药理学复习总习题

2020-03-06 来源：乌哈旅游

Chpt. 01 Introduction Study Questions

1. Which of the following is not included in the study of pharmacology? A. drug effects

B. drug formulation C. drug absorption D. drug metabolism

E. mechanism of drug action

2. Which of the following statements is wrong? D A. drugs are usually chemicals B. drugs are used to prevent diseases

C. drugs can regulate physiological processes of the body D. drugs are used in physical therapy E. drugs are used in chemotherapy

3. What is the subject that is often defined as the science of substances used to prevent, diagnose, and treat disease? A

A. medical or clinical pharmacology B. basic pharmacology C. toxicology

D. pharmacodynamics E. pharmacokinetics

4. What is the subject that is the branch of pharmacology and deals with the undesirable effects of chemicals on living systems? A. medical pharmacology B. basic pharmacology C. toxicology

D. pharmacodynamics E. pharmacokinetics

Answers 1. B 2. D 3. A 4. C

Chpt. 02 Pharmacodynamics

Study Questions

Part 1

1. Receptors are macromolecules that C A. Are designed to attract drugs B. Are resistant to antagonists

C. Exist as targets for physiological neurotransmitters and hormones D. Are only on the outer surface of cells E. Are only inside of cells

2. All of the following are capable of initiating a signal transduction process EXCEPT B A. Combination of an agonist with its receptor B. Combination of an antagonist with its receptor C. Combination of a neurotransmitter with its receptor D. Combination of a hormone with its receptor E. Combination of a cytokine with its receptor

3. Which of the following chemical bonds would create an irreversible combination of an antagonist with its receptor? d A. Ionic bond B. Hydrogen bond C. Van der Waals bond D. Covalent bond

E. None of the above bond

Answers 1.C 2.B 3.D

Part 2

4. In a strict pharmacological view, which of the following is the action of noradrenalin? A A. activation of αreceptor B. constriction of blood vessels C. increase of blood pressure D. arresting bleeding E. reduction of heart rate

5. Under which dosage that a drug´s adverse reaction is called its side effect? A A. therapeutic dose B. ineffective dose C. maximum dose D. LD50 E. toxic dose

6. Which of the following can only be used as quantal response parameter? b A. blood pressure B. death

C. body temperature D. breathing rate E. heart beat

7. Which of the following can be used as a parameter for evaluation of a drug´s safety? C A. minimum effective dose c B. maximum dose C. therapeutic index D. therapeutic dose

E. median effective dose

8. A receptor agonist usually A. has no affinity.

B. has no intrinsic activity.

C. has affinity but has no intrinsic activity. D. has intrinsic activity but has no affinity. E. has both affinity and intrinsic activity.

Answers 4. A 5. A 6. B 7. C 8. E

Part 3

9. A laboratory experiment is being conducted in which a mammal is injected with a

noncompetitive antagonist to the histamine receptor. Which of the following best describes this agent? c

A. The drug binds to the histamine receptor and partially activates it. B. The drug binds to the histamine receptor but does not activate it.

C. The drug binds to the receptor, but not where histamine binds, and prevents the receptor from being activated.

D. The drug reversibly binds to the histamine receptor and renders it ineffective.

10. A 25-year-old medical student is given a prescription for asthma, which the physician states has a very high therapeutic index. Which of the statements best characterizes the drug as it relates to the therapeutic index? d

A. The drug's serum levels will likely need to be carefully monitored.

B. The drug is likely to cross the blood-brain barrier.

C. The drug is likely to have extensive drug-drug interactions. D. The drug is unlikely to have any serious adverse effects.

Chpt. 03 pharmacokinetics Study Questions Part 1

1. Following oral administration, a drug is absorbed into the body, wherein it can exert its action. For a drug given orally, the primary site of drug absorption is: c (A) The esophagus (B) The stomach

2. Patients can exhibit alterations in the rate and extent of drug absorption because of various factors. All of the following factors might affect the rate and/or extent of drug absorption EXCEPT: e

(A) Gastric emptying time (B) Intestinal motility (C) The presence of food

(D) The formulation of the drug (E) The same batch of the drug

3. The body has developed defense mechanisms that reduce the amount of foreign chemicals, such as drugs, that enter the body. One of the more prominent of these mechanisms is an efflux transport system that pumps some drugs back into the intestinal lumen following absorption into the enterocytes and that is responsible for the lack of complete absorption of some drugs. This efflux transport system is: B (A) Facilitated diffusion (B) P glycoprotein

(E) Passive transport system

4. All of the following statements concerning the blood-brain barrier and the passage of drugs from the systemic circulation into the cerebrospinal fluid (CSF) are TRUE EXCEPT: A (A) Ionized drugs are more likely to cross into the CSF than un-ionized drugs.

(B) The higher the lipid solubility of a drug, the more likely it will cross into the CSF.

(C) Inflammation of the meninges improves the likelihood that drugs will cross the blood-brain barrier as compared to the uninflamed state (i.e., normal condition).

(D) P glycoprotein serves to pump drugs back into the systemic circulation from endothelial cells lining the blood-brain barrier.

(E) Un-ionized drugs are more likely to cross into the CSF than ionized drugs.

Answers Part 1 1.C 2.E 3.B 4.A

Part 2

5. Concerning regulation of CYP-mediated drug metabolism, all of the following statements are true EXCEPT a

(A) Drugs that competitively inhibit CYP enzymes cause a decrease in concentrations of the object (original) drug.

(B) Induction of drug-metabolizing enzymes results in a decrease in concentrations of the object (original) drug, thus potentially reducing efficacy.

(C) Induction of drug-metabolizing enzymes frequently requires the synthesis of new enzyme protein and thus may not occur immediately upon introduction of the inducing agent.

(D) Drugs that induce CYP enzymes can cause a decrease in concentrations of themselves. (E) Drugs that inhibit CYP enzymes can cause an increase in concentrations of themselves.

6. Which of the following CYP enzymes is associated with metabolism of the greatest number of drugs and thus most likely to be involved in drug–drug interactions? a (A) CYP3A4 (B) CYP2C9 (C) CYP2D6 (D) CYP2E1 (E) CYP1A2

7. Conjugation of a drug with glucuronic acid via the glucuronosyl transferases will result in all of the following EXCEPT e

(A) Production of a more water-soluble moiety that is more easily excreted (B) A new compound that may also possess pharmacological activity (C) A drug molecule that may be more susceptible to biliary elimination

(D) A drug molecule that may undergo enterohepatic recirculation and reintroduction into the bloodstream

(E) A drug with a different pharmacological mechanism of action

8. Concerning the renal excretion of drugs: c

(A) Drugs that are ionized in the renal tubule are more likely to undergo passive reabsorption than those that are unionized

(B) Low-molecular-weight drugs are much more likely to be actively secreted than filtered. (C) Only drug that is not bound to plasma proteins (i.e., free drug) is filtered by the glomerulus. (D) Decreasing renal tubular fluid pH will increase elimination of weakly acidic drugs. (E) Decreasing renal tubular fluid pH will decrease elimination of weakly basic drugs.

9. Drug presence in breast milk is most likely for: (A) Drugs highly bound to plasma proteins (B) Lipid-soluble molecules

Answers Part 2 5.A 6.A 7.E 8.C 9.B

Part 3

10. Frequently it is useful to consider the overall exposure of a person to a drug during the dosing interval. Which of the following pharmacokinetic parameters defines the exposure of a person to a drug? C (A) Cmax (B) Tmax

11. Organs such as the liver remove exogenous chemicals, such as drugs, from the body. For drugs such as phenytoin, for which the difference between the minimum effective concentration and the minimum toxic concentration is small, clinicians must calculate the rate at which a given individual removes drug from the body. The volume of fluid from which drug can be completely removed per unit of time (rate of drug removal) is termed: b (A) Distribution (B) Clearance (C) Metabolism (D) Excretion (E) Elimination

12. For a drug such as piroxicam with a 40-hour half-life and being dosed once daily (i.e., every 24 hours), steady state will be reached firstly following which DOSE (not which half-life)? d

(A) 1st dose (B) 3rd dose (C) 5th dose (D) 8th dose (E) 12th dose

13. Volume of distribution (Vd), though not a physiological volume, helps a clinician to estimate drug distribution in the body. Drugs distribute throughout the body to differing degrees depending on a number of factors. Which of the following factors is TRUE concerning drug distribution? (A) In general, a drug with a higher degree of plasma protein binding will have a lower volume of distribution.

(B) All drugs distribute to the same degree in all tissues.

(C) The binding of drugs to tissues has no relationship to the distribution of drug in the body. (D) In general, lipophilic drugs distribute to a lesser extent than hydrophilic drugs.

(E) In general, a drug with a lower degree of plasma protein binding will have a lower volume of distribution.

14. A clinician must be concerned with the amount of a drug dose that reaches the systemic circulation, since this will affect the plasma concentration and therapeutic effects observed. The fraction of a dose reaching the systemic circulation as unchanged drug (i.e., intact) is defined as: C (A) Theoretical dose (B) Cmax

Answers Part 3 10.C 11.B 12.D 13.A 14.C

Part 4

15. An agent is noted to have a very low calculated volume of distribution(Vd)．Which of the following is the best explanation? E

A. The agent is eliminated by the kidneys, and the patient has renal insufficiency. B. The agent is metabolized by the liver, and the patient has liver insufficiency. C. The agent is extensively sequestered in tissue. D. The agent is eliminated by zero-order kinetics.

E. The agent is extensively bound to plasma proteins.

16. Which of the following describes the first-pass effect? c

A. Inactivation of a drug as a result of the gastric acids. B. Absorption of a drug through the duodenum.

C. Drug given orally is metabolized by the liver before entering the circulation.

D. Drug given intravenously accumulates quickly in the central nervous system (CNS). E. Drug given intravenously is excreted quickly by the kidneys.

17. A bolus of drug R is given intravenously. The drug is noted to follow first-order kinetics. Which of the following describes the elimination of drug R? C A. The rate of elimination of drug R is constant.

B. The rate of elimination of drug R is proportional to the patient's renal function.

C. The rate of elimination of drug R is proportional to its concentration in the patient's plasma. D. The rate of elimination of drug R is dependent on a nonlinear relationship to the plasma protein concentration.

E. The rate of elimination of drug R is proportional to the patient's liver function.

Chpt. 04 Factors that influence drug efficacy Study Questions

1. For each type of drug interaction below, which pair of substances interact at receptor level? C A. tetracycline and milk

B. Phenobarbital and caffeine C. Isoproterenol and propranolol D. L-dopa and carbidopa

E. Sulfamethoxazole and trimethoprim

2. For each type of drug interaction below, which pair of substances interact at physical level? A

A. tetracycline and milk

B. Phenobarbital and caffeine C. Isoproterenol and propranolol D. L-dopa and carbidopa

E. Sulfamethoxazole and trimethoprim

3. For each type of drug interaction below, which pair of substances interact at physiologic level? B.

A. tetracycline and milk

B. Phenobarbital and caffeine C. Isoproterenol and propranolol D. L-dopa and carbidopa

E. Sulfamethoxazole and trimethoprim

4. Which of the following term is most likely to be associated with immunologically mediated reaction to drug observed soon after administration E A. Supersensitivity

B. Tachyphylaxis C. Tolerance

D. Hyposensitivity E. Anaphylaxis

5. Which of the following term is most likely to be associated with a rapid reduction in the effect of a given dose of a drug after only one or two doses B A. Supersensitivity B. Tachyphylaxis C. Tolerance

D. Hyposensitivity E. Anaphylaxis

6. Which of the following term is most likely to be associated with the effect of a drug becoming weaker after it is used for a long time C A. Supersensitivity B. Tachyphylaxis C. Tolerance

D. Hyposensitivity E. Anaphylaxis

7. A drug M is injected intravenously into a laboratory subject. It is noted to have high serum protein binding. Which of the following is most likely to be increased as a result? A A. Drug interaction

B. Distribution of the drug to tissue sites C. Renal excretion D. Liver metabolism E. Bioavailability

Answers

1.C 2.A 3.B. 4.E 5.B 6.C 7.A

Chpt. 06 Introduction to autonomic pharmacology Study Questions

1. All of the following types of cells are innervated by the autonomic nervous system EXCEPT: b (A) Smooth muscle of blood vessels (B) Skeletal muscle (C) Sinoatrial node (D) Salivary glands

(E) Intestinal smooth muscle

2. All of the following structures have a significant cholinergic innervation EXCEPT: a

(A) Ventricular wall (B) Sinoatrial node

3. The radial smooth muscle of the iris is innervated by: a (A) Primarily sympathetic noradrenergic neurons (B) Primarily sympathetic cholinergic neurons

(E) Equally by sympathetic and parasympathetic neurons

4. The receptors on the skeletal muscle end plate respond to: b (A) Acetylcholine and muscarine (B) Acetylcholine and nicotine

(C) Acetylcholine, muscarine, and nicotine (D) Only muscarine of the three choices in C (E) Only nicotine of the three choices in C

5. α1-Adrenoceptors are prominently involved in which one of the following?e (A) Cardiac acceleration (B) Intestinal relaxation (C) Cardiac contractility (D) Presynaptic inhibition (E) Vasoconstriction

6. Smooth muscle relaxation is most associated with which one of the following adrenoceptors?b (A) β1 (B) β2 (C) β3 (D) α1 (E) α2

Answers 1.B 2.A 3.A 4.B 5.E 6.B

Chpt. 07 Acetylcholine receptor agonist

Study Questions

1. Indication of methacholine is: A

A. Xerostomia and Measurement of bronchial hyperactivity in bronchoscopy B. Cardiac arrest and migraine prophylaxis

C. Severe recurrent ventricular tachyarrhythmias D. Migraine prophylaxis and xerostomia

E. Hereditary prolonged QT syndrome and cardiac arrest

2. Indication of carbachol is: C

A. Shock B. Asthma C. Glaucoma D. Eye surgery

E. Acute hypertension

3.Indication of bethanecol is: E

A. Severe recurrent ventricular tachyarrhythmias and urinary retention B. Pheochromocytoma and gastric retention C. Sinus tachycardia and flatulence

D. Movement disorders and gastric atonia E. Postoperative ileus and gastric atonia

4. Which of the following is not associated with pilocarpine? E A. stimulation of M-receptor B. treatment of glaucoma C. treatment of Iritis D. to result in miosis

E. to result in cycloplegia

Answers 1.A 2.C 3.E 4.E

Chpt. 08 Anticholinesterase drugs and Acetylcholinesterase reactivators Study Questions

1. Mechanism of action of neostigmine is: D

A. Depletes catecholamines

B. Induces catecholamine release from axonal terminal C. beta-2 agonist

D. Acetylcholinesterase inhibitor E. beta agonist

2. Indication of neostigmine is: A

A. Myasthenia gravis B. Asthma C. Glaucoma

D. Tricyclic antidepressant poisoning E. Xerostomia

3. Compared with neostigmine, the feature of pyridostigmine is: B

A.Short half-life

B.Longer duration of action C.Faster in onset of effect

D.Strong M receptor activating activity

E.Only used in treatment of myasthenia gravis 4. Indication of physostigmine is: C

A.GI motility stimulation B.Asthma C.Glaucoma

D.Tricyclic antidepressant poisoning E.Spasticity in denervation syndromes

5. Which of the following drugs is used for diagnosis of myasthenia gravis D

A. neostigmine B. pyridostigmine C. physostigmine D. edrophonium E. ambenonium

6. Which of the following drugs is used for treatment of glaucoma C

A. neostigmine B. pyridostigmine C. demecarium D. edrophonium E. ambenonium

7. Which of the following drugs is an acetylcholinesterase reactivator? D

A. neostigmine B. atropine C. demecarium D. Pralidoxime E. ambenonium

Chpt. 09 Cholinoceptor blocking drugs Study Questions

1. Indication of atropine is: C

A. Gastric ulcer provoked by emotion or exercise B. Pheochromocytoma

C. Bradycardia by marked reflex vagal discharge. D. Glaucoma

E. Cardiac stimulation by emotion or exercise

2. Mechanism of action of homatropine is: B A. Depolarizing neuromuscular blocker B. Muscarinic antagonist C. Muscarinic agonist D.alpha antagonist E. beta-1 antagonist

3. Indication of Scopolamine is: E A. Gastric ulcer B. Pheochromocytoma C. Cardiac stimulation D. Glaucoma

E. pre-anaesthetic medication

4. Indication of Anisodamine is: D A. xerostomia

B. pre-anaesthetic medication C. Cardiac arrest

D. infectiously intoxicated shock E. abdominal distension

5. Mechanism of action of Pirenzepine is: A A. M1 receptor antagonist B. M1 receptor agonist C. alpha-1 receptor agonist D.alpha-1 receptor antagonist

E. beta-1 antagonist.

6. Which of the following is not the indication of propantheline bromide? E A. peptic ulcer as an adjuvant B. pregnant vomiting C. gastric spasm D. bed-wetting E. constipation

7. Which of the following is not the indication of benactyzine? D A. peptic ulcer with anxiety B. gastritis C. gastric spasm D. glaucoma

E. symptoms of bladder irritation

8. Which of the following drugs is used for relaxation of skeletal muscle? E A. Pralidoxime B. Carbachol C. Physostigmine D. Neostigmine E. Succinylcholine Answers

1.C 2.B 3. E 4.D 5.A 6.E 7. D 8. E

Chpt 10 Adrenocepter agonists Study Questions

1. Indication of norepinephrine is: D A. Asthma B. Biliary colic

C. Bladder motility stimulation

D. Hypotension induced by drug intoxication E. Myasthenia gravis

2. Which of the following is not related to metaraminol? E A. acts on α1 receptor B. causes NA release

C. postoperative shock

D. spinal anesthesia induced shock E. anaphylactic shock

3. Which of the following is not related to phenylephrine? C A. is not readily hydrolyzed by COMT and MAO B. induces mydriasis

C. is hydrolyzed by acetylcholinesterase D. treatment of supraventricular tachycardia E. treatment of nasal mucosal congestion

4. Indication of methoxamine is: A A. supraventricular tachycardia B. hypertension C. glaucoma

D. abdominal pain E. bladder irritation

5. Which of the following statements is wrong concerning adrenaline? B A. activates α and β receptors B. constricts coronary vessel

C. dilates arterioles in skeletal muscle

D. is used in the treatment of anaphylactic shock E. is contraindicated in patients with hypertension

6. Which of the following statements is TRUE regarding dopamine? C A. activates α and M1 receptors B. constricts coronary vessel C. relaxes renal artery

D. is used in the treatment of anaphylactic shock E. blocks D1 receptor

7. Which of the following statements is wrong regarding Ephedrine? D A. is αand β agonist

B. promotes the release of NA C. relaxes renal artery D. is orally inactive

E. has central excitatory action

8. Which of the following statements is wrong concerning Isoprenaline? E A. is a β agonist

B. relaxes bronchial muscle

C. is used in the treatment of cardiac arrest D. is contraindicated in patients with myocarditis E. is used in the treatment of hyperthyroidism

9. Which of the following statements is wrong concerning Dobutamine? A A. is an alkaloid from plants B. is selective for β1 receptor

C. is not active if orally administered

D. is with more prominent inotropic effects than chronotropic effects

E. is used in the treatment of congestive heart failure following acute myocardial infarction

Chpt. 11 Adrenoceptor Antagonists Study Questions

1. Which of the following actions of epinephrine (adrenalin) would be antagonized by prazosin but not by propranolol? B (A) Increase in heart rate

(B) Increase in blood pressure (C) Release of renin (D) Bronchiolar dilation (E) Glycogenolysis

2. Which of the following adrenoceptor antagonists will reduce responses mediated by both α- and β-receptors? D (A) Propranolol (B) Prazosin

3. This question is based on the information provided in the accompanying diagram. Shown is the effect of applying norepinephrine on the arterial pressure of an isolated (in vitro) segment of artery from an experimental animal before and after adding drug X to the tissue. Drug X is present during the second application of norepinephrine. Drug X is most likely: D (A) Guanethidine (B) Propranolol (C) Cocaine

(D) Phentolamine (E) Atropine

4. This question is based on the information provided in the accompanying diagram. The experimental setup is the same as in the previous question. Drug Y is administered before and after timolol. Drug Y is most likely: C (A) Bradykinin (B) Histamine (C) Isoprenaline (D) Acetylcholine (E) Phenylephrine

5. Which of the following βreceptor antagonists has intrinsic sympathomimetic activity? E (A) Propranolol (B) Timolol (C) Nadolol (D) Atenolol

(E) Pindolol

6. All of the following βreceptor antagonists are selective forβ1 receptor EXCEPT FOR: A (A) Timolol (B) Acebutolol (C) Atenolol (D) Metoprolol (E) Esmolol

Answers

1.B 2.D 3.D 4.C 5.E 6.A Anxiolytics and Sedative-hypnotics

1．Which of the following is a competitive benzodiazepine receptor antagonist?

a. Chlordiazepoxide b. Flumazenil c. Ketamine d. Midazolam e. Triazolam

2. Which of the following is not associated with enhancement of the activity of gamma-aminobutyric acid E A. Chordiazepoxide B. Phenobarbital C. Diazepam D. Valproic acid E. Chlorpromazine

A 36-year-old male has been experiencing intense pressure to be more productive at work. This has resulted in his becoming extremely anxious, which makes it very difficult for him to function effectively. He wishes to keep his job. Physical examination and blood chemistries are normal. He is given diazepam, which diminishes his anxiety and allows him to concentrate on his work. What is the mechanism of action of diazepam? B

A. It directly opens the Cl- channel of the GABA receptor

B. It increases the frequency of opening of the Cl- channel of the GABA receptor C. It prolongs the duration of opening of the Cl- channel of the GABA receptor D. It decreases the frequency of opening of the Cl- channel of the GABA receptor E. It closes the Cl- channel of the GABA receptor

4. Which of the following is not the indication of diazepam E A. Treatment of anxiety

B. Treatment of status epilepticus C. Short-term treatment of insomnia

D. Adjunctive treatment of spastic muscular paresis caused by cerebral or spinal cord conditions such as stroke, multiple sclerosis, and spinal cord injury. E. Treatment of schizophrenia

5. Which of the following is not a sedative? C A. Buspirone

B. Chloral hydrate C. Methylphenidate D. Meprobamate E. Triazolam

6. All of the following statements concerning Buspirone are true EXCEPT (E)

A. Its structure is unrelated to those of the benzodiazepines.

B. It is thought to act by altering the brain's serotonin system, particularly by serving as a partial agonist of the 5-HT1A presynaptic receptor.

C. It has an efficacy comparable to diazepam in treating generalized anxiety disorder.

D. The main disadvantage of buspirone is that it takes several weeks before its anxiolytic effects become noticeable.

E. It has anticonvulsant and muscle relaxant effects.

1．There should be little argument that nowadays the only medically justified long-term use of phenobarbital is for managing which of the following conditions?

B. alcohol withdrawal signs/symptoms B. Anxiety management C. Certain epilepsies

D. Endogenous depression

E. Sleep disorders such as insomnia

2．A patient develops status epilepticus. Which of the following is the best first IV drug to give? A. Carbamazepine

B. Lorazepam C. Phenobarbital D. Diazepam E. Valproic acid

3．A young boy who has been treated for epilepsy for a year is referred to an oral surgeon for evaluation and probable treatment of massive overgrowth of his gingival tissues. Some teeth are almost completely covered with hyperplastic tissue. Which of the following drugs is associated with this finding?

A. Carbamazepine B. Lorazepam C. Phenobarbital D. Phenytoin E. Valproic acid

4. A 20-year-old male with absence seizures is treated with ethosuximide. What is the principal mechanism of action of ethosuximide? D A. Sodium channel blockade

B. Increase in the frequency of the chloride channel opening C. Increase in GABA

D. Calcium channel blockade

E. Increased potassium channel permeability

5. A 30-year-old female with partial seizures is treated with vigabatrin. What is the principal mechanism of action of vigabatrin? C A. Sodium channel blockade

B. Increase in frequency of chloride channel opening C. Increase in GABA

D. Calcium channel blockade

E. Increased potassium channel permeability

6. All of the following statements concerning carbamazepine are true EXCEPT (B)

A. It stabilizes the inactivated state of sodium channels, making brain cells less excitable. B. It is used for treating myoclonic epilepsy. C. It is used for treating trigeminal neuralgia. D. It is used for treating mania.

E. It is used for treating generalized seizures of the grand mal type.

1．A patient who has been treated with levodopa is switched to a regimen with a proprietary product that contains both levodopa and carbidopa. What is the main role of carbidopa in this approach?

a. Block Ach release in the CNS, thereby facilitating levodopa’s ability to restore a dopamine-Ach balance.

b. Help activate dietary vitamin B6, a deficiency of which occurs during levodopa therapy

c. Increase permeability of the blood-brain barrier to levodopa, giving levodopa better access to the CNS

d. Inhibit metabolic conversion of levodopa to dopamine in the gut

e. Reduce levodopa-induced hypotension by blocking vascular dopamine receptors

2．Which of the following drugs is a selective inhibitor of monoamine oxidase type B (MAO-B) and is useful in treating some cases of parkinsonism?

a. Bromocriptine b. Carbidopa c. Galantamine d. Selegiline e. Tacrine 3．Which of the following drugs specifically enhances the activity of brain dopamine by inhibiting the metabolic inactivation of dopamine?

a. Benzatropine b. Selegiline c. Pergolide

d. Bromocriptine e. Chlorpromazine

4．Which of the following is a dopamine receptor agonist that is useful in the therapy of Parkinson’s disease?

a. Selegiline b. Bromocriptine c. Apomorphine d. Amantidine e. Belladonna

5．A patient who has been treated for parkinson’s disease for about a year presents with purplish, mottled changes to her skin. Which of the following is the most likely cause?

a. Amantadine b. Bromocriptine c. Levodopa (alone)

d. Levodopa combined with carbidopa e. Selegiline

1．A woman develops akathisia, a Parkinson-like syndrome, galactorrhea, and amenorrhea, during

drug therapy. These responses reflect which of the following?

A. Blockade of muscarinic receptors B. Blockade of α-adrenergic receptors C. Blockade of dopamine receptors

D. Supersensitivity of dopamine receptors E. Stimulation of nicotinic receptors

2．Which of the following antidepressants selectively inhibits neuronal serotonin (5-HT) reuptake and has minimal effect on the reuptake of norepinephrine or dopamine?

A. Nortriptyline B. Fluoxetine C. Imipramine D. Maprotiline E. Trazodone

3．One reason for the declining use of tricyclic antidepressants is the prevalence of side effects or adverse responses, even with therapeutic serum levels. One of those ―very common‖ side effects is due to which of the following?

A. Anticholinergic effects B. Arrhythmias C. Hepatotoxicity D. Nephrotoxicity E. Seizures

4．Chlorpromazine is prescribed for a patient with schizophrenia. Which other signs/symptoms that the patient may also have might be beneficially affected by the drug?

A. Epilepsy B. Hypotension

C. Nausea and vomiting

D. Urinary retention, as from prostatic hypertrophy E. Xerostomia (dry mouth)

5．In comparing side effects profiles of chlorpromazine and haloperidol, we find that haloperidol tends to cause or is associated with which of the following? A. A higher incidence of extrapyramidal reactions B. Intense atropine-like side effects

C. More frequent and lethal blood dyscrasias D. More frequent orthostatic hypotension E. Very slow onset of psychomotor symptom

6．After a few weeks on a drug, a patient reports profound thirst and the production of copious volumes of clear (dilute) urine each day. This is a fairly common, and unique, side effect of which of the following?

A. Diazepam B. Fluoxetine C. Haloperidol D. Lithium E. Phenytoin

7．We prescribe fluoxetine for a 40-year-old man with repetitive obsessive behavior that prevents him from carrying out simple tasks. This drug is classified as which of the following? A. MAO inhibitor (MAOI)

B. Tricyclic nonselective amine reuptake inhibitor C. Heterocyclic nonselective amine reuptake inhibitor D. Selective serotonin reuptake inhibitor

E. 2-adrenergic receptor inhibitor

8．Clozapine is prescribed for a patient with a psychiatric disorder. Which of the following is the most serious side effect or adverse response for which we must monitor?

A. Agranulocytosis

B. Extrapyramidal side effects (parkinsonian) C. Hypoglycemia

D. Hypotension, severe

E. Ventilatory depression or arrest

9．A 31-year-old woman is treated with an antipsychotic agent because of a recent history of spontaneously removing her clothing in public places and claiming she hears voices telling her to do so. Her blood pressure is normally 130/70 mmHg. Since being treated with a drug, she has had several bouts of syncope. Orthostatic hypotension was noted on physical examination. Which of the following drugs most likely caused this? A. Chlorpromazine

B. fluphenazine C. Haloperidol D. Clozapine E. Sulpiride

I. A-type choice questions

1. Morphine produces its analgesic effect by A. blocking muscarinic cholinergic receptors

B. inhibition of prostaglandin synthesis in peripheral C. blocking sodium channels

D. activating  opioid receptors in CNS E. blocking  opioid receptors in CNS Answer: D

2. All of the following are pharmacologic effects of narcotic analgesics except for: C A. activation of the opioid receptors in the CNS B. decreasing intestinal peristalsis C. decreasing arterial PaCO2 D. suppression of cough reflex

E. constriction of biliary tract smooth muscle Answer: C

3. Death from overdosage of opioid analgesics usually result from B A. cardiac arrest

B. respiratory depression C. seizure D. shock

E. hypertensive crisis Answer: B

4. With continued use of morphine, tolerance develops to all of the following effects except for: A. analgesia B. sedation C. nausea D. euphoria E. miosis Answer: E

5. Which of the following statement concerning opioid analgesics is true? E

A. Morphine is well absorbed, and has high bioavailability via the oral route of administration B. Opioid analgesics decrease ureteral and bladder tone

C. Abstinence syndrome of narcotic-analgesics can be prevented by naloxone D. Opioid analgesics are appropriate for the treatment of chronic mild pain E. Opioid analgesics can be used to treat diarrhea

Answer: E

6. Which of the following is not the sign or symptom of acute opioid toxicities? A. Body temperature increase B. Pin-point pupils

C. Respiratory depression D. Stupor and coma E. Urinary retention Answer: A

7. Which of the flowing is not true for methadone? A. Morphine congener B. High oral bioavailability

C. Half life is longer than morphine

D. Tolerance and dependence develops rapidly

E. Used in substitution therapy for opioid withdrawal syndrome Answer: D

8. The precautions and contraindications of morphine include the following except for E A. bronchial asthma B. head injury

C. undiagnosed abdominal pain D. pregnancy E. bone fracture Answer: E

I. A-type choice questions

1. Important effects of aspirin include all of the following except for: A. Reduction of fever

B. Reduction of prostaglandin synthesis in inflamed tissues C. Respiratory stimulation when taken in toxic dosage D. Reduction of bleeding tendency E. Tinnitus and vertigo Answer: D

2. Which is the best choice to reduce fever for a patient with peptic ulcer? b A. Aspirin

B. Acetaminophen C. Indomethacin D. Ibuprofen E. Naproxen Answer: B

3. Drugs and their characteristics are incorrectly matched in which of the following? e

A. Acetaminophenhas fewer gastrointestinal adverse effects than aspirin B. Indomethacin is a potent nonselective COX inhibitor C. Aspirinproduces anti-inflammatory effects at high dose D. Ibuprofenis better tolerated than aspirin and indomethacin E. Meloxicamselectively inhibits cyclooxygenase-1 Answer: E

4. Which of the following is not the contraindication of aspirin? A. Peptic ulcer B. Renal failure C. Haemophilia D. Asthma

E. Arterial thrombogenesis Answer: E

5. Inhibition of the activity of COX-2 is responsible for the following: A. analgesia

B. antipyretic effect

C. loss of GI cytoprotection D. antiplatelet effect E. a and b Answer: E

6. In treating rheumatoid arthritis, NSAIDs are not effective in C A. relieving inflammation symptoms for more than one month B. relieving the pain associated with the disease C. stopping the progression of the disease

D. decreasing PG-induced increases in swelling and edema E. enabling patients to effectively have joint function Answer: C

7. The most common side effect of NSAIDs is related to: A. gastrointestinal complications B. renal complications C. Reye’s syndrome D. allergic reactions

E. respiratory complications Answer: A

8. Misoprostol would be administered with an NSAID to: A. enhance antipyretic effect

B. enhance anti-inflammatory effect

C. decrease adverse gastrointestinal complications D. increase the rate of renal elimination of the NSAID

E. none of the above is true Answer: C

第22章钙通道阻滞药

Chapter 22 Calcium Channel Blockers

Question 1

All of the following statements regarding calcium channel blockers are true EXCEPT: A. They cause relaxation of venous smooth muscle at normal doses. B. They cause vasodilation of arterioles at normal doses. C. They inhibit L-type calcium channels.

D. They have little effect on receptor-operated calcium channels.

E. They are widely used in the treatment of angina pectoris, arrhythmia and hypertension. (A)

Question 2

All of the following statements regarding verapamil are true EXCEPT: A. It markedly increases AV node effective refractory period. B. It depresses sinus node automaticity.

C. It increases the rate of Purkinje fiber phase-0 depolarization.

D. It is not effective in preventing or suppressing most ventricular arrhythmias. E. It is an effective preventive medication for migraine. (C)

Question 3

This drug is in the class of calcium channel blockers known as the dihydropyridines. A. Flunarizine B. Verapamil C. Diltiazem D. Nifedipine E. Prenylamine (D)

Question 4

This drug is the first choice in calcium channel blockers for the treatment of prinzmetal’s (vasospastic) angina.

A. Diltiazem B. Verapamil C. Nifedipine D. Prenylamine E. Perhexiline (C)

Question 5

All of the following statements regarding verapamil are true EXCEPT: A. It blocks L-type calcium channels. B. It increases heart rate.

C. It relaxes coronary artery smooth muscle. D. It depresses cardiac contractility.

E. It is used for the treatment of hypertension. (B)

Question 6

All of the following statements regarding nifedipine are true EXCEPT: A. It typically causes reflex tachycardia. B. It reduces preload. C. It reduces afterload.

D. Its metabolism can be inhibited by a constituent of grapefruit juice. E. Its main uses are as an antianginal and antihypertensive. (B)

Question 7

All of the following statements regarding diltiazem are true EXCEPT: A. It dilates coronary arterioles.

B. It can depress cardiac contractility in patients with heart failure. C. It increases myocardium oxygen consumption.

D. It slows conduction of impulses through the AV node.

E. It’s side effects include hypotension, bradycardia, dizziness, and flushing. (C)

Question 8

This drug is a phenylalkylamine calcium channel blocker. A A. Verapamil

B. Nifedipine C. Propranolol

D. Glyceryl trinitrate E. Diltiazem (A)

Question 9

All of the following are common adverse effects of calcium channel blockers EXCEPT:

A. Skeletal muscle weakness B. Dizziness C. Headache D. Flushing

E. Peripheral edema (swelling of ankles, feet, or lower legs). (A)

Chapter 23 ACE inhibitors and AT1 blokers

A 型选择题：

1. Which of the following enzymes is inhibited by captopril? D

A．Acetylcholinesterase

B．Choline-O-acetyltransferase C．COMT

D．AngiotensinⅠconverting enzyme E．DOPA decarboxylase

2．Which of the following is associated with the hypotensive effect of captopril? C A．Blockade of AT1 receptor B．Reduction of renin production

C．Retardation of bradykinin degradation D．Binding to aldosterone

E．Inhibition of Na+-K+-ATPase

3．Which of the following is not the clinical indication of captopril? E A．Mild essential hypertension B．Moderate essential hypertension

C．Hypertension with congestive heart failure

D．Hypertension in Renal Diseases associated with diabetes mellitus E．Bilateral renal artery stenosis

4．Which of the following adverse reactions is the common reason leading to withdrawal of captopril? A

A．Persistent dry cough B．Rash

C．Dizziness D．Alopecia E．Hyperkalemia

5. Which of the following is considered to be the disadvantage of captopril based on the New Concepts in Hypertension Therapy? B A．Weak effect on blood vessels B．Short half-life

C．Elevations in serum potassium D．Head and neck angioedema E．Hypotension

6．Which of the following drugs blocks AT1 receptor? D A．Propranolol

B．Sodium nitroprusside C．Captopril D．Losartan E．Chlortalidone

7．Which of the following statements regarding Losartan is right? D A．Inhibition of angiotensinⅠconverting enzyme B．Postural hypotension is frequent. C．Dry cough is frequent.

D．EXP3174 is its active metabolite. E．It is indicated in renal artery stenosis.

8. All of the following statements regarding losartan are correct EXCEPT: A A．It is an angiotensin type 1 (AT1) receptor agonist. B．Hyperkalemia can result from its administration.

C．It is an alternative for patients who develop intractable cough associated with ACE inhibitors. D．It is contraindicated in the second and third trimesters of pregnancy. E．It is indicated in essential hypertension.

第24章抗高血压药

Chapter 24 Antihypertensive drugs

Question 1

This drug is sometimes part of fixed-dose combinations used to treat essential hypertension. A

A. Hydrochlorothiazide B. Amiloride C. Acetazolamide

D. Spironolactone E. Mannitol (A)

Question 2

All of the following statements concerning antihypertensive drugs are correct EXCEPT:

A. In general, the newer drugs produce a lower incidence of side effects than the older drugs.

B. In general, withdrawal from these drugs should be gradual rather than abrupt. C. In general, the effectiveness and patient's acceptance of antihypertensive drugs is highly predictable.

D. In general, it is rational to prescribe two drugs with the same mechanism of action. E. Both B and C (D)

Question 3

This drug reduces blood pressure by actions on cardiovascular control centers in the CNS.

A. Labetalol B. Clonidine C. Enalapril D. Nifedipine E. Nitroprusside

(B)

Question 4

Each of the following is a rational drug combination for treating hypertension EXCEPT:

A. Captopril and spironolactone

B. Hydrochlorothiazide, hydralazine and propranolol C. Metoprolol and hydrochlorothiazide D. Diltiazem and enalapril E. Minoxidil and propranolol (A)

Question 5

All of the following statements regarding prazosin are true EXCEPT: A. It can cause a precipitous fall in blood pressure. B. It does not impair exercise tolerance. C. It adversely affects serum lipid levels.

D. It acts at vascular post-synaptic alpha-1 adrenergic receptors. E. It is orally active.

Question 6

All of the following statements regarding vasodilators are true EXCEPT: B A. Hydralazine causes tachycardia.

B. Fenoldopam is a dopamine receptor antagonist. C. Nitroprusside dilates both arterioles and veins. D. Minoxidil can cause hypertrichosis. E. Pinacidil can produce fluid retention.

(B) (Note: Fenoldopam is a selective D1 receptor partial agonist)

Question 7

All of the following statements regarding verapamil are true EXCEPT: A. It blocks L-type calcium channels. B. It increases heart rate.

C. It relaxes coronary artery smooth muscle. D. It depresses cardiac contractility. E. It is a class IV antiarrhythmic. (B)

Question 8

All of the following statements regarding clonidine are true EXCEPT: A. It reduces sympathetic output from the CNS.

B. Orthostatic hypotension occurs infrequently after its administration. C. It is an alpha-2 adrenergic antagonist.

D. Sedation is a possible side effect of its administration. E. It is an agonist on the I1-receptor (imidazoline receptor). (C) (Note :It is an alpha-2 adrenergic agonist.)

Question 9

All of the following statements concerning the treatment of primary hypertension are true EXCEPT:

A. Successful, long-term control improves life expectancy by reducing or preventing the development of secondary cardiovascular complications.

B. Most cases require the use of one or more drugs for optimal control.

C. Drug treatment can usually be withdrawn after two to three years of maintaining blood pressure at optimal levels.

D. Newer types of antihypertensive drugs often permit successful therapy without seriously compromising patients' quality of life. E. Both A and B (C)

Question 10

All of the following statements regarding the use of diuretics for the treatment of hypertension are true EXCEPT: D

A. Mild hypertension can often be managed by treatment with thiazide diuretics alone.

B. High-ceiling (loop) diuretics (e.g. furosemide ) are generally reserved for advanced hypertension in the presence of kidney or heart failure.

C. Combination therapy with two or more drugs typically includes a diuretic preparation.

D. Potassium-sparing diuretics such as triamterene are especially useful in combination with an angiotensin-converting enzyme (ACE) inhibitor.

E. When administered acutely thiazides lower blood pressure by causing diuresis, a fall in plasma volume and a reduction in cardiac output. (D)

第25章抗心律失常药

Chapter 25 Drugs used in cardiac arrhythmias

Question 1

All of the following statements regarding quinidine are true EXCEPT: (B)

A. It slows the upstroke of the action potential and conduction, and prolongs the QRS duration of the ECG, by blockade of sodium channels.

B. It shortens the action potential duration by nonspecific blockade of potassium channels.

C. Many patients receiving this drug develop cinchonism.

D. Its toxic cardiac effects include excessive QT interval prolongation and induction of torsade de pointes arrhythmia.

E. It is used only occasionally to maintain normal sinus rhythm in patients with atrial flutter/fibrillation. Because of its cardiac and extracardiac side effects, its use is now largely restricted to patients with normal (but arrhythmic) hearts.

Question 2

All of the following statements regarding amiodarone are true EXCEPT: (B)

A. In the USA, amiodarone is approved for oral and intravenous use to treat serious ventricular arrhythmias.

B. It is not effective in the treatment of supraventricular arrhythmias such as atrial fibrillation.

C. It markedly prolongs the action potential duration (and the QT interval on the ECG) by blockade of IKr.

D. Dose-related pulmonary toxicity is its most important adverse effect and fatal pulmonary fibrosis may be observed in 1% of patients.

E. The skin deposits result in a photodermatitis and a gray-blue skin discoloration in sun-exposed areas, eg, the malar regions.

Question 3

All of the following statements regarding Procainamide are true EXCEPT: A

A. By blocking potassium channels, procainamide slows the upstroke of the action potential, slows conduction, and prolongs the QRS duration of the ECG.

B. Procainamide has ganglion-blocking properties. This action reduces peripheral vascular resistance and can cause hypotension, particularly with intravenous use. C. The most troublesome adverse effect of long-term procainamide therapy is a

syndrome resembling lupus erythematosus and usually consisting of arthralgia and arthritis.

D. Procainamide is effective against most atrial and ventricular arrhythmias.

E. Procainamide is the drug of second choice (after lidocaine) in most coronary care units for the treatment of sustained ventricular arrhythmias associated with acute myocardial infarction.

Question 4

This drug is used in treating supraventricular tachycardias. A A. Digoxin B. Dobutamine

C. Mexiletine D. Dopamine E. Lidocaine (A)

Question 5

This drug has beta-adrenergic blocking activity. A. Flecainide B. Sotalol C. Lidocaine D. Verapamil E. Procainamide (B)

Question 6

This drug is a Class IC antiarrhythmic drug. A. Flecainide B. Sotalol C. Lidocaine D. Verapamil E. Quinidine (A)

Question 7

All of the following statements regarding Adenosine are true EXCEPT: C

A. Its mechanism of action involves activation of an inward rectifier K+ current and inhibition of calcium current.

B. It causes marked hyperpolarization and suppression of calcium-dependent action potentials.

C. It is currently the drug of choice for prompt conversion of paroxysmal

supraventricular tachycardia to sinus rhythm because of its high efficacy (90–95%) and very long (should be short) duration of action.

D.Its effects are potentiated by adenosine uptake inhibitors such as dipyridamole. E. It is less effective in the presence of adenosine receptor blockers such as theophylline or caffeine.

Question 8

In patients with structural heart disease (such as a history of myocardial infarction, or left ventricular dysfunction) and also patients with ventricular arrhythmias, the drug actually increases the chance of suffering a fatal arrhythmia. D A. Propranolol B. Procainamide C. Lidocaine D. Flecainide E. Verapamil

Question 9

This drug is a Class IV antiarrhythmic drug. A. Flecainide B. Sotalol C. Lidocaine D. Verapamil E. Disopyramide (D)

Question 10

All of the following statements regarding Sotalol are true EXCEPT: (E)

A. It has both -adrenergic receptor-blocking (class 2) and action potential prolonging (class 3) actions.

B. Its beta-adrenergic blocking action is not cardioselective and is maximal at doses below those required for action potential prolongation.

C. Its most significant cardiac adverse effect is an extension of its pharmacologic action: a dose-related incidence of torsade de pointes that approaches 6% at the highest recommended daily dose.

D. It is approved for the treatment of life-threatening ventricular arrhythmias and the maintenance of sinus rhythm in patients with atrial fibrillation.

E. It is not approved for treatment of supraventricular and ventricular arrhythmias in the pediatric age group.

Question 11

This drug is useful in terminating atrial tachycardias, but not ventricular tachycardias. A. Flecainide B. Sotalol C. Lidocaine

D. Verapamil E. Phenyoin (D)

Question 12

This is a drug of choice for acute treatment of ventricular tachycardias. A. Flecainide B. Sotalol C. Lidocaine D. Verapamil E. Propranolol (C)

Question 13

Mexiletine is an orally active congener of this drug. C A. Flecainide B. Sotalol C. Lidocaine D. Verapamil E. Phenytoin （C）

Question 14

All of the following statements regarding verapamil are true EXCEPT: A. It blocks L-type calcium channels. B. It increases heart rate.

C. It relaxes coronary artery smooth muscle. D. It depresses cardiac contractility.

E. It suppress both early and delayed afterdepolarizations. (B)

第26章治疗充血性心力衰竭的药物 Chapter 26 Drugs used in congestive heart failure

Question 1

All of the following are therapeutically useful combinations of drugs for treating patients with heart failure EXCEPT: A

A. Quinidine - Digoxin B. Digoxin - Captopril

C. Isosorbide dinitrate - Hydralazine D. Captopril - Furosemide

E. Captopril - Furosemide - Digoxin (A)

Question 2

All of the following statements regarding congestive heart failure (CHF) are true EXCEPT:

A. Inotropic drugs have been proven to extend life expectancy of patients with CHF. B. Exercise intolerance is a major symptom of the syndrome. C. Virtually all forms of heart disease can lead to CHF.

D. Treatment of systolic heart failure typically begins with a diuretic and a vasodilator. (A)

Question 3

All of the following statements regarding cardiac glycosides are true EXCEPT: A. They inhibit the Na+/K+-ATPase and thereby increase intracellular Ca++ in myocardial cells.

B. They cause a decrease in vagal tone.

C. Children tolerate higher doses of digitalis than do adults.

D. The most frequent cause of digitalis intoxication is concurrent administration of diuretics that deplete K+. (B)

Question 4

All of the following statements regarding cardiac glycosides are true EXCEPT: A. They inhibit the activity of the Na+/K+-ATPase.

B. They decrease intracellular concentrations of calcium in myocytes. C. They increase vagal tone.

D. They have a very low therapeutic index. (B)

Question 5

All of the following statements regarding cardiac glycoside-induced ventricular tachyarrhythmias are true EXCEPT:

A. Lidocaine is a drug of choice in treatment.

B. Digibind should be used in life-threatening cases.

C. They occur more frequently in patients with hyperkalemia than those with hypokalemia.

D. They are more likely to occur in patients with a severely damaged heart. (C)

Question 6

All of the following statements regarding digitalis are true EXCEPT: A. It increases the rate of calcium efflux from cardiac myocytes. B. It inhibits the sodium-potassium ATPase.

C. It does not reduce overall mortality in patients with heart failure compared with placebo.

D. It should not be given in combination with quinidine. (A)

Question 7

All of the following statements regarding cardiac glycosides are true EXCEPT: A. Digoxin is a mild inotrope. B. Digoxin increases vagal tone.

C. Digoxin has a longer half-life than digitoxin. D. Digoxin acts by inhibiting the Na+/K+ ATPase. E. Digoxin is mainly eliminated by kidneys. (C)

Question 8

All of the following are recommended in the initial stages of treating patients with heart failure EXCEPT: A. Reduced salt intake B. Verapamil C. ACE inhibitors D. Diuretics (B)

第27章抗心绞痛药

Chapter 27 Drugs used in angina pectoris

Question 1

All of the following statements concerning antianginal drugs are true EXCEPT:

A. The effect of calcium channel blockers on afterload is more marked than their effect on preload. B. The beta-blockers are effective in treating exertional angina since they decrease cardiac oxygen consumption during exercise.

C. The dihydropyridines present no hazard when used alone in the treatment of angina.

D. Organic nitrates are effective in treating Printzmetal's angina because they decrease preload and dilate coronary arteries.

E. Undesirable effects of beta-blocking agents in angina include an increase in end-diastolic volume and an increase in ejection time. (C)

Question 2

All of the following statements concerning organic nitrate esters are true EXCEPT: A. The fully nitrated molecules are the most lipophilic form of these drugs. B. Glyceryl trinitrate (nitroglycerin) increases platelet activation.

C. Low plasma concentrations produce more venous dilation than arterial dilation. D. Nitric oxide (NO) is thought to be the active molecular intermediate that accounts for their mechanism of action

E. Nitrates are often used in combination with beta receptor blockers in order to decrease adverse reactions and increase treatment efficacy. (B)

Question 3

All of the following statements describing the cardiovascular effects of the organic nitrates are true EXCEPT:

A. They reduce myocardial work by decreasing preload and afterload.

B. They selectively dilate large epicardial vessels without impairment of autoregulation in small vessels.

C. They are effective in relieving all three types of angina.

D. They directly alter the inotropic and chronotropic state of the heart.

E. They increase heart rate by indirect effects evoked by baroreceptors responding to decreased arterial pressure. (D)

Question 4

All of the following are rational drug combinations for the treatment of typical angina EXCEPT:

A. Nitroglycerine and nifedipine B. Verapamil and propranolol C. Nitroglycerin and propranolol

D. Nitroglycerin, nifedipine and propranolol E. Amlodipine and propranolol (B)

Question 5

All of the following statements regarding combination therapy for the treatment of angina are true EXCEPT: A

A. Verapamil and an organic nitrate are a useful combination for treating angina in patients with heart failure.

B. A combination of an organic nitrate and a beta-blocker is an effective treatment of stable angina. C. The combination of verapamil and propranolol is typically contraindicated.

D. Triple therapy with an organic nitrate, a calcium channel blocker, and a beta-blocker can be effective in the treatment of angina in some cases if single and double drug therapy does not work. E. For maintenance therapy of chronic stable angina, the combination of propranolol with nifedipine has been shown to be more effective than individual drugs used alone. (A)

For maintenance therapy of chronic stable angina, long-acting nitrates, calcium

channel-blocking agents, or beta-blockers may be chosen; the best choice of drug will depend on the individual patient's response.

The combined use of propranolol and organic nitrates theoretically should enhance the therapeutic effects of each and minimize their adverse effects

In the presence of overt heart failure, all calcium channel blockers can cause further worsening of heart failure as a result of their negative inotropic effect. Amlodipine, however, does not increase the mortality of patients with heart failure due to left ventricular systolic dysfunction and can be used safely in these patients.

For maintenance therapy of chronic stable angina, the combination of a -blocker with a calcium channel blocker (eg, propranolol with nifedipine) or two different calcium channel blockers (eg, nifedipine and verapamil) has been shown to be more effective than individual drugs used alone.

If response to a single drug is inadequate, a drug from a different class should be added to maximize the beneficial reduction of cardiac work while minimizing undesirable effects. Some patients may require therapy with all three drug groups.

Question 6

This drug has the least effect in treating vasospastic angina. A. Propranolol B. Verapamil C. Diltiazem D. Nitroglycerine E. Nifedipine (A)

Question 7

All of the following statements regarding vasospastic angina are true EXCEPT:

A. Anginal attacks are effectively treated in most patients using calcium channel blockers and organic nitrates.

B. Beta-adrenergic blockers are drugs of first choice for treating this form of angina. C. This form of angina is also known as Prinzmetal's angina.

D. This form of angina may occur in the absence of coronary artery disease. E. Nifedipine is very effective for treating this form of angina. (B)

Question 8

All of the following statements regarding unstable angina are true EXCEPT: A. This form of angina is best left untreated.

B. This form of angina is caused by platelet clots at the site of a ruptured atherosclerotic plaque. C. This form of angina is characterized by prolonged episodes of angina at rest. D. Many patients with unstable angina benefit from treatment with aspirin. E. Intravenous heparin is indicated in most patients with unstable angina. (A)

Question 9

9.1 This drug slows heart rate by antagonizing the sympathetic nervous system. C 9.2 Tolerance develops rapidly with this drug. D

9.3 This drug slows heart rate by blocking L-type calcium channels in the SA node. A A. Verapamil B. Nifedipine C. Propranolol D. Glyceryl trinitrate E. Neostigmine

第28章抗动脉粥样硬化药

Chapter 28 Drugs used in hyperlipidemia

Question 1

All of the following statements concerning colestyramine are true EXCEPT: C A. It would not be a good choice for treating patients with familial hypertriglyceridemia.

B. It is not well accepted by patients.

C. It works by directly binding cholesterol in the blood.

D. It is an effective drug for treatment of types IIa and IIb hyperlipidemia. E. It is a strong ion exchange resin. C

Question 2

All of the following statements concerning nicotinic acid are true EXCEPT: A. It reduces the rate of synthesis of VLDL.

B. Sustained-release preparations of this drug are largely free of side effects. C. Almost all patients taking the traditional dosage form of this drug experience uncomfortable flushing.

D. It should not be used with antihypertensives. (D)

Question 3

All of the following statements concerning drugs which inhibit cholesterol synthesis are true EXCEPT:

A. When used alone, they are the most effective agents for lowering LDL cholesterol. B. They are often effective in patients in whom diet, with or without a bile acid-binding resin or niacin, has failed.

C. Lovastatin plus a resin causes regression of coronary lesions in about one third of treated patients.

D. Members of this drug class are generally not as well tolerated as the older bile acid-binding resins. (D)

Question 4

All of the following statements concerning the fibric acid derivatives are true EXCEPT:

A. Clofibrate is the drug of choice for therapy of Type III hyperlipidemia. B. Gemfibrozil increases HDL cholesterol while lowering LDL cholesterol.

C. Gemfibrozil has been shown to reduce mortality associated with heart disease. D. Gemfibrozil is generally well tolerated. (C)

Question 5

All of the following statements concerning the bile acid-binding resins are true EXCEPT:

A. They decrease total cholesterol and LDL.

B. They are contraindicated in patients with hypertriglyceridemia.

C. When used alone, they do not slow the progression of atherosclerotic lesions. D. They are the drugs of choice for therapy of type II hyperlipidemia when used either alone or in combination with selected agents. (C)

Question 6

All of the following statements concerning nicotinic acid are true EXCEPT: A. Both triglycerides and LDL cholesterol are reduced by this drug.

B. The drug acts by directly decreasing the rate of synthesis of apoproteins.

C. Doses greater than 3 g/day are no longer used because of possible disturbances in hepatic or pancreatic function.

D. Most patients taking this drug experience uncomfortable cutaneous flushing, itching, and/or rashes. (B)

Question 7

This drug both inhibits an enzyme and indirectly enhances clearance of low density lipoproteins (LDL). A. Cholestyramine B. Lovastatin C. Nicotinic acid D. Gemfibrozil E. Probucol (B)

Question 8

This drug binds bile acids in the GI tract. A. Cholestyramine B. Lovastatin C. Nicotinic acid D. Gemfibrozil E. Probucol (A)

Question 9

This drug may block oxidation of low density lipoproteins (LDL). A. Cholestyramine B. Lovastatin C. Nicotinic acid D. Gemfibrozil

E. Probucol (E)

Question 10

Flushing caused by this drug can be reduced by taking it after meals and/or by pretreatment with aspirin. A. Cholestyramine B. Lovastatin C. Nicotinic acid D. Gemfibrozil E. Probucol (C)

Question 11

Up to half of all patients receiving this medication discontinue therapy. A. Cholestyramine B. Lovastatin C. Nicotinic acid D. Gemfibrozil E. Probucol (C)

Question 12

This drug can cause muscle damage, especially when used with any of several drugs including erythromycin. A. Cholestyramine B. Lovastatin C. Nicotinic acid D. Gemfibrozil E. Probucol (B)

Question 13

This drug decreases blood levels of high density lipoproteins (HDL). A. Cholestyramine B. Lovastatin C. Nicotinic acid D. Gemfibrozil E. Probucol (E)

Question 14

This fibric acid derivative increases blood levels of high density lipoproteins (HDL). A. Cholestyramine

B. Lovastatin C. Nicotinic acid D. Gemfibrozil E. Probucol (D)

第29章利尿药和脱水药 Chapter 29 Diuretics and dehydrants

Question 1

This drug acts at the proximal tubule. A. Acetazolamide B. Amiloride C. Furosemide

D. Hydrochlorothiazide E. Spironolactone (A)

Question 2

This drug acts by competing with aldosterone for its cytosolic receptors. A. Acetazolamide B. Amiloride C. Furosemide

D. Hydrochlorothiazide E. Spironolactone (E)

Question 3

Chronic use of this drug can lead to distal tubular hypertrophy, which may reduce its diuretic effect. A. Acetazolamide B. Amiloride C. Furosemide

D. Hydrochlorothiazide E. Spironolactone (D)

Question 4

Sustained use of this drug results in increased plasma urate concentrations. A A. Furosemide B. Acetazolamide C. Spironolactone D. Amiloride E. Mannital (A)

Question 5

This drug needs aldosterone present in order to be effective. A. Furosemide B. Acetazolamide C. Amiloride D. Spironolactone

E. Hydrochlorothiazide (D)

Question 6

These drugs act by competitively blocking the Na+/K+/2Cl- cotransporter. A. Loop diuretics B. Thiazide diuretics

C. Potassium-sparing diuretics D. Carbonic anhydrase inhibitors E. Osmotic diuretics (A)

Question 7

These drugs act at the collecting tubules. A. Loop diuretics B. Thiazide diuretics

C. Potassium-sparing diuretics D. Carbonic anhydrase inhibitors E. Osmotic diuretics (C)

Question 8

These drugs are the most potent diuretics.

A. Loop diuretics B. Thiazide diuretics

C. Potassium-sparing diuretics D. Carbonic anhydrase inhibitors E. Osmotic diuretics (A)

Question 9

This drug can cause ototoxicity. A. Acetazolamide B. Furosemide

C. Hydrochlorothiazide D. Amiloride E. Spironolactone (B)

Question 10

This drug blocks the sodium/potassium/chloride cotransporter in the thick ascending loop of Henle. A. Acetazolamide B. Furosemide

C. Hydrochlorothiazide D. Amiloride E. Spironolactone (B)

Question 11

This drug should never be administered to patients who are hyperkalemic. D A. Acetazolamide B. Furosemide

C. Hydrochlorothiazide D. Amiloride E. Sorbitol (D)

Question 12

This drug is usually given in combination with a thiazide diuretic.

A. Acetazolamide B. Furosemide

C. Hydrochlorothiazide D. Amiloride E. Bumetanide (D)

Question 13

Furosemide acts at this nephron site: A. Proximal convoluted tubule

B. Ascending thick limb of the loop of Henle C. Distal convoluted tubule D. Collecting duct E. Both C and D (B)

Question 14

Acetazolamide acts at this nephron site: A. Proximal convoluted tubule

B. Ascending thick limb of the loop of Henle C. Distal convoluted tubule D. Collecting duct E. Both B and D (A)

Part 1

1. In treating anemia: b

(A) Oral iron is often poorly absorbed by iron-deficient anemics.

(B) Patients with vitamin B12 deficiency may have neurologic abnormalities. (C) Folate deficiency may occur because of gastroinstinal bleeding.

(D) Vitamin B12 is not deficient in patients that fail to secrete intrinsic factor. (E) Anemia should always be treated in the first instance by blood transfusion.

2. Common types of anemia and their causes include all of the following EXCEPT c (A) Microcytic hypochromic anemia: gastrointestinal bleeding. (B) Megaloblastic anemia: gastrectomy.

(C) Microcytic hypochromic anemia: folic acid deficiency. (D) Microcytic hypochromic anemia: pregnancy. (E) Aplastic anemia: cancer chemotherapy.

3. All of the following statements about iron-deficiency anemia are true EXCEPT d (A) Menstruating females require about twice as much dietary iron as men do (B) Iron deficiency can lead to syndrome of pallor, fatigue and dizziness. (C) Ferrous sulfate is the most common drug for iron-deficiency anemia. (D) Ferrous sulfate absorption is increased by the presence of antacids. (E) Diarrhea or constipation can occur with ferrous sulfate use。

4. Megaloblastic anemia caused by methotrexate should be treated with: c (A) Ferrous sulfate. (B) Folic Acid.

Answers: B C D C

Part 2

5. Which of the following statements describes why warfarin is not used to prevent blood coagulation in blood collection devices used at blood donating centers? b (A) Warfarin does not bind to plastic tubing or glass.

(B) The anticoagulant effect of warfarin occurs only in vivo.

(D) The gastric enzymes needed to convert R-warfarin into S-warfarin are unstable near plastic. (E) Warfarin is chemically unstable and is degraded unless made fresh and used immediately.

6. Heparin: c

(A) Can be taken orally.

(B) Exert anticoagulant effect only in vivo.

hospitalized patients.

(D) Is not antagonized by protamine sulphate.

(E) Causes the side effect of bleeding less frequently than Low molecular weight heparins.

7. Drugs that may interact with warfarin exclude: d (F) Phenytoin. (G) Cimetidine. (H) Barbiturates. (I) Trimethoprim. (J) Aspirin.

8. Activation of plasminogen to plasmin c (A) Is brought about by heparin given orally.. (B) Is brought about by warfarin given orally.

(D) Is used preoperatively and during surgery in patients prone to deep vein thrombosis. (E) Can be reversed by administration of vitamin K1 oxide.

9. Aspirin should be used cautiously in a patient receiving heparin because aspirin d (A) Inhibits vitamin K absorption (B) Has antithrombin activity.

10. Which of the following drug and drug effect pairs is INCORRECTLY matched? c (A) Urokinase—converts plasminogen to plasmin. (B) Heparin—prevents fibrin formation.

(D) Warfarin —interferes with vitamin K-dependent reactions. (E) Warfarin —interferes with synthesis of clotting factors.

11. Which of the following description about warfarin is INCORRECT? a (A) Warfarin is active in vitro.

(B) Warfarin can be antagonized by Vitamin K. (C) Bleeding is the most common adverse effect.

(D) Warfarin should not be given to pregnant women in the first trimester. (E) Warfarin can be used to treat pulmonary embolism.

12. Aspirin: b

(A) Inhibits the production of mediators that induce platelet aggregation but not mediators that prevent platelet aggregation.

(B) Improves the prognosis in acute myocardial infarction. (C) Decreases bleeding time.

(D) Low dose may be safely given to patients with allergy to aspirin. (E) Is contraindicated in cerebrovascular disease.

Answers: 5B 6C 7D 8C 9D 10C 11A 12B

第31章作用于呼吸系统的药物

Chapter 31 Drugs affecting the respiratory system

Question 1

When β-agonists are used for the treatment of asthma:

A. They activate β1 receptors on smooth muscle of the bronchi. B. They are only used in an oral dosage form.

C. The smooth muscle of the bronchi can become hypersensitive to β-agonists.

D. The levels of cyclic AMP in smooth muscle of the bronchi decrease. E. The release of histamine by mast cell in bronchi is decreased. (E)

Question 2

In the treatment of asthma, Ipratropium: D A. Often causes sedation.

B. Lowers vagal tone of the bronchial smooth muscle. C. Decreases saliva production. D. Acts at muscarinic receptors. E. All of the above are correct. (D)

Question 3

Theophylline is no longer a primary drug in asthma treatment because: A. It acts via adenosine receptors.

B. It does not make enough profit for the drug industry.

C. It can cause convulsions at doses close to the therapeutic level. D. It is not a good bronchodilator.

E. It increases the levels of cyclic AMP. （C）

Question 4

All of the following antihypertensive drugs can be used to treat patients with bronchial asthma EXCEPT: A. Enalapril B. Clonidine C. Timolol D. Verapamil E. Diltiazem (C)

Question 5

This drug is contraindicated in patients with bronchial asthma. A. Labetalol B. Clonidine C. Enalapril D. Nifedipine E. Diltiazem (A)

第32章作用于消化系统的药物

Chapter 32 Drugs affecting gastrointestinal function

Question 1

Activation of which of the following receptors on basolateral parietal cell inhibits gastric acid secretion? A. adrenergic receptor B. prostaglandin receptor C. histamine 1 receptor D. histamine 2 receptor E. muscarinic receptor (B)

Question 2

Which kind of drug has a cytoprotection by binding to the base of the ulcer, promoting mucin and bicarbonate production and inhibiting bacteria? A. metronidazole B. tetracycline

C. bismuth compounds D. omeprazole E. atropine (C)

Question 3

Which drug has the side effects, such as urinary retention, blurred vision and xerostromia? B A. cimetidine B. atropine C. nifedipine

D. bismuth compounds E. omeprazole (B)

1. Which of the following effects might be observed in a patient who is accidentally given a large overdose of histamine while being tested for achlorhydria? c (A) Severe localized blanching of the skin. (B) Decreased capillary permeability. (C) Bronchoconstriction.

(D) Relaxation of gastrointestinal smooth muscle. (E) Gastric acid suppression.

2. Classic H1 receptor blockers are indicated for the treatment of c (F) Peptic ulcer.

(G) An acute asthma attack. (H) Motion sickness. (I) The common cold.

(J) Oversedation.

3. Many H1 receptor antagonists have additional effects which are likely to include all of the following EXCEPT d

A. Antimuscarinic action in bladder tone. B. Local anesthetic effects if injected. C. Antimotion sickness effect.

D. Increase in total peripheral resistance. E. Sedation.

4. Diphenhydramine e (A) Produces sedation.

(B) Prevents motion sickness. (C) Produces local anesthesia. (D) Blocks H1 histamine-receptors. (E) All of the above.

5. Mechanism of action of ranitidine is：a (A) Competitively inhibits H2 receptors. (B) Serotonin antagonist.

Answers: C C D E A

第37章肾上腺皮质激素类药物 Chapter 37 Adrenocortical hormones

A型题

1. Which of the following is induced by glucocorticoids and inhibits the synthesis of leukotrienes? （B） A. phospholipase A2 B. lipocortin-1 C. prostaglandins

D. platelet-activating factor E. interleukins

2. Glucocorticoids inhibit NOS (Nitric oxide synthase) in macrophages, which is involved in (C)

A. immunosuppression B. anti-shock effect

C. anti-inflammatory effects

D. stimulation of bone marrow function E. thrombocytosis

3. Which of the following glucocorticoids has the highest anti-inflammatory potency? （D）

A. hydrocortisone B. cortisone C. triamcinolone D. dexamethasone E. prednisolone

4. Which of the following glucocorticoids has the lowest anti-inflammatory potency? （B）

A. Hydrocortisone B. cortisone C. triamcinolone

D. methylprednisolone E. fluocinolone

5. Which of the following glucocorticoids has the greatest impact on water and electrolyte metabolism? （A） A. hydrocortisone B. prednisone

C. methylprednisolone D. triamcinolone E. betamethasone

6. Which of the following glucocorticoids has the greatest impact on carbohydrate metabolism ? （E） A. hydrocortisone B. cortisone C. Prednisone D. triamcinolone E. dexamethasone

7. Which of the following glucocorticoids has the shortest half-life (t1/2)? （A） A. hydrocortisone B. prednisone C. prednisolone D. methylprednisone E. triamcinolone

8. Which of the following is considered long-acting glucocorticoids? （D） A. hydrocortisone B. methylprednisone C. cortisone

D. dexamethasone E. prednisolone

9. Which of the following is the therapeutic indication of dexamethasone? （A） A. aplastic anemia B. varicella C. shingles D. diabetes

E. fungal infection

10. Which of the following is a common but infrequently recognized adverse effect associated with a long-term use of large doses of glucocorticoid? （A） A. osteoporosis B. neutropenia

C. thrombocytopenia

D. anaphylactoid purpura (Henoch-Schonlein purpura) E. hay fever

11. High-dose glucocorticoid pulse therapy is suitable for the treatment of: （A） A. septic shock

B. nephrotic syndrome

C. connective tissue disease D. malignant lymphoma E. refractory asthma

12. Low-dose glucocorticoid replacement therapy is used for the treatment of: （D） A. aplastic anemia B. neutropenia

C. thrombocytopenia D. Addison disease

E. connective tissue disease

13. The administration time for alternate day glucocorticoid therapy is: （E） A. at noon every other day

B. in the afternoon every other day C. at night every other day D. at midnight every other day E. in the morning every other day

14. Which of the following drugs is the best choice for alternate day glucocorticoid therapy? （C） A. cortisone

B. hydrocortisone C. prednisone

D. dexamethasone E. betamethasone

15. Which of the following is the effect of glucocorticoids? （D） A. increase in leukotriene B. increase in prostaglandin

C. increase in platelet-activating factor D. increase in platelet E. increase in IL-3

16. Which of the following is the effect of glucocorticoids? （C） A. increase in IL-1 B. increase in GM-CSF

C. reduction of tumor necrosis factor

D. increase in macrophage colony-stimulating factor E. increase in lymphocytes

17. The primary goal of glucocorticoid treatment in severe acute infection is: （E） A. to reduce the inflammatory response B. to reduce the after-effects C. to enhance the body defense

D. to enhance the body's stress capacity

E. to relieve symptoms and help patients pass the critical stage

18. The main effect of glucocorticoids on hematological and hematopoietic system is: （D）

A. increase in red blood cells B. increase in neutrophil C. increase in platelet

D. stimulation of haematopoietic function of bone marrow E. increase in concentration of fibrinogen

19. Which of the following is not the pharmacological effect of glucocorticoids? （C）

A. anti-inflammation B. immune suppression C. killing of virus D. anti-shock E. anti-allergy

20. Which of the following is the contraindication of corticosteroids? （D） A. iritis B. keratitis C. retinitis

D. corneal ulcers E. optic neuritis

第38章甲状腺激素和抗甲状腺药

Chapter 38 Thyroid hormones and antithyroid drugs

A型题

1. Levothyroxine may produce all of the following effects EXCEPT: D A. tachycardia.

B. increased cardiac output. C. heart failure.

D. increased peripheral resistance. E. angina pectoris.

2. All of the following indicate how liothyronine (T3) differs from levothyroxine EXCEPT that: B

A. it requires a smaller dose to produce the same effect.

B. it does not have as marked an effect on oxygen consumption. C. it must be administered more frequently. D. its onset of action is more rapid.

E. it is found in lower concentrations in the peripheral blood.

3. Each of the following statements is true EXCEPT: C A. methimazole inhibits iodination of monoiodotyrosine. B. propylthiouracil inhibits coupling of diiodotyrosine. C. perchlorate inhibits the release of thyroxine. D. iodide reduces the vascularity of the thyroid. E. iodide inhibits the release of thyroxine.

4. Propylthiouracil: E

A. inhibits iodide uptake by the thyroid. B. has long duration of action. C. inhibits release of TSH.

D. inhibits proteolysis of thyroglobulin.

E. inhibits the conversion of thyroxine (T4) to liothyronine (T3).

X型题

A= 1,2,3; B=1,3; C=2,4; D=4;E=All

5. The following drugs are useful in the management of hyperthyroidism for the reasons stated. C＝2,4

(1) Propylthiouracil--inhibits iodide concentrating mechanism in thyroid gland.

(2) Iodide--inhibits release of thyroxine.

(3) Propranolol--inhibits conversion of iodide to iodine.

(4) Methimazole(thiamazole)--inhibits iodination of tyrosine.

6. When patients with myxedema are given levothyroxine (T4)? B＝1,3

(1) the euthyroid serum T4 levels will be higher than in patients treated with liothyronine (T3).

(2) the therapeutic effect will occur sooner than in patients treated with liothyronine (T3).

(3) the daily dose is larger than that required for liothyronine (T3). (4) the drug is given several times daily because of its short haft-life.

7. Propylthiouracil E＝1,2,3,4

(1) inhibits the thyroid coupling reaction.

(2) may cause agranulocytosis in about 0.2% of the patients.

(3) in hyperthyroidism may produce remissions that persist after drug withdrawal. (4) is absorbed rapidly after oral administration.

8. Radioiodine (131I) C＝2,4

(1) is useful for treating hyperthyroidism mainly because of its strong gamma radiation.

(2) can destroy the thyroid gland and cause hypothyroidism.

(3) can cause so many mutations that it has no clinical usefulness. (4) may be concentrated in papillary and follicular thyroid carcinoma.

第39章胰岛素及口服降血糖药

Chapter 39 Insulin and oral hypoglycemic drugs

Part 1 Question 1

The mechanism of action for sulfonylurea drugs used in the treatment of type II diabetes includes: ( )

A. Hydrolysis of sugar into absorbable monosaccharides and inhibitation of glucose absorption in the gut.

B. Increased gluconeogenesis in the liver.

C. Blockage of glucose uptake into insulin target cells.

D. Decreasing the number of insulin receptors at the target cell plasma membrane. E. Depolarization of the pancreatic ß cell plasma membrane. (E)

Question 2

All of the followings are adverse effects of insulin EXCEPT D A. Hypoglycemia B. Insulin allergy C. Insulin resistance D. Anemia E. Lipoatrophy (D)

Question 3

Which of the following agents is used to treat type I diabetes ( ) A. Insulin

B. Glibenclamide C. Metformin D. Pioglitazone E. Repaglinide (A)

Part 2

4. The main reason metformin should not be used in patients with renal failure is that A (A) It increases the risk of lactic acidosis. (B) It increases the risk of ketoacidosis.

A. Metformin causes lactic acidosis in patients with renal failure and severe congestive heart failure. It does not increase the risk of ketoacidosis and showed a reduction in cardiovascular comorbidities

in a large study. It is contraindicated in patients with severe liver disease but does not cause hepatic necrosis.When used as monotherapy, metformin rarely causes hypoglycemia.

5. Hypoglycemia is rarely seen with these drugs when used as monotherapy EXCEPT: D (A) Metformin (B) Rosiglitazone (C) Miglitol (D) Glyburide (E) A, B, and C

D. One of the most important therapeutic objectives is to maintain normal glucose levels without producing frequent hypoglycemia.The main class of hypoglycemic drugs that have a propensity to cause hypoglycemia are the sulfonylureas, of which glyburide is one.This is not a problem with the other choices.

6. All of the following are true statements about the thiazolidinediones EXCEPT B (A) Thiazolidinediones may be hepatotoxic in some individuals.

(B) Thiazolidinediones increase the number of insulin receptors on the cell membrane surface. (C) Thiazolidinediones bind a nuclear receptor in tissue termed PPAR-γ, which augments the expression of insulin-regulated genes.

(D) Thiazolidinediones take many days to weeks to begin exerting a blood glucose–lowering effect in diabetics.

(E) The most common side effects of thiazolidinediones are weight gain and edema.

B. The thiazolidinediones decrease insulin resistance and enhance insulin action in target tissues. The original prototype drug of this class was removed from the market because of hepatotoxicity. These compounds activate the PPAR-γ-receptor. Although patients may see some benefit within a few days, a clinically significant effect generally takes weeks.The most common side effects are edema and weight gain that is independent of the weight gain seen in edema.

Chpt. 41 Antimicrobial Agents Study Questions

1. The remarkably powerful and specific activity of antimicrobial drugs is due to c A．their multi-functions.

B．their unique chemical structures.

C．their selectivity for targets that are either unique to microorganisms or much more important in them than in humans.

D．their pharmacokinetic features.

E．their tolerance to enzymes produced by microorganisms.

2. In the strictest sense, antibiotics can be described as a A．substances produced by various species of microorganisms (bacteria, fungi, actinomycetes) that suppress the growth of other microorganisms.

B．substances synthesized artificially that suppress the growth of microorganisms.

C．substances both produced by various species of microorganisms and synthesized artificially that suppress the growth of microorganisms.

D．small molecular chemicals that suppress the growth of microorganisms. E．peptides that suppress the growth of microorganisms.

3. Which of the following is not included in the mechanisms of action of antibiotics? e A．Inhibit synthesis of bacterial cell walls. B．Act directly on the cell membrane, affecting permeability and leading to leakage of intracellular compounds.

C．Affect the function of 30S or 50S ribosomal subunits to cause a reversible inhibition of protein synthesis.

D．Affect bacterial nucleic acid metabolism. E．Block α receptors.

4. Usually bacterial resistance to an antimicrobial agent falls into three general categories. They are: d

A．(1) the drug does not reach its target, (2) the drug is not metabolized, and (3) the target is altered.

B．(1) the drug does not absorbed orally, (2) the drug is not active, and (3) the target is altered. C．(1) the drug does not water-soluble, (2) the drug is not active, and (3) the target is altered. D．(1) the drug does not reach its target, (2) the drug is not active, and (3) the target is altered. E．(1) the drug does not reach its target, (2) the drug is not active, and (3) the target is in the cell wall.

5. Which of the following is not the indication for the clinical use of combinations of antimicrobial agents. d

A．for empirical therapy of an infection in which the cause is unknown; B．for treatment of polymicrobial infections;

C．to enhance antimicrobial activity (ie, synergism) for a specific infection; D．to prevent diarrhea caused by unhygienic food. E．to prevent emergence of resistance.

6. Which of the following is not justified for prophylaxis of infection with antimicrobial agents? e A．use of rifampin to prevent meningococcal meningitis in people who are in close contact with a case;

B．prevention of gonorrhea or syphilis after contact with an infected person;

C．intermittent use of trimethoprim-sulfamethoxazole to prevent recurrent urinary tract infections usually caused by E. coli.

D．to prevent a variety of infections in patients undergoing organ transplantation or receiving cancer chemotherapy.

E．to prevent emergence of resistance.

Answers

1.C 2.A 3.E 4.D 5.D 6.E

Chpt. 42中 β-lactam antibiotics Study Questions

1. Penicillinase-sensitive, a broad antibacterial spectrum, and oral and parenteral effectiveness characterizes best B A. penicillin G.

B. ampicillin.

C. benzathine penicillin. D. cloxacillin. E. methicillin.

2. An analogue of penicillin G particularly effective against urinary tract infections due to Pseudomonas or resistant strains of Proteus is B A. ampicillin. B. carbenicillin.

C. phenoxymethyl penicillin. D. cloxacillin. E. phenethicillin.

3. An antibacterial agent related to penicillin G in structure and mode of action but which has significant nephrotoxicity is E A. erythromycin. B. cycloserine. C. ampicinin. D. ceftazidime. E. cephaloridine.

4. Which of the following agents is least likely to produce an allergic response in a patient with documented anaphylaxis to penicillin G? B A. Procaine penicillin G B. Aztreonam C. Carbenicillin D. Ampicillin E. Dicloxacillin

5. All of the following statements about first-generation cephalosporins are true EXCEPT that C A. they are generally resistant to penicillinase.

B. they have a longer plasma half-life than penicillin G. C. they are effective in treating enterococcal endocarditis. D. they diffuse poorly into the cerebrospinal fluid.

E. they may cause thrombophlebitis when administered intravenously.

6. Which of the following antibiotics is not effective orally for systemic infections? E A. Oxaciilin B. Erythromycin C. Clindamycin D. Cephalexin. E. Vancomycin

7. Which of the following microorganisms is not susceptible to Penicillin G? D

A. Staphylococci B. Meningococci

C. Bacillus anthracis D. Chlamydiae E. Leptospira

8. Which of the following antibiotics is not resistant to penicillinase? A A. Amocillin B. Oxacillin C. Cloxallin D. Dicloxallin E. Nafcillin

9. Which of the following antibiotics is not active against pseudomonas? C A. Ticarcillin B. Carbenicillin C. Oxacillin D. Furbenicillin E. Piperacillin

10. All of the following statements about Cefepime are true EXCEPT that D A. It is more resistant to hydrolysis by chromosomal β-lactamases. B. It has good activity against P aeruginosa.

C. It is highly active against haemophilus and neisseria. D. It is highly active against flavobacterium and anaerobes.

E. It has good activity against most penicillin-resistant strains of streptococci.

11. Which of the following antibiotics has no activity against gram-positive and anaerobic bacteria? E

A. Imipenem B. Latamoxef C. Cefoperazone D. Cefoxitin E. Aztreonam

12. Which of the following drugs has β-lactamase inhibitory activity? A A. Tazobactam B. flomoxef C. Ceftriaxone D. Cefotaxime E. Cefpirome

Answers

1.B 2.B 3.E 4.B 5.C 6.E 7.D 8.A 9.C 10. D 11.E 12. A

Chpt. 43 中 Macrolides, Clindamycin and Polypeptide Antibiotics Study Questions

1. As to the mechanism of action for erythromycin, which of the following is correct? E

A. Binds to PBPs and then interferes with aminoacyl translocation reaction, leading to inhibition of protein synthesis.

B. Binds to 30S subunit of the ribosome and then interferes with aminoacyl translocation reaction, leading to inhibition of protein synthesis.

C. Binds to 50S subunit of the ribosome and then interferes with aminoacyl translocation reaction, leading to inhibition of RNA synthesis.

D. Binds to 50S subunit of the ribosome and then interferes with aminoacyl translocation reaction, leading to inhibition of dihydrofolates.

E. Binds to 50S subunit of the ribosome and then interferes with aminoacyl translocation reaction, leading to inhibition of protein synthesis.

2. Which of the following is not the clinical use of erythromycin? E

A. Corynebacterial infections (diphtheria, corynebacterial sepsis, and erythrasma); B. In respiratory, neonatal, ocular, and genital chlamydial infection; C. In treatment of community-acquired pneumonia; D. Used for the patients allergic to penicillin G; E. Diarrhea caused by E. coli.

3. Which of the following drugs is with a longer tissue half-life (2-4 days) and administered once-daily? C A. erythromycin B. clarithromycin C. azithromycin D. doxycycline E. penicillin V

4. The primary differences between vancomycin and teicoplanin are A A. that teicoplanin can be administered safely by intramuscular injection. B. that teicoplanin has a totally different chemical structure from vancomycin. C. that teicoplanin has a different mechanism of action from vancomycin. D. that teicoplanin has a different spectrum of activity from vancomycin. E. that teicoplanin has a different route of elimination from vancomycin.

5. All of the following statements about Clindamycin are true EXCEPT that C A. It is indicated for treatment of severe anaerobic infection caused by bacteroides.

B. It is in combination with an aminoglycoside or cephalosporin to treat infection originating in

the female genital tract.

C. It is used in the treatment of severe infections caused by enterococcus or aerobic Gram negative bacteria.

D. It is in combination with primaquine to treat moderate to moderately severe Pneumocystis carinii pneumonia in AIDS patients.

E. It is in combination with pyrimethamine for treatment of AIDS-related toxoplasmosis of the brain.

ANSWERS 1.E 2.E 3.C 4.A 5.C

Chpt. 44中 Aminoglycosides Study Questions

1. Many antibiotics appear to have as their mechanism of action the capacity to inhibit bacterial cell wall synthesis. This does NOT appear to be a mechanism of A A. Aminoglycosides B. Penicillins C. Bacitracin

D. Cephalosporins E. Vancomycin

2. Aminoglycoside antibiotics are frequently used in combination with the β-lactam antibiotics. Which of the following choices best explains the rationale for this use? B A. The combination provides for a much greater spectrum of activity. B. A synergistic effect is often seen when the combination is employed.

C. The β-lactam antibiotics prevent toxic effects of the aminoglycoside antibiotics. D. The combination decreases incidence of superinfections.

E. The combination decreases the doses of the two class antibiotics.

3. All of the following statements about Gentamicin are true EXCEPT that C A. It is Effective against both gram-positive and gram-negative organisms. B. It is employed mainly in severe infections. C. It has good activity against anaerobes.

D. It should not be used as a single agent to treat staphylococcal infections. E. It should not be used for single-agent therapy of pneumonia.

4. As a class, the aminoglycoside antibiotics do not exhibit significant metabolism in the patient. The most likely reason is that D

A. Their chemical structure is unique and not prone to chemical reactions commonly seen in drug

metabolism.

B. The liver does not contain appropriate enzymes to break down the compounds.

C. The body apparently lacks a necessary cofactor for the metabolism of aminoglycosides. D. Aminoglycosides do not readily get to the site of degradative enzymes. E. Aminoglycosides are not ionized.

ANSWERS 1. A. 2. B. 3. C. 4. D.

Chpt. 45 Tetracyclines and Chloramphenicol Study Questions

1. All of the following statements about Doxycycline are true EXCEPT that E A. It can be dosed once a day.

B. It causes less diarrhea and superinfection than tetracycline. C. It is 2-10 times more active than tetracycline.

D. It has taken the place of tetracycline as the first choice drug in the group. E. It is highly active against Salmonella typhi.

2. As to tetracyclines, which of the following is wrong? A A. Are primarily bactericidal

B. Bind to the 30S subunit of microbial ribosomes.

C. Are less active against G+ organisms than penicilins and cephalosporins.

D. Are less active against G- organisms than aminoglycosides and chloramphenicol. E. have the favorable effects on Rickettsiae, Mycoplasma, Chlamydiae and Spirochete.

3. Which of the following is not the untoward effect of tetracyclines? E A. Gastrointestinal reactions. B. Superinfection.

C. Sepression of bone growth. D. Serious hepatic damage. E. Gray - baby syndrome.

4. Which of the following is not related to chloramphenicols? E A. Attach to the 50S subunit of the ribosome.

B. First choice for the treatment of typhoid and paratyphoid. C. Bone marrow depression. D. Gray - baby syndrome. E. Serious ototoxicity.

ANSWERS 1. E 2. A 3. E 4. E

Chpt. 46 synthetic antibacteral drugs Study Questions

1. A 24-year-old AIDS patient is interested in starting chemoprophylaxis for Pneumocystis pneumonia (PCP) and cerebral toxoplasmosis. He has no drug allergies. Which of the following prophylactic agents is appropriate for the prevention of both PCP and cerebral toxoplasmosis? B A. Nitrofurantoin

B. Trimethoprim–sulfamethoxazole C. Norfloxacin D. Methenamine E. Nalidixic acid

2. A 3-day-old baby is given a presumptive diagnosis of kernicterus. Which of the following mechanisms is involved in sulfonamide-induced kernicterus? A A. Competes for the bilirubin-binding sites on plasma proteins B. Defective bilirubin hepatic conjugation and metabolism

C. Physiological jaundice due to destruction of fetal red blood mass D. Pregnancy-induced hepatic congestion and cholestasis E. Primary biliary cirrhosis of the liver

3. A 6-year-old relatively healthy boy is diagnosed with external otitis and was prescribed a 7-day course of TMP-SMX. Which of the following is the basic mechanism of action of the sulfonamides? B

A. Selective inhibition of incorporation of PABA into human cell folic acid synthesis. B. Competitive inhibition of incorporation of PABA into microbial folic acid. C. Inhibition of transpeptidation reaction in bacterial cell wall synthesis.

D. Changes in DNA gyrases and active efflux transport system resulting in decreased permeability of drug.

E. Structural changes in dihydropteroate synthase and overproduction of PABA.

4. A 16-year-old girl, a cystic fibrosis patient, is diagnosed with a ciprofloxacin-resistant Pseudomonas aeruginosa lower respiratory tract infection. Bacteria acquire quinolone resistance by which of the following mechanisms? B A. Overproduction of PABA

B. Changes in the synthesis of DNA gyrases

C. Plasmid-mediated changes in efflux transport system

D. Inhibition of synthesis of peptidoglycan subunits in bacterial cell walls

E. Inhibition of folic acid synthesis by blocking different steps

5. Which of the following fluoroquinolones has the most active effect against gram-negative bacteria? C A. Norfloxacin B. Levofloxacin C. Ciprofloxacin D. Lomefloxacin E. Pefloxacin

6. The most common Adverse Reactions of fluoroquinolones are D A. headache, dizziness, and insomnia. B. acute hepatitis

C. photosensitive dermatitis

D. nausea, vomiting, and diarrhea. E. arthropathy

7. Nitrofurantoin is primarily used in the treatment of E A. dysentery and other intestinal infections. B. trichomonas vaginal infections

C. periodontitis caused by anaerobic bacteria D. pseudomembranous colitis E. urinary tract infections.

8. Which of the followings is not the indication of Metronidazole? C A. pseudomembranous colitis caused by C. difficile B. abscesses in the liver, pelvis, abdomen and brain C. pneumocystis pneumonia D. bacterial vaginosis

E. periodontitis caused by anaerobic bacteria

ANSWERS 1. B 2. A 3. B 4. B 5. C 6. D 7. E 8. C

Chpt. 51 Cancer Chemotherapy Study Questions

1. A patient of yours has been receiving 5-fluorouracil as palliative therapy for adenocarcinoma of the pancreas. You suspect that the patient has become resistant to the treatment. You want to understand the most likely cause of the resistance before you select another agent. Which of the following is the most likely cause? C A. Drug transport into cells is decreased. B. P-glycoprotein is increased.

C. The tumor can no longer activate the drug.

D. The tumor is detoxifying the drug more rapidly.

E. The tumor has developed an increase in metallothionein content.

2. Which of the following is a cell cycle specific agent C A. Cyclophosphamide B. Cisplatin C. Bleomycin D. Mitomycin C E. Dactinomycin D

3. Which of the following is not the common adverse effects of antineoplastic drugs? E A. stomatitis B. alopecia

C. Myelosuppression D. bladder toxicities E. ototoxicity

4. Which of the following combination is now a preferred approach for the cure treatment of Choriocarcinoma? A

A. etoposide with cisplatin B. dacarbazine witn carbop;atin

C. Bleomycin with cyclophosphamide D. Carmustine with taxotere

E. Fluorouracil with hydroxyurea

5. Which of the following enzyme is inhibited by the active form of Fluorouracil ? E A. topoisomeraseⅠ.

B. ribonucleotide reductase C. dihydrofolate reductase D. DNA polymerase E. thymidylate synthase

6. Which of the following combination for the treatment of Testicular Cancer could give a cure result? D

A. dactinomycin, vincristine and leucovorin B. etopoxide, cisplatin and methotrexate

C. dactinomycin, vincristine and cyclophosphamide

D. cisplatin, etoposide, and bleomycin E. methotrexate etoposide and leucovorin

7. Which of the following is the preferred combination regimen for the treatment of Hodgkin's Disease? B

A. mechlorethamine, vincristine, procarbazine, and prednisone B. doxorubicin, bleomycin, vinblastine, and dacarbazine

C. doxorubicin, vinblastine, mechlorethamine, and prednisone D. vincristine, bleomycin, etoposide, and prednisone E. etopoxide, cisplatin, bleomycin and methotrexate

8. Which of the following is an estrogen antagonist? D A. anastrozole B. flutamide C. leuprolide D. tamoxifen

E. aminoglutathimide

ANSWERS 1. C 2. C 3. E 4. A 5. E 6. D 7. B 8. D

简要问答题共30题（每题5分）要求：中英文回答均可

1. 试述药理作用、效应、治疗作用、不良反应的概念，以及它们之间的关系。 2. 从信息转导的角度可将受体分为哪些类型? 每类各举一个具体的受体说明之。 3. 试述半数有效量、半数致死量、治疗指数的概念与关系及意义。 4. 试述首过消除、肝肠循环、药物消除半衰期的概念及临床意义?

5. 缓释剂、配伍禁忌、安慰剂、耐受性、成瘾性、麻醉药品、药物滥用、耐药性的概念。

6. 试比较新斯的明、吡斯的明、毒扁豆碱、依酚氯铵、安贝氯铵的药理学与临床应用特点？ 7. 与阿托品比较,后马托品,贝那替秦,哌仑西平,东莨菪碱有哪些药理学和临床应用的特点? 8. 与普萘洛尔相比, 噻吗洛尔、艾司洛尔、吲哚洛尔、拉贝洛尔有哪些药理学及临床应用特点。

9．试比较苯妥英钠、乙琥胺、地西泮、丙戊酸钠的抗癫痫特点？ 10．简述左旋多巴与卡比多巴合用治疗帕金森病的原理及优点？

11．长期使用氯丙嗪会出现哪些锥体外系反应？原因是什么？如何处理？

12．氯丙嗪的临床应用有哪些？其降温作用与阿司匹林的解热作用有何不同？ 13．试比较他克林、占诺美林、丙戊茶碱、吡拉西坦治疗阿尔茨海默病的原理？ 14．简述地西泮的药理作用及作用机制。

15. What are the mechanism of actions and the therapeutic uses of NSAIDs?

16．乙酰水杨酸和对乙酰氨基酚是临床常用的解热镇痛药物，请比较二者的药理作用和临床应用有何异同。

17. 简述钙通道阻滞药的作用特点，与其他血管扩张药相比在高血压治疗方面有何优点？ 18. 举一代表药物说明血管紧张素转化酶（ACE）抑制药与ACE的结合方式，用药初期降压和长期降压的可能原因是什么？

19. 简述根据高血压的严重程度不同如何选用治疗药物？ 20. 简述抗心律失常药物的分类？每类列举一个代表药物。

21. 根据充血性心力衰竭（CHF）发病的病理机制，临床上使用的药物主要包括哪几类？每类列举一个代表药物。

22. 简述β受体阻滞剂与硝酸酯类合用治疗心绞痛的原理和优点，并举一合用实例。 23. 按作用机制不同可将调血脂药物分为哪些类型？每类列举一个代表药物。 24. 按效能和作用部位不同可将利尿药分为哪几类？每类列举一个代表药物，并说明其作用部位。

25．血管扩张药、β-受体阻断药与利尿药联合用于抗高血压的药理学基础是什么？

26．糖皮质激素的用药方法一般分为哪四种(包括选用药物)，各用于哪些疾病的治疗？ 27. Describe the major pharmacological effects and clinical uses of glucocorticoids. 28. Give specific drugs to describe the classification and the clinical uses of antithyroid agents.

29. Give specific drugs to compare the mechanisms of action of agents used in the treatment of asthma.

30. 肝素和华发林的抗凝作用机制、药理作用特点以及使用方法有何不同？ 31. 按作用机制不同，抗消化性溃疡药物可分为哪些类型？每类列举一个代表药物。

32. 抗微生物药物的主要作用机理是什么？ 33. 导致病原微生物耐药的主要机制是什么？

34. 试比较天然青霉素G和人工半合成青霉的优缺点(或特点)。每类人工半合成青霉素各举一个具体的药物说明之。

35. 试比较第一、二、三、四代头孢菌素的优缺点(或特点). 36. 请简述氨基糖苷类抗生素药理作用与不良反应的共同点.

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