Pharma 1st exam
C.I. Valencia, MD (20%)
A. True or false (6%)
1.
2.
By definition, general pharmacology is a dichotomy of two sciences: pharmacology and toxicology.
For practical learning methodology, a basic assumption in pharmacodynamics is that an administered drug dose will almost always
translate to an effective concentration.
3. Pharmacodynamics is the study of what the living body does to the drug referring to the processes of absorption, distribution and
elimination.
4. A beneficial pharmacological effect is always manifested as a clinical or therapeutical effects.
5. Clinical pharmacology is the study of drugs in the treatment and prevention of disease.
6. Most drug actions are not mediated by receptors as they are more often just chemical interactions.
7. Pharmacovigilance is the art and science of alertness towards the adverse reaction to drugs.
8. Maximal effect results when all the receptors are occupied by a drug ligand which gives rise to the plateau in the log doseresponse curve.
9. Efficacy is drug effectiveness irrespective of dose.
10. Potency is relative drug effectiveness or effectiveness of a drug with respect top dose.
11. The importance of potency begins when the ease of administration ends.
12. Condition #11 above may not be realistic as drug manufacturers will not manufacture drug products that are not easy to administer
and therefore will not sell.
13. Minor modifications in the molecular structure of a drug have little effects on the physicochemical and/or pharmacologic
properties of a drug.
14. The linear relationship between a drug dose and pharmacologic response is represented by a sigmoid curve.
15. The symbolism of a “standing cobra” for a dose-response curve reflects a slow change in pharmacologic effect with large changes
in the drug dose.
Answer key: True- 1, 2, 8, 9, 10, 11, 12 False-3, 4, 5, 6, 7, 13, 14, 15
B. Encircle the letter/s that correspond to the correct answer/s (14%)
1.
Pharmacology according to the definition of the department of pharmacology is the discipline that includes the study of
a. Pharmacy
b. The selective biologic activity of drugs
c. Molecular pharmacology
d. Pharmacodynamics
e. Pharmacokinetics
f. Therapeutics
g. Clinical pharmacology
2.
Pharmacodynamics has the following uses and objectives: to
a. Design newer and better drugs
b. Study structure-activity relationship
c. Design a rational therapeutic use for a drug
d. Elucidate mechanisms of actions
e. Identify pharmacological effects
3.
Some basic realities or practical assumptions in pharmacodynamics are:
a. Not all drug doses give therapeutically effective concentrations
b. To convert a drug dose to an effective bioavailable dose, there must be a factor “p” multiplied with the drug dose
c. For the same dose to give an effective concentration, “p” should be a variable
d. A range of doses will cover variations in individual responses
e. Pharmacodynamics studies the effects of the living host on the drug
4.
A beneficial pharmacological effect can address the following characteristics of disease
a. Etiology
b. Pathology
c. Laboratory abnormalities
d. Clinical manifestations
e. Prognosis
5.
The most important properties of a drug are:
a. Efficacy
b. Potency
c. Safety
d. Quality
e. Affordability/cost
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6.
7.
8.
9.
10.
11.
12.
13.
14.
According to the therapeutic use, drugs may be classified into
a. Origin or sources-natural or synthetic
b. Six categories of therapeutic effects from prophylactis to strictly non-therapeutic outcome
c. Anti-pathogens, function modifiers, and restoratives
d. Chemical structure such as acidic or basic drugs
e. Physiologic use such as anti-hypertensives, vasodilators or hypolipidemics
The following phrases comprise the definition of a receptor
a. Macromolecular component of a living cell
b. Possesses stereospecificity
c. With which a xenobiotic agent binds
d. The binding is akin to a lock and key fashion
e. To initiate a chain of biochemical events leading to a pharmacological response
The following are examples of non-receptor drug mediation
a. Agonist-antagonist interaction
b. Chemical interaction such as acid-base interaction
c. Acting on the osmolality of body fluids
d. Counterfeit incorporation mechanism
e. Colligative mechanism
f. Down-regulation
g. Up-regulation
The ideal arithmetic dose-response curve is a
a. Sigmoid
b. Parabola
c. Hyperbola
d. Spiral
e. Straight line
The essential property/ies of the log-dose response curve is/are
a. Potency
b. Slope
c. Plateau or efficacy
d. Location along the vertical axis
e. Variability
The quantal dose-response curve is
a. An all-or-none curve
b. Gaussian curve
c. Normal distribution
d. Skewed to the right or left
e. A reflection of the population distribution in response to drug dose
The therapeutic index is
a. Measures the margin of safety of the drug
b. A separation distance between the effective level and the toxic level
c. The ratio of the toxic or lethal dose to the effective dose
d. The ratio of the effective dose to the toxic or lethal dose
e. More straight than the standard safety margin
An adverse reaction
a. Is harmful to the body
b. Includes suicide or homicide
c. May not be related to drug effect
d. May arise from the administration of the usual recommended drug dose
e. May arise from an accidental overdose
Adverse experiences not directly caused by the drug include
a. Concurrent disease
b. Concomitant medications
c. Psychogenic influence
d. Patient non-compliance
e. Adverse drug interaction arising from the exacerration of effect by either drugs
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15.
Adverse effects of a drug can be manifested as a
a. Toxic effect
b. Hypersensitivity reaction
c. Idiosyncracy
d. Tachyphylaxis
e. Habituation
f. Addiction
CH How, MD Autacoids (20%)
Encircle the letter corresponding to the BEST answer:
1. Histamines are found in abundance on the body surfaces where they play a major role
a. Allergy and prophylaxis
b. Tissue growth, regeneration and repair
c. Gastric acid reaction
d. All of the above
e. A and b only
2.
3.
4.
5.
6.
7.
8.
Blocking H1 receptors will block the following pharmacologic actions of histamine
a. Vasoconstriction
b. Stimulation of sensory nerve endings
c. Contraction of endothelial cells
d. A and b only
e. B and c only
Clocking H2 receptors will block the following pharmacologic actions of histamine
a. vasodilation( full blockade
b. Contraction of smooth muscles
c. Gastric acid secretion
d. All of the above
e. A and c only
Antihistamines (H1 blockers or antagonists have the following clinical uses
a. Relieve rashes and itching
b. Sedation and preanesthetic medication
c. Antimotion sickness
d. All of the above
e. A and c only
Serotonin or 5-hidroxytryptamine
a. Is onvolved in regulation of GI motility, hemostasis and vascular diseases
b. Like histamine, causes vasodilation, contraction of smooth muscles, itch and___
c. Is a central chemical transmitter
d. All of the above
e. A and c only
Development of serotonin agonist and anatagonist has found clinical uses in
a. Migraine headaches
b. Management of chemotherapy-induced vomiting
c. Obsessive-compulsive behavior and depression
d. All of the above
e. A and c only
Angiotensis II is the most important active metabolite in the RAS pathway, with___ following pharmacologic actions and effects
a. Increase in blood volume and blood pressure
b. Inhibition of aldosterone and antidiuretic factor action
c. Vasoconstriction and stimulation of symphathetic nervous system
d. All of the above
e. A and c only
Hypertension can be controlled by different modes at different sites of action___
a. Inhibiting rennin which acts on the precursor angiotensinogen
b. Blocking the angiotensis receptor and reducing agonist activity
c. Inhibiting synthesis by inhibition of the converting enzyme
d. All of the above
e. B and c only
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9.
A principal role of prostaglandin id in the inflammatory reation where
a. The enzyme cyclooxygenase is involved
b. Where the enzyme phospholipase A2 is incvolved
c. These enzymes lead to synthesis of prostaglandins involved in the inflammatory reaction
d. All of the above
e. A and c only
10. COX2 inhibitors like celecoxib and rofecoxib
a. Are more effective than COX1 inhibitors like aspirin
b. Unlike aspirin and other nonselective COX1 inhibitors, aredevoid of side effects
c. Are claimed to cause less side effects such as peptide ulcer disease, bleeding, nephrotoxicity but can cause serious cardiac toxicity
even death
d. A and b only
e. A and c only
II. Match the blocker or enzyme inhibitor under column a with the corresponding autacoids involved under column B
Column A (blocker, enzyme inhibitor)
column B (autacoids & corresponding enzyme involved)
1. Loratadine
A. histamine via H1 receptor
2. Diphenhydramine
B. histamine via H2 receptor
3. Enalapril
C. angiotensin II
4. Cimetedine
D. prostaglandin via COX
5. Losartan
E. prostaglandin via phosphalipase A2
6. Celecoxib
F. serotonin
7. Aspirin
G. none of the above
8. Corticosteroids
9. Ondansetron
10. Fluoxetine
Answer key: A A C B C D D E F F
Encircle the best answer (1% each)
1. New drugs can be discovered thru modification of a known molecule which is exemplified by the ff
a. Sulfonamide
b. Misoprostol
c. Acetohexamide
d. Chlororhiazide
2. Cyclosporine an immunosuppressant drug was discovere by
a. Rational design based on understanding of biologic mechanism of immunosuppression
b. Libraries of peptide and nucleic acids
c.
Modification of an existing chemical molecule
d. Screening of biologic activity and natural product
3. With combinatorial chemistry, the cost of drug development per project and time of research decreased but the project success rate
remained at
a. 10%
b. 15%
c. 20%
d. Between 20 to 30%
4. This drug revealed the disastrous outcome when animal testing for durg safety can not predict effects on humans
a. Misoprostol
b. Lidocaine
c. Thalidomide
d. Rifampicin
5. The following studies are done In the preclinical phase except
a. Mutagenecity studies
b. Ames test
c. Teratogenecity studies
d. None of the above
6.
This guideline is important for deciding theappropiate formulation of a drug
a. GLP
b. GMP
c. GCP
d. GPD
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7.
8.
9.
10.
The best evidence for a drug’s effectiveness is
a. Cross over clinical trial
b. Multicenter open trial
c. Randomized, controlled clinical trials
d. Parallel multicenter clinical trials
To control for ubject or observer bias this methodology is utilized
a. Blinding
b. Washout
c. Crossover
d. Quasi-experiment
This contains hundreds of volumes of full reports of clinical and preclinical data petainingto the drug under review
a. NDA
b. NDA (pinatanggal ung choice na to)
c. NDD
d. IND
Drugs that are off-patent and produced and marketed by other companies
a. Me-too drug
b. Generics
c. Multi-source products
d. All of the above
Matching type
COLUMN A
1. Preclinical
2. Phase 2 clinical trial
3.
4.
5.
6.
Phase 3 clinical trial
Phase 1 clinical trial
Phase 4 clinical trial
Orphan drug
7.
8.
Washout period
Phase 5 clinical trial
9. Rats
10. IND
COLUMN B
A. DEC for filariasis
B. status of a drug after intensive and extensive
Pre-clinical studies
C. animal model for toxicologic studies
D. cross over designes
e. parallel designs
F. animal model for cardiovascular action of
Drugs
G. first time a candidate drug is used in humans
H. drugs administered to more patients to
determine efficacy and safety against standard drugs
I. drug uses against a placebo
J. study new indication of a drug
K. postmarketing surveillance
L. Ames test
Answer key: L I H G K A D J C B
Essential druh concepts and history
WRITE TRUE IF THE STATEMENT IS CORRECT AND FALSE IF INCORRECT
1. A drug may be defined as any chemical agent that interacts with the biologic system. T
2. The relationship between dose and effect can be separated into these components. F
Pharmaco kinetics
pharmacodynamics
Dose------------------------------------------concentration--------------------------------------effect
3. The reponse resulting from drug action represents drug effect. T
4. The component of the human genome which is most druggable is the lipid component. F
5. One of the major factors influencing the potential toxicity of a chemical is the administered or the exposure concentration.
T
6. Assessment of a new compound is usually based in a profile of pharmacokinetic axctivity in a range of test systems. T
7. Resonse to drug treatment can vary greatlybetween patients, genetic factors _____ major role in treatment outcome. T
8. The pharmaceutical industry is composed solely of health professionals. F
9. Phase I clinical trial refers to the study of a promising drug in animals or in set up. F
10. It is the goal of the Philippine national drug policy to ensure that safe, efficient and good quality essential drugs are made
available to all Filipinos at any time at reasonable cost, with emphasis on rational drug use. T
11. Sources of drugs include only products of chemical synthesis and p___ animals. F
12. Themost important characteristicsof an ideal drug is effectivity. T
13. R.A. 6425 refers to the generics law of 1988. F
14. One of the minor goals of health professionals is to educate their pe____ use of drugs. F
15. R.A. 9502 is officially known as ther universally accessible cheaper medicines act of 2008. T
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Identification
Choose from the following:
A. Quality control
B. Rational drug use
C. Self reliance
D. Tailored procurement
E. People empowerment
1. Refers to a carefully considered pattern of behavior both prescriber and consumer. B
2. This pilar seeks to strengthen filipinos’ own capabilities to manufacture basic and intermediate ingredients for drugs and medicines. C
3. This aims to assist people in exercising an informed choice in the purchase of an efficient medicine. E
4. The objective of thispillar is to make available to its own clientele, particularly the __ imcome sectors of the society the best drugs at
the lowest possible cost. D
5. This involves the regulation of the importation, manufacture, marketing and consumption and utilization of all drugs. A
HHo, MD
Choose A if the statement is TRUE ans B is the statement is False
1. Absolute bioavailability always compare against AUC of intravenous dose. A
2. The clearance of a drug in xpressed in amount per unit time such as mg per hour. B
3. Elimination can be used interchangeablt with excretion. B
4. First order kinetics imply that the rate oc\f changeof the plasma drug concentration is proportional to the current
concentration. A
5. Pharmacokinetics is the study of the effect of drugs on the body. B
6. Cmax is the best measure of exposure to a drug. B
7. Tmax is the maximum time. B
8. In a two compartment model, elimination occurs onlt during thr elimination phase. B
9. In a one-copartment model, distribution is assumed to be instantaneous and homogenous. A
10. Volume of distribution can never be greater than 1000 L. B
Multiple choice
1. In the computation of AUC, we use the trapezoidal rule. The area of a particular trapezoid is>>> e.(ci+Ci+1)(ti-1-t1)/2 sorry,, hassle kasi
i-type ung mga equation…
2. The apparent volume of the distribution refers to
a. Total body water volume
b. Intracellular fluid volume
c. Extracellular fluid volume
d. Plasma volume
e. None of the above
3. Halflife is the time needed for a rug to reach half its present concentration
a. True
b. false
4. The following factors can affect oral bioavailability
a. Liver metabolism
b. Gut metabolism
c. Gut absorption
d. None of the above
Drug A satisfies a first order one compartment model. The half life is 1 hr and the total clearance is 6.93 liter’hr/ (hint: remember the
relationship of half life, clearance, volume of distribution and elimination rate constant)
5. What is the limination rate constant (Kel) of drug A?
a. 1/hr
b. ln 1/hr
c. ln 2/hr
d. 2/hr
6. What is the apparent volume of distribution?
a. 1 L
b. 10 L
c. 6.93 L
d. 100 L
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7.
In the formula CL= dose/AUC, we use
a. AUC0-t
b. AUCt-infinity
c. AUC0-infinity
What happens to the half life of the drug if
1. Clearance is decreased by 50%
a. Halflife will be decreased by half
b. Halflife will be twice as long
c. Halflife wil be decreases to one fourth its original
d. There will be no effect to halfilfe
2. Volume of distribution is decreased by 50%
a. Halflife will be decreased by half
b. Halflife will be twice as long
c. Halflife will be decreased to one fourth it original
d. There will be no effect on halflife
3. Both clearance and volume distribution are decreased by half
a. Halflife will be decreased by half
b. Halflife will be twice as long
c. Halflife will be decreased to one fourth is original
d. There will be no effect on halflife
Hint: remember the relationship of clearance, half-life and volume of distribution
Huwaw! GOD BLESS SA ATING LAHAT. *WINK*
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