LECTURE 1: WHAT IS PHARMACOLOGY?

1. Which phase of controlled trials evaluates the overall risk-benefit ratio in a demographically
diverse sample?
A. Phase I
B. Phase II
C. Phase III
D. Phase IV

2. Which factors are not evaluated during phase II of controlled trials?

A. Pharmacokinetics
B. Pharmacodynamics
C. Bioavailability
D. Pharmacoeconomics

3. What is the duration of study for phase IV controlled trials?

A. Up to 1 month
B. 2-3 months
C. 2-3 years
D. 9-10 years
E. Ongoing following FDA approval

4. Pharmacogenomics refers to the study of

A. The many different genes that determine the variability of drug response
B. Scientific discipline that compares the value of one pharmaceutical drug or drug therapy
to another
C. Adverse effects of chemicals on living organism
D. Inherited differences (variation) in drug metabolism and response

5. What refers to the study of inherited differences (variation) in drug metabolism and response?
A. Pharmacogenomics
B. Pharmacogenetics
C. Pharmacoeconomics
D. Pharmacodynamics
E. pharmacokinetics

6. Patients with ancestry from areas in which HLA B*1502 is present should be screened for
the HLA B*1502 allele before starting treatment with
A. Carbamazepine
B. Flumazenil
C. Dabigatran
D. Digoxin
E. Neostigmine
 7. What is the objective of phase I controlled trials?
A. Monitor ongoing safety in large populations
B. Obtain additional info regarding effectiveness on clinical outcomes and evaluate overall
risk-benefit ratio
C. Determine short term side effects and identify common risks for specific population and
disease
D. Determine metabolic and pharmacological actions and maximally tolerated dose

8. Which phase of controlled trials is designed as randomized and controlled with a broader
eligibility criteria?
A. Phase I
B. Phase II
C. Phase III
D. Phase IV

LECTURE 2: HOW DRUGS WORK?

1. What is efficacy?
A. Tendency of drug to bind and form stable complex with the receptor
B. Tendency of drug to bind and form unstable complex with the receptor
C. Capacity of drug to initiate a response once it occupies the receptor site
D. Ability of drug to produce a maximum response
E. Measure of drug activity expressed in terms of amount required to produce an effect of
given intensity

2. Which of the following is defined as the measure of drug activity expressed in terms of
amount required to produce an effort of given intensity?
A. Efficacy
B. Affinity
C. Intrinsic activity
D. Pharmacodynamics
E. Potency

3. Which of the following receptors is located on the surface of membrane?

I ligand ion gated channels
II G-Protein coupled receptors
III receptor kinase
IV nuclear receptor

A. I and II
B. III and IV
C. I, II and III
D. I, II and IV
E. All of the above
4. Which of the following receptors function by undergoing direct coupling?
I ligand ion gated channels
II G-Protein coupled receptors
III receptor kinase
IV nuclear receptor

A. I and II
B. I and III
C. II and IV
D. III and IV
E. None of the above

5. Steroid receptors are example of what type of receptors?

A. Ligand gated ion channel
B. G-protein coupled receptors
C. Receptor kinase
D. Nuclear receptor

6. Which of the following are examples of ligand gated ion channels?

I Nicotinic Ach receptor
II Muscarinic Ach receptor
III GABAA receptor
IV cytokine receptor

A. I and II
B. I and III
C. II and IV
D. III and IV
E. None of the above

7. What is the mechanism of action of sildenafil?

A. Reverse side effects of anticoagulant heparin
B. Blocks sodium pump
C. Inhibit phosphodiesterase and preventing cAMP from being hydrolysed
D. Bind to GABA receptor and facilitates opening of channel
E. Blocks proton pump

8. Ahmad who had just recently underwent a heart surgery has been prescribed a medication to
prevent and reduce the risk of acquiring bacterial endocarditis. The doctor explained to
Ahmad that the drug prescribed works by interfering in bacterial cell wall synthesis. The drug
is most probably
A. Tetracycline
B. Aspirin
C. Lignocaine
D. Desferrioxamine
E. Penicillin
 9. Which drug acts by blocking proton pump?
A. Omeprazole
B. Digoxin
C. Lignoxaine
D. Penicillin
E. Tetracycline

10. Match the following drugs with its correct statement

A neostigmine
B omeprazole
C Al(OH)3
D tetracycline
E penicillin
F lignocaine
G fludocortisone

i) Block Na+ channels in pain neuron

ii) Acts reversibly on acetylcholinesterase
iii) Blocks H+ pump
iv) Neutralize gastric acid
v) Replace aldosterone
vi) Inhibit bacterial protein synthesis
vii) Interferes in bacterial cell wall synthesis

LECTURE 3: PHARMACOKINETICS I
1. Which of the following are advantages of rectal route of administration?
I Avoid first pass metabolism
II Rapid absorption
III Stable environment for drug absorption
IV Convenient for infants and unconscious patients

A. I, II and III
B. II, III and IV
C. I, II and IV
D. I, II, III and IV
E. None of the above

2. Which of the following routes of administration can be used i)to administer irritating
solutions and ii) method it is administered?
A. i) intravenous route ii)slowly
B. i) intravenous route ii)quickly
C. i) intramuscular route ii)slowly
D. i)intramuscular route ii)quickly

3. Which of these drugs will delay penicillin’s excretion, causing its effect to be prolonged?
A. Tetracycline
B. Clindamycin
C. Probenecid
D. Erythromycin
 E. Benzodiazepine

4. Rate and extent of drug distribution depends mainly on

I Tissue blood perfusion
II Drug molecular size
III Tissue binding
IV Drug plasma protein binding

A. I and II
B. II and III
C. I, II and IV
D. II, III and IV
E. All of the above

5. Which of the following drugs will lead to yellowing of teeth and retardation of bone growth?
A. Thiopentone
B. Heparin
C. Diazepam
D. Tetracycline
E. Chloroquine

6. Fill in the blanks with the correct word for first pass effect,
“First pass effect is the degradation of drug by tissue/organ that is found along the journey
when the drug travels from the point it is _________ till it reaches the________ circulation.”

A. administered; pulmonary
B. metabolized; pulmonary
C. administered; systemic
D. metabolized; systemic

7. Which of the following are the reasons that systemic bioavailability,F is lower when drug is
administered orally?
I First pass metabolism
II incomplete drug absorption
III improper drug formulation
IV poor dissolution of drug tablets

A. I and II
B. III and IV
C. I, II and IV
D. II, III and IV
E. All of the above

8. Abu has recently been complaining of chest pain for the past few days. When the GP obtained
a history from him, the GP found out that Abu has been diagnosed with coronary heart
disease few years back. The GP proceeds to prescribe nitroglycerin, a drug used to treat his
chest pain (angina pectoris). How is this drug administered?
 A. Buccal
B. Sublingual
C. Rectal
D. Intravenous
E. Intramuscular

9. Which of these routes of administrations is able to bypass “first pass” hepatic effects?
I oral
II sublingual
III inhalation
IV transdermal

A. I, II and IV
B. I, III and IV
C. II, III and IV
D. All of the above
E. None of the above
10. Which of these routes of administration can be used for rapid and emergency use?
A. Intravenous
B. Intramuscular
C. Oral
D. Rectal
E. Sublingual

11. Which of these are the characteristics of the bound form of drug during distribution?
I pharmacologically inactive
II non-reversible
III non-diffusible
IV non-specific

A. I,II and III

B. II, III and IV
C. I, II and IV
D. I ,III and IV
E. All of the above

12. Match of the following with the correct statements

A chloroquine
B thiopentone
C sulphonamides
D radioactive iodine
E tetracycline
F phenylbutazone

i) Displaces warfarin, causing increase in free warfarin and thus, leads to excessive
bleeding
ii) Displaces bilirubin, causing kernicterus in newborns
iii) Yellowing of teeth and retardation of bone growth
iv) Accumulates in fat
v) Accumulates in eyes, causing retinopathy
vi) Accumulates in thyroid gland
LECTURE 4: PHARMACOKINETICS II
1. Which of the following is NOT the mechanism involved in phase II metabolism?
A. Dealkylation
B. Glucuronidation
C. Sulfation
D. Acetylation
E. Glutathione conjugation

2. During paracetamol poisoning, accumulation of which of the following substance will lead to
cell necrosis and liver failure?
A. GSH transferase
B. Glutathione
C. Glucuronide sulphate
D. NAPQI
E. N-acetylcysteine

3. During paracetamol poisoning, which of the following can be given to replenish GSH for the
detoxification of NAPQI?
A. Tetracycline
B. Erythromycin
C. Penicilin
D. Clindamycin
E. N-acetylcysteine

4. Which organ below is the main organ

5. of drug metabolism
A. Kidney
B. Liver
C. Lung
D. Heart
6. Which of these drugs can act to inhibit liver metabolizing enzymes?
A. Carbamazepine
B. Rifampicin
C. Ketoconazole
D. Barbiturates
E. Polychlorinated biphenyls

7. Puan Aida had been complaining to her husband that their newborn son has been vomiting
frequently and has loss of appetite. The newborn is also cyanosed and has an irregular
respiration rate. Upon inspection, the doctor had diagnosed the baby to have “grey baby”
syndrome. Accumulation of which of the following drugs will cause the condition?
A. Carbamazepine
B. Chloramphenicol
C. Ketoconazole
D. Clindamycin
E. Neostigmine
8. Which of the following are factors affecting renal drug secretion rate?
I carrier saturation
II drug transfer rates across tubular membranes
III degree of drug-plasma protein binding
IV rate of drug delivery to secretory sites

A. I, II and III
B. I, II and IV
C. II, III and IV
D. I, III and IV
E. All of the above

9. Which of these is related to the following statement

“Process that modifies/transforms the molecule of a drug endogenously into a different
chemical entity”
A. Biotransformation
B. Bioavailability
C. Pharmacokinetics
D. Pharmacodynamics
E. Pharmacogenomics

10. Which of these are characteristics of phase 1 reaction?

I synthetic
II conjugation
III non-synthetic
IV functionalization

A. I and II
B. III and IV
C. I and III
D. II and IV
E. All of the above

11. Which enzyme is the main enzyme for reduction reaction?

A. Esterase and amidase
B. Sulphotransferases
C. Cytochrome P450
D. UDP-glucuronosyltransferase (UGT)
E. N-acetyltransferases

12. Which of these reactions occur in the smooth endoplasmic reticulum?

I oxidation
II reduction
III glucuronidation
IV sulphation
A. I and II
B. III and IV
C. I, II and III
D. II, III and IV
E. All of the above
LECTURE 5: CYTOCHROME P450 + DRUGS METABOLISM
1. Which of the following enzymes are most abundant?
A. CYP1A2
B. CYP3A4
C. CYP4A11
D. CYP2C19
E. CYP2E1

2. Which of the following name is given to a foreign chemical substance which is not produced
by the body?
A. Antibiotics
B. Exobiotics
C. Endobiotics
D. Xenobiotics

3. Which of the following are other P450 catalysed reactions

I hydroxylation
II deamination
III N-dealkylation
IV O-dealkylation

A. I and II
B. III and IV
C. I, II and IV
D. II, III and IV
E. All of the above

4. In which of the following cases will GSH be depleted, leading to paracetamol poisoning?
A. Fasting
B. Strenuous exercise
C. Adequate food intake
D. Sedentary lifestyle
E. Stress

5. Which of the following is not a component of the mixed-function oxygenase (MFO) system?
A. Oxygen
B. NADPH
C. Cytochrome P450
D. Cytochrome P450 reductase
E. Proton

6. Which of these are NOT a factor affecting rate of drug metabolism?

A. Liver blood flow
B. Intrinsic clearance
C. Plasma protein binding of drug
D. Route of administration
E. None of the above
 7. Which of these drugs can lead to a drop in warfarin metabolism, hence increasing the
warfarin effect?
A. Cimetidine
B. Phenobarbitone
C. Phenytoin
D. Rifampicin
E. Carbamazepine

8. What will an inducer cause?

A. Increase the amount of isozymes and increase metabolism
B. Decrease the amount of isozymes and increase metabolism
C. Increase the amount of isozymes and decrease metabolism
D. Decrease the amount of isozymes and decrease metabolism
E. None of the above

9. Which of the following is true regarding drug metabolism?

A. Highly plasma protein bound drugs increases the chances of free drugs formation
B. High drug affinity to enzyme minimizes the metabolism of drugs
C. Reduced blood flow to liver increases the rate of metabolism process
D. Impaired kidney function will in general decrease the excretion of drug metabolites, thus
increasing the toxicity

LECTURE 6: DRUGS AFFECTING PARASYMPATHETIC SYSTEM

1. Which of the following is FALSE regarding parasympathetic nervous system?
A. Originates from brain and sacral area
B. Short preganglionic and long postganglionic fibres
C. Ganglia located near effector organs
D. Limited distribution
E. Discrete type of response

2. Which of these are the site of origin for the parasympathetic nervous system?
I Brain
II Thoracic region of spinal cord
III lumbar region of spinal cord
IV sacral region of spinal cord

A. I and II
B. III and IV
C. II and III
D. I and IV
E. II and IV
3. Which of the following is NOT an effect of parasympathetic nervous system?
A. Constriction of pupils
B. Stimulation of salivation
C. Slowing of heartbeat
D. Stimulates bile release
E. Relaxes bladder

4. What are the 2 main neurotansmitters in the autonomic nervous system?

I dopamine
II GABA
III acetylcholine
IV noradrenaline

A. I and II
B. I and IV
C. II and III
D. II and IV
E. III and IV

5. Which of these substances can act to inhibit the transport of choline?

A. Botulinum toxin
B. Spider venom
C. Hemicholinium
D. Acetylcholinesterase
E. Neostigmine

6. What is the effect of parasympathetic stimulation to cardiac activity?

A. Decrease heart rate and increase contractility
B. Increase heart rate and decrease contractility
C. Decrease heart rate and decrease contractility
D. Increase heart rate and increase contractility
E. No effect

7. AV nodal conduction can be enhanced by increased sympathetic activity or by blocking

parasympathetic function. Which of these can act to block the parasympathetic function?
A. Atropine
B. Edrophonium
C. Neostigmine
D. Physostigmine
E. Echothiopate
8. Myasthenia gravis is an autoimmune disease associated with a reduced number of functional
skeletal muscle nicotinic receptors. Which of these can be used for the diagnosis of
Myasthenia gravis?
A. Neostigmine
B. Edrophonium
C. Physostigmine
D. Donezepil
E. Rivastigmine

9. Match the following drugs to their correct statement

A. Donezepil
B. Ecothiopate
C. Edrophonium
D. Neostigmine
E. Chloramphenicol
F. Bethanechol
G. Ethambutol

i) Diagnosis of Myasthenia gravis

ii) Treatment of Myasthenia gravis
iii) Slowing progression of Alzheimer’s disease
iv) Treatment of glaucoma
v) Treatment of urinary retention

10. Which of the following muscarinic receptor subtypes is associated with the control of the
heart?
A. M1
B. M2
C. M3
D. M4
E. M5

11. Sjogren’s syndrome is an autoimmune disorder whereby the salivary and lacrimal glands are
attacked by mistake due to autoimmunity, causing dry mouth and dry eyes. Which of these
drugs can be used clinically for patients with this condition?
A. Pilocarpine
B. Neostigmine
C. Cevimeline
D. Phenobarbital
E. Digoxin

12. Which of these is not the adverse effects of antimuscarinics?

A. Blurred vision
B. Dry mouth
C. Urinary retention
D. Diarrhea
E. Tachycardia
ANS
L1:
1. C
2. D
3. E
4. A…..D is pharmacogenetics and B is pharmacoeconomics
5. B
6. A
7. D….A is IV, B is III and C is II
8. C

L2:
1. D…..A is affinity, C is intrinsic activity and D is potency
2. E
3. C…..IV is intracellular
4. B….A and C is direct, B is G protein and D is via DNA
5. D
6. B….I is ligand ion, II is GPCR, III is ligand ion and IV is receptor kinase
7. C….A is protamine sulphate, B is digoxin, D is benzodiazepine and E is omeprazole
8. E….A is inhibit bacterial protein synthesis, B is COX-1 inhibitor, C blocks Na+ channel in
pain neuron and D binds to heavy metal in poisoning
9. A…B blocks Na pump, C blocks Na+ channel in pain neuron, D inhibit bacterial cell wall
synthesis and E inhibit bacterial protein synthesis
10. i) F
ii)A
iii)B
iv)C
v)G
vi)D
vii)E

L3:
1. B….A is reduced (50%)
2. A
3. C
4. E
5. D…A accumulates in fat, B is bleeding, C is liver disease and D is retinopathy
6. C
7. E
8. B
9. C
10. A
11. D….II is reversible
L4:
1. A
2. D
3. E
4. B
5. C…others all induce
6. B
7. E
8. A
9. B…..I and II is phase 2
10. C…A is hydrolysis, B is sulphation, D is glucuronidation and E is acetylation
11. C…IV cytosol

L5:
1. B
2. D
3. E
4. A
5. E…B -> NADPH is proton carrier
6. D
7. A…B causes increase warfarin metabolism and decrease warfarin effect
8. A
9. D

L6:
1. B
2. D…other 2 is sympathetic
3. E
4. E
5. C
6. C
7. A….B to diagnose MG, C and D for Tx MG, E is cholinesterase inhibitor (also D)
8. B….A Tx, B is glaucoma Tx, D and E is for Alzheimers
9. i) C
ii) D
iii)A
iv)B
v)F
10. B…A is for glands (salivary), C is GIT exocrine glands, D and E is CNS
11. C…A is glaucoma and B is MG Tx
12. D (constipation)