RAWAL INSTITUTE OF REHABILITATION SCIENCES

Mid-Term Exam

Subject: Pharmacology Course Instructor: Dr. Maryam

Total marks: 50

1. A patient complaints of reduction in the is doubled, what response in the steady

improvement of symptoms and shows state concentration will be expected?
rapidly diminishing response to a drug a. Decrease by 50%
on repeated administration at frequent b. Doubled
intervals. Which of the following terms c. Increase by 50%
best describes this phenomenon? d. Increase by 4 times
a. Anaphylaxis e. Remain unchanged
b. Hyposensitivity 5. A patient is given a drug which
c. Supersensitivity. undergoes biotransformation by hepatic
d. Tachyphylaxis enzymes to be converted to polar form.
e. Tolerance Which one of the following is not a
2. A drug when administered in the body phase II hepatic metabolic reaction?
undergoes pharmacokinetic changes. a. Acetylation
Which of the following does not occur b. Glucuronidation
after drug metabolism? c. Hydrolysis
a. Decreased time of action of the d. Methylation
drug e. Sulfation
b. Increased polarity of the drug. 6. Drug A has a half-life of 10 hours. If it is
c. Increased ionization of the drug administered by continuous I.V. infusion
d. Increased time of action of the to a patient, how long will it take Drug A
drug to reach 75% of its steady state
e. Increased renal excretion of the concentration?
drug a. 10 hours
3. A drug is administered in the body by
severel routes. Which of the following b. 20 hours
routes cannot avoid hepatic first pass c. 25 hours
metabolism?
a. Intramuscular d. 30 hours
e. 50 Hours
b. Intravenous 7. A drug produces its maximum effect and
c. Rectal relieves the pain. The maximum effect
d. Sublingual (E max) achieved by a drug is a
e. Transdermal measure of which of the following?
4. A drug X is given by intravenous a. Efficacy
infusion. If the rate of infusion of a drug
 b. Potency and thus decrease the bioavailability of
c. Quantal Response the affected drug:
d. Receptor Affinity a. Anti-tubercular drugs
e. Therapeutic Index
b. Broad-spectrum antibiotics
8. Which of the following is calculated as
the ratio of the area under the curve c. Anti-cancer antibiotics
(AUC) obtained by oral administration d. Anti-retroviral drugs
vs. the AUC for intravenous e. Systemic anti-fungal drugs
administration of the same drug? 13. Which of the following clinical
a. Absorption situations in a patient, is unlikely to
b. Bioavailability increase the half-life of a drug?
c. Clearance
a. Congestive cardiac failure
d. Extraction
e. Volume of distribution b. Increase volume of
9. A patient shows a qualitatively abnormal distribution
harmful response to a drug which is c. Decreased volume of
unpredictable, not related with dose and distribution
is not related with immune system. It is d. Impairment of hepatic
thought to be because of genetic function
predisposition. This is called:
e. Impairment of the Kidney
a. Idiosyncrasy
function
b. Pharmacogenetics 14. Which of the following most accurately
c. Anaphylaxis describes the transmembrane signaling
process involved in the action of insulin?
d. Tachyphylaxis a. Activates adenylate cyclase
e. Tolerance
through GPCRs
10. Adrenaline is a life saving drug in the
treatment of anaphylaxis. Reversal of b. Activates on tyrosine kinase
histamine induced bronchospasm and linked receptors
vasodilation by adrenaline is due to: c. Binding & activation of
a. Physiological antagonism intracellular receptors
b. Pharmacological antagonism d. Diffusion of STATs across the
c. Chemical antagonism cell membrane
d. Competitive antagonism
e. Opening of ion channels
e. None Competitive antagonism
11. Study of biochemical and physiological involving Na+ & K+
effects of drugs as well as their 15. Which of the following provides
mechanism of action is dealt with by information about the variation in the
which branch of Pharmacology? effectiveness of a drug within the
a) Pharmacokinetics population studied?
b) Pharmacoepidemiology a. Potency of the drug
c) Clinical pharmacology b. Graded dose response curve
d) Pharmacogenomics c. Maximal efficacy of the drug
e) Pharmacodynamics d. Therapeutic index of the drug
12. Which of the following drugs can e. Quantal dose response curve
interfere with enterohepatic recycling
16. A patient undergoes decreasing response 20. Epinephrine is a life saving drug when
to a drug on repeated administration, but used in anaphylactic shock. It
the same response can be achieved by counteracts the harmful effects of
released histamine by which of the
increasing the dose of the drug. This
following types of antagonism?
phenomenon is termed as: a. Chemical antagonism
a. Photosensitivity b. Pharmacological
b. Tachyphylaxis antagonism
c. Drug allergy c. Pharmacokinetic
d. Drug dependence antagonism
e. Tolerance d. Physiological
antagonism
17. Therapeutic window is a clinically
e. Physical antagonism
useful parameter to determine the safety 21. A nonvolatile highly lipid soluble drug is
margin of a drug. It is calculated as a metabolized at a rate of 15% per hour.
ratio of: On IV injection it produces general
a. Maximum toxic & minimum anesthesia only for 10 min. Which
effective dose process is responsible for quick
b. Median lethal dose & median termination of its action?
a. Metabolism in the liver
effective dose
b. Plasma protein binding
c. Minimum toxic & minimum c. Excretion by the kidneys
effective dose d. Redistribution of drug
d. Minimum toxic & maximum e. Lipid solubility of drug
effective dose 22. The study of biochemical and
e. Maximum toxic &maximum physiological effect of drugs as well as
their mechanism of action is dealt with
effective dose
by which branch of Pharmacology?
18. A 63 years old patient in intensive care a. Pharmacokinetics
unit requires infusion of procainamide. b. Pharmacoepidemiology
Its half life is 2 hrs. The infusion begins c. Clinical pharmacology
at 9 AM in the morning. What %age of d. Pharmacogenomics
steady state plasma concentration will be e. Pharmacodynamics
reached at 3 pm on the same day? 23. Which of the following is the branch of
a. 75 % pharmacology which deals with the
b. 50 % doses of drugs?
c. 93 % a. Chemotherapy
d. 87 % b. Therapeutics
e. 100 % c. Pharmacy
19. In addition to slow intravenous infusion, d. Pharmacokinetic
which of the following routes of drug s
administration allows for titration of the e. Posology
dose of a drug with the response? 24. Alkaloids are important active principal
a. Sublingual of drugs coming from natural plant
b. Transdermal source. Which of the following is an
c. Inhalational important feature of an alkaloid?
d. Nasal insufflation a. Soluble in
e. Subcutaneous alcohol
 b. Non-nitrogenous receptors. Which of the following terms
comp describes a characteristic of loratadine
c. Acidic in binding to the H1 receptor?
reaction a. Intrinsic activity
d. Soluble in water b. Potency
e. Biologically c. Maximal efficacy
inactive d. Affinity
25. If a drug has got a very large volume of e. Receptor activation
distribution, which of the following 29. A 65 year old woman suffering from
properties can be present in this atrial fibrillation had been taking a drug
particular drug? to treat this condition for 6 months. The
a. It has got very high water drug had no intrinsic activity and bound
solubility reversibly to β1 receptors. Which of the
b. It is a strongly ionized polar following terms best defines this drug?
drug a. Partial agonist
c. It is a lipid soluble b. Inverse agonist
compound c. Irreversible antagonist
d. Lipid soluble with tissue d. Competitive antagonist
binding e. Agonist - Antagonist
e. A quaternary ammonium 30. A 50 years old female was taking
compound propranolol, a beta adrenergic blocker,
26. A 12 year old boy recently diagnosed for the last two years. Her physician
with type 1 diabetes started a therapy switches her to an ACE inhibitor. Two
with twice daily subcutaneous days later she was received in
administration of insulin. Which of the emergency with acute attack of angina.
following permeation processes best Which of the following may be most
explains the absorption of insulin from likely cause?
the site of s/c injection? a. Receptor desensitization.
a. Bulk flow transport b. Receptor down regulation
b. Lipid diffusion c. Receptor up regulation
c. Facilitated diffusion d. Activation of spare
d. Endocytosis receptors
e. Active transport e. Temporal sparseness of
27. A 22 year old man suffering from autism receptors
and violent behavior started a treatment 31. A patient shows rapidly diminishing
that included buspirone, a drug with a response to a drug on repeated
large first – pass effect. Which of the administrations of this drug at frequent
following pharmacokinetic properties of intervals. This phenomenon is called:
drug was most likely affected by this a. Hypersensitivity
large first-pass effect?
a. Volume of distribution b. Tolerance
b. Oral bioavailability c. Supersensitivity
c. Renal clearance
d. Sublingual bioavailability d. Tachyphylaxis
e. Intramuscular bioavailability e. Idiosyncrasy
28. A 14 year old suffering from seasonal 32. Which of the following parameter is
rhinitis started a therapy with loratadine, calculated as the ratio of the area under
a drug that binds to H1 histamine the plasma concentration versus time
 curve (AUC) obtained by oral d. Concentration gradient
administration vs. the AUC after e. Nature of the drug
intravenous administration of the same 37. An elderly patient has problem remembering
drug? to take her medication three times a day.
f. Absorption Which one of the drug formulations might
g. Bioavailability be particularly useful in this case?
h. Clearance a. Extended-release
i. Elimination rate b. Suspension
j. Extraction ratio c. Suppository
33. After binding to a proteinaceous d. Skin-patch
membrane carrier, drugs are transported e. Enteric-coated
across the body membranes against the 38. If food decreases the rate but not extent of
concentration gradient with the
the absorption of a particular drug from the
expenditure of cellular energy, where
gastrointestinal tract, then taking the drug
they are released. Which of the
with food will result in a smaller.
following process is involved in such
transport? a. Area under the plasma
a. Filtration drug concentration time
b. Simple diffusion curve
c. Facilitated diffusion b. Maximal plasma drug
d. Active transport concentration
e. Endocytosis c. Time at which the
34. Hepatic biotransformation reactions that maximal plasma drug
unmask or introduce a functional group concentration occurs
like OH, NH2, or SH, are known as d. Fractional
which of the following? bioavailability
a. Conjugations e. Total clearance
b. Glucuronidations 39. After a person ingests an overdose of an
c. Phase 1reactions opioid analgesic, the plasma drug
d. Phase 2 reactions concentration is found to be 32 mg/L. How
e. Synthetic reactions
long will it take to reach a safe plasma
35. Pick out the appropriate alimentary route of
concentration of 2 mg/L if the drug’s half
administration when passage of drugs
life is 6 hours?
through liver is minimized:
a. Oral a. 12 hours
b. Transdermal b. 24 hours
c. Rectal c. 48 hours
d. Intraduodenal d. 72 hours
e. Non of the above e. 1 Week
36. Most of the drugs are absorbed from GIT 40. We start intravenous infusion of a drug
after oral administration by the process of using an infusion pump to ensure that the
passive diffusion. The transmembrane rate of drug delivery is constant over time.
permeation of drugs through this process is What one factor determines how long it will
inversely related to which of the following? take for the drug to reach a steady-state
a. Lipid solubility concentration (Css) in the blood?
b. Permeability coefficient a. Apparent volume of
of the drug distribution
c. Thickness of the b. Bioavailability
membrane
 c. Clearance and bioavailability are known, what would
d. Half-life one need to know?
e. Infusion rate (mg of a. Rate of drug clearance
drug/min)
41. A patient is given a non competitive
b. Plasma half-Life of drug
irreversible antagonist followed by
c. Rate of drug Infusion
administration of increasing doses of
agonist. In the presence of the non
d. Volume of Distribution
competitive irrervsible antagonist the
e. Rate of drug metabolism
agonist’s
45. A drug with a half-life of 10 hours is
a. Potency is increased
administered by continuous intravenous
b. Maximum efficacy is
infusion. Which of the following best
increased
approximates the time for the drug to reach
c. Ed50 is increased
steady state?
d. Ed50 is decreased
a. 10 hours
e. Affinity is decreased
b. 20 hours
42. In the presence of drug A, higher
c. 33 hours
concentration of drug B is required to elicit
d. 40 hours
full pain relief. Drug A has less analgesic
e. 60 hours.
effect than does drug B even at the highest
46. Elimination of drugs via the kidneys into
dose. So the drug A can be labeled as:
urine involves the processes of glomerular
a. Competitive antagonist
filteration, active tubular secretion and
of drug B
_________.
b. Drug A is the partial
a. Passive tubular
agonist
reabsorption
c. Drug B is less
b. Active tubular reabsorption
efficacious than drug A
c. Active tubular
d. Drug B is less potent
redistribution
than drug A
d. Passive tubular
e. Drug A is a non
redistribution
competitive antagonist
e. Loop of henle secretion
43. Nitroglycerine is a drug administered
sublingually to terminate an attack of angina 47. Most important route of drug elimination is
Which of the following is an advantage of through which of the following organ:
sublingual route of administration? a. Blood
a. It has no risk of first pass b. Bile
metabolism c. Kidney
b. It is suitable for all age d. Breast milk
groups of pts e. Lungs
c. It can be used in 48. Variation in the sensitivity of a population of
unconscious patient individuals to increasing doses of a drug is
d. It can be given if repeated best determined by which of the following?
doses required a. Efficacy of the drug used
e. There is no risk of b. Potency of the drug used
aspiration of drug c. Therapeutic index of the
44. To calculate the loading dose of a drug, drug
when the desired steady state concentration
 d. Graded dose response curve
e. Quantal dose response curve
49. Half life of a drug may be helpful to
determine a
a. Dosage schedule of the
drug
b. Level of absorption
c. Distribution into different
body systems
d. Rate of absorption through
GIT
e. Time to get the steady
state.
50. The steady state concentration of a drug can
be doubled by
a. Doubling both rate of
infusion and conc.
b. Doubling the rate of
infusion only
c. Doubling loading dose
d. Tripling the rate of
infusion
e. Quadrupling the rate of
infusion