Answer

Answer reason: Phenobarbital is a barbiturate that causes CNS depression (sedation), carries risk of physical and psychological dependence, and can worsen absence (petit mal) seizures; thus all listed effects are correct.

Question 25

Indicate the antiseizure drug, which is a phenyltriazine derivative?

Accepted Answer

Answer reason: Lamotrigine is an anticonvulsant of the phenyltriazine class; the others are a barbiturate (phenobarbital), a benzodiazepine (clonazepam), and a dibenzazepine derivative (carbamazepin).

Question 26

The drug of choice in the treatment of petit mal (absence seizures) is?

Accepted Answer

Answer reason: Ethosuximide is the first-line drug for absence (petit mal) seizures via T-type calcium channel blockade. Phenytoin and carbamazepine can worsen absence seizures; phenobarbital is not first-line.

Question 27

Benzodiazepine's usefulness is limited by?

Accepted Answer

Answer reason: Chronic benzodiazepine use leads to tolerance and dependence, which limits their long-term usefulness. They are not associated with atropine-like effects or causing psychotic episodes, and myasthenic syndrome is not the typical limiting factor.

Question 28

Which of the following analgesics is a phenanthrene derivative?

Accepted Answer

Answer reason: Morphine is a phenanthrene opioid. Fentanyl is a phenylpiperidine, methadone is a diphenylheptane, and pentazocine is a benzomorphan.

Question 29

Morphine causes the following effects EXCEPT?

Accepted Answer

Answer reason: Morphine causes constipation, urinary retention, and histamine-mediated bronchoconstriction. In the biliary tract, it increases sphincter of Oddi tone causing spasm and increased pressure—not dilatation—so dilatation is the exception.

Question 30

Which of the following opioid analgesics is a partial mu receptor agonist?

Accepted Answer

Answer reason: Buprenorphine is a partial mu-opioid receptor agonist (with a ceiling effect), whereas morphine, methadone, and sufentanyl are full mu agonists.

Question 31

Non-narcotic analgesics are mainly effective against pain associated with?

Accepted Answer

Answer reason: Non-narcotic analgesics (e.g., NSAIDs, acetaminophen) are most effective for mild to moderate nociceptive pain driven by inflammation and tissue injury via prostaglandin inhibition; they are less effective for severe ischemic or postoperative pain where opioids are preferred.

Question 32

Non-narcotic analgesics are all of the following drugs EXCEPT?

Accepted Answer

Answer reason: Butorphanol is an opioid (narcotic) agonist–antagonist analgesic, whereas paracetamol, acetylsalicylic acid, and ketorolac are non-opioid analgesics.

Question 33

Which of the following non-narcotic agents is salicylic acid derivative?

Accepted Answer

Answer reason: Aspirin (acetylsalicylic acid) is a salicylic acid derivative and a non‑narcotic analgesic/antipyretic. Phenylbutazone is a pyrazolone NSAID, ketamine is an NMDA antagonist anesthetic, and tramadol is an opioid-like analgesic.

Question 34

Indicate the antipsychotic drug, which is a phenothiazine aliphatic derivative?

Accepted Answer

Answer reason: Chlorpromazine is a phenothiazine with an aliphatic side chain. The others are different classes: thiothixene (thioxanthene), risperidone (atypical benzisoxazole), and clozapine (atypical dibenzodiazepine).

Question 35

Indicate the antipsychotic drug having a muscarinic-cholinergic blocking activity?

Accepted Answer

Answer reason: Low-potency first-generation antipsychotics like chlorpromazine strongly block muscarinic cholinergic receptors; haloperidol and risperidone have minimal anticholinergic effects.

Question 36

Which of the following phenothiazine derivatives is a potent local anesthetic?

Accepted Answer

Answer reason: Chlorpromazine, a phenothiazine antipsychotic, has notable membrane‑stabilizing (quinidine-like) activity that produces potent local anesthetic effects; the others do not.

Question 37

Which of the following antipsychotic drugs has high affinity for D2 and 5-HT2 receptors?

Accepted Answer

Answer reason: Risperidone is an atypical antipsychotic with strong antagonism at both 5-HT2 and D2 receptors, unlike clozapine (low D2) and typicals like droperidol or thiothixene (primarily D2).

Question 38

The drug of choice for manic-depressive psychosis is?

Accepted Answer

Answer reason: Lithium carbonate is the classic first-line mood stabilizer for bipolar (manic-depressive) disorder; the others are antidepressant/anxiolytic agents not used as drug of choice for mania.

Question 39

Which of the following agents is related to tricyclic antidepressants?

Accepted Answer

Answer reason: Amitriptyline is a tricyclic antidepressant; the others are different classes (nefazodone is a SARI, fluoxetine is an SSRI, isocarboxazid is an MAOI).

Question 40

Which of the following antidepressants is a selective short-acting MAO-A inhibitor?

Accepted Answer

Answer reason: Moclobemide is a reversible, selective MAO-A inhibitor (short-acting). Maprotiline and amitriptyline are TCAs, and selegiline is selective for MAO-B.

Question 41

Which of the following tricyclic and heterocyclic antidepressants has the greatest sedation?

Accepted Answer

Answer reason: Doxepin and amitriptyline (TCAs) and trazodone (heterocyclic) are all highly sedating due to strong antihistaminic/alpha-1 blockade; each is among the most sedating antidepressants.

Question 42

Which of the following tricyclic and heterocyclic agents has the least sedation?

Accepted Answer

Answer reason: Protriptyline is one of the least sedating TCAs, whereas trazodone, amitriptyline, and mirtazapine are strongly sedating due to antihistaminic effects.

Question 43

Indicate a tricyclic or a heterocyclic antidepressant having least antimuscarinic effects?

Accepted Answer

Answer reason: Trazodone, bupropion, and mirtazapine are atypical/heterocyclic antidepressants with minimal muscarinic receptor blockade, so all have low anticholinergic effects.

Question 44

Which of the following antidepressants has significant alfa2-adrenoreceptor antagonism?

Accepted Answer

Answer reason: Mirtazapine is a NaSSA that blocks presynaptic alpha-2 adrenergic receptors, increasing norepinephrine and serotonin release; the others do not have significant alpha-2 antagonism.

Question 45

Sertraline and paroxetine are similar to fluoxetine in the mechanism of action and therapeutic use; sertraline is less likely to interact adversely with other drugs?

Accepted Answer

Answer reason: Fluoxetine, paroxetine, and sertraline are SSRIs with similar MOA and uses. Fluoxetine and paroxetine are strong CYP2D6 inhibitors causing many interactions, whereas sertraline has minimal CYP inhibition and fewer drug interactions. Therefore the statement is true.

Question 46

Anxiolytics are also useful for?

Accepted Answer

Answer reason: Benzodiazepine anxiolytics have anticonvulsant effects, are used as hypnotics for insomnia, and provide muscle relaxation in certain neuromuscular conditions; thus all listed uses apply.

Question 47

Which of the following anxiolytics is a benzodiazepine derivative?

Accepted Answer

Answer reason: Chlordiazepoxide is a classic benzodiazepine anxiolytic; buspirone is an azapirone, meprobamate is a carbamate, and chloral hydrate is a sedative-hypnotic.

Question 48

Which of the following benzodiazepines has the shortest duration of action?

Accepted Answer

Answer reason: Triazolam is an ultra–short-acting benzodiazepine with a very short half-life and no long-acting active metabolites; the others (clorazepate, prazepam, chlordiazepoxide) are long-acting.

Question 49

Which of the following anxiolytics is preferred in patient with limited hepatic function?

Accepted Answer

Answer reason: Among the listed agents, the long-acting benzodiazepines (diazepam, chlordiazepoxide, quazepam) rely on hepatic oxidative metabolism and accumulate with impaired liver function. Buspirone is a non-benzodiazepine anxiolytic and is safer relative to those options in hepatic dysfunction, so it is preferred among the given choices.

Question 50

Additive CNS depression can be predicted if benzodiazepines are used with?

Accepted Answer

Answer reason: Ethanol, opioids like morphine, and phenothiazines such as chlorpromazine are CNS depressants; combined with benzodiazepines they produce additive CNS depression.

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