Bahri University

College of Medicine
Tutorial
Select only one correct answer:
1. Drug administered through the following route is most likely to be subjected
to first-pass metabolism:
A. Oral
B. Sublingual
C. Subcutaneous
D. Rectal

2. Alkalization of urine hastens the excretion of:

A. Weakly basic drugs
B. Weakly acidic drugs
C. Strong electrolytes
D. Nonpolar drugs

3. Majority of drugs cross biological membranes primarily by:

A. Passive diffusion
B. Facilitated diffusion
C. Active transport
D. Pinocytosis

4. Bioavailability of drug refers to:

A. Percentage of administered dose that reaches systemic circulation in the
unchanged form
B. Ratio of oral to parenteral dose
C. Ratio of orally administered drug to that excreted in the faeces
D. Ratio of drug excreted unchanged in urine to that excreted as metabolites

5. the most important factor governing absorption of a drug from intact skin is:
A. Molecular weight of the drug
B. Site of application
C. Lipid solubility of the drug
D. Nature of the base used in the formulation
6. If the total amount of a drug present in the body at a given moment is 2.0 g
and its plasma concentration is 25 μg/ml, its volume of distribution is:
A. 100 L
B. 80 L
C. 60 L
D. 50 L

7. The following attribute of a drug tends to reduce its volume of distribution:

A. High lipid solubility
B. Low ionization at physiological pH values
C. High plasma protein binding
D. High tissue binding

8. Marked redistribution is a feature of:

A. Highly lipid soluble drugs
B. Poorly lipid soluble drugs
C. Depot preparations
D. Highly plasma protein bound drugs

9. Which of the following is not true of the blood-brain barrier:

A. It is constituted by tight junctions between the endothelial cells of brain
capillaries and the glial tissue
B. It allows passage of lipid soluble drugs into the brain
C. It limits entry of highly ionized drugs into the brain
D. It regulates passage of substances from brain into blood

10. Weakly acidic drugs:

A. Are bound primarily to α1 acid glycoprotein in plasma
B. Are excreted faster in alkaline urine
C. Are highly ionized in the gastric juice
D. Do not cross blood-brain barrier

11. High plasma protein binding:

A. Increases volume of distribution of the drug
B. Facilitates glomerular filtration of the drug
C. Minimises’ drug interactions
D. Generally makes the drug long acting

12. Which of the following cytochrome P450 isoenzymes is involved in the

metabolism of largest number of drugs in human beings and has been
implicated in some dangerous drug interactions:
A. CYP 3A4
B. CYP 2C9
C. CYP 2E1
D. CYP 1A2

13. the most commonly occurring conjugation reaction for drugs and their
metabolites is:
A. Glucuronidation
B. Acetylation
C. Methylation
D. Glutathione conjugation

14. Microsomal enzyme induction can be a cause of:

A. Tolerance
B. Physical dependence
C. Psychological dependence
D. Idiosyncrasy

15. The following drug metabolizing reaction is entirely non microsomal:

A. Glucuronide conjugation
B. Acetylation
C. Oxidation
D. Reduction

16. Glomerular filtration of a drug is affected by its:

A. Lipid solubility
B. Plasma protein binding
C. Degree of ionization
D. Rate of tubular secretion
17. Drugs which undergo high degree of first-pass metabolism in liver:
A. Have low oral bioavailability
B. Are excreted primarily in bile
C. Are contraindicated in liver disease
D. Exhibit zero order kinetics of elimination

18. If a drug undergoes net tubular secretion, its renal clearance will be:
A. More than the glomerular filtration rate
B. Equal to the glomerular filtration rate
C. Less than the glomerular filtration rate
D. Equal to the rate of urine formation

19. The plasma half-life of penicillin-G is longer in the newborn because their:
A. Plasma protein level is low
B. Drug metabolizing enzymes are immature
C. Glomerular filtration rate is low
D. Tubular transport mechanisms are not well developed

20. If a drug is excreted in urine at the rate of 10 mg/hr at a steady-state plasma

concentration of 5 mg/L, then its renal clearance is:
A. 0.5 L/hr
B. 2.0 L/hr
C. 5.0 L/hr
D. 20 L/hr

21. If a drug is eliminated by first order kinetics:

A. A constant amount of the drug will be eliminated per unit time
B. Its clearance value will remain constant
C. Its elimination half-life will increase with dose
D. It will be completely eliminated from the body in 2 × half-life period

22. If a drug has a constant bioavailability and first order elimination, its
maintenance dose rate will be directly proportional to its:
A. Volume of distribution
B. Plasma protein binding
C. Lipid solubility
D. Total body clearance
23. When the same dose of a drug is repeated at half-life intervals, the steady-
state (plateau) plasma drug concentration is reached after:
A. 2–3 half lives
B. 4–5 half lives
C. 6–7 half lives
D. 8–10 half lives

24. The loading dose of a drug is governed by its:

A. Renal clearance
B. Plasma half life
C. Volume of distribution
D. Elimination rate constant

25. What is true in relation to drug receptors?

A. All drugs act through specific receptors
B. All drug receptors are located on the surface of the target cells
C. Agonists induce a conformational change in the receptor
D. Partial agonists have low affinity for the receptor

26. Study of drug-receptor interaction has now shown that:

A. Maximal response occurs only when all receptors are occupied by the drug
B. Drugs exert an ‘all or none’ action on a receptor
C. Receptor and drugs acting on it have rigid complementary ‘lock and key’
structural features
D. Properties of ‘affinity’ and ‘intrinsic activity’ are independently variable

27. A partial agonist can antagonise the effects of a full agonist because it has:
A. High affinity but low intrinsic activity
B. Low affinity but high intrinsic activity
C. No affinity and low intrinsic activity
D. High affinity but no intrinsic activity

28. Receptor agonists possess:

A. Affinity but no intrinsic activity
B. Intrinsic activity but no affinity
C. Affinity and intrinsic activity with a + sign
D. Affinity and intrinsic activity with a – sign

29. Which of the following is a G protein coupled receptor:

A. Muscarinic cholinergic receptor
B. Nicotinic cholinergic receptor
C. Glucocorticoid receptor
D. Insulin receptor

30. The following receptor has an intrinsic ion channel:

A. Histamine H1 receptor
B. Histamine H2 receptor
C. Adrenergic alfa receptor
D. GABA-benzodiazepine receptor

31. Select the receptor that is located intracellularly:

A. Opioid μ receptor
B. Steroid receptor
C. Prostaglandin receptor
D. Angiotensin receptor

32. All of the following sub serve as intracellular second messengers in receptor
mediated signal transduction except:
A. Cyclic AMP
B. Inositol trisphosphate
C. Diacyl glycerols
D. G proteins

34. The receptor transduction mechanism with the fastest time-course of

response effectuation is:
A. Adenylyl cyclase-cyclic AMP pathway
B. Phospholipase C-IP3: DAG pathway
C. Intrinsic ion channel operation
D. Protein synthesis modulation

35. Down regulation of receptors can occur as a consequence of:

A. Continuous use of agonists
B. Continuous use of antagonists
C. Chronic use of CNS depressants
D. Denervation

36. When therapeutic effects decline both below and above a narrow range of
doses, a drug is said to exhibit:
A. Ceiling effect
B. Desensitization
C. Therapeutic window phenomenon
D. Nonreceptor mediated action

37. Drug efficacy’ refers to:

A. The range of diseases in which the drug is beneficial
B. The maximal intensity of response that can be produced by the drug
C. The dose of the drug needed to produce half maximal effect
D. The dose of the drug needed to produce therapeutic effect

38. Which of the following is always true:

A. A more potent drug is more efficacious
B. A more potent drug is safer
C. A more potent drug is clinically superior
D. A more potent drug can produce the same response at lower doses

39. Higher efficacy of a drug necessarily confers:

A. Greater safety
B. Therapeutic superiority
C. Capacity to produce more intense response
D. Cost saving

40. The therapeutic index of a drug is a measure of it’s:

A. Safety
B. Potency
C. Efficacy
D. Dose variability

41. If the effect of combination of two drugs is equal to the sum of their
individual effects, the two drugs are exhibiting:
A. Potentiation
B. Addition
C. Cross tolerance
D. Antagonism
42. The antagonism between adrenaline and histamine is called ‘physiological
antagonism’ because:
A. Both are physiologically present in the body
B. They act on physiological receptors
C. Both affect many physiological processes
D. They have opposite physiological effects

43. A drug ‘R’ producing no response by itself causes the log dose-response
curve of another drug ‘S’ to shift to the right in a parallel manner without
decreasing the maximal response: Drug ‘R’ is a:
A. Partial agonist
B. Inverse agonist
C. Competitive antagonist
D. Noncompetitive antagonist

44. A drug which does not produce any action by itself but decreases the slope
of the log dose-response curve and suppresses the maximal response to another
drug is a:
A. Physiological antagonist
B. Competitive antagonist
C. Noncompetitive antagonist
D. Partial agonist

45. The pharmacokinetics of drugs in the neonate differs from that in adults,
because their:
A. Intestinal transit is fast
B. Drug metabolizing enzymes are overactive
C. Tubular transport mechanisms are not well developed
D. Glomerular filtration rate is high

46. In an anaesthetized dog, repeated intravenous injection of ephedrine shows

the phenomenon of:
A. Anaphylaxis
B. Tachyphylaxis
C. Idiosyncrasy
D. Drug resistance
47. An undesirable effect of a drug that occurs at therapeutic doses and can be
predicted from its pharmacological actions is called:
A. Side effect
B. Toxic effect
C. Allergic reaction
D. Idiosyncrasy

48. Which of the following is a type B (unpredictable) adverse drug reaction:

A. Side effect
B. Toxic effect
C. Idiosyncrasy
D. Physical dependence

49. The side effect of a drug which has been used as atherapeutic effect in
another condition is:
A. Constipation caused by codeine
B. Cough caused by captopril
C. Uterine stimulation caused by quinine
D. Diarrhoea caused by ampicillin

50. A ‘toxic effect’ differs from a ‘side effect’ in that:

A. It is not a pharmacological effect of the drug
B. It is a more intense pharmacological effect that occurs at high dose or after
prolonged medication
C. It must involve drug induced cellular injury
D. It involves host defense mechanisms
51. Which of the following antimuscarinic drugs is used by inhalation in
the treatment of bronchial asthma?
a. Dicyclomine hydrochloride
b. Cyclopentolate hydrochloride
c. Ipratropium bromide
d. Methscopolamine bromide

52. The cholinesterase inhibitor that is used in the diagnosis of myasthenia

gravis is
a. Edrophonium chloride
b. Ambenonium chloride
c. Malathion
d. Physostigmine salicylate
53. A 58-year-old male with angina is treated with atenolol. Select the
Mechanism of action of atenolol
a. α-adrenergic agonist
b. α-adrenergic antagonist
c. β-adrenergic agonist
d. β-adrenergic antagonist
54. A male patient is brought to the emergency department (ED) following
ingestion of an unknown substance. He is found to have an elevated
temperature, hot and flushed skin, dilated pupils, and tachycardia. Of the
following, which would most likely cause these findings?
a. Propranolol
b. Atropine
c. Prazosin
d. Guanethidine
55. A 16-year-old male treated for bronchial asthma develops skeletal
Muscle tremors. Which of the following agents may be responsible for this
finding?
a. Ipratropium
b. Zileuton
c. Salmeterol
d. Cromolyn
56. Which of the following agents might mask the hypoglycemia in treated
Diabetics?
a. An α-adrenergic agonist
b. An α-adrenergic antagonist
c. A β-adrenergic agonist
d. A β-adrenergic antagonist
57. Following are irreversible anti-cholinesterases, except
a. Parathion
b .Pyridostigmine
c. Dyflos
d. Ecothiopate

58. Pralidoxime chloride is a drug that

a. Reduces the vesicular stores of catecholamines in adrenergic and
dopaminergic neurons
b. Blocks the active transport of choline into cholinergic neurons
c. Reactivates cholinesterases that have been inhibited by
organophosphate cholinesterase inhibitors
d. Stimulates the activity of phospholipase C with increased formation of
inositol triphosphate
59. Of the many types of adrenergic receptors found throughout the body,
which is most likely responsible for the cardiac stimulation that is observed
following an intravenous injection of epinephrine?
 a. α1-adrenergic receptors
b. α2-adrenergic receptors
c. β1-adrenergic receptors
d. β2-adrenergic receptors

60. Both phentolamine and prazosin

a. Are competitive antagonists at α1-adrenergic receptors
b. Have potent direct vasodilator actions on vascular smooth muscle
c. Enhance gastric acid secretion through a histamine-like effect
d. Cause hypotension and bradycardia