Revision Test 1-3

BPharm III
2017
Test 1

2017
 Pharmacokinetics Principles

T a. steady state is reached when the rate of drug administration equals the elimination rate

F b. in first-order kinetics, drug elimination is constant

T c. active transport occurs against a concentration gradient

T d. weak base drugs are ionized in the stomach

T e. hepatic drug metabolism increases drug water solubility

Pharmacokinetics

T a. phenytoin inhibits cytochrome P450 enzymes

F b. a drug with a volume of distribution >50L is confined to the plasma

F c. after two half-lives more than 90% of a drug is eliminated

T d. active tubular secretion occurs in the proximal convoluted tubule

F e. in zero-order kinetics, the half-life of a drug is constant

Regarding Second Messengers

T a. in myocardial tissue, cAMP levels is increased by adrenaline

T b. acetylcholine is an agonist at skeletal end plate receptors

F c. an agonist at beta-1-adrenoceptors, inhibits the activity of adenylate cyclase

T d. inhibition of myocardial phosphodiesterase increases intracellular calcium

F e. cAMP decreases intracellular calcium in the myocardial tissue

 Drugs acting on the parasympathetic nervous system
T a. neostigmine is indicated in the management of myasthenia gravis
T b. oxybutinin is used in the treatment enuresis
F c. hyoscine exacerbates motion sickness symptoms
F d. atropine increases salivation
T e. ipratropium bromide is indicated in the treatment of COPD

Drugs acting on the sympathetic nervous system

T a. topical phenylephrine causes nasal vasoconstriction
F b. atenolol is an alpha-1-adrenoceptor blocker
F c. salbutamol causes bronchoconstriction
T d. prazosin is indicated in the treatment of benign prostatic hyperplasia
F e. dopamine is a beta-1-adrenoceptor blocker
 Neuromuscular blockers and Muscle Relaxants
T a. dantrolene is used in the management of malignant hyperthermia
T b. cis-atracurium is preferred to vecuronium in patients with hepatic impairment
T c. succinylcholine stimulates histamine release
F d. pancuronium is less cardiotoxic than vecuronium
F e. orphenadrine causes muscle spasms

Local anaesthetic agents

T a. the ionised state inhibits the entry of sodium into neuronal cells
F b. prilocaine is metabolised by plasma cholinesterase
F c. in infected tissue, the concentration of the non-ionised state is increased
F d. an agent with a lower pKa will have a slower onset of action
T e. bupivacaine has a longer duration of action than procaine

Pethidine
F a. is a mu-opioid receptor antagonist
T a. analgesic properties are reversed by naloxone
T a. is commonly associated with constipation
T a. emetic properties are reversed by cyclizine
F a. inhibits the synthesis of the antidiuretic hormone (ADH)
 Correctly match the drug with its mechanism of action:
F a. cyclizine - histamine-2-receptor antagonist
T b. diosmectite - water adsorbent agent
T c. lansoprazole - H+/K+-ATPase inhibitor
F d. mesalazine - inhibits bacterial folic acid synthesis
F e. bisacodyl - osmotic laxative

Correctly match the drug with its adverse effect:

T a. misoprostol - uterine contractions
F b. promethazine - somnolence
F c. liquid paraffin - vitamin C deficiency
T d. aprepitant - hiccups
T e. infliximab - reactivation of tuberculosis
 Which of the following drugs increase GIT motility by prostaglandins-like mechanism of
action?
F a. erythromycin
T b. senna
T c. sucralfate
T d. misoprostol
F e. magnesium hydroxide

GIT drugs
T a. domperidone is a 5HT4 receptor agonist
F b. dexamethasone antagonises the antiemetic effect of ondansetron
T c. sulfasalazine induces reversible nephrotoxicity
T d. amitriptyline is effective in patients with irritable bowel syndrome
F e. atropine antagonises the antidiarrhoeal effect of diphenoxylate

Glucocorticosteroids
F a. prednisone inhibits the activity of cyclooxygenase-II (COX-II)
F b. fluticasone is more likely than beclomethasone to cause adrenal suppression
T c. alternate day dosing of methylprednisolone decreases the risk for adrenal suppression
T d. the long term use of oral corticosteroids in children inhibits long bone growth
T e. in long term methylprednisolone therapy, supplementation with the combination of calcium and
vitamin D decreases the risk for osteoporosis
 NSAIDs and Paracetamol
T a. toxic doses of paracetamol deplete liver glutathione
T b. aspirin irreversibly acetylates COX-I
T c. ibuprofen is used to manage pain associated with dysmenorrhoea
F d. paracetamol is more likely to worsen a peptic ulcer than indomethacin
F e. ibuprofen is a more selective inhibitor of COX-II than celecoxib

Pharmacotherapy of Gout
T a. colchicine causes alopecia as an adverse effect
F b. probenecid inhibits neutrophil migration
F c. colchicine inhibits purine metabolism
F d. allopurinol inhibits the reabsorption of uric acid in the kidney
T e. febuxostat is a xanthine oxidase inhibitor
 a. adrenaline k. pancuronium
b. articaine l. prilocaine
c. benzocaine m. procaine
d. bupivacaine n. rocuronium
e. cis-atracurium o. ropivacaine
f. cocaine p. ropivacaine
g. etidocaine q. succinylcholine
h. levobupivacaine r. vecuronium
i. lignocaine
j. mepivacaine

1) Which of the above agents has the same mechanism of action as

lignocaine, but is more lipophilic, has a shorter duration of action,
does not accumulatively bind to cardiac sodium channels during
diasystole and its metabolism is blocked (<10%) by cimetidine.
Answer: articaine (B)
 a. alfenatinil k. loperamide
b. aspirin l. methadone
c. buprenorphine m. morphine
d. codeine n. N-acetylcysteine
e. dantrolene o. naloxone
f. dextromethorphan p. neostigmine
g. diclofenac q. pethidine
h. diphenoxylate r. remifentanil
i. fentanyl s. succinylcholine
j. lignocaine t. tramadol

2) A 42 year old man is undergoing elective surgery. He had severe muscle rigidity during a previous
surgical procedure due to the adjunct opioid used. Which one of the above drugs would provide potent
intra-operative analgesia and would be broken down in the patients’ plasma?
Answer: Alfenatinil (A)

3)Which one of the above agents decreases GIT motility, has no analgesic properties and has the lowest
risk of causing euphoria at therapeutic doses?
Answer: Loperamide (K)

4)A 26 year old male underwent surgery and was given vecuronium to facilitate endotracheal intubation.
Which drug would be used to reverse the effects of vecuronium?
Answer: Neostigmine (P)
 a. allopurinol k. meloxicam
b. aspirin l. misoprostol
c. atenolol m. naproxen
d. atropine n. oxybutinin
e. bethanecol o. pilocarpine
f. colchicine p. prednisone
g. diclofenac q. probenecid
h. etoricoxib r. salbutamol
i. indomethacin s. scopolamine
j malathion t. tropicamide

5) This drug is the treatment of choice in organophosphate poisoning and has anti-muscarinic side-effects
Answer: D (Atropine)

6) A 50-year old female presents to the ophthalmologist with acute angle closure glaucoma. Which topical
drug would increase the drainage of the aqueous humour and would be the most appropriate treatment
for acute angle closure glaucoma?
Answer O (Pilocarpine)

7) A 63-year-old man with a history of gout presented to his GP complaining of excruciating pain in his left
big toe, a clinical presentation of an acute gout attack. His GP had previously started him on colchicine and
allopurinol. Past medical history reveals that he is a cardiac patient with coronary artery disease.
Considering his cardiac history, what is the NSAID of choice to treat his acute gout attack?
Answer M (Naproxen)
 a. allopurinol k. meloxicam
b. aspirin l. misoprostol
c. atenolol m. naproxen
d. atropine n. oxybutinin
e. bethanecol o. pilocarpine
f. colchicine p. prednisone
g. diclofenac q. probenecid
h. etoricoxib r. salbutamol
i. indomethacin s. scopolamine
j malathion t. tropicamide

8) A 56-year old man has recently suffered an acute myocardial infarction for which he was treated. Prior
to his discharge, his physician places him on beta blockers, anti-hypertensive agents and lipid lowering
agents. The patient has no known history of peptic ulcer disease, asthma or hypersensitivity reactions.
What the name of the NSAID that should be co-prescribed to reduce the risk of a secondary myocardial
infarction as it inhibits platelet aggregation?
Answer B (Aspirin)

9)A 35-year old man with a medical history of acute gouty arthritis was seen by his GP as a follow up
patient. The patient has noticed skin changes on his ear auricle and fingers. Blood results revealed high
serum uric acid levels. The GP has confirmed these skin changes were tophi. His doctor would like to
prescribe him a drug that inhibits purine metabolism. What is the first line drug of choice is this patient?
Answer A (Allopurinol)
 a. allopurinol k. meloxicam
b. aspirin l. misoprostol
c. atenolol m. naproxen
d. atropine n. oxybutinin
e. bethanecol o. pilocarpine
f. colchicine p. prednisone
g. diclofenac q. probenecid
h. etoricoxib r. salbutamol
i. indomethacin s. scopolamine
j malathion t. tropicamide

10) A 39-year old man with a history of hypertension and aspirin sensitive asthma experiences
excruciating pain in his right ankle only. Microscopic examination of aspirated joint fluid
revealed uric acid crystals and he was diagnosed with acute gout. He was prescribed a drug to
manage his symptoms. He was told to take two tablets immediately and then one tablet every
two hours. After taking a few doses of the prescribed drug he develops severe abdominal pain,
nausea and diarrhoea. What is the name the name of the drug that he was prescribed which
caused these adverse effects?
Answer F (Colchicine)
 a. alginate k. domperidone
b. aluminum hydroxide l. erythromycin
c. amitriptyline m. lactulose
d. calcium carbonate n. loperamide
e. ciprofloxacin o. magnesium hydroxide
f. codeine p. methylcellulose
g. dicyclomine q. metoclopramide
h. dimeticone r. metronidazole
i. diosmectite s. senna
j diphenoxylate t. sodium bicarbonate

11) A 37-year old man is admitted into hospital to the undergo surgery on his colon. Which one of the
above agents would empty his GIT tract in approximately two hours in preparation for the surgery?
Answer: Magnesium hydroxide (O)

12) A 65-year old woman taking tramadol complains to her GP about being constipated. Her history
reveals she has had a hypersensitivity reaction to galactose. Her doctor advises her to take the laxative
before she goes to bed. Which one of the above agents would relieve her constipation within 24 hours?
Answer: Senna (S)

13) A 53-year old accountant has been experiencing mild gastro-oesophageal reflux disease and has been
taking antacids to relieve her condition. She has now developed further symptoms of dyspepsia such as
bloating and flatulence. Which one of the above agents would be combined with an antacid to reduce
flatulence?
Answer: Dimeticone (H)
 a. alginate k. erythromycin
b. aluminum hydroxide l. esomeprazole
c. amoxicillin m. lansoprazole
d. bismuth n. magnesium hydroxide
e. cimetidine o. metoclopramide
f. cinnarizine p. metronidazole
g. clarithromycin q. misoprostol
h. clindamycin r. prochlorperazine
i. cyclizine s. ranitidine
j domperidone t. sucralfate

14) This drug is able to increase GIT motility as well as possesses antiemetic properties and is
safe to use during pregnancy.

Answer: Metoclopramide (O)

15) A 37-year old woman is diagnosed with a peptic ulcer and prescribed peptic ulcer
eradication therapy (triple therapy) for a seven day period. The pharmacist dispensing the
medication could read the first two drugs on the script: esomeprazole and metronidazole, but
the third is unclear. The patients profile reflects that she is allergic to penicillin. Which one of
the above drugs should be dispensed to complete the script?

Answer: Clarithromycin (G)

 a. aspirin k. hydrocortisone
b. betamethasone l. latanoprost
c. celecoxib m. meloxicam
d. cyclizine n. methylprednisolone
e. dexamethasone o. naproxen
f. diclofenac p. omeprazole
g. doxylamine q. ondansetron
h. etoricoxib r. prednisolone
i. fludrocortisone s. prednisone
j fluticasone t. triamcinolone

16) This agent is administered by inhaler, decreases inflammation in the lungs, is not likely to
increase plasma glucose levels, and has a high first pass metabolism.
Answer: J (Fluticasone)

17) A 35 year old man was with severe pain as a result of acute gout was prescribed
indomethacin and oral prednisone to treat his attack. His physician is concerned about this
combination increasing his risk of developing a peptic ulcer. What is the name of the drug
that is co-prescribed with this combination to reduce the risk of peptic ulcer disease?
Answer: P (Omeprazole)
18) A 27-year old woman with a known history of peptic ulcers and mild hypotension, requires an analgesic for moderate pain relief following a
minor car accident. Considering her medical background, which ONE of the following drugs would promote central pain control and would not
worsen her hypotension at analgesic doses?
a) Pethidine
b) Tramadol
c) Codeine
d) Indomethacin
Answer B

19) A 56-year old man receiving cisplatin chemotherapy is suffering from intense nausea. He has a history of heart failure and is taking atenolol.
Which ONE of the following is the preferred antiemetic in this patient?
a) Palonosetron
b) Aprepitant
c) Ondansetron
d) Metoclopramide
Answer D

20)A 21-year woman is concerned about experiencing motion sickness whilst on her flight to an urgent meeting. She needs to finish a report
on the plane before the meeting. Which ONE of the following agents is the LEAST likely to cause sedation and can be used to manage her
motion sickness symptoms?
a) Domperidone
b) Metoclopramide
c) Cinnarizine
d) Doxylamine
Answer C

21) A 32-year old woman is diagnosed with an acute flare-up of ulcerative colitis and her doctor prescribes her medication to eliminate any
causative bacteria. Which ONE of the following agents would her doctor prescribe to eliminate any causative bacteria?
a) Bismuth
b) Metronidazole
c) Co-trimoxazole
d) Clarithromycin
Answer B
22) A 61-year old construction worker presents to his GP complaining of intense dizziness when he moves his head from
right to left and nausea. Clinical examination revealed nystagmus after the Dix-Hallpike maneuver. He is diagnosed with
benign paroxysmal positional vertigo. He requested that any medication he is prescribed must be non-sedating. Which
ONE of the following drugs would be preferred agent to treat his vertigo?
a) Betahistine
b) Domperidone
c) Doxylamine
d) Prochlorperazine
Answer A

23) A 30-year old female patient presents to her GP as a newly diagnosed case of myasthenia gravis. Which ONE of the
following drugs is used to confirm the diagnosis of myasthenia gravis?
a) Pyridostigmine
b) Edrophonium
c) Donepezil
d) Atropine
Answer B

24) A 38-year old pregnant woman on her 32nd week of gestation is admitted to hospital for pre-mature labour. She is
administered a dexamethasone injection every 6 hourly for 24 hours. Which ONE the following best describes the
rationale for the use of dexamethasone at this stage of gestation?

a) Prevent premature labour

b) Suppress pain and inflammation to the mother during the birthing process
c) Improve lung function and the decrease respiratory distress in the neonate
d) Increase the production of breast milk in the mother
Answer C
Test 2

2017
 In the treatment of thyroid disorders
T a. thyroxine inhibits the release of thyroid stimulating hormone (TSH)
F b. atenolol is used to treat hypothyroidism
F c. triiodothyronine is deiodinated to thyroxine
T d. carbimazole inhibits the coupling of iodine to tyrosine in the thyroid
F e. Lugol’s iodine is used in the treatment of congenital hypothyroidism

Asthma/COPD
F a. tiotropium bromide has a shorter duration of action than ipratropium bromide
F b. fluticasone is a beta-2-adrenoceptor agonist
T c. theophylline clearance is reduced in the adults >55 years
T d. indacaterol increases intracellular cyclic AMP
T e. montelukast is used to manage aspirin-sensitive asthma

Asthma/COPD management
T a. ipratropium bromide causes dry mouth
F b. zafirlukast inhibits phosphodiesterase
T c. ciclisonide is less likely to cause hoarseness than beclomethasone
F d. fenoterol causes bradycardia as an adverse effect
T e. montelukast increases the risk of nightmares
 The following antihistamines are correctly paired with their clinical indications:
F a. desloratadine - nausea
T b. cyclizine - motion sickness
T c. rupatadine - allergic rhinitis
F d. doxylamine - dry mouth
T e. cetirizine - chronic idiopathic utercaria

Antihistamines
T a. desloratadine has a longer duration of action than chlorpheniramine
F b. levocetirizine is used in the management of vertigo
T c. cyclizine is indicated for the management of nausea
F d. cinnarizine is an antitussive agent
T e. diphenhydramine decreases tremors in patients with Parkinson’s disease
 Coughs and Colds
T a. topical oxymetazoline has a longer duration of action than topical phenylephrine
F b. pseudoephedrine causes drowsiness as an adverse effect
F c. codeine is mu-opioid receptor antagonist
T d. dornase alpha causes voice alterations as an adverse effect
T e. promethazine causes urinary retention as an adverse effect

First-generation (typical) antipsychotics

F a. are competitive agonists of dopamine D2 receptors

F b. levodopa enhances their therapeutic effects

T c. causes Parkinsonism as an adverse effect

F d. cause metabolic syndrome as an adverse effect

T e. are contraindicated in patients with blood dyscrasias

Adverse effects commonly associated with tricyclic antidepressants (TCA)

T a. constipation
F a. hyponatraemia
F a. anorgasmia
T a. hypotension
T a. xerostomia
 Mechanism of action of Benzodiazepines in anxiety

F a. increases the duration of chloride (Cl-) channel opening

F b. inhibits the presynaptic reuptake of GABA molecules

F c. selectively binds to BDZ1 receptors in the CNS

T d. potentiates the actions of GABA in the CNS

T e. promotes neuronal hyperpolarization

Acute cocaine toxicity

F a. alcohol is cardioprotective when combined with cocaine

T b. hyperthermia is the leading cause of fatality

T c. lorazepam is indicated in the prevention of convulsions

T d. coronary vasoconstriction causes acute chest pain

F e. bupropion is the antidote of cocaine toxicity

 Pharmacological properties of lithium
T a. is indicated for the management of bipolar disorders

F b. inhibits the reuptake of monoamine neurotransmitters

T c. plasma levels of lithium exhibit narrow therapeutic index

F d. lithium has a large plasma protein-binding affinity (>80%)

T e. thyroid function test is required for chronic use

The following anticonvulsants are correctly paired with their adverse effects
F a. phenytoin - hypercalcemia

T b. valproate - hepatotoxicity

T c. vigabatrin - visual field defects

T d. carbamazepine - hyponatraemia

F e. topiramate - gingival hyperplasia

The following anticonvulsants are correctly paired with their mechanisms of actions
F a. clonazepam - GABA transaminase inhibitor
T b. carbamazepine - Sodium (Na+) channel blocker
F c. lamotrigine - GABA analogue
T d. ethosuximide - T-type calcium (Ca+) channel blocker
F e. levetiracetam - Glutamate NMDA inhibitor
 Pharmacokinetics of general anaesthetics
T a. desflurane has a lower volatility than halothane
T b. sevoflurane is metabolized by the liver to a nephrotoxic metabolite
F c. nitrous oxide is metabolized by the lungs to tissue toxic hydrocarbons
T d. when administered in short intervals, the risk for halothane toxic reactions are common
F e. halothane is formulated in a propylene solution due to its low lipophilicity

Pharmacotherapy of Parkinson’s correctly paired with their pharmacological classes

F a. apomorphine - ergot dopamine receptor agonist
T b. entacapone - catechol-O-methyltransferase inhibitor
T c. carbidopa - dopamine decarboxylase inhibitor
F d. rasagiline - antiviral agent
F e. benztropine - reversible anticholinesterase inhibitor
 a. bromhexine k. fluticasone
b. buclizine l. formoterol
c. budesonide m. indacaterol
d. carbocysteine n. loratadine
e. chlorpheniramine o. mesna
f. ciclisonide p. n-acetylcysteine
g. codeine q. oxymetazoline
h. dextromethorphan r. prednisone
i. diphenhydramine s pseudoephedrine
j. fenoterol t. salmeterol

1) A 33 year old female patient with a history of asthma presents to her physician for a repeat prescription
of her asthma medication. During the course of the consultation the patient reveals that she has had two
acute exacerbations which have landed her in hospital, and that she is only using her controller pump
(containing a low dose combination of a long acting beta-2 agonist and corticosteroids) to relieve her
wheezing and tightness of chest. Her physician wants to change her to another combination pump of
budesonide and a long acting beta-2-agonist. This combination pump can be used as both a controller and
a reliever. What is the name of this long acting beta-2-agonist?
Answer: L (Formoterol)

2) A 56 year old truck driver with a history of allergic rhinitis, treated with promethazine, presents to you at
the pharmacy. He is looking for an oral antihistamine (as he does not like nasal sprays) which he can use
that will not cause as much daytime sedation as his current medicine. What is the drug of choice in this
patient?
Answer: N (Loratadine)
 a. bromhexine k. fluticasone
b. buclizine l. formoterol
c. budesonide m. indacaterol
d. carbocysteine n. loratadine
e. chlorpheniramine o. mesna
f. ciclisonide p. n-acetylcysteine
g. codeine q. oxymetazoline
h. dextromethorphan r. prednisone
i. diphenhydramine s pseudoephedrine
j. fenoterol t. salmeterol

3) A 25 year old man presents to the pharmacy complaining of a blocked nose with accompanying rhinitis.
The pharmacist prescribes a topical decongestant for his blocked nose, but warns the man not to use the
decongestant for longer than 7 days as it will cause rebound congestion. What is name of this drug?
Answer: Q (Oxymetazoline)

4) This drug is a mucolytic agent. It is contraindicated for use in asthmatic patients and patients with a
known history of peptic ulcer disease. It can also be given intravenously as an antidote in paracetamol
poisoning. What is the name of this drug?
Answer: P (N-acetylcysteine)

5) A 79 year old woman with a history of asthma is prescribed a beta-2-adrenoceptor agonist to use as a
reliever. Each time she used the pump to relieve her bronchospasm she would suffer with hand tremors.
What is the name of the drug she was prescribed?
Answer: J (Fenoterol)
 a. bromhexine k. fluticasone
b. buclizine l. formoterol
c. budesonide m. indacaterol
d. carbocysteine n. loratadine
e. chlorpheniramine o. mesna
f. ciclisonide p. n-acetylcysteine
g. codeine q. oxymetazoline
h. dextromethorphan r. prednisone
i. diphenhydramine s pseudoephedrine
j. fenoterol t. salmeterol

6) A 35 year old woman with a history of asthma presents to the clinic with a low peak
expiratory flow rate and is also tachycardic and tachypnoeic. She is diagnosed with acute
severe asthma and is given 40% oxygen via facemask as well as salbutamol via inhalation. In
addition to these two agents, what is the third agent which should be given orally to this
patient to reduce inflammation?
Answer: R (Prednisone)
 a. amitriptyline k. lamotrigine
b. aripiprazole l. lithium
c. atomoxetine m. marijuana
d. bupropion n. methamphetamine
e. caffeine o. methylphenidate
f. clomipramine p. quetiapine
g. fosphenytoin q. risperidone
h. fluoxetine r. topiramate
i. gabapentin s. valproate
j. haloperidol t. varenicline
7) A 32-year old female recently diagnosed with Major Depressive Episode (MDE). Prior to her diagnosis, the
patient had experienced depressive mood, insomnia, with two separate episodes of attempted suicide.
Considering her recent diagnosis and past psychiatric history, what is the first-line drug of choice to control
her depression symptoms? Answer: Fluoxetine (H)

8) A 16-year old male recently diagnosed with focal-complex epilepsy and placed on anticonvulsant therapy.
The treating doctors decided to start him on a high dose due to the frequency of his seizures. Two weeks
after starting his new medicine, the patient started to develop a maculopapular rash all over his body and
was immediately admitted to the high care unit with provisional diagnosis of drug-induced Stevens - Johnson
syndrome. Which anticonvulsant agent is likely to be the cause of this patient’s serious adverse skin
reaction? Answer: Lamotrigine (K)

9) A 23-year old male was admitted to the high care unit. On examination, the patient presented with
tachypnoea, tachycardia and raised body temperature. The patient was very agitated and confused before
his level of consciousness deteriorated. His friends reported him injecting himself with a drug cocktail
offered by a nightclub friend. Which substance of abuse is likely to be the cause of his toxic presentation?
Answer: Methamphetamine (N)
 a. amitriptyline k. lamotrigine
b. aripiprazole l. lithium
c. atomoxetine m. marijuana
d. bupropion n. methamphetamine
e. caffeine o. methylphenidate
f. clomipramine p. quetiapine
g. fosphenytoin q. risperidone
h. fluoxetine r. topiramate
i. gabapentin s. valproate
j. haloperidol t. varenicline

10) A 41-year old female was seen by her psychiatrist as a follow up case of schizophrenia. She has been
diagnosed with schizophrenia 3 years ago and her negative symptoms been well-controlled with risperidone.
Her psychiatrist recently discovered that her serum glucose and cholesterol were very high and decided to
change her current antipsychotic therapy. What is the drug of choice to substitute her risperidone in
patient with metabolic syndrome?
Answer: Haloperidol (J)

11) A 9-year old girl was recently diagnosed with ADHD. Her past medical history revealed that she suffered
from Tourette’s syndrome (an inherited neuropsychiatric disorder). What is the first-line treatment of
choice for her ADHD symptoms?
Answer: Atomoxetine (C)
 a. acamprosate k. midazolam
b. amantadine l. nitrous oxide
c. bromocriptine m. propofol
d. carbamazepine n. rasagiline
e. desflurane o. rivastigmine
f. disulfiram p. selegiline
g. ethosuximide q. sevoflurane
h. flumazenil r. thiamine
i. levetiracetam S. vigabatrin
j. lorazepam t. zopiclone

12) A 37-year old male was recently seen by his GP. Over the past few months, the patient’s sleep pattern has dramatically
changed with frequent episodes of insomnia. All previous attempts of non-pharmacological approaches have failed and the
patient’s lack of sleep started affecting his job productivity. The GP has explored all pharmacological options for the patient
who refused all benzodiazepine agents due to a past history of abuse. What is the drug of choice to be prescribed for his
condition? Answer: Zopiclone (T)

13) A 41-year old female known with bronchial asthma was seen by her private surgeon as an outpatient case of breast
tissue lipoma. Her preoperative blood results revealed low estimated glomerular filtration rate (eGFR) of <40% with high
serum creatinine levels. In order to introduce rapid induction and recovery for her operation, what is the safest inhaled
anaesthetic agent of choice to be used to perform her operation? Answer: Desflurane (E)

14)A 71-year old male known with Parkinson’s disease was seen by his specialist. Over the past 4 months, the patient has
been experiencing “on-off” motor dysfunction more frequently for which a monoamine oxidase (MAO) type B inhibitor was
added to his dopamine-based therapy. The new therapy improved the patient’s motor function but insomnia was the main
side-effect challenging therapy compliance. His physician has substituted his (MAO) type B inhibitor with another agent
from the same class. What is the (MAO) type B inhibitor agent associated with a lower risk of insomnia? Answer:
Rasagiline (N)
 a. acamprosate k. midazolam
b. amantadine l. nitrous oxide
c. bromocriptine m. propofol
d. carbamazepine n. rasagiline
e. desflurane o. rivastigmine
f. disulfiram p. selegiline
g. ethosuximide q. sevoflurane
h. flumazenil r. thiamine
i. levetiracetam S. vigabatrin
j. lorazepam t. zopiclone

15) A 7-year old boy brought by his mother to the paediatric neurology clinic. Over the past 6 months, both
parents and school teacher have noticed that the child was behaving abnormally. His teacher reported him
experiencing ‘day dream-like’ symptoms with lack of response associated with abnormal blinking lasting for
few seconds. He has been diagnosed with absence seizure and his neurologist started him on a special
anticonvulsant therapy. What is the drug of choice to treat his condition? Answer: Ethosuximide (G)

16) A 29-year old male was transported by the police as a case of alcohol-related car accident. The
breathalyzer test (conducted by the police) revealed high alcohol levels. On hospital admission, the patient’s
level of consciousness was very low with an acidotic blood pH (pH 6.9) in room air. What is the treatment of
choice to be immediately administered together with folic acid to prevent Wernicke encephalopathy?
Answer: Thiamine (R)
 a. amantadine e. levithyroxine
b. carbemazole f. midazolam
c. carbamazepine g. nitrous oxide
d. I131 h. rasagiline

17) A 29 year old man is diagnosed with hyperthyroidism. His doctor wishes to prescribe
him a drug that is concentrated in the thyroid gland but may take up to 3 months to be fully
effective. It causes irreversible destruction of the colloid in the thyroid gland. What is the
name of this drug?
Answer: D (I131)
18) Which ONE of the following Parkinson’s therapies is contraindicated in patients with glaucoma?
a) Benztropine
b) Entacapone
c) Amantadine
d) Ropinirole
Answer: A
19) Which ONE of the following targets is the site of action of escitalopram?
a) Presynaptic norepinephrine reuptake receptors
b) Postsynaptic alpha-adrenergic receptors
c) Postsynaptic dopamine receptors
d) Presynaptic serotonin reuptake receptors
Answer: D
20) Which ONE of the following agents is approved for the management of ADHD?
a) Orlistat
b) Modafinil
c) Diethylpropion
d) Phentermine
Answer: B
21) Which ONE of the following statements is the rationale behind ‘levodopa-carbidopa’ combination?
a) Carbidopa enhances the GI absorption of levodopa
b) Levodopa enhances the CNS bioavailability of carbidopa
c) Carbidopa prevents the peripheral metabolism of levodopa
d) Levodopa prevents the peripheral metabolism of carbidopa
Answer: C
22) A 35 year old male patient, who has previously been diagnosed with asthma, presents to the clinic, with patchy
cream like plaques in his oropharynx. He is currently using salbutamol as a reliever, a combination of salmeterol and
fluticasone and montelukast orally every evening as controllers. He is diagnosed with oropharyngeal candidiasis. Which
ONE of the drugs in his therapeutic regimen is the most likely cause of his candidiasis?
a) Fluticasone
b) Salbutamol
c) Salmeterol
d) Montelukast

Answer: A
23) A 14 year old female with a history of allergic rhinitis presents to the clinic. She was previously prescribed loratadine.
Her symptoms are continuing and she is prescribed intranasal beclomethasone. Which ONE of the following is the most
likely adverse effect of nasal corticosteroid use?
a) Abdominal obesity
b) Osteoperosis
c) Diabetes Mellitus
d) Nasal Bleeds (Epistaxis)
Answer: D
24) A 40 year old woman with a history of weight loss tachycardia and suspected atrial fibrillation presents at the clinic.
On examination she has protruding eyes, a rapid heart rate and a mild goitre. Bloods are taken to confirm thyroid
function. Her doctor decides to operate to remove her thyroid. Which ONE of the following therapies would be used to
reduce the vascularity and function of the thyroid gland prior to surgery:
a) Carbimazole
b) Lugol’s iodine
c) Amiodarone
d) Triiodothyronine
Answer: B
Test 3

2017
 Hypothalamic and pituitary hormones

F a. somatropin inhibits the release of growth hormone

T b. follitropin-α increases the risk of an ectopic pregnancy
T c. oxytocin induces postpartum lactation
T d. leuprorelin is a gonadotropin-releasing hormone (GnRH) analogue
F e. bromocriptine is a dopamine antagonist

Regarding Androgens and Antiandrogens

T a. danazol is used in the treatment of endometriosis
T b. testosterone stimulates endogenous erythropoeitin production
F c. flutamide increases the risk of prostate cancer
T d. cyproterone acetate is used in the treatment of hirsuitism
F e. nandrolone is used in the treatment of erectile dysfunction

The following drugs reduce the efficacy of the progestin only pill:

T a. rifampicin
T b. griseofulvin
T c. nevirapine
F d. ampicillin
F e. erythromycin
 Alendronate
F a. is administered intravenously
T b. is used in the treatment of osteoporosis
T c. is more likely than pamidronate to cause oesophageal ulceration
F d. is more likely than calcitonin to cause allergic reactions
T e. increases osteoclast apoptosis

In the prevention of thrombus formation

F a. alteplase prevents the activation of factor Xa
T b. enoxaparin is less likely than heparin to cause drug induced thrombus formation
F c. the onset of the anticoagulant effect of warfarin is less than two hours
T d. aspirin prevents the synthesis of platelet thromboxane A2
T e. warfarin decreases the formation of factor VII
 In the management of coagulation disorders
T a. streptokinase cause the dissolution of physiological clots
F b. heparin inhibits the action of antithrombin III
T c. warfarin prevents the action of vitamin K epoxide reductase
F d. clopidogrel binds to platelet thromboxane A2
F e. rivaroxaban is safe to use in combination with spinal anaesthesia

In the treatment of anaemia

T a. parenteral iron therapy increases the risk for anaphylactic reactions
F b. folic acid is contraindicated in the treatment of acutely ill pernicious anaemia patients
T c. severe vitamin B6 deficiency causes peripheral neuropathy
T d. an overdose of iron tablets causes necrosis of the GIT
F e. folic acid antagonists cause pernicious anaemia

Antiretroviral agents

T a. tenofovir is best avoided in patients with renal failure

F b. emtricitabine is more likely than stavudine to cause peripheral neuropathy

T c. ritonavir prolongs the plasma half-life of lopinavir

T d. efavirenz is preferred to nevirapine in pregnant patients taking HAART (highly active

antiretroviral treatment)
F e. efavirenz blocks the binding of the HIV outer envelope protein gp120 to the CCR5 chemokine
receptor
 Agents used in the treatment of Mycobacterium tuberculosis
T a. a KatG mutation indicates resistance to isoniazid
T b. rifampicin decreases plasma concentrations of warfarin
F c. ethambutol inhibits mycobacterial mycolic acid synthesis
F d. pyrazinamide decreases blood uric acid levels
F e. bedaquiline has a half-life of 5 hours

Antiviral agents
T a. interferon has immunomodulatory effects
F b. acyclovir is inactivated by herpes thymidine kinase
T c. oseltamivir inhibits the release of progeny influenza virus from infected cells
F d. entecavir inhibits reverse transcriptase of HBV (Hepatitis B virus)
T e. probenecid decreases the renal elimination of acyclovir
 Which of the following statements are true or false regarding the action of
autonomic drugs and the cardiovascular system?
T a. propranolol is more likely than atenolol to cause bronchoconstriction in COPD
F b. doxazosin increases hypertrophy of the prostate gland
F c. ephedrine is an agonist at alpha-1-adrenoreceptors
T d. adrenaline (epinephrine) causes bronchial smooth muscle relaxation
F e. hyoscine blocks the activity of acetylcholine esterase

Drugs that interfere with the electrical conducting system of the heart
T a. atropine increases the rate of sinoatrial node depolarisation
T b. digoxin increases the sensitivity of muscarinic receptors in the atrial ventricular node
T c. bisoprolol blocks the action of adrenaline on the sinoatrial node
F d. dobutamine is an antagonist at beta-1-adrenoreceptors
F e. malathion inhibits the release of acetylcholine from the vagus nerve

The action of Diuretics on the kidney and cardiovascular system.

T a. indapamide increases the calibre (diameter) of arterioles in hypertension
F b. furosemide stimulates the activity of the Na+/K+ 2Cl- -pump in the ascending loop of the
loop of Henlé
F c. triamterene blocks the action of aldosterone at the collecting duct
T d. hydrochlorothiazide inhibits NaCl reabsorption at the distil convoluted tubule
T e. spironolactone increases the risk of hyperkalaemia in patients treated with losartan
 In the treatment of hypertension and heart failure
T a. captopril blocks the breakdown of bradykinin in the larynx
F b. verapamil blocks the action of angiotensin II on AT1-receptors
T c. diltiazem inhibits the entry of calcium in arteriolar vascular smooth muscle
F d. amlodipine increases the entry of calcium in myocardial contractile tissue
F e. losartan increases circulating levels of angiotensin I

Drugs used in angina

F a. nifedipine increases resistance in peripheral arteriolar vessels
T b. isosorbide mononitrate increases intracellular cGMP-levels in venous blood
vessels
T c. diltiazem prevents the nitrate-induced increase in sinoatrial node activity
F d. nitro glycerine increases left ventricular end-diastolic pressure
T e. propranolol decreases exercise induced tachycardia
 a. alendronate k. methyltestosterone
b. anastrozole l. nandrolone
c. cabergoline m. pamidronate
d. calcitonin n. pioglitazone
e. cyanocobalamin o. raloxifene
f. finasteride p. risedronate
g. glibenclamide q. strontium ranelate
h. gliclazide r. tetracosactide
i. liraglutide s. vildagliptin
j. metformin t. zoledronate

1) This oral hypoglycemic agent is used as monotherapy or in combination with other agents for optimal
glycemic control in type 2 diabetes patients. The agent is an incretin enhancer and works by inhibiting
dipeptidyl peptidase 4 (DPP-4) enzymes. What is the name of this drug?
Answer: Vildagliptin (S)

2) This agent is used in the treatment of type 2 diabetes along with diet and exercise. It works by lowering
blood sugar by making the cells of the body more sensitive to the action of insulin. This agent is an agonist at
the peroxisome proliferator-activated receptor – γ (PPARγ). It modulates the transcription of the insulin-
sensitive genes involved in the control of glucose metabolism in muscular tissues and in the liver. What is
the name of this drug?
Answer: Pioglitazone (N)

3) A 28 year-old obese woman with type 2 diabetes, diabetic retinopathy, hypertension, and hirsutism
presents to discuss an elevated prolactin level found by her gynaecologist two months ago. Her last
menstrual cycle was over a year ago. A repeat prolactin level was also elevated. What is the drug of choice
to decrease prolactin levels to normal range and restore gonadal function?
Answer: Cabergoline (C)
 a. alendronate k. methyltestosterone
b. anastrozole l. nandrolone
c. cabergoline m. pamidronate
d. calcitonin n. pioglitazone
e. cyanocobalamin o. raloxifene
f. finasteride p. risedronate
g. glibenclamide q. strontium ranelate
h. gliclazide r. tetracosactide
i. liraglutide s. vildagliptin
j. metformin t. zoledronate

4) A 21 year-old male, diagnosed with androgenetic alopecia arrives at the clinic to discuss hair loss
treatment. The dermatologist explains to the patient that the hair loss could be attributed to a combination
of hereditary as well as hormonal factors. The dermatologist prescribed a drug that blocks the conversion of
testosterone to dihydrotestosterone. This drug is also used in the treatment of benign prostatic hypertrophy.
What is the name of the drug that was prescribed?
Answer: Finasteride (F)

5) A 52 year-old obese woman developed polyuria, polydipsia and polyphagia. Her random blood glucose
was found to be 13mmol/l and she was diagnosed with Type 2 diabetes. She has no history of heart failure,
renal failure or lactic acidosis. Her physician decides to prescribe her an insulin sensitizer. What is the first
line drug of choice for this patient?
Answer: Metformin (J)
 a. abacavir k. isoniazid
b. acyclovir l. lopinavir/ ritonavir
c. amikacin m. maraviroc
d. atazanivir/ritonavir n. moxifloxacin
e. bedaquiline o. nevirapine
f. delamanid p. oseltamivir
g. emtricitabine q. rifampicin
h. ethambutol r. streptomycin
i. ethionamide s. tenofovir
j. foscarnet

6) A 30 year-old male presented to an MDR-TB facility after 1 month of treatment for MDR-TB with second
line TB drugs. He complained of abdominal pain, nausea and vomiting. Test results revealed elevated liver
enzymes. After considering other causes, he was diagnosed with drug-induced hepatitis. Which second line
agent is responsible for the hepatitis?
Answer: Ethionamide (I)

7) A 35 year-old male presented at his clinic after 1 month of treatment for primary drug susceptible TB
complaining of a tingling sensation in his hands and feet. The clinician attributed this to a drug in his TB
regimen and prescribed pyridoxine to control this adverse effect. Which drug in his first line TB regimen is
responsible for his peripheral neuropathy?
Answer: Isoniazid (K)

8) A 30 year-old female presents to the pharmacy explaining that she experienced a tingling, itching, burning
sensation around her mouth for the past 2 days with the emergence of a blister on her upper lip and
associated swelling. On examination, the pharmacist explained to her that it was a cold sore caused by a
Herpes simplex virus. Which topical antiviral would be the most suitable treatment for this patient?
Answer: Acyclovir (B)
 a. abacavir k. isoniazid
b. acyclovir l. lopinavir/ ritonavir
c. amikacin m. maraviroc
d. atazanivir/ritonavir n. moxifloxacin
e. bedaquiline o. nevirapine
f. delamanid p. oseltamivir
g. emtricitabine q. rifampicin
h. ethambutol r. streptomycin
i. ethionamide s. tenofovir
j. foscarnet

9) A 35 year-old male, recently diagnosed as HIV-positive was started on a fixed dose combination regimen
of tenofovir/emtricitabine/efavirenz. After 2 months of taking his ARV medications, he has developed an
acute psychosis. His physician wants to change the efavirenz in his regimen. What is the drug of choice to
replace efavirenz given the patient’s acute psychosis?
Answer: Nevirapine (O)

10) A 45 year-old, HIV-positive patient is being swopped over to a 2nd line regimen after failing a Tenofovir-
based 1st line regimen. He is prescribed zidovudine, lamivudine and lopinavir/ritonavir (LPV/r). Three
months after starting this regimen his fasting lipid panel, indicates dyslipidemia and his Framingham score
is adjudged as a 25% risk for developing a CVS event in 10 years. What is the medicine of choice to replace
lopinavir/ritonavir considering both his Framingham score and lipid panel results?
Answer: Atazanivir/ritonavir (d)
 a. dabigatran e. rivaroxaban
b. enoxaparin f. streptokinase
c. eptifibatide g. tenecteplase
d. prasugrel h. warfarin

11) This agent is given to select patients after a myocardial infarction, converts plasminogen to
plasmin and causes lysis of physiological clots. Antibody formation to this agent restricts its use.
What is the name of this drug?
Answer: Streptokinase (F)

12) A 36 year-old pregnant patient develops a pulmonary embolism during the 9th week of her
pregnancy. From the list above, choose the most appropriate and safest anticoagulant
medication for both the mother and the foetus?
Answer: Enoxaparin (B)
 a. alpha methyldopa k. furosemide
b. amiloride l. gemfibrozil
c. amlodipine m. indapamide
d. atorvastatin n. isosorbide mononitrate
e. bisoprolol o. losartan
f. captopril p. nifedipine
g. digoxin q. propranolol
h. diltiazem r. spirinolactone
i. dobutamine s. verapamil
j. doxazosin

13) This low ceiling diuretic agent is often used as an add-on agent to ACE or ARB therapy for the
treatment of hypertension. It has a moderate renal effect and also decreases total peripheral resistance
and causes hypokalemia as an adverse effect. What is the name of this drug?
Answer: Indapamide (M)

14) In the treatment of hypertension this drug is restricted to add on therapy after 2-3 other drugs have
been tried. It has a particular tendency to cause first dose hypotension and is also prescribed as a
treatment for benign prostatic hypertrophy. What is the name of this drug?
Answer: Doxazosin (J)

15) A 49 year old man with abdominal obesity is diagnosed with dyslipidemia having a fasting lipid panel
indicative of low HDL-C levels, high triglyceride levels. His cardiologist wishes to prescribe an agent used
in the treatment of dyslipidemia. The drug primarily lowers triglyceride, increases HDL-C, but has
marginal effects on LDL-C when compared to statins. What is the name of this drug?
Answer: Gemfibrozil (L)
 a. alpha methyldopa k. furosemide
b. amiloride l. gemfibrozil
c. amlodipine m. indapamide
d. atorvastatin n. isosorbide mononitrate
e. bisoprolol o. losartan
f. captopril p. nifedipine
g. digoxin q. propranolol
h. diltiazem r. spirinolactone
i. dobutamine s. verapamil
j. doxazosin

16) This calcium channel blocker is a potent vasodilator and acts on vascular smooth muscle but no
effect on the heart. Since it has a rapid onset of action, it has been reformulated into a slow release
drug that does not cause a reflex sympathetic response. What is the name of this drug?
Answer: Nifedipine (P)

17) In the management of stable angina, this beta-blocker has a major effect on limiting exercise
maximal heart rate and lowering myocardial oxygen consumption. It is generally considered to have
negligible effects on bronchiole smooth muscle. What is the name of this drug?
Answer: Bisoprolol (E)
18)A 54-year-old woman presents at a nearby clinic with complaints of hot flashes, vaginal dryness and decreased libido. The
patient has previously been informed about estrogen replacement therapy and requested more information about all the
benefits and risks associated with the different estrogen preparations. Which ONE of the following adverse effects is most
commonly associated with the administration of estrogen therapy?
a) Venous thromboembolism (VTE)
b) Osteoporosis
c) Acne
d) Dysmenorrhea
Answer: A
19) A 28 year-old married female suffering from polycystic ovarian syndrome (PCOS) has been trying to fall pregnant for the past
two years. She has consulted with her gynecologist about fertility treatment before visiting fertility specialists. Her gynecologist
informs her about the most common first-round intervention ovulation-induction medication and mentioned clomiphene
citrate. Which ONE of the following statements is the most accurate regarding clomiphene citrate?
a) Clomiphene is a selective estrogen receptor modulator
b) Clomiphene is contraindicated in patients with PCOS
c) Clomiphene decreases the risk of multiple pregnancies
d) Clomiphene inhibits the secretion of GnRH and gonadotrophins
Answer: A
20) A 28 year-old male was seen by his GP complaining of an acute cough, sore throat, rhinorrhea, congestion, body aches,
headache, chills, tiredness, diarrhoea and vomiting. His GP has informed him that his symptoms are possibly due to an influenza
virus, and ordered nasal and throat swabs for testing. The swab serology results came back positive for the H1N1 virus. What
ONE of the following is the antiviral of choice in this patient to treat his H1N1 infection?
a) Acyclovir
b) Oseltamivir
c) Lamivudine
d) Ganciclovir
Answer: B
21) A 54 year-old post-surgical woman is on anticoagulant therapy to prevent thrombus formation. She presents with a persistently
decreased platelet count and suffers an acute pulmonary embolism. Which ONE of the following agents is most likely responsible
for this event?
a) Heparin
b) Rivaroxiban
c) Warfarin
d) Aspirin
Answer: A
22) A 62 year-old man with heart failure is on a combination of captopril, carvedilol and spironolactone. Which ONE of the following
best describes his blood biochemistry after 2 months on this regimen?
a) hyponatraemia
b) hyperkalaemia
c) hypokalaemia
d) hypoernatraemia
Answer: B
23) A 49 year-old man with persistently high LDL-C levels and high triglyceride levels is seen by his cardiologist. He complains of
muscle pains (myopathy) on the highest dose of simvastatin. Which ONE of the following combinations is a suitable alternative to
treat his dyslipidemia and is associated with a lower risk of myopathy (muscle pain)?
a) atorvastatin + bezafibrate
b) rosuvastatin + ezetemibe
c) gemfibrozil + atorvastatin
d) bezafibrate + gemfibrozil
Answer: B
24)A 65 year-old man is diagnosed with heart failure and is prescribed enalapril, carvedilol and furosemide. The use of carvedilol in
the management of heart failure is explained by all of the following mechanisms EXCEPT:
a) reduction in resting heart rate
b) drop in total peripheral resistance
c) an increase in contractility
d) prevention of catecholamine induced damage
Answer: C