Question 1

Indicate the drug belonging to antitussives of narcotic type of action?

Accepted Answer

Answer reason: Aethylmorphine is an opioid (narcotic) antitussive; glaucine, Tusuprex (oxoladin), and Libexine (prenoxdiazine) are non‑narcotic antitussives.

Question 2

All of these drugs contain free sulfhydryl groups EXCEPT?

Accepted Answer

Answer reason: N-acetylcysteine is a sulfhydryl-containing mucolytic. Ambroxol and bromhexine are non-sulfhydryl mucolytics, and trypsin is a proteolytic enzyme; it does not act via a free –SH group. Thus trypsin is the exception.

Question 3

Select the side-effect characteristic for non-selective beta2-adrenomimics?

Accepted Answer

Answer reason: Non-selective beta-agonists stimulate both β1 and β2 receptors; β1 cardiac stimulation produces increased heart rate, causing tachycardia. The other options reflect CNS depression, alpha-mediated vasoconstriction, or anticholinergic effects.

Question 4

All of the following drugs are antiemetics EXCEPT?

Accepted Answer

Answer reason: Metoclopramide, ondansetron, and chlorpromazine have antiemetic properties; apomorphine is a dopamine agonist that is emetogenic, not antiemetic.

Question 5

Aminocaproic acid is a drug of choice for treatment of?

Accepted Answer

Answer reason: Aminocaproic acid is an antifibrinolytic that inhibits plasminogen activation; it is used to control bleeding due to excessive fibrinolysis, including as an antidote to fibrinolytic (thrombolytic) therapy.

Question 6

Digoxin is thought to increase intracellular concentrations of calcium in myocardial cells by indirectly slowing the action of the sodium-calcium exchanger. This consideration is?

Accepted Answer

Answer reason: Digoxin inhibits the Na+/K+ ATPase, increasing intracellular Na+ and reducing the activity of the Na+/Ca2+ exchanger, thereby increasing intracellular Ca2+ in cardiac myocytes. Thus the statement is true.

Question 7

The most cardiac manifestation of glycosides intoxication is?

Accepted Answer

Answer reason: Cardiac glycoside (e.g., digoxin) toxicity can precipitate many arrhythmias including AV junctional rhythms, AV blocks, and ventricular tachycardia; therefore all listed are manifestations.

Question 8

The manifestations of glycosides intoxication are?

Accepted Answer

Answer reason: Cardiac glycoside (e.g., digoxin) toxicity typically presents with gastrointestinal upset, visual disturbances, and potentially life‑threatening ventricular tachyarrhythmias; therefore all listed manifestations are correct.

Question 9

This drug is useful for treating heart failure because it increases the inotropic state and reduces afterload?

Accepted Answer

Answer reason: Amrinone (inamrinone) is a PDE3 inhibitor that increases cAMP, producing positive inotropy and peripheral vasodilation, thereby reducing afterload. The other options do not both increase contractility and reduce afterload.

Question 10

Drugs most commonly used in chronic heart failure are?

Accepted Answer

Answer reason: Standard chronic heart failure therapy includes ACE inhibitors to reduce afterload and mortality, diuretics for fluid overload, and cardiac glycosides (e.g., digoxin) for symptom control; therefore all listed options are used.

Question 11

All of the following calcium channel blockers are useful in the treatment of cardiac arrhythmias EXCEPT?

Accepted Answer

Answer reason: Non-dihydropyridine CCBs (verapamil, diltiazem) and bepridil depress AV nodal conduction and can treat arrhythmias; nifedipine is primarily vasoselective and does not control cardiac conduction.

Question 12

All of the following are common adverse effects of calcium channel blockers EXCEPT?

Accepted Answer

Answer reason: Common adverse effects of calcium channel blockers include dizziness, headache, and flushing; skeletal muscle weakness is not a typical adverse effect.

Question 13

Side effect of nitrates and nitrite drugs are, EXCEPT?

Accepted Answer

Answer reason: Nitrates commonly cause vasodilation-related effects: orthostatic hypotension with reflex tachycardia, throbbing headache, and they develop tolerance with continuous use. GI disturbance is not a characteristic adverse effect, making it the exception.

Question 14

Tick the drug with nonselective beta-adrenoblocking activity?

Accepted Answer

Answer reason: Propranolol is a nonselective beta-blocker (blocks both β1 and β2). Atenolol, metoprolol, and nebivolol are β1-selective.

Question 15

ARV for HIV exposed New born is given?

Accepted Answer

Answer reason: Standard PMTCT guidance provides daily nevirapine to HIV-exposed newborns for 6 weeks (longer only for high-risk situations).

Question 16

50 years old man was treated with high dose vincristine before his surgery now he is feeling nausea and vomiting so what should be the coice of drug as an antiemetic?

Accepted Answer

Answer reason: Chemotherapy-induced nausea and vomiting from vincristine is best prevented/treated with a 5-HT3 antagonist; ondansetron (spelled here as Ordanosetron) is first-line and more effective than dopamine antagonists or benzodiazepines.

Question 17

Penicillin interfere with the bacterial cell by inhabiting ____________?

Accepted Answer

Answer reason: Beta-lactam antibiotics (penicillins) inhibit peptidoglycan cross-linking by blocking transpeptidase enzymes (PBPs); they do not inhibit glycosylation or NAM/NAG formation.

Question 18

A young football player is having has lab finding tests in which mycoplasma and claymydia is +ve so what should be the drug of choice in floroguinolones?

Accepted Answer

Answer reason: Respiratory fluoroquinolones (e.g., levofloxacin; 3rd gen) have reliable activity against atypicals such as Mycoplasma and Chlamydia, unlike earlier generations.

Question 19

What is characteristic of the oral route?

Accepted Answer

Answer reason: Oral drug absorption is influenced by GI secretions and motility. Onset is not fast, first-pass hepatic metabolism occurs, and sterility of dosage forms is not required.

Question 20

Biotransformation of the drugs is to render them?

Accepted Answer

Answer reason: Drug metabolism increases polarity and water solubility to facilitate excretion; thus drugs become less lipid soluble (and usually less active).

Question 21

Conjugation is?

Accepted Answer

Answer reason: Conjugation is a Phase II metabolic reaction where a drug or its metabolite is coupled with an endogenous molecule (e.g., glucuronic acid, sulfate) to increase polarity and facilitate excretion.

Question 22

Elimination rate constant (Kelim) is defined by the following parameter?

Accepted Answer

Answer reason: In pharmacokinetics, the elimination rate constant (ke) is related to and defined by the drug's half-life: ke = ln(2)/t1/2.

Question 23

The substance binding to one receptor subtype as an agonist and to another as an antagonist is called?

Accepted Answer

Answer reason: A drug that stimulates one receptor subtype while blocking another is termed a mixed agonist–antagonist.

Question 24

What term is used to describe a more gradual decrease in responsiveness to a drug, taking days or weeks to develop?

Accepted Answer

Answer reason: A gradual loss of drug responsiveness over days to weeks is tolerance; tachyphylaxis is rapid-onset desensitization.

Question 25

What term is used to describe a decrease in responsiveness to a drug which develops in a few minutes?

Accepted Answer

Answer reason: A rapid decrease in drug responsiveness occurring within minutes is termed tachyphylaxis; tolerance develops more slowly, cumulative effect is due to drug build-up, and refractoriness is a persistent lack of response.

Question 26

Tolerance and drug resistance can be a consequence of?

Accepted Answer

Answer reason: Enzyme induction increases drug metabolism, lowering effective concentrations and producing pharmacokinetic tolerance and resistance. The other options do not explain tolerance.

Question 27

Dependence is often associated with tolerance to a drug, a physical abstinence and psychological dependence (craving). This consideration is?

Accepted Answer

Answer reason: Drug dependence typically involves tolerance and withdrawal (physical abstinence) and may include psychological dependence/craving; therefore the statement is correct.

Question 28

What does the term “potentiation” mean?

Accepted Answer

Answer reason: Potentiation refers to a drug interaction where the combined use of two agents results in a greater-than-expected effect, i.e., one intensifies the effect of the other.

Question 29

Characteristic unwanted reaction which isn't related to a dose or to a pharmacodynamic property of a drug is called?

Accepted Answer

Answer reason: Hypersensitivity (drug allergy) is an unpredictable, non–dose-related reaction not explained by the drug’s pharmacodynamic actions. Tolerance and teratogenicity are dose/long-term effects, and idiosyncrasy is a rare genetic peculiarity.

Question 30

Most local anesthetic agents consist of?

Accepted Answer

Answer reason: Local anesthetics share a common structure: a lipophilic aromatic ring, an intermediate linkage (ester or amide), and a terminal amino group; therefore all listed components are included.

Question 31

Which one of the following groups is responsible for the potency and the toxicity of local anesthetics?

Accepted Answer

Answer reason: Potency and systemic toxicity of local anesthetics correlate with lipid solubility; the aromatic lipophilic group enhances membrane penetration and increases both potency and toxicity.

Question 32

Most local anesthetics can cause?

Accepted Answer

Answer reason: Local anesthetics block cardiac Na+ channels, reducing automaticity and conduction, produce negative inotropy, and at high systemic levels can lead to cardiovascular collapse, so all listed effects are possible.

Question 33

Characteristics of carbachol include all of the following EXCEPT?

Accepted Answer

Answer reason: Carbachol is a direct cholinergic agonist that causes miosis, lowers intraocular pressure, has both muscarinic and nicotinic activity, and is resistant to acetylcholinesterase; therefore it does not cause mydriasis.

Question 34

Which of the following cholinomimetics is most widely used for paralytic ileus and atony of the urinary bladder?

Accepted Answer

Answer reason: Neostigmine is an acetylcholinesterase inhibitor that increases acetylcholine at muscarinic sites, enhancing GI and bladder smooth muscle contraction; it is a standard therapy for postoperative paralytic ileus and urinary retention.

Question 35

The excessive stimulation of muscarinic receptors by pilocarpine and choline esters is blocked competitively by?

Accepted Answer

Answer reason: Atropine is a competitive antagonist at muscarinic receptors, reversing muscarinic effects of agonists like pilocarpine and other choline esters. Edrophonium and echothiophate are acetylcholinesterase inhibitors, and pralidoxime reactivates AChE; none competitively block muscarinic receptors.

Question 36

M3 receptor subtype is located?

Accepted Answer

Answer reason: M3 muscarinic receptors are located on effector cell membranes of glands and smooth muscle, mediating secretion and contraction. M2 are in myocardium; ganglia and motor end plates use nicotinic receptors.

Question 37

Which of the following antimuscarinic drugs is often effective in preventing or reversing vestibular disturbances, especially motion sickness?

Accepted Answer

Answer reason: Scopolamine, a central antimuscarinic (M1) agent, is specifically effective for motion sickness and other vestibular disturbances; the other options are not used for this purpose.

Question 38

Which of the following agents is most effective in regenerating cholinesterase associated with skeletal muscle neuromuscular junctions?

Accepted Answer

Answer reason: Pralidoxime (2-PAM) reactivates inhibited acetylcholinesterase by cleaving the phosphate bond formed by organophosphates, most effective at the skeletal muscle neuromuscular junction. The other options are not cholinesterase reactivators.

Question 39

Hexamethonium blocks the action of acetylcholine and similar agonists at?

Accepted Answer

Answer reason: Hexamethonium is a nicotinic Nn receptor antagonist that blocks synaptic transmission in autonomic ganglia, not muscarinic receptors or the neuromuscular junction.

Question 40

Indicate the ganglion-blocking drug, which can be taken orally for the treatment of hypertension?

Accepted Answer

Answer reason: Mecamylamine is an orally active ganglionic blocker historically used for severe hypertension. Trimethaphane is given IV only, scopolamine is antimuscarinic (not a ganglion blocker), and vecuronium is a neuromuscular blocker.

Question 41

Indicate the neuromuscular blocker, whose breakdown product readily crosses the blood-brain barrier and may cause seizures?

Accepted Answer

Answer reason: Atracurium is metabolized to laudanosine, a metabolite that crosses the blood–brain barrier and can provoke seizures, especially with high doses or prolonged infusions. The other listed agents do not produce this seizure‑provoking metabolite.

Question 42

Neuromuscular blockade by both succinylcholine and mivacurium may be prolonged in patients with?

Accepted Answer

Answer reason: Both drugs are hydrolyzed by plasma pseudocholinesterase; atypical variants or reduced enzyme levels (as in hepatic disease) prolong blockade, whereas renal failure does not.

Question 43

Indicate the following neuromuscular blocker, which would be contraindicated in patients with renal failure?

Accepted Answer

Answer reason: Pipecuronium is a long-acting nondepolarizing neuromuscular blocker that is primarily eliminated by the kidneys; in renal failure it accumulates, causing prolonged paralysis. Atracurium is largely organ-independent (Hofmann elimination), succinylcholine is not specifically contraindicated by renal failure alone, and rapacuronium is mainly hepatic.

Question 44

Indicate the agent, which effectively antagonizes the neuromuscular blockade caused by nondepolarizing drugs?

Accepted Answer

Answer reason: Nondepolarizing neuromuscular blockade is reversed by acetylcholinesterase inhibitors (e.g., neostigmine), which increase acetylcholine at the neuromuscular junction to outcompete the blocker. Atropine is an antimuscarinic, acetylcholine is not practical due to rapid hydrolysis, and pralidoxime treats organophosphate poisoning.

Question 45

A relatively pure alfa agonist causes all of the following effects EXCEPT?

Accepted Answer

Answer reason: Alpha-1 agonists (e.g., phenylephrine) cause arterial and venous vasoconstriction, raising peripheral resistance and venous return, which triggers reflex bradycardia. Therefore the statement that they have no effect on blood vessels is incorrect.

Question 46

A nonselective beta receptor agonist causes all of the following effects EXCEPT?

Accepted Answer

Answer reason: Nonselective beta agonists (e.g., isoproterenol) stimulate beta-1 to increase cardiac output and beta-2 to vasodilate skeletal muscle vasculature, decreasing peripheral resistance and mean arterial pressure. They do not increase peripheral arterial resistance.

Question 47

Beta1 receptor stimulation includes all of the following effects EXCEPT?

Accepted Answer

Answer reason: Beta1 receptors are primarily cardiac, causing increased heart rate, contractility, and AV nodal conduction. Bronchodilation is mediated by beta2 receptors, not beta1.

Question 48

Epinephrine is used in the treatment of all of the following disorders EXCEPT?

Accepted Answer

Answer reason: Epinephrine is indicated for anaphylaxis and acute bronchospasm and has been used topically for open-angle glaucoma; it is not used to treat cardiac arrhythmias and can precipitate them.

Question 49

Which of the following agents is an alfa2-selective agonist with ability to promote constriction of the nasal mucosa?

Accepted Answer

Answer reason: Xylometazoline is an imidazoline nasal decongestant with alpha-2 agonist activity that causes vasoconstriction of nasal mucosa. Phenylephrine and methoxamine are primarily alpha-1 agonists, and epinephrine is nonselective.

Question 50

Indicate the sympathomimetic, which may cause hypotension, presumably because of a clonidine-like effect?

Accepted Answer

Answer reason: Xylometazoline (an imidazoline nasal decongestant) can stimulate central alpha-2/imidazoline receptors, producing a clonidine-like effect that may cause hypotension. Methoxamine and phenylephrine are peripheral alpha-1 agonists that raise BP; isoproterenol is a beta agonist without clonidine-like action.

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