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dental pharmacology multiple choice
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В.А. КОСОЛАПОВ, М.В. ЧЕРНИКОВ, О.Ю. ГРЕЧКО,
И.Н. ИЕЖИЦА, А.Ф. КУЧЕРЯВЕНКО
ТЕСТОВЫЕ ВОПРОСЫ ПО ФАРМАКОЛОГИИ
Волгоград 2006
001. Pharmacokinetics is: a) The study of biological and therapeutic effects of drugs b) The study of absorption, distribution, metabolism and excretion of drugs c) The study of mechanisms of drug action d) The study of methods of new drug development 002. What does “pharmacokinetics” include? a) Complications of drug therapy b) Drug biotransformation in the organism c) Influence of drugs on metabolism processes d) Influence of drugs on genes 002. What does “pharmacokinetics” include? a) Pharmacological effects of drugs b) Unwanted effects of drugs c) Chemical structure of a medicinal agent d) Distribution of drugs in the organism 003. What does “pharmacokinetics” include? a) Localization of drug action b) Mechanisms of drug action c) Excretion of substances d) Interaction of substances 004. The main mechanism of most drugs absorption in GI tract is: a) Active transport (carrier-mediated diffusion) b) Filtration (aqueous diffusion) c) Endocytosis and exocytosis d) Passive diffusion (lipid diffusion) 005. What kind of substances can’t permeate membranes by passive diffusion? a) Lipid-soluble b) Non-ionized substances c) Hydrophobic substances d) Hydrophilic substances 006. A hydrophilic medicinal agent has the following property: a) Low ability to penetrate through the cell membrane lipids b) Penetrate through membranes by means of endocytosis c) Easy permeation through the blood-brain barrier d) High reabsorption in renal tubules 007. What is implied by «active transport»? a) Transport of drugs trough a membrane by means of diffusion b) Transport without energy consumption c) Engulf of drug by a cell membrane with a new vesicle formation d) Transport against concentration gradient 008. What does the term “bioavailability” mean? a) Plasma protein binding degree of substance b) Permeability through the brain-blood barrier c) Fraction of an uncharged drug reaching the systemic circulation following any route administration d) Amount of a substance in urine relative to the initial doze 009. The reasons determing bioavailability are: a) Rheological parameters of blood b) Amount of a substance obtained orally and quantity of intakes c) Extent of absorption and hepatic first-pass effect d) Glomerular filtration rate 010. Pick out the appropriate alimentary route of administration when passage of drugs through liver is minimized: a) Oral b) Transdermal c) Rectal d) Intraduodenal 011. Which route of drug administration is most likely to lead to the first-pass effect? a) Sublingual
a) True b) False
025. The term “biotransformation” includes the following: a) Accumulation of substances in a fat tissue b) Binding of substances with plasma proteins c) Accumulation of substances in a tissue d) Process of physicochemical and biochemical alteration of a drug in the body 026. Biotransformation of the drugs is to render them: a) Less ionized b) More pharmacologically active c) More lipid soluble d) Less lipid soluble 027. Tick the drug type for which microsomal oxidation is the most prominent: a) Lipid soluble b) Water soluble c) Low molecular weight d) High molecular weight 028. Pick out the right statement: a) Microsomal oxidation always results in inactivation of a compound b) Microsomal oxidation results in a decrease of compound toxicity c) Microsomal oxidation results in an increase of ionization and water solubility of a drug d) Microsomal oxidation results in an increase of lipid solubility of a drug thus its excretion from the organism is facilitated 029. Stimulation of liver microsomal enzymes can: a) Require the dose increase of some drugs b) Require the dose decrease of some drugs c) Prolong the duration of the action of a drug d) Intensify the unwanted reaction of a drug 030. Metabolic transformation (phase 1) is: a) Acetylation and methylation of substances b) Transformation of substances due to oxidation, reduction or hydrolysis c) Glucuronide formation d) Binding to plasma proteins 031. Biotransformation of a medicinal substance results in: a) Faster urinary excretion b) Slower urinary excretion c) Easier distribution in organism d) Higher binding to membranes 032. Conjugation is: a) Process of drug reduction by special enzymes b) Process of drug oxidation by special oxidases c) Coupling of a drug with an endogenous substrate d) Solubilization in lipids 033. Which of the following processes proceeds in the second phase of biotransformation? a) Acetylation b) Reduction c) Oxidation d) Hydrolysis 034. Conjugation of a drug includes the following EXCEPT: a) Glucoronidation b) Sulfate formation c) Hydrolysis d) Methylation 035. Metabolic transformation and conjugation usually results in an increase of a substance biological activity: a) True b) False 036. In case of liver disorders accompanied by a decline in microsomal enzyme activity the duration of action of some drugs is: a) Decreased b) Enlarged c) Remained unchanged d) Changed insignificantly
037. Half life (t ½) is the time required to: a) Change the amount of a drug in plasma by half during elimination b) Metabolize a half of an introduced drug into the active metabolite c) Absorb a half of an introduced drug d) Bind a half of an introduced drug to plasma proteins 038. Half life (t ½) doesn’t depend on: a) Biotransformation b) Time of drug absorption c) Concentration of a drug in plasma d) Rate of drug elimination 039. Elimination is expressed as follows: a) Rate of renal tubular reabsorption b) Clearance speed of some volume of blood from substance c) Time required to decrease the amount of drug in plasma by one-half d) Clearance of an organism from a xenobiotic 040. Elimination rate constant (Kelim ) is defined by the following parameter: a) Rate of absorption b) Maximal concentration of a substance in plasma c) Highest single dose d) Half life (t ½) 041. The most rapid eliminated drugs are those with high glomerular filtration rate and actively secreted but aren’t passively reabsorbed: a) True b) False 042. Systemic clearance (CLs) is related with: a) Only the concentration of substances in plasma b) Only the elimination rate constant c) Volume of distribution, half life and elimination rate constant d) Bioavailability and half life
001. Pharmacodynamics involves the study of following EXCEPT: a) Biological and therapeutic effects of drugs b) Absorption and distribution of drugs c) Mechanisms of drug action d) Drug interactions 002. Pharmacodynamics involves the study of following? a) Mechanisms of drug action b) Biotransformation of drugs in the organism c) Distribution of drugs in the organism d) Excretion of drug from the organism 003. Pharmacodynamics involves the following? a) Information about main mechanisms of drug absorption b) Information about unwanted effects c) Information about biological barriers d) Information about excretion of a drug from the organism 004. Pick out the answer which is the most appropriate to the term “receptor” a) All types of ion channels modulated by a drug b) Enzymes of oxidizing-reducing reactions activated by a drug c) Active macromolecular components of a cell or an organism which a drug molecule has to combine with in order to elicit its specific effect d) Carriers activated by a drug 005. What does “affinity” mean? a) A measure of how tightly a drug binds to plasma proteins b) A measure of how tightly a drug binds to a receptor c) A measure of inhibiting potency of a drug d) A measure of bioavailability of a drug 006. Target proteins which a drug molecule binds are: a) Only receptors b) Only ion channels c) Only carriers
d) All of the above
019. All of the following statements about efficacy and potency are true EXCEPT: a) Efficacy is usually a more important clinical consideration than potency b) Efficacy is the maximum effect of a drug c) Potency is a comparative measure, refers to the different doses of two drugs that are needed to produce the same effect d) The ED 50 is a measure of drug’s efficacy 020. Give the definition for a therapeutical dose: a) The amount of a substance to produce the minimal biological effect b) The amount of a substance to produce effects hazardous for an organism c) The amount of a substance to produce the required effect in most patients d) The amount of a substance to accelerate an increase of concentration of medicine in an organism 021. Pick out the correct definition of a toxic dose: a) The amount of substance to produce the minimal biological effect b) The amount of substance to produce effects hazardous for an organism c) The amount of substance to produce the necessary effect in most of patients d) The amount of substance to fast creation of high concentration of medicine in an organism 022. Which effect may lead to toxic reactions when a drug is taken continuously or repeatedly? a) Refractoriness b) Cumulative effect c) Tolerance d) Tachyphylaxis 023. What term is used to describe a more gradual decrease in responsiveness to a drug, taking days or weeks to develop? a) Refractoriness b) Cumulative effect c) Tolerance d) Tachyphylaxis 024. What term is used to describe a decrease in responsiveness to a drug which develops in a few minutes? a) Refractoriness b) Cumulative effect c) Tolerance d) Tachyphylaxis 025. Tachyphylaxis is: a) A drug interaction between two similar types of drugs b) Very rapidly developing tolerance c) A decrease in responsiveness to a drug, taking days or weeks to develop d) None of the above 026. Drug resistance is a term used to describe the loss of effectiveness of antimicrobial or antitumour drugs. This consideration is: a) True b) False 027. Tolerance and drug resistance can be a consequence of: a) Drug dependence b) Increased metabolic degradation c) Depressed renal drug excretion d) Activation of a drug after hepatic first-pass 028. Tolerance and drug resistance can be a consequence of: a) Change in receptors, loss of them or exhaustion of mediators b) Increased receptor sensitivity c) Decreased metabolic degradation d) Decreased renal tubular secretion 029. Tolerance develops because of: a) Diminished absorption b) Rapid excretion of a drug c) Both of the above d) None of the above 030. Dependence is often associated with tolerance to a drug, a physical abstinence syndrome, and psychological dependence (craving). This consideration is: a) True b) False
031. The situation when failure to continue administering the drug results in serious psychological and somatic disturbances is called? a) Tachyphylaxis b) Sensibilization c) Abstinence syndrome d) Idiosyncrasy 032. What is the type of drug-to-drug interaction which is connected with processes of absorption, biotransformation, distribution and excretion? a) Pharmacodynamic interaction b) Physical and chemical interaction c) Pharmaceutical interaction d) Pharmacokinetic interaction 033. What is the type of drug-to-drug interaction which is the result of interaction at receptor, cell, enzyme or organ level? a) Pharmacodynamic interaction b) Physical and chemical interaction c) Pharmaceutical interaction d) Pharmacokinetic interaction 034. What phenomenon can occur in case of using a combination of drugs? a) Tolerance b) Tachyphylaxis c) Accumulation d) Synergism 035. If two drugs with the same effect, taken together, produce an effect that is equal in magnitude to the sum of the effects of the drugs given individually, it is called as: a) Antagonism b) Potentiation c) Additive effect d) None of the above 036. What does the term “potentiation” mean? a) Cumulative ability of a drug b) Hypersensitivity to a drug c) Fast tolerance developing d) Intensive increase of drug effects due to their combination 037. The types of antagonism are: a) Summarized b) Potentiated c) Additive d) Competitive 038. The term “chemical antagonism” means that: a) two drugs combine with one another to form an inactive compound b) two drugs combine with one another to form a more active compound c) two drugs combine with one another to form a more water soluble compound d) two drugs combine with one another to form a more fat soluble compound 039. A teratogenic action is: a) Toxic action on the liver b) Negative action on the fetus causing fetal malformation c) Toxic action on blood system d) Toxic action on kidneys 040. Characteristic unwanted reaction which isn’t related to a dose or to a pharmacodynamic property of a drug is called: a) Idiosyncrasy b) Hypersensitivity c) Tolerance d) Teratogenic action 041. Idiosyncratic reaction of a drug is: a) A type of hypersensitivity reaction b) A type of drug antagonism c) Unpredictable, inherent, qualitatively abnormal reaction to a drug d) Quantitatively exaggerated response 042. Therapeutic index (TI) is: a) A ratio used to evaluate the safety and usefulness of a drug for indication b) A ratio used to evaluate the effectiveness of a drug
012. Indicate the local anesthetic, which is a toluidine derivative: a) Lidocaine b) Bupivacaine c) Prilocaine d) Procaine 013. Which of the following local anesthetics is a thiophene derivative? a) Procaine b) Ultracaine c) Lidocaine d) Mepivacaine 014. Local anesthetics are: a) Weak bases b) Weak acids c) Salts d) None of the above 015. For therapeutic application local anesthetics are usually made available as salts for the reasons of: a) Less toxicity and higher potency b) Higher stability and greater lipid solubility c) Less local tissue damage and more potency d) More stability and greater water solubility 016. Which of the following statements is not correct for local anesthetics? a) In a tissue they exist either as an uncharged base or as a cation b) A charged cationic form penetrates biologic membranes more readily than an uncharged form c) Local anesthetics are much less effective in inflamed tissues d) Low ph in inflamed tissues decreases the dissociation of nonionized molecules 017. Which one of the following statements about the metabolism of local anesthetics is incorrect? a) Metabolism of local anesthetics occurs at the site of administration b) Metabolism occurs in the plasma or liver but not at the site of administration c) Ester group of anesthetics like procaine, are metabolized systemically by pseudocholinesterase d) Amides such as lidocaine, are metabolized in the liver by microsomal mixed function oxidases 018. Indicate the anesthetic agent of choice in patient with a liver disease: a) Lidocaine b) Bupivacaine c) Procaine d) Etidocaine 019. Which of the following local anesthetics is preferable in patient with pseudocholinesterase deficiency? a) Procaine b) Ropivacaine c) Tetracaine d) Benzocaine 020. The primary mechanism of action of local anesthetics is: a) Activation of ligand-gated potassium channels b) Blockade of voltage-gated sodium channels c) Stimulation of voltage-gated N-type calcium channels d) Blockade the GABA-gated chloride channels 021. Which of the following local anesthetics is more water-soluble? a) Tetracaine b) Etidocaine c) Procaine d) Bupivacaine 022. Indicate the local anesthetic, which is more lipid-soluble: a) Bupivacaine b) Lidocaine c) Mepivacaine d) Procaine 023. The more lipophylic drugs: a) Are more potent b) Have longer duration of action c) Bind more extensively to proteins d) All of the above 024. Which of the following fibers is the first to be blocked?
a) Type A alpha fibers b) B and C fibers c) Type A beta fibers d) Type A gamma fibers
025. Indicate the function, which the last to be blocked: a) Pain, temperature b) Muscle spindles c) Motor function d) Touch, pressure 026. Which of the following fibers participates in high-frequency pain transmission? a) Type A delta and C fibers b) Type A alpha fibers c) Type B fibers d) Type A beta fibers 027. Which of the following local anesthetics is an useful antiarrhythmic agent? a) Cocaine b) Lidocaine c) Bupivacaine d) Ropivacaine 028. Indicate the route of local anesthetic administration, which is associated with instillation within epidural or subarachnoid spaces: a) Topical anesthesia b) Infiltrative anesthesia c) Regional anesthesia d) Spinal anesthesia 029. The choice of a local anesthetic for specific procedures is usually based on: a) The duration of action b) Water solubility c) Capability of rapid penetration through the skin or mucosa with limited tendency to diffuse away from the site of application d) All of the above 030. Which of the following local anesthetics is a short-acting drug? a) Procaine b) Tetracaine c) Bupivacaine d) Ropivacaine 031. Indicate the local anesthetic, which is a long-acting agent: a) Lidocaine b) Bupivacaine c) Procaine d) Mepivacaine 032. The anesthetic effect of the agents of short and intermediate duration of action can not be prolonged by adding: a) Epinephrine b) Norepinephrine c) Dopamine d) Phenylephrine 033. A vasoconstrictor does not: a) Retard the removal of drug from the injection site b) Hence the chance of toxicity c) Decrease the blood level d) Reduce a local anesthetic uptake by the nerve 034. Vasoconstrictors are less effective in prolonging anesthetic properties of: a) Procaine b) Bupivacaine c) Lidocaine d) Mepivacaine 035. Which of the following local anesthetics is only used for surface or topical anesthesia? a) Cocaine b) Tetracaine c) Procaine d) Bupivacaine
a) Slow onset b) Low potency c) Long duration d) High toxicity
049. Correct statements concerning bupivacaine include all of the following EXCEPT: a) It has low cardiotoxicity b) It has amide linkage c) It is a long-acting drug d) An intravenous injection can lead to seizures
PART II Cholinomimetic drugs
001. Acetylcholine is not a specific neurotransmitter at: a) Sympathetic ganglia b) Sympathetic postganglionic nerve endings c) Parasympathetic ganglia d) Parasympathetic postganglionic nerve endings 002. Muscarinic receptors are located in: a) Autonomic ganglia b) Skeletal muscle neuromuscular junctions c) Autonomic effector cells d) Sensory carotid sinus baroreceptor zone 003. Indicate the location of M 2 cholinoreceptor type: a) Heart b) Glands c) Smooth muscle d) Endothelium 004. The symptoms of mushroom poisoning include all of the following EXCEPT: a) Salivation, lacrimation, nausea, vomiting b) Dryness of mouth, hyperpyrexia, hallucination c) Headache, abdominal colic d) Bradycardia, hypotension and shock 005. Which of the following cholinomimetics activates both muscarinic and nicotinic receptors? a) Lobeline b) Pilocarpine c) Nicotine d) Bethanechol 006. Indicate a cholinomimetic agent, which is related to direct-acting drugs: a) Edrophonium b) Physostigmine c) Carbachol d) Isoflurophate 007. Characteristics of carbachol include all of the following EXCEPT: a) It decreases intraocular pressure b) It causes mydriasis c) It exerts both nicotinic and muscarinic effects d) It is resistant to acethylcholiesterase 008. Acetylcholine is not used in clinical practice because: a) It is very toxic b) The doses required are very high c) It is very rapidly hydrolyzed d) It is very costly 009. Parasympathomimetic drugs cause: a) Bronchodilation b) Mydriasis c) Bradycardia d) Constipation 010. Which of the following direct-acting cholinomimetics is mainly muscarinic in action? a) Bethanechol b) Carbachol c) Acetylcholine d) None of the above
011. Which of the following direct-acting cholinomimetics has the shortest duration of action? a) Acetylcholine b) Methacholine c) Carbachol d) Bethanechol 012. Bethanechol has all of the following properties EXCEPT: a) It is extremely resistant to hydrolysis b) Purely muscarinic in its action c) It is used for abdominal urinary bladder distention d) It exerts both nicotinic and muscarinic effects 013. A M-cholinimimetic agent is: a) Carbachol b) Pilocarpine c) Acetylcholine d) Bethanechol 014. Characteristics of pilocarpine include all of the following EXCEPT: a) It is a tertiary amine alkaloid b) It causes miosis and a decrease in intraocular pressure c) Causes a decrease in secretory and motor activity of gut d) It is useful in the treatment of glaucoma 015. Which of the following cholinomimetics is a plant derivative with lower potency than nicotine but with a similar spectrum of action? a) Lobeline b) Pilocarpine c) Carbochol d) Acetylcholine 016. Which of the following cholinomimetics is indirect-acting? a) Lobeline b) Edrophonium c) Pilocarpine d) Carbachol 017. The mechanism of action of indirect-acting cholinomimetic agents is: a) Binding to and activation of muscarinic or nicotinic receptors b) Inhibition of the hydrolysis of endogenous acetylcholine c) Stimulation of the action of acetylcholinesterase d) Releasing acetylcholine from storage sites 018. Indicate a reversible cholinesterase inhibitor: a) Isoflurophate b) Carbochol c) Physostigmine d) Parathion 019. Which of the following cholinesterase inhibitors is irreversible? a) Physostigmine b) Edrophonium c) Neostigmine d) Isoflurophate 020. Indicate cholinesterase activator: a) Pralidoxime b) Edrophonium c) Pilocarpine d) Isoflurophate 021. Isofluorophate increases all of the following effects except: a) Lacrimation b) Bronchodilation c) Muscle twitching d) Salivation 022. Indicate a cholinesterase inhibitor, which has an additional direct nicotinic agonist effect: a) Edrophonium b) Carbochol c) Neostigmine d) Lobeline
d) Vomiting and diarrhea
035. Which of the following drugs is used for acute toxic effects of organophosphate cholinesterase inhibitors? a) Atropine b) Pilocarpine c) Pralidoxime d) Edrophonium
PART III Cholinoreceptor blocking drugs
001. The group of nicotinic receptor-blocking drugs consists of: a) Ganglion-blockers b) Atropine-similar drugs c) Neuromuscular junction blockers d) Both a and c 002. M 3 receptor subtype is located: a) In the myocardium b) In sympathetic postganglionic neurons c) On effector cell membranes of glandular and smooth muscle cells d) On the motor end plates 003. Which of the following drugs is both a muscarinic and nicotinic blocker? a) Atropine b) Benztropine c) Hexamethonium d) Succinylcholine 004. Indicate a muscarinic receptor-blocking drug: a) Scopolamine b) Pipecuronium c) Trimethaphan d) Pilocarpine 005. Which of the following agents is a ganglion-blocking drug? a) Homatropine b) Hexamethonium c) Rapacuronium d) Edrophonium 006. Indicate the skeletal muscle relaxant, which is a depolarizing agent: a) Vencuronium b) Scopolamine c) Succinylcholine d) Hexamethonium 007. Which of the following drugs is a nondepolarizing muscle relaxant? a) Pancuronium b) Succinylcholine c) Hexamethonium d) Scopolamine 008. Indicate the drug, which is rapidly and fully distributed into CNS and has a greater effect than most other antimuscarinic agents? a) Atropine b) Scopolamine c) Homatropine d) Ipratropium 009. The effect of the drug on parasympathetic function declines rapidly in all organs EXCEPT: a) Eye b) Heart c) Smooth muscle organs d) Glands 010. The mechanism of atropine action is: a) Competitive ganglion blockade b) Competitive muscarinic blockade c) Competitive neuromuscular blockade d) Noncompetitive neuromuscular blockade 011. The tissues most sensitive to atropine are:
a) The salivary, bronchial and sweat glands b) The gastric parietal cells c) Smooth muscle and autonomic effectors d) The heart
012. Atropine is highly selective for: a) M 1 receptor subtype b) M 2 receptor subtype c) M 3 receptor subtype d) All of the above 013. Which of the following antimuscarinic drugs is often effective in preventing or reversing vestibular disturbances, especially motion sickness? a) Atropine b) Ipratropium c) Scopolamine d) Homatropine 014. Atropine causes: a) Miosis, a reduction in intraocular pressure and cyclospasm b) Mydriasis, a rise in intraocular pressure and cycloplegia c) Miosis, a rise in intraocular pressure and cycloplegia d) Mydriasis, a rise in intraocular pressure and cyclospasm 015. Patients complain of dry or “sandy” eyes when receiving large doses of: a) Atropine b) Hexamethonium c) Pilocarpine d) Carbachol 016. All of the following parts of the heart are very sensitive to muscarinic receptor blockade except: a) Atria b) Sinoatrial node c) Atrioventricular node d) Ventricle 017. Atropine causes: a) Bradycardia, hypotension and bronchoconstriction b) Tachycardia, little effect on blood pressure and bronchodilation c) Decrease in contractile strength, conduction velocity through the AV node d) Tachycardia, hypertensive crisis and bronchodilation 018. Atropine is frequently used prior to administration of inhalant anesthetics to reduce: a) Muscle tone b) Secretions c) Nausea and vomiting d) All of the above 019. Atropine is now rarely used for the treatment of peptic ulcer because of: a) Slow gastric empting and prolongation of the exposure of the ulcer bed to acid b) Low efficiency and necessity of large doses c) Adverse effects d) All of the above 020. Which of the following antimuscarinic drugs is a selective M (^1) blocker? a) Atropine b) Scopolamine c) Pirenzepine d) Homatropine 021. Atropine causes: a) Spasmolitic activity b) Intestinal hypermotility c) Stimulation of contraction in the gut d) Stimulation of secretory activity 022. Which of the following drugs is useful in the treatment of uterine spasms? a) Carbachol b) Vecuronium c) Atropine d) Edrophonium 023. Atropine may cause a rise in body temperature (atropine fever):
