ALTAMASH INSTITTE OF DENTAL MEDICINE

DEPARTMENT OF PHARMACOLOGY
2ND YEAR BDS
MID TERM EXAM PHARMACOLOGY
Total marks: 90
th
DATE: 9 May 2016 Time: 2hrs
NAME: _________________________________________
ROLL NUMBER:______________
INSTRUCTIONS:

⮚ Choose the best answer

⮚ Each question carries 1 mark

⮚ There is no negative marking

⮚ If mark more than one, the question will be cancelled

Section 1: BCQs

1. A farmer came to the emergency with excessive body secretions

and delirium. The doctor saved his life as he knew that
poisoning by insecticides should be treated with
a. Dimercaprol
b. Pralidoxime
c. Physiostigmine
d. Protamine Sulphate

2. Which of the following is a Class- 4 Anti-arrhythmic drug:

a. Encainamide
b. Metoprolol
c. Quinidine
d. Verapamil

3. Therapeutic index is the ratio and gives the concept of which

property of the drug:
a. Excretion of drug
 b. Distribution of drug
c. Potency of drug
d. Toxicity of drug

4. If 2 drugs show comparable bioavailability they are termed as

having:
a. Antagonist
b. Bioequivalence
c. Therapeutic equivalence
d. Synergism

5. Which purgative agent gets stimulated in small intestine in to

ricinoleic acid:
a. Bisacodyl
b. Cascara
c. Castor oil
d. Senna
6. A 49 years old male was kept on multiple drugs for his high
blood pressures and diabetes. After some time of therapy he
developed dry cough. Which of the following drug could be
responsible for this problem:
a. Enalapril
b. Losartan
c. Propranolol
d. Verapamil

7. Which of the following antimuscaranic agent is used for the

treatment of asthma and COPD:
a. Atropine
b. Glucopyrrolate
c. Ipratropium
d. Pirenzepine

8. Which of the following is a mast cell stabilizing drug given for

asthmatic prophylaxis:
a. Ipratropium bromide
b. Montelukast
c. Nedocromil sodium
d. Prednisolone

9. Which of the following anti-inflammatory drug (NSAID) blocks

prostaglandins by irreversible acetylation thus inhibits
cyclooxygenases:
a. Acetaminophen
b. Aspirin
c. Diclofenac
d. Ibuprofen

10. Killing or removal of all microorganisms including spores is

known as:
a. Antiseptic property
b. To Disinfect
c. Sterilization
 d. To Synergize

11. Which of the following non selective beta-blocker can be given

for the prophylaxis of migraine
a. Atenolol
b. Carvedilol
c. Esmolol
d. Propranolol
12. Select the direct acting potassium sparing diuretic:
a. Amiloride
b. Chlorthiazide
c. Furosemide
d. Mannitol

13. Which of the following addictive anti tussive drug can lead to
pin point pupils and severe constipation:
a. Acetylcystiene
b. Codeine
c. Morphine
d. Dexomethorphen
14. Which of the following volatile oil is used in carminative
mixtures :
a. Canola oil
b. Cod liver oil
c. Corn oil
d. Peppermint oil

15. Which of the following drug leads to irreversible inhibition of

proton pump at the parietal cells
a. Famotidine
b. Misoprostol
c. Pantoprazole
d. Pirenzepine

16. Identify the drug used for peptic ulcer treatment which can lead
to reversible anti- androgenic effects of gynecomestia, impotence
and decreased sperm count:
a. Cimetidine
b. Esmoprazole
c. Pirenzepine
d. Sucralfate

17. Which of the following local anesthetics is a useful

antiarrhythmic agent?
a. Bupivacaine
b. Cocaine
c. Lidocaine
d. Ropivacaine

18. Gradual decrease in response of a drug is known as:

a. Idiosyncracy
b. Hyporeactivity
c. Tachyphylaxsis
d. Tolerance
19. Identify the Para-sympathomimetic drug used to diagnose
Myasthenia Gravis and also differentiate it from cholinergic
crises:
a. Echothiophate
b. Edrophonium
c. Neostigmine
d. Physostigmine

20. A 13 years old female accidently ingest toxic amount of

Acetaminophen. What is the most likely pathology which can
lead to death due to this overdose :
a. Acute nephropathy
b. Heart block
c. Acute liver failure
d. Status asthmaticus

21. Select the inotropic cardiac glycoside used for the treatment of
heart failure:
a. Digoxin
b. Domperidone
c. Dopamine
d. Doxazocin
22. A 34 years old male suffering from cerebral edema is best
treated with:
a. Amiloride
b. Ethacrynic acid
c. Furosemide
d. Mannitol

23. Which of the following is a non-sedating second generation

antihistamine agent:
a. Dimenhydrate
b. Diphenhydramine
c. Loratidine
d. Phineramine

24. Which of the following anti-arrhythmic agent working on K, Ca

and Na channels can lead to fatal pulmonary fibrosis and thyroid
dysfunction :
a. Amidarone
b. Disopyramide
c. Esmolol
d. Procainamide

25. A physician may use insulin to counteract the hyperglycemic

effects of glucocorticoids; this is an example of what kind of
antagonism?
a) Chemical
b) Competitive
c) Irreversible
d) Physiological

26. Half-life of a drug is directly proportional to its:-

a) Volume of distribution.
b) Renal clearance
c) Rate of metabolism.
 d) Rate of absorption.

27. Absorption of vitamin B12 which is a very large molecule

complexed with binding protein crosses the gut by which one of
the following process of permeation:
a) Lipid Diffusion
b) Aqueous Diffusion
c) Facilitated diffusion
d) Endocytosis

28. Acetyl choline is synthesized by the catalytic action of:

a. Dopa decarboxylase
b. Tyrosine hydroxylase
c. Choline acetyl transferase
d. Acetyl Choline esterase

29. Production of Nitrous Oxide which leads to generation of GMP,

use to decrease blood pressure is the main mechanism of which
of the following drug:
a. Atenolol
b. Clonidine
c. Nitroglycerine
d. Verapamil

30. Which of the following prostaglandin is long acting and used

topically for the treatment of glaucoma
a. Alprostadil
b. Carboprost
c. Latanoprost
d. Misoprostol

31. A competitive antagonist is a substance that:

a. Interacts with receptor and produces submaximal response

b. Binds to receptor and progressively inhibits the response of
agonists
c. Binds to non-specific site of tissue
d. Binds to one receptor as an agonist and to other receptor as
antagonists
32. The increase in second messengers (cAMP, cGMP)
concentration leads to:
a. Inhibition of intracellular protein kinases and protein
phosphorylation
b. Blocking of interaction between receptor and effector
c. Protein kinases activation and protein phosphorylation
d. Antagonism with endogenous ligands

33. What term is used to describe a more gradual decrease in

responsiveness to a drug, taking days and weeks to develop:
a. Refractoriness
b. Cumulative effect
c. Tolerance
d. Tachyphylaxsis

34. Select the best treatment for a patient suffering from chronic
heart failure and diabetes:
a. Verapamil
b. Chlorothiazide
c. Propranolol
d. Lisinopril

35. Kernicterus or severe jaundice in neonates treated with

sulphonamides is due to:
a. Enhanced synthesis of bilirubin
b. Displacement of bilirubin from albumin
c. Inhibition of bilirubin excretion
d. Defective metabolism of bilirubin

36. Which of the following term refer to rapid diminution of tissue

sensitivity to a drug after administration?
a. Hypersensitivity
b. Hyporeactivity
c. Idiosyncrasy
d. Tachphylaxsis

37. Safety of the drug is determine by which of the following:

a. Potency of the drug
b. Selectivity of the drug
c. Therapeutic index
d. Efficacy of the drug
38. Patients complain of dry sandy eyes when receive large doses of
a. Atropine
b. Hexamethonium
c. Pilocarpine
d. Carbachol

39. Which of the following processes proceeds in the second phase

of biotransformation?
a) Acetylation
b) Reduction
c) Oxidation
d) Hydrolysis

40. A 60-year-old asthmatic man comes in for a checkup and

complains of headache and rapid heartbeat. Physical examination
indicates that the man has a blood pressure of 160/100 mm Hg.
Which of the following medications would be useful in treating
the condition?
a) Metoprolol
b) Phentolamine
c) Propranolol
d) Labetolol

41. Indicate the reversible cholinesterase inhibitor, which penetrates

the blood-brain barrier:
a) Physostigmine
b) Edrophonium
c) Neostigmine
d) Pyridostigmine

42. A student is asked during the viva examination to name the most
suitable drug affecting the autonomic nervous system to treat
premature labour. The answer would be:
a) Bethanechol
b) Norepinephrine
c) Phenylephrine
 d) Ritodrine

43. Cinchonism , a syndrome causing nausea, vomiting tinnitus and

vertigo is an adverse effect of which of the following drugs.
a) Artimisinin
b) Pyrimithamine
c) Quinine
d) Mefloquine

44. The phenomenon of “ANTAGONISM” is seen in the case of,

a) Norepinephrine and propranolol on bronchioles
b) Physostigmine and adrenaline on pupil
c) Acetylcholine and epinephrine on heart
d) Cimetidine and histamine on gastric mucosa

45. Which of the following antacid drug should be prescribed for

nocturnal acid suppression?
a. Alumunium bi carbonate
b. Cimetidine
c. Misoprostol
d. Omeprazole
46. Which of the following NSAID act as anti-inflammatory as well
as anti-platelet agent?
a. Aspirin
b. Ibuprofen
c. Indomethacin
d. Paracetamol

47. Which of the following agent is mucolytic in nature when used

as antitussive?
a. Acetylcystine
b. Codeine
c. Dimenhydranate
d. Granifenestin

48. Which of the following is leukotriene receptor antagonist ?

a. Budesonide
b. Cromolyn sodium
c. Ziferleukast
d. Zileutin
49. Which of the following describes the pathway of nitric oxide
(NO)?
a. Stimulates guanylylcyclase, increase cGMP
concentration, vasodilation
b. Stimulates guanylylcyclase, decreases cGMP
concentration, vasodilation
c. Stimulates guanylylcyclase, increase cGMP
concentration, vasoconstriction
d. Inhibits guanylylcyclase, increase cGMP concentration,
vasodilation

49. Which of following salt is added in triple regime for H. Pylori

infection treatment:
a. Sodiumbi carbonate salt
b. Magnium salt
 c. Bismuth salt
d. Calcium salt

50. Which of the following signaling mechanisms can involve heat-

shock protein(hsp90)?
a. Intracellular receptors for lipid soluble ligands
b. Transmembrane receptors
c. G-protein coupled receptors
d. Ligand-gated ion channels

51. Which of the following b-blockers is used for decreasing

aqueous humor secretionsfrom the ciliary body?
a. Propranolol
b. Nadolol
c. Carvedilol
d. Timolol

52. Which of the following is NOT a major symptom of atropine

toxicity?
a. Blind as a bat
b. Red as a beet
c. Mad as a hatter
d. Wet as a towel
53. A process that destroys most vegetative microbes or viruses but
not spores on inanimate surfaces
a. Antisepsis
b. Disinfection
c. Sterilization
d. Pasteurization

54. Therapeutic use of aspirin is

a. Glaucoma
b. Malaria
c. Osteoarthritis
d. Myasthenia gravis

55. Antiseptics are used

a. To treat dry mouth
b. To reduce plaque and gingivitis
 c. To remove stains of tobacco
d. To treat fluorosis

56. Sulfonamides effective for prevention of burn wound infection

a. Sulfadoxine
b. Sulfasalazine
c. Sulfa pyridine
d. Silver sulfadiazine

57. Following is true regarding true for somatriptan

a. Effective in mild to moderate migrane
b. Act on 5HT1A receptors
c. Reduces severity of migraine
d. Onset of parental drug is 1-2 hrs

58. Regarding proton pump inhibitors

a. Adverse effects are very frequent
b. They increase the oral bioavailability of vitamin B12
c. They are less effective than H2 antagonists
d. Chroinc treatment with proton pump inhibitors may
result in hypergastrinemia

59. A 44yr old female with chronic rheumatoid arthritis has been
taking aspirin for many years.She now has developed epigastric
discomfort and has tried numerous over the counter medications,
none of which have helped her. She refuses to stop her aspirin.
The best agent to help her peptic ulcer disease is:
a. Magnesium hydroxide
b. Bismuth sulfate
c. Misoprostol
d. Omeprazole

60. A 55 yr old woman with a duodenal ulcer was treated with a

combination of drugs intended to heal the mucosal damage and
to eradicate H.pylori. Which of the following antibacterial drug
is used commonly to eradicate intestinal H.pylori?
a. Ciprofloxacin
b. Clindamycin
c. Clarithromycin
d. Cefazolin
61. A long acting beta2 agonist that is used as an inhaled therapy for
moderate to severe asthma is
a. Ipratropium
b. Montelukast
c. Salmeterol
d. Zifurlukast

62. On examination of a patient,nurse notes vital signs of Heart rate

96 beats per minute,Respiratory rate 18 breaths per minute and
blood pressure 116/78 mm/Hg. The patient has clear breath
sounds and hand tremors. Which drug is responsible for these
effects
a. Ipratropium bromide
b. Albuterol
c. Theophylline
d. Montelukast

63. Frequent aerosol administration of these drugs may cause oral

candidiasis and hoarseness of voice
a. Albuterol
b. Formoterol
c. Inhaled corticosteroids
d. Cromolyn and nedocromil

64. Acetyl choline is synthesized by the catalytic action of:

a. Dopa decarboxylase
b. Tyrosine hydroxylase
c. Choline acetyl transferase
d. Acetyl Choline esterase
EMQ
THEME: ANTIHYPERTENSIVE DRUGS
OPTIONS:
a) Amlodipine f) Hydralazine
b) Atenolol g) Labetalol
c) Clonidine h) Losartan
d) Enalapril i) Prazosin
e) Guanethidine j) Trimethaphan

Each option can be used once, more than once or not at all.
LEAD IN:
Choose the drug from the list given above for the appropriate
mechanism of antihypertensive effect:

(01) Blockade of voltage gated calcium channels (a)

(02) Inhibition of angiotensin II receptors (h)

(03) Inhibition of norepinephrine release by activation of central α2

receptors (c)

(04) Inhibition of α & β receptors(g)

(05) Release of endothelial derived relaxing factor (EDRF)
(f)
THEME: DIURETICS
OPTIONS:
a) Acetazolamide f) Furosemide
b) Amiloride g) Indapamide
c) Chlorthalidone h) Mannitol
d) Chlorthiazide i) Metolazone
e) Dorzolamide j) Spironolactone

Each option can be used once, more than once or not at all.
LEAD IN:
For each of the following statements choose suitable drug:

6. A 52 year old male with a history of heart disease is brought to the

emergency room with difficulty in breathing. Examination &
investigation reveals that he has pulmonary edema. An intravenous
injection of a diuretic improves his condition (f)

7. A 52 year old male with a history of heart disease is brought to the

emergency room with difficulty in breathing. Examination &
investigation reveals that he has pulmonary edema. An intravenous
infusion of a diuretic by junior nurse worsens patient’s condition
(h)

8. A group of college students is planning a mountain climbing trip.

To prevent mountain sickness sports physician advised a drug (a)

9. An alcoholic male has developed hepatic cirrhosis. To control the

ascites and edema a diuretic has been prescribed (j)
10. A 54 year old male has started a new diuretic advised by his
physician, noticed breast enlargement and his recent electrolyte
report shows elevated serum potassium level (j)
THEME: DRUGS USED FOR THE MANAGEMENT OF
BRONCHIAL ASTHMA
OPTIONS:

a) Adrenaline
b) Albuterol
c) Beclomethasone
d) Cromolyn
e) Ipratropium
f) Isoprenaline
g) Montelukast
h) Theophylline
i) Zafirlukast
j) Zileuton
Each option can be used once, more than once or not at all.
LEAD IN:
For each of the following statements choose suitable drug:

11. A bronchodilator that inhibits phosphodiesterase(H)

12. A corticosteroid that is useful for the management of bronchial
asthma (C)
13. A mast cell stabilizer useful for prevention of bronchial asthma (D)
14. A selective β2 agonist that is widely used for the management of
bronchial asthma (B)
15. An anticholinergic bronchodilator (E)
 23

THEME: Pharmacokinetics and Pharmacodynamics

OPTIONS:
a. Oral route
b. Rectal route
c. Antagonists
d. Agonists
e. Partial agonists
f. Active transport
g. Passive diffusion
h. Intravenous route
i. Intramusular route
j. Inducers
k. Inhibitors
For each numbered description below, select only one lettered option
from the given list which is closely associated with it. Each option can
be used once, more than once or not at all.
16. Drugs that decrease the actions of another drug or
endogenous ligand.(c)
17. Route of drug administration which results in 100%
bioavailability.(h)
18. Most common method of drug permeation into the cell
membrane.(g)
19. Drugs capable of increasing the synthesis of one or more
CYP isozymes.(j)
20. Entral Route of drug administration in which
biotransformation of drugs by the liver is minimized(b)

THEME: NON STEROIDAL ANTIINFLAMMATORY DRUGS

OPTIONS:
a) Aspirin c) Diclofenac
b) Acetaminophen d) Ibuprofen
 24

e) Celecoxib h) Aceclofenac
f) Indomethacin i) Naproxen
g) Piroxicam j) Nabumetone

Each option can be used once, more than once or not at all.

LEAD IN:
Select suitable drug for the following statements:
21. A drug that is used for the management of patent
ductusarteriosus(f)
22. A non-acid NSAID (j)
23. A NSAID that may follow zero order kinetics of elimination
(a)
24. An analgesic agent that has no anti-inflammatory activity
(b)
25. An irreversible cyclooxygenase (COX) inhibitor (a)
List options:

A. Epinephrine
B. Phenyl ephedrine
C. Latanoprost
D. Atropine
E. Pilocarpine
F. Nor epinephrine
G. Dobutamine
H. Digitoxin
I. Propanolol
J. Acebutolol
K. Pyridostigmine
L. Tubocurare
M. Pirenzepine
N. Nitroglycerine
O. Amylnitrite
 25

P. Dipyridamole
Q. Verapamil
R. Nifedipine
S. Misoprostol

Q78. Which of the drug is mainly used as Nasal Decongestant? (B)

Q79.which of the drug can be used for Mushroom poisoning (D)

Q80. Which drug is a prostaglandin analog used for Glaucoma (C)

Q81. Which of the drug is a potent vasoconstrictor agent mainly used with local
anesthesia (A)

Q82. First line of treatment and main drug for Cardiac failure (H)

Q83. Which of the drugs is a Competitive neuromuscular blocker? (L)

EMQ 3:

OPTION LIST:

A. Furosemide
B. Cholthalidone
C. Acetazolamide
D. Nitrates
E. Atropine
F. Pirenzepine
G. Pempidine
H. Amylnitrite
I. Hexamethonium
J. Enalapril
K. Calcium carbonate
L. Diltiazam
M. Almunium hydroxide
N. Cimetidine
O. Sodium hydroxide
 26

P. Verapamil
Q. Prazocin
R. Digoxin
S. Ranitidine
T. Pirenzepine
U. Magnesium chloride

Which of the following side effects can usually be seen with which of the above
mentioned drugs?

Q84. Encephalopathy (M)

Q85.Monday disease (D)

Q86.Ototoxicity (A)

Q87. Cardiac arrhythmias (R)

Q88. Photophobia (F)

Q89. Cough (J)

Q90. Gynecomastia (N)

Q91.Milk Alkali syndrome (K)