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Copyright 2008, New Age International (P) Ltd., PublishersPublished by New Age International (P) Ltd., PublishersAll rights reserved.No part of this ebook may be reproduced in any form, by photostat, microfilm,xerography, or any other means, or incorporated into any information retrievalsystem, electronic or mechanical, without the written permission of the publisher.All inquiries should be emailed to email@example.comISBN (13) : 978-81-224-2926-8PUBLISHING FOR ONE WORLDNEW AGE INTERNATIONAL (P) LIMITED, PUBLISHERS4835/24, Ansari Road, Daryaganj, New Delhi - 110002Visit us at www.newagepublishers.com
This book is dedicated toMy Parents, Late Shri G. C. Naidu andParents,Smt. G. LalithaFor their untiring efforts and hardwork in bringing me up to what all Iam today.Prof. Dr. G. Vidya Sagar
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SNIPPETSVery useful book for students preparing for GATE & USMLE. Recommended reading.Dr. Sanjay PaiAl-Ameen college of PharmacyBangalore.I found the book absorbing, questions are well framed.Dr. GabheC.U Shah College of Pharmacy,Mumbai.Good Reference for PG medical entrance. Recommended reading.Dr. Kaushik ShahM.S.(Gen. Surgery)Rana Hospital, MandviThis book will be of good use for students appearing for Competitive exams.Presentation of the matter is good.Prof. Y. Madhusudhan RaoUniv. College of Pharmaceutical SciencesKakatiya University, Warangal.
FOREWORDMedical & Pharmacy are fast growing professions with a wide range of opportunities open to the students after a basicdegree. These professions play a vital role in health care management.This book will be of immense value for students to develop themselves as the meritorious & motivated candidates foradmission to post graduate courses like M.D., M.S. & M.Pharm.I compliment the author for his pains-taking efforts in mobilizing a very large number of good MCQs from a vastsubject like Pharmacology. Adequate coverage of all topics is done.I feel that this book will be a very useful companion for professional PG entrance examinations. I strongly recommend this book to college library collectionPROF. DR. KANTIBHAI GORVice ChancellorK. S. K. V. Kachchh UniversityBhuj - Kutch.
ACKNOWLEDGEMENTSI acknowledge the help rendered by the following well wishers during the preparation of the manuscript. Dr. Ananta Naik NagappaProfessor, Pharmacy practice, Manipal College of Pharm. Sciences, Manipal, Karnataka. Dr. K. R. MahadikPrincipal, Bharati Vidyapeeth Deemed University’s College of Pharmacy, Pune. Prof. Vijay Raghunath PatilPrincipal, Tapi Valley Education Society’s College of PharmacyFaizpur, Maharashtra. Dr. Havigiray R. ChitmeProfessor of Pharmacology, Oman medical College, Oman Dr. Chandrakant S. MagdumVice Principal, Shri Appasaheb Birnale College of Pharmacy,Sangli, Maharashtra. Dr. B. P. NagoriDirector, Lachchoo Memorial College of Pharmacy,Jodhpur.My sincere thanks are due to Mr. Ojas M. Suroo, Lecturer, Computer Science of my institute for his meticuloustyping the manuscript and the final format of the book.Finally, I would like to place on record the generous help rendered by New age International (P) Limited,Publishers in bringing out this book.Prof. Dr. G.Vidya Sagar.
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CONTENTSPrefaceCHAPTER 1(xi)1General PharmacologyCHAPTER 229Drugs Acting on Central Nervous SystemCHAPTER 385Drugs Acting on Autonomous Nervous SystemCHAPTER 4103Vitamins & MineralsCHAPTER 5107Analgesics & AntipyreticsCHAPTER 6121Cardiovascular DrugsCHAPTER 7135Drugs Used in Respiratory DisordersCHAPTER 8143AntibioticsCHAPTER 9157Drugs Used in Gastrointestinal Tract DisordersCHAPTER 10165Oxytocics & Uterine Muscle RelaxantsCHAPTER 11Chemotherapy167
xivCHAPTER 12193Drugs used in Endocrine disorders (Hormones)CHAPTER 13207ANTIDIABETICSCHAPTER 14211AnticoagulantsCHAPTER 15215Antihyperlipedemic agentsCHAPTER 16217AntacidsCHAPTER 17221AntiemeticsCHAPTER 18Match the Following223
CHAPTER 1GENERAL PHARMACOLOGY1. All of the following are generalmechanisms of drug permeation Except(a)(b)(c)(d)(e)Aqueous diffusionAqueous hydrolysisLipid diffusionPinocytosis or endocytosisSpecial carrier transport2. If the plasma concentration of a drugdeclines with “first-order kinetics”, thismeans that(a) There is only one metabolic path for drugdisposition(b) The half-life is the same regardless of theplasma concentration(c) The drug is largely metabolized in the liverafter oral administration and has lowbioavailability elimination(d) The rate of climination is proportionate tothe rate of administration at all times(e) The drug is not distributed outside thevascular system3. Regarding termination of drug action(a) Drug must be exerted from the body toterminate their action(b) Metabolism of drugs always increases theirwater solubility(c) Metabolism of drugs always abolishes theirpharmacologic activity(d) Hepatic metabolism and renal excretion arethe two most important mechanisms involved(e) Distribution of a drug out of the bloodstreamterminates the drug’s effect4. Distribution of drugs to specific tissues(a) Is independent of blood flow to the organ(b) Is independent of the solubility of the drug inthat tissue(c) Depends on the unbound drug concentrationgradient between blood and tissue(d) Is increased for drugs that are strongly boundto plasma proteins(e) Has no effect on the half-life of the drug5. A physical process by which a weak acidbecomes less water-soluble and morelipid-soluble at low pH is(a) Distribution(c) First-pass effect(e) Protonation(b) Elimination(d) Permeation6. Dose-response curves are used for drugevaluation in the animal laboratory andin the clinic, Quantal dose-responsecurves are often(a) Used for determining the therapeutic indexof a drug(b) Used for determining the maximal efficacyof a drug(c) Invalid in the presence of inhibitors of thedrug being studied(d) Obtained from the study of intact subject butnot from isolated tissue preparations
MCQs IN PHARMACOLOGY2(e) Used to determine the statistical variation(standard deviation) of the maximal responseto the drug.7. The following are excreted faster in basicurine(a) Weak acids(c) Weak Bases(b) Strong acids(d) None of the above8. Which of the following statements aboutspare receptors is most correct ?(a) Spare receptors, in the absence of drug, aresequestered in the cytoplasm(b) Spare receptors will be detected if theintracellular effect of drug-receptor interactionlasts longer than the drug-receptor interactionitself(c) Spare receptors influence the maximalefficacy of the drug-receptor system(d) Spare receptors activate the effectormachinery of the cell without the need for adrug(e) Spare receptors may be detected by thefinding that the EC50 is greater than the Kdfor the agonist9. Which of the following terms bestdescribes an antagonist that interactsdirectly with the agonist and not at all oronly incidentally, with the receptor ?(a)(b)(c)(d)(e)Pharmacological antagonistPartial agonistPhysiological antagonistChemical antagonistNoncompetitive antagonist10. Which of the following terms bestdescribes a drug that blocks the action ofepinephrine at its receptors by occupyingthose receptors without activating them ?(a)(b)(c)(d)(e)Pharmacological antagonistPartial agonistPhysiological antagonistChemical antagonistNoncompetitive antagonist11. Which of the following provides informationabout the variation in sensitivity of the drugwithin the population studied ?(a)(b)(c)(d)(e)Maximal efficacyTherapeutic indexDrug potencyGrade dose-response curveQuantal dose-response curve12. Which of the following most accuratelydescribes the transmembrane signalingprocess involved in steroid hormoneaction ?(a) Action on a membrane spanning tyrosinekinase(b) Activation of a G protein which activates orinhibits adenyl cyclase(c) Diffusion into the cytoplasm and binding toan intracellular receptor(d) Diffusion of “STAT” molecules across themembrane(e) Opening of transmembrane ion channels13. Which of the following is a phase II drugmetabolizing reaction ?(a) Acetylation(c) Hydrolysis(e) Reduction(b) Deamination(d) Oxidation14. Which of the following drugs may inhibitthe hepatic microsomal P450 responsiblefor warfarin metabolism(a) Cimetidine(c) Phenobarbital(e) Rifampin(b) Ethanol(d) Procainamide15. With regard to clinical trials of new drugs,which of the following is most correct ?(a) Phase I involves the study of a small numberof normal volunteers by highly trained clinicalpharmacologists(b) Phase II involves the use of the new drug in alarge number of patients (100-5000) whohave the disease to be treated(c) Phase III involves the determination of thedrug’s therapeutic index by the cautiousinduction of toxicity(d) Chemical antagonist(e) Phase II requires the use of a positive control(a known effective drug) and a placebo16. Animal testing of potential newtherapeutic agents
GENERAL PHARMACOLOGY3(a) Extends over a time period of at least 3 yearsin order to discover late toxicities(b) Requires the use of at least two primatespecies, eg. Monkey and baboon(c) Requires the submission of histopathologicslides and specimens to the FDA forgovernment evaluation(d) Has good predictability for drug allergy-typereactions(e) May be abbreviated in the case of some verytoxic agents used in cancer17. The “dominant lethal” test involves thetreatment of a male adult animal with achemical before mating; the pregnantfemale is later examined for fetal deathand abnormalities. The dominant lethaltest therefore is a test genicityAll of the aboveNone of the above18. The Ames test is a method for detecting(a)(b)(c)(d)(e)Carcinogenesis in rodentsCarcinogenesis in primatesTeratogenesis in any mammalian speciesTeratogenesis in primatesMutagenesis in bacteria19. “Nicotinic” sites include all of thefollowing except(a)(b)(c)(d)(e)Bronchial smooth muscleAdrenal medullary cellsParasympathetic gangliaSkeletal muscleSympathetic ganglia20. A good example of chemical antagonism(a)(b)(c)(d)Heparin & ProtamineProtamine & ZincHeparin & ProthrombinAll the above21. Which of the following agents is a prodrug that is much less toxic in mammalsthan in insects ?(a) Acetylcholine(b) Bethanechol(c) Physostigmine(e) Neostigmine(d) Pilocarpine22. Phenylephrine causes(a)(b)(c)(d)(e)Constriction of vessels in the nasal mucosaIncreased gastric secretion and motilityIncreased skin temperatureMiosisAll of the above23. Pretreatment with propranolol will blockwhich one of the following ?(a)(b)(c)(d)Methacholine-induced tachycardiaNicotine-induced hypertensionNorepinephrine-induced bradycardiaPhenylephrine-induced mydriasis24. Most drug receptors are(a) Small molecules with a molecular weightbetween 100 and 1000(b) Lipids arranged in a bilayer configuration(c) Proteins located on cell membranes or in thecytosol(d) DNA molecules(e) RNA molecules25. With regard to distribution of a drug fromthe blood into tissues(a) Blood flow to the tissue is an importantdeterminant(b) Solubility of the drug in the tissue is animportant determinant(c) Concentration of the drug in the blood is animportant determinant(d) Size (volume) of the tissue is an importantdeterminant(e) All of the above are important determinants26. The pH value is calculated mathematicallyas the(a)(b)(c)(d)(e)–Log of the hydroxyl ion (OH ) concentration–Negative log of the OH concentration Log of the hydrogen ion (H ) concentration Negative log of the H concentration –Ratio of H /OH concentration27. Which property is classified as colligative?(a) Solubility of a solute(b) Osmotic pressure
MCQs IN PHARMACOLOGY4(c) Hydrogen ion (H ) concentration(d) Dissociation of a solute(e) Miscibility of the liquids28. The colligative properties of a solution arerelated to the(a)(b)(c)(d)pH of the solutionNumber of ions in the solutionTotal number of solute particles in the solutionNumber of unionized molecules in thesolution(e) pKa of the solution29. The pH of a buffer system can becalculated with the(a)(b)(c)(d)(e)Noyes – Whitney equationHenderson – Hasselbalch equationMichaelis – Menten equationYong equationStokes equation30. Which mechanism is most oftenresponsible for chemical degradation?(a) Racemization(c) Hydrolysis(e) Oxidation(b) Photolysis(d) Decarboxylation31. Which equation is used to predict thestability of a drug product at roomtemperature from experiments ataccelerated temperature?(a)(b)(c)(d)(e)The stokes equationThe Yong equationThe Arrhenius equationThe Michaelis – Menten equationThe Hixson – Crowell equation32. Based on the relation between the degreeof ionization and the solubility of a weakacid, the drug aspirin (pKa 3.49) will bemost soluble at(a) pH 1.0(c) pH 3.0(e) pH 6.0(b) pH 2.0(d) pH 4.033. The particle size of the dispersed solid ina suspension is usually greater than(a) 0.5 µm(b) 0.4 µm(c) 0.3 µm(e) 0.1 µm(d) 0.2 µm34. In the extemporaneous preparation of asuspension, levigation is used to(a)(b)(c)(d)(e)Reduce the zeta potentialAvoid bacterial growthReduce particle sizeEnhance viscosityReduce viscosity35. Active transport differs from facilitatedtransport in following ways, except(a)(b)(c)(d)Carrier is involvedIt is against concentration gradientEnergy is requiredAll of the above36. Vanishing cream is an ointment that maybe classified as(a)(b)(c)(d)(e)A water –soluble baseAn oleaginous baseAn absorption baseAn emulsion baseAn oleic base37. Rectal suppositories intended for adultuse usually weigh approximately(a) 1g(c) 3g(e) 5g(b) 2g(d) 4g38. In the fusion method of making cocoabutter suppositories,which substance ismost likely to be used to lubricate the mold?(a) Mineral oil(b) Propylene glycol(c) Cetyl alcohol(d) Stearic acid(e) Magnesium silicate39. A very fine powdered chemical is definedas one that(a)(b)(c)(d)Completely passes through a # 80 sieveCompletely passes through a # 120 sieveCompletely passes through a # 20 sievePasses through a # 60 sieve and not morethan 40% through a # 100 sieve(e) Passes through a # 40 sieve and not morethan 60% through a # 60 sieve
GENERAL PHARMACOLOGY540. Which technique is typically used to lverization and interventionGeometric dilutionAttrition41. Which type of paper best protects adivided hygroscopic powder?(a) Waxed paper(b) Glassine(c) White bond(d) Blue bond(e) Vegetable parchment42. Which capsule size has the smallestcapacity?(a) 5(c) 1(e) 000(b) 4(d) 043. The shells of soft gelatin capsules maybe made elastic or plastic–like by theaddition of(a)(b)(c)(d)(e)SorbitolPovidonePolyethylene glycolLactosepKa of the solution44. Nonionic surface-active agents used assynthetic emulsifiers include(a) Tragacanth(b) Sodium lauryl sulphate(c) Sorbitan esters(spans)45. A ceramic mortar may be preferable to aglass mortar when(a) A volatile oil is added to a powder mixture(b) Colored substances (dyes) are mixed into apowder(c) Comminution is desired in addition to mixing46. Divided powders may be dispensed in(a) Individual-dose packets(b) A bulk container(c) A perforated, sifter –type container47. Agents that may be used to coat entericcoated tablets include(a) Hydroxypropyl methyl cellulose(b) Carboxymethyl cellulose(c) Cellulose acetate phthalate48. For each tablet processing problem listedbelow, select the most likely reason forthe condition(a) Excessive moisturein the granulation(b) Entrapment of air(c) Tablet friability(d) Degraded drug(1) Picking(2) Mottling(3) Capping(4) Sticking(e) Tablet hardness49. For each description of a comminutionprocedure below, select the process thatit best describes(a) Trituration(b) Spatulation(c) Levigation(d) Pulverization by intervention(e) Tumbling(1) Rubbing or grinding a substance in amortar that has a rough inner surface(2) Reducing and subdividing a substanceby adding an easily removable solvent(3) adding a suitable agent to form a pasteand then rubbing or grinding the pastein mortar50. Match the drug product below with thetype of controlled-release dosage formthat it represents(a) Matrix device(b) Ion-exchangeresin complex(c) Hydrocolloidsystem(d) Osmotic system(1) BiphenamineCapsules(2) ThorazineSpansule Capsules(3) Valrelease(4) Slow - K(e) Coated granules51. The route of drug administration thatgives the most rapid onset of the pharmacological effect is(a) Intramuscular injection(b) Intravenous injection(c) Intradermal injection
MCQs IN PHARMACOLOGY6(d) Peroral administration(e) Subcutaneous injection52. Acidic drugs mainly bind to plasma(a)(b)(c)(d)Albuminá1 – acid glycoproteinBoth (a) and (b)None of the above53. After peroral administration, drugsgenerally are absorbed best from the(a) Buccal cavity(c) Duodenum(e) Rectum(b) Stomach(d) Ileum54. The passage of drug molecules from aregion of high drug concentration to aregion of low drug concentration isknown as(a) Active transport (b) Bioavailability(c) Biopharmaceutics (d) Simple diffusion(e) Pinocytosis55. What equation describes the rate of drugdissolution from a tablet?(a)(b)(c)(d)(e)Fick’s lawHenderson – Hasselbach equationLaw of mass actionMichaelis – Menten equationNoyes Whitney equation56. Dose dumping is a problem in theformulation of(a)(b)(c)(d)(e)Compressed tabletsModified- release drug productsHard gelatin capsulesSoft gelatin capsulesSuppositories57. The rate of drug bioavailability is mostrapid when the drug is formulated as a(a)(b)(c)(e)Controlled – release productHard gelatin capsuleCompressed tablet (d) SolutionSuspension58. Creatinine clearance is used as a measurement of(a) Renal excretion rate(b) Glomerular filtration rate (GFR)(c) Active renal secretion(d) Passive renal absorption(e) Drug metabolism rate59. The earliest evidence that a drug is storedin tissue is(a) An increase in plasma protein binding(b) A large apparent volume of distribution (VD)(c) A decrease in the rate of formation ofmetabolites by the liver(d) An increase in the number of side effectsproduced by the drug(e) A decrease in the amount of free drugexcreted in the urine60. The intensity of the pharmacologic actionof a drug is most dependent on the(a) Concentration of the drug at the receptor site(b) Elimination half-life (t½) of the drug(c) Onset time of the drug after oraladministration(d) Minimum toxic concentration (MTC) of thedrug in plasma(e) Minimum effective concentration (MEC)of the drug in the body61. Drug that show nonlinear pharmacokinetics have which property?(a) A constant ratio of drug metabolites is formedas the administered dose increases(b) The elimination half-life (t½) increases as theadministered dose increases(c) The area under the plasma drugconcentration versus time curve (AUC)increases in direct proportion to an increasein the administered dose(d) Both low and high doses follow first-orderelimination kinetics(e) The steady-state drug concentration increasesin direct proportion to the dosing rate62. The loading dose (DL) of a drug is usuallybased on the(a) Total body clearance (ClT) of the drug(b) Percentage of drug bound to plasma proteins
GENERAL PHARMACOLOGY7(c) Fraction of drug excreted unchanged in the urine(d) Apparent volume of distribution (VD) anddesired drug concentration in plasma(e) Area under the plasma drug concentrationversus time curve (AUC)63. The renal clearance of insulin is used asa measurement of(a)(b)(c)(d)(e)Effective renal blood flowRate of renal drug excretionIntrinsic enzyme activityActive renal secretionGlomerular filtration rate (GFR)64. All of the following statements aboutplasma protein binding of a drug are trueexcept(a) Displacement of a drug from plasma proteinbinding sites results in a transient increasedvolume of distribution (VD)(b) Displacement of a drug from plasma proteinbinding sites makes more free drug availablefor glomerular filtration(c) Displacement of a potent drug that is normallymore than 95% bound may cause toxicity(d) Albumin is the major protein involved inprotei
(b) Phase II involves the use of the new drug in a large number of patients (100-5000) who have the disease to be treated (c) Phase III involves the determination of the drug’s therapeutic index by the cautious induction of toxicity (d) Chemical antagonist (e) Phase II requires the use of a positive control (a known effective drug) and a .