Question 1

Statins: Identify the odd one out?

Accepted Answer

Answer reason: Cilastatin is not an HMG-CoA reductase inhibitor (statin); it is a dehydropeptidase I inhibitor used with imipenem. The others—atorvastatin, simvastatin, and rosuvastatin—are statins.

Question 2

Odd One Out — Mu-Opioid Agonists - Bind to mu-opioid receptors and provide analgesia?

Accepted Answer

Answer reason: Ibuprofen is an NSAID that inhibits COX enzymes; it is not a mu-opioid receptor agonist. Morphine, fentanyl, and codeine are mu-opioid agonists providing analgesia.

Question 3

Odd One Out: Opioid Antagonists - Block opioid receptors and reverse the effects of opioid agonists?

Accepted Answer

Answer reason: Naloxone, nalmefene (misspelled as nalmfefene), and naltrexone are opioid antagonists. Oxymorphone is an opioid agonist analgesic, making it the odd one out.

Question 4

Odd One Out: Intravenous induction agents used to induce general anesthesia quickly?

Accepted Answer

Answer reason: Propofol, thiopental, and etomidate are intravenous induction agents; desflurane is an inhalational volatile anesthetic, not an IV induction agent.

Question 5

Antibiotics: Identify the odd one out?

Accepted Answer

Answer reason: Tetracyclines, penicillins, and cephalosporins are classes of antibiotics; statins are lipid-lowering agents, not antibiotics.

Question 6

Odd One Out: Thyroid Hormone Receptor Agonists - Activate thyroid hormone receptors to treat hypothyroidism?

Accepted Answer

Answer reason: Methimazole is an antithyroid drug that inhibits thyroid hormone synthesis (used for hyperthyroidism), whereas levothyroxine, liothyronine, and triiodothyronine are thyroid hormone receptor agonists used to treat hypothyroidism.

Question 7

Antihistamines: Identify the odd one out?

Accepted Answer

Answer reason: Ranitidine is an H2 receptor antagonist used for acid suppression, whereas loratadine, diphenhydramine, and cetirizine are H1 antihistamines used for allergic symptoms.

Question 8

Bronchodilators: Identify the odd one out?

Accepted Answer

Answer reason: Bromhexine is a mucolytic/expectorant, not a bronchodilator. Albuterol (beta-2 agonist), ipratropium (anticholinergic), and theophylline (methylxanthine) are bronchodilators.

Question 9

Anticonvulsants: Identify the odd one out?

Accepted Answer

Answer reason: Metformin is an antidiabetic agent, whereas carbamazepine, gabapentin, and phenytoin are anticonvulsants.

Question 10

At normal pH, penicillin remains in?

Accepted Answer

Answer reason: Penicillins are weak acids (pKa ~2–3) and are ionized at physiologic pH, so they remain in the aqueous phase rather than the organic solvent or precipitating.

Question 11

ADR'S like decrease in sperm count, gyncomestia, galactorrhea is related to?

Accepted Answer

Answer reason: Cimetidine, an H2-receptor antagonist, has antiandrogenic effects and can increase prolactin, causing gynecomastia, galactorrhea, and decreased sperm count.

Question 12

The mechanism of antidiarrheal agent is to?

Accepted Answer

Answer reason: Antidiarrheals reduce diarrhea by increasing fluid/solute absorption, decreasing intestinal motility (e.g., opioids), and decreasing intestinal secretion (e.g., bismuth, somatostatin analogs). Thus, all listed mechanisms are correct.

Question 13

Encircle emmolient laxative from the following?

Accepted Answer

Answer reason: Docusate sodium is an emollient (stool softener). Bisacodyl and anthraquinone glycosides are stimulant laxatives, while polycarbophil is a bulk-forming agent.

Question 14

The antiviral action of which drug includes inhibition of both RNA and DNA synthesis?

Accepted Answer

Answer reason: Ribavirin is a nucleoside analog that inhibits viral nucleic acid synthesis (affecting both RNA and DNA). Ritonavir and Indinavir are protease inhibitors, and Amantadine blocks the M2 ion channel—neither inhibits nucleic acid synthesis.

Question 15

Identify the first line antimycobacterial drug?

Accepted Answer

Answer reason: Pyrazinamide is a first-line antitubercular drug, whereas cycloserine, ethionamide, and capreomycin are second-line agents.

Question 16

__________ has the same mode of action to that of penicillin?

Accepted Answer

Answer reason: Cephalosporins are beta-lactam antibiotics like penicillins and inhibit bacterial cell wall synthesis by binding PBPs and blocking peptidoglycan cross-linking. The other classes act on ribosomes or DNA gyrase.

Question 17

Identify the drug which has been without from the market due to its higher toxicities?

Accepted Answer

Answer reason: Carbenicillin has significant toxicity (notably high sodium load and platelet dysfunction leading to bleeding) and has been largely withdrawn/replaced in many markets; the other listed antibiotics remain in common use.

Question 18

Pick out the parenteral route of medicinal agent administration?

Accepted Answer

Answer reason: Parenteral refers to administration that bypasses the gastrointestinal tract. Oral, sublingual, and rectal are enteral routes; inhalation bypasses the GI tract, so it is the best choice among the options.

Question 19

Biological barriers include all except?

Accepted Answer

Answer reason: Biological barriers in pharmacokinetics are membranes that limit drug movement such as cell membranes, capillary walls, and special barriers like the placenta. Renal tubules are part of excretion processes and are not typically classified as distribution barriers.

Question 20

Tolerance develops because of?

Accepted Answer

Answer reason: Drug tolerance typically results from cellular/receptor adaptations or increased metabolism (enzyme induction), not from diminished absorption or rapid excretion per se.

Question 21

Local anesthetics are?

Accepted Answer

Answer reason: Most local anesthetics are tertiary amines that behave as weak bases; they are often formulated as hydrochloride salts but the active drugs are weak bases.

Question 22

A M-cholinimimetic agent is?

Accepted Answer

Answer reason: Pilocarpine is a direct muscarinic (M) cholinergic agonist. Carbachol and acetylcholine stimulate both muscarinic and nicotinic receptors, while bethanechol is muscarinic but the single best classical M-cholinomimetic choice here is pilocarpine.

Question 23

Indicate muscles, which are more resistant to block and recover more rapidly?

Accepted Answer

Answer reason: With neuromuscular blockers, centrally located muscles like the diaphragm are more resistant to paralysis and recover earlier than peripheral muscles (e.g., hand).

Question 24

Indicate the alfa2-selective agonist?

Accepted Answer

Answer reason: Xylometazoline is an imidazoline nasal decongestant with alpha-adrenergic action showing alpha2-selectivity. Epinephrine is nonselective alpha/beta, Dobutamine is beta1-selective, and Methoxamine is alpha1-selective.

Question 25

Indicate the irreversible alfa receptor antagonist?

Accepted Answer

Answer reason: Phenoxybenzamine is a nonselective alpha blocker that irreversibly alkylates alpha receptors; tolazoline, labetalol, and prazosin are reversible antagonists.

Question 26

Indicate the beta1-selective antagonist?

Accepted Answer

Answer reason: Metoprolol is a cardioselective beta1-adrenergic blocker. Propranolol and sotalol are nonselective beta blockers, and carvedilol blocks beta1, beta2, and alpha1 receptors.

Question 27

Indicate the indirect-acting adrenoreceptor blocking drug?

Accepted Answer

Answer reason: Reserpine is an indirect-acting adrenergic blocker; it depletes norepinephrine from storage vesicles, reducing sympathetic activity. Tolazoline, Carvedilol, and Prazosin are direct adrenoceptor antagonists.

Question 28

Hypnotic drugs are used to treat?

Accepted Answer

Answer reason: Hypnotics promote sleep and are primarily used for insomnia; they are not treatments for psychosis, narcolepsy (managed with stimulants like modafinil), or Parkinsonian disorders (managed with dopaminergic agents).

Question 29

Indicate the competitive antagonist of BZ receptors?

Accepted Answer

Answer reason: Flumazenil is a competitive antagonist at the benzodiazepine (BZ) site on the GABA-A receptor. Picrotoxin blocks the GABA-A chloride channel noncompetitively, and zolpidem and temazepam are agonists.

Question 30

Zolpidem and zaleplon have effectiveness similar to that of hypnotic benzodiazepines in the management of sleep disorders?

Accepted Answer

Answer reason: Z-drugs (zolpidem, zaleplon) act at GABA-A receptors and provide hypnotic effects with efficacy comparable to benzodiazepine hypnotics for insomnia.

Question 31

Indicate an anti-absence drug?

Accepted Answer

Answer reason: Valproate is effective for absence seizures (alternative to ethosuximide). Phenobarbital, carbamazepine, and phenytoin are not used for absence and may worsen it.

Question 32

The drug of choice for partial seizures is?

Accepted Answer

Answer reason: Carbamazepine is a first-line agent and classic drug of choice for focal (partial) seizures. Ethosuximide treats absence seizures; diazepam is for acute status epilepticus; lamotrigine is effective for focal seizures but traditionally not the single drug of choice.

Question 33

Lamotrigine can be used in the treatment of?

Accepted Answer

Answer reason: Lamotrigine is a broad-spectrum antiepileptic effective for focal seizures and several generalized seizure types, including absence and myoclonic seizures.

Question 34

The drug of choice in the treatment of myoclonic seizures is?

Accepted Answer

Answer reason: Valproate is first-line for generalized myoclonic seizures; phenytoin may worsen them, and phenobarbital or felbamate are not preferred first-line agents.

Question 35

Indicate the narcotic analgesic, which is a natural agonist?

Accepted Answer

Answer reason: Morphine is a natural opioid agonist derived from opium; meperidine and fentanyl are synthetic opioids, and naloxone is an opioid antagonist.

Question 36

Methemoglobinemia is possible adverse effect of?

Accepted Answer

Answer reason: Acetaminophen (paracetamol) overdose can oxidize hemoglobin to methemoglobin via its toxic metabolite; the other listed NSAIDs are not typical causes.

Question 37

Tick mixed (opioid/non-opioid) agent?

Accepted Answer

Answer reason: Tramadol has dual mechanisms—weak μ-opioid receptor agonism plus inhibition of norepinephrine/serotonin reuptake—making it a mixed opioid/non-opioid analgesic.

Question 38

Indicate the atypical antipsychotic drug?

Accepted Answer

Answer reason: Clozapine is an atypical (second-generation) antipsychotic; haloperidol, thioridazine, and thiothixene are typical first-generation agents.

Question 39

Indicate the second-generation heterocyclic drug?

Accepted Answer

Answer reason: Maprotiline is a second-generation heterocyclic (tetracyclic) antidepressant; imipramine is a TCA, phenelzine is an MAOI, and fluoxetine is an SSRI.

Question 40

Indicate the competitive antagonist of BZ receptors?

Accepted Answer

Answer reason: Flumazenil is a competitive antagonist at the benzodiazepine binding site on GABA-A receptors. Buspirone is a 5-HT1A partial agonist, picrotoxin is a noncompetitive GABA-A channel blocker, and diazepam is a benzodiazepine agonist.

Question 41

Indicate the drug belonging to proton pump inhibitors?

Accepted Answer

Answer reason: Omeprazole is a proton pump inhibitor; ranitidine is an H2 blocker, pirenzepine is an M1 antagonist, and trimethaphan is a ganglionic blocker.

Question 42

Most of drugs are antacids EXCEPT?

Accepted Answer

Answer reason: Maalox, Mylanta, and Almagel are antacid preparations; misoprostol is a prostaglandin E1 analog used for ulcer prevention, not an antacid.

Question 43

All of the following drugs stimulate appetite EXCEPT?

Accepted Answer

Answer reason: Bitters and insulin are known to increase appetite; vitamins are commonly used as appetite tonics. Fepranone is an anorectic (appetite suppressant), so it does not stimulate appetite.

Question 44

Select the drug which inhibits peristalsis?

Accepted Answer

Answer reason: Loperamide is an antimotility opioid agonist that reduces intestinal motility and inhibits peristalsis; castor oil, bisacodyl, and sorbitol are laxatives that increase motility.

Question 45

Pick out the drug belonging to anticoagulants of direct action?

Accepted Answer

Answer reason: Heparin is a directly acting anticoagulant (acts in the blood via antithrombin III). Dicumarol and phenprocoumon are indirect oral anticoagulants (vitamin K antagonists), and aspirin is an antiplatelet agent.

Question 46

Tick the drug used as an oral anticoagulant?

Accepted Answer

Answer reason: Dicumarol (a vitamin K antagonist) is an oral anticoagulant. Heparin, dalteparin, and enoxaparin are parenteral anticoagulants (UFH/LMWH).

Question 47

All of these drugs are antiplatelet agents EXCEPT?

Accepted Answer

Answer reason: Urokinase is a fibrinolytic (thrombolytic) agent, not an antiplatelet. Aspirin, ticlopidine, and clopidogrel are antiplatelet drugs.

Question 48

The non-glycoside positive inotropic drug is?

Accepted Answer

Answer reason: Dobutamine is a beta-1 adrenergic agonist (catecholamine) that increases contractility but is not a cardiac glycoside; digoxin, digitoxin, and strophanthin K are glycosides.

Question 49

Aglycone is essential for?

Accepted Answer

Answer reason: In cardiac glycosides, the aglycone (genin) steroid nucleus confers the cardiotonic activity, while the sugar moiety mainly affects pharmacokinetics such as protein binding and half-life.

Question 50

This drug is a selective beta-1 agonist?

Accepted Answer

Answer reason: Dobutamine is a relatively selective beta-1 adrenergic agonist used to increase cardiac contractility. Digoxin is a cardiac glycoside, amrinone is a PDE3 inhibitor, and dopamine has dose-dependent dopaminergic, beta-1, and alpha effects and is not beta-1 selective.

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Statins: Identify the odd one out?

Odd One Out — Mu-Opioid Agonists - Bind to mu-opioid receptors and provide analgesia?

Odd One Out: Opioid Antagonists - Block opioid receptors and reverse the effects of opioid agonists?

Odd One Out: Intravenous induction agents used to induce general anesthesia quickly?

Antibiotics: Identify the odd one out?

Odd One Out: Thyroid Hormone Receptor Agonists - Activate thyroid hormone receptors to treat hypothyroidism?

Antihistamines: Identify the odd one out?

Bronchodilators: Identify the odd one out?

Anticonvulsants: Identify the odd one out?

At normal pH, penicillin remains in?

ADR'S like decrease in sperm count, gyncomestia, galactorrhea is related to?

The mechanism of antidiarrheal agent is to?

Encircle emmolient laxative from the following?

The antiviral action of which drug includes inhibition of both RNA and DNA synthesis?

Identify the first line antimycobacterial drug?

__________ has the same mode of action to that of penicillin?

Identify the drug which has been without from the market due to its higher toxicities?

Pick out the parenteral route of medicinal agent administration?

Biological barriers include all except?

Tolerance develops because of?

Local anesthetics are?

A M-cholinimimetic agent is?

Indicate muscles, which are more resistant to block and recover more rapidly?

Indicate the alfa2-selective agonist?

Indicate the irreversible alfa receptor antagonist?

Indicate the beta1-selective antagonist?

Indicate the indirect-acting adrenoreceptor blocking drug?

Hypnotic drugs are used to treat?

Indicate the competitive antagonist of BZ receptors?

Zolpidem and zaleplon have effectiveness similar to that of hypnotic benzodiazepines in the management of sleep disorders?

Indicate an anti-absence drug?

The drug of choice for partial seizures is?

Lamotrigine can be used in the treatment of?

The drug of choice in the treatment of myoclonic seizures is?

Indicate the narcotic analgesic, which is a natural agonist?

Methemoglobinemia is possible adverse effect of?

Tick mixed (opioid/non-opioid) agent?

Indicate the atypical antipsychotic drug?

Indicate the second-generation heterocyclic drug?

Indicate the competitive antagonist of BZ receptors?

Indicate the drug belonging to proton pump inhibitors?

Most of drugs are antacids EXCEPT?

All of the following drugs stimulate appetite EXCEPT?

Select the drug which inhibits peristalsis?

Pick out the drug belonging to anticoagulants of direct action?

Tick the drug used as an oral anticoagulant?

All of these drugs are antiplatelet agents EXCEPT?

The non-glycoside positive inotropic drug is?

Aglycone is essential for?

This drug is a selective beta-1 agonist?

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