Question 1

What type of medication is vancomycin classified as?

Accepted Answer

Answer reason: Vancomycin is a glycopeptide antibiotic; it is not a beta-lactam, an antiviral, or a corticosteroid.

Question 2

At an acidic pH, penicillin remains in?

Accepted Answer

Answer reason: Penicillin is a weak acid; at an acidic pH it is largely unionized and partitions into the organic solvent during extraction, not into the aqueous phase.

Question 3

MRSA is mostly susceptible to which of the following?

Accepted Answer

Answer reason: MRSA has altered penicillin-binding proteins, making it resistant to oxacillin and nafcillin. Vancomycin is a standard, effective agent against MRSA.

Question 4

Erythromycin + methylated nitrogen = ____________?

Accepted Answer

Answer reason: Azithromycin is an azalide derived from erythromycin by the insertion of a methylated nitrogen into the lactone ring, forming a 15-membered ring.

Question 5

Which of the following antivirals is excreted in the urine at about 90%?

Accepted Answer

Answer reason: Acyclovir is predominantly eliminated unchanged in the urine (~60–90%). Indinavir is mainly hepatically metabolized, and ribavirin is not eliminated (~90% in urine). So acyclovir best fits.

Question 6

Which ADR is more related to anticancer drugs?

Accepted Answer

Answer reason: Anticancer (cytotoxic) drugs target rapidly dividing cells, leading to common adverse effects such as alopecia and oral mucosal injury (stomatitis). Hence, both listed ADRs are related.

Question 7

Dicyclomine is a ________ agent?

Accepted Answer

Answer reason: Dicyclomine (spelled here as dicycloamine) is an antimuscarinic and anticholinergic used as an intestinal antispasmodic.

Question 8

The types of antagonism are?

Accepted Answer

Answer reason: Competitive antagonism is a recognized pharmacologic antagonism in which an antagonist competes with an agonist at the same receptor. The other choices (additive, potentiated, summation) describe synergistic or summation interactions, not antagonism.

Question 9

Indicate the cholinesterase activator?

Accepted Answer

Answer reason: Pralidoxime reactivates acetylcholinesterase that has been inhibited by organophosphates, effectively restoring enzyme activity. Edrophonium and isoflurophate inhibit cholinesterase, and pilocarpine is a muscarinic agonist.

Question 10

Bronchial smooth muscle contains?

Accepted Answer

Answer reason: Bronchial smooth muscle predominantly expresses beta2-adrenergic receptors; stimulation causes relaxation and bronchodilation. Alpha1 and alpha2 are mainly vascular and neuronal, and beta1 is primarily cardiac.

Question 11

Indicate the beta-1-selective agonist?

Accepted Answer

Answer reason: Dobutamine is primarily a beta1-adrenergic agonist, increasing cardiac contractility. Isoproterenol is nonselective for beta1 and beta2; metaproterenol is beta2-selective; and epinephrine is nonselective for alpha and beta.

Question 12

Flumazenil blocks the actions of?

Accepted Answer

Answer reason: Flumazenil is a competitive antagonist at the benzodiazepine site on the GABA-A receptor, reversing benzodiazepines and Z-drugs such as zolpidem, not barbiturates, opioids, or ethanol.

Question 13

Tick pyrazolone derivative?

Accepted Answer

Answer reason: Analgin (metamizole) is a pyrazolone derivative analgesic; methyl salicylate is a salicylate, paracetamol is an aniline derivative, and ketorolac is an acetic acid derivative NSAID.

Question 14

Neuroleptics are used to treat?

Accepted Answer

Answer reason: Neuroleptics (antipsychotics) are indicated for psychotic disorders such as schizophrenia. They are not treatments for neurosis, narcolepsy, or Parkinsonism.

Question 15

Cimetidine has no effect on hepatic drug metabolism?

Accepted Answer

Answer reason: Cimetidine inhibits hepatic cytochrome P450 enzymes, reducing the metabolism of many drugs and increasing their levels; therefore, the statement is false.

Question 16

Antacids are weak bases that react with gastric hydrochloric acid to form salt and water?

Accepted Answer

Answer reason: Antacids are basic compounds (e.g., Mg(OH)2, Al(OH)3, CaCO3) that neutralize gastric HCl via acid-base reactions, producing a salt and water (and CO2 for carbonates).

Question 17

This drug prolongs repolarization?

Accepted Answer

Answer reason: Sotalol is a Class III antiarrhythmic that blocks potassium channels, prolonging Phase 3 repolarization and the QT interval. Flecainide (Class Ic) slows conduction without prolonging repolarization, lidocaine (Class Ib) shortens repolarization, and verapamil (CCB) primarily affects AV nodal conduction.

Question 18

This drug is an inhibitor of renin synthesis?

Accepted Answer

Answer reason: Beta-blockers, such as propranolol, inhibit renin release from juxtaglomerular cells, reducing RAAS activity. Enalapril inhibits ACE; losartan blocks AT1 receptors, and diazoxide is a vasodilator.

Question 19

Which of the following agents is a full antagonist of opioid receptors?

Accepted Answer

Answer reason: Naloxone is a pure opioid receptor antagonist (mu, kappa, and delta). Meperidine is a full agonist, buprenorphine is a partial agonist, and butorphanol is a mixed agonist–antagonist.

Question 20

Drug used to treat hookworm infection?

Accepted Answer

Answer reason: Hookworm (Ancylostoma/Necator) is treated with benzimidazole anthelmintics—albendazole or mebendazole. Metronidazole targets protozoa/anaerobes, not nematodes.

Question 21

How many days is the treatment given for neonatal bacterial meningitis?

Accepted Answer

Answer reason: Neonatal bacterial meningitis requires prolonged IV antibiotics; standard therapy is at least 21 days (often longer for gram-negative organisms).

Question 22

Anti-tubercular second-line drug is?

Accepted Answer

Answer reason: Among the options, ciprofloxacin is a fluoroquinolone used as a second-line antitubercular drug. Pyrazinamide and isoniazid are first-line drugs, and amantadine is an antiviral for influenza.

Question 23

Administration of which of these can increase the excretion of a weak acid, i.e., aspirin toxicity?

Accepted Answer

Answer reason: Urinary alkalinization with a weak base (e.g., sodium bicarbonate) increases the ionization of weak acids such as salicylate, reducing renal reabsorption and enhancing excretion via ion trapping.

Question 24

A group of drugs that bind to a receptor but do not produce any pharmacological effect is called?

Accepted Answer

Answer reason: Antagonists bind to receptors with affinity but have no intrinsic activity, so they produce no pharmacologic effect and block agonist actions.

Question 25

Metoprolol and Atenolol?

Accepted Answer

Answer reason: Metoprolol and atenolol are cardioselective beta1-adrenergic blockers. They are selective, lack intrinsic sympathomimetic activity, and do not possess clinically relevant local anesthetic (membrane-stabilizing) effects.

Question 26

A client taking the drug disulfiram (Antabuse) is admitted to the ER. Which clinical manifestations are most indicative of recent alcohol ingestion?

Accepted Answer

Answer reason: Alcohol ingestion while on disulfiram triggers acetaldehyde accumulation, causing severe nausea, vomiting, tachycardia, and chest pain.

Question 27

Select the drug that inhibits peristalsis?

Accepted Answer

Answer reason: Loperamide is a peripherally acting opioid antidiarrheal that decreases intestinal motility, thus inhibiting peristalsis. The others are laxatives that increase bowel motility or draw water into the intestine.

Question 28

Which of the following groups of antibiotics demonstrate a bacteriostatic effect?

Accepted Answer

Answer reason: Macrolides inhibit protein synthesis by binding to the 50S ribosomal subunit, and are typically bacteriostatic, whereas carbapenems, aminoglycosides, and cephalosporins are bactericidal.

Question 29

Which drug is an analog of prostaglandin E1?

Accepted Answer

Answer reason: Misoprostol is a synthetic prostaglandin E1 analog; the other options are not prostaglandins.

Question 30

Telenzepine is?

Accepted Answer

Answer reason: Telenzepine (often spelled Talenzapine here) is a selective M1 antimuscarinic antisecretory drug, not a proton pump inhibitor, an H2 blocker, or a mucosal protective agent.

Question 31

Indicate the drug that is a proton pump inhibitor?

Accepted Answer

Answer reason: Omeprazole is a proton pump inhibitor that irreversibly blocks the H+/K+-ATPase in gastric parietal cells. Pirenzepine is an antimuscarinic, ranitidine is an H2 blocker, and trimethap is not a PPI.

Question 32

Which of the following drugs is penicillinase-resistant?

Accepted Answer

Answer reason: Oxacillin is a penicillinase (beta-lactamase)-resistant penicillin used for beta-lactamase-producing staphylococcal infections. Amoxicillin and penicillin G are penicillinase-sensitive, and Bicillin-5, a benzathine penicillin G preparation, is also sensitive.

Question 33

All of the following drugs demonstrate a prolonged effect, except?

Accepted Answer

Answer reason: Procaine penicillin is a depot formulation, and azithromycin has a long half-life with sustained tissue levels; penicillin G preparations are known for prolonged effects. Amoxicillin lacks a prolonged effect and requires more frequent dosing.

Question 34

Which of the following groups of antibiotics demonstrate a bactericidal effect?

Accepted Answer

Answer reason: Penicillins inhibit bacterial cell wall synthesis, leading to cell lysis and a bactericidal effect. Tetracyclines and macrolides are primarily bacteriostatic protein-synthesis inhibitors.

Question 35

Choose the drug that irritates the gut and causes increased peristalsis?

Accepted Answer

Answer reason: Phenolphthalein is a stimulant laxative that irritates the intestinal mucosa and increases peristalsis. Methyl cellulose is bulk-forming; proserine is a cholinesterase inhibitor; and mineral oil is a lubricant.

Question 36

Tick the antimalarial drug that influences tissue schizonts?

Accepted Answer

Answer reason: Primaquine acts on hepatic tissue schizonts (including the dormant hypnozoites of P. vivax and P. ovale), unlike mefloquine, chloroquine, and quinidine, which target blood schizonts.

Question 37

Indicate an antiemetic agent that is related to neuroleptics?

Accepted Answer

Answer reason: Prochlorperazine is a phenothiazine antipsychotic (neuroleptic) used as an antiemetic. Metoclopramide is a prokinetic dopamine antagonist, nabilone is a cannabinoid, and tropisetron is a 5-HT3 antagonist.

Question 38

Choose the drug that is an 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 mucosal protective agent.

Question 39

Azoles have an antifungal effect because of...?

Accepted Answer

Answer reason: Azole antifungals inhibit fungal CYP450 14α-demethylase, blocking the conversion of lanosterol to ergosterol and depleting membrane ergosterol.

Question 40

An antibiotic that inhibits bacterial RNA synthesis is?

Accepted Answer

Answer reason: Rifampin inhibits bacterial DNA-dependent RNA polymerase, blocking RNA synthesis. Erythromycin and chloramphenicol inhibit protein synthesis, and imipenem inhibits cell wall synthesis.

Question 41

Penicillin G is?

Accepted Answer

Answer reason: Aqueous benzylpenicillin (penicillin G) has a very short half-life and requires frequent dosing; the long-acting preparations are benzathine or procaine penicillin G.

Question 42

Indicate the drug that causes metabolic alkalosis?

Accepted Answer

Answer reason: Excess intake of sodium bicarbonate adds bicarbonate base, producing metabolic alkalosis; the other listed agents do not typically cause this effect.

Question 43

Indicate the laxative drug that belongs to osmotic laxatives?

Accepted Answer

Answer reason: Sodium phosphate is a saline osmotic laxative that draws water into the intestinal lumen. Docusate is a stool softener, while bisacodyl and phenolphthalein are stimulant laxatives.

Question 44

Tick the drug that forms a physical barrier to HCl and pepsin?

Accepted Answer

Answer reason: Sucralfate polymerizes in an acidic pH to form a viscous protective barrier that adheres to ulcers, shielding them from gastric acid and pepsin. Ranitidine (an H2 blocker), omeprazole (a PPI), and pirenzepine (an antimuscarinic) reduce acid but do not form a physical barrier.

Question 45

The following drugs are more likely to be excreted in alkaline urine?

Accepted Answer

Answer reason: Alkaline urine ionizes weak acids, decreasing tubular reabsorption and increasing renal excretion (ion trapping).

Question 46

Rifapentine tablets are used for the treatment?

Accepted Answer

Answer reason: Rifapentine is a rifamycin antibiotic used in combination therapy for tuberculosis, including latent TB regimens.

Question 47

What is the primary route of drug excretion from the body?

Accepted Answer

Answer reason: Most drugs and their metabolites are eliminated primarily by the kidneys via renal excretion into urine; other routes like feces, sweat, and saliva are minor.

Question 48

What is a serious side effect of prolonged linezolid use?

Accepted Answer

Answer reason: Prolonged linezolid therapy can cause mitochondrial toxicity leading to peripheral and optic neuropathy; the other options are common but less serious and not specific to long-term use.

Question 49

Which of the following is a prokinetic drug?

Accepted Answer

Answer reason: Domperidone is a peripheral D2-receptor antagonist that enhances gastric motility (prokinetic). Cimetidine is an H2 blocker, ondansetron a 5-HT3 antagonist antiemetic, and hyoscine an antimuscarinic that reduces motility.

Question 50

What is the drug of choice for diazepam toxicity?

Accepted Answer

Answer reason: Flumazenil is a competitive benzodiazepine receptor antagonist that reverses benzodiazepine (e.g., diazepam) effects. Beta blockers, Digiband, and penicillamine are antidotes for other conditions.

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